One of the most overlooked of all serious complications of diabetes is cardiovascular autonomic neuropathy (CAN), which encompasses damage to the autonomic nerve fibers that innervate the heart and blood vessels, resulting in abnormalities in heart rate control and vascular dynamics. It also demonstrates that autonomic dysfunction can affect daily activities of individuals with diabetes and may invoke potentially life-threatening outcomes. Advances in technology, built on decades of research and clinical testing, now make it possible to objectively identify early stages of CAN with the use of careful measurement of autonomic function and to provide therapeutic choices that are based on symptom control and that might abrogate the underlying disorder. The autonomic nervous system is subdivided into the parasympathetic and sympathetic components that work antagonistically to provide a very fine degree of control over their target organs. In general, the parasympathetic nervous system predominates during rest by slowing heart rate, lowering blood pressure, and promoting digestion. The sympathetic nervous system is responsible for mounting responses to physical and psychological stimuli. The system uses ECG Cardio-Tachogram (R-R interval) and an advanced automatic NIBP (Non-Invasive Blood Pressure) module to conduct a battery of six tests. Being fully automatic, it eliminates the need for manual recordings, readings and calculations. These tests are done with patients' co-operation and the PC onscreen panel helps them to complete the tests successfully. Parasympathetic : Resting ECG : Resting HR Deep Breathing : • Coeff. Of Variation • Expiration Inspiration Ratio Supine to Standing : • Coeff. Of Variation • 30:15 Ratio Valsalva Maneuver : • Coeff. Of Variation • Valsalva Ratio Sympathetic : Postural Hypotension : • Resting BP • BP immediately after standing • BP after standing 1/2/3 minute • Fall in Systolic BP Sustained Handgrip : • Resting BP • BP after sustained handgrip • Increase in Diastolic BP Final Interpretation : • Parasympathetic Function

Our All-in-one Complete Diabetic Foot Lab model DIABETIK MINILAB is our one of the best products that can measure and document all the important parameters such as the Ankle Brachial Index(ABI), Toe Brachial Index(TBI), Doppler Waveform, Monofilament 10gm, Biothesiometry, Foot Pressure and Foot Temperature. In addition to the above reports, a master report is created by the software will capture the medical history with symptoms of the patient, dermatological exam, musculoskeletal exam, vascular and footwear exams along with the recorded test results and their interpretations. A colorful 6 pages report is generated by the software. The Diabetik Minilab is supplied with all the accessories and a sturdy trolley. An all-in-one scanner/copier/printer of a particular specification is supplied with the device. A Windows 7/8/10 operated laptop is to be arranged by the buyer. Vascular Screening: Whenever one suspects Peripheral Arterial Disease (PAD), the clinician must perform a few non-invasive vascular testing methods that are commercially available and widely implemented. Features: • Unidirectional 8MHz probe • Photo-plethysmograph PPG Toe sensor • BP cuffs for ABI/TBI • Ankle Brachial Index (ABI) • Toe Brachial Index (TBI) • Doppler Velocity Waveform • Venous Examination (No documentation) • Carotid, Penile examination (No documentation) Neuropathy Screening: Diabetes can result in long-term health complications, with one of the most common being microvascular damage that leads to diabetic neuropathy (DN), which affects multiple body systems and increases amputation risk. A typical form of DN is diabetic peripheral neuropathy (DPN), which is known to be a primary cause of balance issues, and sensation loss in the feet, and a major contributor to nontraumatic lower-limb amputations. Loss of sensation in the foot can be diagnosed with a 10gm Monofilament and a Biothesiometry. Semmes‐Weinstein monofilament test (SWMT): The SWMT is a common screening tool for assessing the sensory function and the loss of pressure sensation (light touch perception). A 10-gm monofilament test (also referred to as the 5.07 monofilament) is the most common in practice. 25 Nos of such monofilament in a box are supplied with the device. The filament is applied to at least six sites on the foot until it buckles, which occurs at 10 g of linear pressure when the patient is asked to detect its presence. If it is not detected on at least four out of six sites, then the protective sensation is considered to be lost. Biothesiometry: Vibration perception threshold (VPT) has been shown to be strongly associated with foot ulceration. VPT determination by using a Digital Biothesiometer has been used to identify peripheral sensory neuropathy and subjects at risk of the foot. Digital Biothesiometer helps us quantitate the threshold and monitor progressive changes or trends on following up testing. Sensory neuropathy increases the risk of foot ulcerations by seven-fold and peripheral arterial disease (PAD) by three folds in people with diabetes. Peripheral neuropathy is the major causal factor in the development of foot ulcerations among diabetic subjects. Early detection of vibration perception threshold (VPT) helps better prevention. Prevention is better than no cure. 50% of all non-traumatic amputations occur in diabetes which is a high-risk group. . Features: • First Company to introduce Digital Biothesiometry in India - 2003 • Digital 0 to 50 Volts indicator • Vibrator with Mute/Check & Record key • Full solid-state design Plantar Pressure measurement: Understanding foot biomechanics is an important component in the evaluation of diabetic foot. The abnormal plantar pressure distribution plays a key role in the formation of plantar calluses and diabetic foot ulcers. Abnormal value of foot pressure, as well as neuropathy, could play an important role in the formation of plantar ulcers independently. Current international guidelines advocate achieving at least a 30 % reduction in maximum plantar pressure to reduce the risk of foot ulcers in people with diabetes. Features: • Foot Imprinter Harris Mat FM1111 • Licensed software to scan and image process FM1111 foot image. • Report to include the footwear measurements. • Multi-color picture image indicates the pressure mapping. IR Foot Temperature measurement: Monitoring of skin temperatures at the foot, along with subsequent offloading can dramatically reduce the occurrence of ulcerations. The defined threshold reported in numerous studies is an asymmetrical difference of 4ºF (2.2°C) between the sites. Because most patients at risk for ulceration are also at risk for Charcot, monitoring foot temperature would be an effective tool. Features: • Simple one-handed operation • Laser targeting • oC / oF select switch, Accuracy +/- 2% • Early marker for Charcot foot • Can reduce the risk of ulceration.

