The demographics, epidemiology, first aid, clinical management, treatment and outcome of snake bites causing no significant signs of systemic envenoming were documented in Chittagong Medical College Hospital, Bangladesh, between May 1999 and October 2002. Among 884 patients admitted, 350 were systemically envenomed and 534 were without signs of either systemic or significant local envenoming. The average age of patients with physical evidence of snake bite but no systemic envenoming was 26.4 years. Most had been bitten on their feet or hands. Ligatures had been applied proximal to the bite site in >95% of cases and the bite site had been incised in 13%. Patients were typically discharged at 24h. Those with clinical signs of systemic envenoming resembled the non-envenomed cases demographically and epidemiologically except that they arrived at hospital significantly later than non-envenomed patients, having spent longer with traditional healers. No non-envenomed patient was treated with antivenom and none went on to develop symptoms of systemic envenoming after discharge. The potential complications and confusing signs caused by ligatures and incision demand that all patients admitted with a history of snake bite be kept under observation for 24h after admission even if they have no signs of systemic envenoming.
We describe 70 cases of monocled cobra (Naja kaouthia) bite admitted to Chittagong Medical College Hospital, Bangladesh. The biting snakes were identified by examining the dead snake and/or detecting N. kaouthia venom antigens in patients' serum. Bites were most common in the early morning and evening during the monsoon (May–July). Ligatures were routinely applied to the bitten limb before admission. Thirty-seven patients consulted traditional healers, most of whom made incisions around the bite site. Fifty-eight patients experienced severe neurotoxicity and most suffered swelling and pain of the bitten limb. The use of an Indian polyvalent antivenom in patients exhibiting severe neurotoxicity resulted in clinical improvement but most patients experienced moderate-to-severe adverse reactions. Antivenom did not influence local blistering and necrosis appearing in 19 patients; 12 required debridement. Edrophonium significantly improved the ability of patients to open the eyes, endurance of upward gaze, and peak expiratory flow rate suggesting that a longer-acting anticholinesterase drug (neostigmine) could be recommended for first aid. The study suggested that regionally appropriate antivenom should be raised against the venoms of the major envenoming species of Bangladesh and highlighted the need to improve the training of staff of local medical centers and to invest in the basic health infrastructure in rural communities.
We studied crop damage and human-langur conflicts in six villages of Keshabpur upazila in the Jessore district of Bangladesh from September 2009 to August 2010. Data were collected by interviewing local people with a questionnaire. We discuss the attitudes of locals towards crop damage inflicted by the common langur (Semnopithecus entellus). We analysed local deterrent methods for reducing crop damage and the management strategy adopted by the Forest Department to conserve langurs. Thus, we investigated how demographic variables were associated with the perceptions of locals towards crop damage and conflicts. A total of 27 different crop species were cultivated across the villages, among which langurs mostly damaged fruits. Although most damage occurred during the fruiting season langurs damaged crops throughout the year. Around 55 % of the respondents reported that the local deterring methods were effective but that they affect their children's education and economy. Furthermore, almost 59 % of the respondents were tolerable towards the langur damage. People living in villages with a high langur population and where weak conservation methods were used reported greater crop damage than their counterparts. A linear regression analysis revealed that the occupation, landholding status, and ethical and religious beliefs of the people included in this study has a significant impact on their attitudes regarding conservation. Therefore, there is an urgent need to implement conservation measures to mitigate human-langur conflicts as well as to conserve common langurs in areas where humans and langurs coexist.
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