Abstract

A STUDY OF CLINICAL PROFILE OF SNAKEBITE AND RESPONSE TO TREATMENT AT A TERTIARY HOSPITAL

Author(s): Mitta Venkata Krishna Hareesh, G. Swarnalatha Devi

BACKGROUND Snake bite is a major public health problem throughout the world, especially in tropical and subtropical countries. The objective of the study is to analyse the factors, which determine the prognosis of patients admitted with poisonous envenomation. The prognostic factors include- 1) Time since snake bite and admission to ASRAM hospital. 2) Whether patient received first aid. 3) Systemic involvement. 4) Site of Bite. MATERIALS AND METHODS Total number of cases studied is 35, of which 60% were male, 40% were female. A detailed history of bite including time of bite, site of bite, type of snake, first aid history, patient’s manifestation and history of treatment received from outside was taken. A detailed clinical examination was done, and each patient was subjected to investigations like complete blood count, BT, CT, PT, blood urea, serum creatinine, electrolytes and ECG. All investigations were repeated to evaluate the progress. RESULTS 1. Age group of 12 – 40 years (82.84%). 2. Occupation – Purely agricultural workers (85.71%) 3. Site of bite – there was more incidence of bite on lower extremity. 4. Time of arrival to Hospital: There was no complication in patients presenting within 6 hrs of bite. 5. Type of envenomation: out of 35 cases of snake bite 18 were neurotoxic and 17 were vasculotoxic and of these 2 patients expired of neurotoxic envenomation. CONCLUSION In this study, maximum number of patients (54.28%) reported between 6- 24 hours of bite and all those who presented within 6 hours of bite, did not have any complications. In the present study, none of the patients received proper first aid and so first aid as a prognostic factor cannot be concluded. Systemic involvement worsened the prognosis, the more severe the systemic involvement, the bad is the prognosis.