Eating disorders, primary care, and stigma: an analysis of research trends and patterns.

Eating disorders (EDs) are a growing concern affecting millions worldwide. Early detection and treatment are crucial, but stigma can prevent people from seeking help. Primary care providers can play a critical role in early detection by coordinating care with other professionals. Understanding the research landscape on EDs, primary care, and stigma is essential for identifying knowledge gaps to direct future research and improve management. In this study, we aimed to analyze the scientific trends and patterns in research about EDs, primary care, and stigma. A bibliometric analysis was conducted using the Web of Science database to collect articles published between May 1986 and May 2023. Bibliometric indicators were utilized to examine authorship, collaboration patterns, and influential papers. Topic analysis was performed to identify stigma-related terms within the dataset. A total of 541 research articles were analyzed, and it was found that the average number of publications per year has increased linearly from nearly zero in 1986 to 41 in 2022. One of the study's main findings is that despite this linear increase over the years, the subject of stigma did not take a prominent place in the literature. Only a few stigma concepts could be identified with the topic analysis. The authors in the field are also interested in; screening, neurotic symptoms, training, adolescent, obesity-related conditions, and family. One-third of all publications were from 15 journals. However, only two of them were primary healthcare journals. Leading authors' collaborations were another critical finding from the network analysis. This may help to expand primary care related EDs research to end the mental health stigma. This study provides insights into the research trends and patterns regarding eating disorders, primary care, and stigma. Our findings highlight the need to address primary care's impact and stigma on EDs. The identified research gaps can guide future studies to improve the prevention, diagnosis, and treatment of eating disorders in primary care settings.

Translation and Validation of the Turkish Version of the Quality of Postoperative Recovery Score QoR-15: A Multi-Centred Cohort Study.

OBJECTIVE: The Quality of Recovery-15 questionnaire is a self-rated questionnaire used to assess the quality of the postoperative recovery and health status of patients in the early period following surgery. The aim of this study was to assess the reliability, validity, and responsiveness of the Turkish version of the Quality of Recovery-15. METHODS: After approval by the Maltepe University local ethics committee, this observational study was conducted among patients who received surgical interventions at Mersin University Hospital between July 2019 and January 2020. Reliability, feasibility, and validity were assessed to validate the Turkish version of the Quality of Recovery-15. RESULTS: The completion rate of the form was determined to be 92% and a total of 200 patients were enrolled in the study. The Cronbach's alpha of the global Turkish version of the Quality of Recovery-15 was 0.927. Test-retest reliability was 0.84 [CI 95%: 0.75-0.90] and Cohen's effect size was 0.319. The total standardized response mean was determined as 0.53. CONCLUSIONS: This is the first study in which the Quality of Recovery-15 scale was translated into Turkish with our knowledge. The Turkish version of the Quality of Recovery-15 showed satisfactory reliability and validity in evaluating the quality of recovery after surgery in the Turkish population.

Barriers to losing weight for women attending group visits in primary care: A qualitative exploration using in-depth interviews.

BACKGROUND: Despite the accumulated evidence suggesting the positive aspects of using group visits in obesity, the number of qualitative studies that examine why and how the effects occur at an individual level is limited. OBJECTIVES: This qualitative study aimed to explore the experiences and perspectives of women who participated in group visits and had different weight loss outcomes in the programme. METHOD: Purposive maximum variation sampling was performed. Data collection and analysis were performed iteratively, and the data saturation method was used as a guideline for sample size. All participants who completed the group visits were approached, and finally, 20 individuals were included in the study. Semi-structured in-depth interviews were audio-recorded, transcribed verbatim, and analysed thematically using a phenomenological approach. RESULTS: The mean age of the individuals was 38.5 ± 9.8 years, the education level ranged from incomplete-high school to university degree, and the weight changes were between +4.1% and -17.1%. Two main themes emerged from the thematic analysis revealing barriers: weight stigma (two sub-themes: internal and external stigma) and traumatic life events (three sub-themes: 'loss of relatives,' 'childhood traumas,' and 'conflicting intimate partner relationships'). CONCLUSION: Considering the barriers to weight loss efforts in this study, these issues need to be explicitly investigated before and during the group visits in addition to weight loss practices and behavioural changes.

A comparative study of the antiemetic efficacy of dexamethasone, ondansetron, and metoclopramide in patients undergoing gynecological surgery.

