International Journal of Medical Toxicology and Forensic Medicine

Background: This study evaluated the therapeutic efficacy and interactions of intravenous lipid emulsion (ILE) and ethanol in methanol toxicity, focusing on biochemical parameters, organ function, and histopathology.

Methods: Sixty-four male rats were assigned to seven groups: control, methanol, methanol + ethanol, methanol + ILE, methanol + ethanol + ILE, ethanol, and ILE. Methanol (4 g/kg) was administered orally, followed by ethanol (1 g/kg) an hour later. ILE (1.5 ml/kg) was given within 30 minutes of methanol ingestion, with two additional doses every six hours. After five days, blood and organ samples were analyzed.

Results: Ethanol significantly reduced ALT, AST, and ALP, while LDH was lowest in the methanol + ethanol + ILE group. Ethanol improved kid`ney function (p<0.001), whereas ILE alone increased creatinine. No significant differences were observed in 8-OHdG (p=0.572). Histopathology showed ethanol reduced liver congestion (p=0.0067), lung inflammation (p=0.0186), and congestion (p=0.0067). The combined therapy showed no significant advantage over ethanol alone.

Conclusion: Ethanol remains the most effective treatment, while ILE’s role appears complex and timing-dependent, warranting further investigation.

Background: Aluminum phosphide (AlP) exposure can cause fatal poisoning due to severe oxidative damage. The current study evaluated the effects of sodium bromide (NaBr), calcium carbonate (CaCO₃), and potassium nitrate (KNO₃) on ALP-induced cardiac and lung injuries and determined the oxidative stress markers.

Methods: Sixty-six male Wistar rats were allocated into 11 groups: Normal control, ALP group (40 mg/kg body weight AlP was administered by oral gavage), ALP + Low dose of CaCo₃, ALP + High dose of CaCo₃, ALP + Low dose of KNO₃, ALP + High dose of KNO₃, ALP + Low dose of NaBr, ALP + High dose of NaBr, High dose of CaCO₃, High dose of KNO₃, and high dose of NaBr.

Results: Administration of CaCO₃ and NaBr reduced ALT, MDA, and SOD levels and increased TAC levels in the serum and lung tissue.

Conclusion: CaCO₃ and NaBr may be promising and potential options for managing and treating AlP toxicity.

Background: In this work, a fingerprint powder was used to reveal latent fingerprints from different surfaces. This powder was derived from the Date fronds as activated carbon.

Methods: In preparing the activated carbon, three parameters were studied: activation time, activation temperature, and impregnation ratio. Fourier Transform Infrared Spectroscopy (FTIR) was used to characterize the prepared Date frond activated carbon (DFAC) as well as the raw material (Date frond plant). Brunauer-Emmett-Teller (BET) was used to measure the specific surface area of DFAC. The surface shape and the element composition of the prepared powder were investigated using (SEM-EDS) analysis. A Central Composite Design (CCD) was employed to determine the optimal preparation conditions and to elucidate the relationship between the studied parameters and the response (yield). Sodium acetate and mineral oil were added to the (DFAC) powder in five different concentrations to enhance the intensity of the expression, thereby revealing latent fingerprints.

Results: The results show that the best powder recipe was one with 20% sodium acetate and mineral oil, respectively. The Date frond activated carbon (DFAC) powder was compared with the commonly used importer powder (Sirchie) and tested for several surfaces. Additionally, the time of the latent fingerprints' presence on the surfaces was determined. It took fifteen days to notice the perfectly distinct fingerprint.

Conclusion: Activated carbon derived from Date fronds was successfully used to reveal latent fingerprints on various non-porous materials. The Date frond activated carbon (DFAC) powder showed good adherence to friction ridges and was more effective than the commercial Sirchie powder, DFAC demonstrated similar excellent results in displaying detailed fingerprint patterns. Enhancing the DFAC powder with sodium acetate and mineral oil improved the visualization intensity, with the optimal formula being 20% sodium acetate and 2% mineral oil.

Background: Hospitalized patients frequently experience hyperglycemia, and numerous studies have demonstrated a substantial correlation between the risk of complications and hyperglycemia, extended hospital stays, and mortality for both diabetic and nondiabetic patients. The significance of hyperglycemia extends to patients with non-critical illness, as previous research has demonstrated that glucose control in the intensive care unit improves clinical outcomes by lowering the risk of multi-organ failure, systemic infection, and death. For the mainstream of adult patients with critical illness, stringent blood glucose control has been advised based on some previous observational and interventional investigations.

