Common Symptoms of Peripheral Neuropathy

Peripheral Neuropathy
The Common Symptoms of Peripheral Neuropathy
The peripheral nervous system serves the areas in the extremities of the body. The nerves within that
system provide a number of functions, depending upon which one is being affected. Typically,
nerves can be classified as sensory (receiving sensation), motor (controlling muscle movement) and
autonomic (regulating functions such as heart rate and blood pressure). One of the issues that may
occur with those nerves is peripheral neuropathy. A number of symptoms of the condition may be
experienced.
Peripheral neuropathy is an issue in which the peripheral nerves are damaged. This often leads to
symptoms that are associated with either the hands or the feet but it may also affect more than one
area
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Neuropathy Program Pros And Cons
The neuropathy solution program
Introduction
I have heard many people complaining about feeling pain in some part of the body. This makes me
ask the question, what are the causes of neuropathy? Nobody loves being tormented with numbness,
intense stabbing pains among others.
My friend once told me that the doctor had told him there was no cure for the neuropathy he was
experiencing. The only thing the doctor could do is help reduce the pain by prescribing some
medicines. In addition, he was informed that he would experience this neuropathy the rest of his
life. When I heard about this program, I immediately informed him.
There is no doubt that neuropathy robs us some of the best moments in our life because we cannot
anything because of pain. Honestly speaking, this ... Show more content on Helpwriting.net ...
There are no frequent doctor's appointment involved or buying of expensive drugs
It relieves us from those painful nervous pains
The diet program makes us have more energy and also have a good feeling about ourselves
You may start losing weight from the exercises you engage yourself in during the program
It has a 8weeks money back guarantee if the program does not work for you during the 8weeks after
purchase
Once you purchase this program, you will customer care support any time you have a question
about this program
Cons
I honestly haven't come across any disadvantage of using this program.
Is Neuropathy solution program

A Brief Note On Diabetes And The World Health Organization
or insulin can be required (Diabetes UK 2012). This case study states at what stage he was
diagnosed, and what were his present risk factors. The main factors contributing to diabetes is
obesity, there also other pre–diabetic risk factors such as ethnicity, poverty, and age. Obesity has
become a major factor also known as an increased BMI (body mass index). The world Health
Organisation has mentioned that by 2015, 2.3 billion people will be obese. In UK alone the rates
have doubled in the past years. Different ethnic minorities have higher prevalence in diabetes,
figures have shown ethnicities such as African, Caribbean, and Pakistani origins are more obese in
comparison to Bangladeshi and Chinese. This 45 year old gentleman incurred a trauma injury to the
metatarsal and that had caused a wound, which later developed an infection, but was showing no
signs of healing. He was admitted to the hospital and Further tests were done such as the HBA1c
(glycated haemoglobin). Diabetes UK (2015) states An HbA1c of 48mmol/mol (6.5%) is
recommended as the cut off point for diagnosing diabetes, other tests done were UE, FPG (fasting
[plasma glucose test, FBC, ESR (erythrocyte sedimentation rate) , and CRP, Raised Triglycerides
and total cholesterol were also present. From this it showed he had undiagnosed type 2 diabetes for
over 10 years, 2 years prior to this injury he was diagnosed with retinopathy. Retinopathy (is
damage to the retina) this is a complication that

Optic Neuropathy Essay
Leber's Hereditary Optic Neuropathy: A Genetic Disease that Affects Metabolism In 1971, Theodor
Leber, a German ophthalmologist, first described distinctive symptoms of central vision loss in a
group of patients. Leber's hereditary optic neuropathy (LHON) was later named in his honor. With
the discovery of mitochondrial DNA came the ability to identify the genetic cause of this disease. It
is a maternally inherited mitochondrial disease that most commonly affects young men aged 15 to
30 years old. Its painless symptoms usually leave patients with significant, permanent blindness due
to optic nerve damage in both eyes. There have been some reports of neurologic abnormalities such
as tremors and cardiac arrhythmias. An ophthalmologist will examine the patients' eyes and perform
various ... Show more content on Helpwriting.net ...
It is a mitochondrial disorder inherited only from mothers because mitochondria are passed on to the
developing embryo from egg cells ("Genetics Home Reference,"2013). Mitochondria are important
structures inside the cells to generate ATP, a form of energy that can be used in our body. Since our
eyes require large amounts of energy, any dysfunction of the mitochondria can have a dramatic
effect in vision. The majority of patients diagnosed with LHON have genetic mutations in
mitochondrial DNA (mtDNA). Approximately 90% of patients with LHON have one of three
mtDNA mutations: m.11778G>A (the most common), m.3460G>A, or m.14484T>C ("Leber
Hereditary Optic Neuropathy," n.d., Causes section, para. 3). These mutated genes disrupt the
proteins in the mitochondrial enzyme complex that help convert oxygen, fats, and simple sugars to
energy which cause optic nerve cell damage ("Genetics Home Reference,"2013). It is important to
note that even though an individual may be a carrier of one the gene mutations, does not mean they
will develop the disease. Scientists have been unable to find out why it affects more males than

Peripheral Neuropathy In Diabetes
Diabetes mellitus is a metabolic disorder caused by the inability of the pancreas to produce
sufficient amounts of insulin to deal with the quantity of glucose and other carbohydrates entering
the body, or by the insensitivity of the body to the normal action of insulin.
One of the most common complications of diabetes is neuropathy, occurring in 60–70 percent of
diabetic patients. This refers to nerve damage caused by abnormally high levels of various
metabolites in response to high sugar levels in the blood and tissues. Its prevalence is higher with
longer duration of disease, and with age, as well as with unstable or uncontrolled hyperglycemia,
hypertension, obesity, and hyperlipidemia.
Causes and symptoms
Neuropathy in diabetes is postulated to be ... Show more content on Helpwriting.net ...
Peripheral neuropathy in diabetes frequently leads to amputation; for this reason, foot care is of
paramount importance. Daily personal foot examination is mandatory to arrest problems early. In
addition, expert appraisal is also recommended, several times a year.
Normalizing blood glucose levels is the first step in managing diabetic peripheral neuropathy. In
fact, diabetic peripheral neuropathy is best prevented by a tight control of blood glucose levels. This
is achieved by careful monitoring, dietary modifications, exercise, and the use of medications or
insulin. Newer treatments to slow down the progress of or to reverse neuropathy are still under
study.
Symptomatic treatment may help to control pain. This can range from topical preparations or oral
pain–relieving medication to bed cradles which prevent bedding from touching the painful limb.
Smoking and drinking increase the risk of amputation and should be stopped, with help if

Chief Complaint Case Study
Chief Complaint
Peripheral neuropathy.
History
Patient is 71–year–old white right–handed white female who presents with her sister for evaluation
of peripheral neuropathy. She states that it started about a year and a half ago in her toes and has
slowly increased to involve her soles of her feet and the dorsum and now the lower one third of her
calves bilaterally. There is occasional problems with edema in her lower extremities, but this has
come later. The severity of the numbness changes if she walks for a long period of time, at which
point it gets more numb. She currently is not having any burning or jabbing pain. She does not have
the symptoms in her hands or in her torso. She does have hypothyroidism, but she is on medication.
She is obese with problems with fasting glucose and hyperglycemia. Her hemoglobin A1C went
from 4 to slightly over 5 over the course of the last year, but she has not been given the diagnosis of
diabetes. She has no other medical risk factors for developing the peripheral neuropathy. She is
unable to give any further history, except on detailed questioning, she does not have any problems
with ambulation in the dark or on uneven surfaces and has not had any falls. ... Show more content
on Helpwriting.net ...
The EMG of the lower extremities was normal. The MCV revealed mainly decreased amplitudes of
the sensorimotor nerves, but with decreased tibial velocities bilaterally.
Review of Systems
Morbidly obese, decreased visual acuity requiring glasses, tinnitus, GERD, hip pain, G4, P4,
postmenopausal, insomnia, seasonal allergies.
Social History
She does smoke. She drinks

