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The Effect of a Polyvalent Antivenom on the Serum Venom Antigen Levels of Naja sputatrix (Javan Spitting Cobra) Venom in Experimentally Envenomed Rabbits

Yap MK, Tan NH, Sim SM, Fung SY, Tan CH

Basic Clin Pharmacol Toxicol, 2015 Oct;117(4):274-9.
PMID: 25819552 DOI: 10.1111/bcpt.12398

The treatment protocol of antivenom in snake envenomation remains largely empirical, partly due to the insufficient knowledge of the pharmacokinetics of snake venoms and the effects of antivenoms on the blood venom levels in victims. In this study, we investigated the effect of a polyvalent antivenom on the serum venom antigen levels of Naja sputatrix (Javan spitting cobra) venom in experimentally envenomed rabbits. Intravenous infusion of 4 ml of Neuro Polyvalent Snake Antivenom [NPAV, F(ab')2 ] at 1 hr after envenomation caused a sharp decline of the serum venom antigen levels, followed by transient resurgence an hour later. The venom antigen resurgence was unlikely to be due to the mismatch of pharmacokinetics between the F(ab')2 and venom antigens, as the terminal half-life and volume of distribution of the F(ab')2 in serum were comparable to that of venom antigens (p > 0.05). Infusion of an additional 2 ml of NPAV was able to prevent resurgence of the serum venom antigen level, resulting in a substantial decrease (67.1%) of the total amount of circulating venom antigens over time course of envenomation. Our results showed that the neutralization potency of NPAV determined by neutralization assay in mice may not be an adequate indicator of its capability to modulate venom kinetics in relation to its in vivo efficacy to neutralize venom toxicity. The findings also support the recommendation of giving high initial dose of NPAV in cobra envenomation, with repeated doses as clinically indicated in the presence of rebound antigenemia and symptom recurrence.

Matched MeSH terms: Snake Bites/blood; Snake Bites/drug therapy*; Snake Bites/immunology
Antivenom in sea-snake bit poisoning

Reid HA

Lancet, 1975 Mar 15;1(7907):622-3.
PMID: 47960

Among a series of 101 patients bitten by sea-snakes in Malaya in the years 1957-64, 80% were fishermen. Bathers and divers are occasionally bitten. Before sea-snake antivenom became available the mortality-rate (despite the high toxicity of sea-snake venom) was only 10%; however, of 11 with serious poisoning, 6 died. Subsequently 10 patients with serious poisoning received specific sea-snake antivenom; 2 patients, admitted moribund, temporarily improved but died, and 8 patients recovered dramatically. In serious poisoning the suitable dosage of intravenous sea-snake antivenom is 3000-10,000 units; in mild poisoning 1000-2000 units should suffice.

Matched MeSH terms: Snake Bites/drug therapy; Snake Bites/enzymology; Snake Bites/mortality
Hugh Alistair Reid OBE MD: investigation and treatment of snake bite

Hawgood BJ

Toxicon, 1998 Mar;36(3):431-46.
PMID: 9637363

Alistair Reid was an outstanding clinician, epidemiologist and scientist. At the Penang General Hospital, Malaya, his careful observation of sea snake poisoning revealed that sea snake venoms were myotoxic in man leading to generalized rhabdomyolysis, and were not neurotoxic as observed in animals. In 1961, Reid founded and became the first Honorary Director of the Penang Institute of Snake and Venom Research. Effective treatment of sea snake poisoning required specific antivenom which was produced at the Commonwealth Serum Laboratories in Melbourne from Enhydrina schistosa venom supplied by the Institute. From the low frequency of envenoming following bites, Reid concluded that snakes on the defensive when biting man seldom injected much venom. He provided clinical guidelines to assess the degree of envenoming, and the correct dose of specific antivenom to be used in the treatment of snake bite in Malaya. Reid demonstrated that the non-clotting blood of patients bitten by the pit viper, Calloselasma rhodostoma [Ancistrodon rhodostoma] was due to venom-induced defibrination. From his clinical experience of these patients, Reid suggested that a defibrinating derivative of C. rhodostoma venom might have a useful role in the treatment of deep vein thrombosis. This led to Arvin (ancrod) being used clinically from 1968. After leaving Malaya in 1964, Alistair Reid joined the staff of the Liverpool School of Tropical Medicine, as Senior Lecturer. Enzyme-linked immunosorbent assay (ELISA) for detecting and quantifying snake venom and venom-antibody was developed at the Liverpool Venom Research Unit: this proved useful in the diagnosis of snake bite, in epidemiological studies of envenoming patterns, and in screening of antivenom potency. In 1977, Dr H. Alistair Reid became Head of the WHO Collaborative Centre for the Control of Antivenoms based at Liverpool.

