Prevalence of Palm-Print Patterns and their Association with ABO Blood Group and Gender, among Medical Students of North India.

Introduction: The Palmprint, a dermatoglyphic marker, is defi¬ned as the print of a palm, which is mainly composed of the palmar flexion creases and ridges. The palm print patterns and blood groups are unique, stable and remain unchanged throughout the life. Hence, the present study was undertaken to investigate association between Palm print patterns and ABO and Rh blood groups in both the genders of the North Indian population. Material and Method: The sample for the cross- sectional study was consist of palmprints from 300 (Male: female 1:1,150 each) medical students of North India. The palmprints of both the hands of the subjects were recorded by the ink and roller method. Result: The distribution of palmprint patterns of both hands showed a high frequency of Category 5, moderate of category 4, small of category 6 & 3 and none of category 1 &2. The study also show gender discrimination as category 5 was more common in males while Category 4 was more common in females (P-value for Right hand is.012 and for Left hand is <.001). Positive correlation was found between palm print patterns and blood group but was not statistically significant.
Conclusion: The findings of present study revealed statistically significant sexual dimorphism in the study population. Palm print patterns also showed a positive correlation with ABO blood groups. Copyright:

INTRODUCTION

Dermatoglyphics is a scientific study of naturally occurring epidermal ridges and their configuration on the digits, palms, and soles.[1] The corrugated skin patterns of palm, which are in the form of lines, wrinkles, and ridges, are functionally useful in the grasping of objects. These flexor lines are also helpful in discovering anthropologic characteristics. The palm print, a dermatoglyphic marker, is defined as the print of a palm, which is mainly composed of the palmar flexion creases and ridges.[2] The palmar flexion creases are also called principal lines which are unique, stable and remain unchanged throughout the life, but most of the other creases are not. The identical twins have different palm-print patterns, even the palm-print patterns of two hands do not resemble with each other.[3] Hence, in the present study, we were mainly concerned about three principal lines on the palm and categorized them according to Wu et al.[3] classification. Afework[4] used another classification by Bali and Chaube[5] who defined the zone of origin of the three primary creases on the radial side of the palm and classified them according to the manner of origins as one, two, or three points of origin.

The palm creases were believed to result from flexion of the fetal skin. In 1937, Würth[6] found that they develop before digital movement is observed. The three “principal palmar lines” start developing during the 2nd and 3rd month of embryonal development, and onset of hand movements in embryos does not occur before 11.5 weeks during gestation;[7] hence, the primary flexion creases were confirmed to be formed independently from the flexion movements of the hand during pregnancy but influenced by heredity and accidental or environmental changes in their intrauterine life.[8] Hence, the deviations of palm-print patterns could be suggestive of insults during early intrauterine development.

Another biological document that developed well before birth and remains unchanged throughout the lifetime is the ABO blood group, discovered by Austrian Scientist Karl Landsteiner in 1901. ABO blood group is classified into four principal types: A, B, AB, and O, on the basis of presence of corresponding antigen in plasma, while the Rhesus system is classified into Rh-positive and Rh-negative due to the presence or absence of D antigen. Clinically, ABO and Rh blood groups are the most commonly used systems as compared to other blood groups.[9]

Bloterogel and Bloterogel (1934) expressed a correlation between physical characters and blood groups. After them, several studies were conducted to show the association of fingerprint patterns with blood group and gender.[10] In 2015, Rekha et al.[11] investigated the correlation of palm print with lip print, but regarding the association of palm-print patterns with blood group and gender, no study was found. Therefore, the present study was undertaken to investigate the predominant palm-print patterns and to identify the association between palm-print patterns and ABO and Rh blood groups in both the genders of the North Indian population. This study would help in the identification of individuals as well as in the determination of sexual dimorphism in the study population.

MATERIALS AND METHODS

Study population

The present study was carried out in Government Medical College, Amritsar (North India), after obtaining permission from Institutional Ethics Committee. The sample for the cross-sectional study consisted of palm prints from 300 (male:Female 1:1150 each) undergraduate students pursuing MBBS, aged between 17 and 25 years. The subjects were thoroughly explained about the objectives of the study and voluntary written consent was obtained. Other details such as name, age, sex, and blood group were also noted on pro forma and confidentiality of the subjects was maintained all through.

The materials used for the study were printer duplicating black ink from Kores, black color stamp pad, ink slab, roller, A-4 size white papers, gauze pads, and magnified lens.

Collection of palm prints

The palm prints of both the hands of the subjects were recorded by the ink and roller method, as was suggested by Cummins and Midlo.[12] The subjects were asked to wash and dry their hands to remove any dirt and grease. A plain glass plate was uniformly smeared with a thin layer of black printers' ink (Kores, Bombay) using the inking roller. Then with help of the roller, the same ink was smeared on both the hands one by one. The completely inked palmar surface of the right hand was then gently pressed on a clean, white bond paper, and it will be removed immediately. The same procedure was repeated for the left hand and then, the palm prints were analyzed.

