'routine checks'

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.

The Durometer is commonly also known as Shore Meter. There are two variants in this Shore Meter. They are Shore Meter A and Shore meter D. Shore durometer A is a device for measuring the hardness of soft material, typically of polymers, elastomers, and rubbers. Shore Meter D is mainly for hard materials like plastics, steel etc., We are distributing Shore Meter A and all the discussions and descriptions are about them only. Higher numbers on the scale indicate a greater resistance to indentation and thus harder materials. Lower numbers indicate less resistance and softer materials. Durometer measurement scales range from 0 to 100 and simply represent a relative comparison of hardness difference. The durometer has shown consistent reliability in the objective assessment of skin hardness in patients with systemic sclerosis and localized scleroderma. It is an easy-to-use and simple method, which can provide a correct numeric evaluation of hypertrophic scars induration and objective control of therapeutic efficacy during treatment over time. Determination of skin hardness by this instrument has been proven to be accurate and reproducible, both in normal and pathological conditions. Increased foot sole hardness and peripheral neuropathy are suggested to be important risk factors for foot ulceration. In subjects with diabetes, it was found in numerous research that differences and variations in foot sole hardness were found to be significantly different in subjects with and without diabetic neuropathy using Durometer (Shore meter). Hence shore meter was more sensitive and provided a feasible means of measuring foot sole hardness in subjects with diabetic neuropathy. Foot sole hardness in diabetic feet can be considered as a potential determinant of foot sole ulcerations. The durometer has potential use in many dermatological disorders as a tool to be used routinely to demonstrate improvement in treatment, particularly in burn patients where cosmetic appearance and functional status represent major concerns for the patient.

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

These Podiatry chairs were developed for a comfortable seated position for the client at all times. Its slender appearance makes the room or consultation area appear more spacious. In addition, the arms fold up completely, making it easy for the client to get in and out of the chair from the side. The leg supports of the chair are contoured and the height and length can be adjusted individually. Their ergonomic shape provides stable support for the lower leg and foot. PC303 - 3 function Podiatry Chair provides motorized adjustment of backrest, height and tilt using a hand remote control. PC305 - 5 function Podiatry Chair model inaddition to the PC303 model the leg rest right, left can also be adjusted individually by a motorized function.