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PubMed1998

Snake bite in the Thar Desert.

Snake bite remains a common injury in endemic areas of Pakistan. A facility based observational study was undertaken to ascertain the incidence of snake bite, its mortality and the management in public health facilities located in the Thar Desert of Province of Sindh, Pakistan. A total of 771 cases of snake bite were reported to seven randomly selected health facilities during a one-year period. Most (75%) occurred during nighttime in summer, affecting primarily males (70%) who were bitten mostly on the lower extremities (83%). Five hundred and thirteen bites (66%) were identified as poisonous and 4 deaths were reported. Seventy two percent of patients reached the health facility within 24 hours and twenty percent within 6 hours and of being bitten. Snake bite remains an important problem in endemic areas of Pakistan. People do seek assistance at public health facilities, where appropriate treatment including anti snake venom is given.

Adolescent↗
PubMed1999

[Use of snake venom proteins in medicine].

Snakes feed exclusively on freshly killed prey animals which, following their immobilization, have to be swallowed whole. Venomous snakes effect prey immobilization by injection of their venom. Snake venoms are highly concentrated, complex mixtures of individual proteins which, either as enzymes, enzyme effectors or blocking ligands, acting as single agents or in synergistic conjunction with other venom components, modify vital structures of the prey organism to destroy their biological function. Predominantly neurotoxic venoms paralyze respiratory activity by pre- or postsynaptic blockade of neuromuscular transmission. Predominantly haemocytotoxic snake venoms contain components which interact with proteins of the haemostasis, kallikrein or complement system, causing blood volume loss, hypotension or intravascular coagulation which finally lead to circulatory failure. Several isolated snake venom proteins with a known mode of action have found practical application as pharmaceutical agents, diagnostic reagents or preparative tools in the field of haemostaseology, neurobiology and complement research.

Animals↗
PubMed1998

Anatomical position of heart in snakes with vertical orientation: a new hypothesis.

It has been observed that climbing arboreal snakes have hearts closer to the head than nonclimbing terrestrial or aquatic snakes. The closeness to the head is said to minimize the work of the heart in pumping blood to the head. However, there is ample evidence that the gravitational pressure in the arteries going to the head is counterbalanced (neutralized) by the gravitational pressure of the blood in the veins going down to the heart. Hence, the heart does not do extra work so, another explanation must be sought. It is proposed that the position of the heart may be related to the filling pressure of the heart which is influenced by the compliance of the vessels above and below the heart. Some observations suggest that the caudal vessels in climbing snakes are less compliant than that of aquatic snakes. This tends to move the hydrostatic indifferent point closer to the head and provides an adequate filling pressure in climbing snakes in the vertical position.

Animals↗
PubMed1998

Anatomical position of heart in snakes with vertical orientation: a new hypothesis.

It has been observed that climbing arboreal snakes have hearts closer to the head than nonclimbing terrestrial or aquatic snakes. The closeness to the head is said to minimize the work of the heart in pumping blood to the head. However, there is ample evidence that the gravitational pressure in the arteries going to the head is counterbalanced (neutralized) by the gravitational pressure of the blood in the veins going down to the heart. Hence, the heart does not do extra work so, another explanation must be sought. It is proposed that the position of the heart may be related to the filling pressure of the heart which is influenced by the compliance of the vessels above and below the heart. Some observations suggest that the caudal vessels in climbing snakes are less compliant than that of aquatic snakes. This tends to move the hydrostatic indifferent point closer to the head and provides an adequate filling pressure in climbing snakes in the vertical position.

Animals↗
PubMed2002

Snake and staff symbolism, and healing.

Since time immemorial the snake has been venerated as an enigmatic creature with supernatural powers. As a snake and staff symbol it is also traditionally associated with the healing arts, either as the single-snake emblem of Asklepios, or as the double-snake emblem (caduceus) of Hermes. The mythological basis for this symbolism is reviewed. The Asklepian emblem has been associated with health care since the 5th century BC, when Asklepios became accepted by the Greeks as the god of healing. Whether he was also an historical figure as healer in earlier ages is less certain. The origin of the double-snake emblem is shrouded in the mists of antiquity. In classical times it became the herald's wand of Hermes, messenger of the gods who guided departed souls to the underworld, and was seen as protector of travellers, shepherds and merchants. In the latter capacity Hermes also conveyed a negative connotation as protector of thieves. During the Middle Ages the caduceus became a symbol of the healing sciences (pharmacy and alchemy in particular), and today, although mythologically incorrect, it is in common usage in the health care field.

Animals↗
PubMedDate not supplied

Neurological manifestations of snake bite in Sri Lanka.

