Purpose： In this study, we aimed to investigate the discrepancy between interview by medical personnel using 3‒point verbal rating scale (VRS) and patient complaints using numerical rating scale (NRS) in nausea diary for chemotherapy‒induced nausea. Patients and Method： In this study, we targeted patients who received chemotherapy at the gynecology department in our hospital and who recorded information in nausea diary. The discrepancy was estimated from NRS in nausea diary and the degree of nausea obtained by medical interview at approximately the same time period. We classified it into overvaluation, undervaluation or non‒discrepancy. Result： A total of 663 cases was analyzed, and 54 patientswere enrolled. The discrepancy was 25.2％ (undervaluation 5.4%; overvaluation 19.8％), and mostly overvaluation was observed. NRS in nausea diary had a significant correlation with the degree of nausea obtained by medical interview（P<0.001, r=0.66） , and the kappa statistic was 0.36. Conclusion： Ratio of non‒undervaluation is approximately 95%; hence, we conclude that interview by medical personnel using VRS accurately reflects the degree of nausea.

Introduction: Tramadol (TRM) has been included as a weak opioid at the second step of the WHO analgesic ladder and has been widely used in palliative medicine. Here we report a case of amelioration of cancer pain by TRM therapy in a female patient with myasthenia gravis (MG). Case:The patient was a 70’s woman who was diagnosed with advanced endometrial carcinoma and suffered from chest pain caused by chest metastasis. 25 mg of a TRM capsule was orally administered three times a day. The dose was increased to 50 mg twice a day. It was resulted in sound pain relief with transient muscle weakness but without a myasthenic crisis.