Displaying publications 1 - 20 of 25 in total

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  1. Linear lucency of the skull vault: Fracture or accessory skull suture
    Koo ZP, Siew SF, Chainchel Singh MK
    Leg Med (Tokyo), 2022 Feb;54:101971.
    PMID: 34656422 DOI: 10.1016/j.legalmed.2021.101971
    Sutures are a type of fibrous joint that occur only in the skull. However, partial or complete division of bones resulting in anomalous or accessory skull sutures may be misinterpreted as fractures when identified on radiological examination. Thus, it is of paramount clinical and medicolegal importance that these sutures be differentiated from actual fractures which can lead to severe consequences such as false accusation and mis-management of patient. It must be remembered though that the diagnosis in such cases is not straight forward even during postmortem examination which requires careful evaluation of findings with the aid of histology examination and radiology imaging. We present a case of a mis-diagnosis of an anomalous parietal suture in a three-month-old infant.
  2. Sequence polymorphism of the mitochondrial DNA hypervariable regions I and II in 205 Singapore Malays
    Wong HY, Tang JS, Budowle B, Allard MW, Syn CK, Tan-Siew WF, et al.
    Leg Med (Tokyo), 2007 Jan;9(1):33-7.
    PMID: 17150401
    Mitochondrial DNA sequences of the hypervariable regions HV1 and HV2 were analyzed in 205 unrelated ethnic Malays residing in Singapore as an initial effort to generate a database for forensic identification purposes. Sequence polymorphism was detected using PCR and direct sequencing analysis. A total of 152 haplotypes was found containing 152 polymorphisms. Out of the 152 haplotypes, 115 were observed only once and 37 types were seen in multiple individuals. The most common haplotype (16223T, 16295T, 16362C, 73G, 146C, 199C, 263G, and 315.1C) was shared by 7 (3.41%) individuals, two haplotypes were shared by 4 individuals, seven haplotypes were shared by 3 individuals, and 27 haplotypes by 2 individuals. Haplotype diversity and random match probability were estimated to be 0.9961% and 0.87%, respectively.
  3. Study on the criteria for assessing skull-face correspondence in craniofacial superimposition
    Ibáñez O, Valsecchi A, Cavalli F, Huete MI, Campomanes-Alvarez BR, Campomanes-Alvarez C, et al.
    Leg Med (Tokyo), 2016 Nov;23:59-70.
    PMID: 27890106 DOI: 10.1016/j.legalmed.2016.09.009
    Craniofacial superimposition has the potential to be used as an identification method when other traditional biological techniques are not applicable due to insufficient quality or absence of ante-mortem and post-mortem data. Despite having been used in many countries as a method of inclusion and exclusion for over a century it lacks standards. Thus, the purpose of this research is to provide forensic practitioners with standard criteria for analysing skull-face relationships. Thirty-seven experts from 16 different institutions participated in this study, which consisted of evaluating 65 criteria for assessing skull-face anatomical consistency on a sample of 24 different skull-face superimpositions. An unbiased statistical analysis established the most objective and discriminative criteria. Results did not show strong associations, however, important insights to address lack of standards were provided. In addition, a novel methodology for understanding and standardizing identification methods based on the observation of morphological patterns has been proposed.
  4. Quantification of secondary dentin formation based on the analysis of MDCT scans and dental OPGs in a contemporary Malaysian population
    Hisham S, Abdullah N, Noor MHM, Franklin D
    Leg Med (Tokyo), 2019 02;36:59-66.
    PMID: 30415193 DOI: 10.1016/j.legalmed.2018.11.004
  5. Above or below 14 years? An orthopantomographic study based on chronological course of eruption of mandibular premolars and second molars in a sample of south Indian children
    Thomas LA, Thomas LR, Balla SB, Gopalaiah H, Kanaparthi A, Sai Sravanthi G, et al.
    Leg Med (Tokyo), 2021 Feb;48:101814.
