View
247
Download
0
Category
Preview:
Citation preview
7/27/2019 Nightingale Health Journal (September-2013)
http://slidepdf.com/reader/full/nightingale-health-journal-september-2013 1/16
usef ;rma&;*sme,ftrS wf-37? puf wifbmv? 2013-ckES pf NIGHTINGALE 1
trS wf - 37? puf wifbmv? 2013 - ckES pf jref rmEd kifiHaq;ynm&Sif rsm;toif ;(BMA)
rS xk wfa0onf/
ay;tyfonfh qkrSm Nidrf;csrf;a&;? w&m;rQwa&;ESifh vl om;tusKd;jyKvkyfief;rsm; vk yf aqmifaeol yk*¾ dKvf rsm;udk 1998 ck ESpfrSpí ESpfpOf a&G;cs,f qkcsD ;jrih fcJ hNyD; ,ck
2013 ckESpf Nid rf;csrf ;a&;qktwGuf a'gufwm pifoD,marmiftm; 16 OD ;ajrmuftjzpf a&G;cs,f csD;jr§ if h
waeYawmh aq;cef;rSm zkd ;uD;wa,muf olU&G mrSmbJ qHk ;yg; oGm;NyDvk dY owif;xG ufvmw,f/ olY&J Uvkyfazmfuk difzuf um;orm;awG? aq;cef;0efxrf;awGvnf; pd wfraumif ; Mubl ;aygh/
usef;rma&;eJ Y rudkufwJ h trans-fats awG rsm;wJh yufpx&D? udwf? uG wfuD;? jyKjyif xm;wJh tom;-ig;? rm*s&if?
tvG,f 0,f &wJ h tpm;tpmawG
usef ;rma&;avmuqkd wm jynf olvlxkusef;rma&; twGuf aqmif&G ufoltm;vkH;yg0ifwJh BuD ;rm;? us,fysH UwJh vlrI 0ef;usifBuD;vkd Y qkdEkdifygw,f
bdef;pm&Guf aomufokH ;&if tod tm½kHawG a00g;xdkif;rIdif; NyD; tod pdwf arhavsmhwJh twGuf wcsdKY[m armfawmf qdkifu,fpD;aepOf ,mOfwdk ufrI jyóemjzpfcJh zl ;w,fvd kY
pdwf zd pD;rIrsm;wJ h jzpf&yf wcktay: vlwa,muf&JU ud kif wG ,fwkef Yjyef rI[m wjcm;wa,muf a,muf &J U wkef YjyefyHkeJY rwlygbl;/
acG ;uk d uf cH &&if tJ 'DacG ; aumif ;w,f? raumif;bl;qk d wm csufcsif ;rod Ekd if wmrkd Y aq;½kH oGm;NyD ; acG;½l;umuG ,faq; xk d;oifh ygw,f
q&m0ef q&mrawG[m aq;½Hk wckvH k;udk axmifvd k yd wfqdk YNyD ; rd rdwd kYudk
rdrdwdk Y aq;½HkcsKyfcscJhw,f/ 'grS Nrd KUxJudk rul ;Ed kif? wEd kif iHvHk;ud k rul;Edk ifrS mjzpfw,f/
jrefrmjynf wGif;rSm tajymif ;tvJ awGjzpf aeNyD qdk ayr,fh xdk if ;Edk if iH xJa&muf aewJh a&T Uajymif;tvk yf orm;OD ;a& avsmhoG m;zdk Y tvm;tvma0;aeao;
pmrsufES m (6) ...
pmrsufESm (6) ...
pmrsufESm (6) ...
pmrsufESm (6) ...
pmrsufES m (6) ...
pmrsufESm (6) ...
pmrsuf ESm (6) ...
pmrsufES m (6) ...
pmrsufESm (6) ...
7/27/2019 Nightingale Health Journal (September-2013)
http://slidepdf.com/reader/full/nightingale-health-journal-september-2013 2/16
usef ;rma&;*sme,f trS wf-37? puf wifbmv? 2013-ckES pf2 NIGHTINGALE
t ,f 'D w mh t m a b mft ,f 'D w mh t m a b mft ,f 'D w mh t m a b mft ,f 'D w mh t m a b mft ,f 'D w mh t m a b mf
usef;rma&; ta[mod uH jzpf rI jrefrmEdkifiHES ifh tjcm;zGH YNzd K;qJwd kif ;jynfrsm;wG if ausmif;
om;rsm; ynma&;vrf;ckvwfrSxGufcGmNyD; vkyfief;cGifxJ 0if oG m;Muojzif h rl v&if ;ES D ;xm;onf h uk ef usp&d wf rsm; tv [ójzpf rI? uav;ol i,frsm; ynmwydk if ;wpom &&Sd rIwd kY aMumif h ynma&;ta[mod uH jzpf jcif ; [l aoma0g[m& acwf pm;cJhonf/ ,ckvnf;acwfpm;aeqJjzpfonf/
tvm;wl r&S d rjzpf ta&;ygonf h usef ;rma&;e,f y,f wG if vnf; usef;rma&;qdkif&m &efyHkaiGrsm;? twwf ynmrsm;ud k rS ef uef pG m toH k ;rcsEd k if ojzif h ta[mod uH jzpf aejcif ;rsm; &S d ae onf/
jref rmEdkifiHwGif tqkwf a&m*gwdkufzsufa&;pDrHudef;rSm vrf;vG Jaeaom aq;wdk ufauR;rIpepf? BuD ;MuyfrIpepf rsm;
aMumifh aq;ywf jynf hatmif aq;rpm;awmhojzif h aq;,Of wDbDykd;rsm; wdk;yGm;vmaeonf/ wD bD? iS uf zsm;? td yf csf tdk if AG D [l onf h a&m*goHk ;rsKd; wd kuf
zsuf a&;twG uf Ed k if iH wumrS &ef yH k aiG rsm; axmuf yh H ay;aeaomf vnf ; aq;0g;&oif h ol 40 rS 60 &mcd k if EI ef ;txd uif ;uG mae onf/ xd kol wdk YrS m a&m*gjzefYjzL;a&;orm;(Carrier) rsm; jzpf vmMuonf/
usef;rma&;ESif hrnD onfh pHcsd efrrD tpm;taomuf rsm; ppfaq;rIudk xda&mufjrefqefpG mESifh t*wduif;uif; raqmif &Guf Edk ifojzifh uif qmESifhtjcm;a&m*grsm; jzpfyGm; apEd k if onf h tpm;tpmrsm; aps;uG uf twG if ;ysH UES H Yvsuf &S d onf/
taMumif;trsKd ;rsKd ;aMumif h Ed kif iH wumpHEIef;rsm;? vrf; ñT ef rsm;twd k if ; oef Ypif rI? xd ef ;od rf ;rI rvk yf ojzif h cG J pd wf cef ; rsm;rS m tonf;a&mif bD yd k ; pD ydk ; jzef YjzL;&mae&mrsm; jzpfvm
cJ h onf/ urÇmh usef;rma&;tzG JYBuD; (WHO) rS wurÇ mvHk ;twG uf csrS wfxm;onfh vrf;ñT efcsufrsm;&Sdaomf vnf; jrefrmEdkifiH wGif b@ma&;taMumif;jycsufjzifh aq;0g;a[mif;? ukxH k; a[mif ;? umuG,faq;a[mif;rsm;udk qufvufzuf wG,f oHk ;pG Jaeojzif h rzdwf pifoifh onf h vl emrsm;? uav;rsm; zdwf pif aeMu&onf/
,cktcg jref rmEdkifiH&S d aq;wuúod kvfav;cku wESpf vQif q&m0ef 2400 arG;xkwf aeaomfvnf; usef;rma&; 0efBuD ;XmewG if trI xrf ;ol tvG efenf ;yg;aeovd k yk *¾ vd u e,fy,fwGif vk yfudk ifolvnf ; &S m;yg;aeojzif h e,frsm;wG if tyfykef;rsm;uom wGif us,fBuD;pdk;aeqJjzpf onf/ jynfy xG uf í (aq;zuf r[k wf onf h ) tjcm;tvk yf vk yf ol rsm;? jynf wGif ;üyif (aq;zufr[k wfonfh ) tjcm;tvk yfvk yfol rsm;
rsm;jym;aeonf/ ppf wyf aq;wuú od k vf uarG ;xk wf aom q&m0ef rsm;rS mrl vd k tyf onf h ta&twG uf ud k ausmf vG ef oG m;ojzif h ppf wyf q&m 0ef rsm;ud k omref aq;rSL;tvkyf? ol emjyKtvk yf? a&S ;OD ;ol em jyK Muuf ajceDtvkyfrsm; cd kif ;ae&onf/
usef;rma&;ESif hywf oufonfh NGO rsm;\ &ef yHk aiGrSmOverhead charges ac: txufXme0efxrf;rsm;\ pD rHcef YcGJ
a&; p&dwfpursm;u xuf0ufausmf,lxm;onf[laom pG yf pG J csuf rsm;rS m ,aeYjref rmEd k if iH wG if ;üvnf ;aumif ;? e,f pyf a'orsm;üvnf;aumif ;? tjcm;aomzGHY NzdK;qJ EdkifiHrsm;ü vnf;aumif; txift&Sm;awGYae&onf/
jref rmtpdk;&u 2009 ckESpf u EdkifiH jcm;bPfrsm;ü a': vm 6 bDvD,H eD;yg; tyf ESH Edk ifcJh NyD; ,aeYwG if a':vm 11 bDvD,H tyfES Hxm;onf[k owif ;rsm;xGuf ay:ae&m jynf
olYusef;rma&;twGuf Edk ifiHjcm;tpdk;&rsm;?NGO
rsm;ukd vdk tyf onf xuf yd k rS D cd k aeonf rS m vH k ;0em;rvnf Ed k if p&m jzpf ae onf/
ynma&;ta[mod uHjzpfrIESifh usef;rma&;ta[mod uH jzpf rI wd kYrS m tajccH tm;jzif h Edk if iHa&;pepfrS xG uf ay:vmjcif ; jzpfaomf vnf; usef;rma&;0efxrf;rsm;uvnf; jynfol ukd tvkyftauR;jyKa&;tawG;tac:jzifh rdrdwdkYwwfEdkifonfh bufrS pkaygif;0dkif;0ef; ajz&Sif;oifhygonf/
t,f'D wmcsKyf- a'guf wmpifoD ,mar mif wm0efcHt,f'D wm -*grPdt,f'D wmtzG J U 0if - a'guf wmcifapm0if ;
a'guf wmoD [armifa'guf wmvG Pf ;aqG
Layout & Design - ausmftJe,f pmpD pm½d k uf- apmtJtJ
Mo*kwfv 15 &uf aeYnu
{&m0wDwdkif; a&MunfNrdKUe,f oD wmuk ef ;jrif h wd k uf e,f aq;½H k rS m &ifcsif ;quftrTm atmif jrif pGm AdkufcGJarG;zGm;ay;EdkifcJhygw,f/ arG ;ay;ol rSm wd k uf e,fq&m0ef a'gu fwmae0if ;xGe f;jzpfN yD; trT mnDtpfr&J U rdbrsm ;rS m av;rsuf ES mNrd KUe,f 0uf uk ef ;&G m u OD;aZmfrsKd ;oufeJY a':at; at;rd k;wdk Y jzpf ygw,f/ &ifcsif; qufaewmud k cG Jpdwfzdk Y &ef ukef wd kif ; &efuif ;uav;aq;½Hk udk ydkYcJ hayr,fh ES vHk;wckwnf;om
&ifcsif;quftrT m
jref rmEd k if iH rS m tqk wf wD bD a&m*gonf oHk ;odef;cefY odkYr [k wf vl wod ef ;rSm a&m*gonf 525 a,muf &Sd NyD; 'D xJrS m aq; ,Of wD bD a&m*gonfwaomif ; cG J avmuf &S d r,f vd k Y jyif opf tajc pd k uf e ,f pnf ;rjcm;q&m0ef rsm; tzG JY MSF u ajymvdkufy g w,f/ 'g[m urÇmhyQrf;rQEIef; xuf 2 qavmuf&Sdygw,f/
'gay r,f h jref rmEd kif iH wD bD wd k uf zsuf a&;pD rH ud ef ;[m 2012
azazmf 0g&D 2 &uf aeYu &S rf ; jynf e,f? yifvH kNrdKUe,f? vG,f rGwf&GmrS m ytdk0f;wdkif;&if;om; rdbrsm;jzpfwJh cGefpH a'G; eJ Y eef; aemifhaemifhwdkYu ajcaxmuf av;acsmif;? rt*Fg 2 ck? ptdk 2 ckygwJh rdef;uav;wOD;udk zGm;jrifcJhNyD;aemuf Zlvdkif 16
ajcav;acsmif;eJ Yuav;
jrefrmEd kifiHeJ YwDbD
&Sd wJh trTmnD tr[m 18 &uf
aeYrSm qHk;oG m;cJh ygw,f/ Zl vd k if 9 &uf naeuvnf ;
&efukefwdki f; ajrmu fOuúvm aq;½H k BuD ;rSm &if csif ;quf trT m nD tpf rES pf OD ;ud k arG ;zG m;ay;cJ h NyD ; 'D trT mawG udk touf wESpf cGJ usrS cEmudk ,f ESpf ckudk cGJ jcm;wJh cGJ pd wf rI vk yfrS mjzpf ygw,f/
tcktcsdef txd jref rmEdkifiH rSm &ifcsif;quftrTmpkpk aygif ;7 pHk arG;zGm;cJhNyD; jzpfygw,f/
Modern News Journal /
Good Health
&ufaeYeJY Mo*kwf 16 &ufaeY awG rS m &ef uk ef wd k if ; &ef uif ; u av; aq;½H kBuD;rS m yH k rSef uav; jzpfatmif cGJpdwf ay;cJhygw,f/
cGJpdwfrIudk OD;aqmifolu t½kd;txl;ukyg&*lBuD; a'guf wm jrifhaomif; jzpfygw,f/
DVB
arv 7 &ufu yJcl;wdk if; taemuf jcrf; a&TawmifNrd KUe,f aq;½HkrSm udk ,f0efaqmif r,k ZmvIdif rD;zG m;&if; aoqHk;cJhrIeJ Y ywfoufNyD ; rD'D,meJY tifwm eufrSm owif;rsm; ysHUESHYcJhNyD;
ae mu f wm0e f& SdwJ h vu f axmuf q&m0ef a'guf wmod ef ;
Mo*kwf 5 &ufu u&if jynfe,f jr0wD Nrd KUe,f oCFef ; nDaemif trSwf (1) tv,f wef;ausmif;rSm tvSL&SifawG vmvS LwJ h xrif ;[if ;awG pm;rd vdk Y ausmif;om; 60 avmuf tpmtqd yf oif h rl ;a0 atmh tef cJ h Muygw,f/ &uf vG ef aewJ h ig;
aowåmAl;awGaMumif hvdkY ,lq &NyD ; aq;½H k wif &wJ h tajctae r&Sd cJh yg/
ZGef 19 &uf aeYu aejynf awmf aZ,smoD&dNrd KUe,f 0JBuD; &Gm rlvwef;ausmif;rSm tv um;vma0wJh a&cJ acsmif ;pm;rd vdk Y ausmif;om; 7 OD; acgif;rl; atmhtef vk d Y aq;½Hk wifuk ocJ h & ygw,f/
w&ufwnf;rSmbJ u,m; jynf e,f 'D armqd k Nrd KUe,f [ef vD &G mu OD;qm;bm rdom;pk[m
uRJacs;rIdwrsKd;udk csufpm;cJh &m u 5 &uf twGif; rd cifa': rm wav;emeJY om;orD; 4 OD; aoqHk;cJh ygw,f/ zcif OD;qm; bmeJY ti,fqHk ; 2 vom; u av;ud k awmhvG d Kif aumf aq;½H k rS m uk oaeqJjzpf ygw,f/
ZG ef 18 &uf aeYrS mvnf; u
wm0efrJ hq&m0efta&;,lcH&
tpmeJ Ytqdyf ,m;jynf e,f z½l qk d Nrd KUe,f c½d k U cl&G mrSm &Gmom; 3 OD ; rId eJY zm; om; a&mpm;vd kY aoqHk;cJhy g w,f/
jrefrmEdk ifiH pm;oHk ;ol um uG ,fa&;toif;OuúX OD;Atkyf cdkifu jrefrmwdkY t"dupm;oHk; aewJh a&Bud Kig;yd 80% rS m ,l
&D ;,m;"mwfajrMoZmrsm; xnf h oG if ;xm;wm awG Y&w,f vd k Y Mo *kwfvtwGif; xkwfazmfajym Mum; vdkufygw,f/ ig;t½dk; awG tjrefaqG ;ajrUNyD; ig;yd t jref &apz dkY "mwfajrMoZmud k oHk;wm jzpfEdkifw,fvdkY qdkyg w,f/ ,l ;&D ;,m;ygwJh ig;yda& BudK ? azmfrvifygwJ h yJjy m;? rJe,fqdk;xm;wJh ykZGef? "mwk a[mf rkef ;awG zsef;xm;vd kY tq rwef BuD;xG m;aewJh oD;ES Hrsm;? ydk;owfaq;trsm;tjym; oHk;
xm;wJh oD;ESHrsm;[m uifqm jzpf apEd kifw,fvdk Y ygarmu© a'guf wmjrod ef ;[ef u ajymyg w,f/
7 Day Daily /
uEÅ m&0wD wd kif ;rf / The Voice /
Family Health / Yangon
Media
Edk ifud k acwåae&ma&T U wm0efcs xm;vdku fygw,f/ q&m0ef tjyif txuf wef;ol emjyK q &mr 2 OD ;udkvnf; a&TUajymif ; ypfvdkufygw,f / (jzp fpOfud k Zlvdkifvxkwf Edkufwifa*;vf
*sme,frSm azmfjycJh NyD; jzpfyg w,f/) The Voice
ckESpfrS m aq;,Ofa&m*gonf 800 ausmfud kbJ ukoay;EdkifcJh NyD ; 2013 ck ES pf twG uf qd k &if vl em 500 twGufbJ aq;0g;vHk avmufrI &Sd w,fvdk Y qdk ygw,f/
urÇ mvH k ;qdk if&m&ef yH k aiG tzG J YGlobal Fund u jref rmEdkifiH rSm
wDbDwdk uf zsuf a&;twG uf a': vm 111 oef; 3 odef ; 8 aomif;ausmf axmufyHhzdkY t wnfjyKxm;NyD jzpfygw,f/
RFA / Global Fund
2013 ck yxr 6 vt wG if; &efuk efwd kif ;rSm aoG;vGef wkyfauG; jzpfwJ h uav;OD;a& 1727 OD; &SdoG m;NyDjzpfygw,f/ 2012 ck yxr 6 vwHk ;uawmh aoG ;vG ef wk yf auG ;jzpf wJ h uav; 1144 OD;bJ &S dcJ hygw,f/ 2011 ck wESpfvH k;rSmawmh uav;
500 ausmf bJ aoG ;vG ef wk yf auG ; jzpfcJ hygw,f/ 'D ES pf rS m a&m*gjzpf ol 1727
&efukefaoG;vGefwkyfauG; OD;rSm 7 OD ;bJ aoqHk;w,f vdkY w&m;0ifajym Mum;ayr,fh w u,fh ta&twG ufu 'Dhxuf ydk rsm;w,fvdkY aq;½H krsm;eJY eD;pyf oltcsKd Uu qd kygw,f/
&efukefwdkif;rSm aoG;vGef wk yf auG ;tjzpf rsm;wJ h ae&mrsm; u oefvsif? a&Tjynfom? om
auw? wk d uf BuD ;? arS mf bD wd k Yjzpf ygw,f/DVB
ta&jym;- nbufacR;xG ufjcif;- jzLazsmhaejcif;
tqkwf wDbD\ t"dua&m *gvu©Pmrsm;
A[dktm½HkaMum- cH wGif ;ysuf jcif ;- tm;enf ; EH I;csd jcif ;
tqkwf
- &ifbwfatmifh jcif;- acsmif ;qd k;aoG;ygjcif ;- ovd yfxG ufjcif;- acsmif;quf wdk ufqdk ;jcif ;
7/27/2019 Nightingale Health Journal (September-2013)
http://slidepdf.com/reader/full/nightingale-health-journal-september-2013 3/16
usef ;rma&;*sme,ftrS wf-37? puf wifbmv? 2013-ckES pf NIGHTINGALE 3
xdkif;bmomeJ Y ]ql 0eferpf} qd k wm ygVd pum; ]ok 0PÖ ed rd wf} udk qdk vdk wmjzpfygw,f/ vlxk tajcjyK vl rI tzG JUtpnf ;rsm; pk pnf;NyD ; xdk if;-jref rme,fpyf w avQmuf u jref rmjynf ol vl rsKd ; aygif;pHk&JU usef;rma&;? ynm a&;? vlrIa&; tcuftcJawGudk yl ;aygif; ajz&S if;Ed k if zdk Y w&m;0if azmif a';&S if ;tzG J Y xl axmif xm; wm jzpf ygw,f/
zG J Y pnf ;wnfaqmuf yH k ql0eferpfazmif a';&S if; zGJY
pnf ;zd kY a'gufwmpi foD,m armif eJ Y rd wf aqG tzG J Ytpnf ;awG [m 2 ESpf Mumatmif emrnf? &nf&G,fcsuf? zGJYpnf ;yHk? w&m; 0if rSwf yH k wif enf;vrf ; &S mazG rI pwmawG jyifqifcJh&ygw,f/ 2009 ck rSm xk dif ;tpd k;&qD w &m;0if rS wf yH k wif cG if h &zk d Y avQmuf cJh NyD; 2010 ck ESpf {NyD 27 &uf rS m rS wfyHk wif uscJ hygw,f/
xd k if ;Ed k if iH Oya't& xd k if ;Ed k if iHom; vlBuD;vlaumif; vlrI a&;orm;awG[m 'g½dkufwm bk wf tzG J YrS m yg0if aqmif &G uf Mu NyD ; a'guf wmpif oD ,marmif u awm h vky fief ;qy faum frw D OuúXtjzpf wm0ef,lygw,f/ bkwftzGJ YrSm Ouú X a'guf wm AD csKd if ;csKd uD AD Aswf (xd k if ;usef ;rm a&; 0efBuD;Xme tNidrf;pm;nTef csKyf )? 'k Ouú X a'guf wm zdk vm 'ufzifz&mxd (xkdif;'k0efBuD; a[mif ;)? b@ma&;rSL; rpö pf'g &uf pfcsKp&D (tNid rf;pm;olemjyK q&mrBuD;) wdk Yjzpf NyD; vl YtcG ifh ta&;vI yf&S m; wuf<uol xdk if ; trsKd ;orD ; csmvD 'gw*sm&G if pG wf (tm&Sypdz dwfazmf &rf )u 'g ½d k uf wmbk wf t zG J YtwG if ;a&;rS L; wm0ef ,l xm;ygw,f/ vlrI a&; vIyf &S m;wuf<uol aemufxyf
xdkif ;Edk ifiHom; 3 a,mufeJY bkwf tzGJYudk wkd;csJUzd kY tpD tpOf &Sdygw,f/ r,f awmf aq;cef ;eJY ESpf aygif ;rsm;pG m vuf wG JtusKd; jyKcJ h wJh vl xkusef ;rma&; pD rH cef Y cGJrI ynm&Sif xdkif;trsKd;orD; ywfxD ;eD uvnf; vk yf ief;qyf aumfrwD 'g½dk ufwmtjzpf ql 0rferpfazmifa';&Sif ;½H k;udk BuD; MuyfpDrH ay;aeygw,f/
yg0ifxlaxmifcJhwJh tzGJYt
pnf ;awG uawmh r,f awmf aq; cef; (MTC)? jrefrmEdk ifiH aq;y nm&Sifrsm;toif; (BMA)? t rsKd;orD;ES ifh uav;ul nD apmif h a&S mufa&;tzG JY (SAW)? uav; tcGifhta& ;umuG, f apmifh a&S mufa&;aumfrwD (CPPCR)? jref rma&T Uajymif ;tvk yform; y nma&;aumfrwD (BMWEC)? jref rma&T Uajymif ;a'o q&m-q &mrrsm;tpnf;t½Hk; (BMTA)? jrefrmh trsKd;orD ;or*¾ (BWU)? ta&;ay: u,f q,faxmufyh H
a&; vI yf &S m;rI tzG J Y(ERT)
wd k Yjzpf NyD ; vuf&S dtcsd efrSm yxr 5 zGJY u qufvufyg0if vufwGJ ae ygw,f/
tzGJYtpnf;ig;zGJY&JU udk,f pm;vS,fawGu vkyfie f;qyf aumfrwD0ifawGtjzpf aqmif &G uf Muygw,f/ 'g½d k uf wmbk wf tzG J YeJ Y a'guf wmpif oD ,m tyg t0if vk yf ief ;qyf aumf rwD[m wESpf rSm 2 cg awGYqH kpnf;a0; MuNyD; vk yf ief;qyfaumfrwDu awmh vpOfaqG;aEG;n§dEIdif;wm vk yfygw,f/
vI yf&S m;rI rsm; tckqd k&if ql0eferpfazmif
a';&S if ;[m Ed k if iH wumtvS L&S if tzG J YBuD ; 11 zG J YeJ Y wjcm;tzG J Yi,f awG? woD ;yk *¾ vawG eJ Y vuf wG J aqmif &Guf aeygw,f/ 'DxJrSm
xif&Sm;wJhvkyfief;awGuawmh tcrJhrsufpdcGJpdwfa&;vkyfief;? 2010 a&G;aumufyGJumv jr0 wDwdkufyGJppfajy;'ku©onfrsm; ta&;ay: ulnDa&;vkyfie f;? 2013 rJ aqmuf-jr0wDa&ab; u,fq,fa&;v kyf ief ;? a&T U ajymif ;tvk yf orm; uav;i,f rsm ;twGu f pmoifausmif; aqmuf vk yf a&;eJYabmf 'gaqmif rsm; axmuf yH h ul nD a&;vk yf ief ;?
