THIS refers to the news report ‘Hiccups in ASV supply by NIH CMCH runs short of anti-snake venom' (Sept 4). Deaths with snakebites are nowadays very rare in the world. If you diagnose and treat the patient appropriately and promptly, the patient can survive no matter what species of the snake bit him. This is a peak season of snake bites, the report indicated that various hospitals receive about 25 to 30 cases daily during this season.

There are about 3,100 species of the snake and only 10 per cent of them are dangerous. Venomous effects are varied among species but all of them can be treated, successfully. Snake viper's bite is severe: it comes with rhabdomyolysis which is associated with renal failure.

This condition develops due to oedema, myotoxic agents and haemorrhagic factors that is responsible for two types of potentially fatal complications, i.e. acute renal failure and hyperkalaemia.

After viper bites, antivenom therapy is recommended as soon as possible. Successful diagnosing of snake bites cases at an early stage usually helps to save a life.

Viper bites require close clinical monitoring in order to detect early signs of envenomation, particularly in children, in order to initiate specific therapy promptly because venomous dose could be very high for children due their body size.

There is an urgent need, particularly in the monsoon season, to ensure availability of antivenom drugs at an affordable price in all hospitals and medical stores. The government must ensure that all hospitals of the country, particularly rural hospitals, have enough stock of antivenom drug. Antivenoms prevent and neutralise the envenomings effects.

H.H. LAGHARI Canada