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Dc¯’vcK : Av”Qv Gi ci †h cÖkœUv P‡j Av‡m †h Avcwb [Wv: gÄyiæj ] valve surgery
Ki‡jb aortic valve ev mitral valve| †Zv GB valve surgeryi c‡i GKRb †ivMx wK
Avevi my¯’ my›`i Rxe‡b wd‡i †h‡Z cv‡i-
Wv: gÄyiæj Avjg : nu¨v, cv‡i Aek¨B
cv‡i Ges A‡bK fv‡jvI _v‡K| Z‡e
Dbv‡K ixwZgZ ev gv‡m 1 evi A_ev 2
gv‡m 1 evi †h Wv³vi mv‡ne Dbvi mvR©vwi
K‡i‡Qb †h cardiac mvR©b Zvi mv‡_
†hvMv‡hvM ivL‡Z n‡e A_ev d‡jvAv‡c
_vK‡Z n‡e Kvib valve surgery Avgiv
†hUv Kwi †mUv n‡”Q Rb¥MZ fv‡e †hUv
gvby‡li _v‡K Avjøvni †`qv valve †mUv
†Zv Avgiv change K‡iB †dwj Avgiv
mechanical valve ewm‡q †`B| †mB mechanical valve G i‡³i †h ZijZv _v‡K
†mUv‡K maintain Ki‡Z nq Gi Rb¨ Avgiv blood thiner warin tablet use Kwi †Zv
GUv cÖwZ gv‡m ev (1-2) gvm ci ci Avgiv GKUv test Kwi blood Gi 1Uv n‡jv PT
Av‡iKUv n‡jv INR| Av‡iKUv n‡jv International normalized ratio (PT I INR) K‡i
Avgiv warin dose Uv adjust Kwi mvaviYZ GUv depend K‡i mitral valve G GK ai‡bi
warin Avgiv maintain Kwi Avi aortic valve G GK ai‡bi dose wn‡m‡e †h report Uv
cvIqv hvq †mUvi Dci wfwË K‡i Avgiv dose Uv adjust Kwi| gv‡b GUvi D‡Ïk¨ n‡jv
†h i³Uv‡K Zij ivLv| hv‡Z mechanical valve w`‡q i³Uv easily pass Ki‡Z cv‡i|
Zv bv n‡j †hUv nq i‡³i NbZ¡Uv †e‡o hvq i‡³i _ª¤^vm †hUv‡K Avgiv ewj _ª¤^vm ev clot
formation n‡q brain stroke Ki‡Z cv‡i|
Dc¯’vcK : Av”Qv, Wv: gÄyiæj Avcwb Av‡iKUv mvR©vwi K_v e‡jwQ‡jb †h Avgiv heart
G GKUv mvRv©wi K‡i _vwK| Avgiv cÖvqB ïwb beating heart surgery Kiv nq †Zv GB
mvR©vwiUvi wel‡q wKQz ej‡eb?
Wv: gÄyiæj Avjg : nu¨v, mvRv©wi coronary mvR©vwi, that is cardiac surgery GUvi †h
wK gRv GUv Avgiv feel Kwi wKsev Avgv‡`i senior †`i‡KI Ki‡Z †`LwQ Prof. Dr.
Nasiruddin Sir Avgvi cardiac chief wQ‡jb, †Zv m¨v‡ii mv‡_ Avwg cÖvq A‡bK w`bB
KvR K‡iwQ Ges Avgv‡`i senior doctor†`iI †`‡LwQ cardiac surgery †Z mePvB‡Z
comfortable surgery Ges patient†`i Rb¨ benefit †mUv n‡jv beating heart surgery
Dc¯’vcK : Wv: gÄyiæj GB beating heart surgery Gi gv‡bUv wK?
Wv: gÄyiæj Avjg : Beating heart surgery gv‡b n‡”Q heart cÖwZ wgwbUB cv¤ú Ki‡Z
_v‡K gv‡b heart wgwb‡U wbw`©ó cwigv‡b (78-80) evi beat K‡i| heart beat Ki‡e
Gi wfZ‡i Zvi Mv‡q †h K‡ivbvix AvU©vwi Av‡Q †mB AvU©vwi‡Z Avgiv stabilizer](https://image.slidesharecdn.com/part9bookfinal-241108073312-456ac640/85/pdf-26-320.jpg)
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ev wUwfi †nW jvBb ¸‡jv cwo| Zvn‡j †`Le ïay †h K‡ivbv cwiw¯’wZ w`b w`b Lviv‡ci
w`‡K hv‡”Q A_ev K‡ivbv cwiw¯’wZ fqsKi GKUv iæc avib Ki‡Q ev Ki‡e Ges wK
ev¯ÍeZvI Avm‡j ZvB, †Zv eZ©gv‡b mevB Rvwb Avgiv †h bZzb we‡kl variant e‡j
Indian variantI e‡j A‡bK mgq| GLb †h‡nZz AvÂwjK †Kvb welq wb‡q PvBbv wKsev
GUv wbqgI bv, †mRb¨ Avm‡j variant Uvi bvg w`‡q‡Q delta variant GLb GB delta
variant evsjv‡`‡k Avmvi c‡i B`vwbs Avgiv †`L‡ZwQ †h, kbv‡³i †P‡q hviv AvµvšÍ
n‡q‡Qb Zv‡`i‡K Genome sequence K‡i †`Lv wM‡q‡Q †h Avµv‡šÍi 60-80% delta
variant around Avm‡j hZRbB AvµvšÍ n‡”Qb Zvi †_‡K major person B †_‡K delta
variant n‡”Q| GLb †h‡nZz delta variant G n‡”Q Avgiv Rvwb GB †h variant Uv n‡”Q
†hUv India †Z already †gmvKvi w`‡q Avm‡Q ZvB Indiai eZ©gvb cwiw¯’wZ GKUz DbœwZ
n‡q‡Q GLb g„Zz¨nvi Ges Avµv‡šÍi nviI K‡g‡Q †Zv evsjv‡`‡kI Av‡¯Í Av‡¯Í mxgvšÍeZx©
AÂj w`‡q ejv n‡”Q †h GUv evsjv‡`‡ki centre w`‡K Av‡¯Í Av‡¯Í GwM‡q Avm‡Q Gi
g‡a¨ n‡jv 3Uv †hUv †h wZbUv †Rvb w`‡q Avgv‡`i g~jZ BwÛqvi mv‡_ cb¨ Av`vb-cÖ`vb
n‡q _v‡K Ges eW©vi Av‡Q we‡kl K‡i mvZÿxiv, PzqvWv½v, VvKziMuvI GB wZb A‡ji
Pvwicv‡k †h †Rjv ¸‡jv Av‡Q †h, †Rjv ¸‡jv‡Z msµg‡bi msL¨v †ewk Avi †Kvb †Kvb
A‡j †`Lv hv‡”Q 90% Gi Dc‡i Av‡Q| hv‡`i cixÿv Kiv n‡”Q Zv‡`i †_‡K †`Lv
hv‡”Q 90% Gi Dc‡i Avm‡Z‡Q| Zvi gv‡b Avµv‡šÍi msL¨v w`b w`b evo‡Z‡Q Ges
g„Zz¨nviUv †hUv gvSLv‡b K‡g wM‡qwQj, †mUv Avgiv †`L‡ZwQ †h Avevi evo‡Z‡Q|
Av‡iKUv n‡j †h mg¯Í †ivMx Avgv‡`i mxgvšÍ AÂj †_‡K Avm‡Z‡Q Avgiv †`L‡ZwQ
†h wewfbœ heart attack wb‡q †hgb heart Gi mgm¨v wb‡q Avm‡Z‡Q wKsev heart attack
cieZx© wewfbœ follow up ev cieZx©‡Z †Kvb angiogram jvM‡e wKbv A_ev angiogram
Kiv n‡j Zviv refer K‡i w`‡”Q GB †ivMx ¸‡jv‡KI Avgiv hLb †`L‡ZwQ cixÿv-bxwiÿv
K‡i GB †ivMx ¸‡jv‡K †Kb Zv‡`i heart attack Uv n‡jv Avm‡j GZw`b Zviv stable
wQj A_ev †Kvb †ivMx GgbI e‡j †Kvb complain K‡i bvB Av‡M heart attack wQj ev
ey‡K e¨_v wQj nqZ wKQz risk factor wQj G¸‡jviI hLb Avgiv cixÿv K‡i †`wL †hgb
indirect wKQz test Av‡Q Avgv‡`i †hgb CBC, CRP, Ferritin level G¸‡jv K‡i hLb
†`L‡ZwQ cÖ‡Z¨KUv level B †ewk cvw”Q Zvi gv‡b somehow Zvi K‡ivbv n‡qB GB heart
attack ¸‡jv n‡”Q|
Dc¯’vwcKv : wR¦ m¨vi Aek¨B, GB †h Avcwb GKwU ¸iæZ¡c~Y© K_v e‡j‡Qb †h, heart
attack Gi mv‡_ K‡ivbvi m¤ú„³Zv GUv wb‡q Aek¨B Avcbvi mv‡_ Avevi K_v eje
Avgv‡`i †h Av‡iKRb AwZw_ Av‡Qb ÔWv : Avn‡¤§` bvRgyj AvbvgÕ Avcbvi `„wó‡Kvb
†_‡K Avm‡j welqUv Rvb‡Z Pvw”Q †h, Avcbviv 1Uv wekvj Rb‡Mvwô wb‡q KvR K‡ib|
ev”Pv‡`i‡K wb‡q †Zv I‡`i w`‡K w`‡q Avcbv‡`i †Kvb experience hw` share Ki‡Z
Pvb GB variant Uv wb‡q I‡`i Dci wKiæc Ges †Kgb cÖfve †dj‡Q|
Wv: Avn‡¤§` bvRgyj Avbvg : m¨vi [Wv: †gv: †ZŠwdKzi ingvb] †hgb ej‡jb Avm‡j
eZ©gv‡b mxgvšÍeZx© A‡ji w`‡Ki cwiw¯’wZ GK K_vq A‡bK fqven Ges Avµv‡šÍi
msL¨v cÖwZw`bB evo‡Q Ges GB †h mxgvšÍeZx© AÂj Gi me RvqMv †_‡K Avgv‡`i](https://image.slidesharecdn.com/part9bookfinal-241108073312-456ac640/85/pdf-40-320.jpg)
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Kv‡Q †ivMx ¸‡jv Avm‡Q Avi Avwg telemedicine wPwKrmvI w`‡q _vwK| †Zv †h ai‡bi
AwfÁZv ¸‡jv Avgvi n‡”Q Zv †_‡K Avwg g‡b KiwQ †h, Avgv‡`i †`‡k †hUv n‡”Q †h
ev”Pv‡`i †ÿ‡ÎI fv‡e test Kivi AvMÖnUv Rb‡Mvôxi g‡a¨ GL‡bv M‡o I‡Vwb wKš‘ †hB
evmvq COVID positive patient Av‡Q Ges ev”Pv‡`iI hw` Avgiv IiKg symptoms†`wL
Zvn‡j Avgiv AwffveK‡`i e‡j †`B †h, Avcwb a‡iB †bb Avcbvi ev”Pvi COVID
n‡q‡Q Ges H fv‡eB Avcwb †h mg¯Í Kg©KvÛ Av‡Q Avcwb Kiæb †Zv, test Avcwb †hgbUv
e‡j‡Qb †h child Gi †ÿ‡ÎI Avgiv K‡ivbv positive fv‡jvB cvw”Q| Avevi A‡b‡K‡Zv
COVID positive report wb‡qI Avgv‡`i Kv‡Q Avm‡Q|
Dc¯’vwcKv : GB †ÿ‡Î 2Uv cÖkœ m¨vi [Wv: Avn‡¤§` bvRgyj] Avcbv‡K Ki‡Z PvB Avcwb
†hUv ej‡jb ev”Pv‡`i test Kiv‡bvi e¨vcv‡i AbvMÖn GUvi KvibUv wK gv‡b child
population wb‡qB †Zv mevB Avm‡j wPwšÍZ _v‡K, evev-gv †ewk †Zv Zv‡`i GUv bv
Kiv‡bvi wcQ‡b KvibUv wK, Avi Kiv‡bvi DcKvwiZv Uv KZUzKz-
Wv: Avn‡¤§` bvRgyj Avbvg : Avgv‡`i
†hUv GKUv fq _v‡K †h COVID test
nq Ggb GKUv RvqMvq wb‡q _v‡K ev”Pvi
hw` COVID bv n‡q _v‡K Zvn‡j †Zv
Zvi n‡q hv‡e GiKg 1Uv e¨vcvi Av‡QB
Avi mevB †hUv g‡b K‡i †h evev-gv
COVID positive nq Zvn‡j mv‡_ mv‡_
Avgv‡`i informed K‡i †h m¨vi Avgvi
†Zv positive †Zv eveyi †ÿ‡Î wK Kie Avwg ZLb †gvUvgywU 90% patient Gfv‡eB deal
K‡iwQ †h test wb‡q †Zv Avgvi Kv‡Q COVID positive patient G‡m‡QB hviv ev”Pv‡`i
positive wb‡q G‡m‡Q wKš‘ g~jZ Avwg GUvB †`‡LwQ †h hviv COVID positive n‡q‡Q
†mB evev-gv Avgv‡`i Kv‡Q Rvb‡Z †P‡q‡Qb †h Zv‡`i ev”Pv‡`i VvÛv Kvwk GB ai‡bi
symptoms develop K‡i‡Qb GLb Zv‡`i Kibxq wK-
Dc¯’vwcKv : †m‡ÿ‡Î †Zv Avcbviv ev”Pv‡`i‡K test Ki‡Z e‡jb-
Wv: Avn‡¤§` bvRgyj Avbvg : nu¨v, definitely Avwg ev”Pv‡`i COVID test Ki‡Z ewj †h
Av‡`Š positive Av‡Q wKbv Kvib Aek¨B Avcbv‡K confirm n‡Z n‡e Avcbvi ev”Pvi
COVID n‡q‡Q wKbv-Avcwb avibv K‡iB †Zv H ai‡bi treatment Zv‡K w`‡Z cvi‡eb
bv| Kvib me wKQziB †Zv GKUv protocol Av‡Q| †Kbbv Avcbvi quarantine Gi e¨vcvi
Av‡Q, Avcwb †Zv Av‡iK Rb‡K affected Ki‡Z cv‡ib bv| Zvn‡j Avwg eje definitely
Avcbv‡K Gi Rb¨ COVID test Ki‡Z n‡e| Ô†Kbbv Avcwb g‡b g‡b fve‡jB n‡e bv
†h Avgvi g‡b nq COVID n‡q‡Q †mUvi †Kvb g~j¨B Avm‡j Avgv‡`i wPwKrmv weÁv‡b
†bB| COVID positive Avcbv‡K confirm n‡Z n‡e Ges †mB protocol Abyhvqx wPwKrmv
MÖnY Ki‡Z n‡e|](https://image.slidesharecdn.com/part9bookfinal-241108073312-456ac640/85/pdf-41-320.jpg)
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Dc¯’vwcKv : wR¦ m¨vi, Avgiv Avevi K_v eje Avcbvi mv‡_ GB welqUv wb‡q| GB gyû‡Z©
GKRb `k©K †Uwj‡dv‡b Avgv‡`i mv‡_ hy³ n‡q‡Qb| `k©K Avcbvi bvg Ges eqm e‡j
Avcbvi cÖkœwU Avgv‡`i‡K Rvbvb|
`k©K 2 : nu¨v‡jv, Avmmvjvgy AvjvBKzg,
Dc¯’vwcKv : IqvjvKzg Avmmvjvg,
`k©K 2 : Avgvi MZ (4-5) w`b R¦i, VvÛv, Mjv e¨_v Avwg K‡qKw`b Av‡M ivRkvnx‡Z
†eov‡Z wM‡qwQjvg †mLvb †_‡K Avmvi ci †_‡KB Avgvi R¦i, VvÛv Avi bvcv †L‡j R¦iUv
_v‡K bv wKš‘ Ggwb‡Z me-mgq _v‡K 100 wWwMÖi gZ| GLb Avwg Rvb‡Z Pvw”Q Avgvi
eZ©gv‡b KiYxq Kx?
Dc¯’vwcKv : m¨vi [Wv: †gv: †ZŠwdKzi ingvb] Avcbvi †Kvb cÖkœ Av‡Q wKbv `k‡K©i Kv‡Q-
Wv: †ZŠwdKzi ingvb : (`k©K) Avcbvi †Kvb risk factor Av‡Q we‡kl K‡i diabetes,
high pressure ev Av‡M †Kvb angiogram K‡i‡Qb wKbv-
`k©K 2 : D”P i³Pv‡ci Jla Lvw”Q Avi diabetes Gi Rb¨ Comprid LvB Avevi ev‡Zi
mgm¨v Av‡Q Zvi Rb¨ Jla LvB|
Dc¯’vwcKv : R¦x `k©K, ab¨ev` Avcwb Avgv‡`i mv‡_B _vKzb| m¨vi [Wv: †gv: †ZŠwdKzi
ingvb] Avcwb hw` `k©‡Ki cÖ‡kœi DËiUv hw` w`‡Zb, †h‡nZz Dwb Rvb‡Z Pv‡”Qb|
Wv: †ZŠwdKzi ingvb : Av”Qv, Gi ga¨ Dwb Lye fv‡jv GKUv information w`‡q‡Qb †h
Dwb K‡qKw`b Av‡M ivRkvnx‡Z wM‡qwQ‡jb| Avgiv Gi g‡a¨ †h wZbUv †Rv‡bi K_v
ejjvg GB †Rv‡bi g‡a¨ PvcvBbeveMÄ GKwU ivRkvnxi cv‡kB Ges wfZ‡ii GKUv
eW©vi Avi Avcbvi †h‡nZz R¦i n‡q‡Q- Avwg Avgvi †ivMx‡`i‡K me mgq GKUv K_v
ewj †h GB wmR‡b nqZ GKUz e„wó c‡o nvjKv VvÛv jv‡M ¯^vfvweK wKš‘ hLb pandemic
P‡j pandemic PjvKvjxb mg‡q Kv‡iv Dc¯^M© nq we‡kl K‡i R¦i wb‡q hw` †KD Av‡m
Avwg ewj 99% †ivMx‡`i GLb †h‡nZz K‡ivbv Pj‡Q †m‡nZz K‡ivbv nIqvi m¤¢vebv
Av‡Q| Avgiv A‡bK mgq GgbI †`LwQ A‡bK †ivMx‡`i Dc¯^M© _vKv m‡Ë¡ K‡ivbv
cixÿv Kiv‡bvi ci result negative Avm‡Q wKš‘ Aci w`K w`‡q GB †ivMxiB oxyzen
jvM‡Q, Zv‡K nvmcvZv‡j fwZ© Ki‡Z n‡”Q, ICU †Z wb‡Z n‡”Q †ivMxi oxyzen K‡g
hv‡”Q ZviciI e‡j Avgvi †Zv test negative Avm‡Q †Zv GB Kvi‡b Avwg †ivMx‡`i‡K
ewj K‡ivbv direct cixÿv Kivi cvkvcvwk indirect wKQz cixÿv Av‡Q †hUv i‡³i cixÿv
wKQzUv Av‡m †hgb CBC definitely lymphocytes, countreous lico sitosis A‡bK mgq
cvB CRP cixÿv Kiv nq| CRP positive Av‡m| Ferritin level Kwi, D-dimer Kwi,
LDH Kwi KL‡bv KL‡bv CPK ev SGPT evowZ Av‡m| GB †h test ¸‡jv Av‡Q G¸‡jv
hw` Avcwb K‡ib mv‡_ mv‡_ K‡ivbvi RT PCR †h Avgiv ewj †mB test Gi cvkvcvwk
result ta Rvb‡Z cvi‡eb| Proper result Uv Rvb‡Z cvi‡eb Zvi Rb¨ Aek¨B Avcbv‡K
GKRb Wv³v‡ii ¯^ibvcb¨ n‡Z n‡e Ges Zvi civgk© Abyhvqx test ¸‡jv K‡i †`L‡Z n‡e](https://image.slidesharecdn.com/part9bookfinal-241108073312-456ac640/85/pdf-42-320.jpg)
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Avi Avcwb †h‡nZz Suspect Ki‡Qb †m‡nZz Avcwb Wv³v‡ii mv‡_ Av‡jvPbv K‡i cixÿv
¸‡jv K‡i wb‡Z cv‡ib †Kvb mgm¨v bvB| †h‡nZz Avcbvi eqm 52 eQi| hw` eq‡mi
K_v Avgiv ewj eqmUv n‡”Q me‡P‡q risk factor me K‡ivbvi Rb¨|
Dc¯’vwcKv : R¦x m¨vi [Wv: †gv: †ZŠwdKzi ingvb] ab¨ev`, Avgv‡`i mv‡_ Avm‡j Av‡iK
Rb `k©K hy³ n‡q‡Qb `k©K Avcbvi bvg Ges eqm e‡j Avcbvi cÖkœwU Rvbvb|
`k©K 3 : Avmmvjvgy AvjvBKzg, Avgvi bvg kvnxbyi, Avgvi eqm 55, Avwg wgicyi †_‡K
ejwQ| MZ eQi Avgvi K‡ivbv n‡qwQj Ges K‡ivbv‡Z Avgvi lungs Gi 70% infected
n‡q wM‡qwQjvg hvi Rb¨ Avwg nvmcvZv‡j fwZ© n‡qwQjvg Gi c‡i †hUv n‡jv Avgvi myMvi
†e‡o n‡q‡Q Avi platelets K‡g wM‡q‡Q †Zv myMvi Avjøvni ing‡Z bigv‡j P‡j Av‡m
wKš‘ platelets `xN© (3-4) gvm hver 100 wQj| K‡ivbv nIqvi Av‡M Avgvi platelets wQj
301 eZ©gv‡b platelets †b‡g 78 G `vwo‡q‡Q, Avwg Pvw”Q †h GUv †Kvb g‡Z evov‡bv hvq
wKbv Avi wKfv‡e|
Dc¯’vwcKv : m¨vi [Wv: †gv: †ZŠwdKzi ingvb] Avcbvi †Kvb cÖkœ Av‡Q wKbv Avgv‡`i
`k‡K©i Kv‡Q|
Wv: †ZŠwdKzi ingvb : bv ab¨ev`,
Avm‡j Avcbvi †hUv Av‡Q platelets
100 gv‡b n‡”Q 1,00,000 Avi 301
gv‡b 3,01,000 wQ‡jb Av‡M GLb
†mUv K‡g wM‡q 78,000 n‡q‡Q|
GLb e¨vcvi Uv n‡”Q †h GB †h Avcbvi
platelets 1,00,000 wQj Zv K‡g
78,000 n‡q wM‡q‡Q gv‡b K‡ivbvi
†h cÖK…wZ Avgiv †`L‡ZwQ †mUv n‡jv
†h K‡ivbv‡Z platelets K‡g hvq wVKB wKš‘ cieZ©x‡Z Avevi Av‡¯Í Av‡¯Í ¯^vfvweK P‡j
Av‡m| ¯^vfvweK Av‡Mi Ae¯’v‡Z bv Avm‡jI GK †_‡K †`o jv‡Li g‡a¨ P‡j hvq|
bigv‡ji w`‡K P‡j Av‡m GUvB ¯^vfvweK wKš‘ Avcbvi †h‡nZz 1 jvL n‡q Avevi 1
jv‡Li †_‡KI K‡g †M‡Q †m‡ÿ‡Î Avcbv‡K †Lqvj ivL‡Z n‡e †h, Avcbvi recurrent
infection n‡”Q wKbv- recurrent infection gv‡b Avcbvi nvjKv nvjKv R¦i n‡e, B`vwbs
†hUv Avgiv K‡ivbvi Dc¯^M© †`L‡ZwQ mg¯Í †ivMxi wKš‘ R¦i _v‡K bv| GLbKvi †ivMxiv
†h complain K‡i we‡kl K‡i delta variant Gi †ÿ‡Î nqZ nvjKv nvjKv R¦i, A‡bK
mgq †ivMx †bvwUkI K‡i bv e‡j †h, bv R¦i bv, GKUz g‡b nq paracetamol †L‡qwQj 1
†ejvi Rb¨ Avi †hUv e‡j discomfort †h †cU dz‡j _v‡K Ges Wvqwiqv nq continuously
K‡jivi g‡Zv Wvqwiqv| GB K‡jivi g‡Zv hw` Wvqwiqv nq †mUvI wKš‘ eZ©gv‡b K‡ivbvi
1wU symptoms GLbKvi delta variant Gi †ÿ‡ÎI common WvqwiqvUv †Zv †m‡ÿ‡Î
Avcwb †`L‡eb †h‡nZz Avcbvi platelets K‡g‡Q 1Uv m¤¢vebv †_‡K _v‡K Avcbvi Avevi
recurrent infection n‡q‡Q wKbv| 2 bv¤^i n‡”Q Avcbvi platelets count Uv †h †m›Uvi](https://image.slidesharecdn.com/part9bookfinal-241108073312-456ac640/85/pdf-43-320.jpg)
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†_‡K Kwi‡q‡Qb Avm‡j H †m›Uvi A_ev fv‡jv †Kvb †m›Uvi †_‡K Avevi repeat Kiv
DwPZ| hw` Avcbvi platelets K‡g hvq †m‡ÿ‡Î Avcbvi worried nIqvi wKQz bvB|
†Kbbv K‡ivbv‡Z platelets †W½yi g‡Zv bv †W½y‡Z †hgb platelets avg avg K‡i K‡g
hvq Ges Avjv`v platelets Avevi w`‡Z nq| GB K‡ivbvi †ÿ‡Î Avevi platelets †`qvi
cÖ‡qvRb nq bv| †Kbbv GB †ÿ‡Î platelets GKUv certain mg‡q G‡m c‡i Avevi Av‡¯Í
Av‡¯Í evo‡Z _v‡K| myZivs Avcbvi worried nIqvi wKQz bvB| Avm‡j Avcbvi Kibxq
†Zgb wKQz bvB Avcbv‡K ïay observe Ki‡Z n‡e, gv‡S gv‡S platelets test K‡i †h Gi
†_‡K Av‡iv †ewk K‡g hvq wKbv-Avi †m‡ÿ‡Î Avcwb hw` g‡b K‡ib Lye †ewk cÖ‡qvRb
g‡b K‡ib Zvn‡j †Kvb hematologist Gi ¯^ibvcb¨ n‡Z cv‡ib|
Dc¯’vwcKv : GUv Avm‡j KZ w`b ci ci observe Ki‡e Kvib Dwb †ek K‡qK evi
†Zv test Uv Kwi‡q‡Qb hvi Rb¨ Dwb ej‡Z cvi‡Qb-Wv: †gv; †ZŠwdKzi- MZ 1 eQi hver
test Kwi‡q‡Qb Dwb Zvi gv‡b †Kbbv Dwb K‡ivbvi Av‡M c‡i Ges eZ©gv‡b †Kgb Av‡Q
platelets Zv ej‡Z cvi‡Qb|
Dc¯’vwcKv : Zvn‡j KZ w`b ci ci platelets Uv cixÿv Kiv DwPZ Avi wK-
Wv: †ZŠwdKzi ingvb : Avgvi g‡b nq (2-3) mßvn ci ci Avcwb †`L‡Z cv‡ib †h
Avcbvi platelets Uv †Kvb w`‡K hv‡”Q| hw` platelets GKevi evov‡Z ïiæ K‡i Zvn‡j
Avcwb wbwðZ _v‡Kb †h Avcbvi platelets Av‡¯Í Av‡¯Í Av‡iv evo‡e hw`I ev infection
bv nq| myZivs Avgvi Kv‡Q g‡b nq GUv wb‡q Avcbvi Lye †ewk wPwšÍZ nIqvi wKQz bvB|
Dc¯’vwcKv : R¦x, ab¨ev` m¨vi [Wv: †gv: ˆZŠwdKzi]| Wv: bvRgyj Avcbvi mv‡_ †h welqUv
wb‡q K_v ejwQjvg ev”Pv‡`i Paediatric group Gi †ÿ‡Î †hgb GKRb `k©K-02 GLb
†dvb K‡i‡Qb Zvi platelets level Uv K‡g hv‡”Q Ges m¨vi [Wv: †gv: †ZŠwdKzi] ej‡jb
wKQz test K‡i Avgiv wKQz cwieZ©b †`L‡Z cvB RT PCR test negative Avm‡jI|
ev”Pv‡`i †ÿ‡ÎI †WvR ¸‡jv ev Zv‡Zi †ÿ‡ÎI wK test ¸‡jv similar ev Zv‡`i †ÿ‡ÎI
result wK ¸‡jv GKB iKg cv‡”Qb|
Wv: Avn‡¤§` bvRgyj Avbvg : Avm‡j Basic idea Uv GKB iKg| Avgiv I ILv‡b
complete blood count, serum ferritin, C-reactive protein, D-dimer G¸‡jv meB Kwi
Avgiv LDH Kwi Z‡e †h ev”Pv‡`i †ÿ‡Î †h symptoms †mB symptoms w`‡q Avm‡j
Avgiv assesse Kivi †Póv Kwi| A‡b‡K ev”Pv‡`i common cold wb‡q Av‡m R¦i Av‡Q,
ev”Pvi Avevi GKUz k¦vmKó n‡”Q| ZLbB Avgiv wPšÍv-fvebv Kwi †h †Kvb evwK Av‡Q
wKbv Ges †m Abyhvqx Avgvi ev”Pvi evev-gv‡K ewj †h GB certain test ¸‡jv Kiv‡eb
Ges Avgv‡K Rvbv‡eb|
Dc¯’vwcKv : Av”Qv m¨vi [Wv: †gv: bvRgyj] GB †h GLb Avcwb †h †ivM ¸‡jvi K_v ej‡jb
ev †h Dc¯^M© †Zv ev”Pv‡`i Ab¨vb¨ Amy¯’Zvi †ÿ‡ÎI n‡q _v‡K we‡kl K‡i GLbKvi †h
season Uv GB summer season G ev GLb Avevi †h elv©Kvj ïiæ n‡”Q| †Zv GLbKvi
†h †ivM¸‡jv †`Lv w`‡”Q GB mg‡q GB eq‡mi ev”Pv‡`i †m¸‡jv hw` Avgv‡`i `k©K‡`i](https://image.slidesharecdn.com/part9bookfinal-241108073312-456ac640/85/pdf-44-320.jpg)
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GKUz ej‡Zb| Kvib mvaviY †ivM¸‡jvI †Zv n‡”Q GB K‡ivbvi mv‡_B| m¨vi [Wv: †gv:
bvRgyj] GKUz Avcbv‡K disturb Kwi Avcwb ïiy Kivi Av‡M Avgv‡`i mv‡_ GKRb `k©K
hy³ n‡q‡Qb Dbvi cªkœwU wb‡q Avgiv back KiwQ- (`k©K-4) Avcbvi bvg Ges eqmwU
e‡j Avcbvi cÖkœwU Rvbvb|
`k©K 4 : AvmmvjvgyAvjvBKzg, Avgvi eveyi eqm 22 gvm, Ii 3 w`b a‡i ewg n‡”Q,
R¦i †ewk n‡”Q, Ii R¦i n‡”Q 99-100| I‡K cvwb LvIqvB ev m¨vjvBb LvIqvB ev bvcv
LvIqvB hvB LvIqvw”Q Zv‡ZB ewg Ki‡Q, Avwg GKUz e‡j †`B Avwg Avgvi gv‡qi Kv‡Q
_vwK K‡qKw`b Av‡M, Avgvi gvi eqm n‡e 94 eQi Dbvi CT scan G lungs G 25%
damage aiv c‡o‡Q Ges report G wjLv wQj mild stoke COVID positive wKš‘ Zv‡K
hLb COVID test Kiv‡bv n‡q‡Q ZLb negative G‡m‡Q report, Av¤§vi mv‡_ Avgiv
†Zgb †Kvb wgjvwgkv Kwi bvB Avgiv normal wgjvwgkvB KiwQ G‡Z K‡i Avgvi †ewe
affected n‡q‡Q wKbv ev GUv †Kvb symptoms wKbv COVID Gi?
Wv: Avn‡¤§` bvRgyj Avbvg : wR¦
ab¨ev` Avcbv‡K (`k©K-04) Lye
my›`i 1wU cÖkœ K‡i‡Qb| †`Lyb
†h‡nZz Avcbvi eveyi GKUz R¦i R¦i
Av‡Q mv‡_ ewgI Av‡Q Avevi R¦i
R¦i ewg n‡jB †h COVID e¨vcviUv
wKš‘ Zv bq| Z‡e †n Avcbvi gvi
COVID hw`I negative wKš‘ Avcwb
g‡b Ki‡Qb †h‡nZz Dbvi lungs Gi
25% affected ev infection †hgbUv Avcwb e‡j‡Qb| yes, Avgiv Zv‡K bR‡i ivLe
wKš‘ Avwg g‡b KiwQ †h, Avcwb GUv wb‡q GLbB wePwjZ n‡qb bv Avgvi †hUv g‡b n‡”Q,
Avcwb †Lqvj ivL‡eb ev”Pvi cvZjv cvqLvbv n‡”Q wKbv, Zvi ewgi c‡i cvZjv cvqLvbv
ïiæ n‡”Q wKbv| yes hw` cvZjv cvqLvbv nq Ges GUv progress Ki‡Z _v‡K ZLb
Avcwb Aek¨B wPwKrm‡Ki civgk© wb‡eb| Avwg GLb ch©šÍ g‡b KiwQ, †h‡nZz Avcbvi
eveyi 3w`b a‡i Gi Avcwb AvcvZZ †hUv Ki‡Z cv‡ib Avgiv †h¸‡jv †`B Avgiv
emistat GKUv syrup †`B Av`v PvgP K‡i 3 evi 3 w`b Ges GKUz m¨vjvBb LvIqv‡eb
wbIm¨vjvBb ev GB ai‡bi m¨jvBb K_v Avgiv ewj Avcbvi eveyi †h‡nZz 22 gvm eqm
Avgiv eje (10-15) PvgP m¨vjvBb Avcwb LvIqv‡eb Avi observation G ivL‡eb R¦iUv
evo‡Q wKbv Ges †Kvb ai‡bi cvZjv cvqLvbv ïiæ n‡”Q wKbv-ZLb Avcbv‡K Aek¨B
Wv³v‡ii wbKU ¯^ibvcb¨ n‡Z n‡e Ges hw` Wv³vi †Kvb cixÿv Ki‡Z Pvb Aek¨B
†m¸‡jv K‡i wb‡eb hw` cÖ‡qvRb nq RT PCR †mUvI Ki‡Z cv‡i wKš‘ GLb ch©šÍ Avwg
g‡b KiwQ Avcbvi wePwjZ nIqvi wKQz bvB, ab¨ev` Avcbv‡K|
Dc¯’vwcKv : A‡bK ab¨ev` m¨vi [Wv: bvRgyj] Avkv KiwQ `k©K Zvi Avkvbyiæc DIiwU
†c‡q †M‡Qb| Dwb Avm‡j Zvi ev”Pv‡K wb‡q Lye worried Zvi K_v ï‡bB eySv hvw”Qj](https://image.slidesharecdn.com/part9bookfinal-241108073312-456ac640/85/pdf-45-320.jpg)
![41
Ges GUvi KviYI i‡q‡Q Dchy³ †h‡nZz Dbvi gv infected GiKg Dbviv wPšÍv Ki‡Qb|
†Zv `k©K Avcwb wPšÍv Ki‡eb bv, m¨vi [Wv: bvRgyj] †h civgk© ¸‡jv w`‡q‡Qb †m¸‡jv
d‡jv Kivi Rb¨ Ges hw` Avcwb †`‡Lb †h Avcbvi eveyi Dc¯^M© †e‡o hv‡”Q Zvn‡j
Aek¨B wkï‡ivM we‡klÁi mv‡_ K_v e‡j †mB civgk© Abyhvqx wPwKrmv MÖnY Ki‡eb|
m¨vi [Wv: bvRgyj] †hUv wb‡q K_v ejwQjvg †h GB season G ev”P†`i wKQz common AmyL
K‡i _v‡Kb †hgb Dwb [`k©K-4] GKUvi K_v ej‡jb ewg, Wvqwiqv G¸‡jv †Zv GKUz hw`
`k©K‡`i ej‡Zb †h wK wK †ivM ev”Pv‡`i n‡q _v‡K-
Wv: Avn‡¤§` bvRgyj Avbvg : Av”Qv Avwg Dbvi cÖm½B awi †h, GB wRwbm¸‡jv Avgiv
A‡bK †ewk cvw”Q we‡kl K‡i Mi‡gi †h mgqUv‡Z Wvqwiqvi †h cÖ‡Kvc †hUv Avgiv acute
gastroenteritis disease ewj Dwb (`k©K-04) †hUv typical symptoms ej‡Qb nvjKv
nvjKv R¦i c‡i ewg ïiæ n‡q‡Q Ges suddenly cvZjv cvqLvbv ïiæ nq| GUvB ¯^vfvweK
GUvB nIqvi K_v| Zvn‡j GB wRwbm¸‡jv Avgiv LyeB cvw”Q Avi f‡qi welq n‡”Q
G¸‡jvi cÖwZUv symptoms B COVID Gi mv‡_ hvq Avi eZ©gv‡b Avgv‡`i mgm¨vUv
HLv‡bB Ges ev”Pv‡`i †ÿ‡Î Avcwb ej‡Z cvi‡eb bv †h †hgb GKUv eo gvbyl G‡m e‡j
Zvi discomfort jvM‡Q ev others symptoms Gi K_v Zviv ej‡Z cv‡i, Mjv e¨_vi K_v
ej‡Z cv‡i| GKUv ev”Pv †Zv †m¸‡jv ej‡Z cv‡ibv| ZLb Avgv‡`i‡K assess Ki‡Z
Zv‡K †`L‡Z nq Ges H Abyhvqx cÖ‡qvRbxq wmØvšÍ wb‡Z nq Avi Avcwb (Dc¯’vwcKv)
†hUv ej‡Qb nu¨v, Wvqwiqvi cvkvcvwk me mgq †hUv wbI‡gvwbqv Ges †eªvswKDjvBwUR
G¸‡jv‡Zv Avgiv me mgq cvB| commonly bronchitis B cvB 82-95% †m‡ÿ‡Î
Avgiv bronchitis cvB GB GKB †ÿ‡Î G‡ZI wKš‘ VvÛv R¦i k¦vmKó nq| Zvn‡j Gme
†ÿ‡Î Aek¨B Avcwb Wv³v‡ii civgk© wb‡eb Ges Wv³v‡ii civgk© Qvov Avcwb KLb
COVID test Kiv‡eb GUv Wv³viB Avcbv‡K e‡j w`‡Z cvi‡e| †Kbbv †KvwfW †ivMxiv
Avcbvi Kv‡Q Avm‡eB k^vmKó wb‡q| cÖPÛ k¦vmKó †mB mv‡_ R¦i bvK w`‡q cvwb ci‡Q
†h¸‡jv typical COVID patient †`i _v‡K| †h¸‡jv evev-gv‡`i worried K‡i †`q Avi
†mB mv‡_ evmvq †Kvb Kvi‡b COVID case †_‡K Zvn‡j †Zv Avwg eje Avcbv‡K Av‡iv
`ªæZ Wv³v‡ii kibvcb¨ nIqv DwPZ|
Dc¯’vwcKv : Avgv‡`i mv‡_ Av‡iKRb `k©K-05 hy³ n‡q‡Qb `k©K-05 Avcbvi bvg Ges
eqm e‡j Avcbvi cÖkœwU Kiæb|
`k©K 05 : Avmmvjvgy AvjvBKzg, Avgvi ev”Pvi Rb¨ ejwQjvg, ev”Pvi eqm 2 eQi 7
gvm Ii †`ogvm Av‡M UvBd‡qW n‡qwQj| UvBd‡qW fv‡jv nIqvi c‡i GLb †h mgm¨v
Ii cvqLvbv Lye k³ cvqLvbv Ki‡Z em‡jB Lye KvbœvKvwU K‡i G‡ÿ‡Î avolac syrup
LvIqvB‡qwQjvg wKš‘ †Kvb cwieZ©b nqwb-
Wv: Avn‡¤§` bvRgyj Avbvg : cvqLvbv KlvUv wK Zvi Av‡M †_‡K n‡Zv bvwK gv‡S gv‡S
recurrent n‡”Q
`k©K 05 : bv, m¨vi GB UvBd‡q‡Wi ci †_‡KB GB mgm¨v n‡”Q|](https://image.slidesharecdn.com/part9bookfinal-241108073312-456ac640/85/pdf-46-320.jpg)
![44
history †bqvi †Póv Kwi evi evi K‡i| †h Avcbvi wK (2-3) mßvn Av‡M wKsev hLb Uv
n‡qwQj Zvi Av‡M wK Avcbvi nvjKv nvjKv R¦i n‡qwQj ZLb †ivMx DËi †`q †h Ònu¨v
Avgvi R¦i wQjÓ|
Dc¯’vwcKv : ZLb nqZ Dbviv Rv‡bbB bv †h Dbv‡`i infection n‡qwQj wKš‘ cieZ©x‡Z
mgm¨v wb‡q Avcbv‡`i Kv‡Q Avm‡Q| R¦x m¨vi [Wv: †gv: †ZŠwdKzi ingvb] A‡bK ab¨ev`|
Avm‡j GB Z_¨¸‡jv Avgiv PvB †h Avgv‡`i `k©Kiv RvbyK- complication A_ev mgm¨v
†h ai‡biB †nvK Ae‡njv bv K‡i †hb wPwKrm‡Ki mibvcb¨ nb|
Wv: †ZŠwdKzi ingvb :- †h †Kvb
R¦i, nvjKv R¦i n‡jI †hb
Ae‡njv bv K‡ib| we‡kl K‡i
eq¯‹ †ivMx| Avi Wv³vi‡`iI
wKQy awareness Av‡Q †h,
†ivMx attack wb‡q Avm‡jv
GB †ivMxUvi hv‡Z Avwg GKUz
we¯ÍvwiZ history †bB †h, Zvi
†Kvb R¦i wQj wKsev Av‡Q wKbv
A_ev Zvi COVID test Kivi cÖ‡qvRb Av‡Q wKbv|
Dc¯’vwcKv : R¦x m¨vi (Wv: †gv: †ZŠwdKzi) Aek¨B| Wv: bvRgyj Avcbvi Kv‡QI GKB
welq wb‡q Rvb‡Z PvB †h‡nZz Avgv‡`i K_vi cÖm½ GKUvB Avi AvcwbI GKB wel‡qi
we‡klÁ cardiologist on child †Zv Avcbvi (Wv: bvRgyj) observation Uv wK ev”Pv‡`i
†ÿ‡Î|
Wv: Avn‡¤§` bvRgyj Avbvg : †`Lyb Avgv‡`i Kv‡Q Avcwb †hUv ej‡jb COVID Gi mgq
Avm‡j g~jZ Avgv‡`i Kv‡Q †hUv Av‡m VvÛv, Kvwk G¸wj| A‡bK evey Avgv‡`i Kv‡Q
hLb VvÛv-Kvwk wb‡q evi evi Av‡m| Avwg wewfbœ platform G GUv evi evi ej‡Z †P‡qwQ
Kv‡iv ev”Pvi VvÛv-Kvwk ¯^w`© n‡”Q, ev”Pvi IRb evo‡Qbv wewfbœ RvqMvq hv‡”Q, gv ej‡Q
m¨vi evKx Av‡Q †c‡jB 1Uv antibiotic w`‡”Q, nvmcvZv‡j fwZ© Ki‡Q wbD‡gvwbqv e‡j|
Avgiv Zv‡`i‡K webxZfv‡e Aby‡iva Kie wkï cardiologist †`i mv‡_ †hvMv‡hvM Kiæb
†Kbbv hw` heart G †Kvb ai‡bi Shunt lession _v‡K †hUv Avgiv ASD ewj, PDA
ewj †mvRv evsjvq hw` ewj heart G hw` †Kvb dzUv _v‡K Zvn‡j wKš‘ Zvi symptoms
GiKB n‡e| evi evi VvÛv-Kvwk n‡Z _vK‡e, ev”Pv‡K wb‡q evi evi Wv³v‡ii Kv‡Q
†h‡Z n‡e Ges ev”Pvi IRb evo‡e bv †hUv Avgiv failure to thrived ewj Ges ev”Pv j¤^v
n‡Z _vK‡e bv| GB mg¯Í symptoms hw` Avcbvi eveyi †ÿ‡Î nq ZLb mv‡_ mv‡_ wkï
cardiologist Gi mv‡_ †hvMv‡hvM Kiæb|
Dc¯’vwcKv : m¨vi (Wv: bvRgyj) GB †ÿ‡Î wkï‡`i eq‡mi mv‡_ †Kvb m¤ú„³Zv Av‡Q
wKbv-](https://image.slidesharecdn.com/part9bookfinal-241108073312-456ac640/85/pdf-49-320.jpg)
![48
Dc¯’vwcKv : ¯^v¯’¨ wewa †g‡b Pjvi †h welqUv †hUvi Dci Avgiv evievi †Rvi w`w”Q
f¨vKwm‡b‡UW _vK‡j GLb A‡b‡KB welqUv †_‡K `~‡i P‡j hv‡”Qb †Zv f¨vKwmbI hviv
†c‡q‡Qb ZvivI hv‡Z G welqUv †g‡b P‡j | [ Wv: †ZŠwdKzi ingvb ] f¨vKwm‡b‡UW hviv
ZvivI wKš‘ K‡ivbvq AvµvšÍ n‡”Q nqZ gvivZœK bv n‡jI n‡Z cv‡i| myZivs †g‡b Pj‡Z
n‡e ¯^v¯’¨ wewa|
Dc¯’vwcKv : Avcbv‡`i `yÕRb‡K A‡bK ab¨ev` Rvbvw”Q ¸iæZ¡c~Y© Z_¨¸‡jv Avgv‡`i
`k©K‡`i Rvbv‡bvi Rb¨| `k©K Avm‡j Avgiv †h Av‡jvPbv K‡iwQ †mUv‡Z Avgiv me
mgq GwK K_v e‡jwQ Avgv‡`i GLbKvi †h cwiw¯’wZ K‡ivbv GKUv msµvgK e¨vwa
GLvb †_‡K hw` Avgiv wb‡R‡`i protected ivL‡Z PvB Aek¨B ¯^v¯’¨ wewa †g‡b Pj‡Z
n‡e, f¨vKwmb †Zv Avgiv wb‡evB †mB mv‡_ wbqwgZ nvZ †avqv, gv¯‹ covi †h welqUv
Avgiv evwn‡i hvw”Q †mUv hv‡Z Avgiv Aek¨B †g‡b Pwj| Dwb Wvt bvRgyj Lye ¸iæZ¡c~Y©
GKUv K_v e‡j‡Qb, ev”Pv‡`i Rb¨ evev- gviv AbyKiYxq welq| Avcbviv hw` ‡m¸‡jv
†g‡b P‡jb Zvn‡j ev”Pviv †`‡LI †m¸‡jv wkL‡e Ges ¯^v‡¯’¨i
†h welq¸‡jv Avgiv me mgq †Póv Kwi Avgv‡`i jvBd ÷vBj
‡hUv Av‡Q †mUv hv‡Z my›`ifv‡e †g‡b Pwj| Avkv KiwQ we‡klÁ
AwZw_‡`i my civgk© ¸‡jv Avcbviv †g‡b Pj‡eb| Avgv‡`i
mv‡_ wQ‡jb Aa¨vcK Wvt †gvt †ZŠwdKzi ingvb, Aa¨vcK Wvt
bvRgyj Avbvg Avcbv‡`i `yÕRb‡K Avev‡iv ab¨ev` Rvbvw”Q|
Avcbviv `k©K fv‡jv _vK‡eb AvMvgx‡Z Avev‡iv †`Lv n‡e
Ab¨‡Kvb welq wb‡q| Avjøvn& nv‡dR|
K‡Y©j gv‡jK †gwW‡Kj K‡jR nvmcvZvj, gvwbKM‡Ä wmwcAvi (CPR) cÖwkÿY
Kg©kvjv I mb`cÎ weZi‡Yi wKQz w¯’i wPÎ](https://image.slidesharecdn.com/part9bookfinal-241108073312-456ac640/85/pdf-53-320.jpg)
Uploaded byPROFESSOR DR. MD. TOUFIQUR RAHMAN
হৃদ স্পন্দন ৯ম খন্ড (সাক্ষাৎকার পর্ব ৪) .pdf
The document outlines various protocols related to health and medical practices, specifically in the context of cardiac care as presented by Dr. Toufiqur Rahman. It includes detailed methodologies and pricing information for services and materials provided by the 'Dr. T Rahman Cardiac Care Foundation'. Additionally, contact details and promotional information for further engagement are provided.
