scholarly journals Delayed neurological manifestation in viper bite despite anti-snake venom therapy

2017 ◽  
Vol 4 (1) ◽  
pp. 286
Author(s):  
Robin George Manappallil
Keyword(s):  
Renal Failure ◽  
Compartment Syndrome ◽  
Snake Venom ◽  
Neurological Manifestation ◽  
Snake Bite ◽  
Medical Emergency ◽  
Neurological Manifestations ◽  
Middle Aged ◽  
Life Threatening ◽  
Systemic Manifestations

Envenomation due to snake bite is an acute life threatening medical emergency. Among the different families of snakes, viper bites are known to cause local manifestations like cellulitis, blebs, compartment syndrome; as well as systemic manifestations which include neurological, hematological and renal failure. This is a case of a middle aged man who presented with viper bite. He was given anti-snake venom (ASV) and became asymptomatic. After about 72 hours of ASV therapy, he started developing generalised paralysis. He was given another course of ASV, following which he recovered completely. To the best of knowledge, this form of delayed neurological manifestations following viper bite, despite receiving ASV has not been reported yet.

Alcohol Related Non-traumatic Rhabdomyolysis and Compartment Syndrome

2007 ◽  
Vol 6 (1) ◽  
pp. 33-34
Author(s):  
JPL Ong ◽  
◽  
LA Thomas ◽  
Keyword(s):  
Skeletal Muscle ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Lower Extremity ◽  
Compartment Syndrome ◽  
Early Recognition ◽  
Clinical Entity ◽  
Threatening Condition ◽  
Life Threatening ◽  
Renal Support

Rhabdomyolysis is a serious and life-threatening condition in which skeletal muscle is damaged, commonly resulting in acute renal failure. The causes of this clinical entity can be traumatic and non-traumatic. In the latter group, alcohol is the commonest cause. This report describes the case of a 25 year old man who presented with rhabdomyolysis leading to acute renal failure after an alcohol binge. He presented with painful legs and lower extremity compartment syndrome. The patient recovered with surgical fasciotomy and renal support. This case illustrates the importance of early recognition and treatment of alcohol related non-traumatic rhabdomyolysis and compartment syndrome.

scholarly journals Pharmacotherapeutic study of efficacy, safety and prognostic analysis of anti snake venom serum in snake bite patients

2017 ◽  
Vol 6 (4) ◽  
pp. 906 ◽  
Author(s):  
Khalid Inamdar ◽  
Sudhakar M. Parhate ◽  
Rahul D. Randad
Keyword(s):  
Mechanical Ventilation ◽  
Snake Venom ◽  
Rural Areas ◽  
Tertiary Care ◽  
Optimal Dose ◽  
Snake Bite ◽  
Medical Emergency ◽  
Time Interval ◽  
Male Victims ◽  
Effective Measure

Background: Snakebite is a common medical emergency especially in the rural areas. The effective measure to treat most of the manifestations of venomous snake bite is timely administration of anti-snake venom serum (ASVS). Problems associated with ASVS use are lack of evidence for optimal dose schedule and occurrence of hypersensitivity reactions.Methods: A retrospective review of snakebite cases was carried out from record section of a tertiary care teaching hospital from January 2011 to December 2011.Results: Out of total 202 snakebite patients admitted during the study period, age group of 21-30 years (mainly male victims) accounted for highest no. of snakebite cases (25.7%). The mean (±SD) dose of ASVS used was 124 (±112) mL. 11.8% patients had suffered from adverse drug reactions due to ASVS. 7.4% patients required mechanical ventilation. Overall mortality in our study was 9.4%. Mortality was higher (50%) where the time interval between the snakebite and initiation of treatment was >6 hours. Out of total 15 patients who required mechanical ventilation, n=10 (66.6%) patient died.Conclusions: In our study, mean dose of ASVS used was as per WHO guidelines. Less incidence of adverse drug reaction due to ASVS may be because of co-administration of corticosteroids and anti-histaminics. Delay in getting treatment with ASVS, neurotoxic envenomation and respiratory failure, were the risk factors associated with adverse prognosis due to snake bite in our set up.

scholarly journals Snake-Bite in Nepal

2014 ◽  
Vol 2 (3) ◽  
pp. 45-53 ◽  
Author(s):  
S Chaudhary ◽  
S Singh ◽  
N Chaudhary ◽  
SK Mahato
Keyword(s):  
Rural Areas ◽  
Neglected Tropical Diseases ◽  
Review Article ◽  
Snake Bite ◽  
World Health ◽  
Medical Emergency ◽  
Medical Sciences ◽  
Treatment Facility ◽  
Treatment And Prevention ◽  
Life Threatening

