E-ISSN:2456-3110

Case Report

Diabetic Ulcer

Iptv Zaman N0w V21 Exclusive [hot] -

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. iptv zaman n0w v21 exclusive

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. The original "IPTV Zaman N0W" tool, which many

Keywords: Dushta Vrana, Avachoornana, Diabetic Ulcer, Lakshadi Choorna This includes: Latest Hollywood movies

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: iptv zaman n0w v21 exclusive		 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		 iptv zaman n0w v21 exclusive

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%

iptv zaman n0w v21 exclusiveiptv zaman n0w v21 exclusive © 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

The original "IPTV Zaman N0W" tool, which many users have encountered, is a utility focused on playlist and link management, not video playback. Its features [13†L1-L48] include:

: Many users suggest using a VPN to maintain privacy and bypass potential ISP throttling.

In addition to live TV, IPTV Zaman N0w V21 Exclusive offers a massive Video on Demand library. This includes: Latest Hollywood movies. Popular international films. Full seasons of TV series and box sets.

Since this is an exclusive third-party version, you typically need to download the APK file from a trusted source or the developer's provided link.

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This is a special file called an M3U playlist. It contains links to thousands of live television channels. People love it because it brings premium content straight to your screen for free. Key Features

As an "Exclusive" release, V21 typically focuses on stability and library depth. Key characteristics include: Massive Content Library:

IPTV Zaman N0w V21 is a premium streaming application and service architecture designed to deliver live television, movies, and series over the internet. Unlike traditional IPTV setups that often suffer from buffering or outdated links, the V21 "Exclusive" tag indicates a refined backend. This version utilizes private servers and optimized data compression to ensure high-definition playback even on modest internet speeds. Key Technical Specifications Specialized APK with low-latency protocols.

While tools like IPTV Zaman N0w V21 Exclusive are popular, users must be aware of the legal and security risks. The software itself is a tool—much like a web browser—but what you do with it determines its legality.

: This version is generally optimised for use on Android-based Smart TVs, TV Boxes, and Firestick devices. Exclusive Content

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


jaims_2093_02.JPG

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Final product

Figure 2: The method of Lakshadi Avachoornana

jaims_2093_04.JPG


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

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


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

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

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

Iptv Zaman N0w V21 Exclusive [hot] -

The original "IPTV Zaman N0W" tool, which many users have encountered, is a utility focused on playlist and link management, not video playback. Its features [13†L1-L48] include:

: Many users suggest using a VPN to maintain privacy and bypass potential ISP throttling.

In addition to live TV, IPTV Zaman N0w V21 Exclusive offers a massive Video on Demand library. This includes: Latest Hollywood movies. Popular international films. Full seasons of TV series and box sets.

Since this is an exclusive third-party version, you typically need to download the APK file from a trusted source or the developer's provided link.

In the world of digital entertainment, IPTV (Internet Protocol Television) has revolutionized the way we consume television content. Offering a vast array of channels, movies, and series at your fingertips, IPTV services have become increasingly popular. Among these, IPTV Zaman Now V21 Exclusive stands out as a premier choice for those seeking high-quality streaming and an extensive content library.

Navigating the world of "IPTV Zaman N0W v21 exclusive" is a journey into a complex landscape. The search for easy, free access often leads to outdated software, security risks, and legal gray areas. While the original IPTV Tools software has interesting features for managing public playlists, the "exclusive v21" version likely doesn't exist as advertised.

This is a special file called an M3U playlist. It contains links to thousands of live television channels. People love it because it brings premium content straight to your screen for free. Key Features

As an "Exclusive" release, V21 typically focuses on stability and library depth. Key characteristics include: Massive Content Library:

IPTV Zaman N0w V21 is a premium streaming application and service architecture designed to deliver live television, movies, and series over the internet. Unlike traditional IPTV setups that often suffer from buffering or outdated links, the V21 "Exclusive" tag indicates a refined backend. This version utilizes private servers and optimized data compression to ensure high-definition playback even on modest internet speeds. Key Technical Specifications Specialized APK with low-latency protocols.

While tools like IPTV Zaman N0w V21 Exclusive are popular, users must be aware of the legal and security risks. The software itself is a tool—much like a web browser—but what you do with it determines its legality.

: This version is generally optimised for use on Android-based Smart TVs, TV Boxes, and Firestick devices. Exclusive Content

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

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Journal of Ayurveda and Integrated Medical Sciences 2022;7(9)202