Abstract

Snake bite is considered as one of the medical emergency, either hemotoxic, neurotoxic, cytotoxic or a combination of these. The consequence of envenomation can range from minimal local tissue injury to multi-organ dysfunction. It is suspected that snake venom functions as an acute-phase reactant and interacts with target cells such as macrophages that release inflammatory mediators such as IL(Interleukin)-6 and 8. IL6 is believed to act on the liver, increasing acute phase reactants' production like c-reactive protein, ESR, serum amyloid, haptoglobin, etc¹. Hemolysis, a typical manifestation of snake bite is thought to generate phospholipase, an essential component of snake venom. Serum lactate dehydrogenase (LDH) levels found to be associate well with snake venom hemotoxicity and snake bite envenomation severity². The ability to detect grade of envenomation at presentation is that of challenge and novel markers for the same would be a good guide for treatment as well at prognosis. Snakes are categorized into four families; these are  Elapidae, Hydrophidae, Atractaspididae and Viperidae. In Indian  subcontinent major families found to be  Elapidae, which includes Common cobra, king cobra  and  krait,  Viperidae  that includes Russells viper, Pit viper and Saw-scaled viper and Hydrophidae.³

Of the 70 poisonous species in India majority of bites and consequent mortality is attributable to 5 species which are King Cobra (Ophiophagus Hannah), Common Cobra (NajaNaja), Russells viper (Daberia Ruselli), Saw-Scaled viper (Echis Carinatae) and Krait (Bungarus Caeruleus).³