    PMID: 33246253 DOI: 10.1016/j.legalmed.2020.101814
    In the context of dental age assessment, two significant factors can be studied; tooth mineralisation and tooth emergence. Little is known about the role of a second molar eruption in forensic age estimation. This paper aims to contribute to forensic age estimation using an age threshold of 14 years, studying the eruption stages of permanent mandibular premolars and second molars. Totally 640 orthopantomograms (OPGs) of south Indian children, aged between 10 and 18 years, were evaluated using Olze et al. staging of tooth eruption stages (A-D). Spearman's rho correlation showed a strong, positive, and statistically significant correlation between the chronological age and the eruption stages of both sexes' teeth. Accuracy, sensitivity, specificity, likelihood ratios, and post-test probability values were calculated for all tested teeth. The best performance to discriminate individuals above or below 14 years showed stage D in second molars. The sensitivity varied between 89% and 94% and specificity between 75% and 84%, respectively. Receiver operating characteristic curve analysis revealed high diagnostic performance for stage D, with area under the ROC curve (AUC) values of 84% and 85% for tooth 37 and 85% and 83% for tooth 47 in males and females, respectively. In conclusion, it is possible to predict age over 14 years in south Indian children using tooth emergence stages from OPGs with a relatively high interobserver agreement and good diagnostic accuracy. However, there are some limitations and, therefore, must be used in conjunction with other methods.
  6. Age estimation based on bone length using 12 regression models of left hand X-ray images for Asian children below 19 years old
    Darmawan MF, Yusuf SM, Abdul Kadir MR, Haron H
    Leg Med (Tokyo), 2015 Mar;17(2):71-8.
    PMID: 25456051 DOI: 10.1016/j.legalmed.2014.09.006
    Age estimation was used in forensic anthropology to help in the identification of individual remains and living person. However, the estimation methods tend to be unique and applicable only to a certain population. This paper analyzed age estimation using twelve regression models carried out on X-ray images of the left hand taken from an Asian data set for subjects under the age of 19. All the nineteen bones of the left hand were measured using free image software and the statistical analysis were performed using SPSS. There are two methods to determine age in this study which are single bone method and all bones method. For single bone method, S-curve regression model was found to have the highest R-square value using second metacarpal for males, and third proximal phalanx for females. For age estimation using single bone, fifth metacarpal from males and fifth proximal phalanx from females can be used due to the lowest mean square error (MSE) value. To conclude, multiple linear regressions is the best techniques for age estimation in cases where all bones are available, but if not, S-curve regression can be used using single bone method.
  7. Histopathological studies of cardiac lesions after long term administration of methamphetamine in high dosage--Part II
    Islam MN, Jesmine K, Kong Sn Molh A, Hasnan J
    Leg Med (Tokyo), 2009 Apr;11 Suppl 1:S147-50.
    PMID: 19345131 DOI: 10.1016/j.legalmed.2009.02.035
    A small amount of Methamphetamine (MA) can produce behavioural changes such as euphoria, increased alertness, paranoia, decreased appetite and increased physical activity. In cardiovascular system, it can produce chest pain and hypertension which can result in cardiovascular collapse. In addition, MA causes accelerated heartbeat, elevated blood pressure. It can also cause irreversible damage to blood vessels in the brain. A number of sympathomimetic amines are capable of causing myocardial damage, but the cardio-toxic action of MA has been of particular interest since standardized dosage consistently produces myocardial lesions. As this drug is a choice of many teenagers and young adults, the damage to their health, as well as their future aspects could be greatly affected, therefore more evidence must be sought to convince them the negative root and show them the optimism of recovery and salvation. To clarify the effect of Methamphetamine (MA) on myocardium, 56 male Wister rats aged four weeks were divided equally into MA, Methamphetamine withdrawal (MW), Placebo (P) and Control (C) group were examined following daily intra-peritoneal administration of MA at a dose of 5 mg/kg body weight for 2, 4, 8 and 12 weeks. Normal saline was similarly injected in P group. Light microscopic changes was seen in the myocardium of MA treated group including eosinophilic degeneration, atrophy, hypertrophy, disarray, edema, cellular infiltration, myolysis, granulation tissue, fibrosis and vacuolization. On the other hand, the withdrawal group showed evidence of gradual recovery of those myocardial changes. Optimism is therefore generated about possibility of returning towards normal by withdrawing of this drug by the addicts.
  8. Commentary on article: Aerobic microbe community and necrophagous insects associated with decomposition of pig carrion poisoned with lead by Aneyo et al. (DOI: https://doi.org/10.1016/j.legalmed.2019.101638)
    Zaini NA, Ivorra T, Azmiera N, Natasha NA, Heo CC
    Leg Med (Tokyo), 2021 02;48:101818.
