scholarly journals Analysis of Snake Bite Victims in a Tertiary Care Center

2015 ◽  
Vol 12 (1) ◽  
pp. 24-28
Author(s):  
V Dharma Rao ◽  
P Bickram ◽  
R P Ramyatha ◽  
N Sumalatha

Background: Snake-bite is a common cause of morbidity and mortality in tropical countries. In India, there are 216 species of snakes, of which only four (cobra, krait, Russell’s viper and saw scaled viper) are venomous. Objective: The aim of the study was to evaluate the epidemiological profile, clinical features, complications and mortality rate of snake bite victims admitted in a tertiary care hospital in Andhra Pradesh, India. Methods: The study was conducted at Mamata General Hospital, khammam from June 2010 to May 2012. A total of 39 cases with history of snake bite were analysed. Results: Out of 39 cases, majority of the cases were observed in the age group 20-50 year (66%). High incidence of snake bite was observed in males 62%). The common victims were farmers and housewives. The bite was commonly encountered while walking bare foot (30%) followed by while sleeping (14%). Fifty Four percent of victim were bitten during outdoor and agriculture related activities. Maximum number of cases (54%) presented within 12 hour of snake bite and 66% cases had 1-5 days of hospital stay. Majority (82%) were bitten on the legs below knee. Localized oedema at the site of bite was present in 70% victim. Fang/teeth marks were noted in (41%) cases. There were 59% neurotoxic snake bites, 26% haemolytic, 5% mixed and 8% non-poisonous snake bites. Most of the cases developed cellulitis at the site of snake bite (21%), shock (12%), and acute kidney injury (8%). One tenth of the cases required assisted ventilation and overall mortality rate was 8%.Conclusion: Snakebites are still common in the rural population of India. There is need to educate the public about the preventive measures of snake bite, advantages of early hospital referral and treatment.DOI: http://dx.doi.org/10.3126/hren.v12i1.11981        Health Renaissance 2014;12(1):24-28

Author(s):  
Priya Somu ◽  
Sakthi Narmatha D.

Background: Maternal mortality rate and Infant mortality rate remains high in India when compared to several other countries. Understanding and being aware about the basic care provided during pregnancy is an important factor to make the pregnant woman to utilize the antenatal care. Hence this study was planned to assess the existing knowledge of primi gravid mothers attending the tertiary health care center about the various antenatal care services provided.Methods: This cross-sectional study was conducted among the primi gravid females attending the outpatient department of Obstetrics and Gynecology in Sri Muthukumaran Medical College Hospital and Research Institute, Chennai during months of June 2018 to May 2019. A total of 280 primi gravid mothers were included in the study. Data was collected through one to one interview and analyzed using statistical package for social sciences (SPSS) version 17.Results: In this study 82.9%, 70.4%, 80.7% of the mothers were aware about consumption of IFA tablets, TT injection and adequate ANC visits, respectively. PNDT act was known to 76.1% of the participants. Only 12.5% of the primi mothers were aware about Janani Suraksha Yojna (JSY) scheme and 91.8% of the mothers were aware about Dr. Muthulakshmi Maternity Benefit scheme.Conclusions: Knowledge about ANC services was found to be fair among the primi mothers but not sufficient, which shows the need for the healthcare professionals to educate young woman even from adolescent age itself.


2019 ◽  
Vol 6 (6) ◽  
pp. 1727
Author(s):  
Keshava Murthy M. R. ◽  
Aruna C. Ramesh

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.


Author(s):  
Twinkle Ann George ◽  
Asha A. V. ◽  
Risha Ravindran ◽  
Latha N. V.

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.


