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
Background: There are several diseases in the body following recovery from COVID-19 infection because this virus operates on human genes in various types of peripheral tissue in the human body. It penetrates host cells via Angiotensin-converting enzyme-2 receptors and may have effects on bone remodeling, leading to osteopenia or osteoporosis, which are characterized by low bone mineral density, resulting in diminished bone strength. Bone Alkaline Phpsphatase is an enzyme released into the bloodstream as a soluble homodimer after being cleaved by a phospholipase and can be utilized as a biomarker of bone development. Objective: This research was designed to investigate the alteration of bone homeostasis balance in Iraqi post-COVID-19
... Show MoreThis study was undertaken to diagnose routine settling problems within a third-party oil and gas companies’ Mono-Ethylene Glycol (MEG) regeneration system. Two primary issues were identified including; a) low particle size (<40 μm) resulting in poor settlement within high viscosity MEG solution and b) exposure to hydrocarbon condensate causing modification of particle surface properties through oil-wetting of the particle surface. Analysis of oil-wetted quartz and iron carbonate (FeCO₃) settlement behavior found a greater tendency to remain suspended in the solution and be removed in the rich MEG effluent stream or to strongly float and accumulate at the liquid-vapor interface in comparison to naturally water-wetted particles. As su
... Show MoreThis paper presents a vibration suppression control design of cantilever beam using two piezoelectric patches. One patch was used as an actuator element, while the other was used as a sensor. The controller design was designed via the balance realization reduction method to elect the reduced order model that is most controllable and observable. the sliding mode observer was designed to estimate six states from the reduced order model but three states are only used in the control law. Estimating a number of states larger than that used is in order to increase the estimation accuracy. Moreover, the state estimation error is proved bounded. An optimal LQR controller is designed then using the estimated states with the slid
... Show MoreEco-friendly concrete is produced using the waste of many industries. It reduces the fears concerning energy utilization, raw materials, and mass-produced cost of common concrete. Several stress-strain models documented in the literature can be utilized to estimate the ultimate strength of concrete components reinforced with fibers. Unfortunately, there is a lack of data on how non-metallic fibers, such as polypropylene (PP), affect the properties of concrete, especially eco-friendly concrete. This study presents a novel approach to modeling the stress-strain behavior of eco-friendly polypropylene fiber-reinforced concrete (PFRC) using meta-heuristic particle swarm optimization (PSO) employing 26 PFRC various mixtures. The cement was partia
... Show MoreHard-grade asphalt binders, such as AC 20–30, offer excellent resistance to permanent deformation but are inherently brittle, making them highly susceptible to fatigue and low-temperature cracking. While polymer modification addresses these issues, virgin polymers remain expensive. Despite the growing interest in recycled plastics, the rheological impact of complex waste streams, specifically polyvinyl chloride (PVC) derived from flex banners containing plasticizers, on excessively stiff binders within the complete Superpave Performance Grading (PG) framework remains critically underexplored. This study introduces a novel valorization approach by utilizing solvent-extracted flex banner waste (WPVC) as a dual-action modifier. It leverages
... Show MoreThe present research was conducted to reduce the sulfur content of Iraqi heavy naphtha by adsorption using different metals oxides over Y-Zeolite. The Y-Zeolite was synthesized by a sol-gel technique. The average size of zeolite was 92.39 nm, surface area 558 m2/g, and pore volume 0.231 cm3/g. The metals of nickel, zinc, and copper were dispersed by an impregnation method to prepare Ni/HY, Zn/HY, Cu/HY, and Ni + Zn /HY catalysts for desulfurization. The adsorptive desulfurization was carried out in a batch mode at different operating conditions such as mixing time (10,15,30,60, and 600 min) and catalyst dosage (0.2,0.4,0.6,0.8,1, and 1.2 g). The most of the sulfur compounds were removed at 10 min for all catalyst ty
... Show MoreIn this work a model of a source generating truly random quadrature phase shift keying (QPSK) signal constellation required for quantum key distribution (QKD) system based on BB84 protocol using phase coding is implemented by using the software package OPTISYSTEM9. The randomness of the sequence generated is achieved by building an optical setup based on a weak laser source, beam splitters and single-photon avalanche photodiodes operating in Geiger mode. The random string obtained from the optical setup is used to generate the quadrature phase shift keying signal constellation required for phase coding in quantum key distribution system based on BB84 protocol with a bit rate of 2GHz/s.
Acute 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
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