A STUDY OF PROFILE, MANAGEMENT AND OUTCOME OF PATIENTS ADMITTED FOR SNAKE BITE WITH ENVENOMATION IN GENERAL MEDICINE DEPARTMENT, GOVERNMENT CHENGALPATTU MEDICAL COLLEGE AND HOSPITAL

BACKGROUND In any part of the world, snake produces unimaginable fear and anxiety. India is reported to have the highest snakebite incidence and mortality in the world. World Health Organization (WHO) estimates the total number of bites to be 84,000 per year with 11,000 deaths. In our Government Chengalpattu Medical College and Hospital, situated in Kanchipuram district, snake bite cases comprises a major proportion among hospital admissions. OBJECTIVES In spite of good care and timely management some cases end up in complications or death. Main reasons are patients presenting lately for treatment due to lack of awareness, patients undergone native treatment and then getting admitted to hospital with complications, comorbid illness of the patients. So a detailed clinical profile study of patient admitted with snake bite with envenomation becomes necessary, which can aid in treating and predicting the complication of these patients in future. METHODS This study was carried out from June 2013 to May 2014 (One Year Study); the study was conducted prospectively. The study comprised of 181 cases of snakebite patients (> 13 years) with signs of envenomation admitted to the Department of General Medicine, Government Chengalpattu Medical College and Hospital, Chengalpattu. RESULTS AND CONCLUSION Neurotoxicity constitutes (35.38%) among all the toxicities followed by pure haemotoxicity (25.42%) and local reactions like cellulitis oedema (22.65%). A significant association was noted between prolonged bite to needle time and mortality with 7 out of 9 patients (78%), who presented more than 6 hours after bite were dead. Native treatment especially tourniquet application is a strong determinant of outcome with 100% prevalence in dead and 85.28% in patients who had undergone surgeries and 27.28% in alive patients without surgeries. On analysing all the comorbid illness with outcome, we found that comorbid illness is not a strong determinant in determining the mortality.