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Record Based Study of Snake Bite Cases Admitted at Shri Vasantrao Naik Government Medical College & Hospital, Yavatmal (Maharashtra) *R.C

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Record Based Study of Snake Bite Cases Admitted at Shri Vasantrao Naik Government Medical College & Hospital, Yavatmal (Maharashtra) *R.C [Downloaded free from http://www.ijph.in on Tuesday, July 09, 2013, IP: 5.245.110.203] || Click here to download free Android application for this journal Record Based Study of Snake Bite Cases Admitted at Shri Vasantrao Naik Government Medical College & Hospital, Yavatmal (Maharashtra) *R.C. Kirte1, S.N. Wahab2, P.R. Bhathkule3 Summary The present hospital record based cross-sectional study was undertaken with the objectives of finding out the epidemiological profile of snake bite cases admitted in Shri V. N. Govt. Medical College and hospital during the period of 1998-2002. The data was collected from the filled case papers of snake bite cases, through medical record section under the department of PSM and analyzed manually. The outcome of snake bite treatment was noted and defined. Proportional case rate of snake bite cases varied from 6.8 per 1000 admissions in 1998 to 6.0 per 1000 in 2002. Snake bite cases were seen among Males (69.4%), 97.4% of cases were agricultural workers and labourers. The cases seen during the period of June to Aug (35.5%) followed by Septeber to November (33.5%). About 78.7% of the victims either got relived or cured with a experienced mortality 4.3%. Key words: Record based study; Epidemiological profile; Snake bite cases. Worldwide on an average nearly 2,00,000 person was obtained regarding different characteristics like are bitten by snake and 30,000 to 40,000 of them die age, sex, residence etc. from medical record section because of complications following snake bites1. and analyzed manually. The outcomes of snake bite treatment was defined as Relieved, if there was relief Snake bites are mostly encountered in rural areas of symptoms and patient was fully cured, Cured, if and has been linked with environmental and the patient became free from symptoms and occupational conditions2. complication, Expired, if the case died in due course Although snake bite is a serious medical problem of treatment, LAMA, if cases left against medical in many parts of India, reliable data for the morbidity advise and SNR if status of the cases were not and mortality are not available since there is incomplete recorded3. reporting and many people seek only traditional A total of 1103 cases of snake bite admitted in methods of treatment. Most of the available studies in Shri V. N. Govt. Medical College and Hospital Yavatmal India deal with clinical and management aspects. from January 1998-December 2002. Total inpatient Epidemiological studies related to snake bite are very of all disease were 1,54,508 out of that in 1998 few. (26,453), 1999 (28,740), 2000 (29,035), 2001 V. N. Govt. Medical College and hospital, being (32,974) and 2002 (37,306). The proportional case a teaching hospital, many complicated cases are rate of snake bite 6.8 per 1000 admission in 2002. referred from Yavatmal District. The present study was The distribution of snake bite cases admitted in undertaken with the objective of finding out the hospital depicts that majority of cases were from rural epidemiological profile of snake bite cases presenting areas 878 (80%) and only 225 cases were from urban at V. N. Govt. Medical College and hospital during areass (20%). In the admitted cases of snake bite it 1998-2002. was observed that age group 29.3% and 25.9% were A total 1103 cases of snake bite were admitted in in the age group 21-30 years and 31-40 years Shri V.N. Govt. Medical College and hospital from respectively. This was followed by 194 cases (17.6%) January 1998 to December 2002. data was collected in 11 - 20 years, 140 (12.7%) in 41 - 50 years, 78 from the Case papers of snake bite cases, information (7%) in 51-60 years, 53 (5%) in >60 years and (2.5%) 1Lecturer, 2Prof. & Head, 3Associate Prof., Department of PSM, Sri V.N. Govt. Medical College, Yavatmal (Maharashtra *Corresponding author [Downloaded free from http://www.ijph.in on Tuesday, July 09, 2013, IP: 5.245.110.203] || Click here to download free Android application for this journal 36 Indian Journal of Public Health Vol.XXXXX No.1 January-March, 2006 in ≤ 10 years age groups. The youngest case was of 7 income group. Similar findings have been reported in years and 9 months and the oldest case were of 73 Brazil8, Thailand5, and Pakistan6. 75.7% cases came years and 72 years respectively. 765 cases (69.4%) from distance 0-50 kms and 24.3% cases came from a were males and 338 (30.6%) were female. 