    PMID: 33271415 DOI: 10.1016/j.legalmed.2020.101818
  9. Reporting beetles in a mummified human corpse in Malaysia: Necrobia rufipes (Fabricius, 1781) (Coleoptera: Cleridae) and Dermestes maculatus De Geer, 1774 (Coleoptera: Dermestidae)
    Ivorra T, Rahimi R, Zaini NA, Heo CC
    Leg Med (Tokyo), 2023 May;62:102238.
    PMID: 36913819 DOI: 10.1016/j.legalmed.2023.102238
    This case study reports on two unrecorded Coleopteran species found together on a human corpse in Malaysia. The mummified human remains were discovered in a house in Selangor, Malaysia. The pathologist confirmed that the death was due to a traumatic chest injury. Maggots, beetles, and fly pupal casings were found mainly on the front part of the body. Empty puparia of Diptera were collected during the autopsy and identified later as the muscid Synthesiomyia nudiseta (van der Wulp, 1883) (Diptera: Muscidae). Also, the insect evidence received included larvae and pupae of Megaselia sp. (Diptera: Phoridae). According to the insect development data, the minimum postmortem period was estimated by the time to reach the pupal developmental stage (in days). The entomological evidence included the first record of Dermestes maculatus De Geer, 1774 (Coleoptera: Dermestidae) and Necrobia rufipes (Fabricius, 1781) (Coleoptera: Cleridae), which have not previously been recorded on human remains in Malaysia.
  10. Sex estimation of Malaysian sub-adults using craniometrics: A computed tomography study
    Syed Mohd Hamdan SN, Rahmat RA, Abdul Razak F, Abd Kadir KA, Mohd Faizal Abdullah ER, Ibrahim N
    Leg Med (Tokyo), 2023 Sep;64:102275.
    PMID: 37229938 DOI: 10.1016/j.legalmed.2023.102275
    Sex estimation is crucial in biological profiling of skeletal human remains. Methods used for sex estimation in adults are less effective for sub-adults due to varied cranium patterns during the growth period. Hence, this study aimed to develop a sex estimation model for Malaysian sub-adults using craniometric measurements obtained through multi-slice computed tomography (MSCT). A total of 521 cranial MSCT dataset of sub-adult Malaysians (279 males, 242 females; 0-20 years old) were collected. Mimics software version 21.0 (Materialise, Leuven, Belgium) was used to construct three-dimensional (3D) models. A plane-to-plane (PTP) protocol was utilised to measure 14 selected craniometric parameters. Discriminant function analysis (DFA) and binary logistic regression (BLR) were used to statistically analyze the data. In this study, low level of sexual dimorphism was observed in cranium below 6 years old. The level was then increased with age. For sample validation data, the accuracy of DFA and BLR in estimating sex improved with age from 61.6% to 90.3%. All age groups except 0-2 and 3-6 showed high accuracy percentage (≥75%) when tested using DFA and BLR. DFA and BLR can be utilised to estimate sex for Malaysian sub-adult using MSCT craniometric measurements. However, BLR showed higher accuracy than DFA in sex estimation of sub-adults.
  11. Three-dimensional surface area analyses of developing maxillary second premolar root apices for age estimation using CBCT images
    Gohain M, Asif MK, Nambiar P, Mohd Noor NS, Hidayah Reduwan N, Ibrahim N
    Leg Med (Tokyo), 2024 Feb;66:102391.
    PMID: 38211402 DOI: 10.1016/j.legalmed.2024.102391
    Three-dimensional surface area analyses of developing root apices for age estimation in children and young adults have shown promising results. The current study aimed to apply this three-dimensional method to develop a regression model for estimating age in Malaysian children aged 7 to 14 using developing maxillary second premolars. A training sample of 155 cone-beam computed tomography scans (83 Malays and 72 Chinese) was analysed, and the formula was subsequently validated on an independent sample of 92 cone-beam computed tomography scans (45 Malays and 47 Chinese). The results showed a strong correlation (r = 94 %) between the chronological age as a dependent variable and the predictor variables, including root surface area of the apex, sex, ethnicity, and root development status (open/closed apices). For this model, the predictor variables accounted for 88.4 % of the variation in age except sex and ethnicity. A mean absolute error value of 0.42 indicated that this model can be reliably used for Malaysian children. In conclusion, this study recognises the method of three-dimensional surface area analyses as a valuable tool for age estimation in forensic and clinical practice. Further studies are highly recommended to assess its effectiveness across different demographic groups.
