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lrk], guGxfpg] tyf w]/} dfqfdf x'G5 .
sfg klg xNsf ;'Gg sd x'G5 .
o; lsl;dsf] /f]udf hLp HofgnfO{
vt/f x'g] ;Defjgf sd x'G5 . of]
/f]unfO{ Mucosal Type sf] /f]u klg
elgG5 .
CSOM AA
o;
df s] x'G5 <
/f]udf
sfgsf]
hfnLsf]
dflyNnf] efudf Kjfn k5{ jf hfnL
leq tflgP/ dWosfgdf 5fnfsf]
kf]sf] (Cholesteatoma) aGb5 .
Cholesteatoma n] cfkm\gf] jl/k/L
/]x]sf xf8x?nfO{ s'xf“p5 . ;fy}
sfgleqsf ;fgf x8\8Lx? (Ossicles)
klg s'lxG5 / ;'gfO{df ;d:of pTkGg
ub{5 . s'lxg] k|lqmof lg/Gt/ eO{
/xg] x'gfn] o;df cfpg] kLk afSnf],
kx]nf], uGxfpg] / yf]/} x'G5 . kLk
dlxgf}, jif}{;Dd nuftf/ alu/xG5 .
of] /f]unfO{ squamous type sf] /f]u
klg elgG5 .
sfg kfSgfn] s:tf
hl6ntfx? cfpg ;S5 <
3fts slxn]sflx“ sfgsf] kLk sfgsf]
jl/kl/ km}lnP/ cGo hl6ntfx?
cfpg ;S5 . tL dWo] lgDg
hl6ntfx? w]/}h;f] b]lvG5g\ .
— d'v af+uf] x'g] (Facial Paralysis)
— sfg k5f8L ;'lGgg] /
kLk el/g] (Mastoiditis)
— leqL sfgdf ;+qmd0f
eO{ l/+u6f nfUg] tyf alx/f]
x'g] (Labyrinthitis)
— lbdfudf lkk hDg]
(Brain Abscess)
—d]lgg\hfOl6;
o; lsl;dsf hl6ntfx? CSOMTT df eGbf CSOM-AA df lgs} a9L
x'G5g\ .
;f+lu|nf hg:jf:Yo
s_ g'xfp“bf jf cGo sfd ubf{
sfgleq kfgL gkfg]{ .
v_ sfgdf t]n jf cGo emf]n kbfy{
gxfNg] .
u_ hf]8n] ;L“ ;L“ u/]/ l;“ufg
gkmfNg] .
3_ s'g} klg j:t'n] sfg gsf]6\ofpg]
ª_ ;fgf aRrfx?sf] ;Gbe{df,
aRrfnfO{ b'w, kfgL v'jfp“bf
6fpsf] ;f]emf] / dfly kf/]/
v'jfpg] . 6fpsf] sf]N6f] kf/]/,
;'tfP/ jf 6fpsf] tn kf/]/ emf]n
j:t' v'jfp“bf sfg kfSg]
;d:ofsf] ;'?jft x'g ;S5 .
sfg kfs]sf] ;d:ofsf]
pkrf/ s] xf] <
sfg kfs]df s:tf] k|sf/sf] /f]un]
sfg kfs]sf] xf], ;f] s'/f lgbfg ug{
lrlsT;snfO{ b]vfpg' k5{ . /f]usf]
k|sf/ cg';f/ pkrf/ km/s km/s
x'G5 . olb CSOM-TT ePdf sfgdf
xfNg] PlG6jfof]l6s yf]kf / vfg]
PlG6jfof]l6s cf}iflwsf] k|of]u ug'{
kb{5 . k6s k6s kfSg glbg dfly
pNn]lvt /f]syfdsf pkfox? Klg
ckgfpg' k5{ olt ub}{df k|foMsf] sfg
kfSg 5f]8\5 / ;fgf] vfnsf] Kjfn
-hflnsf]_ eP cfkm}“ 6flng ;S5 .
t/ sfg kfSg 5f]8\b}df lgsf] ePsf]
7fGg' x'“b}g . lsgeg] hfnLdf k/]sf]
sfg kfSg glbg s] s:tf
/f]syfdsf pkfox? ug{
;lsG5 <
sfg kfs]df pkrf/ ug'{sf ;fy;fy}
kfSg 5f]8] kl5 km]l/ kfSg glbg
lgDg pkfox? ckgfpg' k5{ .
7
Kjfn aGb gePsf] klg x'g ;S5 .
o:tf] cj:yfdf :yfoL pkrf/sf] nflu
ck/];g -h;nfO{ Myringoplasty
elgG5_ g} ug'{k5{ . of] ck/];g ubf{
lgDg kmfObfx? x'G5g\ M
— sfgaf6 kLk cfpg ;w}“sf nflu
aGb x'G5 .
— ;'Gg] zlQmdf ;'wf/ x'g ;S5 .
— sfgsf] ;'Gg] zlQm 36\b} hfg]
qmd /f]lsG5 .
— sfg gkfSgsf nflu ul/g]
/f]syfdsf pkfox? ckgfO/xg'
kb}{g .
— /f]uaf6 x'g] hl6ntfx?sf
;Defjgf x6fp“5 .
olb CSOM-AA ePdf cf}iflw pkrf/sf]
kl5 nfUg' eGbf (Mastoid Surgery)
ul/G5 . of] ck/];gsf] d'Vo p4]Zo
sfgsf] ;'Gg] zlQmdf ;'wf/ ug'{ geO{
sfgaf6 /f]unfO{ lgsfn]/ kmfNg'
xf] . ck/];g kZrft\ sfg kfSg
5f]8\5 / o;af6 x'g] hl6ntfx?sf]
;DefjgfnfO{ Go"g ub{5 . To;sf/0f
sfg kfSbf lrlsT;snfO{ b]vfO{ ;xL
k/fdz{ tyf pkrf/ u/fpg' k5{ .
hl6n ;d:of eO{;s]kl5 k5'tfP/
a:g'eGbf ;dodf g} /f]usf] pkrf/
u/fpg' a'l4dfgL x'G5 . ¢
8
;f+lu|nf hg:jf:Yo
cfhsf] ;Gbe{
e'sDk
/ hf]lvd
? ;+ud zfSo (Pharmacist)
e'sDkn] z/L/ / dfgl;stfdf
7"nf] c;/ k'¥ofp“5 . e'sDkn] ;a}
ljklQ ;DalGwt d[To'sf] nueu ^)
k|ltzt cf]u6]sf] 5 . @))$ df
e'sDkaf6 cfPsf] ;'gfdLn] nueu
@,)),))) sf] hLjg lnPsf] lyof] .
;+;f/sf w]/} 7"nf zx/x? -h:t}
n; PGhn;, Go"of]s{, 6f]Sof], lbNnL,
;+3fO{ / sf7df8f}+_ bf]if nfOgdf
lgdf{0f ePsf 5g\, h;n] nfvf}+
dflg;nfO{ e'sDksf] hf]lvddf kf/]sf]
5 .
ljzfn e'sDkn] ;8s, k'n, lgdf0f{ /
lrlsT;f ;'ljwf k|bfg ug]{ c:ktfnx?
gi6 ug{ ;S5 / To;n] lrlsT;f
cfk"tL{df afwf kg{ ;S5 . d[To' /
rf]6sf] cg'kftsf] l/kf]6{ leGg ePtf
klg w]/} cWoogn] !÷# lkl8tx? t'?Gt}
dg]{ b]vfPsf] 5 . k|f/lDes d[To'lzv/
kl5, bf];|f] d[To'lzv/ e'sDksf] s]lx
306fkl5 x'g ;S5 . h;sf] sf/0f
liver / spleen laceration -ulx/f]
rf]6_, Pelvic fracture, sub dural
succumb x'g ;S5 . t];|f] d[To'
lzv/ sepsis / ax' c+u ljkmntf
n] ubf{ x'g ;S5 . To:t}, dw'd]x,
pRr /Qmrfk, x[bo /f]u h:tf 7"nf]
/f]u ef]uL/x]sfx? klg cf}iflwsf]
clgoldttf / x]/ljrf/sf] sdLn]
ubf{ d[To'sf] 7"nf] hf]lvddf kl//x]sf
x'G5g\ .
hg;+Vofsf] @ k|ltzt b]lv %
k|ltzt dflg;x?dfyL ef/L ef/
v;]/ c+uR5]bsf] lzsf/ ePsf x'g
;S5g\ h;n] ubf{ d[uf}nf3ft jf c?
d[uf}nf /f]ux? x'g;S5 . e'sDkdf
d[uf}nf ljkmntf jf d[uf}nf3ftaf6
dg]{sf] d[To'b/ !$ k|ltzt b]lv !*
k|ltzt ;Dd x'g;S5 .
;a}eGbf ;fdfGo e'sDk lkl8t
3fOt]x? df %^ k|ltzt ulx/f] rf]6,
@@ k|ltzt fractures, ^ k|ltzt
contusions / sprains, #—@)
k|ltzt crash injuries h;df &$
k|ltzt v'§fdf rf]6 nfu]sf dfG5]x?
x'g ;S5g\ .
7"nf e'sDkkl5 dflg;x? cf—
cfkm\gf] 3/af6 lj:yflkt x'G5g /
o; le8ef8 / kmf]x/af6 ;+qmd0f x'g]
/f]ux?sf] dfxfdf/L km}lng ;S5 t/
o:tf dfxfdf/L jf zjsf k|efj cS;/
gf6lso ldl8of4f/f overestimated
ul/Psf] kfOG5 . dfxfdf/Lsf] Psdfq
pbfx/0f nf;x? / kmf]x/x?af6 x}hf
km}lnPsf] 36gfdf dfq l;ldt 5 .
-3fp nfu]/ hLjf0f'sf] ;+qmd0f
a9\b} hfg'_ n] klg s]lx xb ;Dd d[To'
x'g;S5 . c? ;fdfGo :jf:Yo d'4fdf
Sepsis
Post traumatic stress disorder /
c?
dfgl;s :jf:Yo ;d:ofx? kb{5g
h;df ^ k|ltzt b]lv &@ k|ltzt
ar]sfx?df pbf;Lgtf b]lvg ;S5 .
jo:ssf] t'ngfdf aRrfx?nfO{
cS;/ e'sDksf] ;dodf rf]6 /
d[To'sf] hf]lvd a9L x'G5 . k|d'v
e'sDkkl5 afn/f]uL / a[4 dfG5]x?sf]
;fdfGo hg;+Vofsf] t'ngfdf hf]lvd
a9L x'G5 . j[4x?sf] dfdnfdf
ltlgx? lz3| cfkmgf] 3/ 5f]8g
c;dy{ jf clgR5's x'g' klg k|d'v
sf/0f x'g ;S5 .
yk :jf:Yo r'gf}ltx?
— rfkdf c:ktfn / :jf:Yo ;]jf
—vf]k÷pkrf/df
clgoldttf÷l9nfO{
— oftfoftdf sdL
— v'nf cfsfzdf a;fO{
— ;kmf kfgL, tfhf vfgf / ;/;kmfO{sf] sld
e'sDkkl5sf]
;/ ;kmfO{ ;'emfj
!= aflx/L ;kmfO{ ug'{xf];\
e'sDkkl5 cfkm\gf] lgjf; glhs}
k]6L, af6f] / cGo If]qsf] ;/;kmfO{
cToGt h?/L x'G5 . tkfO{“n] ;/sf/,
Ph]G;L / ;]jf ;d'x gcfpbf
;Dd cfkm'x? Psh'6 eP/ ;Sbf]
of]ubfg lbg kg]{ x'G5 . o;n]
;/;kmfO{ lgoGq0f / ;+qmlds /f]usf]
dfxfdf/Laf6 hf]lug dxTjk"0f{ e'ldsf
v]N5 . kmf]x/x?df 5l/Psf kftx?,
9n]sf ?vx?, /l4 6f]s/L, l;;f /
cGo kmf]x/x?sf] lhDd]jf/L cfkm}n] /
jl/kl/sf l5d]sLx?n] lng'k5{ .
