Snakebite profile from a medical college in rural setting in the hills of Himachal Pradesh, India

Abstract

Objective:The objective of the following study is to assess the clinical profiles and manifestations of snakebite patients in the rural hilly setting of Shivalik and the Lesser Himalayan region of Himachal Pradesh.Materials and Methods:A hospital record-based retrospective descriptive study was carried out that included details on demography, clinical profile, treatment and outcome among 200 patients over a period of 2 years. The data was analyzed using Chi-square test for comparison.Results:142 (71%) patients were young (age group of 16-45 years) and the number of male patients was 118 (59%) and female patients were 82 (41%). All the cases recorded presented in the months of April to November. Not a single case was recorded from December to March. The most frequently bitten sites were the lower limbs particularly the feet. 86 (43%) of the patients presented without any features of envenomation. Neuroparalysis was the commonest presentation in 53 (46%) patients followed by hemotoxicity in 36 (31%) among symptomatic patients. Early morning neuroparalysis syndrome was the presentation in 26.4% patients. Allergic reactions in the form of early anaphylaxis were noted in 7% patients.Conclusion:Snake bite is a neglected tropical disease affecting poor villagers in rural areas. Future research focusing on understanding epidemiological determinants of snake bite is desired.

The North-South divide in snake bite envenomation in India

“…[345678] P < 0.05 Our research shows that the Russell's viper is virtually nonexistent in North, and there is enough published evidence to prove this fact. [345678910111213141516] Neurotoxic snake Krait is responsible for high mortality throughout North India. [345678] Hence, the North Indian profile is neurotoxicity predominant (Krait), and South Indian profile is hemonephrotoxicity predominant (Russell's and saw-scaled vipers).…”

“…North Indian snakes predominantly cause neurotoxicity in 70.95% of cases (877 envenomations) [Table 2]. [345678] P < 0.05 Our research shows that the Russell's viper is virtually nonexistent in North, and there is enough published evidence to prove this fact. [345678910111213141516] Neurotoxic snake Krait is responsible for high mortality throughout North India.…”

“…[12] Russell's viper is the most poisonous snake among “the big four” and is ubiquitous in South India, but it is missing completely from all of North Indian reports. [345678] South Indian snakes predominantly cause hemotoxicity or nephrotoxicity in 83.59% of cases (1965 envenomations) [Table 1]. [910111213141516] This trend becomes apparent as we move Southward from Delhi early as Maharashtra, which has thus been included by us in South India.…”

Retrospective Study of Neuroparalytic Snake Envenomation in a Tertiary Care Hospital of Chhattisgarh

“…In our ICU all patients received ASV and the mean ASV used for neuroparalytic snake bite was 22 vials which was nearer to the recommended dose of National snake bite management protocol 2008 (India). (13) Agarwal R and others observed that Low dose of snake antivenom is as effective as high dose in patients with severe neurotoxic snake envenomation. (14,15) As seen in our study, 66.66 % patients presented beyond 6 hours after the bite.…”

Management of snake bite victims in a Tertiary Care Intensive Care Unit in North India

“…[1] We would like to share our experience and emphasize on the different management regimes being followed world over.…”