  12. Leave methamphetamine to be alive--Part II
    Islam MN, Khan J, Jaafar H
    Leg Med (Tokyo), 2009 Apr;11 Suppl 1:S143-6.
    PMID: 19345604 DOI: 10.1016/j.legalmed.2009.02.045
    Series of experiments have been completed with Methamphetamine (MA). Some were with the higher, medium or lower duration of MA administration and some were with acute or chronic doses. Whatever may be the dose or duration the ultimate result came out with the further establishment of cardio-toxic effect of this drug. Cardiovascular symptoms related to MA toxicity include chest pain, palpitations, dyspnoea, hypertension, tachycardia, atrial and ventricular arrhythmias, and myocardial ischemia. MA abusers often go through a repeated pattern of frequent drug administrations followed by a period of abstinence. Previous studies have focused largely upon the chronic effect of MA intake to major organs, such as the brains and the heart, by using animal experiments. However, there is a lack of research into the effects of acute dose of MA, especially pertaining to the heart. To clarify the effect of MA on myocardium, 22 male Wister rats aged six weeks were divided into MA, Placebo (P) and Control (C) group were examined following single intraperitoneal administration of MA at a dose of 50 mg/kg body weight. Normal saline was similarly injected in P group. Light microscopic changes was seen in the myocardium of MA treated group including cellular infiltration, with clusters of macrophage-like cells having large nuclei and little cytoplasm evident in the sub-endocardium region. There were presence of few macrophages, leucocytes, and spindle-like fibroblasts. Bringing in to account of cardiac changes by a single dose of MA, slogan should be voiced out to leave methamphetamine.
  13. Three-dimensional image analysis of developing mandibular third molars apices for age estimation: A study using CBCT data enhanced with Mimics & 3-Matics software
    Asif MK, Nambiar P, Ibrahim N, Al-Amery SM, Khan IM
    Leg Med (Tokyo), 2019 Jul;39:9-14.
    PMID: 31158731 DOI: 10.1016/j.legalmed.2019.05.003
    Three-dimensional imaging has improved the method of analysis in many forensic science investigations. The study aimed to derive regression equation for age estimation by investigating the relationship between chronological age and surface area of the developing mandibular 3rd molars apices. Furthermore, other predictor variables: ethnicity (Malay and Chinese), gender and status of the root development completion (open/closed apices) were also investigated in terms of fit to the age estimation model. One hundred and twenty eight training and 55 validation samples of intact mandibular 3rd molars were selected from 183 CBCT scans. The samples comprised of 93 Malays and 90 Chinese, ranging in age from 13 to 24 years. Three-dimensional image modeling and surface area analysis of the developing mandibular 3rd molars apices were performed using Mimics and 3-Matics software. Multiple linear regression analysis was used to derive age estimation model using chronological age as a dependent variable and surface area of the apices, ethnicity, gender and status of the root development completion (open/closed apices) as predictor variables. A strong inverse correlation (r = 0.95, SD = 1.144) was observed between chronological age and all the predictor variables. The results showed that 89.6% of the variation in age can be explained by the predictor variables. Mean absolute error (MAE) value of 0.8223 was observed when the derived regression equation was tested on the independent validation sample. In conclusion, three-dimensional surface area analysis of the developing mandibular 3rd molars apices can be used as a reliable method for age estimation.
  14. Dental age estimation in Malaysian adults based on volumetric analysis of pulp/tooth ratio using CBCT data
    Asif MK, Nambiar P, Mani SA, Ibrahim NB, Khan IM, Lokman NB
    Leg Med (Tokyo), 2019 Feb;36:50-58.
