Treatment Of Bite Research Articles

Perspectives of next generation sequencing in the microbiological evaluation and treatment of dog bites

Az antibiotikum-rezisztencia a modern orvoslás egyre több kihívást adó problémája. A kutyaharapás gyógyításának számos esetben elengedhetetlen része az antibiotikus kezelés. Az eredményes gyógyításhoz minél hamarabb ismerni kellene a kórokozókat és azok antibiotikum-érzékenységét. Ajelenlegi módszerekkel - baktériumtenyésztés és antibiogram-készítés - napokba, akár hetekbe telhet, mire lelethez jutunk. A közben alkalmazott empirikus antibiotikum-kezelés újabb rezisztens törzseket szelektálhatki. Az új generációs genomszekvenálással (NGS), illetve nanopore szekvenálással nyert genomszintű adatok gyors, teljes-körű mikrobiológiai lelet lehetőségét ígérik kutyaharapás esetében is. Aharmadik generációs nanopore szekvenálás jövőbe mutató módszernek látszik a humán orvoslásban is a mikrobiológiai leletek elkészítésében.

SNAKEBITE POISONING: Advances in treatment, Vaccination, and Management Strategies

So, roughly 15% of the 3000 snake species discovered globally are thought to be harmful to humans. The eastern and western diamondback rattlesnakes cause the most fatalities. Snake poisoning deaths are more common in youngsters, the elderly, and those to whom antivenom is not supplied or is administered late or in insufficient quantities. Snake poisoning kills mostly young individuals between the ages of 17 and 27. Snakebites envenoming is mostly an occupational condition that can result in death or severe disability. The treatment is based on both the patient's history and a syndromic approach. The treatment should be provided rapidly and affordably to all citizens of the particular country. Snakes have both dry and moist bites. Dry bites do not produce envenoming symptoms. In such a situation, many people noticed it as a miraculous solution that suggested the bite from the offending snake species was quite innocuous. The diagnosis for such bites is also not noted in the literature, which may cause difficulty while treating the sufferer with antivenom. Because humans are too huge to be considered food for even the largest dangerous snakes, snakes may not always deliver venom when they bite, instead saving this metabolically costly weapon for predation. These dry bites appear as bites from non-venomous snakes, which exhibit comparable symptoms. To aid with this, a greater awareness of both the snake-related and human-related aspects involved in both wet and dry snakebites is essential. Snake venom poisoning is a complex medical emergency that not only involves the site of bite but also multiple organ failure; hence, contacting a physician who is qualified in the diagnosis and treatment of venomous snake bites is vital.

Challenges in Snakebite Management in India: Insights from a Physician Survey with Special Focus on Kerala and treatment of bites by Hump-nosed Pit Vipers (Hypnale spp.)

Background India has a high incidence of snakebite-related mortality, making effective snakebite management crucial. This study aimed to explore current practices, challenges, and opportunities for improvement in snakebite management across India. Methods A cross-sectional survey was conducted among physicians in India covering aspects such as scope of practice, snake identification, first aid measures, institutional management, and specific management practices for hump-nosed pit viper ( Hypnale hypnale) bites. The survey included 37 questions across 5 sections, with data collected via emails, professional networks, and online platforms. Statistical analysis was performed using SPSS Statistics 23 (IBM Corp, Armonk, NY), and manual thematic analysis was applied to open-ended responses. Results The survey revealed a discrepancy between physicians’ confidence and accuracy in snake identification, with some still reporting outdated first aid and treatment practices. Despite recognizing the importance of snake species identification, a significant portion of respondents incorrectly identified the snakes. The study highlighted variability in institutional practices for snakebite management, such as administering prophylactic antibiotics and tetanus prophylaxis and monitoring periods for asymptomatic patients. In managing H hypnale viper bites, a demand for specific guidelines and a monovalent antivenom was evident because the current polyvalent antivenom is ineffective for this species. Conclusions The survey emphasizes the need for improved training in snake identification, standardized treatment protocols, and the development of region-specific antivenoms. It emphasizes the necessity of updating guidelines to address the unique challenges of snakebite management in India, particularly for species not covered by existing antivenoms.

