Novel Approach to Respiratory Rate Measurement Using Resonance Tube with Contradictory Thresholding Technique

In this paper, we propose a novel approach to respiratory rate measurement using resonance tube to enhance the performance of microphone inserted and fixed at the end of the tube to catch breath sound signal from the mouth and/or nose. The signal is amplified and passed into envelope detector circuit after which it is compared with a suitable reference voltage in comparator circuit to generate a pulse train of square wave synchronized with the respiratory cycle. A simple algorithm is developed in a small microcontroller to detect rising edges of each consecutive square wave to calculate respiratory rate together with analysis of breathing status. In order to evade noises which will cause errors and artifacts in the measuring system, the reference voltage is creatively designed to intelligently adapt itself to be low during expiration period and high during inspiration and pause period using the concept of resolving contradiction in the theory of inventive problem solving (TRIZ). This makes the developed device simple and low-cost with no need for complicated filtering system. It can detect breath sound as far as 250 cm from the nose and can perform accurately as tested against End Tidal CO2 Capnography device. The result shows that the developed device can estimate precisely from as low as 0 BrPM to as high as 98 BrPM and it can detect shallow breathing as low as 10 mV of breath sound

Review of clinical studies of perampanel in adolescent patients

Aim: To assess the clinical trial and real-world data for adjunctive perampanel in adolescents and develop consensus recommendations to guide the use of perampanel in this population in clinical practice. Methods: In May 2015, 15 epilepsy experts attended a Consensus Development Meeting to assess the clinical trial data for perampanel, specific to the adolescent age group (12-17 years) and develop consensus treatment recommendations. Results and Discussion: Analysis of the adolescent subgroup data of three pivotal placebo-controlled, double-blind, phase 3 trials investigating perampanel in patients with ongoing focal epileptic seizures despite receiving one to three antiepileptic drugs found that perampanel 4-12 mg was superior to placebo. The tolerability profile of perampanel was generally acceptable. Adolescent patients receiving long-term treatment with perampanel in an open-label extension study maintained improvements in seizure control compared with baseline, with a favorable risk-benefit profile. A phase 2 study showed that perampanel had no clinically important effects on cognitive function, growth, and development. Conclusion: Perampanel is a welcome addition to the armamentarium of existing antiepileptic drugs as it represents a new approach in the management of epilepsy, with a novel mechanism of action, and the potential to have a considerable impact on the treatment of adolescents with epilepsy