法医学ジャーナル

Clinical Profile of Snake Bite Poisoning Cases Admitted at Tertiary Care Centre, North Kerala

Abstract

Jini Bhuvanendran

Introduction: Snake envenomation is a common medical emergency and the epidemiological features vary from region to region. A descriptive crossectional study was conducted at Govt Medical college Kozhikode to review the clinical profile of snake envenomation in Malabar region, Northern Kerala. This tertiary care centre caters to all 6 districts of Kerala including Kozhikode, Kannur, Malappuram, Kasargod, Palakkad and Wayanad.

Objectives: 1.To study the clinical profile of poisonous snake bites.

Methods: Sampling procedure: This was a descriptive cross-sectional study of all patients admitted with snake envenomation at Snake Bite unit, Govt Medical College, Kozhikode. Study period was from July 2017-June 2018. Patients are included if they had a definite history of poisonous snake bite and developed features of envenomation and are evaluated based on a proforma with detailed history and clinical examination. Data are collected regarding age, sex, occupation, time of bite, symptoms, investigations, mode of treatment given and complications. Sample size is 110.

Study Analysis: Data are analysed using computer software, Statistical Package for Social Sciences (SPSS) version 18. Data are expressed in its frequency and percentage. To elucidate the associations and comparisons between different parameters, qualitative variables are analysed using Chi-square test and quantitative variables by t-test. The Institutional Ethics Committee of Govt. Medical College, Kozhikode approved the research project. Written informed consent is obtained from all patients who had participated in this study in their vernacular language.

One hundred and two cases of Poisonous snake bite, admitted at Govt Medical College Kozhikode over a period from July 2017 to June 2018 constituted the material for the study. Detailed history with special reference to the type of snake, circumstances leading to the bite and clinical consequences are studied and final outcome is noted. Hemotoxic symptoms present in 40(39.2%) victims, neurotoxic features present in 32(31.3%) victims, both hemotoxic and neurotoxic features are present in 12(11.7%) victims.

Conclusion: Poisonous snake bite is a life threatening emergency in our region. Morbidity and mortality due to this can be reduced by early administration of antisnake venom and management of complications. So prompt referral of victims with poisonous snake bite to centres where facilities in managing snake bite is crucial in preventing mortality.