    PMID: 30415192 DOI: 10.1016/j.legalmed.2018.10.005
    Forensic odontology plays an important role in human identification and dental age estimation is an integral part of this process. The aim of the study was to investigate the association between chronological age and pulp/tooth volume ratio in a Malaysian population (Malays and Chinese) from cone-beam computed tomography (CBCT) scans, enhanced with Mimics software. Three hundred CBCT scans of 153 males and 147 females, aged between 16 and 65 years were divided into 5 age groups. Volumetric analysis of the pulp/tooth ratio was performed in maxillary left canines, maxillary right canines and maxillary right central incisors. Simple linear regression and Pearson correlation analysis indicated the strongest coefficient of correlation (R) values for maxillary right central incisors (0.83) followed by maxillary right canines (0.74) and maxillary left canines (0.73). Fisher's Z test indicated that dental age estimation is gender independent. The derived regression equations were further validated on an independent group of 126 teeth. The results indicated mean absolute error (MAE) values of 6.48 and 8.58 years for maxillary right central incisors and maxillary canines respectively. It was also noticed that MAE values were higher among the age groups ranging from 46 to 65 years. This study showed that a volumetric change in the pulp cavity with age is a valuable assessment method for dental age estimation among Malaysian population.
  15. Exploring the feasibility of smartphone cameras for 3D modelling of bite patterns in forensic dental identification
    Kurniawan A, Hamdani J, Chusida A, Utomo H, Rizky BN, Prakoeswa BFWR, et al.
    Leg Med (Tokyo), 2024 Mar;67:102399.
    PMID: 38219704 DOI: 10.1016/j.legalmed.2024.102399
    The field of bitemark analysis involves examining physical alterations in a medium resulting from contact with teeth and other oral structures. Various techniques, such as 2D and 3D imaging, have been developed in recent decades to ensure precise analysis of bitemarks. This study assessed the precision of using a smartphone camera to generate 3D models of bitemark patterns. A 3D model of the bite mark pattern was created using 3Shape TRIOSTM and a smartphone camera combined with monoscopic photogrammetry. The mesiodistal dimensions of the anterior teeth were measured using Rapidform Explorer and OrtogOnBlender, and the collected data were analyzed using IBM® SPSS® Statistics version 23.0. The mean mesiodistal dimension of the anterior teeth, as measured on the 3D model from 3Shape TRIOSTM and smartphone cameras, was found to be 6.95 ± 0.7667 mm and 6.94 ± 0.7639 mm, respectively. Statistical analysis revealed no significant difference between the two measurement methods, p > 0.05. The outcomes derived from this study unequivocally illustrate that a smartphone camera possessing the specific parameters detailed in this study can create a 3D representation of bite patterns with an accuracy level on par with the outputs of a 3D intraoral camera. These findings underscore the promising trajectory of merging smartphone cameras and monoscopic photogrammetry techniques, positioning them as a budget-friendly avenue for 3D bitemark analysis. Notably, the monoscopic photogrammetry methodology assumes substantial significance within forensic odontology due to its capacity for precise 3D reconstructions and the preservation of critical measurement data.
  16. Population data on 15 STR loci using AmpF/STR Identifiler kit in a Malay population living in and around Kuala Lumpur, Malaysia
    Maruyama S, Minaguchi K, Takezaki N, Nambiar P
    Leg Med (Tokyo), 2008 May;10(3):160-2.
    PMID: 18180191 DOI: 10.1016/j.legalmed.2007.11.002
    Allele frequencies for 15 short tandem repeat (STR) loci D8S1179, D21S11, D7S820, CSF1PO, D3S1358, TH01, D13S317, D16S539, D2S1338, D19S433, vWA, TPOX, D18S51, D5S818 and FGA (AmpF/STR Identifiler PCR Amplification kit, PE Applied Biosystems) were obtained from a sample of 110 unrelated individuals from the Malay population living in and around Kuala Lumpur, Malaysia, and the characteristics of the population was compared with other East Asian populations.
  17. A comparative study between xerographic, computer-assisted overlay generation and animated-superimposition methods in bite mark analyses
    Tai MW, Chong ZF, Asif MK, Rahmat RA, Nambiar P
    Leg Med (Tokyo), 2016 Sep;22:42-8.
