Essential Medicines at the National Level : The Global Asthma Network's Essential Asthma Medicines Survey 2014

Patients with asthma need uninterrupted supplies of affordable, quality-assured essential medicines. However, access in many low- and middle-income countries (LMICs) is limited. The World Health Organization (WHO) Non-Communicable Disease (NCD) Global Action Plan 2013-2020 sets an 80% target for essential NCD medicines' availability. Poor access is partly due to medicines not being included on the national Essential Medicines Lists (EML) and/or National Reimbursement Lists (NRL) which guide the provision of free/subsidised medicines. We aimed to determine how many countries have essential asthma medicines on their EML and NRL, which essential asthma medicines, and whether surveys might monitor progress. A cross-sectional survey in 2013-2015 of Global Asthma Network principal investigators generated 111/120 (93%) responses41 high-income countries and territories (HICs); 70 LMICs. Patients in HICs with NRL are best served (91% HICs included ICS (inhaled corticosteroids) and salbutamol). Patients in the 24 (34%) LMICs with no NRL and the 14 (30%) LMICs with an NRL, however no ICS are likely to have very poor access to affordable, quality-assured ICS. Many LMICs do not have essential asthma medicines on their EML or NRL. Technical guidance and advocacy for policy change is required. Improving access to these medicines will improve the health system's capacity to address NCDs.Peer reviewe

Deficiency and Mixed Anemia

Background: Reticulocytes are the youngest erythrocytes released from the bone marrow into the blood and they circulate for 1 - 2 days before becoming mature erythrocytes. In literature, there were studies about reticulocyte parameters that could help in differentiation of iron deficiency anemia (IDA) from vitamin B12 deficiency anemia. However, in those studies there were no data about differentiation of mixed anemia (vitamin B12 deficiency and IDA). The purpose of this study is to explore a response to 'could reticulocyte parameters help in differential diagnosis of mixed anemia?' in 6 - 12 years old children.Methods: The study enrolled 26 patients with IDA, 22 patients with mixed anemia, 32 patients with vitamin B12 deficiency, and 32 age and gender matched healthy controls. Blood for hematological parameters such as complete blood count, reticulocyte count, CHr, MCVr, CHCMr were collected into standard tubes containing EDTA.Results: There is a statistically significant difference of both MCV (mean corpuscular volume)/MCVr (Reticulocyte mean corpuscular volume) ratio and MCVr between IDA and controls; in controls and vitamin B12 deficiency anemia; in controls and mixed anemia; in IDA and vitamin B12 deficiency anemia; in IDA and mixed anemia. Also in terms of both CHr and CHCMr (Corpuscular mean hemoglobin concentration of reticulocyte), there is a statistically significant difference between controls and IDA; controls and mixed anemia; IDA and mixed anemia; IDA and vitamin B12 deficiency anemia.Conclusions: In mixed anemia, MCV could be normal or decreased, and in peripheral blood smear erythrocytes cells could be morphologically normal. For this reason diagnosis of mixed anemia is not easy and needs additional laboratory investigations. Our results suggest that in a differential diagnosis of mixed anemia from vitamin B12 deficiency, IDA, and healthy controls, CHr, CHCMr, and MCVr (together with MCV and individually) could be useful. So, with a simple and cheap laboratory parameter, differentiation of mixed anemia could be done

A Case of Acute Lymphoblastic Leukemia with Isolated Orbital Relapse

Acute lymphoblastic leukemia (ALL) is the most common malignancy of childhood. Central nervous system is the most frequent place of both at the onset and relapse of the disease, but orbital involvement is rarely seen. A seven-year-old girl diagnosed with high risk ALL and Turkish ALL-Berlin Frankfurt Munster (BFM)-2000 high risk group treatment was given. However, after induction and consolidation treatments, before the maintenance treatment she had blindness in her right eye. Ophthalmologic examination her visual acuity was fingers to count in two meters. In her right eye there was exudative retinal detachment and her orbital magnetic resonance imaging (MRI) showed that, there was a mass lesion in the posterior of right orbital globe, on the neighbourhood of optic disc, consistent with metastasis. After ALL-REZ-BFM-2002 relapse protocol treatments and radiotherapy her visual acuity was increased to 6/10. In control orbital MRI regression of mass lesion size was established. Bone marrow transplantation was planned. Orbital involvement is rarely seen in leukemia, but it is responsive to chemotherapy and radiotherapy combination

From the Newspapers of Istanbul in Tanzimat Period the Newspaper Basiret, 1871: Assessment - Index

"Menâfi'-i vataniyye ve havâdis-i umûmiyeye dâir millet gazetesidir." İbaresi ile misyonunu en güzel şekilde ifade eden Basîret gazetesi, yayımladığı haberler ve haberlere ilişkin yazılan makaleler ve yorumlarla bu misyonunu gerçekleştirmek için uğraştığını göstermiştir. Basîret, yayınının ikinci yılı olan 1871 senesinde özellikle Prusya-Fransa Savaşı'nın sonuçları, Fransa Vukuâtı, İşkodra Vak'ası, Asîr Muzafferiyeti, şimendifer hatları yapımı, yapılan ıslâhâtlar, tenkîhâtlar ve İstanbul ile ilgili konuları günü gününe okuyucularına aktarmıştır. Bu çalışma ile adı geçen yıl ve konuların yanında gerek Osmanlı İmparatorluğu içerisinde ve gerek Dünya'da meydana gelen ekonomik, sosyal, politik, eğitim, askeri ve sağlık alanlarındaki gelişim ve değişimler tespit edilmeye çalışılmıştır. Bunun için de Basîret gazetesinin 1871 yılını ihtiva eden (281-557) nüshaları taranmıştır.The best phrase that can summarize the Basiret and its mission is; "It is a national newspaper which is about national benefits and general news". This is well documented with the publicated news and the related articles and opinions that try to accomplish that mission. In 1871 at the second year of its publication, the major topics that were published on daily basis were the consequences of France-Prussian War, Paris Events, Shkodra Events, the Victory of Asir, Chemin de Fer ( railway) construction, Reforms, Tenkihat (establishing a balance between revenue and expenses reducing wages and the number of officers in a state agency) and Istanbul. In this study, in addition to aforementioned years and events It is also examined developments and changes in the field of economics, social, political, educational system, military and health care systems inside of the Ottoman Empire and all over the World. Hence, It has been searched (281-557) issues of the Basiret newspaper that describes year 1871

Essential Medicines at the National Level: The Global Asthma Network's Essential Asthma Medicines Survey 2014

10.3390/ijerph16040605INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH16