54 J Contemp Med Sci | Vol. 6, No. 2, March–April 2020: 54–58 Original ISSN 2413-0516 Introduction Modern humans exhibit great diversity of physical differences because of some factors such as sexual dimorphism, topogra- phy, climate, geographical location, and diet.1, 2 These physical differences account for different races, tribes, and ethnicities.3ÿ It also has very important influence on the health and iden- tification of an individual; therefore, becomes very necessary to establish baseline for health and physical identification of humans for each population.4, 5 Physical anthropology relies mainly on external mea- surements (Anthropometry) and descriptions (Morphology) of the human body. Such measurements are useful in the analysis and classification of fossil remains as well as study of living population. Anthropometry comes from a Greek word “Anthropos” which means human and “metron” which means measure. It is a non-invasive technique to measure the dimen- sions of the human body and skeleton.1, 6 Anthropometry has become essential tool of biological anthropology that involves a series of standardized measuring techniques that express quantitatively, the dimensions of human body. Cephalic and facial indexes are very important anthropometric index used in describing head and facial dimensions and morphology, respectively.7-9 Cephalic index (CI) is very useful in racial, ethnic, and gender identification of individuals. It is defined as the ratio of maximum cephalic width to maximum cephalic length mul- tiplied by hundred percent. Based on the value of CI, there are six different types of heads.10 Facial index (Prosopic index), on the other hand, is used to describe the facial proportion, prognosis of orthodontic treatments as well as indicating the direction of growth of craniofacial complex. The facial index is also defined as the ratio of morphological facial height to the ratio of facial width (bizygomatic width) multiplied by hun- dred percent. There are five different types of face based on facial index.10, 11 The facial and cephalic indices of an individual are deter- mined by growth and developmental pattern. According to Virchow’s law of parallel and perpendicular bone expansion, patency of the metopic and sagittal sutures are responsible for the adequate growth of cranial vault in the anterior–posterior while that of coronal and lambdoid sutures account for the growth in the transverse directions.12 The fusion of metopic suture occurs between 3 and 9 months while the others fuse between 22 and 39 months.13 Premature fusion of the sagittal suture may result an increase the entire length of the head in the anterior–posterior direction but in early fusion of metopic suture, only the anterior length is reduced.13 Although a high amount of report on cephalic and facial indices exist among various tribes and ethnic groups but there are little or no published data of such kind exist for the Akan people in Ghana. This study therefore aims at establishing for the first time, the baseline of cephalic and facial indices among the Akan people of Ghana. Materials and methods A total of 100 (50 males and 50 females) Akan volunteer adults between the age of 20 and 58 years (mean age of 29.7 years for males and 30.7 years for females) were recruited for the study. These volunteers were randomly selected from teach- ers and students of ObiriYeboah SHS and College of Distant Education, UCC (ObiriYeboah SHS Center) as well as inhab- itants of AssinFosu and the neighboring towns within the Cephalofacial characteristics of the Akan people in the Assin Districts in Central Region of Ghana: Anthropometric studies Gordon Kyei1,2, Ghazaleh Moshkdanian3, Parichehr Pasbakhsh1, Farid Abolhassani1, Tayebeh Rastegar1, Gholamreza Hassanzadeh1,4,* 1International Campus, Tehran University of Medical Science, Tehran, Iran. 2Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. 