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A cross-sectional study to observe the effects of dose of anti-snake venom on outcomes and adverse effects in snake bite cases

Swapnil P Chube, Anand S Kale, Vinod S Deshmukh, Harshal N Pise.

Abstract
Background: Snake bite is a major problem in rural India. The lack of universal consensus toward the dose of ASV to be used and dose-related adverse effects have been long-standing issues in the snake bite management protocols.

Objective: To observe the effects of dose of anti-snake venom (ASV) on outcomes and adverse effects in snake bite cases, in a rural tertiary care hospital in Maharashtra, India.

Materials and Methods: A cross-sectional observational study was carried out in the medicine intensive care unit (ICU) of SRTR GMC, Ambajogai by scrutinizing the prescriptions of 70 snake bite patients admitted to the ICU during the study period of 3 months. Data were analyzed using descriptive statistics and Microsoft Excel 2007. Statistical analysis was carried out using the Fisher’s Exact test.

Result: Acute kidney injury developed in 6 (20%) and 9 (22.5%) patients, neuroparalysis requiring ventilator support developed in 4 (13.3%) and 6 (15%) patients, hospital stay duration was 1.36 and 2.92 days and the mortality rate was 3.3% versus 5%, in patients given low and high dose of ASV, respectively. But, the occurrence of adverse effects to ASV was significantly less with low dose of ASV.

Conclusion: Results were found to be comparable in terms of treatment outcomes. So, low doses of ASV can be utilized to optimize usage and minimize its adverse effects.

Key words: Acute kidney injury, anti-snake venom, neurotoxic, rural, vasculotoxic



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