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  • To determine the discriminatory power of the ischiopubic

    2019-04-29

    To determine the discriminatory power of the ischiopubic index, the ROC curve was used (Fig. 3). The area under the curve for sex differentiation was 83.5% for the ischiopubic index. In the study population with a differentiation point of 100.47°, sensitivity of 82%, specificity of 78%, and accuracy of 80%, the ischiopubic index was different in men and women. In the studied population, significant differences were seen between in mean of the ischiopubic index and the length of the pubis between men and women, such that both of them were significantly more in women than in men (p<0.000). Table 4 shows that the length of the symphysis pubis, width of the pubis body, and ratio of the length of the symphysis pubis to the width of the pubis body were significantly different in men and women (p<0.000). According to Fig. 4, the under curve surface for the length of the symphysis pubis, midwidth of the pubis body, minimum width of the pubis body, ratio of the length of the symphysis pubis to the minimum width of the pubis body, and ratio of the length of the symphysis pubis to the midwidth of the pubis body were 65.8%, 78.8%, 83.6%, 81.1%, and 79.8%, respectively. All the mentioned items were significantly different between men and women (p<0.000). The mean length of the symphysis pubis in men, the minimum and midwidth of the pubis in women, and the mean ratio of the length of the symphysis pubis to the minimum and midwidth of the pubis in men were higher than the corresponding factors in the opposite sex. A comparison of the mean of the minimum width of the pubic superior ramus and the ratio of the length of the symphysis pubis to the minimum width of the pubic superior ramus were significantly different in men and women (p<0.000), as demonstrated in Table 5. According to the ROC curve, the under curve surface for the ratio of the length of the symphysis pubis to the minimum width of the pubic superior ramus was 63% (Fig. 5). The differentiation point, sensitivity, specificity, and accuracy were, respectively, 13 mm, 74%, 86%, and 80% for the minimum width of the pubic superior ramus, and 203.69 mm, 57%, 75%, and 66% for the ratio of the length of the symphysis pubis to the minimum width of the pubic superior ramus; this shows the differentiation between men and women. The difference between the minimum width of the pubic superior ramus and the ratio of the length of the symphysis pubis to the minimum width of the pubic superior ramus was significant, as the mean of the former was higher in men and the latter was higher in women (p<0.000).
    Discussion The mean values of the subpubic angle in this study were 101.51±13.4 in men and 135.47±14.8 in women, with the mean being significantly more in women than in men. In the study Sulfo-NHS-Biotin of Igbigbi and Nanono-Igbigbi, the mean values of the subpubic angle were 93.86±21.12 and 116.11±17.79 in men and women, respectively. These angles were larger in an Iranian population than in a black Ugandan study group, which shows the impact of ethnic and regional differences. In the study of Oladipo et al on Sulfo-NHS-Biotin radiographs of an Indian population, the mean values of the subpubic angles were 102.31±12.5 in men and 143.28±15.82 in women. In the work of Oladipo et al, the mean values were 109.38±10 in men and 119.48±12.06 in women in a Nigerian population. In the study of Vasheghi Farahani, the mean values of the subpubic angle were 116.31±23.67 and 140.53±14.33 in male and female, respectively. The results of these studies were inconsistent with the result of the current study, wherein the angle was larger in female than in male, and the size of the angles were almost similar to the angle size of this study. In the study of Small et al focusing on black and white South African populations, the mean values of the subpubic angle in male and female were, respectively, 70.67±9.36 and 93.86±11.15 in the white population, and 63.9±11.08 and 84.1±8.9 in the black population. The subpubic angle was significantly larger in the black population than in the white one, and the size of the angle was significantly different in male and female. The subpubic angle in the black population was larger than that in the Iranian population in both men and women. The difference between the result of this study and the results of other studies can be attributed to the shape of the pubic bones, the wide pelvis of Iranians, height differences, and environment. The mean values of the ischiopubic index in the current study were 94.28±9.18 in male and 107.96±11.54 in female. In this study, the length of the pubis in male and that in female were 82.10±7.21 mm and 87.35±7.78 mm, respectively, and the length of the ischium was 87.51±7.95 in men and 81.52±8.83 in women. In the study of Ekanem et al in Nigeria, the length of the pubis was 56.6 mm and 75.6 mm in male and female, respectively. The length of the ischium was 69.9 mm and 63.6 mm in men and women, respectively, and the ischiopubic index was 94.2 mm in men and 118.8 mm in women. Okoseimiema and Udoaka revealed that the length of the pubis was 74.99 mm in male and 84.88 mm in female, and the mean length of the ischium was 85.03 in male and 79.52 mm in female. Additionally, values of the ischiopubic index were 88.65 and 106.45 in men and women, respectively. In a study by Oladipo et al, the mean values for the length of the pubis, length of the ischium, and ischiopubic index were 78.51±12.4 mm, 85.58±11.6 mm, and 91.66±5.86, respectively, for Urhobo men, and 92.39±7.08 mm, 81.97±12.00 mm, and 114.93±18.14, respectively, for Urhobo women. In addition, the mean values for the length of the pubis, length of the ischium, and ischiopubic index were 82.20±10.62 mm, 83.84±10.82 mm, and 98.40±9.37, respectively, for Itsekiri males, and 92.05±6.36 mm, 85.03±14.59 mm, and 111.03±18.37 for their women counterparts, respectively, which show a significant difference among the sexes. In the study of Ekanem et al, the mean values for the ischiopubic index were 101.05 for men and 115.99 for women, and the mean value for the pubic length was significantly longer in women, whereas the ischial length was significantly higher in men. Results of previous studies and that of the current study have determined that the ischial length is larger in male while the pubic length is larger in female, and the mean value of the ischiopubic index was significantly higher in women. In the present work, the mean values of ischial length and pubic length were almost similar with that of the study of Okoseimiema and Udoaka, and were lower than the Ekanem study, which may be due to the wider pelvis in the Iranian population. The mean value of the ischiopubic index for men in the current study was higher than that in other studies; however, for women, it was lower than that in other studies, which may be due to the effect of ethnicity, environment, or age of participants.