Venomous snakebite is considered the single most important cause of human injury from venomous animals worldwide. Coagulopathy one commonest systemic clinical syndromes and can be complicated by serious life-threatening haemorrhage. Venom-induced consumption coagulopathy (VICC) resulting occurs in envenoming Viperid snakes, certain elapids, including Australian a few Colubrid (rear fang) snakes. Procoagulant toxins activate clotting pathway, causing broad range factor deficiencies depending...

Background: The 20-min whole blood clotting test (WBCT20) is widely used for the identification of coagulopathy in snake envenoming, but its performance practice has not been evaluated. Aim: We aimed to investigate diagnostic utility WBCT20 Russell's viper envenoming. Design: Prospective observational study. Methods: Adult patients with envenoming were recruited. Age, sex, bite information, clinical effects, serial and antivenom treatment recorded. Definite was confirmed venom specific...

In vitro antivenom efficacy studies were compared to rodent lethality test two Indian snake antivenoms (VINS and BHARAT) against four Sri Lankan snakes. was tested at venom concentrations consistent with human envenoming. Efficacy statistically for one batch from each manufacturer where multiple vials available. binding EC50 all VINS less than BHARAT D. russelii [553 μg/mL vs. 1371 μg/mL;p = 0.016), but greater N. naja [336 70 < 0.0001]. of both only slighty different E. carinatus B....

Objective We aimed to investigate neurophysiological and clinical effects of common krait envenoming, including the time course treatment response. Methodology Patients with definite (Bungarus caeruleus) bites were recruited from a Sri Lankan hospital. All patients had serial neurological examinations stimulated concentric needle single-fibre electromyography (sfEMG) orbicularis oculi in hospital at 6wk 6–9mth post-bite. Principal Findings There 33 enrolled (median age 35y; 24 males). Eight...

Context: Russell’s viper is more medically important than any other Asian snake, due to number of envenoming’s and fatalities. populations in South India Sri Lanka (Daboia russelii) cause unique neuromuscular paralysis not seen vipers. Objective: To investigate the time course severity dysfunction definite bites, including antivenom response. Methodology: We prospectively enrolled all patients (>16 years) presenting with bites over 14 months. Cases were confirmed by snake identification...

The Russell's viper (Daboia russelii) is responsible for 30–40% of all snakebites and the most number life-threatening bites any snake in Sri Lanka. clinical profile bite includes local swelling, coagulopathy, renal dysfunction neuromuscular paralysis, based on which syndromic diagnostic tools have been developed. currently available Indian polyvalent antivenom not very effective treating patients Lanka decision regarding therapy primarily driven by laboratory evidence envenoming....

The hump-nosed pit vipers of the genus Hypnale are substantial medical importance in Sri Lanka and India, being included among five snakes most frequently associated with life-threatening envenoming humans. has hitherto been considered to comprise three species: H. hypnale, common Western Ghats peninsular India; nepa walli, both which endemic Lanka. latter two species have confused literature. Here, through a review all extant name-bearing types genus, supplemented by examination preserved...

Russell's viper envenoming is a major problem in South Asia and causes venom induced consumption coagulopathy. This study aimed to investigate the kinetics dynamics of clotting function envenoming.In prospective cohort 146 patients with envenoming, we measured concentrations, international normalised ratio [INR], prothrombin time (PT), activated partial thromboplastin (aPTT), coagulation factors I, II, V, VII, VIII, IX X, von Willebrand factor antigen. The median age was 39 y (16-82 y) 111...

Context. Limited information exists on the coagulopathy caused by hump-nosed pit viper (Hypnale hypnale) envenoming. Objectives. This study aimed to characterise in bites measuring laboratory clotting times and factor studies. Materials methods. Cases of envenoming were included from a prospective cohort Sri Lankan snake-bite patients. Patient age, sex, snake identification, time bite clinical effects recorded. Patients did not receive anti-venom because no specific vipers exists. All...

