awarness in heart disease in Bengali, ECG, ECHO, Chest pain, Raised cholesterol, congenital heart disease , interventional cardiology, PCI, Angiogram

1. ü`‡ivM K_KZv
(1g LÛ)
AvBGmweGb bst 978-984-33-4764-0
ü`‡ivM K_KZv (1g LÛ)
Wvt †gvt †ZŠwdKzi ingvb (dviæK)
cÖKvkK
Wvt wU ingvb KvwW©qvK †Kqvi dvD‡Ûkb
80/7/2 K`gZjv, evmv‡ev, meyRevM, XvKv-1214|
cÖ_g cÖKvk
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dvivn& Zvmbxg †gŠwg
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cÖ”Q` cwiKíbvq
Rbve `vD`yj Bmjvg
gyj¨
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US $ 50 (Fifty Dollar only)
GB eB‡qi we qjä mgy`q A_©
ÔWvt wU ingvb KvwW©qvK †Kqvi dvD‡ÛkbÕ-G
Mixe †ivMxi wPwKrmvq e¨q n‡e|
cÖvwß ¯’vb
†gwW‡bvfv †gwW‡Kj mvwf©‡mm
†nvmvd UvIqvi, gvwjevM †gvo, XvKv|
†dvb t 01911917600, 01716461346, 01677639325,
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‘Ridrog Kothokata’ (Volume 1) written by Dr. Md. Toufiqur Rahman Faruque was
published by ‘Dr. T Rahman Cardiac Care Foundation’ in February 2012,) Cover designed
by Mr. Dawodul Islam, Price. Tk. 500.00 (Five hundred)/US $ 50 (Fifty Dollar only)
Wvt †gvt †ZŠwdKzi ingvb (dviæK)
GgweweGm, GdwmwcGm, GgwW
mn‡hvMx Aa¨vcK, KvwW©IjRx
RvZxq ü`‡ivM Bbw÷wUDU I nvmcvZvj
†ki-B-evsjv bMi, XvKv

2. evev †gvt Av‡bvqvi †nv‡mb †gvjøv I gv wg‡mm †iv‡Kqv LvZzb
hv‡`i FY KL‡bvB †kva Kiv hvq bv|
Ges
wcÖqZgv ¯¿x Zûiv LvZzb (kiwgb)
hvi Aby‡cÖiYvq Rxe‡bi KwVb c_Pjv
DrmM©
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f‚wgKv
wewfbœ cwÎKvq m¤úv`K I mn-m¤úv`K‡`i Aby‡iv‡a ¯^v¯’¨ I ü`‡ivM welqK
wewfbœ wel‡q wfbœ wfbœ mg‡q A‡bK¸wj mvÿvZKvi w`‡qwQjvg| †ivMx I
myaxR‡bi Aby‡iv‡a ü`‡ivM wel‡q Rbm‡PZbv e„w×i j‡ÿ¨ D³ mvÿvZKvi
¸wj‡K GK‡Î msKjb K‡iB eB cÖKvk Kiv nj|
G‡Z Avkv Kwi ü`‡ivMxiv QvovI Ab¨vb¨ cvVK I †gwW‡Kj wkÿv_©xiv DcK…Z
n‡eb| G‡ZB Avgvi ¯^v_©KZv|
h‡_ó cwikªg I †Lqvj Kiv m‡Ë¡I g~`ªYRwbZ fzj-ÎæwU¸‡jv gvR©bxq| †h‡Kvb
wel‡q Dc‡`k I w`Kwb‡`©kbv K…ZÁwP‡Ë ¯§ibxq|
Wvt †gvt †ZŠwdKzi ingvb (dviæK)
B ‡gBj t drtoufiq19711@yahoo.com
drtoufiq1971@gmail.com
†gvevBj t +8801715024994

3. m~PxcÎ
G ü`‡ivM wPwKrmvq B›Uvi‡fbkbvj KvwW©IjwR 1
G ü`‡ivM wbY©‡q BwmwR I Ab¨vb¨ cixÿv 5
G gwnjv‡`i ü`‡ivM I KiYxq 7
G ü`wc‡Ûi i³bvjxi (K‡ivbvix) wfZi eøK wbY©‡q GbwRIMÖvg 10
G ü`‡iv‡Mi DcmM© I jÿYmg~n 14
G k¦vmKó †ivMx‡`i KiYxq 16
G ü`wcÛ eo n‡q †M‡j KiYxq 18
G Wvqv‡ewUm I ü`‡ivM 20
G K‡ivbvwi ü`‡ivM I D”P i³Pvc ü`‡ivMx‡`i 24
Rb¨ Lv`¨ ms všÍ civgk©
G ‡ivRvq ü`‡ivMx‡`i KiYxq 25
G Wvq‡ewUK I ü`‡ivMx‡`i Lv`¨ 28
G evZR¡i I ü`‡ivM 30
G evZR¡i RwbZ ü`‡ivM I Rb¥MZ ü`‡ivMx‡`i civgk© 33
G D”Pi³ Pvc I ü`‡ivM 34
G eq¯‹‡`i D”P i³Pv‡c KiYxq 37
G evZR¡i RwbZ I fvje& RwbZ ü`‡iv‡M B›Uvi‡fbkb 38
G Mf©Kvjxb D”P i³Pvc 51
G ü`‡ivM wPwKrmvq †cm‡gKvi 43
G cwikª‡g ey‡K e¨_v n‡j KiYxq 45
G ü`‡ivM wbY©‡q BwUwU 48
G nvU© G¨vUvK †ivMx‡`i Kibxq 51
G evZ e¨_v I ü`‡ivM 52
G nvB‡cv_vBiqwWRg I ü`‡ivM 54
G i‡³ Pwe©i AvwaK¨ KviY, cÖwZKvi, cÖwZ‡iva 57
G R¤§MZ ü`‡iv‡Mi wQ`ª wPwKrmvq B›Uvi‡fbkb 63
G wd« †gwW‡Kj K¨v¤ú I mvsMVwbK mdi 65
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4. ü`‡ivM wPwKrmvq B›Uvi‡fbkbvj KvwW©IjwR

5. B›Uvi‡fbkbvj KvwW©IjwR wK ?
wewfbœ Device ev hš¿ ev Baloon Gi mvnv‡h¨
ü`&‡iv‡Mi wewfbœ wPwKrmv Kivi c×wZ‡K
B›Uvi‡fbkbvj KvwW©IjwR e‡j| G Kvi‡b
B›Uvi‡fbkbvj KvwW©IjwR wPwKrmv
Zzjbvg~jKfv‡e e¨q mv‡c¶|

6. B›Uvi†fbkbvj KvwW©IjwR÷‡`i
wPwKrmv weÁv‡b fywgKv wK wK ?
wKQy RwUj ü`‡ivM wPwKrmv ‡hgb : Mitral
Stenosis, Aortic Stenosis, Aortic Regurgitation, Pulmonary Stenosis,
nv‡U©i i³bvjx‡Z eø‡KR, ü`h‡š¿i kø_MwZ A_ev Malignant
arrhythmia, nv‡U©i wQ`ª wPwKrmvq, GgbwK nvU© †dBji wPwKrmvq
B›Uvi‡fbkbvj KvwW©IjwRó‡`i fywgKv Acwimxg|

7. nv‡U©i i³bvjx‡Z eø‡KR wK ?
nv‡U©i i³bvjx‡Z A‡bK mgq Pwe©i Av¯—i c‡o i³bvjxi Diameter
K‡g †h‡Z cv‡i Ges i³bvjx mi“ n‡j i³ PjvP‡j euvav n‡Z cv‡i,
Zv‡K nv‡U©i i³bvjxi eø‡KR ev Coronary artery stenosis e‡j|

8. nv‡U©i i³bvjx‡Z wK wK Kvi‡b eø‡KR n‡Z cv‡i ?
mvavibZ : Wvqv‡ewUm _vK‡j, aygcvb Ki‡j, D”P i³Pvc _vK‡j ev
i‡³ Pwe©i AvwaK¨ _vK‡j ev †R‡bwUK Kvi‡b nv‡U©i i³bvjx‡Z Pwe©
R‡g i³bvjx eø‡KR n‡Z cv‡i|

9. nv‡U©i i³bvjxi eøK wPwKrmvq B›Uvi†fbkbvj KvwW©IjRx‡÷i
fywgKv wK ?
nv‡U©i i³bvjxi eøK wPwKrmvq B›Uvi†fbkbvj KvwW©IjwR‡÷iv eøK `yi Kivi
Rb¨ wcwUwmG, †÷bwUs ev wis jvMv‡bv, †ivUv‡eøkb, †jmvi cÖf…wZ c×wZ Aej¤^b
K‡i _v‡Kb| G mKj wPwKrmv AwZ AvaywbK, †ivMxi eyK KvUv †uQovi cÖ‡qvRb
1
c‡o bv, GgbwK †ivMx 1/2 w`‡bi wfZi c~b© my¯’ n‡q ¯^vfvweK Rxeb hvcb
Ki‡Z cv‡i| G‡Z ‡ivMxi †Kvb i³ †`qviI cÖ‡qvRb nq bv|

10. †ejyb GbwRIcøvwó wK ?
†ejyb GbwRI cøvwó GK ai‡bi nv‡U©i i³bvjxi AvaywbK wPwKrmv †hLv‡b
i³bvjx‡Z eøK n‡j Zv †ejyb w`‡q dzwj‡q eøK `yi Kiv hvq ev eø‡Ki
gvÎv Kgv‡bv nq|

11. †÷w›Us ev wis wPwKrmv wK ?
†÷w›Us ev wis jvMv‡bv wPwKrmv n‡jv nv‡U©i i³bvjxi eøK ev stenosis
wPwKrmvi GKwU AvaywbK c×wZ| G wPwKrmvq nv‡U©i i³bvjxi eøK †ejyb
w`‡q dzwj‡q Zvi Dci GKwU wis ev †÷›U ewm‡q †`qv nq | d‡j
i³bvjxi cybivq eøK nIqvi SuzwK A‡bKvs‡k K‡g hvq|

12. †÷›U ev wis wK wRwbm ?
†÷›U ev wis nj GK ai‡bi AwZ my¶ Zv‡ii ˆZix Kj‡gi wis Gi gZ
†`L‡Z, hv †ejyb w`‡q dzjv‡j i³bvjxi Mv‡q AvU‡K _v‡K|

13. wis KZ cÖKvi ?
wis mvavibZ: `yB cÖKvi BMS Ges DES. BMS nj Bare Metal Stent
Ges DES nj Drug Eluting Stent. BMS wewfbœ cÖKv‡ii Metal Gi
Alloy Øviv ˆZwi Ges G¸‡jvi `vg DES Gi †P‡q Kg, cÖvq A‡a©K ev
wZbfv‡Mi GK fvM| DES wewfbœ cÖKvi Drug Øviv Coated.

14. BMS Gi myweav I Amyweav n‡jv wK wK ?
BMS n‡jv Kg `vgx, jvMv‡bvi ci `xN© mgq Anti platelet Jla bv
n‡jI P‡j, d‡j Acute or sub-acute stent thrombosis Gi Szu&wK Kg|
wKš‘ Restenosis A_v©r cybivq eøK nIqvi m¤¢vebv †ekx|

15. DES Gi myweav I Amyweav wK wK ?
DES n‡jv AwZg~‡j¨i, jvMv‡bvi ci `xN© mgq Anti platelet Jla †L‡Z
nq Ges †ekx †Wv‡R, Ab¨_vq Acute Stent thrombosis or sub acute
stent thrombosis S„yuwK A‡bK ¸b †ekx| wKš‘ DES Gi myweav n‡jv
Restenosis A_©vr cybivq eøK nIqvi Gi m¤¢vebv A‡bK Kg|

16. †Kvb& †Kvb& †¶‡Î DES e¨envi Kiv DwPZ ?
DES or Drug eluting stent mvavibZ: †h me †¶‡Î Restenosis Gi SzuwK
†ekx †hgb - Wvqv‡ewUm †ivMx‡`i †¶‡Î, mi“ K‡ivbvix i³bvjxi ‡¶‡Î,
2
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17. Left main coronary artery disease Gi †¶‡Î, Restenosis wPwKrmvq
DES e¨envi Kiv DwPr| G‡Z cybivq Stenosis Gi Szu&wK K‡g |

18. DES jvMv‡bvi ci wK wK mveavbZv Aej¤^b Kiv DwPZ ?
DES or drug eluting stent jvMv‡bi ci `xN© mgq, Kgc‡¶ 1 ev 11
/2
eQi Anti-Platelet Jla wظb †Wv‡R LvIqv DwPZ| †Kvb †Kvb †¶‡Î
mvivRxeb LvIqv DwPZ| DES jvMv‡bvi ci †Kvb †ivMxi Acv‡ikb
Kivi cÖ‡qvRb n‡j Anti Platelet eÜ Kivi †¶‡Î mveavbZv cÖ‡qvRb|

19. BMS (Bare Metal Stent) Gi LiP wK ai‡bi ?
BMS jvMv‡bvi Rb¨ Cathlab charge eve` 45-65 nvRvi UvKv I wis
Gi LiP cÖwZwU 45-75 nvRvi UvKv n‡Z cv‡i, hv wewfbœ Brand ev
quality †f‡`|

20. Drug Eluting stent Gi g~j¨ wK ai‡bi n‡Z cv‡i ?
Drug Eluting stent Gi g~j¨ cÖKvi †f‡` Ges †KvqvwjwU †f‡`
1,20,000/- †_‡K 2 jÿ ch©š— n‡Z cv‡i Ges Gi mv‡_ K¨v_j¨ve
PvR© eve` 45 nvRvi †_‡K 65 nvRvi UvKv jv‡M|

21. wis ev †÷›U Gi ci †ivMx my¯’ n‡Z KZ mgq jv‡M ?
wis ev †÷›U Gi ci mvavibZ: 2/3 w`‡bi g‡a¨ †ivMx c~b© my¯’ n‡q
evox †h‡Z cv‡i I 1 mßv‡ni g‡a¨ ¯^vfvweK Rxeb hvcb Ki‡Z cv‡i|

22. wis ev †÷›U civ‡bv †ivMx‡`i Rxeb hvÎv †Kgb nIqv DwPZ ?
wis jvMv‡bv ev †÷›U Gi †ivMxiv ¯^vfvweK Rxeb hvcb Ki‡Z cv‡i|
†ivMx‡K ˆ`wbK 30 †_‡K 45 wgwbU nuvUv DwPZ| Lvev‡ii g‡a¨ ‰Zjv³
ev Pwe©i AvwaK¨ eR©b Kiv DwPZ| aygcvb cy‡ivcywi eÜ Ki‡Z n‡e|
kvKmwâ djgyj ‡ekx K‡i †L‡Z n‡e| we‡kl K‡i Wvqv‡ewUm m¤úyb©
wbqš¿b Ki‡Z n‡e | i‡³i Pwe© wbqš¿‡b †i‡L gv‡S gv‡S mswkó ü`‡ivM
we‡klÁ‡`i civgk© Abyhvqx Pj‡Z n‡e| Ab¨_vq cybivq i³bvjx‡Z
ev †÷›U Gi wfZi Pwe© R‡g †h‡Z cv‡i|

23. nv‡U©i i³ bvjx‡Z eø‡KR n‡j wK wK mgm¨v n‡Z cv‡i ?
nv‡U©i i³bvjx‡Z eø‡KR n‡j i³ bvjx mi“ n‡q i³ PjvP‡j evav m„wó
K‡i| d‡j nv‡U©i gv‡mj ch©vß cwigvb Aw·‡Rb I Lvevi cvq bv|
e¨vqvg ev AwaK cwikª‡gi mgq hLb Aw·‡Rb I Lvev‡ii Pvwn`v †e‡o
3
hvq Z_vwc mieivn bv evo‡j nv‡U© GK ai‡bi Zxeª Chest discomfort nq
hv‡K Angina e‡j | d‡j Chronic stable angina n‡Z cv‡i| G Qvov
i³bvjxi Pwe©i ¯—i †d‡U wM‡q Gi Dci i‡³i `vbv Rgv n‡q i³bvjx
AvswkK ev cy‡iv eÜ n‡q Acute coronary syndrome n‡Z cv‡i|

24. Chronic stable angina wPwKrmvq Avcbv‡`i B›Uvi†fbkbvj
KvwW©IjwR÷†`i fywgKv wK ?
Chronic stable angina ‡Z Jla wPwKrmv †ivMxi Kó Dckg Ki‡Z bv
cvi‡j †ivMxi GbwRI MÖvg K‡i †`Lv nq i³bvjx‡Z †Kv_vq †Kv_vq I
KZ¸wj eøK Av‡Q Ges G Rb¨ cieZx©‡Z wK wPwKrmv Ki‡Z n‡e| eøK
_vK‡j mvavibZ: Angioplasty Ges stenting ev Acv‡ikb Ki‡Z nq|

25. Stenting ev wis jvMv‡bv A_ev Angioplasty KLb Kiv nq ?
nv‡U©i i³bvjxi eøK hw` Left main coronary artery †Z bv nq A_ev
Ab¨vb¨ i³bvjxi Dchy³ RvqMvq nq Ges Zv GKwU `ywU A_ev wZbwU
i³bvjx‡KB involve K‡i Zvn‡j stenting ev wis jvMv‡bv m¤¢e| i³bvjxi
wZb ev Z‡ZvwaK eø‡Ki wPwKrmvqI Angioplasty ev wis jvMv‡bv †h‡Z cv‡i
hw` Stenosis ¸‡jv Suitable nq ev †ivMx Acv‡ikb bv K‡i wis jvMv‡bvi
Rb¨ wcovcxwo K‡i | Left main coronary artery stenosis n‡j mvavibZ
CABG Kiv nq wKš— eZ©gv‡b wewfbœ KvwW©qvK †m›Uv‡i Interventional
cardiologist iv left main G AZ¨š— mdjZvi mv‡_ Stenting Ki‡Qb|

26. CABG bv K‡i Stenting Kiv hvq wK bv ?
n¨vu, CABG bv K‡i Stenting Kiv nq hw` Stenosis ¸‡jv Stenting Gi
Rb¨ Suitable nq A_ev †ivMxi eyK †K‡U Acv‡ikb Ki‡Z ivRx bv _v‡K
ZLb †Kvb †Kvb †¶‡Î AvswkK Revascularization Kiv ‡h‡Z cv‡i|
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mvÿvrKviwU ÔAvb›` Av‡jvÕ 16 gvP© 2011 msL¨v ÔI Wv³viÕ cvZvq 39 c„ôvq cÖKvwkZ nq
wPÎ t †ejybmn †÷›U ev wis

28. K‡ivbvix AvU©vix wWwR‡R (CAD) KLb BwmwR ¯^vfvweK _vK‡Z cv‡i ?
mvavibZ: nvU© A¨vUvK ev gv‡qvKvwW©qvj BbdviKkb bv nIqv ch©š—
BwmwRi †Kvb ¸i“Z¡c~b© cwieZ©b Av‡m bv| ZvB, †Kvb i“Mxi nv‡U©i
i³bvjx‡Z GK ev GKvwaK eøK _vK‡jI BwmwR ¯^vfvweK n‡Z cv‡i|

29. ‡m‡¶‡Î Avgiv wKfv‡e K‡ivbvix AvU©vix‡Z eøK Av‡Q Zv Abygvb Ki‡Z cvwi ?
hw` BwmwR ¯^vfvweK nq, wKš‘ †ivMxi eqm 40 eQ‡ii †ekx nq, ey‡K
e¨_v nq A_ev †ivMx aygcvqx nq A_ev †ivMxi Wvqv‡ewUm _v‡K ev †ivMxi
D”P i³Pvc ev i‡³i †Kv‡jóij Gi gvÎv †ekx _v‡K Z‡e Aek¨B
†ivMx‡K mwVK g~j¨vq‡bi (Proper evaluaion) Gi Rb¨ ETT ( Exercise
Tolerance Test) Kiv DwPZ| Zvn‡j nv‡U©i i³bvjx‡Z hw` 70% Gi
†ekx eøK (Stenosis) _v‡K Zv aiv covi m¤¢vebv †ekx|

30. BwmwR ¯^vfvweK _vK‡j ETT Kivi Av‡M wK Echo Kivi cÖ‡qvRb Av‡Q ?
wKQy wKQy ü`‡ivM Av‡Q †hgb Aortic Senosis A_ev HOCM
(Hypertrophic Obstructive Cardiomyopathy) ‡hLv‡b BwmwR ¯^vfvweK
_v‡K wKš‘ ETT Kiv‡j ETT Kivi mgq gvivZ¡K `~N©Ubv NU‡Z cv‡i|
G mg¯— †ivMx‡K Avgiv ETT †_‡K weiZ ivwL| ZvB wKQy wKQy †ivM
†hLv‡b BwUwU Kiv‡j SzuwK †ekx †m mg¯— †ivM Exclude Kivi Rb¨I
A‡bK mgq ETT Kivi Av‡M Echo cix¶v Kiv‡Z nq|

31. GKRb †ivMxi eyKe¨_v _vK‡j I ECG ¯^vfvweK n‡j wK Kiv DwPZ ?
GKRb †ivMxi ey‡K e¨_v n‡j I ECG ¯^vfvweK n‡j †mme †¶‡Î ey‡K e¨_vi
KviY wbb©‡qi Rb¨ Echocardiography (B‡KvKvwW©IMÖvwd), ETT (BwUwU),
USG of Upper abdomen(‡c‡Ui AvjUªvm‡bvMÖvg), CXR P/A View(ey‡Ki
G·‡i) Ges cÖ‡qvR‡b Angiogram(GbwRIMÖvg) Kiv DwPZ|
5

