SNAKE BITE

Introduction: 15 percent of the snakes are poisonous and present a potential life threatening risk to human lives. Objectives: (1) To review the demographic, epidemiological, clinical and laboratory findings of 48 patients of snake bite treated in a field hospital. (2) To evaluate the treatment and outcome of these patients. Design: A retrospective study. Setting: Field hospital in rural Sindh. Period: From January 2002 to December 2003. Material & Methods: All patients diagnosed with snake bite had first aid treatment by a either a nursing staff close to the place of bite or by a quack and later on transferred to field hospital. The first aid treatment consisted of pain relief (injectable diclofenac, oral acetaminophen), application of bandage or tourniquet proximal to the bite, antihistamine (oral or injectable chlorpheniramine) anti- inflammatory (injection hydrocortisone) and immobilization of the affected limb with a splint. Results: We are treated 48 patients with snake bite. There were 45(94%) male patients and 3(6%) female patients. Age range was 18 to 56 years with a mean age of 29.8 years. 35(73%) patients suffered from snake bite between the months of May and September. The timing of the bite was also peculiar with 36(75%) patients bitten between 8pm and 8am whereas only 12(25%) patients during other times of the day. 38(79%) patients gave history of seeing the snake themselves and 10(21%) patients were not able to see the snake mainly because of darkness. Conclusion It should be remembered that not all snakes are poisonous and that they are more afraid of humans than we are of them. Psychological effects of the bite are at times more devastating than the clinical effects, therefore patient reassurance forms part of the treatment.

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DIABETIC RETINOPATHY

The Professional Medical Journal ◽

10.29309/tpmj/2010.17.02.2374 ◽

2010 ◽

Vol 17 (02) ◽

pp. 257-262

Author(s):

NAUMAN AYUB SHAIKH ◽

FAROOQ AHMAD

Keyword(s):

First Aid ◽

Snake Bite ◽

Clinical Effects ◽

Field Hospital ◽

Laboratory Findings ◽

Life Threatening ◽

History Of ◽

Male Patients ◽

Age Range ◽

Study Setting

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Clinical profile and outcome of snakebite poisoning in sub-district hospital Akhnoor

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20211402 ◽

2021 ◽

Vol 8 (5) ◽

pp. 644

Author(s):

Chandan Sharma ◽

Ashima Badyal ◽

Sanjeev Kumar

Keyword(s):

Rainy Season ◽

District Hospital ◽

First Aid ◽

Snake Bite ◽

Rural Background ◽

Study Results ◽

Chief Complaints ◽

History Of ◽

Minimum Delay ◽

Health Care Centers

Background: In a predominantly agricultural country like India, with rich in flora and fauna, long rainy season and rural background, the encounter between man and snake is a frequent occurrence. Viper-bites are more common than other poisonous snakebites. Only the cases of snakebite with severe envenomation reach the health care centers. This study was planned to analyze the presentation of complaints and symptoms in snake bite patients.Methods: This ‘record based descriptive observational study’ was carried out over a period of 6 months from May 2020 to November 2020 in Sub District hospital Akhnoor. A total of 96 patients with a history of snake bite and signs of envenomation were included in this study. Results: Incidence was higher among people from rural background (86.46%), more among males (67.71%) and highest among farmers (53.13%) and labourers (16.67%). Maximum no of snakebites took place during night and on the lower parts of body, mainly legs (54.17%); while the period of the study contained the peak rainy season of the region. As many as 39.58% of victims didn’t receive any kind of formal first aid at all and as many as 48.96% patients reported after a minimum delay of 6 hours, which could be considered as potentially fatal. Chief complaints among the reported patients of snake bite were found to be: Local edema, bleeding, vomiting, drowsiness, ptosis and Ophthalmoplegia.Conclusions: There is an urgent and dire need for awareness and education among rural population about the hazards involved and treatment of snakebite.

