Ü`‡ivM cÖwZ‡iva I cÖwZKvi welqK Abyôvb

Aa¨vcK (Wvt) †gvt †ZŠwdKzi ingvb (dviæK)
GgweweGm (wWGgwm), GdwmwcGm (†gwWwmb), GgwW (KvwW©IjwR)
GdGwmwm (Av‡gwiKv), GdBGmwm (BD‡ivc), GdAviwmwc (Møvm‡Mv I GwWbevM©)
Gdwmwmwc (Av‡gwiKv), GdGGBPG (Av‡gwiKv), GdGwmwc (Av‡gwiKv)
GdGmwmGAvB (Av‡gwiKv), GdGGmB (Av‡gwiKv), GdGwcGmwm (Rvcvb), GdGwcGmBwm (wm½vcyi)
Aa¨vcK I wefvMxq cÖavb, KvwW©IjRx wefvM
mn-mfvcwZ, evsjv‡`k †mvmvBwU Ae KvwW©IfvmKzjvi B›Uvi‡fbkb
iKgvwi.Kg Ô†nj_& wdU‡bm I †cÖmwµckb eyKÕ K¨vUvMwi‡Z †e÷ †mjvi eB Ôü` ¯ú›`b I ü`‡qi K_vÕGi †jLK
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ü` ¯ú›`b
(mv¶vrKvi ce©-01)
6ô LÛ

'Rhid Spondon' 6th
Part written by Prof. (Dr). Md. Toufiqur Rahman Faruque was published by
'Dr. T Rahman Cardiac Care Foundation' in 29th
September, 2022.
Cover designed by Kazi Atik,
Price. Tk. 2,000.00 (Two Thousand Tk.)/US $ 30 (Thirty dollar only)
ü` ¯ú›`b 6ô LÛ (mv¶vrKvi ce©-01)
cÖKvk
ÔWvt wU ingvb KvwW©qvK †Kqvi dvD‡ÛkbÕ
80/7/2, K`gZjv, evmv‡ev, myeRevM, XvKv-1214|
1g cÖKvk
wek^ nvU© wèm, 29 †m‡Þ¤î 2022|
¯^Ë¡
Zûiv LvZzb kviwgb (MÖš’¯^Ë¡ msiw¶Z)
cÖ”Q` cwiKíbvq
KvRx AvwZK
gy`ªY
el©v cÖvB‡fU wjwg‡UW
8/3, eveycyiv, bxj‡ÿZ, XvKv-1205
g~j¨
BDT 2,000.00 (`yB nvRvi UvKv gvÎ)
US $ 30 (Thirty dollar only)
GB eB‡qi weµqjä mgy`q A_©
ÔWvt wU ingvb KvwW©qvK †Kqvi dvD‡ÛkbÕ-G Mixe †ivMx‡ì wPwKrmvq e¨q n‡e|
cÖvwß¯’vb
†gwW‡bvfv †gwW‡Kj mvwf©‡mm wjt, †nvmvd UvIqvi, gvwjevM †gvo, XvKv|
ccyjvi WvqvMbw÷K †m›Uvi wjt, kvwšÍ bMi †gvo, XvKv|
†dvb : 01911660914, 01711047189, 01777751251, 8333811-13

f~wgKv
ü` ¯ú›`b - 6ô LÛ (mv¶vrKvi ce©-01) Avgvi †jLv ü`‡ivM welqK m‡PZbvg~jK
12Zg eB| eBwU‡Z wewfbœ mg‡q wewfbœ †Uwjwfk‡b mivmwi m¤cÖPvwiZ †gvU 7wU
mv¶vrKvi Gi UªvÝwµckb K‡i msKwjZ| mv¶vrKvi¸wj‡Z wewfbœ ai‡bi ü`‡iv‡Mi
KviY, SzuwKmg~n, wbb©‡qi wewfbœ c×wZ, wPwKrmv I cÖwZ‡iva wb‡q we¯ÍvwiZ Av‡jvPbv
Kiv n‡q‡Q| GB mv¶vrKvi¸wj wewfbœ mg‡q evsjvwfkb, MvRx wUwf, P¨v‡bj-24, Gb
wUwf, wbDR-24 I wWwewm wbDR wUwf‡Z ¯^v¯’¨ welqK wewfbœ Abyôvb mivmwi
m¤cÖPvwiZ n‡q‡Q| Abyôvb¸wj‡Z KLbI GKKfv‡e ev KLbI mn‡hvMx ü`‡ivM
we‡klÁ ev KLbI KLbI Ab¨vb¨ wel‡qi we‡klÁM‡bi mv‡_ Avgwš¿Z AwZw_ wn‡m‡e
AskMÖnY Kwi| Dc‡iv³ wUwf P¨v‡bj mg~‡n ü`‡ivM, D”P i³Pvc, i‡³i D”P gvÎvi
†Kv‡j‡÷ij welqK Av‡jvPbvq AskMÖnY K‡i †ivMx‡ì I mvaviY gvby‡li GB †ivM
m¤ú‡K© m‡PZbZv evov‡bvi my‡hvM K‡i †Ìqvi Rb¨ D³ P¨v‡bjmg~‡ni †gwW‡Kj
welqK wewfbœ Abyôv‡bi cÖ‡hvRK, Zv‡ì mnKvix, Abyôvb cwiPvjbvq mKj e¨w³,
KjvK‚kjx, Abyôvb mÂvjK I `k©K gÛjx mK‡ji Kv‡Q A‡bK K…ZÁZv| BDwUD‡e
mnRjf¨ GB wfwWI Abyôvb¸wji cvkvcwk Abyôvb¸wji UªvÝwµckb eB AvKv‡i
Qvcvi A¶‡i jf¨ nIqvq A‡bK cvVK I †ivMx Ges Rbmvavi‡bi †ivM m¤ú‡K©
m‡PZbZv e„w×‡Z A‡bK f‚wgKv ivL‡e e‡j Avgvi wek¦vm| ü`‡ivM wbb©q I wPwKrmv
A‡bK e¨qeûj nIqvq Zv cÖwZ‡iva Kiv DËg I A‡bK mnR|
h‡_ó cwikÖg I †Lqvj Kiv m‡Ë¡I g~`ªYRwbZ f‚j- ÎæwU ¸‡jv gvR©bxq| GB eB
msµvšÍ †h †Kvb Dc‡`k I w`Kwb‡`©kbv K…ZÁ wP‡Ë ¯§iYxq|
Aa¨vcK Wvt †gvt †ZŠwdKzi ingvb (dviæK)
B-‡gBj: drtoufiq1971@gmail.com
†gvevBj: 01911660914, 01826978159, 01714908651
†gwW‡bvfv †gwW‡Kj mvwf©‡mm wjt, †nvmvd UvIqvi, gvwjevM †gvo, XvKv|
ccyjvi WvqvMbwóK †m›Uvi wjt, kvwšÍbMi †gvo, BDwbU-2|
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BANGLA VISION
Abyôvb:- fv‡jv _vKzb|
welq:- ü`‡ivM cÖwZ‡iva I cÖwZKvi| 06
wRwUwf‡Z cÖPvwiZ
n¨v‡jv Wv³vi
ZvwiLt 03-10-2019
welq t Ònv‡U©i my¯’ZvÓ 22
P¨v‡bj-24 †Uwjwfk‡b cÖPvwiZ
Beacon Pharmaceuticals †gwW‡Kj 24
welq t Ò†ivRvq my¯’ZvÓ 38
evsjv wfkb †Uwjwfk‡b cÖPvwiZ ü`‡ivM welqK Abyôvb
Thai Baby Diaper fv‡jv _vKzb
AvR‡Ki welq: D”P i³Pvc cÖwZ‡iva I cÖwZKvi 53
NTV-†Z cÖPvwiZ ¯^v¯’¨ welqK Abyôvb
Ò¯^v¯’¨ cÖwZw`b Ó
AvR‡Ki welq: i‡³ D”P gvÎvq †Kv‡j÷ij 65
wbDR 24 G cÖPwiZ ü`‡ivM welqK Abyôvb
Ò¯^v¯’¨ msjvcÓ
welqt ü`‡iv‡Mi RwUjZv 74
DBC News-G cÖPvwiZ ¯^v¯’¨ welqK Abyôvb
Servier nv‡U©i mgm¨v I mgvavb 86
†jLK cwiwPwZ 93
Wvt wU ingvb KvwW©qvK †Kqvi dvD‡Ûk‡bi Kg©KvÛ 95
m~wPcÎ

BANGLA VISION
Abyôvb:- fv‡jv _vKzb|
ZvwiL:- 03.10.2019
welq:- ü`‡ivM cÖwZ‡iva I cÖwZKvi|
Dc¯’vcKv: Wv: mvbwR`v †nv‡mb cvwcqv|
Avgwš¿Z AwZw_: Aa¨vcK (Wvt) bRiæj Bmjvg
Aa¨vcK (Wvt) †gv: †ZŠwdKzi ingvb (dviæK)
Dc¯’vwcKv: mywcªq `k©K,
Avcbv‡ì mevB‡K
Avgš¿b Rvwb‡q ïiæ
KiwQ Thai baby
diaper wb‡ew`Z Òfv‡jv
_vKzbÓ Abyôv‡bi,
AvR‡Ki c‡e© Avcbv‡ì
mv‡_ AvwQ Avwg ÒWv:
mvbwR`v †nv‡mbÓ| †h
welqwU wb‡q AvR Avgiv Av‡jvPbv Kie †mwU n‡”Q Ònv‡U©i mgm¨v Ges Zvi mgvavbÓ,
Ges G welqwU wb‡q Av‡jvPbv Kivi Rb¨ Avgv‡ì gv‡S Dcw¯’Z Avv‡Qb †`‡ki ¯^bvg
ab¨ 2 Rb e¨w³- cÖ_†gB cwiPq Kwi‡q w`w”Q Zv‡ì mv‡_- Avgv‡ì mv‡_ Av‡Qb,
†`k e‡ib¨ KvwW©IjwR wefv‡Mi whwb cªv³b cwiPvjK I wefvMxq cÖavb wn‡m‡e Kg©iZ
wQ‡jb RvZxq ü`‡ivM BbwówUD‡U Avgv‡ì mevi AZ¨šÍ cwiwPZ ÒAa¨vcK Wv:
bRiæj BmjvgÓ m¨vi, mv‡_ Av‡iv Av‡Qb ÒAa¨vcK Wv: †gv: †ZŠwdKzi ingvbÓ
KvwW©IjwR wefvM, K‡Y©j gv‡jKÕ †gwW‡Kj K‡jR, gvwbKMÄ| Avcbv‡ì `yRb‡KB
¯^vMZ Rvbvw”Q m¨vi, Avgv‡ì AvR‡Ki Abyôv‡b| wcÖq `k©K, Avgv‡ì mv‡_ hw`
Avcbviv hy³ n‡Z Pvb ev nv‡U©i mgm¨v ev mgvavb wel‡q hw` †Kvb cÖkœ _v‡K Zvn‡j
†`wi bv K‡i `ªæZ Avgv‡ì ¯Œ‡j †`Lv‡bv bv¤^v‡i Wvqvj K‡i †hvMv‡hvM Kiæb Avgv‡ì
mv‡_, GQvovI †dmeyK †_‡K Avgv‡ì mv‡_ hy³ n‡Z cv‡i www. Facebook.com
bangla vision| Avgiv K_v ejwQ Ônv‡U©i mgm¨v Ges cªwZKviÕ wb‡q `k©K Avgv‡ì
m‡½B _vKzb| Avcbv‡ì 2 Rb †KB AveviI ¯^vMZ Rvbvw”Q Avgv‡ì Abyôv‡b Avmvi
Rb¨| †hwU cÖ_‡gB Avgiv Rvb‡Z Pvw”Qjvg †h, nv‡U©i mgm¨v wb‡q Avgiv K_v eje
Ges Lye `yfv©M¨ n‡jI mZ¨ †h, we‡kî Ab¨vb¨ †`‡ki mv‡_ Zvj wgwj‡q evsjv‡`‡kI
GB nv‡U©i mgm¨v w`b w`b wKš‘ †e‡oB P‡j‡Q, Kg‡Q bv| hwÌ ev Avgv‡ì g‡a¨
GLb m‡PZbZv †e‡oB P‡j‡Q Zvici Gi KvibUv wK m¨vi (Wv bRiæij Bmjvg)
cÖ_‡gB Rvb‡Z PvBe Ges nv‡U©i mgm¨v ej‡Z Avm‡j †Kvb mgm¨v ¸‡jv‡K †evSv‡bv
nq?

Wv: bRiæj Bmjvg: abëv`, Avm‡j
ïiæ‡Z Avgiv GKUv wRwbm GKUz
Av‡jvPbv K‡i †bB, †mUv n‡jv, GB
†h, Avgiv ü`‡ivM, nv‡U©i †ivM ev
nv‡U©i mgm¨v GB †h K_v ¸‡jv
D”Pvib Kwi †m¸‡jv ej‡Z Avm‡j
wK eywS Avgiv? hw` Avgiv ü`‡ivM
g‡b Kwi ev nv‡U©i †ivM ewj Zvn‡j eyS‡Z n‡e †h, nv‡U©i hZ ai‡bi †ivM †nvK bv
†Kb me¸‡jv‡KB Avgiv eywS| wKš‘ cªK…Zc‡ÿ Avgiv †hUv †`wL †hUv Avgv‡ì Rb¨
LyeB K‡ói GKUv welq †mUv n‡jv heart attack ev Ischemic heart disease †hUv
e‡j| Gi KvibUv GKUz eySv ìKvi, †Kbbv GB †ivMUv m¤ú©‡K GKUy eySv ìKvi|
†Kbbv GB ü`‡iv‡Mi g‡a¨ ischemic heart disease †hUv †mUv n‡jv †ewki fvMB
Avgv‡ì heart †h cv¤ú K‡i, i³ mg¯Í kix‡i †cŠwQ‡q †`q GUvi D‡Ïk¨ n‡jv
nutrition †`qv| wKš‘ nv‡U©i wbR¯^ nutrition wKQz i³bvwj Av‡Q †h i³bvwj w`‡q
heart wb‡R Zvi Lvevi MÖnb K‡i _v‡K, hw` GB i³bvwj ¸‡jv †Kvb †iv‡Mi Kvi‡b
occluded n‡q hvq ev narrow n‡q hvq Zvn‡j †h †ivM nq Zv‡K ischemic heart
disease e‡j, Ges Gi P~ovšÍ iæc n‡jv heart attack Avi heart attack m¤ú©‡K
Avgv‡ì mevi avibv Av‡Q †h, heart attack hv‡ì nq Zv‡ì g‡i hvIqvi m¤¢vebv
_v‡K ev hviv †eu‡P _v‡Kb Zv‡ìI mviv Rxeb wPwKrmv wb‡Z nq| †Zv mvaviYZ
üìvM wb‡q †h fxwZUv heart Gi, GB particular †ivMUv wb‡qB wKš‘ Avgv‡ì
me‡P‡q †ewk fq, wPšÍv Ges A‡bK åvšÍ avibvI wKš‘ GUv wb‡qB Av‡Q| hvi d‡j GB
†ivMUv‡K Avgv‡ì †evSvi †Póv Ki‡Z n‡e| 1g K_v n‡jv, GUv‡K Avgiv wKfv‡e
Gwo‡q Pj‡Z cvwi GUv n‡jv me‡P‡q eo K_v| wKš‘ hLb Kv‡iv GB mgm¨vUv n‡q hvq
ZLb †hb Zvi †hŠw³K wPwKrmvUv nq, †mUv †ivMxi mv‡_ civgk© µ‡g Ki‡j †ivMx
Gi cieZx© mgq fv‡jv _vK‡e| GB wRwbmUvB Avgv‡ì †evSvi †Póv Ki‡Z n‡e Ges
†ivMUv‡K wbqš¿‡b ivL‡Z n‡e| †ivMUv‡K †h Avgiv fq Kwi Avm‡j wRwbmUv †mUv
bv| Avi ü`‡ivM ej‡Z Avgiv †hUv Rvwb †mUv basically heart attack, GQvovI
wKš‘ rheumatic Kvi‡b ü`‡ivM n‡Z cv‡i, Rb¥MZ Kvi‡b ü`‡ivM n‡Z cv‡i,
diabetes Gi Kvi‡b ü`‡ivM n‡Z cv‡i, Av‡iv GKUv wRwbm †hUv nq Avgiv †hUv
Kvi‡b ewj ev risk factor ewj, SzuwK ewj hv‡ì diabetes _v‡K, hv‡ì GKUz sugar
_v‡K, hv‡ì high pressure Av‡Q, hv‡ì cholesterol †ewk Av‡Q, hviv Pwe©
RvZxq Lvevi †ewk Lvb, KvR-K©g †ewk K‡ib bv, †Ljv-ayjv K‡ib bv, Zv‡ì
A‡b‡Ki GB †ivMUv n‡Z cv‡i Ges Zviv GKUz SzuwKc~b© Ae¯’vq _v‡Kb| †Zv myZivs
GUvI Avgiv wKQzUv prevent Ki‡Z cvwi| †mUv wKfv‡e mevB‡K g‡b ivL‡Z n‡e †h,
ü`‡ivM ej‡Z Avgiv wK eywS? ü`‡ivM wKfv‡e prevent Kiv hvq, Zvi kZ©¸‡jv wK
wK Ges n‡q †M‡j Avgiv wKfv‡e Pje G¸‡jvi wel‡q avibv †bqv|

Dc¯’vwcKv: m¨vi (Wv: †ZŠwdKzi ingvb) ischemic heart disease m¤ú©‡K GKUz
Avcbvi Kv‡Q Avgiv Rvbe| Avm‡j heart disease ej‡Z †hwU †evSv‡bv nq cÖ_gZ
†hwU wb‡q gvby‡li me‡P‡q †ewk fq †mwU GKUz Rvb‡Z PvB m¨vi (Wv: †ZŠwdKzi
ingvb) ischemic heart disease Avm‡j wK? Ges Gi jÿb¸‡jv m¤ú©‡K Rvbe
Avgiv|
Wv: †ZŠwdKzi ingvb: nu¨v,
Ae¨kB ischemia heart
disease ej‡Z 1 †g Avgiv wK
eywS ischemia n‡jv Avgv‡ì
heart Gi †h gvsm Av‡Q ev
muscle Av‡Q A_©vr gvsm‡cwk
GB gvsm‡cwk †Z m¨vi (Wv:
bRiæj Bmjvg) †hUv ej‡jb
†h nutrition ev cywó ìKvi, Aw·‡Rb Ges Lvevi †h cwigv‡b ìKvi, hw` †mB
cwigv‡b bv cvq Zvn‡j †mUv‡K Avgiv ej‡ZwQ ischemia, Avgv‡ì GB Lvevi bv
cvIqvi Rb¨ ev AwK&ª‡Rb Kg cvIqvi Rb¨ †h ischemia ¸‡jv n‡e †mUv‡K Avgiv ewj
angina A_©vr ey‡K e¨_v, GLb GUvi Rb¨ wK n‡Z cv‡i, †h‡nZz i³ mieivn K‡g
hv‡e heart G i³ supply Kg n‡e- wK Kvi‡b Kg n‡e? m¨vi (Wv: bRiæj Bmjvg)
†hUv ej‡jb, i³bvwji †h agbx GB agbxi ga¨ w`‡q i³ mieivn K‡g hv‡e| GB
K‡g hvIqvi Kvib nqZ i³bvwj‡Z †Kv_vI block n‡q‡Q evsjvq Avgiv †hUv ewj Pi
cov| GB Pi ev block nIqvi Kvi‡b i³bvwj‡‡Z i³ mieivn Kg n‡Z cv‡i, A_ev
†Kvb Kvi‡b hw` heart Gi muscle †gvUv †ewk n‡q hvq, hvi Kvi‡b Zvi AwK&ª‡Rb I
Lvev‡ii demand †e‡o hvq wKš‘ †mB cwigv‡b i³bvwj i³ mieivn Ki‡Z cv‡i bv|
wKš‘ i³bvwj‡Z †Zv block bvI _vK‡Z cv‡i Zvn‡jI wKš‘ ey‡K e¨_v n‡Z cv‡i A_ev
angina n‡Z cv‡i| ZLb GB angina Gi mgm¨v wb‡q †ivMx Avgv‡ì Kv‡Q present
Ki‡Z cv‡i| Avevi GKUv †ivMxi nqZ block Av‡Q 30 ev 40% block ev 50%
block †ivMxi wKš‘ †Kvb symptoms bvI _vK‡Z cv‡i A_©vr †ivMx wKš‘
asymptomatic ev DcmM©wenxb _vK‡Z cv‡i| A_©vr GKUv †ivMxi block Av‡Q wKš‘
Zvic‡iI A‡b‡Ki †Kvb ai‡bi †Kvb mgm¨v bvI _vK‡Z cv‡i| gv‡b, †Kvb iKg Kó
cªKvk QvovB †ivMx GB block wb‡q `xN©w`b Rxeb-hvcb Ki‡Z cv‡i, GgbI n‡Z
cv‡i †ivMxi †Kvb symptom bvB wKš‘ GB †h, †h PiUv ev block Uv Av‡Q GB block
Uv wKš‘ †h‡Kvb mgq †d‡U wM‡q †ivMxi heart attack n‡Z cv‡i, Ges GB heart
attack Gi ciB †ivMx Rvb‡Z cvij †h, Zvi Av‡M †_‡KB heart Gi mgm¨v wQj|
Dc¯’vwcKv: m¨vi (Wv: †ZŠwdKzi ingvb) GB welq ¸‡jv wb‡q Avgiv c‡i Av‡iv
Av‡jvPbv Kie wKš‘ GB gyn~‡Z¡© Avgv‡ì mv‡_ GKRb `k©K hy³ Av‡Qb †dv‡b Avgiv
Zvi cÖkœwU †R‡b †bB, n¨v‡jv- `k©K 1: Avm&mvjvgy AvjvBKzg|