32. †Kvb ‡ivMxi eyK e¨_v n‡j ‡c‡Ui AvjUªvm‡bvMÖvg (USG of Upper
abdomen) †Kb Kiv‡Z n‡e ?
A‡bK mgq wcË_jx‡Z Bb‡dKkb ev cv_i n‡j we‡klZ: gwnjv
†ivMx‡`i †¶‡Î (Cholelithiasis) ey‡K e¨_v n‡Z cv‡i ev Upper
Abdomen discomfort ev eyK e¨_v e‡j g‡b n‡Z cv‡i| ZvB ‡c‡Ui
AvjUªvm‡bvMÖvg (USG of Upper Abdomen) cix¶v Kiv‡bv DwPZ|

33. ey‡K e¨_v †ivMxi wK G‡ÛvmKwc (Endoscopy of Upper) GIT
cix¶vi †Kvb fywgKv Av‡Q ?
n¨vu, ey‡K e¨_v †ivMxi G‡ÛvmKwc (Endoscopy of Upper GIT) cix¶v
Kiv‡bv jvM‡Z cv‡i| KLbI KLbI †ccwUK Avjmvi wWwRR ev Non Ulcer
Dyspepsia n‡j A_ev Ab¨vb¨ Stomach pathology ev Lv`¨bvjx
(esophagus) Gi mgm¨vi Kvi‡b we‡kl K‡i GERD(Reflux esophagitis)
n‡j cÖPÛ eyK e¨_v n‡Z cv‡i| ZvB G mg¯— †ivM Exclude Kivi Rb¨I
G‡ÛvmKwc (Endoscopy of Upper GIT) Kiv jvM‡Z cv‡i|

34. †Kvb †ivMxi BwmwR ¯^vfvweK n‡j ey‡Ki G·‡i (CXR P/AView) cix¶vi fywgKv wK ?
BwmwR ¯^vfvweK n‡jI ey‡K e¨_vi Ab¨vb¨ KviY †hgb dzmdzm Gi (Pahology)
Gi mgm¨v wbi“c‡bi Rb¨ ey‡Ki G·‡i (CXR P/A View) cix¶v Kiv‡bv nq|

35. BwmwR ¯^vfvweK _vK‡jI ey‡K e¨_v n‡j wK †Kvb †ivMxi K‡ivbvix
GbwRIMÖvg (Coronary angiogram) Kiv jvM‡Z cv‡i ?
ey‡K e¨_v n‡j I BwmwR ¯^vfvweK _vK‡j, hw` †ivMxi eqm 40 Gi †ekx nq
ev Wvqv‡ewUm ev D”Pi³Pvc _v‡K ev aygcvqx nq ev BwUwU cwRwUf nq ev
BwUwU †Kvb Kvi‡b Kiv bv hvq Z‡e K‡ivbvix GbwRIMÖvg (Coronary
angiogram) mivmwi Kiv ‡h‡Z cv‡i ‡h, i³bvjx‡Z †Kvb eøK (Stenosis)
Av‡Q wKbv Zv †`Lvi Rb¨| BwmwR ¯^vfvweK _vK‡jI †Kvb †ivMxi i³bvjx‡Z
GK ev GKvwaK Zvrch©c~b© ev AZvrch©c~b© eøK (Stenosis) _vK‡Z cv‡i|

36. BwmwR ¯^vfvweK _vK‡jI wK †Kvb i“Mxi nv‡U© gvivZœK mgm¨v _vK‡Z cv‡i ?
n¨vu, BwmwR ¯^vfvweK _vK‡jI †Kvb †Kvb i“Mxi nv‡U© gvivZ¡K mgm¨v
_vK‡Z cv‡i| †hgb : †ivMxi Ischaemic Heart Disease A_ev Valvular
Heart Disease, Cardiomyopathy, Pericardial Heart Disease _vK‡Z
cv‡i, †hLv‡b ECG cy‡ivcywi ¯^vfvweK n‡Z cv‡i|
6
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37. BwmwRi wi‡cvU© ¯^vfvweK
_vK‡jI wK ü`‡ivM
_vK‡Z cv‡i ?
n¨vu, BwmwRi wi‡cvU© ¯^vfvweK
_vK‡jI wewfbœ cÖKvi
ü`‡ivM _vK‡Z cv‡i|
ü`‡ivM wbY©‡q BwmwR I Ab¨vb¨ cixÿv
Ôˆ`wbK hyMvšÍiÕ cwÎKvq 30 GwcÖj 2011 Zvwi‡L cÖKvwkZ nq|

39. gwnjv‡`i wK wK R¤§MZ ü`‡ivM nq ?
gwnjv‡`i mvavibZ: ü`wc‡Ûi Af¨š—‡i wQ`ªRwbZ ü`‡ivM †hgb :
ASD, VSD, PDA ai‡bi ü`‡ivM †`Lv hvq| ZvQvov TOF(Tetralogy
of fallot) ai‡bi ü`‡ivM I †`Lv hvq|

40. gwnjv‡`i wK ai‡bi evZR¡i RwbZ ü`‡ivM †`Lv hvq ?
gwnjv‡`i `xN©w`b evZR¡i _vK‡j Zv ü`wc‡Ûi wewfbœ fvj&e Av gb K‡i
Zv bó K‡i †d‡j, d‡j fvj&e mi“ n‡q hvq A_ev fvj&e wVKgZ eÜ nq bv
d‡j fvj&e wjK K‡i | fvj&e mi“ n‡q †M‡j Avgiv (‡÷‡bvwmm) Stenosis
ewj Ges fvj&e wjK Ki‡j Avgiv regurgitation(wiMviwR‡Ukb) ewj |

41. evZR¡i RwbZ ü`‡iv‡M mvavibZ: ü`wc‡Ûi †Kvb& fvj&e Av vš— n‡q _v‡K ?
evZR¡i RwbZ ü`‡iv‡M mvavibZ: ü`wc‡Ûi gvBUªvj fvj&e (Mitral
Valve) †ekx Av vš— n‡q _v‡K| Zvici Aortic Valve Ges KLbI
KLbI Tricuspid fvj¦ Av vš— nq| d‡j Mitral Stenosis A_ev Mitral
regurgitation, Aortic Stenosis A_ev Aortic regurgitation A_ev
Tricuspid Stenosis †ivM †`Lv hvq|

42. i³bvjx‡Z eøK RwbZ ü`‡iv‡M gwnjv‡`i Av vš— nevi SyuwK KZLvwb ?
gwnjv‡`iI ü`wc‡Ûi i³bvjx‡Z eøKRwbZ ü`‡ivM †`Lv hvq| Z‡e
gvwmK eÜ nIqvi c~‡e© A_©vr 50 eQi eqm nIqvi c~‡e© G †ivM nIqvi
7
m¤¢vebv Lye Kg| Z‡e gvwmK eÜ nIqvi ci A_ev 50 eQi eqm nIqvi
ci eøKRwbZ ü`‡iv‡Mi SzuwK A‡bK ev‡o|

43. gvwmK eÜ (Premenopausal) nIqvi Av‡M wK Kvi‡Y mvavibZ:
gwnjv‡`i eøKRwbZ ü`‡ivM nq ?
Kg eq¯‹ gwnjv‡`i hv‡`i wbqwgZ gvwmK nq Zv‡`i mvavibZ: eøKRwbZ
ü`‡ivM Kg †`Lv hvq| wKš— gwnjviv `xN© mgq R¤§wbqš¿b ewo †L‡j
A_ev `xN©w`b Wvqv‡ewUm †iv‡M fyM‡j, D”P i³Pvc _vK‡j, aygcvb
Ki‡j, Aí eq¯‹ gwnjv‡`iI eøKRwbZ ü`‡ivM n‡Z cv‡i|

44. gwnjv‡`i ey‡K e¨_v n‡j KiYxq wK ?
gwnjv‡`i ey‡K e¨_v n‡j ü`‡ivM we‡kl‡Ái civg‡k© ey‡Ki G·-‡i,
BwmwR, BwUwU, B‡KvKvwW©IMÖvg, Avëªvm‡bvMÖvg I cÖ‡qvR‡b G‡ÛvmKwc
cix¶v Kiv DwPZ|

45. ey‡K e¨_v n‡j Avëªvm‡bvMÖvg cix¶vi cÖ‡qvRbxqZv wK ?
ey‡K e¨_v n‡jI KLbI KLbI Avëªvm‡bvMÖvg cix¶vi cÖ‡qvRb Av‡Q,
KviY wcË_wj‡Z cv_i (Gall Stones) _vK‡j I ey‡K e¨_v n‡Z cv‡i hv
Avëªvm‡bvMÖvg cix¶vi gva¨‡g aiv m¤¢e|

46. ey‡K e¨_v n‡j wK ey‡Ki X-ray Kivi cÖ‡qvRb Av‡Q ?
n¨vu, ey‡K e¨_v n‡j Zv dzmdym A_ev ey‡Ki LvuPvi nv‡oi mgm¨vi Kvi‡bI
n‡Z cv‡i hv X-ray cix¶v K‡i wbY©q Kiv m¤¢e|

47. ey‡K e¨_v n‡j Endoscopy cix¶vi cÖ‡qvRb wK ?
cvK¯’jx‡Z ev Lv`¨bvjx‡Z Nvu n‡j ev Avjmvi n‡j, GgbwK Lv`¨bvjx‡Z
wUDgvi ev K¨vÝvi n‡j ev Reflux esophagitis n‡j ey‡K e¨_v n‡Z
cv‡i hv Endoscopy- i gva¨‡g wbb©q Kiv m¤¢e|

48. gwnjv‡`i eøKRwbZ ü`‡ivM wKfv‡e wbb©q Kiv hvq|
gwnjv‡`i eøKRwbZ ü`‡ivM BwmwR, B‡KvKvwW©IMÖvg, BwUwU, wmwU
GbwRIMÖvg I K‡ivbvix GbwRIMÖv‡gi gva¨‡g wbb©q Kiv hvq|

49. gwnjv‡`i eqm †ekx n‡j A_ev cv‡q mgm¨ _vK‡j BwUwU Ki‡Z bv
cvi‡j wK Kiv DwPZ :
gwnjv‡`i wewfbœ Kvi‡b †hgb †ekx IRb nIqvi Rb¨ A_ev wMivi
mgm¨vq hw` BwUwU Ki‡Z bv cv‡i Z‡e wmwU GbwRIMÖvg ev K‡ivbvix
GbwRIMÖvg Kiv DwPZ|
8
K
K
7

50. gwnjv‡`i mvavibZ: †Kvb& ai‡bi
ü`‡ivM †ekx †`Lv hvq ?
gwnjv‡`i mvavibZ: evZR¡i RwbZ
ü`‡ivM hv ü`h‡š¿i fvj¦‡K bó K‡i, Ggb
ü`‡ivM Gi AvwaK¨ †`Lv hvq|

51. gwnjv‡`i wK wK ai‡bi ü`‡ivM nq?
gwnjv‡`i R¤§MZ ü`‡ivM, evZR¡i RwbZ
fvj‡ei ü`‡ivM, i³bvjx‡Z eøKRwbZ
ü`‡ivM, ü`wc‡Ûi Pvicv‡k cvwb Rgv RwbZ
ü`‡ivM, ü`wc‡Ûi wfZ‡i Bb‡dKkbRwbZ
ü`‡ivM, ü`wc‡Ûi gvsk‡ckx‡Z cÖ`vn RwbZ
ü`‡ivM n‡q _v‡K|
gwnjv‡`i ü`‡ivM I KiYxq

53. wK wK Kvi‡b gwnjv‡`i eøKRwbZ ü`‡iv‡Mi SzwuK ev‡o ?
R¤§wbqš¿b ewo †ekx †meb Ki‡j, Wvqv‡ewUm Awbqš¿‡b _vK‡j, D”P
i³Pvc _vK‡j, †ekx `ywðš—v Ki‡j, cwiev‡ii Ab¨ m`m¨‡`i ü`‡ivM
_vK‡j, Aí eq‡m gvwmK eÜ n‡q †M‡j (Early menopause) gwnjv‡`i
eøKRwbZ ü`‡iv‡Mi SzuwK †ekx|

54. gwnjv‡`i R¤§MZ ü`‡ivM wbb©‡qi Rb¨ wK wK cix¶v Kiv cÖ‡qvRb ?
gwnjv‡`i R¤§MZ ü`‡ivM wbb©‡qi Rb¨ ey‡Ki G·-‡i , BwmwR, B‡Kv,
Kvjvi Wcjvi I KvwW©qvK K¨v‡_Uvi cix¶v Kiv cÖ‡qvRb|

55. gwnjv‡`i R¤§MZ ü`‡ivM aiv co‡j wKfv‡e wPwKrmv Kiv DwPZ ?
gwnjv‡`i R¤§MZ ü`‡ivM †hgb : nv‡U©i wfZi wQ`ª _vK‡j Zv Device
ev Coil Gi gva¨‡g Intervention Gi mvnv‡h¨ eÜ Kiv hvq, A_ev
mvR©vix K‡i wQ`ª eÜ Kiv nq| ZvQvov wKQy wKQy Jla †meb Ki‡Z n‡e|

56. gwnjv‡`i ü`wc‡Û eøKRwbZ ü`‡ivM aiv co‡j wKfv‡e wPwKrmv
Ki‡Z n‡e ?
gwnjv‡`i ü`wcÛ eøKRwbZ ü`‡ivM aiv co‡j Jl‡ai cvkvcvwk GbwRIMÖvg
K‡i eøK `yi Kivi Rb¨ GbwRIcvwó ev wis emv‡bv nq Ges eø‡Ki cwigvb †ekx
n‡j A_ev wis emv‡bvi Dc‡hvMx bv n‡j evBcvm Acv‡ikb Kiv nq|

57. gwnjv‡`i ü`wc‡Ûi fvj&e mi“ n‡q †M‡j A_ev fvj&e bó n‡j
wKfv‡e wPwKrmv Ki‡Z n‡e ?
gwnjv‡`i ü`wc‡Ûi fvj&e evZR¡i RwbZ Kvi‡b bó n‡j ev mi“ n‡q
†M‡j Jl‡ai cvkvcvwk †ejyb w`‡q mi“ fvj&e †gvUv Kiv hvq hv‡K
wcwUGgwm e‡j| ZvQvov fvje †ekx bó n‡q wjK Ki‡j †m fvje
cwieZ©b K‡i bZzb K…wÎg fvj&e ms‡hvRb Kiv nq|
9
K
K
8
mvÿvrKviwU ÔAvb›` Av‡jvÕ cwÎKvq ÔI Wv³viÕ cvZvq 16 RyjvB, 2011, 07 el©, 07 msL¨vq Qvcv nq|
wPÎ t gvBUªvj †÷‡bvwmm wPÎ t eø‡Ki Kvi‡Y ey‡K e¨_v

59. GbwRIMÖvg Kivi cy‡e© †ivMxi wK wK ai‡bi cix¶v cÖ‡qvRb nq ?
GbwRIMÖvg Kivi c~‡e© †ivMxi Dchy³Zv hvPvB‡qi cix¶v Kiv nq| †ivMxi
CBC, BT,CT, Blood urea, S.creatinine, S.electrolytcs, CXR P/A
View, ECG, Echocardiogram, HBsAg, VDRL,Anti HCV, HIV, Blood
grouping & Rh factor cÖf„wZ cix¶v ¸‡jv Kiv cÖ‡qvRb|

60. GbwRIMÖvg Kivi c~e© cÖ¯‘wZ wK wK †bIqv nq ?
GbwRIMÖvg Kivi c~‡e© †ivMxi wdU‡bm †`Lvi Rb¨ wKQy wKQy i³cix¶vmn
Ab¨vb¨ cix¶v Kiv Avek¨K| ZvQvov bvfx †_‡K ga¨ivb ch©š— †jvg
cwi¯‹vi Ki‡Z n‡e|

61. GbwRIMÖvg Kivi mgq wK ‡ivMx‡K AÁvb Kiv nq ?
bv, GbwRIMÖvg Kivi Rb¨ †ivMx‡K AÁvb Kiv nq bv, m¤ú~b© Ávb _v‡K| ïaygvÎ
KzPKxi Kv‡Q wKQy RvqMv wjM‡bv‡KBb (Lignocaine) Jla w`‡q Aek Kiv nq|

62. GbwRIMÖvg Kivi mgq wK e¨_v cvIqv hvq ?
mvavibZ: GbwRIMÖvg Kivi mgq KuzPwKi Kv‡Q Aek Kivi Rb¨
wjM‡bv‡KBb Bb‡RKkb †`qvi mgq mvgvb¨ e¨_v jv‡M Ab¨_vq
GbwRIMÖvg m¤úyb© e¨_v gy³ cix¶v|
10

63. GbwRIMÖvg †Kvb c‡_ Kiv nq ?
GbwRIMÖvg mvavibZ: KzuPwKi Kv‡Q wd‡gvivj agbxi gva¨‡g Kiv nq|
†Kvb †Kvb †¶‡Î nv‡Zi †iwWqvj agbxi gva¨‡gI GbwRIMÖvg Kiv nq |

64. GbwRIMÖvg †ivMx‡K wK D‡cvm _vKvi cÖ‡qvRb Av‡Q ?
bv, GbwRIMÖvg †ivMx‡`i D‡cvm _vKvi ‡Kvb cÖ‡qvRb †bB| GbwRIMÖvg
†ivMx‡`i mvavibZ: mKv‡j nvjKv bv¯—v Ki‡Z ejv nq |

65. Wvqv‡ewUK †ivMxi GbwRIMÖvg Ki‡Z mKv‡ji Bbmywjb A_ev
U¨ve‡jU LvIqv wK `iKvi ?
bv, Wvqv‡ewUK †ivMx‡`i GbwRIMÖvg Ki‡Z mKv‡ji Bbmywjb †WvR ev
U¨ve‡jU eÜ ivL‡Z ejv nq |

66. GbwRIMÖvg Ki‡Z wK †Kvb we‡kl nvmcvZvj ev †gwk‡bi `iKvi ?
n¨vu, GbwRIMÖvg Ki‡Z KvwW©qvK we‡klvwqZ nvmcvZv‡ji K¨v_j¨ve
cÖ‡qvRb nq hv cÖwZ¯’vcb Ki‡Z 3-6 †KvwU UvKv cÖ‡qvRb |

67. GbwRIMÖvg Ki‡Z KZ mgq jv‡M ?
mvavibZ : GbwRIMÖvg Ki‡Z 10-15 wgwbU mgq jv‡M|

68. GbwRIMÖvg Kivi Rb¨ wK †ivMx‡K nvmcvZv‡j fwZ© _vK‡Z nq ?
n¨vu, GbwRIMÖvg Kivi Rb¨ †ivMx‡K mvavibZ: 12-24 N›Uvi Rb¨
nvmcvZv‡j fwZ© _vK‡Z nq| †Kvb ‡Kvb †¶‡Î †iwWqvj agbxi gva¨‡g
ev Avjbvi agbxi gva¨‡g GbwRIMÖvg Ki‡j †ivMx †W †Km wnmv‡e
nvmcvZv‡j ivÎ _vKvi cÖ‡qvRb bvB|

69. GbwRIMÖvg Kivi mgq †Kvb mgm¨v n‡Z cv‡i wK ?
n¨vu, GbwRIMÖvg Kivi mgq Aí ev †ekx i³¶ib n‡Z cv‡i| ZvQvov
KzuPwKi RvqMvq i³RgvU evua‡Z cv‡i , e¨_v n‡Z cv‡i Vaso vagal
attack n‡Z cv‡i | K‡ivbvix wW‡mKkb (Dissection) n‡Z cv‡i, cv‡qi
agbx‡Z (Peripheral artery) †Z Dissection n‡Z cv‡i, †ivMxi i³Pvc
K‡g †h‡Z cv‡i, V.T, V.F bvgK (malignant arrhythmia) n‡Z cv‡i,
GgbwK †ivMx gviv ch©š— †h‡Z cv‡i| Z‡e Zv LyeB Kg †`Lv hvq|
11
K
K
9

70. GbwRIMÖvg wK ?
GbwRIMÖvg GKwU ü`†ivM wbY©‡qi c×wZ|
GB cix¶vi gva¨‡g ü`wc‡Ûi i³bvjxi
(K‡ivbvix) wfZi †Kvb eøK ev (Stenosis)
_vK‡j Zv wbY©q Kiv hvq|

71. GbwRIMÖvg Kv‡`i Kiv nq ?
‡h mg¯— †ivMxi nvU© A¨vUvK nq, †m mg¯—
†ivMxi i³bvjxi eøK †`Lvi Rb¨ I
cÖ‡qvRbxq wPwKrmv Kivi Rb¨ GbwRIMÖvg
Kiv nq| ZvQvov hv‡`i BwUwU cwRwUf nq
A_¨v©r K‡ivbvix nvU© wWwRR nevi m¤¢vebv
†ekx Zv‡`iI GbwRIMÖvg Kiv nq|
ü`wc‡Ûi i³bvjxi (K‡ivbvix) wfZi
eøK wbb©‡q GbwRIMÖvg

73. GbwRIMÖvg Ki‡Z KZ UvKv LiP nq ?
evsjv‡`‡k GbwRIMÖvg Ki‡Z †m›Uvi †f‡` 12500/- †_‡K 17000/-
UvKv LiP nq

74. GbwRIMÖvg wi‡cv‡U© SVD (Single Vessel Disease) wK ?
GbwRIMÖvg wi‡cv‡U© wm‡½j †f‡mj wWwRR (Single Vessel Disease) nj
ü`wc‡Ûi K‡ivbvix agbxi †h †Kvb GKwU i³bvjx hw` 70 fv‡Mi †ekx
eøK ev †÷‡bvwmm _v‡K Zvn‡j Zv‡K wm‡½j †f‡mj wWwRR (Single
Vessel Disease) e‡j |

