Association between standardized vitamin 25(OH)D and dyslipidemia: a community-based study in Riyadh, Saudi Arabia

BACKGROUND@#Vitamin D deficiency associated with dyslipidemia can contribute towards cardiovascular diseases. Previous studies have found that Saudi Arabia has a high burden of vitamin D deficiency and cardiovascular disease risk factors. We aimed to explore the relationship between vitamin D deficiency and dyslipidemia, including total cholesterol, low-density lipids, high-density lipids (HDL), and triglycerides (TG) in apparently healthy Saudi male and female participants aged 30-75 years.@*METHODS@#A cross-sectional study was conducted on 1717 apparently healthy Saudi participants from 18 primary health care centers in Riyadh. Data collectors conducted the interviews, took anthropometric measurements, and collected the blood samples. Serum 25-hydroxyvitamin vitamin D (25(OH)D) levels were measured using an electrochemiluminescence assay method. Lipid panel was measured by a fully automated analyzer using enzymatic methods.@*RESULTS@#Multivariable logistic regression analysis revealed that the adjusted odds ratio (OR) of low level of HDL cholesterol in association with 25(OH)D deficiency was 2.1 times higher in males (OR = 2.1; 95% CI = 1.1, 3.9) and 1.3 times higher in females (OR = 1.3; 95% CI = 0.9, 1.9). A significant excess odds ratio of high levels of TG in association with 25(OH) D deficiency was observed in females (OR = 3.0; 95% CI = 1.1, 7.9) but not in males.@*CONCLUSION@#Vitamin D deficiency is highly prevalent in Saudi Arabia. Low levels of HDL cholesterol in men and high TG levels in women are associated with vitamin D deficiency. The results emphasize the importance of treating vitamin D deficiency in the general population.

Study of obesity associated proopiomelanocortin gene polymorphism: relation to metabolic profile and eating habits in a sample of obese Egyptian children and adolescents

Background: Melanocortinergic system represents a known system involved in the central regulation of body weight with the central proopiomelanocortin [POMC] neurons forming a potent anorexigenic network. Polymorphisms in the POMC gene locus are associated with obesity phenotypes

Aim: To assess the contribution of the POMC gene 9-bp insertional polymorphism in the susceptibility to obesity and its relation to body mass index [BMI] and adiposity-related co-morbidities in obese children and adolescents; as well as binge eating behavior

Patients and methods: Fifty obese children and adolescents with simple obesity were screened for Binge Eating Disorder [BED] by The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition [DSM-5], they were compared to 50 age, sex and pubertal stage-matched non obese controls. Anthropometric measurements, blood pressure, abdominal ultrasound for fatty liver, measurement of fasting lipid profile, fasting insulin, fasting blood glucose and assessment of POMC gene 9-bp insertional polymorphism were done

Results: Obese patients had significantly higher anthropometric measurements, blood pressure percentiles, fasting glucose, fasting insulin, homeostasis model assessment for insulin resistance [HOMA-IR] and fasting lipid profiles, and higher frequency of occurrence of non alcoholic fatty liver disease and BED. Allelic frequencies of POMC gene 9 bp insertional polymorphism were comparable in patients and controls [p= 0.956]. Fasting insulin levels were significantly higher in the heterozygous cases having the polymorphism than in wild homozygous cases; whereas no difference was observed among the controls

Conclusion: This polymorphism was associated with higher fasting insulin levels in the obese patients only. These findings support the hypothesis that the melanocortin pathway may modulate glucose metabolism in obese subjects indicating a possible gene-environment interaction. POMC variant may be involved in the natural history of polygenic obesity, contributing to the link between type 2 diabetes and obesity

Dual diagnosis and suicide probability in poly-drug users

Objective: To determine the frequency of suicidal thoughts and suicidal probability among poly-substance abusers in Saudi population, and to examine the relation between dual diagnosis and suicidal thoughts

Study Design: Case control study

Place and Duration of Study: Al-Baha Psychiatric Hospital, Saudi Arabia, from May 2011 to June 2012

Methodology: Participants were 239 subjects, aged 18 - 45 years. We reviewed 122 individuals who fulfilled the DSM-IV-TR criteria of substance abuse for two or more substances, and their data were compared with that collected from 117 control persons

