Disulfiram Ethanol Reaction with Alcohol-Based Hand Sanitizer: An Exploratory Study.

AIMS: We conducted a cross-sectional survey to estimate the prevalence and clinical manifestation of disulfiram ethanol reaction (DER) and isopropanol toxicity (IT) in patients with alcohol use disorders, on disulfiram. Alcohol-based hand rub contains either ethanol or isopropanol or both. COVID-19 pandemic has led to wide scale usage of sanitizers. Patients with alcohol use disorders, on disulfiram, might experience disulfiram ethanol like reactions with alcohol-based sanitizers. METHODS: We telephonically contacted 339 patients, prescribed disulfiram between January 2014 and March 2020. The assessment pertained to the last 3 months (i.e. third week of March to third week of June 2020). RESULT: The sample consisted of middle-aged men with a mean 16 years of alcohol dependence. Among the 82 (24%) patients adherent to disulfiram, 42 (12.3%) were using alcohol-based hand rubs. Out of these, a total of eight patients (19%; 95% CI 9-33) had features suggestive of DER; four of whom also had features indicative of IT. Five patients (62.5%) had mild and self-limiting symptoms. Severe systemic reactions were experienced by three (37.5%). Severe reactions were observed with exposure to sanitizers in greater amounts, on moist skin or through inhalation. CONCLUSION: Patients on disulfiram should be advised to use alternate methods of hand hygiene.

Role of personal and family factors in alcohol and substance use among adolescents: an international study with focus on developing countries.

Most studies examining adolescent alcohol and substance use or abuse hardly include samples from developing countries. To bridge some gap, the prevalence and associated social correlates of alcohol and substance use and abuse was examined among a cohort of school-going adolescents sampled from seven developing countries. Alcohol and substance abuse was measured using the CRAFFT instrument, independent socio-demographic correlates were determined using regression models. A total of 2454 adolescents completed the study, among which 40.9% reported using either alcohol or at least one other substance during the previous 12 months. This was mostly alcohol (37.8%), followed by marijuana/hashish (8.6%) and other substances (8.1%). Among the adolescents who reported using at least one substance, 45% (18.3% of total sample) had CRAFFT scores indicative of problematic or hazardous substance use. Several personal and family factors were independently associated with use/abuse, and the modifiable nature of these factors calls for appropriate intervention strategies.

Why is premixed insulin the preferred insulin? Novel answers to a decade-old question.

A wide range of sources have been used to create an equally wide range of types of insulin (rapid acting, fast acting, premixed, intermediate acting and long acting). While some of these insulins are no longer in clinical use, others are being used extensively across the world. Premixed insulin is the most frequently prescribed and used insulin in Asia; basal insulin is more extensively used in USA. As compared with basal insulin alone, premixed regimens tend to lower HbA1c to a larger degree while providing enhanced convenience. It is a challenge for diabetologists to assess the conflicting guidelines and decide which one to follow. This is especially true with regard to choosing appropriate insulin for initiation of therapy. Besides, ethnicity may play a key role in determining choice of insulin therapy among different populations. Here, the authors discuss the various factors, pharmacological as well as psychological, that have made premixed insulins the preferred insulin for type 2 diabetes in India and the many parts of Asia. The authors utilize well known theories of psychology, namely generalization, cognitive dissonance and concordance to provide a rational explanation for the preference for premixed insulin that Indian people with diabetes, and their physicians, have.

Body shape and eating attitudes among female nursing students in India.

OBJECTIVES. Eating disorders have been associated with body image disturbances, disordered eating attitudes, and other psychiatric difficulties. There is limited published literature on body shape and eating attitudes from non-western settings. This article presents the findings of a study of eating attitude and body shape concerns among female nursing students in India. METHODS. A cross-sectional observational study was conducted at a government nursing college associated with a tertiary-level multi-specialty hospital. Instruments used included semi-structured proforma, Eating Attitudes Test-26 (EAT-26), and the Body Shape Questionnaire (BSQ). Correlations of age and body mass index with EAT-26 and BSQ scores were carried out using Pearson's correlation statistics. The level of statistical significance was accepted at p < 0.05. RESULTS. A total of 97 nursing students returned the completed study questionnaire. There was a significant positive correlation between body mass index and BSQ score. However, body mass index was not found to be correlated with EAT-26 score. CONCLUSIONS. The findings from the current study bring some interesting insights into body shape and eating attitudes of female nursing students from India.

Inhalant abuse: a study from a tertiary care de-addiction clinic.

OBJECTIVES: Inhalant use has been considered one of the most dangerous forms of substance abuse leading even to serious accidents and death. The current study explored the correlates of inhalant abuse in subjects from a drug de-addiction clinic. METHODS: The study was conducted at a tertiary-level multi-specialty hospital in India, which entailed a chart review of patients with inhalant abuse / dependence presenting to the clinic over a 2-year period. All the treatment records of the de-addiction clinic were reviewed and information gathered regarding these patients. RESULTS: The study involved the records of 36 subjects, with a mean age of 16 years (standard deviation, 4; range, 11-26 years). Most subjects (86%) were adolescents; three-quarters of whom had no family history of substance abuse. The mean (standard deviation) age of initiation of inhalant use was 14 (4) years. The commonest cause of first use reported by the subjects was experimentation (94%), and 97% of them came to know of inhalant from their inhalant-using friends. CONCLUSIONS: These findings provide important information on a relatively under-researched area.