Evidence map›Paper›PMID 30935096›Full record

ReviewToxins2019

Long-term Effects of Snake Envenoming.

Subodha Waiddyanatha, Anjana Silva, Sisira Siribaddana, Geoffrey K Isbister

Open access · goldAbstract readReview
In one paragraph

Review in Toxins, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 79 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
79citing papers in PubMed, 3 pooled it
11.1field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

79 citing papers in PubMed, 3 syntheses or guidelines pooled it, 144 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Genotoxic Activity ofBiology · 2026
    Article
  5. Article
  6. Article
  7. Article
  8. Article
  9. Article
  10. Article
  11. Article
  12. Clinical characteristics and long-term disabilities in children followingThe journal of venomous animals and toxins including tropical diseases · 2026
    Article
  13. Article
  14. Oral microflora ofOpen veterinary journal · 2025
    Article
  15. Article
  16. Vipera Snakebite in Children: A Focus on Europe.Children (Basel, Switzerland) · 2025
    Review
  17. Article
  18. Article
  19. Article
  20. An overview of hypopituitarism's causes.Frontiers in endocrinology · 2025
    Review

19 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 2 countries.

Subodha WaiddyanathaFaculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura 50008, Sri Lanka. subodhawaid@gmail.com.
Anjana SilvaFaculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura 50008, Sri Lanka. nkanjanasilva@gmail.com.ORCID 0000-0002-9968-3707
Sisira SiribaddanaFaculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura 50008, Sri Lanka. sisira.siribaddana@gmail.com.ORCID 0000-0001-5821-2557
Geoffrey K IsbisterSouth Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya 20400, Sri Lanka. geoff.isbister@gmail.com.ORCID 0000-0003-1519-7419
University of Peradeniya · LKRajarata University of Sri Lanka · LK

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Long-term effects of envenoming compromise the quality of life of the survivors of snakebite. We searched MEDLINE (from 1946) and EMBASE (from 1947) until October 2018 for clinical literature on the long-term effects of snake envenoming using different combinations of search terms. We classified conditions that last or appear more than six weeks following envenoming as long term or delayed effects of envenoming. Of 257 records identified, 51 articles describe the long-term effects of snake envenoming and were reviewed. Disability due to amputations, deformities, contracture formation, and chronic ulceration, rarely with malignant change, have resulted from local necrosis due to bites mainly from African and Asian cobras, and Central and South American Pit-vipers. Progression of acute kidney injury into chronic renal failure in Russell's viper bites has been reported in several studies from India and Sri Lanka. Neuromuscular toxicity does not appear to result in long-term effects. Endocrine anomalies such as delayed manifestation of hypopituitarism following Russell's viper bites have been reported. Delayed psychological effects such as depressive symptoms, post-traumatic stress disorder and somatisation have been reported. Blindness due to primary and secondary effects of venom is a serious, debilitating effect. In general, the available studies have linked a clinical effect to a snakebite in retrospect, hence lacked accurate snake authentication, details of acute management and baseline data and are unable to provide a detailed picture of clinical epidemiology of the long-term effects of envenoming. In the future, it will be important to follow cohorts of snakebite patients for a longer period of time to understand the true prevalence, severity, clinical progression and risk factors of long-term effects of snake envenoming.

Indexed as

AnimalsHumansHypopituitarismMental DisordersNeurotoxicity SyndromesRenal Insufficiency, ChronicSnake Biteschronicdelayedenvenominglong-termsnakebite

Identifiers

PMID30935096
PMCPMC6521273
OpenAlexW2928204335

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.