Avascular necrosis of hip joint has emerged as one of the most disabling conditions of present era of Orthopedics. It poses a challenge in front of the medical fraternity due to non-availability of accurate management for this condition. Surgery offers hip joint replacement that is not so commonly available and expensive too. Ayurveda can provide a suitable answer through appropriate Panchakarma modalities useful in Asthi dhatu kshaya. A diagnosed case of Avascular necrosis with complaints of pain at bilateral hip joint and restricted movements approached the out-patient division of the hospital and was managed by Udwartana, Virechana and Tikta ksheera vasti by following classical principles of Ayurveda. Significant improvement was noticed after the treatment. Pain was reduced significantly and the patient was able to walk and climb stairs at the end of the treatment. Results obtained were encouraging and restricted disease progression was observed.

Infected wounds are manifested as a complication of trauma or due to various pathological conditions and are difficult to manage because of their non-healing nature. In Ayurveda, infected wounds can be compared with Dusta vrana. Besides other modalities of treatment; leech application has been emphasized in the management of such manifestations. A male patient of 45 years age having Vata kaphaja prakriti visited OPD of Shalya tantra with complaints of severe pain, swelling with ulceration over the dorsum of right foot and intermittent fever with history of unknown insect bite for the past two weeks. Local examination revealed an ulcer covered with necrotic tissue with progressive inflammatory changes. Based upon the history and clinical findings; the case was diagnosed as Dusta vrana due to Kita dansha. Leech application was done by following classical guidelines of Ayurveda. Simultaneously, cleaning of wound with Panchavalkala Kwatha and dressing with powder of Katupila (Securinega leucopyrus) mixed with Tila Taila (sesame oil) was done daily. Changes in size, shape, floor, and margin of the ulcer were recorded at regular interval. Pain, discharge were completely subsided after three consecutive sittings of leech application. The ulcer was completely healed within two months with minimal scar formation. Leech application along with local application of Katupila has significant role in controlling inflammation and promoting healing of infected wounds without any adverse effect.

Hashimoto’s Thyroiditis (HT) is the most common auto-immune thyroid disease and the commonest cause of hypothyroidism. In conventional medicine, treatment of choice for HT is replacement of thyroid hormone. A case of HT was managed at the OPD level by following Ayurveda principles and found to be effective. A treatment protocol was designed based on the signs and symptoms and assigned in this patient. Snehapana followed by Vamana and Virechana and at the end Shamana was done with Varunadi kwatha bhavita shilajatu for a period of three months with two months follow up. The treatment protocol was found to be effective in symptomatic and biochemical profiles of the patient. Patients of HT should be able to have a choice against the lifelong hormone therapy. This can be achieved by adequate evaluation of the individual action of the therapies adapted here and replicating the same in a much larger group.

Ayurveda serves best in many disease conditions where conventional system face several limitations. Ankylosing spondylitis is one such condition, whose effective management is becoming a challenge. It is a systemic auto-immune rheumatic disease, which shows a strong association with genetic factor HLA-B27. Early stages of disease show inflammation of spine and other symmetrical small joints and other soft tissues, whereas chronic stage presents with axial deformity and pain. NSAIDs and steroids are generally prescribed in conventional systems, but are not a complete remedy. The signs and symptoms of this disorder are not mentioned in Ayurveda, but, based upon the clinical picture, treatment can be planned. A male 24 years patient diagnosed with axial and peripheral Ankylosing spondylitis having HLA-B27 positive case was managed with Panchakarma procedures followed by suitable Ayurvedic medicines. After completion of the treatment, pain in the sacro-illiac region, morning stiffness of joints were significantly reduced with reduced ESR and CRP. As the signs and symptoms of this disease are not mentioned in Ayurveda classics; specific treatment protocol and formulations cannot be given. Selection of drugs may differ from case to case. The treatment plan followed in this study may be adopted in future cases changing the selection of drugs based upon the necessity to obtain good results.

Diabetes is having a steep rise in prevalence and is on the way to take shape of a global epidemic, mostly associated with improper diet and lifestyle. Musculoskeletal problems are common in diabetics but are not so well- known as compared to other complications of the disease. Frozen Shoulder, one such musculoskeletal problem, is estimated to affect diabetic patients five times more as compared to non-diabetics, resulting in pain and limited range of movement and is compared to Apabahuka in Ayurveda. Conventional treatment modalities like analgesics, NSAIDs, steroids and surgery etc have certain limitations. Hence, alternatives are being searched from other systems of medicines. A 64 years old female patient, presented with pain and restricted movements of left shoulder joint; was treated with Udvartana followed by local Swedana with Jambeera pinda and Panchatikta panchaprasritika vasti for five five days. After completion of therapy, pain was subsided and satisfactory improvement was found in the shoulder joint movements. Panchakarma in the form of Basti regimen and external therapies is surely a result oriented therapy in the management of Diabetes and such complications like Frozen shoulder. Panchakarma in the form of external therapies and Vasti regimen is a result oriented therapy in the management of Frozen Shoulder and also effective in Diabetes.

Changed life style of current scenario has provoked several disharmonies in the biological system. Hypothyroidism is one such manifestation, which is believed to be a common health issue in India. The pathogenesis of Hypothyroidism according to Ayurveda is basically due to the abnormal functioning of Agni, which in turn affects Dhatwagni, eventually brings out pathological sequence and ultimately the disease condition develops. This condition can be managed by Ayurveda principles. A diagnosed case of Hypothyroidism presenting with puffiness of face and eyelids, weakness, lethargy, fatigue, prolonged intermenstrual period, dry and coarse skin, was managed with Triphaladya guggulu (1000 mg twice a day) and Punarnavadi kashaya (50 ml twice a day) for a period of 45 days. Thyroxine (100 mcg) that was being used by the patient since one year was withdrawn one week before starting the treatment. Serum TSH levels were reduced from 93.250 μIU/ml to 53.701 μIU/ml by the end of treatment. Triphaladya guggulu and Punarnavadi kashaya are beneficial countering signs and symptoms and bringing down the TSH levels. As the observations were drawn from a single case; can be revalidated through well designed clinical trials.