alcohol

Drug addiction remains a major health concern following its devastating consequences to the users and the economy. Current statistics show a rising trend in substance abuse around the globe with approximately 284 million people engaging in drug abuse. Various approaches are used to treat the victims of drug abuse. Cognitive behavior therapy, a form of nonpharmacological intervention, has also been shown to be an effective treatment option for drug addiction. The use of Cognitive Behavioral Therapy (CBT) has grown since the 1970s to become one of the most important models of psychotherapy in this decade. Various empirical studies have shown the efficacy of CBT in well-controlled trials. A total of 19 randomized trials (cases) (with over 1400 patients treated) were selected and studied. In the various cases, results showed that patients were treated for drug and substance abuse disorders with the majority being those who abused cannabis, cocaine, alcohol and other opioids. In most cases, the CBT techniques that were used for drug addiction included cognitive restructuring, relapse prevention and contingency management. Components of CBT for drug addiction include skills and training, amplification of non-substance-related activities, approaches for managing urges, drug rejection and improvement of social aptitudes. Cognitive restructuring focuses on the identification of misconceptions and influencing the way people think about themselves by eliminating distorted thinking. Relapse prevention focuses on the identification and prevention of high-risk situations that may trigger the patient to engage in drug abuse. Contingency management reinforces positive behaviors and reduces negative behaviors through the use of rewards and incentives.

Aim: This study aimed to investigate the association between sleep quality, as measured by the Pittsburgh Sleep Quality Index (PSQI), and laboratory findings in patients presenting with the complaint of leg pain due to varicose veins.Materials and Methods: A total of 160 patients with leg pain were included in this study. Sleep quality was assessed using the PSQI, and laboratory tests were conducted to evaluate ferritin, iron, vitamin B12, Thyroid Stimulating Hormone (TSH), C-reactive protein (CRP), albumin, low-density lipoprotein (LDL), and hemoglobin levels. Statistical analyses were performed using the independent t-test or Mann-Whitney U test for continuous variables and the chi-square test for categorical variables.Results: Patients with poor sleep quality had a significantly higher prevalence of leg pain complaints compared to those with good sleep quality (p < 0.001). Females were more likely to report poor sleep quality (p = 0.006). No significant associations were found between sleep quality and age, smoking status, alcohol use, or pack/year of smoking. Patients with poor sleep quality had significantly lower ferritin levels (p = 0.008), lower albumin levels (p = 0.031), and lower hemoglobin levels (p = 0.036) compared to patients with good sleep quality. However, no significant differences were observed in other laboratory parameters.Conclusion: The findings suggest a significant association between poor sleep quality and leg pain complaints in patients with varicose veins. Lower ferritin, albumin, and hemoglobin levels in patients with poor sleep quality may indicate potential underlying mechanisms linking sleep quality and leg pain. Addressing sleep quality issues in patients with leg pain could improve overall well-being and treatment outcomes.

Internet addiction is a growing addictive behavior and a major public health problem worldwide. Several psychological factors can contribute to the problematic use of the Internet. This study aimed to determine the prevalence of Internet Addiction (IA) in a sample of university students and to examine the relationship between IA, self-esteem, and attachment styles.The present study was a cross-sectional study, involving 135 students from the Faculty of Medicine of Monastir. The participants completed a questionnaire, which contained the socio-demographic data, the reasons for Internet use, the Young Cyberaddiction scale to seek IA, the Relationships-style-questionnaire-RSQ to assess attachment style, and the Rosenberg Self-Esteem Scale (RSES).The mean age of the students was 21.5 ± 1.9 years old. They were 112 (83%) females. The prevalence of Internet addiction was 23.7%. The average connection time was 3.5 ± 1.8 hours/day. The most frequent online activities were chat (online discussion, forums ...) in 94.8% of cases followed by download activities (78.5%), scientific research (75.6%), online games (23.7%), and online shopping (13.3%). IA was associated with school failure, alcohol use, online gaming, and low self-esteem. The majority of the participants (84.4%) in this study reported an insecure attachment style. Logistic regression analysis showed a strong association between IA and fearful attachment style.IA was frequent among students. Fearful attachment style was found to be a risk factor for IA. This study highlights the impact of relationships between child and their caregivers on the development of addiction.