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হৃদ স্পন্দন ৯ম খন্ড (সাক্ষাৎকার পর্ব ৪) .pdf
- 1. ü` ¯ú›`b9g LÛ iKgvwi.Kg†e÷ †mjvi eB Ôü`‡qi K_vÕ I Ôü`‡ivM cÖwZ‡ivaÕGi †jLK Aa¨vcK Wv. †gvt †ZŠwdKzi ingvb (mv¶vrKvi ce©-04)
- 2. Òü` ¯ú›`b -9g LÛ (mv¶vrKvi ce©-04)Ó Avgvi †jLv ü`‡ivM welqK m‡PZbvg~jK 17Zg eB| eBwU‡Z wewfbœ mg‡q wewfbœ †Uwjwfk‡b mivmwi m¤cÖPvwiZ †gvU 5wU mv¶vrKvi I ˆ`wbK hyMvšÍi cwÎKvq cÖKvwkZ Rxeb euvPv‡Z CPR cÖwkÿY cÖeÜ 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, GwUGb evsjv, wRwUwf, P¨v‡bj-I 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, K‡ivbv welqK Av‡jvPbv Ges igRv‡b KiYxq kxl©K Av‡jvPbvq AskMÖnY K‡i †ivMx‡`i I mvaviY gvby‡li GB †ivM m¤ú‡K© m‡PZbZv evov‡bvi my‡hvM K‡i †`Iqvi Rb¨ D³ P¨v‡bjmg~‡ni †gwW‡Kj welqK wewfbœ Abyôv‡bi cÖ‡hvRK, Zv‡`i 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„wׇZ 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| ü` ¯ú›`b9g LÛ iKgvwi.Kg †e÷ †mjvi eB Ôü`‡qi K_vÕ I Ôü`‡ivM cÖwZ‡ivaÕGi †jLK Aa¨vcK Wv. †gvt †ZŠwdKzi ingvb (mv¶vrKvi ce©-04)
- 3. ü` ¯ú›`b ü` ¯ú›`b9g LÛ (mv¶vrKvi ce©-04) 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 www.facebook.com/profdrtoufiq Youtube page : Toufiqur Rahman
- 4. 'Rhid Spondon' 9th Partwritten by Prof. (Dr). Md. Toufiqur Rahman Faruque was published by 'Dr. T Rahman Cardiac Care Foundation' in November, 2024. Cover designed by Dr. Farah Tasneem Mowmi, Price. Tk. 2,000.00 (Two Thousand Tk.)/US $ 30 (Thirty dollar only) ü` ¯ú›`b 9g LÛ (mv¶vrKvi ce©-04) Aa¨vcK (Wvt) †gvt †ZŠwdKzi ingvb (dviæK) iKgvwi.Kg Ô†nj_& wdU‡bm I †cÖmwµckb eyKÕ K¨vUvMwi‡Z †e÷ †mjvi eB Ôü` ¯ú›`b I ü`‡qi K_vÕGi †jLK cÖKvk ÔWvt wU ingvb KvwW©qvK †Kqvi dvD‡ÛkbÕ 80/7/2, K`gZjv, evmv‡ev, myeRevM, XvKv-1214| 1g cÖKvk b‡f¤^i, 2024| ¯^Ë¡ Zûiv LvZzb kviwgb (MÖš’¯^Ë¡ msiw¶Z) cÖ”Q` cwiKíbvq Wvt dvivn& Zvm&bxg †gŠwg gy`ªY el©v cÖvB‡fU wjwg‡UW wcqvimÝ UvIqvi, 299 Gwjd¨v›U †ivW, XvKv| 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‡`i wPwKrmvq e¨q n‡e| cÖvw߯’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
- 5. ˆ`wbK hyMvšÍi cwÎKvqcÖKvwkZ wmwcAvi (KvwW©Icvj‡gvbvwi wimvwm‡Ukb) welq: Rxeb euvPv‡Z CPR cÖwkÿY cÖeÜ 1 evsjv wfk‡b cÖPvwiZ Ò¯^v¯’¨ K_vÓ welq: AvaywbK c×wZ‡Z ü`‡ivM wPwKrmv, 4 Channel –I i cÖPvwiZ Abyôvb Avcbvi my-m¦v¯’¨ welq: ü`‡ivM 17 ATN Bangla i cÖPvwiZ Abyôvb †nj&_ Rskb welq: K‡ivbvq ¯^v¯’¨ e¨e¯’vcbv Ges K‡ivbvq ü`‡iv‡Mi wPwKrmv 25 Bangla vision television i wbqwgZ Av‡qvRb m¦v¯’¨ K_v welq: K‡ivbv cwiw¯’wZ 34 wRwUwf-†Z cÖPvwiZ Abyôvb wmqv‡g my¯’Zv welq: igRv‡b ü`‡ivMx‡`i my¯’Zv 49 †jLK cwiwPwZ 58 Wvt wU ingvb KvwW©qvK †Kqvi dvD‡Ûk‡bi Kg©KvÛ 60 wmwcAvi (CPR) †Uªwbs 2023-2024 61 m~wPcÎ
- 6. 1 ˆ`wbK hyMvšÍi cwÎKvqcÖKvwkZ wmwcAvi (KvwW©Icvj‡gvbvwi wimvwm‡Ukb) welq: Rxeb euvPv‡Z CPR cÖwkÿY cÖeÜ wmwcAvi (CPR), ev KvwW©Icvj‡gvbvwi wimvwm‡Ukb, GKwU Rxeb iÿvKvix wPwKrmv c×wZ hv Riæix Ae¯’vq ü`wcÐ Ges k¦vm-cÖk¦vm cybiæ×vi Ki‡Z e¨eüZ nq| GwU mvaviYZ KvwW©qvK A¨v‡i÷ (ü`hš¿ eÜ n‡q hvIqv) ev k¦vm‡ivaRwbZ cwiw¯’wZ‡Z cÖ‡qvM Kiv nq| wmwcAvi `ywU cÖavb Dcv`v‡bi mswgkÖ‡Y m¤úbœ nq: ey‡Ki ms‡KvPb (‡P÷ Kg‡cÖkb) Ges K…wÎg k¦vm (‡iw¯‹D weªw`s)| wmwcAv‡ii †gŠwjK D‡Ïk¨ 1. Aw·‡Rb mieivn: wmwcAv‡ii g~j jÿ¨ n‡jv gw¯Í®‹ Ges ü`wc‡Ð Aw·‡Rbhy³ i‡³i cÖevn eRvq ivLv, hv‡Z wUmy¨¸wj‡Z Aw·‡R‡bi Afve bv nq| 2. gw¯Í‡®‹i ÿwZ cÖwZ‡iva: gw¯Í‡®‹i †Kvl¸wji Aw·‡R‡bi Afv‡e `ªæZ ÿwZ n‡Z cv‡i| wmwcAvi `ªæZ cÖ‡qvM Ki‡j GwU †iva Ki‡Z cv‡i Ges mwVK mg‡q wPwKrmv cvIqvi my‡hvM m„wó K‡i| 3. i³ mÂvjb cybiæ×vi: ey‡Ki ms‡KvPb Øviv i³ mÂvjb Pvjy ivLv nq, hv cÖ‡qvRbxq A½¸wj‡Z i³ cÖevn wbwðZ K‡i| wmwcAv‡ii cÖ‡qvRbxqZv wmwcAvi ZLbB Ki‡Z n‡e hLb: • ü`hš¿ eÜ n‡q hvq: hLb e¨w³i ü`wcÐ KvR Kiv eÜ K‡i †`q Ges cvjm cvIqv hvq bv| • k¦vm-cÖk¦vm eÜ n‡q hvq: hw` e¨w³ ¯^vfvweKfv‡e k¦vm wb‡Z bv cv‡i ev k¦vm-cÖk¦vm A¯^vfvweK nq (‡hgb, A¨vMbvj †imwc‡ikb)| wmwcAv‡ii avcmg~n 1. cwiw¯’wZ g~j¨vqb • wbivcËv wbwðZ Kiæb: cÖ_‡g wbwðZ Kiæb †h cwi‡ek wbivc`| †Kv‡bv wec` †bB wK bv Zv wbwðZ Kiæb| • AvµvšÍ e¨w³‡K WvKzb: ÒAvcwb wK wVK/fv‡jv Av‡Qb?Ó wR‡Ám Kiæb Ges mvov †`q wKbv †`Lyb| • k¦vm-cÖk¦vm cixÿv Kiæb: k¦vm wb‡”Q wKbv Zv †`Lyb Ges cvjm Abyfe Kivi †Póv Kiæb| hw` cvjm bv _v‡K Ges wZwb k¦vm wb‡”Qb bv, Zvn‡j wmwcAvi ïiæ Ki‡Z n‡e|
- 7. 2 2. Riæwi †mev†hvMv‡hvM • 999 G †dvb Kiæb: hw` AvµvšÍ e¨w³i cvjm †bB Ges k¦vm †bB, Awej‡¤^ 999 b¤^‡i †dvb K‡i mvnvh¨ PvB‡Z n‡e| Riæwi †mev Avmv ch©šÍ wmwcAvi Pvwj‡q †h‡Z n‡e| 3. ey‡Ki Pvc (‡P÷ Kg‡cÖkb) • ey‡Ki gvSLv‡b nv‡Zi Zvjy ivLyb: `yB nv‡Zi Zvjy GKwÎZ K‡i ey‡Ki gv‡Si As‡k ivLyb| • Pvc w`b: cÖwZ wgwb‡U 100 †_‡K 120 evi Pvc w`b, Pvc †`Iqvi MfxiZv cÖvq 5 †_‡K 6 †mwg (2 BwÂ) nIqv DwPZ| • wkw_j Kiæb: Pvc †`Iqvi ci eyK‡K m¤ú~Y© wkw_j Kiæb hv‡Z ü`wc‡Ði i³ mÂvjb mwVKfv‡e n‡Z cv‡i| 4. K…wÎg k¦vm (‡iw¯‹D weªw`s) • 30:2 AbycvZ: cÖwZ 30wU eyK Pvc †`Iqvi ci 2wU K…wÎg k¦vm w`b| • k¦vm †`Iqvi cÖwµqv: AvµvšÍ e¨w³i bvK eÜ Kiæb Ges gy‡Li gva¨‡g k¦vm w`b| wbwðZ Kiæb †h eyK DV‡Q| • wkï‡`i †ÿ‡Î: wkï‡`i †ÿ‡Î, 15:2 AbycvZ e¨envi Kiv nq| wkï‡`i ey‡Ki Pvc †`Iqvi mgq `yB Av½yj e¨envi Kiæb Ges gyL Ges bvK †X‡K w`b| 5. AED (¯^qswµq evwn¨K wWwdweª‡jUi) e¨envi Kiæb • hw` AED Dcjä nq, `ªæZ Zv e¨envi Kiæb| GwU ü`wc‡Ði ¯^vfvweK Q›` wdwi‡q Avb‡Z mvnvh¨ K‡i| AED e¨envi Kivi Rb¨ cÖ‡qvRbxq wb‡`©kvejx AbymiY Kiæb| wmwcAv‡ii Kvh©KvwiZv • gw¯Í‡®‹ Aw·‡R‡bi Afve: mvaviYZ, 4 wgwb‡Ui g‡a¨ i³ cÖevn eÜ n‡q †M‡j gw¯Í‡®‹ ÿwZ n‡Z ïiæ K‡i, Ges 7 wgwbU ci GwU ¯’vqx n‡Z cv‡i| • i‡³i cÖevn: wmwcAvi ïiæ Kivi ci hZ `ªæZ m¤¢e i³ cÖevn Pvjy Ki‡Z n‡e| wmwcAv‡ii mgqKvj • hZÿY bv e¨w³ ¯^Ztù‚Z© mÂvjb (ROSC) wd‡i Av‡m ev wPwKrmK G‡m g„Z †NvlYv bv K‡ib, ZZÿY ch©šÍ wmwcAvi Pvwj‡q †h‡Z n‡e| wmwcAv‡ii P¨v‡jÄ Ges mgm¨v • MwZ I MfxiZv: ey‡Ki Pvc †`Iqvi MwZ I MfxiZv mwVKfv‡e eRvq ivLv LyeB ¸iæZ¡c~Y©| hw` Pvc †`Iqvi MwZ Kg ev †ewk nq, Zvn‡j i‡³i mÂvjb K‡g †h‡Z
- 8. 3 cv‡i Ges GwU¸iæZi ÿwZi KviY n‡Z cv‡i| • AcÖwkwÿZ D×viKvix‡`i Rb¨: AcÖwkwÿZ D×viKvix‡`i Rb¨ ey‡Ki Pvc w`‡qB wmwcAvi Kiv †h‡Z cv‡i, K…wÎg k¦vm †`Iqv ev` †`Iqv †h‡Z cv‡i| we‡kl cwiw¯’wZ • wkï‡`i wmwcAvi: wkï‡`i †ÿ‡Î ey‡Ki Pvc Ges k¦vm †`Iqvi AbycvZ Avjv`v n‡Z cv‡i| wkï‡`i k¦vmcÖk¦vmRwbZ mgm¨v mvaviYZ KvwW©qvK mgm¨vi †P‡q †ewk †`Lv hvq, ZvB K…wÎg k¦vm †`Iqvi ¸iæZ¡ †ewk| • beRvZK‡`i wmwcAvi: beRvZK‡`i †ÿ‡Î ey‡Ki Pvc Ges k¦vm †`Iqvi AbycvZ 30:2 hw` GKRb D×viKvix _v‡K Ges 15:2 hw` `yBRb D×viKvix _v‡K| wmwcAv‡ii cieZ©x c`‡ÿc • wWwdweª‡jkb: KLbI KLbI ü`wc‡Ði ¯^vfvweK Kvh©µg cybiæ×vi Ki‡Z ˆe`y¨wZK kK (wWwdweª‡jkb) cÖ‡qvRb n‡Z cv‡i| wmwcAvi Kivi mgq wWwdweª‡jUi e¨envi Kiv n‡j, GwU i³ mÂvjb Pvjy ivLvi cvkvcvwk ü`wc‡Ði Q›` wdwi‡q Avb‡Z mnvqZv K‡i| Dcmsnvi wmwcAvi n‡jv GKwU Rxeb iÿvKvix wPwKrmv cÖwµqv, hv †Kv‡bv Ae¯’v‡ZB ¸iæZ¡c~Y©| GwU †kLv I cÖwkÿY †bIqv cÖ‡Z¨‡Ki Rb¨ Avek¨K| mwVK mg‡q Ges mwVKfv‡e wmwcAvi cÖ‡qvM Ki‡j, GwU gvby‡li Rxeb evuPv‡Z mvnvh¨ Ki‡Z cv‡i| wmwcAv‡ii gva¨‡g wPwKrmvi mgqm~wP evov‡bv Ges gw¯Í‡®‹i ÿwZ cÖwZ‡iva Kiv m¤¢e| wmwcAvi †kLvi gva¨‡g, Avgiv wb‡Ri Ges A‡b¨i Rxeb evuPv‡Z mÿg n‡Z cvwi| wkÿYxq c‡q›U 1. wbqwgZ cÖwkÿY: wmwcAvi Ges AED e¨env‡ii cÖwkÿY MÖnY Kiæb| 2. mZK©Zv: cwiw¯’wZ wbivc` wKbv Zv wbwðZ Kiæb| 3. h_vmg‡q wmwcAvi: `ªæZZvi mv‡_ wmwcAvi ïiæ Kiæb, KviY GwU Rxeb evuPv‡bvi g~j PvweKvwV| 4. K‡¤úÖkb MfxiZv I MwZ: ey‡Ki Pvc †`Iqvi MfxiZv I MwZ eRvq ivLyb| 5. `jMZ cÖ‡Póv: GKvwaK D×viKvix _vK‡j Kv‡Ri g‡a¨ mgš^q Kiæb Ges wWwdweª‡jU‡ii cÖ¯‘wZ wbb| wmwcAvi GKwU ¸iæZ¡c~Y© Rxeb iÿvKvix †KŠkj, hv mwVK cÖwkÿY Ges Aweivg cÖ‡Póvi gva¨‡g Rxeb iÿv Ki‡Z cv‡i|
- 9. 4 evsjv wfk‡b cÖPvwiZÒ¯^v¯’¨ K_vÓ welq: AvaywbK c×wZ‡Z ü`‡ivM wPwKrmv, †m‡Þ¤^i 2019 Dc¯’vcK : Wvt wmdvZ ingvb| Avgwš¿Z AwZw_: (1) Aa¨vcK (Wvt) Agj Kzgvi †PŠayix (2) Aa¨vcK Wv: †gv: †ZŠwdKzi ingvb| Dc¯’vcK : mywcÖq `k©K, Avcbv‡`i mevB‡K Avgš¿Y Rvwb‡q ïiæ KiwQ evsjvwfk‡bi ¯^v¯’¨ welqK mivmwi m¤úªPvwiZ Ò¯^v¯’¨ K_vÓ Abyôv‡bi AvR‡Ki c‡e©| Avcbv‡`i mv‡_ AvwQ Avwg Wvt wmdvZ ingvb| `k©K, AvR‡K Avgiv †h welqwU wb‡q K_v ej‡Z hvw”Q, †mwU n‡”Q ÒAvaywbK c×wZ‡Z ü`‡ivM wPwKrmvÓ Avi G welqwU wb‡q K_v ejvi Rb¨ AvR‡K Avgv‡`i ózwWI‡Z Avgš¿Y Rvwb‡qwQ 2 Rb L¨vZbvgv ü`‡ivM we‡klÁ‡K| Pjyb Zv‡`i mv‡_ cwiwPZ n‡q †bB| Avgv‡`i mv‡_ AvR‡K ózwWI‡Z Dcw¯’Z Av‡Qb ÒAa¨vcK (Wvt) Agj Kzgvi †PŠayixÓ whwb ü`‡ivM we‡klÁ wn‡m‡e RvZxq ü`‡ivM BbwówUD‡U Kg©iZ Av‡Qb| Avgv‡`i mv‡_ AvR‡K Av‡iv Dcw¯’Z Av‡Qb ÒAa¨vcK (Wvt) †gvt †ZŠwdKzi ingvb(dviæK)Ó whwb Aa¨vcK I wefvMxq cÖavb (KvwW©IjRx), K‡Y©j gv‡jK †gwW‡Kj K‡jR I nvmcvZvj, gvwbKM‡Ä Kg©iZ Av‡Qb| `k©K, Avcbviv wKš‘ PvB‡j Avgv‡`i we‡klÁ Wv³vi‡`i mv‡_ mivmwi †dv‡b K_v ej‡Z cv‡ib, GQvovI †dmeyK jvB‡f AvwQ †mLv‡bI Avgv‡`i mv‡_ R‡qb n‡Z cv‡ib| Avcbv‡`i 2 Rb †K Avgš¿Y Rvbvw”Q Avgv‡`i Abyôv‡b| m¨vi Wvt Agj Kzgvi AvR‡K †Zv Avgiv ü`‡iv‡Mi AvaywbK wPwKrmv wb‡q K_v eje †Zv wPwKrmv wb‡q K_v ejvi Av‡M Avwg GKUz ïiæ‡ZB Rvb‡Z Pvw”Q †h, mvaviYZ nv‡U© wK wK ai‡bi mgm¨v n‡q _v‡K? Wvt Agj Kzgvi : ab¨ev`, wmdvZ, Avwg Avgv‡`i `k©Ke„‡›`i aviYv †`qvi Rb¨ Rvbvw”Q †h, Avgv‡`i mg¯Í kix‡i GKgvÎ A½ †hUv nvU© ev ü`wcÛ GKUv h‡š¿i mv`„k¨| f~‡Yi gv‡qi M‡f© 20 mßvn †_‡K cv¤ú ïiæ K‡i Ges †hw`b g„Zz¨ n‡q hv‡e †mw`b Zvi g„Zz¨ N‡U| kix‡ii Avi †Kvb A½ cÖZ¨½ Gfv‡e h‡š¿i mv`„k¨ gyf‡g›U K‡i bv| Zviv w¯’wZkxj †_‡K Zv‡`i KvR K‡i wKWbx, †eªBb G‡`i †h gyf‡g›U †h, Kvh©KvwiZv Giv †eu‡P Av‡Q bv g‡i †M‡Q Avgiv wKš‘ ai‡Z cvie bv wKš‘ nvU© cv¤ú Ki‡Q GUv G·- †i †Z †`Lv hv‡e, GbwRIMÖv‡g †`Lv hv‡e GUv GKUv h_vh_ mv`„k¨ wRwbm| Dc¯’vcK : evBi †_‡K wKš‘ Avgiv wb‡RivB Abyfe Ki‡Z cvwi †h, Avgv‡`i nvU© cv¤ú Ki‡Q| Wvt Agj Kzgvi : n¨uv, Avgv‡`i nvU© †h cv¤ú Ki‡Q GUv Avgiv mevB eyS‡Z cvwi| Avi AmyL ¸‡jv Avwg GKUz ms‡ÿ‡c e‡j †bB †h, Rb¥MZ AmyL w`b w`b evo‡Q, †Kb evo‡Q? †mB KviY Avgiv exact GLbI Rvb‡Z cvwiwb, Z‡e Bb‡dKkb, cwi‡ek `~lY, Lv`¨vfvm cwieZ©b G¸‡jv g~j KviY| wØZxq n‡”Q, Avgv‡`i evZR¦i †hUv Mjv e¨_v, wMiv e¨_v
- 10. 5 n‡j nv‡U©i fvj¦bó nIqv ïiæ K‡i| GUvI Avgv‡`i w¯’wZkxj, evo‡QI bv Kg‡QI bv| m‡PZbZvi Kvi‡Y g‡b nq wiWvKkb †ewk n‡”Q| Dc¯’vcK : m¨vi, Wvt Agj Kzgvi GB welqUv‡K wK Avcbviv wiI‡gwUK nvU© wWwRR e‡j _v‡Kb? Wvt Agj Kzgvi : nu¨v, wiIg¨vwUK nvU© wWwRR GUv mvaviYZ wKQzUv A_©‰bwZKfv‡e B‡KvbwgK ÷¨vUvm hviv Mixe, hviv ew¯Í‡Z _v‡K GB MÖæ‡ci GKUz †ekx nq| Z…Zxq n‡”Q nvBcvi‡Ubkb †hUv wekvj gnvgvwi AvKv‡i meviB Av‡Q| PZz_© n‡”Q, i³bvwji eøK ev Pwe©| Avcbvi (Dc¯’vwcKv) gva¨‡g Avwg `k©K‡`i GKUz Rvbv‡Z PvB cÖ_‡g i³bvwj †hLv‡b Pwe© R‡g †mUv n‡”Q nv‡U©i, †m‡KÛ n‡”Q †eªB‡b| †eªB‡bi i³bvwj‡Z Pwe© R‡g hLb eøK K‡i †eªBb ÿwZMÖ¯’ nq ZLb †mUv‡K †÷ªvK e‡j Avi nv‡U©i i³bvwj‡Z Pwe© R‡g hLb nvU© m¤ú~Y© eÜ n‡q hvq ZLb Zv‡K nvU© G¨vUvK e‡j| cÖvqB †`wL Avgv‡`i A‡bK wkwÿZ, Aa© wkwÿZ me eÜzivI Zviv e‡j †h, Wvt Agj Avgvi evevi †Zv †÷ªvK n‡q‡Q, ZLb c‡i †`Lv †Mj GUv nvU© G¨vUvK| †÷ªvK Ges nvU© G¨vUvK, †÷ªvK n‡”Q †gwW‡Kj kã †mUv Easy e‡j Take up Ki‡Q mevB| nvU© G¨vUv‡Ki †gwW‡Kj kãUv GKUz KwVb Myocardial infarction GB kãUv ejv GKUz KwVb, G Rb¨ GUv nvU© G¨vUvK wn‡m‡e, nvU© G¨vUvK wKš‘ Bswjk kã| †÷ªvK ej‡Z n‡j †eªBb G¨vUvK ej‡Z n‡e c‡i Bswjk kã ej‡Z n‡j †eªBb G¨vUvK ej‡Z n‡e| AvR‡K Avcbv‡`i (Dc¯’vwcKv) welq ev Avgiv †hUv wb‡q Av‡jvPbv Ki‡Z AvmwQ Bk‡KwgK nvU© wWwRR nv‡U©i i³bvwj‡Z eøK n‡j wK cwiYwZ n‡Z cv‡i| eøK †Zv G‡Kev‡i m¤ú~Y©fv‡e GKUv i³bvwj eøK bv| nv‡U©i cÖavb wZbUv i³bvwj Av‡Q, nvU© hw` wb‡R i³ bv cvq, Lv`¨ bv cvq Zvn‡j †m cv¤ú K‡i mg¯Í kix‡i i³ w`‡e wK K‡i? Zvn‡j eøK ïiæ n‡Z cv‡i †h wfwWIUv †`Lv‡jb Zv me¸‡jv Avgv‡`i Rb¨ mnR K‡i w`‡q‡Q| GB KviY ¸‡jv wKš‘ nv‡U©i Pwe© Rgv K‡i| Aí GKUz Pwe© hw` 70% Gi bx‡P eøK nq Zvn‡j †ivMx Avgv‡`i Kv‡Q bvI Avm‡Z cv‡i| A‡b‡K fvwi KvR Ki‡Z †M‡j e¨_v Abyf~Z nq Zvici hw` 70-90 % eøK nq Zvi Av‡M wKš‘ 2-5 avc nuvU‡j 5-10 †KwR wb‡q evRv‡i †M‡j e¨_v Abyf~Z KiZ bv| GivB wKš‘ SuzwKi m¤§yLxb _v‡K †h †Kvb mgq 70% GKw`b nVvr K‡i GKUv †÷ªP cij wdwRK¨vj ev gvbwmK Pv‡c ci‡j wKš‘ i³ RgvU †eu‡a 100% n‡q †Mj| GB 100% n‡q †M‡jI †h Ae¯’v _v‡K Zvi Av‡iv AebwZ N‡U| Dc¯’vcK : m¨vi (Wvt Agj Kzgvi) Avcbvi KvQ †_‡K GB wel‡q Av‡iv we¯ÍvwiZ Rvbe Zvi Av‡M m¨vi (Wvt †gvt †ZŠwdKzi ingvb) Kv‡Q Rvb‡Z PvB m¨vi (Wvt Agj Kzgvi) ejwQ‡jb †h GZ % eø‡Ki †ÿ‡Î †ivMxiv mvaviYZ GB ai‡bi †h wdPvi ¸‡jv †mB ¸‡jv Zviv Abyfe K‡i _v‡K| m¨vi (Wvt †ZŠwdKzi) Avcbvi Kv‡Q Avevi GB welqUv wb‡q Avwg GKUz Rvb‡Z Pvw”Q? Wvt †ZŠwdKzi ingvb : GLb †hUv ¯úó Avgv‡`i m¨vi Wvt Agj Kzgvi †hUv ej‡jb- K‡ivbvwi agbx- †hUv nv‡U©i i³bvjx- †mUv‡Z eøK n‡jB †h, Avgvi ey‡K e¨_v n‡e Ggb wKš‘ bv| GgbI n‡Z cv‡i †ivMxi eøK Av‡Q wKš‘ †Kvb jÿY bvB, †ivMx nuvU‡Z‡Q, †`Šov‡”Q,
- 11. 6 wmuwo w`‡q DV‡Z‡Qgv‡b Zvi wfZi †Kvb jÿY bvB, Avevi †Kvb †Kvb †ÿ‡Î †`Lv hvq †h, 70% †h eøK Gi †_‡K hw` Kg _v‡K 20-40% eøK Avevi GB eøK _vK‡jI A‡bK †ivMx‡`i †Kvb †Kvb †ÿ‡Î ey‡K e¨_v n‡Z cv‡i| †Kbbv KLbI eøK _vK‡j i³bvwj‡Z ¯úvRg ev ms‡KvPb n‡Z cv‡i hvi Rb¨ gv‡S gv‡S †ivMxi ey‡K e¨_v n‡Z cv‡i| Dc¯’vcK : m¨vi (Wvt †ZŠwdKzi) †dv‡b Avgv‡`i GKRb `k©K A‡cÿv Ki‡Q `k©K Avcbvi bvg e‡j cÖkœwU Kiæb? `k©K 1 : AvmmvjvgyAvjvBKzg| Dc¯’vcK : IqvjvBKzg Avmmvjvg| `k©K 1 : Avgvi cÖkœUv Aa¨vcK Wvt Agj Kzgvi †PŠayix m¨v‡ii Kv‡Q Ges Aa¨vcK Wvt †ZŠwdKzi ingvb m¨v‡ii Kv‡Q m¨vi (Wvt Agj Kzgvi) gvgyb ejwQjvg, †gvnv¤§`cyi †_‡K, Avwg G¨vbwRIMÖvg Kwi‡qwQ †Zv Avgvi g~j i³bvwj‡Z eøK Av‡Q, †m‡ÿ‡Î Avgvi wis cov‡bv jvM‡e wKbv? Avwg Jla Lvw”Q, Jla †L‡q Avwg fv‡jv AvwQ| Avwg nuvU‡Z cvwi, †gwk‡b hw` Avwg nuvwU 5-6 w¯ú‡W nuvwU Ges wKQz wKQz e¨vqvgI Ki‡Z cvwi †m‡ÿ‡Î m¨vi Avgvi wis cov‡bv jvM‡e wKbv? Dc¯’vcK : m¨vi Avcbv‡`i wK †Kvb cÖkœ Av‡Q `k©‡Ki Kv‡Q? Wvt Agj Kzgvi : bv, Avcbvi †Zv Lye fv‡jv Ávb Av‡Q, Avcwb i³bvwji bvg mn e‡j w`‡q‡Qb, LAD †Z hw` 30 % eøK _v‡K, RCA †Z hw` 40% eøK _v‡K, GKUv OM eÜ nIqvi Kvi‡Y Avcbvi wis cov‡bv jvM‡e bv| hw` AiwRbvj wmwW Uv †`L‡Z cvi‡j 100% wbwðZ K‡i ej‡Z cvie †h, GB OM Uvi WvqvwgUvi KZ, KZ Gwiqv eøvW mvcøvB w`‡”Q exactly ej‡Z cvie| †h‡nZz Avcbvi †Kvb symptoms n‡”Qbv †m‡nZz Avcwb Jla †L‡q fv‡jv _vK‡Z cv‡ib| Avcwb †hfv‡e eY©bv w`‡jb H wn‡m‡e wis Uv Avcbvi Rb¨ eva¨Zvg~jK bv, ZviciI GKRb KvwW©IjwR÷‡K Avcbvi wmwW Uv GKevi †`wL‡q wb‡eb| Wvt †ZŠwdKzi ingvb : Avwg hw` Gi mv‡_ GKUz †hvM Kwi †h, A‡bK mgq †`Lv hvq †h, eøK Kg e‡j †ivMxiv nqZ ej‡Z cv‡i †h, eøK †h‡nZz Kg Av‡Q Avgvi †Kvb Kó n‡”Q bv Avwg GZ `vwg `vwg Jla †Kb Lve? †m‡ÿ‡Î n‡jv †h, Avcbvi †h 30% ev 40% eøK Av‡Q, †mB eøK wKš‘ †h †Kvb mgq †du‡U wM‡q Avcbvi nvU© G¨vUvK n‡Z cv‡i| 30% ev 40% eøKI †h, GK`g †QvU Zv wKš‘ bv| nu¨v, Avgvi nqZ †Kvb Symptoms n‡ebv, Kó n‡ebv, Avgiv ¯^vfvweK †h KvRKg© Kwi Zv‡Z euvav w`‡e bv, wKš‘ GB 30-40% eøK immature plaque e‡j GUv wKš‘ †h †Kvb mgq †du‡U wM‡q nvU© G¨vUvK n‡Z cv‡i| myZivs GB nvU© G¨vUvK Uv‡K cÖwZ‡iva Kivi Rb¨ Avgiv wKQz Jla †`B hv‡Z Avcbvi GB 30-40% eøK hv‡Z bv dv‡U ev GUv mature nq †mRb¨ wKš‘ wKQz wKQz Jla Av‡Q|
- 12. 7 myZivs GUv‡K cÖwZ‡ivaKivi Rb¨ n‡jI Avcbv‡K wbqwgZ fv‡e me mgq Jla †L‡q †h‡Z n‡e| Dc¯’vcK : Av”Qv, `k©K Avcbv‡K A‡bK ab¨ev` Avgv‡`i Kv‡Q †dvb Kivi Rb¨| m¨vi (Wvt †ZŠwdKzi) Avcwb ejwQ‡jb †h, KZ % eøK G mvaviYZ wK wK ai‡bi jÿY †`Lv †`q? Wvt †ZŠwdKzi ingvb : nu¨v, †hUv ej‡ZwQjvg GB cÖm½‡ZB nqZ Avm‡Q 30-40% eøK †h¸‡jv †mUvI wKš‘ Avgv‡`i Symptoms Ki‡Z cv‡i †hgb- KL‡bv ¯úvRg n‡j gv‡S gv‡S e¨_v n‡”Q| GLb e¨_v hw` `xN© mgq ev wKQz mgq ey‡K Pvc w`‡q _v‡K ev a‡i _v‡K Zvn‡j †`Lv hv‡e nvU© G¨vUvK Gi g‡Zv Sweating n‡Z cv‡i Avevi GB †h ey‡K †h Pvc w`‡q Av‡Q †`Lv †Mj GUv A‡bK mgq †Q‡o w`‡j †`Lv hv‡”Q Avevi Av‡Mi Ae¯’vq wd‡i Avm‡jv| GLb hLb Avgvi i³bvwjUv ms‡KvwPZ n‡j ev ey‡K Pvc Pvc Abyfe n‡jv H gyû‡Z© hw` Avwg BwmwR Kwi †`Lv hv‡e Avgvi BwmwR‡ZI wKQz cwieZ©b Av‡Q Avevi hLb Avgvi ¯^vfvweK Ae¯’vq Avgvi e¨_vUv P‡j †M‡j ZLb BwmwR Ki‡j †`Lv hv‡e nqZ Avgvi †Kvb ai‡bi †Kvb Symptoms bvB| BwmwR GK`g ¯^vfvweK| Zvn‡j GB †h 30- 40% eøK GUv †hgb ey‡K e¨_v †h †Kvb mgq Ki‡Z cv‡i Avevi H †ivMxi (`k©K 1) cÖm‡½ Avwg †h, K_v ej‡Z wQjvg Dbvi mgm¨v cÖm‡½ †h †Kvb mgq eøK †du‡U wM‡qI wKš‘ nvU© G¨vUvK Ki‡Z cv‡i| Zvi gv‡b 70% bx‡P †h, eøKUv Av‡Q 30-40% eøK GB eøKI †h wbivc` Zv wKš‘ bv| GUvI Avgv‡`i mgm¨v Ki‡Z cv‡i G Rb¨ mywbw`©ófv‡e Wv³vi mv‡n‡ei mv‡_ civgk© Kiv `iKvi Ges †mB Abyhvqx Jla †L‡Z n‡e| Dc¯’vcK : gv‡b GUv hv‡Z further progress bv K‡i †mRb¨ Jla| Wvt †ZŠwdKzi ingvb : nu¨v, cybivq hv‡Z †cÖv‡MÖm bv K‡i GUv GKUv, Av‡iKUv n‡jv GUv hv‡Z †h †Kvb mgq mgm¨v bv K‡i, Avevi 70 fv‡Mi †ekx eøK n‡j †hUv nq mvaviYZ †`Lv hvq †h, Avgiv nuvU‡Z †M‡j, wmuwo w`‡q DV‡Z †M‡j ev fvix KvR Ki‡Z †M‡j, fvix wKQz wb‡q nuvU‡Z †M‡j Avgv‡`i ey‡K ZLb GK ai‡bi Pvc Pvc Abyfe nq| A‡bK mgq †ivMxiv Avgv‡`i e‡j m¨vi Avgvi †Zv e¨_v bvB, Avgvi ey‡K GK ai‡bi g‡b nq †KD Pvc w`‡q Av‡Q ev ey‡K cv_i w`‡q Av‡Q| Avm‡j nv‡U©i e¨_vUv wKš‘ G ai‡biB cÖ_‡g mivmwi e¨_v Abyf~Z nq bv, nv‡U©i GKUv wWmKg‡cvU© Av‡Q| Zvn‡j G iKg n‡Z cv‡i fvix KvR Kivi mgq A_ev †`Lv hvq †h, Avgvi 70% †ewk hw` eøK _v‡K Zvn‡j wKš‘ Avgvi mgm¨v bvI n‡Z cv‡i| A‡bK mgq 80-90% eøK n‡j ZLb e¨_v n‡Z cv‡i| gv‡b GUv Avm‡j †iv‡M †iv‡M ev gvby‡l gvby‡l Vary K‡i Avi 70 fv‡Mi Dc‡i eøK n‡”Q GB eø‡KB Avgvi mgm¨v n‡”Q bv, Zvn‡j ZLb Avgiv Avm‡j wKfv‡e wbY©q Ki‡Z cvwi- ZLb wKš‘ Avgv‡`i BwmwR †`Lv hv‡e- BwmwR ¯^vfvweK Avm‡Z‡Q, Avgiv B‡Kv KvwW©IMÖvg Kwi, B‡Kv KvwW©IMÖv‡g †`Lv hv‡e- †Kvb ai‡bi †Kvb mgm¨v cvw”Q bv| ZLb A‡bK mgq BwUwUi cÖ‡qvRb n‡Z cv‡i| ZLb BwUwU Ki‡j A‡bK mgq †`Lv hvq †h, Avgv‡`i wi‡cvU© nqZ cwRwUf Avm‡Q, ZLb Avgiv H fv‡e Jla †L‡Z cvwi Avevi KLbI eøK evo‡Z evo‡Z 95-99% hLb nq ZLb A‡bK mgq †UvUvj i³bvwj eÜ n‡q wM‡q i³ mieivn cy‡ivcywi eÜ nq ZLb Avgv‡`i nvU© G¨vUvK n‡Z cv‡i, Avevi GB †h,
- 13. 8 10-70% eøK GBeøK Avevi †h †Kvb mgq †du‡U wM‡q Zvi Dc‡i i‡³i PvKv RgvU n‡q cy‡iv i³bvwj eÜ n‡q Avgv‡`i nvU© G¨vUvK n‡Z cv‡i| Dc¯’vcK : m¨vi (Wvt †ZŠwdKzi) Avgv‡`i mv‡_ †dv‡b Av‡iK Rb `k©K A‡cÿv Ki‡Qb, `k©K, Avcbvi bvg e‡j cÖkœwU Kiæb? `k©K 2 : AvmmvjvgyAvjvBKzg| Avwg Wv³vi‡`i Kv‡Q Rvb‡Z Pvw”Qjvg Avgvi evg cv‡k©¦ gv‡S gv‡S e¨_v K‡i cÖwZwbqZ e¨_v K‡i| Avwg ü`‡ivM nvmcvZv‡j A‡bK cixÿv bxwiÿv K‡iwQ, BwUwU K‡iwQ Avgv‡K Zviv ejj †Kvb mgm¨v bvB wKš‘ cÖ‡Z¨KUv w`b Avgvi evg cv‡k GB e¨_vUv †Kb K‡i? Wvt Agj Kzgvi : ab¨ev`, `k©K-2 Avcbv‡K, Avcbvi hw` BwUwU, B‡Kv G¸‡jv hw` ¯^vfvweK _v‡K Zvn‡j Ab¨ †Kvb Kvi‡Y e¨_vUv n‡Z cv‡i| ey‡K e¨_vi Ab¨Zg KviY wKš‘ nv‡U©i e¨_v bv| A‡bK Kvi‡Y ey‡K e¨_v n‡Z cv‡i,Avcbv‡K hw` ü`‡ivM nvmcvZvj †_‡K e‡j _v‡K †h, nv‡U©i mg¯Í cixÿv¸‡jv ¯^vfvweK Zvn‡j Avcwb nv‡U©i w`K †_‡K wbwðZ †_‡K Avcwb Ab¨ †Kvb Wv³vi‡K †`Lv‡Z cv‡ib| Dc¯’vcK : m¨vi (Wvt Agj Kzgvi) Avwg GB cÖm½Uv‡Z Avm‡Z Pvw”Qjvg Avgv‡`i `k©K 2 †hUv ej‡jb- Wvt †ZŠwdKzi ingvb : Avwg GB cÖm‡½ GKUz †hvM Ki‡Z PvB †mUv †ivMxi eqm hw` 15-20 eQi GiKg ej‡Z‡Q †hLv‡b eøK nIqvi m¤¢vebv LyeB Kg mvaviYZ| eøK GLb †h †Kvb eq‡mB n‡Z cv‡i, Zvn‡j †m‡ÿ‡Î nqZ BwmwR, B‡Kv, BwUwU ¯^vfvweK| Avgiv nqZ over look Ki‡Z cvwi †h bv nqZ Avcbvi e¨_v Ab¨ Kvi‡Y n‡”Q| †Kbbv ey‡K e¨_v A‡bK Kvi‡Y nq| GLb GKUv †ivMxi hw` Wvqv‡ewUm _v‡K, D”Pi³Pvc nq, †¯§vKvi ev †ivMxi hw` wi¯‹ d¨v±i _v‡K A_ev eqm hw` 30 Gi Dc‡i nq| Zvn‡j †m‡ÿ‡Î hw` BwmwR, B‡Kv, BwUwU ¯^vfvweK nq wKš‘ Zvi gv‡S gv‡S ey‡K e¨_v nq wKš‘ ey‡Ki e¨_v hw` Ggb nq suggestive ev Bk‡KwgK nvU© wWwRR †h ey‡Ki e¨_vi aibUv †`‡L g‡b n‡”Q e¨_ vUv nv‡U©i e¨_v n‡Z cv‡i| Zvn‡j †m‡ÿ‡Î Avgvi BwUwU †b‡MwUf n‡jI H †hUv Avgiv ejjvg †h, 70% Dc‡i bv †M‡j †Zv BwUwU cwRwUf n‡e bv| †m‡ÿ‡Î Avgvi 30-60% mgm¨v _vK‡Z cv‡i| †m‡ÿ‡Î Zvi (`k©K-2) cÖkœ _vK‡Z cv‡i †h, Zvn‡j Avgvi KiYxq wK? Avwg wKfv‡e wbwðZ n‡Z cvie †h, Avgvi eøK bvB ev Avgvi nv‡U©i mgm¨v bvB| †m‡ÿ‡Î Avcwb G¨vbwRIMÖvg bv K‡iI eZ©gv‡b wmwU G¨vbwRIMÖvg K‡i wbwðZ n‡Z cv‡ib †h, Avcbvi 20-30% eøK Av‡Q wKbv? wKsev Avcbvi K¨vjwmqvg †¯‹vwis KZ? †m‡ÿ‡Î Avcbvi wbw`©ó †Kvb Jla †L‡Z n‡e wKbv nv‡U©i †mB e¨cv‡i Avcwb wbwðZ n‡Z cv‡ib|
