Management Of Bites Research Articles

Ayurvedic management of Unknown Insect Bite (Keeta Visha) - A Case Report

Acharya Charaka in Chikitsasthan of Charaka Samhita, Acharya Sushruta in Kalpasthan of Sushruta Samhita and Acharya Vagbhata in Uttartantra of Ashtanga Hridaya recited the origin of Visha and Keeta Visha. Acharya Sushruta has explained Keeta Visha under Jangama Visha (Animate poison) and categorized 67 different type of Keeta under mainly 4 groups. It causes acute as well as severe manifestations in the human beings. The main characteristics of insect bite are itching, burning sensation, erythema at the site of bite. As there are various types of Keeta Visha, hence they vary in their diagnosis and treatment and most of the time they are unidentified as signs and symptoms may resembles the skin disease. This is case report of 25 year old female who had given the history of unknown insect bite and presented to the outpatient department with the complaints of itching, burning sensation, spreading erythema over the skin of neck region. In Sushruta Samhita in Kalpasthan Acharya Sushruta has mentioned Dushivishari Agad as a most potent Agad for all types of Visha. Hence, patient was treated with Dushivishari Agad orally along with local application of Shatdhautghrita which also has Vishaghna properties. In present case Dushivishari Agad and Shatdhautghrita have shown assuring results in the management of unknown insect bite.

Management of Snake Bites in the Agricultural Sector

Snake bites are the one that causes high rates of morbidity and mortality among workers in the agricultural sector. Snake bites can be a medical emergency that can endanger human life, and snake venom can damage local tissues, resulting in permanent disability and amputation. This study aims to identify farmers' knowledge related to snakebite management. A literature review searched three databases, Google Scholar, ScienceDirect, and PubMed, for all study designs between 2019 and 2023. The researcher found ten studies that met the inclusion criteria in the review. The high risk of snake bites for farmers makes it essential for farmers to know the most critical things in snakebite management. When bitten by a snake, the most important thing to do is first aid treatment in a threatening situation. Some factors that can affect the management of snake bites on farmers are the characteristics of farmers who are usually male with a low educational background and level of knowledge. In addition, low experience will affect the ability to handle first aid. Nurses can be present as extension workers to increase farmers' knowledge about first aid for snake bites to farmers.

Assess the Knowledge regarding Snake Bite Management among Group-D Workers with the View to Develop an Information Booklet at Amity University Manesar, Gurugram, Haryana

Assess the Knowledge regarding Snake Bite Management among Group-D Workers with the View to Develop an Information Booklet at Amity University Manesar, Gurugram, Haryana

Enhancing Primary Health-care Worker Training through High-fidelity Simulation for Snake Bite Management.

Enhancing Primary Health-care Worker Training through High-fidelity Simulation for Snake Bite Management.

Management of Human Bites in a Rural Kenyan Setting: A Plastic Surgeon's 8-Year Experience.

The treatment of human bites is a common issue facing healthcare practitioners in the developing countries of Sub-Saharan Africa where it has been noted as a growing public health concern. Generally, the desired outcomes from surgical management are healing, function, and aesthetics. We share our 8-year experience at Kapsowar Hospital in Kenya with the presentation, management, and outcome of human bites. We are uniquely situated to do so given the prevalence of human biting in our community and the full-time presence of a plastic surgeon at our institution. To the best of our knowledge, this study is the first to present human bite surgical management by a plastic surgeon certified by the American Board of Surgery working full-time on the African continent. A retrospective chart review was conducted on all patients who presented to the operating theater at Kapsowar Hospital with a human bite between 2013-2021. After identification of eligible patients, charts were reviewed assessing parameters including age, gender, timing from injury to presentation at hospital, localization of bite, severity of facial wounds using Lackmann's classification, surgical procedure(s), postoperative complications, surgical revisions, antibiotics administered, and circumstance of incident. Data were analyzed using SPSS 29.0.0.0. Forty-four patients were identified. Seventeen (38.6%) were female and 27 (61.4%) were male. Thirty-one patients had facial bites and 13 patients had bites to other parts of the body. Of facial bites, 70.3% resulted in amputation of the affected part while 29.7% were lacerations. Using Lackmann's classification for facial bite severity, IIIA bites (complete avulsion) were most common for both males (9) and females (7). Females comprised 68.4% of total lip bite victims. Bites to the extremity were associated with late presentation and infection. We report a salvage rate of 85.7% for infected digits. Compared with most other studies on human bites, our patient population presents with a higher rate of avulsive lip injuries, most commonly among women. Our postoperative infection rate is lower than many others reported in the literature. Satisfactory cosmetic outcome with low risk of infection can be achieved by following well-established principles of wound healing and tension-free closure.