txufwef;ynma&; oif½dk; nTef;wrf;a&;qG Ja&;v kyfief;? e,f pyf a'o vl i,f rsm;twG ufPAYAP University, Chiang Mai
eJY MopaMw;vswHcg;zGifh wuú odkvf ynma&;vkyfief;? rsdK; qufyGm; usef;rma&;ynmay; oifwef; ? aq;oifwef;oHk; pmtkyfrsm; xkwfa0a&; vkyf ief;? tdyfcs ftdkifA GDvlemrs m;t wG uf xdkif;tpdk;& usef ;rma&; Xmeuay;wJ h attmAG D aq; &&S d a&;udk qufpyfulnDyHhyk d;a&;
vk yf ief ;? r,fawmf aq;cef ;opf aqmuf vkyfa&;vkyfief ;wdkY jzpf ygw,f/
e,f pnf;rjcm;q&m0efrsm; tzGJ Y (MSF) xdkif;e,fpyfu ½k yf odrf;NyD; jrefrmEdkifiHxJ0ifoGm; csdefupvd kY xd kif;e,fpyfu tdyf csf td k if AG D vl em wcsKdU aq;0g;yH h yd k ; a&; tMuyftwnf ; &if qd kifcJh & wmudk ql0rferpf azmif a';&Sif; u wzuf wvrf;u uGufvyf jznfh ay;aeygw,f/
ql0rferpfazmifa';&Sif;&JU t"duvk yfief ;awGxJrSm vlxk tajcjyKtzG JYtpnf ;awG twG uf &efyHkaiG&SmazGa&;eJY pepfwus pD rH cef YcG J a&;vnf ; yg0if ygw,f/ azmif a';&S if ;eJ Y ywf ouf wJ h tzG J Y wd kif ;? vkyf ief;wdk if;rSm Ed kif iHw umpH eJYnDwJh pm&if;ud k if pm&if ; ppfpepf? pDrHcefYcGJa&;pepfawG
usifh oHk;EdkifzdkYvnf; aqmif &Guf aeygw,f/
Oya't& w&m;0ifrSwfyHk wifxm;cGifhr&S dwJh tzGJ Utpnf ; awGudk &efyHkaiG wdk uf½dk ufray; Ed k if wJ h wcsKdUtvS L&S ifawGu w &m;0ifrSwfyHkwifxm;wJh azmif a';&Sif ;uwqifh aq;cef;t wGufjzpfap? wjcm; ynma&;? vlrIa&;awGtwGufjzpfap vSL Edk if rSmjzpf ygw,f/
ajr,myd kifqd kif rI r,f awmfaq;cef;eJY jrefrm
vl xk tajcjyKtzG J Utpnf ;rsm;[m xdkif;EdkifiHrSm w&m;0ifajr,m yd kif qdkifcGif h r&Sdyg/ vuf&S d r,f awmfaq;cef;u 0,f,lxm;wJ h ajr,m tm;vHk ;udk ql 0eferpf azmif a';&S if ;trnf eJ Y vT J ajymif ; xdef;od rf ;zd kYudk Oya'twd kif; pD pOf aqmif &Gufaeygw,f/
tem*wftd yf ruf
jref rmjynf wG if ;rS m tajymif ; tvJaw Gjzp faeNyD qdkayr,fh xdkif;EdkifiHxJa&mufaewJh a&TU ajymif;tvkyform;OD;a& avsmh oG m;zd k Y tvm;tvma0;aeao; ovdk xdkif;aq;½Hkwuf cG ifh & t vk yf vk yfcGif h vuf rS wf r&S d olawG uvnf ; od od omomBuD ;avsmh enf;oG m;wm r&Sdao;bJ r,f awmf aq;cef ;rSm vma&muf uk orIcH,l wJh jrefrmEdk if iHom; t a&twGuf qufvufrsm;jym; aeqJ jzpf ygw,f/
xd k if ;jref rme,f pyf wavQmuf u a&TUajymif ;vlxkawG? xk dif ; Ed kif iH eJ Y jref rme,f pyfwavQmuf rSm arG;zGm;vmNyD ; EdkifiH rJh jzpfae qJjzpfwJh uav;rsm;eJY vli,f rsm;? vlrIywf0ef ;usif tajct aet& (pD;yG m;a&;? vlrIa&;? Oya'yd kif ;qdkif&mta&;) tum tuG,fenf ;yg;wJh trsdK;orD; rsm;twG uf ql 0ef erpf azmif a'; &S if ;[m quf vuf &S if oef aeyg w,f/ 2015 tmqD,H vl rI t od k if ;t0d k if ;rS m cG J jcm;quf qH rI y aysmuf NyD; vlU*kP fodu©m& Sd&Sd aysmf&Tif pG m twlwuG aexd kif oGm;Ed kif zd kY vl xktajcjyK vlrIt zG J Utpnf ;rsm;u wpd k uf rwf rwf quf vuf Bud K;yrf ;tm;xk wf ae Muygw,f/ t,f'D wmtzG JY
a &T a & m if td yf r uf rs m ; t a u m if t x nf a y: a p zdkY
ql 0 ef e r pf a z m if a ' ; &S if ;
MopaMw;vsm;Ed k if iH? qpf '
eD Nidrf ;csrf ;a&; azmif a';&S if ;u
ay;tyfaom qpf'eDNidrf;csrf;
a&;qkudk 2013 ckESpftwGuf
xd k if ;-jref rm e,f pyf wavQmuf
usef;rma&;ES ifh vlrI a&;tul t
nDrsm; tcrJ h ul nD rI ay;aeonf h
r,fawmfaq;cef; xlaxmifol
a'gufwmpi foD,marmiftm;
a&G;cs,f csD ;jr§ if hvd kufonf/ ,ckvdk ay;tyfonfh qk rSm
Nidrf;csrf;a&;? w&m;rQwa&;ES if h
vlom;tusKd;jyK vkyfief;rsm ;
vkyfaqmi faeolyk* ¾dKvfrsm ;udk
1998 ck ES pf rS pí ES pf pOf a&G ;cs,f
qkcsD;jrihfcJhNyD; ,ck 2013 ck ESpf
Nidrf;csrf;a&;qktwGuf a'guf
wm pif oD,marmiftm; 16 OD;
ajrmuftjzpf a&G ;cs,fcsD ;jr§ifhcJh
jcif ;jzpfonf/
qkcsD;jr§ifhcH&jcif;ESifh ywf
oufí a'gufwmpifoD,m armif u ]t"duawmh tck usr
wd k Yvk yf aqmif aewJ h usef ;rma&;
vkyfief;awG? vlrIa&;vkyfief;
awGtay:rSm tajccHNyD ;awmh
ay;tyf wm jzpfygw,f}[k qdk
onf/
a'gufwmpifoD,marmif
onf xdkif;-jrefrme,fpyf rJ
aqmufNrdK UwGif tajcpdkufNyD;
usef ;rma&;? vl rI a&;? ynma&;?
ulnD u,fq,fa&; vkyfief;
rsm;ud kOD;aqmif um vk yfaqmif aeonf htjyif tjcm;aom vl rI
tzGJ Ytpnf;rs m;ESifhvnf; yl;
aygif;í vlrI tusdK;jyKvkyfief;
rsm; vkyf aqmif aeol jzpf onf/
qpf'eDNidrf;csrf;a&;qkudk
Edk0ifbm 7 &uf aeYwG if Mop
aMw;vsm;Edk ifiH ? qpf'eDNrdKU ?
Nrd KUawmfcef;rwG if tcrf ;tem; jyKvky fí csD; jr§if hoGm;&ef&Sd NyD;
qka Mu;aiGtjzpf MopaMw;
vsm; a':vm 5 aomif ;udk
vnf; &&SdrnfjzpfaMumif;ESifh
&&Sdvmaom qkaiGrsm;udk vuf
&S d vk yf aqmif aeonf h vl rI tusKd ;
jyKvk yf ief;rsm;twG uf jyef vnf
toHk;jyKoGm;rnf [k a'gufwm
pifoD ,marmifu ajymonf/
quf vuf í a'guf wmpif
oD ,marmifu ]'D qkuae &wJh
aiGudk toHk;jyKNyD ;awmh usrwdk Y wwf pG rf ;orQ vk yf ief ;awG quf
vuf BudK;pm;vkyfaqmifoGm;
r,f? tckvdk usrwd kYudk tod t
rSwf jyKay;wmudk vnf ; auseyf
rd ygw,f? aemufNyD ;awmh vl xk
awG twG uf wu,f vd k r,f h vk yf
ief ;awG ud k quf vuf vk yf aqmif
Edkifz dkYvnf ; cGeftm ;jzpfapyg
w,f} [k jznfhpGuf ajymonf/
MopaMw;vsm;Ed k if iH? qpf '
eD Nid rf ;csrf ;a&; azmif a';&S if;u
ay;tyf aom qpf'eD Nid rf;csrf; a&;qk ud k awmif tmz&d uEd k if iH rS
EdkbJ vfNidrf;csrf;a&;qk&S if bk ef;
awmf BuD ; 'uf prGefwl ;wl;? tdkif
,mvef or® wa[mif ; ar&D a&mf
bif qif ES if h b*F vm;a'h &S f Ed k if iH rS
ygarmu© rd k [mruf ,l EG wf pf wd k Y
tm; ay;tyfcJ hNyD;jzpfonf/
vl rI ul nD a&;vk yf ief ;rsm;ud k
aqmif &Guf aeonfh a'gufwm
pifoD,marmi fon f ta& SU
awmiftm&S a&r Gef rufaq;
aq; (South-east Asia’s Ramon
Magsaysay Award) qk ES ifh ,ck
qpf'eDNid rf;csrf;a&;qk tygt
0if Ed kif iHwumrS ay;tyf csD;jr§ ifh
onf hqkaygif; 16 ck vuf cH &&Sd
cJhNyD;jzpfaMumif; od&onf/
u&ifowif ;pOf
a'guf wmpifoD ,marmif ud k
qpf'eD Nid rf ;csrf ;a&;qk a&G ;cs,fcsD ;jr§if h
7/27/2019 Nightingale Health Journal (September-2013)
http://slidepdf.com/reader/full/nightingale-health-journal-september-2013 4/16
usef ;rma&;*sme,f trS wf-37? puf wifbmv? 2013-ckES pf4 NIGHTINGALE
wkyfauG; (Dengue Hemorragic Fever - DHF) vk dY ac:wmyg/ aoG ;vGefwk yf auG;twGuftpGrf;xufaq;yif wrsd K;u jref rm
trnf ]uRJausmif ;rifaq;}yif? ½ku© aA'tyiftrnf Euphorbia
Hirta vkdY ac:NyD; rav;&Sm;? tif 'k deD ;&Sm;EkdifiHawGrS m Pokok Su Su
Nabi, Gelang Nabi, Patikan Kebau, Tawa Tawa vkdY emrnf trsdK;rsdK; ac:Muygw,f/ t*Fvdyfvkd vlodrsm;wmu Prophet's
Milk) jzpfygw,f/ &if MuyfwmtwGuf pmrsufESm (5) od kY ```
vG ef cJ h wJ h q,f ES pf avmuf u
urÇ mBuD ;[m xl ;jcm;qef ;Mu,f NyD; aMumufp&maumif;vSwJ h qm;pfa&m*guy fab;ud k MuHK awG YcJ h &ygw,f/ qm;pf Ad k if ;&yf yd k ; [m &meJYcsDwJhvlemawGudk t ouf qHk;apcJh NyD; axmifeJYcsDwJh vlawGudk a&m*guyfNidapcJhyg w,f/ 'gayr,fh vuf wqkyf pmavmuf ta&twG uf &S d wJ h q &m0efawG olemjyKq&mr awG uom owå d &S d &S d eJ Y &if rqd k if cJ h &if uyfab;BuD;[m trsm;BuD ; ydk qdk ;oG m;Edk if ygw,f/
2003 ckESpfwHk;u a'guf wm atmf vpf AD ,muuf wif [m AD,uf erf Ed kif iH Nrd KUawmf [EG dKif ; u jyif opf aq;½H k rS m tvk yf vk yf aeygw,f/ azazmf0g&D vukef ydkif;rSm wkyfauG;vdkY,lq&wJh a&m*geJY tajctaeqd k;wJh a*smf eDcsif;qdkol vlemwOD;a&muf vmcJh ygw,f/ &uf ydk if;twGif ; aq;½H krS m&Sd wJh vl 40 eD;yg;udk ul;pufoGm;ygw,f/ aq;0ef xrf ;wcsKd Uvnf; yg0ifc Jhy g w,f/ a'gufwmuufwif r
eufwdkif;aq;½ Hka&mufwJhtcg vlemawG yd krsm;rsm;vmwm ol awG YcJ h w,f/ aomMumaeY waeY a&muf awmh (q&mrawG tygt 0if ) vl emawG ud k vk d uf Munf h Ed k if
aorif;wrefa&m*gud k ppfcif;cJ hpOfu zkdY aq;½HkrSm ol emjyKq&mr w
a,mufbJ usefygawmhw,f/ wu,f awmhtJ 'D q&mrvJ zsm; aeygNyD/ vlemaw GxJrSm 7 a,muf aooG m;cJ h ygw,f/ 'D vd k eJY tJ'Daq;½HkuaeNyD; qm;pf a&m*g SARS ac: ½k wfcsnf; jyif ;xef touf½SLvrf ;aMumif ; a&m*gpk ud k wurÇ mvH k ; tm½H k pd k uf vmcJh &ygw,f/
'Da&m*g[m tifrwef ul; pufvG,fNy D; tifrwefvnf ; jyif ;xef ygw,f/ wurÇ mvH k ;rS m vl 8096 OD; a&m*gjzpfcJhNyD;
774 OD;aocJ hygw,f/ 'Da&m*g ud k ppf yG J wyG J wd k uf ovd k wd k uf cJ h & ygw,f/
[EGdKif;? jyifopfaq;½HkrSm vlemawG&JU "mwf rSefawGudk q &m0ef awG avh vmwJ h tcg tif r wefxl;jcm;NyD; qdk;0g;jyif;xef vSwJ ha&m*gwckudk awGYae&NyD qdkwm oabmaygufvmNy D; tm;vH k ; wk ef vI yf ajcmuf jcm;uk ef ygw,f/ yxrqH k ; a&muf vmNyD ; aooGm;wJh a*smfeD csif ;&J U "mwf rS ef yH k eJY aemuf xyf jzpf vmwJ h vl
emawG (aq;0efxrf ;awGtyg t0if ) &J U "mwf rS ef yH k awG wax &mwnf ;w laewm awG Y&yg w,f/
Ad k if ;&yf pf yd k ;[m a&m*gaES mif ;
yd kif ;umvrS m ul;puf EI ef ;tjrif h
qH k; jzpfaeygw,f/ tJ 'D tcsdef [m vl emtajctae tqdk;qHk; jzpf aevd k Y aq;½H k a&muf aewJ h t csd ef vnf ;jzpf ygw,f/ 'gaMumif h aq;½Hk ay:&S daewJ h wjcm;a&m*g onf vlemawG? q&m0ef q&m rawG udk awmrD ;vd kul ;puf ysH UESH Y oG m;wm jzpfygw,f/
'gaMumifh q&m0ef q&mr awG [m aq;½H k wck vH k ;ud k axmif vdk ydwfqdkYNyD; rdrd wdk Yudkrdrdwd kY aq;½H k csKyf cscJh w,f/ 'grS Nrd KUxJ ud k rul ;Ed k if? wEd k if iH vH k ;ud k rul ;
Ed k if rS mjzpf w,f/ wcsKd Uaq;½H k awG rS m q&m0efq&mrawG[m qm;pf a&m*gtaMumif ;owif; Mum;awmh aq;½Hk rvmawmhbJ xG uf ajy;MuwmawG vnf ;&S d w,f/ 'gayr,f h aq;0ef xrf ;tenf ;pk uawmh touf pG ef YNyD ; aq;½H k xJ avS mifydwf cH &if qd kif cJ h Muw,f/]]'g[m q&m0ef Ywm0efbJav}}
vdk Y 3 ESpf orD ;av;wa,muf &JU rdcif a'guf wmvDoD uk,ifrdk if u ½dk;½dk;av;bJ jyefajymjyyg w,f/
wdkufyGJ rSm trsm;BuD; t axmuftul&cJhwmu WHO
ul ;pufa&m*gyg&*l tD wvD q &m0ef umvdktmbef eD jzpfyg w,f/ ol[m WHO ½Hk;rSmbJ xd kif raeawmh bJ aq;½HkawG rSm aoG ;erl em? ovd yf erl emawG ,l? ppf aq;? oH k ;oyf NyD ; urÇ mBuD ;ud k t&ifqH k;wyfvS ef YEdk if cJ hw,f/ 'D vd k aoG;erl em? ovd yf erl em ,l wm[m a&m*gul ;Ed k if wJ h tvm; tvm ti frwe fr sm ;w,f/ ol [m &ufowåywfaygif;rsm; pG m jyif opf aq;½H k rS m tvk yf vk yf cJhNyD;aemuf olYud kvnf; a&m*g ul ;oG m;NyD ; 2 ywf tMumrS m ao qH k;cJ hw,f/
pD ;yG m;a&;orm;a*smf eD csif ;[m AD ,uf erf ud k a[mif aumif uae vmcJhwmjzpfw,f/ 'gaMumifh a[mifaumifNrdKUu a0vrif;
om;aq;½Hk rSmvnf; q&m0ef q&mr 24 a,muf csrf;wkef tyl BuD ; acsmif ;qd k ;NyD ; a&m*gjzpf cJh Muw,f/ w&uf xufw&uf vlemawG wd k;vmw,f/ XmerS L; ygarmu© *sKd;Zuf qGef ;u aq; 0efxrf;aw Gudk ESpfzGJY cGJv dkuf w,f/ wzGJYuwjcm;vlemawG
ud k Munf h? aemuf wzG J Y (npf nrf ; tzG J Y)uawmhqm;pf a&m*g vl em awGudk pGefYvTwfpGefYpm; udkif wG,fukoz dkY wm0efc svd kuf w,f/
om;orD ;&S d wJ h aq;0ef xrf ; awGudk npfnrf;tzG JYxJuae uif ;vGwfcGif hay;cJhw,f/ vl ysKd vl vGwfawGeJ Y om;orD ;awG t &G,fa&mu fNyD;jzpfwJh aq;0ef xrf ;awGudk awmh npf nrf ;tzGJY rSmygzdkY awmif;qdk cJh w,f/ tJ'D rSm aq;0efxrf ;awG[m rdrd
qE´ tavsmuf npf nrf ;tzG J YxJ trsm;BuD ;yg0ifcJh Muw,f/ 'D vd k ta&twG uf trsm;BuD ; wm0ef ,lMuwJhtwGuf a&m*gul;NyD; vJoGm;wJh aq;0ef xrf;awG ae &mud k jznfh qD;Ed kifcJ hw,f/ aq; Xmeu0ef xrf ;awG uk efoGm;wJh tcg cGJ pdwf ukXme? t½dk ;Xme? om;zGm;rD ;,yfXmeu aq;0ef xrf;awGu apwemtavsmuf npf nrf ;tzG J YxJ yg0if wm0ef ,l Muw,f/ rsuf pdXme? em; ESm acgif; vnfacsmif;XmeawGu
q&m0ef q&mrawG awmif vk yf tm;ay;Muw,f/ ygarmu© qG ef;[m oHk ;vMumrS aq;½H kxJ uae tjyif jyef xG uf Ed k if cJ h w,f/
taemuf urÇ mjcrf ; uae'g Ed k if iH? wd k &G ef wd k Nrd KUrS m erd k ;eD ;,m; a&m*gonf vd k Y ,l qcJ h rd ol vl em wOD;[m pumbdk½dk *a&Upfaq; ½Hku aq;0efxrf; 3-40 udk a&m*gul ;puf apcJh w,f/ vlem awmf awmf rsm;rsm;ud k Nrd KUjyifu wD bD aq;½H k a[mif ;ud kyd kYNyD ; oD ; oef Yydwfqd kY uk ocJh w,f/ tJ'D rSmvnf; usef;rma&;0efxrf; wcsKd Uu xGufajy;oGm;ovdk wcsKd Uuawmh tdrfrjyef awmhbJ aq;½H kxJ rS mbJ aeNyD; tvk yf vk yf Muwm&S d w,f/
'D vdkeJY 2003 ckESpf v,frS m awmh qm;pfa&m*g vlvlcsif; ul ;puf rI ud k jzwf awmuf ypf Ed k if cJ h ygw,f/ b,f tcsd ef rS m ul ;puf rI tjrifh qHk ;vJ? b,f vd k Bud Kwif umuG ,f rI awG vk yf &rvJqd k wm udk q&m0efawG odoGm;cJ hyg w,f/ wu,f awmh qm;pfa&m *g[m av,mOfc&D;awGuw qif h wEd k if iH NyD ;wEd k if iH ul ;puf cJ h wm jzpf ygw,f/
qm;pfa&m*geJY ppfcif;cJhwJh aq;ynm&S if awG[m 2013 rS m ay:vmwJh rm;pfa&m*gud k &if qdkifzdkY rcufawmh ygbl ;/
Mqm*gref; BBC
ar;/ av;bufema&m*gqk dwm bmaMumifh jzpf&wmvJ/ b,favmufta&;BuD ;ovJqk d wm od yg&ap/
ajz/ av;bufema&m*g (Rheumatic Fever) qkd wm Group (A)
Beta - Haemolytic Streptocooci qkd wJh bufwD ;&D;,m;a&m*gykd; awG aMumif h yk d ;0if a&m*g (Infection) &wmjzpf NyD ; trsm;tm;jzif h vnf acsmif ;em (Sore Throat) jzpf ay:NyD ; 14-28 &uf twG if ; jzpf ay:vm
wwfwJ h a&m*gwrsdK;yg/ 'D a&m*gjzpf &if tzsm;eJ Ytwl cE¨ muk d ,f u tqpf tjrpf BuD ; (Big
Joints) awG jzpfwJh wHawmifqpfESpfzuf? 'l ;qpfESpfzuf (t"du)eJ Y wcsdKYqk d&if vufaumuf0wf? ajcusif ;0wf tqpfawGrSmyg a&mif &rf ;emusifapygw,f/ vuf ESpf zuf? ajcES pf zuf? av;zuf pvk H;rSm jzpfapvk dY av;bufemvkdY ac:Muwmjzpfygw,f/
av;buf emjzpf &if 'D a&m*gyk d ;u ES vk H ;uk d ,f wG if ;t*F guk d tjyif ; txef twGi f;a&mtjyi fyg xdck dufy sufpD; NyD ; Pericarditis,
Endocarditis, Pancarditis jzpfapwmaMumif h aemufykdif;rSm a&&Snf qk d ;0g; tusKd ;quf tjzpf ES vk H ;tcef ;tqk d Y&S if (Heart Valves) awG uk d ysuf pD ;apygw,f/ (Mitral Regurgitation, Aortic Regurgitation) qk d wJ h ½lrufwpf ESvkH ;a&m*g (Rheumatic Heart Diseases) jzpfvmap Ekdifygw,f/ ES vkH;omru ta&jym;? tqpf tjrpf? tm½kHaMum xd
ckduf rI (Syndeham Chorea) qd kwmawGvnf; jzpf apygw,f/ 'gaMumifh av;bufemqkdwm ta&;BuD;NyD; owdjyKqifjcif
umuG ,foif hwJ ha&m*gwck yg/ a&&S nf qk d;usKd ;eJY a&&S nf aq;0g;uk orI cH,lzk dYvkd wmrk d Y omref
vnf acsmif ;emwm&,f vk dY rayghqMubJ pepf wus q&m0ef awG eJ Y ppf aq;prf;oyf ukorIcH,loifh Muygw,f/
ar;/ aoG;vGefwkyfauG;a&m*gtwG uf tpGrf;xufy&aq;yifrsm; &Sd ygovm;/ taemufwkdif; aq;ynmukorIeJY ukoygvQufeJY a&m*gjyif;
xef&ifaoqk H ;rIawG&S d wmaMumif h (jznf h pG ufuk xk H ;) ^(Compliementary
Medicine)wjcm;a&G ;p&maq;ynm(Alternative Medicine) ukenf ;awGodcsif ygw,f/
ajz/ wkyfauG;Ak dif ;&yfpfyk d; (Dengue Virus 1,2,3,4) aMumif h jzpf&
wJ h wk yf auG ;zsm;jzpf cJ h &if Ak d if;&yf pf yk d; wk d uf ck d uf rI aMumifhqH jcnf rQif aoG;aMum? aoG;aMumi,frsm;ysufpD;NyD; twGif;aoG;,kdxGufrI(Internal Bleedings - Capillaries Haemorrage) jzpf wmaMumifh ta&
jym;atmuf teD puf (Rashes) xGufwm? tpmtd rfeH&HuxGuf wJh aoG ;eJ Y tpmtd rf tuf ppf (HCI) awG Yxd "mwf ajymif ;um aumf zD a&mif te,ftES pfawG tef wwf ygw,f/ aoG;twG if ; aoG ;cJ&mrSmyg0if ta&;BuD;wJh aoG ;OrTm; (Platelets) ta&twG uf avsmhus? aoG; xdwfvefYrI (Shock) jzpfapwmaMumifh (DSS) Dengue Shock
Syndrome jzpf &if touftEÅ&m,f &S dygw,f/ 'gaMumif h aoG;vGef
usef;rma&;&m okw tajz&S m
M q m * g
7/27/2019 Nightingale Health Journal (September-2013)
http://slidepdf.com/reader/full/nightingale-health-journal-september-2013 5/16
usef ;rma&;*sme,ftrS wf-37? puf wifbmv? 2013-ckES pf NIGHTINGALE 5
vnf ; tpGrf ;xufvkd Y wcsdKUae&m awG rSm Asthma Plant vk dY vlod rsm;ygw,f/
vrf ;ab;rS m tvG ,f wul awG YEkd if wJ h jruf NcH KyifawG Mum;u t
