Clinical profile of snake bite patients at a tertiary care hospital in Northern India - An observational study.

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.