Correlation between timing of ASV administration and complications in snake bites.

AIMS OF STUDY : The present study was undertaken to study the relationship between the time of anti-snake venom (ASV) administration due to late arrival of patient at hospital and subsequent development of complications. MATERIAL AND METHODS: All patients of snake bite that presented to our institution over a period of 1 1/2 years were included in the present study. A detailed clinical history, clinical examination and investigations were carried out. The patients were administered ASV within 10 minutes of presentation. The bite to needle time (time between the bite and start of ASV) was noted. The patients were then followed up to note any subsequent development of complications. The end-point of the study was normalization of haematological and neurological parameters. RESULTS: Fifty patients became eligible for the study. Twenty patients (40%) had complications while remaining 30 patients (60%) were uncomplicated. An attempt was made to study relationship between bite to needle time and subsequent development of complications. It was found to be significant at 5% level of significance (p<0.05) by chi square test. CONCLUSION: Incidence of complications was directly proportional to the duration of venom in the blood prior to neutralization by ASV due to late arrival of patient at hospital. The early institution of ASV is beneficial in preventing complications however severe is the systemic envenomation.

Carcinoma del páncreas: utilidad de la clasificación histológica y frecuencia de coagulación intravascular diseminada / Carcinoma of the pancreas. Relevance of the histologic classification and frecuency of diseminated intravascular coagulation

Se revisaron 96 casos de autopsia de carcinoma de páncreas con objeto de determinar la relación entre el tipo histológico y el pronóstico. Se estudió además la frecuencia de la coagulación intravascular ddiseminada en este grupo de casos y se comparó con la de un grupo testigo de noplasmas malignas no pancreáticas apareado por edad y sexo. La mayoría de los casos (86.4%) correspondió a adenocarcionomas de los conductos. El tiempo promedio de evoluación fue de 2.8 meses. Con excepción de algunos tumores raros, como el cistadenocarcinoma mucinoso, la clasificación histológica tiene poco valor poruqe el pronóstico es semejante en las distintas variedades. La coagulación intravascular diseminada y las tromboembolias nenosas y de arterias pulmonares fueron más comunes en casos de carcinoma de páncreas que en otras neoplasias malignas (p<0.035 y p>0.001 respectivamente). Esta diferencia se debe problablemente a la mayor producción de substancias tromboplásticas por el carcinoma de páncreas.