Purpose: While the first defecation pain is a problem following hemorrhoidectomy, it is unknown whether the stool consistency has an influence on pain. This pilot study aimed to investigate whether the intensity of defecation pain varied according to stool consistency. Methods: This prospective cohort study evaluated patients who underwent hemorrhoidectomy in combination with injection sclerotherapy for grade III or IV hemorrhoids. The pain intensity and stool form during the first postoperative defecation were self-recorded by the patients using a visual analogue scale (score of 0–10) and Bristol Stool Form Scale, respectively. The patients were classified into 3 groups according to stool consistency, and the intensity of defecation pain was compared among the groups using analysis of variance. Results: A total of 61 patients were eligible for this study and were classified into the hard stool (n=15), normal stool (n=21), and soft stool groups (n=25). No significant intergroup differences were identified in the intensity of pain at defecation (P=0.29). Conclusion This pilot study demonstrated that there were no clear differences in pain intensity during the first defecation after surgery among the 3 groups with different levels of stool consistency.

PURPOSE: Injection sclerotherapy for hemorrhoids has been performed for many years. Currently, 5% phenol in almond oil (PAO) and aluminum potassium sulfate and tannic acid (ALTA) are used as the agents. The purpose of this study was to compare the efficacy of the two agents. METHODS: A retrospective study was conducted involving 135 patients who underwent injection therapy for grade 3 hemorrhoids for the first time between 2013 and 2014 (PAO, 55 patients; ALTA, 80 patients). The efficacy was established as the proportion (%) of patients without symptoms such as hemorrhage and prolapse one year after treatment. We investigated four factors-sex, age, number of hemorrhoids, and agent-that might have an influence on the efficacy. RESULTS: The efficacies of ALTA and PAO one year after treatment were 75% and 20%, respectively. Only the agent was a significant independent factor (P < 0.01). CONCLUSION: The results suggest that ALTA is markedly more useful than PAO for injection sclerotherapy for grade 3 hemorrhoids.
Aluminum* ; Hemorrhage ; Hemorrhoids* ; Humans ; Phenol* ; Potassium* ; Prolapse ; Prunus dulcis* ; Retrospective Studies ; Sclerotherapy* ; Tannins*

  Frequent bathtub bathing (BB) improves sleep quality and mental health of middle-aged and older Japanese individuals. This study investigated the chronic effects of BB with and without a bath additive (bathtub bathing with KIKIYU [BBK]) in healthy young adults. The study involved healthy young adults who habitually showered, as opposed to bathing. Nineteen participants were randomly assigned to either the BB or BBK groups for 14 consecutive nights. After a 2-week washout period (shower bathing), the participants were asked to switch their bathing styles (a crossover design). The artificial bath additive for the BBK group contained inorganic salts and carbon dioxide. The participants were evaluated by using the Oguri-Shirakawa-Azumi Sleep Inventory-Middle-aged version (OSA-MA) and 1-ch sleep electroencephalography (EEG) for sleep quality, the Profile of Mood States (POMS), Self-rating Depression Scale (SDS), and Apathy Scale (AS) for mental conditions.  Sleepiness on waking and refreshing scores in the OSA-MA significantly differed between the shower bathing and BBK groups. EEG results did not significantly differ among the bathing styles. Vigor T-score and total mood disturbance (TMD) scores showed significant differences in the two bathing groups (shower vs. bathing), and fatigue T-score was significantly lower in the BBK group compared with both the BB and shower groups. SDS score was significantly lower in the BBK group compared with the shower group. AS score was significantly lower in the two bathing groups (shower vs. bathing).   The OSA-MA score was possibly influenced by vasodilatation and circulation by using carbon dioxide and keeping the body warm after bathing by using inorganic salts. The OSA-MA score was possible also affected by fatigue alleviation and maintenance of vitality by using a citrus lemon scent and yellow-green hue. Furthermore, frequent body heating affects the central nervous function related to mood and emotion.  Based on these results, we can conclude that BB and BBK prior to shower bathing improved the mental health of the young adults in this study.

Objective: In this study, we investigated the occurrence of skin damage following the initiation of low-dose lamotrigine.Methods: We retrospectively analyzed the incidence of skin disorders within 8 weeks of the start of lamotrigine administration, prescribing for 3 years from July 2014 to June 2016.In addition, we also confirmed the onset time of skin disorders in the low- and normal-dose groups.Results: The incidence of skin damage was 7.7 and 24.6 % in the low- and normal-dose lamotrigine start groups, respectively. The onset of skin disorders was relatively early in the normal-dose lamotrigine start group.On the other hand, no tendency was found in the low-dose lamotrigine start group because the number of cases was small.Conclusion: The initiation of low-dose lamotrigine and extension of introduction period might reduce the onset of early skin damage.