Human rabies encephalomyelitis in the background of rabies outbreak in animals in Gelephu, Bhutan, 2023: a case report

BackgroundRabies continues to pose significant public health challenges in many developing countries including Bhutan. A probable case of rabies was admitted to our hospital and its reporting led to the uncovering of an outbreak in domestic and wild animals. We discuss the challenges in the diagnosis and management of rabies in a resource-limited setting.Case presentationA 35-year-old male presented with intermittent fever, bilateral lower limb weakness that was rapidly progressive, urinary incontinence with episodes of palpitations and sweating. He had sustained a Category III bite on the right lower thigh with four bite marks, inflicted by a stray dog. He had received post-exposure prophylaxis with intra-dermal anti-rabies vaccine. On initial examination, the patient was in distress but cooperative for the interview. He had pulse rate ranging from 60 to 100/min with episodes of diaphoresis and palpitations, but with normal capillary blood glucose. In the lower limb, the muscle power was zero with absent tendon reflexes in the lower limb and impaired abdominal reflex below T10 level. He had hyperaesthesia below T8, hydrophobia, aerophobia and photophobia. He had multiple spontaneous fasciculations in both the thighs and right deltoid and these later involved the intercostal muscles, neck and face muscles. He had altered sensorium and desaturation for which he required mechanical ventilation. Polymerase chain reaction for rabies virus was negative in cerebrospinal fluid and saliva. Rabies virus neutralizing antibody was negative in cerebrospinal fluid but had high titres in the serum. He received Human Rabies Immunoglobulin after admission. He was managed in the intensive care unit and died 23 days later. After this case was notified, a rapid response team was deployed in the field, and uncovered rabies outbreak in animals in the locality.ConclusionsThis case called for a serious evaluation of the country’s efforts in achieving zero rabies deaths by 2030. The management of this case identified several critical areas of context-specific interventions in Bhutan. There is also an urgent need to improve diagnostic capabilities at the national reference laboratory and enhance the technical competencies of healthcare workers in the management of dog bite cases.Graphical

Management of Dental Anterior Open Bite Treated by Combination of Orthodontics and Cosmetic Dentistry: A 2 Years Follow Up Case Report

Management of Dental Anterior Open Bite Treated by Combination of Orthodontics and Cosmetic Dentistry: A 2 Years Follow Up Case Report

Medicinal plants used in the traditional management of dog bites by herbalists in Eastern, Western, and Central Uganda

Medicinal plants used in the traditional management of dog bites by herbalists in Eastern, Western, and Central Uganda

The Royal Armoury: Venomics and antivenomics of king cobra (Ophiophagus hannah) from the Indian Western Ghats

Despite being famous as ‘the king’ of the snake world, the king cobra (Ophiophagus hannah) has remained a mysterious species, particularly with respect to its venom ecology. In contrast, venom research has largely focussed on the ‘big four’ snakes that are greatly responsible for the burden of snakebite in the Indian subcontinent. This study aims to bridge the current void in our understanding of the O. hannah venom by investigating its proteomic, biochemical, pharmacological, and toxinological profiles via interdisciplinary approaches. Considering their physical resemblance, the king cobra is often compared to the spectacled cobra (Naja naja). Comparative venomics of O. hannah and N. naja in this study provided interesting insights into their venom compositions, activities, and potencies. Our findings suggest that the O. hannah venom, despite being relatively less complex than the N. naja venom, is equally potent. Finally, our in vitro and in vivo assays revealed that both Indian polyvalent and Thai Red Cross monovalent antivenoms completely fail to neutralise the O. hannah venom. Our findings provide guidelines for the management of bites from this clinically important yet neglected snake species in India.

Presentation and management of insect bites in out-of-hours primary care: a descriptive study

ObjectivesTo describe the population presenting to out-of-hours primary care with insect bites, establish their clinical management and the factors associated with antibiotic prescribing.DesignAn observational study using routinely collected data from...