Efficacy of Clear Aligner Therapy for the Treatment of Anterior Open Bite in Adults: A Systematic Review and Meta-Analysis.

The objective of the present systematic review and meta-analysis was to assess the effectiveness of clear aligner therapy (CAT) for the treatment of anterior open bite (AOB) in adults. The focused question was "Is CAT effective for the management of AOB in adults?". Databases were searched without time and language barriers up to and including August 2024 based on pre-specified eligibility criteria. Risk of Bias (RoB) assessment was performed using the Risk-of-Bias-In-Non-randomised-Studies-of-Intervention (ROBINS-I) tool. Meta-analyses were conducted using a random effects model (REM) for change in AOB and cephalometric measurements with an evaluation of the mean difference (MD) and/or standardised mean difference (SMD). The Grades of Recommendation, Assessment, Development and Evaluation (GRADE) tool was used to assess the quality of evidence. Publication bias was assessed using Funnel plots and Egger's regression test. There were 14 studies included in the qualitative assessment and 12 in the meta-analysis. The RoB was moderate in 13 studies and low in one. The meta-analysis showed significant AOB correction with CAT [(MD) = 2.76 mm, 95% confidence interval (CI): 2.23-3.28] due to maxillary and mandibular incisor extrusion (MD = 0.85 mm, CI: 0.43-1.26 and MD = 0.86 mm, CI: 0.29-1.44, respectively). There were no significant changes identified for maxillary and mandibular molar intrusion or changes in the mandibular plane angle (MPA). The level of confidence was high for AOB correction, incisor extrusion, and molar intrusion and low for MPA. CAT leads to a significant correction of AOB of approximately 2.76 mm, which can be mainly attributed to incisor extrusion.

Assessment of Quality parameters and Safety in Indigofera tinctoria L. (Avuri) Rootbark extract

Avuri (Indigofera tinctoria Linn) has widely been used for the treatment of poisonous bites, epilepsy, nervous disorders, bronchitis, dermatological disorders, and liver ailments in Indian traditional medicine. Extensive research has been made into the aerial extracts of this plant for medicine preparation. Despite being used in medicinal formulations, especially in the treatment of poisonous bites the root bark has been less studied. This study is the physiochemical and safety of methanolic extract of Avuri verpattai. Roots were excised from mature plants collected from the Hills of Palani, then the root bark was peeled and air-dried. Extraction was done in a Soxhlet apparatus using a methanolic extraction procedure. Further, the extracts were used for preliminary phytochemical, physiochemical analysis, and safety analysis like aflatoxin, pesticide residue, Microbial contamination, and heavy metals. The phytochemical analysis showed the presence of alkaloids, flavanoids, steroids, triterpenoids, coumarin, phenol, tannin, saponin, sugar and betacyanin. The physiochemical tests conducted on the root bark extract unveiled specific parameters: pH(4.73), Total ash (3.59% w/w), acid insoluble ash (0.4751% w/w), loss on drying at 105°C(3.45% w/w), water-soluble extractive (8.74%w/w), and alcohol soluble extractive (1.91% w/w). The bulk density was 0.2496g/ml, while the tapped density was determined as 0.4940g/ml for the extracts. Safety assessment conducted via aflatoxin analysis, microbial contamination, and pesticide residues, indicated the absence of such toxins in the extract. Additionally, trace amounts of heavy metals mercury and arsenic were detected at levels of 0.334 and 1.970ppm, respectively. The study reveals that the Methanolic extract of Avuri verpattai has significant quality and safety. Consequently, these parameters can serve in the study of Avuri verpattai Extract, as an important Siddha medicinal preparation.

