The aim of this study is to identify different risk factors r. A 72-year-old woman was admitted to our hospital with fever and abdominal pain. Day wise relation of urinary output and renal function, All figure content in this area was uploaded by Sultan Mahmood. This species seems to prey heavily on flies which can be pests. They will also collect meat from freshly dead insects. Two patients stuck by more than 75 stings developed refractory pulmonary edema and died in the course of treatment. Recovery from AKI following multiple wa. Among the major toxic effects are hemolytic anemia, acute renal failure (ARF), and shock. In our study, we successfully recruited homology modeling and molecular dynamic (MD) simulation to model Ves a 1 three-dimensional structure. The offending wasp was brought to the hospital and the species was confirmed by a zoologist (Vespa affinis). after the sting with 2%. Photos copyright and courtesy of Christophe Barthelemy (Hong Kong). This chapter explains how several drugs are eliminated during their passage from the gut lumen to the systemic circulation. Along with several other pathomechanisms, rhabdomyolysis is a distinguished cause of acute kidney injury (AKI) in patients with wasp sting. Most patients survived with complete recovery of their kidney function. are not commercially available for this species. We report a case of hornet (Vespa affinis) sting causing Kounis syndrome in Sri Lanka and present a review of literature. All rights reserved. One patient had complete recovery of renal function on follow-up, while the other was lost to follow-up. Nests built in high trees are generally elongated, and look similar to the nest of Vespa velutina. Immediately she was seen by a local physician and was treated with the injection of hydrocortisone and pheniramine maleate. These complications may be seen more in children, elders, and patients whose physical strength is weak, Translational research in the field of Toxicology, To study the clinical and laboratory abnormalities associated with Star Fruit intoxication, Nipah virus poses a continued significant public health threat to Bangladesh as its outbreak occurs almost on yearly basis since 2001. Subgroup analysis showed no difference in the mortality rates between the CVVH, CVVH + PE, and IHD groups (8.0%, 7.1%, and 11.1%, respectively; P>0.99). :v(�Pء���:4���@s�9�`4���@g�3��T���G9K1K9K1K9K1K9K1K9K1K9K1Kُ��\�\�\]�E?�~�(�Q���Gя�E?�~����o����o����o����o���џN�h; Possibly, larger colony sizes and constant hot weather cause most wasps to be more defensive in tropical regions. Interestingly, molecular docking predicted another lipid binding region apart from its corresponding catalytic site, suggesting an auxiliary role of the alternative site at the Ves a 1 surface. H�\�͊�@�OQ��E��n�� H'ݐ��0�y ���0Q1f���:��FHW�s��,O���/��4dU����u���a�����ߦ6N]v���G�n��'^b?�­׮����/����D�/˞�m��������?�ct�r�"��x�&Nu�YU�c���t��ط�ݷ�ˎ��w=eU���"�R�������y˼E�1�ߘߐߙ��|�����y�\2�Ȟ�#� ����ʬ��l�tz8=�N�a� �2��,4B�� 4B�� 4B�� 4B�� 4B�� 4�b`��� Fatalities due to anaphylaxis following V. affinisstings have been reported in Sri Lanka [11][12][13] and South East Asia [2,[14][15][16][17] Several case reports of V. affinis allergy and envenomation have also been reported from India [18][19][20], Nepal [21,22] and Bangladesh, ... Maybe if these individuals were stung at many times, they would face severe complications such as muscle destruction, kidney failure, and even death (52)(53)(54)(55). The recovery time for kidney function was significantly shorter in the CVVH and CVVH + PE groups than in the IHD group (31.9±8.5 days, 28.6±9.4 days, and 41.6±8.1 days, respectively; P<0.001). endstream endobj 495 0 obj <>stream On the other hand, specimens from Southeast Asian regions such as Singapore are fully black, without reddish brown markings, and the abdominal band is a brilliant orange. We herein report a case in which the patient developed rhabdomyolysis followed by AKI due to multiple wasp stings. Use of The secreted toxic components from venom glands are vital to wasp survival in protection against enemies and in prey hunting [2]. Clin J Am Soc Nephrol 2013; 8(11): attack by Africanized bee stings. Also, there is an interesting variation of nest shapes; in tropical areas, the top of the nest is very narrow but tapers out downwards, forming a "pear-shaped" or "drop-shaped" structure. by an expert zoologist. The highest percentage of redness in the individuals was 47% in the first day, and the lowest belonged to four or five days unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. This circumstance has prevented efficient design of a potential phospholipase A1 inhibitor. a case series. This is a small to medium-sized hornet, with queens reaching 30mm, males 26mm and workers being an average of 22 to 25mm. The first 100 words appear below: Sting complications in the individuals were studied according to the ���D�H�U`5��~`�� �$�X����"e����t���`]`R!