Suspected snakebite in a tertiary referral centre in Western Sydney: a 10-year case series

ABSTRACT We aimed to determine the epidemiology and clinical management of patients presenting to an Australian tertiary emergency department (ED) with a suspected snake bite. Nepean Hospital covers a geographical area known to harbour venomous elapid snake species. A Retrospective chart review of all patients presenting to Nepean ED from 2011 to 2020 was performed. We searched the electronic medical records (eMR) for triage presentations including search terms of “snakebite”, “bite” “envenomation”, or “bite-snake” and a discharge or independent diagnosis of “snakebite” or “envenomation”. Our review identified 110 patients presenting with snakebite, of whom nine had signs or symptoms indicating envenomation. The most common envenomation syndrome was venom-induced consumption coagulopathy (VICC) and the most commonly suspected culprit snake was the Eastern Brown Snake. Our data broadly agreed with national data on epidemiology and demographics. We noted a satisfactory rate of compliance with local snake bite protocols with evidence of early diagnosis and antivenom administration. We had no cases of anaphylaxis and one case of serum sickness. Our study of a tertiary hospital experience in the management of snake bite demonstrated an appropriate adherence to national guidelines and early clinician recognition of envenomation syndromes. It also demonstrated appropriate antivenom use without obvious time delay.

A Descriptive Study to Assess the Knowledge Regarding First Aid Management of Dog Bite

Background: Dog bite is a painful, dangerous and threatening situation, which instills fear about the animal. A dog bite is a main source of rabies. There are myths and misconceptions about the disease and wound management. Practices like application of harmful substances like turmeric, lime and mud are the problems hindering rabies prevention and control. Proper steps need to be taken up to control the canine rabies. This present study was intended to assess the knowledge regarding first aid management of dog bite among college students. Materials and Methods: A non experimental cross sectional survey design was adopted in this study. The study was conducted among 70 students of Sree Narayana College, Sreenivasapuram, Varkala The objectives of the study were to assess the knowledge regarding first aid management of dog bite among college students and find out the association between the level of knowledge regarding first aid management of dog bite and selected socio-demographic variables.. A semi-structured questionnaire was used to collect socio-demographic data and knowledge regarding first aid management of dog bite among college students. Result: The data were analysed using descriptive and inferential statistics. The study revealed that among 70 students, 13 (19%) had poor knowledge, 57 (81%) had average knowledge and none of them have good knowledge regarding first aid management. The study concluded that there were significant association between level of knowledge regarding first aid management of dog bite and religion, monthly family income.

Animal bites management in Northern Iran: Challenges and solutions

ObjectivesAnimal bite is considered a serious social, economic, and health risk for societies with poor animal bites and population management. The objective of this study was to propose a model for animal bites management in Golestan Province. MethodsThe present study is a multi-method study conducted quantitatively and qualitatively. First, as a cross-sectional study, the animal bites in Golestan Province and the country were calculated and their trend was predicted. Secondly, in the qualitative study (content analysis), the challenges, barriers, and methods of animal bite control were extracted through conducting semi-structured interviews and focused group discussion meetings. Finally, the model of animal bite management was developed and it was confirmed by Round Delphi. The data were analyzed via content analysis using MAXQDA18. The participants in this study consisted of university professors, managers, and executive officers involved in animal bite and rabies control plans. ResultsThis study revealed that the animal bite in Golestan Province had an upward trend, as in the country, and dogs were the main cause of bites (90%). The obstacles and challenges of current animal bites control program in eight areas were expressed by the participants. Also, the animal bite management model, which was obtained from the data of different stages of this study, included nine fields and 41 sub-fields. The fields of the animal bite management model included: providing a cultural package, resolving barriers to animal population control plans, wide coverage of dog vaccination, passing and enacting preventive laws, attracting financial support, constructing standard equipment, providing proper medical services, enhancing inter-departmental coordination, and controlling rabies in the wild. This model was confirmed in a Delphi round. ConclusionOur study indicated that Golestan Province with an average bite higher than twice the country's average is one of the leading provinces in this regard. Thus, revising the animal bite and animal population control plans in this province is necessary. The model designed in this study can be used as a practical guide by policy makers and officials to manage animal bite and related consequences in this province.

Real-Time Surveillance of Dog Bite Incidence in Islamabad: A Cross-Sectional Study from December 2019 to July 2020

