CARDIAC DISORDER DIAGNOSIS THROUGH NADI (PULSE) USING

BIOMEDICAL INSTRUMENTATION
S.RAJESH PRABU M.GIRIDHARAN
DEPT OF EIE DEPT OF EIE
rajeshprabus@gma!."#m gr$hara%.m&@gma!."#m
P.DEEPA'
DEPT OF EIE
s($ee%@gma!."#m
ARUNAI ENGINEERING )O**EGE
TIRU+ANNAMA*AI
ABSTRA)T
Diagnosing Diseases through pulse
finding any disease using nadi is an
automated system to find the diseases and its
related information about the human body.
This project provides detailed information
and reports on patients by obtaining their
nadi as a time series. The nadi pulses are
sensed by the fingertip, which actually
measure the pressure exerted by the artery.
These pulsations are very minute in pressure
units and a set of three such pressure
transducers is mounted on the wrist to sense
three location pulses, namely Vata, Pitta and
Kapha. The electrical signal proportional to
the pressure experienced, in differential
mode, by the pressure sensing element is
then digitied using the !"#bit multifunction
data ac$uisition card %& '()#"*!+
,%ational &nstruments, T-, '(./, having an
interface with the personal computer. The
data is captured at a sampling rate of 0++ 1
,which is sufficiently higher than the
%y$uist criteria/ for a predetermined length
of time. 2ur application shows the probable
disease results according to the pulse
waveform and pressure applied at the
sensing element per unit time. 1ence our
&ndian 3edicine 4ractitioners can use this
system as automated computer#aided
diagnostic tool.
'e,-#r$s.
%adi, 4ulse, 5ata, 4itta, 6apha, 4ressure
(ensors
INTRODU)TION
Diagnostic system followed by
ancient &ndian 3edicine 4ractitioners in 7ig
,!/. &n ancient literatures, be it (iddha,
.yurveda, 8hinese, 'nani, or 9ree:, pulse
based diagnosis has its own unparalleled
importance.
The organ under distress is eroed
down by feeling the palpation from the three
fingers ,index, middle and ring/ placed on
the radial artery. These pulsations dictate the
physiological status of the entire human
body. This is a tedious and delicate process
and hence it ta:es years of practice to master
this art 7ig ,!/. .s a result this approach is
subjective in nature. .yurveda meaning the
;science of life< believes that cosmos
comprises of five basic elements air, water,
earth, fire and space. 1uman life is
considered as a conglomeration of three
humors ,5ata, 4itta and 6apha/, seven
dhatus ,tissues/ and three mains ,waste
products/.
5ata ,=ind, .ir/ The 4rinciple of
movement and impulse
4itta ,)ile, 7ire/ The 4rinciple of
assimilation and transformation
6apha ,3ucus, =ater/ The
4rinciple of stability
.ccording to ancient literatures, any
ailment in the body brings about a change in
the constitution of these humors. These
changes are then sensed by the fingers of a
pulse examiner 7ig ,!/. &n this project in our
device, we are using three sensors which
simulate the human fingers to a large extent.
4ulse has been ubi$uitously accepted by
modern clinicians as well. They examine the
pulse using the method of trisection i.e.
apply pressure until the pulse is maximal,
and then vary pressure while concentrating
on the phases of the pulse. The arterial pulse
variants ,for example pulsus alternans,
bisferiens pulse, and bigeminal pulse/ are
basically used in detecting cardiac disorders.
1owever, &ndian medicine practitioners
carefully examine pulses at different depths,
each connected with a specific part of the
body and each believed to register even the
slightest physiological based changes.
*ITERATURE SUR+E/
.fter a long literature study and
boo: literature and discussion with the
&ndian medicine nadi practitioners, we are
going to develop the electronic setup and
nadi reading li:e 7ig ,*/ and dictate the
probable disease from the readings that are
read from the patients.
&n our setup, we have tried to imitate
the practitioner<s fingers 7ig ,!/. The system
has three fingers li:e projections whose
positions can be placed at the tip region to
find out the best locations to capture the
signals. (prings attached to them help in
damping, thus imitating the natural damping
present due to muscles in the tip region of
the practitioner<s fingers 7ig ,*/. The setup
of reading the ,5ata, 4itta and 6apha data/
&n our design, we used three identical
pieo film based sensors to capture the
waveform. The raw signals are filtered,
amplified, and read by our software
application, and then our system plots the
graph according to the signals and dictates
the probable diseases.
