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Chani Mohamed

Chani Mohamed

Military Training Hospital, Morocco

Title: Specific treatments for serious viper envenomation: Is there a place for plasmapheresis?

Biography

Chani Mohamed is a doctor Colonel. He recognized as a Doctor in 1986 at the age of 26 followed by a two-year assignment in an operational area as doctor captain. After that, he did a one-year training in aeronautical medicine in Paris which allowed him to be assigned to the center of expertise for aircrew to the military hospital in Rabat where he prepared the competition assistantship Val de Grace in anesthesia-reanimation which allowed him to go to Paris for six years' training to be a specialist in anesthesia resuscitation at hospital of Val de Grace, the Hospital Cochin and that to the hospital Lapitie Salpitriere in Paris. In 1998, he was seconded to the Centre Hospital de Libreville, Gabon for four years. In 2003, he returned to Morocco to be head of the Emergency Department at the Military Hospital Moulay Ismail in Meknes. In 2005, he prepared to contest oxyologie aggregation in the Val de Grace Hospital in Paris. In 2009, he was appointed Professor in oxyologie to the Faculty of Medicine and Pharmacy of Rabat in Morocco and the clinical detached Royal to become part of the medical staff of Her Majesty. He is also a national expert in the field of viper envenomation.

Abstract

Immunotherapy is the only specific treatment of severe viper envenomation to reduce the mortality. Plasmapheresis has been reported in a few articles mentioning the empirical use in envenomation. In 2006, a Turkish team reported in 16 patients poisoned the rapid improvement of hemostasis in the aftermath of a plasmapheresis. But in 2007, an Australian team showed no improvement by this technique for the evolution of four bites Pseudonaja an Australian élapidé in patients who had received specific antivenom. In 2009, a Moroccan team discussed the improvement in 48 hours hemostasis of a patient poisoned by a snake, with two sessions of plasmapheresis, while antivenom was not available. A recent clinical case of a bite by Echis pyramidum was ineffectively treated by a specific E antivenin. Echis carinatus shows only transient improvement induced by plasmapheresis. An earlier article had not shown any improvement plasmapheresis at the time evolution of a bite from Bothrops asper. Total elimination of toxins or ophidian protein plasmapheresis treatment can be attempted as a last chance when the antivenom treatment is not available, but, in the absence of randomized comparison or measurement of concentrations of venom before and after the sessions, it has not yet made the factual evidence of its effectiveness.

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