Rabies is a neglected viral zoonotic disease with an almost 100% fatality rate. A pilot project was initiated by the National Institute of Health (NIH), Islamabad, in collaboration with Health Security Partners (HSP) to establish a real-time dog bite surveillance in humans in public sector secondary care hospitals of Islamabad. The main objective of this study was to analyze different characteristics of dog bite cases, identify gaps in surveillance, and recommend suggestions to improve and strengthen real-time dog bite surveillance systems. An observational cross-sectional study was conducted in two major public sector hospitals in Islamabad from December 2019 to July 2020. Data on demographic information, site of the dog bite, category of the dog bite, and treatment was collected via a WVS mobile-based application. Descriptive analysis was carried out for different variables at a p-value of <0.05. A total of 338 dog bite cases were captured in the World Veterinary Service (WVS) application, and most cases (n = 226, 85.6%) were reported in December 2019 with a male-to-female ratio of 2:1. Most cases were reported from the age group of 22 to 31 years (n = 178, 53%). Out of the total number of cases, 263 (78%) presented with a single anatomical location, and 174 (51%) had Category II wounds. All dog bite patients were given only the first dose of the anti-rabies vaccine at the hospital level. Real-time dog bite surveillance via a mobile-based application proved to be effective for the timely recording and management of dog bite cases. Young people were reported to be mostly affected by dog bites, and nearly half of the cases were managed in hospitals. Refresher training was conducted for medics and paramedics for mobile-based applications, dog bite management, and proper referral of cases to tertiary care hospitals.

Implementation of Ecological Distribution of Venomous Snakes for Clinical Management of Snakebite in Bangladesh

Background: Snakebite envenoming is a global health problem, mostly in tropical and subtropical countries. Bangladesh is a subtropical country facing thousands of snakebite envenoming death every year. Knowledge of the distribution of venomous snakes is necessary to identify snakebite-prone areas, develop strategies for prevention and management, and reduce venom-induced mortalities and morbidities. Methods: An integrated effort of direct observations of snakes, qualitative analysis of museum specimen records, clinical records of snakebites, and scholarly literature records were used to understand the pattern of distribution of venomous snakes in Bangladesh. Results: We enlist 65 venomous snake species from Bangladesh and present detailed documentation on their distribution pattern. However, only nine species were considered medically relevant species because of their venom potentiality to kill humans and available clinical records of envenomation. The distribution pattern of those species divides the country into two major portions. A portion consists of northern, northwestern, and western parts of the country, which are habitats of Naja naja, Bungarus caeruleus, and B. lividus. Another portion comprised of the northeastern, southeastern, and southern parts of the country provides habitats for N. kaouthia, B. niger, and Trimeresurus erythrurus. However, Daboia. russelii had a different distribution pattern along the bank of the Padma and Meghna, and some coastal districts. Moreover, B. walli had a scattered distribution over the country. The knowledge of this ecological distribution of venomous snakes across the country bears a significant practical effect on clinical management of snakebite. Treating physicians can have a better understanding of possible offending snake species using this knowledge and the clinical syndromes produced by venoms. Conclusion: Pattern of distribution of medically relevant venomous snakes in Bangladesh approaches to initiate concise and specific bite management strategies for two distinct distributional regions of the country. Moreover, the distribution of D. russelii and B. walli demands specific strategies for bite management. J MEDICINE 2023; 24(2): 139-151

Summer poisoning hazards

There is a seasonal risk with some poisons and in the summer, when stinging insects and adders are more active, there is a risk of envenomation. Diagnosis of an adder bite may be missed in horses, as the biting event is rarely witnessed. Envenomation may result in local swelling and occasionally, systemic effects. Multiple bee stings are particularly hazardous as this can result in multi-organ involvement, which may be fatal. Grazing on some plants, such as ragwort or bracken, for a prolonged period can also result in poisoning as ragwort contains pyrrolizidine alkaloids which cause liver failure and bracken contains an enzyme that has an anti-thiamine effect, inducing thiamine deficiency. Photosensitisation following exposure to plants containing phototoxins and bright sunlight is also a risk in summer. Treatment of plant poisoning in horses is generally supportive and involves removing the plant, providing good quality food and supportive care. Thiamine supplementation may be required in severe cases of bracken poisoning. Animals should be protected from sunlight following exposure to a phototoxin, with supportive management of skin lesions. Management of adder bite is supportive with administration of adder antivenom. Multiple bee stings require aggressive supportive care.

Approach to the diagnosis and management of snakebite envenomation in South Africa in humans.

Snake bite management is largely driven by expert opinion and consensus, however there are a few large retrospective studies and RCT's that have improved the quality of medical guidance currently available. South African snakes are different in the venomous potential and it behooves the hospital provider and the average medical practitioner to know the current best practice concepts concerning assessment, treatment and antivenom use. The recent SASS meeting in July 2022 provided an update and national consensus from which this Hospital Care document is derived.