Results: Suicidal cases were highly present among poly-substance abusers 64.75%. Amphetamine and cannabis were the most abused substances, [87.7% and 70.49%, respectively]. A statistically significant association with suicidality was found with longer duration of substance abuse [p < 0.001], using alcohol [p=0.001], amphetamine [p=0.007], volatile substances [p=0.034], presence of comorbid psychiatric disorders [dual diagnosis] as substance induced mood disorder [p=0.001], schizo-affective disorder [p=0.017], major depressive disorders [p=0.001], antisocial [p=0.016] and borderline [p=0.005] personality disorder. Suicidal cases showed significant higher scores [p < 0.001] of suicide probability scale and higher scores in Beck depressive inventory [p < 0.001]

Conclusion: Abusing certain substances for long duration, in addition to comorbid psychiatric disorders especially with disturbed-mood element, may trigger suicidal thoughts in poly-substance abusers. Depression and suicide probability is common consequences of substance abuse

Effectiveness of prebiotic as an alternative to the antimicrobial growth promoter on growth performance, blood constituents, intestinal healthiness and immunity of broilers

This study was designed to compare the effect of the prebiotic and antimicrobial growth promoter [AGP] on the growth performance, blood constituents, intestinal bacteriology and histomorphometric parameters as well as humeral immunity of broiler chicks. A total of 90 unsexed commercial Cobb chicks were randomly assigned to 3 dietary treatments [control, AGP and prebiotic groups], each group contains 30 chicks. Each group subdivided into 3 replicates, 10 chicks each, and was reared for 42 days. The prebiotic supplemented group showed a significant improvement in growth performance parameters in comparison to the control and AGP-supplemented groups. Total leukcocytic count, lymphocyte percent, total protein, total globulin and gamma globulin were significantly increased in the broilers fed on prebiotics. Moreover, prebiotics supplementation significantly reduced heterophil percent, heterophil/ lymphocyte ratio [H/L ratio], albumin/globulin ratio, aspartate and alanine aminotransferase [AST and ALT], uric acid and creatinine compared to the AGP-supplemented and control groups. The AGP-supplemented group exhibited a significant reduction in the total aerobic count when compared to the control and prebiotic-supplemented groups. However, the prebiotic supplemented group showed a significant reduction in the coliform count when compared to the control and antibiotic supplemented groups. The prebiotic supplemented group induced a significant increase in the villus height [VH] all over the small intestine. In addition, it induced a significant increase in villus height: crypt depth ratio in the duodenum and jejunum in comparison to the control and antibiotic supplemented groups. However, there were no significant differences among the different groups regard to the crypt depth [CD] in the duodenum and jejunum. Prebiotics could be considered as safe and effective antimicrobial alternatives for broiler chicks' growth performance, immunity and intestinal bacteriology and morphology

Health related quality of life and psychological problems in Egyptian children with simple obesity in relation to body mass index

Obesity in childhood or adolescence could affect quality of life [QOL] There is little existing information about the health-related quality of life [HRQOL] of obese children and adolescents. To assess HRQOL and psychiatric co-morbidities in obese children and adolescents; and their relationship to body mass index [BMI]. Fifty obese children and adolescents were compared to 50 healthy age-, sex- and pubertal stage-matched non obese children and adolescents serving as controls. They were assessed by child self-report and parent proxy report using a pediatric HRQOL inventory scale, also, Children Anxiety Scale and Children Depression Inventory [CDI] were assessed. Obese children had total HRQOL score: 69.1 +/- 8.4 versus 81.1 +/- 7.8 respectively, p < 0.001 and their parents had total score: 62.9 +/- 9.5 versus 74.9 +/- 7.2 respectively, p < 0.001. Obese children reported lower health-related QOL scores in all domains than controls. BMI standard deviation score [SDS] correlated negatively with total score and all domains in child self report and parent proxy report. Anxiety [mild: 8%, moderate: 38%, severe: 54%] and depression [mild: 18%, moderate: 24%, severe: 58%] were pre-existing or diagnosed in all obese children with significant positive correlations between BMISDS and each of anxiety [r = 0.81, p < 0.01] and CDI scores [r = 0.78, p = 0.01]. BMI [OR: 5.72, 95%CI: 2.57-5.9] and waist circumference [OR:2.27, 95%CI: 1.99-5.31] SDSs were independent risk factors affecting the total QOL score Obese children and adolescents have lower health-related QOL that correlated negatively with BMI, also they are more susceptible to anxiety and depression symptoms than non obese children

