Context:Many advances have taken place in the detection of diabetic polyneuropathy with respect to examination scores, electrophysiological techniques and quantitative sensory testing.Aim:This study aims to evaluate the discriminative power of the Diabetic Neuropathy Examination Score (DNE), 10-g Semmes-Weinstein Monofilament Examination (SWME) and Quantitative Sensory Testing by Vibration Perception Threshold (VPT) in the diagnosis of diabetic polyneuropathy and seek an optimal screening method in diabetic clinic.Materials and Methods:Hundred consecutive patients with Type 2 diabetes were subjected to Diabetic Neuropathy Symptom Score, DNE score, Semmes-Weinstein monofilament examination, Vibration Perception Threshold and Nerve Conduction Studies; mean ± SD for the various characteristics were calculated. Sensitivity and specificity for the DNE, SWME and VPT were calculated, taking NCS as gold standard.Results:Seventy one of 100 subjects had evidence of neuropathy confirmed by Nerve Conduction Studies, while 29 did not have neuropathy. The DNE score gave a sensitivity of 83% and a specificity of 79%. The sensitivity of SWME was 98.5% and specificity was 55%. Vibration Perception Thresholds yielded a sensitivity of 86% and a specificity of 76%.Conclusions:A simple neurological examination score is as good as Vibration Perception threshold in evaluation of polyneuropathy in a diabetic clinic. It may be a better screening tool for diagnosis of diabetic polyneuropathy in view of the cost effectiveness and ease of applicability.
Introduction: The number of people with lower-limb amputations (LLA) is expected to double by the year 2050, largely because of vascular disease associated with an aging population and increased incidence of diabetes and heart disease. The change in weight pattern will help us in designing linear spring based osseointegrated prosthetics for people living in hilly areas with amputation who living in hilly terrain. Methodology: N were selected for the study. We used weights and heights obtained during inpatient and outpatient clinical encounters. N going under transtibial amputation were selected and the patients were categorized under two groups Type-1 and Type -2 diabetes. Height and B.M.I. was taken from the case record form at the time of entry of a patient in the general surgery department. Percent weight change, calculated as the difference between weight at time x and weight at baseline, divided by baseline weight x 100, was the primary outcome of interest. Results: Among 20 patients selected for the study (n=100). Out of which 6 patients were Type-1 diabetic and the rest 14 were type two diabetic. The height of twenty patients ranged from 154cm-174cm. with a mean height of 163.8cm. As expected based on our matching, the distribution of ages, BMI, reference years, and presence of a diabetes: 65 percent of individuals were between the ages of 25 and 74 yr, 73 percent had diabetes, and nine patient were overweight (range 25.5-29.9) where rest eleven patients were obese, out of which nine have B.M.I. 30-35 and rest two were above 35.1.The difference in change in weight between type one and type two patient were noted. Type one patient showed mean weight increase of 5055gm, where as type two diabetic showed an increase of 4894gm within the span of three months.
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