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Background and Aims: Thyromental height test (TMHT) is a recently described anatomical bedside screening tool in predicting difficult laryngoscopy. It has been shown to be more accurate than the modified Mallampati score, thyromental distance (TMD), and sternomental distance with regard to sensitivity and positive predictive value (PPV). Airway assessment studies based on the anatomic parameters of the upper airway are limited in the subcontinent population. We attempted this study to evaluate and validate the predictive value of TMHT at 50 mm in an Indian population in predicting difficult laryngoscopy. Methods: This prospective observational study was conducted in a tertiary teaching hospital on 340 patients. TMHT along with other bedside predictors of difficult intubation, including modified Mallampati score, interincisor gap (IIG), TMD, neck circumference (NC), and neck extension were assessed. We compared the sensitivity, specificity, PPV, negative predictive value (NPV), and diagnostic accuracy of TMHT with other bedside tests such as the modified Mallampati score, IIG, TMD, NC, and neck extension individually in predicting difficult laryngoscopy. Any Cormack and Lehane's intubation grade II b and above was considered to be difficult laryngoscopy. Results: TMHT had the highest sensitivity (84.62%) and specificity (98.97%), and had the most PPV (88%) and NPV (98.63%) when compared with the modified Mallampati score, IIG, TMD, NC, and neck extension. TMHT was followed by the modified Mallampati score and IIG. Conclusion: TMHT appears promising as a single anatomical measure to predict the risk of difficult laryngoscopy, however, validation will require further studies in more diverse patient populations.

Background: The Glasgow coma scale (GCS) is the most commonly used scale, and the full outline of unresponsiveness (FOUR) score is new validated coma scale as an alternative to GCS to measure the level of consciousness and evaluate the severity of the injury in traumatic brain injury (TBI) patients. Aims and Objectives: The present study compared the performance of FOUR scores and GCS in outcome predictions of TBI cases. Materials and Methods: This prospective and cross-sectional study was conducted over a year by the Emergency Department of a tertiary care hospital, Kovai Medical Center and Hospital, Coimbatore, India. Of 159, 123 patients were recruited from intensive care unit (ICU), and 36 from the ward were included in this study. Data were collected using an observation checklist to determine the similarities and differences in predicting outcomes using the two assessment scales (GCS and FOUR). Results: Most patients were 51-60 years (38%), with a mean age of 41.57. About 82% were male, 18% were female, and 31% had comorbidity of hypertension. Data analysis showed a significant statistical difference in mean FOUR and GCS scores between ICU and ward admission. A multivariate logistic regression study revealed that the probability of ICU admission in trauma patients from the emergency department was associated with a decline in GCS and FOUR scores. The range of predicted ICU admission was similar in both GCS and FOUR score models. Conclusion: Although both scores are good predictors of TBI patients, we concluded that the FOUR score is a recommended predictive model for patients admitted to the medical ICU. [ABSTRACT FROM AUTHOR]

Jejunal intramural hematoma (JIH) is rare. A 5-year-old girl, a known attention-deficit hyperactivity disorder child with paraneoplastic symptoms, on imaging showed a suspicion of Jejunal intramural mass with internal bleeding. Laparotomy showed a JIH. Evacuation of hematoma and Histopathological Examination (HPE) ruled out tumor. Possible explanation of the manifestation is suggested., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Journal of Indian Association of Pediatric Surgeons.)

Objective: High burden of rotavirus associated diarrhea has been documented among Indian children. The phased introduction of an indigenous rotavirus vaccine 'ROTAVAC' in India's national immunization programme began in 2017. Phase-III trial showed the vaccine to have a low-intussusception-risk profile. However, evaluation of post-licensure trends of intussusception is necessary to assess potential vaccine-associated intussusception risk. This study's objective was to describe the epidemiology of intussusception hospitalizations in children under two years of age in Tamil Nadu and Puducherry following ROTAVAC introduction., Methods: A cross-sectional surveillance was established in six hospitals in Tamil Nadu and Puducherry. Children under two years of age with intussusception fulfilling Brighton Collaboration's criteria for level 1 diagnostic certainty were enrolled. Patient and disease characteristics were captured using a standardized questionnaire. Descriptive and inferential statistical analyses were performed using Stata Version 13., Results: Overall, 287 cases were enrolled and had a median age of seven months. Frequently presenting symptoms were vomiting (78%), abdominal pain (76%), and blood in stool (71%). Abdominal ultrasonography or radiography confirmed diagnosis in 65% of cases and managed by nonoperative measures. Remaining 35% of cases were diagnosed and managed with surgery. Over 98% of the cases had positive treatment outcomes. Age less than five months (OR = 4.36), and hospitalization at a state government health facility (OR = 5.01) were significant predictors for children to receive surgical management., Conclusions: The present study documents the epidemiology of intussusceptions immediately after the rollout of rotavirus vaccine in Tamil Nadu and Puducherry. No appreciable increase in intussusception hospitalizations was seen in the study hospitals after vaccine introduction.

Kaposiform hemangioendothelioma involving whole of a leg in a neonate with Kasabach-Merritt phenomenon causing limb and life-threatening situation has not been reported. One such case and its successful management is presented in this case report. Literature review is made.

The title compound, C19H12ClF3O3, obtained by the photochemical transformation of 2-[5-chloro-2-(prop-2-yn-yloxy)benzo-yl]-3-[4-(tri-fluoro-meth-yl)phen-yl]oxirane adopts a Z conformation with respect to the enolic C=C double bond. The dihedral angle between the benzene rings is 12.25 (16)° and an intra-molecular O-H⋯O hydrogen bond closes an S(6) ring. An intra-molecular C-H⋯O inter-action also leads to an S(6) ring. In the crystal, very weak C-H⋯O inter-actions and short Cl⋯Cl contacts [3.3221 (16) Å] are seen, as well as weak aromatic π-π stacking inter-actions [centroid-centroid separation = 3.879 (2) Å].