A Measure to Study Skin Reflectance using Non-Invasive Photosensor with Economic Design

A Measure to Study Skin Reflectance using Non-Invasive Photosensor with Economic Design

Prabhu Ravikala Vittal (Center for Medical Electronics & Computing, M.S. Ramaiah Institute of Technology, Bangalore, India), N. Sriraam (Center for Medical Electronics & Computing, M.S. Ramaiah Institute of Technology, Bangalore, India), C.K. Mala (Department Medical Electronics, M.S. Ramaiah Institute of Technology, Bangalore, India) and J. Saritha (Department Medical Electronics, M.S. Ramaiah Institute of Technology, Bangalore, India)
Copyright: © 2015 |Pages: 13
DOI: 10.4018/IJBCE.2015010105
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Abstract

Non-invasive mode of clinical testing has created a major impact on the society and finds huge demand in the clinical domain. There are several instances where such approach receives more co-operations from the patient. Replacing the traditional practice with such non-invasive procedure requires appropriate clinical investigation and validations, specifically exact location of veins for intravenous applications like venepuncture and other medical procedures. Collection of blood samples for bilirubin test for new-borns, blood sugar level detection also needs a special attention where such non-invasive procedure is highly preferred. Such clinical methodology highly relies on the selection/design of photo sensor and works on the principles of light that gets scattered from the human skin. This specific research study attempts to measure the effect of the photo sensor on the skin reflection and how the properties can be exploited for bilirubin test to detect jaundice for new-borns. Neonatal jaundice often referred as hyperbilirubinemia which indicates the concentration of serum bilirubin levels in blood stream. The higher and lower bilirubin levels can cause irreversible brain damage which is referred as kernicterus. The yellowish spot due to bilirubin deposition in the neonatal skin tissue indicates the presence or absence of jaundice. Several attempts have been made in the recent past to develop non-invasive mode of measuring the blood concentration level for recognition of bilirubin levels. The proposed research study involves in measuring the skin reflectance using photo sensor and to measure the bilirubin concentration in a non-invasive mode. A GaAsP yellow LED with a wavelength of 590nm with TEPT5700 light sensors was applied and Arduino real time processor was interfaced to the circuitry. The system was designed in such a manner that the buzzer activation indicates the severity of the bilirubin concentration. The lab based circuitry was converted in to indigenous prototype and was tested with newborn in a real time mode. The clinical validation was found to be quite promising. It can be concluded that the designed system was found to be more economic and can introduce in the primary healthcare sector.
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Introduction

Non-Invasive measurement of physiological parameters in the clinical domain has gained much attention in the recent years due to its painless procedure. It ensures infection free facilities with an extension of real-time clinical monitoring (Kraitlet al., 2013). Specifically several attempts have been made to exploit the human skin tissue properties to measure non-invasively by appropriate design procedure. Most of such applications make use of photo sensors due to the compactness and ability to derive the necessary tissue characteristics. Invasive methods comprise of collection of blood samples through injection and later used to test the blood glucose, haemoglobin, vein related procedures, bilirubin level concentration for detecting jaundice in new-borns. The optical properties of light on tissue level interaction were exploited in most of the non-invasive procedures. Kraitl et al., (2012) have proposal by making use of neon-infrared (NIR) spectroscopy and photo plethysmography. The haemoglobin derivate was discovered based on the absorption co-efficient of blood in the visible and NIR region. Sravani et al., (2013) have proposed a portable subcutaneous vein imaging system. The system comprises of NIR LED’s of 800nm wavelength embedded in the IR web camera. It has been shown that the proposed system was able to locate the various veins and proved to be potential device for intravenous applications like venipuncture and other clinical applications (Sravani et al., 2013).

Understanding of skin reflectance is well motivated by number of clinical application including Bilirubin detection, pulse plethysmography, galvanic skin response, etc (Knussen et al., 1996; Salomatina et al., 2011; Van Gemert et al., 1989; Elli Angelopoulou., 2012;Fallow et al., 2013;Pradhapan et al., 2013). Several studies on the physics of the skin reveal the “w” pattern of the skin with absorption and reflectance capabilities (Elli Angelopoulou., 2012). Being the largest organ of the body, the skin comprises of epidermis and dermis regions. These superficial and inner layers of the skin exhibit various physiological properties. Depending upon the clinical applications, one can measure the reflectance of the skin by the means of the parameter wavelength. These wavelengths can be exploited by means of the chromospheres present in the various layers of the skin (Elli Angelopoulou., 2012).

Bilirubin is a yellowish red pigment that is formed and released in to the blood stream when red blood cells are broken down, this usually severe in case of neonates. Large amount of bilirubin in the blood can lead to jaundice. Jaundice is the most common reason to check bilirubin levels. The level of bilirubin in a newborn’s blood serum is measured to determine if the circulating level of the bilirubin is normal or abnormal. When too much of bilirubin is generated, the excess is discarded into the blood stream and deposited in the skin tissues as temporary storage. Usually in hospitals blood serum are taken to quantify bilirubin of the neonates and in the case of severity the blood serum are taken two to three times a day from neonates. Though there is a transcutaneous method to check the bilirubin level for the neonates, it is expensive not used by many hospitals. This research study brings the non-invasive point of care device for quantifying the bilirubin using the skin reflectance method economically. An evaluation of the proposed system reveals its capability to detect process and display the result in real time with two levels of jaundice indication as normal or critical.

Bilirubin is a yellowish red pigment in the blood stream caused when there is excessive breakdown of red blood cells. Usually bilirubin is excreted in the bile and in the urine when it exceeds certain level. Excessive bilirubin is accumulated in the skin tissue. Two types of Bilirubin are found in the body, they are direct bilirubin (conjugated) and indirect bilirubin (unconjugated). Jaundice is the condition in which the skin and eyes become yellow due to large amount of bilirubin deposition in the dermis layer of the skin. Jaundice occurs in neonates for 2 reasons, the first reason because of the excess breakdown of red blood cells, which results in large amount of bilirubin, the second reason is that, liver of neonate is immature to handle excess bilirubin which is generated and it cannot be processed by neonates. The excessive bilirubin may lead to diseases like Cerebral palsy, Deafness, Kernicterus and may cause death of a new born baby.

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