75. ü`wc‡Ûi i³bvjx KZwU ?
ü`wc‡Ûi i³bvjx cÖavbZ: wZbwU | Wvbw`‡K Wvb K‡ivbvix agbx
(Right coronary artery), evgw`‡K evg cÖavb K‡ivbvix agbx (Left
main coronary artery) hv fvM n‡q `yÕwU i³bvjx Left anterior
descending artery Ges Left circumflex artery| GQvov Gme
i³bvjxi wKQy kvLv i³bvjx Av‡Q †hgb : Wvqv‡Mvbvjm& (Diagonals),
i¨vgvm (Ramus), Ges Obtuse marginals (OM) cÖf„wZ †h¸‡jv‡Z eø-
K n‡j Zv Zvrch©c~b© n‡Z cv‡i|

76. †Kvb& i³bvjx‡Z eøK n‡j Zv †ekx wec¾bK ?
mvavibZ: †h †Kvb i³bvjx‡Z eø‡KR n‡j Zv gvivZ¡K n‡Z cv‡i |
Z_vwc Left main coronary
artery ev left anterior
descending artery- i ïi“‡Z
eøK n‡j Zv †ekx wec¾bK|

77. ü`wc‡Ûi i³bvjx‡Z eøK
n‡j wPwKrmv wK ?
ü`wc‡Ûi i³bvjx‡Z wm‡½j
†f‡mj wWwRR (Single
Vessel Disease) n‡j wPwKrmv
Stenting ev Angioplasty;
12
Double vessel disease n‡j Ges Lesion hw` Dchy³ _v‡K Z‡e
Stenting Kiv nq Ab¨_vq CABG ev evBcvm Acv‡ikb | wKš‘ Left
main coronary artery eøK n‡j ev Triple vessel disease n‡j mvavibZ:
bypass Acv‡ikb A_ev CABG Kiv fvj | Z‡e eZ©gv‡b hw` Lesion
(eøK) Suitable nq Z‡e me‡¶‡Î PTCA ev Angioplasty ev Stenting
nj AvaywbK wPwKrmv|

78. Double vessel disease (DVD) I Triple vessel disease(TVD) wK ?
hw` cÖavb cÖavb `ywU i³bvjx‡Z Zvrch©c~b© A_©vr mËi fv‡Mi †ekx eøK
_v‡K Zv‡K
Double vessel
disease (DVD)
Ges wZbwU
i³bvjx‡Z eøK
_v‡K Zv‡K Triple
vessel disease
(TVD) e‡j|

79. GbwRIMÖvg
wi‡cvU© †Kvb eøK
Zvrch©c~b© ?
GbwRIMÖvg Kivi mgq hw` i³bvjx‡Z 70% eøK aiv c‡o Z‡e Zv
Zvrch© c~b©|

80. i³bvjxi eø‡Ki cwigvb wbb©‡qi Rb¨ GbwRIMÖvgB wK GKgvÎ cix¶v ?
bv, i³bvjxi eø‡Ki cwigvb wbb©‡qi Rb¨ GbwRIMÖvg QvovI AvBfvm
(IVUS) AwZ ¸i“Z¡ c~b©|

81. i³bvjx‡Z eøK _vK‡jB wK wis emv‡bv ev Stenting Gi cÖ‡qvRb ?
bv, i³bvjx‡Z hw` Zvrch©c~b© A_¨©vr 70 fv‡Mi Dc‡i eøK bv _v‡K Z‡e
Stenting Gi cÖ‡qvRb †bB| Avevi hw` †Kvb eøK Flow limiting bv nq
A_¨v©r i³cÖevn †Zgb evuavi m„wó bv K‡i Z‡e Stenting Gi cÖ‡qvRb †bB|
13
K
K
10
mvÿvrKviwU Ô‰`wbK mgKvjÕ cwÎKvq 11 Ryb, 2011 Bs Zvwi‡L cÖKvwkZ nq|wPÎ t GbwRIMÖv‡g ü`wc‡Ûi i³bvjx
wPÎ t K¨v_j¨v‡e ü`wc‡Ûi i³bvjx‡Z †÷bwUs Ki‡Qb ‡jLK

82. D”Pi³Pvc RwbZ ü`‡ivM, cÖ`vnRwbZ ü`‡ivM A_ev ü`wc‡Ûi Pvi
cv‡k cvwb Rgv ü`‡iv‡M Av všÍ n‡Z cv‡i|

83. eøK RwbZ ü`‡iv‡M †ivMxi ey‡K e¨_vi aiY wK n‡Z cv‡i ?
eøK RwbZ ü`‡iv‡M †ivMxi ey‡K e¨_v ey‡Ki gvSLv‡b mvaviYZ nq Ges
eyK e¨_v cwikªg Ki‡j ev wmwo fv½‡j ev‡o A_ev evRv‡ii e¨vM nv‡Z
wb‡q nuvU‡j ev‡o GgbwK Lvevi MÖnY Kivi ci nuvU‡j ev‡o| e¨_v evo‡j
†ivMxi k¦vmKó I AwZwi³ Nvg n‡Z cv‡i| ey‡Ki G e¨_v wRnŸvi bx‡P
bvB‡UªU †¯cÖ Ki‡j ev bvB‡UªU U¨ve‡jU wRnŸvi bx‡P ivL‡j mv‡_ mv‡_
eyK e¨_v K‡g hvq| ey‡Ki G e¨_v evg n‡Z w`‡q bvg‡Z cv‡i|

84. Rb¥MZ ü`‡ivM wK wK DcmM© †`Lv hvq ?
Rb¥MZ ü`‡iv‡M †ivMx nVvr bxj n‡q †h‡Z cv‡i, eyK aodo Ki‡Z
cv‡i, k¦vm Kó n‡Z cv‡i A_ev ey‡K mvgvb¨ e¨_v n‡Z cv‡i|

85. eøK RwbZ ü`‡iv‡M †ivMxi wK wK DcmM© nq ?
ü`wc‡Ûi i³bvjxi eøKRwbZ ü`‡iv‡M ey‡K Zxeª e¨_v n‡Z cv‡i hv
cwikªg Ki‡j ev‡o, k¦vmKó n‡Z cv‡i, GgbwK nvU© A¨vUvK n‡j Zxeª
ey‡K e¨_v, cvkvcvwk AwZwi³ Nvg I ewg n‡Z cv‡i|
14

86. nvU© †dBjvi n‡j wK wK DcmM© †`Lv hvq ?
nvU© †dBjvi n‡j ïiæi w`‡K Aí cwikª‡g †ivMxi k¦vmKó n‡Z cv‡i ev
`~e©j jvM‡Z cv‡i, Ges iv‡Z †kvevi ci AwaK iv‡Z k¦vmK‡ó Nyg
†f‡½ †h‡Z cv‡i| nvU© †dBjvi AwZwi³ n‡j †ivMxi emv Ae¯’vq k¦vmKó
n‡Z cv‡i GgbwK dzmdz‡m cvwb Rgv QvovI `ycv‡q cvwb Avm‡Z cv‡i|

87. nvU© †dBjv‡i wjfv‡i wK mgm¨v n‡Z cv‡i ?
A‡bKw`b ax‡i Awbqwš¿Z nvU© †dBjvi _vK‡j i³ wjfv‡i Rgv n‡Z
_v‡K Ges hK…‡Zi †Kvl¸‡jv Av všÍ n‡q †Kvb †Kvb †Kvl bó n‡Z
cv‡i| G‡Z wjfvi GbRvBg i‡³ e„w× cvevi cvkvcvwk RwÛm n‡Z cv‡i,
GgbwK wjfvi bó n‡Z cv‡i| wjfvi bó n‡q KvwW©qvK wm‡ivwmmI n‡Z
cv‡i, Zv‡Z †c‡U cvwb Avmvi cvkvcvwk Ab¨vb¨ DcmM© †`Lv hvq|

88. nv‡U©i B‡jKwUªK jvB‡b eøKRwbZ ü`‡ivM n‡j wK wK DcmM© n‡Z cv‡i ?
nv‡U©i B‡jKwUªK jvB‡b eøK n‡j ü`wc‡Ûi MwZ kø_ n‡q c‡o Ges d‡j
ü`wc‡Ûi Kvh©ÿgZv ev AvDUcyU K‡g hvq| d‡j †ivMx `ye©jZv †eva Kivi
cvkvcvwk nvU© †dBjv‡ii DcmM© wb‡q Wv³v‡ii Kv‡Q Avm‡Z cv‡i|

89. evZR¡i RwbZ ü`‡ivM n‡j †ivMx wKfv‡e Wv³v‡ii Kv‡Q Avm‡Z cv‡i ?
evZR¡i RwbZ ü`‡ivM
_vK‡j †ivMxiv wMive¨_v ev
wMivdzjvi cvkvcvwk, eyK
aodo Kiv, ey‡K e¨_v,
k¦vmKó nIqv, kix‡i cvwb
bvgv wb‡q Wv³v‡‡ii Kv‡Q
Avm‡Z cv‡i|

90. ü`wc‡Ûi Pvicv‡ki
cvwb Rg‡j †ivMxi wK
DcmM© n‡Z cv‡i ?
ü`wc‡Ûi Pvicv‡k cvwb
Rg‡j †ivMxi k¦vmKó, ey‡K
Pvc Abyfe Kiv GgbwK
†cU I cv dzjv wb‡q
Wv³v‡ii Kv‡Q †h‡Z cv‡i|
15
K
K
11

91. GKRb ü`‡ivMx wK wK DcmM© wb‡q
ü`‡ivM we‡kl‡Ái Kv‡Q Avm‡Z cv‡i ?
GKRb ü`‡ivMx Zvi ü`‡iv‡Mi aib
Abymvix wewfbœ DcmM© wb‡q ü`‡ivM
we‡kl‡Ái civg‡k©i Rb¨ Avm‡Z cv‡i|
ü`‡ivMxiv mvaviYZ ey‡K e¨_v, k¦vmKó ev
eyK aodi Kiv, nVvr bxj n‡q hvIqv wb‡q
Wv³v‡ii wbKU Avm‡Z cv‡i|

92. GKRb e¨w³ wK wK ai‡bi ü`‡iv‡M
Av všÍ n‡Z cv‡i ?
GKRb e¨w³ Rb¥MZ ü`‡ivM, i³bvjx‡Z
eøKRwbZ ü`‡ivM, evZe¨_v RwbZ ü`‡ivM,
ü`‡iv‡Mi DcmM© I jÿYmg~n
26 b‡f¤^i 2011 Zvwi‡L Ô‰`wbK hyMvšÍi cwÎKvÕq cÖKvwkZ nq|
wPÎ t nvU© A¨vUv‡Ki Kvi‡Y ey‡K e¨_v

93. k¦vmKó †ivMx‡`i Kibxq

94. wK wK Kvi‡b k¦vmKó nq?
ü`‡ivM, dzmdz‡mi †ivM, ey‡Ki LuvPvi nv‡oi †ivM, gvbwmK `ywðšÍvi
Kvi‡b k¦vmKó n‡Z cv‡i|

95. k¦vmKó †ivMx‡`i wK wK wRwbm cwinvi Ki‡Z n‡e?
Zyjv, VvÛv, †cvlv KyKzi, weovj, N‡i Kv‡c©U, Av‡jv , AÜKvi m¨uvZ‡mu‡Z
Ni, Ni Svo– †`Iqv cwinvi Kiv DwPZ|

96. wK wK KvR Kiv DwPZ bq?
Ni Svo– †`Iqv, N‡ii Szj Svov, ¸uov gmjv, Pvj, Wvj, Mg Svovi KvR
ev evQvi KvR cwinvi Ki‡Z n‡e|

97. Lv‡`¨i e¨vcvi wK wK mZK©Zv Aej¤^b Ki‡Z n‡e?
‡h me Lvev‡ii k¦vmKó ev‡o ‡hgb- VvÛv wRwbm, AvBmw g, wPswo gvQ,
†LRy‡ii im Gi e¨vcv‡i mZK©Zv Aej¤^b Ki‡Z n‡e

98. Jl‡ai e¨vcv‡i wK wK mZK©©Zv Aej¤^b Ki‡Z n‡e?
B‡Kvw¯cÖb, G¨vWjK, Bb‡Wfvi, †U‡bv‡ib, †U‡bvjK, Kvwf©÷v KvwWU¨ve
wWjv‡UªW RvZxq Jla, kix‡ii e¨_vi Jla Wv³v‡ii civgk© Qvov LvIqv
DwPZ bq|

99. kxZKv‡j wK wK mZK©Zv wb‡Z n‡e?
kxZKv‡j †Mvm‡j, IRy‡Z ev nvZ cv ay‡Z h_vm¤¢e Mig cvwb e¨envi Ki‡Z
n‡e, Kzmyg Mig cvwb cvb Ki‡Z n‡e Avi †kvevi Ni Mig ivL‡Z n‡e|
16
K
K
12

100. ‡ckvMZ Kvi‡b k¦vmKó
n‡j wK Kiv DwPZ?
cÖ‡qvR‡b †ckv cwieZ©b
Ki‡Z n‡e,Ab¨_vq Kg
ayjvi ¯’v‡b KvR‡K cwieZ©b
Kiv| Kv‡Ri mgq bvK I
gy‡Li Dci cvZjv Kvc‡oi
gv¯‹ ev gy‡Lvk e¨envi
Ki‡Z n‡e| wPÎ t wewfbœ cÖKv‡ii Gjvi‡Rb hv k¦vmK‡ói KviY

101. k¦vmKó †ivMxi wPwKrmvq cwiev‡ii f~wgKv wK?
gvbwmK Pvc, DrKÉv, `ywðšÍvi Kvib n‡jv †ekxi fvM †ÿ‡Î ‡ivMxi
Avw_©K I mvgvwRK mgm¨v, hv k¦vmKó e„w× cvevi Ab¨Zg Kvib| Avi
ZvB cwiev‡ii Ab¨vb¨ mevi `vwqZ¡ †ivMxi gvbwmK Pvc‡K Kgv‡Z mvnvh¨
K‡i|

102. k¦vmKó †ivMxi Avi wK wK mveavbZv Aej¤^b Kiv DwPZ?
aygcvb Kiv hv‡e bv, GgbwK Ab¨ †KD Ki‡j bv‡K iægvj e¨envi Ki‡Z
n‡e| cwikªg ev ‡`Šov‡`Šwo K‡i k¦vmKó n‡j Dchy³ Jla †me‡bi ci
Zv Ki‡Z n‡e, Ab¨_vq AwZwi³ cwikª‡gi KvR cwinvi Ki‡Z n‡e|

103. k¦vmKó gyw³‡Z †`kxq ev ebvRx Jla ev nvZz‡o wPwKrmvi f‚wgKv wK ?
Av‡ivM¨ jv‡fi Avkvq wewfbœ weÁw߇Z AvK…ó n‡q ev †jvK m¤§y‡L
gyL‡ivPK K_v ï‡b wewfbœ ai‡bi †`kxq ev nvZzwo wPwKrmvq Avkªq †bIqv
DwPZ bv, KviY Gme Jla ¯^í‡gqv`x wKQz Dcmg Ki‡jI `xN© †gqvw`
e¨env‡i wKWbx I wjfv‡ii gvivZ¥K mgm¨v Ki‡Z cv‡i|

104. k¦vmKó †ivMx‡`i Gw›U A¨vj¨vwR f¨vKwmb Gi Kvh©KvwiZv wK ?
GUv GKUv wejvwmZv gvÎ, f¨vKwmb w`‡q gvÎ kZKiv 5 fvM †ivMx
DcKvi cvq, wKš‘ G DcKvi LyeB ÿY¯’vqx I e¨qeûj|
17
wPÎ t Bb †njvi wPÎ t A¨vKz‡njvi

105. ü`wcÛ eo n‡q †M‡j Kibxq

106. ey‡Ki G·‡i-†Z ü`h‡š¿i AvKvi eo n‡q †M‡j Kibxq wK?
ey‡Ki G·‡i-†Z ü`h‡š¿i AvKvi eo n‡j, mwZ¨B ü`wcÛ eo n‡q †M‡Q
wKbv Zv cixÿv Ki‡Z n‡e B‡KvKvwW©IMÖv‡gi gva¨‡g| G cixÿv Øviv
eyS‡Z cviv hv‡e †h ü`wcÛ Avm‡j eo n‡q‡Q wKbv, A_ev ü`wcÛ eo
nevi KviYI wbY©q Kiv hvq|

107. ey‡Ki G·‡i wi‡cvU© nvU© GbjvR© A_v©r ü`wc‡Ûi AvKvi eo n‡q
†M‡j DwØMœ nevi KviY Av‡Q wK?
- nu¨v, ü`wc‡Ûi AvKvi eo n‡j ü`wc‡Ûi wKQz wKQz ¸iæZi †iv‡Mi
Kvi‡Y Zv n‡Z cv‡i| hw`I ü`wc‡Ûi AvKvi mwZ¨Kvi fv‡e ¯^vfvweK
_vK‡jI A‡bK mgq ey‡Ki G·‡i-†Z ü`wc‡Ûi AvKvi eo Avm‡Z
cv‡i|

108. wK wK Kvi‡Y ey‡Ki G·‡i-†Z ü`wc‡Ûi AvKvi eo Avm‡Z cv‡i?
ü`wc‡Ûi wewfbœ Awj›` ev cÖ‡Kvô eo n‡q ‡M‡j, nvU© G¨vUvK n‡j,
KvwW©Igv‡qvc¨vw_ n‡j, ü`wc‡Ûi Pvicv‡k cvwb Rg‡j, ü`wc‡Ûi
gvsm‡cwk‡Z ms‡KvPb ÿgZv A‡bK n«vm †c‡j ey‡Ki G·‡i‡Z ü`wc‡Ûi
AvKvi eo n‡Z cv‡i|

109. ey‡Ki G·‡i-‡Z ü`wc‡Ûi AvKvi ü`wc‡Ûi †Kvb ¸iæZi Amy‡Li
Kvi‡Y eo n‡q‡Q wKbv Zv wKfv‡e eySv hvq?
ey‡Ki G·‡i-‡Z ü`wc‡Ûi AvKvi eo n‡q †M‡j GKRb ü`‡ivM
we‡kl‡Ái civgk© ‡g B‡Kv Kvjvi Wcjvi cixÿv Kiv‡j ü`wc‡Ûi
†`qv‡ji mÂvjb, fvj&‡ei Ae¯’v, evwn‡ii c`v©i Ae¯’v m¤ú‡K© Rvbv
hv‡e I KviY wbY©q Kiv hv‡e|

110. ey‡Ki G·‡i-‡Z ü`wc‡Ûi AvKvi eo cvIqv †M‡j B‡Kv Wcjv‡ii
gva¨‡g wK wK Z_¨ cvIqv hvq?
B‡Kv Wcjvi Ki‡j ey‡Ki G·‡i-‡Z ü`wc‡Ûi AvKvi eo nIqvi KviY
‡hgb- fvj‡ei wj‡KR ev †÷‡bvwmm, KvwW©Igv‡qvc¨vw_, †cwiKvwW©qvj
BwdDkb, gv‡qvKvWv©BwUm †ivM wbY©q Kiv hvq|
18
K
13

111. ü`wcÛ eo n‡q hvIqvi
KviY wK wK?
ü`wcÛ eo nIqvi
mvaviY KviY¸‡jv
n‡jv nvU©A¨vUvK,
wbK wiDg¨vwUK
nvU© wWwRR ev
evZR¡i, wewfbœ
wfUvwg‡bi Afve,
ü`wc‡Ûi c`v©q
h²v, nvB‡cv_vB-
‡ivwWRg, i³ïb¨Zv,
kix‡ii wewfbœ
19
RvqMvq K¨vÝvi hv ü`wc‡Û Qovq cÖf…wZ|

112. ü`wcÛ hv‡Z eo bv n‡q hvq †mRb¨ wK wK mveavbZv Aej¤^b Ki
DwPZ?
nvU© G¨vUv‡Ki ci wbqwgZ Jla LvIqv I ü`‡ivM we‡klÁi ZË¡veav‡b
_vKv, evZR¡i wbqš¿Y Kiv I wbqwgZfv‡e cÖ‡qvR‡b B‡KvKvwW©IMÖvg
cixÿv Kiv|

113. ü`wcÛ eo n‡q †M‡j †ivMxi wK wK mgm¨v n‡Z cv‡i?
ü`wcÛ eo n‡q †M‡j †ivMxi k¦vmKó we‡kl K‡i iv‡Z †kvevi ci, Aí
cwikª‡g nvuwc‡q DVv, cv‡q cvwb Avmv, wjfvi eo n‡q hvIqv mn Ab¨vb¨
DcmM© n‡Z cv‡i|

114. ü`wcÛ eo n‡q †M‡j wK wK cixÿv Kiv‡bv DwPZ?
BwmwR, B‡KvKvwW©IMªvg I Kvjvi Wcjvi, _vBi‡qW dvskb †U÷,
wn‡gv‡Møvwe‡bi gvÎv cixÿv Kiv‡bv DwPZ|

115. ü`wcÛ eo n‡q ‡M‡j wK wPwKrmv Kiv‡Z n‡e ?
ü`wcÛ eo n‡q †M‡j KviY Abymv‡i wPwKrmv Ki‡Z n‡e| evZR¡‡ii
Kvi‡b n‡j evZR¡i wPwKrmv, nvU© G¨vUv‡Ki Kvi‡Y n‡j ‡mfv‡e wPwKrmv,
nvB‡cv_vBiqwWRg n‡j _vBi‡qW wi‡cøm‡g›U wPwKrmv Ki‡Z n‡e|

