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Lonappan DK, Kuruvalli G, Shaik AH, Hebbani AV, Reddyvari H, Damodara Reddy V, Vadamalai V. Alcohol-induced hormonal and metabolic alterations in plasma and erythrocytes-a gender-based study. Toxicol Mech Methods 2024; 34:350-358. [PMID: 38031273 DOI: 10.1080/15376516.2023.2290071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 11/27/2023] [Indexed: 12/01/2023]
Abstract
PURPOSE This study aimed to understand the gender-specific alcohol-induced biochemical changes and TBARS association with the endocrine system. METHODS Human male and female subjects ranging from 35 ± 10 years old with an 8-10-year drinking history were included in the study. RESULTS The results demonstrated that testosterone levels were lower in male alcoholics and higher in female alcoholics, as well as higher estrogen and cortisol levels in both genders. In addition, we found lower T3, T4, and thyroid-stimulating hormone (TSH) levels in alcoholics of both sexes. Furthermore, plasma TBARS, protein carbonyls, nitrite, and nitrate levels increased significantly with concomitant decrease in reduced glutathione (GSH), catalase (CAT), superoxide dismutase (SOD) and glutathione peroxidase (GPx) activities in both male and female alcoholics. Furthermore, erythrocyte lysate nitrite and nitrate levels membrane total cholesterol, phospholipid and cholesterol/phospholipid (C/P) ratio with lower total membrane proteins in both genders of alcoholics. SDS-PAGE analysis of erythrocyte membrane proteins revealed increased density of band 3, protein 4.1, 4.2, 4.9 and glycophorins, whereas decreases in spectrin (α and β) were observed in both genders of alcoholics. Besides, alcoholics of both sexes had a lower ability to resist osmotic hemolysis. Plasma TBARS was negatively correlated with testosterone, TSH, T3 and T4 in male alcoholics, moreover, estradiol and cortisol were positively correlated in males and females respectively. CONCLUSION Female alcoholics may be more susceptible to osmotic hemolysis due to increased erythrocyte membrane lipid peroxidation with decreased antioxidant status, which results in an altered membrane C/P ratio and membrane protein composition.
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Affiliation(s)
| | - Gouthami Kuruvalli
- Department of Biochemistry, REVA University, Bangalore. Karnataka, India
| | - Althaf Hussain Shaik
- Department of Zoology, College of Science, King Saud University, Riyadh, Saudi Arabia
| | | | - Hymavathi Reddyvari
- Department of Thoracic Medicine and Surgery, Temple University, Philadelphia, PA, USA
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Venkateswaran S, Thirumalai R. A Follow-up Study on Coping Strategies and its Association with Relapse Among Alcohol-dependent Patients. Indian J Psychol Med 2024; 46:245-252. [PMID: 38699765 PMCID: PMC11062311 DOI: 10.1177/02537176231222968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/05/2024] Open
Abstract
Background Alcohol Dependence Syndrome is a chronic illness that is relapsing in nature. Past research has shown that coping strategies that are specific to alcohol dependence are useful in preventing long-term relapse. This follow-up study is, therefore, an attempt to understand the coping styles and strategies that are associated with relapse among individuals dependent on alcohol. Methods We aimed to cross-sectionally assess the severity of alcohol dependence and coping styles of Alcohol dependent individuals. One hundred and twenty-seven consecutive patients who satisfied the International Classification of Diseases Tenth Edition (ICD 10) criteria for alcohol dependence and who were above the age of 18 years were included. This study was conducted in the de-addiction outpatient services of a Tertiary care center in South India between April 2019 and June 2020. Our Institutional Ethical Committee granted the approval for this study. We used a self-designed proforma for collecting the socio-demographic details. The Severity of Alcohol Dependence Questionnaire (SADQ) and Coping Orientation to Problems Experienced Inventory (Brief - COPE) were administered. Patients were followed up for six months. Motivation Enhancement Therapy was given to all our participants during their monthly follow-up visit. Descriptive analysis was performed using mean and standard deviation. We used the student t-test and chi-squared test to understand the differences in the coping strategies between relapsed and non-relapsed persons. Spearman's correlation was used to assess the correlation between the severity of alcohol dependence and coping strategies. A p value of <.05 was taken as significant. Results Non-relapsed individuals had significantly higher scores on active coping (p = .008), emotional support (p = .044), informational support (p = .017), planning (p < .001), acceptance (p = .030), and humor (p = .001). Relapsed individuals had statistically significant scores on denial (p = .005), substance use (p = .024), and self-blame (p = .012). We found a positive correlation between the severity of alcohol dependence and maladaptive coping strategies (p < .01). Conclusions Relapsed individuals were found to have significantly higher maladaptive coping strategies. Non-relapsed individuals exhibited greater adaptive coping styles. Maladaptive coping strategies positively correlated with the severity of alcohol dependence.
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Affiliation(s)
- Sabitha Venkateswaran
- Dept. of Psychiatry, Chengalpattu Medical College and Hospital, Chengalpattu, Tamil Nadu, India
| | - Ranganathan Thirumalai
- Dept. of Psychiatry, Chengalpattu Medical College and Hospital, Chengalpattu, Tamil Nadu, India
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3
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Landa-Blanco M, Vásquez G, Portillo G, Sproviero F, Echenique Y. The impact of adverse childhood experiences on mental health, sexual risk behaviors, and alcohol consumption in adulthood. Front Psychiatry 2024; 15:1352824. [PMID: 38659462 PMCID: PMC11039929 DOI: 10.3389/fpsyt.2024.1352824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 03/25/2024] [Indexed: 04/26/2024] Open
Abstract
The purpose of the study was to determine how Adverse Childhood Experiences (ACE) relate to adulthood flourishing, symptoms of depression, anxiety, somatization, self-reported health, sexual risk behaviors, and alcohol consumption. A quantitative cross-sectional methodology was used. A total of 452 adults completed the survey. The most prevalent ACE include physical abuse (44.69%), separation/divorce of parents (41.81%), living with someone with alcohol problems (39.38%), and being sworn, insulted, or humiliated by adults at home (35.62%). Almost one out of every four respondents (24.34%) reported being touched by an adult, 17.92% reported that an adult tried to manipulate the respondent into touching them, and 8.19% were forced to have sexual intercourse. Results indicate that women reported a higher number of ACE than men. The number of ACE is inversely related to flourishing and self-reported health; while being positively associated with participant's scores in depression, anxiety, somatization, sexual risk behaviors, and alcohol use. The regression model, including the eleven ACE and respondents' sex and age, achieved medium effect sizes for somatization, depression, and anxiety symptoms and small effect sizes for flourishing, self-reported health, sexual risk behaviors, and alcohol consumption. Specific ACE have a particularly significant negative impact on mental health outcomes: forced intercourse, witnessing familial violence, verbal humiliation, and living with individuals struggling with mental health issues and drug consumption or who were incarcerated. In conclusion, the study highlights the alarming prevalence of ACE among the Honduran population and their significant negative impact on mental health outcomes during adulthood.
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Affiliation(s)
- Miguel Landa-Blanco
- School of Psychological Sciences, National Autonomous University of Honduras, Tegucigalpa, Honduras
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4
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Hu Y, Wang Z, Wu L. Multidimensional health heterogeneity of Chinese older adults and its determinants. SSM Popul Health 2023; 24:101547. [PMID: 38021459 PMCID: PMC10661850 DOI: 10.1016/j.ssmph.2023.101547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 10/25/2023] [Accepted: 10/25/2023] [Indexed: 12/01/2023] Open
Abstract
Background Nowadays, the "Healthy China" and "Actively Addressing Population Aging" are two important national strategies in China. Promoting high-quality development of demand-driven older adults health services is an important way to achieve these strategies. From the perspective of active ageing, assessing the health status of older adults from multiple dimensions becomes crucial as it helps identify their specific health service needs, intervention measures, and health policies tailored to this population. Methods Data were derived from the China Health and Retirement Longitudinal Study (CHARLS) wave 4 (2018). A total of 4190 older adults (aged ≥60 years) were included as the analysis sample. Latent class analysis was performed to categorize older adults based on 6 health indicators, including Activities of Daily Living (ADLs), Instrumental Activities of Daily Living (IADLs), doctor diagnosed chronic diseases, depressive symptoms, cognitive function, and social participation. Multinomial logistic model was used to explore determinants associated with the various patterns of multidimensional health of older adults. Results The multidimensional health of older people was classified into three latent classes: Relatively Healthy (Class 1, n = 2806, 66.97%), Highly Depressed and Relatively Health Risk (Class 2, n = 1189, 28.38%), and Functional Impairment (Class 3, n = 195, 4.65%). Gender, age, education, marital status, number of children, alcohol consumption, physical activity, savings, residence, air quality satisfaction, and medical service satisfaction had significant effects on the attribution of all multidimensional health latent classes. Conclusion Heterogeneous and multidimensional health classes exist in China's older population, and these classes are influenced by a variety of factors and to varying degrees. Policymakers and healthcare providers can use these evidence to further address the diverse needs of older adults and improve older-care health services, ultimately achieving the goal of Active Ageing and Healthy China.
