A study 50 cases of clinical outcome and analysis of cases of snake bite admitted at P.D.U. hospital

 

 

Abstract              Background: Snake bite has become a very important preventable public health hazard. Snake bite usually take place in villages and forests. About 2 million people are bitten by snake and about 35000-50000 cases prove fatal showed the mortality of about 1.75% to 2.5% due to snake bite. Objective of study: 1. To study the various complications of snake bite 2. To study the overall outcome of snake bite. 3. To study the cause of death in snake bite patients. Methodology: 50 cases of snake bite admitted at P.D.U hospital, Rajkot were studied, from December 2015 to July 2017 during the season of monsoon and post monsoon starting from June 2016. The clinical history and examinations were carried out in detail, all necessary investigations done, their clinical course and development of complications were studied, then outcome and analysis of cause of death were recorded. Observations: Most of cases of snake bite occurred in rural areas with 70 % of cases whereas only 30 % cases in urban areas. The highest incidence of snake bite is between May to August 37(72%) and the incidence in post monsoon is 26%. In clinical evaluation 44(88%) had symptoms of toxic snake bite within 3 hours and 6(12%cases) took >3 hours to develop symptoms. On examination local pain was reported in almost all cases 42(84%) out of 50 cases and local swelling was reported in 34(68%) cases. Local bleeding occurred in 24 (48%) cases which is the commonest manifestation, whereas other haematological manifestations like Heamaturia, Heamoptysis, Hemetemesis and Epistaxis occurred in 1 (2%) cases. Neurological manifestation like blurring of vision 23 (46%) cases, difficulty in breathing 20 (40%) cases and ptosis 20 (40%) cases. Local complications like cellulitis occurred in 29(58%) cases and systemic complications like bulbar palsy in 20(40%) cases, respiratory paralysis in 20(40%) cases, DIC occurred in 3(6%) cases. In outcome highest mortality noted in 2 cases out of 9 cases (22%) of cobra bite whereas 1 case died out of 9 cases of krait bite. in analysis of cause of death 2 cases were died due to respiratory paralysis and 1 case due to haematological toxicity. Conclusion: Most common presentation was cellulitis and bulbar and respiratory paralysis. Majority of the patients complicated and died due to respiratory failure.

Key Word: Snake bite.