E-ISSN:2456-3110

Case Report

Diabetic Ulcer

Dukes Hardcore Honeys - Close Encounters 1-8 -a...

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. Dukes Hardcore Honeys - Close Encounters 1-8 -A...

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. You don't generally read "Hardcore Honeys" for intricate,

Keywords: Dushta Vrana, Avachoornana, Diabetic Ulcer, Lakshadi Choorna | | Youthful Rebellion | “Break the walls,

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: Dukes Hardcore Honeys - Close Encounters 1-8 -A...
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
Dukes Hardcore Honeys - Close Encounters 1-8 -A...

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%

Dukes Hardcore Honeys - Close Encounters 1-8 -A...Dukes Hardcore Honeys - Close Encounters 1-8 -A... © 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].

You don't generally read "Hardcore Honeys" for intricate, award-winning plotlines, but "Close Encounters" makes a genuine effort to string a narrative together.

| Theme | Example | Interpretation | |-------|---------|----------------| | | “Fly high, never land” – “Skybound” (Vol 4) | Reflects the desire to transcend mundane reality through the rave’s collective high. | | Technological Futurism | “Binary love, code of the night” – “Digital Dreams” (Vol 6) | Mirrors the early 2000s fascination with the internet and emerging digital culture. | | Youthful Rebellion | “Break the walls, smash the silence” – “Rave‑Riot” (Vol 2) | Aligns with the anti‑establishment sentiment prevalent in post‑rave legislation era. |

By the time the sun began to bleed over the horizon, the Sector’s "A-Team" was left stranded on the shoulder, their tires shredded and their electronics fried by Roxie’s custom EMP pulses.

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The series showcases a range of performers, offering a platform for individuals from various backgrounds to gain exposure. This diversity is crucial for representation within the industry and for meeting the varied tastes of audiences.

🤓 Dukes Hardcore Honeys - Close Encounters 1-8 -A... - Google Drive

For fans of the Close Encounters series, episodes 1-8 are a treasure trove of sultry performances, steamy encounters, and unforgettable moments. Here's a brief rundown of each episode:

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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


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

Dukes Hardcore Honeys - Close Encounters 1-8 -a...

You don't generally read "Hardcore Honeys" for intricate, award-winning plotlines, but "Close Encounters" makes a genuine effort to string a narrative together.

| Theme | Example | Interpretation | |-------|---------|----------------| | | “Fly high, never land” – “Skybound” (Vol 4) | Reflects the desire to transcend mundane reality through the rave’s collective high. | | Technological Futurism | “Binary love, code of the night” – “Digital Dreams” (Vol 6) | Mirrors the early 2000s fascination with the internet and emerging digital culture. | | Youthful Rebellion | “Break the walls, smash the silence” – “Rave‑Riot” (Vol 2) | Aligns with the anti‑establishment sentiment prevalent in post‑rave legislation era. |

By the time the sun began to bleed over the horizon, the Sector’s "A-Team" was left stranded on the shoulder, their tires shredded and their electronics fried by Roxie’s custom EMP pulses.

In the realm of adult entertainment, there exist numerous franchises that have managed to carve out a niche for themselves, captivating audiences with their unique blend of sensuality, intimacy, and raw passion. Among these, Dukes Hardcore Honeys has emerged as a prominent player, offering a distinctive fusion of hardcore pornography and captivating storylines. Within this franchise, the Close Encounters series stands out as a testament to the producers' ability to craft engaging narratives that push the boundaries of erotic storytelling.

The neon sign above “The Hive” flickered, casting a bruised purple glow over the line of motorcycles parked out front. Inside, the air was thick with the scent of ozone, leather, and cheap whiskey. This wasn't just any roadside bar; it was the unofficial headquarters of the , an all-female crew known for taking no grief and leaving no witnesses.

The series showcases a range of performers, offering a platform for individuals from various backgrounds to gain exposure. This diversity is crucial for representation within the industry and for meeting the varied tastes of audiences.

🤓 Dukes Hardcore Honeys - Close Encounters 1-8 -A... - Google Drive

For fans of the Close Encounters series, episodes 1-8 are a treasure trove of sultry performances, steamy encounters, and unforgettable moments. Here's a brief rundown of each episode:

The popularity of series focusing on "encounters" marked a transition in how adult content was consumed. By removing the traditional "movie" structure, these productions offered a more direct and visceral experience. This trend eventually paved the way for the point-of-view (POV) and amateur styles that dominate the digital era today. Historical Context and Physical Media

Would you like to know more about the adult entertainment industry or a related topic? I'm here to provide informative responses.

The appeal of "Dukes Hardcore Honeys - Close Encounters 1-8" can be attributed to several factors:

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]

10. Sastry, JLN. Dravyaguna Vijnana, Varanasi: Chaukamba orientalia; 2012.p.200-4.

11. Sastry, JLN. Dravyaguna Vijnana, Varanasi: Chaukamba orientalia; 2012.p.328-33.

12. Sastry, JLN. Dravyaguna Vijnana, Varanasi: Chaukamba orientalia; 2012.p.338-42.

13. Sastry, JLN. Dravyaguna Vijnana, Varanasi: Chaukamba orientalia; 2012.p.958-9.

14. Sastry, JLN. Dravyaguna Vijnana, Varanasi: Chaukamba orientalia; 2012.p.513-8.

15. Sastry, JLN. Dravyaguna Vijnana, Varanasi: Chaukamba orientalia; 2012.p.54-6.

16. Sastry, JLN. Dravyaguna Vijnana, Varanasi: Chaukamba orientalia; 2012.p.123-7.

17. Sastry, JLN. Dravyaguna Vijnana, Varanasi: Chaukamba orientalia; 2012.p.325-7.

18. Sastry, JLN. Dravyaguna Vijnana, Varanasi: Chaukamba orientalia; 2012.p.834-5.

19. Sastry, JLN. Dravyaguna Vijnana, Varanasi: Chaukamba orientalia; 2012.p.850-1