a study of the dermatoglyphic pattern in diabetic and
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A STUDY OF THE DERMATOGLYPHIC PATTERN IN
DIABETIC AND ESSENTIAL HYPERTENSIVE
SUBJECTS IN KALABURAGI DISTRICT
By
Dr. MOHD IBRAHIM PASHA
Dissertation Submitted to the
Rajiv Gandhi University of Health Sciences, Karnataka, Bangalore
In partial fulfillment
of the requirements for the degree of
DOCTOR OF MEDICINE In
ANATOMY
Under the Guidance of
Dr.V.B. NANDYAL M.S., F.I.A.S
Professor & HOD
Department of Anatomy
DEPARTMENT OF ANATOMY
M.R. MEDICAL COLLEGE, KALABURAGI-585 105
2016
ii
RAJIV GANDHI UNIVERSITY OF HEALTH
SCIENCES, KARNATAKA, BANGALORE
DECLARATION BY THE CANDIDATE
I hereby declare that this dissertation entitled “A STUDY OF THE
DERMATOGLYPHIC PATTERN IN DIABETIC AND ESSENTIAL
HYPERTENSIVE SUBJECTS IN KALABURAGI DISTRICT” is a
bonafide and genuine research work carried out by me under the guidance of
Dr.V.B. Nandyal, Professor & HOD, Department of Anatomy.
Date:
Place: KALABURAGI. Dr.MOHD IBRAHIM PASHA
iii
RAJIV GANDHI UNIVERSITY OF HEALTH
SCIENCES, KARNATAKA, BANGALORE
CERTIFICATE BY THE GUIDE
This is to certify that the dissertation entitled “A STUDY OF
THE DERMATOGLYPHIC PATTERN IN DIABETIC AND
ESSENTIAL HYPERTENSIVE SUBJECTS IN KALABURAGI
DISTRICT” is a bonafide research work done by
Dr. MOHD IBRAHIM PASHA in partial fulfillment of the
requirement for the degree of DOCTOR OF MEDICINE in ANATOMY.
Date:
Place: KALABURAGI. Dr.V.B. NANDYAL
M.S., F.I.A.C
Professor & HOD
Department of Anatomy
iv
RAJIV GANDHI UNIVERSITY OF HEALTH
SCIENCES, KARNATAKA, BANGALORE
ENDORSEMENT BY THE HOD, PRINCIPAL/
HEAD OF THE INSTITUTION
This is to certify that the dissertation entitled “A STUDY OF
THE DERMATOGLYPHIC PATTERN IN DIABETIC AND ESSENTIAL
HYPERTENSIVE SUBJECTS IN KALABURAGI DISTRICT” is a
bonafide research work done by Dr.MOHD IBRAHIM PASHA under
the guidance of Dr.V.B. NANDYAL, Professor & HOD, Department of
Anatomy.
Dr.V.B. NANDYAL. Dr. SAINATH K. ANDOLA M.S., F.I.A.S M.D, DCP, FICP, FIAMS, MIAC.
Professor & HOD Principal
Department of Anatomy M.R. Medical College,
M.R. Medical College, KALABURAGI
KALABURAGI
Date: Date:
Place: KALABURAGI. Place: KALABURAGI
v
COPYRIGHT
DECLARATION BY THE CANDIDATE
I hereby declare that the Rajiv Gandhi University of
Health Sciences, Karnataka shall have the rights to
preserve, use and disseminate this dissertation/ thesis
in print or electronic format for academic/ research
purpose.
Date:
Place: KALABURAGI. Dr.MOHD IBRAHIM PASHA
© Rajiv Gandhi University of Health Sciences, Karnataka
vi
ACKNOWLEDGEMENT
It is my privilege to express my deep sense of gratitude and thankfulness. I
express my indebtedness to my guide Dr.V.B Nandyal, Professor& HOD, Department
of Anatomy, Dr. S.S. Imran Associate Professor, Department of Anatomy, who has
been a fountain head of inspiration. I thank my professor with utmost sincerity for the
affection and kindness he has shown towards me and for the valuable support he has
given to me throughout my PG course.
I owe deep sense of gratitude towards my revered teachers in the Department
of Anatomy, for their valuable guidance, constant encouragement, expert suggestions
and timely help during their busy schedule and testing circumstances to overcome the
obstacles and difficulties and without them this work would not have been a reality.
I thank Dr.Sainath K. Andola, Dean, M.R. Medical College for encouraging
and securing me all the required facilities for the work.
I express my humble gratitude to Dr.Sarita Sylvia, Associate Professors, and
Assistant Professor Dr.Archana Hatti, Dr.Sangeeta Patil and Dr. Sharada for their
motivation and constructive ideas during the study.
I express my humble gratitude to Dr. Shrishail Goli who is expert Statistician
in SPM Department, M.R. Medical College, Kalaburagi for his selfless guidance.
I am thankful to all my post graduate colleagues and undergraduate students
for their contributions and help. I also would like to thank the non teaching staff of
Dept of Anatomy for their help.
Date:
Place: KALABURAGI. Dr.Mohd Ibrahim Pasha
vii
LIST OF ABBREVIATIONS
UL ............................ Ulnar loop
RL ........................ Radial loop
atd rt ...................... atd angle right side
atd lt ...................... atd angle left size
TFRC..................... Total finger ridge count
AFRC .................... Absolute finger ridge count
a-6 RC rt .................. a-b ridge count right side
a-b RC lt ................... a-b ridge count right side
M .............................. Male
F. ............................. Female
T2DM ................... Type-2 diabetes mellitus
HTN ...................... Hypertension
viii
ABSTRACT
Background and objectives:
Dermatoglyphics is the scientific study of epidermal ridges and their
configurations on the palmar region of hand and fingers and plantar region of foot and
toes. Diabetes mellitus is a metabolic disorder characterized by hyperglycemia
resulting from defect in insulin secretion, action or both. Essential hypertension is the
category of hypertension that has no identifiable cause, it is associated with aging and
inherited genetic factors. Positive family history increases the risk. Dermatoglyphic
patterns are genetically determined and can be used as supportive for diagnosis of
various hereditary disorders including T2DM and essential hypertension. This study
was carried out to compare palmar dermatoglyphic pattern in T2DM,essential
hypertension and control group and compare with previous studies.
Method:
A hospital based case control study was conducted 100 cases of T2DM and
100 essential hypertensive patients are taken from Basaweshwar hospital Gulbarga,
and another 100 persons are included as control group. The palms and fingers are
smeared with ink to bring out the dermatoglyphiic patterns which were subsequently
studied.
Result:
There was increased number of whorls and decreased number of ulnar loops in
both T2DM and essential hypertensive patients compared with normal individuals.
Total finger ridge count and Absolute finger ridge count is increased in both T2DM
and Essential hypertension patients and there is also increased atd angle.
Conclusion;
ix
The knowledge of dermatoglyphics in patients with T2DM and essential
hypertension can be utilized to find out genetic correlation. The existence of such
relation might be important for the screening programme for prevention of T2DM and
essential hypertension.
Key words: dermatoglyphics,T2DM and essential hypertension.
x
LIST OF CONTENTS
1. Introduction ...................................................................... 1-2
2. Objectives ...........................................................................3
3. Review of Literature ...................................................... 4-28
4. Materials and Methods ................................................ 29-32
5. Results .......................................................................... 33-48
6. Discussion .................................................................... 49-51
7. Conclusion .........................................................................52
8. Summary ...........................................................................53
9. Recommendation ...............................................................54
10. Bibliography ................................................................ 55-59
11. Annexure ...................................................................... 60-83
Proforma
Master Chart
xi
LIST OF TABLES
Sl
No. Particulars
Page
No.
