Biomedical Engineering Department

Faculty of Engineering

Project:

Measuring Pulse Oximeter

and Cholesterol Level by
NIR

Under supervision:
Dr. Ashraf Wahba

Submitted by:

Hadeer Magdy tamer

Sondos Ragab Eliwa
Aisha Hisham said
Mai Abdelkader GadElkarim
Dina Saeed zaki

2020-2021
1
 Table of Contents

Contents
Abstract ................................................................................................................................... 5
Chapter 1 ................................................................................................................................. 6
Introduction and Background ..................................................................................................... 6
1.1 An Overview of the cholesterol ............................................................................................. 7
1.1.1 CHOLESTEROL .................................................................................................................. 7
1.1.2 Cholesterol measurement................................................................................................ 10
1.1.3 Needing of cholesterol test .............................................................................................. 11
1.2 An Overview of the pulse oximetry ...................................................................................... 14
1.2.1 OXYGEN ......................................................................................................................... 14
1.2.2 OXYGEN TRANSPORT TO THE TISSUES ............................................................................... 15
1.2.3 OXYGEN SATURATION ..................................................................................................... 17
1.2.4 Tests to measure patient's oxygen levels ........................................................................... 19
1.2.5 Diaphragmatic Breathing: ................................................................................................ 26
Chapter 2 ............................................................................................................................... 28
Principle Overview .................................................................................................................. 28
2.1 Infrared radiation .............................................................................................................. 29
2.2.1 Near-infrared light .......................................................................................................... 30
2.3 oxygen Saturation and the idea of pulse oximeter ................................................................. 31
2.4 Physical properties used in pulse oximetry ........................................................................... 33
2.5 Calibration Adjustment ...................................................................................................... 43
2.6 Problems with pulse oximeter ............................................................................................. 47
2.7 Idea of non-invasive cholesterol level measurement.............................................................. 54
Chapter 3 ............................................................................................................................... 55
Design Overview ..................................................................................................................... 55
Design and circuits of device .................................................................................................. 56
Our project includes two parts: ............................................................................................. 56
1) pulse oximeter................................................................................................................. 56
Every part has its circuit, and its components. ......................................................................... 56
3.1 Pulse oximeter: ................................................................................................................. 56
Preparation: Pulse Oximetry .................................................................................................. 57
3.1.1 Block diagram: ................................................................................................................ 58
2

3.1.2 Circuit diagram: .............................................................................................................. 59

3.1.3 Components................................................................................................................... 59

3.2 Non-invasive cholesterol sensor: ......................................................................................... 61

3.2.1 Materials and Methods ................................................................................................... 61
Chapter 4 ............................................................................................................................... 70
Hardware and software Implementation ................................................................................... 70
4.1 Simulation of pulse oximeter circuit: .................................................................................... 72
4.2 Simulation of cholesterol circuit .......................................................................................... 72
4.3 Pulse oximeter and cholesterol sensor hardware implementation........................................... 73
Chapter 6 Conclusion and Future work ...................................................................................... 74
Conclusion ............................................................................................................................. 75
Further Ideas for future: .......................................................................................................... 76
References ............................................................................................................................. 77
APPENDIX .............................................................................................................................. 82

3
4
 Abstract
oxygen saturation, and cholesterol are important parameters
in the human body that measured to show if their levels are
normal or not. the abnormal levels of them are a sign of some
diseases. the common biomedical measurement of these
parameters is done by invasive methods that use blood
samples taken from the body, then Some procedures are
applied on these samples to analyze them and determine the
levels of the parameters in them. these methods have some
disadvantages like it may be painful, increases risk for
inflammation, and it is impractical for patients requiring
multiple checks a day, and those engaged in manual activities.
the aim of the project is to avoid these disadvantages by using
a non-invasive method to check the normality of the two
parameters levels in the blood. near-infrared (NIR) was used
to detect the changes in the two parameters by using one
device that was designed and programmed to achieve this
aim.
5
 Chapter 1
Introduction and Background

6
1.1 An Overview of the cholesterol

1.1.1 CHOLESTEROL

Every cell of the body has cholesterol and each of it has important
natural functions. It is produced by the body and can also come from
food. It appears as waxy and fat-like. As cholesterol is oil-based, so it
does not mix with the blood, which is water-based. It is therefore
transported around the body in the blood by lipoproteins [1][3].
The functions of cholesterol are to contribute to the structure of cell
walls, makes up digestive bile acids in the intestine, allows the body to
produce vitamin D and enables the body to make certain hormones. It
also constructs and preserves membranes; it controls membrane
fluidity over the range of physiological temperatures. The hydroxyl
group on cholesterol work together with the polar head groups of the
membrane phospholipids and sphingolipids, while the bulky steroid and
the hydrocarbon chain are rooted in the membrane, alongside the
nonpolar fatty-acid chain of the other lipids. Through the contact with
the phospholipids fatty-acid chains, cholesterol rises membrane
packing, which decreases membrane fluidity [2].

Two types of lipoproteins that can carry cholesterol throughout

patient's body are low-density lipoproteins (LDL) and high-density
lipoproteins (HDL), It is important to have healthy levels of both types
of lipoproteins [4], LDL or Low-density lipoproteins are known as the
"bad cholesterol". LDL is manufactured by the liver. It carries
cholesterol and other lipids (fats) from the liver to different parts of the
body, such as muscles, tissues, organs, and the heart. It is very essential
7

to keep LDL levels low because high levels of LDL show that there is
much more cholesterol in the bloodstream than necessary, therefore
growing the risk of heart disease [3], HDL or High-density lipoprotein is
considered the "good" cholesterol. HDL is manufactured by the liver to
carry cholesterol and other lipids (fats) from tissues and organs back to
the liver for reprocessing or degradation. High levels of HDL are a good
indicator of a healthy heart. It is because less cholesterol is available in
the blood to attach to blood vessels that cause plaque formation [1].

VLDL or Very low-density lipoproteins are lipoproteins that transport

cholesterol from the liver to organs and tissues in the body. They are
made by a combination of cholesterol and triglycerides. VLDLs are
heavier than low-density lipoproteins and are also linked with
atherosclerosis and heart disease. This number is gained by dividing
patient's triglyceride levels by 5 [3].
Total cholesterol is made up of LDL cholesterol, HDL cholesterol, and
VLDL cholesterol. An appropriate level of total cholesterol is less than
200. Higher levels of LDL raise the risk of heart disease and stroke.
Usually, doctors will determine LDL goals based on a number of risk
factors and medical history. An optimum level of LDL is less than 100. If
good cholesterol or HDL is high the risk of cardiovascular disease
decreases [6].
For men, an HDL below 40 is measured as a risk factor for
cardiovascular disease. For women, an HDL below 50 is measured as a
risk factor for cardiovascular disease. Triglycerides are the most
common type of fat in the body. When triglycerides are greater than
normal (150 or more), the risk of heart disease or stroke may be bigger.
Non-HDL cholesterol should not be over 30 above any LDL goal [5].
8
Currently, a factor that causes Cardiovascular disease is atherosclerosis.
Atherosclerosis is a condition that changes inner blood vessels to
become thickness by fat. The fat accumulates between the blood
vessels that is a cause of high cholesterol. Normally cholesterol is in
many healthy cell functions if it is higher than the normal level, the body
will have harm. The level of cholesterol in the blood is divided into three
levels; a normal level that should be at least 200 milligrams per deciliter
(mg/ dL), a moderately high level that is between 200 to 239 mg/dL,
and a high level of over 240 mg/dL [7][8][9] [10].

Fig [1].Atherosclerosis

There are a large number of people who have high cholesterol

(Dyslipidemia) in which the population is at risk for high blood
pressure and risk for disorder continuously. According to the Thai
Registry in Acute Coronary Syndrome (TRACS) study, it is found that
the common risk factors in Thai people who are treated with coronary
heart disease, Dyslipidemia is as high as 83. 2%. Dyslipidemia is a
disease that can cause many complications such as obesity, coronary
heart disease, and ischemic heart disease [11].
There are important causes of hyperlipidemia such as Genes,
Diabetes, and consuming food with high fat. The preventive for
9
Dyslipidemia from consumption of food, we can control Dyslipidemia
by reduced fat in food. For patients with Dyslipidemia, it is necessary
to often test blood Cholesterol to control lipid in blood in a normal
range and adjust food that is suitable for them.

1.1.2 Cholesterol measurement

-invasive measurement (cholesterol test)

If patient have high cholesterol, patient may not experience any
symptoms at all, but patient could be at significant risk for heart
disease. A cholesterol test can give patient's health care provider
important information about the cholesterol levels in patient's blood
[13]. The test measures:

LDL levels. Also known as the "bad" cholesterol, LDL is the main source
of blockages in the arteries.
HDL levels. Considered the "good" cholesterol, HDL helps get rid of
"bad" LDL cholesterol.
Total cholesterol. The combined amount of low-density lipoprotein
(LDL) cholesterol and high-density lipoprotein (HDL) cholesterol in
patient's blood.
Triglycerides A type of fat found in patient's blood. According to some
studies, high levels of triglycerides may increase the risk of heart
disease, especially in women [14].
VLDL levels. Very low-density lipoprotein (VLDL) is another type of
"bad" cholesterol. Development of plaque on the arteries has been
10

linked to high VLDL levels. It's not easy to measure VLDL, so most of the
time these levels are estimated based on triglyceride measurements
[14].

