RELATIONSHIP BETWEEN DERMATOGLYPHICS AND SICKLE CELL ANAEMIA JAMES NKETSIAH
INTRODUCTION Dermatoglyphics (fingerprint and palmprint). (Lakshmana et al ., 2017). Development of dermatoglyphics. (Bhat et al ., 2014; Margi et al ., 2016). Characteristics of dermatoglyphics: genetic, unique, permanent. ( Eboh, 2013; Bhat et al., 2014). Uses of dermatoglyphics: identification, diagnosis, authentication, mirror of one’s potential and talent. (Kucken and Newell, 2005; Offei et al., 2014; Atinga, 2017). 1
SICKLE-CELL ANAEMIA (SCA) Genetic blood disorder that affects the haemoglobin within the RBC. (Wadood et al ., 2012). 300,000 infants are born each year worldwide. (WHO, 2006). Prevalent in West Africa (2-5)% and 2% in Ghana. (WHO, 2006; Asare et al ., 2018). 18,000 babies born each year with SCA in Ghana. (Dennis-Antwi, 2018). Effects of sickle cell anaemia: Chronic anaemia and damage to body organs. (Johnson, 2005; Sun, 2013). 2
PRESENT STUDY Solubility test and haemoglobin electrophoresis may give a false negative result when performed too early in infants. (Wethers, 2000). Infants less than 6 months possess predominantly foetal haemoglobin. (Piel, 2017). Inaccuracy of diagnostic methods in babies less than 6 months. (Pagrut and Chide, 2017). Dermatoglyphics can be use to diagnose some genetic and non-genetic diseases. (Andani et al ., 2007). 3
PRESENT STUDY Limited data correlating dermatoglyphics and SCA. Limited dermatoglyphics parameters studied. Ethnic and racial variations in dermatoglyphics. 4
AIM To generate detailed baseline data to elucidate the possible diagnostic value and worth of dermatoglyphics for earlier detection of sickle cell anaemia. 5
SPECIFIC OBJECTIVES To determine: the distribution of fingerprint patterns between sickle cell anaemic (SCA) group and normal individuals. finger ridge counts (TFRC and AFRC) between SCA and normal individuals. palmar inter-digital ridge counts (A-B, B-C and C-D) between SCA and normal individuals. the distribution of PIC patterns between SCA and normal individuals. palmar ATD and ADT angles between SCA and normal individuals. 6
MATERIALS AND METHODS Study design and location • Cross sectional study. • Sickle Cell Units of Komfo Anokye Teaching Hospital (KATH), Kumasi. • School of Medicine and Dentistry- KNUST, Kumasi. Duration: February, 2018 – April, 2019. Informed participants’ consent and Ethical approval were sought from KSMD/KATH Committee of Human Research, Publications and and Ethics. 7
MATERIALS AND METHODS Sample size: 400 • 200 pre-diagnosed with SCA (SS) : 100 (50%) males and 100 (50%) females. • 200 without SCA (AA) : 100 (50%) males and 100 (50%) females. Inclusion criteria • All ten fingers and palm intact. • Exclusively either SS or AA genotypes. Exclusion criteria Physical fingers and palm deformities due to injury and burns. • • Absent fingers, extra, webbed or worn out fingers. Data Analysis • SPSS version 23.0 (Inc., Chicago, IL, USA). 8
MATERIALS AND METHODS Data collection B A Figure 1: Photographs illustrating method of taking (A) palmar and fingerprints and (B) thumb print using CanoScan lide 120 scanner (X 0.2). 9
MATERIALS AND METHODS Distribution of fingerprint patterns Figure 2: A schematic presentation showing the eight subdivisions of fingerprint patterns (Stevenson et al ., 2001) . 10
MATERIALS AND METHODS Total Finger Ridge Count (TFRC) and Absolute Finger Ridge Count (AFRC) TFRC : Addition of the finger ridge counts taking the highest count of a whorl for all the ten fingers (Ahmad and Pimpalkar, 2017). AFRC: Addition of the finger ridge counts of all the ten fingers taking into consideration the presence of both count of a whorl (Ramesh et al ., 2011). b b a c a Figure 3: An illustration showing finger ridge counts; A- arch, B- loop and C-whorl (Source: Kahn et al. , 2001 ) . 11
MATERIALS AND METHODS PALMAR ATD, DAT AND ADT ANGLES a a d d t t Figure 4: A photograph of the palm illustrating atd, dat and adt angles (X 0.2). 12
MATERIALS AND METHODS A-B, B-C AND C-D PALMAR INTER-DIGITAL RIDGE COUNTS A B C A B C D D B A Figure 5: A photograph (A) and illustration (B) showing palmar inter-digital a-b, b-c and c-d ridge counts (Source: Lakshmana et al ., 2017 ). 13
