Manipur can sometimes be a place, especially remebering that , almost every form of drugs had been abuse. Be it nitrezepam(the famous N10) to the asabas and heroins. It is alarming to come across so many students and youngster who are so much into the nitrezepam and spasmoproxyvon. But Alcohol surpases everyone of the substance,remembering that 90% of the people all over the world take alcohol in one time or the other. And with so many rice wines and illegal foreign liquor outlets in Manipur, we may be well within world averages,inspite of the prohibitions and the Meira paibis.

Alcohol can and had brought about a lot of consequences. It makes the weekend better for many, swasti pujas are another manipuri fav drink time. Wedding and drinks,... pheijoms has almost become the official yuthak phee. And for the countless manipuri student, never a visit to home for vacation is completed without counting the number of times we had visited one of those places for asaba and atingba.

Infact Alcohol has occupied a a very influential part of almost evryone, only thing is how much is worth the "influence". Statistically, 50% of the world population has encountered someone in their family with alcohol related problems, which can range from the minor scuffle among family members to alcohol related death.

For whatever reasons, people who have become addicted to alcohol - the quality of life including the people around him, had decline. And for the few strongs ones who had recovered, the quality of life including the people around him - improves.

Keeping in mind of the huge alcohol culture and the consequent numerous quarrels that had occured both in and out of the family, maybe we got think again before the next drink.

Today there was a patient, an alcoholic and I thought it will be good knowing what alcohol can really do our body.

We saw this gentleman, who rather looks like in his forties on appearance. He was very short of breath, and had a massive body with a typical beer belly.

Once we start talking, we found out that he has been drinking 10 cans of beer almost everyday, and was heavily depending on it. Taking great pain and weight in adjusting him on the examination bed, I had a close look. If he was a lady, we probably would have ended saying , there was a twin in there, and won't mind putting all my money in my pocket( very less!) for that.

During our conversation, he obviously had difficulty with the problem solving skills, and was very slow when it comes to processing of information. which I would most probably put down to his frontal lobe of his brain and that they were not working optimally. Remember, researchers have found that brains of alcoholics are smaller and have an increased number of brain tissue loss then the comparable non alcoholic.

Unfortunately for the hard alcoholics and those keen on it, according to the premature aging hypothesis, alcohol is stated to "accelerate normal aging" and make the young alcoholics older then they really are. This kind of aging due to alcohol allows the younger non-alcoholics of the same age, faster and quicker in cognitive abilities. Which explain why our patient look to be in his late forties then his actual 34 years of age.

But what concerns me was because of his prolonged alcohol intact, was there anything sinister which was life threatening to him at that moment.

On closer examination, his sclera or the white of the eye were no longer white but tan with yellow - jaundice!. His feets were swollen to his knees, body hair were less and he even got a breast(gynaecomastia). His pulse were fast, and he was breathing around 40 times a minute. I actually didn't enjoy counting his pulse as his hands were shaking a lot.

Upon listening to his heart and chest they were a lot wet and croaky and with a extra hissing sound to his heart sound. The liver were hugely enlarged, and I bet there were at least 5 liters of fluid in his tummy. And it was tender just below his rib cage on both sides of his chest. A quick neurological examination reveal, his sensory system were awful for any daily activities down below his knees.

My first impression, was liver failure with an enlarged failing heart, and peripheral neuropathy and wanted to rule out pancreatitis and/or any obstruction to the gall bladder tract....... and worst of all, the probability of whether he going to die anytime.

Honestly he could die of pancreatitis, heart failure, lung failure, kiney failure, liver failure, any failure which will eventually give a Tyson knock out punch in his already traumatized shrunken brains. Alcohol really do effects everywhere and anywhere in the body.

On further blood and other investigation, his vitamins levels has gone down maybe an all time low, blood clotting factors an all time high. He can bleed anytime from anywhere. Luckily, there were not any visible bleeds.

There were severe disturbances in his body sodium, potassium, etc levels. There were so much of unwanted acids accumulating, inspite of his breathing trying to compensate for it. It is only a matter of time before breathing can no longer compensate if left alone.

His heart were enlarged and weak, and was beating a lot faster, and ever hungry for oxygen. Unfortunately many a territories of the lungs were fill with fluids, instead of oxygen. increasing the burden, kidney was very lazily working, not able to throw the fluids out properly.

The liver, has enlarged itself to act against any alcohol insult. But this time it seems to have cross its limit. The tracing of the heart were not at all encouraging, and the amount of oxygen in his blood were far from satisfactory.

The alcohol has declared full swing war on all his organs, and Only God knows how long he will live without a new liver.

By the time, we came out of the hospital, just before I wrote this mail... he was transferred to the intensive care unit. He could not breath anymore by himself and had been put on a mechanical ventilator. I have a feeling he will need dialysis in the late evening.

He knew he might not live even another day for even a pint of beer.

B. Elangbam