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Affiliation(s)
- Yi Hu
- Shenzhen Health Development Research and Data Management Center, Shenzhen, Guangdong, 518028, China
| | - Zhenyu Wang
- School of Government, Sun Yat-sen University, Guangzhou, Guangdong, 510006, China
| | - Liqun Wu
- Shenzhen Health Development Research and Data Management Center, Shenzhen, Guangdong, 518028, China
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5
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Nguyen CT, Nguyen HT, Vu TMT, Le Vu MN, Vu GT, Latkin CA, Ho CSH, Ho RCM. Mapping Studies of Alcohol Use Among People Living with HIV/AIDS During 1990-2019 (GAPRESEARCH). AIDS Behav 2023; 27:3981-3991. [PMID: 37338623 DOI: 10.1007/s10461-023-04112-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2023] [Indexed: 06/21/2023]
Abstract
Alcohol drinking has long been reported to be common in people living with HIV/AIDS, having biological and behavioral impacts on the transmission, progression, and prevention of HIV/AIDS. A total of 7059 eligible articles and reviews published in English from 1990 to 2019 were extracted from the WOS. Results show an increase in publication volume, while citations peak for papers published in 2006. Content analysis reveals a wide-ranging coverage of topics, with the most popular being effects of alcohol consumption on ART adherence and outcomes, alcohol-related sexual behaviors, TB co-infection, and psycho-socio-cultural considerations in examining and designing measures targeting alcohol use and interventions to reduce alcohol dependence in PLWHA. This calls for more active engagement of governments in research and in designing and implementing interventions, as well as collaborations and knowledge transfer from high-income countries to developing counterparts, to effectively address alcohol use-related issues in PLWHA, moving toward the HIV/AIDS eradication target.
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Affiliation(s)
- Cuong Tat Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang, 550000, Vietnam.
- Faculty of Medicine, Duy Tan University, Da Nang, 550000, Vietnam.
| | - Hien Thu Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang, 550000, Vietnam
- Faculty of Medicine, Duy Tan University, Da Nang, 550000, Vietnam
| | - Thuc Minh Thi Vu
- Institute of Health Economics and Technology, Hanoi, 100000, Vietnam
| | - Minh Ngoc Le Vu
- Institute of Health Economics and Technology, Hanoi, 100000, Vietnam
| | - Giang Thu Vu
- Center of Excellence in Evidence-based Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, 700000, Vietnam
| | - Carl A Latkin
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - Cyrus S H Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore
| | - Roger C M Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore, 119077, Singapore
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Sushma, Mishra S, Kanchan S, Divakar A, Jha G, Sharma D, Kapoor R, Kumar Rath S. Alcohol induces ER stress and apoptosis by inducing oxidative stress and disruption of calcium homeostasis in glial cells. Food Chem Toxicol 2023; 182:114192. [PMID: 37980976 DOI: 10.1016/j.fct.2023.114192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 11/08/2023] [Accepted: 11/11/2023] [Indexed: 11/21/2023]
Abstract
Alcohol has teratogenic effects that can cause developmental abnormalities and alter anatomical and functional characteristics of the developed brain and other organs. Glial cells play a crucial role in alcohol metabolism and protect neurons from toxic effects of alcohol. However, chronic alcohol exposure can lead to uncontrollable levels of reactive oxygen species, resulting in the death of glial cells and exposing neuronal cells to the toxic effects of alcohol. The exact molecular mechanism of alcohol-induced glial cell death has not been fully explored. This study reported that different concentrations of alcohol induce different expressions of ER stress markers in glial cells, focusing on the role of endoplasmic reticulum (ER) stress. Alcohol-induced concentration-dependent toxicity in both cells also induced oxidative stress, leading to mitochondrial damage. The expression of p53 and apoptotic proteins was significantly up-regulated after alcohol exposure, while Bcl2 (anti-apoptotic) was down-regulated. The signalling pathway for ER stress was activated and up-regulated marker proteins in a concentration-dependent manner. Cells pre-treated with BAPTA-AM and NAC showed significant resistance against alcohol assault compared to other cells. These in vitro findings will prove valuable for defining the mechanism by which alcohol modulates oxidative stress, mitochondrial and ER damage leading to glial cell death.
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Affiliation(s)
- Sushma
- Genotoxicity Laboratory, Division of Toxicology & Experimental Medicine, CSIR-Central Drug Research Institute, Lucknow, 226001, India
| | - Sakshi Mishra
- Genotoxicity Laboratory, Division of Toxicology & Experimental Medicine, CSIR-Central Drug Research Institute, Lucknow, 226001, India
| | - Sonam Kanchan
- Genotoxicity Laboratory, Division of Toxicology & Experimental Medicine, CSIR-Central Drug Research Institute, Lucknow, 226001, India
| | - Aman Divakar
- Genotoxicity Laboratory, Division of Toxicology & Experimental Medicine, CSIR-Central Drug Research Institute, Lucknow, 226001, India
| | - Gaurav Jha
- Genotoxicity Laboratory, Division of Toxicology & Experimental Medicine, CSIR-Central Drug Research Institute, Lucknow, 226001, India
| | - Divyansh Sharma
- Genotoxicity Laboratory, Division of Toxicology & Experimental Medicine, CSIR-Central Drug Research Institute, Lucknow, 226001, India
| | - Radhika Kapoor
- Genotoxicity Laboratory, Division of Toxicology & Experimental Medicine, CSIR-Central Drug Research Institute, Lucknow, 226001, India
| | - Srikanta Kumar Rath
- Genotoxicity Laboratory, Division of Toxicology & Experimental Medicine, CSIR-Central Drug Research Institute, Lucknow, 226001, India.
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Sivaraman T, Solomon S, Ramamurthy P, Thilakan P. Six-month course and outcome of treatment-seeking individuals with alcohol dependence syndrome. Indian J Psychiatry 2023; 65:1184-1189. [PMID: 38249137 PMCID: PMC10795655 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_326_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 10/08/2023] [Accepted: 11/03/2023] [Indexed: 01/23/2024] Open
Abstract
Background Despite the availability of several pharmacological and nonpharmacological treatments, a significant proportion of patients with alcohol dependence relapse to alcohol use after treatment. The objectives of this study were to determine the 6-month course and outcome in treatment-seeking individuals with alcohol dependence syndrome and to determine the sociodemographic and clinical correlates of the outcome in these patients. Materials and Methods A longitudinal observational study was conducted in treatment-seeking male patients with alcohol dependence syndrome. Baseline sociodemographic and clinical details were gathered using a structured pro forma. The patients were followed up at 2 weeks, 1 month, 3 months, and 6 months. During the follow-up evaluation, abstinence status, number of abstinent days, and number of heavy drinking days were noted. Logistic regression was conducted to evaluate the factors associated with abstinence at 6 months. Results Ninety-four patients were recruited for the study. The mean age of the participants was 43.98 years (standard deviation (SD) 10.68). Two patients were lost to follow-up. At the end of 2 weeks, 74 (80.43%) out of 92 participants remained abstinent. At the end of 1 month and 3 months, 59 (64.13%) and 38 (41.3%) participants of 92 were abstinent, respectively. At the end of 6 months, 26 (30.23%) of 86 patients were abstinent. Among those who were not abstinent at 6 months, the mean number of abstinent days was 113 (SD 51.62) days and the mean number of heavy drinking days was 56 (SD 51.62) days. Outpatients were found to have 2.91 times higher odds of remaining abstinent at 6 months when compared to inpatients. Conclusion Nearly one-third of treatment-seeking patients with alcohol dependence syndrome remained abstinent at the end of 6 months. The locus of treatment was associated with abstinence at 6 months.