;f+lu|nf hg:jf:Yo
@= 5tsf] hf“r ug'{xf];\
e'sDkkl5 cfkm\gf] 3/ jf jf;:yfgsf]
5tsf] hf“r ug{ clt cfjZos x'G5 .
t'?Gt} jiff{sf] ;'?jft x'g ;Sg]
x'gfn] klxnf] k|fyldstf 5tsf] hf“r
/ dd{tnfO{ lbg'k5{ .
#= kvf{n÷leQf ;'b[9 ug'{xf];\
3/sf] 5t h:t} leQf, kvf{nx? klg
rls{/x]sf] x'g;S5 h'g csf]{ ;fgf]
em6\sfn] klg elTsg ;S5 . To;}n]
leQfsf] rsf{O{, Kjfn / lsNnfx?sf]
hf“r ug'{k5{ . tkfO{ k]zfut 3/
dd{t ug]{ dfG5]sf] ;Nnfx kl5
lng ;Sg'x'G5 . of] ;a} s'/f tkfO{
rf“8f] eGbf rf“8f] ug{ cfjZos 5
lsgsL csf]{ ;fgf] em6\sf lgs6
eljiodf 3fts x'g;S5 .
$= km'6]sf l;;fx?sf] ;kmfO{
/ plrt Joj:yfkg ug'{xf];\
km'6]sf em\ofnsf l;;f, P]gf, l;;fsf
ef8fs'“8f / km'6]sf aQLx?nfO{ s'rf]
jf s'g} dfWodaf6 a6'n]/ ;'/lIft
7f“pdf /fVg'k5{ . o;n] yk b'3{6gf
x'g lb“b}g . yk b'3{6gfaf6 aRg
cfkm\gf] cf]R5\ofg, tl:j/, P}gf, k|m]d
/ em\ofnaf6 6f9f /fVg] ug'{k5{ .
tkfO{n] cfkm\gf] ;'/Iff / ;+/If0fdf
s'g} sld / ;Demf}tf ug'{x'“b}g .
%= rflxg] ;fdfgx?sf]
Joj:yfkg ug'{xf];\
Ifltu|:t 3/leqaf6 rflxg] ;fdfg
;lsG5 eg] lgsfnf}“ . af6f]df
kg]{ afwf / c8\rgsf] ;/;kmfO{
/ Joj:yfkg u/f}“ / o;sf nfuL
rflxg] yk pks/0fsf] Joj:yf u/f}+ .
lsgsL o;sf nflu ;a} eGbf a9L
phf{sf] cfjZostf kg{ ;S5 .
9
o;n] tkfO{sf] 3/sf] k'g{:yfkgf jf
gljs/0fsf] k|of;nfO{ ;kmn agfpg
d4t ug]{5 .
^= em\ofn 9f]sf v'nf
/fVg'xf];\
em\ofn 9f]sf vf]Ngf;fy leqsf]
w'nf], w'jf“ jf jfkm aflx/ lgl:sG5 .
o;n] leq hDdf ePsf JofS6]l/of,
hLjf0f'x?nfO{ klg aflx/ kmfNg] sfd
ub{5 .
&= ljB'lto pks/0f aGb
ug'{xf];\
;/ ;kmfO{ z'? ug'{ cl3 d'Vo
switch aGb u/f}“ / c? Knudf
hf]8]sf pks/0fx?nfO{ klg cnu
u/f}+ . o;n] klg yk b'3{6gf x'gaf6
arfp“5 .
*= ;/;kmfO{ ;xfotfsf] nflu
;/sf/nfO{ u'xfg'{xf];\
slt ;/;kmfO{ cfkm\gf] -xfd|f]_ j;df
x'“b}g eGg] s'/f gla{;f}+ . 9n]sf 7"nf
?vx?, 3/ jf ;DktL Iflt / To;sf]
dd{tsf nflu cfjZos 7"nf / ef/L
pks/0fx?sf] nflu ;/sf/;+u
;xof]u dfUg ;lsG5 . tkfO“{ bdsn ,
k|x/L, ;fd'bflos ;]jf / c? cfjZos
ljefusf ;xof]u lng ;Sg'x'G5 .
(= ;/;kmfO{ cl3 tl:j/
lng'xf];\
w]/} dflg;x? of] ;'emfj ljdf
dfusf] nflu dfq xf] eGg] ;f]R5g
t/ jf:tjdf o;n] tkfO{nfO{ ePsf]
Iflt / tkfO{n] ug'{ePsf] of]ubfgsf]
;j]{If0f ;+rfng ubf{ k|i6 kf5{ . ¢
10
;f+lu|nf hg:jf:Yo
/f]u Ps hfgsf/L
vfg] gnLsf]
SofG;/
?8f= of]u]Gb| k|;fb l;+x
olt a|]i6 P08 afj]n SofG;/ k|f]h]S6 g]kfn
vfg] gnLsf] dflyNnf], dWo cyjf tNnf]
efudf ePsf] SofG;/nfO{ vfg] gnLsf] SofG;/
(Esophageal Cancer) elgG5 . ;a}eGbf a9L
SofG;/ x'g] vfg] gnLsf] dWo efu xf] . vfg]
gnLsf] h'g;'s} k/tdf SofG;/ x'g ;S5 .
;fdfGotM vfg] gnLsf] SofG;/ ;j{k|yd ghLs}sf]
lnDkm u|GyLx? (Lymph nodes) df ;b{5 .
o;sf] ;fy ;fy} Zjf;gnL (Trachea),
7"nf /QmgnLx? tyf ghLssf cGo
c+ux?df k|foM of] ;g]{ ub{5 . vfg]
gnLsf] SofG;/ kmf]S;f], sn]hf],
cfdfzo tyf cGo efux?df km}lng
;S5 . o;/L vfg] gnLsf] SofG;/nfO{
b'O{ efudf ljeflht ug{ ;lsG5 .
s= k|f/lDes vfg] glnsf] SofG;/
(Primary Esophageal Cancer) M
vfg] gnLsf] SofG;/ vfg] gnLaf6
z'? ePsf] SofG;/ xf] eGg] a'lemG5 .
v= cGt ;/]/ uPsf] vfg] gnLsf]
SofG;/ (Metastatic Esophageal
Cancer) M of] vfg] gnLsf]
SofG;/ z/L/sf] c? efudf ;/]/
uPsf] SofG;/ xf] / c? efudf
b]vfkg]{ of] SofG;/nfO{ ;]s]G8/L
6\o'd/ (Secondary Tumor) elgG5 .
o;}u/L z/L/sf] cGo efusf SofG;/
vfg] gnLdf ;/]/ cfPsf] v08df To;
efusf] SofG;/nfO{ z/L/sf] cGo efusf]
;]s]G8/L 6\o'd/ elgG5 .
vfg] gnLsf] ;fdfGo /rgf
(Anatomy)
vfg] gnL eg]sf] nueu !) OGr
nfdf] df+;k]zLo gnL xf] . of]
3f“6Lb]lv z'? eP/ 5ftLsf] clnslt
bflxg] efu x'“b} k]6df cfdfzo;+u
hf]l8G5 . vfg] glnsf] leqL k/t
k|foM 3f“6Lsf] sf]ifx?n] ag]sf] x'G5
t/ tNnf] efusf] ! OGr hlt efu
cfdfzosf] sf]ifx?n] ag]sf] x'G5 .
o;} sf/0fn] ubf{ gnLsf] tNnf]
efusf] SofG;/, dflyNnf] cyjf dWo
efusf]eGbf km/s vfnsf sf]ifx?
ePsf] x'gfn] pkrf/ k|lqmof klg
km/s x'ghfG5 . vfg] gnLsf] leqL
k/t rflx“ df+;k]zLx?n] ag]sf] x'gfn]
o;nfO{ df+;k]zLo gnL elgG5 .
kfrg gnLsf] cGo efu h:tf] vfg]
gnLdf aflx/L k/t rflx“ x'“b}g . vfg]
glnsf] SofG;/ dflyNnf] / dWo
efudf qmdzM ;a}eGbf sd / a9L
x'g] ub{5 .
sf/0fx?
vfg] gnLsf] SofG;/sf] vf;} sf/0f
;flat geP klg o;df SofG;/
u/fpg ;Sg] ljleGg ;+efJo tTjx?
eg] kfOPsf] 5 . dflyNnf] efusf]
sf]ifx?sf] SofG;/ a9L Plzog tyf
clk|msg k'?ifx?, w'd|kfg ;]jg
ug]{, /S;L lkpg] tyf cfly{s cj:yf
sdhf]/ ePsf dfG5]x?df kfOG5 .
klZrdL d'n'sx?df eg] nueu %)
k|ltzt hltdf vfg] gnLsf] tNnf]
efusf] sf]ifx?sf] SofG;/ kfOG5 .
o;/L vfg] gnLsf] SofG;/ pTkGg
u/fpg ;Sg] tTjx? lgDgfg';f/ 5g\ M
!= SofG;/sf] sf/s kbfy{ M
h:t} gfO6«f];fldG;n] vfg] gnLsf]
SofG;/ x'g] ;+efjgfnfO{ a9fp“b5 .
To;df klg gfO6«f];fldG;sf] c;/nfO{
/S;L, w'd|kfg tyf dfOsf]6lS;gn]
emg\ a9fp“b5 .
@= cfsfnflhof (Achalasia) M
of] eg]sf] gnLsf] vf; :yfo'sf]
cefjn] ubf{ vfg] gnLsf] ultdf
cj/f]w cfp“b5 / h;n] ubf{ vfg]
gnLaf6 vfg]s'/f /fd|/L cfdfzodf
hfg kfp“b}g . ToxL vfg] s'/fsf]
nfdf] ;do;Ddsf] k|efjn] ubf{ ;f]
gnLdf SofG;/ x'g] ;+efjgf a9]/
hfG5 . cf}iflw pkrf/ ul/Psf]
cfsfnflhofsf] lj/fdLdf eg] SofG;/
x'g] ;+efjgf /lx/xG5 .
#= a}/]6\; P;f]km]u;
(Barrett's Esophagus) M
of] eg]sf] vfg] gnLsf] leqL k/tsf]
sf]ifx?df c;fdfGo kl/jt{g cfpg'
xf] . h:t}, cfdfzosf] leqL k/tsf
sf]ifx? h:t} vfg] gnLdf x'g' /
;f+lu|nf hg:jf:Yo
of] cj:yfdf lj/fdLnfO{ vfgf pln{g'
eg] x'G5 . oL lj/fdLx?df ;fdfGo
hg;+Vofsf] bf“hf]df a9L vfg] gnLsf]
SofG;/ x'g] ub{5 .
