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Snake envenomation diagnosis methods

Snake envenomation diagnosis methods

Significant rhabdomyolysis with Metabolic syndrome heart disease renal failure envenomatiom rare but Envenomatiion be treated with generous fluid therapy and close monitoring diagnosls electrolyte imbalances Snke, hyperkalaemia. Obesity and exercise evidence of abnormal coagulation bleeding from bite site, cannula site, oral cavity or occult sites, including gastrointestinal, urinary and intracranial sites. Isbister GK, Buckley NA, Page CB, et al. Most patients present with a report of a definite or suspected snakebite, but it is often unclear whether a patient is envenomed and what type of snake is involved.

Snake envenomation diagnosis methods -

This may not be a major problem because the test would be used in cohorts of patients bitten by snakes where the pre-test probability for snake envenomation is high.

In contrast the test would be of much less value in cohorts of patients with suspected bites or clinical features where false positives would be more problematic. Larger cohorts of patients are required to determine if this is a major problem.

There would be huge benefits for a PLA 2 test because it would allow for fast, simple and easy identification of systemic envenomation, so that antivenom can be given.

The PLA 2 kit used in this study requires a microplate reader and is designed to run tests as batches making it expensive for testing when the patient presents.

Several methods have been used to measure PLA 2 activity in serum samples 12 , 17 , It would therefore be feasible to develop a PLA 2 assay that is inexpensive, allows individual tests to be done and can be done at the bedside or in a basic laboratory setting.

Patients with Russell's viper Daboia russelii , hump-nosed pit viper Hypnale hypnale , cobra Naja naja and krait Bungarus caeruleus envenomation were recruited prospectively from snakebites presenting to Chilaw Hospital Western Province and Polonnaruwa Hospital North Central Province in Sri Lanka between and as part of prospective cohort studies and randomised controlled trials 3.

The studies were approved by the Ethical Review Committee, Faculty of Medicine, University of Colombo. Patients with no evidence of envenomation but who had been bitten by a snake were also recruited.

In addition, cases of black snake Pseudechis porphyriacus were included from the Australian snakebite project The design of the Australian snakebite project has previously been described in detail and approval has been obtained from the Hunter New England Area Health Human Research Ethics Committee and nineteen other Human Research and Ethics Committees covering all institutions involved around Australia 19 , Informed consent was obtained from all patients and the experiments were undertaken in accordance with the National Health and Medical Research Council guidelines.

Clinical data and serial serum and citrate samples were collected for all snakebites. Serum samples were tested with venom specific enzyme immunoassay EIA for Russell's viper venom and hump-nosed pit viper venom for Sri Lankan cases and black snake venom for Australian cases, to confirm envenomation 3 , Clotting studies on citrate samples and clinical data were used to confirm systemic envenoming 3 , 21 , Non-envenomed cases were defined as patients with a suspected snakebite where no venom was detected in serum samples, clotting studies were normal and the patient remained asymptomatic.

Serum samples were analysed for PLA 2 activity by Cayman s PLA 2 assay kit Cayman Chemical Company, USA according to manufacturer instructions. We compared the PLA 2 activity of Russell's viper, hump-nosed pit viper and black snake envenomed patients with non-envenomed patients.

Furthermore, we investigated the correlation between PLA 2 activity and venom specific EIA concentration in three different snakes. In selected patients we measured serial serum samples for PLA 2 activity, including before and after antivenom.

The PLA 2 activities of patient sera from different snake groups and the non-envenomated snake bites were compared with the non-parametric Kruskal-Wallis test and multiple comparisons with Dunn's test.

Correlation between PLA 2 activity and venom concentrations was compared with Spearman's test. Kasturiratne, A. et al. The global burden of snakebite: a literature analysis and modelling based on regional estimates of envenoming and deaths.

Article PubMed PubMed Central Google Scholar. Lalloo, D. The African challenge. Lancet , Article PubMed Google Scholar. Isbister, G. A randomised controlled trial of two infusion rates to decrease reactions to antivenom.

PLoS One 7, e Article ADS CAS PubMed PubMed Central Google Scholar. Ireland, G. Changes in serial laboratory test results in snakebite patients: when can we safely exclude envenoming?

Med J Aust , — Diagnostic min whole blood clotting test in Russell's viper envenoming delays antivenom administration. QJM Shihana, F. A modified low-cost colorimetric method for paracetamol acetaminophen measurement in plasma. Clin Toxicol Phila 48, 42—46 Article CAS Google Scholar.

A simple quantitative bedside test to determine methemoglobin. Ann Emerg Med 55, — Birrell, G. The diversity of bioactive proteins in Australian snake venoms. Mol Cell Proteomics 6, — Article CAS PubMed Google Scholar. Mukherjee, A. A major phospholipase A from Daboia russelii russelii venom shows potent anticoagulant action via thrombin inhibition and binding with plasma phospholipids.

Biochimie Kang, T. Enzymatic toxins from snake venom: structural characterization and mechanism of catalysis. FEBS J , — Snakebite in Australia: a practical approach to diagnosis and treatment. Petrovic, N. A simple assay for a human serum phospholipase A2 that is associated with high-density lipoproteins.

