[Purpose]We report a case concerning 5 months of left elbow and knee joint pain thought to be caused by repetitive use at work. Symptoms were improved successfully (checked by M-test) by a single acupuncture treatment.
[Case]We used acupuncture to treat a 50-year-old woman who visited our Acupuncture and Moxibustion Centerwith complaints of increasing elbow and knee joint pain in the left side. Since 4 months ago, her job involved frequent stair-climbing while carrying an 18-liter can of cooking oil. The soft tissues seemed to be damaged and caused pain due to the repeated lifting of heavy cans at work. Acu-points were decided by M-Test to check limitations of movement, which identified damaged regions and provided feedback for optimal treatment. According to the specific operations of the patient's work, we identified limited movements of left-elbow joint flexion-extension, left-shoulder joint extension, and left hip joint inner rotation and external gyration. These were regarded as target motions for the treatment. Her Visual Analog Scale (VAS) scores before treatment were 90 mm in the left elbow and 80 mm in the left knee. Despite only a single round of acupuncture treatment, the respective values dropped to 18 mm and 15 mm.
[Consideration and Conclusion]The limited movement identified by M-Test could expose the affected areas and help in treating the appropriate acu-points. Therefore, acupuncture using M-Test might improve painful motions of the body.

This study was performed by the purpose of early detection of Hand－Foot Syndrome (HFS) in patients receiving capecitabine therapy. Ten patients receiving chemotherapy with capecitabine after resection of colon cancer were included in this study. Surgeons decided the reduction or suspension of capecitabine when adverse effects were found. Pharmacists instructed the patients of the way of intake and side effects. Nurses instructed the patients how to make skin care with brochure and DVD. We called to or made an interview to the patients once a week in the first eight weeks of administration by evaluating the symptoms of HFS. Finally, a questionnaire was taken to evaluate the degree patients’ satisfaction. All of the ten patients continued the skin care in the study. HFS above grade 2 appeared in three cases, and early decision of reduction or suspension of capecitabine was achieved as the result of support by telephone call or interview. Support by either telephone call or interview by nurses in the medical team of chemotherapy can contribute to the completion of chemotherapy by capecitabine by detecting the HFS in the early stage which leads to the early decision of reduction or suspension and by reduce the anxiety of the patients. We also suggest the necessity of the construction of individualized support system to the patients in the future.

Background  This study explored the association of residence, caste, social determinants of health (SDH) of parents, and daily junk food intake with the nutritional status of school children living in different residential areas of a district in Nepal. Methods  A survey was conducted from December 2017 to March 2019, including 331 school children aged 6 to 12 years as well as their parents, in the primary village for Japan International Cooperation Agency (JICA) support and the surrounding area in the Machapuchare Administrative Region of Kaski District, Gandagi Province, Nepal. In this study, the body mass index for age z-score (BMIZ), a criterion used by the WHO for assessing malnutrition, was used for determining underweight; BMIZ <−2 SD was defined as underweight.  The children’s anthropometric data were measured to assess their nutritional status, and a survey on children’s daily junk food intake and parents' SDH was conducted among parents. The responses were analyzed by logistic regression analysis.Results  Of the children who participated in the survey, 31 (9.4%) were underweight.   An association between parents’ SDH and children’s underweight was found after adjusting for mothers’ age at marriage, number of siblings, and daily junk food intake, and the results showed that lower caste (OR＝0.241, p＝0.001), lower education of mothers (OR＝3.879, p＝0.011) and non-literacy of fathers (OR＝2.790, p＝0.023) had statistically significant effects on BMIZ.Conclusions  In this study, BMIZ, indicating underweight in Nepalese school children, was associated with higher caste and a mother’s level of educational attainment and father’s of non-literacy. To understand the factors influencing children’s health, it is necessary to evaluate sociodemographic parameters of parents as childcare providers, including culture, education, employment, living conditions, and diet, and to conduct surveys that capture data on the SDH of parents from various perspectives.