Biochemical Evaluation of a Potentially Ubiquitous Element in Snake Bite: Myths and Facts-A Tertiary Rural Hospital Study in India (original) (raw)
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Objectives: The present study was under taken to know the spectrum of renal histopathology in snake-bite cases autopsied in Victoria hospital mortuary, Bengaluru. To know the haematological and biochemical changes leading to renal pathology in nonfatal snake bite cases admitted to Victoria hospital, Bengaluru. Methods: Collection of information from in patient case records during the period of 18 Months according to proforma. Medico legal autopsy (MEA) reports from Victoria Hospital, Bengaluru. The data collection is done as per the proforma. Results: Neurotoxic envenomation was responsible for 14 deaths with mortality rate of 23.33% among snake bite cases. In autopsied cases of snake bite poisoning, microscopically renal parenchymal congestion& ischaemic changes in tubules are commonly noted, apart from inflammatory changesin Glomeruli. In 05 cases no abnormalities were noted
2014
Background: Snake bite is predominantly an occupational hazard and a common cause of morbidity and mortality. Acute renal failure has been associated with venomous viper and sea snake bites. AIMS: This study was carried out to study the incidence and clinical profile of the snake bite patients who develop acute renal failure;and to identify the predictors of morbidity and mortality in these patients. Material and methodology: We carried out prospective study on fifty (50) cases of definitive snake bite admitted to Department of Medicine/Emergency medicine, Kempegowda institute of medical sciences, Bangalore from May 2012 to November 2013. Statistical analysis: SPSS for Windows version 17.0 (SPSS, Inc, Chicago, Ill) was used for statistical analysis. The Pearson Chi-Square Test was used to analyze parametric variables. A P value of 0.05 or less was considered statistically significant.
Clinicopathological spectrum of snake bite-induced acute kidney injury from India
World Journal of Nephrology
Informed consent statement: All patients included in the study gave written informed consent for investigation and treatment. No direct consent was taken from the patients to the study as this is a retrospective study and the analysis used anonymous clinical data. Consent, instead, was obtained from the Hospital Authorities and Institutional Review Board of Indira Gandhi Medical College Hospital, Shimla to use the information contained in the patient record solely for the educational purpose of this research only.
Sri Lanka Journal of Child Health, 2021; 50(1): 12-16 , 2021
Background: Snake bite can result in local as well as systemic manifestations. Major systemic complications include acute renal failure, neurological symptoms requiring ventilator support and coagulation disorders. The coagulation disorders lead to various serious systemic complications like haemorrhage, infarction and even death if the diagnosis and treatment are delayed. Objectives: To describe the clinical profile of the snake bitten patients who developed coagulopathy and the role of coagulation markers to evaluate the morbidity and mortality of the victims. Method: A cross-sectional hospital based study was done on patients aged 12 years or less having local or systemic signs of envenomation and no history of bleeding or coagulation disorders. The coagulation profile was assessed by peripheral blood sampling and urine analysis. Results: In the present study haemorrhagic manifestations seen included bleeding from injection site (46.7%), haematemesis (5%), haematuria (33.3%), bleeding gums (11.7%), epistaxis (1.7%), and haemoptysis (3.3%). Haemoglobin estimation revealed anaemia in 53.3% cases. The 20 minute whole blood clotting time (WBCT20) was positive in 86.4% of vasculotoxic snakebites and negative in all neuro-paralytic bites. Leucocytosis was observed in 60% cases with relative neutrophilia in 63.3%, thrombocytopenia was observed in 8.3%, bleeding time was prolonged in 13.3% and clotting time was prolonged in 56.7%. Conclusions: WBCT 20 is an important test to differentiate between viperine and elapine bites as it was positive in 46.7% of viperine bites and was negative in all elapine bites
A Study to Correlate Elevated Creatinine Phosphokinase with Snake Bite and Acute Kidney Injury
IOSR Journals , 2019
CONTEXT Hemotoxic snake bite is associated with acute kidney injury in around two thirds of cases. Thisstudy is toestablish therelation betweenelevated CPK values with acute kidney injuryand reversibility with alkaline diuresisin snakebite patients of GovernmentRajajiHospital, Madurai. AIMOFTHESTUDY To establish the correlation between creatinine phosphokinase with hemotoxic snakebite and acute kidney injury. To find out the benefit of sodium bicarbonate infusion in preventing creatinine elevation in such cases. SETTINGSANDDESIGN Prospective Cross sectional study MATERIALSANDMETHODS STUDY POPULATION: Patients with history of snake bite who fulfill the inclusion and exclusion criteria getting admitted in General Medicine wards of GOVT RAJAJI HOSPITAL, MADURAI, during the period of JANUARY 2016 TO JUNE 2016. STATISTICALANALYSIS Mean, standard deviation RESULTS The CPK values tend to correlate with the incidence of acute kidney injury and it can be prevented with soda bicarbonate infusion. CONCLUSIONS: This study correlates one of the factors in the prevention of AKI, but there are more than 10 mechanims attributed to the cause of renal failure in snake bite patients. So this intervention may be in addition to the other treatment with IVF, anti-venom, antibiotics and prevention of dehydration. The CPK values tend to correlate with the incidence of renal failure and it can be prevented with soda bicarbonate infusion. Other factors like NGAL levels were not measured to asses for the incidence of renal failure. So all these is to be considered in treating a patient with hemotoxic snake bite with elevated CPK values.