Matched MeSH terms: Snake Bites/history*; Snake Bites/epidemiology; Snake Bites/therapy
Functional proteomic approach to discover geographic variations of king cobra venoms from Southeast Asia and China

Chang HC, Tsai TS, Tsai IH

J Proteomics, 2013 Aug 26;89:141-53.
PMID: 23796489 DOI: 10.1016/j.jprot.2013.06.012

This study deciphers the geographic variations of king cobra (Ophiophagus hannah) venom using functional proteomics. Pooled samples of king cobra venom (abbreviated as Ohv) were obtained from Indonesia, Malaysia, Thailand, and two provinces of China, namely Guangxi and Hainan. Using two animal models to test and compare the lethal effects, we found that the Chinese Ohvs were more fatal to mice, while the Southeast Asian Ohvs were more fatal to lizards (Eutropis multifasciata). Various phospholipases A2 (PLA2s), three-finger toxins (3FTxs) and Kunitz-type inhibitors were purified from these Ohvs and compared. Besides the two Chinese Ohv PLA2s with known sequences, eight novel PLA2s were identified from the five Ohv samples and their antiplatelet activities were compared. While two 3FTxs (namely oh-55 and oh-27) were common in all the Ohvs, different sets of 3FTx markers were present in the Chinese and Southeast Asian Ohvs. All the Ohvs contain the Kunitz inhibitor, OH-TCI, while only the Chinese Ohvs contain the inhibitor variant, Oh11-1. Relative to the Chinese Ohvs which contained more phospholipases, the Southeast Asian Ohvs had higher metalloproteinase, acetylcholine esterase, and alkaline phosphatase activities.

Matched MeSH terms: Snake Bites/genetics; Snake Bites/metabolism
Snake bite in Kelantanese children: a five year experience

Tan KK, Choo KE, Ariffin WA

Toxicon, 1990;28(2):225-30.
PMID: 2339437

The records associated with 83 children from 16 months to 12 years of age who were admitted with snake bite to Kota Bharu General Hospital and University Hospital, Universiti Sains Malaysia over a 5 year period were reviewed. Elapid bites were more common than viper bites while sea-snake bites were not recorded. Symptoms were relatively mild, the common clinical features being pain and local swelling. Antivenom therapy was required in 11 children. Only three of the 11 children developed minor adverse reactions to antivenom. Four of the 83 required ventilatory support for respiratory failure and two children died.

Matched MeSH terms: Snake Bites/epidemiology*; Snake Bites/therapy
Fulltext Snake bite: experience in Bukit Mertajam District Hospital, Pulau Pinang

Muthusamy E

Singapore Med J, 1988 Aug;29(4):383-6.
PMID: 3249968

A retrospective study of 224 cases of snake bites in Bukit Mertajam Hospital over a two year period is reported. Snake bites formed 0.5% of the total and 1.7% of the Medical and Paediatric admissions and accounted for 0.3% of the total hospital deaths. The commonest snake species involved was the Malayan pit viper. 89% of the patients escaped with negligible poisoning and went home in less than seven days. Most of the bites were inflicted in the lower limbs and occurred in the dark. Only 5% of the patients were given anti-venom, of whom one-third had adverse reaction.

Matched MeSH terms: Snake Bites/epidemiology*; Snake Bites/therapy
The role of a point-of-care ultrasound protocol in facilitating clinical decisions for snakebite envenomation in Taiwan: a pilot study

Ho CH, Ismail AK, Liu SH, Tzeng YS, Li LY, Pai FC, et al.

