Asian Institute of Medical Sciences is a tertiary care hospital and institute located in Faridabad, India. It was established in 2010 and is accredited by NABH and NABL.The hospital was founded by Padmashri awardee Dr. Narendra Kumar Pandey. He is also the recipient of the Dr. B. C. Roy Award, the highest award in medicine instituted by the Government of India. He was honored for his pioneering work in video-assisted thoracoscopic surgery.In 2017, the hospital made waves by successfully treating a man who had allegedly swallowed 150 pins and needles.
INTRODUCTION:Obesity is highly prevalent in India, creating an urgent need for effective management interventions. The study hypothesizes that synthetic semaglutide has comparable safety and efficacy to the innovator drug when used in obese adults for weight management. METHODS:A phase III multicenter randomized active-controlled non-inferiority trial enrolled adults with obesity across 19 centers in India. Subjects were randomized to the test arm receiving synthetic semaglutide (Alkem Laboratories Limited) or the reference arm administered with innovator semaglutide (Wegovy®, Novo Nordisk) over 24 weeks in a 2:1 ratio. The primary efficacy endpoint was the percentage change in body weight,24 weeks post-intervention. Synthetic semaglutide was established to be non-inferior if the lower bound of the one-sided 97.5% confidence interval for the between-group difference did not exceed 4.5%. RESULTS:Of the 249 randomized participants, 246 (98.8%) completed the study. Mean percentage weight loss after 24 weeks was -14.39 ± 4.17% in the test arm and -14.61 ± 4.36% in the reference arm. The least square-mean difference was 0.15% (-0.93 to 1.24), meeting the predefined non-inferiority criterion. Weight loss >10% was achieved by 86.67% (n=143) in the test arm and 83.95% (n=68) in the reference arm (p = 0.5666), while >15% weight loss occurred in 38.79% (n=64) and 40.74% (n=33), respectively (p = 0.7683). Mean body mass index decreased by -4.93 ± 1.43 kg/m² in the test arm and -5.00 ± 1.50 kg/m² in the reference arm (p = 0.7128). Treatment-emergent adverse events were reported in 55.42% (n=92) of test-arm participants and 54.22% (n=45) of reference-arm participants. CONCLUSIONS:Test semaglutide demonstrated non-inferior efficacy, comparable safety, and similar tolerability to the innovator product.
Abstract This chapter examines semaglutide as a multiorgan therapeutic strategy for cardiometabolic risk reduction, with particular focus on cardiovascular disease, chronic kidney disease, and metabolic dysfunction-associated steatotic liver disease/metabolic dysfunction-associated steatohepatitis. It integrates contemporary guidance from the American Diabetes Association (ADA) 2025 Standards of Care, the ADA/European Association for the Study of Diabetes /EASD consensus, and Kidney Disease: Improving Global Outcomes recommendations with evidence from Semaglutide Unabated Sustainability in Treatment of Type 2 Diabetes-6, Semaglutide Effects on Cardiovascular Outcomes In People With Overweight or Obesity, effect of semaglutide versus placebo on the progression of renal impairment in subjects with type 2 diabetes and chronic kidney disease (FLOW), Semaglutide Cardiovascular Outcomes Trial, and effect of semaglutide in subjects with noncirrhotic nonalcoholic steatohepatitis, alongside mechanistic literature on glucagon-like peptide-1 receptor agonist-mediated cardioprotective and nephroprotective effects. In cardiovascular prevention, semaglutide is positioned early in high-risk type 2 diabetes on the basis of risk-factor clustering, visceral adiposity, inflammation, and residual cardiometabolic risk, independent of glycated hemoglobin alone. In chronic kidney disease, the review highlights FLOW as a practice-changing kidney outcomes trial demonstrating reduction in major kidney events, slower estimated glomerular filtration rate decline, and reduction in albuminuria. In metabolic dysfunction-associated steatotic liver disease/MASH, semaglutide is presented as a clinically meaningful option for steatohepatitis resolution and fibrosis-related benefit, particularly in obesity- and diabetes-associated liver disease. Overall, the chapter supports semaglutide as an organ-protective therapy whose benefits extend beyond glucose lowering toward integrated cardiovascular, renal, and hepatic risk reduction.
