Muhammad Aftab Akbar, Mahe Munir Awan, Misbahul Islam Khan, Ijaz Hussain Malik.
Outcome following delayed presentation with snake envenomation.
Pak J Med Res Jan ;42(3):139-42.

A prospective and observational study was done on the cases of snakebite to find the severity and complications of snake envenomation in the victims with delayed presentation. The snakebite cases admitted to Medical Department, Nishtar Hospital, Multan from November 2001 to July 2002 were included in this study. All victims of snakebite who did not receive antivenom therapy were divided into two groups based upon the reporting time after bite. Severity of coagulopathy, ventilatory insufficiency, hospital stay, number of antivenom vials needed, sepsis rate, surgical interventions, disability and death rate were assessed and compared in both the groups. Severity of coagulopathy, sepsis, vials of antivenom required, disability and death rate were higher in victims arriving late. Similarly assisted ventilation, blood/fresh frozen plazma transfusion and surgical help was more frequently needed in sufferers of envenomation reporting late. Delay in presentation has an overall negative effect on the outcome.

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