title: To compare the accuracy of prayer's sign and Mallampatti test in predicting difficult intubation in diabetic patients.
abstract: OBJECTIVE
  To determine the accuracy of Prayer's sign and Mallampatti test in predicting difficult endotracheal intubation in diabetic patients.
  
  
  METHODS
  The cross-sectional study was performed at Aga Khan University Hospital, Karachi, over a period from January 2009 to April 2010, and comprised 357 patients who required endotracheal intubation for elective surgical procedures. Prayer's sign and Mallampatti tests were performed for the assessment of airway by trained observers. Ease or difficulty of laryngoscopy after the patient was fully anaesthetised with standard technique were observed and laryngoscopic view of first attempt was rated according to Cormack-Lehan grade of intubation. SPSS 15 was used for statistical analysis.
  
  
  RESULTS
  Of the 357 patients, 125 (35%) were classified as difficult to intubate. Prayer's sign showed significantly lower accuracy, positive and negative predictive values than Mallampatti test. The sensitivity of Prayer's sign was lower 29.6 (95% Confidence Interval, 21.9-38.5) than Mallampatti test 79.3 (95% confidence interval, 70.8-85.7) while specificity of both the tests was not found to be significantly different.
  
  
  CONCLUSIONS
  Prayer's sign is not acceptable as a single best bedside test for prediction of difficult intubation.
authors.forename: Mirza Mudassir Ali
authors.initials: MM
authors.lastname: Baig
authors.forename: Fazal Hameed
authors.initials: FH
authors.lastname: Khan
mesh_terms: D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010154:Pakistan; D011237:Predictive Value of Tests