Differing genetic variants associated with liver fat and their contrasting relationships with cardiovascular diseases and cancer.

BACKGROUND & AIMS: The mechanisms underlying the association of steatotic liver disease with cardiovascular and cancer outcomes are poorly understood. We aimed to use MRI-derived measures of liver fat and genetics to investigate causal mechanisms that link higher liver fat to various health outcomes. METHODS: We conducted a genome-wide association study on 37,358 UK Biobank participants to identify genetic variants associated with liver fat measured from MRI scans. We used a Mendelian randomisation approach to investigate the causal effect of liver fat on health outcomes independent of BMI, alcohol consumption and lipids using data from published genome-wide association studies and FinnGen. RESULTS: We identified 13 genetic variants associated with liver fat that had differing effects on the risks of health outcomes. Genetic variants associated with impaired hepatic triglyceride export showed liver fat-increasing alleles to be correlated with a reduced risk of coronary artery disease and myocardial infarction but an elevated risk of type 2 diabetes, while variants associated with enhanced de novo lipogenesis showed liver fat-increasing alleles to be linked to a higher risk of myocardial infarction and coronary artery disease. Genetically higher liver fat content increased the risk of non-alcohol-related cirrhosis, hepatocellular carcinoma, and intrahepatic bile duct and gallbladder cancers, exhibiting a dose-dependent relationship, irrespective of the mechanism. CONCLUSION: This study provides fresh insight into the heterogeneous effect of liver fat on health outcomes. It challenges the notion that liver fat per se is an independent risk factor for cardiovascular disease, underscoring the dependency of this association on the specific mechanisms that drive fat accumulation in the liver. However, excess liver fat, regardless of the underlying mechanism, appears to be causally linked to cirrhosis and cancers in a dose-dependent manner. IMPACT AND IMPLICATION: This research advances our understanding of the heterogeneity in mechanisms influencing liver fat accumulation, providing new insights into how liver fat accumulation may impact various health outcomes. The findings challenge the notion that liver fat is an independent risk factor for cardiovascular disease and highlight the mechanistic effect of some genetic variants on fat accumulation and the development of cardiovascular diseases. This study is of particular importance for healthcare professionals including physicians and researchers, as well as patients, as it allows for more targeted and personalised treatment by understanding the relationship between liver fat and various health outcomes. The findings emphasise the need for a personalised management approach and a reshaping of risk assessment criteria. It also provides room for prioritising a clinical intervention aimed at reducing liver fat content (likely via intentional weight loss) that could help protect against liver-related fibrosis and cancer.

Genetic scores associated with favourable and unfavourable adiposity have consistent effect on metabolic profile and disease risk across diverse ethnic groups.

AIM: This study aims to investigate the associations between genetic risk scores (GRS) for favourable and unfavourable adiposity and a wide range of adiposity-related outcomes across diverse populations. METHODS: We utilised previously identified variants associated with favourable (36 variants) and unfavourable (38 variants) adiposity to create GRS for each adiposity phenotype. We used summary statistics from 39 outcomes generated by the Pan-UKB genome-wide association studies Version 0.3, incorporating covariates such as age, sex and principal components in six populations: European (n = 420,531), African (6636), American (980), Central/South Asian (8876), East Asian (2709) and Middle Eastern (1599). RESULTS: The favourable adiposity GRS was associated with a healthy metabolic profile, including lower risk of type 2 diabetes, lower liver enzyme levels, lower blood pressure, higher HDL-cholesterol, lower triglycerides, higher apolipoprotein A, lower apolipoprotein B, higher testosterone, lower calcium and lower insulin-like growth factor 1 generally consistently across all the populations. In contrast, the unfavourable adiposity GRS was associated with an adverse metabolic profile, including higher risk of type 2 diabetes, higher random glucose levels, higher HbA1c, lower HDL-cholesterol, higher triglycerides, higher liver enzyme levels, lower testosterone, and higher C-reactive protein generally consistently across all the populations. CONCLUSION: The study provides evidence that the genetic scores associated with favourable and unfavourable adiposity have consistent effects on metabolic profiles and disease risk across diverse ethnic groups. These findings deepen our understanding of distinct adiposity subtypes and their impact on metabolic health.

