Siddharth Kapoor1

In Jammu region the majority of snake bites occur between May and October, the maximum incidence being in rainy season. The region of Jammu harbours various types of poisonous snakes, mainly belonging to families Elapidae and Viperidae. Snakes belonging to family Elapidae are mainly neurotoxic, though some amount of haemotoxic and cardiotoxic effect have also been reported. Those belonging to family Viperidae are mainly haemotoxic and are commonest ones in Jammu.
Summer and rainy seasons constitute the time when snakes are out of hibernation. Snake bites during this period comprise a major part of hospital morbidity and mortality, thus a study of poisonous snake bites in Jammu is of interest because of two important reasons-
a. In finding out the behaviour of this accidental ailment;
b. In finding out the best possible approach to handle the victim admitted to the hospital.
There has been a lot of controversy regarding the mode of administration of A.V.S. that has been used in varying schedules and with variable success.
106 cases of poisonous snake bites- 100 haemotoxic and 6 neurotoxic- admitted to male and female wards of Medicine, Government Medical College, Jammu, between May 2002 and April 2003 have been studied.
The commonest cause of poisonous snake bite in Jammu region is found to be Echis carinatus. Bleeding manifestation is the commonest disorder caused by viper bites, in the presence or absence of swelling at the site of bite. Incidence of uraemia is high in our setup and increases with the delay in the institution of management. Coagulation studies performed on 30 patients have revealed primary fibrinogenolysis in 27 and disseminated intravascular coagulation in 3 cases. The most effective mode of administration of antivenom serum has been worked up. Clotting time and clot quality have been found to be reliable guides to determination of antivenom therapy on the bed side. It has been found that rapid infusion of antivenom serum not only quickly neutralises the venom but also reduces the rate and magnitude of complications, duration of morbidity and stay in the hospital. Bleeding manifestations or coagulation defect did not occur in cases of neurotoxic snake bites. The response to antivenom therapy in elapid bites has been dramatic with rapid recovery.