BACKGROUND: Postoperative nausea and vomiting (PONV) are some of the most-common and undesirable adverse effects after surgery performed under general anesthesia. We investigated the prophylactic value of dexamethasone as an alternate to ondansetron or metoclopramide to prevent PONV after gynecologic surgery. MATERIAL/METHODS: One hundred sixty ASA I-II patients scheduled for elective gynecologic surgery were enrolled. Before induction of anesthesia, patients were randomly allocated to receive intravenously dexamethasone (8 mg) in group D, ondansetron (4 mg) in group O, metoclopramide (10 mg) in group M, and saline (2 mL) in group P. Total incidence of nausea and vomiting, rescue antiemetic requirement, pain scores, and any adverse effects were recorded at 3 observational periods (0-2 hours, 2-12 hours, and 12-24 hours). RESULTS: Total rates of PON, POV, and PONV were significantly higher in group P at 0-2 hours and 2-12 hours compared with group D, O, and M (P<.05). There was no difference in PON, POV, and PONV among D, O, and M groups. None of the groups differed in PONV in the subsequent 12-24 hours. Number of patients requiring rescue antiemetic was significantly higher in group P than the other groups at 0-2 hours (10%, 10%, 15%, and 45% in group D, O, M, and P) (P<.05). CONCLUSIONS: Prophylactic IV dexamethasone 8 mg significantly reduces the incidence of PONV in gynecologic surgery. At this dosage, dexamethasone is as effective as ondansetron 4 mg and metoclopramide 10 mg, and is more-effective than placebo.

Lumbar Erector Spinae Plane Block as a Main Anesthetic Method for Hip Surgery in High Risk Elderly Patients: Initial Experience with a Magnetic Resonance Imaging.

OBJECTIVE: Since initial description by Forero for thoracic region, ultrasound guided erector spinae plane (ESP) block has experienced several surgeries for postoperative pain management, chronic pain or surgical anesthesia. Although ESP block has been reported to provide effective analgesia in the thoracic region, its effect in lumbar region still unclear. In this study we aimed to showed our successful experience with lumbar ESP block as a main anesthetic technique in fifteen high risk elderly patients undergoing hip surgery with mild propofol sedation. MATERIALS AND METHODS: In this observational study high risk elderly fifteen patients received lumbar ESP block as a main anesthetic technique with mild propofol sedation. 40 mL of local anesthetic mixture (20 mL bupivacaine 0.5%, 10 mL lidocaine 2%, and 10 mL normal saline) was administered between the erector spinae muscles and transverse process at the level of the 4th lumbar vertebra. Also we demonstrate magnetic resonance images and discuss the anatomic basis of lumbar ESP block. RESULTS: All patients' surgeries were completed without requirement for general anesthesia or local anesthesia infiltration of the surgical site. All patients' pain scores were <2/10 in the recovery room. Significant contrast spread was observed between the Th12 and L5 transverse process and erector spinae muscle and between multifidus muscle and iliocostal muscle at the L2-4 levels. Contrast material was observed at the anterior of the transverse process spreading to the paravertebral, foraminal and partially epidural area/spaces and also in the areas where the lumbar nerves enter the psoas muscle. CONCLUSION: Lumbar ESP block when combined with mild sedoanalgesia provides adequate and safe anesthesia in high risk elderly patients undergoing hip surgery.

[Effectiveness of simplified predictive intubation difficulty score and thyromental height in head and neck surgeries: an observational study]. / Eficácia do escore simplificado preditivo de dificuldade de intubação e da altura tiromentoniana em cirurgias de cabeça e pescoço: estudo observacional.

BACKGROUND AND OBJECTIVES: In this study, we aimed to investigate the predictive value of different airway assessment tools, including parts of the Simplified Predictive Intubation Difficulty Score (SPIDS), the SPIDS itself and the Thyromental Height Test (TMHT), in intubations defined as difficult by the Intubation Difficulty Score (IDS) in a group of patients who have head and neck pathologies. METHODS: One hundred fifty-three patients who underwent head and neck surgeries were included in the study. The Modified Mallampati Test (MMT) result, Thyromental Distance (TMD), Ratio of the Height/Thyromental Distance (RHTMD), TMHT, maximum range of head and neck motion, and mouth opening were measured. The SPIDSs were calculated, and the IDSs were determined. RESULTS: A total of 25.4% of the patients had difficult intubations. SPIDS scores > 10 had 86.27% sensitivity, 71.57% specificity and 91.2% Negative Predictive Value (NPV). The results of the Receiver Operating Curve (ROC) analysis for the airway screening tests and SPIDS revealed that the SPIDS had the highest area under the curve; however, it was statistically similar to other tests, except for the MMT. CONCLUSIONS: The current study demonstrates the practical use of the SPIDS in predicting intubation difficulty in patients with head and neck pathologies. The performance of the SPIDS in predicting airway difficulty was found to be as efficient as those of the other tests evaluated in this study. The SPIDS may be considered a comprehensive, detailed tool for predicting airway difficulty.