1. Sex wise distribution of study samples 33
2. Comparison of palmer dermatoglyphic pattern of right and left in
control group 34
3. Comparison of palmer dermatoglyphic pattern of right and left in dm
group 35
4. Comparison of palmer dermatoglyphic pattern of right and left in
hypertension group 36
5. Comparison of right palmer dermatoglyphic pattern between dm group
and control group 37
6. Comparison of left palmer dermatoglyphic pattern between dm group
and control group 38
7. Comparison of palmer dermatoglyphic pattern between dm group and
control group 39
8. Comparison of right palmer dermatoglyphic pattern between
hypertension group and control group 40
9. Comparison of left palmer dermatoglyphic pattern between
hypertension group and control group 42
10. Comparison of palmer dermatoglyphic pattern between hypertension
group and control group 44
11. Comparison of right palmer dermatoglyphic pattern between dm group
and hypertension group 45
12. Comparison of left palmer dermatoglyphic pattern between dm group
and hypertension group 46
13. Comparison of palmer dermatoglyphic pattern between dm group and
hypertension group 47
14. Total number of dermatoglyphics pattern on right and left hand 48
xii
LIST OF FIGURES
Fig
No. Particulars
Page
No.
1. The development of epidermal ridges 10
2. Fingers print pattern 16
3. Triradii 18
4. Palmar pattern configurations 19
5. Palmar Flexion creases 21
6. Simian crease & Sydney line 22
7. Palm patterns 23
8. Ridge counting in figure patterns 25
9. Method of measuring atd angle 27
10. (A) Lens (B) Protractor (C) Stamp Pad (D) Ink bottle
(E) Observers hand (F) Patients hand 31
11. (A) Ink bottle (B) Lens (C) Stamp Pad (D) Protractor
(E) Gloves 32
xiii
LIST OF GRAPHS
Graph
No Particulars
Page
no
1 Multiple bar diagram represents sex wise distribution of
samples
33
2 Multiple bar diagram represents comparison of palmer
dermatoglyphic pattern of right and left in control group
34
3 Multiple bar diagram represents comparison of palmer
dermatoglyphic pattern of right and left in dm group
35
4 Multiple bar diagram represents comparison of palmer
dermatoglyphic pattern of right and left in hypertension group
36
5 Multiple bar diagram represents comparison of right palmer
dermatoglyphic pattern between dm group and control group
37
6
Multiple bar diagram represents comparison of left palmer
dermatoglyphic pattern between dm group and control group
38
7
Multiple bar diagram represents comparison of palmer
dermatoglyphic pattern between dm group and control group
39
8
Multiple bar diagram represents comparison of right palmer
dermatoglyphic pattern between hypertension group and
control group
41
9 Multiple bar diagram represents comparison of left palmer
dermatoglyphic pattern between hypertension group and
control group
43
10 Multiple bar diagram represents comparison of palmer
dermatoglyphic pattern between hypertension group and
control group
44
11 Multiple bar diagram represents comparison of right palmer
dermatoglyphic pattern between dm group and hypertension
group
45
12 Multiple bar diagram represents comparison of left palmer
dermatoglyphic pattern between dm group and hypertension
group
46
13 Multiple bar diagram represents comparison of palmer
dermatoglyphic pattern of TFRC and AFRC between dm
group and hypertension group
47
1
INTRODUCTION
Dermatoglyphic is the scientific study of epidermal ridges and their
configuration on the palmar region of hand and fingers and plantar region of foot and
toes1.The term dermatoglyphic was coined by cummins and midlo in 1926 and was
derived from Greek words ‘Derma’ means skin and ‘glyphics’ means Carvings2.
Dermatoglyphics can be traced back to 1892 when one of the most original
biologists of his time Sir Francis Galton, a cousin of charles Darwin, published his
work on fingerprints (The study was later on termed as dermatoglyphics by Dr.
Horald Cummins)3.
Papillary ridges are confined to the palms and the soles and the flexor surfaces
of the digits, where they form narrow parallel or curved arrays separated by narrow
furrows. The epidermal ridges correspond to on underlying interlocking pattern of
dermal papillae, an arrangement which helps to anchor the two layers firmly together.
The pattern of dermal papillae determines the early development of epidermal ridges.
This arrangement is stable throughout life, unique to the individual, and therefore
significant as a means of identification4.
From cradle to grave, ’Hastarika’ the science of palmistry, is a legacy
bequeathed to humanity by ancient seers and saint of India. The roots of this science
can be traced to the Ancient East-according to kunagusu Minakatas notes in nature.
Chinese records mention the use of fingerprint is very ancient times of india. Ancient
system of Indian palmistry called ‘Samudrik Mudr’ classified ridge patterns into
padma (lotus) Sankha (conch shell) and chakra(wheel).These objects are also found
expressed on the palms, soles and digits of the sculptured images of lord Buddha,
which is in Indian museum at Calcutta. Bidloo provided a description of ridge detail
in the seventeenth century. Since then, additional information have been added by
anthropologist, biologists, geneticists, and anatomists5.
2
During the last century, the fact that each individuals ridge confirmation are
unique has seen utilized as a means of personal identification especially by law
enforcement officials widespread medical interest in epidermal ridges developed only
in the last few decades when it became apparent that many patients with chromosomal
abbreviation had unusual patterns. Inspection of skin ridges therefore promise to
provide a simple, inexpensive means of information to determine whether a given
patient could have a particular chromosomal defect. Geneticists were able to
demonstrate that inheritance of dermal ridge configuration depended on multiple gene
effect6.
There are many diseases known to be caused by abnormal genes. Whenever
there is any abnormality in the genetic makeup of parents, it is inherited to the
children and is reflected in dermatoglyphic pattern7.
Diabetes has a strong hereditary background offspring of two Diabetic parents
have an 80% lifetime risk of Diabetes8. The peculior pattern of the epidermal ridges
serve as diagnostic tool in a number of diseases that have a strong hereditary
background. DM is one such disease with a strong genetic basis.9
In the present study finger and palmer dermatoglyphic pattern in diabetes and
essential hypertension and are compared with controls. An attempt is made to
determine the significant dermatoglyphic parameter criteria in DM an HTN patients
which can be used in Diagnosis Mellitus and essential Hypertension.
3
AIMS AND OBJECTIVES
1. To Study the Palmar Dermatoglyphic pattern in the patients of Diabetes
Mellitus and essential hypertension
2. To compare our present findings with previous studies.
3. To find out, whether the specific dermatoglyphic trait exist in the patients of
Diabetes mellitus and essential hypertension and whether it is significant.
4. To co-relate the findings and bring about an awareness in the people in this
regard.
4
REVIEW OF LITERATURE
A HISTORICAL REVIEW:
Dermatoglyphics sterms from the ancient art of palmistry, which was
practiced from time immemorial and is still followed throughout India by the Joshi
caste. There appears to exist an extremely old volume, on the markings on the hands
possessed and treasured by the Hindus. From here, this art has spread throughout the
world.
From the Greek civilization “cheir”, the hand was studied in depth.
Anaxogoras taught and practiced it in 423BC.This study was sanctioned by Aristotle
and other great minds like pliny. In Aristotle’s writings it was found,” the hand is the
organ of organs, the active agent of the passive powers of the entire system10
.
The most famous of ancient finger print designs carvings on the wall of
Neothalic burial passage, situated on the island of Brittany in France, its inner walls
are covered with incised designs of circular patterns, spirals, arches, sinuous and
straight lines occurring on various combinations11
. In ancient time, finger prints were
used on pottery to indicate the marker and brand of pottery. In ancient days Arryria,
finger prints served as a seal to give authenticity to documents of importance. They
appeared in clay tablets, now treasured in British Museum12
.
An aboriginal Indian carving was found at the edge of kejimkoojir lake in
Novascotia in Canada, where within the outlines of human hand carved in stone
showed lines which represented dermatolgyphics and flexions creases.
5
Sir William Herschel, a collector in Bengal(1858) was the first person to take
finger and hand prints of a contractor which is still preserved in museum of London.
He used the system for identification of criminals12
.
