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Medical Care



Experimental Study of Cardiac Functionality for
the Wellness of Individual by developing an
Android Application
Damanpreet Kaur Gowrishankar.S, Siddaraju Department of Computer Science and Engineering, Department of Computer Science and Engineering, Dr. Ambedkar Institute of Technology, Dr.Ambedkar Institute of Technology Bengaluru-560056, Karnataka, India. Bengaluru-560056, Karnataka, India. [email protected] [email protected] AbstractSince the beginning of the twenty-first century,
Keywords— Healthcare, Wearable, Physiological, Android, Heart
healthcare cost has increased exponentially which has burdened the
common man across the world. India being the country of having
high youth concentration, needs a cost-effective quality healthcare
delivery system to generate the healthy workforce. Here, comes the
Today, the world population has breached the mark of 7 billion role of wearable device which provides users the flexibility to know
which reveals the need of a cost-effective quality healthcare about their health irrespective of their location. Though it is one of
system. But achieving this target has become a mammoth task for the means to access body vitals, it does not analyze them. Therefore,
all countries, irrespective of developed or emerging economy, it is necessary to discover a solution for the world's burgeoning
due to the continuous rise in health-care costs and the onset of population to analyze the physiological parameters viz. heart rate,
chronic diseases every year. Thus the healthcare system has respiratory activity, blood pressure etc. captured from wearable
undergone a paradigm shift from the conventional hospital- devices and provide customized healthcare recommendations. This
centered system to an individual-centered system [1]. This paper attempts to develop an android application which takes the
heart rate data of the users as an input using wearable device
individual-centered system is referred as wearable technology. application
Over the past decade, we have seen substantial improvement in application predicts cardiac problems on the basis of the recorded
the field of wearable technology which led to the development of heart rate data and thereby recommends precautionary/ curative
cost-effective wearable devices. Wearable devices are the measures in the form of diet prescription, physical activity among
electronic items worn on human organs to monitor a person's others. In this way the state-of-the-art application enables its users
physiological signals. These devices play an important role in to access the cost- effective quality home-based health care which
delivering healthcare solutions such as measurement of heart rate, will make them more prosperous and productive at their workplaces
SpO2 (blood oxygen saturation), blood pressure, respiratory in the long run.
signals etc. These devices address various challenges, such as increasing healthcare cost with low quality services and inability of accessing healthcare services at remote locations. Thus, every wearable device in literature. Thus, it makes sense to wearable devices generate curiosity among the researchers and discuss some of these cardiac wearable devices in the study. medical practitioners to come out with novel ways to address the Valenza [3] propose an application based on wearable needs of the increasing population globally [2]. textile technology which assesses instantaneous nonlinear heart We have seen several advantages of wearable devices. But at the rate variability and characterizes the autonomic status of bipolar same time, they offer various challenges. Though wearable patients by considering their electrocardiogram recordings. On devices assess the physiological parameters, they remain silent on the similar lines, H. H Tsai and C. W Yi [4] establish an algorithm "what to do" based on user's vital values. Therefore, an integrated to analyze the relationship between human heart rate and their solution is required to analyze these bio-signals in real time excitement levels while performing different activities. They environment and enhance the general well-being of the people by have used wearable sensors which also collect ECG signals to providing medical prescriptions. This paper attempts to develop reveal the activity of the Autonomic nervous System (ANN). an android application based on the analysis of one physiological Further, a dynamic direct rate algorithm in wearable devices is parameter i.e. heart rate recorded from a wearable device. The proposed by C. T. Chu, H. K Chiang and J. J Hung [5] to present application predicts possible cardiac problems associated with the a low cost solution for heart rate oximeter with automatic initial different sets of heart rate data, thereby recommends detection process to process feedback analogy error noise. precautionary/ curative measures in the form of customized diet Z. Zhang, Z Pi, B Liu [6] propose a framework to solve the prescription, physical activity, sleeping hours, among others. problem of contaminated photoplethysmographic signals