scholarly journals Non-venomous snake bite and snake bite without envenoming in a brazilian teaching hospital: analysis of 91 cases

1992 ◽  
Vol 34 (6) ◽  
pp. 499-503 ◽  
Author(s):  
Paulo Vitor Portella Silveira ◽  
Sérgio de Andrade Nishioka
Keyword(s):  
Teaching Hospital ◽  
Snake Bite ◽  
Lower Limbs ◽  
Correct Identification ◽  
Age Group ◽  
Clotting Time ◽  
Correct Treatment ◽  
Venomous Snake ◽  
Local Pain ◽  
Venomous Snakes

A retrospective survey of 473 cases of snake bite admitted to a Brazilian teaching hospital from 1984 to 1990 revealed 91 cases of bite without envenoming and/or caused by non-venomous snakes. In 17 of these cases the snake was identified, and one patient was bitten by a snake-like reptile (Amphisbaena mertensii). In 43 cases diagnosis was made on clinical grounds (fang marks in the absence of signs of envenoming). The other 30 cases were of patients who complained of being bitten but who did not show any sign of envenoming or fang mark. Most cases occurred in men (66;73%), in the 10-19 years age group (26;29%), in the lower limbs (51/74;69%), between 6 A. M. and 2 P.M. (49;61%) and in the month of April (16; 18%). One patient bitten by Philodryas olfersii developed severe local pain, swelling and redness at the site of the bite, with normal clotting time. The patient bitten by Drymarcon corais was misdiagnosed as being bitten by a snake of the genus Bothrops, was given the specific antivenom, and developed anaphylaxis. One patient bitten by Sibynomorphus mikanii presented prolonged clotting time, and was also given antivenom as a case of Bothrops bite. Correct identification of venomous snakes by physicians is necessary to provide correct treatment to victims of snake bite, avoiding unnecessary distress to the patient, and overprescription of antivenom, which may eventually cause severe untoward effects.

scholarly journals Clinical profile and outcome of snake bite in children admitted in a tertiary care institute in the metropolitan city of Karnataka, India

2020 ◽  
Vol 7 (12) ◽  
pp. 2295
Author(s):  
Shivaprakash Sosale Chandrashekaraswamy ◽  
Deepthy Verghese ◽  
Chikkanarasa Reddy
Keyword(s):  
Tertiary Care ◽  
Clinical Manifestations ◽  
Public Health Problem ◽  
Snake Bite ◽  
Clinical Profile ◽  
Lower Limbs ◽  
Healthcare Personnel ◽  
Age Group ◽  
Metropolitan City ◽  
Snake Bites

Background: Snake bite is a major medical and public health problem in tropical agricultural world. A high incidence of snake bite envenomation has been reported from rural India, many times the incidence is underestimated due to lack of epidemiological information. The present study analyses the age, mode of presentation, seasonal variation, clinical profile, management and outcome of patients with snake bite in below 18 years of age group of a metropolitan city, India.Methods: This study is a retrospective single centre study conducted in government referral hospital in Bangalore from January 2016 to January 2020 including 53 patients, who presented with a history of snake bite. Clinical data about age, sex, clinical manifestations, complications, management and outcome were analysed.Results: In our study including of 53 patients, maximum snake bites incidents were noted in age group of 6-10 years (47.16%) of the rural population with male predominance (83.01%). Most of the bites occurred during monsoon season (54.71%) in evening time. Bite marks were observed mainly on lower limbs in 71.69% of patients. Tourniquet was the commonly used first aid care (67.92%). Most of the bites were vasculotoxic in (75.47%) followed by neuroparalytic in 15 patients (9.43%) and maximum cases responded to 20 vials of ante venom. Mortality was nil.Conclusions: Snake bite is a life-threatening emergency. The key in minimizing mortality and severe morbidity is aggressive management of sick patient and timely as well as judicious administration of ante snake venom. There is a requirement to sensitize the general public and healthcare personnel on preventive measures, emergency care and treatment of snake bites. The serious clinical features of snake bite warrant early referral and management in tertiary care centers.

