Comparative Efficacy Of Baclofen And Topiramate In Alcohol Dependence Syndrome: A 3 Months Follow Up Study

Objective: Craving plays significant role in relapse in patients with alcohol dependence syndrome. Baclofen and topirmate are effective in reduction of craving and maintenance of abstinence in various placebo controlled trials. Method:It is a retrospective study of patients of alcohol dependence who were admitted in de-addiction ward from January- December 2013. Case record files of patient who completed detoxification and were prescribed either baclofen or topiramate were taken out and analyzed after applying coding plan. Results: A total of 68 patients fulfilled the inclusion criteria, 40 in baclofen group and 28 in topiramte group. Mean age was 38 years in baclofen group and 41 years in topiramate group. Majority of the patients in both the groups were married and employed. Majority of the patients in both the groups had duration of alcohol dependence between 5-10 years. 32.5 % patients in baclofen group did not report craving at 3 months against 14.2% in topiramte group and 47.5% patients in baclofen group remained abstinent at 3 months against 28.5% in topiramate group. Conclusion: Both baclofen and topiramate are effective in reduction of craving and maintaining abstinence in patients with alcohol dependence syndrome and baclofen fared better than topiramate.

Effect Of Risperidone And Clozapine On Executive Functions In First Episode Schizophrenia

Aims:To compare the effect of risperidone and cloazpine on executive functioning in treatment naïve first episode schizophrenia. Methods: A total of 55 treatment naïve first episode patients of schizophrenia as per ICD-10 criteria, were enrolled for the study. Baseline assessment for executive functioning was carried out with TMT- A& B. Clozapine and risperidone were used in the range of 200-600mg/ day and 4- 8 mg/day respectively for 6 months. Results: There was significant improvement in executive functioning in both the groups and the results were statistically significant for clozapine on TMT-B. Conclusion: The findings of current study show that both risperidone and clozapine lead to improvement in executive functioning in first episode of schizophrenia and clozapine fared better than risperidone.

Impact of smoke-free law on tobacco consumption in Chandigarh: A community-based study.

Background and Objectives: Tobacco use is a major public health issue today and it is expected that 650 million smokers will die prematurely due to tobacco use. On 15 July 2007, Chandigarh became the first city to go smoke-free. However, there is no data on the impact of smoke-free law. The objective of the present study was therefore to study the pattern and prevalence of tobacco use and to examine the impact of smoke-free law in Chandigarh. Materials and Methods: Total sample comprised of 3000 subjects. Socio-demographic data sheet along with initial two questions from the General questionnaire were administered on each individual. In addition, all the tobacco users underwent administration of the Fagerstrom test for nicotine dependence or the Fagerstrom test for smokeless tobacco (smokeless tobacco users). Results: There were 43.9% tobacco users in the sample of 3000 subjects. Out of these tobacco users, 357 (11.9%) were pure smokers and 370 (12.3%) were using smokeless tobacco and 590 (19.6%) used both. The mean number of cigarettes/bidis smoked per day was 14 (+8.64) and the mean age of starting smoking was 19.41 (SD + 4.5 years).73.2% of population was aware about implementation of smoke-free law and all the participants (100%) reported smoking in public places. 43.4% smokers reported thoughts of quitting nicotine. Interpretation and Conclusion: Although the prevalence of tobacco use in Chandigarh is lower than the national average but the rates are still alarming and need attention. The findings of this study will help in designing tobacco control strategies and understanding the epidemiology of tobacco related health burden.

Electroconvulsive Therapy for Migraine.

Till date, there have been no reports on the use of electroconvulsive therapy in treatment of migraine. We report a 43-year-old man who was given a course of modified ECTs for severe depression. The patient developed this depression secondarily to his long-standing, medication refractory migraine. After the course of ECT, successful migraine relief was achieved. The patient has since been headache free for a reasonably long period of time. ECT can show promise as a powerful new method of migraine treatment.

Pseudologia Fantastica.

Pseudologia Fantastica is a disorder wherein the person tells lies incessantly. It is usually encountered in forensic practice in those accused of fraud, swindling, making false accusations or false confessions. Their lies are mostly aimed at attracting notice and inflating their importance, in contrast to carefully planned typical frauds. A case presenting with features of Pseudologia Fantastica is described. Although this patient had no legal problems because of his lying habits, he had most of the features of Pseudologia Fantastica. He has shown good response with combined pharmacotherapy and behaviour therapy. As these patients are at high risk of committing various types of frauds, it is very important to diagnose such patients at an early stage so that legal implications of this disorder can be avoided.

Alcohol Dependence Syndrome: One year outcome study.

The major challenge in the treatment of patients with substance use disorders is not only to maintain the follow up but also to prevent relapse. The current study was planned to see the abstinence and relapse rate in patients with Alcohol Dependence Syndrome over a period of one year. A total of 49 patients of alcohol dependence syndrome fulfilling ICD-10 criteria were included in the study. The mean age was 43 years, majority were above 30 years, males (97.9%), employed (81.6%), and from urban (81.6%) background. the mean duration of dependence was 4.3 years, 12.2% had a family history of dependence, 20.4% had a co-morbid affective disorder and 4.0% had a co-morbid non-affective disorder. In total 71.4% received pharmacologist treatment for relapse prevention. At 6 months, abstinence rates were 100% (n = 10/ 10) for disulfiram, 60% (n=6/10) for anticraving agents (Naltrexone and Acamprosate), 30% (n=3/10) for SSRI group. At 12 months, abstinence rates were 66.67% (n=2/3) for disulfiram, 42.9% (n=3/7) for anticraving agents, 0% (n=2) for SSRI group.