What are the challenges facing the development of effective vaccines against pathogens with hyper variable genome sequences?

“What is the point in constantly making new vaccines against the same infectious diseases?”

To answer this question, one must ask: ‘what makes for an effective vaccine?’

To explain this, it is important to recognise that a vaccine is simply an inactive form of a pathogen – the bacterium or virus which causes the disease – and the introduction of this vaccine containing the pathogen stimulates an immune response; which helps fight against the disease. At first glance, it seems an atrocious plan to purposefully sicken us, but the vaccination unsurprisingly, in actual fact, can introduce antibodies, as in passive immunity. Alternatively, they can stimulate the production of them from the individuals own immune system, in ‘active immunity’. One can easily recognise the importance of the antibodies in helping us from becoming bed-ridden or more seriously, they can save us from potentially, the verge of the ominous hazard that is, death.

Although, these antibodies work such that they each have unique binding sites, receptor-like, and the pathogen has ‘antigens’, which almost stick-out and form an identity for the pathogen. For an antibody to be work, its binding site must be of a complementary shape to the antigen, and thus they form an antibody-antigen complex. After forming this ‘complex’ by attaching to antigens, they destroy them, though the means by which they carry out this termination does vary.

However, this doesn’t address the question concerning why we need to make new vaccines for the same diseases. Thus, we need to consider antigenic variability, which is where pathogens essentially change their identity deeming them unrecognisable. This change was the change of antigens on the surface of the pathogen. The antigen no longer corresponded to the aforementioned antibodies, and the ‘complex’ could no longer be formed; thus an immune response would never arise. So, it can be established that a troublesome problem is the changing nature to some pathogens and their antigens, such as the influenza virus. Even more worrying would be the finding of a hyper variable sequence, found in the genome, which run in the nucleotides. Nucleotides are chemicals consisting of an organic base, sugar and a phosphate, and are the basic units of which the nucleic acids DNA and RNA are made. The hyper variable sequence would particularly raise concerns because they have a high rate of variation, though the rate of variation differs from one type to the next. Nonetheless, this stipulates that to form an effective measure against these sequences would also require a vaccine which is as ever varying as the pathogens in question.

Unfortunately, such a vaccine is not yet possible, at least now, within the current progress of research. There are many scientific challenges such as the variation which results in the ill-fated truth that an effective vaccine needs to be able to launch an all-encompassing response to all of the diverse strains of a pathogen with a hyper variable genome sequence. An insufficient knowledge about required immunity means that researchers face uncertainty about the parameters for ample immunity against both infection and disease, and so under current scientific knowledge, are simply unable to find a solution.

This lack of scientific knowledge isn’t helped by the social challenges which arrive in the form of ethical concerns surrounding the nature of human subject trials. It is important to acknowledge that though primate studies and computer models can be useful, they by no means provide as detailed a picture as human subject trials can. Nonetheless, in spite of the advantages, the complications appear, and one reason for the difficulties in carrying out human trials could be the volunteers being entitled to a host of treatments, not the vaccinations alone. They are to be made clear of possible adverse effects which the testing vaccination may have, and they are also to be told of the perils of seropositivity from immunisation. I am surprised to inform you that I had paid enough attention to tell you that seropositivity is merely a rather fancy word for one showing a high level of antibody. Such formalities hinder the progress of trials and consequently, the development of vaccines.

Vaccines have changed countless lives and inevitably will continue to do so in a world of advancing science. New opportunities will surface and many hurdles will be overcome; as has happened before in the past. Nonetheless, in the future, the current scientific challenges need to be overwhelmed and the development of vaccinations needs to include the production of vaccines which solve the impediments raised by the hyper variable genome sequence.

Do legal highs show up on drug tests ?

Are there drug testing kits for legal highs?

This is a very common question with the increased availability of drugs known as legal highs (now, in fact, illegal in the UK for just over 12 months) and also known as New Psychoactive Substances (NPS)

Drug test manufacturers are constantly bringing out new drug test kits that can detect these new drugs. The problem for the drug testing kit manufacturers is that as quickly as they bring out a new test, the drug manufacturers quickly try and alter the drug slightly to try to avoid it being detected on drugs tests.

However, we do now have reliable drug test kits available to purchase in the UK for the following new drugs ( NPS ):

drug testing kits for legal highs

MCAT drug test kit

  • MCAT also is known as Mephedrone
  • K2 also known as Spice
  • MDPV Bath Salts
  • Ketamine

Access Diagnostic Tests have been leading the way in the UK in bringing out a multi-panel urine drug test kit that detects these new drugs.

They can be purchased online at UK Drug Testing

Single-drug test cassettes are also available to detect

  • Mephedrone MCAT drug testing kits
  • K2 Spice drug testing kits
  • Ketamine drug test kit

How to do a ketone test to see if you are in ketosis

ketone tests trips uk

Ketone test strips are available to buy online in UK from Valuemed in canisters of 100 tests strips for under £5

How to do a ketone test on your urine

Simply collect a urine sample at any time of day. There is no need to wait for a first-morning sample or post meal, any time is good to start ketone testing. Collect the sample in any clean container, glass or plastic won’t affect the results. Open and remove an unused ketone test strip and immediately seal the pack. The colour on the pad should be a light fawn or beige tone which roughly matches the negative colour tone on the side of the bottle when dry, and should match the negative result immediately after wetting. Dip in the urine for 3 to 5 seconds, then remove and tap off any excess urine sample. If ketones are present in the sample, the pad will start to discolour towards a purple tone. ( the colour varies from brand to brand) Match the pad colour to the corresponding colour on the results chart at the specified read time and note the ketone level.

How do ketone test strips work

Ketone test strips use a simple chemical reaction that measures the level of one of the 3 ketone bodies, (bodies is a technical term for chemical structure type) produced when fats are being metabolised to produce energy. In healthy, non-dieting adults consuming a modern western diet energy is produced almost exclusively from glucose, with the excess being converted into glycogen or fat. Fat is hardly ever converted back to produce energy as there is almost always an excess of sugary carbohydrates being eaten.

What colour should ketone test strips be when in ketosis

A positive result for ketones in urine is shown by the pad on the strip changing colour. Most ketone test strips give a purple colour change and the degree of colour depth indicates the semi-quantitative level or amount of ketone in the urine. The higher the urine ketone level, the higher the blood ketone level when the urine was being produced by the kidneys.

How to tell if you’re in ketosis with strips

Ketosis in strict physiological terms is when the body is consuming and only burning fat as a primary source of energy. Ketone test strips only tell you when some fat is being used for energy. For most dieters this is all they need to know, it is a good indicator that the carbohydrate total calorie intake has been restricted to a level where the body has used all the available glucose and glycogen reserve and has switched to burning fat deposits. Getting into ketosis requires a much longer period of strict diet modification, moving to fat and protein as primary sources of energy.