3Anatomical Sciences Research Center, Kashan University of Medical Sciences, Kashan, Iran. 4Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran. *Corresponding author: Gholamreza Hassanzadeh (E-mail: hassanzadeh@tums.ac.ir ) (Submitted: 23 January 2020 – Revised version received: 06 February 2020 – Accepted: 03 March 2020 – Published online: 26 April 2020) Objective Cephalic and facial indices are very important in the classification and identification of populations. The present study aims at determining the cephalic and facial indices among the Akan ethnic group living the Assin Districts in the Central Region of Ghana. Methods A total of 100 (50 males and 50 females) Akan volunteer adults between the age of 20 and 58 years were recruited for the study. Cephalic length (CL), cephalic width (CW), facial width (FW) and total facial height (TFH) were measured using a Spreading caliper. Cephalic index (CI) [(CW/CL) × 100] and facial index (FI) or prosopic index (PI) [(TFH/FW) ×100] as well statistical analysis such as z-test and Pearson correlation were performed. The p-value of less than 0.05 was considered statistically significant. Results Our results are comparable with other authors with mean (for both male and females) CI and FI of 78.6± 4.66 and 96.51 ± 12.55, respectively. There was a correlation between CW and FW as well as some other cephlaofacial parameters. There was no sexual dimorphism of both CI and FI. The predominant head type among the study populations was mesocephalic and brachycephalic while hyperleptoprosopic was the face type. Conclusion This study provides baseline data for the Akan people of the Assin Districts of the Central Region of Ghana, which will be a valuable in cephalometric anthropometry and in forensic science. Keywords Cephalic index; Facial index; Anthropometry; Akan People, Ghana. 55 Original Cephalofacial characteristics in Central Region of GhanaGordon Kyei et al. J Contemp Med Sci | Vol. 6, No. 2, March–April 2020: 54–58 Assin Districts. Subjects with history of craniofacial injury or trauma and obstructive hairstyle were excluded from the study. Verbal informed consent was obtained from each participant. The Hrdlicka’s method was used in assessing the ceph- alofacial parameters.14 The cephalic width (CW) was also measured as the maximum transverse diameter between two fixed points of the head (euryon), above the mastoid promi- nence (Fig. 1A). The cephalic length (CL) was measured with the help of spreading calipers, from glabella to mid-point of external occipital protuberance (Fig. 1B). Then the CI was calculated and the head type determined for each subject. Table 1 illustrates the types of heads and their designated val- ues of cephalic indices. CI was calculated using the following formula (No. 1) 15: CI CW CB = ×100 (1) As well, total facial height (TFH) was measured from the nasion to mental tubercle (Fig 1. C). and facial (bizygo- matic) width (FW) was measured as a distance between the right and left zygion (Fig. 1D). Additionally, facial index (FI) was calculated and face type was determined for each case. Table 2 illustrates the types of faces and their designated val- ues of cephalic indices. FI was calculated using the following formula (No. 2) 16: FI FL FW = ×100 (2) All the measurements were taken with the subject sit- ting in relaxed condition and head in anatomical position. To reduce the technical error of the measurements, each dimen- sion was taken twice and the average recorded. All measure- ments were taken to the nearest 1.0 cm. The following give descriptions of the measured parameters: • Cephalic length (CL): Glabella to inion • Cephalic width (CW): Distance between parietal emi- nences (zygion) • Total facial length (TFL): Nasion to gnathion • Facial width (CW): Distance between zygomatic arches. The data obtained were statistically analyzed using IBM- SPSS version 22 and Microsoft Excel 2016 for Windows. Basic descriptive statistics and independent sample t-test were per- formed at 95% confident interval. The p-value of less than 0.05 was considered statistically significant. Results Tables 3–7 show the results of present study. Basic statistics of CL, CW, CI, TFH, FW, and FI are shown in Table 3. The mean CL and CW of males were 18.26 ± 0.85 and 14.20 ± 0.76, while those in females were 17.52 ± 0.91 and 13.88 ±0.82, respec- tively. As the data show, there were significant differences (p<0.05) in both mean CL and CW between male and female subjects. The means of CI were also 77.92 ± 5.37 and 79.28 ± 5.08 for males and females, respectively, but there were no significant differences between the two genders (p=0.052) (Table 4). The mean CI of both males and females was 78.60 ± 4.66, which falls within mesocephalic )a head of medium propor- tions (. This type together with brachycephalic (a moderately