ABSTRACT
Background: Snakes are poikilothermic carnivorous reptiles that have evolved the venomous apparatus for the purpose of procurement of food. Snake bite can result in local and systemic complications. Major systemic complications include acute renal failure, neurologic abnormalities requiring ventilator support and disseminated intravascular coagulation. Disseminated intravascular coagulation can result in serious life-threatening systemic complications like haemorrhage, infarction and even death if the treatment is delayed. The present study was undertaken to study the clinical profile of the snake bite patients who develop coagulopathy and to study the role of coagulation markers to evaluate the morbidity and mortality of snake bite victims.Methods: Hundred patients consecutively admitted with history of snakebite were studied. Patients who have developed local signs of envenomation due to snake bite were included in the study group. The coagulation profile was assessed by doing blood investigations.Results: In this study, patients who developed coagulopathy had prolonged hospital stay and requirement of more blood products transfusion causing increased morbidity. 43 patients (35.8%) had platelets less than 1 lakh and approximately hospitalized for 26 days sand INR was more than 1.5 in 112 patients (93.3%) and hospitalized for 22 days and they received fresh frozen plasma. The survival rate in this study was 86% followed by 13.3% deaths.Conclusions: Use of clinical and laboratory parameter evaluation needed to identify the coagulopathy very early to reduce the hospital stay and mortality.
ABSTRACT
Background: Myocardial Infarction (MI) is the term given for a state of myocardial necrosis which is secondary to an acute interruption of the coronary blood supply. Severity is dependent on level of occlusion, length of time of occlusion and presence or absence of collateral circulation. Myocardial infarction is now considered part of a spectrum referred to as acute coronary syndrome. It is a spectrum of acute myocardial ischemia that also includes unstable angina (STEMI) and non-ST segment elevation myocardial infarction (NSTEMI). The changes in serum electrolytes were studied in this study with a special focus on sodium and potassium serum levels in patients suffering from AMI. Hence, the aim of the study was to examine the changes in serum electrolytes among AMI patients and then comparison was done with the healthy persons.Methods: The study comprised of 80 subjects, which were divided equally into study group and control group. The study group comprised cases of confirmed diagnosis of recent onset of AMI. Clinical data was collected using interviewing questionnaires. The blood samples of both groups were analysed for serum electrolytes (Na+, K+, Cl-, Ca+ and Mg+) with the help of ion sensitive electrode analyser along with quality control sera.Results: There was statistically significant decrease in sodium and potassium levels in AMI patients. It was found that there was decrease in sodium serum levels in AMI patients suffering with hypertension. Potassium levels were increased in AMI patients suffering from Diabetes Mellitus and Hypertension, which was found to be statistically significant.Conclusions: Hyponatremia and hypokalemia are indicators of acute myocardial infarction. Serum sodium and potassium levels are prognostic indicators, i.e., rise in sodium levels after initial fall was indicative of clinical improvement. Therefore, estimation of sodium and potassium level in acute MI patients can help assess their prognosis.