Microsystem Technologies

https://doi.org/10.1007/s00542-019-04675-x (0123456789().,-volV)(0123456789().,-volV)

TECHNICAL PAPER

Epidermal antenna in palmar arch region for anaemia detection

to avoid peripheral perfusion artifact in optical sensor
during hemoglobin measurement
V. Kannagi1 • A. Jawahar2

Received: 17 October 2019 / Accepted: 25 October 2019

Ó Springer-Verlag GmbH Germany, part of Springer Nature 2019

Abstract
The anaemia disease diagnosed with various test such as complete blood count (CBC), ferritin measure, reticulocyte count,
peripheral smear and blood gas analyser. The ferritin measure the storage and usage of iron in human body, reticulocyte
count assess young red blood cell, and Peripheral smear analyse the cell colour, size, and shape of red blood cell through
microscopic image. The blood gas analyser measures methemoglobin (MetHb) and carboxyhaemoglobin. Different test
measure haemoglobin, since iron level show normal in blood for the patient with low total body iron. The iron deficiency
never show symptom or sign in the human body. In this paper, we propose a new non-invasive method for anaemia
measure through epidermal antenna over ulnar region of palm and acquire radiating signal from Haemoglobin protein. The
acquired signal from epidermal antenna analysed with Transverse Dyadic Wavelet Transform for haemoglobin protein
level in red blood cell. The epidermal antenna signal from ulnar region haemoglobin measurement avoids the peripheral
perfusion artifact of optical or image sensor which arise during measurement. The experimental analysis show signal of
epidermal antenna measure the haemoglobin more accurately, through regression modelling than existing optical and
image based point of care device. Experimental result of haemoglobin measurement from ulnar region has validated with
blood gas analyser.

1 Introduction polychythemiavera. Furthermore, anaemia prevails in the

In human body, haemoglobin concentration plays a vital
role to know the physiological status. Haemoglobin in red
blood cell carries the oxygen from lungs to the other part of
the body. The low haemoglobin concentration level in
blood leads to low oxygen transportation and sign of blood
disorder such as anaemia. The anaemia causes due to
destruction of red blood cell, blood loss, and lack of red
cell production. The symptoms of anaemia are heavy
periods, short breath, dizzy, cold and tiredness. The high-
level haemoglobin leads to disease in Lung, heart and
& V. Kannagi
kannagisankar94@gmail.com
A. Jawahar
jawahara@ssn.edu.in
1 iron drugs. The adverse effect of iron drug lead to various
Department of ECE, R.M.K. College of Engineering and
Technology, Chennai, India
2 mellitus, irregular heart rhythm and skin colour change.
Department of ECE, SSN College of Engineering,
Kalavakkam 603110, India
developing country of about 47.4% in preschool-age chil-
dren, 25.4% in school-age children, 41.8% in pregnant
women, 30.2% in non-pregnant women, 12.7% in men,
23.9% in elderly person and total population affect with
anaemia of 24.8% according WHO Global Database. In
India, District health report show 98% of adolescent girls
and 96% of pregnant woman suffer from anaemia. Anae-
mia in young children is about 96% which leads to various
diseases such as cognitive disease and introduces disorders
in behavioural and motor development coordination, lan-
guage development, scholastic achievement and also in-
creases the morbidity of infection disease. The anemia is
more vulnerable in age group of 6–23 months old children
due to lack of immune system. Furthermore, the mea-
surement of haemoglobin level in the blood prevents the
anaemia after proper treatment. The frequent measurement
of haemoglobin avoid over dosage and adverse effect of
disease such as chronic fatigue, liver disease, diabetes
However, prevention of anaemia and maintain proper

