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A killer released from a psychiatric hospital with the all-clear decapitated an 18-month-old baby relative with a knife and brandished the severed head in a public street, eyewitnesses say.
Mikhail Elinsky, 42, also stabbed his niece - the dead girl's mother - resulting in serious abdominal injuries.
A video shows him repeatedly taunting officers with a knife and refusing to give himself up.
He was eventually shot by police and taken to a hospital in Astrakhan, Russia, where he later died.
The man's niece Tatiana had earlier pleaded with the authorities not to release him from psychiatric hospital, fearing he remained a danger after he had killed a woman six years ago.
She desperately tried to save her daughter Natalia but was was stabbed as she came close to the kitchen where Elinsky was butchering the child.
Eyewitness Anastasiya Miloserdova said: "The little girl was his niece, and his mother had begged not to let him out of the mental clinic.
"And look how it ended - he ran around the area with the cut off head of the little one."
Tatiana said: "We were about to go out, and my daughter was sitting on her tricycle.
"He pulled her off, grabbed her and took her to the kitchen.
"He closed the door and began to cut her.
"I tried to stop him and ran to the kitchen but he stabbed me in the stomach with his knife."
Her husband Igor was too grief-stricken to speak.
A local report said the man "ran around the street holding up her head...
"It took police half an hour to detain the man. He was taken to the hospital with three gun wounds."
Law enforcement have confirmed the knifeman killed the child, wounded the mother and that he died of gun shot wounds in hospital.
Six years ago, the knifeman had killed a female shop assistant in the same city, repeatedly stabbing her with a knife in a drunken rage.
He was diagnosed with paranoid schizophrenia and sent by a judge to a high security hospital for treatment.
The man was released recently as "healthy", it was reported.
Tatiana's work colleague Viktoria Mikhaylova said: "It is such a horror.
"I worked with this woman.
"Her daughter was slightly younger than my son.
"It was done by her uncle, he got drunk and did this.
"She had been so happy when her daughter was born. She also has a son.
"Rest in peace, little girl."
The knifeman's mother Valentina Elinskaya said her son had complained about the noise in the family home made by the girl and her four-year-old brother who was unharmed.
"So he stabbed the little girl, who is his grand niece. Her mother is his niece," she said.
"His mood changed two days ago and that was it.
"He was walking around and thinking about something."
A local police source said: "Nobody warned us about this man.
"Nobody sent us any information about him.
"It happens in our country.
"There were no reports to us he was about to be released."