Dc¯’vwcKv: IqvjvBKzg Avmmvjvg, `k©K, Avcbvi bvg Ges eqmwU e‡j cÖkœwU Kiæb-
`k©K:1: Avwg Awbe©vb, `wÿb ebkÖx †_‡K ejwQ, Avgvi MZ eQ‡i wKQz cvwievwiK
†Ubkb wQj, hvi Rb¨ †cÖkvi 160/120 n‡q wM‡qwQj hvi Rb¨ mv‡_ mv‡_
LABAID nvmcvZv‡j fwZ© n‡q GK w`b wQjvg| †Zv Dbviv Avgv‡K †cÖmvi bvwg‡q
w`‡q‡Q Ges Avgv‡K eZ©gv‡b amdocal-5 iv‡Z GKUv Avi cardinor mKv‡j 1 Uv
†L‡Z e‡j‡Q cvkvcvwk rosutin 5 Lvw”Q| Avgvi eZ©gv‡b GUvB Rvbvi B‡”Q †h, GUv
Avwg KZw`b ch©šÍ continue Kie? Avgvi eqm 45|
Wv: bRiæj Bmjvg: AmsL¨ abëv` Avcbv‡K, 1g K_v †hUv n‡jv †h, Avcbvi †h
†ivMUv aiv cij †mUv high blood pressure ev Avgv‡ì Wv³vwi fvlvq Avgiv
hypertension ewj AviwK| 1g K_v g‡b ivL‡Z n‡e †h, high blood pressure
KLbB cure n‡q hv‡e bv, gv‡b m¤ú~b© fv‡e GUv wKš‘ P‡jI hv‡e bv, Avevi fv‡jvI
n‡e bv, †Zv hvi d‡j Avcbv‡K Ki‡Z n‡e wK-†h, JlacÎ Avcbvi consultant
Avcbv‡K w`‡q‡Qb Zvi 1g n‡jv †h Avcbvi †cÖkvi Avcbvi Wv³vi †hUv e‡j‡Qb GB
range G _vKv DwPZ, †mB Abyhvqx Av‡Q wKbv †mUvi Rb¨ Jla eënvi Kiv- wKšÍy
Avcbvi GUv wVK n‡e †h, Jla eënv‡ii cvkvcvwk Av‡iv wKQz life style Av‡Q
†h¸‡jv Avcbvi change Kiv ìKvi †hgb a‡ib, cÖwZw`b Kgc‡ÿ (40-45) wgwbU
nuvUv, Pwe© RvZxq Lvevi LvIqv Kwg‡q †`qv, IRb hw` †ewk _v‡K IRb Kwg‡q
wbqš¿‡b Avbv, Zvn‡j Avcwb GKUz fv‡jv _vK‡Z cvi‡eb| Zvi mv‡_ Avcbv‡K Av‡iv
KZ¸‡jv wRwbm †`L‡Z n‡e, Avcbvi eqm †h‡nZz 45 eQi| Avcbv‡K †`L‡Z n‡e
Avcbvi diabetes Av‡Q wKbv Ges Ab¨vb¨ Av‡iv †Kvb †ivM Av‡Q wKbv †Kbbv hw`
diabetes Ges blood pressure GKm‡½ n‡q _v‡K, ZLb wKš‘ Avcbvi heart
attack nIqvi SzuwK evo‡e| †hUv GKUz Av‡M cÖ‡dmi Wv: †ZŠwdK mv‡ne ej‡jb,
Avwg A‡bK mgq K‡i †ivMx‡ì‡K ewj †h, hvi blood pressure Ges diabetes
Av‡Q Zvi m¤¢eZ cancer nIqvi cÖ‡qvRb bvB| Kvib GUv cancer Gi PvB‡ZI †Kvb
†Kvb †ÿ‡Î fqven| myZivs Avcwb G¸‡jv †g‡b Pj‡eb Ges cvkvcvwk Avcbvi
consultant Gi Kv‡Q gv‡S gv‡S wM‡q †h‡Kvb wel‡q Rvbv‡eb, Dwb Avcbv‡K
assist Ki‡e †mB Abyhvqx Avcwb Pj‡eb|
Dc¯’vwcKv: Zvi gv‡b GwU cy‡ivcywi wbqš¿‡b ivLv m¤¢e hw` GKUz m‡PZb _vKv hvq
Ges wbqg †g‡b Pjv hvq| wKš‘ cy‡ivcywi †h, †m‡i hv‡e †mB Avkv KivUvI Avm‡j wVK
bv Ges †hwU ejwQ‡jb Avgv‡ì `k©K KZw`b ch©šÍ †L‡Z n‡e Jla- Avm‡j GUvI
fvev hv‡e bv|
Wv: †ZŠwdKzi ingvb: GB †h, KZw`b Avm‡j Jla †L‡Z n‡e †mUv Avm‡j ejv hv‡e
bv| Avgiv D”P i³Pvc †h, ewj †ivMxi persistently pressure hLb †ewk _vK‡e
A_©vr †cÖmvi Zvi †ewk cvIqv †M‡Q Dwb(`k©K-1), †hUv ej‡jb Avwg †Ubkb K‡iwQ
hvi Rb¨ Avgvi †cÖkvi †e‡o †M‡Q, d‡j nvmcvZv‡jI fwZ©i cª‡qvRb nq Ges †mLvb

†_‡KB Zvi Jla †hvM Kiv n‡q‡Q| GLb hw` mwZ¨ mwZ¨ Zvi †cÖmvi tension Gi
Rb¨ †e‡o _v‡K, Zvn‡j wKš‘ ¯^vfvweK fv‡eB Zvi pressure evo‡Q| GLb hw` †`Lv
hvq †h, Jla †`qvi ciB Zvi †cÖmvi K‡g hv‡”Q Ges Kg‡Z Kg‡Z Zvi normal Gi
†P‡q †ewk K‡g hv‡”Q, Zvn‡j wKš‘ Zvi Jl‡ai gvÎv Kgv‡Z n‡e| Jl‡ai gvÎv
Kgv‡bvi ciI hw` †`Lv hvq- Zvi i³Pvc †ewk K‡g hv‡”Q, Zvn‡j wKš‘ Zvi Jla
eÜ Kivi cÖ‡qvRb n‡Z cv‡i| †Kbbv hw` Ggb nq †h, ïay †Ubkb Ki‡j A_ev
wbw`©ó †Kvb particular mg‡q Zvi pressure ev‡o Zvn‡j hLb Zvi anxiety relief
n‡q hv‡e Zvi wKš‘ †cÖmvi automatically Kg‡Z ïiæ Ki‡e| †mB †ÿ‡Î Zv‡K wKš‘
Zvi †h Wv³vi Av‡Q cardiologist A_ev internal medicine specialist hv‡K Dwb
†`wL‡q‡Qb Zvi mv‡_ wKš‘ †hvMv‡hvM ivL‡Z n‡e Ges wbqwgZ pressure †PKAvc
Kiv‡Z n‡e| Avi †hUv cholesterol Gi Jla Dwb Lv‡”Qb †mB cholesterol Gi
gvÎv Zvi gv‡S g‡a¨ check K‡i wb‡Z n‡e| bigvj gvÎvi †P‡q hLb Kg‡Z ïiæ
Ki‡e ZLb nqZ Jl‡ai gvÎv Kgv‡bv ev eÜ Ki‡e wKbvÑ Avevi wKQzw`b ci ïiæ
Ki‡Z n‡e wKbvÑ †Kbbv cholesterol Gi Jla ïiæ Ki‡j hLb Kg‡Z ïiæ K‡i
Avevi wKQzw`b ci wKš‘ evo‡ZI ïiæ K‡i ev Ki‡Z cv‡i|
Dc¯’vwcKv: Zvi gv‡b G‡Kev‡i wbwðšÍ _vKvi †Kvb AeKvk †bB Avm‡j GB †ivMwU
wb‡q Z‡e GKRb Wv³vi ev GKRb we‡kl‡Ái under G †_‡K wKQzw`b ci ci
d‡jvAv‡c †_‡K †PKAv‡c hvIqv DwPZ| Avi regular monitoring LyeB `iKvi
Avi GB wel‡q †Zv †Kvb weKí †bB| †hwU ejwQjvg Avgiv jÿb ¸‡jv Zvi g‡a¨ ey‡K
e¨_v GKwU welq P‡j G‡m‡Q| ey‡K e¨_v Avi heart G mgm¨v GB `y‡Uv 1 Uv
Av‡iKUvi mv‡_ IZ‡cÖvZfv‡e RwoZ Ges Avgiv A‡b‡KB g‡b K‡i _vwK †h, ey‡K
e¨_v gv‡bB n‡”Q heart G mgm¨v| GB wel‡q m¨vi (Wv: bRiæj Bmjvg) hw`
ej‡Zb-
Wv: bRiæj Bmjvg: ey‡K e¨_v
Avm‡j LyeB common GKUv
presentation| †ewki fvM †ivMx
†h‡Kvb Kvi‡b ey‡K e¨_v wb‡q
Av‡mÑ ey‡Ki e¨_v wKš‘z wewfbœ
Kvi‡b n‡Z cv‡i, Zvi g‡a¨ heart
Gi e¨_v GUv Ab¨Zg Kvib| wKšÍ
GQvovI ey‡Ki e¨_vi A‡bK Kvib
Av‡Q| mvgvb¨ gv‡mj Gi e¨_v †_‡K n‡Z cv‡i| †Kvb †Kvb †ÿ‡Î †cÖmv‡i A‡b‡K
M¨vw÷ªK †hUv e‡j _v‡K practical I A‡bK ai‡bi mgm¨v n‡Z cv‡i| Avm‡j ey‡Ki
e¨_vi A‡bK¸‡jv characteristics Av‡Q G¸‡jv GKUz g‡b ivLvi †Póv Ki‡Z n‡e|
hv‡Z K‡i e¨_vi aib †`‡L †mUv †evSv hvq| wKš‘ GUvI g‡b ivL‡Z n‡e, GB iKg
n‡jB †h heart Gi e¨_v Zv bv, Z‡e †ewki fvM †ÿ‡Î ZvB n‡q _v‡K| †hgb ey‡Ki

e¨_v hv‡ì ïiæ nq Zv‡ì cÖv_wgK fv‡e wKQz cwim‡ii mv‡_ ïiæ nq Ges rest Ki‡j
wKsev GKUz relax n‡j e¨_vUv nqZ Av‡¯Í Av‡¯Í K‡g hvq GUv n‡jv †ivMUv hLb 1g
w`‡K ïiæ nq| Avevi †h wRwbmUv †`L‡Z nq, †Kvb †Kvb mgq e¨_vUv ey‡Ki
cvkvcvwk †Kvb w`‡K Qwo‡q hvq wKbv- evg nv‡Zi w`‡K †M‡jB nqZ heart Gi †ivM,
wKš‘ bv wRwbmUv GiKg bv, GUv Mjvi w`‡K †h‡Z cv‡i, evg cv‡k †h‡Z cv‡i,
wcQ‡bi w`‡K †h‡Z cv‡i, †Vuv‡Ui w`‡K †h‡Z cv‡i Ges ùv‡ZI e¨_v n‡Z cv‡i|
myZivs †mB wRwbm ¸‡jv hLb n‡e ZLb †hB wRwbmUv Ki‡Z n‡e †h, hLbB †h †Kvb
ey‡K e¨_v nq ZLbB mv‡_ mv‡_ wPwKrm‡Ki civgk© †bqv DwPZ, Ges Zvi ey‡Ki
e¨_vi aiYUv Zv‡K fv‡jv g‡Zv eywS‡q ejv DwPZ, hv‡Z K‡i wPwKrmK eyS‡Z
cv‡ib- wK ai‡bi e¨_v Avi wK Kvi‡b n‡”Q, Ges †m Abycv‡Z cixÿv-wbixÿv K‡i
Zv‡K †hb Zvi wPwKrmK mgvavb w`‡Z cv‡i, †h Avcbvi GB KvibUv cvIqv †Mj ey‡K
e¨_vi Rb¨ Ges Avcbvi GLb GUv Kiv DwPZ| myZivs hZÿb ch©šÍ wbwðZ bv n‡”Q
†h, GB ey‡K e¨_vUv wK Kvi‡b n‡”Q ZZÿb ch©šÍ Zv‡K investigation Pvwj‡q hvIqv
DwPZ Ges wPwKrm‡Ki civgk© †bqv DwPZ| Av‡iKUv n‡jv ey‡Ki e¨_v g~jZ †h
Kvi‡b nq gv‡b, heart Gi Kvi‡b †h ey‡K e¨_v nq †mUv n‡jv- hw` sudden †Kvb
severe e¨_v nq| GB e¨_vUvi e¨cv‡i †Kvb cÖKvi neglect Kiv wVK bv, Avgv‡ì
AmsL¨ †ivMx‡ì †`wL †h, ey‡Ki e¨_vq Lye severe n‡”Q ivZ †_‡K weKv‡j, ZLb
KZ¸‡jv wRwbm Zviv K‡i _v‡Kb nVvr K‡i M¨v‡mi Jla Lvq, cvwb Lvq Avevi
KLbI eÜz‡K †dvb K‡i, A‡bKUv mgq †m Ace¨q K‡i| wKš‘ DwPZ n‡”QÑ
ZvrÿwbK fv‡e †m wb‡R wPwKrm‡Ki Kv‡Q wM‡q civgk© Kiv, †h‡nZz GUv Lye
serious type Gi †ivM, Ges Av‡iv GKUv Kvib Av‡Q hw` mwZ¨ Kv‡iv heart attack
Gi c‡_ hvq, Zvn‡j GLb Avvgv‡ì †`‡k A‡bK nvmcvZvj Av‡Q †hLv‡b mivmwi
(5-6) N›Uvi g‡a¨ †M‡j †mLv‡b primary PCI ev GK ai‡bi ring cwi‡q w`‡j wKš‘
†mB †ivMUv‡K wPwKrmv K‡i †bIqv hvq| GB my‡hvMUv A‡b‡K bó K‡i †d‡j, Zv‡Z
†`Lv hvq A‡b‡K GUv Ki‡Z Ki‡ZB (5-6) N›Uv †ewk mgq e¨q K‡i †d‡j, Zvi
g‡a¨ heart attack n‡q hvq| A‡b‡K nvmcvZv‡j †cuŠQ‡Z cv‡i Avevi A‡b‡K cv‡iI
bv| hw` †KD nvmcvZv‡j mgq g‡Zv †cuŠQv‡Z cv‡i ZLb Zv‡K †mB ai‡bi wPwKrmv
†`qv nq| Z‡e GUv ejv n‡q _v‡K †h, GB †ÿ‡Î time is muscle, time is money
†hgb †Zgwb GLv‡b time is muscle GB situation n‡j Avgvi suggestion n‡e
hLbB ey‡K e¨_v n‡e- G‡K ev‡iB Kvj †ÿcb bv K‡i mv‡_ mv‡_ wbKU¯’ nvmcvZv‡j
wM‡q wPwKrm‡Ki civgk© Abyhvqx wPwKrmv Mªnb Kiæb|
Dc¯’vwcKv: Avgv‡ì mv‡_ GKRb Av‡Q †dv‡b Avgiv Zvi †dvbwU wb‡q †bB n¨v‡jv
`kK©-02: Avm&mvjvgy AvjvBKzg
Dc¯’vwcKv: IqvjvBKzg Avm&mvjvg, `kK©, Avcbvi bvg Ges eqmwU e‡j cÖkœwU Kiæb?
Avgiv K_v ejwQ nv‡U©i mgm¨v Ges mgvavb wb‡q|

`kK©-02: Avgvi bvg iæûj Avwgb,
Avgi eqm 50 eQi, Avwg 4 eQi hver
nv‡U©i †ivMx| RvZxq ü`‡ivM
BbwówUD‡U †_‡K Avwg wPwKrmv wbw”Q|
Avwg ECG K‡iwQ, Echo K‡iwQ 2
evi, †Zv †mLvb Kvi Wv³vi ej‡jb-
Avgvi heart G block Av‡Q, hw`I
Avcwb A_©‰bwZK w`K †_‡K `~e©j Avgiv †mB w`K we‡ePbv K‡i Avcbv‡K Jla wj‡L
w`w”Q| †hgb fenobate, abicab, avas 10 w`‡q‡Qb, mv‡_ Ny‡gi Jla w`‡q‡Qb Ges
GB Jla¸‡jv Avwg `xN©w`b hver Lvw”Q| wKš‘ GLb ch©šÍ Avwg Avgvi Amy‡Li DbœwZ
ev AebwZ welqUv eyS‡Z cvwiwb, Avgvi g‡b nq mewKQz Av‡Mi g‡ZvB Av‡Q|
eZ©gv‡b Avgvi Kibxq wK?
Wv: †ZŠwdKzi ingvb: Av‡Mi g‡Zv Ae¯’v ej‡Z Avcwb wK eySv‡”Qb? Av‡M Avcbvi
ey‡K e¨_v n‡Zv A_ev k^vmKó n‡Zv Avcbvi-
`kK©-02: nu¨v, Avgvi ey‡K e¨_v n‡Zv Av‡M e¨_vUv me mgq n‡Zv GLb gv‡S gv‡S
nq-
Wv: †ZŠwdKzi ingvb: Av”Qv, gv‡S gv‡S m¨vi (Wv: bRiæi Bmjvg) †hUv wKQzÿb
Av‡M ej‡jb †h, ¸iæZ¡c~b© wKQz jÿb, Avcwb cwikÖg Ki‡j Avcbvi ey‡K e¨_v nq
wKbv ev Avcwb wmwo w`‡q IVvi mgq ey‡K e¨_v nq wKbv?
`kK©-02: wR¦ m¨vi (Wv: †ZŠwdKzi), Avwg cwikªg Ki‡j Lye mn‡R Avwg nuvwc‡q hvB
†ewkÿb Avwg cwikÖ‡gi KvR Ki‡Z cvwibv, gv‡S gv‡S Mjv ïwK‡q hvq iv‡Z
AvKw¯§K fv‡e Nyg †f‡½ hvq, `g eÜ n‡q Av‡m Aw¯’i jv‡M|
Wv: †ZŠwdKzi ingvb: GB †h `g eÜ n‡q hvIqv ev ey‡K e¨_v nIqvUv gv‡S gv‡S †hgb
cardiac Kvi‡b nq, †Zgwb cardiac Kvib QvovI gv‡b nv‡U©i mgm¨v QvovI Ab¨
Kvi‡bI n‡Z cv‡i| GLb †m‡ÿ‡Î Avcbv‡K wbwðZ nIqvi Rb¨ Echo
cardiogram †h‡nZz K‡iwQ‡jb †m‡nZz Avcwb cybivq Avcbvi wPwKrm‡Ki Kv‡Q hvb
Ges Av‡jvPbv K‡ib †h Avcbvi ETT ev angiogram Kiv jvM‡e wKbv, gv‡b bZzb
†Kvb cixÿv-wbixÿvi cÖ‡qvRb Av‡Q wKbv? hw` _v‡K Zvn‡j †m¸‡jv K‡i wbb †Kbbv
H cixÿv ¸‡jv Kivi ciB Avcwb wbwðZ n‡Z cvi‡eb †h, Avm‡j Avcbvi GB †h
ey‡K e¨_vi Kvib GwU wK ü`‡iv‡Mi Kvi‡b ev block RwbZ Kvi‡b n‡”Q wKbv A_ev
Ab¨ †Kvb Kvi‡b n‡”Q wKbv? A‡bK mgq nv‡U©i dvskbI `~e©j n‡Z cv‡i nv‡U©i
dvskb `~e©j nIqvi Kvi‡bI wKš‘ ey‡K e¨_v ev k^vmKó n‡Z cv‡i cwikÖg Ki‡Z
†M‡j| Zvi Av‡M Avcwb wbwðZ nb †h, Avcbvi GB e¨_v wK Kvi‡b n‡”QÑ Zvici
wPwKrmv| Avcbvi wK Jla jvM‡e, bvwK ring emv‡Z n‡e, bvwK bypass Ki‡Z

n‡eÑ bvwK Avcbvi †h KóUv nw”Qj †mUv wK ü`‡iv‡Mi Rb¨ nw”Qj bvwK Ab¨ †Kvb
Kvi‡b nw”Qj|
Dc¯’vwcKv: Avi last K‡e wZwb wPwKrm‡Ki civgk© wb‡qwQ‡jb †mUvI GKwU ¸iæZ¡c~b©
welq †mwUI Rvb‡Z n‡e| `k©K Avcbv‡K A‡bK ab¨ev` Avkv KiwQ Avcbvi DIiwU
Avcwb †c‡q †M‡Qb| †hwU wb‡q Avgiv K_v ejwQjvg Ges m¨vi (Wv: bRiæj)
ejwQ‡jb, GB mg‡q cªwZUv gyn~©Z¡ LyeB ¸iæZ¡c~b© Ges hLb ey‡K Zxeª e¨_v n‡e G‡K
ev‡iB mgq bó bv K‡i mv‡_ mv‡_ nvmcvZv‡j P‡j hvIqv DwPZ| H mgqUv‡Z m¨vi
(Wv: †ZŠwdKzi) hLb ey‡K Zxeª e¨_v n‡e ZLb wK ïay e¨_vUvB Avgiv gv_vq ivLe
bvwK mv‡_ Avbylvw½K Av‡iv KZ¸‡jv jÿb _vK‡e ev _vK‡Z cv‡i heart attack Gi
†ÿ‡Î?
Wv: †ZŠwdKzi ingvb: Zxeª ey‡K e¨_v, Avwg GKUz †f‡½ ewj hw` GiKg ai‡bi e¨_v
nq †h e¨_v Avcwb Gi Av‡M KLbI Abyfe K‡ibwb, GK`g bZzb ai‡bi e¨_v& †hgb
GwmwWwUi e¨_v| GwmwWwUi e¨_v ev M¨vmwóª‡Ki e¨_v GUvI wKš‘ Zxeª e¨_v n‡Z cv‡i&
wKš‘ †mUv Avcwb eyS‡Z cvi‡eb Ges †`L‡eb Gi Av‡MI GB e¨_v GKUz Av‡iKUz
n‡q‡Q| wKš‘z Ggb ai‡bi e¨_v †hUv LyeB Zxeª e¨_v n‡”Q Ges ey‡Ki gvSLv‡b
central chest pain n‡”Q, ev m¨vi †hUv ej‡jb e¨_vUv wewfbœ w`‡K Qwo‡q †h‡Z
cv‡i, mv‡_ hw` Nvg nq| mvaviYZ e¨_vi mv‡_ Ab¨vb¨ †hme †ivM Av‡Q †hme Kvi‡b
ey‡K e¨_v n‡Z cv‡i, Zvi mv‡_ mvaviYZ Nvg nq bv| A_ev Ggb n‡Z cv‡i mv‡_
ewg n‡”Q| hw` GiKg symtoms _v‡K Ges mv‡_ risk factor _v‡K †hgb diabetes
Av‡Q, D”P i³Pvc Av‡Q, i‡³ cholesterol Av‡Q, Avevi †KD cholesterol Gi
Jla Lv‡”Q, Avevi †KD a~gcvb K‡i, Kv‡iv IRb †ewk Zvn‡j Ae¨kB Zv‡K †`wi
bv Kv‡i wbKU¯’ cardiac nvcvZv‡j wb‡q hvIqv DwPZ| Avi †hB service Uvi K_v
m¨vi (Wv: bRiæj Bmjvg) ej‡jb Primary PCI GUv ïay cardiac hospital GB
m¤¢e Ges available| nqZ Avcwb Av‡k cv‡ki nvmcvZv‡j †h‡Z cv‡ib Avcbvi
†ivMUv wbY©q Kivi Rb¨Ñ †mLv‡b ECG Ki‡Z cv‡ib, Zvici †`Lv †Mj Zvi heart
attack n‡q‡Q| Zvn‡j Zviv nqZ refer K‡i w`‡e Avcbv‡K †h nvmcvZv‡j
Avvgv‡`i Primary PCI Kivi my‡hvM-myweav Av‡Q| †Kbbv Primary PCI Kivi
¸iæZ&¦ GZLvwb †hgb normally wKš‘ †`Lv hvq †h †ivMxi block Av‡Q Avgiv Zv‡K
ring jvwM‡q †`B nqZ †`Lv hv‡e H block Gi H RvqMvUv †ivMxi nqZ heart
attack n‡q‡Q Ges attack Gi c‡i †ivMxi H AskUv †ewk GKUv KvR Ki‡Qbv Zv‡K
wKš‘ Avgiv ring ewm‡q w`jvg| GB ring ewm‡q w`‡j †h Ask damage n‡q †M‡Q
†mUv wKš‘ Lye †ewk DcKvi cv‡e bv| wKš‘ hLb Zvi ïiæ‡Z heart attack n‡jv Ges
muscle damage nIqvi Av‡MB Avgiv Zv‡K angiogram K‡i ring ewm‡q w`jvg
Zvn‡j ZLb wKš‘ Zvi cy‡ivcywi muscle damage nIqvi my‡hvMUv iBj bv Ges GB
myweavUv ïay cardiac hospital GB cvIqv m¤¢e|

