Javed Ahmed Phulpoto, Kouro Mal Gurbakhshani, Abrar Shaikh.
Role of bedside methods in evaluation of diabetic peripheral neuropathy.
Rawal Med J Jan ;37(2):137-41.
Objective: To assess the role of bedside methods in evaluation of diabetic peripheral neuropathy in diabetic patients attending diabetic clinic at Ghulam Mohammad Mahar Medical College Hospital, Sukkur, Pakistan. Methods: This cross-sectional study was carried out at Diabetes Clinic, Ghulam Mohammad Mahar Medical College Hospital, Sukkur, from January 2010 to May 2011. A total of 1044 patients with diabetes mellitus were included in this study. All subjects had a detailed clinical assessment including Diabetic Neuropathy Symptom (DNS) score, Diabetic Neuropathy Examination (DNE) score, ankle reflex, vibration sensation with a 128 Hz tuning fork, 10g Semmes-Weinstein monofilament and vibration perception threshold (VPT). Results: The prevalence of peripheral neuropathy was 34.9 % with VPT. Foot care practices were followed by only 214 (20.5%) patients. When compared with VPT, ankle reflex was the most sensitive (90.7%) but least specific (37.3%). The tuning fork and monofilament tests respectively had lower sensitivity (62.5 and 62.8%) but better specificity (95.3 and 92.9%) and accuracy (78.9 and 77.9%). Significant correlations were observed between the VPT score and the DNE (r=0.532, p<0.001) and DNS (r=0.546, p<0.001) scores and absent tuning fork sensation (r=0.590; p<0.001), monofilament sensation (r=0.573; p<0.001) and ankle reflex (r= 0.377, P= 0.01). Conclusions: The findings show that simple bed side tests are useful for assessing peripheral diabetic neuropathy, even in those subjects in whom foot care practices are not followed. (Rawal Med J 2012;37:137-141).
PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com