A study on snake bite poisoning in a tertiary care hospital in rural Odisha, India

Introduction: The study was under taken to know the incidence of snake bite poisoning, the factors affecting survival and key findings during postmortem examination done at MKCG Medical college &Hospital. Material and Methods: Clinico-epidemiological profile, analysis of postmortem findings and histopathologic examination was done to ascertain overall picture of snake bite. Results: An overall incidence of 4.8 per 1000 admissions was found.55 cases (61.8%) were due to poisonous variety and 34 cases (38.2%) were due to nonpoisonous snake bites. Majority of poisonous bites were neurotoxic (elapid) bites (70.9%). The overall mortality was 74.5%. Majority of the victims were males (61.8%) and between 21-30 years of age (34.8%).Most of the victims hailed from rural areas (77.5%) and reportedly worked as farmers (30.3%) and were bitten outside their homes (70.8%) during rainy season (57.3%). Diurnal predominance noticed in majority of the bites (67.4%),however on further categorization neurotoxic bites were well marked in morning hours (43.6%). Lower limbs were the most common site of bite (56.2%). Most of the non-poisonous cases did not reveal definite bite marks and grazing was seen in 73.5% cases. Two definite hemorrhagic puncture wounds corresponding to definite fang marks of being bitten by poisonous snake bite was found in 69.1% cases. The commonest symptom was local pain (41.6%), Ptosis being the most predominant sign of neurotoxic bite(23.5%) and oozing from bite site being the predominant sign in vasculotoxic variety (19.1%). The high rate of deaths during this study appears to be due to late presentation to tertiary care hospital attributed to prevailing traditional beliefs and customs and native treatment of snake bite by traditional healers causing delay in decision making.