Fig. 1 A. The cephalic width (CW) was also measured as the maximum transverse diameter between two fixed points of the head (euryon), above the mastoid prominence. B. The Cephalic length(CL) was measured with the help of spreading calipers, from glabella to mid-point of external occipital protuberance. C. Total facial height (TFH) was measured from the nasion to mental tubercle. D. Facial (bizygomatic) width (FW) was measured as a distance between the right and left zygion. Table 1. Classification of head type based on cephalic index. Type of head Cephalic index Hyperdolicocephalic 65.5–69.9 Dolichocephalic 70.0–74.9 Mesocephalic 75.0–79.9 Brachycephalic 80.0–84.9 Hyperbrachycephalic 85.0–89.9 Ultrabrachycephalic ≥90 Table 2. Classification of face type based on Facial index. Type of face Facial index Hypereuryprosopic <79.9 Europrosopic 80.0–84.9 Mesoprosopic 85.0–89.9 Leptoprosopic 90.0–94.9 Hyperleptoprosopic ≥95.0 56 Original Cephalofacial characteristics in Central Region of Ghana Gordon Kyei et al. J Contemp Med Sci | Vol. 6, No. 2, March–April 2020: 54–58 broad and short head) were the predominant types of head (Tables 1, 3 and 5). The Basic statistics of TFH and FW are shown in Table 3. The mean of TFH and FW were 11.58 ± 0.97 and 12.02 ± 1.12, while those in females were 11.52 ± 0.95 and 12.14 ± 1.23, respectively. There was no significant difference in both mean TFH and FW between male and female subjects (p>0.05, Table 4). Table 4 shows the mean facial index 97.21 ± 12.70 and 95.82 ± 12.49for males and females respectively, and the dif- ference was not statistically significant (p = 0.291). The mean FI of the studied population was 96.51 ± 12.55 (Table 3), which Table 3. Basic descriptive statistic of cephalofacial anthropometric characteristics among the Akan population in Assin Districts. Parameters N Mean ± SD(cm) SEM Range 95% CI CV % CL 100 17.89 ± 0.95 0.095 16.00–20.00 17.70–18.08 5.31 CW 100 14.04 ± 0.80 0.080 12.00–16.00 13.88–14.20 5.70 CI 100 78.60 ±4.66 0.466 66.67–88.88 77.68–79.53 5.93 TFH 100 11.55±0.96 0.096 10–14 11.36–11.74 8.31 FW 100 12.08±1.17 0.117 10.00–15.00 11.85–12.31 9.67 FI 100 96.51 ±12.55 1.255 71.43–130 94.03–99 13.00 Cephalic length (CL)/ Cephalic width (CW)/ Cephalic index (CI)/ Total Facial Height (TFH)/ Facial (bizygomatic) Width (FW)/ Facial index (FI). Table 4. Comparing the cephalofacial characteristics between males and females among the Akan population in Assin Districts. Parameters Gender Mean ± SD (cm) SEM Range 95% CI CV % z /p-value CL Male 18.26 ± 0.85 0.121 16–20 18.26–18.50 4.65 z = 4.199 p< 0.001 Female 17.52 ± 0.91 0.129 16–20 17.26–17.78 5.19 CW Male 14.20 ± 0.76 0.107 13–16 13.99–14.41 5.35 z = 2.023 p = 0.021 Female 13.88 ± 0.82 0.119 12–16 13.65–14.11 5.91 CI Male 77.92 ± 5.37 0.759 68.42–88.89 76.39–79.45 6.89 z = -1.628 p=0.052 Female 79.28 ± 5.08 0.532 66.67–83.33 78.21–80.35 6.41 TFH Male 11.58 ± 0.97 0.137 10.00–14.00 11.30–11.86 8.38 z = 0.331 p=0.370 Female 11.52 ±0.95 0.135 10.00–14.00 11.25–11.79 8.25 FW Male 12.02 ± 1.12 0.158 10.00–14.00 11.70–12.34 9.31 z = -0.511 p=0.304 Female 12.14±1.23 0.174 10.00–15.00 11.79–12.49 10.13 FI Male 97.21 ±12.70 1.796 76.92–127.2 93.6–100.82 13.06 z = 0.552 p= 0.290 Female 95.82 ±12.49 1.766 71.43–130 92.27–99.37 13.03 Table 5. Frequency (percentage) of head types among the Akan population in Assin Districts. Nose type Male n (%) Female n (%) All n (%) Hyperdolicocephalic 3 (6) 1 (2) 4 (4) Dolichocephalic 14 (28) 5 (10) 19 (19) Mesocephalic 18 (36) 18 (36) 36 (36) Brachycephalic 10 (20) 26 (52) 36 (36) Hyperbrachycephalic 5 (10) – 5 (5) Ultrabrachycephalic – – – Table 6. Frequency (percentage) of face types among the Akan population in Assin Districts. Nose type Male n (%) Female n (%) All n (%) Hypereuryprosopic 3 (6) 3 (6) 6 (6) Europrosopic 9 (18) 9 (18) 18 (18) Mesoprosopic 1 (2) 2 (4) 3 (3) Leptoprosopic 14 (28) 16 (32) 30 (30) Hyperleptoprosopic 23 (46) 20 (40) 43 (43) Table 7. Simple Pearson correlation of the Cephalofacial variables (r-value /p-value). Variables CL CW TFL FW CL 0.415/0.0001 0.244/0.007 0.099/0.164 CW 0.142/0.080 0.179/0.037 TFL 0.023/0.408 FW Cephalic length (CL)/ Cephalic width (CW)/ Total Facial Height (TFH)/ Facial (bizygomatic) Width (FW). 