scholarly journals Clinical profile and outcome of snake bite in children

2017 ◽  
Vol 4 (3) ◽  
pp. 910
Author(s):  
Rajkumar M. Meshram ◽  
C. M. Bokade ◽  
Saira Merchant ◽  
Swapnil Bhongade
Keyword(s):  
Medical Record ◽  
Pediatric Population ◽  
Demographic Data ◽  
Tertiary Care ◽  
Case Fatality ◽  
Public Health Problem ◽  
Snake Bite ◽  
Clinical Profile ◽  
Blood Product Transfusion ◽  
Snake Bites

Background: Snake bite is generally considered to be a rural problem and has been linked with environmental and occupational condition is a neglected public health problem. This study was conducted to ascertain clinical profile, complication and outcome of snake bite in pediatric population. Methods:Retrospective observational study was done in paediatrics wards and Paediatric Intensive care unit of tertiary care institute. A medical record files of 80 patients of snakebite, between the periods of January 2011 to February 2016 were recovered from Medical Record and Statistics Section of Institute. Files were analyzed for demographic data; variables included site of bite, time of bite, type of primary treatment and treatment provider, and type of snake poison, common symptoms suggestive of hematotoxicity, myotoxicity and neurotoxicity.Results: Out of total 80 patients, 58.75% were male and most of snake bites were seen in age group of 6-12 years. Clinically 57.5% patients were presented with signs and symptoms of envenomation and most of them were bitten during the months of June to September. All bites were nonprovocative and in 57.5% lower limb was the commonest site of bite. A 77.5% patient were primarily treated by medical personnel, 56.25% patients were received treatment within 1 hour of bite and hospitalized within 6 hours of bite. Coagulation failure was commonest complication (58.33%) followed by hypotension (25%) in vasculotoxic snake bite and respiratory paralysis (68.18%) in neuroparalytic bites. Renal replacement therapy was required in 5%, blood/blood product transfusion in 11% patients and case fatality rate was 11.25%.Conclusions: The most vulnerable to snake bites are boys aged more than 5 years. There is an urgent need to spread awareness among the community for avoidance of traditional treatment and any delay in medical intervention in snakebite incidents.

scholarly journals Epidemiological and clinical profile of paediatric snake bite patients at a tertiary care centre of Himachal Pradesh, India

2020 ◽  
Vol 7 (6) ◽  
pp. 1331
Author(s):  
Arvind Sood ◽  
Aman Rana ◽  
Pancham Kumar
Keyword(s):  
Tertiary Care ◽  
Epidemiologic Study ◽  
Case Fatality ◽  
First Aid ◽  
Himachal Pradesh ◽  
Snake Bite ◽  
Clinical Profile ◽  
Medical Emergency ◽  
Peak Time ◽  
Snake Bites

Background: Pediatric snake bite cases are frequently encountered at health care centers of Himachal Pradesh. It is a medical emergency which require early hospitalisation and immediate medical intervention. This study determines the epidemiological and envenomation details along with clinical profile and management of pediatric snake bite patients in Himachal Pradesh, India.Methods: This prospective clinico-epidemiologic study included 30 paediatric snake bite cases reported at Department of Paediatrics, IGMC, Shimla. Demography, envenomation details, first aid and treatment, antivenom administration and outcome were recorded for all patients.Results: Of the total 30 cases, 56.6% were males and 43.3% were females. All patients were resident of rural areas and most of them belonged to middle socioeconomic status. Most (56.7%) snake bites occurred between 6pm to 12am and peak time was during rainy season. More cases of hemotoxic envenomation were observed as compared to neuroparalytic envenomation. Most common hematologic abnormalities were hematuria (4.8%) and epistaxis (4.8%). Respiratory paralysis, ptosis and opthalmoplegia were the most common presentation in patients with neuroparalytic envenomation. Clinical profile of patients showed thrombocytopenia (26.7%), prolonged PT/INR (76.6%) and 36.7% had prolonged activated partial thromboplastin time. All symptomatic patients were given ASV as primary treatment out of which 79.2% patients required more than 10 vials of ASV. Most common complication observed in neuroparalytic envenomation was respiratory failure (33.3%) and in hemotoxic envenomation was coagulation failure (66.7%). Only 3.3% case fatality was observed in this study.Conclusions: Snake bite in children is a medical emergency in hilly state of Himachal Pradesh where people still follow traditional first aid methods and treatment protocol. A widespread awareness programme is needed to propagate the newly advised first aid methods to prevent mortality by early hospitalization and administration of ASV.

