The Journal of the Association of Physicians of India最新文献

{"title":"Can the Dying Clinical Medicine be Resuscitated?","authors":"Abhijit S Rayate, Basavraj S Nagoba","doi":"10.59556/japi.74.1315","DOIUrl":"https://doi.org/10.59556/japi.74.1315","url":null,"abstract":"","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"74 2","pages":"105"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147445103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Study to Assess the Prevalence, Risk Factors, and Role of Epicardial Fat Thickness in Prediction of Diabetic Retinopathy in Type 2 Diabetic Patients in a Tertiary Care Center in Western Uttar Pradesh.","authors":"Shashank Shekhar, Sandhya Gautam, Chhaya Mittal, Snehlata Verma, Priyank Garg, Chandra Bhushan Pandey","doi":"10.59556/japi.74.1330","DOIUrl":"https://doi.org/10.59556/japi.74.1330","url":null,"abstract":"<p><strong>Introduction: </strong>Diabetic retinopathy (DR) is the most important risk factor causing blindness in diabetic individuals, and its risk progresses with increased disease duration. Epicardial fat thickness (EFT) is an emerging indicator of inflammation and metabolic derangement and has been proposed as a potential biomarker linked to the severity of DR. This study aims to assess the prevalence of DR, identify risk factors associated with DR, and evaluate the predictive role of EFT in detecting DR in subjects with type 2 diabetes mellitus (T2DM).</p><p><strong>Methods: </strong>A cross-sectional observational study was conducted at LLRM Medical College, Meerut, from 2023 to 2024. The participants included 130 T2DM patients who were assessed clinically, radiologically, and biochemically. Demographic data, duration of diabetes, body mass index (BMI), HbA1c levels, and EFT were measured. The severity of DR was determined based on ophthalmic examination. Data were analyzed using Kruskal-Wallis and Chi-squared tests.</p><p><strong>Results: </strong>In this study of 130 patients with T2DM, 64.61% (<i>n</i> = 84) had DR, including 33.84% (<i>n</i> = 44) with nonproliferative DR (NPDR) and 30.76% (<i>n</i> = 40) with proliferative DR (PDR), while 35.38% (<i>n</i> = 46) had no DR. Patients in the PDR group were older on average (60.5 ± 13.9 years), but age differences were not statistically significant (<i>p</i> = 0.154). The duration of diabetes was significantly longer in PDR patients (9.0 ± 3.01 years) compared with NPDR and non-DR groups (<i>p</i> < 0.001). BMI increased with DR severity, reaching 28.49 ± 2.07 kg/m² in the PDR group, in which 20% were obese and 72.5% were overweight. A higher waist-hip ratio (WHR) was significantly associated with more severe DR in males (<i>p</i> < 0.001) but not in females (<i>p</i> = 0.099). HbA1c levels increased with disease severity, from 6.1 ± 0.71% in non-DR to 8.6 ± 1.97% in PDR patients (<i>p</i> < 0.001). Similarly, EFT increased from 3.9 ± 0.47 mm in non-DR to 7.9 ± 1.09 mm in PDR (<i>p</i> < 0.001), suggesting EFT as a potential biomarker for DR severity. These findings highlight strong links between DR severity, poor glycemic control, obesity measures, and longer diabetes duration.</p><p><strong>Conclusion: </strong>These findings suggest that in type 2 diabetes mellitus patients, EFT can serve as a significant marker for the severity of DR. It can be used as a noninvasive investigation to predict PDR. When considered alongside established risk factors such as BMI, HbA1c levels, and diabetes duration, EFT could enhance early identification of patients at risk, potentially helping to prevent advancement to the more severe proliferative stage (PDR). However, larger and more extensive studies are required to confirm these observations and strengthen their clinical relevance.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"74 2","pages":"12-16"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147445131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Catheter-induced Left Main Dissection: A Minefield in Interventional Cardiology.","authors":"Varsha Rakshitha Prakash, M A Sujith, Sathyanarayana Rao Prakash","doi":"10.59556/japi.74.1334","DOIUrl":"https://doi.org/10.59556/japi.74.1334","url":null,"abstract":"<p><p>Coronary angiography is an invasive diagnostic procedure used to assess the coronary anatomy. Although rare, iatrogenic coronary artery dissection during coronary catheterization is a dreaded complication. Here we report the case of an 89-year-old patient diagnosed with acute coronary syndrome-Non-ST-segment elevation myocardial infarction, who underwent coronary angiography. During the coronary angiogram, he sustained a fatal left main coronary artery dissection. Here we discuss the interventions attempted to tackle the situation and a review of the approach to managing iatrogenic left main dissections.