Karakteristik Pendertia Snakebite Disertai Gangguan Hemodinamik dan Asidosis Respiratorik pada Pasien Anak dan Dewasa

Snakebite or snakebite is a defense mechanism for snakes and can become a medical emergency. Snakebites are a significant cause of morbidity and mortality worldwide, especially in South and Southeast Asia, sub-Saharan Africa and Latin America. The snakebite can be life-threatening if it has a neurotoxic, cytotoxic and hemotoxic effect. Complications from snakebite include hemodynamic disturbances and respiratory acidosis. International online databases (PubMed and Google Scholar) were used to search for articles in this systematic review. A total of 24 related research articles indexed by Scopus have been published in the last ten years. This research is a literature systematic review. Research sources were taken in the last 10 years from 2012 to 2022, taken from PubMed and Google Scholar. After exclusion, 24 articles and studies that met the exclusion and inclusion criteria were considered for systematic review. Of all the journals reviewed, there are many that explain snake bite associated with hemodynamic disturbances and respiratory acidosis. Snakebite is proven to provide long-term complications in the form of hemodynamic disturbances around the bite site. Another complication that has been proven to occur in snakeibite victims is cardiac shock, especially impaired cardiac return. Pathophysiology, symptoms, and diagnosis of snakebite in pediatric and adult patients are the same. The majority of journals discuss heart disorders and infections, necrosis of muscles and bones related to venomous snake bites. Hemodynamic disturbances and respiratory acidosis are complications that can occur in snakebite victims. There are similarities in symptoms and management of venomous snake bites in children and adults.

Frequency, Presentation, Management and Outcome of Snake Bite in Children at DGKMC & Hospital, D.G Khan.

Objective: To evaluate the frequency, common presentation, anti-snake venom (ASV) related management and outcome of snake bite cases in admitted children at a tertiary care hospital. Study Design: Case-series study. Setting: Department of Pediatric, Dera Ghazi Khan Medical College (DGKMC) & Hospital. Period: 1st March 2021 to 31st August 2021. Material & Methods: During the study period, all children presenting with snake bite were included. All cases were observed for their presentation, classified according to signs and symptoms, and managed through ASV as needed. Results: During the study period, a total of 52 patients of snake bite admitted in paediatric medical ward of DGKMC & Hospital. There were 37 (71.2%) male and 15 (28.8%) female. Overall, mean age of the children was 6.1±3.1 years. Maximum number of snake bite cases were reported during May, June and July as 15 (28.8%), 13 (25.0%) and 8 (15.4%) respectively. In the presentation, 29 (55.8%) patients presented with local symptoms only while remaining 23 (44.2%) presented with local as well as systemic symptoms. In the management, 3 (5.8%) cases did not require any ASV vial, 35 (67.3%) needed initial doses only. Fourteen (26.9%) cases required initial as well as maintenance doses. In terms of outcome, 49 (94.2%) children were discharged successfully, 1 (1.9%) expired and 2 (3.8%) got left against medical advice (LAMA). Conclusion: Snake bite was a common pediatric medical emergency at our institute. Most children presented with hemotoxic symptoms and needed ASV for resolution of symptoms. Prognosis is good with timely and judicious management of snake bite.

Management of scorpion bite through Ayurveda: A case report

Abstract: Agadatantra, the branch of toxicology in Ayurveda, refers to various methods of eliminating toxins from the body that arises from animate, inanimate, and artificial poisons. Scorpion stings are a serious health concern in rural areas. In Agadatantra, the symptoms of scorpion sting are explained under Vrischika visha (~scorpion venom poisoning). The main characteristics of scorpion venom poisoning are Vahnivat dahanam (~burning sensation like fire), Kshipram urdhvarohanam (~quick spreading in an upward direction), Danshe ruja tishthati (~pain remains at bite site), Sadyah ati ruk (~instant severe pain), Danshashyavata (~brownish discoloration of bite site), and Dansha toda (~ pricking type of pain at bite site). This is a case report of a 24-year-old male, who had an episode of Vrischika damsha (~scorpion bite) and presented to the outpatient department with complaints of severe edema, pain and redness, and itching. The first line of management for scorpion stings is typically symptomatic including strong analgesics, which can be systemic (opiates or paracetamol) or localized (such as a cold compress). Antivenom is the specific treatment for scorpion envenomation that is used in conjunction with supportive measures. In Ayurveda classics, Hinguadi gulika is one of the formulations mentioned in Vrischikavisha prakarana, which has been referred to as the most potent Lepana (~anointment) for scorpion venom poisoning. In comparison to existing conventional treatment modalities, Hinguadi gulika lepana is a very simple and very cost-effective procedure. Hinguadi gulika was given in combination with Kulakadi kashaya which is widely practiced in all Visha (~poison) conditions. In the present case, Hinguadi gulika and Kulakadi kashayam have shown assuring results in the management of acute scorpion envenomation.