$= vfg] gnLdf s8f vfnsf]
t/n kbfy{n] kf]Ng' M
o:tf kbfy{n] klg vfg] gnLsf]
SofG;/ pTkGg u/fpg ;S5 . t/
kf]n]sf] w]/} jif{kl5 dfq SofG;/ b]vf
kb{5 .
vfg] gnLdf hfnf], /QmcNktf /
lha|f]df 3fp cflb nIf0fx? ePsf]
cj:yfdf klg nueu !) k|ltzt
lj/fdLx?df vfg] gnL cyjf 3f“6Lsf]
SofG;/ x'g] ub{5 . o;sf] ;fy;fy}
dflyNnf] Zjf; k|0ffnLsf] SofG;/
ePsf] lj/fdLx?df ;+u;+u} cyjf
kl5 uP/ vfg] glnsf] SofG;/ x'g
;S5 .
vfg] gnLsf] SofG;/sf
nIf0fx?M
vf;df eGg] xf] eg] vfg] gnLsf]
;fgf] 6\o'd/n] ubf{ k|foM s'g} klg
nIf0fx? b]vf kb}{gg\ . ha 6\o'd/
a9\g yfNb5 k|foMh;f] lj/dLnfO{
-nueu ;t k|ltzt_ vfgf lgNg
ufx|f] x'G5 . vfgf vfg] gnL eP/
hf“bf lj/dLnfO{ kf]n]sf], c8\s]sf]
cyjf ;'lGgPsf] cg'ej x'g ;S5 .
vfgf lgNg] ;d:of cfpg] / x/fpg]
ub{5 . z'?df lj/fdLnfO{ 7f];
vfg]s'/f h:t} /f]6L, eft cyjf df;'
cflb vf“bf ufx|f] x'G5 / kfgL lkp“bf
b'Vg ;S5 . vfg] gnLsf] SofG;/sf]
csf]{ dxTjk"0f{ nIf0f xf] vfPsf] s'/f
pln{g' . vfg] gnLdf SofG;/sf]
cj/f]wn] ubf{ vfgf vfPkl5 vfPsf]
11
s'/f pln{P/ cfp“5 . jfGtfdf h:tf]
jfs jfs nfUg] tyf leqsf] s'/f
kmfNg hf]8 ug'{ kg]{ x'“b}g . t/ vfg]
gnLsf] SofG;/n] ckr, d'6' kf]Ng],
jfGtf tyf slxn] vfgf ;ls{g] cflb
x'g ;S5 . oL nIf0fx?n] ubf{ vfg]
gnLsf] SofG;/sf] lj/fdL b'Anfp“b}
hfG5 . vfg] gnLsf] SofG;/sf oL
d'Vo nIf0fx?, vfg lgNg ufx|f] x'g',
vfPsf] plN6g' / jhg 36\b} hfg'sf]
;fy} cGo nIf0fx?, h:t} :j/ 3f]qmf]
x'g', /ut vsf/df cyjf jfGtfdf
b]vfkg'{, 3f“6Ldf uf7f] b]vf kg'{ cyjf
b'Vg] x'g ;S5 .
lgbfg
c? h'g;'s} lj/fdLdf h:t}
pNn]v ul/Psf nIf0fx?sf] sf/0f
kQf nufpg lrlsT;sn] lj/fdLsf]
af/]df lj:t[t ;f]wk'5 ugf{sf ;fy}
;lj:tf/ hf“r ug'{k5{ . vfg] gnLsf]
SofG;/ lgbfgsf] nflu lgDg ljz]if
hf“rx? ug'{kb{5 .
s= a]l/do lgn]kl5sf]
PS;—/] M
o; hf“rsf] nflu lj/fdLn] a]l/od
ePsf] ;]tf] emf]n vfPkl5 nx/}
ljleGg PS;—/] lnOG5 . a]l/od
vfg] gnLsf] leqL k/tdf 6f“l;G5,
h;n] ubf{ SofG;/ cyjf cGo
sf/0fn] ubf{ c;fdfGo k/t jf
cj/f]w 5 eg] ;lhn} PS;—/] df
b]lvG5 . lrlsT;s4f/f ljz]if
PS;—/] d]lzgsf] dfWodaf6 a]l/od
vfg] gnLaf6 cfdfzodf uPsf] x]g{
;lsG5 / cfjZos 7fp“sf] PS;—/]
lnOG5 .
12
;f+lu|nf hg:jf:Yo
v= P;f]km]uf]:sf]kL
(Esophaguscopy) M
o; hf“rnfO{ OG8f]:sf]kL klg
elgG5, h;df lrlsT;s4f/f Pp6f
k|sfzo'Qm dl;gf] 6\o'a lj/fdLsf] d'v
tyf 3f“6L x'“b} vfg] gnL;Dd k7fP/
vfg] gnLsf] k"0f{ hf“r ul/G5 . o;/L
hf“r ubf{ c;fdfGo cyjf z+sf:kb
7f“p b]lvof] eg] 8fS6/n] tGt'sf]
;fgf] 6'qmf lems]/ hf“Rg k7fp“5g\ .
slxn] sf“xL eg] vfg] gnLsf] leqL
txaf6 ljz]if lsl;dsf] a|; u/]/
sf]ifx? hf“Rg k7fOG5 .
u= sf]if tyf tGt'sf] hf“r M
eGg] yfxf x'G5 .
vfg] gnLaf6 lelsPsf] sf]if tyf
tGt'sf] hf“rdf SofG;/ sf]ifx? km]nf
k/]sf] v08df ljz]if1 lrlsT;sn]
s'g lsl;dsf] SofG;/ xf] eGg]
7Dofp“5 . k|foM h;f] vfg] gnLsf]
dWo tyf dflyNnf] efudf dflyNnf]
efusf] leqL k/tsf] sf]ifx?af6 z'?
x'g] SofG;/ x'G5 eg] tNnf] efudf
cfdfzosf] leqL txsf sf]ifx?af6
z'? x'g] SofG;/ x'G5 .
lrlsG;sn] k|foM o:tf] s];df
sDKo"6/o'Qm ljz]if lsl;dsf] PS;—/]
k]6sf] dflyNnf] efu tyf 5ftLsf]
;L=6L= :Sofg u5{g\ . xfn xfd|f] b]zdf
sf7df8f}“ / w/fgdf dfq o:tf] ;'ljwf
pknAw 5 / of] PS;—/] cln dx+uf]
klg 5 . slxn]sfxL“ eg] csf]{ ljz]if
vfnsf] PS;—/], Pd cf/ cfO{, klg
ug'{kg]{ x'G5 .
3= cGo M
vfg] gnLsf] SofG;/ k|dfl0ft eO{
;s]kl5 lrlsT;s4f/f /f]usf]
cj:yf cyjf slt;Dd km}lnPsf]
5 eGg] kQf nufOG5 . lsgeg]
lj/fdLsf] pkrf/ljlw log} s'/fx?df
e/ kb{5 . SofG;/sf] cj:yf kQf
nufpg ljleGg hf“rx? ug'{ kb{5 .
h:t}M lj/fdLsf] zf/Ll/s hf“rdf klg
vf; u/L 3f“6L / 5ftLsf] hf“r,
/utsf] hf“r, s]xL yk PS;—/] /
ljz]if lsl;dsf hf“rx? klg ug'{ kg]{
x'G5 . oL hf“rx?af6 SofG;/ vfg]
glnd} l;ldt 5 jf cGt ;/]sf] 5
lrlsT;sn] vfg] gnLsf] glhssf]
cGo c+ux?sf] ljz]if hf“r ub{5 .
h:t}
3f“6Lsf]
:j/
oGqsf]
OG8f]:sf]lks hf“r tyf Zjf; glnsf]
k/LIf0f ul/G5 . olb vfg] glnsf]
glhssf] lnDkm u|GyL ;'lgPsf] 5 eg]
tL u|GyL klg lems]/ hf“Rg k7fOG5 .
o;/L vfg] gnLsf] SofG;/ cGt
km}lnPsf] 5, 5}g eGg] kQf nufOG5 .
pkrf/
vfg] gnLsf] pkrf/ ljleGg tTjx?df
e/ kb{5 . tL tTjx? dWo] vfg]
gnLsf] s'g 7f“p ljz]ifsf] SofG;/,
6\o'd/sf] dfk / lkmlhPsf] If]q tyf
SofG;/ sf]ifx?sf] lsl;d cflb
dxTjk"0f{ x'g\ . lrlsT;sn] lj/fdLsf]
pd]/ tyf :jf:Yosf] cj:yfnfO{
klg Wofgdf /fv]/ k|To]s JolQmsf]
cfjZostf cg';f/ pkrf/ of]hgf
ug'{ kb{5 .
lrlsT;sn] lj/fdLsf] vfg] gnLsf]
SofG;/sf] pkrf/ u/L /fVg] :jf:Yo
;+:yfsf] lrlsT;s ljz]if1;+u s];
-36gf_ af/] cfjZos ;/;Nnfx ug'{
kb{5 . w]/}h;f] lj/fdL cfkm\gf] /f]uaf/]
/ pkrf/ ljlwx? af/] hfGg pT;'s
x'g' :jefljs g} xf] . lj/fdLn] ljleGg
k|Zgx? p7fpg ;S5g\ / lrlsT;sn]
tL k|Zgx?sf hjfkm lbG5g\ . vfg]
gnLsf] SofG;/sf] pkrf/ljlwx?sf]
af/] lg0f{o lng' eg]sf] Pp6f hl6n
;d:of xf] . pkrf/ z'? ug'{ eGbf
klxn] lj/fdLn] rfx]sf] v08df cfkm\gf]
/f]usf] lgbfg tyf pkrf/ljlwaf/]
csf]{ ljz]if1 lrlsT;;sf] /fo lng'
/fd|f] x'G5 .
pkrf/ ljlwx? M
ha;Dd vfg] gnLsf] SofG;/sf]
lgbfg Psbd} z'?sf] cj:yfdf
cyf{t SofG;/ a9\g z'? ug{ eGbf
klxn] ug{ ;lsPg eg] vfg] gnLsf]
SofG;/nfO{ lgsf] kfg{ ;lsb}“g .
b'ef{Uojz o; SofG;/sf] z'?sf]
cj:yfdf eg] s]xL dfd'nL nIf0fx?
dfq b]vf kb{5 / of] /f]u km}ln;s]kl5
k|foM lgbfg x'G5 . x'g t km}ln;s]sf]
vfg] gnLsf] SofG;/sf] pkrf/ gx'g]
xf]Og, o;sf nIf0fx?nfO{ sd ug{
;lsG5 . af“r'~h]n ;lhnf]sf] nflu
ljleGg pkrf/ljlwx? 5g\ . xfd|f]
c:ktfnx?df eg] vfg] gnLsf]
SofG;/sf lj/fdLx? k|foM h;f] /f]u
km}ln;s]sf] cj:yfdf cfpg] ub{5g\
/ xfd|f] h:tf] l;ldt ;fwg ePsf]
c:ktfndf pkrf/ ljlwx?af6 yf]/}
dfqfdf dfq lj/fdLx?nfO{ nfe x'G5 .
k|foMh;f] vfg] gnLsf] SofG;/sf]
pkrf/ lgDg tLg ljlwx?4f/f ul/G5 .