- 14. 9 Dc¯’vcK : Av”Qvgv‡b wmwU ¯‹¨vb MvBW Gi †h G¨vbwRIMÖvg Zvi gva¨‡g wbwðZ nIqv hv‡e| m¨vi (Wvt Agj) Avwg GB cÖm½Uv‡ZB Avm‡Z Pvw”Qjvg †h, ey‡Ki e¨_v gv‡b GUvi aibUv Avm‡j †Kgb nq, KviY †ekxifvM †ÿ‡ÎB Avgv‡`i †`‡ki †ivMxiv mvaviYZ ey‡K e¨_v n‡j g‡b K‡ib †h, Zv‡`i M¨vw÷ª‡Ki †Kvb mgm¨vi Kvi‡Y e¨_v n‡Z cv‡i Ges GUv wb‡q eiveiB GKUv KbwdDkb ˆZwi nq| Wvt Agj Kzgvi : nu¨v, GUv LyeB ¸iæZ¡c~Y© GKUv cÖkœ Avgv‡`i `k©K‡`i hw` ey‡Ki e¨_v wb‡q avibv bv _v‡K Zvn‡j †Zv mevB nv‡U©i nvmcvZv‡j fxo Ki‡e| ey‡Ki e¨_v n‡jB hw` GKUv g¨v‡mR †`b nv‡U©i e¨_v n‡Z cv‡i| AZGe ey‡Ki e¨_vUvI Rvbv `iKvi †h, †Kvb ai‡bi ey‡Ki e¨_vUv nv‡U©i| Avgiv wZbUv cÖkœ Kwi GKUv †ivMx‡K †h, Avcbvi ey‡Ki e¨_vi RvqMv †KvbUv hw` gvSLv‡b e‡j GKUv †ivMx wKš‘ (`k©K 2) ejj †h Zvi ey‡Ki e¨_v evg cv‡k n‡”Q wKš‘ bv cÖ_g e¨_vUv n‡e 80% †ÿ‡Î ey‡Ki gvSLv‡b e¨_v nq, Ges e¨_vi aiY n‡e Zxeª gv‡b g‡b n‡e †h, †KD †hb ey‡K GKUv Pvc w`‡q †i‡L‡Q| nvwZ hw` ey‡Ki Dci cv Zz‡j †`q †hgb fvix jvM‡e †miKg fvix n‡q _vK‡e| wPKb Nvg n‡e mv‡_ Ges GB e¨_vUv wekÖvg wb‡j K‡g hv‡e wKš‘ cv †dj‡j GKUz KvR Ki‡Z †M‡j evo‡e A_ev wRnŸvi bx‡P Avgiv †h †¯úª †`B GUv w`‡j nVvr K‡i 2-3 †m‡K‡Ûi g‡a¨ ey‡Ki e¨_v K‡g hv‡e| GUvB n‡”Q eySvi Dcvq †h, GUv wK nv‡U©i e¨_v wKbv? Centre chest pain, relief by rest, aggravated by physical and mental activities. GKUz cwikÖg Ki‡Z †M‡j, GKUz Wªwqs iæg †_‡K WvBwbs‡q †h‡Z †M‡jB e¨_vUv †e‡o hv‡”Q, †Mvmj Ki‡Z †M‡j e¨_vUv evo‡Q, k^vm eÜ Ki‡j e¨_vUv †_‡K hv‡”Q Avi gvSLv‡b e¨_v| Z‡e atypical Zxeª e¨_v nv‡U©i memgq n‡Z cv‡i AvšÍRvwZ©K iæj n‡”Q GKUv 18 eQ‡ii Dc‡ii e¨w³ cyiæl A_ev gwnjv hvB †nvK ey‡K e¨_v †_‡K ïiæ K‡i bvwfi Dci †_‡K, nv‡Zi Av½yj, Pz‡ji †Mvov e¨_v Ki‡Q then should be exclude by 10 minutes by doing ECG & Troponin I . GB `yBUv †U÷ K‡i †m Ab¨ RvqMvq †idvi n‡e bv n‡j Amyweav Av‡Q, KviY Avgvi KwjM Wvt †ZŠwdK e‡j‡Qb †h, GB e¨_vq eq‡mi †Kvb wVK wVKvbv bvB| Avwg MZ eQi 18 eQ‡ii GKUv †Q‡ji nvU© G¨vUvK †c‡qwQ, †Zv Avwg †Zv ej‡Z cviwQ bv †h, 20 eQ‡ii bx‡P nvU© G¨vUvK n‡e bv Ges Zvi e¨_vI wQj Zxeª, GKevi e‡j †c‡Ui Dc‡ii w`‡K e¨_v, GKevi evg w`‡Ki nv‡Z e‡j e¨_v Avevi Wvb w`‡Ki nv‡Z e‡j e¨_v c‡i †`Lv †Mj Troponin I - 50-60, nvU© G¨vUv‡Ki c‡i †h eøvW †U÷Uv Kiv nq| AZGe AvšÍRvwZ©K MvBW jvBb n‡”Q †h, bvwfi Dc‡i †h †Kvb e¨_v Should be exclude by heart. GUv nv‡U©i e¨_v wKbv †mUv exclude KiZ ej‡Q wK”Qzbv ïaygvÎ GKUv ECG & Troponin I Øviv| GB `yBUv wRwbm hw` †b‡MwUf nq Zvn‡j Avgiv e‡j w`e, fvB Avcbvi Ab¨ †Kvb mgm¨vi Kvi‡Y GB e¨_v n‡”Q| AZGe Avcwb AvcvZZ Ab¨ Wv³v‡ii civgk© wbb| Dc¯’vcK : m¨vi (Wvt Agj) Avgv‡`i mv‡_ †dv‡b Av‡iKRb `k©K hy³ Av‡Qb Avgiv Zvi cÖkœwU wb‡q †bB, `k©K Avcbvi bvg e‡j cÖkœwU Kiæb? `k©K 3 : AvmmvjvgyAvjvBKzg| Dc¯’vcK : IqvjvBKzg Avmmvjvg|
- 15. 10 `k©K 3 :Avwg wicb ejwQjvg, Avwg Wv³vi mv‡n‡ei Kv‡Q Rvb‡Z Pvw”Qjvg Avgvi evg cv‡k, gv_vi GK cv‡k GKUz e¨_v K‡i, e¨_v gv‡b †ivMx‡`i g‡Zv bv GKUy Kg AviwK| G Rb¨ Avwg A‡bK wbD‡ivjRx Wv³vi †`wL‡qwQ wKš‘ Zviv †Kvb †ivM cvqwb, wKš‘ Avgvi †hUv g‡b nq gv_vi evB‡i †h, bvf©¸‡jv Av‡Q HLv‡b †Kvb eøK Av‡Q bvwK i³ mieivn Kg n‡”Q bvwK| G iKg Avgvi wbR †_‡K g‡b n‡”Q, Avgvi cÖvq A‡bK eQi a‡i GB mgm¨vUv| Wvt Agj Kzgvi : `k©K Avcbvi eqm KZ? `k©K 3 : Avgvi eqm 40 eQi| Wvt Agj Kzgvi : wVK Av‡Q Avcwb (`k©K 3) †hfv‡e ej‡jb Avcbvi KvwW©qvK †PK Avc jvM‡e, K‡i‡Qb wKbv Rvwb bv| KvwW©qvK †PK Avc Avgv‡`i Lye m¯Ív Ges mnRfv‡e Avgiv GUv Ki‡Z cvwi, GKUv BwmwR, GKUv ey‡Ki G· †i, GKUv B‡Kv, GKUv BwUwU| Avcbvi 40 eQi eqm GB 4 Uv cixÿv Ki‡jB A‡bK wKQz jyKvwqZ wRwbm †ewi‡q Avm‡e †h, GUv nv‡U©i mgm¨v wKbv Zvici Avcwb GKRb wbD‡ivjwR‡÷i kibvcbœ n‡eb| Avwg eje Avcbvi Kv‡Qi wbKU¯’ †h ü`‡ivM we‡klÁ Av‡Q Zv‡K †`Lv‡jB Avcbv‡K wbwðZ K‡i e‡j †`‡e †h, GUv nv‡U©i e¨_v msµwgZ n‡”Q wKbv Nv‡o ev gv_vq GUv Avcbv‡K Rvwb‡q w`‡e, Avcbvi f‡qi †Kvb KviY bvB| Avcbvi 40 eQi eqm Avcwb GKUz †PK Avc Kwi‡q †bb| Dc¯’vcK : m¨vi, Avgiv Avgv‡`i cieZ©x Av‡jvPbvq hve Zvi Av‡M GKUv weiZx wb‡q wdiwQ wKQzÿ‡Yi g‡a¨| `k©K weiZxi ci Avev‡iv mevB‡K ¯^vMZ Rvbvw”Q, Ô¯^v¯’¨ K_vÕ Abyôv‡b, Avgiv AvR‡K K_v ejwQ ÔAvaywbK c×wZ‡Z ü`‡ivM wPwKrmvÕ G welqwU wb‡q| `k©K Avgiv P‡j hvw”Q g~j Av‡jvPbvq| m¨vi (Wvt †ZŠwdKzi ingvb) weiZx‡Z hvIqvi Av‡M nv‡U©i wewfbœ iKg jÿY m¤ú‡K© Rvbjvg Ges ey‡K e¨_v n‡j †ivMxiv wK Ki‡e †m welq wb‡q Rvbjvg| GLb P‡j Avwm Avcbviv †h cixÿv bxwiÿvi K_v ¸‡jv evi evi ej‡Qb †h, BwmwR, B‡Kv KvwW©IMÖvg, BwUwU †Zv GB cixÿv bxwiÿv ¸‡jv wK Avgv‡`i evsjv‡`‡ki †h †Kvb RvqMvq wK mn‡R Kiv hvq wKbv? hviv we‡kl K‡i Dc‡Rjv ev MÖvg¨ GjvKv‡Z _v‡K Zviv wK G¸‡jv available cv‡e? Wvt †ZŠwdKzi ingvb : Av”Qv BwmwR †Zv †gvUvgywU mg¯Í ¯^v¯’¨ Kg‡cø‡· available Av‡Q, Ges fv‡jv †gwkbI Av‡Q| B‡Kv KvwW©IMÖv‡gi Rb¨ Avm‡j ¯^v¯’¨ Kg‡cø‡· available bv| GUv †h †Kvb m`i nvmcvZv‡j ev A‡bK RvqMvq †gwW‡Kj K‡jR ¸‡jv‡Z Av‡Q| myZivs BwmwR, B‡Kv KvwW©IMÖvg Ki‡Z †Kvb mgm¨v bvB Ges BwUwUI wKš‘ A‡bK mgq A‡bK †Rjv nvmcvZv‡j available Avi wmwU G¨vbwRIMÖvg ev G¨vbwRIMÖv‡gi Rb¨ Avm‡j wKQz wKQz we‡klvwqZ nvmcvZvj Av‡Q G¸‡jv XvKv‡Z †hgb Av‡Q †Zgwb XvKvi evwn‡i
- 16. 11 wefvMxq kn‡ii A‡bKRvqMv‡ZB Av‡Q †hgb- ivRkvnx, Lyjbv, PÆMÖvg, iscyi, Kzwgjøv, w`bvRcyi GB me ¸‡jv‡ZB Avm‡j G¨vbwRIMÖvg ev wmwU G¨vbwRIMÖvg †gwkb available| myZivs Avgiv nv‡U©i †iv‡Mi eøK Av‡Q wKbv ev Avgvi eøK RwbZ ü`‡ivM Qvov Ab¨vb¨ ü`‡ivM, Rb¥MZ ü`‡ivM Av‡Q wKbv, nvU© †dBjyi Av‡Q wKbv G¸‡jv GK`g Kbdvg© Kivi Rb¨ †gvUvgywU Avgv‡`i wefvMxq kn‡i A_ev †Kvb †Kvb †ÿ‡Î †Rjv kn‡iI Avgiv wbwðZ n‡Z cvwi| Avgv‡`i †h me †ÿ‡ÎB XvKv Avm‡Z n‡e Zv wKš‘ bv| Dc¯’vcK : nv‡U©i †ivMxi †ÿ‡Î †Zv mgqUv Lye ¸iæZ¡c~Y©| hZ Kg mg‡q `ªæZ nvmcvZv‡j †cuŠQv‡bv hvq| Wvt †ZŠwdKzi ingvb : Z‡e wKQz wKQz †ÿ‡Î †hgb Avgvi ey‡K e¨_v n‡jv, ey‡K e¨_vi Rb¨ wPwKrmv wb‡q Avgiv †hUv Av‡jvPbv Ki‡Z wQjvg †h, ey‡K e¨_vi Rb¨ nvU© G¨vUvK n‡q‡Q †h KviY wb‡q Avgiv Av‡jvPbv KiwQjvg †h, i³bvwji g‡a¨ i³RgvU †eu‡a †h nvU© G¨vUvK nq GB RgvU euvav i³Uv‡K Mjv‡bvi Rb¨ †h, Jla Av‡Q GB Jla †`qvi Rb¨ wKš‘ †gvUvgywU evsjv‡`‡ki me m`i nvmcvZv‡j wKš‘ †gwkb Av‡Q ev GiKg JlaI Available wKš‘ GUvi Rb¨ Avevi wPwKrmv †hUv g~j wPwKrmvUv †hUv 100% Successful †mUv n‡jv cÖvBgvwi wcwmAvB| GB cÖvBgvix wcwmAvB nqZ A‡bK RvqMv‡Z Available bvB| †m‡ÿ‡Î nqZ XvKv‡Z ev †h †Kvb KvwW©qvK †m›Uv‡i †hLv‡b cÖvBgvix wcwmAvB n‡jv †ivMx hLb Av‡m H gyû‡Z© Avgiv G¨vbwRIMÖvg Kwi nvU© G¨vUv‡Ki g‡a¨B| G¨vbwRIMÖvg K‡i †h i³bvwj‡Z 100% eÜ n‡q †M‡Q Ges H i³bvwj 100% eÜ nIqvi d‡j †Kvb †d¬v bvB Ges i‡³i PvKv RgvU euvav Av‡Q| GB i³ RgvU euvav Avgiv cÖ‡qvR‡b mvKkb K‡i †ei K‡i wb‡q i³bvwj †UvUvwj 100% Ly‡j w`‡Z cvwi| †hLv‡b nv‡U©i gv‡mj †Kvb ai‡bi W¨v‡gR nIqvi m¤¢vebv bvB| GB 100% mdjZv ïaygvÎ cÖvBgvix wcwmAvB Øviv m¤¢e| Wvt Agj Kzgvi : Av”Qv, Wvt †ZŠwdK, me wKQz my›`i K‡i e‡jB †d‡j‡Q Zvi mv‡_ Avwg GKUz †hvM Kwi, Avgv‡`i AvR‡Ki Av‡jvPbvi welqe¯‘ n‡”Q ÔAvaywbK c×wZ‡Z ü`‡iv‡Mi wPwKrmvÕ †mUv n‡”Q i³ Mjv‡bvi †h K_vUv ejj GUv †Rjv ch©vq †_‡K ïiæ K‡i mevB wb‡q Av‡m wKš‘ i³ Mjv‡bvi ciI wKš‘ †PK G¨vbwRIMÖvg GKUv Ki‡Z n‡e Ges i³ Mjv‡bvi Jla Av‡M Avgv‡`i †`‡k GKUv wQj wKš‘ GLb Av‡iKUv G‡m‡Q †mUv wKš‘ `vgx n‡jI GUvi mdjZvi nvi Av‡Mi cy‡iv‡bv †hUv wQj Zvi †_‡K A‡bK †ekx| cÖvq cÖvBgvix wcwmAvB‡qi K_v †h ejj HUv wKš‘ mKj `k©Ke„›`‡K Avcbvi gva¨‡g Rvwb‡q w`‡Z PvB †h, e¨_v DVvi 12 N›Uvi g‡a¨ wKš‘ GKUv KvwW©qvK †m›Uv‡i †cuŠQv‡Z n‡e| Zvn‡jB †m GB cÖvBgvix wcwmAvB †hUv me©vaywbK wPwKrmv GUv †m cv‡e A_ev i³ Mjv‡bvi †h Jla¸‡jv Lye kw³kvjx Jla¸‡jv 12 N›Uvi c‡i wKš‘ Avi †`Iqv hvq bv K‡qKUv KwÛkb e¨wZZ Avi AvaywbK wPwKrmv †h‡ûZz AvR‡Ki Av‡jvPbv| Av‡iKUv K_v ej‡Z PvB Av‡M Avgiv G¨vbwRIMÖvg KiZvg cv w`‡q Avi GLb G¨vbwRIMÖvg Kwi nvZ w`‡q| Avgv‡`i GLb ÷¨vUvm nvZ w`‡q 60% Avi cv w`‡q 40%| nvZ w`‡q G¨vbwRIMÖvg Kivi myweav n‡”Q †ivMx hw` ¯^vfvweK _v‡K 4 N›Uv ci †ivMx evox P‡j †h‡Z cvi‡e| Avgiv †ivMxi G¨vbwRIMÖvg Kijvg Zvi G¨vbwRIMÖvg †`Lv †Mj ¯^vfvweK A_ev
- 17. 12 gvBbi eøK Zv‡Kï‡q _vK‡Z nq bv Avi cv w`‡q G¨vbwRIMÖvg Ki‡j †hgb 2 w`b cv †mvRv K‡i ï‡q _vK‡Z nq| cv fuvR Ki‡j HLvb †_‡K i³cvZ n‡e| Avi nvZ w`‡q Ki‡j wKš‘ †ivMx bvovPvov GLvb †_‡K ILv‡b hv‡”Q Uq‡jU, ev_iæg, LvIqv- `vIqv †Kvb mgm¨v Zvi n‡”Q bv Ges GUv‡Z wisI emv‡bv m¤¢e cÖwZ gyû‡Z© cv w`‡q †hUv KiZ †mUv nvZ w`‡q| GUv wKš‘ AvaywbK wPwKrmvi gv‡b AvaywbK nv‡U©i wPwKrmvi gvBì †d¬v| GUv‡K ejv nq Radial route Avgv‡`i nv‡Zi †h, i³bvwj GUv‡K Avgiv e¨envi Kwi cv‡qi Uv e¨envi bv K‡i| nv‡Zi i³bvwjUv GKUz miæ Avgv‡`i GKUz mveav‡b Ki‡Z nq wKš‘ †ivMxi Rb¨ A‡bK DcKvix| G‡Z †ivMx Kó Kg cvq| †ivMxi nvmcvZv‡j Ae¯’vb K‡g, nvmcvZv‡j Kg _vK‡Z nq| Dc¯’vcK : m¨vi (Wvt Agj) Avgiv GB cÖm‡½ Avme Av‡iKwU †dvb Kj wb‡q| `k©K Avcbvi bvg e‡j cÖkœwU Kiæb? `k©K 4 : AvmmvjvgyAvjvBKzg| Avwg cvebv †Rjv †_‡K iæ`ª ejwQ| wR¦, Avgvi eqm n‡”Q 19 eQi| Avwg hLb iv‡Î Nygv‡Z hvB gv‡b Avwg hLb weQvbvq ï‡q _vwK| ZLb Avgvi ey‡Ki aicovwb A‡bK †e‡o hvq Ges Avgvi cwikÖg Ki‡Z Lye Kó nq| Avi hLb †Kvb cwikÖg Ki‡Z hvB ZLb kixi †_‡K kw³Uv Avgvi †Q‡o †`q Avi Avgvi †cÖkvi me mgq 150/100 _v‡K Avi Avgvi bv‡K cwjcv‡mi nvjKv mgm¨v Av‡Q| Wvt Agj Kzgvi : Avcbv‡K (`k©K 4) ab¨ev`, Avcbvi 19 eQi eqm ej‡jb| Avcbvi †h‡ûZz Kó nq KvR Ki‡Z †M‡j †m‡nZz Avcbv‡K Aek¨B GKUv KvwW©qvK †PK Avc jvM‡e| GUv dzmdz‡mi Kvi‡YI k^vmKó n‡Z cv‡i, arrhythmia n‡Z cv‡i Avcwb ej‡Qb iv‡Z ï‡q _vK‡j eyK aoco K‡i, AZGe Avcbvi GKRb KvwW©IjwR‡÷i kibvcbœ n‡Z n‡e Ges Dwb hv hv e‡j †hgb- BwmwR Ki‡Z n‡e, ey‡Ki G· †i Ki‡Z n‡e, `iKvi nq GKUv nëvi BwmwR e‡j 24 N›Uvi GKUv cixÿv Av‡Q Zvi GB nvU© weU Uv wbqwgZ bvwK AwbqwgZ GUv aivi Rb¨, 24 N›Uvi nëvi gwbUwis GUv Dwb kix‡ii mv‡_ jvwM‡q wb‡q Ny‡i †eov‡e wbZ¨ wbqwgZ †h KvR Kg© K‡ib †m¸‡jv Ki‡e, c‡i Ly‡j Ii wfZi †h wW¯‹Uv _v‡K Avgiv KvwW©IjwR÷iv †mB wi‡cvU© GbvjvBwmm K‡i †`wL †h, wK Kvi‡Y Zvi eyK aico K‡i, Avi Ab¨ †Kvb †hgb Avcbvi eøK nIqvi m¤¢vebv Kg wKš‘ nv‡U©i †h Ab¨ AmyL ¸‡jv Av‡Q †hUv Avgiv Av‡MI e‡j AvmwQ †h, evZR¦‡ii Kvi‡Y nv‡U©i fv‡j¦ wW‡d± _vK‡Z cv‡i, Rb¥MZ †Kvb µwU _vK‡Z cv‡i, G¸‡jv Avcwb GKUz †PK Avc K‡i wb‡Z cv‡ib| Wvt †ZŠwdKzi ingvb : Avwg hw` GKUz †hvM Ki‡Z PvB (`k©K 4) g‡b nq †hvM Ki‡Q †h, †cÖkvi _v‡K 150/100 me mgq| †cÖkvi †h‡nZz 150/100 _v‡K Avcbvi hw` `xN©
- 18. 13 †gqv`x †cÖkvi GiKg†ekx _v‡K Zvn‡j †h, mgm¨vUv n‡Z cv‡i Avcbvi nv‡U©i gv‡mj Av‡¯Í Av‡¯Í †gvUv n‡Z cv‡i, nvBcvi‡Uªvwc n‡Z cv‡i| nvBcvi‡Uªvwc RwbZ Kvi‡Y wKš‘ Avcbvi k^vmKó ev eyK aico Kiv Avevi †mUv n‡Z cv‡i Aí †Kvb KvR Ki‡jB nuvwc‡q hvIqv| Avcbvi D”Pi³Pvc hw` Avcwb wbqš¿Y bv K‡ib `xN© †gqv`x, Zvn‡j Avcbvi GB ai‡bi mgm¨v n‡Z cv‡i| myZivs Avcwb `ªæZ GKRb ü`‡ivM we‡klÁ wPwKrm‡Ki mv‡_ †hvMv‡hvM K‡ib hv‡Z Avcbvi †cÖkvi wbqš¿Y nq Avi Avcbvi eqm †h‡nZz Kg myZivs Avcbvi GB D”P i³Pv‡ci †m‡KÛvix †Kvb KviY Av‡Q wKbv GUv wKš‘ Avcbv‡K †ei Ki‡Z n‡e| †Kbbv Ab¨ †Kvb KviYI _vK‡Z cv‡i †h‡nZz Avcbvi eqmI Kg Aí eq‡m i³Pvc nIqv Avi i³Pvc wbqš¿Y Ki‡Z n‡e ab¨ev`| Dc¯’vcK : Av”Qv Avgiv ejwQjvg †h, GLb Aí eqmx‡`i g‡a¨I GLb GB jÿY¸‡jv †`Lv hvq| ej‡Z ej‡Z Avgiv GKRb `k©KI †c‡q †Mjvg| Wvt Agj Kzgvi : nu¨v, Avwg †Zv ejjvg Avwg MZ mßv‡n GKRb ev”Pv †c‡qwQ hvi 16 eQi eqm G¨vbwRIMÖvg Ki‡Z n‡q‡Q Zvi nvU© G¨vUvK n‡q‡Q| Dc¯’vcK : m¨vi (Wvt Agj) Avcwb AvaywbK wPwKrmv m¤ú‡K© ejwQ‡jb ? Wvt Agj Kzgvi : nu¨v AvaywbK wPwKrmv GUv wb‡q Avwg GKUz ej‡Z cvwi †h, Avgv‡`i gvbbxq cÖavbgš¿x wKš‘ nv‡U©i wWcvU©‡g›U mg‡Ü Dwb A‡bK wKQz ey‡Sb Dwb wKš‘ e‡j‡Qb †h, †Rjv nvmcvZv‡j Dwb wKš‘ 1 eQ‡ii g‡a¨ wmwmBD †`L‡Z Pvb| Dwb wKš‘ G e¨vcv‡i LyeB m‡PZb| d‡j Avgv‡`i RbMY LyeB fvM¨evb †h, cÖavbgš¿x wb‡R Avgv‡`i cÖvqB wb‡`©k w`‡q _v‡Kb| G AvaywbK wPwKrmvq wKš‘ Avgv‡`i mg¯Í hš¿cvwZ GbAvBwmwfwW †Z †h¸‡jv Av‡Q cÖvB‡fU †m›Uv‡iI 2-1 Uv‡Z †m¸‡jv Av‡Q| †hgb g‡b K‡ib †h, Av‡M GKUv KbwdDkb wQj †h, †ccv‡i cÖvqB mvsevw`K fvB‡qiv †jLv‡jwL KiZ †h, Wv³vi mv‡n‡eiv 40% eø‡K wis jvwM‡q w`‡q‡Q ev †KD 60% wis jvwM‡q w`‡q‡Q| G¸‡jv wVK Kivi Rb¨ Avgv‡`i RvZxq ü`‡ivM BÝwówUDU I nvmcvZv‡ji cwiPvjK g‡nv`q we‡`‡k †hme wRwbm¸‡jv e¨envi Kiv nq †mme ¸‡jvB Avgiv wK‡b †d‡jwQ| GUv wK 40 % bvwK 70%, bvwK nv‡U©i i³ PjvP‡j e¨NvZ NUv‡”Q wKbv- FFR e‡j GKUv †gwkb Av‡Q Fractional Flow Reserve. ïay 2 wgwb‡U GKUv G¨vbwRIMÖvg Kijvg GKUv eøK †cjvg 60% Avwg Avi Avgvi mnKvix ejj bv m¨vi GUv GKUz Kg 40% KviY GUv mve‡RKwUf Avgvi AwfÁZvq g‡b n‡”Q| 70% Ii AwfÁZv g‡b n‡”Q 40% no good, FFR K‡i †dj 2 wgwb‡Ui g‡a¨ FFR e‡j w`‡e GUv wK wµwUKvj bvwK wµwUKvj bv, hvB‡nvK GUv wK †ivMxi Rb¨ ÿwZKviK wKbv, GB eøK Uv wUªU Kiv jvM‡e wKbv? GB †Mj FFR| Dc¯’vcK : m¨vi (Wvt Agj) GB myweav ¸‡jv GbAvBwmwfwW‡Z wK available? Wvt Agj Kzgvi : nu¨v, GbAvBwmwfwW‡Z Av‡Q, cÖvB‡fU 2-1 †m›Uv‡iI Av‡Q, n‡q hv‡e GUv G‡Zv `vwg †gwkb bv mevB wK‡b †dj‡e Av‡¯Í Av‡¯Í| Av‡iKUv Av‡Q †h, Avgiv wis jvMvB wis jvMv‡j wKš‘ AcwUgvB‡Rkb Av‡Q| wis Uv mwVK fv‡e Lyj‡jv wKbv Iqv‡ji mv‡_ jvM‡jv wKbv agbxUv Avv‡Mi g‡Zv Avjøvn cÖ`Ë †hgb Hfv‡e K‡i w`‡Z cvijvg
- 19. 14 wKbv| GBUvi GKUv†gwk‡bi bvg IVUS. Intavascular Ultrasound. K‡ivbvix AvëªvmvDÛ Avgiv wKš‘ GUvI wis jvMv‡bvi c‡i Avevi GKevi †gwkb w`‡q †`‡L Avwm †h, wis †Kv_vI Pvcv _vK‡jv wKbv, †Kv_vI †ekx Pvcv _vK‡jv wKbv, †Kv_vI Kg Pvcv Av‡Q wKbv GUv †`‡L Avevi †ejyb w`‡q Pvc w`‡q my›`i K‡i †`B| GB †h, AcwUgvB‡Rk‡bi d‡j h_vh_fv‡e wis emv‡bvi mg¯Í c×wZ wKš‘ Avgv‡`i †`‡k Av‡Q Ges G‡`i LiP G‡Zv Kg we‡`kx‡`i Zzjbvq Zv wPš‘vB Kiv hvq bv| GZ Kg UvKvq Avgiv wPwKrmv w`‡Z cviwQ| Dc¯’vcK : Av”Qv, hviv GKUz Ae¯’v m¤ú~Y© Zv‡`i GKUv cÖeYZv _v‡K †`‡ki evwn‡i wM‡q wPwKrmv MÖnY Kivi GLb Zvi Avi cÖ‡qvRb n‡e bv Avgv‡`i †`‡k me ai‡bi myweav Av‡Q| Wvt Agj Kzgvi : nu¨v, GB wRwbmUv Avgiv Kwg‡q †d‡jwQ we‡`‡k GLb Avi †Kv‡bv fv‡jv †ivMx hvqbv| hv‡`i A‡Xj UvKv Av‡Q Zviv 2-1 Rb d¨vkb Kivi Rb¨ we‡`‡k †h‡Z cv‡i wKš‘ hviv mwZ¨Kv‡ii †ivMx Zviv Avgvi g‡b nq bv nv‡U©i †ivMx †KD hvq| Wvt †ZŠwdKzi ingvb : GiKg †h K_vUv wQj Av‡M †hgb Avgiv G¨vbwRIMÖvg Kijvg wZbUv i³bvwj‡Z †`Lv †Mj †h, 70% Gi gZ eøK| Avgiv wKš‘ m¨vi (Wvt Agj) †hUv ej‡jb 70% Dc‡i eøK †c‡j wis ewm‡q w`Zvg †mUv n‡jv Av‡Mi Kb‡mÞ| GLb wKš‘ aviYvi cwieZ©b n‡q‡Q e‡j 70% eøK n‡Z cv‡i wKš‘ GB 70% eøK Zvi †P‡qI †ekx 80% g‡b n‡Z cv‡i| wKš‘ GB eøK Uv GgbI n‡Z cv‡i Avgvi †Zgb †Kv‡bv Significant ÿwZ Ki‡Q bv gv‡b ILv‡b Avgvi Aw·‡RbI Lvev‡ii NuvUwZ ci‡Qbv| GLb Aw·‡RbI Lvev‡ii NuvUwZ bv ci‡j †mLv‡b †Zv Avgvi wis jvMv‡bvi †Kvb cÖ‡qvRb bvB| †Zv †mB †ÿ‡Î †`Lv hv‡”Q Avgvi g‡b n‡Z cv‡i Avjv`vfv‡e 70-80% eøK wKš‘ GB eø‡K Avgiv FFR’i gva¨‡g cixÿv K‡i hLb †`wL †h, bv Avm‡j Avgvi †d¬v wjwgU gv‡b Avgvi i³ PjvP‡j †Zgb euvavMÖ¯’ Ki‡Q bv| Avgvi eøK n‡jB †h, i³ euvav cv‡e Zv wKš‘ bv, hw` euvavMÖ¯’ bv K‡i Zvn‡j Avgvi GLv‡b wis Gi cÖ‡qvRb bvB| †mRb¨ A‡bK †m›Uv‡i †`Lv hvq evwn‡ii †m›Uvi ¸‡jv‡Z ev Avgv‡`i †m›Uvi A_ev †Kvb †Kvb †ÿ‡Î †`Lv hvq Avgv‡`i hLb GB †gwkb¸‡jv wQj bv, Avgiv e‡j w`‡qwQ Avcbvi 70% eøK Avcbvi 3 Uv wis jvM‡Z cv‡i| †ivMx hLb evwn‡i †M‡Q ZLb †ivMx e‡j Avgvi wK GKUv wis jvM‡j n‡e, Avgv‡K †Zv Zviv GKUv wis jvwM‡q w`‡q‡Q wKš‘ Avgv‡K †Zv evsjv‡`‡k e‡j‡Q wZbUv wis jvMv‡Z n‡e| wRwbmUv KbwdDkb wKš‘ ZLb †_‡KB ïiæ n‡q‡Q| GLb Avgiv FFR †gwk‡bi mvnv‡h¨ GK`g wbwðZ Ki‡Z cvwi †h, Avm‡j GB †ivMxi wis wK wZbUv jvM‡e, `yBUv jvM‡e bvwK GKUv jvM‡e| Wvt Agj Kzgvi : Wvt wmdvZ (Dc¯’vwcKv) welqUv Zvn‡j wK `uvov‡jv Wvt †ZŠwdK B‡Zvg‡a¨ ejj GKUv †ivMxi 4 Uv eøK _vK‡j Avgiv FFR Ki‡j 2 Uv ev` P‡j hvq
- 20. 15 Zvi 2 Uvwis jv‡M| wZbUv eøK _vK‡j †`Lv †Mj †h, 2 Uv jvM‡e bv| Zvi †Kvb ÿwZ Ki‡Qbv H `yBUv eøK GKUv wis w`‡q n‡”Q| Zvn‡j Avgiv BwZg‡a¨ A‡bK mvw›UwdK Ges jwRK¨vj wPwKrmv‡Z P‡j G‡mwQ| Wvt †ZŠwdKzi ingvb : Avgv‡`i LiPI K‡g †Mj A‡a©K, †hLv‡b wZbUv wis ¯’‡j GKUv wis jvMv‡j Pj‡e| Dc¯’vcK : Av”Qv, G‡Z K‡i †ivMx‡`i mv‡_ Avcbv‡`i †h †hvMv‡hvM ev Avcbv‡`i †h †evSvcov †mUvI wKš‘ evo‡Q| Wvt Agj Kzgvi : nu¨v, Av‡iv evo‡Q †h, m¨viiv Av‡iv fv‡jvfv‡e †`‡L w`j †h, Avgvi H eøK ¸‡jv †Kv‡bv ÿwZ Ki‡Q wKbv? bv Jl‡ai gva¨‡g fv‡jv _vK‡e evwK eøK ¸‡jv| †hUv Lye wµwUKvj GB gyû‡Z© ÿwZ Ki‡Z cv‡i m¨v‡iiv †mUvi wPwKrmv K‡i w`j Avi H ¸‡jv Av‡¯Í Av‡¯Í Jla †L‡j K‡g hv‡e| Dc¯’vcK : m¨vi, Avgiv wPwKrmv wb‡q A‡bK K_v ejjvg GBevi GKUz cÖwZ‡iva wb‡q K_v ewj| Avm‡j nvU©‡K fv‡jv ivLvi Rb¨ wK Kiv `iKvi ? Wvt Agj Kzgvi : cÖwZ‡iv‡ai Rb¨ Avwg †hUv ewj `k©K‡`i Rb¨ 6Uv “S” g‡b ivL‡j me‡P‡q fv‡jv| “S” GUv mviv Rxeb g‡b _vK‡e cÖ_gZ S for Smoking, 2nd “S” for Sedentary life style should be avoided. e‡m _vKv hv‡e bv kvixwiK KvRKg© Ki‡Z n‡e| 3rd “S” for Sugar is very much detrimental for the Diabetes & Heart. ewWi wfZi Xz‡K †gUvewjRg n‡q wewfbœ iKg welv³ `ªe¨ ˆZix K‡i| 4th “S” for Saturated fat gv‡b Pwe©| †iW wgU, Rv¼ dzW, G¸‡jv Aek¨B cwinvi Ki‡Z n‡e| 5th “S” for Stress †hfv‡eB †nvK cwinvi Ki‡Z n‡e| GB cuvPUv “S” hLb Avgiv g‡b ivwL †h, Avgv‡`i KvRKg© evov‡Z n‡e, Avgv‡`i Lvevi `vevi cwieZ©b Ki‡Z n‡e cÖPzi kvKmeRx, Kg wgwó djg~j †L‡Z n‡e| ïay wgwó dj n‡j Avgv‡`i hv‡`i Wvqv‡ewUm Av‡Q Zv‡`i †Zv myMvi †e‡o hv‡e Zviv †L‡Z cvi‡e bv Avi kvwiixK KvR Kg© Avi Lvevi `vevi GB `yBUv hw` †g‡b P‡j Avi aygcvb hw` cwinvi K‡i| Wvt †ZŠwdKzi ingvb : Av‡iKUv “S” for sleep n‡Z cv‡i,Avm‡j GKRb c~Y© eq¯‹ gvbyl my¯’ _vK‡Z †M‡j Zv‡K w`‡b 6-8 N›Uv Nygv‡Z n‡e| Kgc‡ÿ 6 N›Uv, G Rb¨ Avgv‡`i mevB‡K ch©vß cwigv‡Y wekÖvg wb‡Z n‡e| wekÖvg bv wb‡j Avgv‡`i kix‡ii wfZ‡i †h Stress ni‡gvb ¸‡jv Av‡Q †mB Stress ni‡gvb ¸‡jv‡K Kgv‡bvi Rb¨ Avm‡j Nyg `iKvi| Zvn‡j GB Stress ni‡gvb ¸‡jv cieZx©‡Z Avm‡j Avgv‡`i GB †h, ü`‡ivM RwbZ mgm¨v¸‡jv ˆZwi K‡i| Avgvi g‡b nq “S” for sleep †hvM Kiv †h‡Z cv‡i gv‡b cwic~Y© NygUv Avm‡j `iKvi| Dc¯’vcK : GLb †Zv gvby‡li jvBd÷vBj Avm‡j †h iKg n‡q wM‡q‡Q †`Lv †Mj †h, evwn‡i Awd‡m Zviv KvR Ki‡Q N›Uvi ci N›Uv †Kvb ai‡bi kvixwiK kÖg †bB, †Kv‡bv ai‡bi e¨qvg Ki‡Z cvi‡Q bv| m¨vi Avwg GLb †hUv Rvb‡Z PvB hv‡`i nv‡U©i mgm¨v aiv c‡o‡Q nqZ 30% ev 40% eøK Av‡Q, Zviv wK Avm‡j †h †Kvb ai‡bi e¨qvg Ki‡Z cvi‡e?
