bvix I ü`‡ivM

Wv. Z…ßxk P›`ª †Nvl

nvU© †Kqvi dvD‡Ûkb, Kzwgjv, evsjv‡`k

01
bvix I ü`‡ivM
Wv. Z…ßxk P›`ª †Nvl
cÖKvkKvj
†deª“qvix, 2011
cybg©y`ªY
†deª“qvix, 2012
cÖKvkK
nvU© †Kqvi dvD‡Ûkb, Kzwgjv, evsjv‡`k
I‡qe : WWW.heartcarefoundationcb.org

cÖ”Q` cwiKíbv
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k¨vgjx ivq
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50.00 UvKv gvÎ
gy`ªY

180 dwKivcyj, XvKv

Naree O Ridrog
Dr. Triptish Chandra Ghose

Published by
Heart Care Foundation
Comilla, Bangladesh

Price
US $ 1.00
ISBN No - 978-984-33-2541-9

02
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hviv cwiev‡ii mevi nvU©‡K my¯’ ivL‡Z
wb‡R‡`i me©¯^ DRvi K‡i †`q

03
 †jL‡Ki BwZc~ ‡e© cÖKvwkZ MÖš’
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nvU© A¨vUvK I †÷ªvK - Rvbv ARvbv
Ges †`ªv‡ni Avw`g cyi“l (Kve¨ MÖš’)

04
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fqven, GgbwK g„Zz¨i AvksKvI cyi“l‡`i †P‡q †e‡o hvq| c„w_exi
Ab¨vb¨ Dbœqbkxj †`‡k‡Zv e‡UB GgbwK Av‡gwiKvi gZ DbœZ †`‡kiI
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nq ev K‡g hvq, wKš‘ ey‡K e¨_v Abyf~Z nq bv| d‡j K‡ivbvix nvU©
wWwRR wbY©q AviI KwVb n‡q c‡o|
Avevi A‡bK mgq GKB ai‡bi Ae÷ªvKwUf nvU© wWwR‡Ri DcmM© wb‡q
gwnjviv hLb Wv³v‡ii Kv‡Q †ivM eY©bv K‡ib ZLb †mUv cyi“l‡`i
Zzjbvq Kg ¸i“Zi e‡j g‡b nq, d‡j †ivM wbY©‡q mgm¨v †`Lv †`q|
hw`I †Kvb †Kvb DbœZ †`‡k Av‡Mi †P‡q †ekx K‡i bvixiv eyS‡Z cvi‡Q
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Z_vwc A‡bK bvixB ü`‡iv‡Mi wi¯‹d¨v±i Ges Zv‡`i wb‡R‡`i e¨w³MZ
wi¯‹ d¨v±i¸‡jvi mv‡_ †hvMm~Î ¯’vcb Ki‡Z e¨_© nq|
†h mKj bvix †gvUv, kvixwiK cwikªg Kg K‡ib, 65 eQ‡ii †ekx eqmx,
we‡kl b„ZvwËK Rb‡Mvôxi cÖwZwbwaZ¡ K‡i, hv‡`i D”P i³Pvc I i‡³
†Kv‡j‡÷ij †ekx i‡q‡Q Ges hviv Wvqv‡ewUK Zv‡`i ü`‡iv‡Mi SzuwK
†ekx i‡q‡Q|
bvix‡`i ü`‡ivM wbY©q Ges wPwKrmvi †¶‡Î mgm¨vI A‡bK| A‡bK
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Av‡Q wKbv Rvb‡Z cvwi wKš‘ wbw`©ó wKQy cix¶vi Kvh©KvwiZv bvix-cyi“‡l
wfbœ n‡Z cv‡i|

05
Rb¥-wbqš¿‡bi ewo Ges ni‡gvb †_ivwc K‡ivbvix nvU© wWwR‡Ri Dci wK
ai‡bi cÖfve †d‡j †m welqwU GLbI cy‡ivcywi cwi¯‹vi bq d‡j Zv wb‡q
Av‡iv M‡elYvi my‡hvM i‡q‡Q|
ü`‡iv‡Mi Ily‡ai mv‡_ ¯^v¯’¨Ki Lvevi, wbqwgZ KvwqK kªg Ges kvixwiK
IRb wbqš¿Y, ü`‡ivM wbqš¿Y ev cÖwZ‡iva Ki‡Z mvnvh¨ K‡i|
Av‡gwiKvq kZKiv 57 Rb bvix Rv‡b †h K‡ivbvix ü`‡ivM n‡”Q bvix
g„Zy¨i Ab¨Zg cÖavb KviY| 2006 mv‡ji GB cwimsL¨vY c~e©eZx©
eQi¸‡jvi Zzjbvq A‡bK †ekx| Aek¨B GwU weMZ K‡qK eQ‡i IB
†`‡k G wel‡q m‡PZbZv Av‡›`vj‡bi dmj|
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K‡i nvU© A¨vUvK Z_v ü`‡iv‡Mi KviY, DcmM© I j¶Y¸‡jv m¤ú‡K©
Rvb‡Z n‡e Ges Zvi cÖwZKvi I cÖwZ‡iv‡a AviI †ekx m‡PZb n‡Z
n‡e| Avi Avgv‡`i g‡Zv Dbœqbkxj †`‡ki Rb¨, †hLv‡b RbmsL¨vi
A‡a©‡KiI †ekx bvix, GwU GLb mg‡qi `vex| GLbB hw` Avgiv GB
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gnvgvix †_‡K Avgv‡`i †`‡ki bvixmgvR Z_v weivU Rb‡Mvôx‡K i¶v
Kiv KwVb n‡q hv‡e|
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Bbw÷wUDU Ges BD‡ivwcqvb †mvmvBwU Ae KvwW©IjwR mn wewfbœ ms¯’vi
M‡elYvjä Z_¨ †`qv n‡q‡Q|
me‡k‡l GB eB‡qi cÖKvk I cÖPv‡ii mv‡_ mswkó mevi cÖwZ K…ZÁZv|

Wv. Z…ßxk P›`ª †Nvl

06
ü`‡ivM : bvix‡`i Rb¨ †iW GjvU©
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wRwbmwUi †ekx cÖ‡qvRb †mwU n‡jv GKwU my¯’ nvU©| my¯’ nvU© eqm Ges
wj½ wb‡e©‡k‡l mevi Rb¨B cÖ‡qvRb |
ü`‡ivM ïaygvÎ cyi“‡li †ivM bq| nvU© A¨vUvK, †÷ªvK Ges Ab¨vb¨
ü`‡ivM gwnjv‡`i Rb¨I AZ¨š— ¶wZKi| mwZ¨K_v ej‡Z wK, †h Kvi‡Y
nvU© A¨vUvK nq †mB K‡ivbvwi nvU© wWwRR n‡jv Av‡gwiKvq bvix g„Zz¨i
GK b¤^i KviY| A‡bK gwnjviv wKš‘ GLbI wek¦vm K‡i †h, K¨vÝviB
Zv‡`i g„Zy¨i cÖavb KviY, wKš‘ †mUv f~j| we‡kl K‡i Av‡gwiKvi Z_¨
ch©v‡jvPbv Ki‡j †`Lv hvq, ¯—b K¨vÝvimn mKj ai‡bi K¨vÝv‡i hZ
bvixi g„Zz¨ nq Zvi cÖvq wظY g„Zz¨ nq nvU© A¨vUvK Ges †÷ªvKmn Ab¨vb¨
ü`‡iv‡M| nvU© A¨vUvK Ges †÷ªvK n‡”Q c„w_ex‡Z bvix g„Zz¨i GKb¤^i
KviY| GB mZ¨ bvix‡K Rvb‡Z n‡e| cÖwZeQi c„w_ex‡Z 8.6 wgwjqb
bvixi g„Zz¨i nq ü`‡iv‡M Avµvš— n‡q Ges GUvB me‡P‡q eo I GKK
bvix g„Zz¨i KviY|
†Kb bvix ?
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Avgv‡`i †`‡k G hveZ bvixi ¯^v¯’¨ †mevq hZUzKz bRi †`qv n‡q‡Q Zvi
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g„Zz¨ †iv‡a wKQy KvR n‡q‡Q| myZivs GUv Ab¯^xKvh© †h, ü`‡ivMvµvš—
bvixiv Zzjbvg~jKfv‡e Kg wPwKrmv †c‡q _v‡Kb| A‡bK bvixB ü`‡ivM
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GKevi n‡j mvivRxe‡bi Rb¨ Zv e‡q †eov‡Z nq| wewfbœ cwimsL¨vY
†_‡K ejv hvq, Lye Kg msL¨K ü`‡ivMvµvš— bvixi A¨vbwRIcvwó ev
K‡ivbvix AvU©vix evBcvm Acv‡ikb nq| hw`I mwZ¨ K_v nj - K‡ivbvwi
AvU©vix evBcvm Acv‡ikb A_ev GbwRIcvwói gva¨‡g i³, Aw·‡Rb Ges
Ab¨vb¨ cywó nv‡U© mn‡R †cŠuQv‡bvi e¨e¯’v Kiv nq, wKš‘ agwb¸‡jv‡Zv
Amy¯’ †_‡KB hvq| Avi GB i³bvjx¸‡jv µ‡gB Lvivc n‡Z _vK‡e hw`
bv Avcwb - Avcbvi ˆ`bw›`b Rxebavivq cwieZ©b Av‡bb|

07
bvixi mv‡_ m¤úwK©Z ü`‡ivM welqK wKQy M‡elYvjä Z_¨ -
K‡ivbvwi ü`‡ivM

RvwZ ag© eY© wbwe©‡k‡l bvix g„Zz¨i GKb¤^i KviY - ü`‡ivM|

GK Z…Zxqvs‡kiI †ekx bvix †Kvb bv †Kvb ai‡bi ü`‡iv‡M f~M‡Q|
Av‡gwiKvq cÖwZ 4 R‡b 1 Rb ü`‡iv‡M fyM‡Qb Avi cÖwZ 30 R‡b
GKRb ¯—b K¨vÝv‡i gviv hvq|
weMZ 1984 mv‡ji ci †_‡K ü`‡iv‡M bvix g„Zy¨i msL¨v cyi“l‡`i‡K
Qvwo‡q †M‡Q|
GK mgx¶vq †`Lv †M‡Q cÖwZ `k R‡bi g‡a¨ Qq Rb wPwKrmKB g‡b
K‡ib cyi“livB †÷ªv‡K gviv hvq †ekx, hw`I †÷ªv‡K bvixi g„Zz¨ nq
cÖvq kZKiv 11 fvM, wKš‘ cyi“‡li †¶‡Î Zv gvÎ kZKiv 8.5 fvM|
evsjv‡`‡k g„Zz¨i KviY we‡klYagx© GK mgx¶vi wi‡cv‡U© †`Lv hvq
†h, 2009 mv‡ji Rvbyqvix †_‡K wW‡m¤^i gvm ch©š— wewfbœ Dc‡Rjv
¯^v¯’¨‡K›`ª, †Rjv nvmcvZvj, †Rbv‡ij nvmcvZvj I †gwW‡Kj K‡jR
nvmcvZv‡j h_vµ‡g 17.7, 22.8, 16 I 21 kZvsk g„Zy¨i KviY
ü`‡ivM Ges cÂv‡kvaŸ© bvixiv GKB eqm mxgvi cyi“‡li Zzjbvq
†ekx ü`‡iv‡Mi SzuwK‡Z Av‡Qb|
eZ©gv‡b cÖvq 8.4 wgwjqb bvix nvU© A¨vUvK A_ev A¨vbwRbv
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i‡q‡Q gv‡qvKvwW©qvj BbdvK©kb ev nvU© A¨vU¨v‡Ki BwZnvm|
cyi“l‡`i Zzjbvq bvixiv A¨vbwRbv †c‡±vwi‡m Avµvš— nq †ekx hv
wKbv 5.5 wgwjqb ebvg 4.7 wgwjqb|
Pwjk ev Zvi †ekx eqmx bvix‡`i g‡a¨ kZKiv 23 Rb bvix nvU©
A¨vUvK nIqvi 1 eQ‡ii g‡a¨ gviv hvq|
nvU© A¨vUv‡K Avµvš— cyi“‡li (42%) Zzjbvq bvixivB (52%)
†ekx nvmcvZv‡j †bqvi Av‡M g„Zz¨eiY K‡i|

