Estimation of sex based on metrics of the sternum in a contemporary Jordanian population: A computed tomographic study.

ABSTRACT: There is a paucity of osteometric standards for sex estimation from unknown skeletal remains in Jordan and the sexual dimorphism of the sternum has not yet been investigated. The aim of this study was to evaluate the sexual dimorphism in sternal measurements using 3D multidetector computed tomography (MDCT), and to assess their reliability for sex estimation in a Jordanian population. A total of 600 MDCT scans (300 males and 300 females) were used and a total of 8 sternal measurements were studied (manubrium length, sternal body length, combined length of manubrium and body, corpus sterni width at 1st and 3rd sternebrae, sternal index and area). Sexual dimorphism was evaluated by means of discriminant function analyses. Significant sexual dimorphism was found mainly in middle-aged and older adults. Including all subjects, multivariate, and stepwise functions gave an overall accuracy of 83.0% and 84.0%, respectively. Additionally, multivariate and stepwise analyses were conducted separately for each age group. The accuracy of sex estimation in multivariate analysis (all variables) varied from 63.2% in the young, and 83.7% in the middle adults to 84.9% for older adults. In stepwise analysis, the highest accuracy rates were provided by only sternal area in young adults (81.6%), and sternal area combined with sternal body length in middle-aged and older adults (84.2% and 85.3%, respectively). The best sex discriminator using univariate analysis (single variable) was sternal area followed by sternal body length (84.0% and 80.8% respectively). Notably, univariate analyses for most variables gave relatively higher classification accuracies in females but were poor at predicting males in the sample (sex bias ranged between -6.4% and -20%). Our data suggest that dimorphism in the human sternum increases with advancing age and separate discriminant functions are needed for each age group in Jordanians. In addition, multivariate and stepwise analyses using sternum gave higher classification accuracies with comparatively lower sex biases compared to univariate analyses.

Estimation of sex from measurements of foramen magnum region in a contemporary Jordanian population: A computed tomographic study.

Several studies have shown variability in basicranial measurements between populations. Therefore, each population should have specific standards to optimize the accuracy of identification. The aim of this study was to evaluate the sexual dimorphism in foramen magnum and occipital condyles measurements using 3D multidetector computed tomography (MDCT), and to assess their utility and reliability for sex estimation in a Jordanian population by means of discriminant function analyses. A total of 500 MDCT scans (288 males and 212 females) were used and a total of 8 basicranial measurements were studied (3 measurements were derived from foramen magnum, and 5 measurements were derived from occipital condyles). Significant sexual dimorphism was found in all basicranial measurements. The most dimorphic variables were length of occipital condyle and maximum bicondylar distance. Including all variables, multivariate and stepwise functions gave an overall accuracy of 77.8% and 78.6%, respectively. However, the multivariate analyses conducted separately for measurements derived from foramen magnum and occipital condyles gave lower overall accuracy of 68.6% and 70.0%, respectively. Basicranial measurements derived from foramen magnum alone predicted males with relatively higher accuracy but were poor at predicting females in the sample (82.6% were males, 49.5% were females, sex bias 33.1%). Adding occipital condyles measurements to the multivariate analysis increased the percentage of correct sexing in females and reduced considerably the sex bias (78.8% male, 76.4% female, sex bias 1.4%). Discriminant function analysis using basicranial measurements derived from both foramen magnum and occipital condyles measurements can be utilized to estimate sex in our population.

Clinico-radiological correlates of achalasia.

OBJECTIVE: To study the clinical and radiographic characteristics of achalasia in a cohort Jordanian patients and to investigate the presence of any clinico-radiological relationships. METHODS: Thirty-five cases of recently diagnosed untreated achalasia patients were studied at Jordan University Hospital, Amman, Jordan during the period of January 1999 to December 2002. Measurements of maximum esophageal and gastroesophageal (GE) junction diameters, as radiographic features, were obtained from films. The clinical features included age; gender; nature; frequency and duration of typical and atypical symptoms; total number of symptoms; calculated typical symptoms score; and diagnostic delay. Pearson correlation coefficients were calculated between radiographic and clinical features, and among the radiographic features themselves. Using Spearman's correlation coefficients, the later analysis was repeated for patients with diagnostic delay of 2 years or less and patients with more than 2 years. All results were evaluated based on the 0.05 level of significance. RESULTS: There were 35 consecutive achalasia patients enrolled in this study (20 females and 15 males) with a mean age of 42.3 +/- 15.6 years and diagnostic delay of 29 +/- 26 months. On average, each patient has presented 2 typical symptoms and 2 atypical symptoms. The mean typical symptoms score was almost 3 out of the full score of 6. The mean GE junction diameter was 2.4 mms and maximum esophageal diameter was 29 mms. Maximum esophageal diameter was significantly correlated with the number of typical, atypical and total symptoms as well as with the typical symptom score and diagnostic delay. Negative correlation was found between GE junction diameter and maximum esophageal diameter; but only statistically significant for patients with diagnostic delay of more than 2 years. CONCLUSION: Statistically significant relationship exists between maximum esophageal diameter and all clinical variables. Negative correlation exists between maximum esophageal diameter and GE junction diameter; however, only significant for patients with a diagnostic delay more than 2 years. The possibility of achalasia is high in patients with longer diagnostic delay who demonstrate negative relationship between maximum esophageal diameter and GE junction diameter.