Neglected congenital kyphoscoliosis with vertebral aplasia, absent pedicles, and rib anomalies presents a formidable challenge, especially in low-resource settings. We report the case of a 28-year-old man with progressive thoracolumbar deformity, cosmetic concerns, and fatigue. Imaging revealed congenital vertebral aplasia with pedicle agenesis from D10 to D12, a missing left 12th rib, and a dysplastic right L1 pedicle. The patient underwent a single-staged posterior-only surgical correction using basic fluoroscopic guidance. Surgical management included multilevel pedicle screw fixation, wide posterior facetectomies, decompression, foraminotomies, in situ rod contouring, and posterolateral fusion with allograft. No vertebral column resections were performed. Postoperative imaging demonstrated stable correction and alignment. At three months, the patient had significant cosmetic improvement, fatigue resolution, and no neurological deficits. This case demonstrates the utility of posterior-only deformity correction and fusion in complex neglected congenital kyphoscoliosis, using accessible surgical techniques without reliance on advanced intraoperative technology in a resource-limited setting.
Background:The Unani system of medicine, rooted in Greco-Arabic traditions, emphasizes prevention, holistic care, and community well-being. While its contributions to individualized healthcare and public hygiene are well-documented historically, attention to its contemporary applicability in addressing global health challenges has remained limited. Objective:To explore the principles of preventive and social medicine (PSM) in the Unani framework, highlight their historical foundation, and assess their relevance in modern healthcare, particularly in relation to lifestyle disorders, mental health, and pandemics. Methods:A narrative review was conducted by analyzing classical Unani texts, historical contributions, and contemporary research. Emphasis was placed on Asbāb Sitta Darūriyya (six essential factors), Mizāj (temperament), and collective health practices described in Unani literature. Results:Preventive measures in Unani medicine include dietary moderation, exercise-rest balance, Harakat-o-Sukūn Nafsānī (stress regulation), hygiene, and sanitation. Classical physicians such as Ibn Sina advocated quarantine during epidemics, while Galen emphasized sanitation and environmental health. These principles align with modern public health strategies. Recent AYUSH guidelines during the COVID-19 pandemic illustrate the potential of integrating Unani regimens and immunity-boosting interventions into mainstream healthcare. Conclusion:Unani medicine offers a timeless perspective on PSM. Its holistic emphasis on individual well-being, community health, and environmental balance makes it highly relevant to current global healthcare challenges. Future directions include empirical validation of Unani interventions, standardization of practices, and integration into national and global health frameworks. Keywords:Unani Medicine, Preventive Health Services, Public Health, Lifestyle Diseases, Mental Health, Pandemics.
Pheochromocytoma-induced cardiomyopathy is a rare but serious condition caused by excessive catecholamine release, leading to heart failure and life-threatening hemodynamic instability. Managing such cases requires a delicate balance of treatments to stabilize the cardiovascular system while preparing for tumor removal. A 16-year-old boy came to the hospital with severe abdominal pain, palpitations, and breathlessness, which progressively worsened despite multiple medical consultations. He was diagnosed with dilated cardiomyopathy and severe heart failure and was worked up extensively for the same. He was planned for heart transplantation after stabilization. However, a non-contrast computed tomography of the abdomen done as part of the pre-operative workup showed an adrenal lesion, and further testing revealed an adrenal pheochromocytoma. His treatment required careful adjustments of medications to support his heart while ensuring safe tumor resection. Alpha-blockers, inotropes, and fluid management were carefully balanced to prevent complications. A highly coordinated team of endocrinologists, cardiologists, anesthesiologists, and surgeons worked together to optimize his condition before surgery. He underwent a successful open adrenalectomy, and with intensive postoperative care, his left ventricular function gradually improved. A year later, he remains symptom-free, with his catecholamine levels returning to normal and ejection fraction improving from 10% to 40%. This case underscores the importance of personalized care and a multidisciplinary approach in managing pheochromocytoma-related heart failure, ensuring both surgical success and long-term recovery.
