Harmful Alcohol Use Research Articles

An open-label single-arm clinical study to evaluate effectiveness of polyherbal ayurveda formulation in alcoholic liver disease

Introduction: According to the WHO, alcoholism is the third leading cause of disease burden. Harmful use of alcohol results in 2.5 million deaths per year. Years of alcohol abuse harm the liver, causing alcohol liver disease. Patoladi Gana Kashaya, a polyherbal Ayurveda formulation, alleviates the adverse effects of alcohol as well as liver disorders caused by it. Aims and Objectives: To study the effectiveness of Patoladi gana kashaya on Madya janya yakrit vikara (alcohol liver disease). Methods: The present study implemented an open-label, single-arm before and after a study conducted at SDM College of Ayurveda Hospital, Hassan with 30 individuals (who fulfilled the inclusion and diagnostic criteria). A convenience sampling method was used for the selection. The trial drug Patoladi Gana Kashaya was given in the dose of 30 ml thrice daily after food with lukewarm water for 30 days. A predefined symptom scale and laboratory investigation were used to measure the efficacy before and after the treatment. Statistical analysis of subjective parameters was assessed using Cochran's Q and McNemar test and objective parameters by t-test. Results: The trial drug showed statistical significance in liver function test and lipid profile. In subjective parameters, statistical significance was obtained in Mandagni, Jwara, Chardi, Udarashoola, Baddhashakrith, and Peetanetrashakruthmootrata (P < 0.05). Conclusion: The polyherbal formulation (Patoladi Gana Kashaya-30 ml t.i.d. after food with 30 ml of warm water) is effective in the management of Madya Janya Yakrit Vikara (alcohol liver disease) and requires further investigations using a more vigorous method.

Кросс-секционное исследование потребления алкоголя с вредными последствиями у пациентов, госпитализированных по неотложным показаниям в неврологическое отделение многопрофильного стационара

Background. Alcohol abuse has a direct negative impact on many health-related problems. Materials and methods. Screening self-questionnaires (AUDIT-4) and a highly sensitive and specific marker of chronic alcohol intoxication phosphatidylethanol (PEth), were used to study the spread of alcohol-attributed pathology in acutely ill patients of the neurological department of a multidisciplinary city clinical hospital. The study was based on the data, collected at the Moscow site of a joint Norwegian-Russian observational, cross-sectional study conducted by the University Hospital of Oslo and Moscow Scientific and Practical Center for Addictions. Statistical analysis was performed using IBM SPSS Statistics 25.0 software. Results of the study. 25,5% of patients in the neurological department demonstrated harmful use of alcohol (AUDIT-4 threshold ≥5 for women and ≥7 for men). PEth levels, indicating excessive alcohol consumption during 2-4 weeks before hospitalization, were noted in 24,5% of patients. 15,9% of patients admitted the fact of alcohol consumption past 24 hours. The largest proportion of patients with PEth levels equal to or exceeding 0,3 µmol/l was observed in the diagnostic group "Polyneuropathies and other lesions of the peripheral nervous system" (G60-G64) – 78,2%, followed by "Episodic and paroxysmal disorders" (G40-G47) – 47,3%, "Cerebrovascular diseases" (I60-I69) – 21,7% and "Other pathologies" – 16,7%. Conclusions. Our data confirm the need for short-term interventions by primary contact physicians, especially if an alcohol-attributed or alcohol-associated disease is diagnosed. This requires screening for alcohol consumption, preventive interventions and involvement of relevant professionals. The correct definition of the genesis of the disease will provide the patient with the most effective assistance and properly place emphasis in the composition of therapeutic programs.

