H.S.Bawaskar Bawaskar Hospital and Research center Mahad Raigad - - PowerPoint PPT Presentation

H.S.Bawaskar Bawaskar Hospital and Research center Mahad Raigad maharashtra

Clinical Echis RV Krait Cobra Unknow n bite Total (69) 20 (29%) 25 (36%) 14 (20) 2 (3%) 8 (12%) Age in years 20-70(40) 13-68(41)` 10-50(28) 56,13 25- 65(42) Male 11(55%) 22(88%) 10 (72%) 2 5(63%) Female 9 3 4

• 3

Time of bite AM 13 11

• 1

6 PM 7 14

• 1

2 Mid-6AM

• 14
• Site of bite

Upper extremities 9 left hand 6 Neck-4 thumb-2, ear-2 upper arm-2 not seen-4 1 1 Lower extremities 11(55%) 19(76%) 1 7( 88%) Time between bite to hospital 1.5-20(5) 0.5-6(3) 1-8(5) 0.5 and 1 0.5-3(1.5)

Month wise distribution cases

Month Echis RV Krait Cobra Unknown bite March

• 1
• April
• 2
• May
• 1
• 1

June

• 1

2 2 July 22 (38%) 9 10 2 1

• August 12

(17%) 3 2 4

• 3

Sept 11 (16%) 3 2 4

• 2

Octo 8(12%) 5 1 2

• November
• 4
• December
• 2
• `

Clinical Echis RV Krait

Cobra

Pain at the site

• f bite

19` 25

• 2

Edema at bite site and extension 19 25

• 2

20WBCT 19 25

• External bleeding 8

21

• Renal failure

1 2

• Pain in abdomen -

6 11

• Neuroparalysis
• 13

2 Hypertension

• 3
• Hypotension
• 3

Treatmnet ECHIS RV KRAIT COBRA ASV in ML 30 150- 250(200) 200 200 Reaction 3 5 2

• Ventilator
• 4

1 disability

• 2
• Death
• 1

2(1brought dead) Hypertension Pul.oedema

• Management

.

Photograph Confirmatory Diagnosis (Clinical Syndrome) Total Russell's Viper Non- Russell Viper Russell's Viper 47 1 48 Non-Russell's Viper 15 9 24 Total 62 10 72 Identification of preserved specimen Confirmatory Diagnosis (Clinical Syndrome) Total Russell's Viper Non- Russell Viper Russell's Viper 49 47 Non-Russell Viper 13 10 25 Total 62 10 72

Photograph Confirmatory Diagnosis (Clinical Syndrome) Total Echis carinatus Non-Echis carinatus Echis carinatus 20 2 22 Non-Echis carinatus 9 9 18 Total 29 11 40 Identification of preserved specimen Confirmatory Diagnosis (Clinical Syndrome) Total Echis carinatus Non-Echis carinatus Echis carinatus 21 4 25 Non-Echis carinatus 8 7 15 Total 29 11 40

Photograph – Russel’s Viper Photograph- Echis carinatus Specimen- Russel’s Viper Specimen- Echis carinatus Sensitivity 75.8% 68.9% 75.8% 68.9% Specificity 90.0% 81.8% 100% 63.6% Positive Predictive Value 97.9% 90.9% 100% 83.3% Negative Predictive Value 37.5% 50.0% 40.0% 43.7% Diagnostic Accuracy 77.7% 72.5% 79.1% 67.5% Likelihood ratio of a Positive Test 7.5 3.8 'undefined' 1.9 Likelihood ratio of a Negative Test 0.26 0.37 0.24 0.48

Woke from floor bed at 2AM with abdominal pain and vomiting Morning ptosis unable to talk and swallow and life the neck DEAD MORNING

THANKS ASV

20 Minute whole blood clotting test (20WBCT)

CP K 38 4

Patient identify snake by color and tringular big head Bamboo viper

Victim Identified the culprit by color and big triangular head

Bamboo pit viper No Lymphadnopathy

RATIONAL USE OF MODERN GADGET

THANK YOU SIR