COPD and GERD more commonly diagnosed and frequently reported health issues due to overlapping pathophysiological mechanisms and now considered as ‘two sides of same coin’. COPD related anatomical changes and medications will alter the course of existing GERD and increase the risk of new onset GERD. Proximal and distal anatomical locations of GERD have variable presentations such as worsening of COPD, acute non-infective exacerbations, recurrent cough, and respiratory failure. Proximal pathways involve direct lung injury by means of microaspiration of gastric contents and microbiological colonization. Distal pathway involves indirect mechanisms by sharing common anatomical and embryological developments with involvement of vagus nerve mediated noradrenergic cholinergic mediator’s related effects on bronchi and bronchioles. Both proximal and distal pathways have effects on lung functions. GERD has negative impact on natural course of COPD and exists in asymptomatic and symptomatic types. Prevalence of GERD should be actively sought in all COPD cases to prevent exacerbations, decrease lung functions decline, lower the risk of clinical and physiological worsening, and overall cost of care because of these high index issues. PPI therapy has significant effects on patients with COPD in reducing the number of acute attacks, adverse reactions, and mortality. Recurrent exacerbations need GERD to be ruled out in all cases of COPD to have successful treatment outcome. Only symptomatic cases treatment has shown positive outcome in GERD with COPD. Hence, ‘to be or not to be is the real question’ and no treatment is recommended for asymptomatic GERD cases with COPD irrespective of disease severity.

COVID-19 is first corona virus related global pandemic after SARS and MERS and due to rapid evolution of pandemic fast track developments in diagnostics, monitoring and treatment options and vaccine developments has occurred to prevent its significant impact on mortality and morbidity. COVID-19 infection involves a complex interplay of the immunological and inflammatory responses. Inflammatory parameters are closely linked to the COVID-19 severity and mortality. Inflammatory parameters could be used to predict the transition from mild to severe/critical infection in patients of COVID-19. Numerous Inflammatory markers were analysed and used as point of care test to predict severity of illness, monitoring of illness, treatment planning and predicting final outcomes such as CRP, LDH, IL-6, D-dimer and ferritin. Robust data of these inflammatory markers is available and proved crucial in predicting pathophysiological trends such as cytokine storm, coagulation abnormalities, oxygenation status and response to therapy. Isolated assessment of inflammatory markers in absence of clinical and radiological parameters were observed as ‘double edged weapon’ due to overestimation and its impact on health burden and underprediction resulting into progression of illness and resultant poor outcome and increased health care cost. Composite index is combination clinical, radiological and laboratory inflammatory marker assessment. Combination of any two abnormalities were observed crucial role in early suspicion, diagnosis, monitoring, and recognition of complications, management and disposition of patients. Composite index rather than single biomarkers may provide more reliable information. Availability and cost issues cannot be ignored. It would be impossible for clinicians to consolidate and critically analyse the enormous data that is continuously added to the COVID-19 literature to extract practically useful information for the benefit of patients. Still, as of now Composite index should be considered as ‘point of care test’ to honour successful treatment outcome and prevent mortality and morbidity due to this ‘Dragon Pandemic’.

The current piece deals with the issue of non cancerous obstructive uropathy. It hampers the quality of life in males above 45 years of age. An enlarged prostate gland or Benign Prostatic Hyperplasia (BPH) is a leading cause of obstructive uropathy in men. In India, prevalence of BPH is around 50% of men by the age of 60 years. The reader will get an idea of the problem of prostatic issues at global & national level through the eyes of clinical health in the beginning sections before delving in to the Homoeopathic system of the AYUSH platform. Currently, the AYUSH platform has regained its value in the era of the current pandemic. The pandemic has further escalated the prostatic issues further. In the absence of effective therapy in the modern medicine, the article peeps through what homoeopathy can offer to deal with prostatic issues that fulfil the triad criteria of essential medicines as per the National List of Essential Medicines (NLEM). The criteria is that these medicines need to be effective clinically, safe clinically and should be without side effects.