determine frequency of etiological factors in short statured patients presenting at an endocrine clinic of a tertiary care hospital

To determine the frequency of etiological factors in short statured patients presenting at endocrine clinic of National Institute of Child Health, Karachi. This descriptive cross sectional study was conducted at Endocrine clinic of National Institute of Child Health, Karachi. One hundred children [48 boys and 52 girls] aged 3-15 years [mean 9.9 +/- 3.4] with short stature from January 2007 to July 2007 were evaluated during that period. Constitutional growth delay [CGD] and familial short stature [FSS] were identified as the most common, 55% of all short stature cases. Non-endocrinal causes as a single entity was detected in 17 children. Most common etiological factors in order of frequency were normal variant of growth [CGD, FSS], Hypothyroidism, Growth Hormone deficiency [GHD], and Celiac disease. GHD was found in 13% of total cases and it comprises 44% among endocrinal causes. Boys outnumbered girls with ratio of 2.7:1 [p < 0.05]. Most common cause of short stature was normal variants of growth as a group. Children with height falling below 0.4th percentile are more likely to have pathological cause

Celiac disease; effectiveness of treating previously untreated patients with both a gluten free diet and bisphosphonate, gluten free diet alone

To evaluate effectiveness of treating previously untreated patients with celiac disease with both a gluten free diet and bisphosphonate in order to significantly increase their BMD's to a greater extent than a gluten free diet alone. The study was conducted in National Institute of Child Health [NICH] Karachi to evaluate the effectiveness of treating previously untreated patients with celiac disease with a gluten free diet and bisphosphonate in terms of increase in bone mineral density in comparison to a gluten free diet alone over a period of three months [January 2013 - March 2013]. The study includes 30 children patients below fifteen years of age either sex. All study subjects were untreated celiac patients diagnosed by clinical presentation, small bowel histology and serologic testing. On day dexa scan was done. Fifteen patients kept on Gluten Free Diet [GFD] and remaining 15 patients kept GFD plus tablet of bisphosphonate. After three months dexa scan was repeated. The patients with other disease of bone or mineral metabolism, as well as subjects taking systemic glucocorticoids or high doses of thyroid hormones, were excluded. A total of 30 patients with celiac disease were included in this study. Out of 30 patients 18 [60%] were female and 12 [40%] male [M: F = 1:1.5]. Thirty patients were divided in two equal groups [15 patients in each group]. In group-I we gave gluten free diet and in group-II we gave gluten free diet and one tablet of bisphosphonate. Mean +/- SD of Bone Mineral Density [BMD] in group-I was 0.402 +/- 0.081 gm/cm2 [range=0.234 - 0.503 gm/cm2], and in group-II was 0.543 +/- 0.098 gm/cm2 [range= 0.402 - 0.743 gm/cm2], mean difference of bone mineral density was significant between two groups [P-value=0.0002]. At three months DEXA scan showed a significant rise in BMD in group-II as compared to group-I

Morbidity pattern and health education for school age children in Karachi

To screen morbidities among school age children, to assess health education need to prevent these diseases and to compare morbidities with national and international patterns Cross Sectional Epidemiological Study This study was conducted at DIMC, DUHS, Karachi during February and March 2012. This study was conducted of school children of Karachi. Sample size; 125 children from 6 primary, kg and nursery classes data was collected on pre -designed and pre- tested proforma Total 22 morbidities were identified on clinical examination and anthropometry methods common morbidities were max in ear, scabies, lice infestation, alopecia, anemia, and underweight, DNS, Rhinorrhea, 21.5% children had no morbidity while 28.8% needed primary health care/ first aid or simple treatment or referral while 71% needed health education, hygiene or nutrition supplements. Morbidities are same as reported from Pakistan and Indian studies published Journals and books and all morbidities were preventable School age children are suffering from common preventable diseases they need primary health care education hygiene and nutrition supplement to improve their health Medical Universities NGOs and Education and Health Department can manage by health camps or by formal school health services programme

