AUCTORES
Globalize your Research
Research article | DOI: https://doi.org/10.31579/jsrbi.2022/025
Recep Tayyip Erdoğan University (RTEU), Medical Faculty, Department of Medical Physiology, Turkey.
*Corresponding Author: Yıldız L.Z, Recep Tayyip Erdoğan University (RTEU), Medical Faculty, Department of Medical Physiology, Turkey.
Citation: Yıldız L.Z (2022). Diagnostics and Identification of the Degree of Intoxication of Patients Bitten by a Poisonous Snake (Macrovipera Lebetina Obtusa). J. Scientific Research and Biomedical Informatics, 3(1); DOI:10.31579/jsrbi.2022/025
Copyright: © 2022 Yıldız L.Z, This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Received: 27 December 2021 | Accepted: 24 December 2021 | Published: 05 January 2022
Keywords: blood serum; Macrovipera lebetina obtuse; patients; venom snake
This paper presents the results of experimental studies to identify the degree of intoxication of patients bitten by a poisonous snake (Macrovipera lebetina obtusa), who are being treated in the clinic.
The aim of the research was to determine the content of snake venom in the blood of people with intoxication of varying degrees, which develops after the bite of poisonous snakes by the method of introduced fluorescence. The research material was the blood serum of patients bitten by a poisonous snake (Macrovipera lebetina obtusa). The determination of snake venom toxins in the blood of patients was carried out using a combination of extraction methods in the blood-0.9% sodium chloride solution, followed by determination on a Hitachi-850 spectrofluorimeter (Japan).
As a result of experimental studies, a mild degree of intoxication with snake (Macrovipera lebetina obtusa) venom was revealed with the content of toxins in the blood of patients in the range of 0.125-0.850 μg / ml (on average 0.492 μg / ml) and a severe degree of intoxication with the content of toxins in the blood of patients bitten by snake at a concentration of within 14.50-20.30 μg / ml (average 17.10 μg / ml).
Snake venom is of great value for medicine and biology. It is used to prepare antivenom serums. Venom of viper is used as a hemostatic agent and during operations for the removal of tonsils, during nosebleeds, etc. [12].
The rational use of zootoxins in medical practice is impossible without experimental study and theoretical substantiation of the essence of the reactions developing in the body in response to the penetration of one or another venom. Snake venoms have a strong toxic effect only in lethal or sublethal doses. Small doses of venom do not cause any clinical manifestations of poisoning and have long been used in the treatment of many serious diseases [3, 4].
More recent examples of innovation within snakebite diagnostics in Brazil include an impedimetric immunosensor based on electrochemical impedance spectroscopy [5], while a different group similarly developed an ELISA and an immunochromatographic strip for diagnosis of snake species in Taiwan [6].
The poison that has entered the body is distributed very unevenly. Biological barriers (capillary walls, cell membranes, hematoencephalic and placental barriers) have a significant effect on the distribution of toxic compounds. Most zootoxins undergo biotransformation in the body, many aspects of which have not been sufficiently studied [7, 8].Undoubtedly, the effective use of snake venoms in the clinic should be based on a deep knowledge of their composition and properties and, first of all, on experimental research.Experimental studies and clinical observations indicate serious structural disorders in organs and tissues under the poisonous action of snake venoms. Their nature is associated with the species of the snake, the dose of venom and its activity, the place of the bite, etc., which must be taken into account when carrying out medical measures.There are no methods of express-analysis of the concentration of snake venom in the blood of patients bitten by a poisonous snake, contributing to the optimization and rationalization of pharmacotherapy.
Animal poisons are used as diagnostic agents for blood diseases and for obtaining an experimental model, in order to test new drugs in violation of blood clotting, water-salt metabolism, etc. Thus, there is no doubt about the value of snake venom for the diagnosis and treatment of diseases.
