Acute renal failure is an unusual complication of wasp stings. We report three cases who developed acute renal failure after multiple wasp stings (Vespa magnifica). Two patients had evidence of intravascular haemolysis and rhabdomyolysis whereas one patient investigation showed no evidence of intravascular haemolysis or rhabdomyolysis. All three cases had impaired liver functions. Oligo-anuria was seen in all three of the patients and all of them required dialytic support. One patient died of massive gastrointestinal bleeding while the remaining two recovered completely. Although acute renal failure after wasp stings is typically caused by acute tubular necrosis in the setting of haemolysis or rhabdomyolysis, in some patients, renal failure may result from a direct nephrotoxic effect or acute interstitial nephritis from a hypersensitivity reaction to the wasp venom.

<p class="abstract"><strong>Background:</strong> Organophosphate (OP) poisoning is a common cause of significant mortality and morbidity all over the world. In Asia, OP poisoning is the most common form of fatal self harm. Previous studies have suggested hearing loss due to OP poisoning. The aim of the study was to study audiological assessment in the patients with OP poisoning.</p><p class="abstract"><strong>Methods:</strong> 26 patients (age &lt;50 years) of OP poisoning over a period of one year were included in the study following ethical approval from Institute Ethics Committee. 25 healthy subjects served as control. Each subject was subjected to brainstem evoked response audiometry (BERA) examination.  </p><p class="abstract"><strong>Results:</strong> 50% patients with OP poisoning were aged between 20-29 years. Male outnumbered females in the patients (M:F- 17:9) as well as controls (M:F- 17:8). Only absolute wave-v latency (ms) was statistically significantly prolonged in cases when compared with controls in both right (0.035) as well as left ears (0.048). We found no statistical significant difference in interpeak wave I-III, III-V, I-V latency of both ears in cases when compared with controls. On second assessment in the patients, we observed a statistical significant decrease in absolute wave III and V latency, and interpeak I-III interval in right ear when compared with wave latency at first assessment. In left ear on second assessment, a significant decrease in absolute wave I, III, and V latency was observed in the patients.</p><p class="abstract"><strong>Conclusions:</strong> OP compounds may affect entire neural auditory pathway. Further studies with a large sample size are required for the assessment.</p>

No abstract

Objective: Snake bite is an emergency in tropical and subtropical countries. It is a neglected disease and is most commonly seen in rural setups, where people are ignorant about the venomous snake bites. It results in increased mortality and morbidity because precious time is wasted, either in consulting traditional healers or waiting for the development of signs and symptoms of envenomation. Then only the patient is shifted to a health center. Here we studied the clinical profile, management, and outcome of snake bite patients. Materials and methods: This study was done by retrieving the records of patients with snake bites admitted to the Department of Medicine, Indira Gandhi Medical College & Hospital, Shimla, from 1st January 2017 through December 2019. The recorded data was entered in a precoded performa, and analysis was done with respect to various variables. Result: We evaluated the records of 190 patients. The incidence of the bite was higher among females, 62.1% (n = 118). The commonest age group involved was 21–50 years, 70.1% (n = 34). In 55.8% (n = 106), the site of the bite was the upper limb. The daytime bite was present in 54.7% (n = 106). The maximum incidence of snake bites was found during the rainy season, 81.5% (n = 155). 28.4% (n = 54) of patients presented within 6 hours of the bite. Coagulopathy [whole blood clotting test (WBCT) of >20 minutes] and neurotoxicity were seen in 77.9 and 7.9% of patients, respectively. Anti-snake venom (ASV) was given to 87.8% (n = 167) of patients. In 80% (n = 152) of the cases, hospital stay was up to 3 days. Mortality was seen in only two (1.05%) cases. Conclusion: There is a need to create awareness among the community, particularly in rural areas, about snake bite envenomation and early transportation of victims to the nearest health center. Training of health professionals is also needed to manage cases of snake bites efficiently and judiciously, thereby reducing morbidity and morbidity.