1.1.3 Needing of cholesterol test

Recently, World Health Organization (WHO) reported that

cardiovascular diseases (CVD) account for 46% of total deaths in Egypt.
Atherosclerotic cardiovascular diseases (ASCVD) are a key public health
problem with considerable social and economic consequences in terms
of healthcare demands, lost efficiency, and premature mortality [16].
Egypt is having a high incidence of early atherosclerotic cardiovascular
events. The incidence of CVD is fast-shifting to the youth, a trend that
is specifically prevalent in the capital city of Cairo and the underserved
urban societies, where adoption of unhealthy lifestyles, fast food-
eating habits, and sedentary lifestyles are an increasing reality
[16,17,18]. Dyslipidemia is a major risk factor for CVD, and researches
have demonstrated that 37% of the Egyptian population has elevated
blood cholesterol levels with an overall target accomplishment of only
34.4% [19, 20]. Multiple risk factors are usually involved in the
development of ASCVD; therefore, assessment of total cardiovascular
(CV) risk becomes imperative.
Studies have recommended that it is necessary for everyone who has
reached the age of 35 or more to ensure that he does not have high
blood pressure, an increase in blood fats or the presence of diabetes,
before symptoms appear.

patient's doctor may order a cholesterol test as part of a routine exam,

or if patient have a family history of heart disease or one or more of the
11

following risk factors [13] [14]:

-High blood pressure
-Type 2 diabetes
-Smoking
-Excess weight or obesity
-Lack of physical activity
-A diet high in saturated fat
patient's age may also be a factor, because patient's risk for heart
disease increases as patient get older.

during a cholesterol test, a health care professional will take a blood

sample from a vein in patient's arm, using a small needle. After the
needle is inserted, a small amount of blood will be collected into a test
tube or vial. Patient may feel a little sting when the needle goes in or
out. This usually takes less than five minutes [13] [14]. Cholesterol tests
are usually done in the morning, as patient may be asked to refrain from
eating for several hours prior to the test.
Patient may need to fast--no food or drink--for 9 to 12 hours before
patient's blood is drawn. patient's health care provider will let patient
know if patient need to fast and if there are any special instructions to
follow.

Cholesterol is usually measured in milligrams (mg) of cholesterol per

deciliter (dL) of blood. The information below shows how the different
types of cholesterol measurements are categorized.
12
Total Cholesterol Level Category

Less than 200mg/dL Desirable

200-239 mg/dL Borderline high

240mg/dL and above High

LDL (Bad) Cholesterol

Level LDL Cholesterol Category

Less than 100mg/dL Optimal

100-129mg/dL Near optimal/above optimal

130-159 mg/dL Borderline high

160-189 mg/dL High

190 mg/dL and above Very High

HDL (Good)
Cholesterol Level HDL Cholesterol Category

60 mg/dL and Considered protective against

higher heart disease

40-59 mg/dL The higher, the better

13
 HDL (Good)
Cholesterol Level HDL Cholesterol Category

Less than 40 mg/dL A major risk factor for heart disease

A healthy cholesterol range for patient may depend on patient's age,

family history, lifestyle, and other risk factors. In general, low LDL levels
and high HDL cholesterol levels are good for heart health. High levels of
triglycerides may also put patient at risk for heart disease.
The LDL on patient's results may say "calculated" which means it
includes a calculation of total cholesterol, HDL, and triglycerides.
patient's LDL level may also be measured "directly," without using other
measurements. Regardless, patient want patient's LDL number to be
low.

1.2 An Overview of the pulse oximetry

1.2.1 OXYGEN
Human beings depend on oxygen for life. All organs require oxygen for
metabolism but the brain and heart are particularly sensitive to a lack
of oxygen. Shortage of oxygen in the body is called hypoxia. A serious
shortage of oxygen for a few minutes is fatal. During anesthesia,
patients’ airways may become obstructed, their breathing may
become depressed, their circulation may be affected by blood loss or
an abnormal heart rhythm or the anesthetic equipment may develop
a problem such as an accidental disconnection or obstruction of the
14

breathing circuit. These factors can result in a reduction of oxygen

delivery to the tissues which, if not managed correctly, could lead to
injury or death. The earlier the anesthesia provider detects a problem,
the sooner it can be treated so that no harm comes to the patient [12].

1.2.2 OXYGEN TRANSPORT TO THE TISSUES

Oxygen is carried around the body attached to an iron-containing

protein called hemoglobin, (Hb) contained in red blood cells. After
oxygen is breathed into the lungs, it combines with the hemoglobin in
red blood cells as they pass through the pulmonary capillaries. The
heart pumps blood continuously around the body to deliver oxygen to
the tissues. There are five important things that must happen in order
to deliver enough oxygen to the tissues:
• Oxygen must be breathed in (or inspired) from the air or anesthesia
circuit into the lungs.
• Oxygen must pass from the air spaces in the lung (called the alveoli)
to the blood. This is called alveolar gas exchange.
• The blood must contain enough hemoglobin to carry sufficient
oxygen to the tissues.
• The heart must be able to pump enough blood to the tissues to meet
the patient’s oxygen requirements.
• The volume of blood in the circulation must be adequate to ensure
oxygenated blood is distributed to all the tissues.
15
HOW MUCH OXYGEN DOES THE BLOOD CARRY?
In a patient who is in good health:
• Each gram of hemoglobin combines with 1.34 ml of oxygen.
Therefore, in blood with a normal hemoglobin concentration of
15g/dl, 100 ml of blood carries approximately 20 ml of oxygen
combined with hemoglobin. In addition, a small quantity of oxygen is
dissolved in the blood [12].
• The heart normally pumps approximately 5000 ml of blood per
minute to the tissues in an average sized adult. This delivers about
1000 ml of oxygen to the tissues per minute [12].
• The cells in the tissues extract oxygen from the blood for
metabolism, normally around 250ml of oxygen per minute. This means
16

that if there is no oxygen being exchanged in the lung, there is only

enough oxygen stored in the blood for around 3 minutes (only 75% of
the oxygen carried by the hemoglobin is available to the tissues) [12].
• Breathing 100% oxygen prior to induction of anesthesia
(preoxygenation) increases the oxygen stores in the lungs. If a patient
stops breathing and is not ventilated, the amount of oxygen in the
lungs will rapidly diminish. If the patient has been given 100% oxygen
to breathe for several minutes prior to induction of anesthesia, the
increased oxygen reservoir will supply much needed oxygen, adding
potentially life-saving minutes. There are many situations where this
may be important. One example is in the pregnant mother where the
enlarged uterus reduces lung volume and the metabolic demands are
increased by the fetus. Another example is in young children who have
small lung volumes and high metabolic demands. They can use up
oxygen very quickly and can sometimes be resistant to efforts to
preoxygenate them [12].
• Anemic patients have lower levels of hemoglobin and are therefore
unable to carry as much oxygen in the blood. At a hemoglobin
concentration of less than 6g/dl, delivery of oxygen to the tissues may
become too low to meet the metabolic demands. Patients who suffer
major blood loss during surgery and become acutely anemic should be
given 100% oxygen to breathe. This will increase the amount of
dissolved oxygen in the blood and will improve tissue oxygen delivery
by a small amount. Blood transfusion may be lifesaving [12].

1.2.3 OXYGEN SATURATION

Red blood cells contain hemoglobin. One molecule of hemoglobin can
carry up to four molecules of oxygen after which it is described as
“saturated” with oxygen. If all the binding sites on the hemoglobin
17

molecule are carrying oxygen, the hemoglobin is said to have a

saturation of 100%. Most of the hemoglobin in blood combines with
oxygen as it passes through the lungs. A healthy individual with normal
lungs, breathing air at sea level, will have an arterial oxygen saturation
of 95% – 100%. Extremes of altitude will affect these numbers. Venous
blood that is collected from the tissues contains less oxygen and
normally has a saturation of around 75%. (See appendix 1 for more
details about this) [12].
Arterial blood looks bright red whilst venous blood looks dark red. The
difference in color is due to the difference in hemoglobin saturation.
When patients are well saturated, their tongues and lips appear pink
in color; when they are desaturated, they appear blue. This is called
cyanosis. It can be difficult to see cyanosis clinically, particularly in a
dark skinned patient. Patient may not notice this sign until the oxygen
saturation is less than 90%. Detecting cyanosis is even more difficult in
a poorly lit operating theatre [12].
Cyanosis is only visible when the deoxygenated hemoglobin
concentration is greater than 5 g/dl. A severely anemic patient may
not appear cyanosed even when extremely hypoxic as there is very
little hemoglobin circulating through the tissues. During anesthesia the
oxygen saturation should always be 95 - 100%. If the oxygen saturation
is 94% or lower, the patient is hypoxic and needs to be treated quickly.
A saturation of less than 90% is a clinical emergency [12].

