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In Wireless Body Area Network (WBAN), various biomedical sensors (BMSs) are deployed to monitor various vital signs of a patient for detecting the abnormality of the vital signs. These BMSs inform the medical staff in advance before the patient’s life goes into a threatening situation. In WBAN, routing layer has the same challenges as generally seen in WSN, but the unique requirements of WBANs need to be addressed by the novel routing mechanisms quite differently from the routing mechanism in Wireless Sensor Networks (WSNs). The slots allocation to emergency and nonemergency patient’s data is one of the challenging issues in IEEE 802.15.4 and IEEE 802.15.6 MAC Superframe structures. In the similar way, IEEE 802.15.4 and IEEE 802.15.6 PHY layers have also unique constraints to modulate the various vital signs of patient data into continuous and discrete forms. Numerous research contributions have been made for addressing these issues of the aforementioned three layers in WBAN. Therefore, this paper presents a cross-layer design structure of WBAN with various issues and challenges. Moreover, it also presents a detail review of the existing cross-layer protocols in the WBAN domain by discussing their strengths and weaknesses.

Difficult intubation is a term used when insertion of the endotracheal tube with conventional laryngoscopy technique requires more than 10 minutes or greater than three attempts. This study sought to determine the predictive value of two commonly used tests; Mallampati test vs. Upper Lip Bite Test (ULBT). A cross-sectional study conducted on 196 patients aged 18-60 years in lady reading hospital Peshawar presented for elective surgeries planned for general anaesthesia and requiring endotracheal intubation were included during March 2018 to May 2018. Both tests (Mallampati and Upper lip bite test) were performed on each sample. In the total 196 participant 180 (91.8%) were found easy cases and 16 (8.2%) were difficult cases. Out of 16 (8.2%) difficult cases 5 (31.3%) difficult cases were underclass III Upper Lip Bite Test (ULBT) which are true positive. From Modified Mallampati Test 8 (50%) were attributed to MMT class III which is 21.1% of total class III and 3 cases (18.8% of total difficult cases) with MMT class IV which is 75% of MMT class IV are both true positive. During anaesthesia and intubation, most common cause of death and brain damage is encounter because of difficult intubation. In this study, we have performed two tests i.e. ULBT and MMT on total of 196 patients, out of which 16 (8.2%) were found difficult intubation which is in the range (0.5-17.5%) mention in the previous studies. The study has shown most of the difficult were predicted incorrectly. Most cases resulted in difficult intubation, which were predicted easily by two tests (Criteria set by Hoda et al.), so to only rely on ULBT and MMT for predictive measure is not standard.

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