in Heart The organization of this paper is as follows. Literature Review rate monitoring using wrist watch. The framework is called of various wearable devices used for measuring heart rate is TROIKA, which comprises signal decomposition for denoising, carried out in section 2. In Section 3 we discuss various sparse signal Reconstruction for high-resolution spectrum objectives. Section 4 describes the design of cardiac estimation, and spectral peak tracking with verification. questionnaire along with the working of the application. Section Similarly, G Gaoan and Z Zhenmin [7] describe a procedure to 5 describes the precautionary and/or curative measures to be capture the apical pulse signal using acceleration sensor and taken by the users for their general well-being. Section 6 estimate the heart rate. They propose a real-time heart tracking concludes the paper. algorithm for predicting heart rate with the help of wearable II.LITERATURE SURVEY device using phase space method. Moreover, J. Liu, F Xie, Y Zhou, Q Zou, J Wu, [8] propose a multi-functional wearable Wearable devices are the electronic articles acting as clothes device fastened around waist to monitor the user's and/or accessories of human body to measure physiological electrocardiogram (ECG), respiratory activity, and the body parameters. There have been several studies conducted across the globe on wearable device-based health monitoring via measurement of heart rate, SpO2 (blood oxygen saturation), A Keerthika and R Ganesan [9] design a wearable wireless blood pressure, respiratory signals etc. But the most common health monitoring system to measure and transmit the user's vital sign of importance is heart rate, which is sensed by almost arterial blood-oxygen saturation (SpO2) level and heart rate (HR) using sensing devices, low power microcontrollers and modem. Similarly, Young Sung Kim, Bae Sun Kim, Yong Ki Son, Il Yeon
IV. QUESTIONAIRE DESIGN Cho [10] present a wrist- worn wearable device for nonintrusive In this phase of our study, the primary data collection is heart rate sensing with the help of array of sensors mounted on a conducted through a well-designed questionnaire consisting of flexible band. This device helps to avoid the wrist worn rigid cardiac profile. The respondent is a senior cardiologist. We try to form-factors which otherwise make them vulnerable to motion collect even the basic questions related to heart health of an artifacts. Further, D. Da He, E. S Winokur, C. G Sodini [11] individual of different age.
demonstrate a wearable heart monitor that is worn on the ear. They propose that with the help of ear(anchoring point), the heart Cardiac Health Questionnaire: monitor measures the ballistocardiographic (BCG) motion of the Cardiac health questionnaire consists of different questions head using a MEMS tri-axial accelerometer, and the regarding heart health. In our cardiac health questionnaire, we electrocardiogram (ECG) using a single-lead configuration. have included certain questions that can help us to analyze the There are various researches conducted on the effectiveness of data recorded from wearable device: heart based wearable devices, such as E Sardini, M Serpelloni and M Ometto [12] present a wireless device in the form of a shirt Heart rate for different age groups: We have included different to monitor the heart rate derived from ECG signals in a non- set of age groups to get an idea of their corresponding heart rate invasive manner. Hyonyoung Han, Yunjoo Lee and Jung Kim [13] also represent a wearable and motion artifact reduced health Blood pressure: Human heart health is dependent on both monitoring device in the form of finger band that consists of systolic and diastolic blood pressure. We collect the normal range photoplethysmography (PPG) sensor, 3-axis accelerometer, of blood pressure values for different age groups from the microprocessor and wireless module to measure heart beat signals. In this way, we have seen that over the last decade, the heart based wearable devices have been put in place to assess the Blood Glucose level: Human heart health is directly dependent health of the people in real time environment. But we need the on the blood glucose level of each user. Increase in blood glucose immediate solution after assessing our heart rate values. Thus, in level clearly indicates that the person suffers from diabetes which this paper we are trying to develop an application to complement in turn gives the fluctuations in heart rate. Hence to provide the the assessment potential of the wearable device by providing recommendations, it is required to get the reading of the specified suitable recommendations to the users based on their heart rate glucose level for each age. Apart from these cardiac parameters discussed above, some general questions related to heart profile are asked from the senior  To develop an application to predict health problems on the cardiologist in order to fulfill our desired objectives. Some of basis of heart rate data recorded from the wearable device. these questions are described as follows:  To prescribe customized