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“Clinical study on snake bite syndrome, species correlation and ASV dose requirement”

“Clinical study on snake bite syndrome, species correlation and ASV dose requirement” Dr. Ann Miriam Makunda Christian Leprosy and general Hospital Bazaricherra P.O, Karimganj Dist., Assam – 788727 GPS coordinates: 24*25'55.78"N 92*19'51.33"E. Location. GPS coordinates: 24*25'55.78"N

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“Clinical study on snake bite syndrome, species correlation and ASV dose requirement”

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  1. “Clinical study on snake bite syndrome, species correlation and ASV dose requirement” Dr. Ann Miriam Makunda Christian Leprosy and general Hospital Bazaricherra P.O, Karimganj Dist., Assam – 788727 GPS coordinates: 24*25'55.78"N 92*19'51.33"E

  2. Location GPS coordinates: 24*25'55.78"N 92*19'51.33"E

  3. Brief Hospital Statistics 2011-12 Total OP: 91,242 Total IP: 9471 Brief statistics of Karimganj District Population: 12 Lakhs Deaths due to snake bites : 0* Oujha : 2 *According to NRHM data

  4. LOWAIRPOA BLOCK Population : 1 Lakh Bazaricherra Gram panchayat Population : 12 thousand A survey was done and it was noticed that there were only 2 deaths by snake bites in the last 15 years.

  5. Common Poisonous snakes in Makunda Red-necked keelback Rhabdophissubminiatus Banded krait Bungarusfasciatus

  6. Other venomous snakes identified by the local people White lipped pit-viper Greater black Krait Monocled Cobra

  7. Oujha

  8. Probable cause of Cellulitis Treatment by Oujha – Cutting of snake bitten area by using a blade and applying local herbal medicine

  9. Snake bites last year = 10 Venomous bites = 1 Non – venomous bites = 9 Mainly Hemotoxic = 1 Dead snakes brought – Nil

  10. OUTCOMES Patients requiring mechanical ventilation – Nil Patients requiring hemodialysis – Nil Deaths - Nil

  11. FACILITIES AVAILABLE Bleeding time Clotting time Whole blood transfusion Hemodialysis facilities – Machine available (Not in use) Mechanical ventilators – yes High Dependency area

  12. Blood investigations done Hemogram Serum Creatinine Blood Sugar BT / CT Platelet count ECG

  13. INDICATION FOR ASV ADMINISTRATION Prolonged BT/ CT Adrenaline given when there is sign of anaphylaxis Initial dose of ASV 8 – 10 vials Duration of administration 4 – 6 hours Test used for monitoring response - Whole Blood Clotting Time Time of measurement of coagulation parameters – 3 times in a day

  14. ADMINISTRATION OF REPEAT DOSE OF ASV Not given so far ADMINISTRATION OF CONTINUOUS LOW DOSE OF ASV Not given so far

  15. CEILING DOSE No experience USE OF NEOSTIGMINE No experience

  16. INDICATION FOR ANTIBIOTIC THERAPY Cellulitis COMMON ANTIBIOTICS USED Ampicillin and Ampicloxacillin

  17. PATIENTS ADMITTED IN High Dependency area PATIENTS REFERRED FOR No referrals so far

  18. COMPANY OF ASV PURCHASE Haffkine STOCK OF ASV 10 Vials

  19. Why are snake bites so un-common in Makunda? Thickly populated location Venomous snakes present Dense forests Frequent floods

  20. THANK YOU

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