CLINICAL PROFILE OF CHILDREN WITH SNAKE BITE IN A TERTIARY CARE CENTER
Keywords:
Snakebite, Antisnake Venom, Multiorgan FailureAbstract
Background: Snake bite is a major public health problem which leads to significant mortality and morbidity. Its incidence is more in rural India. The clinical profile of the snake bite depends on the various factors such as the type of snake , time of arrival in to the hospital and time of the bite (daytime or nighttime)
Methods: This is a Crossectional observational study conducted in a tertiary care hospital GMC Patiala Punjab from a period of January 2023 to September 2023 on children aged 1 month to 18 years presenting with the history of snake bite and fang marks or swelling at the site or in altered sensorium or with multiorgan involvement were included in the study. The subjects were enrolled in to the study after getting their written consent . The history , physical examination , demographic profile , relevant investigations and outcomes of the patient were analyzed.
Results: In our study total 50 patients were enrolled out of which 28 (56%) were males while 36(72%) were females. 2 (4%) in the age group of less than 1 year, 8(16%) in the age group between 1 year to 5 year,5 (10%) in the age group of between 5 years to 10 years,25 (50%) in the age group between 10 and 15 years and 10(20%) more than 15 years. 36 (72% )of the children were from rural areas while 14(28%) were from urban areas. Mean duration of arrival to the hospital was 2 hours.28(56%) cases presented with neurological dysfunction while 2 (4% )presents with disseminated intravascular coagulation while 15(30%) suffered from shock
As per labs severe anemia was present in 12(24%) and deranged LFT observed in 10(20%) and 15(30%) suffered from prerenal AKI.Mean duration of stay at hospital was 9±1 day
Overall mortality was 5(10%) however absolute mortality was observed in <1 year age group
Conclusion: Snake bite remains a major health problem in India. In our study it was concluded that time of arrival to the hospital , type of the snake and age of the patients are the major factors which influence the final outcome of the patient
Keywords
Snakebite, antisnake venom, Multiorgan failure
Downloads
References
Nelson textbook of pediatrics 22nd edition
Lahori UC, Sharma DB, Gupta KB, Gupta AK. Snake bite poisoning in children. Indian Pediatr. 1981;18(3):193-197
Reilly PL, Simpson DA, Sprod R, Thomas L. Assessing the conscious level in infants and young children: a paediatric version of the Glasgow Coma Scale. Childs Nerv Syst. 1988;4(1):30-33. Doi:10.1007/BF00274080
Pediatric Acute Lung Injury Consensus Conference Group. Pediatric acute respiratory distress syndrome: consensus recommendations from the Pediatric Acute Lung Injury Consensus Conference. Pediatr Crit Care Med. 2015;16(5):428-439.
Squires RH, Jr, et al. Acute liver failure in children: the first 348 patients in the pediatric acute liver failure study group. J Pediatr. 2006;148(5): 652–658.
Kidney Disease: Improving Global Outcomes (KDIGO) Acute Kidney Injury Working Group KDIGO clinical practice guideline for acute kidney injury. Kidney Int Suppl. 2012;2 (1):1–138.
Bhat RN. Viperine snake poisoning in Jammu. J Indian Med Assoc. 1974;63:383–92
Bhalla G, Mhaskar D, Agarwal A. A study of clinical profile of Snake Bite at atertiary Care Centre. Toxicol Int 2014;21(2):203-208.
Rao KV, Ramesh G, Acharya A. Clinicoepidemiology, clinical profile and outcome of venomous snake bite in children in Konaseema region of Andhra Pradesh, India. International Journal of Contemporary Pediatrics 2019; 6(2): 625.