Hi Aminu,
Welcome to our forum and greetings to Nigeria.
I am glad that your project works very well.
Its maximum volume is determined by the impedance of the headphones and their quality. 8 ohm headphones draw 4 times the power of 32 ohm ones, and "rare-earth" neo.....um magnets are more efficient. I recommend using cover-the-ear headphones that block background sound and acoustical feedback.
Background sounds can be reduced mechanically and electronically.
Mechanical:
1) Use a solid and dense "head". I tried a plastic jar lid and background sound went right through it.
2) Seal the microphone to the head with a tight rubber grommet or silicone sealant. Some people mounted the microphone in the plastic tube connected to the head and the background sound went through the sides of the tube.
3) Seal the back of the microphone where its wires connect.
Electronic:
1) The project has a precision 2-pole Sallen and Key Butterworth low-pass filter that cuts-off frequencies above 103 Hz. Heartbeat sounds are passed and background sounds are reduced. The filter has only 2 poles so is not perfect.
You can add a second filter stage like the project's U1b by using a TL071 opamp. You will need to duplicate R5 to R8 and C3 and C4. Connect the new 2nd filter stage between the output of U1b and the volume control. Please see my attached graph showing the cascaded filter's improvement.
2) You can reduce background sounds even more by reducing the cutoff frequency of the filters. Try changing the values of C3 and C4 to 100nF for a 48Hz cutoff. If a 2nd filter stage is added, also change its capacitors.
3) If higher frequency respiratory sounds need to be heard, the filters can have their cutoff frequency increased to 1KHz by changing the value of its capacitors C3 and C4 to 4.7nF. Also change them in the 2nd filter stage if it is added. Because the bandwidth is increased, background sound pickup is also increased.
It is difficult to know the gain of the preamp because it is determined by the ratio of its negative feedback resistor R4 and the series combination of its input resistor R2, C2 and the parallel combination of the microphone and its power-feed resistor R1.
Also it is difficult to know the output voltage of the microphone because it is loaded down by the low impedance of R2.
I recently tested my electret microphone in this circuit. The microphone's current and impedance changed as it warmed-up in 30 seconds! The microphone's impedance in parallel with R1 measured 3.1K ohms. Therefore the gain of U1a with it connected is 8.87 at very low frequencies.
Microphones are made differently by many manufacturers, so their impedance is all different and therefore the gain of the preamp will be different.
View attachment 36569