English

Abstract

BACKGROUND Rabies is a viral disease producing an almost uniformly fatal encephalitis in humans and other mammals. There is no established treatment for rabies once symptoms have begun. Rabies vaccination for prevention and PET is essential in the management of the illness. The purpose of present study was to describe the clinical profile and management of dog bite patients presenting to the tertiary care hospital in the Kumaun region of Uttarakhand. METHODS Patients presenting to the outpatient and emergency department with the complaint of dog bite were enrolled in the study. All particulars of patients, history and examination findings were recorded in the clinical proforma after taking proper informed consent. Wounds were categorized based on WHO guide to postexposure prophylaxis. Local treatment consisted of two parts: first aid and wound management. ARV was administered in category II and III exposures in accordance to the intradermal schedule. Data was analysed for clinical information such as age, sex, socioeconomic status, dog type, site of bite, categories of contact and treatment given. RESULTS In our study of 73 patients, 36 (49.32%) were males and 37 (50.68%) were females. Majority of the patients belonged to the age group of 11-40 years in both male (n=29; 80.5%) and female (n=26; 70.3%) patients. Mean age group of patients in the study was 30.50 years. Based on modified Kuppuswamy scale, most patients belonged to the class III (n=42; 57.6%) followed by class IV (n=14; 19.2%). Dog bites from both strays and pets were almost equal. However, only 50% pet dogs were partially vaccinated and remainder were not vaccinated. Thus, mandating the use of ARV immunization. All the patients sustaining bites from street dogs were vaccinated. Majority of the bites involved the lower extremities (n=31; 42.5%) followed by upper extremities (n=26; 35.6%). Based on WHO guidelines for wound categories, most patients belonged to category II (n=36; 49.3%) followed by category III (n=31; 42.5%). CONCLUSIONS In our study, we found that majority of patients sustaining dog bites were young adults and belonged to lower middle & upper lower class. There was no difference with respect to gender and dog type. Most common sites of dog bite were upper & lower extremities and belonged to WHO category II. No cases of rabies were observed in our study. KEY WORDS Dog, Animal, Bite, Rabies, Immunization, Prophylaxis, Treatment