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Affiliation(s)
- Thenmozhi Sivaraman
- Department of Psychiatry, Pondicherry Institute of Medical Sciences, Kalapet, Puducherry, India
| | - Susan Solomon
- Department of Psychiatry, Pondicherry Institute of Medical Sciences, Kalapet, Puducherry, India
| | | | - Pradeep Thilakan
- Department of Psychiatry, Pondicherry Institute of Medical Sciences, Kalapet, Puducherry, India
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Ambade M, Kim R, Subramanian SV. Socio-economic distribution of modifiable risk factors for cardiovascular diseases: An analysis of the national longitudinal ageing study in India. Prev Med 2023; 175:107696. [PMID: 37666306 DOI: 10.1016/j.ypmed.2023.107696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 07/13/2023] [Accepted: 09/01/2023] [Indexed: 09/06/2023]
Abstract
The association of socioeconomic status (SES) with modifiable risk factors for cardiovascular diseases (CVDs) is unclear in developing nations. We studied SES variations in major risk factors and their percentage distribution for adults aged 45 years or above in India. Using individual records of 59,672 individuals aged 45 years or above from the Longitudinal Ageing Study in India Wave 1 (cross-sectional study design), 2017-18, we chart age-and-sex-adjusted prevalence of clinical risk factors such as measured high blood pressure, hypertension, overweight, obesity, central adiposity and self-reported high blood glucose; and lifestyle risk factors such as excessive use of alcohol, current use of smoking and smokeless tobacco and physical inactivity across SES variables of education, quintiles of mean per capita expenditure and social caste. Multivariable analysis was used to explore the SES gradient of risk factors. The sample used in the study is predominantly rural (69.9%), illiterate (50.7%), has more females (54.2%), and belongs to other backward classes (45.6%). Prevalence of high blood pressure, overweight, obesity, central adiposity, high blood glucose, and physical inactivity increased; and excessive alcohol consumption and current use of smoking/smokeless tobacco decreased with income, education, and social caste. However, no significant income gradient was noted for lifestyle risk factors except the use of smokeless tobacco. The income gradient was largest for central adiposity (waist-circumference) with a difference of 23.4 percentage points as it increased from 38.7% among the poorest to 62.1% among the richest. The major burden of CVDs risk factors among older adults aged 45+ years falls among high SES.
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Affiliation(s)
- Mayanka Ambade
- Indian Institute of Technology Mandi, Himachal Pradesh, India.
| | - Rockli Kim
- Division of Health Policy and Management, College of Health Science, Korea University, Seoul, South Korea; Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, South Korea.
| | - S V Subramanian
- Harvard Center for Population and Development Studies, 9 Bow Street, Cambridge, MA 02138, USA; Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
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Suresh S, Deshmukh AS, Praharaj SK. Efficacy of covert sensitization for a patient with alcohol use disorder with memory impairment: A case report. J Addict Dis 2023; 41:334-340. [PMID: 35946415 DOI: 10.1080/10550887.2022.2108363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
Alcohol use disorder is a chronic, relapsing and remitting illness with limited efficacy of pharmacotherapy in preventing relapse. Several non-pharmacological treatment options are usually used to improve treatment outcomes. In this case report, the patient with alcohol use disorder (as per Diagnostic and Statistical Manual 5th edition criteria) had memory impairments, which was seen to limit the effectiveness of cognitive approaches such as motivational enhancement therapy. Covert sensitization, a behavioral technique based on operant conditioning, was considered an alternative option along with pharmacotherapy to enhance abstinence and was seen to be effective in creating an association between alcohol use and unpleasant consequences in the patient. We observed an improvement in subjective craving and motivation to abstain following the therapy sessions. This highlights the use of covert sensitization as an alternative non-pharmacological intervention for patients with alcohol use disorder with cognitive impairments.
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Affiliation(s)
- Savithri Suresh
- Department of Clinical Psychology, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Anagha S Deshmukh
- Department of Clinical Psychology, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Samir Kumar Praharaj
- Department of Psychiatry, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Kumar P C P, P J P, Manohar S, M K, Pandey MK. How men with alcohol use disorder perceive communication, couple satisfaction, relational boredom, and quality of life compared to wives: Findings from a hospital-based study. J Ethn Subst Abuse 2023:1-12. [PMID: 37724020 DOI: 10.1080/15332640.2023.2253751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/20/2023]
Abstract
In India, use of alcohol between 10 and 70 years is increasing significantly as per the Government of India, Ministry of Social Justice & Empowerment. Chronic alcohol use in men can potentially disrupt their relationships with their wives in several ways, leading to poor communication, trust issues, emotional disconnection, physical abuse, financial strain, and neglecting responsibilities. These factors may reduce the quality of life of the couple and negatively impact the couple's overall well-being. This cross-sectional study assesses the communication, couple satisfaction, relational boredom, and quality of life of wives with alcoholic husbands admitted to inpatient psychiatry services (patients: n = 30; wives: n = 30). A social demographic data sheet, self-perceived communication in couples, couple satisfaction, relational boredom scale, and the World Health Organization's quality of life scales were used to collect data. All participants were chronic alcohol users and had used alcohol for over 10 years. The mean scores of couple satisfaction (p < .001) and quality of life were greater among husbands. In contrast, wives scored significantly higher in communication (p < .001) and relational boredom (p < .001) compared to husbands with alcohol use disorder. Furthermore, communication, couple satisfaction, relational boredom, and quality of life domains were negatively correlated (p < .001). In contrast, communication and relational boredom were positively correlated (p < .001). Men with alcohol use disorder perceived a satisfactory relationship and higher quality of life than did their wives.
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Affiliation(s)
- Pradeep Kumar P C
- Department of Psychiatry, JSS Academy of Higher Education and Research, and JSS Medical College and Hospital, Mysore, Karnataka, India
| | | | - Shivanand Manohar
- Department of Psychiatry, JSS Academy of Higher Education and Research, and JSS Medical College and Hospital, Mysore, Karnataka, India
| | - Kishor M
- Department of Psychiatry, JSS Academy of Higher Education and Research, and JSS Medical College and Hospital, Mysore, Karnataka, India
| | - Manoj K Pandey
- Clinical Psychology, JSS Academy of Higher Education and Research, and JSS Medical College and Hospital, Mysore, Karnataka, India
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Parmar A, Pal A, Sharma P. National List of Essential Medicines 2022 of India: Perspectives from Psychiatrists. Indian J Psychol Med 2023; 45:411-414. [PMID: 37483582 PMCID: PMC10357919 DOI: 10.1177/02537176231155328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/25/2023] Open
Affiliation(s)
- Arpit Parmar
- Dept. of Psychiatry, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Arghya Pal
- Dept. of Psychiatry, All India Institute of Medical Sciences, Raebareli, Uttar Pradesh, India
| | - Pawan Sharma
- Dept. of Psychiatry, Patan Academy of Health Sciences, School of Medicine, Lalitpur, Nepal
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12
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Balhara YPS, Sarkar S, Singh PK, Chattopadhyay A, Singh S. Impact of three years of prohibition on extent and pattern of alcohol use in Bihar: Observations and insights from the National Family Health Survey. Asian J Psychiatr 2023; 82:103479. [PMID: 36738576 DOI: 10.1016/j.ajp.2023.103479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/15/2023] [Accepted: 01/22/2023] [Indexed: 01/24/2023]
Abstract
Bihar Excise (Amendment) Act, 2016 was promulgated in the state and a complete prohibition on alcohol was declared within the state of Bihar. We aimed to assess the impact of the prohibition on extent and pattern of alcohol use in the state of Bihar using the National Family Health Survey data. We also compared the data from Bihar with the data for the whole country, its neighbouring states and the state of Gujarat. There was a 41.78% reduction in the proportion of men who reported alcohol use in Bihar. Among those who reported alcohol use proportion of those who used 'almost every day' reduced by 29.72%. There was a 69.56% reduction in the proportion of women in Bihar who reported alcohol use. There was a significant increase in proportion of men reporting use of tadi madi and country liquor. Since the prohibition of alcohol in the state of Bihar there has been a reduction in self-reported alcohol use among men and women. However, alcohol use continues to be reported in the state even after the prohibition. There are states in the country that have similar extent of alcohol use as compared to Bihar, despite lack of prohibition. This warrants a relook at the policy to address what the prohibition could not achieve.