Hereditary Optic Neuropathy
This is a brief review of Leber's Hereditary Optic Neuropathy (LHON) otherwise known as Harding
disease. LHONs is a degenerative eye disease that causes vision loss in the teen years of those
afflicted. As most optic neuropathies LHONs is heterogeneous genetic and a minimum prevalence
of 1 in 10000. However, differing from many similar hereditary optic neuropathies LHONS is a
maternally inherited mutation and has never been observed to be paternally inherited. Meaning that
the gene responsible is only on the X sex chromosome. In this review, we will be specifically
observing the way in which LHON is more predominantly displayed in males with the gene as
opposed to women and the possible mitochondrial mutations responsible for this. It has ... Show
more content on Helpwriting.net ...
In many parts of the world where smoking is popularly practiced LHONs and other similar optic
atrophic diseases have shown outbreaks in those who have no sign of the responsible mutations for
them (Rosaralis et al. 2015 n.pg). This was shown in a study by Matthew Anthony Kirkman, of
Imperial College London with expertise in Neurosurgery, in this study (the largest study, by
population, done on LHONs ) Kirkman proved the correlation between tobacco and increased risk
for development of vision loss in LHONs type pedigrees. And while he also found a correlation
between alcohol abuse and vision loss he determined that his research was not extensive enough to
determine causation (Kirkman 2009). So while many believe that other environmental factors such
as malnourishment and alcohol abuse there is little proof that anything other than heavy cigarette
smoking can encourage LHONs and similar diseases. Kirches conducted a case study in which the
hereditary movement of LHONs was observed. In this study, it was found that LHONs can cause an
acute loss of retinal ganglion cells and their axons. According to this study "RGC loss occurs in
about 50% of male and only 10–15% of female mutation carriers" this shows evidence that men are
more effected by LHONs it also shows why women do not show symptoms of LHONs (Kirches
2011 n.pg). Showing the true causes of blindness presented with

Benefits Of Peripheral Neuropathy
If your ability to work is affected by peripheral neuropathy, you may be eligible to receive disability
benefits as a result. Peripheral neuropathy is a result of damaged message carrying nerves
throughout parts of the body that are unable to deliver information to the brain and spinal cord. A
person's ability to perform in any given work place can be greatly affected by this.
While there are a variety of medical conditions which go hand in hand with peripheral neuropathy,
diabetes is the most common. When nerves which transmit pain and other signals to the brain are
damaged due to regularly high blood sugar levels, diabetic neuropathy can occur.
People can have difficulty walking or even standing because they are unable to feel or experience

What Is An Appeal For Peripheral Neuropathy?
On Tuesday 06/27/2017, veteran Mr. Saenz walked very angrily in my office with his wife about
11:00 AM. I greeted them and offered to sit down; Mr. Saenz and Mrs. Saenz were very upset and
asked me where they need to go as they have VA examination, they both said "nobody tells them
anything; they have been sitting in waiting room". They told me that the lady on the desk told them
to come to me. Veteran and his wife asked me about "where is his VA examination", why he did not
receive 70 % like other veterans "how he is combined 80% with 130 percent different disabilities"
then he asked about his 2 pending appeals, including his appeal for peripheral neuropathy, IU claim,
why VA is not paying him correctly, he has Malaria and headaches did ... Show more content on
Helpwriting.net ...
Saenz said it is not true. This is wrong. I am unable to work my whole body is disabled and I am
130 percent. Then Mrs. Saenz pointed to her husband and said" He is confused and many times he
cannot understand what is said, at this point Mr. Saenz became upset and tried to shut his wife. Mr.
Saenz then continued that he filed an appeal for IU and many other conditions like neuropathy but
VA did not process them since 2014. I looked VBMS was not working so I referred to VACOL/
MAPD/ and SHARE he had 3 appeals and a 020 pending, I read all the disabilities and the appeal
status in process. Mr. Saenz interrupted and said any veteran he talks to has 70 percent for
neuropathy but VA has not assigned any to him and assigned 20 % for DM2 only. He interrupted me
that He does not want money but he wants to be rated correctly. I asked him if you want to apply for
increase in DM2 if he feels it is worsened. All of a sudden, he said you are saying I am asking for
more money, and Mrs., Saenz stood up and started yelling he will miss VA examination. I told them
let me go and ask if someone call your name, after taking their permission, I went to front desk
secretary on the desk Mr. and Mrs. rushed after me. They started talking to a VA person standing
near the counter. I told the secretary that Mr. and Mrs. Saenz are very upset due to waiting. She
laughed. I continuously tried to explain their inquiries, answer to their questions, kept empathizing,
and remain patient but

The Common Long Term Complications Of Diabetes Mellitus
One of the most common long–term complications of diabetes mellitus is painful neuropathy.
Diabetic neuropathy is estimated to affect about 60–70% of all diabetes patients and can lead to foot
ulcers, amputations, and decreased quality of life. The most common form is chronic peripheral
neuropathy which results in pain and numbness in the extremities, usually described as a burning,
tingling, or steady aching pain.1 Patients may also feel increased sensitivity to pain or experience
paresthesia, a sensation of tingling, tickling, or prickling of the skin.1 According to current
guidelines, intensive glycemic control is very important for the prevention and reduction of
peripheral neuropathy and other microvascular complications.1,2 Medications used to help relieve
nerve pain include duloxetine and pregabalin (Lyrica®), which are both approved by the U.S. Food
and Drug Administration for use in diabetic neuropathy. Other drug classes commonly used are
antidepressants, anticonvulsants, and opioids.3 Although there are many medications used for this
condition, pain relief is often insufficient for patients. Treatment is difficult due to the complicated
pathophysiology of pain transmission and the wide range of mechanisms of action of drugs used to
treat pain. Therefore, there is a continued need for additional medication options for this chronic
painful condition. Lacosamide is an anticonvulsant approved for use as monotherapy or adjunctive
therapy for partial–onset seizures.

