Effect of Prebiotic Dietary Supplement Acacia senegal on Hormonal and Metabolic Markers in Polycystic Ovary Syndrome Patients: A Pilot Study.

Background The most prevalent endocrine condition affecting women of reproductive age is polycystic ovarian syndrome (PCOS), which is linked to a variety of metabolic abnormalities. Although the pathogenesis of PCOS is not fully understood, it is known that oxidative stress, altered gut microbiome, and increased gonadotrophin-releasing hormone play a significant role. Gum arabic (GA) is an edible, dried, gummy exudate from the Acacia senegal tree, well-known for its prebiotic and antioxidant effects. The main objective of the study was to assess the changes in hormonal and metabolic profiles in PCOS patients after the ingestion of gum arabic. Method This was a clinical trial conducted on fifteen patients suffering from PCOS, with a mean age of 27.8 years (20-39 years). All patients experienced irregular cycles. Hormonal and metabolic markers (follicular stimulating hormone (FSH), luteinizing hormone (LH), total testosterone (TT), fasting insulin, total cholesterol (TC), and glycosylated hemoglobin (HBA1c) were measured before and after the ingestion of gum arabic (30 g/day of GA dissolved in 250 ml water for eight weeks) on the second day of the menstrual cycle after granting ethical approval from the National Medicine and Poisons Board and from the participants of the study. Results The study demonstrated a significant decrease in the luteinizing hormone level, FSH/LH ratio, and cholesterol pre- and post-gum arabic ingestion (p-values 0.001, 0.013, and 0.007, respectively). Follicular stimulating hormone slightly reduced post-ingestion with no significant difference (p-value 0.414). No significant changes were seen in the testosterone, insulin, or HBA1c levels. Conclusion The study concluded that gum arabic ingestion for eight weeks decreases the luteinizing hormone and LH/FSH ratio and improves the metabolic profile by reducing the cholesterol level in PCOS patients.

Discovery of Novel Epoxyketone Peptides as Lipase Inhibitors.

Obesity is the most common nutritional disorder in the developed world and is associated with important comorbidities. Pancreatic lipase (PL) inhibitors play a key role in the metabolism of human fat. A series of novel epoxyketones peptide derivatives were investigated for their pancreatic lipase inhibitory activity. The epoxyketone moiety is a well-known reactive electrophile group that has been used as part of proteasome inhibitors in cancer therapy, and it is widely believed that these are very selective for targeting the proteasome active site. Here we investigated various peptide derivatives with an epoxide warhead for their anti-lipase activity. The assessment of these novel epoxyketones was performed by an in-house method that we developed for rapid screening and identification of lipase inhibitors using GC-FID. Herein, we present a novel anti-lipase pharmacophore based on epoxyketone peptide derivatives that showed potent anti-lipase activity. Many of these derivatives had comparable or more potent activity than the clinically used lipase inhibitors such as orlistat. In addition, the lipase appears to be inhibited by a wide range of epoxyketone analogues regardless of the configuration of the epoxide in the epoxyketone moiety. The presented data in this study shows the first example of the use of epoxyketone peptides as novel lipase inhibitors.

A comparison of robotic single-incision and traditional single-incision laparoscopic cholecystectomy.

BACKGROUND: Surgeons continually strive to improve technology and patient care. One remarkable demonstration of this is the development of laparoscopic surgery. Once this proved to be a safe and reliable surgical approach, robotics seemed a logical progression of surgical technology. The aim of this project was to evaluate the utility of robotics in the context of single-incision laparoscopic cholecystectomy (SILC). METHODS: A retrospective review of a prospectively maintained database of robotic single-incision laparoscopic cholecystectomy (RSILC) and traditional SILC performed by a single surgeon at our institution from July 2010 to August 2013 was queried. All consecutive patients undergoing RSILC and SILC during this time period were included. Primary outcomes include conversion rate and operative time. Secondary outcomes include length of stay, duration of narcotic use, time to independent performance of daily activities and cost. Categorical variables were evaluated using Chi-square analysis and continuous variables using t test or Wilcoxon's rank test. RESULTS: Thirty-eight patients underwent RSILC and 44 underwent SILC. BMI was higher in the RSILC group, and the number of patients with prior abdominal surgeries was higher in the SILC group. Otherwise, demographics were similar between the two groups. There was no difference in conversion rate between RSILC and SILC (8 vs 11 %, p = 0.60). Mean operative time for RSILC was significantly greater compared with SILC (98 vs 68 min, p < 0.0001). RSILC was associated with a longer duration of narcotic use (2.3 vs 1.7 days, p = 0.0019) and time to independent performance of daily activities (4 vs 2.3 days, p < 0.0001). Total cost is greater in RSILC ($8961 vs $5379, p < 0.0001). CONCLUSION: While RSILC can be safely performed, it is associated with longer operative times and greater cost.

International surgery and the University of Connecticut experience: lessons from a short-term surgical mission.

BACKGROUND: Surgery is gradually gaining recognition within the international public health community as an essential component to sustainable improvements in health care in resource-poor areas. In this article, we document the University of Connecticut experience with international surgical missions, and we offer avenues for optimization of these efforts. METHODS: A one-week elective trip to San José de Chiquitos, Bolivia to provide essential general surgical care to a rural, underserved population. We collaborated with local health-care personnel in both intraoperative and perioperative care. RESULTS: Forty-one major cases were performed over a week-long period. The majority of cases were open cholecystectomy, but a variety of emergency and elective surgical cases were performed. There were no postoperative complications over a three-month follow-up. CONCLUSIONS: International surgical trips are an essential component of public health initiatives abroad; surgery can provide a vital role in the health care of underserved populations. Few domestic programs have formal international surgical curricula within the residency program; we offer beneficial results based on a short-term model. Future studies should focus on the development of sustainable, surgical programs that focus on education of local health-care personnel in underserved regions.