Snake-bite is one of the diseases which is included in the World Health Organization's (WHO) list of neglected tropical diseases. It is a well-known life threatening medical emergency commonly seen in farmers, plantation workers, herders, fishermen, snake restaurant workers and other food producers. In Nepal, snake-bite take a heavy toll of human lives. It is due to poor health services in rural areas especially for antisnake venom (ASV) treatment facility. Exact magnitudes of problem and mortality from snake-bite are very difficult to estimate due to serious misreporting. This review article aims to discuss the epidemiology, clinical features, diagnosis, treatment and prevention of snake-bite envenomation in South Asia region particularly in Nepal and helping in improving the knowledge and understanding of snake-bite to save precious human lives. DOI: http://dx.doi.org/10.3126/jucms.v2i3.11829 Journal of Universal College of Medical Sciences Vol.2(3) 2014: 45-53

scholarly journals Acute Renal Failure and Seizure following Multiple Wasp Stings: A Case Report

2012 ◽  
Vol 32 (1) ◽  
pp. 65-68
Author(s):  
MK Kumar ◽  
SN Thakur
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Case Report ◽  
Key Words ◽  
Social Wasps ◽  
Multiorgan Dysfunction ◽  
Life Threatening ◽  
Wasp Stings ◽  
Systemic Manifestations ◽  
Local Reactions

Wasps and bees descend from order Hymenoptera. All social wasps belong to family Vespidae. Their stings are not usually life threatening, causing mainly local reactions and rarely anaphylaxis and serious systemic manifestations. Though a few stings cause no major problems, multiple stings can cause serious effects like massive hemolysis, acute renal failure, encephalopathy, multiorgan dysfunction. We report a six years boy with acute renal failure and seizure following multiple wasp stings. Key words: Multiple wasp stings; Acute renal failure; Hymenoptera  DOI: http://dx.doi.org/10.3126/jnps.v32i1.5238   J. Nepal Paediatr. Soc. Vol.32(1) 2012 65-68

A Review on the Use of Reversal Agents of Direct Oral Anticogulant Drugs in Case of Gastrointestinal Bleeding

2020 ◽  
Vol 15 ◽  
Author(s):  
Veronica Ojetti ◽  
Angela Saviano ◽  
Mattia Brigida ◽  
Luisa Saviano ◽  
Alessio Migneco ◽  
...  
Keyword(s):  
Gastrointestinal Bleeding ◽  
Major Bleeding ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Medical Emergency ◽  
Management Approach ◽  
Emergency Setting ◽  
Reversal Agents ◽  
Life Threatening ◽  
Andexanet Alfa

Background : Major bleeding is a life-threatening condition and a medical emergency with high mortality risk. It is often the complication of anticoagulant’s intake. Anticoagulants are commonly used for the prevention and the treatment of thrombotic events. The standard therapy with vitamin K antagonist (warfarin) has been frequently replaced by direct oral anticoagulants (DOACs). The latter agents (rivaroxaban, apixaban, edoxaban, dabigatran, betrixaban) showed a better efficacy and safety compared to standard warfarin treatment and they are recommended for the reduction of ischemic stroke. Literature data reported a high risk of gastrointestinal bleeding with DOACs, in particular with dabigatran and rivaroxaban. In case of life-threatening gastrointestinal bleeding, these patients could benefit from the use of reversal agents. Methods: We performed an electronic search on PUBMED of the literature concerning reversal agents for DOACs and gastrointestinal bleeding in the Emergency Department from 2004 to 2020. AIM: This review summarizes the current evidences about three reversal agents idarucizumab, andexanet alfa and ciraparantag, and the use of the first two in the emergency setting in patients with an active major bleeding or who need urgent surgery to offer physicians indications for a better management approach in order to increase patient’s safety. Conclusion: Although these agents have been marketed for five years (idarucizumab) and two years (andexanet alfa) respectively, and despite guidelines considering antidotes as first-line agents in treating life-threatening hemorrhage when available, these antidotes seem to gain access very slowly in the clinical practice. Cost, logistical aspects and need for plasma level determination of DOAC for an accurate therapeutic use probably have an impact on this phenomenon.. An expert multidisciplinary bleeding team should be established so as to implement international guidelines based on local resources and organization.

