A STUDY ON PROTEINURIA AS AN EARLY INDICATOR OF SYSTEMIC ENVENOMATION IN SNAKE BITE

Abstract

Background: Snakebite is an important public health concern in developing countries. In India, it is estimated that 45900 deaths occur annually due to snake bites. Various studies have shown conicting views on the importance of proteinuria in venomous snake bites. Hence, this study intends to study proteinuria and assess whether it can serve as a reliable early indicator of systemic envenomation in snakebites. The objective of the study:To study the value of proteinuria as an early indicator of systemic envenomation in snakebite. Methodology: A Hospital-based Descriptive study was conducted in the Department of General Medicine, Santhiram Medical College, and General Hospital for six months after approval from the Hospital Ethics and Research Committee. Patients above 18 years presenting with an alleged history of snakebite were included in the study. Urine for proteinuria was tested using the dipstick method and followed up at 0, 6, 12, 18 and 24hours. A total of 60 patients were included in the study. Results: Out of 60 patients included in the study, the majority (64%) of the patients were in the age group of 18-50 years. The dorsum of the right foot was the most common site of bite amongst the patients. Proteinuria had a signicant correlation with deranged bleeding and renal parameters. Interpretation and conclusion- In the present study, it is evident that proteinuria was seen in patients with prolonged WBCT and deranged PT/APTT/INR, and it is observed that proteinuria appeared even before a clotting defect was detectable. Hence it would be of paramount importance to consider proteinuria as an indicator of systemic envenomation in snake bites.