TOXOCON 2

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OBJECTIVES

This conference was planned to evolve a standardized protocol for effective medical management of snakebite, since W.H.O. statistics state that the death toll due to snakebite in India is around 50,000 per annum. In fact, many Indian authorities believe the actual number to be much higher. Currently, treatment quality is highly varied, ranging from excellent quality in some areas, to areas where very poor quality treatment is administered. It is obvious from the WHO statistics that India has the highest death toll in terms of absolute numbers from snakebite, when compared to any other country in the world.

THEME

Snakebite

PROGRAM OUTCOME

An Indian Protocol on the management of snakebite has been evolved through intensive discussions among 40 invited experts over the two-day period of the conference (list of experts enclosed). This has been submitted to the WHO by Mr. Ian Simpson, the Jt. Organizing Secretary for approval, after which it will be published and distributed to all major hospitals in the country.Invited lectures were delivered by some of these experts, as also an international expert, Prof Robert Norris of Stanford School of Medicine, USA, who is renowned for his work on snakebite.

A brief overview of the submitted final protocol is as follows:

  1. First Aid Measures:
    1. Focus on reassurance, immobilization, and transport to nearest hospital.
    2. No tourniquet, incision & suction, cryotherapy, herbal remedies
  2. Hospital Measures:
    1. Admit every snakebite case to hospital for 24 hours
    2. Monitor for signs of envenomation
    3. Give antisnake venom at the earliest on signs of envenomation
    4. No need of test dose. Keep life saving drugs ready for anaphylactic reactions
    5. Do not neglect supportive measures
    6. Refer complicated cases to tertiary hospital
By adopting these guidelines, a major step forward could be taken in reducing Indian snakebite mortality to levels experienced in those countries recognised as leaders in the field.

ORGANIZING SECRETARY

Dr. V. V. Pillay

Poison Control Centre
Amrita Institute of Medical Sciences, Cochin 682 026

JOINT ORGANIZING SECRETARY

Mr. Ian Simpson

W.H.O. Snakebite Treatment Group
Tamil Nadu Government Snakebite Task Force
Little Flower Hospital Snakebite Research Unit
SRM Medical College Snakebite Research Unit

