Determinants of seeking or foregoing allopathic treatment after snakebite: a population-based study from rural Sri Lanka.

Background: Despite the availability of antivenom, not all snakebite victims choose to seek allopathic care. This choice of care is likely to be determined by unexplored personal and external factors. We studied the factors influencing the choice of treatment and first aid measures among snakebite victims.

Lack of controlled studies on snakebite prevention: a rapid review.

Globally, snakebites cause an estimated 80 000-140 000 deaths annually. While there are evidence-based recommendations for managing snakebite victims, recommendations on the prevention of snakebites are limited to expert opinions. We conducted a rapid review to summarise evidence from human studies with a control group on preventing snakebites.

The use of rotational thromboelastometry parameters in understanding the coagulopathy following hump-nosed viper (Hypnale spp) bites: a preliminary study.

Background: Hump-nosed vipers (HNV; Hypnale spp) are one of the medically important venomous snakes in Sri Lanka and South-Western regions of India. The haemostatic dysfunction due to HNV bites is poorly characterized by standard diagnostic tests performed to identify coagulopathy. We aimed to determine the usefulness of rotational thromboelastometry (ROTEM) parameters compared to 20-minute whole blood clotting test (WBCT20) and prothrombin time (PT) in understanding the coagulopathy of HNV bites.

Acute poisoning with acetamiprid: a case report.

Background: Acetamiprid is a potent new first-generation neonicotinoid insecticide in agricultural practices. It is well described that it has low toxicity among animals and is lethal if consumed in large amounts. However, toxicity in humans is rarely reported in literature.

Knowledge on prevention, diagnosis and treatment of snakebite envenoming among doctors in snakebite-dense regions in Sri Lanka.

Background: Sri Lanka is one of the highest envenoming reporting countries globally with >80 000 snakebites per year. Among other factors, knowledge of snakebite among doctors predominantly determines patient outcomes.

Methods: Using a pretested 72-item self-administered questionnaire, we assessed knowledge on identifying common snake species, signs of envenoming and management of venomous snakebites among 280 doctors working in eight state hospitals in regions where snakebite prevalence is highest in Sri Lanka.

Saw-scaled viper envenoming complicated with acute myocardial infarction.

The saw-scaled viper () is considered to be a venomous snake which is especially seen in Northern Sri Lanka. Systemic manifestations are rare and reported complications include coagulopathy and renal impairment. The cardiac toxicity following snakebites is rare and cardiac involvement following the saw-scaled viper bites is extremely rare.

Comparison of rotational thromboelastometry parameters with 20-minute whole blood clotting test as a predictor of envenoming in Russell's viper bite patients.

Background: Coagulopathy is an important and common systemic clinical syndrome caused by snake envenoming. The major clinical effect of Russell's viper (RV) envenoming is haematotoxicity. The 20-min whole blood clotting test (WBCT20) is the standard test for identification of envenoming in resource-limited settings.

Prevalence, vulnerability and epidemiological characteristics of snakebite in agricultural settings in rural Sri Lanka: A population-based study from South Asia.

Background: The burden of snakebite remains poorly characterised because of the paucity of population-based data. Further, factors determining the vulnerability of individuals within rural communities to snakebite have been rarely investigated. We undertook a population-based study to determine the prevalence, vulnerability and epidemiological characteristics of snakebite in rural Sri Lanka.

Thrombotic microangiopathy following hump-nosed viper ' envenomation.

The hump-nosed vipers which compromise ' and have been highly venomous snakes and and are indigenous to Sri Lanka and is endemic to Sri Lanka and India. The clinical presentations range from local swelling, blistering and necrosis at the site of bite with distinct fang marks to systemic envenomations such as coagulopathy, thrombotic microangiopathy, acute kidney injury and death in severe cases. Here, we report a case of thrombotic microangiopathy following hump-nosed viper ' bite.

Severe acute kidney injury following Sri Lankan spp. envenoming is associated with thrombotic microangiopathy.

Context: Acute kidney injury (AKI) is the most serious clinical manifestation of the Sri Lankan hump-nosed pit viper ( spp.) bites. Thrombotic microangiopathy (TMA) is increasingly recognized in association with AKI in cases of spp envenomation.

Adjunct treatment in snakebite envenoming: a systematic review of randomised controlled trials.

Adjunct therapy in snakebite may be lifesaving if administered appropriately or can be harmful if non-judicious use leads to avoidable delays in administering antivenom. This systematic review analyses the evidence from randomised controlled trials (RCTs) on the efficacy of adjunct treatment administered with antivenom. PubMed, EMBASE, Scopus, Cochrane library and CINAHL were searched for RCTs enrolling patients with snakebite envenoming where a treatment other than antivenom has been assessed for its efficacy within the last 25 y.

Health in rural Sri Lanka: A cross-sectional survey of three rural districts.

Introduction: Sri Lanka has a predominantly rural population. However, there is a dearth of research on health and socioeconomic issues in this group.

Objective: To describe basic socioeconomic characteristics and health profile in a rural population.

Thrombotic microangiopathy and acute kidney injury following Sri Lankan and species envenoming.