Three principal lines on the palm are identified, i.e., radial longitudinal crease, proximal transverse crease, and distal transverse crease [Figure 1].

Figure 1

Principal palmar lines

The radial longitudinal crease (A) begins from, with, or slightly below the proximal transverse crease at the radial border of the palm over the metacarpophalangeal joint of the index finger and runs proximally toward the wrist curving laterally

The proximal transverse crease (B) begins at the radial side of the palm and runs medially slightly curving proximally to terminate at the medial border of the hypothenar eminence

The distal transverse crease (C) begins proximal to the interdigital space between the index and middle fingers and runs to the ulnar side of the palm, showing a slight distal ward concavity.

The definitions of these three principal lines have been taken from Afework.[4]

Wua et al.[2] divided the palm prints into six categories according to the number of their principal lines and the number of intersections.

Category 1: Palm prints composed of no more than one principal line

Category 2: Palm prints composed of two principal lines and no intersection

Category 3: Palm prints composed of two principal lines and one intersection

Category 4: Palm prints composed of three principal lines and no intersection

Category 5: Palm prints composed of three principal lines and one intersection

Category 6: Palm prints composed of three principal line and more than one intersection.

Blood grouping

As the study participants were medical students, their blood group was already determined and documented. Therefore, a subsequent test was not needed. Their blood group was noted from their college identity cards.

Inclusion criteria

Both male and female undergraduate students of MBBS were included.

Exclusion criteria

Subject with permanent scars on their palm

Subject with any hand deformities due to injury, birth defect, burns, or disease

Subjects whose father or mother was not of North Indian origin.

Statistical analysis

Percentage distribution of different palm-print patterns according to blood groups was computed and tabulated. To test the statistical significance of the association of blood group and gender with palm-print pattern, a Chi-square test was applied and P < 0.05 was taken as statistically significant. Statistical analysis was performed using SPSS version 20 (SPSS Inc., Chicago, IL, USA).

RESULTS

This study was undertaken to investigate the distribution of palm-print patterns in the North Indian population and their association with ABO and Rh blood groups and gender.

Distribution of palm-print patterns

Table 1 shows the distribution of palm-print patterns in both hands and reveals that the distribution of categories of palm print is different in right and left hand and also shows gender discrimination.

Table 1

Distribution of palm-print patterns

Category of palm print	Male			Female
	Right palm print, n (%)	Left palm print, n (%)	Total, n (%)	Right palm print, n (%)	Left palm print, n (%)	Total, n (%)
1	Nil	Nil	Nil	Nil	Nil	Nil
2	Nil	Nil	Nil	Nil	Nil	Nil
3	Nil	2 (1.3)	2 (1.3)	1 (0.7)	Nil	1 (0.7)
4	29 (19.3)	30 (30)	59 (19.6)	53 (35.3)	63 (42)	116 (38.6)
5	116 (77.3)	113 (75.3)	229 (76.3)	92 (61.3)	82 (54.7)	174 (58.0)
6	5 (03.3)	5 (03.3)	10 (3.3)	4 (02.7)	5 (03.3)	9 (3.0)

Category 5 – It was the most prevalent of palm-print patterns among the medical students of Punjab, found in about 76.3% of male students and in about 58.0% of female students. It was more prevalent in the right hand than the left hand of both the genders [Table 1]

Category 4 was the second most prevalent category, found in 19.6% of male students and 38.6% of females. It was found more commonly in the left hand than right hand in both genders [Table 1]

Category 6 was found in 3.3% of males and 3.0% of females

Category 3 was quite rare and found only in the left palm of males (1.3%) and right palm of females (0.7%)

Category 1 and 2 were not found in the subjects of the present study.

Correlation between palm-print patterns and the gender

Our study shows sexual dimorphism as Category 5 was more common in males (76.3%), while Category 4 was more common in females (66.2%) [Table 2].

Table 2

Gender-wise distribution of palm-print patterns

Categories	Female, n (% with in gender)	Male, n (% with in gender)	Total, n (% with in gender)	P
Right hand
3	1 (0.70)	0	1 (0.30)	0.012
4	53 (35.30)	29 (19.30)	82 (27.30)
5	92 (61.30)	116 (77.30)	208 (69.30)
6	4 (2.70)	5 (3.30)	9 (3.00)
Total	150 (100.00)	150 (100.00)	300 (100.00)
Left hand
3	0	2 (1.30)	2 (0.70)	<0.001
4	63 (42.00)	30 (20.00)	93 (31.00)
5	82 (54.70)	113 (75.30)	195 (65.00)
6	5 (3.30)	5 (3.30)	10 (3.30)
Total	150 (100.00)	150 (100.00)	300 (100.00)

Distribution of blood group

In the present study, the blood group B+ (36.7%) was most prevalent, followed by “O+” (35%), “A+” (14.7%), and “AB+ (6%) in both genders [Table 3].

