Hand Index- A Forensic Tool for Sexual Dimorphism

Introduction: Amongst the various parameters of identification, sex is one  of the most important elements. Figuring out hand index from measurement of hand dimensions is a convenient way to determine sexual dimorphism. This study aims to find out sexual dimorphism from hand dimensions, obtain cut off points for male and female and check percentage accuracy of sex determination from hand dimensions in Nepalese population. Methods: The data was collected from 400 asymptomatic, healthy working staffs  (229 males & 171 females) above 23 years  in the department of Forensic Medicine and Toxicology of a tertiary care center of Western  Nepal. Measurements of  hand length and hand breadth were taken using standard instruments and hand index was calculated therefrom. Results: The mean (+SD) right hand lengths for male and female were found to be 17.87 cm (+0.87) and 16.93cm (+0.58) respectively. The mean (+SD) left hand lengths for male and female were 17.85 cm (+0.86)and 16.97 cm (+0.56)respectively. The average hand breadth for male was 1.00 cm greater for right hand and 0.96 cm greater for left hand as compared to female hand breadth. Differences in length and breadth of hands for both sexes were statistically significant (p<0.001) with no statistically significant difference of hand dimensions in the same sex. Cut off point for right hand index was found to be 42.32 cm and for left hand, 42.30 cm. Conclusion: Hand dimensions and hand index can be reliably used to determine sex in medicolegal cases, especially where isolated hand is obtained

Vision screening among hearing-impaired school children in Biratnagar, Nepal

Background: The prevalence of hearing impairment in Nepal is 16.5%, affecting approximately 2.71 million people. Deaf children are visually dependent, and even a mild refractive error may cause visual discomfort. The goal of this study was to determine the need for vision screenings in schools for the hearing impaired in Biratnagar, Nepal. Methods: A cross-sectional study was conducted with permission from Birat Deaf Secondary School, Biratnagar, Nepal. A total of 130 hearing-impaired students were examined. Non-invasive, comprehensive optometric examinations were performed to detect visual disorders. When a more detailed evaluation was needed, the students were referred to the Pediatric Ophthalmology Department, Biratnagar Eye Hospital Biratnagar, Nepal. Results: Of the 130 hearing-impaired students, 58 (44.6%) were male and 72 (55.4%) were female. The mean ± standard deviation of age was 16.03 ± 3.8 years (range 6–25 years). Twenty-one (16.1%) students had refractive errors: 13 (10%) had myopia, 7 (5.4%) had hyperopia, and 1 (0.8%) had anisometropia. In the cover test, 88 (67.7%) had orthophoria, 19 (14.6%) had exophoria, 11 (8.5%) had esophoria, 5 (3.85%) had exotropia, and 3 (2.3%) had esotropia. Cover tests were not performed in 4 (3.1%) students, as they were unable to fixate due to nystagmus or decreased vision. On ocular examination, 20 (15.3%) students had anterior segment abnormalities, including lid abnormality, conjunctivitis, Bitot’s spots, pterygium, corneal opacity, and lenticular opacity. Posterior segment or retinal abnormalities were found in four students with one having Usher syndrome. Color vision defects, nystagmus, and amblyopia were found in 8 (6.1%), 2 (1.5 %), and 1 (0.8%), respectively. Conclusions: The findings of the present study reflect the need of periodic vision screenings in schools for the hearing impaired in Nepal. These children are at a high risk of vision impairment. How to cite this article: Sah SK, Thakur R, Adhikari PR. Vision screening among hearing-impaired school children in Biratnagar, Nepal. Med Hypothesis Discov Innov Optom. 2021 Spring; 2(1): 36-40. DOI: https://doi.org/10.51329/mehdioptometry123 &nbsp

Estimation of Height from Foot Dimensions

Introduction: Height determination by measuring various body parts is of value in medicolegal investigations as well as in anthropology. The current study was conducted to analyze interrelation between foot dimensions and stature, and to predict stature from foot dimensions. Methods: The study was done in medical students where stature, foot length, and foot breadth were quantified using standard instruments. We calculated correlations between variables with correlation test and predicted stature from foot length and foot breadth using linear regression. Results: The correlation between foot length and stature, and foot breadth and stature were statistically significant in both gender (p < 0.05). Greater correlation coefficient between foot length and stature than that for foot breadth and stature indicated stronger correlation between foot length and stature. Separate formulae were drawn for calculation of stature from foot breadth and foot length by regression analysis. Conclusion: Both foot breadth and foot length were correlated with stature. Foot length was found to be a better predictor of stature

