title: Clinico-epidemiological features of viper bite envenomation: a study from Manipal, South India.
abstract: BACKGROUND
  Snakebite is an important and preventable health hazard. Viper bites are more common than other poisonous snakebites in human beings. The present study aimed to collate the victim profile of viper bite cases in the region and to determine the pattern, manifestations, complications and the associated risk factors of these bites.
  
  
  METHODS
  This was a prospective study of viper bite cases admitted to Kasturba Hospital, Manipal, India between August 2003 and November 2005. The demographic and clinical details of each case were obtained from the patients, their relatives and the patients' hospital records, and analysed.
  
  
  RESULTS
  A total of 31 viper bite cases were reported during the study period. The victims were predominantly male and aged 25-55 years. The highest number of cases occurred during daytime in the months of September and October, which coincided with the harvesting season, and involved the lower limbs. 94% of the snakebite victims were farmers, suggesting that this was an occupational hazard. Envenomation was observed in patients with scratch marks, suggesting the importance of keeping the victim under observation in all alleged snakebite cases, even in the absence of clear fang marks. The mortality rate in our study was 6.5%.
  
  
  CONCLUSIONS
  Immobilising and transporting snakebite victims to the hospital and prompt administration of anti-snake venom remain the best way to reduce morbidity and mortality. It is also important to practise correct first aid measures, as otherwise they may cause more harm than good.
authors.affiliation: Department of Forensic Medicine and Toxicology, AJ Institute of Medical Sciences, Mangalore, India.
authors.forename: F N
authors.initials: FN
authors.lastname: Monteiro
authors.forename: T
authors.initials: T
authors.lastname: Kanchan
authors.forename: P
authors.initials: P
authors.lastname: Bhagavath
authors.forename: G P
authors.initials: GP
authors.lastname: Kumar
authors.forename: R G
authors.initials: RG
authors.lastname: Menezes
authors.forename: K
authors.initials: K
authors.lastname: Yoganarasimha
mesh_terms: D000328:Adult; D017677:Age Distribution; D000818:Animals; D000997:Antivenins / Q000008:administration & dosage*; D015331:Cohort Studies; D003906:Developing Countries; D004630:Emergencies; D005260:Female; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D012621:Seasons; D017678:Sex Distribution; D012909:Snake Bites / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D015996:Survival Rate; D016896:Treatment Outcome; D014757:Viper Venoms / Q000506:poisoning*; D017819:Viperidae / Q000145:classification; D055815:Young Adult
chemical_list: D000997:Antivenins; D014757:Viper Venoms