Command Hospitals are major military hospitals in India. There is not more than one in each Command. The Indian Armed Forces have seven Command Hospitals. They are:.
Hungry bone syndrome (HBS) is a well-recognised complication after curative parathyroidectomy in primary hyperparathyroidism (PHPT), contributing to morbidity and prolonged hospitalisation. Reported predictors remain inconsistent, and data from Indian cohorts are limited, particularly in settings where vitamin D deficiency and advanced skeletal disease may modify risk. This retrospective observational cohort study was conducted at a tertiary surgical centre between January 2023 and December 2025. Twenty-five consecutive patients with biochemically proven PHPT who underwent curative parathyroidectomy were included. Preoperative variables included serum calcium, phosphate, parathyroid hormone (PTH), alkaline phosphatase (ALP), and 25-OH vitamin D. For this study, HBS was defined as postoperative hypocalcaemia persisting for more than 72 h after surgery and requiring clinically significant calcium supplementation; transient asymptomatic biochemical hypocalcaemia was not classified as HBS. Receiver operating characteristic (ROC) curves were constructed, and a three-point bedside score was evaluated in an exploratory manner. HBS developed in 7 patients (28
Clinical and biochemical screening is recommended to monitor hepatobiliary late-effects in childhood acute lymphoblastic leukemia survivors (cALLs). Transient elastography (TE) noninvasively evaluates liver fibrosis by measuring liver stiffness (LSM) with good sensitivity. We screened cALLs for high-LSM using TE, comparing them to controls and evaluated risk factors for high-LSM. This case–control study included cALLs who were under 18 years at diagnosis, had completed therapy between 2016 and 2023, and were at least 6-months post-completion of therapy. This study also included 50 age- and sex-matched controls. TE (Fibroscan®) was used for LSM, with cutoff ≥ 5.1 kPa for high-LSM indicating fibrosis, and for controlled attenuation parameter (CAP), with cutoff > 248 dB/m for steatosis. Fifty-eight cALLs with mean (SD) age of 136.58 (58) months at enrollment were analyzed after mean (SD) duration of 27 (8) months post-completion of therapy. High-LSM was observed in 22/58 (37.9
BACKGROUND:Screening for latent tuberculosis (LTB) before initiating advanced therapy for inflammatory bowel disease (IBD) helps reduce the risk of tuberculosis (TB) development. However, there is limited data on screening practices from TB-endemic regions. AIM:To study the practices of screening for LTB and study the incidence of TB in patients with IBD on biological and small molecule inhibitors. METHODS:This retrospective multicentre study analyzed LTB screening practices in IBD patients starting advanced therapies between 2018 and 2022. We included patients who were initiated on biologics (infliximab, adalimumab, vedolizumab) or small molecule inhibitors (tofacitinib). We assessed compliance with LTB screening methods, including the tuberculin skin test, interferon-gamma release assay (IGRA), chest X-ray, and computed tomography chest, both at initiation and annually. We also evaluated the incidence of active TB and its predictors. RESULTS:Of 378 patients (mean age: 36.9 ± 14.9 years, males: 56.9%), 158 (41.8%) and 216 (57.1%) had ulcerative colitis and Crohn's disease, respectively. Advanced therapy used were anti-tumor necrosis factor in 309 (81.74%), tofacitinib in 41 (10.84%) and vedolizumab in 28 (7.40%). Standard screening and diligent screening strategy was employed in 59% and 33% of patients, respectively. Compliance with tuberculin skin test and IGRA was noted in 261 (69.04%) and 298 (78.83%) patients, respectively. Chest X-Ray and computed tomography chest were performed in 300 (79.36%) and 242 (64.02%), respectively. Annual screening in those on advanced therapy for > 1 year was performed in 27.2% (50/184). Active TB developed in 17 (4.49%); 15 (88.23%) were on anti-tumor necrosis factor. LTB was detected in 40 (10.72%), with most diagnosed on the basis of IGRA (21/40, 52.50%). Among 17 patients who developed active TB, LTB screen was negative in 12 (70.58%). CONCLUSION:Standard screening practices for LTB, prior to starting advanced therapy, remain suboptimal (< 60%) in India despite high TB endemicity.
