Siddha Medicine Research Articles

Antipyretic activity of Nilavembu Kudineer – A Siddha System of Medicine

Aim: To evaluate the antipyretic activity of Nilavembu kudineer against yeast induced pyrexia in Albino rats.
 Study Design: Experimental study
 Place and Duration: Research lab, Department of Siddha Medicine, Tamil University, Thanjavur, India and KPJ Healthcare University College, Nilai, Malaysia between March 2018 and July 2019.
 Methodology: The Nilavembu kudineer powder was extracted by using acetone, methanol and aqueous solvents. The acute toxicity study was carried on swiss albino mice using acetone, methanolic and aqueous extracts of Nilavembu kudineer. From this, the LD50 value was determined and 1/10th of the LD50 value was taken as ED50 value and selected for the antipyretic studies. The Pyrexia was induced by 20% suspension of Brewers’ yeast at a dose level of 20 mg/kg on Albino rats. The test extracts (200mg/kg), Standard Paracetamol (150 mg/kg) and control saline vehicle were administered orally. The phytochemical parameters such as carbohydrates, proteins, lipid, oil, amino acid, glycosides, tannins, phenolic compounds, triterpenoids, flavones, flavanones and alkaloids were tested using standard procedures. Statistical analysis, the values were subjected to one way analysis of variance (ANOVA) followed by Dennett’s test.
 Results: LD50 value of various extracts of Nilavembu kudineer was 2000 mg/kg and 1\10th of ED50 as 200 mg/kg was selected for screening of various pharmacological activities. The treatment with methanolic extract of Nilavembu kudineer at a dose of 200mg/kg significantly (p<0.001) decreased the elevated rectal temperature after 2 hr of administration. Yeast-instigated pyrexia rodents had been controlled with Nilavembu kudineer at a dose of 200 mg/kg to decide the Tamil traditional claim about this plant for its antipyretic property.
 Conclusion: The methanolic extract of Nilavembu kudineer (200 mg/kg) possess potent fever reducing agent in various types of fever. The phytoconstituents such as Flavonoids, Alkaloids, Glycosides, Tannins and Phenolic compounds may be responsible for controlling the elevation of body temperature.

Antibacterial Activity of Ananas comosus Fruit Extract against Clinically Isolated Bacteria from Urinary Tract Infected Patients

Aim: To evaluate the antibacterial activity of Ananas comosus (A. comosus) fruit extract against clinically isolated bacteria from urinary tract infected patients.
 Study Design: Experimental study.
 Place and Duration of Study: Research Lab, Department of Siddha Medicine, Tamil University, Thanjavur, India and Microbiology lab, School of Pharmacy, KPJ Healthcare University College, Malaysia, between February 2019 and January 2020.
 Methodology: In the present study the ethanol and aqueous extracts of A. comosus were analysed for the phytoconstituents and the activity of the plant extract was compared with a standard antibiotic which is used for a wide range of Urinary Tract infection which is Ciprofloxacin (250 mg/mL) using cup plate method.
 Results: The ethanolic extract of A. comosus showed a great level of bacterial inhibition (27.3 mm) against Bacillus cereus as compared with standard (22.3 mm).Whereas the antimicrobial activity was moderate against Klebsiella organism and very less against Staphylococcus. Standard exhibits a huge difference in the zone of inhibition which is (34 mm) and ethanol extract (23 mm) against Enterococcus. While the aqueous extracts do not show any effect on the microorganism.
 Conclusion: The ethanol extract A. comosus exhibited broad-spectrum activity against tested isolates compared to aqueous extract. A. comosus has broad inhibitory activities to pathogenic microorganisms and promising to act as potential antibacterial agents from natural plant sources.

