@article{ref1,
title="Long-term health manifestations of hump-nosed pit viper (genus: Hypnale) bites",
journal="Clinical toxicology (Philadelphia, Pa.)",
year="2023",
author="Rathnayaka, R. M. M. K. Namal and Ranathunga, P. E. Anusha Nishanthi and Kularatne, S. A. M.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="INTRODUCTION: The hump-nosed pit viper (Genus: Hypnale) is a highly medically significant snake in Sri Lanka, responsible for the majority of venomous snakebites (22-77%). They are found throughout Sri Lanka and the Western Ghats region of India. The venom can lead to two types of effects: acute and long-term. Acutely, bites often result in local symptoms, with less common systemic effects such as acute kidney injury, venom-induced consumption coagulopathy, and thrombotic microangiopathy. <br><br>METHODS: We conducted a prospective observational study at Teaching Hospital Ratnapura, Sri Lanka, spanning six years, starting in June 2015. Patients bitten by hump-nosed pit vipers were followed up for two years, with assessments every three months to identify long-term effects. Data was gathered through interviewer-administered questionnaires. <br><br>RESULTS: Out of 728 patients bitten by hump-nosed pit vipers, 22 (3%) were lost to follow-up. Forty-four (6.2%) experienced long-term effects, including chronic kidney disease (24; 3.4%), chronic wounds (five; 0.7%), amputations (five; 0.7%), fasciotomy-related wounds (four; 0.6%), and psychological illnesses (four; 0.6%). There were nine (1.3%) deaths in this group. Among those with chronic effects, 27 (61%) were males, and 17 (39%) were females, with ages ranging from 29 to 82 years (mean 57.6 years). The time it took to diagnose acute kidney injury from the snakebite was 18 h (interquartile range: 15-23.5 h), while the time to diagnose chronic kidney disease was 69 days (interquartile range: 64-74.75 days). In these patients, the estimated glomerular filtration rate was 29.3 mL/min/1.73 m(2) (interquartile range: 14-50.75 mL/min/1.73 m(2)). Among the patients who did not develop long-term complications (662; 91%) 660 (90.7%) experienced local effects, and 82 (11.3%) developed systemic manifestations, including acute kidney injury in 60 (8%) and coagulopathy in 35 (5%). <br><br>CONCLUSION: Following hump-nosed pit viper bites, a subset of patients may experience long-term health complications, including chronic kidney disease, chronic ulcers, amputations, fasciotomy-related wounds, and psychological illnesses, with chronic kidney disease being the most frequently observed among these manifestations.<p /> <p>Language: en</p>",
language="en",
issn="1556-3650",
doi="10.1080/15563650.2023.2265549",
url="http://dx.doi.org/10.1080/15563650.2023.2265549"
}