SNAKE BITE

Abstract

Objective: To determine the frequency of various clinical presentations of snakebitten admitted patients. Study design: Descriptive case series study. Place and duration ofstudy: This study was carried out in General Medicine ward, at Medical department of PeoplesMedical University & Hospital Nawabshah, from September 2011 to March 2012. Methodology:This study consisted of 55 patients admitted through the outpatient department, as well as fromcasualty department of Peoples Medical University & Hospital Nawabshah. Detailed History wastaken from all the patients with special regard to type of snake, age , sex , site , time of bite, timelapsed between bite and reaching to hospital. Detailed clinical examination of local features werefang marks, swelling, bleeding from wound, pain and systemic features like nausea, vomiting,echymosis, drowsiness, discharge from wound, hematuria, ptosis, respiratory failure ofenvenomation. Systemic review was also done to see any co-morbidity. All patients underwentfor base line and specific investigations especially clotting time (CT). Inclusion criteria were thatall diagnosed patients of snake bite, aged > 12 year of either sex admitted with the history ofsnake bite with irrespective of toxicity were included. Patients with history of thorn prick, insectbite were excluded criteria. Results were prepared with help of tables and graphs. Data wasanalyzed through SPSS software. Results: Out of 55 patients included in this study, 39 were men(70.9%) and 16 patients were female (29%); with male to female ratio of 2.4:1. There was widevariation of age ranging from a minimum of >12 year to 60 year. The mean age was 39±5.8 years.In our study mostly patients 35(63.63%) reached hospital within 60 minutes followed by12(21.88%) patients within 30 minutes. 5(9%) patients reached within 90 minutes and onepatients reported more than 120 minutes. Symptoms of patients were pain at the bite side in55(100 %), ecchymosis in 18(32.72%), discharge from wound in 9(16.36%), bleeding from gum in8(4.4%) Nausea and vomiting in 7(12.72 %), hematuria in 11(20%), ptosis in 8(14.54%),drowsiness in 5(9%) and respiratory failure in 5(9%). Conclusions: We conclude that males arecommonly affected than females and the farmers and labourers are the most vulnerable sectionof the population for snake bites. In this study age, presence signs and treatment by faith healersis independent predictors of death in case of snake bite. This may provide important evidence toformulate preventive strategies especially health education.