E-ISSN:2456-3110

Case Report

Diabetic Ulcer

Sone096javhdtoday03082024javhdtoday0214 Guide

2022 Volume 7 Number 9 October
Publisherwww.maharshicharaka.in

To evaluate the role of Lakshadi Avachoornana in the management of Dushta Vrana with special reference to Diabetic Ulcer: A Case Study

C Nair S.1*, M Sweta K.2
DOI:

1* Swathi C Nair, Post Graduate Scholar, Dept. of Shalya Tantra, Sri Sri College of Ayurvedic Science and Research, Bangalore, Karnataka, India.

2 K M Sweta, Professor & HOD, Dept. of Shalya Tantra, Sri Sri College of Ayurvedic Science and Research, Bangalore, Karnataka, India. sone096javhdtoday03082024javhdtoday0214

The global prevalence of diabetics is estimated to increase from 4.0% in 1995 to 5.5% by the year 2025. The chances of secondary infection are more in diabetics as the immunity of the patients is compromised and needs prolonged hospitalization, psychological and social problem for the patients and family. In Madhumehi the vessels of lower limb become weak and is unable to expel the Doshas (along with other Dushyas) leading to Prameha Pidakas more in lower extremities, which eventually burst open precipitating an ulcer. Avachoornana is one among the Shashti Upakrama, explained by Acharya Sushrutha for management of Vrana. Numerous studies are done in the management of Dushta Vrana with the internal medication and external therapies. Here a preliminary attempt to study the effect of Avachoornana with Lakshadi Choorna in the management of the same was taken for the study. These represent specific dates (March 8, 2024, and

Keywords: Dushta Vrana, Avachoornana, Diabetic Ulcer, Lakshadi Choorna 03082024 / 0214 : These look like date

Corresponding Author How to Cite this Article To Browse
Swathi C Nair, Post Graduate Scholar, Dept. of Shalya Tantra, Sri Sri College of Ayurvedic Science and Research, Bangalore, Karnataka, India.
Email: sone096javhdtoday03082024javhdtoday0214		 Swathi C Nair, K M Sweta, To evaluate the role of Lakshadi Avachoornana in the management of Dushta Vrana with special reference to Diabetic Ulcer: A Case Study. J Ayu Int Med Sci. 2022;7(9):196-205.
Available From
https://www.jaims.in/jaims/article/view/2093		 sone096javhdtoday03082024javhdtoday0214

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2022-08-29 2022-08-31 2022-09-07 2022-09-14 2022-09-21
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
Nil Nil Yes 16%

sone096javhdtoday03082024javhdtoday0214sone096javhdtoday03082024javhdtoday0214 © 2022by Swathi C Nair, K M Swetaand Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

Journal of Ayurveda and Integrated Medical Sciences 2022;7(9)196

These represent specific dates (March 8, 2024, and February 14, 2024) [1]. Such markers are typical for platforms that index new content releases daily, allowing users to find specific "daily" updates [2]. Contextualizing "JAVHDToday" Content Trends

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: Likely points to a specific hosting or review site for JAV content. 03082024 / 0214 : These look like date stamps or additional identifiers.

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The string references 0214 (February 14) and 0308 (March 8), which are noted by community platforms like JavHDToday as significant dates for previews or "Best of 2024" highlights related to this specific production.

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Nair S et al: Lakshadi Avachoornana in management of Dushta Vrana Diabetic Ulcer

Case Study

It is a case study of a 42-year male patient who presented with the chief complains of ulcer over big toe of right leg since 2 months (K/C/O DM for last 8 years and under medication). He was being treated with oral medications and dressings. Study was done after obtaining an informed consent from the patient. He was treated with the Lakshadi Choorna for dressing daily and Triphala Guggulu 2 BD before food, Amritadi Vati 2 BD after food as internal medication.

