Ophthalmic Injuries from a Spitting Chinese Cobra

Fung, HT; Choy, C H; Lau, KH; Lam, Tsk

doi:10.1177/102490790901600105

Cited by 5 publications

(4 citation statements)

References 6 publications

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“…Although the medical literature is not short of TCM adverse reactions, most were only case reports of severe cases. [2][3][4] Our study suggested that most of the reactions were actually mild. However, the complete adverse reaction profile of TCM can only be studied prospectively with the cooperation of Chinese Medicine practitioners and Chinese Medicine pharmacists.…”

Section: Discussionmentioning

confidence: 61%

Traditional Chinese Medicine Use among Emergency Patients in Hong Kong

Tse¹,

Lau²

2007

Hong Kong Journal of Emergency Medicine

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Traditional Chinese Medicine (TCM) use has been believed to be common in Hong Kong but no data existed on its prevalence among emergency patients. We conducted a prospective survey to study the prevalence of its use, the type of TCM use, frequency and nature of associated adverse reactions. Methods: All accident & emergency department (AED) attendances at the United Christian Hospital were screened by the triage nurse and attending doctor for TCM use and its type in a consecutive 31 day period. The causal relationships between the TCM and their presenting illness were also assessed and decided by the doctor in-charge. Results: 291 out of 21,475 patients (1.4%) reported TCM use within one week. Among them, 117 (40.2%) consumed Chinese herbal medicine, 75 (25.8%) took proprietary Chinese medicine, 1 (0.3%) took both, 96 (33.0%) received topical treatment and 2 (0.7%) were unclassified, with 22 out of the 291 TCM users (7.6%) presented for TCM-related toxicity. Most complications were mild, the commonest ones being dermatitis after topical treatment (68.2%) and allergic reaction after oral intake (22.7%). Conclusion: A small number of patients took TCM treatment shortly before AED consultation. Most TCMrelated toxicities were mild and the commonest reactions were dermatitis and systemic allergy. (Hong Kong

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Section: Discussionmentioning

confidence: 61%

Traditional Chinese Medicine Use among Emergency Patients in Hong Kong

Tse¹,

Lau²

2007

Hong Kong Journal of Emergency Medicine

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“…Moreover, the venom of the Naja n. nigricollis consists of phospholipase A 2 (an anticoagulant enzyme which inhibits the prothrombinase complex by its binding to coagulation factor Xa) [ 9 , 10 ] and cardiotoxin [ 11 ]. Furthermore, in some cases envenoming by Naja n. nigricollis can induce corneal ulceration and anterior uveitis [ 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

Antisnake Venom Activity ofHibiscus aethiopicusL. againstEchis ocellatusandNaja n. nigricollis

Hasson

Al-Jabri

Sallam

et al. 2010

Journal of Toxicology

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The objective of the study is to investigate whether the Hibiscus aethiopicus L. plant has neutralization activity against venoms of two clinically important snakes. The H. aethiopicus was dried and extracted with water. Different assays were performed to evaluate the plant's acute toxicity and its anti-snake venom activities. The results showed that H. aethiopicus extract alone had no effect on the viability of C2C12 muscle cells, but significantly (P < .05) protected muscle cells against the toxic effects of E. ocellatus venom at 55, 150, and 300 μg/mL. The maximum protective effect of the extract was exhibited at 75 μg/mL. The extract significantly (P < .001) inhibited the cytotoxic effects of E. ocellatus venom at 300 μg/mL. All rabbits (n = 10) and guinea pigs (n = 10) were alive after the two weeks of given the lethal dosage 16 g/Kg of the H. aethiopicus extract herbal solution. No abnormal behaviour was observed of both groups of animals. All guinea pigs (n = 3) treated with venoms alone (5 mg/kg) died. However, all guinea pigs (n = 21) treated with venom (5 mg/kg) and the extract (400 to 1000 mg/kg) survived. Guinea pigs (n = 3) treated with Naja n. nigricollis venom alone (2.5 mg/kg) and guinea pigs (n = 21) venom with the extract (400 to 1000 mg/kg) died. The H. aethiopicus completely (100%) blocked the haemorrhagic activity of E. ocellatus in the egg embryo at 3.3 mg/mL of extract. These findings suggest that H. aethiopicus may contain an endogenous inhibitor of venom-induced haemorrhage.

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“…Despite this, PLA 2 alone does not typically cause visible ocular effects. In fact, it has been suggested that PLA 2 and CTXs work synergistically to induce pain and ocular damage [ 18 , 19 ]. Therefore, when cobra venom toxins come into contact with the eye, they can penetrate through the corneal epithelium and bind to the stroma.…”

Section: Case Discussionmentioning

confidence: 99%

Ashes to eye: A skilled snake handler’s experience with ophthalmic envenomation

Williams¹,

Moejes

Williams

et al. 2023

PLoS Negl Trop Dis

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With the continued growth of human populations, rural urbanisation and habitat degradation are on the rise, resulting in the displacement of native wildlife and an increase in human-wildlife conflicts. The presence of human habitation and waste often attracts rodents and thereby, snakes, leading to increased snake sightings in homes. To address this problem, snake handlers, who are volunteers that remove and relocate snakes away from human development areas, are called upon. However, snake removal is a high-risk task that poses a risk of envenomation, particularly when dealing with spitting snakes. Several cobra species have the ability to spit venom. If the venom enters a person’s eye, it can result in ophthalmic envenomation, which can have serious consequences for their eyesight. Therefore, snake handlers should take precautions, wear suitable eye protection, and use appropriate tools to ensure their safety and that of the snake. In this case, an experienced snake handler was called to remove a spitting cobra, but they were ill-equipped. During the removal, the venom was sprayed across the handler’s face, and some of it entered their eye, resulting in ophthalmic envenomation. The handler promptly irrigated their eye, but medical treatment was still necessary. This report highlights the risks and consequences of ophthalmic injury and the importance of wearing appropriate eye protection and taking due care when dealing with venomous species, particularly those that can spit venom. It serves as a reminder that accidents can happen at any time and experienced snake handlers are not exempt from the risks.

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Ophthalmic Injuries from a Spitting Chinese Cobra

Cited by 5 publications

References 6 publications

Traditional Chinese Medicine Use among Emergency Patients in Hong Kong

Traditional Chinese Medicine Use among Emergency Patients in Hong Kong

Antisnake Venom Activity ofHibiscus aethiopicusL. againstEchis ocellatusandNaja n. nigricollis

Ashes to eye: A skilled snake handler’s experience with ophthalmic envenomation

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