Dc¯’vwcKv: m¨vi (Wv: bRiæj Bmjvg) GB cardiac hospital ej‡Z Avm‡j †Kvb
†Kvb RvqMv ¸‡jv‡K †evSv‡bv n‡q‡Q Ges Avgiv wK Avm‡j mevB Rvwb †h †Kv_vq
†h‡Z n‡e GB mgm¨v¸‡jv n‡j?
Wv: bRiæj Bmjvg: Avm‡j mvaviYZ nq wK, me †`‡kB nvmcvZvj¸‡jv declare
K‡i †h, Zv‡ì nvmcvZv‡j GB service ¸‡jv †`qv nq AviwK| Avgv‡ì †hUzKz Rvbv
Av‡Q †hgb Avgv‡ì XvKv kn‡i RvZxq ü`‡ivM BbwówUD‡U GKUv †hLv‡b Primary
PCI Gi mvwf©‡mi myweav Av‡Q, b¨vkbvj nvU© dvD‡Ûk‡bI Primary PCI Gi myweav
Av‡Q, evi‡W‡g Av‡Q, A‡bK Private nvmcvZv‡jI Av‡Q Primary PCI Gi myweav
†hgb United hospital, Square hospital GMy‡jv‡ZI Av‡Q GB myweav Ges †mLv‡b
†M‡j GKUv myweav wK Quickly GKUv wmØvšÍ †bqv hvq AviwK|
Dc¯’vwcKv: gv‡b `ªæZ MwZ‡Z mwVK wmØvšÍUv †bqv m¤¢e| GKRb `kK© Av‡Qb
Avgv‡ì mv‡_, wR¦ `k©K
`k©K:-03: Avmmvjvgy AvjvBKzg-
Dc¯’vwcKv: IqvBjvKzg Avmmvjvg, `k©K Avcbvi bvg e‡j cÖkœwU Kiæb?
`k©K:-03: Avwg Zvwbqv, ivgcyiv †_‡K ejwQ| Avgvi baby age 7+ GLb Pj‡Q but
Ii hLb 13 w`b ZLb Ii open heart surgery n‡qwQj| eZ©gv‡b I m¤ú~b© fv‡jv
Av‡Q Avm‡j Avwg Rvb‡Z Pvw”Q, fwelr‡Z Ii life lead Uv Avm‡j †Kgb nIqv
DwPZ? I‡K Avwg eZ©gv‡b mewKQz Ki‡Z w`w”Q †Kvb wKQz‡Z I‡K pressure †`qv
nqbv A_ev evav †`qv nqbv| ZviciI Avcbv‡ì AbyôvbUv †`‡L Avm‡j Rvb‡Z
B‡”Q n‡jv †h, Avgvi we‡kl wKQz Rvbvi cÖ‡qvRb Av‡Q wKbv wKsev Ii Rb¨ Ki‡Z
n‡e?
Dc¯’vwcKv: abëv` `k©K, Avcbvi cÖkœwU Kivi Rb¨, gv‡b Avcwb we‡kl wKQz Rvb‡Z
Pv‡”Qb hv‡Z K‡i Avcbvi mšÍvb fwelr‡Z fv‡jv _v‡K| Avcwb Avgv‡ì mv‡_B _vKzb
Avgiv Avcbvi DIiwU wbw”Q Avgv‡ì we‡kl‡Ái KvQ †_‡K| m¨vi (Wv: bRiæj) hw`
`k©‡Ki cÖ‡kœi DIiwU w`‡Zb|
Wv: bRiæj Bmjvg: nu¨v, Ae¨kB †h‡nZz Dbvi (`k©K-03) mšÍv‡bi 13 w`b eq‡m
open heart surgery n‡q‡Q m¤¢eZ †mUv Zvi Rb¥MZ †ivM wQj Ges Rb¥MZ †ivM
¸‡jv mvaiYZ structural defect n‡q _v‡K AviwK, †h‡Kvb ai‡bi GLv‡b surgery
ev operation †hUv n‡q _v‡K †mB defect Uv‡K wVK Kiv n‡q _v‡K| hw` Lye RwUj
ai‡bi nq Zv‡ì Rb¨ GK ai‡bi operation n‡q _v‡K| Avi hv‡ì simple ai‡bi
nq Zv‡ì Av‡iK iK‡gi n‡q _v‡K| †Zv †hUvB †nvK bv †Kb hw` Zvi mwZ¨ mwZ¨
corrective surgery n‡q _v‡K Ges †ek K‡qK eQi Zvi cvi n‡q †M‡Q †Kvb iKg
mgm¨v QvovB Ges Avcbvi mšÍvb fv‡jv Av‡Q fv‡jv fv‡e Pjv‡div Ki‡Q| myZivs
Avcbvi GB e¨vcv‡i Lye GKUv `ywðšÍv Av‡Q e‡j g‡b nqbv| Z‡e GKUv wRwbm †Lqvj

ivL‡Z n‡e Avcbv‡K GKUy †h‡nZz Zvi fvj¦Uv repair Kiv n‡q‡Q , GB ev”Pv hZ eo
n‡Z _vK‡e Zvi mg¯Í A½ cÖZ‡½i mv‡_ wKš‘ Zvi nvU©I grow Ki‡Z _v‡K| ZLb
†Kvb †Kvb †ÿ‡Î GB heart Gi wKQz cwieZ©b NU‡Z cv‡i| †mRb¨ Avcbvi Rb¨ †hUv
fv‡jv n‡e †mUv n‡jv Avcbvi mšÍv‡bi 18 eQi ch©šÍ †Kvb pediatric cardiologist-
hviv ev”Pv‡ì nv‡U©i Wv³vi, Zv‡ì mv‡_ d‡jvAv‡c _vKvÑ Zvi mewKQz Av‡Mi g‡Zv
Av‡Q wKbv| Zvici hLb 18 eQi cvi n‡q hv‡e ZLb adult cardiologist hviv
eo‡ì nv‡U©i Wv³vi Zv‡ì mv‡_ gv‡S gv‡S d‡jvAvc _vKv Z‡e mvaviYZ GUv g‡b
nq bv Lye j¤^v mgq ch©šÍ jvM‡e| wKš‘ Zvici (2-3) eQi ci ci GKUz d‡jvAvc
_vK‡j fv‡jv n‡e| ZvB Avwg Avkv Kwi Ges Avcbvi K_v ï‡b g‡b n‡”Q ev”Pv my¯’
Av‡Q Ges _vK‡eb| Avi life style Gi g‡a¨ †hUv Zvi (`k©K-03) mšÍvb Ki‡Q
mvaviYZfv‡e †mfv‡eB Ki‡e| Z‡e GKUv wRwbm †Lqvj ivL‡Z n‡e †mUv n‡jv hw`
Zvi †Kvb particular KvR Ki‡Z Amyweav nq Zvn‡j 1g K_v n‡jv †mUv eR©b Ki‡Z
n‡e, 2q †mUv Zvi Wv³vi‡K report Ki‡Z n‡e Ges cieZx©‡Z Zvi Wv³vi Zv‡K †h
suggestion w`‡e †mB suggestion Abyhvqx Zv‡K †g‡b Pj‡Z n‡eÑ Z‡e †ewkifvM
†ÿ‡ÎB Kv‡iv Lye GKUv restriction Gi ìKvi nqbv| Avi 10Uv gvby‡li g‡ZvB
ZvivI mvavib fv‡e Pjv‡div Ki‡Z cv‡i, GgbwK cieZx‡Z© Zv‡ì we‡q Kiv, msmvi
Kiv meB ¯^vfvweK|
Dc¯’vwcKv: Valvular heart disease †hwU m¨vi (Wv: bRiæj) BwZga¨ wKQzUv
Avgv‡ì mv‡_ Av‡jvPbv K‡i‡Qb| heart Gi Ab¨vb¨ mgm¨vi g‡a¨ GwUI GKwU
mgm¨v| GwU wb‡q m¨vi wK ej‡Z cv‡ib Avm‡j GwU †Kb nq Ges Gi Dc¯^M© †evSvi
Dcvq wK?
Wv: †ZŠwdKzi ingvb: Valvular heart disease Avgv‡ì nv‡U©i g‡a¨ 4wU valve
_v‡K †m¸‡jv n‡jv 1) Mitral valve 2) Aortic valve 3) Pulmonary valve 4)
Tricuspid valve| GLb evZR¦‡i GB valve mvavibZ AvµvšÍ nq Avgiv †hUv
†`LwQ| wKQz Rb¥MZ Kvi‡b n‡Z cv‡i, †hUv Aí eq‡mB aiv co‡e| Avi †hUv gvSvwi
eq‡m n‡q _v‡K †mB mg‡q Ges †mUv‡Z mvavibZ gwnjviv AvµvšÍ nq| Zviv hLb
Avgv‡ì Kv‡Q Av‡m †`Lv hvq Rheumatic fever ev evZ¡R¦i ewj †mUvi Kvi‡bI
valve AvµvšÍ n‡Z cv‡i, GB AvµvšÍ n‡j mvavibZ 2 ai‡bi mgm¨v nq 1/ valve
miæ n‡q hvq A_ev 2/ valve wjK K‡i| hw` miæ n‡q hvq ev wjK K‡i Zvn‡j Zvi
Rb¨ mywbw`©ó wPwKrmv Av‡Q| hw` Aí wjK K‡i ev Aí miæ n‡q hvq Zvn‡j Zvi Rb¨
GK ai‡bi wPwKrmv Av‡Q| Avi hw` gvSvwi AvKv‡ii valve wjK K‡i ev miæ nq
Zvn‡j Zvi Rb¨ Av‡iK ai‡bi wPwKrmv| A_ev hw` †ewk AvKv‡ii wjK K‡i ev miæ
nq Zvn‡j Zv‡ì Rb¨ I Avjv`v ai‡bi wPwKrmv Ggb n‡Z cv‡i Avgv‡ì valve
change Ki‡Z n‡Z cv‡i A_ev †ejyb Av‡Q GK ai‡bi †mUv w`‡q miæ wQ`ª †gvUvI
Kiv jvM‡Z cv‡i| Avevi eqm Kv‡jI wKš‘ Gi mgm¨v n‡Z cv‡i †m †ÿ‡Î Avgiv
mvavibZ †`wL Aortic valve miæ n‡q †h‡Z cv‡i, HUv †ewkifvM cyiæl †ivMx‡ì

n‡q _v‡K| Zvn‡j GB †h †ivMx‡ì hw` valve Gi mgm¨v nq ZLb mvavibZ wK
symptoms wb‡q Avgv‡ì Kv‡Q Av‡m| †hB jÿb ¸‡jvi K_v GZÿb Avgiv
ejwQjvg †m¸‡jv †_‡K GB jÿb¸‡jv mvavibZ GKUz wfbœ nq| hw` Avgiv ey‡Ki
e¨_vi K_v ewj heart G block RwbZ mgm¨vi Rb¨ †h ai‡bi ey‡K e¨_v nq
†ivMx‡ì, ey‡K e¨_v Zvi †_‡K m¤ú~b©B Avjv`v ai‡bi Gi †ivMx‡ì ey‡K e¨_vUv
mvavibZ Kg nq wKš‘ k^vmKó RwbZ mgm¨vUv GKUz †ewk nq| we‡kl K‡i, cwikÖg
Ki‡Z †M‡j, GKUz nuvU‡Z †M‡j, wmuwo †e‡q Dc‡i DV‡Z †M‡j, ZLb †ivMxiv e‡j †h
m¨vi (2-3) Uv wmuwo †e‡q Dc‡i DV‡j Avwg nuvwc‡q hvw”Q, †Zv Dwb nuvwc‡q hv‡”Q
†Kb?ÑGB nvucvwb wb‡qI wKš‘ †ivMx‡ì A‡b‡KiB fªvšÍ avibv nq| †`Lv hvq †ivMxiv
GB nvcuvwb wb‡q fzj K‡i eÿe¨vwa we‡klÁ wPwKrm‡Ki Kv‡Q hvb wPwKrmv wb‡Z, Ges
GiKg Avgiv A‡bK †ivMx cvBÑ hv‡ì valve Gi mgm¨v Avgiv Echo cardiogram
K‡i confirm Kwi †h †ivMxi valve miæ n‡q †M‡Q ev wjK Ki‡Z‡Q A_P Zviv wKš‘
†`Lv hv‡”Q eûw`b a‡i eÿe¨vwa we‡klÁ †`wL‡q inhaler eënvi Ki‡Z‡Q A_ev
wewfbœ ai‡bi Jla Lv‡”Q k^vmK‡ói Rb¨ G¨vRgv g‡b K‡i| GB G¨vRgvi g‡Zv
presentation †h n‡”QÑ †ivMx‡ì symptoms wn‡m‡e HUvB wKš‘ g~jZ valve Gi
mgm¨v| Zvn‡j valve Gi mgm¨v n‡j Avgv‡ì mvavibZ †ewk nq k^vmKóUv| GQvov
Av‡iv n‡Z cv‡i, †hgb ey‡K nvjKv e¨_v| Avi Avgv‡ì valve Gi mgm¨v wbb©‡qi
†ÿ‡Î me‡P‡q M~iæZ¡c~b© cixÿv wKš‘ Echo cardiogram| †Kbbv Echo
cardiogram Gi gva¨‡g Avgv‡ì heart Gi †h structure †mUv Lye fv‡jv fv‡e †`Lv
hvq Ges HUv‡ZB †evSv hvq †ivMxi valve Gi mgm¨v Av‡Q wKbv Ges valve Gi wK
mgm¨v n‡q‡Q I KZUzKz| Avi GUv w`‡q Avgiv †h valve miæ n‡q wM‡q‡Q ev wjK
Ki‡Z‡Q Zvi gvÎv KZLvwb †mUvI eySv hvq|
Dc¯’vwcKv: m¨vi (Wv: bRiæj), GB †h wewfbœ ai‡bi investigation Gi K_v Avgiv
ïbjvg, Ges Avgv‡ì †`‡ki †ivMx‡ì GKUv common Awf‡hvM _v‡K †h heart
Gi Wv³vi‡ì Kv‡Q †M‡jB GKUz †ewk gvÎvi cixÿv-wbixÿv †`q †Zv cixÿvi wel‡q
hw` wKQz ej‡Zb m¨vi (Wv: bRiæj)| Avm‡jB Avcbviv wK wK ai‡bi cixÿv w`‡q
_v‡Kb Avi †Kvb wRwbmUv KZUzKz Riæix?
Wv: bRiæj Bmjvg: Avm‡j heart Gi †ivM GKUz Av‡MB Avcbviv ky‡b‡Qb cÖ‡dmi
†ZŠwdK e‡j‡Qb †h, GLv‡b valve Gi †ivM, ischemic heart disease A‡bK
ai‡bi †ivM Av‡Q, Ges †iv‡Mi gvÎv †f‡e wewfbœ †iv‡Mi Rb¨ wewfbœ ai‡bi cixÿv
n‡q _v‡K| Av‡iKUv wRwbm †Lqvj ivL‡Z n‡e †h, heart Gi †ivM wKš‘ †ewki fvM
†ÿ‡ÎB cureable bv AviwK| hvi Rb¨ cÖwZ eviB †Kvb bv †Kvb µ‡g †ivMUv
progress Ki‡Q wKbv, DbœwZ n‡”Q wKbv, G¸‡jv †`Lvi Rb¨ gv‡S wKQz wKQz cixÿv
†`qv jv‡M| †Zv GUv I GKUv Kvib †`Lv hvq †h Ab¨vb¨ †iv‡Mi Zzjbvq heart Gi
†ivMx‡ì cixÿv GKUz †ewk jvM‡Q AviwK Ges †ewk w`b a‡i jvM‡Q| †hgb a‡ib
GKUv g¨v‡jwiqv Zv‡K hw` Avcwb 1evi diagnosis †`b †mB result Abyhvqx 1evi

medicine dose †`b Zvi wKš‘ wPwKrmv Jla †kl nIqvi mv‡_ mv‡_B eÜ| wKš‘
heart Gi †ivMx‡ì †ÿ‡Î wKš‘ Zv bv †mUv GKUv Kvib hvi d‡j, †`Lv hvq Avgv‡ì
†ivMx‡ì Dci GKUv Pvc c‡i evi evi cixÿv wbixÿv Kivi Rb¨| †hgb a‡ib GKUv
valve Lvivc n‡”Q bvwK fv‡jv n‡”Q, Zvi operation jvM‡e bvwK jvM‡e bv †mUv
†`Lvi Rb¨ nqZ K‡qK eQi follow up Kiv jvM‡Z cv‡i for their well being
gv‡b Zv‡ì fv‡jvi Rb¨ †h KZLvwb Zv‡ì †ivM¸‡jv wK Ae¯’vq Av‡Q †`Lvi Rb¨
Rvbvi Rb¨, Ges †Kvb ch©vq wM‡q Zv‡K intervention Ki‡Z n‡e operation
Ki‡Z n‡e, †mRb¨ Kv‡iv nqZ 2 eQi, 3 eQi Avevi Kv‡iv (5-6) eQi mgqI
jvM‡Z cv‡i| Zvi Rb¨ †`Lv †Mj 5 gvm, 6 gvm nqZ 1 eQi ci ci wKQz cixÿv
jvM‡Z cv‡i| 2q Av‡iKUv important welq n‡jvÑ †hUv †mUv n‡”Q †Kv‡bv †Kv‡bv
cixÿv GKUz costly, †hgbÑ echo cardiogram Ges †Kv‡bv †Kv‡bv †ÿ‡Î
angiogram jvM‡Z cv‡i| †mB Kvi‡b †ivMx‡ì GwU g‡b n‡Z cv‡i †h, heart Gi
Wv³viiv †ewk †ewk cixÿv- wbixÿv w`‡q _v‡Kb| Z‡e Avgvi e¨w³MZ avibv n‡jv
†h nqZ †Kv‡bv wPwKrmK Avcbvi †ewk test w`‡Z cv‡i wKš‘ Avgvi avibv majority
doctor †hUzKz Avcbvi Rb¨ cÖ‡qvRb †mUzKzB w`‡q _v‡Kb| Gi Kvib n‡jv Avgv‡ì
†`‡ki †ivMx‡ì †h Kg©ms¯’vb GUv wPšÍv K‡iB wKš‘ Dbviv hZUzKz cÖ‡qvRb Zv K‡ib|
Ges AvgviI avibv Avi AvgviI Aby‡iva wPwKrmK‡ì cÖwZ hv‡Z K‡iÑ Zviv
Avgv‡ì †ivMx‡ì Avw_©K Ae¯’v we‡ePbv K‡i AwZ cÖ‡qvRbxq cwiÿv ¸‡jv w`‡q
wPwKrmv Kiv ìKvi, Ges Gi Rb¨ Ae¨kB Zv‡ì clinically aquiment eënvi
Kiv DwPZ gv‡b, wK¬wbK¨vwj eywØgIv eënvi Kiv DwPZ|
Wv: †ZŠwdKzi ingvb: Avwg hw` m¨v‡ii (Wv: bRiæj) mv‡_ GKUz †hvM Kwi AviwK|
†Kbbv GB †h, †ivMx‡ì complain †h‡nZz ejv n‡”Q †ewk cixÿv †Kb jv‡M GLb
Avwg GKRb †ivMxi ECG Kijvg ECG report ¯^vfvweK n‡jv wKš‘ †ivMxi ey‡K e¨_v
Av‡Q Zvn‡j wK †ivMxi heart G mgm¨v bvB, †h‡nZz ECG normal Avm‡Q Avwg
eje †n definitely Zvi heart G mgm¨v Av‡Q| †Kbbv GB †h Zvi ey‡K e¨_v n‡”Q
Ges wmuwo †e‡q Dc‡i DV‡j Zvi Kó n‡”Q Zvi ey‡K Pvc Pvc AbyfzZ n‡”Q GB Pvc
jvMvi RbÏ Zvi heart G mgm¨v n‡Z cv‡i|
Dc¯’vwcKv: abëv` m¨vi (Wv: †ZŠwdK), †hwU n‡qwQj m¨vi (Wv: bRiæj) Avgiv GKUz
Rheumatic fever wb‡qI Av‡jvPbv Ki‡Z PvB Kvib n‡jv Rheumatic fever Gi
mv‡_I wKš‘ heart Gi mgm¨vi GKUv m¤c„³Zv i‡q‡Q)Ñ A‡b‡K GwU wb‡qI wKQz fzj
avibv †cvlb K‡ib, GKUz hw` ej‡Zb m¨vi (Wv: bRiæj) †h, Rheumatic fever wK
Ges †mwU †_‡K heart Gi mgm¨v nIqvi SzwK KZLvwb Ges m¤¢vebv KZLvwb|
Wv: bRiæj Bmjvg: Rheumatic fever GUv wKš‘ GK mgq GB †`‡k ev GB AÂj
cÖPzi fv‡e we¯Í…Z wQj, Ges Zv‡Z nq wKÑ Ggb GKUv wRwbm †hUv Rxevby MwVZ GKUv
†ivM †hUv cÖ_‡g Ubwmj ev Mjvq infection nq| Mjvq infection nq Ges GUv Lye