!= zNolqmof
@= /]l8of]y]/fkL
#= s]df]y]/fkL
lj/fdLx?sf] cfjZostf cg';f/ s]xL
lrlsT;s4f/f s'g} Ps ljlw cyjf
PseGbf a9L ljlw k|of]u ul/G5 . s'g}
a]nf eg] lj/fdLnfO{ SofG;/ pkrf/
ljlwx? pknAw ePsf] ;+:yf k7fOG5
hxf“ ljz]if1x?sf] 6f]nLn] lj/fdLsf]
pkrf/sf] ;d"xut ?kdf of]hgf
agfO{ sfo{ ub{5 . SofG;/ /f]usf]
d]l8sn ;d"xdf kfrg—k|0ffnLsf]
ljz]if1 lrlsT;s, ;h{g, SofG;/
/f]u ljz]if1, kl/rfl/sf -g;{_
8fOl6l;og tyf ;fdflhs sfo{stf{
cflb kb{5g\ .
zNolqmof
vfg] gnLsf] SofG;/sf] pkrf/
of]hgfdf zNolqmof k|foM ;fd]n
/x]sf] kfOG5 . w]/}h;f] lj/fdLdf
;f+lu|nf hg:jf:Yo
vfg] gnLsf] w]/} h;f] efu lgsfNg]
zNolqmof
ul/G5,
h;nfO{
P;f]km]h]S6f]dL elgG5 . vf; u/]/ o;
zNolqmofdf ;h{g4f/f 6\o'd/ ePsf]
vfg] gnLsf] efu, ghLssf] lnDkm
u|GyLx? / ghLs}sf cGo tGt'x?
lemlsG5 . k|foM vfg] gnLsf] af“sL
efunfO{ cfdfzo;“u hf]8\g ;lsG5 .
s]xL cj:yfdf dfq} ;h{g4f/f vfg]
gnLsf] 7fp“df kfrg gnLsf] cGo efu
h:t} 7"nf] cfGb|f NofP/ cfdfzo;+u
hf]l8G5 .
olb 6\o'd/n] vfg] gnLnfO{ cj/f]w
u/]sf] 5 / To;nfO{ lgsfNg ;ls+b}g
eg] csf]{ gof“ gnL agfO{ cfdfzo;+u
hf]l8G5 . s]xL lj/fdLdf eg] vfg]
gnLsf] ;f“3'/f] efunfO{ km/flsnf]
kfl/G5 . s'g} a]nf 6\o'd/ a9\b}
uof] eg] of] ljlwnfO{ k'gM k|of]u
ug'{ kg]{ x'G5 . slxn] sfxL+ eg]
lrlsT;s4f/f vfg] gnLdf 6\o'a
/flvG5 h;n] ubf{ vfg] gnLsf]
KjfnnfO{ v'nf kfb{5 . xfn cfP/
s]xL lrlsT;sx?n] n]h/sf] k|of]u
u/]/ SofG;/ ePsf tGt'x?nfO{ gi6
kfg'{sf ;fy} cj/f]wnfO{ x6fp“b5 .
s]xL lj/fdLdf eg] zNolqmof ug'{
eGbf klxn] cGo pkrf/ljlwsf] k|of]u
ul/G5 .
/]l8of]y]/fkL
o;
pkrf/ljlwdf
zlQmzfnL
ljsL/0fn] SofG;/ sf]ifx?nfO{ gi6
kfg'{sf] ;fy} a9\gaf6 /f]S5 . of] ljlw
klg zNolqmof h:t} l;ldt 7fp“sf]
nflu ul/g] vfg] gnLsf] SofG;/sf]
pkrf/ljlw xf] . /]l8of]y]/fkLsf] k|of]u
zNolqmofeGbf klxnf 6\o'd/nfO{ ;fgf]
kfg{ cyjf zNolqmof kl5 af“sL
/x]sf] SofG;/ sf]ifx?nfO{ gi6
13
kfg{ kfg{ k|of]u ul/G5 . slxn]
sfxL+ /]l8of]y]/fkLsf] k|of]u 6\o'd/sf]
zNolqmof ug{ d'lZsn x'g] 7fp“df
5 eg] zNolqmofsf] ;§fdf k|of]u
ug{ ;lsG5 . s]xL s]; -36gf_ df
eg] :jf:Yosf] c? sf/0fn] ubf{
zNolqmof4f/f k'/f 6\o'd/ kmfNg
g;lsg] cyjf /]l8of]y]/fkL4f/f k"0f{
?kdf gi6 kfg{ g;lsg] s];x?df
klg /]l8of]y]/fkLn] b'vfO{ sd ug{ /
lgNg ;lhnf] kfg{ ;lsG5 .
vfg] gnLsf] SofG;/df k|foM
/]l8of]y]/fkL z/L/ aflx/sf] d]lzg4f/f
ul/G5 . s'g} s'g} lj/fdLdf eg] 6\o'd/
leq ljsL/0fo'Qm, kbfy{ /fv]/ o;
ljlwsf] k|of]u ul/G5 . z/L/ aflx/sf]
d]lzgaf6 lbOg] /]l8of]y]/fkL k|foM
14
;f+lu|nf hg:jf:Yo
xKtfsf] % lbg u/L sof}“ xKtf;Dd
lbOG5 . o:tf] la/fdLnfO{ c:ktfndf
egf{ x'g'kb}{g t/ pkrf/sf] nflu
c:ktfn hfg' k5{ . 6\o'd/leq /fVg]
pkrf/ljlwsf] nflu eg] lj/fdL s]xL
;dosf] nflu c:ktfndf egf{ x'g'
k5{ .
s]df]y]/fkL
SofG;/ sf]ifgfzs cf}iflwx?sf]
k|of]u u/]/ ul/g] pkrf/ljlwnfO{
s]df]y]/fkL elGg5 . o; ljlwdf Ps
jf PseGbf a9L vfnsf cf}iflwx?sf]
k|of]u ul/G5 . /]l8of]y]/fkL h:t} vfg]
gnLsf] SofG;/df s]df]y]/fdL dfq},
cyjf zNolqmofeGbf klxn] 6\o'd/sf]
dfk ;fgf] kfg{ /]l8of]y]/flk;+u cyjf
zNolqmofkl5 af“sL /x]sf SofG;/
sf]ifx? gi6 ug{ o; ljlwsf] k|of]u
ul/G5 . slxn] sfxL+ eg] ck/]zg
ug{ gldNg] cyjf zNolqmof jf
/]l8of]y]/fkLsf] pkrf/kl5 k'gM
knfPsf] SofG;/df klg o; ljlwsf]
k|of]u ul/G5 .
vfg] gnLsf] SofG;/sf] nflu
k|of]u ul/g] cf}iflwx? k|foM g;f
cyjf df+;k]zLdf ;'O{4f/f lbOG5 /
s]xL vfg] cf}iflw klg x'G5 . t;y{
s]df]y]/fkLnfO{ l;ldt 7fp“sf] pkrf/
geP/ /utsf] dfWod eP/ ul/g]
;Dk"0f{ c+u k|To+usf] pkrf/ elgG5 .
s]df]y]/fkL s]xL lbg la/fP/ ljleGg
v08 kf/L lbOG5 . o;/L cf}iflw
ug{df s]xL lbg la/fpg'sf] cj:yfnfO{
k'gM:j:ytf elgG5 . o; pkrf/
ljlwsf] k|of]u cf]=lk=l8= lrlsT;;sf]
lSnlgs cyjf 3/d} klg ug{ ;lsG5 .
t/ cf}iflwsf] lsl;d, la/fdLsf]
cj:yf x]/]/ sf]xL c:ktfndf a:g' kg]{
x'g ;S5 . s]xL hf“rx? s]df]y]/fkL z'?
ug'{ eGbf klxn] / kl5 ug'{ kg]{ x'G5g\ .
o;/L pkrf/sf] sf]z{ k"/f eP klg
lj/fdLn] a]nf a]nfdf lrlsT;s;+u
hrfpg' kb{5 .
pkrf/sf g/fd|f c;/x?
k|foM h;f] SofG;/sf pkrf/ljlwx?
s8f vfnsf x'G5g\ . SofG;/
sf]ifx?nfO{ dfq kmfNg] cyjf gi6
ug]{ sfo{ eg] ax't} d'l:sn x'G5 .
h;n] ubf{ oL pkrf/ljlwx?n] :j:y
sf]ifx?nfO{ klg gf]S;fg k'¥ofp“5 /
g/fd|f c;/x? b]vf kb{5g\ .
oL g/fd|f c;/x? pkrf/ljlw
x]/L km/s km/s x'G5g\ . cyf{t\
pkrf/ljlwsf] lsl;d / slt xb;Dd
pkrf/ ul/Psf] eGg]df oL c;/x?
e/ kb{5g\ / k|To]s JolQmsf] klg
pkrf/ljlw ;xg] cyjf k|ltlqmof
5'§f 5'§} x'G5 . t;y{ lrlsT;s4f/f
oL pkrf/sf g/fd|f c;/x?nfO{
;Sbf] sd ug]{ u/L x]l//x]sf] x'gfn]
s]xL g/fd|f ;d:ofx? pTkGg
ePsf] v08df To;sf] ;xL ;dfwfg
ul/G5 . vfg] gnLsf] SofG;/sf]
pkrf/sf g/fd|f c;/x? lgDgfg';f/
x'g ;Sb5g\ .
s= zNolqmof M vfg] gnLsf]
SofG;/sf] nflu ul/g] zNolqmof
Pp6f 7"nf] vfnsf] zNolqmof xf] .
To;df klg vfgf lgNg g;Sg]
lj/fdLdf eg] emg\ w]/} lbg;Dd
kf}li6s kbfy{ gzfaf6 lbg' kb{5 .
zNolqmofeGbf s]xL lbg klxn] / kl5
klg ;+qmd0f /f]Sg g;faf6 g} kf}li6s
kbfy{ ePsf] ;]nfOg kfgL cf}iflw lbg'
kb{5 . kmf]S;f] ;kmf /fVg lj/fdLn]
ljz]iftM vf]Sg] / ;f; lng] Jofofd
ug'{ kb{5 . b'vfO{ cyjf c;lhnf]kgf
eg] cf}iflwn] lgsf] kfg{ ;lsG5 .
t;y{ lj/fdLn] cfkm\gf] b'vfO{af/]
lrlsT;snfO{ eGg' kb{5 .
v= /]l8of]y]/fkL M /]l8of]y]/fkL
kfO/x]sf lj/fdLx? k|foM yfSg]
ub{5g\ . o;}n] oL lj/fdLx?nfO{
cf/fdsf] w]/} g} cfjZostf x'G5 .
;]s]sf] 7fp“sf] 5fnf k|foM /ftf] cyjf
;'Vvf eP/ cfp“5 . To:tf] efu xfjf
nfUg] agfpg' / 3fdaf6 arfpg' kb{5
/ lj/fdLn] v;|f] vfnsf] n'uf nufpg'
x'“b}g . lrlsT;ssf] ;Nnfx ljgf
lj/fdLn] s'g} lsl;dsf] lqmd cyjf
nf];g nfpg x'“b}g . 3f“6L / 5ftLsf]
/]l8of]y/fkLn] 3f“6L ;'Vvf cyjf
b'Vg] jf ;'Vvf vf]sL nfUg ;S5 .
k|z:t dfqfdf emf]n kbfy{ vfgfn]
kmfObf ub{5 / slxn]sfxL“ vf]sLsf]
nflu cf}iflw vf“bf klg x'G5 . olb
kf]Ng] cyjf b'vfO{n] ubf{ lgNg ufx|f]
eof] eg] lrlsT;n] ;lhnf] kfg{ vfg'
cufl8 cf}iflwsf] k|of]u ug{ lbG5 .
s]xL lj/fdLdf eg] k]6 kf]Nbf k|of]u
x'g] cf}iflwn] klg kmfObf ub{5 .
u= s]df]y]/fkL M s]df]y]/fkLsf]
g/fd|f] c;/ eg] s'g lsl;dsf]
cf}iflw k|of]u ul/Psf] 5 eGg]df e/
kb{5 . ;fwf/0ftof SofG;/ lj?4sf
cf}iflwn] l56f] a9\g] SofG;/ sf]ifx?
tyf ;fdfGo sf]ifx? h:t} /Qm
sf]ifx?, skfnsf] h/fsf sf]ifx?
tyf kfrg gnLsf] leqL k/tsf
sf]ifx? cflbnfO{ k|efj kfb{5 . o;/L
/Qmsf]ifx? h;sf] d'Vo sfo{ ;+qmd0f
/f]Sg], /ut hDg d4t ug]{ tyf
z/L/sf] ljleGg efux?df clS;hg
k'¥ofpg] cflbnfO{ s]df]y]/fkLn] c;/
kf¥of] eg] ;+qmd0f /f]Sg] zlQm sd
x'g], /Qm>fj cyjf /ut 5fnf d'lg
hDdf x'g] cyjf sdhf]/L cg'ej x'g]
x'G5 . s]df]y]/fkLn] skfn emg]{ tyf
vfgfdf c?rL x'g], d'vdf vl6/f
cfpg], jfs jfs nfUg] jf jfGtf x'g
;S5 . t/ oL c;/x? cf}filw k|of]u
ug{ 5f8]kl5 lj:tf/} sd eP/ hfG5 .