Is a Combination of the Serratus Intercostal Plane Block and Rectus Sheath Block Superior to the Bilateral Oblique Subcostal Transversus Abdominis Plane Block in Laparoscopic Cholecystectomy?

OBJECTIVE: The serratus intercostal plane block (SIPB) is a recently defined interfascial plane block. The oblique subcostal transversus abdominis plane block (OSTAP) is another type of interfascial plane block, and it is also used as a part of multimodal analgesia in patients undergoing laparoscopic cholecystectomy (LC). In this retrospective study, we evaluated the effects of the bilateral OSTAP and a combination of the right SIPB and bilateral rectus sheath block (RSB) on the postoperative pain and analgesia requirement in patients undergoing LC. MATERIALS AND METHODS: Data of the patients who underwent LC between May 2018 and November 2018 were evaluated retrospectively. Postoperative pain was evaluated using the numeric rating scale (NRS), and 24-hour tramadol consumption and rescue analgesia requirements were compared. RESULTS: Bilateral OSTAP was applied to 47 patients, and SIPB+RSB was applied to 25 patients. Postoperative pain scores were similar between the two groups. In the first 24 hours, tramadol requirement in the SIPB+RSB group was significantly lower than in the OSTAP block group (p<0.001). There was no statistically significant difference between the NRS averages at different time frames between the two block groups. CONCLUSION: We found that when SIPB is used as a part of multimodal analgesia in a combination with RSB in LS, it improves the quality of analgesia and decreases the analgesic requirement compared to patients undergoing a bilateral OSTAP block. Randomized controlled trials are necessary to compare the effects of SIPB alone and in a combination with other blocks in LC.

Evaluation of ultrasound-guided transversalis fascia plane block for postoperative analgesia in cesarean section: A prospective, randomized, controlled clinical trial.

STUDY OBJECTIVE: Cesarean Delivery (CD) is a commonly performed obstetric procedure. Adding a regional anesthesia technique to multimodal analgesia in CD, may improve the quality of postoperative analgesia. In this study we evaluated the efficacy of Transversalis Fascia Plane Block (TFPB) for postoperative analgesia management in CD. DESIGN: Blinded, prospective, randomized study. SETTING: Postoperative recovery room & ward, tertiary university hospital, Istanbul, Turkey, PATIENTS: Seventy-five patients (ASA II-III) scheduled to undergo Cesarean delivery were recruited. Following exclusion, 70 patients were randomized into two equal groups (block and control group). INTERVENTIONS: Standard multimodal analgesia (routine paracetamol and tramadol PCA in addition to diclophenac sodium as rescue analgesia) was performed in Group C while TFPB block was also performed in the intervention (TFPB) group. MEASUREMENTS: The primary outcome was tramadol consumption within the first 24 h. The secondary outcome was Numeric Rating Scale (NRS) scores during rest and movement/coughing. MAIN RESULTS: Tramadol consumption in the first 24 h was 175 ±â€¯72.32 mg in the control and 101.42 ±â€¯51.45 mg in the TFPB group (p < 0.05). NRS was lower in Group TFPB during the first 3 h and at the 12th hour. There was no difference in NRS scores at other hours. CONCLUSION: Bilateral ultrasound guided TFPB leads to effective analgesia and a decrease in analgesia requirement in first 24 h in patients undergoing CD.

[YouTube as an informational source for brachial plexus blocks: evaluation of content and educational value]. / YouTube como fonte informativa sobre bloqueios do plexo braquial: avaliação de conteúdo e valor educativo.

