scholarly journals Alcohol state markers- facility and utility for clinical management of alcohol use disorders: study from a tertiary care centre in South India

2021 ◽  
Vol 9 (10) ◽  
pp. 3105
Author(s):  
Liji M. J. ◽  
P. R. Varghese ◽  
Susheela Jacob Innah ◽  
Praveenlal Kuttichira
Keyword(s):  
Alcohol Use ◽  
Clinical Management ◽  
Tertiary Care ◽  
Alcohol Use Disorders ◽  
Clinical Manifestations ◽  
Gamma Glutamyl Transferase ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Alcohol Biomarker ◽  
Glutamyl Transferase

Background: Alcoholism is broadly any drinking of alcohol resulting in significant psychological and physiological health problems. As alcoholism is not a recognized diagnostic entity the detection and monitoring of the clinical manifestations of alcoholism is of great importance in the alcohol use disorders (AUD) treatment. Hence, the use of alcohol biomarkers plays a vital role in the diagnosis, treatment and prognosis of AUDs.Methods: This study aimed to understand the utility of state markers in alcohol related distress, both for diagnosis and prognosis in a tertiary care centre. The relative number and the frequency of the alcohol biomarker tests such as AST (aspartate aminotransferase), ALT (alanine aminotransferase), MCV (mean corpuscular volume) and GGT (gamma-glutamyl transferase) investigated in the hospital departments (32 departments) were collected. Test requests and results in January to March on five consecutive years from 2016 to 2020 were analyzed, by comparing psychiatry department with all other departments and AUD with non-AUD cases.Results: The study findings revealed that, the tests AST, ALT and MCV were well utilized for the AUD treatment procedure in the tertiary care centre, irrespective of the department the patient got admitted. Since GGT was the least preferred test, the figures of GGT could not be analysed because of the exceptionally low number.Conclusions: The utility of the commonly available alcohol biomarker tests is especially useful for the clinical management of AUD patients and these are well utilized in an appreciable manner in the study centre. Development of more accurate, specific, and sensitive panel of biomarker tests may further motivate clinicians to better monitor individuals who suffer from alcoholism.

scholarly journals A Cross-Sectional Comparison of Drinking Patterns, Alcohol Use and Related Medical Morbidities in a Secondary Versus Tertiary Setting

2015 ◽  
Vol 11 (2) ◽  
pp. 152-157
Author(s):  
A Risal ◽  
H Tharoor
Keyword(s):  
Alcohol Use ◽  
Alcohol Dependence ◽  
Tertiary Care ◽  
Alcohol Use Disorders ◽  
Care Utilization ◽  
Drinking Patterns ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Patterns Of Drinking ◽  
Level Hospital

Background Alcohol Dependence exists in different spectrums at different settings and associated with various medical morbidities, disability and health care utilization costs. Objectives To study the drinking patterns, alcohol use disorders and alcohol related medical morbidities in patients diagnosed with Alcohol Dependence Syndrome (ADS) and attending out / in-patient psychiatry services at secondary and tertiary care centre. Methods A cross-sectional comparative study was done among the patients diagnosed with ADS attending psychiatry services at District hospital, Udupi and Kasturba Hospital, Manipal. Serial sampling was done. Patients having any other psychiatric illnesses were excluded. The two groups were compared in relation to socio-demographic variables, drinking related variables, patterns of drinking and alcohol related medical morbidities identified. Results Significant differences in some socio-demographic parameters among the patients from the two different treatment centers were found with secondary level hospital (N=50) having more illiterate, laborers and below the poverty line population in comparison to the tertiary level hospital (N=75). Maximum frequency of gastro-intestinal morbidities was seen in both the hospital population, irrespective of the patterns of drinking. Conclusion Alcohol use disorders and alcohol related medical morbidities show some variations in their presentations in the different treatment centers. DOI: http://dx.doi.org/10.3126/kumj.v11i2.12492 Kathmandu University Medical Journal Vol.11(2) 2013: 152-157

scholarly journals Occurrence of Alcohol Dependence, Pattern of Alcohol Use, and Psychiatric Comorbidity in a Tertiary Care Centre in Upper Assam, India

2021 ◽  
Vol 8 (21) ◽  
pp. 1674-1678
Author(s):  
Kamala Deka ◽  
Manju Partha Baruah ◽  
Dipjyoti Bora
Keyword(s):  
Alcohol Use ◽  
Alcohol Use Disorder ◽  
Psychiatric Comorbidity ◽  
Tertiary Care ◽  
Occupancy Rate ◽  
Care Centre ◽  
Bed Occupancy ◽  
Tertiary Care Centre ◽  
Co Morbidity ◽  
Alcohol Dependent