In the literature, there are isolated works on the possibility of using fluorescent probes in pharmacology, in the study of the distribution of drugs in tissues and cells of a living organism. However, there are no data on the study of the pharmacokinetics of the poison of the Transcaucasian viper using a fluorescent probe.Currently, there are no unified methods for the differential determination of the nature of various zootoxins. Methods for detecting the degree of poisoning and non-specific methods of treatment need to be improved, since recommendations and instructions on methods of treatment for snake bites do not always give the desired therapeutic effect [9, 10, 11].For the appropriate conduct of pharmacotherapy, it is important to study the penetration of animal poisons into organs and tissues. The importance of the problem is determined by the fact that the site of impact of snake venoms is not only blood, but also other tissues and cells.The study of the distribution of viper venom during intoxication seems essential to them not only to determine the severity of intoxication, the prognosis of the disease, but also in the development of measures to combat the coming shifts, as well as to prevent possible complications.Elucidation and development of methods for studying this problem is relevant not only from the point of view of determining and choosing the most rational measures to combat the intoxication with snake venoms, often with improper treatment that ends in death. This is of great importance in the light of identifying the possibility of using small doses of venom, as well as its individual fractions and enzymes that make up its composition as medicines for various diseases.
Snakebite envenoming is predominantly an occupational disease of the rural tropics, causing death or permanent disability to hundreds of thousands of victims annually. The diagnosis of snakebite envenoming is commonly based on a combination of patient history and a syndromic approach. As such, achieving timely diagnosis, and thus treatment, is a challenge faced by treating personnel around the globe. For years, much effort has gone into developing novel diagnostics to support diagnosis of snakebite victims, especially in rural areas of the tropics. Gaining access to affordable and rapid diagnostics could potentially facilitate more favorable patient outcomes due to early and appropriate treatment [12].
A small number of works have been devoted to the study of the distribution of animal venoms in the experiment. In the literature, there are isolated works on the application of the method of fluorescent probes in pharmacology, in particular, in the study of pharmacokinetics of drugs [13].Due to the lack of information on the pharmacokinetics of zootoxins, we decided to investigate the kinetics and distribution of the viper venom in an experiment using a fluorescent probe. By measuring fluorescence, information about conformation, binding sites, interactions with a solvent, and other information can be obtained.
Insufficient development of methods for determining the concentration of snake venom in the blood of patients, the lack of an express analysis of the presence of zootoxins, often do not allow practitioners, by quickly eliminating the development of subsequent links in the pathogenesis of intoxication, promptly to contribute to the achievement of the required therapeutic effect.
As you know, the general reaction of the body to snakebites, first of all, depends on the amount, location of the bite and the activity of the injected venom.
The main task in providing assistance to victims of a snake bite, in essence, comes down to blocking or destroying the venom and stimulating the body to fight the secretion of the snake's venomous glands that has penetrated the blood and lymph.
In this regard, the correctness in the appointment of doses, applied medications and serum, determines the outcome of treatment, eliminates their side effects. Therefore, the primary and necessary is the determination of the concentration of the venom in the victim's body.
Thus, all of the above indicates that in the experimental and clinical study of snake venoms there are contradictory and very complex problems that require further study and resolution.
Based on the foregoing, the purpose of these studies was determination of the content of snake venom by the method of introduced fluorescence in the blood of people with intoxication of varying degrees, developing after the bite of poisonous snakes.
Material and research Methods
The research material was the blood of patients bitten by a poisonous snake (Macrovipera lebetina obtusa). The determination of snake venom toxins in the blood of patients was carried out using a combination of extraction methods in the blood-0.9% sodium chloride solution, followed by determination on a Hitachi-850 spectrofluorimeter (Japan).
Research results
The studies were carried out in the blood of patients undergoing treatment at the Republican Toxicological Center after snake bites. The age of the patients ranged from 12 to 42 years, of which 11 were men, 4 were women. The concentration of snake venom toxins was determined spectrofluorimetrically.
During their stay in the clinic, blood was taken from all patients from a finger in an amount of 0.1 ml (once for spectrofluorometric quantitative determination of the content of snake venom), 10 hours after the bite, presumably by a viper, into the lower leg.
