Dinkar Prasad Singh, a 55-year-old is a farmer from Baraini Village in the Mirzapur district of Uttar Pradesh. He belongs to the Yadav community and has his own farm land and a few Jersey cows and other cattle. He is a heavy, obese man and weighs 106 kg. His family grows wheat and bajra (pearl millet) in their fields. He has 4 grown up children.
Bite incident: 13th June 2015. Dinkar and his sons were in a room that had beds spread across the room from wall to wall. At around 1.15 a.m. he felt a sharp pain on his left foot. He got up with a start and realized a cobra was biting him. The snake had to be yanked away. The family panicked. Dinkar was taken to the hospital on a motorcycle. As they were in a rush to take Dinkar to the hospital, they forgot about the snake.
It took around 30 minutes to reach Kachwa Christian hospital. By that time Dinkar’s vision had blurred and he had lost consciousness. The resident doctor, Dr Takemba Ao attended to this patient. At the time of the admission, he was GCS 3/15 – a condition in which only his heart was functioning. There were no other signs of life. Due to Dinkar’s obesity, it was difficult to intubate him. Dr Ao immediately put him on life support and started the first dose of ASV.
Dinkar regained consciousness only on the 5th day of the bite. However, he still needed respiratory support for another 3 days. Necrosis had set in on the local area from the 2nd day of the bite. Tissue damage was severe and spread to the dorsum of his foot. On the 9th day, he was taken off the respiratory support. He received a total of 23 vials of ASV. He was discharged after 18 days. He was later referred to BHU in Varanasi for further treatment of the necrotized area. The wound had festered and chances were his foot could be amputated. The wound needed expert management to ensure his didn’t suffer morbidity. Even today, 8 months after the bite, he does not have sensation on his foot and his left hand has a frozen arm syndrome. Total cost of treatment was Rs 2.5 lakhs (Rs 2,50,000)
What happened on the 19th day of the bite
On the night of the 19th day, a day after Dinkar was discharged from the hospital, he was sleeping on the same bed as on the night of the bite. The room was pitch dark. Around 1 a.m. Dinkar and his sons were awakened by a hissing sound. When they switched on the light, a spectacled cobra with its hood spread was seen right in front of the bed. We are not sure if it was the same snake that had bitten Dinkar. In a fit of rage, Gaurav, Dinkar’s 19-year-old son, chopped the snake in 2 pieces using spear like weapons they kept at home to ward off wild animals raiding the fields and also to guard against dacoity which is rampant in the region.
Deep seated beliefs in dogmas regarding snakes had made the family perform pujas etc. to ward off the curse (it’s a common belief in India that snakebite is a curse by the snake god). The author inspected Dinkar’s house and provided inputs on the changes that the family should make to guard against untoward incidences like snakebites. The room where the family slept had sacks of grains, a pot filled with water and miscellaneous items packed into it along with wall-to-wall beds. This was a perfect habitat for rodents. The gap between the house wall and the roof was almost 6 inches. This gap was not meshed and gave snakes and other animals easy access to the interior of the house. The author provided guidance on snakebite management and how to avoid being bitten in the first place.
To know more about snakebite management, do follow the below mentioned link
Written by Priyanka Kadam