Qualitative and optimal control analysis of a two-serotype dengue model with saturated incidence in co-infection

ABSTRACT The arboviral disease dengue is a life-threatening global public health problem due to its high prevalence rate, morbidity and mortality. Recent studies suggest that morbidity during secondary dengue infection is higher than during primary infection. To deepen our understanding, we have explored a two-serotype co-infected dengue model with bilinear incidence for primary infection and saturated incidence for secondary infection. In the model, we have also included four control measures: mosquito bite prevention control, treatment control, vaccine control and mosquito killing control. The existence and local stability of the disease free, serotype II free, serotype I free and endemic equilibrium points have been studied. The effect of inhibitory or awareness factors on disease dynamics has also been exhaustively examined. By using sensitivity analysis we have identified and quantified the most influential parameters to prevent as well as to control the dengue outbreak. To optimize our strategies, we have characterized the time-dependent optimal control to reduce dengue prevalence and the total implementation cost of the aforementioned controls. Efficiency analysis has been done to identify the best effective combination of the applied controls to reduce dengue infection. Mosquito bites with treatment control is the most effective combined strategy to control dengue infection.

Emergency treatment of tongue bite after rat poison poisoning in a patient with recurrent depressive disorder: a case report

BackgroundRecurrent depressive disorder (RDD) is mainly manifested as a low mood, negative and pessimistic mood, and often presents suicidal tendencies when severe. This study reports on a patient with RDD who experienced rat poison poisoning occurring tongue biting. The patient’s psychiatric symptoms improved after receiving emergency management and subsequent combined medical care.Case presentationThe patient was a 51-year-old female with RDD complicated with rat poison poisoning. Tongue bite occurred on the third day of hospitalization. She received emergency treatment. Depression, anxiety and suicide risk assessment, safety management and caregiver-health education were conducted on the day of admission and before discharge. At the follow-up after discharge, the risk of suicide was reduced.ConclusionsSuicide in patients with RDD is characterized by repetition and complexity. The occurrence of clinical cases involving tongue bite after gastric lavage is rare. Suicide assessment and emergency management play an auxiliary role in the treatment of patients with recurrent depressive disorder.

Effect of Bilvapatra Lepa (Aegle Marmelos) over unknown insect bite Poisoning - A Single Case Study

Ayurveda is the ancient science of life, has eight branches. According to Ayurved there are two main types of poison – Natural and Artificial. Natural poison is of two types – Sthavar and Jangam. (1) Danstrachikita is a Ayurveda toxicology branch. Insect bite is comes under Jangam Visha. A 9 year boy, while playing cricket affect with unknown insect bite complying of itching, swelling, redness and burning pain over upper back region. He was treated by local application of Bilvapatra Lepa (Aegle marmelos). Aegle marmelos is one of the important plants which have medicinal as well as other properties. This study shows that external application of Bilvapatra Lepa is effective in the treatment of unknown insect bite (Kitakadansha)

Surgical and Camouflage Orthodontic Treatment of Anterior Open Bite: Comparison of Profile Attractiveness.

To evaluate the profile's attractiveness between the different protocols for treating the anterior open bite. The sample comprised 39 patients with anterior open bite treated with or without extractions, divided into two groups: The surgical group (G1) comprised 21 subjects (10 males, 11 females) with a mean initial age of 21.86 years (SD = 5.09), treated with fixed orthodontic appliance followed by orthognathic surgery, for a total mean period of 2.53 years (SD = 0.61). The mean overbite was -5.01 mm (SD = 2.50); The camouflaged group (G2) comprised 18 subjects (9 males, 9 females), with a mean initial age of 20.47 years (SD = 4.19), treated only with fixed orthodontic appliance, for a total mean period of 2.56 years (SD = 0.94). The mean overbite was -4.28 mm (SD = 1.15). Lateral photographs from pretreatment and posttreatment were used. These photographs were evaluated by 46 laypeople and 67 dentists, who rated the attractiveness of each profile from 0 (most unattractive profile) to 10 (most attractive profile). Intergroup comparisons were performed with independent t-tests. Both groups presented improvement in the profile attractiveness with treatment (p < 0.001). Before treatment, the profile of the surgical group was significantly less attractive than the profile of the camouflaged group (p < 0.001). The surgical presented a more attractive profile at the final stage than the camouflaged group (p < 0.001). The surgical group showed a greater improvement in profile attractiveness with treatment than the camouflaged group (p < 0.001). In the final stage, the surgical presented a more attractive and greater improvement in profile attractiveness than the camouflaged group. The laypeople and dentists judged similarly the initial profile attractiveness.

