Cognitive Deficits And Alcohol Dependence Syndrome – A Paradigm Relationship

@#Objectives: Background- Chronic alcohol use causes not only physical consequences but causes cognitive deficits also. 50 and 80% of the Alcohol dependent syndrome patients present with cognitive deficits. These cognitive deficits will significantly contribute to poor functional outcomes which lead to reduced health related quality of life. Objectives- To assess Cognitive deficits in Alcohol Dependent syndrome (ADS). To find the relationship between early onset of alcohol use, duration of Alcohol use and large quantity of alcohol use with Cognitive deficit pattern. MethodA cross sectional study was done on 38 patients with ADS, aged 18- 45 years, education ≥7th std, with no major psychiatric or medical co- morbidities. AUDIT scale was administered to look for dependence pattern, CIWA scale was applied to look for withdrawal symptoms. MoCA scale was applied to screen for cognitive impairment in patient with MMSE score (25 and above). In subjects with cognitive impairment on MoCA scale (25 and below), neuropsychological assessment was done using neuropsychological battery of test from NIMHANS Neuropsych battery standardised on Indian Population. Results- There was impairment in the Cognitive domains as follows, speed of processing (BACS - 100%), attention (DF- 97%) working memory (DF-97%, DB-100%, LNS - 84%), visual memory (100%), visuospatial memory (78%), executive functions (CT2 -92%), reasoning and problem solving (maze- 81%) in majority and a significant relation between early onset of alcohol use, duration of Alcohol use. Conclusions- There is a significant impairment in the areas of speed of processing, attention, executive functions, reasoning and problem solving domains. Significant association between Age of onset of ADS (Early onset) with Executive functions. Attention domain was found to be associated with longer duration of alcohol intake, whereas working memory deficits was associated with large quantity of alcohol intake.

Adolescent's Perception about the Introduction of New Cigarette Packaging and Plain Packaging of Cigarette Packs: A Qualitative Study.

INTRODUCTION: Larger health warning labels on cigarette packages were introduced in India in 2016 to more clearly inform consumers about the health risks associated with tobacco use. The aim of this study was to know the adolescent's perception on the introduction of new cigarette packaging and plain packaging of cigarette packs. METHODOLOGY: A qualitative study was carried out among adolescents aged 16-19 years. Eighteen participants were selected using purposive sampling technique. Three focus group discussions with thefirst group consisting of 6 smokers and the second and third groups consisted of 6 quit smokers and 6 nonsmokers were conducted. The data were later transcribed and analyzed using grounded theory approach. RESULTS: Nearly all participants were aware of tobacco products, brand names, colors, and pictorial warnings on tobacco products. While the nonsmokers perceived fear was greater regarding warning and the pictorial messages, the current smoker's perceptions were unaffected by fear appeals. Almost all participants reported that new cigarette warning labels were more visible, informative, and scarier than the older ones. CONCLUSION: Positive impact of warning labels was seen among nonsmokers and few quit smokers whereas the current smoker's perceptions were unaffected.

Psychological morbidity among female commercial sex workers with alcohol and drug abuse.

INTRODUCTION: Substance abuse may act as precursors and also can form outcomes of sexual behaviors. The confluence of drug use, mental stressors, poverty, sexually transmitted diseases, low self-esteem and high-risk partners forms a fertile ground for psychological morbidity. AIM: To assess the psychological morbidity among female commercial sex workers (CSWs) who use alcohol and other substance abuse. MATERIALS AND METHODS: One hundred consecutive CSWs with alcohol and drug abuse patients attending the psychiatric OPD at Victoria hospital were assessed clinically. Relevant investigations were also carried out. General health questionnaire and substance use disorder identification tests were administered. RESULTS: A total of 100 cases between 30-40 years of age were taken up for the study. All were abusing alcohol with tobacco chewing or smoking being (64). Eighty-seven were married. Fifty of them being illiterate. Seventy-eight were suffering from physical illness. Two were HIV patient on treatment. Seventy-eight were having psychological morbidity (depression and adjustment disorder). CONCLUSION: Preventive interventions, targeting substance abuse and stimulating healthier-environments and providing economically independent.

Transscleral diode laser cycloablation in patients with good vision.

