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Envenoming by Russell's viper (Daboia russelii): (a) the snake (specimen from Pune, Maharashtra); (b) local swelling and blistering (Kerala); (c) chemosis, a sign of generalized increase in capillary permeability; (d) bilateral ptosis, external ophthalmoplegia and facial paralysis; (e) chronic pan-hypopituitarism (loss of secondary sexual hair and gynaecomastia) following a bite 3 years previously (Kerala).
