scholarly journals Demography, clinical profile, morbidity and mortality pattern of snake bite cases in children: a study at tertiary teaching hospital

2019 ◽  
Vol 6 (4) ◽  
pp. 1472 ◽  
Author(s):  
Vishwanath B. ◽  
Ganesh P.
Keyword(s):  
Snake Bite ◽  
Lower Limbs ◽  
Older Children ◽  
Mortality Pattern ◽  
Descriptive Case Study ◽  
Local Toxicity ◽  
Snake Bites ◽  
Tertiary Teaching ◽  
Important Health ◽  
History Of

Background: Snake bite is one of the important health problems in tropical and sub-tropical countries including India. Most snake bites present without envenomation as most bites are usually due to non-poisonous snakes and even poisonous snakes can control amount of venom injected. Even though mortality is under reported, India accounts for most of deaths due to snake bite.Methods: A hospital based descriptive case study was conducted at Pediatric ward of VIMS Ballari. All children with definite history of snake bite with fang marks or features of local/systemic envenomation were included in study. Demographic parameters, symptomatology and complications were noted down as per pro forma and data was analyzed.Results: Most bites occurred in lower limbs in older children while playing outdoors. Most cases were from rural area. Majority presented with local toxicity followed by hemotoxicity and neuroparalysis. Two children died, one because of respiratory paralysis and other by acute kidney injury.Conclusions: Snake bite is a preventable health problem. By wearing protective shoes and avoiding outdoor sleep many snake bites can be avoided. Early, aggressive but judicious use of antisnake venom is a cornerstone of management.

scholarly journals UTILITY OF SERUM CRP AND LDH AS MARKERS OF HEMOTOXICITY IN SNAKE BITE VICTIMS: HOSPITAL BASED STUDY

2021 ◽  
Vol 5 (5) ◽  
Author(s):  
Bhagwan Pandharinath Gore
Keyword(s):  
General Medicine ◽  
Snake Bite ◽  
Lower Limbs ◽  
Medical Emergency ◽  
Medical Sciences ◽  
Younger Age ◽  
History Of ◽  
Frequent Site ◽  
Serum Crp ◽  
Symptoms And Signs

Background: Snakebite is a common medical emergency and an occupational hazard commonly seen in the rural as well as suburban population. In this study to determine the utility of Serum CRP and LDH as Markers of hemotoxicity in snake bite victims. Materials & Methods: This hospital based prospective study was conducted a total 60 admitted patients in the department of general medicine at Vedantaa Institute of Medical Sciences, Palghar during June 2020 to December 2020. The patients were included were with alleged history of snake bite & history of unknown bite but with symptoms and signs compatible with snake bite envenomation otherwise patients were excluded. Results: Most frequent site of snakebite was the lower limbs constituting 85.0% of bites. Majority (41.7%) of the patients presented with features compatible with moderate envenomation. Serum CRP showed a significant elevation in their levels in the severe as compared to the mild envenomed group. Conclusion: Snakebite commonly affects people in the younger age group & hemotoxic envenomation is most common manifestation of envenomation observed. Keywords: Snakebite, Envenomation, Serum CRP, LDH, Haematological Parameters.

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 Clinical Study of Snakebite Cases Admitted in Dhaka Medical College Hospital

2014 ◽  
Vol 13 (1) ◽  
pp. 7-12
Author(s):  
Prabal Chakraborty ◽  
Jishu Deb Nath ◽  
MA Faiz ◽  
Anannya Das ◽  
Abdul Qayum Chowdhury
Keyword(s):  
Rural Areas ◽  
Health Hazard ◽  
Medical College Hospital ◽  
Snake Bite ◽  
College Hospital ◽  
Venomous Snake ◽  
Medical College ◽  
Snake Bites ◽  
Important Health ◽  
Seeking Behavior

