Clinical profile of snake bite patients in tertiary care hospital in Himachal Pradesh: a prospective study

Madan Kaushik, Vikas Banyal, Sachin Sondhi, Manish K. Thakur, Aseem Kaushik


Background: To study clinical profile of snake bite patients in tertiary care hospital in Indra Gandhi Medical College at Shimla, Himachal Pradesh of North India.

Methods: Hospital based prospective observational study was conducted in the Department of Medicine, for the duration of one year from 1st June2013 to 31st May 2014.

Results: A total of 78 patients were admitted with mean age of 38.46 years with male to female ratio of 1:1.6. Seasonal variation with peak incidence during rainy season was seen. Most common snake identified was green coloured and peak timing of snake bite was between 07:00am-04:00pm. There was delay in admission of more than 6 hours in 66.67% of cases. Hemotoxicity was predominant manifestation seen in 62.82% of cases and persistence of coagulopathy was most common complication (51.02%) despite giving optimal ASV. There was paucity in ASV administration seen in only 59.46% of referred patients. Mean ASV vials used were 23.41 vials ±8.72 vials.

Conclusions: Mass education is required at both general population and health professional levels to improve snake bite management and monovalent ASV against Green pit viper is more practical option to manage cases in this region.


Anti snake venom, Green pit viper, Snake bite

Full Text:



Warrell DA, Gutiérrez JM, Calvete JJ, Williams D. New approaches & technologies of venomics to meet the challenge of human envenoming by snakebites in India. Ind J Med Res. 2013;138(1):38.

Whitaker R. When a Cobra strikes: Close-up. The Hindu magazine. 2007. Available at:

McGain F, Limbo A, Williams D, Didei G, Winkel KD. Snake bite mortality at Port Moresby General Hospital, Papua New Guinea 1992-2001. Med J Aust. 2004;181:687-91.

Sharma N, Chauhan S, Faruqi S, Bhat P, Verma S. Snake envenomation in a north Indian hospital Emerg Med J. 2005;22:118-20.

Raina S, Raina S, Kaul R, Chander V, Jaryal A. Snakebite profile from a medical college in rural setting in the hills of Himachal Pradesh, India. Indian J Crit Care. 2014;18(3):134-8.

Wanje SD, Gadekar RD. Clinical profile of snake bite cases in Marathwada, India. Ind J Fundamental App Life Sci. 2011;1(4):93-9.

Alirol E, Sharma SK, Bawaskar HS, Kuch U, Chappuis F. Snake bite in South Asia: a review. PLoS Negl Trop Dis. 2010;4(1):e603.

Monteiro FN, Kanchan T, Bhagavath P, Kumar GP. Epidemiology of cobra bite in Manipal, Southern India. J Ind Acad Forensic Med. 2010;32(3):224-7.

Sharma SK, Chappuis F, Jha N, Bovier PA, Koirala S. Impact of snake bites and determinants of fatal outcomes in South Eastern Nepal. Am J Trop Med Hyg. 2004;71(2):234-38.

Anjum A, Husain M, Hanif SA, Ali SM, Beg M and Sardha M. Epidemiological Profile of Snake Bite at Tertiary Care Hospital, North India. J Forensic Res. 2012;3:146.

Bhardwaj A, Sokhey J. Snake bites in the hills of North India. National Med J India. 1998;11:6:264- 5.

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(3):125-7.

Bawaskar HS, Bawaskar PH, Punde DP, Inamdar MK, Dongare RB, Bhoite RR. Profile of Snakebite Envenoming in Rural Maharashtra, India. JAPI. 2008;56:88-95.

Redewad N, Bhaisare SD, Bansod YV, Hire R. Management and outcome study of snake bite cases in central India. Sch J Appl Med Sci. 2014;2:435-41.