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Affiliation(s)
- Yatan Pal Singh Balhara
- National Drug Dependence Treatment Center and Department of Psychiatry, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
| | - Siddharth Sarkar
- National Drug Dependence Treatment Center and Department of Psychiatry, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
| | - Prashant Kumar Singh
- WHO Global Knowledge Hub on Smokeless Tobacco, ICMR - National Institute of Cancer Prevention & Research (NICPR), Indian Council of Medical Research (ICMR), Ministry of Health & Family Welfare, Govt. of India, India; Division of Preventive Oncology & Population Health, WHO Global Knowledge Hub on Smokeless Tobacco, ICMR - National Institute of Cancer Prevention &∼ Research (NICPR), Indian Council of Medical Research (ICMR), Ministry of Health &∼ Family Welfare, Govt. of India, India.
| | - Ankita Chattopadhyay
- National Drug Dependence Treatment Center and Department of Psychiatry, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Shalini Singh
- ICMR - National Institute of Cancer Prevention & Research (NICPR), Indian Council of Medical Research (ICMR), Ministry of Health & Family Welfare, Govt. of India, India.
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13
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Cheng Q, Xie M, Li G, Xue W, Zeng L, Ma D. Bacteria-Loaded Gastro-Retention Oral Delivery System for Alcohol Abuse. ACS Biomater Sci Eng 2023; 9:1460-1471. [PMID: 36848648 DOI: 10.1021/acsbiomaterials.3c00009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
Alcohol abuse is harmful to human health, and many strategies have been developed to retard this harm through protecting liver or activating relative enzymes. In this study, a new strategy of decreasing the alcohol absorption directly depending on the dealcoholization by the bacteria in the upper gastrointestinal (GI) tract was reported. To realize this, a bacteria-loaded gastro-retention oral delivery system with pore structure was constructed through emulsification/internal gelation, which could relieve acute alcohol intoxication in mice successfully. It was found that this bacteria-loaded system kept the above 30% suspension ratio in the simulated gastric fluid for 4 min, displayed good protection effect for the bacteria, and decreased the alcohol concentration from 50 to 30% below within 24 h in vitro. The in vivo imaging results demonstrated that it remained in the upper GI tract until 24 h and reduced 41.9% alcohol absorption. The mice with oral administration of the bacteria-loaded system were found with normal gait, smooth coat, and less liver damage. Although the intestinal flora distribution was influenced slightly during the oral administration, it could restore to normal levels only one day after stopping oral administration quickly, suggesting good biosafety. In conclusion, these results revealed that the bacteria-loaded gastro-retention oral delivery system might intake alcohol molecules rapidly and has huge potential in the treatment of alcohol abuse.
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Affiliation(s)
- Qikun Cheng
- Key Laboratory of Biomaterials of Guangdong Higher Education Institutes, Guangdong Provincial Engineering and Technological Research Center for Drug Carrier Development, Department of Biomedical Engineering, Jinan University, Guangzhou 510632, China
- Institute of Translational Medicine, Zhejiang Shuren University, Hangzhou, Zhejiang 310015, China
| | - Mingzhi Xie
- Key Laboratory of Biomaterials of Guangdong Higher Education Institutes, Guangdong Provincial Engineering and Technological Research Center for Drug Carrier Development, Department of Biomedical Engineering, Jinan University, Guangzhou 510632, China
| | - Guowei Li
- Department of Nuclear Medicine and PET/CT-MRI Center, The First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Wei Xue
- Key Laboratory of Biomaterials of Guangdong Higher Education Institutes, Guangdong Provincial Engineering and Technological Research Center for Drug Carrier Development, Department of Biomedical Engineering, Jinan University, Guangzhou 510632, China
| | - Lexiang Zeng
- Department of Urology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen (Zhongshan) University, Guangzhou 510120, People's Republic of China
| | - Dong Ma
- Key Laboratory of Biomaterials of Guangdong Higher Education Institutes, Guangdong Provincial Engineering and Technological Research Center for Drug Carrier Development, Department of Biomedical Engineering, Jinan University, Guangzhou 510632, China
- MOE Key Laboratory of Tumor Molecular Biology, Jinan University, Guangzhou 510632, China
- Artificial Organs and Materials Engineering Research Center, Ministry of Education, Guangzhou 510632, China
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14
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Sureshkumar K, Rajendran N, Kailash S, Chitravelu S, Rumaisa N. Does a ban on liquor sales benefit alcohol dependence patients? A study on usage and procurement of alcohol during the COVID-19 lockdown. INDIAN JOURNAL OF HEALTH SCIENCES AND BIOMEDICAL RESEARCH (KLEU) 2023. [DOI: 10.4103/kleuhsj.kleuhsj_489_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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15
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Singh SK, Kumar S. Nature, pattern, and changes in alcohol consumption among men in India: Insights from NFHS-4 and NFHS-5. J Ethn Subst Abuse 2022:1-20. [PMID: 36579708 DOI: 10.1080/15332640.2022.2160853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The consumption pattern of alcohol varies between cultures and different communities. Moreover, alcohol consumption pattern depends on age, religion, education, type of drink, and other socio-economic parameters. Alcohol use has reportedly declined in most developed counties, but developing countries still witnessed an increasing trend. The study investigated socio-economic drivers, nature, and patterns of alcohol use among adult men in India. We have also investigated the state-level alcohol prevalence in India better to understand the impact of state-level alcohol prohibition policies. We have retrieved the data from the National Family Health survey's fourth and fifth-round, which was conducted in 2015-2016 and 2020-2021, respectively. We used the bi-variate technique to estimate that percentage of men who consume alcohol. Furthermore, a multivariate logistic regression model was applied to assess the association of each background characteristic with alcohol consumption. It is observed that 19 percent of men aged 15 and above currently drink alcohol, including 20 percent in rural and 17 percent in urban areas. The consumption of tadi/madi/country liquor/homemade liquor was high in rural areas than in urban areas in both rounds of the survey. Additionally, beer or wine consumption is higher in urban areas than in rural areas in NFHS-4 and NFHS-5. Among the 35-49 years of age group, around 6 and 8 times more likely to consume alcohol in NFHS-4 and NFHS-5, respectively. Rural men were 18 and one percent less likely to consume alcohol in NFHS-4 & 5 compared to urban (OR: 0.82 and 0.99 in NFHS-4 & 5 respectively). Despite an overall reduction in alcohol consumption among men, lowering alcohol consumption remains the main priority of policymakers. There is a need to target the most vulnerable socio-economic segments where alcohol consumption is still a problem, one of the primary reasons for violence against women.
