Download rajiv gandhi university of health sciences, bangalore, karnataka

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,
BANGALORE, KARNATAKA.
ANNEXURE-II
PROFORMA FOR REGISTRATION OF SUBJECTS FOR
DISSERTATION
1.
Name of the candidate and : DR. POOJA V.K
address (In block letters)
DEPARTMENT OF ORAL &
MAXILLOFACIAL PATHOLOGY.
NAVODAYA DENTAL COLLEGE AND
HOSPITAL,
RAICHUR – 584103.
Permanent Address
: DR. POOJA V.K
D/O B. VIJAY KUMAR
H.NO 2-907/31 A1
GUBBI COLONY, GULBARGA 585105
2.
Name of the institution
: NAVODAYA DENTAL COLLEGE AND
HOSPITAL,
RAICHUR – 584103.
3.
Course of study and
subject
: MASTER OF DENTAL SURGERY
(ORAL & MAXILLOFACIAL
PATHOLOGY)
4.
Date of admission to the
course
5.
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Title of the topic
: APRIL 2011
: DETERMINATION OF ABO BLOOD
GROUPING AND RHESUS (R h)
FACTOR FROM TOOTH MATERIAL.
6.1
Need for the study:
Blood grouping has been one of the major factors for identification of biological
materials in forensic investigations and ABO blood grouping is a widely used
technique in forensic laboratories. The presence of ABO blood group and Rhesus
factor is applied to inherited antigens detected on red cell surface by specific
antibodies1. Once the blood group and Rhesus factor is established it remains
unchanged throughout life2.
The presence of ABO blood group and Rhesus factor antigen in soft and hard dental
tissues makes it possible to assist in human identification even in decomposed bodies.
Mostly, teeth and bones are the only significant tissues remaining in mass disasters
such as air craft crash or bomb blasts and hence used in human identification1.
Pulp tissue is one of the most protected tissues being surrounded from all sides
by dental hard tissues. Pulp contains numerous blood vessels and blood group antigens
are certainly present in tooth pulp. Blood group substances are presumed to be present
in dentinal tubules.2 It has been proved that blood group antigens in the pulp and
dentine are preserved up to 2 years after death of an individual3.
Hence blood group and Rhesus factor determination for biological evidence on
tooth material is of great importance in forensic odontology.
Till date only ABO blood group determination is done from tooth material. As
Rhesus factor is important in blood grouping, in the present study Rhesus factor
determination is also included along with ABO blood grouping.
2
6.2
Review of literature
R.A. Outteridge (1963), conducted a study on comparison between absorptionelution and absorption- inhibition methods of grouping dried bloodstains in the ABO
system and stated that the Elution method as a method of choice, as it was very much
sensitive than the Inhibition method and was free from the dangers of false results
which the presence of detergents may induce4.
Gurminder Kaur and Vijay k. Sharma (1988), conducted a study on
comparison of absorption-inhibition and absorption- elution methods in detection of
ABO(H) antigens in sweat stains and stated that absorption – elution method was more
suitable and sensitive in comparison to absorption – inhibition method5.
Bregt Smeets, Herman van de Voorde and P. Hooft (1991), conducted a
study of ABO blood grouping on tooth material and observed ABO blood grouping
on enamel, dentine, and pulp by Absorption- Elution method within 6 weeks of
extraction gave 80% positive results in pulp, 65% positive in dentine and 45% positive
in enamel. And over a period of 6-10 months, showed that pulp gave 54% positive
results, dentine gave 54% positive results and enamel gave 47% positive results, all of
which were “O” blood group6.
3
Dr. Mahabalesh Shetty and Dr. Premlata. K (2010), conducted a study on
‘ABO blood grouping from tooth material’ and observed that ABO blood grouping by
Absorption-Elution method on extracted teeth from dead bodies which were kept for a
period of 180 days showed 96.7% sensitivity in the pulp in relation to the control
whereas dentine showed 0% result in relation to control2 .
Sushmini Ballal and Maria Priscilla David (2011), conducted a study on
‘ABO blood grouping from dentine and pulp’ and observed that ABO blood grouping
by absorption- elution technique on 30 extracted teeth over a period of 6 months
showed that the sensitivity of pulp in relation to control was 90%. But sensitivity of
dentine in relation to control was 0%.7
6.3
Objectives of the study
1. To determine the ABO blood grouping and Rhesus factor from Dentine and
Pulp of extracted teeth within 1 week, 3 months, 6 months, and 9 months after
extraction using ‘Absorption-Elution method’.