The Chinese seal were made before third century B.C which showed recording
of an identifying finger print in clay that would have been attached to some
documents, letters or packages. In china in 16th
Century, De Barras mentioned a
custom of recordings ink prints of finger on the deeds of sale13
.
Thomas Bewick an author, from Northumberland in England was wood
engraver, naturalist, made wood engravings of patterns of his own fingers. It is
evident, that he was among the few person of his time who was known to have exact
knowledge of dermatoglyphics14
.
EARLY SCIENTIFIC RECORDS:
A scientific recognition of dermatoglyphics was made long before the first
written records concerning them. A division cannot be set between what may be
rightly considered as scientific knowledge of dermatoglyphics and the primitive
knowledge. The evidence for this is the aboriginal who carved the on a rock in Nova
Scotia may have been as truly scientific in spirit and method as author of technical
article or book.15
In the later years of the 17th
century scientific interest in ridged skin aroused.
Mehemiah Grewin in 1684 presented before the Royal society in London, his
description regarding the sweat pores, the epidermal ridges and their arrangements,
and also presented a drawing showing the configurations of one hand. Later in 1685,
6
his books on human anatomy ‘Bidloo’ included an account on epidermal ridges on the
thumb16
.
In the following year in 1686, Malphigi briefly described the configuration on
the fingers17
. In the eighteenth century, Hintz did several works in dematoglyphics. In
1747 Hintz, Albinus, Mayer were the scientists to describe papillary ridges of the
feet18
.
In the early years of nineteenth century, Purkinje classified finger patterns in
nine configurations of Rugae and Sulci on the terminal phalanges of the hand. Sir
Francis Galton, in 1890 pointed out that complex pattern of parallel ridges and
furrows remain unchanged throughout life, these qualities make finger prints a
real means of persomal identification19
.
Dermatoglyphics has been increasingly studied to establish its worth in
clinical medicine. Interest in the study of skin ridges in relation to clinical medicine
aroused as early as in the later part of 17th
century, but due to absence of suitable
classification progress in the study was slow.
Systematic classification of the ridge pattern in the palms, fingers, and soles
was done by Sir Francis Galton in 1892. He placed the subject which we now know as
dermatoglyphics on good scientific basis. Harold Cummins started making use of
palms, fingers ridges in clinical medicine. In 1936 he reported that patients with
Downs syndrome showed characteristic dermatoglyphics patterns20
.
Holt reported that the total ridge count was controlled by cumulative effect of
genes. Abnormal dermatoglyphics has been established in Trisomy 13 and 18 by Holt.
It is established that dermatoglyphic patterns are under genetic control. There are
reports of finger and palm print studies in inherited chromosomal disorders such as
7
Wilson’s disease, Mental Retardation, Leukemia, Congenital heart disease and Indian
Childhood cirrhosis21.
EMBRYOGENESIS OF DERMAL RIDGES
Dermal ridge differentiation takes place early in fetal development. The
resulting ridge configurations are genetically determined and influenced by
environmental forces. The ultimate epidermal ridge patterns of an adult are found to
be closely related to the fetal volar pads, since these ridge patterns form at the sites of
these pads.
Fetal volar pads are mound-shaped elevations of mesenchymal tissue, situated
above the proximal end of the most distal phalangeal bone on each finger, in each
interdigital area, in the thenar and hypothenar areas of the palms and soles, and in
the calcar area of the sole.The formation of these pads is first visible on the
fingertips during sixth to seventh week of embryonic development.The pads become
very prominent during the subsequent several weeks, diminish again in the fifth
month and disappear completely in the sixth month. The presence of volar pads, as
well as their size and position are responsible for the configuration of papillary ridge
patterns14.
4-6 weeks: Early lines develop; arm buds appear, hands, feet develop, digits separate.
6-8 weeks: Pads appear in the following order--- III, IV interdigital areas, central
palmar, digital apical, thenar, hypothenar paired proximal phalanges.
10-12 weeks: Beginning of pad regression, ridges develop at dermo-epidermal
junction.
13 weeks: Ridge formation, identifiable configurations on skin surfaces.
8
21 weeks: Definite patterns are completed by this time.
The epidermal ridge patterns are completed only after the sixth prenatal
month, when the glandular folds are fully formed and after the sweat gland secretion
and keratinization have begun. At this time, the configurations on the skin surface
begin to reflect the underlying patterns. The surface epidermal furrows correspond to
the furrow folds of the stratum germinativum and each epidermal ridge is formed
above a glandular fold. Ridge differentiation progresses from the apical pads
proximally and in a radioulnar or tibio-fibular direction. The embryogenesis of the
epidermal ridges on the feet is identical to that on the hands, except that each step
occurs 2 or 3 weeks later.
Several hypothesis have been formulated concerning the forces that are
responsible for the development of specific ridge patterns. It was speculated that the
dermal ridge configurations were the result of physical and topographic growth
forces22
. It is believed that the tensions and pressure in the skin during early
embryogenesis determine the directions of the epidermal ridges. Some workers
believed that the finger tip pattern depended on the underlying arrangement of
peripheral nerves, while others suggested that the ridges followed lines of greatest
convexity in the embryonic epidermis.
The present knowledge concerning the induction of glandular folds and in
turn, the formation of epidermal ridges was summarized based on observations made
in the arrangement of the blood vessel- nerve pairs under the smooth epidermis
corium border which exists shortly before the formation of the glandular folds23
. It has
been proved that inadequate supply of oxygen to the tissues, deviations in the
formation and distribution of sweat glands, disturbance in proliferation in the
9
epithelial basal layer and disturbances in keratinization of the epithelium are the other
factors that may influence epidermal ridge patterns. Even environment factors such as
external pressure on the foetal pads and perhaps embryonic movements, particularly
finger movement can influence ridge formation.
There is wide agreement that the mechanism of inheritance of many
dematoglyphic features also confirms to a polygenic system with each gene
contributing a small additive effect. Examples of these dermalotoglyphics traits are
the transversality of the ridges on the palm24’25
, the a-b count,26’27
and the atd angle28
.
Information as to the loci that influence dermatoglyphics is still speculative,
but various reports have appeared that implicate chromosome 21 in the determination
of finger ridge count29’30
and the position of the axial triradius30
. Other chromosomal
loci of genes influencing dermatoglyphics include the X chromosome31,32
and
chromosome 1833
.
More recently, it has been reported that exogenous environmental agents, such
as rubella, may also alter dermatoglyphics and be useful in providing evidence of such
an exposure34-36
.
11
METHODS OF REORDING DERMATOGLYPHICS
Dermatoglyphics patterns are seen by the naked eye preferably with a
magnifying lens, but permanent impression for quantitative analysis.
To enhance the quality of the prints, it is necessary to remove sweat, oil and
dirt from the skin by washing the ridged areas with soap and water and with ethyl
alcohol or ether. Care must be taken to print the ridged areas completely by rolling the
digits, palms, and soles to ensure obtaining a print of the whole pattern37
.
STANDARD METHODS
Ink Method:
It is standard method used by law enforcement agencies for identification
purposes.The necessary equipment consists of printer’s ink, a roller, a glass or metal
inking slab, a sponge rubber pad, and good quality paper. After the area is inked
perfectly, the palm is rolled over a paper covered cylinder to avoid imperfect printing
of hollow areas38
.
Inkless method:
This method makes use of a commercially available patented solution and
specially treated paper. The method is suitable for printing hands or feet with well-
demarcated dermal patterns, such as those of older children and adults39
.
Transparent Adhesive Tape Method:
In this method, the print is produced by applying a dry colouring pigment to
the skin and lifting it off with the transparent adhesive tape. The clouring agent may
be coloured chalk dust, Indian ink, standard ink, carbon paper, graphite stick or
powdered graphite, common oil pasted crayon etc. This method is inexpensive, rapid
12
and easy to use with all types of patients. Prints are clear and not smudged. They can
be preserved for an indefinite period of time40
.
