Determination of the diagnostic value of the Modified Mallampati Score, Upper Lip Bite Test and Facial Angle in predicting difficult intubation: A prospective descriptive study

2017 ◽  
Vol 37 ◽  
pp. 99-102 ◽  
Author(s):  
Ata Mahmoodpoor ◽  
Hassan Soleimanpour ◽  
Samad EJ Golzari ◽  
Arezoo Nejabatian ◽  
Tannaz Pourlak ◽  
...  
Keyword(s):  
Difficult Intubation ◽  
Descriptive Study ◽  
Diagnostic Value ◽  
Upper Lip ◽  
Mallampati Score

Comparison of Upper Lip Bite Test and Ratio of Height to Thyromental Distance in Predicting Difficult Tracheal Intubation in South Indian Population – A Descriptive Study

2021 ◽  
Vol 8 (27) ◽  
pp. 2412-2416
Author(s):  
Baseema Thayyil ◽  
Neetha Thattaparambil Chandran ◽  
Asish Karthik ◽  
Maya Gomathy Amma
Keyword(s):  
Tracheal Intubation ◽  
General Anaesthesia ◽  
Difficult Intubation ◽  
Descriptive Study ◽  
Kappa Statistics ◽  
Fisher Exact Test ◽  
South Indian Population ◽  
Upper Lip ◽  
Airway Assessment ◽  
South Indian

BACKGROUND Failure in managing the airway is the most important cause of death in patients undergoing general anaesthesia (GA). For effectively preventing airway catastrophe it is essential to have a meticulous airway assessment pre-operatively. Many methods are in use to predict difficult airway like Mallampati, Wilson’s scoring, percentage of glottic opening (POGO) scoring, Cormack - Lehane classification, thyromental distance, mandibular hyoid distance, atlantooccipital joint extension etc. In this study, we compared between two popular methods of airway assessment, upper lip bite test (ULBT) and height to thyromental distance ratio (RHTMD) to predict the difficulty in tracheal intubation. METHODS This descriptive study was conducted at Government Medical college, Thrissur, over a period of one year , on 76 patients of American society of Anaesthesiologist (ASA) - PS l - lll, requiring general anaesthesia. ULBT and RHTMD were used to assess the patient’s airway. It was correlated with Cormack - Lehane classification during direct laryngoscopy. The data was analysed using Fisher exact test (P < 0.05) and Kappa statistics. RESULTS Out of the 76 patients, 41 (53.9%) were women 35 were men (46.1 %). ULBT predicted 89.6 % [25 + 43] belonging to class 1 and 2 as easy, while 10.5 % [8] of class 3 as difficult. RHTMD predicted 35 patients (46 %) as easy (grade 1) and 41 patients (54 %) as grade 2. Using ULBT, of the 8 patients predicted to have difficult intubation (Class 3), 2 were found practically difficult and 6 were easy. In remaining 68 patients, 23 patients had difficult view and 45 had easy view. According to Cormac and Lehane, among 41 patients who predicted difficult by RHTMD, 19 patients were practically difficult and 22 were easy. Of 35 patients, 6 patients were difficult and 29 were easy. CONCLUSIONS The RHTMD is more sensitive compared to ULBT in predicting difficult intubation. As assessed by Cormack - Lehane classification. KEYWORDS Difficult Intubation, Ratio of Height to Thyromental Distance, Upper Lip Bite Test

scholarly journals Comparison of Upper Lip Bite Test with Modified Mallampati Score in Predicting Difficult Intubation

2022 ◽  
Vol 7 (1) ◽  
pp. 1-8
Author(s):  
Monish Thomas ◽  
Nichelle M. Saldanha
Keyword(s):  
Difficult Airway ◽  
Endotracheal Intubation ◽  
Difficult Intubation ◽  
Anaesthetic Management ◽  
Class Iii ◽  
Upper Lip ◽  
Intubation Difficulty ◽  
Mallampati Score ◽  
Difficulty Scale ◽  
A Prospective Study