BACKGROUND AND OBJECTIVES: YouTube, the most popular video-sharing website, contains a significant number of medical videos including brachial plexus nerve blocks. Despite the widespread use of this platform as a medical information source, there is no regulation for the quality or content of the videos. The goals of this study are to evaluate the content of material on YouTube relevant to performance of brachial plexus nerve blocks and its quality as a visual digital information source. METHODS: The YouTube search was performed using keywords associated with brachial plexus nerve blocks and the final 86 videos out of 374 were included in the watch list. The assessors scored the videos separately according to the Questionnaires. Questionnaire-1 (Q1) was prepared according to the ASRA guidelines/Miller's Anesthesia as a reference text book, and Questionnaire-2 (Q2) was formulated using a modification of the criteria in Evaluation of Video Media Guidelines. RESULTS: 72 ultrasound-guided and 14 nerve-stimulator guided block videos were evaluated. In Q1, for ultrasound-guided videos, the least scores were for Q1-5 (1.38) regarding the complications, and the greatest scores were for Q1-13 (3.30) regarding the sono-anatomic image. In videos with nerve stimulator, the lowest and the highest scores were given for Q1-7 (1.64) regarding the equipment and Q1-12 (3.60) regarding the explanation of muscle twitches respectively. In Q2, 65.3% of ultrasound-guided and 42.8% of blocks with nerve-stimulator had worse than satisfactory scores. CONCLUSIONS: The majority of the videos examined for this study lack the comprehensive approach necessary to safely guide someone seeking information about brachial plexus nerve blocks.

Evaluation of Ultrasound-Guided Erector Spinae Plane Block and Oblique Subcostal Transversus Abdominis Plane Block in Laparoscopic Cholecystectomy: Randomized, Controlled, Prospective Study.

BACKGROUND: Oblique subcostal transversus abdominis plane block (OSTAP) is a recently described regional anesthetic technique used in upper abdominal surgeries such as laparoscopic cholecystectomy (LC). Erector spinae plane block (ESPB) has also been reported for postoperative analgesia in LC. AIM: We aimed to compare the effectiveness of OSTAP and ESPB in providing postoperative analgesia in patients undergoing these surgeries. SETTING AND DESIGN: This study was designed as a double-blinded, prospective, randomized, efficiency study in a tertiary university hospital, postoperative recovery room, and ward. MATERIALS AND METHODS: A total of 72 patients were recruited and 60 patients were randomized into three equal groups (ESPB, OSTAP, and control group). Pain intensity between groups was compared using Numeric Rating Scale (NRS) scores. In addition, consumption of paracetamol and tramadol and additional rescue analgesic requirement were measured. Standard multimodal analgesia was performed in all groups, while ESPB block was also performed in Group ESPB and OSTAP block was also performed in group OSTAP. STATISTICAL ANALYSIS USED: Descriptive statistics were expressed as mean ± standard deviation. Independent t-test, Mann-Whitney U-test, Chi-square test, Fisher's exact test, Shapiro-Wilk test, one-way ANOVA, and post hoc Tukey's analysis were used for statistical analysis. RESULTS: NRS was lower in block groups during the first 3 h. There was no difference in NRS scores at other hours. Analgesic consumption and rescue analgesic requirement were lower in groups ESPB and OSTAP when compared to those of control group. Block groups were similar. CONCLUSION: Bilateral ultrasound-guided ESPB and OSTAP performed at the end of LC lead to akin analgesia requirement and improve the quality of multimodal analgesia.

Combination of lumbar erector spinae plane block and transmuscular quadratus lumborum block for surgical anaesthesia in hemiarthroplasty for femoral neck fracture.

Femur neck fractures may occur in elderly patients with multiple co-morbidities. Spinal or general anaesthesia may not be safe in such patients, leading to a search for other safer alternatives. Herein, we report a case in which a never previously reported combination of quadratus lumborum block (QLB) and erector spinae plane block (ESPB) was successfully used as the main anaesthetic method for hemiarthroplasty. An 86-year-old female patient with severe aortic stenosis was scheduled for internal fixation or hemiarthroplasty due to right femoral neck fracture. Following sedoanalgesia, the patient was placed in lateral decubitis position and ESPB and transmuscular QLB were performed from the fourth lumbar vertebra level. Adequate and effective surgical anaesthesia was achieved and hemiarthroplasty was performed. The combination of lumbar ESPB and QLB can be used for the anaesthesia management in high-risk patients undergoing hemiarthroplasty.

Case Report Presentation of Ultrasound-guided Erector Spinae Plane Block in Shoulder Surgery: Three Patients and Two Different Results.