Peripheral neuropathy is the prime cause of diabetic foot ulceration. Ulceration, in turn, is the key factor that may precipitate a cascade of events leading to lower-extremity amputation. Checking the loss of Thermal Sense, Vibration sense and protective Touch Sense will help the management of diabetic neuropathy and its effect on the foot. Three important simple devices are packaged in the Neuropathy Assessment Kit (NA03) for the effective management of diabetic neuropathy. The kit contains a Tiptherm, a Vibratip and Monofilament 10gm(25 Nos). TIP THERM® is a simple device for the early diagnosis of symmetrical polyneuropathy by measuring the loss of temperature sensitivity of the skin. TIP THERM® was developed to give the clinician and patient a convenient and easy-to-use method of testing. This device is recommended to use, at a room temperature of 23° C. Failure to perceive variances in temperature in the extremities is the most decisive early symptom of distal symmetric polyneuropathy, a typical ailment accompanying diabetes mellitus (Ziegler 1988). Portable Vibration sense device VIBRATIPTM is a device resembling a small key fob that provides a near-silent vibration of consistent amplitude at a frequency similar to that of a calibrated tuning fork. It is intended for use when testing a person’s vibration perception during routine checks for diabetic peripheral neuropathy (DPN) in people who have type 1 or type 2 diabetes. It is a disposable device works for about 250 patients, and vibrates at 125 Hz with an intensity equivalent to that of a Biothesiometer at 25 Volts. When the patient does not feel the vibration is classified as a high-risk category. MF10GM: Monofilaments 10gm is an effective, convenient, easy to use, relatively inexpensive way of testing for loss of protective touch sense in the feet. It is designed for single-patient use and can be used till 100 bends or filament damage.

