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
Fire incidences are classed as catastrophic events, which mean that persons may experience mental distress and trauma. The development of a robotic vehicle specifically designed for fire extinguishing purposes has significant implications, as it not only addresses the issue of fire but also aims to safeguard human lives and minimize the extent of damage caused by indoor fire occurrences. The primary goal of the AFRC is to undergo a metamorphosis, allowing it to operate autonomously as a specialized support vehicle designed exclusively for the task of identifying and extinguishing fires. Researchers have undertaken the tasks of constructing an autonomous vehicle with robotic capabilities, devising a universal algorithm to be employed
... Show MoreAcute appendicitis is the most common surgical abdominal emergency. Its clinical diagnosis remains a challenge to surgeons, so different imaging options were introduced to improve diagnostic accuracy. Among these imaging modality choices, diagnostic medical sonography (DMS) is a simple, easily available, and cost effective clinical tool. The purpose of this study was to assess the accuracy of DMS, in the diagnosis of acute appendicitis compared to the histopathology report, as a gold standard. Between May 2015 and May 2016, 215 patients with suspected appendicitis were examined with DMS. The DMS findings were recorded as positive and negative for acute appendicitis and compared with the histopathological results, as a gold standard
... Show MoreIn the present study, an attempt has been made to experimentally investigate the flexural performance of ten simply supported reinforced concrete gable roof beams, including solid control specimen (i.e., without openings) and nine beams with web openings of different dimensions and configurations. The nine beams with openings have identical reinforcement details. All beams were monotonically loaded to failure under mid-span loading. The main variables were the number of the created openings, the total area of the created openings, and the inclination angle of the posts between openings. Of interest is the load-carrying capacity, cracking resistance and propagation, deformability, failure mode, and strain development that represent the behav
... Show MorePurpose: clarify the integrative relationship of strategic leadership skills and effective management and the role of those skills combined or individually in achieving effective management.
Research design: The researchers used the quantitative method by surveying a class sample from the heads of the executive departments in a group of Iraqi private banks, consisting of (106) individuals according to the (VUCA Prime) methodology for effective management and the ten skills model for Johansen. The questionnaire was analyzed using a model of the structural equation.
Findings: The most prominent results of the research were the presence of a weak ro
... Show MoreThe foreguts of a total of 515 fish of Chondrostoma regium (Heckel, 1843) (locally: Bala’aot Malloky) were studied. These fish were collected from Tigris River at Salah Al-Deen Province (between Al-Hagag & Yathrib) for 20 months between March and October of the next year. Detritus, plant in origin materials (19.6%, 23.0% & 24.9%); green and blue green algae, mostly Cladophora, Cosmarium and Merismpedia sp. (17.1%, 12.9% & 12.2%) and diatoms, mostly Diatoma, Chanathes, Amphora and Cyulbella sp. (16.9%, 8.8% & 8.2%) were the main food categories taken by these fishes according to occurrence (O%), volumetric methods (V%) and ranking index (R%). Debris (not part of the diet) took 45.3% of the studied fish foreguts by volume. Detritus was also
... Show MoreThe proper operation, and control of wastewater treatment plants, is receiving an increasing attention, because of the rising concern about environmental issues. In this research a mathematical model was developed to predict biochemical oxygen demand in the waste water discharged from Abu-Ghraib diary factory in Baghdad using Artificial Neural Network (ANN).In this study the best selection of the input data were selected from the recorded parameters of the wastewater from the factory. The ANN model developed was built up with the following parameters: Chemical oxygen demand, Dissolved oxygen, pH, Total dissolved solids, Total suspended solids, Sulphate, Phosphate, Chloride and Influent flow rate. The results indicated that the constructed A
... Show MoreThe approach of green synthesis of bio-sorbent has become simple alternatives to chemical synths as they use for example plant extracts, plus green synthesis outperforms chemical methods because it is environmentally friendly besides has wide applications in environmental remediation. This paper investigates the removal of ciprofloxacin (CIP) using green tea nano zero-valent iron (GT-NZVI) in an aqueous solution. The synthesized GT-NZVI was categorized using SEM, AFM, BET, FTIR, and Zeta potentials techniques. The spherical nanoparticles were found to be nano zero-valent, with an average size of 85 nm and a surface area of 2.19m2/g. The results showed that the removal efficiency of ciprofloxacin depends on the initial pH (2.5-10),
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