BACKGROUND There has been an increased rate of diagnosis of alcohol dependent syndrome (ADS) observed in our psychiatry clinic constituting a major portion of them into inpatients care. Evaluation of psychiatric complaints in patients with alcohol dependant syndrome is challenging at times. Depression has been found to be a common psychological association seen in them. Suicidality and other selfharming behaviour as a co morbidity are also not uncommon. There is dearth of information available on occurrence of alcohol dependent syndrome in psychiatry attendees and pattern of alcohol use especially from this part of north-eastern region of Assam. We wanted to assess the occurrence and pattern of alcohol use disorder amongst patients attending psychiatry unit of a tertiary care centre in upper Assam, estimate its bed occupancy rate, and determine psychiatric comorbidity among them. METHODS A hospital based cross sectional study was conducted among 104 consecutive subjects attending Psychiatry department of Jorhat Medical College, Assam. After thorough examination and informed written consent subjects were administered with alcohol use disorder identification test (AUDIT) and MINI plus. Semi structured socio demographic Proforma was used to collect information on demographic data and different variables. As it was a descriptive study, data collected were organized in frequency tables and analysed using percentage. RESULTS In present study, prevalence of alcohol dependent syndrome in psychiatry set up was 12.68 % and bed occupancy rate of ADS was 13 %. Majority were between the age 28 and 47 years, males, Hindus, married, belonged to nuclear family and hailed from upper lower social class followed by lower middle class. Approximately 18 % of cases had psychiatric co morbidity and majority of them had depression and suicidality. CONCLUSIONS A major number of alcohol dependant patients attended psychiatry OPD and occupied almost half of the beds as inpatients of a tertiary care hospital. Mood disorder was the commonest comorbid condition in these patients. Though the results cannot be generalized, it may definitely reflect the magnitude of alcohol use in this region. Hence forth a psychiatry unit like ours warrant a full-fledged department for treatment of ADS and alcohol related problems and some policy to work for its prevention. KEYWORDS ADS, Occurrence, Bed Occupancy, Psychiatric Co-Morbidity

scholarly journals The effect of synbiotics supplement on alcohol use disorders identification test and biochemical parameters, gamma glutamyl transferase, lipopolysaccharide and immunoglobulin a levels, in high risk alcoholics

2020 ◽  
Vol 11 (1) ◽  
pp. 1-6 ◽  
Author(s):  
Vachrintr Sirisapsombat ◽  
Parama Pratummas ◽  
Phuttharaksa Phucharoen ◽  
Thamthiwat Nararatwanchai ◽  
Chaiyavat Chaiyasut ◽  
...  
Keyword(s):  
High Risk ◽  
Alcohol Use ◽  
Biochemical Parameters ◽  
Alcohol Use Disorders ◽  
Immunoglobulin A ◽  
Gamma Glutamyl Transferase ◽  
Gamma Glutamyl ◽  
Identification Test ◽  
Audit Score ◽  
Glutamyl Transferase

Background: Alcohol consumption does not result in dependence or abuse among most people. Nevertheless, a significant group of the population as a whole unavoidably is troubled by chronic alcoholism.Alcohol is involved in a number of diseases, disorders, and injuries, and several social problems. Aims and Objective: To investigate the possible effects of synbiotics supplement affecting to gut-brain axis in high risk alcohol drinkers through alterations between improving of gut related parameters and changes of alcohol use disorders identification test (AUDIT). Materials and Methods: Single group, pre- and post-test study. Participants: 24 male patients, alcohol use disorders identification test at 8 or above. Exclusions included clinical diagnosis of cirrhosis, immunodeficiency, autoimmune disorder, use of drugs other than alcohol, pregnancy and lactation, use of antibiotics and herbs during the course of study. Intervention: Synbiotics containing probiotics 7 species and prebiotic 3 types once a day before bedtime for 8 weeks. Main outcome measures: Primary outcome- the efficacy of synbiotics supplement improving subjective AUDIT score. Secondary outcome- changes on gut related biochemical parameters (lipopolysaccharide and immunoglobulin A levels). Results: Twenty high risk alcoholic subjects (with an average age of 46.14 ± 18.34 years) were supplemented with synbiotics contained 25 billion cells of probiotics per day for 8 weeks. After the end of intervention, there was significantly improved total AUDIT score (p=0.001). The changes in gamma glutamyl transferase (GGT), lipopolysaccharide and immunoglobulin A level was calculated. GGT (from 90.62 ± 56.65 U/l to 67.67 ± 57.00 U/l), lipopolysaccharide (from 23.19 ± 9.57 to 16.67 ± 4.52 mg/ml) and immunoglobulin A (from 377.13 ± 229.88 to 484.16 ± 290.98 ng/ml) levels were significantly changed when compared to the baseline value. Conclusion: The results of the current study suggested that the consumption of synbiotics significantly improved subjective and objective parameters in high risk alcoholic patients, and further studies are mandatory to reveal the effects of synbiotics on gut health link to central neurological system.

scholarly journals CLINICOETIOLOGICAL EVALUATION OF THE PATIENTS OF MACROCYTIC ANEMIA PRESENTING AT A TERTIARY CARE CENTRE IN KUMAON REGION OF UTRRAKHAND

2021 ◽  
pp. 11-14
Author(s):  
Harish Chandra Arya ◽  
Ashok Kumar
Keyword(s):  
Bone Marrow ◽  
Vitamin B12 ◽  
Tertiary Care ◽  
Macrocytic Anemia ◽  
Clinical Manifestations ◽  
Cobalamin Deficiency ◽  
Dietary Habit ◽  
Thyroid Disorder ◽  
Care Centre ◽  
Tertiary Care Centre

