Abstract

Snake bite is a major public health problem throughout the world especially in tropical & subtropical countries. The objective of the study is to analyze the factors which determine the prognosis of patients, admitted with poisonous envenomation. These prognostic factors include:- Time since snake bite and admission to Narayana Medical College & Hospital, Nellore, whether patient received first aid or not, systemic involvement and site of bite. Methods: 35patients with history of snake bite with or without fang marks were included in this study and a detailed history of bite including time of bite, type of snake, first aid history, patient’s manifestation and history of treatment received from outside was taken. A detailed clinical examination was done and each patient was subjected to investigations like complete blood count, bleeding time (BT), clotting time (CT), prothrombin time (PT), blood urea, serum creatinine, electrolytes and ECG, All investigations were repeated to evaluate the progress. Results: Total patients studied were 35, of which 60% were male, 40 % were female. Highest incidence of snake bite was seen in Age group of 12 -40 years (82.84%), Purely agricultural workers (85.71%), There was more incidence of bite on lower extremity. There were no complications in patients presenting within 6 hours of bite. Out of 35 patients of snake bite 18 were neurotoxic and 17 were vasculotoxic and one patient expired due to respiratory paralysis due to neurotoxic envenomation & one from cerebral bleed due to vasculotoxic bite. Interpretation and Conclusion:- In this study maximum number of patients (54.28%) reported were between 6-24 hours of bite and all those who presented within 6 hours of bite did not have any complications. Systemic involvement worsened the prognosis, the more severe the systemic involvement, the bad is the prognosis. Out of 35 patients one died due to respiratory paralysis resulting from neurotoxic bite and one died due to subarachnoid hemorrhage resulting from viper bite.

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