A STUDY OF THE DERMATOGLYPHIC PATTERN IN DIABETIC AND

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



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



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


dermatoglyphic pattern of right and left in dm group

35


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


38

7

Multiple bar diagram represents comparison of palmer


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


control group

43



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


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

.

10

Figure-1: The development of epidermal ridges

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)

16

Figure-2: Fingers print pattern

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.

21

Figure-5: Palmar Flexion creases

22

Figure-6: Simian crease & Sydney line

23

Figure-7: Palm patterns

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.

25

Ridge counting in finger patterns

Figure-8: Ridge counting in figure patterns

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.

32

(A)

(B)

(C)

(D)

(E)

Figure-11: (A) Ink bottle (B) Lens (C) Stamp Pad (D) Protractor

(E) Gloves

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


PATTERN OF RIGHT AND LEFT IN DM GROUP

DERMATOGLYPHIC

PATTERN

RIGHT LEFT t- TEST

VALUE

P-VALUE &


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


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



36


PATTERN OF RIGHT AND LEFT IN HYPERTENSION GROUP

DERMATOGLYPHIC

PATTERN

RIGHT LEFT t- TEST

VALUE

P-VALUE &


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


between right and left in Hypertension group. (P>0.05)


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



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


0

5

10

15

20

25

30

35

40


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


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


0

5

10

15

20

25

30

35

40


1.190.06

3.45

0.27

39.31

28.4

2.65

0.071.94

0.28

37.94

28.8


39



DERMATOGLYPHI

C PATTERN

DM GROUP CONTROL

GROUP

t- TEST

VALUE

P-VALUE &

SIGNIFICANCE


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



0

50

100

150

200

250

TFRC AFRC

121.67

244.55

108.64

236.05


40


PATTERN BETWEEN HYPERTENSION GROUP AND CONTROL GROUP

DERMATOGLYPH

IC PATTERN

HYPERTENSIO

N GROUP

CONTROL

GROUP

t- TEST

VALUE

P-VALUE &

SIGNIFICANCE


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


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



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


1.58

0.03

3.11

0.23

39.92

27.95

2.65

0.07

1.94

0.28

37.94

28.8




44



DERMATOGLYPHI

C PATTERN

HYPERTENSIO

N GROUP

CONTROL

GROUP

t- TEST

VALUE

P-VALUE &

SIGNIFICANCE


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.



0

50

100

150

200

250

TFRC AFRC

118.42

246.01

108.64

236.05


45


PATTERN BETWEEN DM GROUP AND HYPERTENSION GROUP

DERMATOGLYPHI

C PATTERN

DM GROUP HYPERTENSIO

N GROUP t- TEST

VALUE

P-VALUE &


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


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


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



DERMATOGLYPHI

C PATTERN

DM GROUP HYPERTENSIO

N GROUP t- TEST

VALUE

P-VALUE &


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


between DM group and Hypertension group.(P>0.05).


dermatoglyphic pattern between dm group and hypertension group

0

5

10

15

20

25

30

35

40


1.190.06

3.45

0.27

39.3

28.4

1.580.03

3.11

0.23

39.9

27.95


47



DERMATOGLYPHI

C PATTERN

DM

GROUP

HYPERTENSIO

N GROUP t- TEST

VALUE

P-VALUE &


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)


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


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


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


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

62

DERMATOGLYPHIC PATTERN OF CONTROL

63

DERMATOGLYPHIC PATTERN OF ESSENTIAL

HYPERTENSION

64

DERMATOGLYPHIC PATTERN OF T2 DM

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28

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40

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91

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20

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80

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37

28

2

6

77

18

9

81

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3

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38

32

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28

8

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34

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2

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11

2

14

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83

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2

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2

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3

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36

23

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6

11

2

23

9

84

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1

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1

0

4

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6

35

28

2

6

12

4

27

8

85

M

4

1

0

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3

1

1

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4

8

45

34

3

2

11

8

30

3

86

M

0

0

5

0

1

0

4

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3

9

46

28

2

3

12

5

25

0

87

M

0

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0

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5

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3

6

38

24

2

6

13

0

28

5

88

M

1

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4

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0

0

5

0

3

4

36

33

3

0

11

4

25

6

89

M

2

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3

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1

0

4

0

3

8

42

31

2

2

11

5

23

5

8

3

90

M

2

0

3

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1

0

4

0

4

4

46

27

2

6

13

2

24

6

91

M

4

0

1

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2

0

2

1

3

9

41

23

2

5

10

2

19

0

92

M

0

0

5

0

1

0

4

0

4

2

44

25

2

6

13

6

23

9

93

M

0

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5

0

0

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5

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3

5

41

26

2

5

14

3

27

1

94

M

1

0

4

0

2

0

3

0

3

8

34

26

2

9

11

4

23

7

95

M

2

0

3

0

2

0

3

0

3

9

38

28

2

6

10

8

26

5

96

M

3

0

2

0

3

0

2

0

3

8

42

25

2

7

12

1

27

3

97

M

1

0

0

4

1

0

0

0

3

9

40

28

2

7

16

65

98

M

2

1

2

0

2

0

2

0

3

8

37

25

3

1

12

4

23

0

99

M

3

0

2

0

2

0

3

0

4

2

41

26

3

2

13

8

31

7

10

0

M

1

0

4

0

2

0

3

0

47

43

32

2

8

13

8

30

2

Documents

A STUDY OF THE DERMATOGLYPHIC PATTERN IN DIABETIC AND