Burden of diabetes mellitus in the families of medical students of lower Sindh

The non communicable diseases are chronic and exist in human body for long period, diabetes is one of those. The origin word of diabetes means siphon or a pipe from which water or any liquid can pass to another container or bottle the word mellitus is Latin and it means sweet, thus diabetes mellitus means sweet urine excreted from the body of person. To ask history of Diabetes in the families of Medical Students. To alculate the burden of diabetes patients present in the family. cross sectional study. This study was carried out at faculty of community medicine and Public Health Sciences Liaquat University of Medical Health Sciences Jamshoro from 1[st] February 2013 to 31[st] May 2013. It is a cross sectional through a pre design and pre tested. Questionnaire having questions about personal bio data like age, sex, rural, urban, merit seats or self financed seats admission history of diabetes in the family and other relevant. The study shows male and female gender of students out of total 154 medical students there were male were 42 [27.27%] and there were 112 [72.72%] female students regarding the type of History of Diabetes in Families of medical students out of total medical students 154, there were 59 [38.31 %] who reported history of diabetes while 95 [61.68%] of no history of diabetes in their families. The Glucometer is a small machine, available in 53 [34.41%] families-and not available 101[65.58%] in the families of the students. The distribution of students according to seat of admission shows out of total 154 students who participated in the study 733 were on merit while 82 were on self finance which means having good income source. The study concludes that there is high burden of diabetes in medical students families in Sindh. Majority is managed on diet, more counseling is required

Frequency of hypertension in male and female medical students of public sector university of Jamshoro in hilly region

To evaluate the Frequency of Hypertension in male and female Medical students of Public Sector University of Jamshoro in hilly region. Cross sectional study. This study was conducted at Liaquat University of Medical and Health Sciences Jamshoro from October 2012 to November 2012. A total of 94 Medical students studying in 4[th] year MBBS were randomly selected and were administered questionnaire comprising sections on personal information, gender distribution, age distribution, current status of hypertension, hobbies, family history of hypertension, father's occupation, blood pressure readings by using a standardized calibrated mercury column type sphygmomanometer [Certeza CE model CR 2001] in Medical ward were recorded and careful clinical examination of CVS by Senior and trained Doctors. Among male students 26 of Normal [<130/<85 mmHg], 05 of Prehypertension [130-139/85-89 mmHg], Among females 53 of Normal, 08 of prehypertension and 02 of mild hypertension [140-159/90-99 mmHg] .Some subjects had reduced physical activity with preference of watching TV and reading books. Majority of the students were normotensives. The study concludes that the hypertension is a problem of medical students, detection of common habits that might be correlated with hypertension which needs regular counseling and lifestyle changes, awareness and prevention about hypertension

Stunting among children in district east Karachi, Pakistan

To study stunting problem in children attending schools in District East of Karachi, to calculate prevalence of stunting on the basis of study and compare it with national data and to suggest intervention to prevent stunting in school children. Cross sectional epidemiological study. This study was conducted on the school children of Karachi during February 2012 to February 2013. 164 randomly selected children attending private and government schools in Karachi East. There were 164 total children out of them 81 [49.40%] were male and 83 [50.60%] female. Stunting was present in 101 [61.5%], normal height and weight was observed in 7 [4.26%]. Stunting and not stunting proportion of 164 children among them 101 were stunted and 64 were not stunted [P< 0.05]. The study showed the stunting in Karachi needs nutritional intervention and public health and community health education to halt stunting problem in school health children in Karachi east

Indus water related mortality and morbidity due to water borne diseases outbreak in Hyderabad

