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Type: Journal article
Title: Characteristics and relative numbers of lethal snake bite cases in medicolegal practice in central Myanmar - a five year study
Author: Thein, C.
Byard, R.
Citation: Journal of Clinical Forensic and Legal Medicine: an international journal of forensic and legal medicine, 2019; 63:52-55
Publisher: Elsevier
Issue Date: 2019
ISSN: 1752-928X
Statement of
Chan Myae Thein, Roger W. Byard
Abstract: Clinical and pathological case files of lethal snakebites were reviewed from the Magway Region General Hospital, Magway, Myanmar, over a five-year period (January 2013 December 2017). A total of 2069 post-mortem 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.
Keywords: Snake bite; Myanmar; forensic; death; Russell's viper
Rights: © 2019 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.
DOI: 10.1016/j.jflm.2019.03.005
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