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Prevalence and Causes of Dimples Among the Sudanese Medical Students at Al-Neelain University – Faculty of Medicine from April to June 2017

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Prevalence and Causes of Dimples Among the Sudanese Medical Students at Al-Neelain University – Faculty of Medicine from April to June 2017 AL-NEELAIN UNIVERSITY Graduate College Faculty of Medicine Master of Human Anatomy Prevalence and causes of Dimples among the Sudanese medical students at Al-neelain University – faculty of medicine from April to June 2017. Dissertation Submitted in partial Fulfillment of the academic Requirement for the Master Degree in Human Anatomy By Osman Ibrahim Osman Amin M.B.B.S Supervisor Prof. Gouda J.G. M.B.B.CH.; M.Phil.; Ph.D.; Ph.D.; AND Diploma Ultrasound April 2017 Contents Title Page no INITIATION I DEDICATION II ACKNOWLEDGEMENT III ABSTRACT IN ENGLISH IV ABSTRACT IN ARABIC V LIST OF TABLES VI CHAPTER (I) 1 Introduction 2 Justification 3 Objectives 3 CHAPTER II 5 Literature review 6 CHAPTER III 10 Material & Methods 11 CHAPTER IV 14 Results 15 CHAPTER V 39 Discussion 40 CHAPTER VI 42 Conclusion 43 Recommendations 44 References 45 Annex 46 INITIATION بسمميحرلا نمحرلا هللا قال تعالي: (وفي انفسكم افﻻ تبصرون) I DEDICATION الي من عجزت عن شكرهم الحروف والكلمات والداي الي من اعزهم أخوتي واصدقائي الي كل من علمني حرفا واعانني علي ارقاء سلم العلم اساتذتي والي كل من شاركني بالمساعدة بهذا البحث II ACKNOWLEDGEMENT To the great people who supported me and encouraged me on this dissertation Prof. JOHN .G.GOUDA AND My Department members III ABSTRACT This study aimed to determine the prevalence and causes of dimples among the Sudanese medical students at Al-neelain University – faculty of medicine from April to June 2017. Participants (200 in number) had been selected using systemic random sampling. Data were collected using Checklist and well-designed self-administered questionnaire. Dimples were found in about 10.5% of the population in concern. The most common type is the buccalis (cheek) dimples 60%, mentalis dimples 21%, and acromial (shoulder) dimples 14%. The main causes is genetic 62%, surgery 3.4%, injection 13.7%, and teething 6.8% 30.7% of bilateral buccalis (cheek) dimples presents with mentalis (chin) dimples The percentage of dimples is slightly higher in males (12.7%) than females (8.7%). IV الخﻻصة تهدف الدراسة الي تحديد نسبة واسباب الغمازات في طﻻب كلية الطب – جامعة النيلين سودانيي لجنسية , وذلك في الفترة من ابريل الي مايو 7102. تضمن البحث عينة 711 طالب من اصل 170 طالبا .حيث تم جمع البيانات بواسطة استبيان واستمارة حصر تم جمع وادخال بياناتها بواسطة الباحث. نسبة تواجد الغمازات بالعموم بلغت 01,1 % من الفئة المعنية, وكانت اكثر اﻻنواع انتشارا غمازات الخدين بنسبة 60% من كل الغمازات,بينما بلغت نسبة غمازات الذقن 21%,وغمازات الذراع بنسبة %14. اهم اسباب تكون الغمازات كانت جينية المصدر في 62% من العينات , وبسبب الحقن 13.7%, وبسبب الجراحة 3.4% وبسبب التسنين بنسبة %8.6 71.2% من الغمازات الخدية بالجهتين تتواجد مجتمعة مع غمازات الذقن. نسبة الغمازات في الرجال 07.2% اعلي قليﻻ من نسبتها لدي النساء %6.2 V LIST OF TABLES No. of Name of table Page table Table 1 age of participant 15 Table 2 gender of participant 16 Table 3 level of participant 17 Table 4 Presence of Dimples 18 Table 5 Buccalis Dimples (Cheek Dimples) 19 Table 6 Mentalis Dimples (chin Dimples) 20 Table 7 Zygomaticus Dimples 21 Table 8 Acromial Dimples (shoulder 22 dimples) Table 9 Elbow Dimples 23 Table 10 Back Dimples (venus) 24 Table 11 Gluteal Dimples 25 Table 12 Sacral Dimples 26 Table 13 Family history of dimples 27 Table 14 previous history of surgery or 28 creation surgery at dimple site Table 15 previous history of infection 29 (pathology) at dimple site Table 16 previous history of teething 30 abnormalities (super numeric or impacted teeth) at dimple site Table 17 previous history of tumor at dimple 31 site Table 18 previous history of injection at 32 dimple site Table 19 previous history of pain sensation 33 at dimple site Table 20 previous history of trauma at dimple 34 site Table 21 Family history of dimples and 35 presence of dimples cross tabulation Table 22 Acromial Dimples (shoulder 36 dimples) and previous history of injection at dimple site cross tabulation Table 23 buccalis dimples (cheek dimples) 37 and mentalis dimples (chin dimples) cross tabulation Table 24 presence of dimples and gender 38 cross tabulation VII CHAPTER I Introduction, Justification & Objectives 1 Introduction Dimples (known also as a gelasins) are small indentations in some part of the human body. Dimples types of the human body, Fovea buccalis (dimples of cheek), fovea mentalis (dimples of chin), zygomatic dimples, fossa supraspinosus (dimple of shoulder), elbow dimples, fossa lumbales laterales (dimples of back), gluteal dimples and sacro-coocygeal dimples (pilonidal dimples). Dimples are permanently present, but sometimes are not. They vanish away when the excessive fat goes away. Dimples are not indicators of good health (1). The aim of this study was to through more lights on the titles, types and probable causes of dimples. 