Study of plasma amino acid levels in children with autism: an Egyptian sample

The aetiology of autism is unclear and autistic symptoms had been attributed to an abnormal functional imbalance in neurotransmitter amines such as dopamine, noradrenaline and serotonin. To study plasma essential and non-essential amino acid levels, protein electrophoresis, serum ammonia, and urea in autistic children in comparison with controls. Twenty autistic children were compared to twenty healthy age and sex matched normal children serving as control, where serum amino acids, urea, ammonia and protein electrophoresis were estimated. As regards essential amino acid levels, autistic children had significant lower plasma levels of leucine, isoleucine, phenylalanine, methionine and cystine than controls [P < 0.05],while there was no statistical difference in the level of tryptophan, valine, threonine, arginine, lysine and histidine [P > 0.05]. In non-essential amino acid levels, phosphoserine was significantly raised in autistic children than in controls [.P < 0.05]. Autistic children had lower level of hydroxyproline, serine and tyrosine than controls [P < 0.05]. On the other hand there was no significant difference in levels of taurin, asparagine, alanine, citrulline, GABA, glycine, glutamic acid, and ornithine [P > 0.05]. There was no significant difference between cases and controls as regards the levels of urea, ammonia, total proteins, albumin and globulins [alpha 1, alpha 2, beta and gamma] [P > 0.05]. Autistic children had lower levels of some plasma amino acids except for glycine and glutamic acids and phosphoserine were increased with normal serum levels of urea, ammonia, total proteins, albumin and globulins [alpha 1, alpha 2, beta and gamma]

Rate and correlates of depression among elderly people attending primary health care centres in Al Dakhiliyah governorate, Oman

This study determined the rates and correlates of depression among community-dwelling elderly people, based on data from the comprehensive health assessment conducted in Al-Dakhiliyah governorate in Oman in 2008-2010. Data covered sociodemographic characteristics, medical and nutrition status, functional abilities, depression and dementia. The rate of depression was 16.9%, higher among women than men [19.3% versus 14.3%]. Depression was independently predicted by the presence of social risk [OR = 3.44], dementia [OR = 3.17], impairment in activities of daily living [OR - 2.19], joint problems [OR -1.52] and mobility restriction [OR = 1.43]. If dementia was excluded from the model, depression was additionally predicted by poor perception of health [OR = 2.09], impairment in instrumental activities of daily living [OR -1.47] and older ages of 70-< 80 years [OR -1.63] and > 80 years [OR -1.75]. Although not presenting as a complaint, depression in not uncommon among elderly people

Knowledge, attitudes and intended behaviours towards HIV testing and self-protection: a survey of Omani pregnant women

Routine HIV testing of all pregnant women in Oman has been introduced without prior knowledge of women's attitudes towards testing or their behaviour in the event of a positive test. This study recruited 1000 Omani pregnant women from antenatal clinics to explore their knowledge of HIV/AIDS, attitudes towards HIV testing and intended behaviours in the event of a positive test. Mother-to-child transmission was recognized by 86.6% of the women but only 21.0% knew that it was preventable and a few acknowledged the important role of antiviral drugs. Half of the women [51.9%] reported having been tested for HIV and 75.8% agreed about routine HIV testing for all pregnant women. A higher level of knowledge was significantly associated with a favourable intended behaviour related to voluntary testing, disclosure and seeking professional assistance in the event of a positive HIV test. The results are discussed in relation to opt-in and opt-out approaches to voluntary testing during pregnancy

Physical activity and perceived barriers among high-school students in Muscat, Oman

A cross-sectional survey was conducted in March 2011 to study the patterns and determinants of physical activity among 439 secondary-school students in Muscat governorate based on a self-administered questionnaire. Half of the students [52.9%] were enrolled in physical education classes and 95.9% reported afterschool physical activities. The recommended level of physical activity [>/= 1680 MET minutes/week] was met by 23.9% of students, being significantly lower among girls [9.8%] than boys [38.8%]. More girls were in the stages of pre-contemplation [5.8%] and contemplation [26.7%] of adopting exercise while more boys were in the action [15.4%] and maintenance stages [36.0%]. Girls reported significantly more barriers to exercise, related to lack of energy, interest in other activities, lack of encouragement, worries about looks, and time constraints from academic responsibilities and family obligations. The full model logistic regression revealed that boys, 11th-grade students and attempts to regulate weight significantly predicted physical activity meeting the recommended levels.