Photographic method:
This technique is based on the principle of frustrated total internal reflection
which occurs when an object is pressed against a prism. The magnified image is
photographed by a Polaroid camera. It needs relatively expensive equipment.
Recently, even ordinary photographic method has been tried out41
.
Special methods:
These methods are not widely used. However, they may have some
advantages that the standard methods cannot offer, such as allowing the study of the
correlation between the epidermal patterns and the underlying bone structures
(radio\dermatography) 42
, study of sweat pores(hygrophotography) 43
, or study of the
spatial shape of ridged skin areas, for eg, in primates(plastic mould method)44
.
In 1989, some authors have developed a method wherein the investigating
region is blackened with graphite smeared on a piece of cardboard. The print is taken
by the Tesa film and then adhered to a transparent film strip or photo printing foil.
Such a negative could be enlarged five to six times. An automatic apparatus for
taking finger prints without ink and also to count ridge numbers between any 2 given
points was developed in 199045
.
Technologies have been improved in the finger print identification. With a
single small chip, technology provides the basis for fingerprint identification devices
that can prove the users identity using a fingerprint. Optical fingerprint scanner is a
13
device for computer security featuring superior performance,accuracy, durability
based on unique NITGEN fingerprint Biometric Technology.
Dermatoglyphic Pattern Configuration46
:
Numerous investigators have proposed rules, principles and definitions that
allow reliable analysis of dermatoglyphics data. The widespread interest in this field
and a need for a standardized dermatoglyphic terminology stimulated an international
symposium. As a result, “A Memorandum on Dermatoglyphic Nomenclature” was
published in 1968.The memorandum listed and defined dermatoglyphic features,
outlined accepted methods of dermatoglyphic analysis and provided a nomenclature
that was intended to serve as a universal standard.
Ridge detail(Minutiae)47
:
The intricate details of ridge structure, termed minutiae by Galton, are highly
variable and their number, type, shape and position are unique to the individual. The
minutiae therefore, are valuable and reliable tools for personal information.
Six common types of minutiae were initially used in dermatoglyphics and they
are island or point, short ridge, fork, enclosure, end and interstitial line with addition
of one more type later, called comb.
Finger tip Pattern Configurations5:
The ridge patterns on the distal phalanges of the fingertips are generally
categorized into following groups;
1. Arch
2. Loop
14
3. Whorl
4. Composite
ARCH:
The ridges pass from one margin of the digit to the other with a gentle distally
bowed sweep which gives the name to the pattern type. It is actually pattern less as
there is no triradius and the topographic zones of the other finger print type are
lacking. Galton has described many types of arches depending on the shape.These are
plain arch, tented arch, arch with ring etc.
The plain arch is composed of ridges which pass across the finger with a
slight bow distally.There is no triradius.
Tented arch has a triradius located in or near the midaxis of the digit.The
erect distal radiant is associated with abrupt elevation of the transversely curving
ridges forming the tent which gives the name to pattern15
.
LOOP:
It possesses only one triradius.Instead of coursing in complete circuits as in
whorl,the ridge course around only one extremity of pattern forming the head of the
loop, from the opposite extremity the pattern ridges flow to the marging of the
digit.This extremity of the pattern may be considered as open.If the loop opens to the
UInar margin it is called an UInar loop(U,Lu) and if it opens to the Radial margin it is
a Radial loop(R,Lr).
According to the flow of the ridges of the ridges of loop,loops can be further
differentiated into the following types.
15
Plane loops:Composed of succession of ridges which regularly follow a
looped course.
Transitional loops:Present more complex pattern.These are associated with
degenerated loops.
WHORL:
The whorl is regarded as the primitive patterns from which loops and arches
are formed, as simplification of design.The majority of ridges make circuits arount the
core in the pattern area.The Whorl is completely and continuously circumscribed by
the type lines.These types lines are radiants extending from the two triradii.This area
enclosed by type lines is the pattern area.The type lines are considered as the skeleton
of the pattern.That proximal to the pattern area is proximal transverse system and
distal one is the distal transverse system.
Typically Whorls have two triradii.Each triradii is placed at either side of
pattern area, where three ridge systems meet i.e.:
1) Pattern area
2) Proximal transverse system
3) Distal transverse sytem
Whorl core is an internal feature of pattern.In a typical Whorl the core may
appear as an island, a short straight ridge, a hook shaped ridge or a circle or an ellipse.
TYPES:
Concentric whorls-The ridges are arranged as concentric rings or
ellipse(around the core)
17
Spiral whorl-The ridges spiral around the core in clockwise or anticlockwise
direction.
Mixed whorl-It contains a smaller whorl within a loop.It is sub classified as
UInar and Radial according to the side on which outer loop opens.
Lateral pocket whorl or twin loop- These types are morphologically similar,
have 2 triradii.In lateral pocket whorl, both ridges emanating from each core emerge
on the same side of the pattern.In twin loop whorl, the ridges emanating from each
core open towards the opposite of margin of the finger.
Accidentals(whorls)-Complex patterns, which cannot be classified as one of
the above patterns are called accidentals, they represent a combination of two or more
configurations.
COMPOSITES[]:
The composites form a heterogeneous pattern.Two or more designs are
combined in one pattern area.Two or more triradii are present.There are four types:
1) Central pocket loops
2) Lateral pocket loops
3) Twin loops
4) Accidentals
18
RADIANTS:
The three basic dermatoglyphic landmarks found on the fingertips patterns are
the triradii, cores and radiants.
The three radiants of a triradius are traced on the print by following the ridges
which issues from the triradius.In some triradii these rays are easily defined as the
starting points for tracing.
From their typical association with pattern the radius are named according to
their relation with the finger and with the pattern;
1. Marginal radiant passing to the digital border.
2. Distal pattern radiant distal relation to the pattern area.
3. Proximal pattern radiant proximal relation to the pattern area.
TRIRADII:
A triradius is the central meeting point of the three opposing ridge system.In a
typical whorl or loop such a point occurs at the confluence of three topographic zones
the pattern area, the distal transverse system, and the proximal transverse system.
These three ridges are radiating from a common point.
Figure-3: Triradii
19
PALMAR PATTERN CONFIGURATIONS5
In order to carry out dermatoglyphic analysis that can be compared in different
individuals, the palm has been divided into several automatically defined areas.The
areas approximate the sites of embryonic volar pads and include the thenar area, four
interdigital areas(designed I1 I2 I3 I4 from radial to ulnar side) and the hypothenar
area.
Figure-4: Palmar pattern configurations
Palmar flexion Creases48
Flexion creases represent the location of firmer attachment of the skin to
indulging structures. Although they differ in origin from the epidermal ridges and do
not belong strictly to the dermatoglyphic system, palmar creases are usually included
in routine dermatoglyphic analysis because their alterations may be of diagnostic
value in a variety of medical disorders.
20
The palmar creases are divided into three groups:major,minor and secondary creases.
1. Major creases: There are three major creases-
· The radial longitudinal crease.
· The proximal transverse crease.
· The distal transverse crease.
The first to appear is the radial longitudinal crease that borders the thenar
eminence, followed by the proximal transverse crease(PTC) and distal transverse
crease. Sometimes the proximal and distal transverse creases are replaced or joined
into one single crease that traverse the whole palm. This single transverse flexion
crease is usually referred to as Simian crease or line. Variants of single palmar
crease have been noted. They are transitional type1(proximal and distal creases
connected by the bridging crease)and transitional type2(fusion of the transverse
creases with branching proximal and distal segments, incomplete single palmar
crease). Avariation in appearance of PTC in the Sydney line(SL)after the city in
Australia where it was observed first. Sydney line represents proximal transverse
crease beyond hypothenar eminence to the ulnar margin of the palm.
