Evaluation of Lung Volume and Effect of Vital Staining as Motivation to Quit Tobacco among Nicotine Dependents of Kanpur, India

Abstract Objective: To quantify and compare respiratory functions and further screen the oral mucosa of tobacco and non-tobacco users. Material and Methods: First control group, non-tobacco users (n=55); Second group, smokers' group (n=168) who currently smoked cigarettes; Third group smokeless/chewing type, tobacco group (n=81); Fourth group, both smokeless and smoking type tobacco users (n=46). Fagerstrom Test for Nicotine Dependences (FTND) and Fagerström Test for Nicotine Dependence-Smokeless Tobacco (FTND-ST) instruments were used to assess nicotine dependence. Subsequently, spirometry and Toluidine Blue (TB) vital staining were performed. Chi-squared and one-way analysis of variance (ANOVA) were used for statistical analysis. Results: Fagerstrom test resulted in 48.8% of subjects with low dependency, followed by an increase in nicotine dependency from low to moderate (29.2%), moderate (15.6%), and highly dependent (6.4%) groups. All respiratory function tests and oral screening confirmed significant changes amongst tobacco and non-tobacco users. The forced vital capacity of non-smoker group was significantly different from other tobacco users' group (p<0.05). Conclusion: Early effects of tobacco use can lead to complications with the respiratory system and oral cavity. Such data can be used to delineate the harm of tobacco and should be used to urge individuals to evade the utilization of tobacco (AU).

Effect of propolis mouth rinse on oral microorganisms - a randomized controlled trial.

OBJECTIVES: To evaluate and compare the efficacy of prepared propolis mouth rinse with Chlorhexidine mouthwash on oral pathogens and also the plaque and gingival index scores. MATERIAL AND METHODS: A triple-blind, concurrent parallel randomized controlled trial was conducted on 120 participants randomized to 4 mouth rinse study groups: (1) Hot Ethanolic Propolis extract; (2) Cold Ethanolic Propolis extract; (3) Chlorhexidine and (4) Distilled water. After a washout period of two weeks, oral prophylaxis and polishing was performed. Participants rinsed twice a day for 3 months. Saliva was collected at baseline, 5 min and 1 h for microbiological analysis. Plaque and Gingival index were recorded at baseline, 15 days, 1 month and 3 months. Repeated measures ANOVA with Bonferroni post hoc tests were used for statistical analysis. RESULTS: A decline in the concentration of S. mutans was observed in samples collected after the use of mouth rinse (p < 0.05). In comparison with baseline, L. acidophilus and S. mutans count decreased simultaneously when exposed to Hot Ethanolic mouthwash group (5.5 × 102) and Chlorhexidine mouthwash (5.8 × 102) respectively. At the end of 3 months, similar reduction in plaque scores was found in Chlorhexidine (0.45), Cold Ethanolic (0.46), Hot Ethanolic (0.47) mouthwash groups. CONCLUSION: Propolis was found to be as efficient as Chlorhexidine in reducing plaque, gingivitis and dental caries pathogens. CLINICAL RELEVANCE: Common microorganisms implicated in oral disease are S. mutans and L. acidophilus. There is great paucity of information on antimicrobial activity of propolis, against these microorganisms. Hence, the present study has been taken up to assess the effects of propolis on these oral pathogens.The effects of propolis on oral health have been proved which is obviously a new finding of significance.

Sources of Oral Health Information and its Relationship on Knowledge Among Indian Adolescents

ABSTRACT Objective: To assess the current level of oral health knowledge and identify information sources among adolescents in Bhubaneswar, India. Material and Methods: A cross-sectional examination was conducted among 1330 adolescents aged 13 to 15 years enrolled in 24 randomly selected government and private schools in Bhubaneswar. A specially designed self-administered questionnaire was used to collect the responses. Chi-square test with a level of significance set at 5% was used for statistical analysis. Results: Parents (55%) followed by media (18%) were the major sources of oral health information among the study population, which was statistically not significant in relation to gender and school type. Many subjects (95.3%) perceived sweets could cause tooth decay; however, this was statistically significant only among school type (p<0.05). Around (45%) knew about fluoride and only 36% properly identified fluoride's action as preventing cavities. This was statistically significant among both gender and school type (p<0.05). Seventy-five percent of students effectively distinguished gum disease symptoms, which was significant only with gender (p<0.05). Around 55% identified that oral habits have an influence on oral health, which showed significance among gender (p<0.05). Conclusion: Children oral health knowledge was not satisfactory, highlighting the need to utilize parents, schoolteachers and media to provide oral health education. It's essential for designing and implementing a person-centered care model in dentistry.

