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Snakebite envenoming in Kerala, South India: clinical profile and factors involved in adverse outcomes
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  • Published on:
    Re: Snakebite envenoming in Kerala

    Author’s reply:

    The opinion by Dr. S K Munshi and Dr. M Chauhan is very relevant, considering the low prevalence rate of snakebite envenoming in most of the developed countries including the UK. The London School of Hygiene & Tropical Medicine offers masters degree (MSc) in Tropical Medicine & International Health, but the training does not include learning about this important biohazard that is common i...

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    Conflict of Interest:
    None declared.
  • Published on:
    Re: Polyvenin for snake bites

    Author’s reply:

    The use of species-specific snake antivenom is more scientific, as suggested by Prof. Balasundaram, whenever correct species identification of the offender snake is possible. But species identification may not be possible in many cases of snakebites as observed in our study (65.5%). Species-specific antivenom is not freely available in India and the majority of centers use polyvalent antivenom f...

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    Conflict of Interest:
    None declared.
  • Published on:
    Re: Ventricular tachycardia following snake bite envenoming

    Author’s reply:

    The concept of door to needle time/ medical contact to needle time in the treatment snakebite envenoming proposed by Prof. J Francis is important. All the patients who reached the emergency department of our institution directly, with clinical and laboratory evidence of envenoming at the time of arrival, received antivenom as soon as the diagnosis of envenoming was made. Hence the medical contac...

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    Conflict of Interest:
    None declared.
  • Published on:
    Ventricular tachycardia following snake bite envenoming

    Dear Editor,

    Read with interest the original article by Suchithra et al on "Snakebite envenoming in Kerala, South India: clinical profile and factors involved in adverse outcomes". The concept of bite to needle time is quite interesting and informative. The authors found a positive correlation between lower bite to needle time and prognosis. What about the door to needle time / medical contact to needle time? Thi...

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    Conflict of Interest:
    None declared.
  • Published on:
    Snakebite envenoming in Kerala
    • Sunil Munshi, Physician
    • Other Contributors:
      • Sunil K Munshi, Maya Chauhan

    My congratulations to N Suchithra, J M Pappachan and P Sujathan for a brilliant and highly informative article(Emerg. Med. J. 2008;25;200-204)by N Suchithra, J M Pappachan and P Sujathan on this very important topic. Physicians in the west have a very little idea of this aspect of Tropical Medicine and it is very important that institutions teaching and training people in Tropical Medicine in the UK encourage trainees to s...

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    Conflict of Interest:
    None declared.
  • Published on:
    Polyvenin for snake bites

    In my experience in treating snake bites, especially the Malaysian pit viper in the sixties in Kelantan State, it is importnat to make more use of specific anti-venins rather than polyvenins. The latter are known to cause allergic reactions to the horse serum used, delay more specific therapy and poorer outcome. Where the identification of snakes is not possible, clinical features as well as the known prevalence of type...

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    Conflict of Interest:
    None declared.