Rising greenhouse gas emissions have contributed to unprecedented levels of climate change, while microbial conversion and utilization of CO2 is a practical way to reduce emissions and promote green manufacturing. This article mainly summarizes several natural CO2 pathways that have been discovered, including the Calvin cycle, the reduced tricarboxylic acid (rTCA) cycle, the Wood–Ljungdahl (WL) pathway, the 3-hydroxypropionate/4-hydroxybutyrate (HP/HB) cycle, the dicarboxylate/4-hydroxybutyrate (DC/HB) cycle, the 3-hydroxypropionate (3HP) cycle, the reductive glycine (rGly) pathway, and artificially designed carbon fixation pathways includes the CETCH cycle, the MOG pathway, the acetyl-CoA bicycle, and the POAP cycle. We also discussed applications of different carbon fixation enzymes, notably ribulose-1, 5-diphosphate carboxylase/oxygenase, pyruvate carboxylase, carbonic anhydrase, as well as formate dehydrogenase. This paper further addressed the development of photosynthetic autotrophs, chemergic autotrophs and model bacteria Escherichia coli or yeast produced main products for CO2 fixation through metabolic engineering, such as alcohols, organic acids, fatty acids and lipids, bioplastics, terpenoids, hydrocarbons, and biomass.  Future studies on CO2 microbial conversion should focus on improving the efficiency of carbon fixation enzymes, metabolic modules of the carbon sequestration pathway, and intracellular energy utilization. Coupled microbial and electrochemical methods for CO2 fixation, in addition to biological fixation, show considerable promise. 

Objectives: The study’s goals are to evaluate the management of Stroke Mimics (SMs), conditions with stroke-like symptoms but non-vascular origins. It seeks to avoid the unnecessary intravenous thrombolysis, the target therapy delays and determine the best SMs diagnosis approach.Materials and methods: A review was conducted of all patients admitted to the Emergency Department under a “stroke code” from January 1, 2018, to January 31, 2019. Anamnestic and clinical data, along with information on neuroimaging protocols and findings, were collected. Advanced MRI sequences, such as Arterial Spin Labeling (ASL) MR perfusion and MR spectroscopy, were revised to confirm the diagnoses.Results: 513 stroke codes were found; a neurovascular disease was diagnosed in 414 cases: 282 ischemic strokes and 73 intracranial hemorrages and 59 TIAs. The 99 SMs included, 13 infections, 12 syncopes, 11 epileptic seizures, 11 hemodinamic conditions, 10 tumors, 9 metabolic disorders, 9 diziness, 7 migraines, 4 drug/alcohol intoxication, 3 functional disorders, 3 acute hydrocefalus, 2 multiple sclerosis, 2 arteriovenous malformations, 1 spinal cord compression and 2 unexplained conditions. Specific neuroimaging findings were evaluated for all cases. Positive and negative predictive values of clinical diagnosis of SM were respectively 0.23 and 0.35. 125 SM patients underwent MRI examination, 40 of which within 3 hours from the activation of stroke code. Advanced MRI sequences as ASL, MR perfusion, MR spectroscopy were used to reach the correct diagnosis.Conclusions: Advanced multimodal MRI can be a valuable tool in the assessment of, particularly in cases where conventional imaging techniques such as DWI-FLAIR mismatch are inconclusive. The novelty of this retrospective study is to demonstrate that the consistent use of arterial spin labeling perfusion in cases with stroke code leads to a rapid and accurate diagnosis of SMs. The implementation of an MRI-based pathway can expedite the diagnosis and treatment of underlying non-vascular causes such as SMs.

