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.

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.

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.

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

VibraTip a wipe-clean, pocket-sized and disposable device for testing vibration sense. Vibration sense is typically one of the first sensory modalities to be impaired as peripheral neuropathy develops. Graduated tuning forks (e.g. Reidel-Seiffer) and calibrated electronic devices (e.g. Neurothesiometer, Bio-Thesiometer Vibrometer) are recommended to quantify the integrity of vibration sensation. VibraTip is a wipe-clean, disposable, key fob-sized device that provides a constant and reproducible source of vibration. The spherical head facilitates application from any angle and its pocket size means that it is easy to carry and therefore likely to be available at the point of use.

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.

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

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.