RESUMO
Alcohol use disorder (AUD) is a significant public health problem across all regions of the world. Overall evidence regarding outcomes is available from western regions. Detoxification is one of the first steps in treating AUDs. The following case note review looks at community detoxification outcomes in a naturalistic setting. We looked at 100 clients with domiciliary detoxification. We found only 35% had a favorable outcome (follow up as advised) while 65% had unfavorable outcomes (lost to follow up or required admission). Trends of higher alcohol use (units/day) were seen in the unfavorable group. We also found that having a medical co-morbidity was associated with unfavorable outcome. In resource poor setting like our country there is a need to look at ways to enhance home detoxification programs; use of technology and supervised monitoring could probably improve the outcomes.
Assuntos
Transtornos Induzidos por Álcool , Serviços de Assistência Domiciliar , Síndrome de Abstinência a Substâncias/prevenção & controle , Adulto , Transtornos Induzidos por Álcool/epidemiologia , Transtornos Induzidos por Álcool/terapia , Terapia Comportamental , Comorbidade , Hospitalização , Humanos , Índia/epidemiologia , Masculino , Resultado do TratamentoRESUMO
Volatile substance dependence is a relatively rare form of substance use disorders. It is predominantly noted in the adolescent age group. Higher prevalence is also seen in individuals from the lower socio-economic strata. These agents induce a rapid mood change by altering the levels of central neurotransmitters. Here we present a unique case of volatile substance dependence in a middle aged female with iron deficiency anemia. We managed this with the SSRIs and parenteral iron preparations which led to recovery. This emphasizes the fact that any treatment regimen must address all the factors, co-morbidities and patient characteristics for complete recovery.
Assuntos
Administração por Inalação , Depressão , Querosene/efeitos adversos , Petróleo/efeitos adversos , Transtornos Relacionados ao Uso de Substâncias , Anemia Ferropriva/sangue , Anemia Ferropriva/tratamento farmacológico , Comorbidade , Depressão/diagnóstico , Depressão/tratamento farmacológico , Fadiga/etiologia , Feminino , Humanos , Infusões Parenterais , Ferro/uso terapêutico , Pessoa de Meia-Idade , Prevalência , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/etiologiaRESUMO
Marchiafava - Bignami disease is rare sequelae of chronic alcohol use. We present a case with transient ischemic attack like presentation and its management with parenteral thiamine. A 53 year old male with history of country liquor use since 32 years was brought to hospital with acute onset of delirium & mild weakness involving motor functions of left side of the body, non-reactive planters and exaggerated tendon reflexes on left side. The MRI showed bilateral hyper intense signal on T2W and FLAIR images & Hypo intense lesion on T1W images involving body, genu and splenium of corpus callosum. The features are suggestive of Marchiafava - Bignami Disease. There have been few guidelines for management of MBD and literature supports use of parenteral thiamine 500mg leading to remission of symptoms and symptomatic improvement. It is advisable to use parenteral thiamine in all cases as it overlaps management of other co-morbidities of chronic alcoholism.
