Sting Cases Research Articles

EFFECT OF PUNNAGAVYOSHA CHOORNA PINDASWEDA IN TILATAILA AND PATOLADI GANA KASHAYA IN VRISCHIKA VISHA: A RESEARCH ARTICLE

Scorpion envenomation is a major public health problem in many rural areas of India. The annual number of scorpion sting cases exceeds 1.23 million, with over 32,250 (0.27%) potentially being fatal. Scorpion stings are primarily the result of accidental contact. Vrischika visha (scorpion envenomation) is of significant clinical im-portance due to the severity of local and systemic symptoms like Daha (Burning sensation), Ruk (Pain), Damsa-sopha (Oedema), Jwara (Fever), Chardi (Vomiting), etc. Acharya Vaghbata described Vrischika visha with pre-dominance of Vata dosha & the general line of treatment should be Vatahara. In this context, all ayurvedic text-books have mentioned Swedana as the first treatment procedure as it is Vatahara and Shoolahara. Choornapin-dasweda with Punnagavyosha choorna in Tilataila is one of the formulations mentioned in Keetadivisha prakarana in Kriyakoumudi, a traditional Malayalam Visha Chikitsa textbook. Ushna Teekshna gunas of Pun-nagavyosha choorna can act as Vatashamana. Tilataila is considered as the Agryoushadha for Vata. Patoladi-gana Kashaya which is mentioned in Ashtangahridayam is widely used in Visha conditions. This study was an interventional pre-post study with a sample size of 30. Subjects of the age group 16- 60 years, and those reported by the subject as scorpion sting and within 24 hours of the sting were selected for the study. A detailed case his-tory was taken according to the case proforma that included relevant signs and symptoms of Vrischika visha & Class I Scorpion Sting Syndrome. Subjects who have already undergone any other treatment for the same and with any other systemic or infectious diseases which may interfere with the study were excluded. Punnaga-vyosha choorna Pottali was dipped in warm Tila taila and gently applied over the sting site, after confirming the temperature (42oC – 45 oC), for 15 minutes to 45 minutes maximum or till symptoms are reduced at the affected site. After completing the procedure, 48 ml of Patoladigana Kashaya was given for internal administration. Choornapinda sweda and Patoladigana Kashaya were given for 3 days in total. Symptomatic assessment was done on 1st day - before the treatment, after 1 hour from starting of the treatment, on 2nd day, 3rd day and on 5th day (including follow up period of two days). The result shows there is a decrease in the mean score values of Vedana, Daha, Sopha and raktavarnata after Punnagavyosha choorna pinda sweda in Tila taila and Patoladi-gana Kashaya pana

Experıences Of Emergency Physıcıans On Scorpıon Stıngs

INTRODUCTION and PURPOSE: This study aims to evaluate the level of knowledge and approaches of emergency physicians about scorpion stings. MATERIALS and METHODS: In the study, aquestionnaire including 16 questions was administered to emergency physicians about their titles, length of service in the emergency department, geographical region and institutional information, experiences with scorpion stings, treatment approaches, and hospitalization information of the patients. RESULTS: A total of 282 physicians participated in the study. In emergency medicine physicians (EMPs), regularly checking the availability of scorpion antivenom (p=0.01), taking precautions for complications before antivenom administration (p=0.03), and preferring intravenous (IV) route for scorpion antivenom administration were found to be significantly higher compared to other title groups. Needing consultation before scorpion antivenom (p=0.01) and recommending antibiotic prophylaxis to sting patients (p=0.02) were significantly lower in EMPs compared to other title groups. 31.7% (n=26) of general practitioners administered antivenom "half to the wound edge/half intramuscularly", which is significantly higher compared to other groups (p=0.01). Hospitalization problems in sting cases were most frequently experienced in university hospitals (p= 0.01). DISCUSSION and CONCLUSION: Our study indicated errors in managing scorpion sting patients and antivenom use. The necessity of reorganization of vocational and undergraduate training should be evaluated.