BACKGROUND AND AIMS: Snake bite is an important cause of mortality and morbidity in certain parts of Sri Lanka. This study was designed to determine the offending snakes, neurological manifestations, disease course, and outcome in neurotoxic envenomation. METHODS AND MATERIAL: Fifty six consecutive patients admitted with neurological manifestations following snake bite were studied prospectively. Data were obtained regarding the offending snakes, neurological symptoms, time taken for onset of symptoms, neurological signs, and time taken for recovery. RESULTS: The offending snake was Russell's viper in 27(48.2%), common and Sri Lankan krait in 19(33.9%), cobra in 3(5.4%), and unidentified in 7(12.5%). Ptosis was the commonest neurological manifestation seen in 48(85.7%) followed by ophthalmoplegia (75%), limb weakness (26.8%), respiratory failure (17.9%), palatal weakness (10.7%), neck muscle weakness (7.1%), and delayed sensory neuropathy (1.8%). Neurological symptoms were experienced usually within 6 hours after the bite. Following administration of antivenom, the signs of recovery became evident within a few hours to several days. The duration for complete recovery ranged from four hours to two weeks. CONCLUSIONS: Complete recovery of neuromuscular weakness was observed in all patients except for one who died with intracerebral haemorrhage shortly after admission.

Adolescent↗
PubMed2004

[Progress of studies on VEC apoptosis-inducing proteins in snake venom and its mechanism--review].

Hemorrhagic snake venom specially induces apoptosis of VEC (vascular endothelial cells). Five apoptosis-inducing proteins had been purified and characterized from crude snake venom. Two of these are L-amino acid oxidase (LAO), the others belong to metalloprotease/disintegrin family. LAO catalyzes H2O2 production by oxidizing some plasma membrane proteins of VEC, disintegrins interfere with binding of integrins with their ligands. The expression of p53 and bcl-2 increases during VEC apoptosis induced by snake venom, moreover, the mRNA of bcl-2 is spliced into two fragments. It has been proved that one of adhesion-dependent signal molecules, alphavbeta3, and one of phospholipid signal molecules, PC-PLC (phosphatidylcholine-specific phospholipase C), are involved in above apoptosis-inducing signal transudation pathway. These results throw light on finding out specific component from protein is snake venom. This component is able to induce tumor vascular endothelial cells apoptosis. This review summarized progress of research on hemorrhagic snake venoms.

Amino Acid Oxidoreductases↗
PubMedDate not supplied

Antivenom dosing in 35 patients with severe brown snake (Pseudonaja) envenoming in Western Australia over 10 years.

OBJECTIVE: To investigate the doses of antivenom administered to adult patients with severe brown snake envenoming. DESIGN AND SETTING: Review of charts from Western Australian adult teaching hospitals, December 1991 to December 2001. PATIENTS: 35 patients with severe brown snake envenoming, defined prospectively as afibrinogenaemia (< 0.3 g/L) after a bite by a brown snake (genus Pseudonaja). MAIN OUTCOME MEASURE: The dose of antivenom required to neutralise venom, defined prospectively as the dose of antivenom given before the return of detectable fibrinogen levels. RESULTS: Of 88 patients with brown snake envenoming admitted over the 10 years, at least 35 had severe envenoming. Afibrinogenaemia persisted for 10 hours (range, 1.4-68 hours) after the first dose of antivenom; in four patients afibrinogenaemia lasted more than 24 hours. The dose of antivenom given before venom neutralisation ranged from one to 23 ampoules. In two-thirds of cases, venom was neutralised with five ampoules, and 89% had venom neutralised with 10 ampoules. Two patients died, and another had serious bleeding complications. Another patient died during the study period from intracerebral haemorrhage, but did not have fibrinogen levels measured. CONCLUSIONS: Patients received initial doses of antivenom too small to neutralise circulating venom, and remained afibrinogenaemic for prolonged periods, with serious consequences. The authors now use 10 ampoules as an initial dose in severe brown snake envenoming.

Animals↗
PubMed2004

Prevalence of snake bites in Kangar District Hospital, Perlis, west Malaysia: a retrospective study (January 1999-December 2000).

The records of 284 snake bite cases presenting to the Kangar District Hospital, Perlis, west Malaysia, from January 1999 till December 2000 were carefully reviewed. Data on prevalence and types of snake bites, were recorded. The majority of the cases were among Malays (60.2%), followed by Chinese (16.9%), Indians (13%), and others which include Thai nationals, army personnel from Sabah and Sarawak, and foreign tourists (9.8%). A higher incidence was found in males (60.2%) and most cases were seen in the age group of 10-19 years (33%). Snake bites were more common between 2 PM and 9 PM (47.6%) and from 7 AM to 2 PM (33.4%). The snakes were positively identified in 68 cases, of which 50 were common cobras (Naja naja) (73%), 16 were Malayan pit vipers (Agkistrodon rhodostoma) (24%) and two were sea-snakes (3%).