Table 3

Percentage distribution blood groups

Blood group	Male, n (%)	Female, n (%)	Total number of individuals, n (%)	P
A+	28 (18.7)	16 (10.7)	44 (14.7)	0.048
A−	1 (0.7)	4 (2.7)	5 (1.7)
B+	60 (40)	56 (37.3)	116 (36.7)
B−	2 (1.3)	3 (2.0)	5 (1.7)
O+	51 (34)	54 (36.0)	105 (35)
O−	Nil	7 (4.7)	7 (2.3)
AB+	8 (5.3)	10 (6.7)	18 (6)
AB−	Nil	Nil	Nil

There was a significantly higher incidence of Rh +ve in (92.4%) subjects as compared to Rh −ve in (7.6%).

”AB negative” blood group was not found in subjects of the study. In males, the blood group B + was the most prevalent and blood group “O−” was absent, while in females, the blood group B+ was the most prevalent one and blood group B-ve was least. This association was statistically significant with P = 0.048.

Correlation between palm-print pattern and blood group

A positive correlation was found between palm-print patterns and blood group but was not statistically significant [Table 4].

Table 4

Distribution of palm-print patterns among ABO blood group

Blood group	Categories					P
	3, n (%)	4, n (%)	5, n (%)	6, n (%)	Total, n (%)
Right hand
A−	0	5 (6.10)	0	0	5 (1.70)	0.076
A+	0	12 (14.60)	32 (15.40)	0	44 (14.70)
AB+	0	8 (9.80)	10 (4.80)	0	18 (6.00)
B−	0	3 (3.70)	2 (1.00)	0	5 (1.70)
B+	1 (100.00)	30 (36.60)	81 (38.90)	4 (44.40)	116 (38.70)
O−	0	0	7 (3.40)	0	7 (2.30)
O+	0	24 (29.30)	76 (36.50)	5 (55.60)	105 (35.00)
Total	1 (100.00)	82 (100.00)	208 (100.00)	9 (100.00)	300 (100.00)
Left hand
A−	0	3 (3.20)	2 (1.00)	0	5 (1.70)	0.624
A+	0	9 (9.70)	34 (17.40)	1 (10.00)	44 (14.70)
AB+	0	10 (10.80)	8 (4.10)	0	18 (6.00)
B−	0	2 (2.20)	3 (1.50)	0	5 (1.70)
B+	2 (100.00)	37 (39.80)	72 (36.90)	5 (50.00)	116 (38.70)
O−	0	1 (1.10)	6 (3.10)	0	7 (2.30)
O+	0	31 (33.30)	70 (35.90)	4 (40.00)	105 (35.00)
Total	2 (100.00)	93 (100.00)	195 (100.00)	10 (100.00)	300 (100.00)

In our study, we did not find Category 1 and 2.

Category 3 was present only B + blood group

Category 4 was the second most prevalent palm-print pattern and found in every blood group except O−. This was the only category that was present in blood group “A−”

Category 5 was the most prevalent one and found in every type of blood group except “A−”. This one was the only category that was present in blood group “O−”

Category 6 was present only in blood group “B+” and “O+”.

DISCUSSION

Over the past 150 years, dermatoglyphics has been acting as a useful tool in understanding basic questions in anatomy, medicine, genetics, and evolution.[13]

Various individual parameters such as dermatoglyphics and blood groups play a vital role in personal identification. The main objective of our study was to find any significant association of palm-print patterns with blood groups and gender among the student-based North Indian population. In the existing literature, there are no sufficient studies regarding palm prints, so findings from this study, in addition to revealing the status of palmar creases among North Indians, could also provide a baseline for further studies.

The palm print is quite reliable physiological characteristics that is preferred over other dermatoglyphics markers such as fingerprint or iris because it is distinctive, nonintrusive, easily captured by low-resolution devices as well as contains additional features such as principal lines and certain geometric characteristics. These anatomical structures are used widely in the field of anthropology and can be helpful in building a highly accurate biometrics system.

In this study, distribution of palm-print patterns among subjects showed a high frequency of Category 5, moderate of Category 4, small of Category 6 and 3, and none of Category 1 and 2, as well as the frequency of Category 4 is more in females. That is in accordance with studies by Biswas et al.[14] which showed that Categories 1 and 2 were not found and category 4 is more prevalent in females. A study of Rekha et al.[11] among South Kerala population also showed that Category 5 (62.3%) was the most predominant pattern followed by Category 4 (27.2%), followed by Category 2 (6.1%) and Category 3 (4.4%).

