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Am I missing something?
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by kacz on September 12, 2006
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Before my real question I would like to refer to some of your recent news articles and ask (with my tongue firmly in my cheeck) if we should tell Ray Gross (http://www.upi.com/NewsTrack/view.php?StoryID=20060910-053942-2645r) about Dr. Pawar's pill (http://cities.expressindia.com/fullstory.php?newsid=200811#)? It may make fatalities from the very, very dangerous black racer a thing of the past! I bet it will work for Elaphe and Thamnophis envenomations as well. Next time I'm in the field I'll make sure that I take some Pinak along with my weight reduction belt and magnetic bracelet.
The real question is inspired by the article on Australian venom yields (http://abc.net.au/science/news/stories/2006/1735471.htm). The yields to which they refer are from milking. Although this may raise the bar for potential envenomations, except for a few species, it has little correlation to actual bite yeilds. Another article (http://news.bbc.co.uk/2/hi/south_asia/5314104.stm) stated that there was only one fatality in Australia last year. In a country where a venomous snake is the norm, I'd say that their treatment protocol is outstanding. What needs to be re-thought?
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RE: Am I missing something?
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by Cro on September 13, 2006
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Paul, I think the problem is that it is just more difficult to measure actual bite yeilds.
Some studies have done this by injecting radioactive isotopes into snakes venom glands, and then allowing the snake to bite lab animals and then calculating just how much venom was delivered in a bite by the ammount of isotope detected in the bitten animal.
Assuming a snake with a larger milked venom yield would deliver proportionatly more venom in an actual bite than a snake that has a smaller milked venom yield sort of makes sense. At the least, it does tell us that a snake with a larger milked venom yield has the potential to deliver a much more dangerous bite.
It is possible though, as you state, that a snake with a large supply of venom might not use very much in an actual bite.
If the snake is able to meter venom based on its judgement of prey size or threat size, we could have bite venom yields that would vary greatly.
Best Regards JohnZ
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RE: Am I missing something?
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by BGF on September 13, 2006
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The key here is a comparison to the previous milkings that were done decades ago and what are used to guide the antivenom recommendation. The original milkings were of South Australian and Victorian populations but did not investigate Queensland (where more bites also occur). The Queensland populations can give vastly more venom. Thats the most important part of their study. It is milkings compared to milkings, therefore its an appropriate comparison.
Actually translations to real bites may vary of course. But the essential aspect is to get an early bolus of antivenom, this improves clinical outcomes and actually may reduce the total amount needed. Get it in early in a good amount and things turn out much better in the end.
Not exactly rocket science but something many clinicians fail to understand. Sometimes its effectively a case of 'we'll just wait until he starts bleeding inside his brain and out of his bum then we'll do something about that swelling on his arm!'.
Cheers
B
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