Academic literature on the topic 'Upper lip bite test'

Objective: We conducted a prospective, double-blind study todetermine whether a difficult endotracheal intubation could be predicted preoperatively by a simple new technique, theupper lip bite test and compared it with three other tests used for prediction of difficult intubation: Modified Mallampaticriteria (MMC), Thyromental distance (TM) and Mouth opening (MO). Materials and Methods: Five hundred patients,aged above 16 years, and presenting for elective surgery were subjected to the following assessments: (1) Upper lipbite test (ULBT), class I: lower incisors can bite the upper lip above the vermilion line; class II: lower incisors can bitethe upper lip below the vermilion line; class III: lower incisors cannot bite the upper lip; (2) Oropharyngeal classaccording to the MMC. (3) The distance between the chin and thyroid cartilage (thyromental distance). (4) Extend ofmaximum mouth opening test. Results: ULBT had significantly higher accuracy (96%) and specificity (98.3%) and thelowest rate of false positive (p< 0.001). The most sensitive test was the TM test (42%). Conclusion: We concludedthat comparison of the three tests, UPBT has sufficient value in predicting difficult intubation in adults

Objective: To compare sensitivity, specificity, positive and negative predictive values of upper lip bite test and modified mallampatti test to predict difficulty in endotracheal intubation in patients between 16 to 55 years of age. Methods: One hundred ASA1/2 patients admitted for elective surgical procedure requiring endotracheal intubation were prospectively studied to predict difficult intubation in age group 16-55 years of age after obtaining an informed consent. Preoperative Airway assessment was done with modified mallampatti test and upper lip bite test. Results: In our study, eighty four had Upper lip bite test (ULBT) class I and II and sixteen patients had class III. Of these two ofthe ULBT class Iand II and five of the ULBTclassIII had Cormack Lehane grade III . There were one hundred patients predicted to be easy for intubation by MMT (i.e. patients who had ULBT class I and II) out of whom however, we encountered difficult intubation in 6 patients. One in MMT class III also had difficult intubation. None of the patients had class IV MMT.Of the entire one hundred patients, a total of seven patients had difficult intubation, all of whom had Cormack Lehane class III on laryngoscopy. Conclusion: Upper Lip Bite Test (ULBT)is a better test at predicting difficult endotracheal intubation when compared toModified Mallampati Test (MMT). Upper lip bite test and modified mallampatti classification are good predictors of easy intubation rather than difficult intubation. Upper lip bite test should be used in combination with other airway assessment methods viz. Thyromental distance, hyomental distance, inter incisor distance to predict difficult intubation.

Background: Insertion of endotracheal tube is the basic skill acquired by all anesthesiolo­gists. An unanticipated difficult intubation can be catastrophic and is one of the major causes of morbidity and mortality in anesthetic practice. So, there are multiple screening tests de­signed to correctly predict difficult intubation but none of them are 100 % accurate. The study aimed to compare the Modified Mallampatti test with Upper Lip Bite test for correct prediction of difficult intubation. Methods: A cross-sectional study was conducted in the College of Medical Sciences, Bharatpur from 16th June 2020 to December 31st 2020. A total of 610 patients requiring general anesthe­sia with endotracheal intubation were included in the study. The Modified Mallampatti test and Upper Lip Bite test along with laryngoscopy was performed by an experienced anesthesiologist. Sensitivity, specificity, accuracy and positive and negative predictive values for both tests were calculated and compared. Results: The incidence of difficult intubation was 17.7% in our study. The upper lip bite test showed better sensitivity (79.63% vs 37.96%), specificity (93.82% vs 69.92%), positive predictive value (73.5% vs 21.35%), negative predictive value (95.53% vs 83.97%) and accuracy (91.31% vs 64.26%) compared to Modified Mallampatti test Conclusions: Upper lip bite test was a better predictor of difficult intubation compared to MMT with higher accuracy and predictive values.