Normative value of photostress recovery time among various age groups in southern India

Background: To determine the normative data and reference value for photostress recovery time (PSRT) following exposure of the macula to light, in various age groups within the Indian population. Methods: Cross-sectional observational study performed from November 2015 to July 2016 in the Bangalore district of Karnataka state in India. We examined a total of 1,282 eyes of 641 participants and included those with corrected distance visual acuity (CDVA) scoes lower than  or equal to 0.4 Logarithm of the Minimum Angle of Resolution (LogMAR). We performed the photostress procedure under standard conditions using the same approach. Results: The mean ± standard deviation (SD) of the participants’ age was 32.04 ± 15.80, with an age range of 8 to 70 years. The PSRT in participants below 16 years and above 45 years of age were significantly different compared to the 16–25-year-old age group (P  <  0.0001 for both). The PSRT values were significantly different between males and females in the reproductive age group (16 to 45 years old) (P  < 0.0001), but not in the other age groups. Conclusions: The PSRT values were significantly different in children and older patients compared to the 16 to 25 years age group. We found that as age increased, PSRT increased significantly

Changes in anterior segment parameters of normal subjects during accommodation using a Scheimpflug imaging system

Background: Accommodation changes ocular parameters, such as the anterior chamber volume (ACV), anterior chamber depth (ACD), anterior chamber angle (ACA), and pupil diameter (PD), which can reflect a risk of angle-closure glaucoma. Previous studies of changes in ocular anterior segment parameters, have used high diopters or maximum amplitude. Here, we focused on normal accommodation at a reading distance of 30‒40 cm. The aim of this study was to assess changes in anterior segment parameters during a normal accommodative state, using a Scheimpflug imaging system. Methods: In this cross-sectional study, 40 emmetrope subjects (mean ± SD of age: 22 ± 4.0 years) who met the inclusion criteria and provided informed consent were enrolled. Clinical history, refraction, amplitude of accommodation, slit lamp examination, Goldman applanation tonometry, and Pentacam investigations were performed on all subjects. Accommodative and non-accommodative targets were induced via the Pentacam. Two seconds were allowed for accommodation or relaxation prior to measurements in each eye. Results: Eighty normal eyes were evaluated; a small but statistically significant change in ACV, ACA, and PD during accommodation (P < 0.01, < 0.01, and < 0.05, respectively) was observed. The ACD did not change substantially with accommodation (P = 0.29). The mean ± SD values of ACV, ACD, ACA, and PD before and after accommodation were 151.85 ± 24.04 mm3 and 145.38 ± 23.30 mm3, 2.87 ± 0.28 mm and 2.86 ± 0.27 mm, 35.06° ± 3.68° and 33.84° ± 3.72°, and 3.46 ± 0.57 mm and 3.41 ± 0.53 mm, respectively. Conclusions: Accommodation changes ocular parameters, such as ACV, ACA, and PD, in healthy young emmetropes. Interestingly, the ACD remains unaltered during accommodation. Nevertheless, although these changes were statistically significant, they were not clinically significant in our study

Managing Change and Strategic Thinking: Evidences from Hospitality and Tourism Sector of the UK

This qualitative paper examines the strategic thinking and managing change in complex business environment in the hospitality and tourism sector of the UK through the cases of Hilton London Canary Wharf and Hilton London Tower Bridge. For the purpose of analysis, researchers explored the research phenomenon under different models including TALC model and IBTEE Model. Using convenience sampling, researchers interviewed face-to-face 12 Line Managers and 30 employees through open-ended semi-structured interview questions regarding change management process and obstacles interlinked with it. Findings revealed that although Hilton hotels have adapted changes to some extent but there is still more room for further improvement. The management of the selected hotels highly relies on the training purpose for the effective change adaption whereas coaching and research is lagging behind. The biggest constraint during effective change adaption is the diverse background of the workforce as most are from the multicultural backgrounds. Moreover, the communication, ritual, and cultural barriers are causing issues in the change process. Lastly, the recommendations are given for consolidating effective change management at workplace