Advancing a causal role of type 2 diabetes and its components in developing macro- and microvascular complications via genetic studies.

The role of diabetes in developing microvascular and macrovascular complications has been subject to extensive research. Despite multiple observational and genetic studies, the causal inference of diabetes (and associated risk factors) on those complications remains incomplete. In this review, we focused on type 2 diabetes, as the major form of diabetes, and investigated the evidence of causality provided by observational and genetic studies. We found that genetic studies based on Mendelian randomization provided consistent evidence of causal inference of type 2 diabetes on macrovascular complications; however, the evidence for causal inference on microvascular complications has been somewhat limited. We also noted high BMI could be causal for several diabetes complications, notable given high BMI is commonly upstream of type 2 diabetes and the recent calls to target weight loss more aggressively. We emphasize the need for further studies to identify type 2 diabetes components that mostly drive the risk of those complications. Even so, the genetic evidence summarized broadly concurs with the need for a multifactorial risk reduction approach in type 2 diabetes, including addressing excess adiposity.

Anthropometric correlations between parts of the upper and lower limb: models for personal identification in a Sudanese population.

PURPOSE: Identification of a deceased individual is an essential component of medicolegal practice. However, personal identification based on commingled limbs or parts of limbs, necessary in investigations of mass disasters or some crimes, is a difficult task. Limb measurements have been utilized in the development of biological parameters for personal identification, but the possibility to estimate the dimensions of parts of limbs other than hands and feet has not been assessed. The present study proposes an approach to estimate the dimensions of various parts of limbs based on other limb measurements. METHODS: The study included 320 Sudanese adults, with equal representation of men and women. Nine limb dimensions were measured (five based on the upper limb, four based on the lower limb), and extensive statistical analysis of the distribution of values was performed. RESULTS: The results showed that all of the measured dimensions were sexually dimorphic and that there was a significant positive correlation between the dimensions of various parts of limbs. Regression models (direct and stepwise) were developed to estimate the dimensions of parts of limbs based on measurements pertaining to one or more other parts of limbs. CONCLUSIONS: The study revealed that the dimensions of parts of the upper and lower limb can be estimated from one another. These findings can be used in medicolegal practice and extended to constructive surgery, orthopedics, and prosthesis design for lost limbs.

A study of correlations within the dimensions of lower limb parts for personal identification in a Sudanese population.

The presence of an isolated limb or limb parts from different individuals presents a major challenge for medicolegal investigators in establishing identification in cases of wars, mass disasters, and criminal assaults because different populations have different sizes and proportions. The measurement of lower limb dimensions showed a high success rate in establishing individual identity in terms of sex and stature in various populations. However, there is a paucity of data concerning the correlation within the lower limb parts. This study aims to assess the existence of relationships within lower limb parts and to develop regression formulae to reconstruct limb parts from one another. The tibial length, bimalleolar breadth, foot length, and foot breadth of 376 right-handed Sudanese adults were measured. The results showed that all variables were significantly larger in males than in females. A significant positive correlation (P < 0.001) was found within the lower limb parts. Sex-specific linear equations and multiple regression equations were developed to reconstruct the lower limb parts in the presence of single dimension or multiple dimensions from the same limb. The use of multiple regression equations provided a better reconstruction than simple regression equations. These results are significant in forensics and orthopedic reconstructive surgery.

The association between a rotator cuff tendon tear and a tear of the long head of the biceps tendon: Chart review study.