AGATHIYAR KUZHAMBU (HERBO-MINERAL SIDDHA FORMULATION)

Introduction: Agathiyar kuzhambu (A.k) is a herbo-mineral siddha formulation. It is explained in the Siddha Vaith- iya Thiraddu Book. In Siddha Medicine, there are 32 internal & external medicines are explained in the Siddha Literatures. Agathiyar kuzhambu is a one form of the internal medicine which is commonly used in purgation ther- apy. It contains 11 ingredients. Agathiyar kuzhambu has different herbo- mineral ingredients which are having wide range of therapeutic uses. It is commonly used in Siddha OPDs. Aim: The researcher is going to develop the documentary evidence for the effectiveness of Agathiyar kuzhambu. Results and Discussion: Six ingredients herbs have hot potency and Pungent efficacy. These have many pharmacological actions. Commonly, these ingredients are possessed antioxidant, anti-microbial, hepatoprotective, anti-inflammatory, anti-fungal, anthelmintic, anti-dia- betic and anti -hypertensive activity. In Siddha, these ingredients and 5 minerals and metals ingredients were used in many disease conditions. Lots of adjuvants of Agathiyar kuzhambu have hot potency and pungent efficacy. Some of adjuvants have cool potency and sweet efficacy. In Siddha, these adjuvants were used in many disease conditions. Conclusion: According to the above study, Agathiyar kuzhambu may be act as stimulant and osmotic purgative at the same time it can use as a treatment aspect of many diseases. This study gives documentary evidence of Agathiyar kuzhambu as a purgative & possess many pharmacological activities in Siddha medicine. Keywords: Agathiyar kuzhambu, Siddha Medicine, Purgative, Croton tiglium

Platelet enhancement by Carica papaya L. leaf fractions in cyclophosphamide induced thrombocytopenic rats is due to elevated expression of CD110 receptor on megakaryocytes

Ethnopharmacological relevanceCarica papaya leaf juice/decoction has been in use in folk medicine in Srilanka, Malaysia and in few parts of India for enhancing the platelet counts in dengue. In Siddha medicine, a traditional form of medicine in India, papaya leaf juice has been used for increasing the platelet counts. Papaya leaf has been reported to enhance blood volume in ancient Ayurveda books in India. Carica papaya leaf is well known for its platelet enhancement activity. Although many preclinical and clinical studies have demonstrated the ability of papaya leaf juice for platelet enhancement, but the underlying mechanisms are still unclear. Aim of the studyThe study is aimed at identifying the key ingredients of papaya leaf extract and elucidate the mechanism (s) of action of the identified potent component in mitigating thrombocytopenia (Thp). Materials and methodsC. papaya leaf juice was subjected for sequential fractionation to identify the anti-thrombocytopenic phytochemicals. In vivo, stable thrombocytopenia was induced by subcutaneous injection of 70 mg/kg cyclophosphamide (Cyp). After induction, rats were treated with 200 and 400 mg/kg body weight papaya leaf juice and with identified fractions for 14 days. Serum thrombopoietin level was estimated using ELISA. CD110/cMpl, a receptor for thrombopoietin on platelets was measured by western blotting. ResultsAdministration of cyclophosphamide for 6 days induced thrombocytopenia (210.4 ± 14.2 × 103 cells/μL) in rats. Treating thrombocytopenic rats with papaya leaf juice and butanol fraction for 14 days significantly increased the platelet count to 1073.50 ± 29.6 and 1189.80 ± 36.5 × 103 cells/μL, respectively. C.papaya extracts normalized the elevated bleeding and clotting time and decreased oxidative markers by increasing endogenous antioxidants. A marginal increase in the serum thrombopoietin (TPO) level was observed in Cyp treated group compared to normal and treatment groups. Low expression of CD110/cMpl receptor found in Cyp treated group was enhanced by C. papaya extracts (CPJ) and CPJ-BT. Furthermore, examination of the morphology of bone marrow megakaryocytes, histopathology of liver and kidneys revealed the ability of CPJ and fractions in mitigating Cyp-induced thrombocytopenia in rats. ConclusionC. papaya leaf juice enhances the platelet count in chemotherapy-induced thrombocytopenia by increasing the expression of CD110 receptor on the megakaryocytes. Hence, activating CD110 receptor might be a viable strategy to increase the platelet production in individuals suffering from thrombocytopenia.