Clin Toxicol (Phila), 2021 Sep;59(9):794-800.
PMID: 33605805 DOI: 10.1080/15563650.2021.1881535

BACKGROUND: The incidence of acute compartment syndrome (ACS) following snakebite envenomation may be seriously overestimated in Taiwan. Snakebite-induced ACS is difficult to determine solely by clinical examination. Snakebite patients previously underwent surgical intervention based on speculation and general clinical examinations suggesting ACS presentations instead of direct intracompartmental pressure (IP) measurement prior to fasciotomy. Point-of-care ultrasound (POCUS) is a relatively widely available noninvasive tool. This study aimed to evaluate snakebite-envenomated patients for the presence of subcutaneous edema and diastolic retrograde arterial flow (DRAF).
MATERIALS AND METHODS: Snakebite patients were prospectively recruited between 2017 and 2019. All patients were examined with POCUS to locate edema and directly visualize and measure the arterial flow in the compressed artery. The presence of DRAF in the compressed artery is suggestive of ACS development because when compartment space restriction occurs, increased retrograde arterial flow is observed in the artery.
RESULTS: Twenty-seven snakebite patients were analyzed. Seventeen patients (63%) were bitten by Crotalinae snakes, seven (26%) by Colubridae, one (4%) by Elapidae, and two (7%) had unidentified snakebites. All Crotalinae bit patients received antivenom, had subcutaneous edema and lacked DRAF in a POCUS examination series.
DISCUSSION: POCUS facilitates clinical decisions for snakebite envenomation. We also highlighted that the anatomic site of the snakebite is an important factor affecting the prognosis of the wounds. There were limitations of this study, including a small number of patients and no comparison with the generally accepted invasive evaluation for ACS.
CONCLUSIONS: We are unable to state that POCUS is a valid surrogate measurement of ACS from this study but see this as a starting point to develop further research in this area. Further study will be needed to better define the utility of POCUS in patients envenomated by snakes throughout the world.

Matched MeSH terms: Snake Bites/diagnosis*; Snake Bites/drug therapy*; Snake Bites/epidemiology; Snake Bites/physiopathology
Non-front-fanged colubroid ("colubrid") snakebites: three cases of local envenoming by the mangrove or ringed cat-eyed snake (Boiga dendrophila; Colubridae, Colubrinae), the Western beaked snake (Rhamphiophis oxyrhynchus; Lamprophiidae, Psammophinae) and the rain forest cat-eyed snake (Leptodeira frenata; Dipsadidae)

Weinstein SA, Griffin R, Ismail AK

Clin Toxicol (Phila), 2014 Apr;52(4):277-82.
PMID: 24645905 DOI: 10.3109/15563650.2014.897352

Non-front-fanged colubroid snakes (NFFC; formerly and artificially taxonomically assembled as "colubrids") comprise the majority of extant ophidian species. Although the medical risks of bites by a handful of species have been documented, the majority of these snakes have oral products (Duvernoy's secretions, or venoms) with unknown biomedical properties/unverified functions and their potential for causing harm in humans is unknown.

Matched MeSH terms: Snake Bites/physiopathology*; Snake Bites/therapy
Efficacy evaluations of Mimosa pudica tannin isolate (MPT) for its anti-ophidian properties

Ambikabothy J, Ibrahim H, Ambu S, Chakravarthi S, Awang K, Vejayan J

J Ethnopharmacol, 2011 Sep 1;137(1):257-62.
PMID: 21640180 DOI: 10.1016/j.jep.2011.05.013

Evaluations of the anti-snake venom efficacy of Mimosa pudica tannin isolate (MPT) obtained from root of the plant.

Matched MeSH terms: Snake Bites/blood; Snake Bites/drug therapy*
Fulltext Retrospective prevalence of snakebites from Hospital Kuala Lumpur (HKL) (1999-2003)

Jamaiah I, Rohela M, Ng TK, Ch'ng KB, Teh YS, Nurulhuda AL, et al.