we‡kl ai‡bi GKUv Rxevbyi infection w`‡q Zvi cÖ‡KvcUv n‡q _v‡K| GUvi GKUv
gRvi welq n‡jv GUv Mjvq infection nq wKš‘ mg¯Í kix‡i GK ai‡bi cwieZ©b
Avwb‡q †`q Ges cwieZ©‡bi g‡a¨ A‡bK RvqMvq GUv infected K‡i, Zvi g‡a¨
R‡q›U n‡Z cv‡i Ges heart GB 2 Uv RvqMv‡Z infection K‡i †ewk|
Dc¯’vwcKv: †Kvb eqwm ev”Pv‡ì GwU n‡q _v‡K Rheumatic fever?
Wv: bRiæj Bmjvg: mvaviYZ ejv n‡q _v‡K (5-15) eQi eqm ch©šÍ ev”Pv‡ì n‡q
_v‡K| wKš‘ Gi †_‡K wKQz †ewkI n‡Z cv‡i Avevi early I n‡Z cv‡i| wKš‘
mvavibZ 5 eQi eq‡mi Av‡M ev”Pv‡ì GwU †`Lv hvq bv †ewki fvM †ÿ‡ÎB| †Zv
GB Rheumatic fever nIqvi †ÿ‡Î wK nq R‡q›U e¨_v K‡i| Avi ev‡Zi K_v ejv
n‡”Q GB R‡b¨ †h‡nZz throat †_‡K ev‡Z Avgv‡ì joint G involve K‡i Ges
Rheumatic fever G involve K‡i GRb¨ GUv‡K evZ¡R¦i ejv nq | Zvi gv‡b R¦i
I Av‡Q, Mjv e¨_v Av‡Q Ges wMiv e¨_v Av‡Q GUv †_‡KB| GUvi Av‡iv GKUv
dangerous wRwbm n‡jv GB †h †ivMUv n‡jv †mUvi Rb¨ A‡b‡K antibiotic †L‡jv
ev Jla †L‡q fv‡jv n‡q hvq| wKš‘ Gi Rb¨ †h my`yi cÖmvwi GKUv complication nq
Zvi Rb¨ †`Lv hvq A‡b‡Ki (10,15,20) eQi ci †`Lv †Mj †h, valve Gi †h
RvqMvUv †Kv_vI infection n‡qwQj †mB RvqMvU‡Z cwieZ©b nIqv ïiæ Kij Wv:
†ZŠwdK †hUv e‡jwQ‡jb | †h †Kvb †Kvb mgq GUv open †_‡K narrow n‡q i³
PjvPj K‡g †h‡Z cv‡i| cwieZ©b n‡q †h‡Z cv‡i| GKw`‡K i³ hvIqvi K_v Dëv
w`‡K hvIqv ïiæ K‡i GUvi gva¨‡g wKš‘z cy‡iv structure damage n‡q hvq GUv
†ewki fvM †ÿ‡Î operation †j‡M †h‡Z cv‡i AviwK-
Dc¯’vwcKv: H ch©šÍ hv‡Z †h‡Z bv nq †mRb¨ wK Kibxq?
Wv: bRiæj Bmjvg: †mRb¨ 1g K_v K_v n‡jv, †h mg¯Í ev”Pv‡ì Mjv e¨_vq 1g
wPwKrmv K‡i hv‡Z K‡i GUv AvU‡K †`qv nq| hw` Kv‡iv Rheumatic fever n‡qI
hvq †mLv‡b I wKQz wPwKrmv eë¯’v Av‡Q wKQz Jla LvIqv‡bv nq †Kv‡bv †Kv‡bv mgq
mviv Rxeb, †Kv‡bv mgq (30,50) eQi ch©šÍ| wPwKrm‡Ki civgk© g‡Zv Abyhvqx Zvi
Rheumatic fever n‡qwQj a‡i wb‡q Zv‡K Zvi standard wPwKrmv †bqv cÖ‡qvRb |
Zvn‡j all most mg¯Í †ÿ‡ÎB GB heart Gi valve †h defect n‡q hvIqvi K_v †mB
SuzwKUv †_‡K cwiÎvb cvIqv hvq|
Dc¯’vwcKv: Angiogram GKwU we‡kl ai‡bi wPwKrmv| GB c×wZwU diagnosis Gi
†ÿ‡Î eënvi Kiv nq nv‡U©i mgm¨vi Rb¨Ñ cieZ©x‡Z nv‡U©i KZ % i³bvjx‡Z
block Av‡Q Ges cieZx© c`‡ÿcwU †mwU wKš‘ Angiogram Gi †ÿ‡ÎB †bqv nq
†gvUvgywU GB wel‡q wbwðZ nIqv hvq| GB Angiogram wb‡qI Avgv‡ì `kK©‡ì
GKwU åvšÍ avibv Av‡Q Ges Zviv GwU Ki‡Z A‡b‡KB Awbnv cÖKvk K‡iÑ †Zv GwU
†Kb Ges Zv‡ì‡K Avcbviv ZLb counseling Uv †`b wKfv‡e?

Wv: †ZŠwdKzi ingvb: GLb Angiogram mvaviYZ †Kvb †Kvb †ivMxi †ÿ‡Î jvM‡e
GUv ¸iæZ¡c~b©| hw` †Kvb †ivMxi cÖ‡qvRb nq ZLb †Zv Zvi Ki‡ZB n‡e| GLb
GKRb †ivMxi heart attack n‡q †M‡Q, Zvn‡j Zvi †h heart attack n‡jv Ae¨kB
Zvi Av‡M †Kvb block wQj| GB block Gi Kvi‡b Zvi heart attack n‡q‡Q| GLb
GgbI †Zv n‡Z cv‡i, †h block Gi Kvi‡b Zvi heart attack n‡jv, Zvi †Zv Av‡iv
block _vK‡Z cv‡i †h‡nZz Zvi heart attack n‡q‡Q| GLb Zvi †h Av‡iv block
Av‡Q Ges GB block †_‡K fwelr‡Z Zvi heart cybivq Avevi attack n‡e wKbv
†mUv Avgiv wKfv‡e eySe? Gi Rb¨ Avvgv‡ì GUv eySvi Rb¨ Angiogram Gi
cÖ‡qvRb| GB Angiogram Ki‡j Zvi definitely †h Kvi‡b G¨vUvK n‡q‡Q H
i³bvwj eyS‡Z cvie block n‡q‡Q wKbv Avi dvi`vi GB block Qvov Zvi Ab¨
†Kv‡bv block Av‡Q wKbv Avi †mB Kvi‡b Avgvi Angiogram jvM‡e| Avevi
primary PCI †hB K_vUv Avgiv ejjvg †h, ey‡K Zxeª e¨_v wb‡q †ivMx Avm‡Q, GLb
Avgiv A‡bK mgq †h i³Uv RgvU eva‡jv †mUvi Kvi‡b †h heart attack n‡jv †mUv
i³ RgvU evav Avgiv †hgb Jla w`‡q Mwj‡q w`‡Z cvwi| †mB Jl‡ai success wKš‘
100% bv (60-70%)| A_©vr wKQz percent m‡›`n †_‡K hvq Zv nqZ †mB i‡³i
PvKvUv bvI Mj‡Z cv‡i Jl‡ai gva¨‡g Zvn‡j 100% confirm Avgiv wKfv‡e
Ki‡Z cvwi hw` Avgiv Angiogram Kwi Ges Gi gva¨‡g †`Ljvg †h, nu¨v i‡³i
PvKvi gva¨‡g block n‡q †M‡Q ZLb Avgiv †mLv‡b ring ewm‡q w`‡q Zvi total
block gy³ Ki‡Z cvwi| GLb GB 100% wbwðZ †h, wPwKrmv †mUvi RbÏ wKš‘
Avgvi cÖ_‡g Angiogram Ki‡Z n‡e| †hgb Avgiv ewj save the children wKš‘
Avgv‡ì cardiologist †ì Kv‡Q n‡jv save the cardiac muscle GUvB Avgv‡ì
g~j jÿ¨| †Zgwb GKUv †ivMxi †hgb ETT K‡i‡Q ETT stage 1 ev ETT stage 2
†Z positive gv‡b Zvi block _vKvi m¤¢vebv LyeB Kg| wKš‘ Ggb ai‡bi block
Av‡Q hvi Rb¨ nqZ Zvi LyeB Kg| wKš‘ Ggb ai‡bi Av‡Q hvi Rb¨ nqZ Zvi Lye
kxNªB heart attack n‡Z cv‡i| wKš‘ †mB SuzwKUv Gov‡bvi Rb¨ Zvi Angiogram
jvM‡Z cv‡i|
Dc¯’vwcKv: Avgiv GKUz Rvb‡Z PvB wKQz cÖwZ‡iv‡ai welq wb‡q hv m¨vi (Wv:
†ZŠwdK) BwZg‡a¨B Avgv‡ì e‡j‡Qb †h Prevention is better than cure †mwU
nv‡U©i †iv‡Mi †ÿ‡ÎI cÖ‡hvR¨ Ges A‡bK †ewk cÖ‡qvRb Av‡iKUv welq n‡”Q †h ïay
`xN©w`b a‡i Jla †L‡q hv‡”Qb Zvi mv‡_ mv‡_ †h life style ev wbqg gZ Pjv Zvi
Lv`¨vfvm GB welq ¸‡jv A‡bK †ivMxivB gv_vq ivL‡Qb bv| A‡b‡K fv‡e Avwg‡Zv
Jla B Lvw”Q ev Avgvi †Zv surgery n‡q‡QÑ Zvn‡j wK ìKvi, GB wel‡q Ges
Zv‡ì D‡Ïk¨ wK ej‡eb m¨vi (Wv: bRiæj)|
Wv: bRiæj Bmjvg: 1g wRwbm n‡jv †h, ïiæ‡Z †hUv ejwQjvg ü`‡iv‡Mi †ewkifvM
†ÿ‡ÎB we‡kl K‡i ischemic heart disease cure n‡q hvq bv AviwK †Zv GB
wRwbm¸‡jvi wPwKrmK †hUv ejv nq evsjv fvlvq Avgiv ewj †RvivZvwj wPwKrmv|

Avcbvi Jla †`qvUvI †RviZvwj wPwKrmv| ring civ‡bvUvI †RvivZvwj wPwKrmv
Acv‡ikb KivUvI ZvB infact Gi wewfbœ RvqMvq defused †ivM n‡q _v‡K| †Zv GB
wRwbm¸‡jvi Rb¨ KZ¸‡jv c×wZ Av‡Q †mMy‡jv‡Z prevent Kiv hvq wKbvÑ dvi`vi
hv‡Z bv nq ev Ab¨ †Kv_vI bv nq Zvi Rb¨ Avcbvi life style †hUv Avcwb e‡j‡Qb
†mUv LyeB important | †hUvi Rb¨ ideal weight G Avmv, †mUvi Rb¨ exercise
Kiv, fat RvZxq hZ wRwbm Av‡Q †m¸‡jv Kwg‡q †`qv| wmMv‡iU †Zv Ae¨kB e›a K‡i
†`qv| diabetes _vK‡j LyeB fv‡jv fv‡e wbqš¿b Ki‡Z n‡e| Jl‡ai K_v †hUv
e‡j‡Qb †h JlacÎ ¸‡jv eënvi Kiv n‡q _v†K †mB Jla¸‡jv wKš‘ K‡qKUv Kvib
Av‡Q| wK Kvi‡b GB †h narrowing Uv n‡q hvw”Qj ev block nw”Qj ev fat R‡g
hvIqv e‡j GUv‡K prevenent Kivi Rb¨ wKQz Jla †`qv _v‡K| †Zv †h‡nZz GUv
Ki‡Z n‡e| myZivs GUv‡Zv mvivRxeb †L‡Z n‡e| Avwg †ivMx‡ì‡K †evSv‡bvi Rb¨
ewj †hgb GKUv MvQ c‡i hv‡”Q Avcwb †VKv w`‡jb, †mB †VKvUv Avcwb mwi‡q wb‡jb
Z‡e †mB MvQUv †Zv c‡i hv‡e, Avi †mB †VKvi KvRUvB Ki‡e Avcbvi Jla¸‡jv
Ges Zvi mv‡_ wbqg g‡Zv Pjv| myZivs Wv³vi‡ì mv‡_ civgk© K‡i GUv Ki‡Z n‡e
Ges Av‡iv d‡jvAvc Ki‡Z n‡e Avcwb †h Jla¸‡jv Lv‡”QbÑ me¸‡jvB †h
fv‡jvfv‡e KvR K‡i Zv‡Zv bv, Jla ¸‡jv †Zv 19/20 n‡Z cv‡i| †mRb¨B
Wv³vi‡ì mv‡_ gv‡S g‡a¨ d‡jvAvc Kiv Ges Jl‡ai dose ¸‡jv Gw`K Iw`K K‡i
wVK K‡i †bqv|
Dc¯’vwcKv: Avgiv GKUz Rvb‡Z PvBe hv‡ì GLbI nv‡U©i mgm¨v nqwb AvgivI PvBbv
Zv‡ì †nvK Zv‡ì Rb¨ GwU cÖwZ‡iv‡ai †Kvb eë¯’v Av‡Q wKbv Ges Gi Rb¨ wK
Kibxq GKUz †QvU K‡i hw` ej‡Zb m¨vi (Wv: †ZŠwdKzi)?
Wv: †ZŠwdKzi ingvb: nu¨v Zv‡Zv Ae¨kB hv‡ì heart Gi mgm¨v GLbI nq bvB Zv‡ì
†hb GUv bv nq AvgivI PvB GLb heart Gi block RbxZ mgm¨v hv‡ì family †Z
Av‡Q Zv‡ì wK›Zz GB mgm¨vUv †VKv‡bv KwVb| myZivs †m‡ÿ‡G Avcbv‡K gv‡S gv‡S
Avgiv †h risk factor ewj †hgb- diabetes, hypertension, smoking, obesity,
cholesterol Zvici seceondary life style | †hgb cwikÖ‡gi KvR bv K‡i e‡m
e‡m KvR Kiv †Zv GB wRwbm¸‡jv Avgv‡ì LyeB control K‡i Pj‡Z n‡e Avgiv †hUv
ewj eqm evovi mv‡_ mv‡_ block w`b w`b evo‡Z _v‡K Avgv‡ì †hgb Pzj cvK‡Z
_v‡K, †Zgwb wKš‘ i³bvwji g‡a¨ block naturally n‡Z _v‡K| wKš‘ GUv‡K hold
Kiv A_ev mvg‡b hv‡Z GwM‡q †h‡Z bv cv‡i †mRb¨ wKš‘ GB risk factor ¸‡jv‡K
Z¡ivwb¦Z Ki‡Z n‡e Avi Ggwb‡Z Avgv‡ì bZzb Av‡iv wKQz risk factor Av‡Q A‡bK
mgq Avgv‡ì nvmcvZv‡j young patient Aí eq¯‹ Zvi diabetes bvB, wmMv‡iU
Lvq bvB †Kv‡bvw`b, D”P i³Pvc bvB, Zvi i‡³ cholesterolI bvB wKš‘ nVvr K‡i
†`Lv †Mj heart attack wb‡q ev block wb‡q Av‡m| †hUv LyeB `yfv©M¨ RbK NUbv
†mUviI wKš‘ wKQz wKQz bZzb risk factor Av‡Q| †hgb Avgiv homocysteine ewj,
CRP G¸‡jvI wKš‘ Zv‡K gv‡S gv‡S check K‡i †bqv DwPZ|

Dc¯’vwcKv: wR¦ GKUz screening Kwi‡q †bqv DwPZ hviv GKUz SuzwKi g‡a¨ Av‡Qb ev
hv‡ì cwiev‡ii g‡a¨ heart Gi mgm¨v Av‡Q, Zviv †hb GKUz screening Kwi‡q
iv‡Lb †mwU me †ivMxi †ÿ‡Î †Zv Av‡QB nv‡U©i †ivMxi †ÿ‡ÎI cÖ‡hvR¨| m¨vi,
Avcbv‡ì `yRb‡KB A‡bK abëv` G‡Zv e¨¯ÍZvi g‡a¨ I Avcbviv Avgv‡ì‡K mgq
w`‡q‡Qb| abëv` `yRb‡KB evsjvwfk‡b Avmvi Rb¨|
Wv: †ZŠwdKzi ingvb: evsjvwfkb Ges Avcbv‡KI abëv`|
Dc¯’vwcKv: wcÖq `k©K, ïbwQjvg AZ¨šÍ ¸iæZ¡c~b© GKwU A½ †hwU‡K ejv nq heart&
GB üìvM ev heart Gi mgm¨v wb‡q †ek wKQz ¸iæZ¡c~b© Av‡jvPbv ïbjvg| †hwU
Avgv‡ì AwZw_ evi evi K‡i e‡j‡Qb †h, GB †ivMwU hvi nq Zv wKš‘ cy‡iv cywi cure
nq bv ev my¯’ nq bv wKš‘ wbqwgZ Lv`¨vfvm Ges Jla †meb I we‡klÁ wPwKrm‡Ki
ZI¦veav‡b _vKv| GB welq¸‡jvi gva¨‡g wKš‘ Avgiv G‡K ev‡iB wbqš¿‡b ivL‡Z cvwi
GB welqwU wKš‘ D‡V G‡m‡Q Avgv‡ì AvR‡Ki Abyôv‡bi gva¨‡g| mevB fv‡jv
_vK‡eb, my¯’ _vK‡eb Ges fv‡jv ivLvi †Póv Ki‡eb wb‡Ri heart †K| GB e‡jB
we`vq wbw”Q `k©K Avcbv‡ì KvQ †_‡K A‡bK abëv` Avcbv‡ì‡K G‡ZvUv mgq
Avgv‡ì mv‡_ _vKvi Rb¨| Avjøvn& nv‡dR||||||
GKz‡k wUwf-†Z ü`‡ivM welqK mvÿvrKvi
wf‡qZbv‡gi †nv wP wgb wmwU‡Z ü`‡ivM welqK †mwgbvi
wbDR 24 wUwf-†Z Ô¯^v¯’¨ msjvcÕ Abyôv‡b
ü`‡ivM welqK mvÿvrKvi

Abyôvb t wRwUwf‡Z cÖPvwiZ Òn¨v‡jv Wv³viÓ
ZvwiLt 03-10-2019
AvR‡Ki welq t Ònv‡U©i my¯’ZvÓ
Dc¯’vcK: Aa¨vcK (Wvt) Gg. †ZŠwn`yj nK
Avgwš¿Z AwZw_ t Aa¨vcK (Wvt) Gg.G. evwK|
Dc¯’vcK: Avmmvjvgy
AvjvBKzg, `k©K ïf mKvj|
wcÖq `k©K gÛjx Avwg
Aa¨vcK Wvt Gg. †ZŠwn`yj
nK Avgv‡ì wbqwgZ Abyôvb
Òn¨v‡jv Wv³viÓ, Avcbv‡ì
mevB‡K Avgš¿Y Rvbvw”Q|
Avkv KiwQ Avcbviv mevB
fv‡jv Av‡Qb, my¯’ Av‡Qb,
wbivc‡` Av‡Qb| wcÖq
`k©KgÛjx, cÖwZ mßv‡n wVK
GKB w`‡b GKB mg‡q
Avgiv GKwU we‡kl †ivM wb‡q K_v e‡j _vwK| Avm‡j †ivM wU wK, †Kb nq, wK
DcmM© wb‡q Av‡m? wK cixÿv- wbixÿvi gva¨‡g Avgiv †ivMUv wbY©©q Ki‡Z cvwi|
wPwKrmv Ki‡j fv‡jv n‡e Avi hw` wPwKrmv bv Kwi Zvn‡j RwUjZv †`Lv w`‡Z cv‡i
GB welq¸‡jv wb‡q we‡klÁ‡ì gZvgZ wb‡q Avcbv‡ì mvg‡b nvwRi nB| AvR‡K
†h welqwU wb‡q K_v eje †mwU ïay evsjv‡`‡ki bq, m¤ú~Y© c„w_ex‡Z g„Zzï cÖavb
KviY, Avi †mwU n‡jv ü`‡ivM| AvR‡K GB ü`‡ivM wb‡q K_v ejvi Rb¨ Avgv‡ì
ózwWI‡Z 2 Rb we‡klÁ‡K Avgiv Avgš¿Y Rvwb‡qwQ| Pjyb Zv‡ì mv‡_ cwiwPZ n‡q
Avwm| Avgvi Wvb w`‡K Av‡Qb Aa¨vcK Wvt Gg.G. evwK| Av”Qv evwK mv‡ne, Avcwb
†Kv_vq, wK wn‡m‡e Kg©iZ Av‡Qb Avgv‡ì `k©K‡ì D‡Ïk¨ hw` GKUz ej‡Zb|
Wvt Gg. G. evwK: abëv` Avwg ü`‡ivM we‡klÁ Aa¨vcK Wvt Gg. G. evwK RvZxq
ü`‡ivM BÝwówUDU I nvmcvZv‡ji Aemi cÖvß Aa¨vcK (KvwW©IjRx)| eZ©gv‡b
Rvcvb evsjv‡`k †dÛwkc nvmcvZv‡j wmwbqi KvwW©IjwR÷ wn‡m‡e Kg©iZ AvwQ|
Dc¯’vcK: GB †ckvq KZw`b a‡i KvR Ki‡Qb|
Wvt Gg. G. evwK: Avwg cÖvq 35 eQi hver wPwKrmv †ckvq RwoZ|
Dc¯’vcK: Avgv‡ì ÷zwWI‡Z Avmvi Rb¨ AmsL¨ abëv` (Wvt Gg.G. evwK)| wcÖq `k©K
gÛjx Avgv‡ì mv‡_ Av‡iv GKRb we‡klÁ Av‡Qb wZwb n‡jb Aa¨vcK Wvt †gvt