�|D2ځEB@$�}��R�H�t The patient recovered completely after peritoneal dialysis. The photos below show a nest of this species, cut open to reveal four combs. Along with several other pathomechanisms, rhabdomyolysis is a distinguished cause of acute kidney injury (AKI) in patients with. SM also con, to the writing of the case report. Below: Vespa affinis from Singapore. In addition, we performed molecular docking of Ves a 1 with 1,2-Dimyristoyl-sn-glycero-3-phosphorylcholine (DMPC) lipid to assess a possible lipid binding site. J. Discussion: Wasp sting usually results in pain and allergic reactions, though severe anaphylaxis may occasionally occur. We report the cases of two patients who developed acute renal failure following multiple wasp stings. To observe the outcomes of AKI following multiple wasp stings. Case report: A middle aged physician was stung by a swarm of wasps at multiple sites of the body. However species specific report is importan, to understand the geographical distribution (N, in the national guideline of poisoning ma, Bangladesh, so that all level of physicians can r, PU and FRC wrote the case report. endstream endobj startxref Liver enzymes normalized within 2 weeks as well as jaundice. In fully tropical areas, it seems present all the time. Therefore, This species is widespread throughout Asia. Previously unexposed people may develop m, patient developed severe body ache on the day o, tensive haemodialysis. The average RRT time was 18.2±8.4 days, and the average kidney function recovery time was 36.0 (29.0, 41.0) days. Subsequently, creatinine increased for the next three days. Bee venom is a complex substance, which acts in several tissues. Conclusions: High IgE reactivity for five allergens of V. affinis points to the potential of using these allergens in Multiple sting marks with central white necrosis and surrounded erythema and the offender species ( Vespa affinis ). The same appears to be true of Vespa tropica. Vespa affinis forages close to the ground in grassy areas, forest and wasteland. Nests in subtropical regions are simply oval with a rounded top. Mechanisms behind the multiorgan dysfunctionproduced by these mass envenomations are not clearly understood.We present a case of an 8-year-old boy who was stung by multiple bees and developed progressive upper-body swelling andsystemic manifestations of mass envenomation including rhabdomyolysis,renal insufficiency, and a transient transaminase elevation. Below: A mid-stage nest inside an abandoned hen-house in a rural village in Hong Kong. However, data on the venom components attributable to the sting derived-clinical manifestations (local reactions, IgE mediated-anaphylaxis, or systemic envenomation) are lacking. �t�H~O0�d+�%�`Y��`q�YA6�{ t#c ��Q'���q�� �D Most sting cases were in the age group of 11 - 20 However, large numbers of workers will swarm out and attack pugnaciously when the nest is disturbed. However, they can be distinguished by having a more imbricate nest envelope (many individual overlapping circular layers of papering, as opposed to running vertically lengthwise), and the nest has a tough, durable appearance. elated to date palm sap (DPS) collection, marketing and consumption behaviours and practices that are possibly responsible for Nipah outbreaks in Bangladesh by comparing Nipah-affected and non-Nipah-affected areas. Intense itching was one of the main symptoms of velvet ant stings. h�bbd```b``�"��H�*� &7�HA!������ R�D Diffuse tumors of the liver were detected by computed tomography examination on admission. They also love the nectar from flowers of the coconut tree, and often, after drinking their fill, conveniently grab a honeybee from a nearby flower and head for home. %%EOF In Singapore, it can frequently be found on the beach, staying near rotting mussels which smell bad and attract flies. from different areas of Iran. Other supportive measures incl. Unrecognized anaphylactic reactions to hymenopterid stings by apids, or bees, and vespids, or wasps, are a significant cause of sudden and unanticipated deaths outdoors in young people, with and without atopic histories. No other medication was reported in the previous 6 months of the onset of jaundice. Galle Med J 2008; 13(1):55-6. !f �0���2��@��a�f�Q`f�%���U����u/��I@,�� �Y$?in�m^��[�� �*1�N�*�` xCc Although all varieties of honey bee havethe potential for these attacks, the Africanized honey bee (Apismellifera scutellata) is the most commonly implicated subspecies.In the United States, the Africanized strain is found primarilyin the southwestern states and is known for its highly defensivebehavior if disturbed. Hymenopterid stings and subsequent allergic reactions are a common indication for emergency department visits worldwide. Nest built lower in smaller trees or buildings usually stay round and do not attain such large sizes. Wasp sting is a relatively common arthropod assault. Chowdhury FR, Bari MS, Shafi AM, Ruhan AM. Rhabdomyol, intrarenal vasoconstriction and ischaemia in patien, renal hypo-perfusion. The first sign of the sting was a severe and It would be particularly useful in cases with doubtful double-positive results of other diagnostic tests. case of histologically proved cholestatic hepatitis induced by intravenous ajmaline testing. Vespa affinis is the species commonly found in this region which can bring catastrophe.

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