Perioperative Oral Administration of Cystine and Theanine Enhances Recovery After Distal Gastrectomy

Background: It has been reported that cystine and theanine, amino acids related to glutathione synthesis, have immunomodulatory effects, such as suppressing inflammation after strenuous exercise. In this study, we examined the effects of oral administration of cystine and theanine during the perioperative period as a pilot study. Methods: Forty‐three cases of distal gastrectomy for cancer conducted in our department were assigned to the cystine and theanine group (CT group) or to the placebo control group (P group), and a randomized, single‐blind, parallel‐group study was then performed. Cystine (700 mg) and theanine (280 mg) or a placebo was administered to participants for 10 continuous days (4 days before to 5 days after surgery). Changes in pre‐ and postoperative interleukin (IL)–6, C‐reactive protein (CRP), albumin, white blood cell (WBC) count, neutrophil count, total lymphocyte count, resting energy expenditure (REE), and body temperature were compared and examined. Results: Ten patients were excluded, leaving 33 patients in the study. The CT group had significantly lower IL‐6 values (postoperative day [POD] 4), CRP levels (POD 7), neutrophil counts (POD 4), and body temperatures (POD 5) than the P group (P < .05). In addition, REE in the P group peaked on day 1 (1.14 ± 0.16 [pre‐ and postoperative ratio]), whereas the CT group did not show any increase on POD 1 (0.99 ± 0.21, P < .05 vs P group). Conclusions: This study suggests that oral administration of cystine and theanine during the perioperative period may alleviate postgastrectomy inflammation and promote recovery after surgery.     

Menstrual Problems and Health Seeking in Sri Lanka

Menstruation is associated with some morbidity, although it is a normal physiological event. In this article, we draw on qualitative research conducted in Sri Lanka in 2006–2007, which included eight key informant interviews with healthcare providers, six focus group discussions with eight women in each, and five case studies. We describe and analyze women's perceptions of menstruation and menstrual problems, their help-seeking behaviors to reduce these health problems, and the consequences of them on their lives. The majority of women perceived menstruation as a physiological process and related problems to changes in hormone levels, pathological conditions of the uterus, and the side effects of contraceptive methods. Menstrual problems significantly affected their daily activities, mental well-being, social life, and sexual life, but few sought medical advice to resolve these problems. Implications of the findings included the need for health care providers and educators to provide accurate information on menstruation to girls and women to enable them to identify normal variation of menstruation and to take appropriate action regarding health care.     

Emotional and sexual sequelae following hysterectomy

This article explores the literature pertinent to emotional and sexual sequelae following hysterectomy. The relationship between the incidence of psychiatric depression and the response to a lost body part is described. Sexual facts and fallacies that abound in the literature are also discussed. Finally, nursing measures to alleviate the defined difficulties experienced by the hysterectomy patient are discussed.