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
Electrospun nanofiber membranes are employed in a variety of applications due to its unique features. the nanofibers' characterizations are effected by the polymer solution. The used solvent for dissolving the polymer powder is critical in preparing the precursor solution. In this paper, the Polyacrylonitrile (PAN)-based nanofibers were prepared in a concentration of 10 wt.% using various solvents (NMP, DMF, and DMSO). The surface morphology, porosity, and the mechanical strength of the three prepared 10 wt.% PAN-based nanofibers membranes (PAN/NMP, PAN/DMF, and PAN/DMSO) were characterized using the Scanning Electron Microscopy (SEM), Dry-wet Weights method, and Dynamic Mechanical Analyzer (DMA). Using DMF as a solvent resulted in a lon
... Show MoreSensitive information of any multimedia must be encrypted before transmission. The dual chaotic algorithm is a good option to encrypt sensitive information by using different parameters and different initial conditions for two chaotic maps. A dual chaotic framework creates a complex chaotic trajectory to prevent the illegal use of information from eavesdroppers. Limited precisions of a single chaotic map cause a degradation in the dynamical behavior of the communication system. To overcome this degradation issue in, a novel form of dual chaos map algorithm is analyzed. To maintain the stability of the dynamical system, the Lyapunov Exponent (LE) is determined for the single and dual maps. In this paper, the LE of the single and dual maps
... Show MoreABSTRACT. 4-Sulfosalicylic acid (SSA) was used as a ligand to prepare new triphenyltin and dimethyl-tin complexes by condensation with the corresponding organotin chloride salts. The complexes were identified by different techniques, such as infrared spectra (tin and proton), magnetic resonance, and elemental analyses. The 119Sn-NMR was studied to determine the prepared complexes' geometrical shape. Two methods examined the antioxidant activity of (SSA) and prepared complexes; Free radical scavenging activity (DPPH) and CUPRRAC methods. Tri and di-tin complexes gave high percentage inhibition than ligands with both methods due to tin moiety; the triphenyltin carboxylate complex was the best compared with the others. Also, antibacter
... Show MoreIn this work, an anti-reflection coating was prepared in the region (400-1000) nm of wavelength, with a double layer of silicon dioxide (SiO2) as an inner layer and the second layer of the mixture (SiO2) and titanium dioxide (TiO2) with certain ratios, as an outer layer using the chemical spraying method with a number of 6 sprays of layer SiO2 and 12 sprays of layer SiO2 - TiO2. Using the method of chemical spraying deposited on the glass as a substrate with a different number of sprays of SiO2, and a fixed number of TiO2-SiO2. The optical and structural properties were determined using UV-Vis spectroscopy and atomic force mi
... Show MoreClinical keratoconus (KCN) detection is a challenging and time-consuming task. In the diagnosis process, ophthalmologists must revise demographic and clinical ophthalmic examinations. The latter include slit-lamb, corneal topographic maps, and Pentacam indices (PI). We propose an Ensemble of Deep Transfer Learning (EDTL) based on corneal topographic maps. We consider four pretrained networks, SqueezeNet (SqN), AlexNet (AN), ShuffleNet (SfN), and MobileNet-v2 (MN), and fine-tune them on a dataset of KCN and normal cases, each including four topographic maps. We also consider a PI classifier. Then, our EDTL method combines the output probabilities of each of the five classifiers to obtain a decision b
Natural frequency under initial stresses for simply supported cross-ply composite laminated plates (E glass- fiber) are obtained using Refind theory (RPT). This theory accounts for parabolic distribution of the transverse shear strain through the plate thickness and satisfies the zero traction boundary conditions on the surfaces of the plate without using shear correction factors. The governing equations for Eigen value problem under initial stress are derived using Hamilton’s principle and solved using Navier solution for simply supported cross-ply symmetric and antisymmetric laminated plates. The effect of many design factors such as modulus ratio, thickness ratio and number of laminates on the Natural frequency and buckling stresses
... Show MoreSeveral attempts have been made to modify the quasi-Newton condition in order to obtain rapid convergence with complete properties (symmetric and positive definite) of the inverse of Hessian matrix (second derivative of the objective function). There are many unconstrained optimization methods that do not generate positive definiteness of the inverse of Hessian matrix. One of those methods is the symmetric rank 1( H-version) update (SR1 update), where this update satisfies the quasi-Newton condition and the symmetric property of inverse of Hessian matrix, but does not preserve the positive definite property of the inverse of Hessian matrix where the initial inverse of Hessian matrix is positive definiteness. The positive definite prope
... Show MoreThis research utilized natural asphalt (NA) deposits from sulfur springs in western Iraq. Laboratory tests were conducted to evaluate the performance of an asphalt mixture incorporating NA and verify its suitability for local pavement applications. To achieve this, a combination of two types of NA, namely soft SNA and hard HNA, was blended to create a binder known as Type HSNA. The resulting HSNA exhibited a penetration grade that adhered to Iraqi specifications. Various percentages of NA (20%, 40%, 60%, and 80%) were added to petroleum asphalt. The findings revealed enhanced physical properties of HSNA, which also satisfied the requirements outlined in the Iraqi specifications for asphalt cement. Consequently, HSNA can serve as an
... Show MoreIn the present study, an attempt has been to develop a new water quality index (WQI) method that depends on the Iraqi specifications for drinking water (IQS 417, 2009) to assess the validity of the Euphrates River for drinking by classifying the quality of the river water at different stations along its entire reach inside the Iraqi lands. The proposed classifications by this method are: Excellent, Good, Acceptable, Poor, and Very poor. Eight water quality parameters have been selected to represent the quality of the river water these are: Ion Hydrogen Concentration (pH), Calcium (Ca), Magnesium (Mg), Sodium (Na), Chloride (Cl), Sulphate (SO_4), Nitrate (NO_3), and Total Dissolved Solids (TDS). The variation of the water quality p
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