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O iginal Resea ch A icle
S udy o he Angle Be ween Axial and Digi al T i adius o he
De ma oglyphics T ai Among Cance Ce ix Pa ien s in Eas e n Indian
Popula ion
Asu osh P amanik1, Dona Saha2, Madhush ee Pal3, Suchismi a Ghosh4, Falguni
Mondal5
1Assis an P o esso , MBBS, MD Ana omy, Depa men o Ana omy, Ba asa Go e nmen Medical
College and Hospi al, Kolka a, Wes Bengal 700124
2Associa e P o esso , MBBS, MD Ana omy, Depa men o Ana omy, Ba asa Go e nmen Medical
College and Hospi al, Kolka a, Wes Bengal 700124
3Assis an P o esso , MBBS, MD Ana omy, Depa men o Ana omy, Ba asa Go e nmen Medical
College and Hospi al, Kolka a, Wes Bengal 700124
4Senio Residen , MBBS, MD Ana omy, Depa men o Ana omy, Ba asa Go e nmen Medical College
and Hospi al, Kolka a, Wes Bengal 700124
5Sis e Tu o , MSc Nu sing, Depa men o Psychia y, Nu sing T aining School (G. N. M), Be hampo e,
Mu shidabad, Wes Bengal 742101
Recei ed: 01-06-2025 / Re ised: 16-07-2025 / Accep ed: 13-08-2025
Co esponding Au ho : D . Madhush ee Pal
Con lic o in e es : Nil
Abs ac
In oduc ion: De ma oglyphics is he s udy o epide mal idge pa e ns on he inge s, palms, and soles. The
co ela ion o de ma oglyphic pa e ns wi h many ch omosomal abno mali ies and gene ic diseases is e idenced
by many esea che s in he wo ld. As ce ical cance has s ong gene ic associa ion, he de ma oglyphic pa e n
s udy can be use ul as a sc eening me hod o ea ly diagnosis and o ind ou he indi iduals a isk.
Aims: To compa e he angle be ween line d awn om axial i adius ‘ ’ a base o palm be ween he hena and
hypo hena eminences o i adius ‘a’ (a base o index inge ) and o i adius ‘d’ (a base o li le inge )
inbe ween ce ical cance pa ien and con ol g oup.
Ma e ials and Me hod: This hospi al based c oss-sec ional analy ical s udy was conduc ed in di e en Medical
Colleges & Hospi al. His opa hologically con i med se en y wo cases o ce ical ca cinoma o abo e 15 yea s
o age a e conside ed as case & hei i s deg ee ela i es we e selec ed as con ol who a e abo e 15 yea s o age.
The axial and digi al i adius in palma p in was measu ed by using Ink me hod.
Resul : A case-con ol s udy was done among se en y- wo cases o his opa hologically con i med ce ical cance
pa ien o abo e 15 yea s o age and hei i s -deg ee ela i es as con ol g oup o 72 emales o abo e 15 yea s
o age. The palma p in s o bo h palms we e collec ed by ink me hod and a d angle o each p in was measu ed.
Da a we e analyzed by aking mean and s anda d de ia ion and es ed by s uden ’s - es , conside ing p- alue<0.05
as s a is ically signi ican .
Discussion: S a is ically highly signi ican alues a e obse ed in he mean a d angle o he igh hand o ce ical
cance pa ien (40.07± 3.24) compa ed o con ol (44.57±6.39) and also le hand o ce ical cance pa ien (41.49±
4.07) compa ed o con ol (46.88±7.83).
Conclusion: Inc eased a d angle o bo h hand has s ong p edilec ion o he de elopmen o ce ical cance .
Key Wo ds: De ma oglyphics s udy, Axial i adius, Digi al i adius, a d angle, ce ical cance , Ink me hod.
This is an Open Access a icle ha uses a unding model which does no cha ge eade s o hei ins i u ions o access and dis ibu ed unde
he e ms o he C ea i e Commons A ibu ion License (h p://c ea i ecommons.o g/licenses/by/4.0) and he Budapes Open Access Ini ia i e
(h p://www.budapes openaccessini ia i e.o g/ ead), which pe mi un es ic ed use, dis ibu ion, and ep oduc ion in any medium, p o ided
o iginal wo k is p ope ly c edi ed.