&Guf ao;ao;oG,foG,f wzufwcsufqkdifxGufNyD; yifpnfeJY t&Gufqk H&mt&if;rSm tyG ifh jzLao;ao;av;awG tqk yfvk duf yG if h wwfygw,f/ 'Dtyifi,f 4-5 yifavmufukd wrdepf? ESpfrdepf avmuf rD;rQif;rQif;eJ YusKd? tat;cH? tzwfppf? t&nfMunfuk d a&aEG ;Murf ; aomuf ovk d wcgeJ eJ vk yf aomuf ½k H eJ Y aq;½k H uk orI awG(I/v Fluid Therapy, Fibrinogen Treatment) eJYuk&if; vufavsmh&
rvk djzpfwJhvl emawGawmif jyef vnfusef ;rm aysmufuif;wmawG &Sdygw,f/ aq;okawoeawGt& od&wmu 'Daq;yi f[mPlatelet Count uk d aocsmayguf jyef wuf apwm? a&m*guk d wk d ;wuf
ouf omaysmuf uif ; usef;rmapEk d if wmvkd Y od &ygw,f/ wckowd jyKoif hwmu Shock tqif h0ifwJ h DHF a&m*g&S if awGukd rjzpf rae aq;½k H wif uk orI cH ,l &rS mjzpf ovk d yl ;wG J taeeJ Y y&aq;yif t&nf ukd aomufok H;Muzk dYyg/
ar;/ trsdK;orD;&ifom; Ek dYoD;acgif ;uae aoG ;xGufemusif&if pkd ;&drf& ygovm;/ bmaMumif h jzpf&wmygvJ/ ajz/ raygh qoif h bJ *½kwpk duf pepf wus ppf aq;uk orI cH ,l oif h wJh a&m*gvu© Pmwck yg/ &ifom;uk d rawmf wq ukwf jcpf rd&m uae jzpf Ekd if ovkd tvkd tavsmuf 'Pf &mr&S dbJ jzpf ay:vmcJh &ifIntraductal Carcinoma Breast ac:wJ h &if om;uif qm&JU tpueOD ;
a&SUajy; vu©Pmvnf ; jzpfygw,f/
rG ef jynf e,f? u&if jynf e,f eJY weoF m&Dwd kif ;a'otcsKdUrSm
bdef;pm&Gufudk t&yfom; vl i,f rsm;? wuú od k vf ES if h txuf wef; ausmif;om;rsm;? a&vkyf om;rsm;? jcHtvk yf orm;rsm;u rl ;,pf aq;tjzpf tok H ;jyKaeo vdk pD ;yGm;jzpfpd kufysd K;aeMuwm vnf; &S daeygw,f/
oHk;pGJ&mrS m usdKcsufNyD; t jcm; aq;ypö nf ;eJ Y tcsd K&nf a&m aESm ok H;pGJwmjzpfygw,f/ 'Dt wdkif;pm;&if cg;w,f/ wBudrf jyKwf&if q ,f&Guf? q,hfig; &G ufuae t&G ufokH ;q,ftxd
xnhf? acsmif;qdk;aysmufaq;? aumf zDrpf? rD ;acsmif;twGif ;u jy'g;rIeYf? jcifaq;acGjymrIeYf? xdkif ;uvmwJ h vDydktcsK d&nf wrsdK;a&mNyD; xnhfaomuf&if t&omu vuf zuf &nf? aumf zD wd k Yxuf yd k aumif ; w,f? tat; 'Pf? tarm'Pf ud k cH Ed k if NyD ; ud k ,f vuf aygh yg;vef ;qef ;w,f? zef
bd ef;pm&G uf jyóem pD 'd k if ;vd k rl ;,pf apwwf w,f vd k Y qdky gw,f/ aiGaMu;ukefus
oufomNyD; tvG,ftul jyK vkyfEdkifwJh rl;,pfaq;jzpfvdk Y tckvdk oH k;pGJ rIrsm; yk drk dwGif us,f vmyHk &ygw,f/
rsm;rsm;ok H ;wJ h vl i,f awG [m OD ;aES muf yk H rS ef r[k wf awmh bJ r aomuf & raeEd k if avmuf atmif pGJ vrf;oG m;Muygw,f/bdef;pm &Guf aomuf okH;&if todtm½k H awG a00g;xdkif;rIdif;NyD; tod pdwf arh avsmh wJhtwGuf wcsdKY [m armf awmf qd k if u,f pD ;aepOf ,mOfwdkufrI jyóemjzpfcJhzl;
w,fvd kY tNidrf;pm;ausmif;q &mwOD ;u ajymygw,f/ ig;zrf ; puf avS ay:rS m twl tvk yf vk yf ae&if ; bdef;pm&Guf t&S def wuf vmvd k Y yif v,f xJ uk d jref rm ig; zrf ;a&vk yf om;wa,muf ck ef cs cJh zl;w,fvd kY a&vkyfom;w a,muf uajymygw,f/ oH k ;pG J ol wcsKd U[m 7 &uf 8 &uf avmuf
0rf;csKyfNyD; toufqHk;oGm;zl; wmvnf ; &S dygw,f/
bdef ;pm&Guftyif[m t a&SU awmi ftm& SrSm tavhus aygufyiftjzpf awGU&NyD ; ½ku© aA'tac: Mitragyna speciosa
jzpfygw,f/ xdkif;bmomtm; jzihf u&axmif (kratom) vdkY ac:NyD ; xdkif;wd kif;&if;aq;avm urSm 0rf;yd wfaq;? bdef ;jzwf aq;? qD ;csKdukaq;tjzpf oHk; wm &Sdayr,fh xdkif;tpdk;&u 1943 cku pNyD; ydwfyifcJhyg w,f? aq;a jcmufe JYwwef ; wnf ; rl;,pf aq; tqif h -5 t
jzpf owfrSwfxm;ygw,f / tar&d uef Edk ifiHrSmawmh xdef; csKyfpm&if;xJ xnfhrxm;ao; bJ bd ef ;pm&G uf rS myg0if wJ h "mwf ypö nf;ud kom xdef;csKyf pm&if; xJ xnf hxm;ygw,f/ rGef jynf opfygwDeJ Y u&iftrsKd;om; t pnf;t½Hk ; xdef ;csKyfe,fajrrsm; rSm rl;,pfaq;0g;tjzpf wm;
jrpfxm;ovd k jrefrmtpdk ;& usef ;rma&;0e fBuD ; Xmeu vnf; tcktcg rl ;,pfaq;0g; tjzpf owfrSwfwm;jrpfvdkuf NyD jzpfygw,f/
2012 ck puf wif bmaESmif ; ydkif;u rGefjynfe,fvTwfawmf tpnf;ta0;wckrSm rGefa'o
vHk;qdkif&m 'Drdkua&pDygwD&JU oHjzLZ&yfNrdK Ue,f vTwfawmf udk ,f pm;vS ,f OD ;Edk if OD;u bd ef ; pm&Gufud k ta&;,lzdkY tqd kjyKcJh NyD;aemuf oHjzLZ&yfNr dKUe,f ? a&;Nrd KUe,f wd k YrS m pd k uf ysdK; a&mif ; csolawGudk pwifzrf;qD;cJhyg w,f/
xdkif;EdkifiH awmifydkif ;? zl; cufa'orSm oGm;a&mufvkyf udkifMuwJh rGefjynf e,fu a&TU ajymif;vkyfom;rsm;u bd ef;pm ½Guf tudki f;tcufrsm ; jyef
o,faqmifvmcJhNyD ; aetdrf ES if h O,smOf NcH awG rS m pdk ufysKd;cJh &mu 2009 ckES pfrS m rGef jynfe,f armfvNrd Kif? rk 'k H? oH jzLZ&yf? a&; eJY usdKufra&mNrdKUe,fawGxJ jyefUES H Yvmwmjzpf ygw,f/
rGefjynfe,f rSm tckayguf aps;w&Gufudk 200 usyf rS 300 usyfxd &S dygw,f/ bdef;pm&Guf
&if om;rSm tzk? tBudwf&Sd wkdif; &ifom;uifqm (Malignant
Tumour Breasts) r[k wf bJ Fibroadenoma ac:wJ h tzk tBud wf i,fNodule, Fibroadenosis, Cystic Disease of Breast qkdwJh uif
qmr[kwf aomtBudwf awG vnf; jzpf Ek difygw,f/ 'gayr,fh tpyxryk dif;rSm tzktBud wf vkH;0r&S dbJ Blood
Discharge From Nipples eJY emusifrI&SdcJh&if uifqmyk djzpfEk difyg w,f/ txl;ojzifh EkdYyg;pyfac:wJh EIwf crf;yg;pyf ESpf jcrf ;vkd jzpf aewJ h ) &if om;? om;jrwf acgif;awGrS m yk djzpfavh &S d ygw,f/ Nipple
Blood Discharge and Pain vu© Pm&S d ol 70-80 &mck d if EI ef ; avmuf rSm Intraductal/Ductal Carcinoma Breasts (Severe Breast Cancer
Form) jzpfwm awG Y&wmaMumifh apmpD ;pG m ppfaq;ukorI cH,loifh ygw,f/
ar;/ trd 0rf ;wGif ;u vG wfuRwf xG uf NyD ; arG ;zGm;NyD ;p uav;i,fawG rS m wukd ,f vk H ; tqD jyifawG bmaMumif h zk H;aewwf wmvJ/ ajz/ a&owå 0gwykdif;jzpfwJh vlom;uav;i,f[m trdom;tdrf(uterus) twGif ;rSm aexkkd ifpOf (amniotic sac) ac:wJh a&rTmtdwf
twGif ;u a&rTm&nf (amniotic fluid) twG if ;rS m aygavmarsmaeNyD ; trdukd csufBudK; (umbilical Cord)? tcsif ; (placenta) wkdYuwqifh quf oG ,f xm;ygw,f/ tcsif ;? csuf Bud K; wk d YrS m&S d wJ h aoG ;aMumxJ u ae oaE¨om;uav;i,f twGuf vk dtyfwJh MoZm? tm[m&"mwf rsdK;pkHuk d &&S dapwmyg/
'D vk d a&xJ rS mtMumBuD ; &uf owåywf aygif ; 40 avmuf ae& wJ htwG uf tyl? tat;'PfcH Ek dif &nf &Sd zkd Y? a&m*gb,umuG,f zk dY
tyl tat;um (insulator) tjzpf Am;epf aupD ,k d qm (Vanix Caseo-
sa) ac:wJh tqD jyif vTmwrsdK; ta&jym;ay:rS m zk H;tk yfxm;&Sdwm jzpfygw,f/
tqD? tqd rfh? 0ufqD? 0uf om; tpm;rsm;wJ h rd cifavmif; awG &J U uav;awGqk d &if yk d NyD ; tqD jyif xlxJ pG m zkH ;aewwf ygw,f/ 'D vk d arG ;zG m;xG uf vmwJ h arG ;puav;i,f uk d arG ;xG uf vm NyD ;NyD ;
csif; liquid paraffin qk dwJh tqD wrsdK;eJ Y tomt,m yGwfwk duf aq;aMumoefYpifay;NyD ; csuf BudK;jzwfNyD;rSom a&csd K;oefYpif aEG; axG ;ap&ygw,f/
wu,fvkd Y arG;puav;i,f arG;arG;csif ; toH rxG uf? rikd,k d? touf r½S LbJ ae&if q&m0ef? q&mrawG [m uav;i,f &J U ajcES pf acsmif;vkH ;ukd ajcusif ;0wfem;uae yl ;qkyfukdif? aZmuf xkd;qG JNyD; wifyg;uk dtomyk wf um ik d,k dtouf ½S Lapavh &Sd ygw,f/tqDawG aMumif h 'Dvk dukd ifwG ,f&mrSm acsmfxG ufvGwfusNyD; uav;i,f &J U touftEÅ&m,f&S dwm owdjyKMuzk dY vk dygw,f/
a'guf wmok w
wifru jrif ;aq; (,mrm; pdwf<uaq;) udkvnf; a'o wGif;rSm uGrf;,ma&mif ;ovdk a&mif ;aew,f vd k Y bk ef ;awmf BuD ; wyg;u rd efYMum;ygw,f/ ,m rm ; pdwf <u aq;w jy m;ud k 5000-6000 usy f0e f;usif aygufaps;&SdN yD; rGef jynfe,f
Nrd KU&G mtawmf rsm;rsm;rS m tvG ,f wul 0,f,lEdkifygw,f/ 'gay r,fh bdef;pm&Guf avmuf rayg rsm; aps;rouf ombJ tzrf;t qD;vnf; ydk rsm;ygw,f/
xdkif; Edkifi H awmify dkif; rSm bdef;pm&G uf wuDvd kudk bwf aiG 650 (usyfaiG 1 aomif; 8 axmif ausmf) ay;&NyD; &aemif; NrdKU&JU wzufurf; weoFm&D wkdif; aumhaomif;NrdKUrSmawmh wuD vd kuk d bwf aiG 900 (usyf aiG 2 aomif;cG Jausmf) txd
ay;&ygw,f/ weoFm&D wkdif;? Nrdwf? xm; 0,f a'obufu a&vkyfom; rsm;uvnf ; bd ef;pm½G uf udk t arm'Pf cH Ed k if zd k Y ok H ;MuNyD ;? wcsKd U uawmh qD;cs Kd? aoG;wd k;ESifh udk,fvu fud kufcJ oufom atmif wdkif;&if;aq;tjzpf ok H; Muygw,f/ 'gayr,fh tck vl
i,fawG ok H;ovdk usKdcsufa&m pyf ok H ;pG J wm r[k wf bJ t½G uf ud k 0g;pm;wm jzpf ygw,f/ wcsKdU uvnf ; tajcmufcH trI efYvkyf NyD ; pm;oH k ;wm? azsmf pyf wm &S d yg w,f/
xd k if ;Ed k if iH awmif yd k if ;rS mvnf ; bdef;pm&Gufudk &mbmNcH vkyf
om;r sm; ? a&vky fom;rsm ;u wG if us,f pG m ok H ;Muygw,f/ w aeYukd 3 cgavmuf aomufoHk; Muygw,f/ 1990 ckESpfrs m; uwnf;u jrefrma&vkyf om; awG Mum; acwf pm;vmcJ h wmjzpf ygw,f/ xk d if ;Ek d if iH awmif yd k if ; & aemif ;? cßG ef zG ef ;eJ Y zef i c½d k if awG u jrefrm ig;zrf;a&vkyf om; awGMum;rS m 'Dbdef;pm&Gufa&m pyf t&nf [m ]tmqD ,H} qdk wJh emr,f eJ Y a&yef ;pm;ygw,f/ t vkyfNyD;awmh naeyd kif ;rSm vlu
EH k ;csd NyD ; t&rf ;yif yef;aeNyD qd k &if tmqD,Hukd azmfpyf aomuf vdk ufwmeJ Y rem;wrf; jyef NyD ;t vkyfvkyfEd ki fw,f ? cG eftm ; aumif;apNyD ; yif v,f xJ rS m aeY wd kif ; tvk yfMurf;vkyfEdkifw,f vdkY jrefrmig;zrf;a&vkyfom; awGu ajymygw,f/ xk dif ;ig; zrf;pufavS yd kif&SifawGuvnf; ol wd kYtvk yf orm;awG yif v,f xJ roG m;cif ay;Muygw,f/
xd kif ;&J awG u bdef ;pm&Guf w&Gufzrf;rd&if bwfaiG 500
'PfaiGaqmif cdk if ;w,fvd kY od & ygw,f/ 'gayr,fh 'D bdef;pm &G uf awG ud k yif ra&mif ;cs jzef YjzL; ol trs m;p kuawmh a'oc H xd kif; tmPmyk difawG ud k,f wkdif jzpfw,fvdk Y qdk ygw,f/
Independent Mon News
Agency, Irrawaddy, Mizzima,
Kaowao
``` pmrsufES m (4) rS tquf
7/27/2019 Nightingale Health Journal (September-2013)
http://slidepdf.com/reader/full/nightingale-health-journal-september-2013 6/16
usef ;rma&;*sme,f trS wf-37? puf wifbmv? 2013-ckES pf6 NIGHTINGALE
zkd;u D;[m r,fawm faq; cef; um;u kdarmif ;wJhtvky f vk yf ygw,f/ q&mrBuD ; a'guf wmpifoD,marmifu wm0ef ay;xm;vk dY usr rJ aqmufrS m&Sd aepOf umvwavQmuf vH k ; usr ukdaeYpOftBudKtykdY vkyfay;& w,f/ zk d ;uD ;a&vk d Y zk ef ;quf ac: vd k uf wmeJ Y a&muf wJ h ae&muae
rjzpf jzpf wJ h enf ;eJ Y vmBud Kay;yg w,f/ tvkyfeJY ywfouf&if b,fawmhrS NiD;jiLw,fqdk wm r&SdbJ tvkyfudkBudK;pm;wJht jyi f tifrwe f½d k;om;a jzmifh rwfwJ h u&ifav;yg/
vGefcJhwJh 2 ESpfavmufu pNyD; zk d;uD;rSm a0'em(a&m*g) wckuk dcH pm;ae&ygw,f/ vnf yif ;xJ rS m wck ck&S dae ovkd cHpm; &w,f/ tpmwckckukd rsdK cs vkduf &if emusifw,fvk dY qk dyg w,f/ ol Yjzpf wJ h a0'em (a&m*g) ukd r,fawmfaq;cef ;rSma&m? rJ aqmuf aq;½k H rS myg jyocJh w,f vk d Y od &w,f/ aomuf aq;awG ay;w,f/ aq;aomufayr,fh roufombl ;/ 1 veJ Y rouf om? 2 veJ YroufombJ tcsd ef Mumvmawmh olUudk ,fol uif qmvkd Y xifvmygw,f/
'geJY ol&G mudkjyefoGm;w,f vkdY od &w,f/ &Gma&muf awmh Ad aE ¨mq& m? txufvr f; atmufvrf;q&mawGeJY uko w,fvkd Yxi fygw,f/ wae Y awm h aq;cef ;rS m zkd ;uD ;w a,muf ol U&G mrS mbJ qH k ;yg;oG m; NyDvkd Y owif;xGufvmw,f/ ol Y&JUvkyfazmfukdifzuf um;o rm;awG aq;cef;0e fxrf;awG vnf; pd wf raumif;Mubl;aygh/ zkd;u D;u ½kd;om;NyD; oabm vnf;aumi f; ? olwyg;uk d
vnf ; ul nD wwf ol qd k awmh cspf cifolvJaygwmrdkY olUtwGuf tvS LaiG aumufwm xk d if;bwf aiG aomif;eJYcsDNyD; &cJh w,fvkd Y od &w,f/
aemufawm h b,f[kwfr vJ? zkd ;uD;jyefa&mufvmw,f/ wu,faowmr[kwfbl;? , MwmacswmvkdYqkdw,f/ awmf
awmfvnf ; aemufwJ hzk d;uD;bJ/ olYtwG ufaumufcHxm;wJh t vS LaiG awG uk d r,f awmf aq;cef ; uk dbJ jyefvS Lvk duf Muw,f/
Ny D; cJ hw Jh ta cgufu rJ aqmuf jyefawmh zkd;uD;u usr ukd tBud Ktyk dY vkyfray;E dkif awmhbl ;/ ol u tck 6 bD;um; BuD ; armif;aeNyD/ pD 'D pD ausmif; Bud Kum;BuD ;ud k cHh cH h nm;nm;BuD ; armif ;aewm usef ;usef;rmrmeJ Y aw GU &awm h 0r f;omoGm; rd w,f/ a&m*gjzpfaewm 2 ES pf&S d aeNyD qk d awmhuif qma&m*gom jzpf&if 'DwacgufjyefawGUwJh tcsdefrSm awmfawmfydefcs HK;ae oif h NyD? 'grS r[kwf aoG ;tef wm wkd Y ovd yf xJaoG;ygwmwk d Y jzpf ae&rSmaygh/ tckawmh tJ'D vkd r[kwf bl ;? usef ;usef ;rmrmbJ/
'geJYusrvnf; olUa&m*g udk pdwf0if pm;rd w,f/ ausmif; Bud Kp&mrvk d wJ h? ol tm;wJ h tcsd ef rSm olU&JU cH pm;ae&wJh a0'em jzpfpOfukd aoaocsmcsm ar; Munhfawmh pdwfxJrSmxifrdwJh a&m*g&S daew,f/ Pharynx vk dY ac:wJh tpmrsd KcswJ h tpmvrf; aMumif ;t0rS m a,mif uk d if;wm? 'grS r[k wf temvH k ;wck ck &S d rvm;? 'grS r[k wf Esophagus vk dY ac: wJh tpm0ifvrf ;aMumif ;rSm t emwck ck &S d aer,f vk d Y oH o,jzpf rd w,f/ zk d ;uD ;u tck a&m*gjzpf
rS t&ufraomufwm? t&if wk ef;u vl ysKd ayguft&G ,fup NyD; awmt&uftjyif;pm;awG tawmfaomufcJhw,f/ aq; vd yfvnf ; aomufw,f? uGrf; vnf ; pm;w,f/ tckbJ olUt ouf 30 eD;yg;avmufawmif &Sd aeNyDvk dY ,l qEk difw,f/
'geJYbJ olUudk q&m0efeJY
aoaocsmcsmjyNyD ; a&m*g&S mazG ay;r,fvk dY qkH;jzwfvkd ufNyD; rJ aqmufaq;½Hkudk ac:oGm;ay; vkdufw,f/ vkyfxHk;vkyfenf; xH k;pHt& jyifyvlemXmerSm t axG axG a&m*gukq&m0ef eJ Y jy& w,f/ q&m0efuxk dif ;? vlem ajymwwfwmu u&if eJ YArm p um;/ xkdif;vk d eJeJajymwwf w,fvkd Y zkd;u D;uajymw,f/ tJ' DrS m jre frm jyn fzG m;v lem awGudk bmomjyefay;wJh 0ef xrf;vnf;&Sd w,f/ xHk ;pHqk d&if vl emuArmvl rsd K;qd k &if bmom jyef 0ef xrf ;u q&m0ef ud k xk d if ; vk d jyef ay;&wmaygh/ 'gayr,fh usruq&m0efukd t*Fvdyfvkd wkd uf ½kd uf ajymcsif ygw,f? bm omjyefeJYrajymcsifbl;vkdY cGifh awmif;awmh uHtm;avsmfpG m xkdif;q&m0efav;u t*Fvdyf vk dajymEd kif w,f? oabmvnf; aumif ;&Smw,f/
usr&Sif;jywmudk aoao csmcsm em;axmif w,f? oabm vnf ; aygufw,f/ 'geJY vnf acsmif; txl ;ukq&m0ef qD vTJ pma&; ay;vkdufw,f/ usr vnf ; 0rf;omvkd ufwm? ud k,f jzpfcsifwmvnf; 'gbJ/ vnf acsmif;txl;uk q&m0efeJY a&m *g&S m&r,f/ vnf acsmif;xJ udk rSe fajymi f;xnhf Munfh&r,f/
zdk; uD; &JUa& m*g
ud k,f tav;csd ef wd k ;csif wm vG,fwJhudpöawm h r[kwfyg /]ig;usD;ajcmuf Muyfwif} vdkY?]ig;azgif ½dk ;ajcmuf} vdk Y tac:cH
ae&ol rsm;vdk? arG;&myg rsdK;ADZ udku cyfydefydeform;rsm; t wGufqdk ydk cufrnf/ ig;rSm awmif yd ef&if ig;&mroG if;bl ;
xifyg&JU/ 0csif &if t&if qH k ; a&m*gb
,awG uif;aezd kY vdk ygw,f/ od wJ h twd k if ; emwm&Snf a&m*g awG u vl ud k yd ef oG m;apygw,f/TB, HIV-AIDS, uifqm? vnf
yif;Bu D;a[mfrkef;rsm ;aeol p wmawGyg/ wDbD jzp faeol wa,muf aq;ywfvnfvdkY aysmufvm&if aocsmayguf 0 vmygw,f/ wdwdusus qdk& &if ndKNyD; 0vmwmyg/
cyf vG ,f vG ,f oabmayguf
atmifajym&&if 0csif&if BuD; BuD ;MuH ygav/ td E´ d ,ud k a&muf cgp OD;armoD&d qd kwJh pmayqk &zl;ol rdwfaqG BuD;uay;wJh tBuH wck u bmvJqd kawmh ]wH igjzpf rS awmh ig;BuD;BuD ;rQm;yg} wJh/ BuD;BuD;BuH zdkY&m wcgpm; rsm;rsm;? tBudrfrsm;rsm; ? x rif ;vk yf BuD ;BuD ;? xrif ;yef ;uef tpm; ZvH k? ZG ef ;qd k &if a,muf csd K oHk;yg/
0csif&if tav;(0dwf) rç
vS,H kru 0csifygao;vQif
csdef xm;yg/ 1/ cgwd kif; waeYrS m (u,fvd k &D) b,favmuf pm;aeovJ/ 2/ pm;aewmxuf 500 (u,f vdk&D) ydkpm;yg/ pm;Edkifatmif waeY 3 xyfuae 4-5 xyf pm;jypfvdk ufyg/ 3/ (0d wf ) rç yg/Gym oG m;csif
oGm;? td rfrSmbJ vkyfvkyf/ 4/ tav;csd ef jyefcsd efyg/ w ywftNyD; 1-2 aygifwdk;&if aumif ;w,f/ 10 aygif rwdk; csifygeJY / usef;rma&;t& t aumif ; r[k wf yg/ wvuk ef &if 5-8 aygif wd k ;wmaumif ;w,f/ 5/ tav;csdef qufrwdk;&if aemuf xyf u,fvdk &D 250 ydk pm;ygav/
waeY u,fvd k& D b,f avmufvd kwm od zdk Y ]OD ;wdus} awG twG uf az:jrLvm &Sd w,f/
t&ifqHk; bmrSrvkyfbJaewJh tcsdefrsdK;rS m vd kr,f hEI ef;xm;ud k wG uf&w,f/ Resting Metabo-
lic Rate (RMR) vnf ;ac:w,fBasal Metabolic Rate (BMR)
vnf;ac:w,f/ vrf;vnf;r avQmuf? ajy;vnf;rajy;? t omav;aewH k; ud k,f cE¨ mu t ouf½S LzdkY? ES vHk;ckef zd kY? tpmajc aezd kY pwmawG&J U ZD 0tvk yfawG twG uf vd k tyf csuf ud k ajymwm ygbJ/
od zd kY RMR udk 1.25 eJY ajr§muf vdk uf yg/
