Pre-hospital treatment of snake envenomation in patients presented AT a tertiary care hospital in Northwestern India

Chauhan, S; Faruqi, Shoaib; Bhalla, Ashish; Sharma, Navneet; Varma, Subhash; Bali, J.

doi:10.1590/s1678-91992005000300006

Cited by 14 publications

(18 citation statements)

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“…Unlike the study by Kularatne et al from Sri Lanka where men and women were equally affected, in our study men were bitten nearly twice more than women. This difference is probably due to the fact that men carry out the majority of agricultural activities in Sixty-two bites occurred while the victims were sleeping and 10 occured during activities like grass cutting, clearing bricks, and walking, similar to other reported studies [1,2,5]. The mean time interval between bite and admission to hospital (4.5 h) was shorter in our study than that reported by others [5].…”

Section: Discussionsupporting

confidence: 79%

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Role of neostigmine and polyvalent antivenom in Indian common krait (Bungarus caeruleus) bite

Anıl

Singh

Bhalla

et al. 2010

Journal of Infection and Public Health

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Bungarus caeruleus (Indian common krait) bite during monsoons is common in Northwest India. This study was undertaken to find the effectiveness of neostigmine and polyvalent antivenom in improving neuromuscular paralysis following bite. All the consecutive patients admitted between June 2007 and December 2008 with common krait bite, identified either from brought snake or circumstantial evidence were studied. Ten vials of polyvalent antivenom and three doses of 2.5 mg neostigmine at 30 min intervals after administration of 0.6 mg of atropine were administered I.V. and patients were assessed for any improvement in neuroparalysis. Seventy-two patients were admitted during the study period. All the patients except two came from rural areas and were brought between June and September. Sixty-two patients were bitten during the day while clearing bricks, cutting grass or walking. The mean time interval between bite and arrival to hospital was 4.5 h. None of the patients showed any improvement following treatment and all patients developed respiratory paralysis, requiring assisted ventilation. Seventy survived and two died. Neostigmine is ineffective in reversing or improving neuroparalytic features in patients with B. caeruleus bite even at higher dose than normally recommended.

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Section: Discussionsupporting

confidence: 79%

“…The common krait (Bungarus caeruleus) is the most toxic snake found commonly in the plains of Northwest India and bites typically occur during July-September [1][2][3]. Kraits are elapid snakes and within the single genus Bungarus, 12 species are found [4].…”

Section: Introductionmentioning

confidence: 99%

Role of neostigmine and polyvalent antivenom in Indian common krait (Bungarus caeruleus) bite

Anıl

Singh

Bhalla

et al. 2010

Journal of Infection and Public Health

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“…A study done by Chauhan S et al showed that 70 (49.3%) cases received first aid treatment prior to admission which is higher when compared to our study. 21 Soft tissue infections are a majo r complication of snakebite with local envenomation. Extensive tissue destruction caused by the proteolytic property of snake venom leads to bacterial infection of the wound by snake's indigenous oral flora.…”

Section: Discussionmentioning

confidence: 99%

A prospective observational study of drug usage in the management of snake bite patients and their outcome in a tertiary care teaching hospital

Hirebail

Nagabushan

Prakash

2017

Int J Basic Clin Pharmacol

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Background: The objectives of the study were to assess the pattern of management of snakebite especially with respect to use of anti- snake venom and other supportive treatment given and to assess the effect of anti-snake venom on different types of snakebite and to assess their outcome.Methods: A prospective observational study was conducted over a period of 6 months, after getting approval from Institutional Ethics committee. Total of 144 snake bite patients were analysed for six months duration for use of anti-snake venom and other supportive treatment in their management and were assessed for their outcome like recovery, morbidity and mortality.Results: Out of 144 snake bite patients analysed, 71.5% had poisonous type and 28.4% had non- poisonous type of snake bite. Among the total number of snakebites, 47.2% were unknown type and among the known type 25% were viper, 13.2% cobra, 7.6% krait, 6.3% sea snake and 0.7% green snake. Anti-snake venom (ASV) was given to 62 patients depending on severity, of which, 22 patients developed reaction to ASV. Patient with reaction to ASV were treated with corticosteroid and antihistamine injection. Morbidity was seen in 29.1% of patients who developed either cellulitis or gangrene of bitten area, which was more commonly seen among viper bite patients (54.7%).Conclusions: Snakebite is one of the commonest tropical diseases leading to envenomation and poisoning especially in rural areas of tropical countries which has to be treated as early as possible to prevent complications. Majority of the cases in our study were of viper bite and most of them have recovered after treatment.