Diabetic Neuropathy Essay
Diabetic peripheral neuropathy is among the chronic microvascular complications of diabetes
mellitus due to hyperglycemia. Prevalence of diabetic neuropathy is high, affecting more than 60%
of diabetics (Boulton et al., 2005). The clinical manifestation of diabetic neuropathy include
numbness, tingling sensation in toes, feet, legs, arms, hands and fingers (Kumar et al.). It leads to
significant morbidity, impact on quality of life of patients (Zychowska et al.) and increases the risk
of infections leading to the foot ulcers and non traumatic amputations (Bansal et al.). In diabetic
neuronal cells, hyperglycemic flux activates four cellular pathways: the polyol, advanced glycation
end–product, protein kinase C, and hexosamine pathways increasing ... Show more content on
Helpwriting.net ...
It leads to the reduced coupling efficiency in mitochondria and increased superoxide radical
generation damaging both nuclear DNA and mitochondrial DNA leading to activation of poly ADP
ribose polymerase enzyme (PARP) (Fernyhough et al.Brownlee, 2001; Nishikawa et al., 2000b, to
be added). PARP activation leads to inactivation of AMPK which facilitates mitochondrial
biogenesis. Thus, PARP activation compromises the cellular mitochondrial genesis which leads to
accumulation of damaged mitochondria in the cell. Molecular studies have revealed the involvement
of transcriptional regulators such as Nrf2, NF–κB, and COX–2 inflammatory cascade in the
pathology of diabetic neuropathy. The Nuclear factor 2 erythroid related factor (Nrf2) is a redox
transcription factor for the production of endogenous antioxidant defenses and detoxifying enzymes.
Nuclear factor–kappa light chain enhancer of β–cells(NF–κB) is a transcription factor, involved in
pro inflammatory cytokine production (Negi et al.). Both Nrf2 and NF– κB regulation are co–
ordinated in order to maintain redox homeostasis in healthy cells. However, during pathological
conditions this regulation is disturbed offering an opportunity for therapeutic intervention. Diabetic
neuropathy is a condition , in which change in expression pattern of Nrf2 and NF–κB has been
reported(Koriyama et

Diabetes affects virtually every aspect of the body and poorly controlled diabetes increases the risk
for diabetes related complications. Patients diagnosed with mental illness are at an increased risk to
develop diabetes complications as a result of poor self–care management (Green, Gazmarian, Rask,
& Druss, 2010). Dickerson et al (2011) found that patients diagnosed with bipolar disorder tend to
have a more sedentary life, poor dietary intake, be obese, smoke and have an increased risk for
alcohol and illicit drug abuse. Each of these factors contribute to poor glycemic control, which
contributes to the development of diabetic peripheral neuropathy. Up to 50% of patients diagnosed
with diabetes have some form of diabetic neuropathy. Diabetic neuropathy presents in the form of
sensory neuropathy, motor neuropathy or autonomic neuropathy. Sensory neuropathy may also be
called polyneuropathy due to the number of different nerve centers affected by damage. Over time
elevated glucose levels lead to extensive damage to the blood vessels that supply nerves to
numerous sites in the body. Continued assault upon nerves can lead to permanent nerve damage,
resulting in pain to affected areas and increased risk of injury, which can lead to amputation
(Diabetes UK, n.d.). ... Show more content on Helpwriting.net ...
Sensory neuropathy can affect the hands, feet, legs and arms, symptoms may range from mild to
severe, such as numbness, reduced ability to sense pain or extreme temperatures, tingling feeling,
unexplained burning sensations, sharp stabbing pains, often symptoms are more noticeable at night.
People with sensory neuropathy may experience dysesthesia (abnormal sensation) symptoms of
dysesthesia include a burning feeling under the skin and extremely sensitive skin to the extent where
clothes and bedding can cause intense pain (Diabetes UK,

Diabetic Neuropathy Treatment Plan
Management of diabetic neuropathy will reduce the symptoms of the pain and improve the quality
of life of an individual. However, it important that clinicians are thorough in clinical evaluation of
patients to be aware of the indirect warnings of disease process (Cox, DeGraauw, & Klein, 2016).
One cannot design a treatment plan, until a complete history and physical examination are
necessary. Armed with extensive information about diabetes, signs, complications, and cognizance
to make appropriate therapeutic intervention then it can be anticipated that we can take account of
any possibility of differential diagnosis, so as to efficiently classify the patient for treatment or to
direct patients to the proper healthcare provider, thereby minimizing and preventing mortality and
morbidity (Mathers, 2012, p. 216). There are available interventions to employ during rehabilitation
but this is dependent on the type, symptoms and severity of the neuropathy. For instance, the
physical therapist can introduce nerve gliding activities. The said therapy gives emphasis on the
nerves so as it can move ... Show more content on Helpwriting.net ...
It is also our responsibility to promote education to our patients with regards to the importance of
staying healthy by engaging patients with physical activity in combination to their diet and
compliance to their medications. Moreover, taking intense note on medications will favorable to the
individual to avoid any detrimental side effects that may be presented during the course of their
therapy. In rare cases, patient with diabetic neuropathy go through a lot of emotional instabilities,
which is why it is critical for the physical therapist to design a positive atmosphere conducive for

Diabetic Peripheral Neuropathy
Globally, The number of patients with diabetes is increasing rapidly. By the year 2035, the number
of people with diabetes worldwide is expected to rise to 592 million (IDF ATLAS 20131). Diabetic
peripheral neuropathy (DPN) is a common microvascular complication of diabetes and a leading
cause to amputations in hospitals (Boulton 20052). The prevalence of DPN is estimated to be 50–
60% (Sandireddy R 20143). The pain associated with DPN can affect the patient quality of life
(QOL). It affects their sleep, lifestyle, work and even can cause or be associated with depression
(Jensen MP 20074). It is not well understood whether the mechanism behind peripheral neuropathy
with diabetes is hyperglycemia or other insulting pathophysiological mechanism like proinflamatory
immune mediators (Herder C 20135, Goh S–Y 20086). One of the possible mechanisms is the
demyelination of the small C fiber, this is the leading cause behind the pain sensation with ... Show
more content on Helpwriting.net ...
Prevention and slowing the progression of DPN via glucose control has been demonstrated to be
effective in patients with type 1 diabetes, but may not be as effective in patients with type 2 diabetes
(Callaghan BC 201211). Other studies found no correlation between glycated hemoglobin (HbA1C)
with mean of 6.9% and the severity of DPN (Owolabi MO 201212). Diabetic patients are more
susceptible to dyslipidemia and metabolic syndrome. Those patients have body mass index (BMI)
≥30Kg/m2, abnormal glucose metabolism with insulin resistance, high low–density–lipoprotein
(LDL), total cholesterol (TC), triglycerides (TG), and low high–density lipoprotein (HDL). Those
abnormal findings expose patients to atherosclerotic changes and microvascular complications
together with hypertension and cardiovascular diseases (Mooradian AD

Peripheral Neuropathy Essay
Peripheral neuropathy involves damage to the peripheral nervous system which serves as a major
communication network for the brain, the spinal cord other parts of the body. Peripheral nerves are
responsible for sending sensory information such as "cold feet" back to the brain. It is also
responsible for sending signals from the brain and spinal cord to the muscles to elicit movement.
There are more than 100 types of peripheral neuropathy and each is classified based on the type of
damage on the nerve. Some peripheral neuropathies are due to damage to the myelin sheath which is
the fatty protein that coats and insulate the axon. This myelin sheath is important for increasing the
speed at which impulses propagate down a myelinated nerve fiber.