yd k NyD ; pm;Ed k if atmif pm;yH k pm; enf; ajymif;oifh&if ajymif;& r,f/ t0pm; 3 cgeJY oG m;&nf pm 2 cg? 3 cg pm;yg/ aumfzD? vufbuf&nf aomufr,fht pm;? EGm;Edk Y? opfoD;azsmf&nf
aomuf yg/ aygif rH k Ypm;&iftnd K u tjzLxuf ydk w,f/ toD; t&Guf rSmvJ a&rsm;rsm; ygwm rsd K;jzpf wJh a*:zD? yJ pdrf ;pm;O? o cG m;oD ;wd kYxuf tmvl ;? yJ rsdK;pH k? rHkvmOe D? ajymif ;zl;wd kYuom w,f/ toD;awGqd k&if vdar® mf? ydcsf? ZD;oD;? z&JoD;awGxuf iSu fay smo D; ? opf awm hoD ;? axmywf oD;? emewfoD;? yef; oD ;awG uomw,f/ ]qG yf}qd k wJ h [if;&nf qdk&if ]c&if}ygwmu tMunf &nf xuf omw,f/
jzpf Edk if orQtpm;taomuf awGxJr,f pm;oH k;qD xnf h &yg r,f/ oHvGifqD? pm;tkef;qD? axmywf qD wd k Yu aeMumaph qD? yJqDwdk Yxuf omw,f/ om w,f qd k wm u,f vd k &D yd k &wmud k ajymwmyg/ a&S mifoifhwmawG uawmh usef;rma&;eJY rud kuf wJ h trans-fats awGrsm;wJ h yuf px&D? udwf? uGwf uD;? jyKjyif xm;wJh tom;-ig;? rm*s&if? tvG ,f 0,f &wJ h tpm;tpmawG
wm jiif;p&mawmh r&Sdyg/ rsm; rsm ;pm ;zd kY avmufawmh rxd a&mufyg/ ydefol awG &J U ZD0ur® qdkwJ h ouf&Sd wdkY xHk;pHvk yf ay; ae&wJ h jzpf pOf uk d ,f üu jref jref BuD ; vk yf aeol awG jzpf vd k Y (u,f vdk&D)awG ydk &zdkY vdk ygw,f/ pm oifovd k ajym&&if tqifh 5 qifh&Sdw,f/ udk,ftav;csdef
ysif ;awm h ysi f;p&mMuD ;/ ocsFmvdk xyf&Sif;&tkef;r,f/
RMR = 9.99w + 6.25h -
4.92a + 166g-161
w = ud k ,f tav;csd ef uD vd k * &rf? h = t&yf pifwDrDwm? a =
touf ES pf? g = usm;-r? (usm; = 1 r = 0)
waeYwm vd k r,f h u,f vd k &D
yg/ rjzp fraepm;&rSmu y½dk
wi f; "mwfygtpmawG jzpf w,f/ tom;rsdK;pHk? ig;rsdK;pH k/ pm;Ed k if wJ h tom;trsd K;rsd K;tjyif u,fvdk& Drsm ;rsm ;ygwJh axm ywf? 'def? oHvGifqD? c&ifrf qdk wmawG xyfjznfhyg/ tom;r
pmrsufES m (8) od k Y ``` pmrsufES m (12) odk Y ```
a'guf wmwif haqG
a'guf wmcifapm0if ;
7/27/2019 Nightingale Health Journal (September-2013)
http://slidepdf.com/reader/full/nightingale-health-journal-september-2013 7/16
usef ;rma&;*sme,ftrS wf-37? puf wifbmv? 2013-ckES pf NIGHTINGALE 7
vlwkd Yonf acG;arG;jcif;ukd vG ,f vG ,f ul ul awG ;wwf Muyg w,f/ acG;arG;&wm rcufcJay r,f h acG ;uk d uf cH &wmrsd K;uawmh vG ,f ul vS ygw,f/ txl ;ojzif h oGm;&if;vm&if; trSwfwrJh t
ukduf cH&wmrsdK; &Sd ovkd rarQmf vifh wJh ae&mrsdK;rSmvnf; acG ; uk d uf cH &wmrsd K;vnf ; &S d wwf yg w,f/
ac G;[m oci fhtay:r Sm opö m&S d wJ h td rf arG ;wd &d pä mef jzpf NyD ; vlawG&JU ,k HMunfpdwfcs&rI t rsm;qkH ; &&S dMuygw,f/ td rft awmf rsm;rsm;rS m acG ;arG ;avh &S d NyD ; acG;uk dufwwfonfqk dwJh qk dif ; bk wf awG vnf ; csd wf qG J xm;avh &Sd ygw,f/ qkdif;bkwfcsdwf xm; vk d Y uk duf wwf aMumif ; tod ay;
wmu [ef Ywm;rIwck jzpfNyD; r ukdufwwfwmukd ukdufwwf w,fvk dY Ncdrf;a jcmufwmrsd K; vnf; &Sdygw,f/
'gayr,fh rdrdarG;wJhacG ;u vlukdukd ufrd oG m;&if rvG,fyg bl ;/ uk d ,f h acG ;aMumif h vl wOD ;w a,muf tukd ufcH &&if acG;arG ; ol acG;ykdif&Sif rSmyJ wm0ef&Sdyg w,f/ uk d,farG ;wJ hacG ;u vl ukd rukdufatmif? ul;pufa&m*g awG rjyefYyGm;atmif acG;ykdif&Sif wkd if ;rS m wm0ef &S dygw,f/
jyifyuvl awGuk d acG;uk duf wwfonfqkdwJh qkd if ;bkwfa&; xm;½k HES ifh rvk H avmuf ygbl ;/ rd rd arG ;xm;wJ h acG ;uk d k ES pf pOf acG ;½l ; umuG,faq; xkd;ay;zkdYvnf; wm0ef &S dygw,f/
tqk d;qkH ;uawmh vrf ;ay: uacG;avacG ;vGifhrsm;uk d b,f
olrS acG ;½l;umuG,faq; rxkd; ay;wJ h twG uf tvG ef yJ tEÅ &m,f BuD;ygw,f/ acG ;½l;qkdwm tif rwefrS aMumuf p&maumif ;NyD; tuk d uf cH &oltcsd ef rD aq;rxk d ; &if toufq kH;½ IH;o Gm;Ekdi fyg
w,f/ ukorIrS efuefzdkY ta&; BuD;ygw,f/ vrf;ay:u ykdif&Sifr&SdwJh
acG ;avacG ;vGif h awG uawmh acG ; ½l ;a&m*g ul ;puf vG ,f ygw,f/ acG;tcsif;csif;ukduf&if;uae acG ;½l ;a&m*g jye fYyGm ;vmyg w,f/ acG ;½l ;Ak d if ;&yf pf yk d;awG [m acG ;&JUoGm;&nf? Ekd Y&nf eJY rsuf &nfawG uwqif h ul;puf wwf ygw,f/ acG;ao;uvnf; ul; puf Ed kifygw,f/ acG ;waumif eJ Y waumif uk wf zJ h uk wf jcpf &if ;u
vnf; ul;pufwwfygw,f/ acG;½l;a&m*gykd ; ul;pufcH&wJh acG ;waumif[m (1)vrS(3)v txdbJ touf &SifEk dif ygw,f/
ac G;½l ;a&m*guk d ac G;w aumifrSm cHpm;vm&NyDqk d&if y xrOD;qk H ; a[mif oH ajymif ;oG m; wwfygw,f/ tpmrpm;? a&r aomuf bJ aevm&if owd xm;& awmhrSm jzpfygw,f/ wjznf; jznf; vleJYvuf yG ef ;wwD ; rae
awm hbJ cyf cGm cGm jzpfvmyg w,f/ vl uowd xm; a&S mif &S m; &rSm jzpf ygw,f/ uk d ,f arG ;xm; wJ h uk d,fh acG;jzpfayr,fh ½l;pdwf rG efvm&if awmh vI yfvIyf &S m;&S m; jrif orQ uk dufawmh rS mjzpfw,f qk dwmukd oabmayguf xm;zkd Y vkd ygw,f/
acG;½l;a&m*gjzpf aewJh acG; &JUvu©PmawGukd owdxm;
wwfMuygw,f/ ukd,fauR; xm;wJhacG;ukd ½kdufESufarmif; xkwf&ifawmif rBudKufMuyg bl;/
xkdif;Ekdif iHrSmawmh acG ;cspf olawG aygvSygw,f / tdrf wk d if ;vk dvk d acG;arG ;MuNyD; acG ;ukd w,kw, vkyfwwfygw,f/
'g htjyif &yfuGu fvr f;BudK ? vrf ;Mum;awG rSmvnf ; ykd if &Sif rJh acG ;avacG ;vG if h awG &S d aeMuwm ukd okwfoif&Sif ;vif ;jcif;? t qdy fauR;owf jci f; enf ;yg w,f/
tJ'DacG;avacG;vGifhawGu wqif h acG ;½l ;a&m*g&Ek dif wmukd rpOf;pm;r dMuwmrsdK;vnf; &Sd rSmyg/ acG;uk dufcH&&if tJ'DacG ; aumif;w,f? raumif;bl;qkd wm csuf csif ;rod Ek d if wmrk d Y aq; ½kHoGm;NyD; acG;½l;umuG,faq;
xkd ;oifh ygw,f/ acG;uk d uf cH &jcif; a&S ;OD ;jyKpk &rSmuawm h acG;ukdu fcH&wJh 'Pf&m (okd Yr[kwf) uk wfjcpfcH &wJh ae&muk d a&eJ Yqyfjym aq; aMumay;zkdY vkd ygw,f/ NyD;&if wifcsmtkd iftkd'if ;eJY xyfrHaq; aMum&rSm jzpfygw,f/
NyD;&if aq;½kHukdta&muf oGm;NyD; umuG,f aq;awG xkd ; ay;zk dY q&m0efawGu pDpOfay; rSm jzpf ygw,f/ umuG ,faq; xkd;NyD; q,f&uftwG if; rdrdukd
ukduf wJhacG;ukd apmif hMunfh&rS m jzpf ygw,f/ q,f &uf jynf h vk d Y rd rd ukdukd ufwJh acG; taumif;yu wdtwk dif;&S drS pd wfcs&rS m jzpf yg w,f/ wcgwcgawm hvnf; acG ;awG arG;wJh acG ;om;tk yf ru om;orD;t&S def eJY vlawGukd &ef jyKwmukd cH &wwfygw,f/ o wdxm; a&Smif &Sm;zk dY vk dygw,f/
wcsdKUacG;awGu puf bD;pD ; oG m;wJ h vl? qk d if u,f t&S d ef avsmh oGm;wJh vlawGukd &ef jyKuk duf wwfwJh twGuf owdxm;zkd Yvkd ygw,f/ taumif;qkH ;uawmh acG ;½l ;rS r[k wf acG ;aumif ;uk d uf wmvnf; rcH&&if taumif; qkH;ygyJ/
acG;ud kufcH&NyD ;NyD;jcif; acG; ½l;umuG,faq;xkd;Ek difzkdY Bud K; pm;rI[m rSef uef wJh uk orI wck qkdwm vlwkdi f;em;vnfxm; oihfygw,f/ wcsdKU a&ref;eJY jzef ;NyD;ukwmrsd K; tm;ukd;Muyg w,f/ tJ 'Dvk denf ;eJY a&m*gr aysmuf Ekd ifbl;qk dwm od xm;zkdY vkdygw,f/ acG;½l ;jye fa&m*g vu©PmawGay:vmrS aq;½kH oG m;r,f qk d &if aemuf usoG m;yg NyD/ acG;ukduf cH&ol&J U touf tEÅ&m,fukd b,fvkdrS rum uG,fEkdifawmhwmrkdY ukorIt wGuf xda&mufawmhrSm r[kwf ygbl;/
jrefrmwk dif;&if;aq;awGukd
urÇmhusef;rma&;tzG JYBuD ;WHO &J Upm&if;t& jrefrmEdkifiH
rSm vlwoef;rSm 22 a,muf acG ;½l ;jyef a&m*g jzpf aeNyD ; wES pf udk vl 6 odef ; acG ;udkuf cHae& w,f vdk Yqkd ygw,f/ 2012 ckrSm acG ;½l ;jyefa&m*gaMumif h tenf ; qHk ; vl 240 aoqHk;cJh ygw,f/ 'ghtjyif jref rmEd k ifiH u acG ;tm; vHk ;&J U 75% rS m acG ;½l ;a&m*gyd k; &Sdaew,fvdkY arG;jrLa&;eJYuko a&; OD;pD;Xmeu cefYrSef;xm;yg w,f/
pufwif bm 28 &ufaeYudk urÇmhacG;½l; jye fa&m*g aeYvdk Y owfrSwfxm;NyD; oufqkdif&m Xmersm; tzGJYtpnf;rsm; yl; aygif;aqmif &Gufjcif ;jzif h &v'f aumif; jzpfa&;vdkY aqmifyk'f xkwfjyefxm;ygw,f/ 'gay r,fh jrefrmjynfrSm acG;avacG; vGifh jyóemud k pnf yifom,m ubJ tqd yfygtrJom; auR; wJh enf ;eJ Y ud k ifwG,fNyD ; usef ;rm a&;0efBuD;Xme? arG;jrLa&;0ef BuD;Xme pwmawG& JU wjcm; enf ;vrf ;rsm;eJ Y yl ;aygif ;yg0if rI tm;enf ;aew,f vd kY arG ;jrLa&;
eJY ukoa&;OD;pD;Xme t&m&Sd a[mif ;wOD;u ajymygw,f/
acG ;twG uf umuG ,f aq;[m usyf ig;axmifcefYbJ&S dNyD; vl t wGu f umuG,f aq;uawm h ajcmuf aomif;cefY &S dw,fvd kYqd k ygw,f/ 'ghtjyif vltwGuf
acG;½l; jye fumuG,faq; rsK d; quf a[mif ;[m csuf ywf vnf rS m 14 vH k ;xd k ;&wJ h nerve tissue-
based vaccine jzpf NyD; aq;xdk; emusifrI? aq;xd k ;tBudrf rsm;rI? xda&muf rItm;enf;rIwdkYtjyif tm½Hk aMumtrsm; a&mif,rf; ysufpD ;rI Inflammatory Polyne-
uropathy? taMumao oG ufcsm yg'vd kufr I? vlYtoufqH k;rI txd ab;xG uf qk d ;usKd ;awG &S d NyD ; 'DuaeY Edk ifiHwumrS m t"du oHk;aewJh acwfrDrsKd;qufopf umuG,f aq;uawm h vuf armif ;rS m 5 vHk ;bJxd k;&wJh cell-
based vaccine jzpfwJhtwGuf tJovdk qkd;usKd;awG enf;yg w,f/ WHO u tEÅ&m,frsm; wJ h vuf a[mif ; acG ;½l ;umuG ,f aq; roHk ;pG JMuzdk Y 2001 ck ESpf uwnf ;u vrf ;ñT ef csufxk wf jyef xm;ayr,f h jref rmjynf ae&m awmf awmfrsm;rsm;rS m tck tcsd ef xd vuf a[mif;acG ;½l ;jyef um uG ,f aq; oH k ;aeqJ jzpf ygw,f/
2011 arvrS m &ef uk ef wd k if ; ausmuf wef ;Nrd KUe,f u trsKd ;o rD;wOD; acG;udkufcH&NyD;aemuf
vufa[mif ; acG ;½l ;jyefum uG ,f aq; xd k ;cJ h &mu acG ;½l ;jyef a&m*gaMumif h raobJ umuG ,f aq;aMumif h toufqHk;cJhy g w,f/ 7Days News Journal
/ Myanmar Journal of Current
Medical Practice / WHO
acG;½l;owd
txifao;vk dY r[kwfygbl;/ olYae&meJYol tokH;0if? tok H; wnfh wJh wk dif ;&if ;aq;awG &S dyg w,f/ acG ;uk d uf cH &&if awmh acG ; ½l;umuG,f aq;ukd xkd;&rSmjzpf ygw,f/ t&if wkef ;u Akdufukd aq;xkd ;ygw,f/ tck vuf armif;&if;rSm xkd ;vkdY&aeygNyD/
acG;uk d uf cH &&if jref rmt,l tqwck u uH ed rf h w,f vk dY xif Muygw,f/ trS efwu,f uH aumif;c sif&if acG;ukdufrcH& atmif qifjcifMuzkd YyJ jzpfyg w,f/ acG;ukdcspfwJhvlawGu acG ;trsdK;tpm;aygif ;pkH wefzkd; BuD;BuD;ay; 0,f,lNyD ; arG;avh &Sdygw,f/ tarT ;wkd tarT;&Snf acG ;? ½kyf qk d;qk d;acG;awG ygrusef arG ;wwfMuygw,f/ wcsdKUacG; cspfolawGuqkd acG;ukd vl&m oG if ;NyD ; zuf td yf wmwk d Y td yf ,m
xJ xnfht dyfwmwkdY &SdMuyg w,f/ tJ 'DacG ;? aps;BuD ;BuD;ay;NyD ;
0,f &wJ h acG ;vnf ; acG ;½l;a&m*g ul;pufcH&&if vlukdjyefuk duf wwfwmyJ/ acG;ukd cspf vkdY pm; aumif ;aomufzG ,f awGauR;NyD; arG ;Muol rsm;taeeJ Y rd rd arG ;xm; wJhacG; aumif;raumif; tNrJ
avh vmtuJcwfzkd Y vk dygw,f/ acG;cspfolrsm;taeeJY wef
zkd;BuD;BuD;ay;NyD; 0,f&wJhacG; uk d wefzkd;xm;cspfcif ,k ,Mu wmuk d rajymvk dayr,fh acG ;[m acG ;yJ jzpf w,f qk d wmuk d awmh arh xm;vkd Yr&ygbl;/ acG;qk dwm acG ;½l ;a&m*gul ;puf vm&if tif
rwef aMumufp&maumif;NyD; vlYtoufuk dyg zJhacRoGm;wJh a&m*grsd K;qkd ukdvnf; arhrxm; zkdY vk dygw,f/
acG ;uwqif h vl uk dul ;puf &mrS m uk d uf rd? [yf rd &if ul ;puf zk d Y aocsmaewmrk d Y umuG ,f aq; xkd ;zk dY a&ref ;eJ Yt&J ruk d;zkd Y? aq; ynmA[kokw&S dzkd Y? acG;awGukd uav;awGu oGm;NyD ;&efrpzkd Y uk dvnf ; BudKwif umuG,fMu& rSm jzpfygw,f/
oGm;&nfwjrm;jrm;eJY acG;
awG uk d owd xm;apmif h Munf h &o vk d tNrJ wrf ;rd S ef ;aewwf wJ h acG ;? vrf;avQmuf&if ',D ;',k d ifjzpf aewJhacG ;awGukdvnf; apmifh Munhf tuJcwfNyD; aumif;r aumif ;? ½l ;r½l; owd xm;a&S mif &S m;Ek d if&if awmh taumif ;qkH ;yg yJ/
aomif ;0if ;Ad k vf Munh f &if tpmpm;csd ef rSm oD ;NyD; atmuf ar;wGJ usjcif;? oG m;&nf wjrm;jrm;jzpf aejcif ;? yg;pyfu tjr§Kyf awGxGufaejcif ;eJ Y a&ukd tvG ef aMumuf jcif ;wk d Y jzpf ae&if tJ' Dac G; tuk dufrcH&atmif
a&S mif &Sm;zk dYvkd ygw,f/ arG;jrLa&;eJY uk oa&;OD ;pD; Xmeu &efukefrS m&Sd wJh acG;awG uk d ppf aq;Munf h ½I &mrS m acG ; (3) aumifteuf (1)aumifu acG; ½l;a&m*gyk d; &S d aewmuk d ppf aq; awG Y&S d &aMumif ; od &ygw,f/ tJ 'Dvkd ppfaq;awGY&S dcsuf aMumifh tifrwef pkd;&drfp&maumif;ae wmukd owdxm;&rSm jzpfyg w,f/ txl ;ojzif h yk d if &S if r&S d wJ h ykdif&Sif rJh acG;? acG;avacG ;vGif heJY vrf;BudKvrf;Mum;u acG;awG
uk d owdxm;&rSm jzpfygw,f/ owif ;pmykdYwJhol tawmf rsm;rsm;u acG;eJ Y&ifqk dif &wwf NyD; acG;ukdufrcH&awmif acG; [yfcH&wwfygw,f/ acG;awG [m rsdK;quf aygufyGm;rIEIef;u vnf; jrefygw,f/ jrefrmvl rsdK;awGuawmh b,facG;yJjzpf jzpf pm;<uif ;pm;usef auR;zk d Y 0ef rav;wwf Muygbl ;/ jrefrm awG u acG ;awG uk d Muif emoem;
ac G;a rG; jc if; acG ;u dkufc H&j ci f;ESifh
aomif ;0if ;Ad k vf ud kufonf h owå 0g wHawG;rS Adkif ;&yfpf ydk ;
tom;xJodkY 0ifa&mufvm
'Pf&mteD; <uufom;xJ rS
m Ad kif ;&yf pf yd k; yGm;rsm;vmjcif ;
tpGeftzsm; tm½H kaMumpepf rS
ausm½dk;rxJ&Sd
A[dktm½HkaMumpepfqDodkY
Ad kif;&yfpf ul;oef;oGm;jcif ;
ausm½dk ;r twdk if ;
Ad kif;&yfpfydk ;
txufwufvmjcif;
OD;aES mufxJ
Ad kif ;&yfpf yd k;a&muf NyD;
toufaoavmufonf h
OD ;aES mufa&mifa&m*gjzpf jcif ; wHawG;*vif;ESifh
tjcm;t*F grsm;xJodk Y
Adkif ;&yf pfyd k ; 0if a&muf jcif ;
7/27/2019 Nightingale Health Journal (September-2013)
http://slidepdf.com/reader/full/nightingale-health-journal-september-2013 8/16
usef ;rma&;*sme,f trS wf-37? puf wifbmv? 2013-ckES pf8 NIGHTINGALE
waeYoü xk dif ; - jref rme,fpyf rJaqmufNrdKU\ NrdKUrsufESm zk H ; (rd rd rsuf ES muk d ol rsm;rjrif &avatmif wzk H ;zk H ;ES if h yd wf ½k d uf wwf ol rsm;)aexk d if &m rJ aqmuf 0if 'grD ,m (trS ef u &T H UAG uf tvG ef xl aom wJtd rf )ü aexkdifonf h uREk fyfwkd Y\ Zmwf vkdufausmfBuD; ]q&mrkd;} xH ok d Y oD &d (trk d ;pd rf ;puf ½k H)? cif jzL0if ; (tbk d if½k H )? 0if ;pE´ m (zd ck d if ½k HPhi Khaing)? 0if;0if;EG,f (aygifrkef Y½kH SPT )? eD eD 0if; (trk d;jym ½k H)
ponf h trsdK;orD;tvkyf orm; 5 OD;wkd Yonf qkdif;rqifh? AkHrqif h bJ tar*srf; ,drf;uum a&muf&SdvmMuukef\/
racsmig;a,muf(wNydKifeuf )/ / (AsdKU .... q&mrdk;) tBud rf (100)
q&mrk d ;/ / aMomf .. at;at; vmMua[h vmMu/ 'DrSm ewfuEém; jyifxm; tJ av vufzufokwf? *sif;ok wfawG jyifxm;w,f/ pm; &if ;aomuf &if;eJ Y usef ;rma&;pum;0k d if ;av; pvkd uf Mupk dY&J U/ uk dif ; .. b,folu b,fvk dao;ayguf tJ av usef ;rma&;pum; pajym rS mvJ/
0if ;0if ;EG ,f/ / orD;pajymr,f/ Influenza wk yf auG ;taMumif; orD; od oavmuf rQa0r,f aemf/ wk yf auG;[m wkyf auG ;jzpf aewJh ol u wqifh a&m*guk d jyef vnf vufqif hurf ;oGm;? qif hyG m;oGm;wmyg/ 'gaMumif h tck vk d &moD rS m rJ aqmuf aps;vk d aps;awG bmawG oG m;wm a&Smif&r,f/ (tarav; .. ajymom ajym&wm 'D u aps;xJ jzwf avQmuf &wm tvG ef0goemygw,faemf) tJ .. ½k yf&Sif½kHoG m;wm? um;*dwf oGm;wm? uk efya'omqkd if? ukefwkduf oGm;wm pojzifh vl pkpk? pk pk eJ Y &S daewJh ae&mawG uk d toG m;tvm wwf Ekd if orQ a&Smif &r,f &S if h/ ra&S mif Ek d if vk d Y oG m;r,f qk d &if vnf ; uk d ,f cH tm;aumif ;ap zk dYtwGuf AD wmrifpD aq;awG ukd rSD 0J NyD; oGm;&r,fwJ h/
cif jzL0if ;/ / 'gaMumif h [pfa[mhyfoDcsifav;eJY usru ajymjycsif wmaygh/]wk yf auG ; .. t[k wf raES ; .. csrf ;csrf ;NyD ; .. zsm;emw,f a[; .. acgif ;ukduf .. uk d,fuk duf .. quf wkduf ukd .. acsmif;qkd ; w,fa0; .. ES map; .. ruao; .. vnfacsmif ;av; .. emao;w,f aqG ; .. armyef; .. EGrf;e,f .. rpm;omw,f .. a[m'DwkyfauG; .. (auG; .. auG; .. auG;)}
eDeD 0if ;/ / w,fvnf; &Sif;oGm;ygvm; cifjzL0if;a&U/ 'kdYuawmh jrefrmoHpOfppf ppfjzpf wJh oDv&SifqG rf ;cH pum;eJ Y a[m'Dvkd ajymjy
r,f aemf/]wurÇ mvk H ;rS m .. rsm;owå m .. csrf ;omuk d ,f
pdwf .. NrJygap wkyfauG;&efab; .. uif ;pifa0; .. q&mav;wkdY .. qk ay;ygo&Sifh/ ES vkH;? aoG;wkd;? qD;csdK? tqk wf&S dol awG .. wkyfauG;&efab; .. uif ; Muygap .. jzpfyG m;&ifvnf; .. taES;tjrefajy; .. aq;cef;qDukd&Sihf ../ omref vli,f .. vl &G,f awG rSm&Sifh .. &uftenf;i,fem; .. em;Muyg&Sifh ..