Needing for measure pulse oximeter

Several studies have pointed to an unusual phenomenon in a number

of people infected with the Corona virus, which is "silent hypoxia",
which can be a dangerous symptom of respiratory diseases. According
18

to what was published by the Boldsky website, cases of hypoxia that

were not noticed by Covid-19 patients began to be detected as of June
2020. Experts explained that patients with silent hypoxia, can walk and
talk easily, and even have their blood pressure and heartbeat in
normal ranges. , although oxygen levels have fallen below 80%.

Silent hypoxia is defined as a pathological condition in which the levels

of oxygen in the blood drop below the average rate, but the patient
does not feel any symptoms, so he does not notice or suffer from any
trouble until after the disease progresses and severe damage to the
lungs occurs. The oxygen saturation in the bloodstream of a healthy
person is more than 95%, but Covid-19 patients show a dangerous
decrease, in some cases reaching less than 40%.

Reports also indicate that silent hypoxia is becoming increasingly

prevalent among young adults, as "younger patients often experience
hypoxia without experiencing shortness of breath or related
symptoms until oxygen saturation levels drop below 80%."

1.2.4 Tests to measure patient's oxygen levels

Tests to check the level of oxygen in patient's blood can be helpful in

diagnosing or monitoring lung disease.
Tests used include:
-pulse oximetry
-blood gas test
-long term oxygen therapy (LTOT) assessment
19
-hypoxic challenge (fitness-to-fly) test

pulse oximetry
Oxygen is carried around in patient's red blood cells by a molecule
called haemoglobin. Pulse oximetry measures how much oxygen the
haemoglobin in patient's blood is carrying. This is called the oxygen
saturation and is a percentage (scored out of 100). It’s a simple,
painless test which uses a sensor placed on patient's fingertip or
earlobe. People with a lung condition may have a blood oxygen level
lower than normal, so pulse oximetry can help to diagnose if there is a
problem. The more the lungs are damaged, the more likely there is to
be a problem with oxygen uptake. Pulse oximetry can also be used to
measure to how badly a person’s lungs are affected.

The test can be done as a one-off spot measurement. It can also be

used to measure patient's oxygen levels over a period of time, for
example during exercise like walking – or when patient is asleep. Pulse
oximetry results can be affected by medical conditions including
anaemia and Raynaud’s syndrome. Talk to patient's health care
professional if you’re concerned about this.

during a pulse oximetry test, patient will have a small device clipped
to patient's finger or earlobe, called an oximeter. This gadget shines
light through patient's fingertip or earlobe. It works out how much
oxygen is in patient's blood. The oximeter display shows the
percentage of oxygen in patient's blood. For someone who’s healthy,
the normal blood oxygen saturation level will be around 95–100%. If
20

the oxygen level is below this, it can be an indicator that there is a lung
problem. People with low oxygen level may need additional oxygen or
other treatment. patient's health care professional will discuss this
with you.

Blood gas test

A blood gas test is used to measure more accurately how much oxygen
and carbon dioxide there is in patient's blood. The test is called:
 an arterial blood gas test if the sample is taken from patient's
wrist
 a capillary blood gas test if the sample is collected from patient's
earlobe

A blood gas test is used to check how well patient's lungs are working
and whether they’re able to exchange oxygen and carbon
dioxide efficiently. It can be used to see if patient need oxygen
therapy.
during a blood gas test, the tester will take a small sample of patient's
blood. They will normally take this by using a needle and a syringe in
one of the arteries of patient's wrist. Or they may take blood from the
inside of patient's elbow. Sometimes, they will use some local
anaesthetic.
Some hospitals check blood gas by taking a blood sample from
patient's earlobe.
 patient's tester will put a special cream on patient's earlobe that
helps increase blood flow. This makes patient's ear go red and
21

feel hot.
  The blood vessels in patient's ear lobe will then contain about
the same amount of oxygen as blood taken from patient's artery.
 After a few minutes the tester can take a sample by pricking the
earlobe and catching the blood droplet that forms. This isn’t
painful - it’s similar to the way blood sugar levels can be checked
from a pinprick on the fingertip.
The earlobe method can’t usually be used if patient need to have the
test when patient is unwell (such as when you’re admitted to hospital
with a flare-up of COPD symptoms).
What will the results look like?
The results will be a set of readings showing
 oxygen
 carbon dioxide
 acidity / alkalinity (pH)
Abnormal results may mean patient's body is not getting enough
oxygen or is not getting rid of enough carbon dioxide.
A high level of carbon dioxide may mean that patient's breathing is
shallow at night and patient may benefit from using a ventilator device
at home.

Long-term oxygen therapy (LTOT) assessment

Some people with very low oxygen levels may benefit from
using oxygen therapy. A long-term oxygen therapy assessment is a set
of tests to measure the levels of oxygen in patient's blood to see if they
22

are low enough for oxygen therapy to be helpful. A long-term oxygen

therapy assessment is used to test oxygen levels in people who have a
long-term condition such as COPD, pulmonary
fibrosis, asthma, pulmonary hypertension or cystic fibrosis. The
outcome can help patient's health care professional decide if patient
should have oxygen therapy [15].

during an oxygen assessment, an oxygen assessment usually happens

when patient's lung condition is stable and patient don’t have a chest
infection. Oxygen levels can dip down during infections, but unless
patient's oxygen level stays low it is usually not necessary to have
oxygen at home. The assessment involves measuring patient's blood
gases on 2 occasions, a few weeks apart. patient's oxygen levels will
be tested while you’re sitting down. You’ll have a pulse oximetry
test and patient may also have a lung function test using a spirometer.
Sometimes you’ll be asked to do a walking test to see if patient's
oxygen levels go down as patient exercise and, if that happens,
whether extra oxygen means patient can walk further [15].

Some people who don’t need to use oxygen all the time can benefit
from oxygen when they exert themselves. This is called ambulatory
oxygen. This is only beneficial in people whose oxygen levels fall
significantly when they walk. If patient's oxygen levels are low and
patient need to be started on oxygen therapy, patient's blood
gases will be checked again while patient are breathing in extra
oxygen. The oxygen is delivered by small see-through tubes known as
nasal cannulae or a face mask covering the nose and mouth. This check
will help work out how much oxygen patient need to improve the level
of oxygen in patient's blood [15].
23
Hypoxic challenge (fitness-to-fly) test
The hypoxic challenge test simulates the conditions inside the cabin of
an aero plane during a flight. That means you’ll be
breathing reduced levels of oxygen, just as patient would on a
plane. It’s sometimes called a fitness-to-fly test, though it only covers
the question of whether oxygen is needed. It’s used to see if patient
will need oxygen while patient is flying. If patient live with a lung
condition, patient's oxygen levels may be lower than normal. During a
flight, the oxygen level in the cabin air is only around 15%, compared
to 21% at sea level. This means that during flight patient's blood
oxygen levels can fall even further, to a level where there is a risk of
heart problems or other complications. This can be avoided by having
oxygen in flight. The results will help decide if patient will need extra
oxygen when patient fly. If patient is planning a flight, ask patient's
health care professional if patient need this test well in advance. This
will help patient plan patient's trip [15].

during a hypoxic challenge test, while you’re sitting down, you’ll

breathe a low oxygen mixture using a face mask. patient's oxygen
levels and heart rate will be monitored. At the end of the test, a small
blood sample may be taken from patient's earlobe or patient's wrist.
If patient's oxygen levels go down during the test, patient's health care
professional will add extra oxygen to see if patient's oxygen levels go
back to normal. At the end of the test, patient's doctor can make a
decision about patient's need for oxygen during flight. If patient's
oxygen goes down during the test, even after adding extra oxygen, it
may be unsafe for patient to fly. If patient's health care professional
was able to bring patient's oxygen to a stable level, they’ll know the
amount of extra oxygen patient need to be able to fly safely [15].
24
Ways to increase oxygen in the blood naturally:
Breathing is something we do without thinking, so it is easy to take it
for granted. But as people age, they are more likely to develop
respiratory complications and experience breathing difficulties. Along
with this inability to breathe freely and sustain healthy blood oxygen
levels. there are some natural methods of increasing your blood
oxygen level. Everyone can benefit from the improved concentration,
better healing, and better sleep that higher levels of oxygen provide.
Caregivers can help their aging loved ones alleviate troubling
symptoms of chronic illness and improve their overall health through
focused breathing exercises that increase oxygen saturation in the
body and ease physical and mental stress. These ways may be:
1. Eat more fruit.
2. Do exercise .
3. Do aerobic exercise.
4. Breathing from the abdomen.