0OR'ING MODE* OF THE
S/STEM
The nadi pulses are sensed by the
fingertip, which actually measure the
pressure exerted by the artery. These
pulsations are very minute in pressure units
and therefore their ac$uisition is very
challenging. 7or this, initial experiments
were carried out using a ;! 4(&< pressure
sensor from ;(ensym 4roducts<> but were
found to be inade$uate for capturing the
intricacies of the pulse. 1ence, we have
currently adopted ;3illivolt 2utput 3edium
4ressure (ensor< ?3ouser @lectronics, &nc.A
with tiny diaphragm at the center, and
having ;+B inch 1*2< pressure range .s
shown in 7ig. *, a set of three such pressure
transducers is mounted on the wrist to sense
three location pulses, namely Vata, Pitta and
Kapha. The electrical signal proportional to
the pressure experienced, in differential
mode, by the pressure sensing element is
then digitied using the !"#bit multifunction
data ac$uisition card %& '()#"*!+
,%ational &nstruments, T-, '(./, having an
interface with the personal computer. The
data is captured at a sampling rate of 0++ 1
,which is sufficiently higher than the
%y$uist criteria/ for a predetermined length
of time. =e use the data ac$uisition software
C.)5&@= ,%ational &nstruments, T-,
'(./, which controls the digitiation as
well. The minimum change in the signal,
which can be measured, depends solely on
the resolution of the digitier.
*AB1+IE0 PRO)ESSING
There are different methods of 1D5
,1eart Date .nalysis/. 2ne of the methods is
time domain analysis. This method extracts
a few special measures using only the
temporal DD interval signals. .nother
method is spectral analysis. This method
interpolates the DD interval at a certain rate
and transforms this interval into the
fre$uency domain. There are some standards
for these two methods. 2ther methods such
as non#linear analysis and the time
fre$uency analysis have been discussed and
researched.
Cab 5&@= )iomedical Tool:it
provides a palette with several 1D5 analysis
methods. This palette can be found through
B#me$"a!12B#sg%a! Measureme%3s1
2E)G12HR+ A%a!,ss. 7igure 0 shows the
1D5 .nalysis palette. The )iomedical
Tool:it also contains a 1D5 .nalyer
application, which can perform 1D5
analysis more conveniently. 7igure " shows
the panel of 1D5 .nalyer.
R Peaks of ECG Signal & RR Intervals
The entire process of HRV analysis.
The palette of HRV analysis.
Preprocessing
DD interval signals might have some
baseline wandering, which will result in
inaccurate temporal and fre$uency analysis.
Eou can choose whether to detrend the DD
interval signals before analysis, as shown in
7igure F. The method to detrend DD interval
signals is similar to the method mentioned in
the Cab 5&@= for @89 (ignal 4rocessing
document.
Front Panel of the HRV naly!er in
"io#e$ical %ork&ench
Analyzing RR Interval Signals
The following sections describe the
different methods you can use to analye the
DD interval signals.
Preprocessing of RR Interval Signals
Time Domain Analysis
7or time series analysis, time domain
measures are commonly used. 3any
measures can be extracted from the original
DD interval signals to show the changes in
the .%(. &n )iomedical Tool:it, 1D5
(tatistics 5& and 1D5 1istogram 5& provide
the extraction of several common used
measurements, shown in Table !.
Tab!e 4. Time Domain 3easures of 1D5
+arab!es U%3s Des"rp3#%s
(tatistical measures
RR Mean
& Std
s Mean and standard
deviation o a!! RR
interva!s"
HR Mean
& Std
#$%i
n
Mean and standard
deviation o a!! &eart
&ates"
RMSSD %s S'(are root o t&e
%ean o t&e s(% o
s'(ares o
di)eren*es +et,een
ad-a*ent RR interva!s"
NN./
*o(nt
N(%+er o 0airs o
ad-a*ent RR interva!s
di)erin1 +2 %ore
t&an ./ %s in a!! t&e
%eas(re%ents"
0NN./ 3 NN./ *o(nt divided
+2 t&e tota! n(%+er
o a!! RR interva!s"
9eometric measures
HR4 Tota! n(%+er o a!! RR
trian1(!ar
inde5
interva!s divided +2
t&e &ei1&t o t&e
&isto1ra% o a!! RR
interva!s"
TINN %s Base!ine ,idt& o t&e
%ini%(% s'(are
di)eren*e trian1(!ar
inter0o!ation o t&e
&i1&est 0ea6 o t&e
&isto1ra% o a!! RR
interva!s %eas(red
on a dis*rete s*a!e
,it& +ins o 789#:.
