Abstract

Sangeetha Kandasamy, Shivkumar Gopalakrishnan, Murugan Venkatesan and Mohandoss Ramakrishnan

Envenomation and death resulting from snakebite is a particularly important public health problem in the rural tropics. Knowledge about the early clinical and biochemical manifestations of envenomation is imperative to plan effective management strategy. This study aimed to identify potential markers of envenomation. This is a prospective cohort study, wherein consecutive, hospitalized snakebite victims [envenomed and non-envenomed] were enrolled as Cohorts I and II. The complete clinical profile and biochemical parameters [Blood glucose, urea, serum creatinine, Alanine transaminase, Aspartate transaminase, Creatine Kinase and Lactate Dehydrogenase] were assessed. The findings were computed and analyzed. There were 61 patients in each Cohort. In Cohort I, 61.1% were hemotoxic, 24.2% neurotoxic, 9.8% both and 4.9% local envenomation. The predominant clinical manifestations included edema 72.5%, coagulopathy 70.1%, neuroparalysis 34 % and oliguria 33.1%. Biochemical evaluation revealed statistically significant increase in LDH and CK in Cohort I on all 3 days. Snake bite is seasonal. Clinically hemotoxic envenomation is more common than neurotoxic. Biochemically, an early rise in LDH and CK could be used as a reliable marker of systemic envenomation.