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“…This may help to explain why beliefs in traditional and/or contraindicated treatments for snakebite are still deeply rooted among the people of Nepal (Sharma et al, 2004a,b;Pandey, 2007) and why snakebite victims did not use PIB or LCPI (Pandey et al, 2010b). Of all currently non-recommended measures, the application of an arterial tourniquet is most popular in Nepal (93%) (Heap and Cowan, 1991), 88% (Sharma et al, 2004a), 90% (Sharma et al, 2004b), 69% (Pandey et al, 2010b) and other countries [Pakistan (79%) (Chandio et al, 2000), Bangladesh (95%) (Harris et al, 2010), 64% (Rahman et al, 2010), Nigeria (54%) (Michael et al, 2011), India (11%) (Chauhan et al, 2005)].…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, the majority of venomous snakebites, especially krait bites, occur in the evening and at night (27% from 18:00 to 20:00 and 25% from 21:00 to 03:00) (Pandey, 2007), 100% from 23:00 to 05:00 (Ariaratnam et al, 2008) and 36% (Rahman et al, 2010) especially in rural areas (90%) (Kulkarni and Anees, 1994), 82% (Chauhan et al, 2005) and 70% (Inamdar et al, 2010).…”

Section: Discussionmentioning

confidence: 99%

Inclusion of incorrect information on snakebite first aid in school and university teaching materials in Nepal

P¹

2013

J. Toxicol. Environ. Health Sci.

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In previous studies in Nepal, snakebite victims were found to either not have Pressure Immobilization Bandaging (PIB) or Local Compression Pad Immobilization (LCPI) performed for first aid, or had it performed incorrectly. The goal of this study was to evaluate training texts regarding first aid measures for snakebite and the rates of performance of both methods currently recommended, as well as ineffective or harmful practices. The study was conducted from September, 2009 to November, 2010. It evaluated the venomous snakebite first aid measures recommended in the 31 most recently published and commonly used Nepalese reference works and textbooks aimed at paramedical personnel, primary health care workers, medical undergraduates, and students of class five to bachelor´s degree. It compared the suggestions of these with those of published guidelines for the management of snakebite envenomation. Up to 100% of first aid measures advocated in these materials differed significantly from published guidelines. This included the omission of appropriate activities, misstatements and prescription of inappropriate treatments. Among appropriate recommendations that were missing was the advice to apply PIB or LCPI, and the suggestion to go to a snakebite treatment center. Fifty-five percent of the references did recommend emergency transport. Inclusion of accurate evidence-based information regarding first aid measures for venomous snakebite in commonly used texts could help to reduce the application of ineffective or harmful pre-hospital practices, their associated morbidity and mortality, and increase the use of appropriate methods.

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Pre-hospital treatment of snake envenomation in patients presented AT a tertiary care hospital in Northwestern India

Cited by 14 publications

References 1 publication

Role of neostigmine and polyvalent antivenom in Indian common krait (Bungarus caeruleus) bite

Role of neostigmine and polyvalent antivenom in Indian common krait (Bungarus caeruleus) bite

A prospective observational study of drug usage in the management of snake bite patients and their outcome in a tertiary care teaching hospital

Inclusion of incorrect information on snakebite first aid in school and university teaching materials in Nepal

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