Background and Aims: Identifying a patient with a difficult airway is important in planning anaesthetic management so that endotracheal intubation can be achieved safely. This study aims to compare modified Mallampati score with Upper Lip Bite Test to predict difficult intubation using intubation difficulty scale. Materials and methods: A prospective study was carried on 104 patients, both sexes aged between 18 to 60 years scheduled for elective surgeries under general anaesthesia fulfilling inclusion and exclusion criteria. Patient airway was evaluated by MMT and ULBT preoperatively. Predictors of difficult endotracheal intubation were assigned to MMT class III and IV, ULBT class III. After premedication and induction laryngoscopy was performed. After successful intubation Intubation difficulty score was noted down based on the sum of seven assessing parameters. A score >5 was considered difficult intubation. Results: The incidence of difficult intubation in the study was 10.6% (i.e. 11 out of 104 patients). In this study ULBT had a higher sensitivity (90.9% v/s 18.20%), specificity (95.7% v/s 75.3%) PPV (71.4% v/s 8%) and NPV (98.9% v/s 88.6%) than that of MMT Conclusion: Upper lip bite test is better at predicting difficult intubation with higher accuracy when compared to Modified Mallampati test. Both the tests are good predictors of easy intubation. Keywords: Upper Lip Bite Test (ULBT), Modified Mallampati test (MMT), Intubation Difficulty scale (IDS), airway assessment. Difficult intubation prediction, Difficult airway

PREDICTION OF DIFFICULT INTUBATION BY USING UPPER LIP BITE, THYROMENTAL DISTANCE AND MALLAMPATI SCORE IN COMPARISON TO CORMACK AND LEHANE CLASSIFICATION SYSTEM

2021 ◽  
Vol 74 (9) ◽  
pp. 2305-2314
Author(s):  
Ahmed Salam Dawood ◽  
Bashar Zuhair Talib ◽  
Istabraq Sadoon Sabri
Keyword(s):  
Endotracheal Intubation ◽  
Sensitivity And Specificity ◽  
Difficult Intubation ◽  
Classification System ◽  
Elective Surgery ◽  
Upper Lip ◽  
Cross Sectional ◽  
Mallampati Score ◽  
Routine Monitoring ◽  
Venous Cannula

The aim: To evaluate efficacy of Modified Mallampati test (MMT), upper lip bite test (ULBT) and Thyromental distance (TMD) or combination of two method Modified Mallampati test (MMT)+ upper lip bite test (ULBT), Thyromental distance (TMD) + upper lip bite test (ULBT) in prediction of difficult intubation in patients undergoing GA. Materials and methods: Three tests were carried out in all patients by a single anesthesiologist. These were MMT, ULBT and TMD. Laryngoscopy was performed with patient’s head in the sniffing position. The laryngoscopy view was graded according to modified Cormack and Lehane classification system. Study was prospective, single cross sectional, in 151 adult patients who required GA with endotracheal intubation for elective surgery. On arrival in the operating room, routine monitoring and venous cannula were introduced. Midazolam, Fentanyl. and rocuronium, ketamine , propofol were given to facilitate endotracheal intubation. Results: Out of 150 assessed patients, 18 (12%) had difficult intubation. Of those 18 patients, 17 (83.33%) patients had Cormack and Lehane classification III and one patient (16.67%) had classification IV. Compared with Cormack and Lehane classification system as the gold standard for difficult intubation, the sensitivity and specificity of MMT was 66.67% and 96.97% respectively, while ULBT had a sensitivity of 77.78% and a specificity of 93.18%, and TMD had a sensitivity of 55.56% and specificity of 94.97% respectively. A combination of different tests improved their efficiencies. The sensitivity and specificity MMT and TMD combinations was 77.78% and 92.42% respectively, while it was 88.89% and 93.18%, respectively for MMT and ULPT. The combination of TMD and ULBT has a sensitivity of 88.33% and a specificity of 91.67%. Conclusions: Upper lip biting test has the best sensitivity while MMT had the best specificity. No single test alone can be reliable for predicting of difficult intubation. The combination of ULBT and MMT was the best in terms of both sensitivity and specificity for prediction of difficult intubation.