Alcohol in primary health care: attitude of health professionals regarding the consumption and harmful use of alcohol and alcoholism

Resumo Avaliaram-se fatores associados às atitudes de profissionais da Atenção Primária à Saúde (APS) quanto ao consumo e uso prejudicial de álcool e o alcoolismo dos usuários, além de suas percepções sobre possíveis mudanças no consumo de álcool durante a pandemia de covid-19. Trata-se de pesquisa avaliativa feita no interior de São Paulo em 2020. Analisaram-se características sociodemográficas sobre o consumo de álcool e a atitude com os usuários. Dos 94 profissionais do município, 65 participaram, sendo 67,7% deles com experiência no tema. A maioria (80%) não modificou seu consumo durante a pandemia, mas 50,8% deles perceberam aumento no consumo pelos usuários. Identificaram-se atitudes positivas em relação a ser do sexo masculino (p=0,014) e ter cor da pele branca (p=0,020), residir sozinho (p=0,047) e maior consumo pelos profissionais (p=0,037). Atuar na Estratégia Saúde da Família (ESF) associou-se com atitudes mais positivas (p=0,029). Concluiu-se que características pessoais influenciam na atitude, assim como o tipo de serviço. Há muito o que avançar em relação às atitudes dos profissionais de saúde para que ofereçam assistência adequada aos usuários que consomem álcool. Porém, a disseminação de conhecimento específico sobre a doença e a pessoa que faz uso de álcool parece ser uma das principais estratégias de enfrentamento deste importante agravo à saúde.

Medical and social implications of alcohol use among adult women in a rural area of Ranchi, Jharkhand: A cross-sectional study.

The harmful use of alcohol is increasing at a huge pace leading to the occurrence of multiple diseases and has become a leading risk factor for global burden of diseases. The aim of this study is to assess the health profile of adult women and to find out the medical and social effects of alcohol consumption. A cross-sectional study was conducted in the rural field practice area, Ormanjhi of RIMS, Ranchi, for a duration of 27 months (September 2016 to November 2018) among 336 women by multistage random sampling. A pretested semi-structured questionnaire was used for data collection. Templates were generated in MS Excel sheet and analysis of data was done using SPSS software (20.0). The mean BMI of the study subjects was 21.62 ± 3.33 kg/m2. Anaemia was present in 42.6% of the women, 10.4% women were hypertensive and 9.2% were suffering from diabetes. The association between alcohol consumption and occurrence of co-morbidities was found insignificant. The social effects of alcoholism varied ranging from going into debts seen in 35.42% of the women; 62.5% of the women were criticised about their drinking habit by relatives or children. About 9.5% of the women were found to consume alcohol during their last pregnancy, and among women who were on regular intake of alcohol even during pregnancy, majority (65.62%) of them delivered by normal vaginal delivery. Alcohol consumption among females caused several adverse social consequences without any significant effect on health.

O álcool na atenção primária à saúde: atitude dos profissionais de saúde quanto ao consumo e uso prejudicial de álcool e o alcoolismo

Abstract Factors associated with the attitudes of Primary Health Care (PHC) professionals regarding the consumption and harmful use of alcohol and the users’ alcoholism were evaluated, in addition to their perceptions about possible changes in alcohol consumption during the COVID-19 pandemic. This is an evaluative study conducted in the interior of São Paulo in 2020. Sociodemographic characteristics regarding alcohol consumption and attitude towards users were analyzed. A total of 65 of the 94 professionals in the municipality participated, with 67.7% of them having experience in the subject. Most (80%) did not change their consumption during the pandemic, but 50.8% noticed an increase in consumption by users. Positive attitudes towards being male (p=0.014) and having white skin color (p=0.020), living alone (p=0.047) and higher consumption by professionals (p=0.037) were identified. Acting in the Family Health Strategy (Estratégia Saúde da Família - ESF) was associated with more positive attitudes (p=0.029). In conclusion, personal characteristics influence the attitude, as well as the type of service. There is much to be done regarding the attitudes of health professionals to offer adequate care to users who consume alcohol. However, disseminating specific knowledge about the disease and the alcohol user seems to be one of the main coping strategies for this important health problem.

