scholarly journals Clinical Spectrum and Outcome of Snake Bite Cases in Western Nepal

2017 ◽  
Vol 15 (2) ◽  
pp. 26-28 ◽  
Author(s):  
Sujeeta Bajracharya ◽  
R. Joshi ◽  
D. B. Shrestha
Keyword(s):  
Lower Limb ◽  
Clinical Symptoms ◽  
First Aid ◽  
Snake Bite ◽  
Male Victims ◽  
Mortality And Morbidity ◽  
Army Hospital ◽  
Tingling Sensation ◽  
History Of ◽  
Exact Figure

Background: Prevalence of snake bite is high in Nepal. However, there is no exact figure of mortality and morbidity associated with snake-bite probably due to poor reporting. Objectives: To study demographic characters of snake bite victims, to see clinical symptoms of the bite, outcome of snake bite, use of ASVS and its associated anaphylactic reaction. Methods: A retrospective observational hospital based study carried out through July- October 2017 of the patients with the history of snake bite and visited to secondary level hospital (Army Hospital) at Nepalganj. Result: Among 169 cases of snake bite between 6 months to 83 years, 49.70% was between 20-54 years. Highest number of cases (n=110) came from local areas of Nepalganj like Manikapur, Alanagar, Fulltegra, Daduwa, Gayatrinagar and Samsherganj. Male victims were 61.53% (n=104) and 38.46% (n=65) were female. Commonest site of bite was in lower limb (n=116), followed by upper limb (n=47), head, neck and trunk. Maximum number of cases came to the center within 90 minutes of bite while only n= 28 came after 180 minutes of bite. Use of tourniquet as first aid was seen in 68% (n=115) and 3 cases came in with incised wound and sucked wound. A total of 97.04% (n=164) were dry bite with 26.62% (n=45) only had suspicion of snake bite (snake not seen due to invisibility or bite other than snake). A majority of cases presented without any other symptoms (with only history of bite), 45.56% had bite marks, 17.16% had pain and swelling at the bite site, 6.7% had bleeding from the site and burning and tingling sensation. A total of 2.95% (n=5) of snake bite cases needed ASVS and one developed ASVS complication. Conclusion: Snake bite is more common in adult male between 20-54 years and the commonest site is lower limb. Maximum number of cases presented within in 90 minutes of bite using tourniquet on the affected limb as first aid. Only small percentage of snake bite required anti-snake venom treatment and its complication rate is high.

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

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.

scholarly journals SNAKE BITE

2010 ◽  
Vol 17 (02) ◽  
pp. 263-268
Author(s):  
KAMRAN ZAHEER BUTT ◽  
FAHEEM ANWAR ◽  
MOHAMMAD RIZWAN
Keyword(s):  
First Aid ◽  
Snake Bite ◽  
Clinical Effects ◽  
Field Hospital ◽  
Laboratory Findings ◽  
Life Threatening ◽  
History Of ◽  
Male Patients ◽  
Age Range ◽  
Study Setting

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.

scholarly journals DIABETIC RETINOPATHY

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

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. 

scholarly journals Diagnostic Model of Covid-19 for Resource-Limited Countries Based on The Combination Of Clinical Symptoms, Chest Radiography and Laboratory Test 

2020 ◽  
Author(s):  
Herikurniawan Herikurniawan ◽  
Martin C Rumende ◽  
Siti Setiati ◽  
July Kumalawati ◽  
Belinda Thania Deslanthy
Keyword(s):  
Chest Radiography ◽  
Clinical Symptoms ◽  
Area Under The Curve ◽  
Cross Sectional Study ◽  
Diagnostic Process ◽  
Morbidity Rate ◽  
Diagnostic Model ◽  
Cross Sectional ◽  
Mortality And Morbidity ◽  
History Of

Abstract Background: COVID-19 is an infection caused by SARS-CoV 2. RT-PCR test is the gold standard for COVID-19 diagnosis, detecting the virus nucleic acid. However, this test is not yet available in every healthcare center, thus making the diagnostic process lengthy. A prompt diagnosis and immediate management are important to decrease mortality and morbidity rate, as well as to prevent transmission. A simple and practical diagnostic model using determinant factors is needed to guide the physician for a quicker decision-making. Method: This study is a cross sectional study using consecutive sampling method. The study was conducted at RSUPN Cipto Mangunkusumo, Jakarta from March to June 2020. History of contact with COVID-19, clinical symptoms, laboratory examination, and chest radiographs data were taken from medical records. The steps of analysis were univariate, bivariate, and multivariate analyses, followed by ROC curve and Hosmer-Lemeshow calibration. Result: There were 187 patients with the majority of subjects in the age group < 60 years old (65,2%) and male sex (53,47%). The most frequent comorbidities were diabetes mellitus and hypertension. The selected variables in this scoring system were contact history, fever/history of fever, dyspnea with respiratory rate >20 breaths/minute, leucocyte ≤ 10.000 cells/mL and typical chest radiography. The area under the curve for this model was 0,777 (CI 95% (0,706-0,847), P<0,001). The probability was 82% with a cut-off point ≥ 4, PPV: 74%, NPV: 77%. Conclusion: Determinant model based on the combination of contact history, fever/history of fever, dyspnea, leucocyte ≤ 10.000 cells/mL and typical chest radiography provides a good accuracy to establish COVID-19 diagnosis.

