Evoked EMG M-responses obtained from the thenar muscle in the palm by electrical stimulation of the median nerve demonstrate a well-established smooth bipolar shape for normal healthy subjects while kinks are observed in certain neurological disorders, particularly in cervical spondylotic neuropathy. A first differentiation failed to identify these kinks because of comparable values obtained for normally rising and falling segments of the smooth regions, and due to noise. In this study, the usefulness of the wavelet transform (WT), that provides localized measures of nonstationary signals is investigated. The Haar WT was used to analyze a total of 36 M-responses recorded from the median nerves of 6 normal subjects (having smooth shape) and 12 subjects with assumed neurological disorders (having kinks), for two points of stimulation on the same nerve. Features in the time-scale representation of the M-responses were studied using WT to distinguish smooth M-responses from ones with kinks. Variations in the coefficient line of the WT were also studied to allow visualization of WT at different scales (inverse of frequency). The high and low frequency regions in the WT came out distinctively which helped identifications of kinks even of very subtle ones in the M-responses which were difficult to obtain using the differentiated signal. In conclusion, the wavelet analysis may be a technique of choice in identifying kinks in M-responses in relation to time, thus enhancing the accuracy of neurological diagnosis.

Background: Non-adherence to medication increases patient’s risk of morbidity, mortality and economic wastage of scare medical resources. This study was conducted to assess the role of doctor-patient communication and duration of consultation, as tools to improve adherence to hypertension treatment. Methods: Data of this cross-sectional study were collected by face to face interview and document review at Combined Military Hospital (CMH), Dhaka among 253 conveniently recruited hypertensive patients attending outpatient department during July 2016 to June 2017. Mean-age of the respondents was 49.2 (±10.4) years, mostly married male (54.9% male, 95.3% married). Mean consultation duration experienced by the respondents was 5.3 (± 1.3) minutes. Among the participants, 63.64% experienced effective communication, 66% were adherent and 34% were non-adherent to medication. Among the respondents with effective communication, 92.5% were adherent to medication. On the contrary, among the respondents with ineffective communication, 80.4% were non-adherent. Results: Duration of consultation had significant association with adherence to hypertension treatment (p<0.001). Association between communication and adherence to medication was highly significant (p<0.001). Binary logistic regression revealed that respondents were 3.23 times more adherent to medication with favorable response to the item- ‘Doctor gave me as much information as I wanted’ (p = 0.041); and 10.24 times with favorable response to the item- ‘Doctor checked to be sure that I understood everything’(p=0.006). Patients’ faithfulness in carrying out prescription and proscriptions correctly, depends on the adequacy and accuracy of patient’s knowledge of what they were supposed to do and on their motivation. Conclusion: Thus, it is necessary to formulate interventions to scale up communication skill of the physicians, and devise effective ways to educate patients on medication of chronic diseases. Further studies on characteristics of consultation to make it motivating and more effective may be conducted. Bangladesh Med Res Counc Bull 2018; 44: 145-151