24
Palmar dermatoglyphics areas
2. Minor creases: In addition to major cases are often present on the palm. The
most commonly reported minor creases are:
a) Three longitudinal creases running from the central part of the wrist
towards the 3rd
,4th
and 5th
digits.
b) The accuracy distal crease found under the 3rd
and 4th
digits , beyond the
distal transverse crease.
c) ‘E line’ located at the distal ulnar edge of the palm between the origin of
the distal transverse crease and metacarpophalangeal creases of 5th
digit.
d) A hypothenar crease in the hypothenar eminence, running in a proximal to
distal direction concave toward the ulnar side of palm.
3. Secondary creases: Any visible palmar creases other than major and minor
creases. Their number, length, depth and direction vary widely in different
individuals. For the present study, only major flexion creases are included.
RIDGE COUNT:
The characteristics of dematoglyphics can be described quantitatively i.e.,by
counting the number of ridges within a pattern and measuring angles or distances
between specified points of triradii.
The counting was done along a straight line connecting the triradii point to the
point of core. Ridge counts were recorder in order, beginning with thumb to little
finger of both right hand and left hand.
26
The Total Finger Ridge Count(TFRC)
The TRFC was derived by adding the ridge counts on all tens fingers. In a
loop, there is one triradius and so one ridge count. For an arch, the score is zero. For
double loop whorls, the ridge numbers between the two cores was added to the
conventional count.
Absolute Finger Ridge Count(AFRC)
The AFRC was calculated by summing up the ridge counts of all the fingers.
The TRFC and AFRC are the same if no whorls are present.
a-b Ridge Count:
The ridge count most frequently obtained is the a-b ridge count. Counting was
carried out along a straight line connecting the triradii ‘a’ and ‘b’. The count excludes
the ridges forming the triradii. When an accessory triradius ‘a’ is present in the second
interdigital area, counting is still done from the ‘a’ triradius which is invariably the
more radial of the two.
The ‘atd’ Angle:
It was recorded by drawing lines from the digital triradius ‘a’ to the axial
triradius ‘t’ and from this to digital triradius ‘d’. In palms with more than one
triradius , the atd angle originating from each axial triradius was measured.
27
Method of measuring atd angle
CONGENITAL MALFORMATIONS OF DERMATOGCLYPHICS
Dermatoglyphics are studied in congenital malformations and as a physical
sign in pediatrics diagnosis. It is not often recognized, that they can be malformed
also. They pass either unrecognized or abandoned as freak pattern.
There are five classified malformations.
1. Aplasia
2. Hypoplasia
3. Dissociations
4. Off the end
5. Off the end with ridge dissociation
APLASIA: Congenital absence of ridges over entire palm, plantar surfaces. Palmar ,
interphalangeal flexion creases remain normal or with great excess of very small
Figure-9: Method of measuring atd angle
28
creases. It is thought to be autosomal dominantly inherited. It may be due to
disordered keratin production.
RIDGE HYPOPLASIA: Ridges are not absent but reduced in height. It is confused
with ridge atrophy seen in mental retardation, old age, celiac disease. It probably
indicates hidden celiac diseases. It is seen in atutosomal aneuploidy. It is thought to be
autosomal dominant trait.
RIDGE DISSOCIATION: Ridges instead of running neatly in parallel lines are
broken into dots, short ridges and are completely disorganized, mostly seen on the
thumb and palmar triradius, followed by index, middle, ring , and little finger in the
order of frequency. It is autosomal dominant trait or sporadically inherited. It is
confused with scarring after burns. In 430 patients with congenital heart disease, two
had this ridge dissociation. One had multiple cardiac defects and the other had
Truncus Arteriosus, VSD and harelip. It is sometimes seen in normal people[].
Off the end ridges:
Ridges instead of running transversely are vertical to the end of finger tip.
Off the end ridges with dissociation
It is rare. No disease is associated with it. Hypoplasia of the ridges is the
commonest.
29
MATERIAL AND METHODS
Source of Data
The present study is conducted in patients of diabetes and essential
hypertension attending outpatient department (O.P.D.) of HKE Society’s
Basaveshwar Teaching and general Hospital, attached to M.R. Medical College
Kalaburagi and students of first MBBS 2015-16 batch of department of Anatomy,
M.R. Medical College, Kalaburagi.
Materials used
· Camel black ink
· Stamp pad
· Bond paper
· Magnifying lens (x5)
· Protractor
· Pencil and pen
Sampling procedure
Informed consent will be taken from the subjects in a prescribed format.
Cummins method was used for the finger prints. Patients will be asked to wash their
hands with soap and water. So as to remove any oil or dirt after that, 10 fingers are
pressed upon stamp pad and impressed on a white duplicating paper, subject were
asked to roll their fingers from one side of the nail to another to allow for better
clarity of the impression. This was the screened with the aid of magnifying lens (5x).
30
Inclusion criteria
Clinically diagnosed cases of type II diabetes and essential hypertension.
Exclusion criteria
1. Any deformities of finger, palm and infected hand.
2. Diseases causing secondary hypertension
3. Chromosoaml abnormalities like klinefelter’s syndrome, Turner’s syndrome
etc.
4. Deep burns of fingers and palms leading to scars.
Sample:
For this study 100 patients of Type 2 diabetes mellitus and 100 patients of
essential hypertension are taken from Basaveshwar Teaching and general hospital at
Kalaburagi and 100 normal subjects are taken from students of first MBBS 2015-16
batch of department of Anatomy, M.R. Medical College, Kalaburagi.
Type of study:
· Hospital based case control study
· The analysis include finger print pattern and also total finger ridge count a-b-
ridge count and atd angle.
Statistical analysis
In the study statistical data analyzed by SPSS 16.0 version software for
quantitative data analysis, mean and Standard Deviation were calculated and for
significant unpaired t-test was applied p <0.05 was considered as significant.
31
(A)
(B)
(C)
(D)
(F)
(E)
Figure-10: (A) Lens (B) Protractor (C) Stamp Pad (D) Ink bottle
(E) Observers hand (F) Patients hand
Ink was applied to palmar region of patients hand from the stamp pad and
the patient was asked to press their hands on bond paper one by one and hands were
pressed the observer from above and make sure that clear prints have obtained and
patient is asked to lift their hands gently.
