Purpose Covid 19 pandemic has placed challenges in front of medical health sciences in terms of management, prevention and immunity building. Effectiveness of any medication has not conclusively proven; hence there is need for integrative management of covid 19. We have managed a critical case of covid-19 having history of thalassemia, hypothyroidism with integrative management of Ayurveda and modern medicine. Method A 59 years’ male patient with history of thalassemia had complaints of cough and breathlessness since 4 days. He performed RT PCR because he came in close contact with his daughters who were Covid positive. He was treated with Favipiravir at home for 5 days. He deteriorated on 6 th day with SPO 2 dropped to 75%, temp raised to 101 F and respiratory rate (RR) raised to 45/min. He was admitted in Yogeshwari Hospital Daund, Maharashtra; treated with oxygen inhalation, Remdesvir and Ayurveda medicines in intensive care unit (ICU). Ayurveda treatment protocol was advised through telemedicine. Result Significant improvement in clinical symptoms was observed and normal HRCT was observed after complete treatment. Conclusion This case report gives us further directions for integrative management in cases of Covid 19. Further clinical researches in this direction are warranted.

Sleep is responsible for proper metabolic balance. Disturbances in sleep causes insulin resistance, beta cell dysfunction and obesity through various pathways. Snoring is one of the important indicative symptoms of sleep apnoea that leads to disturbances in sleep. A 54-years old male patient was presented to Kayachikitsa casualty Government Ayurveda College Nagpur with complaints of snoring, difficulty in breathing while climbing stairs since 10 years. After evaluation he was diagnosed as obese with type 2 Diabetes mellitus (DM). Sleep study revealed presence of sleep apnoea. We treated this patient following the principle of Vyadhi Hetu Sankar (∼one cause for many diseases). In such a case treatment of Hetu (∼cause of disease) can be principle of treatment. Snoring was subsided in patient after one -month of treatment. Significant reduction in HbA1c, fasting and post prandial blood glucose level were observed along with reduction in Lipid levels and BMI in three months. Ayurveda concepts can bring major breakthrough in treatment of metabolic disorders. Various Ayurvedic concepts of gut, lung endocrinal pathways and Agni (∼metabolic power) can generate future studies in this direction.

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Herpes zoster commonly known as shingle's caused by varicella zoster virus (VZV). Recent studies have shown that exosomes play important role in pathogenesis as well as spread of herpes. Leeches when applied over affected part of herpes sucks the blood and there by interferes with extracellular communication through these exosomes and their by showing pain reduction, reduction in burning and arrest progression of disease. This technique is cost effective and easy to apply. In Ayurveda herpes can be correlated with Pittaj visarpa . Principle of treatment is Raktmokshan (~Bloodletting) and Pradeha (~Local application of medicines). Bloodletting with Jalauka (~Medicinal Leeches) is specifically indicated in management of Pitta dominant disorder. A 65-year-old female known case of Type 2 Diabetes (DM) and presented in Casualty of Government Ayurved College, Nagpur (GACN). We treated her Herpes zoster on the basic principles of management of Pittaj Visarpa . Management of Type 2 DM was continued as per modern medicine consultant. Rapid decrease in pain severity was observed after the 1st setting of leech therapy according to Zoster Specific Brief Pain Inventory (ZBPI) Questionnaire. After each seating pain reduction was observed. Repeated application of Jalauka along with internal medications gave complete relief. Ayurveda pain management in herpes zoster by leech therapy gives innovative easy, better and cost effective treatment. Adaptive trials are necessary to explore further practical applicability of Ayurveda and modern treatment together. Future research on effect of leech application on exosomes is necessary.

Type 2 Diabetes mellitus in obese persons is becoming threatening disease due to increasing prevalence of its microvascular and macro vascular complications. A multi targeted treatment can be considered better over single targeted treatment; in view of multiple pathways involved in pathogenesis of diabetes and its complications. This open labelled randomized controlled clinical Study was aimed to evaluate clinical efficacy of ‘Vidangadi Lauha’(An Ayurveda formulation) in comparison with metformin for obese type II diabetes mellitus. Participants were divided into two groups. Trial group received Vidangadi Lauha 5gm BID and control group received tablet metformin 500mg BID for duration of 3 months. Among 550 screened participants 120 participants were eligible, out of them 100 participants were enrolled and randomized by computer generated method, out of them 80 patients (40 in each group) completed the trial. Both the treatments were equally effective in reducing blood sugar fasting(F), post meal(PM) glycated Haemoglobin (HbA1C) and Body Mass Index (BMI). Vidangadi Lauha is more effective in reducing Ayurvedic Symptoms, waist hip ratio and cholesterol as compared to Metformin. High Density Lipoproteins (HDL) were improved by minor clinical difference in both the groups. Both the treatment does not have statistically significant effect in reducing Low Density Lipoproteins (LDL).