scholarly journals A hospital based study on snake bite poisoning in adults in the western region of Nepal

2017 ◽  
Vol 6 (3) ◽  
pp. 33-38 ◽  
Author(s):  
V P Poudyal ◽  
K M Paudal ◽  
N B Rana ◽  
S Adhikari
Keyword(s):  
Respiratory Distress ◽  
Monsoon Season ◽  
Case Fatality ◽  
Snake Bite ◽  
Western Region ◽  
Management Guideline ◽  
Snake Bites ◽  
Males And Females ◽  
Epidemiological Profile ◽  
June July

Snake bite poisoning is an emergency condition with significant morbidity and mortality. It is more prevalent in Terai and Inner Terai regions of Nepal especially during monsoon season. There is no study on snake bite poisoning in adults in this part of the country after the introduction of national snake bite management guideline in 2003. This retrospective study was conducted to evaluate the clinico-epidemiological profile, amount of anti-snake venom used and outcome of snake bites. Six hundred and thirty eight cases of snake bite poisoning above the age of 15 years admitted in emergency department of the hospital, over a period of 6 years from 2004/2005 to 2009/2010 were evaluated retrospectively. The study showed almost equal numbers of bites in males and females (50.3% vs 49.7%) with two third of victims of 15 to 45 years of age. Most of the poisonings (68%) was seen during June, July and August months corresponding to the monsoon season in Nepal. Majority of the victims could not identify the snakes (45 %).Fingers & hands were bitten in majority cases (43 %). Ptosis was observed in all cases of snake bite poisoning. About 21% of the adults had respiratory distress needing respiratory support. Average ASV used was 21.3 vials. Case fatality rate (CFR) was 11.9% with more fatality on those with respiratory distress. As mortality due to snakebite poisoning and consumption of antisnake venom is still high with the use of national protocol 2003, further study to evaluate alternate protocol is recommended. 

scholarly journals Study of Clinico-Epidemiological Profile and Outcome of Poisonous Snake Bites in Children

1970 ◽  
Vol 32 (1) ◽  
pp. 47-52 ◽  
Author(s):  
KM Paudel ◽  
S Sharma
Keyword(s):  
Respiratory Distress ◽  
Case Fatality Rate ◽  
Monsoon Season ◽  
Case Fatality ◽  
Snake Bite ◽  
Fatality Rate ◽  
Male Predominance ◽  
Snake Bites ◽  
Poisoning In Children ◽  
June July

Introduction: Snake bite poisoning in children is an emergency condition with significant mortality. It is more prevalent in Terai and Inner Terai regions of Nepal especially during monsoon season. There is no study on snake bite poisoning in this part of the country after the introduction of national snake bite management guideline in 2003. This retrospective study was conducted to evaluate the clinicoepidemiological profile, amount of anti-snake venom used and outcome of snake bites. Materials and Methods: Two hundred and forty six cases of snake bite poisoning admitted in emergency department of the hospital up to the age of 14 years, over a period of 6 years from 2004/2005 to 2009/2010 were evaluated retrospectively. Results: The study showed male predominance (57.3%) in snake bites with higher incidence of children above ten years of age (58%). The most of the poisonings (71.9%) was seen during June, July and August months which correspond to the monsoon season in Nepal. Majority of the victims had been bitten by unidentified snakes (52 %), mostly on the fingers & hands (64.6 %). Ptosis was observed in all cases of snake bite poisoning. Slightly less than 1/3rd of the children had respiratory distress needing respiratory support. Average ASV used was 18.2 vials. Case fatality rate (CFR) was quite high (28.2%) with more fatality on those with respiratory distress. Conclusion: As mortality due to snakebite poisoning and consumption of antisnake venom is not reduced by the use of the national protocol 2003, further study to evaluate alternate protocol is recommended. Key words: Case fatality rate; Envenomation; Nepal; Poisoning; Snakebite. DOI: http://dx.doi.org/10.3126/jnps.v32i1.5948   J. Nepal Paediatr. Soc. Vol.32(1) 2012 47-52

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 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 Clinical Features, Management and Outcome of Snake Bite in Children in Manipal Teaching Hospital

2013 ◽  
Vol 2 (2) ◽  
pp. 119-124
Author(s):  
Deepak P Koirala ◽  
E Gauchan ◽  
S Basnet ◽  
S Adhikari ◽  
G BK
Keyword(s):  
Clinical Features ◽  
Teaching Hospital ◽  
Rural Areas ◽  
Case Fatality ◽  
Snake Bite ◽  
Blood Products ◽  
Medical Sciences ◽  
Coagulation Profile ◽  
Snake Bites ◽  
Significant Mortality