Cardiac complexities: all we have to know about our heart

The leading cause of death worldwide is cardiovascular disease (CVD). In 2019, an estimated 17.9 million people died from CVDs, or 32% of all deaths worldwide. Over 75% of deaths from cardiovascular disease occur in low- and middle-income countries. Many CVDs can be prevented by identifying behavioural risk factors like poor diet, smoking, tobacco use, hyperlipedema, obesity, harmful alcohol use, and lack of physical activity. A group of ailments known as cardiovascular diseases (CVDs) include myocardial infarction, cerebrovascular disease, coronary heart disease, rheumatic heart disease, congenital heart disease, and other conditions. Additionally, heart attacks and strokes account for four out of every five CVD deaths, and one-third of these deaths occur in people under the age of 70. Frequently, the basic blood vessel disease goes unnoticed for years. A heart attack or stroke could be the first symptom of an underlying condition. Pain or discomfort in the middle of the chest, as well as discomfort or pain in the left shoulder, arms, jaw, elbows, or back, numbness, and weakness, are all signs of a heart attack. Additionally, the individual could experience respiratory problems or fatigue, numbness, and back pain. Additionally, the person may have shortness of breath or difficulty breathing, nausea or vomiting, faintness and light-headedness, sweating, shivering, and a change in skin colour. Women are more likely than men to have nausea, breathlessness, jaw or back discomfort, and vomiting. An array of imaging studies and laboratory testing are used to diagnose CVDs. The patient's medical history and family history, physical examination, risk factors, and combining these findings with the outcomes of treatments and tests make up the majority of a diagnosis The World Health Organization (WHO) encourages governments to manage, prevent, and monitor cardiovascular diseases (CVDs) by increasing global strategies to minimise the incidence, mortality, and morbidity of these diseases. Some of the typical tests performed to diagnose cardiovascular diseases include: Blood tests and chest X-rays include ECG or EKG, Echocardiogram, Coronary angiogram, MRI, CCTA, and other tests. Reduced risk factors, the cessation of tobacco use, reduced salt intake, increased consumption of fruits and vegetables, well planned physical activity, and abstinence from alcohol abuse have all been demonstrated to reduce the incidence of CVDs . Increasing the capacity of the health system to care for people with CVD, distributing standards of care, and monitoring disease patterns and trends to inform national and international initiatives. The consequences of behavioural risk factors, which are linked to important socioeconomic determinants and drivers including income, ageing, and urbanisation, may manifest in people as raised blood sugar, elevated blood pressure, elevated blood lipids, obesity, and overweight.

Harmful Alcohol Use and Associated Socio-Structural Factors among Female Sex Workers Initiating HIV Pre-Exposure Prophylaxis in Dar es Salaam, Tanzania.

Harmful alcohol use is an important risk factor for premature mortality and morbidity and associated with increased HIV risk and lower uptake of and adherence to HIV interventions. This study aimed to assess the extent of harmful alcohol use and associated socio-structural vulnerability factors among female sex workers in Dar es Salaam, Tanzania, a key population in the HIV epidemic. Data from a study of female sex workers initiating pre-exposure prophylaxis (PrEP) recruited through respondent driven sampling were used. We assessed harmful alcohol use with the Alcohol Use Disorders Identification Test (AUDIT) defined as having an AUDIT score ≥ 16. Associations between harmful alcohol use and socio-structural factors were assessed using logistic regression with marginal standardization. Of the 470 women recruited, more than one third (37.3%) had a drinking pattern suggestive of harmful alcohol use. Such use was independently associated with sex work-related mobility (aPR: 1.36, 95% CI: 1.11-1.61), arrest/incarceration (aPR: 1.55, 95% CI: 1.27-1.84) and gender-based violence (aPR: 1.31, 95% CI: 1.06-1.56). The high prevalence of harmful alcohol use and the interconnectedness with socio-structural factors indicate a need for a holistic programmatic approach to health for female sex workers. Programming should not solely direct attention to individual behavior but also include strategies aiming to address socio-structural vulnerabilities.

