Introduction: Death by hanging may be suicidal, accidental or homicidal. General external appearances, local external neck findings, neck autopsy and neck histological changes play a major role in differentiation between types of hanging. Aims & Objectives: Differentiation among suicidal, homicidal and accidental hanging by using different diagnostic methods including naked eye examination, neck autopsy, examination of neck structure, and histopathological features of the neck structures at the ligation mark site. Subjects and Methods: the study was carried out from March 2018 to March 2019, with 36 cases of deaths due to hanging divided into: Group 1 (18 cases): suicidal hanging, Group 2 (13 cases): homicidal hanging and Group (5 cases): accidental hanging. A thorough external and internal examination of neck structure was performed in all the cases. Results: Suicidal hanging, associated with female sex, was detected in 57.1% of cases. Homicidal and accidental hanging, significantly associated with skin hemorrhage, was detected in 80% of cases. Microscopic examination: Breaking, wrinkling and compression of the skin along with micro hemorrhages in the subcutaneous tissues were notified more commonly with homicidal hanging. Conclusion: The examination of corpse in hanging cases becomes easy by correlating current observation with the autopsy finding. The correlation of external, internal and microscopic findings leads to easy formulation of final opinion of these cases. It also, to some extent helps to differentiate between types of hanging.

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Background: Postmortem redistribution (PMR) is the changes that occur in drug concentrations after death. Lidocaine is the most popular local anesthetic used worldwide and midazolam is a widely used pre-anesthetic anxiolytic and sedative. Aim of the Work: This work was performed to study potential early phase postmortem redistribution of lidocaine and midazolam, as well as, the influence of storage temperature on it in adult albino rats. This was done by measuring their concentrations in blood (cardiac blood and external iliac vein blood) and tissues (heart, lungs and liver). Calculation of cardiac blood to peripheral blood ratio (C/P) and Liver to peripheral blood ratio (L/P) was performed. Materials and Methods: This study was carried out on 36 adult male albino rats which divided into two main groups (18 rats each). Group I (Lidocaine): Rats received a single SC injection of 2% lidocaine HCL (67 mg/kg), and sacrificed 30 minutes later. This group was subdivided into three equal groups; AM control (L-AM), 15 minutes PM at 4ºC (L-PM4) and 15 minutes PM at 21ºC (L-PM21). Group II (Midazolam): Rats received single IV injection of midazolam (75 mg/kg), and sacrificed 30 minutes later. This group was subdivided into three equal groups; AM control (M-AM), 15 minutes PM at 4ºC (M-PM4), 15 minutes PM at 21ºC (M-PM21). Results: There were significant changes in lidocaine and midazolam concentrations in both tissues and blood samples as compared to those of corresponding AM control groups. Markers of PMR revealed early phase PMR of lidocaine by L/P ratios > 20 at 21 ºC. Storage temperature at 4ºC arrested lidocaine PMR as recorded by both C/P ratios < 1 and L/P ratios < 5. Midazolam was prone to postmortem degradation that interfered with PMR assessment. Midazolam revealed minimal early phase postmortem redistribution as demonstrated by C/P ratios just above 1 at 4 ºC. L/P ratio was a more reliable marker for PMR than C/P ratio. Conclusion: Lidocaine was highly liable to undergo early phase PMR as demonstrated by L/P ratios above 20 at 21 ºC. However, storage at 4ºC retarded lidocaine PMR. Midazolam was subjected to postmortem degradation and had minimal early phase PMR as demonstrated by C/P ratios just above 1 at 4 ºC. Recommendation: it is recommended to increase forensic toxicologists' awareness about PMR of lidocaine and midazolam, and their influence on the interpretation of PM toxicological analysis.

This study investigated the hemato- and genotoxic effects of formaldehyde (FA) and the possible mitigating role of hesperidin (HP) and N-acetylcysteine (NAC), each alone and in combination. Sixty-four adult male albino rats were divided into eight equal groups; the study was conducted for 8 weeks; Group I (negative control: received no medication), Group II (positive control: received distilled water), Group III (received HP 50 mg/kg/day), Group IV (received NAC 50 mg/kg/day), Group V (received FA 10 mg/kg/day), Group VI (FA + HP), Group VII (FA + NAC), and Group VIII (FA + HP + NAC). Groups VI, VII, VIII received the same previously mentioned doses and for the same duration. All treatments were given by intraperitoneal administration. At the end of the study, complete blood count, oxidative stress, histopathological changes, immunohistochemical staining of inducible nitric oxide synthase, and proliferating cell nuclear antigen and genotoxicity by comet assay in the bone marrow of treated rats were assessed. FA administration caused significant hematotoxicity represented by elevated white blood cell numbers and serum malondialdehyde levels and reduced red blood cell numbers, platelets, and serum superoxide dismutase values. Histologically, it induced an increase in fat cell numbers in bone marrow tissue with a widening of marrow spaces and decreased cellularity of hematopoietic cells, megakaryocytes, and granulocytes. FA exposure significantly decreased immunoreactivity for proliferating cell nuclear antigen, whereas the immunoreactivity for inducible nitric oxide synthase was increased. Genotoxicity, as measured by comet assay, revealed a significant increase in comet% and tail length in FA-treated group when compared with other groups. The cotreatment with HP and NAC revealed their ability to protect against hematological changes, oxidative damage, histopathological, and immunohistochemical changes, and genotoxicity induced by FA.