Clinical and Demographic Profile of Neurotoxic Snake Bite Patients in a Tertiary Care Hospital in Bangladesh (original) (raw)
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JMS SKIMS, 2020
Background: Snakebite is a major public health problem and its prevalence is high in India. Insufficient epidemiological data and global neglect of this condition prompted the World Health organization to recognize it as a ‘‘neglected tropical disease’’ Objective: To study demographic characteristics of snakebite victims, to see clinical symptoms of bite and outcomes of snakebite. Methods: A prospective observational hospital-based study carried out from November 2016 to October 2017, in patients with a history of snakebite. Results:Total 300 patients were included in this study,170 (56.67%) were bitten by heamotoxic snakes and 130 (43.33%) were bitten by neurotoxic snakes. Majority of patients were in the age group of 20-39 years ( n=153; 51%). Men outnumbered women( n=190; 63.33%), with male to female ratio of 1.7: 1. Higher incidence of snake bite was found in July – September (n=135;45.00 %) followed by April to June( n=124; 41.33%).Majority of patients were farmers in rural a...
2021
Background: Snakebite is a neglected public health problem in many countries of the world. Being a tropical country Bangladesh is also facing this problem. In this case series we have tried to focus the illiteracy, prejudice and mismanagement happen in snake bite cases from primary to tertiary level and how effective management can save life of snake bite victim. Case presentation: Among the 29 snake bite cases admitted in a medicine ward of tertiary care hospital four were venomous bitestwo male and two female. Our patients came from around Dhaka city. Though victim failed to bring the snake, by studying clinical features and syndromic approaches we suspected Kraits as the culprit in three cases and Cobra in one case. Time period between bite and attend to hospital ranged from 4 hr to 16.30 hours. All victims had inappropriate application of tourniquet to their limbs as a first aid management. Most of them first visit OZHA (traditional healer). Two of them developed respiratory fai...
Clinical Study of Snakebite Cases Admitted in Dhaka Medical College Hospital
Chattagram Maa-O-Shishu Hospital Medical College Journal, 2014
Background: Snake bite is an important health hazard which may lead to fatality in rural areas of Bangladesh. An epidemiological study estimated the incidence of snake bite in Bangladesh about 8,000 per year with 22% mortality. In majority of cases the victims die before entrance to hospital because of their treatment seeking behavior from Ohzas. Present study is to see the clinical profile of snake bite cases admitted in Dhaka Medical College Hospital and also to find out problems in diagnosis and management and outcomes.Methods: Fifty patients of snake bites treated in Dhaka Medical College Hospital, Dhaka, Bangladesh between July 2005 and December 2006 were studied. A questionnaire, containing information on bite, physical examination and identification of snake brought was used.Results: Among the patients venomous snake was 6 (50%) with cobra and 6 (50%) with suspected krait bite. Males were bitten more frequently than females 42(82%) versus 9(18%). Regarding occupation, 28 (56%...