117. Wvqv‡ewUm wK ?
Wvqv‡ewUm GKwU wecvKRwbZ †ivM| G †ivM n‡j i‡³ ¯’vqxfv‡e Møy‡KvR
Gi cwigvb †e‡o hvq| Avgv‡`i kix‡i AMœ¨vkq †_‡K Bbmywjb bvgK
GKwU ni‡gvb wbtm„Z nq| GB Bbmywj‡bi KvR n‡”Q i‡³i Møy‡KvR †K
†f‡½ Zv kix‡ii wewfbœ Kv‡R jvMv‡Z mvnvh¨ Kiv| †Kvb Kvi‡Y GB
Bbmywjb ni‡gv‡bi m¤úyb© ev Av‡cw¶K NvUwZi Kvi‡Y wecvKRwbZ
mgm¨vi m„wó n‡q Møy‡KvR †e‡o hvIqv Ges AwZwi³ Møy‡KvR cÖkªv‡ei
mv‡_ †ei n‡q AvmvB n‡”Q Wvqv‡ewUm |

118. Wvqv‡ewUm †iv‡Mi j¶b wK wK ?
1. Nb Nb cÖkªve nIqv, 2. Lye †ekx wccvmv jvMv, 3. AwZwi³ ¶zav
cvIqv, 4. ch©vß LvIqvi c‡iI IRb K‡g hvIqv, 5. Aí‡ZB K¬vwš— I
`ye©jZv †eva Kiv, 6. kix‡ii †Kvb ¶Z¯’vb ïKv‡Z †`ix nIqv, 7. wewfbœ
Pg©‡ivM †hgb †Lvuk-cvuPov BZ¨vw` †ekx cwigv‡Y †`Lv †`Iqv BZ¨vw`|

119. Kv‡`i Wvqv‡ewUm nIqvi m¤¢vebv ?
‡h †Kvb eq‡m, ‡h Kv‡iv Wvqv‡ewUm n‡Z cv‡i, Z‡e hv‡`i G †iv‡M
Av vš— nevi m¤¢vebv †ekx Zviv n‡jb : 1. hv‡`i es‡k G †ivM Av‡Q |
†hgb t evev, gv, `v`v, `v`x hv‡`i G †ivM Av‡Q | 2. hv‡`i IRb
20
†ekx Ges hviv kvixwiK cwikª‡gi †Kvb KvR K‡ib bv| 3. Mf©ve¯’vq
G †iv‡Mi cÖKvk NU‡Z cv‡i |

120. Wvqv‡ewUm n‡j wbqš¿‡bi Rb¨ wK wK Kiv DwPZ ?
Wvqv‡ewUm wbivgq ev m¤ú~Y©i“‡c mviv‡bv hvq bv | Z‡e G †ivM
m¤ú~b©fv‡e wbqš¿b ivLv hvq| K‡qKwU wel‡q †ivMx‡K wbqg gvb‡Z n‡e|
†ivMx‡K Aek¨B GKUv my›`i myôz, k„•Lj Rxebhvcb Ki‡Z n‡e|
†ivMx‡K wKQ~ Lv`¨ MÖn‡Yi bxwZ †g‡b Pj‡Z n‡e| k„•Ljv I Lv`¨ e¨e¯’vi
cvkvcvwk A‡bK †¶‡ÎB Wv³v‡ii civgk©gZ Jla I Bbmywbj‡bi
cÖ‡qvRb n‡Z cv‡i| †h‡nZz Wvqv‡ewUm †ivM‡K mywbqwš¿Z Kiv hvq
†m‡nZz G †ivM m¤§‡Ü fv‡jvfv‡e wk¶vMÖnb K‡i Ges G †iv‡Mi RwUjZv
m¤§‡Ü fv‡jvfv‡e †R‡b mn‡RB G †ivM‡K wbqš¿b ivLv hvq| wbqwgZ
nvuUv-Pjv, nvjKv e¨vqvg Ges kvixwiK cwikªg G †ivM‡K wbqš¿‡b ivL‡Z
mvnvh¨ K‡i|

121. Wvqv‡ewUm n‡j wK wK LvIqv DwPZ bq ?
wgwó RvZxq Lvevi †hgb wgwó RvZxq we¯‹zU, wPwb w`‡q ˆZwi Kiv †KK,
†cwóª, R¨vg, †Rjx, †LRy‡ii im, Zv‡ji im, †KvKv‡Kvjv, †ccwm, Aviwm
†Kvjv, K‡ÛÝ wgé, ¸o, Møy‡KvR LvIqv cy‡ivcywi wbwl×|

122. Wvqv‡ewUm n‡j wK wK wRwbm †ekx †L‡Z n‡e ?
me iKg kvK †hgb cvjskvK, jvjkvK, cyBkvK, KjwgkvK, WvUvkvK,
KPzkvK †ekx †L‡Z n‡e| UK RvZxq dj, KvjRvg, Avgov, †jey, Rv¤^yiv,
Rvgi“j, AvgjwK I
KwP Wv‡ei cvwb
LvIqv hv‡e|
wPbvev`vg, mvgyw`ªK
gvQ †ekx †L‡Z n‡e|

123. Wvqv‡ewUm n‡j wK
wK ai‡bi Jla
e¨envi Kiv nq ?
Wvqv‡ewUm n‡j gy‡L
Lvevi Jla I
Bbmywjb Bb‡RKkb
e¨envi Kiv nq|
21
K
K
14

124. ü`‡iv‡Mi mv‡_ Wvqv‡ewU‡mi m¤úK© wK ?
Wvqv‡ewUm nj K‡ivbvix ü`‡iv‡Mi Ab¨Zg
cÖavb wi¯‹ d¨v±i| ejv nq Wvqv‡ewUm
_vK‡j †ivMxi ü`wc‡Ûi i³bvjx‡Z Pwe©i
Av¯—i Rgv c‡o A_v©r K‡ivbvix ü`‡ivM
Av‡Q| ZvB DbœZ we‡k¦ Wvqv‡ewU‡mi
wPwKrmv mvavibZ: ü`‡ivM we‡klÁivB
K‡i _v‡Kb| Wvqv‡ewUm _vK‡j K‡ivbvix
ü`‡iv‡Mi cvkvcvwk †ivMxi nvZ I cv‡qi
i³bvjxi eøK A_ev nvU© †dBjvi †ivM
n‡Z cv‡i|
Wvqv‡ewUm I ü`‡ivM
wPÎ t Møy‡KvwgUvi w`‡q Wvqv‡ewUm cixÿv

126. Wvqv‡ewU‡mi wPwKrmvq gy‡L Lvevi Jla wK wK ai‡bi e¨envi Kiv hvq ?
Wvqv‡ewUm wPwKrmvq gy‡L Lvevi Jla wnmv‡e mvavibZ : `yB ai‡bi Jla
e¨envi Kiv nq| GK ai‡bi Jla †ivMxi kix‡i c¨vbw qvm bvgK MÖwš’ †_‡K
Bbmywjb wbtmib K‡i Ges Aci ai‡bi Jla Bbmywjb hv‡Z kix‡i fvjfv‡e
KvR Ki‡Z cv‡i I Bbmywjb †iwRóvÝ hv‡Z Kgvq †mfv‡e KvR K‡i |

127. Wvqv‡ewU‡mi wPwKrmvq †Kvb& †Kvb& ai‡bi gy‡L LvIqvi Jla
Bbmywjb wbtmib K‡i ?
Wvqv‡ewU‡mi wPwKrmvq gy‡L LvIqvi Jla hv Bbmywjb wbtmib Kivq
Zviv nj MøvBK¬vRvBW RvZxq Jla (†hgb- WvB‡gij, Kw¤cÖW, KbmyKb,
Wvqv‡cÖv, MøvBwRW BZ¨vw`), wMøwgwcivBW RvZxq Jla (†hgb -
A¨vgvwij)|

128. †Kvb †Kvb ai‡bi Jla
Bbmywjb †iwRóvÝ Kgvq ?
‡gUdiwgb RvZxq Jla
(†hgb - †Kv‡gU, MøvBwgb,
Bbdi‡gU cÖf„wZ) I wMø-
UvRb RvZxq Jla
(†hgb- cvB‡qvwMøUvRb,
iwmwMøUvRb) Bbmywjb
†iwR÷vÝ Kgvq|

129. †gvUv †ivMx‡`i
mvavibZ: †Kvb ai‡bi
Wvqv‡ewUm nq Ges
wPwKrmvq †Kvb ai‡bi Jla e¨envi Kiv nq ?
‡gvUv †ivMx‡`i mvavibZ: UvBc-2 ai‡bi Wvqv‡ewUm nq Ges GB
†ivMx‡`i wPwKrmvi Rb¨ †gUdiwgb RvZxq Jla fvj KvR K‡i|

130. gy‡L Lvevi Jla fvj bv Bbmywjb fvj ?
UvBc-1 Wvqv‡ewUm †ivMx‡`i †¶‡Î Aek¨B Bbmywjb e¨envi Ki‡Z n‡e|
UvBc-2 Wvqv‡ewUm †ivMx‡`i †¶‡Î Wvqv‡ewU‡mi gvÎv Kg n‡j gy‡L
Lvevi Jla w`‡q wbqš¿b Kiv nq| gvÎv A‡bK †ekx n‡j cÖ_‡g Bbmywjb
w`‡q †gvUvgywU wbqš¿b K‡i gy‡L Lvevi Jla w`‡q cieZx©‡Z wbqšÎ†bi
22
†Póv Kiv nq| †ivMxi IRb †ekx n‡j †gUdiwgb RvZxq Jla w`‡q
wbqš¿b Kiv nq|

131. †Kvb †Kvb †¶‡Î gy‡L Lvevi Jla †`qv nq ?
‡ivMxi Wvqv‡ewU‡mi gvÎv Kg _vK‡j ev †ivMxi IRb AZ¨vwaK †ekx
n‡j Avgiv gy‡L Lvevi Jla w`‡q Wvqv‡ewUm wbqš¿b Kwi, A_ev
Bbmywj‡bi cwigvb Lye †ekx cÖ‡qv&Rb n‡j A_vr Bbmywjb †iwRóvÝ
_vK‡jI gy‡L Lvevi Jla Bbmywj‡bi cvkvcvwk e¨envi Kiv nq |

132. Bbmywjb w`‡b KZevi e¨envi Kiv DwPZ ?
nvmcvZv‡j fwZ© †ivMx‡`i †¶‡Î A_ev cÖ_gevi Bbmywjb e¨env‡ii
†¶‡Î A_ev Acv‡ik‡bi mgq Bbmywjb e¨envi Ki‡j Avgiv ¯^íKvjxb
¯’vqx (short acting) Bbmywjb e¨envi Kwi, †m‡¶‡Î w`‡b 3 evi Bbmywjb
e¨envi Kiv nq| Intermediate acting Bbmywjb (Mixtard) e¨envi
Ki‡j w`‡b 2evi Kiv DwPZ| `xN© Kvjxb ¯’vqx (Long acting) Bbmywjb
e¨envi Kiv nq mvavibZ: iv‡Z 1evi (Bbmywjb MøviwRb)|

133. Bbmywjb ev gy‡L Lvevi Jla †L‡j wK wK mZK©Zv †bIqv DwPZ ?
Bbmywjb ev gy‡L Lvevi Jla †L‡j KLbI KLbI Wvqv‡ewU‡mi gvÎv
A‡bK K‡g wM‡q nvB‡cvMøvB‡mwgqv n‡Z cv‡i, G‡Z gvivZœK mgm¨v †`Lv
w`‡Z cv‡i| ZvB G‡¶‡Î mZK©Zv Aej¤^b Kiv DwPZ| cÖ‡Z¨K †ivMxi
evmvq Wvqv‡ewUm gvcvi Rb¨ e¨w³MZ hš¿ _vKv DwPZ| †Kvb m‡›`n
n‡jB wi‡d¬v cix¶v Kiv DwPZ| ZvQvov Wvqwiqv n‡j ev †c‡Ui cxov n‡j
A_ev †Kvb †ejv Lvevi bv †L‡j ev †ivRvi mgq Bbmywjb Gi gvÎv wVK
Ki‡Z n‡e ev gy‡L LvIqvi Jla cÖ‡qvR‡b eÜ ivL‡Z n‡e|

134. nvB‡cvMøvB‡mwgqv n‡j wK Ki‡Z n‡e ?
nvB‡cvMøvB†mwgqv (Hypoglycaemia) n‡j AwZmË¡i eøvW myMvi †PK Kiv
cÖ‡qvRb| eøvW myMvi cix¶v Kiv m¤¢e n‡j Ges Zv Kg gvÎvi n‡j A_ev
†PK Kiv m¤¢e bv n‡j wPwb cvwb‡Z ¸wj‡q †L‡Z n‡e A_ev KvQvKvwQ
Laboratory cix¶vq Møy‡Kv‡Ri gvÎv Lye Kg n‡j nvmcvZv‡j fwZ© n‡Z
n‡e Ges wkivq Møy‡KvR Bb‡RKkb ev m¨vjvBb wb‡Z n‡e|

135. nvB‡cvMøvB‡mwgqv n‡j wKfv‡e eySv hvq ?
nvB‡cMvB‡mwgqv n‡j AZ¨vwaK Nvg †ei nq, cvkvcvwk eyK aodo Kiv,
Aw¯’iZv jvMv GgbwK AÁvb nIqv Ges wLPzubx I n‡Z cv‡i|
23
K
K
15
mvÿvrKviwU 15 wW‡m¤^i 2011 Zvwi‡L ÔmvßvwnKÕ cwÎKvq ¯^v¯’¨ cvZvq cÖKvwkZ nq|
wPÎ t Bbmywjb †bIqvi c×wZ

136. K‡ivbvwi ü`‡ivM I D”P i³Pvc ü`‡ivMx‡`i Rb¨
Lv`¨ ms všÍ civgk© t

137. wK wK Lvevi †ekx cwigvY LvIqv DwPZ bq?
wW‡gi Kzmyg, KwjRv, gv‡Qi wWg, Lvwm, Miæi Pwe©hy³ gvsm, nvum-gyiMxi
Pvgov, nv‡oi g¾¡v, wN, gvLb, WvjWv, mqvweb, Mj`v wPswo, bvwi‡Kj
Ges GMy‡jv w`‡q ‰Zix Lvevi|

138. wK wK Lvevi †ekx †L‡Z n‡e ?
Avukhy³ Lvevi †hgb- me iK‡gi Wvj we‡klZ †Qvjvi Wvj, me iK‡gi
kvK we‡klZ cuyB kvK, mwâ we‡klZ: ‡Lvmvmn mwâ †hgb- †Xom,
eiewU, KPzi jwZ, wkg, UK RvZxq dj-we‡klZ,†Lvmvmn dj †hgb-
†cqviv, Rv¤^yiv, AvgjwK| me iK‡gi gvQ we‡klZ mgy‡`ªi gvQ, †QvU
gvQ, gv‡Qi †Zj, Dw™¢R †Zj, mvbd¬vIqvi I‡qj, mqvweb †Zj, `ya|

139. wK wK Lvevi Kg †L‡Z n‡e?
- kK©iv RvZxq Lvevi fvZ, iæwU, Avjy, wgwó Avjy|
- wgwó dj ‡hgb- cvKv Avg, UvUKv dj, cvKv †c‡c|
- wgwó Lvevi †hgb- wdibx, †mgvB|

140. wK wK Lvevi G‡Kev‡iB LvIqv DwPZ bq?
wewfbœ ai‡bi dv÷dzW, †KK, cywWs, m¨vÛDBP, AvBmw g, †evZjRvZ
†Kvgj cvbxq|
24
K
K
16
wPÎ t mylg Lvevi

141. †ivRvq ü`‡ivMx‡`i KiYxq

142. ü`‡ivMxiv wK igRvb gv‡m †ivRv ivL‡Z cv‡i ?
n¨vu, ü`‡ivMxiv igRvb gv‡m ‡ivRv ivL‡Z cv‡i, Z‡e Jl‡ai gvÎv wKQyUv
cwieZ©b Kiv jvM‡Z cv‡i|

143. †ivRvq kix‡i ¯^vfvweK wK wK cwieZ©b nq ?
‡ivRvq †h‡nZz kix‡i mwÂZ Pwe© †f‡½ kw³ Drcv`b nq, ZvB kix‡ii
evûj¨ Pwe© K‡g hvq, d‡j †ivMxi `ye©jZv K‡g, Wvqv‡ewUm I D”P
i³Pvc wbqš¿b nq, Jl‡ai gvÎv Kg jv‡M|

144. †ivRvq wK wK mgm¨v n‡Z cv‡i ?
†ivRvq eyK R¡vjv‡cvov, evZe¨_v, cvwb k~b¨Zv, †KvóKvwVb¨, Wvqv‡ewUK
†ivMxi i³ myMvi K‡g hvIqv, D”P i³Pvc, †ivMxi i³Pvc K‡g hvIqv
mn Ab¨vb¨ mgm¨v †`Lv w`‡Z cv‡i|

145. †ivRvq eyK e¨_v ev R¡vjv‡cvov Ki‡j wK Kibxq ?
‡ivRvq KLbI KLbI nVvr K‡i eyK R¡vjv‡cvov, eyKe¨_v n‡Z cv‡i|
A‡bK mgq AwZwi³ gmjvhy³ Lvevi †L‡j A_ev fvRv Lvevi †ekx †L‡j
GwmwWwU ev‡o, eyKR¡vjv ev eyK e¨_v n‡Z cv‡i| †m †¶‡Î G›UvwmW ev
IwgcÖvRj MÖ“‡ci Jla †L‡j Zv fvj n‡q hvq| wKš‘ eyK e¨_v Zxeª n‡j
I IwgcÖvRj Jl‡a bv Kg‡j, cÖPzi Nvg n‡j ev ewg n‡j AwZmË¡i
ü`‡ivM we‡klÁ civgk© wb‡Z n‡e A_ev †h †Kvb KvwW©qvK nvmcvZv‡ji
Bgv‡R©wÝ wefv‡M †hvMv‡hvM K‡i BwmwR ev Ab¨vb¨ cÖ‡qvRbxq cix¶v
mv‡c‡¶ †ivM wbb©q K‡i wPwKrmv wb‡Z n‡e|

146. †ivRvq wK IRb †e‡o †h‡Z cv‡i ?
n¨vu, †ivRvq IRb e„w× †c‡Z cv‡i| hw` †KD †mnix I BdZv‡i AwaK
cwigv‡b I AwaK K¨vjix hy³ Lvevi †ekx Lvq| g‡b ivL‡Z n‡e,
AwZwi³ IRb ü`‡iv‡Mi GKwU Ab¨Zg Kvib| ZvB AwZwi³ ˆZjv³
Lv`¨, wgwó, †Kvgj cvbxq cwinvi K‡i AwaK cwigv‡b kvKmâx, d‡ji
im †L‡Z n‡e|

147. †ivRvq †KvóKvwVb¨ n‡j wK Kibxq ?
‡ivRvq †h‡nZz cvwb I Zij Lvevi Kg LvIqv nq ev Lvevi my‡hvM Kg,
ZvQvov MÖx¯§ Kv‡j †ivRv n‡j AwZwi³ Nvg nIqvi Kvi‡b †KvôKvwVb¨
25
n‡Z cv‡i| ZQvov, ü`‡ivMxi †¶‡Î A‡bK Jla †L‡Z nq e‡j †Kvb
†Kvb Jl‡ai Kvi‡bI †KvóKvwVb¨ n‡Z cv‡i| cÖPzi cwigvb cvwb I Zij
Lvevi Ges Avukhy³ Lvevi †hgb - kvK mwâ, Bmye¸‡ji fywl †L‡j
†KvóKvwVb¨ Gov‡bv m¤¢e|

148. †ivRvq hK…Z ev wjfv‡ii wK wK DcKvi nq ?
‡ivRvq †h‡nZz Dcevm _vK‡Z nq ZvB wjfv‡i mwÂZ Pwe© I Møy‡KvR
†f‡½ kix‡i kw³ ‡hvMv‡bvi Rb¨ hK…Z AwZwi³ Pwe©gy³ nq, d‡j
wjfv‡ii Kvh©¶gZv e„w× cvq|

149. †ivRve¯’vq ü`‡ivMxi k¦vmKô evo‡j Aw·‡Rb, Bb‡njvi e¨env‡i
†Kvb ¶wZ Av‡Q wK ?
‡ivRve¯’vq ü`‡ivMx‡`i k¦vmKô evo‡j cÖ‡qvR‡b Aw·‡Rb I Bb‡njvi
jvM‡Z cv‡i | †m‡¶‡Î †ivRvq †Kvb ¶wZ n‡e bv| Bb‡njv‡ii †¶‡Î
`xN©‡gqv`x KvR K‡i Ggb Bb‡njvi e¨envi evÂbxq|

150. †ivRve¯’vq ü`‡ivMx‡`i ey‡K e¨_v n‡j †¯cÖ e¨env‡i KiYxq wK ?
‡ivRve¯’vq ü`‡ivMx‡`i ey‡K e¨_v n‡j Ges cÖ‡qvR‡b bvB‡UªU RvZxq
†¯cÖ e¨env‡ii cÖ‡qvRb n‡j Zv †bqv †h‡Z cv‡i, G‡Z †ivRvi †Kvb
¶wZ nIqvi AeKvk †bB|

151. †ivRve¯’vq ü`‡ivMx‡`i Wvqv‡ewUm _vK‡j Bbmywjb †bIqvi wbqg wK ?
Wvqv‡ewUK †ivMx Bbmywjb wbf©i n‡j †mnixi Av‡M I cÖ‡qvR‡b BdZvixi
Av‡M Bbmywjb wb‡Z cv‡i|

