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LETTER TO EDITOR
Year : 2012  |  Volume : 1  |  Issue : 2  |  Page : 163  

Prazosin, Scorpion Sting and Dr. Bawaskar


Department of Pediatrics, Maharajhas Institute of Medical Sciences, Vizianagaram Dt., Andhra Pradesh, India

Date of Web Publication20-Dec-2012

Correspondence Address:
Yerramilli V. Siva Sankara Murty
Quarter No. B2, MIMS Campus, Maharajhas Institute of Medical Sciences,Nellimerla, Vizianagaram Dt. 535 217, Andhra Pradesh
India
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DOI: 10.4103/2249-4863.104993

PMID: 24479031

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How to cite this article:
Murty YS. Prazosin, Scorpion Sting and Dr. Bawaskar. J Fam Med Primary Care 2012;1:163

How to cite this URL:
Murty YS. Prazosin, Scorpion Sting and Dr. Bawaskar. J Fam Med Primary Care [serial online] 2012 [cited 2014 Oct 1];1:163. Available from: http://www.jfmpc.com/text.asp?2012/1/2/163/104993

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 [2],[3],[4],[5],[6] 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. [7],[8]

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.

 
  References Top

1.Kale AA. A crusade against scorpion sting: Life and works of Dr. Himmatrao Bawaskar. J Fam Med Prim Care 2012;1:52-5.  Back to cited text no. 1
    
2.Bawaskar HS, Bawaskar PH. Prazosin in management of cardiovascular manifestations of scorpion sting. Lancet 1986;1:510-1.  Back to cited text no. 2
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3.Bawaskar HS, Bawaskar PH. Clinical profile of severe scorpion envenomation in children at rural setting. Indian Pediatr 2003;40:1072-5.  Back to cited text no. 3
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4.Bawaskar HS, Bawaskar PH. Efficacy and safety of scorpion antivenom plus prazosin compared with prazosin alone for venomous scorpion (Mesobuthus tamulus) sting: Randomised open label clinical trial. BMJ 2011;342:C7136.  Back to cited text no. 4
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5.Bawaskar HS, Bawaskar PH. Management of the cardiovascular manifestations of poisoning by the Indian red scorpion (Mesobuthus tamulus). Br Heart J 1992;68:478-80.  Back to cited text no. 5
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6.Bawaskar HS, Bawaskar PH. Management of scorpion sting. Heart 1999;82:253-4.  Back to cited text no. 6
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7.Prasad R, Mishra OP, Pandey N, Singh TB. Scorpion sting envenomation in children: Factors affecting the outcome. Indian J Pediatr 2011;78:544-8.  Back to cited text no. 7
[PUBMED]    
8.Adhisivam B. Of prazosin and purses. Lancet 2006;368:1870.  Back to cited text no. 8
[PUBMED]    




 

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