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 A study to assess the clinical profile of patients with snake bites in a tertiary care hospital

2019 ◽  
Vol 6 (6) ◽  
pp. 1727
Author(s):  
Keshava Murthy M. R. ◽  
Aruna C. Ramesh
Keyword(s):  
Rural Areas ◽  
Primary Care Physicians ◽  
Tertiary Care ◽  
Snake Bite ◽  
Clinical Profile ◽  
Medical Emergency ◽  
High Morbidity ◽  
Care Hospital ◽  
Correct Treatment ◽  
Snake Bites

Background: Snakebite is a life-threatening medical emergency. It occurs frequently among rural people, especially those working in the fields. Most houses in rural areas of India are made of mud and have many crevices where rodents flourish. Delay in seeking medical aid or ignorance among primary care physicians about the correct treatment of snakebite is responsible for the high morbidity and mortality. Authors objective was to study the clinical profile of snake bite at a rural tertiary care centre.Methods: A hospital based cross sectional study was conducted at M S Rammaih Medical College Bangalore from   June 2017 to June 2018.  The incidence of Snake bite in Karnataka is 0.5% and at 95% confidence interval with Margin of error at 1% the estimated sample size was 197, but in this study author were able to collect data of 237 cases, hence all the cases were included in the study and analyzed.Results: Majority of the respondents were middle aged between 21-50 years. Around 63.3% of the respondents were male and nearly 56.2% were farmers. The incidence of snake bite of Cobra was seen in 8.9%, Krait 5.1% and viper 4.2%. Around 70% patients had no significant complications following hospitalization in our study. Around 20% had hematotoxic like ARF, DIC and local gangrene.Conclusions: Snakebite is one of the common hazards especially in rural setup as agriculture being the main occupation. Snake bite can present with various manifestations at bite sites, neurotoxicity, hematotoxicity.

scholarly journals Ocular manifestations of snake bites in a tertiary care hospital in rural Northern Kerala, India

2017 ◽  
Vol 5 (3) ◽  
pp. 829 ◽  
Author(s):  
Twinkle Ann George ◽  
Asha A. V. ◽  
Risha Ravindran ◽  
Latha N. V.
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Capillary Leak Syndrome ◽  
Snake Bite ◽  
Care Hospital ◽  
Capillary Leak ◽  
Ocular Manifestations ◽  
Ocular Symptoms ◽  
Snake Bites

Background: Snake bite is a neglected public health problem worldwide especially in the tropics. Studies on ocular manifestations are still fragmentary. The objective of the study was to find ocular manifestations among the snake bite cases with systemic envenomation admitted in the intensive care units in a tertiary care hospital in rural North Kerala, India during a period of 4 years from May 2012 to May 2016.Methods: It was a prospective, observational, cross sectional study. Institutional ethical committee approval was obtained for the study. A descriptive analysis of snake bite cases with systemic envenomation was done.  Other snake bites are excluded from the study. Patients who needed ophthalmological opinion for ocular symptoms were analyzed.Results: Total suspected snake bites admitted in ICUs during the study period were 638. Only 7 patients (1%) with haematotoxic envenomation needed ophthalmological opinion for ocular symptoms. Patients in the present study ranged between the age of 11 and 53. Ocular lesions diagnosed among the 6 patients who developed capillary leak syndrome, were bilateral angle closure glaucoma in 3 patients, pan uveitis, disc edema and retinal haemorrhages in 2 patients, bilateral macular oedema. Youngest patient had intracranial haemorrhage and bilateral orbital hemorrhage, leading to exposure keratitis. SAV was administered in all patients ranging from 11-30 vials. All the patients except the patient with orbital haemorrhage had a grave prognosis. Still only one of these patients expired on day 3, rest all patients had better vision and survived due to timely management.Conclusions: A timely intervention especially at the initial presentation of capillary leak syndrome, can decrease the morbidity and save the life of a patient.

scholarly journals Snakebite Outcome Study in Far west Provincial Hospital Of Nepal

2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Sher Bahadur Kamar ◽  
Kapil Amgain ◽  
Laxman Bhusal ◽  
Kiran Kumar Khanal ◽  
Shureshraman Puri ◽  
...  
Keyword(s):  
Case Fatality ◽  
Public Health Problem ◽  
Snake Bite ◽  
Excellent Outcome ◽  
Provincial Hospital ◽  
Snake Bites ◽  
The Status ◽  
Life Threatening ◽  
One Year ◽  
Almost All

