Introduction:In North India snake bite deaths are predominantly seen with neurotoxic envenomations (NEs) whereas in South India the hemotoxic envenomation (HE) is more common. Krait is responsible for most deaths in North India. It bites people sleeping on the floors, mostly at night. We describe the profile of venomous snake bites over 1 year in 2013.Materials and Methods:The study was conducted in a rural tertiary care hospital in North India. Demographics, circumstances of bite, envenomation, first aid, delay, consultation, treatment, anti-venom, and outcomes were recorded for all victims of snake bite. We included all consecutive adult (>18 years) venomous snake bite victims admitted from January to December 2013.Results:A total of 91 patients with venomous snake bites were included in the study. Pure NEs were 41 (45.1%), pure HE in 31 (34.1%), 7 (7.7%) had mixed NE + HE, and 12 (13.2%) had only local swelling. Forty patients (44%) were bitten during sleep presenting as NE (92.5%), NE + HE (5%), and HE (2.5%). Findings in the 51 patients (56%) bitten during activity were HE (58.8%), local swelling (23.5%), NE + HE (9.8%), and NE (7.8%) (P < 0.0001). First aid was sought by 24 NE patients out of which 23 (96%) went to alternate practitioners or religious healers.Conclusion:Almost all (97.5%) bites during sleep resulted in NE in our study. About 96% of NE sought first aid from alternate practitioners or religious healers in hope of some magical treatment. Thus, a deadly combination of krait bite during sleep and wrong health seeking behavior is responsible for high mortality krait bites in this region. Mass public awareness regarding krait bites can prevent mortality in many such cases.
Reddish black discoloration of urine in absence of red blood cells (RBCs) can be a manifestation of hemoglobinuria or myoglobinuria. We report a patient who was admitted for persistent vomiting. On 2nd day of admission, his urine turned reddish black. The patient then revealed that he had ingested mothballs 1 day back to commit suicide. The patient was managed conservatively with intravenous (IV) fluids and antiemetics. Mothballs are rarely reported as a suicidal agent and most cases are related to accidental exposure of children while playing. IV hemolysis is also reported with mothball ingestion. Our patient quickly became normal within 24 h and there was no residual organ damage.
The Himachal Pradesh acute coronary syndrome registry highlighted a prehospital delay of 780 min. Additional door-to-needle time delay by 1 h increases the hazard ratio of death by 20%. We conducted a retrospective (group 1) and a prospective (group 2) analysis of 63 patients each to measure the impact of a fast-track protocol in the emergency department (ED) on the door-to-needle time in ST-elevation myocardial infarction (STEMI). The fast-track protocol involved zero cost to the hospital and saved 63 precious door-to-needle minutes for patients with STEMI. Thrombolysis in ED can save 33 precious minutes wasted in shifting patients to the coronary care unit.
Objective:Fetal microchimerism during pregnancy and abortion has been linked with autoimmune hypothyroidism in females. We conducted a case–control study to investigate the odds of “abortion in the past” in the newly diagnosed hypothyroid females compared to their age-matched euthyroid controls.Methods:All consecutive newly diagnosed hypothyroid females, over 1 year, were enrolled as cases. Age-matched euthyroid controls were selected from the same region. The exposure variable tested was “past history of abortion (elective or therapeutic).”Results:Totally, 120 cases and 172 controls were recruited over 1 year with a mean age of 42.2 ± 9.8 years and 41.1 ± 12.4 years, respectively. The exposure variable (abortion) was present in 71 (59%) cases and 10 (6%) controls. Odds ratio (OR): 23.5 (12.2–48.9) P < 0.0001. Autoimmunity, based on thyroid peroxidase (TPO) positivity (TPO levels ≥30 U/ml), was present in 92 (77%) of the cases; TPO was negative in 28 (33%) of cases. The exposure variable was documented in 62.4% and 50% of TPO positive and negative cases, respectively (P = 0.28).Discussion and Conclusion:The study suggests that abortion (elective or therapeutic) in the past is strongly associated with newly diagnosed hypothyroidism in females aged 42.2 ± 9.8 years; OR: 23.5 (P < 0.0001). Interestingly, abortion was associated with both, TPO positive and negative hypothyroidism.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.