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Idarucizumab for the Reversal of Dabigatran-induced Anticoagulation in the Treatment of Gastric Bleeding: a Case Report

10.21203/rs.3.rs-415536/v1 ◽

2021 ◽

Author(s):

Yu Jia ◽

Shaohua Wang ◽

Najuan Cui ◽

Quanxi Liu ◽

Wei Wang ◽

...

Keyword(s):

Renal Function ◽

Bleeding Risk ◽

Thrombin Time ◽

Gastric Bleeding ◽

Laboratory Findings ◽

Transfusion Therapy ◽

Abnormal Accumulation ◽

Life Threatening ◽

History Of ◽

Short Time

Abstract BACKGROUND:The drug instruction for dabigatran recommends the does adjustment 110 mg twice-a-day for the patient with bleeding risk, and at least 1 time of renal function test per year for moderate renal impairment. However, dabigatran still can be abnormal accumulation due to the chronic insidiously progressive renal insufficiency, which requiring idarucizumab to reverse the anticoagulation on account of acute erosive gastritis with extensive gastric mucosal bleeding.CASE SUMMARY: A 76-year-old female, with a history of Atrial Fibrillation (AF), took dabigatran 110 mg twice-a-day as recommended does adjustment to reduce the risk of stroke, and admitted to the hospital for the main complaints of hematemesis and melena. The laboratory findings showed severe life-threatening blood-loss anemia with hemoglobin (Hb) 41.0g/L, and significant coagulation abnormalities with thrombin time (TT) > 180s, most likely caused by dabigatran metabolic disorder. Aggressive acid suppressive, hemostatic and blood transfusion therapy brought out a short-time bleed-controlled misconception, which situation was exactly confirmed by re-bleeding. Idarucizumab was given timely to reverse the anticoagulation effect of dabigatran. 12 hours later, TT was tested as 17.4s which belonged to the normal range. Finally, she had no active bleeding signs, with labs showing Hb 104g/L and TT 17.7s.CONCLUSION:It is recommended to monitor renal function regularly, even coagulation function and dabigatran concentration, for the elder. There is at present no general agreement on the use of Proton Pump Inhibitor (PPI)–dabigatran coadministration to prevent upper gastrointestinal bleeding.

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Assessment of Children Exposed to Maras Powder Intoxication

Folia Medica ◽

10.3897/folmed.62.e49485 ◽

2020 ◽

Vol 62 (3) ◽

pp. 515-518

Author(s):

Tahir Dalkiran ◽

Mehmed Mustafa Özaslan ◽

Can Acipayam ◽

Yaşar Kandur ◽

Velid Unsal

Keyword(s):

Medical Records ◽

Treatment Approach ◽

Treatment Strategies ◽

Clinical Effects ◽

Oral Ingestion ◽

Male Patients ◽

The Mean ◽

The Difference ◽

Maras Powder ◽

Age Range

Introduction: A smokeless tobacco known as Maras powder (MP) is commonly consumed in the southern region of Turkey. To the extent of our knowledge, no previous study in literature has reported acute MP intoxication in children. Aim: Our aim was to determine the clinical effects and treatment strategies of MP poisoning in children.Materials and methods: We retrospectively reviewed the medical records of children <18 years of age with MP intoxication who were followed up in the Intensive Care Unit between January 2016 and April 2018 in our center. Results: Forty-one patients (M/F= 25/16) were included in this study. The mean age was 13.2±22.4 months (age range: 7 to 30 months). The patients presented with vomiting (n=23, 56%), cough (n=17, 41.5%), loss of consciousness (n=11, 26.8%), respiratory distress (n=6, 14.6%), convulsion (n=7, 17%), cyanosis (n=1, 2.4%), and abdominal pain (n=1, 2.4%) following oral ingestion of the substance. On their physical examination all patients with convulsion were in a comatose state. Thirty-two patients (78%) had tachycardia; 15 patients (36.5%) had pharyngeal hyperemia; and three (7.3%) had hiccups. Although the female patients had a lesser rate of symptoms than male patients, the difference was not statistically significant. Conclusions: Our aim was to inform the doctors about the clinical picture that develops after taking this substance and contribute to the understanding of the treatment approach.