Rotator cuff (RC) and long head of the biceps tendon (LHBT) tears are common shoulder problems presented to the orthopedic clinic. The aim of this study was to assess the association between RC and LHBT tears among a Saudi population sample. A total of 243 patients who were diagnosed with shoulder pain due to RC or LHBT tear between 2016 and 2018 using a magnetic resonance imaging scan were included in this study. Females comprised 66% of the sample, and 59% (n = 143) of the shoulders were on the right side. The mean age of the patients was 58 ± 11 years, ranging from 23 to 88 years. A significant association was detected between the LHBT and RC tears (P < 0.001). Out of 26 cases showing RC and LHBT tears, 81% had a full thickness tear, whereas 19% had a partial tear. The LHBT tears were presented significantly in 48% of cases with at least two completely torn RC compared to 10% in cases with one completely torn RC (P < 0.001). The LHBT tear was significantly observed in shoulders with RC tears including the tendons of subscapularis, supraspinatus, and infraspinatus, but not the teres minor (P < 0.001). Both types of tears were presented significantly in senior patients aged more than 65 years compared to younger patients (P < 0.01). Thus, the LHBT should be assessed carefully in shoulders with more than one RC tear or in chronic cases.

A Rare Case of Idiopathic Elbow Septic Arthritis in an Adult.

Introduction: Septic arthritis of the elbow is a rare, serious condition that requires prompt medical attention. With proper treatment, most individuals are able to recover fully and regain function in the affected joint. However, without treatment, septic arthritis of the elbow can lead to long-term joint damage and disability. Case Report: This case report presents a rare occurrence of septic arthritis in the elbow joint of a 23-year-old male patient. The patient presented with pain, swelling, and limited range of motion in the affected joint. After a thorough clinical assessment and diagnostic imaging, a diagnosis of septic arthritis was confirmed. The patient was promptly treated with intravenous antibiotics and joint aspiration to drain the infected fluid. Following treatment, the patient showed significant improvement in symptoms and regained full range of motion in the affected elbow joint. Conclusion: Prompt drainage and washout of the impacted joint are recommended for both diagnostic and therapeutic reasons. The functional outcome of the affected joints depends on the time interval between the onset of the symptoms and surgical intervention and it is crucial to quickly and precisely identify the presence of microorganisms in the synovial fluid.

Genetic Evidence Strongly Supports Managing Weight and Blood Pressure in Addition to Glycemic Control in Preventing Vascular Complications in People With Type 2 Diabetes.

OBJECTIVE: To investigate the causal association of type 2 diabetes and its components with risk of vascular complications independent of shared risk factors obesity and hypertension and to identify the main driver of this risk. RESEARCH DESIGN AND METHODS: We conducted Mendelian randomization (MR) using independent genetic variants previously associated with type 2 diabetes, fasting glucose, HbA1c, fasting insulin, BMI, and systolic blood pressure as instrumental variables. We obtained summary-level data for 18 vascular diseases (15 for type 2 diabetes) from FinnGen and publicly available genome-wide association studies as our outcomes. We conducted univariable and multivariable MR, in addition to sensitivity tests to detect and minimize pleiotropic effects. RESULTS: Univariable MR analysis showed that type 2 diabetes was associated with 9 of 15 outcomes; BMI and systolic blood pressure were associated with 13 and 15 of 18 vascular outcomes, respectively; and fasting insulin was associated with 4 and fasting glucose with 2. No robust association was found for HbA1c instruments. With adjustment for correlated traits in the multivariable test, BMI and systolic blood pressure, consistent causal effects were maintained, while five associations with type 2 diabetes (chronic kidney disease, ischemic heart disease, heart failure, subarachnoid hemorrhage, and intracerebral hemorrhage) were attenuated to null. CONCLUSIONS: Our findings add strong evidence to support the importance of BMI and systolic blood pressure in the development of vascular complications in people with type 2 diabetes. Such findings strongly support the need for better weight and blood pressure management in type 2 diabetes, independent of glucose lowering, to limit important complications.

Practical Guide to Undergraduate Medical Curriculum Alignment and Mapping.

