Search results for: Envenomation

Authors: Sathvika Reddy, Devi Revathi

Abstract:

Background: In India, deliberate self-harm (DSH) with poisoning agents carries a significant impact on morbidity and mortality. Changes in the patterns of poisoning vary across various geographical locations. It is important to know the patterns in a given region in order to facilitate rapid clinical diagnosis, appropriate treatment to reduce associated morbidity and mortality. Aim and Objective: To study the patterns, treatment outcomes of acute poisoning in patients admitted to emergency wards in a tertiary care hospital and to provide poison information services. Materials and Methods: This study was conducted at M.S Ramaiah Memorial and Teaching Hospital from November 2016 to March 2017. The patient’s data was obtained from patient case sheet, interaction with health care professionals, interviewing patients and their caretakers (if possible), and were documented in a suitably designed form. Results: The study involved 131 patients with a mean age of 27.76 ± 15.5 years. Majority of the patients were in the age group 21-30 years, literates (n=53) dwelling in urban (n=113) areas belonging to upper middle class (n=50). Analgesics and antipyretics were commonly utilized in intentional drug overdosage (n=49). Envenomation constituted n=21(16.03%). Furthermore, a significant relationship was observed between marital status and self-poisoning (n=64) (P < 0.001) which commonly occurred through oral ingestion. The outcomes were correlated with the GCS and PSS system and n=85 recovered, n=17 were discharged against medical advice, and n=4 died, and n=4 were lost to follow up respectively. The poison information queries include drug overdose (n=29) and management related queries (n=22) provided majorly by residents (n=45) to update knowledge (n=11) and for better patient care (n=40). Conclusion: The trend in poisoning is dynamic. Medications were identified as the main cause of poisoning in urban areas of India. Educational programs with more emphasis on preventive measures are necessary to create awareness among the general public.

Keywords: poisoning, suicides, clinical pharmacist, envenomation, poison information services

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Authors: Walaa H. Salama, Azza M. Abdel-Aty, Afaf S. Fahmy

Abstract:

Background: Egyptian Cobra; Naja haje (Elapidae) is one of most common snakes, widely distributed in Egypt and its envenomation causes multi-organ failure leading to rapid death. Thus, Different medicinal plants showed a protective effect against venom toxicity and may complement the conventional antivenom therapy. Aim: The present study was designed to assess both the antioxidant capacity of methanolic extract of rosemary leaves and evaluate the neutralizing ability of the extract against hepatotoxicity induced by Naja haje venom. Methods: The total phenolic and flavonoid contents and the antioxidant capacity of the methanolic rosemary extract were estimated by DPPH and ABTS Scavenging methods. In addition, the rosemary extract were assessed for anti-venom properties under in vitro and in vivo standard assays. Results: The rosemary extract had high total phenolic and flavonoid content as 12 ± 2 g of gallic acid equivalent per 100 gram of dry weight (g GAE/100g dw) and 5.5 ± 0.8 g of catechin equivalent per 100 grams of dry weight (g CE/100g dw), respectively. In addition, the rosemary extract showed high antioxidant capacity. Furthermore, The rosemary extract were inhibited in vitro the enzymatic activities of phospholipase A₂, L-amino acid oxidase, and hyaluronidase of the venom in a dose-dependent manner. Moreover, indirect hemolytic activity, hepatotoxicity induced by venom were completely neutralized as shown by histological studies. Conclusion: The phenolic compounds of rosemary extract with potential antioxidant activity may be considered as a promising candidate for future therapeutics in snakebite therapy.

Keywords: antioxidant activity, neutralization, phospholipase A₂ enzyme, snake venom

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Authors: Sourav Ghosh, Antony Gomes

Abstract:

