🔺CASE STUDY : NO 46 🔺PART NO: 1 🔺MADATYAYA( ALCOHOLIC INTOXICATION) 🔺 NIDANAM (CAUSATIVE FACTORS) -Atiyoga (excessive use) of Madya -Abhyasa – habitual use of alcohol -Drinking Madya in: -Ajirna (improper digestion) -Empty stomach or immediately after meals -In excessive quantity without considering strength -In unsuitable seasons or conditions -Mixing alcohol with incompatible foods (Viruddha Ahara) -These factors aggravate Doshas (mainly Pitta and Vata) and Rajas & Tamas Gunas of the mind.(Reference: Charaka Chikitsa Sthana 24/5–15 Madatyaya is caused due to) 🔺 PURVAROOPAM (PRODROMAL SYMPTOMS) -Heaviness of the head -Vertigo -Lack of mental clarity (buddhi bhrama) -Slight instability in movement -Excitement or irritation -Mild intoxication symptoms like stammering, dullness (Reference: Charaka Chikitsa Sthana 24/22–24) 🔺 LAKSHANAM (CLINICAL FEATURES) -Vataja Madatyaya -Dryness of mouth, tremors, insomnia -Incoherent speech, delusion -Fear, anxiety, rigidity, joint pain -Pittaja Madatyaya -Burning sensation, thirst, dizziness -Excess sweating, anger -Yellow discoloration of eyes and urine -Foul body odor, vomiting - Kaphaja Madatyaya -Excessive sleepiness, nausea -Heaviness in the body -Indigestion, sluggish speech, loss of appetite -SADHARANA LAKSHANAS (COMMON SYMPTOMS) -Mental confusion, depression -Stammering, delirium -Loss of memory, judgment, and behavior -Unconsciousness in severe cases (Reference: Charaka Chikitsa Sthana 24/25–32; Sushruta Uttara Tantra 52) 🔺 SYSTEMIC EXAMINATION *General Physical Examination -Appearance: Unkempt, confused, disoriented, possible slurred speech -Vital Signs: -Pulse: Tachycardia (due to alcohol-induced vasodilation or withdrawal) -Blood Pressure: Hypotension (in acute intoxication) or hypertension (in withdrawal) -Respiration: Depressed in acute overdose; rapid in withdrawal -Temperature: Hypothermia in acute intoxication; fever in alcoholic hepatitis or infections -CNS Examination -Cognitive function: Impaired memory, confusion, disorientation -Gait: Ataxia (unsteady gait) -Speech: Slurred speech (dysarthria) -Reflexes: Hyperreflexia or decreased deep tendon reflexes -Nystagmus: Common in chronic alcoholism or Wernicke’s encephalopathy *Abdominal Examination -Liver: Hepatomegaly, tenderness in right hypochondrium (suggests alcoholic hepatitis or fatty liver) -Ascites: In advanced liver disease -Splenomegaly: In portal hypertension * Skin & Mucous Membranes -Palmar erythema -Spider angiomas -Jaundice -Bruising or petechiae (due to thrombocytopenia) 🔺 LABORATORY INVESTIGATIONS & EXPECTED RESULTS * Liver Function Tests (LFTs) *AST/ALT ratio > 2:1 (classic of alcoholic hepatitis) *Elevated Gamma-Glutamyl Transferase (GGT) – sensitive marker of chronic alcohol use *Elevated Alkaline Phosphatase and bilirubin (in advanced liver disease) * Complete Blood Count (CBC) *Macrocytic anemia – due to folate deficiency *Thrombocytopenia – due to bone marrow suppression or hypersplenism *Leukocytosis – in alcoholic hepatitis or infection * Serum Electrolytes *Hypokalemia, hypomagnesemia, hypophosphatemia – common in chronic alcoholism or withdrawal *Metabolic acidosis – in alcohol-related ketoacidosis * Blood Glucose *Hypoglycemia – especially in binge drinkers or alcoholic liver disease * Coagulation Profile *Prolonged PT/INR – liver dysfunction * Serum Ammonia -Elevated in hepatic encephalopathy - Blood Alcohol Concentration (BAC) -Measured in suspected acute intoxication Levels > 80 mg/dL indicate intoxication; >300 mg/dL can be life-threatening -Vitamin B12, Thiamine (Vitamin B1) -Often low in chronic alcoholics (risk of Wernicke-Korsakoff syndrome) 🛑https://chat.whatsapp.com/JtHGdxv7A5SA9bAe8ZNIS2