We report a case of persistent pain in a 21-year-old male patient, which responded well to yokukansan and keishikaryukotsuboreito, after biopsy surgery performed 5 years ago. Chronic postsurgical pain (CPSP) is a condition in which pain persists even after the surgical wound has healed, significantly affecting the patient’s daily life and mental state. Our patient was diagnosed with fibrous osteodysplasia based on a biopsy of the sacral region, but his postoperative pain persisted and became chronic. The patient’s activities of daily living (ADL) significantly declined, and he was unable to maintain a normal school life. Simultaneous treatment with shigyakusan, keishibukuryogankayokuinin, tramadol hydrochloride, and acetaminophen was started, and the medication was repeatedly changed. His quality of life notably improved with yokukansan and keishikaryukotsuboreito. In recent years, there have been many reports of the use of yokukansan for chronic pain, and the results of our case suggest that the addition of the anxiolytic and analgesic effects of keishikaryukotsuboreito is effective for intractable chronic pain.

We investigated the relationship between neonatal blood hemoglobin (Hb) and period of oxygen administration in 4 cases of fetomaternal transfusion syndrome at our hospital. The hematological parameters were as follows. Case 1: Hb 7.0 g/dL, reticulocyte count 177‰, no blood transfusion, and oxygen administration for 3 days. Case 2: Hb 4.7 g/dL, reticulocyte count 132‰, blood transfusion given, and oxygen administration for 7 days. Case 3: Hb 4.1 g/dL, reticulocyte count 202‰, blood transfusion given, and oxygen administration for 12 days. Case 4: Hb 3.6 g/dL, reticulocyte count 48‰, and blood transfusion given. In Case 4, we started artificial respiration and oxygen administration for treatment of neonatal asphyxia. Oxygen administration was stopped at 50 days of age. Artificial respiration was continued, and tracheostomy was attempted at 198 days of age. Case 4 was classified as having acute blood loss based on the reticulocyte count and had a poorer prognosis than Cases 1-3, which were classified as having chronic blood loss. In Cases 1-3, peripheral blood Hb level was inversely related to the period of oxygen administration.

Background and Objectives  In Honduras, only a few rehabilitation centers have provided social participation services consistent with the International Classification of Functioning (ICF). The goal of this study were to describe how people with disabilities (PWD) felt a need to participate in society, and to clarify what aspects of social participation were of interest to PWD.Methods  A survey was conducted in a rehabilitation facility operated by the Intibucá department in Honduras. A semi-structured interview was conducted people with physical disabilities who attended the facility to analyze their needs and state of social participation.Results  In total, 22 PWDs participated in this study. Data analysis showed that the needs of PWD were classified into six categories: Improving the Social Environment, Improving Physical Function and Activities of daily living Ability, Reacquiring Work and Productive Activities, Acquiring Home Activities, Spending Time with Family, and Resuming Leisure Activities. Six participants were employed, and those who were unemployed were also limited in their community participation other than work.Conclusion  This study revealed that PWD in the Intibucá Department missed opportunities to participate in the community. PWD stated that improved physical functioning was essential for achieving social participation. Rehabilitation professionals need to develop shared decision-making based on an understanding of the social context of PWD, and both rehabilitation professionals and local community supporters working with PWD should partner with other professionals to support the social participation of PWD.