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hLk b'3{6gfdf Pssf] d[To', gf} 3fOt] 3f] / fxL, ! c;f/ -o';_– t'n;Lk'/ pkdxfgu/ kflnsf–# nfx'/ ] rf} / df z'qmaf/ ofq'jfxs hLk b'3{6gf x'“bf Pshgfsf] d[To' ePsf] 5 eg] gf} hgf uDeL/ 3fOt] ePsf 5g\ . t'n;Lk'/ af6 / f] Nkfsf] h'“uf/ tkm{ hf“b} u/ ] sf] / f ! h %%^ gDa/ sf] 8an Sofk lksck hLk clgolGqt eO{ ;8saf6 Ps ;o ld6/ tn v: bf hLksf rfns / f] Nkf u+ufb] j ufp“kflnsf–! sf #@ jifL{o lji0f'axfb'/ k'gsf] d[To' ePsf] 5 . pxf“sf] / fKtL k|fb] lzs c: ktfn t'n;Lk'/ df pkrf/ sf] qmddf d[To' ePsf] af“sL clGtd k]hdf:
k|ljlwsf] ljsf; u/L /f]huf/ k|j4{g ug{ ;/sf/n] yk rf/ s/f]8 ah]6 ljlgof]hg u/]sf] 5 . ;/sf/n] b'O{ jif{df b'O{ nfv a]/f]huf/nfO{ /f]huf/ lbg] u/L d'VodGqL cfly{s ljsf; sfo{qmd cl3 ;f/]sf] 5 . of] sfo{qmd ;/sf/L, lghL, u}/ ;/sf/L ;+:yf / ljsf; ;fem]bf/;“usf] ;xsfo{df d'VodGqL cfly{s ljsf; sf]if :yfkgf u/L ;~rfng ug]{ cfly{s dfldnf dGqL wgaxfb'/ df:sLn] atfpg'eof] . To:t} ;/sf/n] d'VodGqL gjk|j4{g sfo{qmd klg cl3 ;f/]sf] 5 . /f]huf/L l;h{gf ug{ ;fgf / demf}nf pBdsf] ljsf; ug{ ;/sf/n] b'O{ s/f]8 /sd ljlgof]hg u/]sf] 5 . o;cl3sf] ;/sf/n] NofPsf] :df6{ s[lif sfo{qmdnfO{ lg/Gt/tf lb+b} !) s/f]8 ah]6 ljlgof]hg ul/Psf] 5 .
:yfgLo afnL ;+/If0f sfo{qmdcGtu{t k|b]zsf ljleGg lhNnfsf nflu 5 s/f]8 !* nfv, kz' kfngsf nflu kf“r s/f]8 ah]6 ljlgof]hg ul/Psf] 5. kz' gZn ;'wf/sf nflu b'O{ s/f]8 ah]6 lalgof]hg ePsf] 5 . s[lifdf oflGqsLs/0f / cfw'lgsLs/0f ub}{ d"No >[v + nfdf cfwfl/t ahf/Ls/0fsf] Joj:yf ug]{ of]hgf cl3 ;fl/Psf] 5 . o:t} cfufdL jif{b]lv ljB'ts \ f] /fli6«o k|;f/0f nfOgsf] vfnL /x]sf] hUuf pkef]u ug]{ gLlt cl3 ;f/]sf] 5 . To;sf nflu ;/sf/n] u}/sfi7hGo pTkfbg ug{ b'O{ s/f]8eGbf a9L ah]6 ljlgof]hg u/]sf] df:sLn] hfgsf/L lbg'eof] . To:t} s[lif, jg tyf xl/ofnL k|j4{g ug{ !! s/f]8, u'NdLsf] dbfg] / /];'u+ fdf kof{ko{6g sfo{qmdsf nflu Ps s/f]8 %) nfv ?k}of“ ah]6 ljlgof]hg ePsf] 5 . ;/sf/n] jGohGt'af6 x'g] Iflt Go"gLs/0f ug{ kLl8t;“u k|b]z ;/sf/ sfo{qmd ;~rfng ug{ Ps s/f]8 %) nfv /sd ljlgof]hg u/]sf] 5 . o;}u/L k|b]z ;/sf/n] 3/]n' pTkfbgsf] dlb/f k|a4{g ug{ !@ s/f]8 /sd Joj:yfkg u/]sf] 5 . d'VodGqL l8NnLaxfb'/ rf}w/Ln] o;cl3 g} :yfgLo:t/df pTkfbg x'g] dlb/fnfO{ k|fyldstf lbP/ /f]huf/L / cfly{s Joj:yfkg ug{k' g]{ ljifo p7fp“b} cfpg'ePsf] lyof] . !@ lhNnf /x]sf] n'lDagLdf sf]bf], df}jfnufot ljleGg af“sL clGtd k]hdf:
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k"j{dGqL;lxt !^ hgf k'k{Ifsf nflu sf/fuf/ o'uaf]w ;dfrf/bftf sf7df8f},+ ! c;f/ . g]kfnLnfO{ gSsnL e'6fgL z/0ffyL{ agfO{ cd]l/sf k7fpg] sfo{df ;+nUg /x]sf] eGb} kqmfp k/]sf k"jd{ GqLx? 6f]kaxfb'/ /fodfemL / afns[i0f vf“0f;lxt !^ cleo'QmnfO{ sf7df8f}+ lhNnf cbfntn] k'kI{ fsf nflu sf/fuf/ k7fPsf] 5 . cbfntn] cleo'QmdWo] nIdL dxh{gnfO{ kf“r nfv / 6+s u'?ªnfO{ !) nfv ?k}of“ w/f}6Ldf lx/f;td'Qm ug{ cfb]z lbPsf] 5 . of] d'2fdf !@ hgf eg] cem} km/f/ 5g\ . lhNnf cbfntsf GofofwLz k|]dk|;fb
Gof}kfg]sf] Ohnf;n] z'qmaf/ k"jp { kk|wfgdGqL 6f]kaxfb'/ /fodfemL / k"ju{ x[ dGqL afns[i0f vf“0f tyf axfnjfnf ;lrj;lxt !^ cleo'QmnfO{ sf/fuf/d} /fv]/ d'2f lsgf/f nufpg]u/L cfb]z lbOPsf] xf] . cg';Gwfgsf qmddf kqmfp k/]sf k"jp { kk|wfgdGqL 6f]kaxfb'/ /fodfemL, k"ju{ x[ dGqL afns[i0f vf“0f, ;lrj 6]sgf/fo0f kf08], tTsfnLg u[xdGqL /fdaxfb'/ yfkfsf ;'/Iff ;Nnfxsf/ OGb|hLt /fO{, g]kfn xh ;ldltsf cWoIf zdz]/ ldof“;lxt !^ / d'2f bfo/ ePkl5 lgoGq0fdf lnOPsf b'Oh { gf xfn Goflos
lx/f;tdf 5g\ eg] of] s;'/df c¿ !@ hgf km/f/ 5g\ . e'6fgL z/0ffyL{ k|s/0fdf kqmfp k/]sf !^ / km/f/ !$ u/L #) hgflj?4 lhNnf ;/sf/L jlsnsf] sfof{no sf7df8f}n + ] 7uL, ;+ul7t ck/fw, lst{] / /fHolj?4sf] ck/fw s;'/df s}b, lauf] / hl/jfgf dfubfaL;lxt h]7 !) df d'2f bfo/ u/]sf] lyof] . @)&( r}t !@ df lu/f]xsf gfOs] s]zj b'nfn, ;fg' e08f/L / 6+s u'?ªnfO{ kqmfp u/kl5 ] k|x/Ln] cbfntaf6 Dofb yk u//] cl3 a9fPsf] cg';Gwfgsf qmddf k"jp{ kk|wfgdGqL Pj+ Pdfn] ;f+;b 6f]kaxfb'/ /fodfemL, k"ju{ x[ dGqL
afns[i0f vf“0f, g]kfn ;/sf/sf ;lrj 6]sgf/fo0f kf08], tTsfnLg u[xdGqL /fdaxfb'/ yfkfsf ;'/Iff ;Nnfxsf/ OGb|hLt /fO{, e'6fgL z/0ffyL{ g]tf 6]sgfy l/hfn;lxt !^ hgf kqmfp k/sf ] lyP . /fodfemL, vf“0f, kf08], /fO{ / l/hfn;lxt lu/f]xsf gfOs] b'nfn, e08f/L, u'?ª, sf+u;sf ]| k"j;{ f+;b cfª6fjf z]kf{, g]kfn xh ;ldltsf cWoIf zdz]/ ldof“, k"jp{ kk|wfgdGqL /fodfemLsf 5f]/f ;GbLk, lu/f]xsf ;b:ox¿ ;fu/ /fO{, /fdz/0f s];L, vf0f u[xdGqL x'b“ f pgsf :jsLo ;lrj /x]sf g/Gb| ] s];L / uf]ljGb rf}w/L cg';Gwfgs} qmddf kqmfp k/sf ] lyP .