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Invited Experts
  1. International -
    1. Robert Norris, MD, FACEP (Attended at own expense)
      Associate Professor of Surgery/Emergency Medicine
      Chief, Division of Emergency Medicine
      Stanford University Medical Center, USA
  2. Local -
    1. Dr Joseph K Joseph
      Head of Clinical Medicine
      Little Flower Hospital
      Angamaly
      Kerala
    2. Dr CK Eapen
      Medical Superintendant
      Malankara Orthodox Syrian Medical College
      Kolenchery 682311
      Kerala
    3. Mr. Ian Simpson
      W.H.O. Snakebite Treatment Group
      Tamil Nadu Government Snakebite Taskforce
      India Office: Kooran House, Nayathode, Kerala
    4. Dr. V. V. Pillay
      Chief, Poison Control Centre
      Professor, Dept of Forensic Medicine
      Amrita Institute of Medical Sciences, Cochin, Kerala
    5. Prof. M. R. Chandran
      Vice Principal
      Head, Forensic Medicine & Toxicology
      Amala Institute of Medical Sciences
      Thrissur, Kerala
    6. Prof. R. N. Sharma
      Professor & Head
      Dept of Medicine
      Pushpagiri Institute of Medical Sciences
      Thiruvalla, Kerala
    7. Prof. G. Ganapathi Rao
      Professor & Head
      Dept of Medicine
      Amrita Institute of Medical Sciences
      Cochin, Kerala
    8. Dr Sunil Thomas
      Malankara Orthodox Syrian Medical College
      Kolenchery 682311
      Kerala
  3. Outstation -
    1. Prof. S Mahadevan
      Department of Pediatrics
      J.I.P.M.E.R.
      Pondicherry 605006
    2. Prof. Mabel Vasnaik
      Department of Emergency Medicine
      St Johns Medical College Hospital
      John Nagar
      Bangalore 560034
    3. Prof. Surjit Singh
      Professor
      Department Of Internal Medicine
      Nehru Hospital
      Post Graduate Institute Of Medical Education and Research
      Chandigarh-160012
    4. Dr R.Thirumavalavan
      SRM Medical College Hospital & Research Centre
      SRM Nagar
      Kattankulathur
      Kancheepuram District
      Tamil Nadu 603203
    5. Dr. Sharda Shah Peshin
      Scientist, Department of Pharmacology
      National Poisons Information Centre
      All India Institute of Medical Sciences
      Ansari Nagar
      New Delhi -110029
    6. Lt Col Vivek Lal
      Dept of Pharmacology
      AFMC
      Pune - 411040
    7. Dr C Rajendiran
      Chief IMCU & Poisons Centre
      Madras Medical College
      Chennai 600003
      Tamil Nadu
    8. Dr (Mrs.) R.A.Deshmukh
      Director
      Haffkine Institute for Training, Research & Testing
      Acharya Donde Marg
      Parel, Mumbai – 400 012
    9. Mr Ashok Captain
      3/1 Boat Club Road
      Pune 411 001
      Maharashtra
    10. Dr SP Kalantri
      Professor of Medicine
      Mahatma Gandhi Institute of Medical Sciences
      Sevagram, Wardha
      Maharashtra 442 102
    11. Dr Soumitra Ghosh
      Associate Professor , Medicine
      Calcutta National Medical College
      32, Gora Chand Road
      Kolkata 700014
    12. Chittaranjan Andrade, M.D.
      Professor in Psychopharmacology
      National Institute of Mental Health and Neurosciences
      Bangalore 560 029
    13. Dr. S. K. Shukla
      Director
      Central Forensic Science Laboratory
      Hyderabad
    14. Prof. P. T. K. Subramanian
      Professor & Head
      Dept of Medicine
      Govt Medical College
      Madurai, TN
    15. Prof. P. K. Devadass
      Professor & Head
      Dept of Forensic Medicine & Toxicology
      Bangalore Medical College
      Bangalore
    16. Dr. Somnath Das
      Dept of Forensic Medicine & Toxicology
      Calcutta Medical College
      Kolkata
    17. Prof. B. D. Gupta
      Professor & Head
      Dept of Forensic Medicine & Toxicology
      BJ Medical College
      Jamnagar, Gujarat
    18. Prof. Vina R. Vaswani
      Professor & Head
      Dept of Forensic Medicine & Toxicology
      Yenepoya Medical College
      Mangalore
    19. Dr. P. I. Inamadar
      Dept of Forensic Medicine & Toxicology
      KS Hegde Medical College
      Mangalore
    20. Prof. Silvano Dias Sapeco
      Professor & Head
      Dept of Forensic Medicine & Toxicology
      Goa Medical College
      Goa
    21. Dr. Manoj Kumar Mohanty
      Dept of Forensic Medicine & Toxicology
      Siddhartha Medical College, Gannavaram
      Krishna District, AP
    22. Dr. Vikram Palimar
      Dept of Forensic Medicine & Toxicology
      Kasturba Medical College
      Manipa
    23. Dr. Ritesh G. Menezes
      Dept of Forensic Medicine & Toxicology
      Kasturba Medical College
      Manipal
    24. Dr. Binaya Kumar Bastia
      Associate Professor
      Dept of Forensic Medicine & Toxicology
      SDM Medical College
      Dharwad, Karnataka
    25. Prof. K. H. Manjunath
      Professor
      Dept of Forensic Medicine & Toxicology
      Bangalore Medical College
      Bangalore
    26. Dr. B. R. Sharma
      Professor & Head
      Dept of Forensic Medicine & Toxicology
      Govt Medical College
      Chandigarh
    27. Dr. Madhu S. Ghodkirekar
      Dept of Forensic Medicine & Toxicology
      Goa Medical College
      Goa
    28. Dr. B. N. Mohapatra
      Dept of Medicine
      SCB Medical College
      Cuttack, Orissa
    29. Dr. M. Chakrapani
      Professor
      Dept of Medicine
      Kasturba Medical College
      Mangalore
    30. Dr. Sanjeev Bhoi
      Dept of Emergency Medicine
      AIIMS, New Delhi
    31. Dr. B. Sadananda Naik
      Physician
      Alva’s Clinic, Moodabidri
      Karnataka
    32. Dr. Jasjit Singh
      Dept of Emergency Medicine
      Military Hospital
      Amritsar

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