Bites due to poisonous snakes especially vipers, are one of the challenging public health problems in India. Envenomation in such cases often leads to massive intravascular hemolysis. Hence this prospective observational study was done to find out the relation between hemolysis and prognosis in patients with viper bites. 107 patients admitted with confirmed or suspected viper bites in a tertiary care centre were included. The sociodemographic details of the patients, time and site of bite, bite to needle time, presence or absence of local reaction, treatment details and relevant laboratory investigation reports were recorded. Lactate dehydrogenase levels, hyperbilirubinemia and reticulocytosis were taken as markers of haemolysis. Duration of hospital stay, recovery or in hospital deaths were noted. Data analysis was done using Microsoft excel 2010. It was found that 61.7 % were males. Bites occurred between 4 pm and 8 pm in 45.8%. Many had local reaction, active bleeding, prolonged clotting time and evidence of haemolysis and were brought to the hospital within 6 hours of bite. 20 vials of anti-snake venom were needed in 41.1% patients. Duration of hospital stay was less than 5 days in 55.1% patients. 92.5% patients recovered and 8 patients died in this study. Statistically significant relation was seen between haemolysis and death in these patients. Thus, it can be concluded that haemolysis occurring in poisonous viper bites can be taken as a prognostic indicator in such patients.

Keywords: Hemolysis, Poisonous snakes, Viper bite, Clotting time, Envenomation.

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Dr Aruna R

Additional Professor, Department of Internal Medicine,

Government Medical College, Thiruvananthapuram, Kerala, India

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