An assessment of facility-based care of diabetes, hypertension, and heart failure across western Kenya

Background: Low- and middle- income countries account for three-fourths of the global non- communicable disease related mortality. In response to the increasing number of non- communicable disease diagnoses in Kenya, the government released a national strategy for non- communicable disease in 2015. The purpose of this study was to assess facility-based care of diabetes, hypertension, and heart failure across western Kenya.Methods: A 71-question cross-sectional survey was administered among facility-based healthcare workers in Siaya County, western Kenya, between October 2015 and January 2016. All Level 4 and 5 facilities, as well as a cohort of lower-level facilities were surveyed.Results: Of the 21 health facilities surveyed, six (31.6%) had specific non-communicable disease clinics. Eleven of the 21 (52.4%) facilities had glucometers, and providers indicated that even these glucometers were often not functional. Three of the 21 facilities (14.3%) had a diabetic registry, one a functioning electrocardiogram machine, and one other a congestive heart failure registry.Conclusions: Facilities at every level were lacking equipment and medications expected by the Kenya’s Essential Package of Health Services. Improvement for follow up and referral services could be achieved through the development of comprehensive non-communicable disease registries

Structure-activity relationships of 2,4-diphenyl-1H-imidazole analogs as CB2 receptor agonists for the treatment of chronic pain

 absen

Antiplatelet and antiproliferative effects of SCH 51866, a novel type 1 and type 5 phosphodiesterase inhibitor

SCH 51866 is a potent and selective PDE1 and PDE5 inhibitor. The antiplatelet, antiproliferative, and hemodynamic effects of SCH 51866 were compared with those of E4021, a highly selective PDE5 inhibitor. SCH 51866 inhibited PDE1 and PDE5 isozymes with a 50% inhibitory concentration (IC50) of 70 and 60 nM, respectively. SCH 51866 and E4021 inhibited washed human platelet aggregation induced by collagen with an IC50 of 10 and 4 μM, respectively, and attenuated (p < 0.05) the adhesion of 111indium-labeled platelets to the nylon filament injured rat aorta. The doses of SCH 51866 and E4021 that inhibited platelet adhesion caused significant increases in platelet cyclic guanosine monophosphate (cGMP; p < 0.05). SCH 51866 (1-10 mg/kg, p.o. twice daily) but not E4021 (3-30 mg/kg, p.o. twice daily) inhibited neointima formation in the carotid arteries of spontaneously hypertensive rats (SHRs) subjected to balloon angioplasty. Moreover, SCH 51866 (0.3-10 mg/kg, p.o.) elicited dose-dependent reduction in blood pressure in SHRs, whereas E4021 (3-30 mg/kg, p.o.) did not affect blood pressure in SHRs. In conclusion, the data suggest that inhibition of PDE1 and PDE5 isozymes by SCH 51866 exerts antiplatelet and vascular protective effects. In comparison, inhibition of PDE5 alone by E4021 exhibited antiplatelet effects without affecting neointima formation.link_to_subscribed_fulltex