Hima Surendran, (2018) A clinical study on the effectiveness of early prazosin therapy in children with scorpion sting. Masters thesis, Government Mohan Kumaramangalam Medical College, Salem.
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Abstract
Scorpion sting is a frequent event in tropical and sub-tropical countries. Nearly 1,000 species of scorpion are known worldwide, which belongs to six families. Around 86 species of this family are found in India. These are found abundantly in Western Maharashtra, parts of Karnataka, Andhra Pradesh, Saurashtra, Pondicherry and Tamil Nadu. Mesobuthus tamulus or Indian red scorpion is the most lethal of all scorpion species. Indian red scorpion, is venomous and its envenomation is fatal if not treated in time.2 Scorpion sting in children is a life threatening emergency. Most of the children with severe envenomation die due to the toxin, whereas it is a relatively less serious condition in adults. Reliable statistics are not readily available for this common rural accident. Numerous envenomations are unreported and true incidence is not known. Case fatality rates of 3-22% were reported among children hospitalized for scorpion stings in India.1 Most of the deaths due to scorpion sting are attributed to cardiopulmonary complication such as myocarditis and acute pulmonary edema.7 Outcome of scorpion sting depends upon the dose of the venom, the age of the child, the season of the sting and the time lapse between the sting and hospitalization. The time gap between the scorpion sting and presentation to the hospital is one of the significant risk factors which determine better outcomes and mortality. Children who present after 6 hours of the sting have a significantly higher mortality rate. 5 Prazosin, a postsynaptic alpha –1 blocker, counteracts the effects of excessive catecholamines and arrests the development of severe systemic features. It is used at the dose of 30μg/kg/dose. It has been found to be an effective drug for scorpion sting envenomation and it has reduced the mortality rate to 1% as compared to a 30% mortality rate in the pre-Prazosin era.5 Most of the Scorpion sting cases admitted in tertiary care center are being referred in a state of peripheral circulatory failure due to lack of knowledge regarding the clinical course and the outcome, as there are not many relevant clinical studies on risk factors predicting outcome of scorpion sting envenomation in this particular geographical area, we would like to conduct this study to know the risk factors that predict the outcome of scorpion sting envenomation in children upto 12 years. KEYWORDS: scorpion sting early administration prazosin AIMS AND OBJECTIVES: 1.To study the effectiveness of early prazosin therapy in children with scorpion sting. 2.The determine whether time gap between sting and hospital admission as one of the significant risk factors which determine outcome and mortality. MATERIALS AND METHODS: CASE SELECTION: 100 Cases of suspected and clinically proven scorpion sting at Govt Mohan Kumaramangalam Medical College, Salem during January 2016 to December 2016. Type of the study: Prospective observational hospital based time bound study OBSERVATION: In children with scorpion sting early administration of prazosin help in reduction of complication. CONCLUSION: The early administration of prazosin is effective in reducing the morbidity and mortality of scorpion sting.
| Item Type: | Thesis (Masters) |
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| Subjects: | MEDICAL > Paediatrics |
| Depositing User: | Subramani R |
| Date Deposited: | 15 Aug 2018 00:08 |
| Last Modified: | 15 Aug 2018 00:08 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/9252 |
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