Objective: The internet isflooded with drug information; however, some of it isinappropriate and thisinadequate information could expose the public to health hazards. Therefore, we conducted research on the idea of transmitting drug information to the public via the internet and the current state of the information currently provided by each academic society relevant to the field of Medical Informatics.Methods: A questionnaire was mailed to the website managers for the website of 129 specialist medical societies, all members of the Japanese Association of Medical Sciences. We conducted our research between October to November 2018. We investigated each website administrator’s opinion about offering drug information for consumers via the internet and what information each academic society is currently providing.Results: The effective response rate was 43.4% (56/129 groups). Most respondents thought that drug information overflowed in the current Internet society. Moreover, more than half of the respondents thought that the quality of drug information transmitted to the public wasinadequate. Currently, 30 of the academic groupssurveyed are providing information to the public. When providing information, they did not refer to the “Drug Guide for Patients” much. More than 80% of respondents said they would cooperate with linking to the information provided to the public. However, each academic society felt there would be many problems with doing so such as the need for a system to check the contents of the information provided and a system to perform maintenance.Conclusion: The results showed that the website administrators recognized that there is a need to improve the quality of and system for providing drug information to the public. We believe that an integrated information system can be constructed by aggregating the drug information held by each academic society. However, this cannot be realized without first solving many problems.

Introduction: Some students take showers instead of baths for economic reasons or because they dislike cleaning the bathtub. The purpose of this study was to examine the effect of bathing routines on students’ working efficiency. Subjects: Seventeen (six male and 11 female) healthy young students (19.6 ± 0.7 years old, mean ± SD) who habitually took showers instead of baths participated in this study. Informed consent was obtained from all the subjects and the study was approved by the Ethics Committee of Kumamoto Health Science University. Method: Subjects were randomly assigned into two groups. The subjects in the first group (bathtub bathing [BB]) were immersed to the supraclavicular level in their home bathtub and instructed to rest for 10 minutes with the temperature regulated at 41°C. The subjects of the second group (whole-body warming after BB [BBW]) followed the same bathing protocol and then rested in a sleeping bag and sheet for 30 minutes to keep their bodies warm. Each period was carried out over 2 weeks in a cross-over design. Washout periods were 2 weeks long. The evaluation items of this study included the obstructive sleep apnea (OSA) sleep inventory MA version (OSA-MA), a questionnaire containing a visual analog scale (VAS) to judge the subjective bathing effect, profile of mood states, salivary stress marker (α-amylase), and the Purdue Pegboard test. These tests were evaluated before and after the BB sessions, BBW sessions, and washout interval for a total of four times in a 6-week period. Result: Participants tended to report a better sleep feeling on the OSA-MA after the BB or BBW sessions than after showering. There were significantly better changes in both the BB and BBW in the VAS for bathing effect in terms of “Sense of deep sleep,” “Body fatigue,” “Light feeling of the body” than after a shower. The mean α-amylase value in the saliva of the BBW group participants was significantly lower than that after showering. The mean Purdue Pegboard test scores of both the BB and BBW sessions were significantly higher than that after the shower. Discussion: Sleep quality seemed to be more improved after BB or BBW than after showering, perhaps due to reduced stress. Work efficiency also increased in the BB and BBW groups.

Objective: The purpose of this study was to examine the effects of bathtub bathing （BB） on sleep and working efficiency of healthy young adult students. Furthermore, the effects of BB and prolonged increased body temperature from the use of insulating sheets and sleeping bags after BB （warming after BB: BBW） on sleep and working efficiency were investigated. Subjects: Eighteen （six males, 12 females） healthy young students （19.6±0.7 years old, mean±SD） who habitually took showers instead of baths participated in this study. Informed consent was obtained from all of the subjects, and the study was approved by the Ethics Committee of Kumamoto Health Science University. Methods: Subjects were randomly assigned to two groups （n＝9 in each group）. The subjects in the BB group were immersed in their home bathtub to the supraclavicular level and instructed to rest for 10 min with the temperature regulated at 41°C. The subjects in the BBW group followed the same bathing protocol, and they then rested in a sleeping bag and sheet for 30 min in order to keep their bodies warm. The length of each study period was 2 weeks in a crossover design. After the 2-week-long washout periods, the subject groups were switched. The subjects were evaluated with the Oguri-Shirakawa-Azumi sleep inventory, MA version （OSA-MA）, which utilizes a visual analog scale （VAS） with which subjects rate their sleep when they wake up, and Purdue Pegboard Assembly test. These tests were employed before and after the BB and BBW sessions, resulting in four testing periods in the 6-week period. Results: Sleep rating on the OSA-MA was no significant difference in both the BB and BBW groups compared to ratings recorded after showering. The subjects in the BB and BBW groups had significantly increased VAS ratings for “Feeling of sound sleep,” “Refreshing,” and “Lightness of the body” compared to the ratings after showering. The mean Purdue Pegboard test scores of the subjects in both the BB and BBW groups were significantly higher than those recorded after showering. Discussion: Changing bathing style from shower to BB or BBW improved the working efficiency of students on the Purdue pegboard test. BB and BBW resulted in soothing effects owing to improvements in the subjects’ quality of sleep.