Other signs you’re in ketosis

It is often described by dieters as ‘Ketone Flu’

Common symptoms include:

  • Fatigue
  • Nausea
  • Headaches
  • Cramps
  • Bad Breath
  • Poor sleep
  • Digestive upsets, most commonly constipation
  • Reduced exercise tolerance

And hopefully

  • Weight loss
  • Appetite Suppression

Once some of the symptoms of “Ketone Flu” subside, the urine ketone level will normally reduce once the body has adjusted to ketosis and the symptoms will often subside. It is normal to only measure trace or moderate urinary ketones. This occurs as the liver enzymes increase which converts more of the ketone body measured in urine to the energy producing ketone body used in the Krebs cycle for energy.

Ketone test strips for urine  and blood ketone meters can be purchased online in UK from Valuemed medical supplies

Conceive Plus 75ml lubricant

Conceive plus 75ml lubricant

Conceive Plus fertility friendly lubricant

Conceive Plus is a fertility friendly lubricant that has been designed for couples trying to conceive. It has been clinically proven to be nontoxic to sperm and can be safely used by couples trying to conceive. The lubricant has been designed to mimic fertile cervical mucus and to enhance lovemaking without harming or impeding the movement of sperm through the female reproductive system.

Many other intimate lubricants that are not fertility friendly can impede or damage sperm so it is important for a couple trying to conceive to only use a fertility friendly lubricant.

Conceive Plus is manufactured by Sasmar.

Buy Conceive Plus in the UK from Access Diagnostics

Other fertility friendly intimate lubricants include Pre-Seed fertility lubricant are also available to help you conceive.

Drug Testing Kits

drug testing kits urine

This is a drug testing kit for urine that detects 13 different drugs

Drug testing kits for urine and saliva are now available to screen for most drugs of abuse including many so-called legal highs (now actually illegal under the New Psychoactive Substances law. )

The drug testing kits are very simple to use and give rapid highly accurate results within minutes. They are particularly useful in a workplace setting where being under the influence of drugs or alcohol could endanger the worker or others working with them or members of the general public.

The cheapest and easiest form of drug testing kits are urine drug tests. These are very simple to administer and read. Saliva testing using an oral mouth swab is a slightly more expensive option, and it can sometimes be difficult to get an adequate sample if the person being tested has a dry mouth or is anxious. Oral drug tests are popular with employers, as the chain of custody is much simpler as you can be sure that the sample that you have is from the person being tested.

For more information or if you require any help or advice on choosing drug and alcohol testing kits visit UK Drug Testing 

Medical Student Discounts

student discounts medical equipment

Student discounts available

We know how expensive being a student is these days and with this in mind Valuemed medical supplies do offer student discounts. To obtain a student discount coupon for your university or college to spend on medical equipment or supplies please e-mail us as marketing@adtuk.co.uk with the details of your college or university,  so that we can set a discount code up for you.

In the meantime you can use 5% discount coupon code AUT until the end of January 2017.

Home testing kits for diabetes

With the increase in the number of diabetics diagnosed in the UK and the surrounding publicity in the press in recent years, there has been an increasing demand for home testing kits for diabetes.

Can you test for diabetes at home?

Diabetes can be easily and quickly screened for at home using a urine test strips that detect glycosuria (glucose in the urine ) which is a sign of diabetes.

The presence of glucose in the urine is not a normal finding, and if detected in a non-diabetic means a trip to the doctor for further tests.

You may not have any symptoms and the urine test may be the only indicator of diabetes.

Type 1 diabetes

Type 1 diabetes can develop quite quickly and usually presents with some or all of the symptoms below, though not always. It is most commonly presents in children or young adults.

  • increased thirst
  • increased urination (passing increased volumes of urine or having to urinate more frequently )
  • unexplained weight loss
  • increased hunger
  • fatigue
  • slow healing or increased infections
  • recurrent thrush
  • blurred vision
  • dry mouth

Type 2 diabetes 

In type 2 diabetes the onset is often more gradual and symptoms less severe. Weight loss is not usually a feature of type 2 diabetes. Because the onset is so gradual you may not realise that you have it until it is picked up on a urine test or blood test at the doctor’s. It is much more common if you are overweight. It may also present with any of the symptoms above though not usually weight loss.

How do you test for diabetes at home?

Home diabetes testing kit

Diabetes urine test strips

Collect a urine sample ideally about 2 hours after you have eaten but screening may be carried out at any time of day and dip the glucose test strip into the urine sample and wait the allotted time to read the result. If glucose is detected the pad on the urine test will change colour and give you an indication of how much sugar has been detected in the urine.  The test is very quick and easy to perform and gives immediate results making it very easy to screen your whole family for diabetes regularly.

What to do if the diabetes home test is positive?

If the test is positive or if you have symptoms that suggest you may have diabetes, then you need to make an appointment to see your doctor as soon as possible for further investigations. Do not put it off as it is important to diagnose and treat diabetes quickly to prevent complications.

Buy home testing kits to screen for diabetes online from Valuemed

If you are diagnosed as diabetic by your doctor it is very helpful to get a buy a blood glucose meter as this enables you to monitor the glucose levels in your blood and aim to keep them within target levels. Blood glucose meters are available to purchase from Valuemed Medical Supplies

FED Blood Glucose meter

Blood Glucose Meter

Workplace drug testing kits

Workplace drug testing is on the increase in the UK, and drug testing kit manufacturers are offering an increased range of instant near patient drug testing kits for both urine and saliva to meet this increased demand.

Problems with drugs and alcohol are responsible for poor performance at work, days off sick, and they are also implicated in  a very large proportion of workplace accidents. As an employer you have a duty of care to make the workplace as safe as possible. being under the influence of drugs and or alcohol at work, has implication for the health and safety of not only the individual using them , but also for other members of staff and the general public who come into contact with this employee.

Oral fluid saliva drug testing kits

workplace saliva drug and alcohol testing kits

Saliva drug and alcohol testing kits are ideal for workplace drug testing

The range of saliva drug test kits has increased markedly in the last 12 months with manufacturers now offering up to 12 drug screens including alcohol in one test. These 12 in 1 test kits offer businesses a very comprehensive drug and alcohol screen.

Urine drug testing kits

drug testing vkitsworkplace

Workplace drug & alcohol testing kits

Urine drug test kits are also a popular choice for many companies, as they are far cheaper than an equivalent oral fluid drug test kit, and also offer comprehensive drug screening, and come in a range of drug options.

Visit UK Drug Testing to see our recommended drug testing kits for workplace drug testing

GP’s are well placed to offer occupational drug testing either as part of an employment or pre-employment medical, or on request by companies or individuals. Many occupational health providers already offer drug testing, but as demand for workplace drug testing increases the number of service providers will also need to increase. Many UK companies are already doing there own in house drug & alcohol testing, or are using outside providers to come onsite and perform the tests for them. It is important to remember that onsite tests are screening tests, and that any positive test should be confirmed with a laboratory GCMS urine test with full chain of custody.

