Advancing Solar Energy for Primary Healthcare in Developing Nations: Addressing Current Challenges and Enabling Progress Through UNICEF and Collaborative Partnerships.

This comprehensive document explores the intersection of Sustainable Development Goals (SDGs) and the global transition to renewable energy, with a particular focus on solar energy. The text emphasizes the critical role of reliable and sustainable energy, especially solar power, in achieving health-related SDGs, particularly in low- and middle-income countries (LMICs). It discusses the challenges faced by healthcare facilities in these regions, emphasizing the importance of uninterrupted electricity for critical medical equipment and services. The document highlights the increasing significance of solar energy globally and its potential to address challenges in the healthcare sector. The International Energy Agency's (IEA) estimation that solar photovoltaic (PV) energy has become the cheapest source of electricity is discussed, along with the World Bank's active role in supporting solar energy projects in developing countries. The document presents the current status of solarization, emphasizing the exponential growth of solar capacity and generation. It also discusses global initiatives such as Mission Innovation and the contribution of various international aid organizations, including Sustainable Energy for All (SEforALL), Power Africa, Lighting Global, SolarAid, UNDP - Solar for Health (S4H), and the World Bank. A significant portion of the document focuses on the role of solar energy in healthcare, detailing successful solarization projects in India, sub-Saharan Africa, and other regions. It addresses the challenges of implementing solar PV projects in healthcare facilities, emphasizing the importance of maintenance and proper management. The document also provides insights into the contributions of United Nations Children's Fund (UNICEF) in advancing solar-powered health systems, emphasizing its support to over 80 countries in solarization and off-grid energy solutions for healthcare. In conclusion, this article emphasizes the need for collaboration among international aid organizations, governments, and development partners to ensure universal access to reliable and sustainable electricity, particularly in healthcare facilities. It underscores the importance of long-term planning, sustainability, innovative business models, and awareness campaigns to achieve scalable and impactful results in the intersection of solar energy and healthcare delivery.

A prospective randomized study in 20 patients undergoing bilateral TKA comparing midline incision to anterolateral incision.

BACKGROUND: Lateral flap numbness is a known side-effect of midline skin incision in total knee arthroplasty (TKA) and a cause of patient dissatisfaction. Anterolateral incision is an alternative approach which preserves the infrapatellar branches of the saphenous nerve and avoids numbness. Studies have compared both incisions, but in different patients. However, different patients may assess the same sensory deficit dissimilarly, because of individual variations in anatomy and healing responses. We compared the two incisions in the same patient at the same time, using an anterolateral incision on one knee and a midline incision on the other knee in simultaneous bilateral TKA. Other surgical steps including medial arthrotomy were idential. We also correlated subjective and objective findings. MATERIALS AND METHODS: Twenty patients were prospectively randomized. Sensory loss and skin healing were assessed at 6, 12 and 52 weeks. Subjective preference for the knee with less numbness was charted on Wald's Sequential Probability Ratio Test. Sensation scores for touch, vibration, static and moving two-point discrimination were measured. Scar healing was evaluated using the Patient and Observer Scar Assessment Scale (POSAS). Functional scores were measured. RESULTS: A statistically significant difference favoring knees with anterolateral incision was observed in patient preference at all assessment points and this correlated with sensation scores. A statistically significant difference was observed in POSAS score favoring knees with anterolateral incision at 6 and 12 weeks which became statistically insignificant at 1 year. Functional scores remained comparable. CONCLUSION: We recommend anterolateral incision as a safe and effective method to circumvent the problem of lateral flap numbness with midline incision. LEVEL OF EVIDENCE: I.

Optimizing effectivity of tranexamic acid in bilateral knee arthroplasty - A prospective randomized controlled study.

INTRODUCTION: Tranexamic acid (TEA) is used in reducing surgical blood loss. Literature shows no optimal regimen recommended for Bilateral Total Knee Arthroplasty (TKA). We evaluated three TEA regimens differing in dosage, timing and mode of administration in bilateral TKA to identify the most effective regimen to reduce blood loss. METHODS: We prospectively studied three TEA regimens (25 patients each) as follows: (1) two intraoperative, intravenous doses (IOIO), (2) two intraoperative local applications (LALA), and (3) one preoperative plus two intraoperative, intravenous doses (POIOIO). Two independent parameters of drain loss and total blood loss, calculated by the hemoglobin balance method were statistically evaluated. RESULTS: Mean drain loss was least (412.9ml) in the POIOIO group, greatest (607.2ml) in the IOIO group and LALA group in between (579.4ml), with a statistically significant difference among them (p=0.0022). On paired evaluation, the drain loss in the POIOIO group was significantly less as compared to the other two groups, whereas the difference between IOIO and LALA was not significant. Mean total blood loss was least in the POIOIO group (1207ml) and greatest in LALA group (1270ml). The difference among the groups was not statistically significant (p=0.80). There was no incidence of any thromboembolic phenomenon. On correlation with our study on Most Effective Regimen in Unilateral TKA, both results were found to substantiate each other.

Effect of Preoperative Vitamin D Levels on Functional Performance after Total Knee Arthroplasty.

BACKGROUND: Low vitamin D levels affects muscle function. Vitamin D and calcium deficiency cause osteomalacic myopathy and poor functional recovery after hip fractures. The relationship of vitamin D and functional performance after total knee arthroplasty (TKA) is not previously reported. METHODS: Influence of vitamin D on functional performance before and after TKA was reviewed retrospectively in 120 patients. Of these, 64 had vitamin D deficiency (25-hydroxy vitamin D < 30 ng/mL) preoperatively. All 120 patients received vitamin D oral supplementation postoperatively. Functional parameters including Western Ontario and McMaster Osteoarthritis Index (WOMAC), Short-Form Health Survey questionnaire, and Knee Society Score were assessed pre- and postoperatively at 3 months. RESULTS: Preoperative function was significantly lower in osteoarthritic patients with vitamin D deficiency (WOMAC score; p = 0.040), but at 3 months all functional scores were similar. CONCLUSIONS: We concluded that vitamin D deficiency has a negative effect on function in knee osteoarthritic patients. However, postoperative vitamin D supplementation can lead to functional recovery in these patients. Thus, TKA should not be delayed in vitamin D deficient patients; rather supplementation in the postoperative period is preferable to achieve comparable functional outcome at 3 months to patients with vitamin D sufficiency.