Introduction: Snakebite is well known medical emergencies and cause of hospital admission with significant mortality in our country. Objective of this study is to find out the status and outcome of snake bites envenoming management. Methods: This is prospective observational study from 15th April 2018 to 14th April 2019.Data collected all snake bites presented this hospital and observed till discharged, death or referred. Case management was done as per the WHO guideline for the management of snake bite 2016. Permission for study was taken from Medical Superintendent of Seti provincial hospital and informed consent was taken. The data were entered in Microsoft Excel 2007 and analyzed using latest version of SPSS version and appropriate descriptive statistical tools. Results:  A total of 362 snakebites were landed in the emergency of this hospital during one year period among them 71% non-poisonous and 29% poisonous snake bites. There were 17 deaths (case fatality rate 12%). Among poisonous Krait 36 % were identified snakes and half could not. Major features of envenoming were ptosis,nausea,vomiting and pain abdomen, parotid tenderness, numbness and blister and bleeding in bitten parts. Almost all 86% poisonous bites got 100ml snake venom antiserum. Few cases required additional 10 vials (100ml) and 13.5% required ventilation for respiratory paralysis.  There was no mortality in Intensive Care Unit and ward. Conclusions: Snake bite is the seasonal life-threatening emergency public health problem; significant numbers of snakebite and mortality but timely intervention has excellent outcome. Community awareness and strengthening health systems are major activities to be done.

scholarly journals Clinico-Epidemiological Profile and Outcome of Poisonous Snake Bites in Children using the WHO Treatment Protocol in Western Nepal

2015 ◽  
Vol 4 (1) ◽  
pp. 21-25
Author(s):  
Kiran Mani Paudel ◽  
V P Poudyal ◽  
Rajan Bikram Rayamajhi ◽  
Shyam Sundar Budhathoki
Keyword(s):  
Treatment Guideline ◽  
Treatment Protocol ◽  
Case Fatality ◽  
Public Health Problem ◽  
Snake Bite ◽  
Lower Limbs ◽  
National Guidelines ◽  
Important Public Health Problem ◽  
Snake Bites ◽  
Epidemiological Profile

Background: Snake bite among children is an important public health problem in many tropical and subtropical countries. Limited studies are found on snake-bite in Nepal using the WHO snake-bite management guidelines. This study assessed the clinico-epidemiological profile and their outcome in snake-bite among children using the WHO Guidelines for treatment of snake bite.Methods: This is a descriptive study among 75 children less than 14 years of age admitted in Emergency Room (ER) of Lumbini Zonal Hospital from 2011-2012 with the history of poisonous snake bite.Results: More than half (56%) of the cases were males and 3/5th (58%) were above 10 years of age. About 40% of the patients were brought to ER within 6-12 hrs of snake bite. Common site of snake-bite was lower limbs (32%) followed by upper limbs (29%). Abdominal Pain (44%) was observed as most common sign/symptom of snake-bite poisoning after local pain followed by ptosis (17.3%). The case fatality rate (CFR) was 16.0%.Conclusion: Use of WHO treatment guideline for snakebite case management among children showed low CFR. However further studies need to done to compare the treatment outcomes between WHO guideline and the National Guidelines among snakebite cases among children. Journal of Nobel College of Medicine Vol.4(1) 2015: 21-25

scholarly journals Clinical spectrum and out comes of snake bite patients admitted in a tertiary care hospital , A prospective observational hospital based study

JMS SKIMS ◽  
2020 ◽  
Vol 23 (3) ◽  
Author(s):  
Sameer Anand ◽  
Owais Ahmed ◽  
Vijay Kundal
Keyword(s):  
Clinical Features ◽  
Rural Areas ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Snake Bite ◽  
World Health ◽  
Major Public Health Problem ◽  
Care Hospital ◽  
Female Ratio ◽  
Snake Bites