Acute pericardial tamponade: The initial manifestation of systemic lupus erythematosus with Graves’ hyperthyroidism

Lupus ◽  
2021 ◽  
pp. 096120332110047
Author(s):  
Muming Yu ◽  
Yulei Gao ◽  
Heng Jin ◽  
Songtao Shou
Keyword(s):  
Myocardial Infarction ◽  
Systemic Lupus Erythematosus ◽  
Female Patient ◽  
Lupus Erythematosus ◽  
Pericardial Tamponade ◽  
Medical Emergency ◽  
Systemic Lupus ◽  
Initial Manifestation ◽  
Life Threatening ◽  
Obstructive Shock

Acute pericardial tamponade, which can cause obstructive shock, is a serious life-threatening medical emergency that can be readily reversed by timely identification and appropriate intervention. Acute pericardial tamponade can occur for a number of reasons, including idiopathic, malignancy, uremia, iatrogenic, post-myocardial infarction, infection, collagen vascular, hypothyroidism, and others. Systemic lupus erythematosus (SLE) and hyperthyroidism associated with pericardial tamponade are rarely reported. Here, we report the case of a 20-year-old female patient was final diagnosed of SLE with Graves’ hyperthyroidism.

scholarly journals Myelodysplastic Syndrome Clinically Presenting with the “Classic TTP Pentad”

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Santiago Fabián Moscoso Martínez ◽  
Evelyn Carolina Polanco Jácome ◽  
Elizabeth Guevara ◽  
Vijay Mattoo
Keyword(s):  
Myelodysplastic Syndrome ◽  
Clinical Presentation ◽  
Renal Involvement ◽  
Medical Emergency ◽  
Complete Blood Cell Count ◽  
Blood Cell Count ◽  
Thrombocytopenic Purpura ◽  
Life Saving ◽  
Threatening Condition ◽  
Life Threatening

The clinical presentation of myelodysplastic syndrome (MDS) is not specific. Many patients can be asymptomatic and can be detected only due to an abnormal complete blood cell count (CBC) on routine exam or for other reasons while others can be symptomatic as a consequence of underlying cytopenias. Thrombotic thrombocytopenic purpura (TTP) usually is suspected under the evidence of microangiopathic hemolytic anemia (MAHA) and thrombocytopenia and because it is a life-threatening condition (medical emergency) immediate initiation of plasmapheresis could be life-saving. The following case illustrates an unusual presentation of MDS in a patient who came in to the emergency room with the classic TTP “pentad” of fever, renal involvement, MAHA, mental status changes, and thrombocytopenia. We will focus our discussion in the clinical presentation of this case.

scholarly journals Snakebites by Bothrops spp in children in Campinas, São Paulo, Brazil

2001 ◽  
Vol 43 (6) ◽  
pp. 329-333 ◽  
Author(s):  
Fábio BUCARETCHI ◽  
Sílvia Regina Fontoura HERRERA ◽  
Stephen HYSLOP ◽  
Emílio Carlos Elias BARACAT ◽  
Ronan José VIEIRA
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Compartment Syndrome ◽  
Blood Coagulation ◽  
Sao Paulo ◽  
Blood Coagulation Disorders ◽  
Local Infection ◽  
Coagulation Disorders ◽  
H2 Antagonists ◽  
Clinical Complications

From January, 1984 to March, 1999, 73 children under 15 y old (ages 1-14 y, median 9 y) were admitted after being bitten by snakes of the genus Bothrops. Twenty-six percent of the children were classified as mild envenoming, 50.7% as moderate envenoming and 20.6% as severe envenoming. Two patients (2.7%) showed no signs of envenoming. Most of the patients presented local manifestations, mainly edema (94.5%), pain (94.5%) ecchymosis (73.9%) and blisters (11%). Local and/or systemic bleeding was observed in 28.8% of the patients. Before antivenom (AV) administration, blood coagulation disorders were observed in 60.7% (incoagulable blood in 39.3%) of the 56 children that received AV only in our hospital. AV early reactions, most of which were considered mild, were observed in 44.6% of these cases (in 15/30 patients not pretreated and in 10/26 patients pretreated with hydrocortisone and histamine H1 and H2 antagonists). The main clinical complications observed were local infection (15.1%), compartment syndrome (4.1%), gangrene (1.4%) and acute renal failure (1.4%). No deaths were recorded. There were no significant differences with regard to severity of envenoming versus the frequency of blood coagulation disorders among the three categories of envenoming (p = 0.75) or in the frequency of patients with AV early reactions between the groups that were and were not pretreated (p = 0.55). The frequency of local infection was significantly greater in severe cases (p < 0.001). Patients admitted more than 6 h after the bite had a higher risk of developing severe envenoming (p = 0.04).

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