If you require any help or advice on choosing and using workplace drug testing kits contact UK Drug Testing  or telephone 01263 731 168 during office hours Monday to Friday 8.30am to 4.30pm

Alzheimers disease

Alzheimer’s disease is one of the most common diseases of the brain and whilst we may not yet have any decent therapies for preventing its progression, our understanding of its pathogenesis is growing and it seems likely that soon new pharmacotherapies will arrive. In this article I want to describe the process that leads to neurodegeneration in Alzheimer’s disease in all its gruesome biochemical detail and then highlight the points where future drugs may act.

So what causes Alzheimer’s disease? Well the only currently used method to diagnose a case of dementia as Alzheimer’s disease is post mortem histology (how jolly). If you look at the brain tissue of someone who had Alzheimer’s disease under the microscope, you see two characteristic features. The first is something called extracellular Amyloid Beta plaques.  These are effectively lumps of gunk amongst the neurons. The second key feature is that amongst the normal looking neurons you will see some neurons which have massively distorted cell bodies, which are bursting full of tiny fibres. These cells are known as neurofibrillary tangles. The Amyloid Beta plaques and Neurofibrillary tangles are the pathognomonic features of Alzheimer’s disease and are believed to be responsible for the cognitive and memory losses seen in people with Alzheimer’s disease.

I now want to try and explain what we know about where the Amyloid Beta plaques and Neurofibrillary tangles come from. It all starts with a protein called Amyloid Precursor Protein or APP for short. You can visualise APP as a rod. Now APP is usually cut in half by an enzyme called alpha Secretase. Now this is the good pathway. Indeed the two products as far as we know don’t cause any problems. However there is another enzyme given the fantastic name Beta Secretase, which again cuts the enzyme into two but it cuts it off centre so that one fragment is longer than it would be when alpha Secretase does the cutting and the other fragment is shorter. The fragment which is now shorter, which is called the sAPP for secreted Amyloid Precursor protein, doesn’t cause a problem. But the fragment which is now longer does. This longer fragment can be cleaved into two pieces again, by yep you’ve guessed it gamma Secretase and one of the final fragments it produces is the nasty bit which is going to form the Amyloid Beta plaques.

Now gamma Secretase can actually cut this final fragment in one of two places. If it cuts in the first place it produces Amyloid Beta 40 protein fragment along with a second piece that we’re not interested in. And if it cuts at the fragment at the second of the two places it produces a slightly longer fragment called Amyloid Beta 42 along with a slightly shorter second piece. It is these two proteins Amyloid Beta 40 and 42 which aggregate together to form Amyloid Beta plaques. It is speculated that Amyloid beta plaques form throughout your life and you only get symptoms of Alzheimer’s disease once you have enough neurodegeneration for deficits to begin. The tendency of Amyloid Beta 42 to form plaques is slightly greater than that of Amyloid beta 40. Hence the gamma Secretase enzyme which your body produces may determine whether you get Alzheimer’s disease in your life or not, since if your enzyme prefers to cleave at the second site over the first you will accumulate plaques quicker.

The first thing to say is that we could use this to diagnose someone with dementia with Alzheimer’s disease whilst they were alive. Indeed by taking a lumbar puncture and measuring levels of Amyloid beta 40 and 42 you could make that diagnosis. However this is not currently done because knowing that this process is the cause of their dementia would not effect the treatment that they receive. This is because at present all drug treatments is symptomatic rather than actually preventing the progression of the disease. It is hoped that in the future we will have drugs which can actually prevent the aggregation of Amyloid Beta 40/42 to form Amyloid Beta plaques. Current drugs which are not yet approved for human used which w believe do this are cyclohexanehexols, tramiprosate and Solanezumab. Solanezumab is a fully humanized monoclonal antibody (that’s what the umab on the end of its name means) which binds to Amyloid Beta 40/42 to hopefully prevent them aggregating. Unfortunately its recently failed phase 3 drug trials.

Ok so that is where the Amyloid Beta plaques come from, what about the Neurofibrillary tangles? Well the tangled fibres within neurofibrillary tangles are a protein called tau protein, more specifically they are phosphorylated tau protein. It is this phosphorylation which allows them to aggregate together in the way that they do within neurofibrillary tangles. When amyloid Beta plaques start forming it is speculated that their presence activates other enzymes called kinases, which add this phosphate group onto the tau proteins. Hence it is believed that the neurofibrillary tangles form as a result of the Amyloid Beta plaques.

Valumed Coupon Code

Valumed UK medical supplies online

Just a quick post to remind you to use 5% discount coupon code ADT before the end of January 2016 at UK medical supplies website Valuemed

The discount can also be applied at drug and alcohol testing kits website UK Drug Testing

Delivery is free when you spend over £25 at Valuemed, and when you spend over £75 at UK Drug Testing

What is Gout & can you test for it at home ?

Uric acid meter UK

Monitor uric acid levels at home with the Easylife meter

Gout is a painful condition affecting muscles and joints. It is relatively common and can affect up to 25% of western populations during their lifetime.

Elevated levels of Uric Acid, also known as Urate can crystallise in sold tissue around joints and also in the fluid lubricating joints leading to painful inflammation and eventually arthritis.

Until now the diagnosis of gout has depended on hospital laboratory whole blood analysis, but there is now a handheld digital uric acid meter available giving doctors and patients the ability to test a tiny finger prick sample of blood accurately for uric acid levels.

The digital uric acid meter is distributed by Valuemed in the UK and also tests cholesterol and blood sugar levels. The uric acid meter kit is supplied with a comprehensive easy to follow manual and separate test strips for Uric Acid, cholesterol and glucose. lancets and an auto-lancing device also come with the starter pack. the lancing device is a sprung auto-lancer, so taking a finger prick sample is automated for anyone who may be squeamish about needles.

Testing for gout and monitoring levels during an attack or between episodes is now available as a home test option for thousands of patients affected by this condition. The Easylife uric acid meter is also certified for clinical use by doctors, so it is expected to also find use in outpatient departments and casualty departments where it will come into its own during out of hours consultations, where access to lab services are further restricted.

The price for the 3 in 1 meter is expected to be below £40 and the refill packs of Easylife gout meter test strips well below £1 per test, with the glucose option expected to be even cheaper per test.

Best reflex hammer for medical students

This reflex hammer from Valuemed is both a queens and a babinski reflex hammer

This reflex hammer from Valuemed is both a queens and a babinski reflex hammer

We are often asked the following question: Which is the best reflex hammer for medical students?

The standard traditional choice has always been the Queens reflex hammer. The Queens hammer is a standard round-headed hammer, usually with a metal head (for weight) surrounded with a firm rubber tyre like ring. The head is fixed at 90 degrees to the handle, which is usually plastic or metal with a pointed tip for neuro pressure examinations. Ward reflex hammers are usually long handled 30 to 38cm which make them too long to fit most pockets but a short handled 21cm Queens reflex hammer is available which is perfectly adequate for examination, but also much more practical for white coat pockets or GP bags.

