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Death: clinical and forensic anthropological perspectives Etty Indriati, Etty Indriati
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 35, No 4 (2003)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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All biological living beings inevitably die, and the ways to die vary although in essence death is a manifestation of the absence of Oxygen in the brain. After death, biological remains undertake proteolysis and decomposition. The aim of this article is to discuss clinical death, cerebral or medicolegal death, social death, phases of cerebral death, and biological process after deathÃ¢â¬âwhich is important for forensic medicine and forensic anthropology. How long a person die, if the time elapsed is in minutes, hours, days and a week,-it is within the field of medical forensic and pathological forensic. If the time elapsed after death is in weeks, months, or years, it is within the field of forensic anthropology. The time elapsed from biological death to the examination of the death is called postmortem interval. Five case studies on postmortem interval are presented in this article. It can be concluded that knowledge of the biological process of death and the fate of biological remains after death are important for handling abnormal death both in forensic medicine and forensic anthropology.Key words: clinical death, cerebral death, postmortem interval, forensic medicine, forensic anthropology

The roles of forensic anthropology in fetal death investigation Etty Indriati, Etty Indriati
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 31, No 03 (1999)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Physical anthropologist who has a training in forensic anthropology may be requested to give an expertestimony. In case of discovery of fetal remains, forensic scientist should understand on what main principles of medicolegal examination the evidences are based. In relation with fetal skeletal remains several investigations should be emphasized, i.e. the origin of the skeleton, the maturity compared with gestational age, the prematurity, whether the fetus is viable at birth, is the case an abortion one, the furnish data indicating the possible cause of death, and the time elapased between the interment and the discovery.The aim of this paper is to discuss the role of forensic anthropology in fetal death investigation and to present case studies of fetal death. The methods used in this study are those by various experts, to determine the age of fetuses. The material of the case study is an unknown fetal remain from Java-Indonesia sent by the law enforcement agency. The study was carried out in the Laboratory of Bioanthropology and Paleoanthropology Faculty of Medicine in July 1990. The result shows the Ohtsukis method proved to be the most appropriate in this case, probably due to the similarity in body size between the Japanese and Indonesian. The result also shows that fetal age identification is extremely sensitive to measurement error. An error of 2 mm. Can lead to 3 months difference in fetal age, therefore, a caliper with 0.005 mm. accuracy is suggested. The conclusion drawn from this study is that physical anthropology is a necessary part of forensic investigation.Key Words: fetal remains investigation - Java origin - fetal age - identification method - forensic anthropology

Child sexual abuse: clinical and psychological perspectives Etty Indriati, Etty Indriati
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 33, No 02 (2001)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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This article reviews the clinical and psychological effects of children who suffer sexual abuse. Child sexual abuse (CSA) is a forced sexual behavior toward a child, either from the opposite or same sex. The types of child sexual abuse include exhibitionism, vouyerism, kissing, fondling, fellatio and cunnilingus, sexual intercourse, and pornography. The psychological effects of child sexual abuse often last a long time, in the form of anger, anxiety, nightmares, insecure, confused, scared, sad, and behavioral change from good to bad. The clinical effects of child sexual abuse ranges from bleeding in the genital and anus, fissure on anus, enlargement of vaginal and anal openings, and thinning/damaged of the hymen in the vagina. The Indonesian law no. 290 mentions that sexual offender or perpetrator is to be jailed for at most 7 years. It is hoped this review can be used as a general reference for clinicians in obstetrics and gynecology as well as pediatrics, in diagnosing child sexual abuse. This diagnosis is important for helping the abused child to recover and as medical records for law enforcement.Keywords: child sexual abuse, clinical effects, psychological effects

Epidemiology of cervical-root caries on teeth: High prevalence in the coca leaf chewing in the Andean people. Etty Indriati, Etty Indriati
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 36, No 1 (2004)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Background: Cervical-root caries on teeth often called rampant caries or circular caries often suffered by children who consumed bottled sweet milk. In adult, cervical-root caries occurs in unique cases such as cancer patients who undertake chemotherapy, and narcotic addicts.Objective: The research was aimed to study the dental and oral health of Andean people who have traditionally been chewing coca-leaves as a part of their cultural and integral lives.Materials and Method: The subject of study was 210 Aymara people from highland Chile and Bolivia, Andes. They were given questionnaire whether they chew coca leaves or not. Without knowing whether one chewed coca leaves or not, each individual was examined for: the carious teeth, the caries location, the periodontal stage, the oral pH, the molar radices, the molar loss, and the total number of teeth preserved.Result: The result showed that people who chewed coca-leaves every day suffered cervical-root caries on their molar teeth, only radices of molars preserved, or even lost their molar teeth. They also suffered tongue desquamation and periodontal damage at the buccal area of molar teeth. In contrast, those who did not chew coca-leaves were relatively free from these dental disadvantages. Statistical analysis showed significantly high correlation between duration and intensity of chewing coca leaves with dental disadvantages (R=0,62 for molar loss; R=0,63 for bad periodontal status; and R =0,54 for cervical-root caries).Conclusion: It is concluded that habitual chewing of coca leaves damaged the periodontal region of the molar area, caused the root of the molar teeth to expose and led to cervical-root caries, then, only roots of molar preserved, and last, the lost of molar teeth. The high prevalence of cervical-root caries in coca-leaves chewers is in accord with other conditions such as cancer patients who undertake chemotherapy, and narcotic addicts. The alkaloid in the coca leaves are associated with the drying out the mouth leading to less self-cleansing and damaging the cervical-root area. Understanding the cultural tradition in a society is important if we were to understand the disease processes.Key words: coca leaves - Andes - epidemiology - cervical-root caries - molar