- 21. 16 Wvt Agj Kzgvi: `yBUv Avcwb e‡j‡Qb me Prevention gv‡b cÖwZ‡iva wKš‘ 2 iKg| GKUv cÖv_wgK cÖwZ‡iva, Av‡iKUv n‡”Q Sceondery Prevention †Zv hv‡`i nq bvB Zv‡`i Rb¨ GKB K_v †h, Zviv mKvj weKvj A_ev 24 N›Uvi g‡a¨ 1 N›Uv ¯^v‡¯’¨i Rb¨ †ei Ki‡ZB n‡e kvwiixK cwikÖ‡gi Rb¨| hw` ZiæY nq 40 eQ‡ii bx‡P nq Zviv RwMs Ki‡e Rx‡g hv‡e| eq¯‹ hviv Zv‡`i Rb¨ Avgiv ewj nuvUv †nvK mKv‡j ev weKv‡j 1 N›Uv K‡i nuvU‡e Avi Wv³vi‡Zv mv‡Rkb w`‡”QB Lvevi `vev‡ii wel‡q †h †iW wgU Lv‡e bv, Pwe©hy³ Lvevi Lv‡e bv, myMvi Lv‡e bv, aygcvb Kiv hv‡e bv, G¸‡jv n‡”Q Sceondery Prevention. hviv wis jvwM‡q‡Q Zvi A‡bK Ávbx, Zviv †h Wv³v‡ii Kv‡Q wbqwgZ hv‡”Q wbqwgZ Zviv Dc‡`k cv‡”Q| Wvt †ZŠwdKzi ingvb : GB cÖm‡½ †hUvAv‡QWorldHeartFederation MZ K‡qK eQi a‡i Zviv GKUv cÖPviYv Pvjv‡”Q †mUv n‡jv- Avgiv †hLv‡b Kg© Kwi Avgv‡`i Kg©¯’j, Avgiv wKš‘ AwaKvsk mgq ILv‡b _vwK Ges ILv‡b †`Lv hvq †h, Avgiv Avjv`vfv‡e mgq †ei K‡i Ah_v e‡m bv †_‡K †Kvb GKUv wRg †Lvjvi e¨e¯’v Ki‡Z e‡j‡Q Zviv| hv‡Z K‡i Kgc‡ÿ RwMs Ki‡Z cvwi, e¨qvg Ki‡Z cvwi| myZivs H Kg©‡ÿ‡Îi g‡a¨ nqZ †KD by turn †KD †iv÷vi K‡i wb‡q, †KD Avav N›Uv K‡i mgq wb‡q ILv‡b Awdm mgqB RwMs Ki‡Z cvi‡e| Dc¯’vcK : m¨vi, Avgv‡`i mgq GK`g †kl n‡q †M‡Q, `k©K‡`i Rb¨ GK`g †QvU K‡i GKUv ab¨ev` w`‡q †`b| Wvt †ZŠwdKzi ingvb : evsjvwfk‡bi mKj `k©K‡`i ab¨ev` Ges evsjvwfkb‡KI ab¨ev`| Wvt Agj Kzgvi : evsjvwfkb I evsjvwfk‡bi mg¯Í `k©K‡`i ab¨ev`, Avcbviv fv‡jv _vK‡eb| Dc¯’vcK : m¨vi, Avcbv‡`i `yÕRb‡KB AmsL¨ ab¨ev` Avgv‡`i Abyôv‡b Avmvi Rb¨ Ges Avgv‡`i mgq †`qvi Rb¨| `k©K Avgv‡`i AvR‡Ki c‡e©i Av‡jvPbv GLv‡bB †kl| Avkv KiwQ Avcbviv DcK…Z n‡q‡Qb, †`Lv n‡e AvMvgx c‡e© bZzb †Kv‡bv welq wb‡q †m ch©šÍ Avcbviv mevB my¯’ _vKzb, fv‡jv _vKzb|
- 22. 17 Channel –I icÖPvwiZ Abyôvb Avcbvi my-m¦v¯’¨ welq: ü`‡ivM, GwcÖj, 2024 Dc¯’vcK : Wv: †gv: wRqvDj Kwig Avgwš¿Z AwZw_: (1) Wv: †gv: G †K Gg gÄyiæj Avjg, (2) Wv: †gv: †ZŠwdKzi ingvb| Dc¯’vcK : wcÖq `k©K, †h †hLv‡bB e‡m Av‡Qb Avcbv‡`i mevB‡K ï‡f”Qv Rvwb‡q ïiæ KiwQ Avcbv‡`i mevi wcÖq Abyôvb ÒAvcbvi my-¯^v¯’¨Ó Avcbviv Rv‡bb GB Abyôv‡bi gva¨‡g Avgiv wewfbœ ai‡Yi †ivM Ges †iv‡Mi cÖwZKvi, †ivM wRÁvmv wb‡q Av‡jvPbv K‡i _vwK| AvR‡KI Avgiv GKwU RwUj †ivM wb‡q Av‡jvPbv Kie †mwU n‡jv Òü`‡ivMÓ| GUvi `y‡Uv w`K Av‡Q 1 n‡”Q mvR©vwi Ges 2 n‡”Q †gwWwmb| GB `y‡Uv welq wb‡qB Avgiv Av‡jvPbv Kie| AvR Avgv‡`i ózwWI‡Z GB we‡kl wel‡q gZvgZ cÖKv‡ki Rb¨ Avgv‡`i mv‡_ 2Rb we‡kl AwZw_ Dcw¯’Z Av‡Qb| Zviv n‡”Qb Wv: G †K Gg gÄyiæj Avjg- wZwb RvZxq ü`‡ivM Bbw÷wUD‡U mnKvwi Aa¨vcK wn‡m‡e Kg©iZ Av‡Qb Ges Zvi mv‡_ Av‡Qb Wv: †gv: †ZŠwdKzi ingvb- wZwb mn‡hvMx Aa¨vcK (KvwW©IjwR), RvZxq ü`‡ivM Bbw÷wUDU I nvmcvZv‡j Kg©iZ Av‡Qb| Avwg cÖ_‡gB Wvt †gvt †ZŠwdKzi ingv‡bi Kv‡Q Rvb‡Z PvBe †h Avcbvi interventional cardiology e‡j _v‡Kb- †Zv †mwU ej‡Z Avgiv wK eywS? Wvt †ZŠwdKzi ingvb : Interventional cardiology n‡”Q GKUv wPwKrmv c×wZ| GUv AvaywbK wPwKrmv c×wZ‡Z Avgiv wewfbœ †ejyb ev wWfvB‡mi mvnvh¨ ü`‡iv‡Mi wewfbœ †iv‡Mi wPwKrmv Avgiv K‡i _vwK, †hgb Avgv‡`i heart Gi g‡a¨ hw` †Kvb valve miæ n‡q hvq ev †Kvb valve wjK K‡i A_ev heart Gi †h i³bvwj Av‡Q †mB i³bvwj hw` block nq, GB block ¸‡jv Avgiv †ejyb, ring ev stenting wWfvB‡mi gva¨‡g Avgiv wPwKrmv Ki‡Z cvwi| G¸‡jv‡KB interventional cardiology e‡j| Dc¯’vcK : Wv: †ZŠwdK, Avcbviv †Kvb †Kvb ai‡bi interventional cardiology Avgv‡`i †`‡k K‡i _v‡Kb? Wvt †ZŠwdKzi ingvb : Av”Qv, Avgv‡`i †`‡k interventional cardiology ej‡Z Rb¥MZ ü`‡ivM †hgb ASD,VSD, PDA G¸‡jv, G¸‡jv Av‡M †hgb surgery i mvnvh¨ eÜ Kiv n‡Zv, eyK †K‡U Ki‡Z n‡Zv, GLb wWfvB‡mi mvnvh¨ Avgiv ASD gv‡b Atrial septal defect, VSD ventricular septal defect, PDA Patent Ductus Arteriosus GUvi wPwKrmv Ki‡Z cvwi Ges †Kvb KvUv-†Qov QvovB| GQvovI Avgv‡`i heart Gi i³bvwj‡Z hw`
- 23. 18 †Kvb block n‡q_v‡K GB Uv Avgiv cÖ_‡g †ejyb w`‡q dzwj‡q c‡i HLv‡b Avgiv Stent ev ring Gi g‡Zv 1Uv wRwbm Av‡Q HUv w`‡q Avgiv wPwKrmv Ki‡Z cvwi| d‡j i³ cÖev‡n †h evavUv wQj †mB evavUv Avgiv stenting Gi mvnvh¨ overcome Ki‡Z cvwi| Dc¯’vcK : Av”Qv, Avcwb †h e‡j‡Qb i³bvwj block ev evav Av‡Q †Zv GB evavUv eySvi wK Dcvq Av‡Q A_ev Avcwb †ivMx‡K wKfv‡e ej‡Z cvi‡eb †h Dbvi i³bvwj‡Z block Av‡Q? Wvt †ZŠwdKzi ingvb : mvaviYZ 1†g Avgiv †`wL evav _vK‡j †ivMxiv †mB Dc¯^M© ¸‡jv wb‡q Avgv‡`i Kv‡Q Av‡m †ivMxi Dcm¦M© ¸‡jv wK n‡Z cv‡i? †ivMxi ey‡K e¨_v n‡Z cv‡i, e¨_v †Kb n‡e- bigvwj Avgv‡`i heart Gi i³bvwj w`‡q †h i³ cÖevn n‡”Q hLb †mLv‡b block nq block nIqvi d‡j †mLv‡b i³ mieivn K‡g hvq| †h‡nZz gvbyl cwikÖg Ki‡Z‡Q †h †Kvb cwikÖg wmuwo †e‡q Dc‡i DVv, evRv‡ii e¨vM nv‡Z wb‡q nuvUv ev Dc‡i DVv, †h †Kvb cwikÖ‡gi KvR Ki‡Z PvB‡j ZLb, i‡³i demand ev‡o, Lvev‡ii demand ev‡o, Aw·‡R‡bi demand ev‡o, heart Gi wUmy¨i| d‡j wK nq GK ai‡bi e¨_v K‡i hw` †Kvb †ivMx ev f`ª‡jvK, f`ªgwnjvi hw` †`Lv hvq, †h †Kvb KvR Ki‡Z †M‡j Zvi ey‡K e¨_v nq ev k^vmKó ZLb Avgiv Abygvb Ki‡Z cvwi †h nu¨v, Dbvi heart Gi i³bvwj †Z block Av‡Q| †m‡ÿ‡Î Avgiv wK Kwi- 1‡g ECG Ki‡Z cvwi ECG †Z A‡bK mgq change bvI Avm‡Z cv‡i, †ivMxi i³bvwj‡Z GK ev GKvwaK block _vK‡jI ECG bigvj _vK‡Z cv‡i, †Zv ECG bigvj _vK‡jI Avgiv †`L‡ZwQ †h †ivMxi symptoms Av‡Q| ZLb Avgiv wK Kie GUv‡K confirm Kivi Rb¨ Avgiv Echocardiography Ges ETT-Exercise Tolerance Test Kwi| A_©vr †ivMx Av‡M cwikÖg Ki‡j ey‡K e¨_vi K_v ejZ ev n‡Zv ZLb GB cwikÖgUv Avgiv †gwk‡bi mvnv‡h¨ Ki‡Z †`B exercise Gi gva¨‡g †`B †gwk‡bi mvnvh¨| ZLb wK Av‡m, Avwg ETT Ki‡j ECG †Z change Av‡m GB ECG †Z change Gi cvkvcvwk †ivMxi symptoms nq ey‡K e¨_v nq ZLb Avgiv wbwðZ n‡Z cvwi GB †ivMxi Ischemic Heart Disease ev †ivMxi heart Gi i³bvwj‡Z block n‡Z cv‡i| Dc¯’vcK : †mB †ÿ‡Î block Uv wbY©q Kivi Rb¨ Avcwb †hUv aviYv Ki‡jb- Wvt †ZŠwdKzi ingvb : nu¨v, GUv Avgiv aviYv Ki‡Z cvwi, Avi Avgiv wbwðZ nIqvi Rb¨ GbwRIMÖvgI Ki‡Z cvwi| Angiogram 2 ai‡bi Kiv †h‡Z cv‡i, 1 Uv n‡jv GUv conventional angiogram ev invasive angiogram †ivMx nvmcvZv‡j fwZ© †_‡K Zvici Ki‡Z nq Av‡iKUv n‡jv cardiac CT angiogram ejv nq-GB `y‡Uv c×wZ‡ZB Avgiv heart Gi i³bvwj‡Z block Av‡Q wKbv wbwðZ n‡Z cvwi| Dc¯’vcK : Avcbviv Avm‡j interventional cardiologist hviv Av‡Qb Avgiv cÖvq †`‡L _vwK hLb GKUv †ivMx heart attack wb‡q fwZ© n‡jv ev myocardial infraction †hUv Avcbv‡`i fvlvq †hUv e‡jb fwZ© n‡jv fwZ© nIqvi c‡i hLb Avcbviv GKUv advice w`‡q _v‡Kb †h Avcwb 1 gvm c‡i Avm‡eb ev 2 gvm c‡i Avm‡eb angiogram Kivi Rb¨ GUv †Kb?
- 24. 19 Wvt †ZŠwdKzi ingvb: nu¨v, GUv Avgiv nqZ Discharge ev †ivMx †Q‡o †`qvi mgq Avgiv advice Kwi ïay Zv bv, Avm‡j Avgiv †ivMx fwZ© _vKvKvwjb, even †ivMx †hw`b heart attack wb‡q fwZ© n‡jv- Hw`bI Avgiv angiogram Ki‡Z cvwi| †Kbbv †ivMx fwZ© nevi mgq †`Lv hvq, †h c×wZ‡Z †ivMxi heart attack nq, †`Lv hvq †ivMxi heart Gi i³bvwj‡Z †h block Uv wQj †mB blockUv KLbI KLbI †d‡U hvq| †d‡U †M‡j GB dvUvi g‡a¨ i³ RgvU euva‡Z _v‡K i³ RgvU euvavi d‡j totally i³ mieivn eÜ n‡q hvq| hvi Rb¨ †ivMxi cÖPÛ ey‡K e¨_v nq Sweating ev Nvg nq, †Zv GB Ae¯’vq hLb †ivMx Avgv‡`i Kv‡Q Av‡m Ges ECG †Z Avgiv change cvB| ZLbB Avgiv mivmwi †ivMx‡K cathlab G wb‡q †h‡Z cvwi angiogram Kivi Rb¨, GUvi D‡Ïk¨ wK? Avgv‡`i heart Gi i³bvwj‡Z †h i³Uv RgvU †e‡a‡Q †mB RgvU evavUv wKQz Jl‡ai gva¨‡g Mwj‡q w`‡Z cvwi Plus †h block Uv n‡jv †hUv Pi ev plaque e‡j HLv‡b Avgiv 1Uv wis ewm‡q w`‡Z cvwi GUv‡K Avgiv ewj Primary PCI | Dc¯’vcK : gv‡b Avcwb (Wv: †ZŠwdK) e‡j‡Qb heart attack nIqvi mv‡_ wPwKrmv †`qv,GUvi wK †Kvb timetable Av‡Q? Wvt †ZŠwdKzi ingvb : Time-period Gi g‡a¨ Avgv‡`i nvmcvZv‡j †ivMx fwZ© nIqvi Avav N›Uvi g‡a¨ mvaviYZ Avgiv K‡i _vwK Avi †ivMxi e¨_v nevi(8-12) N›Uv maximum 24 N›Uv Gi g‡a¨ angiogram Ki‡Z nq Zv bv n‡j already heart Gi damage ïiæ n‡q hvq, c‡i Ki‡j ZLb Avm‡j Lye †ewk GKUv jvf nq bv| Dc¯’vcK : Wv: gÄyiæj Avjg Avcwb `xN©w`b hver KvwW©qvK mvR©b wn‡m‡e KvR K‡i hv‡”Qb| Avgiv Avm‡j †hUv †`LwQ †hLv‡b medicine e¨_© n‡”Q †mLv‡b wKš‘ surgery i GKUv †ivj _v‡K, †Zv Wv: †ZŠwdKzi ingvb e‡j‡Qb ring jvMv‡bvi K_v wKš‘ Avgiv †`wL Avcbviv surgeryI K‡i _v‡Kb bypass surgery †hUv †Zv Avgvi cÖkœ n‡”Q †Kvb †Kvb †ÿ‡Î bypass surgery K‡i _v‡Kb? Wv: gÄyiæj Avjg : Left main disease G heart Gi block Uv Lye †Mvovi w`‡K _v‡K g~j i³bvwj K‡ivbvwi artery| †Zv †mLv‡b ring jvMv‡Z A‡bK †ÿ‡Î Kó nq| †KD cv‡i †KDev fail nq †h‡nZz Zviv cv‡ibv †mB †ÿ‡Î Zviv Avgv‡`i Kv‡Q refer K‡i bv¤^vi (1)| bv¤^vi(2) length of lesion A_©vr K‡ivbvwi AvUv©wii †h RvqMv‡Z block Gi cwigvb A_ev †h cwigvY Pwe© R‡g i³bvwj block n‡q Av‡Q Zvi length Uv A‡bK †ewk| †hLv‡b ring jvMv‡bvi stage G bvB A_ev Avgiv diffuse lesion ewj K‡ivbvwi AvU©vwi‡Z †hUv right KY©v‡iI n‡Z cv‡i left KYv©‡iI n‡Z cv‡i| A_©vr wewfbœ RvqMvq ring Gi Rb¨ †hLv‡b
- 25. 20 possible bv †hLv‡bblock Gi Rb¨ Zviv †ivMx‡`i‡K Avgv‡`i Kv‡Q cvVvq| †m¸‡jv Avgiv K‡i _vwK Ges Avgiv GLbI g‡b Kwi hw` fv‡jv qualityi graft jvMv‡bv hvq I fv‡jv mvR©vwi Kiv hvq Zvn‡j †ivMxi A‡bK benefit n‡e| Dc¯’vcK : Av‡iKUv wRwbm †hUv Avgiv cÖvqB ï‡b _vwK block 2 Gi AwaK ev 3 Gi AwaK ev †ewk _vK‡j Avcbviv mvR©vwii w`‡K hvb| Wvt †ZŠwdKzi ingvb : nu¨v, 2-3 Gi AwaK _vK‡j mvR©vwi Kiv nq| GUviI GKUv D‡Ïk¨ Av‡Q, GKUv †ivMxi †hgb hw` 2 Gi AwaK 3 (5-8) Uv block I _v‡K| GLb hw` †ivMxi 7Uv block _v‡K Avgiv †h ring Gi `v‡gi K_v ejjvg hw` GiKg (50-60) nvRvi UvKvI `vg nq Zvn‡j 7 Uv Gi Rb¨ (6 x 7=42) gv‡b 4 jvL 20 nvRvi gv‡b around (4-5) jvL UvKv LiP n‡e Avi evBcvm mvR©vix Ki‡Z LiP nq mvaviYZ 1 jvL (20-30) nvRvi UvKv ev 2 jvL -3 jvL maximum myZivs GB †ÿ‡Î †ivMxi Rb¨ A‡bK mvkÖqx nq GK ai‡bi| Wv: gÄyiæj Avjg : Wv: †ZŠwd‡Ki K_vi mv‡_ AvwgI GKUz †hvM Kwi †mUv n‡jv (4-5) Uv ring jvMv‡bvi ciI †Kvb guarantee bvB †h 2 w`b c‡i GUv restonosis ewj Avgiv medical termG A_©vr GUv †h cieZx©‡Z Avevi block n‡ebv Zvi †Kvb guarantee bvB| Dc¯’vcK : Wv: gÄyiæj Avcwb GKUz ¯úó K‡i e‡jb bypass mvR©vwi †hUv Avcbviv K‡i _v‡Kb GB mvR©vwii g‡a¨ †Kvb †Kvb mvR©vwi ¸‡jv Avgv‡`i †`‡k n‡”Q GLb heart Gi Dci| Wv: gÄyiæj Avjg : g~jZ hw` heart G block _v‡K K‡ivbvwi AvU©vwi‡Z ZLb Avgiv bypass mvRv©wi advice Kwi| GQvov Rb¥MZfv‡e wKQz AmyL _v‡K ev Rb¥ †_‡KB †h AmyL ¸‡jv wb‡q Av‡m congenital heart disease, Avgiv Atrial septal defect (ASD), Ventricular septal defect (VSD), Patent Ductus Arteriosus (PDA) GB ¸‡jv mvaviYZ Avgiv Kwi| fvj¦ ¸‡jv surgery Kwi, congenital heart surgery Kwi mvaviYZ Aortic I mitral valve heart surgery Kwi Avgiv| Dc¯’vcK : Wv: gÄyiæj Avcwb e‡j‡Qb †h fvj¦ surgery K‡ib †Zv Avgv‡`i †`‡k fvj¦ surgery Kq ai‡bi nq ev wKfv‡e K‡i _v‡Kb, †Kvb †Kvb Acv‡ik‡bUv fv‡jv K‡i _v‡Kb- Wv: gÄyiæj Avjg : mvaviYZ Avgiv mitral valve ¸‡jv mvR©vwi Kwi aortic valve ¸‡jv mvR©vwi Kwi GB `y‡UvB Avgv‡`i †`‡k †ewk nq, Gi wfZ‡i mvR©vwii g‡a¨ Avevi 2 ai‡bi Av‡Q 1 n‡jv m¤ú~Y© iæ‡c Avgiv valve Uv‡K change Ki‡Z cvwi †hgb aortic valve change Ki‡Z cvwi mitral valve †PÄ Ki‡Z cvwi, A‡bK mgq †`Lv hvq GKB patient Gi 2Uv valveB involve n‡q hvq mvR©vwii cÖ‡qvRb nq †m‡ÿ‡Î A‡bK mgq Avgiv mitral valve Uv repair Kwi I aortic valve Uv change Kwi| mvaviYZ mitral valve Uv repairing GKUz †ewk benefit nq hw` cÖ‡qvRb nq| GUv depend K‡i according to the pathlogy of valve, aortic valve Uv Avgiv mvaviYZ Kg repair Kwi change †ewk Kwi|
- 26. 21 Dc¯’vcK : Av”QvGi ci †h cÖkœUv P‡j Av‡m †h Avcwb [Wv: gÄyiæj ] valve surgery Ki‡jb aortic valve ev mitral valve| †Zv GB valve surgeryi c‡i GKRb †ivMx wK Avevi my¯’ my›`i Rxe‡b wd‡i †h‡Z cv‡i- Wv: gÄyiæj Avjg : nu¨v, cv‡i Aek¨B cv‡i Ges A‡bK fv‡jvI _v‡K| Z‡e Dbv‡K ixwZgZ ev gv‡m 1 evi A_ev 2 gv‡m 1 evi †h Wv³vi mv‡ne Dbvi mvR©vwi K‡i‡Qb †h cardiac mvR©b Zvi mv‡_ †hvMv‡hvM ivL‡Z n‡e A_ev d‡jvAv‡c _vK‡Z n‡e Kvib valve surgery Avgiv †hUv Kwi †mUv n‡”Q Rb¥MZ fv‡e †hUv gvby‡li _v‡K Avjøvni †`qv valve †mUv †Zv Avgiv change K‡iB †dwj Avgiv mechanical valve ewm‡q †`B| †mB mechanical valve G i‡³i †h ZijZv _v‡K †mUv‡K maintain Ki‡Z nq Gi Rb¨ Avgiv blood thiner warin tablet use Kwi †Zv GUv cÖwZ gv‡m ev (1-2) gvm ci ci Avgiv GKUv test Kwi blood Gi 1Uv n‡jv PT Av‡iKUv n‡jv INR| Av‡iKUv n‡jv International normalized ratio (PT I INR) K‡i Avgiv warin dose Uv adjust Kwi mvaviYZ GUv depend K‡i mitral valve G GK ai‡bi warin Avgiv maintain Kwi Avi aortic valve G GK ai‡bi dose wn‡m‡e †h report Uv cvIqv hvq †mUvi Dci wfwË K‡i Avgiv dose Uv adjust Kwi| gv‡b GUvi D‡Ïk¨ n‡jv †h i³Uv‡K Zij ivLv| hv‡Z mechanical valve w`‡q i³Uv easily pass Ki‡Z cv‡i| Zv bv n‡j †hUv nq i‡³i NbZ¡Uv †e‡o hvq i‡³i _ª¤^vm †hUv‡K Avgiv ewj _ª¤^vm ev clot formation n‡q brain stroke Ki‡Z cv‡i| Dc¯’vcK : Av”Qv, Wv: gÄyiæj Avcwb Av‡iKUv mvR©vwi K_v e‡jwQ‡jb †h Avgiv heart G GKUv mvRv©wi K‡i _vwK| Avgiv cÖvqB ïwb beating heart surgery Kiv nq †Zv GB mvR©vwiUvi wel‡q wKQz ej‡eb? Wv: gÄyiæj Avjg : nu¨v, mvRv©wi coronary mvR©vwi, that is cardiac surgery GUvi †h wK gRv GUv Avgiv feel Kwi wKsev Avgv‡`i senior †`i‡KI Ki‡Z †`LwQ Prof. Dr. Nasiruddin Sir Avgvi cardiac chief wQ‡jb, †Zv m¨v‡ii mv‡_ Avwg cÖvq A‡bK w`bB KvR K‡iwQ Ges Avgv‡`i senior doctor†`iI †`‡LwQ cardiac surgery †Z mePvB‡Z comfortable surgery Ges patient†`i Rb¨ benefit †mUv n‡jv beating heart surgery Dc¯’vcK : Wv: gÄyiæj GB beating heart surgery Gi gv‡bUv wK? Wv: gÄyiæj Avjg : Beating heart surgery gv‡b n‡”Q heart cÖwZ wgwbUB cv¤ú Ki‡Z _v‡K gv‡b heart wgwb‡U wbw`©ó cwigv‡b (78-80) evi beat K‡i| heart beat Ki‡e Gi wfZ‡i Zvi Mv‡q †h K‡ivbvix AvU©vwi Av‡Q †mB AvU©vwi‡Z Avgiv stabilizer
- 27. 22 ewm‡q †hB RvqMvUv‡Zsurgery Kivi angiogram Gi report †`wL Avgiv cardiologist Colleague angiogram K‡ib| †mB report Uv †`‡L †Kvb RvqMvq block Uv Av‡Q GUv Avgiv angiogram †`‡L confirm Kwi, K‡i Avgiv fieldG hvB| fieldG wM‡q Avgiv K‡ivbvix AvUv©wii g‡b K‡ib left K‡ivbvix AvUv©wii Zvi †Kvb RvqMvq block Av‡Q wVK H RvqMvUvq wM‡q Avgiv stabilizer ewm‡q ïaygvÎ H RvqMvUv‡ZB gv‡b H position UzKz‡Z Avgiv stable Kivi †Póv Kwi ZviciI heart wKš‘ beat K‡i| gv‡b heart beat Pj‡Q Gi g‡a¨B Avgiv Acv‡ik‡b K‡i †djwQ HUvB n‡jv beating heart surgery Ges HUvi Rb¨ †hUv benefited nq gv‡b heart Gi Avgiv cardiac monitor w`‡K ZvwK‡q _vwK heart Gi beat wVK Av‡Q blood pressure wVK Av‡Q wKbv Ges cardiac anaesthetist GKUv †Kvb †ivj Av‡Q †Zv hw` fv‡jv support cvIqv hvq that is very good surgery and benefited to the patient| Wvt †ZŠwdKzi ingvb : Av‡M †hUv n‡Zv, Av‡M mvaviYZ heart †K cÖvq stop K‡i operation Kiv n‡Zv eZ©gv‡b stop bv K‡i PjšÍ Ae¯’vqB Acv‡ik‡b Kiv n‡”Q| GUv GKUv recent technology- heart beating operation| Wv: gÄyiæj Avjg : Ges G‡Z myweav n‡jv †h, mg¯Í patient Gi mvaviYZ renal function impairment _v‡K †hgb wKWwb‡Z AmyL kidney disease Av‡Q wKsev Chronic renal failure CRF Av‡Q wKsev creatinine level †ewk Zv‡`i †ÿ‡Î myweav cvIqv hvq| Avevi liver function †h mg¯Í †ivMxi impairment _v‡K Zv‡`i †ÿ‡Î benefited nq| me PvB‡Z eo welq n‡jv patient †`i recovery development Uv Lye early nq| Dc¯’vcK : Wv: †ZŠwdK Avcwb e‡jwQ‡jb †h ring jvMv‡bvi K_v 1Uv †ivMx ü`‡iv‡M AvµvšÍ n‡q‡Q Zvi block Av‡Q Avcwb ring jvwM‡q‡Qb angiogram Kivi c‡i| Gic‡i †Kvb Jla †meb Kivi cÖ‡qvRb Av‡Q wKbv †ivMxi wKsev Zvi †Kvb d‡jvAv‡ci cÖ‡qvRb Av‡Q wKbv? Wvt †ZŠwdKzi ingvb : nu¨v, d‡jvAv‡ci cÖ‡qvRb Av‡Q †Kbbv †ivMxi †h ring Uv emv‡bv n‡q‡Q †mB ring Avevi eÜ n‡q †h‡Z cv‡i Avgiv †hUv‡K restenosis ewj| GB restenosis hv‡Z bv nq Gi Rb¨ wKQz wKQz Jla †meb Ki‡Z n‡e 1 A_ev GB restenosis Qvov 1Uv wRwbm Av‡Q hvi Rb¨ ring nVvr K‡i eÜ n‡q †h‡Z cv‡i i³ RgvU †e‡a _ª‡¤^vwmm ewj Avgiv †mUvI hv‡Z bv nq Gi Rb¨ wKQz Jla †L‡Z n‡e| cøvm Avgiv †h RvqMvq block n‡jv block Gi Rb¨ Avgiv ring jvwM‡q †`B wKš‘ i³bvwji Ab¨vb¨ RvqMv‡ZI †Zv fwel¨‡Z block n‡Z cv‡i, †Zv †mB blockI hv‡Z bv nq Gi Rb¨I wKQz Jla †L‡Z n‡e|
- 28. 23 Dc¯’vcK : mvaviYZwK wK ai‡bi Jla ¸‡jv Avcbviv GB mg‡q prefer K‡i _v‡Kb? Wvt †ZŠwdKzi ingvb : Avgiv mvaviYZ hv‡Z restenosis bv nq †mRb¨ Avgiv statin bvgK GK ai‡bi Jla Av‡Q †hUv Avgiv Avgv‡`i i‡³ cholesterol †hUv _v‡K cholesterol Gi gvÎv Kgvq Avevi hv‡Z restenosis bv nq †m¸‡jvI prevent K‡i plus Avgv‡`i statin †hUv e‡jwQjvg Drug-eluting stents (DES), Bare-metal stents (BMS)| Bare-metal stent (BMS) Gi GKUz mgm¨v n‡”Q †h G¸‡jv‡Z Nb Nb restenosis nq A_v©r Avevi eÜ n‡q †h‡Z cv‡i Avi Drug-eluting stents (DES) G GK ai‡bi Jla me©ÿb †ei nq| GB JlaUvi D‡Ïk¨ n‡jv †h †hB stent Uv jvMv‡bv n‡q‡Q †mB Uv hv‡Z eÜ bv nq| Dc¯’vcK : Av”Qv, GB Jla jvMv‡bv †h Uvi K_v e‡j‡Qb †h wb‡RB †mB Jla release K‡i †Zv GUv KZw`b ch©šÍ Ki‡e ev GUv cwieZ©b Kivi cÖ‡qvRb Av‡Q wKbv? Wvt †ZŠwdKzi ingvb : bv, cwieZ©b Kivi †Kvb cÖ‡qvRb bvB| Kvib †h stent Uv Av‡Q GUv Avgv‡`i heart Gi †h i³bvwj Av‡Q i³bvwji mv‡_ wg‡k hvq Ges GUv eySv hvq bv nqZ KLbI fwel¨r‡Z angiogram Ki‡j †`Lv hvq ring emv‡bv Av‡Q| mvaviYZ †`Lv hvq Avgv‡`i GB restenosis Gi SzuwKUv _v‡K 2 eQi| Restenosis ev _ªv‡¤^vUm mvaviYZ (1-2) eQi GB drug Uv delivery n‡Z _v‡K| Dc¯’vcK : Wv: †ZŠwdK, Avcwb hv‡`i‡K ring jvwM‡q‡Qb ev hviv Avcbvi Kv‡Q ring jvwM‡q‡Q, Zviv wK fv‡jv Av‡Q- Zviv wK my¯’ ¯^vfvweK Rxeb-hvcb Ki‡Z cv‡i wKbv? Ges †m wK Avcbvi ring jvMv‡bvi ci KZ w`‡bi g‡a¨ ¯^vfvweK Rxe‡b †h‡Z cv‡i- Wvt †ZŠwdKzi ingvb : cÖ_‡gB Avgiv e‡jwQ †h interventional n‡”Q AvaywbK wPwKrmv| Gi me‡P‡q eo myweav n‡jv †hLv‡b Acv‡ik‡b †ivMx‡K (10-15) w`b nvmcvZv‡j- _vK‡Z nq ev bed rest G _vK‡Z nq| Angiogram Gi myweav n‡jv- Angiogram Kiv n‡jv, weKv‡j A_ev mܨvi ci †_‡K †ivMx nvjKv movement Ki‡Z cvi‡e| Zvi ciw`b †_‡K †ivMx GK`g normal movement Ki‡Z cvi‡e Ges (7-10) w`b ci †ivMx Zvi my¯’ ¯^vfvweK Rxeb hvcb Ki‡Z cvi‡e Avi Lvevi `vev‡i Avgv‡`i †h risk factor ¸‡jv Av‡Q Gi g‡a¨ diabetic _vK‡j control Ki‡Z n‡e, D”P i³Pvc _vK‡j control Ki‡Z n‡e, aygcv‡bi Af¨vm _vK‡j aygcvb Kiv hv‡e bv, hw` cholesterol _v‡K Zvn‡j Lvev‡ii wKQz wb‡`©wkKv Av‡Q †m¸‡jv †g‡b Pj‡Z n‡e| Gfv‡e hw` †ivMx wbqg †g‡b P‡j Zvi iywUb fv‡jv _v‡K Zvn‡j ZviI ring fv‡jv _vK‡e Avi hw` Awbqg K‡i Zvn‡j restenosis ev _ª‡¤^vwmm nIqvi SzuwK evo‡e|
- 29. 24 Dc¯’vcK : Av”Qv,Wv: gÄyiæj Avjg, Avcwb surgery †Zv K‡i‡Qb surgery †Zv Gi †h †ivMxiv surgery Kivi ci KZw`b c‡i Zviv ¯^vfvweK Rxe‡b †h‡Z cv‡i Ges mvR©vwi Kivi ci Zviv my¯’ gvby‡li mv‡_ _vK‡Z cv‡i wKbv? Wv: gÄyiæj Avjg : nu¨v, Ae¨kB cvi‡e mvRv©wii GUvB n‡jv myweav| Patient always GKUz tensed _v‡K GB wb‡q †h KLb Avgvi restenosis nq KLbI Avevi m¤¢vebv †ewk _‡K heart G block nIqvi, †Zv mvR©vwii †ÿ‡Î †mUv †h n‡e bv Zv Avwg ewjwb, n‡e wKsev n‡Z cv‡i wKš‘ A‡bKUv mgq ci gvSLv‡b A‡bKUv mgq cvIqv hv‡e fv‡jv _vKvi Rb¨ Ges mvR©vwii c‡iI wKš‘ †ivMx‡K wKQz wbqg-Kvbyb †g‡b Pj‡Z nq| †hgb Wvqv‡ewUm _vK‡j Zv control Ki‡Z n‡e Zvici Zv‡K wbqwgZ Zvi Lvev‡i wbqš¿b ivL‡Z n‡e Ges cÖwZw`b Avav N›Uv †_‡K 1 N›Uv wbqg K‡i nuvUvnvwU Ki‡Z n‡e ¯^vfvweK Rxeb-hvc‡bi Rb¨| GB me wKQz wgwj‡q Dwb fv‡jv _vK‡Z cvi‡e| mvR©vwi Kivi gv‡b GB bq †h Dwb G‡Kev‡i my¯’ n‡q †Mj| mvR©vwi GKUv wPwKrmv gvÎ, Gi cvkvcvwk mvR©vwii c‡i post operatively Dbv‡K wbqš¿b Ki‡Z n‡e| Dc¯’vcK : Wv: †ZŠwdK, Avcbvi ü`‡ivMx‡`i Rb¨ hw` †Kvb advice _v‡K hviv ring jvwM‡q‡Qb Zviv wKfv‡e Pj‡eb ev Zv‡`i Rxeb-hvcb wKfv‡e Ki‡e A_ev Zv‡`i LvIqv -`vIqvi Af¨v‡mi †Kvb cwieZ©‡bi cÖ‡qvRb Av‡Q wKbv? Wvt †ZŠwdKzi ingvb : mvaviYZ ring jvMv‡bvi c‡i †ivMx‡`i wKQz wKQz AvksKv _v‡K, Avevi A‡b‡K cÖkœI K‡ib, m¨vi Avgv‡`i ring wK Qz‡U †h‡Z cv‡i-Zv‡`i Rb¨ DËi n‡jv- ring KLbB Qz‡U bv †hLv‡b jvwM‡q †`qv nq †mLv‡bB _v‡K mvivRxeb Avi 2 bv¤^vi cÖkœB n‡jv ring eÜ n‡q †h‡Z cv‡i Z‡e eÜ nIqvi SzuwK Kg _v‡K hw` Avgiv Drug- eluting stents (DES) jvMvB †m‡ÿ‡Î SzuwK Kg wKš‘ hw` Avcwb Avcbvi risk factor ¸‡jv †h¸‡jvi Rb¨ SzuwK nq †m¸‡jv hw` wbqš¿b bv K‡ib †hgb Wvqv‡ewUm, †cÖmvi wbq‡š¿‡b ivLv, aygcvb bv Kiv, wbqwgZ nuvUvPjv Kiv G¸‡jv bv Ki‡j fwel¨‡Z Avcbvi Avevi block n‡Z cv‡i, AZGe GB wRwbm ¸‡jv Avcbv‡K †g‡b Pj‡Z n‡e| Dc¯’vcK : Wv: gÄyiæj Avjg Ges Wv: †ZŠwdKzi ingvb Avgv‡`i ózwWI‡Z Avmvi Rb¨ Avcbv‡`i `yRb‡KB AmsL¨ ab¨ev` Ges ü`‡ivM Ges m&¦v¯’¨ m‡PbZv wel‡q Avgv‡`i `kK©‡`i GZ g~j¨evb Z_¨ ¸‡jv w`‡q‡Qb, Gi Rb¨I ab¨ev`| `kK© AvMvwg Abyôv‡b Avgš¿Y Rvwb‡q Avcbviv my¯’ _vKzb GB Kvgbvq- GB Avgv‡`i Abyôvb GLv‡bB †kl KiwQ †Lv`v nv‡dR|