So our first choice for function and cost is a 21 cm Queens reflex hammer.

For a little more, the options offered by the telescopic Babinski Queens hammer give greater examination options and is a more robust reflex hammer. A metal telescopic extending handle (with the point) extends from 21cm to 36cm, giving a full-size hammer option as required. The metal and rubber head unscrews from the handle and can be attached at 90 degrees as in a traditional Queens, or in line with the handle, giving an inline hammer similar to the Taylors reflex hammer arrangement. Look for models which un-screw rather than twist and lock, as the latter tend to loosen as they get older, leaving the head dangling, loose on a metal stick (not great and not useful)

Finally, if you want something functional, practical and unbreakable go for a good old Taylor reflex hammer. Steel handle holding a firm plastic triangular head. No moving parts, basic and functional.

If you still can’t decide consider the full reflex hammer pack, with everything you are likely to ever need in a neurology examination.

There are a range of reflex hammers in different sizes and makes available to buy in the UK from Valuemed medical supplies including Queens, Babinski, and Taylors reflex hammers.


New roadside drug testing for drivers in the UK came into force 2nd March 2015

Saliva drug driving test kit screens for Cannabis, Cocaine, Opiates, Amphetamine, Methadone and Benzodiazepines

Saliva drug driving test kit screens for Cannabis, Cocaine, Opiates, Amphetamine, Methadone and Benzodiazepines

The big news story this week has been the introduction in the UK of new rules that enable the police to perform roadside drug tests on drivers.
The new regulations came into effect on the 2nd March 2015 and allow the police to perform a roadside drug test using a saliva drug testing kit on motorists that they believe to be under the influence of drugs.

If the driver tests positive with the mouth swab drug testing kit the police will then take them back to the police station for further testing.

The penalties if you are found guilty of drug driving are similar to those for drink driving. This new test will make it much easier for the police to test drivers whom they suspect of driving while under the influence of drugs. Some of the drugs being tested for are prescription drugs including a group of drugs known as benzodiazepines which include amongst them Temazepam, Diazepam, and Lorazepam. Drivers may also be tested for Opiates and Methadone as well as Cannabis, Cocaine & Amphetamine.

For more information or to buy oral drug testing kits that screen for the drugs that are tested for on a drug driving drug tests visit UKDrugTesting.co.uk

Drug Testing Kits Saliva

Swab cube saliva drug testing kit

Swab cube saliva drug testing kit

Drug testing kits for saliva also called oral drug testing kits are becoming increasingly popular as more employers use onsite drug testing to screen employees for drug use and in particular being under the influence of drugs at work.

The introduction in March of the new drug driving law will see the police in the UK also using saliva drug test kits to screen motorists at the roadside.

The advantages to saliva drug testing are that it can be done anywhere and does not require the individual being tested to use a toilet to provide a urine sample so saliva drug testing kits are particularly popular for testing at building sites, roadsides, tracksides and for post-incident drug screening.

It is important to remember when performing a saliva drug test that adequate saliva needs to be collected on the mouth swab to run the test correctly. The more drugs that the individual oral drug test kit screens for, the more saliva that is required to perform the test. It is not merely a quick wipe around the mouth. This means that a 12-panel saliva drug test will require more saliva then say a 6-panel saliva drug test.

The range of saliva drug testing kits available has increased markedly this year and so employers now have a choice of which kits to choose and which drugs to test for.

If you need help deciding which is the best saliva drug testing kit for your company or business please contact us and we will be happy to advise.

For more information on saliva drug testing kits or to buy online visit UK Drug Testing

Ketone Test Strips & Dieting

Mission urine ketone test strips

Mission urine ketone test strips

We have had a rush on ketone test strips after the recent BBC Horizon programme “Which diet is right for you’ aired earlier this month.

In the programme they showed some of the dieters who were following one of the diets using ketone test strips to check their urine for ketones. The presence of ketones in the urine when you are dieting is an indication of ketosis & that you are burning fat.

This can help to motivate the dieter to stick to the diet. Other popular diets that use ketosis test strips are the Atkins diet and other low carbohydrate diets.

Buy ketone test strips online in the UK from Valuemed

Recruiting Guest Bloggers For Medical Blog -Would you like to guest blog on this site

We are currently recruiting guest bloggers for this medical blog.

If you are working in a field of medicine or alternative medicine or if you are a medical student or student studying medicine or a related subject and would like to guest blog for this medical blog then please get in touch to kate@adtuk.co.uk or simply register and post in comments and we will contact you.

If you are planning to apply for medical school we would also love to hear from you as we have and many student bloggers who have gone on to study at medical school. Many of them have found that writing blogs a helpful way to increase their knowledge of areas of medicine and to share it with others. Some have written about their experiences of applying to for medicine.



Describe the components of an atherosclerotic plaque, indicating the factors which lead to plaque formation. Why are such lesions a threat to health?

Atherosclerosis is one of the major diseases of the western world. Indeed it is estimated that 50% of people in the western world die of atherosclerosis related complications. Atherosclerotic plaques consist of both an atheromatous component and a sclerotic component. The atheromatous component is a lipid core at the centre of the lesion which contains lipid filled cells called foam cells and crystals of free cholesterol. The sclerotic component consists of a tough fibrous cap which develops over the lipid core.

The Lipid core and its pathogenesis

The best theory of why atherosclerosis occurs is that of continued damage. The hypothesis is that prolonged and continuous damage to the endothelial lining of a blood vessel is what starts the process. When the endothelial cells become damaged they allow lipoproteins in the blood plasma called LDL to cross into the subendothelial space, which is the space in tunica intima between the basement membrane of the endothelium and the internal elastic lamina. In addition they start expressing surface molecules to which leukocytes and platelets can bind. The specific leukocytes which are very important in atherogenesis are monocytes. These monocytes bind to the surface molecules and translocate into the subendothelial space becoming macrophages.

The macrophages start releasing inflammatory cytokines and importantly oxidising agents. The inflammatory cytokines act as chemotaxic agents drawing more macrophages and other inflammatory cells into the atherosclerotic lesion. Whilst the oxidising agents convert the LDL molecules into oxidised LDL.

Macrophages have an uptake mechanism for LDL called the scavenger receptor pathway. In this pathway macrophages absorb LDL and store it within their cytoplasm. Molecules of oxidised LDL have a particularly high affinity for this pathway. Hence macrophages end up taking up a huge amount of this oxidised LDL. When looked at under the microscope these LDL filled cells look foamy and are hence referred to as foam cells. In addition the oxidised LDL is toxic to the macrophages which ingest it, so many of them undergo necrosis and release the lipid that they were storing into the subendothelial space. This free lipid, which in particular contains large amounts of cholesterol forms crystals in the subendothelial space which are again visible under the microscope. These are two of the main features of the lipid core of atherosclerotic plaques, i.e. the macrophages which have converted into foam cells along with deposits of free cholesterol.