Assessing the effect of oral diseases on oral health related quality of life of institutionalized elderly using Oral Health Impact Profile (OHIP-14) questionnaire: a pilot study.

BACKGROUND: India establishes a geriatric population of about 80 million which is 7.2% of the total population. The geriatric population is often faced by a negative impact on their quality of life due to poor oral health. OBJECTIVES: To assess the impact of oral disease on daily activities and quality of life among the institutionalized elderly in Kanpur, India. MATERIALS AND METHOD: A total of fifty-six patients were purposively selected from two old age homes through convenience sampling technique. To assess the oral health status WHO basic oral health survey form (1997) was used. Short version of Oral Health Impact Profile (OHIP - 14) questionnaire was used to assess the Oral Health Related Quality of Life (OHRQoL). Independent t-test and ANOVA test was done to determine the relationship between the groups. RESULTS: Presence or absence of grossly decayed teeth, chronic periodontitis, based on edentulism and remaining sound teeth status produced no significant differences in any of the domains. In comparison with males, females experienced greater impact of oral diseases with respect to mean OHIP-14 score; however, it was non - significant (p=0.45). CONCLUSION: Oral health status of the institutionalized subjects in Kanpur city is poor, with edentulism and periodontitis. The effect of oral diseases on the lives of elderly is comparatively low and is non-significant.

Risk factors and patterns of traumatic dental injuries among Indian adolescents.

BACKGROUND/PURPOSE: Dental injuries in children have functional, esthetic, and psychological effects, with consequences for the child, parent, and dentist. This study assessed the pattern of traumatic dental injuries and their relationship with predisposing factors among 12- and 15-year-old school children in Kanpur, India. MATERIALS AND METHODS: A cross-sectional study was conducted on 1100 boys and girls aged 12 or 15 years. Anterior permanent teeth were examined based on the modified Ellis classification. Type of damage, size of incisal overjet, and adequacy of lip coverage were also recorded. Chi-square tests and multiple regression analysis were used for statistical analysis. RESULTS: The prevalence of traumatic dental injuries to anterior teeth was 10.9%. Age and gender distribution indicated that most injuries occurred in 15-year-old age group (11.3%) and among boys (11.5%). The gender-related difference was statistically significant (p < 0.024). Maxillary central incisors (83.7%) were frequently involved. The predominant injury type was enamel fracture (68.3%) mainly due to falls (52.5%). Increased overjet, inadequate lip coverage, type of school, and gender were significant contributing factors for traumatic dental injuries. CONCLUSION: Study reveals the frequency and cause of traumatic injuries to anterior teeth, which assists in identifying risk groups and treatment needs in order to establish effective preventive strategies.

Mature landfill leachate treatment using sonolytic-persulfate/hydrogen peroxide oxidation: Optimization of process parameters.

The suitability of stand-alone ultrasound (US) system, coagulation pre-treatment followed by US, hydrogen peroxide added US system (US-H2O2) and persulfate added US system (US-PS) for the treatment of matured landfill leachate was investigated. With US system, around 67% COD removal and an increase in BOD/COD ratio were observed (from 0.033 to 0.142) after 15 min at 30% US amplitude. However, the energy input required for landfill leachate treatment in US system was found to be very high due to the presence of fixed solids. Coagulation pretreatment using alum was carried out to improve the overall COD removal and reduce the cost of treatment. As a result, the COD removal was increased to 78% (42% in pretreatment and 36% in US) in 15 min. On the other hand, US-H2O2 and US-PS hybrid systems have shown significant improvement in COD removals (93% and 86%, respectively) from raw leachate after 15 min. Subsequently, a three factor (i.e. PS dose (mg/L), H2O2 dose (mol/L), and US amplitude (%)) 5-level design of experiment was used to maximize the COD removal efficiency by response surface methodology (RSM). The RSM model generated a quadratic equation to accurately analyze the influence of input variables on COD removal efficiency (R2 of 0.92). A maximum COD removal of 98.3% was predicted using the model and the corresponding optimal experimental condition were identified as follows: PS dose ∼4700 mg/L, H2O2 dose ∼0.7 mol/L and US amplitude ∼49%. The overall observations reveals that PS and H2O2 coupled with US system has a great prospective to treat mature landfill leachate.