Erector spinae block (ESPB) is an effective therapy for chronic shoulder pain. However, ESPB has not been used as a postoperative analgesia method in shoulder surgeries. In this case report, we report three patients undergoing shoulder surgeries that received ESPB preoperatively for postoperative analgesia. All patients had relief of preoperative pain and no associated motor block. Two of the patients manifested with low maximum pain scores (4/10, 3/10) on a numeric rating scale (NRS). The other patient reported a maximum pain score of 8/10 on NRS. While this patient's shoulder mobility immediately improved after ESPB application, the ESPB did not provide adequate analgesia for the postoperative period. The use of the ESPB for acute postoperative analgesia after shoulder surgery is novel and clinically interesting. However, postoperative analgesia was not completely opioid-sparing. Consequently, the efficiency of ESPB at the level of T2 for postoperative analgesia should be considered for surgeries that involve the shoulder cap given the possible inadequate migration of local anesthetic into the cervical plexus. Clinicians should carefully consider an ESPB as a postoperative analgesic option when considering shoulder operations and the possibility for the incomplete spread of local anesthetic in targeted neural structures.

Family Physician-Led Group Visits for Lifestyle Modification in Women with Weight Problems: A Pilot Intervention and Follow-Up Study.

OBJECTIVE: Lifestyle modification requires extensive information sharing and counseling. However, one-on-one primary care consultations are lacking to cover all necessary components due to time constraints. This preliminary study aims to investigate the feasibility and effects of lifestyle-changing intervention by family physician-led group visits (GVs) on weight management in overweight and obese women. METHODS: 60 volunteers fulfilling the inclusion criteria were enrolled. Baseline and 6th month assessments consisted of anthropometric measurements, SF-36 Health Survey, blood variables, exercise test, and resting metabolic rate. Weight maintenance was controlled at the 12th month. RESULTS: Although weight loss among participants varied, the mean body weights were significantly decreased by 8.2% in full-attenders (n = 30). A significant increase in HDL-cholesterol and decreases in heart rate and blood pressure were found. SF-36 summary scales were significantly improved. Weight change was moderately correlated with exercise duration, compliance to diet, and baseline mental component score. It was determined that 62.5% of the participants either lost or maintained body weight at the 12th month. CONCLUSION: Significant weight loss and quality of life improvement was achieved in this pilot study. GVs may be a promising alternative to primary care consultations for obesity management; however, the high dropout level and diverse outcomes need further assessment.

Evaluation of ultrasound-guided erector spinae plane block for postoperative analgesia in laparoscopic cholecystectomy: A prospective, randomized, controlled clinical trial.

STUDY OBJECTIVE: Laparoscopic cholecystectomy (LC) is a commonly performed minimally invasive procedure that has led to a decrease in procedure-related mortality and morbidity. However, LC requires analgesia that blocks both visceral and somatic nerve fibers. In this study, we evaluated the effectiveness of Erector Spinae Plane Block (ESPB) for postoperative analgesia management in LC. DESIGN: Single-blinded, prospective, randomized, efficiency study. SETTING: Tertiary university hospital, postoperative recovery room & ward. PATIENTS: 36 patients (ASA I-II) were recruited in two equal groups (block and control group). Following exclusion, 30 patients were included in final analysis. INTERVENTIONS: Standard multimodal analgesia was performed in Group C (control) while ESPB block was also performed in Group B (block). MEASUREMENTS: Pain intensity between groups were compared using Numeric Rating Scores (NRS). Also, tramadol consumption and additional rescue analgesic requirement were measured. MAIN RESULTS: NRS was lower in Group B during the first 3 h. There was no difference in NRS scores at other hours. Tramadol consumption was lower in Group B during the first 12 h. Less rescue analgesia was required in Group. CONCLUSION: Bilateral ultrasound guided ESPB leads to effective analgesia and a decrease in analgesia requirement in first 12 h in patients undergoing LC.

Comparison of Ultrasound-Guided Lumbar Erector Spinae Plane Block and Transmuscular Quadratus Lumborum Block for Postoperative Analgesia in Hip and Proximal Femur Surgery: A Prospective Randomized Feasibility Study.