The Fibrous cap

The damaged endothelial cells also start secreting growth factors such as endothelial derived growth factor (commonly referred to as EDGF). They also express a surface membrane protein called Von Willebrand Factor on their luminal membranes. Thrombocytes in the Blood adhere to this Von Willebrand factor and when they do they start secreting Platelet derived Growth factor (PDGF). Both of these growth factors diffuse into the artery wall, through the tunica intima to the tunica media. Here they trigger activity in the smooth muscle cells. They cause smooth muscle cells to dedifferentiate and digest away their contractile infrastructure. These modified cells then migrate along the chemotaxic gradient towards the source of the growth factors. Hence they migrate to just under the basement membrane of the endothelial cells of the blood vessel, i.e. over the lipid core. Some of the smooth muscle cells don’t make it all the way to the endothelium and instead end up absorbing LDL and converting into foam cells.

Once they arrive there, they begin fibroblast like behaviour. They proliferate to make a covering of these dedifferentiated smooth muscle cells over the lipid core and they also start secreting extracellular matrix proteins, such as collagen. Hence a fibrous layer containing these cells forms over the lipid core and this covering is known as the fibrous cap.


Another central feature of atherosclerotic lesions and one that is important with regards to the complications of atherosclerosis is Neovascularization. Indeed the damaged endothelial cells also start secreting vascular endothelial growth factor (VEGF), which causes the growth of new blood vessel towards the site of the cells which secrete it. Hence blood vessels present in the tunica adventicia, called vasa vasorum, begin to grow branches into the deeper layers of the blood vessel towards the atherosclerotic plaque. Eventually these blood vessels reach the plaque and they typically grow into the shoulder of the plaque. The shoulder refers to the periphery of the plaque, i.e. where it borders with the healthy endothelium.

Risk factors for atherosclerosis

The four main risk factors for the development of atherosclerotic lesions in the walls of your arteries are hypertension, smoking, diabetes mellitus and hyperlipidaemia and we will now address each of these in turn.

Hypertension means too high mean blood pressure. If your blood pressure is too high then your endothelial cells are constantly being exposed to a very large strain. So they are more likely to get damaged and activate the inflammatory response which leads to the formation of an atherosclerotic plaque. This is demonstrated by the fact that the most common site for atherosclerosis to occur is the posterior wall of the abdominal aorta. The pressure that the endothelial cells of the aorta have to endure is very large, because the aorta is the first blood vessel off the heart. But in addition this site is particularly at risk of damaged because it sits anterior to the vertebral column, so every time the heart beats blood is crushing the posterior wall of the aorta against the solid vertebral column and this leads to endothelial damage. If your blood pressure is raised then this crushing will be worsened.

Cigarette smoke contains a huge number of toxins, which the smoker and anyone unfortunate enough to be in their presence breathe in. These chemicals diffuse across the alveolar membrane and into the blood stream. Here they can lead to the damage of the endothelial cells.

In people who suffer from Diabetes mellitus, the blood glucose levels are often unstable and can reach dangerously high levels (hyperglycaemia), because of the lack of control by insulin. These elevated blood glucose levels can directly damage endothelial cells and begin the process of atherosclerosis. Diabetics are particularly at risk of getting atherosclerotic plaques developing in the popliteal arteries in the legs.

Finally Hyperlipidaemias result in much higher blood LDL levels. This means that if the endothelium does become damaged then more LDL will move into across the damaged endothelium into the subendothelial space and the resulting atherosclerotic plaque will be worse than if lipid levels were normal. People who are obese often have extremely high blood lipid levels as well as hypertension and are thus at high risk of atherosclerosis.

Complications of atherosclerosis

There are many ways in which atherosclerosis can lead to complications. Firstly the lesion can lead to stenosis or worse occlusion of blood vessels. It can do this in three ways; either the plaque can gradually grow and narrow the lumen. Or the plaque can ulcerate and then thrombosis can occur on the exposed surface. The resulting thrombus then limits blood flow through the vessel. Or the newly formed blood vessels in the shoulder of the plaque can rupture and lead to intraplaque haemorrhage. This leads to the lipid core swelling as it fills with blood and this swollen lesion can then limit blood flow.

The formation of an atherosclerotic plaque in the aorta is not going to significantly reduce blood flow through that vessel because the aorta is so large. But the second most common site for atherosclerosis to occur is within the coronary arteries and the fourth and fifth most common sites are the carotid arteries and the arteries of the circle of Willis respectively. These arteries have much smaller lumen and the presence of a growing atherosclerotic plaque can seriously limit blood flow to the heart and brain. Hence atherosclerosis in this way can lead to exertional angina pectoris and potential myocardial infarction. Or if the stenosis occurs in an artery supplying the brain then it can potentially lead to occlusive stroke.

The second major complication of atherosclerotic plaques is that they can ulcerate, which is where the fibrous cap becomes detached from the atheromatous portion of the lesion. The process of thrombosis commonly occurs on the exposed surface of the lesion and a thrombus hence forms. As previously discussed this then leads to the stenosis or potentially occlusion of the blood vessel and will result in ischemia and maybe infarction of the tissue which that blood vessel supplies, with serious consequences if it is the brain or the heart. However, another complication is that the thrombus can throw off thromboemboli which can circulate and lodge in other blood vessels. Commonly they lodge in pulmonary vessels causing a pulmonary embolism.

Finally, another complication is that atherosclerosis can lead to aneurysmal dilatation. The atherosclerotic plaque severely weakens the wall of the blood vessel on which it is established and if the blood vessel is under very high pressure from the blood, such as the aorta, this can lead to the blood vessel dilating to a massive size, such as is the case in a triple A. If this ruptures it can lead to major internal haemorrhage and death.


Atherosclerosis is dangerous and very common. By the late teenage years, individuals will have fatty streaks on their aortas, which are speculated to be the forerunners of atherosclerosis. Regular exercise and a healthy diet are thought to lower your risk for developing full-blown atherosclerotic plaques and there is a considerable body of evidence that moderate consumption of resveratrol in red wine also helps.

A blood cholesterol test meter to monitor cholesterol level can be purchased online from Valuemed

Compare and contrast the role of endothelial cells and platelets in haemostasis and coagulation

Haemostasis is the process by which blood vessels with a hole in them produce a stable plug to fill in the hole and prevent haemorrhage. Coagulation is the process by which a soluble protein called fibrinogen, produced by the liver and normally present in the blood is converted into insoluble polymers of fibrin monomers. These fibrin polymers are interwoven into a plug to increase its stability. Both endothelial cells and platelets have essential roles in the processes of haemostasis and coagulation. But as we shall see the role of endothelial cells is more in signalling the need for the formation of a haemostatic plug, whilst platelets actually form the haemostatic plug.