Evaluating the Prevalence and Prognostic Factors in Children With Scorpion Sting

Objectives: Scorpion stings are a major public health problem in many countries and several parts of Iran, especially in Hormozgan Province. This study aimed to evaluate the prevalence and the effect of several variables on the prognosis of scorpion stings. Methods: This retrospective study was conducted on 606 patients admitted to Bandar Abbas Children’s Hospital, Bandar Abbas Port, Iran, from April 2014 to November 2017. We used a checklist to collect data about scorpionism. Results: Of 606 people who participated in the survey, 55.1% were males and 44.9% were female. The scorpion sting cases mainly occurred in the summer (38.9%) and spring (29.9%). Also, 61.9% were from rural areas. In addition, 68.6% of stings were seen in exposed extremities, 30.9% happened in the morning, and 75% of patients were referred to the hospital after 3 hours. Discussion: Hormozgan province is a significant economic area, and most scorpion sting cases occur in summer and spring. The development of medical knowledge and the availability of antivenom are essential indicators to control the outcome of scorpion stings.

Ischemic Stroke After Bee Sting: A Case Report

Introduction The global impact of a bee sting extends beyond common perceptions, showing various indications that may range from local reactions to more severe complication. This report details a compelling case involving a 63-year-old male who developed neurological deficits merely six hours after a bee sting. Case Report A 63 -year-old male patient was brought to the emergency department because of widespread redness, pain and itching at the sting area after a bee sting while pruning roses in the garden. During the follow-up in the emergency room, the patient developed weakness in his right lower/upper extremities. However, the diffusion magnetic resonance imaging of the patient showed an infarction detected in the area adjacent to the left lateral ventricle (Figure1). Discussion Various clinical presentations after a bee sting have been described in the literature. Bee sting cases are generally associated with mild and transient local symptoms. Sometimes life-threatening allergic reactions may occur. Conclusion The scarcity of the reported after-sting strokes emphasizes the need for further exploration into this uncharted territory to better comprehend and manage these exceptional indications. This case is presented for its rarity, underscoring the imperative for increased attention and research on these complications. Keywords: Bee sting, ischemic, stroke.

Scorpion sting among children with respect to its complications and outcome

Scorpion sting is an acute time limiting medical emergency commonly encountered in rural villages of the country. It is a major public health problem in many tropical and sub tropical countries. India is most affected country in Asian epidemiological data. This study was done to study the complications and outcome of scorpion sting in children. This is a prospective observational study.a total of 100 cases of scorpion sting selected from the patients admitted to Vijayanagar Institute of Medical Sciences, Ballari. The demographical features, clinical presentation, complications, outcome and the response to standard treatment protocol were observed and analysed.Scorpion sting is a common and major health problem in our area. Most commonly affected age group was 4-6 years (27%), and male children (67%) were most commonly affected. These cases were most commonly seen during March (15%) to May (14%) months. Pain at the site of sting (99%) and excessive sweating (92%) were most common presenting complaints, cold extremities (88%), tachycardia (84%), and restlessness (72%) were most common signs noted. Most common complication was myocarditis (15%), followed by pulmonary edema (7%) and encephalopathy (2%). About 98% of cases recovered without sequelae and 2% of cases died due to complications.Scorpion sting is a serious, potentially fatal emergency in our area. Cardiovascular manifestations are most common and are life threatening complication. Administration of prazosin as early as possible is the single most effective intervention to prevent complications and mortality

Revamped mini-αA-crystallin showed improved skin permeation and therapeutic activity against melittin-induced toxicity

