scholarly journals Retrospective study of outcome in patients with scorpion sting using prazosin with/without dobutamine

2015 ◽  
Vol 7 (2) ◽  
pp. 61-63
Author(s):  
L Venugopal ◽  
H Anilkumar ◽  
Dilip M Ram Pure ◽  
L Suresh Kumar ◽  
G Rajashekharappa
Keyword(s):  
Retrospective Study ◽  
Left Ventricular Dysfunction ◽  
Ventricular Dysfunction ◽  
Public Health Problem ◽  
Left Ventricular ◽  
Major Public Health Problem ◽  
Scorpion Sting ◽  
Early Use ◽  
Life Threatening ◽  
Severe Degree

Introduction: Scorpion sting is a major public health problem in India with severe life threatening complications. Toxin can cause autonomic overstimulation leading to hypertension, arrhythmias and pulmonary edema with left ventricular dysfunction. Prazosin has been the ideal antidote for patients with mild to moderate envenomation. In patients with severe envenomation, dobutamine is found to be very useful to prevent morbidity and mortality.Materials and Methods: Retrospective study was done on patients admitted from March 2011 to November 2013 with a history of scorpion bite and adults aged between 20-60 yrs were included. All the patients were subjected to grading of envenomation as mild, moderate and severe degree. Prazosin was given to all 80 patients and dobutamine was given to those who did not show response to prazosin.Results: Majority of patients were in the age group of 31-40 years followed by 21-30 years. Mean age was 31.23±7.23 years. Fifty four patients (67.5%) were male and twenty six (32.5%) were female. 28 patients had mild envenomation, 36 had moderate envenomation and 16 had severe envenomation. 83.33% of patients responded to dobutamine infusion in prazosin resistant cases in our study.Conclusion: Early use of dobutamine should be considered in patients with severe envenomation with left ventricular dysfunction to prevent morbidity and mortality. 2D echo has to be considered to assess left ventricular dysfunction and need for early use of dobutamine.Asian Journal of Medical Sciences Vol.7(2) 2015 61-63

Echocardiographic Evaluation of the Response to Prazosin Treatment in Scorpion Sting

2020 ◽  
Author(s):  
Khaled A Abdel Baseer ◽  
Mohamed Gamil Aboelela ◽  
Heba M Qubaisy
Keyword(s):  
Cardiogenic Shock ◽  
Pulmonary Edema ◽  
Left Ventricular Dysfunction ◽  
Ventricular Dysfunction ◽  
Cardiovascular Complications ◽  
Left Ventricular ◽  
Scorpion Sting ◽  
Scorpion Envenomation ◽  
Echocardiographic Evaluation

Abstract Background Scorpion envenomation is a major public health problem in children that can induce lethal neurological, respiratory and cardiovascular complications. We aimed to evaluate cardiovascular complications with a follow-up of envenomed children for 1 month for possibility of incomplete recovery. Methods This was a prospective study conducted for children who presented with scorpion sting to Emergency and Intensive Care units. Demographic, clinical and laboratory findings of patients were recorded. Cases with suspected clinical and electrocardiographic manifestations of myocarditis were subjected to bedside echocardiography with follow-up at the end of the first week and the first month. Results Scorpion sting cases presented to our hospital were 81 cases during 1-year study; of them, 17 cases were stable without systemic manifestations after 12 h observation and discharged. Sixty-four cases suffered systemic organic complications and needed ICU admission; their mean age was 11.52 ± 3.74 and 64% of them were males. Twenty-eight of admitted cases showed manifestations of myocarditis and by echocardiography, all of them had evidence of left ventricular dysfunction. On follow-up, there was significant improvement at the end of first week and complete improvement at the end of first month except three cases who died due to pulmonary edema and cardiogenic shock. Conclusion Acute toxic myocarditis is a common and an important cause of morbidity and mortality following scorpion envenomation that necessitates early and aggressive management. High index of suspicion, serial electrocardiogram monitoring and echocardiography are three integrative lines required to recognize this serious complication. Lay summary Acute toxic myocarditis is a common cause of morbidity and mortality following scorpion envenomation that necessitates rapid medical treatment. We aimed to evaluate cardiovascular complications after scorpion sting with a follow-up of envenomed children for 1 month for possibility of incomplete recovery. Tachycardia was the most frequent observed cardiac sign followed by hypotension, while the least was bradycardia and hypertension. All cases with manifestations suggestive of myocarditis were evaluated by bedside two-dimensional echocardiography and showed evidence of left ventricular dysfunction, that begin to regress within 1 week of treatment unless progressive pulmonary edema and resistant cardiogenic shock occurred. On follow-up for survivors, complete improvement at the end of first month was noticed. Clinical suspicion, serial ECG monitoring and echocardiography are required for rapid and early diagnosis. Early use of prazosin therapy can prevent long-term residual damage as evidenced by echocardiographic evaluation.

