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.

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.

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

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.

In diabetes mellitus, polyneuropathy is an important complication and should be diagnosed as early as possible in order to prevent damage to the patient. Determination of warm, cold, and heat pain thresholds enables one to judge small nerve fibre sensitivity. 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). The Thermometry HCP may be used on patients with neurological diseases (especially peripheral neuropathy). The system is designed to measure and store patient responses to a series of thermal stimuli, but does not make any diagnosis. The test results should be used with the results of other medically accepted tests in order to assist the physician in making a final diagnosis. The product is highly accurate and truly calibrated to produce repeatable results. When the patients are properly explained and instructed before the testing, the results of the tests are highly sensitive, specific, and quantified. Features: • Full solid state Design PC enabled • Non invasive testing of pain thresholds • Range : 10 C to 500 C (Restricted for the purpose of safety) • Rate of change : 0.50 C per second for Hot/Cold • Helps to find Cool, Warm, Hot, and Cold Perception Thresholds • Data storage on Personal Computer. • Easy operation with hand remote • Helps detecting Diabetic Polyneuropathy at an early stage