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Sir,
I read the recent publication on scorpion envenomation with a great interest [1]. Prasad et al. reported the high rate of shock and concluded that “All patients had perspiration and cold extremities [1].” I would like to share my opinion on this topic. Of interest, the severity in this report by Prasad seems to be higher than those reported in previous publications [2, 3]. If we believe that there was no problem in case assessment in this report and there was no difference in the quality of the treatment, the exact cause of the difference is very interesting. Whether the different findings in different settings are due to the kind of the scorpions, is an interesting question to be answered.
References
Prasad R, Mishra OP, Pandey N, Singh TB. Scorpion sting envenomation in children: factors affecting the outcome. Indian J Pediatr. 2010 Oct 13. [Epub ahead of print].
Bosnak M, Ece A, Yolbas I, Bosnak V, Kaplan M, Gurkan F. Scorpion sting envenomation in children in southeast Turkey. Wilderness Environ Med. 2009;20:118–24.
Bosnak M, Levent Yilmaz H, Ece A, et al. Severe scorpion envenomation in children: management in pediatric intensive care unit. Hum Exp Toxicol. 2009;28:721–8.
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Sir,
Regarding the main concern that all patients had perspiration and cold extremities, I would like to reply that our center is a tertiary care teaching hospital, where patients are refered from periphery in late stages i.e. primary, community and district health centers. In addition, we excluded grade 1 envenomation i.e. local pain and swelling.
Moreover, patients included in this study were those who were admitted in the pediatric indoor and it is true that all admitted children. with envenomation had perspiration and cold extremities.
Dr. Rajniti Prasad,
Assistant Professor,
Department of Pediatrics,
Institute of Medical Sciences,
Banaras Hindu University,
Varanasi-221005, India.
e-mail: rajnitip@gmail.com
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Wiwanitkit, V. Scorpion Sting Envenomation. Indian J Pediatr 78, 1021 (2011). https://doi.org/10.1007/s12098-010-0320-x
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DOI: https://doi.org/10.1007/s12098-010-0320-x