Sexual Dimorphism of Maxillary Sinus: A Morphometric Analysis using Computed Tomography

 Introduction: Gender determination is the important aspect of forensic science. Most of the bones used for sex determination are badly disfigured and found in incomplete state, thus bones recovered intact are used. Maxillary sinus being recovered intact can be used for gender determination by measuring maxillary sinus dimension through computed tomography (CT). The aim of this study was to assess sexual dimorphism using morphometric maxillary sinus measurements through CT scan. Methods: This analytical cross-sectional study included CT scan images of 80 patients (40 males and 40 females). Maxillary sinus mediolateral (ML), superoinferior (SI), anteroposterior (AP) linear dimensions and volume were measured. All the measured parameters were then subjected to Student’s t-test to determine mean difference between males and females and discriminative statistical analysis to determine gender. Results: The mean value of maxillary sinus length, width, height and volume in males on both right and left sides were (3.80±0.175, 3.74±0.209) cm, (2.57±0.317, 2.51±0.295) cm, (3.55±0.338, 3.5±0.286) cm and (17.49±3.909, 16.54±3.274) cm3 respectively and in females (3.67±0.250, 3.64±0.256) cm, (2.37±0.297, 2.34±0.3222) cm, (3.29±0.280, 3.23±0.254) cm and (14.42±2.935, 13.81±2.779) cm3 respectively. The discriminative analysis showed that the accuracy of maxillary sinus measurements was 72.5% in females and 75% ofmales (overall accuracy = 73.8%). Conclusion: The maxillary sinus measurements are valuable guide for sex determination with relatively good accuracy rate

Managing Strategic Change and ERP Implementation under Distinctive Learning Styles: Quantitative case of Burberry PLC

This paper examines the effective strategic change management and Enterprise Resource Planning implementation under distinctive learning styles namely; diverging, converging, assembling, and accommodating learning styles through case of Burberry brand at Bicester Village, Cheshire Oaks, and Chatham Place. Additionally, paper investigates the strategic changes and organizational factors in relation with the ability to adopt change and successful ERP implementation. Total 87 respondents were approached through snowball, purposive, and convenience sampling. Findings revealed that accommodating learning style is the most influential learning style that significant positively affects the ERP implementation process. Interestingly, all learning styles (diverging, converging, assimilating, and accommodating) have statistically significant correlation with organizational change process. Additionally, complexity is the most critical organizational component affecting employees' ability to accept changes

Pattern of Head Injuries in Western Hilly Region of Nepal: A Hospital-based Cross-sectional Study

Introduction: Subtle or gross structural changes of scalp, skull and its contents due to application of direct or indirect external force are known as head injuries. Head being the most vulnerable and prominent part of body, injuries to it cause major mortality and morbidity globally. This study focussed to find the pattern of traumatic head injuries in patients presented to Lumbini Medical College Teaching Hospital, Palpa, Nepal. Methods: The data was collected from 252 patients (164 males and 88 females) with head injuries attending Emergency or out-patient department of Neurosurgery of the institute. All patients with traumatic head injuries (scalp injury, skull fracture, intracranial haemorrhage and brain injury) were included in the study and brought dead patients and patients with non-traumatic brain lesions were excluded. Results: Among the various modes of head injuries, the most frequent was road traffic accidents accounting 125 (49.60%) cases and fall from height 108 (42.86%) cases was second to it followed by physical assault 12 (4.76%) and others 7(2.78%). Manner of injuries were unintentional in 238 (94.44%) of cases. Among males, intentional injuries were present in 5 (2.98%) cases and among females, 9 (10.72%) cases presented with intentional injuries. In 105 (41.67%) of the cases, head injuries were associated with injuries to the other body parts as well. Conclusion: The most common cause of head injury was found to be road traffic accident followed by fall from height. Intentional injuries were more common in females when compared to males