Much of the ill health in developing countries is connected to unsafe drinking water. The number of sick people suffering from water borne diseases in a year is more than 2.5 billion out of this 2 million die. Diarrhea is top killer of children in Pakistan. River water is most polluted water and carries, chemical substances, pathogens, which cause water borne diseases. Indus river flows on the west of Hyderabad city. An outbreak of water borne diseases occurred in Hyderabad in 2004. To analyze epidemiological data of water borne outbreak in Hyderabad during 2004. To collect data from various hospitals and director general health record, admission of patients and their mortality. To calculate the case fatality rate of water borne diseases among the patients who were treated admitted in Hyderabad city hospitals. Epidemiological cross sectional study. This study based on the data pertaining to Indus water pollution which occurred in the summer month of 2004. The study is epidemiological based on the data of water borne diseases due to Indus water pollution in Hyderabad city. Five hospitals where patients were admitted and 8 sites from where water samples were collected and tested. A special proforma and survey of hospitals and director general health Sindh reports were used for the study. There were 4979 patients who were admitted in big hospitals of Hyderabad. The laboratory report of the samples shows total dissolved salts 1536, coliform bacteria and conductivities parameters were unfit and above the permissible level of World health organization standards. Case fatality rate was 7.43 per thousand. The major hospitals were the main facilities to treat the patients. Only the fresh water from Sukkur barrage and community awareness of using safe and alternative water in Hyderabad improve the water borne outbreak. The medical universities must create awareness for water borne diseases

Body mass index [BMI] of international medical student in OJHA Campus Karachi, Pakistan

Measuring body mass index [BMI] by calculating height and weight gives significant information on the health and nutritional status of individuals. Wide range of factors including blood pressure level, heart disease, asthma, headache, backache, joint pain, anesthesia risks, menstrual abnormalities and insulin resistance is associated with increase in BMI. [1] To measure height and weight for Body Mass Index calculation. [2] To compare national data of Body Mass Index. Cross sectional study. This study was conducted at the Department of Community Medicine, Dow International Medical College [DIMC], Dow university of Health sciences OJHA campus Karachi from April 2012 to April 2013. The sample of the study was 112 medical student selected through random sampling method from DIMC. BMI trend of American student [10.90%] and Pakistani Local student is slightly different were under weight in local Pakistani student [20.65%]. While over weight were more in American student [over weight 29.64%]. Majority of local and International students are fall in Normal range [55.35%]. It was interesting that obesity in American students [3.70%] and local born students [3.44%] was almost same. The study concludes that BMI of International student who were born in Pakistani migrant family have different trend. How ever over all majority of students both local and international fall in normal BMI range

Toxicity of isoniazid [INH]; role of biochemical monitoring tests and history of weakness. the management of pulmonary tuberculosis in placebo controlled study

To compare the untoward effects of isoniazid [inh] and placebo as an anti-tuberculosis therapy in tuberculosis patients. Study Prospective study. Free T.B Clinic, Muhammad Medical College Hospital Mirpurkhas Sindh. Period: June 2007 to Dec 2007. Patients, Method and Patients were selected with filling of consent forms from free T.B Clinic. Prospective study of adverse effects of INH Isoniazid in tuberculosis treatment. It is concluded like other anti-biotics, Isoniazid must be carefully, mentioned in combination therapy of Anti-Tuberculosis Therapy. The major side effects are those giving rise to serious health hazards, require discontinuation of the drug and referral to chest physician

Scabies in community of Jamshoro hills

Introduction: The Muslim Physician Avenzoar described itch mite [Acarus Scabiei] in the twelfth century. Problem is worldwide in superpower country like USA 5% to 10%children have Scabies. The situation in other poor countries can be much worse. Frequent changes of underclothing and bedding are control measures of value. 1. To collect data on prevalence of Scabies infection in community residing in Jamshoro Hills. 2. to record Socio-demographic character of patients of scabies. 3. To recommend control and prevention strategies based on this research. Descriptive and cross sectional study. This study was carried on patients who utilized services of LUH Skin OPD in Jamshoro from 1[st] February 2007 to 1[st] February 2008. Dermatology Out Patient Department of Liaquat University Hospital Jamshoro. 112 patients were included in study sample. Study was conducted on 112 patients who utilized services of skin OPD at LUH out of these 30[26.2%] were children in the age group of 1-9 years, 38[33.9%] adolescents and teen angers in age group of 10-19 years this was largest age group of scabies patients. while infection was 10.7% to 5.4% in 40-49 years age and above showing low prevalence. Regarding sex of patients suffering from scabies out of 112 patients the ratio of male to female was 50:62 i.e. 50 [44.6%] and 62 [55.4%].This showed females suffered more the occupation of patients showed strong association with scabies diseases occurrence P<001 as out of total 112 patients house wives were 26 [23.2%] students 31[27.7%], laborer 15[13.4%] children 33[29.5%] office Job 7[6.3%] while education was not significant. Study concludes that scabies is common in rural areas of Jamshoro in young age and teen agers. Occupation wise students and house wives had more scabies. Community based cheap treatment of sulphur ointment programme supported by IEC material and free skin camps be promoted