08
 cyi“l‡`i Zzjbvq bvix‡`i nvU© A¨vUvK nq GKUz †ekx eq‡m| Avi
†ekx eqmx bvix‡`i AwaKvsk nvU© A¨vUv‡Ki K‡qK mßv‡ni g‡a¨B
gviv hvq|
45-65 eQi eqmx bvix‡`i cÖwZ 8 R‡b 1 Rb ü`‡iv‡M Avµvš— nq
Avi 65 eQ‡ii †ekx eqmx bvix‡`i †¶‡Î GB cwimsL¨vY †e‡o n‡q
hvq 4 R‡b 1 Rb |
`yB-Z…Zxqvsk bvix nvU© A¨vUv‡Ki ci cy‡ivcywi my¯’ n‡q D‡V bv| nvU©
A¨vUv‡Ki 6 eQ‡ii g‡a¨ bvix‡`i wØZxqevi A¨vUvK nq|
ü`‡iv‡Mi Kvi‡Y nVvr g„Zz¨eiY K‡i Ggb kZKiv 64 Rb bvixi
†¶‡Î c~‡e© K‡ivbvwi nvU© wWwR‡Ri †Kvb DcmM© †`Lv hvq bv|
†÷ªvK
cÖwZ eQi Av‡gwiKvq cyi“l‡`i †_‡K cÖvq 55 nvRvi †ekx bvix
†÷ªv‡K Avµvš— nq| KviY bvixiv cyi“l‡`i Zzjbvq †ekx w`b euv‡P
Avi †÷ªvK nIqvi nvi e„× eq‡mB †ekx|
2006 mv‡j Av‡gwiKvq †÷ªv‡K gviv hvq cÖvq 82595 Rb gwnjv hv
wQj †÷ªv‡K mKj g„Zz¨i kZKiv 60.2 fvM| Avi IB eQi mvgwMÖK
g„Zz¨i kZKiv 43.6 Rb gviv hvq †÷ªv‡Ki Kvi‡Y|
Av‡iKwU ¸i“Z¡c~Y© Z_¨ n‡jv GB g„Zz¨i kZKiv 41.1 Rb n‡jv
†kZv½ bvix Ges kZKiv 51.0 K…òv½ bvix|
nvU© †dBwjDi
Av‡gwiKvq eZ©gv‡b cÖvq 27 j¶ bvix nvU© †dBwjDi wb‡q emevm
Ki‡Qb|
GK Rix‡c †`Lv †M‡Q 2006 mv‡j mvgwMÖKfv‡e nvU© †dBwjD‡ii
Kvi‡Y gviv †M‡Q kZKiv 89.2 fvM †jvK, Gi g‡a¨ kZKiv
56.3 fvM bvix| Avi Zvi g‡a¨ 80.3 Rb †kZv½ bvix Ges
kZKiv 84.4 Rb K…òv½ bvix|
nvU© A¨vUvK nIqvi 6 eQ‡ii g‡a¨ kZKiv 46 Rb bvix nvU©
†dBwjD‡ii Kvi‡Y Kg©¶gZv nvwi‡q †d‡j|

09
Rb¥MZ ü`‡ivM
Av‡gwiKvq 2006 mv‡j mvgwMÖK g„Zz¨i kZKiv 1.2 fvM gviv hvq
Rb¥MZfv‡e nv‡U©i ΓwUi Kvi‡Y, Gi g‡a¨ kZKiv 1 Rb bvix Avi
kZKiv 1.3 Rb cyi“l|
evZR¡i
evsjv‡`‡k MÖvgxY wkï‡`i g‡a¨ GK Rix‡c †`Lv †M‡Q †h, 5-15
eQi eqmx‡`i g‡a¨ cÖwZ GK nvRvi R‡b 1.2 Rb evZR¡‡i Ges
1.3 Rb evZR¡i RwbZ ü`‡iv‡M Avµvš—| c¶vš—‡i Av‡gwiKvq
2006 mv‡ji Rix‡c †`Lv hvq evZR¡i RwbZ ü`‡iv‡M eQ‡i g„Zz¨
nvi kZKiv 1.1 fvM| hvi g‡a¨ 1.3 Rb †kZv½ bvix Ges kZKiv
0.9 Rb K…òv½ bvix|
mviv c„w_ex‡Z hZ bvixi g„Zz¨ nq Zvi GK Z…Zxqvs‡ki g„Zz¨ nq nvU©
A¨vUv‡K| Avi Dbœqbkxj †`k¸‡jv‡Z GB wPÎ AviI AvksKvRbK|
hw`I gwnjviv K‡ivbvwi nvU© wWwR‡R Avµvš— nq cyi“‡li †P‡q cÖvq 10
eQi c‡i KviY FZzmªve ¯’vqxfv‡e eÜ n‡q hvIqvi c~‡e© B‡÷ªv‡Rb bvgK
ni‡gv‡bi cÖwZ‡ivax ¶gZvi Kvi‡Y FZzeZx gwnjv‡`i nvU© A¨vUv‡Ki
m¤¢vebv Kg _v‡K| Z_vwc mKj bvixg„Zz¨i cÖvq A‡a©KB nq nvU© A¨vUvK
Ges †÷ªvK Gi Kvi‡Y| †ekxifvM bvixivB Rv‡bbv †h Zv‡`i g„Zz¨i cÖavb
KviY n‡jv ü`‡ivM Ges †÷ªvK|
ü`‡ivM bvix cyi“l mevi Rb¨B g„Zz¨i Ab¨Zg cÖavb KviY| ZviciI GB
†iv‡Mi Dcm‡M©i cÖKvk, Zvi wPwKrmv c×wZi Kvh©KvwiZv wKsev
wbivcËvi wel‡q bvix Ges cyi“l `yR‡bi †¶‡Î wfbœZv j¶¨ Kiv hvq|
GQvovI wewfbœ Jly‡ai Kvh©KvwiZvI bvix cyi“‡l wfbœ n‡Z cv‡i| AZx‡Z
ü`‡ivM welqK wewfbœ M‡elYvq bvix‡`i AskMÖnY Zzjbvg~jKfv‡e A‡bK
Kg n‡q‡Q| myZivs cyi“‡li cvkvcvwk bvixi ü`‡ivM cÖwZ‡iva I Zvi
wPwKrmvi wewfbœ w`K wb‡q AviI †ekx K‡i M‡elYvi ¸i“Z¡ Ab¯^xKvh©|
bvix n‡”Q Avgv‡`i cwiev‡ii nvU©| bvixiv mviv Rxeb wb‡R‡`i me©¯^
DRvi K‡i w`‡q cwiev‡ii mevi nvU©‡K my¯’ ivL‡Z †Póv K‡i wKš‘ GB
bvix‡`i nvU©B hw` Ae‡nwjZ _v‡K Zvn‡j Zv‡`i wb‡R‡`i Rxeb‡Zv
e‡UB †MvUv cwiev‡ii ¯^v¯’¨B wecbœ n‡q c‡o| myZivs Avgv‡`i Aek¨B
bvixi ü`¯^v¯’¨ i¶vq AviI †ekx ¸i“Z¡ w`‡Z n‡e|

10
ü`‡iv‡Mi wi¯‹ d¨v±i
K‡ivbvwi ü`‡ivM n‡jv GKvwaK Kvi‡Y m„wó nIqv A‡bK¸‡jv †iv‡Mi
e„n`v‡_© mgwš^Z bvgKiY| Avi wi¯‹ d¨v±i nj GKai‡bi Ae¯’v ev
Af¨vm hv †ivM ˆZix‡Z mvnvh¨ K‡i| GKwU my¯’ nvU© †h mKj Kvi‡Y
Amy¯’ n‡q hvq †m¸‡jv‡KB ü`‡iv‡Mi wi¯‹ d¨v±i e‡j|
†h Kvi‡Y GB †ivM nq A_©vr wi¯‹ d¨v±i Ges GB †iv‡Mi j¶Y I
DcmM©¸‡jv m¤ú‡K© Rvbv n‡”Q GB †iv‡Mi wei“‡× jovB‡qi cÖ_g
c`‡¶c Avi Gi gva¨‡gB bvixi Rxeb evuPv‡bv m¤¢e|
40 †_‡K 60 eQi eqmx bvix‡`i kZKiv 31 R‡bi Kgc‡¶ GKwU
wi¯‹d¨v±i Av‡Q hv wKbv †m cwieZ©b Ki‡Z cv‡i| Av‡iv kZKiv 31
R‡bi 2wU Ges kZKiv 17 R‡bi 3wU ev Zvi AwaK wi¯‹ d¨v±i Av‡Q|
Av‡gwiKvb nvU© G‡mvwm‡qkb, Av‡gwiKvb K‡jR Ae KvwW©I‡jvwR,
BD‡ivwcqvb †mvmvBwU Ae KvwW©I‡jvwRmn wewfbœ ms¯’v M‡elYv K‡i nvU©
A¨vUvK Ges †÷ªv‡Ki KZK¸‡jv wi¯‹ d¨v±i wbY©q K‡i‡Q| †h bvixi
kix‡i hZ †ewk wi¯‹ d¨v±i i‡q‡Q Zvi nvU© A¨vUvK Ges †÷ªv‡Ki m¤¢vebv
ZZ †ewk| wKQy wKQy wi¯‹ d¨v±i‡K wbqš¿Y Kiv m¤¢e bq, †hgb
µgea©gvb eqm, wj½ I eY©, ü`‡iv‡Mi cvwievwiK BwZnvm Ges
ü`‡iv‡Mi c~e© BwZnvm | wKš‘ AwaKvsk wi¯‹ d¨v±iB cwieZ©b ev wbqš¿Y
K‡i nvU© A¨vUvK Ges †÷ªv‡Ki m¤¢vebv‡K Kwg‡q Avbv m¤¢e|
ü`‡iv‡M g„Zz¨i kZKiv 70 fvMB wbqš¿Y‡hvM¨ wi¯‹ d¨v±i¸‡jvi mv‡_
m¤úwK©Z|
nvU© A¨vUvK Ges †÷ªv‡Ki wi¯‹ d¨v±i ev SzuwKi KviY¸‡jv‡K `yÕfv‡M fvM
Kiv hvq -
1) wbqš¿Y ev cwieZ©b A‡hvM¨
2) wbqš¿Y ev cwieZ©b †hvM¨

11
1) wbqš¿Y ev cwieZ©b A‡hvM¨
nvU© A¨vUvK Ges †÷ªv‡Ki †h mKj wi¯‹d¨v±i¸‡jv wbqš¿Y ev
cwieZ©b Kiv m¤¢e bq -
eqm
wj½
eY©
nvU© A¨vUvK I †÷ªv‡Ki c~e© BwZnvm
nvU© A¨vUvK I †÷ªv‡Ki cvwievwiK BwZnvm

2) wbqš¿Y ev cwieZ©b †hvM¨

nvU© A¨vUvK Ges †÷ªv‡Ki †h mKj wi¯‹d¨v±i¸‡jv wbqš¿Y ev
cwieZ©b Kiv m¤¢e -
a~gcvb
i‡³ †Kv‡j‡ói‡ji fvimvg¨nxbZv ev wWmwjwc‡Wwgqv
D”P i³Pvc ev nvBcvi‡Ubkb
i‡³ D”PgvÎvq My‡KvR ev Wvqv‡ewUm
Awbqwš¿Z Lv`¨vf¨vm
AwZwi³ IRb ev †g`fu~wo
Ach©vß kvixwiK kªg
AwZwi³ g`¨cvb
mvgvwRK Pvc I gvbwmK `~wðš—v
3) we‡kl ai‡bi wi¯‹ d¨v±i
†gUvewjK wmbWªg
w¯c-A¨vcwbqv
4) bZzb ai‡bi wi¯‹ d¨v±i
wm-wiq¨vKwUf †cÖvwUb (wmAviwc)
†nvgwmw÷b
wdweª‡bv‡Rb
jvB‡cv‡cÖvwUb - G

12
nvU© A¨vUv‡Ki wbqš¿Y A‡hvM¨ SzuwK mg~n
eqm
eqm hZ evo‡e nvU© A¨vUvK Ges †÷ªv‡Ki m¤¢vebvI evo‡Z _vK‡e|
55 eQ‡ii c‡i cÖwZ 10 eQi Aš—i ü`‡iv‡Mi SzuwK wظY e„w× cvq|
gwnjviv †h‡nZz †ekx w`b euv‡P myZivs Zv‡`i eqm evovi mv‡_ mv‡_
nvU© A¨vUvK Ges †÷ªv‡Ki SzuwKI evo‡Z _v‡K| 45-65 eQ‡ii cÖwZ
8 R‡b 1 Rb bvix ü`‡iv‡M Avµvš— nq Z‡e GB eqm †e‡o 65
†ekx n‡j GB cwimsL¨vY †e‡o 4 R‡b 1 Rb n‡q hvq|
Pwjk ev Z`yש †h mKj bvixi GKevi nvU© A¨vUvK n‡q‡Q Zv‡`i
g‡a¨ kZKiv 43 Rb cieZx© 5 eQ‡ii g‡a¨ ü`‡iv‡M g„Zz¨eiY
K‡ib|
wj½
FZzewZ gwnjv‡`i Zzjbvq cyi“l‡`i nvU© A¨vUv‡Ki SzuwK †ewk Ges
cyi“l‡`i nvU© A¨vUvK nq Zzjbvg~jKfv‡e Kg eq‡m|
FZz eÜ n‡q hvIqvi ci cyi“l Ges gwnjv‡`i ü`‡iv‡Mi SzuwK cÖvq
mgvb|
Aciw`‡K cyi“l‡`i Zzjbvq gwnjv‡`i †óªv‡Ki SzuwK †ewk| cÖwZ eQi
55 nvRvi †ekx bvix †÷ªv‡K Avµvš— nq Ges †÷ªv‡K g„Zz¨i kZKiv
60 fvMB bvix|
eY©
†k¦Zv½ bvix‡`i Zzjbvq K…òv½ Ges Gwkqvb bvix‡`i ü`‡iv‡Mi
SzuwK †ekx| †k¦Zv½‡`i Zzjbvq Avwd«Kvb-Av‡gwiKvb cyi“l Ges
gwnjv Df‡qiB †÷ªv‡Ki Kvi‡Y g„Zz¨ nvi †ewk|
eY© Ges RvwZMZfv‡e msL¨vjNy bvix‡`i Aí eq‡m nvU© A¨vUv‡K
g„Zz¨nvi †k¦Zv½ bvix‡`i Zzjbvq †ekx| Aek¨ Ggb msL¨vjNy
bvix‡`i g‡a¨ Wvqv‡ewU‡mi AvwaK¨I G AKvj g„Zz¨i Rb¨
A‡bKvs‡k `vqx| cvkvcvwk G †ivM m¤^‡Ü G‡`i g‡a¨ m‡PZbZvi
AfveI ¸i“Z¡c~Y© fywgKv iv‡L|