Candidal carriage in diabetic patients: a microbiological study.

OBJECTIVE: Candida yeast species are widespread opportunistic microbes and incidence of its carriage in diabetic patients compared with non-diabetic controls is not clearly defined. The present study was carried out to isolate and identify the candida species in type I, type II diabetes mellitus patients and in controls. Study comprised of 60 subjects in the age range of 20 to 65 years, consisting of two groups of diabetes patients with controlled diabetic status (20 subjects each with type I and type II) and 20 age and sex matched controls. Saliva samples were collected from all groups and inoculated on Sabouraud's Dextrose Agar (SDA) to check for the fungus growth. The confirmed candidal colonies were further inoculated on CHROMagar for different colour differentiation. Out of 60 samples, 40 (66.67%) showed a positive fungal prevalence. Out of 40 positive fungal prevalence 82.50% were representative of candida. The positive fungal prevalence for candida I was 48.48%, in group II was 30.30%, in group III was 21.21 %. Further speciation in CHROMagar revealed different species of candida predominantly of candida albicans 20% and few mixed culture of candida albicans with candida krusei 5% and candida albicans with candida tropicalis 5% in group I. In group II, candida albicans was 35% and mixed culture of candida albicans with candida glabrata was 5%. In group III, candida albicans was 25% and candida tropicalis was 5%. The findings confirm that diabetic patients harbor yeast in their oral cavity and are more susceptible to oral candidiasis and also that CHROMagar medium is a satisfactory isolation medium for oral cavity specimens, allowing rapid and accurate identification of yeast colonies with easy recognition of mixed culture and is easy to use.

Assessment of hospital based prevalence of oral cancer among population of Kanpur, Uttar Pradesh.

BACKGROUND: Oral cancer incidence depends on both qualitative and quantitative factors wherein the incidence of oral cancer in patients with smoking and tobacco chewing habit is 8.4 times higher than that of patients with no habit. AIM: To understand about the prevalence of oral cancer in population of Kanpur reported to the hospital and analyse the association with age, gender and tobacco habit. MATERIAL AND METHOD: All 320 cases of Squamous cell carcinoma diagnosed histopathologically, since January 2007 to December 2016, were retrieved from the archives and a retrospective study was conducted along with association with the variables such as age, gender, site, habit and histopathological type. RESULTS: A total of 71 cases were reported in the age group of 30-39 (22.18%) and 60 cases (18.75%) were seen to be below 30yrs. Among individuals with habit, 135 (42.18%) were tobacco chewers and smoking was prevalent in about 48 (15%). The prevalence was more in males 37 (15.22%). Amongst both males (44.03%) and females (48.05%) gingivo-buccal sulcus was the most common site. The least common site was seen to be lip with only 10 (3.12%) patients. Well differentiated squamous cell carcinoma was common in both males and females with 155 (63.78%) and 47 (61.03%) respectively. Poorly differentiated squamous cell carcinoma was only reported in 4(1.64%) males. CONCLUSION: Early detection of these oral cancers will enable appropriate clinical management and monitoring. Moreover, improving the incidence, mortality, and survival rates of oral cancer requires a multi-tier structural approach that targets society, dentists, communities, and the individual.

Cavitary myiasis and its management.

OBJECTIVE: Myiasis is a parasitic disease of humans and vertebrates, caused by fly larvae feeding on the host's necrotic or living tissue. Myiasis is classified into cutaneous and cavitary myiasis. Cavitary myiasis is rare and occurs more frequently in tropical and subtropical regions of Africa and America associated with low economic status and poor hygiene. This article reviews current literature, provides general descriptions, and discusses life cycles of each species. It also gives diagnosis, treatment techniques and descriptions of each type of illness that result from interaction / infestation.

Awareness on cytology procedure in oral cancer detection among undergraduates: An institutional study.