District hospital [DHQ] capable to treat snake bite cases

1, To know the proportion of Haemotoxie and Nuerotoxic snake bite cases admitted in DHQ Hospital, 2. To collect data about victims and their cure rate by ASV injectable serum, 3. To determine that DHQ hospital is capable to treat snake bite victims or not, 4. To recommend improvements for snake bite treatment on basis of this study, Cross sectional study, This study was conducted at Medical ward of District Hospital Mirpurkhas, Sindh from January to December 2005 on snake bite cases. 135 patients of snake bite were taken in this study. Patients were taken of both sexes and all ages. Only patients with snake bite history and clinical signs of bite fang punctures were included. Snake bite cases with only history no fang puncture marks and no clinical envenomation signs or treated by private hospital or GPs were excluded. 1. 135 Cases admitted during 12 months of the year 2005, 120 [86.2%] were male and 20 [14.8%] females [Table-1]. 2. The age distribution of snake bite cases showed that 12 [8.9%] were small children age 01-04 years showing a miserable situation of neglect by mother and family. An other group 38 [28.1%] were also children aged between 05 -09 years, the third group is also children between 9-14 years, which is 20 [14.8%], there were 11 [8.1%] in teen age [15 to 19] years. There were 39 [28.9%] cases in age of 30 and above [Table-8]. 3. The type or species of snake bite as stated by patients or their attendants revealed that 112 [83. 0%] said viper [lundi] have bitten which is haemotoxic and 23 [17.0%] snake bite cases were bitten by Cobra [Nanagor sanp] which is neurotoxic. 4. After ASV treatment all snake bite cases were cured, and no death or referral was reported. Hence DHQ hospitals are capable to deal with snake bite cases of all types. 5. Stock of ASV and supply in DHQ hospital was satisfactory as per data 134 [99.3%] cases when admitted. But for 01 case it was not available. This shows that this Vaccine should be available in excess quantity. Snake bite is endemic and common public health problem in district Mirpurkhas adolescents and teenagers are bitten in large number but cure rate with Anti Snake Venom [ASV] injection is highly satisfactory, viper and cobra are frequently stated species present in Mirpurkhas. DHQ hospitals are capable to deal all the cases of snake bite. Anti snake Venom supplied in Pakistan is very effective against cobra and viper

Control of hypertension; efficacy and safety of losartan and atenolol alone and in combination

