Background: The prevalence of obesity is increasing worldwide, and anesthesiologists are facing challenges in the airway management of such patients. Excessive adipose tissue influences pharyngeal spaces and affects the laryngoscopic grade. Standard ramp positioning is time-consuming and difficult to prepare, and requires expensive equipment. Objectives: The aim of this study was to compare the standard ramp position with the proposed low-cost and easily accessible modified ramp position in laryngoscopic view during the intubation of patients with morbid obesity. Methods: In this single-blind clinical trial, 84 patients candidate for bariatric surgery at Rasoul Akram Hospital in 2020 were assigned to the rapid airway management positioner (RAMP) (R) and new modified RAMP (MR) groups by the block randomization method. The laryngoscopic view of the glottis based on the Cormack-Lehane scale, ventilation quality, duration of intubation, intubation attempts, oxygen saturation at the end of intubation, and the need for backward, upward, rightward pressure (BURP) maneuver for successful intubation were recorded. Normal distribution tests and Mann-Whitney and Kruskal-Wallis tests were used to analyze the data. Results: The results showed no significant differences between the two groups regarding ventilation score, laryngoscopy grade, number of intubation attempts, duration of intubation, and the need for BURP maneuvers during intubation (P > 0.05). Conclusions: The two methods are not significantly different, and the new modified ramp position can be used with more ease and availability and less cost.

The aim of current study was to evaluate the outcome of some laboratory tests and accuracy of diagnostic tests for patients with COVID-19. The QUADAS-2 tool was utilized to quality assessment of diagnostic accuracy studies. For data extraction, two reviewers blind and independently extracted data from abstract and full text of studies that included. 95% confidence interval for effect size with fixed effect model and Inver-variance method were calculated. Meta-analysis was performed using Stata/MP v.16 software. 469 studies were reviewed, of which the full text of 52 studies was reviewed and finally twenty-two studies were selected for meta-analysis. Mean differences of Alanine transaminase was 3.40 U/L (MD, 95% CI -2.45, 9.25), correlation between Alanine transaminase and severe COVID-19 was not significantly. Stool, feces, rectal swabs 25% (ES, 95% CI 0.32, 0.82), Urine 1% (ES, 95% CI 0.05, 0.58), overall sensitivity of PCR for detection of COVID-19 was 44% (ES, 95% CI 0.19, 0.68), less sensitive observerd when PCR detection of COVID-19. Evidence revealed that at the time of admission of patients with COVID-19, a specific laboratory model can be used to perform relevant tests and make decisions about patients. PCR using sputum samples was highly sensitive for detecting COVID-19 and after that computed tomography of the chest was identified with high sensitivity.