PURPOSE: To investigate the effect of diode laser cyclophotocoagulation for glaucoma on central visual function in patients with good visual acuity (VA). PATIENTS AND METHODS: Patients with preoperative VA 20/60 or better who had undergone cyclodiode treatment according to a standard protocol were evaluated retrospectively. The primary outcome variable was a recorded loss of two or more Snellen lines of best corrected VA during follow-up. Successful intraocular pressure (IOP) control was defined as being between 6 and 21 mmHg inclusive without oral acetazolamide or other glaucoma surgery. RESULTS: 49 eyes of 43 patients with a median pretreatment acuity of 20/30 were included (range 20/16-20/60). After a mean duration of follow-up of 5.0 years, median VA was 20/60 with a line loss of two or more recorded in 15 eyes (30.6%) (mean survival time 7.7 years). 67.3% (33/49) retained VA 20/60 or better, but VA deteriorated by one Snellen line or more in 31 (63.2%), and in 16.3% (8/49), final VA was <20/200. In cases experiencing a two-line loss in acuity, the main causes were glaucoma progression (nine cases) and macula oedema (four cases). Visual loss was unrelated to total treatment dose (mean 99.7 J), initial acuity or initial IOP level. IOP was controlled at final follow-up in 39/49 (79.6%) with no cases of hypotony. CONCLUSIONS: Most of these eyes with difficult to manage glaucoma retained their good VA over long-term follow-up after undergoing diode laser cyclophotocoagulation. The proportion losing two Snellen lines is in line with that reported after trabeculectomy or tube surgery. These results suggest a possible role for the use of transscleral cyclodiode in selected eyes with significant visual potential. Further controlled prospective studies are required to better define this role.

Design, in vitro and in vivo evaluation of glipizide Eudragit microparticles.

Glipizide microparticles made with Eudragit (RS 100 and RL 100), prepared by emulsion solvent evaporation technique were evaluated for various in-vitro properties viz. encapsulation efficiency, particle size and surface morphology, drug release pattern and in-vivo hypoglycaemic activity. The optimized formulation parameters were used to prepare smooth and spherical microparticles (2-32 microm) with higher entrapment efficiency (67-89%). Drug release patterns of glipizide microparticles of Eudragit RS 100 and Eudragit RL 100 with drug-to-polymer ratio of 1 : 4 (i.e. EGM14 and ELGM14) have shown gradual and extended release for 24 h with cumulative release of glipizide to the extent of 72.3% and 83.9%, respectively. However, EGM14 showed a significant in-vivo hypoglycaemic effect up to 12 h in rabbits while ELGM14 showed for 9 h. Hence, glipizide microparticles of Eudragit RS 100 (glipizide: polymer 1 : 4) is better suited for oral sustained release formulation.

Psychiatric rehabilitation.

Psychiatric rehabilitation is an important component in the management of the mentally ill. This article presents a selective review of the publications in this journal. Questions addressed in this review range from assessment of rehabilitation needs to different rehabilitative approaches. Although the number of publications providing the answers is meager, there are innovative initiatives. There is a need for mental health professionals to publish the models they follow across the country.

Evaluation of the hemodynamic effects of interpleural bupivacaine in dogs.

The hemodynamic effects of interpleural (IP) bupivacaine were studied in six halothane-anesthetized dogs. On four separate occasions, each dog received IP saline (S), or bupivacaine at a low dosage of 1.5 mg/kg (L), high dosage of 3.0 mg/kg (H), or high dosage of 3.0 mg/kg with epinephrine 5 micrograms/mL (HE). Heart rate, systolic and mean arterial pressures, and base excess were significantly lower in the H dosage group than in the other treatment groups. Cardiac output, expressed as a percentage of change from baseline, was significantly higher in the L group than in the H and S groups. Pulmonary arterial pressure and respiratory rate were significantly higher in the HE group than in the other three groups. Mean plasma concentrations of bupivacaine peaked between 5 and 15 minutes after IP injection. Maximum plasma concentrations in individual dogs were variable; however, mean maximum plasma concentrations in the H and HE groups were not significantly different. Clinically significant hypotension occurred in one dog in the H group and in one dog in the HE group. No pulmonary complications were detected.