Management of Snakebite and Research Management of Snakebite ...

Management of Snakebite and Research
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Table 4. Systemic bleeding and complications of Russell’s viper bite cases
Features Myinmu
n=43
(Danuphyu), haematemesis, haematuria and albuminuria (Danuphyu and Yaekyi), malena
(Kyauksae and Taungd-wingyi), conjunctival haemor-rhage (Kyauksae and Danuphyu),
hypotension and conjunctival oedema (Nyaunglaybin), renal failure (Danuphyu and
Nyaunglaybin). Fatality rate is high in Kyauksae, Danuphyu and Nyaunglaybin (12.5 –19.3 %).
Use of first-aid in snakebite is shown in Table 5. Traditional first aid, tourniquets are
used in all cases, however application of herbal medicine, suction, incision and tattooing
are widely used in all except Taungdwingyi and Myinmu. Chicken pad is used in
Taungdwingyi only.
DISCUSSION
Kyauksae
n=24
Taungdwingyi
n=134
Danuphyu
n=31
Yaekyi
n=34
Nyaunglaybin
n=28
Gums % *1 - - 28 4 13
Haematemesis % *1 - 7 22 23 -
Malena % - 27 18 6 12 7
Epistaxis % *1 - - 17 8 -
Haemoptysis % *1 - - 44 4 -
Haematuria % - 20 13 39 35 7
Conj. Hage. % *1 13 2 11 4 -
Hypotension % - 27 22 28 19 47
Albuminuria % - 3 10 56 77 4
Conj. Oedema % - 13 18 11 12 27
Renal failure % - 16.6 11 22.5 11.7 21.4
Fatality % - 12.5 8.9 19.3 8.8 17.8
* number of cases
Table 5. First aid method used in Russell’s viper bite cases
Upper Myanmar Lower Myanmar
Myinmu Kyauksae Taungdwingyi
Danuphyu Yaekyi Nyaunglaybin
Tourniquet % 90 92 71 77 91 82
Herb % - 21 1 7 6 11
Suction % - 58 - 10 12 25
Incision % - 25 2 10 9 25
Tattoo % - 58 1 26 15 18
Chicken Pag % - - 9 - - -
Immobilization % 70 33 - 10 29 61
The results of the studies support observations made in earlier studies (Aung-Myint et al.,
1998, Kyaw-Than et al., 1997, Min-Than et al., 1998, Myint-Lwin et al., 1985, Myint-Soe