Southeast Asian J. Trop. Med. Public Health, 2006 Jan;37(1):200-5.
PMID: 16771235

A hospital based retrospective study of the prevalence of snakebite cases at Hospital Kuala Lumpur was carried out over a five-year period from 1999 to 2003. A total of 126 snakebite cases were recorded. The highest admission for snakebites was recorded in 2001 (29 cases). The majority of cases were admitted for three days or less (79%). Most of the snakebite cases were reported in the 11-30 years age group (52%). The male:female ratio was 3:1. The majority of cases were Malaysians (80%, 101 cases). Of the non-Malaysians, Indonesians constituted the most (56%, 14 cases). Bites occurred most commonly on the lower limbs (49%), followed by upper limbs (45%) and on other parts of the body (6%). No fatal cases were detected and complications were scarce. In 60% (70 cases) the snake could not be identified. Of the four species of snakes that were identified, cobra (both suspected and confirmed) constituted the largest group (25%), followed by viper (10%), python (4%) and sea snake (1%). The most common clinical presentations were pain and swelling, 92% (116 cases). All patients were put on snakebite charts and their vital signs were monitored. Of the snakebite cases, 48% (61 cases) were treated with cloxacillin and 25% (32 cases) were given polyvalent snake antivenom.

Matched MeSH terms: Snake Bites/epidemiology*; Snake Bites/therapy
Pharmacokinetics of the Sri Lankan hump-nosed pit viper (Hypnale hypnale) venom following intravenous and intramuscular injections of the venom into rabbits

Tan CH, Sim SM, Gnanathasan CA, Fung SY, Tan NH

Toxicon, 2014 Mar;79:37-44.
PMID: 24412778 DOI: 10.1016/j.toxicon.2013.12.011

The knowledge of venom pharmacokinetics is essential to improve the understanding of envenomation pathophysiology. Using a double-sandwich ELISA, this study investigated the pharmacokinetics of the venom of hump-nosed pit viper (Hypnale hypnale) following intravenous and intramuscular injections into rabbits. The pharmacokinetics of the venom injected intravenously fitted a three-compartment model. There is a rapid (t1/2π = 0.4 h) and a slow (t1/2α = 0.8 h) distribution phase, followed by a long elimination phase (t1/2β = 19.3 h) with a systemic clearance of 6.8 mL h(-1) kg(-1), consistent with the prolonged abnormal hemostasis reported in H. hypnale envenomation. On intramuscular route, multiple peak concentrations observed in the beginning implied a more complex venom absorption and/or distribution pattern. The terminal half-life, volume of distribution by area and systemic clearance of the venom injected intramuscularly were nevertheless not significantly different (p > 0.05) from that of the venom injected intravenously. The intramuscular bioavailability was exceptionally low (Fi.m. = 4%), accountable for the highly varied median lethal doses between intravenous and intramuscular envenomations in animals. The findings indicate that the intramuscular route of administration does not significantly alter the pharmacokinetics of H. hypnale venom although it significantly reduces the systemic bioavailability of the venom.

Matched MeSH terms: Snake Bites/pathology*; Snake Bites/therapy
Unusual ocular manifestations following viper bite

Aye MTH, Naing T, Myint KT

BMJ Case Rep, 2018 Sep 05;2018.
PMID: 30185451 DOI: 10.1136/bcr-2018-225040

We report a case of a 70-year-old farmer admitted for viper bite who presented with bilateral hyphema and angle closure attack. He was managed conservatively with topical steroids and cycloplegics. He responded well and was discharged after 2 weeks.