Organization of restrictive quarantine measures to prevent especially dangerous infections

2020 ◽  
pp. 6-11
Author(s):  
Petr Ilyin
Keyword(s):  
Infectious Diseases ◽  
Clinical Symptoms ◽  
International Health ◽  
World Health ◽  
The World ◽  
History Of ◽  
Entire History ◽  
Health Organization ◽  
Former Ussr ◽  
Health Regulations

Especially dangerous infections (EDIs) belong to the conditionally labelled group of infectious diseases that pose an exceptional epidemic threat. They are highly contagious, rapidly spreading and capable of affecting wide sections of the population in the shortest possible time, they are characterized by the severity of clinical symptoms and high mortality rates. At the present stage, the term "especially dangerous infections" is used only in the territory of the countries of the former USSR, all over the world this concept is defined as "infectious diseases that pose an extreme threat to public health on an international scale." Over the entire history of human development, more people have died as a result of epidemics and pandemics than in all wars combined. The list of especially dangerous infections and measures to prevent their spread were fixed in the International Health Regulations (IHR), adopted at the 22nd session of the WHO's World Health Assembly on July 26, 1969. In 1970, at the 23rd session of the WHO's Assembly, typhus and relapsing fever were excluded from the list of quarantine infections. As amended in 1981, the list included only three diseases represented by plague, cholera and anthrax. However, now annual additions of new infections endemic to different parts of the earth to this list take place. To date, the World Health Organization (WHO) has already included more than 100 diseases in the list of especially dangerous infections.

CASE REPORT: RARE FORM OF HIRSCHPRUNG’S DISEASE

2020 ◽  
Vol 30 (5) ◽  
pp. 82-84
Author(s):  
Ilja Skalskis
Keyword(s):  
Down Syndrome ◽  
Case Report ◽  
Clinical Symptoms ◽  
Hirschsprung Disease ◽  
Distal Colon ◽  
Total Colonic Aganglionosis ◽  
Sphincter Function ◽  
Anal Sphincter Function ◽  
History Of ◽  
High Index Of Suspicion

Hirschsprung disease (HD) is a developmental disorder characterized by the absence of ganglia in the distal colon, resulting in a functional obstruction. Incidence of total colonic aganglionosis (TCA) is 1 in 500 000 and it accounts for 5-10% of all cases of HD. HD should be suspected in patients with typical clinical symptoms and a high index of suspicion is appropriate for infants with a predisposing condition such as Down Syndrome (DS), or for those with a family history of HD. The treatment of choice for HD is surgical, such as Swenson, Soave, and Duhamel procedures. The goals are to resect the affected segment of the colon, bring the normal ganglionic bowel down close to the anus, and preserve internal anal sphincter function. We present a clinical case report of TCA in a child with Down syndrome (DS) and review of literature.

Etiology and clinical features of epididymo-orchitis: A single-center study in Tehran, Iran

2020 ◽  
Vol 20 ◽  
Author(s):  
Sara Abolghasemi ◽  
Mohammad Alizadeh ◽  
Ali Hashemi ◽  
Shabnam Tehrani
Keyword(s):  
Chlamydia Trachomatis ◽  
Clinical Symptoms ◽  
Urine Culture ◽  
Clinical Manifestations ◽  
Urinary Frequency ◽  
Serological Tests ◽  
Duration Of Symptoms ◽  
Two Samples ◽  
History Of ◽  
Tract Infections

Introduction: Epididymo-orchitis is a common urological disease among men. Little is known about the clinical and epidemiological aspects of the disease in Iran. Thus, the present study was aimed to investigate the etiology, clinical sequelae and risk factors of patients with epididymo-orchitis in Tehran, Iran. Materials and Methods: Patients presenting with epididymo-orchitis were prospectively analyzed in order to study the etiology and pattern of the disease. Bacteriological, molecular and serological tests were undertaken to look for Chlamydia trachomatis, Neisseria gonorrhoeae, Brucella spp., Mycoplasma spp, and other bacteria. Results: Fifty patients with epididymo-orchitis were evaluated according to their clinical symptoms, duration of symptoms, physical examination, and laboratory studies. The mean age of the patients was 53 years. Fever, dysuria, pain in the flanks, urinary frequency and discharges occurred in 58.0%, 50.0%, 50.0%, 28.0% and 6.0%, respectively. Bacterial pathogen was identified in 26% (13/50) of patients by urine culture. Escherichia coli was the etiological agent in 11/13 patients (84.6%). Two out of 50 patients (4.0%) were also positive for Chlamydia trachomatis. Two samples were serologically positive for Brucella spp. High Mean age, fever, urinary frequency, history of the underlying disease and history of urinary tract infections were found to have a significant association with the positive bacteriologic urine culture (P<0.05). Conclusions: The most common clinical manifestations were fever, dysuria, and abdominal pain. E. coli and C. trachomatis were the major causative agents. Use of a set of diagnostic approaches including clinical symptoms, urine culture and more precise techniques such as PCR should be taken into consideration for the definitive diagnosis.

