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Hence Dr. Sharma recommends people to opt for topical skincare treatments like serums, which are pain-free and much safer than injectable neurotoxins. B. arietans, B. gabonica, D. angusticeps, D. jamesoni, D. polylepis, Hemachatus haemachatus, N. annulifera, N. melanoleuca, N. mossambica, N. nivea
Both SRs found one trial from Brazil on Bothrops envenomation patients to prevent reactions due to Bothrop specific SAV (three manufactures: Instituto Butantan, Fundaçao Ezequiel Dias, or Instituto Vital Brazil) and found no difference in acute reactions between those who received promethazine and those who did not (RR 0.98; 95% CI 0.50 to 1.93). One patient from each treatment group suffered severe anaphylaxis. No death was reported in either of the groups. Antivenoms can be raised against the venom of a single species (monospecific) or against multiple species (polyspecific), and have already proven to be effective in preventing many of the lethal and damaging effects of envenomation [ 4]. Antivenom administration can reverse the major effects of envenomation, such as anti-hemostasis, neurotoxicity, and hypotension [ 4]. In contrast, venom-induced local damage is not well prevented by antivenoms unless it is administered soon after the bite [ 39]. In addition, despite being therapeutically efficient, some antivenoms currently used can induce adverse reactions. The SR found two old observational studies (with no comparison group) when early excision along with tourniquet and ice-water immersion but not SAV being administered typically showed worse tissue outcomes (not exactly specified). In the modern context, where SAV administration is the norm, the review found no comparative clinical trials which had examined role of early excision (alone or as an adjunct with SAV). It however, found 16 studies which showed excellent results (outcomes were not explicitly stated) with SAV without incisions or excisions in comparison to just one study which found to the contrary. The SR found no literature in relation to debridement of necrotic tissue or in relation to management of puncture wounds on tendon sheaths for patients with snake envenomation. Duration of hospitalisation was reported from two studies and results were pooled to find that low-dose SAV led to 1.27 less days of hospitalisation compared to the high dose group (MD −1.27 days, −2.05 to − 0.5). Another study also reported duration of hospitalisation, but the SR could not pool the data due to non-reporting of standard deviation. It found "no difference in the average hospital stay (days) between the low dose and high dose (8.42 vs. 9.02 days).
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Today, many people depend on injectable neurotoxins to treat wrinkles, pigmentation, skin roughness, laxity and fine lines. Sharma SK, Alirol E, Ghimire A, Shrestha S, Jha R, Parajuli SB, et al. Acute Severe Anaphylaxis in Nepali Patients with Neurotoxic Snakebite Envenoming Treated with the VINS Polyvalent Antivenom. Journal of Tropical Medicine. 2019;2019:2689171. pmid:31205473 The estimated number of snakebites in the world is about 400,000/year with approximately 20,000 deaths/year [ 1]. Another estimate shows that there are around 1.8–2.7 million snake envenomations annually, resulting in around 81,000–138,000 deaths, and that there may be as many as 400,000 people with permanent disabilities resulting from snakebite each year [ 2, 3, 4]. The SR identified two studies on effect of snake stones (animal bones or stones used in folk and indigenous medicine for treatment of snakebite) and found: Chippaux J.P. Estimate of the burden of snakebites in sub-Saharan Africa: a meta-analytic approach. Toxicon. 2011; 57(4):586–599. Mar 15. [ PubMed] [ Google Scholar]
Collagen is a key structural component of the connective tissue in skin. It’s abundantly present in young skin and is responsible for firmness and elasticity. Aging skin loses the ability to produce enough collagen. Snake Venom Face Cream helps replace it. Identifying snake species—Occasionally patients or accompanying persons may bring the killed snake for identification or have a picture of it. A herpetologist can be consulted to help identify the species. 29 Identification of snakes based on description by victims or recognition from pictures is often unreliable. 29 82 83 Identifying biting-species helps avoid unnecessary antivenom in patients bitten by non-venomous snakes or by species whose venoms are not neutralised by available products. It can help select appropriate antivenom in countries with products specific against single species and anticipate clinical progression. However, delaying emergency treatment until the species is identified is unnecessary. Nuchpayoon et al [ 13] included only one trial from Sri Lanka which found that those who received adrenaline had significantly lesser adverse allergic reactions to SAV (Haffkine poly-specific) overall (RR 0.25; 95% CI 0.11 to 0.57) than those receiving placebo. The trial had also noted that severe reactions were many times more in the placebo group over the adrenaline group (RR 0.10; 95% CI 0.01 to 1.77). No death was recorded in either of the groups. No patient developed hypertension (blood pressure >160/100 mmHg), arrhythmia (other than sinus tachycardia), or neurological deficits suggestive of cerebrovascular accidents in either of the groups. Lavonas EJ, Schaeffer TH, Kokko J, Mlynarchek SL, Bogdan GM. Crotaline Fab antivenom appears to be effective in cases of severe North American pit viper envenomation: an integrative review. BMC emergency medicine. 2009;9:13. pmid:19545426Significant decrease in the duration of hospitalisation in those whose snakebite wound was incised in comparison to those whose bite wound was not incised (2.9±1.6 days vs 4.6±2.2 days; MD -1.70 days; p = 0.03) The SR included 19 cohort studies (two cohorts were within the context of RCTs) consisting of 1017 patients. Late bleeding was seen in nine patients (0.9%; 95% CI 0.4% to 2.2%) with five patients developing medically significant late bleeding. (0.5%; 95% CI 0.1% to 1.7%) [ 14]. Eight of the nine patients who had late bleeding were cases of Rattlesnake envenomation. No deaths or sequalae of any kind was reported. Venom has been used throughout history to treat illness and there has been a significant amount of research in recent times into the potential applications of synthetic venoms to treat a variety of ailments. For example, ziconotide from cone snails to treat chronic pain or lepirudin from leeches to prevent blood clots. No difference in the occurrence of death or disability between those treated with snake stones in comparison to those receiving no first aid (OR 13; 95% CI 0.39 to 823).
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