02001nas a2200253   4500000000100000008004100001653003900042653001400081653002400095653001500119100001300134700001200147700001400159700001500173700001300188700001600201700001400217700001100231245012500242300001000367490000800377520134800385022001401733       2010                            d10aNeglected tropical diseases (NTDs)10asnakebite10aSystemic envenoming10aBangladesh1 aHarris J1 aFaiz MA1 aRahman RM1 aJalil MM A1 aAhsan MF1 aTheakston D1 aWarrell D1 aKuch U00aSnake bite in Chittagong Division, Bangladesh: a study of bitten patients who developed no signs of systemic envenoming.  a320-70 v1043 a<p>The demographics, epidemiology, first aid, clinical management, treatment and outcome of snake bites causing no significant signs of systemic envenoming were documented in Chittagong Medical College Hospital, Bangladesh, between May 1999 and October 2002. Among 884 patients admitted, 350 were systemically envenomed and 534 were without signs of either systemic or significant local envenoming. The average age of patients with physical evidence of snake bite but no systemic envenoming was 26.4 years. Most had been bitten on their feet or hands. Ligatures had been applied proximal to the bite site in &gt;95% of cases and the bite site had been incised in 13%. Patients were typically discharged at 24h. Those with clinical signs of systemic envenoming resembled the non-envenomed cases demographically and epidemiologically except that they arrived at hospital significantly later than non-envenomed patients, having spent longer with traditional healers. No non-envenomed patient was treated with antivenom and none went on to develop symptoms of systemic envenoming after discharge. The potential complications and confusing signs caused by ligatures and incision demand that all patients admitted with a history of snake bite be kept under observation for 24h after admission even if they have no signs of systemic envenoming.</p>
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