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AbstractIntroduction:Conjugated linoleic acid (CLA) is a food supplement that is proposed as an anti-obesity supplement in animal and human studies. Animal studies have shown a significant anti-obesity effect of CLA, but results in humans were inconsistent, where some of the studies found an anti-obesity effect while other studies failed to find any decline in obesity markers after CLA supplementation. This meta-analysis aimed to determine if oral CLA supplementation has been shown to reduce obesity-related markers in women.Method:Pub Med, Cochrane Library, and Google Scholar were used to identify the eligible trials using two main searching strategies: the first one was to search eligible trials using keywords “Conjugated linoleic acid”, “CLA”, “Women”, and the second strategy was to extract the eligible trials from previously published systematic reviews and meta-analyses. The eligible trials were placebo control trials where women supplemented with CLA mixture in the form of oral capsules for 6 months or less. Furthermore, eligible trials reported body weight (BW), body mass index (BMI), total body fat (TBF), percentage body fat (BF%), and/ or lean body mass (LBM). The quality of each included study was assessed using both JADAD scale and an adapted CONSERT checklist.Results:Meta-analysis of 8 eligible trials showed that CLA supplementation was significantly associated with reduced BW (Mean ± SD, 1.2 ± 0.26 kg, p < 0.001), BMI (0.6 ± 0.13kg/m2, p < 0.001) and TBF (0.76 ± 0.26 kg, p = 0.003) in women, when supplemented over 6–16 weeks. Subgroup meta-analysis demonstrated a significant reduction in BW (1.29 ± 0.31 kg, p < 0.001), BMI (0.60 ± 0.14 kg/m2, p < 0.001) and TBF (0.82 ± 0.28 kg, p = 0.003) in the trials that had recruited overweight-obese women. The second subgroup meta-analysis, that considered the menopausal status of the participants, found that CLA was significantly associated with reduced BW (1.35 ± 0.37 kg, p < 0.001; 1.05 ± 0.36 kg, p = 0.003) and BMI (0.50 ± 0.17 kg/m2, p = 0.003; 0.75 ± 0.2 kg/m2, p < 0.001) in both pre and post-menopausal age women, respectively. A reduction in TBF (1.09 ± 0.37 kg, p = 0.003) was only significant in post-menopausal women.Discussion:This meta-analysis suggests a moderate anti-obesity effect of CLA on BW, BMI and TBF reduction in women, when supplemented over 6–16 weeks, particularly in overweight-obese women and post-menopausal women. More well-designed trials are required to confirm this meta-analysis results.

Human guts are occupied with 100-1000 microbial species which plays a significant role in the host health and disease (1) . Lactobacillus species have shown a paradoxical effect in relation to body composition. Clinical trials using lactobacillus gasseri (L. gasseri) have demonstrated an anti-obesity effect, exhibiting significant reductions in visceral and subcutaneous fat, body weight, body mass index (BMI), and waist and hip circumferences (2) . Moreover, L. gasseri has contributed to the regulation of abdominal obesity and showed a potential immunomodulatory effect in infants as well as boosting the immune system of healthy adults (3,4) . Rodent models have found an association between the presence of L. gasseri and positive outcomes in relation to weight loss, fasting blood glucose (FBS) (5) , and inflammation (6). The aim of this study to look at the effect of 4 weeks of supplementation with L. gasseri THT 031301 on obesity, glycaemic, and inflammatory markers.This is a single centre, double-blind, randomised, placebo-controlled pilot study that recruited fourteen adult subjects with BMI > 25 kg/m2, who were randomly assigned to receive either a supplement containing L. gasseri THT 031301 (n = 6) or a placebo (n = 7). Pregnant and lactating women, subjects on anti-diabetic medications, and subjects who have undergone heart surgery have been excluded. Consented subjects were asked to consume 2 capsules per day continuously for 4 weeks. L. gasseri THT 031301 daily dosage was approximately 6x 109cfu. Alterations in obesity markers were assessed using BMI and waist-to-height ratio (WtHR), and inflammatory markers were measured using enzyme-linked immunosorbent assay (ELISA). FBS level, HBA1c, and insulin measured to indicate the glycaemic markers. Each marker measured at baseline and after 4 weeks.After 4-weeks supplementation, a significant reduction in waist circumference (WC) (P = 0.022) and (WtHR) (P = 0.035) was identified in the THT 031301 compared to the placebo. Within-group comparisons attributed this finding to a significant increase in WC (93.4 ± 10.1 vs 94.6 ± 9.5, P = 0.040) and WtHR (0.55 ± 0.04 vs 0.56 ± 0.04, P = 0.047) in the placebo group. THT 031301 identified a small increase in the anti-inflammatory cytokine IL-10; however, this was not statistically significant. No changes were identified with the glycaemic markers HbA1c, fasting blood glucose, or insulin.The current pilot study suggests a potential anti abdominal obesity effect of L. gasseri THT 031301 on the glycaemic markers in healthy adults, but this effect needs to be investigated in a large adequately powered RCT. The study did not find a significant effect of L. gasseri THT 031301 on the glycaemic markers. Future studies might recruit obese and overweight subjects or subjects with diabetes to confirm the anti-obesity, anti-diabetic and anti-inflammatory effect of L. gasseri THT 031301.

A 61-year-old male with a background of COPD and non-small cell lung carcinoma diagnosed ten years prior to presentation was seen with chest symptoms. He was an ex-smoker and presented with exertional dyspnoea, chest pain, cough, and wheeze. He had been on chemoradiotherapy for his cancer. The patient was seen in the clinic and admitted intermittently due to shortness of breath, pleural effusion, and exacerbations of COPD. He had undergone CT, MRI, PET scan and missed the PAD diagnosis due to post-chemo-radiotherapy effects. The patient was diagnosed with PAD incidentally through CTPA. The patient was treated medically throughout for Pulmonary hypertension. He was not fit for any surgical intervention and passed away approximately 21 months after diagnosis of Pulmonary artery dissection. The case highlight survival of months in a case of Pulmonary artery dissection without any intervention therapy, including surgery