Clinical and Demographic Profile of Neurotoxic Snake Bite Patients in a Tertiary Care Hospital in Bangladesh

Abstract

Background:Neurotoxic Snake bite is an important health hazard that may lead to fatality in Bangladesh, particularly in rural areas. Epidemiological data point to 700000 incidences of snake bite resulting in 6000 deaths in a year. Despite the criticality of this issue, limited studies are available in the pertinent literature. Consequently, to bridge the gap and offer fresh insights into this domain, the present study was an effort to observe the clinical and demographic profile of neurotoxic snake bite in tertiary care hospital of Bangladesh. Methods:This research was a hospital based observational study which was conducted at the inpatient department of Medicine in Dhaka Medical College Hospital (DMCH). Thirty five patients admitted in DMCH for neurotoxic snake bite were examined according to the inclusion and exclusion criteria. Ethical issues were ensured properly throughout the study. After obtaining a written informed consent, patents’ history was taken and physical examination was done and data were recorded in structured case record form. In the end, the collected data was analysed by computer via SPSS 22. Results: Neurotoxic snake bite was most frequent (34.3%) in age group 21-30 years. The mean age of the subjects was 32.31 ±14.33 SD. Total 11 Neurotoxic snake was identified and 7 were Cobras and 4 were Kraits. Difficulty in swallowing, difficulty in speech, double vision, and difficulty in breathing were found in 11.4%, 28.6%, 5.7%, and 37.1% of the cases, respectively.  Moreover, all the subjects had Ptosis (100%), 14.3% had external ophthalmoplegia, 57.1% had broken neck sign. Furthermore 60% of the cases recovered completely, 17.1% recovered with complications, but unfortunately 22.9% of the patients died. Conclusion: Ptosis and broken neck signs are the most frequent neurotoxic signs. However, a larger study is needed to validate and approve this finding.