Melittin is honey bee venom's primary and most toxic pharmacologically active component. Melittin causes haemolysis, lymphocyte lysis, long-term pain, localised inflammation followed by rhabdomyolysis, and severe renal failure. Renal failure or cardiovascular complications could lead to the victim's death. Severe honey bee bites are treated with general medication involving antihistaminic, anti-inflammatory, and analgesic drugs, as a specific treatment option is unavailable. An earlier study showed the anti-hemolysis and anti-lymphocyte lysis activity of mini- αA-crystallin (MAC), a peptide derived from human eye lens alpha-crystallin. MAC's use has often been restricted despite its high therapeutic potential due to its poor skin permeability. This study compared the skin permeation, anti-inflammatory and analgesic activities of natural peptide MAC and its modified version (MAC-GRD) formed by attaching cell-penetrating peptide (CPP) and GRD amino residues into MAC. Gel formulations were prepared for MAC and MAC-GRD peptides using carbopol (1% w/w), Tween 80 (1%), and ethanol (10%). An ex-vivo skin permeation study was performed using a vertical-type Franz diffusion apparatus. Preclinical in-vivo experiments were conducted to compare the native and modified peptide formulations against melittin-induced toxicity in Wistar rats. MAC gel, MAC–GRD gel and 1% hydrocortisone cream significantly reduced the melittin-induced writhing (20.16 ± 0.792) response in rats with 15.16 ± 0.47, 11.16 ± 0.477 and 12.66 ± 0.66 wriths, respectively. There was a significant reduction in melittin-induced inflammation when MAC-GRD gel was applied immediately after melittin administration. At 0.5, 1, 3, and 5 h, the MAC-GRD-treated rat paws were 0.9 ± 0.043 mm, 0.750 ± 0.037 mm, 0.167 ± 0.0070 mm, and 0.133 ± 0.031 mm thick. Administration of melittin resulted in reduced GSH (antioxidant) levels (47.33 ± 0.760 μg/mg). However, treatment with MAC-GRD gel (71.167 ± 0.601 μg/mg), MAC gel (65.167 ± 1.138 μg/mg), and 1% hydrocortisone (68.33 ± 0.667 μg/mg) significantly increased the antioxidant enzyme levels. MAC-GRD gel significantly reduced the elevated MDA levels (6.933 ± 0.049 nmol/mg) compared to the melittin group (12.533 ± 0.126 nmol/mg), followed by the 1% hydrocortisone (7.367 ± 0.049 nmol/mg) and MAC gel (7.917 ± 0.048 nmol/mg). MAC-GRD demonstrated more skin permeability and superior anti-inflammatory, analgesic, and antioxidant activities when compared to MAC gel. When compared to standard 1% hydrocortisone cream, MAC-GRD had better anti-inflammatory, analgesic, antioxidant, and comparable action in anti-oxidant restoration against melittin. These findings suggest that the developed MAC-GRD gel formulation could help to treat severe cases of honey bee stings.

The first report of human biting by Lipoptena cervi from Slovakia.

The first bite by deer ked Lipoptena cervi (Linnaeus, 1758) on humans has been reported from Slovakia. The host was bitten on the head and neck. Pain and itching appeared immediately after the bite. The skin lesion persisted for several weeks. Although the first documented case of human stings is published here, bites may have occurred in the past, albeit rarely.

Epidemiology of scorpion stings in the West Bank, occupied Palestinian territory.

Scorpionism (scorpion sting envenoming) is an endemic public health concern in many Arab Middle Eastern countries. However, our knowledge of the epidemiology of scorpion stings in the West Bank is limited. To investigate the epidemiology of scorpion stings in 4 districts of the West Bank over a specified period. We obtained scorpion sting records from the main hospitals in 4 districts of the West Bank for 2012 and 2014-2020. A total of 2175 cases were analyzed retrospectively using SPSS version 17. The average age and standard deviation (±SD) for both sexes was 24.7±17.5 years (22.7±16.5 and 27.1±18.4 years for males and females, respectively). The median age was 20 years and 47.2% were children under 18 years. Most cases were reported during the summer months, between June and October, with a peak in July-August. By anatomic site, the right hand was the most commonly stung in both sexes, followed by the right foot. The chest, buttocks and scrotum were the least affected body parts. Clinical data were available for 405 cases, in which pain, vomiting and sweating were the most common symptoms. The overall incidence of stings was 26.32 per 100 000 inhabitants per year over the study period of 8 years (59.21-171.67, 95% CI). Scorpion stings are commonly encountered by adults and children in the West Bank. There is a need for awareness among the West Bank populations on how to avoid being stung, to train medical staff to better manage sting cases, and to evaluate the antivenom currently being used by physicians for scorpion stings.

