scholarly journals Autonomic Dysfunction Following Neurotoxic Snake Envenomation: Does Site of Bite Predispose?

2021 ◽  
Vol 6 (2) ◽  
pp. 47-49
Author(s):  
Anju Bala ◽  
Parul Bhardwaj ◽  
Vipan Garg
Keyword(s):  
Blood Pressure ◽  
South Asian ◽  
Autonomic Dysfunction ◽  
Snake Bite ◽  
Morbidity And Mortality ◽  
Naja Naja ◽  
Snake Envenomation ◽  
Venomous Snakes ◽  
Echis Carinatus ◽  
Russell’S Viper

South Asian subcontinent is among the highest burden areas in respect of snake bite. India is commonest place in this subcontinent with mortality following snake envenomation. The four most important venomous snakes in India are cobra (Naja naja) and common krait (Bungarus caeruleus), which are neurotoxic, and the saw-scaled viper (Echis carinatus) and Russell’s viper (Daboia russelii), which are hemotoxic1. Various autonomic dysfunction following neuro-paralytic envenomation with krait and cobra has been reported. Timely recognition and appropriate management of snake envenomation along with autonomic dysfunction helps to reduce morbidity and mortality. Keywords: Autonomic dysfunction, hypertension, antisnake venom, blood pressure.

scholarly journals Snake bite, a neglected menace: a prospective observational study in a tertiary care pediatric intensive care unit

2020 ◽  
Vol 7 (5) ◽  
pp. 1096
Author(s):  
Shatabdi Giri ◽  
Swarup Kumar Bisoi ◽  
Dillip Kumar Dash ◽  
M. D. Mohanty ◽  
S. K. Parida
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Prospective Observational Study ◽  
Tertiary Care ◽  
First Aid ◽  
Snake Bite ◽  
Morbidity And Mortality ◽  
Snake Envenomation ◽  
Snake Bites ◽  
Atypical Presentations

Background: Snake bite is a neglected and underestimated public health problem in tropical and subtropical region. Snake envenomation is a well-known cause of morbidity and mortality in India. In 2009, WHO declared snake bite a neglected disease. Ophitoxaemia is an exotic term characterising the clinical spectrum of snake bite. Objective of this study was to know the outcome in paediatric snake bite cases in a tertiary care PICU (Paediatric Intensive Care Unit) with special reference to envenomation time and also to evaluate and analyse few atypical presentations of snake envenomation by proper history taking, physical examination and help start early intervention to prevent morbidity and mortality.Methods: A prospective observational study was done in Paediatric Intensive care unit of the hospital from June 2017 to June 2019.Results: Around 56.8% of 109 cases were non-poisonous snake-bites. Out of 47 cases admitted to PICU, 68.08% developed cellulitis at the site of bite with Staphylococcus aureus being the commonest organism isolated (56.25%). Anaerobes (bacteroides and clostridium) were also isolated in few cases. Edema at site of bite (hematotoxic) and ptosis(neurotoxic) were most common initial presentation. 36.17% of patients received ASV (Anti- Snake Venom) and first aid within 6 hours of snake bite. The morbidity and mortality were significantly less (p<0.05) as compared to those who didn't receive ASV. 12.76% of cases with normal CRT (Clot Retraction Time) presented with features of coagulopathy. DIC (58.33% of hematotoxic bites) and respiratory paralysis 68 (75% of neurotoxic bites) were the commonest complications. Renal replacement therapy was required in 6.38%, transfusion in 10.63% cases and case-fatality-rate was 12.7%. There were a few atypical presentations of snake bite mimicking Gullain-Barre syndrome, acute onset encephalitis with absent brainstem and pupillary reflexes, intracerebral hemorrhage and cortical blindness.Conclusions: Most snake bites are non-poisonous. Early first aid and ASV administration has better outcome. Fibrinogen levels are more reliable than CRT to diagnose coagulopathy. Acute presentations i.e, altered sensorium, paralysis, blindness and stroke like features should always be evaluated for snake envenomation in suspected cases to prevent morbidity and mortality.