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dosage of iron drug need frequent measurement of hae- the measurement of the concentration of Hb. The variation
moglobin level in the blood. in Hb measurement arise in the venous, artery and capillary
The haemoglobin level measures with clinical and home regions. The Hb measurement variations also arise due to
diagnostic instrument. The clinical laboratory measurement the skin temperature and tissue region of finger. The
methods are hemiglobincyanide-spectrophotometric, spectrophotometer varies the measurement due to inter-
Sodium Lauryl Sulphate, and Azide-methemoglobin. The reflections, wavelength accuracy, photometric polarisation,
home diagnostic measurement methods of haemoglobin finger angle and tilt, multi-reflection due to bone, tissue,
level are portable hemoglobinometer, CO-oximetry and skin, capillary and obliquity effects. To avoid the mea-
WHO colour scale. However, frequent measurement of surement error and to improve accuracy the epidermal
Haemoglobin level at home measured through optical antenna is proposed.
sensor instrument. The proposed antenna evaluates the optimum location
Home haemoglobin device work with spectrophoto- for the measurement such as artery, veins and capillary.
metric principle for haemoglobin measurement. The spec- Till now and then, the point of care instruments measure
trophotometric devices measure haemoglobin level from the haemoglobin in the finger clips through the spec-
loop capillaries of finger. The handheld haemoglobin trophotometer sensor. The haemoglobin measurement from
instrument has certain drawbacks such as concentration of the point of care instrument accuracy is less when com-
haemoglobin varies due to skin temperature, depth of skin pared to the blood analysers because of the surrounding
penetration and colour (Baart et al. 2016; Sümnig et al. light, vasoconstriction and pressure in the finger capillary
2015; Al-Khabori et al. 2014). Furthermore, inherent region. The measurement of haemoglobin from the region
variation in the measurement of haemoglobin in the dif- of human body also leads to inaccuracy measurement. The
ferent finger of same person arises due to in flow charac- inaccuracy arise because of the venous, artery and tissue
teristics of plasma (Wood et al. 2001). The variation in regions.
measurement of haemoglobin may arise due to sensitivity The proposed epidermal antenna placed in the different
of the ambient light condition in environment (Stott and region of palmar surface to evaluate the better location for
Lewis 1995; Quinto et al. 2006; Paddle 2002). Moreover,
haemoglobin measurement from venous and finger stick
shows the overestimated haemoglobin value of about
7–8 g/L (Daae et al. 1988).
The capillary blood of an arterial region show high
haemoglobin level than venous region and variation of
haemoglobin level is influenced with posture during mea-
surement (Schalk et al. 2007; Jacob et al. 2005). The blood
samples of about 2425 donor samples has measured for
venous haemoglobin and show the variation in the sex and
iron status (ferritin \ 12 ng/ml) (Cable et al. 2011). Fur-
thermore blood samples from the fingertip, arterial and
venous (Yang et al. 2001) tested for three times in same
analyser device and found variation in coefficients of about
2.45% in fingertip, 1.46% in venous and 1.30% in arterial
blood.
In the non-invasive method the point of care instrument,
apply spectrophotometer sensors for measurement using
finger clips. The finger clips in the non-invasive Hg devices
shows the variations due to position and thickness of the
skin. The finger clip covers the sensor to avoid the envi-
ronment light interference, which leads to inaccurate
measurement.
The inaccurate measurements arise due to the vaso-
constriction and pressor in capillary region of finger. The
vasoconstriction and pressor arise in the capillary region,
due to finger clips during measurement. The variation in
the spectrophotometer sensor such as IR, NIR and also
smart phone image based Hg measuring device influences Fig. 1 Anatomy of palmar region

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the measurement of haemoglobin. Furthermore, the Fig. 1 4 Inferences

shows the palmar anatomy of hand region and artery,
capillary and vein.
2 Contributions
i. The proposed epidermal antenna consists of mini-
mum conductor area to reduce heat absorption by the
skin and underlying tissue.
ii. To classify and differentiate the haemoglobin value
obtained from palmar region such as arteries, veins
and capillary.
iii. The epidermal antenna based haemoglobin value
avoids the peripheral perfusion due to vasoconstric-
tion and vasopressors.
3 Related work
Haemoglobin measurement require for detection of anae-
mia and for blood management of in and out patients. The
tracking of haemoglobin(Hb) avoid the sustained anaemia
and over-transfusion in the critical care unit (Hayden et al.
2012; Shander et al. 2011). Furthermore, the various
methods and potential variation in the Hb measurement is
tabulated in Table 1 with advantages and disadvantages
never useful for clinical decision. The haemoglobin mea-
surement of home and clinical diagnostic instrument with
error variation has shown in the Table 1.
For clinical decision, the accurate measurement of hae-
moglobin avoids the sustained anaemia and over transfu-
sion. However, in all existing methods the point of care
instrument suit for the frequent measurement in non-inva-
sive method.
In the non-invasive method the point of care instrument
apply spectrophotometer sensors for measurement using
finger clips. The finger clips in the non-invasive Hb devices
shows the variations due to position and thickness of the
skin. The Finger clip covers the sensor to avoid the envi-
ronment light interference, which leads to inaccurate
measurement. The inaccurate measurements arise due to
the vasoconstriction and pressor in capillary region of
finger. The vasoconstriction and pressor arise in the cap-
illary region, due to finger clips during measurement.
The variation in the spectrophotometer sensor such as
IR, NIR and also smart phone image based Hb measuring
device influences the measurement of the concentration of
Hb. The variation in Hb measurement arise in the venous,
artery and capillary regions. The Hb measurement varia-
tions also arise due to the skin temperature and tissue
region of finger.
The spectrophotometer varies the measurement due to
inter-reflections, wavelength accuracy, photometric polar-
isation, finger angle and tilt, multireflection due to bone,
tissue, skin, capillary and obliquity effects. To avoid the
measurement error and to improve accuracy the epidermal
antenna is proposed. The proposed antenna evaluates the

