RESUMO
Introduction: There are 216 species of snakes in India, ofwhich 52 species are poisonous. The most common highlyvenomous snakes are cobra (Najanaja), Russell’s viper(Dabiolarusselii), saw-scaled viper (Echiscarinatus) and thecommon krait (Bungaruscaeruleus). It is estimated that up to20,000 people die annually in India from snake bites. Severityof symptoms is the traditional guideline used to estimate theanti-venom requirement. Study objectives were to assess theclinical profile of snake-bite envenomation, the predictors ofseverity and ASV usage in relation to outcomes in patientsadmitted with snake-bite envenomation to this rural tertiarycare hospital in South India.Material and methods: This was a cross-sectional studyof snakebite patients admitted to this tertiary care hospitalfrom April 2008 to April 2017. The subjects were stratifiedinto two groups based on outcome. The profile of snakebite envenomation was detailed, including demographicdetails, snake-bite information, symptoms, treatment andhospitalisation. The severity was graded based on thetraditional symptom-based grading and using the Snake-biteSeverity Score (SSS). The number of vials of Anti Snake-biteVenom (ASV) administered were compared in relation to theoutcome.Results: Snake bites are more common in summer but themortality is greater in the monsoon season. Out of the 127patients, 119 (93.7%) recovered and were discharged and 8(6.3%) died in hospital. In the symptom-based grading allthe patients with poor outcome were in grades 3 or 4. TheSSS was above 8 in 29 (22.8%) patients, of whom 8 (27.6%)succumbed to the bite. The SSS is a good tool to predictoutcome.Conclusion: The Snake-bite Severity Score is a validatedtool for assessing the extent of envenomation and predictingpatient outcomes following snake-bites. This study wasplanned to find out the clinical profile, symptomatology andpredictors of severity and polyvalent anti snake venom (ASV)usage in relation to outcomes in patients with snake-biteenvenomation.
RESUMO
Background: The objective of the study was to investigate the effect of fenofibrate on acute and subacute models of inflammation in adult male Wistar rats.Methods: After obtaining clearance from Institutional Animal Ethics Committee, six adult male Wistar rats were allocated to each of the three groups i.e. control, aspirin and fenofibrate. Acute inflammation was studied using carrageenan induced rat paw oedema and the volume displacement due to paw oedema was measured using the plethysmograph. Subacute inflammation was studied using foreign body insertion (cotton pellet and grass pith) models. Dry granuloma weight and histopathological examination of the granuloma were the outcome measures for measuring subacute inflammation. The percentage inhibition of inflammation with aspirin and fenofibrate was calculated in both acute and subacute models. The experiments were conducted according to the guidelines of the Committee for the Purpose of Control and Supervision on Experiments on Animals (CPCSEA). The mean volume displacement obtained with a plethysmograph, the mean dry weight of granuloma and the percentage inhibition with aspirin and fenofibrate were analyzed by one way analysis of variance (ANOVA) using Graph pad prism software.Results: Aspirin and fenofibrate significantly reduced both acute and subacute inflammation (p<0.001). Dunnet’s test showed a significant difference in the study groups when compared to the control. The reduction of inflammation with fenofibrate was comparable to aspirin.Conclusions: Oral fenofibrate showed significant anti-inflammatory activity, which was comparable to aspirin, in both acute as well as sub-acute models of inflammation. This anti-inflammatory effect may benefit atherosclerosis in patients receiving fenofibrate for hyperlipidemia.