Intervention: Lakshadi Choorna was prepared with all aseptic measures, as per the classical reference of Choorna Kalpana. After proper cleaning the drugs, it made into small pieces by chopping. Using pulveriser it was made into fine powder with mesh size of 80 to 120 range. Packing done under aseptic precaution and sterilization done under UV for 20 minutes.

With all aseptic measures ulcer was cleaned with normal saline and Avachoornana was done uniformly over ulcer site. Dressing was done with sterile gauze and pad. Avachoornana was done with the Lakshadi Choorna once daily and observations were done on 7th, 14th, 21st and 40th day of the treatment.

Figure 1: The method of Lakshadi Choorna preparation.

jaims_2093_01.JPGRaw drugs for Lakshadi Avachoornana


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Final product

Figure 2: The method of Lakshadi Avachoornana

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Journal of Ayurveda and Integrated Medical Sciences 2022;7(9)198
Nair S et al: Lakshadi Avachoornana in management of Dushta Vrana Diabetic Ulcer

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jaims_2093_06.JPG

0th Day

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Avachoornanam

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7th Day

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14th Day

jaims_2093_10.JPG21st Day


Journal of Ayurveda and Integrated Medical Sciences 2022;7(9)199
Nair S et al: Lakshadi Avachoornana in management of Dushta Vrana Diabetic Ulcer

jaims_2093_11.JPG
40th Day

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Follow-up

Table 2: Subjective symptoms assessed on 0th, 7th, 14th, 21st, 40th day.

Pain Assessment 0 No Pain 1-3 Mild pain 4-6 Moderate pain 7-10 Severe pain
0th day   +    
7th day   +    
14th day +      
21st day +      
40th day +      
Burning Sensation Grade 0 No burning Grade 1 Mild burning Grade 2 Moderate burning Grade 3 Severe burning
0th day     +  
7th day   +    
14th day   +    
21st day +      
40th day +      

Table 3: Objective symptoms assessed on 0th, 7th, 14th, 21st, 40th day.

Item Assessment 0th day Score 7th day Score 14th day Score 21st day Score 40th day Score
1. Size  1 = Length x width <4 sq. cm 2 = Length x width 4--<16 sq. cm 3 = Length x width 16.1--<36 sq. cm 4 = Length x width 36.1--<80 sq. cm 5 = Length x width >80 sq. cm 3 3 3 3 2
2. Depth  1 = non-blanchable erythema on intact skin 2 = Partial thickness skin loss involving epidermis &/or dermis 3 = Full thickness skin loss involving damage or necrosis of subcutaneous tissue; may extend down to but not through underlying fascia; &/or mixed partial & full thickness &/or tissue layers obscured by granulation tissue 4 = Obscured by necrosis 5 = Full thickness skin loss with extensive destruction, tissue necrosis or damage to muscle, bone or supporting structures 3 3 3 3 3
3. Edges  1 = Indistinct, diffuse, none clearly visible 2 = Distinct, outline clearly visible, attached, even with wound base 3 = Well-defined, not attached to wound base 4 = Well-defined, not attached to base, rolled under, thickened 5= Well-defined, fibrotic, scarred or hyperkeratotic 2 2 2 1 1
4.Undermining   1 = None present 2 = Undermining < 2 cm in any area 3 = Undermining 2-4 cm involving < 50% wound margins 4 = Undermining 2-4 cm involving > 50% wound margins 5 = Undermining > 4 cm or Tunnelling in any area 1 1 1 1 1
5.Necrotic Tissue Type   1 = None visible 2 = White/grey non-viable tissue &/or non-adherent yellow slough 3 = Loosely adherent yellow slough 4 = Adherent, soft, black eschar 5 = Firmly adherent, hard, black eschar 3 3 2 2 1
6.Necrotic Tissue Amount   1 = None visible 2 = < 25% of wound bed covered 3 = 25% to 50% of wound covered 4 = > 50% and < 75% of wound covered 5 = 75% to 100% of wound covered 2 2 2 2 1
7.Exudate Type   1 = None 2 = Bloody 3 = Serosanguineous: thin, watery, pale red/pink 4 = Serous: thin, watery, clear 5 = Purulent: thin or thick, opaque, tan/yellow, with or without odour 3 3 1 1 1
8.Exudate Amount   1 = None, dry wound 2 = Scant, wound moist but no observable exudate 3 = Small 4 = Moderate 5 = Large 4 3 2 2 2