- 30. 25 ATN Bangla icÖPvwiZ Abyôvb Ò†nj&_ RskbÓ welq: K‡ivbvq ¯^v¯’¨ e¨e¯’vcbv Ges K‡ivbvq ü`‡iv‡Mi wPwKrmv, b‡f¤^i 2021 Dc¯’vcK : Wv: kv‡n` Bgivb Avgwš¿Z AwZw_: (1) Aa¨vcK Wv: †gv: †ZŠwdKzi ingvb| (2) Aa¨vcK Wv: Kvgiæj nvmvb Lvb| Dc¯’vcK : wcÖq `k©K, Avgš¿b Rvbvw”Q ATN Bangla Gi wbqwgZ ¯^v¯’¨ welqK mivmwi m¤úªPvwiZ Av‡qvRb Drug International Ltd, “ Health Junction” Abyôv‡b| `k©K cÖwZ iwe †_‡K e„n¯úwZevi GB mg‡q ¯^v¯’¨ welqK civgk© mivmwi w`‡q _vwK Ges Avgv‡`i mv‡_ _v‡Kb †`k e‡iY¨ wPwKrmKe„›`| `k©K, Avgiv Rvwb †h K‡ivbvi GKwU ˆewk^K gnvgvwi- GUv‡K A‡b‡K Avgiv AwZgvwiI ewj, GiKg GKwU gnvgvwii mg‡q A‡bK `~‡hvM© G‡m‡Q evsjv‡`‡k, `~‡h©vM G‡m‡Q Z_¨ e¨e¯’vi Dc‡i, `y‡h©vM G‡m‡Q Avgv‡`i gvby‡li DciI wKš‘ Gi Kvi‡b GKwU `y`©kv, Av¯’vnxbZv, †Kvb †Kvb †ÿ‡Î fq AvksKvI KvR Ki‡Q| GB mg‡q Avgv‡`i me PvB‡Z AvcbRb hviv, Zviv n‡jb wPwKrmK I ¯^v¯’¨ †mev Kgx©iv| `k©K, GB ÿz`ª RxevYyi weiæ‡× †h hy×wU Pj‡Q †mB hy‡× AMÖYx †mbv wn‡m‡e KvR K‡i‡Qb Avgv‡`i spiderman Avwg hv‡`i‡K ewj| Avgv‡`i comrade ZzwK©, †mB ZywK©iv n‡”Qb Avgv‡`i wPwKrmK e„›`iv| Avgv‡`i †mB wPwermKe„›` †_‡KB †`‡ki 2 Rb ¯^bvg L¨vZ wPwKrmK‡K Avgv‡`i Abyôv‡b AvR‡K Avgiv †c‡qwQ| Pjyb cwiwPZ nB Avgv‡`i AvR‡Ki AwZw_‡`i mv‡_ Av‡Qb, Aa¨vcK (Wvt) †gvt †ZŠwdKzi ingvb (dviæK) - GgweweGm, GdwmwcGm (†gwWwmb), GgwW (KvwW©IjwR), Aa¨vcK I wefvMxq cÖavb (KvwW©IjwR), K‡Y©j gv‡jK †gwW‡Kj K‡jR nvmcvZvj, gvwbKM‡Ä Kg©iZ Av‡Qb| Aa¨vcK (Wvt) †gvt †ZŠwdKzi ingvb (dviæK) Avcbv‡K AmsL¨ ab¨ev` Ges ¯^vMZ Rvbvw”Q GB mg‡q Avgv‡`i ózwWI †Z Avmvi Rb¨| Wvt †ZŠwdKzi ingvb : ab¨ev` Avcbv‡K, ab¨ev` ATN bangla †K| Dc¯’vcK : `k©K, Avgv‡`i mv‡_ Online G hy³ Av‡Qb †`‡ki Av‡iv GKRb weL¨vZ wPwKrmK, MYgva¨g e¨w³Z¡ Aa¨vcK Wv: Kvgiæj nvmvb, mv‡eK DcvPvh©, e½eÜy †kL gywRe †gwWK¨vj wek^we`¨vjq| m¨vi, Avcbv‡K AmsL¨ ab¨ev` Rvbvw”Q Avgv‡`i ózwWI †_‡K Avwg Wv: kv‡n` Bgivb| Wvt Kvgiæj nvmvb : Avcbv‡K I ATN bangla †KI ab¨ev`| Dc¯’vcK : ab¨ev` m¨vi, (Wv: Kvgiæj nvmvb)| `k©K myZivs eyS‡ZB cvi‡Qb Avgv‡`i mv‡_ †h‡nZz GKRb ü`‡ivM we‡klÁ i‡q‡Qb Ges GKB mv‡_ i‡q‡Qb †`‡ki GKRb
- 31. 26 weL¨vZ c¨v_jwRó IMYgva¨g e¨w³Z¡ wPwKrmK Ges mv‡eK DcvPvh© wQ‡jb Avgv‡`i †`‡ki hv‡K Avgiv AwffveK wPwKrmK e‡j g‡b Kwi| †ZgbB GKRb e¨w³Z¡ ÒAa¨vcK Wv: †gv: Kvgiæj nvmvb Lvb| Avgiv AvR‡K ¯^v¯’¨ wb‡q K_v eje, ¯^v¯’¨ e¨e¯’v wb‡q K_v eje Ges GKB mv‡_ ü`‡iv‡Mi wPvKrmv Avgiv eZ©gv‡b wKfv‡e wb‡Z cvwi ev wK mgm¨v n‡Z cv‡i GB K‡ivbv Kvjxb †m¸‡jv wb‡q Avgiv Av‡jvPbv Kie Ges Avcbviv Rv‡bb †h GB Abyôv‡b mivmwi hy³ n‡Z cv‡ib Avgv‡`i GwUGb evsjvi w¯Œ‡b †`Lv‡bv bv¤^v‡i †dvb K‡i Ges Avgiv †Póv Kie Avcbv‡`i cÖkœ¸‡jv wb‡q K_v ej‡Z| Pjyb `k©K, Gi Av‡M †`‡L Avwg K‡ivbv cwiw¯’wZ wb‡q ATN bangla Gi me©‡kl Lei| # †`‡k K‡ivbv cwiw¯’wZ, 24 N›Uvq g„Zz¨-16 Rb, cyiæl-15 Rb Ges bvix-1 Rb, †gvU g„Zz¨: 6,108 Rb| ‡`‡k K‡ivbv cwiw¯’wZ, cixÿv j¨ve-115 wU, bgybv cixÿv j¨ve-13,520 wU, †gvU cixÿv j¨ve-24,70,168 wU| 24 N›Uvq kbv³-1,699 Rb, kbv‡³i nvi-12.57%, †gvU kbv³-4,23,620 Rb| MZ 24 N›Uvq my¯’-1,648 Rb, G ch©šÍ my¯’-3,41,416 Rb, my¯’Zvi nvii-80.59% `k©K eyS‡ZB cvi‡Qb kbv‡³i nvi wKš‘ †gv‡UI Kg bq Ges gyZz¨ ZvwjKvI `xN© †_‡K `xN©vwqZ n‡”Q| Avgv‡`i mZK©Zvi †Kvb weKí †mB myZivs GB g~û‡Z¡© Avgv‡`i wK Kibxq i‡q‡Q I Avgv‡`i mvavib RbMYiv wK Ki‡eb, †mB welq ¸‡jv wb‡qB Avgiv K_v eje| m¨vi (Wv: †ZŠwdKzi) cÖ_‡gB Avgiv †h welqwU wb‡q Rvb‡Z Pvw”Q †h, eZ©gv‡b K‡ivbv gnvgvwi µvwšÍKvj AwZµg Ki‡Q, K‡ivbvi eqmI wKš‘ 7 gvm cvi n‡q‡Q| GiKg GKwU ev¯ÍeZvq Avgiv †`‡LwQ †h ü`‡iv‡Mi SzuwK| hviv ü`‡iv‡M fzMwQ‡jb Zviv GB K‡ivbvi Rb¨ Covid-19 G hw` fz‡M _v‡Kb, evwo‡Z _v‡Kb †m‡ÿ‡Î evowZ SzuwKi fq i‡q‡Q| Avcbvi Kv‡Q †hwU Rvb‡Z Pvw”Q m¨vi (Wv: †ZŠwdKzi) †mwU n‡jv Avm‡j wK ai‡bi mgm¨v n‡Z cv‡i Covid-19 Gi mv‡_ hviv ü`‡iv‡M fzM‡Qb Zv‡`i| Wvt †ZŠwdKzi ingvb : GLb Avgiv mevB †h strategic †`LwQ †h, hviv ü`‡ivM AvµvšÍ Zv‡`i g„Zz¨ nvi †ewk| Ggb †h AvµvšÍ nIqvi m¤¢vebv mgvb wKš‘ hviv ü`‡iv‡M Av‡M †_‡K fzM‡Qb we‡kl K‡i hv‡`i heart i pumping ÿgZv Kg Avgiv heart failure ewj ev ejection fraction ewj, GB me †ivMxiv hviv Av‡Q hv‡`i Av‡M †_‡K bypass mvR©vwi Kiv Av‡Q Ges heart wKQzUv `ye©j hv‡`i Av‡M †_‡K ring jvMv‡bv Av‡Q A_ev hv‡`i Av‡M heart attack n‡q‡Q hvi Rb¨ heart Gi function wKQzUv `ye©j| GgbI n‡Z cv‡i cardiac transplant Kiv n‡q‡Q ev heart Gi Elevated gv‡b assist device jvMv‡bv _v‡K A‡bK mgq heart Gi function †K assist Kivi Rb¨ Avjv`v hš¿ jvMv‡bv Av‡Q, GB me †ivMxiv mvaviYZ risk G †ewk _v‡K Ges Avgiv mvaviYZ hZUzKz Rvwb †h K‡ivbv wKfv‡e †ivMUv ‰Zwi K‡i, hw` GUv Rvwb Zvn‡j Ab¨ me wKQz RvbvUv Avgv‡`i Kv‡Q mnR n‡e| Avgiv mevB Rvwb †h, K‡ivbv Avgv‡`i kix‡i cÖ‡ek Kivi c‡i mvavibZ c¨v_wdwRIjwR
- 32. 27 †h †ivMUv K‡i†mUv n‡jv Avgv‡`i kix‡i i³ RgvU evavi tendency Uv evwo‡q †`q Avgiv †hUv‡K Coagulopathy ewj Ges mevB Avgiv GUv Rvwb †h Gi gva¨‡g i³ RgvU evavi tendency ev‡o Avi heart attack G †hUv nq ev heart G †h †ivM ¸‡jv ˆZwi nq me¸‡jv‡ZB wKš‘ i³ RgvU evavi tendency evovq| d‡j †`Lv hvq hv‡`i Av‡M †_‡KB existing heart Gi mgm¨v Av‡Q Avevi hviv wbqwgZ Jla Lvq bv Zv‡`i †`Lv hvq †h, i³ RgvU evavi tendency †e‡o hvIqvi Kvi‡b Zv‡`i cybivq heart attack ev block nIqvi AvksKv †e‡o hvq| Dc¯’vcK : A_v©r ü`‡iv‡Mi SuywK wKš‘ Av‡iv ev‡o| Wvt †ZŠwdKzi ingvb : ü`‡iv‡Mi SzuwK †hgb ev‡o Avevi hviv ü`‡iv‡M AvµvšÍ Zv‡`i gvÎvI ev‡o Aviv gvÎv †e‡o †M‡j ¯^vfvweK fv‡e †hUv †`Lv hvq Avgiv †`wL GKUv †ivMxi nvU© `~e©j nIqvi Kvi‡b Zvi k^vmKó n‡”Q †mB k^vmKó Zvi Av‡iv †e‡o hv‡”Q A_ev hvi k^vmKó wQj bv Zvi k^vmKó n‡”Q| GiKg cÖvqB Avgiv †`LwQ Avgiv hLb †ivMxiv Avm‡j wR‡Ám Kwi †h, gvSLv‡b Avcbvi wK k^vmKó nVvr K‡i †e‡o‡Q bvwK ax‡i ax‡i †e‡o‡Q Gici †ivMx wKš‘ e‡j †h, nvjKv nvjKv K‡i (4-5) w`b R¦i wQj Gici nVvr K‡i †`wL Avgvi k^vmKó †e‡o †M‡Q| Zvi gv‡b Av‡M †hUv Zvi nv‡U©i mgm¨v wQj †mUvB GB pre-exixting heart Gi mgm¨v nVvr K‡i GB K‡ivbvi Rb¨ Avevi GUv †e‡o hvq| Dc¯’vcK : ab¨ev` m¨vi, Avcbvi mv‡_ Avgiv GB ü`‡ivM wb‡q Av‡iv A‡bK K_v eje, A‡bK welq Avcbvi KvQ †_‡K Rvbvi Av‡Q, Avgv‡`i mv‡_ online G hy³ Av‡Qb Aa¨vcK Wv; Kvgiæj nvmvb Lvb, Avgiv m¨v‡ii Kv‡Q hve Zvi Av‡M Avgv‡`i mv‡_ GKRb `k©K hy³ n‡q‡Qb Avgiv Zvi cÖkœUv wb‡q †bB, `k©K Avcbvi bvg Ges eqm e‡j cÖkœwU Kiæb| `k©K-01 : Avgvi bvg iv‡mj, Avwg gvwbKMÄ †_‡K ejwQ| Avgvi Wv: †ZŠwdKzi ingvb dviæK m¨v‡ii Kv‡Q cÖkœ wQj †h, nv‡U©i †ivMx‡`i emergency †Z nidocard spray Uv e¨env‡ii welqUv hw` m¨vi GKUz ej‡Zb| Dc¯’vcK : Aek¨B, Avgiv GB welqwU wb‡q Av‡jvPbv Kie Avcbvi cÖkœwU Avgiv eyS‡Z †c‡iwQ| GwU wb‡q Avgv‡`i mv‡_ ü`‡ivM we‡klÁ i‡q‡Qb wZwb Av‡jvPbv Ki‡eb| Zvi Av‡M Avgiv Aa¨vcK Wv: Kvgiæj nvmvb Lvb Avcbvi Kv‡Q Avgiv †h‡Z PvB wbðqB Avcwb Avg‡K ïb‡Z cvi‡Qb| m¨vi, Avgiv GB K‡ivbv gnvgvwi‡Z Ae¨e¯’vcbvi g‡a¨ i‡qwQ mviv wek^ e¨vwc| m¨vi, Avgv‡`i evsjv‡`k e¨e¯’vcbv wb‡q A‡bK wj‡L‡Qb, M‡elYv K‡i‡Qb Ges Avgiv Rvwb †h, Avcwb GLbI GB M‡elYvi KvR Pvwj‡q hv‡”Qb|
- 33. 28 m¨vi Avcbvi Kv‡QcÖkœ †h, GB K‡ivbv Kvwjb ¯^v¯’¨ e¨e¯’vi †h Ae¯’vq i‡q‡Q †mwU‡K KZUzKz remodeling hw` ewj hw` cwieZ©b ev gvb‡bœvq‡bi cÖ‡qvRb e‡j KZUzKz g‡b K‡ib Avcwb m¨vi| Wvt Kvgiæj nvmvb : ab¨ev` kv‡n`, Avwg †ZŠwd‡Ki mv‡_ GKUz hy³ Ki‡Z PvB †h, ïaygvÎ hviv ü`‡iv‡Mi †ivMx Av‡Q Zv‡`i †ÿ‡ÎB †h mgm¨vUv n‡”Q welqUv Zv bv| Zv‡`i mgm¨v †Zv n‡”Q Gi Dc‡`ªve Cytokine storm †hUv nq GUv wKš‘ mg¯Í organ †K effect K‡i but heart Gi †ÿ‡Î wKš‘ bZzb K‡i we‡kl K‡i percarditis n‡Z cv‡i ev bvbv ai‡bi myocarditis n‡Z cv‡i G¸‡jv virus Gi Kvi‡b Avevi bZzb K‡i n‡Z cv‡i| †mRb¨ Avgv‡`i‡K mZK© _vK‡Z n‡e| †Zv Avwg †hUv ejwQ †h ¯^v¯’¨ e¨e¯’vi a‡ib †h,evsjv‡`‡k hLb Avgiv msµgb †`Ljvg ZLb wKš‘ †ek Ae¨e¯’vcbv Avgiv †`‡LwQ wKš‘ Avwg g‡b Kwi GB g~û‡Z© cÖavbgš¿xi n¯Í‡ÿ‡ci c‡i GB wPwKrmvi GKUv †gvUvgywU fv‡jv e¨e¯’v Av‡Q Ges GUv wb‡q Avgiv eZ©gv‡b mš‘ó| Kvib Avcwb †`‡Lb †h wek¦ Ry‡oB wKš‘ bZzb K‡i wkw_j mg‡q †h mZK©Zv Kiv n‡qwQj †mwU wKš‘ Avgiv ev¯Í‡e iæcvšÍwiZ n‡Z †`LwQ Ges Avgiv †`L‡Z cvw”Q †h, wek^Ry‡o bZzb †XD ïiæ n‡q wM‡q‡Q †hgb MZKvj‡K 24 N›Uvq hy³iv‡ó 2 jÿ 17 nvRvi Rb K‡ivbvq AvµvšÍ n‡q‡Q Ges cÖvq †`o jv‡Li g‡Zv msL¨v gviv wM‡q‡Q| GUv LyeB `~we©ln GKwU welq hv mviv we‡k^ †e‡oB P‡j‡Q| GLb K_v n‡jv †h, Avgv‡`i G cwiw¯’wZ‡Z evsjv‡`k‡K †h‡nZz Avgiv g‡b Kwi kxZKvjxb †`k bq, kxZKvjxb †`‡k †hfv‡e msµgbUv evo‡e, Avgv‡`i aviYv evsjv‡`‡k AZUv cwigv‡b evo‡e bv| evsjv‡`‡kI wKš‘ msµgb evov ïiæ n‡q wM‡q‡Q Ges gyZ…¨ nvi GKUv RvqMvq w¯’i n‡q Av‡Q I IVvbvgv Ki‡Q| †Zv †mB Kvi‡b Avgv‡`i GB K‡ivbv‡K cÖwZ‡iva Kivi Rb¨ Avgv‡`i †h ¯^v¯’¨ e¨e¯’vcbvi, ¯^v¯’¨wewa A_©vr GLv‡b cwi®‹vifv‡e ewj †h K‡ivbv cªwZ‡iv‡ai Rb¨ wZbUv c_ Av‡Q 1 wU n‡jv ¯^v¯’¨ wewa, Av‡iKwU n‡”Q wPwKrmv e¨e¯’v, A‡iKwU vaccine| vaccine wb‡q Avcwb Rv‡b †h MZ †mvgevi wek^Ry‡o GK bZzb msev` †ei n‡q‡Q †h pfizer Gi vaccine wU 90 fvMB Kvh©Kix Ges GwU Avgv‡`i wewfbœ AvšÍ©RvwZK we‡klÁ e„›`iv i‡q‡Qb ZvivI †gvUvgywU GwU accept K‡i‡Qb| †Zv GLb K_v n‡jv †h Avwg GLv‡b GKwU confession Ki‡Z PvB Avgiv wKš‘ GB w`bwUi g‡a¨ vaccine K‡e Avm‡e gvby‡li Kv‡Q K‡e †cuŠQ‡e GwU wKš‘ wbwðZ bq Avi Ab¨ w`‡K wPwKrmvi †ÿ‡Î hvIqvi Av‡M GLb †`Lv †M‡Q †h MZ 10 eQ‡ii AwfÁZvq †h Avm‡j ¯^v¯’¨wewa n‡”Q mePvB‡Z Kvh©Kix cš’v| Dc¯’vcK : A_v©r cvjb KivUv Lye Riæix m¨vi (Wv: Kvgiæj nvmvb) Avgiv †hwU ewj m¨vi †h †hB virus wU msµwgZ n‡”Q †mB msµg‡bi †mKjwU hw` †f‡½ w`‡Z cvwi
- 34. 29 Avgiv Zvn‡j wbðqBGB K‡ivbv fvBiv‡mi msµg‡bi n‡Z Avgiv myiÿv cve| Rather than Avgiv hw` ewj m¨vi Lye PgrKvi K‡i †h cÖwZ‡la‡Ki A‡cÿvq bv †_‡K eis ¯^v¯’¨wewa Avgiv †ewk K‡i gvbe| †Kbbv Avcwb hy³iv‡óªi K_v e‡jwQ‡jb, hy³iv‡óªi bZzb †cÖwm‡W›U n‡q‡Qb †Rv-evB‡Wb DwbI wKš‘ m¤úªxwZ e‡j‡Qb †h, mevB‡K mask co‡Z n‡e Ges ¯^v¯’¨ wbqg wewa gvb‡Z n‡e| Avgv‡`i gvbbxq cÖavbgš¿x Dwb 2q †XD Gi e¨cv‡i AvksKv K‡i‡Qb GiRb¨B nqZ m¨vi Avcwb e‡j‡Qb 2q †XD‡qi e¨cv‡i Av‡iv mZ©K _vK‡Z| m¨vi (Wv: Kvgiæj nvmvb) mvg‡b kxZKvj Ges Avcbvi KvQ †_‡K cÖwZ‡laK wb‡q Av‡iv Z_¨ Rvbe GB ch©vq Wv: †ZŠwdK Avgiv Avcbvi Kv‡Q Rvb‡Z PvB m¨vi (Wv: Kvgiæj nvmvb) Avcbv‡K wKQz supplement I K‡i‡Qb| Avgiv GB ch©vq Rvb‡Z Pvw”Q Avgv‡`i GKRb `k©K GKwU cÖkœ K‡iwQ‡jb †h, Avgv‡`i nidocard Rtd spray wU Avm‡j KLb cÖ‡qvRb ev GwU KZUzKz ¸iæZ¡c~b© e‡j Avcwb g‡b K‡ib| Wvt †ZŠwdKzi ingvb : ab¨ev` Avcbv‡K, `k©K‡KI ab¨ev` G‡Zv my›`i cÖkœ Kivi Rb¨| Avm‡j e¨vcviUv n‡jv †h nidocard spray Uv Avgv‡`i KLb cÖ‡qvRb c‡i| GLb nidocard Gi KvRUv hw` Avgiv †`wL †mUv n‡jv †h Avgv‡`i nv‡U©i i³bvwj w`‡q †h i³ mieivn nq †mUv‡K evov‡jv hv‡Z K‡i Avgv‡`i nv‡U©i g‡a¨ †h Aw·‡Rb K‡g wM‡q‡Q hvi Rb¨ eyK e¨_v n‡”Q †mB Aw·‡Rb I Lvevi msMÖn K‡i nv‡U© †cŠQ‡bv AviwK| GLb hw` nVvr K‡i Kv‡iv ey‡K cÖPÛ e¨_v nq Ges e¨_vi aibUv hw` Ggb nq †h bv GUv cardiac e¨_v n‡”Q heart Gi e¨_v n‡”Q| GLb heart Gi e¨_v Avgiv mywbw`ó fv‡e eywS ey‡K Pvc w`‡”Q Ges Avgiv cwikÖg Ki‡j nqZ e¨_v n‡”Q mv‡_ Nvg n‡”Q| e¨_vUv nqZ move Ki‡Q Gw`K Iw`K hv‡”Q wKš‘ g~jZ ey‡Ki gvSLv‡b n‡”Q e¨_vUv hw` GiKg nq Zvn‡j †m‡ÿ‡Î Avgiv ewj †h, GB e¨_vUv‡K `ªæZ Kgv‡bvi Rb¨ sublingual nitrate spray e¨envi Kivi K_v ewj Ges GB †¯úªUv e¨envi Ki‡j i³bvwj †K cÖmvwiZ K‡i i³ mieivn evovq hvi gva¨‡g ey‡Ki e¨_vUv Dckg nq ev wbivgq nq GUv GKUv| Av‡iKUv n‡jv ey‡K e¨_v bv n‡q k^vmK‡ói g‡Zv n‡Z cv‡i Ges GB k^vmKóUvI hw` cardiac Kvi‡b n‡q _v‡K †h g‡b nq `g eÜ n‡q Avm‡Q GiKg n‡jI Avgiv †¯úª e¨envi Kie hvi gv‡a¨‡g Avgv‡`i k^vmKóUv Kg‡Z cv‡i| Dc¯’vcK : m¨vi, Avgiv nvmcvZv‡j †`LwQ, hviv fwZ© i‡q‡Qb Zv‡`i †`LwQ, Avgv‡`i Aa¨vcK Kvgiæj nvmvb m¨vi Lye fv‡jv ej‡Z cv‡i‡eb, wbðq Avgiv c¨v_jwRi wKQz test Kwi Ges †mLv‡b D-Dimer †ewk _vK‡j Avgiv 1wU Bb‡RKkb e¨envi Kwi cardinex RvZxq Bb‡RKkb GB Jla ¸‡jv Avgiv †Kb e¨envi Kwi Ges nvmcvZv‡j †_‡K †hme †ivMx P‡j hv‡”Q Zv‡`i Rb¨ wK ai‡bi Jl‡ai cÖ‡qvRb †mB welqwU wb‡q Av‡jvPbv Kie Zvi Av‡M GKRb `k©K Av‡Qb Zvi cÖkœwU wb‡q †bB| `k©K Avcbvi bvg e‡j cÖkœwU Kiæb| `k©K-02: Avmmvjvgy AvjvBKzg- Dc¯’vcK : IqvjvBKg Avmmvjvg, `k©K, †K ejwQ‡jb-
- 35. 30 `k©K-02: Avwg †gv:Avãyi gv‡jK, bqvcvov †_‡K ejwQjvg, Avwg GKRb Heart Gi †ivMx| K‡ivbv Avmvi ci †_‡K Lvevi c‡i nuvU‡j ey‡Ki Wvb cv‡k I Mjvq e¨_v n‡Zv| Gici Avwg h‡kv‡i GKRb ü`‡ivM we‡klÁ Wvt KvRj KvwšÍ‡K †`wL‡qwQ| Avwg Rvb‡Z Pvw”Q Lvevi c‡i nuvU‡j Avgvi ey‡K I Mjvq †Kb e¨_v K‡i GUvB| Dc¯’vcK : `k©K Avcbvi eqm KZ Ges Avcbvi diabetes, D”P i³Pvc Av‡Q wKbv Avgv‡`i cardiologist m¨vi Rvb‡Z †P‡q‡Qb| `k©K-02: Avgvi †cÖkvi 120/80 GiKgB _v‡K Avi Avgvi †Kvb diabetes †bB| Dc¯’vcK : ab¨ev` `k©K, Avcwb ïb‡Z _vKzb Avgv‡`i AbyôvbwU GwU wb‡q Avgiv Av‡jvPbv Kie| m¨vi (Wv: †ZŠwdKzi) Avgiv cÖ‡kœi DIiwU w`‡q Avgv‡`i g~j cÖkœ wd‡i hve| Wvt †ZŠwdKzi ingvb : GLb †ivMx †hfv‡e (`k©K-02) eY©bv w`‡”Q †mB history Uv LyeB suggestive †h Lvevi c‡i nuvU‡Z †M‡j ey‡K Pvc †`q| †h‡nZz Lvevi c‡i nuvU‡Z †M‡j ey‡K e¨_v ev Pvc w`‡”Q myZivs GUv cardiac mgm¨v nIqvi m¤¢vebv †ewk Ges Avcwb †hB cardiologist †K †`wL‡q‡Qb cywjk nvmcvZv‡j h‡kv‡i †h Wv³vi mv‡n‡ei bvg ej‡jb †mB Wv³vi h‡_ó cwigv‡bi appropriate Av‡Q| GLb KibxqUv wK Dwb (Wv³vi) nqZ Avcbv‡K (`k©K-02) Jla w`‡q‡Qb Ges Avcwb hw` †`‡Lb †h Jla LvIqvi c‡i Avcwb nuvU‡Z †M‡j Avcbvi ey‡K Avi e¨_v n‡”Q bv Zvn‡j Dwb (`k©K-02) Jla Pvwj‡q hv‡e GUv n‡jv ideal GLb hw` †`Lv hv‡”Q †h bv Dwb Jla Pvwj‡q hvIqvi ciI and optimum dose ch©šÍ †Zv Aek¨B Zvi †h KqUv jv‡M †m KqUv Jla †Zv Zv‡K †L‡ZB n‡e| †Zv Jla LvIqvi ciI Zvi ey‡K Pvc jvM‡Z‡Q ev wmuwo w`‡q DV‡Z †M‡j Dbvi Kó n‡”Q Zvn‡j †mB †ÿ‡Î Avgv‡`i next wKQz cixÿv-wbixÿv cÖ‡qvRb co‡e even angiogram Gi I cÖ‡qvRb n‡Z cv‡i Kvib A‡bK †ÿ‡Î †`Lv hvq †h nv‡U©i wfZ‡i hw` block Gi gvÎv †ewk nq Zvn‡j Jla wKš‘ KvR bvI Ki‡Z cv‡i, †Zv †mB †ÿ‡Î Avgv‡`i nqZ angiogram Kiv, stenting Kiv, bypass mvR©vwi Kiv G¸‡jvi cÖ‡qvRb n‡Z cv‡i, GLb wK jvM‡e Dwb (`k©K-02) Avm‡j wKQzw`b Jla LvK Gici wKQzw`b ci Dwb follow up KiæK c‡i Wv³vi mv‡neB decision w`‡eb †h, cieZx© mg‡q Dbvi Avm‡j wK Kiv DwPZ| Z‡e Dwb †h eY©bv w`‡q‡Qb definitely Dbvi cardiac mgm¨v i‡q‡Q hvi Rb¨ ey‡K e¨_v ev Pvc AbyfzZ n‡”Q| Dc¯’vcK : wcÖq `k©K, Avkv KiwQ Avcwb Avcbvi cÖ‡kœi DËiwU †c‡q‡Qb Ges Avkv KiwQ Avcbvi mgm¨vwU Avcwb eyS‡Z †c‡i‡Qb †h Avgv‡`i ü`‡ivM we‡klÁ AwZw_ †hwU ej‡jb Avcwb wbðqB †mwU cvjb Kivi †Póv Ki‡eb| m¨vi (Wv: †ZŠwdKzi) Avgiv GKwU cÖkœ K‡iwQjvg †h, Avgv‡`i A‡b‡K †c‡Ui Pvicv‡k ej‡jB A‡b‡K †ev‡S †Zv GB Bb‡RKkbUv †h †`qv n‡”Q Avevi ejv n‡”Q GB Bb‡RKkbUv A‡bK Kvh©Kix| †Kbbv mywbw`©ó †Kvb wPwKrmv e¨e¯’vI †bB GLb Avgv‡`i nv‡Z| †Zv GB Bb‡RKkbUv Avm‡j †Kb †`qv nq ev n‡”Q m¨vi (Wv: †ZŠwdKzi) GUvB Rvb‡Z Pvw”Q|
- 36. 31 Wvt †ZŠwdKzi ingvb: LyeB mgq Dc‡hvMx cÖkœ, GUv Kvib †Kb ejwQ Avgiv A‡bK †ÿ‡Î †ivMx †`LwQ hv‡`i n‡jv D-Dimer, ferritin level, CRP, LDH, even SGPT level - me¸‡jv evowZ I CBC complete blood count Gi g‡a¨ Neutrophils, lymphocytes Gi †iwkI †hUv Av‡Q †mUv mv‡o 3 Gi †ewk| GUv nIqvi ciI Avgiv †`L‡ZwQ †Kvb Kvi‡b report negative Avm‡Z‡Q A‡b‡Ki (2-3) evi K‡i report Ki‡Z‡Q ZvI negative Avm‡Q| GLb GLv‡b mgm¨v †hUv n‡”Q †mUv n‡jv wPwKrmvi e¨vcv‡i| GLb 2 Uv wRwbm n‡”Q 1 Uv n‡jv †ivMxi Wv³v‡ii Dci Av¯’vi GKUv welq P‡j Avm‡Q, †ivMx g‡b Ki‡Z‡Q †h, Wv³vi mv‡ne Avgvi K‡ivbvi K_v ejj Zvn‡j GB e¨vcv‡i diagnosis n‡”Q wKbv 2 bv¤^vi n‡jv GB †h Bb‡RKk‡bi K_v ej‡Qb GB Bb‡RKkbUv GKUz `vwg, Avi Bb‡RKbUv †Zv GKUz invasive wRwbm GUv‡Zv Avgv‡K wKQzUv nvjKv n‡jI hw` e¨_v jv‡M d‡j ZLb †ivMxi GKUz confusion nq †h Avwg Bb‡RKkb e¨envi Kie wKbv? †m‡ÿ‡Î Jla †bqvi Rb¨ GKUv Awbnv ˆZwi nq †Zv negative †hUv Av‡Q RT-PCR Avgiv ewj †mUv wKš‘ negative wewfbœ Kvi‡b n‡Z cv‡i| †`Lv †Mj (4-5) w`b R¦i nevi c‡i hw` Avwg Kwi Zvn‡jI wKš‘ negative n‡Z cv‡i| †Kbbv ZLb Avm‡j kix‡ii g‡a¨ Rxevby K‡g †M‡Q ev †hLvb †_‡K Avwg wbw”Q †mLvbI nqZ Rxevby bvB| gv‡b sample c×wZi Rb¨I report G fzj Avm‡Z cv‡i wKš‘ Zvi kix‡i †h RxevYy †bB Zv wKš‘ bv| GLb D-Dimer wb‡q †hUv Av‡jvPbv n‡”Q †h GB †ÿ‡Î †ivMx‡`i Kv‡Q Avgv‡`i suggestion †h Avcbvi †hB cixÿv¸‡jvi K_v Avgiv ejjvg GB cixÿv ¸‡jv Kivi c‡i hw` D-Dimer †ewk _v‡K Zvn‡j wKš‘ Avcbv‡K wbwðZfv‡e g‡b Ki‡Z n‡e †h welqwU wb‡q Avgiv Av‡jvPbv Ki‡Z wQjvg †h i³ RgvU †e‡a hvIqvi tendency GUv wKš‘ A‡bK †ewk †e‡o hv‡e| Ges GLb †gvUvgywU wbðZ n‡q‡Qb Avgv‡`i Wv: Kvgiæj nvmvb m¨vi †hUv ej‡jb †h kix‡i wewfbœ organ involve nq GLv‡b brain n‡Z cv‡i, kidney n‡Z cv‡i, dzmdzm n‡Z cv‡i †ivM nIqvi mechanism wKš‘ same A_©vr me RvqMv‡ZB i³ RgvU †e‡a hvq GUv †_‡K dzmdz‡m, wKWbx‡Z ev brain G| Dc¯’vcK : m¨vi, GB ai‡bi †ivMxiv hv‡`i GB Bb‡RKkbUv cª‡qvRb n‡”Q nvmcvZv‡j Zviv hLb discharge n‡q hv‡”Qb fv‡jv n‡q evmvq wdi‡Qb Zv‡`i‡K Avgiv ZLb avaron ev vermox UvB‡ci Jla¸‡jv G¸‡jv Avm‡j KZw`b hver e¨envi Ki‡eb- Wvt †ZŠwdKzi ingvb : Gi Kvib n‡jv Avgiv A‡bK mgq †`L‡ZwQ Gi Av‡MI †`‡LwQ wKQz †ivMx †`Lv †Mj nvmcvZvj †_‡K evmvq hvIqvi ci (2-3) mßvn c‡i gviv †M‡Qb| A‡bK mgq †`Lv hv‡”Q ïiæ‡Z Avgv‡`i †ivMx fv‡jv wQj Zv‡K discharge w`e Avwg (2- 3) mßvn c‡i ev Gi Av‡M †ivMx gviv hv‡”Q| Zvi gv‡b i³ RgvU evavi tendency †hUv Av‡Q †mUv wKQzw`b ch©šÍ persist K‡i GLb GB Kvi‡b Avgiv Bb‡RKkb †`qvi c‡i (5-
- 37. 32 7) w`b ZviciAvgiv ewj A_ev nvmcvZv‡j Kqw`b _v‡K †m Kqw`b Avgiv Bb‡RKkbUv †`B| Zvici evwn‡i ev evmvq hvIqvi mgq hw` †ivMx Severe condition nq Zvn‡j mvavibZ 3 gvm tablet †L‡Z nq Avi infection hv‡`i GKUz _v‡K ev Severity Kg _v‡K Zv‡`i‡K Avgiv 1 gvm ch©šÍ †L‡Z ewj hv‡Z K‡i Covid cieZ©x mg‡q Avm‡j bZzb K‡i Avevi †Kvb RwUjZv bv nq| Dc¯’vcK : A‡bK ab¨ev` m¨vi (Wv: †ZŠwdKzi)| `k©K ïbwQ‡jb A‡bK PgrKvi K‡i GB g~û©‡Z¡i wPwKrmv I wPwKrmv c×wZ Ges ü`‡ivMx hviv Av‡Qb Zv‡`i‡K Avgiv wKfv‡e nvmcvZvj Ges nvmcvZv‡ji evwn‡i, evmv‡Z wKfv‡e wK ai‡bi wPwKrmv †bqv cª‡qvRb †mB wel‡q| Aa¨vcK Kvgiæj nvmvb Av‡Qb Avgv‡`i mv‡_ m¨vi (Wv: †ZŠwdKzi) †hgbwU ejwQ‡jb, m¨vi (Wv: Kvgiæj) Avcwb wb‡RI GKRb c¨v_jwR÷ Avcwb GwU Av‡iv Rvb‡eb †h D-Dimer, ferritin level †`‡L Avgiv mvavibZ GB wPwKrmv ¸‡jv K‡i _vwK| m¨vi (Wv: Kvgiæj) Avgiv GKUz GB RvqMvUv †Z †h‡Z Pvw”Qjvg †hwU m¨vi (Wv: †ZŠwdKzi) ejwQ‡jb †h, GKwU Av¯’vnxbZvi RvqMv _v‡K Ges A‡bK mgq A‡bK wmØvšÍ †bqvi †ÿ‡Î Avgv‡`i wPwKrmK‡`i Dci A‡bK wKQz wbf©i Ki‡Z cv‡ibv Avgv‡`i GB evsjv‡`k e¨e¯’vi Rb¨| GB e¨e¯’vcbv wb‡q Avcbvi Kv‡Q GKUz Rvb‡Z PvB m¨vi (Wv: Kvgiæj) †h nvmcvZvj e¨e¯’vcbvq wPwKrmv Ges wPwKrmK‡`i f‚wgKv wb‡q hw` Avm‡j KZUzKz f‚wgKv Zviv cvjb Ki‡Q- Wvt Kvgiæj nvmvb : ab¨ev` kv‡n` Bgivb, Zvi Av‡M AZ¨šÍ ¸iæZc~b© GKwU Z_¨ w`‡Z PvB, MZKvj‡K †hwU cÖKvwkZ n‡q‡Q †mwU n‡jv England Gi Oxford University Gi g‡bv‡ivM we‡klÁ Pol Herry San GKUv Z_¨ w`‡q‡Qb Ges GwU Avcwb Rv‡bb †h wek^ weL¨vZ Medical Journal lencet-G cÖKvwkZ wZwb ej‡Qb, GB †h K‡ivbvi †ivMx my¯’¨ n‡q hvIqvi ciI cÖvq 20 kZvsk †ivMx gvbwmK †iv‡M AvµvšÍ nq Ges GwU ïiæ nq K‡ivbv †_‡K my¯’¨ nIqvi 3 gvm gv‡b 90 w`b ci †_‡K Ges GLv‡b Zvi †h †m mgm¨v n‡Z cv‡i Zv MZ †deªæqvwi‡Z cÖKvwkZ n‡q‡Q Zv n‡jv Zvi wb`ªvnxbZv n‡e, AvZs¼ Pj‡Z cv‡i Zvi brain g‡a¨ Aekv` Avi me‡P‡q eo welq †hUv †mUv n‡jv Zvi ¯§ib kw³ K‡g hv‡e Gi d‡j Av‡¯Í Av‡¯Í Brain damage n‡Z _vK‡e G Rb¨ K‡ivbvi †ivMxiv my¯’¨ n‡q hvevi ciI Zv‡`i gvbwmK w`K ¸‡jv Avgv‡`i Lye ¸iæZ¡ mnKv‡i †`L‡Z n‡e| Avcwb (Dc¯’vcK) †h K_vUv e‡jwQ‡jb, Avcwb Rv‡bb †h evsjv‡`‡k eZ©gv‡b Av‡jvwPZ welq n‡”Q wM‡q gvBÛm nvmcvZv‡j GKRb ZiæY †gavex cywjk Kg©KZ©v g„Zz¨eib K‡i‡Qb| †mUv wb‡qB GLb bvbv ai‡bi Av‡jvPbv Pj‡Q Ges AvgivI †mLv‡b hy³ nw”Q Ges GLv‡b †hUv †`Lv †Mj †h †mLv‡b Zvi †Kvb wPvKrmv nw”Qj bv Ges wK Kvi‡b Avgvi g‡b nq †h e¨e¯’vcbvi welqUv Avi wPwKrm‡`i wPwKrmvi welqUv wb‡q Av‡iv Clear nIqv DwPZ| GB K‡ivbv Kvjxb mg‡q †`‡ki gvbyl eyS‡Z †c‡i‡Q †h, wPwKrmKiv Zv‡`i Rxe‡bi SzuwK wb‡q wKš‘ K‡ivbvi †gvKv‡ejv K‡i‡Q Ges †mLv‡b A‡bK AmsMwZ wQj †mLv‡b A‡bK wKQzi cÖ‡qvRbI wQj hv Zviv cvqwb we‡kl K‡i wPwKrmK‡`i myiÿv e¨e¯’cbvi †Kvb e¨e¯’vI Kiv nqwb ZviciI wKš‘ wPwKrmKiv Zv‡`i †ivMxi wPwKrmv Ges †mev cÖ`vb wVKB K‡i‡Qb| hvi Kvi‡b Avgv‡`i evsjv‡`‡ki wPwKrmK Ab¨vb¨ †`‡ki PvB‡Z