57 Original Cephalofacial characteristics in Central Region of GhanaGordon Kyei et al. J Contemp Med Sci | Vol. 6, No. 2, March–April 2020: 54–58 falls within hyperleptoprosopic (a very long narrow face) type of face (Table 2). According to our data, hyperleptoprosopic is also the pre- dominant type of face as depicted in Table 6. Furthermore, the correlation between the head width and facial width has been shown in Table 7. Discussion In the present study, cephalofacial anthropometric character- istics of the Akan people in the Assin Districts (Central Region of Ghana) were investigated. This study has revealed that the CI of the Akan people in the Assin Districts was 78.60 ± 4.66. This value is in agreement with the results obtained by many authors such as Basu17 and Bhargav and Kher.29 However, in a study conducted by Madadi et al18 among Iranian medical stu- dents, the CI of 83.51 was recorded.18 Anupama et al. (2009) also obtained a CI of 85.53 among Punjabi students.19 These results do not correlate with the result of the current study, however it confirms the fact that there are differences in the CI among different populations. According to the results, no significant difference was observed between males and females CI. Our findings corrob- orated with the results of Oladipo and Paul19 as well as Shema et al.20 In contrast, the results of Babatunde21 and Anupama et al22 were not in accordance with our findings. The reasons for the absence of difference in CI between male and female are not clear but may be due to the fact that the effect and interplay amongst growth, thyroid, and sex hormones seem to have the similar effect in both sexes. The dominant types of head in our study are mesocephalic and brachycephalic. The existence of more than one dominant head type with an equal percentage of distribution within the same study population is uncommon in the published lit- eratures. However, both head types observed in the present study are among the most common head type in the African population.19, 23 The facial index of the studied population was 96.51 ± 12.55. By comparing with the results in other populations, our value showed a degree of variations. Among Fars and Turkmen of Iran, males and females showed a prosopic index of 74.3 and 81.6, respectively.24 Bini tribe of Nigeria recorded a prosopic index of 86.93,25 while in Malaysia, males and females respec- tively had a prosopic index of 85.72 and 87.91.26 However, our results were comparable with Ukwuani indigenes in Nigeria who had a prosopic index of 99.15 ± 6.11 and 94.54 ± 9.89 among males and females, respectively.27 As well, Jaberi et al recorded 92 ± 6 for an Iranian population.7 Indigenes of Maiduguri also had prosopic indexes of 99.59 and 97.54 for males and females, respectively.28 Among the Qazvin people of Iran, Azizi et al recorded a prosopic index of 102.88 in males and 96.69 in females, respectively.11 In this study, similar to the CI, there was no significant sex- ual dimorphism between males and females in the prosopic index as well. The reasons for this observation are not clear but can be the same with CI reasons. The dominant type of face in the study population was hyperleptoprosopic in both males and females. This is in the direct agreement of the face type amongst Bini People of Nigeria. Finally, our results indicate that there are a significant positive correlation between cephalic length and cephalic width, cephalic length and total facial length as well as cephalic width and facial width. These findings agree with that of Umar et al30 among Hausa and Yoruba ethnic groups of Nigeria. Obaje et al30 also came to the same conclusion in their study of cephalic indices among Benue ethnic groups of Nigeria. Conclusion This study has revealed that the CI and facial index among the Akan people of the AssinDistricts in the Central Region of Ghana are, respectively, 78.60 and 96.51. This population has both Mesocephalic and Brachycephalic as dominant types of head. The dominant face type among them is hyperlepto- prosopic. There was a positive correlation between head width and facial width among them. Data obtained from this study will serve as a baseline for forensic scientist and anthropolo- gists, and for comparisons between the Akan people of Assin Districts and other ethnic groups within or outside Ghana. Acknowledgment We appreciate the effort of all those who helped to enrich this project specially Miss Pricilla Afuwa, Mr. Emmanuel Adjei, Mr. YussifAlhassan and third year psychology students (2018/ 2019 academic year) of CoDE, UCC (OYESS Centre). Special gratitude also goes to all the 100 volunteered Akan people of Assin Districts who participated in this study. Conflict of Interest There was no conflict of interest. References 1. Navid S, Mokhtari T, Alizamir T, Arabkheradmand A, Hassanzadeh G. Determination of stature from upper arm length in medical students. Anat Sci J. 2014;11(3):135–40. 