Profile of snakebite envenoming in western Maharashtra, India

Area of Science:

• * Clinical Medicine
• * Toxicology
• * Epidemiology

Background:

• * Snakebite is a significant public health issue in rural India.
• * Accurate identification of venomous snakes and timely treatment are critical for patient outcomes.
• * Understanding the clinical presentation and management of different snakebite types is essential.

Purpose of the Study:

• * To analyze the clinical features and outcomes of snakebite cases admitted to a general hospital in Maharashtra, India.
• * To evaluate the effectiveness of current treatment protocols, including anti-snake venom (ASV).
• * To identify key factors influencing snakebite mortality and morbidity.

Main Methods:

• * Retrospective analysis of 91 snakebite cases admitted between January 1998 and January 2001.
• * Data collection included patient demographics, snake identification (when available), clinical signs and symptoms, treatment administered, and outcomes.
• * Utilized the 20-minute whole blood clotting test for assessing coagulopathy.

Main Results:

• * Of 91 admissions, 45 (49.5%) had snakebite without envenoming. Paralysis was observed in 26 (28.6%) patients.
• * Ten (11.0%) patients died, with 3 dying en route to the hospital.
• * Early ASV administration, intubation, ventilation, and anticholinesterase treatment improved survival rates, especially for Elapidae bites.

Conclusions:

• * Prompt medical intervention, including ASV, airway management, and specific treatments for neurotoxic envenoming, is crucial for reducing snakebite mortality.
• * The 20-minute whole blood clotting test is a valuable tool for diagnosing coagulopathy and guiding ASV administration.
• * Effective snakebite management requires a multidisciplinary approach and timely access to healthcare facilities.