a&eJY"mwfqm; .. aqmifxm;Mu&Sif h .. Muuf pGyfeJY Muufaygif;&nf .. rSD0JraoG&Sifh .. aq;awGrSD0J ..
rvG J eJ Y&S if .. aq;nT ef ;twk d if ; .. aomuf Mur,f &S if h ...}oD&d/ / eDeD0if;wkdYuawmh oD v&SifeJY awmfawmfwl wmygyJ
uG ,f/ 'k d Yuvnf ; awmif awmf a&T yk yÜ g;qk d wJ h ewf oD csif ;av;eJ Y wk yf auG;taMumif ;ukd qkd jyr,faemf/
](yk yÜ g; .. yk yÜ g; .. awmif awmf a&T yk yÜ g;) .. wk yf auG ; .. t[kwfraES; .. awmf awmfuk dauG; .. (ykyÜg; &,fom .. vmcsif yghav; .. ykyÜ g;&,fom .. vm csif ygh av; ..) (wkyf auG ;&,f em .. aysmuf csif vS oav;) 2 .. (aq;vdyf&,f a&Smif .. tcsdKvGef
(a&rSef .. a&rSef .. csdK;csdK; .. vrf;awG .. vrf;awGavQmuf .. acR;xG ufatmif .. vkyfay;a[h ..)}
'ghtjyif pGyfjyKwfylylav; aomufMur,faygh/ pGyfjyKwf&JU tylcsdefu at;jrwJhavat;eJY cE¨mukd,fEGrf;vsaewmukd aEG; axG;apNyD;awmhum cRJovdyfudkvnf ; &Sif;xkwfEk difw,fav/ tat;rda&m*gukdvnf ; awmf½kHe JYr0ifapbl;av/ pGyfjyKwfqkd &mrSmvnf; tom;enf ;enf;eJY [if ;oD;[if ;&Guf pkH? a*:zD? yef; rkef vm? MuufoG ef jzL? i½k wfaumif ;? MumZH ('grS r[kwf ) jrLpG rf
pwmawGukd aomufvkdY aumif;atmif csdK? ief? pyf ylylav; vkyfNyD ;aomuf &if od yfaumif; tm;BuD;aumif;awmh/
cif jzL0if ;/ / trawGuawmh vk yf NyD/ ajym&if ;eJYawmif yg;pyfxJ rSm o½kd;o&DjzpfvmNyD aemf/ qufajym&&if a&csdK;wmvnf ; odyft a&;BuD;w,f/ wcsdKUu a&csdK;wkdif; acgif ;avmif;NyD ; csdK;wwf Mu wmukd ;/ tJ'g ]xd yf uyfem} jzpfapowJh/ OD;a&cGH[m tNrJwrf; tat;rdaeNyD;awm h ESmap;wm[mvnf; raysmufawmhbl;wJ h/ 'gaMumifh wywfrSmwBudrfyJ acgif;avQmfygwJh/ aemufwcku]tat;rd a&m*g} ul ;puf w,fqk dwmu usrwk d Y&JU vuf awG aMumif h
jzpfwmyg/ vufawGuwqifh Akd if ;&yfpf aygif;pk H[m tcsdefra&G;? ae&mra&G;ygEk dif w,f av/ 'gaMumif h vuf awG ukd qyf jym? a&wk d YeJ Y pifMu,fatmif aq;&yghr,f/ 'ghtjyif tpmpm;wkdif;eJ Y rpm;rD? pm;NyD ;csd ef? td rf omoG m;NyD ;csd ef pwmawG eJ Y npf ayaewJ h ypö nf ;awG eJ Y
tvkyfwckckvkyf NyD;wkdif;rSm vufudk aoaocsmcsm aq;oifh wmaygh aemf/eDeD 0if ;/ / at;[Jh/ vl awG&J Upd wf[m wcgw&H rS m uk d ,f xif wmxuf
yk d NyD ; qef ;Mu,f w,f ath/ qk d vk d wmu pd wf xJ uae aeraumif ;bl ; vk d Yxif &if cE¨ muk d ,f uvnf ; bma&m*grSoauF wrjybJ eJ Y zsm;csif ovd k vk d? emcsif ovk dk vd k cH pm;&wm&S dw,f av/ 'gaMumifh rk d Yvk d Y pdwf cGef tm;ukd wkd ;jr§ifhay;wJh pmayawG ukd zwfay;&r,f/ bmoma&; av; bmav; vk duf - vk dufpm; tJ av vkd ufpm;&if aumif;wm aygh/ a,m*usif h pOf vk d rsd K;? ur® Xmef ;vk d rsd K; usif h BuH &if vnf ; &wmyJ av/ aemuf wck u rk d ;a&pk d pOf rS m ul ;puf a&m*g t0ifa&muf Ek d if qk H ; u ES macgif ;eJ Yyg;pyf r[k wf vm;/ ES macgif ;uwqif h avxJ uyk d ;rT m; awG 0if a&muf Ek d if ovk d roef Y&S if ;wJ h vuf uvnf ; ES macgif ;eJ Yyg;pyf ukd uk dif wG,frdwwf Muw,f av/ 'gaMumif hrk dYvkdY wwf Ekd if &if ESm
acgif;pGyf (armuf umAm) pGyfxm;oifhwmaygh/q&mrk d ;/ / tdef; .. td ef; aumif;o[/ aumif;o[/ 'Dawmhum a&m*gjzpf &ifvnf ; aocsmwd wdusus uk oNyD;rS yJ tjyif xG uf oif h w,f a[h/ 'gh tjyif rdrdwk dY[m vwfqwfwJh toD ;tESHawG? ADwm rifatygwJh tpm;tpmawGuk d pm;&r,fuGJY/ aemufNyD;awmhvnf; wudk,fa&oefY&Sif;zkdYuawmh rvGJraoGvkdtyfwJh enf ;vrf;t& waeYuk d tenf ;qk H ; xrif ;ES pf Bud rfpm; (aocsmem;axmifNyD ;rS rS wf aemf/ [k d½l ;aMumif rl;aMumif 0efBuD;jrif hvI d if ajymovk d xrif;weyf avsmhpm;ckdif;wm vkH ;0? vkH ;0rajymbl ;aemf) 'D awmh um xrif ;ES pf Bud rf pm;? a&ES pf cgcsd K;? td rf omES pf cgwuf ygwJ h/ (wu,f rygcsif &if vnf; n§ pfNyD;yg ygvkd Y q&mrkd ;u vkH;0rwk dufwGef;bl ;aemf) 'ght jyif qyf jymeJY vuf aq;ygaygh/ NyD;awmhwcg rk d;a&pkd xm;wJ h tusÐ t0wftpm;awG ukd aocsmpG m avQmf zGwf ygaygh/ aevS rf;aygh/ oyf oyfeJ YrS &yf&yf (anmif;&if awmh cPxkd if aeaygh) aexk dif Mu&jzifh 0oEÅ rk d;umvuk d vSvSa&m? yya&m jzwfausmfEdkifrSmayghuG ,f/
tm;vk H ; (wNydKifeuf )/ / ]tm;vkH;? tuk efvk H;aysmf&Tifzk dY usef ;rma&; uk d vkd uf - vk dufpm;Mupk dY}
tJonfvd k q&mrkd ;ESifh olYwynfh r ig;a,muf wkd Yonf NydKifwl a<u; aMumfoHay;MuNyD;oumv xkdif; - jrefrme,f pyf rJaqmuf Nrd KU? r,f awmf aq;cef;teD;&Sd Ek dufwifa*;vf *sme,fwkduf &S d&mok dY rnfr Q vkdu f - vkdu fpm; MuaMumif ;jyo&ef wcsDwarmif; ajcvsifanmif; Muavownf ;/
qef wmuavmh pf (acwå - t*F yl )
'd k Ytvkyform;awGvnf;usef;rma&;vd kuf-vd kufpm;Mupd k Y a&S mif Mua[;) 2 .. &ifbwfukdaEG;aEG; .. axG;apzkd Yav .. tuk duftcJ&,f .. aysmuf .. aq;uk dawmh av .. ES map;&,f aysmuf .. acsmif;qkd ;&,f aysmuf .. wGJ raomufeJYav; .. ik Haq;awGaqmif .. acsmif ;qk d ;aysmuf oav.. vnf acsmif ;&,f em .. oH yk &meJ Yysm;&nf .. a&aEG;eJY azsmfum aomufygpkd Y .. raES ; (a[; .. a[;)}
q&mrk d ;/ / awmfygNyD? &ygNyD/ q&mav;wkdY? tar*srf;wkd Y? rESJav; wk dYa& ../ [kd; .. pawmh yf? pawmhyf tara&,mOfwk dY&JU/ uJ 'Dwcg tck vkd (0oEÅ ) 0oefrkd;&moDumvrSm b,fvkd b,fykH a&m*gawG
jzpf wwf ovJ/ 'gawG uk d *vk d? *vk d ausmf vT m;Mu &r,f h taMumif ; azmufonfcsMuOD;pkdY/ ukdif;.. b,f olpajym rvJ/ 0if ;pE´ m/ / orD;pajymr,f/ tm;vk H;odMuwJh twkdif;/ rkd ;&moD[m a&awG taiG YysH rI eJYtwl a&wGif;? a&uef? tif ;tkd ifawG rSm a&awG jynf haeovkd ykd ;rTm;awG vnf ; tvG ,f wul ayguf yGm;Ek dif ygw,f/ tJovk d ywf0e f;usif pkdp Gwfr Irsm ;avav bufwD ;&D;,m;? Ak d if ;&yf pf yk d ;awG yk d NyD ;awmh ayguf yG m;avav jzpf ygw,f/ rk d ;&moD rS m tjzpfvG,fwmu a&BuD;a&vQHwm tJav a&m*gawGuawmh ES map;wm? acsmif ;qk d ;wm? tat;rd a&m*gawG tjyiftpmraMuwm? tla&mif ief;zsm;jzpfwm? 0rf;ysuf0rf;avQmwmeJY 0rf;ukduf a&m*g pojzifhayghav/ tJ 'gawG jzpfEk difygowJh&Sif/
oD&d/ / 0if;pE´ m aMumf jim0ifNyD;NyDqkdawmh 'k dYwawG u qufajym& awmh rSmaygh uG ,f/]ighb0&JU .. rD;tdrf &S ifyg .. ighb0&J U .. rD;tdrf&Sif av;yg ..
ighb0&JU .. wefckd;&Sifyg .. ighb0&JUtm;tifyg .. eif[m .. ewf orD;av;yg .. ) .. (rkd;xJrS m .. xD;awGyg .. rk d;xJrSm .. rkd;umyg .. rkd ;xJrS m .. rkd;pD;zd eyf .. 0wfqifum .. oGm;Muyg .. waeYvk H;uG,f rk d;a&pkd .. oif[mraeoif hbl; ..}
0if ;0if ;EG ,f/ / tr,f oD&dwkd Yu ]qkdaw;}oDcsif;tvkduf eJY [JoG m; wmqk dawmhum 'k dYu uk dvHbD ,mtqkd ausmf eJ Y armf ',fvf½kyf &S if rif ;orD; &SmuD&m&J U ]0gum0gum} oDcsif ;tvkduf twdk if; ajymjy r,f aemf/]*sar .. *sar .. a[;a[; .. 0gum .. 0gum .. a[;a[;)
qef wmuavmh pf
pmrsufESm (9) odk Y ```
``` pmrsufES m (6) rS tquf
vkdtyf &if txl ;"mwf rSef½kd ufzkdY vnf;vkd r,f/
'geJY vnfacsmif;txl;uk q&m0efqDa&mufawmhvnf; q&m0ef ud k t*F vd yf vk d bJ &S if ;jy vk du fy gw,f / q&m0 efu vnf ; t*Fvdyf vkd wwfw,f? A rmvkdvJ xrif;pm;a&aomuf ajymwwfw,f/ 'geJYzkd;uD ;&JU
vnfacsmif;xJudk Fiberscope
vkd Yac:wJ h rS efajymif ;xnf hNyD ; t pm>yefvrf;aMumif ;xJud k Munh f
ygw,f/ a&m*gawGUygNyD/ tJ'D a&m* gu GERD vk dY ac :y g w, f/ Gastro-esophageal
Reflux Disorder vkdYac:w,f/ tpmtdrfxJ u tufqpft&nf awG txuf udkvS efwuf NyD; t pmjyGefeH &Huk d a,mifukdif;apwJh
a&m*gjzpf ygw,f/
GERD jzpf&jcif ;taMumif ;rsm;
1/ t&ufaomuf? aq;vdyf aomufrsm;ol
2/ 0NzdK;ol odk Yr[kwf uk d,f 0ef aqmifrsm;
3/ tudkuf tcJaysmuf aq; t vG ef trif; oHk ;pGJ olrsm;
4/ pdwfzdpD ;rI cHpm ;&olrsm ;
(GERD jzpf Ny D; a0'em aMumifh pdwfzdpD;rI cHpm;& vQif a&m*gykdqd k;ygonf )
GERD \ a&m*gvu© Pmrsm; 1/ vnfyif;emjcif;? vnfyif ;
xJw Gif wckckwpfq kdY ae onf[k cHpm;&jcif;/
2/ &ifbwf xJwG if ylavmifem usifNyD; wcgw&H aemuf
ausmbuftxd emusifrI ysHUEk difonf/
3/ ac sm if ;a jc mu fq dk ;j ci f; ?
acsmi f;qkd ;onfhtcg tm acgif emjcif ;/
4/ tpmraMuovk djzpf NyD ; av csOfwuf jcif ;/
GERDa&m*g[k wf r[k wfppfaq;enf ;rsm;
1/ vnf acsmif ;xJ ok d Y rS ef ajymif ; xnhf Munh fjcif ;/
2/ Barium Swallow ac:onhf
aq;jzL&nf wrsd K;aomuf NyD ; "mwf rSef ½k dufjcif ;/
3/ tpmjyG efxJ ok dY u&d ,mwck xnh f NyD ; tuf qpf "mwf rsm; rrsm;prf ;oyfjcif ;/
4/ tpm>yeftom;p erl em,l
jref rma&T Uajymif ; odapaMumif ;
7/27/2019 Nightingale Health Journal (September-2013)
http://slidepdf.com/reader/full/nightingale-health-journal-september-2013 9/16
usef ;rma&;*sme,ftrS wf-37? puf wifbmv? 2013-ckES pf NIGHTINGALE 9
wday;rIpepfu vlawG&JU OD; aESmufu cHpm;rI? aphaqmfrIeJ Y taBumufw&m;awGud k xdef; csKyf xm;wJ h OD ;aES muf &J Uae&mawG eJ Uvnf; qufoG,faeygw,f/
obm0pdwfzdpD;rI wkefYjyefcsuf 0½kef ;okef ;um; jzpf vmwJ htcg
cE¨mudk ,f &J U pd wf zd pD ;rI wk ef Y jyefwJ hpepfu trsm;tm;jzifh ud k ,f wd k if uef Yowf rI &S d ygw,f/ od em;vnfxm;NyD ;jzpfwJ h Ncd rf; ajcmuf rI wckvG ef ajrmuf oG m;NyD ; wJh tcsdef rS m a[mfrkef;tqif hu yH k rS ef jyef jzpf oG m;ygw,f/ t'&D evif eJY aumfwD qdk;vf yrmP usvmwJhtwGuf vlawG &JU ES vH k;ck efEIef;eJ U aoG;zd tm;u t
ajccH tqif h ud k jyef a&muf oG m;NyD ; wjcm;pepf awG uvnf ;ol wd k U&J U yHkrSefvIyf&Sm;rI awG udk jyef pvkyf vmBuygw,f/
'gayr,f h pdwfzdpD ;rIud k jzpf apwJ h t&mawG tNrJ yJ &S d aewJ h t csdef rS mawmh vl awG [m tpOf w pd k uf twd k uf cd k uf cH ae&w,f vd k Y cHpm;ae&NyD ; wdkuf rvm; ajy;r vm;qd kwJh tajctaewkefYjyefrI [m quf &S daetHk;rSmygyJ/
pdwfzdpD;rI wkefYjyefpepf&JU a&&Snf vIyf&S m;aqmif&G ufa&; twGufjyifqifrI eJY aemufydkif; aumf wD qd k ;vf eJ Y wjcm; pd wf zd pD ; rI a[mfrkef ;awGudk tvGeftuRH cH vm&wmawG u vl awG &J U cE¨ m ud k ,f vk yf ief ;pOf awG tm;vH k ; eD ; yg;ud k &yfqd kif;oGm;apEdki fyg w,f/ tJ'gu - ylyifaomu - pd wf"mwf usrI - tpmacsrIqdk if &mjyóem - ES vH k;a&m*g - ttdyfqdk if &m jyóem - udk ,f tav;csd efwd k;vmrI - rS wf ÓPf eJ Y tm½H k pl ;pd k uf Ed k if rI tm;enf;avQm hyg;rIawG tyg t0if rsm;jym;vSwJ husef ;rma&; jyóemawG jzpfvmEdkifwJ h tEÅ &m,f ud k wdk ;rsm;vmapygw,f/
tJ 'gawG [m vlawG &J U b0 rSm pd wfzd pD;rIud k jzpf ay:apwJh t&mawG udk ukd if wG,f xdef;csKyf
zdk Y aumif;rG efwJ h enf;vrf ;awG ud k od em;vnf xm;zd k Y ta&;BuD ; &wJ h taBumif;ygyJ/
jzpf vmEdk ifajc&Sd wJh pdwfzdpD ; rIrsm;wJh jzpf &yfwcktay: vl wa,muf&JU udk if wG,f wkefYjyef rI [m wjcm; wa,muf a,muf &J U wk ef Yjyef yH k eJ Y rwl ygbl ;/ vl w
a,muf &J Ub0rS m pd wf zd pD ;rI jzpf apwJh t&mawGudk udkifwG,f wkef YjyefrI[m atmufrSmazmf jy xm;wJ h tcsufawG vdk rsd K;awG &J U oufa&muf rIaBumif h jzpfEdkifyg w,f/
rsdK;½d k ;ADZ/ pd wf zd pD ;rI wk ef Yjyef csufu dkxde f;cs KyfwJh rs dK; ADZ qJvfawGu vltrsm;pkrSm t ajccHt& tawm fav; nDrQ ygw,f/ wcgwav avmuf yJ wd kufrvm; ajy;rvm; tajct aerSm cE¨mudk ,ftwGuf vd ktyf
csuf awG ud k jznf h qnf ;ay;wwf wmyg/ twuf<uvG ef 'grSr [kwf rwufr<u pdwfzdpD ;rI wk ef Yjyef rI awG uawmh tJ 'D rsd K;AD Z qJvfawGxJ u tenf ;tyg; r wluGJjym;rIav;awG zGHUNzdK;jzpf ay:vmwm jzpfEdkifygw,f/
b0tawGUtBuHK/ tm ; aumif ;wJh pdwf zd pD ;rI wkefYjyef rI awG [m wcgw&H pdwf'Pf&m 'Pfcsu f jzp fapwhJtjzpft ysufawGu pvmw,f qd kwm awGU&ygw,f/ uav;b0u
vpfvsL½Iwm 'grSr[kwf ESdyf
pdwfzdpD;rIxdef;csKyfEd kifrIeJ Yusef;rma&; emwm&Snf pdwfzdpD ;rIu
usef;rma&;ud k tEÅ &,f &S d vmap Edk if? vlawG&JU pdwf ydk if;eJU cE¨ m udk,fudk qdk;0g;vmapE dkifyg w,f/
vl awG &J U cE¨ mud k ,f [m ol U udk 0g;Nrd Kacszsufypf csifol awG eJY wjcm;&efvd k xdyg;vdkol awG &JU Ncdrf;ajcmufrIudk tumt uG ,f ay;zd k Y pd wf zd pD ;rI awG ud k wk ef U jyefEdki fatmif arG;uwnf;u zef wD ;xm;NyD ;jzpfygw,f/ 'D vdk Ncdrf;a jcmufrI awGu 'Duae Y acwfrSmawmh &Sm;yg;vmNyDvdkY qd k &rS m jzpf ayr,f h b0[m pd wf zdpD;rIawGuae vG wfuif;aeNyD vd kYawmh ajymvd k Ur&ao;ygbl ;/
qef Yusif buftaeeJY BuD ;
rm;wJ h tvk yf yd rI ud k wm0ef ,l ae &wm? xrif;eyf rS ef zd kY vk yf &wm awGeJ Y udk,f h rdom;pkudk apmifh a&Smuf&wm pwJh trsdK;rsdK; t axG axG vd k tyf rI awG ud k &if qdk if ae&r,fqdk wmuawmh aocsm ygw,f/ vl awG &J U cE¨mud k ,f u tJ 'D ti,f pm; jyóem tcuf tcJ awG vd k Yac:wJ h [mawG ud k ud k if wG,f aqmif&Gufay;ygw,f/
&v'f taeeJ Yuawmh vl awG [m tpOf wpd k uf wd k uf cd k uf rI ud k cH ae &wmjzpfw,f vd k Y cHpm;vm&Edk if ygw,f/ 'gayr,fh vlawGu jyefNyD;ckcHwd kufcdk ufEdkifygw,f/
vlawG u olwdk Y&JU b0awGudk pdwfzdpD ;rIu xdef;cs Kyfwmudk cGif hjyKaep&m rvdkygbl;/
obm0 pd wf zd pD ;rI wkef Y jyef csuf ud kem;vnf jcif ;
vlwa,muf[m odem;
vnfxm;NyD ;jzpfwJ h Ncdrf ;ajcmuf
rIwckudk &ifqd kif&wJ h tcsdefrSm
Oyrm. . reufy dkif ; vrf; avQmufaewHk; acG;tBuD;BuD; waumif ua[mif aewmrsd K;rS m vl awG &JU OD;aESmuf tajcyd kif;u
ao;i,fw Jh ae&muav;u cE¨ mud k ,f owd ay;pepfud k vI yf &S m;vmapygw,f/ tm½H k aBumeJ U a[mf rk ef ; aygif ;pyf trS wf oauF wawGuwqifh tJ'D pepfu t'&Devif eJ Y aumfwDqdk ;vf wd kY tygt0if a[mf rkef;awGud k t vH k ;t&if ;eJ Y xk wf vT wf zd k Y vl awG &J Uausmuf uyf xd yf rS m&S d wJ h t'&D e,f *vif ;awG ud k tvk yf vk yf vm apygw,f/
t'&D evifu vlawG &JU ESvHk ;ck efEIef;udk jrif h
wufvmap? aoG;zd tm;udk jrif hwufvm apjyD; pGrf;tifjzpf vmap Ed k if wmawG ud k jr§ if h wif ay;yg w,f/ tajccH
pdwfzdp D;rI a[m fr kef ;
aumf wD qd k ;vf u aoG;aMum awG xJrS m *vl;
ud k Upf oBum;"mwf udk wdk ;rsm;vmap NyD; OD ;aESmuf&JU * vl ;udkUpf toHk; jyK rIud k tm;aumi f; vmapovd k wpf ½S L; awGudk jye fvnf jyifqifay;EdkifwJh t&mawG &&S d Edk if rI
ud k vnf ; wd k ;
pufwmcH cJh Bu&wJh vl awG[m txl ;ojzif h pdwfzd pD ;rI jzpfwwf ygw,f/ tMurf;zuf &mZ0wf rI awG&JU om;aumifawGeJY av ,mOf ysuf uswmrS m touf&Sif usef &pfolawG? ppfom;awG? yk vd yft&m&S dawGeJ Y rD ;owf orm; awG[mvnf; tvm;wl jzpf
wwfygw,f/ vl awG &J U wcsd KUrd wf aqG awG
rS m t&mtm;vH k ;eD ;yg;rS m aemuf qkwfoGm;wwfwJholawGeJY t ao;rTm;qH k; pd wfzd pD ;rIrS mawmif cdkifrmtm;aumif;wJh wkefYjyefrI vk yf wwf wJ h wjcm;ol awG vnf ; &Sd Ed kifygw,f/ b0&J U pdwf zd pD;rI jzpf p&mawGudk wkefYjyefrItrsm; pk [m tJ 'D tvG ef tuRH jzpf rI awG Bum;rS m Nyd KvJ oG m;wwf ygw,f/
b0&JUpdwfzdpD;rI jzpfp&mawGudk
aumif ;rGef wJ henf ;vrf ;eJ Ywkef Y jyef zd k Yoif ,l jcif ; pd wf zd pD ;rI rsm;wJ h jzpf &yf awG
[m b0&J U wu,f h trS ef w&m; awGygy J/ vlawGu ukd,fh&JU vuf&Sd tajctaeudk ajymif;vJ vdkY r&Edk ifwmr sdK; jzpfEdkif yg w,f/ 'gayr,fh vlawGtay: jzpf&yfawG &JU oufa&mufrIudk udk if wG,f xd ef ;csKyfEdkifwmawG u k d olwdk Yud k,f wdkif vkyfEdkifBu ygw,f/
vl awG u olwd kYud k zdpD ;ae
wmawG[m bmqd k wm azmf
rsm; vmapygw,f/ aumfw Dqdk;vfu wdkufr
vm;? ajy;rvm; qd kwJh tajct aewckrSm rvdkty fwJh 'grSr [kwf tzsuftqD; jzpfapwJh vkyf ief;aqmifwmawG udk vnf; xd ef ;csKyf ay;ygw,f/ ol u a&m *gNyD ;pepf &J Uwk ef Yjyef rI ud k ajymif ;
vJoGm;apNyD ; tpmajcpep feJU rsdK;yGm;pepf? zGHUNzd K;BuD;xGm;rI p epfaw Gudk &yfwe fYoGm;apyg w,f/ 'D ½I yf axG ;wJh obm0 o
aqmifzd kY oif,l Ed kif ovdk pdwf zdpD;rI rsm;jym;wJh tajctae awGudk &ifqd kif&wJhtc sdef rSm ½kyfydkif;t&eJYpdwfvIyf&Sm;rIt& ud k ,f h ud k ,f ud k b,f vd k *½k pd k uf & r,f qd k wmud k vnf ; oif ,l vd k Y& Ed kif ygw,f/
pd wf zd pD ;rIxdef ;csKyfa&; r[mAsL[m xJ rS m - usef;rma&; aumif;apwJh tpm;tpmawG pm;? avh usif h cef ; rSefrS efvk yf? rsm;rsm;tdyfyg/ - tem;,l tyef ;ajzwJ h enf ; pepfawG udk vk yfyg? 'grSr[kwf pdwfudk wnfNidrfatmifvky fzdkY oif ,lyg/ - aumif;rGef wJh rd wfaqG&if; csm aygif;oif;qufqHa&;udk wnf aqmuf yg/ - [mo"mwf cH &S dygap/
- vd k tyf wJ h tcsd ef rS m uRrf ;usif ol awG&JU tBuHÓPfudk &,lyg/ pd wfzd pD ;rIudk xd ef ;csKyf Edk if zdk Y
oif,l avh vmwm[m pdwf &JU Nid rf;csrf ;rI eJ Y yd k rd k aumif;rGef &S nf BumwJh b0ud k &&Sd vmapEd kif yg w,f/
pdwfzdp D;rI rsm;aeayr,fh rsm;rS ef ;rod Bu tajz&S mr& jzpf aeBuwJ h jref rmEdk ifiH om;awG t wG uf owdjyKEdkif Buzd kY rQa0ay; vdk ufwmyg/
pd k ;aevif ;Ref; Mayo Clinic staff
``` pmrsufES m (8) rS tquf
p d k ; a e v i f ;
NyD; ppfaq;jcif;/
GERD ukoenf ; 1/ t&uf? aq;vdyf? uGrf;
a&SmifMuOf &rnf/ 2/ tyltpyf i½k yf oD;? csOfzwf?