- 38. 33 A‡bK †ewk gyZz¨eib K‡i‡Qb| Zv‡`i‡K Avgiv AwZ kÖ×vi mv‡_ ¯§ib Kwi| †mB Kvi‡b Avgv‡`i evsjv‡`‡ki e¨e¯’vcbv GKUz `~ej© Ae¯’vq Av‡Q| GwU hw` KvwU‡q DVv hvq Zvn‡j a‡ib nvmcvZv‡ji †h †Kvb ANUb NUbvi Rb¨ wPwKrmK‡K †KD `vqx Ki‡Z cvi‡ebv| †Kbbv wPwKrmKiv wKš‘ Zv‡`i KvR Zviv wVK K‡i hv‡”Q| GLb e¨e¯’vcbvi RvqMvUvB Avgv‡`i Av‡iv †Rvi`vi Kiv DwPZ Ges †mwUi Rb¨B Avgiv KvR K‡i hvw”Q| Avgv‡`i management Gi RvqMvUv hw` Avgiv develop Ki‡Z bv cvwi GK`g PU K‡iB †Zv Avi GUv m¤¢e n‡e bv, Avgv‡`i evsjv‡`‡k GKwU Dbœqbkxj †`k †Zv ZvB Avwg PvB‡jI g~û‡Z©i g‡a¨ GUv cwieZ©b K‡i †dj‡Z cvie bv wKš‘ Avgv‡`i meviB cwiKíbvUv mwVK n‡Z n‡e| †mRb¨ Avgv‡`i cÖ‡Z¨KUv RvqMv‡Z hw` bRi `vwi bv Ki‡Z cvwi, Ae¨e¯’vcbv ¸‡jv hw` mwVK Ki‡Z bv cvwi, Awbqg¸‡jv hw` wbqš¿b Ki‡Z bv cvwi Ges A‡hvM¨ I A‰ea RvqMv¸‡jv hw` Avgiv eÜ Ki‡Z bv cvwi Zvn‡j wKš‘ G ai‡bi Awf‡hvM wKsev gvby‡li Kv‡Q Av¯’vnxbZvi RvqMvUv wKš‘ evo‡ZB _vK‡e| †mB Kvi‡b Avwg g‡b Kwi Avgv‡`i †h `~ej©Zvi RvqMv ¸‡jv Av‡Q gvbekw³ manpower GB wel‡q Kov bRi`vwi †`qv †hUv LyeB `iKvi| GLv‡b Avgv‡`i `~we©m‡ni welq †h GKUv gvbyl Zvi nvmcvZv‡j †iwR‡óªkb bvB bvm© †ivMx †`L‡Q Ges †mLv‡b Wv³viI bvB Zvn‡j GB ¯^v¯’¨ e¨e¯’vcbv¸‡jvB Avgv‡`i wbqš¿b Kiv `iKvi †mRb¨ GLv‡b mr, e¨w³wbô Ges mvnmx e¨w³i cÖ‡qvRb| Dc¯’vcK : m¨vi A_v©r, †hwU ejwQ‡jb †h, hy× †ÿ‡Î †hv×v‡`i cÖ‡qvRb| Avgiv Abyôv‡bi GK`g †kl ch©v‡q P‡j G‡mwQ m¨vi (Wv: Kvgiæj) Avcbv‡K AmsL¨ ab¨ev`, Avcwb Lye MyiæZ¡c~b© Z_¨ Avgv‡`i w`‡q‡Qb †hwU Avgv‡`i mvavib gvby‡li Rb¨ Rvbv Lye cÖ‡qvRb| m¨vi (Wv: †ZŠwdKzi) Avcbv‡KI AmsL¨ ab¨ev` Avgv‡`i `k©K‡`i G‡Zv ¸iæZ¡c~Y© Z_¨ †`evi Rb¨| Wvt †ZŠwdKzi ingvb : Avcbv‡KI ab¨ev`| Dc¯’vcK : `k©K gÛjx, Avgiv Drug International Ltd Helath junction G †Póv Kwi Avcbv‡`i ¯^v¯’¨ Z_¨ Ges K‡ivbv Kvjxb mg‡q wKfv‡e Avgv‡`i mvavib RbMb fv‡jv _vK‡e †mB wel‡q civgk© †`evi Rb¨| wcÖq `k©K AvR GB ch©šÍ cieZx© mg‡q Avev‡iv †`Lv n‡e Avcbv‡`i mv‡_ †mB ch©šÍ fv‡jv _vK‡eb my¯’¨ _vK‡eb ATN bangla Gi mv‡_ _vK‡eb| XvKv †gwW‡Kj K‡jR nvmcvZv‡j wmwcAvi (CPR) cÖwkÿY Kg©kvjvi wKQz w¯’i wPÎ
- 39. 34 Bangla vision televisioni wbqwgZ Av‡qvRb m¦v¯’¨ K_v welq: K‡ivbv cwiw¯’wZ| Ryb 2021 Dc¯’vwcKv : Wv: Avdwib myjZvbv| Avgwš¿Z AwZw_: (1) Wv: †gv: †ZŠwdKzi ingvb (2) Wv: Avn‡¤§` bvRgyj Avbvg| Dc¯’vwcKv : myax `k©K, Avmmvjvgy AvjvBKzg, Avkv KiwQ fv‡jv Av‡Qb, my¯’ Av‡Qb Ges myiÿxZ Av‡Qb| Avcbv‡`i‡K m¦vMZ Rvbvw”Q evsjvwfk‡bi mvßvwnK Av‡qvRb Òm¦v¯’¨ K_vÓ Abyôv‡b| Avcbv‡`i mv‡_ AvwQ Avwg Wv: Avdwib myjZvbv| Avgiv G Abyôv‡b cÖwZ mßv‡n †Póv K‡i _vwK Avgv‡`i ¯^v¯’¨ welqK †h mgm¨v ¸‡jv Av‡Q †m¸‡jvi e¨vcv‡i K_v ej‡Z Ges Zvi Rb¨ mycivgk© †`qvi Rb¨ me mgq Avgv‡`i mv‡_ we‡klÁ AwZw_e„›`iv _v‡Kb| GLb K‡ivbvi †h cwiw¯’wZ †mUvi e¨vcv‡i Avgiv K_v eje Ges †mB mv‡_ Avgv‡`i †h we‡klÁ AwZw_iv Av‡Qb Zv‡`i mv‡_ Zv‡`i we‡klvwqZ welq wb‡q Avgiv K_v eje Avgv‡`i GB Abyôv‡b| Avgv‡`i AbyôvbwU Facebook live G hv‡”Q †mLv‡bI Avcbviv Avgv‡`i mv‡_ †hvM`vb Ki‡Z cv‡ib Ges Avcbv‡`i Kv‡Q Avgv‡`i AwZw_‡`i Rb¨ hw` †Kvb cÖkœ _v‡K †m‡ÿ‡Î Avgv‡`i w¯Œ‡b †`Lv‡bv bv¤^v‡i Rvbv‡Z cv‡ib A_ev †dmey‡K K‡g›U Ki‡Z cv‡ib| Avgv‡`i mv‡_ AvR‡K †h AwZw_iv Av‡Qb Zviv n‡”Qb 1g Rb we‡klÁ Aa¨vcK (Wvt) †gvt †ZŠwdKzi ingvb (dviæK) - GgweweGm, GdwmwcGm (†gwWwmb), GgwW (KvwW©IjwR), whwb Aa¨vcK I wefvMxq cÖavb (KvwW©IjRx), K‡Y©j gv‡jK †gwW‡Kj K‡jR nvmcvZvj, gvwbKM‡Ä Kg©iZ Av‡Qb Ges 2q Rb we‡klÁ AwZw_ n‡”Qb Wv: Avn‡¤§` bvRgyj (Avbvg) whwb child specialist Ges child cardiologist wn‡m‡e divRx nvmcvZvj, ebkÖx‡Z Kg©iZ Av‡Qb| Avcbv‡`i 2 Rb‡KB ¯^vMZ Rvbvw”Q Avgv‡`i AvR‡Ki Abyôv‡b| Avkv KiwQ Avcbviv `yRbB fv‡jv Av‡Qb| m¨vi (Wv: †gv: †ZŠwdKzi ingvb) Avgiv †Zv Avm‡j me mgq †Póv Kwi Avgv‡`i `k©K‡`i hv‡Z ¯^v¯’¨ wel‡q m‡PZb Ki‡Z cvwi Ges Zv‡`i †h mgm¨v ¸‡jv Av‡Q †m¸‡jv wb‡q hv‡Z Av‡jvPbv Ki‡Z cvwi Ges †m wel‡qi mgvavb w`‡Z cvwi †mB †PóvB K‡i _vwK| eZ©gvb K‡ivbv cwiw¯’wZ †Zv Ggb GKUv welq †hUv wb‡q wbqwgZB Avgiv K_v ejwQ hv‡Z mwVK Z_¨ ¸‡jv Avgv‡`i `k©K‡`i Kv‡Q hvq| GLbKvi †h K‡ivbv cwiw¯’wZ †mUvi wel‡q Avgv‡`i `k©K‡`i hw` wKQz ej‡Zb m¨vi| Wv: †ZŠwdKzi ingvb : ab¨ev` Avcbv‡K, ab¨ev` evsjvwfkb‡K, Avgv‡K Avgš¿b Rvbv‡bvi Rb¨| Avm‡j K‡ivbv cwiw¯’wZ GLbKvi hw` ˆ`wbK cwÎKv ¸‡jv check Kwi
- 40. 35 ev wUwfi †nWjvBb ¸‡jv cwo| Zvn‡j †`Le ïay †h K‡ivbv cwiw¯’wZ w`b w`b Lviv‡ci w`‡K hv‡”Q A_ev K‡ivbv cwiw¯’wZ fqsKi GKUv iæc avib Ki‡Q ev Ki‡e Ges wK ev¯ÍeZvI Avm‡j ZvB, †Zv eZ©gv‡b mevB Rvwb Avgiv †h bZzb we‡kl variant e‡j Indian variantI e‡j A‡bK mgq| GLb †h‡nZz AvÂwjK †Kvb welq wb‡q PvBbv wKsev GUv wbqgI bv, †mRb¨ Avm‡j variant Uvi bvg w`‡q‡Q delta variant GLb GB delta variant evsjv‡`‡k Avmvi c‡i B`vwbs Avgiv †`L‡ZwQ †h, kbv‡³i †P‡q hviv AvµvšÍ n‡q‡Qb Zv‡`i‡K Genome sequence K‡i †`Lv wM‡q‡Q †h Avµv‡šÍi 60-80% delta variant around Avm‡j hZRbB AvµvšÍ n‡”Qb Zvi †_‡K major person B †_‡K delta variant n‡”Q| GLb †h‡nZz delta variant G n‡”Q Avgiv Rvwb GB †h variant Uv n‡”Q †hUv India †Z already †gmvKvi w`‡q Avm‡Q ZvB Indiai eZ©gvb cwiw¯’wZ GKUz DbœwZ n‡q‡Q GLb g„Zz¨nvi Ges Avµv‡šÍi nviI K‡g‡Q †Zv evsjv‡`‡kI Av‡¯Í Av‡¯Í mxgvšÍeZx© AÂj w`‡q ejv n‡”Q †h GUv evsjv‡`‡ki centre w`‡K Av‡¯Í Av‡¯Í GwM‡q Avm‡Q Gi g‡a¨ n‡jv 3Uv †hUv †h wZbUv †Rvb w`‡q Avgv‡`i g~jZ BwÛqvi mv‡_ cb¨ Av`vb-cÖ`vb n‡q _v‡K Ges eW©vi Av‡Q we‡kl K‡i mvZÿxiv, PzqvWv½v, VvKziMuvI GB wZb A‡ji Pvwicv‡k †h †Rjv ¸‡jv Av‡Q †h, †Rjv ¸‡jv‡Z msµg‡bi msL¨v †ewk Avi †Kvb †Kvb A‡j †`Lv hv‡”Q 90% Gi Dc‡i Av‡Q| hv‡`i cixÿv Kiv n‡”Q Zv‡`i †_‡K †`Lv hv‡”Q 90% Gi Dc‡i Avm‡Z‡Q| Zvi gv‡b Avµv‡šÍi msL¨v w`b w`b evo‡Z‡Q Ges g„Zz¨nviUv †hUv gvSLv‡b K‡g wM‡qwQj, †mUv Avgiv †`L‡ZwQ †h Avevi evo‡Z‡Q| Av‡iKUv n‡j †h mg¯Í †ivMx Avgv‡`i mxgvšÍ AÂj †_‡K Avm‡Z‡Q Avgiv †`L‡ZwQ †h wewfbœ heart attack wb‡q †hgb heart Gi mgm¨v wb‡q Avm‡Z‡Q wKsev heart attack cieZx© wewfbœ follow up ev cieZx©‡Z †Kvb angiogram jvM‡e wKbv A_ev angiogram Kiv n‡j Zviv refer K‡i w`‡”Q GB †ivMx ¸‡jv‡KI Avgiv hLb †`L‡ZwQ cixÿv-bxwiÿv K‡i GB †ivMx ¸‡jv‡K †Kb Zv‡`i heart attack Uv n‡jv Avm‡j GZw`b Zviv stable wQj A_ev †Kvb †ivMx GgbI e‡j †Kvb complain K‡i bvB Av‡M heart attack wQj ev ey‡K e¨_v wQj nqZ wKQz risk factor wQj G¸‡jviI hLb Avgiv cixÿv K‡i †`wL †hgb indirect wKQz test Av‡Q Avgv‡`i †hgb CBC, CRP, Ferritin level G¸‡jv K‡i hLb †`L‡ZwQ cÖ‡Z¨KUv level B †ewk cvw”Q Zvi gv‡b somehow Zvi K‡ivbv n‡qB GB heart attack ¸‡jv n‡”Q| Dc¯’vwcKv : wR¦ m¨vi Aek¨B, GB †h Avcwb GKwU ¸iæZ¡c~Y© K_v e‡j‡Qb †h, heart attack Gi mv‡_ K‡ivbvi m¤ú„³Zv GUv wb‡q Aek¨B Avcbvi mv‡_ Avevi K_v eje Avgv‡`i †h Av‡iKRb AwZw_ Av‡Qb ÔWv : Avn‡¤§` bvRgyj AvbvgÕ Avcbvi `„wó‡Kvb †_‡K Avm‡j welqUv Rvb‡Z Pvw”Q †h, Avcbviv 1Uv wekvj Rb‡Mvwô wb‡q KvR K‡ib| ev”Pv‡`i‡K wb‡q †Zv I‡`i w`‡K w`‡q Avcbv‡`i †Kvb experience hw` share Ki‡Z Pvb GB variant Uv wb‡q I‡`i Dci wKiæc Ges †Kgb cÖfve †dj‡Q| Wv: Avn‡¤§` bvRgyj Avbvg : m¨vi [Wv: †gv: †ZŠwdKzi ingvb] †hgb ej‡jb Avm‡j eZ©gv‡b mxgvšÍeZx© A‡ji w`‡Ki cwiw¯’wZ GK K_vq A‡bK fqven Ges Avµv‡šÍi msL¨v cÖwZw`bB evo‡Q Ges GB †h mxgvšÍeZx© AÂj Gi me RvqMv †_‡K Avgv‡`i
- 41. 36 Kv‡Q †ivMx ¸‡jvAvm‡Q Avi Avwg telemedicine wPwKrmvI w`‡q _vwK| †Zv †h ai‡bi AwfÁZv ¸‡jv Avgvi n‡”Q Zv †_‡K Avwg g‡b KiwQ †h, Avgv‡`i †`‡k †hUv n‡”Q †h ev”Pv‡`i †ÿ‡ÎI fv‡e test Kivi AvMÖnUv Rb‡Mvôxi g‡a¨ GL‡bv M‡o I‡Vwb wKš‘ †hB evmvq COVID positive patient Av‡Q Ges ev”Pv‡`iI hw` Avgiv IiKg symptoms†`wL Zvn‡j Avgiv AwffveK‡`i e‡j †`B †h, Avcwb a‡iB †bb Avcbvi ev”Pvi COVID n‡q‡Q Ges H fv‡eB Avcwb †h mg¯Í Kg©KvÛ Av‡Q Avcwb Kiæb †Zv, test Avcwb †hgbUv e‡j‡Qb †h child Gi †ÿ‡ÎI Avgiv K‡ivbv positive fv‡jvB cvw”Q| Avevi A‡b‡K‡Zv COVID positive report wb‡qI Avgv‡`i Kv‡Q Avm‡Q| Dc¯’vwcKv : GB †ÿ‡Î 2Uv cÖkœ m¨vi [Wv: Avn‡¤§` bvRgyj] Avcbv‡K Ki‡Z PvB Avcwb †hUv ej‡jb ev”Pv‡`i test Kiv‡bvi e¨vcv‡i AbvMÖn GUvi KvibUv wK gv‡b child population wb‡qB †Zv mevB Avm‡j wPwšÍZ _v‡K, evev-gv †ewk †Zv Zv‡`i GUv bv Kiv‡bvi wcQ‡b KvibUv wK, Avi Kiv‡bvi DcKvwiZv Uv KZUzKz- Wv: Avn‡¤§` bvRgyj Avbvg : Avgv‡`i †hUv GKUv fq _v‡K †h COVID test nq Ggb GKUv RvqMvq wb‡q _v‡K ev”Pvi hw` COVID bv n‡q _v‡K Zvn‡j †Zv Zvi n‡q hv‡e GiKg 1Uv e¨vcvi Av‡QB Avi mevB †hUv g‡b K‡i †h evev-gv COVID positive nq Zvn‡j mv‡_ mv‡_ Avgv‡`i informed K‡i †h m¨vi Avgvi †Zv positive †Zv eveyi †ÿ‡Î wK Kie Avwg ZLb †gvUvgywU 90% patient Gfv‡eB deal K‡iwQ †h test wb‡q †Zv Avgvi Kv‡Q COVID positive patient G‡m‡QB hviv ev”Pv‡`i positive wb‡q G‡m‡Q wKš‘ g~jZ Avwg GUvB †`‡LwQ †h hviv COVID positive n‡q‡Q †mB evev-gv Avgv‡`i Kv‡Q Rvb‡Z †P‡q‡Qb †h Zv‡`i ev”Pv‡`i VvÛv Kvwk GB ai‡bi symptoms develop K‡i‡Qb GLb Zv‡`i Kibxq wK- Dc¯’vwcKv : †m‡ÿ‡Î †Zv Avcbviv ev”Pv‡`i‡K test Ki‡Z e‡jb- Wv: Avn‡¤§` bvRgyj Avbvg : nu¨v, definitely Avwg ev”Pv‡`i COVID test Ki‡Z ewj †h Av‡`Š positive Av‡Q wKbv Kvib Aek¨B Avcbv‡K confirm n‡Z n‡e Avcbvi ev”Pvi COVID n‡q‡Q wKbv-Avcwb avibv K‡iB †Zv H ai‡bi treatment Zv‡K w`‡Z cvi‡eb bv| Kvib me wKQziB †Zv GKUv protocol Av‡Q| †Kbbv Avcbvi quarantine Gi e¨vcvi Av‡Q, Avcwb †Zv Av‡iK Rb‡K affected Ki‡Z cv‡ib bv| Zvn‡j Avwg eje definitely Avcbv‡K Gi Rb¨ COVID test Ki‡Z n‡e| Ô†Kbbv Avcwb g‡b g‡b fve‡jB n‡e bv †h Avgvi g‡b nq COVID n‡q‡Q †mUvi †Kvb g~j¨B Avm‡j Avgv‡`i wPwKrmv weÁv‡b †bB| COVID positive Avcbv‡K confirm n‡Z n‡e Ges †mB protocol Abyhvqx wPwKrmv MÖnY Ki‡Z n‡e|
- 42. 37 Dc¯’vwcKv : wR¦m¨vi, Avgiv Avevi K_v eje Avcbvi mv‡_ GB welqUv wb‡q| GB gyû‡Z© GKRb `k©K †Uwj‡dv‡b Avgv‡`i mv‡_ hy³ n‡q‡Qb| `k©K Avcbvi bvg Ges eqm e‡j Avcbvi cÖkœwU Avgv‡`i‡K Rvbvb| `k©K 2 : nu¨v‡jv, Avmmvjvgy AvjvBKzg, Dc¯’vwcKv : IqvjvKzg Avmmvjvg, `k©K 2 : Avgvi MZ (4-5) w`b R¦i, VvÛv, Mjv e¨_v Avwg K‡qKw`b Av‡M ivRkvnx‡Z †eov‡Z wM‡qwQjvg †mLvb †_‡K Avmvi ci †_‡KB Avgvi R¦i, VvÛv Avi bvcv †L‡j R¦iUv _v‡K bv wKš‘ Ggwb‡Z me-mgq _v‡K 100 wWwMÖi gZ| GLb Avwg Rvb‡Z Pvw”Q Avgvi eZ©gv‡b KiYxq Kx? Dc¯’vwcKv : m¨vi [Wv: †gv: †ZŠwdKzi ingvb] Avcbvi †Kvb cÖkœ Av‡Q wKbv `k‡K©i Kv‡Q- Wv: †ZŠwdKzi ingvb : (`k©K) Avcbvi †Kvb risk factor Av‡Q we‡kl K‡i diabetes, high pressure ev Av‡M †Kvb angiogram K‡i‡Qb wKbv- `k©K 2 : D”P i³Pv‡ci Jla Lvw”Q Avi diabetes Gi Rb¨ Comprid LvB Avevi ev‡Zi mgm¨v Av‡Q Zvi Rb¨ Jla LvB| Dc¯’vwcKv : R¦x `k©K, ab¨ev` Avcwb Avgv‡`i mv‡_B _vKzb| m¨vi [Wv: †gv: †ZŠwdKzi ingvb] Avcwb hw` `k©‡Ki cÖ‡kœi DËiUv hw` w`‡Zb, †h‡nZz Dwb Rvb‡Z Pv‡”Qb| Wv: †ZŠwdKzi ingvb : Av”Qv, Gi ga¨ Dwb Lye fv‡jv GKUv information w`‡q‡Qb †h Dwb K‡qKw`b Av‡M ivRkvnx‡Z wM‡qwQ‡jb| Avgiv Gi g‡a¨ †h wZbUv †Rv‡bi K_v ejjvg GB †Rv‡bi g‡a¨ PvcvBbeveMÄ GKwU ivRkvnxi cv‡kB Ges wfZ‡ii GKUv eW©vi Avi Avcbvi †h‡nZz R¦i n‡q‡Q- Avwg Avgvi †ivMx‡`i‡K me mgq GKUv K_v ewj †h GB wmR‡b nqZ GKUz e„wó c‡o nvjKv VvÛv jv‡M ¯^vfvweK wKš‘ hLb pandemic P‡j pandemic PjvKvjxb mg‡q Kv‡iv Dc¯^M© nq we‡kl K‡i R¦i wb‡q hw` †KD Av‡m Avwg ewj 99% †ivMx‡`i GLb †h‡nZz K‡ivbv Pj‡Q †m‡nZz K‡ivbv nIqvi m¤¢vebv Av‡Q| Avgiv A‡bK mgq GgbI †`LwQ A‡bK †ivMx‡`i Dc¯^M© _vKv m‡Ë¡ K‡ivbv cixÿv Kiv‡bvi ci result negative Avm‡Q wKš‘ Aci w`K w`‡q GB †ivMxiB oxyzen jvM‡Q, Zv‡K nvmcvZv‡j fwZ© Ki‡Z n‡”Q, ICU †Z wb‡Z n‡”Q †ivMxi oxyzen K‡g hv‡”Q ZviciI e‡j Avgvi †Zv test negative Avm‡Q †Zv GB Kvi‡b Avwg †ivMx‡`i‡K ewj K‡ivbv direct cixÿv Kivi cvkvcvwk indirect wKQz cixÿv Av‡Q †hUv i‡³i cixÿv wKQzUv Av‡m †hgb CBC definitely lymphocytes, countreous lico sitosis A‡bK mgq cvB CRP cixÿv Kiv nq| CRP positive Av‡m| Ferritin level Kwi, D-dimer Kwi, LDH Kwi KL‡bv KL‡bv CPK ev SGPT evowZ Av‡m| GB †h test ¸‡jv Av‡Q G¸‡jv hw` Avcwb K‡ib mv‡_ mv‡_ K‡ivbvi RT PCR †h Avgiv ewj †mB test Gi cvkvcvwk result ta Rvb‡Z cvi‡eb| Proper result Uv Rvb‡Z cvi‡eb Zvi Rb¨ Aek¨B Avcbv‡K GKRb Wv³v‡ii ¯^ibvcb¨ n‡Z n‡e Ges Zvi civgk© Abyhvqx test ¸‡jv K‡i †`L‡Z n‡e
- 43. 38 Avi Avcwb †h‡nZzSuspect Ki‡Qb †m‡nZz Avcwb Wv³v‡ii mv‡_ Av‡jvPbv K‡i cixÿv ¸‡jv K‡i wb‡Z cv‡ib †Kvb mgm¨v bvB| †h‡nZz Avcbvi eqm 52 eQi| hw` eq‡mi K_v Avgiv ewj eqmUv n‡”Q me‡P‡q risk factor me K‡ivbvi Rb¨| Dc¯’vwcKv : R¦x m¨vi [Wv: †gv: †ZŠwdKzi ingvb] ab¨ev`, Avgv‡`i mv‡_ Avm‡j Av‡iK Rb `k©K hy³ n‡q‡Qb `k©K Avcbvi bvg Ges eqm e‡j Avcbvi cÖkœwU Rvbvb| `k©K 3 : Avmmvjvgy AvjvBKzg, Avgvi bvg kvnxbyi, Avgvi eqm 55, Avwg wgicyi †_‡K ejwQ| MZ eQi Avgvi K‡ivbv n‡qwQj Ges K‡ivbv‡Z Avgvi lungs Gi 70% infected n‡q wM‡qwQjvg hvi Rb¨ Avwg nvmcvZv‡j fwZ© n‡qwQjvg Gi c‡i †hUv n‡jv Avgvi myMvi †e‡o n‡q‡Q Avi platelets K‡g wM‡q‡Q †Zv myMvi Avjøvni ing‡Z bigv‡j P‡j Av‡m wKš‘ platelets `xN© (3-4) gvm hver 100 wQj| K‡ivbv nIqvi Av‡M Avgvi platelets wQj 301 eZ©gv‡b platelets †b‡g 78 G `vwo‡q‡Q, Avwg Pvw”Q †h GUv †Kvb g‡Z evov‡bv hvq wKbv Avi wKfv‡e| Dc¯’vwcKv : m¨vi [Wv: †gv: †ZŠwdKzi ingvb] Avcbvi †Kvb cÖkœ Av‡Q wKbv Avgv‡`i `k‡K©i Kv‡Q| Wv: †ZŠwdKzi ingvb : bv ab¨ev`, Avm‡j Avcbvi †hUv Av‡Q platelets 100 gv‡b n‡”Q 1,00,000 Avi 301 gv‡b 3,01,000 wQ‡jb Av‡M GLb †mUv K‡g wM‡q 78,000 n‡q‡Q| GLb e¨vcvi Uv n‡”Q †h GB †h Avcbvi platelets 1,00,000 wQj Zv K‡g 78,000 n‡q wM‡q‡Q gv‡b K‡ivbvi †h cÖK…wZ Avgiv †`L‡ZwQ †mUv n‡jv †h K‡ivbv‡Z platelets K‡g hvq wVKB wKš‘ cieZ©x‡Z Avevi Av‡¯Í Av‡¯Í ¯^vfvweK P‡j Av‡m| ¯^vfvweK Av‡Mi Ae¯’v‡Z bv Avm‡jI GK †_‡K †`o jv‡Li g‡a¨ P‡j hvq| bigv‡ji w`‡K P‡j Av‡m GUvB ¯^vfvweK wKš‘ Avcbvi †h‡nZz 1 jvL n‡q Avevi 1 jv‡Li †_‡KI K‡g †M‡Q †m‡ÿ‡Î Avcbv‡K †Lqvj ivL‡Z n‡e †h, Avcbvi recurrent infection n‡”Q wKbv- recurrent infection gv‡b Avcbvi nvjKv nvjKv R¦i n‡e, B`vwbs †hUv Avgiv K‡ivbvi Dc¯^M© †`L‡ZwQ mg¯Í †ivMxi wKš‘ R¦i _v‡K bv| GLbKvi †ivMxiv †h complain K‡i we‡kl K‡i delta variant Gi †ÿ‡Î nqZ nvjKv nvjKv R¦i, A‡bK mgq †ivMx †bvwUkI K‡i bv e‡j †h, bv R¦i bv, GKUz g‡b nq paracetamol †L‡qwQj 1 †ejvi Rb¨ Avi †hUv e‡j discomfort †h †cU dz‡j _v‡K Ges Wvqwiqv nq continuously K‡jivi g‡Zv Wvqwiqv| GB K‡jivi g‡Zv hw` Wvqwiqv nq †mUvI wKš‘ eZ©gv‡b K‡ivbvi 1wU symptoms GLbKvi delta variant Gi †ÿ‡ÎI common WvqwiqvUv †Zv †m‡ÿ‡Î Avcwb †`L‡eb †h‡nZz Avcbvi platelets K‡g‡Q 1Uv m¤¢vebv †_‡K _v‡K Avcbvi Avevi recurrent infection n‡q‡Q wKbv| 2 bv¤^i n‡”Q Avcbvi platelets count Uv †h †m›Uvi
- 44. 39 †_‡K Kwi‡q‡Qb Avm‡jH †m›Uvi A_ev fv‡jv †Kvb †m›Uvi †_‡K Avevi repeat Kiv DwPZ| hw` Avcbvi platelets K‡g hvq †m‡ÿ‡Î Avcbvi worried nIqvi wKQz bvB| †Kbbv K‡ivbv‡Z platelets †W½yi g‡Zv bv †W½y‡Z †hgb platelets avg avg K‡i K‡g hvq Ges Avjv`v platelets Avevi w`‡Z nq| GB K‡ivbvi †ÿ‡Î Avevi platelets †`qvi cÖ‡qvRb nq bv| †Kbbv GB †ÿ‡Î platelets GKUv certain mg‡q G‡m c‡i Avevi Av‡¯Í Av‡¯Í evo‡Z _v‡K| myZivs Avcbvi worried nIqvi wKQz bvB| Avm‡j Avcbvi Kibxq †Zgb wKQz bvB Avcbv‡K ïay observe Ki‡Z n‡e, gv‡S gv‡S platelets test K‡i †h Gi †_‡K Av‡iv †ewk K‡g hvq wKbv-Avi †m‡ÿ‡Î Avcwb hw` g‡b K‡ib Lye †ewk cÖ‡qvRb g‡b K‡ib Zvn‡j †Kvb hematologist Gi ¯^ibvcb¨ n‡Z cv‡ib| Dc¯’vwcKv : GUv Avm‡j KZ w`b ci ci observe Ki‡e Kvib Dwb †ek K‡qK evi †Zv test Uv Kwi‡q‡Qb hvi Rb¨ Dwb ej‡Z cvi‡Qb-Wv: †gv; †ZŠwdKzi- MZ 1 eQi hver test Kwi‡q‡Qb Dwb Zvi gv‡b †Kbbv Dwb K‡ivbvi Av‡M c‡i Ges eZ©gv‡b †Kgb Av‡Q platelets Zv ej‡Z cvi‡Qb| Dc¯’vwcKv : Zvn‡j KZ w`b ci ci platelets Uv cixÿv Kiv DwPZ Avi wK- Wv: †ZŠwdKzi ingvb : Avgvi g‡b nq (2-3) mßvn ci ci Avcwb †`L‡Z cv‡ib †h Avcbvi platelets Uv †Kvb w`‡K hv‡”Q| hw` platelets GKevi evov‡Z ïiæ K‡i Zvn‡j Avcwb wbwðZ _v‡Kb †h Avcbvi platelets Av‡¯Í Av‡¯Í Av‡iv evo‡e hw`I ev infection bv nq| myZivs Avgvi Kv‡Q g‡b nq GUv wb‡q Avcbvi Lye †ewk wPwšÍZ nIqvi wKQz bvB| Dc¯’vwcKv : R¦x, ab¨ev` m¨vi [Wv: †gv: ˆZŠwdKzi]| Wv: bvRgyj Avcbvi mv‡_ †h welqUv wb‡q K_v ejwQjvg ev”Pv‡`i Paediatric group Gi †ÿ‡Î †hgb GKRb `k©K-02 GLb †dvb K‡i‡Qb Zvi platelets level Uv K‡g hv‡”Q Ges m¨vi [Wv: †gv: †ZŠwdKzi] ej‡jb wKQz test K‡i Avgiv wKQz cwieZ©b †`L‡Z cvB RT PCR test negative Avm‡jI| ev”Pv‡`i †ÿ‡ÎI †WvR ¸‡jv ev Zv‡Zi †ÿ‡ÎI wK test ¸‡jv similar ev Zv‡`i †ÿ‡ÎI result wK ¸‡jv GKB iKg cv‡”Qb| Wv: Avn‡¤§` bvRgyj Avbvg : Avm‡j Basic idea Uv GKB iKg| Avgiv I ILv‡b complete blood count, serum ferritin, C-reactive protein, D-dimer G¸‡jv meB Kwi Avgiv LDH Kwi Z‡e †h ev”Pv‡`i †ÿ‡Î †h symptoms †mB symptoms w`‡q Avm‡j Avgiv assesse Kivi †Póv Kwi| A‡b‡K ev”Pv‡`i common cold wb‡q Av‡m R¦i Av‡Q, ev”Pvi Avevi GKUz k¦vmKó n‡”Q| ZLbB Avgiv wPšÍv-fvebv Kwi †h †Kvb evwK Av‡Q wKbv Ges †m Abyhvqx Avgvi ev”Pvi evev-gv‡K ewj †h GB certain test ¸‡jv Kiv‡eb Ges Avgv‡K Rvbv‡eb| Dc¯’vwcKv : Av”Qv m¨vi [Wv: †gv: bvRgyj] GB †h GLb Avcwb †h †ivM ¸‡jvi K_v ej‡jb ev †h Dc¯^M© †Zv ev”Pv‡`i Ab¨vb¨ Amy¯’Zvi †ÿ‡ÎI n‡q _v‡K we‡kl K‡i GLbKvi †h season Uv GB summer season G ev GLb Avevi †h elv©Kvj ïiæ n‡”Q| †Zv GLbKvi †h †ivM¸‡jv †`Lv w`‡”Q GB mg‡q GB eq‡mi ev”Pv‡`i †m¸‡jv hw` Avgv‡`i `k©K‡`i
- 45. 40 GKUz ej‡Zb| KvibmvaviY †ivM¸‡jvI †Zv n‡”Q GB K‡ivbvi mv‡_B| m¨vi [Wv: †gv: bvRgyj] GKUz Avcbv‡K disturb Kwi Avcwb ïiy Kivi Av‡M Avgv‡`i mv‡_ GKRb `k©K hy³ n‡q‡Qb Dbvi cªkœwU wb‡q Avgiv back KiwQ- (`k©K-4) Avcbvi bvg Ges eqmwU e‡j Avcbvi cÖkœwU Rvbvb| `k©K 4 : AvmmvjvgyAvjvBKzg, Avgvi eveyi eqm 22 gvm, Ii 3 w`b a‡i ewg n‡”Q, R¦i †ewk n‡”Q, Ii R¦i n‡”Q 99-100| I‡K cvwb LvIqvB ev m¨vjvBb LvIqvB ev bvcv LvIqvB hvB LvIqvw”Q Zv‡ZB ewg Ki‡Q, Avwg GKUz e‡j †`B Avwg Avgvi gv‡qi Kv‡Q _vwK K‡qKw`b Av‡M, Avgvi gvi eqm n‡e 94 eQi Dbvi CT scan G lungs G 25% damage aiv c‡o‡Q Ges report G wjLv wQj mild stoke COVID positive wKš‘ Zv‡K hLb COVID test Kiv‡bv n‡q‡Q ZLb negative G‡m‡Q report, Av¤§vi mv‡_ Avgiv †Zgb †Kvb wgjvwgkv Kwi bvB Avgiv normal wgjvwgkvB KiwQ G‡Z K‡i Avgvi †ewe affected n‡q‡Q wKbv ev GUv †Kvb symptoms wKbv COVID Gi? Wv: Avn‡¤§` bvRgyj Avbvg : wR¦ ab¨ev` Avcbv‡K (`k©K-04) Lye my›`i 1wU cÖkœ K‡i‡Qb| †`Lyb †h‡nZz Avcbvi eveyi GKUz R¦i R¦i Av‡Q mv‡_ ewgI Av‡Q Avevi R¦i R¦i ewg n‡jB †h COVID e¨vcviUv wKš‘ Zv bq| Z‡e †n Avcbvi gvi COVID hw`I negative wKš‘ Avcwb g‡b Ki‡Qb †h‡nZz Dbvi lungs Gi 25% affected ev infection †hgbUv Avcwb e‡j‡Qb| yes, Avgiv Zv‡K bR‡i ivLe wKš‘ Avwg g‡b KiwQ †h, Avcwb GUv wb‡q GLbB wePwjZ n‡qb bv Avgvi †hUv g‡b n‡”Q, Avcwb †Lqvj ivL‡eb ev”Pvi cvZjv cvqLvbv n‡”Q wKbv, Zvi ewgi c‡i cvZjv cvqLvbv ïiæ n‡”Q wKbv| yes hw` cvZjv cvqLvbv nq Ges GUv progress Ki‡Z _v‡K ZLb Avcwb Aek¨B wPwKrm‡Ki civgk© wb‡eb| Avwg GLb ch©šÍ g‡b KiwQ, †h‡nZz Avcbvi eveyi 3w`b a‡i Gi Avcwb AvcvZZ †hUv Ki‡Z cv‡ib Avgiv †h¸‡jv †`B Avgiv emistat GKUv syrup †`B Av`v PvgP K‡i 3 evi 3 w`b Ges GKUz m¨vjvBb LvIqv‡eb wbIm¨vjvBb ev GB ai‡bi m¨jvBb K_v Avgiv ewj Avcbvi eveyi †h‡nZz 22 gvm eqm Avgiv eje (10-15) PvgP m¨vjvBb Avcwb LvIqv‡eb Avi observation G ivL‡eb R¦iUv evo‡Q wKbv Ges †Kvb ai‡bi cvZjv cvqLvbv ïiæ n‡”Q wKbv-ZLb Avcbv‡K Aek¨B Wv³v‡ii wbKU ¯^ibvcb¨ n‡Z n‡e Ges hw` Wv³vi †Kvb cixÿv Ki‡Z Pvb Aek¨B †m¸‡jv K‡i wb‡eb hw` cÖ‡qvRb nq RT PCR †mUvI Ki‡Z cv‡i wKš‘ GLb ch©šÍ Avwg g‡b KiwQ Avcbvi wePwjZ nIqvi wKQz bvB, ab¨ev` Avcbv‡K| Dc¯’vwcKv : A‡bK ab¨ev` m¨vi [Wv: bvRgyj] Avkv KiwQ `k©K Zvi Avkvbyiæc DIiwU †c‡q †M‡Qb| Dwb Avm‡j Zvi ev”Pv‡K wb‡q Lye worried Zvi K_v ï‡bB eySv hvw”Qj
- 46. 41 Ges GUvi KviYIi‡q‡Q Dchy³ †h‡nZz Dbvi gv infected GiKg Dbviv wPšÍv Ki‡Qb| †Zv `k©K Avcwb wPšÍv Ki‡eb bv, m¨vi [Wv: bvRgyj] †h civgk© ¸‡jv w`‡q‡Qb †m¸‡jv d‡jv Kivi Rb¨ Ges hw` Avcwb †`‡Lb †h Avcbvi eveyi Dc¯^M© †e‡o hv‡”Q Zvn‡j Aek¨B wkï‡ivM we‡klÁi mv‡_ K_v e‡j †mB civgk© Abyhvqx wPwKrmv MÖnY Ki‡eb| m¨vi [Wv: bvRgyj] †hUv wb‡q K_v ejwQjvg †h GB season G ev”P†`i wKQz common AmyL K‡i _v‡Kb †hgb Dwb [`k©K-4] GKUvi K_v ej‡jb ewg, Wvqwiqv G¸‡jv †Zv GKUz hw` `k©K‡`i ej‡Zb †h wK wK †ivM ev”Pv‡`i n‡q _v‡K- Wv: Avn‡¤§` bvRgyj Avbvg : Av”Qv Avwg Dbvi cÖm½B awi †h, GB wRwbm¸‡jv Avgiv A‡bK †ewk cvw”Q we‡kl K‡i Mi‡gi †h mgqUv‡Z Wvqwiqvi †h cÖ‡Kvc †hUv Avgiv acute gastroenteritis disease ewj Dwb (`k©K-04) †hUv typical symptoms ej‡Qb nvjKv nvjKv R¦i c‡i ewg ïiæ n‡q‡Q Ges suddenly cvZjv cvqLvbv ïiæ nq| GUvB ¯^vfvweK GUvB nIqvi K_v| Zvn‡j GB wRwbm¸‡jv Avgiv LyeB cvw”Q Avi f‡qi welq n‡”Q G¸‡jvi cÖwZUv symptoms B COVID Gi mv‡_ hvq Avi eZ©gv‡b Avgv‡`i mgm¨vUv HLv‡bB Ges ev”Pv‡`i †ÿ‡Î Avcwb ej‡Z cvi‡eb bv †h †hgb GKUv eo gvbyl G‡m e‡j Zvi discomfort jvM‡Q ev others symptoms Gi K_v Zviv ej‡Z cv‡i, Mjv e¨_vi K_v ej‡Z cv‡i| GKUv ev”Pv †Zv †m¸‡jv ej‡Z cv‡ibv| ZLb Avgv‡`i‡K assess Ki‡Z Zv‡K †`L‡Z nq Ges H Abyhvqx cÖ‡qvRbxq wmØvšÍ wb‡Z nq Avi Avcwb (Dc¯’vwcKv) †hUv ej‡Qb nu¨v, Wvqwiqvi cvkvcvwk me mgq †hUv wbI‡gvwbqv Ges †eªvswKDjvBwUR G¸‡jv‡Zv Avgiv me mgq cvB| commonly bronchitis B cvB 82-95% †m‡ÿ‡Î Avgiv bronchitis cvB GB GKB †ÿ‡Î G‡ZI wKš‘ VvÛv R¦i k¦vmKó nq| Zvn‡j Gme †ÿ‡Î Aek¨B Avcwb Wv³v‡ii civgk© wb‡eb Ges Wv³v‡ii civgk© Qvov Avcwb KLb COVID test Kiv‡eb GUv Wv³viB Avcbv‡K e‡j w`‡Z cvi‡e| †Kbbv †KvwfW †ivMxiv Avcbvi Kv‡Q Avm‡eB k^vmKó wb‡q| cÖPÛ k¦vmKó †mB mv‡_ R¦i bvK w`‡q cvwb ci‡Q †h¸‡jv typical COVID patient †`i _v‡K| †h¸‡jv evev-gv‡`i worried K‡i †`q Avi †mB mv‡_ evmvq †Kvb Kvi‡b COVID case †_‡K Zvn‡j †Zv Avwg eje Avcbv‡K Av‡iv `ªæZ Wv³v‡ii kibvcb¨ nIqv DwPZ| Dc¯’vwcKv : Avgv‡`i mv‡_ Av‡iKRb `k©K-05 hy³ n‡q‡Qb `k©K-05 Avcbvi bvg Ges eqm e‡j Avcbvi cÖkœwU Kiæb| `k©K 05 : Avmmvjvgy AvjvBKzg, Avgvi ev”Pvi Rb¨ ejwQjvg, ev”Pvi eqm 2 eQi 7 gvm Ii †`ogvm Av‡M UvBd‡qW n‡qwQj| UvBd‡qW fv‡jv nIqvi c‡i GLb †h mgm¨v Ii cvqLvbv Lye k³ cvqLvbv Ki‡Z em‡jB Lye KvbœvKvwU K‡i G‡ÿ‡Î avolac syrup LvIqvB‡qwQjvg wKš‘ †Kvb cwieZ©b nqwb- Wv: Avn‡¤§` bvRgyj Avbvg : cvqLvbv KlvUv wK Zvi Av‡M †_‡K n‡Zv bvwK gv‡S gv‡S recurrent n‡”Q `k©K 05 : bv, m¨vi GB UvBd‡q‡Wi ci †_‡KB GB mgm¨v n‡”Q|