The Primary Haemostatic plug

Healthy endothelial cells are incredibly important for preventing the formation of a haemostatic plug in a healthy blood vessel. But if for some reason the endothelial cells are damaged then a primary haemostatic plug forms. When endothelial cells are injured the collagen of the basement membrane of the endothelial cells and the collagen of the extra cellular matrix (depending on how severe the injury is) are exposed on the luminal surface of the blood vessel. In addition the injured endothelial cells begin to produce and secrete a protein called Von Willebrand factor onto the surface of the exposed collagen where it binds. Platelets, also called thrombocytes which are in the circulation possess a surface glycoprotein called gp1B which will bind to the Von Willebrand factor. Hence a layer of platelets will form over the exposed collagen. This is known as platelet adhesion.


In addition the exposed collagen will activate the platelets and cause them to secrete granules which are stored in their cytoplasm. These granules contain many substances but some particularly important ones are Thromboxane A2, Serotonin (also called 5-Hydroxytryptamine) and ADP. Both Thromboxane A2 and Serotonin are vasoactive and produce vasoconstriction of the arterioles leading to the damaged blood vessel. Hence less blood will be reaching the damaged wall and this will help to reduce blood loss due to the injury. Similarly injured endothelial cells also take action to try and reduce blood flow to the affected area, but rather than producing a vasoconstrictor, they instead stop secreting the vasodilator Prostacyclin.


The final of the products that platelets release is ADP. Platelets have on their surface receptors for ADP and when ADP binds to this receptor it activates the platelet. Activated platelets will then bind to other platelets; specifically they will bind to the platelets which have formed a layer over the exposed collagen, to produce a multilayered structure of platelets. This structure is known as the primary haemostatic plug. The antithrombotic drug Clopidogrel works by binding to the receptor for ADP on the surface of platelets and not stimulating it, i.e. it is an antagonist and simply prevents ADP binding and activating the receptor.


Overall with regards to the formation of the primary haemostatic plus we can see that platelets and endothelial cells have vastly different functions. The platelets actually form the structure which will plug the hole. Whilst endothelial cells are essential for preventing the formation of such a structure in healthy blood vessels and ensuring that it is only produced at sites of injury. So their role is more in coordinating haemostasis.




The purpose of the coagulation cascade is to transform the primary haemostatic plug into a secondary haemostatic plug. A primary haemostatic plug as previously described consists of a multilayered structure of platelets. Whilst a secondary haemostatic plug is a multilayered structure of platelets but with a dense meshwork of fibrin between the platelets holding them in position. The secondary haemostatic plug is far more stable than the primary haemostatic plug and prevents haemorrhage more effectively.


In order to produce such a dense meshwork of fibrin it is necessary to turn fibrinogen which is a soluble protein in the blood plasma into these fibrin strands. The enzyme which converts fibrinogen into fibrin monomers is called Thrombin and the inactive precursor of thrombin, called Prothrombin is constitutively present in the blood plasma. Another enzyme called Factor XIIIa then converts the fibrin monomers into Fibrin strands. Hence in order to produce the fibrin strands it is necessary for Prothrombin to be converted into thrombin and the series of reactions by which this conversion occurs is known as the coagulation cascade.


Similarly to in the formation of the primary haemostatic plug it is the damaged endothelial tissue which starts the coagulation cascade. Damaged endothelium does this in two ways. The first way is through the intrinsic pathway, when there is damage the protein HMW kinin, standing for heavy molecular weight kinin is produced. This converts factor XII into XIIa. The activated factor XII then in turn activates XI to XIa and XIa activates IX into IXa. Then comes the important stage which is the activation of factor X. Factor X is activated by factor IXa, but it must be in the presence of factor VIIIa, calcium and phospholipids. This is important because it is the activated platelets which release calcium ions and it is also the platelets which act as a surface of phospholipids on which this reaction can occur. Hence this stage means that the coagulation cascade can only occur on platelets surfaces, i.e. it ensures that the fibrin is going to be produced in the primary haemostatic plug.


Factor X has two stages of activation. The first we have just seen and the second is done by Factor Va. Once factor X is activated to factor Xa, it will catalyse the conversion of prothrombin to thrombin and hence coagulation can begin. Thrombin then further activated factor V to Va to produce a positive feedback loop.


The second pathway by which endothelial cells can activate the coagulation cascade is through the extrinsic pathway. In this pathway, the endothelial cells along with any damaged cells in the interstitum underneath produce a protein called tissue factor. Tissue factor converts factor VII to factor VIIa and factor VIIa can undertake the first portion of factor X activation. Again though this transformation must take place on a phospholipids surface and in the presence of calcium, which helps to ensure that fibrin deposition occurs actually within a primary haemostatic plug and not just in the free circulation.



Overall we have seen that in both the formation of the primary haemostatic plug and its conversion to a secondary haemostatic plug, via the coagulation cascade, endothelial cells have a regulatory function. Indeed they help in both cases to ensure that both processes only occur when there is damage. They do this by preventing exposure of the underlying collagen in the case of platelet adhesion and by expressing surface molecules like Antithrombin which inactivates thrombin in the case of coagulation. Platelets on the other hand play a more active role in the case of primary plug formation, since they are the structures which will actually bind together to form the plug. With regards to coagulation they are more similar to endothelial cells and play a guiding role, i.e. they ensure that fibrin deposition happens at the correct site.

Drug Testing Kits-latest discount coupons

Use 5% discount coupon ADSUM to save 5% every time you order drug testing kits this summer at the following websites.




Coupon code may be used multiple times. One coupon is applied per order. Coupon must be used at the time the order is placed.

Coupon active until end of August 2014

Wholesale professional drug testing kits & supplies

Instalert professional drug testing kits

Instalert professional drug testing kits

Professional drug test kits by InstAlert, manufactured by Alere, one of the worlds largest biotech companies are available wholesale in the UK in professional CE packs of 40 cassettes and 50 strip tests and 25-panel test for multiple drug group screening.

Individual packs of these very reliable & accurate professional drug test kits are available for sale from ukdrugtesting.co.uk 

Instalert professional drug testing kits

InstAlert offers the highest level of professional accuracy available from any instant near patient brand, and also a full range of up to 14 drug group test strips. All cut off levels for detection are set to European and UK standard sensitivities, ensuring consistently high standards of drug detection.

Instalert professional wholesale drug test kits are suitable for all types of healthcare drug testing, including clinical trial drug screening and all drug and alcohol treatment and rehabilitation drug testing. The InstAlert range of professional drug testing kits is also ideal for employment and workplace drug testing.

Bulk supplies of professional drug testing kits in any quantity can be supplied in the IntsAlert brand. Also available is a made to order service, where any bespoke combination of drug test strips can be manufactured to a requested combination in 7 panel, 8 panel, 10 panel and even 14 panel drug combinations. Standard combinations are normally available from stock for next day delivery. Professional drug testing kits are available in both urine drug test and saliva drug test formats, but the range of saliva drug testing kits are available in a smaller range.

Access Diagnostic Tests UK also import and distribute WHPM drug test kits, Saliva Confirm drug testing kits , and their own branded range of UKDrugTesting drug testing kits for both urine and saliva.

