E-ISSN:2456-3110

Case Report

Diabetic Ulcer

Indobokep Persi Panjang 2 -

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. Indobokep Persi Panjang 2

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. A major film company based in Jakarta that

Keywords: Dushta Vrana, Avachoornana, Diabetic Ulcer, Lakshadi Choorna Indonesia boasts one of the most active gaming

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: Indobokep Persi Panjang 2
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
Indobokep Persi Panjang 2

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%

Indobokep Persi Panjang 2Indobokep Persi Panjang 2 © 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].

A major film company based in Jakarta that develops and distributes prominent Indonesian content for both local and international markets. Culture & Lifestyle Content

Despite the digital rise, traditional TV remains a staple for millions of households.

This refers to low-effort, silly, or absurd humor that is instantly relatable and easy to consume.

Indonesia boasts one of the most active gaming communities in the world. Consequently, gaming entertainment makes up a massive slice of the popular video pie. Mobile Gaming Dominance

The Indonesian entertainment landscape in 2026 is a powerhouse of digital growth, characterized by a booming film industry and a "hyper-engaged" creator economy. Indonesia is currently the , with local productions capturing a massive 65-67% of the domestic box office share . The Rise of Indonesian Cinema

Indonesian film and television, or "film dan televisi Indonesia," have also gained popularity globally. Some notable Indonesian films include:

The film industry also had a spectacular year in 2025. Local productions took roughly of the Indonesian box office, a figure that underscores a decisive shift in audience preference away from Hollywood blockbusters. The year's biggest success was the animated film "Jumbo" , directed by Ryan Adriandhy, which garnered over 10 million viewers in its theatrical run, making it not just the highest-grossing film of the year but one of the most successful Indonesian films of all time.

The Digital Boom: A Deep Dive into Indonesian Entertainment and Popular Videos

While the government blazes a trail of takedowns, the most crucial area of concern is the protection of children and adolescents. Recent data from Indonesia's Central Statistics Agency (BPS) reveals that , making them exceptionally vulnerable to stumbling upon or actively seeking explicit content. A 2024 BPS survey further found that more than 60% of teenagers admitted to having accessed pornography, mostly through their personal smartphones.

This keyword is significant because it is not a generic search for pornography, but a targeted query for specific local content. This demonstrates a high level of demand for Indonesian-language or locally produced material. While specific direct information about the series is not publicly available due to its nature, the popularity of such a search term speaks to a broader trend: the preference for local, relatable content in a genre that is globally dominated by foreign productions.

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


jaims_2093_02.JPG

jaims_2093_03.JPG

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


jaims_2093_11.JPG
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

Indobokep Persi Panjang 2 -

A major film company based in Jakarta that develops and distributes prominent Indonesian content for both local and international markets. Culture & Lifestyle Content

Despite the digital rise, traditional TV remains a staple for millions of households.

This refers to low-effort, silly, or absurd humor that is instantly relatable and easy to consume.

Indonesia boasts one of the most active gaming communities in the world. Consequently, gaming entertainment makes up a massive slice of the popular video pie. Mobile Gaming Dominance

The Indonesian entertainment landscape in 2026 is a powerhouse of digital growth, characterized by a booming film industry and a "hyper-engaged" creator economy. Indonesia is currently the , with local productions capturing a massive 65-67% of the domestic box office share . The Rise of Indonesian Cinema

Indonesian film and television, or "film dan televisi Indonesia," have also gained popularity globally. Some notable Indonesian films include:

The film industry also had a spectacular year in 2025. Local productions took roughly of the Indonesian box office, a figure that underscores a decisive shift in audience preference away from Hollywood blockbusters. The year's biggest success was the animated film "Jumbo" , directed by Ryan Adriandhy, which garnered over 10 million viewers in its theatrical run, making it not just the highest-grossing film of the year but one of the most successful Indonesian films of all time.

The Digital Boom: A Deep Dive into Indonesian Entertainment and Popular Videos

While the government blazes a trail of takedowns, the most crucial area of concern is the protection of children and adolescents. Recent data from Indonesia's Central Statistics Agency (BPS) reveals that , making them exceptionally vulnerable to stumbling upon or actively seeking explicit content. A 2024 BPS survey further found that more than 60% of teenagers admitted to having accessed pornography, mostly through their personal smartphones.

This keyword is significant because it is not a generic search for pornography, but a targeted query for specific local content. This demonstrates a high level of demand for Indonesian-language or locally produced material. While specific direct information about the series is not publicly available due to its nature, the popularity of such a search term speaks to a broader trend: the preference for local, relatable content in a genre that is globally dominated by foreign productions.

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