Distal symmetrical polyneuropathy detected by vibration perception threshold among adults with and without diabetes attending a general outpatient clinic in Ilorin, Nigeria

The aim of this study is to compare the prevalence, severity, and symptoms of Distal Symmetrical Polyneuropathy (DSP) among adult patients with diabetes and those without diabetes in a primary care clinic. It was a cross-sectional comparative study involving 72 adults of between 40-60 years of age living with diabetes and 72 age-matched adults without diabetes. DSP was assessed with a biothesiometer device, and data analysis was performed using the SPSS Version 21 statistical software. The overall prevalence of neuropathy among the participants was 68.1% for those living with diabetes and 38.9% for the other group. Furthermore, 22.3% of the diabetes group had severe neuropathy compared with 8.3% of the other group. These differences were found to be statistically significant with p=0.001 (df = 2, X2 = 14.07). We reported higher prevalence and severity of DSP in those living with diabetes. We also found significant association between high VPT (≥25V) and presence of neuropathic symptoms thereby enhancing the use of the biothesiometer device in the diagnosis of adults with DSP in the primary care setting.

Effects on vibration perception threshold and the quality of life in the patients of high-risk diabetic foot treated with the pestle needling therapy / 中国针灸

OBJECTIVE@#To evaluate the effects of the pestle needling therapy on the vibration perception threshold (VPT) and the quality of life (QOL) in the patients of high-risk diabetic foot.@*METHODS@#A total of 132 patients of high risk diabetic foot were randomized into an observation group and a control group, 66 cases in each one. In the control group, the routine treatment and nursing for diabetes were applied. In the observation group, on the base of the treatment as the control group, the pestle needling therapy was used at , , , Zusanli (ST 36), Yongquan (KI 1), Sanyinjiao (SP 6) and Taixi (KI 3). The intervention with the pestle needling therapy was given once every day, consecutively for 4 weeks. The follow-up visit was conducted in 3 months and 6 months after the intervention. Vibration perception threshold (VPT) was observed before and after intervention in the two groups. Separately, before intervention, at the end of intervention, 3 months after intervention and 6 months after intervention, the type 2 diabetes mellitus quality life scale (DMQLS), the revised edition was adopted to compare the QOL between the two groups. The effects were evaluated in the two groups.@*RESULTS@#After intervention, the VPT and QOL were all improved in the two groups (<0.01, <0.05). In the observation group, after intervention, VPT at the first toes and the dorsum of the feet was lower than the control group at the same time point (all <0.01). In the observation group, the total scores and the score of each dimension item in the DMQLS of the revised edition were all lower than the control group correspondently at the end of intervention, 3 months after intervention and 6 months after intervention (<0.01, <0.05). The repeated ANOVA results showed that the differences were significant in the total scores and the score of each dimension in the aspects of time, inter-group and interaction effect (<0.01, <0.05). The total scores and score of each dimension item in the DMQLS were lower than those the earlier time point (<0.01, <0.05). The total effective rate was 100.0% in the observation group, which was superior to 95.1% (59/62) in the control group (<0.05).@*CONCLUSION@#The pestle needling therapy reduces the foot VPT and improves the sensory nerve function of the foot and the QOL in the patients of high-risk diabetic foot.

Evaluation of Early Neurologic Abnormalities on the Workers Exposed to Acrylamide / 대한산업의학회지

OBJECTIVES: Acrylamide is a neurotoxin inducing central-peripheral distal axonopathy. The authors evaluated several neurologic tests to screen the early effect of occupational acrylamide exposure. METHODS: Fifty-two males working either in the production of acrylamide monomer or in the handling of acrylamide in Ulsan, Korea, were selected and subcategorized into the high-exposure group (n=10, mean age of 30. 4 years) and the low-exposure group (n=42, mean age of 28.9 years). Twenty-three males (mean age 29.4 years) from medical professionals and students were chosen as a non-exposed reference group. Symptom questionnaire, neurologic examination, electrodiagnostic test, vibrotactile threshold test, and Lanthony desaturated 15 panel test (LD-15D) were done. RESULTS: The high-exposure group showed more number of specific symptoms on questionnaire and more abnormal two point discrimination test. High-exposure group showed a significant difference in the median motor conduction velocity, peroneal nerve motor latency, sensory amplitude of median nerve action potential, and sensory latency of sural nerve. The vibrotactile threshold of the high-exposure group was significantly higher in both hands and feet than that of the low-exposure group and the reference group. Average color confusion index on the LD-15D was significantly higher in the high-exposure group (median 22.7, range 0-135.7) than in the reference group (median 2.4, range 0-33.2). CONCLUSIONS: The symptom questionnaire, vibrotactile threshold test, and color discrimination test are sensitive in detection of the early acrylamide-induced neuropathy, and the combination of these tests would further facilitate the effectiveness of the screening.