Journal of Bangladesh College of Physicians and Surgeons, 2010
Snake bite is one of the significant causes of global morbidity and mortality. It has been estimated that 5 million snake bite cases occur worldwide every year, causing about 100,000 deaths. 1 In Bangladesh adequate data is not available due to lack of systematic record keeping system and lack of information and awareness at community level. An epidemiological study estimated the incidence of snake bites in Bangladesh about 8000 per year with 22% mortality 2 which has been identified to be one of the highest in the world. Bangladesh supports approximately 80 species of snakes. 3-6 Among them only few are venomous. These are Cobra, Krait, Russel's viper, Saw scaled viper, green snakes, sea snakes. Most bites are occurred by non-poisonous snakes and as many as 40% bites inflicted by venomous snakes do not produce signs of envenoming. Bites usually result from an unfortunate accidental interaction between a snake and a human victim. It occurs mostly when the people are at work like cultivation, gardening, plantation, wood collection, watching the crops even during walking. However bites are fairly common when victims are at sleep. Snake bite is a horrifying experience for the victim. During the bite it is unlikely that people can identify the offending snake. They may think that every bite could result in fatality. Venomous snake bites can be presented with local or systemic features of envenoming-neurological, haematotoxicities, myotoxicities, organ failure and some nonspecific features. Frequently victims present with complication of treatment by traditional healers or self induced inappropriate application of tourniquet. As for centuries people are used to take treatment from traditional healers, ohzas who demonstrate a number of rituals which are useless and harmful. The mainstay of management is anti-snake venom which although
Knowledge of Snake Bite Management among Health Service Providers at a Rural Community of Bangladesh
Journal of current and advance medical research, 2018
Background: Snake bile is a very common incidence among the rural people. Objective: This study was aimed to assess the pattern of snakebite in rural community through community engagement. Methodology: It uses the methodological triangulation qualitative and quantitative approach as well as a case study design in analyzing data, whereby the exploratory-descriptive design is followed. The findings from survey study on snake bite have been elicited from face to face interview with 243 number of medical professionals/health service providers consisting of 113 number of MBBS doctors, 86 number of nurses and 46 number of other health practitioners. The study area consisted of 5 zilla sadar hospitals and 15 upazilla health complexes. We purposively select the 243 sample(Doctors, Nurses, Paramedics ,Others) from the selected districts and its consisting random upazillas from the govt. sector hospitals keeping in mind gender balance (Male-Female) as a primary total target population. So in total, 5division and itsconsisting random upazilas hospital including union health complex hospital personnel will be interviewed throughout mention areas of Bangladesh. Result: Most of the health professionals (93.8%) stated that the existence of facilities in their respective hospitals is not adequate to manage the treatment of snake bite victims. Of the total number of medical personnel-around 30.0% of the health professionals had the opportunity to manage snake bite in their respective span of service (50.4% of MBBS docs + 11.6% of nurses + 11.4% of other practitioners).The findings show that majority of 87.6% of doctors, 85.0% of nurses and 95.5% of other practitioners mentioned rainy season as the most prevalent time for occurrence of snake bite in rural areas of Bangladesh. As for whether all snake bites are poisonous-around 17.0% of doctors followed by 18.6% of nurses and 16.0% of other practitioners are found to have wrong notion about mentioning that all snake bites are poisonous but in reality this is not true. Conclusion: There is insufficient knowledge, skill and experience of how to treat snake bite victims.
Asia Pacific Journal of Medical Toxicology, 2012
Background: Snakebite is the most important cause of envenomation in South Asia particularly in Bangladesh, though there is lack of data from the rural part of the country. About 82 species of snakes (28 venomous) exist in Bangladesh. In this study, demographic characteristics of the victim, circumstances behind the bite along with pre-hospital and hospital managements and outcomes were evaluated. Methods: It was a cross-sectional study during January 2010 to June 2012 at Rangpur Medical College Hospital. Only venomous snakebite cases were included and diagnosis was made on clinical syndrome. Descriptive statistics were presented using percentage and proportion. Results: Out of 28 patients (mean age: 31.7 years), 20 (71.4%) were males with a significant male-female ratio (2.5:1). Majority were farmers (46.4%) and most (50%) of the bites happened during household activities. Lag period between bite and hospitalization was ≤5 hours in 50% patients; 6 to 10 hours in 39.2% and >10 ho...