Table 1 and 2 show the spectrofluorometric parameters of blood in patients bitten by a poi-sonous snake. As can be seen from tables 1 and 2, toxic effects are observed in patients with different concentrations of toxins. The severity of intoxication practically depends on the on cen-tration of the venom. A moderate effect is observed when the content of toxins in the blood of patients is in the range of 0.125-0.850 μg / ml (on average 0.492 μg/ml), and serious toxic signs of snake venom - at a concentration of 14.50-20.30 μg / ml (average 17.10 μg/ml).
Figure 1 shows a diagram of the grouping of patients bitten by snake, according to the levels of toxins in the blood. Based on the data on the concentration of snake venom in the blood of patients, it is possible to establish a high level of toxins and the maximum permissible safe concentration, that is, to establish the likelihood of extremely toxic phenomena.
If the level of venom is higher than the maximum allowable, then the safety of treatment may be at risk. Although the values of the average minimum and maximum permissible concentrations can vary individually, nevertheless, in many cases, the differences turn out to be much smaller than the individual fluctuations.
An illustration of the concentration of snake venom depending on the severity of poisoning is shown in Figure 2.
As can be seen from the figure, toxic effects are observed in different patients with different values of the concentration of snake venom.
The method of introduced fluorescence applied by us, from our point of view, can become one of the most effective ways to control the content of zootoxins in the blood of patients with snake venom poisoning. It should be especially emphasized that the method of fluorescent probes is one of the methods of express analysis, which requires a minimum amount of time - about 20 minutes (from the moment of sampling) and a small amount of blood - 0.2-0.02 ml.
Thus, with the use of fluorescein, priority results were obtained, ways of their practical application in medical zootoxinology were developed, and the prerequisites for its diagnostic use were determined.
Conclusions
Clearly Auctoresonline and particularly Psychology and Mental Health Care Journal is dedicated to improving health care services for individuals and populations. The editorial boards' ability to efficiently recognize and share the global importance of health literacy with a variety of stakeholders. Auctoresonline publishing platform can be used to facilitate of optimal client-based services and should be added to health care professionals' repertoire of evidence-based health care resources.
Journal of Clinical Cardiology and Cardiovascular Intervention The submission and review process was adequate. However I think that the publication total value should have been enlightened in early fases. Thank you for all.
Journal of Women Health Care and Issues By the present mail, I want to say thank to you and tour colleagues for facilitating my published article. Specially thank you for the peer review process, support from the editorial office. I appreciate positively the quality of your journal.
Journal of Clinical Research and Reports I would be very delighted to submit my testimonial regarding the reviewer board and the editorial office. The reviewer board were accurate and helpful regarding any modifications for my manuscript. And the editorial office were very helpful and supportive in contacting and monitoring with any update and offering help. It was my pleasure to contribute with your promising Journal and I am looking forward for more collaboration.
We would like to thank the Journal of Thoracic Disease and Cardiothoracic Surgery because of the services they provided us for our articles. The peer-review process was done in a very excellent time manner, and the opinions of the reviewers helped us to improve our manuscript further. The editorial office had an outstanding correspondence with us and guided us in many ways. During a hard time of the pandemic that is affecting every one of us tremendously, the editorial office helped us make everything easier for publishing scientific work. Hope for a more scientific relationship with your Journal.
The peer-review process which consisted high quality queries on the paper. I did answer six reviewers’ questions and comments before the paper was accepted. The support from the editorial office is excellent.
Journal of Neuroscience and Neurological Surgery. I had the experience of publishing a research article recently. The whole process was simple from submission to publication. The reviewers made specific and valuable recommendations and corrections that improved the quality of my publication. I strongly recommend this Journal.
Dr. Katarzyna Byczkowska My testimonial covering: "The peer review process is quick and effective. The support from the editorial office is very professional and friendly. Quality of the Clinical Cardiology and Cardiovascular Interventions is scientific and publishes ground-breaking research on cardiology that is useful for other professionals in the field.
Thank you most sincerely, with regard to the support you have given in relation to the reviewing process and the processing of my article entitled "Large Cell Neuroendocrine Carcinoma of The Prostate Gland: A Review and Update" for publication in your esteemed Journal, Journal of Cancer Research and Cellular Therapeutics". The editorial team has been very supportive.