Kalanchoe pinnata, also known as air leaf or life leaf, is a plant used in traditional medicine in different world regions. In Mexico, it is included in the Atlas de la Medicina Tradicional Mexicana with a wide variety of applications, such as antimicrobial, anti-inflammatory, anticancer, and antihistamine, among others. However, neither a secondary metabolite profile of the flower has been reported nor information on its possible toxicity. The latter is the purpose of this work. A phytochemical profile of extracts with solvents of different polarity (aqueous, methanol, ethanol, and ether) was carried out. In this profile, the structural compounds could be qualitatively determined by chemical reactions, and some changes in coloring or precipitation were observed. The acute toxicity test of the extracts was performed with an aquatic organism, Artemia sp, and a terrestrial organism Eisenia foetida, as well as the evaluation of the antioxidant capacity of the extracts in the organism of Eisenia foetida. The ABTS radical method and TROLOX were applied as synthetic antioxidants for the evaluation of the inhibition percentage. Most important secondary metabolites were qualitatively identified in the extracts of K. pinnata flowers. Mainly in the alcoholic extracts (methanol and ethanol) tannins, alkaloids, and flavonols were found. As mentioned above, they are reported to have toxicological effects. The toxicity and antioxidant activity tests confirm the preliminary results obtained in the identification of secondary metabolites. It is therefore concluded that the flower of Kalanchoe pinnata contains secondary metabolites that may be of great therapeutic interest.

Introduction: Bleeding from varices is a severe complication in patients with cirrhosis. Despite its treatment has been well established in the last three decades the mortality can be still high. This study compares the epidemiological features and the bleeding-related outcomes of a group of patients published about ten years ago with a more recent group of 168 consecutive patients. Methods: The diagnosis, the treatment, and the main outcomes (5-day failure, 5-day and 6-week rebleeding, 5-day and 6-week mortality) of variceal bleeding were evaluated according to the current guidelines.Results: The number of patients with cirrhosis admitted for variceal bleeding every year has progressively decreased in the last ten years. The age sex and severity of liver disease, evaluated with Child Pugh and MELD scores, were comparable in the two series. In the more recent series, there were significantly fewer patients with HCV infection and more patients with alcohol-related cirrhosis. The main outcomes of bleeding were comparable too. Overall, at 6 weeks 36.4% of patients did not overcome the bleeding episode. Conclusion: The decreasing incidence of bleeding from varices is likely attributable to antiviral treatment of HCV and HBV and the larger diffusion of beta-blockers in primary prophylaxis. Despite the larger application of the gold standard therapy, the mortality of variceal bleeding remains high in patients with cirrhosis.

The global impact of the COVID-19 pandemic on mental health and substance use behaviors has sparked extensive research efforts. The COMET-G international study, organized by the Department of Medicine and the Rectorate of the Aristotle University of Thessaloniki in collaboration with the World Psychiatric Association, delved into these issues. Running from March 2020 to April 2021, the study collected responses from 55,589 individuals across 40 countries. Through a comprehensive questionnaire, participants provided insights into their mental state, attitudes toward the pandemic, and the resultant changes in their personal and daily lives. Findings revealed, among other things, significant patterns of change in substance use, with notable correlations between reduced usage and the severity of lockdown measures among non-binary individuals. Mental health history emerged as a strong predictor of substance use changes, with influences from anxiety disorders, depression, and self-harm. Additionally, family and social dynamics, including economic expectations and household composition, significantly shaped substance use behaviors during lockdowns. Given these findings, the development of comprehensive approaches targeting the adverse effects of the pandemic on individual behaviors and general welfare is crucial.