Adolescent↗
PubMedDate not supplied

Record based study of snake bite cases admitted at Shri Vasantrao Naik Government Medical College & Hospital, Yavatmal (Maharashtra).

The present hospital record based cross-sectional study was undertaken with the objectives of finding out the epidemiological profile of snake bite cases admitted in Shri V. N. Govt. Medical College and hospital during the period of 1998-2002. The data was collected from the filled case papers of snake bite cases, through medical record section under the department of PSM and analyzed manually. The outcome of snake bite treatment was noted and defined. Proportional case rate of snake bite cases varied from 6.8 per 1000 admissions in 1998 to 6.0 per 1000 in 2002. Snake bite cases were seen among Males (69.4%), 97.4% of cases were agricultural workers and labourers. The cases seen during the period of June to Aug (35.5%) followed by Septeber to November (33.5%). About 78.7% of the victims either got relived or cured with a experienced mortality 4.3%.

Adolescent↗
PubMed1989

Antigenic relationship among antihemorrhagic factors from snake and opossum plasmas.

Immunological relationships among antihemorrhagic factors (AHF) present in the plasma of different snakes and a mammal (opossum) were studied. Antibodies were prepared against purified Bothrops jararaca and Didelphis marsupialis aurita (opossum) AHF. The antigen-antibody reaction was determined by direct ELISA and by the competition of homologous antigen-antibody reaction with a heterologous competitor antigen. Plasmas from several snakes and from opossum were used as antigens. Anti-AHF (B. jararaca) reacted only with snake plasmas. Antibody against opossum AHF was detectable only when the homologous antigen was used. Differences in the reactivity of snake plasmas with antibodies against B. jararaca were demonstrable only when a competition assay was used: B. alternatus showed a reaction pattern similar to that of B. jararaca while Crotalus durissus terrificus and the nonvenomous snake, Wanglerophis merremii, presented reduced reactivity.

Animals↗
PubMed1987

Envenomation by the Eastern coral snake (Micrurus fulvius fulvius). A study of 39 victims.

We gathered data on 39 victims of Eastern coral snake bite over a 12-year period. The most common situation resulting in snakebite was erroneous identification of the snake as the nonpoisonous scarlet king snake. While no patient died, several experienced severe envenomation, including bulbospinal respiratory paralysis. We found that neurologic symptoms may be delayed for 12 hours, and then may be precipitous. Envenomation occurs in 75% of the persons bitten by a coral snake. Antivenin is effective and should be intravenously administered early to patients who have been bitten by a positively identified coral snake, depending on the clinical presentation.

Adolescent↗
PubMed1979

[Salmonella in free living snakes of Northern Germany (author's transl)].

Fourty-nine adders (Vipera berus L.) and thirty-one grass-snakes (Nitrix natrix L.) from northern Germany were investigated by cloacal swabs. The samples were usually taken in the field and preenriched in peptone water and further-on processed in three steps of tetrathionate. After each step of enrichment the material was transfered to salmonella shigella agar and fuchsine lactose agar (acc. to Endo). Salmonella screening was done by inoculation of lactose positive and lactose negative colonies into lysine iron agar (acc. to Edwards and Fife). Salmonella excretion was found in 59% of the adders and in 68% of the grass-snakes. Some specimens excreted several Salmonella species. 22 different species resp. variants were detected, of which 19 species belonged to subgenus III (Arizona). Subgenus I occured infrequently and was represented by S. duesseldorf, S. heidelberg and S. sunnycove. Three new triphasic variants S. III 17:Z10: e, n, x, z15: z56, S. III 38: (k): z35:z56 and S. III 50:z10:z:z56 of species already known and four so far unknown species S. III (6), 14: 1,v:z (Ar. 7a, 7c:23-31), S. III 21:1,v:z57 (Ar. 22:23-40a,40c), S. III 43:1,v:z56 (Ar. 21:23-38) and S. III 28:z10:z57 (Ar. 35:27-40a,40c) were discovered. The present results suggest that adders and grass-snakes in northern Germany represent autonomous reservoirs of salmonellae. There exist only few relations between the Salmonella species in these kinds of snakes and other European snakes.

Animals↗
PubMed1983

The management of snake bite.