Objective: Curriculum development and reviews are of paramount importance for academic programs curriculum management. Medical curricula need proper construction and frequent updates to suits learning outcomes considering their integrative nature and rapid scientific advancement. Curriculum alignment and mapping are fundamental for proper integration and planning of medical curriculum. This process is beneficial in detecting gaps and redundancies, and ensuring proper instruction, integration, and transparency. However, there is a paucity in the literature of a practical guidance to such process. Hence, this manuscript provides a practical guidance that was adopted in our institutes. Methods: A detailed description of twelve step-by-step guidance to curriculum alignment and mapping was provided. The process needed for each step and the flow chart of work was detailed. Results: This guide was developed and implemented successfully. Among many benefits encountered, many gaps in the contents, learning outcomes and assessment methods were detected and rectified. Additionally, better curriculum integration has been achieved. The current mapping will make any future curriculum reviews easier. Conclusion: This guide could be utilized by newly developed and existing programs for curriculum alignment and mapping. It fills a gap in academic literature through stepwise workflow which has been tested and implemented.

Stature estimation for Saudi men based on different combinations of upper limb part dimensions.

ABSTRACT: Estimating stature based on body/limb parts can help define the characteristics of unidentified bodies. The most studied upper limb part is the hand, although few studies have examined whether stature can be estimated using fingers plus other hand dimensions. Moreover, there is paucity in anthropometric studies that determined whether bilateral whole limb parts (e.g., arms, forearms, and hands) are related to stature among the living subjects.This prospective cross-sectional study aimed to evaluate the relationship between different upper limb measurements and the stature of Saudi men. Furthermore, I assessed whether upper limb asymmetry was present, and developed regression models to estimate stature based on different available measurements. Stature and 13 upper limb parameters were measured for 100 right-handed Saudi men who were 18 to 24 years old.All measurements were positively correlated with stature (P < .001), and the best single predictor was the bilateral ulnar length. Asymmetry was more pronounced in the hand measurements. A multiparameter model provided reasonable predictive accuracy (±3.77-5.68 cm) and was more accurate than single-parameter models. Inclusion of the right-side fingers improved the model's accuracy.This study developed potential models for estimating stature during the identification of bodies of Saudi men.

Morphometric Analysis of the Mandibular Canal, Anterior Loop, and Mental Foramen: A Cone-Beam Computed Tomography Evaluation.

This study investigated the cone-beam computed tomography (CBCT)-based features of the mandibular canal, mental foramen, anterior loop, and accessory mental foramina with respect to age and sex. A total of 306 CBCT mandibular images were included in this retrospective study to measure the mandibular canal location and extension, the mental foramen position, the presence of the anterior loop, and the accessory mental foramina. The measurements were obtained in sagittal, coronal, and axial views. Descriptive statistics are presented. Sex-related differences, correlations, and comparisons were calculated using SPSS at 5% significance level. The mandibular canal was located more coronal and medial in male patients. The majority of cases had the mental foramen located just apical to the mandibular second premolar with a mean height of 2.94 mm and a mean length of 3.28 mm. Age affected the size of the mental foramen. The mental canal in all cases tended to show a coronal direction. Mesial extension of the anterior loop was found in 66.01% of the images while accessory mental foramina were detected in 2.6%. The complexity of the mandibular canal, mental foramen, anterior loop, and accessory mental foramina among Sudanese patients with respect to age and sex was confirmed.

Estimation of sex based on the sterna of Sudanese adults using multidetector computed tomography: a comparison of discriminant function analysis and binary logistic regression.