Cognitive impairment has been increasingly observed among patients with anxiety disorders and major depressive disorders impacting their normal daily functioning as well as quality of life. A multitude of evidence suggests that the most affected cognitive abilities are memory, attention, perception, and executive functioning in patients with anxiety and depression. Impairment in these higher-order cognitive functions can be attributed to age, education, diet, hormonal changes, stress, and prolonged use of drugs/alcohol/ medicines. To address the issues related to cognitive impairment various non-pharmacological therapeutic modalities such as Cognitive remediation approaches viz; cognitive rehabilitation, cognitive stimulation, and cognitive training; Audio-visual entrainment; mindfulness-based interventions; and neurofeedback have come into play in recent years. It is imperative to understand that the ability to test, measure, and monitor cognitive performance along with implementing cognitive remediation approaches viz; cognitive stimulation, cognitive training, etc. across the lifespan helps in early identification, accessing treatments faster, staying healthy for longer, and improving overall quality of life. This article discusses a case study of a client suffering from generalized anxiety disorder and moderate depression who after undergoing and following a novel therapeutic approach, ‘The Cognitome Program’ has shown credible improvement in cognitive abilities, along with a prominent reduction in the symptoms of anxiety, depression, and better psychological and physical well-being. Guided by the concept of neuroplasticity and cognitive plasticity, our innovative neuroscientific holistic program- ‘The Cognitome Program’ empowers unlocking hidden cognitive potential using cutting-edge methodologies and personalized strategies.

Severe alcoholic hepatitis is an ethical and clinical conundrum, wherein a liver transplant is often recommended. The adequacy of medical treatment versus the risk of recidivism after transplant is often debated. Complete recovery in 26 of 27 patients with severe alcoholic hepatitis was observed, and hence the data was retrospectively analysed.Methods: 27 patients, with severe alcoholic hepatitis, with Maddrey's discriminant function between 59.7 to 165.2 (mean 107.53), from June 2017 to May 2022, were followed up for between 11 months to 6 years. INR ranged from 1.99 to 3.7 (mean 2.709), and bilirubin was between 7.6 to 37.01, (mean 20.859). 8 patients had pre-existing liver cirrhosis. All patients received probiotics, nutritional support, physical rehabilitation, saturated fat (clarified butter/ desi ghee) supplementation, and anti-oxidant support. At 90 days, total bilirubin improved to between 1.0 to 6.8 (mean 2.625). ALT (Alanine Transaminase/ SGPT) ranged from 65 to 550 (mean ALT – 197); and AST (Aspartate Transaminase / SGOT) ranged from 58 to 810 (mean AST – 271.51). Both the AST and ALT were near normal after 90 days. One patient died due to bacterial pneumonia and sepsis; the remaining 26 patients made a complete recovery. All patients including those with diagnosed liver cirrhosis, had complete resolution of their ascites, and near-normal liver function. At the last outpatient visit, none had ascites, edema, or encephalopathy, and had normal albumin levels and INR values. Conclusion: Probiotics, nutrition, a saturated fat diet, and exercise; all have shown benefits in patients with severe alcoholic hepatitis when tested individually. Concomitant use of all the above has not been reported in the treatment of alcoholic hepatitis. The role of nutrition alone versus the contribution of nutritional deficiencies and the role of gut-derived endotoxemia need to be studied in detail. How to identify patients who need a transplant, if it is needed at all, remains a challenge.

Mesenchymal stem cell (MSC) transplantation may be an alternative to liver transplantation for patients with end-stage liver disease. A 24-year-old patient with Hepatic Encephalopathy due to alcoholic liver cirrhosis underwent UCMSC transplantation because there were no donors available for liver transplants involving adult deceased and living individuals. The patient was given allogeneic Umbilical cord-derived MSCs, which were then cultured following accepted practices. Subsequently, the UCMSCs were infused through the intravenous route 3 times at the interval of 30 days. Serum bilirubin, globulin, and ammonia levels were improved after the infusion and the morphology of the liver and spleen had also improved.