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Affiliation(s)
- S K Singh
- Department of Survey Research and Data Analytics, International Institute for Population Sciences, Mumbai, India
| | - Shubham Kumar
- Department of Survey Research and Data Analytics, International Institute for Population Sciences, Mumbai, India
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16
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Khan J. Nutritional status, alcohol-tobacco consumption behaviour and cognitive decline among older adults in India. Sci Rep 2022; 12:21102. [PMID: 36473919 PMCID: PMC9726887 DOI: 10.1038/s41598-022-25563-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022] Open
Abstract
Cognition capacity is essentially age-dependent and it is associated with the overall well-being of an individual. The public health aspects of cognitive research primarily focus on the possible delaying of cognitive decline among the older adult population. In this context, using the most recent round of the Longitudinal Ageing Study in India, 2017-2018 data, this study examines the cognition capacity among older adults aged 45 and above subject to their nutritional health and health behaviour (tobacco and alcohol consumption). It is observed that almost one in every tenth individual (10%) above 45 years of age in India shows low cognition scores. Low cognition is much more prevalent among 60 + females than males. Around one-fifth of the underweight older adults (18%) demonstrate low cognition capacity among them. Of those older adults who consume only tobacco, 11% of them demonstrate low cognition than the rest. The partial proportional odds model estimation shows that older adults are at higher risk of developing low cognition with increasing age and beyond age 65, the individuals carry a critically higher risk to experience low cognition. The estimation also shows that with increasing age older adults are higher likely to experience poor cognition independent of nutritional status, but underweight older adults are comparatively more likely to experience low cognition followed by normal and overweight older adults. In terms of alcohol-tobacco consumption behaviour, older adults who consume both are more likely to experience low cognition with increasing age followed by 'only alcohol consumers', and 'only tobacco consumers'.
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Affiliation(s)
- Junaid Khan
- grid.419349.20000 0001 0613 2600International Institute for Population Sciences, Deonar, Mumbai, 400088 India ,grid.466534.60000 0004 8340 2194School of Public Health, Asian Institute of Public Health University, Bhubaneswar, 752101 India
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17
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Yohannes K, Ayano G, Toitole KK, Teferi HM, Mokona H. Harmful Alcohol Use Among Patients with Tuberculosis in Gedeo Zone, Southern Ethiopia. Subst Abuse Rehabil 2022; 13:117-125. [DOI: 10.2147/sar.s384921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 11/23/2022] [Indexed: 12/15/2022] Open
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18
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K S, Nattala P, B A A, Murthy P. Nurses' perspectives regarding integrated nursing interventions for psychoactive substance use cessation: A mixed methods study from South India. Perspect Psychiatr Care 2022; 58:2183-2189. [PMID: 35133648 DOI: 10.1111/ppc.13045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 01/16/2022] [Accepted: 01/29/2022] [Indexed: 11/26/2022] Open
Abstract
PURPOSE To obtain nurses' perspectives regarding integrated interventions for substance use cessation for patients in general hospital settings. DESIGN AND METHODS (a) Quantitative survey (N = 207) (nurses' knowledge, attitude, practice, confidence regarding integrated interventions; (b) Focus groups exploring nurses' perspectives regarding integrated interventions (N = 32). FINDINGS Participants' scores (mean, SD): Knowledge-112.5 (10.4) (maximum score-198); Attitude-30.99 (7.05) (maximum-52); Practice-1.66 (2.63) (maximum-28); Confidence-11.90 (3.82) (maximum-24). From the focus groups, four themes were identified: Substance use patterns among patients seeking treatment at the hospitals where the nurses are employed; Nurses' role in providing integrated interventions; Nurses' training needs for providing integrated interventions; Feasibility of providing integrated interventions. PRACTICE IMPLICATIONS Findings provide clear justification for module development to train nurses in providing integrated interventions.
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Affiliation(s)
- Sugavanaselvi K
- Department of Nursing, College of Nursing, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, India
| | - Prasanthi Nattala
- Department of Nursing, & Nursing Consultant, Center for Addiction Medicine, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, India
| | - Arvind B A
- Department of Epidemiology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, India
| | - Pratima Murthy
- Department of Psychiatry, Center for Addiction Medicine, & Director, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, India
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19
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Balhara YPS, Chattopadhyay A, Sarkar S. The "Hidden Story" about Change in Alcohol Use in India over the Past Two Decades: Insights from a Secondary Analysis of Data from the National Family Health Survey. Indian J Psychol Med 2022; 44:234-238. [PMID: 35656423 PMCID: PMC9125478 DOI: 10.1177/02537176211033004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Studies and published reports have not commented on the change in the proportion of the Indian population that consumed alcohol over the years. METHODS We report the findings on changes in alcohol use in India over the past two decades, based on a secondary analysis of the data gathered over the successive National Family Health Surveys (NFHS-3 to 5). RESULTS There was a significant decline (P < 0.001) of around 8% and 45% for the current use of alcohol among men and women from NFHS-3 to NFHS-4. There was a decline in the proportion of men reporting alcohol use across all but one state in NFHS-5 compared to NFHS-3. The decline was statistically significant (P < 0.001) for all but one state. There was a decline in the proportion of women reporting alcohol use in 12 states and an increase in three states. Also, there was a significant (P < 0.001) decline in the proportion of men reporting alcohol use in all the states in NFHS-5 compared to NFHS-4. There was an increase in the proportion of women reporting alcohol use in nine states (statistically significant in six states) in NFHS-5 compared to NFHS-4. However, the proportions were more than NFHS-3 values in two states. CONCLUSIONS These observations on changes in alcohol use in the country over the past two decades will help better understand the trends in alcohol consumption and help better plan the future strategy to address alcohol use and alcohol use disorders.
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Affiliation(s)
- Yatan Pal Singh Balhara
- National Drug Dependence Treatment Center and Dept. of Psychiatry, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Ankita Chattopadhyay
- National Drug Dependence Treatment Center and Dept. of Psychiatry, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Siddharth Sarkar
- National Drug Dependence Treatment Center and Dept. of Psychiatry, All India Institute of Medical Sciences (AIIMS), New Delhi, India
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20
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Singh PK, Dubey R, Singh L, Singh N, Kumar C, Kashyap S, Subramanian SV, Singh S. Mixed Effect of Alcohol, Smoking, and Smokeless Tobacco Use on Hypertension among Adult Population in India: A Nationally Representative Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:3239. [PMID: 35328927 PMCID: PMC8950998 DOI: 10.3390/ijerph19063239] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 02/21/2022] [Accepted: 02/24/2022] [Indexed: 02/01/2023]
Abstract
Sporadic evidence is available on the association of consuming multiple substances with the risk of hypertension among adults in India where there is a substantial rise in cases. This study assesses the mutually exclusive and mixed consumption patterns of alcohol, tobacco smoking and smokeless tobacco use and their association with hypertension among the adult population in India. Nationally representative samples of men and women drawn from the National Family and Health Survey (2015-2016) were analyzed. A clinical blood pressure measurement above 140 mmHg (systolic blood pressure) and 90 mmHg (diastolic blood pressure) was considered in the study as hypertension. Association between mutually exclusive categories of alcohol, tobacco smoking and smokeless tobacco and hypertension were examined using multivariate binary logistic regression models. Daily consumption of alcohol among male smokeless tobacco users had the highest likelihood to be hypertensive (OR: 2.32, 95% CI: 1.99-2.71) compared to the no-substance-users. Women who smoked, and those who used any smokeless tobacco with a daily intake of alcohol had 71% (OR: 1.71, 95% CI: 1.14-2.56) and 51% (OR: 1.51, 95% CI: 1.25-1.82) higher probability of being hypertensive compared to the no-substance-users, respectively. In order to curb the burden of hypertension among the population, there is a need for an integrated and more focused intervention addressing the consumption behavior of alcohol and tobacco.
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Affiliation(s)
- Prashant Kumar Singh
- Division of Preventive Oncology & Population Health, ICMR-National Institute of Cancer Prevention and Research, Noida 201301, India; (R.D.); (N.S.)
