Rediscovery of Severe Saw-Scaled Viper (Echis sochureki) Envenoming in the Thar Desert Region of Rajasthan, India》.pdf

Wilderness and Environmental Medicine, 18, 75 85 (2007) ORIGINAL RESEARCH Rediscovery of Severe Saw-Scaled Viper (Echis sochureki) Envenoming in the Thar Desert Region of Rajasthan, India D. K. Kochar, MBBS, MD; P. D. Tanwar, MBBS, MD; Robert L. Norris, MD; M. Sabir, MBBS, MD; K. C. Nayak, MBBS, MD; T. D. Agrawal, MBBS, MD; V. P. Purohit, MBBS, MD; A. Kochar, MBBS; Ian D. Simpson, BSc, DM From S.P. Medical College Bikaner, Rajasthan, India (Drs D. Kochar, Tanwar, Sabir, Nayak, Agrawal, Purohit, A. Kochar, and Simpson); Stanford University Medical Center, Palo Alto, CA (Dr Norris); and World Health Organization Snakebite Treatment Group (Dr Simpson). Category 1 Continuing Medical Education credit for WMS member physicians is available for this article. Go to /cme/cme.asp?whatarticle 1821 to access the test questions. Objectives.—In India, venomous snakebite remains an enigma. Although ineffective first aid treat- ments that are centuries old continue to be used by people bitten by snakes, important factual infor- mation, such as the importance and uniqueness of bites by the northern saw-scaled viper (Echis sochureki), has been largely lost and forgotten. In this paper, we report the first systematically gathered data on the clinical course of envenoming by E sochureki in Rajasthan, India. Clinical information is reported on 12 victims bitten by definitively identified E sochureki, and 2 clinical cases are described in greater detail to illustrate the severity of envenoming by this snake. Methods.—A data collection form was developed and used to prospectively gather clinical infor- mation regarding patients who were bitten by E sochureki and who brought the dead snake with them to hospital. All snakes were definitively identified by an experienced