Scorpion sting in Hafizabad, Pakistan: Facility based epidemiological study

Scorpion envenomation is a widespread issue in tropical and subtropical countries. In the present study epidemiology of scorpion sting cases and potential treatment options in district Hafizabad, Pakistan are documented. Hafizabad city and the adjacent villages were selected for the data collection. Age, gender, time, site of scorpion sting on the body, scorpion sting symptoms, number of patients obtaining medical attention and the number of fatalities (if any) were noted. Data showed that scorpion envenomation often occurs in people between the ages of 16–47 years. There were more female victims (55%) and most of the scorpion sting incidences (55.49%) occurred between 07 PM and 02 AM Among body parts, both the hands (41.71%) and feet (48.57%) were more vulnerable to scorpion stings. In rural areas, the incidences of scorpion stings were higher (68.57%). The reported symptoms of scorpion stings include pain, hypertension, nausea and allergy. Out of all the victims, only 56.05% sought treatment from health care units as well as traditional medicine practitioners. However, others (43.94%) fully healed on their own without any treatment. People were using different types of plant-based materials and dead scorpions with mustard oil as a potent remedy against scorpion stings. Moreover, in the health care units there was no antivenom available and medical staff usually used common pain killers such as Xylocain and Lignocain for the treatment of scorpion sting.

A Hybrid Approach Based on Seasonal Autoregressive Integrated Moving Average and Neural Network Autoregressive Models to Predict Scorpion Sting Incidence in El Oued Province, Algeria, From 2005 to 2020.

This study was designed to find the best statistical approach to scorpion sting predictions. Study Design: A retrospective study. Multiple regression, seasonal autoregressive integrated moving average (SARIMA), neural network autoregressive (NNAR), and hybrid SARIMA-NNAR models were developed to predict monthly scorpion sting cases in El Oued province. The root mean square error (RMSE), mean absolute error (MAE), and mean absolute percentage error (MAPE) were used to quantitatively compare different models. In general, 96909 scorpion stings were recorded in El Oued province from 2005-2020. The incidence rate experienced a gradual decrease until 2012 and since then slight fluctuations have been noted. Scorpion stings occurred throughout the year with peaks in September followed by July and August and troughs in December and January. Sting cases were not evenly distributed across demographic groups; the most affected age group was 15-49 years, and males were more likely to be stung. Of the reported deaths, more than half were in children 15 and younger. Scorpion's activity was conditioned by climate factors, and temperature had the highest effect. The SARIMA(2,0,2)(1,1,1)12, NNAR(1,1,2)12, and SARIMA(2,0,2)(1,1,1)12-NNAR(1,1,2)12 were selected as the best-fitting models. The RMSE, MAE, and MAPE of the SARIMA and SARIMA-NNAR models were lower than those of the NNAR model in fitting and forecasting; however, the NNAR model could produce better predictive accuracy. The NNAR model is preferred for short-term monthly scorpion sting predictions. An in-depth understanding of the epidemiologic triad of scorpionism and the development of predictive models ought to establish enlightened, informed, better-targeted, and more effective policies.

Scorpion Stings in Minas Gerais (Brazil): A Monocentric Retrospective Study Evaluating All Envenoming Cases of Local Scorpionism

We aim to provide better insights into the demographic, epidemiological, and seasonal characteristics of scorpion envenomation reported in the Rio Doce Valley, Brazil. We conducted this monocentric retrospective descriptive study with data on Investigation Forms of Accidents by Venomous Animals, only envenoming cases of scorpion stings, between January 1, 2017 and December 31, 2020, belonging to the compulsory notification system of the Municipal Hospital of Governador Valadares. There were 3032 accidents, and the male-to-female ratio was 1.17:1 (male, 54%; females, 46%). Accidents occurred every month, but there was an increase in June, July, and October to January. In most cases, the time between the scorpion sting and medical care was between 1 and 3 h (n=1304; 43%). The most frequent clinical and systemic manifestations were pain at the bite site (94%) and vagal symptoms (7%). Cases were mild (n=2750, 91%), moderate (n=221, 7%), and severe (n=56, 2%). Children younger than 10 y constituted the most cases, 522 (17%). There was a significant difference between clinical severity and age (P<0.01). Ten patients developed acute pulmonary edema. Two 4-y-old children died. All severely envenomated patients as well as 74% and 2% of mild and moderately envenomated patients, respectively, received specific scorpion antivenoms. Scorpion envenomation is of greater severity in children aged <10 y. The clinical presentation includes mainly local pain associated with vagal symptoms. Accidents occur every month, but there was an increase in June, July, and October to January.

