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. phoenixcard v424 best

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. , such as tablets and development boards

Keywords: Dushta Vrana, Avachoornana, Diabetic Ulcer, Lakshadi Choorna Dual Operating Modes Product Mode Converts the SD

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: phoenixcard v424 best
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
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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%

phoenixcard v424 bestphoenixcard v424 best © 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].

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Converts the SD card into an installer media. When inserted into a bricked or uninitialized board, it immediately overrides the onboard NAND/eMMC flash memory with the new image.

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To achieve the best results with PhoenixCard v4.2.4, certain environmental factors must be managed. According to PINE64 documentation , using a high-quality, Class 10 MicroSD card with at least 8GB of capacity is essential for data integrity. Furthermore, users should always use an external card reader rather than built-in laptop slots to ensure the software can correctly identify and lock the drive. Conclusion PhoenixCard tutorial

PhoenixCard is noted for its reliability compared to alternatives like LiveSuite. Users on platforms like Reddit suggest that version is often the "sweet spot" for compatibility when newer versions fail to properly boot Android images.

Users should generally select mode when installing or recovering an operating system on their device's internal storage. The Startup mode is useful for testing operating systems without overwriting the existing firmware on the device.

: Older versions often failed to revert SD cards back to a standard FAT32/NTFS partition after use. v4.2.4 reliably restores the full capacity of the card. Script Integration : It better handles the sys_config.fex

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

jaims_2093_04.JPG


jaims_2093_05.JPG

jaims_2093_06.JPG

0th Day

jaims_2093_07.JPG

Avachoornanam

jaims_2093_08.JPG

7th Day

jaims_2093_09.JPG

14th Day

jaims_2093_10.JPG21st Day


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40th Day

jaims_2093_12.JPG
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

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, such as tablets and development boards. It is primarily used for flashing or updating firmware (ROMs) when a device cannot be updated through standard USB methods. Core Features of PhoenixCard v4.2.4 Image Writing (Burn) : Allows users to select a firmware file and write it directly to a Micro SD card. Dual Operating Modes Product Mode

Converts the SD card into an installer media. When inserted into a bricked or uninitialized board, it immediately overrides the onboard NAND/eMMC flash memory with the new image.

Across countless forum threads and technical discussions, v4.2.4 is repeatedly recommended as the “version that just works.” For example, when users of the Vontar H1 set‑top box needed to create a rescue card, the consensus was clear: use v4.2.4 for Windows XP or v4.2.8 for Windows 10. Many developers keep a copy of archived on their hard drives because they know it will not let them down.

PhoenixCard is a free, lightweight Windows utility designed specifically for Allwinner ARM processors. Its primary purpose is to burn firmware files—typically .img files—onto SD (Secure Digital) or MicroSD memory cards, transforming them into bootable drives. Once the bootable SD card is created, it is inserted into the target device (such as a TV box, tablet, or development board) to install a new operating system or recover a corrupted one.

sits in the "sweet spot." It was released during the peak maturity of the H3, H6, and A64 chipsets. Here is why techs consider phoenixcard v424 best :

To achieve the best results with PhoenixCard v4.2.4, certain environmental factors must be managed. According to PINE64 documentation , using a high-quality, Class 10 MicroSD card with at least 8GB of capacity is essential for data integrity. Furthermore, users should always use an external card reader rather than built-in laptop slots to ensure the software can correctly identify and lock the drive. Conclusion PhoenixCard tutorial

PhoenixCard is noted for its reliability compared to alternatives like LiveSuite. Users on platforms like Reddit suggest that version is often the "sweet spot" for compatibility when newer versions fail to properly boot Android images.

Users should generally select mode when installing or recovering an operating system on their device's internal storage. The Startup mode is useful for testing operating systems without overwriting the existing firmware on the device.

: Older versions often failed to revert SD cards back to a standard FAT32/NTFS partition after use. v4.2.4 reliably restores the full capacity of the card. Script Integration : It better handles the sys_config.fex

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]

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