152. †ivRv Ae¯’vq ü`‡ivM wbb©‡qi Rb¨ B‡Kv, BwUwU, BwmwR cix¶v Kiv
hvq wK ?
‡ivRv Ae¯’vq ü`‡ivM wbb©‡qi Rb¨ BwmwR, B‡Kv Ki‡Z †Kvb Amyweav
bvB| wKš‘ BwUwU †h‡nZz kªgmva¨ I cÖPzi Nvg n‡Z cv‡i ZvB †ivRv ivLv
Ae¯’vq AwaK Kó n‡Z cv‡i| †m‡¶‡Î †ivRv fvOvi ci mܨvi c‡i
BwUwU Kiv †h‡Z cv‡i|

153. †ivRv Ae¯’vq †ivM wbb©‡qi Rb¨ i³ cix¶v Kiv‡j †ivRv bó nq wK
bv ?
bv, †m‡¶‡Î †ivRv bó nIqvi †Kvb m¤¢vebv †bB, GgbwK i³`vb Ki‡jI
†ivRv f½ n‡e bv |
26
K
K
17

155. †ivRv Ae¯’vq ü`‡ivMxiv `ycy‡ii B‡Kvw¯cÖb ev K¬wcW†MÖj Jla KLb
Lv‡e ?
`ycy‡ii B‡Kvw¯cÖb ev K¬wcW‡MÖj Jla BdZv‡ii ci ev iv‡Z Lvevi ci
LvIqv †h‡Z cv‡i|

156. †ivRvi Ae¯’vq ü`‡ivMx‡`i GbwRIMÖvg ev GbwRIcøvwó A_ev
KvwW©qvK K¨v_ Ki‡Z †Kvb Amyweav Av‡Q wK ?
†ivRv Ae¯’vq ü`‡ivMx‡`i GbwRIMÖvg, GbwRIcøvwó ev KvwW©qvK
K¨v‡_Uvi Kiv‡Z †Kvb Amyweav ‡bB| wKš‘ AwZwi³ i³¶i‡bi d‡j
`ye©j nIqvi AvksKv _vK‡j GbwRIMÖvg cix¶v mܨvq BdZv‡ii ci
Kiv †h‡Z cv‡i|
27
K
K
18
wPÎ t K¨v_j¨v‡e K‡ivbvix GbwRIMÖvg Kiv Ae¯’vq †jLK

157. Wvq‡ewUK I ü`‡ivMx‡`i Lv`¨

158. Wvq‡ewUK †ivMx‡`i w`‡b Kqevi †L‡Z n‡e?
Wvq‡ewUK †ivMx‡`i w`‡b cuvPevi LvIqv DwPZ|

159. Wvq‡ewUK †ivMx‡`i wK wK Lvevi m¤úyb© wb‡la?
wgwó RvZxq Lvevi †hgb wgwó we¯‹zU, wPwb w`‡q ‰Zix Lvevi, †KK, wgwó,
R¨vg, †Rwj, ‡LRy‡ii im, Zv‡ji im, Av‡gi im, †KvKv‡Kvjv, †m‡fb
Avc, †ccwm, Aviwm †Kvjv, Kb‡WÝW wgé, Møy‡KvR LvIqv m¤c~Y© wb‡la|
28

160. mKvj 11Uvq wK wK bv¯Ív Ki‡e?
gywo ev wPov ev we¯‹zU, dj †h ‡Kvb 1wU, Pv|

161. `ycy‡ii Lvev‡i wK Lv‡e?
`ycy‡i fvZ 3 Kvc, gvQ ev gvsm 2 UzKiv, Wvj I mwâ|

162. weKvj 5Uvi bv¯Ívq wK LvIqv hvq?
weKvj 5Uvi bv¯Ívq
`ya(mi Qvov) 1 Møvm,
we¯‹zU, wPbvev`vg
LvIqv hv‡e|

163. iv‡Z wK wK LvIqv
hv‡e?
iv‡Z AvUvi iæwU, gvQ
ev gvsm 1UzKiv, Wvj,
mwâ, `ya 1Møvm(mi
Qvov)|

164. Wvq‡ewUK I
ü`‡ivMxiv wK
cwigvY jeY I †Zj
cªwZw`b †L‡Z
cvi‡eb?
Wvq‡ewUK I
ü`‡ivMxiv jeY 1Pv
PvgP cÖwZw`b I ‰Zj
hZLvwb Kg m¤¢e(30
wgwj) †L‡Z cvi‡e|

165. Wvq‡ewUK I ü`‡ivMx‡`i wK wK Lvevi ¯^v‡¯’i Rb¨ fvj?
mvgyw`ªK gvQ, wPbvev`vg ¯^v‡¯’¨i Rb¨ fvj|
29
K
K
19

166. Wvq‡ewUK †ivMxiv †Kvb& †Kvb& kvK-mewR BPQvgZ †L‡Z cv‡i?
cvjbkvK, jvj kvK, cuyB kvK, Kjwg kvK, dzjKwc, evavKwc, g~jv,
IjKwc, KuvPv U‡g‡Uv, KuvPv †c‡c, kkv, wLivB, Kijøv, wS½v, wPwP½v,
ay›`j, cUj, PvjKzgov, WvUv, jvD, mvRbv, †e¸b cªf„wZ|

167. Wvq‡ewUK †ivMxiv †Kvb †Kvb dj BPQvgZ †L‡Z cvi‡e?
KvjRvg, †jey, Avgov, Rv¤^yiv, Kvgiv½v, ev½x, Rvgiæj, AvgjwK, KwP
Wv‡ei cvwb B”QvgZ †L‡Z cvi‡e|

168. †Kvb& RvZxq dj †ekx LvIqv DwPZ?
UK RvZxq dj †ekx K‡i †L‡Z n‡e|

169. Wvq‡ewUK †ivMx‡`i mKv‡ji bv¯Ívq wK wK LvIqv hv‡e?
mKv‡ji bv¯Ívq AvUvi iæwU, ey‡Ui Wvj, mwâ I †h ‡Kvb GKwU dj I 1wU
wWg (Kzmyg Qvov)|
wPÎ t Wvqv‡ewUK †ivMx‡`i Lvevi - mwâ
wPÎ t Wvqv‡ewUK †ivMx‡`i Lvevi - dj (†h †Kvb 1wU
cÖwZw`b)

171. evZR¡i I ü`‡iv‡Mi m¤úK© wK ?
evZR¡i n‡j ü`wc‡Ûi fvje&, c`©v I gvsk‡ckx Av vš— n‡Z cv‡i , A_ev
bvI n‡Z cv‡i| evZR¡‡i ü`wc‡Ûi fvj&e Av vš— n‡q fvje& mi“ n‡Z cv‡i,
A_ev †ekx ¶wZMÖ¯’ n‡j fvj&e Gi wjK ev wiMviwR‡Ukb n‡Z cv‡i| Avevi
ü`wc‡Ûi gvsk‡ckx cÖ`vn& n‡q gv‡qvKvW©vBwUK n‡Z cv‡i, G‡Z
gv‡qvKvwW©qvK ev ü`wc‡Ûi dvskvb K‡g wM‡q nvU© †dBjvi n‡Z cv‡i|
Avevi ü`wc‡Ûi Pvicv‡ki c`©v Av vš— n‡q †cwiKvwW©qvj BwdDkb ev cvwb
Rg‡Z cv‡i|

172. evZR¡i wK ?
evZR¡i GK ai‡bi cÖ`vnRwbZ
†ivM †hLv‡b `xN©w`b R¡i _vK‡Z
cv‡i, Mjv e¨_v n‡Z cv‡i, cv‡qi
wMiv e¨_v A_ev cv‡qi wMiv
dzj‡Z cv‡i, hv‡K Av_©vBwUm
e‡j|

173. evZR¡‡i wK wK DcmM© †`Lv
hvq?
evZR¡‡i Mjv e¨_v nevi mv‡_ mv‡_
A_ev mßvn Lv‡bK ci cv‡qi wMiv
dzjv, ü`‡ivM, Pvgovq `vM nIqv,
Pvgovq †MvUv nIqv mn gvbwmK mgm¨v n‡Z cv‡i|

174. evZR¡‡i nvZ ev cv‡qi wMivi wK mgm¨v nq ?
evZR¡‡i nvZ ev cv‡qi wMivq e¨_v ev dz‡j †h‡Z cv‡i, evZR¡‡i mvavibZ:
eo eo wMiv¸‡jv Av vš— †ekx nq †hgb : nvuUzi wMiv, KbyBi wMiv | evZR¡‡i
wMivdz‡j †M‡j mv‡_ R¡i Ges wMiv e¨v_v ev dzjvi gvÎv †ekx n‡j †ivMxi
nuvU‡Z mgm¨v n‡Z cv‡i | GgbwK †ivMx kh¨vkvqx n‡Z cv‡i|

175. evZR¡‡i ü`wc‡Ûi wK wK mgm¨v nq ?
evZR¡i ü`wc‡Ûi fvj&e gvsk‡ckx I evwn‡ii c`©v Av vš— n‡Z cv‡i|
fvje& Av vš— n‡j fvje& mi“ n‡Z cv‡i hv‡K †÷‡bvwmm e‡j A_ev
30
fvje& wjK Ki‡Z cv‡i (wiMviwR‡Ukb)| ü`wc‡Ûi gvsk‡ckx cÖ`vn n‡j
gv‡qvKvW©vBwUm n‡Z cv‡i| G‡Z ü`wc‡Ûi gvsk‡ckxi Kvh©¶gZv K‡g
wM‡q nvU© †dBjvi n‡Z cv‡i| Avevi ü`wc‡Ûi ewn: Avei‡Y mgm¨v n‡j
ü`wc‡Ûi Pvicv‡k cvwb R‡g †cwiKvwW©qvj BwdIkb n‡Z cv‡i|

176. evZR¡‡i ü`wc‡Ûi †Kvb& †Kvb& fvje& Av vš— n‡Z cv‡i ?
evZR¡‡i ü`wc‡Ûi gvBUªvj fvje&, G‡qvwU©K fvje& A_ev UªvBKvmwcW
fvje& Av vš— n‡Z cv‡i| gvBUªvj fvje& †ekxifvM †¶‡Î Av vš— n‡Z
cv‡i|

177. evZR¡‡i gvBUªvj fvj&e Gi wK mgm¨v n‡Z cv‡i ?
evZR¡‡i gvBUªvj fvj&e me‡P‡q †ekx Av vš— nq| gvBUªvj fvje& †gvUv
n‡q ‡h‡Z cv‡i| Avevi gvBUªvj fvj&e †gvUv n‡Z n‡Z fvj&e Gi gyL mi“
n‡Z cv‡i, Zv‡K †÷‡bvwmm e‡j|
fvje& †ekx ¶wZMÖ¯’ n‡j fvj&e
wjK Ki‡Z cv‡i G‡K
wiMviwR‡Ukb e‡j|

178. evZR¡‡i G‡qvw©U©K fvje& Gi wK
mgm¨v n‡Z cv‡i ?
evZR¡‡i G‡qvw©UK fvj&e Av vš—
n‡Z cv‡i, fvj&e Av vš— n‡j
†÷‡bvwmm ev wiMviwR‡Ukb n‡Z
cv‡i|

179. evZR¡i wbY©‡q wK wK cix¶v Kiv nq ?
evZR¡i wbY©‡qi Rb¨ CBC, ESR, CRP, ASO titre, ECG, Throat swab
R/E and C/S, Echo cardiogram, CXR P/A View cix¶v Kiv nq|

180. evZR¡i wbY©‡q ASO titre Gi fywgKv wK ?
evZR¡i wbb©‡q †ivMxi BwZnvm I †ivMxi j¶b mg~n AZxe ¸i“Z¡c~b© |
ASO titre evZR¡i wbY©‡q mnvqK cix¶v| ASO titre 200 Gi †ekx
_vK‡jB evZR¡i bvI _vK‡Z cv‡i, A‡bK mgq Mjv e¨_v n‡j ev Pvgovq
Bb‡dKkb n‡j ASO titre evo‡Z cv‡i| hw` ASO titre Gi gvÎv †ekx
31
K
K
20
evZR¡i I ü`‡ivM
wPÎ t evZR¡‡i Av všÍ †dvjv wMiv wPÎ t evZR¡‡i Av všÍ nv‡U©i bó fvj¦

181. _v‡K Ges evZR¡i Gi Ab¨vb¨ DcmM© I j¶b _v‡K Z‡eB ASO titre
¸i“Z¡ c~b©, Ab¨_vq ïaygvÎ ASO titre cix¶vi wi‡cvU© †`‡L evZR¡i
wbi“cb Kiv mwVK b‡n|

182. evZR¡i n‡j B‡KvKvwW©IMÖvdx I Kvjvi Wcjvi Gi fywgKv wK ?
evZR¡i n‡j ü`wc‡Ûi fvje& Av vš— n‡j Echo cardiography I
Colour doppler Gi gva¨‡g ü`wc‡Ûi fvje& Gi †÷‡bvwmm I Gi gvÎv
Ges wiMviwR‡Ukb I Gi gvÎv gvcv hvq I cieZx© wPwKrmvi cwiKíbv
Kiv hvq| ZvQvov B‡Kvi gva¨‡g ü`wc‡Ûi Kg©¶gZv I ü`wc‡Ûi
Pvicv‡k cvwb Rg‡j ZvI wbb©q Kiv hvq|

183. evZR¡‡i Av vš— n‡j wK †ivMx A¯^vfvweK AvPib Ki‡Z cv‡i ?
n¨vu, evZR¡‡i Av vš— n‡j †ivMx A¯^vfvweK AvPib Ki‡Z cv‡i| G‡Z †ivMxi
A¯^vfvweK A½ mÂvjb n‡Z cv‡i, G‡K wm‡Wbnvgm& †Kvwiqv e‡j|

184. evZR¡i _vK‡j wKfv‡e wPwKrmv w`‡Z n‡e ?
evZR¡i _vK‡j cÖwZ 21 w`b ci ci †cwbwmwjb Bb‡RKkb ev cÖwZw`b
†cwbwmwjb U¨ve‡jU †L‡Z n‡e|

185. evZR¡i _vK‡j KZw`b wPwKrmv wb‡Z n‡e ?
evZR¡i _vK‡j Ges wMiv dzjv _vK‡j 18 eQi eqm ch©š— A_ev †gvU 5
eQi †cwbwmwjb Jla e¨envi Ki‡Z n‡e| evZR¡‡i ü`wc‡Ûi fvje&
Av vš— n‡j mvivRxeb Jla †L‡Z n‡e|

186. evZR¡‡i †cwbwmwjb Bb‡RKkb ev †cwbwmwjb ewo †KvbwU †kªq ?
evZR¡i n‡j †cwbwmwjb Bb‡RKkb 21 w`b ci ci A_ev †cwbwmwjb
U¨ve‡jU cÖwZw`b †L‡Z n‡e| †ivMx hw` wbqwgZ †cwbwmwjb U¨ve‡jU
†L‡Z AcviM nq A_ev wbqwgZ Jla bv Lvq Z‡e 21 w`b ci ci
Bb‡RKkb †`qv fvj|

187. Kv‡`i evZR¡i †ekx nq ?
evZR¡i mvavibZ: ¯‹zjMvgx wk¶v_x©‡`i eq‡m A_¨©r 6 eQi †_‡K 16
eQi ch©š— †ekx nq| ZvQvov N‡i Av‡jv evZvm Kg _vK‡j , Ni
m¨uvZ‡mu‡Z n‡j, AwaK gvbyl GKN‡i evm Ki‡j evZR¡i nevi m¤¢vebv
‡ekx|
32
K
K
21

189. kix‡ii †Kvb Ask Aem n‡j ev
c¨vivjvBwmm n‡j Zrÿbvr
nvmcvZv‡j †hvMv‡hvM Ki‡Z n‡e|

190. AwZwi³ fvix I Abf¨¯Í KvR Kiv
wb‡la|

191. Mf©avi‡bi c~‡e© Aek¨B
wPwKrm‡Ki civgk© wb‡Z n‡e|

192. cvwb I jeY LvIqvi e¨vcv‡i
mZK©Zv Aej¤^b Ki‡Z n‡e|

193. meai‡bi Lvevi LvIqv hv‡e|
33
K
K
22

194. evZR¡i Av všÍ †ivMx‡`i wbqwgZ
†cwbwmwjb ewo ev Bb‡RK&kb wb‡Z n‡e|

195. Mjv e¨v_v n‡j `ªæZ wPwKrm‡Ki civgk©
Abyhvqx Gw›Uev‡qvwUK Jla ‡L‡Z n‡e|

196. ‡h †Kvb Acv‡ik‡bi c~‡e©- ü`‡ivM
we‡klÁ‡`i civgk© wb‡Z n‡e Avi
cÖ‡qvR‡b Gw›Uev‡qvwUK Jla †L‡Z n‡e|

197. mw`© Kvwk A_ev k¦vmKó n‡j, Kvwki
mv‡_ i³ †M‡j ZvovZvwo wPwKrmv Ki‡Z
n‡e|
evZR¡i RwbZ ü`‡ivM I Rb¥MZ ü`‡ivMx‡`i
civgk©
wPÎ t nv‡U©i wfZi wQ`ª (GGmwW)

198. D”P i³Pvc I ü`‡ivM
34
Zv n‡jv - 1. †÷ªvK (gw¯—‡®‹i i³¶iY), 2. nvU© A¨vUvK, 3. nvU© †dBji,
4. wKWwbi †dBji nIqvi Avk¼v _v‡K, 5. †Pv‡Li i³bvwji gvMZ
Pvc ev‡o I Zv ùxZ n‡q hvq, 6. i³bvwji evB‡i †`qv‡j ¶Z m„wó I
k³ nIqv, 7. i³bvwji †fZ‡ii †`qv‡j Pwe© I Ab¨vb¨ c`v_© R‡g
i³cÖevn evavMÖ¯— nIqv Ges 8. †hŠbKv‡R A¶gZv|

199. D”P i³Pv‡ci j¶Y Kx Kx?
50 kZvsk †ivMxi †¶‡Î †Kv‡bv kvixwiK mgm¨v †`Lv hvq bv Ges Ab¨
Kvi‡Y wPwKrm‡Ki Kv‡Q wM‡q †cÖkvi gvcvi ci mnmv D”P i³Pv‡ci
Dcw¯’wZ Rvbv hvq - 1. gv_ve¨_v: Zxeª gv_ve¨_v, mKv‡ji w`‡K nq, Aí
K‡qK w`b a‡i nq, ewg ewg fve, ax‡i ax‡i `„wókw³ K‡g Av‡m; 2.
gv_v wSgwSg fve; 3. Nyg Kg nIqv; 4. k¦vmKó Ges 5. bvK w`‡q i³
cov|

200. D”P i³Pvc wbqš¿‡Y Rxebe¨e¯’vq Kx Kx cwieZ©b Ki‡Z nq?
AvRxeb wPwKrmv Pvwj‡q †h‡Z n‡e| my¯’‡eva Ki‡jB wPwKrmv ev` †`Iqv
hv‡e bv| IRb Kgv‡Z n‡e| Lv`¨ZvwjKvq - AwZwi³ †mvwWqvg jeY,
Pwe©hy³ gvsm, †Kv‡j‡÷ij mg„× Lv`¨ eR©b Ki‡Z n‡e| wekªvg wb‡Z
n‡e - Ny‡gi gva¨‡g, †hvMe¨vqv‡gi gva¨‡g wKsev
mewKQz mnRfv‡e MÖnY K‡i wekªvg †bIqv hv‡e|
e¨vqvg Ki‡Z n‡e, Z‡e AwZwi³
e¨vqvg Kiv hv‡e bv Ges K¬vš—
nIqvi Av‡MB e¨vqvg eÜ Ki‡Z n‡e|
wbqwgZ Ilya †L‡Z n‡e, Wvqv‡ewUm _vK‡j
†mUv wbqš¿Y Ki‡Z n‡e| wbw`©ó mgq ci
ci wPwKrm‡Ki m‡½ mv¶vZ Ki‡Z
n‡e, a~gcvb eÜ Ki‡Z n‡e|

201. D”P i³Pvc _vK‡j wK cÖwZw`b
†cÖkvi gvc‡Z n‡e?
bv, D”P i³Pvc _vK‡j cÖwZw`b †cÖkvi gvcvi cÖ‡qvRb †bB| †cÖkvi
Awbqwš¿Z _vK‡j cÖ_g w`‡K GK w`b ci ci, c‡i mßv‡n GK w`b Ges
cieZ©x mg‡q `yB mßv‡n GKevi ev gv‡m GKevi †cÖkvi gvcv DwPZ|

202. D”P i³Pvc _vK‡j Kx Kx cix¶vi cÖ‡qvRb Av‡Q?
D”P i³Pvc _vK‡j D”P i³Pv‡ci KviY wbY©q Kivi Rb¨ Ges D”P
i³Pv‡ci cÖfve †`Lvi Rb¨ wKQz cix¶vi cÖ‡qvRb Av‡Q|
35
K
K
23

203. D”P i³Pvc I ü`‡iv‡Mi m¤cK© Kx?
D”P i³Pvc ev Awbqwš¿Z i³Pvc `xN© mgq
_vK‡j ü`wc‡Êi i³bvwj‡Z Pwe©i Av¯—i
R‡g eø‡KR n‡Z cv‡i Ges i³cÖevn evav
cvIqvi d‡j Ischemic heart disease n‡Z
cv‡i, hv ü`wc‡Êi GKwU fqven †ivM|