INTRODUCTION: Various anatomical measurements and non‑invasive clinical tests can be performed to predict difficult intubation. Recently introduced “Upper lip bite test” (ULBT) is claimed to have a high predictability. However, limited data exists to support its high predictability both nationally and internationally.
 OBJECTIVE: To determine the diagnostic accuracy of upper lip bite test in the prediction of difficult airway.
 METHODOLOGY: This was a cross sectional study. A sample of 283 patients was calculated by using WHO sample size calculator and sampling was done by non-probability consecutive sampling. All the selected patients were assessed for upper lip bite test and Cormack and Lehane laryngoscopy grade separately. Data was collected on pre-designed proforma. Accuracy of ULBT was calculated based on the acquired data.
 RESULTS: The calculated accuracy of ULBT for predicting difficult airway was found to be 91.2%.
 CONCLUSION: ULBT is a reliable bedside technique with a high accuracy for predicting a difficult airway.
 KEY WORDS: Upper lip bite test, Cormack and Lehane scale, difficult airway.

Objective: To compare the accuracy of Upper lip bite test with modified Mallampati classification for predicting the difficultlaryngoscopic intubation. Study Design: Cross sectional Study. Place and duration of study: The study was carried out at Department ofAnaesthesiology, Intensive Care and Pain management, Combined Military hospital, Rawalpindi from September 2008 to August 2009.Patients and Methods: Four hundred patients undergoing elective surgery meeting the inclusion/exclusion criteria were enrolled afterwritten informed consent. The airways of the patients were evaluated by using the modified Mallampati classification (MMP) and theUpper lip bite test (ULBT). MMP class 3 or 4 and ULBT class 3 were considered as indicators of difficult intubation. The laryngeal view wasgraded by Cormack and Lehane classification (Gold standard). Grade 1 or 2 was considered to represent easy intubation and grade 3 or 4to represent difficult intubation. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy werecalculated for both the tests separately by using the 2×2 table. Results: ULBT had a higher accuracy of 94%, specificity of 99.2% andpositive predictive value 70% compared to MMP accuracy of 82.7%, specificity of 84.4% and positive predictive value of 22.7%.Conclusions: The diagnostic accuracy of the Upper lip bite test was more than the modified Mallampati classification. We suggest that itbe compared with the other prevailing tests as well which are often used to assess difficult intubations.

Introduction: The prediction of difficult intubation using simple bedside test is of great importance to prevent mismanagement of airway. This study was conducted to compare Upper Lip Bite Test (ULBT) with Modified Mallampati Test (MMT) and Thyromental Distance (TMD) for the prediction of difficult intubation.
 Method: This was descriptive cross-sectional study conducted in 121 patients of American Society of Anaesthesiologists Physical Status (ASA PS) I and II patients scheduled for elective surgery requiring general anaesthesia with endotracheal tube. The airway assessment of the patients was done one day prior to the surgery using Upper Lip Bite Test (ULBT), Modified Mallampati Test (MMT) and measurement of Thyromental Distance (TMD) . On the day of surgery during laryngoscopy, Cormack-Lehane (CL) grading was recorded. The CL grading of III and IV was labeled as difficult intubation. The Sensitivity, Specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV), Likelihood Ratio (LR) of ULBT, MMT and TMD were calculated and compared.
 Results: The total percentage of difficult intubation, defined by Cormack-Lehane (CL) III and IV was 16.52 %. The sensitivity, specificity, PPV, NPV and accuracy of Upper Lip Bite Test (ULBT) was 50%, 100%, 100%, 91% and 91.74% respectively. ULBT had a significantly higher sensitivity, specificity and PPV when compared to MMT or TMD or MMT and TMD when combined together.
 Conclusions: Upper Lip Bite Test (ULBT) is better predictor of difficult intubation and it should be used along with other test during airway assessment.

Objective: To study the ability of upper lip bite test and thyromental distance to predict difficult endotracheal intubation when compared to standard assessment tests such as Mallampati and inter incisor distance. Study Design: Cross-sectional validation study. Place and Duration of Study: Department of Anesthesiology, Pak-Emirates Military Hospital, Rawalpindi, Pakistan, Sep 2020 to Mar 2021. Methodology: We studied a total of 50 patients who reported for the administration of general anesthesia. All patients underwent evaluation with modified Mallampati test, upper lip bite test and thyromental distance test. All participants underwent subsequent intubation according to a standard protocol. The researcher documented difficult intubations. Results: We found the upper lip bite test to have a sensitivity of 75.7%, a specificity of 84.2%, and a diagnostic accuracy of 78.6%. Thyromental distance had a sensitivity, specificity, and diagnostic accuracy of 51.4%, 78.9% and 60.7%, respectively while the modified Mallampati had a sensitivity of 64.9%, 89.5%, specificity and a diagnostic accuracy of 73.2%. Conclusion: Upper lip bite test is a useful bedside assessment tool with which to predict the probability of a difficult endotracheal intubation. Height to thyromental distance ratio test is also acceptable for rapid assessment.