scholarly journals A critical review on vrischika visha W.S.R. to keraliya visha chikitsa

2021 ◽  
Vol 12 (2) ◽  
pp. 1162-1167
Author(s):  
Shanti R Nair ◽  
Suwarna Meshram ◽  
Prasanth R Krishnan
Keyword(s):  
Public Health ◽  
Older Adults ◽  
Public Health Problem ◽  
Treatment Modalities ◽  
Medical Attention ◽  
Major Public Health Problem ◽  
Scorpion Sting ◽  
Life Threatening ◽  
Scorpion Stings ◽  
Specific Symptoms

Scorpion stings are major public health problem especially in rural parts of India. Envenomation from Scorpions if estimating on yearly basis it is about 12 lakh people per year and is responsible for nearly about 3250 deaths. There are about 1400 species of scorpions identified worldwide out of this only 53 are reported to be dangerous to humans, In India we have identified around 86 species. Poison due to insect bite is common and can be accompanied with a variety of symptoms ranging from simple itching to life threatening situations. Many may go through minor problems like swelling, tingling or numbness due to the sting. Scorpion sting usually results in severe symptoms, as its venom is more potent. Young children and older adults may require immediate treatment. Vrischikadamsha is such a specific envenomation that requires medical attention. There are ample references treatment modalities and medicines in Keraleeyavisha chikitsa granthas and ayurvedic classics which are described for managing vrischikavisha. Many of the keraliyavishagrantha are written in Malayalam hence there is a need to explore and bring out the remedies. So in this article a humble effort is made to bring out the different vrischika and treatment modalities described in keraleeyagrandhas along with the specific symptoms.

scholarly journals Life-threatening ventricular arrhythmia and left ventricular dysfunction associated with anti-mitochondrial antibody-positive myositis: a case report

2021 ◽  
Vol 5 (12) ◽  
Author(s):  
Yuki Hasegawa ◽  
Daisuke Izumi ◽  
Takeshi Kashimura ◽  
Tohru Minamino
Keyword(s):  
Ventricular Tachycardia ◽  
Case Report ◽  
Ventricular Arrhythmia ◽  
Left Ventricular Dysfunction ◽  
Endomyocardial Biopsy ◽  
Ventricular Dysfunction ◽  
Left Ventricular ◽  
Optimal Drug ◽  
Life Threatening ◽  
Mitochondrial Antibody

Abstract Background Anti-mitochondrial antibody (AMA)-positive myositis is an atypical inflammatory myopathy characterized by chronic progression of muscle atrophy and cardiac involvement. Few detailed reports have shown the clinical course of the cardiac complications of AMA-positive myositis. Case summary A 47-year-old man presented with shortness of breath on exertion. Cardiac dilatation was visible on chest X-ray, and echocardiography demonstrated diffuse hypokinesis with a reduced left ventricular (LV) ejection fraction of 30%. He had mild muscle weakness in the bilateral iliopsoas muscles, and his creatine kinase (CK) and anti-mitochondrial M2 antibody levels were elevated. A liver biopsy showed no findings of primary biliary cholangitis. Coronary angiography revealed normal coronary arteries. An endomyocardial biopsy showed interstitial fibrosis and marked degeneration of the mitochondria. Fluorodeoxyglucose (FDG)-positron emission tomography/computed tomography showed circumferential abnormal accumulation in the LV myocardium, and he was diagnosed with cardiomyopathy associated with AMA-positive myositis. Optimal drug therapy for heart failure was started, and a cardiac resynchronization therapy-defibrillator was implanted. However, his cardiac function did not improve, and he was hospitalized due to ventricular tachycardia storm 5 years after the diagnosis. Ventricular tachycardia was terminated by radiofrequency catheter ablation on the LV-anterior papillary muscle. Steroid therapy was initiated and resulted in a decreased uptake of FDG and a normalized CK level at 3 months after his second discharge; however, LV systolic dysfunction remained 1 year later. Discussion Anti-mitochondrial antibody-positive myositis can affect the myocardium and cause severe LV dysfunction and life-threatening ventricular arrhythmia over time. Keywords Anti-mitochondrial antibody-positive myositis • Endomyocardial biopsy • Ventricular tachycardia • Left ventricular dysfunction • Case report • Magnetic resonance imaging • Near-infrared spectroscopy-intravascular ultrasound

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