204. D”P i³Pv‡c ü`wc‡Êi Kx Kx ai‡bi
ü`‡ivM nq?
D”P i³Pv‡c ü`wc‡Êi i³bvwj‡Z Pwe©i
Av¯—i c‡o Ischemic heart disease QvovI
ü`wc‡Êi †`qvj †gvUv n‡q nvBcvi‡Ubwmf
nvU© wWwRR, nvU© †dBji n‡Z cv‡i|

205. i³Pvc Kx?
i³ PjvP‡ji mgq i³bvwj‡Z †h Pvc †`q, Zv‡KB i³Pvc e‡j|

206. D”P i³Pvc Kx?
i³Pvc agwb, wkiv Z_v i³bvwji AvKv‡ii Ici wbf©i K‡i, Avi
i³bvwj msKxY©Zi n‡j kix‡ii wewfbœ As‡k GKB cwigv‡Y i³
mieiv‡ni Rb¨ ü`wcʇK A‡c¶vK…Z †ewk KvR Ki‡Z nq| G iKg
Ae¯’vq ü`wcʇK ¯^vfvwe‡Ki †P‡q †ewk Pvc w`‡q i³ mieivn eRvq
ivL‡Z nq| Avi G †ewk Pvc †`Iqvi Ae¯’v‡KB D”P i³Pvc e‡j|

207. D”P i³Pvc Kx Kx Kvi‡Y n‡Z cv‡i?
30 †_‡K 50 eQi eq‡m mvaviYZ D”P i³Pv‡ci mgm¨v †`Lv †`q|
cyi“‡li D”P i³Pv‡ci cÖeYZv I cÖKUZv bvix‡`i †P‡q †ewk| Mf©Kvjxb
I Rb¥wb‡ivaK Ilya MÖnYKv‡j bvix‡`i D”P i³Pvc n‡Z cv‡i| hvu‡`i
IRb D”PZvi Zzjbvq †ewk, Zvu‡`i D”P i³Pvc nIqvi Avk¼vI †ewk|
cwiev‡i †Kv‡bv AvZ¥x‡qi (‡hgb: evev-gv) D”P i³Pvc _vK‡j D”P
i³Pvc †iv‡Mi Avk¼v †e‡o hvq|

208. D”P i³Pvc Avgv‡`i kix‡i Kx ¶wZ K‡i?
D”P i³Pvc Rxe‡bi ûgwK¯^iƒc| D”P i³Pvc Avgv‡`i kix‡ii wewfbœ
¸i“Z¡c~Y© A½-cÖZ¨‡½i ¶wZ K‡i| D”P i³Pvc _vK‡j †hme mgm¨v nq
wPÎ t i³Pvc
gvcvi hš¿

210. D”P i³Pv‡ci Kvi‡Y ü`‡ivM n‡j Kx Kx cix¶vi cÖ‡qvRb?
D”P i³Pv‡ci Kvi‡Y ü`‡ivM n‡j ü`‡iv‡Mi gvÎv wbiƒc‡Yi Rb¨
BwmwR, B‡Kv (Kvjvi Wcjvi) BwUwU, wmG·Avi wc/G wfD cix¶v¸‡jv
Kiv cÖ‡qvRb|

211. D”P i³Pv‡ci m‡½ ü`‡ivM _vK‡j Kx Kx Ilya e¨envi Kiv hvq?
D”P i³Pv‡ci m‡½ A_©vr
ü`wc‡Êi i³bvwj‡Z eøK
_vK‡j Avgiv A¨vmwcwib-
RvZxq Ilya, weUv eøKvi Ilya,
bvB‡UªU-RvZxq Ilya, ÷¨vwUb
MÖ“‡ci Ilya e¨envi Kwi|

212. D”P i³Pvc I ü`‡ivM,
†hgb - nvBcvi‡Ubwmf nvU©
wWwRR A_©vr ü`wc‡Êi
†`qvj †gvUv n‡j Kx Kx Ilya
e¨envi Kiv hvq|
D”P i³Pv‡ci m‡½ ü`wc‡Êi
†`qvj †gvUv n‡j Avgiv
GwmB BbwnweUi ev G Avi we
MÖ“‡ci Ilya w`B|
36
K
K
24
28 †m‡Þ¤^i, 2011 ÔcÖ_g Av‡jvÕ cwÎKvq Ô¯^v¯’¨ KzkjÕ cvZvq cÖKvwkZ nq|
wPÎ t †eªb †÷ªvK - D”Pi³Pv‡ci RwUjZv
wPÎ t wKWbx mgm¨v - Awbqwš¿Z D”Pi³Pv‡ci RwUjZv

213. eq¯‹‡`i D”P i³Pv‡c KiYxq

214. eq®‹‡`i †Kvb ai‡bi D”P i³Pvc †`Lv hvq ?
eq¯‹‡`i AvB‡mv‡j‡UW wm‡÷vwjK nvBcvi‡Ubkb A_©¨vr †`Lv hvq
ïaygvÎ wm‡÷vwjK i³Pvc ‡ekx _v‡K I Wvqvm‡UvwjK i³Pvc ¯^vfvweK
_v‡K|

215. eq®‹ †ivMx Kv‡K e‡j ?
‡ivMxi eqm 65 eQi ev
†ekx n‡j Zv‡`i‡K eq¯‹
†ivMx e‡j|

216. AvU‡mv‡jwUW wm‡÷vwjK
nvBcvi‡Ubkb KZ cÖKvi ?
3 cÖKvi - †MÖW -1 nj
wm‡÷vwjK i³ Pvc 140-
160 Gi g‡a¨, †MÖW 2 nj
wm‡÷vwjK i³Pvc 160-180 Gi g‡a¨ I †MÖW - 3 nj wm‡÷wjK i³Pvc
180 Gi Dc‡i|

217. cvjm& †cÖmvi wK ?
wm‡÷vwjK i³Pvc I Wvqv‡÷wjK i³Pv‡ci cv_©K¨‡K cvjm& †cÖmvi ev
cvjm& i³Pvc e‡j|
wm‡÷vwjK i³Pvc hZ †ekx n‡e A_ev Wvqv‡÷vwjK i³Pvc hZ Kg
n‡e ZZ cvjm& i³Pvc †ekx n‡e|

218. cvjm& i³Pv‡ci Zvrch© wK ?
cvjm& i³Pvc hZ †ekx _v‡K ZZ KvwW©IfvmKzjvi wi¯‹ †ekx n‡e A_©vr
ZZ †ekx †eªb †÷ªvK ev nvU© A¨vUv‡Ki SzuwK †ekx n‡e|

219. D”P i³Pvc wbqš¿‡Y ivL‡j wK wK `~N©Ubv Gov‡bv m¤¢e?
D”P i³Pvc wbqš¿‡Y ivL‡j fwel¨‡Z †eªBb †÷ªvK, nvU© A¨vUvK, nvU©
†dBjvi, wKWbx mgm¨v, ¯§„wZ bó nIqv †_‡K cwiÎvb cvIqv hvq|
37
K
K
25
wPÎ t i³Pvc gvcvi c×wZ

221. Mitral Stenosis nv‡U©i †Kvb& ai‡bi †ivM ?
Avgiv Rvwb, nv‡U©i wfZi PviwU fvje _v‡K| `xN©w`b evZR¡‡i
(Rheumatic Fever) Av vš— _vK‡j heart valve deformed n‡q c_ mi“
n‡q hvq| G‡¶‡Î nvU© Gi Mitral
valve †ekxifvM †¶‡Î Av vš— n‡q
_v‡K| G‡K Mitral Stenosis e‡j|

222. Mitral Stenosis wPwKrmvq
B›Uvi†fbkbvj KvwW©IjwRóiv wK
f~wgKv cvjb K‡i _v‡Kb ?
Mitral Stenosis Gi Valve Gi
c_ mi“ n‡q _vK‡j Zv †ejyb w`‡q
dzwj‡q w`‡j fvj¦ Gi mi“c_ †gvUv n‡q hvq| fvj¦ mi“ _vK‡j
i³PjvP‡j evav cvq| Valve Gi c_ †gvUv n‡q †M‡j i³ PjvPj e„w×
cvq|

223. B›Uvi‡fbkbvj KvwW©IjwR wK ?
wewfbœ Device ev hš¿ ev Baloon Gi mvnv‡h¨ ü`&‡iv‡Mi wewfbœ wPwKrmv
Kivi c×wZ‡K B›Uvi‡fbkbvj KvwW©IjwR e‡j| G Kvi‡b
B›Uvi‡fbkbvj KvwW©IjwR wPwKrmv Zzjbvg~jKfv‡e e¨q mv‡c¶|

224. B›Uvi†fbkbvj KvwW©IjwR÷‡`i wPwKrmv weÁv‡b fywgKv wK wK ?
wKQy RwUj ü`‡ivM wPwKrmv ‡hgb : Mitral Stenosis, Aortic Stenosis,
Aortic Regurgitation, Pulmonary Stenosis, nv‡U©i i³bvjx‡Z eø‡KR,
ü`h‡š¿i kø_MwZ A_ev Malignant arrhythmia, nv‡U©i wQ`ª wPwKrmvq
GgbwK nvU© †dBji wPwKrmvq B›Uvi‡fbkbvj KvwW©IjwRó‡`i fywgKv
Acwimxg|

225. Mitral Stenosis Gi †ivMxi wK wK mgm¨v nq ?
Mitral Stenosis G Valve mi“ n‡q †M‡j i³ PjvP‡j evav cvq| d‡j
i³ nv‡U©i evg‡P¤^v‡ii Dc‡ii fv‡M Rgv n‡Z _v‡K Ges Gi wfZ‡ii
†cÖmvi evo‡Z _v‡K| d‡j Left atrium eo n‡Z _v‡K Ges i‡³i cÖevn
K‡g hvq, d‡j i³ RgvU †ue‡a Clot n‡Z cv‡i, G‡K Left atrial
38
thrombus e‡j| G Thrombus cieZx©‡Z nv‡U©i wfZi †_‡K Qz‡U
wM‡q `yieZx© Ab¨ i³bvjx‡Z ev agbx‡Z wM‡q Brain stroke or acute
limb ischemia or acute blindness A_ev Ab¨ †Kvb eo ai‡bi `~N©Ubv
NU‡Z cv‡i | ZvQvov Left atrium Gi †cÖmvi †e‡o †M‡j Pulmonary
vein and artery †cÖmvi †e‡o wM‡q Pulmonary hypertension or
pulmonary edema n‡Z cv‡i| G‡Z †ivMxi gvivZ¡K k¦vmKó n‡Z
cv‡i| ZvQvov mgqgZ Mitral stenosis Gi wPwKrmv bv Kiv‡j hK…Z
eo n‡Z cv‡i ev cv‡q cvwb Rg‡Z cv‡i, GgbwK nvU© †dBji n‡Z cv‡i,
ZvB mgqgZ Mitral stenosis Gi wPwKrmv Kiv cÖ‡qvRb|

226. Mitral stenosis Gi wPwKrmvq PTMC Gi LiP †Kgb ?
Mitral stenosis Gi wPwKrmvq Baloon (PTMC) Gi Rb¨ XvKv kn‡ii
wewfbœ KvwW©qvK †m›Uv‡i 40 nvRvi †_‡K 75 nvRvi UvKv LiP nq|

227. Mitral stenosis-G Baloon Ki‡j †ivMx KZ w`b fvj _v‡K ?
Mitral stenosis-G Baloon Kiv‡j †ivMx mvavibZ: 5-10 eQi A_ev
Zvi †P‡q †ekx mgq DcmM©gy³ ev fvj _v‡K Ges Zv wbf©i K‡i
Operator KZUv `¶ A_ev Baloon Uv wK gv‡bi e¨envi Kiv n‡q‡Q|

228. Aortic stenosis G (B›Uvi‡fbkbvj KvwW©IjwRó‡`i) fywgKv wK ?
Aortic stenosis G Valve Gi wQ`ª mi“ n‡q hvq Ges mi“ n‡q hvIqvi
gvÎv Zxeª n‡j h_vixwZ Acv‡ikb K‡i
Valve cwieZ©b Kiv nq| wKš¿ †ivMxi
eqm †ekx n‡j A_ev Acv‡ikb Kivi
c~e©eZx© mg‡q Baloon K‡i Valve Gi
wQ`ª †gvUv Kiv †h‡Z cv‡i|

229. Aortic regurgitation B›Uvi †fbkbvj
KvwW©IjwRóiv †ivMxi wK DcKvi
Ki‡Z cv‡i ?
Aortic regurgitation †iv‡M mvavibZ:
Aortic Valve Gi Leak nq A_¨v©r wQ`ª
wVKgZ eÜ bv n‡j i³ Regurgitate
K‡i Aorta †_‡K Avevi Ventricle i³
†diZ Av‡m| d‡j Ventricle G i‡³i Overload nq Ges ‡g ‡g
nv‡U©i dvskb Kg‡Z Kg‡Z nvU© †dBjvi n‡Z cv‡i| ZvB Aortic
regurgitation G mvavibZ: wPwKrmvi Rb¨ GZw`b Valve cwieZ©b
39
K
K
26
evZR¡i RwbZ I fvje& RwbZ ü`‡iv‡M B›Uvi‡fbkb
wPÎ t wcwUGgwm †ejyb I c×wZ
wPÎ t cvj‡gvbvix fvjfz‡jvcøvw÷
†ejyb I c×wZ

230. Kiv n‡Zv, wKš— Aaybv Kv‡j Percutaneous Aortic Valve ms‡hvRb Kiv
n‡”Q| G‡Z ‡ivMxi eyK KvUv nq bv | B›Uvi†fbkb G wd‡gvivj AvUv©ixi
gva¨‡g Valve aorta †Z cÖwZ¯’vcb Kiv nq Ges Zv Aek¨ A‡bK e¨qeûj|

231. Pulmonary stenosis G B›Uvi‡fbkbvj KvwW©IjwR÷†`i f~wgKv wK ?
Pulmonary stenosis GKwU R¤§MZ
ü`‡ivM, G †iv‡M Pulmonary Valve
Gi wQ`ª mi“ n‡q hvq| d‡j Right
Ventricle Gi Dci Pvc c‡o Ges
Right ventricle †dBjvi n‡Z cv‡i|
G †iv‡M mvavibZ : Baloon w`‡q
Valve dzwj‡q †`qv nq, G Kv‡Ri Rb¨
wbw`ó ai‡bi †ejyb e¨envi Kiv nq|

232. Pulmonary stenosis wPwKrmvi Rb¨
LiP †Kgb ?
Pulmonary stenosis wPwKrmvi Rb¨
Pulmonary Valvuloplasty ‡Z
40-70 nvRvi UvKv ch©š— LiP n‡Z cv‡i|
40
K
K
27
wPÎ t cvj‡gvbvix fvje& I †÷‡bvwmm
wPÎ t gvBUªvj fvje&-G wcwUGgwm Kiv Ae¯’vq †jLK

233. Mf©Kvjxb D”P i³Pvc

234. Mf©Kvjxb D”P i³Pvc wK ?
Mf©Kvjxb mg‡q wm‡÷vwjK i³Pvc 140 wgwg cvi` Gi mgvb ev †ekx
Ges A_ev Wvqv÷wjK i³Pvc 90 Gi mgvb ev †ekx n‡j Zv‡K
Mf©Kvjxb D”Pi³Pvc e‡j|

235. Mf©Kvjxb D”P i³Pvc wKfv‡e wbwðZ Kiv hvq ?
Mf©Kvjxb mg‡q Kgc‡ÿ `ywU gvc `ywU wfbœ mg‡q †bIqv nq A_ev 24
N›Uv Kvjxb i³Pvc cwigvc K‡i Mf©Kvjxb D”P i³Pvc wbwðZ Kiv nq|

236. Mf©Kvjxb wK wK cÖKv‡ii D”P i³Pvc †`Lv hvq ?
Mf©Kvjxb wZb ai‡bi D”P i³Pvc †`Lv hvq (K) c~e© ¯’vqx D”P i³Pvc
(L) Mf©Kvjxb D”P i³Pvc (M) c~e©¯’vqx D”P i³Pvc †hvM nIqv|

237. c~e©¯’vqx D”P i³Pvc Kv‡K e‡j ?
D”Pi³Pvc hw` Mf©Kvjxb mg‡qi Av‡MB †_‡K _v‡K A_ev Mf©Kvjxb 20 mßvn
mg‡qi Av‡MB D”P i³Pvc aiv c‡o Z‡e Zv‡K c~e© ¯’vqx D”P i³Pvc e‡j|

238. c~e©¯’vqx D”P i³Pvc wK wK mgm¨v nq Ges KLb fvj nq ?
c~e©¯’vqx D”Pi³Pv‡c _vK‡j †ivMxi Mf©Kvjxb mg‡q cÖmªv‡ei mv‡_ AwZ
cÖ‡qvRbxq A¨vjeywgb †ei n‡q hvq| G‡Z kix‡i cvwb Avmvmn Ab¨vb¨ DcmM©
†`Lv hvq| GUv mvaviYZ ev”Pv †Wwjfvix nIqvi 6 mßvn c‡iI †_‡K hvq|

239. Mf©Kvjxb D”P i³Pvc Kv‡K e‡j KLb nq ? KLb fvj n‡q hvq ?
Mf©Kvjxb D”P i³Pvc ïaygvÎ ev”Pv †c‡U Avmvi ci nq Ges mvaviYZ 20
mßvn ci aiv c‡o Zv‡Z cÖmªv‡ei mv‡_ A¨vjeywgb †ei n‡q hvq Ges ev”Pv
†Wwjfvixi 6 mßv‡ni ci
GB D”P i³Pvc fvj n‡q
hvq Ges Jl‡ai cÖ‡qvRb
nq bv G NUbv‡K wcÖ-
GK¬vgwmqv e‡j|

240. Mf©Kvjxb D”P i³Pvc
wK wK mgm¨v nq ?
Mf©Kvjxb D”P i³Pv‡c
cÖmªv‡ei mwnZ AwZ
¸iæZ¡c~Y© Dcv`vb
A¨vjeywgb †ei n‡q hvq,
41
kix‡i A‡bK mgq cvwb R‡g kixi dz‡j hvq, ev”Pv wVKgZ †e‡o D‡V
bv, ev”Pvi IRb Kg nq| GgbwK me©bvk ev Geikb ch©šÍ n‡Z cv‡i,
ev Rivqy‡Z ev”Pv gviv †h‡Z cv‡i| G QvovI †ivMxi gvivZ¥K wLuPzbx n‡Z
cv‡i Zv‡K GK¬vgwkqv e‡j|

241. Mf©Kvjxb D”P i³Pvc wKfv‡e wPwKrmv Kiv hvq|
Mf©Kvjxb D”P i³Pvc n‡j †ivMx‡K cy‡ivcywi wekªvg wb‡Z ejv nq |
fvix KvR cwinvi Ki‡Z n‡e, cv‡Z jeb LvIqv eÜ Ki‡Z n‡e| wg_vBj
†Wvcv j¨v‡eUjj Ges K¨vjwmqvg P¨v‡bj eøKvim †hgb A¨vg‡jvwWwcb,
wbwdwWwcb, w`‡q wPwKrmv wb‡Z n‡e|

242. Mf©Kvjxb D”P i³Pvc wbqš¿‡Y †Kvb †Kvb Jla e¨envi Kiv wb‡la ?
GwmB BbwnweUim MÖæ‡ci Jla cy‡ivcywi wb‡la, cy‡iv Mf©Kvjxb mg‡q
G‡Z ev”Pvi gvivZ¥K ÿwZ n‡Z cv‡i|

243. AwZwi³ K¨vjwmqvg Ges I‡gMv-3 d¨vwUGwm‡Wi f‚wgKv wK ?
Lvev‡i AwZwi³ K¨vjwmqvg ev K¨vjwmqvg mvwcø‡g‡›Ukb I I‡gMv-3
d¨vwUGwm‡Wi f‚wgKv mxwgZ|

244. ¯^í gvÎvi A¨vmwcwib KLb e¨envi Kiv nq|
wcÖ-GK¬vgwkqv _vK‡j ¯^í gvÎvi A¨vmwcwib e¨envi Kiv hvq, 25 mßvn ch©šÍ|

245. Mf©Kvjxb D”P i³Pv‡ci Rb¨ KLb nvmcvZv‡j fwZ© K‡i wPwKrmvi
cÖ‡qvRb nq ?
Mf©Kvjxb D”P i³Pvc 170/110 wgwg ci` Gi †ekx n‡j Aek¨B
nvmcvZv‡j fwZ© K‡i wkivc‡_ j¨v‡eUjj, wg_vBj †Wvcv I gy‡L
wb‡dwWwcb ewo e¨envi K‡i Mf©Kvjxb D”P i³Pvc wbqš¿Y Kiv hvq|

246. nvmcvZv‡j fwZ©Kvjxb mg‡q Mf©Kvjxb D”P i³Pvc wbqš¿‡Y wK wK
Jla e¨envi Kiv hvq ?
wkivc‡_ bvB‡UªvcÖæmvBW, WvBD‡iwUKm& e¨envi Kiv †h‡Z cv‡i|

247. wLuPzwb n‡j wK e¨envi Kiv hvq ?
GK¬vgwkqv ev wLPuzwb n‡j wkivc‡_ g¨vM‡bwkqvg mvj‡dU e¨envi Kiv
hvq hv LyeB Kvh©Kix|

248. ‡Kvb †Kvb Mf©Kvjxb D”P i³Pvc wbqš¿YKvix Jla ey‡Ki `y‡ai
mv‡_ ev”Pvi kix‡i †h‡Z cv‡i ?
cÖcÖvbjj Ges wb‡dwWwcb †ekx cwigvY ey‡Ki `y‡ai mv‡_ wbM©Z nq e‡j
GB `y‡Uv Jla †ewk cwigv‡b ev”Pvi kix‡i †h‡Z cv‡i|
42
K
K
28
wPÎ t Mf©Kvjxb D”Pi³Pvc, AwZwi³ IRb I kixi †dvjv

