A comparative study of different modalities of treatment in nicotine dependence syndrome.

UNLABELLED: There are different modalities for management of Nicotine dependence, but it is still inconclusive which is the best modality for the treatment of Nicotine dependence syndrome (NDS). In this background the present study was carried out to assess the efficacy and to compare different modalities for the treatment of NDS. METHODS: Patients diagnosed as NDS as per ICD-10 were taken up for study. These patients were administered proforma to elicit sociodemographic details, Fagerstrom test for Nicotine Dependence, Questionnaire of Smoking Urges-Brief and breath analysis was done using carbon monoxide meter. Assessment was done at base line and at weekly follow-ups for 12 weeks. Patients were divided into six groups randomly. Group A received BUP at a dose of 150mg/day for 3 days; subsequently increased to 300mg/day, Group B: for initial 6 weeks Nicotine gum of 4mg every 1-2 hourly was used and next 6 weeks every 2-4 hourly was used, Group C: BI, Group D: BI+BUP, Group E: BI+NRT, Group F received BUP+NRT+BI. RESULTS: The quit rates at end of the study were BUP-30%, NRT-26.66%, BI-23.33%, BI+BUP-43.33%, BI+NRT-33.33%, and BI+BUP+NRT-50%. BI+BUP+NRT had 2-3 times more quit rates than the individual modality treatment group. CONCLUSION: There was no statistically significant difference between the study groups, but there was clinical difference in quit rates. Among the groups BI+BUP+NRT had higher quit rates compared to other groups. Combination modalities yield better quit rates than individual modalities.

An acoustical respiratory phase segmentation algorithm using genetic approach.

This paper proposes a robust and fully automated respiratory phase segmentation method using single channel tracheal breath sounds (TBS) recordings of different types. The estimated number of respiratory segments in a TBS signal is firstly obtained based on noise estimation and nonlinear mapping. Respiratory phase boundaries are then located through the generations of multi-population genetic algorithm by introducing a new evaluation function based on sample entropy (SampEn) and a heterogeneity measure. The performance of the proposed method is analyzed for single channel TBS recordings of various types. An overall respiratory phase segmentation accuracy is found to be 12 +/- 5 ms for normal TBS and 21 +/- 9 ms for adventitious sounds. The results show the robustness and effectiveness of the proposed segmentation method. The proposed method has been a successful attempt to solve the clinical application challenge faced by the existing phase segmentation methods in terms of respiratory dysfunctions.

A filter bank-based source extraction algorithm for heart sound removal in respiratory sounds.

In this paper, we consider the problem of heart sounds (HS) removal from respiratory sounds (RS), and a novel semi-blind single-channel source extraction algorithm is proposed. The proposed method is able to extract the underlying pure RS from the HS corrupted noisy input signals by incorporating the filter banks and template-based matching using FIR filters. For performance evaluation of the presented method, the average power spectral densities (PSD) of the input RS segments without HS have been compared with the PSD of the reconstructed signals over six selected frequency bands from 20 to 800Hz. The proposed method is tested for various types of RS recordings and found effective by yielding an overall maximum spectral difference of 2.8707+/-0.9875dB for a frequency range below 800Hz.

Tracking and time-frequency analysis on nonlinearity of tracheal sounds.

In this communication, identification of nonlinear portions in tracheal sound (TS) using third-order cumulant has been performed. The tracked nonlinearity has been then analyzed in time-frequency (TF) domain by applying a novel nonlinear analysis method based on optimally weighted Wigner-Ville distributions of the weighted subband signals from a filter bank. Similarity measurements between the optimally weighted and unweighted TF distribution outputs provide quantitative evaluation of the existence of nonlinearities. Recordings of both preprocessed as well as heart sound contaminated real recorded TS have been investigated.

Failed suicide and deliberate self-harm: A need for specific nomenclature.

BACKGROUND: Out of those who attempted self-harm and survived, many actually wanted to die and many did not. Presently, no distinctive nomenclature exists for these two groups, which causes difficulty in understanding as well as in management and research. AIM: To study whether there exist two such groups which are distinct and can be differentiated clinically. METHODS: Seventy-eight persons who attempted self-harm were evaluated in detail by a psychiatrist. The data were recorded in an especially designed proforma which documented sociodemographic variables, psychiatric and physical illnesses, psychosocial stress factors, substance abuse, past and family history and details of suicide attempt. RESULTS: Two groups emerged with distinct characteristics. The two groups were different in factors such as age, diagnosis, intentionality, lethality, mode, motive to kill oneself, past/family history, relation to stress, personality traits and precaution to prevent detection before and/or after the act. The group which had persons who really wanted to die but survived is suggested to be named as the 'failed suicide' group and the other group which had persons who did not actually want to die is suggested to be named as the 'deliberate self-harm' group. CONCLUSION: THOSE WHO CAUSE HARM TO THEMSELVES BUT SURVIVE CAN BE DISTINCTLY PUT INTO TWO GROUPS: (i) the 'failed suicide' group constituting those who actually wanted to kill themselves and (ii) the 'deliberate self-harm' group constituting those who did not actually want to die. The criteria for distinctions are suggested.

Dissociative disorder presenting as catatonia.

Three cases of dissociative disorder presenting with catatonia are described. Catatonia is generally believed to be associated with schizophrenia. However, many other conditions are also known to cause catatonia. A brief review of literature is provided. All the cases improved rapidly with a few ECTs. This report aims to highlight the presentation of dissociative disorders with catatonia. It also seeks to bring to notice the need to avoid lumping all non-organic catatonics under the rubric of schizophrenia so as to ensure proper treatment.

BIOFEEDBACK IN MEDICAL PRACTICE.

Biofeedback is emerging as a non-pharmacological method of treatment, mainly as an adjunct in the management of a large number of common medical conditions seen in general hospital set-up. Origin of biofeedback, biofeedback methods and their clinical applications are discussed.

Image enhancement based on a nonlinear multiscale method.

An image enhancement method that reduces speckle noise and preserves edges is introduced. The method is based on a new nonlinear multiscale reconstruction scheme that is obtained by successively combining each coarser scale image with the corresponding modified interscale image. Simulation results are included to demonstrate the performance of the proposed method.

Simplified method of determining fetal brain weight in utero.

Analysis of autopsy data shows that, from the 26th through the 38th gestational weeks, fetal brain weight (BrW) is a function of the 3.124 power of the largest head circumference (HC). Because there is excellent correlation between prenatal ultrasound measurement and postnatal tape measurement of the HC, it is possible to determine fetal BrW in utero. An alteration of the BrW:somatic weight (SW) relationship is an important physical stigma of asymmetric intrauterine growth retardation (IUGR). The value of longitudinal studies of fetal BrW and SW as a means of discriminating between normal and asymmetric growth is tested in a population at risk for IUGR.