Background: Snake bite is a widely distributed and neglected condition with a significant mortality. Medically significant snakes are: Elapidae, which are mainly neurotoxic and Viperidae, which are hemotoxic. Most studies on snake bites are done in Terai belt of Nepal and this is a first study of its kind in children in western region of Nepal. Methods: This was a 7 year retrospective study in Pediatric unit of Manipal Teaching Hospital, Pokhara, Nepal. Relevant data from all cases of snake bite in children up to 18 years of age was collected in a structured proforma and analyzed. Results: Among the 39 cases of Snake bites; it was more in boys (M: F=1.16:1), from rural areas (62%) and was more common during monsoon (64%). The commonest site of bite was foot (64%). Snakes were identifiable in only 23% of the cases. Local swelling (77%) and pain (74%) were common clinical features. Coagulation profile was deranged in 80% of the patients, hematuria was observed in 13% patients and 15% patients had thrombocytopenia. Most of the snakes were hemotoxic (77%) and only 1 case (2.5%) was neurotoxic. Only 44% of the patients received polyvalent anti-snake venom and blood products were required in 51% of the patients. Most patients improved (75%) and the case fatality rate was 2.5%. Conclusion: Most snakes found in mountainous region of Nepal are hemotoxic and lead to deranged coagulation profile. Mortality is low in hemotoxic as compared to neurotoxic envenomations. Nepal Journal of Medical Sciences | Volume 02 | Number 02 | July-December 2013 | Page 119-124 DOI: http://dx.doi.org/10.3126/njms.v2i2.8954

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 prognostic indicators of neurotoxic snake bite in rural India

2019 ◽  
Vol 6 (6) ◽  
pp. 1876
Author(s):  
Suhail Hassan ◽  
Rijul Saini ◽  
Monuj Aggarwal
Keyword(s):  
Neglected Tropical Diseases ◽  
Monsoon Season ◽  
Snake Bite ◽  
Prognostic Indicators ◽  
Rural India ◽  
Traditional Methods ◽  
Healthcare Facilities ◽  
Young Males ◽  
Snake Bites ◽  
Methods Of Treatment

Background: In rural India, snakebite is an occupational and environmental hazard. WHO listed snakebite as one of the neglected tropical diseases and in rural India it is underreported because of popular traditional methods of treatments and lack of healthcare facilities. This study is an attempt to look into the epidemiological, clinical and prognostic indicators of neurotoxic snake bite in rural India.Methods: This study is a prospective, descriptive study of 25 neurotoxic snake bites admitted in our hospital from January to September 2019. Clinical factors like age, sex, clinical features, management and the outcome of patients are studied.Results: Young males were common victims of snakebite in evening hours during monsoon season. All patients received traditional methods of treatment, and despite this 64% of our patients reported to the hospital within 6 hours after the bite. Overall, the mortality rate in this study was 12%. Poor outcome was also noted in cases who were having respiratory failure and needed artificial ventilation (30%). Mortality was 22.2% in patients where bite to admission time was greater than 6 hours as compared to 6.25% in patients where it was less than 6 hours.Conclusions: Author concluded that a neurotoxic snake bite is a life-threatening emergency. In preventive measures, outdoor activities in dim lights during monsoon season should be restricted. Traditional treatments are still popular and trusted methods of treatment in rural India and these healers can be educated to recognize and refer immediately all neurotoxic bites to nearby medical facilities.

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
Keyword(s):  
Mortality Rate ◽  
Care Center ◽  
Tertiary Care ◽  
Kidney Injury ◽  
Assisted Ventilation ◽  
Snake Bite ◽  
Care Hospital ◽  
Hospital Referral ◽  
Snake Bites ◽  
Epidemiological Profile

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

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 SNAKEBITE POISONING IN CHILDREN

2003 ◽  
Vol 41 (144) ◽  
pp. 463-467
Author(s):  
Binod M Shrestha
Keyword(s):  
Risk Factors ◽  
Respiratory Distress ◽  
Key Words ◽  
Case Fatality Rate ◽  
Monsoon Season ◽  
Case Fatality ◽  
Fatality Rate ◽  
Mortality And Morbidity ◽  
Male Sex ◽  
Poisoning In Children

Snakebite Poisoning is a common paediatric emergency especially during the monsoonseason in the terai and inner terai regions of Nepal. There is hardly any study conductedso far in Nepal to highlight different aspects of snakebite poisoning in children. Thisretrospective study was therefore conducted basically to find out the clinicoepidemiologicalfeatures, case fatality rate and risk factors for death in childrenadmitted in Lumbini Zonal Hospital (LZH) with features of snakebite poisoning.The study showed the highest incidence of snakebite poisoning among children agedabove 10 years. The peak incidence of poisoning was seen during July-August. Thesemonths correspond with the monsoon season in Nepal. Most of the victims had bitesby unidentified snakes (75%), mostly on the fingers & hands (nearly 50%). Nearly47% of the children had respiratory distress, and a large majority of them requiredrespiratory support therapy. Case fatality rate (CFR) was nearly 29%. The relativerisk factors for death due to snakebite poisoning were: age above 5 years, male sex,bites on the finger & hand and bites by Kraits. Mortality and morbidity due to snakebitecan be reduced by early & judicious use of anti-snake venom (ASV).Key Words: Snakebite, Poisoning, Children, Case fatality rate, Nepal

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. 

Sign in / Sign up

Export Citation Format

Share Document