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"74 2","pages":"98-100"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147445097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"The Cancer that Carried the Chalk\"-NXP2+ Paraneoplastic Dermatomyositis Unleashing Calcinosis Cutis and Peripheral Neuropathy.","authors":"Jayaram Saibaba, Nidhish Chandra, Deepak Amalnath, Dks Subrahmanyam","doi":"10.59556/japi.74.1364","DOIUrl":"https://doi.org/10.59556/japi.74.1364","url":null,"abstract":"<p><p><b>How to cite this article:</b> Saibaba J, Chandra N, Amalnath D, <i>et al.</i> \"The Cancer that Carried the Chalk\"-NXP2+ Paraneoplastic Dermatomyositis Unleashing Calcinosis Cutis and Peripheral Neuropathy. J Assoc Physicians India 2026;74(2):102-103.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"74 2","pages":"102-103"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147445128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Educating for Equity: The Role of Educational Intervention in Shaping Health Care Students' Knowledge of Universal Health Coverage and Primary Health Care.","authors":"Rachel Sushmita Daniel, Shailaja S Patil, Chandrika Doddihal, Vijaya Sorganvi","doi":"10.59556/japi.74.1329","DOIUrl":"https://doi.org/10.59556/japi.74.1329","url":null,"abstract":"<p><strong>Background: </strong>Universal health coverage (UHC) and primary health care (PHC) are critical components of equitable health systems. Medical and allied health science students, as future healthcare providers, need to possess knowledge and understanding of these concepts. Educational interventions are pivotal in enhancing this knowledge and preparing students for effective healthcare delivery.</p><p><strong>Objectives: </strong>This study aimed to assess the impact of an educational intervention on the knowledge and perception of UHC and PHC among healthcare students at a private medical university in north Karnataka.</p><p><strong>Methodology: </strong>A quasi-experimental study design was employed involving 300 healthcare students during June-August 2024. The study comprised 3 phases: a pretest to gauge baseline knowledge about UHC and PHC. An educational session focused on UHC and PHC was conducted, and a posttest to evaluate the knowledge acquired was done. The pretest and posttest consisted of a 23-item questionnaire. Statistical analysis comprised the Kruskal-Wallis and Wilcoxon signed ranks tests to compare pre- and postintervention knowledge scores.</p><p><strong>Results: </strong>The pretest results indicated a mean knowledge score of ±8.07. Following the educational intervention, the posttest results revealed a significant increase in knowledge, with a mean score of ±13.8. This positive outcome emphasizes the effectiveness of the educational intervention.</p><p><strong>Conclusion: </strong>The study demonstrates that targeted educational interventions can significantly improve the knowledge of UHC and PHC among healthcare students. Incorporating regular educational programs, including practical seminars on UHC and PHC, in their study curricula is recommended to sustain and enhance this knowledge.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"74 2","pages":"18-20"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147445179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"To Determine Vitamin B12 Deficiency in Type 2 Diabetes Mellitus Patients on Metformin Therapy.","authors":"Rakesh Bhadade, Namdeo Dongare, Minal Harde, Rosemarie deSouza, Ani Patel","doi":"10.59556/japi.74.1371","DOIUrl":"https://doi.org/10.59556/japi.74.1371","url":null,"abstract":"<p><strong>Introduction: </strong>India harbors the second-largest population with diabetes, with over 100 million, and type 2 diabetes mellitus (T2DM) constitutes the major share. Metformin remains the first-line pharmacotherapy for T2DM due to its safety profile, cost-effectiveness, and beneficial metabolic effects.