Diabetic Peripheral Neuropathy Essay
Diabetic Peripheral Neuropathy (DPN) is one of the most common microvascular complications in
diabetes and can result in foot ulceration, ampuation and an impaired quality of life(Carrington AL,
et al 2002,Boulton AJ,et al 2004). The reported prevalence of diabetic peripheral neuropathy ranges
from 16% to as high as 66%2 and its prevelance is believed to increase with the duration of diabetes
and poor glucose control.(Boulton AJ.et al 2000) It's accounts for 50–75% of non–traumatic
amputations in diabetic patients.(Holzer SE, et al 1998, Boulton AJM, 1998,Malay DS, et al 2006)
DPN has been defined as "the presence of symptoms and/or signs of peripheral nerve dysfunction in
people with diabetes after the exclusion of other causes" ... Show more content on Helpwriting.net
...
Assessment and diagnosis
The early diagnosis of neuropathy is crucial to stop progression to advanced stages, and further
complications. (Toopchizadeh V., et al.2016) Early intervention can protect diabetic patients from a
risk of foot ulcers and amputation, improve the quality of life (Vlckova–Moravcova E, et al
2008.Van Schie CH. 2008, Ismail K, et al 2007) and mitigate the socioeconomic consequences of
diabetic foot disease. (Davis WA,et al 2006,Lavery LA,et al 2007,Gordois A,et al 2003 )
The diagnosis of DPN is primarily clinical, based on clinical suspicion and confirmatory
examination findings from the history and examination, followed by the exclusion of other potential
causes.(Vinik A, et al 2013) Importantly, in any patients with neuropathy and specifically patients
with a severe form,it is essential to rule out any other causes apart from diabetes such as ,drug
induced neuropathy (e.g. isoniazid) , alcohol abuse, nutritional deficiency like vitamin B12
deficiency(Wile DJ,et al 2010),vasculitis , inherited neuropathies, and renal disease (Freeman
R.2009) The clinical presentation of DPN vary markedly from one patient to another depending on
the type of sensory fibers involved. About 50% of patients is symptomatic, commonly present with
a burning

Neuropathy Essay
peripheral neuropathies (14).
On current 1.5T scanners (GE machine), 2D (dimensional) imaging can be performed with near–
similar resolution as on
3T scanners; however, 3D imaging is often limited, especially if smaller voxels are used or fat
suppression is applied. On the other hand, if there is metal in the field–of–view, in order to mitigate
susceptibility artifacts and for superior nerve visualization,
1.5T imaging is often favored. 2D pulse sequences include high resolution (base resolution 256 or
higher, in plane resolution 0.3–0.4 mm) T1–weighted and fat suppressed T2w images (16).
Suprascapular neuropathy is difficult and challenging diagnosis for clinicians because of symptoms
overlapping with a number of other regional conditions. ... Show more content on Helpwriting.net ...
The abnormal nerve may also show one or more of the following findings: abnormally increased SI,
heterogeneous
SI, focal or diffuse nerve enlargement, enlargement and effacement due to different degrees of
edema, and fascicular disruption with intraneural and/or perineural fibrosis (22,23).
Denervation changes of muscle can have several MRI appearances. In the subacute phase the
affected muscle demonstrates increased T2–signal resulting from muscle edema. In the chronic
stages, fatty infiltration usually accompanied by muscle atrophy represents irreversible muscle
injury (24).
Our study includes 30 patients complaining of shoulder pain and 10 healthy volunteers as control
group, and the cause of nerve injury in our series includes the direct trauma and repetitive activities
which led to overuse of the upper limb in the athletic ones.
In the current study 12 cases showed decreased bulk and fatty infiltration of the supra and infra
spinatus muscles and the supraspinatus was more affected than the infraspinatus.
Unlike the study of Po¨ yhia¨ et al. in 2005 (25) that diffuse atrophy of the supra & infra spinatus
muscles with more affection of the infraspinatus muscle (62% and 70%) respectively, since the
infraspinatus muscle is innervated by a higher nerve branch of the brachial plexus since denervation
generally causes severe atrophy of the infraspinatus muscle and not the supras
Nearly the same results as ours

Diabetic Neuropathy
Diabetic neuropathy is a nerve disorders caused by diabetes. Symptoms include pain, tingling, or
numbness, loss of feeling in hands, arms, feet, and legs. Nerve problems can occur in every organ
system. Diabetic neuropathies appears more common in people who have problems controlling their
blood glucose, those with high levels of blood fat, high blood pressure and obese (Porth, 2015).
Metabolic factors include high blood glucose, abnormal blood fat levels, and low insulin levels.
Neurovascular factors are associated to damage to the blood vessels that carry oxygen and nutrients
to nerves (Porth, 2015). Autoimmune factors that cause inflammation in nerves. Mechanical injury
to nerves, for example, carpal tunnel syndrome (Porth, 2015). Inherited ... Show more content on
Helpwriting.net ...
It affects the nerves that control the heart, regulate blood pressure, and control blood glucose levels
(Callaghan, 2012). Autonomic neuropathy interferes with the body's ability to adjust blood pressure
and heart rate, resulting in blood pressure to drop sharply after sitting or standing, causing light–
headed or even to fainting. Damage to the nerves that control heart rate can mean that the heart rate
stays high, instead of rising and falling in response to normal body functions and physical activity.
Nerve damage to the digestive system commonly causes constipation, causing the stomach to empty
too slowly (Callaghan, 2012). This can lead to persistent nausea and vomiting, bloating, and loss of
appetite, making blood glucose levels fluctuate widely, due to abnormal food digestion. Nerve
damage to the esophagus makes swallowing difficult, while nerve damage to the bowels can cause
constipation alternating with frequent, uncontrolled diarrhea (Callaghan, 2012). Autonomic
neuropathy often affects the control of urination, which can prevent the bladder from emptying
completely, allowing bacteria to grow in the bladder and kidneys and causing urinary tract
infections. Urinary incontinence may result due to not being able to sense when the bladder is full or
control the muscles that release urine. It can also gradually decrease sexual response in both

What Do If Someone You Love Has Neuropathy
What to Do If Someone You Love Has Neuropathy
If someone you love has neuropathy and suffers from chronic, often debilitating pain, you probably
know all too well how seriously it can wear a person down – physically, emotionally, spiritually –
and affect their overall quality of life. Sometimes though, it's hard to know exactly what to do for
someone who is chronically ill, especially when you are also feeling the effects of your loved ones
illness. While you can't solve all of their problems, you can certainly be there to support them and
help manage their discomfort.
Understand their pain
The unique and complicated factors that surround neuropathy often make it difficult for someone to
communicate what they're going through. Particularly ... Show more content on Helpwriting.net ...
On the other hand, the nerves may not send a pain signal even if something is injuring them.
Fighting pain can take everything a person has just to get through the day. Sometimes the person
may struggle so hard to cope with the constant onslaught of pain that they can't see the stress they
are inflicting on others. Don't take things personally and try to put yourself in their shoes.
Questioning his or her pain is hurtful to the person experiencing it and can erode the relationship
between you and your loved one.
How to help specifically with neuropathy
One of the most common complications of diabetes is diabetic neuropathy. In fact, between 60 to 70
percent of people with diabetes have some form of neuropathy according to the National Institute of
Diabetes and Digestive and Kidney Diseases. If someone you love has neuropathic diabetes they
may be experiencing pain, tingling, or numbness (loss of feeling) in the hands, arms, feet and legs.
And they could even have nerve problems in every organ system, including the digestive tract, heart
and sex organs. The type of pain he or she feels depends on the type of neuropathy they have. There
are four classifications of diabetic neuropathy – peripheral neuropathy, autonomic neuropathy,
proximal neuropathy and focal neuropathy – and each affects different parts of the body in a
different way.
Clearly, the pain your loved one is experiencing is real, and because of the chronic pain they may
prefer to withdraw and