BACKGROUND: The screening and the early detection of the premalignant and malignant lesions are the only means for controlling the oral cancer which is known to be one of the leading causes for mortality worldwide. Oral exfoliative cytology though not a substitute for biopsy can be a powerful tool for its early detection. Dental Surgeons can play a great role in this direction. AIMS AND OBJECTIVES: The present study was undertaken to assess the self-reported knowledge and attitude regarding the early detection of oral cancer and exfoliative cytology among the undergraduates of Rama Dental College, Kanpur. MATERIAL AND METHODS: A pretested questionnaire based cross sectional study consisting of twenty four questions was conducted among hundred randomly selected students from third year, final year and intern's batch. RESULTS: According to 73% of students biopsy was the special test done in oral cancer detection and only 59% had heard regarding oral cytology technique. Formalin was the fixative known for cytology smears among 61%. Significance of toluidine blue staining was not known by 62%. Seventy seven percent of students were not aware about classes of cytology reporting. Eighty six percent of students felt that the adequacy of training in cytology was lagging. CONCLUSION: This survey identified an existing gap in the knowledge among the dental students regarding cytology as a diagnostic aid in oral cancer detection. This emphasizes the need to provide training for undergraduates at clinical level on regular basis and also through CDE and oral can-cer detection workshops.

Assessment of relationship of ABO blood groups among tobacco induced oral cancer patients of Kanpur Population, Uttar Pradesh.

BACKGROUND: The possibility of association between ABO blood groups and malignancy was first discussed by Anderson DE & Haas C. The association between blood group and oral cancer is least explored and hence this study was undertaken to evaluate relationship of ABO blood groups with an increased risk for oral cancer. MATERIALS AND METHOD: The present study was conducted at various cancer hospitals in Kanpur. The study samples comprised 100 oral cancer patients and 50 controls with tobacco chewing habit. The information regarding the socio demographic profile, history on tobacco habits, type of oral cancer and ABO blood group profile was obtained from the case sheets of the patients. RESULTS: The frequency of squamous cell carcinoma was significantly higher in men (78%) than women (22%) and mostly found in the age range of 45-65 years and also consuming chewing type of tobacco. It was found that out of 100 patients, 53 were of blood group B+ve, 28 of O +ve, 16 of A+ve and 3 had the blood group AB+ve. The high potential risk of developing OSCC was more in B+ve blood group (1.96 times), and relative frequency (%) in blood group O+ve (1.64 times) than in the control group Among locations of oral cancers, squamous cell carcinoma of tongue (25%) and buccal mucosa (15%) was more common in B+ve and Carcinoma of floor of mouth (11%) was more common in O+ve blood group cases. It was found that people with blood group B+ve, followed by O+ve had increased risk of developing OSCC with most prevalent being Well Differentiated OSCC as compared to people of other blood groups. CONCLUSION: The present study reveals that there is an inherited element in the susceptibility against different types of oral cancers. The people with blood group B+ve and O+ve having tobacco chewing habits can be appraised that they are more at risk to develop oral cancer than people with other blood groups.

Micronuclei assay in exfoliated buccal cells of radiation treated oral cancer patients.

BACKGROUND: Micronuclei are suitable internal dosimeters for revealing tissue-specific genotoxic damage in individuals exposed to carcinogenic mixtures. Evaluation of radiation-induced cellular changes to predict radiosensitivity has invested many investigators since such changes were first found in biopsy material. AIM: The aim of the present study was to assess the relationship of with histopathological grade and number of radiation therapy sittings with the frequency of micronuclei and nuclear anomalies among oral cancer patients. MATERIAL & METHOD: Thirty male patients with histologically proven cases of oral cancer undergoing radiation therapy and age and sex matched 20 healthy controls were included in the study. Scrape cytology smears of exfoliated buccal cells were prepared and stained using Feulgen stain and frequency of micronuclei and other nuclear anomalies counts were evaluated with the help of light microscope expressed as per 1000 buccal cells. RESULTS: The mean values of the micronuclei and nuclear anomalies were 14.03 and 21.30 respectively. There was a significant association and strong positive correlation of Radiation exposure and grades of squamous cell carcinoma with micronuclei and nuclear anomalies. There was no statistically significant association and correlation between nuclear anomalies in well differentiated and moderately differentiated carcinomas. CONCLUSION: With increase number of radiation therapy sittings, there was increase in number of micronuclei and nuclear anomalies. Hence the result of this study highlights that increased number of micronuclei and nuclear anomalies provides information regarding radiosensitivity of epithelial cells.

Detection of microorganisms on formalin-fixed and stored pathology tissues: A microbiological study.

