E-ISSN:2456-3110

Case Report

Diabetic Ulcer

Machine Gunner - -digital Playground- 2023 Web-dl... Work __link__

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. Machine Gunner -Digital Playground- 2023 WEB-DL... WORK

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. This overview explores the technical elements of the

Keywords: Dushta Vrana, Avachoornana, Diabetic Ulcer, Lakshadi Choorna This highly anticipated release promises to deliver non-stop

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: Machine Gunner -Digital Playground- 2023 WEB-DL... WORK		 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		 Machine Gunner -Digital Playground- 2023 WEB-DL... WORK

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%

Machine Gunner -Digital Playground- 2023 WEB-DL... WORKMachine Gunner -Digital Playground- 2023 WEB-DL... WORK © 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

This overview explores the technical elements of the 2023 release, focusing on the production aspects and the digital distribution standards.

The wait is over! "Machine Gunner" from Digital Playground is now available as a 2023 WEB-DL. This highly anticipated release promises to deliver non-stop action, thrilling sequences, and an unforgettable experience.

The video and audio tracks are extracted seamlessly from the host server, ensuring the exact visual clarity intended by director Ricky Greenwood.

Cast * Kira Noir. Nikki Ransom. 4 episodes • 2023. * Nicole Doshi. Maggie Tombs. 4 episodes • 2023. * Kayley Gunner. Rena Lockett. Machine Gunner (TV Mini Series 2023) - IMDb

Narrative and Themes

In the landscape of 2023 digital media releases, certain productions are highlighted for their high production value and technical execution. This specific release from the Digital Playground studio has garnered technical interest due to its high-definition quality and the specific "WEB-DL" format used for its distribution. This format represents a modern standard for streaming-first content, offering viewers high fidelity direct from the digital source.

"Machine Gunner" is not your average adult film. The story is steeped in military action tropes. The narrative follows a secret paramilitary unit led by the formidable protagonist, Nikki Ransom (played by the award-winning Kira Noir). Ransom and her elite squad of black-ops soldiers are tasked with a high-stakes mission: hunt down and capture Colonel Joe Riggs, a disgraced soldier who has gone rogue.

: Secure digital communities rely on cryptographic hash functions to ensure a file matching this description has not been altered or bundled with malicious software.

: It blends traditional action movie tropes—such as tactical gear, stunts, and mercenary squads—with frequent adult vignettes. Key Cast & Crew Director/Producer : Ricky Greenwood. Main Cast : Kira Noir as Nikki Ransom (Team Leader). Kayley Gunner as Rena Lockett. Nicole Doshi as Maggie Tombs. Luna Star as Daytona. Alex Jones as the villain, Joe Riggs.

Digital Playground has historically built its brand identity around high-concept, narrative-driven feature parodies. Machine Gunner represents a continuation of this legacy. Rather than relying solely on performance sequences, the feature invests heavily in world-building, pacing, and comedic yet intense action choreography.

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

Machine Gunner - -digital Playground- 2023 Web-dl... Work __link__

This overview explores the technical elements of the 2023 release, focusing on the production aspects and the digital distribution standards.

The wait is over! "Machine Gunner" from Digital Playground is now available as a 2023 WEB-DL. This highly anticipated release promises to deliver non-stop action, thrilling sequences, and an unforgettable experience.

The video and audio tracks are extracted seamlessly from the host server, ensuring the exact visual clarity intended by director Ricky Greenwood.

Cast * Kira Noir. Nikki Ransom. 4 episodes • 2023. * Nicole Doshi. Maggie Tombs. 4 episodes • 2023. * Kayley Gunner. Rena Lockett. Machine Gunner (TV Mini Series 2023) - IMDb

Narrative and Themes

In the landscape of 2023 digital media releases, certain productions are highlighted for their high production value and technical execution. This specific release from the Digital Playground studio has garnered technical interest due to its high-definition quality and the specific "WEB-DL" format used for its distribution. This format represents a modern standard for streaming-first content, offering viewers high fidelity direct from the digital source.

"Machine Gunner" is not your average adult film. The story is steeped in military action tropes. The narrative follows a secret paramilitary unit led by the formidable protagonist, Nikki Ransom (played by the award-winning Kira Noir). Ransom and her elite squad of black-ops soldiers are tasked with a high-stakes mission: hunt down and capture Colonel Joe Riggs, a disgraced soldier who has gone rogue.

: Secure digital communities rely on cryptographic hash functions to ensure a file matching this description has not been altered or bundled with malicious software.

: It blends traditional action movie tropes—such as tactical gear, stunts, and mercenary squads—with frequent adult vignettes. Key Cast & Crew Director/Producer : Ricky Greenwood. Main Cast : Kira Noir as Nikki Ransom (Team Leader). Kayley Gunner as Rena Lockett. Nicole Doshi as Maggie Tombs. Luna Star as Daytona. Alex Jones as the villain, Joe Riggs.

Digital Playground has historically built its brand identity around high-concept, narrative-driven feature parodies. Machine Gunner represents a continuation of this legacy. Rather than relying solely on performance sequences, the feature invests heavily in world-building, pacing, and comedic yet intense action choreography.

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