13
nvU© A¨vUvK I †÷ªv‡Ki c~e© BwZnvm
†h mKj gwnjvi GKevi nvU© A¨vUvK n‡q‡Q Zv‡`i wØZxqevi nvU©
A¨vUv‡Ki m¤¢vebv A‡bK †ewk|
40 †_‡K 69 ermi eqmx bvix hviv GKevi nvU© A¨vUvK ev †÷ªv‡K
Avµvš— nIqvi ci †eu‡P Av‡Q Zv‡`i g‡a¨ kZKiv 22 R‡bi
cieZ©x 5 (cuvP) eQ‡ii g‡a¨ wØZxqevi nvU© A¨vUvK ev †÷ªv‡K
Avµvš— nIqvi m¤¢vebv _v‡K|
¶Y¯’vqx B‡¯‹wgK A¨vUvK (TIA) ev Õwgwb †÷ªvKÕI †÷ªv‡Ki GKwU
wi¯‹ d¨v±i|

nvU© A¨vUvK I †÷ªv‡Ki cvwievwiK BwZnvm

bvix-cyi“l Df‡qi †¶‡ÎB hv‡`i evev-gv, fvB-†evb ev i‡³i
m¤úwK©Z †Kvb wbKUvwZ¥‡qi nvU© A¨vUvK wKsev †÷ªv‡K Avµvš—
nIqvi BwZnvm Av‡Q Zv‡`i nvU© A¨vUvK wKsev †÷ªv‡Ki m¤¢vebv
†ewk|
hv‡`i evev-fvB 55 eQi Ges gv-†evb 65 eQ‡ii c~‡e© ü`‡ivM ev
†óªv‡K Avµvš— n‡q‡Q Zv‡`i ü`‡iv‡Mi SzuwK †ewk|

14
nvU© A¨vUv‡Ki wbqš¿Y‡hvM¨ SzuwK mg~n
bvix‡`i nvU© A¨vUv‡Ki †¶‡Î a~gcv‡bi cÖfve
a~gcvb bvix‡`i †¶‡ÎI ü`‡iv‡Mi Ab¨Zg cÖavb KviY| a~gcvb
n‡”Q Av‡gwiKvq g„Zz¨i GKK cÖavb cÖwZ‡iva‡hvM¨ KviY|
ü`‡iv‡Mi Ab¨vb¨ SzuwKi gvÎv Kwg‡q Avbvi ciI a~gcv‡bi Kvi‡Y
gwnjv‡`i g‡a¨ ü`‡iv‡M Avµvš— n‡q g„Zz¨i nvi †ekx| KviY
bvix‡`i g‡a¨ wb‡KvwUb †gUv‡evwjRg Lye `ª“Z nq we‡kl K‡i hviv
Rb¥wbqš¿‡Yi ewo †meb K‡i|
hZ Kgeq‡m a~gcvb ïi“ Ki‡e ü`‡iv‡Mi m¤¢vebv ev SzuwK evo‡e
ZZ †ewk| we‡kl K‡i hviv 15 eQ‡iiI Kg eq‡m a~gcvb ïi“ K‡i
Zv‡`i nvU© A¨vUv‡Ki SzuwKi gvÎv A‡bKvs‡k †e‡o hvq|
Kg©‡¶‡Î wKsev N‡i a~gcvqx‡`i Av‡k-cv‡k Ae¯’vbKvix‡`i
a~gcv‡bi c‡iv¶ cÖfv‡e (Passive Smoking) ü`‡iv‡Mi SzuwK
†e‡o hvq kZKiv 30 fvM, GgbwK hviv a~gcvb K‡i bv ZvivI GB
SzuwKi g‡a¨ Av‡Qb|
a~gcvb Ges Rb¥wbqš¿‡Yi ewo GKm‡½ †meb Ki‡j Aí eq‡m
bvix‡`i g‡a¨ nvU© A¨vUv‡Ki SzuwK eû¸Y †e‡o hvq|
a~gcvqx‡`i Dci †gUvGbvjvBwm‡m †`Lv hvq a~gcvqxiv nvU©
A¨vUv‡Ki ci a~gcvb †Q‡o w`‡j g„Zz¨ nvi kZKiv 46 fvM K‡g
hvq|
†h mKj gwnjviv a~gcvb K‡ib Zv‡`i B‡¯‹wgK †÷ªvK Ges gw¯—‡®‹
i³¶iYRwbZ †÷ªvK `y‡UviB m¤¢vebv †ekx|

15
bvixi i‡³ †Kv‡j‡÷i‡ji fvimvg¨nxbZv ev wWmwjwc‡Wwgqv
i‡³ D”PgvÎvq †Kv‡j‡÷ij nvU© A¨vUvK Ges †÷ªv‡Ki Ab¨Zg
cÖavb SzuwKi KviY|
wewfbœ M‡elYvq †`Lv †M‡Q, 55 eQ‡ii ci gwnjv‡`i i‡³
†Kv‡j‡÷ij cyi“l‡`i Zzjbvq †ekx _v‡K|
i‡³ D”PgvÎvq GjwWGj †Kv‡j‡÷ij (Lvivc †Kv‡j‡÷ij)
ü`‡ivM Ges nvU© A¨vUv‡Ki SzuwK evwo‡q †`q| Ab¨w`‡K i‡³ D”P
gvÎvq GBPwWGj †Kv‡j‡÷ij (fvj †Kv‡j‡÷ij) ü`‡ivM Ges
nvU© A¨vUv‡Ki SzuwK Kgvq|
M‡elYvq †`Lv †M‡Q, gwnjv‡`i i‡³ GBPwWGj †Kv‡j‡÷ij Kg
_vK‡j nvU© A¨vUv‡Ki SzuwK cyi“l‡`i Zzjbvq †e‡o hvq|

†Kv‡j‡÷ij Kgv‡bvi Jla Gi e¨envi

bvix Ges cyi“l Df‡qi †¶‡ÎB †÷wUb (i‡³ †Kv‡j‡÷ij Kgv‡bvi
Jla) ü`‡iv‡Mi NUbv ev m¤¢vebv Kgvq|
mv¤cÖwZKKv‡j RywcUvi Uªvqv‡j †`Lv‡bv n‡q‡Q hv‡`i Av‡M
ü`‡iv‡Mi †Kvb BwZnvm †bB, i‡³ GjwWGj †Kv‡j‡÷ij ¯^vfvweK
Ges wmAviwc D”PgvÎvq ¯úk©KvZi †m †¶‡Î imyfv‡÷wUb (i‡³
†Kv‡j‡÷ij Kgv‡bvi Jla) bvix Ges cyi“l Df‡qi †¶‡ÎB
D‡jL‡hvM¨ cwigv‡Y ü`‡iv‡Mi SzuwK Kgvq|
2007 mv‡j BD‡ivwcqvb MvBWjvBb Abymv‡i bvix cyi“l Df‡qi
Rb¨B hv‡`i ü`‡ivM n‡q‡Q Ges hv‡`i i‡³ D”PgvÎvq
†Kv‡j‡÷ij Av‡Q Zv‡`i Rb¨ †÷wUb MÖnY Kivi mycvwik Kiv
n‡q‡Q|

16
bvix‡`‡n D”P i³Pvc ev nvBcvi‡Ukb - Gi cÖfve
D”P i³Pvc nvU© A¨vUvK Ges †÷ªvK `y‡Uvi Rb¨B Ab¨Zg cÖavb
SzuwKi KviY|
Kb‡Rw÷f nvU© †dBwjD‡ii GK b¤^i wi¯‹ d¨v±i - D”P i³Pvc|
†h mKj bvix‡`i D”P i³Pv‡ci cvwievwiK BwZnvm i‡q‡Q, hviv
†gvUv, Mf©eZx, wbqwgZ Rb¥wbqš¿‡Yi ewo †L‡q _v‡Kb Ges hv‡`i
gvwmK eÜ n‡q †M‡Q A_©vr †g‡bv‡cvR n‡q‡Q Zv‡`i D”P i³Pvc
nIqvi m¤¢vebv A‡bK †ekx|
M‡elYvq †`Lv †M‡Q 45 eQi ch©š— bvix‡`i Zzjbvq cyi“l‡`i D”P
i³Pv‡ci nvi †ekx wKš‘ 45 †_‡K 64 eQ‡i D”P i³Pv‡ci nvi
bvix-cyi“‡l cÖvq mgvb mgvb| Avevi 64 eQ‡ii c‡i cyi“‡li
Zzjbvq bvix‡`i g‡a¨ D”P i³Pv‡ci cÖ‡Kvc A‡bK †ekx|
Av‡gwiKvq cÖwZ wZb R‡b GKRb D”P i³Pv‡c f~M‡Q|
i³Pvc hZ Kg n‡e bvix ev cyi“l Df‡qi †¶‡Î ü`‡iv‡Mi SzuwK
ZZ Kg n‡e|
D”Pi³Pvc Kgv‡bvi mydjI bvix-cyi“l Df‡qi †¶‡Î cÖvq mgvb|
Z‡e D”P i³Pv‡ci wPwKrmvq Mf©eZx ev Mf©avi‡Y B”QyK bvix‡`i
GwmB BbwnweUi (ACE Inhibitor) ev GAviwe (ARB) Dfq MÖ“‡ci
IlyaB Gwo‡q Pjv DwPZ| KviY G Ily‡a mš—v‡bi ¶wZi m¤¢vebv
†ekx _v‡K|
†hme bvix‡`i Mf©Kvjxb mgq D”P i³Pvc †`Lv w`‡q‡Q Zv‡`i
cieZ©x Rxe‡b nvU© Gi †ivM nIqvi m¤¢vebv †ekx| myZivs Zv‡`i
Aek¨B wbweo ch©‡e¶‡Y ivLv DwPZ|

17
bvixi i‡³ D”PgvÎvq My‡KvR ev Wvqv‡ewUm

Wvqv‡ewUm Ges K‡ivbvwi nvU© wWwRm G‡K Ac‡ii mv‡_

I‡Zv‡cÖvZfv‡e RwoZ|
Wvqv‡ewUm A‡bK Av‡M †_‡KB ü`‡iv‡Mi Ab¨Zg KviY wn‡m‡e
cÖwZwôZ| Wvqv‡ewUm cyi“l Ges bvix Df‡qiB ü`‡iv‡Mi Ab¨Zg
SzuwKi welq| Z‡e gwnjv‡`i Rb¨ SzuwKi cwigvY †ewk|
Wvqv‡ewUK bvix‡`i Wvqv‡ewUK cyi“l‡`i Zzjbvq nvU© A¨vUvK nIqvi
m¤¢vebv wZb †_‡K Pvi ¸Y †ekx|
Wvqv‡ewUK bvix‡`i wØZxqevi nvU© A¨vUv‡Ki m¤¢vebv wظY|
Wvqv‡ewUK bvixi Ab¨‡`i Zzjbvq nvU© A¨vUv‡K g„Zz¨nvi `yB †_‡K
Pvi ¸Y †ewk|
wewfbœ M‡elYvq †`Lv †M‡Q, AvMvgx 2025 mv‡j Wvqv‡ewUK †ivMxi
msL¨v †e‡o `uvov‡e 300 wgwjq‡b| hv wKbv c„w_exi RbmsL¨vi
kZKiv 5.4 fvM|
eZ©gv‡b ü`‡iv‡M hZ g„Zz¨ nq Zvi kZKiv 1.4 fvM g„Zz¨i Rb¨
`vqx Wvqv‡ewUm Ges `ytLRbK n‡jI mwZ¨ †h GB g„Zz¨nvi fwel¨‡Z
AviI e„w× cv‡e|
Av‡iv GK M‡elYvq †`Lv †M‡Q, †h mKj bvix Mf©Kvjxb mgq
Wvqv‡ewU‡m Avµvš— n‡q‡Q Zv‡`i cieZ©x‡Z Wvqv‡ewUm nIqvi
m¤¢vebv A‡bK †ewk|
wewfbœ M‡elYvq †`Lv †M‡Q Wvqv‡ewU‡mi Ilya - _vqv‡RvwjwWwbWb
†L‡j Wvqv‡ewUK gwnjv‡`i nvo fv½vi SzuwK Ab¨‡`i Zzjbvq wظY
nq Ges cyi“l I gwnjv Df‡qi †¶‡Î nvU© †dBwjD‡ii SzuwK evovq|
BD‡ivwcqvb †mvmvBwU Ae Wvqv‡ewUm Ges Av‡gwiKvb Wvqv‡ewUK
G‡mvwm‡qkb gwnjv‡`i †ivwmwMUvRb e¨env‡ii wec‡¶ gZ w`‡q‡Q
Ges _vqv‡RvwjwWwbWb e¨env‡i mZ©K nIqvi civgk© w`‡q‡Q|