BACKGROUND: Formalin is widely used to fix histological preparations and as preservatives in embalming solutions and is an age-long practice in medical laboratories. It is generally accepted that the risk of contracting infections is relatively high among medical laboratory workers and pathologists. Recent studies have, however, suggested that formalin does not effectively inactivate all kinds of microbes in formalin-fixed tissue (FFT). Long time preserved tissues in formalin may develop growth of microbes on the surface of the formalin. AIMS AND OBJECTIVES: The purpose of the study is to determine the growth of microorganisms on the surface of FFTs. MATERIALS AND METHODS: Fifty-one containers of 10% formalin with fixed tissues and undiscarded formalin solution not containing tissues of years 2013-2015 (17 in each year) were selected, and samples for inoculation onto the cysteine lactose electrolyte deficient agar plates were taken from the surface of the FFT using sterile cotton tips. The growth of the colonies was checked for after 48 h. RESULTS: Out of 51 samples from 2013 to 2015, 17 had shown growth of microbial colonies. Six out of 17 samples of 2013, 7 out of 17 of 2014 and 4 out of 17 samples of 2015 had colonies of microbes on agar plates. Gram-negative bacilli, Bacillus subtilis and micrococci were mostly found. CONCLUSION: There were viable microbes on the surfaces of formalin solution containing pathology tissue. Since cross-contamination by microbes may occur during regrossing or processing, protocols to decrease cross-contamination should be instituted.

Basal cell adenoma of palatal glands.

OBJECTIVE: Salivary gland neoplasms represent less than 3% of all tumors in the general population of which benign adenomas account for 65.5%. Basal cell adenoma which is classified as a subtype of monomorphic adenomas accounts for 1-2% of all salivary gland epithelial tumors, and more than 80% of them arise in the major salivary glands, mostly the parotid gland and has female predominance reporting mostly in the elderly age groups. We here report a case of basal cell adenoma of trabecular type in a male patient of age 45 years in the minor salivary glands of left posterior palatal region.

Prevalence of odontogenic lesions among the Kanpur population: an institutional study.

BACKGROUND: The frequency and incidence of odontogenic cysts and tumors are controversial and depends in the geographic location. These lesions have great clinical and histopathological diversity, and reflect a need for epidemiological profile to be considered when these lesions are studied. AIM: The purpose of this study was to determine the prevalence of odontogenic cysts and tumors over a period of 10 years and to compare with other data reported around the world. MATERIALS AND METHODS: Data for the study were obtained from the archives of the Department of Oral and Maxillofacial Pathology, diagnosed as the cases of Odontogenic cysts and tumors histopathologically, reported from January 2007 to March 2016. Case records of the patients that fit the histological classification of the World Health Organization (2005) were included in the study and the variables analyzed were: Age, sex, anatomical location, and histological type. RESULTS: In a total of 1319 biopsies reported, 112 were odontogenic in nature. Of these 112 odontogenic lesions reported, Odontogenic Cysts accounted for 54.4% and odontogenic tumors of 45.53%. Of them 61.60% of the patients were males. Common age of occurrence was 21-50 years and mandibular posterior was the most common site of occurrence. Most common odontogenic cyst and tumor reported was dentigerous cyst and ameloblastoma respectively. CONCLUSION: This study provides epidemiological information on odontogenic cyst and tumors at an institutional level. The relative frequency of these cysts and tumors can be analyzed at a global level to understand their prevalence, incidence, biological behaviour, and distribution.

Evaluation of the Secretor Status of ABO Blood Group Antigens in Saliva among Southern Rajasthan Population Using Absorption Inhibition Method.

INTRODUCTION: The ABO blood group system was the significant element for forensic serological examination of blood and body fluids in the past before the wide adaptation of DNA typing. A significant proportion of individuals (80%) are secretors, meaning that antigens present in the blood are also found in other body fluids such as saliva. Absorption inhibition is one such method that works by reducing strength of an antiserum based on type and amount of antigen present in the stains. AIM: To check the efficacy of identifying the blood group antigens in saliva and to know the secretor status using absorption inhibition method among southern Rajasthan population. MATERIALS AND METHODS: Blood and saliva samples were collected from 80 individuals comprising 20 individuals in each blood group. The absorption inhibition method was used to determine the blood group antigens in the saliva and then the results were correlated with the blood group of the collected blood sample. The compiled data was statistically analysed using chi-square test. RESULTS: Blood groups A & O revealed 100% secretor status for both males and females. While blood groups B and AB revealed 95% secretor status. CONCLUSION: Secretor status evaluation of the ABO blood group antigen in saliva using absorption inhibition method can be a useful tool in forensic examination.

