Background: Although several types of laryngoscope blades of different sizes and shapes are present, Miller (MIL) blade is the most preferable blade among paediatric population. However, there is dearth in the literature regarding the use of these blades in the adult population. This study aimed to compare the laryngoscopic view and ease of intubation using MIL and Macintosh (MAC) blade among adults. Methods: A total of 172 patients who were >18 years age, with ASA grades I and II, undergoing elective surgeries with general anaesthesia were included. Patients were distributed in two groups (MAC/MIL and MIL/MAC), where laryngoscopy was first done with MAC blade, followed by MIL blade in the MAC/MIL group and vice-versa in the MIL/MAC group. Grading of laryngoscopic views, number of attempts, ease of intubation and use of backward, upward, rightward pressure (BURP) were noted. R v 3. 6. 0 was used for statistical analysis and P values≤ 0. 05 were considered as statistically significant. Results: MIL blade showed better laryngoscopic view compared to MAC blade (32. 6% vs. 15. 1%; P< 0. 002). BURP application helped improve the laryngoscopic views with MAC blade. Intubation with MIL blade was easier with regards to ease of intubation and number of attempts 19 (P value<0. 05). Conclusion: Glottis visualization is better with the MIL blade as compared to the MAC blade. Therefore, the MIL blade might be helpful in securing the airway among adult patients.

Background: The prevalence of obesity is increasing worldwide, and anesthesiologists are facing challenges in the airway management of such patients. Excessive adipose tissue infl uences pharyngeal spaces and aff ects the laryngoscopic grade. Standard ramp positioning is time-consuming and diffi cult 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 modifi ed 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 modifi ed 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 signifi cant diff erences 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 signifi cantly diff erent, and the new modifi ed ramp position can be used with more ease and availability and less cost.

Introduction: Treatment of Helicobacter pylori has various side effects like antibiotic resistance. The purpose of this study was to evaluate the effects of cinnamon extract on complications of treatment and eradication of H. pylori in infected people. Methods: In this randomized clinical trial, a total of 98 eligible healthy and H. pylori-infected patients approved by esophageal endoscopy were selected. The cinnamon group received multi-drug treatment including clarithromycin, amoxicillin and pantoprazole as well as a cinnamon extract capsule. The control group received multi-drug treatment and a 40 mg starch capsule. In order to analyze the cinnamon extract efficacy, the urea breath test (UBT) was performed 3 months after the start of treatment. Clinical symptoms were evaluated by a questionnaire at the beginning (day of 0), 7 days and 14 days after starting treatment. Results: The clinical symptoms such as nausea, vomiting, diarrhea, constipation, blurred vision, headache, metallic flavor, epigastric pain, BURP, and appetite were significantly reduced in cinnamon group (P < 0. 05). The odds ratio exhibited a higher eradication rate of H. pylori in cinnamon group (73. 47% in cinnamon group compared to 53. 06% in the control group) (P = 0. 036). Conclusion: Cinnamon as assisted therapy is able to alleviate the disease and reduce the complications of H. pylori treatment.