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Background: Snakebite envenomation is a global public health concern, especially in tropical and subtropical regions. We describe the demography, presentations, treatments and outcomes of snakebites from a community snakebite treatment centre in Nepal.

Methods: This was a retrospective study of snakebite cases from 2008 to 2021 presenting in a community-based treatment centre in eastern Nepal.

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Article Synopsis
  • - Hemorrhage is the main cause of preventable death in trauma situations, leading to military and civilian advancements in medical practices, particularly through the use of tourniquets to manage extremity bleeding and save lives.
  • - While tourniquets have significantly decreased deaths from bleeding in military settings, noncompressible hemorrhage still poses a major risk, especially before patients receive definitive medical care.
  • - The study explores using a small, disposable pressure monitor during resuscitative endovascular balloon occlusion of the aorta (REBOA) to enhance blood pressure monitoring, facilitate better resuscitation practices, and reduce the need for blood products in extreme environments.
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Importance: Prophylactic administration of antibiotics before skin incision is an important component in the prevention of periprosthetic joint infection in arthroplasty surgery. For antibiotics to be effective, the local tissue concentration (LTC) must exceed the minimum inhibitory concentration of typical infecting organisms; however, the LTC of cefazolin during arthroplasty is poorly understood.

Objective: To compare the systemic concentration of cefazolin in serum with the LTC in fat, synovium, and bone during primary total knee arthroplasty (TKA) while assessing the effect of tourniquet inflation.

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Background: Post-ischemia reperfusion can lead to oxidative stress and an increase in oxidative markers. Employing preventive strategies and antioxidant agents may help mitigate ischemia-reperfusion injury (IRI). The use of a tourniquet in extremity surgery has been associated with IRI.

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Background: Vancomycin is a prophylactic antibiotic with bactericidal activity against methicillin-resistant that is commonly used in total joint replacement surgery. In total knee arthroplasty (TKA), intraosseous infusions administered following tourniquet inflation have demonstrated improved local vancomycin concentrations with decreased systemic absorption. This administration method results in no adverse reactions locally, as well as equivalent or lower systemic complications compared with other vancomycin administration methods.

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