Matched MeSH terms: Snake Bites/complications*; Snake Bites/drug therapy
Fulltext Epidemiological profile and outcomes of snakebite injuries treated in emergency departments in South Korea, 2011-2016: a descriptive study

Senek MZF, Kong SY, Shin SD, Sun KM, Kim J, Ro YS

Trans R Soc Trop Med Hyg, 2019 10 11;113(10):590-598.
PMID: 31225621 DOI: 10.1093/trstmh/trz050

BACKGROUND: Snakebite is a global public health crisis, but there are no nationwide data on snakebite in South Korea. The aim of this study was to describe the epidemiological profile and outcomes of snakebite cases in South Korea seasonally.
METHODS: The selected subjects were patients of all ages with a chief complaint of snakebite who presented to participating emergency departments (EDs) between 1 January 2011 and 31 December 2016.
RESULTS: A total of 1335 patients were eligible for the study. There were an average of 223 snakebite cases reported each year. Most snakebites occurred during the summer months (55.9%) in patients aged 40-59 y (36.3%) and males (61.5%). Snakebites occurred most frequently on Mondays (22.9%) between 12:00 and 17:59 h (42.0%) outdoors (57.9%) and in farm areas (20.7%). Over 82% of the bites were by venomous snakes across all seasons, and 66% of the patients visited EDs without using emergency medical services. Based on the excess mortality ratio-adjusted injury severity score, 88, 9.2 and 2.8% had mild, moderate and severe injuries, respectively. There were 10 fatalities during the study period.
CONCLUSION: This study provides essential information to understand and assess the burden and distribution of snakebites in South Korea and provides valuable information for developing appropriate prevention and control interventions to address it.

Matched MeSH terms: Snake Bites/epidemiology*; Snake Bites/therapy
Fulltext An in vitro α-neurotoxin-nAChR binding assay correlates with lethality and in vivo neutralization of a large number of elapid neurotoxic snake venoms from four continents

Pruksaphon K, Tan KY, Tan CH, Simsiriwong P, Gutiérrez JM, Ratanabanangkoon K

PLoS Negl Trop Dis, 2020 Aug;14(8):e0008581.
PMID: 32857757 DOI: 10.1371/journal.pntd.0008581

The aim of this study was to develop an in vitro assay for use in place of in vivo assays of snake venom lethality and antivenom neutralizing potency. A novel in vitro assay has been developed based on the binding of post-synaptically acting α-neurotoxins to nicotinic acetylcholine receptor (nAChR), and the ability of antivenoms to prevent this binding. The assay gave high correlation in previous studies with the in vivo murine lethality tests (Median Lethal Dose, LD50), and the neutralization of lethality assays (Median Effective Dose, ED50) by antisera against Naja kaouthia, Naja naja and Bungarus candidus venoms. Here we show that, for the neurotoxic venoms of 20 elapid snake species from eight genera and four continents, the in vitro median inhibitory concentrations (IC50s) for α-neurotoxin binding to purified nAChR correlated well with the in vivo LD50s of the venoms (R2 = 0.8526, p < 0.001). Furthermore, using this assay, the in vitro ED50s of a horse pan-specific antiserum against these venoms correlated significantly with the corresponding in vivo murine ED50s, with R2 = 0.6896 (p < 0.01). In the case of four elapid venoms devoid or having a very low concentration of α-neurotoxins, no inhibition of nAChR binding was observed. Within the philosophy of 3Rs (Replacement, Reduction and Refinement) in animal testing, the in vitro α-neurotoxin-nAChR binding assay can effectively substitute the mouse lethality test for toxicity and antivenom potency evaluation for neurotoxic venoms in which α-neurotoxins predominate. This will greatly reduce the number of mice used in toxicological research and antivenom production laboratories. The simpler, faster, cheaper and less variable in vitro assay should also expedite the development of pan-specific antivenoms against various medically important snakes in many parts of the world.

Matched MeSH terms: Snake Bites/immunology; Snake Bites/mortality
Proteomic insights into short neurotoxin-driven, highly neurotoxic venom of Philippine cobra (Naja philippinensis) and toxicity correlation of cobra envenomation in Asia

Tan CH, Wong KY, Chong HP, Tan NH, Tan KY

J Proteomics, 2019 08 30;206:103418.
PMID: 31201947 DOI: 10.1016/j.jprot.2019.103418