The 20-minute whole blood clotting test (WBCT20) is used as a bedside diagnostic for coagulopathic snake envenoming. We aimed to assess the performance of WBCT20 in diagnosis venom induced consumption coagulopathy (VICC) Russell's viper Adult patients admitted with suspected bites were recruited from two hospitals. and prothrombin time (PT) performed on admission. was done by trained clinical research assistants using 1 ml 5 borosilicate glass tube 10 mm internal diameter. PT measured...

Background Acute kidney injury (AKI) is a major complication of snake envenoming, but early diagnosis remains problematic. We aimed to investigate the time course novel renal biomarkers in AKI following Russell's viper (Daboia russelii) bites. Methodology/Principal findings recruited cohort patients with definite envenoming and collected serial blood urine samples on admission (<4h post-bite), 4-8h, 8-16h, 16-24h, 1 month 3 months post-bite. stage (1–3) was defined using Kidney Injury...

Snakebite envenoming is a neglected tropical disease that predominantly affects impoverished rural communities in sub-Saharan Africa, Asia, and Latin America. The global efforts to reduce the impact of this must consider local national contexts and, therefore, comparative studies on envenomings different countries are necessary identify strengths, weaknesses needs. This work presents analysis snakebite Costa Rica, Sri Lanka, Nigeria. comparison included following aspects: (a) burden...

In Sri Lanka, the saw-scaled viper (Echis carinatus) is distributed in arid, dry and sandy coastal plains a prospective study we describe its bites Jaffna peninsula. Of 304 snake bite admissions to Hospital 2009, 217 (71.4%) were bitten by either venomous species or envenomed unidentified snakes. There 99 (45.6%) reported bites, of which 26 confirmed cases. The length offending snakes ranged from 228-310mm mainly occurred nearby islands. median age cases was 34 years (range 1.5-72 years);...

Diagnosis of snake envenomation is challenging but critical for deciding on antivenom use. Phospholipase A2 enzymes occur commonly in venoms and we hypothesized that phospholipase activity detected human blood post-bite may be indicative envenomation. Using a simple assay, potentially bedside test, high sera patients with viper elapid compared to minimal non-envenomed patients.

Essentials•Russell's viper envenoming is a major health issue in South Asia and causes coagulopathy.•We studied the effect of fresh frozen plasma two antivenom doses on correcting coagulopathy.•Fresh did not hasten recovery coagulopathy.•Low‐dose worsen coagulopathy.Summary: BackgroundRussell's (Daboia russelii) venom‐induced consumption coagulopathy (VICC).ObjectivesTo investigate effects (FFP) VICC.MethodsWe undertook an open‐label randomized controlled trial patients with VICC at Sri...

Background Sri Lankan Russell's viper (Daboia russelii) envenoming is reported to cause myotoxicity and neurotoxicity, which are different the effects of by most other populations vipers. This study aimed investigate evidence in envenoming, response antivenom toxins responsible for myotoxicity. Methodology Findings Clinical features were assessed authenticated bite patients admitted a teaching hospital. Toxins isolated using high-performance liquid chromatography. In-vitro venom was...

Venom-induced consumption coagulopathy (VICC) is an important clinical consequence of Russell's viper (Daboia russelii) envenoming. There limited evidence for antivenom effectiveness in resolving VICC. We aimed to compare the recovery VICC patients who received and did not receive following This was a non-randomized observational study comparing with from envenoming given systemic those antivenom. Antivenom administration decided by treating physicians. included 44 confirmed bites one or...

Envenoming by south Asian hump-nosed pit vipers (Genus: Hypnale) is a significant health issue in Sri Lanka and peninsular India. Bites these snakes frequently lead to local envenoming, coagulopathy acute renal failure even resulting death. Recently the genus was revised existence of three species viz H. hypnale, nepa zara were recognized. There is, however, paucity information on toxicity venoms species. Hence, we compared toxic effects Hypnale using BALB/c mice. Intraperitoneal median...