To compare the efficacy and tolerability of Losartan and Atenolol in alone and combination in treatment of hypertension. Comparative study. Medical out patients department of Jinnah Postgraduate Medical Centre Karachi from January 2007 to June 2007. There were 60 patients previously untreated with mild and moderate essential hypertensions were registered for study. The selected patients were divided into three groups. Group A was given atenolol, Group B was given Losartan, and Group C was given both drugs. The target blood pressure was 120-140/80-90 mmHg. There were 42 males and 18 females with age range 25-65 years. The mean baseline score of groups A, B and C were showed systolic blood pressure 182 +/- 19, 174 +/- 20 and 168 +/- 12 respectively. The diastolic blood pressure was 104.5 +/- 11, 102.5 +/- 9 and 104.5 +/- 10 respectively. The difference in mean systolic and diastolic blood pressure was not significant statistically as P=0.06 and 0.76 respectively. After 4 months of treatment with atenolol, systolic blood pressure decreased to 147 +/- 17, and diastolic blood pressure fell to 87 +/- 4. Losartan decreased systolic blood pressure 138 +/- 13 and diastolic blood pressure 87 +/- 4 in 4 months of treatment. The combined therapy decreased systolic blood pressure 115 +/- 4.6 and diastolic blood pressure 75 +/- 4.7. The effect of treatments on systolic and diastolic blood pressure was significantly different as [p<0.001] and [p 0.036] respectively. Side effects observed in 2 [10%] patients from group C, 8 [40%] in group A and 4 [20%] in group B. Combination therapy proved more effective in controlling hypertension than mono therapy and also fewer side effects. Patients showed better control on combination therapy as compared to mono therapy. Losartan proved a little better in controlling hypertension then atenolol and was more expensive. Patients showed better results with combination therapy for hypertension compared to individual drug

Utilization pattern of health delivery system at primary and secondary level and problems encountered by users in mirpur khas division

To know the current utilization status of the health facilities at primary and secondary level in Mirpur Khas Division. Information was collected on a specially designed questionnaire which was also translated in local language for easiness of the patients. Data were collected from 47.7% [84] out of 176 primary health care facilities and 81.8% [09] out of 11 secondary level health care facilities. The users and doctor's incharges were interviewed. The data were collected from the field were compiled, entered and analyzed at PMRC Research Centre, LMC Jamshoro, The questionnaire covered basic information of the health facilities. Staff strength, provision of medicines and consumable supplies from DHO, officers, operation and maintenance of equipments provided and other general problems highlighted. The project was conducted during 1998-99 under the HSR Grant received from PMRC Islamabad. The population of Mirpur Khas Division was 45, 56, 570. The total health care facilities were 176 [165 + 11] primary and secondary respectively. Data were collected from PHC facilities 47.7% and 81.8% secondary level. The study showed 23.7 users visited primary health care facilities while 251.33 visited secondary level. The primary and secondary care health facilities are under utilized due to shortage of staff, particularly WMOs in this division. Tharparkar desert is 22,000 km area and there are no ambulance services to transport serious patients and pregnant ladies to some tertiary care hospital for urgent surgeries or neonatal care. Most of the deaths are observed while transporting pregnant mothers on the back of the camel which is frequent traditional mode of transport in desert

Clinical spectrum and outcome of accidental poisoning in children

Childhood poisoning is an important health problem which is usually accidental and is responsible for serious morbidity with mortality all over the world. Accidental poisoning is the second most common cause of death in Iran. This descriptive study is designed to assess the clinical spectrum and outcome of poisoning among children. This study was conducted in Liaquat University Hospital Hyderabad over a period of one year from 1[st] January 2007 to 31[st] December 2007. A total of 62 children up to 12 years of age admitted for acute poisoning to children ward were included. The cases were studied to see the clinical spectrum, complication and outcome of the poisoning. In one year period a total of 62 children including 35 [56.45%] boys' and 27 [43.54%] girls presented with acute poisoning. Maximum number of cases with poisoning was seen in the age group 1-5 year. Kerosene oil was the commonest form of ingredient used followed by drugs. The most common systems involved were cultural nervous system [CNS], respiratory and GIT. Over the period 2 [3.22%] children died, one of them was poisoned by lice killer liquid and other by insecticide. Most of the cases of poisoning are due to common household products and drugs. It is therefore necessary to educate the population on preventive measure