In oduc ion
Ce ical ca cinoma is he ou h mos common
cance among women wo ldwide, wi h an es ima ed
6, 61,021 new cases and 3, 48,189 dea hs wo ldwide
in 2022.[1] Wide a ia ions in incidence and
mo ali y om he disease exis be ween coun ies.
Cases and dea hs ha e declined ma kedly in he las
ew yea s as a esul o ex ensi e sc eening
p og ams and ad ancemen in ea men me hods.
Ce ical cance anks in he op i e cance s o bo h
incidence and mo ali y in low and medium HDI
(Human De elopmen Index) egions and India. An
es ima ed one million child en became ma e nal
o phans in 2020 because hei mo he died om
cance in ha yea , wi h close o one hal o hese
o phans he esul o ma e nal dea hs om ei he
emale b eas o ce ical cance .[1]
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P amanik e al. In e na ional Jou nal o Cu en Pha maceu ical Re iew and Resea ch
510
De ma oglyphics is he scien i ic s udy o epide mal
idges and hei con igu a ions on he palma egion
o hand and inge s and plan a egion o oo and
oes. The idge pa e n depends upon he co ni ied
laye o epide mis and de mal papillae. The ypical
pa e ns o epide mal idges a e de e mined since
hei o ma ion in e us. The e is p oli e a ion o
cells in he lowe zone o epide mis which p ojec s
in o he de mis as a egula ly spaced hickenings and
he de mis subsequen ly p ojec s upwa d in he
epide mal hollows. This is ollowed by he
appea ance o ele a ions o med by hem on he skin
su ace which gi es ise o epide mal idge.[2]
De ma oglyphics is he scien i ic s udy o epide mal
idges and hei con igu a ions on he palma egion
o hand and inge s and plan a egion o oo and
oes. The e m de ma oglyphics was coined by
Cummins H and Midlo C2 in 1926 and was de i ed
om G eek wo ds ‘de ma’ means skin and
‘glyphics’ means ca ings [3]. De elopmen o
de ma oglyphic pa e n is unde gene ic con ol.
This is e iden om he clea esemblance o
de ma oglyphics among ela ed pe son [4].
The e a e many diseases known o be caused by
abno mal genes. Whene e he e is any abno mali y
in he gene ic makeup o pa en s i is inhe i ed o he
child en and is e lec ed in de ma oglyphic pa e n
[5]. De ma oglyphics as a diagnos ic aid is now well
es ablished in a numbe o diseases, ha ing s ong
he edi a y basis, and also employed as a me hod o
sc eening anomalies [6]. De ma oglyphics has been
s udied ex ensi ely in ch omosomal diso de s & i
p o ed qui e use ul in he medico-legal,
an h opological & clinical ields. The ce ical
cance is one o he mos ex ensi ely s udied cance s
& i s gene ic basis was well es ablished [7]. The
sc eening p ocedu es like Pap smea es ha e been
e ec i ely educing he incidence a e by 80% and
mo ali y by 70% bu hey a e expensi e and
in asi e p ocedu es and also equipped se up is
equi ed [8]. The e iology o ce ical ca cinoma is
mul i- ac o ial wi h gene ics playing an impo an
ole. Taking in o conside a ion o gene ic
p edisposi ion o de ma oglyphics and ce ical
ca cinoma, he s udy was unde aken o ind ou
co ela ion be ween hem. Being inexpensi e and
non-in asi e p ocedu e de ma oglyphics may be
use ul sc eening p ocedu es o he popula ion a
isk in ce ical ca cinoma.