Use of Clear Aligners with a Surgery-First Approach for Treatment of the Anterior Open Bite: A Systematic Review and Comparison with Conventional Fixed Appliances

Use of Clear Aligners with a Surgery-First Approach for Treatment of the Anterior Open Bite: A Systematic Review and Comparison with Conventional Fixed Appliances

Are zygomatic implants an alternative to orthognathic surgery in the treatment of a vertical discrepancy ? A case series to describe an open bite treatment protocol

IntroductionThis report aims to present case series to describe a treatment protocol for correction of severe open bite in non-growing patients MethodologyPatients diagnosed with skeletal open bite malocclusion (overbite range: -3 to -6 mm) were treated using a bonded appliance and skeletal anchorage. Intrusive force was applied between buccal bars of appliance and zygomatic multipurpose implants (MPI). Intrusion was continued until positive overbite occurred. Treatment progressed with conventional fixed orthodontic treatment for alignment and settling. MPIs were retained until the end of treatment for retention of intrusion ResultsClinically effective open bite correction was achieved by intrusion of maxillary buccal segment and mandibular counterclockwise autorotation ConclusionThis protocol includes zygomatic anchorage and an appliance that aims triple intrusion effect through combination of orthodontic and physiological forces. Achieving significant maxillary intrusion, controlling mandibular eruption and maximizing mandibular counterclockwise autorotation are the main outcomes of this protocol.

Clinical efficacy and safety of Luofushan-Baicao oil in the treatment of Aedes albopictus bites: a paired, self-controlled study

Clinical efficacy and safety of Luofushan-Baicao oil in the treatment of Aedes albopictus bites: a paired, self-controlled study

Antioxidant Potential and Phytochemical Screening of Extracts from &lt;i&gt;Senegalia nigrescens&lt;/i&gt;-A Traditional Swazi Medicinal Plant

Senegalia nigrescens has been used in traditional Swazi medicine. S. nigrescens is used in the treatment of wounds, toothache, diabetes, dysentery, snake bites, convulsions and skin diseases. In this study, we aimed to evaluate the antioxidant potential, determine the half-minimal inhibition concentration (IC50) values and analyze phytochemical constituents of various solvent extracts obtained from the leaves and stem-bark of S. nigrescens. The maceration technique together with the hot solvent extraction approach was used for the obtainment of various solvent extracts. 2,2-Diphenyl-1-picrylhydrazyl (DPPH) radical scavenging potential, IC50 values and phytochemical analysis were performed as per established procedures. The radical scavenging potential of extracts from leaves and stem-bark of S. nigrescens and positive control (ascorbic acid) were found to be in the ranges of 7.55 ± 0.004 ~ 62.19 ± 0.004%, 9.04 ± 0.003 ~ 63.24 ± 0.006% and 50.98 ± 0.002 ~ 71.0 ± 0.007%, respectively at a concentration range of 200 ~ 3,000 μg/mL. The methanol extracts from the leaves, stem-bark and positive control exhibited IC50 values of 921.69, 735.74 and &lt; 200 μg/mL, respectively. Several classes of phytochemicals were identified in these extracts which include alkaloids, steroids, terpenoids, flavonoids, phenolics and tannins. We concluded that S. nigrescens showed a weak to moderate DPPH radical scavenging potential and possessed various classes of phytochemicals.