tcsOfwnfxm; aom t pm;tpmrsm;? aumf zDa&S mif &rnf/
3/ tpm;taomuf yrmPukd enf;enf;eJY rMumcP pm; &rnf? wcgwnf ;Ak d uf wif; atmif rpm;&yg/
4/ ntd yf &if acgif ;tH k ;jrif h jrif h eJ Y tdyf&rnf? 0NzdK;oljzpfvQif tav;csdefavsmh &rnf/
5/ tpmtd rfxd ckd ufapaom t udku ftcJ aysmufaq;rsm; a&Smif Munf&rnf/
6/ GERD ukoaomaq;0g; trsd K;pH k&S dygonf/ tpmtdrf aq;tjyiftema,mif ud k if ; rI oufomapaomaq;? tpmtdrf rS tufqpftcsOf "mwfx kwfrI avsmhyg;ap aomaq;? tpmaMuaq;? tpmtd rf <uuf om;rsm; oef rmapaomaq;rsm;udk q &m0efu nTefMum;ygvdrhf rnf/
7/ aq;uk ocsdef 6 vcefYMum
jrif hrnf? 6 vvH k;vHk ; q&m 0ef nTefMum;aom aq;ud k rS ef rS ef rysuf ruG uf aomuf zk dY vkd tyfygonf/
aq; 6 vaomufNyD; roufom&if bmquf vk yf&rvJ
1/ aq;u dk wu,frS ef rS ef aomuf&if a&m*gaysmufzkdY 95% ausmf aocsmygonf/
2/ wu,f vk d Y rouf omcJ h vQif bmqufv kyf&r,fqkdwm vnf acsmif ;txl ;uk q&m0ef u qHk ;jzwfygvdrfhrnf/
3/ tpmvrf ;aMumif ;>yef ES if h t pmtdrfqufaomae&mudk cGJpdwfjyifqifvkdY&Ekdifaom ukoenf ;vnf ; &S dy g onf/ vlemtrsm;pkrS m cG J pdwf&efrvkdbJ aysmuf uif ; Muygonf/
zk d ;uD ;&J Uoifcef ;pm 1/ vlemESifhq&m0ef? vl emESif h
usef;rma&;vkyfom; Mum; rSm Communication (quf oG,frI) t&rf;ta&;BuD; ygonf/ vlemu rdrd &J U a0 'emcHpm;rIukd aoaocsm csm ajymjywwfzkdY vkdtyf ovk d q&m0ef? usef ;rma&; vk yf om;u vl emajymwmuk d
pd wf &S nf &S nf eJ Y av;av;pm; pm; em;axmifoih fonf/
2/ bmomjyef eJY pum;ajym jcif ;ud k rjzpf rS vk yf yg/ wk d uf ½kd ufpum;ajymjcif;[m t xda&mufqHk ;jzpf ygonf/
3/ a0'emwpH kwckudk pdwfpGJ vk dYjzpf wJh pdwfa&m*gvk dY t vsifpvkdrowfrSwfbJ w u,f a&m*g&S d r&S d uk d aocsm pGmppfaq;NyD;? wu,fudk a&m*gr&S drS 'g[mpdwfpGJvkd Y jzpf wJ h a&m*gvk d Yowf rS wf yg/
4/ t&uf? aq;vdyfeJY uGrf; [m b,fawmhrS b,folU udkrS aumif;usdK;ay;aom t&mrsm; r[k wfwmrk dY a0; a0;u a&Smif Muyg/
5/ a&m*gjzpf vQif od yÜ H enf ;us uk ojcif ;[m txufvrf; atmu fvrf ; ukojci f; enf;xufykdNyD; vufawGU usus aysmufuif;apEkd if wmrdk Y ,HkMunfyg/
6/ q&m0efnTefMum;c sufu dk ,H k Munf av;pm;NyD ; aq;ud k aq;ywfvnfNyD;qHk;onf txd oHk ;pG Jyg? rd rdoabmeJ Y aq;udk rjzwf ygeJ Y/
]tm;vHk ; usef;rm
&Tifvef ;Muygap }
a'guf wm cifapm0if ;
7/27/2019 Nightingale Health Journal (September-2013)
http://slidepdf.com/reader/full/nightingale-health-journal-september-2013 10/16
usef ;rma&;*sme,f trS wf-37? puf wifbmv? 2013-ckES pf10 NIGHTINGALE
]]jref rmwd k if ;&if ;om;rsm; xJ rS taemufwdkif; aq;ynmudk yxrqHk ; vdk uf pm;cJh ol? tar&d uef jynf axmifpk uvdAfvif ; aq;aumvdyf rS q&m0efbJ GYESifh *kPfxl;aqmif r[m0dZÆmbJGYudk yxrqH k ;&cJ h ol? td E´ d ,ES if h tar &d uefodk Y udk ,f xl ;ud k,f cGsef pG efY pm;um ynmoif oGm;a&muf cJh
NyD ; c&pf ,mef aumif ; yD opG m q &m0efynmESifh ausmi f;q&m vkyfief;udk tcaMu;aiG t"d u rxm;bJ qif ;&J om;rsm; tusKd ; aqmif &G uf cJ h aom y&[d wynm &SifwOD; jzpfonf/}}
a'gufwma&Smvlud k 1839 ck ES pf? Zef e0g&D v 1 &uf aeYwG if armfvNrdK ifNr dKUwGif zGm; jrifcJh onf/ tz OD;a&Touf? trd a':zGm;vS wdkY\ om;tBuD;qHk ;
jzpfonf/ od kYaomf OD;a&Touf \ t&uftvGeftuRHaomuf jcif;aMumifh 1854 ckESpfwGif a':zGm;vSESifh vrf;cGJcJhMuav onf/ rdbrsm;\ tdrf axmif a&;*,uf aMumif h a&S mvl av;ud k trsdK;rsm;u wm0ef,l apmifh a&S muf Mu&ayonf/
1856 ckESp f? a&Smvl t ouf 15 ESpf t&G ,fwGif td rfrS pGef Ypm;í xGufajy;um tdE´d, Edk ifiH umvuwåm;ü oGm ; a&muf ynmoifonf/ oH k;ES pf cefYtMumwGif tdE´d,wyfwG if ppf bm&D yk ef uef rI BuD ; ay:ayguf vm&m tdE´d,ü quf vuf y nmoif&ef tcuftcJ BuHKvm &onf/ 1857 ckESpfwGif jref rmjynfod k Yjyef NyD ; oif ;tk yf q&m OD ;a&Tat;rS ESpf jcif ;ay;um ½G dKif ,,f vd uf (,ck uef awmf BuD ;)
wG if ES pf jcif ;c&pf ,mef bmom cH ,lcJ h onf/ 1858ckES pf wGif jrefrmEdk if iH
oHk ;q,f Nrd KUwG if c&pf,mef om oemjyK q&mrMuD ; rpö rm&D ,m tifa*gES ifh awGYqHkcJhNyD; q&mr BuD;\ ulnDrIjzifh tar&duef od kY ynmoif vdkuf ygcJhonf/ q&mrBuD;rS m tm;vyf &ufwGif tar&duefodk Y acwåjyefjcif; jzpf&m armifa&S mvl ;u awGYqHk NyD ; tusKd ;taMumif; ajymjycJh onf/ ynmvdkvm;ol armif
a&Smvl; taMumif;udk q&mr BuD ;u oabFmuy Üwde ftm ; wqif h ajymjyay;onf/ vrf;c &D ;w Gi f oabF mctw Gu f oabFmpm;aomufcef; pm;yJG xd k;tjzpf 0if a&muf vk yf ud k ifcJ h & onf/
1857 ck ES pf ES pf uk ef yd k if ;wG if e,l;a,mufNrd KUodkY a&muf &S dNyD; xdktcsdefu e,l;a,mufwGif vlOD;a& woef;ausm f om&dS
onf/ e,l ;a,muf rS uk ef onf wOD ;\ taxmuf tyH hjzifh yif q,f aA;eD;,m;jynfe,f vl 0Dp Awf wuú odkvf (1886 rSpí bufe,fvfwuúodkvf tjzpf trnf ajymif ;vJ onf) ü 1859 ck ES pf wG if ynmoif cG if h &cJ h onf/ ynmoif Mum;&if ; tm;vyfcd sef
rsm;wGif tvkyf rsdK ;pHkvkyfc Jh& onf/ t,ltqqdk if&m yg armu©MuD; a'gufwmaomvf rwf tufzfumwpf \td rf wGif wem&D q,f qif h jzif Y tvk yf vk yf ud k if &if ; wzuf wvrf ;rS 0if aiG &,lcJhonf/ ausmif;ydwf&uf rsm;wGif tjcm;Nrd KUBuD;rsm;odkY oG m;a&muf um jrefrmY"avYESifh jref rmvl rsKd ;rsm;taMumif ; a[m ajymjcif ;jzif h 0if aiG &S monf/armif a&Smvlonf vl0DpAwfrS a[m ajymyG J rsm;wG if vnf ; jref rm,Of
aus;rI "avh p&d k uf rsm;ud k vl 0D p Awf y&dowfr sm;E Sifh &if;ES D; uRrf;0ifrI&Sd atmifvnf; a[m ajymEdk if cJh oljzpfonf/
armi fa&Smvlonf 1864 ck ES pf wG if vl 0D pAwf wuú od k vf rS 0d ZÆ mbJ G Y&cJ h onf/ 0d ZÆ mbG J YtwG uf *&d? vufwifbmom pum; rsm;? ocFsm? obm0 odyÜH? eu© wåaA'? "mwkaA'? edkifiHa&;? abm*aA'? zD vd k qd k zD? pd wf ynm ES if h tar&d uef zG J Upnf ;tk yf csKyf yH k Oya'wdk Yud k oif,l cJh onf/ xdk
tcsd efu tar&duefwGif jynf wGif ;ppf jzpf yGm;qJ jzpfonf/ bDatbJG Y&NyD;aemuf armif
a&S mvl onftd k [d k if ;,d k ;jynf e,f uvd Af vif ;&S d csd KUwJ h ol rsm;aq; aumvdy f (Charity Hospital
Medical College) ü aq;ynm qu fvuf qn f; yl ;onf / 1867 ck ES pf wG if aq;yg&*l trf 'DbGJ U&onf/ *kPfx l;aqmif trf atbJGYvnf ; cDs ;jr §if hcH &
jzpf onf/ c&pf ,mefbmom0if rGef vlrd sK;jzpfonf/ armf vNrdKif wGif c&pf,mef omoem jyK a'guf wm*s'f qif ES if h td rf eD ;csif ; jzpfonf/ uav;b0u armf vNrd Kif wGif a'gufwm *s'fqif tm; aq;ukoay;rnfh q&m 0ef r&d S í tar&d uef od k Y oabF m jzifh jyef oGm;&onf h a'gufwm
*s'f qif\tjzpf udk BuHKawGUcJh & onfh tcdsef rSpí armifa&Smvl onf q&m0ef jzpf &ef &nf rS ef;cJ h onf/ a'gufwma&Smvl \ q &m0efr jzpfrD i,fpOfb0rsm; um; Murf ;wrf;vS ayonf/ ol onf i,f pOf u ynmoifMum; a&;udk pdwf tm;xufoef onf/
ol\zcif OD;a&ToufrSm t*F vdyf t&m&Sd rsm;udk jref rmpm jyol txl ;qk&xm;ol jzpfol
a'gufwma&S mvl xl ;cRef xif&S m; aq;orm;
pmrsufES m (13) od kY ```
pm;ol awG vJ 0Ed k if wmyg/ <uuf om;awG rmwif;NyD; oef csif &if awmh tom;pm;olrsm ;u ydk omygw,f/
pd wf vI yf &S m;rI awG [m u,f vdk&Dtawmf jzKef;ypf w,f/ 'gh aMumifh pdwfat;at;xm;yg/ vGrf ;p&m0wå KawG rzwfeJU / a[mvd 0k 'f u o&J um;? ]atvD ,ef} um;? tuf&Sifum;awG rMunfheJY? Zmwfremematmi f ½d kufxm;wJ h udk&D;,m;um;? uk vm;um;awG rMunf heJ U/ Arm awG 'gaMumifh ydefaewm/
pm;cd k if;wmawmh [k wf ygNyD? pm;csi fpdw f ydkaumif ;atmif b,fvdkvkyfrvJ/ ADwmrifbD tk yf pk aq;awG u taxmuf tyH h jyKygw,f/ Cyproheptadine
(Cypon) qd kwJ haq;u ]tvm*sD} pwmawGtwGuf jzpfayr,fh
Anorexia nervosa ac:wJh pm; csifaomufcsifpdwf enf ;aeol awGudk vJ ay;Edkifygw,f/ u av;awG[m eJeJav; jzpfvd kuf wmeJ Y usoG m;? yd ef oG m;jzpf wwf w,f/ Cypon wdk uf &ifvnf; c PeJY jyefpm;csifvmMur,f/
aemuf wcku tpyfpm;wJh vl? rqvmBud Kuf ol? tcsOf ygrS qd k ol awG cH wG if ;awG U&if pm;om pm;ygav/ tpyfwdkY? [if;cyf tarT;tBudKifwdkYqdkwm pm;csif vmatmif vkyfay;wJ h wefcd k;&Sd w,f/ w½k wf eH eH (BuH rqd k if ) cyf xm;wJ h [if ;csd K&nf u yd k csd Kovd k
r[k wf vm;/ ]ES mnG ef Yud k jcLwwf aom} qd kwJh tpm;aygh/
i½kwfoD;u rwl wJhtusd K; ESpfrsdK;&apygw,f/ tpyfawG [m u,fvdk &D yd koHk;vdkY ydef ap w,f/ tpyfygrS pm;csifpdwf ydkvd kY 0apr,f/
onf/ aq;ynmoif Mum;rI NyD ; qH k ;aomtcg armif a&S mvl onf tar&duef orw tif'½l;*G sef qif ud k oG m;a&muf awG UqH k cG if h & cJhonf/ tar&duef or®w\ rif;wkef;rif;xH ay;tyfaom o0PfvTmud k vufcHí 1867 ck ES pf? atmufwd k bmvwG if jref
rmjynf odk Y jyef cJ honf/ vrf;c&D;ü vef'efwG if w
v? yg&D wG if wywf em;ae avh vmí at'if? oD[d kVf? umv uwå m;rS wqifh jrefrmjynf odk Y jyefvmcJhonf/ xdk tcd sefu pl; tuf wl;ajrmif; razmuf&ao; acs/ 1868 ck ESpf? ZG ef vwG if t ar&d uef or® w\ o0Pf vT mud k rif ;wk ef ;rif ;xH quf o&ef rEÅ av;odkY qefwufcJhonf/ o &ufNrdKUta&mufwG if rif;wkef; rif;\ jreef ;pMum a&,mOfES if h
rEÅ av;od kY c&D ;quf onf/ rif ; wk ef ;rif ;onf a'guf wma&S mvl udk aumif;pGm vufcHawGUqHk onf/ eef;wGif ; ajrmuf O,smOf awmfü taqmifwc kay;um eef ;wG if ;pm;awmf tk yf ud k aeYpOf ydkYaponf/ &uf 20 cefYMum aomf atmufjrefrmjynfjyefí ausmif;q&mESifh q&m0ef vkyf ief;rsm; aqmif&GufcGif h awmif; onf/ rif;wk ef;rif ;u cG ifh jyKí qkvmbfESifh aiG'*Fg ;rsm;u dk vnf ; cDs;jr§ if hcJ honf/
a'gufwma&Smvl onf &ef ukef wGif t*F vd yf tpd k;&\ tm; ay;ul nDrI r&aomaMumif h rk wå rü udk,fydkifausmif ;zGifh um t oufarG;onf/ 6 v tMum wGif arm fvNrdKi f atbDtrf ausmif;ü q&m tcuftcJawG Y &m q&mtjzpf 0ifa&muf ulnD cJh onf/ atbDtrfausmif;wGif 10 ESpfcefY q&mtjzpfaqmif &G uf onf/
xdk Yaemuf aus;Zl ;&S if q&m rBuD ; rpörm&D,mti fa*gudk aus;Zl ;wH kYjyef aomtm;jzif h oH k; q,f jrd KU tar&d uef omoemjyK q&m0efrBuD; a'gufwm t,f vif rD cs,fxH wGif vuf axmuf q&m0eftjzpf 10 ESpf xrf; aqmif jyD ;aemuf armf vNrd Kif üyif
ud k ,f yd k if aq;cef ;zG if h onf/ qif ; &JEGrf ;yg;olrsm;udk tcaMu;aiG r,lbJ aq;ukay;onf/ t ouf BuD ;&if h onf h wd k if vl em&d S &m odk Y udk ,f wdk if vd kufí aq;uko onf/ wzuf wG if vnf ; armf v Nrd Kif tpdk ;&ausmif;ESifh aemfref ausmif;wd k YwG if ausmif ;tkyf csKyf a&; tzJGU0iftjzpf aqmif&Guf onf/
a'gufwma&S mvl onf &ef uk ef tpd k ;&txuf wef ;ausmif ; ü q&mtjzpf wm0ef xrf ;aqmif
aepOf t*FvdyftrsdK;orD; rpö vl pDy&J ,m;ESifh tdrfaxmif jyKcJh NyD ; om;orD; 7 a,muf (om; av;a,muf? orD ; oH k ;a,muf ) xG ef ;um;cJ h onf/ ZeD ;uG ,fvG ef í 2 ESpftMumü tar&duef omoemjyK rd ef ;uav;ausmif; rS ausmif ;tk yf a':a&TES ifh xyfrH td rf axmif jyKonf/ om;orD ; 3 a,muf (om;wa,muf? orD; ES pf a,muf )&onf/
a'guf wm a&S mvl onf armf vNrd Kif Nrd KUü 1929 ck ES pf? atmuf
wd kbmv 10 &uf eH euf 5;30 wG if uG,fvG efcJh onf/ a'guf wma&Smvl\ psmyerSm pnf um;vSonf/ c&pf,mef bk ef; BuD;rsm;omru jrefrm bkef; awmf BuD;rsm;yg wufa&mufcJY MuaMumif ; rS wfwrf;rsm;u qdk onf/
&nf ñTef ;/ armifaZ,sma&;om;wJ h ]jref rmvlausmf100
(yxrtk yf )
udk,fcE¨ m BuD;xGm;apwJ h a[mfrkef;qdk wm vlYOD;aESmufu ae xkwfay;aew,f/ tav;r ol rsm; <uufom;awG oefrm vmwm olYtpGrf ;yg/ obm0 r[k wf bJ tyd k aqmif ;csif ol awG twG uf pwD ½Gd Kufa[mfrkef ;aq; aw Gv J &S dy gw,f / Human
Growth hormone (HGH),
Growth factors and Testoster-
one-based analogs qd kwmawG yg/ 'D aq;awG ud k t&G,f vG efol a,mufsm;awG twGuf a&m tm; upm;orm;rsm;twG ufyg oHk; aewmjzpf w,f/ td kvHypf qkwH
qd yf jyef tyf olawG renf ;awmh bl; r[k wfvm;/ a[mf rkef;qdk wm tpGrf;BuD;ovd k owdBuD; BuD ;vnf ; xm;oH k ;&wmrsd K; jzpf w,f/
*syef qlrdk eyrf;orm;enf; u ]u,fvdk&Drsm;wJ h tpmawG
pm;? tqDrrsm;apeJY}/ tifql vif qd k wJ h oMum;"mwf xd ef ;wJ h a[mf rk ef ;ud k qG ay;vd k Y? u,f vd k &D rsm;&if odrf;xm;wJh tqDudk xkwfoH k;p&m rvdkawmhbl ;/
wcgwnf; rsm;rsm;pm;Edkif atmif wcsdKUu reufapmapm pm rpm ;bJ aew,f/ olv dk udk,f vdkawGu waeYrS 2000- 3000 om pm;w,f/ qlr dk ey rf ;o rm ;aw G waeYud k u,fvdk &D 6000 uae 20000 txd pm;owJ h/ t&uf bD,m vnf; aomu fygwJh/ olvd k udk,fvd kbJaygh/ wxdk ifxJ bD
,mAl; 100 ukef olqdk wm&Sd qdk bJ/ avhusifhcef ;udk ydkNyD ;? jyif ; jyif ;xef xef? aeYpOf rS ef rS ef? vk yf wmaMumifh pm;csif pdwf awG ydk vmapw,f/
ud k ,f tav;csd ef wd k ;csif wmeJ Y a[mf rkef;aq; vHk;0 rnTef yg/
roH k;ygeJ Y/ rsuf pd atmuf rS mwif tvGe f0Ny D; tvSvnf;ysuf? a&m*gvnf; quf &wJh rdef;u av;awG&Sdw,f/ t&yftac: 0ufaq;qd kwmaomufowJh/ apmf um;ovdkawmhjzpfr,f? w u,f0uf eJ Ywl vmw,f/ jyef jyif ,l vd k Y r&awmh wJ h tajctaexd a&muf oGm;&S mMuw,f/
wufpwdkpwD½kef; (Testo-
sterone) ac:wJh a,mufsm; a[mfrkef ;aq; oHk;wmawG &Sd yg
w,f/ t&G,f vGef aoG;qHk ;jyD; aemuf trsdK;orD;BuD;awGoHk; wmu twlaecsifpdwf quf xd ef ;zd kYvd k rS om q&m0ef u nT ef w,f/ um,AvtwG uf <uuf om;awG a,muf sm;awG vd k jzpf zd k Y rSmvnf;oHk ;w,f/
Estrogen tDpx½d k* si f a[mfrkef;rSmvJ ab;xGufqdk; usd K;awG ursm;w,f/ trsm;oHk ; wmu aoG ;qHk;umeD; trsdK;o
``` pmrsufES m (6) rS tqu f
7/27/2019 Nightingale Health Journal (September-2013)
http://slidepdf.com/reader/full/nightingale-health-journal-september-2013 11/16
usef ;rma&;*sme,ftrS wf-37? puf wifbmv? 2013-ckES pf NIGHTINGALE 11
xdk odkY q&mBuD ;awG&JU awGY &Sd csuf awG ud k usuf rS wf avhvm &ovdk wwd, MB rSonfFinal (aemuf qH k ;ES pf ) txdvl em
eJY avhvm&mwGif vnf; q&m BuD ;awG &JU prf;oyfenf ;rsm;udk od &S d rS wf om;&ygw,f/
tNzp frsm ;wJh a&m*gawGeJ Y prf;oyf enf;rsm;udk rSwfom;rd orQ wifNyay;ygr,f/
'D aqmif ;yg;awG a&;aeNcif ; rSm vli,frsm;twGuf OD;wnf
xm;ygw,f/ yd k rd k em;vnf wwf uRrf;o lrsm;u trSm;t,Gif; rsm;ud k axmuf NyMuyg&ef eJ Y ar; vmaom ar;cGef ;rsm;u dk ajz Mum;ay;Muyg&ef arwåm&yfcH tyfygw,f/
Cheyne-Stokes respiration
touf½SLEIef ;ajymif ;vJ wm touf½S L Nr ef aer, f?
aemuf aES ;vmr,f? aemuf awmh puú ef Yrsm;pG mtxd touf ½SL&yf oGm;r,f/ OD ;aESmufrSm&SdwJh t ouf ½SLrI xdef;csKyfwJ hae&mawG ysuf pD ;aewJ htwG uf Nzpf w,f/ arsmaewJh Coma vl emawGrSm awGY&w,f/
J.Cheyne (1777-1836) uawmh paumhorm; awm f/ aemu fwa,mufuawmh W.
