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

K M Sweta; Swathi C Nair

E-ISSN:2456-3110

Case Report

Diabetic Ulcer

Ams1gn Ipa Patched

2022 Volume 7 Number 9 October

Publisher

www.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. ams1gn ipa patched

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. : Accessing paid features in apps like Spotify

Keywords: Dushta Vrana, Avachoornana, Diabetic Ulcer, Lakshadi Choorna A patched IPA is an original app file

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:	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

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%

ams1gn ipa patched © 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

Back To Article Download PDF Introduction Aim and
Objective Materials and
Methods Case Study Results Discussion Conclusion Reference

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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 7^th, 14^th, 21^st and 40^th day of the treatment.

Figure 1: The method of Lakshadi Choorna preparation.

Raw drugs for Lakshadi Avachoornana

Final product

Figure 2: The method of Lakshadi Avachoornana

Journal of Ayurveda and Integrated Medical Sciences 2022;7(9)198

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

0^th Day

Avachoornanam

7^th Day

14^th Day

21^st 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

40^th Day

Follow-up

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

Item	Assessment	0^th day Score	7^th day Score	14^th day Score	21^st day Score	40^th 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