scholarly journals Study of clinical and epidemiological profile of poisonous snake bite in a tertiary centre in North Kerala

2019 ◽  
Vol 7 (11) ◽  
pp. 4059
Author(s):  
Manu Mathews ◽  
Sudha Balakrishnan
Keyword(s):  
Snake Bite ◽  
South East Asia ◽  
Age Group ◽  
Venomous Snake ◽  
Mortality And Morbidity ◽  
Tertiary Centre ◽  
Important Health ◽  
Medical Emergencies ◽  
Area North ◽  
Epidemiological Profile

Background: Snakebites are well-known medical emergencies in many parts of the world, especially in rural areas.The incidence of snakebite mortality is particularly high in South-East Asia. Rational use of snake anti-venom can substantially reduce mortality and morbidity due to snakebites. Snake bite is an important health problem in India also especially in North Kerala which has an agricultural background. There is a lack of study regarding this topic in this area. North Kerala differs from other areas in the country as hump nosed pit viper bites are more common here due to its proximity to western Ghats where it .Anti snake venom is ineffective to bites by hump nosed pit viper. Authors objectives  was to assess the clinical and epidemiological profile and outcome of poisonous snake bites.Methods: Retrospective observational study done among patients with snake bite with envenomation admitted in Academy of Medical education, Pariyaram, Kannur, Kerala from January 2018 to September 2018.Results: There were 90 cases of venomous snake bite during the study period. Of these males were predominant (70%). Majority were in the age group between 20 and 40. Majority of bites occurred in the months of June and July. Bite in the extremities were more common. Nine patients were brought 1 day after the bite. Snake identified most common was Russell’s viper followed by pit viper. Majority of the systemic envenomation was hemotoxic 80 patients (85%).Conclusions: The study stress the fact that snake bite is an important problem in North Kerala. The study also shows that delay in treatment is a major risk factor for morbidity. Hump nosed pit viper bites are more common in this area.

scholarly journals Knowledge, attitude and practice regarding snakes and snake bite among rural adult of Belagavi, Karnataka

2017 ◽  
Vol 4 (12) ◽  
pp. 4527 ◽  
Author(s):  
Ishan Pathak ◽  
Chandra Metgud
Keyword(s):  
Medical Treatment ◽  
Snake Bite ◽  
Basic Knowledge ◽  
Cross Sectional ◽  
Venomous Snake ◽  
Bite Marks ◽  
Venomous Snakes ◽  
Attitude And Practice ◽  
Study Participants ◽  
Knowledge Attitude And Practice

Background: India is home to over 270 species of snakes, including 60 venomous. Belagavi, set in foothills of Western Ghats, is home to four major venomous snakes viz. Russell’ s viper, spectacled cobra, common krait and saw scaled viper. Surveys suggest that around half of the snake bite related deaths take place in India and are largely avoidable and treatable. The objective of the study was to assess the knowledge, attitude and practice regarding Snakes and Snake bite among adult in a rural area of Belagavi, Karnataka.Methods: This community based cross-sectional study was conducted among 400 adults who were permanent residents of Kinaye village located in the field practice area of JN Medical College, Belagavi. A predesigned and pretested questionnaire was used to assess their knowledge, attitude and practice after taking written informed consent. Results: Most of the study participants when shown different photographs could differentiate between venomous and non-venomous snakes and their bite marks. 100% of the study participants knew that medical treatment was available for snakebite and would rush to a health facility in an event of snakebite. Most common venomous Snake to be identified was Spectacled Cobra (72%) while Common Krait was the least identified (24%). About 75% of study subjects correctly differentiated between the pictures of venomous and non-venomous Snake bite marks. Nearly 90.5% believed that Snakes bite for self-defence. Conclusions: In the present study majority of the participants had basic knowledge about Snake identification and snakebite. Most correctly identified venomous and non-venomous Snakes was Spectacled Cobra and Green Vine Snake respectively, while most incorrectly identified venomous Snake was common Krait. All the participants knew that there is medical treatment available for snakebite and most of them were in favour of not killing Snakes. 