Table 1 Different methods of Hb measurement from home and clinical diagnostic instrument
S. Authors Methods Advantage and disadvantages
No

1 Pi et al. FS by Hemocue, VS by FS capillary sample has 0.32 g/dL higher haemoglobin level
automated Hematologyanalyzer
2 Schalk et al. Hematologyanalyzer Advia 120 Mean differences between capillary and venous hematological values of ? 1.8%
3 Rudolf- Hemocue Hemo Control Capillary haemoglobin higher than Venous
Oliveira
et al.
4 Patel et al. Hemocue 201 Capillary haemoglobin levels were found to be significantly higher than venous
haemoglobin levels
5 Darragh FS by Hemocue, VS by A cutoff for capillary haemoglobin of 12 g/dL for females and 13 g/dL for males
et al. hematology Analyser equates to venous Hb that meets regulatory requirements: 12.5 and 13.5 g/dL,
respectively
6 Radtke et al. ELS and FS by PH,VS by Mean overestimation with ear-stick sample was 7.8%. 89% donors with
hematology Analyser unacceptable haemoglobin level would pass the ear-stick haemoglobin screening
7 Proposed Epidermal antenna Identifies the optimal location in Palmar region for Hb measurement
Avoids the error measurement because of light, skin colour, capillary and venous
region through regression model about 0.7%

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optimum location for the measurement such as artery, veins
and capillary.
5 Epidermal antenna as sensor
The Epidermal electronics has introduced in the year of
2011 for regular monitoring or assessment of human health
through the electronics and sensors in clothes or personal
accessories directly on the human skin (Kim et al. 2011;
Amendola and Marrocco 2017).
The growth of epidermal electronics leads to the ‘tatoo-
like’ sensors in the health care devices and such sensors
unobtrusively sense and collect the data for measuring skin
temperature, hydration strain and bio potentials, irrespec-
tive of texture and soft surface of human body (Huang et al.
2014; Jae-WoongJeong et al. 2014).
An epidermal antenna in palmar arch region is proposed
for anaemia detection to avoid peripheral perfusion artifact
in optical sensor during haemoglobin measurement. The
proposed Epidermal antenna structure covers an area of
12 9 18 mm2 with a grounded FR4 substrate with a
thickness of 1.524 mm and dielectric constant of 4.6.
The antenna structure consists of a truncated rectangular
ground plane, a microstrip feed-line and a modified radi-
ating patch for Epidermal sensing and microstrip stub,
which is placed between the zig plane.
Furthermore, zig arm acquire the signal from artery,
veins and capillary because of microstrip stub placed in-
between zig. The microstrip feed-line has modified at the
intersection end with the radiating patch provides efficient
acquisition.
In addition, a surface-mount assembly connector con-
nected to the other end of the feed-line for signal trans-
mission in the antenna. The antenna parameters such as
Return Loss, Gain, Directivity, Radiation Pattern, Effi-
ciency are measured and compared to fabricated antenna
using Vector Network Analyzer.
The proposed Epidermal antenna is shown in Fig. 2.
Figure 2a shows the Epidermal antenna design and b shows
its Layout design.
The design equations for meander line antenna are
shown below. The width (d) of the mender antenna arm
determined by
d ¼ 0:16  keff ð1Þ
where keff is the effective wavelength.
The length (s) of meander antenna arm given by
S ¼ 0:42  keff ð2Þ
The length of meander line given by
L ¼ 0:70  keff ð3Þ
The width of meander line given by
W ¼ 0:05  keff ð4Þ
pffiffiffiffiffiffiffi
keff ¼ k0 = ref ð5Þ

Fig. 2 Epidermal antenna

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Table 2 Epidermal antenna parameter