Background: Snake bite is an important health hazard which may lead to fatality in rural areas of Bangladesh. An epidemiological study estimated the incidence of snake bite in Bangladesh about 8,000 per year with 22% mortality. In majority of cases the victims die before entrance to hospital because of their treatment seeking behavior from Ohzas. Present study is to see the clinical profile of snake bite cases admitted in Dhaka Medical College Hospital and also to find out problems in diagnosis and management and outcomes.Methods: Fifty patients of snake bites treated in Dhaka Medical College Hospital, Dhaka, Bangladesh between July 2005 and December 2006 were studied. A questionnaire, containing information on bite, physical examination and identification of snake brought was used.Results: Among the patients venomous snake was 6 (50%) with cobra and 6 (50%) with suspected krait bite. Males were bitten more frequently than females 42(82%) versus 9(18%). Regarding occupation, 28 (56%) was farmer. Majority 37(74%) came from rural areas. Highest number of bite occurred in evening 20(40%). Most snake bite occurred during rural foot walking (30%) followed by sleeping (14%).Total 54% of bite occurred during outdoor activities. Most common site of bite is lower limb 35(70%). Tight tourniquet used in 45(90%) cases and in 8(16%) cases limb was immobilized. Twenty eight (56%) of the patients received treatment from Ohzas. All venomous bites (12) presented with features of neurotoxicity with local envenoming in 6(50%) cases. In 6(50%) cases there were only neuroparalysis. Four (33.34 % of venomous snake) patients required respiratory support and 10(83% of venomous bite) patients required antivenom. There were no anaphylactic reactions and only 2 patients suffered pyrogenic reaction. The outcome was excellent with only one death and only one case of residual effects.Conclusion: To develop an appropriate prevention and control strategy, reliable and timely information has a crucial role. A functional mechanism should be developed to gather information not only about the cases and deaths but other aspects of the snakebite epidemiology.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i1.19410

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 A prospective study on clinico-epidemiological profile and outcome in management of poisonous snake bite

2020 ◽  
Vol 9 (5) ◽  
pp. 695
Author(s):  
Mukesh Kumar Chaudhary ◽  
Laxmi K. Gupta ◽  
Lokendra B. Chand ◽  
Ramesh Chaudhary ◽  
Sabin Ranpal
Keyword(s):  
Health Care ◽  
Rural Areas ◽  
Snake Bite ◽  
National Guidelines ◽  
Major Health Problem ◽  
Major Health ◽  
Snake Bites ◽  
History Of ◽  
Epidemiological Profile ◽  
A Prospective Study

Background: Snake bite is a major health problem in Nepal. According to WHO, annual morbidity due to snake bite is 162 out of 100,000 people in Nepal. Aim of the study is to observe epidemiology, clinical features, and analysis of possible relationship between time delay in administration of anti-snake venom (ASV) and mortality. Methods: This prospective observational study analyses the data of 81 patients admitted to the Lumbini zonal hospital, Butwal, Rupandehi, Nepal with history of snake bite between April to September, 2017.Results: In this study 56% patients were female. Patients of age group (15-30) years were maximum (38.27%). The study showed that 50.61% of snake bites were occurred outside home. Most of patients (84%) were from the Terai region. Average no. of vials used per case was (28±10) vials. Most of victims of snake bite were from rural areas. In most of cases we found that prothrombin time was prolonged. It was found that most of patients 57% reach hospital before 4 hours of snake bite. The mean days of hospital stay was 6±2.86. Most of case of snake bite was unknown (62%). The mortality rate in this study was 6.17%.Conclusions: There is a great need to improve in existing health care conditions for effective management of snake bite; it requires training of the personnel engaged in the emergency health care management, development of national guidelines based on the clinical trials, improving the distribution and easy availability of antivenom. 

scholarly journals Incidence of Snake bites in Dhanusha District of Nepal: a study in tertiary care centre

2016 ◽  
Vol 3 (1) ◽  
pp. 52-55
Author(s):  
RN Mandal ◽  
Z Ahmed ◽  
A Mishra ◽  
RC Das
Keyword(s):  
Rural Areas ◽  
Economic Status ◽  
Tertiary Care ◽  
Snake Bite ◽  
Lower Limbs ◽  
Medical Emergency ◽  
Tertiary Care Centre ◽  
Mortality And Morbidity ◽  
Medical College ◽  
Snake Bites