Adherence to the post-exposure prophylaxis among animal bite patients attending rabies clinic at tertiary care hospital – A cross-sectional study

Background: Rabies is an acute and 100% fatal viral disease transmitted to humans through the bite or lick of an infected animal. It can be successfully prevented if a complete course of anti-rabies vaccine (ARV) is taken following an animal bite. The present study reveals the compliance of animal bite victims to post-exposure prophylaxis (PEP). Aims and Objectives: The objectives of the study are as follows:(1) To determine the adherence to PEP among animal bite victims and factors influencing it. Materials and Methods: A retrospective record-based cross-sectional study was conducted at the anti-rabies clinic of VIMS Hospital Ballari. Information regarding sociodemographic variables, animal bite history, category of bite, treatment received, and completion of ARV schedule of all the animal bite cases were collected from the animal bite register and treatment card during the period from July 2023 to December 2023. Results: Out of the total 350 animal bite victims, all of them received the first dose of vaccine, 86.28% completed two doses, 72% completed three doses, and only 51.14% completed the schedule by taking all four doses, 37% of them completed the schedule without any delay, 14% delayed one or more doses, and the rest 49% did not complete the schedule. Conclusion: Adherence to PEP is a dire necessity as rabies is a fatal disease. Counseling the animal bite victims about the importance of adhering to the complete PEP schedule at the time of administering the first dose of vaccine is crucial.

Does Invisalign Outperform Fixed Appliance in Treating Vertical Discrepancies?

Aligners became popular among adult patients for their superior aesthetics and comfort in comparison to conventional fixedappliances. It has undergone numerous enhancements over time, allowing it to address more complex malocclusions. Many researchers argued that managing vertical discrepancies is more challenging than addressing anteroposterior issues. This complexity arose from the mechanical requirements for treatment and the required mechanics to prevent relapse. Studies assessing the treatment outcome of anterior open bite closure using clear aligners have yielded conflicting results regarding the mechanisms of bite closure. Proposed mechanisms included extrusion of upper or lower incisors, lingual tipping of upper or lower incisors, intrusion of upper or lower molars, counterclockwise rotation of the mandible, or various combinations of these mechanisms. The research highlighted the biomechanical challenges associated with using aligners for the treatment of deep bites as mandibular incisor intrusion and leveling the curve of Spee remain among the least predictable movements. Given the widespread use of aligners, it is imperative to rigorously assess the effectiveness of clear aligners in achieving overbite correction to ensure they deliver the desired outcome. This review aimed to assess the performance of Invisalign in the management of vertical discrepancies. It sought to identify the dentoskeletal effects of clear aligners in addressing deep bite and anterior open bite cases, understand the mechanisms behind overbite correction, and provide a comprehensive overview of the existing research on this topic.

Descriptive Study on Treatment of Poisonous Bites Followed by Traditional Medical Practitioners in Vilavancode Taluk, Kanyakumari District

Descriptive Study on Treatment of Poisonous Bites Followed by Traditional Medical Practitioners in Vilavancode Taluk, Kanyakumari District

Three dimensional evaluation of maxillary anterior teeth intrusion for treatment of anterior deep bite accompanied with gummy smile using two different biomechanical techniques.

Three dimensional evaluation of maxillary anterior teeth intrusion for treatment of anterior deep bite accompanied with gummy smile using two different biomechanical techniques.