STUDY OBJECTIVE: Lumbar Erector spinae Plane block (L-ESPB) is a modification of a recently described block. Both L-ESPB and Transmuscular Quadratus Lumborum block (QLB-T) have been reported to provide effective postoperative analgesia in hip and proximal femur surgery. Herein, we compare the effectiveness of L-ESPB and QLB-T in providing postoperative analgesia in patients undergoing hip and femur operations. DESIGN: Double-blinded, prospective, randomized, feasibility study. SETTING: Tertiary university hospital, postoperative recovery room and ward. METHODOLOGY: A total of 72 patients (American Society of Anesthesiology physical status classification II-III) were recruited. After exclusion, 60 patients were allocated to three equal groups (control, L-ESB and QLB-t). INTERVENTIONS: Standard multimodal analgesia was performed in the control group while L-ESPB or QLB-T was performed in the block groups. MEASUREMENTS: Pain intensity between groups was compared using Numeric Rating Scores. Furthermore, tramadol consumption and additional rescue analgesic requirement was measured. RESULTS: There was no difference between demographic data or type of surgery. While there was no difference in Numeric Rating Scale (NRS) score at any hour between the block groups; NRS scores at the 1st, 3rd and 6th h, tramadol consumption during the first 12 h and total tramadol consumption, the number of patient required rescue analgesic in 24 h were significantly higher in the control group compared to both block groups. CONCLUSION: While L-ESPB and QLB-T have similar effect, they improve analgesia quality in patients undergoing hip and proximal femoral surgery when compared to standard intravenous analgesia regimen.

[YouTube as an information source of spinal anesthesia, epidural anesthesia and combined spinal and epidural anesthesia]. / YouTube como fonte de informação de raquianestesia, anestesia peridural e anestesia combinada raquiperidural.

INTRODUCTION: Social media as YouTube have become a part of daily life and many studies evaluated health-related YouTube videos. Our aim was to evaluate videos available on YouTube for the conformity to textbook information and their sufficiency as a source for patient information. MATERIAL AND METHOD: A search of the YouTube website was performed using the keywords "spinal anesthesia, epidural anesthesia, combined spinal epidural anesthesia". Firstly, 180 videos were evaluated and the characteristics of the video were noted, and the features of the video too were noted if the video was regarding neuraxial anesthesia. Questionnaire 1 (Q1) evaluating the video quality relating to neuraxial anesthesia was designed using a textbook as reference and questionnaire 2 (Q2) was designed for evaluating patient information. RESULTS: After exclusions, 40 videos were included in the study. There was no difference in Q1 or Q2 scores when videos were grouped into 4 quarters according to their appearance order, time since upload or views to length rate (p>0.05). There was no statistical difference between Q1 or Q2 scores for spinal, epidural or combined videos (p>0.05). Videos prepared by a healthcare institute have a higher score in both Questionnaires 1 and 2 (10.87±4.28 vs. 5.84±2.90, p=0.044 and 3.89±5.43 vs. 1.19±3.35, p=0.01 respectively). CONCLUSION: Videos prepared by institutes, societies, etc. were of higher educational value, but were still very lacking. Videos should be prepared in adherence to available and up-to-date guidelines taking into consideration appropriate step by step explanation of each procedure, patient safety and frequently asked questions.

Evaluation of the reliability of preoperative descriptive airway assessment tests in prediction of the Cormack-Lehane score: A prospective randomized clinical study.

STUDY OBJECTIVE: In this study we investigated and compared the predictive values of different airway assessments tests including thyromental height measurement test, which has been recently suggested, in difficult laryngoscopy (Cormack and Lehane [C-L] scores 3 and 4). In addition, we compared the effectiveness of methods and C-L scores, by IDS, in terms of predicting difficult intubation. DESIGN: Prospective, blinded study. SETTING: Maltepe University. PATIENTS: Four hundred fifty-one patients selected randomly who underwent general anesthesia. INTERVENTIONS: In this study we compared predictive value of thyromental height measurement test (TMH), which has been recently suggested, modified Mallampati test (MMT), upper lip bite test (ULBT), and thyromental distance measurement test (TMD) in difficult laryngoscopy. Final C-L scores were compared with intubation difficulty scale (IDS) in terms of predicting difficult intubation. MEASUREMENTS: Patient's American Society of Anesthesiology score, age and weight were recorded. TMH, TMD, MMT, ULBT, IDS and C-L scores were measured and determined. MAIN RESULTS: The optimal cut-off point for TMH for predicting difficult laryngoscopy was 43.5 mm and for TMD was 82.06 mm. Use of TMH <43.5 with MMT has the highest sensitivity for predicting difficult intubation (78.38) with 75.36% specificity and 97.50% negative predictive value. TMH showed sensitivity of 91.89% and specificity 52.17% at 50 mm cut-off value. In the comparison of the area under the receiver operating characteristic curve values, none of the tests came forth individually or in combination with MMT test. CONCLUSIONS: The present study demonstrates the practicality of TMH as a digitalized test however the clinical benefits of TMH in daily medical practice are drawn into question. The additional variable of race may have had some bearing on this and further studies, larger in patient sample size, may need to use different methodology concerning age-, sex-, and race-dependent variables in evaluating these tests.