Benefits of Breathing Exercises:

If practiced regularly ٫
1. breathing exercises can help rid the lungs of accumulated stale
air.
2. increase oxygen levels and get the diaphragm to return to its job
of helping you breathe .
3. breathing exercises can help improve overall respiratory health
and lung capacity.
25
1.2.5 Diaphragmatic Breathing:

there is a right way to breathe, but most people don’t practice it.
Patients with limited lung capacity often fall into the habit of taking
short, shallow breaths into their chest. If a person’s chest rises as they
take a breath, it is a likely indicator of improper breathing. A proper
breath will draw air into the lungs, pushing the diaphragm down and
visibly expanding the belly. This is why diaphragmatic breathing is also
called “belly breathing.” Follow these steps to engage in deep,
diaphragmatic breathing:

1) Sit up straight, with one hand on the stomach and the other on
the chest.
2) Inhale slowly and deeply through the nostrils, feeling the
stomach expand with each full, diaphragmatic breath.
3) Exhale slowly out of the mouth.
4) Repeat six or more times each minute for up to 15 minutes.

Tips for reducing your cholesterol naturally:

It’s normal to want to try to control cholesterol with lifestyle choices,

diet, and supplements as the first line of treatment rather than
starting medication. Steps you can take to lower your cholesterol
without medication include the following six tips:
26

1 .Avoid trans and saturated fats:

Eating foods that contain saturated or trans fats can increase your
cholesterol level.
2 .Eat lots of soluble fiber:

Upping your daily intake of soluble fiber can decrease Trusted Source
low-density lipoprotein (LDL) cholesterol.
3 .Exercise:

Walking, jogging, biking, and swimming are all exercises that can help
lower cholesterol, especially if you do them three times per week or
more.
4 .Cut down on your alcohol intake:

Cutting down on beer, wine, and liquor can be a simple first step to
lowering your cholesterol.
5 .Try fish oil supplements

Fish oil supplements contain omega 3-chain fatty acids. These acids
may help lower triglycerides.
6 .Take a garlic supplement:

research suggested that garlic may help to reduce your body’s

absorption of cholesterol and lower triglycerides in your blood.
27
 Chapter 2
Principle Overview

28
2.1 Infrared radiation

Infrared radiation (IR), or infrared light, is a type of radiant energy that's

invisible to human eyes but that we can feel as heat. All objects in the
universe emit some level of IR radiation, but two of the most obvious
sources are the sun and fire.
IR is a type of electromagnetic radiation, a continuum of frequencies
produced when atoms absorb and then release energy. From highest
to lowest frequency, electromagnetic radiation includes gamma-rays,
X-rays, ultraviolet radiation, visible light, infrared radiation, microwaves
and radio waves. Together, these types of radiation make up the
electromagnetic spectrum.
Similar to the visible light spectrum, which ranges from violet (the
shortest visible-light wavelength) to red (longest wavelength) as shown
in fig [3], infrared radiation has its own range of wavelengths. The
shorter "near-infrared" waves, which are closer to visible light on the
electromagnetic spectrum, don't emit any detectable heat and are
what's discharged from a TV remote control to change the channels.
The longer "far-infrared" waves, which are closer to the microwave
section on the electromagnetic spectrum, can be felt as intense heat,
such as the heat from sunlight or fire. 29
One of the most useful applications of the IR spectrum is in sensing and
detection.

2.2.1 Near-infrared light

Near-infrared (NIR) refers to light within the wavenumber range of

12,500 to 4,000 cm-1 (wavelengths from 800 to 2,500 nm). Near
infrared light is selected for its characteristics which make the
measurement is more accurate, these characteristics are Methods and
systems for noninvasive blood analysis are revealed in which a blood
sample is noninvasively illuminated through a patient's tissue, such as
the skin, at a range of wavelengths, including a reference and a data
wavelength, for a target analyte. These wavelengths are preferably
selected from the near-infrared spectrum and are also preferably
closely spaced to each other in order to minimize interference from
other solutes in the blood.

Noninvasive measurements of the absorption of light at such

wavelengths are taken (e.g., by measuring reflectance or
transmittance), and noninvasive analysis of absorption ratios is
performed for various sets of these wavelengths. Changes in the
detected reflectance or transmittance ratios are then correlated with
specific material properties, such as the concentration of glucose, urea,
or cholesterol in a subject's circulatory system. The term "near-
infrared" or "near IR" is projected to encompass light in a spectrum
ranging from l000 to 2500 nm, more preferably from 1300 to 2300 nm,
and, in some cases most preferably from 1500 to 1800 nm.
30
2.3 oxygen Saturation and the idea of pulse oximeter

Pulse oximeters measure oxygen saturation. Before we learn the

principles of how pulse oximeters work, we need to have an
understanding of what oxygen saturation is.
We all know that we need oxygen for life. Oxygen enters the lungs and
then is passed on into blood. The blood carries the oxygen to the
various organs in our body. The main way oxygen is carried in our
blood is by means of hemoglobin. You can imagine hemoglobin
molecules ( Hb) as “cars” and the “roads” being our blood vessels. The
oxygen molecules get into these cars and travel around the body till
they reach their destination [21].

The hemoglobin without oxygen we will call de oxygenated

hemoglobin (deoxy Hb). The hemoglobin with oxygen, we will call
oxygenated hemoglobin (oxy Hb).

Oxygen saturation simply refers to the percentage of the available

hemoglobin that carries oxygen. Take the situations below. There are
16 hemoglobin units and none of the 16 have oxygen. The oxygen
saturation is therefore 0 %.
31
a)

b)

c)

d)
fig [2] [ a) The oxygen saturation is therefore 0 %. b) Here, 8 of the 16
Hb have oxygen. The oxygen saturation is therefore 50 %. c) Similarly
for 75 %, d) when all the Hb have oxygen, the saturation is 100 %.]
32
So in summary, oxygen saturation tells you the percentage of the total
hemoglobin that is carrying oxygen [21].

2.4 Physical properties used in pulse oximetry

Pulse oximetry uses light to work out oxygen saturation. Light is

emitted from light sources which goes across the pulse oximeter probe
and reaches the light detector. If a finger is placed in between the light
source and the light detector, the light will now have to pass through
the finger to reach the detector. Part of the light will be absorbed by
the finger and the part not absorbed reaches the light detector [21].

The amount of light that is absorbed by the finger depends on many

physical properties and these properties are used by the pulse
oximeter to calculate the oxygen saturation.
The amount of light absorbed depends on the following:
1. concentration of the light absorbing substance.
2. length of the light path in the absorbing substance
3. oxyhemoglobin and deoxyhemoglobin absorbs red and infrared
light differently
The physical properties that a pulse oximeter employs will be
explained using the probe shown below. A finger is shown inserted
33

into the probe. Above the finger are the light sources that emit light.
In the finger is an artery which carries the blood the pulse oximeter is
interested in and a vein through which the blood leaves the finger.
Below the finger is the light detector [21].

Physical property No.1 : Amount of light absorbed is proportional to

the concentration of the light absorbing substance
Hemoglobin (Hb) absorbs light. The amount of light absorbed is
proportional to the concentration of Hb in the blood vessel. In the
diagram below, the blood vessels in both fingers have the same
diameter. However, one blood vessel has a low Hb concentration ( i.e.
low number of Hb in each unit volume of blood) and the other blood
vessel has a high Hb concentration ( i.e. high number of Hb in each unit
volume of blood). Each single Hb absorbs some of the light, so more
the Hb per unit area, more is the light is absorbed. This property is
described in a law in physics called “Beer’s Law” [21].
Beer’s Law: Amount of light absorbed is proportional to the
concentration of the light absorbing substance
By measuring how much light reaches the light detector, the pulse
oximeter knows how much light has been absorbed. More the Hb in
the finger , more is the light absorbed.
34
Physical property No.2 : Amount of light absorbed is proportional to
the length of the light path.
Look at the two fingers shown below. Both arteries have the same
concentration (same Hb per unit area, blue square) However, the
artery on right is wider than the one on the left [21].

The light emitted from the source has to travel through the artery. The
light travels in a shorter path in the narrow artery and travels through
a longer path in the wider artery (paths are shown as green lines
below). Though the concentration of Hb is the same in both arteries,
the light meets more Hb in the wider artery, since it travels in a longer
path. Therefore, longer the path the light has to travel, more is the
light absorbed. This property is described in a law in physics called
35

“Lambert’s Law”.
Lambert’s Law: Amount of light absorbed is proportional to the length
of the path that the light has to travel in the absorbing substance.

Physical property No.3 : oxyhemoglobin absorbs more infrared light

than red light & deoxyhemoglobin absorbs more red light than infrared
light (this is explained below !)
We have seen how concentration and light path affect the absorbance
of light. In addition to these, the pulse oximeter makes use of another
important property to calculate oxygen saturation. That is, oxy
hemoglobin and deoxy hemoglobin absorb light of different
wavelengths in a specific way.
Before we go further, we need to remember what wavelength is. All
light is composed of waves. The distance between the “tips” of the
waves is equal to the wavelength.

