In-vivo Study of the Efficacy of Sanjeevani Vati in Snake Venom Poisoining

Background: Visha (Poison) is a substance, which after entering the body, disturbs natural and physiological functions of body (i.e. Dosha, Dhatu, Mala). Due to its potency, it may potentially cause death in a relatively short period. A significant proportion of Indians live in villages distant from the city and work in agriculture with their lower extremities exposed. Snake-rat habitat is more prevalent in rice and sugarcane fields. Aims and Objective: To study the efficacy of Sanjeevani Vati in common cobra venom poisoning and Russell’s viper venom as a first aid measure. Materials and Methods: The preparation of Sanjeevani Vatiis carried out in Department of Rasashastra, Govt. Ayurved College, Nagpur and venom was collected from snake farm’, Haffkine Institute for Training Research and Testing, Mumbai. Animal Experiment for efficacy of Sanjeevani Vati as a first aid measure on Common cobra venom and Russell’s viper venom was carried out in National Toxicology Center (NTC) Pune. Results: The results of survival period in Russell’s viper venom group were proved to be statistically significant. P value is 0.0055(Unpaired t-test; Two tail).But in results of Common Cobra venom, it was observed that there is no delay in appearance of paralysis, convulsion & survival period. In fact all these symptoms appear near about at same time, when Sanjeevani Vati was given orally after ingestion of Cobra Venom. Conclusion: Sanjeevani Vati property is an ophidian. If you have Russell's viper venom, it is helpful as a first aid measure since it extends its life time. Poly Valent Anti snake venom serum does not interact with it (PVASVS).

Neutrophil Gelatinase–Associated Lipocalin Acts as a Robust Early Diagnostic Marker for Renal Replacement Therapy in Patients with Russell’s Viper Bite–Induced Acute Kidney Injuries

Snakebite-induced acute kidney injury (AKI) is frequently observed in patients following bites from vipers such as Russell’s viper (Daboia russelii) in India. Currently, the levels of serum creatinine are mainly used as a marker to determine the necessity for renal replacement therapy (RRT) (haemodialysis) in severe cases of AKI. However, it takes up to 48 h to ascertain a distinct change in creatinine levels compared to its baseline level upon admission. The time lost between admission and the 48 h timepoint significantly affects the clinical management of snakebite victims. Moreover, early diagnosis of AKI and decision on the necessity for RRT in snakebite victims is critical in saving lives, reducing long-term complications, and minimising treatment costs arising from expensive haemodialysis. Neutrophil gelatinase–associated lipocalin (NGAL) has been recently studied as a robust early marker for AKI in non-snakebite patients. However, its suitability for clinical use in snakebite victims has not been rigorously established. Here, we demonstrate the clinical significance of plasma NGAL as a robust marker for RRT following AKI using a large cohort (309) of Russell’s viper victims without any pre-existing health conditions. NGAL levels upon admission are positively correlated with creatinine levels at 48 h in different stages of AKI. Overall, NGAL acts as a robust early marker to ascertain the need for RRT following Russell’s viper bites. The quantification of NGAL can be recommended as a routine test in hospitals that treat snakebites to decide on RRT at early time points instead of waiting for 48 h to confirm the increase in creatinine levels. The diagnostic use of NGAL in Russell’s viper victims with pre-existing comorbidities and for other vipers should be evaluated in future studies.

A case report of peritoneal dialysis for management of acute kidney injury caused by Russell’s viper envenomation in a dog

This report describes a five-year-old dog who had been bitten by a Russell’s viper. The patient presented clinical signs of anorexia, vomiting, lethargy, and anuria. Collectively with the laboratory test results of azotemia and hyperkalemia, acute kidney injury was diagnosed. Peritoneal dialysis (PD) was instigated when the azotemia became worse and anuria persisted, despite aggressive medical and fluid therapy. After 14 days of PD, the anuria was resolved, and the patient was discharged 7 days later. At the end of the last dialysis cycle, there was a significant reduction in the severity of the azotemia, and the serum hyperkalemia had returned to normal. One month after PD, the patient no longer had any abnormal clinical signs. Both the patient’s serum blood urea nitrogen level and creatinine levels returned to within the normal limit. PD proved to be an effective management of acute kidney injury in Russell’s viper envenomation in the reported dog. This report also describes a detailed procedure of PD which can be instigated in any veterinary practice

A Biochemical and Pharmacological Characterization of Phospholipase A2 and Metalloproteinase Fractions from Eastern Russell’s Viper (Daboia siamensis) Venom: Two Major Components Associated with Acute Kidney Injury

Acute kidney injury (AKI) following Eastern Russell’s viper (Daboia siamensis) envenoming is a significant symptom in systemically envenomed victims. A number of venom components have been identified as causing the nephrotoxicity which leads to AKI. However, the precise mechanism of nephrotoxicity caused by these toxins is still unclear. In the present study, we purified two proteins from D. siamensis venom, namely RvPLA2 and RvMP. Protein identification using LCMS/MS confirmed the identity of RvPLA2 to be snake venom phospholipase A2 (SVPLA2) from Thai D. siamensis venom, whereas RvMP exhibited the presence of a factor X activator with two subunits. In vitro and in vivo pharmacological studies demonstrated myotoxicity and histopathological changes of kidney, heart, and spleen. RvPLA2 (3–10 µg/mL) caused inhibition of direct twitches of the chick biventer cervicis muscle preparation. After administration of RvPLA2 or RvMP (300 µg/kg, i.p.) for 24 h, diffuse glomerular congestion and tubular injury with minor loss of brush border were detected in envenomed mice. RvPLA2 and RvMP (300 µg/kg; i.p.) also induced congestion and tissue inflammation of heart muscle as well as diffuse congestion of mouse spleen. This study showed the significant roles of PLA2 and SVMP in snake bite envenoming caused by Thai D. siamensis and their similarities with observed clinical manifestations in envenomed victims. This study also indicated that there is a need to reevaluate the current treatment strategies for Thai D. siamensis envenoming, given the potential for irreversible nephrotoxicity.