Literature DB >> 24479031

Prazosin, scorpion sting and dr. Bawaskar.

Yerramilli V Siva Sankara Murty1.   

Abstract

Entities:  

Year:  2012        PMID: 24479031      PMCID: PMC3893974          DOI: 10.4103/2249-4863.104993

Source DB:  PubMed          Journal:  J Family Med Prim Care        ISSN: 2249-4863


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Dear Editor, We read with great interest Ajinkya A Kale's inspirational biography “A crusade against scorpion sting: Life and works of Dr. Himmatrao Bawaskar”.[1] In our routine pediatric practice we see Prazosin doing wonders in the management of scorpion bite. Scorpion bite delays the inactivation of sodium channels of autonomic nervous system resulting in autonomic storm. The scorpion venom acts as a powerful stimulus for massive release of catecholamines, suppression of insulin secretion, and elevation of plasma angiotensin II level, which in turn cause pathological changes, metabolic disturbances, and cardiovascular manifestations of scorpion sting. Prazosin antagonises the effects of catecholamines thereby preventing further damage of myocardium though it cannot reverse the damage. Prazosin also acts by reducing preload, after load and blood pressure without increase in heart rate. It is an inhibitor of phosphodiaesterase and causes accumulation of cGMP and inhibits formation of inositol triphosphate. Thus, Prazosin results in blunting of catecholamine action on myocardium. It also increases insulin secretion. This results in correction of hyperglycemia, hyperkalemia, and helps in saving the myocardial muscle. The work of Dr. Himmatrao Saluba Bawaskar on Prazosin and scorpion sting[23456] needs lot of appreciation and applaud. It is a common observation in our routine practice that the outcome of scorpion sting envenomation depends largely on the time taken from scorpion sting to administration of prazosin. This was also reported by several authors who worked in the field.[78] Not only Dr. Bawaskar's research on management of scorpion sting is commendable but also his concern for the society. He travelled throughout western Maharashtra where Mesobuthus tamulus scorpion flourish, and taught all peripheral doctors how to treat scorpion sting victims resulting in prevention of several deaths.[6] In an attempt to describe the life and work of Dr. Bawaskar the author Ajinkya A Kale brought about how a doctor should be. In today's world to earn back the crores of fee paid to the private medical colleges doctors are not even having the “himmat” to think of rural practice. In contrast to resource poor settings of Dr. Bawaskar, doctors now are having latest gadgets and technology but not having the inclination to produce a scientific paper except for their promotion. The duty mindedness of Dr. Bawaskar in attending to a patient despite his father's death is in sharp contrast to today's doctors who are only worried about accumulating wealth for the generations to come. The message of Dr. Bawaskar at the end of the article only sums up how a doctor should live his life. In brief, the author gave a great example to follow for the doctors around the world. Such inspirational articles are the need of the hour.
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1.  Management of scorpion sting.

Authors:  H S Bawaskar; P H Bawaskar
Journal:  Heart       Date:  1999-08       Impact factor: 5.994

2.  Of prazosin and purses.

Authors:  B Adhisivam
Journal:  Lancet       Date:  2006-11-25       Impact factor: 79.321

3.  Prazosin in management of cardiovascular manifestations of scorpion sting.

Authors:  H S Bawaskar; P H Bawaskar
Journal:  Lancet       Date:  1986-03-01       Impact factor: 79.321

4.  Scorpion sting envenomation in children: factors affecting the outcome.

Authors:  Rajniti Prasad; Om Prakash Mishra; Nisha Pandey; Tej Bali Singh
Journal:  Indian J Pediatr       Date:  2010-10-13       Impact factor: 1.967

5.  Clinical profile of severe scorpion envenomation in children at rural setting.

Authors:  Himmatrao S Bawaskar; Promodini H Bawaskar
Journal:  Indian Pediatr       Date:  2003-11       Impact factor: 1.411

6.  Management of the cardiovascular manifestations of poisoning by the Indian red scorpion (Mesobuthus tamulus).

Authors:  H S Bawaskar; P H Bawaskar
Journal:  Br Heart J       Date:  1992-11

7.  Efficacy and safety of scorpion antivenom plus prazosin compared with prazosin alone for venomous scorpion (Mesobuthus tamulus) sting: randomised open label clinical trial.

Authors:  Himmatrao Saluba Bawaskar; Pramodini Himmatrao Bawaskar
Journal:  BMJ       Date:  2011-01-05

8.  A crusade against scorpion sting: life and works of dr. Himmatrao bawaskar.

Authors:  Ajinkya A Kale
Journal:  J Family Med Prim Care       Date:  2012-01
  8 in total

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