Is Quantitative Determination of Fibrin(ogen) Degradation Products and Thrombin-Antithrombin III Complexes Useful to Diagnose Deep Venous Thrombosis in Outpatients?

1989 ◽  
Vol 62 (04) ◽  
pp. 1043-1045 ◽  
Author(s):  
Paul F M M van Bergen ◽  
Eduard A R Knot ◽  
Jan J C Jonker ◽  
Auke C de Boer ◽  
Moniek P M de Maat
Keyword(s):  
Quantitative Determination ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Antithrombin Iii ◽  
Degradation Products ◽  
Family Doctor ◽  
Diagnostic Value ◽  
Impedance Plethysmography ◽  
Fibrin Degradation Products

SummaryWe studied the diagnostic value of recently introduced ELISA’s for the determination of thrombin-antithrombin III (TAT) complexes, fibrin degradation products (FbDP), fibrinogen degradation products (FgDP) and total degradation products (TDP) for deep venous thrombosis (DVT) in plasma of 239 consecutive outpatients, suspected for DVT by their family doctor. DVT was confirmed by impedance plethysmography in 60 patients. Using the 95th percentile range of 42 healthy volunteers the sensitivity for the detection of DVT was: 37% for TAT, 95% for TDP, 92% for FbDP and 90% for FgDP. Specificity was: 88% for TAT, 16% for TDP, 20% for FbDP and 25% for FgDP.We conclude that these assays are of little value in the diagnosis of DVT in outpatients.

GASCHROMATOGRAPHIC DETERMINATION OF STEROIDS IN THE URINE OF PATIENTS WITH CUSHING'S SYNDROME

1971 ◽  
Vol 67 (2) ◽  
pp. 303-315 ◽  
Author(s):  
A. J. Moolenaar ◽  
A. P. van Seters
Keyword(s):  
Liquid Chromatography ◽  
Cushing’S Syndrome ◽  
Normal Subjects ◽  
Diagnostic Value ◽  
Cushing's Syndrome ◽  
Gas Liquid Chromatography ◽  
Obese Subjects

ABSTRACT The 17-oxosteroids were estimated in the urine of 27 patients with Cushing's syndrome by gas-liquid chromatography (G. L. C.). The values of the various steroid fractions are compared with those of normal subjects, patients with thyrotoxicosis and obese subjects. The effect of the age of the patients on the diagnostic value of the invidual 17-oxosteroids and their ratios is discussed.

scholarly journals Evaluation of free and total L-thyroxine in serum by a commercial procedure.

1981 ◽  
Vol 27 (1) ◽  
pp. 149-152 ◽  
Author(s):  
M J Obregon ◽  
A Kurtz ◽  
R Ekins ◽  
G Morreale de Escobar
Keyword(s):  
Pregnant Women ◽  
Plasma Proteins ◽  
Diagnostic Value ◽  
Free Thyroxine ◽  
Total Thyroxine ◽  
Dialysis Method ◽  
Hypothyroid Patients ◽  
Hyperthyroid Patients ◽  
Normal Controls

Abstract We assessed a commercial kit (Corning Medical) for "free" and total thyroxine determination, results being compared to those obtained by the Ekins and Ellis dialysis method (free thyroxine) and the method of Weeke and Orskov (total thyroxine). The kit procedure permits determination of both free and total thyroxine within 4 to 5 h, and the combined results may disclose changes in binding to plasma proteins that would be missed if only free thyroxine were determined. With both free-thyroxine methods, the values distinguished hyperthyroid patients from normal controls and pregnant women with 100% accuracy, but there was some overlap between hypothyroid patients and controls. Absolute values with the kit procedure often exceed those obtained by dialysis, especially for hypothyroid patients and pregnant women. We conclude that the kit may be of as much diagnostic value as the dialysis method if the limitations regarding absolute values are kept in mind and the test is not used as a substitute for thyrotropin determinations in cases of suspected hypothyroidism.

