A 33yr old male , who is shopkeeper by occupation
C/O •alcohol consumption since 10 years (360 ml whisky per day)
• Tobacco consumption since 10 years (2 judebail per day)
Patient was apparently asymptomatic 10 years back then he started consuming whisky 90 ml per day and gradually increased to 360 ml per day. Financial stressors present, eye openers present. Patient experiences sleep disturbance, tremors, fear, palpitation when not consuming alcohol. Patient is aware about harmful effects of alcohol but consuming despite of awareness. Patient started having judebail 10 years back half back per day and increase it to two packs per day. Patient experience is headache irritability and not consuming judebail. Patient is aware about harmful effects of judebail , but consuming it despite awareness.
History of seizures episode one day after stopping alcohol 2 episodes till now- 6 months and one month ago.
Associated with loss of consciousness tonic and clonic movements of upper limb and lower limb, uprolling of eyeBall
History of occasional loss of interest, decreased appetite death wishes at times.
No history of head injury, any other substance use, flight of ideas,grandiosity
K/C/O Chronic pancreatitis diagnosed 1 year ago ( on Tab.Pancreatin and Tab.levosulpride)
PERSONAL HISTORY:-
Diet - mixed
Appetite- lost
Sleep- inadequate
Bowel and bladder movements- Regular
Addictions-
•Alcohol consumption since 10 years- Daily 360ml whisky
•Tobacco chewing- since 10 years
GENERAL EXAMINATION:
Pt is conscious,coherent,cooperative
Height -168cms
Weight - 72kgs
Bp-120/80 mmHg
Pr-82bpm
Temp -98.5°F
SpO2- 99%@RA
TREATMENT:
1.TAB.LIBRIUM 25mg
1—1—2 for 3 days
↓
1—x—2 for 3 days
↓
x—x—2 for 3 days
2. Tab.baclofen xl po/bd
3.Tab.nodict 50mg po/bd
4.Tab.benfomet plus po/od
5.Tab.Mecupan 40mg po/od
6.Tab.pregaba M 75mg po/od
7.Tab.Propranolol 20mg po/od
8.Nicotex gums 2mg sos
From 1/5/22,stopped taking Tab.sizodone
Present Treatment:
1.Tab.Baclofen xl 20mg po/od
2.Tab.nodict 50mg po/od
3.Tab.Mecupan 40mg Sos
4.Tab.pregabalin M 75mg po/od
5.Protein x powder 2tsp
6.Tab.Telmisartan 20mg po/od
7.Tab.Lasix
1(40mg)—x—1(20mg)
8.Nicotex gums 2mg
1—x—x
On 25/3/22,
Patient c/o suspicion that other patients are consuming alcohol
Hearing of voices of friends
Suspicion that other patients might harm him
Then started Tab.SIZODON PLUS PO/OD
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