Background: Supraspinatus tendon tears are the most common form of rotator cuff injuries, leading to pain, reduced shoulder function, and disability. Although arthroscopic repair is widely practiced, open supraspinatus repair using suture anchors remains a reliable and cost-effective method, especially in resource-limited settings.

Aim: To evaluate the functional outcome of open supraspinatus repair using anchor sutures.

Materials and Methods: This study included 10 patients diagnosed with supraspinatus tendon tears who underwent open repair using suture anchors. Patients with full-thickness tears and symptomatic partial tears not responding to conservative treatment were included. Preoperative assessment was done clinically and with MRI. Functional outcomes were evaluated using standard scoring systems (Constant/UCLA score) during follow-up.

Results: Out of 10 patients, 8 had full-thickness tears and 2 had partial tears. The mean preoperative functional score improved significantly from 35–45 to 75–90 postoperatively. Excellent results were seen in 5 patients, good in 4, fair in 1, and poor in 0, with an overall success rate of 80%. Significant pain relief and improved range of motion were observed in 8 patients. Complications included superficial infection and shoulder stiffness in one case each, with no cases of anchor failure or re-tear.

Conclusion: Open supraspinatus repair using anchor sutures is a safe, effective, and economical technique that provides good to excellent functional outcomes, making it a valuable option in the management of rotator cuff tears.

Background: ST-segment elevation myocardial infarction (STEMI) patients undergoing percutaneous coronary intervention (PCI) typically require 3 to 5 days of hospitalization. Prolonged length of stay (LOS) significantly impacts healthcare quality, family burden, and resource allocation. This study aimed to identify clinical predictors and explore the effect of pre-discharge functional capacity on prolonged hospitalization in STEMI-PCI patients in Thailand.

Methods: A retrospective observational cohort study was conducted using the Acute Coronary Syndrome registry at the Queen Sirikit Heart Center (June 2021–June 2023). The analysis included 536 STEMI-PCI survivors, categorized into standard LOS (≤ 5 days; n = 379) and prolonged LOS (> 5 days; n = 157) groups. Independent predictors were determined using multiple logistic regression.

Results: The prolonged LOS cohort was significantly older, had a higher proportion of females, presented with greater clinical severity, and experienced more in-hospital complications. Following multivariate adjustment, initial Killip class IV emerged as the strongest independent predictor of prolonged hospitalization (Adjusted OR = 4.73; 95% CI: 2.56–8.74, p < 0.001). Mechanical complications demonstrated a borderline trend for extended stays (p = 0.053). Conversely, higher physical activity capacity, as indicated by higher estimated pre-discharge METs, was significantly associated with a shorter duration of hospitalization.

Conclusion: Initial hemodynamic compromise, notably Killip class IV, is the primary driver of prolonged hospitalization in STEMI patients following PCI. Higher pre-discharge functional capacity correlates with shorter stays, underscoring the vital role of cardiopulmonary reserve and early rehabilitation strategies in optimizing patient recovery.

Background: Intertrochanteric fractures are a major cause of morbidity in the elderly, with cephalomedullary fixation widely accepted for unstable patterns. Proximal femoral nail (PFN) and proximal femoral nail anti-rotation (PFN-A) offer biomechanical advantages; however, comparative evidence from large Indian cohorts with extended follow-up remains limited.

Methodology: This retrospective observational study evaluated 286 skeletally mature patients with AO/OTA 31-A1 to A3 intertrochanteric fractures treated between 2022 and 2025 using closed reduction and internal fixation with PFN (n=162) or PFN-A (n=124). Postoperative radiological parameters including tip–apex distance (TAD), Cleveland index positioning, neck-shaft angle restoration and reduction quality were analysed. Fracture union was assessed up to two years. Statistical analysis was performed using SPSS version 22.

Results: Unstable fracture patterns constituted 79% of cases, and radiographic osteoporosis was present in 52%. Operative duration and haemoglobin drop were significantly lower in the PFN-A group (p<0.001). Radiological fixation quality was comparable between implants (mean TAD 22.1±4.2 mm; optimal Cleveland positioning 93%). Overall fracture union at two years was 97% (96% PFN vs 98% PFN-A; p=0.99). PFN-A demonstrated earlier radiological progression towards union and superior outcomes in osteoporotic patients (p=0.04). Complication rates were low and similar between groups. Logistic regression identified TAD >25 mm and negative reduction as independent predictors of fixation failure.

Conclusion: Both PFN and PFN-A provide reliable radiological and functional outcomes in intertrochanteric fractures. Fixation success is primarily influenced by reduction quality and optimal implant positioning rather than implant design alone, although PFN-A offers perioperative advantages and improved performance in osteoporotic bone.

Background: Gestational diabetes mellitus (GDM) is among the most frequently encountered metabolic complications of pregnancy, yet how best to screen for it and when remains a matter of ongoing debate. While the DIPSI glucose challenge test (GCT) is widely recommended in India. There is also a lack of systematic data on how the performance of these tests varies across trimesters, despite clear evidence that insulin resistance increases progressively as pregnancy advances. This gap in evidence  particularly in the context of Indian tertiary care centres  formed the basis for the present study.

Objectives: We undertook this study to directly compare the diagnostic yield of GCT (DIPSI criteria), FBS, and PPBS for GDM detection across all three trimesters of pregnancy, and to examine how each test relates to maternal risk factors and antenatal complications.

Methods: A prospective and retrospective observational study was conducted among 130 pregnant women attending the obstetric OPD at SVS Hospital, Mahbubnagar, between August 2025 and January 2026. All participants underwent FBS, PPBS, and a non-fasting 75g GCT (DIPSI criteria) within their respective trimester. GDM was diagnosed at a 2-hour plasma glucose threshold of ≥140 mg/dL per DIPSI guidelines, with WHO 2013 criteria applied for comparison.