Background: Snakebite is a major public health problem and its prevalence is high in India. Insufficient epidemiological data and global neglect of this condition prompted the World Health organization to recognize it as a ‘‘neglected tropical disease’’ Objective: To study demographic characteristics of snakebite victims, to see clinical symptoms of bite and outcomes of snakebite. Methods: A prospective observational hospital-based study carried out from November 2016 to October 2017, in patients with a history of snakebite. Results:Total 300 patients were included in this study,170 (56.67%) were bitten by heamotoxic snakes and 130 (43.33%) were bitten by neurotoxic snakes. Majority of patients  were in the age group of 20-39 years  ( n=153; 51%). Men outnumbered women( n=190; 63.33%), with male to female ratio of 1.7: 1. Higher incidence of snake bite was found in July – September (n=135;45.00 %) followed by April to June( n=124; 41.33%).Majority of patients were farmers in rural areas ( n=242; 80.80%).Out of 300 patients,80required ICU care.In patients with neuroparalytic snake bites, clinical features were; ptosis (n=126; 96.92%),ophthalmoplegia  (n=98; 75.38%),respiratory paralysis (n=60; 46.15%),bulbar weakness ( n=74; 56.92%) andabdomen pain(n=25; 19.23%).Clinical features in patients of haemotoxic snake bites were ; bleeding from bite site(n=110; 65.29%) , cellulitis(n=100; 58.82%), gum bleed(n=53; 31.18%), ecchymosis(n=49; 28.82%),epistaxis(n=27; 15.82%),gastrointestinal bleeding(n=25; 14.71%) andhaemoptysis(n=19; 11.18%). Complications  observed  were  acute kidney injury ( n=62; 20.67%) , respiratory failure ( n=51; 17.00%) , DIC( n=7; 2.33%) and  ARDS( n=5; 1.67%) . Out of 170 hemotoxic snake bite patients, 157 (92.35%)  patients  recovered  and 13 (7.65%) patients  died and out of 130 neurotoxic snake bites, 124 (95.39%) patients  recovered and 6 (4.61%)  patients   died, overall mortality was 6.3%. In our study, bite to needle time  was less than 1 hour in 47 patients (15.66%), less than  6 hrs in 120 patients (40%) and more than 24 hours in 45 (15%). Conclusion: Snakebite is common in adult males between 20 to 50 years and the commonest site is the lower limb. The majority of the victims are farmers who work in fields. A maximum number of cases presented within 1-6 hours of bite using a tourniquet on the affected limb as first aid. The complications and mortality of snakebite are high.

scholarly journals Clinical profile and outcomes of snake bite poisoning in a tertiary care centre in South Tamilnadu

2017 ◽  
Vol 6 (2) ◽  
pp. 418
Author(s):  
Meenakshi B. ◽  
Shantaraman K. ◽  
Indhumathi M. ◽  
Arumugapandian S. Mohan
Keyword(s):  
Tertiary Care ◽  
Cross Sectional Study ◽  
Snake Bite ◽  
Clinical Profile ◽  
Tertiary Care Centre ◽  
College Hospital ◽  
Cross Sectional ◽  
Mortality And Morbidity ◽  
Medical College ◽  
Snake Bites

Background: Snake-bites are well-known common medical emergencies in many parts of the world. In India 46,000 people are dying every year from snakebites. However, the true scale of mortality and morbidity from snake-bite remains uncertain. This study analyses the clinical profile and outcomes of the snake bite poisoning in patients admitted to this centre.Methods: This cross sectional study analyses the data of 150patients admitted to the Intensive Medical Care Unit of Tirunelveli Medical College Hospital with the history of snake bite between April and September of 2015 as available in their case records.Results: In this study, 42.7% of the patients were in the age group of 18 to 40 years and 64% were males with rural: urban ratio of 2.3: 1. About 82.7% of bites were haematotoxic, 10.7% neurotoxic and the remaining nontoxic bites. About 54% patients recovered completely, 44% had some form of morbidity at discharge and mortality was 2%. Out of 136 patients who were treated with Anti-snake venom (ASV), 9.6% developed ADR. The common ADR was itching and hypotension followed by rigor, breathlessness and edema of lips and eyes.Conclusions: This study highlights the need for early treatment intervention post bite. Imparting health education about early pre-hospital management and transfer to the hospital will help in the prevention of deaths due to snakebite. Identification of the type of snake is essential to decide on the type of toxicity and method of treatment to be instituted.

scholarly journals A clinical profile of poisonous snake bite in children of North Kerala, India

2018 ◽  
Vol 5 (2) ◽  
pp. 310 ◽  
Author(s):  
Shyna K. P. ◽  
Sudhakaran K. ◽  
Mohammed M. T. P.
Keyword(s):  
Tertiary Care ◽  
Kidney Injury ◽  
Public Health Problem ◽  
The Body ◽  
Snake Bite ◽  
Clinical Profile ◽  
Morbidity And Mortality ◽  
Medical Emergency ◽  
Cross Sectional ◽  
Management Of Complications

