Hormonal profile of survivors of breast cancer with fatigue: A pilot study.

Background & objectives: One of the most common problems experienced by breast cancer survivors (BCSs) is fatigue. There has been little research about the status of hormones in breast cancer patients as an aetiology of cancer-related fatigue (CRF). Hence, a pilot study was conducted to assess the levels of hormones such as thyroid, cortisol, dehydroepiandrosterone sulphate (DHEAS), oestrogen and progesterone in BCSs with fatigue. Methods: BCSs with complaints of fatigue were assessed using the Brief Fatigue Inventory (BFI) tool and evaluation of the hormone profiles was done in moderate-to-severe fatigued survivors. Data collected were analyzed to look for any association between fatigue and altered hormonal levels. Results: In this study, 56 per cent (n=62) of survivors experienced moderate-to-severe fatigue out of 110 patients reporting fatigue. Thyroid functions were deranged in 22 patients (35.48%). The thyroid stimulating hormone (TSH) levels were found to have a significant negative association with the severity of fatigue, (P<0.05). Twelve patients (19.35%) had reduced DHEAS levels suggestive of impaired hormone synthesis in the adrenal gland. Twenty two postmenopausal survivors (35.48%) had raised oestradiol levels. Interpretation & conclusions: The findings of this study suggest that the hormonal milieu, especially thyroid hormone and DHEAS may have a role in CRF experienced by BCSs and needs further exploration.

A prospective randomized comparison of sexual function and semen analysis following laparoscopic totally extraperitoneal (TEP) and transabdominal pre-peritoneal (TAPP) inguinal hernia repair.

BACKGROUND: With standardization of laparoscopic technique of groin hernia repair, the focus of surgical outcome has shifted to lesser studied parameters like sexual function and fertility. METHODS: This prospective randomized study was conducted in a single surgical unit at a tertiary care hospital. A sample size of 144 was calculated with 72 in each group (Group 1 TEP and Group 2 TAPP). Primary outcomes measured included comparison of sexual function using BMFSI, qualitative semen analysis and ASA levels between patients undergoing TEP or TAPP repair. Semen analysis and ASA was measured pre-operatively and 3 months post-operatively. RESULTS: A total of 145 patients were randomized into two groups, TAPP (73) and TEP (72) patients. Both the groups were comparable in terms of demographic profile and hernia characteristics with majority of the patients in both the groups having unilateral inguinal hernia (89.0% in TAPP group and 79.2% in TEP group). Both the groups showed statistically significant improvement in overall sexual function score (BMFSI) at 3 months; however, there was no inter group difference. Both the groups were also comparable in terms of ASA and qualitative semen analysis. CONCLUSION: Both TEP and TAPP repair are comparable in terms of sexual function and effect on semen analysis. Laparoscopic repair improves the overall sexual functions in patients with groin hernia.

Transplantation of live allograft kidney with double ureter: A case report and review of literature.

Duplication of ureter is an uncommon anomaly with a reported incidence of 0.6%-1%. It can be either complete or a partial duplication. We present a case of live-related renal transplant in which complete duplication of ureter was found as a surprise during bench preparation of the donor kidney, which was reported as partial duplication on the pre-operative multidetector computed tomography. A common ostium was made from the two ureters and was anastomosed to the bladder. At 2-months follow-up, the patient has good graft function and no evidence of ureteric complications. Since double ureter does not seem to increase urological complications, such donors should not be rejected.

Smartphone applications (apps) in general surgical practice: An insight into their reliability and usefulness.

Objectives: In today's day and age with the advent of smartphones along with the handy apps available for download, there is increasing opportunities for surgeons to integrate such technology into clinical practice with great ease. This study aims to provide a systematic classification of apps in order to provide dependable data for choosing the right app by both surgeons and trainees. Material and Methods: A series of methodical searches were carried out on "Google Play Store" and "Apple's App Store" with pre-decided keywords. The results were then sorted and segregated into relevant categories like core surgery, apps related to surgical practice, patient utility apps and other surgical branches. Thereafter, the apps that met with our cut-offs, were assessed for their credibility and utility, based on predefined parameters. Results: There were a lot of variations in between the categories we segregated the apps into. Using predefined cutoff criteria, (rating >3 and reviews >30), 48 of the apps were assessed finally for their utility and credibility. Out of these 48 apps, 42 were on android platform while the remaining 6 were on iOS. Ten apps were found to be having high credibility and 15 apps have high utility. Conclusion: The role of smartphone apps in surgery and surgical training appears highly promising and using apps with high credibility and utility will provide dependable and updated information for the surgeons and trainees.