18
Awbqwš¿Z Lv`¨vf¨vm I ü`‡ivM
bvix cyi“l Df‡qi Rb¨ Awbqwš¿Z Lv`¨vf¨vm nvU© A¨vUv‡Ki R‡b¨
A‡bKUvB `vqx| †hgb- Mi“i gvsm, Lvmxi gvsm ev ïK‡ii gvsm
A_©vr †iW wgU nv‡U©i †ivM †W‡K Avb‡Z cv‡i|
†iW wgU I Ab¨vb¨ Pwe© RvZxq Lvevi †L‡j i‡³ UªvBwMmvivBW I
†Kv‡j‡÷i‡ji gvÎv evo‡Z _v‡K Ges K‡ivbvwi agbxi wfZ‡i
Pwe©RvZxq c`v_© Rg‡Z Rg‡Z agbx mi“ n‡Z _v‡K| ejv evûj¨
GUvB K‡ivbvwi AvU©vwi wWwR‡Ri Ab¨Zg KviY|
†hme cwiev‡i nvU© A¨vUv‡Ki NUbv N‡U‡Q †mB cwiev‡ii m`m¨‡`i
GK`g Aí eqm †_‡KB †iW wgU bv LvIqv fvj |
†iW wg‡Ui g‡ZvB nv‡U©i Amy‡Li Rb¨ `vqx P‡Kv‡jU, wPwb I
AwZwi³ wgwó, dv÷ dzW Ges †Kvì wWªsK&m| GBme Lvev‡i
K¨v‡jvwi †ekx _vKvq wbqwgZ G¸‡jv †L‡j IRb evo‡Z _v‡K| Avi
GB evowZ IRb nvU© A¨vUv‡Ki KviY n‡Z cv‡i|

GKRb cÖvßeq¯‹ gvby‡li cÖwZw`b 25-30 MÖv‡gi †ewk d¨vU ev Pwe©

LvIqv DwPZ bq| Avi GB cwigvY Pwe© Avgiv cÖwZw`‡bi Lvevi
†hgb : Wvj, gvQ, ZiKvwi, wWg BZ¨vw`i g‡a¨B †c‡q _vwK|
dv÷ dz‡Wi g‡Zv †KK, †cw÷ª, P‡Kv‡jU, AvBmwµg, wPcm&, PvbvPzi
ev †Z‡jfvRv Lvevi kix‡i Pwe©i cwigvb evwo‡q w`‡q nv‡U©i mgm¨v
Ki‡Z cv‡i| myZivs nvBcviwjwcwWwgqv I D”P i³Pvc m¤úbœ gvbyl
Z_v ü`‡ivMx‡`i G¸wj GK`g LvIqv DwPZ n‡e bv|

M‡elYvq †`Lv hvq †h, Ab¨vb¨ Lvev‡ii †P‡q †ekx cwigvY `vbvhy³
Lvevi †L‡j nvU© A¨vUv‡Ki m¤¢vebv A‡bKvs‡k K‡g| cvkvcvwk Aí
cwigv‡b P‡Kv‡jU †L‡j gwnjv‡`i nvU© †dBwjD‡ii m¤¢vebv K‡g|

19
AwZwi³ IRb ev †g`fu~wo I ü`‡ivM
bvix-cyi“l Df‡qi kix‡i hw` AwZwi³ Pwe© R‡g, we‡kl K‡i
Zj‡cU Ges †Kvg‡i Z‡e bvbviKg kvixwiK mgm¨v †`Lv w`‡Z
cv‡i, †hgb - D”P i³Pvc, i‡³ gvÎvwZwi³ †Kv‡j‡÷ij I
UªvBwMmvivBW, Wvqv‡ewUm (UvBc II), ü`‡ivM, Ges †÷ªvK| Avi
AwZwi³ IRb G mg¯— †iv‡M g„Zz¨i SzuwKI eûjvs‡k evwo‡q †`q|
AwZwi³ IR‡bi d‡j ¯^vfvweK Avqy®‹vj M‡o 9 eQ‡ii gZ K‡g
hvq|

gwnjv‡`i nvU© A¨vUv‡K Ach©vß kvixwiK kª‡gi cÖfve

wewfbœ mgx¶vq †`Lv †M‡Q, Ach©vß kvixwiK kªg bvix‡`iI
ü`‡iv‡Mi Ab¨Zg SzuwKi KviY Ges c‡iv¶fv‡e †÷ªv‡Ki SzuwKI
evovq|
M‡elKiv †`wL‡q‡Qb, kvixwiK Kg©V e¨w³‡`i Zzjbvq Ajm
e¨w³‡`i g‡a¨ ü`‡iv‡Mi nvi wظY|
Kg©nxb ev Ajm Rxebhvcb Ki‡j LvIqv †ekx nq d‡j ZvovZvwo
kvixwiK IRb †e‡o hvq| †ekxifvM †¶‡ÎB IRb †e‡o hvIqvi
Kvi‡Y Wvqv‡ewUm, i³Pvc I i‡³ †Kv‡j‡÷ij †e‡o hvq d‡j nvU©
A¨vUvK I †÷ªv‡Ki SzuwK eûjvs‡k †e‡o hvq|
wbqwgZ kvixwiK cwikªg ev e¨vqvg ü`‡iv‡Mi Kvi‡Y g„Zz¨i nvZ
†_‡K gvbyl‡K i¶v K‡i| myZivs Av‡gwiKvb nvU© G‡mvwm‡qk‡bi
civgk© †g‡b cÖwZw`b A_ev mßv‡n Kgc‡¶ cuvP w`b b~¨bZg 30
wgwbU nuvUzb ev KvwqK cwikªg Ki“b|
18 eQi ev Zvi †ekx eq‡mi bvix‡`i g‡a¨ kZKiv 30.6 Rb
Zv‡`i Kv‡Ri Aem‡i e¨vqvg ev KvwqK cwikªg K‡i _v‡K|
AviI Kg©V †nvb (†hgb - evMv‡b MvQ jvMvb, Mvox †avqv-†gvQv K‡i
cwi¯‹vi Ki“b, nuvUzb, muvZvi KvUzb, mvB‡Kj Pvjvb) Ges wUwf eÜ
ivLyb|

20
bvix‡`i ü`-¯^v‡¯’¨ AwZwi³ g`¨cv‡bi cÖfve
hviv G‡Kev‡iB Gj‡Kvnj cvb K‡i bv Zv‡`i Zzjbvq hviv mnbxq
gvÎvq (bvix‡`i †¶‡Î M‡o cÖwZw`b GK †cM) Gj‡Kvnj cvb K‡i
Zv‡`i ü`‡iv‡Mi SzuwK Kg| Aí cwigv‡b Gj‡Kvnj i‡³
GBPwWGj-Gi gvÎv evovq|
AwZwi³ g`¨cvb IRb evovq, i‡³ UªvBwMmvivBW evovq, i³Pvc
e„w× K‡i Ges †÷ªvK I nvU© A¨vUv‡Ki SzuwK evovq| Mf©eZx bvix‡`i
†Kvbfv‡eB g`¨cvb Kiv DwPZ bq|
nvU© A¨vUv‡K mvgvwRK Pvc I gvbwmK `~wðš—vi f~wgKv
M‡elYvq GUv GLbI cwi®‹vi bq †h, gvbwmK Pvc mivmwi
ü`‡iv‡Mi SzuwK evovq wKš‘ GwU a~gcvb, g`¨cvb I A¯^v¯’¨Ki Lvevi
MÖnY evwo‡q †`q hv wKbv ü`‡iv‡Mi Ab¨Zg KviY|
hviv AwZwi³ `ywðš—vMÖ¯— ev DwØMœ _v‡Kb Zv‡`i nvU© A¨vUv‡Ki SzuwK
Kg `ywðš—vMÖ¯— gvby‡li †P‡q wظY| Z‡e hviv cÖ_g w`‡K †ewk
`ywðš—vMÖ¯— _v‡Kb wKš—y cieZx©‡Z `ywðš—v Kwg‡q Avb‡Z cv‡ib ev
Av‡¯— Av‡¯— cÖkgb Ki‡Z cv‡ib Zv‡`i †¶‡Î nvU© A¨vUv‡Ki SzuwKI
K‡g hvq|
µwbK †óªmB ü`‡iv‡Mi Rb¨ `vqx| µwbK †÷ª‡mi Kvi‡YB mgm¨v
†ekx nq| `xN©w`‡bi gvbwmK Pvc wewfbœ wbD‡ivni‡gv‡bi ¯’vqx
cwieZ©‡bi Rb¨ `vqx| Avi Gi d‡jB nvU© A¨vUv‡Ki m¤¢vebv hvq
†e‡o|
UvBc-G (Type A) cvi‡mvbvwjwU m¤úbœ gvbyl‡`iI ü`‡iv‡Mi
m¤¢vebv cÖej| Giv Anin UvKv Avi L¨vwZi †cQ‡b †`uŠovb ev
AKvi‡Y †Ubkb K‡ib|
AwZwi³ †Ubkb I †÷ªm gvby‡li wmgc¨v‡_wUK mœvqyZ‡š¿i KvRKg©
evwo‡q †`q| Gi d‡j A¨v‡_‡ivm&‡K¬‡ivwm‡mi MwZ †e‡o hvq,
ürwc‡Ûi ¯ú›`b, agwbi ms‡KvPb Ges i³PvcI evo‡Z _v‡K|
GiKg Pj‡Z _vK‡j ürwc‡Û i³ PjvPj e¨vnZ nq| d‡j nvU©
A¨vUv‡Ki m¤¢vebvI †e‡o hvq| G K_v AvR cÖwZwôZ mZ¨ †h gb
kvš— _vK‡j Ab¨vb¨ wi¯‹ d¨v±i _vKv m‡Ë¡I nvU© A¨vUv‡Ki m¤¢vebv
K‡g|

21
†gUvewjK wmb‡Wªvg I ü`‡ivM
†gUvewjK wmb‡Wªvg n‡jv ü`‡iv‡Mi A‡bK¸‡jv wi¯‹ d¨v±‡ii mgš^q|
hvi g‡a¨ i‡q‡Q D”P i³Pvc, i‡³ wjwcW fvimvg¨nxbZv, Bbmywjb
†iwR‡÷Ý Ges Ge‡Wvwgbvj I‡ewmwU ev †cU †gvUv| GKKfv‡e Giv
cÖ‡Z¨‡KB ü`‡iv‡MiI wPwýZ wi¯‹ d¨v±i| myZivs G¸‡jvi mgwš^Z
Ae¯’vb Aek¨B ü`‡iv‡Mi SzuwK‡K eûjvs‡k evwo‡q †`q|
wbgœwjwLZ cvuPwU Ae¯’vi g‡a¨ †h‡Kvb wZbwU we`¨gvb _vK‡j bvix‡`i
†gUvewjK wmb‡Wªvg Av‡Q e‡j wPwýZ Kiv hvq| †hgb -
†Kvg‡ii gvc 35 Bw ev 88 †m.wg. Gi †ewk n‡j|
cÖwZ 100 wgwj i‡³ UªvBwMmvwi‡Wi cwigvb 150 wgwjMÖvg ev Gi †ewk n‡j|
cÖwZ 100 wgwj i‡³ GBPwWGj †Kv‡j‡÷ij 50 wgwjMÖ vg Gi Kg n‡j|
i³Pvc 130/85 wgwg Ae gviKvwi ev Gi †ewk n‡j|
Afy³ Ae¯’vq cÖwZ 100 wgwj i‡³y‡Kv‡Ri
M cwigvb 100 wgwjMÖ
vg ev Gi †ewk n‡j|
w¯c-A¨vcwbqv
Ny‡gi g‡a¨ cybt cybtfv‡e k¦vm eÜ nIqv Ges Avevi ïi“ nIqv‡K w¯c-
A¨vcwbqv e‡j| Gi d‡j nVvr K‡i Aw·‡Rb ¯^íZv †`Lv ‡`q Ges
i³Pvc †e‡o hvq| cvkvcvwk KvwW©IfvmKzjvi wm‡÷‡gi Dc‡i Pvc c‡o
d‡j K‡ivbvwi ü`‡iv‡Mi m¤¢vebv †`Lv †`q|
wm-wiq¨vKwUf †cÖvwUb (wmAviwc)
GKai‡bi ¯^vfvweK †cÖvwUb| kix‡ii †Kvb Ask dz‡j †M‡j Ges
K‡ivbvix agbx mi“ n‡q †M‡j i‡³ wmAviwc gvÎv †e‡o hvq| D”PgvÎvq
wmAviwc‡K ü`‡iv‡Mi GKwU wi¯‹ d¨v±i wn‡m‡e MY¨ Kiv nq|
wdweª‡bv‡Rb
GKai‡bi †cÖvwUb hv i³ RgvU euva‡Z mvnvh¨ K‡i| AwZwi³ cwigv‡Y
wdweª‡bv‡Rb i³ Ges i‡³i †cU‡jU RgvU euvwa‡q nvU© A¨vUvK Ges
†÷ªvK nIqvq ¸i“Z¡c~b© f~wgKv cvjb K‡i|
†nv‡gvwmw÷b
†g‡bvc‡Ri ci i‡³ †nv‡gvwmw÷b †e‡o hvq| cÖPzi cwigv‡b dwjK
GwmW, wfUvwgb we6, wfUvwgb we12 †L‡j †nv‡gvwmw÷b K‡g hvq|
jvB‡cv †cÖvwUb 'G'
G ai‡bi jvB‡cv‡cÖvwUb i³ RgvU evua‡Z mvnvh¨ K‡i| wbqvwmb RvZxq
†Kv‡j‡÷ij Kgv‡bvi Jla †L‡j i‡³ jvB‡cv‡cÖvwUb K‡g|

