RESUMO
Background: The aim of this study is to analyze the clinical profile and outcome of the neurotoxic envenomation in children inJammu region and to identify the species based on the syndromic approach developed by WHO.Materials and Methods: A retrospective hospital record based descriptive study which analyses the case records of childrenreporting to pediatric emergency with signs and symptoms of neurotoxic envenomation.Results: A total of 22 cases of the neurotoxic envenomation reported between April 15 and October 15. These included 14males and 8 females between the age group of 2.5 years and 16 years. The highest incidence of snakebite was observed inthe age group of 4–8 years. A total of seven cases presented neuroparalytic symptoms and local signs suggesting cobra bite.Bite was reported in the afternoon or evening hours between 12.30 pm and 10.30 pm and 83% bites were outdoors. A total of15 children presented with neuroparalytic symptoms with no local signs suggesting krait bite. 86% of the bites were indoor withonset of symptoms between 12 am and 7 am.Conclusion: Both cobra and krait cause neurotoxic envenomation in children in Jammu region with krait bite accounting for 68%of the total cases. Most of these cases are brought to the pediatric emergency late. Training of the peripheral doctors regardingearly recognition of neurotoxic snakebite, species diagnosis as per the WHO syndromic approach, prompt institution of initialmanagement with neostigmine and after visit summary, endotracheal intubations and AMBU bag ventilation, and quick referralto a center with ventilator facility should help in reducing the morbidity and mortality due to krait and cobra bite in children.
RESUMO
Objective To investigate the relationship between serum secreted phospholipase A2 (sPLA2) and the severity of the disease in cobra bite patients. Methods Fifty-two cobra bite patients admitted to our hospital from January 2015 to December 2015 were selected according to the inclusion and exclusion criteria. According to the degree of disease, patients were divided into the light and heavy risk groups. According to the degree of swelling of the affected limbs, patients were divided into the mild swelling group and moderate-severe swelling group. According to the time difference between visits, patients were divided into: visit time <8 h group and visit time ≥ 8 h group. Twenty healthy adult volunteers served as the control group. The levels of serum sPLA2, C reactive protein (CRP), D-dimer (DD), lactic acid (LAC) and peripheral blood leukocyte count (WBC) were measured and compared in different groups. Quantitative data were analyzed using t test and rank sum test. Results The levels of serum sPLA2 in the light and heavy risk group were statistically different from those in the control group (P<0.05), and were statistically significant between the light and heavy risk groups (P<0.01) and between the mild swelling group and moderate-severe swelling group (P<0.05). The serum sPLA2 levels in group A and group B were also significantly different from those in the control group (P<0.05). The level of sPLA2 was positively correlated with the level of LAC, DD and WBC, and the correlation coefficients were 0.3142, 0.2752 and 0.6534, respectively. Conclusions The higher the level of serum sPLA2, the more serious the patient's poisoning symptoms. It is of certain clinical value to evaluate the condition of cobra.