Acute Pituitary Apoplexy following Snake Bite: A Rare but Treatable Complication

2017 ◽  
Vol 16 (06) ◽  
pp. 397-399
Author(s):  
Narendrakumar Barad
Keyword(s):  
Public Health ◽  
Acute Kidney Injury ◽  
Developing Countries ◽  
Rural Areas ◽  
Pituitary Apoplexy ◽  
Kidney Injury ◽  
Snake Bite ◽  
Important Public Health ◽  
Russell’S Viper ◽  
Public Health Hazards

AbstractPoisonous snake bite is one of the important public health hazards in developing countries, such as India, where majority of the population resides in rural areas. Among various poisonous species of snakes, Russell's viper venom causes neurotoxicity, myotoxicity, hemolysis, and coagulopathies leading to shock and acute kidney injury. Pituitary apoplexy causing acute hypopituitarism is an extremely rare but treatable complication following viper bite. Here in, we report the case of a 14-year-old boy admitted with Russell's viper bite complicated by disseminated intravascular coagulation (DIC), acute kidney injury, and pituitary apoplexy with secondary acute hypopituitarism.

scholarly journals To Determine the Correlation between Anthropometric Variables of Obesity and Hypertension at NGMC: A Tertiary Care Hospital

2018 ◽  
Vol 14 (2) ◽  
pp. 70-74
Author(s):  
Bhawana Neupane Pant ◽  
Manoj Pant ◽  
Rajesh Kumar Goit ◽  
Ashish Neupane ◽  
Ganesh Prasad Neupane ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Tertiary Care ◽  
Morbidity And Mortality ◽  
Care Hospital ◽  
Hip Circumference ◽  
Specific Population ◽  
Anthropometric Indices ◽  
Arterial Blood ◽  
Skin Fold ◽  
Scientific Validation

Aim: Obesity is associated with the metabolic risk factors such as high blood pressure, body fat abnormality, and glucose intolerance which may influence the morbidity and mortality due to cardiovascular diseases. The present study is to determine the correlation of common anthropometric indices of obesity with blood pressure among population in mid-western region of Nepal. The result will provide us insight on relevant anthropometric indices for predicting hypertension based on linear correlation calculated from our data. Methods: We screened 500 healthy subjects to study the correlation between anthropometric indices and blood pressure.Result: Our result showed strong correlation between Sum of Skin fold, waist circumference, and waist hip ratio with blood pressure (systolic blood pressure, diastolic blood pressure and mean arterial blood pressure). However some of the anthropometric indices like hip circumference and body mass index did not have significant correlation with blood pressure. Conclusion: Provided obesity related morbidity and mortality is burgeoning in our society it is imperative to identify right indicators of cardiovascular disease for specific population. Relevant anthropometric indices can serve as excellent indicators if used based of scientific validation. JNGMC, Vol. 14 No. 2 December 2016, Page:70-74

Snakebite Mitigation Project of the Madras Crocodile Bank/Centre for Herpetology, India: background and a brief summary of activities

2018 ◽  
Vol 113 (12) ◽  
pp. 818-819
Author(s):  
Romulus Whitaker
Keyword(s):  
Public Awareness ◽  
Rural India ◽  
Awareness Campaign ◽  
Naja Naja ◽  
Life Saving ◽  
Mitigation Project ◽  
Treatment Centre ◽  
Echis Carinatus ◽  
Agricultural Areas ◽  
Big Four

Abstract Snakebite is a serious problem in rural India where several highly venomous species are commonly found in and around agricultural areas where prey such as rodents and amphibians are abundant. Four snake species, referred to as the Big Four, are responsible for the most serious and fatal bites: spectacled cobra (Naja naja), Russell’s viper (Daboia russelii), common krait (Bungarus caeruleus) and saw-scaled viper (Echis carinatus). A polyvalent antivenom is made to treat these bites but public awareness and distribution of this life-saving drug is inadequate. The Madras Crocodile Bank and its partners are conducting a snakebite project which includes venom sampling and research, snake and snakebite treatment centre mapping, and a nationwide awareness campaign for snakebite mitigation.

scholarly journals Improving Blood Pressure Control in Over-the-Road Truck Drivers: Is Provision of Medication Therapy Management by Pharmacists Feasible?

2015 ◽  
Vol 6 (1) ◽  
Author(s):  
Keri D. Hager ◽  
Benjamin D. Aronson ◽  
Reid C. Smith ◽  
David Parra ◽  
Michael Swanoski
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Control ◽  
Pressure Control ◽  
Medication Therapy Management ◽  
Truck Drivers ◽  
Morbidity And Mortality ◽  
Therapy Management ◽  
The Road ◽  
Medication Therapy ◽  
On The Road

Purpose This pilot sought to determine feasibility of studying the impact on hypertension in over-the-road truck drivers who met with pharmacists for Medication Therapy Management (MTM) compared to those who did not. Design/methodology/approach Drivers were randomly assigned to control or treatment (MTM) group for 52 weeks. Drivers assigned to the MTM arm could receive services in person or via secure videoconferencing technology located in a private space at the trucking company. All subjects were provided education and received a blood pressure monitor and log for recording daily blood pressures. Findings Eleven drivers enrolled and seven drivers completed the study. The primary barriers to participation included unpredictable driver schedules and lack of access to MTM provider while on the road. Research limitations/implications This pilot study was limited by small sample size. Pharmacists were not available to meet with truckers "on demand." Therefore, researchers are encouraged to test alternate opportunities to increase enrollment of drivers in studies and access to MTM services while drivers are on the road. Practical implications Hypertension is the second highest health-related cost burden, and over-the-road truck drivers have unique challenges that can make it difficult to attain blood pressure control. Pharmacist-provided MTM has been shown to improve blood pressure control. Improving access to MTM, perhaps using a national network of pharmacists or technology from the road, may decrease morbidity and mortality in drivers. Originality/value This paper fulfills an identified need to study how to improve driver access to care to reduce cardiovascular-related morbidity and mortality.   Type: Clinical Experience

