Objective: Shoulder pain, which is common in hemiplegic stroke patients, decreases quality of life and interferes with rehabilitation. Although many local injection therapies have been reported for shoulder pain in hemiplegic stroke patients, that to the coracohumeral ligament has not been reported. In a stroke paraplegic patient with shoulder pain, we evaluated the effect of local steroid injection therapy on pain, sleep and range of movement.Methods: Among stroke hemiplegia patients with shoulder pain admitted to our rehabilitation department, 14 shoulders with inadequate pain control by joint range of motion training, anatomical restoration, and analgesic medication were included in this study. Local steroid injections were performed on the coracohumeral ligament under ultrasound guidance. The evaluation items were pain during movement, nocturnal pain, sleep disturbance, and changes in shoulder joint range of motion (flexion, abduction, and external rotation in the pronated position). The Athens Insomnia Scale score was used to assess sleep disturbance. Each item was evaluated before injection, 2 weeks after injection, and 4 weeks after injection.Results: Pain during movement 4 weeks after injection, nocturnal pain and Athens Insomnia Scale score 2 and 4 weeks after injection improved significantly. The range of motion of the shoulder joint was also significantly improved in flexion 2 weeks after injection and in external rotation after 4 weeks of injection.Conclusion: Local steroid injections into the coracohumeral ligament may be one treatment option to reduce shoulder pain in stroke hemiplegic patients, as it significantly reduced pain during movement and nighttime pain and sleep disturbances.

Objective: Shoulder pain, which is common in hemiplegic stroke patients, decreases quality of life and interferes with rehabilitation. Although many local injection therapies have been reported for shoulder pain in hemiplegic stroke patients, that to the coracohumeral ligament has not been reported. In a stroke paraplegic patient with shoulder pain, we evaluated the effect of local steroid injection therapy on pain, sleep and range of movement.Methods: Among stroke hemiplegia patients with shoulder pain admitted to our rehabilitation department, 14 shoulders with inadequate pain control by joint range of motion training, anatomical restoration, and analgesic medication were included in this study. Local steroid injections were performed on the coracohumeral ligament under ultrasound guidance. The evaluation items were pain during movement, nocturnal pain, sleep disturbance, and changes in shoulder joint range of motion (flexion, abduction, and external rotation in the pronated position). The Athens Insomnia Scale score was used to assess sleep disturbance. Each item was evaluated before injection, 2 weeks after injection, and 4 weeks after injection.Results: Pain during movement 4 weeks after injection, nocturnal pain and Athens Insomnia Scale score 2 and 4 weeks after injection improved significantly. The range of motion of the shoulder joint was also significantly improved in flexion 2 weeks after injection and in external rotation after 4 weeks of injection.Conclusion: Local steroid injections into the coracohumeral ligament may be one treatment option to reduce shoulder pain in stroke hemiplegic patients, as it significantly reduced pain during movement and nighttime pain and sleep disturbances.

Introduction: We investigated a protocol to support the treatment of constipation that was developed in collaboration with physicians and the effectiveness of Protocol Based Pharmacotherapy Management (PBPM) performed by pharmacists in improving constipation.Methiod: Patients with constipation who underwent PBPM between August 2020 and May 2021 were included in this study. The results of the Constipation Scoring System (CSS) and the Bristol Stool Form Scale (BSFS) assessments by pharmacists on the first day of intervention and at discharge were collected retrospectively to evaluate the efficacy of PBPM. Wilcoxon's signed rank test was used for statistical analysis, and the threshold value for rejecting the null hypothesis was p < 0.05.Results: Of the 23 eligible patients, three were excluded according to the criteria, and 20 patients were included. Median CSS improved significantly from 11.5 points [8.25-16.75] at the first intervention to 5.5 points [2.75-10.25] at discharge. The median BSFS improved significantly from Type 2 [2-3] to Type 3.5 [3-4]. Conclusion: PBPM by pharmacists to support the treatment of constipation resulted in improvement of constipation.

Objective : To examine the relation between psychoactive drugs and the outcome of dysphagia in patients with psychiatric disorders. Methods : We examined 53 inpatients who were prescribed speech therapy in the psychiatry ward of our hospital from January 2011 to April 2012. We categorized the patients into a poor outcome group and a good outcome group by the necessity for alternative nutrition at discharge and analyzed the number and kind of typical antipsychotic, atypical antipsychotic, hypnotic, antidepressant and mood stabilizer, total amount of typical antipsychotic, atypical antipsychotic used at admission and at discharge, sex, psychiatric disorder, central nervous system disease, aspiration pneumonia, duration of hospitalization, psychiatric disorder disease period, speech therapy intervention period and GAF scale at admission. Results : The outcome of dysphagia had a significant relation with the number and kind of antipsychotic used, especially typical antipsychotic used at admission. The good outcome group had a higher total amount of antipsychotic use, especially atypical antipsychotics. Conclusion : Long-term practical oral intake should not comprise antipsychotic polypharmacy, especially typical antipsychotics before onset of dysphagia, but should instead consist of a monopharmacy approach with atypical antipsychotics.