22
bvix‡`i nvU© A¨vUv‡Ki j¶Y
nvU© A¨vUv‡Ki j¶Y wVKgZ eyS‡Z cviv A‡bK mgq KwVb| †KvbiKg
c~e© j¶Y QvovB kZKiv 64 fvM bvix Ges 50 fvM cyi“l K‡ivbvwi nvU©
wWwR‡R Avµvš— n‡q nVvr g„Zy¨eiY K‡i| bvix‡`i mvaviYZ nvU©
A¨vUv‡Ki mywbw`©ó j¶Y¸‡jv j¶¨ Kiv hvq bv, †h Kvi‡Y nvU© A¨vUv‡K
Avµvš— cyi“‡li †P‡q bvixiv nvmcvZv‡j †bqvi c~‡e©B gviv hvq †ekx|
wKQy wKQy nvU© A¨vUvK Lye `ª“Z Ges Zxeªfv‡e †`Lv †`q wKš‘ †ekxifvM
†¶‡ÎB Zv ïi“ nq Av‡¯— Av‡¯—, g„`y e¨v_v ev ey‡Ki wfZi GKai‡bi
A¯^w¯—fve Abyf‡ei gva¨‡g|
j¶Y mg~n
ey‡Ki gvSLv‡b e¨v_v, Pvc Abyfe Kiv ev A¯^w¯—fve|
nvU© A¨vUv‡Ki Dcm‡M©i g‡a¨ ey‡Ki e¨_v ev A¯^w¯—fve A‡bKmgq
ey‡K bv n‡q ïay evg evû A_ev `yBevû, wc‡Vi w`‡K, Nv‡o-Mjvq,
†Pvqv‡j wKsev †c‡Ui Dc‡ii w`‡K Abyf~Z n‡Z cv‡i|
kix‡ii Ab¨vb¨ As‡k e¨v_v ev A¯^w¯—fve|
k¦vmKó nIqv| †Kvb †Kvb †¶‡Î nvU© A¨vUv‡Ki j¶Y ïaygvÎ
k¦vmK‡ói g‡a¨B mxgve× _vK‡Z cv‡i|
kixi VvÛv n‡q Nvg †`qv|
Ab¨vb¨ j¶Y - bvix‡`i †¶‡Î †KvbiKg KviY QvovB `ye©j jvMv,
`ywðš—vMÖ¯— nIqv ev A¯^vfvweK Nve‡o hvIqv, e`nRg, †c‡U M¨v‡mi
gZ e¨_v Abyf~Z nIqv, ewgi fve nIqv ev nVvr K‡i gv_v
nvjKvfve †eva Kiv, Nyg bv Avmv BZ¨vw` DcmM©¸‡jv‡KI nvU©
A¨vUv‡Ki mZK©xKiY j¶Y wnmv‡e aiv nq|
mvaviYZ cÖwZ PviR‡bi g‡a¨ GKRb bvixi nvU© A¨vUv‡Ki †¶‡Î GB
DcmM©¸‡jv j¶¨ Kiv hvq, wKš‘ `ytLRbK n‡”Q Zviv GUv‡K eyS‡Z
cv‡ibv, †Kbbv GB DcmM©¸‡jv ey‡Ki e¨_v QvovI †`Lv w`‡Z cv‡i|

23
hw` KL‡bv Avcwb ev Avcbvi Av‡kcv‡ki Kv‡iv nVvr ey‡K e¨v_v ev
A¯^w¯—‡ev‡ai cvkvcvwk AviI GK ev GKvwaK Dc‡iv³ j¶Y †`Lv †`q
Z‡e cvuP wgwb‡Ui †ekx Kvj‡¶cY bv K‡i `ª“Z †Kvb ü`‡ivM we‡klÁ ev
by¨bZg †h †Kvb wPwKrm‡Ki Kv‡Q wb‡q hv‡eb|

bvix‡`i †÷ªv‡Ki j¶Ymg~n

nVvr K‡i g~L, nvZ Ges cv‡qi GKcvk (Wvb A_ev evg cvk) `ye©j
ev Aek Aek jvMv|
mnmv K_v ej‡Z ev †KvbwKQy wPš—v Ki‡Z Amyweav nIqv Ges
wm×vš—nxbZv †`Lv †`qv|
nVvr K‡i †Kvb GK A_ev `y‡Pv‡LB †`L‡Z Amyweav nIqv|
nVvr nvuU‡Z Amyweav nIqv, gv_v †Nviv‡bv ev fvimvg¨nxbZv Abyf~Z
nIqv|
c~e©ÁvZ †Kvb KviY QvovB cÖPÛ gv_v e¨v_v nIqv|
nVvr K‡i Ávb nvwi‡q †djv|
GLv‡b D‡jL¨, cÖwZwU †÷ªv‡Ki †¶‡ÎB Dc‡ii me¸wj j¶Y †`Lv w`‡Z
bvI cv‡i| Z‡e hLbB Gai‡bi j¶Y †`Lv †`‡e mv‡_ mv‡_ wPwKrm‡Ki
civgk© wb‡Z n‡e|

24
ü`‡ivM wbY©q
†d«wgsnvg wi¯‹ †¯‹vi
hw` K‡ivbvix ü`‡ivM e‡j m‡›`n K‡ib Z‡e Aek¨B cix¶v wbix¶v K‡i
†iv‡Mi aib Ges ch©vq m¤ú‡K© wbwðZ nIqv `iKvi| †hmKj bvixi
ü`‡iv‡Mi †Kvb DcmM©B aiv c‡owb Zv‡`i †¶‡Î wK Kiv DwPZ? wbqwgZ
¯^v¯’¨ cix¶vi Kivi gva¨‡g cÖwZwU †ivMxi ü`‡iv‡Mi SzuwKi gvÎv wbY©q
Kiv †h‡Z cv‡i Ges Zv wbY©‡qi GKwU c×wZ nj †d«wgsnvg wi¯‹ †¯‹vi|
Gi gva¨‡g wewfbœ wi¯‹ d¨v±i¸‡jv cwigvc K‡i (†hgb t eqm, a~gcvb,
D”Pi³Pvc Ges i‡³ †Kv‡j‡÷i‡ji gvÎv), G¸‡jvi Pzovš— djvd‡ji
wfwˇZ ejv hv‡e wbw`©ó IB †ivMx nvU© A¨vUvK wKsev g„Zz¨i KZUzKz SzuwKi
g‡a¨ Av‡Q A_©vr IB †ivMx Aí, ga¨g, bvwK †ewk SzuwK m¤úbœ|

bvixi ü`‡ivM wbY©‡q cix¶v wbix¶v

AwaKvsk bvixi Kgc‡¶ GKwU BwmwR cix¶v Kiv‡bv DwPZ| †h me
bvixi ü`‡iv‡Mi †Kvb DcmM© †bB ev K‡ivbvwi ü`‡iv‡Mi Kg SzuwK
m¤úbœ Zv‡`i Ab¨‡Kvb cix¶v bv Kiv‡jI Pj‡e|
BwmwR‡K GKwU mvavib ¯^v¯’¨ cix¶vi Ask wnmv‡eB we‡ePbv Kiv n‡q
_v‡K| cÖv_wgK †gwW‡Kj †iKW© wnmv‡e mKj bvixiB Zv‡`i cÖ_g Rxe‡b
GKwU BwmwR K‡i ivLv fvj| hv‡Z cieZ©x Rxe‡b †Kvb †ivMxi K‡ivbvwi
ü`‡ivM wbY©‡qi j‡¶¨ BwmwRi cwieZ©b¸‡jv Wv³vi B‡”Q Ki‡j c~‡e©i
my¯’ mg‡qi ¯^vfvweK BwmwRi mv‡_ wgwj‡q wb‡Z cv‡ib| GQvovI GKwU
my¯’ mg‡qi BwmwR Wv³vi‡K IB †ivMx m¤ú‡K© A‡bK ¸i“Z¡c~Y© Z_¨ w`‡q
mnvqZv Ki‡Z cv‡i|
ü`‡iv‡Mi AwaK Ges gvSvix SzuwK m¤úbœ bvix‡`i BwmwR QvovI Ab¨vb¨
cix¶v wbix¶v Kivi cÖ‡qvRb nq Zvig‡a¨ †÷ªm †U÷ (e¨vqvg Ges
Ily‡ai mvnv‡h¨), †UªWwgj †U÷, wbDwK¬qvi †÷ªm †U÷| Z‡e gwnjv‡`i
Rb¨ †UªWwgj †U÷ AwaKvsk †¶‡ÎB Lye †ekx Kvh©Ki e‡j cÖZxqgvb
nqwb| Ab¨vb¨ bb Bb‡fwmf †U‡÷i Zzjbvq| G cwiw¯’wZ †gvKv‡ejvq
†÷ªm †U‡÷i Av‡iv DbœZ ch©vq wbDwK¬qvi †÷ªm †U÷ bvix‡`i Rb¨ AwaK

25
ü`‡iv‡Mi AwaK Ges gvSvix SzuwK m¤úbœ bvix hv‡`i ü`‡iv‡Mi
DcmM©¸‡jv †`Lv hvq Zv‡`i B‡gwRs c×wZi bZzb GK iƒc - AvjUªvmvDÛ
(B‡KvKvwW©IMÖvg) Gi gva¨‡g nv‡U©i Mfxi wPÎ aviY Kiv m¤¢e Ges
K‡ivbvix agbxi Dc‡i †÷ª‡mi cÖfveI wbY©q Kiv m¤¢e|

bb-Bb‡fwmf †U÷¸‡jv nv‡U©i AvÂwjK i³mÂvj‡bi gvÎv cwigvc Ki‡Z

cv‡i| †h mKj bvixi nv‡U©i Kg©¶gZv K‡g †M‡Q ev nvU© mwVKfv‡e KvR
Ki‡Q bv Zv‡`i nv‡U©i cwic~b© i³mÂvjb mwVKfv‡e cwigvc Kivi Rb¨
Bb‡fwmf †U÷ - KvwW©qvK K¨v‡_UvivB‡Rkvb (K‡ivbvwi A¨vbwRIMÖvg) Kiv
†h‡Z cv‡i|

wPwKrmv
K‡ivbvwi ü`‡ivM nv‡U©i A‡bK¸‡jv Ae¯’vi †h †Kvb GKwU iƒc n‡Z
cv‡i| myZivs Zvi Rb¨ we‡kl †Kvb GKwU wPwKrmv c×wZ Kvh©Ki bvI
n‡Z cv‡i| bvixi ü`‡ivM wPwKrmvi g~j welq n‡”Q KZ ZvovZvwo Zv‡K
mwVK wPwKrmvi e¨e¯’v Kiv †h‡Z cv‡i| Z‡e mgm¨v hw` wZ¶è Ges
Ri“ix nq Z‡e †m‡¶‡Î †ivMx‡K ZvovZvwo nvmcvZv‡j †bqv cÖ‡qvRb|
M‡elYvq †`Lv †M‡Q bvixi ey‡K e¨_v n‡jI nvmcvZv‡ji Ri“ix wefv‡M
†h‡Z †h‡Z A‡bK †`ix K‡i †d‡j hvi d‡j Zv‡K _ª‡¤^vjvBwUK
(streptokinase) Jla e¨env‡ii mgq cvi n‡q hvq|

GLv‡b D‡jL¨ †h, GB _ª‡¤^vjvBwUK Jla i³bvjxi eK fv½‡Z mnvqZv

K‡i Ges GwU hw` nvU© A¨vUvK nIqvi 1 N›Uvi g‡a¨ †`qv hvq Z‡e Gi
Kvh©KvwiZv kZKiv 50 fvM mdjZv jvf Ki‡Z cv‡i| Avi 2 †_‡K 6
N›Uvi g‡a¨ w`‡j gvÎ 20 fvM mdjZv Avkv Kiv hvq| MvBWjvBb
Abymv‡i †gwW‡Kj Ges mvwR©‡Kj `yB c×wZ‡ZB ü`‡iv‡Mi wPwKrmv
m¤¢e| Z‡e †m‡¶‡Î †ivM wbY©‡qi mv‡_ mv‡_ hZ `ª“Z m¤¢e wPwKrmv ïi“
KivB Ri“ix|

