Utility of scorpion antivenin vs prazosin in the management of severe Mesobuthus tamulus (Indian red scorpion) envenoming at rural setting.

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dc.contributor.authorBawaskar, H Sen_US
dc.contributor.authorBawaskar, P Hen_US
dc.date.accessioned2007-01-21en_US
dc.date.accessioned2009-05-31T05:18:21Z
dc.date.available2007-01-21en_US
dc.date.available2009-05-31T05:18:21Z
dc.date.issued2007-01-21en_US
dc.description.abstractBACKGROUND : Scorpion antivenom (SAV) is specific antidote to scorpion venom..SAV did not prevent the cardiovascular morbidity and mortality (autonomic storm), hence its utility in the management for severe scorpion envenomingmay be limited. Since 1983 the advent of prazosin revolutionized the management of severe scorpion sting. Since 2002 SAV against Indian red scorpion (IRS) for the treatment of scorpion sting cases is available at primary health centers. We compared the effects of SAV Vs Prazosin (PRA) in the management of severe scorpion stung cases at rural setting in a non-randomised open label manner. METHODS : From January 2002 to December 2004, 53 patients accidentally stung by scorpion were admitted in hospital at Mahad. Of these 25 patients received intravenous SAV at primary health centers and were referred to Mahad for further management. 28 patients directly reported to Mahad were treated with oral prazosin (PRA). Time interval between sting and hospitalization, the total dose of SAV and PRA administered was noted. Clinical manifestations were noted in a standard protocol. Details of SAV patients were noted from referred letters or in case of a doubt, details were obtained by direct communication with the medical officer who first saw and examined the case. All 53 cases were evaluated clinically for improvement, deterioration or fatal outcome. RESULTS : SAV Vs PRA ( 25 Vs 28) cases reported to hospital within 11/2 -3 (1.4) Vs 1/2-4 (1.3) hours after stung. On arrival 21 (84%) Vs 26 (92%) had hypertension, 2 (8%) Vs 1 (3.5%) had hypotension, 2 (8%)Vs 1 (3.5%) had normal blood pressure. Heart rate 58-102 (82) Vs 48-120 (80.2) respectively. 9 cases received 20 ml, 1 case 30 ml and remaining 15 cases were given 10 ML of SAV on arrival to PHC, while 28 cases received oral prazosin. 20 (80%) Vs 2 (7.5%) had acute pulmonary edema, 5 (20%) Vs 8 (30%) had persistent raised blood pressure. 4 (16%) Vs 0% died. Recovery time was 11-4 (2.26) Vs 1-2 (1.25) days respectively. CONCLUSION : We found that SAV is no more effective to alleviate or reverse the cardiovascular effects of scorpion venom actions in severe case as against prazosin prevents and cures the cardiovascular manifestations in a severe scorpion envenomation. Therefore role of SAV in severe scorpoin venomation needs to be relooked and prazosin needs to be a standard of care in such cases to overcome the autonomic storm.en_US
dc.description.affiliationBawaskar Hospital and Research Center, Mahad, Dist-Raigad Maharashtra, India 402 301.en_US
dc.identifier.citationBawaskar HS, Bawaskar PH. Utility of scorpion antivenin vs prazosin in the management of severe Mesobuthus tamulus (Indian red scorpion) envenoming at rural setting. Journal of the Association of Physicians of India. 2007 Jan; 55(): 14-21en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/95467
dc.language.isoengen_US
dc.source.urihttps://www.japi.orgen_US
dc.subject.meshAdolescenten_US
dc.subject.meshAdrenergic alpha-Antagonists --therapeutic useen_US
dc.subject.meshAdulten_US
dc.subject.meshAnimalsen_US
dc.subject.meshAntivenins --therapeutic useen_US
dc.subject.meshArachnidism --physiopathologyen_US
dc.subject.meshChilden_US
dc.subject.meshChild, Preschoolen_US
dc.subject.meshFemaleen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshPrazosin --therapeutic useen_US
dc.subject.meshRural Populationen_US
dc.subject.meshScorpion Venoms --antagonists & inhibitorsen_US
dc.subject.meshScorpionsen_US
dc.titleUtility of scorpion antivenin vs prazosin in the management of severe Mesobuthus tamulus (Indian red scorpion) envenoming at rural setting.en_US
dc.typeCase Reportsen_US
dc.typeClinical Trialen_US
dc.typeJournal Articleen_US
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