Ambulatory blood pressure monitoring (ABPM) is being increasingly recommended for routine clinical practice. It may be particularly useful in evaluating the patient with variable blood pressure readings in the office, or the patient with wide discrepancies between the blood pressure readings at home and the clinician's office (ie, "white coat" hypertension). ABPM and, in particular, nocturnal blood pressure readings, may also provide prognostic data. Ambulatory blood pressure (ABP) monitoring involves measuring blood pressure (BP) at regular intervals (usually every 15–30 minutes) over a 24 hour period while patients undergo normal daily activities, including sleep. . What are the indications? • Suspected white-coat hypertension (including in pregnancy) • Suspected masked hypertension • Suspected nocturnal hypertension or no night time reduction in BP (dipping) • Hypertension despite appropriate treatment • Patients with a high risk of future cardiovascular events (even if clinic BP is normal) • Suspected episodic hypertension • Prolonged Diabetes Supplied with unit, Adult BP cuff, Wide BP cuff for obese patients and software.

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.

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). Small-fiber Test (HCP) provides an easy-to-use and scientifically validated measure of warm, cool and heat pain thermal sensory thresholds, all clinically useful determinants in the evaluation of diabetic neuropathy. 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-folds 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 helps better prevention. Prevention is better than no cure. 50% of all non-traumatic amputations occur in diabetes who is a high-risk group. Our Neuropathy Analyser model Vibrotherm Dx has inbuilt both VPT and HCP in a single device. The Windows 7/8/10 supported software supplied helps to capture the VPT, COLD, HOT and Monofilament 10gm testing for storage and a patient report. FEATURES: • Full solid-state design with PC enabled • Easy Tool to quantify Neuropathy • Digital Biothesiometer VPT and Thermometry HCP combined • Digital 0 ~ 50 Volts Vibration output • 1 ~ 50o C temperature output range • 1o C rate of change per second • Remote keypad helps easy operation • Single probe delivers both Hot & Cold temperatures • Automatic interpretation based on set reference values • Early detection of Small Fiber Neuropathy • Software supports Windows Win 7 / Win 8 / Win10 computer • Patient report storage, export, pdf options available • USB interface

This basic neuropathy Assessment kit consists of one Tiptherm, one VibraTip and 25 Nos. 10gm Monofilaments to check the loss of temperature, vibration and touch sensitivity. Early diagnosis of distal symmetric polyneuropathy by testing temperature sensitivity, can prevent complications of diabetic foot. Precious time is gained if examinations are geared towards detecting this symptom. Regular testing of temperature sensitivity should therefore be a compulsory part of basic diabetes treatment. 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). TIP THERM® is ideal for testing temperature sensitivity. It is not dependent on external power sources, is practically indestructible, easy to handle and small and light enough to fit in any jacket or overall pocket. VibraTipTM: a wipe-clean, pocket-sized and disposable device for testing vibration sense. The advantages include ease and speed of the test with little required training, less user variability compared with the calibrated tuning-fork test, small size, and easy cleaning.

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.

One of the frequent causes of non-traumatic lower-limb amputation is Diabetes and is usually preceded by foot ulcer and infection. The reason of this ulceration is commonly a loss of protective sensation due to peripheral neuropathy, for which there is no prevention strategy. Current research promotes early detection of neuropathy so that secondary prevention measures, such as intensive foot-care education and treatment, can be used for individuals. In an effort to standardize and simplify the detection of insensate foot, the 5.07/10-gm Monofilament is recommended by the International Diabetes Federation and the World Health Organization as a device that can be used by health professionals at every level of care. A standardised filament is pressed against part of the foot. When the filament bends, its tip is exerting a pressure of 10 grams (therefore this monofilament is often referred to as the 10 gram monofilament). If the patient cannot feel the monofilament at certain specified sites on the foot, he/she has lost enough sensation to be at risk of developing a neuropathic ulcer.

Automated diabetic foot evaluation lab model Diabetik Autolab is capable of screening (1) Vascular Insufficiencies using Ankle Brachial Index, Toe Brachial Index, Velocity waveform analysis, (2) Diabetic neuropathy using loss of vibration perception threshold (VPT)-Biothesiometry and loss of protective touch sense-Monofilament 10gm, (3) plantar pressure screening using advance electronic sensor platform by checking static(weight bearing), dynamic(walking) and postural imbalance, (4) Non-contact measurement of temperature in the foot for early assessment of inflammation in the foot. A master report is generated with the patients clinical information, medical information and the measured data with interpretation. Device is supplied in a trolley and a branded i3 based laptop computer and an EPSON ink tank printer. Sales and service team across India to train the user periodically. ISO13485:2016 certified company.

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.

Monofilaments MF10GM contain a small strand of filament attached to a visiting card-like handle. When placed upon the skin perpendicularly and applied an amount of pressure before the filament bends or buckles. The point at which the filament bends or buckles is rated in grams of force. 10gm Monofilament is widely accepted by the medical community and recommended by WHO and IDF for evaluating the loss of protective touch sense. The MF10GM Monofilament is intended to be used to determine whether a person with diabetes has the presence of an adequate level of protective sensation in their feet as indicated by having enough tactile sensitivity to perceive 10 grams of force against the skin of their feet. The monofilament is tested on multiple points on the foot of the person to be tested and they should feel the sense in the majority of the test points. If they don’t feel the sense in multiple spots, then it is indicated that they would have lost the protective touch sense. It should be used on adult Diabetic patients on a periodic basis to evaluate changes in sensory perception in the feet due to Diabetic peripheral sensory neuropathy. This device is not a complete replacement for routine sensory evaluation by a health care provider. They are available in a box of 25pcs and cost Rs. 650 inclusive of GST and Courier.