scholarly journals A 6 months retrospective observational study to assess the rationality and effectiveness of snake bite management in a tertiary care teaching hospital of rural Bengal, India

2018 ◽  
Vol 7 (10) ◽  
pp. 2047
Author(s):  
Satrajit Dan ◽  
Ananya Mandal ◽  
Abhijit Das ◽  
Sourav Chakrabarty ◽  
Tanmoy Gangopadhyay
Keyword(s):  
Observational Study ◽  
Teaching Hospital ◽  
West Bengal ◽  
Tertiary Care ◽  
Snake Bite ◽  
Retrospective Observational Study ◽  
Standard Protocol ◽  
Venomous Snake ◽  
Tertiary Care Teaching Hospital ◽  
Care Teaching

Background: Snake envenomation is a common life-threatening problem encountered all-over West Bengal particularly in the rural areas. There are a large number of patients attending the Emergency unit and being admitted to the Medicine ward, some in the intensive care unit (ICU) and intensive therapy unit (ITU) of the tertiary health care facilities. The objective of this study was to assess rationality and effectiveness of management of venomous snake bite following standard protocol – Standard treatment guidelines of Government of West Bengal and National snakebite management protocol of Government of India.Methods: This was a retrospective observational study of six months (May - October 2017) duration. Data were collected from the treatment records of patients admitted with history of snake bite in the Medicine ward, ICU and ITU of tertiary care teaching hospital of rural Bengal.Results: Of the 63 venomous bite patients, most (82.5 %) were diagnosed to have features of neurotoxic envenomation. All of them (100%) received anti-snake venom (ASV). There was no incidence of anaphylactic reaction as well as any serious adverse drug reaction following ASV administration. Two patients developed acute renal failure, needed haemodialysis. Overall percentage of mortality was 3.2%.Conclusions: The survival rate in venomous snake bite is found to be high in this institution. The practice of snake bite management is found to be adherent with standard protocol. A multicentric study of longer duration is suggested to draw a firm conclusion.

scholarly journals Epidemiology and Clinical Outcome of Snakebite in Western Nepal: A Retrospective Study

2019 ◽  
Vol 12 (1) ◽  
pp. 53-57
Author(s):  
D Karki ◽  
B Sharma ◽  
R Koirala ◽  
A Nagila
Keyword(s):  
Retrospective Study ◽  
Clinical Outcome ◽  
Teaching Hospital ◽  
Hospital Admissions ◽  
Tertiary Care ◽  
Snake Bite ◽  
Medical Emergency ◽  
Care Hospital ◽  
Age Group ◽  
Snake Bites

Introduction: Snakebite is an environmental hazard associated with significant morbidity and mortality. It is an important medical emergency and cause of significant numbers of hospital admissions in many parts of the Asian region. In this study, we assess the epidemiology and clinical outcome of snake bite. Methods: This was a retrospective study of all patients with snake bites admitted to the Department of Internal Medicine, Manipal Teaching Hospital, Pokhara, kaski, Nepal. A total numbers of 265 snake bite cases in the period of 2013 to 2016 were enrolled in this study. Snake bite cases by person, place and time along with month of snake bite and time of bite, were analyzed. We also identified the types of snake and site of the bite. Sign and symptoms were clinically observed and the management of the snake bite cases was clinically done. Prothrombin time (PT) test along with INR value was performed by Medical Technologist at the Department of Laboratory, Manipal Teaching Hospital. Data was entered in to the Microsoft excel and analyzed by SPPS version 21.0. Percentages were applied to find the results. Results: Total numbers of snake bite cases were 265. More than half, 60.4% of the snake bite cases were females. Regarding the age group, nearly half, 47.9% were in the age group of 20 - 40 years and 9.8% cases were in the age group of 60 years and above. In this study, 50.6% bite cases were held at the day time and most of the bites were reported/ observed in the limb, 53.6% in lower limb, and 43.4% in the upper limb. Very few bites were in the head, neck and trunk. Our result shows 49.1% were green snake and 30.9% snake were unidentified. When we observed the sign and symptoms, 153 (57.7%) cases showed local swelling, 83 (31.3%) showed fang mark. Hematological manifestation were 144 (54.3%) cases and complication observed in 145 (54.7%) cases. Snake bite cases were managed after PT/INR test, INR. Antibiotic were prescribed in 154 cases and in 135 (50.9%) cases blood was transfused. There were no fetal cases noticed among hospital admitted snake bite cases. Conclusion: There is gross disparity in the management and outcomes of snake bite in different hospitals. Snake bite cases should manage in tertiary care hospital as early as possible.