26
ni‡gvb †_ivwc
ni‡gvb bvix‡`i ü`‡ivM SzuwK‡Z we‡kl cÖfve †d‡j
Ify‡jk‡bi mgq bvix‡`i i‡³ B‡÷ªv‡Rb ni‡gvb cvIqv hvq| GB
B‡÷ªv‡Rb hLb bvixi Ifvix ev wW¤^vkq †_‡K cÖvK…wZKfv‡e ˆZix nq
ZLb †mUv nv‡U©i myi¶vq KvR K‡i| wKš‘ hLb K…wÎgfv‡e evB‡i †_‡K
bvixi kix‡i cÖ‡ek Kiv‡bv nq ZLb Gi Kvh©KvwiZv wb‡q weZK© i‡q‡Q|
35 eQ‡ii wb‡P mvaviYfv‡e my¯’ gwnjviv hw` B‡÷ªv‡Rb mg„×
Rb¥wbqš¿‡bi ewo MÖnY K‡i Z‡e Zv nvU© A¨vUv‡Ki SzuwK enb K‡i bv|
Z‡e †hmKj gwnjv‡`i D”P i³Pvc, Wvqv‡ewUm, i‡³ D”PgvÎvq
†Kv‡j‡÷ij Av‡Q Ges hviv a~gcvb K‡i Zv‡`i Rb¨ Aek¨B AwaK SzuwK
enb K‡i| †g‡bv‡cvR cieZx© mg‡q wKQy DcmM© Ges G‡Ûv‡gwUªqvj
K¨vbmvi I Aw÷I‡cviwmm cÖwZ‡iv‡a A‡b‡K ni‡gvb MÖnY K‡i _v‡Kb|
hv‡K ni‡gvb wi‡cm‡g›U †_ivwc ev eZ©gv‡b †cv÷‡g‡bv‡cvRvj ni‡gvb
†_ivwc e‡j| Gme mgm¨v mgvav‡b ni‡gvb wKQyUv mydj e‡q Avb‡Z
†c‡i‡Q wVKB wKš‘ B‡÷ªv‡Rb-cÖ‡Rw÷b †hŠ_ ni‡gvb †_ivcx‡Z nvU©
A¨vUvK, †÷ªvK, i³RgvU euvav, ¯—b K¨vbmvi e„w× Ges nvo fv½vi gZ
NUbv j¶¨ Kiv †M‡Q| d‡j Av‡gwiKvb dzW GÛ WªvM GWwgwb‡÷ªkvb
(GdwWG) †g‡bv‡cvR cieZx© ni‡gvb †_ivwc MÖnY Ki‡Z eviY Ki‡Q|
ZviciI hw` †cv÷ †g‡bv‡cvRvj ni‡gvb †_ivwc wb‡Z nq Z‡e Kg
†Wv‡R Ges Aí mg‡qi Rb¨ †bqvi civgk© w`‡q‡Q GdwWG|

Gmwcwib Gi e¨envi
Gmwcwib cyi“‡li †¶‡Î nvU© A¨vUv‡Ki SzuwK Kgvq kZKiv 32 fvM| wKš‘
†÷ªv‡Ki SzuwK Kgvq bv| wKš‘ bvix‡`i †¶‡Î †÷ªv‡Ki SzuwK Kgvq kZKiv
20 fvM| wKš‘ nvU© A¨vUv‡Ki SzuwK Kgvq bv| Aek¨ eq¯‹ gwnjv‡`i
†¶‡Î nvU© A¨vUvK cÖwZ‡iv‡a Gmwcwib mvnvh¨ K‡i| Z‡e cyi“l Ges
gwnjv mevi Rb¨ cÖ_gevi nvU© A¨vUvK I †÷ªvK cÖwZ‡iv‡a Gmwcwib
mgvbfv‡e Kvh©Ki|

27
Mf©eZx bvix I ü`‡ivM
Aek¨B ü`‡ivM Mf©ve¯’vi Rb¨ AwZwi³ SzuwKc~Y© Ges cÖm~wZ g„Zz¨i GKwU
Ab¨Zg KviY| hw` `¶Zvi mv‡_ cwiPvjbv Kiv hvq Z‡e AwaKvsk bvix
hv‡`i ü`‡ivM i‡q‡Q Zviv mdjfv‡e Mf©Kvjxb mgq cvi n‡q ev”Pv
cÖme Ki‡Z cv‡ib|
Mf©Kvjxb mg‡q ü`hš¿ I i³bvjxi cwieZ©b
Mf©Kvjxb 5g mßvn †_‡K 35Zg mßvn ch©š— mylg Ges wbqwgZfv‡e
†`‡n i‡³i AvqZb e…w× cvq hv wKbv ¯^vfvweK Ae¯’vi †P‡q kZKiv 30
†_‡K 50 fvM †ewk| Mf©Kvjxb †kl cuvP mßvn †_‡K cÖmeKvjxb mgq
ch©š— i‡³i AvqZb ax‡i ax‡i Kg‡Z _v‡K| cÖm‡ei 4 †_‡K 6 mßv‡ni
g‡a¨ i‡³i AvqZb ¯^vfvweK Ae¯’vq wd‡i Av‡m| mvwe©K i³ msenb
Z‡š¿i mv‡_ mv‡_ cvj‡gvbvix i³ msenbZ‡š¿I AwZwi³ i³cÖevn nq|
wekªv‡g _vKve¯’vq hw` Mf©eZx gv‡qi ü`¯ú›`‡bi MwZ †e‡o hvq Z‡e
†mUv Aek¨B wPwKrm‡Ki bR‡i Avb‡Z n‡e| †Kbbv GB mgq i‡³i
AvqZb K‡g K‡ivbvix agbx‡Z i‡³i cÖevn K‡g †h‡Z cv‡i| Mf©Kvjxb
wØZxq av‡c Wvqv‡÷vwjK evW‡cÖmvi Kg‡Z _vK‡e| hv wKbv cieZ©x
mg‡q Mf©Kvjxb †kl av‡c wM‡q †e‡o hvq|
cÖme cieZ©x mgqI G‡Kev‡i SzuwK gy³ bq| we‡kl K‡i hZ¶Y ch©š—
i³ msenb ¯^vfvweK Ae¯’vq wd‡i bv Av‡m Avi †mRb¨ cÖme cieZ©x
Kgc‡¶ AviI GKgvm cÖ‡qvRb| fvj wPwKrmv wbf©i K‡i GKwU mgwš^Z
wUg Iqv‡K©i Dci †h wU‡gi m`m¨ _vK‡e cÖv_wgK wPwKrmK, ¯¿x‡ivM I
avÎxwe`¨v we‡klÁ, GKRb ü`‡ivM we‡klÁ, GKRb G‡b‡¯’wmI‡jvwR÷
Ges †¶Îwe‡k‡l GKRb wkï we‡klÁ|

28
Mf©Kvjxb mg‡q ü`‡iv‡Mi †kªYxweb¨vm
evZR¡iRwbZ ü`‡ivM - Dbœqbkxj †`‡k Mf©Kvjxb mg‡q †h mg¯—
ü`‡ivM nq Zvi g‡a¨ evZR¡i RwbZ ü`‡ivM me‡P‡q †ewk| hw`I
DbœZ we‡k¦ Zv me‡P‡q Kg| evZR¡iRwbZ ü`‡iv‡Mi g‡a¨ nv‡U©i
fv‡j¦i †ivM - gvBUªvj †÷‡bvwmm me‡P‡q †ewk †`Lv hvq| ZvQvov
Ab¨vb¨ fv‡j¦i †ivMI n‡q _v‡K| 1994-2000 mv‡ji g‡a¨
fviZe‡l©i wewfbœ nvmcvZvj Rix‡c †`Lv †M‡Q †h, Mf©eZx
gwnjv‡`i ü`‡iv‡Mi kZKiv 88 fvMB evZR¡i RwbZ|
Rb¥MZ ü`‡ivM ev Rb¥MZ ΓwURwbZ ü`‡ivM - cvj‡gvbvix
nvBcvi‡Ubkvb, mvqv‡bvwUK nvU© wWwRR BZ¨vw`|
e¨vK‡Uwiqvj G‡ÛvKvW©vBwUm - evZR¡iRwbZ ü`‡iv‡Mi RwUjZv
†_‡K e¨vK‡Uwiqvj G‡ÛvKvW©vBwUm n‡Z cv‡i|
nvU© A¨vUvK - mvaviYZ Mf©ve¯’vq nvU© A¨vUvK Kg n‡q _v‡K| wKš‘
hv‡`i cvwievwiKfv‡e D”PgvÎvq †Kv‡j‡÷ij Av‡Q, hviv ¯’zjKvq,
a~gcvb K‡ib, Wvqv‡ewUm Av‡Q Ges Zzjbvg~jKfv‡e hviv †ekx
eq‡m Mf©aviY K‡ib Zv‡`i nvU© A¨vUv‡Ki m¤¢vebv _v‡K| Avevi
GIiwUK ev K‡ivbvwi AvU©vix wW‡mKk‡bi Kvi‡YI nvU© A¨vUvK n‡Z
cv‡i| D‡jL¨, Mf©ve¯’vq nvU© A¨vUvK n‡j _ª‡¤^vjvBwUK
(†÷ª‡ÞvKvB‡bm) e¨envi Kiv DwPZ bq|
nvU© †dBwjIi - GwU GKwU `yj©f RwUjZv hv AwZ D”P i³Pvc ev
GK¬vgwmqvi †¶‡Î NU‡Z cv‡i| wKš‘ Mf©Kvjxb mg‡q µwbK
G‡mwÝqvj nvBcvi‡Ubk‡bi †¶‡Î Zv N‡U bv ej‡jB P‡j|
KvwW©Igv‡qvc¨vw_ - GB †¶‡Î Kb‡Rw÷f nvU© †dBwjDi nq wKš‘
GwUI Mf©Kvjxb LyeB `yj©f †ivM|
KvwW©qvK A¨vwi`wgqv - c~e© †_‡K we`¨gvb †Kvb ü`‡ivM Qvov
KvwW©qvK A¨vwi`wgqv ev ü`¯ú›`‡bi Q›` ˆelg¨ Mf©Kvjxb mgq
mvaviYZ nq bv|

29
†h mKj †iv‡Mi Kvi‡Y Mf©eZx gv‡qiv †ekx SzuwKi m¤§yLxb
†h †Kvb Kvi‡YB †nvK bv †Kb, †h mKj †ivMx Mf©ve¯’vq nvU© †dBwjIi
-Gi ¸i“Zi (NYHA K¬vm - III ev IV) ch©v‡q †cŠ‡Q‡Q, ZvivB me‡P‡q
†ewk SzuwKi m¤§yLxY| G‡¶‡Î wbgœwjwLZ †ivM mg~n D‡jL‡hvM¨ -

cvj‡gvbvix D”Pi³Pvc - Rb¥MZfv‡e nv‡U©i c`©vq wQ`ª mn

(Eisenmenger syndrome) ev wQ`ª Qvov cvj‡gvbvix D”Pi³Pvc
Mf©ve¯’vq gvZ…g„Zz¨i kZKiv 30 †_‡K 50 fvM KviY enb K‡i|
nv‡U©i fv‡j¦i †ivM - we‡kl K‡i gvBUªvj †÷‡bvwmm (MS) Ges
GIiwUK †÷‡bvwmm (AS)|
Aw·‡Rb ¯^íZv m¤^wjZ Rb¥MZ ü`‡ivM (Congenital Cyanotic
Heart Disease) - mvgwMÖKfv‡e kZKiv 2 fvM gv‡q‡`i g„Zz¨ nq
mvqv‡bvwUK nvU© wWwR‡Ri Kvi‡Y| GQvov kZKiv 30 fvM gv‡q‡`i
Bb‡dw±f G‡ÛvKvW©vBwUm, Gwi`wgqv, Kb‡RmwUf nvU© †dBwjIi
BZ¨vw` nIqvi m¤¢vebv _v‡K|
nvBcviUªwdK KvwW©Igv‡qvc¨vw_|
hv‡`i Rb¥MZ ΓwUm¤úbœ i³bvjx Av‡Q †hgb - gvidvb wmb‡Wªvg
ev agwbi †KvqvK©‡Ukb|
hv‡`i nv‡U©i fvj¦ cvwë‡q bZzb fvj¦ jvMv‡bv n‡q‡Q Ges Gw›U
†Kvqv¸‡j›U w`‡q wPwKrmv cÖ‡qvRb|

Kg SzuwK m¤úbœ Mf©eZx gv

Mf©avi‡Yi c~ ‡e© hviv nvU© †dBwjIi -Gi cÖv_wgK ch©v‡qi (NYHA
K¬vm I ev II) Aš—f©y³ wQ‡jb|
hv‡`i ü`wc‡Û Rb¥MZfv‡e wQ`ª Av‡Q Ges †h Kvi‡Y evg †_‡K
Wvb w`‡K i³PjvPj K‡i| hv‡`i fvj¦yjvi wiMviwR‡Ukb Av‡Q|
hv‡`i Aí gvÎvq GIiwUK †÷‡bvwmm Ges cvj‡gvbvix †÷‡bvwmm
Av‡Q|