Epidemiology of Scorpion Sting in Southwestern Iran Over Five Years

Background: Scorpionism is a considerable public health problem worldwide in tropical and subtropical regions. It is one of the major health problems and the leading cause of death in the western and southern parts of Iran. Objectives: This study was performed with the aim of investigating the epidemiological features of scorpion stings in Shoushtar city. Methods: This cross-sectional study was performed on 5479 cases in Shoushtar city, Khuzestan province, Iran, from January 1, 2014 until December 31, 2018. First, the incidence rate of scorpion stings was calculated for the study years; then, the bites frequency distribution chart was drawn by month. The t-test and Fisher exact test were used for data analysis using SPSS 22. Results: The average incidence rate of scorpion stinging during the study period was 579.55 per 100000. There was a gradual decrease in the incidence rate over the study period. The incidence of scorpionism was lower in winter, especially in January and February. The most prone body parts of sting were arms and legs (76%); the stings were more common in men than women and more in urban areas than rural areas. Household women had the highest frequency of stings, so almost 1 of every 3 victims was household women; most stings happened indoors. There was a significant association between gender and location, so it was 13 times more in women than men in an indoor location (P = 0.001, OR = 0.076). Conclusions: Shoushtar is a city with a high incidence rate of scorpion sting in the country, especially in the warm seasons. Most cases of stings occur in Housekeepers and in indoor environments. It seems renovation of residential areas, using chemical controls in roofed areas, and enhancing people's knowledge regarding the advantage of using gloves and boots can be vital in the reduction of sting incidences.

Modeling the time series of Scorpion sting in Southwestern Iran

Scorpion stings pose a significant public health concern in Iran, resulting in approximately 45,000-50,000 cases and 19 deaths annually. Scorpions, belonging to the Arachnida class, are venomous arthropods found in all continents except Antarctica. They are of particular concern in tropical and subtropical regions. The Khuzestan and Hormozgan provinces have the highest reported incidence, with an estimated 36,000 cases each year. This study focused on modeling the time series data of scorpion stings specifically in Shoushtar city from 2017 to 2022. Our objective was to investigate the presence of seasonality and long-term trends in the incidence of scorpion stings by utilizing advanced analytical techniques such as the Autoregressive Integrated Moving Average (ARIMA) model. We applied the Seasonal ARIMA model to fit a univariate time series of scorpion sting incidence. This study revealed a significant seasonal trend and an overall increase and decrease in scorpion sting cases during the study period. The best-fitting model for the available data was a seasonal ARIMA model in the form of ARIMA (0,0,1) (1,1,1)12. This model can forecast the frequency of scorpion sting cases in Southwestern Iran over the next two years. As a result, Time series analysis can provide valuable insights into the patterns and trends of Scorpion sting incidents, allowing for better planning and allocation of healthcare resources. By understanding the seasonal variations, proactive measures can be implemented to address the growing issue of Scorpion stings in Iran effectively.

Anaphylaxis reaction to samsum ant (Pachycondyla sennaarensis): a Case Series Study.

Purpose. Anaphylaxis is a life-threatening hypersensitivity reaction. The present study aimed to investigate the cases of anaphylaxis to ant stings in Iran to determine the characteristics of patients, geographical distribution and the type of ants that cause anaphylaxis. Patients and Methods. Patients with a history of anaphylaxis to ant sting underwent skin allergy test with extracted substance from Solenopsis invicta. Samples of ants were collected from the sites where each patient was bitten and their species were identified by a medical entomologist. Results. Nineteen patients (mean age: 26.2 years; range: 4-48 years) were included in the study. Most patients (89.5 percent) were female. The lower limb was the most common site of the sting and most stings had occurred in the morning (31.6 %) and evening (31.6%). Skin manifestations were the most common clinical symptoms (94.7%). Most cases of stings were observed in the Hormozgan province (89.5%) located in southern Iran. Sixteen patients had positive skin prick test for ant venom. All collected ants that caused anaphylaxis belonged to the Pachycondyla sennaarensis species. Conclusions. Ant sting anaphylaxis is not uncommon in Iran, especially in its southern regions. All cases of anaphylaxis in this study were due to samsum ant sting (Pachycondyla sennaarensis), which is a species similar to the fire ant (Solenopsis invicta). Allergy skin testing with fire ant extract was positive and helpful in identifying samsum ant allergy in all cases.

