Background: Amlapitta (functional dyspepsia, FD) is experienced as a heterogeneous group of upper abdominal symptoms characterized by upper abdominal colic or discomfort which may also comprise heartburn, bloating, regurgitation, early satiety, anorexia, postprandial fullness, belching, and nausea. Traditional Ayurveda medicines are frequently practiced for FD since long; however, available scientific proof relating to their competence and mechanism of actions are insubstantial. In this article, we report a protocol of a prospective, single-arm, open-label, multicenter clinical study by means of classical Ayurveda formulation to examine the effectiveness, mechanism, and safety of the patients diagnosed with Amlapitta (FD). Materials and methods: Present protocol is a single-arm, open-label multicenter clinical study to find the safety and efficacy of classical Ayurveda formulations Narikela Lavana and Amalakyadi Churna in the management of Amlapitta. A total of 110 patients with Amlapitta will be selected based on the inclusion and exclusion criteria. All the patients will be treated orally; with traditional Ayurveda medicine, i.e., powder Narikela Lavana 2 g, twice daily, before food; and Amalakyadi Churna 3 g, twice daily, after food. The entire participant will undergo 12-week treatment and 2-week follow-up. A total of seven visits will be scheduled for each of the participants, i.e., each one in week 0, 2, 4, 6, 8, 10, and 12. The primary outcomes include changes in FD symptoms in dyspepsia questionnaire; changes in symptoms of Amlapitta disease in Amlapitta symptom rating scale (ASRS) along with satisfactory therapeutic response. The secondary outcomes include disease relapse rate after successful treatment; assessment of quality of life in the participants of FD by the World Health Organization Quality of Life (WHO-QOL) scale; and psychological assessment by Beck's depression inventory scoring scale. Therapeutic mechanism outcomes, safety outcomes, and end-point outcomes will also be assessed. Discussion: Present protocol has been designed with expected better clinical outcome and safety profile in dyspepsia patients in addition to reduce relapse rate of disease during posttreatment period. If found effective, the selected drug will be listed in terms of better efficacy, safety, and cost-effective treatment of Amlapitta. The selected drug may lead to a step ahead of better understanding and management of other gastrointestinal disorders.

Introduction: Ayurvedic interventions have been in practice for treatment of thyroid-related disorders alone or in combination with complementary medicine. No systematic review has been conducted for assessing the efficacy and safety of Ayurvedic intervention in hypothyroidism. Present study aimed to provide quality evidence to assess for the efficacy and safety of Ayurveda interventions for hypothyroidism in the 18-60 years' age-group. Materials and methods: For collection of data, all research article based on randomized controlled trials, multiple-arm clinical trials, nonrandomized clinical trial, quasi-randomized controlled trials having intervention period of at least 12 weeks' duration will be considered and searched from inception to September 2019 in several databases. Primary outcome will include response to treatment (improvement in subjective criteria of assessment, i.e., hypothyroidism-related symptoms), effect on values of laboratory measures related to thyroid gland functioning like tri-iodothyronine (T3), tetra-iodothyronine (T4), and thyroid-stimulating hormone (TSH) and serious adverse events. Secondary outcome will include measurement of health-related quality of life. Data extraction will be done independently by three reviewers in a predefined format. A narrative synthesis will be conducted for all included study. If extracted data will be eligible for meta-analysis, a meta-analysis will be conducted. Ethics and dissemination: This review does not require formal ethical assessment and approval, as no confidential participant data will be included. Findings will be disseminated widely through publication, conference, and symposia.

Coronavirus disease-2019 (COVID-19) caused by SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) has caused global health crisis. Initially considered a respiratory tract pathogen, it can cause multiple organ dysfunction. It has also been described to predispose to venous and arterial thromboembolism; however, limited published data is available regarding mesenteric thrombosis COVID-19. We report 6 cases of COVID-19 positive patients with mesenteric/intestinal ischemia. These patients were examined with variables including demographics, laboratory blood tests including coagulation panels, medical and surgical history, comorbidities, and postoperative follow-up period.

Mucormycosis is an infrequent infectious disease engendered by Mucorales fungi that primarily affects COVID-19-positive patients in India. Corticosteroids are frequently used to treat COVID-19. Corticosteroids vanquish the body’s immune response and raise blood sugar levels in diabetic COVID-positive patients and are often found with the Rhino-orbital cerebral Mucormycosis. Neutropenia, solid organ, and stem cell grafting, excessive intake of iron, and deferoxamine therapy are associated risk factors. The saprophytic fungus initially attacks the sinuses before spreading to the oral cavity, lungs, and eye orbit, causing an acute phase of inadequate blood supply to the tissue which finally led to Necrosis. If left untreated, it can result in temporary or permanent loss of vision, fever, headache, reddened and swollen skin near the nose or eyes, facial pain, and eventually death. Laboratory parameters, tissue biopsy, CT scan, and reverse transcriptase-polymerase chain reaction are few investigations. Amphotericin B and Micafungin are the commonest advisable anti-fungal medication. Surgical debridement or removal of contaminated tissue, particularly in infections of the rhino-orbito-cerebral, cutaneous, and gastrointestinal Mucormycosis, is required.