41yr old male with alcohol dependence

 A 41 year old male with c/o head ache and generalised 

body pains since 3 months 

H/o trauma -present 

Pt was apparently asymptomatic 4 months back then he developed head ache and generalised body pains associated with on and off giddiness and on and off numbness and tingling of feet and hands and multiple somatic complaints 

No significant negative history 

Like fever , convulsions, Loc ,vomitings, loose stools 

H/o past illness 

Not a k/c/o HTN ,DM, TB, asthma, epilepsy 

Personal history -

He has mixed diet

Bowel and bladder movements- regular 

He is alcoholic since 20 years -180ml of whiskey /day 

O/E

Pt is conscious, coherent, cooperative 

No signs of pallor, icterus , cyanosis, clubbing, koilonychia, generalised lymphadenopathy, edema 

Vitals -Bp-130/100mmhg,

Pr-78bpm, RR-16cpm, temp-98.4F

CVS-S1,S2+

RS-BAE+

P/A-soft, nontender

CNS-NAD

Diagnosis-Alcohol and tobacco dependence syndrome .

?dysthmia

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