SNAKE BITE

VASCULOTOXIC EFFECTS IN PATIENTS

Abstract

Snake bites are increasing amongst those who unlawfully keep snakes as pets
worldwide. The rural population active in agricultural works, laborers, herders, professional
snake handlers, trekkers, snake charmers and fishermen are at risk for snake bites. Objectives:
To determine the frequency and pattern of vasculotoxic effects in patients with snake bite.
Design: Case Study. Period: Six Months Setting: Liaquat University Hospital Hyderabad.
Patients and methods: All the patients who initially present in casualty department of hospital
with the history of snake bite were enrolled in the study. The vasculotoxic effects were evaluated
by whole blood clotting time (WBCT) test, bleeding time, PT/APTT, hypofibrinogemia, DIC and
thrombocytopenia. Relevant information would be entered in specifically designed proforma
for this study. The data was entered, saved and analyzed in SPSS. So no test of significance
would be applied. Results: Out of 140 patients 112(80%) had vasculotoxic effects, of which
80(72%) were males and 32(28%) were females. The mean age ±SD of the overall patients was
37.53±8.72 whereas the mean age ±SD of male and female population was 38.98±7.44 and
34.88±4.32 respectively. The systemic bleeding was observed in 99% patients, the fang marks
in 94 patients, the prolonged bleeding time, WBCT and PT/APTT in 103, 96 and 101 patients,
thrombocytopenia in 93 patients, hypofibrinogemia in 81 patients and DIC in 76 patients.
The hamaturia (22%), hamoptysis(16%) and hametemesis (11%) was predominant features.
The gangrene was observed in 02 patients, vomiting was observed in 60% of patients had
haematemesis in 11%, bleeding gums in 03 cases and haemoptysis in 16%. Renal failure was
observed in 12 cases. Conclusions: The coagulation tests disturbed as venom increases the
clotting time. Proteins digesting enzymes or thrombin like activity of venom may be one of the
causes for prolongation coagulation tests (vasculotoxic effects)