E-ISSN:2456-3110

Case Report

Diabetic Ulcer

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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.

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.

Keywords: Dushta Vrana, Avachoornana, Diabetic Ulcer, Lakshadi Choorna

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.
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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
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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%

-Bestiality- Young Couple Gets Fuck With Dog - www.sickporn.in --Bestiality- Young Couple Gets Fuck With Dog - www.sickporn.in - © 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].

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The Ultimate Guide to Animal Welfare and Rights

Introduction

Animal welfare and rights are essential considerations in modern society. As humans, we have a responsibility to treat animals with respect, kindness, and compassion. This guide provides an overview of animal welfare and rights, including key principles, laws, and ways to make a positive impact.

Understanding Animal Welfare

Animal welfare refers to the physical and emotional well-being of animals. It encompasses their living conditions, treatment, and experiences. Good animal welfare involves:

  1. Providing adequate food and water: Ensuring access to nutritious food and clean water.
  2. Safe and comfortable living conditions: Providing suitable shelter, space, and protection from harsh weather conditions.
  3. Minimizing pain and distress: Preventing and alleviating pain, injury, and stress.
  4. Promoting socialization and enrichment: Allowing animals to engage in natural behaviors and interact with their environment.

Animal Rights

Animal rights refer to the moral and legal entitlements of animals. The concept of animal rights is based on the idea that animals have inherent value and should be treated with respect and dignity. Key animal rights principles include:

  1. The right to life: Protection from killing and harm.
  2. The right to freedom from exploitation: Protection from forced labor, experimentation, and abuse.
  3. The right to freedom from cruelty: Protection from physical and emotional abuse.

Laws and Regulations

Many countries have laws and regulations in place to protect animal welfare and rights. Some notable examples include:

  1. The Animal Welfare Act (USA): Regulates the treatment of animals in research, exhibition, and transportation.
  2. The European Union's Animal Welfare Directive: Sets standards for animal welfare in the EU.
  3. The Animal Protection Act (Canada): Protects animals from cruelty and neglect.

Making a Positive Impact

There are many ways to make a positive impact on animal welfare and rights:

  1. Adopt, don't shop: Choose to adopt pets from shelters or rescue organizations.
  2. Support animal-friendly businesses: Choose companies that prioritize animal welfare.
  3. Reduce meat consumption: Consider a plant-based diet or reduce meat consumption to minimize animal exploitation.
  4. Volunteer: Get involved with local animal welfare organizations or shelters.
  5. Support animal welfare legislation: Contact your representatives and express support for animal welfare laws.

Common Animal Welfare Issues

  1. Animal testing: The use of animals in scientific research and testing.
  2. Factory farming: The intensive farming of animals for food.
  3. Animal cruelty: Physical and emotional abuse of animals.
  4. Wildlife conservation: Protection of endangered species and their habitats.

Resources

  1. The Humane Society: A leading organization for animal welfare and rights.
  2. The World Wildlife Fund: A global organization dedicated to conservation and wildlife protection.
  3. The Animal Rights Coalition: A grassroots organization advocating for animal rights.

Conclusion

Animal welfare and rights are essential considerations in modern society. By understanding key principles, laws, and ways to make a positive impact, we can work towards creating a more compassionate and just world for all beings. Remember, every small action counts, and collective efforts can lead to significant positive change.

Take Action!

  1. Share this guide: Spread awareness about animal welfare and rights.
  2. Get involved: Volunteer, donate, or participate in local animal welfare initiatives.
  3. Make conscious choices: Support animal-friendly businesses and consider a plant-based diet.

Together, we can create a better world for animals.


Part II: The Moral Maze of Modern Use

The tension between these two views is not theoretical. It plays out daily in the arenas where humans and animals intersect.

The Factory Farm Dilemma

Modern industrial agriculture is the crucible of the debate. In a concentrated animal feeding operation (CAFO), the "Five Freedoms" are routinely violated. Sows are confined in gestation crates so small they cannot turn around. Broiler chickens, bred to grow so fast their legs collapse, live in sheds of 20,000. Egg-laying hens are crammed into battery cages, stacked to the ceiling. The Ultimate Guide to Animal Welfare and Rights

From a welfare perspective, the solution is incremental reform: Ban gestation crates. Mandate environmental enrichment. Require stunning before slaughter. The "Better Chicken Commitment" (adopted by major food companies like Nestlé and Unilever) is a classic welfarist victory—it demands more space, perches, and natural light.