Ma e ials & Me hod
This hospi al based c oss-sec ional analy ical s udy
was conduc ed in di e en Medical Colleges &
Hospi al du ing June 2014 o May 2021. W i en
consen was aken om e e y pa ien included in
his s udy. The s udy was done a e aking
pe mission om he ins i u ional e hical commi ee
and e iew Boa d. His opa hologically con i med
se en y- wo cases o ce ical ca cinoma o abo e 15
yea s o age a e conside ed as case (Fig 1-3) & hei
i s -deg ee ela i es we e selec ed as con ol who
a e abo e 15 yea s o age o see he gene ic
p edisposi ion. Ce ical cance pa ien wi h no i s -
deg ee ela i es, e y se iously ill pa ien s, women
ha ing gene ic diso de o skin hype sensi i i y o
idge aplasia/hypoplasia we e excluded om he
s udy. Among he a ious me hods o
de ma oglyphics, his s udy was done by Ink Me hod
(desc ibed by Cummins H in 19369 and Cummins H
and Midlo C, 19612) o bo h palms. A e aking
p ope consen and explaining he p ocess, he
subjec s we e asked o clean hei hands wi h soaps
and wa e . A small amoun o Ko es black
duplica ing ink was placed on he glass slab a hin
e en ink ilm was made by ubbe olle . The a ea o
he palm o be p in ed was p essed upon he slab
gen ly. Then he inked a ea o he palm was place on
sligh ly glazed good quali y pape which was kep
o e he p essu e pad. Wi h he help o magni ying
glass axial and digi al i adius in palma p in o
s udy subjec s we e iden i ied. (Fig 4) A d angle has
been ex ensi ely used in de ma oglyphic
examina ions since i was o iginally in oduced by
Pen ose in 194910.The i adius is o med by h ee
idge sys ems in he palm. The i adius is ound a
he base o each inge excep he humb and hey
a e designa ed as a, b, c, d digi al i adii in o de
om index o li le inge . Ano he i adius is also
ound a he base o he palm be ween he hena and
hypo h¬ena eminences and i is known as axial
i adius ‘ ’. The angle be ween a line d awn om ‘ ’
o ‘a’ and ‘ ’ o ‘d’ is a d angle.[Fig: 1 ]. A d angle
is an indica ion o he deg ee o dis al displacemen
o axial i adius; and he angle inc eases as he
i adius is mo e dis ally loca ed. Da a was analyzed
e ealing mean and s anda d de ia ion and es ed by
wo- ailed s uden ’s - es (independen ).
Di e ences we e conside ed s a is ically signi ican
i P alues we e less han 0.05.
Figu e 1: Ke a in pea ls su ounded by malignan ce ical squamous cells in 40X magni ica ion
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Figu e 2: Nes s & co ds o ke aninised malignan ce ical squamous cells in 40X magni ica ion
Figu e 3: Nes s o malignan squamous cells wi h unde lying s omal in asion in ca cinoma ce ix in 40X
magni ica ion
Figu e 4: Measu emen o a d angle in bo h palm
Resul s and Analysis: In he p esen s udy a e aking inge p in s o bo h hands o all 144 (72 cases and 72
con ols) emales, ollowing obse a ions we e made.
Table 1: Age wise dis ibu ion o ce ical cance pa ien s and con ol g oup
Age g oup in yea s
Pa ien s
Con ols
F equency
Pe cen age
F equency
Pe cen age
16-20
2
2.78
5
6.94
21-25
1
1.39
6
8.32
26-30
13
18.06
14
19.45
31-35
10
13.89
10
13.89
36-40
16
22.22
13
18.06
41-45
13
18.06
8
11.11
46-50
14
19.44
11
15.28
>51
3
4.16
5
6.95
To al
72
100
72
100
Table 1 shows mean age o he ce ical cance pa ien s and con ol g oup we e 38.19 and 36.07 espec i ely.
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Table 2: S a is ical analysis o a d angle (deg ee) among pa ien s (n1=72) & con ols (n2=72)
G oups
a d angle(deg ee)
Righ hand(mean±SD)
Le hand(mean±SD)
Pa ien s
40.07±3.24
41.49±4.07
Con ols
44.57±6.39
46.88±7.83
alue
5.090
5.183
P alue
<0.001
<0.001
Rema ks
ES
ES
Table 2 shows ha , cance ce ix pa ien s show
signi ican ly lowe mean a d angle (deg ee) as
compa ed o con ols in igh hand and le hand, he
di e ences a e highly s a is ically signi ican .