Sex estimation is critical during forensic and anthropological investigations, and various techniques are used based on the presence of complete or fragmented human remains. This study evaluated sexual dimorphism in Sudanese sterna using multidetector computed tomography. This information was used to develop models for estimating sex, and to compare the accuracies of models based on discriminant function analysis (DFA) and binary logistic regression (BLR). The study included 126 Sudanese men and 144 Sudanese women who underwent computed tomography scans to create three-dimensional reconstructions. Six linear dimensions were measured on the manubrium and mesosternum. Men had larger mean values for most parameters, and nine parameters exhibited highly significant sexual dimorphism. The leave-one-out cross-validated sex estimation accuracies were 60.4-88.9% for DFA-based models and 60.4-89.3% for BLR-based models. The BLR-based models had noticeably better performances, with six parameters having sex estimation accuracies of >80% (vs. three parameters for DFA). The best BLR-based models incorporated the lengths and widths of the manubrium and mesosternum (accuracy: 89.3%, sex bias: 2.2%) and the combined manubrium and mesosternum lengths (accuracy: 85.6%, sex bias: 2.7%). Thus, computed tomography may be useful for measuring sternal dimensions and estimating sex among Sudanese subjects.

Topological variability and sex differences in fingerprint ridge density in a sample of the Sudanese population.

Fingerprints are important biometric variables that show manifold utilities in human biology, human morphology, anthropology, and genetics. Their role in forensics as a legally admissible tool of identification is well recognized and is based on their stability following full development, individualistic characteristics, easy classification of their patterns, and uniqueness. Nevertheless, fingerprint ridge density and its variability have not been previously studied in the Sudanese population. Hence, this study was conducted to analyze the topological variability in epidermal ridge density and to assess the possibility of its application in determining sex of Sudanese Arabs. The data used for this study were prints of all 10 fingers of 200 Sudanese Arab individuals (100 men and 100 women) aged between 18 and 28 years. Fingerprint ridge density was assessed for three different areas (radial, ulnar and proximal) for all 10 fingers of each subject. Significant variability was found between the areas (p < 0.01). Women showed significantly higher ridge density in the three areas for all and each fingers. Men and women showed similar patterns of densities with distal areas being denser than proximal ones. Side asymmetry was more evident in distal areas. Ridge density thresholds for discrimination of sexes were developed. Hence, fingerprints found in forensic examinations/crime scenes can be useful to determine sex of Sudanese individuals based on fingerprint ridge density; furthermore, ridge density can be considered a morphological trait for individual variation in forensic anthropology.

Cephalo-facial analysis to estimate stature in a Sudanese population.

Medico-legal practitioners are often confronted with dismembered remains from which they need to develop a biological profile to establish identity. Accurate estimation of stature is an initial, crucial component of any meaningful medico-legal evaluation. However, sometimes only cephalo-facial remains are available. The most accurate statistical estimations of biological attributes are based on population-specific standards. Therefore, this study assessed the ability to estimate stature using 15 cephalo-facial measurements in 240 Sudanese adults (120 men, 120 women) aged 18-25years. Stature and cephalo-facial measurements of men were significantly higher than those of women. Most of the measurements were significantly correlated with stature (p<0.05), with better correlations for women than for men. The accuracy of stature estimation using sex-specific simple and stepwise multiple regression equations ranged from ±52.53 to ±60.28mm. This study provides new forensic standards for stature prediction in a Sudanese population. However, the equations should be used with caution in forensic cases when the more reliable body parts (e.g., limbs) are not available for human identification.

Altered Lamin A/C splice variant expression as a possible diagnostic marker in breast cancer.