Egyptian Journal of Forensic Sciences
Background: Death due to poisonous snakebite is a formidable health hazard. It is a matter of concern especially in agrarian countries. Clinically snakebite envenomation are neurotoxic and vasculotoxic. Krait (Bungarus faciatus) Venom is essentially neurotoxic.Nephrotoxicity in krait bite is an important issue that has been less studied and reported. Case presentation: In the present series, we report three cases of deaths in consecutive bites by a single banded krait. Significant renal involvement was found at autopsy. The kidneys showed interstitial haemorrhage and inflammatory cell infiltration. The renal changes were similar in all the three cases bitten by the same snake. Conclusions: From the findings of autopsy and histology of the present case series we can conclude that nephrotoxicity is an important effect of krait bite. Though less reported and researched kidney changes in krait bite is a significant issue in treatment as well as autopsy diagnosis.. We can also infer that the immunogenicity of the snake venoms can be different from our expectation.
Study of snakebite and toxicological assessment of the biochemical concoction of snake venom
2021
Fear of snakes known as Ophidiophobia or Ophiophobia is a powerful and abnormal fear of snakes. A lot of psychologists, physicians and evolutionists have been fascinated by this primeval innate human emotion. Be that as it may, snakes still not are paid enough attention to adequately as agents of human sickness; also, the logical bits of knowledge given by the clinical phenotype of human envenoming have been disregarded for quite a while. Over an era of research has given that snake venom can be rich integration of pharmacologically active proteins, various protein derivatives and peptides. In this way, due to snake bite every person envenomed turns into a whiz try, giving out insight into the pathophysiological and humanitarian test. The logical investigation of snake bite can be a part of activities of venom chemicals, while exhibiting a therapeutic clinical toxicology, that sub forte of toxicology that manages the impacts of characteristic poisons and toxins of microbial, plant and animal inception on people and domesticated animals, especially their counteractive action, conclusion, treatment, the study of disease transmission, and pathophysiology.
BMC Nephrology, 2017
Background: Snakebite-related acute kidney injury (AKI) is a common community-acquired AKI in tropical countries leading to death and disability. The aims of this study were to (1) determine the occurrence of snakebite-related AKI, (2) assess factors at presentation that are associated with snakebite-related AKI, and (3) determine the outcomes of patients with snakebite-related AKI. Methods: We conducted a prospective observational study of patients with snake envenomation at the three academic tertiary care hospitals in Yangon, Myanmar between March 2015 and June 2016. Patient data including baseline characteristics, clinical and laboratory findings, hospital management, and outcomes were recorded in a case report form. A stepwise multivariate logistic regression analysis using a backward selection method determined independent factors significantly associated with AKI. Results: AKI was observed in 140 patients (54.3%), the majority of whom were AKI stage III (110 patients, 78.6%). AKI occurred at presentation and developed during hospitalization in 88 (62.9%) and 52 patients (37.1%), respectively. Twenty-seven patients died (19.3%), and 69 patients (49.3%) required dialysis. On multivariate logistic regression analysis, (1) snakebites from the Viperidae family (odds ratio [OR]: 9.65, 95% confidence interval [CI]: 2.42-38.44; p = 0.001), (2) WBC >10 × 10 3 cells/μL (OR: 3.55, 95% CI: 1.35-9.34; p = 0.010), (3) overt disseminated intravascular coagulation (OR: 2.23, 95% CI: 1.02-4.89; p = 0.045), (4) serum creatine kinase >500 IU/L (OR: 4.06, 95% CI: 1.71-9.63; p = 0.001), (5) serum sodium <135 mmol/L (OR: 4.37, 95% CI: 2.04-9.38; p < 0.001), (6) presence of microscopic hematuria (OR: 3.60, 95% CI: 1.45-8.91; p = 0.006), and (7) duration from snakebite to receiving antivenom ≥2 h (OR: 3.73, 95% CI: 1.48-9.37; p = 0.005) were independently associated with AKI. Patients bitten by Viperidae with normal renal function who had serum sodium <135 mmol/L had a significantly higher urine sodium-to-creatinine ratio than those with serum sodium ≥135 mmol/L (p < 0.001). Conclusions: Identifying factors associated with snakebite-related AKI might help clinicians to be aware of snakebite patients who are at risk of AKI, particularly patients who demonstrate renal tubular dysfunction after Viperidae bites.