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Association of polycystic ovary syndrome with insulin resistance and glucose transporter GLUT 4.

The Professional Medical Journal ◽

10.29309/tpmj/2020.27.10.4353 ◽

2020 ◽

Vol 27 (10) ◽

pp. 2182-2186

Author(s):

Roohi Jabbar ◽

Rukhshan Khurshid ◽

Uzma Jabbar ◽

Mudassir Zia ◽

Abeera Mazhar Siddiqui ◽

...

Keyword(s):

Insulin Resistance ◽

Glucose Transporter ◽

Fasting Glucose ◽

Polycystic Ovary ◽

Cross Sectional Study ◽

Cross Sectional ◽

Glut 4 ◽

History Of ◽

Age Range ◽

Study Setting

Objectives: The study was designed to find out the association of PCOS with insulin resistance and GLUT4. Study Design: Cross Sectional study. Setting: Outdoor Department of Sir Ganga Ram Hospital Lahore. Period: March 2016 to December 2016. Material & Methods: 37 PCOS women visited Outdoor Department of Sir Ganga Ram Hospital Lahore. Their age range was 25- 36 years. 20 ages matched medical staff of the Sir Ganga Ram Hospital, Lahore with no history of any disease were selected as control. Rotterdam’s criteria were used to confirm PCOS. Levels of circulating insulin, GLUT 4 and fasting glucose were estimated. Results: Mean age of PCOS patients and of controls was 30.55 and 29.00 years respectively. Values of BMI were insignificantly raised in PCOS in comparison to controls. Levels of circulating GLUT-4, fasting glucose, insulin and resistance of insulin were increased significantly in women with PCOS in comparison to the controls. Decreased ratio of glucose to insulin was seen in PCOS women in comparison to their controls. Conclusion: A good association of PCOS was observed with insulin mediated release of glucose transporter GLUT 4 and insulin resistance.

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Clinical profile and surgical management of primary vaginal hydrocele: our experience in a rural India

International Surgery Journal ◽

10.18203/2349-2902.isj20171615 ◽

2017 ◽

Vol 4 (5) ◽

pp. 1653

Author(s):

Mohd Hamid Shafique Ahmed ◽

Bankar S. S. ◽

Gosavi V. S. ◽

Dalavi S. B. ◽

Gurav P. D.

Keyword(s):

Wound Infection ◽

Surgical Management ◽

Surgical Procedures ◽

Clinical Profile ◽

Medical College ◽

History Of ◽

Male Patients ◽

A Prospective Study ◽

Age Range

Background: Hydrocele is one of the commonest diseases occurring worldwide. Since olden days surgical procedures have been described for the treatment of hydrocele. Aim of the study was to analyse the clinical profile, diagnosis and surgical management of primary vaginal hydrocele in adults (>12 years)Methods: A prospective study of 60 male patients of age range of more than 12 years with a history of scrotal swellings were studied for their clinical profiles, diagnosis and management. The study was carried out in Government Medical College, Miraj, Maharashtra, India from November 2010 to November 2012. In the present study Jaboulay's Procedure was performed on 48 patients and Lord's Procedure was performed on 12 patients.Results: The data was collected and results were analysed. Post-operatively about 1.6% of patients developed hematoma, 5% developed wound infection, 21.66% of the patients developed skin oedema and only 1 patient i.e 1.6 % had recurrence over a period of 2 years of follow up. Out of the total 60 patients,12 patients who underwent Lord's plication 8.33%,0%,0% developed skin oedema, hematoma and wound infection respectively as compared to 25%,2.08%,6.25% in the remaining 48 patients who underwent Jaboulay's procedure, respectively.Conclusions: These two surgical procedures were very safe, easy to perform and economical and associated with minimal recurrence. Lord's procedure has lesser incidence of post-operative complications as compared to Jaboulay's procedure.