2. Akhlaghi M, Bakhtavar K, Bakhshandeh H, Mokhtari T, Farahani MV, Parsa VA, et al. Sex determination based on radiographic examination of metatarsal bones in Iranian population. Int J Med Toxicol Foren Med. 2017;7(4 (Autumn)):203–8. 3. Moshkdanian G, Mahaki Zadeh S, Moghani Ghoroghi F, Mokhtari T, Hassanzadeh G. Estimation of stature from the anthropometric measurement of lower limb in Iranian adults. Anat Sci J. 2014;11(3): 149–54. 4. Mojaverrostami S, Mokhtari T, Malekzadeh M, Noori L, Kazemzadeh Sh IS. Stature estimation based on fingers anthropometry in Iranian population. Anat Sci. 2017;14(4):163–8. 5. Eftekhar Vaghefi SH, Sheikhbahaei F, Mokhtari T, Khademi F, Bahari H, Ghorbani R. A model for individual height estimation from forearm length in natives of Kerman, Iran. Anat Sci J. 2014;11(3):141–4. 6. Asharani S, Hiremarali LT, Rajendra R, Surendra M. Study of Nansal Index Among Students of Tertiary Medical Care Institute in Southern India. 2015. 7. Jaberi KR, Kavakebian F, Mojaverrostami S, Najibi A, Safari M, Hassanzadeh G, et al. Nasofacial anthropometric study among students of Shiraz University of Medical Sciences, Iran: A population based study. Ind J Otolaryngol Head Neck Surg. 2019;71(2):206–11. 8. Mohammed I, Mokhtari T, Ijaz S, Ngaski AA, Milanifard M, Hassanzadeh G. Anthropometric study of nasal index in Hausa ethnic population of northwestern Nigeria. J Contemp Med Sci. 2018;4(1). 9. Hassanzadeh G, Sadr M, Alaghbandha N, Dehbashipour A, Abbas MA, Heydar Zeidi O. Anthropometric characteristics of craniums in residents of Qazvin, Iran and Dera Ghazi Khan, Pakistan: A comparative study. Anat Sci J. 2013;10(1):43–9. 10. Kumari KL, Babu PV, Kumari PK, Nagamani M. A study of cephalic index and facial index in Visakhapatnam, Andhra Pradesh, India. Int J Res Med Sci. 2015;10:2320–6012. 11. Azizi M, Hassanzadeh G, Barbarestani M, Sadr M, Dehbashipour A, Alaghbandha N, et al. Comparative anthropometric analysis of facial 58 Original Cephalofacial characteristics in Central Region of Ghana Gordon Kyei et al. J Contemp Med Sci | Vol. 6, No. 2, March–April 2020: 54–58 dimensions and types in Qazvin, Iran and DeraGhazi Khan, Pakistan. Anat Sci J. 2014;11(3):119–26. 12. Shah G, Jadhav H. The study of cephalic index in students of Gujarat. J Anat Soc India. 2004;53(1):25–6. 13. Cohen JM, Kreiborg S. Cranial size and configuration in the Apert syndrome. J Craniofac Genet Dev Biol. 1994;14(3):153-62. 14. Hrdlička A. Practical Anthropometry. Wistar Institute of Anatomy and Biology; 1952. 15. Yagain VK, Pai SR, Kalthur SG, Chethan P, Hemalatha I. Study of cephalic index in Indian Students. Int J Morphol. 2012;30:125–9. 16. Wai MM, Thwin SS, Yesmin T, Ahmad A, Adnan AS, Hassan AA, et al. Nasofacial anthropometric study among university students of three races in Malaysia. Adv Anat. 2015;2015. 17. Basu A. Anthropometry of the kayasthas of Bengal. J Anat Soc India. 1963;3:20–5. 18. Madadi S, Khanehzad M, Tahmasebi F, Gordon K, Hassanzadeh G. Correlation of horizontal cephalic index and cranial parameters in Iranian medical students. Acta Med Iran. 2018;56(9):577–84. 19. Oladipo G, Olotu J, Suleiman Y. Anthropometric studies of cephalic indices of the Ogonis in Nigeria. Asian J Med Sci. 2009;1(2):15–7. 20. Nair SK, Anjankar VP, Singh S, Bindra M, Satpathy D. The study of cephalic index of medical students of central India. Asian J Biomed Pharm Sci. 2014;4(28):48. 21. Akinbami BO. Measurement of cephalic indices in older children and adolescents of a Nigerian population. BioMed Res Int. 2014;2014. 22. Mahajan A, Khurana BS, Batra APS. The study of cephalic index in Punjabi students. J Punjab Acad Foren Med Toxicol. 2009;9(2):66-70. 23. Oladipo GS, Paul CW. Anthropometric comparison of cephalic indices between the Urhobo and Itsekiri ethnic groups of Nigeria. Global J Pure Appl Sci. 2009;15(1). This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly. dx.doi.org/10.22317/jcms.v6i2.723