The Philippine cobra, Naja philippinensis, is a WHO Category 1 venomous snake of medical importance responsible for fatal envenomation in the northern Philippines. To elucidate the venom proteome and pathophysiology of envenomation, N. philippinensis venom proteins were decomplexed with reverse-phase high-performance liquid chromatography, and protein fractions were subsequently digested with trypsin, followed by nano-liquid chromatography-tandem mass spectrometry analysis and data mining. Three-finger toxins (3FTX, 66.64% of total venom proteins) and phospholipases A2 (PLA2, 22.88%) constitute the main bulk of venom proteome. Other proteins are present at low abundances (<4% each); these include metalloproteinase, serine protease, cobra venom factor, cysteine-rich secretory protein, vespryn, phosphodiesterase, 5' nucleotidase and nerve growth factor. In the three-finger toxin family, the alpha-neurotoxins comprise solely short neurotoxins (SNTX, 44.55%), supporting that SNTX is the principal toxin responsible for neuromuscular paralysis and lethality reported in clinical envenomation. Cytotoxins (CTX) are the second most abundant 3FTX proteins in the venom (21.31%). The presence of CTX correlates with the venom cytotoxic effect, which is more prominent in murine cells than in human cells. From the practical standpoint, SNTX-driven neuromuscular paralysis is significant in N. philippinensis envenomation. Antivenom production and treatment should be tailored accordingly to ensure effective neutralization of SNTX. BIOLOGICAL SIGNIFICANCE: The venom proteome of Naja philippinensis, the Philippine cobra, is unravelled for the first time. Approximately half the protein bulk of the venom is made up of short neurotoxins (44.55% of the total venom proteins). As the only alpha-neurotoxins present in the venom, short neurotoxins are the causative toxins of the post-synaptic blockade and fast-onset neuromuscular paralysis in N. philippinensis envenomation. A substantial amount of cytotoxins (21.31%) was also detected in N. philippinensis venom, supporting that the venom can be cytotoxic although the effect is much weaker in human cells compared to murine cells. The finding is consistent with the low incidence of local tissue necrosis in N. philippinensis envenomation, although this does not negate the need for monitoring and care of bite wound in the patients.

Matched MeSH terms: Snake Bites/etiology; Snake Bites/epidemiology*; Snake Bites/therapy
Challenges in diagnosing and treating snakebites in a rural population of Tamil Nadu, India: The views of clinicians

Williams HF, Vaiyapuri R, Gajjeraman P, Hutchinson G, Gibbins JM, Bicknell AB, et al.

Toxicon, 2017 Feb 24;130:44-46.
PMID: 28238804 DOI: 10.1016/j.toxicon.2017.02.025

Snakebites cause death, disability and economic devastation to their victims, people who live almost exclusively in rural areas. Annually an estimated two million venomous bites cause as many as 100,000 deaths worldwide as well as hundreds of thousands of deformities and amputations. Recent studies suggest that India has the highest incidence of snakebite and associated deaths worldwide. In this study, we interviewed 25 hospital-based clinicians who regularly treat snakebites in Tamil Nadu, India, in order to gauge their opinions and views on the diagnostic tools and treatment methods available at that time, the difficulties encountered in treating snakebites and improvements to snakebite management protocols they deem necessary. Clinicians identified the improvement of community education, training of medical personnel, development of standard treatment protocols and improved medication as priorities for the immediate future.

Matched MeSH terms: Snake Bites
Toxicity and cross-neutralization of snake venoms from two lesser-known arboreal pit vipers in Southeast Asia: Trimeresurus wiroti and Trimeresurus puniceus

Lee LP, Tan KY, Tan CH

Toxicon, 2020 Oct 15;185:91-96.
PMID: 32585219 DOI: 10.1016/j.toxicon.2020.06.012

