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BackgroundAlcohol withdrawal syndrome (AWS) is a distressing condition, generally controlled by benzodiazepines (BZD's). Baclofen, a gamma-aminobutyric acid-B (GABAB) agonist, has also shown promising results in controlling AWS. As there are few studies comparing the efficacy and tolerability of chlordiazepoxide with baclofen, the present study was taken up. The objective of this study was to compare efficacy and tolerability of baclofen with chlordiazepoxide in uncomplicated AWS.MethodsSixty subjects with uncomplicated AWS were randomized into two groups of 30 each, to receive baclofen (30 mg) or chlordiazepoxide (75 mg) in decremented fixed dose regime for 9 days. Clinical efficacy was assessed by Clinical Institute Withdrawal Assessment for Alcohol-Revised Scale (CIWA-Ar) and tolerability by the nature and severity of adverse events. Lorazepam was used as rescue medication. Secondary efficacy parameters were Clinical Global Impression scores, symptom-free days, and subject satisfaction as assessed by visual analog scale. This study was registered with Clinical Trial Registry-India (CTRI/2013/04/003588), also subsequently registered with WHO's ICTRP clinical trial portal.ResultsBoth baclofen and chlordiazepoxide showed a consistent reduction in the total CIWA-Ar scores. However, chlordiazepoxide showed a faster and a more effective control of anxiety and agitation requiring lesser lorazepam supplementation, and also showed a better subject satisfaction compared to baclofen. Both the drugs showed good tolerability with mild self-limiting adverse events.ConclusionThe present study demonstrates that baclofen is not as good as chlordiazepoxide in the treatment of uncomplicated AWS. However, baclofen might be considered as an alternative.

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Background: Visual impairment poses a significant threat to proper medication practice leading to medication related challenges and some adopted self coping strategies with substantial impact on medication adherence. Visually impaired are potentially more likely to have unsafe medicine related practice which by itself is more rampant in general population. Studies related to them are largely unexplored and can provide data to improve disease management and health related quality of life. Objectives was to study the level of medication adherence, medication related challenges and self adopted coping strategies in visually impaired people.Methods: A cross sectional descriptive study enrolling 204 subjects with VI was done. Medication adherence was assessed using MMAS. Medication related challenges and self-adopted coping strategies was assessed by using pre-validated semi-structured questionnaire.Results: Majority of the subjects showed medium medication adherence with forgetfulness to take medicine as the main reason for non adherence. Difficulty in remembering the instructions, spilling of liquid medicine, taking wrong dose, difficulty in using topical medications were the most common challenges faced by them in daily drug administration. To overcome challenges locating the drugs at different places, finger felt volume for liquid medication, textural feeling of the drug or container, time tracking were the major self adopted coping strategies by the visually impaired subjects.Conclusions: Creating awareness of the medication related problem faced by visually impaired helps to provide adequate assistance to medication use and improve proper health care services in them.