Investigations Haemoglobin Peripheral blood smear Total Leucocyte Count and Differential Leucocyte Count Blood glucose Serum electrolyte levels Serum bilirubin SGOT/ SGPT Prothrombin time Serum albumin/ globulin ratio CT scan- Head USG abdomen Upper Gastro -intestinal tract endoscopy Fibroscan Indications Nutritional deficiency Nutritional deficiency Infection (possible cause of delirium) Hypoglycaemia (possible cause of delirium) Dyselectrolytemia (possible cause of delirium) Hepatic dysfunction Hepatic dysfunction Hepatic dysfunction Hepatic dysfunction Head injury (possible cause of delirium) Hepatic damage Oesophageal varices Cirrhosis of liver 72. What is delirium tremens? Whether it is a life threatening condition? The development of acute psychosis in a patient with history of sudden cessation of alcohol intake in a chronic alcoholic patient is suggestive of the condition called delirium tremens. Delirium tremens develops between 2- 5 days of cessation of alcohol use, but can appear even up to a week after stopping alcohol use. Yes, it could be life threatening. Delirium tremens (DT) is the most severe form of ethanol withdrawal manifested by altered mental status (global confusion) and sympathetic overdrive (autonomic hyperactivity: sweating & tachycardia), which can progress to cardiovascular collapse. Only about 5% of patients with ethanol withdrawal progress to DT. Patients with disturbed liver and kidney function tests are more at risk for deaths. Though, myocardial infarction due to occlusive coronary artery disease could also be a coincidence with delirium tremens. Delirium tremens should be managed in inpatient setting. MEDICAL DIMENSION OF FREQUENTLY ENCOUNTERED CASES | 54