![]() Subsequently he was noted to be abstinent from alcohol, compliant with treatment and free from all kinds of hallucinations. On improvement he was sent on four weeks sick leave on the advice of immunologist. The dose was gradually increased to 4 mg per day and he responding quickly. He was put on three drugs ART regime by the immunologist. His CD4 and CD8 counts were 235 and 674, respectively. The patient was advised regular follow-up by the neurosurgeon. ![]() Investigations showed human immunodeficiency virus (HIV) positive status (ELISA and Western blot), raised Aspartate Amino Transferase (AST) and Alanine Amino Transferase (ALT), computed tomography (CT) and Magnetic resonance imaging (MRI) brain revealed bilateral lateral ventricle enlargement with narrowing of lower end of aqueduct of sylvius. Mental status examination showed multimodal hallucinations in visual, auditory and tactile spheres, no delusions but biodrives were deranged. Physical examination was within normal limits except for fine digital tremors. There were multiple unprotected exposures to commercial sex workers. There was no other significant family or past history. His behavior was abnormal and hence he was hospitalized. There also he started consuming about 120 ml of rum daily. After the initial training of short duration, while on leave he was consuming country liquor daily, before joining the new unit. Though his family members got him treated from local doctor, there was no significant improvement. All these things used to disturb him, he was not doing any job and to over come these problems used to drink country liquor regularly. He also used to feel as if someone touching and fondling with his genitals. Sometimes he used to see the faces of pervious acquaintances, which used to change in shape and size. Initially he used to reply to these voices but gradually started neglecting them. He complained of hearing voices of family members, even when he was alone, abusing him and threatening him. By 2005, family members noted him to be talking to himself, not taking adequate self care and becoming irritable easily. He used to have sleep disturbances irritability and tremors on temporarily stopping alcohol consumption.Īfter leaving the service in 2004, he started consuming about 600 ml of country liquor daily. He had been consuming alcohol since 1984 and gradually the frequency and quantity increased to 360 ml of rum daily by 1996. Evaluation revealed that he was apparently asymptomatic when he retired after 18 year of service in Army (Para Unit) in 2004. He was found to be gloomy, reclusive, not sleeping and talking to oneself. A 43-year-old DSC soldier with few months of service was referred for psychiatric evaluation in January 2010 by unit authorities in view of his behavioral abnormalities noted since joining the unit.
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