Hi-Tech Medical College & Hospital

Background: Among pediatric populations, iron-deficiency anemia (IDA) represents a highly prevalent micronutrient deficit that potentially compromises the respiratory tract via disrupted systemic oxygen delivery alongside modified immunological pathways. Despite this, the clinical relationship linking iron deficiency to the recurrence rate and clinical intensity of acute wheezing attacks among preschoolers has not been conclusively characterized. Materials & Methods: This prospective, facility-centered observational comparative analysis evaluated 120 pediatric subjects between 2 and 5 years old presenting with acute or episodic wheeze. Cohorts were divided into an IDA cohort (n = 60) and a non-IDA cohort (n = 60) using objective serum iron indices and peripheral blood counts. Comprehensive clinical profiles were recorded, focusing on annual attack counts, symptom severity, hospital admissions, urgent care presentations, and persistence of attacks. Data evaluation utilized independent Student's t tests, chi-square or Fisher's exact contingency tests, odds ratios (ORs) paired with 95% confidence intervals (CIs), as well as multivariable logistic models. Statistical significance was established using a two-tailed alpha threshold of P less than 0.05. Results: The annual frequency of wheezing exacerbations was considerably elevated in the IDA cohort relative to non-anemic controls (4.1 ± 1.9 compared to 2.8 ± 1.5; P less than 0.001), reflecting greater odds of sustaining 3 or more yearly episodes (71.7% compared to 48.3%; OR 2.70, 95% CI 1.25–5.84). Presentations categorized as moderate-to-severe (65.0% vs. 38.3%), inpatient stays (26.7% vs. 11.7%), and acute emergency presentations (45.0% vs. 25.0%) emerged with markedly greater incidence in the IDA population. Furthermore, episode resolution required a significantly longer timeframe within the iron-deficient cohort (5.0 ± 1.8 versus 3.8 ± 1.4 days; P less than 0.001). Conclusions: Pediatric patients aged 2 to 5 years demonstrated a robust clinical link between IDA and both a higher recurrence rate and heightened acute wheezing severity. Routine screening for depleted iron reserves could serve as an effective strategy to stratify young children vulnerable to frequent, severe episodes, underscoring the urgency for prospective clinical trials evaluating whether targeted iron repletion mitigates adverse pulmonary manifestations. Keywords: Iron-deficiency anemia; Iron deficiency; Preschool children; Acute wheezing; Recurrent wheezing; Wheezing severity; Respiratory morbidity;

Visual impairment remains a major global health concern associated with disorders such as diabetic retinopathy, glaucoma, cataract, and age-related macular degeneration. Early detection of ocular abnormalities remains essential for preventing irreversible visual loss. Conventional diagnostic methods rely on clinical examination and specialised imaging, yet limitations in accessibility, diagnostic variability, and delayed detection continue to affect effective eye-care delivery in many settings. Advances in digital technologies have introduced innovative diagnostic approaches integrating artificial intelligence (AI), ocular biometric evaluation, and tele-optometry to improve efficiency and reach of ophthalmic care. The objective of this review involves a comprehensive examination of recent developments in digital ophthalmic diagnostics, focusing on AI-based image analysis, biometric measurement technologies, and tele-optometry platforms. Relevant literature addressing AI applications, ocular biometric assessment, and remote ophthalmic screening systems was evaluated to synthesise current knowledge on diagnostic capability and clinical relevance. Current evidence indicates that AI algorithms enable automated interpretation of retinal images and facilitate early identification of ocular diseases. Biometric evaluation provides precise anatomical measurements that support refractive assessment and surgical planning. Tele-optometry systems expand diagnostic access through remote imaging and consultation services, improving screening coverage in underserved populations. Integration of AI, biometric technologies, and tele-optometry demonstrates strong potential to enhance disease detection, strengthen clinical decision support, and expand accessibility of ophthalmic diagnostic services.

Abstract Objectives To evaluate the efficacy and safety of Synthetic Semaglutide Injection manufactured by Sun Pharma (Test arm) with Ozempic® Injection (Reference arm) in Indian patients with Type 2 Diabetes Mellitus (T2DM) in three subgroups based on BMI: <23 kg/m2 (Subgroup 1 [S1]), 23 to <25 kg/m2 (Subgroup 2 [S2]), ≥25 kg/m2 (Subgroup 3 [S3]). Materials and Methods This was a phase III, multicentre, randomized, open-label, active controlled study. Total 314 adults (18-65 years) with T2DM (HbA1c: 7.0-10.5%) on diet/exercise uncontrolled with stable metformin dose (≥1500 mg or maximum tolerated dose) for ≥12 weeks were enrolled. Eligible patients were randomized in a 1:1 ratio and received Test product or Reference product, subcutaneous injections in a weekly dose of 0.25 mg to 2 mg for 24 weeks. [CTRI Registration number: CTRI/2025/02/080592]. Results At baseline, distribution of patients was as follows: 38 patients with BMI <23 kg/m2(S1), 72 patients with BMI 23 to <25 kg/m2(S2) and 204 patients with BMI ≥25 kg/m2(S3). HbA1c reduction from baseline to Week 24 in Test arm was comparable to comparator arm: S1: −2.26 ± 0.91% vs −1.89 ± 0.87% (P = .2028), S2: −2.21 ± 0.76% vs −2.25 ± 0.74% (P = .9033), S3: −1.95 ± 0.82% vs −1.85 ± 0.95% (P = .4848). Significant reduction from baseline HbA1c was observed across all three sub-groups at Week 24 in both the study arms. Significant reductions in post-prandial and fasting blood glucose levels at Week 24 were seen in both the study arms and the changes were comparable across all three BMI subgroups. Proportion of patients achieving HbA1c <7.0% were comparable between the Test and Comparator arms, S1:15 (88.2%) vs 13 (76.5%) (P = .3697), S2: 23 (74.2%) vs 27 (75.0%) (P = .7267), S3: 68 (72.3%) vs 68 (73.1%) (P = .9184) across all three BMI subgroups. Three patients experienced hypoglycaemia. None of the patients required rescue medication. The incidence of treatment-emergent adverse events (TEAEs) was similar in both arms. Most common TEAEs were gastrointestinal events (Diarrhoea, Nausea, Vomiting) in all three subgroups. Study medications were well tolerated. Conclusions Semaglutide injection (Test product) demonstrated comparable glycaemic control to Reference product in T2DM patients uncontrolled on metformin monotherapy across all three BMI subgroups of normal weight, overweight and obese patients.

