E-ISSN:2456-3110

Case Report

Diabetic Ulcer

Tallador De Diamantes Pdf — El

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. el tallador de diamantes pdf

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. Desarrollar una mentalidad de abundancia basada en dar

Keywords: Dushta Vrana, Avachoornana, Diabetic Ulcer, Lakshadi Choorna I need to gather information about what this

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: el tallador de diamantes pdf		 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		 el tallador de diamantes pdf

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%

el tallador de diamantes pdfel tallador de diamantes pdf © 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

Desarrollar una mentalidad de abundancia basada en dar en lugar de competir.

user wants a long article about the keyword "el tallador de diamantes pdf". This likely refers to a Spanish-language book or document about diamond cutting. I need to gather information about what this document is, its author, content, significance, and where to find it. I should also understand the context of diamond cutting in Spanish literature. I will perform several searches to cover these aspects. search results show that "El Tallador de Diamantes" is a book by Michael Roach, a bestseller about applying Buddhist principles to business. There are PDF versions available. I need to gather more details about the book, its author, content, themes, and availability. I will open several relevant links. search results provide a good overview. The book "El Tallador de Diamantes" by Michael Roach is a guide to applying Buddhist principles to business, based on the Diamond Sutra. PDF versions are available online. The user likely wants a comprehensive article covering the book's content, author, themes, and where to find the PDF. I will structure the article with an introduction, sections on the book's origins, key concepts, the author, the metaphor, critical reception, and a conclusion. I'll also include information about finding the PDF. Now I will write the article.El Tallador de Diamantes PDF: Una Guía Definitiva del Éxito Empresarial Basada en la Sabiduría Budista**

Has sembrado caos o inestabilidad en la vida de otros.

Si buscas aplicar lo que encuentres en el PDF de "El Tallador de Diamantes", debes memorizar y ejecutar estas cuatro reglas kármicas:

: Disponible en formato físico y audiolibro en sitios como BuscaLibre , Mercado Libre , y Amazon . Los Tres Pilares del Libro

: If the term relates to a technical or educational context about diamond cutting, you might find relevant PDFs through:

Para lograr cualquier meta (dinero, pareja, salud), Roach propone un método ultra práctico de cuatro pasos: en una frase corta y clara.

Todo lo que sucede en tu negocio y vida es un reflejo de acciones pasadas (karma). Si quieres clientes, ayuda a otros a conseguirlos.

Quienes buscan el generalmente quieren acceder rápidamente a estas secciones prácticas:

The PDF version of "El Tallador de Diamantes" is well-formatted and easy to navigate. The text is clear and readable, with properly formatted headings and subheadings. The PDF also includes a table of contents, making it easy to jump to specific sections of the book.

es una de las obras más influyentes de la literatura de desarrollo personal y negocios a nivel mundial, pues fusiona de manera perfecta la antigua filosofía del budismo tibetano con la gestión empresarial estratégica y moderna. Escrito por Geshe Michael Roach , un graduado de la Universidad de Princeton que pasó más de 20 años estudiando en un monasterio tibetano, el libro narra cómo el autor aplicó los principios del ancestral Sutra del Cortador de Diamante para fundar y hacer crecer la división de diamantes de Andin International . La empresa comenzó con una inversión mínima y alcanzó ventas anuales superiores a los 100 millones de dólares gracias a estas enseñanzas de sabiduría.

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

jaims_2093_03.JPG

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

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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

Tallador De Diamantes Pdf — El

Desarrollar una mentalidad de abundancia basada en dar en lugar de competir.

user wants a long article about the keyword "el tallador de diamantes pdf". This likely refers to a Spanish-language book or document about diamond cutting. I need to gather information about what this document is, its author, content, significance, and where to find it. I should also understand the context of diamond cutting in Spanish literature. I will perform several searches to cover these aspects. search results show that "El Tallador de Diamantes" is a book by Michael Roach, a bestseller about applying Buddhist principles to business. There are PDF versions available. I need to gather more details about the book, its author, content, themes, and availability. I will open several relevant links. search results provide a good overview. The book "El Tallador de Diamantes" by Michael Roach is a guide to applying Buddhist principles to business, based on the Diamond Sutra. PDF versions are available online. The user likely wants a comprehensive article covering the book's content, author, themes, and where to find the PDF. I will structure the article with an introduction, sections on the book's origins, key concepts, the author, the metaphor, critical reception, and a conclusion. I'll also include information about finding the PDF. Now I will write the article.El Tallador de Diamantes PDF: Una Guía Definitiva del Éxito Empresarial Basada en la Sabiduría Budista**

Has sembrado caos o inestabilidad en la vida de otros.

Si buscas aplicar lo que encuentres en el PDF de "El Tallador de Diamantes", debes memorizar y ejecutar estas cuatro reglas kármicas:

: Disponible en formato físico y audiolibro en sitios como BuscaLibre , Mercado Libre , y Amazon . Los Tres Pilares del Libro

: If the term relates to a technical or educational context about diamond cutting, you might find relevant PDFs through:

Para lograr cualquier meta (dinero, pareja, salud), Roach propone un método ultra práctico de cuatro pasos: en una frase corta y clara.

Todo lo que sucede en tu negocio y vida es un reflejo de acciones pasadas (karma). Si quieres clientes, ayuda a otros a conseguirlos.

Quienes buscan el generalmente quieren acceder rápidamente a estas secciones prácticas:

The PDF version of "El Tallador de Diamantes" is well-formatted and easy to navigate. The text is clear and readable, with properly formatted headings and subheadings. The PDF also includes a table of contents, making it easy to jump to specific sections of the book.

es una de las obras más influyentes de la literatura de desarrollo personal y negocios a nivel mundial, pues fusiona de manera perfecta la antigua filosofía del budismo tibetano con la gestión empresarial estratégica y moderna. Escrito por Geshe Michael Roach , un graduado de la Universidad de Princeton que pasó más de 20 años estudiando en un monasterio tibetano, el libro narra cómo el autor aplicó los principios del ancestral Sutra del Cortador de Diamante para fundar y hacer crecer la división de diamantes de Andin International . La empresa comenzó con una inversión mínima y alcanzó ventas anuales superiores a los 100 millones de dólares gracias a estas enseñanzas de sabiduría.

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