Civil society's role in improving hypertension control in Latin America / El papel de la sociedad civil en la mejora del control de la hipertensión en América Latina / O papel da sociedade civil na melhoria do controle da hipertensão arterial na América Latina

ABSTRACT Despite effort in Latin America to implement the HEARTS initiative, hypertension control is still inadequate. There are many advances in the medical and technical arena, but little to promote political and systemic change. The vibrant civil society that has advanced policy change in tobacco control, food policy, and other public health initiatives can make a crucial contribution to prioritize hypertension control in the political agenda, ensure sustainable funding, promote the procurement of affordable and effective medications, and expand community demand for action. The recommended first step for civil society's involvement is to analyze the political landscape to design an advocacy plan. The political landscape includes a legal analysis, policy mapping, stakeholders mapping, identifying obstacles, mapping community strategies, and risk assessment. The second step is to define policy goals and an advocacy strategy. Based on experience, there would be two main policy goals: to increase political will to make hypertension a top priority, securing necessary resources; and strengthen community awareness and social demand for action. The third step is to develop and implement the advocacy plan with the tools familiar to civil society, including building a case for support, advocacy towards decision makers, media advocacy, coalition building, countering the opposition, and civil society monitoring and accountability. To jumpstart this approach, there should be incentives for civil society and a transition for transferring competencies to a new arena. The results would be more sustainable and scalable hypertension control, better health outcomes, and advances toward the 2030 Sustainable Development Goals and universal health coverage.

RESUMEN A pesar de los esfuerzos para poner en marcha la iniciativa HEARTS en América Latina, el control de la hipertensión sigue siendo inadecuado. Ha habido muchos avances en el ámbito médico y técnico, pero poco ha logrado hacerse para promover el cambio político y sistémico. La vibrante sociedad civil que ha logrado avances en el cambio de políticas sobre el control del tabaco, las políticas relacionadas con los alimentos y otras iniciativas de salud pública puede realizar una contribución crucial para que se dé prioridad al control de la hipertensión en la agenda política, se garantice la financiación sostenible, se promueva la compra de medicamentos asequibles y efectivos, y se amplíe la demanda de medidas por parte de la comunidad. El primer paso recomendado para lograr la participación de la sociedad civil es analizar el panorama político para diseñar un plan para abogar por la causa. El panorama político incluye el análisis legal, el mapeo de políticas y de las partes interesadas, la definición de los obstáculos y las estrategias comunitarias, y la evaluación de riesgos. El segundo paso es definir los objetivos de las políticas y diseñar una estrategia para abogar por la causa. Con base en la experiencia, las políticas tendrían dos objetivos principales: lograr una mayor voluntad política para convertir la hipertensión en una prioridad absoluta, asegurando los recursos necesarios, y fortalecer la concientización de la comunidad y la demanda de acción por parte de la sociedad. El tercer paso es elaborar y ejecutar un plan para abogar por la causa con herramientas familiares para la sociedad civil, lo que incluye buscar argumentos para lograr el apoyo, abogar ante los responsables de tomar decisiones y los medios de comunicación, crear coaliciones, contrarrestar la oposición, dar seguimiento a la sociedad civil y establecer mecanismos de rendición de cuentas de la sociedad civil. Para impulsar este enfoque, debería haber incentivos para la sociedad civil y una transición para la transferencia de competencias en un nuevo escenario. Los resultados serían un control de la hipertensión más sostenible y ampliable, mejores resultados de salud y avances hacia los Objetivos de Desarrollo Sostenible de la Agenda 2030 y la cobertura universal de salud.

RESUMO Apesar dos esforços feitos na América Latina para implementar a iniciativa HEARTS, o controle da hipertensão arterial continua sendo inadequado. Houve muitos avanços na área médica e técnica, mas pouco no sentido de promover mudanças políticas e sistêmicas. A sociedade civil vibrante que impulsionou mudanças nas políticas de controle do tabaco, na política de alimentação e em outras iniciativas de saúde pública pode fazer uma contribuição fundamental no sentido de priorizar o controle da hipertensão na agenda política, garantir financiamento sustentável, promover a aquisição de medicamentos eficazes a preços acessíveis e aumentar a demanda da comunidade por ações. Recomenda-se que o primeiro passo para envolver a sociedade civil seja uma análise do cenário político para elaborar um plano de promoção da causa. O cenário político inclui análise jurídica, mapeamento de políticas, mapeamento de interessados diretos, identificação de obstáculos, mapeamento de estratégias comunitárias e avaliação de riscos. O segundo passo é definir metas para as políticas e uma estratégia de promoção da causa. Com base em experiências anteriores, as políticas teriam duas metas principais: aumentar o compromisso político de dar prioridade máxima à hipertensão, assegurando os recursos necessários, e fortalecer a conscientização da comunidade e a demanda social por ações. O terceiro passo é desenvolver e implementar o plano de promoção da causa utilizando ferramentas já familiares para a sociedade civil, como a elaboração de argumentos para obter apoio, a defesa da causa junto a tomadores de decisão, a promoção nos meios de comunicação, a formação de coalizões, o combate a oponentes e o monitoramento e responsabilização da sociedade civil. Para alavancar essa abordagem, deve haver incentivos para a sociedade civil, com uma transição para a transferência de competências para uma nova área. Os resultados seriam um controle mais sustentável e expansível da hipertensão, melhores resultados de saúde e avanços em direção aos Objetivos de Desenvolvimento Sustentável 2030 e à cobertura universal de saúde.

