MATERIALS AND METHODS: A prospective cohort study involving 240 patients undergoing mobile-bearing medial UKA was conducted. Group A (na=80) received postoperative correction of Vitamin D3 Deficiency (VDD), Group B (nb=80) received pre-operative correction of VDD, while Group C (nc=80) had normal Vitamin D3 levels to begin with (≥30ng/ml). Correction was done by three doses of intramuscular injection of 600,000 IU Arachitol® (Vitamin D3) given at an interval of one week each. All groups were matched for demography and outcome measures. The level of bone pain by checking for tibial shin tenderness quantified by the visual analog scale (VAS) and evaluated pre-operatively, and at 2, 4, 6 and 12 weeks post-operatively.
RESULTS: Group B and C showed similar post-operative trends and remained significantly superior to Group A till the 6th-week follow-up. The biostatistical difference between Group A and the other two groups started decreasing after the completion of post-operative correction regime as noticed on the 6th-week follow-up. By 12 weeks post-operatively, all three groups had similar levels of bone pain.
CONCLUSION: Vitamin D3 serves as an important preoperative investigation in patients undergoing UKA as it is a modifiable risk factor affecting post-operative bone pain. Its correction pre-operatively gives excellent post-operative pain control.
METHODS: We analyzed data from 91 seroprevalence surveys and sentinel surveillance among antenatal care clinic (ANC) attendees using model-based geostatistical methods to produce estimates of HIV prevalence across 43 countries in SSA, from years 2000 to 2018, at a 5 × 5-km resolution and presented among second administrative level (typically districts or counties) units.
RESULTS: We found substantial variation in HIV prevalence across localities, ages, and sexes that have been masked in earlier analyses. Within-country variation in prevalence in 2018 was a median 3.5 times greater across ages and sexes, compared to for all adults combined. We note large within-district prevalence differences between age groups: for men, 50% of districts displayed at least a 14-fold difference between age groups with the highest and lowest prevalence, and at least a 9-fold difference for women. Prevalence trends also varied over time; between 2000 and 2018, 70% of all districts saw a reduction in prevalence greater than five percentage points in at least one sex and age group. Meanwhile, over 30% of all districts saw at least a five percentage point prevalence increase in one or more sex and age group.
CONCLUSIONS: As the HIV epidemic persists and evolves in SSA, geographic and demographic shifts in prevention and treatment efforts are necessary. These estimates offer epidemiologically informative detail to better guide more targeted interventions, vital for combating HIV in SSA.