Anantharaj, A (2023) Clinical Profile of Scorpion Envenomation with Electrocardiographic Changes and Cardiac Biomarkers. Masters thesis, Tirunelveli Medical College, Tirunelveli.
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Abstract
INTRODUCTION: Scorpion (Mesobuthus tamulus) envenomation is a frequently encountered medical condition in our area. Most bites are harmless, even though some may produce significant morbidity and occasional mortality. Cardiovascular manifestations are more Indian red scorpion envenomation and common following myocarditis is the most complication, and is the lethal major cause of death. As the criteria for myocyte injury in scorpion sting is not well established, the measurement of the clin cardiac biomarkers and ECG monitoring may augmentical diagnosis in scorpion envenomation. AIMS AND OBJECTIVES 1. To study the clinical profile and Cardiovascular manifestations following scorpion sting. 2. To study the electrocardiographic changes seen following scorpion sting. 3. To assess the significance of serum levels of CPK MB and SGOT as biomarkers of myocardial injury. 4. To study the correlation between these biomarkers and ECG changes and clinical status following scorpion envenomation. MATERIALS AND METHODS: Study area: All patients hospitalized for scorpion sting in Tirunelveli medical college Study period: Two years. Ethical committee approval: The study was carried out after approval by the institutional scientific and Ethics Committee. Sample size: 60. Inclusion Criteria: ● Patients between the age group of 13-70 years with definite history of scorpion sting. ● Patients admitted within first 24 hours of scorpion bite. Exclusion Criteria: ● The patient with doubtful scorpion bite. ● Patient with known heart disease (congenital and acquired). ● Patient with recent trauma or surgical intervention. ● Pediatric age groups and patient more than 70 years of age. Study design: Hospital based prospective study. RESULTS: 60 cases were studied in our research, In our study male patients constitute about 66% of cases and female cases contribute to about 33% of cases. The sample size Out of 60 cases in our study 13 cases had abnormal ECG and 30 cases had normal ECG. 30 cases had in our study by comparing severity with the ECG changes, statistical test was done and and p value was found to be 0.00001, which is statistically significant. And in our study following ECG changes are noted, Regarding distribution of cases according to ECG changes 45% of cases show ecg changes among that. sinus tachycardia seen in 11 cases, sinus tachycardia with ST depression seen in 4 cases.ST elevation seen in 2 cases, ST depression seen in 2 cases, ST depression with T wave inversion seen 1 case, right bundle branch block seen in 1 case, Tall T waves seen in 3 cases, complete heart block seen in 1 case and left bundle fascicular block seen in 2 cases, CONCLUSION: In our study 60 cases were studied, and most common age group is 20, 29 years of age, male patients accounts for about 66.67% of cases and female patients accounts for about 33.37% of cases. Most common symptom is pain 37 cases had pain and most common sign is tachycardia 22 cases had encountered. Regarding severity grade 1 in 46% of cases, grade 2 in 13% of cases, grade 3 in 24% of cases. Most common ECG change is sinus tachycardia seen in 18.3% of cases RBS is elevated in 8% of cases,60% of cases reached hospital in 1 3 hours. CPK MB elevated in 50% of cases, SGOT elevated in 56% of cases In our study statistical significant correlation established between severity with CPK MB level (p value 0.00001), grading with SGOT (p value 0.00001), severity with time (p value 0.02), Time with ECG p values is 0.003, SGOT with ECG p value is 0.00004, CPK MB with ECG 0.00001, and grading with ECG p value less than 0.000001. Since significant p values are obtained hence ECG changes and cardiac bio markers can be used as important tool changes. In evaluating ECG When establishing statistical relationship between RBS with ECG, gender with ECG and age with ECG, p values are found to be 0.24,0.58 and 0.49 and it is statistically insignificant. Hence, since statistical significance established in the cardiac biomarkers and ECG changes, It can be used as marker in evaluation of scorpion sting.
| Item Type: | Thesis (Masters) |
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| Additional Information: | Reg.No.200120104003 |
| Uncontrolled Keywords: | Clinical Profile, Scorpion Envenomation, Electrocardiographic Changes, Cardiac Biomarkers. |
| Subjects: | MEDICAL > General Medicine > MEDICAL > General Medicine |
| Depositing User: | Subramani R |
| Date Deposited: | 25 Apr 2021 12:39 |
| Last Modified: | 25 Mar 2024 01:20 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/15322 |
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