3= cGo M vfg] gnLsf] SofG;/sf
lj/fdLsf] jhg 36\b} hfg] ePsf]
x'gfn] lgoldt ?kdf jhg dfkg
ug'{ kb{5 . lgNg ufx|f] tyf cK7\of/f]
x'g] / yfSgfn] vfg c?lr x'g]
ub{5 . t/ klg o:tf lj/fdLx?df
/fd|f] kf]if0f clt g} dxTjk"0f{ x'G5 .
lsgeg] kf}li6s kbfy{ ;]jg ug]{
lj/fdLx? cfkm"nfO{ ;Grf] ePsf], an
kg]{ tyf pkrf/sf g/fd|f c;/x?
;xg ug{ ;Sb5g\ . oL lj/fdLx?nfO{
yf]/} vfgf t/ w]/} rf]6L vfgnfO{
k|f]T;flxt ug'{ kb{5 . o;sf] ;fy
;fy} vfgf vfPkl5 s]xL a]/ ;Lwf
eP/ a:g] cyjf jfGtf /f]Sg] cf}iflwsf]
;]jg ug'{ kb{5 . 7f]; vfg]s'/f lgNg
ufx|f] eof] eg] g/d vfg]s'/f cyjf
kf}li6s kbfy{o'Qm emf]n vfg]s'/f vfP
;f+lu|nf hg:jf:Yo
x'G5 . o:tf] a]nfdf lrlsT;s, g;{
cyjf 8fOl6l;ogsf] ;Nnfx w]/} g}
dxTjk"0f{ x'G5 .
/f]syfd
vfg] gnLsf] SofG;/sf] vf;} sf/0f
;fljt eO;s]sf] 5}g . t/ o;
sfo{df cg';Gwfgstf{x? tlNng
ePsf] kfOG5 . sf/0f yfxf ePdf
/f]syfdsf] klg 7f]; pkfo klxnfpg
;lsG5 . vfg] gnLsf] SofG;/ klg
cGo SofG;/ h:t} lgDg b'O{ tl/sfn]
/f]syfd ug{ ;lsG5 .
!= k|f/lDes /f]syfd M vfg]
gnLsf] SofG;/sf] k|f/lDes /f]syfd
eGgfn] o;sf vf; sf/s tTjx?nfO{
x6fpg] cyjf sd ug]{ eGg] a'lemG5 .
ljZjd} ljleGg 7fp“x?df 7"nf]
hg;+Vofdf cfwfl/t cWoogaf6
cg';Gwfgstf{n] vfg] gnLsf] SofG;/
pTkGg ug{ ;Sg] ljleGg tTjx?
kQfnufPsf 5g\ . tL a9L ;+efjgf
ePsf hg;d'bfonfO{ nlIft kf/L
;a}n] SofG;/ ;DalGw lzIff4f/f tL
tTjx?nfO{ x6fpg cyjf sd ug{
;lsG5 . pbfx/0fsf] nflu vfg]
gnLsf] SofG;/ d'VotM $% jif{eGbf
a9L pd]/df b]lvG5 eg] :jf:gL dfG5]
eGbf nueu b'u'gf hlt a9L k'?ifdf
kfOG5 .
w'd|kfg tyf a9L /S;L vfg] dfG5]df
vfg] gnLsf] Sofg;/sf] ;+efjgf
a9]/ hfG5 . oL b'Oj6} ntdf dfG5]df
slxn] klg /S;L gvfPsf] cyjf r'/f]6
gvfg]sf] eGbf a9L SofG;/ ePsf]
b]lvG5 . /S;L lkpg 5f8]/ cyjf
sd u/]/ vfg] gnLsf] SofG;/sf]
;+efjgfaf6 aRg ;lsG5 . w'd|kfg
15
ug{ 5f]8]/ klg vfg] gnLsf] SofG;/
nufot cGo SofG;/x? h:t} kmf]S;f],
d'v, 3f“6L, :j/ oGq, d'qy}nL /
k}glqmofh cflbsf] ;+efjgfnfO{ sd
ug{ ;lsG5 . w'd|kfgn] ubf{ Pp6f
SofG;/ eof] eg] Tof] dfG5]df csf]{
vfnsf] SofG;/ x'g] ;+efjgf a9L
x'G5 . k|foM h;f] lrlsT;sn] vfg]
gnLsf] SofG;/sf] lj/fdLnfO{ gof“
SofG;/af6 tyf vf]sL nfUgaf6 aRg
w'd|kfg 5f8\g nufp“5g\ .
vfg] gnLsf] SofG;/ x'g] csf]{
Pp6f dxTjk"0f{ tTj nfdf] ;do;Dd
s]xL s'/fn] lahfO /fVof] eg] h:t}
cfdfzoaf6 kms]{sf] kbfy{nfO{ dflgG5 .
o;} sf/0fn] ubf{ vfg] gnLsf sf]ifx?
cfdfzosf sf]ifx? h:tf] x'g' xf] /
o:tf] kl/jt{gn] SofG;/ x'g] ;+efjgf
a9fp“5 . cGo s8f vfnsf] kbfy{n]
vfg] gnLnfO{ xfgL k'¥ofpgfn] klg
SofG;/ x'g] ;+efjgf x'G5 . g/fd|f]
kf]if0fn] klg vfg] gnLsf] SofG;/ x'g]
;+efjgf x'G5 . t;y{ vfg] gnLsf]
SofG;/sf] ;+efjgf ePsf lj/fdLx?n]
lrlsT;s;+u ;/;Nnfx ug'{ kb{5 .
lrlsT;sn] SofG;/ u/fpg ;Sg]
tTjx? x6fpg]af/] 1fg lbG5g\ .
@= bf];|f] r/0fsf] /f]syfd M
bf];|f] r/0fsf] /f]syfdsf d'Vo p4]Zo
SofG;/nfO{ z'?sf] cj:yfdf klxrfg
u/L plrt pkrf/ ljlw4f/f lgsf] kfg'{
xf], h'g ls vfg] gnLsf] SofG;/df
k|foM ufx|f] x'G5 . c? SofG;/df
h:t} bf];|f] r/0fsf] /f]syfddf k|d'v
sbdx?df klxrfg / plrt pkrf/
kb{5g\ . ¢
16
;f+lu|nf hg:jf:Yo
dlxnf :jf:Yo
cGtM
uef{zosf] ;"hg
?
lgZdf ah|frfo{ (Pharmacist)
Endometritis -cGtM
uef{zosf] ;"hg_ eg]/
a'em\g ;lsG5 . o;
Endometritis nfO{
uef{j:yf ;DalGwt
/ c;DalGwt u/]/
b'O{ efudf ljefhg
ug{ ;lsG5 . olb
uef{j:yf;+u of]
;DalGwt 5}g eg]
o;nfO{ Pelvic
Inflammatory
Disease ->f]l0f ;"hg_
elgG5 . >f]l0f ;"hg M
of] cj:yfdf uef{zo,
c+08fzox?df c;/
ug{ ;Sb5 h;n] ubf{
dlxnfx?df afemf]kgsf]
;d:of b]lvG5 .
x'+bf k|fo dlxnfx?df
xNsf Hj/f] cfpg] tNnf] k]6 b'Vg]
h:tf ;d:ofx? b]vf kb{5g\ .
Endometritis sf] ;d:of ljz]if
u/]/ zNolqmof4f/f aRrf hGdfPsf
dlxnfx?df b]lvg] ePsf] x'gfn]
c:ktfndf egf{ u/]/ o;sf] pkrf/
ug{ ;lsG5 . ;fy} ;fdfGo ?kn] aRrf
hGdfPsf dlxnfx?df of] ;d:of
b]vf k/]df Antibiotics -k|lthLjf0f'
cf}iflw_ sf] k|of]u ug]{ ub{5 .
Endometritis
g]kfn h:tf] ljsf;f]Gd'v b]zdf hxf“
k|fo dlxnfx? c1fgtfsf] sf/0fn]
cfkm\gf ;d:ofx? JoQm ub}{gg\ . oxf“
:qL /f]u ;DalGw hgr]tgf hufpg
cTofjZos x'g hfG5 . h;sf] nfuL
k|of; xfd|f] :t/af6 x'g' cToGt
h?/L 5 .
Endometritis
sf nIf0fx?
— k]6df c;lhnf]kg / xfjf el/Psf]
h:tf] dxz'; x'g' / ;'lGgg'
—of]lgaf6 c;fdfGo ?kdf /ut aUg'
—c;fdfGo of]lg ;|fj x'g'
—lbzf a:bf c;xhtf x'g'
—Hj/f] cfpg'
—lhp yfs]sf] h:tf] dxz'; x'g'
—tNnf] k]6 b'Vg'
;f+lu|nf hg:jf:Yo
17
lrlsT;ssf] k/fdz{ lnP/ pkrf/
Antibiotics,
u/fpg' kg]{ k/LIf0fx?
lrlsT;sn] >f]l0f / tNnf] k]6sf]
hf“r u/]/ k]6df s'g 7f“pdf c;xhtf
5 eGg] s'/fsf] kQf nufp“b5 / ;fy}
uef{zo sf] k/LIf0f ug]{ ub{5 /
lgDg lnlvt k/LIf0fx? lrlsT;ssf]
k/fdz{ cg'?k ug{ h?/L x'G5 .
—uef{zosf] tNnf] efudf
Chlamydia, gonorrhea / c?
s'g} hLjf0f' 5 5}g eg]/ Nofadf
k/LIf0f u/fpg'
—cGtM uef{zosf] afof]K;L
u/fpg] h;df cGtM uef{zoaf6
sf]lifsf lnP/ To;df ca'4{
sf]ifx? (Cancerous cells) 5g\ ls
5}g eg]/ k/LIf0f ug]{ ub{5 .
— ESR (Erythrocyte sedimentation
rate) of] /utaf6 hf“r ug]{
k|lqmof xf] . h;df Red blood
cells -/ftf] /Qm sf]lzsf_ ! 306fdf
slt lylu|G5 eg]/ k/LIf0f ul/G5 .
olb z/L/sf] c;fdfGo cj:yf ePsf] v08df tf]lsPsf] eGbf
o:sf] dfqf al9 x'G5 .
— Laproscopy -n}k|f]:sf]kL_ M
of] zNolqmofsf] Ps k|lqmof xf] .
h;df z/L/df ;fgf] Kjfn agfP/
lrlsT;4f/f k]6 / >f]l0fsf] hf“r
ul/G5 .
— WBC -;]tf] /Qm sf]lzsf_ sf]
k/LIf0f o;sf] dfqfn] z/L/df /f]u
;+u n8\g ;Sg] Ifdtfsf] hf“r
ul/G5 .
— Wet prep M of] of]lg >fjsf]
k/LIf0f ug]{ Pp6f t/Lsf xf] .
cGtM uef{zosf]
;d:ofnfO{ /f]Sg / pkrf/
ug{sf] nfuL k|of]u ul/G5 /
lrlsT;sn] of] cf}iflw ;Dk"0f{
hf“r kl5 dfq lbg] ub{5g\ .
nIf0fx? sd eO ;s]sf]
v08df klg of] cf}iflwsf] k'/f
dfqfdf k|of]u ug'{ cToGt h?/L
x'G5 . k"/f dfqf vfO{ ;s]kl5
km]/L lrlsT;ssf] k/fdz{ lng'
klg plQs} cfjZos x'G5 .
olb cGtM uef{zosf] ;d:of
;fx|} hl6n eO;s]sf] v08df
c:ktfndf egf{ u/]/ pkrf/
u/fpg' kg]{ klg x'g ;Sb5 .
olb of] zf/Ll/s ;Dks{af6
klg alNemg] cj:yf b]lvPsf]
v08df :qL Pj+ k'?if b'j}sf]
pkrf/ ug'{ kg]{ x'G5 .
