සුව පියස

yDo frda.j,ska fífrkak Èkm;d t<j¿ iy m,;=re wdydrhg .kak'


wE; w;S;fha§ yDohdndOhlg f.dÿreùu jeäysá msßia w;r muKla olakg ,enqK;a” wo jkúg yDohdndOhla we;sùu ;reK mrmqr w;r;a” <ud mrmqr w;r;a olakg ,efí’ f,dalfha isÿjk urKj,g m%Odk fya;=jla ù we;af;a yDoh iy reêrjdyskS iïnkaO frda. ;;a;ajhkah fuu ;;a;aj ksid f,dalfhka wld,fha iuq .kakd Ôú; ixLHdj o< jYfhka ñ,shk 179 la nj fi!LH wxY fmkajd fohs

YS% ,xldfõ yDoh wdYs%; frda. ksid Èklg 100 fokl= urKhg m;afõ’ tfukau wo jkúg YS% ,xldfõ wêl reêr mSvkfhka fmf<k ixLHdj ck.ykfhka 265] ls yDofrda. úfYaI{hkaf.a w;S; o;a;hkag wkqj yDohdndOhla we;sùfï m%jK;dj ;sfnk wju jhi f,i jhi wjq 16 y÷kd .;a;;a wo jkúg th jhi wjq 8 olajd my;g meñK ;sîu ieneúkau fÄokSh ;;a;ajhls fï i|yd fi!LHiïmkak fkdjk wdydr rgdj” YÍr l%shdldrlï u|lu ÿïfld< iy uoHidr Ndú;h by< hEu ld¾hnyq, Ôú;h” wêl wd;;sh mßir ¥IKh ia:q,Ndjh hk idOl n,mdk nj y÷kdf.k ;sfí’ fï ksid wo jkúg mdi,a orejkag mdi,a ld,h ;=< lS%vdjl ksr;ùu wksjd¾hh lr we;

iema;eïn¾ 29 jeksodg fhfok f,dal yoj;a Èkh fjkqfjka fujr f;audj jkafka zyoj;skau yoj; iqrlsuqZ hkakhs fuys§ Tfí yoj; .ek Tn mÍCIdfjka isàu” Tn jgd isák msßif.a yojf;a wdrCIdj ms<sn|jo Tn ie,ls,su;a ùu” ±kgu;a yDo frda.j,ska fmf<kakka i|yd m%;sldr ,nd .ekSug Woõ lsÍu ms<sn|j wjOdkh fhduq flf¾

yDohdndOhla we;sjkafka

lsÍgl Ouksj,ska yDo jia;==fõ udxYfmaYSkaj,g reêrh imhk w;r tfia reêrh iemhSu b;du;a jeo.;a fõ’ lsÍgl Ouksj, fldf,iagfrda,a ;ekam;a ùfuka lsÍgl Ouks isyska ùug mgka .kS’ by; i|yka l< wdldrhg lsÍgl Ouks isyska ùfuka yDo udxYfmaYSj,g ,efnk Tlaiscka m%udKh iy reêr m%udKh wvq fõ’ fufia ùu ;=< udxYfmaYSka ñh hEug mgka .kshs’ yDo jia;=fõ lsÍgl Ouks wjysr ùu yDohdndOhla we;sùug fya;=jhs’ lsÍgl Ouksj,ska yDo jia;==fõ udxYfmaYSkaj,g reêrh imhk w;r tfia reêrh iemhSu b;du;a jeo.;a fõ lsÍgl Ouksj, fldf,iagfrda,a ;ekam;a ùfuka lsÍgl Ouks isyska ùug mgka .kS by; i|yka l< wdldrhg lsÍgl Ouks isyska ùfuka yDo udxYfmaYSj,g ,efnk Tlaiscka m%udKh iy reêr m%udKh wvq fõ fufia ùu ;=< udxYfmaYSka ñh hEug mgka .kshs yDo jia;=fõ lsÍgl Ouks wjysr ùu yDohdndOhla we;sùug fya;=jhs

