Selvaraj, S (2015) Acute Kidney Injury in Snakebite Patients and Its Clinical Predictors. Masters thesis, Madurai Medical College, Madurai.
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Abstract
INTRODUCTION: In many parts of India, snake is worshipped and in some areas special prayers are performed. In Northern India on Naga Panjami day people worship snake idol. In certain areas of Maharashtra and Goa the live snakes, rarely live cobras are brought for worship. Snake charmers carry snakes especially cobra, door to door for worship. At every house the snake’s mouth is forced open and some milk is poured down in its throat though milk is not snake food. It is also believed that snakes bite people who harmed them in their previous birth. When snakes are killed, people offer special prayers and bury them. People also believe that snakes take revenge against those who harmed them. In view of their strong beliefs and many associated myths, people resort to magico-religious treatment for snake bite thus causing delay in seeking proper treatment. As a result, valuable time is lost in some of the deserving cases. It is poignant to note that some of the cinema and TV serial stories even now propagate non-scientific ideas on snakes and snakebites, and display traditional treatment. Hence, there is a need for the health department to disseminate the scientific aspects related to snakebites to the community. AIMS AND OBJECTIVES: 1. To study the clinical profile of renal involvement in snake bite patients. 2. To study the in-hospital outcome of acute kidney injury in snake bite patients. SUMMARY: This study is a descriptive study of 50 randomly selected patients with snake bite induced AKI. These patients were admitted to Government Rajaji Hospital, Madurai from June 2014 to October 2014. In our study, mean age of patients studied was 43.8±12.63 years. Male to female ratio was 1.63:1 with male preponderance. The mean interval between snakebite and presentation to KR-Hospital was 15.37 hours. All snake bites were inflicted to lower limbs and 48% of snake bites were due to Viper as identified by patients. Ninety-eight per cent of patients presented with local signs of inflammation indicating the vasculotoxic nature of envenomation. Fifty-two per cent of patients presented with coagulation abnormality and 60% with decreased urine output which were associated with increase severity of AKI and need for haemodialysis in 12% (6) of patients. Only 26% of patients presented with thrombocytopenia which was not associated with the severity of AKI. CONCLUSION: From our study we conclude that 1. Common manifestations of poisonous snake bite include cellulitis, abnormal coagulation profile and decreased urine output. 2. Overall mortality due to snake bite induced AKI is 6%. 3. Lapse of time in presenting to the hospital and abnormal coagulation profile are the predictors of poor outcome in snake bite induced acute kidney injury.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Acute Kidney Injury ; Snakebite Patients ; Clinical Predictors. |
| Subjects: | MEDICAL > General Medicine |
| Depositing User: | Punitha K |
| Date Deposited: | 18 May 2018 18:53 |
| Last Modified: | 18 May 2018 18:53 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/7892 |
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