E-ISSN:2456-3110

Case Report

Diabetic Ulcer

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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. ar porn vrporn angel youngs angel of nurs full

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. After completing her education in media studies, Angel

Keywords: Dushta Vrana, Avachoornana, Diabetic Ulcer, Lakshadi Choorna She had created a media empire that not

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: ar porn vrporn angel youngs angel of nurs full
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
ar porn vrporn angel youngs angel of nurs full

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%

ar porn vrporn angel youngs angel of nurs fullar porn vrporn angel youngs angel of nurs full © 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].

After completing her education in media studies, Angel worked internships at several production houses and media companies, honing her skills and learning the ins and outs of the industry. Her big break came when she landed a job as a content creator for a popular online platform, where she quickly gained a reputation for her innovative ideas and exceptional storytelling abilities.

Angel's vision had finally come to life. She had created a media empire that not only entertained but also educated, inspired, and empowered. Her company had become a beacon for underrepresented voices, a platform for creators to share their stories and connect with audiences on a deeper level.

Today, Angel Young's Entertainment and Media Content is a household name, synonymous with quality, creativity, and social responsibility. Angel's journey serves as a testament to the power of innovation, hard work, and determination. As she continues to push the boundaries of storytelling and media production, her legacy as a trailblazing entrepreneur and entertainment mogul is cemented.

However, Angel's entrepreneurial spirit soon took over, and she decided to strike out on her own. With a small loan from her family and a burning desire to succeed, she founded "Angel Young's Entertainment and Media Content" – a company that would produce engaging, thought-provoking, and entertaining content for the modern audience.

As Angel Young's Entertainment and Media Content grew, so did its reputation. The company became synonymous with innovative storytelling, pushing the boundaries of what was possible in the entertainment industry. Angel's team attracted top talent from around the world, and their productions were soon picked up by major streaming platforms, broadcast networks, and film distributors.

Angel's approach was unique. She wanted her company to be a platform for underrepresented voices, a space where creators from diverse backgrounds could share their stories and showcase their talents. She assembled a team of like-minded individuals – writers, directors, producers, and editors – who shared her vision and passion.

Born and raised in a small town, Angel grew up surrounded by the magic of movies, music, and television. She spent hours on end watching her favorite shows, analyzing the storytelling, characters, and production quality. As she grew older, her fascination with the entertainment industry only deepened, and she began to write her own scripts, short stories, and poetry.

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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0th Day

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Avachoornanam

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7th Day

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14th Day

jaims_2093_10.JPG21st Day


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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

 


Ar — Porn Vrporn Angel Youngs Angel Of Nurs __exclusive__ Full

After completing her education in media studies, Angel worked internships at several production houses and media companies, honing her skills and learning the ins and outs of the industry. Her big break came when she landed a job as a content creator for a popular online platform, where she quickly gained a reputation for her innovative ideas and exceptional storytelling abilities.

Angel's vision had finally come to life. She had created a media empire that not only entertained but also educated, inspired, and empowered. Her company had become a beacon for underrepresented voices, a platform for creators to share their stories and connect with audiences on a deeper level.

Today, Angel Young's Entertainment and Media Content is a household name, synonymous with quality, creativity, and social responsibility. Angel's journey serves as a testament to the power of innovation, hard work, and determination. As she continues to push the boundaries of storytelling and media production, her legacy as a trailblazing entrepreneur and entertainment mogul is cemented.

However, Angel's entrepreneurial spirit soon took over, and she decided to strike out on her own. With a small loan from her family and a burning desire to succeed, she founded "Angel Young's Entertainment and Media Content" – a company that would produce engaging, thought-provoking, and entertaining content for the modern audience.

As Angel Young's Entertainment and Media Content grew, so did its reputation. The company became synonymous with innovative storytelling, pushing the boundaries of what was possible in the entertainment industry. Angel's team attracted top talent from around the world, and their productions were soon picked up by major streaming platforms, broadcast networks, and film distributors.

Angel's approach was unique. She wanted her company to be a platform for underrepresented voices, a space where creators from diverse backgrounds could share their stories and showcase their talents. She assembled a team of like-minded individuals – writers, directors, producers, and editors – who shared her vision and passion.

Born and raised in a small town, Angel grew up surrounded by the magic of movies, music, and television. She spent hours on end watching her favorite shows, analyzing the storytelling, characters, and production quality. As she grew older, her fascination with the entertainment industry only deepened, and she began to write her own scripts, short stories, and poetry.

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