The present article reviews current knowledge on the epidemiology, pathophysiology, and treatment of snake bite, with particular reference to the situation in developing countries. There is little reliable information on the incidence of snake bite in many parts of the world, and epidemiological studies are needed, using enzyme-linked immunosorbent assay to identify and quantify serum levels of venom antigen and antibody. The pathophysiology and clinical features of envenoming by medically important snakes are discussed. Antivenom, if used correctly, can reverse systemic poisoning even if given days after the bite. It is therefore wise to wait for the appearance of signs of systemic poisoning before administering antivenom, rather than using it routinely. WHO has designated the Liverpool School of Tropical Medicine as a Collaborating Centre for the Control of Antivenoms, and this Centre now holds a collection of reference venoms from several important snake species. Characterization of these and of standard antivenoms should significantly improve the management of snake bite throughout the world.

Antivenins↗
PubMed1980

Snakebite and snake venom ophthalmia.

Snakebite is not necessarily snake envenomation. Of about 2,500 known species of snakes, only about 40 are regarded as being dangerous. A snake will not go out of its way to attack a person and even in defense, snakes bite humans usually to dissuade and not to kill.Early surgical excision of the bitten area is regarded as a most important aspect in the management of a poisonous snakebite, and because of the side effects of horse serum, cautious use of antivenin is advised only in cases of severe systemic poisoning.When a snake spits into the eyes, prompt treatment is indicated to prevent future blindness.

Adolescent↗
PubMed1980

Insulins from different species--chicken and snake.

We have worked out a new adsorption method for the preparation of insulins from different species. At present, we are mainly involved in chicken and snake insulins. In all insulins so far studied, only chicken insulin has been reported to have much higher activity. However, results from different laboratories are quite different from one another. We have obtained chicken insulin in typical rhombohedral crystalline form and determined its activity in vivo which is not appreciably different from that of porcine insulin. From the pancreas of a non-venomous snake, Zaocys dhumnades dhumnades (Cantor), we have prepared snake insulin which is different from rattle snake insulin reported earlier. The dodecahedral crystals of the snake insulin are similar to those of zinc-free porcine insulin.

Animals↗
PubMed1994

Snake bites in Zimbabwe: a clinical study with emphasis on the need for antivenom.

A retrospective analysis of 83 consecutive patients (42 males and 41 females) treated for snake bites at Mpilo Central Hospital between January 1990 and June 1992 is presented. In Zimbabwe poisonous snakes belong to four families; Colubrids (Boomslang), Vipers (Puff Adder), Elapids (Mambas and Cobras) and Atractaspids (Bibron Stilleto snake). The Puff Adder is responsible for three quarters of the bites. Forty eight pc (40/83) of the patients were below 20 years of age (range 1 year 10 months to 72 years). Most bites occurred at night (61 pc) in the rainy season (November to April). The majority of snake bites occurred on the lower limb, 64 pc (53/83), with most of the remainder occurring on the upper limb, 34 pc (28/83). The most common clinical features were; pain (95 pc), swelling (87 pc), tachycardia (20 pc), fever (13 pc) and vomiting (8 pc). This study, carried out at a time when there was no antivenom in stock at Mpilo Hospital, shows a considerable mortality (5 pc, 4/83) and morbidity (37 pc, 31/83) rate from poisonous snake bites in Zimbabwe. These observations highlight the need to maintain adequate stocks of antivenom in the major hospitals in Zimbabwe.

Adolescent↗
PubMed1995

Venomous snake bite without clinical envenoming ('dry-bite'). A neglected problem in Brazil.

Venomous snake bite without envenoming ('dry-bite') has been recognized throughout the world, but neglected in the Brazilian literature. Forty cases of patients bitten by venomous snakes of the genera Bothrops (lance-headed vipers) and Crotalus (South American rattlesnakes), confirmed by identification of the captured or dead snake, were seen in a 34-month prospective study carried out in a teaching hospital in southeastern Brazil. Out of the 33 cases of lance-headed viper and 7 of rattlesnake bite, respectively 10 (30.3%) and 3 (42.9%) had no clinical or laboratory evidence of local or systemic envenoming. Both within the Bothrops and Crotalus groups, there was no significant difference in sex and age of the patients, and time between bite and medical assistance between the patients who had from those who did not have clinical envenoming. The high prevalence of 'dry-bite' in this study may have several possible explanations, and has implications on the indication of antivenom for the treatment of venomous snake bite. Antivenom administration may be postponed or even not indicated for victims of snake bite presenting no manifestations of local or systemic envenoming.

Adolescent↗