Annual incidence of snake bite in rural bangladesh

Background

Snake bite is a neglected public health problem in the world and one of the major causes of mortality and morbidity in many areas, particularly in the rural tropics. It also poses substantial economic burdens on the snake bite victims due to treatment related expenditure and loss of productivity. An accurate estimate of the risk of snake bite is largely unknown for most countries in the developing world, especially South-East Asia.

Methodology/Principal Findings

We undertook a national epidemiological survey to determine the annual incidence density of snake bite among the rural Bangladeshi population. Information on frequency of snake bite and individuals'' length of stay in selected households over the preceding twelve months was rigorously collected from the respondents through an interviewer administered questionnaire. Point estimates and confidence intervals of the incidence density of snake bite, weighted and adjusted for the multi-stage cluster sampling design, were obtained. Out of 18,857 study participants, over one year a total of 98 snake bites, including one death were reported in rural Bangladesh. The estimated incidence density of snake bite is 623.4 / 100,000 person years (95% C I 513.4–789.2 /100,000 person years). Biting occurs mostly when individuals are at work. The majority of the victims (71%) receive snake bites to their lower extremities. Eighty-six percent of the victims received some form of management within two hours of snake bite, although only three percent of the victims went directly to either a medical doctor or a hospital.

Conclusions/Significance

Incidence density of snake bite in rural Bangladesh is substantially higher than previously estimated. This is likely due to better ascertainment of the incidence through a population based survey. Poor access to health services increases snake bite related morbidity and mortality; therefore, effective public health actions are warranted.     

Herbs and herbal constituents active against snake bite

Snake bite, a major socio-medical problem of south east asian countries is still depending on the usage of antisera as the one and only source of treatment, which has its own limitations. In India, mostly in rural areas, health centres are inadequate and the snake bite victims mostly depend on traditional healers and herbal antidotes, as an alternative treatment. The present review has been focussed on the varied folk and traditional herbs and their antisnake venom compounds, which might be a stepping stone in establishing the future therapy against snake bite treatment and management.     

血液透析治疗毒蛇咬伤致急性肾功能衰竭的护理

目的 探讨血液透析治疗毒蛇咬伤致急性肾功能衰竭(ARF)患者的护理.方法 根据对12例毒蛇咬伤致ARF患者的血液透析治疗的护理体会,探讨蛇伤患者血液透析的护理特点.结果 12例患者中11例治疗成功,1例男性患者因合并呼吸衰竭死亡.有效病例血液透析后血肌酐(Cr)、尿素氮(BUN)和尿酸(UA)均明显下降.结论 遵循血液透析的基本原则,注意毒蛇咬伤的特点,有针对性地进行护理,才能保证抢救成功.     

Proteomic tools against the neglected pathology of snake bite envenoming

This article covers the application of proteomic tools ('venomics', 'antivenomics' and 'venom phenotyping') to study the composition and natural history of snake venoms, and the cross-reactivity of antivenoms with homologous and heterologous venoms, to help address the neglected pathology of snake bite envenoming. The identification of evolutionary and immunological trends may help to replace the traditional geographic- and phylogenetic-driven hypotheses for antivenom production strategies with a more rational approach based on proteome phenotype and immunological profile similarities. Antivenomics and venom phenotyping may also contribute to expand the clinical range of currently existing antidotes.     

Proteomic tools against the neglected pathology of snake bite envenoming

This article covers the application of proteomic tools (‘venomics’, ‘antivenomics’ and ‘venom phenotyping’) to study the composition and natural history of snake venoms, and the cross-reactivity of antivenoms with homologous and heterologous venoms, to help address the neglected pathology of snake bite envenoming. The identification of evolutionary and immunological trends may help to replace the traditional geographic- and phylogenetic-driven hypotheses for antivenom production strategies with a more rational approach based on proteome phenotype and immunological profile similarities. Antivenomics and venom phenotyping may also contribute to expand the clinical range of currently existing antidotes.     

蛇毒清合剂治疗金环蛇咬伤的疗效观察

目的观察蛇毒清合剂对金环蛇咬伤的临床疗效。方法将71例病人分为治疗组35例,对照组36例。两组均给予常规治疗,治疗组加服蛇毒清合剂,并比较两组患者伤后48h的血清酶学三项（CK、LDH、AST）及治疗5天后的疗效、治疗结束时的疗程及呼吸衰竭发生率。结果两组患者临床疗效比较有显著性差异,治疗组优于对照组（P〈0．05）,酶学三项和疗程、呼吸衰竭发生率均有显著性差异（P〈0．05）。结论蛇毒清合剂对金环蛇咬伤有显著疗效。     

三七皂苷对蛇伤致全身炎症反应综合征的影响

目的探讨三七皂苷对毒蛇咬伤致全身炎症反应综合征的影响。方法将60例毒蛇咬伤病人按随机双盲的原则分为两组,治疗组(A组)30例采用常规治疗加用三七皂苷,对照组(B组)30例采用常规治疗。观察两组病人在治疗过程中心率、血压、血常规、体温等的变化,并进行比较。结果A组病人心率、血压、血常规、体温等在治疗过程中的变化均优于B组。结论三七皂苷对毒蛇咬伤病人的全身炎症反应综合征有拮抗作用,有利于蛇伤病人器官功能不全的预防与治疗。     