The nexus between harmful alcohol use and intimate partner violence, a case study

Globally, alcohol use is an important public health concern which often contributes to Intimate Partner Violence (IPV/F), Femicide and Gender Based Violence (GBV). Interfacing of alcohol use and intimate partner violence in under-resourced and rural areas has received little empirical attention and interventions for enlightening the crisis of IPV and related social ills. This paper explored the nexus between alcohol use and intimate partner violence in under-resourced and rural areas. The study employed a qualitative, exploratory multiple case study design. Purposive, snowballing and convenience sampling techniques were employed. The study was cleared ethically by the registered body at the university. Data was analysed thematically. This study found that the majority of the cases showed a linkage between intimate partner violence and substance abuse incidents. It can be concluded that the availability and affordability of alcohol play a role in IPV. Awareness campaigns about the linkage between substance abuse and IPV should be implemented.

Emotion regulation in young adults with family history of harmful alcohol use: A fMRI study

BackgroundAlcohol use disorder is associated with difficulties in emotion regulation and cognitive reappraisal. Family history of harmful alcohol use increases risk of substance use disorders, but no studies have examined whether family history is associated with altered neural activation during cognitive reappraisal relative to passive viewing of negative images in a sample of young adults without current substance use disorders. MethodsParticipants (N = 75 with positive [n = 31] or negative [n = 44] family histories of harmful alcohol use) completed the emotion regulation task during an MRI scan, and the Emotion Regulation Questionnaire to assess use of emotion regulation and suppression strategies. Whole-brain analyses and amygdala region of interest analyses using linear mixed-effects models assessed family history group and cue effects on neural activation during the task. ResultsThe groups did not differ on trait reappraisal, suppression, or negative emotion following reappraisal. In general, group effects in whole-brain and amygdala activation during the cognitive reappraisal contrast indicated small effect sizes (2.2% of voxels had d>0.20) that were not significantly different. Participants with positive family histories engaged the right middle and superior frontal gyri to a greater extent than participants with negative family histories during the decrease-negative cue (t = 4.14, p = .001). ConclusionsFor at-risk young adults without current harmful substance use, family history of harmful alcohol use does not appear to be associated with disrupted emotion regulation when instructed to apply cognitive reappraisal. Reappraisal may be a feasible therapeutic target for those who develop a substance use disorder with associated emotion dysregulation.

Insulin resistance phenotype is associated with vascular risk phenotype at the end of the second decade of life: a population-based study

We hypothesize that early events of diabetes and cardiovascular disease continuums would be ongoing and associated in adolescents. We investigated the association between the Insulin Resistance Phenotype and the Vascular Risk Phenotype at the end of the second decade of life and indirect pathways from social vulnerability, alcohol consumption, and body fat mass. It is a population-based study in the RPS cohort of 18–19 years (n = 2,515), São Luís, Brazil. The theoretical model analyzed the association between Insulin Resistance Phenotype and Vascular Risk Phenotype by sex, using structural equation modeling (SEM). The Insulin Resistance Phenotype was a latent variable deduced from the correlations of Triglyceride to HDL ratio, Triglyceride Glycemic index, and VLDL; the Vascular Risk Phenotype was deduced from Systolic Blood Pressure, Diastolic Blood Pressure, and Pulse Wave Velocity. The Insulin Resistance Phenotype was directly associated with the Vascular Risk Phenotype in males (standardized coefficient SC = 0.183; p < 0.001) and females (SC = 0.152; p < 0.001). The Insulin Resistance Phenotype was an indirect pathway in the association of alcohol consumption and higher values of fat mass index with the Vascular Risk Phenotype. VLDL presented the highest factor loading, appearing as a marker of insulin resistance linked to cardiovascular risk in young people. Lower values of socioeconomic status, harmful use of alcohol, and high body fat values were also associated with higher values of the two phenotypes. The association of the Insulin Resistance Phenotype with the Vascular Risk Phenotype suggests common pathophysiological mechanisms present in early events in the continuums of diabetes and cardiovascular disease in adolescence.

Strong chū-hai, a Japanese ready-to-drink high-alcohol-content beverage, and hazardous alcohol use: A nationwide cross-sectional study.