nutritional diet by analyzing the Test Recommendation: As our application provides home based different sets of heart rate values. solution to cardiac problems, so it becomes necessary for us to  To recommend precautionary and/or curative measures to the ask the cardiac specialist to recommend that at what age should a users for their general well-being. person begin paying attention to heart health and what tests  High blood pressure: High blood pressure causes a should be recommended. specific heart disease which can affect the muscles of Causes of Heart ailment: Our project revolves around the  Diabetes: High blood sugar level and heart disease go recommendations provided to the users. Thus, to provide the hand in hand. If a person is suffering from diabetes, there appropriate solutions, we first list certain factors causing heart are more chances of heart disease as high glucose level ailment that are as follows: damages nerves and vessels.  Sedentary lifestyle: Our heart health depends on our  Overweight: As a person's body mass index increases, daily lifestyle. People having sitting jobs, or those who risk of coronary heart disease increases. don't do physical activities on a regular basis, are at high  Anxiety: Anxiety increases blood pressure which in turn risk of getting cardiovascular problems. affects the heart.  Physical Inactivity: Physical activity, in general, is important for healthy living. If a person doesn't do Symptoms prominent in heart ailment: There are certain symptoms for each heart problem. The user may exhibit some or physical exercises on a regular basis, risks of heart all of the following symptoms in case of heart problem. diseases increase as there is improper flow of blood to  Chest Pain or Pressure: a person feels pressure  Liquor Consumption: Consumption of alcohol increases surrounding the chest region and this pain moves up to cholesterol level, which in turn increases blood pressure and ultimately leads to heart failure.  Shortness of Breath  Smoking: Smoking affects the heart arteries in such a  Palpitations, irregular heartbeats, fast or slow heart rates way that it damages their lining and leads to narrowing  Fainting, near fainting, or dizziness the wall of the arteries.  Swelling of legs  Eating habits (lack of nutritional foods): Excessive  Blue fingernails intake of both salt and sugar in a diet can affect human  Leg pain or cramps heart badly. A person should have nutritional food, which consists of vitamins, minerals, proteins etc. to Symptoms between men and women: Women have more maintain his health and to get rid of the cardiac problems atypical asymptomatic heart beats (Myocardial infarction) as compared to men.  Poor sleep: Getting insufficient sleep (insomnia) The application works in a series of steps as shown below: increases the blood pressure which in turn affects the heart health badly. Application Authorization in the wearable device takes place in  Hereditary factor: If a person suffers from two ways, viz. code grant and implicit grant flow. The code grant cardiovascular disease at an early age, there may be flow is generally recommended for the application that uses web hereditary factor behind this. interface as a service and thus, it requires server to server communication to perform the function.

In our project we are using implicit grant flow that works as Figure 2 represents the outline of the application. The sequence follows, shown in Fig. 1. of steps performed in the process are shown using arrows. It starts with the measurement of cardiac activity followed by the  Application redirects the user to the wearable device customized dietary recommendations to the user. authorization page which consists of parameters: Client _id, response type, scope, redirect_uri, etc.  When user gets redirected to the authorization page, permission is required from the user to allow the application to use the wearable device data. Thus, on user approval the application gets redirected to the callback URL where the access token is present as a URL fragment.  Further, the application gets access to the required token, which is used to make the request to the wearable device API.  Finally, the user needs to specify the lifetime of an access token in authorization page during implicit grant flow which can be of a day, a week, or a month. Fig.2. Application data flow V. Recommendations After getting an insight into the causes and symptoms of cardiac problems, we are trying to recommend certain precautionary measures to avoid these problems with the help of our application, based on the expert recommendations. Some of these measures are described as follows:  Physical activity type & duration: For having good heart health, it is recommended to do moderate aerobic exercises, with regular physical activities that include walking, running etc.  Sleeping Duration: Minimum of 7-8 hours' sleep is required to avoid heart problem.  Recommended Diet: Don't skip any meal, intake of less salt and sugar, high protein diet, avoid consumption of Fig.1. Overview of user phase saturated fats like ghee, butter, fried food etc.