Antioxidative potential of Kabasura Kudineer (KSK), an official Siddha polyherbal formulation.

Siddha’s folk medicine system is used to enhance immune responses as preventive medicine Siddha medicine’s enormousplethora of data will enhance human wellbeing Since the oldyears, Kabasura Kudineer(KSK) has beenanimmunedrugtoseveralillnesses Aqueous extract was employed for preparing the extract and analyzed for Total Antioxidant Capacity, Fe2+ chelating activity assay, Hydrogen peroxide scavenging activity, ABTS Scavenging assay and Reducing power assay Thiswas found to possess high antioxidant properties of aqueous extract of KSK and their derivatives have been confirmed with the different tests This experimentation further affirms the antioxidative nature of KSK extract, which further aid in the fight in this COVID-19 pandemic situation

A contemporary review on phytochemistry and pharmacology of Andrographis paniculata

Andrographis paniculata is a well-known medicinal plant that belongs to the Acanthaceae family and is also commonly known as "Kalmegh or king of bitters". It is a bitter herb used in Siddha, Ayurveda, and homoeopathy medicines, as well as tribal medicines in india and other countries. This article describes the synonyms, biological sources, phytoconstituents and various pharmacological activities of Andrographis paniculate includes Anti-inflammatory activity, hepatoprotective, antidiabetic, anticancer, antibacterial, antimalarial, antivenom, analgesic, antifertility, antioxidant, antidiarrhoel, neuroprotective, cardioprotective, antiviral and Nephroprotective activities.

A Review on Efficacy of Siddha Medicinal Herbs as Antiviral Drugs against COVID-19

In a very short time, the Coronavirus disease (COVID-19) caused by the SARS-CoV-2 virus, has become a global pandemic. It has infected about 29,155,581 patients and brought forth death rate about 926,544 among 216 countries as recorded by World Health Organization on 15th September 2020. At present, there is no specific and direct treatment or vaccine for this infectious disease. No therapeutic options available to cure the infection in till date which increases the mortality rate across the countries. Currently there is no antiviral treatments have been approved, several approaches have been proposed in western medicine, Chinese medicine, CAM, AYUSH and other systems. Siddha Herbal medicines are achieving high attention because of the extensive therapeutics like potent anti-microbial, immunomodulatory, anti-inflammatory, and antioxidant properties. Ministry of AYUSH, Govt. of India recommended 12 Siddha herbals (Inji – Zingiber officinale, Thulasi – Ocimum sanctum, Milaku – Piper nigrum, Karunjeeragam – Nigella sativa, Keezhanelli – Phyllanthus niruri, Adhimathuram – Glycyrrhiza glabra, Vellaippoondu – Allium sativum, Citramutti – Sida cardifolia, Seenthil – Tinospora cordifolia, Manjal – Curcuma longa, Elumitchai – Citrus lemon and Vembu – Azadirachta indica) for the prevention by enhancing immunity as well as for the management of this infectious disease in its recent official publication ‘Guidelines for Siddha Practitioners for COVID 19’. This is the common advisory and the anti-viral activity of these herbals against COVID 19 is not established yet. The current situation demands proper herbal drug utilization to prepare the population immunity to fight against the infection. The present review spotlight on the literature review and the review of pharmacological actions of these herbals.

