02379nas a2200253   4500000000100000008004100001260004800042653002000090653001700110653002700127653002700154653001800181100001100199700001200210700001300222700001400235700001300249245016500262856007400427300001200501490000600513520159200519022001402111       2025                            d  c12/2025bJaypee Brothers Medical Publishing10aAntisnake venom10aenvenomation10aVasculotoxic snakebite10aNeuromuscular Diseases10aneurotoxicity1 aPaul G1 aKumar J1 aSharma S1 aGautam PL1 aTaneja S00aClinical Spectrum, Management Strategies, and Outcome of Snake Envenomation Cases Admitted to a Tertiary Care Hospital of North India: Need for a Paradigm Shift  uhttps://www.jacutecare.com/doi/JAC/pdf/10.5005/jp-journals-10089-0191  a115-1190 v43 a<p><strong>Background:</strong>&nbsp;</p>

<p>Snakebite is a major global public health issue recognized by the World Health Organization (WHO), with India accounting for nearly half of worldwide snakebite deaths. Despite the magnitude, available data are limited. This study describes the clinical spectrum, management strategies, and outcomes of snake envenomation cases at a tertiary care center in North India.&nbsp;</p>

<p><strong>Materials and methods:</strong>&nbsp;</p>

<p>After ethical approval, a retrospective analysis of all snakebite cases admitted over 1 year was conducted. Data on demographics, clinical presentation, management, and outcomes were analyzed using descriptive statistics.&nbsp;</p>

<p><strong>Results:</strong>&nbsp;</p>

<p>Most victims were young males (80%), and the lower limbs were the commonest bite sites (87%). The mean time to reach the nearest hospital was 7 hours, with referral to our tertiary center occurring after an average of 34 hours. Neurotoxic (<em>Elapidae</em>) and vasculotoxic (<em>Viperidae</em>) bites accounted for 49 and 34.5% of cases, respectively. Antisnake venom (ASV) usage varied widely, reflecting the lack of a standardized protocol. Despite delayed presentation, there were no fatalities.&nbsp;</p>

<p><strong>Conclusion:</strong>&nbsp;</p>

<p>Polyvalent ASV in India targets only four snake species, limiting its effectiveness. Wide variability in treatment practices underscores the urgent need for standardized national protocols, improved primary care training, and better public awareness.</p>
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