More information about how to order wholesale professional drug testing kits & supplies is available by contacting UK Drug Testing by e-mail on trade@adtuk.co.uk or telephone 01263 731 168 during office hours Monday to Friday

Uric acid test meter now available in UK


A home test kit for uric acid, the cause of gout, is now available for the first time in the UK. The uric acid test meter is a handheld digital meter which uses a finger prick of blood to test blood levels of uric acid, also known as urate.

High levels of uric acid are associated with painful joint and muscle condition gout. The uric acid test meter allows instant measurement of the uric acid blood levels making a diagnosis of gout fast and easy. The meter is expected to be used by healthcare professionals in surgeries and clinics as an aid to diagnosis. The uric acid meter is also expected to be popular with patients with a history of gout, giving them the ability to monitor their condition and enable earlier treatment decisions when flare-ups occur.

Blood uric acid tests have previously required a whole blood sample to be sent for laboratory analysis, delaying the results for patients and doctors. the uric acid meter uses single-use uric acid test strips which are supplied with the uric acid meter starter packs and are available for sale as uric acid refill test strip packs of 25 uric acid tests

Uric acid test strips

Uric acid test strips

Separate uric acid test strips are supplied with the meter which tests cholesterol blood levels and glucose blood levels. Separate refill packs of cholesterol test strips and glucose test strips are also available making the meter multi-purpose. Extra uric acid test strips for the meter can be purchased online

The uric acid meter starter pack is supplied with lancets and an auto-lancing device which makes finger prick blood sampling simplicity itself. Packs of 100 universal lancets are also available from Valuemed UK Medical Supplies

In conclusion, the uric acid meter system makes uric acid testing simple, easy and low cost, giving fast access to uric acid test results, aiding diagnosis and treatment decision making for physicians and patients.

Urine Testing Strips UK

Urine testing strips

Urine testing strips

We have an extensive range of urine testing strips manufactured by leading international biotechnology companies. Access Diagnostic Tests UK Ltd import and distribute the Mission brand of urine Testing kits (URS tests) used by NHS trusts, GP surgeries and private healthcare providers. The urine testing kits are available in single urine test kits for glucose, and ketones, two test urine testing kits for glucose/ketones and glucose/protein,  A 5 pad urine testing kit, and 8 pad urine testing kit (URS-8) and a 10 pad urine testing kt (URS-1o)

Urine testing kits are used by doctors in hospitals and clinics to test human urine instantly for a wide range of disease. A simple urine dip test can detect multiple indicators of disease, most have 8 or 10 individual results, some test up to 12. (these will be available in the Mission range spring 2014)  The great advantage of near patient urine testing kits is that the results from urine dip test are almost instant, available in 1-2 minutes. This makes the decision to seek further tests or to start treatment much easier than waiting for a lab result which may take several days.

The Mission range of urine testing kits is CE marked for import and sale across Europe and worldwide. The brand is marketed at professional healthcare users but is also available for home testing by individuals with medical conditions requiring home diagnosis and monitoring as part of their ongoing healthcare.

Mission urine test strips

Mission urine test strips

The Mission range of Urine Testing kits is available from Valuemed.co.uk and wholesale and bulk sales of the urine test kits are available from adtuk.co.uk

Mission urine testing strips wholesale

Mission urine testing strips wholesale

Access Diagnostic Tests UK Ltd also import and distribute the InstAlert brand of professional urine drug testing kits. InstAlert is a leading internationally branded urine drug test kit range, offering both urine drug testing and saliva drug testing options.

Urine drug testing kits are available in single urine test kits for cannabis, cocaine, amphetamine, opiates, methamphetamine, MDMA, ketamine, buprenorphine, benzodiazepines, phencyclidine, barbiturates, oxycodone, cannabis, methadone, TCA, and EDDP. Urine drug testing remains the most cost-effective and clinically reliable method of drug screening used in healthcare and employment procedures. InstAlert urine testing kits are CE, FDA, ISO AND TUV quality certified with market-leading accuracy, specificity, and sensitivity, making them the first choice brand for healthcare professionals worldwide.

Instalert drug testing kits

Instalert drug testing kits

The InstAlert professional range or drug urine testing kits is available from www.ukdrugtesting.co.uk

Contact us for wholesale pricing on drug testing kits

Medical Student Discounts

Use your medical student discount coupon to purchase a Littmann Classic 11SE

Use your medical student discount coupon to purchase a Littmann Classic 11SE stethoscope which still remains in our opinion the best stethoscope for medical students and is recommended by UK medical schools.

The cost of being a medical student has never been higher in the UK. Not only do students have to take a student loan to cover their six years of medical school, (most other university degrees are only 3 years ) but they also have the added expense of purchasing medical equipment and medical textbooks which can be very costly.

To help ease the financial burden Valuemed issue discount coupons to medical students on request. We remember what it was like to be in your position.

If you are currently a medical student and would like a medical student discount that you can use & share with your fellow students then please do get in touch with us by e-mail to marketing@adtuk.co.uk

Once you have your medical student discount coupon it can be used at www.valuemed.co.uk to purchase any items on the website including a Littmann stethoscope & any other medical equipment you require for your clinical studies.

Read our FAQ section for medical students if you are unsure which is the best stethoscope & medical equipment to buy

Smoking shisha; is the WHO right?

I have decided to write an article because I had once been asked to smoke shisha, being insisted that there were no health implications involved and shisha was essentially the perks of smoking without the drawbacks, such as the continuity of use being able to possibly cause lung cancer! My decision to write this article was also perhaps encouraged by the growing market of shisha, which to has seen roughly a 210% rise in the number of cafes offering in since the smoking ban was implemented in 1 July 2007, as reported by the Independent. Moreover, there were 179 shisha bars in 2007 but there were 556 in 2012. So I now will begin writing a little bit of what I know to do with this subject.

“An oriental tobacco pipe with a long, flexible tube that draws the smoke through water contained in a bowl” describes ‘hubble-bubble’, ‘hookah’, ‘waterpipe smoking’ and any other alias the infamous shisha tends to spread under. First discovered by Abul-Fath Gilani according to popular belief, the upcoming craze originated from the humble, and likewise, booming country that used to be Persia; India – though this is said to be a disputed merit.

Shisha, often written under as a safer alternative to cigarettes, is a ‘glass-bottomed waterpipe’ which emits radiant fruity smells of your desires. But, surprisingly, for such a simple task of smoking, shisha requires a rather sophisticated device, inclusive of many components from grommets to diffusers. Thus, there is already a physical distinction from its cigarette counterpart. However, it is from the water jar where, unsurprisingly, most of the common misconceptions about shisha arise.