250. nv‡U©i eø‡KR wK wRwbm ?
Avm‡j nv‡U©i wfZi `yÕai‡bi eøK n‡Z cv‡i| Avgv‡`i evmvevox‡Z †hgb
cvwbi jvBb I B‡jKwUªwmwU jvBb, ‡ZgbwU nv‡U©i wfZi i‡³i jvBb I
B‡jKwUªK jvBb _v‡K| GB `yB bvjxi jvBb G eøK n‡Z cv‡i| B‡jKwUªK
jvB‡b eøK n‡j nv‡U©i ü`¯ú›`‡bi MwZ kø_ n‡q hvq| i³bvjxi wfZi
eøK n‡j i³ cÖevn evav cvq G‡K Stenosis e‡j|

251. nv‡U©i ‡Kvb& ai‡bi eø‡K †Kvb& ai‡bi wPwKrmv Kiv nq ?
nv‡U©i B‡jwUªK eøK n‡j ü`¯ú›`‡bi MwZ kø_ n‡j Pacemaker RvZxq
Device w`‡q wPwKrmv Ki‡Z nq Ges nv‡U©i i³bvjx wfZi eøK
(Stenosis) n‡j stenting ev wis Øviv wPwKrmv Kiv nq|

252. †cm‡gKvi wK c×wZ‡Z kix‡i ¯’vcb Kiv nq ?
‡cm‡gKvi mvavibZ : `yÕai‡bi, ¯’vqx †cm‡gKvi I A¯’vqx †cm‡gKvi
| A¯’vqx †cm‡gKvi mvavibZ: Aí w`‡bi Rb¨ ¯’vcb Kiv nq Ges
cÖ‡qvRb n‡j A¯’vqx †cm‡gKvi Ly‡j ¯’vqx †cm‡gKvi jvMv‡bv nq|
A¯’vqx †cm‡gKvi mvavibZ: cv‡qi KzPKxi Kv‡Q Femoral Vein Gi
gva¨‡g Zvi cÖ‡ek Kwi‡q nv‡U©i Right Ventricle G Lead ivLv nq
Ges Generator ev controlling Device kix‡ii evB‡i ivLv nq| ¯’vqx
†cm‡gKv‡ii †¶‡Î AvswkK Acv‡ikb K‡i ey‡Ki Wvb ev evg cv‡k
Pvgovi bx‡P c‡KU K‡i Generator or controlling Device wU ivLv nq
43
Ges Gi mv‡_ mshy³ ZviwU Cephalic vein / subclavian vein w`‡q
nv‡U©i Right Ventricle ‡P¤^v‡ii mv‡_ hy³ Kiv nq|

253. KLb A¯’vqx †cm‡gKvi I KLb ¯’vqx †cm‡gKvi kix‡i ¯’vcb Kiv nq ?
‡hme †¶‡Î nVvr nv‡U©i B‡jKwUªK jvB‡b eøK nq †hgb - nvU© G¨v&Uv‡Ki
mv‡_ Third degree heart block ev second degree heart block n‡j
nv‡U©i ü`¯ú›`b kø_ n‡j A¯’vqx †cm‡gKvi jvMv‡bv nq| Aciw`‡K,
nv‡U© `xN© †gqv`x †iv‡Mi Kvi‡b A_ev Degenerative Kvi‡b Heart
Block n‡j ¯’vqx †cm‡gKv‡ii cÖ‡qvRb nq|

254. ‡cm‡gKvi jvMv‡bvi ci wKfv‡e
Pjv‡div Kiv DwPr ?
‡cm‡gKvi jvMv‡bvi ci
†cm‡gKv‡ii RvqMvq bL w`‡q
LyUv DwPr bq| †h cv‡k
Gernerator _v‡K, †mcv‡ki
nvZ †ekx DuPz‡Z DVv‡bv DwPZ
bq| †cm‡gKvi jvMv‡bvi
1gvm, 3gvm I cieZx©‡Z cÖwZ
6 gvm ci ci Followup
Kiv‡bv DwPr| eZ©gv‡b Avgiv
†h me †cm‡gKvi jvMvB †m‡¶‡Î
MRI ev metal detector Gwo‡q Pjv DwPr| wKš‘ eZ©gv‡b wKQy AvaywbK
Pacemaker Av‡Q †h¸‡jv MRI compatible wKš‘ G¸‡jv wKQyUv `vgx|

255. †cm‡gKvi jvMv‡bvi ci KZw`b ci cvëv‡bv DwPZ ?
‡cm‡gKvi jvMv‡bvi ci hw` e¨vUvixi Kg©¶gZv K‡g hvq Zvn‡j bZzb Generator
jvMv‡bv DwPZ| mvavibZ: 1wU †cm‡gKvi jvMv‡bvi ci 5-10 eQi P‡j|

256. †cm‡gKvi jvMv‡Z KZ LiP nq ?
¯’vqx †cm‡gKv‡ii `vg †KvqvwjwU I specification Gi Dci wfwË K‡i
Kg‡ekx nq| GKwU †cm‡gKvi 80 nvRvi †_‡K 3 jvL 50 nvRvi UvKv
ch©š— `v‡gi n‡Z cv‡i| ZvQvov Cathlab LiP wnmv‡e AwZwi³ 50
nvRvi UvKv jv‡M|
44
K
K
29

257. ü`h‡š¿i MwZ kø_ n‡j Avcbv‡`i
(B›Uvi‡fbkbvj KvwW©IjwR÷‡`i) fywgKv wK ?
ü`h‡š¿i MwZ kø_ n‡j kix‡ii cÖ‡qvRbxq
Metabolic Pvwn`v c~ib Kiv m¤¢e nq bv |
ZvB ü`h‡š¿i kø_ MwZi wPwKrmvi Rb¨
Pacemaker jvMv‡bv nq hv GKwU
Artificial device, Gi KvR n‡jv nv‡U©i
ü`¯ú›`‡bi MwZ evwo‡q nv‡U©i ¯^vfvweK I
cÖ‡qvRbxq Q›` wdwi‡q Avbv| ZvB Avgiv
ü`h‡š¿i MwZ kø_ n‡j †U‡¤úvivix
Pacemaker A_ev cÖ‡qvR‡b ¯’vqx
Pacemaker (†cm‡gKvi) jvMvB|
ü`‡ivM wPwKrmvq †cm‡gKvi
14 †g 2011 Zvwi‡L Ô‰`wbK hyMvšÍi cwÎKvÕq Ômy¯’¨ _vKzbÕ cvZvq cÖKvwkZ nq|
wPÎ t †cm‡gKvi †Rbv‡iUi I mshy³ Zvi

258. cwikª‡g ey‡K e¨_v n‡j KiYxq
45

259. ü`wc‡Ûi i³bvjxi eøKRwbZ e¨_v n‡j wK mgm¨v n‡Z cv‡i|
ü`wc‡Ûi eøK RwbZ e¨_v n‡j Zv M¨vw÷ªK Gi e¨_v †f‡e fyj n‡Z
cv‡i| Zv cwibv‡g me©bvk †W‡K Avb‡Z cv‡i| A‡bK mgq Dc‡ii
†c‡U e¨_v n‡j Zv i“Mx wb‡R A_ev Rywbqvi Wv³viiv Zv M¨vw÷ªK Gi
e¨_v g‡b K‡i G¨v›UvwmW ev M¨vwóªK Gi Ab¨vb¨ Jla w`‡q †ivMx‡K
wPwKrmv Kiv‡Z cv‡ib hv †ivMxi Rb¨ gvivZœK n‡Z cv‡i|

260. †c‡U e¨_vi KviY wK ? M¨wóªK bv nvU© Av¨vUvK Zv wKfv‡e eySv hvq ?
M¨vw÷ªK Gi e¨_v mvavibZ: eûw`b a‡i gv‡S gv‡S nq| wKš‘ nv‡U©i
i³bvjxi eø‡Ki
Kvi‡b nvU©-
A¨vUvK n‡j
Dc‡ii †c‡Ui
e¨_v cÖ_g
ev‡ii Rb¨ ev
bZzb ai‡bi
e¨_v AbyfyZ
n‡j Ges Gi
mv‡_ hw` cÖPzi
Nvg nq ev ewg
ewg fve nq Z‡e
Zv nvU© G¨vUv‡Ki Rb¨ nIqvi m¤¢vebv †ekx|

261. †c‡U e¨_v nvU© A¨vU©v‡Ki d‡j n‡j †m‡¶‡Î wK Kiv DwPr ?
‡Kvb †ivMxi †Kvbw`b †c‡U e¨_v bv n‡j Ges nVvr K‡i †Kvbw`b †c‡U
e¨_v n‡j, mv‡_ cÖPzi Nvg n‡j ev ewg n‡j †m‡¶‡Î †h‡nZz ü`wc‡Ûi
eøKRwbZ Kvi‡b nIqvi m¤¢vebv †ekx, †m‡¶‡Î AwZmË¡i wbKU¯’
nvmcvZvj ev ¯^v¯’¨ †K‡›`ª BwmwR ev i³cix¶v †hgb KvwW©qvK Uª‡cvwbb
AvB cix¶vwU Kwi‡q †bIqv DwPr|

262. ü`wc‡Ûi i³bvjx‡Z eøKRwbZ ey‡K e¨_vi ˆewkó¨ wK wK ?
ü`wc‡Ûi i³bvjx‡Z eKRwbZ ey‡K e¨_v mvavibZ: ey‡Ki gvSLv‡b nq|
cwikªg Ki‡j ev‡o, wekªvg wb‡j K‡g, bvB‡UªU RvZxq Jla wRnŸvi bx‡P
w`‡j ev wRnŸvi bx‡P †¯cÖ Ki‡j K‡g| ey‡Ki e¨_v evg nv‡Zi wfZ‡ii
46
K
K
30

263. cwikª‡gi mgq wK
Ki‡j ey‡K e¨_v n‡Z
cv‡i ?
cwikª‡gi mgq ü`wc‡Ûi
i³bvjx‡Z eøK _vK‡j
ev i³cÖev‡n evavMÖ¯’
n‡j ey‡K e¨_v n‡Z cv‡i|

264. cwikª‡gi mgq †Kb ey‡K e¨_v nq ?
ü`wc‡Ûi K‡ivbvix i³bvjx‡Z eøK _vK‡j ev i³bvjx‡Z Pwe©i Av¯—i
R‡g i³bvjx mi“ n‡j cwikª‡gi mgq AwZwi³ i³ mieiv‡ni cÖ‡qvRb
nq wKš‘ i³bvjx‡Z eøK _vKvi Kvi‡Y i³ mieiv‡ni NvUwZ †`Lv hvq
d‡j ü`wc‡Ûi gvsk‡ckx‡Z Aw·‡Rb I Lvevi Afve †`Lv hvq, G‡Z
ey‡K e¨_v K‡i|

265. ü`wc‡Ûi i³bvjx‡Z eøK n‡j KLb ey‡K e¨_v nq ?
cwikª‡gi mgq A_¨v©r wmwo w`‡q DVvi mgq, cvnv‡o DVvi mgq, †`Š‡o
ev‡m DVvi mgq, Zvovûov K‡i †Kvb KvR Kivi mgq, evRv‡ii e¨vM
nv‡Z wb‡q nuvUvi mgq, fvix KvR Kivi mgq, †Kvb fvix wRwbm ‡Zvjvi
mgq, AZ¨vwaK D‡ËwRZ n‡j, Lvevi ci fiv‡c‡U nvU‡j ey‡K e¨_v ev
Pvc AbyfyZ n‡Z cv‡i|

266. ü`wc‡Ûi i³bvjxi eøK RwbZ e¨_v ey‡Ki ‡Kv_vq nq ?
ü`wc‡Ûi i³bvjx‡Z eøKRwbZ e¨_v mvavibZ: ey‡Ki gvSLv‡b nq, Z‡e
KLbI KLbI evgcv‡k A_ev Wvbcv‡kI n‡Z cv‡i| G e¨_v ey‡Ki Dci
w`‡K Mjvi Kv‡Q GKs evg nvZ w`‡q Qwo‡q co‡Z cv‡i|

267. ü`wc‡Ûi i³bvjxi eøKRwbZ e¨_v Avi †Kv_vq †Kv_vq n‡Z cv‡i ?
ü`wc‡Ûi i³bvjxi eøKRwbZ e¨_v Dc‡ii †c‡U n‡Z cv‡i ev M¨w÷ªK
Gi e¨_v †f‡e fyj n‡Z cv‡i | ZvQvov G ai‡bi e¨_v ïaygvÎ Mjvi
Dci Pvc Pvc ai‡bi n‡Z cv‡i, g‡b nq Mjvq AvU‡K Av‡Q Ges wb:k¦vm
eÜ n‡q Avm‡e| GQvov ü`wc‡Ûi eøKRwbZ e¨_v wc‡Vi wcQ‡b n‡Z
cv‡i, Wvb nvZ ev evgnv‡Z n‡Z cv‡i|
wPÎ t B‡KvKvwW©IMÖvg I Kvjvi Wcjvi Kiv Ae¯’vq †jLK

268. w`K w`‡q bx‡Pi w`‡K bv‡g, ey‡K e¨_vi mv‡_ mv‡_ AwZwi³ Nvg n‡Z
cv‡i|

269. cwikª‡gi mgq ey‡K
e¨_v n‡j wK KiYxq ?
cwikª‡gi mgq ey‡K e¨_v
n‡j Zv ü`wc‡Ûi
i³bvjx‡Z eøKRwbZ
Kvi‡b n‡Z cv‡i weavq
AwZmZ¡i ü`‡ivM
we‡kl‡Ái civgk©
cÖ‡qvRb| BwmwR,
B‡KvKvwW©IMÖvg, BwUwU
Ges Ab¨vb¨ cix¶v
†hgb - K‡ivbvix GbwRIMÖvg Ki‡Z cv‡ib|

270. cwikª‡gi d‡j ey‡K e¨_v n‡j wK wK Jla e¨envi Kiv nq ?
ü`wc‡Ûi i³bvjx‡Z eøKRwbZ Kvi‡b ey‡K e¨_v n‡j i³bvjxi wfZi
i³ mieivn e„w× Kivi Rb¨ bvB‡UªU RvZxq Jla, ü`wc‡Ûi †ckxi
Aw·‡Rb I cywó mieiv‡ni Rb¨, UªvB‡gUvwRwWb ai‡bi Jla e¨envi
Kiv nq| ZvQvov weUeøKvi Jla, i³cvZjv ivLvi Rb¨ B‡Kvw¯cÖb ev
K¬wc©W‡MÖj RvZxq Jla Ges i³bvjxi eøK Kgv‡bvi Rb¨ ÷vwUb RvZxq
Jla hv i‡³i †Kv‡jóij Kgvq Ggb Jla e¨envi Kiv nq|
K cwikª‡gi d‡j ey‡K e¨_v n‡j wK wK cix¶v Kiv‡bv DwPZ ?
cwikª‡gi d‡j ey‡K e¨_v n‡j BwmwR, BwUwU, B‡KvKvwW©IMÖvg I cÖ‡qvR‡b
wmwU GbwRIMÖvg ev Bb‡fwmf GbwRIMÖvg Ki‡Z n‡e|
K ü`wc‡Ûi i³bvjx‡Z eøKRwbZ Kvi‡b ey‡K e¨_v n‡j wK BwmwR
¯^vfvweK _vK‡Z cv‡i ?
n¨vu, ü`wc‡Ûi i³bvjx‡Z eøKRwbZ Kvi‡b ey‡K e¨_v n‡j BwmwR
¯^vfvweK _vK‡Z cv‡i|
47
K
K
31
17 wW‡m¤^i 2011 Zvwi‡L Ô‰`wbK hyMvšÍi cwÎKvÕq Ômy¯’¨ _vKzb cvZvÕq cÖKvwkZ nq|
wPÎ t GbwRIMÖv‡g Wvb K‡ivbvix agbx‡Z eøK

272. BwUwU wKfv‡e Kiv nq ?
BwUwU‡Z †ivMx‡K GKwU Treadmill G nuvU‡Z nq Ges †ivMxi H mgq
gvMZ BwmwR Kiv nq| G mgq BwmwR Gi cwieZ©b †`‡L BwUwU wi‡cvU©
Kiv nq|

273. BwUwU Kivi Av‡M †Kvb †Kvb cix¶vi wi‡cvU© mv‡_ ivLv DwPZ ?
BwUwU cix¶vi mgq BwmwR I B‡KvKvwW©IMÖvg cix¶vi wi‡cvU© mv‡_ ivLv
DwPZ |

274. BwUwU cwRwUf wi‡cv‡U©i A_© wK ?
BwUwU cwRwUf wi‡cvU© gv‡b ü`wc‡Ûi i³bvjx‡Z Zvrch©c~b© (70 fv‡Mi
†ekx) eøK _vKvi m¤¢vebv †ekx|

275. BwUwU ‡b‡MwUf Gi wi‡cv‡U©i A_© wK ?
BwUwU †b‡MwUf wi‡cv‡U©i gv‡b ü`wc‡Ûi i³bvjx‡Z Z©vrch©c~b© (70
fv‡Mi †ekx ) eøK _vKvi m¤¢vebv Kg| wKš‘ Gi gv‡b bq †h, i³bvjx‡Z
†Kvb eøK †bB |

276. BwUwU †b‡MwUf n‡jI wK nvU© A¨vUvK n‡Z cv‡i ?
n¨uv, BwUwU †b‡MwUf n‡jI nvU© A¨vUvK n‡Z cv‡i| BwUwU †b‡MwUf gv‡b
ü`wc‡Ûi i³bvjx Zvrch©c~b© A_¨v©r 70 fv‡Mi †ekx eøK †bB wKš‘ 70
48
fv‡Mi bx‡Pi eøK _vK‡jI †mB eøK ‡d‡U wM‡q (Rupture) _ªg‡evwmm
n‡q, (Thrombosis) i³bvjx RgvU †eu‡a Acute coronary syndrome ev
nvU© A¨vUvK n‡Z cv‡i| ZvB BwUwU †b‡MwUf n‡jB wbwð‡š— nIqv hvq bv|

277. BwUwU cwRwUf n‡j cieZx©‡Z wK Kiv DwPr ?
BwUwU cwRwUf n‡j †h‡nZz eøK _vKvi m¤¢vebv †ekx ZvB K‡ivbvix
GbwRIMÖvg Kiv DwPZ| mv‡_ mv‡_ wKQy wKQy Jla LvIqv DwPZ|

278. BwUwU †b‡MwUf n‡j wK Kiv DwPZ ?
BwUwU †b‡MwUf n‡jI hw` GK ev GKvwaK Risk Factor Dcw¯’Z _v‡K
†hgb - Wvqv‡ewUm, D”P i³Pvc, aygcvb ev i‡³i D”PgvÎvi †Kv‡j÷ij
_vK‡j Ges Ischaemic heart disease nIqvi m¤¢vebv _vK‡j CT
Angiogram ev Invasive angiogram Kiv DwPZ|

279. ey‡K e¨_v n‡j KLb BwUwU Kiv DwPZ ?
cwikªg Ki‡j ey‡K e¨_v n‡j, eqm 40 Gi †ekx n‡j, Wvqv‡ewUm _vK‡j,
D”P i³Pvc _vK‡j, aygcvqx n‡j, i‡³ D”P‡Kv‡j÷ij _vK‡j BwUwU
Kiv DwPZ| Kvib G mKj †¶‡Î ü`wc‡Ûi K‡ivbvix agbx‡Z eøK _vKvi
m¤¢vebv †ekx|

280. BwUwU Kivi mgq wK †Kvb Amyweav n‡Z cv‡i ?
n¨vu, BwUwU Kivi
mgq Zxeª ey‡K e¨_v,
i³Pvc K‡g hvIqv,
GgbwK nvU©
A¨vUvKI n‡Z cv‡i,
ZvB BwUwU Kivi
mgq mveavbZv
Aej¤^b Kiv DwPZ|
BwUwU Kivi Av‡M
Aek¨B mv¤cÖwZK
BwmwR I B‡Kv
wi‡cvU© mv‡_ _vKv
cÖ‡qvRb|
49
K
K
32

281. BwUwU wK ?
BwUwU nj Exercise Tolerance Test A_v©r
Exercise Gi gva¨‡g †`Lv nq ü`wc‡Ûi
i³bvjx‡Z †Kvb eøK Av‡Q wK bv Zv Abygvb
Kiv nq|

282. BwUwU Kv‡`i Kiv nq ?
hv‡`i ey‡K e¨_v nq cwikªg Ki‡j A_ev
hv‡`i Wvqv‡ewUm, D”Pi³Pvc Av‡Q ev
aygcvb K‡i, †m mg¯— †ivMx‡`i BwUwU Kiv
nq| GQvov nvU© A¨vUv‡Ki ci I BwUwU Kiv
nq|
ü`‡ivM wbY©‡q BwUwU
wPÎ t gvwjevM †gwW‡bvfvq bb Bb‡fwme j¨v‡e BwUwU Kiv
Ae¯’vq †jLK|

284. BwUwU‡Z Treadmill †gwk‡b KZ¶b nuvU‡Z nq ?
BwUwU‡Z Treadmill †gwk‡b mvavibZ 6-9 wgwbU nuvU‡Z nq, cÖ‡qvR‡b
AviI †ekx nuvU‡Z n‡Z cv‡i |