HYBRID CLASSIFIER TO CLASSIFY THE FINGER NAIL ABNORMALITIES

Nail diagnosis is a method to predict the possibilities of organ failures and various systemic diseases. Nail abnormalities are considered as the signs of certain diseases in traditional medicines such as Siddha Medicine, Ayurveda, Yunani and Chinese medicine etc. In this paper, the performance of existing techniques such as SVM classifier and KNN classifiers are compared with the proposed method. The metrics precision, recall, F-measure and accuracy are calculated and compared. The 100 images had taken for study and the proposed novel segmentation method gives the best accuracy. The experiment uses 480 (increase the dataset) images of eight types of abnormalities. 70% of images were used for training and 30% of images were used for testing. (Discuss the performance measure)

<p><strong>Inhibition of cystathionine-γ-lyase-mediated hydrogen sulfide production in LPS-stimulated RAW 264.7 macrophages by polyherbal extract</strong></p>

The polyherbal formulation chandraprabha vati (CV) comprising 29 herbs is traditionally used as an anti-inflammatory agent for arthritis and urinary ailments in Indian Siddha medicine. Earlier, we reported that lipopolysaccharide (LPS) induced apoptosis in RAW 264.7 macrophages is mediated by hydrogen sulfide (H 2 S), a potential target for many inflammatory diseases. Here, we hypothesized that pretreatment with CV decreases H 2 S level and thereby alleviate the inflammatory conditions induced by LPS in RAW 264.7 macrophages, and this protective effect occurs through alterations in cystathionine-γ-lyase (CSE), a H 2 S synthesizing enzyme. Accordingly, we evaluated the anti-inflammatory effect of CV in LPS-stimulated RAW 264.7 macrophages in vitro . The CV pretreatment followed by 12 h of LPS-stimulation showed significantly decreased TNF-α, H 2 S production possibly through CSE gene expression and NF-кB activation compared to the non pretreated macrophages. Our results further confirm that the polyherbal extract chandraprabha vati may be a useful therapy for inflammatory disorders by reducing H 2 S levels.

Energy Efficiency Enhancement and Climate Change Mitigations of SMEs through Grid-Interactive Solar Photovoltaic System

According to the International Energy Agency’s estimation, Indian primary energy demand is expected to increase by about 1250 Mtoe and 1500 Mtoe by 2030. The 3 M management concept now changed into a 4 M management concept that includes energy management. In the case of energy management, the electrical energy sector assumes critical importance. An energy cost occupies nearly 30-40% of the production cost in small and medium-size enterprises (SMEs). Bureau of Energy Efficiency (BEE) has initiated a separate energy efficiency intervention to the SME’s, where the energy-efficient technologies, operational procedures, and proper awareness programs to SMEs are stated. This paper discusses the complete electrical energy audit on a small-scale Siddha and Ayurveda medicine industry. The traditional medicine manufacturing technologies make the process complex (process loads are intermittent/interlinked) during analysis. Hence, the detailed energy auditing/conservation studies on the power factor/harmonics were carried out without affecting Indian traditional medicine manufacturing technology. The postauditing design and installation of an intelligent controller by considering the intermittent/interlinked loads are carried out, and the effectiveness of the intelligent controller is ascertained with the energy conservation and the carbon emission reduction of SME. In addition, the climate change mitigation is ensured through the design and deployment of grid-interactive rooftop solar photovoltaic power plant using Solar Pro v4.5 (Photovoltaic System simulation software) with the power analysis, economic analysis and life cycle carbon emission of the proposed plant. The proposed solar photovoltaic power plant ensures energy self-sufficiency and sustainable energy utilization by carbon emission reduction on electricity utilization of SMEs.