30
†h mKj ü`‡iv‡Mi Kvi‡Y Mf©¯’ wkïi SzuwK †e‡o hvq
Rb¥MZ ü`‡ivM m¤úbœ cÖ‡Z¨K bvixiB Zv‡`i Mf©¯’ wkï‡`i SzuwK
wbiƒcY Kiv cÖ‡qvRb| †Kbbv GB mKj gv‡q‡`i M‡f© Rb¥ †bqv
wkï‡`i kZKiv 2 †_‡K 16 fv‡MiB Rb¥MZ ü`‡ivM nIqvi
m¤¢vebv _v‡K|
†h mKj Mf©eZx gv‡q‡`i nvU© †dBwjIi (NYHA K¬vm III ev IV
Gi ch©v‡q) Av‡Q, hviv wbqwgZ A¨vw›U †Kvqv¸‡j›U U¨ve‡jU
Wareferin 5 wgwjMÖv‡gi †ekx †meb K‡i Ges hv‡`i GK¬vgwmqv I
wcÖ-GK¬vgwmqv Av‡Q| GQvov †hme bvixiv Rb¥MZfv‡e AwZwi³
Aw·‡Rb ¯^íZvRwbZ ü`‡iv‡M fyM‡Qb, Zv‡`i wkïiv †ewk SzuwKi
m¤§yLxY| †hgb - kZKiv 50 fvM Mf©¯’ wkï ¯^Zù‚Z© Mf©cvZ n‡q
_v‡K, kZKiv 30 †_‡K 50 fv‡Mi AKvj cÖme Ges eq‡mi Zzjbvq
Kg IR‡bi n‡q _v‡K|
D”P SzuwK m¤úbœ gv‡q‡`i Rb¨ civgk©
hv‡`i nv‡U©i fv‡j¦i †ivM Av‡Q -
nv‡U©i fv‡j¦i †ivM m¤úbœ mKj †g‡q‡`iB, DcmM© _vKzK ev bvB
_vKzK B‡KvKvwW©IMÖvwd †U‡÷i gva¨‡g nv‡U©i Ae¯’v †`‡L †bqv
`iKvi| nv‡U©i fv‡j¦i †iv‡Mi wPwKrmv c×wZ m¤ú‡K© Mf©avi‡bi
c~‡e©B wPwKrmK Ges †ivMxi mv‡_ Av‡jvPbv nIqv `iKvi|
Mf©ve¯’vi wØZxq avc †_‡KB wPwKrm‡Ki wbweo ZË¡veav‡b _vKv
DwPZ|
Jl‡ai mvnv‡h¨ wPwKrmv djcÖm~ bv n‡j Mf©ve¯’vqI fv‡j¦i
Acv‡ikb Kiv †h‡Z cv‡i| Z‡e gv‡qi Rxeb †Kej ûgwKi m¤§~wLb
n‡jB I‡cb nvU© mvR©vixi wm×vš— †bqv †h‡Z cv‡i| Mf©eZx bvix
hv‡`i K…wÎg fvj¦ ms‡hvRb Kiv n‡q‡Q Zv‡`i Gw›U‡Kvqv¸‡j›U
MÖn‡Yi †¶‡Î mZK© _vK‡Z n‡e| m‡e©vcwi Aek¨B avÎxwe`¨v
we‡klÁ Ges G‡b‡¯’wmIjwR‡÷i m‡½ Av‡jvPbv K‡iB †Wwjfvwi
msµvš— wm×vš— MÖnY Ki‡Z n‡e|

31
hv‡`i KvwW©Igv‡qvc¨vw_ Av‡Q -
WvB‡j‡UW KvwW©Igv‡qvc¨vw_ (DCM) - hv‡`i DCM -Gi cvwievwiK
BwZnvm Av‡Q Zv‡`i cieZ©x‡Z cÖm‡ei Av‡M Ges c‡i
KvwW©Igv‡qvc¨vw_ ev Peripartum Cardiomyopathy (PPCM)
nIqvi m¤¢vebv we‡ePbvq ivL‡Z n‡e|
hv‡`i c~e© †_‡KB WvB‡j‡UW KvwW©Igv‡qvc¨vw_ Av‡Q wKsev hv‡`i
DCM A_ev PPCM-Gi cvwievwiK BwZnvm Av‡Q Zv‡`i Mf©avi‡Yi
c~‡e©B B‡KvKvwW©IMÖvwd †U÷ Ki‡Z n‡e| Gme †ivMx‡`i g‡a¨
hv‡`i nv‡U©i Kg©¶gZv Kg (EF<50), Zv‡`i‡K Mf©avi‡Y
wbi“rmvwnZ Ki‡Z n‡e|
WvB‡j‡UW KvwW©Igv‡qvc¨vw_ (DCM) m¤úbœ Mf©eZx bvixiv
D”PgvÎvq SzuwKi m¤§yLxb| myZivs we›`ygvÎ Ae¯’vi AebwZ n‡jB
mv‡_ mv‡_ nvmcvZv‡j fwZ© Ki‡Z n‡e|
nvBcviUªwdK KvwW©Igv‡qvc¨vw_ (HCM) - DcmM© bv _vK‡j
KvwW©Igv‡qvc¨vw_i †ivMx‡`i †¶‡Î †Zgb †Kvb mgm¨v nqbv|
ïaygvÎ DcmM© †`Lv w`‡jB wPwKrmvi cÖ‡qvRb nq| Z‡e hv‡`i
nv‡U©i Wvqv‡÷vwjK Kg©¶gZv Kg Zv‡`i nvmcvZv‡j fwZ© †i‡L
wekªvg Ges Ily‡ai gva¨‡g wPwKrmv Kiv †h‡Z cv‡i|
Bb‡dw±f ev e¨v‡±wiqvj G‡ÛvKvW©vBwUm - cÖ‡qvR‡b Acv‡ik‡bi
wm×vš— hZ `ª“Z m¤¢e wb‡Z n‡e| †Kbbv Mf©¯’ wkïi SzuwK wbf©i K‡i
gv‡qi Ae¯’vi Dci|
hv‡`i K…wÎg fvj¦ ms‡hvRb Kiv n‡q‡Q Ges hv‡`i G‡ÛvKvW©vBwU‡mi
c~e© BwZnvm Av‡Q Zv‡`i ¯^vfvweK †Wwjfvwii mg‡qI cÖwZ‡ivag~jK
Gw›Uev‡qvwUK e¨envi Ki‡Z n‡e|
†ewkifvM †ivMx‡`i †¶‡ÎB ¯^Ztù‚Z©fv‡e cÖme Kiv‡bvi †Póv Kiv
n‡q _v‡K| Z‡e D”P SzuwK m¤úbœ gv‡q‡`i †¶‡Î wPwKrm‡Ki civgk©
Abyhvqx c~e©wba©vwiZ mg‡q Acv‡ik‡bi gva¨‡g cÖme Kiv‡bv DwPZ|

32
bvixi Rxe‡bi wewfbœ ¯—‡i ü`‡ivM I Zv cÖwZ‡iv‡ai Dcvq
20 †_‡K 30 eQ‡ii bvix I ü`‡ivM
wb‡Ri ¯^v¯’¨ m¤ú‡K© hZœevb nIqvi Rb¨ G eqmUv †gv‡UI ZvovZvwo ejv
hv‡ebv| wek-Gi †KvVvq hv‡`i eqm Zv‡`i ü`‡ivM cÖwZ‡iva Ki‡Z wK
Ki‡Z n‡e?
Avcbvi eqm hw` nq wek-Gi †KvVvq A_©vr 20 †_‡K 30 eQ‡ii g‡a¨
Avcwb ZLb gy³ wen‡½i gZ| Rxe‡bi cÖwZ¶Y ZLb Avcbvi Rb¨
†mvbvjx gyûZ©| mwZ¨ K_v ej‡Z wK ¯^v¯’¨ wb‡q wPš—v Kivi mgq †Kv_vq?
ZLb Avcbvi Kv‡Q †ekx ¸i“Z¡ cvq cov‡jLv, KvR ev PvKzix| †mB mv‡_
Rxe‡bi bZzb m¤ú‡K©i bvbv cÖfve| ZLb g‡b nq ¯^v¯’¨ wb‡q wPš—v Kivi
Rb¨ cÖPzi mgq cvIqv hv‡e Rxe‡bi cieZx© As‡k| wKš‘ f~j! ü`‡ivM †h
†Kvb eq‡mB Avcbv‡K AvµgY Ki‡Z cv‡i| myZivs GUv LyeB ¸i“Z¡c~Y©
†h Avcwb hw` GLbB my›`i Ges ¯^v¯’¨ m‡PZb wm×vš—¸‡jv wb‡q †bb Z‡e
Zv eZ©gv‡b †Zv e‡UB fwel¨r Rxe‡bI Avcbvi Rb¨ mydj e‡q Avb‡e|
Avcbvi cvwievwiK BwZnvm, i³Pvc, i‡³ †Kv‡j‡÷ij, Avcbvi IRb,
KvwqK cwikªg, a~gcvb Ges ZvgvK RvZxq `ªe¨ MÖn‡Yi Af¨vm,
Wvqv‡ewU‡mi Dcw¯’wZ Ges Rb¥ wbqš¿‡Yi c×wZ ü`‡ivM I †÷ªv‡Ki
†¶‡Î ¸i“Z¡c~Y© cÖfve we¯—vi K‡i| Av‡gwiKvq 20 eQi ev Zvi †ekx
eq‡mi bvix‡`i g‡a¨ kZKiv 7.9 fvM Wvqv‡ewUm-G Avµvš—| myZivs
wb‡Ri Rxe‡bi mZ¨¸‡jv D`&NvUb Ki“b Ges Avcbvi ü`¯^v‡¯’i eZ©gvb
Ae¯’v‡K wfwË a‡i GLbB KvR ïi“ Ki“b|
ü`¯^v¯’¨ m¤ú‡K© my¯úó wPÎ memgq Avcbvi mvg‡b _vK‡Z n‡e|

AvMvwg `k eQ‡i Avcbvi nvU© A¨vUv‡Ki m¤¢vebv KZUzKz †mwU

Avcbv‡K †R‡b wb‡Z n‡e|
Avcbvi cvwievwiK BwZnvm m¤ú‡K© †R‡b wbb|
wb‡R a~gcvb ev ZvgvK RvZxq `ª‡e¨i e¨envi †_‡K weiZ _vKzb|
†mB mv‡_ a~gcv‡bi c‡iv¶ cÖfve †_‡KI gy³ _vK‡Z †Póv Ki“b|

33
 cwigvb gZ cvwb cvb Ki“b|
mwVK Rb¥wbqš¿Y c×wZ MÖn‡Yi †¶‡Î mZ©K nDb|

Avcbvi msL¨v¸‡jv Rvbyb|

j¶¨gvÎv
d¨v±i
†UvUvj
< 200†Kv‡j‡÷ij
wgMÖv/wWGj(wUwm)
†jv-†WbwmwU
< 100 wgMÖjvB‡cv‡cÖ
v/wWGj vwUb (GjwWGj)
nvB-†WbwmwU
> 50 wgMÖv/wWGj
jvB‡cv‡cÖvwUb (GBPwWGj)
UªvBwMmvivBW
> 150 wgwg(wUwR)
gviKvwi
evW< †cÖ
120/80
mvi (wewc)
wgMÖv/wWGj
Afy<³100
Ae¯’wgMÖ
vq vi‡³
/wWGj
myMv‡ii cwigvY
ewW< gvm
25 Bb‡W·
†KwR/ wg2
(weGgAvB)
†Kvg‡ii
> 35 BwÂ
gvc
e¨vqvg
30 wgwbU K‡i cÖwZw`b
mßv‡n Kgc‡¶ 5 w`b

Avcbvi ¯^v¯’¨‡K GLbB my›`i Ki‡Z n‡j Kg jeYhy³ Lvevi LvIqvi

Af¨vm Ki“b| wbqwgZ e¨vqvg Ki“b| cvkvcvwk cÖwZw`b cwiwgZ wekªvg
wbwðZ Ki“b| gvbwmK Pvc Gwo‡q Pj‡Z †Póv Ki“b| KL‡bv †÷ªm ev
Pvc wRwq‡q ivL‡eb bv| †÷ª‡mi KviY Lyu‡R †mUv wgwU‡q †djyb|