From a rights perspective, reform is a trap. Francione calls this the "new welfarism"—making people feel morally comfortable about consuming animals by easing their conscience. A "happy cow" is still a cow executed at a fraction of her natural lifespan. To a rights advocate, improving the cage distracts from the goal of abolishing the cage.

Part III: The Paradox of Welfare – A Stepping Stone or a Trap?

The most contentious debate inside the animal protection community is not between advocates and opponents, but between welfarists and abolitionists.

The Welfarist View: Welfare reforms save lives and reduce suffering now. When the EU banned barren battery cages for hens, hundreds of millions of birds were moved into enriched colony cages with perches and nesting areas. When McDonald’s required “stunning before slaughter” for its suppliers, millions of animals were spared the terror of shackling and throat-cutting while conscious. Welfarists argue that perfection is the enemy of the good. While we work toward a vegan world, we have a moral obligation to make the current system less hellish.

The Abolitionist Critique: Abolitionists (notably Gary Francione) argue that welfare reforms entrench animal use. By making factory farming appear more “humane,” they pacify consumer guilt and legitimate the property status of animals. A bigger cage is still a cage. A “humane” slaughterhouse is still a slaughterhouse. Furthermore, welfare reforms often create perverse incentives. For example, “enriched” cages for hens are more expensive to build, leading egg companies to keep the same number of birds in new cages rather than transitioning to cage-free systems. Worse, some advanced welfare standards (like controlled-atmosphere stunning) are so efficient that they lower the psychological barrier to killing livestock.

This is “the welfare paradox”: reforms reduce suffering in the short term but may extend the life of animal agriculture in the long term.

Part 3: Key Differences at a Glance

| Feature | Animal Welfare | Animal Rights | |---------|----------------|----------------| | Goal | Humane treatment; reduce suffering | Abolition of use; recognize personhood | | Use of animals | Permitted under standards | Generally impermissible | | Property status | Accepts animals as property | Rejects property status | | Killing | Permitted if humane | Prohibited (except mercy) | | Diet | Permits meat, eggs, dairy from "humane" farms | Requires veganism | | Reform approach | Work within systems (e.g., Prop 12) | Reject welfare reforms as co-optation |

Animal Rights: The Abolitionist Vision

Animal rights is a deontological philosophy—meaning it is based on duties and rules rather than consequences. Drawing heavily from the philosopher Tom Regan ( The Case for Animal Rights ), it argues that animals are "subjects-of-a-life." They have inherent value, beliefs, desires, memory, and a sense of the future.

The core principle is inviolability. If an animal has a right to life and liberty, then using that animal as a resource is inherently wrong, regardless of how "humanely" it is done. You cannot violate a right in a gentle way. Providing adequate food and water : Ensuring access

In practice: A rights advocate is a vegan. They oppose all forms of animal exploitation: factory farming, hunting, animal testing, circuses, zoos, and even guide dog breeding (viewing it as coerced labor). They do not seek bigger cages; they seek empty cages.

Key distinction: While a welfarist asks "Is the animal suffering?", a rights advocate asks "Is the animal being used?"

Part IV: The Psychology of Denial

Why, given the evidence of factory farm suffering (documented by undercover investigators for decades), do most people continue to eat meat, wear leather, and visit dolphin shows?

Psychologist Melanie Joy coined the term "carnism" —the invisible belief system that conditions us to eat certain animals (pigs, cows) but not others (dogs, horses). It is a violent system, but it is masked by three Ns: Necessary, Natural, Normal.

The welfare/rights debate often triggers a defense mechanism. When a rights activist says "Go vegan," the listener feels judged. When a welfarist says "Buy free-range," the listener feels relieved—they can continue their habits, just with a premium product. This is why corporate agriculture prefers welfarism. It stabilizes the system. It creates a premium tier (organic, cage-free) while 95% of animals remain on factory farms.

Conclusion: Beyond the Binary

While animal welfare and animal rights appear opposed, many practical advocates operate in the tension between them. A humane society investigator may enforce welfare laws while personally believing in rights. A rights-oriented lawyer may support a "cage-free" ballot initiative because it reduces suffering incrementally.

