Department of Molecular Biology and Biotechnology, School of Sciences, Tezpur University, Tezpur, 784028, Assam, India.
Demow Government Community Health Centre, Raichai, Konwar Dihingia Gaon, Sivasagar, Assam, India.
Toxicon. 2023 Jul;230:107175. doi: 10.1016/j.toxicon.2023.107175. Epub 2023 May 29.
Assam, a Northeastern State of India, is inhabited by several venomous snake species causing substantial morbidity and mortality. The data on the epidemiology of snakebites and their management is underreported in this region. Hence, a secondary health-based retrospective study was carried out at Demow Model Hospital, Sivasagar, Assam, to evaluate the clinical and epidemiological profile of snakebite cases reported in this rural hospital and their management. Snakebites occurring between April 2018 to August 2022 were reviewed based on socio-demographic details of the patient, clinical symptoms, and treatment using a standard questionnaire. Out of the 1011 registered snakebite cases, 139 patients (13.7%) counted for venomous bites, among which 92 patients (66.19%) accounted for viper bites (green pit viper and Salazar's pit viper), and 30 patients (21.5%) were bitten by elapid snakes (Indian monocled Cobra, banded krait, and greater/lesser black krait). A maximum number of snakebite cases (80.5%) were reported from the interior rural villages and documented from July to September (51.3%). Elapid snake envenomed patients, except one, were successfully treated with commercial antivenom, neostigmine, and glycopyrrolate. Because commercial polyvalent antivenom against "Big Four" venomous snakes of India showed poor neutralization of pit-vipers envenomation; therefore, pit-viper bite patients were treated with repurposed drugs magnesium sulfate and glycerin compression dressing. Adverse serum reactions were reported only in 3 (11.1%) cases. The preventive measures and facilities adopted at the Demow Model Hospital significantly reduce snakebite death and morbidity; therefore, they can be s practised across various states in India as a prototype.
印度东北部的阿萨姆邦栖息着几种毒蛇，它们会导致大量的发病率和死亡率。该地区对蛇咬伤的流行病学和管理数据报道不足。因此，在阿萨姆邦迪莫医院进行了一项基于二级卫生的回顾性研究，以评估该农村医院报告的蛇咬伤病例的临床和流行病学特征及其管理情况。根据患者的社会人口统计学细节、临床症状和使用标准问卷进行的治疗，对 2018 年 4 月至 2022 年 8 月发生的 1011 例登记的蛇咬伤病例进行了回顾。在 139 例（13.7%）确诊为毒蛇咬伤的患者中，92 例（66.19%）为蝮蛇咬伤（青环海蛇和萨尔扎的海蛇），30 例（21.5%）为眼镜蛇咬伤（印度单眼眼镜蛇、金环蛇和银环蛇）。报告的蛇咬伤病例中，有 80.5%（80.5%）来自内陆农村村庄，记录时间为 7 月至 9 月（51.3%）。除 1 例外，所有被毒蛇咬伤的患者均成功接受了商业抗蛇毒血清、新斯的明和硫酸阿托品治疗。由于印度“四大”毒蛇的商业多价抗蛇毒血清对海蛇的中和作用较差；因此，海蛇咬伤患者采用了重新利用的药物硫酸镁和甘油压缩敷料进行治疗。仅报告了 3 例（11.1%）不良血清反应。迪莫模型医院采取的预防措施和设施显著降低了蛇咬伤的死亡率和发病率；因此，它们可以作为一种模式在印度的各个邦推广。