Mental illness is an international health crisis that puts the lives of over three hundred million people (Four percent of the world’s population) at risk. The study was conducted at the Erigavo Mental Hospital in Somaliland and its main focus was the bond between substance abuse and mental illness. The research was to check the influence of the different drugs, screen mental health problems, and draw a link between drugs and mental illness. The sources of the quantitative data were a total of 27 employees and managers. This study is cross-sectional. We employed the measure of the magnitude and direction of a linear relationship between two variables with the Pearson correlation coefficient. The outcomes that were acquired show that there was use and particularly abuse of khat, substance smoking, and alcohol consumption, the score means of which were quite high. The investigation results, however, imply that through drug use and other forms of alcohol drug abuse, one of them counter various mental health problems. Furthermore, the addicted people demonstrated the tendency to use force in their attempt to solve the conflicts and to experience the highest degree of tension, with the mean score of the former giving 4.11 while the standard deviation of the latter giving 1.086, thus this shows the mental impact of drug use on the inhabitants of Erigavo. The main result of the study was the strong, positive relationship between drug addiction and mental illness, which became evident through an r - value of 0.509 and a p - value of 0.559. It means that those people who are involved in drug misuse are the ones who are likely to have mental health disorders. Based on the findings of the study, we suggest a combination of measures to recover drug addiction and mental illness. This consists in strengthening prevention. The study that lays the groundwork for suggestions, involves an approach that is holistic in nature. The main ideas of preventing drug usage, psychological health care, enhancing mental health services, and working towards certified professionals are key integrated activities of the whole concept. The hospital, thus, will be in a better position to eliminate the two major disease components namely; drug abuse and mental ailment. Thus, in this way, with the help of the new treatment approaches, a hospital provides and their patients who are quite likely to recover and lead healthy.

Background: Non-Communicable Diseases (NCDs) in India have increased from 37.9% in 1990 to 61.8% in 2016. They are slowly progressive are of long duration and are responsible for more than 50% of the global burden of disease Very few studies have been conducted that studied the prevalence of risk factors in non-communicable diseases among medical students. The authors observed that most of the students are at risk of developing NCDs, and the cumulative effect of risk factors bundles up and eventually leads to disease as students advance through their lives.Aim and objectives: (i) To estimate the prevalence of risk factors of NCD amongst medical students, (ii) To study the association between various risk factors and NCDs in study subjects.Settings and design: A cross-sectional analytical study involving 362 undergraduate students of Rama Medical College using simple random sampling.Material and methods: The study used a pretested structured questionnaire which was conducted by using the WHO NCD steps approach.Statistical analysis used: Data analysis was done by using M S Excel and software SPSS version 26.Results: Our study results showed that physical activity is Prevalent in female students at 51% and in male students at 48.9%, almost equal. Junk food consumption had an overall prevalence of 69.34% of females outnumbering males in junk food consumption. The association of BMI with NCD as a risk factor was statistically significant in the current 75 smokers only.Conclusion: There is a huge opportunity to reduce modifiable risk factors and NCD among our future doctors by encouraging them to change their behavior-related lifestyles such as smoking habits, alcohol use, junk food, etc.

Venous Thromboembolism (VTE) is a major public health concern, affecting approximately 900,000 people annually in the United States. In rare cases, a Patent Foramen Ovale (PFO) may allow a venous thrombus to cross into the arterial circulation, causing a paradoxical embolism. This case report presents a 46-year-old male who developed left renal artery stenosis after a paradoxical embolism, likely triggered by a prolonged flight and binge alcohol consumption. The patient was found to have a moderate-sized PFO and renal infarction, confirmed by imaging studies. Despite initial anticoagulation therapy and a planned stenting procedure, intraoperative findings revealed only mild stenosis, leading to cancellation of the stent placement. The patient ultimately underwent PFO closure with an Amplatzer Talisman device. This case underscores the diagnostic challenges in managing paradoxical embolism and the need for individualized treatment, particularly concerning anticoagulation duration, the decision for PFO closure, and post-procedural antithrombotic therapy. Further research is required to establish optimal management strategies for cryptogenic embolic events.

