title: Clinical course and outcome of snake envenomation at a hospital in Karachi.
abstract: BACKGROUND
  Snake envenomation is a frequently reported medical emergency at the Civil Hospital Karachi, Pakistan, [corrected] thus obviating the need to assess the patterns of the clinical course and outcome of snake envenomation cases.
  
  
  METHODS
  The demographic characteristics, clinical signs and symptoms, laboratory findings, treatment and outcome of 80 victims of snake bite were recorded. These patients were admitted to the Civil Hospital Karachi between January 2006 and September 2007. The data of all the cases was analysed statistically using the Statistical Package for the Social Sciences version 11.0.
  
  
  RESULTS
  The majority of the 80 victims of snake bite were male (80 percent) and 20 percent were female. The mean age of the patients was 33.3 years. The main type of envenomation was vasculotoxic (92.5 percent), and none were neurotoxic or myotoxic. Both local and systemic clinical features of envenomation were present. Bleeding was reported in 43.8 percent of the patients. 71.3 percent of the patients showed coagulopathy of defibrination and the anti-coagulant type. All patients received anti-snake venom. Five (6.3 percent) patients in the study died.
  
  
  CONCLUSIONS
  The most common type of snake envenomation in this part of the province of Sindh is vasculotoxic due to the high inhabitancy of Viperidae. High morbidity and mortality rates can be reduced significantly through patient education on the precautions that need to be taken by farmers and field workers against snake bite. Early referral to a well-equipped health facility is necessary, as the mortality rate was high among those patients who arrived late.
authors.affiliation: Department of Medicine, Civil Hospital Karachi and Dow University of Health Sciences, Baba-e-Urdu Road, Karachi 7400, Sindh, Pakistan.
authors.forename: K
authors.initials: K
authors.lastname: Mahmood
authors.forename: I H
authors.initials: IH
authors.lastname: Naqvi
authors.forename: A
authors.initials: A
authors.lastname: Talib
authors.forename: S
authors.initials: S
authors.lastname: Salkeen
authors.forename: B
authors.initials: B
authors.lastname: Abbasi
authors.forename: T
authors.initials: T
authors.lastname: Akhter
authors.forename: N
authors.initials: N
authors.lastname: Iftikhar
authors.forename: A
authors.initials: A
authors.lastname: Ali
mesh_terms: D000328:Adult; D000818:Animals; D000997:Antivenins / Q000627:therapeutic use; D001778:Blood Coagulation Disorders / Q000175:diagnosis / Q000209:etiology; D004635:Emergency Medicine / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010154:Pakistan; D010314:Partial Thromboplastin Time; D011517:Prothrombin Time; D018805:Sepsis; D012909:Snake Bites / Q000175:diagnosis* / Q000401:mortality* / Q000628:therapy; D012910:Snake Venoms
chemical_list: D000997:Antivenins; D012910:Snake Venoms