So the misconceptions, which are often seen as a major contributor to why shisha has become increasingly popular since the noughties, become intriguing as a blur between fact and fiction becomes visible. The first main myth to this tobacco craze would be the bubbling water creates the illusion of the smoke being cleansed and purified thus apparently being made healthy. Although, in reality the water, bubbling it may be, does not filter out all the toxins and the fruity smell is only the guise for the smoke which contains the otherwise cancer causing chemicals. Dr Sellehudin Abu Bakr even goes as far as to call the water ‘filter’ a ‘gimmick’. Additionally, passive smoking can be dangerous as it can be the smoke and its composition which causes harm. In the smokes composition exist an addictive substance: nicotine, which can cause a dependence upon this social commodity which increasingly seems harmful. Unfortunately, this is not where the problems end, as sharing a mouthpiece increases the risk of infection with TB or hepatitis, both of which come with disastrous implications.

As a result of public unawareness, the World Health Organisation (WHO) had, from their research published as ‘Waterpipe Tobacco Smoking’ in 2005, which found that, contrary to ancient lore and popular belief, the smoke of shisha contained many toxicants which can cause lung cancer, heart disease and can have other detrimental effects to your body. The WHO also came to the conclusion that 1 hour of smoking shisha is equivalent to up to 200 cigarettes worth of smoke, and this isn’t particularly ‘good’ smoke as the heat sources for shisha are often cinders or charcoals. These are dangerous as they release carbon monoxide.

Additonally, shisha delivers nicotine which as many of you may know, is an addictive substance. Despite the water absorbing some of it, it still enters your body in substantial amounts, so much so, that it can cause addiction, like other tobacco products. The study also highlighted the dangers of second-hand shisha smoking. So by even entering a shisha bar where others are smoking, even by not smoking yourself, you can still be endangered. Also, another important note to focus on is that in this research, they had showed shisha, like cigarettes to contain the capacity to have an adverse effect on the unborn baby during pregnancy. So by smoking shisha, one can potentially harm their baby.

Therefore, one must ask the question on whether smoking shisha is really as harmless as others advocate. In light of the WHO research, it becomes increasingly clear that there are dangerous aspects to this craze, but the research isn’t conclusive enough, many seem to argue. Thus, in order to really clear the misconceptions surrounding shisha, more research needs to be carried out.

A short introduction

Hello readers,

I am a new Valuemed blogger hoping to contribute to this site as ‘mLukon’.

An aspiring doctor wanting to read medicine at university, I am going to apply for medical school this October. I am currently undertaking my A-Levels at Sixth Form, all of which are thoroughly engaging.

I became interested in writing medical-related posts for ‘Valuemed’ after an intriguing summer neurosurgery placement sparked an interest in the brain and degenerative neurological disorders. Through the placement, I became familiar with research papers and so, I would now like to take to ‘Valuemed’ to write a few of my own articles which concern areas of medicine and healthcare that I am fascinated by.

I hope to write interesting and thought-provoking articles soon and would appreciate any feedback and discussion on my blogs.

Wholesale Urine Drug Test Kits UK

Wholesale urine drug test kits

Wholesale urine drug test kits

Access Diagnostic Tests have an extensive range of professional multi-panel urine drug testing kits that are available in wholesale volumes to business, trade & NHS customers.

They also have an extensive range of professional integrated cup urine drug test kits 

If you are using large volumes of urine drug testing kits please contact our wholesale team for pricing either by e-mail on trade@adtuk.co.uk or by telephone during office hours

Visit UK Drug Testing kits website to purchase drug testing kits online

‘Love your Littmann’ Stethoscope Student Promotion


This Thursday thousands of UK students will find out if they have the required grades to gain entry to medical school. The successful ones will start their course in October and amongst the list of required items for many medical schools will be a stethoscope.

The Littmann Classic 11 SE Stethoscope has been the first choice stethoscope for most UK medical students now for many decades and still remains so. The reason is that it is a reasonably priced high quality double headed ie with a bell and a diaphragm acoustic stethoscope that is ideal for medical students who need to master all the basics of auscultation.

The Littmann Dual 111 cardiology stethoscope is also a popular choice due to its superior acoustic performance particularly when listening to heart murmurs and has always been a popular choice wit final year medical students & young doctors. It also makes a good choice for medical students.

This year Littmann in their ‘Love your Littmann ‘ promotion is offering a free cardiac sounds auscultation cd with each Littmann Classic 11 Se stethoscope in the promotion and also with the Littmann Dual 111 cardiology stethoscopes in the promotion.

To find out more about the current ‘Love your Littmann ‘ stethoscope deals visit Valuemed UK and to see our full range of Littmann Stethoscopes available to buy online

Drug and alcohol testing kits for parents in UK


With parents being increasingly concerned about teenagers abusing drugs & alcohol the demand for drug and alcohol testing kits has increased in recent years.

UK Drug Testing offers an extensive range of drug and alcohol test kits and breathalyzer kits that can be used by parents to monitor whether their teenagers are abusing drugs or alcohol.  The use of the test kits can act as a deterrent to drug or alcohol use and may help the teenager to resist peer pressure to take drugs or to drink.

For more information or to buy drug and alcohol testing kits and breathalyzers for parents from UK drug testing kits supplier visit UKDrugTesting.co.uk

The good and the bad of the NHS reforms

The changes which took place on the 1st April 2013 have been dubbed the ‘most radical’ changes to the NHS so far, as the Government creates a massive 200 new organisations.

In order for primary care to be effective, both the doctor and patient must trust each other. Many would go as far to say that there is a ‘special bond’ between the doctor and patient, and doctors have frequently placed amongst the ‘most trusted professionals’ in recent polls. However, what will happen to this ‘special relationship’ when GPs have control of the budget? On one hand, it could be argued that they will have the best idea about how to spend the budget as they are the ones closest to those who need it. However, some argue that this will damage the ‘special relationship’ between the GP and the patient, and a recent poll held by the British Medical Association showed that over 75% of GPs feared the reform, as there is a possibility that patients could become suspicious if they do not get the prescription they would prefer, in order to save money.

Another of the reforms is to improve the care received by those with chronic conditions. Too often, the care required by these individuals is not available, and patients end up in hospital when they suffer from emergencies. In fact, there are over 15 million people with long-term illnesses in the UK, but caring for them accounts for 70% of the budget spent by health care sectors – a massive chunk! However, over 30% of these hospital admissions are avoidable, and the new reforms are pushing for a network of much more integrated community clinics to help those who need it.

Responsibility for public health will now be passed to the Government, who will now be responsible for promoting stopping smoking, better diets and more physical activities. Public health directors who have previously been working for primary care trusts are now being transferred to local authorities, and whilst the rest of the local government is facing huge cuts, public health directors will be issued a budget of just under 3 billion pounds a year.

One of the most controversial reforms that has possibly caused the most worry to the public is undoubtedly the rise of the private sector. Whilst many have been quick to assume that the private sector will simply pick the most profitable services for themselves, it is believed that these firms will be able to provide better, more efficient services which will drastically drive up standards across the entire sector. What many do not realise, however, is that the private sector is already partially involved in providing NHS care.

However, despite the massive amounts of attention these reforms have attracted, possibly the biggest and most shocking thing is that in the short term particularly, there will be little visible change.