controlled study of nitazoxanide [NTZ] 3 years after treatment of hepatitis C genotype

This study is an extension of an earlier, randomized; placebo-controlled that showed the efficacy of nitazoxanide [NTZ] 500 mg tablets twice daily for 6 months in treating HCV genotype 4. Access was available to 13/32 patients of the original study with chronic HCV during more than 3 years after the study was finished. One patient [with portal hypertension and oesophageal varices [O.V]] was among 3 with SVR out of 9 of the NTZ treated patients suggesting that NTZ could successfully be used even in patients with O.V. SVR remain so up to the end of the follow-up period compared to none of the other 4 patients who received placebo. A fourth patient of NTZ group achieved virological response at the end of follow-up although she firstly showed RVR and then viral breakthrough. Most of the remaining patients of the NTZ group who did not achieve SVR showed variable partial response. No serious adverse events were reported in both groups during treatment and thereafter

Fever prevalence and management among three rural communities in the North West Zone, Somalia

Between March and August 2008 we undertook 2 cross-sectional surveys among 1375 residents of 3 randomly selected villages in the district of Gebiley in the North-West Zone, Somalia. We investigated for the presence of malaria infection and the period prevalence of self-reported fever 14 days prior to both surveys. All blood samples examined were negative for both species of Plasmodium. The period prevalence of 14-day fevers was 4.8% in March and 0.6% in August; the majority of fevers [84.4%] were associated with other symptoms including cough, running nose and sore throat; 48/64 cases had resolved by the day of interview [mean duration 5.4 days]. Only 18 [37.5%] fever cases were managed at a formal health care facility: 7 within 24 hours and 10 within 24-72 hours of onset. None of the fevers were investigated for malaria; they were treated with antibiotics, antipyretics and vitamins

Pregnancy outcomes of diabetic women: charting Oman's progress towards the goals of the saint vincent declaration

Oman provides comprehensive care for the detection and management of diabetes during pregnancy with the goal of reducing or eliminating adverse outcomes for mothers and newborns. We assessed the outcome of pregnancies complicated with diabetes as compared to healthy controls. A 1-year retrospective review of registry records was conducted on pregnant women with gestational diabetes mellitus [GDM] and pre-gestational diabetes mellitus [PGDM]. Of the 5394 women registered, 225 had GDM and 56 had PGDM. Fourteen cases of GDM and 2 cases of PGDM were excluded. For each patient recruited, the next healthy control of the same age and parity was selected. Nearly 80% of diabetic women achieved good glycemic control [hemoglobin A1c <7%]. Adjusted for hypertension and body mass index, the risk of macrosomia was three times higher among women with GDM [OR=3.03, 95% CI=1.36-6.75] and up to seven times higher among those with PGDM [OR=7.20, 95% CI=2.30-22.61]. A significantly higher risk of cesarean delivery was observed among women with GDM [OR=2.70, 95% CI=1.17-4.03] and PGDM [OR=4.39, 95% CI=1.68-11.49]. Admission to the special care baby unit was higher among infants born to mothers with PGDM [OR=5.70, 95% CI=2.40-13.51] and GDM [OR=2.85, 95% CI=1.68-4.83]. The findings indicate that many of the unfavorable pregnancy outcomes of diabetes for women and infants have not been brought under control despite the comprehensive care provided. Further studies are recommended to evaluate the system of care provided to pregnant women and to identify gaps in achieving the goals of the St. Vincent Declaration

Determination of mirtazapine in spiked human plasma and tablets by first derivative spectrofluorimetric method

A sensitive first derivative spectrofluorimetric method [[1]D-spectrofluorimetry] was developed for the determination of mirtazapine. Calibration graph for mirtazapine determination was established using the first derivative amplitudes of the mirtazapine emission spectrum [lamda[ex]= 314 nm] in 0.1 M sulphuric acid measured at 375-435 nm from peak to peak, as the analytical signals. Moreover, the ratio of [1]-spectrophotometric peak amplitudes at these wavelengths was calculated and used for the detection of the presence of interferences. Linearity range was found to be between 1 and 40 ng ml[-1] with correlation coefficient [r] = 0.9999. The limit of quantitation [LOQ] was 1.0 ng ml[-1] and the limit of detection [LOD] was 0.2 ng ml[-1]. The proposed method was validated according to ICH; and it has been applied for the drug determination in human plasma without prior extraction and in tablets. The proposed method's accuracy, reproducibility, selectivity and simplicity suggest its application in quality control analysis of the drug

