Can difficult intubation be accurately predicted using upper lip bite test?

Objective: To determine the diagnostic accuracy of Upper Lip Bite Test [ULBT] in the diagnosis of difficult intubation taking Cormack-Lehane's classification as the gold standard

Methodology: This cross-sectional validation study was carried out at Ayub Teaching Hospital, Abbotabad Hospital from February to December 2012. 450 patients aged >/=16 yr, scheduled to undergo surgery under general anesthesia were included in the study. Preoperatively, two anesthesiologists not involved in intubating the airways of the patients evaluated the patients using ULBT. Anesthesiologists, who were not informed of the preoperative upper lip bite classes, assessed difficulty of laryngoscopy at intubation according to the method described by Cormack and Lehane. The preoperative assessment data and the intubation findings were used to determine the accuracy of the above mentioned tests in predicting difficult intubation. Accuracy, Sensitivity, specificity, accuracy, and positive and negative predictive values were calculated for ULBT

Results: The mean age of the patients was 38.8+/-14.09 years and 196 [43.6%] were males. Forty seven [10.4%] of them were found at laryngoscopy to have airways that were difficult to intubate, exhibiting laryngoscopy grade III or IV. There were no failed intubations. The calculated accuracy, sensitivity, specificity, positive predictive value and negative predictive value of ULBT were 95.5%, 91.5%, 96%, 72.8% and 98.9% respectively

Conclusion: ULBT is a highly accurate, sensitive and specific for predicting difficult intubations

Comparison between signs and symptoms of medulloblastomas and desmoblastic medulloblastomas

To compare the signs and symptoms of Medulloblastomas and Desmoblastic Medulloblastomas. Retrospective study. This study was conducted at King Khalid University Hospital, Rayadh, Saudi Arabia from 1[st] January 2001 till 31[st] December 2010. Total of 37 patients were included in the study. After taking written consent from all the patients or their relatives, this study was conducted. Permission was also taken from the ethical committee of the hospital. 37 patients were included in the study. Percentage of important symptoms of intracranial tumors like headache, reduced vision and hydrocephalus was comparatively higher in medulloblastomas as compare to desmoblastic medulloblastomas. None of the desmoblastic variety had metastasis on presentation, hence all of them completely excised. Unfortunately, we were able to excise only 82.14% of medulloblastomes. 14.28% were partially excised while in 3.57% of cases, surgeon was only able to take biopsy. Desmoblastic variety of medulloblastoma had better prognosis as compare to Classical Medullblastoma