Pharmacological Potential of the Stinging Plant Tragia Species: A Review

Tragia is well known in the botanical world a stinging plants. Apart from this, the genus also occupies an important constituent of alternative systems of medicine as well as ethnobotany. Among the various species of Tragia, the most studied and experimented species is T. involucrata. This genus is used for several ethnobotanical uses such as cancer, diarrhea, constipation, scorpion bite, rheumatism, whooping cough and diabetes. Apart from this the genus is also an important constituent of ayurvedic and siddha medicines. Owing to these properties several researches has been conducted to validate the traditional uses, finding out new uses and understanding the phytochemical profile. Alkaloids, phenols, terpenoids and tannin are present in the genus Tragia. Calcium oxalate and shellsol is responsible for the stinging property. Various species of Tragia has been validated for its important properties such as antibacterial, antifungal, cytotoxic, wound healing and anti-inflammatory activities. All these properties has been related to the occurrence of secondary metabolites. However the exact lead metabolite for the pharmacological properties has to be identified. Based the experimentally proved pharmacological properties, Tragia possesses significant potential on a medicinal species.

SIDDHA MEDICAL MANAGEMENT ON COVID-19 POSITIVE CASE STUDY IN GSMCandH, TIRUNELVELI, TAMIL NADU,INDIA

The most recently discovered coronavirus causes coronavirus disease COVID-19. The common symptoms of COVID-19 are fever, dry cough, and tiredness. Siddha medicines which mainly focusses on enhancing the host immunity could play a major role in viral diseases. As per Siddha classical wisdom, improving immunity with immune boosters is one of the key approaches for prevention of disease and maintenance of health. The treatment protocol was fixed such as all the patients admitted in the ward were given kabasura kudineer as base medicine. In addition, other siddha medicines were given based on the associated symptoms. If fever was present Linga chendooram with thirikaduku chooranam, Brahmanantha Birava mathirai twice a day was given additionally. If cough was present Thalisadi vadagam, Adathodai manapagu was given additionally until the symptoms subsides. If anosmia was present Herbal Smolder, vasantha kusumahara mathirai, thalisadi vadagam and adathoda manapagu twice a day, if loose motion was present sundai vatral was given additionally. The treatment protocol and diet pattern was planned such that it balances the three humours, combats the diseases, improves general immunity with specific actions on the respiratory tract and provides adequate nutrition. Apart from this the entire In Patient (IP) block was disinfected using herbal fumigation. Further, a novel herbal air cleanser pouch was also provided to all patients which is to be kept inside the mask which would precisely filter the inhaling air & ward off the airborne microorganisms. The results and observations are encouraging. The combined therapy and procedure seemed to be very effective in the management of COVID-19 disease

A Prospective Observational Study of the Outcome of Treatment with Kabasura Kudineer among Patients with SARS-nCOV-2 Infection

Introduction: The novel Coronavirus disease 2019 (COVID-19), caused by Severe Acute Respiratory Syndrome Corona Virus-2 (SARS-CoV-2), has been considered a major life-threatening danger to the human population worldwide. The traditional Indian medicines also play an important role as possible novel therapeutic approaches, exclusively targeting SARS-CoV-2 and its pathways. Among the Siddha medicines, Kabasura kudineer is a formulation composed of 15 ingredients used against fever caused by respiratory infections. Aim: To determine the outcome of Kabasura kudineer, among SARS CoV-2 patients admitted in a tertiary care hospital of Tamil Nadu with mild to moderate symptoms or asymptomatic patients. Methods: A prospective observational study was carried out in Covid care Hospital, Tirunelveli Medical College Hospital, Tirunelveli after the approval of Institutional Ethics Committee. Written informed consent forms were obtained from the patients. A total of 100 patients with positive Real Time Polymerase Chain Reaction (RT-PCR) for SARS-nCov-2 with asymptomatic and mild to moderate symptoms were included in this study. Among them, 50 patients were included in the control group and the other 50 patients were provided with 60 mL Kabasura kudineer for 5 days. Again on the sixth day, RT-PCR was repeated. Results: Among 50 participants in each group, by the sixth day, RT-PCR converted into negative for 27 patients in group B, by 10th day 25 in group A and 22 in group B, by 14th day 25 in group A and remaining 1 in group B became negative. Conclusion: The present study showed Kabasura kudineer was effective when compared with the control group against SARS-nCoV-2 patients with no symptoms and mild symptoms and also the conversion of RT-PCR.