Protein C levels in beta-thalassemia major patients in the east Nile delta of Egypt

Thalassemic patients have an increased risk for thromboembolic complications. To determine if this might be due to a deficiency in protein C, we investigated the status of the protein C anticoagulant pathway in thalassemia major patients and its relationship to the hypercoagulable state. Fifty patients with beta-thalassemia major [30 non-splenectomized and 20 splenectomized] and 20 healthy children as a control group were tested for levels of serum ferritin, liver enzymes, serum albumin, fibrinogen, protein C and protein S, thrombin antithrombin complex [TAT] and D-dimer. Thalassemic patients had lower levels of protein C and S and higher levels of D-dimer and TAT than the control group. These findings were more obvious in splenectomized patients and in those with infrequent blood transfusion. Protein C plays a major role in the hypercoagulable state in thalassemic patients. These findings raise the issue as to whether it would be cost-beneficial to recommend prophylactic antithrombotic therapy in high-risk thalassemic patients. A wider prospective study is necessary to delineate under which circumstances therapy might be needed, and at what level of protein C deficiency to start prophylactic antithrombotic therapy

Nurses' knowledge versus their performance regarding the care of neonates undergoing phototherapy in Kuwait

Neonatal period is the first weeks of life. Some neonates during this period are 'at risk' for various health problems. Neonatal jaundice is the most common medical condition in neonates, whether physiologic or pathologic which required medical attention. It is first noticed in the face then it descends downwards as the bilirubin level increases. Phototherapy is the standard of care for the treatment of hyperbilirubinemia in neonates, where blue wavelengths of light are employed to alter unconjugated bilirubin in the skin. Neonatal nurse is the person who is responsible for providing the neonates with the essential care. She is responsible for the assessment of neonates for early detection of problems and initiation of prompt management. Providing care to a neonate with hyperbilirubin-emia requires knowledge and skills from the nurse to achieve optimal outcomes. This study aims to investigate nurses' knowledge versus their performance regarding the care of neonates' underphoto-therapy. A convenient sample of 50 neonatal nurses from Neonatal Intensive Care Units and Special Care Units of Maternity hospital located in El-Sabah Medical Region-Kuwait was the study subjects. Data were collected through an observational checklist for nurses' performance regarding care of neonates undergoing phototherapy, and a structured questionnaire of nurses' knowledge regarding care of neonates undergoing phototherapy. Results of the present study revealed that the majority of nurses had poor knowledge scores and unsatisfactory performance scores regarding the care of neonates undergoing phototherapy. Continuing education programs a-e recommended for nurses in work place and a strict and nurses' continuous supervisions are mandatory to improve nurses' performance

HLA-DRB1 alleles in Egyptian children with systemic lupus erythematosus

Systemic lupus erythematosus [SLE] is an autoimmune disease characterized by multisystem organ damage due to autoantibody production. Polymorphism in genes at the Major histocompatibility complex [MHC] region represents an important susceptibility factor for SLE, especially HLA-DRBI and HLA-DQB1. Moreover; it was noted that ethnicity has a significant role in both disease susceptibility and disease expression. This work was planned out to study HLA-DRBI alleles association with SLE susceptibility and clinical presentations in Egyptian children with juvenile onset SLE. HLA-DRBI allele typing was done using polymerase chain reaction-sequence-specific oligonucleotide probe for 65 juvenile SLE patients and compared to 150 healthy controls of the same ethnic group. P values were corrected for the number of the alleles tested [Pc]. HLADRB1 asterisk 15 allele was significantly increased in SLE children Vs controls [OR=3.44; 95%CI=1.51-7,83; P=0.004 and Pc=0.048]. No HLA-DRB1 allele was found to be statistically significantly associated with renal, musculoskeletal, cutaneous, hematologic, cardiac or neuropsychiatric manifestations in children with SLE [P>0.05]. Although HLADRB1 asterisk 15 [15g] allele may be a susceptibility allele in Egyptian children with juvenile SLE; however HLA-DRB1 alleles do not contribute to SLE clinical presentations in these children