33
RESULTS
TABLE NO.1: SEX WISE DISTRIBUTION OF STUDY SAMPLES
GROUPS
MALES FEMALES TOTAL
NO. % NO. % NO. %
CONTROL GROUP 60 60.0 40 40.0 100 100.0
DM GROUP 58 58.0 42 42.0 100 100.0
HYPERTENSION
GROUP 63 63.0 37 37.0 100 100.0
TOTAL 181 60.3 119 39.7 300 100.0
X2 (chi-square) TEST
P-VALUE X
2 (chi-square) = 13.17 P<0.001 highly significant
There is no statistical significant difference of sex among the groups
Graph-1: Multiple bar diagram represents sex wise distribution of samples
0
10
20
30
40
50
60
70
CONTROL GROUP DM GROUP HYPERTENSION
GROUP
6058
63
4042
37
NO
. O
F S
AM
PL
ES
GROUPS
MALES
FEMALES
34
TABLE NO.2: COMPARISON OF PALMER DERMATOGLYPHIC
PATTERN OF RIGHT AND LEFT IN CONTROL GROUP
DERMATOGLYPHIC
PATTERN
RIGHT LEFT t- TEST
VALUE
P-VALUE &
SIGNIFICANCE MEAN ± SD MEAN ± SD
UL 2.63 ± 1.29 2.65 ± 1.38 t = 0.106 P=0.916, NS
RL 0.05 ± 0.22 0.07 ± 0.25 t =0.593 P=0.554, NS
WHORL 2.07 ± 1.41 1.94 ± 1.57 t =0.616 P=0.538, NS
ARCH 0.25 ± 0.59 0.28 ± 0.62 t =0.35 P=0.727, NS
ATD 37.9 ± 3.58 37.94± 3.53 t =0.079 P=0.937, NS
A-B RC 28.20 ± 4.27 28.8 ± 4.31 t =1.01 P=0.273, NS
No statistical significant difference of all palmer dermatoglyphic patterns
between right and left in control group.(P>0.05)
Graph-2:Multiple bar diagram represents comparison of palmer dermatoglyphic
pattern of right and left in control group
0
5
10
15
20
25
30
35
40
UL RL WHORL ARCH ATD A-B RC
2.63
0.05
2.07
0.25
37.9
28.2
2.65
0.07
1.940.28
37.94
28.8
ME
AN
V
AL
UE
S
PALMER DERMATOGLYPHIC PATTERN
RIGHT SIDE MEAN LEFT SIDE MEAN
35
TABLE NO.3: COMPARISON OF PALMER DERMATOGLYPHIC
PATTERN OF RIGHT AND LEFT IN DM GROUP
DERMATOGLYPHIC
PATTERN
RIGHT LEFT t- TEST
VALUE
P-VALUE &
SIGNIFICANCE MEAN ± SD MEAN ± SD
UL 1.42 ± 1.40 1.19 ± 1.34 t = 1.18 P=0.237, NS
RL 0.02 ± 0.14 0.06 ± 0.27 t =1.28 P=0.201, NS
WHORL 3.41 ± 1.52 3.45 ± 1.55 t =0.164 P=0.870, NS
ARCH 0.14 ± 0.47 0.27 ± 0.63 t =1.64 P=0.101, NS
ATD 39.67 ± 3.69 39.31± 3.12 t =0.74 P=0.458, NS
A-B RC 28.63 ± 3.56 28.42 ± 3.83 t =0.402 P=0.688, NS
No statistical significant difference of all palmer dermatoglyphic patterns
between right and left in DM group. (P>0.05)
Graph-3: Multiple bar diagram represents comparison of palmer
dermatoglyphic pattern of right and left in dm group
0
5
10
15
20
25
30
35
40
UL RL WHORL ARCH ATD A-B RC
1.420.02
3.41
0.14
39.6
28.6
1.190.06
3.45
0.27
39.3
28.4
ME
AN
V
AL
UE
S
PALMER DERMATOGLYPHIC PATTERN
RIGHT SIDE MEAN LEFT SIDE MEAN
36
TABLE NO.4: COMPARISON OF PALMER DERMATOGLYPHIC
PATTERN OF RIGHT AND LEFT IN HYPERTENSION GROUP
DERMATOGLYPHIC
PATTERN
RIGHT LEFT t- TEST
VALUE
P-VALUE &
SIGNIFICANCE MEAN ± SD MEAN ± SD
UL 1.55 ± 1.27 1.58 ± 1.28 t = 0.166 P=0.869, NS
RL 0.03 ± 0.17 0.03 ± 0.17 t =0.00 P=1.00, NS
WHORL 3.13 ± 1.49 3.11 ± 1.48 t =0.094 P=0.924, NS
ARCH 0.29 ± 0.78 0.23 ± 0.54 t =0.628 P=0.531, NS
ATD 39.33 ± 3.83 39.92 ± 3.65 t =0.770 P=0.440, NS
A-B R 28.19 ± 3.56 27.95 ± 3.66 t =0.469 P=0.639, NS
No statistical significant difference of all palmer dermatoglyphic patterns
between right and left in Hypertension group. (P>0.05)
Graph-4: Multiple bar diagram represents comparison of palmer
dermatoglyphic pattern of right and left in hypertension group
0
5
10
15
20
25
30
35
40
UL RL WHORL ARCH ATD A-B R
1.550.03
3.13
0.29
39.3
28.19
1.580.03
3.11
0.23
39.9
27.95
ME
AN
VA
LU
ES
PALMER DERMATOGLYPHIC PATTERN
RIGHT SIDE MEAN LEFT SIDE MEAN
37
TABLE NO.5: COMPARISON OF RIGHT PALMER DERMATOGLYPHIC
PATTERN BETWEEN DM GROUP AND CONTROL GROUP
DERMATOGLYPHI
C PATTERN
DM GROUP CONTROL
GROUP
t- TEST
VALUE
P-VALUE &
SIGNIFICANCE
MEAN ± SD MEAN ± SD
UL 1.42 ± 1.40 2.63 ± 1.29 t = 6.34 P=0.00, HS
RL 0.02 ± 0.14 0.05 ± 0.22 t =1.12 P=0.251, NS
WHORL 3.41 ± 1.52 2.07 ± 1.41 t =6.44 P=0.00, HS
ARCH 0.14 ± 0.47 0.25 ± 0.59 t =1.45 P=0.148, NS
ATD 39.67 ± 3.69 37.9 ± 3.58 t =3.44 P=0.001, HS
A-B R 28.63 ± 3.56 28.20 ± 4.27 t =0.774 P=0.440, NS
There is statistical significant difference in right palmer dermatoglyphic
patterns of UL, WHORL, ATD. Between DM group and control group. There is no
statistical significant difference in right palmer dermatoglyphic patterns of RL,
ARCH, A-B R. between DM group and control group. Mean UL is significantly lower
in DM group as compare to control group and Mean WHORL and ATD values are
significantly higher in DM group as compare to control group.
Graph-5:Multiple bar diagram represents comparison of right palmer
dermatoglyphic pattern between dm group and control group
0
5
10
15
20
25
30
35
40
UL RL WHORL ARCH ATD A-B R
1.420.02
3.41
0.14
39.67
28.6
2.63
0.052.07
0.25
37.9
28.2
DM GROUP CONTROL GROUP
38
TABLE NO.6: COMPARISON OF LEFT PALMER DERMATOGLYPHIC
PATTERN BETWEEN DM GROUP AND CONTROL GROUP
DERMATOGLYPHI
C PATTERN
DM GROUP CONTROL
GROUP t- TEST
VALUE
P-VALUE &
SIGNIFICANCEMEAN ± SD MEAN ± SD
UL 1.19 ± 1.34 2.65 ± 1.38 t = 8.35 P=0.00, HS
RL 0.06 ± 0.27 0.07 ± 0.25 t =1.32 P=0.278, NS
WHORL 3.45 ± 1.55 1.94 ± 1.57 t = 8.27 P=0.00, HS
ARCH 0.27 ± 0.63 0.28 ± 0.62 t =0.45 P=0.575, NS
ATD 39.31± 3.12 37.94± 3.53 t =3.62 P=0.001, HS
A-B R 28.42 ± 3.83 28.8 ± 4.31 t =0.654 P=0.476, NS
There is statistical significant difference in left palmer dermatoglyphic
patterns of UL, WHORL, ATD. Between DM group and control group. There is no
statistical significant difference in left palmer dermatoglyphic patterns of RL, ARCH,
A-B R. between DM group and control group. Mean UL is significantly lower in DM
group as compare to control group and Mean WHORL and ATD values are
significantly higher in DM group as compare to control group
Graph-6: Multiple bar diagram represents comparison of left palmer
dermatoglyphic pattern between dm group and control group
0
5
10
15
20
25
30
35
40
UL RL WHORL ARCH ATD A-B R
1.190.06
3.45
0.27
39.31
28.4
2.65
0.071.94
0.28
37.94
28.8
DM GROUP CONTROL GROUP
39
TABLE NO.7: COMPARISON OF PALMER DERMATOGLYPHIC
PATTERN BETWEEN DM GROUP AND CONTROL GROUP
DERMATOGLYPHI
C PATTERN
DM GROUP CONTROL
GROUP
t- TEST
VALUE
P-VALUE &
SIGNIFICANCE
MEAN ± SD MEAN ± SD
TFRC 121.67 ± 22.97 108.64 ± 22.6 t =39.69 P=0.000, VHS
AFRC 244.55 ± 33.93 236.05 ± 35.74 t =33.2 P=0.000, VHS
There is statistically very highly significant difference in palmer
dermatoglyphic patterns of TFRC AND AFRC Between DM group and control group.
