Background & objective: Difficult intubation remains a risk for patients undergoing general anesthesia (GA) or mechanical ventilation in an intensive care unit (ICU). Macroglossia is a known factor for difficult intubation. But it is not routine to assess the tongue size to predict difficult intubation. Studies are found deficient in comparing usefulness of measuring thyromental distance and the tongue thickness (TT) measured by ultrasonography to estimate difficult intubation. We compared tongue thickness measured by ultrasonography and thyromental distance as a means to anticipate difficult intubation. Methodology: A convenient sample of 60 patients; 32 males and 28 females, who were undergoing elective surgery with GA were included. Thyro-mental distance (TMD), along with tongue thickness (TT) were measured consecutively in each patient in a transitional room. After induction of GA, Cormack Lehane (CL) score was assessed for all patients to detect difficult intubation. Results: Thyro-mental distance was significantly reduced in patients with difficult intubation, while the reverse was in the measurement of tongue thickness; where patients with difficult intubation had significantly a greater TT than those with no difficult intubation. TT measurement had significantly higher sensitivity and specificity (38%, and 96% respectively; P = 0.002) than thyro-mental distance in the detection of difficult intubation. Conclusion: In this study we demonstrated that there was statistically significant inverse relationship of thyro-mental distance on CL, and statistically significant direct relationship of tongue thickness on CL. The results showed that tongue thickness was more effective to detect difficult intubation. Abbreviations: CL - Cormack Lehane; TMD - Thyro-mental distance; TT - Tongue thickness; Keywords: Tongue Thickness; Thyromental Distance; Difficult Intubation Citation: Kadhim AB, Hamid GR. A comparative study between tongue thickness measured by ultrasonography and thyromental distance in anticipation of difficult intubation. Anaesth. pain intensive care 2024;28(3):431−435; DOI: 10.35975/apic.v28i3.2465 Received: March 16, 2024; Reviewed: March 29, 2024; Accepted: March 31, 2024
The aim of the present study was to investigate the histological structure of the tongue in Mongoose (Herpestes javanicus) and its related to the feeding pattern. Five adult animals were used in this study . The tongues were dissected and fixed in 10% formalin, then prepared by following stages (dehydration, clearing, and embedding).The serial section(5µ) were stained with(H&E) and some special stains.The histological examination showed that the tongue consists of three tunicae (mucosa, submucosa and musclaris) and the lining epithelium of the filiform papillae is composed of keratinized stratified squamous epithelial tissue. The cylindrical papillae are covered with a highly keratinized stratified squamous epithelial tissue, whereas the k
... Show MoreNutrient agar medium with various concentrations of cefotaxime was used for isolation spontaneous mutants from wild type strain of P.aeruginosa PHA-1. Eighty-two mutants were successfully isolated with the viable count 52×107 , these mutants were confirmed as spontaneous not physiological adaption mutants by reculture on the same medium. Then, wild type PHA-1 and mutants were examined for production pyocyanin; a blue greenish pigment was clearly noticed on King A medium. Remarkably the mutant strain named S300-8 was distinguished in productivity in comparison with wild type strain PHA-1; the amount of pigment was 56.0667mg/l and 74.53mg/l respectively. In addition, pyocyanin produced by mutant strain S300-8 revealed a potent efficacy again
... Show MoreComparative Analysis of Economic Policy Stability between Monarchical and Republican Systems: A Theoretical Fundamental Research
For criminal investigations, fingerprints remain the most reliable form of personal identification despite developments in other fields like DNA profiling. The objective of this work is to compare the performance of both commercial charcoal and activated carbon powder derived from the Alhagi plant to reveal latent fingerprints from different non-porous surfaces (cardboard, plain glass, aluminum foil sheet, China Dish, Plastic, and Switch). The effect of three variables on activated carbon production was investigated. These variables were the impregnation ratio (the weight ratio of KOH: dried raw material), the activation temperature, and the activation time. The effect factors were investigated using Central Composite Design
... Show MoreFor criminal investigations, fingerprints remain the most reliable form of personal identification despite developments in other fields like DNA profiling. The objective of this work is to compare the performance of both commercial charcoal and activated carbon powder derived from the Alhagi plant to reveal latent fingerprints from different non-porous surfaces (cardboard, plain glass, aluminum foil sheet, China Dish, Plastic, and Switch). The effect of three variables on activated carbon production was investigated. These variables were the impregnation ratio (the weight ratio of KOH: dried raw material), the activation temperature, and the activation time. The effect factors were investigated using Central Composite Design (CCD) softwa
... Show MoreABSTRACT Background: Tuberculosis is a worldwide infectious disease in spite of advancement in health care system. Tuberculous lymphadenitis is the most prevalent form of extra pulmonary tuberculosis with predilection of cervical lymph nodes. Objectives: To evaluate the reliability of grey scale ultrasonography together with color Doppler in the diagnosis of cervical tuberculous lymph adenitis and evaluation of early therapeutic response. Subjects and methods:From July 2015 to May 2016 in Al-Karama teaching hospital /Kut city- Wasit-Iraq, 25 patients (14 males and 11 females) with ages range from (6-50) years. Ultrasonography examination was done for all patients and grey scale criteria (distribution, size, shape, echogenicity, echogenic hi
... Show MorePolice play an important role in any society. Where they maintain public order by stopping and deterring crime and bringing criminals to justice. In order to achieve these objectives, they have certain means of law (search, arrest, use of force that may be lethal in some cases). However, such means may be misused in a way that harms members of society such as (Exceeding the Scope of a search warrant, violation of privacy of individuals, False Imprisonment, Excessive use of force, Sudden Deaths in custody, Sexual Assault and Harassment, Failure to respond for Domestic violence calls), which raises the civil liability of police officers and their agencies for such damage. Police officers may even abuse their characteristics even outside offic
... Show MoreCastellated columns are structural members that are created by breaking a rolled column along the center-line by flame after that rejoining the equivalent halves by welding such that for better structural strength against axial loading, the total column depth is increased by around 50 percent. The implementation of these institutional members will also contribute to significant economies of material value. The main objectives of this study are to study the enhancement of the load-carrying capacity of castellated columns with encasement of the columns by Reactive Powder Concrete (RPC) and lacing reinforcement, and serviceability of the confined castellated columns. The Castellated columns with RPC and Lacing Reinforcement improve com
... Show MoreBackground: Nasal obstruction is common in otorhinolaryngology outpatient visitors. The diagnosis of such compliant is by history, clinical examination and diagnostic procedures. Nasal endoscopy and computerized tomography scan are common diagnostic investigations. Nasal obstruction is either anterior or posterior (nasal septal deviations, hypertrophied turbinate pathological cyst, polyps, mass etc), or postnasal obstruction (hypertrophied turbinate, adenoid hypertrophy, nasopharyngeal cyst or nasopharyngeal tumors).
Aim of study: Prospective study to compare endoscopic finding and computerized tomography of nose, paranasal sinuses and postnasal space as diagnostic methods for nasal obstruction and other nose, p
... Show MoreBackground: Acute appendicitis is the most common surgical abdominal emergency with a life time prevalence of 1 to 7 individuals. Because the clinical diagnosis of acute appendicitis remains a challenge to surgeons, so different aids were introduced like different scoring systems, computer aided programs, ultrasonography, computerized tomography, Magnetic resonance imaging, Gastrointestinal tract contrast studies and laparoscopy to improve the diagnostic accuracy.
Objective: To evaluate ultrasound in the diagnosis of acute appendicitis in those patients clinically diagnosed with histopathology as gold standard.
Methods: A cross sectional study carried in Al-kindy Teaching
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