Kabasura kudineer, a siddha medicine against COVID-19 infection: scope and future perspective

Kabasura kudineer, a siddha medicine against COVID-19 infection: scope and future perspective

A narrative review of Siddha polyherbal formulation

Introduction: Early detection of kidney disease care and management helps prevent morbidity and mortality and improves cost-effectiveness and sustainability. Kidney-related diseases continue to increase every year and pave way to the fifth leading cause of death by 2040. Urolithiasis is a challenging problem nowadays, and many standard pharmaceutical drugs are available but they have a serious adverse effect that compromises for a long-term use. Materials and Methods: The available information was collected from various Siddha books and scientific databases such as PubMed, Science Direct, Scopus, Web of Science, and Google Scholar. Results: The traditional system of medicine particularly Siddha medicine is in great demand in South India, especially Tamil Nadu because of their less side effects, excellent bioactive components, most affordable, and easily accessible source when compared with surgical procedures. A huge number of mankind is impressed by the herbal-based drugs in order to overcome the synthetic drugs adverse effects. Conclusion: This review reveals essential data focussing on the traditional use, phytochemistry, and pharmacological profile of Siddha polyherbal formulation of Amurthathi chooranam, thereby identifying research gaps and future opportunities for investigation on this drug.

A retrospective time-to-event analysis on COVID-19 patients using integrated medicine (Allopathy and Siddha medicine)

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a single-stranded RNA virus that causes SARS. The virus was originally called SARS-CoV-2 named officially by the World Health Organization as COVID-19 and a global health emergency. Aim: The aim of this article is to assess various clinical findings, comorbidities, and outcomes including periods of hospital stay of asymptomatic/symptomatic COVID-19 patients admitted at the Government Medical College, Omandurar, Chennai District of Tamil Nadu state and those who were under Integrated Medical care of hydroxychloroquine and Kabasura Kudineer. Materials and Methods: This study is a retrospective cross-sectional study on 162 asymptomatic/symptomatic laboratory-confirmed SARS-CoV-2-infected patients from both sexes and all age groups, admitted to the Government Medical College, Omandurar, Chennai District of Tamil Nadu state, India from March 30, 2020 to April 30, 2020. Results: SARS-CoV-2 confirmed 162 patients: 114 (70.4%) males and 48 (29.6%) females participated in the study. About 37.7% of the participants belonged to the age group of 26–40 years, 32.7% belonged to the age group 41–60 years, 16% belonged to the age group 13–25 years, 9.9% belonged to the age group greater than 60 years, and 3.7% belonged to the age group of 0–12 years. Around 16.7% have comorbidities, whereas the remaining 83.3% were free from comorbid conditions. All participants were given Kabasura Kudineer, but the treatment of allopathy medicine intake varies from person to person depending on their health status and disease severity. Abdominal computed tomography scan or chest X-rays of 24 (14.8%) patients were done during the study period. Two patients died and two were referred to another hospital, remaining 97.5% completely recovered from the viral infection. Admission days varied from 1 to 23 days. The overall median length of stay was 16 days based on this study. Conclusion: This study reveals that 97.5% of the patients were completely recovered from the viral infection and both average and median hospital stay is 16 days.

Therapeutic potential of Withania somnifera (Linn) Dunal (Ashwagandha) in historical perspective and pharmacological evidence

Withania somnifera widely known as Aswagandha, highly acclaimed medicine in ancient medical systems such as Ayurveda, Unani, Siddha and Chinese traditional medicine. The pharmacological importance of Withania somnifera is described in the different classical Ayuvedic narrative such as Charaka Samhita, Sushruta Samhita, Astangahridaya, Chakaradatta and various Nighantus. The plant used for the treatment of various ailments and works as nonspecific basis for better health and finer longevity. Nowadays it is scientifically proved that the plant possesses antioxidant activity, protect from anxiety and depression, nootropic effect, cardiovascular protection, anti-bacterial activity, anti-inflammatory properties, aphrodisiac,a nti-venom, anti-fungal, anti-viral, sedative effects, hypoglycemic, thyro-protective, anti-diabetic and different cancer.This study aims to review and relist the various therapeutic applications of this plant and its importance in Ayurveda as per ancient classical texts.