Mini-αA-Crystallin Stifled Melittin-Induced Haemolysis and Lymphocyte Lysis

Melittin, the most potent pharmacological ingredient of honey bee venom, induces haemolysis, lymphocyte lysis, long-term pain, localised inflammation, and hyperalgesia. In this study, efforts were made to subdue the melittin’s ill effects using a chaperone peptide called ‘mini-αA-crystallin’ (MAC) derived from eye lens αA-crystallin. Haemolytic test on human red blood cells, percentage viability, and DNA diffusion assay on Human peripheral blood lymphocytes (HPBLs) were performed with melittin in the presence or absence of MAC. Propidium iodide and Annexin V-FITC dual staining were performed to analyse quantitative levels of necrotic and apoptotic induction by melittin in the presence or absence of MAC on HPBLs using a flow cytometer. A computational study to find out the interactions between MAC and melittin was undertaken by modelling the structure of MAC using a PEP-FOLD server. The result showed that MAC inhibited melittin-induced lysis in nucleated (lymphocytes) and enucleated (RBC) cells. Flow cytometric analysis revealed a substantial increase in the necrotic and late apoptotic cells after treating HPBLs with melittin (4 µg/ml) for 24 h. Treatment with MAC at a 2:1 molar ratio prevented HPBLs from developing melittin-induced necrosis and late apoptosis. In the docking study, hydrogen, van der Waals, π-π stacking, and salt bridges were observed between the MAC and melittin complex, confirming a strong interaction between them. The MAC-melittin complex was stable during molecular dynamics simulation. These findings may be beneficial in developing a medication for treating severe cases of honeybee stings.

Retrospective Evaluation of Patients With Scorpion Stings Admitted to the Pediatric Emergency Clinic.

Introduction Scorpion sting in children is still a serious health problem today. Children are at greater risk of developing severe cardiac, respiratory, and neurological complications because of their low body weight. In this study, we retrospectively evaluated the demographical changes, complaints, clinical findings, and laboratory results of scorpion sting casesadmitted to the pediatric emergency department. Materials and Methods The records of 72 patients who were followed up with the diagnosis of scorpion sting in the Dicle University Pediatric Emergency Department between 2013 and 2017 were retrospectively analyzed. Results The patients included in the study were between one and 15 years (7.64±4.04 years) and 43.1% were male, and 56.9% were female. While 65.3% of the cases lived in rural areas, 34.7% lived in the city center. The most common stung areas in the cases were the lower extremity (51.4%) and the upper extremity (34.7%). The most common complaints in the patients were 70.8% pain, 58.3% edema, 41.7% cold extremities,23.6% sweating, 22.2% vomiting, and 12.5% excessive salivation. Of the cases, 71.4% had mild, 25.7% had moderate, and 2.9% had severe stages. Of the patients, 91.6% were given antivenom, 75.7% were given antihistamines, 74.3% were given steroids,65.7% were given antibiotics, 64.3% were given analgesics, 44.3% were given tetanus vaccine, 2.8% were given erythrocyte suspension and 1.4% were given platelet suspension. In addition, 11.4% of the cases were given prazosin treatment. While 32.9% of the cases required intensive care, two patients died. A statistically significant difference was found between the glucose, urea, creatine, total protein, sodium, potassium, alanine aminotransferase, white blood cell count, red blood cell count, hemoglobin, hematocrit, neutrophil count values of the patients at admission and discharge. Conclusion Scorpion sting cases are still a significant health problem.The severe clinical course is more common in children. The management of patients with severe clinical forms is based on early recognition of the sting, antivenom serum administration, and cardiorespiratory and systemic support.

Genetic diversity of medically important scorpions of the genus Centruroides (Buthidae) from Panama including two endemic species

With more than 33,000 sting cases and 47 deaths recorded between 2000 and 2016, Panama is the country with the highest incidence of envenomations by scorpions in Central America. Species in the genus Centruroides are responsible for most scorpion sting reports, however, identification at the species level is complicated because the genus has considerable intraspecific morphological variation. To date no molecular data have been reported from Panama that would help to estimate their genetic diversity and validate morphometric identification methods. We provide here the first genetic diversity data of the two endemic species (C. granosus and C. panamensis) and other two species reported in Panama (C. bicolor and C. limbatus). A total of 41 specimens were sequenced for COI and 16S rDNA mitochondrial genes. The phylogenetic concatenated analysis separates the Panamanian samples into four well-supported clades represented by C. bicolor, C. granosus and (C. panamensis + C. limbatus). The two endemic species are not the closest relatives in the tree. Low diversity in combination with its very narrow distribution suggest that C. panamensis is susceptible to environmental degradation. A single specimen of Coiba island is intermediate in the tree structure between C. bicolor and C. panamensis and may represent an early stage of speciation. The haplotype network is also consistent with the phylogenetic trees.

