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 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 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 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 THE INFLUENCE OF CHRONIC DISEASES ON THE MANIFESTATION OF COVID-19 INFECTION

2021 ◽  
pp. 126-132
Author(s):  
S. O. Yastremska ◽  
O. M. Krekhovska-Lepiavko ◽  
B. A. Lokay ◽  
O. V. Bushtynska ◽  
S. V. Danchak
Keyword(s):  
Chronic Diseases ◽  
Case Fatality ◽  
The Novel ◽  
Fatality Rate ◽  
The World ◽  
Control And Prevention ◽  
The Usa ◽  
Life Threatening ◽  
One Year ◽  
Novel Coronavirus

Summary. The first known case of infection from the novel coronavirus was recorded almost one year ago, in China’s Hubei province. The city of Wuhan was infamous the world over as the original virus epicenter, seeing more than half of China’s reported cases and deaths. The outbreak of COVID-19 virus, as sickened more than 14.7 million people. At least 610.200 people have died. The aim of the study – to analyze and systematize the literature data about the influence of chronic diseases on the manifestation of COVID-19 infection. Materials and Methods. The study uses publications of the world scientific literature on COVID-19 infection, in particular the causes and mechanisms of its development, treatment, complications and its consequences as well as the influence of different chronic disorders on the course of COVID-19. Results. A sample of patients hospitalized with COVID-19 across 14 states of the USA in March was analyzed by The Centers for Disease Control and Prevention. It was found that many (89 %) had underlying health problem and 94 % of patients were at the age 65 and older. The case fatality rate for those under age 60 was 1.4 percent. For those over age 60, the fatality rate jumps to 4.5 percent. The older the population, the higher the fatality rate. For those 80 and over, Covid-19 appears to have a 13.4 percent fatality rate. Moreover, it was recognized, that older adults don't present in a typical way of the course of different disorders, and we're seeing that with Covid-19 as well. Conclusions. Chronic diseases and conditions are on the rise worldwide. COVID-19 became the most challenging pandemic influencing all countries worldwide. Chronic diseases are suggested to be one of the main causes of different life-threatening complications of COVID-19 infection and one of the main factors of poor prognosis for the patients.

scholarly journals Brief Epidemiological Report on Chikungunya Outbreak in Bihar, India in 2017: Implications for Control

2019 ◽  
pp. 1-6
Author(s):  
Ragini Mishra ◽  
Navin Mishra
Keyword(s):  
Disease Surveillance ◽  
Age Groups ◽  
Case Fatality ◽  
State Level ◽  
Health Department ◽  
The State ◽  
Control Measures ◽  
Age Group ◽  
The Status ◽  
Almost All

Aims: The present study was done to identify the epidemiology of the disease outbreak in Bihar in 2017 and suggest remedial measures for the prevention of possible future outbreaks of Chikungunya. Study Design:  Daily reports on Chikungunya were collected in prescribed format from the District Surveillance Unit, Integrated Disease Surveillance Programme (IDSP) that included case details from Govt. Medical Colleges and various Private Hospitals in the State. Place and Duration of Study: Index case of Chikungunya was reported in Bihar, India on 15 Feb 2017. After that, few scattered cases were reported till 23 Aug 2017. Cases started increasing from 24 Aug 2017 onwards. From 15 Feb till 31 Dec 2017, total 1223 cases were reported from 32 districts in Bihar. Methodology: The cases were analysed concerning time, place and person. Daily reporting on the health conditions of the cases and the status of the control measures like fogging and larvicidal spray in the affected area was monitored at the State level. Results: Case Fatality Rate (CFR) due to the disease was Nil in the State. The outbreak peak laid from 3-Nov to 12-Nov when 218 cases were reported. Out of 1223 cases, 100% cases were ELISA confirmed. Almost all age groups were affected, but the frequency was greater in the age group 21-30 (25%)> 31-40 (21%)>11-20 (19%). Males (61%) were more affected than females (39%). Out of the total 1223 cases, 100% of the cases were reported from Govt. institutions. State Health Department, Govt. of Bihar took many measures to limit the outbreak, and through strengthening the surveillance and response activities, transmission of the disease was curtailed in the State.     Conclusion: Patna district was most affected followed by Nalanda and Vaishali. Young adults of age group 21-30 were most affected. Males were more affected than females.