Aim and objective: This study aimed to determine the prevalence and characteristics of drug dependency among patients in various rehabilitation centers in the Shimla district. Introduction: Drug abuse is a multifaceted and significant issue impacting individuals worldwide, and the city of Shimla in Himachal Pradesh is no exception. Despite its reputation as a picturesque hill station known for its natural beauty and rich cultural heritage, Shimla faces challenges related to substance abuse. Materials and methods: A cross-sectional survey was conducted, gathering demographic data, drug history, and indicators of dependency from the participants.Results: The findings revealed that 60% of the patients were drug-dependent, with 44% addicted to heroin and 11% to alcohol. Additionally, 60% of the patients reported a family history of chemical dependency. The study also identified associated psychological disorders such as depression and anxiety, as well as interpersonal and environmental factors like peer pressure and coping mechanisms such as avoidance and denial. Conclusion: These findings underscore the complexity of drug dependency, highlighting the need for comprehensive, multidimensional approaches to address the medical, emotional, and social aspects of addiction.

Background: The health professional appears to be concerned given the number of questions surrounding the patient’s post-transplant survival, patient selection method, and the continuous search for scores that reflect their reality and reconcile the results they desire with the patient’s expectations. It is from these considerations that the present work was born with the purpose of understanding the reality of patients hospitalized for hepatocellular carcinoma and what adherence to the Model For End-Stage Liver Disease (MELD) criteria meant in Brazil. Methods: This study is a discrete, univariate time series on emergency hospitalizations that occurred between 2000 and 2018, in the city of São Paulo, Brazil. Python version 3.11 was the software used for statistical treatment and analysis of the time series. Results: There were 6887 hospitalizations for malignant neoplasm of liver and intrahepatic bile ducts, in the period 2000-2006, of which 2898 were elective and 3915 (56.85%) were urgent in the period. There was an increase of 63.97% in the number of emergency hospitalizations in relation to the period 2000-2006 and 2007-2013. To highlight, in 2013 there were 1270 emergency admissions, which represented an increase of 109.22% in relation to the number of emergency admissions in 2006. The contingency correlation analysis demonstrated a significant association between the variables in which the chi-square value was 82.18, the p-value was 1.24 x 10-19, and the critical value was 3.84 with one degree of freedom. There was a 123.65% increase in the number of hospitalizations for chronic hepatitis, not elsewhere classified, between the periods 2000-2006 and 2007-2013. The chi-square value of the contingency association was 221.22, with a p-value of 4.90 x 10-50, a critical value of 9.488, with a significance level of 5% and one degree of freedom. The study showed an increase in hospitalizations of 21.88% for alcoholic liver disease between the periods 2000-2006 and 2007-2013. In the period 2000-2006, there were 21330 hospitalizations, 19224 of which were urgent (90.13%). In the period 2007-2013, there were 25997 hospitalizations, of which 22,802 (87.71%) occurred urgently. The chi-square value was 68.95, the p-value was 1 x 10-16, and the critical value was 3.84, with one degree of freedom. Conclusion: The MELD score, as it is sensitive to the patient’s severity, selects those who are at an advanced stage of the disease for liver transplantation. In this scenario, patients do not necessarily have access to outpatient services and begin to attend them regularly when MELD identifies the advanced stage of the disease, opening a gap between prevention, treatment, and rehabilitation.

Some preliminary results of studies on the assessment of the possibilities and prospects for obtaining products with a high Antioxidant Activity Index (AOA) from the waste of the coffee beverage production industry - "silver skin" (SC, silverskin, CS) are presented.The obtained data on the extraction of SC with aqueous-alcoholic extractants, the effect of extraction conditions on the yield of extracts, and extractive substances are discussed. It is reported on the production of dry powders of extracts that retain their properties during long-term storage.Data on the antioxidant properties of both liquid and dry forms of extracts are presented and good AOA of the studied objects is noted in comparison with the "standard" antioxidant - rosemary extract, and it is also shown that the AOA of dry forms of extracts can be increased by doping with synergists - polyphenols of natural genesis. The antioxidant activity of the obtained compositions was studied on real objects - animal fats and natural dyes, the results of which confirmed the prospects of the studied antioxidants (AO) for practical purposes.