Background: Despite the burgeoning burden of diabetes mellitus (DM) and cardiovascular diseases (CVD) in low and middle income countries (LMIC), access to affordable essential medicines and diagnostic tests for DM and CVD still remain a challenge in clinical practice. The Access to Cardiovascular diseases, Chronic Obstructive pulmonary disease, Diabetes mellitus and Asthma Drugs and diagnostics (ACCODAD) study aimed at providing contemporary information about the availability, cost and affordability of medicines and diagnostic tests integral in the management of DM and CVD in Uganda.
Methods: The study assessed the availability, cost and affordability of 37 medicines and 19 diagnostic tests in 22 public hospitals, 23 private hospitals and 100 private pharmacies in Uganda. Availability expressed as a percentage, median cost of the available lowest priced generic medicine and the diagnostic tests and affordability in terms of the number of days' wages it would cost the least paid public servant to pay for one month of treatment and the diagnostic tests were calculated.
Results: The availability of the medicines and diagnostic tests in all the study sites ranged from 20.1% for unfractionated heparin (UFH) to 100% for oral hypoglycaemic agents (OHA) and from 6.8% for microalbuminuria to 100% for urinalysis respectively. The only affordable tests were blood glucose, urinalysis and serum ketone, urea, creatinine and uric acid. Parenteral benzathine penicillin, oral furosemide, glibenclamide, bendrofluazide, atenolol, cardiac aspirin, digoxin, metformin, captopril and nifedipine were the only affordable drugs.
Conclusion: This study demonstrates that the majority of medicines and diagnostic tests essential in the management of DM and CVD are generally unavailable and unaffordable in Uganda. National strategies promoting improved access to affordable medicines and diagnostic tests and primary prevention measures of DM and CVD should be prioritised in Uganda.
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http://dx.doi.org/10.1186/s12939-017-0651-6 | DOI Listing |
Discov Oncol
January 2025
Institute of Clinical Medicine, Surgery, University of Eastern Finland, Kuopio, Finland.
Purpose: This retrospective single-center study aimed to determine the correlation between The Paris System (TPS) urine cytology classification, cystoscopy findings, and non-muscle-invasive bladder cancer diagnosis. In addition, we sought to identify factors that might explain the abnormal cytology classification in cases in which no malignancy was detected.
Methods: A Total of 855 patients evaluated with urine cytology between 2017 and 2020 at Kuopio University Hospital were included.
BMJ Case Rep
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Pediatría, Hospital Universitario de Móstoles, Mostoles, Madrid, Spain.
Adnexal torsion is a rare cause of abdominal pain in middle childhood and, in general, the diagnosis is often delayed due to the lack of specificity of symptoms and imaging tests. We describe the case of a girl in middle childhood who came to the emergency department for pain in the right iliac fossa of approximately 15 hours of evolution associated with partial refusal of food intake and vomiting. The initial examination showed normal vital signs, a soft abdomen, pain on palpation in the lower region, but no signs of peritoneal irritation, a mild leucocytosis with no other signs of infection and the initial abdominal ultrasound showed no objective pathology.
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January 2025
General Internal Medicine & Infectious Diseases, Hiroshima Prefectural Hospital, Hiroshima, Japan.
Varicella-zoster virus (VZV) is a known cause of meningoencephalitis, typically in immunocompromised inpatients. We report a case of meningitis caused by VZV in an immunocompetent man in his 20s. Diagnosis was delayed due to the atypical presentation of painless occipital zoster mimicking atopic dermatitis, and the presence of hypoglycorrhachia in his cerebrospinal fluid.
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Department of Obstetrics and Gynecology, Sidney Kimmel Medical College at Thomas Jefferson University, 833 Chestnut Street, Philadelphia PA 19107.
Objective: To assess the perceived impact of state and institutional policies on managing pregnancies of unknown location (PUL) at U.S. Ryan residency programs.
View Article and Find Full Text PDFAutoimmun Rev
January 2025
Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. Electronic address:
Tuberculosis (TB), caused by Mycobacterium TB, is the most significant infectious cause of mortality across the globe. While TB disease can prey on immunocompetent individuals, it is more likely to occur in immunocompromised individuals. Immune-mediated inflammatory diseases (IMIDs) are a group of diseases (rheumatoid arthritis, inflammatory bowel disease, ankylosing spondylitis, psoriasis, hidradenitis suppurative, autoimmune blistering diseases, and others) where there may be a need for systemic immunosuppression to control the disease manifestations, treat symptoms and improve long term outcomes.
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