{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T03:28:37Z","timestamp":1777951717858,"version":"3.51.4"},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T00:00:00Z","timestamp":1770163200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Teaching Hospital Ratnapura"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hump-nosed pit vipers (genus Hypnale) are the most common cause of venomous snakebites in Sri Lanka, accounting for more than one-third of all snakebites, as they are widely distributed throughout the country. It is a highly medically important snake in Sri Lanka. Even though several life-threatening complications, including venom-induced consumption coagulopathy, acute kidney injury, venom-induced thrombotic microangiopathy and cardiac effects, are reported following their bites, no antivenom is currently available for Hypnale - envenomed patients either in Sri Lanka or India. Apart from the acute manifestations of snakebites, chronic health effects have rarely been described in the literature.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A case series of 11 patients who developed long-term health effects following hump-nosed pit viper bites was prospectively studied at the Teaching Hospital, Ratnapura, Sri Lanka, from June 2015 to May 2021. Data on clinical presentation, examination findings, investigations, management and two-year follow-up were collected.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>This case series describes some of the chronic health manifestations following hump-nosed pit viper bites in 11 patients, including chronic kidney disease, fasciotomy-related injuries, musculoskeletal disabilities and pulmonary effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Hump-nosed pit viper bites can cause severe long-term sequelae that require follow-up. Physicians should be aware of these manifestations when managing patients and this case series highlights the need for an effective antivenom for Hypnale bites.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/trstmh\/traf148","type":"journal-article","created":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T08:49:11Z","timestamp":1770194951000},"page":"486-496","source":"Crossref","is-referenced-by-count":0,"title":["Chronic health manifestations following hump-nosed pit viper (\n                    <i>Hypnale<\/i>\n                    spp.) bites: an authenticated case series"],"prefix":"10.1093","volume":"120","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2628-7383","authenticated-orcid":false,"given":"R M M K Namal","family":"Rathnayaka","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Sabaragamuwa University of Sri Lanka Department of Pharmacology, , Hidellana, Ratnapura 70\u00a0012 ,","place":["Sri Lanka"]},{"name":"Teaching Hospital , Ratnapura 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