 Immediate home remedy if person suffers from extreme Figure 3 shows the overview of health application consisting of chest pain: Sub-lingual Tab. Sorbitrate. different fields, viz. heart rate, activity, food plan etc. Table I presents the symptoms and the causes of abnormal heart rate values which are described in the heart scope of the Table I: Cardiac Functionality
Heart Rate
Everything is fine. No Recommendation Chest pain, pressure rate ( more than Shortness of breath ( Fig.3. Drop down: Physiological Parameter with stress, rest or Figure 4 shows the symptoms and the causes of the cardiac Blue fingernails Leg pain, swelling Shortness of breadth Fatigue (Low- energy rate( less than 60) Lightheadedness. Cramps while walking Fig.4. Low heart rate: Causes, Symptoms, Cure Table II describes the causes of low heart rate and also recommends certain solutions in the form of dietary sources. Each value in the following table is associated with users low heart beat as recorded by the wearable device and every user is provided with the recommendations

Table II: Irregular Heart Rate (< 60): Causes &
What it means
What needs to be done
Excessive loss of 1. Use an ORS(Oral Rehydration Therapy) body, which causes 2. Drink Lots of water, juice and avoid dairy products. 3. Eat foods with High water content like Fruits: Watermelon, muskmelon Vegetables: Broccoli, eggplant, lettuce, spinach, zucchini, tomatoes Endocrine gland is Consult doctor for certain Figure 5: Normal Heart Rate Profile responsible for how Require hormones Table III describes the causes of high heart rate and also recommends certain solutions in the form of dietary sources. Aging leads to a general weakening of the heart, which can cause a slow heart rate. It can also be due to after- In our application, if the user heart rate comes in normal series, then the user is provided with no recommendations as shown in Fig. 5. In this figure, heart rate field is chosen, which denotes the heart rate in three different positions, viz. resting, normal and exertive heart rate. It presents the default heart rate value, i.e. 70- 80, which signifies "everything is fine". Table III: Irregular Heart Rate (>100): Causes &
Healthcare Service Provisioning", ICBET, Copenhagen, Denmark, Vol. 7, pp. 163-168. [3] G Valenza, L Citi, C Gentili, A Lanatá, E. P Scilingo, R What It Means
What needs to be
Barbieri, 2015,"Characterization of Depressive States in Bipolar Patients Using Wearable Textile Technology and Take stairs instead of Sedentary life style include sitting, reading, Instantaneous Heart Rate Variability Assessment", IEEE Walk break at any time television, and no Play sports instead of transaction on Biomedical and Health Informatics, Vol. 19,No. indoor entertainment [4] H. H Tsai, C. W Yi, 2015, "Wearable ECG for Tension Requires regular Physical inactivity movements like walk, Assessment in Movie Watching and Adventure Riding", in cycling or any other 30 minutes' walk proceedings of 11th IEEE International Conference on physical activity Moderate aerobics and workout Mobile Ad-hoc and Sensor Networks (MSN), pp. 23-30. Your family history also [5] C. T. Chu, H. K Chiang, J. J Hung, 2015, "Dynamic heart rate Hereditary factor gives chances of monitors algorithm for reflection green light wearable device", cardiovascular risk factors, cholesterol in proceedings of IEEE International Conference on problem, obesity etc. Intelligent Informatics and Biomedical Sciences (ICIIBMS), Blood pressure >140/90 Take healthy diet. Okinawa, Japan, pp. 438-445. Take diet rich in whole [6] Z. Zhang, Z Pi, B Liu, 2014, "TROIKA: A General Framework dairy products and low Photoplethysmographic Signals During Intensive Physical Reduce sodium intake in diet Exercise", IEEE transactions on Biomedical Engineeringl. 