Hussain Bux, Mashood Akhan, Allah Bachayo Memon, Riaz Hussain Shah, Rafi Ahmed Ghouri.
Snake bite, types & its effects on human beings.
Med Channel Jan ;12(2):59-61.

OBJECTIVE: Objective of this study is to know types of snakes bite, First Aid treatment and removal of fear from patients. TYPES OF STUDY: Descriptive and observational type of study. PLACE & DURATION OF STUDY: This study was carried out at PAF Bases in southern areas, Pirpatho, Mirpur Khas and Nawabshah from 1st Jan to 31 Dec 2005. SUBJECT & METHODS: PAF personnel and civilians of the area bitten by the snakes were included in this study. 75 patients were of vipredee bite and four were Cobra bite and neurotoxic from 1st Jan, 2005-Dec, 2005. Patients were admitted/detained in Medical Investigations Rooms at various Bases of Pakistan Air Force. 70 patients brought dead snakes with them whereas 09 patients could not bring the dead snakes with them. Their clotting time was taken, and observed for signs of envenomation. The clinical features like edema was present in 29 patients, bleeding from bite site was in 79 patients, Pain was in 79 patients, Vomiting was in 13 patients, Fever in 02 patients, no bleeding patches were seen in patients, Clotting tune was raised in 30 patients and Drowsiness in 04 patients were observed. Four patients died, all four were of neurotoxic bite. In 35 patients t heir BT,CT was taken, detained till their BT,CT become with in normal limits. 44 patients developed signs of envenomation and CT was between 10-30 minutes patients having CT 10 minutes (11 patients) were given one vial of 50ml ASV in 500ml dextrose saline water. CT become normal with in two-days, patients having CT with in 20 minutes (25 patients) 2 vial of 50ml ASV in 500ml of dextrose saline were given. CT became with in normal limit after one week. Patients having 30 minutes CT (07 patients) were given 3vial of 50ml ASV in 500ml of dextrose water remained hospitalized for one week in Medical Investigation Room and CT become normal with in one The patients bitten by neurotoxic snakes were given 50ml of ASV, 1cc of TT, Inj.Solucortef, Oxygen inhalation, IV route maintained by 10% dextrose water, were transferred to main Hospital where they were put on ventilator and could not survive. Patients whose CT was with in normal limits were detained and observed for two days assurance was given to them and were discharged after two days. Urine R/E, FDP, PT PTTK, Platelets count and fibrinogen level were not taken due to non-availability of facility in the field. RESULT: It was noted that patient bitten by viperadee snakes 75 (95%) and 4 (5%) patients were bitten by Cobra snakes. The vipradee bites were hemotoxic and 35 patients does not developed signs of envenomation 44 patients developed signs of envenomation and 4 patients were bitten by Cobra snakes they developed signs of envenomation and were transferred to main Hospital for management. 04 patients died in Hospital and 02 patients were sensitive to ASV and they were treated under high doses of steroid and antihistamine. CONCLUSION: The patients of snake bite can be treated effectively even in remotest areas and the patients bitten by neurotoxic snakes should be given first aid and then evacuated as soon as possible to nearest main hospital.

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