;dodf pkrf/ gubf{
x'g;Sg] hl6ntfx?
—af“emf]kg
—>f]l0fdf ;"hg x'g'
(Pelvic Peritonitis)
—>f]l0f / uef{zodf kmf]8f
(abscess) b]lvg'
—;]lK6;Lldof (Septicemia) of]
/utdf hLjf0f' b]vf kg]{ eofjx
l:ylt xf] h;n] z/L/sf ljleGg
efu h:t} M kmf]S;f], k]6, d"qgnLdf
c;/ ub{5 .
—;]lK6s ;bdf (Septic Shock) M
of] l:ylt k|fo h;f] septic
infection sf] ;dodf pkrf/
gu{gfn] x'G5 . h;n] ubf{ d[To' /
z/L/sf] s'g} c+un] sfd gug]{
h:tf eofjx l:yltx? x'g] ub{5 .
/f]syfd
—cGt uef{zosf] ;d:ofaf6 aRg
dfyL pNn]vLt s'g} nIf0f b]vf
k/]df t'?Gt lrlsT;s sxf hfg'
kg]{ x'G5 .
— ;'/lIft of}g ;Dks{ /fVg clgjfo{
x'G5 . aRrf hGdfp“bf s'zn
:jf:YosdL{sf] xftaf6 ;'/lIft
k|lqmof ckgfP/ hGdfpg'
k5{ . ue{kft / ue{lg/f]wsf]
k|lqmof ckgfpg' k/]df klg bIf
:jf:YosdL{s} xftaf6 u/fpg'
kb{5 .
—nIf0f b]vf kbf{ lrlsT;sn]
lbPsf] cf}iflw dfqf / k"/f ljlw
ckgfP/ ;]jg ug'{kb{5 . ¢
18
;f+lu|nf hg:jf:Yo
k|wfg ;Dkfbsaf6
s] xf] t af:tjdf
Uof:6«fOl6; <
?
lgZdf ah|frfo{ (Pharmacist)
g]kfndf ;/;kmfO{ / :j:Yo cfxf/sf]
sdLsf] sf/0fn] ubf{ ljleGg k]6sf
;d:ofx? x'g] ub{5g\ . t/ xfdL
g]kfnLx? k]6sf] ;d:ofnfO{ Uofl:6«s
eG5f}+ . sof}“ k6s t xfdL cfkm}
klg o;sf] pkrf/ ub{5f}“ . o;/L
lrlsT;ssf] k/fdz{ ljgf :j]lR5s
pkrf/n] w]/} g]kfnLx?df k]6sf
ljleGg ;d:of b]vf k/]sf 5g\ . To;}n]
o; hg:jf:Yodf Uof:6«fOl6; s] xf]
eGg] ljifodf cfh xfdL o; ;+fu|Lnfsf
;d:t kf7sj[Gbsf] Wofgfsif{0f
ub{5f}+ .
Uof:6«fOl6; s] xf] <
Uof:6«fOl6; jf:tljs ?kdf k]6sf]
txdf 3fp jf ;'hg x'g uP/ b]vf
kg]{ ;d:of xf] . of] ljz]if u/]/ k]6sf]
/IffTds Zn]ifdf (Mucosa) df ljleGg
sf/0f4f/f cf3ft x'g uP/ b]lvG5 .
Uof:6«fOl6; nfO{ ltj| (acute) /
hL0f{ (Chronic) eg]/ b'O{ efudf
ljefhg ug{ ;lsG5 . b'j}sf] nIf0f
p:t} eP klg ltj| ?kdf ;'? ePsf]
Uof:6«fOl6;n] hL0f{ ?k ln“b} uP/
cGo hl6ntf klg lgDTofp“b5 .
Uof:6«fOl6; sf] k|d'v
sf/0f
Uof:6«fOl6; sf] k|d'v sf/0f eg]sf]
helicobacter pylori xf] . of] hLjf0f'
k]6sf] Zn]ifdf c;/ u/]/ k]6sf] o;
/IffTds txdf If]b u/L ljleGg ;d:of
lgDTofp“b5 . o;n] k]6sf] txnfO{
gf]S;fgL u/L k]6df 3fp / ;'hg
;d]t agfp“b5 . Uof:6«fOl6; sf]
cGo k|d'v sf/s tTj eg]sf] b'vfO{
/ ;'hg sd u/fpg] cf}iflw (NSAIDS)
sf] cToflws k|of]u klg xf] .
Uof:6«fOl6; x'g'df jf ;d:ofnfO{
aNemfpgdf lgDg lnlvt sf/s
tTjx?n] klg k|d'v e"ldsf lgefp“b5 .
— AofS6]l/of, efO/; / k/lhjLsf]
;+qmd0f
— cocaine h:tf nfu'kbfy{sf] ;]jg
— hf“8 /S;Lsf] cTolws ;]jg
— lkQsf] ;d:of
— km+u;sf] ;+qmd0f
— PnhL{
— cTolws tgfj
— ljls/0f pkrf/ k4tL
— vfgfdf ljiffSttf
— cGo zf/Ll/s cf3ft
Uof:6«fOl6;sf] nIf0f
Uof:6«fOl6;sf]
nIf0f
ljleGg
JolQmx?df ljleGg lsl;dsf] x'G5 .
t/ ;jf{lws b]lvg] nIf0f lgDg
k|sf/sf 5g\ M
— jfsjfsL nfUg'
— k]6 b'Vg'
— k]6 ;'lGgg'
— ckr
— lxs lxs nfUg'
— vfg dg gnfUg'
— v}/f] jfGtf x'g'
— sfnf] lb;f x'g'
Uof:6«fOl6;sf] k/LIf0f
/ lgbfg
obL dfyL pNn]lvt ;d:of lnP/
lrlsT;ssf]df hfg' x'G5 eg] lgDg
lnlvt k/LIf0f kl5 Uof:6«fOl6;sf]
lgbfg ul/G5 .
;f+lu|nf hg:jf:Yo
19
k]6sf]
dflyNnf]
efusf]
OG8f]:sf]kL M o;df tkfO{“sf] d'vaf6
Sofd]/f ePsf] ;fgf] kfOk k]6 leq
l5/fOG5 / k]6df ;'hg / 3fp 5 jf
5}g egL hf“r ul/G5 . ;fy} k]6af6
sf]lifsfx?nfO{ lems]/ k/LIf0f ul/G5
h;nfO{ biopsy elgG5 . o;n]
k]6sf] cj'b{/f]u xf] jf xf]Og eg]/
klg 5'6\ofp“b5 .
u/L /fxt k'¥ofp“b5 .
/ut k/LIf0f M tkfO{“nfO{ /QmcNktf
5 jf 5}g / H. Pylori Uof:6«fOl6;
u/fpg ;Sg] hLjf0f'sf] ;+qmd0f 5 ls
5}g eg]/ klg of] k/LIf0f u/fOG5 .
olb tkfO{“nfO{ Vit B12 sf] sldn]
/QmcNktf ePsf] 5 eg] lrlsT;sn]
Vit B12 vfg] ;'emfj lbg' x'g]5 .
;fy} slt JolQmnfO{ l3p / cTolws
b"wsf] ;]jgn] klg Uof:6«fOl6; x'g
;Sg] ePsf]n] o:tf vfB kbfy{sf]
;]jg klg sd ug'{ pko'Qm x'G5 .
lb;f hf“r M lb;fdf /ut b]vf
k/]sf] 5 ls 5}g eg]/ kl5 of] hf“r
ul/G5 . lb;fdf /ut b]vfkg'{ klg
Uof:6«fOl6;sf] hl6ntf x'g ;Sb5 .
Uof:6«fOl6;sf] pkrf/
o; ;d:ofsf] pkrf/df lrlsT;ssf]
k/fdz{ lnP/ Antacids (Megacid
Gel), Proton Pump Inhibitors
(Panocid-DR, Rabocid, Esoflux,
h:tf cf}iflwsf] ;]jg ug'{ kg]{
x'G5 . h;n] k]6df cDnsf] dfqf sd
Oniz)
Uof:6«fOl6;sf] ;d:of ePsf] v08df
w]/} d;nfo'Qm / lk/f] vfgf vfg' x'“b}g .
olb H. Pylori sf] ;+qmd0f ePsf]
xf] eg] lrlsT;s4f/f antibiotics
/ cDn sd ug]{ cf}iflwsf] k/fdz{
ul/G5 .
dfyL pNn]lvt ;a} cf}iflw
lrlsT;ssf] k/fdz{ kl5 dfq k|of]
u ug'{ kb{5 . ;fy} ;/;kmfO{ /
vfgfsf] :j:Yotfdf ljrf/ k'¥ofP/
xfdL o; Uof:6«fOl6;af6 aRg
;Sb5f}“ . dfyL pNn]lvt nIf0f b]vf
k/]sf] v08df :j]lR5s pkrf/ ug'{
eGbf lrlsT;ssf] k/fdz{ lng'
clgjfo{ x'G5 . ¢
20
;f+lu|nf hg:jf:Yo
3/]n' pkrf/
? b]jflzif l;+x clwsf/L (Pharmacist)
dx / bfnlrgLsf]
dL>0fsf
kmfObfx?
dxsf] o'uf}o'ub]vL dfgj ;Eotf;+u
gftf /x]sf] 5 . Oltxf;sf kfgf
kN6fp“b} hfbf dx O;fk"j{ @!))
df ;'d]/ / a]lanf]g ;Eotfsf]
lznfn]vdf pNn]v ul/Psf] kfOPsf]
5 . of] eGbf klg klxn], dfx'/Lv]tLsf]
lrq0f O;fk"j{ &))) df O:k]gsf
u'kmfx?df e]l§Psf] 5 . dfof ;Eotf
/ kl;{og ;Eotfx?n] ljleGg vfg]
kl/sf/x?nfO{ u'lnof] agfpg dxsf]
k|of]u ul/Psf] ljleGg n]vx?df
pNn]v ul/Psf] 5 .
g]kfndf dfx'/Lkfngsf] Oltxf;
lgs} jif{ b]vL 5 . ljleGg k|sf/sf
xfjfkfgL / kof{j/0fsf aLrdf /x]sf]n]
ubf{ xfd|f] b]z g]kfndf y/Ly/Lsf
km"nx? kfOG5g\ . olt w]/} ljljwtf
/ pko'Qm xfjfkfgL /x]sfn] g]kfn
dfx'/Lv]tL / To;af6 pTkfbg
x'g] dxsf] nflu Psbd} pko'Qm /
;'xfpbf] 7fpF xf] .
o;}u/L bfnlrgL g]kfnsf] dWod
/ dflyNnf] prfO{x?df kfOG5 .
g]kfnL Jo+hg ;]n—/f]6L agfpg /
efOl6sfdf d;nfsf] ¿kdf k|of]u x'g]
ePsfn] ubf{ bfnlrgL g]kfnLx?sf
nflu ;'lg/xg] zAb xf] . oL b'O{
:yfgLo vfg]s'/fx?sf] ;lDd>0fsf]
k|of]un] ljleGg ;d:ofx?nfO{ /f]Sg
/ sd ug{ w]/} d2t ub{5 .
cg';Gwfgn] dx / bfnlrgLsf]
dL>0fn] z/L/sf ;a}h;f] a]yfx?
lgsf] kf5{ eg]/ b]vfPsf] 5. dx
;+;f/sf ;a} b]zx?df pTkfbg ug{
;lsG5 . cfhsf j}1flgsx? ;d]t
dxn] z/L/sf ;a}h;f] /f]ua]yf ;+rf]
kf5{ eGg] tYodf ljZjf; u5{g\ . dx
;]jg ugf{n] z/L/df s'g} k|sf/sf]
;fO8 Okm]S6 tyf v/faL klg x'Fb}g .