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3/leqsf] kmf]xf]/ af6f] 5]p“5fp“df hyfefjL kmfn]sf] b]lvof] . cfkm\gf] 3/sf] kmf]xf]/ 3/leq} Joj:yfkg ug{] / kmf]xf]/ p7fpg] uf8L cfp“bf To;df /flvlbg] xf] . cGoyf sf/jfxL ef]Ug'k5{ .Ú cfkm\gf] cf“vfn] dfq} gb]Vg] u/L ul/g] ;/;kmfO pknlAwd"ns gx'g] pxf“n] atfpg'eof] . sfo{qmddf ;/;kmfO cleoGtf ljdn l/hfnn] ahf/ If]qaf6 lg:sg] Knfl:6s / c:ktfnhGo kmf]xf]/sf] plrt Joj:yfkg x'g g;s]sf]
atfpg'eof] . pxf“n] eGg'eof]– …Pp6f cfdgful/ssf] lx;fan] jt{dfg :yfgLo ;/sf/s} kfnfdf kmf]xf]/ Joj:yfkg s]Gb| Jojl:yt¿kdf ;~rfng x'g]5 eGg] ck]Iff u/]sf] 5' .Ú sfo{qmddf t'n;Lk'/ pjf;+3sf cWoIf /fdk|;fb rfln;] / r]Da/ ckm sd;{sf cWoIf 6f]kaxfb'/ 3tL{n] kmf]xf]/ Joj:yfkgsf nflu kflnsfnfO{ ;+:yfut¿kdf ;xof]u ug{ tof/ /x]sf] atfpg'eof] . sfo{qmdsf k|dv ' cltly tyf
e"–;+/If0f sfof{no t'n;Lk'/sf k|dv ' z]ifbQ rf}w/Ln] aGb sf]7fleqsf] sfo{qmdn] dfq kmf]xf]/ Joj:yfkg x'g g;Sg] eGb} o;sf nflu gful/sx¿sf] Jofks ;xeflutf u/fpg'kg{] wf/0ff /fVg'eof] . jg tyf jftfj/0f dGqfno, n'lDagLsf jftfj/0f lg/LIfs lgd{n rf}w/Ln] k|b]zsf s'g} klg kflnsf;“u cfkm\gf]] kflnsfdf pTkfbg x'g] kmf]xf]/sf] tYof+s gePsf]n] kmf]xf]/ Joj:yfkgdf ;d:of x'g] u/]sf] atfpg'eof] . Knfli6shGo k|bi" f0f lgd{n " kf/f},+ jftfj/0fd}qL ljsNksf] pkof]u u/f}+ eGg] d"n gf/fsf ;fy z'qmaf/ t'n;Lk'/df %) cf}+ ljZj jftfj/0f lbj; dgfOPsf] 5 . sfo{qmdk"j{ t'n;Lk'/sf] jL/]Gb|rf]sb]lv pkdxfgu/sf] sfof{no u]6;Dd ;/;kmfO ul/Psf] lyof] . sfo{qmd gu/ k|dv ' 6Lsf/fd v8\sfsf] cWoIftfdf ePsf] xf] . sfo{qmdaf/] kmf]xf]/d}nf Joj:yfg zfvfsf k|dv ' dfwj kf}8]nn] hfgsf/L u/fpg'ePsf] lyof] eg] sfo{qmdsf] ;xhLs/0f ;"rgf clws[t afa'/fd Gof}kfg]n] ug{e ' Psf] lyof] .
e'd] kj{ M 3f] / fxL–!# j8x/ fdf z'qmaf/ e'd] kj{sf] cj;/ df gfRb} yafªL ;dfh bfªsf du/ ;d'bfo . x/ ] s jif{ c;f/ ! ut] e"ldsf] k"hf tyf gfrufg u/ ] / dgfOg] e'd] kj{ bfª;lxt c7f/ du/ ft If] qdf j;f] jf; ug{] du/ ;d'bfosf] d'Vo kj{ xf] . tl: a/ M s'nbLk Gof} kfg]
b]z lrgfpg rnlrq dxTjk"0f{ dfWod M ;~rf/dGqL o'uaf]w ;dfrf/bftf 3f]/fxL, ! c;f/ . ;~rf/ tyf ;"rgf k|ljlwdGqL /]vf zdf{n] b]znfO{ /fli6«o cGt/f{li6«o?kdf lrgfpg rnlrq dxTjk"0f{ dfWod aGg] atfpg'ePsf] 5 . rnlrq dgf]/~hgsf] ;fwg dfq geO{ ;Gb]z k|jfxsf] ;zQm dfWod klg ePsf] atfp“b} pxf“n] o'jfx?df /fli6«o efjgf ljsf; u/fpg rnlrq If]qn] dxTjk"0f{ e"ldsf v]Ng] ljZjf; JoQm ug'e{ of] . rnlrq ljsf; af]8{sf] cfof]hgfdf z'qmaf/b]lv bfªdf z'? ePsf] k|yd /fli6«o afn rnlrq dxf]T;jdf k|dv ' cltlysf ?kdf af]Nb} dGqL zdf{n] cfkm\gf] klxrfg snf ;+:s[ltnfO{ rnlrqdfkm{t Aofks agfpg ;s] of] b]z lrgfpg] ultnf] dfWod x'g] atfpg'ePsf] lyof] . …rnlrq dgf]/~hgsf] ;fwg dfq} geO{ dflg;sf] dg abNg] cfwf/
