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Biomedical subjects

S Mahasandana

Publications and source records attributed to S Mahasandana.

11 recordsLinked to original sources
PubMed1998

Prognostic factors of green pit viper bites.

Clinical features of green pit viper bites vary from asymptomatic to fatal bleeding. Antivenin promptly reverses the coagulopathy but has considerable adverse side effects. In this study, potential clinical predictors of severe outcomes (wound necrosis, wound infection, and systemic bleeding) and antivenin allergy were determined in 271 moderate to severe cases of green pit viper bites by multivariate analysis. The incidences of systemic bleeding, wound necrosis, secondary infection, and antivenin allergy were 17.3%, 6.6%, 5.5%, and 20.8% respectively. The predictors of systemic bleeding were the combination of thrombocytopenia and prolonged venous clotting time and bite sites away from digits. A bite on the fingers or toes was a risk factor for skin necrosis (P = 0.03). Systemic absorption of the venom from digits may be poor, resulting in severe local but mild systemic effects. The presence of blisters often led to necrosis and secondary infections (P = 0.0037 and P = 0.0006, respectively). Although negative skin test results do not exclude the possibility of antivenin allergy, positive results indicate a high risk (P = 0.016) requiring special precautions.

Adolescent↗
PubMed1997

Kinetic study of Russell's viper venom in envenomed patients.

Serum levels of Russell's viper venom in 30 patients bitten by Russell's viper were measured by an ELISA. In the initial serum samples, which were collected immediately after admission to the hospital (0.5-19 hr after the bite), venom was detected in 24 patients (80%), with levels ranging from 3 to 92 ng/ml. These levels correlated well with the patient's clinical signs. At 6-12 hr after antivenom therapy, the venom levels in most of the serum samples (21 of 24, 87%) had decreased to undetectable levels. In the remaining patients, whose serum venom levels could be detected 36-72 hr after therapy, the levels varied according to the effect of the antivenom therapy and the release of venom from a deposit at the bite site.

Adolescent↗
PubMed1994

Monospecific antivenin therapy in Russell's viper bite.

Venom antigenemia was detected in 24 out of 30 Russell's viper bites. Those who suffered clinical bleeding (N = 14) had higher venom antigenemia than those who did not. The mean value of the amount of monospecific antivenin correcting blood incoagulability was 165 +/- 59.3 ml. Consequently, the recommended treatment is 60 ml of antivenin being administered intravenously at 6-hour intervals until blood coagulability is restored. There were no serious complications after antivenin administration. Renal complication (3 cases) was the major problem following this snake bite. One patient with clinical diagnosis of central nervous system bleeding died on admission.

Adult↗
PubMed1993

Lupus anticoagulant in Thai systemic lupus erythematosus patients.

In the past decade, interest in the potential clinical significance of lupus anticoagulant (LA) has grown tremendously. Recent reviews from the Western countries have found an average frequency of 34% for LA in patients with systemic lupus erythematosus (SLE). By using various laboratory procedures, namely, standard and diluted activated partial thromboplastin time, kaolin clotting time, tissue thromboplastin inhibition test and platelet neutralization test, we found the frequency of LA in 91 consecutive Thai SLE patients to be 17.5%, compared with 0.8% in the age-matched normal control population. The presence of LA was significantly associated with disease activity (p = 0.01). A statistically significant association was also observed between the presence of LA and convulsive disorders (p = 0.04), thrombocytopenia (p = 0.001) and autoimmune hemolytic anemia (p = 0.02).

Adolescent↗
PubMed1991

Necrotizing fasciitis of previous surgical wound complicating intensive postremission chemotherapy.

Necrotizing fasciitis of previous surgical wound developed in a leukemic patient after receiving intense postremission chemotherapy. A unique feature was profound granulocytopenia and the recovery of Escherichia coli in the blood and necrotic tissue. We believe the hematogenous seeding of the surgical wound during the episode of E. coli septicemia was the cause of our patient's necrotizing fasciitis.

Adolescent↗
PubMed1990

The species of green pit viper in Bangkok.

The aims of this study were to delineate the species of Green pit viper and clinical patterns in Bangkok areas. This study was a blind independent comparison. Among 188 Green pit vipers collected only two species, i.e. Trimeresurus alborabris and T. macrops were found. There were no differences in snake sizes and in clinical patterns of snake bite. The majority of the clinical cases (90.1%) was classified as of mild degree of severity and severe envenomation was observed only in T. alborabris victims. The ratio between T. alborabris and T. macrops victims in Bangkok residents was 1.7:1 but the ratio was reversed in Thonburi residents.

Adult↗
PubMed1980

Clinical manifestations of bleeding following Russell's viper and Green pit viper bites in adults.

Clinical features and laboratory investigations following bites by Russell's viper and Green pit viper were described. Bleeding was the most important manifestation of envenomation. Clinically, bleeding patterns were local and systemic. Swelling was the principal local effect. Russell' viper victims showed less local effect but frequently developed renal complication i.e. acute renal failure. The local effects were more marked in Green pit viper victims. Digital bites developed gangrene more frequently than other bitten sites. Haematemesis and bleeding gums were the commonest types of systemic bleeding. The coagulation abnormalities following Russell's viper bite were compatible with DIC. After Green pit viper bites thrombocytopenia and increased fibrinolytic activity were observed in addition to defibrination. Cerebral haemorrhage was the cause of death in one of these victims.

Adolescent↗