Dataset Information

Documentation of a proven Mountain Pitviper (Ovophis monticola) envenomation in Kathmandu, Nepal, with its distribution ranges: implications for prevention and control of pitviper bites in Asia.

ABSTRACT: We document inadequately diagnosed coagulopathy (potential to be life threatening) due to Ovophis monticola bite. Although its bites are common in the hills of Nepal, associated envenomations have not been documented elaborately. Herein, we present the clinical and treatment details of a proven O. monticola bite and areas where it may pose the risk of envenomations (suggesting huge populations in Asia to be vulnerable to its bites). Its envenomation was managed symptomatically with several non-evidence-based interventions. Since no specific pitviper antivenom is available in Nepal yet, managing coagulopathy associated to O. monticola envenomation is still challenging. This case emphasizes the need of developing the standard protocol for the diagnosis and management of pitviper bites and study of effectiveness of the available pitviper antivenoms until specific pitviper antivenom is available. Further, the demonstrated distribution localities of this species may have implications for snakebite prevention and designing and distribution of the effective antivenoms.

SUBMITTER: Pandey DP

PROVIDER: S-EPMC7970453 | biostudies-literature | 2021

REPOSITORIES: biostudies-literature

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Documentation of a proven Mountain Pitviper (Ovophis monticola) envenomation in Kathmandu, Nepal, with its distribution ranges: implications for prevention and control of pitviper bites in Asia.

Pandey Deb Prasad DP Chaudhary Budhan B Ram Shrestha Bhola B

Journal of venom research 20210106

We document inadequately diagnosed coagulopathy (potential to be life threatening) due to Ovophis monticola bite. Although its bites are common in the hills of Nepal, associated envenomations have not been documented elaborately. Herein, we present the clinical and treatment details of a proven O. monticola bite and areas where it may pose the risk of envenomations (suggesting huge populations in Asia to be vulnerable to its bites). Its envenomation was managed symptomatically with ...[more]

PMID: 33747433

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Project description:IntroductionAntivenom is currently considered standard treatment across the full spectrum of severity for snake envenomation in the United States. Although safe and effective antivenoms exist, their use in clinical practice is not universal.ObjectiveThis study explored physicians' perceptions of antivenom use and experience with snake envenomation treatment in order to identify factors that influence treatment decisions and willingness to administer.MethodsWe conducted a qualitative study including in-depth interviews via online video conferencing with physicians practicing in emergency departments across the United States. Participants were selected based on purposive sampling methods. Data analysis followed inductive strategies, conducted by two researchers. The codebook and findings were discussed within the research team.FindingsSixteen in-depth interviews with physicians from nine states across the US were conducted. The participants' specialties include emergency medicine (EM), pediatric EM, and toxicology. The experience of treating snakebites ranged from only didactic education to having treated over 100 cases. Emergent themes for this manuscript from the interview data included perceptions of antivenom, willingness to administer antivenom and influencing factors to antivenom usage. Overall, cost-related concerns were a major barrier to antivenom administration, especially in cases where the indications and effectiveness did not clearly outweigh the potential financial burden on the patient in non-life- or limb-threatening cases. The potential to decrease recovery time and long-term functional impairments was not commonly reported by participants as an indication for antivenom. In addition, level of exposure and perceived competence, based on prior education and clinical experience, further impacted the decision to treat. Resources such as Poison Center Call lines were well received and commonly used to guide the treatment plan. The need for better clinical guidelines and updated treatment algorithms with clinical and measurable indicators was stated to help the decision-making process, especially among those with low exposure to snake envenomation patients.ConclusionsA major barrier to physician use of antivenom is a concern about cost, cost transparency and cost-benefit for the patients. Those concerns, in addition to the varying degrees of awareness of potential long-term benefits, further influence inconsistent clinical treatment practices.

Project description:AimThe study of the factors that influence population connectivity and spatial distribution of genetic variation is crucial for understanding speciation and for predicting the effects of landscape modification and habitat fragmentation, which are considered severe threats to global biodiversity. This dual perspective is obtained from analyses of subalpine mountain species, whose present distribution may have been shaped both by cyclical climate changes over ice ages and anthropogenic perturbations of their habitats. Here, we examine the phylogeography, population structure and genetic diversity of the lacertid lizard Iberolacerta monticola, an endemism considered to be facing a high risk of extinction in several populations.LocationNorthwestern quadrant of the Iberian Peninsula.MethodsWe analyzed the mtDNA variation at the control region (454 bp) and the cytochrome b (598 bp) loci, as well as at 10 nuclear microsatellite loci from 17 populations throughout the distribution range of the species.ResultsAccording to nuclear markers, most sampling sites are defined as distinct, genetically differentiated populations, and many of them show traces of recent bottlenecks. Mitochondrial data identify a relatively old, geographically restricted lineage, and four to six younger geographically vicariant sister clades, whose origin may be traced back to the mid-Pleistocene revolution, with several subclades possibly associated to the mid-Bruhnes transition. Geographic range fragmentation of one of these clades, which includes lowland sites, is very recent, and most likely due to the accelerated loss of Atlantic forests by human intervention.Main conclusionsAltogether, the data fit a "refugia within refugia" model, some lack of pattern uniformity notwithstanding, and suggest that these mountains might be the cradles of new species of Iberolacerta. However, the changes operated during the Holocene severely compromise the long-term survival of those genetic lineages more exposed to the anthropogenic perturbations of their habitats.

Dataset Information

Documentation of a proven Mountain Pitviper (Ovophis monticola) envenomation in Kathmandu, Nepal, with its distribution ranges: implications for prevention and control of pitviper bites in Asia.

Publications

Documentation of a proven Mountain Pitviper (<i>Ovophis monticola</i>) envenomation in Kathmandu, Nepal, with its distribution ranges: implications for prevention and control of pitviper bites in Asia.

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