Contents. What is orthodontics?. Definitions. Orthodontic assessment. The Index of Orthodontic Treatment Need. Cephalometrics. More cephalometrics. Treatment planning. Management of the developing dentition. Extractions. Extraction of poor quality first permanent molars. Spacing. Distal movement of the upper buccal segments. Buccally displaced maxillary canines. Palatally displaced maxillary canines. Increased overjet. Increased overbite. Management of increased overbite. Anterior open bite (AOB). Reverse overjet. Crossbites. Anchorage. Temporary anchorage devices (TAD). Removable appliances. Fixed appliances. Functional appliances—rationale and mode of action. Types of functional appliance and practical tips. Orthodontics and orthognathic surgery. Cleft lip and palate.

The objective of this study was to report a clinical case of a patient diagnosed with mucocele in the lower lip, describing its pathology, identification and treatment. Mucocele occurs in the lower lip, but can also be found in the upper lip, tongue, oral mucosa, and rarely in the retromolar region and palate. It is one of the benign lesions that most affects the oral cavity, commonly asymptomatically. They can be confused with ranulas, but are differentiated by their location, since ranulas are located on the floor of the mouth and under the tongue. It manifests clinically with a bluish or colorless coloration, translucent and circumscribed. In some cases, the lesion ruptures spontaneously. A seven-year-old female patient attended the dental clinic complaining of an asymptomatic “lump on the lower lip”. The guardian reported that the child frequently bit her lips and that this had manifested three times. After clinical examination, the presence of a traumatized salivary gland in the lower lip was observed. The diagnosis of mucocele was obtained. Due to the complaint of the guardian of recurrence of this lesion that was occurring for the third time, after diagnosis and planning by the dental surgeon, the traumatized gland was excised and sutured. The child was cooperative during the surgery, which was performed under local anesthesia, dispensing with general anesthesia. After complete excision of the mucocele, the guardian was instructed to instruct the child not to bite his lip anymore, avoiding recurrence of the lesion. The patient returned after 30 days, without complaints of recurrence of the mucocele. The case was followed up for six months and no further recurrence was observed. It was concluded that the topic addressed is of high relevance, therefore the pediatric dentistry professional must be aware of mucocele for correct diagnosis and treatment, in addition to instructing the guardian on the importance of the patient's cooperation to prevent recurrence.

Objective: This study investigates the perception of facial aesthetics and the attractiveness of the smile, with associated malocclusions and lip piercing, via eye tracking. Methods: In the frontal images of the smiling faces of a male and a female, the teeth were altered by adding the IOTN grades 1, 5, and 8, in conjunction with a "ball" type piercing located in the upper left lip. The images were evaluated by 96 laypeople aged 18 to 76 years old and divided into young adults, middle-aged adults, and elderly people. Two software programs, OGAMA, and The Eye Tribe Tracker®, were used together. A visual analog scale (VAS) was applied with a questionnaire surveying individuals' perceived employability, honesty, intelligence, and ability to meet obligations. Kruskal-Wallis and one-way ANOVA tests were applied (p<0,05). Results: There was no difference in the ANOVA test for assessing AOI at the first fixation of the gaze or in the fixation time, regardless of the age or sex of the raters. The presence of a piercing does not cause an initial focus on the piercing area. Images with IOTN grade 1 showed more attractiveness than IOTN grades 5 and 8 for both genders. “Employability”, “intelligence”, and “meets the obligations” influence VAS response. Conclusions: Piercing did not obscure the malocclusion. Young adults consider people with aligned teeth more intelligent and have a greater chance of finding a job than middle-aged and elder adults, independent of the presence of piercings.