Vibration Perception Threshold of Male Workers Exposed to Carbon Disulfide / 대한산업의학회지

This study was conducted on 367 male workers to evaluate the change of vibration perception threshold (VPT) according to exposure degree to carbon disulfide. VPT was measured on both metacarpal bones of index and little fingers and on fibular malleoli by Vibrometer (Rion, on 125Hz). The exposure degree was classified by the name of department. Workers in department 1 had been exposed to high concentration of carbon disulfide, those in. department 2 had been exposed to carbon disulfide moderately or intermittently, and those in department 3 had been exposed to undetectable concentration of carbon disulfide. The results were as follows: 1. The mean values of VPT of metacarpal(MC) bones showed dose-response pattern, i.e., the mean values of VPT at department 1 were highest, and those of VPT at department 3 were lowest with similar work duration or age. But the mean values of VPT of fibular malleoli (FM) showed dose-response pattern only in workers having above 5 years of work duration or whose age were above 30. 2. The mean values of VPT of MC bone of workers increased by age. 3. There were statistically significant difference in mean values of VPT of MC bone only in workers having 5-10 year work duration. And there were statistically significant difference of mean values of VPT of left 2nd and 5th MC bone in workers whose age was 30's, of right 2nd MC bone in those whose age was 40's, and of left 2nd MC bone in those whose age was 50's. 4. The variables affecting VPT significantly were department and age (or age group) both in multiple regression and general linear model. The department showed to have more effect to VPT than age in multiple regression, but age group showed to have more effect to VPT than department in general linear model. 5. The variables were transformed to indicator variable to do logistic regression analysis. Department 1, 2, 3 were classified into high exposure (spinning department) and low exposure (other department), age was classified into old (above 30) and young, and work duration was classified into long(above 10 years) and short. The exposure and age were significant variables by logistic regression analysis. Odds ratios of department and VPT on metacarpal bones or malleoli were 2.7-3.2 and those of age and VPT were 2.6 or 2.7. Odds ratio of age and abnormality of VPT on'any point was 3.3(1.59-6.;8), and that of department and VPT was 2.8(1.5-5.5). We concluded that exposure of carbon disulfied was significantly associated with reduction of VPT regardless of age; and that the test of VPT would be useful tool for screening and early detection in neuropathy by carbon disulfide or other neurotoxic chemicals,even though it is simple and cheap.

Selection of Testing Frequency in Bone Vibrator of Audiometer for Measurement of Vivration Perception Threshold / 대한산업의학회지

Both to determine testing frequency in bone vibrator of audiometer for measurement of vibration perception threshold(VPT) and to evaluate factors influencing VPT, ninty seven healthy adults were tested on their second metacarpal head of both hands, at 250Hz, 500Hz, 1,000Hz and so on. Measures of the VPTs at 1,000Hz were excluded in analysis because frequency 1,000Hz was not recognized as a vibration sense. Mean and standard deviation(S.D.) of the VPTs in the both hands measured at 250Hz were 19.9+/-6.7dB, 21.0+/-7.3dB, respectively and at 500Hz were 33.6+/-8.3dB, 34.9+/-8.1dB, respectively. Both mean and S.D. tended to be lower at 250Hz than 500Hz, and mean differences of VPTs between the left and the right hand at the both frequencies appeared statistically significant (p<0.01). VPTs were significantly correlated with each other (p<0.01). Age was positively correlated(p<0.001) with VPTs and education was negatively(p<0.01). Multiple regression analysis showed that age was the only factor influenced on VPT. These results suggest that, when using the bone vibrator of audiometer for measurement of VPT, the frequency 250Hz as a testing frequency may be more useful than frequency 500Hz, and VPT should be measured on both hands.