lsÍgl Ouks wjysr jkafka

  • fï i|yd n,mdk fya;+ka .Kkdjla ;sfí’ tkï”
  • wys;lr fldf,iagfrda,a (LDL) ;ekam;a ùu
  • md,kh fkdl< wêreêr mSvkh
  • Èhjeähdj
  • wênr $ ;rndrej $ ia:q,;dj
  • jhia.; ùu
  • udkisl wd;;sh $ iudchSh wd;;sh
  • Èklg .;hq;= t<j¿ iy m<;=re m%udKh wdydrhg fkd.ekSu ^tfia ùu ;=< ffokslj wekaáTlaisvkaÜ (Antioxidant) m%udKh fkd,eîu&
  • fi!LHu;a fkdjk wdydr mßfNdackh jHdhdu fkdlsÍu iy ldhsl l%shdldrlïj, u| nj
  • ÿïfld< Ndú;h uoHidr iy u;aøjH Ndú;h
  • mßir ¥IKh
  • yDohdndOhl§ mmqfõ fõokdj we;s jkafka

    yDohdndOhla we;s ùfï§ ±fkk fõokdj mqoa.,hdf.ka mqoa.,hdg fjkia úh yelsh’ úfYaIfhka ;reK flfkl=g fuu fõokdj we;sjkafka mmqfõ yßueo ysrùula jeks fõokdjla f,igh th ;jÿrg;a úia;r lrkjd kï yDojia;=j máhlska ne| ;nkjd fuka ±kSula” yDojia;=j u; mSvkhla we;s lrkjdla fuka ±kSula f,i úh yel fuf,i we;sjk ;o fõokdj fn,a,g fyda jï fyda ol=Kq Wrysi iy w; Èf.a .uka lrk w;r wêl f,i oyäh ±óula o isÿúh yel’ fuh meh 1$2 l muK ld,hla mej;sh yelsh’ fujeks wjia:djl§ tu frda.shd <Õu ;sfnk frday,lg /f.k hEu l< hq;=hs ;j;a flkl=g fuu fõokdj jï wf;a fõokdjla f,i ±fkñka th w; Èf.a .uka l< yelsh th wms f¾äfhaIka (Radiation) f,i y÷kajuq’ we;eful=g tu fõokdj je<ñg olajd .uka lrñka je<ñg mekSula fyj;a ialsma f¾äfhaIka (Skip Radiation) ;;a;ajh olajd .uka l< yelsh ;j;a fldgilg yl= fofla muKla fõokdjla we;s ù o;a wudrejla wdldrhg o ±ksh yelsh W.=f¾ fõokdjla f,i o fuu fõokdj we;sjk wjia:d we;’ l,d;=rlska flkl=f.a ol=Kq wf;a muKla fõokdjla ±kS yDohdndOhla we;súh yelsh

    .eiag%hsàia fõokdfjka fjkia jkafka

    fuys§ jvd;a jeo.;a jkafka yDohdndOhl§ we;sjk fõokdj .eiag%hsàia frda.fha§ we;sjk mmqfõ fyda nfâ ±ú,af,ka fjka lr y÷kd .ekSuhs’ fï wkqj mmqfõ we;sjk by; wdldrfha fõokdjla lsisúfgl;a fkdi,ld yeÍu fkdl< hq;=h

    wekachskd fõokdjla ojfia jeämqr we;s jkafka

    idudkHfhka yDohdndOhla Wfoa mdkaor we;sùfï m%jK;djla ;sfí’ tfia;a fkdue;s kï wêl uykaishla fyda ysf;a l,n,hla fyda wêl fldamhla we;sjk wjia:dj,§ jqjo yDohdndO we;súh yel lsÍgl Ouksfha wjysr;djla ;sfnk nj y÷kd.; yelafla jHdhdu lrk wjia:dj,§” lkaola kÕsk wjia:dj,§ wêl f;fyÜgqjla fyda wêl uykaishla we;sùfuks fujeks wjia:djla yDohdndOhlg fmr we;sjk wekachskd fõokdjla f,i wmg uq,ska y÷kd.; yelsfõ’ WodyrK f,i óg fmr fyd¢ka jHdhdu l< flfkl=g miqld,Skj jHdhdu l< fkdyels kï wêl uykaishla ±fka kï” fyd¢ka weúo .sh flfkl=g ±ka tfia l< fkdyels kï wêl uykaishla ±fka kï yDohdndOhla we;sùug fmr lrk wk;=re weÕùó ;sfnk neúka ta ms<sn|j iqÿiqlï ,;a ffjoHjrhl= yuqù mÍCId lr .ekSu jeo.;a fõ’