Light wavelengths are very short, and the unit of measurement is

nanometer (nm) ( 1 meter = 1,000,000,000 nanometers !). For an
example, the wave on the left has a wavelength of 650 nm and the
36

wave on the right has a longer wavelength of 950 nm.

The pulse oximeter uses the property that oxyhemoglobin and
deoxyhemoglobin absorb light of different wavelengths in a specific
way. This property can be demonstrated in a laboratory as will be now
described. We can first demonstrate how oxyhemoglobin absorbs light
of different wavelengths in a specific way. We use a special light source
of which we can adjust the wavelength of the light it emits. This light
source sequentially passes light of different wavelengths through a
sample of oxy Hb. The detector notes how much light, at each
wavelength, has been absorbed [21].
A graph for the absorbance of oxy hemoglobin at different
wavelengths will look like this. It shows that oxy Hb doesn’t absorb the
same amount of light at different wavelengths.

37
We can repeat the same demonstration using deoxy Hb. Again notice,
how like oxy Hb, Deoxy Hb absorbs different amount of light at
different wavelengths.

Now let us see the absorbance graph of oxy Hb and the absorbance
graph of deoxy Hb together so you can compare them. Note how each
of them absorbs light of different wavelengths very differently.

The pulse oximeter uses two lights to analyze hemoglobin.

38
One is a red light, which has a wavelength of approximately 650 nm.
The other is an infrared light, which has a wavelength of 950 nm.
(Throughout our description, we will show the infrared light in light
blue. In reality, infrared light is invisible to the human eye) [21].

Now look at the oxy Hb absorbance graph again, but this time paying
attention to the wavelengths of light used in pulse oximeters. You will
see that oxy Hb absorbs more infrared light than red light.
39
Below is the graph that shows the absorbance of deoxy Hb. It is seen
from the graph that deoxy Hb absorbs more Red light than Infrared
light.

The pulse oximeter works out the oxygen saturation by comparing

how much red light and infrared light is absorbed by the blood.
Depending on the amounts of oxy Hb and deoxy Hb present, the ratio
of the amount of red light absorbed compared to the amount of
infrared light absorbed changes [21].

40
Using this ratio, the pulse oximeter can then work out the oxygen
saturation.

For an example, at 100 % saturation, the absorbance ratio (i.e.

comparing how much red light and infrared light is absorbed) will be
same as that seen with the oxy Hb absorbance curve that we saw
earlier.

At 0 % saturation, there is only deoxy Hb. The absorbance ratio ( i.e.

comparing how much red light and infrared light is absorbed) will
therefore be same as that seen with the de oxy Hb absorbance curve
that we saw earlier.
41
Now look at when the patient has an oxygen saturation of 75 %. The
blood has both, oxy Hb and deoxy Hb. The absorbance pattern is now
somewhere in between the oxy Hb curve and deoxy Hb curve (both
shown in grey). The ratio of absorbed red light and infrared light is
different and using this information, the pulse oximeter is able to
calculate the oxygen saturation as 75 %.

At 50 % oxygen saturation, the absorbance pattern is different to when

the saturation was 75 %. The ratio of red light and infrared light
absorbed is also therefore different and the pulse oximeter uses this
to calculate the saturation as 50 %.

To summarize things so far, the absorbance of light depends on:

1. concentration of the light absorbing substance.
42
2. length of the light path in the absorbing substance
3. oxyhemoglobin and deoxyhemoglobin absorbs red and infrared
light differently
The pulse oximeter computer takes these things factors and computes
the saturation.

2.5 Calibration Adjustment

Early on, we discussed how the pulse oximeter uses Beer’s and
Lambert’s Law (absorbance depends on concentration and path
length) as part of its factors that it uses to compute oxygen saturation.
Unfortunately, there is a problem. In physics, the Beer and Lambert
law have very strict criteria to be accurate. For an example, the light
that goes through the sample should go straight through like the lights
rays in the image below [21].

However, in real life, this does not happen. Blood is not a neat red
liquid. Instead, it is full of various irregular objects such as red cells etc.
This makes the light scatter, instead of going in a straight line.
Therefore, Beer and Lamberts Law cannot be applied strictly [21].
43
Because Beer and Lamberts law cannot be applied strictly, there would
be errors if they were used to directly calculate oxygen saturation. A
solution to this is to use a “calibration graph” to correct for errors. A
test pulse oximeter is first calibrated using human volunteers. The test
pulse oximeter is attached to the volunteer and then the volunteer is
asked to breath lower and lower oxygen concentrations. At intervals,
arterial blood samples are taken. As the volunteers blood desaturates,
direct measurements made on the arterial blood are compared
simultaneously with the readings shown by the test pulse oximeter.In
this way, the errors due to the inability of applying Beers and Lamberts
law strictly are noted and a correction calibration graph is made.
However, in order to not harm the volunteers, the oxygen saturation
is not allowed to drop below about 75 – 80 % [21].

A copy of this correction calibration graph is available inside the pulse

oximeters in clinical use. When doing its calculations, the computer
refers to the calibration graph and corrects the final reading displayed.
As mentioned before, the volunteer studies described before do not
allow the saturation to go below about 75 – 80 %. For saturations
below this, the calibration curve is mathematically estimated.
Therefore, pulse oximeters are typically less accurate below
saturations of about 75 – 80 % [21].
44
Pulse oximeters measure pulsatile blood
In a body part such as a finger, arterial blood is not the only thing that
absorbs light. Skin and other tissues also absorb some light. This poses
a problem, because the pulse oximeter should only analyse arterial
blood while ignoring the absorbance of light by surrounding tissues.
For an example of how tissues can interfere, take the two situations
shown below. One is a thin finger and the other is a fat finger. The
tissues in the thin finger absorbs only a little extra light, while the fatter
finger shown on the right absorbs much more light. However, the
pulse oximeter has no way to measure if the finger is fat or thin, and
therefore has the potential to get confused because it doesn’t know
how much light is absorbed by blood and how much is absorbed by the
tissues surrounding blood [21].
45
Fortunately, there is a clever solution to the problem. The pulse
oximeter wants to only analyse arterial blood, ignoring the other
tissues around the blood. Luckily, arterial blood is the only thing
pulsating in the finger. Everything else is non pulsating. Any “changing
absorbance” must therefore be due to arterial blood.

On the other hand, the pulse oximeter knows that any absorbance that
is not changing, must be due to non pulsatile things such as skin and
other “non arterial” tissues.

So the final signal picture reaching the pulse oximeter is a combination

of the “changing absorbance” due to arterial blood and the “non
changing absorbance” due to other tissues.
46
The pulse oximeter is able to use some clever mathematics to extract
the “changing absorbance” signal from the total signal, as will be
described. As shown below, the computer subtracts the non changing
part of the absorbance signal from the total signal. After the
subtraction, only the “changing absorbance signal” is left, and this
corresponds to the pulsatile arterial blood. In this way, the pulse
oximeter is able to calculate the oxygen saturation in arterial blood
while ignoring the effects of the surrounding tissues.

2.6 Problems with pulse oximeter

Problem of movement
When you think of problems associated with pulse oximeters it is
important to remember that the signal that is analyzed is really tiny.
As explained before, it is only about 2 % of the total light that is
analyzed.
47
Which such a small signal, it is easy to see how errors can occur. Pulse
oximeters are very vulnerable to motion, such as a patient moving his
hand. As the finger moves, the light levels change dramatically. Such a
poor signal makes it difficult for the pulse oximeter to calculate oxygen
saturation [21].

Problem of optical shunting

The pulse oximeter operates best when all the light passes through
arterial blood, as shown in the upper finger in the image below.
However, if the probe is of the wrong size or has not being applied
properly, some of the light, instead of going through the artery, goes
by the side of the artery (shunting) (lower finger in image below). This
reduces the strength of the pulsatile signal making the pulse oximeter
prone to errors. It is therefore important to select the correct sized
probe and to place the finger correctly in the chosen probe for best
48

results [21].
Problem of too much ambient light
As discussed before, in addition to the light from the LEDs, ambient
(room) light also hits the detector. For good functioning of the pulse
oximeter, the strength of the LED light falling on the detector should
be good when compared with the strength of the ambient light falling
on the detector [21].

If the ambient light is too strong, the LED light signal gets “submerged”
in the noise of the ambient light. This can lead to erroneous readings.
49
Therefore, it is important to minimize the amount of ambient light
falling on the detector. One can try and move away strong sources of
room light. One can also try and cover the pulse oximeter probe and
finger with a cloth etc.

