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 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 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 Snake bite, a neglected menace: a prospective observational study in a tertiary care pediatric intensive care unit

2020 ◽  
Vol 7 (5) ◽  
pp. 1096
Author(s):  
Shatabdi Giri ◽  
Swarup Kumar Bisoi ◽  
Dillip Kumar Dash ◽  
M. D. Mohanty ◽  
S. K. Parida
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Prospective Observational Study ◽  
Tertiary Care ◽  
First Aid ◽  
Snake Bite ◽  
Morbidity And Mortality ◽  
Snake Envenomation ◽  
Snake Bites ◽  
Atypical Presentations

Background: Snake bite is a neglected and underestimated public health problem in tropical and subtropical region. Snake envenomation is a well-known cause of morbidity and mortality in India. In 2009, WHO declared snake bite a neglected disease. Ophitoxaemia is an exotic term characterising the clinical spectrum of snake bite. Objective of this study was to know the outcome in paediatric snake bite cases in a tertiary care PICU (Paediatric Intensive Care Unit) with special reference to envenomation time and also to evaluate and analyse few atypical presentations of snake envenomation by proper history taking, physical examination and help start early intervention to prevent morbidity and mortality.Methods: A prospective observational study was done in Paediatric Intensive care unit of the hospital from June 2017 to June 2019.Results: Around 56.8% of 109 cases were non-poisonous snake-bites. Out of 47 cases admitted to PICU, 68.08% developed cellulitis at the site of bite with Staphylococcus aureus being the commonest organism isolated (56.25%). Anaerobes (bacteroides and clostridium) were also isolated in few cases. Edema at site of bite (hematotoxic) and ptosis(neurotoxic) were most common initial presentation. 36.17% of patients received ASV (Anti- Snake Venom) and first aid within 6 hours of snake bite. The morbidity and mortality were significantly less (p<0.05) as compared to those who didn't receive ASV. 12.76% of cases with normal CRT (Clot Retraction Time) presented with features of coagulopathy. DIC (58.33% of hematotoxic bites) and respiratory paralysis 68 (75% of neurotoxic bites) were the commonest complications. Renal replacement therapy was required in 6.38%, transfusion in 10.63% cases and case-fatality-rate was 12.7%. There were a few atypical presentations of snake bite mimicking Gullain-Barre syndrome, acute onset encephalitis with absent brainstem and pupillary reflexes, intracerebral hemorrhage and cortical blindness.Conclusions: Most snake bites are non-poisonous. Early first aid and ASV administration has better outcome. Fibrinogen levels are more reliable than CRT to diagnose coagulopathy. Acute presentations i.e, altered sensorium, paralysis, blindness and stroke like features should always be evaluated for snake envenomation in suspected cases to prevent morbidity and mortality.

scholarly journals Clinical profile of snake bite patients in tertiary care hospital in Himachal Pradesh: a prospective study

2018 ◽  
Vol 6 (7) ◽  
pp. 2444 ◽  
Author(s):  
Madan Kaushik ◽  
Vikas Banyal ◽  
Sachin Sondhi ◽  
Manish K. Thakur ◽  
Aseem Kaushik
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Himachal Pradesh ◽  
Snake Bite ◽  
Clinical Profile ◽  
Care Hospital ◽  
Female Ratio ◽  
Medical College ◽  
Gandhi Medical College ◽  
A Prospective Study

Background: To study clinical profile of snake bite patients in tertiary care hospital in Indra Gandhi Medical College at Shimla, Himachal Pradesh of North India.Methods: Hospital based prospective observational study was conducted in the Department of Medicine, for the duration of one year from 1st June2013 to 31st May 2014.Results: A total of 78 patients were admitted with mean age of 38.46 years with male to female ratio of 1:1.6. Seasonal variation with peak incidence during rainy season was seen. Most common snake identified was green coloured and peak timing of snake bite was between 07:00am-04:00pm. There was delay in admission of more than 6 hours in 66.67% of cases. Hemotoxicity was predominant manifestation seen in 62.82% of cases and persistence of coagulopathy was most common complication (51.02%) despite giving optimal ASV. There was paucity in ASV administration seen in only 59.46% of referred patients. Mean ASV vials used were 23.41 vials ±8.72 vials.Conclusions: Mass education is required at both general population and health professional levels to improve snake bite management and monovalent ASV against Green pit viper is more practical option to manage cases in this region.

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 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 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.

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 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 bites with Neuropsychiatric Presentation ─ A Study in Hill Tracts of Bangladesh

2018 ◽  
Vol 8 (1) ◽  
pp. 20-24 ◽  
Author(s):  
Ahmed Tanjimul Islam ◽  
Shamrin Sultana ◽  
Md Kafil Uddin ◽  
Matiur Rahman
Keyword(s):  
Tertiary Care ◽  
Snake Bite ◽  
Medical Emergency ◽  
Care Hospital ◽  
Mortality And Morbidity ◽  
Snake Bites ◽  
Neuropsychiatric Manifestations ◽  
Causes Of Mortality ◽  
Psychiatric Manifestations ◽  
Late Stages

Background: Snake bite is a common medical emergency and one of the important causes of mortality and morbidity in hill tracts of Bangladesh. Neurological and psychiatric features predominate as both early and late features of snake bite patients and need to be identified correctly for proper management.Objective: The aim of this study was to find out the pattern of early and late neuropsychiatric manifestations of snake bite in hill tracts with clinical outcomes.Materials and Methods: This descriptive hospital-based study was done on 121 snake bite patients during the period from January 2015 to July 2016 using simple, direct, standardized questionnaire with history, neurological examination and psychiatric evaluation.Results: Majority of cases (71.9%) were admitted into hospital after two hours of snake bite. Lower limb was the commonest site (75.2%) of bite. Generalized weakness (50.4%) and anxiety (52.9%) were the commonest early neurological and psychiatric manifestations. Numbness (57%) and depression (33.9%) were the commonest late neurological and psychiatric manifestations among survivors; 37.2% needed referral to tertiary care hospital and 34.7% received antivenom. Death rate was 17.4% and 73.6% were cured completely without complication.Conclusion: As neurological and psychiatric manifestations are common in both early and late stages in snake bite in hill tracts, these are to be considered in the total management to decrease mortality and morbidity.J Enam Med Col 2018; 8(1): 20-24

Sign in / Sign up

Export Citation Format

Share Document