Thrombotic microangiopathy (TMA) resulting in acute kidney injury (AKI) is an important complication of venomous snakebites. We aimed to describe TMA secondary to Russell's viper () and hump-nosed viper ( spp.) bites and assess the effect of different treatments.

Determination of the sub-lethal nephrotoxic dose of Russell's viper (Daboia russelii) venom in Wistar rats.

Wistar rats were administered increasing doses of Russell's viper venom (RVV; 0.025-0.4 mg/kg) intraperitoneally to investigate acute kidney injury (AKI) by measuring creatinine (1.

Long-term health complications following snake envenoming.

Background: Snakebite is an important public health problem in tropical regions of the world. Although devastating effects of envenoming such as kidney failure, tissue necrosis, bleeding diathesis, and neurotoxicity are well known in the acute stage following a snakebite, the long-term effects of snake envenoming have not been adequately studied.

Materials And Methods: A population-based study was conducted among 8707 residents in a rural district in Sri Lanka to assess the long-term sequelae following snakebite.

Venomics of Bungarus caeruleus (Indian krait): Comparable venom profiles, variable immunoreactivities among specimens from Sri Lanka, India and Pakistan.

Unlabelled: The Indian krait (Bungarus caeruleus) is one of the "Big Four" venomous snakes widely distributed in South Asia. The present venomic study reveals that its venom (Sri Lankan origin) is predominated by phospholipases A (64.5% of total proteins), in which at least 4.

Management of scorpion envenoming: a systematic review and meta-analysis of controlled clinical trials.

Background: Scorpion stings cause an estimated 3000 deaths per annum worldwide. We conducted a systematic review of all controlled clinical trials related to scorpion sting management.

Methods: We searched PubMed, EMBASE, Scopus, Web of Science and CINAHL and included controlled prospective clinical trials (randomized or non-randomized).

Prevention of krait bites by sleeping above ground: preliminary results from an observational pilot study.

Introduction: Neurotoxic envenoming following the bites of kraits ( spp.) is a common cause of death in the dry zone of Sri Lanka and elsewhere in South Asia. Most of these bites occur at night and are inflicted on people sleeping on the ground.

Chronic Musculoskeletal Disabilities following Snake Envenoming in Sri Lanka: A Population-Based Study.

Background: Snakebite is a major public health problem in agricultural communities in the tropics leading to acute local and systemic impairments with resultant disabilities. Snakebite related long-term musculoskeletal disabilities have been a neglected area of research. We conducted a population-based, cross-sectional study in an agricultural community to describe the chronic musculoskeletal disabilities of snake envenoming.

Plasmodium falciparum and Mycoplasma pneumoniae co-infection presenting with cerebral malaria manifesting orofacial dyskinesia and haemophagocytic lymphohistiocytosis.

Background: Malaria is a mosquito-borne infectious disease with diverse clinical manifestations caused by a parasitic protozoan of the genus Plasmodium. Complex inter-relationships between Mycoplasma species and Plasmodium parasites have been previously noted in vitro. This is the first report of Plasmodium falciparum and Mycoplasma pneumoniae co-infection in a human host presenting with cerebral malaria manifesting orofacial dyskinesias and haemophagocytic lymphohistiocytosis.

Pulmonary effects and complications of snakebites.

This review is on the pulmonary complications of snakebites, which can have fatal consequences. We identified three common themes as reported in the literature regarding envenomation: generalized neuromuscular paralysis affecting airway and respiratory muscles, pulmonary edema, and pulmonary hemorrhages or thrombosis due to coagulopathy. Respiratory paralysis and pulmonary edema can be due to either elapid or viper bites, whereas pulmonary complications of coagulopathy are exclusively reported with viper bites.

Exchange transfusion can be life-saving in severe propanil poisoning: a case report.

Background: Propanil is an important cause of herbicide poisoning in Sri Lanka, accounting for about 2% of all cases of self-poisoning. The outcome is extremely poor when the poisoning is severe and current medical care is of limited efficacy. Death usually occurs due to the severe and prolonged methaemoglobinaemia.

Presumptive thrombotic thrombocytopenic purpura following a hump-nosed viper (Hypnale hypnale) bite: a case report.

Hump-nosed viper bites are frequent in southern India and Sri Lanka. However, the published literature on this snakebite is limited and its venom composition is not well characterized. In this case, we report a patient with thrombotic thrombocytopenic purpura-like syndrome following envenoming which, to the best of our knowledge, has not been reported in the literature before.

Saw-scaled viper bites in Sri Lanka: is it a different subspecies? Clinical evidence from an authenticated case series.

The saw-scaled viper (SSV) (Echis carinatus) is considered to be a highly venomous snake in Sri Lanka despite any published clinical justification. Being a rarity, the clinical profile of SSV bites is not well established in Sri Lanka. We report a series of 48 (n-48) SSV bites from the Northern Province of Sri Lanka.

Complications and management of acute copper sulphate poisoning; a case discussion.

Copper sulphate ingestion (accidental or deliberate) is a rare form of poisoning usually limited to the Indian subcontinent. Though the rates are on the decline, it is essential that physicians are aware of its lethal complications and management strategies. The main complications of copper sulphate ingestion include intravascular haemolysis, methaemoglobinaemia, acute kidney injury and rhabdomyolysis.