1075 distance more than 50 kms and 15.1% cases came (97.4%) of snake bite cases were observed to be from distance even beyond 100 kms. In the present labourers and agricultural workers. 66.6% of cases had study, number of snake bite reported in June to August income less than Rs.1000 per month. It was observed were 35.5% followed by september to November that 835 (75.7%) of cases came to hospital from a (33.5%), during the period of year there is usually a distance between 0-50 kms. and 268 (24.3%) came heavy rainfall. Similar associated cases were reported from a distance more than 50 kms. More than half the from New Delhi3, Brazil8, and Zimbabawe7, studies. cases (57.8%) were admitted in the hospital within 5 In the present study, the mortality rate among hrs after being bitten by snake. About 35.55 cases of snake bite cases was observed to be 4.3%. It is higher snake bite were seen in the months of June to August when compared with Brazil8 (0.4%), New Guinea10, followed by 33.5% of cases in the months of September (0.07%) and Thailand5 (3.5%), but is less compared - November. to New Delhi3 (13.5%). On analysis of various outcomes of treatment it Facilities for management, time interval between was observed 708 (64.2%) cases were cured, 139 the bite and admission and distance traveled by the (14.5%) were relieved and only 48 (4.3%) of cases patient might be factors responsible for differentials in died while receiving treatment. mortality. Much of the information available on snake bite Snake bite were seen more among adult male is based on hospital studies. The actual incidence and agricultural labourers and farmers during the period thereby the actual burden would only be known from of June to August. About 78.7% of the victims either community based studies. The proportion of snake bite got relieved or cured. Mortality was about 4.3%. cases was 713 cases per lakh admission in the present study, compared to 380 per lakh admission in JIPMER Community awareness should be generated hospital (New Delhi)3 and 330 per lakh admitted cases regarding first aid management of snake bite cases to in Ambejogai study4. 80% of cases are encountered in reduce complications and mortality. rural areas. This might be due to environmental and occupational conditions. References In the present study, 93% of cases were in age 1. Wallce J.F.: Disorders caused by Venoms, Bites, group 11-60 yrs. It may be due to the fact that this age Stings in Isselbache K.1Martin JB, Braunwald group is engaged in various occupations. In a similar E. editors, Harrisons Principal of Internal study from Ambejogai 88% of cases were in age group Medicine, New York, McGraw Hill Inc. 2001 vo12 4 11-50 yrs. , 81.8 cases belonged to 15-60 yrs in - 2617 - 2618. JIPMER hospital study3. The age group affected in other studies were 10-40 yrs. in Nepal5, 15-44 yrs. in 2. Hati A.K. Mandal M, Mukhadi. Epidemiology of Pakistan6 and 6-40 yrs. in Zimbabwe7. Male snake bite in District of Burdwan, Journal of prepnderance has been observed in present study, Indian Medical Association 1992,90, 145 - 147. 69.4% males as compared to 30.6% females. Male to 3. Pannalal, Dutta Shrihari, Rotti S.B., Danabalan female ratio was 2.2:1 as compared to other studies, M. Epidemiological Profile of snake bite cases 4 3.2:1 in Ambejogai study , 2.1:1 in JIPMER hospital admitted in JIPMER hospital, Indian Journal of 3 (New Delhi) study . Community Medicine, Jan-March 2001; 26 In the present study snake bite cases were (1):36-38. commonly seen among the laborers and agricultural 4. Mulay D.V., Kulkarni V.A., Kulkarni S.G., Kulkarni workers (97.4%) whose occupation exposed them to N.D., Jaju R.B. Clinical Profile of snake bite cases risk of snake bites. Most of them belonged to low at SRTR Medical College Hospital, Ambejogal. [Downloaded free from http://www.ijph.in on Tuesday, July 09, 2013, IP: 5.245.110.203] || Click here to download free Android application for this journal Record Based Study of Snake Bite Cases Admitted at Shri V. N. Govt. Medical College & Hospital... 37 (Maharashtra) Indian Medical Gazette 1986, 8. Rebeiro LA, Jorge MT, Iversson LB, Epidemiology 131:363 - 363. of accidents due to bites of poisonous snakes, A study of cases attended in 1988 Revista de suade 5. Buranasin P. Snake bite at Maharat Nakhon publica 1995:29:382 - 388. Ratchasima Regional Hospital: South East Asian Journal of Tropical Medicine and Public Health. 9. Kulkarni N, Anees S. Snake venom poisoning, 1993: 24: 186 - 192. experience in 633 cases. Indian Pediatrics 1994:31:123. 6. Rano Mal A. Study of snake bite cases. 10. Lalloo DC, Trevett AJ, Sewari A, Naragui S, Journal of Pakistan Medical Association 1994: Theakstone RD, Warrell DA, The Epidemiology 44 :289.
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