Detection of areas vulnerable to scorpionism and its association with environmental factors in São Paulo, Brazil

Accidents caused by scorpions are considered a neglected condition and represent a major health problem in most tropical countries, especially for children and elderly people. In Brazil, scorpionism is recurrent in the southeast region, mainly in the state of São Paulo, due to the progressive increase in scorpions found in urban habitats. Thus, our study aimed to provide better insights into the geographic and epidemiological characteristics of scorpion envenomation in São Paulo state and identify the environmental factors that are associated with these accidents. This is an ecological and retrospective study with secondary data on scorpion accidents in the state of São Paulo from 2008 to 2018 obtained from the Notifiable Disease Information System. The SatScan software was used to identify the higher- and lower-risk spatiotemporal clusters. A total of 145,464 scorpion sting cases were recorded in the state of São Paulo, between 2008 and 2018; there was a four-fold increase in the incidence rate. Accidents occurred more frequently in the spring season, wherein higher-risk clusters were in the north and northwest regions of the state. High temperatures, low precipitation, and poor natural vegetation are associated with higher risk areas. Our study mapped vulnerable areas for scorpion accidents that can aid in the design of efficient public health policies, which should be intensified during the spring season.

Predictive Value of Glycemia and Free Fatty Acid Levels upon Admission of Children with Scorpionism in Egypt.

Scorpion envenomation is a life-threatening emergency and causes serious health problems in tropical and subtropical regions. The aim of this study was to correlate the serum levels of biochemical parameters at admission in children with scorpion envenomation with subsequent morbidity and mortality. It was a prospective, observational, and descriptive study conducted for scorpion-envenomed children who presented to emergency and intensive care units between April 2019 and September 2019. Demographic, clinical, and laboratory findings of patients were recorded and tabulated. Routine investigations were done for all patients in addition to blood levels of lactate, free fatty acids (FFA), and insulin. All patients were compared according to outcome as survivors and nonsurvivors and according to glucose level as normoglycemic and hyperglycemic groups. There were 62 scorpion sting cases; their mean age was 8.6 ± 3.2 years. Patients aged more than 6 years (74.2%), and males (66.1%) were more affected than others. As regards severity, 25.8% were suffering organ dysfunction, 40.3% suffered systemic manifestations without organ dysfunction, and (33.9%) with only local manifestations. Serum glucose and FFA were significantly higher in nonsurvivors compared with survivors. Shock, convulsion, coma, heart failure, and pulmonary edema were significantly more common in hyperglycemic than normoglycemic group. Hyperglycemia, and raised FFA were associated with severe scorpion envenomation. Raised FFA was well correlated with presence of heart failure, leucocytosis, and hyperglycemia. Adding serum glucose and FFA to monitoring parameters of scorpionism severity can help the prediction of high-risk patients.

Venomous animal bites and stings in Lordegan city, Chaharmahal Bakhtiari province of Iran in 2019–2020

The present study was conducted to investigate the prevalence of venomous animal sting and bites in Lordegan city, Chaharmahal Bakhtiari province of Iran. In this descriptive study, data were collected based on the available information of Lordegan health centers during 2 years. The data were extracted, categorized, and analyzed statistically by tables. In the years 2019 to 2020, 1038 cases of bites have been reported in Lordegan city. Among the animals, stings with scorpion 67.8% and then bees 6.2%, snakes 3.6% and bites with unknown factor 22.2% were involved. Most cases of sting and bites occurred in the age range of 25 to 34 years (19.2%) and the lowest in the age group over 65 years (3.6%). Sting and bites were observed in men by 48.7% and in women 51.3%. Due to the sting and bites of various animals and the fact that some of these factors have been introduced as unknown, the need to increase the knowledge and awareness of health care staff and the same public education in high-risk areas can be significantly effective in the reduction of being bitten and its subsequent hardship.