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Introduction: Alcohol is a common substance that is legally available in India. Its prevalence varies across geographical and cultural boundaries. There were sudden restrictions on the supply of alcohol use during the COVID-19 lockdown. We conducted this study to understand the pattern of alcohol withdrawal among COVID-19-positive patients admitted for isolation. Methodology: A cross-sectional study was conducted from March 2020 to May 2020 at the District Government General Hospital, Nizamabad, Telangana, India. Seventy consenting patients admitted to the COVID isolation ward with a history of alcohol use were included in the study. A structured pro forma was used to collect sociodemographic and clinical profiles from the case sheets. The Alcohol Use Disorders Identification Test (AUDIT) score was calculated to understand the problems with alcohol use. Results: Eighty-eight percent of the patients consumed local adulterated toddy. The majority were male (88%), with a mean age of 45 years. The median AUDIT score was high (30). They presented with a significantly higher incidence of complications related to alcohol withdrawal including seizures, delirium, and psychosis. The mortality rate was 11%. Conclusions: There was a high prevalence of alcohol use and related complications in the study population. Adulteration of toddy with long-acting benzodiazepines may have been a reason for the higher incidence of complicated withdrawals. Primary care and family physicians must be cognizant of the problem and must take adequate capacity-building measures to manage the complications.

Substantial variability exists in the evolution of symptoms during alcohol withdrawal. This study is an endeavour to compare the distinction between complicated and uncomplicated alcohol withdrawal syndrome (AWS) with regards to their clinical manifestations. This study was a prospective hospital-based comparative study conducted at the Central Institute of Psychiatry, India. The total sample consisted of 60 male patients of alcohol dependence syndrome who had taken their last drink within 6 h before admission. Measures such as socio-demographic and clinical data sheet, Windsor Clinic Alcohol Withdrawal Assessment Scale and AWS Scale were applied on selected patients. Patients with complicated withdrawal syndrome had symptoms such as withdrawal seizures, delirium tremens along with psychological symptoms. While patients having uncomplicated withdrawal syndrome predominantly showed psychological symptoms such as anxiety, restlessness and agitation accompanied by tremor. Anxiety, tremor and agitation are the universal symptoms of alcohol withdrawal. Complicated alcohol withdrawal is a severe form of withdrawal having predominance of mental symptoms from the outset, though somatic symptoms also become significant from the second day onwards. Complicated alcohol withdrawal is also marked by a longer duration compared to uncomplicated alcohol withdrawal. [ABSTRACT FROM PUBLISHER]

Abstract: Self-mutilation has been defined as deliberate self injury to body tissue without the intent to die. There has been an association between substance abuse and self mutilation. Alcoholic hallucinosis is usually in auditory modality and regarded as harmless. But patients can indulge in self harm behavior when the hallucinosis is commanding type. We are presenting a case in which the patient inflicted multiple stab injury to his own abdomen in response to alcoholic hallucinosis. This has clinical implication to enquire about substance abuse in patients presenting to emergency setting. [Copyright &y& Elsevier]