A new ready-to-drink premixed high-alcohol-content beverage, called strong chū-hai, was launched in Japan, and more recently, in Taiwan and Australia. We aimed to examine the popularity and association of strong chū-hai with individual alcohol use, both of which remained unclear. We conducted a cross-sectional study using data from the Japan "Society and New Tobacco" Internet Survey conducted from February 1 to 28, 2022, in Japan. We enrolled 27,993 respondents (aged 15 to 81 years; male 48.5%), including 15,083 current alcohol users. Using inverse probability weighting of data from the 2016 Comprehensive Survey of Living Conditions on Health and Welfare, we estimated the weighted proportions of strong chū-hai users among all respondents and constructed multivariable logistic regression models to estimate the weighted odds ratios (OR) and 95% confidence intervals (CI) of strong chū-hai use for hazardous and harmful alcohol use, defined as a score ≥8 of the Alcohol Use Disorder Identification Test, among current alcohol users. Among all respondents, 56.2% (weighted proportions: past, 35.9%; and current, 20.3%) drank strong chū-hai. Among drinkers, both past and current strong chū-hai use, compared to never use, were associated with hazardous and harmful alcohol use (past, OR 1.73, 95% CI 1.42 to 2.12; current, OR 2.19, 95% CI 1.79 to 2.69). Our study found that more than half of the respondents experienced strong chū-hai consumption, suggesting that it is widely used in Japan. In addition, both past and current strong chū-hai use were associated with hazardous and harmful alcohol use among current alcohol users.

The Relationship of the Cardiovascular System Health With Demensia at the Age of 50-60 Years at Haji General Hospital

Dementia is a syndrome in which there is a decline in memory, thinking, behavior and ability to carry out daily activities. Several studies have shown a link between the development of cognitive impairment and dementia and educational attainment, and lifestyle-related risk factors, such as physical inactivity, tobacco use, unhealthy diet and harmful use of alcohol. Dementia can be identified using the MMSE ( Mini Mental State Examination ). Furthermore, certain medical conditions are associated with an increased risk of developing dementia, including hypertension, diabetes, dyslipidemia, obesity and depression. The ideal cardiovascular health score, also referred to as Life's Simple 7, consists of four health behavior indicators, and three biologics. analysis using a cross-sectional design , which was carried out at the Hajj Hospital, December 2020 - March 2021 and involved 70 respondents. Data obtained by medical records and interviews. Based on the results of the study, the results of the somer's d correlation test obtained a value of p = 0.000 (p &lt;0.05) so that a significant relationship was found between the Health of the Cardiovascular System and the Incidence of Dementia at the Age of 50-60 Years . There is a relationship between the health of the cardiovascular system and the incidence of dementia at the age of 50-60 years.

Harmful Alcohol Use Among Patients with Tuberculosis in Gedeo Zone, Southern Ethiopia.

Alcohol consumption among patients with tuberculosis is on the rise. There is evidence that alcohol consumption negatively affects treatment outcomes for these populations. Due to this, a substantial number of people relapse, withdraw from treatment, or even die as a result of their alcohol addiction. Despite this, little research has been conducted on the factors associated with the harmful use of alcohol by this group of people in Ethiopia. The purpose of this study was to determine the prevalence and associated factors of harmful alcohol use among patients with tuberculosis in the Gedeo Zone, southern Ethiopia. A cross-sectional study was conducted at healthcare facilities. Four hundred and fifteen participants aged 18 and older were recruited using a systematic random sampling method. Data on sociodemographic factors, clinical factors, social support, perceptions of the stigma associated with tuberculosis, and depression were collected using structured and validated instruments. Measurement of harmful alcohol consumption was conducted using the AUDIT. The prevalence of harmful alcohol use among tuberculosis patients was 20% (95% CI; 16.1-24.2%). There is a significant correlation between medical comorbidity (AOR = 2.44, 95% CI: 1.29-4.62), disease duration (≥12 months) (AOR = 2.88, 95% CI: 1.03-3.04), and being male (AOR = 2.10, 95% CI: 1.17-3.77) with harmful alcohol consumption. Our study revealed that alcohol consumption was high among tuberculosis patients. The presence of comorbidities, being male, and having a long-term illness were significant predictors of harmful alcohol consumption. It is imperative to screen patients who have suffered from chronic tuberculosis for an extended period of time. It is also pertinent to screen patients with comorbid medical conditions for alcohol abuse. Screening for alcohol abuse at an early stage can prevent poor treatment outcomes as well as the effects of comorbid medical conditions and harmful use of alcohol.