%s (#$#:9 s)"
Eou can also use 1D5 .nalyer application
to obtain these measurements.
HRV nalysis 'sing the Ti#e (o#ain
nalysis )etho$
Se%s#r
2ur strain gauge transducer is
approximately of dimension !cm!cm. &t
consists of a flexible diaphragm at the center
,as shown in 7ig. */, which is a force#
gathering element that gets deformed by
arterial pressure waves. . =heatstone
bridge circuit consisting of three constant
resistors and a variable resistor transforms
the strain into a proportional electrical
signal. &n addition, the sensor utilies a
micro machined, stress concentration
enhanced structure to provide a very linear
output to measured pressure.
Tra%sm33er
The transmitter is a standard
industrial amplifier with B*+ m. output,
which linearies and conditions the signal.
=hile connecting to !"#bit digitier, the B#
*+m. is converted to *!+ 5 through a
resistor ,0++ ohm/. &t also provides the ero
and span adjustments. The ero adjustment
is calibrated to adjust the ero, such that at
ero pressure ,atmospheric pressure/, the
output is B m.. The span adjusts the degree
of amplification for output of the signal. The
data obtained in this way is usually
corrupted because of implicit and explicit
electronic and electrical noise, but the noise
level obtained in our developed system is
negligible, after proper shielding.
&n the mechanical design, the system
has three fingers li:e projections whose
positions can be adjusted at the tip region to
find out the best locations to capture the
signal. (prings attached to them help in
damping thus simulating the natural
damping present due to muscles in the tip
region of the practitioner<s fingers ,Fgure
5/.
2nce the three best positions are
found, they are loc:ed with another hard
spring fitting. This loc: resists the motion
artifacts as well. Discrete increments in
pressure are possible by changing the loc:<s
position towards the slant side. ,Fgure &/.
)ON)*USIONS
This system will be very useful to
our &ndian 3edicine 4ractitioners as an
automated computer#aided diagnostic tool.
The tool diagnoses the chronic diseases of
the human body. &t reveals detailed and
related information of the human body.
7or @xample when the tool
diagnoses lung disease for a patient then it
will reveal the overall information related to
that particular lung disease such as
predetermined monitory, causes, symptoms,
complications etc. 3edical practitioners will
also have a clear idea about which part of
the body is affected by the disease, so that
the curative medicine can be provided
appropriately. This tool will be very much
useful in our 9overnment 1ospitals,
4rimary 1ealth 8entre ,Department of
Indian Medicine/ in the exact diagnosis of
diseases. &n 9overnment 1ospitals and
4rimary 1ealth 8entre even a staff nurse or
a attendee can handle this tool with safety
for diagnosing the disease so that the doctors
can able to visit more patients with out any
confusions. Ci:e @lectronic Diabetes, )lood
4ressure measuring instrument even
common people can use this system in their
home itself. )y this they can self diagnose
the disease. To predetermine a serious or a
complicated disease in its 4remonitory stage
itself so that our 4ractitioners can able to
treat the diseases in its earlier stage by
avoiding further complications. This system
will help our practitioners in a $uic: and
uniform diagnosis of disease.
=e have a lot of proven records in
ancient literature that there is not a single
disease in the human body which cannot be
diagnosed by examining the pulse. 1owever,
ancient medical practitioners had to totally
rely upon years of clinical experience in
order to come to any conclusive diagnosis.
8linicians today have limited examination
of the pulse to its rate, rhythm and volume
by virtue of which they hardly come to a
concrete diagnosis based upon pulse alone.
&f there could be a system by which the
radial pulse could be critically examined just
li:e the ancient ayurvedic practitioners and
others, it could be one of the most useful
tools in the field of non#invasive modern
medical diagnosis of disease. 7rom the
implementation in section &5, it can be seen
that read the signals of ,5ata, 4itta and
6apha/ in the three channels. Thus our
system has potential to objectively measure
and display the changes occurring in the
radial artery in accordance with ayurvedic
principles without having to undergo
subjective interpretations. 7uture research
will concentrate on the diagnosis of disease
li:e ,8ancer types and (ugar level/ using
our improved version.