Problem of electromagnetic interference

Electrical equipment such as surgical diathermy emits strong electric
waves which may be picked up by the wires of the pulse oximeter.
These waves (shown in green below) make small currents form in the
wires, confusing the pulse oximeter which assumes these currents
come from the light detector. During diathermy use, one should be
cautious about interpreting pulse oximeter readings [21].
50
Problem of poor peripheral perfusion
A good peripheral blood flow makes the arteries in fingers nicely
pulsatile. As discussed before, it is the pulsatile change in absorbance
that is used in the calculation of oxygen saturation.

When the peripheral perfusion is poor (e.g. in hypotension), the

arteries are much less pulsatile. The change in absorbance is therefore
less and the pulse oximeter may then find the signal inadequate to
correctly calculate oxygen saturation.

Problem of not detecting hyperoxia

In the beginning , we discussed that oxygen saturation refers to how
much of the hemoglobin is carrying oxygen. In the example below, all
the hemoglobin are carrying oxygen, and therefore the oxygen
saturation is 100 %.
51
However, hemoglobin is not the only way oxygen is carried in blood.
Additional oxygen can also be dissolved in the solution in which red
blood cells travel (plasma). The problem is that the pulse oximeter
cannot “see” the extra dissolved oxygen. So even though this patient's
blood is full of extra oxygen, the saturation still shows 100 %, instead
of say 120 % [21].

The 100 % saturation in the above example tells us that the patient is
getting enough oxygen. However, it does not tell you that the patient
is getting too much oxygen (hyperoxia). Oxygen, while necessary for
life, can be harmful if given in excess. Therefore, other means (e.g.
arterial blood gas) have to be used to detect hyperoxia [21].
Problem of calibration
As mentioned before, pulse oximeters are calibrated using humans.
This means that low saturations may not be accurate.
52
Problem of Colored dyes and nail polish
The dye, methylene blue, if in the patient's circulation, will artificially
lower the displayed oxygen saturation. Finger nail polish can affect the
accuracy of saturation determination [21].

Problem of abnormal hemoglobins

Abnormal hemoglobin can affect pulse oximeter readings. Carbon
monoxide combines with hemoglobin to form carboxy hemoglobin
(carboxy Hb). Most pulse oximeters cannot separately detect carboxy
Hb. Instead, it considers carboxy Hb as oxy hemoglobin. This is
dangerous as carboxy Hb doesn’t carry oxygen, and the artificially high
oxygen saturation displayed may wrongly reassure everyone. Another
abnormal hemoglobin, called methemoglobin, causes the saturation
to falsely show readings towards about 85 % [21].
53
2.7 Idea of non-invasive cholesterol level measurement

It has the same principle of pulse oximeter, the cholesterol part of

project aims to study the design and construct a non- invasive
cholesterol sensor at fingertip by using light absorption principles in the
near-infrared range at a wavelength of 1,200 nm because cholesterol
can be absorbed better than other substances. The developed sensor
uses with the patient who can measure blood cholesterol by himself or
herself in anytime and anywhere. It will be used with patients who are
afraid of blood collection, reduced patient’s injury, reduced infection
due to blood collection and reduced infectious waste.

54
 Chapter 3
Design Overview

55
Design and circuits of device
Our project includes two parts:
1) pulse oximeter
2) Non-invasive cholesterol sensor
Every part has its circuit, and its components.

3.1 Pulse oximeter:

In order to understand how to build a pulse oximeter, it is first
necessary to understand the theory behind its operation. The
principle mathematical equation used is known as Beer-Lambert's
Law.

Beer-Lambert's law is a well-used equation that describes the

relationship between the concentration of a substance in a solution
and the transmittance (or absorbance) of light passed through said
solution. In a practical sense, the law says that increasingly greater
amounts of light are blocked by increasingly greater particles in a
solution. The law and its components are described below [22].
56

Absorbance = log10(Io/I) = εbc

Where:
Io = Incident light (before added sample)
I = Incident light (after added sample)
ε = Molar absorption coefficient (function of wavelength and
substance)
b = Path length of light
c = Concentration of substance in sample

When measuring concentrations using Beer's Law, it's convenient to

select a wavelength of light in which the sample absorbs most. For
oxygenated hemoglobin, the best wavelength is about 660nm (red).
For deoxygenated hemoglobin, the best wavelength is about 940nm
(Infrared). Using LEDs of both wavelength, the relative concentration
of each can be calculated to find a %O2 for the blood being measured
[22].

Preparation: Pulse Oximetry

Our device uses two LEDs for the 660nm and 940nm wavelengths.
These are alternated on/off, and the Arduino records the result from
the detector on the opposite side of the finger from the LEDs. The
detector signal for both LEDs pulses in time with the heartbeat of the
patient. The signal can thus be divided into two portions: a DC portion
(representing the absorbance at the specified wavelength of
57

everything but the blood), and an AC portion (representing the

 absorbance at the specified wavelength of the blood). As specified in
the Beer-Lambert section, Absorbance is related to both of these
values (log10[Io/I]) [22].

%O2 is defined as: Oxygenated Hemoglobin / Total Hemoglobin

Substituting in the Beer Lambert Equations, solved for concentration,

the result is a very complex fraction of fractions. This can be simplified
in a few ways.

1. The path length (b) for both LEDs is the same, causing it to drop out of
the equation
2. An intermediate ratio (R) is used. R =
(AC640nm/DC640nm)/(AC940nm/DC940nm)
3. Molar Absorption coefficients are constants. When divided, they can
be replaced with a generic fit factor constant. This causes a slight loss
in accuracy, but seems to be pretty standard for these devices.

3.1.1 Block diagram:

58
3.1.2 Circuit diagram:

3.1.3 Components

-Arduino Uno

-Red led the 660nm

-Infrared led 940nm

-Photodiode

-150 Ohm Resistor

-180 Ohm Resistor

59

-10 kOhm Resistor

-100 kOhm Resistor

-47 nF Capacitor

-Wires

Arduino

The Arduino Uno required for this project is known as a

microprocessor, a class of devices that continuously runs a set of
preprogrammed instructions. Microprocessors can read inputs to the
device, do any required math, and write a signal to its output pins.
This is incredibly useful for any small-scale project that requires math
and/or logic [22].
60
3.2 Non-invasive cholesterol sensor:

3.2.1 Materials and Methods

A study on the design and construct of a non- invasive cholesterol

sensor at fingertip was to use the principle of light absorption principles
in a near- infrared wavelength of 1200 nm and red light and the
principle of electronics. There were two parts:
1) Design and construction of non-invasive cholesterol sensor
2) Testing and calibration of the cholesterol sensing device.

3.1 Design and construction of a non-invasive cholesterol sensor

The design and construct of a non- invasive cholesterol sensor
consisted of 4 parts.
A) the signal detector by using the sensor which consisted of Near-
Infrared LED and Red Light-Emitting Diode as a transmitter and
photodiode as a receiver.
B) the signal conditioning by using LM324.
C) the signal processing by using Arduino Nano 3.0.
D) the display by using the LCD.
The diagram illustrating a study on the design and construct a non-
invasive cholesterol sensor was shown in Figure 1.
61
Figure 1 Diagram illustrating of a non-invasive cholesterol sensor
a. Signal detector part
The design and construction of signal detector part consisted of a light
transmitter and a light receiver inside the sensor that was set in the
finger clip probe. The light transmitter consisted of two different lights.
The first light was the near-infrared wavelength 1200 nanometer which
can be absorbed by blood cholesterol and the second light was the red
light that used as the background due to the red light does not affect
the absorption of cholesterol in the blood. The light receiver was used
as a photodiode. For the sensor circuit used Arduino Nano 3. 0 which
was the digital of microcontroller port as the power supply (Vs) and
used resistor R1 to limit current pass through the near-infrared LED and
used resistor R2 to limit current pass through the red LED in the circuit
to prevent damage to the light sources. The sensor circuit in part A1
was as shown in Figure 2 and could be calculated the resistance R1 and
R2 value to use in the circuit as the equation (1).

Figure 3 Signal detector part

62
Where RIR was the resistance that used to limit current on the near-
infrared light, VS was the voltage of power supply, VIR was the bias
voltage of near- infrared light and IIR was the bias current of near
infrared light.

Where RR was the resistance that used to limit current on the near-
infrared light, VS was the voltage of power supply, VRED was the bias
voltage of red light and IRED was the bias current of red light. The
power supply (Vs) from Arduino Nano 3.0 port was 5 Volts.
From the description of the near infrared LED light, it showed that
there would be VIR was 1 Volt and IIR was 20 milli amperes when
substitute in equation (1), the resistance R1 was 200 ohms. From the
description of the red LED light, it showed that there would be VRED
was 3 Volts and IRED was 20 milli amperes when substitute in equation
(2), the resistance R2 was 100 ohms.
Therefore, the resistances R1 and R2 used in a sensor circuit were 200
ohms and 100 ohms. For the light receiver used a photodiode that
received light energy and changed into a voltage by using the current
to voltage converter in part A1.
63
The current to voltage converter was used zero voltage biasing and
requires a Vout of 5 millivolts, the current of a photodiode (Id) was 1
nano-ampere, and the resistance in the circuit was calculated by the
Ohm law. Therefore, the resistance in current to voltage circuit R3 was
5 Mega ohms.

b. Signal conditioning part

Due to the signal from the detector was a small signal, and there was
an interfering signal, this project was used the processing part to
improve the signal to reduce the interfering signal and enlarge the
signal. The signal conditioning part used the AC amplifier circuit, which
consisted of a high pass filter, non- inverting amplifier, and low pass
filter. The diagram illustrating of processing part was shown in Figure 3.