dx / bfnlrgLsf] ld>0fsf]
k|of]u xhf/f}+ aif{ cl3b]lv lrgL
k/Dk/fut cf}iflw / cfo'j]{bdf k|of]u
x'“b} cfPsf] 5 . bfnlrgL / dxdf
x'g] tTjn] vfgfdf AofS6]l/of /
9';L pd|g lbb}g . cfo'j]{bdf dxnfO{
æof]ujfxLÆ, cyf{t hl8a'6Lsf lgsf]
ug]{ u'0fnfO{ z/L/sf sf]lifsfdf
nUg] jfxs, eg]/ lrlgG5 . olb
dxnfO{ hl8a'6Lx?;+u ld>0f u/]df
dxn] To; hl8a'6Lsf] /f]ud'Qm kfg]{
u'0fnfO{ /fd|/L phfu/ ug{ d2t u5{
eGg] dfGotf 5 . dxsf] olx u'0fnfO{
bfnlrgL;+u ldnfPdf w]/} /f]ux?
lj?4sf] pko'Qm k|fs[lts pkrf/
aGg hfG5 .
d'6'sf ;d:ofx?
dx / bfnlrgLsf] w'nf] ;lxtsf] dL>0f
tof/ kfg{';\ / o;nfO{ h]nLsf] ;§f
kfp/f]6L tyf /f]6L;Fu cfˆgf] vfhfdf
lgoldt ?kdf vfg'xf];\ . o;n]
sf]n:6«f]n tyf x[bo3ftnfO{ k/}
/fV5 . olb tkfO{n] klxnf]
xf6{c6\ofssf] cg'ej ul/;Sg' ePsf]
5 eg] of] dx / bfnlrgLsf] dL>0f
k|of]u ug{'eof] eg] bf];|f] xf6{c6\ofs
slxNo} tkfO{“ 5]p cfpFb}g . lgoldt
?kdf dx / bfnlrgL ;]jg ugf{n]
d'6'sf] w8\sgnfO{ alnof] agfpF5 .
cd]l/sf / Sofgf8fsf w]/}h;f]
gl;{ªxf]dx?df d'6'sf ;d:ofaf6
lk8Ltx?nfO{ of] dx / bfnlrgLsf]
dL>0f lbg] ugf{n] d'6'sf] eNjdf
k'gM tfhuL kfOg] u/]sf] tYo
;kmntfsf ;fy k|sfzdf cfPsf] 5 .
hf]gL{sf ;d:ofx?
;f+lu|nf hg:jf:Yo
tyf hf]gL{hGo ;d:ofx?af6 u|:t
la/fdLx?n] Ps sk tftf] kfgLdf
b'O{rDrf dx / Ps ;fgf] rDrf
bfnlrgLsf] w'nf] ld;fP/ ;]jg
ugf{n] kmfObf k|fKt x'G5 . sf]kg
x]ug ljZjljBfndf ul/Psf] Ps
cg';Gwfgdf @)) cfy{/fOl6;sf
la/fdLx?df of] bfnlrgL /
dxsf] dL>0f ljwL ckgfOPsf] lyof] .
h;df &) hgf la/fdLx? Ps xKtfd}
cf+l;s ;+rf] eP eg] cGo la/fdLx?
Ps dlxgfdf k'0f{ ;+rf] eP .
cfGb|fdf ;+qmd0f
cfGb|f tyf k]6df ;+qmd0f jf ;d:of
5 eg] dx / bfnlrgL dgtftf] kfgLdf
dfly ;Nnfx lbP h:t} u/L ;]jg
ug{'xf];\ . o;n] k]6df ePsf] ls6f0f'
;vfk kfg{'sf] ;fy} ;+qmd0faf6 s]xL
lbgd} 5'6sf/f lbnfpF5 .
sf]n:6«f]n
dfly pNn]v u/] h:t} ul/ dx /
bfnlrgL dgtftf] kfgLdf ;]jg
ugf{n] /utdf sf]n:6«f]nsf] dfqf b'O{
306fd} !) k|ltztn] 36]/ hfG5 .
cg';Gwfgn] s] b]vfPsf] 5 eg]
z'4 dx lgoldt ?kn] ;]jg ugf{n]
sf]n:6«f]n cfk;]cfk lgoGq0fdf
cfpF5 .
21
ckr tyf k]6 b'vfO{
dx / bfnlrgLsf] dL>0fn] cN;/ tyf
k]6hGo b'vfO{af6 5'6sf/f lbnfpF5 .
k]6df xfjf tyf Uof;
hfkfgdf ul/Psf] cWoog cg';f/ dx
/ bfnlrgLsf] dL>0fn] k]6sf] xfjf
tyf Uof;nfO{ ;xh} lgsf] kf5{ .
Ogkm'n'PGhf
:k]gsf Ps j}1flgsn] u/]sf] cWoog
cg';f/ dxdf Ps k|sf/sf] k|fs[lts
u'0f x'G5 h;n] OGkm\n'PGhfsf]
ls6f0f'nfO{ dfl/lbG5 / la/fdLnfO{
ˆn'af6 hf]ufpF5 .
5fnf ;kmf u5{
dx / bfnlrgLsf] dL>0f tftf] kfgLdf
ld;fP/ lrofsf] ;§fdf lbgsf]
ltgk6s ;]jg ugf{n] 5fnfdf tfhuL
cfpg'sf ;fy} rfp/L k/]sf] 5fnf
d'nfod x'Fb} 5fnfdf vl6/f tyf
808Lkmf]/ klg cfpFb}g .
3f“6L b'v]sf]
3f“6L b'v]sf] a]nf Ps rDrf dx k|To]s
tLg 306fdf r';]/ vfgfn] b'vfO{
s]xL lbgd} x/fP/ hfG5 .
808Lkmf]/
?3fvf]sL
dfly pNn]v ul/P h:t} dx /
bfnlrlgnfO{ dgtftf] kfgLdf ld;fP/
tLglbg ;Dd lgoldt ?kdf lbgsf]
b'O{ k6ssf b/n] ;]jg u/]df k'/fgf]
tyf gofF ?3fvf]sL / lkgf;af6
;xh} 5'6sf/f ldN5 .
cfy{/fOl6; nufot z/L/ ;'lGgg]
tLg rDrf dx / Ps rDrf
bfnlrgLsf] n]k tof/ kfg{'xf];\ /
o;nfO{ /ftL ;'Tg'k'j{ 808Lkmf]/sf] jl/
k/L lj:tf/} bNg'xf];\ . clg ljxfgkv
cfˆgf] cg'xf/ dgtftf] kfgLn]
kvfNg'xf];\ . of] ljwL b'O{ xKtf ;Dd
lgoldt ?kn] ckgfpgfn] cg'xf/sf]
808Lkmf]/sf] h/f ;lxt ;kmf eP/
hfG5 .
22
;f+lu|nf hg:jf:Yo
tf}n 36fpg
laxfg vfhf vfg' k'j{ vfnL k]6df
/ /ftL ;Tg' cl3 dgtftf] kfgLdf
b'O{rDrf dx / Ps rDrf bfnlrgLsf]
w'nf];]jg ugf{n] cTolws tf}n
ePsfx?sf] ;d]t z/L/sf] tf}n 36b}
hfG5 . clg of] dL>0f lgoldt ;]jg
ugf{n] hlt g} Sofnf]/L a9L ePsf]
vfgf vfP klg af];f] hDg kfpFb}g
eGg] tYofÍn] b]vfPsf] 5 .
ysfg
xfn} ul/Psf] cWoog cg';f/
dxdf ePsf] u'lnof]kgfn] z/L/nfO{
km'lt{nf] kf5{ . Ps cWoog cg';f/
a[4n] ;d]t Ps rDrf dx / cfwf
rDrf bfnlrgL Ps sk kfgLdf
ld;fP/ laxfg vfnL k]6df / /ftL
;'Tg'cl3 ;]jg ugf{n] z/L/df tfut
pTkfbg x'G5 .
;f; uGxfpg]
;fpy cd]l/sfsf dflg;x? laxfg
p7\g] laltSs} Ps rDrf dx
/ bfnlrgLsf] w'nf] dgtftf]kfgLdf
ld;fP/ s'Nnf u5{g\ h;sf sf/0f
plgx?sf] ;f; lbge/ uGxfpFb}g .
sfg g;'Gg] ;d:of
lgoldt ?kdf laxfg / a]n'sf
dx / bfnlrgL ;]jg ugf{n] sfg
g;'Gg] ;d:ofdf lj:tf/} ;'wf/ cfpg
yfN5 / sfgsf cGo ;d:ofx?af6
klg 5'6sf/f kfOG5 .
skfn emg]{ ;d:of
g'xfpg !% ldg]6 cuf8L ! lrofrDrf
dx / ! lrofrDrf bfnlrgLsf]
w'nf]nfO{ yf]/} cf]lnjsf] t]ndf /fv]/
n]bf] agfpg] / skfndf nufpg] .
o;/L nufpbf skfn emg]{ ;d:ofsf]
;dfwfg x'G5 .
lk;fasf] gnLsf] ;d:of
! lrofrDrf bfnlrgLsf] w'nf] /
cfwf lrofrDrf dxnfO{ Ps lunf;
dgtftf] kfgLdf /fv]/ lkPdf lk;fasf]
gnLdf /xg] ljleGg AofS6]l/ofaf6
x'g;Sg] ;+qmd0fnfO{ sd ug{ ;lsG5 .
bft b'Vg] ;d:of
bfnlrgLsf] w'nf] / dx ldnfP/ aGg]
n]bf]nfO{ b'v]sf] bftdf nufP b'vfO{
sd x'g hfG5 .
zf/Ll/s ;antf
lbgx'“ dx / yf]/} bfnlrgLsf] w'nf] xfn]/
lrof lkPdf z/L/sf] cfGtl/s k|lt/Iff
k|0ffnL -Immune System_ alnof]
x'ghfG5 . o;/L z/L/nfO{ ljleGg
efO/; / AofS6]l/ofsf cfqmd0faf6
arfpg w]/} d2t k'U5.
dw'd]x / cTolws
df]6f]kgf
bfnlrgLn] OG;'lngsf] sfo{IfdtfnfO{
cem /fd|f] agfp5 . j}1flgsx? eG5g
bfnlrgLsf] k|of]un] OG;'lng nueu
@) u'gf a9L lqmofzLn x'ghfG5 /
o;n] dw'd]xL / w]/} jhg ePsf
JolQmx?nfO{ k|lts'n c;/ b]vfp“5 .
dxn] z/L/sf] af];f]nfO{ krfpg /
cGTodf 36fpg d2t ug]{ ePsfn]
bfnlrgL / dxsf] ld>0f dw'd]xLx?sf
nfuL lgs} nfebfos x'G5 .
lbgx' laxfg vfgf vfgeGbf cfwf
306f cuf8L vfnL k]6df ! lrofrDrf
dx;“u cfwf lrofrDrf bfnlrgLsf]
w'nf] kfgLdf pdfn]/ vfPdf dw'd]xL
/ cTolws df]6f] JolQmx?nfO{ lgs}
nfebfos x'ghfG5 .
g]kfndf dx / bfnlrgL ;lhn} e]l6g]
ePsfn] oL b'O{sf ld>0f agfP/ k|of]u
ug{ ;xh} ;lsG5 / nfdf] ;do;Dd
nfe p7fpg ;lsG5 . ¢
;f+lu|nf hg:jf:Yo
23
cf}iflw 1fg
lsg bf“t ;+j]bgzLn x'G5 <
bf“t Hofbft/ wear & tear sf]
sf/0fn] ;+j]bgzLn (Sensitive) x'G5 .
s]xL dflg;x?sf] nfuL Enamel sf]
Iflt jf xfgLn] klg bf“t ;+j]bgzLn
x'g;S5 . c? sf/0fx?df cavities,
bf“tdf cracks , uLhfsf] Ifltx?
kb{5g . o;n] ubf{ sdhf]/ nerve
endings x? vfgf / t/n kbfy{sf]
;Dks{df cfp“5g h;n] ubf{
;+j]bgzLntf dx;'; x'G5 .
bf“tsf] ;+j]bgzLntf
(Sensitivity) af6 s;/L
hf]lug] <
bf“tsf] ;+j]bgzLntfaf6 hf]lug
;+j]bgzLntf ljsfz ug]{ s'g}
sfo{x? gug'{ ;a}eGbf /fd|f] ljsNk
xf] . ;+j]bgzLntfsf] k|d'v sf/0f
Teeth Grinding xf] . w]/} dflg;x?
