CLINICAL PROFILE AND OUTCOME OF SNAKE BITE PATIENTS ADMITTED AT TERTIARY CARE HOSPITAL IN INDIA
Main Article Content
Keywords
Snake Bite, Anti-snake venom, Tertiary care hospital, India
Abstract
Background: Snake bite is a major medical and public health problem in India. 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.
Objective: The present study aimed to analyse the clinical profile and outcome of snake bite cases admitted in a tertiary care teaching hospital.
Materials and Methods: This descriptive, cross-sectional, single-center study was carried out in Dr V M Govt Medical College and Hospital ,Solapur, Maharashtra, India between October 2019 to September 2021 on 84 patients who were bitten with snakes and admitted in Dr.V M Govt Medical College and Hospital Solapur between the study duration. Inclusion criteria was composed of all cases of snake bite of age group of more than 12yrs of both gender and the patients or their legally accepted representatives consenting for the study. Whereas, exclusion criteria were composed of patients not consenting for study. A detailed information about demographic parameters such as age of patient, gender distribution and site of bite were collected. A thorough clinical examination was carried out in each case. All poisonous snake bite was with signs of envenomation were treated with anti-snake venom. The collected data was entered in Microsoft Excel to maintain the quality of data. The data was tabulated and analyzed by using Statistical Package for the Social Sciences (version 24). The data was analyzed and percentages were calculated.
Result: Snake bite was observed in all age groups. The maximum number of patients were present in the age group up to 40 years (73.8%). Incidence of snake bite is common among both males and females (50%). Our study showed local swelling and local pain at bite site to be the most common (53.57%) manifestation. The ptosis (34.52%) was the commonest sign observed in snake bites. Vasculotoxic bite was found in 42 (50%) patients. In present study, 71 (84.50%) patients were given ASV. Mortality was found in 5 (5.95%) patients.
Conclusion: 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. The serious clinical features of snake bite warrant early referral and management in tertiary care centers.
Objective: The present study aimed to analyse the clinical profile and outcome of snake bite cases admitted in a tertiary care teaching hospital.
Materials and Methods: This descriptive, cross-sectional, single-center study was carried out in Dr V M Govt Medical College and Hospital ,Solapur, Maharashtra, India between October 2019 to September 2021 on 84 patients who were bitten with snakes and admitted in Dr.V M Govt Medical College and Hospital Solapur between the study duration. Inclusion criteria was composed of all cases of snake bite of age group of more than 12yrs of both gender and the patients or their legally accepted representatives consenting for the study. Whereas, exclusion criteria were composed of patients not consenting for study. A detailed information about demographic parameters such as age of patient, gender distribution and site of bite were collected. A thorough clinical examination was carried out in each case. All poisonous snake bite was with signs of envenomation were treated with anti-snake venom. The collected data was entered in Microsoft Excel to maintain the quality of data. The data was tabulated and analyzed by using Statistical Package for the Social Sciences (version 24). The data was analyzed and percentages were calculated.
Result: Snake bite was observed in all age groups. The maximum number of patients were present in the age group up to 40 years (73.8%). Incidence of snake bite is common among both males and females (50%). Our study showed local swelling and local pain at bite site to be the most common (53.57%) manifestation. The ptosis (34.52%) was the commonest sign observed in snake bites. Vasculotoxic bite was found in 42 (50%) patients. In present study, 71 (84.50%) patients were given ASV. Mortality was found in 5 (5.95%) patients.
Conclusion: 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. The serious clinical features of snake bite warrant early referral and management in tertiary care centers.
References
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3. Ghosh R, Mana K, Gantait K, Sarkhel S. A retrospective study of clinico-epidemiological profile of snakebite related deaths at a Tertiary care hospital in Midnapore, West Bengal, India. Toxicology reports. 2018 Jan 1;5:1-5.
4. Pore SM, Ramanand SJ, Patil PT, Gore AD, Pawar MP, Gaidhankar SL, Ghanghas RR. A retrospective study of use of polyvalent anti-snake venom and risk factors for mortality from snake bite in a tertiary care setting. Indian journal of pharmacology. 2015 May;47(3):270.
