scholarly journals Pattern of alcohol withdrawal syndrome and its clinical correlates

Biomedicine ◽  
2021 ◽  
Vol 41 (2) ◽  
pp. 278-282
Author(s):  
Ankur Sachdeva ◽  
Vipin Kumar ◽  
S. Aijaz Abbas Rizvi ◽  
Shilpa Khullar ◽  
Syed Sibte Akbar Abidi ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Alcohol Withdrawal ◽  
Withdrawal Syndrome ◽  
Care Center ◽  
Demographic Data ◽  
Tertiary Care ◽  
Management Strategies ◽  
Alcohol Withdrawal Syndrome ◽  
North India ◽  
Audit Score

Introduction and Aim: Management strategies of Alcohol Withdrawal Syndrome could be optimized if patients with greater risk are identified early and treated aggressively. Studying the pattern and predictors of alcohol withdrawal syndrome was the main objective of our study.   Materials and Methods: A total of 100 consenting male patients in the age group of 18-60 years diagnosed with alcohol dependence and uncomplicated alcohol withdrawal undergoing in-patient detoxification in tertiary care center in north India were included in the study. A semi structured proforma was used to collect socio-demographic data, Alcohol Use Disorders Identification Test (AUDIT) was used as screening tool and Clinical Institute Withdrawal Assessmentfor Alcohol-revised (CIWA- Ar) was used to assess severity of withdrawal.   Results: Symptoms like difficulty in orientation, seizures and hallucinations were relatively specific for severe AWS, while tremors and anxiety were common to all the patients and were non-specific for predicting severity of AWS. The severity of AWS symptoms correlated significantly with increasing age, duration of alcohol use and AUDIT score.   Conclusion:We concluded that increasing age, longer duration of alcohol use, higher AUDIT score and symptoms related to hallucinations, orientation and seizure are linked to severe alcohol withdrawal. Prior knowledge of these predictors will help to identify the patients at risk of severe alcohol withdrawal so that individual care can be enhanced.

scholarly journals Anticonvulsants for the Treatment of Alcohol Withdrawal Syndrome and Alcohol Use Disorders

CNS Drugs ◽  
2015 ◽  
Vol 29 (4) ◽  
pp. 293-311 ◽  
Author(s):  
Christopher J. Hammond ◽  
Mark J. Niciu ◽  
Shannon Drew ◽  
Albert J. Arias
Keyword(s):  
Alcohol Use ◽  
Alcohol Withdrawal ◽  
Withdrawal Syndrome ◽  
Alcohol Use Disorders ◽  
Alcohol Withdrawal Syndrome

Thrombocytopenia in Patients Hospitalized for Alcohol Withdrawal Syndrome and Its Associations to Clinical Complications

2019 ◽  
Vol 54 (5) ◽  
pp. 503-509 ◽  
Author(s):  
Andrzej Silczuk ◽  
Bogusław Habrat ◽  
Michał Lew-Starowicz
Keyword(s):  
Risk Factor ◽  
Alcohol Use ◽  
Alcohol Withdrawal ◽  
Withdrawal Syndrome ◽  
Alcohol Withdrawal Syndrome ◽  
Clinical Complications ◽  
The Relationship

The association of thrombocytopenia (TP) and alcohol use has been demonstrated. Also TP as possible risk factor for alcohol withdrawal complications (cAWS) have been reported. In this study, the relationship between the presence of TP and cAWS was clearly established and assessed below what platelets count (<119k/mL) this risk increases.

scholarly journals The effect of alcohol withdrawal syndrome severity on sleep, brain and cognition

2020 ◽  
Vol 2 (2) ◽  
Author(s):  
Alice Laniepce ◽  
Nicolas Cabé ◽  
Claire André ◽  
Françoise Bertran ◽  
Céline Boudehent ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Sleep Quality ◽  
Alcohol Withdrawal ◽  
Withdrawal Syndrome ◽  
Alcohol Use Disorder ◽  
Grey Matter ◽  
Short Term Memory ◽  
Alcohol Withdrawal Syndrome ◽  
Healthy Controls ◽  
Sleep Alterations

Abstract In alcohol use disorder, drinking cessation is frequently associated with an alcohol withdrawal syndrome. Early in abstinence (within the first 2 months after drinking cessation), when patients do not exhibit physical signs of alcohol withdrawal syndrome anymore (such as nausea, tremor or anxiety), studies report various brain, sleep and cognitive alterations, highly heterogeneous from one patient to another. While the acute neurotoxicity of alcohol withdrawal syndrome is well-known, its contribution to structural brain alterations, sleep disturbances and neuropsychological deficits observed early in abstinence has never been investigated and is addressed in this study. We included 54 alcohol use disorder patients early in abstinence (from 4 to 21 days of sobriety) and 50 healthy controls. When acute physical signs of alcohol withdrawal syndrome were no longer present, patients performed a detailed neuropsychological assessment, a T1-weighted MRI and a polysomnography for a subgroup of patients. According to the severity of the clinical symptoms collected during the acute withdrawal period, patients were subsequently classified as mild alcohol withdrawal syndrome (mild-AWS) patients (Cushman score ≤ 4, no benzodiazepine prescription, N = 17) or moderate alcohol withdrawal syndrome (moderate-AWS) patients (Cushman score &gt; 4, benzodiazepine prescription, N = 37). Patients with severe withdrawal complications (delirium tremens or seizures) were not included. Mild-AWS patients presented similar grey matter volume and sleep quality as healthy controls, but lower processing speed and episodic memory performance. Compared to healthy controls, moderate-AWS patients presented non-rapid eye movement sleep alterations, widespread grey matter shrinkage and lower performance for all the cognitive domains assessed (processing speed, short-term memory, executive functions and episodic memory). Moderate-AWS patients presented a lower percentage of slow-wave sleep, grey matter atrophy in fronto-insular and thalamus/hypothalamus regions, and lower short-term memory and executive performance than mild-AWS patients. Mediation analyses revealed both direct and indirect (via fronto-insular and thalamus/hypothalamus atrophy) relationships between poor sleep quality and cognitive performance. Alcohol withdrawal syndrome severity, which reflects neurotoxic hyperglutamatergic activity, should be considered as a critical factor for the development of non-rapid eye movement sleep alterations, fronto-insular atrophy and executive impairments in recently detoxified alcohol use disorder patients. The glutamatergic activity is involved in sleep-wake circuits and may thus contribute to molecular mechanisms underlying alcohol-related brain damage, resulting in cognitive deficits. Alcohol withdrawal syndrome severity and sleep quality deserve special attention for a better understanding and treatment of brain and cognitive alterations observed early in abstinence, and ultimately for more efficient relapse prevention strategies.