Snake bites with Neuropsychiatric Presentation ─ A Study in Hill Tracts of Bangladesh
Background: Snake bite is a common medical emergency and one of the important causes of mortality and morbidity in hill tracts of Bangladesh. Neurological and psychiatric features predominate as both early and late features of snake bite patients and need to be identified correctly for proper management. Objective: The aim of this study was to find out the pattern of early and late neuropsychiatric manifestations of snake bite in hill tracts with clinical outcomes. Materials and Methods: This descriptive hospital-based study was done on 121 snake bite patients during the period from January 2015 to July 2016 using simple, direct, standardized questionnaire with history, neurological examination and psychiatric evaluation. Results: Majority of cases (71.9%) were admitted into hospital after two hours of snake bite. Lower limb was the commonest site (75.2%) of bite. Generalized weakness (50.4%) and anxiety (52.9%) were the commonest early neurological and psychiatric manifestations. Numbness (57%) and depression (33.9%) were the commonest late neurological and psychiatric manifestations among survivors; 37.2% needed referral to tertiary care hospital and 34.7% received antivenom. Death rate was 17.4% and 73.6% were cured completely without complication. Conclusion: As neurological and psychiatric manifestations are common in both early and late stages in snake bite in hill tracts, these are to be considered in the total management to decrease mortality and morbidity.
Pakistan Armed Forces Medical Journal, 2006
Background: Snake bite is a real emergency and an important cause of morbidity and mortality. The objective of the study was to observe different aspects of snake bite including proportion of poisonous snake bites, clinical features of poisoning and outcome of treatment with polyvalent antivenom serum. Patients and Methods: 188 cases of snakebite were prospectively studied from June 2001 to Dec. 2002. Among them 132 were males and 56 were females. Age of the patients ranged from 10-70 yrs. Tourniquet was applied in all the cases of snake bite. Results: Peak incidence 74(39.36%) was in the age group 10-20 yrs. 108(57.44%) cases were venomous and 80(42.55%) were non-venomous. 158(89.04%) case of snake bite occurred out side the house and the common site of bite was lower extremities in 124 (65.95%) cases. Common feature of poisoning was drooping of the upper eyelid in 108 (100%) cases followed by external ophthalmoplegia in 82(75.92%) cases. Out of 108 venomous snake bite cases 101(93...
Journal of Evidence Based Medicine and Healthcare, 2018
BACKGROUND Globally, most of the snake bites occur in India; approximately 46000 deaths annually. Therefore, it is important to carry out an observational study to know the local trends of demography, clinical manifestations, treatment practices, complications and outcome of snake bite patients, so that appropriate steps can be taken to manage such patients effectively for better outcome. MATERIALS AND METHODS A hospital based observational study was conducted, enrolling all indoor patients of snake bite admitted between 15 May to 15 August 2018. Patients' data was analysed for age, sex, occupation, address, time & site of bite, manifestations, local practices, treatment, complications and outcome. RESULTS A total of 120 patients, consisting of 77 males & 43 females were enrolled in study. The mean age of admitted patient was 30 ± 12 years. Most of the patients belonged to rural background and were engaged in agricultural activities. Patients were bitten mostly in lower extremity, during night time outside the house. Most of the patients had neurotoxic manifestations. Local traditional treatment practices like tourniquet, incision and suction are still common in society. Complications and mortality rate were more in patients with vasculotoxic manifestations and patients presenting late to hospital. All patients were treated with antisnake venom and other supportive care and most of them were discharged in satisfactory condition. CONCLUSION Most of the bites were neurotoxic, occurred during night, outside house in people with rural background. Most of the complications and deaths were because of delay in initiating proper treatment due to cultural belief in traditional local treatment, lack of transport facilities during night, financial constraints as well as lack of well-equipped local hospital capable of managing such patients. Public awareness programme should be started to discourage local cultural practices at home as well as by quacks and encourage people to seek early treatment from hospitals equipped with facilities for snakebite management. Moreover, hospitals at periphery should be strengthened to manage snake bite cases effectively.
Annual Incidence of Snake Bite in Rural Bangladesh
PLOS Neglected Tropical Diseases, 2010
Background: Snake bite is a neglected public health problem in the world and one of the major causes of mortality and morbidity in many areas, particularly in the rural tropics. It also poses substantial economic burdens on the snake bite victims due to treatment related expenditure and loss of productivity. An accurate estimate of the risk of snake bite is largely unknown for most countries in the developing world, especially South-East Asia.