†ZŠwdKyi ingvb dviæK| dviæK Avgv‡ì ÷zwWI‡Z Avmvi Rb¨ Avcbv‡K AmsL¨
abëv`| Avcwb †Kv_vq wK wn‡m‡e KvR Ki‡Qb Avgv‡ì `k©K‡ì hw` GKUz ej‡Zb|
Wvt †ZŠwdKzi ingvb: abëv` Avwg Aa¨vcK Wvt †gvt †ZŠwdKzi ingvb dviæK Avwg
MZ (18-19) eQi a‡i RvZxq ü`‡ivM BÝwówUDU I nvmcvZv‡j ü`‡ivM we‡klÁ
wn‡m‡e Kg©iZ wQjvg| eZ©gv‡b Avwg Aa¨vcK I wefvMxq cÖavb (KvwW©IjRx), K‡Y©j
gv‡jK †gwW‡Kj K‡jR I nvmcvZvj, gvwbKM‡Ä Kg©iZ AvwQ|
Dc¯’vcK: Avgv‡ì ÷zwWI‡Z Avmvi Rb¨ abëv` Wvt dviæK Avcbv‡K| wcÖq `k©K,
ü`‡ivM wb‡q K_v ej‡Z †M‡j †h wRwbmUv Avgv‡ì cÖvqB g‡b Av‡m †mwU n‡jv nvU©
G¨vUvK| †`Lyb Avgiv Pjv‡div Ki‡Z †M‡j wKQz kw³i cÖ‡qvRb nq, hvi Rb¨
Avgv‡ì wKQz LvIqv `vIqvi cÖ‡qvRb nq, GB LvIqv `vIqvi kw³Uv †Kv_vq †_‡K
Av‡m wbðqB Avcbviv ej‡eb †h Avgiv hv LvB Gi g~j AskUzKz Avgv‡ì kix‡i Kv‡R
jv‡M | Avm‡j nv‡U©i ïiæ wKš‘ gvZ…Mf© †_‡K hv AvRxeb ch©šÍ KvR K‡i hvq| GB
Kv‡Ri Rb¨ nv‡U©i wKQz kw³i cÖ‡qvRb nq| GB kw³Uv †Kv_vq †_‡K Av‡m| wcÖq
`k©K i‡³i gva¨‡g GB kw³Uv Av‡m| Avgv‡ì †`‡ni g‡a¨ Avgv‡ì nvU© wKš‘
wbiwewQbœ fv‡e cv¤ú K‡i hv‡”Q Avgiv wKš‘ wekÖvg †bB wKš‘ nv‡U©i wekÖv‡gi cÖ‡qvRb
nq bv| Zvi Rb¨ Gi kw³i ìKvi Avi GB kw³Uv Av‡m i‡³i gva¨‡g| GLb cÖkœ
Rv‡M GB nv‡U©i KqwU Ask wKfv‡e KvR Ki‡Q Gi wK wK mgm¨v nq GB welq¸‡jv
Avgiv Av‡jvPbv Kie| nvU© wb‡q hw` Avgiv ej‡Z PvB †h, GwU wK n‡”Q †QvU GKwU
gvsm wcÛ| GwUi Ae¯’vb ey‡Ki gvSLv‡b, GwU †Kvb wekÖvg bvB| wcÖq `k©K, GKwU
nvU© †K wb‡q hw` Avgiv wPšÍv Kwi ejvi myweav‡_©, †jLv covi myweav‡_© GwU‡K 3wU
fv‡M fvM Kiv n‡q‡Q| 1wU evwn‡ii c`©v, 2wU gvSLv‡bi c`©v I 3 wU wfZ‡ii c`©v|
GwU‡K Avgiv ewj Endocardium, Myocardium & Epicardium. Endocardium
Gi g‡a¨ wKš‘ 4 wU fvj¦ _v‡K Avi Dc‡ii w`‡K _v‡K K‡ivbvwi AvU©vwi GB `ywU
wRwb‡mi gva¨‡g nvU© Zvi kw³ †c‡q _v‡K| GLb Avgiv †h welqwU wb‡q K_v ej‡Z
Pvw”Q †mwU n‡jv nv‡U©i mvaviYZ wK wK †ivM nq? GK K_vq ewj, nv‡U©i A‡bK ai‡bi
†ivM nq GB †ivM¸‡jvi g‡a¨ D”P i³Pvc GKwU †ivM Av‡Q, nv‡U©i †ivM | Avevi
Av‡Q Rb¥MZ †ivM †mwUI nv‡U©i g‡a¨ n‡q _v‡K| evZ¡RiRwbZ ü`‡ivM Av‡Q,
GQvovI Av‡Q Bk‡KwgK A_©vr i³ PjvP‡j ¯^íZv kix‡ii †Kv_vI †Kv_vI i³
PjvP‡j evavMÖ¯Í nq G¸‡jvI wKš‘ nv‡U©i †ivM| Av‡iv A‡bK ai‡bi †ivM Av‡Q GB
†QvU GKwU nvU© wb‡q| Wvt evwK mv‡ne Avcbvi Kv‡Q Avgiv Rvb‡Z PvBe †h, nvU© Gi
A‡bK ai‡bi †ivM Av‡Q Ges †iv‡Mi cÖavb DcmM© n‡”Q ey‡K e¨_v GLb ey‡K e¨_v
n‡jB wK nv‡U©i e¨_v|
Wvt Gg. G. evwK: abëv` Avcbv‡K, Avm‡j GB cÖkœUv wKš‘ mvaviY RbM‡Yi g‡a¨
Lye †ekx Rv‡M AviwK †h, ey‡Ki e¨_v n‡jB wK nv‡U©i e¨_v wKbv- DËiUv n‡jv †h
ey‡Ki me e¨_vB wKš‘ nv‡U©i e¨_v bv wKš‘ ey‡Ki e¨_v‡K AeÁv Kiv DwPZ bv|

Dc¯’vcK: Zvn‡j nvU© Gi e¨_vi
Aek¨B wKQz wbw`©ó êwkó¨ Av‡Q| hw`
†mB ‰ewkó ¸‡jv Avgv‡ì `k©K‡ì
GKUz eywS‡q ej‡Zb Wvt evwK mv‡ne|
Wvt Gg. G. evwK: nv‡U©i e¨_vi êwkó¨
n‡jv nv‡U©i mgm¨vi Rb¨ †h ey‡K e¨_v
nq, cÖ_g‡Zv GwU cwikÖ‡gi mv‡_
wi‡j‡UW| GKRb e¨w³ gwb©s IqvK
K‡i †Zv †m ¯^vfvweK fv‡e 2
wK‡jvwgUvi c_ nuv‡U| †Zv Dwb hw`
†mB mgq Uv‡Z †Lqvj K‡ib †h, 10 wgwbU nuvUvi ci Zvi ey‡K Pvc w`‡q Avm‡Z‡Q
A_ev 1 Uv e¨_v Av‡Q GUv GKUv wmMwbwd‡K›U| Kv‡iv hw` Lvev‡ii Av‡M ey‡K e¨_v
nq †mUv Ab¨ ai‡bi wmMwbwd‡K›U| Avgiv A‡bK mgq GwU‡K GwmwWwU ewj| wKš‘
ey‡Ki e¨_v 1g †hUv ‰ewkó ev †hUv Avcbvi Lye †ekx êwkó MZ PwiÎ †mUv n‡jv GUv
wKš‘ 1g ch©v‡q GUv Aek¨B cwikÖ‡gi mv‡_ RwoZ| †mRb¨ ¯^vfvweK GKRb gvbyl hw`
†gvUvgywU cwikÖg K‡ib A_ev wmuwo w`‡q DV‡Z †M‡j Zvi wZb Zjv evwo †m wmuwo w`‡q
DVvi mgq †Lqvj Ki‡jb 2 Zjv DVvi ciB Zvi ey‡K e¨_v D‡V‡Q GUv wKš‘ Lye
êwkó g~jK e¨_v| Av‡iKUv wRwbm eyS‡Z n‡e nv‡U©i e¨_v me mgq GK RvqMvq K‡i
bv †ivMxiv wKš‘ wewfbœfv‡e GUv‡K e¨vL¨v K‡i| A‡bK mgq A‡bK Typical nv‡U©i
†ivMxiv G‡m e‡j m¨vi Avgvi wKš‘ ey‡K e¨_v nqbv| Avgiv ZLb Rvb‡Z PvB Avcbvi
wK mgm¨v nq ZLb e‡j †h Avwg wKQz`~i nuvUvi c‡i Avgvi Kv‡Q g‡b nq †h ey‡Ki
wfZi Pvc Pvc Abyf~Z nq| Avm‡j GUvB wKš‘ nv‡U©i e¨_vi ‰ewkó| Avi GB e¨_v
wKš‘ (3-4) iKg n‡Z cv‡i| GKUv n‡jv Typical †cBb †hUv ey‡Ki gvSLv‡b nq,
KLbI KLbI GB e¨_v evg nv‡Zi w`‡K Qovq, KLbI GUv Mjvi w`K †_‡K
†Pvqv‡ji wbP ch©šÍ P‡j Av‡m GUv LyeB gvivZœK ai‡bi GKUv ANU‡bi ms‡KZ †hB
e¨_vUv eyK †_‡K †Pvqv‡ji w`‡K Av‡m ev nv‡Zi w`‡K hvq| Av‡iKUv n‡jv A‡b‡Ki
g‡b nq †h Aí nuvUvi ci Avgiv nuvwc‡q hvw”Q Avi Pv‡ci g‡Zv e¨_v | myZivs KLbI
Kv‡iv hw` ey‡Ki †h wWmKg‡dvU© †mUv hw` Abyf~Z nq Zvn‡j †`wi bv K‡i mv‡_ mv‡_
Wv³v‡ii †`qv civgk© Abyhvqx Pjv DwPZ| Avi Avcwb †hUv ej‡jb (Dc¯’vcK) me
e¨_v wK nv‡U©i e¨_v Aek¨B bv Avi mvaviY RbMY‡K Avgiv KLbB fq †`Lve bv †h,
me ey‡K e¨_v n‡jB nv‡U©i e¨_v| Z‡e c~Y© eq¯‹ GKRb e¨w³i ey‡K e¨_v n‡j GUv‡K
Ae‡njv bv K‡i GKRb Wv³v‡ii gva¨‡g GUv‡K ch©v‡jvPbv Kiv DwPZ| KviY Aviwj
Stage GUv ai‡Z n‡e 1g ch©vq Avcwb (Dc¯’vcK) GKUz Av‡M †h K_vUv ej‡jb †h
nv‡U©i Dc‡i †h, i³bvwj _v‡K †h i³bvwj¸‡jv‡Z Kibvwi AvU©vwi ev nv‡U©i AvU©vwi
e‡j †ewm‡Kwj nq wK H AvU©vwi w`‡q nvU© Uv mviKz‡jkb cvq Zvi †h i³ mieivn
†mUv cvq| Avwg GKUv D`vniY¯îæc †ivMx‡ì †K eySvB †h GKRb eveywP© ev cvPK

†m wKš‘ ivbœv K‡i mevB‡K LvIqvq wKš‘ Zvi wb‡RiI Lvev‡ii cÖ‡qvRb nq welqUv
wVK GiKg AviwK| GKUv †Rbv‡iUi †hgb (5-7)Zjv ch©šÍ wewìs‡q cvwb mieivn
Ki‡Z‡Q wKš‘ †mB †Rbv‡iUi‡K hw` Avcwb dz‡qj bv †`b †m wKš‘ cv¤ú Ki‡e bv|
GKw`‡K Avgv‡ì nvU©I wKš‘ †Rbv‡iUi, Avgv‡ì nvU© cÖwZ wgwb‡U 60-70 evi †m
cv¤ú Ki‡Z‡Q GUv Avgv‡ì m„wó KZ©vi Acvi GK m„wó Ges †m cv¤ú K‡i mg¯Í
kix‡i i³ mieivn Ki‡Z‡Q Zvi †h kw³i ìKvi Zvi Mv‡q †h K‡ivbvwi AvU©vwi
Av‡Q †mLvb †_‡K nq| †ewm‡Kwj mgm¨vUv nq wK GB i³bvwj‡Z †Zv eøK Av‡Q,
i³bvwj‡Z hLb eøK Av‡Q Ges nvU© hLb cwikÖg Ki‡Z hvq, Avcwb hLb cwikÖg
K‡ib, nvU©I †Zgwb cwikÖg K‡i nvU© hLb i³ Pvq †Zv hLb †m i³ cvqbv, †mB i³
¯^íZvi Kvi‡Y GK ai‡bi e¨_v Abyf~Z nq GUv‡K GbRvBbv e‡j| GUvB wKš‘ cÖ_‡g
Av‡m Gi Rb¨ gvbyl I wKš‘ cÖ_g †Ui cvq Zvi ÿgZv g‡b nq GKUz K‡g †M‡Q, Avwg
†Zv Av‡M Lye wbwe‡Nœ gwbs IqvK KiZvg 2 wK‡jvwgUvi nvUZvg †mB RvqMvq wKQzÿY
nuvU‡jB g‡b n‡”Q Avwg GKUz ewm GB †h Abyf~wZ Uv g‡b nq Avwg GKUz ewm GUv
wKš‘ nv‡U©i cÖvBgvwi GKUv wm¤úUgm|
Dc¯’vcK: AmsL¨, abëv` evwK mv‡ne| dviæK mv‡ne Avcbvi Kv‡Q GKUz Rvb‡Z
PvB †h, Avgiv †Zv QvÎ‡ì‡K †jLv covi mgq wR‡Ám Kwi †h what are the
chartarististic of chest pain A_v©r ey‡K e¨_vi nvU© RwbZ ü`‡ivM RwbZ e¨_vi
†h ‰ewkó †h †m›Uªvwj GB e¨_v n‡e Ges †cÖv‡Mwmfwj GUv evo‡e I wekÖvg wb‡j K‡g
hvq| Avevi KLbI KLbI H †h wRnŸvi wb‡P †¯úª eënvi Kwi Avgiv †mUv‡ZI wKš‘
K‡g hvq Ges we‡kl wK êwkó e‡j‡Qb †hUv evwK mv‡ne e‡j‡Qb, †h e¨_vwU gvSLvb
†_‡K †Pvqv‡j Avm‡Z cv‡i ev nv‡Zi w`‡K †h‡Z cv‡i| Avcbvi (Wvt †ZŠwdKzi)
Kv‡Q Avgvi cÖkœ e¨_v Qvov wK nv‡U©i mgm¨v n‡Z cv‡i wKbv?
Wvt †ZŠwdKzi ingvb: Avcbv‡K abëv`, nu¨v, e¨_v QvovI nv‡U©i mgm¨v n‡Z cv‡i
GgbI †`Lv hvq †h KLbI
e¨_v wQj bv wKš‘ nVvr K‡i
eyK aoco K‡i Av‡M
KLbI ey‡K e¨_v wQjbv
A_P nVvr ey‡K e¨_v n‡q
cÖ_g Ae¯’vq nvU© G¨vUvK
n‡Z cv‡i, GB nvU© G¨vUv‡K
Zvi g„ZzÏ n‡Z cv‡i|
myZivs GKUv gvby‡li ey‡K
e¨_v bvB ev n‡”Q bv wKš‘
eqm 40 ev 40 Gi †ekx
aygcvb K‡ib ev Wvqv‡ewUm
Av‡Q, D”P i³Pvc Av‡Q, wi¯‹ d¨v±i ¸‡jv Av‡Q, Zvi †Kv‡j÷ij Gi gvÎv †ekx

Zv‡K wKš‘ †PK Avc Kwi‡q †bIqv DwPZ †h Avm‡j Zvi nv‡U©i g‡a¨ †Kvb ai‡bi
†Kvb mgm¨v ev cwieZ©b Av‡Q wKbv GUv‡K Avgiv ewj wm¤ú‡Uv‡gwUK nqZ †ivMxi
†Kvb mgm¨v wQj bv GKUv †Zv n‡jv ey‡K e¨_v Av‡iKUv n‡jv ey‡K e¨_vi g‡Zv
k^vmKó nq nqZ cwikÖg Ki‡Z †M‡j Zvi †Kvb ey‡K e¨_v bvB wKš‘ k^vmKó n‡”Q hvi
Rb¨ †m eyK a‡i _v‡K| A_ev iv‡Îi †ejv A‡b‡K e‡j iv‡Z †kvevi ci k^vmKó nq,
Avevi D‡V em‡j k^vmKó K‡g hvq GUv A‡bK mgq †`Lv hvq nv‡U©i mgm¨v Av‡Q
nv‡U© i³ mieivn Kg n‡”Q †mLvb †_‡K nqZ Zvi nv‡U©i Kvh©ÿgZv fv‡jv n‡”Qbv
d‡j Zvi k^vmKó n‡”Q| GiKg mgm¨v wb‡qI †ivMxiv Avgv‡ì Kv‡Q Dcw¯’Z nq|
Dc¯’vcK: AmsL¨ abëv` Wvt †ZŠwdK| Avgv‡ì GKRb `k©K A‡bKÿY a‡i
A‡cÿv Ki‡Q †dv‡b Pjyb Zvi mv‡_ GKUz K_v e‡j Avwm| wcÖq `k©K Avmmvjvgy
AvjvBKzg-
`k©K 1: Avwg h‡kvi †_‡K ejwQ Avgvi eqm 38 eQi| Avwg Rvb‡Z Pvw”Qjvg Avgvi
ey‡Ki Wvbcv‡k nVvr nVvr e¨_v nq, gv‡S gv‡S e¨_vUv nq me mgq _v‡K bv|
Dc¯’vcK: Avcbvi wK Wvqv‡ewUm Av‡Q ev D”P i³Pvc Av‡Q, Avcwb wK aygcvb K‡ib
Avcbvi cwiev‡ii wfZi evev gv ev AvZœxq¯^Rb Kv‡iv wK nv‡U©i mgm¨v Av‡Q wKbv-
`k©K 1: nu¨v Avgvi Wvqv‡ewUm Av‡Q MZ 2 gvm hver aiv c‡o‡Q Avi †cÖkvi †bB|
Avwg aygcvbI Kwibv Avi cwiev‡ii wfZi Kv‡iv nv‡U©i mgm¨v bvB|
Dc¯’vcK: Av”Qv Wvt evwK mv‡ne GB †h `k©K ej‡Qb ey‡Ki Wvb cv‡k e¨_v GB
e¨_vUv‡K Avcwb wKfv‡e g~j¨vqb Ki‡eb Avi Avcbvi hw` wKQz wRÁvmv _v‡K
`k©‡Ki Kv‡Q Ki‡Z cv‡ib-
Wvt Gg. G. evwK: Avcwb †hUv ej‡jb ey‡K e¨_v nq GB e¨_vUv wK hLb wekÖv‡g
_v‡Kb evmvq ï‡q e‡m _v‡Kb ZLb nq bvwK cwikÖ‡gi mgq nq|
`k©K 1: m¨vi cwikÖg A_ev wekÖvg †h †Kvb mgq gv‡S gv‡S nq|
Wvt Gg.G. evKx: Av”Qv Avcbvi wK cvqLvbv Klv GB ai‡bi †Kvb mgm¨v Av‡Q wKbv-
`k©K 1: m¨vi Avgvi GB ai‡bi †Kvb mgm¨v bvB nVvr K‡i Wvqv‡ewUm Uv aiv c‡o
Avi Avwg †Zv GLb Jla Lvw”Q Wvqv‡ewUm Gi Avi e¨_vUv gv‡S gv‡S P‡j Av‡m|
Wvt Gg. G. evwK: †h‡nZz e¨_vUv Wvb w`‡K e‡j‡Qb Ges GUv cwikÖ‡gi mv‡_ mv‡_
m¤ú„³Zv †bB ZvB cÖv_wgKfv‡e Avgiv GUv g‡b Ki‡Z cvwi †h, GUv nv‡U©i Rb¨ bvI
n‡Z cv‡i| Wvb w`‡Ki e¨_v Ges †hUv nVvr nVvr nq Avevi P‡j hvq ZeyI Avgvi
g‡b nq Wvb w`‡Ki e¨_vi Rb¨ Avëªvm‡bvMÖvg K‡i MjeøvWvi Uv †`Lv DwPZ Avi
†h‡nZz Avcbvi †cÖkvi ev Wvqv‡ewUm Av‡Q †m‡nZz Avcwb GKUv BwUwU K‡i Av‡iv
wbwðZ n‡q †h‡Z cv‡ib| GB `y‡Uv cixÿv K‡i Avcbvi GB e¨_v nv‡U©i †_‡K n‡”Q

wKbv GUv Avcwb †gvUvgywU wbwðZ n‡q †h‡Z cvi‡eb| Avi Avwg †h `y‡Uv cixÿvi
K_v ejjvg †mUv h‡kv‡iB m¤¢e XvKv‡Z Avmvi cÖ‡qvRb bvB|
Wvt †ZŠwdKzi ingvb: Av”Qv GB e¨vcv‡i Avgvi GKUz gZvgZ Av‡Q - A‡bK mgq
†ivMx‡ì A‡bK cÖkœ _v‡K m¨vi Avgvi BwmwR, B‡Kv KvwW©IMÖvg †Zv ¯^vfvweK Zvn‡j
Avgvi wK nv‡U©i mgm¨v _vK‡Z cv‡i? Avwg BwUwU K‡iwQ BwUwU Avgvi †b‡MwUf Avgvi
wK nv‡U©i mgm¨v _vK‡Z cv‡i ev eøK _vK‡Z cv‡i- GB †h BwmwR, B‡Kv ¯^vfvweK,
BwUwU †b‡MwUf| nu¨v Avcbvi eøK _vK‡Z cv‡i| GgbI cÖkœ K‡i Avgvi wK nvU© G¨vUvK
n‡Z cv‡i nu¨v Avcbvi nvU© G¨vUvKI n‡Z cv‡i, wKfv‡e GLb GKRb †ivMxi 70
fv‡Mi †ekx eøK _vK‡j ZLb Zvi BwUwU cwRwUf Avm‡e| Avgvi wKš‘ eøK Av‡Q KLbI
G¨vUvK I nq bvB †`Lv hv‡e Zvi BwmwR, B‡Kv ¯^vfvweK _vK‡Z cv‡i| AZGe BwmwR
B‡Kv ¯^vfvweK Zvi gv‡b Zvi nv‡U©i mgm¨v bvB GUv ejv hv‡e bv, Avevi †ivMxi hw`
GgbI cÖkœ K‡i †h m¨vi, Avgvi †Zv wi¯‹ d¨v±i Av‡Q Wvqv‡ewUm Av‡Q, D”Pi³Pvc
Av‡Q, wmMv‡iU hwÌ Avwg LvBbv Zvn‡j Avgvi wK nv‡U©i mgm¨v n‡Z cv‡i wKbv?
KLbI GB †h ey‡K e¨_v †mUv nv‡U©i Kvi‡Y n‡Z cv‡i wKbv- nu¨v n‡Z cv‡i| GgbI
Av‡Q †ivMxi 70 fv‡Mi Dc‡i eøK bv †_‡K (30-50) fvM eøK Av‡Q Avevi †`Lv hvq
GB (30-40) fvM eøK nVvr K‡i gv‡S gv‡S ¯úvRg nq, †Ubmb Ki‡j n‡Z cv‡i ev
DwØMœ| Stage _vK‡j †Zv GB ¯úvR‡gi RbÏ Zvi ey‡K e¨_v n‡Z cv‡i GUvI wKš‘
KvwW©qvK Kvi‡Y n‡Z cv‡i| Avgv‡ì MjeøvWvi Gi e¨_vi mv‡_ mv‡_ GUvI we‡ePbv
Kiv DwPZ †h‡nZz Zvi mywbw`ó wKQz wi¯‹ d¨v±i Av‡Q, Wvqv‡ewUm Awbqwš¿Z Avevi
†`Lv hvq †h KLbI KLbI †ivMxi cÖkœ, m¨vi, Avgvi wK G¨vUvKI n‡Z cv‡i, nu¨v
G¨vUvKI n‡Z cv‡i| Avevi †`Lv hvq A‡bK mgq G¨vbwRIMÖvg K‡i †ivMxi 30-40%
eøK †c‡q †ivMx‡K e‡j †`B Avcbvi †Zv GUv †Zgb †Kvb mgm¨v bv Avcwb fv‡jv
Av‡Qb| wKš‘ G‡ÿ‡Î mgm¨v †hUv nq GB gvÎvi eø‡K nqZ Zvi wis jvM‡ebv ev
evBcvm jvM‡ebv, wKš‘ GB †h eøK Uv Av‡Q †mB eøK Gi wPwKrmvUv Zv‡K w`‡Z n‡e
†Kbbv GB 30-40% eøK †K Avgiv Acwic° cøvK ewj GB cøvK wKš‘ †d‡U †h‡q
†h‡Kvb nvU© G¨vUvK n‡Z cv‡i, Gi Rb¨ Zvi †h ey‡K e¨_v n‡e bv ev BwUwU †b‡MwUf
n‡e A_P Zvi nvU© †_‡K KLbI †Kvb mgm¨v n‡e bv ev nvU© G¨vUvK n‡e GUv ejv hv‡e
bv ev fvev hv‡e bv| ZLb cÖkœ n‡Z cv‡i †h, m¨vi Avgvi Zvn‡j cieZx Avi wK Kiv
jvM‡e hvi Rb¨ Avgvi nv‡U© G¨vUvKI n‡e bv ev eøKI n‡ebv- †Zv †mB‡ÿ‡Î wmwU
G¨vbwRIMÖvg ev G¨vbwRIMÖvg Kiv †h‡Z cv‡i| Z‡e GBme †ÿ‡Î wmwU G¨vbwRIMÖvg
Bb‡fwkf G¨vbwRIMÖvg Kivi †P‡q AwaKZi wbivc`|
Dc¯’vcK: wR¦ AmsL¨ abëv` Wv t †ZŠwdKzi ingvb| Avgv‡ì Av‡iKRb `k©K
A‡cÿv Ki‡Z‡Q Avgiv K_v e‡j Avwm| wcÖq `k©K, Avmmvjvgy AvjvBKzg, Avcbvi
cwiPqwU w`‡q cÖkœwU Kiæb|
`k©K 2: IqvjvBKzg Avmmvjvg, Avwg XvKv †_‡K wiZv ejwQ, Avgvi mgm¨v n‡”Q

