Clinical profile, species-specific severity grading, and outcome determinants of snake envenomation: An Indian tertiary care hospital-based prospective study

Abstract

Objective:We undertook this study to assess the clinical profile and outcome determinants of different snake envenomation as well as to assign species-specific severity grade to different cases based on clinico – laboratory evidence scale.Materials and Methods:A prospective clinico – epidemiologic evaluation for outcome determinants of snakebite envenomation was carried out based on a clinico – laboratory severity grading scale, among 76 patients over a period of 2 years, in a tertiary care hospital in southern India.Results:Majority of patients were male agricultural workers (53.9%) followed by housewives (19.7%), and students (9.2%). Occurrence of viper snake envenomation with hemotoxic syndrome (73.68%) was highest followed by cobra and krait envenomation with neurotoxic (19.73%) and hemo – neurotoxic (5.3%) syndrome, respectively. On the contrary, maximum mortality and severity was seen in krait (60%) followed by cobra (13.33%) and viper (8.9%) envenomation. The average dose of anti-snake venom (ASV) administered varied from 9.83 (±7.22) to 20.25 (±4.92) vials throughout grade I to IV in all snake species envenomation. An increase in severity grade, ASV dose, and mortality were observed with the corresponding delay in ‘bite to needle time.’ Also, initial traditional treatments and krait species envenomation were significantly associated with higher grades of severity and mortality.Conclusion:There is an urgent need to spread awareness among the community for avoidance of traditional treatment and any delay in medical intervention in snakebite incidents.

Study of Seasonal Variation in Snake Bite Patients Admitted To a Mangalore Based Tertiary Care Hospital

“…The male preponderance observed in our study and the age group affected is in close correlation with studies conducted at other centers 4,5 .This may be attributed to their lifestyles involving outdoor activities or occupation as farmers 6 . Most bites in our study were observed during the months of May to November which represents the monsoon.…”

Clinical profile and outcomes of snake bite poisoning in a tertiary care centre in South Tamilnadu

“…4,12,13 This could possibly be due to the social behaviour of men as the dominant earning member of the family working out-doors. Of the patients, 69.33% were domiciled in rural areas with a rural: urban ratio of 2.3: 1 similar to other studies reported.…”

“…Of the patients, 69.33% were domiciled in rural areas with a rural: urban ratio of 2.3: 1 similar to other studies reported. 12,13 Higher incidence in rural areas can be attributed to farming as an occupation, the habit of walking barefoot and thatched unprotected households. The site of bite was predominantly in the lower limb (80%) while one person had bite in the face.…”

Nephrotoxicity in krait bite: a rare case series of three fatalities in consecutive bites by a single snake

“…This can serve as an indication for further research in elucidating the pathology of krait bite induced nephrotoxicity. Regarding the management of krait bite, polyvalent serum still remains the mainstay of therapy (Bawaskar & Bawaskar, 2015;Saravu et al, 2012;Robed Amin et al, 2014;Warrel, 2010).There may be need for organ specific system support for better results. Clinicians should be aware of these conditions while treating cases of krait bite.…”

“…Severe envenomation leads to rapid respiratory failure and death. A hospital based study revealed maximum mortality and severity in krait (60%) followed by cobra (13.33%) and viper (8.9%) envenomation (Saravu et al, 2012).…”