Some factors associated with outcome of hospitalized russell's viper bite patients

Most of the Russell's viper patients with severe envenomation development oliguric acute renal failure. Majority of these patients failed to respond to conservative medical treaatment and required peritoneal dialysis (PD) for their survial. Some of them expired even after peritoned dialysis. In this study,some factors associated with development of acute renal failure, PD requirement and final outcomes i.e. recovered or expired, in the proven Russell's viper bitevictims admitted to the Thingangyun Sanpya Hospital were determined. It was found that the prognosis of these patients was apparently related to the time intervals between: the bite and receiving anti-venom, the bite and hospitalization, and the bite and treatment with peritoneal dialysis. It is suggested that antivenom should be administered within 2 hours and the victims hospitalized within 24 hours after the bite. Besides, peritoneal dialysis should be regarded as a lifesaaving measure for Russell's viper bite patients with oliguric acute renal failure and instituted as early as possible i.e. within 4 days after the bite.

Cobra bite in Sanpya Hospital, Thingangyun

Cobra bite is the second commonest poisonous snake bite in Myanmar. This descriptive study includes definite cobra bite patients (n=10) admitted to Thingangyun Sanpya Hospital from May 1999 to January 2000. their ages ranged from 5 years to 38 years; 70 per cent were bitten in South Dagon. 40 per cent had severe local reactions requiring wound debridement and skin grafting; 10 per cent had digital amputation. All patients received antivenom and 80 per cent received prostigmine and atropine; 9 patients survived; 30 per cent required assisted ventilation. One patient, who received antisnake venom 100ml within 20 minutes, died after 30 hours on respirator. although antisnake venom and respirator are useful in the management of cobra bite, survival rate is not 100 per cent. as 40 per cent of bites occurred while sleeping, particular attention should be given to tucking and sleeping in the middle of big mosquito net. As cobra bite also occurred in suburbs of Yangon, alnd survival despite therapy is not 100 per cent, everysone should exercise snake bite preventive measures.