    PMID: 27591538 DOI: 10.1016/j.legalmed.2016.07.009
    This study was to compare the suitability and precision of xerographic and computer-assisted methods for bite mark investigations. Eleven subjects were asked to bite on their forearm and the bite marks were photographically recorded. Alginate impressions of the subjects' dentition were taken and their casts were made using dental stone. The overlays generated by xerographic method were obtained by photocopying the subjects' casts and the incisal edge outlines were then transferred on a transparent sheet. The bite mark images were imported into Adobe Photoshop® software and printed to life-size. The bite mark analyses using xerographically generated overlays were done by comparing an overlay to the corresponding printed bite mark images manually. In computer-assisted method, the subjects' casts were scanned into Adobe Photoshop®. The bite mark analyses using computer-assisted overlay generation were done by matching an overlay and the corresponding bite mark images digitally using Adobe Photoshop®. Another comparison method was superimposing the cast images with corresponding bite mark images employing the Adobe Photoshop® CS6 and GIF-Animator©. A score with a range of 0-3 was given during analysis to each precision-determining criterion and the score was increased with better matching. The Kruskal Wallis H test showed significant difference between the three sets of data (H=18.761, p<0.05). In conclusion, bite mark analysis using the computer-assisted animated-superimposition method was the most accurate, followed by the computer-assisted overlay generation and lastly the xerographic method. The superior precision contributed by digital method is discernible despite the human skin being a poor recording medium of bite marks.
  18. Modified method of dental age estimation of Malay juveniles
    Bunyarit SS, Jayaraman J, Naidu MK, Yuen Ying RP, Danaee M, Nambiar P
    Leg Med (Tokyo), 2017 09;28:45-53.
    PMID: 28772147 DOI: 10.1016/j.legalmed.2017.07.009
  19. A novel method of age estimation in children using three-dimensional surface area analyses of maxillary canine apices
    Asif MK, Ibrahim N, Al-Amery SM, Muhammad AMA, Khan AA, Nambiar P
    Leg Med (Tokyo), 2020 Feb 24;44:101690.
    PMID: 32135489 DOI: 10.1016/j.legalmed.2020.101690
    The study aimed to develop a novel and reliable age estimation method using three-dimensional surface area analyses of maxillary canine apices among Malaysian children using CBCT data. A validated regression equation for age estimation was derived and correlation between chronological age and the surface areas of the developing maxillary canine's apices were investigated. Variations based on ethnicities, gender and status of root development were also investigated in terms of fit to the age estimation model. CBCT images of the patients ranging in age from 7 to 14 years were included in the study. Training sample of 191 intact permanent maxillary canines was selected from 191 CBCT images belonging to 100 Malays and 91 Chinese. Moreover, an independent validation sample of 96 permanent maxillary canines was selected from 96 CBCT images belonging to 48 Malays and 48 Chinese. Three-dimensional image modeling and surface area analyses of the developing canine's apices were performed using Mimics and 3-Matics software. A strong correlation (r = 0.978) was observed between chronological age and surface area of the developing maxillary canine's apices. 95.6% of the variation in age can be explained by surface area of canine's apices, gender and status of the root development (open/closed apices). However, ethnicity did not contributed to the fit of age estimation model. Female showed advanced development as compared to male. Mean absolute error values indicated that this newly developed 3D surface area analyses of canine apex can be used as a reliable method for age estimation among Malaysian children.
  20. Sex determination from carpal bone volumes: A Multi Detector Computed Tomography (MDCT) study in a Malaysian population
    M Didi AL, Azman RR, Nazri M
    Leg Med (Tokyo), 2016 May;20:49-52.
    PMID: 27161924 DOI: 10.1016/j.legalmed.2016.04.002
    PURPOSE: The use of Multi Detector Computed Tomography (MDCT) volume measurements of bones for sex determination allows fragile, fragmented human remains to be assessed without compromising the specimen. We set out to assess the ability of MDCT carpal bone volume measurement in determining sex in a Malaysian population.

    MATERIALS AND METHODS: 52 healthy volunteers were scanned in a 16-slice MDCT, and the volume of 104 sets of carpal bones was measured using a Syngo workstation (Both CT and workstation-Siemens Healthcare, Erlangen, Germany).

    RESULTS: Male carpal bones were of higher volume compared to the female carpal bones (p<0.001). Area under the curve (AUC) assessment of responder-operator characteristics curves showed that the trapezium bone was best able to predict sex with an AUC of 0.986. At a trapezium bone volume of ⩾1.94cm(3), there was a 93.5% probability that the subject was male. Binary logistic regression analysis found that the highest accuracy was derived using the pisiform, trapezium and capitate bones. There was a strong relationship between sex prediction and grouping of the carpal bone volumes (Nagelkerke R(2)=0.923) with an overall prediction accuracy of 97%.

    CONCLUSION: All 8 carpal bones exhibit sexual dimorphism to varying degrees. A binary regression analysis combining the 5 carpal bones with the highest predictive values for sex produces an accurate predictive model.

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