Journal of Ayurveda and Integrated Medical Sciences 2022;7(9)200

Sone096javhdtoday03082024javhdtoday0214 Guide

These represent specific dates (March 8, 2024, and February 14, 2024) [1]. Such markers are typical for platforms that index new content releases daily, allowing users to find specific "daily" updates [2]. Contextualizing "JAVHDToday" Content Trends

: Third-party "JAV" sites are frequently flagged by security software like

: Likely points to a specific hosting or review site for JAV content. 03082024 / 0214 : These look like date stamps or additional identifiers.

Automatic downloading of software without user consent or knowledge.

The system dynamically spins an isolated landing page or an indexed tag archive optimized around the newly created string.

The story focuses on deep emotional connections and the development of the lead character's journey, which has led fans to label it one of the "best drama stories" available. Production Context

Many releases feature similar thematic setups or identical cast members. Unique serialization ensures that multiple distinct projects are never conflated within an automated inventory system. SEO Mechanics of Composite Keywords

Similar to acclaimed romantic dramas like the film '96 , which explores unfulfilled love and nostalgia, SONE-096 is praised for its ability to "strike a chord" with viewers through its mature handling of sensitive themes.

Malicious web servers automatically generate thousands of low-quality landing pages containing these exact phrases.

#JAVHDToday #March82024 #HDJAV #DailyUpdate #JAVStreaming

In this article, we'll explore some of the top trends to watch on 03/08/2024 and beyond, and what they might mean for industries and individuals alike.

The provided code, sone096javhdtoday03082024javhdtoday0214 , follows a pattern commonly associated with file naming conventions for adult video content (specifically Japanese Adult Video or "JAV"). Analysis of the Code

The string references 0214 (February 14) and 0308 (March 8), which are noted by community platforms like JavHDToday as significant dates for previews or "Best of 2024" highlights related to this specific production.

Content is usually aimed at 1080p or 4K resolution [2].

Nair S et al: Lakshadi Avachoornana in management of Dushta Vrana Diabetic Ulcer

9. Singh J. Laksha (Lac) - LacciferLacca [Internet]. Ayurtimes.com. 2015 [cited 2021 Jul 4]. Available from: https://www.ayurtimes.com/lac-laccifer-lacca-health-benefits-uses-side-effects.[accessed on 2021-7-1]

10. Sastry, JLN. Dravyaguna Vijnana, Varanasi: Chaukamba orientalia; 2012.p.200-4.

11. Sastry, JLN. Dravyaguna Vijnana, Varanasi: Chaukamba orientalia; 2012.p.328-33.

12. Sastry, JLN. Dravyaguna Vijnana, Varanasi: Chaukamba orientalia; 2012.p.338-42.

13. Sastry, JLN. Dravyaguna Vijnana, Varanasi: Chaukamba orientalia; 2012.p.958-9.

14. Sastry, JLN. Dravyaguna Vijnana, Varanasi: Chaukamba orientalia; 2012.p.513-8.

15. Sastry, JLN. Dravyaguna Vijnana, Varanasi: Chaukamba orientalia; 2012.p.54-6.

16. Sastry, JLN. Dravyaguna Vijnana, Varanasi: Chaukamba orientalia; 2012.p.123-7.

17. Sastry, JLN. Dravyaguna Vijnana, Varanasi: Chaukamba orientalia; 2012.p.325-7.

18. Sastry, JLN. Dravyaguna Vijnana, Varanasi: Chaukamba orientalia; 2012.p.834-5.

19. Sastry, JLN. Dravyaguna Vijnana, Varanasi: Chaukamba orientalia; 2012.p.850-1


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