DOI: http://dx.doi.org/10.18203/2349-3933.ijam20195161

A study to assess the clinical profile of patients with snake bites in a tertiary care hospital

Keshava Murthy M. R., Aruna C. Ramesh

Abstract


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.


Keywords


Cobra, Emergency, Krait, Mortality, Poison, Snake bite

Full Text:

PDF

References


Bawaskar HS, Bawaskar PH. Profile of snakebite envenoming in western Maharashtra, India. Transactions Royal Society Trop Med Hygiene. 2002 Jan 1;96(1):79-84.

Punde DP. Management of snake-bite in rural Maharashtra: A 10-year experience. Nat Med J Ind. 2005 Mar 1;18(2):71.

Warrell DA. The clinical management of snake bites in Southeast Asian region. Southeast Asian J Trop Med Public Health 1999; 30(Suppl 1):1-67.

Reid HA, Theakston RD. The management of snake bite. Bull WHO. 1983;61(6):885-95.

Oram S, Ross G, Pell L, Winteler J. Renal cortical calcification after snake-bite. British Med J. 1963 Jun 22;1(5346):1642-2.

Hood VL, Johnson JR. Acute renal failure with myoglobinuria after tiger snake bite. Medical J Aus. 1975 Oct;2(16):638-41.

Reid HA. Animal poisons. In: P.E.C. Manson-Bahr, F.I.C. Apted (Eds.), Manson's Tropical Diseases 18th Ed., Balliere Tindall, London; 1982:544-566.

Sakaguchi H, Kawamura S. Electron microscopic observations of the mesangiolysis the toxic effects of the “habu snake” venom on the renal glomerulus. Keio J Med. 1963;12(2):99-112.

Warrell DA, editor. The clinical management of snake bites in the Southeast Asian region. Southeast Asian J Tropic Med Public Heal; 1999.;30:1-85.

Simpson ID, Norris RL. Snakes of medical importance in India: is the concept of the “Big 4” still relevant and useful?. Wilderness Environment Med. 2007 Mar 1;18(1):2-9.

Saini RK, Sharma S, Singh S, Pathania NS. Snake bite poisoning: a preliminary report. J Assoc Physicians Ind. 1984 Feb;32(2):195-7.

Mittal BV. Acute renal failure following poisonous snake bite. J Postgrad Med. 1994 Jul 1;40(3):123-6.

Bennett JE, Dolin R, Blaser MJ. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases: 2-Volume Set. Elsevier Health Sciences; 2014 Aug 28.

Goldstein EJ, Citron DM, Gonzalez H, Russell FE, Finegold SM. Bacteriology of rattlesnake venom and implications for therapy. J Infect Dis. 1979 Dec 1;140(5):818-21.

Jorge MT, Mendonça JS, Ribeiro LA, Silva ML, Kusano EJ, Cordeiro CL. Bacterial flora of the oral cavity, fangs and venom of Bothrops jararaca: possible source of infection at the local bite. Revista Instituto Med Tropic São Paulo. 1990 Feb;32(1):6-10.

Kerrigan KR, Mertz BL, Nelson SJ, Dye JD. Antibiotic prophylaxis for pit viper envenomation: prospective, controlled trial. World J Surg. 1997 May 1;21(4):369-73.

Nigam P, Tandon VK, Kumar R, Thacore VR, Lal N. Snake bite--a clinical study. Ind J Med Science. 1973;27(9):697-704.

Bhat RN. Viperine snake bite poisoning in Jammu. J Ind Med Assoc. 1974;63(12):383-92.

Sarangi A, Jena I, Sahoo H, Das JP. A profile of snake bite poisoning with special reference to haematological, renal, neurological and electrocardiographic abnormalities. J Assoc Physicians Ind. 1977;25(8):555-60.