Background: The poor reliability of traditional screening tools to identify a potentially difficult airway makes the difficult laryngoscopy and tracheal intubation rate remains at 1.5-13%.The hypothesis is that fat pads affect the view during direct laryngoscopy so the increasing thickness of pretracheal soft tissue or pre-epiglottic space could be strong predictors of difficult laryngoscopy as the mobility of the pharyngeal structures is impaired. Upon that, we aimed to evaluate ultrasound-measured distance from skin to epiglottis for prediction of difficult laryngoscopy in Egyptian population. Methods: This was a prospective single blind randomized clinical study conducted on 80 patients requiring general anesthesia.Preoperatively, airway evaluation was performed using three parameters including Mallampati score, thyromental distance and ultrasound-measured distance from skin to epiglottis at the level of thyrohyoid membrane. The primary outcome was to correlate ultrasound measured distance from skin to epiglottis with difficult laryngoscopy in Egyptian population using Cormack -Lehane grading. Results: Difficult laryngoscopy group displayed greater thickness of the ultrasound measured distance from the skin to epiglottis(2 ± 0.3 cm versus 1.7 ± 0.3 cm; p = 0.002). The cut-off point for difficult laryngoscopy was >1.85 cm with sensitivity of 80%, specificity of 70.8% and area under the receiver operating characteristic curve was 0.759. Mallampati score and thyromental distance had poor area under the curve = (0.651, 0.670 respectively). Conclusion:Our study revealed good correlation between ultrasonograohic measurement of the skin to epiglottis distance and Cormack-Lehane grade in Egyptian population, therefore it might be considered as a predictor of difficult laryngoscopy.Clinical trial number: NCT03799055.

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Although the exact cause of osteoarthritis (OA) is unknown, it is believed to be a collection of related but distinct diseases that can occur due to a variety of biological and mechanical factors, such as metabolic predisposition, genetic or hereditary predisposition, age, and physical factors like obesity. Slowly progressing articular disease, osteoarthritis causes joint pain, stiffness, and a loss of mobility. Anti-inflammatory characteristics of corticosteroids make them popular in pain management. Adrenal corticosteroids are commonly utilised in epidural, joint, peripheral nerve, and soft tissue injections. They are produced in the adrenal cortex. It was the goal of this study to assess the effectiveness of ozone, steroid, and a placebo in patients with osteoarthritis of the knee following radiofrequency ablation of the genicular nerves. It was conducted at the Benha university hospital and comprised 75 patients with osteoarthritis of the knee joint who were randomly assigned to receive either a placebo or an active treatment. No differences were found between the study groups in age, gender, BMI, pain duration, or Kellgren-Lawrence grade, according to the research. The median VAS score revealed a considerable disparity among the three study groups. Results showed it was substantially higher in group I (7 points) than in groups II (six points) and III (4 points) (5). At the beginning of the research, there were no significant differences between the study groups in terms of VAS. In terms of the oxford knee score (OKS), there was no significant difference between the study groups at the beginning. There was no discernible difference in overall patient satisfaction across the trial groups. Patients with osteoarthritis of the knee had their genicular nerves ablate using radiofrequency.