Heat stroke victims in Sukkur city of Sindh - Pakistan

This is a descriptive, cross-sectional study, conducted on 14 cases of heat stroke and hyperpy-rexia admitted in Civil Hospital, Sukhur between 1st Jan. and 31st Dec, 2006. The objective was to evaluate the clinical presentation, socio-demographic pattern and to suggest preventive strategies for the control of this problem. Data analysis showed mean age was 32.86 with S.D. +/- 17.06. 85.7 were males and 14.37 females, making a male to female ratio of 6:1 occupation wise, date showed 7.17, house wives, 28.47, labourers, 43.9% farmers and 21.4% were children. With proper and efficient management the cure rate was 100%. Study concluded that the lives of the victims of heat stroke and hyperpyrexia could be saved with proper preventive measures, first aid programmes and efficient treatment practices

Outbreak of cutaneous leishmaniasis in Somniani, Balochistan - implementation of preventive measures for deployed personnel of armed forces

To evaluate the number of cutaneous leishmaniasis [CL] cases reporting from Somniani between years 2001 to 2005 and to explore the preventive measures being used against sandfly bite. This observational study was conducted at the dermatology department of Combined Military Hospital, Malir Cantonment, Karachi from January 2001 to December 2005. Between year 2001 and 2005, suspected cases of CL reporting from Somniani, Balochistan were identified, evaluated, diagnosed and included in this study. Diagnosis was based on clinical examination, slit skin smear for detection of Leishman-Donovan [LD] bodies and skin biopsy for histopathology. Patients were then asked to fill a structured, anonymous, self-administered and close ended questionnaire which included questions about the use of various preventive measures against cutaneous leishmaniasis. A total of 108 patients were diagnosed as CL from Somniani during the study period. The peak was seen in year 2004 [n=58] which coincided with increased troop activity in the area. Nodulo-ulcerative lesions were the commonest mode of presentation. Skin biopsy for histopathology was the most effective method of diagnosis. Overall only 28% personnel were using preventive measures against sand fly bite. Only 15% personnel had disease awareness. Lack of application of preventive measures and knowledge of disease were the reasons for increase in CL cases

Basal cell carcinoma involoving the skin of breast a rare site

Basal cell carcinoma [BCC] is the most common and least lethal form of all cancers. The estimated lifetime risk of BCC in the white population is 33-39% in men and 23-28% in women. It occurs most frequently in people over 50 years of age and almost twice as often in men as in women. Up to 85% of BCCs are found in the head and neck region, but the lesions occasionally occur in unusual and routinely photoprotected locations. These include breast, vulva, scrotum, earlobe and middle ear. With such an atypical presentation of BCC, a keen and skeptical eye for diagnosis is required. No population-based epidemiologic studies to assess the incidence of BCC have been done in Pakistan. However, some scattered data can be found in local medical literature, which shows the highest frequency in 51-60 years age group with a male preponderance. We report a case of non healing ulcerated lesion over breast that was being treated for 5 years unsuccessfully. On skin biopsy, it came out to be BCC. As far as we have searched, it is the first report of such a case in Pakistani literature

Hepatitis-B surface antigen [HBSAG] screening and vaccination experience in Tharparkar

Hepatitis B is a very common communicable viral disease due to multiple uses of syringes and infusions, unsafe blood transfusions. Tharparkar desert where doctors and health facilities are less as compare to other parts of Sindh Province, a study based on proforma filled during free hepatitis B vaccination and Hepatitis B surface antigen [HBsAg] tests, conducted with the sponsorship of pathologist and philanthropists In two towns [Naukot and Chalhar total population of 10,000] of Tharparkar desert selected for this services during January 2005 to January2006. Total 612 residents of theses towns were enrolled for screening and and vaccination services of Hepatitis B out of 612, residents 321 were male 291 were female their age was ranging, from less than 10 years to more than 60 years. The HBsAg surface antigen was positive in 45 males and 28 females showing 73 out of 539 +ve cases giving HbsAg positive rate 11.9%. which is more than the national average of 10%. Study found early adolescence and teenagers showed high carrier rate. This is an alarming situation and needs urgent remedlal steps to prevent this growing problem HBV Vaccine in EPI is showing positive results and children below 10 are showing low infection rate than adults showing and adolescent ages

Family planning: knowledge, attitude and practice among married couples in northern Pakistan