Carbamazepine Speech For Diabetes
"On average geniuses weren't qualitatively better in their fields than their peers. They simply
produced a greater volume of work, which gave them more variation and a higher chance of
originality."
By–Adam Grant
So, just what is carbamazepine and why would you need to know about it?
I have said several times here on Niume, that I am no Hemmingway and that holds true, I'm also,
most assuredly NOT a doctor but I am a type II diabetic, an amputee in a wheelchair and have had
lens inplant surgery performed on both eyes. so, if you are a diabetic, or holds a diabetic person
close to your heart, I would strongly advise you read this report or at the very least, please direct
your loved one to see what I have to say here.
My wife of 43 years standing, ... Show more content on Helpwriting.net ...
For some people, these symptoms are mild; in my case, diabetic neuropathy is disabling and painful.
It could be fatal if ignored.
Even though diabetic neuropathy is a common serious complication of diabetes, you can often
prevent or treat diabetic neuropathy or slow its progress with tight blood sugar control and a healthy
lifestyle.
There are four main types of diabetic neuropathy. You may have just one type or symptoms of
several types. Most develop gradually, and you may not notice problems until considerable damage
has occurred.
The signs and symptoms of diabetic neuropathy vary, depending on the type of neuropathy and
which nerves are affected.
PERIPHERAL NEUROPATHY
I have peripheral neuropathy which is the most common form of diabetic neuropathy. Feet and legs
are often affected first, followed by hands and arms. Symptoms of peripheral neuropathy are worse
at night, and may include:
* Numbness or reduced ability to feel pain or temperature changes
* A tingling or burning sensation
* Sharp pains or

The Use Of Physical Therapy Rehabilitation Centers
Working in various settings of physical therapy rehabilitation centers is one of the most challenging
and complicated. Apart from the 40–hour workweek, it is physically strenuous as well. Physical
therapists often have to the need to stoop, kneel, crouch, lift, and stand for extensive periods. Above
and beyond, physical therapists move heavy equipment and lift patients or help them turn, stand, or
walk.
Most of the patients that I have encountered are diagnosed with Diabetic Neuropathy (DN). Diabetic
Neuropathy is a brought about by a complication of Type 1 and Type 2 Diabetes. In 2012, there are
about 29.1 million Americans, or 9.3% of the population, had diabetes (American Diabetes
Association [ADA], 2016). Due to its increase ... Show more content on Helpwriting.net ...
Acting in accordance with National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), diabetic neuropathies are family of nerve syndromes affected by diabetes (2009). People
with diabetes can be asymptomatic overtime and some can have notable signs with radicular
symptoms in the upper and lower extremities (NIDDK, 2009), Moreover, can affect even the
digestive, cardiac, and reproductive system in serious conditions (NIDDK, 2009). In fact, based on
academic literatures, about two thirds of patients with diabetes have medical or subclinical
pathology of nerve (Bansal, Kalita, & Mistra, 2006). The occurrence of neuropathy amplified from
approximately 7 percent to 50 percent on admittance at 25 years in consequence (Bansal, Kalita, &
Mistra, 2006).
The threatening factors of diabetic neuropathy are as follows: decreased glycemic regulation, old
age, high blood pressure, prolonged diabetic mellitus (DM), increased cholesterol, smoking,
alcoholic, tall height, and HbA1c level (Quann, Lin, & Khardori , 2015). About close to 26 percent
of seniors or above 65 years of age are impacted with DN (ADA, 2016).
Diabetes was the 7th primary cause of mortality in the United States in 2010 (ADA, 2016).
Pathogenesis of DN
Several assumptions were made due to unexplained pathological mechanism of DN

Assessment Toolss : Assessment Forms And Methods Of CIPN
Assessment tools It has been established that there are at present no adequate forms of preventing
CIPN (Cavaletti, 2014). Additionally, CIPN is often under–rated and under–reported particularly as
patients do not like to miss treatments (Stubblefield et al., 2009). Therefore, comprehensive
evaluations using standardized and sensitive assessment tools to prevent severe neurotoxicity are a
critical step for early intervention. According to Stubblefield et al. (2012), it is essential a baseline
assessment including any preexisting neuropathy and predisposing factors, such as diabetes, be
performed prior to initiation of treatment. This baseline assessment should include not only
subjective symptoms, but assessment of strength, reflexes and ... Show more content on
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This is a patient questionnaire that uses a score of 0–4 to assess subjective neuropathic symptoms
(Functional Assessment of Chronic Illness Therapy, 2007).
The Total Neuropathy Score (TNS), initially was used to assess diabetic neuropathy, utilizes
objective criterion, such as pin prick, with a subjective account of all neuropathic areas including
sensory, autonomic and motor (Curcio, 2016). However, it is too time consuming for nurses to use
routinely (Curcio, 2016). The Total Neuropathy Score – clinical version (TNSc) was recommended
for broader use (Curcio, 2016). This abbreviated version which was developed is more sensitive
than other tools including the NCI–CTCAE (Curcio, 2016). In a systematic review by Haryani et al.
(2017) similar conclusions were realized. They analyzed nineteen studies and twenty CIPN
assessment tools and determined that both the FACT/GOG–Ntx and TNSc were recommended
(Haryani et al., 2017). Further, since CIPN is more subjective than objective in nature, utilizing the
FACT/GOG–Ntx first, followed by a provider validation using the TNSc is suggested (Haryani et
al., 2017).
In the clinical setting, it would be advantageous to facilitate the use of a self–administered
neurotoxicity portion of the FACT/GOG questionnaire. The at risk chemotherapy patient could
complete it upon arrival to the infusion center. This could be followed by performing the
abbreviated TNSc, which would consist of a

Giant Axonal Neuropathy
Yanmin Yang
Liu JJ, Ding J, Wu C, et al. Retrolinkin, a membrane protein, plays an important role in retrograde
axonal transport. Proc Natl Acad Sci USA. 2007;104(7):2223–8.
Yang Y, Allen E, Ding J, Wang W. Giant axonal neuropathy. Cell Mol Life Sci. 2007;64(5):601–9.
These two papers examine the phenomenon of retrograde axonal transport, which is the focus of
Yanmin Yang's lab. The first paper, "Giant Axonal Neuropathy," examines the aforementioned
disease, which is a rare autosomal recessive disorder that results in giant axons with imbalances in
cytoskeletal components. This results in neurodegeneration of the neuronal cytoskeleton which
subsequently alters brain activity and functionality. Within this paper, Yang's lab examines giant
axonal ... Show more content on Helpwriting.net ...
Effects of stress on immune function: the good, the bad, and the beautiful. Immunol Res.
2014;58(2–3):193–210.
Dhabhar FS, Malarkey WB, Neri E, Mcewen BS. Stress–induced redistribution of immune cells––
from barracks to boulevards to battlefields: a tale of three hormones––Curt Richter Award winner.
Psychoneuroendocrinology. 2012;37(9):1345–68.
Dhabhar Lab looks particularly into how emotional status can impact a person's immunological
state. The first article looks into short term stress that could be used clinically to enhance
immunoprotection. Dhabhar demonstrates how short term stress can enhance primary and secondary
immune response. Nonetheless, chronic stress does enhance the risk of cancer by increasing T–cell
functionality. Effectively, this paper argues that stress can be used with caution to enhance healing,
but shouldn't be abused to the point where it could result in adverse health effects.
The second article looks into the stress, the hormones released as a result of stress, and the
immunological effects these hormones have. Looking into particularly the secondary immune
defense system, Dhabhar demonstrates how stress hormones can be used to mobilize particular
leukocyte subpopulations to tissue or blood to help with vaccination, healing, infection resistance, or
cancer. Essentially they demonstrate that hormones can be used to enhance protective immunity and
present a model of short term stress on immune cell populations, functionality, and

