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
Abstract
The Classical Normal Linear Regression Model Based on Several hypotheses, one of them is Heteroscedasticity as it is known that the wing of least squares method (OLS), under the existence of these two problems make the estimators, lose their desirable properties, in addition the statistical inference becomes unaccepted table. According that we put tow alternative, the first one is (Generalized Least Square) Which is denoted by (GLS), and the second alternative is to (Robust covariance matrix estimation) the estimated parameters method(OLS), and that the way (GLS) method neat and certified, if the capabilities (Efficient) and the statistical inference Thread on the basis of an acceptable
... Show MoreThe lower Cretaceous sandstones of Zubair and Nahr Umr formations are the main producing reservoirs in Subba oilfield in southern Iraq. Key differences in their petrophysical and depositional attributes exist affecting their reservoir characteristics. The evaluation of well logs and core porosity-permeability data show better reservoir properties in Nahr Formation. The Litho-saturation logs indicate greater thickness of oil-saturated reservoir units for Nahr Unr Formation associated with lower values of shale volume, and higher values of effective porosity. In addition, higher values of permeability for Nahr Umr Formation is suggested by applying porosity-irreducible water saturation cross plot. The reducing reservoir quality of Zub
... Show MoreThe purpose of the current investigation is to distinguish between working memory ( ) in five patients with vascular dementia ( ), fifteen post-stroke patients with mild cognitive impairment ( ), and fifteen healthy control individuals ( ) based on background electroencephalography (EEG) activity. The elimination of EEG artifacts using wavelet (WT) pre-processing denoising is demonstrated in this study. In the current study, spectral entropy ( ), permutation entropy ( ), and approximation entropy ( ) were all explored. To improve the classification using the k-nearest neighbors ( NN) classifier scheme, a comparative study of using fuzzy neighbourhood preserving analysis with -decomposition ( ) as a dimensionality reduction technique an
... Show MoreBackground: Suffering from recurrent boils (furunclosis) is a common problem in our locality as it is noticed by many dermatologists especially in association with increasingly hot weather. The most common causative organisms are staphylococci. Objective: The aim of the study was to shed the light upon this problem and compare two systemic therapeutic agents for the prevention of recurrence, doxycycline and rifampicin. Patient and method: One hundred thirty-five (135) Patients with recurrent boils from Al-Yarmouk teaching hospital dermatology outpatient department were included in this study; age ranged from 10 to 64 years old and out of total patients 32 were males and 103 were females. Patients were assessed by full history and cl
... Show MoreAbstract. In this work, Bi2O3 was deposited as a thin film of different thickness (400, 500, and 600 ±20 nm) by using thermal oxidation at 573 K with ambient oxygen of evaporated bismuth (Bi) thin films in a vacuum on glass substrate and on Si wafer to produce n-Bi2O3/p-Si heterojunction. The effect of thickness on the structural, electrical, surface and optical properties of Bi2O3 thin films was studied. XRD analysis reveals that all the as deposited Bi2O3 films show polycrystalline tetragonal structure, with preferential orientation in the (201) direction, without any change in structure due to increase of film thickness. AFM and SEM images are used to investigate the influences of film thickness on surface properties. The optical measur
... Show MoreThe results of this study showed that the tongue of the adult Iraqi domestic cat is divided into three regions of apex, body and root. The dorsal surface of all regions possesses five types of lingual papillae, two mechanical which are filiform and cylindrical papillae, while the other three types are taste papillae which are foliate, fungiform and circumvallate papillae, while these papillae are absent on its ventral surface. The histological examination of all tongue areas revealed that it consisted of three tunica, the tunica mucosa and the tunica submucosa (the lamina propria) and the tunica muscularis. The tunica mucosa consisted of the epithelial lining, which is a stratified squamous epithelial tissue covering the lingual papillae, a
... Show MoreResearching the effects of the research and technological development contract, determining its extent and demarcating the boundaries of the obligations imposed in it, is the cornerstone of economic growth and development, because defining these obligations removes the ambiguity and conflict between interests, by stating the rights owed to each party and even trying to reconcile them, or impose protection by specifying guarantees that are compatible with the essence of the R&D contract, For the purpose of studying the subject thoroughly, we will divide this research into two sections. The first is devoted to identifying the parties to the research and technological development contract. As for the other topic, we will explain the obligation
... Show MoreThe other day in the Holy Quran and the four Gospels