An Unusual Presentation of Vasculotoxic Snake Bite.

In India, viper bites are more common than any other poisonous snake bites. In these patients, the cardinal features are local pain, swelling and mild coagulation abnormalities; but gangrenous changes involving bilateral upper and lower limbs are uncommon. We are reporting a case of a 62-year-old man bitten by a Russell viper on the right thumb. He experienced local pain, swelling and later developed disseminated intravascular coagulopathy, pre-renal azotemia, sepsis, acute respiratory distress syndrome (ARDS) and peripheral gangrenous changes involving bilateral upper and lower limbs. He succumbed to his ailment 5 months after the bite. There have been very few cases of gangrenous changes involving distal part of extremities associated with snake bite.

Long-term Survival in Tricuspid Atresia after Palliative Surgery

Here we report a rare case of tricuspid atresia. A 46 years old male treated palliatively by pulmonary artery banding. Patient is still surviving and is almost asymptomatic with limited exertion for so many years in spite of chronic hypoxia.