5. Sawai Y, Honma M. Snake bites in India. InToxicon 1975 Jan 1 (Vol. 13, No. 2, pp. 120-121). The Boulevard, Langford Lane, Kidlington, Oxford, England Ox5 1gb: Pergamon-Elsevier Science Ltd.
6. Nigam P, Tandon VK, Kumar R, Thacore VR, Lal N. Snake bite--a clinical study. Indian J Med Sci. 1973.
7. Brunda G, Sashidhar RB. Epidemiological profile of snake-bite cases from Andhra Pradesh using immunoanalytical approach. Indian journal of medical research. 2007 May 1;125(5):661.
8. Chattopadhyay S, Sukul B. A profile of fatal snake bite cases in the Bankura district of West Bengal. Journal of forensic and legal medicine. 2011 Jan 1;18(1):18-20.
9. Lima AC, Campos CE, Ribeiro JR. Epidemiological profile of snake poisoning accidents in the State of Amapá. Revista da Sociedade Brasileira de Medicina Tropical. 2009 May 1;42(3).
10. Rahman R, Faiz MA, Selim S, Rahman B, Basher A, Jones A, d'Este C, Hossain M, Islam Z, Ahmed H, Milton AH. Annual incidence of snake bite in rural Bangladesh. PLoS neglected tropical diseases. 2010 Oct 26;4(10):e860.
11. Chew KS, Khor HW, Ahmad R, Rahman NH. A five-year retrospective review of snakebite patients admitted to a tertiary university hospital in Malaysia. International journal of emergency medicine. 2011 Dec;4(1):1-6.
12. Kalantri S, Singh A, Joshi R, Malamba S, Ho C, Ezoua J, Morgan M. Clinical predictors of in‐hospital mortality in patients with snake bite: a retrospective study from a rural hospital in central India. Tropical Medicine & International Health. 2006 Jan;11(1):22-30.
13. Bubalo P, Curic I, Fister K. Characteristics of venomous snakebites in Herzegovina. Croat Med J. 2004 Feb 1;45(1):50-3.
14. Yakubu AS, Abdul-Mumin A, Adam A. Clinical and demographic profile of patients with snakebite in a tertiary hospital in Ghana. Sahel Medical Journal. 2019 Oct 1;22(4):194.
15. Currie BJ. Snakebite in tropical Australia: a prospective study in the “Top End” of the Northern Territory. Medical Journal of Australia. 2004 Dec;181(11-12):693-7.
16. Harris JB, Faiz MA, Rahman MR, Jalil MM, Ahsan MF, Theakston RD, Warrell DA, Kuch U. Snake bite in Chittagong Division, Bangladesh: a study of bitten patients who developed no signs of systemic envenoming. Transactions of the Royal Society of Tropical Medicine and Hygiene. 2010 May 1;104(5):320-7.
17. Singh J, Bhoi S, Gupta V, Goel A. Clinical profile of venomous snake bites in north Indian Military Hospital. Journal of emergencies, trauma and shock. 2008 Jul;1(2):78.
18. Sarangi A, Jena I, Sahoo H, Das JP. A profile of snake bite poisoning with special reference to haematological, renal, neurological and electrocardiographic abnormalities.
19. Shoukat AR, Indikar MA. Clinical Profile of Snake Envenomation with Complications and Outcome in a Tertiary Health Care Centre, Kalburgi. Journal of Evolution of Medical and Dental Sciences. 2020 Mar 2;9(9):608-13.
20. Kulkarni ML, Anees S. Snake venom poisoning: experience with 633 cases. Indian pediatrics. 1994 Oct 31;31:1239.
21. Sharma N, Chauhan S, Faruqi S, Bhat P, Varma S. Snake envenomation in a north Indian hospital. Emergency medicine journal. 2005 Feb 1;22(2):118-20.
22. Bawaskar HS, Bawaskar PH. Profile of snakebite envenoming in western Maharashtra, India. Transactions of the Royal Society of Tropical Medicine and Hygiene. 2002 Jan 1;96(1):79-84.
23. Williams DJ, Jensen SD, Nimorakiotakis B, Müller R, Winkel KD. Antivenom use, premedication and early adverse reactions in the management of snake bites in rural Papua New Guinea. Toxicon. 2007 May 1;49(6):780-92.