</p><p><strong>Materials and methods: </strong>The aim of the study was to assess the frequency of vitamin B12 deficiency in patients with T2DM on metformin therapy and compare it with their cohabiting family members who are not on metformin but share similar dietary habits.</p><p><strong>Results: </strong>This study included 180 participants with 90 cases and controls each, and we enrolled 89 females (49.4%) and 91 males (50.6%). The mean age was 57 (± 4.88) years, and overall gender distribution and dietary pattern were nearly balanced among cases and controls. The mean duration of diabetes among cases was 7.69 ± 4.35 years, and duration of metformin use was 5.22 ± 3.77 years, ranging from 1-16 years. The mean daily dose of metformin was 1238.89 ± 586.50 mg/day, with a median dose of 1000 mg/day. The mean serum vitamin B12 level in metformin users was significantly lower than in controls (206.66 ± 59.09 pg/mL vs 301.44 ± 72.28 pg/mL, <i>p</i> < 0.001). Vitamin B12 deficiency was present in 40.0% of metformin users versus 11.1% of controls, yielding an odds ratio of 5.33 (95% CI: 2.44-11.65), which was a highly significant difference between the two groups (<i>t</i> = -9.631, <i>p</i> < 0.001), strongly suggesting an association between metformin use and reduced B12 levels. Neurological symptoms were observed in 14.4% of cases (OR 4.896, 95% CI: 1.345-17.827; <i>p</i> = 0.009).</p><p><strong>Conclusion: </strong>Long-term metformin use in T2DM patients is strongly associated with both biochemical vitamin B12 deficiency and an increased likelihood of neurological symptoms.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"74 2","pages":"68-73"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147445199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lipoprotein(a) Augments Coronary Risk Estimation in Type 2 Diabetes: A Cross-sectional Study.","authors":"Sonali Sharma, Ramesh Kumar Chandak, Krishna Kumar Sharma, Soneil Guptha, Rajeev Gupta","doi":"10.59556/japi.74.1331","DOIUrl":"https://doi.org/10.59556/japi.74.1331","url":null,"abstract":"<p><strong>Objective: </strong>Risk estimation tools have been developed to predict coronary heart disease (CHD) in type 2 diabetes (T2D). To evaluate augmentation following the addition of lipoprotein(a) [Lp(a)] to risk calculation, we performed a pilot study.</p><p><strong>Methods: </strong>A total of 90 successive T2D patients were included. Details of clinical and biochemical features were obtained. Lp(a) was determined using ELISA. CHD risk estimation was performed using Framingham, QRISK-3, SCORE-2D, INTERHEART, and European Atherosclerosis Society (EAS) algorithms with and without Lp(a). Descriptive statistics are reported.</p><p><strong>Results: </strong>Mean age of patients was 55.0 ± 8 years, BP systolic/diastolic 133.7 ± 12/95.0 ± 9 mm Hg, body mass index (BMI) 26.0 ± 1.9 kg/m², waist-hip ratio 0.96 ± 0.08, fasting glucose 198.0 ± 38 mg/dL, HbA1c 9.3 ± 1.3%, total cholesterol 197.0 ± 26 mg/dL, LDL cholesterol 114.2 ± 25 mg/dL, non-HDL cholesterol 153.8 ± 27 mg/dL, and triglycerides 197.8 ± 44 mg/dL. Lp(a) was mean 23.1 ± 9.7 mg/dL and median 22.0 (25-75 IQR 15.9-29.5) mg/dL. Mean risk scores were Framingham 11.2 ± 8.7, QRISK-3 28.6 ± 15.3, INTERHEART 21.0 ± 6.0, SCORE-2D 14.9 ± 8.3, and EAS 29.2 ± 15.2. Patients with raised Lp(a) >30 mg/dL had higher levels of total, LDL, and non-HDL cholesterol and triglycerides (<i>p</i> < 0.01). Spearman's correlation of Lp(a) with risk scores was Framingham 0.127, QRISK-3 0.174, INTERHEART 0.137, SCORE-2D 0.050, and EAS 0.320, while EAS-Lp(a) was 0.397. In different risk algorithms, high risk for CHD were: Framingham 14.4%, QRISK-3 64.4%, INTERHEART 45.6%, SCORE-2D 30.0%, EAS 71.1%, and EAS with Lp(a) 74.4%. Area under the curve (AUC) for Lp(a) with various scores were Framingham 0.53 (CI: 0.39-0.68; <i>p</i> = 0.644), QRISK-3 0.57 (CI: 0.42-0.71), INTERHEART 0.55 (CI: 0.39-0.69), SCORE-2D 0.47 (CI: 0.32-0.61), EAS 0.65 (CI: 0.50-0.79), and EAS-Lp(a) 0.68 (CI: 0.54-0.83). In addition, adding Lp(a) to the EAS risk calculator increased risk reclassification by a range of 4.6-19.3%.</p><p><strong>Conclusion: </strong>Substantial variation in coronary artery disease (CAD) risk prediction using various clinical algorithms is observed in T2D. The EAS algorithm provides the most robust estimate. The addition of Lp(a) to the risk algorithms augments risk stratification significantly. The results of this pilot study need confirmation with larger prospective studies.