Testimony of Journal of Clinical Otorhinolaryngology: work with your Reviews has been a educational and constructive experience. The editorial office were very helpful and supportive. It was a pleasure to contribute to your Journal.
Dr. Bernard Terkimbi Utoo, I am happy to publish my scientific work in Journal of Women Health Care and Issues (JWHCI). The manuscript submission was seamless and peer review process was top notch. I was amazed that 4 reviewers worked on the manuscript which made it a highly technical, standard and excellent quality paper. I appreciate the format and consideration for the APC as well as the speed of publication. It is my pleasure to continue with this scientific relationship with the esteem JWHCI.
This is an acknowledgment for peer reviewers, editorial board of Journal of Clinical Research and Reports. They show a lot of consideration for us as publishers for our research article “Evaluation of the different factors associated with side effects of COVID-19 vaccination on medical students, Mutah university, Al-Karak, Jordan”, in a very professional and easy way. This journal is one of outstanding medical journal.
Dear Hao Jiang, to Journal of Nutrition and Food Processing We greatly appreciate the efficient, professional and rapid processing of our paper by your team. If there is anything else we should do, please do not hesitate to let us know. On behalf of my co-authors, we would like to express our great appreciation to editor and reviewers.
As an author who has recently published in the journal "Brain and Neurological Disorders". I am delighted to provide a testimonial on the peer review process, editorial office support, and the overall quality of the journal. The peer review process at Brain and Neurological Disorders is rigorous and meticulous, ensuring that only high-quality, evidence-based research is published. The reviewers are experts in their fields, and their comments and suggestions were constructive and helped improve the quality of my manuscript. The review process was timely and efficient, with clear communication from the editorial office at each stage. The support from the editorial office was exceptional throughout the entire process. The editorial staff was responsive, professional, and always willing to help. They provided valuable guidance on formatting, structure, and ethical considerations, making the submission process seamless. Moreover, they kept me informed about the status of my manuscript and provided timely updates, which made the process less stressful. The journal Brain and Neurological Disorders is of the highest quality, with a strong focus on publishing cutting-edge research in the field of neurology. The articles published in this journal are well-researched, rigorously peer-reviewed, and written by experts in the field. The journal maintains high standards, ensuring that readers are provided with the most up-to-date and reliable information on brain and neurological disorders. In conclusion, I had a wonderful experience publishing in Brain and Neurological Disorders. The peer review process was thorough, the editorial office provided exceptional support, and the journal's quality is second to none. I would highly recommend this journal to any researcher working in the field of neurology and brain disorders.
Dear Agrippa Hilda, Journal of Neuroscience and Neurological Surgery, Editorial Coordinator, I trust this message finds you well. I want to extend my appreciation for considering my article for publication in your esteemed journal. I am pleased to provide a testimonial regarding the peer review process and the support received from your editorial office. The peer review process for my paper was carried out in a highly professional and thorough manner. The feedback and comments provided by the authors were constructive and very useful in improving the quality of the manuscript. This rigorous assessment process undoubtedly contributes to the high standards maintained by your journal.
International Journal of Clinical Case Reports and Reviews. I strongly recommend to consider submitting your work to this high-quality journal. The support and availability of the Editorial staff is outstanding and the review process was both efficient and rigorous.
Thank you very much for publishing my Research Article titled “Comparing Treatment Outcome Of Allergic Rhinitis Patients After Using Fluticasone Nasal Spray And Nasal Douching" in the Journal of Clinical Otorhinolaryngology. As Medical Professionals we are immensely benefited from study of various informative Articles and Papers published in this high quality Journal. I look forward to enriching my knowledge by regular study of the Journal and contribute my future work in the field of ENT through the Journal for use by the medical fraternity. The support from the Editorial office was excellent and very prompt. I also welcome the comments received from the readers of my Research Article.
Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.
I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!
"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".
I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.
We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.
I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.
I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.
I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.
Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.
“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.
Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.
Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.