Saving more lives and limbs: applying a cardiac rehabilitation model of structured exercise to symptomatic peripheral arterial disease

2021 ◽  
pp. 1-8
Author(s):  
Susan Matthews ◽  
Martin Fox ◽  
Sarah Coy ◽  
Jane Whittaker ◽  
Gail Brough ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Blood Pressure ◽  
Peripheral Arterial Disease ◽  
Cardiac Rehabilitation ◽  
Intermittent Claudication ◽  
Arterial Disease ◽  
Morbidity And Mortality ◽  
Supervised Exercise ◽  
Peripheral Arterial

Background/Aims Peripheral arterial disease is common among those aged 60 years or above and can cause debilitating intermittent claudication. This impacts quality of life and is a marker for increased morbidity and mortality, mainly from cardiovascular disease. Access to recommended exercise programmes for people with symptomatic peripheral arterial disease is poor in most areas of the UK. This study aimed to evaluate the benefits of expanding an established cardiac rehabilitation service to accommodate supervised exercise for people with peripheral arterial disease Methods The study evaluated 11 participants peripheral arterial disease and intermittent claudication who were referred by the Manchester leg circulation service. Participants underwent the programme involving eight weekly 1.5 hour sessions of supervised exercise and cardiovascular education with support, reassurance and motivation. The participants' blood pressure, walking impairment, quality of life, anxiety and depression were monitored and reviewed. Results Overall, the participants' walking distance, intermittent claudication, quality of life and blood pressure had improved. The participants' overall satisfaction with the programme was excellent. The programme also demonstrated clinical and cost-effectiveness. Conclusions A structured, supervised exercise programme can have considerable benefits for people with peripheral arterial disease, improving their symptoms and quality of life. It may also help to reduce the morbidity and mortality risks associated with inactivity in this patient group.

Abstract 14615: The Preventable Causes of Cardiovascular Diseases in China: Comparative Risk Assessment of Dietary, Lifestyle, and Metabolic Risk Factors

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Yanping Li ◽  
Frank Hu
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Risk Factor ◽  
High Blood Pressure ◽  
Physical Inactivity ◽  
Metabolic Risk Factors ◽  
Morbidity And Mortality ◽  
Metabolic Risk ◽  
Rapid Urbanization ◽  
Exposure Distribution

Background: fuelled by rapid urbanization and changes in dietary and lifestyle choices, cardiovascular disease (CVD) has emerged as the leading cause of death in China. Purposes: to estimate the CVD events that potentially contributed to 9 modifiable dietary, lifestyle, and metabolic risk factors in China. Methods: We used data on risk factor exposures in the Chinese population from nationally representative health surveys and CVD morbidity and mortality statistics from the China Health Statistical Yearbook and the National Population Census. We obtained the etiological effects of risk factors on CVD risk, by age, from systematic reviews and meta-analyses of epidemiological studies. We estimated the number of CVD events attributable to all non-optimal levels of each risk factor exposure, by urban/rural, age and sex. Results: Based on the exposure distribution estimated by 2009 China Health Nutrition Survey, the population attributable risk (PAR) on CVD events was 47.3% for high blood pressure, 23.2%, for physical inactivity, 18.5% for smoking, 13.5 for high BMI, 13.0% for high LDL cholesterol, 11.8% for high blood glucose, 11.1% for low dietary intakes of fruit and vegetable, 7.1% for high sodium intake and 3.5% for low PUFA intake, which was 78.0%, 18.8%, 20.9%, 21.9%, 8.2%, 16.1%, 12.0%, 20.3% and 2.0%, respectively, based on exposure distribution of 2002 China National Nutrition and Health Survey. In 2009, high blood pressure was responsible for 3.9 million CVD events, including 1.4 million CHD, 1.5 million ischemic strokes and 1 million hemorrhagic strokes. Large gender difference was found for PAR% of smoking (male 27.8%/female 6.5%). Conclusions: High blood pressure, smoking and physical inactivity, which all have effective interventions, are responsible for the largest number of CVD events in China. Other dietary, lifestyle, and metabolic risk factors for chronic diseases also cause a substantial number of CVD morbidity and mortality in China.

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