The lesser-known Sundaic lance-headed pit vipers Trimeresurus wiroti (Malaysia) and Trimeresurus puniceus (Indonesia) contribute to the disease burden of snakebite envenomation in Southeast Asia, but their venom toxicity and neutralization remain insufficiently investigated. This study demonstrated that both venoms were procoagulant (involving thrombin-like activity), hemorrhagic, and lethal to mice, with T. wiroti venom being more lethal (LD50 = 0.78 μg/g c.f. 1.21 μg/g). The hetero-specific antivenom from Thailand, Green Pit Viper Antivenom (GPVAV, raised against Trimeresurus albolabris) cross-reacted with T. wiroti and T. puniceus venoms with a higher efficacy of immunological binding activity for the latter. The antivenom was also effective in cross-neutralizing the procoagulant, hemorrhagic and lethal effects of the venoms. In lethality neutralization, GPVAV showed a potency of 0.79-1.05 mg venom per mL antivenom, corresponding to the complete neutralization of approximately 8-10 mg venom per unit vial of antivenom for T. wiroti and T. puniceus venoms. Taken together, it was inferred that T. wiroti, T. puniceus, and T. albolabris venoms share common toxin epitopes, thus enabling the cross-neutralization observed. These findings suggest that GPVAV may be potentially useful in the management of envenomation by T. wiroti and T. puniceus while awaiting clinical trial and validation.

Matched MeSH terms: Snake Bites
Fulltext A Rare Infection Following Snakebite

Cheong, C.Y., Lee, C.K., Zuki Z.

Malays Orthop J, 2010;4(1):-.
MyJurnal

Snakebite is very common especially in Asia. We report a rare case of Providencia rettgeri infection following snakebite on the foot. This patient was treated with early and aggressive wound debridement, daily wound dressing during hospitalization and then skin coverage with split skin graft. No anti-venom was given administered. Appropriate intravenous antibiotics were given to the patient while hospitalized and oral antibiotic were prescribed upon discharge. The outcome of this treatment was successful.

Matched MeSH terms: Snake Bites
Fulltext Phytochemical analysis and in-vitro effects of Ethanolic Tamarindus Indica seed extract on snake venom

Soraya Ismail, Nur Farhana Azmi, Khin, Maung Maung, Oothuman, Pakeer

International Medical Journal Malaysia, 2017;16(11):25-25.
MyJurnal

Snakebite has been categorised as a ‘neglected tropical disease’ by WHO
in 2009 and it affects mainly the poorer countries like Africa and Asia. The standard
treatment for snake envenomation is the anti-snake venom medication which can be
very expensive, not readily available and specific against a snake species. This study
was conducted to screen the phytochemical compounds of Tamarindus indica seed
extract (TSE) and its in-vitro effects on snake venom of three snake species; namely
Daboia russelli, Naja kaouthia and Ophiophagus hannah. (Copied from article).

Matched MeSH terms: Snake Bites
Fulltext Effect of Mucuna pruriens Seed Extract Pretreatment on the Responses of Spontaneously Beating Rat Atria and Aortic Ring to Naja sputatrix (Javan Spitting Cobra) Venom

Fung SY, Tan NH, Sim SM, Aguiyi JC

Evid Based Complement Alternat Med, 2012;2012:486390.
PMID: 21785646 DOI: 10.1155/2012/486390

Mucuna pruriens Linn. (velvet bean) has been used by native Nigerians as a prophylactic for snakebite. Rats pretreated with M. pruriens seed extract (MPE) have been shown to protect against the lethal and cardiovascular depressant effects of Naja sputatrix (Javan spitting cobra) venoms, and the protective effect involved immunological neutralization of the venom toxins. To investigate further the mechanism of the protective effect of MPE pretreatment against cobra venom toxicity, the actions of Naja sputatrix venom on spontaneously beating rat atria and aortic rings isolated from both MPE pretreated and untreated rats were studied. Our results showed that the MPE pretreatment conferred protection against cobra venom-induced depression of atrial contractility and atrial rate in the isolated atrial preparations, but it had no effect on the venom-induced contractile response of aortic ring preparation. These observations suggested that the protective effect of MPE pretreatment against cobra venom toxicity involves a direct protective action of MPE on the heart function, in addition to the known immunological neutralization mechanism, and that the protective effect does not involve action on blood vessel contraction. The results also suggest that M. pruriens seed may contain novel cardioprotective agent with potential therapeutic value.

Matched MeSH terms: Snake Bites

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