Results: GCT identified GDM in 13.8% of participants, compared to 10.8% detected by FBS and PPBS combined. A combined approach using all three tests yielded the highest detection rate of 16.2%. Mean glucose values rose consistently from the first to the third trimester across all three modalities. GDM prevalence was higher in older women, those with elevated BMI, and grand multipara. Antenatal complications occurred in 36.2% of participants, and GCT showed the strongest correlation with adverse outcomes among all three tests (r=0.63, p<0.01).

Conclusion: GCT outperforms FBS and PPBS as a standalone GDM screening tool and shows the strongest association with adverse antenatal outcomes. A combined screening strategy maximises case detection. Given the progressive rise in GDM prevalence across trimesters, repeat testing at each trimester is essential and should be standard practice. The DIPSI test, requiring no prior fasting, is well suited for routine antenatal care in Indian settings and deserves broader implementation.

Background: Fracture of the neck of the femur remains a challenging injury due to risks of non-union and avascular necrosis. In young and physiologically active patients, internal fixation is preferred to preserve the native femoral head. Dynamic Hip Screw (DHS) fixation provides controlled compression at the fracture site; however, rotational instability of the femoral head during and after fixation may adversely affect outcomes. Supplementation with a derotation screw has been advocated to enhance rotational stability.

Objectives: To evaluate the functional and radiological outcomes of fracture neck of femur treated with Dynamic Hip Screw fixation supplemented with a derotation screw and to assess associated complications.

Materials and Methods: This prospective study included patients with fracture neck of the femur managed with DHS and an additional derotation screw. Patients were followed up at regular intervals with clinical and radiological assessments. Fracture union, implant position, and complications such as non-union, avascular necrosis, and implant failure were documented. Functional outcome was assessed using a standard hip scoring system.

Results: In a total of 20 patients, fracture union is achieved in 19 patients (95%) of the patients, with a mean union time of 15 weeks. According to the Harris Hip Score, Functional outcome showed excellent to good results in 15 patients (75%) with a mean HHS of 86. Complications were observed in 10% of the patients, which included non-union in 1 patient (5%) and avascular necrosis in 1 patient (5%). Better functional and radiological outcomes were noted in Garden II & III fractures compared to Garden IV. DHS with a derotational screw provided improved rotational stability with no incidence of implant failure.

Conclusion: Dynamic Hip Screw fixation supplemented with a derotation screw is an effective and reliable method for managing selected fractures of the neck of femur. The technique provides enhanced rotational stability, satisfactory union rates, and favourable functional outcomes with minimal complications.

Introduction: Patients with pulmonary hypertension (PH) are affected by symptoms such as fatigue, weakness, shortness of breath, depression due to dependence on others, and limitations in daily life activities, etc.

Objectives: To study the factors that influence the quality of life (QoL) of patients with pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH).

Methods: This study employed a retrospective cross-sectional design using data from outpatient medical records of patients who attended the pulmonary vascular disease clinic (PVD Clinic) at a university hospital. The sample consisted of 78 patients aged 18 years and older who were diagnosed with PAH or CTEPH between January 2024 and December 2025. A questionnaire, consisting of three parts, was used as the research instrument: demographic characteristics, health assessment, and emPHasis-10, QoL assessment scale. Data analysis used descriptive statistics, including frequency, percentage, mean, and standard deviation.

Results: Patients with PAH had 64.1% and CTEPH had 35.9%. The assessment of patient QoL revealed that patients who underwent treatment over the 24-month period demonstrated a mean QoL score at a high level (M = 1.20, SD = 0.88). The factors that statistically significantly influenced QoL care among patients with PH (p < 0.05) included BMI, six-minute walk distance (6MWD), types of PH, physical limitation, Digoxin, and PAH-therapy. Collectively, these factors explained 28.8% (R² = 0.288) of the variance in patient’s QoL, with a standard error of the estimate of 2.79 (SEE = 2.79).

Conclusion: The identification of factors influencing QoL among patients with PH offers meaningful implications for the prevention and management of health problems from the initial stage of health assessment. Family members and healthcare professionals may utilize these findings to develop more effective healthcare strategies and policies. Ultimately, such efforts are expected to sustainably promote and enhance the QoL for this patient population.​​​​​​​​​​​​​​​​

Proximal tibial fractures, particularly Schatzker type V and VI, represent complex intra-articular injuries often associated with significant soft tissue damage and functional impairment of the knee joint. This prospective study evaluates the functional outcome of bicondylar plating in the management of such fractures.

A total of 30 patients aged 18 years and above with proximal tibia fractures (Schatzker type V and VI) were included and followed for a period of 24 weeks. Functional outcomes were assessed using the Oxford Knee Score, while pain was evaluated using the Visual Analog Scale (VAS). Radiological union and range of motion were also documented.

The mean Oxford Knee Score improved from 22.8 preoperatively to 37.0 at 24 weeks. Pain scores decreased significantly from a mean VAS score of 7.25 preoperatively to 2.15 at final follow-up (p < 0.001). The average time to radiological union was approximately 12 weeks. Functional outcomes were graded as excellent in 30% of patients, good in 66%, and fair in 4%. Minor complications such as superficial infections and stiffness were observed in a few cases. Bicondylar plating provides stable fixation, promotes early mobilization, and yields favorable functional outcomes in complex proximal tibial fractures. It remains a reliable and effective surgical option for Schatzker type V and VI fractures.