Mean TFRC and AFRC values are significantly higher in DM group as compare to
control group
Graph-7: Multiple bar diagram represents comparison of palmer
dermatoglyphic pattern between dm group and control group
0
50
100
150
200
250
TFRC AFRC
121.67
244.55
108.64
236.05
DM GROUP CONTROL GROUP
40
TABLE NO.8: COMPARISON OF RIGHT PALMER DERMATOGLYPHIC
PATTERN BETWEEN HYPERTENSION GROUP AND CONTROL GROUP
DERMATOGLYPH
IC PATTERN
HYPERTENSIO
N GROUP
CONTROL
GROUP
t- TEST
VALUE
P-VALUE &
SIGNIFICANCE
MEAN ± SD MEAN ± SD
UL 1.55 ± 1.27 2.63 ± 1.29 t = 5.95 P=0.00, HS
RL 0.03 ± 0.17 0.05 ± 0.22 t =0.719 P=0.431, NS
WHORL 3.13 ± 1.49 2.07 ± 1.41 t =5.16 P=0.00, HS
ARCH 0.29 ± 0.78 0.25 ± 0.59 t =0.408 P=0.642, NS
ATD 39.33 ± 3.83 37.9 ± 3.58 t =2.72 P=0.01, S
A-B R 28.19 ± 3.56 28.20 ± 4.27 t =0.018 P=0.986, NS
There is statistical significant difference in right palmer dermatoglyphic
patterns of UL, WHORL, ATD. Between hypertension group and control group.
There is no statistical significant difference in right palmer dermatoglyphic patterns of
RL, ARCH, A-B R. between hypertension group and control group. Mean UL is
significantly lower in Hypertension group as compare to control group and Mean
WHORL and ATD values are significantly higher in Hypertension group as compare
to control group.
41
0
5
10
15
20
25
30
35
40
UL RL WHORL ARCH ATD A-B R
1.550.03
3.13
0.29
39.33
28.2
2.63
0.05
2.07
0.25
37.9
28.2
HYPERTENSION GROUP CONTROL GROUP
Graph-8: Multiple bar diagram represents comparison of right palmer
dermatoglyphic pattern between hypertension group and control group
42
TABLE NO.9: COMPARISON OF LEFT PALMER DERMATOGLYPHIC
PATTERN BETWEEN HYPERTENSION GROUP AND CONTROL GROUP
DERMATOGLYPHI
C PATTERN
HYPERTENSIO
N GROUP
CONTROL
GROUP
t- TEST
VALUE
P-VALUE &
SIGNIFICANCE
MEAN ± SD
MEAN ± SD
UL
1.58 ± 1.28
2.65 ± 1.38
t = 6.03
P=0.00, HS
RL
0.03 ± 0.17
0.07 ± 0.25
t =1.16
P=0.214, NS
WHORL
3.11 ± 1.48
1.94 ± 1.57
t = 5.97
P=0.00, HS
ARCH
0.23 ± 0.54
0.28 ± 0.62
t =0.511
P=0.575, NS
ATD
39.92 ± 3.65
37.94± 3.53
t =2.84
P=0.01, S
A-B R
27.95 ± 3.66
28.8 ± 4.31
t =1.073
P=0.284, NS
There is statistical significant difference in left palmer dermatoglyphic
patterns of UL, WHORL, ATD. Between hypertension group and control group.
There is no statistical significant difference in left palmer dermatoglyphic patterns of
RL, ARCH, A-B R. between hypertension group and control group. Mean UL is
significantly lower in Hypertension group as compare to control group and Mean
WHORL and ATD values are significantly higher in Hypertension group as compare
to control group.
43
0
5
10
15
20
25
30
35
40
UL RL WHORL ARCH ATD A-B R
1.58
0.03
3.11
0.23
39.92
27.95
2.65
0.07
1.94
0.28
37.94
28.8
HYPERTENSION GROUP CONTROL GROUP
Graph-9: Multiple bar diagram represents comparison of left palmer
dermatoglyphic pattern between hypertension group and control group
44
TABLE NO.10: COMPARISON OF PALMER DERMATOGLYPHIC
PATTERN BETWEEN HYPERTENSION GROUP AND CONTROL GROUP
DERMATOGLYPHI
C PATTERN
HYPERTENSIO
N GROUP
CONTROL
GROUP
t- TEST
VALUE
P-VALUE &
SIGNIFICANCE
MEAN ± SD MEAN ± SD
TFRC
118.42 ± 26.04
108.64 ± 22.6
t =17.69
P=0.000, VHS
AFRC
246.01 ± 44.40
236.05 ± 35.74
t =38.6
P=0.000, VHS
There is statistical very highly significant difference in palmer dermatoglyphic
patterns of TFRC and AFRC Between hypertension group and control group. Mean
TFRC and AFRC values are significantly higher in Hypertension group as compare to
control group.
Graph-10: Multiple bar diagram represents comparison of palmer
dermatoglyphic pattern between hypertension group and control group
0
50
100
150
200
250
TFRC AFRC
118.42
246.01
108.64
236.05
HYPERTENSION GROUP CONTROL GROUP
45
TABLE NO.11: COMPARISON OF RIGHT PALMER DERMATOGLYPHIC
PATTERN BETWEEN DM GROUP AND HYPERTENSION GROUP
DERMATOGLYPHI
C PATTERN
DM GROUP HYPERTENSIO
N GROUP t- TEST
VALUE
P-VALUE &
SIGNIFICANCEMEAN ± SD MEAN ± SD
UL 1.42 ± 1.40 1.55 ± 1.27 t = 0.686 P=0.493, NS
RL 0.02 ± 0.14 0.03 ± 0.17 t =0.451 P=0.653, NS
WHORL 3.41 ± 1.52 3.13 ± 1.49 t =1.33 P=0.185, NS
ARCH 0.14 ± 0.47 0.29 ± 0.78 t =1.64 P=0.102, NS
ATD 39.67 ± 3.69 39.33 ± 3.83 t =0.638 P=0.543, NS
A-B R 28.63 ± 3.56 28.19 ± 3.56 t =0.873 P=0.384, NS
No statistical significant difference of all palmer dermatoglyphic patterns
between DM group and Hypertension group.(P>0.05)
Graph-11: Multiple bar diagram represents comparison of right palmer
dermatoglyphic pattern between dm group and hypertension group
0
5
10
15
20
25
30
35
40
UL RL WHORL ARCH ATD A-B R
1.420.02
3.41
0.14
39.67
28.6
1.550.03
3.13
0.29
39.3
28.19
DM GROUP HYPERTENSION GROUP
46
TABLE NO.12: COMPARISON OF LEFT PALMER DERMATOGLYPHIC
PATTERN BETWEEN DM GROUP AND HYPERTENSION GROUP
DERMATOGLYPHI
C PATTERN
DM GROUP HYPERTENSIO
N GROUP t- TEST
VALUE
P-VALUE &
SIGNIFICANCEMEAN ± SD MEAN ± SD
UL 1.19 ± 1.34 1.58 ± 1.28 t = 1.213 P=0.247, NS
RL 0.06 ± 0.27 0.03 ± 0.17 t =1.044 P=0.285, NS
WHORL 3.45 ± 1.55 3.11 ± 1.48 t =1.42 P=0.171, NS
ARCH 0.27 ± 0.63 0.23 ± 0.54 t =0.745 P=0.464, NS
ATD 39.31± 3.12 39.92 ± 3.65 t =0.854 P=0.375, NS
A-B R C 28.42 ± 3.83 27.95 ± 3.66 t =0.656 P=0.492, NS
No statistical significant difference of all palmer dermatoglyphic patterns
between DM group and Hypertension group.(P>0.05).
