English

Abstract

BACK GROUND AND OBJECTIVES: Snake bite is a major public health problem through out the word especially in tropical countries like India. The objective of the study is to analyse the factors, which determine the prognosis of patients, admitted with snake bite envenomation. These prognostic factors include 1. Time since snake bite and admission to Government Chengalpattu Medical college & Hospital, Chengalpattu. 2. Whether patient received native treatments before admission. 3. Co morbid illness. 4. Site of bite. METHOD: 181 adult patients admitted with signs of snake bite envenomation were included in this study and a detail history of bite including time of bite, site of bite, type of snake, patients manifestation and history of native treatment received before admission was taken .A detailed history of co morbid illness was obtained from all patients. A detailed clinical examination was done and each patient was subjected to investigations like complete blood count, BT, CT, PT, blood urea, serum creatinine, electrolytes and ECG. All investigations were repeated to evaluate the progress. RESULTS: Total cases studied are 181, in which 64% are males and 36% are females. Highest incidence of snake bite was seen in 1. Age group of 30-40 yrs(26.8%). 2. Purely agriculture workers (46.41%). There was more incidence of bite on lower extremity (50.83%). Complications are low in patients presenting within 6 hours of bite. Out of 181 cases of snake bite 35.38% were neurotoxic, 25.42% were haemotoxic and Local reactions like cellulitis, edema comprises 22.65% and of these 9 patients expired. INTERPRETATION AND CONCLUSION: 1. A significant association was noted between prolonged bite to needle time and mortality with 7 out of 9 patients (78%) who presented more than 6 hours after bite were dead. 2. There was no relation between site of bite and severity of envenomation. 3. On analysing co morbid illness versus death wise distribution of study population, we found that among 15 diabetic patients 93% were alive and 7% were dead. Among 17 hypertensive patients only 6% died. Similarly on analysing all the co morbid illness with outcome we found that co morbid illness is not a strong determinant in determining the mortality. 4. Native treatment especially tourniquet application is a strong determinant of outcome with 100% prevalence in dead and 85.28% in patients who had undergone surgeries and 27.28 % in alive patients without surgeries.