- 47. 42 Dc¯’vwcKv : ab¨ev``k©K Avcwb Avgv‡`i mv‡_B _vKzb| Wv: Avn‡¤§` bvRgyj Avbvg : GB Klv cvqLvbv Avm‡j Avgv‡`i GKUv common mgm¨v GB mgm¨v wb‡q A‡bK ev”Pvi gv eveviv Avgv‡`i Kv‡Q Av‡mb †Zv Avcwb †hUv Rvb‡Z Pv‡”Qb Avcbvi ev”Pvi UvBd‡q‡Wi ci †_‡KB constipation n‡”Q †Zv yes that is very good information Avwg g‡b KiwQ †h Avcwb GUv UvBd‡q‡Wi mv‡_ constipation bv †f‡e Avcwb GUv isolated ev Avcwb GUv Avjv`v fv‡eB fv‡eb Ges Avwg g‡b KiwQ Avcwb GB gyû‡Z© †hUv avolac w`‡”Qb Avwg Rvwbbv †mUv Avcwb KZUzKz dose K‡i w`‡”Qb †Zv Avgiv eje GKUz fiber containing Lvevi Gi e¨vcv‡i †Rvi`vi Kiæb| †Kbbv Avcbvi eveyi GUv †Kvb †iv‡Mi Kvi‡b n‡”Q, Avwg GLbI g‡b KiwQbv| Avgiv GKUz Avk RvZxq Lvevi †L‡Z ewj like †cu‡c, †pok, jvD, wS½v Ges Aek¨B hw` GKUz UK `B LvIqvb Ges Av‡c‡ji †Lvmv bv Qvwo‡q Av‡cjUv LvIqvb GKUv U‡g‡Uv LvIqvb| GB ai‡bi Lvevi Avgiv ewj †h, Avcwb GKUz dvBevi add Kiæb Avi avolac Gi dose Uv (2-2.5 1/2) PvgP K‡i (2-3) evi †`Iqvi my‡hvM Av‡Q| †Zv Avwg g‡b KiwQ Avcwb avolac Gi dose Uv evovb Ges Gi mv‡_ fiber containing Lvevi LvIqvb Ges cvwb| water is very important to combat sorrow of constipation, constipation †VKv‡bvi Rb¨ Avgiv cvwb‡K †ewk ¸iæZ¡ †`B Ges cvwb †ewk K‡i LvIqv DwPZ| yes wKQz †iv‡Mi †ÿ‡Î †Zv constipation nqB †mUv Avgv‡`i gv_vq Av‡Q| ZvI Avcbvi eveyi †ÿ‡Î †h‡nZz nVvr B n‡jv †m‡nZz GB ai‡bi †Kvb wmØvšÍ Avwg fvewQB bv| Avwg g‡b KiwQ Avcwb Gfv‡e Ki‡j Wv‡qUvix g¨vbycy‡jkb GKUz change K‡ib Avi cvwbUv wVK g‡Zv LvIqvb Avwg g‡b KiwQ Avcbvi eveyi GUv wVK n‡q hv‡e Ges yes Avcwb glycerin suppositery †hUv 1.1 †hUv Avgiv †`B evey‡`i †mUv wbwØ©avq w`‡Z cv‡ib cvqLvbv hw` bv nq| Avcwb e¨envi Kiæb Avwg g‡b KiwQ Avcbvi eveyi mgm¨vUv wVK n‡q hv‡e ab¨ev`| Dc¯’vwcKv : A‡bK ab¨ev` m¨vi (Wv: bvRgyj) Avcbv‡K| `k©K Avkv KiwQ Avcwb Avcbvi cÖ‡kœi DIiwU †c‡q‡Qb Avm‡j †KvôKvwVb¨ GKUv mgm¨v mevi Rb¨B Avi GUv Lvev‡ii mv‡_ m¤ú„³ _v‡K| Avcwb †hUv Ki‡Z cv‡ib ev”Pvi Lvev‡ii mv‡_ Auvkhy³ Lvevi †`qvi Rb¨ Avi chvß© cwigvb cvwb hZevi K‡i otherwise Avcwb hZ Jla †`b ev”Pv‡K hw` Lvev‡ii habit Uv wVK bv nq Zvn‡j wKš‘ mgm¨vUv cy‡ivcywi †m‡i DV‡e bv| Avgiv AveviI Avgv‡`i we‡klÁ AwZw_‡`i mv‡_ Av‡jvPbvq wdie Zvi Av‡M Avgiv GKUv †QvÆ weiwZ‡Z hvw”Q ZZÿY ch©všÍ Avgv‡`i mv‡_ _vKzb| `k©K Avgiv wd‡i G‡mwQ Avgv‡`i Ô¯^v¯’¨K_vÕ Abyôv‡b| Avgiv weiZx‡Z hvIqvi Av‡M
- 48. 43 †hB welqUv wb‡qK_v ejwQjvg †mUv n‡jv GB K‡ivbv cwiw¯’wZ‡Z ev”Pv‡`i Ges eo‡`i Kv‡`i wK cwigvb Ges †Kgb mZK©Zv Aej¤^b Kiv DwPZ Ges wK Dc¯^M© n‡j wKiæc e¨e¯’v MÖnY Kiv DwPZ| m¨vi (Wv: †gv: †ZŠwdKzi) Avcbvi mv‡_ 1Uv welq wb‡q GKUy K_v ej‡Z PvB Avgiv hLb Av‡jvPbv KiwQjvg Avcwb 1Uv K_v e‡jwQ‡jb †h COVID †ivMx hviv Av‡Q heart Gi patient Zv‡`i mv‡_ wKQz m¤ú„³Zv Avcbvi cv‡”Qb Ges heart attack Gi rate UvI Avcbviv †ewk cv‡”Qb GB 2Uv welq hw` Avgv‡`i `k©K‡`i GKUz Rvbv‡Zb| Wv: †ZŠwdKzi ingvb : GLb K_v n‡jv †h, †ivMx ¸‡jv Avgv‡`i Kv‡Q Avm‡Q †mUv hospitalized †ivMx ev Avgv‡`i chamber Gi †ivMx chamber Gi †ivMx‡`i A‡bK †`Lv hvq ey‡K e¨_v n‡”Q, we‡kl K‡i very far zone ¸‡jv‡Z nvmcvZv‡j fwZ© K‡i‡Q Zviv Avevi Avgv‡`i Kv‡Q refer Ki‡Q angiogram Kivi Rb¨| angiogram Kie wKsev angiogram KLb Kie GB e¨vcvi civgk© Kivi Rb¨ Avi Avgiv GB †ivMx ¸‡jvi g‡a¨ †Kb Zv‡`i GiKg n‡”Q Kvib ¸‡jv †ei Kivi †Póv KiwQ Kvib Zviv average G young age Gi _v‡K A‡bK mgq young patient ¸‡jvi attack n‡”Q †Zv young patient †`i attack Gi †ÿ‡Î Avevi †`wL diabetes Gi diabetes Av‡Q wKsev diabetes uncontrol Av‡Q wKbv even A‡bK mgq Obesity ev AwZwi³ IRb GKwU cÖavb Kvib A‡bK mgq Obesity patientI †c‡q _vwK| Avgiv †Zv A‡bK mgh risk factor QvovI †`Lv hvq diabetes bvB, pressure bvB nqZ A‡b‡K wmMv‡iU Lvq A‡b‡K Lvq bv Zv‡`iI attack n‡”Q| ZLb Avgiv K‡ivbvi †ÿ‡Î wKQzÿY Av‡M †h ejj indirect wKQz test Av‡Q nqZ †m¸‡jv Kie| Kvib GLb †Zv Avi RTPCR positive Avm‡ebv †h‡nZz †gvUvgwU 2 mßvn n‡q †M‡Q| H test ¸‡jv K‡i †`wL Avgiv †h bigvj indirect test †j‡f‡ji †P‡q GKUz †ewk ZLb Avgiv avibv Kwi †h †n K‡ivbvi †_‡K nqZ Dbvi GB attack Uv n‡q‡Q| ZLb Avgiv wcQ‡bi history Uv †bqvi †Póv Kwi| Dc¯’vwcKv : Zvn‡j Avcbviv GB welq¸‡jv me †P‡q †ewk young generation Gi g‡a¨ cv‡”Qb| Wv: †ZŠwdKzi ingvb : young generation Gi mv‡_ eq¯‹‡`i †Zv Av‡QB| Zv‡`i mv‡_ young generation Gi †h‡nZz cvIqv hv‡”Q-GKUv eq¯‹ patient Gi heart attack nIqv Avi GKUv young patient Gi heart attack Gi g‡a¨ wKš‘ cv_K¨© i‡q‡Q| young patient‡`i‡K wKš‘ Avgiv ¸iæZ¡Uv †ewk w`‡q _vwK| ¸iæZ¦Uv †ewk w`‡q _vwK Kvib Aí eq‡m heart Gi †Kvb mgm¨v n‡j Zv‡K †Zv mviv Rxeb †mUv wb‡q struggle Ki‡Z n‡e young patient Gi attack n‡j, heart Gi muscle damage n‡j k^vmKó n‡Z cv‡i, heart failure n‡Z cv‡i wewfbœ RwUjZv n‡Z cv‡i heart Gi Rb¨ Avgiv GB †ivMx ¸‡jv‡K GKUz special care w`‡q _vwK Avi eq¯‹ †ivMx‡`i †ÿ‡Î A‡bK mgh heart attack n‡j nqZ heart Gi function nvjKv K‡g †M‡jI †m Zvi normal activity ¸‡jv Ki‡Z cv‡i Lye †ewk mgm¨v Zvi nq bv| eZ©gv‡b young †ivMx A_ev eq¯‹ †ivMx meviB wKš‘ heart attack Gi rate Uv GKUz †e‡o †M‡Q| †Zv ZLbB Avgiv GB †ivMx‡`i wcQ‡bi
- 49. 44 history †bqvi †PóvKwi evi evi K‡i| †h Avcbvi wK (2-3) mßvn Av‡M wKsev hLb Uv n‡qwQj Zvi Av‡M wK Avcbvi nvjKv nvjKv R¦i n‡qwQj ZLb †ivMx DËi †`q †h Ònu¨v Avgvi R¦i wQjÓ| Dc¯’vwcKv : ZLb nqZ Dbviv Rv‡bbB bv †h Dbv‡`i infection n‡qwQj wKš‘ cieZ©x‡Z mgm¨v wb‡q Avcbv‡`i Kv‡Q Avm‡Q| R¦x m¨vi [Wv: †gv: †ZŠwdKzi ingvb] A‡bK ab¨ev`| Avm‡j GB Z_¨¸‡jv Avgiv PvB †h Avgv‡`i `k©Kiv RvbyK- complication A_ev mgm¨v †h ai‡biB †nvK Ae‡njv bv K‡i †hb wPwKrm‡Ki mibvcb¨ nb| Wv: †ZŠwdKzi ingvb :- †h †Kvb R¦i, nvjKv R¦i n‡jI †hb Ae‡njv bv K‡ib| we‡kl K‡i eq¯‹ †ivMx| Avi Wv³vi‡`iI wKQy awareness Av‡Q †h, †ivMx attack wb‡q Avm‡jv GB †ivMxUvi hv‡Z Avwg GKUz we¯ÍvwiZ history †bB †h, Zvi †Kvb R¦i wQj wKsev Av‡Q wKbv A_ev Zvi COVID test Kivi cÖ‡qvRb Av‡Q wKbv| Dc¯’vwcKv : R¦x m¨vi (Wv: †gv: †ZŠwdKzi) Aek¨B| Wv: bvRgyj Avcbvi Kv‡QI GKB welq wb‡q Rvb‡Z PvB †h‡nZz Avgv‡`i K_vi cÖm½ GKUvB Avi AvcwbI GKB wel‡qi we‡klÁ cardiologist on child †Zv Avcbvi (Wv: bvRgyj) observation Uv wK ev”Pv‡`i †ÿ‡Î| Wv: Avn‡¤§` bvRgyj Avbvg : †`Lyb Avgv‡`i Kv‡Q Avcwb †hUv ej‡jb COVID Gi mgq Avm‡j g~jZ Avgv‡`i Kv‡Q †hUv Av‡m VvÛv, Kvwk G¸wj| A‡bK evey Avgv‡`i Kv‡Q hLb VvÛv-Kvwk wb‡q evi evi Av‡m| Avwg wewfbœ platform G GUv evi evi ej‡Z †P‡qwQ Kv‡iv ev”Pvi VvÛv-Kvwk ¯^w`© n‡”Q, ev”Pvi IRb evo‡Qbv wewfbœ RvqMvq hv‡”Q, gv ej‡Q m¨vi evKx Av‡Q †c‡jB 1Uv antibiotic w`‡”Q, nvmcvZv‡j fwZ© Ki‡Q wbD‡gvwbqv e‡j| Avgiv Zv‡`i‡K webxZfv‡e Aby‡iva Kie wkï cardiologist †`i mv‡_ †hvMv‡hvM Kiæb †Kbbv hw` heart G †Kvb ai‡bi Shunt lession _v‡K †hUv Avgiv ASD ewj, PDA ewj †mvRv evsjvq hw` ewj heart G hw` †Kvb dzUv _v‡K Zvn‡j wKš‘ Zvi symptoms GiKB n‡e| evi evi VvÛv-Kvwk n‡Z _vK‡e, ev”Pv‡K wb‡q evi evi Wv³v‡ii Kv‡Q †h‡Z n‡e Ges ev”Pvi IRb evo‡e bv †hUv Avgiv failure to thrived ewj Ges ev”Pv j¤^v n‡Z _vK‡e bv| GB mg¯Í symptoms hw` Avcbvi eveyi †ÿ‡Î nq ZLb mv‡_ mv‡_ wkï cardiologist Gi mv‡_ †hvMv‡hvM Kiæb| Dc¯’vwcKv : m¨vi (Wv: bvRgyj) GB †ÿ‡Î wkï‡`i eq‡mi mv‡_ †Kvb m¤ú„³Zv Av‡Q wKbv-
- 50. 45 Wv: Avn‡¤§` bvRgyjAvbvg : nu¨v, definitely GKUv †QvU eqm †_‡KB gv ej‡e †h m¨vi, GKUv †Zv K‡i H dzUvUv KZ eo Ges †Kvb location G Av‡Q Av‡iv A‡bK wKQzi Dc‡i| †gvUv `v‡M Avgiv eje 1Uv ev”Pvi Nb Nb (2-3) gvm eqm †_‡KB hw` VvÛv-Kvwk jvM‡Z _v‡K wbI‡gvwbqv nq Ges Zv‡K hospital G fwZ© n‡Z nq Ges ev”Pvi R‡b¥i mv‡_ mv‡_ ev”Pvi IRb Avk¼vRbK fv‡e Kg n‡”Q Zvn‡j ev”Pvi evev-gvi Aek¨B DwPZ Wv³v‡ii mv‡_ Av‡jvPbv Kiv| Preferably G ewj GKRb wkï cardiologist †K †`wL‡q wb‡eb Zvi eveyi heart G †Kvb mgm¨v Av‡Q wKbv GUv Rvbvi Rb¨| H †h ejjvg heart G dzUv _vK‡j ev”Pvi GB symptoms ¸‡jvB †`Lv w`‡e ev NU‡e| Dc¯’vwcKv : Avm‡j GB mg¯Í Dc¯^M© hw` _v‡K GKUv ev”Pvi Zvn‡j we¯ÍvwiZ assessmentK‡i ZLb Zvi wPwKrmvUv †`qv DwPZ ev `iKvi Ges †hUv GKRb wkï cardiologist B better| Avgv‡`i mv‡_ †dvb K‡j GKRb `k©K hy³ n‡q‡Qb| `k©K Avcbvi bvg Ges eqm e‡j Avcbvi cÖkœwU Avgv‡`i Rvbvb| `k©K 6 : Avmmvjvgy AvjvBKzg Avwg Avwmd, Avwg kixqZcyi †_‡K ejwQ, Avgvi eqm n‡”Q 31| †Zv Avgvi recently †h mgm¨v ¸‡jv n‡”Q Avgv‡`i A¯^vfvweK fv‡e IRb K‡g hv‡”Q like (12-15)| GLb A‡bK `ye©j jv‡M Ges kixi Kv‡c †Zv Avwg Gastroentrology department G e½eÜz †gwW‡K‡j †`wL‡qwQjvg HLvb †_‡K Dbviv Avgv‡K GKUv RIAU bv‡gi test w`‡q‡Q Ges IAU GB test Uvi Rb¨ Avgv‡K G _vK‡Z nq Ges GUv 3 gvm ci serial cve Avwg Ges ZLb Kiv‡Z cvie| hvi Rb¨ eZ©gv‡b Avgv‡K †Kvb Jla w`‡”Qbv †Zv Avgvi cÖkœUv n‡jv GUvi KvibUv wK Ges eZ©gv‡b Avwg GLb wK Ki‡Z cvwi| Wv: †ZŠwdKzi ingvb : GLb e¨vcviUv n‡”Q †h Avcbvi _vB†q‡Wi †Kvb mgm¨v Av‡Q wKbv- GLb †h‡nZz weight loss n‡”Q, weight loss GKwU Ab¨Zg cÖavb KviY n‡jv Avgiv †hUv commonly †`wL Avcbvi gZ (`k©K-06) GB eq‡m| hw`I †g‡q‡`i †ÿ‡Î GKUz common nvBcvi _vB‡ivwWRg ewj, _vBi‡q‡Wi mgm¨v function †ewk Kivi Kvi‡Y IRb K‡g hvq GwU GKUv common Kvib †`wL AviwK Avgiv Avi 2 bv¤^vi †hUv GUvI common †mUv n‡jv anxiety †Z †fvM anxiety neurosis †Z fzM‡jI wKš‘-Dwb †hgb ejj (12-15) †KwR IRb K‡g wM‡q‡Q anxietyi mgm¨vi Rb¨ I wKš‘ GiKg weight loss n‡Z cv‡i| Av‡iKUv wRwbm n‡”Q hw` Kv‡iv nR‡g mgm¨v nq, A‡bK mgq A‡b‡Ki †c‡U mgm¨v malabsorption ev G ai‡bi wVKgZ hw` absorption bv nq †c‡U mgm¨v nq Zvn‡jI wKš‘ IRb K‡g †h‡Z cv‡i| †Zv Avcbv‡K †h test w`‡q‡Q †mUv Kiv‡Z †h‡nZz mgq jvM‡Q †Zv Avcbvi g‡b nq GB mg‡qi g‡a¨ Avwg †h mgm¨vi K_v ¸‡jv ejjvg G¸‡jvi test Avcbvi Kiv‡bv n‡q‡Q wKbv Avwg Rvwbbv †Zv GB e¨vcv‡i Avcwb GKRb we‡klÁ Wv³v‡ii mv‡_ Avjvc Ki‡Z cv‡ib| hw` _vBi‡q‡Wi mgm¨v Avcbvi bv _v‡K, †c‡Ui mgm¨v bv _v‡K wKsev †hUv anxiety e‡j| A‡bK mgq Avgiv †`wL me test fv‡jv me test Gi result positive wKš‘ †ivMxi IRb Kg‡Q †Zv †mB †ÿ‡Î weight loss Gi Rb¨ D³ cixÿv ¸‡jv Kiv plus dibetes UvI cixÿv Kiv| Dc¯’vwcKv : Avm‡j A‡bK ¸‡jv KvibB Av‡Q Gi wcQ‡b †m¸‡jvi me ¸‡jvB †ivMx‡K
- 51. 46 Wv³v‡ii ¯^ibvcb¨ n‡qhvPvB K‡i †bqv DwPZ Ges Aek¨B AwaK ¸iæZ¡ †`qv DwPZ Kvib †h‡nZz weight loss n‡”Q Gi wcQ‡b Aek¨B †Kvb bv †Kvb Kvib Av‡Q Avi Avcwb Wv³vi †`Lv‡”Qb †h‡nZz Avcbv‡K test Gi K_v e‡j‡Q Ges †mUv wb‡q Aek¨B Wv³v‡ii d‡jvAv‡c _vK‡eb, wK Kvi‡b GiKgUv n‡”Q †mB Kvib †ei K‡i ZLbB Avcbv‡K mwVK wPwKrmvUv †`qv m¤fe| Avgv‡`i mv‡_ Av‡iKRb `k©K hy³ n‡q‡Qb †dvb K‡j, `k©K Avcbvi bvg Ges eqmwU e‡j cÖkœwU Kiæb `k©K 7 : Avmmvjvgy AvjvBKzg, Avgvi bvg Zgv Ges Avgvi eqm 28| Avgvi bv me mgq VvÛv †j‡MB _v‡K ïKbv VvÛv problem nqbv wKš‘ e„wó ev`j n‡j GKUz nq| GLb †hUv n‡”Q cÖvq 3 gvm a‡i Avgvi Kvwk †j‡MB _v‡K, KvwkUv hv‡”QB bv Avwg Wv³vi †`Lvjvg Montelukast †Ljvg fexofenadine VvÛvi Rb¨ 2 GK iK‡gi wmivc †L‡qwQ wKš‘ Kvwk Kg‡Z‡Q bv GLb fvewQ GUv K‡ivbvi †Kvb symptoms wKbv- Dc¯’vwcKv : Avcwb (`k©K-07) wK †Kvb wPwKrm‡Ki civgk© wb‡q‡Qb- `k©K 7 : nu¨v Avwg Wv³vi †`wL‡qwQ| Dc¯’vwcKv : m¨vi (Wv: †gv; †ZŠwdKzi) Avcbvi wK †Kvb cÖkœ Av‡Q `k©‡Ki Kv‡Q- Wv: †ZŠwdKzi ingvb : wVK Av‡Q A‡bK ab¨ev` Avcbv‡K| GLb e¨vcviUv n‡”Q †h Avcbvi Wv³vi nqZ evaluation Ki‡Q †h Avcbvi GjvwR© Av‡Q wKbv- Gi Rb¨ nqZ Wv³vi Avcbv‡K montin, flexo, plus e‡j‡Qb †h inhaler I Avcwb e¨envi K‡ib| G¸‡jv e¨envi K‡iI (2-3) gv‡mi g‡a¨ Dbvi (`k©K-07) Kvwki DbœwZ nqwb| GLb Avgv‡`i pediac cardiologist (Wv: bvRgyj) Dwb †hUv ej‡ZwQ‡jb †h Kvwki †hUv Kvib 1 Uv †Zv n‡jv †h dzmdz‡mi Kvib Kvwk wKš‘ Av‡iKUv Ab¨Zg Kvib n‡jv †h Avgvi heart Gi Kvib| Av‡iKUv †hUv ej‡jb Avcwb (`k©K-07) †h Avcwb m‡›`n Ki‡Z‡Qb GUv Avevi K‡ivbvi Rb¨ n‡”Q wKbv but positive †hUv n‡jv K‡ivbvi Kvwk Avcbvi 3 gvm _vK‡e bv 1 b¤^i K_v| K‡ivbv hLb n‡e K‡ivbv hLb Avcbvi †`‡n cÖ‡ek Ki‡e ZLb nqZ Avcbvi (2-4) w`b Kvwk n‡e Gici Severe Gi w`‡K hv‡e A_ev Avcwb cy‡ivcywi fv‡jv n‡q hv‡eb| cieZx©‡Z Avcbvi GB mgm¨v nIqvi K_v bv hw` bv lungs Lye †ewk fibrosis bv nq Lye †ewk damage bv nq, Zvn‡j Avcbvi Kvwk Lye †ewk Ki‡e bv Avi †h‡nZz Avcwb gbwUb, flaxo Lv‡”Qb inhaler wb‡”Qb definetely Avcbvi Kvwk DbœwZ nevi K_v| Av‡¯Í Av‡¯Í DbœwZ n‡jI hw` ZviciI bv nq †m‡ÿ‡Î †hUv ejjvg Avgv‡`i cardiac †Kvb Kvi‡b Avcbvi Kvwk n‡”Q †mUv Avm‡j Avcbvi GKUz evaluation K‡i †bqv DwPZ| †m‡ÿ‡Î Avcwb GKRb medicine specialist A_ev cardiologist Gi ¯^ibvcb¨ n‡q †hUv Kiv `iKvi †mUv K‡i Zvici wPwKrmv †bqv fv‡jv| Dc¯’vwcKv : R¦x A‡bK ab¨ev` `k©K-07 Avkv KiwQ Avcwb Avcbvi cÖ‡kœi DIiwU †c‡q‡Qb| Avm‡j m¨vi (Wv: †gv: †ZŠwdKzi) †hUv ej‡jb 1Uv mgm¨v †h me mgq 1Uv Dc¯^‡M©i Rb¨B Avm‡j wRwbmUv nq, Zv bv| A‡bK mgq Ab¨vb¨ Kvi‡bI n‡Z cv‡i| †mUv Avcwb †Póv Ki‡eb cieZx© mgq hw` Avcbvi mgm¨vi DbœwZ bv nq GKRb
- 52. 47 cardiologist Gi mv‡_†hvMv‡hvM K‡i wb‡Z| m¨vi (Wv: bvRgyj) Avgv‡`i gZ GKB mgm¨v wb‡q Avm‡j ev”PvivI †Zv Av‡m ev”Pv‡`iI wK Avcbviv GKB iKg mgm¨v †`L‡Z cvb †h A‡bK †ewk Kvwk Kvwk ev fv‡jv n‡”Qbv †m‡ÿ‡Î Avcbv‡`i civgk© wK _v‡K GKUz †QvU K‡i hw` ej‡Zb- Wv: Avn‡¤§` bvRgyj Avbvg : †n †QvU K‡i hw` ewj, Kvwk wb‡qI ev”Pv‡`i Avgv‡`i Kv‡Q Av‡m †hgb H f`ª gwnjv †dvb Ki‡jb (`k©K-07) Avgiv eje yes Av‡m| cÖ_gZ Avgiv GjvwR©i Kvwk fvwe G¸‡jv ev”Pv‡`i commonly I Kvi to be problem G¸‡jv ev”Pv‡`i _v‡KB ZLb Avgiv long process Gi Jla¸‡jv †`B wKš‘ Avwg GKUv K_v eje †mUv n‡jv Kvwk e‡j †hb Avgiv †KD e‡m bv _vwK hw` long †Kv‡m©I nq| Avcwb GKUz kindly Avcbvi ev”Pvi heart Uv cixÿv Kiv‡eb †mLv‡b †Kvb anomaly Av‡Q wKbv †hUv me mgq ewj †Kvb ai‡bi ev †Kvb ai‡bi shunt lesions wQ`ª Av‡Q wKbv- wQ`ª _vK‡j wKš‘ long †Kv‡m© ev”Pviv G ai‡bi symptoms wb‡q Avm‡Z cv‡i| Dc¯’vwcKv : Av”Q Avi K‡ivbvi symptoms †Zv Av‡QB †mUv wb‡q †h‡nZz Ô¯^v¯’¨ K_vÕ Avgiv ewj ev”Pv‡`i Rb¨ †Kvb civgk© Av‡Q wKbv m¨vi (Wv: †gv: bvRgyj) AwfveK‡`i Rb¨| Wv: Avn‡¤§` bvRgyj Avbvg : †`Lyb Avwg eje †h, cª‡Z¨K evev-gv Zvi ev”Pvi Rb¨ GK Rolemodel| Avcwb wb‡R hw` health hygiene ¸‡jv †g‡b P‡jb †mUv eveyI follow Ki‡e| †Kbbv GB K‡ivbv wmPz‡qk‡bi g‡a¨ Avcbvi evey †Kv_vI hv‡”Q bv, Zv‡`i ¯‹zj eÜ Zviv evwn‡i †ei n‡”Q bv| There is no way Zvi infected nIqvi †Kvb Kvib wKš‘ bvB| Zvn‡j AvcwbI wKbZz Avcbvi ev”Pv‡K SzuwK‡Z †dj‡Qb| Avcwb Avcbvi hygiene Uv maintain Kiæb| wmuwo †e‡q DV‡j Avcwb mv‡_ mv‡_ nvZUv ay‡q †djyb| evmvq D‡VB ev”Pv‡K mv‡_ mv‡_ ¯úk© Ki‡eb bv, hZÿY bv chšÍ© Avcwb proper fresh n‡q hv‡”Qb| †dvbUv use Kivi ci Avcwb proper hygin Uv maintain Kiæb, nuvwP- Kvwk w`‡j gy‡L nvZ w`‡q evey‡K †`wL‡q ejyb †mI †hb Gfv‡e nuvwP-Kvwk Avm‡j †`q Ges Gi Øviv Avcbvi eveyI Avcbvi mv‡_i virus †_‡K `~‡i _vK‡e| Gfv‡e maintain Kivi d‡j Avcbvi eveyi Ab¨ †Kvb RvhMv †_‡K infected nevi †Kvb my‡hvMB bvB| Dc¯’vwcKv : ev”Pviv †Zv Avm‡j AbyKib K‡i †hUv ev”Pv‡`i wkLv‡bv n‡eB †mUvB Zviv follow K‡i| m¨vi (Wv: †gv: †ZŠwdKzi) Avcbvi hw` `k©K‡`i Rb¨ †Kvb civgk© †_‡K _v‡K- Wv: †ZŠwdKzi ingvb : Lye †QvU K‡i n‡”Q, GLb K‡ivbv Kvjxb mg‡q K‡ivbv nIqvi †P‡q prevention nIqv A‡bK fv‡jv cÖ‡Z¨K gvby‡li Rb¨| 1 Uv n‡jv mask cov| †hUv Avwg me mgq ewj †h K‡ivbv‡Z AvµvšÍ nIqvi ci †mUv KZUzKz cwigv‡bi Lvivc n‡e †mUv wbf©i K‡i KZ cwigvb Rxevby Avcbvi †`‡ni wfZ‡i cÖ‡ek K‡i‡Q GUv‡K Avgiv virus load ewj †mUvi Dci| GB †h Avcbvi †`‡n Kg virus cÖ‡ek Ki‡Q †mUv cÖwZ‡iva Ki‡Q mask| hLb Avcwb GKv _vK‡Qb ZLb Avcbvi mask civi `iKvi †bB wKš‘ hLbB public place G hv‡eb Aek¨B mask co–b Ges distance maintain Kiæb|
- 53. 48 Dc¯’vwcKv : ¯^v¯’¨wewa †g‡b Pjvi †h welqUv †hUvi Dci Avgiv evievi †Rvi w`w”Q f¨vKwm‡b‡UW _vK‡j GLb A‡b‡KB welqUv †_‡K `~‡i P‡j hv‡”Qb †Zv f¨vKwmbI hviv †c‡q‡Qb ZvivI hv‡Z G welqUv †g‡b P‡j | [ Wv: †ZŠwdKzi ingvb ] f¨vKwm‡b‡UW hviv ZvivI wKš‘ K‡ivbvq AvµvšÍ n‡”Q nqZ gvivZœK bv n‡jI n‡Z cv‡i| myZivs †g‡b Pj‡Z n‡e ¯^v¯’¨ wewa| Dc¯’vwcKv : Avcbv‡`i `yÕRb‡K A‡bK ab¨ev` Rvbvw”Q ¸iæZ¡c~Y© Z_¨¸‡jv Avgv‡`i `k©K‡`i Rvbv‡bvi Rb¨| `k©K Avm‡j Avgiv †h Av‡jvPbv K‡iwQ †mUv‡Z Avgiv me mgq GwK K_v e‡jwQ Avgv‡`i GLbKvi †h cwiw¯’wZ K‡ivbv GKUv msµvgK e¨vwa GLvb †_‡K hw` Avgiv wb‡R‡`i protected ivL‡Z PvB Aek¨B ¯^v¯’¨ wewa †g‡b Pj‡Z n‡e, f¨vKwmb †Zv Avgiv wb‡evB †mB mv‡_ wbqwgZ nvZ †avqv, gv¯‹ covi †h welqUv Avgiv evwn‡i hvw”Q †mUv hv‡Z Avgiv Aek¨B †g‡b Pwj| Dwb Wvt bvRgyj Lye ¸iæZ¡c~Y© GKUv K_v e‡j‡Qb, ev”Pv‡`i Rb¨ evev- gviv AbyKiYxq welq| Avcbviv hw` ‡m¸‡jv †g‡b P‡jb Zvn‡j ev”Pviv †`‡LI †m¸‡jv wkL‡e Ges ¯^v‡¯’¨i †h welq¸‡jv Avgiv me mgq †Póv Kwi Avgv‡`i jvBd ÷vBj ‡hUv Av‡Q †mUv hv‡Z my›`ifv‡e †g‡b Pwj| Avkv KiwQ we‡klÁ AwZw_‡`i my civgk© ¸‡jv Avcbviv †g‡b Pj‡eb| Avgv‡`i mv‡_ wQ‡jb Aa¨vcK Wvt †gvt †ZŠwdKzi ingvb, Aa¨vcK Wvt bvRgyj Avbvg Avcbv‡`i `yÕRb‡K Avev‡iv ab¨ev` Rvbvw”Q| Avcbviv `k©K fv‡jv _vK‡eb AvMvgx‡Z Avev‡iv †`Lv n‡e Ab¨‡Kvb welq wb‡q| Avjøvn& nv‡dR| K‡Y©j gv‡jK †gwW‡Kj K‡jR nvmcvZvj, gvwbKM‡Ä wmwcAvi (CPR) cÖwkÿY Kg©kvjv I mb`cÎ weZi‡Yi wKQz w¯’i wPÎ
- 54. 49 wRwUwf-†Z cÖPvwiZ Abyôvb wmqv‡gmy¯’Zv welq: igRv‡b ü`‡ivMx‡`i my¯’Zv, GwcÖj 2022 Dc¯’vwcKv : Wvt gwb †PŠayix Avgwš¿Z AwZw_: (1) Aa¨vcK (Wvt) †gvt †ZŠwdKzi ingvb (dviæK) Dc¯’vwcKv : wcÖq `k©K, AvmmvjvgyAvjvBKzg| Avcbv‡`i mv‡_ AvwQ Avwg Wvt gwb †PŠayix| GB igRv‡b kvixwiK my¯’Zvi Rb¨ `iKvi ¯^v¯’¨ m‡PZbZv †h‡nZz Lv`¨vfv‡m wekvj cwieZ©b Av‡m ZvB wKQz wbqgbxwZ †g‡b Pj‡jB my¯’¨ _vKv m¤¢e| GB welq¸‡jv‡K jÿ¨ †i‡L wRwUwfi ¯^v¯’¨ welqK Av‡qvRb †Kjwf‡bUi wb‡ew`Z Òwmqv‡g my¯’ZvÓ| AvR Avgiv †h welqwU wb‡q Av‡jvPbv Kie †mwU n‡jv ÒigRv‡b ü`‡ivMx‡`i my¯’ZvÓ Avi G welqwU wb‡q Av‡jvPbv Ki‡Z Avgv‡`i mv‡_ Av‡Qb Aa¨vcK Wvt †gvt †ZŠwdKzi ingvb (dviæK) whwb Aa¨vcK I wefvMxq cÖavb(KvwW©IjRx), K‡Y©j gv‡jK †gwW‡Kj K‡jR, gvwbKM‡Ä Kg©iZ Av‡Qb| Pjyb `k©K K_v ewj Avgv‡`i AvR‡Ki we‡klÁ Wv³v‡ii mv‡_| m¨vi Avcbv‡K ¯^vMZ Rvbvw”Q Avgv‡`i AvR‡Ki Av‡qvR‡b| Wvt †ZŠwdKzi ingvb : ab¨ev` Avcbv‡K, ab¨ev` wRwUwf‡K, Avgv‡K Avgš¿Y Rvbv‡bvi Rb¨| Dc¯’vwcKv : m¨vi, cÖ_‡g †h welqwU wb‡q Rvb‡Z PvB †mUv A‡b‡KB cÖkœ K‡i _v‡Kb †h ü`‡iv‡M AvµvšÍ †ivMxiv †ivRv ivL‡Z cvi‡e wKbv- Wvt †ZŠwdKzi ingvb : ab¨ev` Avcbv‡K, LyeB ¸iæZ¡c~Y© cÖkœ †ivMxiv hLb Avgv‡`i Kv‡Q igRv‡bi Av‡M mvaviYZ d‡jv Av‡ci Rb¨ Av‡m ZLb Avgv‡`i Kv‡Q wR‡Ám K‡i †h m¨vi, Avgiv A_ev Avwg wK †ivRv ivL‡Z cvie wKbv- Avgvi †Zv wewfbœ ai‡bi mgm¨v Av‡Q, †KD e‡j Avgvi †Zv †cÖkvi Av‡Q, Kv‡iv nqZ nv‡U© eøK Av‡Q, Kv‡iv nqZ wis jvMv‡bv Av‡Q ev Kv‡iv evBcvm mvR©vix Kiv Av‡Q wKsev nvU© †dBjyi Av‡Q Ges mv‡_ mv‡_ Av‡iv A‡bK mgm¨v Av‡Q †hgb- D”P i³Pvc, i‡³ †Kv‡j÷i‡ji gvÎv †ewk, Wvqv‡ewUm Zv‡`i †K Avgiv ewj nu¨v, Avcwb †ivRv ivL‡Z cvi‡eb, †ivRv ivL‡Z †Kvb mgm¨v †bB ev Amyweav n‡e bv wKš‘ wKQz wKQz †ÿ‡Î hviv D”P i³Pv‡c fzM‡Q ev hv‡`i nvU© †dBjyi Av‡Q GB ai‡bi †ivMx‡`i †ÿ‡Î Avgiv wKQz wKQz Jl‡ai †WvR GWRv÷‡g›U K‡i _vwK ev wKQz Jla _v‡K hv †PÄ Kiv n‡Z cv‡i †¯úkvwj †ivRvi gv‡m| we‡kl K‡i hviv D”P i³Pv‡c fzM‡Q Zv‡`i‡K Avgiv diuretics bv‡g GK ai‡bi Jla Av‡Q GB JlaUv Avgiv A‡bK mgq nvU© †dBjyi ev D”P i³Pv‡ci wPwKrmvq w`‡q _vwK| GB diuretics †hUv K‡i Avgv‡`i cÖ¯ªv‡ei mv‡_ cvwb Ges cÖ‡qvRbxq wKQz jeY †ei K‡i †`q †hgb- †mvwWqvg,