Background and Objectives: Envenomation by poisonous snakes is considered as an occupational hazard. Snake bite is a common medical emergency and one of the important causes of mortality and morbidity in tropical region.Material and Methods: The present study was conducted in the emergency department of JMCTH. All the patients admitted to JMCTH from April 2014 to November 2014 with snake bite were followed up from the time of admission to throughout their stay in hospital. The data was obtained from hospital case records, direct interrogation from relatives, friends, person accompanying the patients. The information was collected in a pre-formed Proforma. Data were entered and analyzed using Microsoft Excel.Results: The victims of snake bite predominantly were male. Maximum numbers of snake bite cases were between the age group of 31 to 40 yrs and of low socio-economic status. 67.34 % cases were from rural areas and farmers were the most common victim (69.38 %).Conclusion: Maximum cases occurred during the summer and pre-monsoon months, during daytime and involved the lower limbs. Ptosis was the chief neurotoxic feature followed by dysarthria.Janaki Medical College Journal of Medical Sciences (2015) Vol. 3 (1):52-55

scholarly journals SNAKE BITE

2015 ◽  
Vol 22 (03) ◽  
pp. 299-305
Author(s):  
Mohammad Asif Ansari ◽  
Ahmed Hussain ◽  
Nisar Ahmed Shah ◽  
Syed Zulfiquar Ali Shah ◽  
Zulfiqar Ali Qutrio Baloch
Keyword(s):  
Bleeding Time ◽  
Relevant Information ◽  
Snake Bite ◽  
University Hospital ◽  
Female Population ◽  
Prolonged Bleeding Time ◽  
Snake Bites ◽  
Coagulation Tests ◽  
History Of ◽  
The Mean

Snake bites are increasing amongst those who unlawfully keep snakes as petsworldwide. The rural population active in agricultural works, laborers, herders, professionalsnake handlers, trekkers, snake charmers and fishermen are at risk for snake bites. Objectives:To determine the frequency and pattern of vasculotoxic effects in patients with snake bite.Design: Case Study. Period: Six Months Setting: Liaquat University Hospital Hyderabad.Patients and methods: All the patients who initially present in casualty department of hospitalwith the history of snake bite were enrolled in the study. The vasculotoxic effects were evaluatedby whole blood clotting time (WBCT) test, bleeding time, PT/APTT, hypofibrinogemia, DIC andthrombocytopenia. Relevant information would be entered in specifically designed proformafor this study. The data was entered, saved and analyzed in SPSS. So no test of significancewould be applied. Results: Out of 140 patients 112(80%) had vasculotoxic effects, of which80(72%) were males and 32(28%) were females. The mean age ±SD of the overall patients was37.53±8.72 whereas the mean age ±SD of male and female population was 38.98±7.44 and34.88±4.32 respectively. The systemic bleeding was observed in 99% patients, the fang marksin 94 patients, the prolonged bleeding time, WBCT and PT/APTT in 103, 96 and 101 patients,thrombocytopenia in 93 patients, hypofibrinogemia in 81 patients and DIC in 76 patients.The hamaturia (22%), hamoptysis(16%) and hametemesis (11%) was predominant features.The gangrene was observed in 02 patients, vomiting was observed in 60% of patients hadhaematemesis in 11%, bleeding gums in 03 cases and haemoptysis in 16%. Renal failure wasobserved in 12 cases. Conclusions: The coagulation tests disturbed as venom increases theclotting time. Proteins digesting enzymes or thrombin like activity of venom may be one of thecauses for prolongation coagulation tests (vasculotoxic effects)

scholarly journals Snake bite management in a toddler: a case report in Sumbawa Besar

2021 ◽  
Vol 61 (4) ◽  
pp. 171-4
Author(s):  
Ferry Liwang ◽  
Fitria Nuraeni ◽  
Mulya R. Karyanti
Keyword(s):  
Rural Areas ◽  
Epidemiological Data ◽  
Snake Bite ◽  
Lower Limbs ◽  
Intervention Measures ◽  
Life Saving ◽  
Snake Bites ◽  
The Face ◽  
Life Threatening ◽  
Low Coverage

