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
Specimens of the hedgehog Hemiechinus auritus Gmelin. which were trapped in two places on the Eastern shores of the Tigris River, some 50 and 60 Km, south of Baghdad. central Iraq. were searched for ectoparasites. They revealed the following parasites: One species of Anoplura: polyplex spinulosa (Burm.), family Hoplople uridae, two species of fleas: Synostrnus pallidus (Tasch.) and Ctenocephalides felis (Bouche), family pulicidae, One mite species: Ornithonyssus bacoti (Hirst), family Macronyssidae and two tick species: Rhipicephalus leporis and R. turanicum family Ixodidae. All these ectoparasite species are new records on this hedgehog in Iraq.
In this study, the modified Rayleigh-Ritz method and Fourier series are used to determine the thermal buckling behavior of laminated composite thin plates with a general elastic boundary condition applied to in-plane uniform temperature distribution depending upon classical laminated plate theory(CLPT). A generalized procedure solution is developed for the Rayleigh-Ritz method combined with the synthetic spring technique. The transverse displacement of the orthotropic rectangular plates is not a different term as a new shape expansion of trigonometric series. In this solution approach, the plate transverse deflection and rotation due to bending are developed into principle Fourier series with a sufficient smoothness auxi
... Show MoreIn this paper, a dynamic investigation is done for strip, rectangular and square machine foundation at the top surface of two-layer dry sand with various states (i.e., loose on medium sand and dense on medium sand). The dynamic investigation is performed numerically using finite element programming, PLAXIS 3D. The soil is expected as a versatile totally plastic material that complies with the Mohr-Coulomb yield criterion. A harmonic load is applied at the base with an amplitude of 6 kPa at a frequency of (2 and 6) Hz, and seismic is applied with acceleration – time input of earthquake hit Halabjah city north of Iraq. A parametric study is done to evaluate the influence of changing L/B ratio (Length=12,6,3 m and width=3 m), type of sand
... Show MoreStatistical studies are reported in this article for an active galactic nuclei sample of different type of active galaxies Seyferts 1, Seyferts 2, and Quasars. These sources have been selected from a Catalogue for bright X-ray galaxies. The name of this index is ROSAT Bright Source Catalogue (RBSC) and the NRAO VLA Sky Survey (NVSS). In this research, multi-wavelength observational bands Radio at 1.4 GHz, Optical at 4400 A0, and X-ray at energy 0.1-2.4 KeV have been adopted in this study. The behavior of flux density ratios has been studied , with respect to the absolute magnitude . Furthermore, the Seyfert1 and Seyfert 2 objects are combined in one group and the QSOs are collectest in another group. Also, it has been fo
... Show MoreThe root lesion nematode, Pratylenchus neglectus, is one of the most damaging nematodes to affect wheat worldwide. The nematode is widely distributed in Montana, primarily affecting winter wheat within the state. Managing the nematode primarily involves rotation to resistant and moderately resistant crops (peas, lentils, and barley). A nematode survey was conducted across the state nearly 10 years after an initial survey, to reassess the nematode threat and assess the impact of changing trends in crop rotations. To assess the broad applicability of rotation crops to control P. neglectus across Montana, greenhouse trials were conducted to challenge rotational crops using eight populations of P. neglectus collected from geographicall
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The influence of Cr3+ doping on the ground state properties of SrTiO 3 perovskite was evaluated using GGA-PBE approximation. Computational modeling results infered an agreement with the previously published literature. The modification of electronic structure and optical properties due to Cr3+ introducing into SrTiO 3 were investigated. Structural parameters assumed that Cr3+ doping alters the electronic structures of SrTiO 3 by shifting the conduction band through lower energies for the Sr and Ti sites. Besides, results showed that the band gap was reduced by approximately 50% when presenting one Cr3+ atom into the SrTiO 3 system and particularly positioned at Sr sites. Interestingly, substituting Ti site by Cr3+ led to eliminating the ban
... Show MoreFurfural is a toxic aromatic aldehyde that can cause a severe environmental problem especially the wastewater drown from petroleum refinery units. In the present work, a useless by-product from local furniture manufacturing industry; sawdust was used as raw material for the preparation of activated carbon which is chemically activated with phosphoric acid. The effect of adsorption variables which include initial pH of solution (2-9), agitation speed (50-250) rpm, agitation time (15-120) min, initial concentration of furfural (50-250) ppm, and amount of adsorbent material (0.5-2.5) g for the three adsorbents used (prepared activated carbon, commercial activated carbon and raw sawdust) were investigated in a batch process
... Show MoreThe main aim of this paper is studied the punching shear and behavior of reinforced concrete slabs exposed to fires, the possibility of punching shear failure occurred as a result of the fires and their inability to withstand the loads. Simulation by finite element analysis is made to predict the type of failure, distribution temperature through the thickness of the slabs, deformation and punching strength. Nonlinear finite element transient thermal-structural analysis at fire conditions are analyzed by ANSYS package. The validity of the modeling is performed for the mechanical and thermal properties of materials from earlier works from literature to decrea
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