scholarly journals Gastrointestinal duplication cysts: experience from a tertiary care center in North India and review of literature

2020 ◽  
Vol 8 (1) ◽  
pp. 180
Author(s):  
Divya Aggarwal ◽  
Kim Vaiphei
Keyword(s):  
Congenital Malformations ◽  
Clinical Presentation ◽  
Care Center ◽  
Demographic Data ◽  
Tertiary Care ◽  
Case Series ◽  
North India ◽  
Male Predominance ◽  
High Index Of Suspicion ◽  
Age Range

Background: Duplication cysts (DC) are uncommon congenital malformations which predominantly present in infants and young children. Owing to their variable clinical presentation, radiology and/or histopathology are often required to clinch the diagnosis. We present a case series of 66 patients, which is the largest series reported so far.Methods: A search of prospectively maintained institutional database was carried out to identify patients who were diagnosed and operated for gastrointestinal DC between January 2013 and August 2018. For all cases, the demographic data, site of DC, details of clinical presentation, associated conditions and histopathology findings were recorded. The slides of all cases were retrieved and re-examined.Results: The age range was 1 day to 47 years, with a slight male predominance (1.3:1). Ileum was the most common site followed by jejunum. Ectopic mucosae noted were gastric, pancreatic, biliary and respiratory. One case showed glial heterotopia. Perforation, gangrene and intussusception were among the co-existing pathologies noted.Conclusions: Duplication cysts are rare congenital malformations. The variability in clinical presentation makes the diagnosis elusive. Timely diagnosis and appropriate management require a high index of suspicion and a holistic diagnostic approach with clinical, radiological and histopathological inputs. 

Treatment of the Acute Alcohol-Withdrawal Syndrome

1958 ◽  
Vol 19 (1) ◽  
pp. 118-124 ◽  
Author(s):  
Lincoln Godfrey ◽  
Martin D. Kissen ◽  
Thomas M. Downs
Keyword(s):  
Alcohol Withdrawal ◽  
Withdrawal Syndrome ◽  
Alcohol Withdrawal Syndrome

Evaluation of Various Diagnostic Techniques for the Diagnosis of Pulmonary and Extra Pulmonary Tuberculosis at a Tertiary Care Center in North India

2020 ◽  
Vol 20 (4) ◽  
pp. 433-439
Author(s):  
Monika Rajani ◽  
Molay Banerjee
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Diagnostic System ◽  
Diagnostic Techniques ◽  
Automated System ◽  
North India ◽  
Mortality And Morbidity ◽  
Indicator Tube ◽  
Extra Pulmonary ◽  
Uv Lamp

Introduction: Tuberculosis (TB) is a one of the main causes of mortality and morbidity worldwide. Bactec MGIT (Mycobacteria Growth Indicator Tube) system is a rapid, reliable automated system for early diagnosis of pulmonary and extra pulmonary TB in setups where purchase of expensive instruments is not possible. The present study was thus carried out to evaluate AFB microscopy, culture on Lowenstein Jensen media and micro MGIT system for early and accurate diagnosis of Tuberculosis. Methods: A total of 280 samples were processed for direct AFB smear examination, and culture on micro MGIT and LJ media. The identification of Mycobacterium tuberculosis complex in positive cultures was done by MPT64 Ag card test (BD MGIT TBC Identification Test). Results: Out of the processed samples, (47.1%) 132/280 were positive for Mycobacterium spp by Micro MGIT, (35%) 98/280 on LJ medium and (25.7%) 72/280 by AFB smear. A total of (48.5%) 136 samples were positive by a combination of Micro MGIT and LJ medium. Among the total positive samples (136/280), Micro MGIT was found to be positive in 97% (132/136) of samples, LJ was positive in 72% (98/136), while 52.9% (72/136) were positive by AFB smear. Conclusion: Manual MGIT System is a simple and efficient, safe to use the diagnostic system. It does not require any expensive/special instrumentation other than the UV lamp for the detection of fluorescence. In areas with limited resources where the purchase of expensive instruments such as the MGIT 960 is out of scope, the use of manual MGIT for rapid susceptibility testing for MDR-TB could be an option. We would recommend testing MGIT 960 using first and secondline drugs to determine DST.

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