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Perbedaan Antara Penanganan Luka Snake Bite dengan Insisi dan Tanpa Insisi Terhadap Kecepatan Penurunan Pembengkakan Luka di RSUD Pacitan

(JKG) JURNAL KEPERAWATAN GLOBAL ◽

10.37341/jkg.v1i1.15 ◽

2016 ◽

Vol 1 (1) ◽

Author(s):

Akhmad Rifai ◽

Tri Andriani Cholifah

Keyword(s):

Experimental Research ◽

Research Method ◽

Sampling Technique ◽

First Aid ◽

Snake Bite ◽

Wound Treatment ◽

Bite Wound ◽

Chi Square ◽

The Past ◽

Life Threatening

Abstrack: Snake Bite, Incision And Without Incision, Decreasing Speed Of Wound Swelling. Snake bite has different effects, ranging from a simple wound up to life-threatening and even can lead to death. The principle of first aid for snake bite is to avoid the spread of snake poison and to prevent the infection in the bitten part. In the past, the snake bite was treated by using incision while some sources recently stated that the snake bite is not necessary treated by using incision. This study aims to determine The differences between snake bite wound treatment with incision and without incision toward the decreasing speed of wound swelling at RSUD Pacitan. The study design used non-experimental research method : a comparative with retrospective or historical documentary approach. The samples were taken by using total sampling technique. The sum of the samples was 88 documents. They were taken from medical record documents. The statistic test used Chi square with significant value 0.05. The result of the study showed that there were differences between snake bite wound treatment with incision and without incision toward the decreasing speed of wound swelling at RSUD Pacitan in 2009 – 2011.

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Clinico-radiological profile of COVID-19 in a tertiary care hospital of western Rajasthan

IP Indian Journal of Immunology and Respiratory Medicine ◽

10.18231/j.ijirm.2021.033 ◽

2021 ◽

Vol 6 (3) ◽

pp. 152-155

Author(s):

Priyanka Soni ◽

Laxman Kumar Soni ◽

K.C Agarwal

Keyword(s):

Tertiary Care ◽

Left Lung ◽

Care Hospital ◽

Lung Involvement ◽

Laboratory Findings ◽

Reactive Protein ◽

Radiological Data ◽

Life Threatening ◽

History Of ◽

Novel Coronavirus

Coronavirus disease 2019 (COVID-19) is a pandemic infectious disease caused by a novel coronavirus, known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Infection by COVID-19 can result in a range of clinical outcomes, from asymptomatic to severe life-threatening course or death. The purpose of our research was to evaluate the presentation of COVID19 disease based on the clinical and radiological characteristics of our population. 100 COVID19 patients recorded by RTPCR. Clinical, biochemical and radiological data from April-May, 2021. Of the 100 patients, in our study 66% were males and 26% patients had history of recent travel. Majority of patients were asymptomatic and don’t have comorbid illness. Thrombocytopenia and lymphopenia, increased levels of lactate dehydrogenase (LDH) and serum ferritin and C-reactive protein were common in these patients. CT finding were 63% had normal CT chest. Among the 37% patients who had CT chest findings, 25% had bilateral diseases, 8% patients had right lung involvement while 4% patients have left lung involvement. COVID-19 disease has a relatively mild course in this part of the subcontinent. Clinical and laboratory findings are similar to those found in viral diseases. Studies involving larger sample size and interventional trials are need of the hour.

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Mortality of babies enrolled in a community-based support programme: CONI PLUS (Care of Next Infant Plus)

Archives of Disease in Childhood ◽

10.1136/archdischild-2014-307232 ◽

2015 ◽

Vol 100 (7) ◽

pp. 637-642 ◽

Cited By ~ 6

Author(s):

Alison J Waite ◽

Robert C Coombs ◽

Angela McKenzie ◽

Charlotte Daman-Willems ◽

Marta C Cohen ◽

...