Figure [4] Diagram illustrating of signal conditioning part

The AC amplifier circuit was used in the processing part as non-inverting

circuit due to the properties of the circuit which can be specified cut-
off frequency range (fc) in high pass filter circuit and low-pass filter
circuit. The AC amplifier circuit in part B1 was as shown in Figure 4.
64
 Figure [5] AC amplifier circuit

The processing part used the high pass filter which was used cut off
frequency 0. 5 Hertz, and a capacitor (C2) has capacitance 1 microfarad.
The resistance R4 was calculated by equation (3).

From the signal amplifier circuit in part B1 obtained the input voltage
(Vin) was 5 millivolts by determining the output voltage from non-
inverting amplifier circuit Vout in positive was 2 volts because the
circuit used a single- phase of the power supply is positive and the
voltage gain (Av) was 400. The current was used in op-amp was
calculated by equation (4).
65
Where IB(max) = 300 nano-amperes, therefore the current in equation
(4) was 30 microamperes. The design required Ri = R6 and Rf = R5
resistance R5 and R6 was calculated by Ohm’ s law and the voltage gain
as equation (5) and (6).

In the low pass filter in part B1 used to cut off frequency 2. 5 Hertz
and a capacitor (C3) has capacitance 1 microfarad. The resistance R5
in the circuit was 60 k and the capacitance was calculated by
equation (7).

Therefore, the design of AC amplifier circuit used R4 = 300 ₙΩ, R5 = 60

k Ω, R6 = 160 Ω and C3 =1.6μF
but in this project, we used C3 ~ 1.0 μF.
For the signal amplifier circuit in part B1 had remained an interfering
signal at high frequency. In this project used low pass filter to prevent
the effect in signal processing part which was used cut off frequency
66

2.5 Hertz, a capacitor (C) has capacitance 1 microfarad, the voltage

gain (Av) was 1, the resistor R7 used in low pass filter and R8 used for
the suitable of the amplifier signal so that the resistance R7, R8 was
equal. The resistance R7, R8 was calculated by equation (8).

c. Signal processing part

In the project use microcontroller Arduino Nano 3.0 which has enough
resolution to process the signal in the desired range well. There is an
analog signal converter circuit into a digital signal, and there is the
highest voltage from the input part equal to 5 volts.
From the signal conditioning, the output from op-amp was an analog
signal which converted to a digital signal by using the analog to digital
converter. Then, the equation of the relationship between the
concentration of cholesterol in the blood in milligrams per deciliter and
digital output values was used to writing a signal processing program
into a microcontroller.
d. Display part
A 16 x 2 LCD screen was chosen in the display part to show the user's
blood cholesterol level in milligrams per deciliter (mg/ dL). When
measured blood cholesterol levels, the signal from the signal processing
part was commanded by a microcontroller that sent to the display part
and showed the alphabets and numbers on the LCD screen. The design
and construction non- invasive cholesterol sensor circuit described
above are shown in Figure 5.
67
Figure [6] Non-invasive cholesterol sensor circuit

3.2 Testing and calibration of the cholesterol sensing device

In order to develop the non- invasive cholesterol sensor device for
practical use, it was necessary to establish of the calibration curve the
cholesterol sensing device and find the percentage error of Non-
invasive cholesterol sensor compared with cholesterol from blood
collection.
3.2.2 Design of ring
Design of ring where the finger should place in fig [], it contains the IR
and RED LEDs and photodiode, it contains two circuits, first one for
cholesterol and second for cholesterol, LEDs will start emitting light
towards the finger and photodiode will transmit the reflected part.
68
Fig [7]: Design of ring where the finger should place
69
 Chapter 4
Hardware and software
Implementation
70
71
Our project divided into software and hardware parts, hardware part
includes implementation circuit and software part includes Arduino
control code refer to APPENDIX.

4.1 Simulation of pulse oximeter circuit:

4.2 Simulation of cholesterol circuit

72
 4.3 Pulse oximeter and cholesterol sensor hardware implementation

Ring of sensors
and
photodiodes

LCD

Cholesterol sensor PCB Arduino uno

73
Chapter 6 Conclusion and
Future work
74
 Conclusion

In this project, a device designed to measure oxygen saturation and

cholesterol level in the blood, it is divided into two parts, software and
hardware parts, hardware part includes implementation circuit and
software part includes Arduino control code. the project aims to
measure the cholesterol level and oxygen saturation by non-invasive
method that uses the properties of near infrared light. A ring is
designed to place the LEDs and photodiodes, the human finger is placed
on this ring, then the LEDs are emitted and the light transfer through
the finger to the photodiode, the signal coming out of the photodiode
is fed into the circuit and microcontroller to processing it, then display
it.

75
Further Ideas for future:

1. it is maybe using infrared, and adding Code for calculating and

reporting the heartbeat, glucose of the patient, along with SpO2
2. Bluetooth connection for exchanging data with a computer

76
References

77
[1] Freeman MW, Junge C. "Understanding cholesterol: the
good, the bad, and the necessary. In: The Harvard Medical
School Guide to Lowering patient's Cholesterol", New York, US:
McGraw-Hill, 2005.

[2] Savada Dr Hilis DM, HeIer HC Berenbeum MR(20 11).

"Life: The science of biology 9th edition". San

francisco:freenam.pp 105-1 v4 ISBNI-4292-4646-4

[3] "Cholesterol". Bethesda, US: Medline Plus, National
Institutes of Health. Information published online,
accessed March 2015.

[4] "What is cholesterol?" Bethesda, US: National

Institutes of Health, National Heart, Lung and Blood
Institute. Information published online, accessed March
2015.

[5] Kim K. Birtcher, Christie M. Ballantyne,

"Measurement of Cholesterol: A Patient Perspective"
Circulation. 2004;110:e296- e297, American Heart
Association, 2004.

[6] Ask Mayo Expert. "Screening recommendations for

asymptomatic men". Rochester, Minn. Mayo Foundation for
Medical Education and Research. 2010.

[7] Soliman, G. A. (2018). Dietary Cholesterol and the Lack of

Evidence in Cardiovascular Disease. Nutrients,
10(6), 780. doi:10.3390/nu10060780.

[8] Blesso, C. N., & Fernandez, M. L. (2018). Dietary Cholesterol,

Serum Lipids, and Heart Disease: Are Eggs
78
Working for or Against You?. Nutrients, 10(4), 426.
doi:10.3390/nu10040426.

[9] Cox, R. A, García-Palmieri, M. R. (1990). Cholesterol, Triglycerides,

and Associated Lipoproteins. In:
Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History,
Physical, and
Laboratory Examinations. 3rd edition. Boston: Butterworths; Chapter
31. Available from:
https://www.ncbi.nlm.nih.gov/books/NBK351/

[10] Huff, T., & Jialal I. (2019). Physiology, Cholesterol. [Updated 2019
Mar 13]. In: StatPearls [Internet].
Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from:
https://www.ncbi.nlm.nih.gov/books/NBK470561/

[11] Nelson, R. H. (2013). Hyperlipidemia as a risk factor for

cardiovascular disease. Primary care, 40(1), 195–211.
doi:10.1016/j.pop.2012.11.003.

[12] Pulse Oximetry Training Manual - WHO. (n.d.).

https://www.who.int/patientsafety/safesurgery/pulse_oximetry/wh
o_ps_pulse_oxymetry_training_manual_en.pdf?ua=1.

[13] Mayo Foundation for Medical Education and Research. (2021,

May 15). Cholesterol test. Mayo Clinic.
https://www.mayoclinic.org/tests-procedures/cholesterol-
test/about/pac-20384601.

[14] U.S. National Library of Medicine. (2020, July 30). Cholesterol

Levels: MedlinePlus Medical Test. MedlinePlus.
79

https://medlineplus.gov/lab-tests/cholesterol-levels/.
[15] Tests to measure patient's oxygen levels. British Lung
Foundation. (2021, July 19). https://www.blf.org.uk/support-for-
you/breathing-tests/tests-measure-oxygen-levels.