Molecular detection, isolation and characterization of avian rotavirus from broiler chicken

Chicken rotaviruses [CRVs] were detected, identified and characterized in broiler chicken with diarrhea for the first time in Egypt Fecal samples were collected from 85 naturally occurring diarrheal outbreaks in commercial chicken broilers fmis that are located in a wide range of geographical areas including many Egyptian govemorates mainly 6th Octobar, Elfayom, Giza, Qaluobea, Menofla and Elmansoura during year 2008. CRV was detected in the fecal samples by ELISA using monoclonal antibodies [Mabs] against VP6, Electron Microscopy [EM], Reverse Transcription-Polymerase Chain Reaction [RTPCR] and the virus was isolated using SPF chickens. The obtained results confirmed the isolation and identification of group A chicken rotavirus while the molecular characterization analysis using different primers sets suggested that the isolated chicken rotavirus does not belong to the same cluster of Chi rotavirus strain but most likely more related to Po-13 strain [mammalian like chicken rotavirus strains]. This study reports the importance of rotaviruses in broiler chickens with delayed growth and diarrhea

Carbon dioxide reforming of methane on Ni/CaO-AI2O3 catalysts

NiO/AI2O3 and NiO/CaO-AI2O3 samples were prepared and calcined at 700-900°C. Characterization of these samples was made using X-ray diffraction, low temperature nitrogen adsorption, thermal programmed reduction [TPR] and chemisorption of hydrogen at 700°C. The samples were reduced and the initial catalytic methane reforming activities were determined at 700°C. The crystalline phases in each catalyst and their domination as well as textural properties of the catalysts depend on the chemical composition and calcination temperatures. The thermal programmed desorption profiles and the chemisorption of hydrogen depend on the chemical composition of the catalysts and their calcinations temperature. Hydrogen chemisorption allowed the determination of important catalytic parameters which play dominant roles in determining the initial activity of these catalysts toward methane reforming to synthesis gas by carbon dioxide at 700°C

Purification of wet-process phosphoric acid by solvent extraction

High grade phosphoric acid can be obtained using liquid-liquid extraction technique. The influence of type of solvent, solvent concentration, organic/aqueous phase ratio, temperature, shaking time and phosphoric acid concentration on P2O5 extraction was studied. Scrubbing and stripping were also investigated, n-octanol proved to be the most efficient and selective. The temperature has a slight positive effect and the extraction was enhanced by increasing P2O5 and with the increase of organic/aqueous phase ratio. The stripping efficiency slightly increased with shaking time and the optimum organic/aqueous phase ratio was determined to be 2.0. For 9.2 M H3PO4, 99.90% of iron, 97.99% of fluoride and 99.99% of manganese were removed whereas complete removal of copper, cadmium and zinc was attained

hemodynamic effects and complications of tracheal intubation with intubating laryngeal mask airway: a comparison with direct laryngoscopy

The intubating laryngeal mask airway [ILMA] is designed to facilitate blind tracheal intubation. Direct laryngoscopy, to facilitate tracheal intubation, produces a marked pressor response. This randomized, controlled study -was undertaken to compare the complications of insertion and hemodynamic effects following tracheal intubation through intubating laryngeal mask airway [ILMA] with that of conventional Macintosh laryngoscope. One hundred adult patients undergoing elective surgery were randomly allocated into two equal-sized groups. All patients received general anesthesia using a standard balanced anesthesia technique. Tracheal intubation was performed using either intubating laryngeal mask airway or Macintosh laryngoscope. The intubation time, number of attempts required for successful intubation, the problems encountered during intubation, hemodynamic changes and postoperative pharyngolaryngeal complications were recorded. Time to intubation was comparatively longer in ILM.4 group than laryngoscopy group [58.6 +/- 8.2 sec. versus 29.2 +/- 5.6 sec. p <0.001]. The overall intubation success rate was comparable among the two study groups. The changes-in mean blood pressure were significantly less in ILMA group as compared to laryngoscope group [p <0.05]. The incidence of postoperative sore throat and hoarseness of voice was comparable among groups. Our results suggest that ILMA offers advantage over laryngoscope in minimizing the hemodynamic effects to intubation. Therefore, it can be used as a suitable alternative to laryngoscopy for tracheal intubation