MATERIALS AND METHODS PIC model • PIC 101 • PIC 200, 201 • PIC 210, 211 • PIC 300, 311, 310 (Mensvoort, 2009; Atinga, 2017) Distal transverse crease Proximal transverse crease Radial longitudinal crease Figure 6: A photograph showing the Primary Palmar Creases (X 0.2). 14
MATERIALS AND METHODS PIC patterns Figure 7: Cartoons showing PIC 101, PIC 200, PIC 201, PIC 211, PIC 300, PIC 311 and PIC 310 (Source: Mensvoort, 2009 ). 15
MATERIALS AND METHODS PIC patterns PIC PIC PIC PIC PIC 310 301 300 200 310 PIC PIC 201 300 Figure 8: Photographs showing PIC patterns (X 0.2). 16
RESULTS AND DISCUSSION 1600 1388 1400 1297 1200 1000 800 600 468 400 400 235 212 200 0 WHORL LOOP ARCH PRIMARY FINGERPRINT PATTERNS BETWEEN SCA AND CONTROL GROUPS SCA CG Figure 9: A bar chat showing the distribution of the primary fingerprint patterns between the SCA and control groups. Consistent with: ( Oladipo et al ., 2007; Ramesh et al ., 2011; Shetty and Sarda, 2017 ) 17
RESULTS AND DISCUSSION 1600 1372 1400 1284 1200 FREQUENCY 1000 800 600 386 333 400 213 204 200 53 52 30 22 14 16 13 8 0 CPW DLW PCW UL RL PA TA SUB-DIVISION OF THE FINGERPRINT PATTERN BETWEEN THE SCA AND CONTROL GROUPS SCA CG Figure 10: A bar chart showing the distribution of the subdivisions of fingerprints between the SCA and control groups. SCA-Sickle Cell Anaemia; CG-Control Group; CPW- Central pocket whorl; DLW – Double loop whorl; PCW – Plain concentric whorl; RL- Radial loop; UL- Ulnar loop; PA- Plain arch; TA- Tented arch. 18
RESULTS AND DISCUSSION 70 61.25 60 54.75 50 PERCENTAGE 39.5 40 35 30 20 10 2.5 1.25 0.75 0.75 0.75 0.5 0.5 0.25 0.25 0.25 0.25 0 0 0 0 0 0 0 0 0 0 200 201 211 300 301 310 311 321 400 410 430 500 520 PIC PATTERN DISTRIBUTION OF PIC PATTERN BETWEEN THE SCA AND CONTROL GROUPS SCA CG Figure 11: A bar chart showing the distribution of the PIC pattern between the SCA and Control groups. SCA-Sickle Cell Anaemia; CG-Control Group; PIC- Primary crease, Intersections of primary crease and Complete transverse crease. PIC 310 and 300 dominate in the Ghanaian population ( Offei et al ., 2014; Atinga, 2017 ). 19
RESULTS AND DISCUSSIONS New PIC’s patterns recorded PIC PIC PIC PIC 520 430 410 400 Figure 12: Photographs showing new PIC’s recorded in the study (X 0.2). 20
RESULTS AND DISCUSSION Table 1: Comparison of palmar ‘atd’ angle between the SCA and control groups . SICKLE CELL CONTROL 95% CI ANAEMIA GROUP Mean SD Mean SD lower Upper t p 43.62 5.92 41.61 5.26 0.442 3.65 2.542 0.015 SD= standard deviation; t = test statistic and p-value- statistically significant at 0.05. Consistent with Oladipo et al. (2007); Shetty and Sarda (2017). 21
RESULTS AND DISCUSSION Table 2: Comparison of ‘adt’ angle between the SCA and control groups. SICKLE CELL CONTROL 95% CI ANAEMIA GROUP Mean SD Mean SD lower Upper t p 60.35 5.52 62.11 5.62 -3.415 0.381 2.212 0.045 SD= standard deviation (SD); t = test statistic and p-value- statistically significant at 0.05. Paucity of literature 22
RESULTS AND DISCUSSION Table 3: Comparison of total finger ridge count (TFRC) between SCA and control groups. TFRC SCA CG 95% CI SIDE Mean SD Mean SD Lower Upper t p 38.12 52.34 42.31 51.74 -14.417 6.047 -0.804 0.422 Right hand 29.05 47.26 36.18 50.98 -16.793 2.533 Left hand -1.451 0.148 67.17 94.52 78.49 97.64 -15.605 4.290 -1.177 0.240 Both hands SD= standard deviation; t = test-statistic and p-value- statistically significant at 0.05. Consistent with Ramesh et al . (2011). SCA is inherited as monogenic trait (chromosome 11) (Koch et al ., 2000) FRC is inherited as a polygenic trait (chromosome 5 and 1: 5q14.1) (Medland et al ., 2007). Problematic ridge count method (Acree, 1999). 23
RESULTS AND DISCUSSION Table 4: Comparison of absolute finger ridge count (AFRC) between the SCA and control groups. AFRC SCA CG 95% CI SIDE Mean SD Mean SD Lower Upper t p 74.47 23.43 70.57 28.94 -1.276 9.076 1.481 0.139 Right hand 74.78 29.97 68.04 30.37 0.084 12.667 2.232 0.026 Left hand 149.25 50.71 138.61 57.26 -0.680 10.872 1.967 0.058 Both hands SD= standard deviation; t = test statistic and p-value- statistically significant at 0.05. Inconsistent with Ramesh et al. (2011). SCA is inherited as monogenic trait (chromosome 11) (Koch et al ., 2000). FRC is inherited as a polygenic trait (chromosome 5 and 1: 5q14.1) (Medland et al ., 2007). Significant association might : both genes might co-occur on the same chromosome. 24
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