A retrospective study of snake bite envenomation in a tertiary care teaching hospital in Southern India

Authors

  • Arul Murugan Department of Medicine, SRM Medical College and Hospital, Kattankulathur, Kancheepuram, Chennai
  • Sarfaraz Ahmed Department of Medicine, SRM Medical College and Hospital, Kattankulathur, Kancheepuram, Chennai
  • Mohammad Gani Department of Medicine, SRM Medical College and Hospital, Kattankulathur, Kancheepuram, Chennai

DOI:

https://doi.org/10.18203/2320-6012.ijrms20150641

Keywords:

Snake bite, Envenomation, Antisnake venom, Severity, Hemotoxicity

Abstract

Background: Snake bite is an important occupational and rural hazard because India has always been a land of poisonous snakes. In southern India common poisonous snakes are Russell’s viper, Cobra, Krait and Saw Scaled Viper. It is a fact that despite of significant morbidity and mortality, very little attention is paid by the clinicians to this occupational hazard. The objective of the present study was undertaken with the objectives of assessing poisonous snake envenomation, ASV use, Dosage of ASV and clinical outcomes in snake bite victims.

Methods: This is a Retrospective study of snakebite victims from November 2013 to April 2015 in a tertiary care teaching hospital in Tamil-Nadu.

Results: A Total of 82 cases were studied in our hospital. Out of these 82 Poisonous bites, 42 (51.22%) cases were viper bites, 20 (24.39%) cases were unidentified poisonous bites, 16 (19.51%) cases were Krait, and 4 (4.88%) cases were Cobra. Coagulopathy, cellulitis, wound infection, renal failure and respiratory paralysis were the common complications. Average dose of ASV administered range from 8.57 (± 0.98) to 20.78 (± 4.18) Vials. An increase in mortality, ASV dose and complications were directly proportional to the Bite to ASV Administration time.

Conclusions: Delay in hospitalization is associated with poor prognosis and increased mortality rate due to complications. There is an emergent need of awareness among the community for avoidance of traditional form of treatment and delay in early medical interventions.

 

References

Neglected tropical diseases: Snakebite. Available from website, http://www.who.int/neglected_diseases/diseases/snakebites/en/.

Bawaskar HS. Snake venoms and antivenoms: Critical supply issues. J Assoc Physicians India. 2004;52:14-7.

Meenatchi sundaram S, Parameswari G, Michael A, Ramalingam S. Neutralization of the pharmacological effects of Cobra and Krait venoms by chicken egg yolk antibodies. Toxicon. 2008;52:221‑7

Snake bite : Indian protocol http://www.apiindia.org/medicine_update_2013/chap94.pdf

Bhattacharya P, Chakraborty A. Neurotoxic snake bite with respiratory failure. Indian J Crit Care Med. 2007;11:161-4.

http:// emedicine.medscape.com/ article/ 168828-treatment,Medscape : Snakebite Treatment & Management Author: Brian J Daley, MD, MBA, FACS, FCCP; Chief Editor: Joe Alcock MD, MS

Serum institute of India /Antisera products Available at website, http://www.seruminstitute.com/content/products/product_antisera.htm

Epiinfo Software available at website Http://wwwn.cdc.gov/Epiinfo/7/index.htm.

Gutiérrez JM, Theakston RD, Warrell DA. Confronting the neglected problem of snake bite envenoming: The need for a global partnership. PLoS Med 2006; 3:e150.

Kasturiratne A, Pathmeswaran A, Fonseka MM, Lalloo DG, Brooker S, De Silva HJ. Estimates of disease burden due to land‑snake bite in Sri Lankan hospitals .Southeast Asian J Trop Med Public Health. 2005;36:733‑40.

Paul V, Pratibha S, Prahlad KA, Earali J, Francis S, Lewis F. High‑dose Anti‑snake venom versus low‑dose anti‑snake venom in the treatment Of poisonous snake bites‑a critical study. J Assoc Physicians India. 2004;52:14‑7.

Chippaux JP. Venomous and poisonous animals. II. Viper bites. Med Trop (Mars). 2006;66:423‑8.

Hayat AS, Khan AH, Shaikh TZ, Ghouri RA, Shaikh N. Study of snake Bite cases at Liaquat University Hospital Hyderabad/Jamshoro. J Ayub Med Coll Abbottabad. 2008;20:125‑7.

Mahasandana S, Rungruxsirivorn Y, Chantarangkul V. Clinical Manifestations of bleeding following Russell’s viper and Green pit Viper bites in adults. Southeast Asian J Trop Med Public Health. 1980;11:285‑93.

Mahasandana S, Rungruxsirivorn Y, Chantarangkul V. Clinical manifestations of bleeding following Russell’s viper and Green pit viper bites in adults. Southeast Asian J Trop Med Public Health. 1980;11:285-93.

Danis R, Ozmen S, Celen MK, Akin D, Ayaz C, Yazanel O. Snakebite induced acute kidney injury: Data from Southeast Anatolia. Ren Fail. 2008;30:51-5.

SitprijaV. Snakebite nephropathy (Review article). Nephrology (Carlton). 2006;11:442-8.

National Snakebite Management Protocol, Directorate General of Health Services, Ministry of Health and Family Welfare, Government of India 2009.

Kumar MR, Veeraprasad M, Babu PR, Kumar SS, Subrahmanyam BV, Rammohan P, et al. A retrospective review of snake bite victims admitted in a tertiary level teaching institute. Ann Afr Med. 2014;13(2):76-80.

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Published

2017-01-12

How to Cite

Murugan, A., Ahmed, S., & Gani, M. (2017). A retrospective study of snake bite envenomation in a tertiary care teaching hospital in Southern India. International Journal of Research in Medical Sciences, 3(9), 2419–2424. https://doi.org/10.18203/2320-6012.ijrms20150641

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Original Research Articles