The deepest question is not about cages or slaughter methods, but about moral status: Can a being who is not human, who cannot vote, speak, or sign a contract, still be a person under the law? The answer to that question will determine whether future generations look back at factory farms and laboratories as necessary evils or as moral atrocities comparable to human slavery.

As the philosopher Martha Nussbaum writes, justice for animals requires not just compassion but a capabilities approach – ensuring each sentient being the opportunity to flourish according to its own nature. Whether that vision is realized through reformed welfare or full rights remains the defining ethical struggle of our relationship with the more-than-human world.


The Five Freedoms

The most influential standard in animal welfare is the Five Freedoms, originally developed by the UK Farm Animal Welfare Council in 1965: Animal Rights Animal rights refer to the moral

  1. Freedom from Hunger and Thirst – access to fresh water and a diet to maintain full health.
  2. Freedom from Discomfort – an appropriate environment including shelter and resting areas.
  3. Freedom from Pain, Injury, and Disease – prevention, rapid diagnosis, and treatment.
  4. Freedom to Express Normal Behavior – sufficient space, proper facilities, and company of the animal’s own kind.
  5. Freedom from Fear and Distress – conditions that avoid mental suffering.

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


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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


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40th Day

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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

9.Skin Colour Surrounding Wound  1 = Pink or normal for ethnic group 2 = Bright red &/or blanches to touch 3 = White or grey pallor or hypopigmented 4 = Dark red or purple &/or non-blanchable 5 = Black or hyperpigmented 1 1 1 1 1
10.Peripheral Tissue Edema 1 = No swelling or edema 2 = non-pitting edema extends < 4 cm around wound 3 = non-pitting edema extends > 4 cm around wound 4 = Pitting edema extends < 4 cm around wound 5 = Crepitus and/or pitting edema extends >4 cm around wound 2 2 1 1 1
11.Peripheral Tissue Induration 1 = None present 2 = Induration, < 2 cm around wound 3 = Induration 2-4 cm extending < 50% around wound 4 = Induration 2-4 cm extending > 50% around wound 5 = Induration > 4 cm in any area around wound 2 1 1 1 1
12.Granulation Tissue   1 = Skin intact or partial thickness wound 2 = Bright, beefy red; 75% to 100% of wound filled &/or tissue overgrowth 3 = Bright, beefy red; < 75% & > 25% of wound filled 4 = Pink, &/or dull, dusky red &/or fills < 25% of wound 5 = No granulation tissue present 3 2 2 2 2
13.Epithelialization   1 = 100% wound covered, surface intact 2 = 75% to <100% wound covered &/or epithelial tissue extends to > 0.5cm into wound bed 3 = 50% to <75% wound covered &/or epithelial tissue extends to <0.5cm into wound bed 4 = 25% to < 50% wound covered 5 = < 25% wounds covered 5 5 5 4 3
Total Score 34 31 26 24 20

Results

Reduction of Symptoms of ulcer was achieved within 14-21 days of Lakshadi Avachoornana and later complete healing was achieved without any other complications.

Discussion

Lakshadi Gana with the properties of Tikta Kashaya Rasa, Laghu Rooksha Guna, Ushna Veerya, Katu Vipaka, Kaphapittahara and Arthi Nashanam is indicated in Dushta Vrana, Kushta and Krimi. Acharya Susrutha has included this Gana in Dravya Sangrahaneeya Adyaya and indicated in Dushta Vrana. In the present situation, due to hampered foot habits and physical exertion, life style disorders are more along with its complications. Lakshadi Avachoornana helps in reducing the symptoms of Dushta Vrana, thereby helps in getting desired

result. Tikta Kashya Rasa helps in promoting healing of wound and it has Pittahara property, thereby helps in reducing the burning sensation.

Due to its Usha Veerya, it helps in Vatashamana, thereby reducing the pain. This Gana also possess, Krimighna, Kushtagna property, hence its Vranasodhana and Ropana nature in Dushta Vrana is highlighted.

Further clinical study is needed to evaluate the effectiveness in larger sample.

Conclusion

Significant relief on symptoms of Dushta Vrana including Poothi Pooya, Srava, Athigandha etc was being observed in the course of treatment. There was better healing and sustained symptomatic relief in this patient with the Lakshadi Avachoornana. Due to its easy and convenient mode of application it makes the procedure significant.

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