Since 1894 anti-snake venom serum (ASVS) is the only available treatment against snake envenomation, although there are many side effects and limitations. The need for a supportive treatment was felt for a long time to overcome the side effects and limitations of ASVS. Andrographolide conjugated with gold nanoparticle (A-GNP) has been found to antagonize viper venom-induced local damages. The present study was aimed to study the protective efficacy of A-GNP against Viper venom-induced inflammatory response and organ toxicity in animal model. Ethical clearance was obtained from animal experiments. Physico-chemical characterization of A-GNP was done by DLS (diameter and zeta potential), FE-SEM and XRD. Swiss albino male mice were divided into 4 groups: Gr.1-Sham control, Gr.2- Russell’s Viper venom (RVV) control, Gr.3- andrographolide treated and Gr.4- A-GNP treated. The 1/5th minimum lethal dose of RVV (500µg/kg, s.c.) was induced in animals of group 2, 3 & 4 animals, followed by treatment with andrographolide (100mg/kg, i.p.) and A-GNP (100mg/kg, i.v.) in group 3 & 4 animals, respectively. Blood was collected after 18 h, serum was prepared, and inflammatory markers (IL 1β, 6, 17a, 10, TNF α) and biochemical markers (AST, ACP, LDH, urea, creatinine) were assessed. Values were expressed as mean±SEM (n=4), one way ANOVA was done, P<0.05 was considered as statistically significant. DLS size showed the hydrodynamic diameter of A-GNP to be 230-260nm with polydispersity index of 0.103 and zeta potential was -18.32mV. XRD data confirmed the presence of crystalline gold in A-GNP, and FESEM indicated the presence of nearly spherical particle with size18-24nm.Treatment with A-GNP significantly decreased viper venom-induced proinflammatory markers (IL 1β, 6, 17, TNF α) increased anti-inflammatory markers (IL 10) and decreased organ toxicity markers (AST, ACP, LDH, urea, creatinine) in animal model. Venom neutralization efficacy of A-GNP was > andrographolide, which confirmed the increased efficacy of andrographolide after gold nanoparticle conjugation. Venom neutralization by A-GNP was due to anti-oxidant/anti-inflammatory activity of andrographolide, which showed increased efficacy after gold nanoparticle tagging. Thus, A-GNP may serve as a supportive therapy in snake-bite (against inflammatory response and organ toxicity) subject to further detail studies.

Keywords: andrographolide, gold nanoparticle, inflammatory response, organ toxicity, snake venom, snake venom neutralization, viper venom

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Authors: Ramesh Chinnasamy, Srishti Semalty, Vishnu S. Nair, Thirumurugan Vedagiri, Mahesh Ganeshan, Gautam Talukdar, Karthy Sivapushanam, Abhijit Das

Abstract:

Snakes form an integral component of ecological systems. Human population explosion and associated acceleration of habitat destruction and degradation, has led to a rapid increase in human-snake encounters. The study aims at understanding the level of awareness, knowledge, and attitude of the people towards human-snake negative interaction and role of awareness programmes in the Moyar river valley, Tamil Nadu. The study area is part of the Mudumalai and the Sathyamangalam Tiger Reserves, which are significant wildlife corridors between the Western Ghats and the Eastern Ghats in the Nilgiri Biosphere Reserve. The data was collected using questionnaire covering 644 respondents spread across 18 villages between 2018 and 2019. The study revealed that 86.5% of respondents had strong negative perceptions towards snakes which were propelled by fear, superstitions, and threat of snakebite which was common and did not vary among different villages (F=4.48; p = <0.05) and age groups (X2 = 1.946; p = 0.962). Cobra 27.8% (n = 294) and rat snake 21.3% (n = 225) were the most sighted species and most snake encounter occurred during the monsoon season i.e., July 35.6 (n = 218), June 19.1% (n = 117) and August 18.4% (n = 113). At least 1 out of 5 respondents was reportedly bitten by snakes during their lifetime. The most common species of snakes that were the cause of snakebite were Saw scaled viper (32.6%, n = 42) followed by Cobra 17.1% (n = 22). About 21.3% (n = 137) people reported livestock loss due to pythons and other snakes 21.3% (n = 137). Most people, preferred medical treatment for snakebite (87.3%), whereas 12.7%, still believed in traditional methods. The majority (82.3%) used precautionary measure by keeping traditional items such as garlic, kerosene, and snake plant to avoid snakes. About 30% of the respondents expressed need for technical and monetary support from the forest department that could aid in reducing the human-snake conflict. It is concluded that the general perception in the study area is driven by fear and negative attitude towards snakes. Though snakes such as Cobra were widely worshiped in the region, there are still widespread myths and misconceptions that have led to the irrational killing of snakes. Awareness and innovative education programs rooted in the local context and language should be integrated at the village level, to minimize risk and the associated threat of snakebite among the people. Results from this study shall help policy makers to devise appropriate conservation measures to reduce human-snake conflicts in India.

Keywords: Envenomation, Health-Education, Human-Wildlife Conflict, Neglected Tropical Disease, Snakebite Mitigation, Traditional Practitioners

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