Snake bite is an often-neglected,1 life-threatening emergency prevalent in rural areas of tropical countries such as Indonesia.2 The WHO reported a worldwide incidence of 5 million snake bites per year, with 100,000–200,000 deaths.3 The incidence rate and likelihood of subsequent complications are higher in children than adults.4 According to the WHO, 35% of child deaths related to poisonous animal bites are attributable to snake bites and occur more frequently in boys than girls.5 In Indonesia, no national epidemiological data on snake bites in children is available, but the WHO estimated that 5–8 snake bite cases occur weekly in Lombok, West Nusa Tenggara.6 Lower limbs are the most common site for bites (72%), while facial bites are quite rare (10%).7 Bites involving children and/or the face are considered as severe envenomation and usually require antivenom at an appropriate dose and timing to be effective.8 Therefore, it is important that hospitals are equipped with life-saving intervention measures to optimize care and improve the chances of survival.9 Nevertheless, in developing countries, the use of antivenom is limited by the absence of standardized guidelines, scarcity/unavailability, and high cost.9 In Indonesia, the only antivenom, serum antibisa ular (SABU), is costly and difficult to obtain due to limited quantities, especially in rural areas. Furthermore, SABU is a polyvalent antivenom with low coverage, as it is only indicated for Naja sputatrix, Bungarus fasciatus, and Agkistrodon rhodostoma, despite the numerous other snake species endemic to Indonesia.2

Screening for haemorrhagic disorders in paediatric patients by means of a questionnaire

2009 ◽  
Vol 29 (S 01) ◽  
pp. S87-S89 ◽  
Author(s):  
I. Music ◽  
M. Novak ◽  
B. Acham-Roschitz ◽  
W. Muntean
Keyword(s):  
Predictive Value ◽  
Laboratory Diagnosis ◽  
Von Willebrand Disease ◽  
Control Group ◽  
Older Children ◽  
Mild Disease ◽  
History Of ◽  
Von Willebrand ◽  
Specific Symptoms ◽  
Infants And Young Children

SummaryAim: In children, screening for haemorrhagic disorders is further complicated by the fact that infants and young children with mild disease in many cases most likely will not have a significant history of easy bruising or bleeding making the efficacy of a questionnaire even more questionable. Patients, methods: We compared the questionnaires of a group of 88 children in whom a haemorrhagic disorder was ruled out by rigorous laboratory investigation to a group of 38 children with mild von Willebrand disease (VWD). Questionnaires about child, mother and father were obtained prior to the laboratory diagnosis on the occasion of routine preoperative screening. Results: 23/38 children with mild VWD showed at least one positive question in the questionnaire, while 21/88 without laboratory signs showed at least one positive question. There was a trend to more specific symptoms in older children. Three or more positive questions were found only in VWD patients, but only in a few of the control group. The question about menstrual bleeding in mothers did not differ significantly. Sensitivity of the questionnaire for a hemostatic disorder was 0.60, while specifity was 0.76. The negative predictive value was 0.82, but the positive predictive value was only 0.52. Conclusions: Our small study shows, that a questionnaire yields good results to exclude a haemostatic disorder, but is not a sensitive tool to identify such a disorder.

Aspergillus Spondylodiscitis After Spinal Stenosis Surgery: A Case Report

2020 ◽  
Vol 5 (3 And 4) ◽  
pp. 155-160
Author(s):  
Mohsen Aghapoor ◽  
◽  
Babak Alijani Alijani ◽  
Mahsa Pakseresht-Mogharab ◽  
◽  
...  
Keyword(s):  
Antifungal Drugs ◽  
The Body ◽  
Lower Limbs ◽  
Lumbar Pain ◽  
Case Presentation ◽  
Delay In Diagnosis ◽  
Death Case ◽  
Therapeutic Results ◽  
History Of ◽  
Probable Diagnosis

Background and Importance: Spondylodiscitis is an inflammatory disease of the body of one or more vertebrae and intervertebral disc. The fungal etiology of this disease is rare, particularly in patients without immunodeficiency. Delay in diagnosis and treatment of this disease can lead to complications and even death. Case Presentation: A 63-year-old diabetic female patient, who had a history of spinal surgery and complaining radicular lumbar pain in both lower limbs with a probable diagnosis of spondylodiscitis, underwent partial L2 and complete L3 and L4 corpectomy and fusion. As a result of pathology from tissue biopsy specimen, Aspergillus fungi were observed. There was no evidence of immunodeficiency in the patient. The patient was treated with Itraconazole 100 mg twice a day for two months. Pain, neurological symptom, and laboratory tests improved. Conclusion: The debridement surgery coupled with antifungal drugs can lead to the best therapeutic results.

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