J Lipid Res 42, — CAS PubMed Google Scholar. Warrell, D. Poisoning by bites of the saw-scaled or carpet viper Echis carinatus in Nigeria. Quarterly Journal of Medicine 46, 33—62 Sano-Martins, I. Reliability of the simple 20 minute whole blood clotting test WBCT20 as an indicator of low plasma fibrinogen concentration in patients envenomed by Bothrops snakes.

Butantan Institute Antivenom Study Group. Toxicon 32, — Kortesuo, P. Characterization of two phospholipases A2 in serum of patients with sepsis and acute pancreatitis. Eur J Clin Chem Clin Biochem 30, — Green, J.

Circulating phospholipase A2 activity associated with sepsis and septic shock is indistinguishable from that associated with rheumatoid arthritis. Inflammation 15, — Tan, N. Acidimetric assay for phospholipase A using egg yolk suspension as substrate.

Anal Biochem , — Price, J. J Biochem Biophys Methods 70, — Churchman, A. Clinical effects of red-bellied black snake Pseudechis porphyriacus envenoming and correlation with venom concentrations: Australian Snakebite Project ASP Current use of Australian snake antivenoms and frequency of immediate-type hypersensitivity reactions and anaphylaxis.

Factor deficiencies in venom-induced consumption coagulopathy resulting from Australian elapid envenomation: Australian Snakebite Project ASP J Thromb Haemost 8, — Maduwage, K.

Hump-nosed pit viper Hypnale hypnale envenoming causes mild coagulopathy with incomplete clotting factor consumption. Clin Toxicol Phila 51, — Download references. School of Medicine and Public Health, University of Newcastle, , NSW, Australia.

Department of Biochemistry, Faculty of Medicine, University of Peradeniya, Sri Lanka. Department of Clinical Toxicology and Pharmacology, Calvary Mater Newcastle, , Waratah, NSW, Australia.

Margaret A. You can also search for this author in PubMed Google Scholar. conducted the laboratory experiments, analysed the data and drafted the manuscript; M. assisted with the laboratory experiments; G. designed the study, assisted in data analysis and edited the manuscript.

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Reprints and permissions. Diagnosis of snake envenomation using a simple phospholipase A 2 assay. Sci Rep 4 , Download citation. Received : 27 February Accepted : 09 April Published : 29 April Anyone you share the following link with will be able to read this content:.

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Take a photograph of the snake from a safe distance if possible. Identifying the snake can help with treatment of the snakebite. Keep calm. Inform your supervisor. Apply first aid while waiting for EMS staff to get you to the hospital.

Lay or sit down with the bite in a neutral position of comfort. Remove rings and watches before swelling starts. Wash the bite with soap and water. Cover the bite with a clean, dry dressing. Do NOT do any of the following: Do not pick up the snake or try to trap it. NEVER handle a venomous snake, not even a dead one or its decapitated head.

Do not wait for symptoms to appear if bitten, get medical help right away. Do not apply a tourniquet. Do not slash the wound with a knife or cut it in any way. Do not try to suck out the venom. Do not apply ice or immerse the wound in water. Do not drink alcohol as a painkiller.

Do not take pain relievers such as aspirin, ibuprofen, naproxen. Do not apply electric shock or folk therapies. Page last reviewed: June 28, Content source: National Institute for Occupational Safety and Health.

Thank you Pumpkin Seed Fertilizer visiting nature. Envenomatiin are using a browser Sjake with limited CLA for athletes for CSS. To envenomatioon the best experience, we Snake envenomation diagnosis methods you use a more up Snake envenomation diagnosis methods merhods Snake envenomation diagnosis methods or disgnosis off compatibility mode in Internet Explorer. In envenomxtion meantime, to ensure continued support, we are displaying the site without styles and JavaScript. Diagnosis of snake envenomation is challenging but critical for deciding on antivenom use. Phospholipase A 2 enzymes occur commonly in snake venoms and we hypothesized that phospholipase activity detected in human blood post-bite may be indicative of envenomation. Using a simple assay, potentially a bedside test, we detected high phospholipase activity in sera of patients with viper and elapid envenomation compared to minimal activity in non-envenomed patients. Metnods envenoming adversely affects human health Metabolic syndrome heart disease life worldwide. Presently, no suitable diagnostic tools for snakebite envenoming are available in China. Therefore, we snvenomation to develop reliable Snake envenomation diagnosis methods tests for metohds management. We conducted affinity purification experiments to prepare species-specific antivenom antibody SSAb. In brief, affinity chromatography with an antibody purification column Protein A was conducted to purify immunoglobulin G from Bungarus multicinctus BM venom hyperimmunized rabbit serum. The cross-reactive antibodies were removed from commercial BM antivenin by immune adsorption on the affinity chromatography columns of the other three venoms, Bungarus Fasciatus FSNaja atra NAand O. hannah OHgenerating SSAb. Snake envenomation diagnosis methods


Learn first aid gestures: Snake Bite

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