Stokes (1804-78) tdkif;&pf orm;awmf/
Colles’ fracture
tawGY&rsm;wJh vufzsHt½kd;BuD; usdK;Ncif ;/
vuf aumuf 0wf tem;udistal end of radius t½k d ;usd K;Ncif ;
td kif ;&pf cGJ pd wfq&m0efBuD ; A.Colles (1773-1843) u p wifawGY/ 'Dt½kd;usdK;ygu yHk o@mef ysuf,Gif;Ncif; (Defor-
mity) eJY vuf aumuf 0wf vI yf &Sm;rI av;vH Ncif; (Stiffness) wd k Y
aemufqufwG J Nzpf wwf w,f/
Cushings’s syndrome
ud k ,fcE¨ mrS mCorticosteroid a[mf rkef ;awGvGef uJaewJ h taNctae/
tav;csd ef awG wd k ;vmr,f? rsuf ESm vnf yif;awG eDNref;ae r,f? rsufESmeJY udk ,fcE¨ mrS m t arG;trSifawG xlxyfvmr,f? aoG;aw Gwdk;aer,f? t½kd;udk uspf vpf apwJ hMineral "mwf awG avsmhenf ;vmawmh t½kd;yGvm
r,f? aoG ;xJrS m oMum;"mwf yrmP rsm;vmr,f? 'ghtNyif pdwf yd kif;qd kif&m ysuf,G if ;rI awG yg Nzpf vmwwf w,f/ 'gaMumif h a&m*gvu© Pmaygif ;pk/
Adrenal *vif ;tBud wf awG aMumifh Nzpf wwfayr,fh pwD; ½GdKufaq;yrmP vGefuJNcif; awG rS m tawG Y&rsm;w,f/ tar &duefcGJpdwfq&m0efBuD; H.W.
Cushing (1869-1939) u awGY&S d cJh w,f/
Glasgow Coma Scale (GCS)
rwwf rae&/ OD ;acgif ;xd cd k uf 'Pf &m &NyD ;
aemuf vlem\ owd&S drI taNc taeudk trSwf ay; cefYrS ef;wJh pepf/
rsufvHk ;- 4 (rsufvH k; zGif h Ed k if Ncif ;)
vIyf&Sm;- 5 (udk,fvuf t*F g vIyf&Sm;Edk if rI )
pum;- 6 (wk ef YNyef aNymqd k Ed k if rI )
trS wf rsm;avaumif;av/ vl aumif ;qd k &if 15 rS wf tNynf h uawmh &S if ;ygw,f/ 7 rSwf qdk &if Lucky eHygwf qdk ayr,fhComa NzpfaeNyD/
Glasgow uawmh wuú odk vf emrnf/
Graves’ disease
ocsdKif;a&m*gvm;aygh/ r[k wf/ rsufvHk;NyL; vnfyif;BuD;
a&m*g/ 'D a&m*gaMumifh odk if; &G d uf a[mf rk ef ;vG ef uJ Ncif ; a&m*g vu©PmpkawG Nzpfvmwwf w,f/
Thyrotoxicosis
ESvHk ;cke fwmawGNrefr,f/ acR;xG ufr,f/ vufwkefr,f/ pd k ;&d rf pd wf awG rsm;aer,f/ ud k ,f tav;csdefusr,f/ at;wJhae
&mawGrSmyJ aecsifw,f/Graves’ disease rSmawmh
vnf yif ;BuD ;vmNyD ; rsuf vH k ;NyL; aer,f/
td k if ,mvef orm;awmf R.J.
Graves (1797-1853) u awG Y cJ h wm/
Guillian-Barre syndrome
aNc axmufawG xHkusi f tm;enf;wJ ha&m*g/
touf½SLvrf;aMumif ; odk Y r[kwf tpmtdrf awG rSm a&m*g ydk;0ifNyD; 10-20 &ufavmuf MumvmwJ h tcg tpG ef tzsm; tm ½k H aMumawG ud k Allergic response
t& xdcdkuf oGm;vdk Y Nzpf&wm/ Nyif opf OD ;aES muf tm½k H aMum
ynm&S if BuD ;awG u awG YcJ h w,f/G.Guillian (1836-1961)
eJY A.Baree (1880-1967) wdk Y jzpfygw,f/
McBurney’s point
q&m0efwdk if ;od w,f/ 0rf; Adkuf wGif aygif ½kd;tpGef;rS csuf txd rsOf;aMumif;qGJNyD ; 3 yH k 1 yHkae&m/ tltwuf &Sdaomae &m/ ½k wf w&uftl twuf a&mif &rf;jcif;wG if temqH k;ae&m/
tar&duef cGJ pd wfq&mBuD;C.Burney (1845-1913) p
wifawG Y&S d owfrS wf/ tl twuf a&mif wmeJ Y ywf
ouf NyD ; &D p&mwck awG Yzl ;w,f/ avS mif wm r[k wf bl ;/ aq;½k H w ckrSm usaemf wm0efuspOfu jzpf w,f/
vlemwa,mufudk Appen-
dicitis qdk NyD; q&m0efi,f av; wO D;u ta&; ay :wifvm w,f/ usaemhq&m Surgeon
u vlemAd kufudk vSef Munfh w,f/ aemuf q&m0ef i,f av; udk ac:cdkif;w,f/ a&mufvm awmh Munfh wJh/
a[m tl twuf cG J pd wf trm &G wfa[mif;BuD;udk awG Y&vdkuf w,f/
ol rsm; trS m;qDu twk,l NyD; 'Dvdk rsdK;trSm;udk usaemf r vkyfrd zdk Y tNrJowdxm;cJ hw,f/ udk,fhtrSm;uvnf; oif,l& wmayghav/ vlemprf ;oyfNcif ; udk i,f i,fuwnf ;u wd wd
usus enf;vrf;usus avh usif h xm;zd k Y vd k w,f qd k wm Nyae w,f/
usaemf wd k Yud k oif Mum;ay;cJ h wJh q&m0efBuD;awGudk tckt csd ef txd aus;Zl ;wif aerd w,f/
qdkvdkwmu Adam’s apple
onf vnfZvkyf Nzp fonf ? Achilles. . qdkonfrSm ...? RIF
wGif emaom a&m*grsm;rSm ... ponf ponf ...
pmawG &ae,H k eJ Y q&m0efw a,muf Nzpf zd k Y rvG ,f bl ; qd k wm?
pmawG tNrJzwfae&r,f qdk wm? vl em tNrJ prf;ae&r,f qdk wm? ygeD rvmvdkY pdwfysuf vnf ; avh usif h ae&r,f qd k wm/
vlemaw G pdwfcs rf ;om atmif? q&mawG oif ay;&usd K; eyfatmif? trSm;t,Gif;enf; atmif ? rodao;wm odvm atmif? Bud K;pm;ae&r,f .. qd k awmh
q&m0ef vk yfrdwm ... rSm; ovd k vd k? em;csd ef awmif r&S d ovd k?]q&m vlem} qdk aigufueJ x
tdyfa&;ysufnawG Nzwfoef;& r,f qd k wmud k? q&m0ef rsm; *sm e,f orm;awGtaqmf cH ae&wm awGudk? owåd &Sd rS q&m0ef vkyf vdk Y&w,fqd kwm odvmw,f/
usaem h q&mBuD; Ortho
surgeon BuD;qdk cG Jpdwfcef;0if wdkif; tNrJaNymw,f? ]uJ rdkuf vd kufMu&atmif ud k...}
usaemf BudKufw,f olYp um; / bmNzpfvdk YvJqdk awm h vl em t½k d ;Nzwf r,f h vT aqG; vT a[mif;BuD;eJY usaemh q&meJY usaemf 'D aeY acR;'D ;'D ; usOD ;r,f qd k wm...
usaem fwdkY taumi f;qH k; vkyfcJ hwmuawmh trSef ...
Adam’s apple onf vnf Z vkyf qd kwmvnf; trSef ... /
a'guf wmwif haZmfOD ;
od kif;½G dKufa[mf rkef;vGefa&m*g
rsuf vH k ;jyK;us,f jcif ;
vnf yif ;BuD ;jcif ;
tyd kif ; (2)
ADAM'S APPLE qd konf rS m
vnf Zvk yfjzpf ygonfa'guf wmwif haZmfOD ;
aiGukefoHjym usef;rma&;t,f'D wm&Sif h
usef;rma&;u vlYb0&JU wefzk d;t&Sdqk H; "ejzpfw,fwJ h/ 'g aMumif h rd om;pk wpk rS m aysmf &T if csrf ;ajrYzk d Y vk d tyf csuf awG xJ rS m usef ; rma&;uvnf; t"duae&mu yg0if aew,f/ usr wkdYrdom;pkrSm vnf; usrarar&JU usef;rma&;tajctaeaMumifh vGefcJ hwJh v t enf;i,f avmufu vG ef pG mpd wfxdckduf yifyef;cJh &ygw,f &S if/
ararh &J U a&m*gvu© Pmu wcgw&H trsKd ;orD ;obm0 "r® wm vm&if qD;pyfu t&rf;uk dufcJNyD ; uav;arG;wJhtcg n§ pf ovkd n§pfcsifw,f vkdYqkd ygw,f/ NyD;awmh aemufwcku &if acgif;xJ uvnf; pl;NyD ;atmifh wJh a0'emcHpm;&wmyg/
jzpfpuawmh usrwk dYNrdKU&JU ½kd;½kd ;aq;cef ;rS myJ jyae&if;u ol Y
a&m*gtajctaeukd tJ'Daq;cef;rSm&S dwJh q&m0efu prf;oyf&if; &ifacgif;uatmifhwmu tpmtdrfa&mifaevkdYajymNyD; tpmtdrf aq;awG aomuf &w,f/ NyD;awmh tzwfygwJh tpm;awGvnf; rpm;&bl;qkd awmh araru t&nf awG yJ aeYwk dif;aomuf&w,f/ "r®wmvm&if uk dufcJwmuawmh aoG ;qkH;cgeD ;rk dYvk dY jzpfwmqkd NyD; om;td rf tm;aq; qkdwmrsKd;awG xk d;ay;w,f/ aomufaq;awG vnf ; ay;w,f/ 'gayr,f h jzpf wJh a&m*gvu© Pmuawmh aysmuf uif ;roG m;bJ aeYwk d if ; t&nf yJ aomuf ae&wJ h tusKd ;quf u yd ef NyD ; tm;enf ;ovk djzpfvmw,f/
'geJ Y &efukef rS mjyMunf hzkd Y qk H;jzwf NyD; &efukefu yk*¾ vd u aq; cef;wckrSm txl;uk q&mBuD;awGeJY ukocJ hw,f/ q&m0efBuD;u "mwfrSef½kdufckdif;cJhw,f/ wywftMum "mwfrSefutajzxGuf vmawmh ararh &J U om;td rf rS m tvk H ;&S d aew,f wJ h/ NyD ;awmhtonf ;
uvnf; enf;enf ;a&mif aew,fvk dY tajzxG ufygw,f/ usrwk d YNrd KUu aq;cef ;rS m xG uf wJ h tajzeJY tck txl ;ukeJ Y jyNyD ; "mwfrS efuxG uf vmwJh tajzeJY aMumufp&maumif ;avmuf atmif uG J jym;aewmuk d awG Uvk d uf &ygw,f/ usrawG ;vk d uf rd wmu yk d uf qH enf;enf;ay;&if jzpfovkdyJ aocsmrprf;oyfbJ vlYtoufw acsmif ;uk d tvG ,f wul aumuf csuf csNyD ; usrwk d YNrd KUu q&m0ef awG aq;uk aeMuovm;/ 'D vk d rsKd ; ae&mtES H Ytjym;rS maum jzpf aeNyD vm; qkd wmygyJ/
ararjywJh om;zG m;rD;,yf txl ;uk q&m0efBuD;u om;td rfxJ rSm tvkH;&SdwJhtwGuf cGJpdwfrvm;? 'grSr[kwf apmihfMunfhOD; rvm;vkd Y ararh &J UoabmqEuk d ar;ygw,f/ aemufawmh ol uyJ tBuH ay;ygw,f/ om;td rfxJ u tvkH;&JU tom;pukd,l Munf hNyD; uif qm [k wf r[k wf prf ;oyf NyD ;rS cG J pd wf zk d Y oih f roih f qk H ;jzwf zk d Yyg/ 'Dawmh tJ 'D q&m0efBuD; ajymwJhtwdkif;yJ tom;p,lNyD ; ppfMunfh vk d uf ygw,f/
uifqmr[kwf bl;qkdwJh tajz&vmygw,f/ araruvnf; qD ;pyf uk duf wmu olwk d Yay;wJ h aq;eJ Y rouf omygbl ;/ aemuf qk H; awmh om;td rf xkwfvkd ufzkd Y oabmwlvk duf w,f/
txl;ukaq;cef;awGuawmh ykdufqH&Sd&if tukeftqifajy w,fvkdY yxrxifvkd ufayr,fh aemufykd if; usr&JUxif jrif,lq csuf u rrSef cJh ygbl ;/ ararhukd cGJpdwfawmh n 7 em&D/ n 9 em&D avmuf rS m q&m0ef BuD;u cG Jcef ;xJu xG uf vmNyD; cGJ xk wf vk d uf wJ h ararh &J Uom;td rf tvk H ;uk d vl em&S if awG uk d Munf h cG ih f ay;ygw,f/ ol u ajymygw,f ]om;tdrfu awmfawmfxl aew,f/ om;tdrfacgif;u vnf; omrefxuf yk dNyD;a&mifaew,f awG Uvm;} vkd Y jyygw,f/ usrwk d YtaeeJ Yuawmh Munf h om Munf h ae&w,f/ em;vnf vk d Yawmh r[kwfygbl;/ bmyJ jzpf jzpf cGJ xkwfvk dufvk dYtjyif a&mufvmNyD/ vl em&S if awG arQmf vih f wmu vl emtajctae aumif ;zk d YygyJ/ tJ 'D vk d cGJxk wfvkdufwJhypö nf ;awG vmjyNyD; jyef0if oGm;ygw,f/ 9 em&DcGJ avmufrS mawmh q&mBuD;jyef xG uf vmygw,f/ tm;vk H; aumif ;yg w,f wJ h/
reuf jzef vmMunfhr,fvk dY uref ;uwrf;ajymNyD ; cGJ cef;xJu xG uf oG m;ygw,f/ araruk d cG J pd wf wJ h txl ;uk q&m0ef BuD ;u aemuf waeY ararhtajctaeukd
t ,f 'D w mh xH a y ; p m u @t ,f 'D w mh xH a y ; p m u @t ,f 'D w mh xH a y ; p m u @t ,f 'D w mh xH a y ; p m u @t ,f 'D w mh xH a y ; p m u @
pmrsufES m (12) od kY ```
7/27/2019 Nightingale Health Journal (September-2013)
http://slidepdf.com/reader/full/nightingale-health-journal-september-2013 12/16
usef ;rma&;*sme,f trS wf-37? puf wifbmv? 2013-ckES pf12 NIGHTINGALE
usef;rma&;avmuqkdwm aq;ynmavmuxJ u bmom &yfcG J e,fy,fwckqkd&if rrS m; ygbl ;/ bmaMumif hvJ/ aq;y nm^aq;od yÜH rSm t"d utaeeJ Y u@ESpfck &Sd ygw,f/ ukoa&; eJY umuG,f a&; qkdwmyg/
aemufwcg bmom&yfcGJ t"d uav;cktjzpf aq;ynm? cGJpd wfukynm? om;zG m;rD;,yf ynmeJY uav;oli,f usef;rm a&;awG &S dygw,f/
aq;wuú ok dvf awG u oif Mum;ay;wJ h wuú ok d vf ynmawG ukd ESpf &Snf vrsm; (jref rmEkdifiH aq;wuúokdvfawGrSm 7 ESpf? wcsd KUEkdifiHawG rS m tenf;qk H; 5 ES pf) oif Mum;em,l avh usif h NyD ; rS q&m0ef a'gufwmbGJ Ytjzpf jref rmEkdifiH rSm M.B.,B.S ? tar &duef? *syef? xkdif0rf? xkd if;? zd vpf yk d if pwJ h Ek d if iH awG rS m (tar&d uefpepf)v kdY qkdEk difwJ h M.D
(Doctor of Medicine) &olwk dif ; [m 'Dbmom&yf 4 ck ukd tajc
jyK oifMum;cJh Mu&ygw,f/ 'D xuf yd k jrif h wJ h bG J YawG uawmh jref rmEdkifiH rSm aq;ynmr[mod yÜH bGJ Y (M.Med.Sc.)? yg&*lbG J YPh.D. awGjzpfNyD; urÇmhaq;y
nmavmurSm wefzdk ;txm;
aq;ynmavmu ,Ofaus;rI qHk;? tjrifhqHk;bGJYawGuawmh NAd wdef Ed k if iHuay;wJ h awmf 0if o rm;awmfbGJ Yaw GjzpfwJ h aq; ynmtxl;uk (MRCP)? cGJ pd wf txl;uk (FRCS)? om;zGm;rD; ,yf txl;uk (MRCOG)? u av; txl;uk (MRCPH)? wdkY jzpf ygw,f/
aq;ynm&S if (orm;awmf ) udk a'gufwm Doctor (Dr.)
(q&m0ef) vdkYac:qdkMuovdk? ynm&yfwckckudk uRrf;usifESHY
pyf wzufurf ;cwfatmif avh vm qnf ;yl;NyD ; qif jcif wHkw &m;eJ Y jynf h 0ol awG ud k awG ;ac:rI ynm&Sif Doctor of Philosophy
(Ph.D) vd k Y urÇ m w0S rf ;ynm&S if avmu wuúodkvftoD;oD ;u owfrSwf csD;jr§ ifh wJh (aq;ynm avh vmol r[kwf wJh ) ynm&Sif wr sK d;ud kvnf ; a' gu fwm (Ph.D. a'guf wm) vd k Yowf rS wf avh& SdMuygw,f/ 'gayr,fh (a'guf wm q&m0ef) vdk Yawmh rac:yg/ q&m0e favmur Sm
vnf; aq;ynmbG JYDr.
a&m?Ph.D. a'guf wmbG J Y ES pf rsKd ;pvHk ; &olawG &S d Muygw,f/ (Oyrm- jref rmEdk if iH? usef;rma&;0ef BuD; jzpf cJ h zl ;wJ h a'guf wm OD ;azod ef ; pwJh q&m0ef BuD ;rsm;)/
jrefrmEk dif iHtygt0if tdEd´ ,? rav;&S m;? eDaygpwJh t*F vd yfaq;ynmpepfukd tajcjyK &m EkdifiH awGrS m M.B (Bachelor
of Medicine) bG J Y &&S d Muygw,f/ jre frmEkd ifi H&J U vufO D;pepf ? vuf OD;q&m[m t*Fvef Ekd ifiH jzpfvk dY M.B tjyif tajccH cGJ pd wf ukynmuk d yg avh usif h oif Mum;ay;wmaMumif h B.S (Bach-
elor of Surgery) udkyg jznfhpGuf NyD; M.B;B.S (ES pf bGJY)ukd wNydKif
wnf; csD;jrifhay;tyfygw,f/ bJ GY 2 ckaygif ;[m tajccH bG J Yjzpf wJ h 0d ZÆ m (Bachelor) &NyD ; bG J YvG ef jzpf wJ h r[m0d ZÆ m (Master) bG J Y& wmrsd K;jzpfvk dY M.B;B.S (ESpfbGJ Y) bGJYESif;obif0wfpkHukd bGJYESif; obiftwGuf 0wfqif&mrS m &ifbwfvT rf;? zJjym;a&T0ga&mif tjym; BuD; wvTmw&p fxJukd qif jref ;Mu&m jzpf ygw,f/ om reftm;jzifh tajccH0dZÆm B.A,
B.Sc awGqkd&if oufqkdif&m bmom&yftvkduf ta&mift
rsdK;rsdK; 2 &pf? OyrmB.Sc
bGJ Y twGuf tpdrf;a&mif? B.A 0dZÆm bGJ YtwG uf yef;a&mif 0wf&wm jzpf ygw,f/ 'D tcsuf uk d od wJ h vl enf;ygw,f/ trsm;pk u rod Muygbl;/
aq;ynm^aq;od yÜ H &J U xyf qif h cG J bmom&yf i,f awG rS m a&m *gaA' (a&m*grsm ;taMumif; avh vmrI)? aq;0g;aA' (aq; 0g;taMumif ;avh vmrI )? tPk ZD 0aA' (a&m*gykd;rTm;avh vmrI )? rIcif ;qkdi f&maq;ynm? vlrI a&;aq;ynm (ckaemufyk dif;t
ac: jynf ol Yusef;rma&;^ vl xk aq;ynm)? "mwf rS ef ynm pwJh pwJ h bmom&yf cG J awG &S d ygw,f/
aqmif;yg;tp ukoa&;eJY umuG,fa&; vk yfief ;BuD ;ESpfck ukd jyef aumuf &&if ]umuG,f jcif ;onfuk ojcif ;xuf yk d rk d xd a&mufonf}qkdwJhtwkdif ; um uG,fa&;jyKvkyf jcif;jzifh ukop &m rvk d wm? enf ;yg;wmaMumif h jynf ol vl xk tm;vk H ; usef ;rmap zkd Y &nf&G ,fwJh jynf olYusef;rm a&;^ vlxk usef;rma&;rSm (um
uG,fa&;)uk d t"du OD;pm;ay; ygw,f/ jrefrmEkd ifiH wwkdif ;jynf
vkH;&JU usef;rma&;ukd &nf &G,f wJh jrefrmEd kifi H usef;rma&; pepf BuD ;rS m bG J Y&q&m0ef awGvk H avmuf atmif rarG;xkwfEkdifrD 80 &mck difEIef;eD ;yg; aus;vuf ae jynf ol vl xk twG ufusef ;rm a&;apmif ha&S mufr Ivky fief ;ukd aqmif &G uf zk d Y vuf axmuf usef ; rma&;rSL; (HA - Health Assista-
nt)? xrdef tjym0wfol emjyK q
&mrBuD;(LHV - Lady Health
Visitor)? om;zGm;q&mr (MW -
Midwife) qk d wmawG uk d avh usif h arG ;xkwfNyD ; aus;vuf usef;rm a&;Xmersm; zGif hvSpfcJhygw,f/
]vlwk dif ;usef;rm ouú&mZf 2000} rSm t,fvfrmtmwm aMunmpmwr f;q kdwmaw GeJ Y urÇmw0Srf;vkH; usef ;rma&; zGHY Nzd K;wk d;wufaumif;rG ef zkd Y 1978 ckESpfupwifNy D; jrefrmEk difi H jynfolYusef;rma&;pDrHudef; p wifcJh NyD;aemufy kdif;rSm vlxk
Mum;uae a&G;cs,farG;xkwf ? tif tm;jznf h NyD ; yPmrusef ;rm a&;apmifh a&SmufrI vkyfief;t wG uf vl xk usef ;rma&;vk yf om; rsm ; (CHW)? rdom;pkapmifh a&SmufrItwG uf t&efom;zG m;
q&mr (AMW) rsm;qk dwJ h apw emh 0ef xrf ; usef ;rma&;vk yf om;(VHW) awG ay:vmcJ hygw,f/
Nrd KUjyaq;½k H BuD ;awG vk d uk o a&;vkyfief; t"duxm; vkyf uk d if wJ h ywf 0ef ;usif rS m q&m0ef trsdK;rsdK;? olemjyKq&mr BuD;? vwf? i,f toG ,f oG ,f (xrd ef
tpdrf;? tjym? teD0wf)awG? aq;pyfq&m (Compounder)? "mwfcG Jcef;uRrf;usif ol (LAB -
Technician)? temaq;xnfh(Dresser) pwmawG eJY tMurf;
zsOf; zGJYpnf ;vkyfukd ifygw,f/ aemu fNyD ; jre frmE kdif iH&J U
usef ;rma&;zG J Ypnf ;yk H pepf rS m a&m *gwkd uf zsuf a&; (Campaign) t rsd K;rsd K; (Oyrm iSufzsm;? wD bD? rsuf crf;pyf? temBuD;? umv om;a&m*g)pwJ h tzG JYawG vnf; &S d wmaMumif h qk d if &musef ;rma&;
0efxrf;awG &Sd Muygw,f/ 'D awmh usef;rma&;avmu qkdwm jynfolvlx kuse f;rm a&;twGuf aqmif&Gufoltm; vkH ; yg0if wJh BuD;rm;? us,f ysHU wJh vl rI 0ef;usif BuD ;vkdY qkdEkdif ygw,f/
aq;ynmavmuvkdY qkd vkd uf&if t"du todynm&Sif vkd Y qk dvkd NyD; tqifh jrif h aq;y nmavhvma&;? aq;okawo ejyKa&;? txl ;uk bGJYvGefbm om&yfqkdif&m ynm&SifawGukd
&nfñTef;ygw,f/ "mw fcG Jce f;uRrf ;usifo l? "mwf rS ef qk d if &muRrf ;usif ol pwJ hMedical Technology wckckukd
avhu sif hwwf ajrmufxm;ol awGukdawm h twwfynm& Sif(Technician) vkdY owfrSwfyg
w,f/ olwkdYawGukd ,cifu aq;bufqkd if& m ynmoif ausmif; (Paramedical)? ,ck tqif hjrifh NyD; wuúok dvftqifh (Oyrm ol emjyK wuú ok dvf ) qk d wmawG u avh usifh arG;xk wfyg
w,f/ vuf eufuk difwyf zGJ Yqk dif &m (aq;wyf )awG rS mawmhusef;rm a&;twGuf (aq;wyfom; 0ef xrf; Medic )awG yg0ifzGJYpnf; ygw,f/ t&yfbufqkd if&m0ef
xrf ; (Civil Staff) eJ Yqk d &if Medic
qkd wm a&S Uwef;ppfajrjyifqkd if &m usef;rma&;0efxrf;awGjzpf wmrkd Y aus;vuf usef;rma&;Xm e (RHC) zGJYpnf ;yk HxJu CHW
eJ Y tMurf ;zsOf ; nD rQw,f vkd Y qk d Ekdifygw,f/ wyfxJu t&mcH vufaxmuf aq;rSL; (MA) awG
uawmh aus;vufusef ;rma&; Xmeu vufaxmufusef;rm a&;rS L; (HA) eJ Y nD rQEd k if ygw,f/
tqif htwef;? &mxl;cG Jjcm; wmr[kwfayr,fh jrefrmrI e,f y,f rS m? jref rmh ,Ofaus;rI rS m ]'l ; ae&m 'l;? awmfae&m awmf} qk dwJh qkd ½kd ;pum;&Sd ygw,f/ q &m0ef csif ;wl wmawmiftxl ;uk q&m0ef trsd K;rsd K;? taxG axGuk q&m0efqk dNyD ; trsd K;rsd K; &Sd Muo vk d usef ;rma&;Xme tzG JYtpnf ; wck rS mvnf ; wk d uf e,f q&m0ef?