24. Simpson ID. A study of the current knowledge base in treating snake bite amongst doctors in the high-risk countries of India and Pakistan: does snake bite treatment training reflect local requirements?. Transactions of the Royal Society of Tropical Medicine and Hygiene. 2008 Nov 1;102(11):1108-14.
25. Mahmood K, Naqvi IH, Talib A, Salkeen S, Abbasi B, Akhter T, Iftikhar N, Ali A. Clinical course and outcome of snake envenomation at a hospital in Karachi. Singapore medical journal. 2010 Apr 1;51(4):300.
26. Acton HW, Knowles E. The Dose of Venom given in Nature by a Cobra at a Single Bite. Indian Journal of Medical Research. 1914;1(3).
27. Habib AG, Abubakar SB. Factors affecting snakebite mortality in north-eastern Nigeria. International Health. 2011 Mar 1;3(1):50-5.
28. Sharma SK, Chappuis F, Jha N, Bovier PA, Loutan L, Koirala S. Impact of snake bites and determinants of fatal outcomes in southeastern Nepal. The American journal of tropical medicine and hygiene. 2004 Aug 1;71(2):234-8.
2. Sarker SK, Salim M, Hossain MM, Mandal BK. Snake Envenomation in the Intensive Care Unit of a Tertiary Care Hospital, Dhaka, Bangladesh: A Prospective Cohort Study. Journal of Current and Advance Medical Research. 2022 May 19;9(1):48-55.
3. Ghosh R, Mana K, Gantait K, Sarkhel S. A retrospective study of clinico-epidemiological profile of snakebite related deaths at a Tertiary care hospital in Midnapore, West Bengal, India. Toxicology reports. 2018 Jan 1;5:1-5.
4. Pore SM, Ramanand SJ, Patil PT, Gore AD, Pawar MP, Gaidhankar SL, Ghanghas RR. A retrospective study of use of polyvalent anti-snake venom and risk factors for mortality from snake bite in a tertiary care setting. Indian journal of pharmacology. 2015 May;47(3):270.
5. Sawai Y, Honma M. Snake bites in India. InToxicon 1975 Jan 1 (Vol. 13, No. 2, pp. 120-121). The Boulevard, Langford Lane, Kidlington, Oxford, England Ox5 1gb: Pergamon-Elsevier Science Ltd.
6. Nigam P, Tandon VK, Kumar R, Thacore VR, Lal N. Snake bite--a clinical study. Indian J Med Sci. 1973.
7. Brunda G, Sashidhar RB. Epidemiological profile of snake-bite cases from Andhra Pradesh using immunoanalytical approach. Indian journal of medical research. 2007 May 1;125(5):661.
8. Chattopadhyay S, Sukul B. A profile of fatal snake bite cases in the Bankura district of West Bengal. Journal of forensic and legal medicine. 2011 Jan 1;18(1):18-20.
9. Lima AC, Campos CE, Ribeiro JR. Epidemiological profile of snake poisoning accidents in the State of Amapá. Revista da Sociedade Brasileira de Medicina Tropical. 2009 May 1;42(3).
10. Rahman R, Faiz MA, Selim S, Rahman B, Basher A, Jones A, d'Este C, Hossain M, Islam Z, Ahmed H, Milton AH. Annual incidence of snake bite in rural Bangladesh. PLoS neglected tropical diseases. 2010 Oct 26;4(10):e860.
11. Chew KS, Khor HW, Ahmad R, Rahman NH. A five-year retrospective review of snakebite patients admitted to a tertiary university hospital in Malaysia. International journal of emergency medicine. 2011 Dec;4(1):1-6.
12. Kalantri S, Singh A, Joshi R, Malamba S, Ho C, Ezoua J, Morgan M. Clinical predictors of in‐hospital mortality in patients with snake bite: a retrospective study from a rural hospital in central India. Tropical Medicine & International Health. 2006 Jan;11(1):22-30.
13. Bubalo P, Curic I, Fister K. Characteristics of venomous snakebites in Herzegovina. Croat Med J. 2004 Feb 1;45(1):50-3.
14. Yakubu AS, Abdul-Mumin A, Adam A. Clinical and demographic profile of patients with snakebite in a tertiary hospital in Ghana. Sahel Medical Journal. 2019 Oct 1;22(4):194.