Ethano medicinal plants used as nephroprotective in different traditional medicine: A review

Indian traditional system of medicines like Ayurveda, Siddha, Unani and folk medicines are widely accepted globally due to their effectiveness with fewer side effects in comparison to other modern systems of medicine. Herbal plants are widely used in India by rural and urban peoples for treatment of different diseases. These herbal plants may serve as renoprotective in different clinical condition like drug-induced nephrotoxicity, chronic kidney disease, end stage renal disease, etc. This paper gives information related to dose dependent nephroprotection of selected medicinal plants in drug induced nephrotoxicity animal model. These plants are showing nephroprotection due to their chemical constituents, which are present in different parts of the plant. The chemical constituent of these plants may serve as novel compounds for development of new cost-effective medicine with fewer side effects for all aged renal patients.

Home Care Preventive Measures And Practices Using Traditional Siddha Medicine Towards COVID-19 Among Residents Of Containment Zones, Chennai, Tamil Nadu, India, 2020: Cross-Sectional Study

Many campaigns rolled out to enhance the awareness of people on COVID-19 prevention, control, and promotive measures. Siddha polyherbal formulations, namely Kabasura kudineer (KSK) and Nilavembu kudineer (NVK) were recommended by the Ministry of AYUSH, Govt of India as an advisory for AYUSH interventions for COVID-19. This study was conducted to estimate traditional siddha medicine practices and preventive measures against COVID 19 among the population accessing research clinic facility and the residents of containment zones of Chennai, the capital of Tamil Nadu State, India. We interviewed 569 participants, and most of the participants aware of adopting general preventive measures of COVID-19, 85% practiced hand wash and 95% wore mask. Siddha-specific measures such as drinking of KSK is reported in 77% (n=444, 77%) and NVK in 60% (n=360) in the containment zone areas for prevention and control of COVID-19. The population behavior documents belief in traditional medical system and to consider integrated medical approach for effective communication during public health emergencies.

Comorbidity profile of Siddha Varmam therapy patients and insight into integrative pain management: A cross sectional study

Introduction: Traditional medical system is one of the centuries old practices and serving mankind to fight against disease. Siddha System of medicine is one among the Indian system of medicine popular in India and other Tamil speaking countries. Varmam therapy, which is unique to Siddha System, which involves manipulation of life energy points in the body. Methods: Objective: To explore the comorbidity of the patients with musculoskeletal disease conditions and insight into integrative pain management. Design: Cross sectional study. Setting: Siddha Varmam Thokkanam and Traditional Bone setting (VTTB) division out-patient department, at Siddha Central Research Institute, Chennai, during the July to December 2019. Results: There were 1592 adult patients, of which 830 were male and 762 were females and majority of them were in the age group 51-60 years (32.53%) and 25.75% in the age group 61-70years and 22.8% in 41-50 years age group. 55.4% of patients visiting the facility were within 10km distance from their residence while 3.84% were travelling more than 100km to reach the facility. 60.18% of the patient had diabetes, 50.31% had hypertension, 9.8% hypothyroidism, 4.45% cardiovascular disease, 22.5% had combined diabetes and hypertension, for which, 10.65% was taking only siddha medicine for their diabetic control and 15.97% were on integrative treatment, allopathy and Siddha medicine for their diabetic control. Conclusion: The present study insists to consider the comorbid conditions of patients visiting Siddha health facilities across the state and projecting integrative Siddha Varmam therapy for pain considering comorbidities irrespective of pharmacological interventions.