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 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 Snake Bite as a Public Health Problem: Bangladesh Perspective

2016 ◽  
Vol 5 (1) ◽  
pp. 24-29
Author(s):  
ABM Saiful Alam ◽  
AKM Monwarul Islam ◽  
Humayra Jesmin
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Problem ◽  
Public Health Problem ◽  
Snake Bite ◽  
Health Care Personnel ◽  
Incidence Density ◽  
Delayed Presentation ◽  
Tropical Condition ◽  
Snake Bites

Snake bite is an important but often under-recognized public health problem in Bangladesh, with an incidence density one of the highest in the world, which may be 623.4/100,000 person years. The proportion of poisonous snake bites is 10 to 45%, with the reported mortality 0.5 to 22%. Among the 82 species of snakes, 28 are venomous; bites by green pit vipers, cobras and kraits are the most commonly identified ones. High population density, widespread agricultural activities, numerous venomous snake species and lack of functional snake bite control programs favour the high burden of snake bites. Poorer rural populations are the main victims, imposing considerable socioeconomic impact. Treatment of snake bite is largely dominated by traditional snake charmers (Ozha) or ‘Kaviraj’ offering unscientific practices and healers, causing undue delay and precluding standard medical management. Delayed presentation to the hospital, lack of availability of antivenom and modern management facility are the main causes of death. Antivenoms are entirely dependent on import, are expensive, and are not ‘customized’ to local needs. Auxiliary intensive care facilities are not widely available; health care personnel often lack necessary expertise. However, the trend is changing. Public awareness is growing, health care personnel are being trained, and a national guideline for snake bite management has been formulated. Further research, introduction of modern diagnostic facilities, local manufacture of antivenom, and above all, integrated approach on the part of Government, policy-makers and international community can change the outlook of snake bite as a neglected tropical condition in Bangladesh.Birdem Med J 2015; 5(1): 24-29

scholarly journals Leptospirosis in Coastal South India: A Facility Based Study

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Ramesh Holla ◽  
Bhagwan Darshan ◽  
Latika Pandey ◽  
Bhaskaran Unnikrishnan ◽  
Nithin Kumar ◽  
...  
Keyword(s):  
Multiorgan Failure ◽  
Case Fatality ◽  
Public Health Problem ◽  
Clinical Feature ◽  
Medical College ◽  
Life Threatening ◽  
Study Population ◽  
The Mean ◽  
Time Of Admission ◽  
Study Setting

Background. Leptospirosis is a major neglected public health problem and is highly underreported in India. The spectrum of clinical features ranges from subclinical infection to multiorgan failure. The burden of leptospirosis is more in developing countries. Objective. The present study was designed to assess the sociodemographic characteristics, clinical feature, and outcome of leptospirosis patients. Methods. This record based retrospective study was conducted in hospitals affiliated to Kasturba Medical College, Mangalore. The registries of the leptospirosis patients during the period of four years between January 2011 and December 2014 were reviewed and the information on demographic and clinical profile of the leptospirosis patients was recorded in the data capture sheet. The information obtained was analyzed using SPSS version 11.5. Results. The study included 202 leptospirosis victims. The mean age of the study population was 40.48 (±14.8) years. Majority of the patients presented with fever (92.1%) at the time of admission. Acute renal failure was found to be the most common complication (79.2%). Case fatality rate was found to be 3.5%. Conclusion. High proportion of cases indirectly reflects the endemic nature of the disease in the study setting. The clinical presentation of the leptospirosis is highly protean and may vary from a mild illness to life-threatening complications as evident from the current study.

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.

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