15. Currie BJ. Snakebite in tropical Australia: a prospective study in the “Top End” of the Northern Territory. Medical Journal of Australia. 2004 Dec;181(11-12):693-7.
16. Harris JB, Faiz MA, Rahman MR, Jalil MM, Ahsan MF, Theakston RD, Warrell DA, Kuch U. Snake bite in Chittagong Division, Bangladesh: a study of bitten patients who developed no signs of systemic envenoming. Transactions of the Royal Society of Tropical Medicine and Hygiene. 2010 May 1;104(5):320-7.
17. Singh J, Bhoi S, Gupta V, Goel A. Clinical profile of venomous snake bites in north Indian Military Hospital. Journal of emergencies, trauma and shock. 2008 Jul;1(2):78.
18. Sarangi A, Jena I, Sahoo H, Das JP. A profile of snake bite poisoning with special reference to haematological, renal, neurological and electrocardiographic abnormalities.
19. Shoukat AR, Indikar MA. Clinical Profile of Snake Envenomation with Complications and Outcome in a Tertiary Health Care Centre, Kalburgi. Journal of Evolution of Medical and Dental Sciences. 2020 Mar 2;9(9):608-13.
20. Kulkarni ML, Anees S. Snake venom poisoning: experience with 633 cases. Indian pediatrics. 1994 Oct 31;31:1239.
21. Sharma N, Chauhan S, Faruqi S, Bhat P, Varma S. Snake envenomation in a north Indian hospital. Emergency medicine journal. 2005 Feb 1;22(2):118-20.
22. Bawaskar HS, Bawaskar PH. Profile of snakebite envenoming in western Maharashtra, India. Transactions of the Royal Society of Tropical Medicine and Hygiene. 2002 Jan 1;96(1):79-84.
23. Williams DJ, Jensen SD, Nimorakiotakis B, Müller R, Winkel KD. Antivenom use, premedication and early adverse reactions in the management of snake bites in rural Papua New Guinea. Toxicon. 2007 May 1;49(6):780-92.
24. Simpson ID. A study of the current knowledge base in treating snake bite amongst doctors in the high-risk countries of India and Pakistan: does snake bite treatment training reflect local requirements?. Transactions of the Royal Society of Tropical Medicine and Hygiene. 2008 Nov 1;102(11):1108-14.
25. Mahmood K, Naqvi IH, Talib A, Salkeen S, Abbasi B, Akhter T, Iftikhar N, Ali A. Clinical course and outcome of snake envenomation at a hospital in Karachi. Singapore medical journal. 2010 Apr 1;51(4):300.
26. Acton HW, Knowles E. The Dose of Venom given in Nature by a Cobra at a Single Bite. Indian Journal of Medical Research. 1914;1(3).
27. Habib AG, Abubakar SB. Factors affecting snakebite mortality in north-eastern Nigeria. International Health. 2011 Mar 1;3(1):50-5.
28. Sharma SK, Chappuis F, Jha N, Bovier PA, Loutan L, Koirala S. Impact of snake bites and determinants of fatal outcomes in southeastern Nepal. The American journal of tropical medicine and hygiene. 2004 Aug 1;71(2):234-8.
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Published
Nov 25, 2022
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How to Cite
Dr Vijaykumar V Ingle. (2022). CLINICAL PROFILE AND OUTCOME OF SNAKE BITE PATIENTS ADMITTED AT TERTIARY CARE HOSPITAL IN INDIA. Journal of Population Therapeutics and Clinical Pharmacology, 29(04), 4796-4802. https://doi.org/10.53555/dyp6ts94
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Author Biography
Dr Vijaykumar V Ingle
Associate Professor, Dr V M Govt Medical College Solapur. Maharashtra.413001
How to Cite
Dr Vijaykumar V Ingle. (2022). CLINICAL PROFILE AND OUTCOME OF SNAKE BITE PATIENTS ADMITTED AT TERTIARY CARE HOSPITAL IN INDIA. Journal of Population Therapeutics and Clinical Pharmacology, 29(04), 4796-4802. https://doi.org/10.53555/dyp6ts94