Perceived barriers to the provision of preventive care among dentists of Udaipur, India.

AIM: To investigate the practice-, patient- and dentist related barriers to the provision of preventive dental care as perceived by dentists of Udaipur city, Rajasthan, India. SETTINGS AND DESIGN: - A cross sectional descriptive survey was conducted among 120 dentists of Udaipur city, Rajasthan. MATERIAL AND METHODS: Mean Content Validity Ratio (CVR) was calculated as 0.87 based on the opinions expressed by a panel of total six academicians. Cronbach's coefficient was found to be 0.88, which showed a high internal reliability of the questionnaire. The questionnaire consisted of demographic questions and 12 specific research questions. STATISTICAL ANALYSIS USED: - Student's t-test and ANOVA test were applied for the statistical evaluation of means. Level of significance was set at 0.05. RESULTS: The barriers correlated strongly with each other (0.60 to 0.85). A significant gender difference was observed in mean sums of scores of practice and patient related barriers. Practice, dentist and patient related barriers for very much hindrance were reported by 8 to 13%, 5 to19% and 0 to 29% of the dentists respectively. A significant difference was observed among mean of sum scores of practice and patient related barriers with age and experience. Qualification was significantly related to practice related barriers. CONCLUSIONS: Perception of dentists showed that patient related barriers were found to be the foremost to the provision of preventive care. Also, dentist's attitude towards health promotion and disease prevention needs a radical transformation. Key words:Dental care, dentists, patients, perception.

Relationship between oral clinical conditions and daily performances among young adults in India - a cross sectional study.

Objective of the present study was to investigate relationship between oral health-related quality of life using Oral Impacts on Daily Performances (OIDP) scale and specific clinical dental measures. A cross sectional descriptive survey was conducted among 800 students. Oral health status and impacts were assessed using WHO guidelines and OIDP index respectively. Chi square test and multiple logistic regressions were employed for statistical analysis. Participants with caries were significantly (p⩽0.05) more likely to have an impact on cleaning (OR=2.487) and sleeping and relaxing (OR=8.996). Similarly participants with oral mucosal conditions were more likely to have an impact on eating (OR=3.97), cleaning (OR=2.966) and physical activities (OR=11.190). Dental Aesthetic Index (DAI) impacted on cleaning (OR=2.134), emotional stability (OR=3.957) and social contact (OR=3.21). OIDP Index showed acceptable psychometric properties in the context of an oral health survey. Subjects presented a strong and consistent relationship between dental status and perceived impacts.

Dimorphic Mandibular canines in gender determination in Moradabad population of Western Uttar Pradesh.

BACKGROUND AND OBJECTIVES: Among morphological characteristics that differentiate a male from a female, tooth size has also been evaluated in various populations for its applicability in anthropologic and forensic investigations to identify the gender from dental remains. The present study was undertaken to investigate the accuracy of mesio-distal width of the mandibular canines, inter-canine arch width, and Mandibular Canine Index (MCI) with which gender can be differentiated in Moradabad population and to correlate the results with other available data. MATERIALS AND METHODS: A cross-sectional study was conducted on the casts of 30 males and 30 females between the age group of 19-30 years. RESULTS: The mean right and left canine dimension (RCW and LCW) for females was between 6.28 mm and 6.54 mm while that of males was 7.06 mm and 7.45 mm. The mean inter-canine arch width (ICW) in males was 27.64 mm, whereas in females was 23.42 mm. Area under curve (AUC) of ICW, RCW, and LCW had 100%, 98%, and 99.7%. The predicted sensitivity and specificity observed of three criteria was 100% for ICW, 93.3% and 93.3% for RCW, and 96.7% and 100% for LCW, which were found to be highly statistically significant. The mean values of right and left CMI were significantly higher in females as compared to males (P < 0.001). CONCLUSION: The MCI parameter in the present study was a quick and reliable method for sexual identification and showed sexual dimorphism by both the RMCI and LMCI with greater significance in identifying females by using RMCI.