Instead of individual autonomic symptoms, we monitored all patients using clinical composite score which includes autonomic symptoms [1]. We have reported mean duration of vasopressor requirement instead of mean dose of prazocin. We used antivenom in a dose in accordance with study by Natu, et al. [1]. Clinical recovery was assessed in our study, based on a set of uniform parameters like heart rate, respiratory rate and blood pressure for age and sex of the patients, and presence of normal neurological status. ECG was used for management but data regarding its use were not reported in our study. Echocardiography was not used due to lack of resources.

The high incidence of pulmonary edema in our series was due to late reporting of patients, and this might be the reason for high mortality rate in our study [2]. Previous studies also reported that in cases with late hospital admission, the beneficial effect of antivenom and/or prazosin is limited [2]. Non-availability of ventilators in our institute during study period may be another contributory factor in this regard.

1. Natu VS, Kamerkar SB, Geeta K, Vidya K, Natu V, Sane S, et al. Efficacy of anti-scorpion venom serum over prazosin in the management of severe scorpion envenomation. J Postgrad Med. 2010;56:275-80.