Discussion
De ma oglyphics as a diagnos ic ool is now well
es ablished in a numbe o diseases which
ha e s ong he edi a y basis. Ce ical ca cinoma
being he he edi a y backg ound, ce ain
de ma oglyphic a ia ions we e o be expec ed in i .
The mean age o ca cinoma ce ix emales was
38.194 yea s. In his s udy he e is dec ease in mean
a d angle in ce ical cance pa ien s which was
ound o be 40.07±3.24compa ed o con ol g oup o
44.57±6.39in case o igh palm and 41.49±4.07 in
le palm compa ed o 46.88±7.83 o con ol g oup.
This inding was almos simila o he indings by
Wa amwa PP [11] in No h Indiain popula on
ha ing a d angle o 38.8±3.8 (con ol 47.4±6.4) and
38.8+4.4(con ol 47.3±6.3) o igh and le palm
espec i ely. Ou s udy e ealed highly signi ican
associa ion be ween a d angle and ca cinoma ce ix
which co esponds wi h simila s udy done in
U a p adesh, India by K P a allika[12] who ound
ha a d angle o igh palm was 44.92±2.91 and o
le palm was 43.84±3.70. Howe e , in con a y o
ou s udy, he a d angle was ound o be inc eased in
bo h s udies done by Pa il [13] in wes e n pa o
India & by Gahlo [14] in No h Indian popula ion.
Va ia ions in ATD angle no only ela ed o ce ical
cance bu also ela ed o o he gene ic diseases and
cance s. ATD angle was s a is ically signi ican ly
highe in bo h palm in pa ien s wi h b eas cance
seen in he s udy o Joh i V [15], and Rawa [16] &
Ganesh done on Indian popula ion & also in he
s udy o Me o ic A [17] done on Bosnian-
He zego inian popula ion. In he s udy o Olidipo
G.S [18] i was obse ed ha p os a e cance
pa ien s had signi ican ly lowe mean ATD angle
han he no mal subjec s. S udies done in India
showed he a d angle was la ge among ype 2
Diabe es Melli us pa ien s as compa ed o no mal
indi iduals.[19-21] This c oss-sec ional s udy
included 300 u e ine-ce ix cance pa ien s aged
be ween 21-60 yea s (mean=45.66 yea s).
P edominan age g oup a ec ed was 41-50 yea s,
ollowed by 51-60 yea s and 31- 40 yea s. Minimal
incidence was seen in 21-30 yea s age g oup. This
c oss-sec ional s udy included 300 u e ine-ce ix
cance pa ien s aged be ween 21-60 yea s
(mean=45.66 yea s). P edominan age g oup
a ec ed was 41-50 yea s, ollowed by 51-60 yea s
and 31- 40 yea s. Minimal incidence was seen in 21-
30 yea s age g oup
Limi a ions o he s udy
Conside ing all pa ame e s o de ma oglyphic ai
o bo h palm and sole a he han only a d angle
would ha e ende ed be e esul s. Including
subjec s om di e en geog aphical popula ions
and di e en e hnici ies migh inc ease ou sample
size and p oduce mo e app op ia e da a. Though
da a collec ion is quick, simple, non-in asi e,
inexpensi e and eadily accessible, bu inc ease in
size o hand wi h age esul s in al e a ion o a d
angle. The main limi a ion o he s udy was smalle
sample size wi h egional speci ici y. Some po en ial
e o in measu emen o subjec i e a ia ions may
occu du ing he measu emen by di e en
examine .
Fu u e Scope
In u u e, his ype o s udy can be done by
conside ing la ge sample size in di e en
geog aphical a ea along wi h o he de ma oglyphics
pa ame e s. To exclude obse e bias, machine
lea ning can be done o pa e n ecogni ion which
will ende mo e accu a e eadings.
Acknowledgmen
We hank all he pa ien s and hei amilies included
in he s udy and especially g a e ul o he depa men
o Pa hology and depa men o Gynaecology &
Obs e ics o di e en medical colleges o hei
suppo .
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