E-ISSN:2456-3110

Case Report

Diabetic Ulcer

Wii Wads !!exclusive!!

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. wii wads

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. For enthusiasts, installing WADs allows for a highly

Keywords: Dushta Vrana, Avachoornana, Diabetic Ulcer, Lakshadi Choorna These act as your safety nets; if your

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: wii wads		 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		 wii wads

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%

wii wadswii wads © 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

For enthusiasts, installing WADs allows for a highly personalized user experience. You can turn your Wii into a dedicated retro-gaming hub, bypass tedious loading steps for homebrew apps, and change the visual theme of your system menu. Essential Prerequisites for Using WADs

and Priiloader configured. These act as your safety nets; if your system bricks, Priiloader allows you to access a recovery menu before the system crashes. An SD card or USB drive formatted to FAT32. Step-by-Step Installation Guide

If prompted to select an IOS, leave it on the default option (usually or standard IOS with AHBPROT enabled) and press A . Navigate to and select WAD Manager . Choose Wii SD Slot as your source device. Step 4: Install the WAD

In the context of the Nintendo Wii, a (which stands for Where's All the Data ) is a file format used by Nintendo to package and distribute software for the console's internal storage. WAD files act essentially like installer packages (similar to .exe or .msi files on Windows, or .apk files on Android).

Because Nintendo officially shut down the Wii Shop Channel in 2019, WAD files have become the primary method for preserving and restoring digital Wii history. Without WAD files, legitimate digital games that were never released physically would be permanently lost to time.

You can create "forwarder" channels, which are small WADs that act as a shortcut to a game stored on an SD card or USB drive.

If you want to customize your system further, you can explore how to safely format your SD card or use homebrew tools to extract your own game discs. Share public link

Introduction The Nintendo Wii, released in 2006, became one of the most influential consoles of its generation due to its motion controls, broad appeal, and expansive library. Alongside official channels for games and updates, a vibrant homebrew scene emerged that used WAD files (Wii Application Data packages) to install channels, applications, and game backups onto the console. This essay explains what WADs are, how they were used in the Wii community, why they matter, and the legal and ethical questions they raise.

When searching for Wii WADs online, you will frequently encounter repositories hosting commercial Virtual Console and WiiWare titles. Downloading files for games you do not legally own constitutes digital copyright infringement. To stay ethical and legal, users are encouraged to:

A full brick happens when a critical system file, such as a System Menu WAD or an important IOS file, is corrupted, deleted, or replaced with an incompatible version (e.g., installing a Region-A System Menu on a Region-J console). The console will fail to boot entirely, often showing only a black screen. Essential Safety Measures

If you want, I can:

Native apps like the Mii Channel, Photo Channel, Internet Channel, and the system settings menu itself.

A softmodded Nintendo Wii with the Homebrew Channel installed. An SD card formatted to FAT32.

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

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

Wii Wads !!exclusive!!

For enthusiasts, installing WADs allows for a highly personalized user experience. You can turn your Wii into a dedicated retro-gaming hub, bypass tedious loading steps for homebrew apps, and change the visual theme of your system menu. Essential Prerequisites for Using WADs

and Priiloader configured. These act as your safety nets; if your system bricks, Priiloader allows you to access a recovery menu before the system crashes. An SD card or USB drive formatted to FAT32. Step-by-Step Installation Guide

If prompted to select an IOS, leave it on the default option (usually or standard IOS with AHBPROT enabled) and press A . Navigate to and select WAD Manager . Choose Wii SD Slot as your source device. Step 4: Install the WAD

In the context of the Nintendo Wii, a (which stands for Where's All the Data ) is a file format used by Nintendo to package and distribute software for the console's internal storage. WAD files act essentially like installer packages (similar to .exe or .msi files on Windows, or .apk files on Android).

Because Nintendo officially shut down the Wii Shop Channel in 2019, WAD files have become the primary method for preserving and restoring digital Wii history. Without WAD files, legitimate digital games that were never released physically would be permanently lost to time.

You can create "forwarder" channels, which are small WADs that act as a shortcut to a game stored on an SD card or USB drive.

If you want to customize your system further, you can explore how to safely format your SD card or use homebrew tools to extract your own game discs. Share public link

Introduction The Nintendo Wii, released in 2006, became one of the most influential consoles of its generation due to its motion controls, broad appeal, and expansive library. Alongside official channels for games and updates, a vibrant homebrew scene emerged that used WAD files (Wii Application Data packages) to install channels, applications, and game backups onto the console. This essay explains what WADs are, how they were used in the Wii community, why they matter, and the legal and ethical questions they raise.

When searching for Wii WADs online, you will frequently encounter repositories hosting commercial Virtual Console and WiiWare titles. Downloading files for games you do not legally own constitutes digital copyright infringement. To stay ethical and legal, users are encouraged to:

A full brick happens when a critical system file, such as a System Menu WAD or an important IOS file, is corrupted, deleted, or replaced with an incompatible version (e.g., installing a Region-A System Menu on a Region-J console). The console will fail to boot entirely, often showing only a black screen. Essential Safety Measures

If you want, I can:

Native apps like the Mii Channel, Photo Channel, Internet Channel, and the system settings menu itself.

A softmodded Nintendo Wii with the Homebrew Channel installed. An SD card formatted to FAT32.

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