TY  - JOUR
PY  - 2019//
TI  - Characteristics and relative numbers of lethal snake bite cases in medicolegal practice in central Myanmar - A five year study
JO  - Journal of forensic and legal medicine
A1  - Thein, Chan Myae
A1  - Byard, Roger W.
SP  - 52
EP  - 55
VL  - 63
IS  - 
N2  - Clinical and pathological case files of lethal snakebites were reviewed from the XXXX, Magway, Myanmar, over a five-year period (January 2013 December 2017). A total of 2069 postmortem examinations were performed which included 84 cases of lethal snake bite (4.1%). The annual numbers ranged from 10 out of a total of 268 autopsies in 2013 (3.7%), to 31 out of a total of 501 autopsies in 2016 (6.2%). There were 54 males (64%) and 30 females (36%) (M:F = 1.9:1; age range 5-75yrs, mean 33yrs). The most common time for lethal envenomation was August (16/84-19%), the middle of the monsoon season. 45/84 (54%) had acute renal failure, 27/84 (32%) were shocked, and the remaining 12/84 (14%) had disseminated intravascular coagulation. Twenty cases (24%) died within 24 h after envenomation. Fang marks were identified on the legs (either right or left) in 73/84 cases (87%) and on the arms in five cases (6%). The predominant findings at autopsy were of acute renal injury (82/84-98%), pituitary haemorrhage/necrosis (36/84-43%), and adrenal gland haemorrhage (30/84-36%). Despite the reduction in fatalities over the years snakebite from Russell's viper in particular remains an important contributor to mortality in central Myanmar despite the availability of antivenom.<br><br>Copyright © 2019. Published by Elsevier Ltd.<p />  <p>Language: en</p>
LA  - en
SN  - 1752-928X
UR  - http://dx.doi.org/10.1016/j.jflm.2019.03.005
ID  - ref1
ER  -