{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T05:28:07Z","timestamp":1773120487597,"version":"3.50.1"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"919","license":[{"start":{"date-parts":[[2002,5,1]],"date-time":"2002-05-01T00:00:00Z","timestamp":1020211200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2002,5,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Common krait (Bungarus caeruleus) is the deadliest snake found commonly in the dry zone of Sri Lanka. In Anuradhapura, 210 farmers bitten by the common krait over a three year period were investigated prospectively from 1 January 1996. The sex ratio was equal, 110 (52%) patients were in the age group 10\u201330 years. One hundred and one (48%) patients were severely envenomed and needed mechanical ventilation from 12 hours to 29 days (mode two days). The bite occurred at night while the victims were asleep on the floor. In 99 (47%) situations killed specimens were available for identification. The cardinal symptom was abdominal pain developing within hours of the bite. Alteration in the level of consciousness was observed in 150 (71%) patients: drowsy in 91 (43%), semiconscious in 24 (11%), and deep coma in 35 (17%). Autonomic disturbances included transient hypertension, tachycardia, lacrimation, sweating, and salivation. These manifested in 139 (66%) patients with moderate to severe envenomation. One hundred and forty nine (71%) had hypokalaemia and 105 (50%) metabolic acidosis, anterograde memory loss in 84 (40%), and delayed neuropathy in 38 (22%) patients. Polyvalent antivenom had no significant benefit (t = 0.5) in reversing respiratory paralysis and preventing delayed neurological complications. Sixteen (7.6%) patients died and a submucosal haemorrhage in the stomach was seen at necropsy in three cases. Mortality could be minimised with early and free access to mechanical ventilation.<\/jats:p>","DOI":"10.1136\/pmj.78.919.276","type":"journal-article","created":{"date-parts":[[2002,7,27]],"date-time":"2002-07-27T10:46:58Z","timestamp":1027766818000},"page":"276-280","source":"Crossref","is-referenced-by-count":124,"title":["Common krait (<i>Bungarus caeruleus<\/i>) bite in Anuradhapura, Sri Lanka: a prospective clinical study, 1996\u201398"],"prefix":"10.1093","volume":"78","author":[{"given":"S A M","family":"Kularatne","sequence":"first","affiliation":[{"name":"General Hospital , Anuradhapura , Sri Lanka"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2002,5,1]]},"reference":[{"key":"2023042416172034600_R1","first-page":"435","volume-title":"Ophidia taprobanica or the snake of Ceylon","author":"Wall","year":"1921"},{"key":"2023042416172034600_R2","first-page":"67","volume-title":"A coloured atlas of some vertebrates from Ceylon","author":"Deraniyagala","year":"1955"},{"key":"2023042416172034600_R3","first-page":"746","volume-title":"Recent advances in toxicology research","author":"De Silva","year":"1992"},{"key":"2023042416172034600_R4","first-page":"479","volume-title":"Snakes of medical importance (Asia-Pacific region)","author":"De Silva","year":"1990"},{"key":"2023042416172034600_R5","first-page":"117","article-title":"Snake bite in Anuradhapura district","volume":"13","author":"De Silva","year":"1981","journal-title":"The Snake"},{"key":"2023042416172034600_R6","first-page":"113","article-title":"Some epidemiological and clinical aspects of Bungarus caeruleus bite","volume":"10","author":"De Silva","year":"1987","journal-title":"Proceedings of the Kandy Society of Medicine"},{"key":"2023042416172034600_R7","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1016\/0035-9203(90)90297-R","article-title":"Envenoming by the common krait (Bungarus caeruleus) and Sri Lankan cobra; efficacy and complication of therapy with Haffkin antivenom","volume":"84","author":"Theakston,","year":"1990","journal-title":"Trans R Soc Trop Med Hyg"},{"key":"2023042416172034600_R8","first-page":"331","volume-title":"Biology and conservation of the amphibians, reptiles and their habitats in South Asia","author":"Kularatne","year":"1998"},{"key":"2023042416172034600_R9","first-page":"163","article-title":"Death from snake bite in Anuradhapura","volume":"28","author":"Swai","year":"1983","journal-title":"Ceylon Med J"},{"key":"2023042416172034600_R10","first-page":"144","article-title":"Epidemiology of snake bite in Sri Lanka: a review","volume":"28","author":"De Silva","year":"1983","journal-title":"Ceylon Med J"},{"key":"2023042416172034600_R11","first-page":"8","article-title":"Lesson from four studies on the management of snake bite in Sri Lanka","volume":"42","author":"Sellahewa","year":"1987","journal-title":"Ceylon Med J"},{"key":"2023042416172034600_R12","doi-asserted-by":"crossref","first-page":"682","DOI":"10.1016\/0035-9203(93)90291-W","article-title":"Neurotoxic envenoming by the Sri Lankan krait (Bungarus ceylonicus) complicated by traditional treatment and a reaction to antivenom","volume":"87","author":"De Silva","year":"1993","journal-title":"Trans R Soc Trop Med Hyg"},{"key":"2023042416172034600_R13","first-page":"40","volume-title":"An historical relation of the island of Ceylon in the East Indies: together with an account of detaining in captivity the author and divers other Englishmen now living there, and of the authors miraculous escape","author":"Knox","year":"1681"},{"key":"2023042416172034600_R14","first-page":"284","volume-title":"Hutchison\u2019s clinical method","author":"Swash","year":"1989"},{"key":"2023042416172034600_R15","doi-asserted-by":"crossref","first-page":"1637","DOI":"10.1002\/(SICI)1097-4598(199912)22:12<1637::AID-MUS4>3.0.CO;2-A","article-title":"Neuromuscular transmission failure due to common krait (Bungarus caeruleus) envenomation","volume":"22","author":"Singh","year":"1999","journal-title":"Muscle Nerve"},{"key":"2023042416172034600_R16","first-page":"662","article-title":"Snake bite in India","volume":"42","author":"Ahuja","year":"1954","journal-title":"Indian J Med Res"},{"key":"2023042416172034600_R17","first-page":"39","article-title":"A case report. 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