285. BwUwU Ki‡Z
†gvU KZ¶b
mgq jv‡M ?
BwUwU Ki‡Z
m v a v i b Z :
15-20 wgwbU
mgq jv‡M |

286. BwUwU Kivi
mgq KLb
†gwkb eÜ
Kiv nq ?
BwUwU Kivi
mgq ey‡K e¨_v
n‡j A_ev BwmwR cwieZ©b n‡j A_ev j¶¨gvÎv AwR©Z n‡j BwUwU eÜ
Kiv nq |

287. BwUwU Ki‡Z LiP KZ ?
BwUwU Ki‡Z 2000-2500 UvKv jv‡M|

288. BwUwU Ki‡Z Lvwj †c‡Ui cÖ‡qvRb nq wK bv ?
BwUwU Ki‡Z Lvwj †cU cÖ‡qvRb †bB Z‡e Lvwj †c‡U †gwk‡b nvuU‡Z
myweav nq|

289. wK wK mgm¨v _vK‡j ETT Kiv hvq bv ?
ECG †Z Right bundle branch block (RBBB)/LBBB (Left bundle
branch block) A_ev ST depression _vK‡j A_ev †ivMxi Aortic
stenosis ev HOCM or pulmonary Stenosis _vK‡j ETT Kiv hvq
bv|
50
K
K
33
mvÿvrKviwU ÔmvßvwnKÕ cwÎKvq Ô¯^v¯’¨Õ cvZvq
29 wW‡m¤^i, 2011, 04 el©, 33 msL¨vq cÖKvwkZ nq|
wPÎ t GbwRIMÖvg Kiv Ae¯’vq †jLK|

290. nvU© G¨vUvK †ivMx‡`i Kibxq

291. nvmcvZvj Z¨v‡Mi ci KZw`b wekªvg wb‡Z n‡e?
Pvi †_‡K Qq mßvn| gvš^‡q nvjKv †_‡K ¯^vfvweK Kvh© g ïiæ
Ki‡Z n‡e|

292. cÖ_g mßv‡n wK wK KvR Kiv hv‡e?
cÖ_g mßv‡n N‡ii g‡a¨ nuvUv-Pjv, evmvq e‡m Awd‡mi dvBj †`Lv
†h‡Z cv‡i|

293. 2q I 3q mßv‡n wK Kiv hvq?
2q I 3q mßv‡n Av‡¯Í Av‡¯Í nuvUvi cwiwa I mgq evov‡bv hv‡e Ges
gvš^‡q Av‡¯Í Av‡¯Í evov‡Z n‡e| 3 mßvn c‡i 30 wgwbU †_‡K 1
N›Uv nuvUv hv‡e|

294. Qq mßvn ci wK wK
Kiv hv‡e?
Qq mßvn ci Awdm
Kiv hv‡e, GgbwK
nvj&Kv Mvox Pvjv‡bv
hv‡e, Z‡e fvix I
Abf¨¯Í KvR Kiv
hv‡e bv|

295. nvU© G¨vUv‡Ki ci
Avi wK wK civgk©
gvb‡Z n‡e?
- kix‡ii IRb
wbqš¿Y ivL‡Z n‡e|
- Pwe© mg„× Lvevi Z¨vM Ki‡Z n‡e|
- aygcvb, RÏv©©/ZvgvK eR©b Ki‡Z n‡e|
- `ywðšÍv gy³ _vK‡Z n‡e|
- D”Pi³Pvc, Wvq‡ewUm I wKWbx †ivM wbqš¿Y ivL‡Z n‡e|
- Wv³v‡ii civgk© Qvov †Kvb Jla LvIqv hv‡e bv ev †Kvb Jla
eÜ Kiv hv‡e bv|
51
K
K
34
wPÎ t nvU© G¨vUvK †ivMx‡`i e¨vqvg, ¯^v¯’¨Ki Lvevi
I nvwm Lywk Rxeb hvcb

296. wPwKrmvq wKQz wKQz Jl‡ai Kvi‡YI ü`‡ivM n‡Z cv‡i| Avevi
ü`‡iv‡Mi wPwKrmvq Jl‡ai Kvi‡YI evZ e¨_v †ivM n‡Z cv‡i|

297. evZR¡i I ü`‡iv‡Mi m¤úK© wK ?
evZR¡‡i wMiv e¨_v I wMiv dzjvi mv‡_ ü`‡ivMI n‡Z cv‡i hv‡K
KvW©vBwUm e‡j| G‡Z ü`wc‡Ûi fvje& Av všÍ n‡Z cv‡i Ges fvj&e
ÿwZMÖ¯’ n‡q fvje& miæ n‡Z cv‡i ev fvje wjK& n‡Z cv‡i| ZvQvov
ü`wc‡Ûi gvsk‡ckx Av všÍ n‡q nvU© †dBjvi ev ü`wc‡Ûi Pvi cv‡k
c`©v Av všÍ n‡q †cwiKvwW©qvj BbwdDkb n‡Z cv‡i|

298. BDwiK GwmW I ü`‡iv‡Mi m¤úK© wK ?
BDwiK GwmW †ekx _vK‡j ü`wc‡Ûi K‡ivbvix agbx‡Z Pwe©i Av¯Íi R‡g
fwel¨‡Z nvU© G¨vUvK ev G‡_‡iv‡¯‹‡jv‡ivwUK nvU© wWwRR n‡Z cv‡i|
Avevi ü`‡iv‡M e¨eüZ wKQz Jla †hgb WvBD‡iwUKm& hv kix‡ii
AwZwi³ cvwb †ei Kivi Rb¨ e¨envi Kiv nq, †m mg¯Í Jla BDwiK
GwmW evwo‡q w`‡Z cv‡i hvi d‡j kixi e¨_v I wMiv dzj‡Z cv‡i|

299. wMiv evZ (wiDgvU‡qW Av_©vBwUm) I ü`‡iv‡Mi m¤úK© wK ?
wMiv evZ ev wiDgvU‡qW Av_©vBwUm G A‡bK mgq ü`wc‡Ûi Pvicv‡k
cvwb Rg‡Z cv‡i| ZvQvov wMivev‡Z e¨eüZ e¨_vi Jla †hgb- Gb Gm
52
G AvB wW (NSAIDs) †Z kix‡i cvwb Avm‡Z cv‡i Ges eûw`b a‡i G
RvZxq Jla e¨envi Ki‡j Bm‡KwgK nvU© wWwRR RvZxq ü`‡ivM n‡Z
cv‡i, GgbwK †Kvb †ivMxi nvU© `~e©j _vK‡j G RvZxq e¨_vi Jla
e¨envi K‡i nvU© †dBjvi ev Zxeª k¦vmKó n‡Z cv‡i|

300. ‡Kvb †ivMxi nv‡U©i mgm¨v _vK‡j Jla †me‡b wK wK mZK©Zv
Aej¤^b Kiv DwPZ ?
†Kvb evZ e¨_v †ivMxi nv‡U©i mgm¨v _vK‡j e¨_vi Jla †me‡b mZK©Zv
Aej¤^b Ki‡Z n‡e| WvB‡K¬v‡db, AvBey‡cÖv‡db, wK‡Uv‡cÖv‡db RvZxq
GbGmGAvBwW Jla †L‡j nVvr Zxeª k¦vmKó n‡Z cv‡i A_©vr nVvr nvU©
†dBjvi n‡Z cv‡i| ZvQvov Gb Gm G AvB wW (bb †÷qWvj Gw›U
Bbd¬v‡gUix WªvMm) RvZxq Jla k¦vm `xN© mgq e¨envi Ki‡j B‡¯‹vwgK
nvU© wWwRR A_©vr i³bvjx‡Z eøK n‡Z cv‡i|

301. Aw÷I Av_©vBwUm †ivM ev eq¯‹ RwbZ evZ †iv‡Mi mv‡_ ü`‡iv‡Mi
m¤úK© wK ?
Aw÷I Av_©vBwUm ev eq¯‹ RwbZ evZ †ivM †h‡nZz eq¯‹ †ivMx‡`i nq Ges
i³bvjxi eøK RwbZ ü`‡ivMI eq¯‹ †ivMx‡`i †ekx nq, †m‡ÿ‡Î ev‡Zi
wPwKrmvi Rb¨ e¨_vi Jla mveav‡b †L‡Z n‡e A_ev cwinvi Ki‡Z n‡e
A_©vr ü`‡ivM bZzb K‡i n‡Z cv‡i ev ü`‡iv‡Mi gvÎv †ekx n‡Z cv‡i|

302. wm‡÷wgK jycvm BivB‡_gv‡Uvmvm (Gm. Gj. B) Gi mv‡_
ü`‡iv‡Mi m¤úK© wK ?
Gm. Gj. B †Z mvaviY wMiv e¨_v I wMiv dzj‡Z cv‡i| G Qvov Gm Gj
B n‡Z Pvgovq ÿZ Gi cvkvcvwk wKWbx, †eªb, dzmdzm Av všÍ n‡Z
cv‡i| ZvQvov Gm. Gj. B †Z ü`wc‡Ûi Pvicv‡k cvwb Rgv QvovI
ü`wc‡Ûi B‡jKwUªK jvB‡b eøK n‡Z cv‡i|

303. evZ e¨_v I ü`‡ivM _vK‡j †ivMxi wK wK mZK©Zv cvjb Kiv DwPZ ?
evZ e¨_v I ü`‡ivM _vK‡j evZ e¨_v Kgv‡bvi Rb¨ bb ÷iqWvj GwÛ
Bbd¬v‡gUix WªvMm (Gb Gm G AvB wW) Gi e¨envi mveav‡b Kiv DwPZ ZvB
cÖ‡qvR‡b Zv cwinvi K‡i Ab¨ MÖæ‡ci Jla †hgb c¨vivwmUvgj ev UªvgvWj
RvZxq Jla e¨envi Kiv †h‡Z cv‡i hv Zzjbvg~jKfv‡e A‡bK wbivc`|
53
K
K
35

304. evZ e¨_v †ivM wK ?
‡Kvb †Kvb †iv‡M kixi ev wMivq e¨_v
n‡Z cv‡i G‡K evZ e¨_v †ivM e‡j|

305. wK wK Kvi‡Y evZ e¨_v †ivM nq ?
mvaviYZt evZ R¡i, BDwiK GwmW †ekx _vK‡j,
wMiv evZ _vK‡j, Aw÷I Av_©vBwUm _vK‡j,
GbKvB‡jvwms ¯úbWvBjvBwUm _vK‡j, Gm Gj
B _vK‡j evZ e¨_v †ivM n‡Z cv‡i|

306. evZ e¨_v †iv‡Mi mv‡_ ü`†iv‡Mi m¤úK© wK ?
wKQz wKQz evZ e¨_v †iv‡Mi Kvi‡Y ü`‡ivM
n‡Z cv‡i Avevi evZ e¨_v †iv‡Mi
evZ e¨_v I ü`‡ivM
29 A‡±vei 2011 Zvwi‡L Ô‰`wbK hyMvšÍi cwÎKvÕq cÖKvwkZ nq|

308. nvB‡cv_vBiqwWRg †iv‡M ü`wc‡Ûi Pvicv‡k cvwb Rgvi cvkvcvwk
Avi wK wK mgm¨v n‡Z cv‡i ?
Hypothyroidism †iv‡M Pericardial effusion Gi cvkvcvwk GB †iv‡Mi
Ab¨vb¨ DcmM© _vK‡Z cv‡i ‡hgb : kixi dz‡j hvIqv, cv‡q cvwb Avmv,
`ye©jZv †eva nIqv, kix‡ii Pvgov LmL‡m n‡q hvIqv, Pzj c‡o hvIqv,
Mjvi ¯^i †gvUv n‡q hvIqv cÖf~wZ|

309. nvB‡cv_vBiqwWRg †iv‡M Pericardial effusion mvavibZ: wK
cwigvb nq ?
nvB‡cv_vBiqwWRg †iv‡M Pericardial effusion G cvwbi cwigvb Aí ev
gvSvix cwigv‡bi n‡q _v‡K| Z‡e Lye Kg ‡¶‡Î severe amount n‡Z
cv‡i|

310. nvB‡cv_vBiqwWRg G Pericardial effusion n‡j wKfv‡e wPwKrmv
Kiv‡eb ?
nvB‡cv_vBiqwWRg G Pericardial effusion n‡j mvavibZ:
nvB‡cv_vBiqwWRg Gi wPwKrmvi Rb¨ Thyroxine Replacement w`‡j
†ivMxi Ab¨vb¨ Dcm‡M©i DbœwZi cvkvcvwk cvwbi cwigvb I K‡g hvq
Ges mvavibZ: cvwb †ei Kivi cÖ‡qvRb nq bv|
54

311. nvB‡cv_vBiqwWRg wK ?
nvB‡cv_vBiqwWRg GK ai‡bi endocrine †ivM A_¨v©r hormone RwbZ
mgm¨v| †Kvb Kvi‡b kix‡ii thyroid hormone Gi cwigvb K‡g †M‡j
Zv‡K nvB‡cv_vBiqwWRg e‡j|

312. nvB‡cv_vBiqwWRg †iv‡M Thyroxine replacement KZw`b w`‡Z nq ?
nvB‡cv_vBiqwWRg †iv‡M Thyroxine replacement wnmv‡e mvavibZ:
mviv Rxeb ‡L‡Z nq |

313. nvB‡cv_vBiqwWRg †iv‡Mi wPwKrmvq Thyroxine †L‡Z †L‡Z
gvSLv‡b eÜ Ki‡j †Kvb mgm¨v nq wK ?
n¨vu, gvSc‡_ Thyroxine LvIqv †Q‡o w`‡j Av‡Mi DcmM© Avevi †`Lv
w`‡e | IRb †e‡o hvIqv, kixi dz‡j hvIqv, cv‡q cvwb Avmv, kix‡ii
Pvgov LmL‡m n‡q hvIqv BZ¨vw`|

314. Thyroxine eÜ Kivi ci hw` DcmM© wd‡i Av‡m Z‡e wK Ki‡Z n‡e ?
Aek¨B wPwKrk‡Ki civgk© Abyhvqx Avevi Thyroxine ïi“ Ki‡Z n‡e|

315. ü`‡iv‡Mi †¶‡Î Thyroxine
e¨env‡i mZK©Zv Av‡Q wK ?
n¨vu, ü`‡ivMx‡`i †¶‡Î Thyroxine
e¨env‡i mZK©Zv Aej¤^b Kiv
DwPZ| ü`‡ivMx‡`i †¶‡Î Aí
†Wv‡R Thyroxine ïi“ K‡i ax‡i
ax‡i Jl‡ai gvÎv evov‡bv DwPr
Ges cÖ‡qvR‡b mv‡_ β-Blocker
RvZxq Jla (Betaloc, Tenoloc)
e¨envi Kiv DwPr |

316. nvB‡cv_vBiqwWRg †ivMx‡`i
wKfv‡e Follow-up Ki‡Z n‡e ?
nvB‡cv_vBiqwWRg †ivMx‡`i
Follow-up Gi Rb¨ wKQy Clinical
parameter I wKQy Laboratory parameter †`L‡Z n‡e| Clinical
parameter †hgb †ivMxi my¯’Zv (Well being ) IRb Kgv, ü`wc‡Ûi
MwZ evov, Pvgovi LmL‡m fve K‡g hvIqv, kixi dzjv K‡g hvIqv, cÖf„wZ
55
K
K
36

317. ü`wc‡Ûi Pvicv‡k cvwb Rgvi
(Pericardial effusion) mvaviY
KviY¸wj wK wK ?
ü`wc‡Ûi Pvicv‡k cvwb Rgvi mvavib
(Common) Kvib¸‡jv nj t h¶v,
Malignancy (K¨vÝvi), Hypothyroidism,
KvwWqvK mvRv©ix Acv‡ik‡bi c‡i, nvU©
†dBjvi, PCI Kivi mgq Coronary
dissection n‡j, PTMC Kivi mgq Free
wall rupture n‡j Pericardial effusion
n‡Z cv‡i|
nvB‡cv_vBiqwWRg I ü`‡ivM
wPÎ t _vBi‡qW MøvÛ

318. †Lqvj Ki‡Z n‡e Ges Laboratory parameter Gi †¶‡Î FT4, TSH
cix¶v Ki‡Z n‡e 6 gvm cici|

319. nvB‡cv_vBiqwWRg ‡ivMxi Pregnancy †Z I wK Thyroxine †L‡Z
n‡e ? †L‡j †Kvb Amyweav Av‡Q wK ?
nvB‡cv_vBiqwWRg ‡ivMx‡`i Pregnancy †ZI Thyroxine replacement
Aek¨B Pvwj‡q †h‡Z n‡e Ges G Jla †L‡j Pregnancy †Z †Kvb Amyweav
n‡e bv| Z‡e Pregnancy †Z Thyroxine Gi cwigvb ‡ekx jvM‡Z cv‡i|

320. nvB‡cv_vBiqwWRg †Kb nq ?
‡Kvb Kvi‡Y we‡klZ auto immunity Kvi‡b thyroid Gland Gi
Kg©¶gZv K‡g †M‡j Gland †_‡K Thyroid ni‡gvb Kg †ei nq| ZvQvov
MjMÛ †iv‡Mi Kvi‡bI Hypothyroidism n‡Z cv‡i|

321. R¤§MZ Kvi‡bI wK nvB‡cv_vBiqwWRg n‡Z cv‡i ?
n¨vu, R¤§MZ mgm¨vi Kvi‡bI Hypothyroidism n‡Z cv‡i G‡K
Cretinism e‡j| G †iv‡M †ivMxi Mile stone of development Pigfv‡e
evavMÖ¯’ n‡Z cv‡i|

322. nvB‡cv_vBiqwWRg †iv‡M ü`h‡š¿i Pvicv‡k cvwb Rgv Qvov Avi wK
wK ai‡bi ü`‡ivM n‡Z cv‡i ?
nvB‡cv_vBiqwWRg †iv‡M ü`h‡š¿i Pvicv‡k cvwb Rgv QvovI ü`h‡š¿i
kø_MwZ (Bradycardia), Ischaemic heart disease, i‡³ †Kv‡j‡÷ij
I UªvBMøvB‡mivB‡Wi D”P gvÎv n‡Z cv‡i|

323. Sub-clinical hypothyroidism wK ? wPwKrmvq cÖ‡qvRb Av‡Q wK ?
hw` thyroid hormone Gi gvÎv (FT3, FT4) Gi cwigvb ¯^vfvweK
_vK‡jI, TSH Gi cwigvb ¯^vfvweK gvÎvi †_‡K †ekx _v‡K Zv‡K Sub-
clinical nvB‡cv_vBiqwWRg e‡j| G Ae¯’vq Aek¨B Thyroxine
Replacement w`‡q wPwKrmv Ki‡Z n‡e|

324. nvB‡cv_vBiqwWRg †ivMx‡`i Lactation Gi mgq A_©¨vr Breast
feeding Gi mgq Thyroxine LvIqv hvq wKbv ?
nvB‡cv_vBiqwWRg †ivMx‡`i Lactation Gi mgq A_v©r Breast feeding Gi
mgqI Thyroxine †L‡Z n‡e, G‡Z †ivMx ev ev”Pvi †Kvb mgm¨v n‡e bv|
56
K
K
37
mvÿvrKviwU ÔAvb›` Av‡jvÕ cwÎKvq ÔI Wv³viÕ cvZvq
16 b‡f¤^i, 2011, 07 el©, 14 msL¨vq cÖKvwkZ nq|

325. i‡³ Pwe©i AvwaK¨ KviY, cÖwZKvi, cÖwZ‡iva

326. i‡³ wK wK ai‡bi †Kv‡j‡÷ij ev Pwe© _v‡K ?
i‡³ Pvi ai‡bi Pwe© _v‡K| h_v -Total Cholesterol (TC), Low
Density Lipoprotein (LDL), High Density Lipoprotein (HDL) and
Triglyceride (TG).

327. fvj †Kv‡j‡÷ij I Lvivc †Kv‡j‡÷ij wK ?
HDL Cholesterol †K fvj †Kv‡j‡÷ij I LDL Cholesterol †K Lvivc
†Kv‡j‡÷ij e‡j|

328. HDL †Kv‡j‡÷ij †K fvj †Kb e‡j ?
HDL i‡³ †ekx _vK‡j i³bvjx‡Z Atherosclerosis (Pwe©i Av¯—i Rgv)
Kg nq, d‡j i³bvjx‡Z Stenosis (eø‡KR) nq bv|

329. LDL †Kv‡j‡÷ij Lvivc ejv nq †Kb ?
LDL †Kv‡j‡÷ij i‡³ †ekx cwigv‡b _vK‡j LDL Gi ga¨w¯’Z Pwe©
kix‡ii wewfbœ ¯’vb GgbwK Coronary i³bvjx‡ZI Rgv n‡q
Atherosclerosis (Pwe©i Av¯—i Rgv) Plaque ˆZwi n‡q i³bvjx mi“ n‡q
hvq (Stenosis), d‡j i³ cÖevn evavMÖ¯’ n‡q Angina (ey‡K e¨_v) n‡Z
cv‡i A_¨v©r Ischaemic Heart disease n‡Z cv‡i|

330. HDL †Kv‡j‡÷ij †ekx _vK‡j Coronary atherosclerosis Kg
nq †Kb ?
HDL nj High Density Lipoprotein A_©¨vr HDL Gi g‡a¨
Unesterified Cholesterol and Cholesterol ester Gi cwigvb Kg _v‡K
Ges Protein Gi cwigvb †ekx _v‡K weavq NbZ¡ †ekx | HDL particle
G Cholesterol cwigvb Kg _vKvq Zv i³bvjx‡Z Rgv nevi my‡hvM Kg
_v‡K|