ABSTRACT
Background: Alcohol dependence is a global public health issue; it is a chronic and relapsing illness. Relapse is multifaceted by both neurobiological and psychosocial processes. The aim of the study was to examine the expressed emotions and coping among persons with alcohol dependence. Methodology: The study was descriptive and hospital-based. A purposive sampling technique was used. This study was conducted at the Centre for Addiction Psychiatry, CIP, Ranchi. The total sample size was 50. Twenty-five persons with alcohol dependence who relapsed within six months following treatment formed a study group. Another 25 persons with alcohol dependence who were abstinent for a minimum period of six months after treatment formed a comparative group. Ways of Coping Questionnaire and the Level of expressed emotions Scale were used, and informed consent was taken from the participants. Chi- square and independent sample 't' test, Pearson's correlation was used to analyse the data. Results: Mean age of relapsed patients was 35.3 years (S.D±7.6), and abstinent patients were 35.4 yrs. (S.D±6.8), years of education of relapsed patients was 12 yrs. ±2.63 and 11.6 yrs. ±3.26 in abstinent patients. A majority (60%) of relapsed patients were from rural background, 92% in the abstinent group were employed. 60% of abstinent patients had a family history of alcohol dependence. Abstinent patients had scored significantly high in all the domains of ways of coping. Relapsed patients had higher scores in perceived lack of emotional support, perceived irritability, perceived intrusiveness, and perceived criticism compared to abstinent patients Conclusion: The study provided further evidence that coping and perceived expressed emotions significantly influenced relapse among persons with alcohol dependence.
ABSTRACT
Subclinical hypothyroidism or mild thyroid failure is a familiar problem, with a prevalence of 3-15% in a population without any known overt thyroid disorder. The prevalence increases with age and is relatively higher among females. Subclinical hypothyroidism is defined as serum thyroid stimulating hormone (TSH) levels above the upper limit of normal (4 mU/L) while the triiodothyronine (T3) and thyroxine (T4) enduring within the normal range. Additionally, there exists a log-linear relationship between TSH and circulating T3 and T4; hence, measurement of serum TSH becomes mandatory for diagnosing mild thyroid failure when free T3and T4 are lying within normal limits. Though, autoimmune thyroid disease is the most common cause for elevated TSH; thyroid functions can be afflicted by long-term consumption of drugs like lithium, amiodarone. The causal relationship between benzodiazepine class of drugs, particularly clonazepam and subclinical hypothyroidism has never been established clinically, yet there are some pre-clinical studies to claim the effect of benzodiazepine on thyroid functions; operating at various levels – hypothalamus, thyroid gland, peripheral cells and nuclear receptors. Henceforth, we would like to report a rare occurrence of subclinical hypothyroidism in an elderly female receiving clonazepam for her underlying psychiatric illness.
ABSTRACT
One peek into the history of malaria, shows us that despite many attempts by mankind to counter the development and propagation of malaria, it has always risen back like a ‘phoenix from its ashes’. This has been possible by virtue of the singular ability of the malarial parasite to mutate and evade the actions of various anti-malarial drugs. The emergence of drug resistant malarial parasites by virtue of the various molecular mechanisms, has put the authorities under the cosh and forced the scientists to start generating newer and better anti-malarial drugs. In this review, we have dwelt upon the various molecular mechanisms which have allowed the malaria parasite to develop resistance, as it can serve to educate the scientists in their effort to generate newer anti-malarials.