BACKGROUND: Lamin A/C alternative splice variants (Lamin A, Lamin C, Lamin AΔ10 and Lamin AΔ50) have been implicated in cell cycle regulation, DNA replication, transcription regulation, cellular differentiation, apoptosis and aging. In addition, loss of Lamin A/C expression has been observed in several cancers, including breast cancer, and it has been found that Lamin A/C suppression may lead to cancer-like aberrations in nuclear morphology and aneuploidy. Based on these observations, we hypothesized that Lamin A/C transcript variant quantification might be employed for the diagnosis of breast cancer. METHODS: Newly designed TaqMan qRT-PCR assays for the analysis of Lamin A/C splice variants were validated and their use as biomarkers for the diagnosis of breast cancer was assessed using 16 normal breast tissues and 128 breast adenocarcinomas. In addition, the expression levels of the Lamin A/C transcript variants were measured in samples derived from seven other types of cancer. RESULTS: We found that the expression level of Lamin C was significantly increased in the breast tumors tested, whereas the expression levels of Lamin A and Lamin AΔ50 were significantly decreased. No significant change in Lamin AΔ10 expression was observed. Our data also indicated that the Lamin C : Lamin A mRNA ratio was increased in all clinical stages of breast cancer. Additionally, we observed increased Lamin C : Lamin A mRNA ratios in liver, lung and thyroid carcinomas and in colon, ovary and prostate adenocarcinomas. CONCLUSIONS: From our data we conclude that the Lamin C : Lamin A mRNA ratio is increased in breast cancer and that this mRNA ratio may be of diagnostic use in all clinical stages of breast cancer and, possibly, also in liver, lung, thyroid, colon, ovary and prostate cancers.

Morphological study of palatal rugae in a Sudanese population.

Palatal rugae patterns have unique characteristics and have been proposed as an alternative method to establish identity when other means, such as fingerprints and dental records, are not attainable. This study was conducted to determine the morphological characteristics of palatine rugae and to assess the existence of side asymmetry in them in Sudanese Arabs. It also assesses the possibility of determining sex using logistic regression. One hundred dental casts for 50 males and 50 females aged between 18 and 23 were studied for palatal rugae dimensions, shapes, and orientations, as well as sexual dimorphism and side symmetry. The most predominant rugae were primary, and the most prevalent shapes in both sexes were wavy, curved, and straight forms. The predominant orientation was forward. Side asymmetry existed more in the orientations than in the shapes, but no side asymmetry was recorded in the dimensions. There was no significant sexual dimorphism in the rugae dimensions, shapes, and orientations, except for forward-directed rugae (P < 0.037). A predictive value of 60% was obtained in assigning sex using dimensions and orientations and of 58% using shapes alone. Therefore, the palatal rugae are not recommended for assigning sex effectively among Sudanese Arabs unless it is the only means available.

Estimation of sex from the anthropometric ear measurements of a Sudanese population.

The external ear and its prints have multifaceted roles in medico-legal practice, e.g., identification and facial reconstruction. Furthermore, its norms are essential in the diagnosis of congenital anomalies and the design of hearing aids. Body part dimensions vary in different ethnic groups, so the most accurate statistical estimations of biological attributes are developed using population-specific standards. Sudan lacks comprehensive data about ear norms; moreover, there is a universal rarity in assessing the possibility of sex estimation from ear dimensions using robust statistical techniques. Therefore, this study attempts to establish data for normal adult Sudanese Arabs, assessing the existence of asymmetry and developing a population-specific equation for sex estimation. The study sample comprised 200 healthy Sudanese Arab volunteers (100 males and 100 females) in the age range of 18-30years. The physiognomic ear length and width, lobule length and width, and conchal length and width measurements were obtained by direct anthropometry, using a digital sliding caliper. Moreover, indices and asymmetry were assessed. Data were analyzed using basic descriptive statistics and discriminant function analyses employing jackknife validations of classification results. All linear dimensions used were sexually dimorphic except lobular lengths. Some of the variables and indices show asymmetry. Ear dimensions showed cross-validated sex classification accuracy ranging between 60.5% and 72%. Hence, the ear measurements cannot be used as an effective tool in the estimation of sex. However, in the absence of other more reliable means, it still can be considered a supportive trait in sex estimation. Further, asymmetry should be considered in identification from the ear measurements.

Quantification of insulin receptor mRNA splice variants as a diagnostic tumor marker in breast cancer.

