Tuesday, November 20, 2012

A Rupture Uterus and a nagging Snake Bite . . .

Two patients bothered me as I woke up today morning. 

The first was SD, a lady with a rupture uterus. SD had a Cesarian section couple of years back. But, as has been the case with many of our other patients, nobody told her that her next one should also be an institutional delivery. We had lost our previous patient, AD with a rupture uterus following a previous Cesarian section. 

SD’s pain started early morning yesterday. She was being managed at home. They decided to take her to the nearest district hospital, where she reached at around 6 pm yesterday. From the district hospital, they asked her to be referred here.

SD reached NJH at around midnight. It was an obvious rupture uterus with a dead baby. And the family was so poor. They did not know what to do. Till morning they did not go anywhere. They did not know what it took to arrange blood. To make matters she was also in sepsis.

Sometime around morning, couple of our staff agreed to donate blood. And we proceeded with the surgery.

The mother is doing well. We hope she will recovery without problems.

The best part about SD was that she had a referral letter . . . 

The second patient I was quite concerned about was Loric Singh, who has been in the ventilator for more than couple of weeks. He was on the road to recovery till today morning, when he started to deteriorate because of which he had to be put once again into the ventilator. 

I was thinking aloud of whether it could be something else which bit him.

That was when the bystander told me that the type of krait which bit him was of a very poisonous nature. I told him that I thought all kraits were of the same type. Then he told me that the snake had been kept safe with the family back in his village. A very common custom in the region, where the snake is caught and kept alive till the victim is cured or dead.

I enquired if it is possible to bring the snake.

The snaps of the snake are below.

The villagers know this a ‘ghadait’ . . . a coarser version of ‘krait’. It is the elder of the krait . . .  a very old krait. Some claimed that it was a different species.

However, on closer examination, it is evident that it is a krait.

However, according to many of our staff from the villagers, it is commonly believed that a ‘ghadait’ bite is always fatal. One of the elderly villagers told me that he does not know anybody who has survived a ‘ghadait’ bite.

Something new . . .  An elderly krait has a more potent and lethal venom than an young krait . . .

Would appreciate your comments . .  .

1 comment:

  1. Dear Kuruvilla , no doubt about it that it is a Common Krait Snake. The unmistakable slender white bands up to the end of the tail is the feature of Common Krait . According to an article ( in Quarterly Review by Raptacoss & Brett Co. ) by the great Dr. Himmat S. Bawaskar C K are called Kali Gandait in Urdu.I am sorry that you cannot understand my Bengali Tutorial on C K . In Bengali , there are some folk lores on the fatality of CK bite , in Burdwan and Birbhum districts C K is called Domna snake. They say , " Yodi kaate Domna , aan tobe Khangna " ; this means , it anybody is bitten by a Domna snake , you have to arrange for digging the grave yard ( Khangna means the spade used for digging a grave yard ). I do use this flok lore as a mnemonic for my students to keep in mind that , the white bands are up to the end of the tail of the most deadly snake ( bite from which leads to END of life ).