Sexual dimorphism of pelvic girdle: pelvimetry and pelvic types in Javanese Etty Indriati, Etty Indriati
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 39, No 01 (2007)
Publisher : Universitas Gadjah Mada

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Background: Each population has certain phenotypic traits that are unique compared to other populations. Pelviss size and morphology are two of them. A western formula of obstetric conjugate = diagonal conjugate - 1.5 to 2.0 em; may not be applicable to Javanese population; and sexual traits in Western pelves may not entirely be the same with Indonesians.Objective: to get a formula for obstetric conjugate, and conduct various pelvic measurements in order to find out the metric pattern as well as the distribution of pelvic types in Javanese.Material and Methods: 27 pelves consisting of 6 females and 21 males housed at the Department of Anatomy, Embryology and Anthropology were studied by connecting the sacrum with the right and left pelvis forming pelvic girdles. Superior inlet, diagonal conjugate, angle of greater sciatic notch, diameter and width of pelves were among the metric studied.Results: Widely used traits such as greater sciatic notch that are used in Western literature to differentiate male and female pelves in Caucasian is not consistent for Javanese pelves. The most consistent skeletal traits for sexing female pelvis are wide subpubic angle (> 75 degree), preauricular sulci, flat posterior pubic symphisis, and short ischiopubic rami. The common type of ginecoyd pelvis in Javanese (48%) is in accord with western pelvis reaching 50%. Compared to the western obstetric conjugate, Javanese obstetric conjugate has a slightly different formula = diagonal conjugate - 1 to 2.6 cm.Conclusions: Several traits in sexual dimorphic of pelvic bone in Javanese do not match with skeletal traits widely used in Western literature, portraying the importance of studying regional human biological variation. The obstetric conjugate of Javanese pelves is not entirely the same with Western formula, though the difference is not significant.Key words: Javanese, pelves, sexual dimorphism, obstetric conjugate

The effectiveness of piper betel solution and combination of sodium hypochlorite and hydrogen peroxide in root canal irrigation for endodontic treatment: A scanning electron microscope study. Etty Indriati, Etty Indriati
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 35, No 2 (2003)
Publisher : Universitas Gadjah Mada

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Background: Root canal irrigation is a step needed in endodontic treatment, after extirpation of dental nerves, to clean the debris in the root canal in infected tooth pulp. The cleaned root canal was then filled with synthetic nerves and thus allowed the tooth crown to be preserved and function normally in the oral cavity.Objective: This study was aimed to compare the effectiveness of piper betel solution with the combination of sodium hypochlorite and hydrogen peroxide as irrigation material in dental root canal treatment. Material and Method: The material of study consisted of 6 upper incisors that were sectioned longitudinally into 12 parts. This study used in vitro method, by applying standard root canal treatment: preparation, extirpation, and irrigation of the root canal of incisor teeth. After irrigation (one group of teeth used piper betel solution; and the other group used combination of sodium hypochlorite and hydrogen peroxide), the tooth was longitudinally cut becoming mesial and distal parts. These parts were examined under scanning electron microscope with 500 magnification, and photographed using electron micrograph on the apical, middle, and coronal sections. The amount of debris was calculated (pm2) in each of those sections.Results: Irrigation using piper betel solution showed less amount of debris (n = 12, mean = 565 pm2) in the root canal, compared to combination of sodium hypochlorite and hydrogen peroxide (n = 12, mean =703,um2). However, the t test statistical analysis showed no significant difference between the two.Conclusion: Because of the toxicity of combination of sodium hypochlorite and hydrogen peroxide, no significant difference in irrigation material for root canal treatment, and the cleaner effect of piper betel solution, I suggest piper betel solution to be used widely as irrigant in endodontic treatment.Key words: root canal, piper betel, sodiumÂ hypochlorite, hydrogen peroxide, incisor teeth

Individuation in decapitation with C7-T1 vertebral scanning Etty Indriati, Etty Indriati
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 35, No 3 (2003)
Publisher : Universitas Gadjah Mada