Keyword(s):

Extended Family ◽

Sudden Infant Death ◽

Sudden Infant ◽

Unexpected Death ◽

Community Based ◽

Support Programme ◽

Life Threatening ◽

History Of ◽

The Uk ◽

Age Range

ObjectiveTo report mortality in babies enrolled on a community-based programme, Care of Next Infant Plus (CONI PLUS), which primarily supports parents anxious because of previous sudden unexpected death in infancy (SUDI) in their extended family or following an apparent life threatening event (ALTE) in their baby.DesignProspective observational study from 1996 to 2010 in the UK.ResultsOf 6487 babies enrolled, 37 died (5.7 per 1000). There were 2789 (43.0%) SUDI related babies of whom, six died suddenly and unexpectedly (2.15 per 1000). Four babies were sharing a sofa at night or a bed with parent(s) who smoked or had consumed alcohol. Of the 1882 (29.0%) babies enrolled following an ALTE, five died suddenly and unexpectedly (2.66 per 1000): four unexplained and one due to infection. None occurred while sharing a sleep surface, and at least three died during the day. The remaining 1816 (28%) babies were enrolled for other reasons. Seven died suddenly and unexpectedly (3.85 per 1000), two were unexplained and none associated with bed sharing.ConclusionsThe number of SUDI deaths in babies enrolled on CONI PLUS is higher than expected from UK averages. Deaths in babies enrolled because of family history of SUDI were mostly associated with inappropriate sharing of a sleep surface at night and mostly outside the peak age range for sudden infant death. The opposite is true for those enrolled following an ALTE. The number of deaths is small but findings suggest a different mechanism for death in these two groups.

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Management and outcome of spontaneous subaponeurotic fluid collections in infants: the Hospital for Sick Children experience and review of the literature

Journal of Neurosurgery Pediatrics ◽

10.3171/2016.4.peds1641 ◽

2016 ◽

Vol 18 (4) ◽

pp. 442-447 ◽

Cited By ~ 4

Author(s):

Shelly Wang ◽

James Drake ◽

Abhaya V. Kulkarni

Keyword(s):

English Language ◽

Fluid Collection ◽

Infectious Complications ◽

Unknown Etiology ◽

Laboratory Findings ◽

Imaging Characteristics ◽

History Of ◽

Sick Children ◽

Fluid Collections ◽

Age Range

OBJECTIVE Spontaneous subaponeurotic fluid collection (SSFC) is an uncommon and newly described entity of unknown etiology, observed in infants less than 1 year of age. The authors report on series of infants who presented to the Hospital for Sick Children (HSC) with SSFC, focusing on the natural history of this condition. METHODS Data from the Hospital for Sick Children were retrospectively reviewed for the period between January 2004 and June 2015. Patient age and sex, birth history, medical history, laboratory findings, and symptoms were reviewed. SSFC location, imaging characteristics, management, and outcome were also analyzed. A MEDLINE and Embase literature search was performed on the condition, yielding previously reported cases of SSFC in the English language. RESULTS Nine cases involving patients who presented with SSFC during the study period were identified. The patients were 4 male and 5 female infants (age range 5 weeks to 11 months). All cases of SSFC developed spontaneously over a period of days, and the infants had no history of injuries, trauma, or hair manipulation in the immediate period preceding the development of the subgaleal collections. Six patients underwent remote forceps- or vacuum-assisted instrumented births, although none of the patients developed scalp collections or skin discoloration immediately after birth. All of the cases were managed conservatively on an outpatient (6 cases) or inpatient (3 cases) basis. In 1 case, the size of the fluid collection fluctuated over 4 months, but in all of the cases, the collections resolved spontaneously without structural or infectious complications. CONCLUSIONS This is the largest series describing SSFC to date and summarizes 9 cases managed at a large academic neurosurgical center. Although the specific pathophysiology of SSFC remains unknown, in some cases the condition may be associated with a remote history of instrumented delivery. SSFC occurs spontaneously without immediate preceding trauma, and an extensive hematology or child abuse workup is not necessary. A conservative approach with outpatient follow-up is advocated.

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