Clinical-anamnestic analysis of the course and treatment of benign and borderline epithelial ovarian tumors

2016 ◽  
pp. 86-93
Author(s):  
M.Yu. Yegorov ◽  
◽  
A.A. Sukhanova ◽  
Keyword(s):  
Varicose Veins ◽  
Clinical Manifestations ◽  
Abnormal Uterine Bleeding ◽  
Abdominal Distension ◽  
Ovarian Tumors ◽  
Lower Limbs ◽  
Benign Tumors ◽  
Age Group ◽  
Venous Disorders ◽  
Serous Tumors

The objective: study the features of gynecological, physical history, diagnosis and treatment of patients with benign epithelial ovarian tumors (BeEOT) and borderline epithelial ovarian tumors (BEOT), determining the frequency of recurrence of ovarian tumors in the postoperative period. Patients and methods. According to a retrospective analysis of case histories of 112 women with epithelial ovarian tumors (EOT) underwent conservative or radical surgical treatment in a hospital, two groups were formed: I group – patients with benign epithelial ovarian tumors (BeEOT), which amounted to 85 (75.9%) women, and group II – patients with borderline epithelial ovarian tumors (BEOT), which amounted to 27 (24.1%) women. It was found that the main complaints of patients with EOT were pain (49.1%), abdominal distension (17%), and abnormal uterine bleeding (12.5%). The highest incidence of BeEOT (31.8%) observed in the age group of 41–50 years, while the peak incidence of BEOT (44.4%) corresponds to the age group of 51–60 years. Results. In BEOT endocrine pathology occurs significantly more frequently (p<0.05) than in BeEOT – 25.9% vs. 9.4%, respectively. Pathology of pancreatic-hepatobiliary system occurs significantly more frequently (p<0.05) in patients with BEOT compared with BeEOT – 81.5% versus 57.6%, respectively. Venous disorders (varicose veins of the pelvic organs, lower limbs, haemorrhoids) observed in BEOT significantly more frequently (p<0.05) than in BeEOT – 18.5% vs. 5.9%, respectively. EOT most often diagnosed in the period from 1 to 6 months after the first clinical manifestations with an average uptake of medical care 4.6±0.57 months. In assessing of peritoneal exudate cytogram the mesothelium cells are significantly more common for BeEOT (p<0.01) than BEOT – 79.4% versus 40.9%, respectively. Cervicitis is more likely significantly to occur in BeEOT (p<0.01) than in BEOT – 29.4% vs. 7.4%, respectively. The most common histological type among the benign tumors of the ovaries are endometriomas, which occurred in 48.2% of all BeEOT cases, and among the borderline tumors – serous tumors, which accounted for 59.3% of all BEOTs. Conclusion. The use of organ sparing surgery in EOT increases the risk of recurrence, especially in the case of endometrial histology or borderline variant of tumor. Key words: benign and borderline epithelial ovarian tumors, clinical-anamnestic analysis, diagnosis, treatment.