2 Justification: Dimples are usually considered as an attractive feature of facial beauty, it enhance facial beauty and expression. They occur in both sexes and may express unilaterally or bilaterally .it’s also known to be genetically inherited as a dominant trait. There is an increasing demand for dimple creation surgery in all part of the globe. No data collected before about the Prevalence and causes of dimples among Sudanese population. Objectives: General objective: To estimate prevalence of Dimples among the Sudanese medical students. To identify the main causes of dimples. Specific objectives: To estimate the percentage of each type of dimples. To calculate male to female ratio in each type of dimples. To estimate the prevalence of unilateral and bilateral dimples. 3 To identify the cause (dominant inheritance from family history of dimple, infection, injection, tumor, trauma, others). 4 CHAPTER II Literature review 5 Literature review Dimples are visible indentations of the skin and a dominant trait. Anatomically, dimples may be caused by variations in the structure of the some body tissue for example muscles, connective tissues, skin and subcutaneous tissue. They may be genetically inherited as a simple dominant trait. Dimples is the word given to any natural indentation or dent on the body, but usually refers to the face. Most notably in the cheek or on the chin .They are most commonly visible when someone smiles. They are a genetic trait following an autosomal dominant pattern of inheritance. Dimples are one of the most dominant facial traits, which mean that it only takes one gene to inherit dimples. If neither of your parents have dimples, you shouldn’t have them either, unless you experience a spontaneous mutation. If one of your parents has dimples, you have a 25-50% chance of inheriting the gene (2), since it means that parent inherited the gene from one or both parents. If both of your parents have dimples, you have a 50-100% chance of inheriting the gene, depending on how they inherited their dimple genes (2). The dominant genes responsible for the inheritance of facial dimples have been suggested to be located on chromosome 5 for cheek dimple gene and chromosome 16 for chin dimple gene it could therefore be inferred that both dominant genes reside in people who express these dominant traits. From this survey, it was observed that 25% of the subjects inherited the two forms of facial dimples from either one or both of their parents who also expressed both phenotypes; a rate higher in females than males. 6 Types of Dimples: Fovea buccalis (dimple of cheek). Fovea mentalis (dimple of chin). Zygomatic dimples. Fossa supraspinosus (bi-acromial dimple=dimple of shoulder). Elbow dimples. Fossa lumbales laterales (dimple of back). Gluteal dimples. Sacral or coccygeal dimples (pilonidal dimple). Cheek Dimple (“Fovea Buccalis”, also known as smiling dimple) enhance facial beauty and expression. They occur in both sexes with no particular preponderance, may express unilaterally or bilaterally and are genetically inherited, as a dominant trait. Anatomically, dimples are thought to be caused by buccinators muscle defect (a double or bifid zygomaticus major muscle), whose facial strands inserts into the dermis and cause dermal tethering effect (3). There are people exited in plastic surgery who had made cheek dimple after for beauty purposes. Fovea Mentalis (Chin Dimple) (refer to a dimple on the chin. It is a Y-shaped fissure on the chin with an underlying bony peculiarity. Specifically, the chin fissure follows the fissure in the lower jaw bone that resulted from the incomplete fusion of the left and right halves of the jaw, or muscle, during the embryonic and fetal development. For other individuals, it can develop over time. This is an inherited trait in humans, where the dominant gene causes the cleft chin, while the recessive genotype presents without a cleft. However, it is also a classic example for variable penetrance with environmental factors or a modifier gene possibly affecting the phonotypical expression of the actual genotype. Cleft chins are common among people originating from Europe. It has been 7 reported that the chin dimple results from incomplete fusion of the two halves of the jaw during fetal development, forming a notch. It can also be caused by a dehiscence or failure of the paired mentalis muscle over the chin to come together during development) (4). Zygomatic Dimple: They are thought to develop in the wound resulting from the fetal tissue being compressed between a sharp bony point and the uterine wall (5). The skin and subcutaneous tissue become compressed and adherent, and when the pressure is released, the surrounding parts can stand up, while the attached part remains tied down, forming small dimples or fossae, what have been called "pressure dimples”. Fossa Supraspinosus : Bi-acromial dimples (shoulder dimples) are an anatomical peculiarity that should be considered as an anatomic variation (6).
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