Background: Snake bite is a major health problem in Nepal. According to WHO, annual morbidity due to snake bite is 162 out of 100,000 people in Nepal. Aim of the study is to observe epidemiology, clinical features, and analysis of possible relationship between time delay in administration of anti-snake venom (ASV) and mortality. Methods: This prospective observational study analyses the data of 81 patients admitted to the Lumbini zonal hospital, Butwal, Rupandehi, Nepal with history of snake bite between April to September, 2017.Results: In this study 56% patients were female. Patients of age group (15-30) years were maximum (38.27%). The study showed that 50.61% of snake bites were occurred outside home. Most of patients (84%) were from the Terai region. Average no. of vials used per case was (28±10) vials. Most of victims of snake bite were from rural areas. In most of cases we found that prothrombin time was prolonged. It was found that most of patients 57% reach hospital before 4 hours of snake bite. The mean days of hospital stay was 6±2.86. Most of case of snake bite was unknown (62%). The mortality rate in this study was 6.17%.Conclusions: There is a great need to improve in existing health care conditions for effective management of snake bite; it requires training of the personnel engaged in the emergency health care management, development of national guidelines based on the clinical trials, improving the distribution and easy availability of antivenom.

Introduction: Objective: To describe the clinical and epidemiological profile of hemophilia patients in the pediatric age group at a tertiary care center in Western Uttar Pradesh. Materials and Methods: This was an observational cross-sectional study that was conducted at the Department of Pediatrics, S.N. Medical College, Agra. Pediatric patients (0-18 years) with hemophilia admitted in the Pediatrics emergency ward for Anti-Hemophilic factor transfusion or having a history of such type of transfusion during the year 2018-19 were consecutively enrolled in the present study. A detailed clinical history was taken from the parent or guardian accompanying the case. Results: Out of the total 93 pediatric hemophilia patients, the majority 61% (57/93) belonged to 11 to 18 years of age group. 2.1% (2/93) were< 1 year of age. 17.2 % (16/93) were in 1-5 years of age group. 19.35% were in 6-10 years of age group. Out of the total, 98.9% (92/93) were males while only 1.07% (1/93) were female. Type A hemophilia was observed in 87.09% (81/93) patients while Type B hemophilia was present in only 12.9% (12/93) patients. Out of 81 Type-A hemophilia patients, only one had developed Inhibitor (1.07%). None among Type B hemophilia patients had Inhibitors. Out of total cases, only one patient (1.07%) had von Willebrand Deficiency.91% (85/93) patients presented with joint bleed. The knee joint was the most commonly affected joint, as observed in 64.7% (55/85) patients. Conclusion: A better insight into the disease prevalence is pivotal for early diagnosis and to provide quality care to all hemophilia patients. The development of an inhibitor is a major concern. Physiotherapy and RICE (Rest, Ice, Compression and elevation) should be emphasized for the better quality of life and preventing joint hemarthrosis.