- WHO FCTC Knowledge Hub on Smokeless Tobacco, ICMR-National Institute of Cancer Prevention and Research, Noida 201301, India;
| | - Ritam Dubey
- Division of Preventive Oncology & Population Health, ICMR-National Institute of Cancer Prevention and Research, Noida 201301, India; (R.D.); (N.S.)
| | - Lucky Singh
- ICMR-National Institute of Medical Statistics, New Delhi 110029, India;
| | - Nishikant Singh
- Division of Preventive Oncology & Population Health, ICMR-National Institute of Cancer Prevention and Research, Noida 201301, India; (R.D.); (N.S.)
| | - Chandan Kumar
- Department of Policy and Management Studies, TERI School of Advanced Studies, New Delhi 110070, India;
| | - Shekhar Kashyap
- Department of Cardiology, Army Research & Referral Hospital, New Delhi 110010, India;
| | - Sankaran Venkata Subramanian
- Harvard Center for Population and Development Studies, Cambridge, MA 02138, USA;
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Shalini Singh
- WHO FCTC Knowledge Hub on Smokeless Tobacco, ICMR-National Institute of Cancer Prevention and Research, Noida 201301, India;
- ICMR-National Institute of Cancer Prevention and Research, Noida 201301, India
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21
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Murillo-Rodríguez E, Carreón C, Acosta-Hernández ME, García-García F. Stimulants and Depressor Drugs in the Sleep-Wake Cycle Modulation: The case of alcohol and cannabinoids. Curr Top Med Chem 2022; 22:1270-1279. [PMID: 34986773 DOI: 10.2174/1568026622666220105105054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 11/26/2021] [Accepted: 12/05/2021] [Indexed: 11/22/2022]
Abstract
A complex neurobiological network drives the sleep-wake cycle. In addition, external stimuli, including stimulants or depressor drugs, also influence the control of sleep. Here we review the recent advances that contribute to the comprehensive understanding of the actions of stimulants and depressor compounds, such as alcohol and cannabis, in sleep regulation. The objective of this review is to highlight the neurobiological mechanism engaged by alcohol and cannabis in sleep control.
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Affiliation(s)
- Eric Murillo-Rodríguez
- Laboratorio de Neurociencias Moleculares e Integrativas. Escuela de Medicina, División Ciencias de la Salud Universidad Anáhuac Mayab. Mérida, Yucatán. México
| | - Cristina Carreón
- Laboratorio de Neurociencias Moleculares e Integrativas. Escuela de Medicina, División Ciencias de la Salud Universidad Anáhuac Mayab. Mérida, Yucatán. México
| | | | - Fabio García-García
- Biomedicine Department, Health Science Institute, Veracruzana University. Xalapa, Veracruz. México
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22
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Shetty K, Manikappa S, Murthy S, Anjanappa J, Rawat V. Expressed emotion among families of individuals with alcohol dependence syndrome: A pilot study. ANNALS OF INDIAN PSYCHIATRY 2022. [DOI: 10.4103/aip.aip_14_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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23
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Vasavada B. "Nonalcoholic Steatohepatitis: A Rapidly Increasing Indication for Liver Transplantation in India". J Clin Exp Hepatol 2022; 12:1023-1024. [PMID: 35677502 PMCID: PMC9168709 DOI: 10.1016/j.jceh.2021.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 11/08/2021] [Indexed: 12/12/2022] Open
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24
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Khan J, Shaw S. Socio-economic context of alcohol consumption and the associated risky behavior among male teenagers and young adults in India. JOURNAL OF SUBSTANCE USE 2021. [DOI: 10.1080/14659891.2021.2006344] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- Junaid Khan
- Department of Population & Development, International Institute for Population Sciences, Mumbai, India
| | - Subhojit Shaw
- Department of Development Studies, International Institute for Population Sciences, Deonar, Mumbai, India
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25
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Jana K, Ray S, DAS R, Kumar D, Mandal TS, DAS S. ALCOHOLIC VS. NON-ALCOHOLIC CHRONIC PANCREATITIS: SURGEONS' PERSPECTIVE FROM A TERTIARY CENTRE IN INDIA. ACTA ACUST UNITED AC 2021; 34:e1595. [PMID: 34669885 PMCID: PMC8521776 DOI: 10.1590/0102-672020210002e1595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 03/04/2021] [Indexed: 11/21/2022]
Abstract
Background: Although alcohol is the most common cause for chronic pancreatitis worldwide, idiopathic type is prevalent in India. Natural history and disease progression are different between these two groups. There is paucity of data comparing surgical outcome and quality of life in these patients. Aim: To evaluate clinical features, surgical outcome and quality of life between these two groups of patients. Method: All patients with chronic pancreatitis who underwent surgery were prospectively reviewed. Results: From 98 patients, 42 were alcoholic. Number of male and the mean age at the time of operation was significantly more in alcoholic patients. Smoking, preoperative hospital admission rate and the prevalence of local complications like inflammatory pancreatic head mass, biliary stricture and left sided portal hypertension were distinctly more common in alcoholic group. Frey procedure was required more commonly in alcoholic group. Mean postoperative hospital stay and overall postoperative complication rate were comparable between the two groups. Over a median follow up of 18 months there was significant improvement in quality of life and pain score in both the groups. Improvement of physical functioning score at follow-up was significantly more in alcoholic group but the requirement for analgesic medications were significantly more in alcoholic group. However, appetite loss was more perceived by non-alcoholic group. Conclusion: Alcoholic chronic pancreatitis presents with more local complications associated with chronic pancreatitis. Frey procedure is a safe and well accepted surgery in this group. Though they required more analgesic requirement in short term follow up, other aspects of quality of life are similar to non-alcoholic group.
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Affiliation(s)
- Koustav Jana
- Department of Surgical Gastroenterology, SSKM Hospital and IPGMER, Kolkata, West Bengal-700020, India
| | - Sukanta Ray
- Department of Surgical Gastroenterology, SSKM Hospital and IPGMER, Kolkata, West Bengal-700020, India
| | - Roby DAS
- Department of Surgical Gastroenterology, SSKM Hospital and IPGMER, Kolkata, West Bengal-700020, India
| | - Dilip Kumar
- Department of Surgical Gastroenterology, SSKM Hospital and IPGMER, Kolkata, West Bengal-700020, India
| | - Tuhin S Mandal
- Department of Surgical Gastroenterology, SSKM Hospital and IPGMER, Kolkata, West Bengal-700020, India
| | - Somak DAS
- Department of Surgical Gastroenterology, SSKM Hospital and IPGMER, Kolkata, West Bengal-700020, India
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Balasubramani K, Paulson W, Chellappan S, Ramachandran R, Behera SK, Balabaskaran Nina P. Epidemiology, Hot Spots, and Sociodemographic Risk Factors of Alcohol Consumption in Indian Men and Women: Analysis of National Family Health Survey-4 (2015-16), a Nationally Representative Cross-Sectional Study. Front Public Health 2021; 9:617311. [PMID: 34513774 PMCID: PMC8429933 DOI: 10.3389/fpubh.2021.617311] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 07/21/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: To map the alcohol hot spots and understand the Sociodemographic Indices (SDI) affecting alcohol consumption in Indian men and women. Methods: Data from National Family Health Survey-4 carried out from 2015 to 2016 with a sample size of 103,411 men and 699,686 women were used for Geographic Information System mapping, and hot spot identification by spatial statistics (Getis-Ord Gi*). Bivariate analyses and multiple logistic regressions were used to analyze SDI. Results: India has three major alcohol hot spots: (1) North-East (NE) states, (2) Eastern Peninsular states formed by Chhattisgarh, Odisha, Jharkhand, and Telangana, and (3) Southern states of Tamil Nadu and Kerala. Hot spot analysis strongly correlated with region-wise analysis of SDI. Respondents who consumed tobacco have higher odds (men adjusted odds ratio [aOR]: 5.42; women aOR: 4.30) of consuming alcohol. Except for religion and social category, other socioeconomic factors have a low to moderate effect on alcohol consumption. Conclusions: Hot spots and high-risk districts of alcohol consumption identified in this study can guide public health policies for targeted intervention. Alcohol use is at the discretion of individual states and union territories, and stringent anti-alcohol policies strictly enforced across India are the keys to control alcohol use.