VACCINATION FOR COVID -19 PATIENTS WITH ARTERIAL HYPERTENSION

Cardiovascular disease (CVD) is the leading cause of death worldwide: no other cause causes as many deaths each year as CVD. An estimated 17,9 million people died from CVD in 2016, accounting for 31% of all deaths worldwide. 85% of these deaths were due to heart attack and stroke. Most cardiovascular diseases can be prevented by addressing risk factors such as tobacco use, unhealthy diet and obesity, physical inactivity and harmful use of alcohol through population-wide strategies [1]. In Uzbekistan, the risk of premature death (among the population aged 30-69 years) from the four major NCD groups is approximately 31%; CVD is the leading cause of death. A quarter of adults aged 18-64 and almost a third of adults aged 40-64 are at high risk of having a heart attack or stroke within the next 10 years. Men are particularly at risk for cardiovascular risk given their tobacco use and the harmful use of alcohol. In general, men tend to underuse health services; blood pressure in this population is also under-controlled [2].

Feasibility of SMS booster for alcohol reduction in injury patients in Tanzania.

Alcohol use is associated with 3 million annual deaths globally. Harmful alcohol use, which is associated with a high burden of disease in low- and middle-income countries (LMICs), often increases the probability of traumatic injury. Treatments for harmful alcohol use in LMICs, such as Tanzania, lack trained personnel and adequate infrastructure. The aim of this study was to assess the feasibility of using SMS boosters to augment a hospital based brief negotiational intervention (BNI) in this low resourced setting. We conducted a three stage, four arm feasibility trial of a culturally adapted BNI for injury patients with harmful and hazardous drinking admitted to Kilimanjaro Christian Medical Centre (KCMC) in Moshi, Tanzania. Post hospital discharge, two of the four arms included patients receiving either a standard or personalized short message service (SMS) booster to enhance and or perpetuate the effect of the in-hospital BNI. Text messages were sent weekly throughout a 3-month follow-up period. SMS feasibility was assessed according to the TIDier checklist evaluating what, when, how much, tailoring processes, modifications and how well (intervention fidelity). Data was collected with SMS logs and short answer surveys to participants. A total of 41 study participants were assigned to each receive 12 SMS over a three-month period; 38 received messages correctly, 3 did not receive intended messages, and 1 received a message who was not intended to. Of the 258 attempted texts, 73% were successfully sent through the messaging system. Of the messages that failed delivery, the majority were not able to be sent due to participants traveling out of cellular service range or turning off their phones. Participants interviewed in both booster arms reported that messages were appropriate, and that they would appreciate the continuation of such reminders. At 6-month follow-up, 100% (n = 11) of participants interviewed believed that the boosters had a positive impact on their behavior, with 90% reporting a large impact. This study demonstrated feasibility and acceptability of the integration of SMS mobile health technology to supplement this type of nurse-led BNI. SMS booster is a practical tool that can potentially prolong the impact of a brief hospital based intervention to enact behavioral change in injury patients with AUD.