A Brief Note On Diabetic Peripheral Neuropathy ( Dnp )
Diabetic Foot Problems Diabetic peripheral neuropathy (DNP), also know as Neuropathy nerve
damage. "Diabetes can impair blood flow to your feet and cause nerve damage" (Castro 180). High
blood sugar can injure nerve fibers throughout your body, but diabetic neuropathy most often
damages nerves in legs and feet. " Enigmatically, recent reports have described that long–term tight
glycemic control may be major risk factor for the development of diabetic neuropathy" (Zhang, et
al. 1). Diabetic neuropathy can also affects the eyes, retinopathy, increasing the risk for glaucoma
and blindness. Physicians recommend eye exams every six months to one year. The eyes must be
checked often as vision can deteriorate quickly in patients with diabetes. A person with diabetes may
not be aware of a wound or injury to their foot due to a decreased sensation in their feet, a condition
called diabetic neuropathy. Therefore, great care must be taken to inspect the feet everyday.
Neuropathy is a chronic condition, which will get worst over the time. Been diagnosed with
neuropathy can change a patients life; this can turn into a chronic disease that will be treated with
adequate medication, maintaining low blood sugars, doing self–examinations of the feet to prevent
any further complications and visiting the physician as directed to do routine check ups.
"Diabetic neuropathy begins as a generalized asymptomatic dysfunction of sensorimotor or
autonomic peripheral nerve fibers and is by far the

Diabetic Patients : An Ignored Cause Of Abdominal Pain
Truncal neuralgia in diabetic patients: An ignored cause of abdominal pain
Mohamed Lotfy, Hazem N. Ashri, Mostafa M. Khairy
ABSTRACT
Aims: We aim to study diabetic patients, with abdominal pain and neuralgia somewhere else in their
bodies, and search for the relation between their abdominal pain and the lower intercostal neuralgia
(T7–11 and subcostal).
Methods: Between July 2016 and February
2017 this study was carried out in emergency department, Zagazig University Hospital. 23 patients
were subjected to this study and divided into (group A = 15 patients had right upper abdominal pain)
and (group B = 8 patients had right lower abdominal pain). This grouping was not created for
comparative reasons, it was done because we were studying the ... Show more content on
Helpwriting.net ...
Truncal neuralgia should be put in the surgeon's mind when managing any diabetic patient with
abdominal pain of unrevealed aetiology by the usually used investigations.
Keywords: Abdominal pain, Diabetic, Truncal neuralgia How to cite this article
Lotfy M, Ashri HN, Khairy MM. Truncal neuralgia in diabetic patients: An ignored cause of
abdominal pain.
Edorium J Surg 2017;6():****.
Article ID: *********
*********
doi:**********
INTRODUCTION
Intercostal neuralgia is defined as a neuropathic state affecting the intercostal nerves, presenting as
strong pain.
It may be shooting, sharp, or of burning quality. The pain is steady and May involve any of the
intercostal nerves and the subcostal nerve [1, 2].
Intercostal Neuralgia is caused by a diversity of reasons such as diabetes mellitus, nerve entrapment,
ORIGINAL ARTICLE PEER REVIEWED | PROVISIONAL PDF
Edorium Journal of Surgery, Vol. 6; 2017.
Edorium J Surg 2017;6():****. www.edoriumjournalofsurgery.com Lotfy et al. 2 iatrogenic
neuroma, traumatic, persistent nerve irritation and herpes zoster [1].
Intercostal neuralgia is common in diabetes mellitus
(DM) patients. It is one of the types of peripheral neuropathies linked to DM. It is present as a
localized abdominal or chest pain, which may mimic a referred pain from the intra–abdominal or

intrathoracic organs. When it is ignored as a cause of pain in such regions it may lead to do
extensive and unneeded clinical investigations and surgical procedures

Alpha Lipoic Neuropathy Report
Alpha–Lipoic Acid and Diabetic Neuropathy Name: Ola Taji Student number:999188383 Alpha–
Lipoic Acid and Diabetic Neuropathy Introduction Alpha–Lipoic Acid (ALA) (aka thioctic acid), is
a naturally occurring substance found in our diets such as vegetables (spinach, broccolis) and in
meat (intestines),also,ALA is synthesized in our body through the function of different enzymes that
take part in mitochondrial oxidative metabolism found in plants and animals. When ALA is
consumed it gets absorbed by the gastrointestinal tract and transported to other organs in the body,
for example, it can cross the blood–brain barrier to enter the brain, or it can go to the liver where
ALA gets reduced to its reduced form called dilhydrolipic acid (DHLA). Both ALA and DHLA have
many biochemical functions ... Show more content on Helpwriting.net ...
The results showed that upon injecting high glucose in the PC12 cells, the activity of the cells
decreased, and it increased the level of ROS, the ratio of ADP/ATP, and the apoptotic protein (Bax,
and caspase 3). However, after injecting ALA the viability of the cells increased back, ALA also
inhibited ROS, ADP/ATP, and the apoptotic proteins (Bax and caspase 3). Therefore, all of the
studies found all showed the same thing that ALA has positive effect of diabetic neuropathy. Despite
all of these results, there was some limitations in the experiments such as the clarification if the
neuroprotective potential of ALA according to diabetic type, diabetic stage, and also another
limitation is that some of the studies were observational studies. Overall, the most important thing is
that the actually mechanism in which ALA functions in order to decrease the symptoms of diabetic
neuropathy is not yet

Peripheral Neuropathy Research Paper
A Peripheral Neuropathy A peripheral neuropathy is an injury to the peripheral nerves which can
result in pains and weakness of the hands and feet. A peripheral neuropathy can be caused by a
traumatic injury or an infection. Symptoms and sings for a peripheral neuropathy depend on the
types of nerves that are affected including: sensory, motor and autonomic nerves. The signs and
symptoms of these three types of nerves are: pains as burning in the hands, arms, feet or legs, weak
muscles, falling down, dizziness and digestion problems etc... There are a lot of reasons why a
person will have a peripheral neuropathy including alcohol, infection, diabetes, medications,
inherited and taking poisons. Moreover, it's safer to see a specialist in

Idiopathic Progressive Neuropathy
My patient has idiopathic progressive neuropathy. This means that the cause of his neuropathy
cannot be determined and is developing gradually. Nerve damage is interfering with the functioning
of the peripheral nervous system (PNS). Damaged nerves can occur in the brain and spinal cord and
affect how the peripheral nervous system communicates with the rest of the body, it sends incorrect
signals which can be a risk factor for falls. He is not a diabetic which is one of many causes of
neuropathy.
Neuropathy can affect the nerves that provide feeling or cause movement, if both are affected it is
called sensorimotor. The nerve fibers also known as Axons (nerve cell) are the first to fail, and are
the furthest from the spinal cord and brain. Neuropathy

The Most Vital Functions Of The Nervous System
The most vital functions of the nervous system is to provide information about the occurrence or
threat of injury. One of the ways this is done is in form of pain. However, sometimes, established
pain can go beyond its protective role, thus becoming a disease in itself than just being a symptom.
This condition is called chronic pain. The injury or the precipitating event can be physical (like in
case of phantom limb pain or post–surgical pain), infection (as with post–herpetic neuralgia),
systemic disease (like with diabetic neuropathy), drug (chemotherapy induced peripheral
neuropathy) or can sometimes be unknown (trigeminal neuralgia, migraine, cluster headache, etc.)
Even today, the pathological processes involved in genesis, establishment and continuation of such
diseases are poorly understood. Eventually, such painful conditions usually remain refractory to
available treatments.
According to International Association for the Study of Pain (IASP), globally, it has been estimated
that 1 in 5 adults suffer from pain and that another 1 in 10 adults are diagnosed with chronic pain
each year. Moreover, according to a recent (2014) article in the Journal of Pain, chronic pain is the
most prevalent and disabling condition affecting at least 100 million Americans. It is also the most
expensive public health condition with annual cost to society exceeding that of combined costs of
diabetes, cancer, and heart diseases. Then, we have set of diseases that follow chronic pain. This