/ftdf cfkmgf] bf“t hfgL ghfgL ls6\g]
ub{5g / ltlgx?nfO{ Tof] s'/f yfxf
klg x'“b}g . o;sf] lglDt /flt ;'Tg] a]nf
Mouth Guard sf] k|of]u ug{ ;lsG5
h;n] bf“tsf] lar /x]/ Grinding
/f]S5 .
unt Toothbrush k|of]u ugf{n] jf
cg'lrt tl/sfn] brushing ugf{n]
klg ;j]bgzLntfnfO{ lgDTofp“5 .
Tooth brush vl/b ubf{ Soft Bristled
tooth brush ;'lglZrt u/]/ dfq
vl/b ug'{k5{ . w]/} a|;x? medium
jf hard bristled klg x'G5g h;n]
;lhn} bf“tdf xflg k'¥of“pg ;S5g\ .
Brush ubf{ light motion / tn
wSsf lagf jl/kl/ ug'{k5{ . lbgdf
b'O{ k6s eGbf a9L brush ug{ x'“b}g
/ clwstd brushing n] erosion
nfO{ lgDTofp“5 .
Toothpaste sf]
k|d'v tTj xf] .
Potassium Nitrate n]
bf“tsf] nerve
fibers sf] desensitization ug{ d4t
u5{ h;n] ubf{ neural transmission
cj?4 x'G5 .
n] bf“tsf] Enamel nfO{
Bacteria sf] cfqmd0faf6 arfp“b5
h;n] Dental caries (cavity) u/fpg
;S5 .
SMP
DENTSEAL GEL
Composition :
Potassium Nitrate BP 5% w/w
Sodium Monofluorophosphate
(SMP) USP 0.625% w/w
Indication
lk8fbfos bf“t, bf“tsf] ;+j]bgzLntf,
dental caries / luhfsf] /f]ux?sf]
df}lvs ;'/Iffsf] nflu Dentseal sf]
k|of]u ul/G5 .
Pharmacology
eg]sf] bf“tdf
pTkGg x'g] ltvf], lk8fbfos cg'e'tL
xf] h;sf] sf/0f ljleGg stimuli h:t}
tftf], lr;f], u'lnof], cldnf] / :k;{
x'g ;S5g\ . o;n] hLjgsf] u'0f:t/df
(Quality of Life) c;/ u5{ /
s]xL vfg] s'/f / k]o kbfy{sf]
pkef]uaf6 klg al~rt agfp“5 .
Dental sensitivity
df Potassium nitrate
x'G5 . h;n] bf“tnfO{ tftf], lr;f],
u'lnof], cldnf] / :k;{sf] bb{gfs
;+j]bgzLntfaf6 ;'/Iff u5{ . of]
Dentseal
Dentseal
df
Fluroide
h;n] Dental
x'gaf6 hf]ufp5 .
kl5 x'G5
Caries (Cavities)
Precautions
—$ xKtf eGbf a9L k|of]u ug{nfO{
cfkm\gf] bGt lrlsT;ssf] k/fdz{
lng'xf];\ .
— nIf0f ljBdfg jf v/fa ePdf
k|of]u /f]Sgsf] ;fy;fy} cfkm\gf]
bGt lrlsT;s÷8fS6/sf] k/fdz{
lng'xf]; .
— ^ jif{ d'lgsf aRrfx?sf] kx'“raf6
6f9f /fVg'xf];\ .
—olb em'lSsP/ lgNguPdf t'?Gt
8fS6/sf] ;Nnfx lng'xf]nf .
Presentation
DENTSEAL GEL 50 gm Tube
(Sugar Free with MINT Flavour)
¢
24
;f+lu|nf hg:jf:Yo
kf7s ljz]if
dda.gov.com.np
af6 ;fef/ ul/Psf]
gof“ kmfd]{;L k;n btf{ ug]{ tl/sf
;f+lu|nf hg:jf:Yo
25
26
;f+lu|nf hg:jf:Yo
;f+lu|nf hg:jf:Yo
27
28
;f+lu|nf hg:jf:Yo
;f+lu|nf hg:jf:Yo
29
30
;f+lu|nf hg:jf:Yo
;f+lu|nf hg:jf:Yo
31
32
;f+lu|nf hg:jf:Yo
;f+lu|nf k|ltof]lutf g+ #% sf] ;lx hjfkm
7f8f]
!= ;'lGgg], /ftf] x'g] / b'Vg] ;d:ofnfO{ ;+lIfKtdf s] elgG5 <
@= NPL Winward 4f/f pTkflbt Eye Decongestant
#= NPL 4f/f pTkflbt
Levodropropizine syrup
$= NPL Div II 4f/f pTkflbt
NASAL Decongesation
%= Queen amongst quinolones....
^=pTs[i6 AHU 4f/f pTkflbt pTs[i6
Ampicillin + Cloxacillin
&= ue{df /x]sf] lzz' -e|'0f_
*= lkgf; ==================
t];f]{
!= cfwf 6fpsf]÷6fpsf]sf] s'g} ;fgf] efudfq} cyjf k"/} efu klg b'Vg] of]
;d:of k'?ifsf] t'ngfdf dlxnfdf Hofbf b]lvG5 .
@= "To prevent your patients flux with gastric pain"
(Ferrous Ascorbate + Folic Acid)
#= ESTHETICA Div. 4f/f pTkflbt
Propylene Glycol IP 1.5%w/w
$= SofG;/ ljz]if1
%= NPL 4f/f ahf/df ev{/} dfq
pknAw u/fOPsf] IRON tablets ;f+lu|nf k|ltof]lutf
g+ #% sf] ljhoL
dxfg'efjx?
xflb{s awfO{ ÛÛÛ
k|yd k'/:sf/
nId0f kf}8]n
lu|g l;l6 xl:k6n k|f= ln=
wfkf;L, sf7df8f}+ .
;fGTjgf k'/:sf/
;fu/ dfg >]i7
rDkfk'/ d]l8sn xn
rfkfufp“, nlntk'/ .
lszf]/ >]i7
lszf]/ d]l8sn xn
Ujfsf]{, nlntk'/ .
;f+lu|nf k|ltof]lutf g+ #$ sf k'/:sf/ ljh]tf /fdx/L s]=;L=, gjo'u kmfd]{;L, hfjnfv]nnfO{
k'/:sf/ k|bfg ub}{ Pg= lk= Pnsf k|f]8S6 PSh'So'l6e cfzf 9'²fgf tyf Pd= cf/= czf]s vqL .
;f+lu|nf hg:jf:Yo
;f+lu|nf k|ltof]lutf g+ #^
33
o; k|ltof]lutfdf oxf“x?sf] j[xt ;xeflutfn] xfdL cem
pT;flxt ePsf 5f}+ . ;fy} eljiodf o:t} lg/Gt/tfsf] xfdL
cfzf /fVb5f}+ . pQ/ cfO{kU' g' kg]{ clGtd ldlt M c;f]h @%, @)&@
7f8f]
!= NPL 4f/f pTkflbt Esomeprazole
@= Insulin pTkfbg ug]{ c+Ë
#= Lapen 4f/f pTkflbt Sitagliptin
$= Beauty Bone sf] jf:tljs gfd
%= NPL 4f/f ahf/df pknAw u/fO{Psf]
IRON tablets (Ferrous Ascorbate
+ Folic Acid)
t];f]{
!= cj'{b /f]u
@= z/L/df /Qm;+rf/ u/fpg] c+u
#= s/Ë ;+u ;DalGwt
$= d'vdf x'g] / rkfpg d4t ug]{ c+u
%= xft jf v'§ ds]{/ b'Vg'
s[kof tn cfkm\gf] gfd, k"/f 7]ufgf, ;Dks{ g+= / ;xL /fv]/ o; kfgfnfO{ vfdleq /fvL k7fOlbg'xf]nf . uf]nfk|yfåf/f
;xL pQ/ k7fpg' x'g] tLg dxfg'efjx?sf] gfd k|sflzt tyf k'/:s[t ul/g]5 .
gfd M========================================================================== 7]ufgf M==============================================================
z}lIfs of]Uotf M============================================================;Dks{ g+============================== ;xL M========================
;'emfj k]l6sf
g]kfn kmdf{:o"l6sN;åf/f k|sflzt …;f+lu|nf hg–:jf:YoÚ k|lt cfkm\gf] ljrf/ Pjd\ ;'emfj JoQm ul/lbg' x'g xflb{s
cg'/f]w ub{5f}+ . ;jf]{Qd ;'emfjsf] sb/ u/L k'/:s[t ul/g]5 .
;+flu|nf hg :jf:Yok|lt oxf“sf] ;'emfj M ====================================================================================================
==========================================================================================================================================================
==========================================================================================================================================================
==========================================================================================================================================================
==========================================================================================================================================================
gfd M =================================================================================================================================================
7]ufgf M =================================================================================================;xL M =====================================
34
;f+lu|nf hg:jf:Yo
pTs[i6 ;'emfj
d ;f+lu|nf hg:jf:Yosf] lgoldt kf7s x'“ . lgs} 1fgd"ns ePsfn] dnfO{ of]
klqsf k9\g lgs} dgk5{ . ljutsf dlxgfx?df xfdL k'/} g]kfnLx?n] e"sDksf]
df/ ef]Ug k¥of] . clxn] ;d]t af6f]df 7'nf uf8L rn]/ hldg yls{bf dg
8/fp“5 . o:tf] kl/l:yltdf s] ubf{ dgsf] qf; sd x'G5 eg]/ xfdLx?nfO{
r]tgfd'ns sfo{qmddf ;fd]n ul/lbP xfdL Pg=kL=Pn= k|lt cfef/L x'g] lyof}“ .
cflzif j}w, r08]Zj/L d]l8sn xn, ag]kf .
hf“bf hf“b}= = = = = = = =
xfd|f] kf7sj[Gbn] lbg'ePsf]
;'emfj cg'?k tkfO{ klg :jf:Yo
If]qdf sfo{ ug]{ qmddf tkfO{
;dIf b]vfk/]sf / tkfO{n] ef]u]sf
tLtfdL7f cg'ejx? xfdLnfO{
k7fpg'xf];\ . /f]rs tyf
kf7sju{nfO{ nfe x'g] cg'ej
o; klqsfdf k|sflzt ul/g]5 .
wGojfb Û
…oxf“sf] lh1f;fÚ
===============================================================================================================================================
===============================================================================================================================================
===============================================================================================================================================
===============================================================================================================================================
===============================================================================================================================================
===============================================================================================================================================
gfd M=======================================================================================================================================
7]ufgf M==============================================================;lx M=======================================
xfd|f] kqfrf/sf] 7]ufgf M
g]kfn kmdf{:o"l6sN; Nofaf]/]6f]/L k|f= ln=
ahf/ Joj:yfkg sfof{no M Pg= lk= Pn= xfp;, s[i0f uNnL, nlntk'/, g]kfn
kmf]g g+=M— %%@()%(, %%@($#$, email: [email protected]

SANGRILA JANASWASTHYA VOL NO 36

Transcription

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