PATENT DUCTUS ARTERIOSUS WITH REVERSAL OF FLOW

PEDIATRICS ◽  
1956 ◽  
Vol 18 (3) ◽  
pp. 410-423
Author(s):  
Ray C. Anderson ◽  
Paul Adams ◽  
Richard L. Varco
Keyword(s):  
Patent Ductus Arteriosus ◽  
Ductus Arteriosus ◽  
Diagnostic Value ◽  
Successful Outcome ◽  
Exertional Dyspnea ◽  
Artery Segment ◽  
Pulmonary Arterial ◽  
The Right ◽  
Patent Ductus

Ten cases are presented of children having patent ductus arteriosus with reversal of shunt. Cyanosis, often greater in the toes, was present in all. Exertional dyspnea developed early. Murmurs were of no diagnostic value, but an accentuated pulmonic second sound was uniformly present. Right ventricular preponderance was found in all cases on the electrocardiogram. Cardiac size varied on roentgenography, but there was usually prominence of the pulmonary artery segment. Six cases showed evidence of bi-directional shunts, one showed only a reversed shunt, while data were insufficient to determine this point in the remaining three. Three patients had surgery, one with a successful outcome. The latter was a 1-year-old infant in whom lung biopsy at surgery revealed only minimal pulmonary arterial changes. Forty-five cases are reviewed from the literature. The majority of these occurred in adults. Twenty-two have been subjected to surgery, four with good results, three of the latter being children. The differential diagnosis is briefly discussed. The safest and simplest diagnostic test to perform is the determination of oxygen saturation of samples of blood obtained simultaneously from the right brachial and femoral arteries. Angiocardiography and cardiac catheterization also provided helpful information. The diagnosis will not be made unless the examiner keeps the entity in mind. The entity can no longer be considered rare. Surgical treatment of the condition has been very disappointing, especially in the adult. There is reason to believe that surgical intervention very early in life will yield a higher salvage rate.

scholarly journals Descriptive Study of the Different Tools Used to Evaluate the Adherence to a Gluten-Free Diet in Celiac Disease Patients

Nutrients ◽  
2018 ◽  
Vol 10 (11) ◽  
pp. 1777 ◽  
Author(s):  
Luis Rodrigo ◽  
Isabel Pérez-Martinez ◽  
Eugenia Lauret-Braña ◽  
Adolfo Suárez-González
Keyword(s):  
Celiac Disease ◽  
Multidisciplinary Approach ◽  
Descriptive Study ◽  
Duodenal Mucosa ◽  
Gluten Free Diet ◽  
Gluten Free ◽  
Autoimmune Process ◽  
Duodenal Biopsies

Celiac disease (CD) is a genetically conditioned autoimmune process that appears in susceptible people. It can affect people of any age, and slightly predominates in females. It has a fairly homogenous global distribution, with an average prevalence of 1–2%, the frequency having increased in recent decades. The only effective treatment is a strict and permanent gluten-free diet (GFD), although the level of compliance is poor, at about 50% of cases. To monitor the effectiveness of the GFD, several procedures involving various approaches are employed: (a) Periodic visits by expert Nutritionists; (b) Clinical follow-up; (c) Serological time controls of specific antibodies; (d) Serial endoscopies with collection of duodenal biopsies; (e) Use of structured questionnaires; and (f) Determination of gluten peptides derived from gluten in faeces and/or urine. All of these procedures are useful when applied, alone or in combination, depending on the cases. Some patients will only need to consult to their doctors, while others will require a multidisciplinary approach to assess their compliance with the GFD. In children, normalization of duodenal mucosa was achieved in 95% of cases within two years, while it is more delayed in adults, whose mucosa take longer time (3–5 years) to heal completely.

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