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"74 2","pages":"33-37"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147445182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and Laboratory Profile of Patients with Tropical Coinfections Admitted at a Tertiary Care Center in North India.","authors":"Amandeep Kaur, Monica Gupta, Nidhi Singla, Sarabmeet Singh Lehl, Sahil Attri","doi":"10.59556/japi.74.1326","DOIUrl":"https://doi.org/10.59556/japi.74.1326","url":null,"abstract":"<p><strong>Background: </strong>Tropical coinfections (CI) are the simultaneous occurrence of two or more vector-borne diseases in a single host. The prevalence of such illnesses is not uncommon among tropical and subtropical regions such as India; however, these CIs have not been systematically studied prospectively. Mixed infections can prove potentially detrimental if underdiagnosed or undertreated. We undertook this study to estimate the prevalence and compare the clinical profile, laboratory characteristics, and various outcomes among the patients with tropical CI who presented with acute undifferentiated febrile illness (AUFI).</p><p><strong>Materials and methods: </strong>A prospective, observational study was conducted on adult patients hospitalized with tropical CIs. As per the clinical suspicion, a panel of tests for dengue fever (D), malaria (M), scrub typhus (S), leptospirosis (L), chikungunya (C), and brucella (B) was carried out. Statistical analysis was done using standard methods.</p><p><strong>Results: </strong>The mean age of the population was 39.4 ± 17.3 years. Among 986 patients presenting with AUFI, 8.1% of the patients had CIs. Of these CIs, 95% had dual infections, and 5% had CIs with three tropical pathogens. We observed 17 diverse tropical CI combinations; four predominant being D + L, D + S, D + C, and S + L with a prevalence of 26.2, 25, 15, and 13.8%, respectively. 16.25% of the patients with tropical CIs died, mostly those suffering from D + S and D + L. Coinfection with D + S had predominant acute kidney injury (AKI), whereas acute transaminitis was highest in the D + L category. Acute respiratory distress syndrome (ARDS) was clinically significant in S + L, and multiorgan dysfunction was highest in the D + S combination. Using logistic regression, AKI, hepatitis, ARDS, shock, gastrointestinal bleeding, and myocarditis were independent risk factors for mortality.</p><p><strong>Conclusion: </strong>Our study identified 17 different combinations of CIs. Four groups, i.e., D + L, D + S, D + C, and S + L-accounted for 80% of CIs. Despite significant organ involvement in certain CI combinations, we conclude that a clinical bedside differentiation of tropical CIs from monomicrobial infections is often difficult. Hence, optimal treatment for a possible CI may well be commenced empirically and early, bearing in mind an 8% probability of a concurrent tropical coinfection.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"74 2","pages":"28-32"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147445184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of β-Blockers Across the Cardiovascular Continuum: A Real-World Perception Survey (ROBUST).","authors":"J S Hiremath, Arup Dasbiswas, Jps Sawhney, Subhash Chandra, P P Mohanan, Swati Srivastava, Baishali Nath","doi":"10.59556/japi.74.1374","DOIUrl":"https://doi.org/10.59556/japi.74.1374","url":null,"abstract":"<p><strong>Background: </strong>Understanding Indian healthcare professionals' (HCPs) perceptions of beta (β)-blockers is critical, given the high burden of hypertension (HTN) and cardiovascular (CV) diseases in the country.</p><p><strong>Materials and methods: </strong>A cross-sectional survey was conducted among 1,000 Indian HCPs, including consulting physicians, cardiologists, and specialists in diabetes/metabolism experienced in managing adult patients across the HTN and CV disease continuum. Conducted between April 2023 and March 2024, the survey employed a 26-item structured questionnaire, developed through literature review and expert consultation, to assess β-blockers utilization patterns, prescribing preferences, and perceived barriers.