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.

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.

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

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.

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.