#2781 Renal cortical necrosis—a rare cause of acute kidney injury

Abstract Background and Aims Renal cortical necrosis (RCN) is a rare and catastrophic cause of acute kidney injury (AKI). It is characterized by ischemic destruction of all the elements of renal cortex due to marked reduction in renal arterial perfusion of renal cortex due to vascular spasm and microvascular injury. It can be patchy or diffuse depending upon the cause and extent of hypoperfusion. Snake bite is rare cause of RCN. Incidence of RCN following snake bite has been reported to be as high as in 25% of the bitten patients to &amp;lt;1%. Lack or delay in receiving anti snake venom (ASV) has been observed to be a contributing factor in development of RCN following snake bite. Method A 45-year-old female had an unknown bite on foot while returning to home at twilight. She had intense pain at site of bite with slight ooze of blood. Overnight she had vomiting and pain abdomen. Subsequently she developed progressive fall in urine output and dyspnoea. After about 36 hours of bite at the time of admission in hospital she had anuria, prolonged whole blood clotting time, tachypnoea, hypoxemia and required oxygen (O2) to maintain normal O2 saturation. She was given two doses of polyvalent ASV 6 hours apart which corrected her coagulation defect. Investigations showed: haemoglobin—9 gm/dl, total leucocyte count—18700/mcl, platelet—1.15 lakh/mcl, blood urea—88 mg/dl and serum creatinine—10.5 mg/dl. She was managed with haemodialysis and supportive care. Even after 3 weeks of onset of AKI, she had anuria so a kidney biopsy was done. Results kidney biopsy on light microscopy examination showed 9 glomeruli; 8 revealing global tuft necrosis along with necrosis of adjacent tubules and vasculature and necrotic process affected around 60% of sampled cortical area consistent with cortical necrosis (Fig. 1). She was continued with haemodialysis support and urine output and pre-dialysis serum creatinine were monitored. Her urine output after 3 months of onset of AKI is around one litre per day but her pre-dialysis serum creatinine stays in the range of 9-10 mg/dl and so she continues to receive biweekly haemodialysis. Conclusion In our index case, there was delay in getting ASV which may have contributed to development of RCN. So, early treatment of snake bite is important to prevent this catastrophic complication.

Lack of documentation in animal bite cases and its impact on rabies biologicals utilization.

Rabies has significant health and economic consequences for both humans and animals. Annually, India witnesses 17.4 million dog bites, yet only 3 million individuals receive post-exposure prophylaxis (PEP). There is a shortage of anti-rabies vaccine in India as quoted in many news reports. In India, lack of documentation of previous vaccination against animal bites is there, hence resulting in the re-administration of the anti-rabies vaccine, leading to a significant biological loss (anti-rabies vaccine). A cross-sectional, retrospective study was conducted. Data was collected, and analyzed from June 2021 to June 2023 a period of 2 years. Majority of the patients reported within the first 24 hours after being bitten while approximately one-third reported after 24 hours. Majority were Category 3 bites and unprovoked. Males, lower-middle class, and bites on lower extremities were common among 4291 patients attending the clinic. Out of 217 re-exposure cases, 185 did not have any documentation regarding their previous treatment of animal bites. Among 4291 patients attending the clinic, majority were Category 3 bites on the lower extremities. 85.25% of re-exposure cases had to be administered a full course of treatment due to a lack of documentation leading to rabies as a biological wastage. This avoidable wastage can be a resource for treating more patients.

Role of neutrophil–lymphocyte ratio in the management of children with snake bite envenomation: A single-center prospective observational study

Background: Neutrophil–lymphocyte ratio (NLR) has recently gained popularity as a simple, inexpensive, and highly accurate inflammatory marker. When the differential count of leukocytes is checked following it is characterized by leukocytosis with an increase in neutrophil count and a decline in lymphocyte counts. This study was conducted to assess whether alteration in the differential count of leukocytes following envenomation has the ability to diagnose and predict the severity and prognosis in children and to derive a cutoff value for the same. Subjects and Methods: This prospective observational study was done in the pediatric intensive care unit (ICU) of a tertiary care hospital from July 2019 to June 2020. From the complete blood count of patients done at admission, NLR1 was calculated. All patients were treated as per the national snake bite treatment protocol. The amount of antisnake venom (ASV) given, duration of hospital stay, and ICU stay were correlated with NLR1 values. Results: An NLR value of 3.35 can predict envenomation with 95% sensitivity and 100% specificity. Similarly, an NLR value of 6.72 can predict the need for more than 10 ASV vials with a sensitivity of 93% and specificity of 97%, and an NLR value of 6.72 can predict the occurrence of major complications with a sensitivity of 89.3% and specificity of 94%. Conclusions: NLR can differentiate poisonous snake bites from nonpoisonous bites and can also predict the severity of the envenomation.