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Affiliation(s)
| | - Winnie Paulson
- Department of Epidemiology and Public Health, Central University of Tamil Nadu, Thiruvarur, India
| | | | | | - Sujit Kumar Behera
- Department of Epidemiology and Public Health, Central University of Tamil Nadu, Thiruvarur, India
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Malathesh BC, Kumar CN, Kandasamy A, Moirangthem S, Math SB, Murthy P. Legal, Social, and Occupational Problems in Persons with Alcohol Use Disorder: An Exploratory Study. Indian J Psychol Med 2021; 43:234-240. [PMID: 34345099 PMCID: PMC8287396 DOI: 10.1177/0253717620956466] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Very few studies have examined the extent and nature of legal, social, and occupational problems among persons who have SUDs. This study was aimed at studying the prevalence and patterns of the aforementioned problems among individuals with alcohol use disorders (AUDs) and their relationship with the quantity of alcohol consumed and other variables. METHODS We conducted a cross-sectional study of adult patients with a diagnosis of AUDs admitted to the deaddiction unit of a tertiary care facility in India, using a semistructured questionnaire prepared for this study. RESULTS The mean age (SD) of the 91 subjects (95.6% males) was 40.3 years (8.5). Majority of them (92.3%) had started alcohol consumption before the age of 25 years. Common problems reported were work absenteeism (83.5%), a major altercation with spouse (69.3%), assaulting someone while intoxicated (53.8%), and driving under the influence of alcohol (59.3%). Significant association was found between being unemployed and having a police complaint lodged against them (chi-square = 5.7, P = 0.01). Quantity of alcohol consumed per day was significantly more among those who had a history of work absenteeism (Z = 2.27, P = 0.01), major altercation with spouse (Z = 2.25, P = 0.02) and assaulted someone under intoxication (Z = 2.33, P = 0.02). CONCLUSION The quantity of alcohol consumed is significantly more in those who had several legal, social, and occupational problems when compared to those who did not have, highlighting the need for routine assessment of the aforementioned problems among patients of AUDs. Treatment of AUDs should be multidisciplinary, with targeted interventions tailored to the aforementioned problems. Doing so will go a long way in reducing the harm to patients and the community at large.
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Affiliation(s)
- Barikar C Malathesh
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | | | - Arun Kandasamy
- Center for Addiction Medicine, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Sydney Moirangthem
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Suresh Bada Math
- Forensic Psychiatry services, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Pratima Murthy
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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28
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Prevalence and Determinants of Substance Use Among Indigenous Tribes in South India: Findings from a Tribal Household Survey. J Racial Ethn Health Disparities 2021; 9:356-366. [PMID: 33495925 DOI: 10.1007/s40615-021-00964-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 01/05/2021] [Accepted: 01/07/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Indigenous populations have higher substance use than non-indigenous populations. Current evidence on indigenous substance use is largely derived from national household surveys, while there are no specifically designed, culturally specific methodological studies available to determine the prevalence of substance abuse among the indigenous tribes. The present study examined the prevalence and predictors of alcohol use, smoking, and betel quid chewing among indigenous tribes in South India. METHOD We conducted a cross-sectional population-based random survey of 2186 tribal households in the Wayanad District, Kerala. A self-prepared, pilot-tested structured interview schedule was used to collect information on sociodemographic variables and substance use. Multivariate logistic regression models were used to examine the sociodemographic predictors of substance use. RESULTS The overall prevalence of current alcohol use, current smoking and daily betel quid use was 17.2%, 18.8% and 47.6% respectively. Consistently, male gender (alcohol use OR = 13.55; smoking OR = 3.42; betel quid use OR = 1.65), increasing age (OR = 1.32; OR = 1.01; OR = 1.03), Paniya tribe status (OR = 2.24; OR = 1.39; OR = 5.38) and employment status being working (OR = 2.07; OR = 1.77; OR = 1.26) increased the risk of alcohol use, smoking and betel quid chewing. Furthermore, having 'no formal education' was associated with smoking (OR = 1.35), and betel quid chewing (OR = 3.27). CONCLUSION Substance use was high among the indigenous tribes. The male gender, increasing age, Paniya tribe and working status significantly influenced alcohol use, smoking and betel quid chewing. The results underscore the need for indigenous specific de-addiction policies and programmes, alongside a consideration of the critical sociodemographic predictors.
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Revaiah PC, Vemuri KS, Vijayvergiya R, Bahl A, Gupta A, Bootla D, Kasinadhuni G, Nevali KP, Palanivel Rajan M, Uppal L, Gawalkar A, Rohit M. Epidemiological and clinical profile, management and outcomes of young patients (≤40 years) with acute coronary syndrome: A single tertiary care center study. Indian Heart J 2021; 73:295-300. [PMID: 34154745 PMCID: PMC8322929 DOI: 10.1016/j.ihj.2021.01.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 11/16/2020] [Accepted: 01/14/2021] [Indexed: 11/25/2022] Open
Abstract
Objective: To study the epidemiological and clinical profile, angiographic patterns, reasons for the delay in presentation, management, and outcomes of the acute coronary syndrome (ACS) in young patients (≤40yrs) presenting to a tertiary care hospital in North India. Methods: We included a total of 182 patients aged ≤40 years and presenting with ACS to the cardiology critical care unit of our department from January 2018 to July 2019. Results: The mean age of the study population was 35.5 ± 4.7years. 96.2% were males. Risk factors prevalent were smoking (56%), hypertension (29.7%), family history of premature coronary artery disease (18.2%), and diabetes (15.9%). The median time to first medical contact and revascularization was 300 (10–43200) minutes and 2880 (75–68400) minutes, respectively. ST-elevation ACS (STE-ACS) accounted for 82% and Non-ST-elevation ACS (NSTE-ACS) accounted for 18% of cases. Thrombolysis was done in 51.7% of the cases. Coronary angiography was done in 91.7% and percutaneous coronary intervention (PCI) in 52.2% (95/182) of the total cases. Coronary artery bypass surgery (CABG) was done in 2 patients (1.1%). Among those who underwent coronary angiography, single-vessel disease (SVD) was seen in 53% of the cases. There were no deaths in hospital, and only one patient died during the 30 days follow up. Conclusions: STE-ACS was the most common presentation of ACS in the young population. Smoking was the most common risk factor. The majority of the patients had single-vessel disease, and there was a significant delay in first medical contact and revascularization.
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Affiliation(s)
- Pruthvi C Revaiah
- Department of Cardiology, Post Graduate Institute of Medical Education & Research, Chandigarh, 160012, India
| | - Krishna Santosh Vemuri
- Department of Cardiology, Post Graduate Institute of Medical Education & Research, Chandigarh, 160012, India
| | - Rajesh Vijayvergiya
- Department of Cardiology, Post Graduate Institute of Medical Education & Research, Chandigarh, 160012, India
| | - Ajay Bahl
- Department of Cardiology, Post Graduate Institute of Medical Education & Research, Chandigarh, 160012, India
| | - Ankur Gupta
- Department of Cardiology, Post Graduate Institute of Medical Education & Research, Chandigarh, 160012, India
| | - Dinakar Bootla
- Department of Cardiology, Post Graduate Institute of Medical Education & Research, Chandigarh, 160012, India
| | - Ganesh Kasinadhuni
- Department of Cardiology, Post Graduate Institute of Medical Education & Research, Chandigarh, 160012, India
| | - Krishna Prasad Nevali
- Department of Cardiology, Post Graduate Institute of Medical Education & Research, Chandigarh, 160012, India
| | - M Palanivel Rajan
- Department of Cardiology, Post Graduate Institute of Medical Education & Research, Chandigarh, 160012, India
| | - Lipi Uppal
- Department of Cardiology, Post Graduate Institute of Medical Education & Research, Chandigarh, 160012, India
| | - Atit Gawalkar
- Department of Cardiology, Post Graduate Institute of Medical Education & Research, Chandigarh, 160012, India
| | - Manojkumar Rohit
- Department of Cardiology, Post Graduate Institute of Medical Education & Research, Chandigarh, 160012, India.