Background: Snake bite is a common medical emergency and underestimated public health problem causing significant morbidity and mortality worldwide. Poisonous snake bite is a common problem in north Kerala and a significant number of children are bitten by snakes every year. Majority of studies in this respect have been done on adult snake bite victims and only limited studies are available based on poisonous envenomation in children in our region. The clinical profile of snake bite in children can differ significantly from adult snake bite victims so study was conducted to find the clinical profile of poisonous snake bite in children less than fifteen years.Methods: This was a descriptive cross sectional study conducted in a tertiary care academic institution located in the northern part of Kerala from December 2009 to November 2010. All children less than 15 years with poisonous snake bite were included in this study. Patients with non-poisonous bite, without signs of envenomation and with pre-existing bleeding and renal disorders were excluded.Results: There were fifty cases of poisonous snake bite and among them 76% were males and 24% were females. The highest numbers of bites (50%) occurred in the age group between 11-15 years. Maximum number of snake bite occurred during the months of June and July. The majority of the bites occurred during night between 6 pm to 9 pm (42 %). Among the identified venomous bite Viper accounted for the highest number (48%), followed by Krait (12 %) and Cobra (4%). Lower extremities were the most observed bitten part of the body (82%) and the commonest site was foot. Eighty four percentage of victims reached hospital within 6 hours of snake bite. The most common clinical manifestation was local pain (94%) followed by swelling (90%) and regional lymphadenopathy (82%). Majority had hemotoxicity (94%) and neurotoxicity (6%) was comparatively lesser in our study. Most common complication was overt bleeding manifestations (14%) followed by gangrene of bite site (8%), acute kidney injury (6%) and respiratory paralysis (2%). Thirty eight percent of cases required more than 10 vials of ASV and reaction to ASV occurred in 40% of cases. No mortality occurred during this study period.Conclusions: Poisonous snake bite is a common life threatening medical emergency in our region. Morbidity and mortality due to this can be reduced by early administration of anti-snake venom and prompt recognition and management of complications. So, prompt referral of children with poisonous snake bite to centres where facilities in managing snake bite is crucial in preventing mortality. 

scholarly journals Epidemiological and clinical profile of snakebite patients: a retrospective analysis at a tertiary care teaching hospital of southern Rajasthan, India

2020 ◽  
Vol 9 (1) ◽  
pp. 121
Author(s):  
Sanjay Kumar Paliwal ◽  
Syed Javed ◽  
Arth Shah
Keyword(s):  
Mechanical Ventilation ◽  
Teaching Hospital ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Clinical Profile ◽  
Traumatic Experience ◽  
Published Data ◽  
Local Pain ◽  
Tertiary Care Teaching Hospital ◽  
Care Teaching

Background: Snakebite - a global public health problem can be a traumatic experience for patients. They may develop local pain and swelling at the site with or without systemic involvement (haematological and neurological) and at times complications depending upon nature of snake. The present study was planned to determine the epidemiological and clinical profile of snakebite patients at a tertiary care teaching hospital of southern Rajasthan, India.Methods: This retrospective observational study was carried out at a tertiary care teaching hospital only after approval from institutional ethics committee. The data of patients aged between 18-80 years of either gender that had presented with a history of snakebite and admitted to the intensive care unit (ICU) in past 3 years were included. Data related to epidemiological, clinical and investigational parameters was collected and analysed. Data was presented as number (percentage) or mean ± standard deviation.Results: Total 80 patients were analyzed. Male:female ratio was 1.67:1 and mean age of study population was 33.91±14.34 years. Maximum 71 (89%) patients belonged to rural region. Only 16 (20%) patients complained of local pain. Bleeding was noted in 5 (6.25%) patients whereas 36 (45%) patients had ptosis. Prolonged coagulation markers were reported in 35 (44%) patients. Only 2 (2.5%) patients had acute kidney injury. Altered liver and renal function tests were noted in 71 (89%) and 63 (79%) patients respectively. Mechanical ventilation was required in 27 (34%) patients.Conclusions: Young adult males and rural population were prone to snakebites. Local and systemic manifestations were noted in relatively lesser patients compared to the published data. Only fewer patients in I.C.U. required mechanical ventilation.

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