Diabetic Neuropathy Research Paper
Diabetic Neuropathy Definition
Diabetic neuropathy is nerve damage that occurs with diabetes. Approximately half of all people
with diabetes have some form of neuropathy. It is more common in people who have had the disease
for many years. Tight control of blood sugar can prevent neuropathy from occurring. Those who
already have diabetic neuropathy can stop it and prevent it from becoming worse with healthier
eating habits, medications and exercise.
Diabetic Neuropathy Causes
In people who have diabetes, their bodies either no longer produce insulin or no longer respond to
the insulin that is produced. As a result, blood sugar levels in the body can go dangerously high
without proper diet, exercise and medication regulating these levels. When blood sugar levels in the
body are ... Show more content on Helpwriting.net ...
Anti–seizure medications and antidepressants are sometimes prescribed to patients who haven't
found relief through other medications. These medications can change how the body senses pain and
bring relief.
Diabetic Neuropathy Complications
People often first become diagnosed with diabetic neuropathy in the hands or feet. Taking care of
the hands and feet to prevent cuts and injuries from occurring is essential to reduce complications.
Because of the nerve damage, cuts and infections will take longer to heal.
Those who have nerve damage in other parts of the body, such as the urinary tract or blood vessels,
may need to take additional medications in order to prevent complications from occurring. For
example, diabetic neuropathy can cause some people to lose the sensation that they need to urinate,
which can cause urinary tract infections. Going to the restroom on a regular schedule and taking
antibiotics can stop this from occurring. Diabetic neuropathy can sometimes affect sexual health. In
this case, medications can be prescribed to help with sexual function in

What Is The Cause Of Peripheral Neuropathy?
The human body has 95 to 100 billion nerve cells, and 85 billion are in the brain ("Nerve Pain and
Nerve Damage"). The nervous system is responsible for everything you do. It regulates breathing,
controls muscles, and sends and receives signals. Nerve damage is damage or destruction to nerves
or the spinal cord ("Nerve Damage"). It can occur in the brain, spinal cord, and peripheral nerves. It
also affects autonomic, motor, and sensory nerves. Although nerve damage can heavily affect your
quality of life, there are common practices and solutions to treat and prevent nerve damage.
Autonomic nerves control the involuntary functions of the body, such as heart rate, digestion,
temperature regulation, and blood pressure. Motor nerves control movements ... Show more content
Nerve damage results in almost $150 billion spent in annual health–care in the United States. Today,
the National Institute of Neurological Disorders and Stroke seeks knowledge about the brain and
nervous system to help prevent neurological disease. In addition to efforts to prevent and treat nerve
damage, other studies inform new strategies for relieving neuropathic pain (National Institutes of
Health). Lidocaine patches are used to relieve neuropathy pain by stopping nerves from sending
nerve signals. Lidocaine is in a class of medications called local anesthetics. It comes as a patch to
apply to the skin whenever it is needed. It has shown improvements in the intensity of nerve
damage. Although nerve damage can heavily affect your quality of life, there are common practices
and solutions to treat and prevent nerve

Taking a Look at Peripheral Neuropathy
Peripheral neuropathy is a fairly common neurological problem and is a generalized term that means
that there is a disorder in the peripheral nervous system. Being that this is a broad definition and
includes many varieties and causes of peripheral nerve disease, a proper diagnosis is needed for the
definition to be specified. The overall prevalence of the condition is about 2400 (2·4%) per 100 000
population, but in people older than 55 years, the prevalence rises to about 8000 (8%) per 100 000.
(Simpson, 2010) Yet this does not include traumatic peripheral nerve injuries meaning that the
number of peripheral neuropathy in our society is greater. In first world countries, the most common
cause of peripheral neuropathy is diabetes mellitus. Diabetes mellitus is a group of metabolic
diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action,
or both. (Loganathan, 2006) Due to the fact that the diagnose of diabetes mellitus has increased in
our general population of the USA, the amount people in risk of diabetic peripheral neuropathy is
also expected to increase.
In our case we are dealing with diabetic peripheral neuropathy that results from nerve damage due
to the high blood glucose levels diabetics. About 60 to 70 percent of people who have had diabetes
for many years have some form of nerve damage, but not everyone has symptoms. (Inzucchi, 2012)
Common types of diabetic neuropathy are those that affect the limbs along with the

Charcot Foot: Peripheral Neuropathy
Charcot Foot
By
Martin Vedder
Charcot neuropathic osteoarthropathy or more commonly referred to as Charcot foot is a condition
most often associated with diabetic neuropathy. This serious condition often affects the bones, joints
and soft tissues and can lead to serious deformation or even amputation of the lower extremity. So,
in the following paragraphs the causes, signs and symptoms, how it's diagnosed, treated, and typical
prognosis will be discussed.
The main cause of Charcot foot is repetitive injuries seen in patients who have peripheral
neuropathy. Peripheral neuropathy is defined as a break in communication, or damage done to, a
peripheral nerve resulting in a loss in varying degrees of sensation. Peripheral neuropathy has ...
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Surgical treatments are based on an expert's opinion. There are many surgical options depending on
the type and severity of the Charcot foot. If it's a mild deformity and the patient has tightness at the
back of the heel, surgical lengthening of the Achilles tendon can help decrease pressure on the front
of the foot. This would allow ulcers in that area to heal and will reduce the chance of them
returning. In more severe cases, a bony prominence is present on the bottom of the foot. If the
deformity is stable, surgery would include removing of the bony prominence. If, however, the
deformity is unstable, the bones would be too lose for a simple removal of the prominence as they
would simply move back into place post–surgery. In this case, it is likely that a new prominence
would develop. If this is the case, having the bones repositioned and fused is often necessary. If
there is deformity in the patient's ankle, a prescriptive shoe or brace is very often ineffective. In this
case, surgical fusion of both the ankle and the joint below it are often required to stabilize the foot.
The amount of damage in the bone and soft tissue present in ankle deformities due to Charcot foot
make the risk of the bone not healing and acquiring an infection high. Amputations are sometimes
required in these situations. It is also notable that in diabetics, the bones tend to

Diabetic Neuropathy
Diabetic neuropathy is defined as damage to nerves caused by diabetes. Nerve damage in the arms,
legs, hands and feet caused by diabetes is referred to as diabetic peripheral neuropathy. While some
patients may have extremely painful symptoms, others may be asymptomatic. If there is damage to
the peripheral nerves, one might not be able to feel normally in their arms, hands, legs, and feet. In
some cases, these parts may feel numb. Some may also have a needles and pins, or burning
sensation. These symptoms are often worsened at night and can interfere with sleep. "Painful
diabetic neuropathy symptoms exhibit a symmetrical 'stocking and gloves' distribution and are often
associated with nocturnal exacerbation (Aslam, Singh, & Rajbhandari, 2014, ... Show more content
One such test is performed using calibrated, sterile, disposable needle . "A constant force is applied
perpendicularly on the skin of the foot until the calibrated mark is reached. A record is made as to
whether the patient responded to any sensation felt in the foot (Nather et al., 2011, para.

