European Journal of Molecular & Clinical Medicine

Snake bite is a major health problem throughout the world, more so in tropical and sub-tropical countries. One of the most important effects of snake envenomation is hematologic abnormalities including coagulopathy, most commonly a venom-induced consumption coagulopathy (VICC).Present study was aimed to study international normalized ratio and whole blood clotting time in patients with vasculotoxic snake bite at a tertiary hospital. Material and Methods: Present study was single-center, prospective, comparative study, conducted in patients of age > 18 years, either gender, with history of snake bite, features suggestive of hemotoxic envenomation - Rapid extension of local swelling from site of bite or early spontaneous systemic bleeding or early systemic symptoms of collapse (hypotension and shock) or passage of cola coloured urine OR Whole blood clotting time more than 20 minutes OR INR > 1.5. Results: In present study, out of 91 snake bite cases, 51 cases were vasculotoxic (56.04 %). Mean age of study patients was 35.23 ± 11.34 years, majority were male (60.78 %). Among 51 cases, 20-minute WBCT was positive in 23 cases (45.1 %) & negative in 28 cases (54.9 %). Based on INR, Coagulopathy (INR >1.5) was noted in 30 cases (58.82 %) & Non-coagulopathy (INR ≤1.5) was noted in 21 cases (41.18 %). Sensitivity and specificity of 20-minute WBCT (by considering INR as standard) was 60 % & 76.19 % respectively. Positive predictive value & negative predictive value of 20-minute WBCT (by considering INR as standard) was 78.2 % & 57.14 % respectively. Conclusion: Sensitivity, specificity, positive predictive value & negative predictive value of 20-minute WBCT (by considering INR as standard) was 60 %, 76.19 %, 78.2 % & 57.14 % respectively.

Background:Snake bite is an occupational hazard for farmers and farm laborers in the Indian
subcontinent. Every year approximately 15,000 people reportedly died due to snake venom
interaction in India alone. However, unreported deaths are estimated to be many times greater
than the reported cases in the subcontinent.
Materials & Methods:ThisCross Sectional Observational Study was carried on sample size of
75 patients of snake bite admitted in Ward/ICU, Department Of Medicine, NSCB Medical
College, and Jabalpur on patients of snake bite reporting from all over mahakaushal area of
central India from March 2017 to August 2018.
Results: CPK-MB analysis shown to have highest raised values in neurotoxic group that is
32.3±0.9 IU/L which was higher in cases where local signs were prominent, 34.0±1.1 IU/L and
in cases without local signs it was lower 30.7±1.6 IU/L. CPK-MB values were for vasculotoxic
bites was also raised 27.3±1.2 IU/L, while for non-poisonous snake bites it was below upper
limit, 21±2.1 IU/L. A total of 39.2% (n=33) patients shown to have positive ECG findings while
rest 60.7% (n=51) shown no abnormality in electrocardiogram. Analysis of 2D-ECHO findings
was done for pattern of positive findings and found that most common positive finding was
pericardial effusion with 9 (10.71%) patients followed by 6 (7.1%) patients showed diastolic
dysfunction, and 5 (5.9%) patients each shown to have systolic dysfunction and RWMA.
Conclusion: CPK-MBanalysis shown to have highest raised values in neurotoxic group which
was higher in cases where local signs were prominent, and in cases without local signs it was
lower. Abnormal ECG was significant predictor of mortality in vasculotoxic snake bites.
Echocardiography was a significant predictor of mortality in neurotoxic bites.

Background: Snake bite is a well-known occupational hazard amongst farmers, plantation workers,
and other outdoor workers and results in much morbidity and mortality throughout the world.
This occupational hazard is no more an issue restricted to a particular part of the world; it has
become a global issue.
Aim: To study the clinical profile and outcome of patients of snake bite admitted JA group of
hospital Gwalior (GRMC Gwalior)
Method: This study was conducted in JA group of hospital Gwalior (GRMC Gwalior) in 75 patients
admitted with history of definite snake bite in ICU, Department of Medicine, G.R. Medical College,
Gwalior, Madhya Pradesh, India over a period of one and a half year from July 2019 to December
2021. All the patients were subjected to history taking, complete physical examination and relevant
blood investigations including compete blood count and renal function test with appropriate
inclusion and exclusion criteria
Results: Most of the cases of snake bite were from age group 21-30 years (28%) and second most
common age group was 41-50 years (24%). Ptosis (74.6%) was found to be most common symptom
followed by ophthalmoplegia (62.6%) in snake bite patients.Almost all (94.6%) patients of snake
bite recovered and only 4 (5.4%) died in hospital due to cardiac arrest while on ventilator.
Conclusion: Snakebite is most often an occupational, domestic or environmental hazard affecting
mostly males and from age group 21-30 years. Mostly patients appeared with
neurotoxicity.Majority of patients of snake bite recovered if they received right treatment

Background: Snake envenomation is a serious medical crisis, wherein the spectrum of
injury can vary from local tissue damage to involvement of almost all vital organs of the
body. Hence, the need to recommend the most effective first aid to the victims bitten by
snakes and to recommend effective steps in the management of this problem. The aim of
this study to find out the incidence of acute kidney injury in snakebite patients.
Materials and Methods: This is a hospital-based prospective observational study in 50
consecutive patients, with history of poisonous snakebite, admitted to Government
Medical College & Hospital, Barmer, newly established tertiary referral centre in
western Rajasthan, India during one-year period. Snakebite and species identification
was confirmed by a reliable history from patients, patient's relatives, specimen brought
and presence of fang marks and signs of local and systemic envenomation. All patients
were interviewed using a standardized questionnaire to maintain a record of patient's
history relevant to snakebite envenomation. All these analyses were performed using a
commercially available software Statistical Package for the Social Sciences (SPSS) 21
version on personal computer.
Results: In our study, mean age group of AKI was 40.7 ± 13.21 years, incidence of AKI
was 60% in male and 40% in female and it was found to be 94% in rural population
and 6% in urban population. Only in 4% of cases, snakes were identified. Incidence of
AKI was found to be 30%.33.33% (N=1/3) of the patients with AKI had neurotoxicity
(p>0.05). Thus, not significant. None of the patients with AKI had brown or black
coloured urine. 75 % of patients with AKI had whole blood clotting time more than
20min (p-0.000), thus highly significant. AKI developed in 62.5% patients with bite to
ASV interval <= 2hours and 37.5% with interval >2 hours (p>0.05), thus not significant.
Conclusion: Snakebites are still a common medical emergency encountered, especially
in rural areas. Timely treatment is the mainstay for reduction of morbidity and
mortality. Recognition of predictor signs is essential for clinical management and early
referral which could lead to a significant decrease in morbidity and mortality. Further
long-term studies might help to assess predictors of renal failure in snake bite
envenomation.