Avwg hLb GKUz nuvUv Pjv Kwi ev mKv‡j nuvU‡Z hvB Ges wmuwo †e‡q Dc‡i DV‡Z
†M‡j †`wL Avgvi ey‡Ki evg cv‡k Pvc w`‡q a‡i, GKUz e¨_v K‡i Avevi wKQzÿY c‡i
†m‡i hvq| gv‡b GKUz `ªæZ ev †Rv‡i nuvUv Pjv Ki‡jB GB mgm¨vUv nq| Avwg 2-3
eQi Av‡M GKUv BwmwR K‡iwQjvg, †mUvi wi‡cv©U fv‡jv wQj| †Zv GB mgm¨vUv †Kb
n‡”Q GUvB Avgvi Rvbvi B”Qv AviwK-
Dc¯’vcK: wcÖq `k©K, Avcbvi Wvqv‡ewUm ev D”P i³Pvc Av‡Q wK?
`k©K 2: bv, Avgvi GB ai‡bi †Kvb mgm¨v bvB|
Dc¯’vcK: Avcbvi cwiev‡ii wfZi evev gv, fvB-†evb ,AvZœxq¯^Rb Kv‡iv wK nv‡U©i
mgm¨v Av‡Q- Avi Avcbvi IRb KZ?
`k©K 2: bv, Avgvi cwiev‡ii Kv‡iv nv‡U©i mgm¨v bvB wKš‘ Wvqv‡ewUm Av‡Q| Avgvi
IRb 67 †KwR|
Dc¯’vcK: wcÖq `k©K, Avgv‡ì mv‡_ _vKzb Avgiv Avcbvi cª‡kœi DËi w`w”Q †QvU
GKUv weiwZi ci|
weiZxi ci Avevi mevB‡K ¯^vMZg | Av”Qv Wvt †ZŠwdK Avcbvi Kv‡Q Rvb‡Z PvB
weiwZi Av‡M `k©K †hUv ej‡jb †h Zvi ey‡Ki evg cv‡k e¨_v nq Ges nuvU‡j e¨_v
ev‡o| Dbvi cwiev‡ii Kv‡iv nv‡U©i mgm¨v bvB wKš‘ Wvqv‡ewUm Av‡Q| GB
wRwbmUv‡K Avcwb wKfv‡e g~j¨vqb Ki‡Z Pvb|
Wvt †ZŠwdKzi ingvb: mvaviYZ Avgiv †`wL †h‡nZz Dwb gwnjv, gwnjv‡ì wKš‘
mvaviYZ 50 eQi Av‡M nvU© G¨vUvK ev nv‡U©i †ivM nZ bv| †m‡nZz †gby‡cv‡Ri Av‡M
nv‡U©i mgm¨v nZ bv| †÷ªv‡Rb bvgK ni‡gvb †g‡q‡ì †cÖv‡UKkb †`q eøK RwbZ
ü`‡ivM ewj †mUv AviwK nqbv| wKš‘ †`Lv hv‡”Q GLb A‡bK mgq †gby‡cv‡Ri
Av‡MI wewfbœ ai‡bi wi¯‹ d¨v±i Wvqv‡ewUm, D”P i³Pvc A‡bK mgq †`wL
contraceptive pill ev Rb¥weiwZKiY wcj Lv‡”Q, GB Rb¥weiZxKiY wc‡ji wi¯‹
d¨v±i Avevi Avjv`v| GUvi Kvi‡Y eøK RwbZ ü`‡ivM n‡Z cv‡i| GLb Dwb †hUv
ej‡Z‡Q Dbvi cwikÖg Ki‡j e¨_v nq wKš‘ Dbvi BwmwR ¯^vfvweK| GLb GB cÖm‡½
Avwg Av‡MI Av‡jvPbv K‡iwQ †h, BwmwR ¯^vfvweK, BwmwR mvaviYZ A¯^vfvweK nq
ZLb hLb Avcbvi eøK Gi gvÎv Lye †ewk †e‡o hvq| GK`g 90-95% eøK n‡q hvq
†hLv‡b KvwW©qvK gv‡m‡j i³ mieivn GK`g n‡”QB bv| A_ev nv‡U©i Ab¨vb¨ mgm¨v
Av‡Q †hgb nv‡U©i Iqvj †gvUv nIqv Ab¨_vq wKš‘ nvU© G¨vUvK Gi Av‡M BwmwR‡Z
mgm¨v cvIqv hvq bv| Zvn‡j Avgiv wK nvU© G¨vUvK nIqv ch©šÍ A‡cÿv Kie, Aek¨B
bv Gi Av‡M cixÿv-bxwiÿv K‡i Avgv‡ì wbwðZ n‡q wb‡Z n‡e †h Avgv‡ì eøK
RwbZ ü`‡ivM Av‡Q wKbv ev eøK Av‡Q wKbvÑ †mRb¨ Avgiv BwUwU Kivi Av‡M Dbvi
fvj¦ RwbZ ü`‡ivM ev Ab¨ †Kvb mgm¨v Av‡Q wKbv †hLv‡b BwUwU Kivi mgq wi¯‹ hw`
bv nq, †m‡ÿ‡Î Avgiv B‡Kv KvwW©IMÖvg Uv K‡i wb‡q GKUv G‡mm K‡i †bB,

KvwW©qvK fvj¦ Ges gv‡m‡ji| GUv Kivi ci Avgiv Zvi BwUwU Ki‡Z cvwi| †h‡nZz
Dbvi Aí cwikÖ‡g ev wmuwo w`‡q DV‡Z †M‡j e¨_v n‡”Q Zvn‡j Avgiv a‡i wb‡Z cvwi
nqZ BwUwU †Z cwRwUf Avm‡e A_ev BwUwU‡Z †PÄ cvIqv hv‡e - hw` BwUwU‡Z †PÄ
ev cwRwUf Av‡m Zvn‡j Stage 1 A_ev Stage 2 †Z cwRwUf P‡j Av‡m A_©vr Aí
GKUz nuvUvi ciB Dbvi BwmwR‡Z †PÄ P‡j Av‡m, Avgiv †h ewj BwUwU A¯^vfvweK,
ZLb Avgiv G¨vbwRIMÖvg GWfvBm Ki‡Z cvwi †ivMx‡K|
Dc¯’vcK: Zvn‡j Avgv‡ì wm×všÍ †ivMx‡K wbKU¯’ †h‡Kvb GKRb ü`‡ivM we‡klÁ
mv‡_ K_v e‡j BwUwU †U÷ Uv K‡i †bIqv DwPZ| Wvt evwK mv‡ne Avcbvi Kv‡Q
Rvb‡Z PvB †h, Avgv‡ì Rb‡Mvwôi wKQz †Q‡j †g‡q Av‡Q, wKQz eq¯‹ Av‡Q , wKQz
e„× Av‡Q, GB †h Rb‡Mvwô, ü`‡ivM wKš‘ KvD‡K Qvo †`q bv| Avcbvi Wvt evwK
mv‡n‡ei Kv‡Q Avgvi cÖkœ wK‡kvi eq‡m ev R‡b¥i c‡i ev”Pv‡ì ü`‡ivM n‡Z cv‡i
wKbv- GB e¨vcv‡i Avgv‡ì `k©K‡ì D‡Ï‡k¨ hw` GKUz ej‡Zb?
Wvt Gg. G. evwK: abëv`, Avcbv‡K GB cÖkœUv LyeB ¸iæZ¡c~b©| Avgv‡ì GKUv aviYv
Av‡Q AviwK ü`‡ivM GKUv cÖvß eq¯‹ †jvK‡ì nq| G Rb¨ Avgv‡ì wkï wK‡kvi
A_ev ZiæY ev hyeK GB ai‡bi hviv wKbv cÖv_wgK ¯Í‡i Av‡Q Zv‡ì hw` ey‡K e¨_v
ev k^vmKó GB ai‡bi mgm¨v nIqvi ci cwievi †_‡K wbwðZ Kiv nq †h †Zvgvi GB
eq‡m GB mgm¨v †Zgb wKQzbv, Zzwg †Zvgvi gZ Pjv‡div Ki, LvIqv-`vIqv Ki wKš‘
GLv‡b gRvi GKwU welq n‡jv ü`‡ivM wKš‘ me eq‡mi me gvby‡liB nq| ü`‡iv‡Mi
aibUv Avjv`v| Avgv‡ì cÖvß eq¯‹ gvby‡li †h ü`‡ivM nq mPivPi †mUv‡K ewj
K‡ivbvwi AvUv©wi ev nv‡U©i i³bvwj‡Z eøK| GKev‡i wkï eq‡m gv hw` †Lqvj K‡ib
†h Zvi ev”PvUv Lv‡”Q bv Ges wK LvIqvi mgq Zvi k^vmKó n‡”Q A_ev †kvevi ci
†`Lv †Mj †h ev”PvwU †hgb k^vm †bIqv DwPZ Zvi †_‡K Nb Nb k^vm wb‡”Q Zvi
k^vmKó n‡”Q| Zvn‡j mv‡_ mv‡_ wPwKrm‡Ki civgk© †bqv DwPZ KviY GUv GKUv
Rb¥MZ ü`‡iv‡Mi jÿY| gvbyl †hgb †VuvU KvUv wb‡q Rb¥MÖnY K‡i, A‡b‡K GK‡PvL
wb‡q ev AÜZ¡ wb‡q Rb¥MÖnY Ki‡Z cv‡ib| wVK GKBfv‡e nv‡U©i wKQz wKQz
GebigvwjwU wb‡qI wKš‘ wkï Rb¥MÖnY K‡ib| ZLb †m mKj wkï mvaviYZ cÖv_wgK
jÿYB nq wKš‘ k^vmKó Ges GB wkïUvi wkï eq‡m k^vmKó bv n‡jI A‡bK mgq
(4-6) eQi eq‡m hLb †m ¯‹z‡j hvq ZLb †`Lv hv‡”Q †h, Ab¨ ev”Pv¸‡jv
¯^vfvweKfv‡e gv‡V †nu‡U †eov‡”Q wKš‘ Aci w`‡K †mB ev”PvUv (5-10) wgwbU ci †m
e‡m hv‡”Q Ges †m Awf‡hvM K‡i †h Avwg nvwc‡q hvw”Q| GB Awf‡hvMUv‡K wKš‘ gv
evev‡ì Aek¨B ¸iæZ¡ mnKv‡i †`Lv DwPZ Ges ch©v‡jvPbv Bs‡iRx‡Z †hUv‡K Avgiv
excludate ewj| Zvi †h k^vmKó Uv n‡”Q GUv wK Zvi i³ ¯^íZvi Rb¨, IRb K‡gi
Rb¨ bvwK nv‡U©i g‡a¨ mgm¨v n‡”Q †mUvi Rb¨ †hgb Avwg GKUv K_v Av‡MI e‡jwQ
†h Rb¥MZ ü`‡ivM †_‡K wKš‘ k^vmKó nq, ey‡K wKQz e¨_v n‡Z cv‡i| GUvi g~jZ
k^vmKó nq evošÍ Kg nq myZivs GUv wKš‘ gv evev‡ì †Lqvj Ki‡Z n‡e| Avi
ZiæY‡ì †Zv Av‡iv mgm¨v GKUv ZiæY †Q‡j hw` e‡j Lye my›ì †Pnviv I‡qj †MÖv_|

wKš‘ †m hw` e‡j †Kvb wKQy Ki‡Z †M‡j ev Aí‡Z Avwg nuvwc‡q hvw”Q, Avgvi ey‡K
e¨_v nq GUv Lye †bM‡jK‡UW GKUv welq nq d¨vwgwj‡Z| Avwg GUv‡ZI eje KviY
ZiæY‡ì wKš‘ Ab¨ †ivMI nq Avcbviv wbðqB `k©K‡ì e‡j‡Qb †h, evZR¦i ej‡Z
GKUv welq Av‡Q| evZR¦i cÖ_gZ wMiv e¨_v wb‡q nq, A‡bK mgq R¦i nq, R¦i P‡j
hvq, †ivMx fz‡j hvq gv-evev, fz‡j hvq †h, Zvi mšÍvb‡bi evZR¦i KLbI n‡qwQj|
wKš‘ GB evZR¦i nv‡U©i wfZ‡i ïiæ †_‡KB GKUv cwieZ©b m„wó Ki‡Z Ki‡Z nv‡U©i
fvj¦ †K ms‡KvwPZ K‡i †d‡j, wPKb K‡i †d‡j A_ev †Kvb †Kvb †ÿ‡Î fvj¦ eÜ
n‡Z mgm¨v m„wó K‡i †d‡j 2 iKg nq| GKUv n‡jv fvj¦ †QvU n‡q hvq, Av‡iKUv
n‡jv fvj¦ wj‡KR n‡q hvq| G¸‡jv †K Avgiv wiI‡gwUK nvU© wWwRR ewj| GB
wiI‡gwUK nvU© wWwR‡R ZiæYiv wKš‘ †ewk AvµvšÍ nq Ges ZvivB wKš‘ cÖ_g Awf‡hvM
†hUv e‡j Avgvi eyK aico Ki‡Z‡Q Ges Avgvi Kv‡Q g‡b nq †h, †ewk nuvU‡j ev
†ekx cwikÖg Ki‡j Avwg nuvwc‡q hvw”Q| A‡bK †ÿ‡Î †`Lv hvq, hv‡ì ¯^v¯’¨ fv‡jv
†`L‡Z GKUz my`k©b Zviv j¾vq ZLb Zv‡ì D³ mgm¨v¸‡jv n‡jI Kv‡iv Kv‡Q
e‡jbv Avevi A‡bK mgq cwievi †_‡KI wbwe©Kvi Kiv nq| wKš‘ Avwg eje hLbB
†KD †Kvb Awf‡hvM K‡i GB Awf‡hvMUv †Zv †m wg‡_¨ e‡jbv| Avwg †ivMx‡ì †K
†hUv ewj †h, Avcbvi †Q‡j †Zv Avi Awfbq Ki‡Z‡Qbv, Zvi †Zv mgm¨v n‡”Q e‡jB
Avcbv‡ì Rvbv‡”Q| GLb GB mgm¨vUv ¸iæZi bvwK †mUv wbwðZ nIqvi Rb¨
`qvK‡i GKRb we‡klÁ Wv³vi †`wL‡q Avcwb wbwðZ n‡Z cv‡ib| gRvi GKwU
NUbv ewj, wKQzw`b Av‡M GKwU AZ¨šÍ my›ì 30 eQ‡ii †Q‡j Avgvi †P¤^v‡i G‡m‡Q
Ges †m wkwÿZ †Q‡j| †m `xN©w`b hver k^vmKó wb‡q fyM‡Qb wKš‘ †m †mUv gy‡L wb‡R
¯^xKvi Ki‡Qb bv, †m ej‡Qb Zvi mgm¨v cÖvq mgq Zvi VvÛv Kvwk nq Ges Avwg
†`Ljvg †m 2-3 Rb Wv³vi‡K †`wL‡q‡Q, GKUz Rywbqi †j‡f‡ji Gi †Zv VvÛv Kvwk
†h‡nZz ej‡Q Zv‡K ZvivI VvÛv Kvwk wn‡m‡eB wPwKrmv w`‡q‡Qb wKš‘ Avwg hLb
†`Ljvg Zvi evZR¦i RwbZ nvU© Gi †ivM n‡q Zvi A‡bKUv GWfvÝ GKUz †ewk Stage
G P‡j †M‡Q Ges Zvi fvj¦ Uv A‡bKUv ms‡KvwPZ n‡q †M‡Q, †hUv‡K Avgiv Wv³vwi
fvlvq gvBU©vj †÷‡bvwmm ewj| gvBUªvj †÷ª‡bvwmm gv‡b, gWv‡iU wcwfAvi †ewk
A‡bKUv GWfvÝ n‡q †M‡Q Ges hvi Rb¨ Zvi evi evi k^vmKó n‡”Q| GUv‡K †m wb‡R
Ges Zvi cwievi evi evi VvÛv Kvwk e‡j e¨L¨v Ki‡Q|
Dc¯’vcK: Avgiv eyS‡Z †c‡iwQ VvÛv Kvwk n‡jB †Kvb cÖKvi Ae‡njv bv K‡i mv‡_
mv‡_ we‡klÁ civgk© wb‡Z n‡e| AmsL¨ abëv`, evwK mv‡ne| Avgv‡ì GKRb
`k©K Av‡Qb †dv‡b, Zvi cÖkœwU Avgiv wb‡q †bB| wcÖq `k©K Avmvjvgy AvjvBKzg,
Avcbvi cwiPq w`‡q cÖkœwU Kiæb| g‡b n‡”Q Avgv‡ì jvBbwU †K‡U wM‡q‡Q `k©K,
Avgiv †QvU GKwU weiZxi ci wdiwQ ZZÿb ch©šÍ Avgv‡ì mv‡_B _vKzb|
weiZxi ci Avev‡iv mevB‡K ¯^vMZg| Wvt †ZŠwdK Avcbvi Kv‡Q Rvb‡Z PvB- Rvbvi
Av‡M GKRb `k©K Av‡Q †dv‡b, Pjyb Zvi cÖkœwU Avgiv wb‡q †bB| `k©K Avcbvi
cwiPq w`‡q cÖkœwU Kiæb|

`k©K 3 : Avwg iscyi †_‡K †mŠif ejwQjvg| Avwg cÖwZw`b mKvj †ejv nuvU‡Z †ei
nB ev †ùŠov‡Z †ei nB, †mB mgq hLb Avwg †÷ªwPs Kwi ZLb †`Lv hvq †h, ey‡Ki
evg cv‡k nVvr K‡i e¨_v D‡V hvq, †m e¨_v wb‡q GLbI K_v ejwQ Avcbvi m‡½|
Avgvi eqm eZ©gv‡b 32 eQi Pj‡Z‡Q, Avgvi IRb 75 †KwR| GQvovI Avgvi
Av‡iKUv mgm¨v nq, hLb †Kvb fvwi KvR Kijvg ZLb †`Lv hvq †h, ey‡K nVvr K‡i
Uvb jvM‡Z‡Q Ges GB e¨_vUv cÖvq 5-7 w`b hver †_‡KB hvq| Avwg BwmwRI
K‡iwQjvg wKš‘ BwmwR‡Z †Zgb †Kvb mgm¨v Av‡mwb| †Zv GB gyû‡Z© Avgvi KiYxq
wK †mUv GKUy Rvb‡Z Pvw”Q?
Dc¯’vcK: Avcbvi cwiev‡ii Kv‡iv †Kvb nv‡U©i mgm¨v Av‡Q? Avi Avcwb wK aygcvb K‡ib?
`k©K 3 : bv, cwiev‡ii Kv‡iv nv‡U©i mgm¨v bvB Ges Avwg aygcvb Kwi bv|
Dc¯’vcK: †`Lyb ózwWIi civgk© w`‡q Avcbvi n‡e bv| Avcbv‡K wbKU¯’ †h‡Kvb
nvmcvZv‡j wM‡q Wv³v‡ii civgk© †bqv DwPZ 1| 2 bv¤^vi Avcbvi †hgb BwmwR‡Z
bigvj Avm‡Z cv‡i, B‡Kv‡Z bigvj Avm‡Z cv‡i, BwUwU‡ZI bigvj Avm‡Z cv‡i
†mB‡ÿ‡Î Avcbv‡K Av‡iv G‡mm‡g›U Ki‡Z n‡e| A‡bK mgq Avgiv widvW© †cBb
ewj, Nvo †_‡K e¨_v ey‡K Avm‡Z cv‡i, †cU †_‡K e¨_v ey‡K Avm‡Z cv‡i, GB
†ÿ‡Î wKQz cixÿv Av‡Q †hUv Avcwb Avcbvi Wv³v‡ii mv‡_ K_v e‡j Avcbvi †h
mgm¨v †mUvi mgvavb Avcwb cv‡eb| GB wel‡q Avgiv Avkvevw` abëv` Avcbv‡K|
Av”Qv, dviæK mv‡ne Avcbvi Kv‡Q Rvb‡Z PvB, Avgv‡ì iscyi †_‡K †h K_v ej‡Qb
iscy‡ii g‡Zv cÖZ¨šÍ AÂ‡j GKRb e¨vw³i ey‡K e¨_v n‡”Q, Avi XvKv kn‡i GKRb
e¨vw³i ey‡K e¨_v n‡”Q, GLb wK †Kvb cixÿvi gva¨‡g Avwg XvKv †_‡K wbwðZ
Ki‡Z cvwi †h, GwU nv‡U©i e¨_v GKUz ej‡eb wcøR----
Wvt †ZŠwdKzi ingvb: GLb iscy‡ii cÖZ¨šÍ AÂ‡j †m cwikÖg Ki‡Z †M‡j †evSv gv_vq
wb‡q nuvU‡Z †M‡j Zvi nqZ eyK a‡i Avm‡Z‡Q, GLb hw` GB ai‡bi mgm¨v nq Zvi
gv‡S gv‡S ey‡K e¨_v n‡”Q Zvn‡j Dwb KvQvKvwQ ¯^v¯’¨ Kg‡cø· G wM‡q BwmwR K‡i
†`L‡Z cv‡i| Avgiv Av‡jvPbv Kijvg †hUv BwmwR †Zv bigvj Avm‡Z cv‡i, nv‡U©i
mgm¨v aiv bvI ci‡Z cv‡i, †m‡ÿ‡Î Dwb hw` mì nvmcvZv‡j Av‡m, †Rjv mì
nvmcvZv‡j cÖvB‡fU †m›Uvi Av‡Q ev †Rjv mì nvmcvZv‡ji A‡bK RvqMvq GLb
B‡Kv †gwkb Av‡Q, BwUwU †gwkb Av‡Q| myZivs B‡Kv Avi BwUwU K‡i †gvUvgywU †m
Kbdvg© n‡Z cvi‡e Zvi nv‡U© eøK RwbZ †Kvb mgm¨v Av‡Q wKbv ev Ab¨ †Kvb mgm¨v
Av‡Q wKbv|
Dc¯’vcK: Wvt †ZŠwdK, Ggb †Kvb i³ cixÿv wK Av‡Q, †hUvi gva¨‡g Avgiv
cÖv_wgK Ae¯’vq Rvb‡Z cvie †h, bv GUv nv‡U©i mgm¨vi Rb¨ n‡”Q?
Wvt †ZŠwdKzi ingvb: GLb Ggb hw` nq, Kv‡iv †h cÖPÛ ey‡K e¨_v n‡”Q, GB e¨_v‡K
Avgiv nv‡U©i e¨_vi g‡Zv g‡b Ki‡ZwQ hw` GUv nvU© G¨vUv‡Ki e¨_v nq, Zvn‡j