62, No. 2, pp. 522-531. [7] G Gaoan, Z Zhenmin, 2014, "Heart rate measurement via Fasting sugar level>110 Take diet lower in smart phone acceleration sensor" , in proceedings of IEEE calories, saturated fat, trans fat, sugar and salt International Conference on Smart Computing, Hong Kong Eat foods with more porridge and whole [8] J. Liu, F Xie, Y Zhou, Q Zou, J Wu, 2013, "A wearable health monitoring system with multi-parameters", in proceedings of Body Mass Index ( Avoid oil, sugar and all 6th IEEE International Conference on Biomedical Engineering More intake of protein and Informatics (BMEI), Hangzhou, pp. 332-336. Eat fruits & vegetables [9] Keerthika A, Ganesan R, 2013, "Pervasive health care system for monitoring oxygen saturation using pulse oximeter sensor", in proceedings of IEEE conference on Information and Communication Technologies, JeJu Island, pp. 819-823. [10] Young Sung Kim, Bae Sun Kim, Yong Ki Son, Il Yeon Cho, [1] J.J Rutherford, 2010, "Wearable Technology", IEEE 2012, "Nonintrusive measurement of heart rate using a flexible Transaction on Medicine and Biology Magazine, Vol. 29, No. sensor array", in proceedings of IEEE International Conference on Consumer electronics (ICCE), Las Vegas, NV, [2] Ogunduyile, O.O , Olugbara O.O, Lall M, 2013, "Development of Wearable Systems for Ubiquitous [11] D. Da He, E. S Winokur, C. G Sodini, 2011, "A continuous, ballistocardiogram (BCG) and head electrocardiogram (ECG)",in proceedings of IEEE Annual International Conference on Engineering in Medicine and Biology Society, Boston, MA, pp. 4729-4732. [12] E Sardini, M Serpelloni, M Ometto, 2011, "Multi-parameters wireless shirt for physiological monitoring", in proceedings of IEEE International Workshop on Medical Measurements and Applications Proceedings (MeMeA), Bari, pp. 316-321. [13] Hyonyoung Han, Yunjoo Lee, Jung Kim, 2007 "Development of a wearable health monitoring device with motion artifact reduced algorithm" , in Proceedings of IEEE International Conference on Control, Automation and Systems, Seoul, pp.1581 – 1584.


250 mg/g powder for oral administration with the drinking water or milk /milk substitute Target species: cattle (calves) and pigs Statement of the active substance(s) and other ingredient(s): 1.0 g powder contains:Pharmacological active substance: Tetracycline hydrochloride 250 mgExcipients:Glucose monohydrate. Indications:Cattle (calves) and pigs:For therapy and metaphylaxis of infectious diseases of the respiratory- and gastro-intestinal tract and infections of the urinary tract in calves and pigs (with the exception of systemic E. coli and Salmonella infections), caused by bacteria sensitive to tetracycline. Contraindications:Hypersensitivity to tetracyclines.Severe disturbances of hepatic or renal function.Do not use in ruminating cattle (calves older than 6 weeks).Resistance to tetracyclines.Adverse reactions:On corresponding disposition, allergical or anaphylactic reactions may occur. In this case withdraw tetracycline hydrochloride immediately and initiate appropriate countermasures (parenteral administration of glucocorticoids and antihistaminics). Gastro-intestinal disturbances with vomiting and diarrhoea may be observed in rare cases when the product is administered to fasting animals. In long-term treatment pay attention to superinfections e.g. with Candida spp. In animals with disturbed fluid balance, the danger of functional disturbance of the kidneys is increased. Tetracycline may cause liver damage. During therapy intensive light insolation on skin with poor pigmentation often causes photodermatitis. Target species:Cattle (calves) and pigs.Dosage for each species, route(s) and method of administration:Pigs:

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