Multi-Dimensional Voice Program (MDVP) vs Praat for Assessing Euphonic Subjects: A Preliminary Study on the Gender-discriminating Power of Acoustic Analysis Software.

OBJECTIVES: The aim of this study was to compare the discriminatory power of the Multi-Dimensional Voice Program (MDVP) and Praat in distinguishing the gender of euphonic adults. STUDY DESIGN: This is a cross-sectional study. METHODS: The recordings of 100 euphonic volunteers (50 males and 50 females) producing a sustained vowel /a/ were analyzed with MDVP and Praat software. RESULTS: Both computer programs identified significant differences between male and female volunteers in absolute jitter (MDVP P < 0.00001 and Praat P < 0.00001) and in shimmer in decibel (dB) (MDVP P = 0.006 and Praat P = 0.001). Using the scale proposed by Hosmer and Lemeshow, we found no gender discrimination for shimmer in dB with either the MDVP (area under the receiver operating characteristics curve [AUC] = 0.658) or Praat (AUC = 0.682). In our series, on the other hand, MDVP absolute jitter achieved an acceptable discrimination between males and females (AUC = 0.752), and Praat absolute jitter achieved an outstanding discrimination (AUC = 0.901). The discriminatory power of Praat absolute jitter was significantly higher than that of the MDVP (P = 0.003). Absolute jitter sensitivity and specificity were also higher for Praat (83% and 80%) than for the MDVP (74% and 49%). CONCLUSIONS: Differences attributable to a subject's gender and to the software used to measure acoustic parameters should be carefully considered in both research and clinical settings. Further studies are needed to test the discriminatory power of different voice analysis programs when differentiating between normal and dysphonic voices.

Secondary amenorrhea in severe Asherman's syndrome: step by step fertility retrieval by Bettocchi's hysteroscope: some considerations.

The aim of this report was to define the best diagnostic and therapeutic approach when secondary amenorrhea is related to undiagnosed Asherman syndrome. We present a single case of secondary amenorrhea with a previous diagnosis of alterated hypothalamic-hypophysary regulation, with a component of ovarian function in probable reduction, which was evaluated in our department and resulted affected by Asherman's syndrome IV stage. We describe step by step the diagnosis and treatment of a previously misdiagnosed case of severe Asherman's syndrome. An appropriate diagnosis and adequate treatment are mandatory to allow menses and fertility to be restored when severe Asherman's syndrome occurs.