Afework,[4] in his study among Ethiopians, classified the principal palmer creases according to their point of origin. He concluded that palmar creases with two points of origin (Category 5) were the most frequent type – 77.3%, followed by three points of origin (Category 4), 19.8%, and one point of origin (Category 3) – 2.8%, in both females and males. He also observed that palmar creases with three points of origin (Category 4) were significantly more prevalent in females.

In the present study, the frequency pattern of the right palm was Category 4%–19.3%, Category 5%–77.3%, and Category 6%–3.3% in males, while in females, it was Category 3%–0.7%, Category 4%–35.3%, Category 5%–61.3%, and Category 6%–12.7%, which is in conformity to studies by Biswas et al.[14] and Debta et al.[15]

The frequency pattern of the left palm was Category 3%–1.3%, Category 4%–30%, Category 5%–75.3%, and Category 6%–3.3% in males, while in females, it was Category 4%–42%, Category 5%–54.7%, and Category 6%–3.3% which is also in conformity to studies by Biswas et al.[14] and Debta et al.[15]

In this study, remarkable and statistically significant differences of palm-print patterns distribution were observed between females and males as well as right and left hands (P value of right hand – 0.012 and of left hand – < 0.001). Afework[4] could not give a definite reason for such association of category of palm-print patterns with gender and sides but pointed toward its correlation with levels of strength in palm flexion. It is a known fact that there is a relatively stronger flexed grip in the males than females, and in the right than left hands. Park et al.[16] also suggested that palm creases with fewer points of origin are more frequent on palms that are adapted for a stronger flexed grip. On these theories, findings of the present study are justified that Category 4, which have more point of origin, is more prevalent in females and in left hands as they have weaker flexor grip.

In this study, Category 1 and Category 2 were not found because principal lines in these two categories are aberrant and indicative of known disease conditions. However, subjects of this study were medical students who are apparently healthy and relatively intelligent.

In the present study, blood group B+ (36.7%) was the most common among the subjects, followed by O+ (35%), and A− and B− are the least common (1.7% each) in both genders. The blood group O− was absent in males and blood group AB− was absent in both male and females. The least common blood group among male is A − and among female was B−. Our observations are in resemblance with the study of Biswas et al.[14] and Ranjan et al.[17] in North Indian population, Rashid and Singla.[18] in Bundelkhand population, and Salmani et al.[19] in Kerala population. In contrast to the present study, other studies done by Radhika.[20] and Viveki and Hunshikatti[21] had found O + blood group to be the most prevalent. There was a significantly higher incidence of Rh +ve in (92.4%) subjects as compared to Rh −ve in (7.6%) in this study.

The present study showed a positive correlation between blood groups and palm-print patterns which is not statistically significant. Category 5 was the most prevalent category among all blood groups and the Category 3 and Category 6 were not present in Rh −ve blood groups and AB +ve blood group [Table 4].

In “A” blood group, the incidences of Category 5 (67%) were more than Category 4 (21%) in Rh +ve blood group, while in Rh −ve blood group showed more incidences of Category 4 (8.1%) than category 5 (2.0%). To more precise, the negative blood group in the right hand showed only category 4. The frequency of category 5 and category 4 was higher in Rh +ve blood group than Rh −ve blood group in both hands.

In “B” blood group, Rh +ve blood group showed Category 3, Category 4, Category 5, and Category 6. The percentile frequency of Category 5 (63%) and Category 4 (27.6%) was higher in Rh +ve blood group than Rh −ve blood group (category 5%–2.1% and category 4%–2.1%).

”O” blood group also showed more incidences of Category 5 than Category 4 in both hands. The percentage frequency of Category 5 (66%) and Category 4 (25.2%) was higher in Rh +ve blood group compared to Rh −ve blood group (category 5%–5.9%, category 4%–0.45%). In the right hand, the Rh −ve blood group showed only category 5.

In “AB” blood group, we observed only Rh +ve blood group having Category 5 and Category 4 in both hands. Hence, the percentage frequency of Category 5 and Category 4 was obviously higher than Rh −ve blood group.

Although the present study has certain limitations, such as small sample size, results obtained in the present study are an opening to a new arena, where, in the near future, early prediction of suspected individuals will be possible using Palm prints as a diagnostic tool, especially when facilities for DNA analysis are not available.

CONCLUSION

We know that palm prints are unique and they never change from birth till death. The present study is an attempt to establish the association between palm-print patterns with the blood groups and gender of the North Indian population. The finding of the present study revealed no significant association between palm-print patterns and the ABO and Rh blood groups but showed statistically significant sexual dimorphism in the study population. This association may enhance the authenticity of the palmprints in field of research.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.