Objective: To report a case of a senile patient with colorectal cancer, multiple adenomatous polyps, renal tumor and COVID-19. To analyze the proposed therapies and the relevance of rectosigmoidectomy and nephrectomy as a treatment for rectal adenocarcinoma and renal carcinoma. Case details: Male patient, 82 years old, sought a hospital in 2019 with abdominal pain crises, extensive ecchymosis in the right upper limb, petechia in the lower lip, chills, diaphoresis, hematuria and melena. Colonoscopy showed a vegetating rectal lesion, ascending colon polyps and colonic diverticulosis. In June 2020, developed dyspnea, fever, weakness and general malaise, confirming COVID-19 in laboratory tests, cured two weeks after treatment. In August 2020, the colonoscopy, several sessile polyps and a 5 cm polypoid lesion in the rectum were observed. Biopsy indicated rectal adenocarcinoma. Renal tumor on the right was identified by computed tomography of the abdomen and ultrasound of the total abdomen. The patient was then submitted to rectosigmoidectomy with colorectal anastomosis and nephrectomy on the right. Final considerations: The colonoscopy is still considered an excellent screening test for intestinal polyps. Regarding rectal adenocarcinoma, rectosigmoidectomy is considered an effective curative treatment. Finally, COVID-19 is considered a risk factor for high mortality in cancer patients.

ABSTRACT: Rotary-percussive drilling technique is an efficient rock-breaking method and can be applied in geothermal drilling. The rock’s fragmentation mechanism was investigated using the distinct element method with the consideration of pre-existing cracks. We developed a cutter-rock interaction model to simulate the rotary-percussive drilling. In this model, a discrete fracture network (DFN) was used to reflect the rock’s complex behavior. Bonded Block Model (BBM) was used to simulate cracks initiation that can merge and propagate to fracture the rock. As a dynamic problem, the rock’s damping effect was introduced into our model by fitting it to the laboratory tests. Results represented the rock’s fragmentation process under the cutter indentation and the coupling of impact load and lateral movement well. The pre-existing cracks can significantly enhance the drilling speed, which demonstrates the significance of considering the rock’s non-continuous nature. Raising dynamic impact load is good for improving the penetration results in our study. For the back rake angle, 50° is the best choice in the evaluated range. But the cutter with the back rake angle of 20° obtains the highest fragmentation volume and lowest specific energy under the coupling of impact load and lateral velocity. This paper’s research is of great significance to guide the application of rotary-percussive drilling and reduce the cost of developing geothermal resources. 1. INTRODUCTION The geothermal resource is increasingly valued as a clean, secure, alternative energy (Liu et al., 2011; Tester et al., 2007; York, 2012; Zhang et al., 2018). Its development requires drilling a lot of wells deep into the target formations, which accounts for 30% to 50% of the cost of the hydrothermal geothermal electricity project and more than half of the total cost of enhanced geothermal systems (EGS) (Glowka, 1997; Yost et al., 2015). It is necessary to develop an efficient drilling method to reduce the time and cost (Miyazaki et al., 2019). Rotary-percussive drilling (RPD) is an efficient method of making holes in hard rocks and is well-suited for geothermal drilling (Finger and Blankenship, 2010; Lundberg and Okrouhlik, 2006). It can provide economic benefits for reducing drilling time and drilling cost by combing rotary drilling and percussive drilling (Patil and Teodoriu, 2013; Peng et al., 2018; Zhong, 2016). In this drilling method, the impactor and upper string’s impact load is imposed on the conventional rotary bit to penetrate and crush the rock (Chiang and Elias, 2008). A sound understanding of bit-rock interaction and rock fragmentation mechanisms under the impact load and rotary movement is essential to design down-hole tools, such as drill bit and impactor, and optimize the drilling parameters.