Objective: We evaluated patients’ degree of understanding of the effects and adverse drug reactions of SGLT2 inhibitors.Methods: We targeted 26 patients who were administered SGLT2 inhibitors during hospitalizations between April 2017 and March 2018. The survey was conducted by interviewing the patients using a questionnaire.Results: In total, 14 patients (53. 8%) were able to explain the term “efficacy.” Although 6 patients (23. 1%) understood “dehydration,” there was little understanding of “urinary tract infection” (7.7%) and “rash/erythema” (2 and 0 patients, respectively). In addition, we confirmed the details of the descriptions of adverse reactions caused by SGLT2 inhibitors with pharmacists, and found that 13 patients (50.0%) clearly received an explanation of “dehydration,” only 3 patients received an explanation of “urinary tract infection” (11.5%), and none of them comprehended “rash/erythema.” Overall, the patients’ awareness of the adverse drug reactions of SGLT2 inhibitors was low.Conclusion: Unlike common drugs for diabetes, SGLT2 inhibitors have been attracting attention as protective agents of the heart and kidneys. Therefore, it is expected that prescriptions for SGLT2 will increase in the future. Pharmacists need to explain the effects and adverse drug reactions of SGLT2 inhibitors to the patients as well as make the patients understand the pharmacological mechanisms of action of SGLT2 inhibitors.

Objective: The purpose of this study was to clarify the chronic effects of bathtub bathing (BB), whole body warming after bathtub bathing (BBW), and bathtub bathing with herbal extracts (BBH) on the mental condition of healthy young persons. Subjects and Methods: Experiment 1: Eighteen (6 male and 12 female; age: 19.6±0.7 years, mean ± SD) healthy young persons who were taking a shower habitually but not bathtub bathing participated in this study.   From November 2012 to December 2012, subjects were randomly assigned into two groups (each 3 male, 6 female): those who had BB or 30-min BBW 14 times for 14 consecutive nights during a 2-week period. After a 2-week washout period, subjects were asked to switch their bathing conditions (a cross-over design). Experiment 2: Twenty (8 male and 12 female; age: 21.3±1.6 years, mean ± SD) healthy young persons who were taking a shower habitually but not bathtub bathing participated in this study.   From October 2013 to November 2013, subejects (4male and 6 female) were randomly assigned to undergo BB or BBH.   The herbal extract contained Dong dang gui (Japanese Angelica Root), Chimpi (Citrus Unshiu peel), Chamomilla recutita, and ginger extracts.   After a 2-week washout period, subjects were asked switch to the other bathing condition (a cross-over design).   All participants provided informed consent for participation in these studies, and these studies were approved by the Ethics Committee of the Kumamoto Health Science University.   The subjects immersed their bodies up to the supraclavian for 10 min, in tap water adjusted to a temperature of 41 °C in their bathtub at home. The subjects’ mental conditions were assessed using Profile of Mood States short version questionnaire.   The differences in the effect of BB and BBW, as well as those of BB and BBH on the subjects’ mental conditions and their mental conditions pre-BB and post-BB, pre-BBW and post-BBW, pre-BBH and post-BBH were analyzed using Wilcoxon’s signed-rank sum test. Results: The points for depression-dejection, fatigue, and confusion in those who had BBH significantly converged to the median average (50 points) compared to the points in those who had BB.   The points for anger-hostility before BBW and BBH significantly converged to the median average (50 points) after BBW and BBH, and there were no significant differences in points before and after BB. Conclusions: The subjects’ anger-hostility was influenced by body warming in BBW and the vasodilatory components of the herbal extracts.   The subjects’ depression-dejection and fatigue was influenced by the fragrance and color of herbal extracts.

Objective: Two types of symbols have been established as industry standards in terms of two-dimensional (2D) symbols with prescription information: one for objects to be printed on prescriptions and the other for electronic versions of medication diaries. However, no studies have investigated the system for using 2D symbols in pharmacies and hospitals/clinics as well as the quality of the information actually stored in these 2D symbols. Therefore, we conducted a survey to clarify the current status and problems pertaining to prescription information sharing via 2D symbols.Methods: We distributed questionnaires to community pharmacies through the Fukui Pharmaceutical Association and asked them to cooperate with us during the survey. The list of items in the survey　included the installation status of devices necessary for reading 2D symbols at each pharmacy, receipt computer in use, and status of the support issued by hospitals/clinics for reading 2D symbols. At the same time, we received 2D symbols created by community pharmacies and conducted reading tests to examine issues related to the collection of prescription information via 2D symbols at medical institutions.Results: The response rate for the survey was 21.8%. Among the 57 stores that responded to the survey, 26 (45.6%) answered that they could read prescription symbols, and 22 of them had actually used the system till date. In addition, 38 community pharmacies were able to provide the 2D symbols for medication diaries. Of the 30 provided symbols for medication diaries, 16 (53.3%) could be read as Japanese data by the barcode reader used.Conclusions: It has become clear that the 2D symbols with stored prescription information are not being completely utilized at present, as both community pharmacies and hospitals/clinics face several issues such as hardware maintenance, software updates, and time and effort required for the usage.