@article{ref1,
title="Scorpions and scorpion sting envenoming (scorpionism) in the Arab Countries of the Middle East",
journal="Toxicon: Journal of the International Society on Toxinology",
year="2020",
author="Amr, Zuhair S. and Abu Baker, Mohammad A. and Al-Saraireh, Mohammad and Warrell, David A.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="The twelve Arab countries of the Middle East are inhabited by 117 species of scorpions of varying medical importance within six families. Scorpion stings are a  very common occurrence throughout the region. Twenty-two scorpion species are  considered to be dangerously venomous, causing potentially life threatening stings. Accessible literature in English and Arabic on scorpions, scorpion stings and  available antivenoms was reviewed to document the scorpion fauna and scorpion stings  in each country. Saudi Arabia, Iraq and Jordan report the highest numbers of stings  and envenomings. Clinically, the most important toxins in Old World scorpion venoms  are α-toxins that target voltage-gated sodium (Na(v)) channels at neurotoxin binding  site 3, causing sympathetic excitation and the endogenous release of catecholamines  that is responsible for transient, but life-threatening myocardial damage.Most  victims of scorpion stings suffer severe local pain, but a few, especially children,  develop systemic envenoming which, in the case of most Middle Eastern buthid  species, such as Androctonus and Leiurus species, is dominated by the cardiovascular  and respiratory consequences of hypercatecholinaemic myocarditis. Other syndromes  include paralysis (Parabuthus leiosoma), coagulopathy (Nebo hierichonticus and  Hemiscorpius species), and local tissue damage, haemolysis and acute kidney injury  (H. lepturus). Early antivenom treatment is recommended but its value remains  controversial. However, intensive care, with the ancillary use of vasoactive drugs  such as prazosin and dobutamine, has proved effective.<p /> <p>Language: en</p>",
language="en",
issn="0041-0101",
doi="10.1016/j.toxicon.2020.12.017",
url="http://dx.doi.org/10.1016/j.toxicon.2020.12.017"
}