四黄散外敷对竹叶青蛇咬伤肿胀的疗效观察

目的 探讨四黄散外敷治疗竹叶青蛇咬伤肿胀的临床疗效.方法 选择2017年10月～2020年4月我院收治的112例竹叶青蛇咬伤肿胀患者为研究对象,采用随机数字表法将患者分为观察组和对照组,每组56例.对照组采用常规蛇咬伤处理方案,包括清创、引流、注射抗蛇毒血清及对症治疗等.观察组在对照组治疗基础上采用四黄散外敷治疗.观察...     

儿童毒蛇咬伤的特点与程序化救治的疗效观察

目的通过分析儿童毒蛇咬伤的特点,评价程序化综合救治方法对儿童毒蛇咬伤的疗效。方法通过观察17例毒蛇咬伤儿童的临床特点,尽早进行病情预测,同时根据毒蛇咬伤的临床病情分型予程序化综合救治。监测病情变化、伤口愈合情况及平均住院时间。结果儿童毒蛇咬伤的特点为不明种类毒蛇咬伤多,症状较成人严重,易发生并发症。经过早期程序化综合救治总有效率100%,伤口渗血、肿胀明显缓解,无1例死亡,平均留观时间4.5天。结论根据儿童毒蛇咬伤特点,早期准确预测和尽快应用程序化救治能提高毒蛇咬伤疗效。     

Coagulopathy after snake bite by Bothrops neuwiedi: case report and results of in vitro experiments

Coagulation studies were performed in a patient who had been bitten by a snake of the species Bothrops neuwiedi. The patient presented with hemorrhagic necrosis at the envenomization site and considerable bleeding from venous puncture sites. He developed a severe defibrination syndrome with a clottable fibrinogen level of approximately 0.1 g/l. Fibrinogen was not measurable by clotting time assay. Fibrin degradation products were greatly elevated. Treatment with antivenom caused an anaphylactic reaction within ten minutes and serum sickness after three days. In vitro experiments revealed that B. neuwiedi venom directly activates Factors II and X, but does not activate Factor XIII. In vivo consumption of Factor XIII after B. neuwiedi envenomization is ascribed to the action of Factor IIa. At low venom concentrations clotting is initiated by activation of prothrombin by the venom either directly or via Factor X activation. Treatment with heparin might be beneficial in coagulopathy secondary to snake bite by reducing circulating active thrombin. The venom contains thrombin-like proteases which cause slow clotting of fibrinogen, and plasmin-like components causing further proteolysis of fibrinogen and fibrin. Antivenom has no effect on the proteolytic action of the snake venom. The in vivo effects of antivenom are presumably caused by acceleration of the elimination of venom components from the circulation. Intravenous administration of antivenom caused normalization of blood coagulation parameters within 48 h.     

基于动物学、临床医学跨界研究快速准确诊断1例不明蛇类咬伤的分析

目的 探讨动物学、临床医学跨界研究成果联合运用于快速准确诊断不明蛇类咬伤中的作用及效果.方法 通过回顾性分析1例不明蛇类咬伤患者的临床资料,从病史、动物学生活习性、咬痕鉴别、流行病学、临床表现、蛇类动物学分布6个方面进行剖析不明蛇类咬伤的诊断思路与方法.结果 该例蛇伤患者的病史特征以及诊断与鉴别诊断:(1)病史特征符合...     

First bite

Dipeptidyl peptidase IV contributes to the regulation of many physiological processes, most notably blood sugar homeostasis, by biting a dipeptide off the N terminus of specific peptides. A structure of this peptidase in complex with an inhibitor will assist efforts to regulate this regulator.     

Enzymes of snake venoms

Snakes' venom is a mixture of biologically active substances, containing proteins and peptides. A number of these proteins interact with haemostasis system components. Activators and inhibitors affecting blood coagulation and fibrinolysis systems are of special interest. Venom components can be classified into three main groups, such as procoagulants, anticoagulants and fibrinolytic enzymes according to their action. This review is focused on enzymes from Agkistrodon halys halys venom. They are thrombine-like enzyme, named Ancystron-H, flbrinogenolytic enzyme, protein C activator and platelet aggregation inhibitor. Ancystron-H is used for determination of fibrinogen level in blood plasma of patients undergoing heparin treatment and blood coagulation inhibitors accumulation. The fibrinogenolytic enzyme can be used as the instrument for protein-protein interactions in fibrinogen-fibrin system. The protein C activator is used for protein C level determination in blood plasma with different pathologies. Functions of the platelet aggregation inhibitor, belonging to disintegrins group, can be used for development of antithrombotic preparations. Information about the use of snake venoms in science and medicine is presented.