jiafm, 2010-32(2) april-june. - forensic medicine

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ISSN 0971-0973 J Indian Acad Forensic Med, 32(2)Original research paperAge Assessment from Radiological Cranial Suture closure in Fourthto Seventh decades (A Jaipur Based Study)*Dr. Rajesh Kumar Verma, **Dr Mukesh K Goyal, ***Dr Shiv. KocharAbstractReasonably a correct estimation of age in important in Legal, Medical, Social and Administrative mattersi.e. regularization of temporary employee, retirement from service or superannuation, re-employment in services,settlement of pension cases, distribution of old age pension, potency certification, for relaxation in imprisonment onthe grounds of old age and good behavior of a prisoner, to provide senior citizen benefits etc.In the dead person the age estimation at the time of autopsy is done to help the Investigating Officer. InIndia and other countries the task of scientific confirmation of disputed age issue of civil and criminal nature is thedomain of Forensic Expert. This study is done to determine the age of individual in the fourth decade to seventhdecades by correlating radiological finding of various views of skull along with the other physical findings.Maximum Number of cases was in the age group of 51-55 yrs (17%). Female to male ratio was 1:2.2, 66% caseswere urban and 34% were rural, 72% Hindu and 73% were from Middle class.Key Words: Cranial Coronal and Squamosal Suture, Age Estimation, Fourth to Seventh decadesIntroduction:The assessment of age is done byanthropologist, archeologist, anatomist and personengaged in medico-legal or forensic case works.Among all these, the work of forensic expertsrequires special attention because his findings aredirectly related to the administration of law, and hisconclusions are debated in court of law. The needs ofage determination vary from intra-uterine life to oldage for different purpose. Sometimes even when theage of person is known by horoscope, hospitalrecords and birth certificate, but still its scientificconfirmation is required by court of law and certainadministrative department. In India and many othercountries the task of scientific conversion of disputedage issue of civil and criminal nature is the domain ofForensic expert.The scientific estimation of age is not aneasy task especially in adult age group.Corresponding Author:Dr Rajesh Kumar Verma,*Assistant Professor,Department of Forensic Medicine,SMS Medical College Jaipur (Rajasthan)Mobile No +91 9413622969**Associate Professor, Department of ForensicMedicine, People‟s College of Medical Sciences,Bhanpur, Bhopal.(M.P.)***Professor, Department of Forensic Medicine,SMS Medical College, Jaipur, RajasthanUsually the age estimation up to 25yrs isdone by physical examination, appearance ofsecondary sexual characters, data from dentaleruption, and maturity of bones, appearance andfusion of various ossification centers. However thesedata to some extent are influenced by heredity,climate, race, diet, hormone level, disease process,etc.After 25 yrs of age, other scientific methodslike tooth microscopy, Gustafson‟s methods(applicable to dead persons only), study of pubicsymphysis, study of union of parts of sternum,lipping of joints and closure of cranial suture areconsidered for age estimation of the individual.Suture are analogus to the epiphysio-diaphysis planein which both are loci of age on radiological changesin cranial suture may be done scientifically in thepost adult age group and elderly persons.Aims and Objectives:The Present study was undertaken with aview to draw a define criteria of estimation of age onthe basis of radiological closure of various suture ofskull of living persons in the known age group of 40-70 yrs. This study was done with following aims andobjectives:1. To study the patterns of closure of various sutureof skull.2. To find out the average age of fusion of varioussutures of skull.3. To find out the earliest age of fusion ofindividual sutures of the skull.4. Comparative study of patterns of closure of skullsuture region wise with available data of120