Methods: A comprehensive search of the literature was performed, followed by screening and eligibility assessment of the retrieved studies. Relevant data were then extracted and synthesized systematically. Finally, the manuscript was prepared through structured scientific writing.

Results: However, the recently randomized controlled studies have demonstrated that assertive glycemic control, contrasting to traditional control, which targets high blood glucose levels, may not enhance clinical results and is associated with a high risk of hypoglycemia. For most intensive care unit (ICU) hyperglycemic patients, the American Diabetes Association (ADA) recommends a glucose level of 140–180 mg/dL after medication is started in 2025.

Conclusion: Research shows that planned subcutaneous insulin (basal, nutritional, and correctional) is favored over sliding-scale insulin alone in non-ICU settings; intravenous insulin is the norm for patients in the critical care unit.

Background: Cyanide is a highly toxic compound that can cause rapid death by inhibiting cellular respiration at the mitochondrial level. Although uncommon, cyanide poisoning presents a significant challenge in forensic medicine due to its fast onset, diagnostic difficulties, and legal implications.

Case Presentation: We report the case of a 24-year-old male who was brought to a hospital with sudden shortness of breath and was declared dead upon arrival. External postmortem examination revealed livor mortis, generalized rigor mortis, cyanosis of the lips and extremities, and dilated conjunctival vessels. Internal examination showed vasodilation in multiple organs, a wrinkled capsule in the spleen, and pulmonary congestion. A rapid screening using a food safety test kit yielded a positive colorimetric result for cyanide in the urine, with an estimated concentration of 0.007–0.010 mg/dL. Biological samples were collected and submitted for confirmatory toxicological analysis. Postmortem toxicological testing confirmed the presence of cyanide in the brain and gastric contents. A rapid screening test indicated cyanide in urine, though this was not confirmed on subsequent laboratory analysis.

Conclusion: The findings support a diagnosis of acute oral cyanide poisoning. This case highlights the importance of timely forensic investigation, proper sample handling, and the utility of rapid screening tools in suspected poisoning deaths. Confirmatory laboratory analysis remains essential for accurate diagnosis and legal interpretation.

Background: Disorders of Sex Development (DSD) encompass a range of congenital conditions involving discordance between chromosomal, gonadal, and phenotypic sex. One complex presentation involves phenotypically female individuals with a 46, XY karyotype, raising differential diagnoses such as Complete Androgen Insensitivity Syndrome (CAIS), Swyer syndrome, and Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome.

Case Presentation: A 22-year-old individual raised as female presented with primary amenorrhea. Physical examination showed Tanner stage 3 breast and pubic hair, absent vaginal introitus, and no palpable uterus. Pelvic MRI revealed agenesis of the uterus, cervix, and upper vagina, with bilateral intrapelvic gonads initially resembling ovaries. Hormonal tests showed elevated testosterone (88.67 nmol/L), high LH (30.8 mIU/mL), and low-normal estradiol (23.6 pg/mL). Karyotyping confirmed 46, XY. Despite initial imaging suggesting MRKH, the hormonal and chromosomal findings supported CAIS. Multidisciplinary assessments, including psychiatry and forensic medicine, affirmed a consistent female gender identity. The patient declined surgical intervention and was referred for long-term follow-up.

Conclusion: This case highlights the importance of integrating clinical, hormonal, radiologic, and genetic data to distinguish among 46, XY DSD etiologies. Accurate diagnosis is essential not only for guiding medical management but also for supporting gender identity and psychological well-being. In CAIS, gender-affirming, individualized care and long-term support are crucial for optimal health outcomes.

Background: Rat poisoning is often used as a method of murder in Indonesia.

Case Presentation: In this case, a woman died from bromadiolone intoxication caused by her ex-husband. Bromadiolone is an anticoagulant poison that works by inhibiting the action of vitamin K, causing bleeding and damage to central nervous cells as it reduces the carboxylase in the brain, causing lowered sulfatide synthetase, which is important in forming myelin sheaths.

Conclusion: Triad of asphyxia was found in external examination, and the widening of vessels as a sign of toxic encephalopathy was found in the examination. Bromadiolone was found in the remains of melon juice drunk by the victims.