Pathophysiology Of Diabetic Neuropathy And Diabetes
Pathophysiology of diabetic neuropathy
Diabetes is a chronic disease that affects blood glucose levels. Diabetes is the loss of pancreatic
metabolic activity that is responsible for the use of energy, which comes from glucose that an
individual consumes. There are two types of diabetes: Type 1 Diabetes is the failure of pancreas to
secrete a hormone called insulin; responsible for the removal of glucose from the body to be used in
the muscles for energy. Type 2 Diabetes is the failure of using the insulin that is secreted form the
pancreas.
Individuals with controlled blood sugar levels due to normal functioning of the endocrine system,
avoid several complications. However, a high percentage of individuals suffering from diabetes also
consequently suffer from hyperglycemia. Uncontrolled diabetes can lead to many serious
cardiovascular diseases in the body like retinopathy, nephropathy and mainly neuropathy (Kumar et
al., 2007), but the neuropathy severity is determined by the duration and intensity of uncontrolled
blood sugar levels (Tesfaye et al., 2005). About 50–60 % of diabetic patients suffer from diabetic
neuropathy, and it generates from having constant hyperglycemia leading to nerve damage in the
body, mainly the extremities starting from the legs and feet (Kumar et al., 2007). Patients describe
the symptoms as 'numbness', 'pins and needles', burning, tingling and weakness of the muscles
(Dejgaard, 1998). Severe cases leads to amputation of the limbs (Kumar et

Diabetic Peripheral Neuropathy Essay
Diabetic Peripheral Neuropathy Peripheral neuropathy is obviously one of the major complications
of chronic diabetes, which affects the nerves and leads to loss of sensation, numbness, and pain in
the legs, feet, or even hands. Sadly, peripheral neuropathy is likely to affect approximately 70% of
people with diabetes. However, not all people who develop this type of complication experience
serious pain. Diabetic peripheral neuropathy is caused by prolonged elevated blood sugar, which
affects the nerves, particularly in the extremities. According to research, diabetic peripheral
neuropathy can affect other parts of the body which can also contribute to other critical conditions.
Causes of Peripheral Neuropathy Of course, diabetes is the main cause ... Show more content on
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Injury to nerves has also been documented as a contributing factor. Research also shows that
diabetic peripheral neuropathy is mostly common among people who have been living with diabetes
for at least 25 years or thereabouts. If this is true, then it is obvious that the majority of people who
suffer the condition are people above 50. Symptoms of Diabetes Peripheral Neuropathy The major
symptoms of diabetes peripheral neuropathy is pain in the region of the affected nerve. The
symptoms may be minor and negligible at the early stage, however, it can develop into a chronic
condition if left untreated. Despite the fact that this serious condition affects the nerves and causes
different problems to the body, some people still live with peripheral neuropathy without noticing
any signs. As the condition becomes critical, it can contribute to other issues and affect the nervous
systems. Some of the common symptoms of peripheral neuropathy are highlighted below: Erectile
dysfunction in men or dryness of the vaginal in women. Tingling, numbness, or pain in the hands,
fingers, toes, legs, and

One of the complications of type 1 and type 2 diabetes is peripheral neuropathy. This complication
occurs because of the damage to the nerves as a result of the high blood sugars. In the majority of
diabetics, peripheral neuropathy affects the lower legs but in some people, it can also affect nerves
in the arms, hand, stomach, and bladder. In general, about 20% of patients with type 1 diabetes and
about 50% of patients with type 2 diabetes develop peripheral neuropathy. Diabetic peripheral
neuropathy tends to affect the small nerves that are responsible for sensing pain and temperature on
the skin. When the large nerves are affected, the patient will have difficulty with balance and
walking. Diabetic neuropathy affects women and men with equal frequency. However, in men type
2 diabetes, the neuropathy tends to present much earlier compared to female diabetics. On the other
hand, diabetic neuropathy tends to be more severe in women compared to men. How does Diabetic
neuropathy present? The diabetic neuropathy can ... Show more content on Helpwriting.net ...
Now research seems to show that there are other culprits involved. Several studies that beside
elevations in blood sugar, an increase in cholesterol, triglycerides, blood pressure and obesity may
also trigger the onset of diabetic neuropathy. Since these risk factors are more common in type 2
diabetics compared to type 1 diabetics, this explains the reason why the onset of peripheral
neuropathy is much earlier. New research shows that these metabolic changes in diabetes lead to the
generation of toxic oxygen molecules which attack the nerves and cause permanent damage. The
diabetic neuropathy is also exacerbated or worsened by smoking and in fact, diabetics who smoke
also tend to develop the neuropathy much earlier than diabetics who do not

Auditory Neuropathy
Most existing research and models of auditory neuropathy has utilised gerbils. At present no robust
model of auditory neuropathy in guinea pigs exists; previous guinea pig models have been used but
these were not robust and were susceptible to confounding. The use of tests such as DPOAE and
assessment of IHC hair cell morphology are important are vital as these provide information about
hair cell status and functioning; without these, elevated ABR thresholds could be exacerbated by
damaged hair cells. Previous research has suggested the guinea pig is unsuited for use as an
Auditory Neuropathy model as Ouabain preferentially damages HCs in guinea pigs (Fu, Ding,
Jiang, & Salvi, 2012; Hamada & Kimura, 1999). Our (current?) research has demonstrated that
Ouabian treatment in guinea pigs can spare HCs while removing SGN and thus can be used as a
model of auditory neuropathy. Of the treatment conditions (#2, 4, 5, 6) #2 (10 mM OB drip 30
minutes) and #5 (5 mM OB Whatman paper 60 minutes) are well suited to an animal model of
auditory ... Show more content on Helpwriting.net ...
The focal lesion created by condition #2 alongside the larger size of the guinea pig (brainstem?)
would facilitate the assessment of tonotopicity for any stem cell based treatment for SGN or HC
replacement. Limitations: Some conditions sample size n=1. No 30min 10mM paper treatment or 60
min 10mM drip treatment from which to analyse impact of duration. No fluorescence. Further
research: Assessment of fibre types impacted by different conditions such as high spon vs low spon?
Assessment of microenvironment at different timepoints as this has been linked to the success or
failure of stem cells to survive (Lang et al., 2008; Warnecke, Mellott, Römer, Lenarz, & Staecker,

Questions On Sexual Health History And Sexual Needs
me to gain my clients trust. Without having the trust of my client, I believe she wouldn't have shared
as much with me as she did. During the last clinical, I had to ask some tough and personal questions
about my client. The questions were about their sexual health history and sexual needs. I personally
didn't feel too comfortable in asking these questions, but I knew they were important to ask. I went
ahead and just asked the questions. The great thing about this situation is that my client didn't really
hesitate about answering the questions and didn't mind being ask those type of questions. I believe
that since I had been able to build a trust in our relationship, that she had enough trust in me to share
her answers for the questions. Socio–political Knowing My client is very much an independent
person, who care about taking care of her health and staying well. Though, relating to age, she is an
older woman that experiences complications in health due to her age. One of the complications that
she's experiencing is weakness. DC uses a walker to help assist when she's mobile. Without her
walker it would make it very difficult for her to walk and get around without the risk of falling. DC
independent, she's able to complete her daily living activities at her own abilities. During my
clinical, DC did indicate that when she takes a shower, she has someone that works at Wesley Acres
that comes and sit her living room while she's showering. She says that this is in case if

Common Symptoms of Peripheral Neuropathy

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