J Indian Acad Forensic Med, 32(2) ISSN 0971-0973previous work of different workers in India andabroad.Methodology:This prospective study was conducted indepartment of Forensic Medicine and Toxicology ofS.M.S. Medical College & Associate Hospital,Jaipur, i.e. Feb-2000 to March-2002. The personselected for the study were in the age group 30-35yrs, 36-40yrs, 41-45yrs, 46-50yrs, 51-55yrs, 56-60yrs,61-65yrs, 66-70yrs, 71-75yrs, 76-0nwards.Aftertaking proper history in relation to determination ofage ,availability of certificate indicating date of birth ,horoscope or any such document, physicalexamination, skiagraphy were carried out afterobtaining their informed consent and the cases wereclassified into two groups.Group I: Subject with confirmed age as per birthcertificate/ horoscope/service records.Group II: Subject without any age proof, whoseage was labellled from their statement withcorrectness within six month to two years.Cases that had any major endocrinological ormetabolic diseases were excluded from thestudy.Observations:All findings which were recorded inspecially designed Performa which were than reducedto tables and subjected to computer aided statisticalanalysis.Discussion and Conclusion:In this study we have used radiologicalobliteration of cranial suture for age estimation alongwith other accessory criteria viz. greying of hair,appearance of lines and furrow on face (Facialaging), arcus senilis and appearance of menopause infemales. These criterion were not considered byYadav S.S. and Puri P.R. (1971) [1] Patil T.L. (1981),[2] Bhagwat S.S.(1983) [3] and Chandrashekharan P.(1985). [4] The fusion process of cranial suture atautopsy has been modified as 0, 1 and 2 by MoondraA.K.(2000), [5] in contrast to Fredric rating scale 0,1, 2, 3, 4. Since our study is radiological study inliving subject. Four Cranial Sutures-Saggital,Coronal, Lambdoid and Squamosal have been studiedand their progression towards fusion has been dividedin three categories: 1- Not commenced, 2- In processof fusion and 3-Fused.The development and consolidation of thebones of the skeleton, which ossify in cartilagesoccurs , as a rules, about two yrs earlier in femalesthan in males ,but obliteration of sutures of vault ofskull sets in a little later and proceeds slowly infemales than in males i.e. the obliteration of vaultsuture occur earlier in males than in females Rentouland Smith, H.(1963), [6] similar observation werealso made by Yadav S.S., Puri R.R. (1971), Vyas,P.c.(1996), [7] Moondra A.K.(2000). [5] We too arein agreement with their observation. Nandy A.(1986), [8] has also found that ossification activityoccur earlier in western population, than Indianpopulation, which is attributed to racial difference,food habits and nutritional status, in the present studyFindings are also in accordance. The workerwho has studied the autopsy specimen for study ofprocess of ossification and suture fusionKrogman(1978). [9] Rentoul & Smith (1973) [6] hasconcluded that the study of ectocranial fusion is lesssignificant than endocranial fusion viz. Dwight(1890), [10] Patil (1981) [2]. Robert Shapiro (1960) ,[11] because suture along the outer table are more orless serrated while at inner table they are combativelystraight, whereas the process is speedy and moreuniform and complete in the endocranial surface. Thephenomenon of lapsed union is more common in theectocranial surface, Todd & Lyon (1924). [12] Ourstudy is based on the radiological facts of the fusionprocess where the difference between ecto andendocranium is not possible on x-ray of skull.Conclusion:In this study we have Important Inferenceregarding Male subjects (67%) are that CoronalSuture the fusion occurred in the lower part of this ofsuture at the age of 42-44 yrs and then proceed toupper 1/2 part at the age of 52yrs. Squamosal Suture -This suture is visualized in lateral view of skull x-rayonly, it get fused at the age of 80 yrs. ImportantInference regarding Female subjects (33%) are thatCoronal Suture - the lower ½ part of this suture getfused at the age of 42-44 yrs and is followed by upper½ part, which is found fused at the age of 56 yrs.Squamasol Suture-appreciable fusion occur at the ageof 81 yrs.References:1. Yadav, S.S. and Puri, R.R. Jr. Indian Academy ForensicScience January. 11: (1971).2. Patil,T.L.,Bhargava and Qureshi, A.A. The study ofcranial suture closure of the vault. J.anat.Soc.of Ind.30-38,(1981).3. Bhagwat S. S., Pal G.P., Outal R.V.R. Patel V. A study ofsutural bones in Gujrati Crania. J. Anat. Soc. India 33 (1): 33,(1984).4. Chandrashekhran, P. Skull suture – Forensic Science as iswhat is: The Forensic Science Society of India, Madras: 166,(1985).5. Moondra A.K. Age assessment from vault suture closure inelderly person(An Autopsy study in Haroti Region):Dissertation for M.D. : University of Rajasthan (2000).6. Rentoul, E. and Smith H. Glaister‟s Medical Jurisprudenceand Toxicology: 13 th ed. Churchill Livingstone, Edinburghand London, 80, (1973).7. Vyas P.C. and Sischer, H. Age estimation by closure ofsuture of skull in individuals of 25-45 yrs of age of Jaipurarea. Dissertation for M.D. (Forensic Medicine) University ofRajasthan (1996).8. Nandy, A. Principles of Forensic Medicine. Ist ed., Newcentral book Agency (P) ltd., Calcutta 77, 78, 83 (1995).121
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