[16] Mach F, Baigent C, Catapano AL, Koskinas KC, Casula M, Badimon

L et al (2020) 2019 ESC/EAS Guidelines for the management of
dyslipidaemias: Lipid modification to reduce cardiovascular risk.
European Heart Journal 41(1):111–188

[17] Baigent C, Blackwell L, Emberson J, Holland LE, Reith C, Bhala N et

al (2010) Efficacy and safety of more intensive lowering of LDL
cholesterol: a meta-analysis of data from 170 000 participants in 26
randomised trials. Lancet. 376(9753):1670–1681

[18] Michos ED, McEvoy JW, Blumenthal RS (2019) Lipid management

for the prevention of atherosclerotic cardiovascular disease. The New
England Journal of Medicine 381(16):1557–1567

[19] Reda A, Abdel-Rehim AA, Etman A, Afifi OSA (2014) Centralized

pan-Middle East Survey on the under-treatment of
hypercholesterolemia: results from the CEPHEUS study in Egypt.
Cardiol Ther. 3(1–2):27–40

[20] Farag ES, Reda A, Farag N, Salama S, Elbahry A, Sanad O et al

(2017) The Egyptian cardiovascular risk factors project, phase (II)
results: a multicenter observational study of the pattern of risk factor
profile in Egyptian patients with acute coronary syndrome.
80

Atherosclerosis. 263:e159
[21] how equipment works .com. how equipment works com. (n.d.).
https://www.howequipmentworks.com/pulse_oximeter/.
[22] Ben, N. and, & Instructables. (2020, July 28). Arduino Pulse
Oximeter. Instructables. https://www.instructables.com/Arduino-
Pulse-Oximeter/.

81
 APPENDIX
Arduino control code of pulse oximeter and cholesterol
senor:

#include <LiquidCrystal.h>

const int rs = 12, en = 11, d4 = 4, d5 = 5, d6 = 6, d7 = 9;

LiquidCrystal lcd(rs, en, d4, d5, d6, d7);

#define BUAD_RATE 9600

#define RED_LED 7
#define IR_LED 8
#define PHOTO_DIODE A1

#define BUAD_RATE 9600

#define PARAMETER_1 0.000005
#define PARAMETER_2 0.0039
#define PARAMETER_3 0.9066
#define PARAMETER_4 154.82
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//parameters for pulse_oximeter
//Input Parameters
const int stabilityDelay = 5; //Delay between turning LED on and
reading detector
const int collectedSamples = 200; //Number of samples collected
before calculating/printing SO2
const float fitFactor = 0.4; //Factor to multiply by R to fit SO2 to the
device
const boolean serialDisplay = true; //Turn on/off serial display

//Declare Pin Numbers

const int LED_RED = 2;
const int LED_IR = 3;
const int detectorPin = A0;

//Declare Variables for Calculation

float redAC = 0;
float redDC = 1024;
float irAC = 0;
float irDC = 1024;
int count = 0;
float rVal;
float SpO2;
83

//parameters for Cholesterol

typedef unsigned char uint8;
unsigned int Photo_Diode_Reading[6] = {0};
long Photo_Diode_Reading_Squared = 0;
long Photo_Diode_Reading_Cubed = 0;
unsigned int Cholesterol_Level_Pure = 0;
float Cholesterol_Level = 0.0;

void setup() {
// put your setup code here, to run once:
pinMode(A2,INPUT);
Initialize_Serial_Monitor(BUAD_RATE);
Initialize_LCD(16, 4);
Print_Welcome_Message();
Initialize_Components_Cholesterol();
Turn_On_Transmitter_Cholesterol();

Set_Analog_Reference_Pulse();
Initialize_Pulse_Components();

}
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void loop() {
// put your main code here, to run repeatedly:
//Pulse_Function();
lcd.clear();
lcd.setCursor(2, 0);
lcd.print("SpO2 = ");
lcd.setCursor(10, 0);
lcd.print(Pulse_Function());

//Cholesterol_Function();
Serial.print(Cholesterol_Function());
Serial.println(" mg/dL");
lcd.setCursor(0, 1);
lcd.print("Cholesterol Lvl = ");
lcd.setCursor(10, 2);
lcd.print(Cholesterol_Function());
delay(250);
}

void Initialize_Serial_Monitor(int baud_rate)

{
Serial.begin(BUAD_RATE);
85

}
void Initialize_LCD(char rows, char columns)
{
lcd.begin(rows, columns);
}

void Print_Welcome_Message(void)
{
lcd.setCursor(4, 0);
lcd.print("Cholesterol");
lcd.setCursor(8, 1);
lcd.print("&");
lcd.setCursor(7, 2);
lcd.print("Pulseoxmeter");
lcd.setCursor(10, 3);
lcd.print("Project");
delay(5000);
}

void Set_Analog_Reference_Pulse(void)
{
analogReference(INTERNAL); //Sets Reference to 1.1V
}
86
void Initialize_Pulse_Components(void)
{
pinMode(LED_RED, OUTPUT);
pinMode(LED_IR, OUTPUT);
pinMode(detectorPin, INPUT); //Sets detectorPin as an input pin
}

float Pulse_Function(void)
{
beginning: //Tag for "goto"

float redVal = readAbsorbance("Red"); //Store absorbance voltage

for red LED in "redVal"
float irVal = readAbsorbance("IR"); //Store absorbance voltage for IR
LED in "irVal"

if(redVal == irVal){ //If redVal = irVal (typical when device is not on a

finger)
goto beginning; //Restart loop
}

while(redVal == irVal)
87

continue;
 if(redVal > redAC)
redAC = redVal; //Makes redAC the max value for the red LED

if(redVal < redDC)

redDC = redVal; //Makes redDC the min value for the red LED

if(irVal > irAC)

irAC = irVal; //Makes irAC the max value for the IR LED

if(irVal < irDC)

irDC = irVal; //Makes irDC the min value for the IR LED

count++; //Increments the count variable

if(count >= collectedSamples)

{
rVal = (redAC / redDC) / (irAC / irDC); //Calculates R for the data
SpO2 = (rVal * fitFactor * (-1.0/3.0) + (3.4 / 3.0))*100; //Calculates
SpO2 for the data
//Reset all variables
count = 0;
redAC = 0;
88

redDC = 1024;
 irAC = 0;
irDC = 1024;
return SpO2;
// lcd.clear();
// lcd.setCursor(2, 0);
// lcd.print("SpO2 = ");
// lcd.setCursor(10, 0);
// lcd.print(int(SpO2));
// //delay(50);

// Serial.print(rVal);
// Serial.print(",");
// Serial.println(SpO2); //Prints rVal and Sp02 to the serial
monitor/plotter
}
}

float readAbsorbance(String pin)

{
if (pin == "Red")
{
digitalWrite(LED_IR, LOW);
89

digitalWrite(LED_RED, HIGH);
 }
else
{
digitalWrite(LED_RED, LOW);
digitalWrite(LED_IR, HIGH);
}

delay(stabilityDelay);

return analogRead(detectorPin);
}

void Initialize_Components_Cholesterol(void)
{
pinMode(RED_LED,OUTPUT);
pinMode(IR_LED,OUTPUT);
pinMode(PHOTO_DIODE,INPUT);
}

void Turn_On_Transmitter_Cholesterol(void)
{
digitalWrite(RED_LED,HIGH);
90

digitalWrite(IR_LED,HIGH);
}

long Power(unsigned int num, uint8 power)

{
switch (power)
{
case 2: return num*num;
case 3: return num*num*num;
}

float Cholesterol_Function(void)
{
for(uint8 i = 0 ; i < 6 ; i++)
{
Photo_Diode_Reading[i] = analogRead(A1);
Serial.println(Photo_Diode_Reading[i]);
}
for(uint8 i = 0 ; i < 4 ; i++)
{
Cholesterol_Level_Pure += Photo_Diode_Reading[i];
Cholesterol_Level_Pure = Cholesterol_Level_Pure/24;
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//if((Photo_Diode_Reading[i] >= 100 && Photo_Diode_Reading[i] <=
200) && (Photo_Diode_Reading[i+1] >= 100 &&
Photo_Diode_Reading[i+1] <= 200) && (Photo_Diode_Reading[i+2] >=
100 && Photo_Diode_Reading[i+2] <= 200))
//{
//Cholesterol_Level_Pure = (Photo_Diode_Reading[i] +
Photo_Diode_Reading[i+1] + Photo_Diode_Reading[i+2]) / 3;
//break;
//}
//else
//{
//Cholesterol_Level_Pure = 0;
//}
}

Serial.print("Digital Reading == ");

Serial.println(Cholesterol_Level_Pure);

Serial.print("Cholesterol Level == ");

Photo_Diode_Reading_Squared = Power(Cholesterol_Level_Pure,2);
Photo_Diode_Reading_Cubed = Power(Cholesterol_Level_Pure,3);

if(Cholesterol_Level_Pure == 0)
92

{
Cholesterol_Level = 0;
}
else
{
Cholesterol_Level = (PARAMETER_1 *
Power(Cholesterol_Level_Pure,3)) - (PARAMETER_2 *
Power(Cholesterol_Level_Pure,2)) + (PARAMETER_3
*Cholesterol_Level_Pure ) + PARAMETER_4;
}
return Cholesterol_Level;

//Serial.print(Cholesterol_Level);
//Serial.println(" mg/dL");
//delay(500);
}

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