الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 134 |  |  |
| | | from | 134 | | |
Abstract
SUMMARY
S
corpion envenomation constitutes a genuine problem of public health all over the world, especially in North-Saharan Africa. Victims such as children and the elderly who suffer from respiratory and/or cardiovascular diseases become at high risk after scorpion envenomation if not managed adequately and quickly. The main life-threatening conditions are cardiopulmonary consequences and are attributed to the mortality in about 1% of all scorpion stings.
Several studies have been conducted recently with the help of hematological parameters, especially, the total and differential leukocytic count together with (PI) as potential new biomarkers to predict the severity of scorpion envenomation.
The aim of this study was to investigate possible alterations in some hematological parameters and their correlations to the severity of scorpion envenomation. In addition to assessment of the relation between these hematological alterations and antivenin therapy.
This study included 36 patients of both sexes presented to the Poison Control Center of Ain Shams University Hospitals (PCC-ASUH) within 24 hours with history of scorpion envenomation, from May 2018 to May 2019.
Patients were classified according to the severity of scorpion envenomation into two groups. group I (mild envenomation): patients presented with local manifestations only. group II (moderate and severe envenomation): patients with minor non –life threatening systemic manifestations in addition to patients with severe life-threatening systemic manifestations, together with presence of at least one of the signs; cardiogenic failure / respiratory failure or neurological failure.
The results were tabulated and statistically analyzed and revealed that: the mean age of patients was 29.65 ± 13.62 years in group I and 29.68 ± 14.79 years in group II. Male patients were the majority in each studied group. The highest percentage of patients came from Mansheyet Naser (25%) followed by El-Diwea (19.4%), El-Mokatam, El-Sharabia and Bolak El-Dakroor (16.6% each), 14.28% and the least number of cases came from Port Said and El-Wahat.
The mean delay time was higher in group II (2.42 ± 1.34) hours when compared with group I (2.15 ± 1.32) hours.
Most of the stings (70.6%) and (78.9%) in group I, II respectively were in lower limbs. No stings were observed in head, neck or trunk in both groups.
The mean values of systolic and diastolic blood pressure, pulse rate, and respiratory rate were significantly higher in group II when compared with group I. While the mean value of temperature was significantly lower in group II when compared with group I.
All cases of group I had no neurological manifestations. There was significant difference regarding headache and anxiety on comparing group II and group I. The majority of patients (94.7%) in group II had dilated pupil equally reacted to light which was highly statistically significant when compared to group I.
group II showed statistically highly significant difference regarding the occurrence of vomiting when compared to group I. Pain at the sting site was the only symptom observed in 41.2% of the patients in group I. While, all patients in group II had local pain at the sting site which was statistically significant when compared to group I.
Patients of group II showed statistically significant increase in hemoglobin level, hematocrit value and total leukocytic count when compared to those of group I. Also, patients of group II showed increase of the neutrophils, and lymphocytes when compared to those of group I.
In group II, patients showed decrease in platelet count when compared to patients of group I. While patients of group II showed increase of the platelet distribution width, mean platelet volume, and platelet large cell ratio when compared to those of group I. Patients of group II showed decrease in plateletcrit when compared to in patients of group I.
Patients of group II showed statistically significant increase in the APTT when compared to patients in group I.
Hematocrit value, total leukocytic count, neutrophils, platelet count, PCT and APTT were significantly lower in group II after antivenom therapy.
Total leukocytic count had the highest sensitivity in differentiating between the grades of severity of scorpion envenomation, followed by P-LCR and APTT. However, these parameters have the least specificity for scorpion envenomation.
All of patients of group I had normal ECG recordings. While, all patients of group II had abnormal ECG recordings in the form of rhythm abnormalities like tachycardia in 94.7% of patients and ST segment elevation in 5.3% of patients.
Forty-seven percentage of patients were observed and discharged from the emergency room while 50% of patients were treated in the inpatient department. Only one patient required admission in the ICU. All the patients were discharged with complete recovery with no morbidity or mortality.