Authors : Shubhankar Mishra, Shubhankar Mishra, Agarwalla Sunil K, Agarwalla Sunil K
DOI : 10.18231/j.ijn.2019.030
Volume : 5
Issue : 4
Year : 2019
Page No : 199-202
Objective and Design: Snakebite is a common hazard in Indian paediatric population. The objectives of
our study was to find out the incidence of neurotoxic snakebite, to evaluate the clinical profile of neurotoxic
snake bites along with outcome after treatment.
Material and Methods: A hospital based study including all cases of neurotoxic snakebite below 14 years
admitted to department of paediatrics, M.K.C.G M.C.H, Berhampur. Patients were diagnosed by clinical
history along with signs and symptoms of envenomation and history of Snakebite during the study period
from OCT 2014- SEP 2018. Management was done according to the WHO criteria. The various features
and complications encountered during the case management were noted down in the format designed for
study.
Study Setting: Dept. of paediatrics M.K.C.G M.C.H, Berhampur, Ganjam
Results: Total numbers of enrolled cases were 113. Out of them highest incidence of bites were seen in
September (15.3%). Males and age group of 10-14 years were mostly attacked. Most frequent site of bite
was leg. Most common identified snake was krait (6 0.7%). Commonest time of hospitalisation is 3-6
hrs after the bite. Ptosis was the most common manifestation. 30.3% of admitted children were having
abnormal CRT whereas 7% were having abnormal BT/CT. 38.7% were treated with ASV and 22% by
neostigmine with atropine. 23% patients were having complications with local gangrene being the most
frequent one. 3.9% children died in my study most of them were in 10-14 age group. Maximum deaths are
due to cobra bite.
Conclusion: Early hospitalisation, abstinence from age old local practices, judicious use of ASV,
aggressive management by neostigmine and atropine in diagnosed cases of neurotoxic snakebite and
extensive treatment of severe complications by the WHO guidelines can lead to decreased mortality.
Keeping the cost benefit ratio and burden of snakebite in mind the ASV should be used when indicated.
Keywords: Snakebite, WHO, ASV, Cobra