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Background: Mutilation to eliminate the identity of murder victim is often conducted in crimes, for instance by cutting the head from the body. In order to determine whether the head belongs to the same individual with the body, research on the vertebral anatomy of the seventh cervical and first thoracic vertebrae is very important to be conducted.Objective: to observe the morphological congruence between the seventh cervical vertebrae and the first thoracic vertebrae.Material and Method: Thirty skeletons housed at the Laboratory of Anatomy, Embryology and Anthropology Gadjah Mada University Faculty of Medicine, Yogyakarta. The methodology is by scanning the C7 and T1 with three-dimensional scanner Umax Astra 2000, which scanned the bones into two dimensional on scanning paper. The scanned C7 is superimposed to T1, in the same individual and also between individual. Result: High degree of congruence between C7-T1 occurred at lamina, the structure that connects the pedicle and spinous process. This congruence extends into the posterio-inferior lateral border at the interior articular facets. Superimposition of C7-T1 inter-individual showed no accordance on the spinous process, lamina, inter-vertebral foramen, transverse process, and corpus vertebrae. Thus there was no two individuals had the same size and contour of C7-T1.Conclusion: This research is important in determining individuation on decapitation homicide where the body is dispersed from the head. This study also shows the contribution of anatomy in forensic sciences.Key words: decapitation, individuation, congruence, vertebrae, scanning

Human behavior and its effect on oral biology: biocuitural observation Etty Indriati, Etty Indriati
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 34, No 03 (2002)
Publisher : Universitas Gadjah Mada

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Human behavior, tradition, habit, and culture are closely associated with human biological condition, their health and sickness. Thus, humans habits and activities mimic in their health and sickness. Among human cultural traditions reviewed are coca-leaf chewing, betel-nut chewing, tobacco chewing, irradiation treatment in cancer patients, tooth-tool use related to task activities, tooth cleaning and palliative purposes, and gum chewing. Many literatures have shown that humans activities and habits have impact on their oral biology, ranging from gingival recession, hyperkeratosis of buccal mucosa, cervical-root caries on molar teeth, desquamation of tongue, approximal grooves, and leucoplakia on the oral mucosa. This review suggests that understanding a disease process requires knowledge of humans activities and cultural tradition due to the close association of culture and biology, behavior and health.Key words: habit, teeth, oral, biology, health

Stature in Yogyakartas students and prehistoric Balinese circa 1100 A.C. Etty Indriati, Etty Indriati
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 34, No 01 (2002)
Publisher : Universitas Gadjah Mada

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Background: Stature is one of growth and development indicators among others such as weight, dental eruption, and bone development. Stature varies between populations and races, and changes across times and spaces.Aim of study: to understand the average stature of groups of Indonesians relative to other populations worldwide; and to understand the anthropological category of Indonesians stature. Material and methods: Subjects were students of National University of Yogyakarta consisted of 245 people. Sex, age and their statures were recorded. In addition, the stature of 47 human skeletal remains from prehistoric Bali were measured utilizing regression formula of Mongolid race.Results: The average stature of Yogyakarta National University students in 1980s was 165 cm and 152.8 cm in males and females respectively. In the 1990s, their statures were 165.4 cm and 153.7 cm respectively. The prehistoric Balinese circa 1100 A.D. had statures of 164.4 cm and 157.3 cm in males and females respectively.Conclusion: Increased stature of 0.4 cm in males and 0.9 cm in females among Yogyakarta students in one decade might have been related to better nutrition, social and economy from the 80s to the 90s. Within two millennia, Indonesian stature has not undertook significance change. Indonesian stature is medium relative to other populations stature worldwide; and in the range of stature of people from China, Hongkong, Taiwan, Thailand, and India. However, Indonesian stature is below the average stature of European and American people. This suggests that race/genetics are more prominent as contributing factors reaching terminal stature, compared to latitude (weather and geograpy).Keywords: stature, Yogyakarta, Bali, anthropology, growth

Permanent tooth eruption in Javanese children Etty Indriati, Etty Indriati
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 33, No 04 (2001)
Publisher : Universitas Gadjah Mada

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Background: Permanent tooth eruption from the alveolus into the oral cavity is one of the basic growth and developmental processes in humans. The permanent tooth eruption occurs gradually with age and therefore the eruption schedule can be used as an age indicator in forensic cases where only skeletons and teeth of children have been found.Objective: This study examines permanent tooth eruption in Javanese children and compares it with other populations.Material and Method: The subjects were 175 children from the state elementary school of Imogiri II, Bantu! District, Yogyakarta. Examinations were carried out using a mouth mirror under natural light. Data was classified in one-year age interval, based on the questionnaire given to parents to fill out with the birth date of each child. In addition, the mean and median ages of dental eruption in boys and girls maxillary and mandibular dentition were also statistically analyzed.Results: Results show that in their maxillas, boys were more advanced than girls in tooth eruption, except for the upper canine teeth. Similarly, in the mandible, boys were more advanced than girls in tooth eruption, except for lower canine and second premolar teeth. In boys, the upper canines erupt later than upper second molars, which is opposite to the pattern of girls. The order of tooth eruption in boys is 11-M1, M, I, 12, 12, P1, P, P2, P2, CO3 M2, CÃÂ°, M2. In girls, the order of tooth eruption is 11, M1, M, P, 12,12, PI, P1, Co, P2-P2, co, M2, M2.Conclusion: Age can be determined on the basis of tooth eruption in children and subadults.Keywords: permanent teeth, eruption, children, age, growth, Java

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