S. No. Antenna parameters Lower frequency Upper frequency

1. Resonance frequency 2.4 GHz 3.5 GHz

2. Simulated return loss - 11.850 dB - 12.18 dB
3. Gain 9.56146 dBi 13.7077 dBi
4. Directivity 9.56146 dBi 13.7077 dBi
5. Input power 0.00142464 W 0.00110344 W
6. Radiated power 0.00142464 W 0.00110344 W
7. Efficiency 100% 100%

c
k0 ¼ ð6Þ
f
where, c is speed of light and f is operating frequency.
The ref is determined by
 
er þ 1 er  1 h 1=2 Fig. 3 Haemoglobin measurement with epidermal antenna
ref ¼ þ 1 þ 10 ð7Þ
2 2 w
The amplified signal processed with transverse dyadic
where h is the height of the substrate, er is the dielectric
wavelet transform for additive noise removal in wavelet
constant of the material, w is the width height of the
bands. The noise in wavelet bands removed by disassoci-
substrate.
ation of corresponding components. Furthermore, signifi-
Furthermore, the return loss S11 parameter of the pro-
cant information in signal linked with wavelet basis
posed antenna is shown in Fig. 2f. The Fig. 2c–e shows
preserve by zeroing amplitude coefficients which are below
Pattern of Antenna along with current flow, Isometric View
predetermined level.
and Bottom View of the proposed antenna, respectively.
The signals obtained from the blood phantom and the
Epidermal Antenna validate minimum measurement
epidermal antenna in ulnar region is compared for the
distance and maintain accuracy from gain. A rapid measure
spectrum and is shown in Fig. 4a and b, respectively.
of the radiation performance obtains from two main planes
The Table 3 shows the signal parameters.
such as horizontal and vertical.
Elastomers has viscoelastic properties and they are
The considerable measurement for characterizing all
polymers. The elastomers are the glass materials, which
steering positions with respect to gain. The Table 2 shows
have the similar properties of the skin models. The Glass
the antenna lower and higher frequency parameter.
materials and the blood signal from epidermal area shows

6 Materials and methods

The Fig. 3 shows blood haemoglobin measurement with

epidermal antenna. The epidermal antenna placed on ulnar
artery in hand. The ulnar artery carry oxygenated blood
from arteries to veins in palm and fingers.
The ulnar artery location is selected due to increased
blood flow in palm region compared to other blood vessels
in finger and wrist region. The blood comprises of hae-
moglobin, plasma, red blood cells and white blood cells
and the ions in blood emit electromagnetic radiation.
The electromagnetic signal of the blood from ulnar
artery is acquired by the epidermal antenna and filtered for
high frequency signal to eliminate signals reflected from
surrounding objects. The acquired electromagnetic signal
strength is improved with AD620.

Fig. 4 Spectrum of the epidermal antenna signal

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Table 3 Comparison of signal parameters of blood phantom and

The multi-resolution analysis and scaling function of
epidermal antenna signal
epidermal antenna signal perform with mother wavelets
Parameters Blood phantom Epidermal antenna w(t) which satisfies the dilation function
pffiffiffi X
RMS value 0.00081635 0.00080948 uðtÞ¼ 2 h0 ðkÞuð2t  kÞ
Dynamic range 43.3463 dB 43.8603 dB k{Z
Crest factor 14.7999 dB 14.3872 dB pffiffiffi X
wi ðtÞ¼ 2 hi ðkÞuð2t  kÞ ð10Þ
Auto correlation 0.11678 s 0.12678 s
k{Z

where the digital filter banks represent by hi (k) where i

ranges from 0 to 2. The filter banks produce high density
the similar patterns in spectrum as well as parameters as wavelet coefficients represented by
shown in above figure and table. Z 1
0
di ðj; kÞ ¼ f ðtÞwi;j;k ðtÞdt; i ¼ 1; 2 ð11Þ
1

7 The transverse dyadic wavelet transform The high density dyadic wavelet transform represented
by
Z 1 t  s
The transverse dyadic transform of epidermal antenna j