2015 ◽  
Vol 6 (3) ◽  
pp. 58 ◽  
Author(s):  
Abubakar Siddique ◽  
Githa Kishore ◽  
EjazMohammed Ahmed ◽  
HafeezAbdul Khader

Author(s):  
Amritesh Kumar ◽  
Soumya Gopakumar ◽  
Sruthy Sathyan ◽  
S. Blessed Singh ◽  
Beena Idicheriya Bhasy

Background: Snake bite is considered as one of the most significant health related problems throughout the world. According to the WHO, a snake bite is an important medical problem. It has been a neglected extrinsic injury in tropical and sub-tropical developing countries including India. It has been estimated that every year there are almost 83,000 snake bites and 11,000 deaths due to snake bites in India. The Goal of this study is to access knowledge, attitude and practice (KAP) among interns so as to find out gaps in academics and bridge them. Findings of this study will benefit community at large.Methods: An institutional based cross sectional study was conducted for the entire batch of interns in a tertiary care center in Trivandrum, Kerala, South India during June–September 2018. A non-probability sampling was done. Data was collected by self-administered questionnaire.Results: Among 100 students 48% had a score equal to and above 8 which was taken as good level of knowledge and 52% had poor level of knowledge. Attitude towards management of snake bite was 100% among study subjects. Only 35% of students had median score above 4 as good level of practice and remaining 65% had poor level of practice.Conclusions: Respondents have adequate knowledge on snake bites. They discarded various prevailing myths in society. Although study showed adequate attitude towards management, that was not reflected in practice. This gap can be overcome by teaching in simulated environment, so as to make them competent enough for managing snake bites. 


JMS SKIMS ◽  
2020 ◽  
Vol 23 (3) ◽  
Author(s):  
Sameer Anand ◽  
Owais Ahmed ◽  
Vijay Kundal

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.


2018 ◽  
Vol 08 (03) ◽  
pp. 168-171
Author(s):  
Harish Kumar ◽  
Adnan Bashir ◽  
M Omer Sultan ◽  
Khadijah Abid ◽  
Nabeel Naeem Baig

Objective: To determine the frequency of Acute kidney injury secondary to snake bite in patients presenting to a tertiary care hospital. Subject and Methods: This was a descriptive cross-sectional study conducted at the department of General Medicine, Jinnah postgraduate medical center, Karachi, from 10th June 2015 to 10th Jan 2016. Patients with diagnosis of snake bite were enrolled. Detailed history, physical examination and biochemical measurements were recorded. Patients underwent serum creatinine levels for diagnosis of AKI. Results: One hundred and twelve patients fulfilling the inclusion criteria were included in this study.There were 90 (83.36%) males and 22 (19.64%) females. The mean ± standard deviation age of study population was 28±0.151 years. On analysis of risk factors it was observed that 33 (29.46%) patients were obese. On analysis of outcome variable, it was observed that 33 (29.46%) had AKI. Conclusion: Around 30% of patients who developed AKI were presented with history of snake bite. However, factors such as age, gender, duration and obesity were not related with the AKI.


Author(s):  
Sandeep Singh ◽  
Abhijit Pall ◽  
Rupesh Singh Kirar

Background: Snake bite is an occupational hazard for farmers and farm laborers in the Indian subcontinent. Most snake venom can adversely affect multiple organs. Various ECG changes have been reported in a large percentage of cases of snake bite (particularly viper and krait) from time to time. Thus, cardiotoxicity was studied with ECG.Methods: This cross-sectional observational study was carried on 84 patients admitted in Ward/ICU, Department Of Medicine, NSCB Medical College, Jabalpur, India on patients of snake bite reporting from all over Mahakaushal area of central India from March 2017 to August 2018.Results: The commonest manifestation in vasculotoxic snake bite was tachycardia (16.67%). On admission, ECG manifestations were 39.1% in poisonous bites were sinus tachycardia (17.8%), sinus bradycardia (9.5%), nonspecific ST-T changes (5.9%), AV block (3.5%) and sinus arrhythmia (2.3%) of all cases. These ECG changes were 2.3% in nonpoisonous patients. In symptomatic cases mortality was 19% with no mortality was seen in non-poisonous snake bite. There was significant difference between outcome of abnormal ECG group and normal ECG group patients (p <0.005).Conclusions: There is significant impact of snake poisons on cardiovascular profile and ECG can be a useful tool to predict outcome.


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