The effects of yoga on cardiovascular risk factors

Cardiovascular diseases is a group of disorders of the heart and blood vessels, including coronary heart disease, cerebrovascular disease, rheumatic heart disease, peripheral artery disease, congenital heart disease, deep vein thrombosis, and pulmonary embolism. The most important behavioral risk factors for heart disease and stroke are poor diet, physical inactivity, smoking, and harmful alcohol use. The impact of behavioral risk factors may manifest in each individual as high blood pressure, hyperglycemia, hyperlipidemia, overweight, and obesity. The purpose of this study was to give a thorough scientific analysis of yoga’s contribution to the management and prevention of cardiovascular diseases and related risk factors. The records are collected from several databases. We performed an extensive search of the PubMed/Medline electronic database. However, it is believed that the risk of cardiovascular disease can be reduced by adjusting for several risk factors, such as increasing physical activity and using relaxation to reduce stress, both of which are elements of yoga. As yoga has become an increasingly popular form of exercise, it could be an important intervention for primary and secondary cardiovascular disease prevention. Evidence suggests that regular exercise can reduce the risk of death from cardiovascular disease, and it is beneficial when included in primary and secondary prevention strategies. This review assessed the effectiveness of yoga in reducing various cardiovascular risk factors (blood pressure, weight, body mass index, lipid profile, blood sugar). There is promising evidence that the practice of yoga improves cardiovascular health. Yoga practice length has a beneficial relationship with reducing the risk of сardiovascular diseases. Numerous studies used limited sample numbers, varied the forms and lengths of their yoga treatments, and omitted information on the processes behind change. The prevention and management of cardiovascular illnesses and associated risk factors, however, might be greatly aided by yoga. To even further understand the numerous possible mechanisms behind yoga’s effects, more research is necessary.

Expert consensus on the diagnosis and management of alcoholic liver disease

&lt;p&gt;Alcoholic liver disease (ALD) is a spectrum of liver injuries caused due to harmful use of alcohol. It is the primary cause of liver disease and is responsible for around 4% of mortality worldwide. ALD progresses from fatty liver to alcoholic hepatitis depending upon risk factors, such as continued alcohol consumption or comorbid liver diseases. Screening and diagnosis are suggested for patients with histological symptoms and in high-risk populations. Management of ALD includes strategies such as abstinence from alcohol consumption, nutrition therapy, pharmacological therapy, and liver transplantation, with alcohol abstinence being the most beneficial to reverse fatty liver conditions. Various novel treatment approaches having distinct mechanisms of action are also developed besides conventional corticosteroid therapy, which include microbiota-based precision medicine, monoclonal antibody therapy, hepatocyte regeneration therapy, epigenetic modulators, liver degeneration boosters, and targeting the gut-liver axis. Ursodeoxycholic acid (UDCA) has shown to benefit ALD patients with cholestasis by exerting biochemical improvements; hence, it can be considered as an adjunct therapy. National and regional advisory board meetings were conducted to discuss the current diagnostic and management techniques, including existing and novel pharmacological treatments available for ALD along with current clinical practices in India.&lt;/p&gt;

Effect of Selective Personality-Targeted Alcohol Use Prevention on 7-Year Alcohol-Related Outcomes Among High-risk Adolescents

Alcohol consumption is one of the leading preventable causes of burden of disease worldwide. Selective prevention of alcohol use can be effective in delaying the uptake and reducing harmful use of alcohol during the school years; however, little is known about the durability of these effects across the significant transition from early adolescence into late adolescence and early adulthood. To examine the sustained effects of a selective personality-targeted alcohol use prevention program on alcohol outcomes among adolescents who report high levels of 1 of 4 personality traits associated with substance use. A cluster randomized clinical trial was conducted to assess the effectiveness of the selective personality-targeted PreVenture program on reducing the growth of risky alcohol use and related harms from early to late adolescence and early adulthood. Participants included grade 8 students attending 14 secondary schools across New South Wales and Victoria, Australia, in 2012 who screened as having high levels of anxiety sensitivity, negative thinking, impulsivity, and/or sensation seeking. Schools were block randomized to either the PreVenture group (7 schools) or the control group (7 schools). The primary end point of the original trial was 2 years post baseline; the present study extends the follow-up period from July 1, 2017, to December 1, 2019, 7 years post baseline. Data were analyzed from July 22, 2021, to August 2, 2022. The PreVenture program is a 2-session, personality-targeted intervention designed to upskill adolescents to better cope with their emotions and behaviors. Self-reported monthly binge drinking, alcohol-related harms, and hazardous alcohol use measured by the Alcohol Use Disorders Identification Test-Concise consumption screener. Of 438 participants (249 male [56.8%]; mean [SD] age, 13.4 [0.5] years) from 14 schools, 377 (86.2%) provided follow-up data on at least 2 occasions, and among those eligible, 216 (54.0%) participated in the long-term follow-up. Compared with the control condition, the PreVenture intervention was associated with reduced odds of any alcohol-related harm (odds ratio [OR], 0.81 [95% CI, 0.70-0.94]) and a greater mean reduction in the frequency of alcohol-related harms (β = -0.22 [95% CI, -0.44 to -0.003]) at the 7.0-year follow-up. There were no differences in the odds of monthly binge drinking (OR, 0.80 [95% CI, 0.56-1.13]) or hazardous alcohol use (OR, 0.87 [95% CI, 0.59-1.27]) at the 7.0-year follow-up. Exploratory analyses at the 5.5-year follow-up showed that compared with the control condition, the PreVenture intervention was also associated with reduced odds of monthly binge drinking (OR, 0.87, [95% CI, 0.77-0.99]) and hazardous alcohol use (OR, 0.91 [95% CI, 0.84-0.99]), but this was not sustained. This study demonstrated that a brief selective personality-targeted alcohol use prevention intervention delivered in the middle school years can have sustained effects into early adulthood. anzctr.org.au Identifier: ACTRN12612000026820.

