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Line 1,566: + + − + − + + + + + + + + + + + − The following ulcer is the case of infected diabetic non healing ulcer (Diabetic foot). Clinical features include severe burning pain, black coloation of first toe with pus discharge, slough, bad smell and deformity in great toe. This is non healing ulcer since 2 months+ − + − The following ulcer is the case of healing traumatic ulcer at anterior part of tibia/lower leg.. Clinical features include mild pain, no discharge, and margins and thick and inflamed due to chronicicty and the granulation tissue are seen at base of ulcer. So this is a healing ulcer. + + − Image 5: Shuddha vrana − Investigations and their clinical interpretation in brief:
→Samprapti (pathogenesis of vrana): based on shadakriya kala
[[File:Dwivraniya1.png|500px]]
[[File:Dwivraniya1.png|500px]]
Clinical pictures of ''vrana'':
==== Clinical pictures of ''vrana'' ====
The following ulcer is the case of diabetic ulcer. Clinical features include throbbing pain, swelling, redness, necrosis of involved tissue and non healing ulcer since 6 months.
The following ulcer is the case of diabetic ulcer. Clinical features include throbbing pain, swelling, redness, necrosis of involved tissue and non healing ulcer since 6 months.
The following ulcer is the case of non healing ulcer due to boils. Clinical features include burning pain, redness, pus discharge, slough, with redness of involved tissue and non healing ulcer since 1month.
The following ulcer is the case of non healing ulcer due to boils. Clinical features include burning pain, redness, pus discharge, slough, with redness of involved tissue and non healing ulcer since 1month.
[[File:DwivImage2.jpg|500px|Image 2: ''Pitta'' dominant ulcer]]
Image 2: Pitta dominant ulcer
'''Image 2: Pitta dominant ulcer'''
The following ulcer is the case of non healing ulcer due to DCT (Deep vein thrombosis). Clinical features include pain, irregular superficial ulcer, redness, mild pus discharge, slough, with redness of involved tissue and non healing ulcer since 8 months.
The following ulcer is the case of non healing ulcer due to DCT (Deep vein thrombosis). Clinical features include pain, irregular superficial ulcer, redness, mild pus discharge, slough, with redness of involved tissue and non healing ulcer since 8 months.
Image 3: Kapha dominant ulcer
[[File:DwivImage3.jpg|500px|Image 3: ''Kapha'' dominant ulcer ]]
'''Image 3: Kapha dominant ulcer'''
The following ulcer is the case of infected diabetic non healing ulcer (Diabetic foot). Clinical features include severe burning pain, black coloration of first toe with pus discharge, slough, bad smell and deformity in great toe. This is non healing ulcer since 2 months.
[[File:DwivImage4.jpg|500px|Image 4: ''Dushta vrana'']]
'''Image 4: ''Dushta vrana'''''
The following ulcer is the case of healing traumatic ulcer at anterior part of tibia/lower leg.. Clinical features include mild pain, no discharge, and margins and thick and inflamed due to their chronic nature and the granulation tissue are seen at base of ulcer. So this is a healing ulcer.
[[File:DwivImage5.jpg|500px|Image 5: ''Shuddha vrana'']]
Image 4: Dushta vrana
'''Image 5: ''Shuddha vrana'''''
==== Investigations and their clinical interpretation in brief ====
The clinical features of ulcers are ulceration /disccontineous of skin, discharge (pus/blood/ serum), bad odor, differenct size, painful/painless ulcers. The above symptoms are described by Acharya Sushruta (Gandha, varna, sava, vedana, Akruti). On the basis of which kind of ulcer (varicose ulcer, diabetic ulcer, aterial ulcer, bedsores, leprotic ulcer, rodent ulcer, etc ) the symptoms may vary. In all types of ulcers on the basis of history and clinical examinations the following investigations play important role in diagnosis and prognosis of the Ulcer. TLC (Total leucocyte count), Hb% , Serum crestnine, BSL (Blood sugar level) swab culture, X-ray of affected part if chronic ulcer. if TLC are increase than normal range suggest the acute infection. if Hb% is low then the ulcer will heal delay due hyposia to the tissue. If serum creatnie is increased that might be due to kidney problem which hampered healing of ulcer. In diabetic patients BSL assessment is important for healing as glucose liden tissue are reluctant to heal. Swab culture of wound discharge is necessary to know the organism. Lastly s-xay is essential to know extension of wound upto bone/osteomylituis.
The clinical features of ulcers are ulceration /disccontineous of skin, discharge (pus/blood/ serum), bad odor, differenct size, painful/painless ulcers. The above symptoms are described by Acharya Sushruta (Gandha, varna, sava, vedana, Akruti). On the basis of which kind of ulcer (varicose ulcer, diabetic ulcer, aterial ulcer, bedsores, leprotic ulcer, rodent ulcer, etc ) the symptoms may vary. In all types of ulcers on the basis of history and clinical examinations the following investigations play important role in diagnosis and prognosis of the Ulcer. TLC (Total leucocyte count), Hb% , Serum crestnine, BSL (Blood sugar level) swab culture, X-ray of affected part if chronic ulcer. if TLC are increase than normal range suggest the acute infection. if Hb% is low then the ulcer will heal delay due hyposia to the tissue. If serum creatnie is increased that might be due to kidney problem which hampered healing of ulcer. In diabetic patients BSL assessment is important for healing as glucose liden tissue are reluctant to heal. Swab culture of wound discharge is necessary to know the organism. Lastly s-xay is essential to know extension of wound upto bone/osteomylituis.
Complications of ulcer: If ulcer is not treated properly it may lead to local and systemic infection leading to septesemia. The tissue necrosis leads to gangrene which further need to amputation.
Complications of ulcer: If ulcer is not treated properly it may lead to local and systemic infection leading to septesemia. The tissue necrosis leads to gangrene which further need to amputation.