    yDohdndOhla we;sùo hkak yßyeá y÷kd .ekSug we;s mÍCIK

    mmqfõ fõokdjla ;sfnk flkl= jydu ls%hd;aul fjñka úkdä 10 la we;=<; BiSÔ (ECG) mÍCIdjlg fhduqùfuka Tjqkag yDohdndOhla we;s o hkak y÷kd .; yel’ ;j;a flkl=g BiSÔ mÍCIdj idudkH jqj;a yDohdndOhla we;sùo hkak ;yjqre lr .ekSu i|yd úkdä 10 lg jrla meh Nd.hl ld,hla f rda.shdf.a BiSÔ mÍCIdjka isÿ lrñka yDohdndOhla we;s ùo hkak yßhgu ;yjqre lr .ekSug isÿjk wjia:d we;’ ta w;r;=r frda.shdg fg%dfmdkskaa whs (Troponin I) reêr mÍCIdj o lrkq ,nhs’ fuys§ yDohjia;=fõ udxYfmaYS ydks jQ úg muKla msg;g meñfKk yDohjia;=fõ we;=<; ;sfnk tkaihsu mÍCIdj u.ska yDohdndOhla we;sùo hkak ksje/Èj y÷kd.; yelS’ ta w;r;=r tflda (ECO) mÍCIdjla o l< yel fuu mÍCIK fol uÕska frda.shdg yDohdndOhla we;sùo hkak ksYaÑ;j y÷kd.; yelshs’ we;eï frda.Skag fg%dfmdkskaa whs (Troponin I) reêr mÍCIdj mjd idudkH ù tflda mÍCIdj muKla widudkH ùfuka yDohdndOhla we;s ù ;sfnk nj ;yjqre fõ’ ta w;r;=r frda.shdf.a b;sydih ms<sn|j ±k.ekSfuka o ksYaÑ;ju yDohdndOhla we;s ùo hkak ;yjqre lr .; yelsh’ ´kEu whl=g lsÍgl Ouksj, wjysr;djla we;a±hs ksYaÑ;j ±k .ekSug we;s fyd|u mÍCIKh jkafka tkaðfhda.%Eï (Coronar Angiography) mÍCIdjhs’

    yDohdndOhla we;s ù ;sfnk nj ;yjqre lr.;aa úg l< yels m%;sldr

    yDohdndOhl§ lrkq ,nk m%;sldr j¾. ;=kls’ lsÍgl Ouksh isyska jQ ;ek iïmQ¾Kfhkau f,a leáh isrjQ wjia:dj,§ kd,fhka my<g reêrh .uka fkdlrk úg tu f,a leáh bj;a lr b;d id¾:l kuq;a ñ, wêl m%;sldr l%uhla jk fldfrdkß wekaðfhdma,diaá l%uh fyj;a iafgkaÜia (Coronary Angioplasty & Stents) ±óu lrkq ,nhs’ kuq;a tu m%;sl¾uhg Ndckh lsÍug myiqlï fkdue;s wjia:dj,§ tu f,a leáh Èh lsÍu i|yd T!IO m%;sldr Ndú; lrhs’ tys§ Ndú; lrk tkak; u.ska Èh l< yelafla f,a leáfhka 60] la muKs’ 40] la muK Èh fkdfõ’ tu tkak;ska f,a leáh Èh fkdjqKq nj y÷kd .;a úg frda.shd iafgkaáka m%;sl¾uh i|yd kej;;a fhduq lrkq ,efí’

    Coronary Angioplasty & Stents m%;sl¾uh l< yelafla iSñ; rcfha frday,a ixLHdjl muKs’ Èklg l< hq;= fuu m%;sldr 400 lska YS% ,xldfõ rcfha frday,aj, wo jkúg lrkq ,nkafka 40 ls’ tla frda.shl= i|yd fujeks m%;sldrhla lsÍug YS% ,xld rch remsh,a ,CI 5 g wêl uqo,la jeh l< hq;= ksid wm l< hq;af;a yDohdndOhla we;sùu l,a;shd j<lajd .ekSuhs’ lsÍgl Ouksh jeä jYfhka wjysr ù we;akï tjeks wjia:dj,§ iafgkaÜia ±óu l< fkdyelsh’ tjeks wjia:djl§ yDo frda. ms<sn| úfYaI{ ffjoHjreka frda.shd nhsmdia Y,Hl¾uh (Coronary Bypass Graft Surgery) i|yd fhduq lrhs’