1
Wfi s; 2 ¼ f ðtÞ pffiffiffiffiffi wi dt
signal x(t) define by wavelet functions w(x) [ L2(R) the 1 2j 2j
wavelet transform of epidermal antenna signal x(t) repre- ¼f w  j ðsÞ; i ¼ 1; 2
i;2
sented by
Z þ1   1  t
  1 xb wi;2j ðtÞ ¼ wi;2j ðtÞ ¼ pffiffiffiffiffi wi  j i ¼ 1; 2 ð12Þ
Wa;b f ð xÞ ¼ f ; wa;b ¼ f ð xÞ w dx ð8Þ 2j 2
1 a a
The higher density Transverse Dyadic Wavelet Trans-
where the value of ‘a’ greater than 0 represents scale form samples the input signal and the Fig. 5 shows the
number. The smoothing function in transverse dyadic electromagnetic signals acquired by epidermal antenna for
wavelet transform represented by different haemoglobin levels.
ohðxÞ The epidermal antenna is placed on ulnar artery of
wðxÞ ¼ ð9Þ
ox persons having different values of haemoglobin levels. The

Fig. 5 Electromagnetic signals acquired by epidermal antenna

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Fig. 6 Haemoglobin signal, Transverse dyadic wavelet transform and multi-resolution analysis of 13.5 g/dl and 15 g/dl levels
signals acquired by the antenna for haemoglobin levels
13.5 g/dl and 15 g/dl are shown in the Fig. 6a and d,
respectively. Figure 6d and e shows the transverse dyadic
wavelet transform signals and multi-resolution analysis of
the above specified haemoglobin levels is shown in Fig. 6c
and f of 13.5 g/dl and 15 g/dl levels.
The electromagnetic absorption increases with hae-
moglobin level as shown in Fig. 6. The transverse and
multi-resolution analysis show improved frequency
response due to iron in blood cell.
The Table 4 shows the comparison of the ulnar signal
for haemoglobin measurement with different transform
such as Discrete Wavelet Transform (DWT) and Short
Time Fourier Transform (STFT). From the comparison the
consistence is seen only in the dyadic transform. The
Dyadic DWT transform processed signal’s statistical value
is the input for the regression modelling.
8 Regression modelling
Linear regression use three variables such as independent
variable X, dependent variable Y and unknown parameter
B. The regression analysis relates dependent variable Y
with independent variable X and unknown parameter B.
The regression model represented by
Y ¼ f ðX; BÞ ð13Þ
In this paper, the epidermal signal from ulnar region
processed with wavelet filter for the multi-resolution
analysis and scaling. The haemoglobin signal and wavelet
processed signal parameters such as Standard deviation
(S.D) is the input for regression model and output with the
l95 laboratory values to measure the haemoglobin level
from the epidermal antenna.
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0.0035
0.0568

2.0145
Haemoglobin Value ¼ 198:9847  ðS:DÞ þ 7:2802:

STFT

2.247

2.547
ð14Þ

DyDWT
The above equation is applied for the 50-person signals

9.6037
0.0024
0.0493
3.6881
2.9132
from ulnar region after processing with dyadic wavelet
transform and S.D obtained and checked for the validity
through the laboratory value. From the results, accuracy is

0.00547
17 g/dl

2.2478

0.0247
2.6578
1.2567
DWT about 95% achieved for the lab value and the error value
for the laboratory and ulnar region is about 5–3%
3.00147
0.00198
0.0347
3.0124
STFT

3.478
9 Conclusion
DyDWT

The iron deficiency in blood cause anaemia. Anaemia

3.1684
0.0014
0.0372
3.0124
3.478
diagnosed by analysing blood sample for iron deficiency
and haemoglobin. The iron deficiency in blood cells take
0.00156

more days to show visible symptoms of abnormalities. The

15 g/dl

2.2458

1.2457
1.0254
DWT

0.254

irregular blood cell size and shape also cause due to other
conditions, which affects haemoglobin level in blood cell.
Hence, the research work focuses on electromagnetic
0.0356

0.2578
STFT

1.254

0.025

1.657

radiation of blood to detect iron deficiency in blood. The

non-invasive, epidermal antenna electromagnetic radiation
DyDWT

change due to iron in blood is analysed. The ulnar artery in

3.2756
0.0010
0.0324
3.4252
2.6649

palm circulates blood to the other blood vessels in the

finger. The non-invasive epidermal antenna is placed on
13.5 g/dl

ulnar artery for electromagnetic absorption. The transverse

2.2568
0.2356
0.5478

2.6547
DWT

2.987
Table 4 Relation between Electromagnetic signal absorption on ulnar nerve and laboratory value

dyadic wavelet multiresolution analysis of electromagnetic

signal indicates blood iron influence on epidermal antenna
3.1856
0.0308
0.0258
0.2854
1.2158

electromagnetic signal.
STFT
DyDWT

2.8925
0.0008
0.0318
3.3585
2.7652

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