BwmwR Ki‡j BwmwR‡Z †PÄ Avm‡Z cv‡i| Avevi KLbI KLbI cwieZ©b bvI Avm‡Z
cv‡i, †mB †ÿ‡Î Avgiv †Uªv‡cvwbb-AvB cixÿv Kwi, GLb †gvUvgywU mg¯Í mì
nvmcvZv‡j miKvix Ges cÖvB‡fU †m›Uv‡i mnRjf¨, †mB‡ÿ‡Î Dwb Dbvi †h e¨_vUv
†mUv wK MjeøvWvi Gi e¨_v, bvwK M¨vwóª‡Ki e¨_v, bvwK nv‡U©i e¨_v Ges ILv‡b †m
wK fwZ© _vK‡e, bvwK cÖv_wgK wPwKrmv wb‡q †m Av‡iv DbœZ wPwKrmvi Rb¨ eo †Kvb
†m›Uv‡i hv‡e †mUv †m wbY©q Ki‡Z cvi‡e| Avi XvKv kni n‡j hw` Kv‡iv ey‡K Zxeª
e¨_v nq, Zvn‡j Zvi Av‡kcv‡k †h‡Kvb WvqvMbwóK †m›Uvi Av‡Q, †mLv‡b wM‡q †m
BwmwR Ki‡Z cv‡i| hw` †`‡L †h, BwmwR †PÄ Avm‡Q, ZLb Zvi DwPZ Avm‡j †hme
nvmcvZv‡j cÖvBgvwi wcwmAvB nq A_©vr m‡½ m‡½ Avgiv †h G¨vbwRIMÖvg K‡i †h
eøKUv cvIqv hvq †mB eøK Uv Ly‡j w`‡q wis jvwM‡q w`‡Z cvwi| A‡bK mgq wisI jv‡M
bv| Avgiv GK ai‡bi Jla †`B, hvi Rb¨ †hB eøK Uv _v‡K †mB eøKUv Qz‡U hvq|
†Zv GB †ÿ‡Î GB †h wPwKrmv cÖvBgvwi wcwmAvB, GB wPwKrmvUv Avgiv ZLbB Ki‡Z
cvie Avi Zv‡ìB Ki‡Z cvwi hviv XvKv‡Z Ae¯’vb Ki‡Qb| †Zv †mBRb¨ mevi cÖwZ
Avgvi Aby‡iva †h, Avcbv‡ì Kv‡iv hw` KLbI ey‡K Zxeª e¨_v nq, ZLb m‡½ m‡½
Avcwb Avcbvi wbKU¯’ †m›Uv‡ii Av‡k cv‡k †Kv_vI BwmwR K‡ib Ges H Wv³vi hw`
Avcbv‡K e‡j †h, Avcbvi nvU© G¨vUv‡Ki g‡Zv n‡q‡Q, Zvn‡j †mB †ÿ‡Î †h †m›Uv‡i
Avgv‡ì cÖvBgvwi wcwmAvB nq, mvaviYZ AwZ `ªæZ hw` †mLv‡b P‡j hvb ZLb
me‡P‡q fv‡jv wPwKrmv cv‡eb| ejv hvq †h, †hB wPwKrmvUv wZwb ZLb cv‡eb, H
wPwKrmv Dbvi nvU© Av‡Mi †h ÷ªvKPvi G wQj wVK †mB iKg Ae¯’vq Dwb wd‡i cv‡eb
Ges GwU evsjv‡`‡ki XvKv kn‡i wewfbœ †m›Uv‡i n‡”Q|
Dc¯’vcK: Wvt †ZŠwdK, AmsL¨ abëv` Avcbv‡K| Av”Qv evwK mv‡ne, Avcbvi Kv‡Q
Rvb‡Z Pvw”Q, Avgv‡ì Kv‡Q Ggb A‡bK †ivMx Av‡m hviv e‡j †h, m¨vi, Avgvi ey‡K
e¨_v Av‡Q Avwg G¨vbwRIMÖvg K‡iwQ| GLb cÖkœ Av‡Q †h, wKQz wKQz †jvK G‡m
Avgv‡ì e‡j †h, m¨vi, Avgvi ey‡K e¨_v n‡”Q, Avwg GKUz wmwU G¨vbwRIMÖvg Ki‡Z
PvB, Zvn‡j Wvt evwK mv‡ne GKRb e¨vw³ hLb wmwU G¨vbwRIMÖvg Ki‡Z Pv‡”Q, Zvi
g‡a¨ hw` eøK aiv c‡i Avevi Zv‡K wK K‡ivbvwi G¨vbwRIMÖvg G †h‡Z n‡e? Avcbvi
Kv‡Q Avgiv GUvB Rvb‡Z PvB †h, †Kvb G¨vbwRIMªvgUv †ewk Kvh©Kwi| KLb wmwU
G¨vbwRIMªvg Ki‡j fv‡jv nq Avi KLb K‡ivbvwi G¨vbwRIMÖvg Ki‡j fv‡jv nq, hw`
Avgvi `k©K‡ì D‡Ï‡k¨ GKUz e‡jb?
Wvt Gg. G. evwK: Avwg cÖ_‡g †hUv eje GUv Gi Av‡MI e‡jwQ †h, †Kvb e¨vw³i hw`
ey‡K e¨_v nq, ZLb wb‡R †Kvb wm×všÍ bv wb‡q GKRb AwfÁ ü`‡ivM we‡kl‡Ái
Kv‡Q wM‡q Avcbvi mgm¨vi K_v ¸‡jv fv‡jvfv‡e e¨vL¨v K‡ib| Avm‡j GKUv wRwbm
nq wK, ïaygvÎ Jla w`‡qI wKš‘ Amy‡Li †Mvov Aew` †cŠuQv‡bv hvq bv ev †gBb
mgm¨vUv Ly‡R cvIqv hvq bv| AmyL wbY©‡qi g‡a¨ wZbUv cvU© Av‡Q, Zvi g‡a¨ GKUv
n‡jv †ivMxi wnw÷ª wdwRK¨vwj wPwKrmv| Avwg mKv‡j GKUv †m›Uv‡i ewm, †mLv‡b
†`wL A‡bK †ivMx Avm‡Z‡Q wb‡R wb‡R cixÿv Kivi Rb¨| BwmwR, B‡Kv K‡i

Avgv‡K Avevi mvgbv mvgwb wR‡Ám K‡i
†bq †h, Wv³vi mv‡ne, Avwg fv‡jv AvwQ
†Zv, Avgvi nvU© wVK Av‡Q †Zv, DË‡i
Avwg ewj †h, Avcbvi BwmwR Ges B‡Kv
fv‡jv Av‡Q| cÖkœUv n‡jv BwmwR fv‡jv,
B‡Kv fv‡jv Av‡Q gv‡b Wvt †ZŠwdK †hUv
ej‡jb| myZivs wnw÷ª ¸iæZ¡c~Y© wK
ai‡bi e¨_v nq hw` Wv³vi mv‡ne g‡b
K‡ib †h, wUªwcK¨vj nv‡U©i e¨_v Ges
†mUv †ekx ch©v‡qi, Zvn‡j Avgiv BwUwU
bv K‡i mivmwi G¨vbwRIMÖvg Gi K_v ewj bv¤^vi 1| bv¤^vi 2 n‡jv Avgiv hw` †`wL
†h, Dwb BwUwU K‡i †d‡j‡Qb ev nvjKv cvZjv e¨_v hvi Rb¨ Avgiv BwUwU Kijvg
Ges BwUwU Kivi c‡i †hUv Wvt †ZŠwdK Av‡MB e‡j‡Qb ÷ªswj cwRwUf| BwUwU gv‡b
wK GKUv BwmwR, †hUv Avgvi nvU©‡K Stress w`‡q †ùŠov‡q †ùŠov‡q Ki‡Z nq GwUB
n‡”Q BwUwU| Avgiv BwmwR hLb Kwi, ZLb GKRb e¨vw³ ï‡q _v‡K Avi GUv‡K
e‡j Resting BwmwR Ges GB Resting BwmwR‡Z wKš‘ mewKQz Av‡m bv| wKš‘ hLbB
H e¨vw³i BwUwU Kivi mgq †gwk‡b †ùŠov‡”Q Ges †ùŠov‡bvi mgq Zvi nv‡U© †h Pvc
m„wó n‡”Q Ges †mB mg‡q †h BwmwRUv n‡”Q, †mB BwmwR‡Z wKš‘ nv‡U©i eøK Av‡Q wKbv
†mUv P‡j Av‡m| hw` Avwg †`wL †h, †h e¨vw³ nv‡U© e¨_v wb‡q Avgvi Kv‡Q
G‡mwQ‡jb, Zvi BwUwU †Z Lye †PÄ P‡j Avm‡Q †hUv Lvivc| Zvn‡j Avwg g‡b Kwi
†h, mivmwi G¨vbwRIMÖvg Kiv fvj, KviY mivmwi G¨vbwRIMÖvg Uv Ki‡j Avwg Zv‡K
wPwKrmvUv w`‡Z cvie| G¨vbwRIMÖvgUv †Zgb wKQzbv G¨vbwRIMÖvg Uv n‡jv G·-†i
g‡Zv| GUv i³bvwji g‡a¨ GKUv Jla w`‡q i³bvwji wfwWI Kiv nq, Av‡iKUv Z_¨
†hUv Rvbvw”Q Avcbv‡ì †h, gvby‡li Av‡M G¨vbwRIMÖvg mg‡Ü GKUv fxwZ wQj 24
N›Uv ev A‡bK mgq 48 N›Uv nvmcvZv‡j fwZ© _vK‡Z n‡Zv Avevi weQvbv‡Z ï‡q
_vK‡Z n‡Zv 12 N›Uv| weQvbv‡Z cÖkÖve-cvqLvbv Ki‡Z n‡Zv, cv bvov‡bv †hZ bv
BZ¨vw` fxwZ wQj| wKš‘ eZ©gv‡b Avcbv‡ì Rb¨ Lywki Lei Avm‡Q, GLb
evsjv‡`‡ki AwaKvsk RvqMv‡Z wbD †UKwbK Avm‡Q, †hUv Avgiv nv‡Zi GKUv
i³bvwj Av‡Q bvg †iwWqvj, GUv w`‡q m¨vjvBbI Kiv nq| †mB †iwWqvj i³bvwj
w`‡q G¨vbwRIMÖvg K‡i †dj‡Z cvwi Avgiv| GUvi mgq jv‡M 10-15 wgwbU Avi
†ivMx‡K nvmcvZv‡j _vK‡Z nq 4-5 N›Uv| †ivMx nvmcvZv‡j Av‡m fwZ© nq, wKQz i³
cixÿv Kiv nq, Zvici Avgiv †hUv Kwi mgqUv jv‡M 10-15 wgwbU Ges 4 N›Uv ci
†ivMx P‡j †h‡Z cv‡ib| Zvn‡j GB †h, mivmwi G¨vbwRIMÖvg Gi wfZ‡i Avgiv †h
2 Uv cvU© wb‡q K_v ewj G¨vbwRIMÖvg Avi wmwU G¨vbwRIMÖvg GB `y‡Uvi g‡a¨
cvk^©cÖwZwµqv Av‡Q| wKš‘ Avgvi g‡Z, mivmwi G¨vbwRIMÖvg AwaKZi wbivc` Ges
GLv‡b me‡P‡q myweav †hUv n‡jv †h, Avwg hw` G¨vbwRIMÖvg Kivi ci †`wL †h,
i³bvwj Lye wµwUK¨vj GKUv Ae¯’vq Av‡Q, Zvn‡j Avwg m‡½ m‡½ †mUvi mgvavb

K‡i w`‡Z cvwi| ZvB Avwg g‡b Kwi †hLv‡b ÷ªswj ey‡K e¨_v †mLv‡b m‡½ m‡½
G¨vbwRIMÖvg Kiv AwaKZi wbivc` Ges GwUB Avgvi Kiv DwPZ|
Dc¯’vcK: AmsL¨ abëv`, Wvt evwK mv‡ne| Avgv‡ì Av‡iKRb `k©K Av‡Q Avgiv
Zvi cÖkœwU wb‡q †bB| wcÖq `k©K, Avcbvi cwiPq w`‡q cÖkœwU Kiæb- jvBbwU g‡b nq
†K‡U †M‡Q| Wvt †ZŠwdK Avcwb wK †hb Supplement Ki‡Z †P‡qwQ‡jb ejyyb-
Wvt †ZŠwdKzi ingvb: mvcwj‡g›Ukb n‡jv Wvt Gg.G. evwK mv‡ne ej‡jb
G¨vbwRIMÖvg †ivMx‡ì Rb¨ ¸iæZ¡c~Y©, Zvn‡j †ivMx‡ì ZLb cÖkœ _vK‡Z cv‡i †h,
wmwU G¨vbwRIMÖvg †h Avwe®‹vi n‡q‡Q †mwU Kv‡ì Rb¨? nu¨v, Wvt evwK mv‡ne †hUv
ej‡jb, hv‡ì wbw`©ó ey‡K e¨_v Av‡Q, cwikÖg Ki‡Z †M‡j ey‡K e¨_v nq ev BwUwU
÷ªswj cwRwUf Av‡Q myZivs Zv‡ì i³bvwj‡Z eøK _vK‡eB Ges Zv‡ì wPwKrmvI
jvM‡e| nq wis wPwKrmv, bv nq evBcvm wPwKrmv jvM‡e myZivs Zv‡ì Rb¨ †Zv Ah_v
wmwU G¨vbwRIMÖvg K‡i mgq Ges UvKv bó Kivi †Kvb cÖ‡qvRb bvB| †m‡ÿ‡Î mivmwi
G¨vbwRIMªvg K‡i †`qvB fv‡jv| wKš‘ Aci w`‡K hw` †`Lv hvq †h, Bqvs †ivMx gwnjv
BwUwU Ki‡Z cv‡ibv, IRb †ekx A_ev Kv‡iv nuvUz‡Z e¨_v hvi Rb¨ BwUwU Ki‡Z
cvi‡Qbv| Gme †ivMxi †ÿ‡Î hv‡ì n‡jv eøK _vKvi m¤¢vebv Kg| GLv‡b 70%
Dc‡i eøK _vKvi m¤¢vebv Kg| †Kvb †ivMx Avm‡Q †h, m¨vi, Avgvi †Zv Wvqv‡ewUm
bvB, D”P i³Pvc bvB, ey‡K e¨_vI nq bv wKš‘ Avgiv wK fwel¨‡Z nvU© G¨vUvK n‡Z
cv‡i? Avgvi wK mgm¨v n‡Z cv‡i? GB †ivMxi assessment Gi Rb¨ wmwU
G¨vbwRIMÖvg Kiv †h‡Z cv‡i| A‡bK mgq †`wL Avgiv Bb‡fwmf G¨vbwRIMÖvg G
(20-40%) eøK I wKš‘ †PvL Gwo‡q hvq eyS‡Z cvwibv assess Ki‡Z cvwibv| B‡fb
wKQy K¨vjwmqvg wW‡cvwRkb n‡jI wKš‘ K¨vjwmqvg †¯‹vwis †hUv e‡j GUv wKš‘ Avgiv
Avgv‡ì Bb‡fwmf G¨vbwRIMÖv‡g †`L‡Z cvwibv| wKš‘ K¨vjwmqvg †¯‹vwis †hUv †h
Aí cwigvY K¨vjwmqvgI hw` wW‡cvwRkb nq, Zvn‡j GUvI wKš‘ GKUv wi¯‹ d¨v±i
fwel¨‡Z nvU© G¨vUvK n‡Z cv‡i, †m‡ÿ‡Î Avgiv wmwU G¨vbwRIMÖvg K‡i GUv wbwðZ
Ki‡Z cvwi| Gi Rb¨ Bqvs †ivMx‡ì hviv BwUwU Ki‡Z cvi‡Qbv Ges hviv Rvb‡Z
Pvq †h, Zv‡ì nvU© G mvgvb¨ cwigvY mgm¨vI Av‡Q wKbv, eøK Av‡Q wKbv, Zv‡ì
Rb¨ wmwU G¨vbwRIMÖvg Uv n‡jv DËg|
Dc¯’vcK: Av”Qv, Wvt †ZŠwdK, Avcbvi Kv‡Q Av‡iKUv wRwbm Rvb‡Z PvB †hUv wb‡q
K_v n‡”Q, aiæb GKRb e¨vw³i G¨vbwRIMÖvg n‡q †M‡Q, Zvi eøK †cjvg GLb cÖkœ
n‡”Q †Kvb eøK Gi wPwKrmv Kiv DwPZ? Kv‡iv a‡ib 30% eøK Av‡Q, Kv‡iv 50%
eøK Av‡Q, Avevi Kv‡iv 90% eøK Av‡Q AviwK †Kvb wPwKrmvUv Av‡M w`‡eb?
Wvt †ZŠwdKzi ingvb: eøK Gi wPwKrmv †hgb Avwg D`vniY ¯îæc ewj, XvKv AvwiPv
†ivW ILv‡b †hgb eøK nIqv Avi Avgvi evmvi mvg‡bi Mwj‡Z eøK nIqv GB 2Uv
eø‡Ki Zvrch© wKš‘ GK bv| XvKv AvwiPv †iv‡W 30-40% eøK n‡j jvL jvL Mvwo
AvU‡K hv‡e, Avi Avgvi evmvi mvg‡b hw` GKB cwigvb eøK nq, Zvn‡j wiKmv,

wmGbwR eo‡Rvo 4-5 Uv Mvwo AvU‡K hv‡e| myZivs 2 Uv †iv‡Wi eøK Gi gvÎv GK
n‡jI cwiw¯’wZ m¤ú~Y© Avjv`v| †Zgwb nv‡U©i i³bvwj g~j i³bvwj n‡jv 3Uv, Avwg
†ivMx‡ì D`vniY¯îæc ewj, cÙv-†gNbv-hgybvi g‡Zv g~j i³bvwj 3Uv Av‡Q|
Avgv‡ì nv‡U©i Wvb cv‡k GKUv Ges evg cv‡k 2 Uv| hw` GB wZbUv g~j i³bvwj‡Z
eøK nq, Zvn‡j mvaviYZ nv‡U©i wekvj As‡ki gvsm‡ckx ÿwZMÖ¯’ nq Ges nvU©
wVKg‡Zv Aw·‡Rb Ges Lvevi cvq bv| †m‡ÿ‡Î GB i³bvwj‡Z eøK hw` 70% †ekx
nq Zvn‡j mvaviYZ Avgiv wis jvwM‡q †`B ev evBcvm mvR©vix K‡i †`B| eøK hw`
GK ev GKvwaK nq †mUv‡ZI wKš‘ wis emv‡bv hvq, hwÌ wis emv‡Z LiP †ekx c‡i
myZivs Wv³vi civgk© Ki‡j †mB‡ÿ‡Î Avgiv evBcvm K‡i w`‡Z cvwi| hw` 70%
Gi Kg eøK nq A_ev †`Lv hvq †h, Ggb Ggb i³bvwj hvi WvqvwgUvi 2 wgwjwgUvi
Gi Kg A_©vr †QvU †QvU i³bvwj †hLv‡b Lye Aí Ask KvwW©qvK gv‡mj ev nv‡U©i
gv‡mj‡K eøvW mvcøvB †`q, Avgvi evmvi mvg‡bi eøK Gi g‡Zv| †`Lv hvq hw` †mLv‡b
†Kvb eøK nq 70-80% wKš‘ †mLv‡bI †Kvb wis ev evBcvm mvR©vixi cÖ‡qvRb nqbv|
†m‡ÿ‡Î Avgiv Jla w`‡q wPwKrmv Kwi| A‡bK mgq †ivMxiv G‡m e‡j, m¨vi,
GKR‡bi †Zv 6-7 Uv eøK wKš‘ †m‡Zv w`weŸ Ny‡i †eov‡”Q, Zvi †Zv †Kvb mgm¨v n‡”Q
bv, Zvi G¨vbwRIMÖvg Kiv n‡q‡Q| ZLb Avwg ewj nu¨v, Kv‡iv hw` 7-10 Uv eøK _v‡K,
Avgvi evmvi mvg‡bi †iv‡Wi eø‡Ki g‡Zv, Zvi †Kv‡bv wPwKrmv bvI jvM‡Z cv‡i ev
hw` 70% Gi Kg eøKI nq Zvn‡j Avcbvi wis ev evBcvm mvR©vix bvI jvM‡Z cv‡i|
wKš‘ Avcbv‡K Aek¨B wbqwgZ Jla †L‡Z n‡e, †Kbbv eøK w`b w`b evo‡ZB _v‡K
GUvB eø‡Ki wbqg|
Dc¯’vcK: abëv` Wvt †ZŠwdK, Avgiv †h eøK wb‡q K_v ejwQ| G¨vbwRIMÖvg mg‡Ü
Avgv‡ì mevi GKUv aviYv _v‡K, G¨vbwRIMÖv‡g eøK †c‡j mvaviYZ Avgiv wK Kwi
Avgiv wPwKrmv †`B †mUv Jl‡ai gva¨‡g †nvK ev Acv‡ik‡bi gva¨‡g n‡Z cv‡i|
GLb Avgvi cÖkœ G¨vbwRIMÖv‡gi c‡i wPwKrmv Pj‡Q Gici evBcvmI Kiv n‡q‡Q
†ivMxi GLbI wm¤úUg Av‡Q Zvici †ivMxi GLbI gv‡S gv‡S k^vmKó nq| GiKg
†ivMx‡ì Avgv‡ì †`‡k bv evwn‡ii †`‡k win¨vwewj‡Ukb bv‡gi 1Uv Uvg© Av‡Q †hUv
KvwW©IjwR †Z, bv me RvqMv‡ZB win¨vwewj‡Ukb †m›Uvi Av‡Q| Avcbvi Wvt Gg.G.
evwK Kv‡Q Avgiv Rvb‡Z PvB evsjv‡`‡k wK †Kvb win¨vwewj‡Ukb †m›Uvi Av‡Q wKbv?
_vK‡j KqwU Av‡Q Ges KvwW©qvK win¨vwewj‡UkbI Kiv n‡”Q Avcwb G wel‡q Rvwb
KvR K‡i _v‡Kb myZivs GB wel‡q Avgv‡ì `k©K‡ì D‡Ï‡k¨ hw` wKQz ej‡Zb-
Wvt Gg. G. evwK: abëv` Wvt †ZŠwn`, Avm‡j wK nvU©© Gi i³bvwj wWwRR GUv wKš‘
GLb †cÖv‡Mwmf wWwRR gv‡b cÖevngvb| AvR‡K GKUv i³bvwj eøK n‡jv Avwg wis
jvwM‡q w`jvg, hw` †m Lv`¨`ªe¨ ev †cÖkvi, Wvqv‡ewUm wbqš¿Y bv K‡ib GB eøK Uv
wKš‘ Av‡iKUv i³bvwj‡Z Avm‡Z cv‡i| Avcwb wKš‘ GUv evievi Bb‡fwmf Ki‡Z
cvi‡eb bv, evievi wis jvMv‡Z cvi‡eb bv| Av‡iKUv Ae¯’v nq evBcvm K‡i
†dj‡jb Zvici †mB e¨vw³ Wvqv‡ewUm wbqš¿Y Kij bv, †cÖkvi wbqš¿Y Kij bv,