Study Of Frontal Air Sinus Opening In Hiatus Semilunaris Of Nasal Cavity

Background: Frontal air sinus opens in Hiatus semilunaris of middle meatus of Nasal cavity. Nowadays plentyof endoscopic surgeries are happening at Middle meatus; so there is need to explore more about detail anatomyof opening of sinuses. So Present study was undertaken to note the exact site of opening of Frontal air sinus inHiatus semilunaris of Nasal cavity.Context and Purpose of study: Study was conducted on 50 specimens. Out of that 27 were from Right side & 23were from Left side. The specimens were the sagittal sections of adult cadavers in the department ofAnatomy,Krishna Institute of Medical sciences University, Karad. The parameters measured were, Distance ofFrontal air sinus opening from Anterior end of Hiatus semilunaris (nasal bone). Distance of Frontal air sinusopening from Posterior end of Hiatus semilunaris(Inferior surface of Body of Spenoid bone). Diameter of Frontalair sinus opening. Shape of Frontal air sinus opening. All these measurements were taken by Sliding VernierCaliper of 30cm length & 0.001 accuracy.Results: The mean Distance of Frontal air sinus opening from Anterior end of Hiatus semilunaris (nasal bone)was- 1.63cms on Left side & 1.52cms on Right side. The mean Distance of Frontal air sinus opening fromPosterior end of Hiatus semilunaris(Inferior surface of Body of Spenoid bone) was- 4.26 cms on Left side &4.17cms on Right side. The mean Diameter of Frontal air sinus opening – 0.19cms on Left side & 0.18cms on Rightside. The shape of Frontal sinus opening is mainly Circular.Conclusion and Summary: Knowledge of the anatomy of the Frontal air sinus opening is basically helpful for theAnatomists, to know where exactly is the site of the opening of Frontal air sinus in the middle meatus of nasalcavity; And secondarily it might be helpful to ENT surgeons during the performance of endonasalcystorhinostomies.

Les cancers colorectaux en milieu hospitalier à Ouagadougou : aspects épidémiologiques et diagnostiques, approche endoscopique (à propos de 43 cas)

le but de l'étude est de décrire les aspects épidémiologiques et diagnostiques des cancers colorectaux en milieu hospitalier à ouagadougou. il s'est agi d'une étude rétrospective et transversale sur une durée de 9 ans et 6 mois. elle a concerné les malades porteurs d'une lésion colorectale suspecte de malignité à la coloscopie. les variables étudiées étaient sociodémographiques, cliniques, endoscopiques et histologiques. l'étude a été réalisée dans 5 structures sanitaires et 3 laboratoires d'anatomie pathologique. 43 lésions suspectes ont été histologiquement confirmées. la fréquence annuelle était de 4,53 nouveaux cas, le sexratio de 0,87 et l'âge moyen de 49,56 ans. les femmes au foyer (30,09%) et les employés subalternes (20,37 %) étaient les professions les plus concernées. il était retrouvé 26 cancers coliques (60,47 %) et 17 cancers du rectum (39,53 %). les formes bourgeonnantes (47,06 %) étaient les plus visualisées pour le cancer du rectum et ulcéro-bourgeonnantes, ulcéro-bourgeonnantes et sténosantes (26,92 % chacune) pour le côlon. l'adénocarcinome était le plus retrouvé (86,42 %). l'histologie et l'endoscopie étaient concordantes dans 65,49 % des cas. enfin les cancers colorectaux semblent rares dans notre pays. Toutefois, seule la mise en place d'un registre des cancers pourrait permettre d'en déterminer l'incidence réelle

Assessment of nutritional status in Indian preschool children using WHO 2006 Growth Standards.

Background & objectives: This study attempts to compare the pattern of growth of Indian children as assessed by weight for age, height for age and BMI for age with the WHO standards for growth (2006) and to explore the implications of differences in undernutrition rates in the 0-59 months of age group as assessed by these three indices. Methods: From the National Family Health Survey -3 database, growth curves for height, weight and BMI for age in Indian preschool children were computed using LMS software and compared with the WHO (2006) standards. Using the WHO (2006) standards, trends in prevalence of undernutrition as assessed by height, weight and BMI for age in the 0-59 month age group were computed. Results: During the first three months there was no increase in underweight and stunting rates. There was progressive increase in underweight and stunting rates between 3-23 months of age. Low BMI for age and wasting rates were highest at birth. Interpretation & conclusions: Poor growth is an adaptation to chronic low energy intake and stunting is a measure of cumulative impact of chronic energy deficiency on linear growth. It is important to prevent stunting because it is not readily reversible. Low BMI is an indictor of current energy deficit. Early detection of energy deficit using BMI for age and expeditious interventions to correct the deficit might be effective in prevention of stunting.

Effect of mersalyl at cholinoceptive sites.

The effects of an organic mercurial compounds, mersalyl, were tested at the muscarinic and nicotinic sites (the smooth muscles, frog heart and frog rectus muscle) in vitro. Mersalyl had an antimuscarinic effect in the smooth muscle tissues and in the myocardium. On the frog rectus muscle, mersalyl had some potentiating effect on acetylcholine response.