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Kan CK, Ragan EJ, Sarkar S, Knudsen S, Forsyth M, Muthuraj M, Vinod K, Jenkins HE, Horsburgh CR, Salgame P, Roy G, Ellner JJ, Jacobson KR, Sahu S, Hochberg NS. Alcohol use and tuberculosis clinical presentation at the time of diagnosis in Puducherry and Tamil Nadu, India. PLoS One 2020; 15:e0240595. [PMID: 33332367 PMCID: PMC7746146 DOI: 10.1371/journal.pone.0240595] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 09/30/2020] [Indexed: 02/07/2023] Open
Abstract
SETTING Alcohol use increases the risk of tuberculosis (TB) disease and is associated with worse outcomes. OBJECTIVE To determine whether alcohol use affects TB severity at diagnosis in a high-burden setting. DESIGN Participants were smear-positive people living with TB (PLWTB) in India. Disease severity was assessed as 1) high versus low smear grade, 2) time to positivity (TTP) on liquid culture, 3) chest radiograph cavitation, and 4) percent lung affected. Alcohol use and being at-risk for alcohol use disorders (AUD) were assessed using the AUDIT-C. Univariable and multivariable analyses were conducted. RESULTS Of 1166 PLWTB, 691 (59.3%) were drinkers; of those, 518/691 (75.0%) were at-risk for AUD. Drinkers had more lung affected than non-drinkers (adjusted mean difference 10.8%, p<0.0001); this was not significant for those at-risk for AUD (adjusted mean difference 3.7%, p = 0.11). High smear grade (aOR 1.0, 95%CI: 0.7-1.4), cavitation (aOR 0.8, 95%CI 0.4-1.8), and TTP (mean difference 5.2 hours, p = 0.51) did not differ between drinkers and non-drinkers, nor between those at-risk and not at-risk for AUD. CONCLUSIONS A large proportion of PLWTB were drinkers and were at-risk for AUD. Alcohol drinkers had more lung affected than non-drinkers. Studies are needed to explore mechanisms of this association.
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Affiliation(s)
- Carolyn K Kan
- Section of Infectious Diseases, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts, United States of America
| | - Elizabeth J Ragan
- Section of Infectious Diseases, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts, United States of America
| | - Sonali Sarkar
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Gorimedu, Puducherry, India
| | - Selby Knudsen
- Section of Infectious Diseases, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts, United States of America
| | - Megan Forsyth
- Section of Infectious Diseases, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts, United States of America
| | - Muthaiah Muthuraj
- Intermediate Reference Laboratory, Government Hospital for Chest Diseases, Gorimedu, Puducherry, India
| | - Kumar Vinod
- Department of Pulmonary Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Gorimedu, Puducherry, India
| | - Helen E Jenkins
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, United States of America
| | - C Robert Horsburgh
- Section of Infectious Diseases, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts, United States of America.,Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, United States of America.,Departments of Epidemiology and Global Health, Boston University School of Public Health, Boston, Massachusetts, United States of America
| | - Padmini Salgame
- Division of Infectious Diseases, Department of Medicine, New Jersey Medical School, Rutgers University, Newark, New Jersey, United States of America
| | - Gautam Roy
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Gorimedu, Puducherry, India
| | - Jerrold J Ellner
- Division of Infectious Diseases, Department of Medicine, New Jersey Medical School, Rutgers University, Newark, New Jersey, United States of America
| | - Karen R Jacobson
- Section of Infectious Diseases, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts, United States of America
| | - Swaroop Sahu
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Gorimedu, Puducherry, India
| | - Natasha S Hochberg
- Section of Infectious Diseases, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts, United States of America
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A critical assessment of the potential of pharmacological modulation of aldehyde dehydrogenases to treat the diseases of bone loss. Eur J Pharmacol 2020; 886:173541. [PMID: 32896553 DOI: 10.1016/j.ejphar.2020.173541] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 09/01/2020] [Accepted: 09/03/2020] [Indexed: 12/19/2022]
Abstract
Chronic alcoholism (CA) decreases bone mass and increases the risk of hip fracture. Alcohol and its main metabolite, acetaldehyde impairs osteoblastogenesis by increasing oxidative stress. Aldehyde dehydrogenase (ALDH) is the rate-limiting enzyme in clearing acetaldehyde from the body. The clinical relevance of ALDH in skeletal function has been established by the discovery of single nucleotide polymorphism, SNP (rs671) in the ALDH2 gene giving rise to an inactive form of the enzyme (ALDH2*2) that causes increased serum acetaldehyde and osteoporosis in the affected individuals. Subsequent mouse genetics studies have replicated human phenotype in mice and confirmed the non-redundant role of ALDH2 in bone homeostasis. The activity of ALDH2 is amenable to pharmacological modulation. ALDH2 inhibition by disulfiram (DSF) and activation by alda-1 cause reduction and induction of bone formation, respectively. DSF also inhibits peak bone mass accrual in growing rats. On the other hand, DSF showed an anti-osteoclastogenic effect and protected mice from alcohol-induced osteopenia by inhibiting ALDH1a1 in bone marrow monocytes. Besides DSF, there are several classes of ALDH inhibitors with disparate skeletal effects. Alda-1, the ALDH2 activator induced osteoblast differentiation by increasing bone morphogenic protein 2 (BMP2) expression via ALDH2 activation. Alda-1 also restored ovariectomy-induced bone loss. The scope of structure-activity based studies with ALDH2 and the alda-1-like molecule could lead to the discovery of novel osteoanabolic molecules. This review will critically discuss the molecular mechanism of the ethanol and its principal metabolite, acetaldehyde in the context of ALDH2 in bone cells, and skeletal homeostasis.
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Gopikrishnan SK, Ponraj DGS, Newtonraj A, Purty AJ, Manikandan M, Vincent A. Prevalence and determinants of Alcohol use in a remote rural area in South India: A community-based cross-sectional study. J Family Med Prim Care 2020; 9:4333-4336. [PMID: 33110855 PMCID: PMC7586508 DOI: 10.4103/jfmpc.jfmpc_917_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 06/21/2020] [Accepted: 07/11/2020] [Indexed: 11/10/2022] Open
Abstract
Introduction: Alcohol use is a major public health problem in India. We sought to study the use of alcohol and its risk factors in a rural area in South India. Methods: This study was conducted in 20 villages surrounding a Rural Health Training Centre, located in South India. The study was done from March 2018 to October 2018 with the help of Medical Interns and Medical Social Workers using a pretested questionnaire. Results: In a total population of 14,925, 11,995 individuals are in the age group of 15 years and above, among whom 1,005 were reported to be using alcohol. The prevalence of alcohol among 15 years and above is 8.4% (7.9–8.9) and the overall prevalence in the total population is 7% (6.3–7.1). Prevalence of alcohol use among males and females are 16% and 1%, respectively. The alcohol use is higher among those who prefer open defecation (adjusted Odds Ratio (aOR) 1.2 (1.0–1.4)), Kutcha house (aOR 1.7 (1.4–2.2)) or semi-pucca house (aOR 1.3 (1.121.6)), lower caste (Most Backward Castes (MBC) aOR 1.7 (1.2–2.2), Scheduled Castes (SC) aOR 2.1 (1.6–2.9)), male gender (aOR 41 (29–59)), Married 5.0 (3.7–6.8), or Separated 2.6 (1.5–4.4) and Diabetes 1.6 (1.1–2.3). Conclusion: Alcohol use in a remote rural area is high among socially deprived communities who live in kutcha and semi-pucca houses and belong to a lower caste. This needs serious public health interventions to improve their socioeconomic status.
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Affiliation(s)
| | | | - Ariarathinam Newtonraj
- Department of Community Medicine, Pondicherry Institute of Medical Sciences, Puducherry, India
| | - Anil Jacob Purty
- Department of Community Medicine, Pondicherry Institute of Medical Sciences, Puducherry, India
| | - Mani Manikandan
- Department of Community Medicine, Pondicherry Institute of Medical Sciences, Puducherry, India
| | - Antony Vincent
- Department of Community Medicine, Pondicherry Institute of Medical Sciences, Puducherry, India
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Johnson A, Gnanaselvam N, Gomes S, Jeskezia JV, Chandran N, Bajaj S. Assessment of 5-year risk of cardiovascular events among adults residing in an urban underprivileged area of Bangalore city: A community-based cross-sectional study. INTERNATIONAL JOURNAL OF NONCOMMUNICABLE DISEASES 2020. [DOI: 10.4103/jncd.jncd_60_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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