    yDohdndOhl§ wm blaukska úh hq;af;a

    yDohg reêrh imhk lsÍgl Ouksh ;=< f,a leáh isrùu ksid yDohg reêrh iy Tlaiscka .uka fkdlrk neúka yDofha udxYfmaYs ñh hd yelsh’ th j<lajd .ekSu i|yd jydu ls%hd;aul ùu w;HdjYH fõ’ udxYfmaYSj, ñh hEfï m%udKh ;SrKh jkafka jydu ls%hd;aul ùu ;=< fõ’ tfia lsÍfuka yDo wl¾ukH;dj fyj;a ydÜ f*a,sh (Heart failure) ;;a;ajfhka frda.shd uqod .; yelsh’

    yDohdndOhla we;s jQ úg jyd ls%hd;aul úh hq;af;a

    l<n,ùula wjYH fkdfõ’ ksjfia zweiamS%kaZ T!IOh ;sfí kï 75 mg fm;s 4 la frda.shdg imd lEug ,nd§u iqÿiq fõ’ ksjfia GTN fm;s ;sfí kï tajd Èj hg ;nd .ekSu l< yel’ fïjd u.ska lsÍgl Ouks úia:drKh lr tu Ouks Tiafia jeä reêr m%udKhla yDo fmaYs fj; /f.k hEug wjldY i,ihs’ tieKska jydu <Õu ;sfnk frday,g frda.shd /f.k hd hq;=h’ /f.k hEfï§ frda.shd fjfyig m;a fkdl< hq;= w;r wdydr ,nd §fuka je<lSu” weúoaoùfuka je<lSu” jdykh meoùfuka je<lSu l< hq;=h’

    yDohdndOhla j<lajd .ekSu i|yd Ôjk rgdfõ fjkia lr .; hq;af;a

    ir, Ôjk rgdjla wkq.ukh lsÍu fuys§ b;du jeo.;afõ’ udkisl wd;;sfhka ñ§u” Èkm;d úkdä 45 la j;a jHdhduj, ksr; ùu” fyd¢ka c,h mdkh lsÍu” iSks iys; wdydr iy wêl fldf,iagfrda,a iys; wdydr .ekSfuka bj;a ùu” ud¿” y;= jeks fm%daàka nyq, wdydr lEu fõ,aj,g tl;= lr .ekSu” t<j¿ .%Eï 400 l m%udKhla Èklg wdydr fõ,a u.ska ,nd .ekSu” m,;=re j¾. ;=klska .%Eï 15 la muK Èklg wdydr f,i tl;= lr .ekSu meh 6-7 l kskaola ,nd.ekSu” ÿïmdkfhka neyer ùu” u;aøjH iy u;ameka mdkfhka bj;a ùu l< hq;=h

    ;reK whg yDohdndO jeäù we;af;a

    úfYaIfhka wo jkúg YS% ,xldfõ ;reK wh yDohdndOj,g f.dÿreùfï jeäùula olakg ,efí’ fï i|yd udkisl wd;;sh fukau Tjqkaf.a wys;lr mqreÿ fya;=ù we; ÿïmdkh” u;ameka mdkh iy u;aøjH Ndú;h ;reK Ôú; wld,fha fuf,i úkdY ùug fya;= ù we;s w;r fuu ;reK msßia ;ukaf.a jdish i|yd u;ameka l=vd m%udKhla ,nd .ekSfuka yDohdndO we;s ùu j<lajd .; yels hehs ñ;Hdjla úYajdi lrhs’ u;ameka l=vd m%udKhla ,nd .;a;;a úYd, m%udKhla ,nd.;a;;a YÍrhg lrk n,mEu ta wdldrfhkau isÿjk neúka ta u.ska f,a leáhla Èh lsÍula lsisfia;a isÿ fkdjk nj u;l ;nd .; hq;=h’ úfYaIfhka l< hq;af;a yDohdndOhla we;s ùu j<lajd .ekSug .; hq;= mshjr Ôú;hg tl;= lr .ekSuhs’

    yDo frda. ms<sn| úfYaI{ ffjoH
    jika;s r;akdhl
    m%OdkS" yDo frda. tallh
    l¿;r uy frday,

    yßkaÈ ,shkf.a