TY  - JOUR
A1  - Faiz, Mohammad Abul
A1  - Ahsan, M. Farid
A1  - Ghose, Aniruddha
A1  - Rahman, M. Ridwanur
A1  - Amin, Robed
A1  - Hossain, Moazzem
A1  - Tareq, Masud N. U.
A1  - Jalil, Mohammad Abdul
A1  - Kuch, Ulrich
A1  - Theakston, R. David G.
A1  - Warrell, David A.
A1  - Harris, John B.
T1  - Bites by the Monocled Cobra, Naja kaouthia, in Chittagong Division, Bangladesh : epidemiology, clinical features of envenoming and management of 70 identified cases
T2  - The American journal of tropical medicine and hygiene
N2  - 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.
Y1  - 2017
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/45759
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-457590
SN  - 1476-1645
SN  - 0002-9637
N1  - This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
VL  - 96
IS  - 4
SP  - 876
EP  - 884
PB  - American Soc. of Tropical Medicine and Hygiene
CY  - Northbrook, Ill.
ER  -