- 55. 50 cUvwmqvg jeY †eiK‡i †`q| GLb igRvb †h wRwbmUv nq, GLb †Zv Mi‡gi g‡a¨ †ivRv Avgv‡`i ¯^vfvweKfv‡e kixi †_‡K Nvg n‡e| Zvici Avevi diuretics e¨envi Kwi hw`, Avgv‡`i cÖ¯ªv‡ei mv‡_ cvwb †ei n‡q hvq Zvn‡j †h wRwbmUv n‡Z cv‡i cÖ_gZ mvivw`b Avgv‡`i wccvmv jvM‡e mv‡_ mv‡_ wKš‘ Avgv‡`i †cÖkvi K‡g †h‡Z cv‡i| Av‡iKUv m¤¢vebv n‡jv †n‡gvK‡m‡›Uªkb (Haemoconcentration) e‡j Gi gv‡b n‡jv i³ Nb n‡q †h‡Z cv‡i, Avi i³ Nb n‡q †M‡j †hUv nq hw`I ev Avgiv GLb ejwQ †h K‡ivbv Avµv‡šÍi cÖ‡Kvc K‡g hv‡”Q Ges K‡ivbvi †Kvb †ivMx GLb Avgv‡`i nvmcvZv‡j fwZ©I bvB wKš‘ GKUv K_v Avgiv GLbI ejwQ †h †KvwfW wUKv †`qvi c‡i Avgv‡`i nqZ K‡ivbvi Rb¨ nvmcvZv‡j fwZ© jvM‡ebv A_ev Avgv‡`i Aw·‡Rb jvM‡ebv wKš‘ K‡ivbv nIqv eÜ n‡e bv| K‡ivbv n‡j GB †h †n‡gvK‡m‡›Uªkb i³ Nb n‡q hvIqv GUv nq Avi GB mg‡q hw` Kv‡iv K‡ivbv nq Zvn‡j Zvi RwUjZv evovi m¤¢vebv †ewk| GB Kvi‡Y hviv diuretics RvZxq Jla Lv‡”Qb D”P i³Pvc wbqš¿‡Yi Rb¨ Zv‡`i Rb¨ civgk© n‡jv igRvb gv‡mi †¯úkvwj GB MÖæ‡ci JlaUv cwieZ©b K‡i Ab¨ MÖæ‡ci Jla LvIqv fv‡jv| Dc¯’vwcKv : m¨vi, Avcwb ejwQ‡jb hviv nvU© †dBjyi Gi mgm¨vq fzM‡Qb Zv‡`i †ÿ‡ÎI wPwKrmv c×wZ wKQz cwiewZ©Z n‡e- †mB m¤ú‡K© GKUz Rvb‡Z PvB m¨vi? Wvt †ZŠwdKzi ingvb : GLb hviv nvU© †dBjyi †ivMx Av‡Qb Zv‡`i nvU© †dBjyi †K wbqš¿‡Yi Rb¨ ¯^vfvweKfv‡e nv‡U©i †h‡nZz cvIqvi K‡g wM‡q, kix‡i cvwb Rgvi cÖeYZv _v‡K| †m Rb¨ kix‡ii cvwb †ei K‡i †`evi Rb¨ A_ev k^vmKó _vK‡j Zv Kgv‡bvi Rb¨ Avgiv wKš‘ GB diuretics RvZxq Jla e¨envi K‡i _vwK| AZGe nvU© †dBjyi †ivMx‡`i †ÿ‡ÎI GKB iKg †h‡nZz, Zv‡`iI cÖ¯ªv‡ei mv‡_ cvwb †ei n‡q †h‡Z cv‡i ZvB Zv‡`iI †cÖkvi K‡g hvIqvi m¤¢vebv _v‡K| Dc¯’vwcKv : †m‡ÿ‡Î m¨vi, hviv ü`‡iv‡M AvµvšÍ Av‡Qb Zv‡`i wK †ivRv ivLvi Rb¨ c~e© cÖ¯‘wZ †ek wKQzw`b Av‡M †_‡K †bqv DwPZ wKbv? Wvt †ZŠwdKzi ingvb : Aek¨B, GB Kvi‡Y Avgiv me mgq ewj hviv ü`‡iv‡M AvµvšÍ Av‡Qb- cÖ_g K_v n‡jv Zviv wK Jla Lv‡”Qb Ges GB Jla¸‡jv igRvb gv‡m wKfv‡e Pvjv‡eb- Gi Rb¨ Avcbvi whwb Wv³vi Av‡Qb ev KvwW©IjwR÷ hvi civg‡k© Avcwb Av‡Qb| Dbvi mv‡_ Avcbvi civgk© Kiv DwPZ gvm Lv‡b‡Ki g‡a¨ †h, D³ Jla¸‡jv wKfv‡e, KLb KLb Lv‡eb Ges ¯^vfvweKfv‡e †`Lv hvq, igRv‡bi Av‡M wKš‘ Avgv‡`i †P¤^v‡i GKUv †jvW c‡i †ivMxi Pvc †e‡o hvq Jla GWRv÷‡g›U Gi Rb¨ wKš‘ hviv Avm‡Z‡Qbv Zv‡`iI wKš‘ DwPZ igRvb gv‡mi Av‡M GB igRv‡b Zv‡`i Jla wKfv‡e Pj‡e, GWRv÷ K‡i †bqv Zvi Wv³v‡ii KvQ †_‡K| †mUv †WvR GWRv÷‡g›UI n‡Z
- 56. 51 cv‡i ev JlacwieZ©b n‡Z cv‡i, †Kbbv JlaI mvgwqK mg‡qi Rb¨ cwiewZ©Z n‡Z cv‡i| Dc¯’vwcKv : m¨vi, A‡b‡K wKš‘ ey‡K e¨_v n‡j †¯úª e¨envi K‡i _v‡Kb, †Zv GB igRv‡b †ivRv †i‡L hw` †¯úª e¨envi K‡ib †m‡ÿ‡Î wb‡`©kbv wK? Wvt †ZŠwdKzi ingvb : ¯^vfvweKfv‡e A‡b‡K Av‡Q †h nuvU‡Z hv‡”Q ev cwikÖg Ki‡Z‡Q ZLb nVvr ey‡K e¨_v nq hvi Rb¨ H mg‡q e¨envi Kivi Rb¨ Avgiv wRnŸvi wb‡P GKUv †¯úª w`‡q _vwK mvaviYZ mevi †cÖmwµck‡b GUv _v‡K| ey‡K Zxeª e¨_v n‡j ev †Kvb mgm¨v n‡j, k^vmKó Abyfe n‡j ZLb wRnŸvi wb‡P †¯úª w`‡e| Avm‡j Avgiv hZUzKz cov‡kvbv K‡iwQ GKUv n‡jv BmjvwgK dvD‡Ûkb Dbv‡`i gZvgZ, Av‡iKUv n‡jv hviv AvšÍRvwZ©K Av‡jg Av‡Qb Zv‡`iI †Zv GB wel‡q wKQy gZvgZ Av‡Q| Dc¯’vwcKv : m¨vi GB wel‡q Avgiv Avcbvi mv‡_ Av‡iv Av‡jvPbv Kie Z‡e K‡qKRb we‡kl‡Ái gZvgZ wb‡q- gydwZ †gvt Avãyjøvn (BmjvwgK dvD‡Ûkb) : wemwgjøvwni ivn gvwbi ivwng| AvmmvjvgyAvjvBKzg cweÎ KziAvbyj Kvix‡g myiv evKvivi †h Avqv‡Zi gva¨‡g cweÎ gv‡n igRvb‡K diR Kiv n‡q‡Q Gi cieZx© K‡qKUv Avqv‡Z gnvb Avjøvn iveŸyj Avjvgxb ¯úó fv‡e e‡j w`‡q‡Qb †h Kv‡iv hw` GKvšÍ mgm¨v nq †KD hw` md‡i _v‡K, Amy¯’ _v‡K Ges †m hw` GB igRv‡b †ivRv ivL‡Z bv cv‡i Zvn‡j †m cieZ©x mg‡q Zvi myweav gZ Kvhv †ivRv Av`vq K‡i wb‡Z cvi‡e| GKB fv‡e hviv nv‡U©i †ivMx Av‡Qb GK ai‡bi †¯úª e¨envi K‡i Avgiv ïwb Avi H †¯úª Uv hw` Bb‡njvi Gi g‡Zv nq Zvn‡j †m‡ÿ‡Î †h‡nZz Bb‡njv‡ii g‡a¨I nv‡U©i †gwWwmb _v‡K †mUv hw` gyL w`‡q e¨envi Kiv nq Zv‡Z †ivRv f½ n‡e| Z‡e hw` †KD †ivRv ivL‡Z Pvq cieZx©‡Z ivL‡e Avi hw` †KD GB †¯úª e¨envi Qvov †ivRv ivL‡Z cv‡i Avjnvg`ywjøvn wKš‘ A‡b‡K †Póv Ki‡Z cv‡i †h GB †¯úª e¨envi Qvov †ivRv ivL‡Z cv‡i †Zv ivL‡eb Avi †¯úª Gi weKí hw` †Kvb Bb‡RKkb _v‡K †hUv kix‡i cyk K‡i †`qv hvq Zvn‡j Avevi †ivRv fv½‡e bv wKš‘ Bb‡njv‡ii cwie‡Z© hw` gy‡L wb‡Z Pvb Zvn‡j †ivRv f½ n‡q hv‡e| †Kvb cixÿvi Rb¨ hw` i³ †bqv nq Zv‡Z †ivRv f½ n‡e bv A_ev Bb‡ÄKk‡bi gva¨‡g Avgv‡K †Kvb †gwWwmb †`qv n‡jv ev m¨vjvBb cyk Kiv n‡jv gv‡b Lvevi wRwbmUvB †mUv Ab¨fv‡e kix‡i †`qv nj ¯^vfvweK wbq‡gi weK‡í GZ †ivRv bó n‡e bv|
- 57. 52 Wvt bvwn`v Avn‡g`(cywówe`, ¸jkvb Wvqv‡ewUK †m›Uvi) : igRvb gvm wmqvg mvabvi gvm GB mg‡q wewfbœ ai‡bi kvixwiK RwUjZv hv‡`i Av‡Q Zv‡`i †ÿ‡Î evi evi ejv nq mveavbZv ev mZK©Zv Aej¤^b K‡i Pjvi Rb¨ †Kbbv †h‡nZz `xN© mgq ch©šÍ cvbvnvi e¨ZxZ _vKv nq †mB †ÿ‡Î A¯^v¯’¨Ki Lvevi MÖnY Ki‡j wKš‘ wewfbœ ai‡bi kvixwiK RwUjZv †`Lv w`‡Z cv‡i| †m Rb¨ Avcbv‡K Aek¨B mZK©Zvi mv‡_ wmqvg mvabv Ki‡Z n‡e| D”P i³Pvc RwbZ RwUjZv hv‡`i Av‡Q Zv‡`i Aek¨B igRvb gv‡m mZK© _vK‡Z n‡e †Kbbv GLb MÖx®§Kv‡j igRvb GB mg‡q A‡b‡Ki †ÿ‡ÎB hviv D”P i³Pvc RwbZ RwUjZv i‡q‡Q Zv‡`i wKš‘ D”P i³Pvc †e‡o hvIqvi m¤¢vebv _v‡K AwaKvsk †mRb¨ Aek¨B mveavbZv Aej¤^b Ki‡Z n‡e Pjv †divq Avb‡Z n‡e mZK©Zv| Avcwb hLb evwn‡i †ei n‡eb ZLb Aek¨B mv‡_ GKwU QvZv ivL‡eb Avi Aek¨B Qvqv hy³ ¯’v‡b Pjv‡div Kivi †Póv Ki‡eb Avi m¤¢e n‡jB †ekxifvM mgqB hw` evmvq KvR bv _v‡K †m‡ÿ‡Î evmv wKsev Awd‡m GKUz kvšÍ cwi‡e‡k _vKvi †Póv Ki‡eb Avi Lv`¨vfv‡m Aek¨B mylg n‡Z n‡e| †Kbbv BdZvi †_‡K †mnwii mgq ch©šÍ Avcwb hw` AwZwi³ gkjvhy³ Lvevi Lvb †m‡ÿ‡Î wKš‘ RwUjZv †`Lv w`‡Z cv‡i| mevi cÖ_‡g eje BdZv‡i Avgiv igRvb gv‡m AwZwi³ Lvev‡ii †hb GKwU Av‡gR ev Drm‡e cwiYZ n‡q hvq Avgv‡`i Lvevi †Uwej| †mRb¨ igRvb gv‡m hv‡`i D”P i³Pvc RwbZ RwUjZv i‡q‡Q Zv‡`i Aí cwigvY jeY ev †Uw÷s më e¨envi K‡i Lvevi MÖnY Ki‡Z n‡e, Wz‡ev †Z‡j fvRv Lvevi cwinvi Ki‡Z n‡e| †Kbbv G‡ÿ‡Î D”P i³Pvc †e‡o hvIqvi m¤¢vebv ‰Zwi n‡Z cv‡i| †mRb¨ Avcbv‡K GKwU K_v Aek¨B gv_vq ivL‡Z n‡e D”P i³Pvc wbqš¿‡Yi †ÿ‡Î cUvwmqvg I g¨vM‡bwkqvg Lvevi ¸‡jv Kvh©Ki f~wgKv cvjb K‡i| cUvwmqvg I g¨vM‡bwkqv‡gi f~wgKv n‡Z cv‡i wewfbœ ai‡bi djg~j I kvK mewR| †mRb¨ Avcbvi BdZv‡ii _vjvwU mvRv‡Z n‡e wewfbœ ai‡bi djg~j I kvK mewR RvZxq Lvevi w`‡q| Avcwb mewR w`‡q m~¨c ˆZwi Ki‡Z cv‡ib, mewR w`‡q wewfbœ ai‡bi AvB‡Ug †h¸‡jv Av‡Q †m¸‡jv ‰Zwi Kivi mgq GKUv K_v gv_vq ivL‡eb †m¸‡jv‡Z †Zj Ges je‡Yi e¨envi hv‡Z Kg Kiv nq| Dc¯’vwcKv : m¨vi Avgiv †`‡L wbjvg we‡kl‡Ái gZvgZ| Avgiv GB ch©v‡q Rvb‡Z PvB A‡b‡KB wKš‘ B‡Kv KvwW©IMÖvwd ev G¨vbwRIMÖvg GB cixÿv¸‡jv Kivi cÖ‡qvRb n‡q _v‡K †m‡ÿ‡Î †ivRv †i‡L wK GB cixÿv¸‡jv Kiv hv‡e- Wvt †ZŠwdKzi ingvb : †ivRv †i‡L †hme cixÿv Kiv hvq †hgb BwmwR cixÿv Ki‡Z †Kv‡bv mgm¨v bvB, B‡Kv KvwW©IMÖvwd cixÿv GLv‡bI †Kvb cwikÖ‡gi e¨vcvi bv| myZivs B‡Kv KvwW©IMÖvwd cixÿv Kiv hv‡e GLv‡b †ivMx‡`i †Kvb Kó bvB ev †ivRv †i‡L Ki‡Z †Kv‡bv mgm¨v bvB| GLb cÖkœ Av‡m BwUwU cixÿv Uv wb‡q GB cixÿvq †ivMx‡`i †gwk‡b nuvU‡Z nq| GLb nuvU‡j †hUv nq †ivMx‡`i cwikÖg nq wKQz NvgI nq GLb †ivRv †i‡L
- 58. 53 hw` †ivMxiv BwUwUK‡i Zv‡Z Zv‡`i †ivRvi †Kvb ÿwZ n‡e bv wKš‘ †ivMxi nqZ Kó n‡Z cv‡i ev †ivMxi nqZ cvwbi wccvmv jvM‡Z cv‡i| †mB Kvi‡Y mvaviYZ Avgiv BwUwU cixÿv †hUv Av‡Q †m¸‡jv Avgiv mvaviYZ BdZv‡ii ci Kwi hv‡Z †ivMx‡`i Kó bv nq wKš‘ †KD hw` †ivRv †i‡L BwUwU Ki‡Z Pvq Zvn‡j c‡i G‡Z K‡i †ivRvi †Kvb mgm¨v n‡e bv Avi G¨vbwRIMÖvg †h cixÿvi K_v ej‡jb GUv Avgiv 2 fv‡e Kwi GKUv n‡jv wmwU K‡ivbvwi G¨vbwRIMÖvg Av‡iKUv n‡jv Bb‡fwmf G¨vbwRIMÖvg| GLb wmwU G¨vbwRIMÖvg Kivi Rb¨ Avgiv GK ai‡bi GKUv Jla e¨envi Kwi nv‡Zi g‡a¨ nv‡U©i Qwe †Zvjvi Rb¨| GUvI GKUv Jla GLv‡bI kw³ea©K †Kvb wRwbm †bB GUv GKUv G· †i g‡Zv ev wmwU ¯‹¨vb Gi g‡Zv e¨vcvi| G‡ÿ‡Î Av‡jg‡`i AwfgZ †ivRvi †Kvb ÿwZ n‡e bv †ivRv fv½‡ebv Avi Bb‡fwmf G¨vbwRIMÖvg †hUv †mUv Ki‡Z wM‡q wKQz i³ÿiY nq| GLb Avgv‡`i A‡b‡Ki aviYv †h kixi †_‡K i³ †ei n‡j ev i³ÿiY n‡j †ivRv †f‡½ hvq| A‡b‡Ki nvZ †K‡U †M‡jI g‡b K‡i †h‡nZz i³ÿiY n‡”Q myZivs Avgv‡`i †ivRv fv½‡e wKbv| †KD Avevi G wb‡q KbwdDk‡b _v‡K †h, Avwg †ivRv _vKv Ae¯’vq mKv‡j Wvqv‡ewUm cixÿv Kie A_ev wmwewm †Kvb i‡³i cixÿv Kie, Gi Rb¨ †Zv i³ †`qvi cÖ‡qvRb nq| ZLb A‡b‡K KbwdDk‡b c‡i hvq †h, nqZ G¸‡jvi gva¨‡g Zvi †ivRv †f‡½ hv‡e| †mB wel‡q Avgvi AwfgZ n‡jv †h, i³ w`‡j Ihy fv½‡e Avgiv †hUv ewj i³ Mwo‡q ci‡j Ihy fv‡½ wKš‘ i³ †`qvi mv‡_ ev i³ hw` `vbI Kiv nq Gi mv‡_ †ivRv fv½vi †Kvb m¤úK© bvB| Dc¯’vwcKv : m¨vi, †ivRv †i‡L hw` Kv‡iv Zxeª ey‡K e¨_v nq †mB mgqUv‡Z wK KiYxq Av‡Q? Wvt †ZŠwdKzi ingvb : †ivRv Ae¯’vq ey‡K e¨_v Avm‡j wewfbœ Kvi‡Y n‡Z cv‡i †m‡ÿ‡Î Avgiv †hUv †`wL †h, ey‡K e¨_vi mv‡_ mv‡_ Zvi kix‡i Nvg n‡”Q wKbv, kix‡i hw` Nvg †`q Ges †m hw` ga¨ eqmx nq Avgiv ewj 40 †_‡K 45 Gi †ewk eqm n‡j Ges mv‡_ hw` wi¯‹ d¨v±i _v‡K †hUv ewj Avgiv `xN© †gqv`x n‡j nvU© G¨vUvK Gi SzuwK †ewk _v‡K| hw` Wvqv‡ewUm Awbqwš¿Z _v‡K, D”P i³Pvc hw` Awbqwš¿Z _v‡K, i‡³ Pwe©i gvÎv †ewk _vK‡j, †ivMx aygcvb Ki‡j A_ev hw` IRb †ewk _v‡K GBme †ivMxi †ÿ‡Î ZLb Avgiv †h‡nZz Zvi wi¯‹ d¨v±i ¸‡jv Av‡Q ZLb Avgiv wPšÍv Kwi Zvi nvU© G¨vUvK n‡Z cv‡i| †h‡nZz †ivMxi wi¯‹ d¨v±i Av‡Q Ges e¨_vi mv‡_ Nvg n‡”Q nvU© G¨vUvK Gi m¤¢vebv Av‡Q GB †ivMx‡K Avgiv eje ZvrÿwYKfv‡e †hb wbKU¯’ †Kvb KvwW©©qvK nvmcvZv‡j wb‡q hvq Avi MÖv‡g hviv _v‡Kb †mLv‡b †Zv KvwW©qvK nvmcvZv‡ji msL¨v A‡bK Kg †m‡ÿ‡Î Zviv wbKU¯’ m`i nvmcvZv‡j ev †nj_& Kg‡cø· †h‡Z cv‡ib| GLb mg¯Í †nj_ Kg‡cø· ev m`i nvmcvZv‡j BwmwR Av‡Q Ges wgwbgvg GKUv BwmwR Kiv hvq Avi Avgiv GKUv i³ cixÿvi K_v ewj Uª‡cvwbb-AvB cixÿv †hUv Øviv Avgiv ey‡K e¨_vi mvaviYZ 4 N›Uv c‡i wbwðZ n‡Z cvwi †h †ivMxi nvU© G¨vUvK n‡q‡Q wKbv †mUv g„`y cwigv‡Y n‡jI hw` GiKg nvU© G¨vUvK n‡q _v‡K Zv‡K Aek¨B hw` Avgv‡`i KvwW©qvK nvmcvZv‡j hvq Zvn‡j Zv‡K Avgiv †mfv‡e e¨e¯’vcÎ w`‡q _vwK Avi hw` MÖv‡g ev kn‡ii evwn‡ii †ivMx _v‡K Zvi hw` nvU© G¨vUvK Gi mvm‡c± nq Zvn‡j Zv‡K Aek¨B m`i nvmcvZv‡j †ivMx g¨v‡bR K‡i
- 59. 54 cieZx©‡Z KvwW©qvK nvmcvZv‡jwb‡q †M‡j Avgiv †mfv‡e †ivMx‡K wPwKrmv w`‡q _vwK| Dc¯’vwcKv : m¨vi Ab¨ Avi wK wK Kvi‡Y ey‡K e¨_v n‡Z cv‡i? Wvt †ZŠwdKzi ingvb : ey‡K e¨_ vi me‡P‡q Kgb †h KviY nvU© G¨vUv‡Ki cvkvcvwk †mUv n‡”Q Avgv‡`i Lv`¨vfvm| Avgiv hw` fuvRv‡cvov Lvevi †ewk LvB Zvn‡j Avgv‡`i GwmwWwU †_‡KI wKš‘ ey‡K e¨_v n‡Z cv‡i, GU GKUv Kgb KviY Ges GwmwWwU †_‡K ¯^vfvweKfv‡e cÖkœ Av‡m †h, GUv wK GwmwWwU †_‡K n‡”Q bvwK Avgv‡`i nvU© G¨vUvK n‡q †M‡Q GUv Avwg wKfv‡e eySe- †`Lv hvq A‡bK mgq Avgiv me ai‡bi e¨_v‡KB GwmwWwU †f‡e e‡m _vwK c‡i †`Lv †Mj iv‡Zi †ejvq ey‡K Zxeª e¨_v n‡jv A‡bK Lvivc Ae¯’v n‡q †Mj| ZLb Avgv‡`i nvmcvZv‡j †`uŠov‡`uŠwo Ki‡Z, nvmcvZv‡j †cŠuQv‡Z †`wi nq ev wPwKrmv wb‡ZI †`wi n‡Z cv‡i| GLb GwmwWwUi Rb¨ ey‡K e¨_v n‡j †mUv nq cÖ_gZ eyK R¦jvi cvkvcvwk Lvev‡i †Kvb Svj RvZxq wKQz †L‡j, †Z‡j fvRv G¸‡jv †L‡j n‡Z cv‡i| Av‡iKUv n‡Z cv‡i †hUv eq‡mi e¨vcvi †h †Kvb eq‡mB GUv n‡Z cv‡i Avi hv‡`i mvaviYZ wnw÷ª _v‡K †h GB †h GwmwWwU ‰Zwii cÖeYZv GUv Av‡M †_‡KB _v‡K Zvi gv‡S g‡a¨B Lvev‡i GKUz Gw`K †mw`K n‡jB Zvi GwmwWwU nq A_ev GKUz Nyg Kg n‡jI Zvi GwmwWwU n‡Z cv‡i, ivZ RvM‡j| Avi me‡P‡q ¸iæZ¡c~Y© †h welqUv n‡jv †mUv n‡”Q nvU© G¨vUvK n‡j ey‡K e¨_vi mv‡_ mv‡_ kix‡i GKUv Nvg nq, †ivMxiv A‡bK mgq e‡j wPKb Nvg n‡”Q, Aw¯’iZv jvM‡Z‡Q GwmwWwU n‡j wKš‘ GiKg wPKb Nvg mvaviYZ nq bv| †gvUvgywU GZUzKz hw` †ivMxiv eyS‡Z cv‡i Zvn‡j Zviv eyS‡e †KvbUv nv‡U©i e¨_v Avi †KvbUv GwmwWwUi e¨_v| GQvovI wKQz G¨v›UvwmW wmivc Avi wKQz M¨vwó‡Ki Jla ev K¨vcmyj Av‡Q †m¸‡jv †ivMx cÖ‡qvRb n‡j †L‡Z cvi‡e Avi LvIqvi ci hw` Zvi e¨_vUv K‡g hvq ZLb Avgvi g‡b nq GUv wb‡q †Ubk‡bi wKQz †bB| GQvovI ey‡K e¨_vi Av‡iv wKQz KviY Av‡Q †hgb Avgiv ewj welbœZv, †÷ªP, `ywkšÍv G¸‡jv wKš‘ Lye Kgb GKUv KviY ey‡K e¨_vi Ges G¸‡jv mvaviYZ ZiæY †ivMx‡`i †ewk nq ev gwnjv‡`iI nq ey‡K e¨_v †mUv welbœZv, †÷ªP, Nyg Kg †_‡KI n‡Z cv‡i| Zxeª ey‡K e¨_v nvU© G¨vUvK Gi g‡Zv n‡Z cv‡i †cwbK G¨vUvK Gi g‡Zv n‡Z cv‡i, †cwbK G¨vUvK †h iKg nq| GQvovI MjeøvWv‡i cv_i _vK‡j †h‡nZz igRvb gv‡m fvRv‡cvov †ewk LvIqv nq Ges †mUv †h‡nZz †Z‡j fvRv †Zv GUv A‡bK mgq †`Lv hvq Kv‡iv hw` wcË_wj‡Z cv_i _v‡K GB cv_‡ii Rb¨ A‡bK mgq wcË_wji Dc‡i GKUv KbUªvKkb nq fvRv †cvovi Rb¨| ZLb †`Lv hvq Av‡M nqZ †m KLbI Abyfe K‡i bvB wKš‘ Zvi †c‡U Zxeª e¨_v n‡Z cv‡i GB e¨_v ey‡KI Ki‡Z cv‡i Ges GB e¨_v `yB Kuvamn wcQ‡bi w`‡K Qwo‡q †h‡Z cv‡i| myZivs HUv‡K AwgU Kiv hv‡e bv †h, GB e¨_v Avgv‡`i wcË_wji cv_i †hUv cv_‡ii e¨_v n‡Z, cv‡i GQvovI
- 60. 55 Av‡iv wewfbœ ai‡biKviY Av‡Q| Dc¯’vwcKv : m¨vi, Avcwb †h welq¸‡jv ejwQ‡jb †h, Lv`¨vfv‡mi Kvi‡Y wKQz e¨_v n‡Z cv‡i †hgb Avgiv †h‡nZz BdZv‡ii mgq fvRv †cvov Lvw”Q, ¯^v¯’¨ m¤§Z Wv‡qU hw` ewj Zvn‡j GB igRv‡b wK ai‡bi Lvevi LvIqv DwPZ| Wvt †ZŠwdKzi ingvb : GLb fvRv †cvovi wel‡q †ivMxiv wR‡Ám K‡i †h m¨vi fvRv †cvov wK Avgiv †L‡Z cvie bvwK GK`g †L‡Z cvie bv †m‡ÿ‡Î Avgvi AwfgZ n‡jv †h fvRv †cvov Avm‡j Aí K‡i LvIqv hv‡e GK`g wb‡la Zv bv| Avcwb fvRv †cvov †L‡Z cvi‡eb Aí K‡i| Avgv‡`i Wv‡q‡Ui g‡a¨ †hUv ivL‡Z n‡e g~jZ †mUv n‡jv Avgiv ewj wewfbœ iK‡gi dj ivLv fv‡jv, d‡ji g‡a¨ Avgv‡`i wmRwb dj ivLv †h‡Z cv‡i Avgv‡`i †`wk dj ivLv †h‡Z cv‡i| Av‡iKUv wWªsKm Gi g‡a¨ Lye Kgb †hUv Avgiv hLb †ivRv ZLb †h †Kvb cvbxq ev mieZ G¸‡jv w`‡q GB wWªsKm Avgiv mvaviYZ cvwb w`‡q †L‡Z cvwi Avi Wvqv‡ewUm †ivMx‡`i Rb¨ kieZ cwinvi Kiv fv‡jv †h‡nZz wPwb _v‡K A_ev A‡b‡K Av‡Q hviv e‡j m¨vi Avgiv Nb wPwb ev wKQz U¨ve‡jU wKb‡Z cvIqv hvq wPwbi weKí wn‡m‡e G¸‡jv w`‡q Avgiv kieZ evwb‡q †L‡Z cvie, Avwg ewj nu¨v, †Kvb Amyweav bvB| Dc¯’vwcKv : m¨vi, ü`‡iv‡M hviv AvµvšÍ Av‡Qb Zv‡`i †Zv Wv‡qU Gi GKUv †gvwWwd‡Kkb Kiv _v‡K †h, Zv‡`i D”P i³Pvc _vK‡j AwZwi³ jeY LvIqv hv‡e bv Avi hw` Kv‡iv Bk‡KwgK nvU© wWwRR _v‡K †m‡ÿ‡Î Pwe© RvZxq Lvevi cwinvi Ki‡e †Zv GB mgqUv‡Z Zv‡`i wK wK mZK©Zv Aej¤^b Kiv DwPZ- Wvt †ZŠwdKzi ingvb : Pwe© RvZxq Lvevi ev jeY G¸‡jv n‡jv me mg‡qi Rb¨ wPi kÎæ| we‡kl K‡i hviv nvU© †dBjy‡ii †ivMx Av‡Qb ev hv‡`i cvwb LvIqvi g‡a¨ mxgve×Zv Av‡Q| Avgiv nvU© †dBjy‡ii †ivMx‡`i cvwbi mxgve×Zv w`‡q _vwK A‡bK mgq †Kvb †ivMxi †ÿ‡Î Avgiv ewj Avcwb †`o wjUv‡ii †ewk cvwb LvIqv hv‡e bv A_ev Mig Kv‡j m‡e©v”P 2 †_‡K 2.5 wjUvi cvwb Lv‡eb| GB mxgve×Zv Uv †ivRvi gv‡mI gvb‡Z n‡e AviwK Avi jeY we‡kl K‡i hviv D”P i³Pv‡ci fzM‡Qb ev hviv nvU© †dBjy‡ii †ivMx Av‡Q Zviv jeY †ewk †L‡j nvU© †dBjyi GwMÖ‡fU n‡q I †cÖkvi evowZ _vK‡j Zv Av‡iv evo‡Z _v‡K Avi `xN© †gqvw` jeY †ewk †L‡j †cÖkvi ev‡o GRb¨ †KD hw` Aí cwigv‡Y jeY Aí mg‡qi Rb¨ Lvq Zvn‡j †Kvb mgm¨v bvB| je‡Yi cwigvYUv Avm‡j †hfv‡e wi‡Kv‡gÛ †mfv‡eB LvIqv fv‡jv †hgb Avgiv ewj †h mvivw`‡b GKUv gvbyl 1 PvgyP cwigvY jeY gv‡b 5 MÖvg GB cwigvY †L‡Z cv‡ie Avi eZ©gv‡b wi‡Kv‡gÛ BD‡ivwcqvbiv, Av‡gwiKvbiv Avgv‡`i †_‡K gvsm A‡bK †ewk Lvq A_P Zv‡`i KvwW©qvK mgm¨v A‡bK Kg eis Avgv‡`i GB †h BwÛqvb mveKw›U‡b›U †hme †`k Av‡Q †hgb evsjv‡`k, kÖxjsKv, mvD_ BwÛqv Avgv‡`i mevi Lvev‡ii aib wKš‘ GK| Avgv‡`i cÖavb Lvevi n‡jv fvZ ev Kv‡e©vnvB‡WªW RvZxq Lvevi| Avgv‡`i GB fzwo nIqv GB fzwo wKš‘ mg¯Í †iv‡Mi KviY GUv Wvqv‡ewUm e‡jb nv‡U©i †ivM e‡jb ev †cÖkvi nIqv GB me wKQzi KviYB †gUvewjK wmb‡Wªvg (Metabolic Syndrome) †mRb¨ ejv nq GLb fvZ Kg †L‡Z n‡e Ges Kv‡e©vnvB‡WªW RvZxq Lvevi
- 61. 56 Kg †L‡Z n‡eAvi wWg, Miæ A_ev Lvwmi gvsm G¸‡jv LvIqv GK`g wb‡la bv Avcwb meB †L‡Z cvi‡eb wKš‘ cwigv‡Y Aí| wWg Avcwb cÖwZw`b Kzmygmn GKwU K‡i †L‡Z cvi‡eb Avi Miæ A_ev Lvwmi gvsm hLbB Lv‡eb 2-3 UzKiv K‡i †L‡Z cvi‡eb| Dc¯’vwcKv : m¨vi, †h‡nZz Obesity ev IR‡bi GKUv K_v G‡m‡Q †Zv hviv Obesity-‡Z fzM‡Qb Zv‡`i †ÿ‡Î GB igRv‡bi DcKvwiZv m¤ú‡K© hw` GKUz ej‡Zb- Wvt †ZŠwdKzi ingvb : ab¨ev`, GB IRb ev KvwW©qvK mgm¨v Øviv hviv fzM‡Qb we‡kl K‡i †gUvewjK wmb‡Wªvg (Metabolic Syndrome) Gi g‡a¨ hviv Av‡Qb hv‡`i GKB mv‡_ IRb †ewk, Wvqv‡ewUm Av‡Q, D”P i³Pvc Av‡Q, i‡³ †Kv‡j÷ij Gi gvÎv †ewk, we‡kl K‡i UªvBwMømvivBW †ewk, GBPwWGj Kg A_ev †UvUvj †Kv‡j÷ij †ewk G‡`i †ÿ‡Î †ivRvi DcKvwiZv A‡bK| †ivRvq †h wRwbmUv nq Avgiv hLb dvw÷s _vwK dvw÷s _vKv gv‡b Avwg mvivw`b LvBwb wKš‘ BdZv‡ii mgq Avwg B‡”Qg‡Zv †Ljvg Gfv‡e H †ewbwdU wKš‘ Avwg cv‡ev bv| †Kbbv GLv‡b ejv Av‡Q †h, mxwgZ LvIqvi Rb¨, hv‡Z K‡i Avgiv Bev`ZI Ki‡Z cvwi Avi †ivRvi gv‡m ejv Av‡Q Bev`‡Zi mIqve 70 ¸b †ewk, †h‡nZz Avgv‡`i Bev`‡Zi mIqve †ewk Avi Avwg hw` LvIqv `vIqv †ewk Kwi Zvn‡j Avgvi Nyg Avm‡e, Avwg Bev`Z Ki‡Z cvie bv| ZvB †ivRvi gv‡m †hgb msh‡gi gvm, w`‡bi †ejvq †hgb Avwg mshg _vKwQ mKj cÖKvi cvbvnviI Av‡gv` dzwZ© †_‡K| †Zgwb iv‡Zi †ejv Avgv‡`i cwiwgZ LvIqv DwPZ| †hUv n‡e hw` Avwg K¨vjwi Kg LvB Zvn‡j Avgv‡`i kixi †_‡K †h mwÂZ Pwe© Av‡Q, GB GMv‡iv gvm a‡i †h Pwe© Rgj, GB Pwe© A‡bK Lvivc wRwbm wKfv‡e GB †m›Uªvj IwewmwU GB Pwe©¸‡jv Bbmywjb †iwR‡UÝ K‡i GK ai‡bi mgm¨v ewj nqZ †ivMxiv bvI eyS‡Z cv‡i| GB wRwbm¸‡jv Avgv‡`i nv‡U©i mgm¨v K‡i, Wvqv‡ewUm ˆZwi K‡i, D”P i³Pvc K‡i, i‡³ Pwe©i †Kv‡j÷ij Gi gvÎv evovq GLb Avgv‡`i kix‡i GB †h, Lvivc Pwe© ¸‡jv Rgv n‡”Q †ivRv ivLvi Kvi‡Y GB Rgv‡bv Pwe©Uv M‡j hvq| GB Pwe© wKš‘ wjfv‡iI _v‡K Avgiv d¨vwU wjfvi ewj| i‡³ †Kv‡j÷ij Gi gvÎv, Wvqv‡ewUm, nv‡U©i mgm¨v, nv‡U©i eøK mg¯Í wKQzB BgcÖæf n‡Z _v‡K hw` Avgiv 30Uv †ivRv ivwL Ges mgqg‡Zv wbqg cvjb Kwi| Dc¯’vwcKv : m¨vi, Avcbv‡K AmsL¨ ab¨ev` G‡Zv e¨¯ÍZvi gv‡SI Avgv‡`i mgq w`‡q‡Qb Avgv‡`i `k©K‡`i Rb¨ Avcbvi wK civgk© _vK‡e| Wvt †ZŠwdKzi ingvb : `k©K‡`i Rb¨ civgk© n‡jv Avcbviv mevB †ivRv ivL‡Z cvi‡eb| A‡b‡Ki hv‡`i Wvqv‡ewUm Av‡Q, nv‡U©i mgm¨v Av‡Q Zviv hw` fv‡eb †h, Avcbviv
- 62. 57 †ivRv ivL‡Z cvi‡ebwKbv- nu¨v, Avcbviv †ivRv ivL‡Z cvi‡eb †ivRv‡Z †Kvb mgm¨v bvB †ivRv‡Z jvf Qvov Avm‡j †Kvb ÿwZ †bB| ïay gvÎ hviv nvU© †dBjy‡ii †ivMx hv‡`i B‡RKkb d«vKkb 25% Gi Kg Zv‡`i GKUz mZK©Zvi mv‡_ †ivRv ivL‡Z n‡e| ab¨ev`|| Dc¯’vwcKv : mywcÖq `k©K, GB wQ‡jv Avgv‡`i AvR‡Ki Av‡qvRb| Avkv Kwi Avgv‡`i AvR‡Ki Av‡jvPbv †_‡K Avcbviv mevB DcK…Z n‡eb| cieZx© Av‡qvR‡b Avgiv Wvqv‡ewUK †ivMx‡`i wb‡q Av‡jvPbv Kie †mB Av‡qvR‡b hy³ nevi Avgš¿Y iBj| `k©K Avcbv‡`i ¯^v¯’¨ welqK †h †Kvb mgm¨vi K_v Avgv‡`i Rvbv‡Z cv‡ib Avgv‡`i †dBmeyK †c‡R| mevB fv‡jv _vK‡eb, my¯’¨ _vK‡eb Ges Aek¨B wRwUwfi mv‡_ _vK‡eb| Avjøvn nv‡dR| SCAN ME †gwW‡bvfv, gvwjevM kvLvq wmwcAvi (CPR) cÖwkÿY Kg©kvjv PjKvjxb wKQz w¯’i wPÎ
- 63. wPwKrmv welqK wWwMÖ: XvKv†gwW‡Kj K‡jR †_‡K MBBS wWwMÖ (‡g, 1997 Ges e¨vP †K-47)| evsjv‡`k K‡jR Ae wdwRwmqvÝ GÛ mvR©Ý (BCPS) †_‡K †gwWwm‡b GdwmwcGm (FCPS) wWwMÖ (2003 Bs) Ges RvZxq ü`‡ivM Bbw÷wUDU I nvmcvZvj (NICVD, Dhaka) †_‡K KvwW©IjRx‡Z W±i Ae †gwWwmb (Gg wW / wW Gg) wWwMÖ (Rvbyqvwi, 2004 Bs)| AvšÍR©vwZK wPwKrmv welqK wWwMÖ 2012 mv‡j h_vµ‡g Gwkqvb c¨vwmwdK †mvmvBwU Ae B›Uvi‡fbkbvj KvwW©IjwRi (APSIC) wWwMÖ (FAPSIC) I Gwkqvb c¨vwmwdK †mvmvBwU Ae KvwW©IjwR (APSC) wWwMÖ (FAPSC)| 2013 mv‡j Gwkqvb c¨vwmwdK nvU© G‡mvwm‡qkb (APHA) †_‡K wWwMÖ (FAPHA), Av‡gwiKvb K‡jR Ae KvwW©IjRx †_‡K wWwMÖ- GdGwmwm (FACC) Ges BD‡ivwcqvb †mvmvBwU Ae KvwW©IjRxi (ESC) wWwMÖ- Gd B Gm wm (FESC)| GKB mv‡j Av‡gwiKvi nvU© G‡mvwm‡qk‡bi (AHA) evsjv‡`‡ki cÖ_g I GKgvÎ wWwMÖ (FAHA) AR©b K‡ib| 2014 mv‡j h_vµ‡g hy³iv‡R¨i Møvm‡Mv i‡qj K‡jR Ae wdwRwkqvbm GÛ mvR©b (RCPS) †_‡K wWwMÖ (FRCP) Ges Av‡gwiKvi †mvmvBwU Ae KvwW©IfvmKyjvi GbwRIMÖvdx GÛ B›Uvi‡fbkb (SCAI) †_‡K (FSCAI) wWwMÖ jvf K‡ib| 2015 mv‡j Av‡gwiKvb K‡jR Ae †P÷ wdwRwkqvb †_‡K Gdwmwmwc (FCCP) wWwMÖ| wZwbB GB Dcgnv‡`‡ki cÖ_g I GKgvÎ e¨w³ whwb Av‡gwiKvb †mvmvBwU Ae B‡KvKvwW©IMÖvwd †_‡K wWwMÖ (FASE) 2017 mv‡j AR©b K‡ib| GKB mv‡j (2017 Bs) Av‡gwiKvb †mvmvBwU Ae wdwRwkqvÝ †_‡K (FACP) wWwMÖ AR©b K‡ib| wPwKrmK G‡mvwm‡qk‡bi AvRxeb m`m¨c` jvf G‡mvwm‡qkb Ae wdwRwkqvb Ae evsjv‡`k (APB)-2005, evsjv‡`k †P÷ GÛ nvU© G‡mvwm‡qkb-2006, evsjv‡`k GRgv G‡mvwm‡qkb-2006, evsjv‡`k KvwW©qvK †mvmvBwU (BCS)-2007, evsjv‡`k †mvmvBwU Ae KvwW©IfvmKyjvi B›Uvi‡fbkb cÖ‡dmi (Wvt) †gvt †ZŠwdKzi ingvb (dviæK) cÖ‡dmi (Wvt) †gvt †ZŠwdKzi ingvb (dviæK) cÖ‡dmi (Wvt) †gvt †ZŠwdKyi ingvb (dviæK), e„nËi Kywóqvi PyqvWv½v †Rjvq Rb¥MÖnb K‡ib| Lyjbv †ivUvwi ¯‹yj †_‡K h_vµ‡g 5g I 8g †kÖwY‡Z e„wË jvf K‡ib, XvKv gwZwSj AvBwWqvj ¯‹yj I K‡jR †_‡K GmGmwm (1987 Bs), XvKv bUi‡Wg K‡jR †_‡K GBPGmwm (1989 Bs) cvk K‡ib| bUi‡Wg K‡jR †_‡K fv‡jv djvd‡j Amvgvb¨ Ae`vb ivLvq Zv‡K Award of Excellence (1989) cÖ`vb Kiv nq| 58
- 64. 25 (cuwPk) 25 (cuwPk) PzqvWv½viLvw`gcy‡i `y¯’‡`i gv‡S kxZ e¯¿ weZiY- 2016 PzqvWv½vq wd« †gwWK¨vj K¨v¤ú PzqvWv½vi Lvw`gcy‡i `y¯’‡`i gv‡S kxZ e¯¿ weZiY- 2015 †gwW‡bvfv, gvwjev‡M wek¦ D”P i³Pvc w`em Dcj‡¶ wd« †gwWK¨vj K¨v¤ú Wvt wU ingvb KvwW©qvK †Kqvi dvD‡Ûk‡bi Kg©KvÛ 60
- 65. 61 wmwcAvi (CPR) †Uªwbs2023-2024 (XvKv †gwW‡Kj, gvwbKMÄ †gwW‡Kj, †gwW‡bvfv-gvwjevM, ccyjvi-kvwšÍbMi )
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- 67. iKgvwi.Kg Ô†nj_& wdU‡bmI †cÖmwµckb eyKÕ K¨vUvMwi‡Z †e÷ †mjvi eB Ôü`‡ivM cÖwZ‡ivaÕ Gi †jLK Aa¨vcK (Wvt) †gvt †ZŠwdKzi ingvb (dviæK)-iwPZ ü`‡ivM welqK m‡PZbvg~jK eB (cÖvw߯’vb: †gwW‡bvfv, gvwjevM / ccyjvi, kvwšÍ bMi) †gvevBj: 01714908651, 01777751251, 01911660914