Reliability of Friedman Staging System and Modified Mallampati Scoring as clinical assessment methods for Obstructive Sleep Apnea - A cross sectional study.

OBJECTIVE: To assess the utility of oropharyngeal crowding indicators as predictors of Obstructive Sleep Apnea (OSA). METHODS: STOP-BANG Questionnaire was administered to 145 adults. Of the 95 with high OSA risk, 42 underwent polysomnography. Intraoral space was assessed using modified Mallampati (MMP) and Friedman Scoring (FS) System. RESULTS: Twenty-four were found to have OSA by polysomnography. Most with low risk (86%) had only Class I MMP. Whereas Class III and IV were seen in 37.9% and 17.9% patients with high risk (p < .001) and 50% and 20.8% patients with OSA (p < .831), respectively. All with low risk had Stage 1 FS. Stages 3 and 4 were observed in 27.4% and 1.1% in the high-risk group (p < .001) and in 29.2% and 4.2% with OSA (p < .092), respectively. CONCLUSION: In limited settings, either MMP or FS scores along with the STOP-BANG questionnaire can be used to diagnose OSA.

Clinical spectrum of Silver - Russell syndrome.

Silver - Russell syndrome is a clinically and genetically heterogenous condition characterized by severe intrauterine and postnatal growth retardation, craniofacial disproportion and normal intelligence downward curvature of the corner of the mouth, syndactyly and webbed fingers. Diagnosis of Silver - Russell syndrome remains clinical; no definite etiology or specific tests have been established. In the recent years, it has been shown that more than 38% of patients have hypomethylation in the imprinting control region 1 of 11p15 and one-tenth of patients carry a maternal uniparental disomy of chromosome seven. The pathophysiological mechanisms resulting in the Silver - Russell phenotype remain unknown despite the recent progress in deciphering the molecular defects associated with this condition. This case report describes the clinical features of Silver - Russell syndrome in a father and daughter.