INTRODUCTION: Macrocytosis is common in various clinical settings and it is found in approximately 1.7– 3.6% of people admitted for care for any cause [1, 2, 3]. Macrocytic anemia is generally classified as megaloblastic or nonmegaloblastic anemia. The causes of macrocytosis fall into two groups: (a) deficiency of vitamin B12 (cobalamin) or folate (or rarely abnormalities of their metabolism) in which the bone marrow is megaloblastic and (b) other causes,in which the bone marrow is usually normoblastic.A high level of suspicion,proper elicitation of the history and thorough examination and investigation of the patient helps in the diagnosis of macrocytic anemia. AIM AND OBJECTIVES: To evaluate the etiology of macrocytic anemia at a tertiary care centre. To determine the etiology of macrocytic anemia.To evaluate clinical manifestations associated with macrocytic anemia. MATERIAL AND METHOD: This 21 month Cross sectional observational study was carried out in OPD/IPD Department of Medicine, Government Medical College Haldwani (Uttarakhand). Full clinical examination and information regarding alcohol intake, dietary habit, drug intake, thyroid disorder and other comorbid illnesses was obtained.All patients were investigated with a completeHaemogramLiver function tests Serum TSH fasting vitamin B12 was measured Ultrasound as and when required. RESULT: In this study106 patients were taken 58 (45.3% ) were male and 48(54.7%) were females. Mean age was 44.83+16.85 years.Hemoglobin and MCV was in the range of 6.42 ± 2.09,(108.24 ± 7.10) respectively .The majority of patient,28 (52.83%) had vit B12 level in the range of 101 – 200 pg/ml,The majority of patients,44 (41.1%) had LDH level in the range of 281 – 1000 IU/L . CONCLUSION: In this study, there was a preponderance of young people.Vegetarians were most susceptible to MA especially cobalamin deficiency. Nutritional deficiency was the most common cause of MA, followed by alcohol and alcoholic liver disease.Data regarding the magnitude of the problem in different parts of India and the factors that might influence its incidence were lacking. Macrocytic anemia must be considered in the differential diagnosis of patients presenting with pyrexia of unknown origin,mild icterus or pancytopenia.

scholarly journals Clinical profile and seroepidemiology of scrub typhus and its concurrent infections associated with other tropical fevers: a two-year study from a tertiary care centre in North India

2020 ◽  
Vol 7 (11) ◽  
pp. 4440
Author(s):  
Monika Matlani ◽  
Supriya Maheshwari ◽  
Neha Dubey ◽  
Shyam S. Mina ◽  
Vinita Dogra
Keyword(s):  
Clinical Presentation ◽  
Scrub Typhus ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Clinical Profile ◽  
North India ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Igm Elisa ◽  
Concurrent Infections

Background: The study showed epidemiological aspects, clinical profile and laboratory features of patients presenting with scrub typhus alone and scrub typhus along with concurrent infections namely typhoid, malaria, leptospira, chikungunya and dengue.Methods: A total of 383 suspected cases of Scrub typhus were tested by IgM ELISA from January 2017 to October 2018. Appropriates tests were performed to determine the coinfections of scrub typhus with dengue, chikungunya, malaria, leptospirosis and typhoid fever.Results: Of the 383 samples received, 68 were positive for scrub typhus. Commonest clinical manifestations were fever, shortness of breath, myalgia, headache and jaundice. Maximum number of co infection cases were observed along with dengue.Conclusions: With the rapidly changing epidemiology of scrub typhus, it is very important to become familiar with its clinical presentation when presenting alone and as a concurrent infection with other acute febrile infections. 

Clinical spectrum of yellow phosphorous poisoning in a tertiary care centre in South India: a case series

2016 ◽  
Vol 47 (3) ◽  
pp. 245-249 ◽  
Author(s):  
Ajay Kumar Mishra ◽  
Nathaniel Samson Devakiruba ◽  
Sudha Jasmine ◽  
Sowmya Sathyendra ◽  
Anand Zachariah ◽  
...  
Keyword(s):  
South India ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Case Series ◽  
Supportive Therapy ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Phosphorus Poisoning ◽  
Yellow Phosphorus ◽  
Physician Awareness

Rodenticides such as yellow phosphorus are highly toxic compounds which are commonly used for pest control. Reports of yellow phosphorus poisoning from tropical nations is scanty. In this retrospective study, we report the clinical features, mortality and predictors of mortality among nine patients at a tertiary care centre in south India. Yellow phosphorus consumption was common among a younger age group of patients. The mean duration of presentation after consumption was five days. The most common clinical manifestations seen were abdominal pain and vomiting followed by a depressed sensorium. Features of acute liver failure including coagulopathy were seen in all patients. Despite all patients receiving supportive therapy, a poor outcome or death resulted in the majority. Early referral to a tertiary care centre, meticulous monitoring and supportive measures are key elements of patient management as there are no specific antidotes available at present. Increase in public and physician awareness to the toxin and implementation of preventive policies is of utmost importance.

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