aygcvb Ki‡Q Avevi I wKš‘ Zvi eøK nq Zvi Rb¨ 2qevi evBcvm wKš‘ GK`g
SzuwKc~Y©| Avcwb 2 evi evBcvm Ki‡jb ZLb eqm n‡jv 60 ZLb wK Ki‡eb| †mRb¨
mviv evsjv‡`‡k KvwW©qvK win¨vwewj‡Ukb †_ivwc Av‡Q †hUv evsjv‡`‡ki cÖ_g Avwg
Rvcvb evsjv‡`k †d«Ûkxc nvmcvZv‡j Pvjy K‡iwQjvg 2009 mv‡j, GLv‡b 2 Uv
†_ivwc †`qv nq| †_ivwc gv‡b Avevi gvby‡li g‡a¨ fzj aviYv nq †h K¨v‡gv †_ivwc
g‡b nq, Avm‡j GUv K¨v‡gv †_ivwc bv GUv GKUv wdwRI‡_ivwci g‡Zv GUvi †Kvb
cvk^© cÖwZwµqv †bB| GKUvi bvg n‡jv BBwmwc, Av‡iKUv n‡jv BGmGgAvi| †Zv GB
`y‡Uv †_ivwc nq wK nv‡U©i wfZ‡i †h i³bvwj ¸‡jv Av‡Q| Avcwb Rv‡bb †h,
Avgv‡ì cÖ‡Z¨KUv AiMvb G wKQz i³bvwj _v‡K †hUv‡K e‡j myÿ i³bvwj| GB myÿ
i³bvwj ¸‡jv‡K RvwM‡q †Zvjvi †h cÖwµqv GB KvwW©qvK win¨vwewj‡Ukb wKš‘ GUvB
K‡i| myZivs GB mg¯Í wPwKrmvi gva¨‡g hLb wis ev evBcvm Kiv hv‡”Q bv A_ev wis
ev evBcvm Kivi c‡i Avev‡iv hLb Zvi e¨_v n‡”Q Ges Dwb wKWwb dvskb ev wewfbœ
Kvi‡Y AvbwdU Av‡Q †mB mg¯Í †ÿ‡ÎB ïaygvÎ KvwW©qvK win¨vwewj‡Ukb Kiv nq Ges
†mUv †ek djcÖmy e‡j Avwg g‡b Kwi| hLb GKUv e¨vw³ Jl‡ai Dc‡i _vK‡Z‡Q wKš‘
Jla Avcbv‡K Avcbvi m¤ú~Y© cÖ‡qvRb wgUv‡Z mÿg n‡”Q bv| ZLb Aek¨B Zvi GB
KvwW©qvK win¨vwewj‡Ukb Gi ìKvi Ges Zv‡ì GB †_ivwc‡Z Avmv DwPZ| A‡bK
Wv³vi e‡jb Avcwb ïay Jla Lvb, †¯úª eënvi K‡ib Avi wKQz Kivi bvB Avcwb
GKUz wPš‘v K‡ib Avwg GKRb †ivMx Avi Avgvi Rb¨ Ggb GKUv gšÍe¨ wKš‘ LyeB
nZvkvRbK | wKš‘ nZvk bv n‡q Avwg g‡b Kwi GB KvwW©qvK win¨vwewj‡Ukb ev
BBwmwc †_ivwc ev BGmGgAvi †_ivwc Rvcvb evsjv‡`k †d«Ûkxc nvmcvZv‡j cÖ_g
Pvjy K‡i‡Q Avgvi ZË¡veav‡b | GB †_ivwc wKš‘ GB †ivMx ¸‡jv‡K nZvkv †_‡K
A‡bKUv Kg‡dvU© wdj Kiv‡e|
Dc¯’vcK: wR¦, AvgivI nZvkv MÖ¯’ n‡Z Pvw”Q bv| hw` fwel¨‡Z Avgv‡ì GUvi
cÖ‡qvRb nq Zvn‡j Aek¨B Avgiv GUv MÖnY Kie| Wvt evwK mv‡ne Avcbv‡K
abëv`| Avgv‡ì mgq GK`gB †kl| Wvt †ZŠwdK Avcbvi Kv‡Q Rvb‡Z PvB †h,
me †ivMxivB GUv Rvb‡Z Pvq †h, Avgiv wK Lve, wKfv‡e Pje cÖkœUv Avm‡j †Kgb
nIqv DwPZ Av‡M hviv nvU© Gi †ivMx Avgiv wis ev evBcvm Kwi|
Wvt †ZŠwdKzi ingvb: GKUv Kgb cÖkœ †ivMxiv nvU© G¨vUvK Gi c‡i ev nvmcvZv‡j
†_‡K hLb QzwU nq ZLb A_ev nvU© G¨vUvK Gi cieZ©x mgq hLb Avgv‡ì †P¤^v‡i
Av‡m, Avwg Kgbwj GKUv †`wL †h, †ivMxiv Lye `ye©j n‡q Av‡m †Kbbv Avgiv
nvmcvZv‡j †_‡K †ivMx‡K Qvovi Av‡M GKUv wmj †g‡i †`B Lvev‡ii GKUv ZvwjKv
†h, †ivMx wK †L‡Z cvi‡e bv Avm‡j eZ©gv‡b GB ai‡bi wiK‡g‡Ûkb bvB, GLb
wbqg n‡jv †ivMxi me LveviB †L‡Z cvi‡e wKš‘ cwiwgZ, eis cwiwgZ bv †L‡j GUv
mgm¨v Ki‡Z cv‡i| GLb Avcwb cÖwZw`b Kzmygmn GKwU wWg †L‡Z cvi‡eb| Avi
Avgiv Kgbwj GKUv K_v ewj Kg Pwe©hy³ Lvevi †Kbbv Miæi gvs‡m wKš‘ Pwe© _v‡K
A‡b‡K ZvB Avgv‡ì Ggb gvsm †L‡Z n‡e †hLv‡b Pwe© Kg Av‡Q| Avi GLbKvi †h

wRwbmUv me‡P‡q †ewk ¸iæZ¡c~Y© †hUv Avgiv IfvijyK K‡i hvB †h Avgiv ev½vwjiv
Kv‡e©vnvB‡WªW hy³ Lvevi †ewk LvB | †`Lv hvq Avgv‡ì Lvev‡ii †cø‡U 90%
Kv‡e©vnvB‡WªW Avi evwK 10% nvB †cÖvwUb ev kvK mewR _v‡K| Avi Avgiv †hUv
mevB‡K ewj hwÌ ejv _v‡K †h Kv‡ev©nvB‡WªW hy³ Lvevi 50-60% wb‡Z n‡e| wKšÍ
†h‡nZz Aí Kv‡e©vnvB‡WªW A‡bK K¨vjwi _v‡K Gi Rb¨ Kv‡e©vnvB‡WªW hy³ Lvev‡i wKš‘
Pwe© _v‡K| ZvB Avgv‡ì mK‡jiB DwPZ Avgv‡ì Lvev‡i c¨vUvb© Gi g‡a¨
Kv‡e©vnvB‡WªW hy³ Lvevi Kg †L‡Z n‡e hvi gva¨‡g Avcbvi IRb Kg‡e, IRb Kg‡j
wbtm‡›`‡n Avcbvi †cÖmvi Kg‡e Av‡iKUv †hUv n‡e Gi gva¨‡g Avcbvi Wvqv‡ewUmI
wbqš¿‡Y _vK‡e|
Dc¯’vcK: Avgv‡ì nv‡Z GK`g mgq †bB Avgiv AvR‡K hv hv Av‡jvPbv Kijvg Gi
†_‡K hw` †Kvb †g‡mR w`‡Z Pvb Avgv‡ì `k©K‡ì Kv‡Q-
Wvt Gg. G. evwK: Avwg cÖ_‡g †hUv ej‡Z PvB †h †ivM nIqvi Av‡MB Zv‡K cÖwZ‡iva
Kiv DËg| AvR‡K †hUv wb‡q Avgv‡ì Av‡jvPbv †mwU nj Ônv‡U©i eøKÕ| nv‡U©i eøK Gi
g~j Dcv`vb n‡jv aygcvb, Wvqv‡ewUm, †cÖkvi, †Kv‡j÷ij| myZivs Avmyb Avgiv
Avgv‡ì Lv`¨`ªe¨ ¸‡jv‡K wbqš¿Y Kwi Avgiv wdwRK¨vj G‡·mvBR ˆ`wbK cwikÖ‡gi
gva¨‡g Avgv‡ì K¨vjwi †K evb© Kwi| Avgiv wb‡R‡ì †cÖkvi wb‡Riv gv‡S g‡a¨ †PK
Kwi hw` Avgv‡ì †cÖkvi †ewk _v‡K Zvn‡j †mUv‡K wbqš¿Y Kwi, Wvqv‡ewUm wbqš¿Y Kwi
Avi KLbI hw` †Kvb wm¤úUg nq Zvn‡j †`wi bv K‡i `ªæZ cÖv_wgK ch©v‡q Wv³vi‡K
†`Lve hw` mgm¨v aiv c‡i Zvn‡j Aek¨B cÖ‡qvRbxq Assessment Kwi‡q wbe|
Dc¯’vcK: AmsL¨ abëv` Wvt evwK mv‡ne, wcÖq `k©K, Avgv‡ì nv‡Z GK`g mgq †bB
Avgiv AvR‡K ü`‡ivM welq wb‡q †h Av‡jvPbv KiwQjvg †mB Av‡jvPbv GLv‡bB †kl
KiwQ| Avgv‡ì ózwWI‡Z Avmvi Rb¨ Wvt Gg.G. evwK mv‡ne Ges Wvt †ZŠwdKyi ingvb
Avcbv‡ì `yRb‡KB AmsL¨ abëv`| fwel¨‡Z Avmvi Rb¨ AveviI Avgš¿Y iBj|
Wvt †ZŠwdKzi ingvb: Avcbv‡K abëv`, wRwUwf‡KI abëv`|
Dc¯’vcK: wcÖq `k©K, †h K_vwU bv ej‡jB bv 2 Rb we‡klÁ wPwKrm‡Ki KvQ †_‡K
ü`‡ivM wel‡q †h K_v ¸‡jv Rvbjvg hviv ü`‡ivM fzM‡Qb Zviv A‡bKUvB DcK…Z
n‡eb| ïaygvÎ eqm †f` bv, Rb¥ †_‡K g„Zz¨ ch©šÍ †h‡Kvb mg‡qB ü`‡ivM n‡Z cv‡i
Z‡e Zvi c¨vUvb© Avjv`v, G‡KK ü`‡iv‡Mi wPwKrmv G‡KK iKg Avi †h K_vwU
Avgv‡ì AwZw_iv evi evi e‡j‡Qb †h, Avcbvi Lv`¨ ZvwjKvq Aek¨B Pwe©hy³ Lvevi
Kg Lv‡eb| Avi hw` aygcvb ev g`¨cv‡bi Af¨vm _v‡K Aek¨B Z¨vM Ki‡Z n‡e|
Wvqv‡ewUm, D”Pi³Pvc _vK‡j wbqš¿Y ivL‡Z n‡e Avi kix‡ii IRb †ekx n‡j Zv
Kgv‡Z n‡e| wcÖq `k©K AvMvgx mßv‡n Avev‡iv bZzb †Kvb welq ev bZzb Av‡jvPbv
wb‡q nvwRi ne †mB ch©šÍ fv‡jv _vK‡eb my¯’ _vK‡eb Avevi †`Lv n‡e Avjøvn nv‡dR|

P¨v‡bj-24 wUwf‡Z cÖPvwiZ
Abyôvb t Beacon Pharmaceuticals †gwW‡Kj 24
AvR‡Ki welq t Ò†ivRvq my¯’ZvÓ
Dc¯’vwcKv: Wvt kviwgb mywg, mnKvix Aa¨vcK (cøvw÷K mvR©vwi)
Avgwš¿Z AwZw_ t Aa¨vcK (Wvt) †gvt †ZŠwdKzi ingvb
Dc¯’vwcKv: mywcÖq `k©K, ¯^vMZ
Rvbvw”Q, P¨v‡bj-24 Gi
wbqwgZ Abyôvb mivmwi
m¤úªPvwiZ ¯^v¯’¨ m‡PZb g~jK
Abyôvb exKb
ÔdvgvwmIwUK¨vjm&Õ wb‡ew`Z
Ô†gwW‡Kj 24Õ G| `k©K eQi
Ny‡i Avev‡iv igRvb gvm P‡j
G‡m‡Q Avgv‡ì gv‡S- G
igRv‡b Avgiv mevB PvB my¯’¨
†_‡K Bev`Z e‡›`Mx‡Z mgq
e¨q Kivi Rb¨| wKš‘ A‡bK mgq †`Lv hvq Lv`¨vfv‡mi Gw`K Iw`K wKsev Mig
A_ev Ab¨ †Kvb ai‡bi Lv‡`ï cÖfv‡e n‡Z cv‡i Amy¯’Zv| wKš‘ Avgiv PvBbv GiKg
†Kvb A¯^w¯’Ki Ae¯’v‡Z Avcwb c‡ib| ZvB Avgiv AvR Avgv‡ì Abyôv‡bi welq
†i‡LwQ Ò‡ivRvq my¯’ZvÓ| Avi Avcbviv †R‡b Avbw›`Z n‡eb AvR Avgiv Avgv‡ì
Abyôv‡b Avgš¿Y Rvwb‡qwQ ¯^bvgab¨ ü`‡ivM we‡klÁ- Aa¨vcK (Wvt) †gvt †ZŠwdKzi
ingvb (dviæK), whwb Aa¨vcK I wefvMxq cÖavb (KvwW©IjwR) wn‡m‡e, K‡Y©j gv‡jK
†gwW‡Kj K‡jR nvmcvZvj, gvwbKM‡Ä Kg©iZ Av‡Qb| m¨vi, Avcbv‡K ¯^vMZ
Rvbvw”Q Avgv‡ì AvR‡Ki Abyôv‡b|
Wvt †ZŠwdKzi ingvb: †Zvgv‡KI AmsL¨ abëv` Ges P¨v‡bj 24 †KI |
Dc¯’vwcKv: `k©K, wUwfi w¯Œ‡b †`Lv‡bv bv¤^v‡i †dvb K‡i mivmwi Avgv‡ì mv‡_
†hvMv‡hvM Ki‡Z cv‡ib Ges Rvbv‡Z cv‡ib Avcbvi g‡b _vKv †h †Kvb cÖkœ ev gšÍe¨|
Avcbv‡ì cÖ‡kœi A‡cÿvq †_‡K Avgiv ïiæ KiwQ Avgv‡ì AvR‡Ki Abyôvb| m¨vi,
†h K_vwU Avgiv ejwQjvg †h, igRvb gvm G‡jB Avgiv †Póv Kwi †h‡nZz mviv eQi
GKUz Ab¨ iKg Kv‡U| GB mgqUv hv‡Z Avgiv Av‡MB cÖ¯‘Z _vK‡Z cvwi| †Zv GB
ai‡bi cÖ¯‘wZ †bqvi Rb¨ Avcwb †h‡nZz ü`‡ivM we‡klÁ cÖ_‡gB Avcbvi Kv‡Q †hUv
Rvb‡Z PvB †h, ü`‡ivMx‡ì Avcbviv GB igRvb gv‡mi Rb¨ wK ai‡bi civgk© w`‡q
_v‡Kb, Zviv wK †ivRv ivL‡Z cvi‡eb?
Wvt †ZŠwdKzi ingvb: mvaviYZ †`Lv hvq †h, †ivhvi Av‡M Avgv‡ì †P¤^v‡i †ivMx‡ì
GKUz Pvc c‡o| †ivMx‡ì cÖkœ _v‡K m¨vi, Avgv‡ì Jla¸‡jv Adjust K‡i w`b|

¯^vfvweKfv‡e Jla wZb †ejv †L‡Z nq,
wKš‘ †ivhvi g‡a¨ 2 †ejvi †ekx my‡hvMI
bvB, Zvn‡j GUv Adjustment Gi
GKUv welq Av‡Q, Avevi A‡bK mgq
†WvR Gi Adjustment Gi GKUv
e¨vcvi Av‡Q| we‡kl K‡i, GLb wKš‘ Lye
Mig co‡Q- GB Mi‡gi mgq †h mgm¨vUv
nq Avgv‡ì A‡bK Sweating / Nvg
nq| GB Sweating / Nvg nIqvi mv‡_
mv‡_ Avgv‡ì Blood Volume K‡g hvq| GB Blood Volume K‡g †M‡j wK n‡e
Zvi †cÖmvi K‡g hvIqvi GKUv cÖeYZv _v‡K| †h‡nZz †ivhv †m‡nZz GB mgqUv‡Z †Zv
cvwb ev m¨vjvBb LvIqvi my‡hvM Kg, †Zv †mB †ÿ‡Î wKš‘ i³Pvc K‡g †h‡Z cv‡i,
†Zv Avgiv hw` A‡bK mgq Anti-Hypertensive †`B Zvn‡j wKš‘y i³Pvc Av‡iv
K‡g †h‡Z cv‡i, †mB †ÿ‡Î wKš‘ †ivMxi nvB‡cv‡Ubkb ev †jv-‡cÖmvi nIqvi my‡hvM
Av‡Q, †m‡ÿ‡Î hw` †`Lv hvq †h, nvB‡cv‡Ubkb Gi my‡hvM Av‡Q Zvn‡j wKš‘ Avgiv
Jl‡ai †WvRUv Kwg‡q †`B GUv GKUv| Av‡iKUv n‡jv, A‡bK mgq †`Lv hvq,
Avgv‡ì Anti-Hypertensive drug ‡h¸‡jv Av‡Q †m¸‡jv wK nq cÖmªv‡ei gva¨‡g
cvwb †ei K‡i w`‡q †cÖmvi K‡›Uªvj K‡i| Zvn‡j cÖ¯ªv‡ei gva¨‡g cvwb †ei K‡i w`‡j
- Ggwb‡ZB †Zv sweating n‡”Q Zvici Avgiv cvwb Kg Lvw”Q, Zvici Avevi hw`
H JlaUv hw` †`qv nq- we‡kl K‡i WvB‡qv‡iwUK MÖæ‡ci Jla, †cÖmvi wbqš¿‡Yi Rb¨
Zvn‡j wKš‘ †m‡ÿ‡Î Av‡iv nvB‡cv‡Ubkb ev †jv-‡cÖmvi nIqvi my‡hvM †ekx|
†m‡ÿ‡Î GB MÖæ‡ci Jl‡ai Adjustment GiI wKš‘ GKUv e¨vcvi Av‡Q| Zvn‡j GUv
†Mj Anti Hypertensive dose adjustment. A‡bK mgq †`Lv hvq †h, †ivMxiv
wR‡Ám K‡i Zuvi nuvU‡Z †M‡j ey‡K Pvc jv‡M, e¨_v K‡i, wmuwo w`‡q DV‡Z †M‡j
e¨_v nq, Zvn‡j †m‡ÿ‡Î A‡bK mgq Kv‡iv Kv‡iv †¯úª eënvi Kivi cÖ‡qvRb nq
A_ev nVvr K‡i ey‡K cÖPÛ e¨_v n‡jv †Zv ey‡K cÖPÛ e¨_v n‡j- Avgiv †¯úª wj‡L †`B
†h, wRnŸvi wb‡P †¯úª wb‡Z n‡e ZLb †ivMx cÖkœ K‡i hw` †¯úª †bqv nq †ivhvi mgq-
w`‡bi †ejv nq, Zvn‡j Avgvi †¯úª †bqvi gva¨‡g †ivhvi †Kvb mgm¨v n‡e wKbv? †Zv
†mB †ÿ‡Î Avgv‡ì Av‡jg‡ì †h AwfgZ, hviv mvaviYZ d‡Zvqv †`q- †h‡nZz GB
mvewjs¸qvj bvB‡UªU Gi g‡a¨ †Kvb wbDwUªkb ev Lvevi bvB ev GUv Avgv‡ì kix‡i
Avjv`v †Kvb kw³ †hvMv‡e bv, myZivs GUv wb‡j Avgv‡ì †ivhv fv½‡e bv| ZvB
Avgv‡ì Wv³v‡ii civgk© Abyhvqx †¯úª Uv w`‡bi g‡a¨ hZevi †bqvi AW©vi Av‡Q,
Avgiv wVK ZZeviB GUv eënvi Ki‡Z cvie|
Dc¯’vwcKv: Avm‡jB Lye my›ì GKwU DËi, A‡b‡KiB cÖkœ _v‡K, m¨vi, GiKg hviv ev
hv‡ì †¯úª eënvi Ki‡Z nq, †h †ivRv †i‡L Zviv †mUv eënvi Ki‡Z cvi‡e wKbv?

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