</p><p><strong>Results: </strong>Responses from 855 HCPs were analyzed. Consulting physicians (431; 50.4%) and cardiologists (342; 40.0%) formed the majority. β-blockers were prescribed to 25-50% of patients with HTN by 489 (57.2%) HCPs. Approximately 429 (50.2%) observed a systolic BP reduction of 10-15 mm Hg, while 465 (54.4%) reported a diastolic BP reduction of 5-10 mm Hg. β-blockers were commonly prescribed for heart failure (381; 44.6%), postmyocardial infarction (214; 25%), and chronic coronary syndrome (309; 36.1%). Metoprolol was the preferred BB in 75% of HTN, post-MI, chronic coronary syndrome (CCS), and AF cases, and in 66.2% for HF management.</p><p><strong>Conclusion: </strong>This survey highlights real-world prescribing patterns and perceptions of β-blockers in India, with metoprolol emerging as the most preferred agent across multiple CV indications, reflecting its strong clinical acceptance and perceived efficacy.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"74 2E","pages":"e1-e7"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147445314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"National Consensus on Semaglutide in Cardiology: From Clinical Evidence to Clinical Translation.","authors":"H K Chopra, Ashwani Mehta, C K Ponde, Navin C Nanda, G S Wander, Abraham Oomman, Prafulla Kerkar, S N Routray, G P Ratnaparkhi, Prashant Advani, Rituparna Shinde, Rajeev Agarwal, Ajay Mahajan, Jay Shah, Gaurav Verma, Sanjay Mittal, Dorairaj Prabhakar, D Ramesh, Arun Kochar, Sanjeev Sidana, Rajesh Badani, Ajay Sinha, S K Parashar, S Ramakrishnan, P K Hazra, Anu Grover","doi":"10.59556/japi.74.1375","DOIUrl":"10.59556/japi.74.1375","url":null,"abstract":"<p><p>Obesity is increasingly recognized as a chronic, relapsing, and progressive disease that acts as a major upstream driver of cardiovascular, kidney, and metabolic disorders, with South Asians experiencing heightened vulnerability at lower adiposity thresholds. Despite this, effective metabolic therapies remain underutilized in cardiology practice. Semaglutide, a GLP-1 receptor agonist, has emerged as a multisystem, disease-modifying agent with benefits that extend well beyond glycemic control. Accumulating evidence from the STEP (Semaglutide Treatment Effect in People with Obesity) program, the SELECT cardiovascular outcomes trial, the SOUL trial, heart failure with preserved ejection fraction (HFpEF) studies, and real-world cohorts underscores its relevance for cardiometabolic risk reduction and symptom improvement. Recognizing the need for India-specific guidance, a panel of cardiologists from across the country reviewed pivotal randomized trials, including STEP 1-8, STEP-HFpEF, STEP-HFpEF DM, STEP TEENS, SELECT, SOUL, SUSTAIN-6, and PIONEER-6, along with meta-analyses, observational data, and international recommendations to formulate practical, context-appropriate guidance for cardiology practice. Across diverse studies, semaglutide consistently produces substantial reductions in body weight and visceral fat, accompanied by improvements in blood pressure, glycemic control, inflammatory markers, and hepatic steatosis. SELECT demonstrated a significant reduction in major adverse cardiovascular events in adults with overweight or obesity and established atherosclerotic cardiovascular disease (ASCVD), independent of diabetes status. Benefits of obesity-related HFpEF include meaningful gains in symptoms, exercise tolerance, and quality of life. Emerging data also support renal and hepatic protection across CKM domains. Findings from high-dose 7.2 mg studies highlight a dose-response continuum but call for careful assessment of tolerability. As international guidelines increasingly position GLP-1 receptor agonists as cardiometabolic therapies, Indian data emphasize the importance of early, phenotype-driven intervention. Semaglutide represents a practice-changing therapy that addresses core pathophysiological drivers of ASCVD and HFpEF through integrated modulation of adiposity and metabolic dysfunction. Its cardiovascular efficacy, multisystem benefits, and suitability for South Asian phenotypes support broader incorporation into contemporary cardiology. This consensus offers a framework for evidence-based patient selection, contraindications, monitoring, maintenance strategies, and coordinated multidisciplinary implementation to ensure safe and effective use in Indian clinical practice.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"74 2E","pages":"e8-e20"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147445214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}