EVALUATION OF METHODS OF TREATMENT OF SNAKE BITE IN EGYPT ,A ClLINCO-EXPERIMENTAL STUDY

Abstract

Snake envenornation represents one of the major causes of morbidity and mortality in tropical and temperate regions especially in rural areas. 'Up to date, no accepted universal scoring system or treatment protocols have been outlined for management of snake envenomation due to ignorance of physicians treating such cases regarding the variability in clinical presentation ' and the pathogenesis of envenomation in different cases, so the present study aimed to study the different treatment strategies currently used in snake envenomation, and to establish a satisfactory scoring system for such cases. The design of this study included two main parts, the clinical part and the experimental part. The clinical part was performed on cases of snake bite presented to Poison Control Center- Ain shams university, Cairo in a period of one year (2000-2001) and included 132 cases of variable presentations. The cases was chosen regardless of age, sex and residence. From these cases, 80 were diagnosed as dry bite, while the remaining 52 cases with significant envenomation were classified according to the presenting symptoms into two main groups, the neuro paralytic group or the Elapidae group (25 cases), and the hemorrhagic group or the Viperidae group (27 cases). Each of these two groups were classified according to the severity of clinical presentation and biochemical parameters into different grades (0-4). Clinical assessment as wel1 as blood sampling were done were done for every case on admission and on consequent days during their hospital stay. The following parameters were performed, CBCs, serum electrolytes, S . urea and creatinine, AST, AST, Alk. Phosphatase, Tbilirubin,, LDH, CK-MB, and coagulation profile (PT, PTT, fibrinogen and E.D.Pg)

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