ABSTRACT Alcohol withdrawal syndrome (AWS) represents one of the most challenging complications in patients with chronic alcohol use disorder, particularly in severe forms such as delirium tremens or benzodiazepine-refractory withdrawal. Although benzodiazepines remain the standard of care, a subset of patients fail to achieve adequate symptom control despite escalating doses, thereby necessitating the use of adjunctive agents. Dexmedetomidine, a selective α2-adrenergic agonist, has emerged as a promising adjunctive drug in this setting due to its anxiolytic, sedative, and sympatholytic properties, while preserving respiratory drive. We describe five patients with severe AWS requiring intensive care unit admission. Dexmedetomidine infusion was administered in addition to benzodiazepines, and other supportive measures. Clinical response was assessed using the Clinical Institute Withdrawal Assessment for Alcohol-Revised (CIWA-Ar), Richmond Agitation-Sedation Scale (RASS), heart rate, blood pressure, benzodiazepine requirement, and adverse effects. Following initiation of dexmedetomidine, all five patients showed improved control of agitation and stabilization of autonomic hyperactivity. Benzodiazepine requirements decreased during treatment, and none of the patients required endotracheal intubation. Two patients developed transient bradycardia, which resolved after temporary dose reduction or interruption of the infusion. No serious cardiovascular or respiratory adverse event was observed. Dexmedetomidine may be a useful adjunct to benzodiazepines in carefully selected patients with inadequately controlled AWS, particularly when autonomic hyperactivity and agitation persist. Larger controlled studies are required to define optimal dosing, safety, and effects on clinically important outcomes.
ABSTRACT Background: Breast cancer is the most common malignancy among women. Breast-conserving surgery (BCS) and modified radical mastectomy (MRM) are standard surgical treatments; yet, their comparative effects on quality-of-life (QoL) and psychological outcomes remain insufficiently understood. Evidence regarding variation in these outcomes across molecular subtypes of breast cancer is scarce. Aim: To compare the impact of BCS and MRM on QoL, psychological outcomes, and suicidal ideation at six weeks, and to examine differences across molecular subtypes of breast cancer. Materials and Methods: This prospective observational study included 52 breast cancer patients, undergoing BCS ( n = 26) and MRM ( n = 26). QoL was assessed using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 and Breast Cancer-Specific Module-23. Psychological outcomes were measured using the Depression, Anxiety, and Stress Scale-21, and suicidal ideation using the Columbia Suicide Severity Rating Scale. Changes from baseline to six weeks between surgical groups were analyzed using a difference-in-differences (DiD) approach. Comparisons across molecular subtypes were performed using the Kruskal–Wallis test. Results: Both surgical groups demonstrated significant improvement in overall QoL and psychological outcomes at six weeks. DiD analysis showed greater improvement in cognitive functioning, dyspnea, and anxiety symptoms among patients who underwent MRM. Across molecular subtypes, patients with triple-negative breast cancer reported poorer future perspective and greater distress related to hair loss. Conclusion: Both surgical approaches improved QoL and psychological outcomes, although better benefits after the MRM.
ABSTRACT Young people (10–24 years old) face significant issues during a critical developmental period. Therefore, resilience interventions are imperative. The current review aimed to assess the types of resilience-based interventions available in India for adolescents and young people. The current review used databases including PubMed, Google Scholar, Cochrane Library, Web of Science, PsycINFO, and EBSCO-Psychological and Behavioral Sciences collection to search for research studies until December 2024. The Quality Assessment Tool for Studies with Diverse Designs was used to evaluate the quality of the identified studies. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis criteria were followed in this review. Eleven studies met the review inclusion criteria. The resilience-based interventions used diverse approaches across studies. In contrast, resilience-based interventions show potential in improving adolescents and young people. The multidimensional wellbeing, enhancing resilience, problem-solving, coping, emotional regulation, mindfulness, and improving mental health were the major outcomes. However, there is a need for more rigorously designed studies, culturally tailored content, and scalable models to ensure sustained impact.
