Clinical Profile and Outcome of Snake Bite Patients from Tertiary Healthcare Center: In Sub-Himalayan Region: A Medical College-based Study

Abstract

Objective: Snake bite is an emergency in tropical and subtropical countries. It is a neglected disease and is most commonly seen in rural setups, where people are ignorant about the venomous snake bites. It results in increased mortality and morbidity because precious time is wasted, either in consulting traditional healers or waiting for the development of signs and symptoms of envenomation. Then only the patient is shifted to a health center. Here we studied the clinical profile, management, and outcome of snake bite patients. Materials and methods: This study was done by retrieving the records of patients with snake bites admitted to the Department of Medicine, Indira Gandhi Medical College & Hospital, Shimla, from 1st January 2017 through December 2019. The recorded data was entered in a precoded performa, and analysis was done with respect to various variables. Result: We evaluated the records of 190 patients. The incidence of the bite was higher among females, 62.1% (n = 118). The commonest age group involved was 21–50 years, 70.1% (n = 34). In 55.8% (n = 106), the site of the bite was the upper limb. The daytime bite was present in 54.7% (n = 106). The maximum incidence of snake bites was found during the rainy season, 81.5% (n = 155). 28.4% (n = 54) of patients presented within 6 hours of the bite. Coagulopathy [whole blood clotting test (WBCT) of >20 minutes] and neurotoxicity were seen in 77.9 and 7.9% of patients, respectively. Anti-snake venom (ASV) was given to 87.8% (n = 167) of patients. In 80% (n = 152) of the cases, hospital stay was up to 3 days. Mortality was seen in only two (1.05%) cases. Conclusion: There is a need to create awareness among the community, particularly in rural areas, about snake bite envenomation and early transportation of victims to the nearest health center. Training of health professionals is also needed to manage cases of snake bites efficiently and judiciously, thereby reducing morbidity and morbidity.

Screening of malnutrition using Patient‐Generated Subjective Global Assessment tool and hand muscle strength in subjects with pancreatitis

“…8,9 Using the right assessment tool and technique is most important to identify patients at risk of malnutrition, intervene nutritionally, and determine a better prognosis. 2,3,6,11 Catabolism of skeletal muscle is increased up to 80% and nitrogen losses to as much as 20-40 g/day, thus leading to decreased stores of amino acid concentration to as much as 40%. 5,6,9 Our pilot study indicated that the presence of malnutrition among all patients with pancreatitis, most of whom were on a hypocaloric liquid diet or in a fasting state for more than 48 h, led to further weight loss during the hospital stay, which increased LOS.…”

“…Nutrition assessment and intervention are the most neglected treatment for pancreatitis and can increase the risk of malnutrition among patients 8,9 . Using the right assessment tool and technique is most important to identify patients at risk of malnutrition, intervene nutritionally, and determine a better prognosis 2,3,6,11 . Catabolism of skeletal muscle is increased up to 80% and nitrogen losses to as much as 20–40 g/day, thus leading to decreased stores of amino acid concentration to as much as 40% 5,6,9 .…”