Abstract Objectives To evaluate the efficacy and safety of Synthetic Semaglutide Injection manufactured by Sun Pharma (Test arm) with Ozempic® Injection (Reference arm) in Indian patients with Type 2 Diabetes Mellitus in three subgroups based on Age: <40 years (Subgroup 1 [S1]), 40 to <50 years (Subgroup 2 [S2]), ≥50 years (Subgroup 3 [S3]) Materials and Methods This was a phase III, multicentre, randomized, open-label, active controlled study. Total 314 adults (18-65 years) with T2DM (HbA1c: 7.0-10.5%) on diet/exercise uncontrolled with stable metformin dose (≥1500 mg or maximum tolerated dose) for ≥12 weeks were enrolled. Eligible patients were randomized in a 1:1 ratio and received Test product or Reference product, subcutaneous injections in a weekly dose of 0.25 mg to 2 mg for 24 weeks. [CTRI Registration number: CTRI/2025/02/080592] Results At baseline, distribution of patients was as follows: 54 patients aged <40 years (S1), 107 patients aged 40 to <50 years (S2) and 153 patients aged ≥50 years (S3). HbA1c reduction (±SD) from baseline to Week 24 in Test arm was comparable to Reference arm across all 3 age subgroups: S1: −1.85 ± 0.70% vs—2.20 ± 0.80% (P = .2220), S2:—2.05 ± 0.87% vs −1.92 ± 0.96% (P = .4542), S3: −2.10 ± 0.83% vs −1.88 ± 0.90% (P = .1557). Significant reduction from baseline in HbA1c was observed across all three sub-groups at Week 24 in both the study arms. Significant reductions in post-prandial and fasting blood glucose levels at Week 24 were seen in both study arms and the changes were comparable across all three age subgroups. Proportion of patients achieving HbA1c <7.0% were comparable between the Test and Reference arms, S1: 19 (86.4%) vs 24 (82.8%) (P = .3426), S2: 36 (72.0%) vs 34 (70.8%) (P = .8843), S3: 51 (72.9%) vs 50 (72.5%) (P = .6315) across all three age subgroups. Three patients experienced hypoglycaemia. None of the patients required rescue medication. The incidence of treatment-emergent adverse events (TEAEs) was similar in both arms. Most common TEAEs were gastrointestinal events (Diarrhoea, Nausea, Vomiting) in all three subgroups. Study medications were well tolerated. Conclusions Semaglutide injection (Test Product) demonstrated comparable glycaemic control to Reference product in T2DM patients uncontrolled on metformin monotherapy across all age groups.

Abstract Objectives To evaluate the efficacy and safety of Synthetic Semaglutide Injection manufactured by Sun Pharma (Test arm) with Ozempic® Injection (Reference arm) in Indian patients with type 2 diabetes mellitus (T2DM) with mild renal impairment (eGFR 60 to <90 mL/min/1.73 m2). Materials and Methods This was a phase III, multicentre, randomized, open-label, active controlled study. Total 314 adults (18-65 years) with T2DM (HbA1c: 7.0-10.5%) on diet/exercise uncontrolled with stable metformin dose (≥1500 mg or maximum tolerated dose) for ≥12 weeks were enrolled. Eligible patients were randomized in a 1:1 ratio and received Test product (manufactured by Sun Pharma) or Reference product, subcutaneous injections in a weekly dose of 0.25 mg to 2 mg for 24 weeks. [CTRI Registration number: CTRI/2025/02/080592]. Results This subgroup analysis included total 109 patients (Test arm [n=55] and Reference arm[n=54]) with mild renal impairment (eGFR 60 to <90 mL/min/1.73 m2). HbA1c reduction (± SD) from baseline to Week 24 was comparable to comparator in this subgroup: −1.95 ± 0.72% vs −1.77 ± 0.88% (P = .3920). Significant reduction from baseline HbA1c was observed in both test arm and reference arm at Week 24. Significant reductions in post-prandial and fasting blood glucose levels at Week 24 were seen in both the study arms and the changes were comparable in this subgroup. Proportion of patients achieving HbA1c <7.0% from baseline to Week 24 were comparable between the Test arm and reference arm 42 (76.4%) vs 42 (77.8%) (P = .7191). One patient experienced hypoglycaemia. None of the patients required rescue medication. The incidence of treatment-emergent adverse events (TEAEs) was similar in both arms (Test arm = 66.2% and Reference arm = 69.5%). Most common TEAEs were gastrointestinal events (Diarrhoea, Nausea, Vomiting). Study medications were well tolerated. Conclusions Semaglutide injection (Test Product) demonstrated comparable glycaemic control to Reference product in T2DM patients uncontrolled on metformin monotherapy with mild renal impairment.