Graph-12: Multiple bar diagram represents comparison of left palmer
dermatoglyphic pattern between dm group and hypertension group
0
5
10
15
20
25
30
35
40
UL RL WHORL ARCH ATD A-B R
1.190.06
3.45
0.27
39.3
28.4
1.580.03
3.11
0.23
39.9
27.95
DM GROUP HYPERTENSION GROUP
47
TABLE NO.13: COMPARISON OF PALMER DERMATOGLYPHIC
PATTERN BETWEEN DM GROUP AND HYPERTENSION GROUP
DERMATOGLYPHI
C PATTERN
DM
GROUP
HYPERTENSIO
N GROUP t- TEST
VALUE
P-VALUE &
SIGNIFICANCEMEAN ± SD MEAN ± SD
TFRC 121.67 ± 22.97 118.42 ± 26.04 t =0.936 P=0.351, NS
AFRC 244.55 ± 33.93 246.01 ± 44.40 t = 0.261 P=0.794, NS
No statistical significant difference of palmer dermatoglyphic patterns of
TFRC and AFRC between DM group and Hypertension group.(P>0.05)
Graph-13: Multiple bar diagram represents comparison of palmer
dermatoglyphic pattern of TFRC and AFRC between dm group and
hypertension group
0
50
100
150
200
250
TFRC AFRC
121.67
244.55
118.42
246.01
DM GROUP HYPERTENSION GROUP
48
TABLE NO. 14: TOTAL NUMBER OF DERMATOGLYPHICS PATTERN ON
RIGHT AND LEFT HAND
Group
Dermatoglyphic pattern
Right Hand Left Hand
UL RL Whorl Arch UL RL Whorl Arch
Control 263 5 207 25 267 7 198 28
Type 2 DM 142 2 342 14 120 6 347 27
Essential Hypertension 155 3 313 29 159 3 315 23
49
DISCUSSION
The association of altered dermatoglyphics pattern with T2DM and essential
HTN was well known as reported by several workers. In this section attempt is made
to compare the observation seen in our study with previous studies conducted to
compare dermatoglyphics pattern is T2DM and essential HTN.
Finger tip pattern
The present study showed increased number of whorls and decreased number
of unlar loops in patients with T2DM which is in agreement with studies conducted
Sant et al (1983)50
. Rakate NS et al (2013)51
.
Comparsion of finger print pattern in Type 2 diabetes
Name of the
study
UL RL Whorls Arches
Present Study
(2016)
-* X +* X
Sant et al
(1983)
-* X +* X
Rakate NS et
al (2013)
-* X +* X
Banarjee et al (1985)52
found higher frequency of loops.
(+) increased, (-) decreased, (x) No significant change, (*) statistically significant.
The ‘atd’ angle
In present study atd angle was increased in both light and left palm of T2DM
patients which correlates with many studies done previously like. Rakate NS et al51
Vadgaonkar Rajnigandha (2006) et al53
.
50
Study Increased ‘atd’ angle
Rt Lt
Present study (2016) Present Present
Rakate NS et al (2013) Present Present
Vadgaonkar Rajnigandha et al (2006) Present Present
Total finger ridge count (TFRc) and Absolute finger ridge count (AFRC)
In present study TFRC and AFRC are increased in T2DM pat4ients compared
to controls which correlates with Barta et al54
study, Iqbal et al study55
.
Comparsion of TFRC and AFRC in different studies
Study TFRC AFRC
Present study (2016) Increased Increased
Barta et al (1970) Increased Increased
Iqbal et al (1978) Increased Increased
Finger Tip pattern
The present study showed increased number of whorls and decreased number
of unlar loop in patients with essential HTN which is correlating with studies
conducted by Tafazoli et al56
and Deepa G et al57
.
Comparsion of finger print pattern in essential HTN
Name of the study UL RL Whorl Arches
Present study (2016) -* X +* X
Tafazoli et al (2013) -* X +* X
Deepa G et al (2013) -* x +* X
51
atd angle
In present study ‘atd’ angle is increased which is comparable with preview
studies, polat MHCM et al58
and Palyzova D et al59
Study Increased ‘atd’ angle
Right Left
Present study (2016) Increased Increased
Polat MHCM et al (1999) Increased Increased
Palyzova D et al (1991) Increased Increased
Total finger ridge count (TFRC) and Absolute finger ridge count (AFRC).
In present study TFRC and AFRC and increased as comparable to preview
studies like polate MHCM et al58
Palyzova D et al59
Comparison of TFRC and AFRC in different studies
Study TRRC AFRC
Present study (2016) Increased Increased
Polat MHCM et al (1999) Increased Increased
Palyzova D et al (1991) Increased Increased
52
CONCLUSION
The dermatoglyphic patterns of 100 Type 2 diabetes mellitus and 100 essential
hypertension patients are compared with 100 control group.
We observed no significant difference of sex among all 3 groups. There is
increased number of whorls and decreased number of ulnar loops in type 2 DM and
essential HTN patients. Total finger ridge count and absolute finger ridge count is
increased in Type 2 diabetes mellitus and essential hypertension patients as
compared to control group. ATD angle is also increased in type 2 diabetes mellitus
and essential HTN patients. The above parameters can be used as a screening
method. Which has a great value in the diagnosis and prevention of T2 DM an
essential HTN.
53
SUMMARY
Dermal ridge differentiation take place during fetal development.
Hence the resulting ridge configuration are genetically determined and
influenced by prenatal insult during the period of formation of these ridges, which can
be studied by method of dermatoglyphics. Thus dermatoglyphics is helpful as a
diagnostic aid in diseases which have a strong genetic background such as T2DM and
essential hypertension.
Dermatoglyphics are studied in 100 T2DM and 100 essential hyp[ertension
patients from Basaweshwar teaching and general Hospital Gulbarga.
Increased numbers of whorls and decreased number of ulnar loops are seen
inT2DM and essential hypertension patients. Total finger ridge count and Absolute
finger ridge count are increased in both T2DM and essential hypertension patients.
Thus dermatoglyphics pattern may provide a means of identifying the
genetically determined fraction of patients of disease like T2DM and Essential
hypertension and can be used for screening and may also have some diagnostic value.
54
RECOMMENDATIONS
1. In this study only palm and finger print dermatoglyphic pattern were studied.
A study of plantar could provide additional information.
2. The study of dermatoglyphic of Type2diabetes mellitus and essential
hypertension patients with relation to dermatoglyphics of their parents would
throw further light on the relationship between genetic influence on the
causation of diabetes mellitus and essential hypertension with dermatoglyphic
patterns
55
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60
PROFORMA
Date:
A Study of dermatoglyphic pattern in diabetic & Essential Hypertensive patients.
Name:
Age:
Sex:
Address:
Occupation:
Diagnosis:
Reading’s: 1)BP Sys/Dias: 2)Blood Sugar: a)FBS: b)PPBS:
c)RBS:
Finger Prints:
Right Hand Left Hand
Ring Finger Little Finger Ring Finger Little Finger
61
PATIENT INFORMED CONSENT FORM
I ……………………………….. have understood the information given in the
information sheet. The nature, objective, duration and expected effects of the study
have been explained to me in …………………. a language in which I am conversant
.I have been informed what I have to do as a part of this study. I have had the time and
opportunity to enquire about the study and I have been fully satisfied with the
explanations given.
· I am ready to participate voluntarily in the study.
· I agree to cooperate with the research staff and voluntarily undergo the
procedures required in this study.
· I understand that I am at liberty to withdraw from this study at anytime
without justifying my decision to withdraw.
· I know that the results from this study may be forwarded to the appropriate
authorities, presented in scientific meetings and published.
· By signing this consent from, I have not given up any legal rights which I am
otherwise entitled to as subject in this study.
· I know that I will get a copy of this consent form which is signed dated.
Signature of the subject
Name of the subject
Date:
I confirm that I have explained the nature, purpose and expected effected of the study
to the subject whose name is printed above
Date:
Signature of the person providing
information
6
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