To assess knowledge, attitude and practice among married couples regarding contraceptive measures in Baltistan [Northern Areas of Pakistan]. Cross sectional study The study was carried out in Baltistan, which is a district in northern areas of Pakistan with headquarter at Skardu. Duration of study was from June 2002 to August 2003. A study was done on married couples with female partner of childbearing age. A study questionnaire was designed and response was obtained from 200 randomly selected married couples [females: 152, males: 48], which reported to health care facilities for some other minor ailment. Majority of the study participants [67%] were of the view that rapidly increasing population is a problem affecting socioeconomic development of the country. There is wide gap between knowledge and practice of family planning. The contraceptive prevalence rate of Baltistan is 8.5% much low from rest of the country, which is above 36%. Important reasons for not using contraceptive measures were that family planning was considered against religious, beside illiteracy, poverty and poor communication. Most of the respondents were in support of early marriage for girls. Efforts are required from family welfare programme, besides long-term measures such as enhancement of women literacy

Snake bite, types and its effects on humanbeings

Objective of this study is to know types of snakes bite, First Aid treatment and removal of fear from patients. Descriptive and observational type of study. This study was carried out at PAF Bases in southern areas, Pirpatho, Mirpur Khas and Nawabshah from 1st Jan to 31 Dec 2005. PAF personnel and civilians of the area bitten by the snakes were included in this study. 75 patients were of vipredee bite and four were Cobra bite and neurotoxic from 1st Jan, 2005-Dec, 2005. Patients were admitted/detained in Medical Investigations Rooms at various Bases of Pakistan Air Force. 70 patients brought dead snakes with them whereas 09 patients could not bring the dead snakes with them. Their clotting time was taken, and observed for signs of envenomation. The clinical features like edema was present in 29 patients, bleeding from bite site was in 79 patients, Pain was in 79 patients, Vomiting was in 13 patients, Fever in 02 patients, no bleeding patches were seen in patients, Clotting tune was raised in 30 patients and Drowsiness in 04 patients were observed. Four patients died, all four were of neurotoxic bite. In 35 patients t heir BT,CT was taken, detained till their BT,CT become with in normal limits. 44 patients developed signs of envenomation and CT was between 10-30 minutes patients having CT 10 minutes [11 patients] were given one vial of 50ml ASV in 500ml dextrose saline water. CT become normal with in two-days, patients having CT with in 20 minutes [25 patients] 2 vial of 50ml ASV in 500ml of dextrose saline were given. CT became with in normal limit after one week. Patients having 30 minutes CT [07 patients] were given 3vial of 50ml ASV in 500ml of dextrose water remained hospitalized for one week in Medical Investigation Room and CT become normal with in one The patients bitten by neurotoxic snakes were given 50ml of ASV, 1cc of TT, Inj.Solucortef, Oxygen inhalation, IV route maintained by 10% dextrose water, were transferred to main Hospital where they were put on ventilator and could not survive. Patients whose CT was with in normal limits were detained and observed for two days assurance was given to them and were discharged after two days. Urine R/E, FDP, PT PTTK, Platelets count and fibrinogen level were not taken due to non-availability of facility in the field. It was noted that patient bitten by viperadee snakes 75 [95%] and 4 [5%] patients were bitten by Cobra snakes. The vipradee bites were hemotoxic and 35 patients does not developed signs of envenomation 44 patients developed signs of envenomation and 4 patients were bitten by Cobra snakes they developed signs of envenomation and were transferred to main Hospital for management. 04 patients died in Hospital and 02 patients were sensitive to ASV and they were treated under high doses of steroid and antihistamine. The patients of snake bite can be treated effectively even in remotest areas and the patients bitten by neurotoxic snakes should be given first aid and then evacuated as soon as possible to nearest main hospital where laboratory facility to tory failure are to be managed properly. When patient is sensitive to ASV under high doses of steroid ASV should be given in presence of Adernaline and anti histamine injection