Sacral plexus disorder caused by a wooden toothpick in the rectum

2021 ◽  
Vol 14 (1) ◽  
pp. e238690
Author(s):  
Takuro Endo ◽  
Taku Sugawara ◽  
Naoki Higashiyama
Keyword(s):  
Lower Limb ◽  
Spinal Nerve ◽  
Leg Pain ◽  
Sacral Plexus ◽  
Lateral Recess ◽  
Lateral Recess Stenosis ◽  
Preoperative Ct ◽  
History Of ◽  
History Of Pain ◽  
The Right

A 67-year-old man presented with a 2-month history of pain in his right buttock and lower limb. MRI depicted right L5/S1 lateral recess stenosis requiring surgical treatment; however, preoperative CT showed an approximately 7 cm long, thin, rod-shaped structure in the rectum, which was ultimately determined to be an accidentally ingested toothpick. It was removed surgically 6 days after diagnosis, because right leg pain worsened rapidly. The pain disappeared thereafter, and the symptoms have not recurred since. The pain might have been localised to the right buttock and posterior thigh in the early stages because the fine tip of the toothpick was positioned to the right of the anterior ramus of the S2 spinal nerve. Although sacral plexus disorder caused by a rectal foreign body is extremely rare, physicians should be mindful to avoid misdiagnosis.

scholarly journals Respiratory tract infections in children with allergic asthma on allergen immunotherapy during influenza season

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yuyun Li ◽  
Dongming Wang ◽  
Lili Zhi ◽  
Yunmei Zhu ◽  
Lan Qiao ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Allergic Asthma ◽  
Respiratory Tract Infections ◽  
Allergen Immunotherapy ◽  
Clinical Symptoms ◽  
Influenza Season ◽  
The Body ◽  
History Of ◽  
Tract Infections ◽  
Stage 1

AbstractTo describle how respiratory tract infections (RTIs) that occurred in children with allergic asthma (AA) on allergen immunotherapy (AIT) during an influenza season. Data including clinical symptoms and treatment history of children (those with AA on AIT and their siblings under 14 years old), who suffered from RTIs during an influenza season (Dec 1st, 2019–Dec 31st, 2019), were collected (by face to face interview and medical records) and analyzed. Children on AIT were divided into 2 groups: stage 1 (dose increasing stage) and stage 2 (dose maintenance stage). Their siblings were enrolled as control. During the study period, 49 children with AA on AIT (33 patients in stage 1 and 16 patients in stage 2) as well as 49 children without AA ( their siblings ) were included. There were no significant differences in occurrences of RTIs among the three groups (p > 0.05). Compared with children in the other two groups, patients with RTIs in stage 2 had less duration of coughing and needed less medicine. Children on AIT with maintenance doses had fewer symptoms and recovered quickly when they were attacked by RTIs, which suggested that AIT with dose maintenance may enhance disease resistance of the body.

Wilderness Medicine Education

2021 ◽  
Vol 9 (1) ◽  
pp. 49-55
Author(s):  
Seth C. Hawkins ◽  
Corey Winstead
Keyword(s):  
Continuing Education ◽  
First Aid ◽  
Program Director ◽  
End User ◽  
First Responder ◽  
Remote Areas ◽  
History Of ◽  
Single Use ◽  
Field Schools ◽  
Medicine Education

AbstractWilderness medicine classes are widely available to archaeologists and field scientists, but because wilderness medicine is an unregulated field, knowing what the various courses and products mean can be difficult. Based on the education chapter in the recently published textbook Wilderness EMS, this article—written by same two authors as the book—explores a number of topics relevant for the field scientist, program director, or administrator seeking to obtain wilderness medicine training for archaeologists. The article first explores the history of wilderness medicine products and certificates available to interested parties. It then differentiates between the various products available today along with their benefits and limitations for the end user. Products and trainings described include certifications (including Wilderness First Aid [WFA], Wilderness Advanced First Aid [WAFA], Advanced Wilderness First Aid [AWFA], and Wilderness First Responder [WFR]), as well as single use or continuing education trainings (including Stop the Bleed, CPR, conference courses, and field schools). Particular attention is paid to the specific and actionable needs of a field scientist in remote areas.

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