A32 year old male with alcohol dependence syndrome and Tobacco dependence syndrome


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A 32 year old male came to the opd with complaints of 
-Alcohol consumption since 6 years (540ml whiskey)
(Last consumption 180ml whiskey on 30/03/22)
-tobacco consumption since 6 years(6 packs gutka /day &1 cigarette /week)

ALCOHOL-
Cravings+
Tobacco + -Due to peer pressure and family stressors
Patient started consuming whiskey 90ml /day gradually increased it ti 540ml /day
Withdrawals+
Patient experiences sleep disturbances,palpitations when not consuming alcohol
Harmful use + Patient is aware of harmful effect of alcohol
Loss of control
Loss of interest in other pleasurable activities Patient is giving more importance to alcohol
TOBACCO-
Cravings+
Patient started chewing gutka 1pack/day,increased it to 6 packs/day in 6 years
Withdrawal +
Harmful use+
H/o use of ? tab .disulfuram 9months back for 3 days and stopped
No h/o seizures,blood in stools,RTA,persistent low mood ,suspicions,grandiosity
No h/o DM,HTN,BA,EPILEPSY, TB

GENERAL EXAMINATION -
Patient is Conscious, coherent,co operative well oriented to time,place,person
No pallor, No icterus, No Cyanosis, No lymphadenopathy, No edema


VITALS-
Height -176cm
Weight-72kgs
Temperature -98.6F
Pulse rate- 84bpm
Blood pressure-120/80mm hg
Respiratory rate -16cpm

SYSTEMATIC EXAMINATION:

CARDIOVASCULAR SYSTEM:
S1,S2 heard, NO Murmurs 

RESPIRATORY SYSTEM:
BAE present,NVBS

CENTRAL NERVOUS SYSTEM:
NAD

PER ABDOMEN:Soft, non tender
No guarding, No rigidity 
Bowel sounds present 


PROVISIONAL DIAGNOSIS-
ALCOHOL DEPENDENCE SYNDROME WITH TOBACCO DEPENDENCE SYNDROME 

INVESTIGATIONS 

CBP-
Hb-14.4gm/dl
Tlc-6,600 cells/cumm
Plt-2.48lakhs/cumm
Smear-NC/NC

 LFT:

TB :1.67mg/dl

DB:0.45mg/dl

SGOT :24IU/L

SGPT:15IU/L

ALP: 194IU/L

TP:6.7gm/dl

ALBUMIN-4.6gm/dl

A/G-2.19

RFT-

Creatinine-0.7mg/dl

Urea-25mg/dl

Uric acid 7.2mg/dl

Na+:143meq/L

K+:4.5meq/L

Cl-:99meq/L


RBS-108mg/dl

TREATMENT-

1.TAB LIBRIUM 25mg PO 1-x-2

2.TAB BENXL PO/OD @2pm

3.TAB BACFEN XL 20mg PO/BD 1-x-1

4.NICOTEX GUMS 4 mg PO/TID 1-1-1

5.CAP GASORAB PO/BD 1-×-1

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