34
w·kvaŸ© bvix I ü`‡ivM
G eq‡m Avcwb nvU©‡K my¯’ †i‡L e¨¯— Rxe‡bi Pvwn`v †gUv‡Z cv‡ib|
w·kvaŸ© bvixiv G eq‡m mvaviYZ Zv‡`i †Kwiqvi Ges cwievi wb‡q GZ
†ekx e¨¯— _v‡Kb †h cÖvqktB Zviv wb‡Ri ¯^v‡¯’¨i e¨vcv‡i D`vmxb
_v‡Kb| Avcbvi wb‡Ri Rxe‡b KL‡bv GgbwU n‡Z w`‡eb bv| g‡b
ivL‡eb Avcwb eq‡m †QvU wKš‘ ZvB e‡j wkï bb| Rxeb gv‡b
mg‡SvZv| Avcbvi mv‡_ Avcbvi eÜz-evÜe Ges cwiev‡ii mg‡SvZv|
Z‡e Avcbvi ¯^v¯’¨‡K G‡¶‡Î me‡P‡q †ekx ¸i“Z¡ w`‡Z n‡e|
ü`wnZKi Af¨vm¸‡jv wb‡Ri wfZi M‡o †Zvjv Ges Gi PP©vi Rb¨
GLwb DËg mgq| M‡elYvq GUv cÖgvwYZ †h Avcwb hw` byb¨Zg 50 eQi
ch©š— ü`‡iv‡Mi Rb¨ `vqx KviY¸‡jv‡K Gwo‡q Pj‡Z cv‡ib Z‡e
Avcbvi fwel¨‡Z nvU© A¨vUvK bv nIqvi m¤¢vebv A‡bK †ekx|

GKRb ga¨ eqmx Amy¯’ bvix Av‡¶c K‡i ejwQ‡jb - Avgvi †Q‡j‡g‡qiv
hLb †QvU wQj ZLb Avwg Avgvi ¯^v¯’¨ wPš—v‡K wku‡Kq Zz‡j †i‡LwQjvg|
ZLb Avgvi wPš—v wQj †h GUv Avgvi e¨vqvg Kiv ev ¯^v¯’¨m¤§Z Lvevi
LvIqvi mgq bq| wKš‘ GLb Avwg eyS‡Z cviwQ, †mB mgq Avgvi
¯^v‡¯’¨i cÖwZ hZœkxj n‡j Avwg Avgvi mš—vb‡`i Gi ‡P‡q fvj wKQy
Dcnvi w`‡Z cviZvg †Kbbv GKRb my¯’ gv-B n‡jv me‡P‡q fv‡jv gv|

35
Pwj‡kvaŸ© bvix I ü`‡ivM
Pwjk ev Gi †ekx eq‡mi bvix GgbUv fve‡ZB cv‡ib †h Rxe‡bi Rb¨
GUv A‡bKUv w¯’wZkxj mgq| G eq‡m Avi bZzb K‡i cwieZ©‡bi wPš—v
K‡i wK jvf? wKš‘ GUv KL‡bvB †ekx †`ix bq| G mgq GKwU †QvÆ
PvIqvB Avcbvi kixi‡K cwieZ©b K‡i w`‡Z cv‡i Ges Avcbv‡K
ü`wnZKi Af¨vm¸‡jvi w`‡K AvK…ó Ki‡Z cv‡i| GB Pwjk eQ‡ii
Rxe‡b Avcwb wK †c‡q‡Qb? GKwU bZzb †ckv, cvwievwiK cwieZ©b wKsev
Rxe‡bi †Kv‡bv gvBjdjK AwZµg - †mUv eo K_v bq| me‡P‡q
¸i“Z¡c~Y© n‡jv my¯’ _vKv| hv‡Z Avcwb Avcbvi AvMvgx Rxeb Ges
mgq‡K Dc‡fvM Ki‡Z cv‡ib| Avcbvi kixi‡K †evSvi †Póv Ki“b Ges
¯^v¯’¨Ki Rxeb hvc‡bi PP©v ïi“ Ki“b Z‡eB Pzovš—fv‡e Avcwb DcK…Z
n‡eb|

ü`‡ivM w¯Œwbs
Avcbvi eqm 45 n‡jB ü`‡iv‡Mi w¯Œwbs K‡i †bIqv DwPZ| Zvi Rb¨
wbæwjwLZ cix¶v wbix¶v Ki‡Z n‡e -
IRb I weGgAvB wbY©q|
†Kvg‡ii gvc †R‡b †bqv|
i³Pvc gvcv - Avcbvi i³Pvc 120/80 wb‡P n‡j Aš—Z: `yB eQi
ci ci gvc‡eb| Z‡e i³Pvc †ekx n‡j ev AviI SzuwKi KviY
_vK‡j Nb Nb gvc‡Z n‡e|
i‡³ †Kv‡j‡÷i‡ji gvÎv wbY©q - Lvwj †c‡U i‡³i wjwcW †cÖvdvBj
K‡i †UvUvj †Kv‡j‡÷ij, GjwWGj †Kv‡j‡÷ij, GBPwWGj
†Kv‡j‡÷ij, Ges UªvBwMmvivBW †`L‡Z n‡e| mvaviYZ my¯’ gvby‡li
Rb¨ cÖwZeQi GKevi GQvov hw` Ab¨ †Kvb SzuwKi KviY we`¨gvb
_v‡K Z‡e Nb Nb gvc‡Z n‡e|

36
 nvU© cix¶v - hv‡Z _vK‡e nvU© †iU ev cvjm&, wbtk¦v‡mi kã, nv‡U©i
kã, Pvgovi is, nvZ cv dz‡j †M‡j ev BwWgv †`Lv w`‡j ZvI
cix¶v K‡i †`L‡Z n‡e|

Afy³ Ae¯’vq i‡³ My‡Kv‡Ri cwigvY - 45 eQ‡ii mg‡q ¯^vfvweK

gvÎvq _vK‡j cÖwZ wZb ermi ci ci gvc‡eb| Avi hw` Avcwb
Mf©eZx nb, ¯’~jKvq nb A_ev Wvqv‡ewU‡m Avµvš— ev Wvqv‡ewU‡mi
SuzwKi g‡a¨ _v‡Kb Z‡e AviI Nb Nb i‡³ My‡Kv‡Ri cwigvY gvc‡Z
n‡e|

cÂv‡kvaŸ© bvix I ü`‡ivM

cÂvk eQ‡ii GKRb bvixi Rxe‡b K¨vwiqvi bZzb †gvo wb‡Z cv‡i| GUv
mš—vb‡K K‡jR cvVv‡bvi mg‡qi cvkvcvwk PvKzix †_‡K Aem‡ii mgqI
Nwb‡q Av‡m| Z‡e GKwU welq Aek¤¢vex| G eq‡m Avcbvi kix‡i GKUv
¸i“Z¡c~Y© cwieZ©b Av‡m hv wKbv Avcbvi nvU© Gi Dci weivU cÖfve
†dj‡Z cv‡i| `yf©vM¨ekZ hv‡`i eqm 55 ev Zvi KvQvKvwQ Zv‡`i nvU©
A¨vUv‡Ki nvi †e‡o hvq| †Kbbv G eq‡mB bvix‡`i FZz m¤ú~Y©iƒ‡c eÜ
n‡q hvq| wKš‘ my‡Li welq GB †h Avcwb Avcbvi GB SuzwKi gvÎv wb‡RB
Kwg‡q Avb‡Z cv‡ib - Avcbvi Lv`¨ ZvwjKvq cwieZ©b G‡b Z_v
Rxebavivq cwieZ©‡bi gva¨‡g|

lv‡UvaŸ© bvix I ü`‡ivM

hv‡`i eqm 60 ev Zvi †ekx, Zviv G mgq Zv‡`i Rxe‡bi we‡kl †Kvb
wel‡qi Dc‡i †ekx K‡i ¸i“Z¡ †`q| Gi g‡a¨ me‡P‡q ¸i“Z¡c~Y© welq
n‡jv Zv‡`i ¯^v¯’¨| M‡elYvq †`Lv †M‡Q gwnjv‡`i nvU© A¨vUv‡Ki †ekxi
fvMB n‡q‡Q Zv‡`i gvwmK eÜ nIqvi `k eQ‡ii g‡a¨| Zvi gv‡b wKš‘
GB bv †h H mgq nvU© A¨vUvK n‡ZB n‡e| Avcwb †Póv Ki‡jB Avcbvi
Lv`¨vf¨v‡m Ges Rxebavivq cwieZ©b G‡b Avcbvi Rxeb‡K `xN© I
Avb›`gq K‡i Zzj‡Z cv‡ib|

37
Avcwb †h cÖkœ¸‡jv Avcbvi Wv³vi‡K Ki‡Z cv‡ib
†h cÖkœ¸‡jvi DËi Rvbv _vK‡j Avcwb Avcbvi ü`¯^v¯’¨ ev nv‡U©i eZ©gvb
Ae¯’v m¤ú‡K© cwi®‹vi aviYv wb‡Z cvi‡eb -
ü`‡ivM -Gi wK wK SzuwK ev wi¯‹ d¨v±i Avgvi g‡a¨ Av‡Q?
Avgvi evW †cÖmvi KZ? GUv Avgvi Rb¨ wK A_© enb K‡i Ges G
e¨cv‡i Avgvi KiYxq wK?
Avgvi i‡³ †Kv‡j‡÷i‡ji msL¨v¸‡jv KZ? (†Kv‡j‡÷i‡ji
msL¨v ej‡Z - †UvUvj †Kv‡j‡÷ij, GjwWGj ev Lvivc †Kv‡j-
‡÷ij, GBPwWGj ev fvj †Kv‡j‡÷ij Ges UªvBwMmvivBW - Gi
cwigvb †evSvq)| G¸‡jv Avgvi Rb¨ wK A_© enb K‡i Ges G
e¨vcv‡i Avgvi KiYxq wK?
Avgvi weGgAvB Ges †Kvg‡ii gvc KZ? my¯^v‡¯’¨i Rb¨ Avgvi
IRb wK Kgv‡bv DwPZ?
Avgvi i‡³ myMvi -Gi cwigvb KZ? GUv w`‡q wK †evSvq †h,
Avwg Wvqv‡ewU‡mi SzuwKi g‡a¨ AvwQ?
ü`‡ivM mbv³Ki‡Yi Rb¨ Avi wK wK †U÷ ev cix¶v Avgvi
Kiv‡bv `iKvi? KZw`b ci ci Avgv‡K ü`¯^v¯’¨ †PKAvc Kiv‡Z
Avm‡Z n‡e?
a~gcvb Qvo‡Z Avcwb Avgv‡K wKfv‡e mvnvh¨ Ki‡Z cv‡ib?
Avgvi nvU© my¯’ ivL‡Z KZUzKz KvwqK cwikªg Kiv `iKvi?
Avgvi Rb¨ ü`wnZKi ivLvi †gby¨ wK nIqv DwPZ? Avgvi wK
†Kvb †iwRóvW© Wv‡qwUwkqvb ev cywówe‡`i civgk© †bqv DwPZ?
Avgvi nvU© A¨vUvK n‡q‡Q wKbv Avwg wKfv‡e eyS‡ev?

38
Avcwb wK nvU© A¨vUv‡Ki SzuwK‡Z Av‡Qb ?
wbæwjwLZ cªkœ¸‡jvi GKwUiI DËi hw` nuv †evaK nq Z‡e Avcwb nvU©
A¨vUv‡Ki SzuwK‡Z Av‡Qb|

Avcwb wK a~gcvb K‡ib?

Avcbvi evW‡cÖmvi wK 140/90 wgwg gviKvwi ev Zvi †ekx? A_ev
Wv³vi wK KLbI Avcbvi D”P i³Pvc Av‡Q e‡j‡Qb?
Wv³vi wK KLbI e‡j‡Qb †h Avcbvi i‡³ D”P gvÎvq GjwWGj
†Kv‡j‡÷ij Av‡Q? ev Avcbvi i‡³ †UvUvj †Kv‡j‡÷ij 200
wgMÖv/wWGj ev Zvi †ekx? A_ev Avcbvi i‡³ GBPwWGj ev fvj
†Kv‡j‡÷ij 40 wgMÖv/wWGj Gi Kg?
Avcbvi evev ev fvB‡qi wK Zv‡`i 55 eQ‡ii c~‡e© nvU© A¨vUvK
n‡q‡Q? A_ev Avcbvi gv wKsev †ev‡bi wK Zv‡`i 65 eQ‡ii c~‡e©
nvU© A¨vUvK n‡q‡Q?
Avcbvi wK Wvqv‡ewUm Av‡Q? A_ev Af~³ Ae¯’vq Avcbvi i‡³
My‡Kv‡Ri cwigvb 126 wgMÖv/wWGj ev Zvi †ekx?
Avcbvi weGgAvB wK 25 ev Zvi †ekx?
mßv‡ni AwaKvsk w`b wK Avcwb 30 wgwb‡Ui Kg KvwqK cwikªg
K‡ib?
Wv³vi wK KLbI e‡j‡Q †h, Avcbvi A¨vbwRbv (ey‡K e¨v_v)
wKsev nvU© A¨vUvK n‡qwQ‡jv?
hw` †Kvb cÖ‡kœi DËi Avcwb bv Rv‡bb Z‡e Avcbvi Wv³v‡ii mnvqZv
wbb| m‡e©vcwi co‡Z Ges Rvb‡Z †Póv Ki“b wKfv‡e Avcbvi SzuwK¸‡jv
Kwg‡q Avbv hvq|
GKwU Amy¯’ nvU© Avcbvi Rxeb‡K A‡K‡Rv K‡i †d‡j| Avmj K_v n‡jv
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