Role of the ghrelin system in alcohol use disorder and alcohol-associated liver disease: A narrative review.

Unhealthy alcohol consumption is a global health problem. Adverse individual, public health, and socioeconomic consequences are attributable to harmful alcohol use. Epidemiological studies have shown that alcohol use disorder (AUD) and alcohol-associated liver disease (ALD) are the top two pathologies among alcohol-related diseases. Consistent with the major role that the liver plays in alcohol metabolism, uncontrolled drinking may cause significant damage to the liver. This damage is initiated by excessive fat accumulation in the liver, which can further progress to advanced liver disease. The only effective therapeutic strategies currently available for ALD are alcohol abstinence or liver transplantation. Any molecule with dual-pronged effects at the central and peripheral organs controlling addictive behaviors and associated metabolic pathways are a potentially important therapeutic target for treating AUD and ALD. Ghrelin, a hormone primarily derived from the stomach, has such properties, and regulates both behavioral and metabolic functions. In this review, we highlight recent advances in understanding the peripheral and central functions of the ghrelin system and its role in AUD and ALD pathogenesis. We first discuss the correlation between blood ghrelin concentrations and alcohol use or abstinence. Next, we discuss the role of ghrelin in alcohol-seeking behaviors and finally its role in the development of fatty liver by metabolic regulations and organ crosstalk. We propose that a better understanding of the ghrelin system could open an innovative avenue for improved treatments for AUD and associated medical consequences, including ALD.

Countrywide "best buy" interventions for noncommunicable diseases prevention and control in countries with different level of socioeconomic development.

Noncommunicable diseases (NCDs) place a heavy burden on populations globally and in particular, onlower-income countries (LIC). WHO identified a package of 16 "best buy" lifestyle and management interventions that are cost-effective and applicable in all settings. The purpose of this study was to evaluate and compare NCD risk factors in all WHO countries and make preliminary assessment of "best buy" interventions. Risk factors estimation was made in 188 countries. NCD attributable "best buys" concern tobacco use, unhealthy diet, physical inactivity, and harmful use of alcohol. Management issues are based on the availability of the national NCD guidelines and provision of drug therapy. Every fourth adult in high-income countries (HIC) has raised blood pressure (RBP). Prevalence of RBP in lower-middle-income countries (LMIC) and LIC is 22%-23% (HIC/LMIC: t = 3.12, p < 0.01). Prevalence of diabetes in LIC is less than half of that in HIC and upper-middle-income countries (UMIC) UMIC/LIC: t = 8.37, p < 0.001. Obesity prevalence is gradually decreasing from HIC to LIC (HIC/LIC: t = 11.48, p < 0.001). Highest level of physical inactivity is seen in HIC, which then gradually declines to LIC (17%). Tobacco prevalence in LIC is almost less than half of that in HIC and UMIC (HIC/LIC: t = 7.2, p < 0.0001). There is a gradual decline in the implementation of "best buys" from HIC to LIC. Wealthier countries have better implementation of the WHO NCD prevention strategy.