DFCI offers a full-featured automated ABI/TBI Vascular System for the diagnosis of PAD. ABI/TBI/PVR/Segmental Doppler/Upper extremity/Carotid Doppler/Penile Doppler/Venous Doppler are the different modalities possible with this model. The system includes 6 pressure cuffs, a graphic waveform LCD display, automatic cuff inflation and deflation along with automatic indices calculation. PC software and USB connectivity are included for storage and performing the standard protocols. Features:- • Automatic ABI, TBI, PVR and segmental measurement • Automatic cuff inflation and deflation system • Guided step by step protocol • Large graphic LCD display • Uni-Directional 8 MHz Doppler Probe • PVR waveform • Photoplethysmography PPG Toe Sensor for TBI • Special Toe cuff is supplied • Separate mode for complete vascular profile study • Penile flow study • Gets connected on to any computer • Standards matching the International specification • Software for patient report generation & storage.

Deformity due to the diabetic foot causes repetitive and excessive pressure to certain areas of the foot, which may result in ulcers and pains. Therefore, it is necessary to measure the pressure of the sole for the prevention and management of diabetic foot lesions. Early identification of feet 'at risk' for ulceration is important in preventing plantar lesions in diabetic patients with insensitive feet. Plantar pressures are higher in diabetic neuropathic patients than non-diabetic and non-neuropathic Counterparts. As high plantar pressure is a proven risk factor for foot ulceration, effective screening for high plantar pressures in diabetic patients could have a major influence on the incidence of diabetic foot ulceration. High plantar foot pressure has been identified as a significant risk factor for ulcerations. A large number of studies have suggested that plantar pressures are high in people with diabetic peripheral neuropathy (DPN) and in people with a history of diabetic foot ulcers. Measurement of these foot pressures is possible utilizing a variety of modalities. Several computerized systems can provide quantitative measurement of plantar foot pressure. These measurements are important in identifying areas of the foot at risk for ulceration and possibly in the evaluation of orthotic adjustments. In order to identify high-risk patients in a clinical setting, a simple system for screening is needed which is easy to use, reliable and gives results that are easy to interpret and can be immediately available to both the patient and staff. Our Foot Imprinter Harris Mat FM1111 has been developed as a simple, inexpensive and practical foot pressure measurement device intended for routine clinical use. It is a semiquantitative footprint mat that quantifies plantar pressure by visual comparison between the greyness of the footprint. Features: • Measures and display patient weight disbursement in greyscale • Detects the area of the greatest concern for ulceration • Useful to identify Charcot arthropathy • Arch of the patient can be detected • More the darker color represent the high pressure • Excellent tool for motivating the patient to upgrade to a good footwear • Kit includes FI1111 mat, rubber roller, ink pad, Ink and prescription pad

Transcutaneous oxygen monitoring (TCOM / tcpO2) is a well-documented technique reflecting the nutritive flow in the capillaries. Today, TCOM / tcpO2 is commonly used in clinical applications such as wound-healing assessment, hyperbaric medicine, amputation-level determinations and more. Precise8001 offers the possibility to monitor the transcutaneous oxygen at the sites of interest. Features: • Fluorescence photo optical system and hence no membrane technology • No membrane and hence minimal operating cost • No pre-heating of sensor and self-automatic calibration while testing • Measurement time is less than 10 min • Automatic marking of end value • 10.1-inch large LCD touch screen Display • Displays the measurement process graphically and numerically • Integrated patient and measurement database • Oxygen partial pressure range of 0 to 2000 mmHg • Sensor temperature range 37 to 44 degree Celsius • Long enough 250cm(2.5meter) sensor cable for ease of placement • USB connection for Computer connection - Optional • Connects external memory for data transfer in txt format • Software for data transfer to computer - Optional • Standalone operation and operate with the computer if software purchased • Measurement is independent of skin pH and salt content • Weighs less than 3 kgs • Built-in rechargeable battery supports minimum 3 hours of operation • Unit works between 100Volts and 230Volts AC power supply • Truly portable

We distribute high-quality selective stainless steel surgical instruments for managing Podiatry applications. These are imported from reputed suppliers and exported to many countries. The Kit contains: 1. Cuticle Pusher double ended 2. Corn Scrapper with handle 3. Cuticle Scissor with ring 4. Barrel spring Nail Cutter 5. Moon shape double spring Nail Cutter