BACKGROUND: The mature human insulin receptor (INSR) has two isoforms: The A isoform and the B isoform. INSR upregulation has been suggested to play a role in cancer. OBJECTIVE: To establish quantitative PCR method for INSR transcript variants and examine their differential expression as a diagnostic tumor marker in breast cancer. METHODS: The differential expression of IR-A and IR-B were evaluated by TaqMan qRT-PCR assay in the commercially available Breast Cancer Disease cDNA and Cancer Survey cDNA arrays. RESULTS: The mRNA expression levels of IR-A was statistically significantly higher in breast cancer when compared to normal breast tissue while IR-B mRNA expression was down regulated significantly in breast cancer. Stratification of patients into groups according to metastatic stages indicated statistically significantly higher levels of IR-A mRNA in clinical stage (CS)-IV, and lower IR-B levels in CS-IIA, CS-IIIB and CS-IIIC. However, IR-A:IR-B ratio showed a statistically significant increase in all stages. Cancer Survey cDNA array demonstrated lower levels of IR-B mRNA in breast adenocarcinoma, liver carcinoma and lung carcinoma only while IR-A expression was significantly altered in kidney carcinoma without any significant differences in IR-A:IR-B ratios. CONCLUSIONS: The results demonstrate an increased IR-A:IR-B ratio in all clinical stages of breast cancer. Thus, IR-A:IR-B ratio may have a diagnostic biomarker utility in breast cancer.

Estimation of stature from the upper limb measurements of Sudanese adults.

The estimation of stature using different parts of the body is crucial for formulating a biological profile during the process of personal identification, especially when mutilated and amputated limbs or body parts are found. Hand anthropometry has been reported in the literature including limited range of populations to be promising for stature prediction, but few studies have attempted to link upper limb anthropometry to stature. No previous research on this topic has been reported for modern Sudanese adults. Therefore, the aim of this study was to assess the relationship between the upper limb dimensions and stature in Sudanese adults and to develop regression formulae to estimate stature from these dimensions. The stature, upper arm length, ulnar length, wrist breadth, hand length, and hand breadth of 200 right-handed subjects, comprising 100 males and 100 females (aged 25-30 years), were measured. Initially, the data were analyzed using basic univariate analysis and independent t-tests; then sex-specific simple and multiple linear regression models were used to estimate stature. The results indicated significant sexual dimorphism for all measurements. There was a positive correlation between upper limb measurements and stature (p<0.01), which was highest for ulnar length. The accuracy of stature prediction ranged from ±3.54 to 5.85 cm. The use of multiple regression equations gave better results than simple regression equations. This study provides new forensic standards for stature estimation from the upper limb measurements of Sudanese adults.

Estimation of sex from the upper limb measurements of Sudanese adults.

Sex estimation is the first biological attribute needed for personal identification from mutilated and amputated limbs or body parts in medical-legal autopsies. Populations have different sizes and proportions that affect the anthropometric assessment of sex. Relatively few published works assess the accuracy of sex estimation from soft tissue measurements of upper limb parts, except for the hand and its components, but these studies involve a limited range of global populations. The current study aimed to assess the degree of sexual dimorphism in upper limb measurements and the accuracy of using these measurements for sex estimation in a contemporary adult Sudanese population. The upper arm length, ulnar length, wrist breadth, hand length, and hand breadth of 240 right-handed Sudanese subjects (120 males and 120 females) aged between 25 and 30 years were measured by international anthropometric standards. Demarking points, sexual dimorphism indices and discriminant functions were developed from 200 subjects (100 males and 100 females) who composed the study group. All variables were sexually dimorphic. The ulnar length, wrist breadth and hand breadth significantly contributed to sex estimation. Forearm dimensions showed a higher accuracy for sex estimation than hand dimensions. Cross-validated sex classification accuracy ranged between 78.5% and 89.5%. The reliability of these standards was assessed in a test sample of 20 males and 20 females, and the results showed accuracy between 77.5% and 90%. This study provides new forensic standards for sex estimation from upper limb measurements of Sudanese adults.