Abstract The United States Army is in the process of developing the next generation of 155mm self propelled artillery through the Armament Systems Division of United Defense in Minneapolis, Minnesota. This next generation artillery system, called Crusader, is fully automated and can fire up to 10 rounds a minute at distances in excess of 40 km. The weapon system employs a new Modular Artillery Charge System (MACS). MACS consists of a low zone charge, the M231, and a high zone charge, the XM232. Both are rigid combustible cylinders filled with propellant and they are approximately 15 cm in diameter and length. The XM232 is filled with approximately 500 cylindrically shaped propellant grains. The grains are similar in size and shape to that of a typical foam ear plug issued to visitors to high noise areas. A two centimeter thick center core of the cylinder which runs the length of both charges is filled with granular explosive powder which is used to centrally ignite the charges. Between one and six of the 15 cm diameter cylinders are loaded into the gun barrel depending on the distance to the target. It is the goal of this new program to have highly accurate first fire capability for maximum effectiveness on the battlefield. It is imperative to have an accurate prediction of the exit velocity of the artillery projectile at time of firing to achieve this goal. Actual firings of the new gun tube with the XM232 propellant canisters revealed that the exit velocity of the projectile was highly dependent on the temperature of the propellant prior to firing. (The velocity achieved by the M231 is relatively insensitive to temperature.) One avenue under review to provide the propellant temperature prior to firing is to physically measure it. This was easily accomplished in earlier artillery systems as the propellant was granular and stored in cloth sacks. The soldier simply inserted a thermometer through the cloth to obtain a bulk temperature of the propellant inside. The new XM232 does not allow this as the canister walls are impervious and even if a way was found to insert a thermometer into the canister — the obtained temperature would be questionable considering the jumbled nature of the small propellant cylinders inside. Additionally, Crusader’s high rate of fire and automated ammunition handling system does not permit the soldier to manually take the temperature of the charge. During August 1998 a series of test firings of the new gun barrel were conducted with the XM232s. Selected XM232s were instrumented with thermocouples located at different locations within the cylinder as shown in figure 1. The MACS were then soaked for 24 hours at either 50C or −30C. The MACS were then placed on wooden racks in a large thermal chamber maintained at 20C. The temperatures of the thermocouples were then recorded over a period of time as they either warmed or cooled. With this transient experimental data in hand a numerical model could be developed to predict the temperature of the MACS under varying environmental conditions. It was desired to achieve a thermal model in the most simple manner as possible. Thus the first effort was to model the XM232 cylinders as a homogeneous material. If reasonable predictions of the XM232 temperature could be achieved in this mode — more complex efforts could be avoided. Consultations with the propellant manufacturer in Radford, Virginia provided the basic thermal properties of the material. A thermal circuit was then created between the outer surface of the XM232 to the inner core. Thermal energy has to pass through the outer shell material and then through the numerous small propellant cylinders and air voids between them. The material was handled as a homogeneous material and the porous nature of the insides was ignored. It was understood that there would be some thermal stratification of the air inside as shown from the experimental data. But it was hoped that reasonable predictions could be accomplished without considering the bouancy of air trapped between the small cylinders. Series and parallel thermal circuits were developed with either the air and propellant in series or in parallel to get the range of thermal resistances between the two situations. It was expected that the actual thermal resistance would lie somewhere between the two situations. Initial efforts involved superimposing transient solutions to one dimensional problems (infinite cylinder and plane wall) to obtain the multidimensional solution to the short cylinder. While that method provided reasonable comparison to the experimental results after an initial two hour period — there was not a very good comparison prior to that time. The Fluent software package was then used with the ambient air temperature profile in the experiments and the initial temperatures of the XM232s to obtain the predicted three dimensional internal temperatures of the XM232. A three dimensional tetrahedral grid was created with approximately 74,000 nodes. Time steps of 100 seconds were applied for the first 20 minutes with longer time steps being applied as the gradients between the outer surface and the surrounding air decreased. The XM232s were cooled or warmed via natural convection from the surrounding ambient air. At the beginning of each time step the average surface temperature would be obtained from the Fluent software package and then the average convective heat transfer coefficient “h” between the outer surface and surrounding ambient air would be calculated usingreadily available correlations from standard heat transfer books. Comparison of the experimental and numerical predictions at various locations within the XM232 for both the hot to ambient and cold to ambient were very good. The numerical predictions were a bit low on the upper half of the cylinder and a bit high on the lower half of the cylinder. This was expected as we did not consider buoyancy in this analysis. The experimentally measured temperature along the outer edge of the inner core tube matched up very well for both the hot and cold XM232 predictions. This was good news considering that the temperature at this location provided excellent correlation to the exit velocity of the projectile. The result of the above efforts was that a simple three dimension numerical model was developed to predict the temperature near the center of the XM232 for both a warming and cooling situation. The next use of the model is to predict the XM232 average temperature under a variety of transient ambient conditions. It is expected that these studies will facilitate higher first fire accuracy for the new Crusader Artillery System.