scholarly journals Clinical Profile of Acute Poisoning in Children at a Teaching Hospital in Lalitpur

2014 ◽  
Vol 34 (2) ◽  
pp. 100-103 ◽  
Author(s):  
Ajaya Kumar Dhakal ◽  
D Shrestha ◽  
A Shakya ◽  
SC Shah ◽  
H Shakya
Keyword(s):  
Teaching Hospital ◽  
Hospital Admissions ◽  
Acute Poisoning ◽  
Childhood Mortality ◽  
Age Group ◽  
Common Cause ◽  
Mortality And Morbidity ◽  
History Of ◽  
The Common ◽  
Poisoning In Children

Introduction: Acute poisonings are one of the common cause of emergency visits and hospital admissions and is potentially preventable cause of childhood mortality and morbidity. The objectives of this study were to identify the common type of poisoning in children, to determine types of poisoning according to age and to find out the common age group in which the incidence of poisoning was high.Materials and Methods: It was a descriptive observational study done in a teaching hospital in Lalitpur, Nepal in patients aged 1 month to 18 years who visited the emergency department and were admitted to hospital with history of alleged poisoning from 2009 July to 2014 January.Results: Fifty patients were included. Drugs, kerosene and organophosphorus were most common cause of poisoning. Drugs and kerosene below 10 years of age and organophosphorus and drugs above 10 years of age were common types of poisoning. Maximum numbers (50%) of children with poisoning cases were below five year of age. Mean duration of hospital stay was 2.1days and mean age of poisoning was 7.8 years with a male(54%) predominance. Majority of poisoning occurred at home (84%) and 68% of patients were symptomatic at presentation to hospital with 84% of patients presenting to hospital within six hours.Conclusion: This study showed that drugs, kerosene and organophosphorus were most common forms of poisoning. Young children were most vulnerable for acute poisoning.DOI: http://dx.doi.org/10.3126/jnps.v34i2.10139J Nepal Paediatr Soc 2014;34(2):100-103 

scholarly journals Analysis of blood transfusion request and utilization pattern at teaching hospital in Eastern Nepal

2018 ◽  
Vol 8 (2) ◽  
pp. 1374-1377 ◽  
Author(s):  
Santosh Upadhyaya Kafle ◽  
Krishna Kumar Jha ◽  
Mrinalini Singh ◽  
Shilpi Shaukin
Keyword(s):  
Blood Transfusion ◽  
Blood Group ◽  
Teaching Hospital ◽  
Whole Blood ◽  
Age Group ◽  
Utilization Pattern ◽  
Total Blood ◽  
Cross Sectional ◽  
Male And Female ◽  
Gynecology And Obstetrics

Background: Blood transfusion unit collection, storage and dispatching on Birat Medical College and Teaching Hospital began from 19 June 2016 via blood bank. After which, many blood distribution were made accessible via this service. This study analyzes the blood transfusion request and utilization pattern and also to monitor for managing the bloodstocks meeting present and future demand in hospital. Materials and Methods: This is descriptive cross-sectional study conducted for all the requests of whole blood dispatched from 19th June, 2016 to 04th July, 2018. Whole blood requisitions from various departments were reviewed regarding the number of requisition, total blood unit replaced, blood group and socio-demographic profile of patients.Results: Of 648 transfusion units dispatched, 131 and 324 patients were male and female respectively, B positive blood group were most common, followed by A positive, O positive, AB positive, A negative, O negative and AB negative respectively. The largest numbers of requisitions were from Gynecology and Obstetric department in the hospital of 258 requisitions followed by internal medicine, surgery department, postoperative ward and orthopaedic department. Majority of the requisitions were for 20-29 years age group from the local district Morang. The total blood units replaced were 75, of which 29 and 46 of male and female respectively. Conclusions: B Positive was the predominant requested blood group with Gynecology and Obstetrics department making the most requests, among 20-29 years age group from Morang district. The total replaced blood units were less in number with some requisition forms even lacked essential details.

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