xf] . d~rdf ul/g] efif0faf6 eGbf rnlrqsf dfWodaf6 gof“ k':tfnfO{ b]z lrgfpg ;xh x'G5Ú– dGqL zdf{n] eGg'eof]– …k"jb{ ]lv klZrd;Dd, t/fO{b]lv kxf8;Dd g]kfndf /x]sf ljleGg ;+:sf/, ;+:s[lt / cfkm\gf]kgnfO{ Jofks?kdf lj:tf/ ug{ ;s] o'jfx?nfO{ b]z lrgfpg ;lsG5 . rnlrqdfkm{t dgf]/~hgdfq xf]Og, o'jfx?df b]zelQm / ;a}vfnsf ljs[lt lj;+ultlj?4 7Ls9+un] ;Gb]z k|jfx ug{ ;lsG5 .Ú
rnlrq If]qnfO{ dgf]/~hgsf] If]qsf ?kdf dfq ga'em]/ ;r]tgf k|jfx ug],{ /fd|f sfd / nfdf] /fhgLlts cfGbf]ngaf6 k|fKt pknlAwnfO{ hgtfsf aLrdf n}hfg] k|efjsf/L dfWodsf ?kdf klg a'em]/ sfd ug'k{ g]{ cfjZostf /x]sf] dGqL zdf{sf] egfO lyof] . pxf“n] b]z / ;dfhsf] ?kfGt/0f;“u rnlrq If]qnfO{ hf]8]/ snfsf/nfO{ rnlrq If]qdf af“sL clGtd k]hdf:
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3f]/fxL, ! c;f/ . cg'udgsf qmddf km]nf k/]sf] ;8]sf] bfn gi6 ul/Psf] 5 eg] Nofj l/kf]6{df ;/sf/L dfkb08 gk'u]sf] rfdn sDkgLdf lkmtf{ ul/g] ePsf] 5 . lhNnf k|zf;g sfof{nosf] 6f]nLn] 3f]/fxL pkdxfgu/kflnsf j8f g+= !$ l:yt k|1f ;Knfo;{sf] uf]bfddf Dofb gf3]sf] rfdn af]/faf6 lgsfn]/ gof“ af]/fdf /fVb} Koflsª ub}{ u/]sf] km]nf k/]kl5 pQm k;nsf] uf]bfd h]7 * ut] l;n u/]sf] lyof] . k|zf;gn] l;n tf]8]/ pQm ;Knfo;{sf] uf]bfddf /x]sf]
Dofb n]an gul/Psf rfdnsf af]/f, Dofb gf3]sf] rfdn, bfn, lrgLnufotsf vfB ;fdu|Lsf] vfB :jR5tf k/LIf0fsf nflu k7fPsf] gd"gfsf] l/kf]6{df kf“r nfv %^ xhf/ ^ ;o d"No a/fa/sf] rf/ ;o *$ af]/f rfdnsf] l/kf]6{df s}lkmot b]lvPsf] xf] . pQm rfdn b]Vbf /fd|f] b]lvPsf]n] gi6 gu/L ;a} ;/f]sf/jfnfsf] ;xdltdf Aoj;foLdfkm{t sDkgLdf lkmtf{ k7fpg] lg0f{o ePsf] ;xfos k|dv ' lhNnf clwsf/L ;fljqf k'gn] hfgsf/L lbg'eof] . pxf“n] ;ft lbgleq rfdn lkmtf{ k7fPsf] sfuhft;lxt lhNnf k|zf;g sfof{nodf
Joj;foLnfO{ xflh/ x'g lgb]z { g lbPsf] hfgsf/L lbg'eof] . k|zf;g sfof{non] tLg ;o &% lsnf] /fhdf bfn ;8]sf] cj:yfdf km]nf kf/]sf]n] gi6 u/]sf] 5 . ;8]sf] bfn #& xhf/ kf“r ;o ?k}of“ a/fa/sf] gi6 ul/Psf] xf] . ;fy} ;f]xL ;Knfo;{af6 o;cl3 hkmt ul/Psf] rf/ xhf/ b'O{ ;o d"No a/fa/sf] lrgL / Ps xhf/ kf“r ;o a/fa/sf] rfdn klg gi6 ul/Psf] 5 . vfB k|ljlw tyf u'0f lgoGq0f sfof{no t'n;Lk'/sf vfB lg/LIfs /fh]z rf}w/Lsf] pkl:yltdf h]7 !& ut] a'waf/ @% s]hLsf] PKkn af“sL clGtd k]hdf:
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MBBS, MD Internal Medicine DM Cardiology
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