2. To compare the blood grouping and Rhesus factor obtained from the Dentine
and Pulp with the respective patient’s blood group obtained by slide method
and is considered as control.
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Materials and methods
7
7.1
Source of Data:
Patients attending Department of Oral Surgery, Navodaya Dental college and
Hospital, Raichur for extraction of teeth for periodontal and orthodontic purpose will
be selected for the study.
7.2
Methods of collection of Data (including sampling procedure, if any)
Study design: Experimental study.
Sample size: A total of 120 cases (4 groups of 30 patients in each) will be taken for
the study, including Males and Females of age ranging 13- 60 years.
Method of study: Patients attending Department of Oral Surgery, Navodaya Dental
College and Hospital, Raichur for extraction of teeth will be selected for the study.
Patient’s blood group will be checked by slide method obtained by a prick on
patient’s finger with a sterile lancet. Monoclonal ABO/Rh, Anti-A, B, and D
antiserum (Agappe diagnostics) is used to detect the blood group, the result obtained is
considered as ‘control’.
The extracted teeth will be tested for presence of ABO/Rh antigen within
1 week of extraction, 3 months, 6 months, and 9 months of extraction using
monoclonal ABO/Rh, Anti- A, B, and D antiserum (Agappe diagnostics) by
Absorption-Elution technique on dentine and pulp.
In this technique the extracted tooth is split vertically with carborundum
5
disc and then the dental pulp is scooped with sterile spoon excavator and placed in test
tube containing a drop of saline. The dentin of the tooth specimen is powdered with
the straight fissure bur and placed in a test tube containing a drop of saline.
The collected specimen is divided into 3 different test tubes. To each test
tube about 3 drops of monoclonal ABO/Rh anti sera- A, B and D antiserum is added
respectively and kept at room temperature for ‘Absorption’ for 3 hours. Then the
samples are washed 5 times with cold saline.
Later the test tubes containing samples is heated in a water bath for 10 minutes
at 500 c - 550 c to ‘Elute’ the antigen- antibody bond. About 2 drops of Prepared
pooled red blood cells of A, B and O positive is added to the respective test tubes and
incubated for 30 minutes at 370 c. After 30 minutes the samples are centrifuged at
2000rpm for 1 minute. On gentle shaking of the test tube presence or absence of
agglutination may be appreciated. For complete verification the sample is observed
under microscope at 40X, and grading of agglutination is noted.
Inclusion Criteria:
1. Both Male and Female patients of age group- 13 to 60 years.
2. Teeth which are extracted for periodontal or orthodontic purpose.
3. Only permanent teeth.
Exclusion Criteria:
1. Age groups below 13 years and above 60 years are excluded.
2. Carious teeth, Root canal treated teeth; grossly destructed teeth with exposed
pulp cavity are excluded.
3. Deciduous teeth are excluded.
6
Plan for Statistical analysis:
Descriptive statistics such as mean, standard deviation, proportion will be used.
For comparison Mc Nemar chi square test and other appropriate statistical test will
be used. Two tailed P value less than 0.05 is considered as significant and 1 is
considered as highly significant.
Does the Study require any investigation or intervention to be conducted on
7.3
Patients or other humans or animals? If so, please describe briefly.
Yes, the study requires collection of capillary blood by a prick on patient’s finger for
blood group investigation.
7.4
Has ethical clearance been obtained from your institution in case of 7.3?
Yes.
7
List of references:
8.
1. Paul G. Stmson and Curtis A. Mertz. Forensic Dentistry. 1997. p.23-24.
2. Dr. Mahabalesh Shetty, Dr. Premlata K. “ABO blood grouping from tooth
material”. Journal of Indian Academy of Forensic Medicine2010; 32(4): 336338.
3. Pramod k Dayal. Text book of Forensic Odontology. 1st ed. Paras publishing;
1998. p. 49-50.
4. R. A. Outteridge. “Blood stain grouping-Elution v. Inhibition”, Journal of
Forensic Science Society 1963; 4(2): 87-90.
5. Gurminder Kaur and Vijay K. Sharma. “Comparison of absorption- inhibition
and absorption- elution methods in the detection of ABO (H) antigens in sweat
stains”. Current Science 1988; 57(22): 122.
6. Berget Smeets, Herman van de Voorde, and P.Hooft. “ABO blood grouping on
tooth material”. Forensic Science International 1991; 50: 227-282.
7. Sushmini ballal, Maria Priscilla David. “Determination of ABO blood
grouping from dentine and pulp”. Pakistan oral and dental journal 2011;
3(1):3-6.
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