Nrd KUe,f q&m0ef? Nrd KUe,f q&m0ef BuD;? jynfe,fusef;rma&;OD ;pD; XmerSL;? usef;rma&;ñTefMum; a&;rSL;? ñTefrSL;csKyf? usef;rm a&;0efBuD; qkd NyD; &mxl;tqifh qifh &S dygw,f/
ckvkd tao;pdwf&Sif;jy&wJh taMumif ;uawmh aq;ynm avmu? usef;rma&;avmu om;awG[m usef ;rma&;qkd wJh vl Ybk H b0? vk yf ief ;wck wnf ;uk d vkyfukdifwmjcif ;wlayr,fh zGJY pnf;yk Hpepf? avhusifh ysd K;axmif
&wJ h tcsd ef umv uG J jym;jcm;em; wmuk d odapvk dwmaMumif hyg/ aemufqHk;tESp fcsKyfawm h
acwf? pHepf? rlawG b,fvdk aumif;aumif;? ajymif;ajymif; vl omvQif y"meuswmrd kY vl awG&JU arG;&mygtusifhp½dkuf? ADZ? BuD;jyif;t&G,fa&mufwJh ywf 0ef ;usif? bmomw&m;? vl rIa&;tqHk;trawGeJ Y uif;a0; NyD ;? twå BuD ;rI? wudk ,faumif; qefrI? avmb? a'go? rmef rm e? rpä &d ,pd wf awG? usOf ;ajrmif ;
wJhtawG ;tac: trltusifh? vl vlcsif; trS efwu,f pmem axmufxm; n§mwmrI uif ;wJh pdwfawGudk jyKjyifajymif;vJzdkY ta&;BuD;ygw,f/
a'guf wmZD 0u (uarÇ mZ)
a'guf wmZD 0u
vmrMunfhygbl;/ wjcm; aq;½k H awGrS m vl emwtm;rsm;aevkd YygwJh/ aq;cef ;u MO av;awG uk dyJ zk ef ;quf NyD ; ararh tajctaeuk d ar;jref ;wmawG U&ygw,f/ aemuf waeY ol emjyKav;awG uk d 'D aeY q&m0ef BuD ; vmrS mvm;vk d Y araru tm;uk d ; wBuD ;ar;jref ;ygw,f/ ol emjyKav;u 'D aeYawmh vmr,f xif w,f wJ h/ nyk d if ;avmuf vmjzpf r,f xif w,f vk d Y ajymygw,f/ n 8 em&D avmufrSm usrukd olemjyKq&mrav;wa,mufu
vmajymygw,f/ q&m0efBuD;urvmEk difvk dY olYqDukd zkef;qufyg wJh/ 'geJY zkef;eHygwfawmif;NyD; zkef;qufvkdufygw,f/ ararh emrnf ajymNyD; olY&JU vlem&S ifygvk dYajymawmh ol rtm;vkd Y rvmEkd if wmukd em;vnfay;z kdYeJY reufjzefawmh qufqufvmyghr,f qkd wmuk d ajymygw,f/
araruawmh ol Yuk d cG J ay;wJ h q&m0ef BuD ;uk d tjypf rwif ygbl ;/ ol wu,f rtm;vk d Y vmrMunf h wmyJ avwJ h/ ararvnf ; ouf om
aewmyJwJ h/ cGJ NyD;vk dY okH;&ufajrmufaeYrS ararhukd cGJ ay;wJh q&m 0ef BuD ;u vmMunf hw,f/ av;&uf ajrmufaeYrS m vmMunf hNyD; cGJ xm;wJ hcsKyf ½k d ;uk d jznf ay;NyD ; csKyf ½k d ;aumif ;w,f/ qif ;csif &if qif; vk dY&NyD vkdY ajymygw,f/ ararh&J U nmbufu om;iH&nfxkwfzk dY ykduf xnfh wJhtaygufav;uk dawmh 'D twkd if ;yJMunf hNyD; od yfrMum cif temusufoG m;vdrf hr,f vkdY ajymw,f/ araraq;½k Hu qif ; NyD; wvavmufMumwJhtxd? om;tdrfxkwfzkdY cGJwJh'Pf&mu
usufwJhtxd tJ 'Dab;em;u taygufuav;u temrusufbl; jzpfaew,f/ aoaocsmcsmMunfhawmh BudK;ptrnf;av; jrif ae&w,f/ csKyf½kd;ukd rjznfrdwm jzpfygvdrfhr,f/ tJ'DBudK;u rjznf &ao;awmh temu rusuf Ekd if bJ emaewk ef;yJ/ aemuf awmh usrwkdYvrf ;xdyf u olemjyKq&mrav;ukd oGm;vkyfckdif;awmhrS yJ BudK;ptukef vkH; xGufoG m;NyD; temuusuf oGm;ygw,f/
'Dvkd awGjzpfaewJh jrefrmhusef ;rma&; aq;avmurSm ykd ufqH
trsm;BuD;ay;&wJh txl;ukqkdwmawGuvnf; tcsdefrtm;vyf ygbl ;qk d wJ h tcsuf eJ Ywifvl emawG uk d tjynf h t0*½k rpk d uf Ek d if ygbl ;/ vl emu ta&;ay:tajctae wck ck jzpf vm&iftvS nf h us waeYw a,muf ajymif ;aewJ h MO av;awG uvnf; q&m0efBuD;ñTef Mum; csufrygbJ bmwckrS vkyfvkdYr&ygbl;/ 'Dawmh txl;ukq&m 0efBuD;awG tcsdefjynfhr&SdwJhtwGuf vlemawG&JU usef;rma&; tmrcHcsufu &ifav;p&myg/ zkef;eJYyJ vlemtajctaeukdar;?
b,f vkdvkyf? bmaq;wkd uf qk dwmeJ YyJ vlemvmrMunfhbJ ñTef Mum;wJh acwfwacwfjzpfygNyD/ jrefrm jynfu jynfolawG&JU usef ;rma&; tajctaeuawmhwm0ef ,l rI? wm0ef cH rI uif ;wJ h [k d vk d vk d 'D vk d vk d? [k d vl uk ovk d vk d 'D vl uk ovk d vk d eJ Y Mum;acsmif NyD ; aiG uk ef oH jymjzpfud ef ;qk duf wJh b0rsKd;a&muf aeygw,f&Sif/
,kef uav;(acwå&ef ukef )
``` pmrsufES m (11) rS tquf
7/27/2019 Nightingale Health Journal (September-2013)
http://slidepdf.com/reader/full/nightingale-health-journal-september-2013 13/16
usef ;rma&;*sme,ftrS wf-37? puf wifbmv? 2013-ckES pf NIGHTINGALE 13
BuH KcJ h&w,f aq;½H kBuD;0,f o k n wavmu jynfwGif ;ukd jyef
a&muf wk ef ; BuH KawG YcJ h &wmav; wckukd jyefajymjycsifygw,f/ jzpf pOfu touf ESpf q,fhig; ok H ; q,f 0ef ;usiftrsd K;orD ;w a,muf[m ukd,f0efae NyD;rS aoG ;ay:jcif ;ud k taMumif ;jyKNyD ; pcJ h w,f/ uk d ,f 0ef &S d NyD ;rS aoG ;t enf;i,fqif ;wwf w,f qk day r,fh aoaocsmc sm ar;jre f; Munh frdawmhrS 0rf;Ak dufatmuf yk d if ;rS m emusif w,f vk d Y qk d vmyg w,f/ olukd,fwkd ifuvnf; awm&GmrS maeawmh bmuk d rS em; rvnf/ aoG;ay:aeawmh uk d ,f 0ef &SdrS ef;awmif rod&Smygbl;/ aoG;vnf;qi f;? emusifvm awmhrS NrdKUay:ukdwufvmNyD; tm;uk d ;&S mawmh wmyJ/
qD ;ppf Munh f vk d uf awmhxif wJ h twk d if ; uG uf wd ygyJ/ uk d ,f 0ef &SdaeygNyD/ a,musfm;u bef aumuf uk d xG uf oG m;wm rMum ao;ygbl;/ 'D awmh ta':jzpf ol uyJ vkd uf yk dY&w,f/ tm;ukd ;
tm;xm; r&Sdavawmh usaemf wk dYyJ 0k d if ;0ef ;ul nD ay;Muw,f/
aq;½k H^aq;cef ;oGm;zkd Y t Bu Hay;w,f / ayghqvk dY r& aMumif ; aocsm&S if ;jyw,f/ us aemf h pd wf xJ rS mawmh jyóemwck ck jzpf aeNyD qk d wmuk d od aew,f/ vl emuk d aocsm&S if ;jyawmh crsm rSm tifwifwi feJY vufcH cJh w,f/ 'geJYyJ oli,fcsif;um;eJY
aq;½kHu tkd*sDq&m0efrwOD; zGifhxm;wJh aq;cef;ukd jref;Mu ava&m/ usaemf awmh rvkd uf oG m;jzpf cJ h ygbl ;/ tk d *sD q&m0ef r qDuk d zkef;BudKqufNyD ; vS rf;t aMumif ;Mum;xm;vkdufw,f/ q&m0efreJY &if;ESD ;aeavawmh tcuf tcJr&S dygbl;/
vlemjyef a&mufvmwJh tcg ar;Munf hvkd ufawmh/ aq;½kH NyD ; cG J pd wf &r,f vk d Yqk d ygw,f/ 'gqk d &ifvnf; cG Jaygh/ uk efusp&d wf ryleJ Y/ eifhtazuk dvnf; t aMumif;Mum;ay;r,f/ ckcsuf csif; aq;½kHukdoGm;vkdYqk dawmh vlemcrsm tifwifwifjzpfae wkef;/ [ raygheJY/ ta&;BuD; w,f/ cG JrS jzpf r,f vkdYajymawmh aq;½kHrwufcsifbl;wJh/ bm aMumif h vJ aygh qk d awmh rajz/ us aemf odygw,f/ usaemfwk dY jref rmjynfu aus;vufaevlxk [m aq;½kHqkdwmu kd rpm ; aumif ;vk d tif rwef aMumuf Mu ygw,f/ tif; aMumufvnf ;
aMumuf csif p&mygyJ/ atmf vk d uf aigufvkd ufeJY/ ukd,f ha0'emuk d BudwfrS dwfcHpm;&if; q&m0ef a&muf tvmuk d arQmf vif h wBuD ; eJ Y arQmf aeMuwJ h rsuf 0ef ;awG uk d [k d ; vG ef avcJ h NyD ;aomumvawG uwnf ;u usaemf awG Y&S d cJ h zl ;yg w,f/
t&ifueJ Y tck tajctae u rwlawmhygbl;vk dY b,fvk d
yif ajymaomf jim;vnf ; vlemu &Sdefaewkef;/ 'geJYyJ usaemfu q&m0efeJY&if;ESD;w,f? tJ'Du olemjyKq&mrwcs dKU eJYvnf ; &if ;ES D ;w,f/ yl p&mrvk d aMumif;? aemuf aeY usaemf uk d ,f wk d if vk d uf vmr,f h taMumif ;ajymvk d uf awmh aq;½kH ukd wGefYqkwfwG ef Yqk wfeJ Y oG m;ygav&J U/ atmf om;O>yef rSm oaE¨wnf aeawmh tjrefcGJ &awmh raygh/ 'gawmifrS tvm apmvkdY/ aemufusoG m;&if ao rif ;eJY eyef;vk H;ae&avmuf NyD/
aemuf waeY usaemf aq;½k H uk d a&muf cJ h w,f/ vl em&J U zcif u cGJ pdwf aqmifatmuf xyf rSm ik wf wk wf xk d if vk d Y/ ar;Munh f awmh cGJcef ;0ifoGm;NyD/ 'gayr,f h t aqmifrSm q&m0efvSnfhaevkdY vlemapmif hawG tjyif xGufae& aMumif ;ajymygw,f/ 'Dawmh usaemfvnf ; xk dif apmifh ayghAsm/
]vl em ..... &J U vl apmif h tjref vmyg}
ac:oH Mum;awmh usaemfu
OD;av;[k drS mac:aeNyD/ oGm; awmh vk d Yqk d awmhuref ;uwef ;eJ Y xNyD; a&S Uaygufu wuf &rvkd aemufaygufu wuf&rvkdukd jzpfua&m/ tay:uatmfoHu vnf; Mumavpdwfr&SnfwJhykH ay:vmw,f/
]jref jref vmav/ Mumvk duf wm/ bmvk yfaewmvJ}
bmnmeJ Y 'Davmufatmf ae
wm ol emjyKvm;? q&m0ef vm; wOD;OD ;jzpfEkdifw,f/ usaem f vnf; 'DacwfrSm 'Dvkd &S dao;o vm;qkd NyD; tay:uk d aocsm Munhfvkdufawmh trav;Asm/ oefY&Sif;a&;0efxrf;cifAs/ t ppf ygyJ/ cG J cef ;t0rS m vl emxG uf vm&ifwG ef ;vS nf ;wG ef ;zk d Y? xrf ; pifeJ Yxrf;zkdY? vuftd wfawG? yk 0gawGukd avQmf zGwf NyD;acgufzkdY cef Yxm;wJ h 0ef xrf ;awG yg/ ab; em;rS m olemjyKq&mracsmacsm av;awG vnf ; &S d aeav&J U/ oef Y &Sif;a&;0efxrf; ta':BuD;u ½k yf qk d ;oavmuf tayguf w,f qkd;ukd;As/ q&mrav;awGu awmh ½k yf vS oavmuf tayguf vS (tJ) oabmaumif;&Smyg w,f/ tomt,myJ vuf ,yf NyD;ac:w,f/
OD;av; 'Dbufuaewuf qk d NyD ; usaemf uk d ,f wk d if a&S UuOD ; aqmifNyD ; oGm;vkduf w,f/ t ay:a&mufawmh ckewke f;u atmfaewJ h 0ef xrf;uk d usaemf
aph aph Munf h vk d uf w,f/ bm&,f awmhr[kwfygbl;/ jynfwGif; jyefa&mufwkef; vkyfpm;Munhf wmyg/ [kduvnf; bmxif oG m;vJ rod bl ;/ tcsd K;uk d ajymif ; a&m/ 'D rS mcPxk d if yg bmnmeJ Y jzpf oGm;w,f/ rSwfyvm;/
BuHKwkef;av;ajym&OD ;r,f/ aq;½k H 0if ;eJ YtwG if ; taqmif u vljrifomwJhae&mawGrSm aq;
vdyfraomuf&? uGrf;wHawGr axG;&q kdwJh pmwef ;awGuy f xm;wmawG Y&w,f/ usaemfu uGrf;rpm;&&if raeEdkif? tJ'D vkd rsd K; apmifh ae&wJ h tcsd efrsdK;qkd &if yk d vk d Yawmif 0g;csif aeao;/ rae Ek d if vk d Y 0ef xrf ;a&S UrS myJ cyf wnf wnfeJ Y w,mxkwf0g ;vkduf
w,f/ NyD;awmh cke0efxrf ;ukd cyfapGapGMunfhw,f/ bmrsm; ajymrvJaygh/ ajymbl;As/ us aemf u pnf ;urf;r&S dvkd Yr[kwf bl;aemf/ uGrf;wHawG; raxG ;& yJ a&;xm;wm/ uG rf;rpm;&vkd YrS rygyJ/ vGwfygw,f/ NyD;awmh vnf; [k dta': a':tmus,f uk d aomuf n§if uyf vkd Y/
cG Jcef ;wHcg;yG ifh vmNyD; q&m 0efrxGufvmw,f/ OD;av;'g u OD ;av;orD; om;O>yefxJu cG J xkwf vk d uf wJ h oaEom;/ ao csmMunhfygqkdNyD; vmjyw,f/ usaemfhu dkawmif ac:jyao; w,f/ rMunfh& JvkdY/ cPae awmh vlemxGufvma&m/ t aqmif ukd wGef;vS nf;eJ Yjyeftykd Y rSm cGJcef ;0u 0efxrf; awGyJ wGef ;ykd Yw,f/ t&ifuqkd&if wGef;vSnf;cqkdNyD; ig;&m? w axmifxkwfay;rS wGef;ay;ay r,fh ckawmh bmwcG ef;rSr[/ aumif ;avpG/
&if;ES D;wJh olemjy Kq&mr awGvnf; *sLwDcsdefr[kwfay r,f h vmNyD; *½k pkd uf &Smygw,f/
wjcm; q&m^r awG vnf ; nif nifomomyJ ajymqkd Muw,f/]ukwifay:ukd jznf;jznf;wif
aemf? t&rf;rvkyf eJ Y} nifompGm yJ ok H;EI ef;Muw,f/ vlem&JUa0 'em w0ufoufomvm;awmh rodbl;/ usaemf a&m vlem apmif h yg pd wf csrf ;omoG m;w,f/ usaemfwk dYrSr[kwfygbl;/ w jcm;vlemawGukdvnf ; 'DvkdyJ ajymqkdqufqHaewmukdawGY& w,f/ eH &H uk d Munf h vk d uf awmh vl emuk d csKdompG majymqkdyg? rdrd
aqGrsdK;&if ;csmuJhok dY jyKpkygwJh/ td rfjyefa&muf awmh xrif;pm; &if;eJY aq;½kHu q&m^rawG quf qH yk H jyef awG ;NyD; auseyf ae &w,f/ [kd oef Y&Sif;a&;ta': BuD;awmh rygbl;/
'Dvkd rsdK; ajymif;vJ rIawG ukd BuHKawGvmcJh&wmawG aemuf ESpf&ufavmuftMumrSmyJ ae a&mifxd wJ hESif;vkd Muuf aysmuf
iSufaysmuf aysmufqkH;ukefyg w,f/ bmaMumif h vJ od ovm;/
jzpf yk H u we*F aEG aeYrS m zk ef ; 0if vmw,f/ aq;½k H uae vl em apmif h uvSrf ;quf wmyg/ aq; 0,f &r,f wJh/ 0,f aygh/ r[k wf bl ;wJ h aq;½k H uwm0ef us ol em jyKu tJ'Daq;qkdifrSmyJ0,f&
r,f/ aq;qk difu we*FaEG qkd ydwfw,f/ b,fvkdvkyf&rvJ wJh/ a[mAsm aq;0,fwmyJ b,f rS m0,f 0,f aygh/ ck awmhol ajymwJ hqkdifrSmyJ 0,f &r,f/ w jcm;qk d if r0,f&bl ;qk dawmh ce av; ]rr}qDzkef;qufvkdufOD ; r,f qk d NyD ; tk d *sD q&m0ef rqD zk ef ; quf &ygava&m/
&,f p&mav;ajymcsif w,f/ usaemf wJ h&if ;ESD ;wJh q&m0ef w a,mufu a'gufwmrawGu olwk dYuk d ]rr}ac:rSBud Kuf w,f/ wk d Yrsm;usawmh b,f ol rS ]uk d uk d} vk d Yrac:Mubl ;/ tJ 'gawmh rw &m;bl;wJh/ &,fp&mqkdayr,fh w&m;rQwrI r&S d bl ;vk d Y xif w,f aemf h/
xm;ygav/ tkd*s Dr (tJ)]rr}u b,fqk dif u0,f 0,f 'D
aq;qkd &ygw,f/ usrvnf; ol wkdYukd cPcP ql aewmyJ/ rrS wf Mubl ;/ tJ 'D wm0ef us q &mrukd usrqlvkd ufyghr,fvkdY ajymvk dufawmh aq;½ kHu kdw acgufoGm;NyD; aq;pm&Guf,l? aq;0,f NyD; ay;vkdufawmhrS
at;oG m;ygawmhw,f/ tJ 'Dq &mruk d vnf ; ½k H ;cef ;xJ rS m ]rr}u ac:qlvk dufwm usaemf awmif jyeftm;em,l&w,f/
tJ'Dvkd usaemfwkdYEkdi fiHrSm wzuf uvnf ; ajymif;vJ rIawG &Sdaew,f/ wzuf uvnf; 'kH &if ;? 'kH&if ;eJY vdrf z,fvd rfz,f oGm;aewmawG trsm;BuD;ygyJ/ usaemf BuHKawG YcJ h&wmu ae&m ao;ao;av;rS myg/ wjynf vk H ; rSm&SdwJh tjcm;ae&mrSma&m 'D xuf rqkd ;Ed kif bl;vkd Y ajymEdkifo
vm;/ yG if hvif;vmNyD? atmfvk dY& NyD? wk d;wuf vmNyDqk dayr,f h w csd KUwae&m waxmif h rS mawmh t &if vk d ygyJ/ vk H ;0rajymif ;vJ ao; wmvnf ; &S dao;w,f/ tJ 'gu jynfolYaq;½kHBuD;ay:rSm ywf wD ;? *Grf ;utp bmqk dbmrSr&Sd bJ tjyif uaeom 0,f,l ae& wmygyJ cifAsm/
okn
``` pmrsufES m (10) rS tquf
rD;aw GtwGufom jzpfw,f/ i,f ol awG rS moH k ;&if &moD rrS ef awmhbl;/ Mum;&ufqif;r,f/ twlaecsif pdwf enf;vmr,f/ wcsdKUrSmawmh ydkwmvJ &S dw,f/ rwnfholawGrS m ta&jym;rSm teDpufay:Edkifw,f/ &ifom; xG m;vmr,f/ qd k;wmu aoG ;cJ wwf w,f/ 'gaMumif h a[mf rk ef ;
2 rsdK;wGJyg udk,f0efwm;aq; rsd K;ud k touf 35 ESpfausmf&if ray;oifhbl;/
Deca Durabolin a[mfrkef; udk a&m*gawG (aoG;tm;enf; a&m*gawGeJY &ifom;uifqm) tjyif a,muf sm;a&m rd ef ;rawG ygoHk;wm &Sdw,f/ 'Daq;rSm ab;xGufq dk;usdK ;awGu w u,f qdk;w,f/ udk,fa&mif
r,f? 'gaMumif h vl u tav;csd ef wd k;vmr,f/ a,muf sm;awG rSm okwfydk;enf;r,f/ usm;taph xd cdk ufr,f/ yef ;nd§K;r,f/ &if om; xGm;r,f/ udkvufpx a&m aumif;wmuenf;NyD; r aumif;wmu rsm;r,f/ aoG;zd tm; wufr,f/ toJxdcdkuf r,f/ qD ;usdwfBuD;r,f/
usef;rma&;owif; topf
pufpufwcku bmajymvJqdk awmh arsmufawGudk pkxm;jyD ; prf ;wJ h tcg? taumif BuD ;awG u Ed kifcsif wmaMumifh pd wfnpf&wJ h arsmufawGrSm tqD pkNyD ;? 0rf ; acgif ; us,f vmowJ h/ aumuf csuf qG J &if pd wf 'k u© &&if 0w,f qd k bJ/ Ed k if vd k rif ;xuftES d yf puf cHae&ol rsm; tawmf bJ aygh/ 'g ayr,fh 'D oDtd k&Du vlawGt
wGuf rSm;ygw,f/ jref rmjynf qd k &if trS m;BuD ;
rSm;w,f/ pdwf aomur sm; wdk if;om 0&&if vm; Armjynf rSm ]qlrdk}orm;csnf;om jzpf awmh r,f/
q&m0efaumif;awGu t aumif;qH k; tBuHay;wm&Sdyg w,f/ trsd K;orD ;-rdef;uav;? ud k ,f tav;csd ef twG uf aomu
ydk rav;ygeJ Y/ cs Kyfvdkuf&if]]a&m*guif;&Sif;? xrif;[if;
rsm;rsm;? aq;0g;vnf;pm;? t av;vnf; rçyg}} cifAsm;/ pm; enf ;vnf ; od NyD/ pm;csif atmif vk yfenf;vnf; od NyD/ pm;csif wm pm;EdkifwJhb0rsdK; &zdkYu awmh arsmuf qd k ;rsm; ES d yf puf wm rcH MuygeJY cif Asm;/
a'guf wmwif haqG
7/27/2019 Nightingale Health Journal (September-2013)
http://slidepdf.com/reader/full/nightingale-health-journal-september-2013 14/16
usef ;rma&;*sme,f trS wf-37? puf wifbmv? 2013-ckES pf14 NIGHTINGALE
ud k ,f cH tm;usul ;puf a&m*g ydk; (HIV) &SdolawGudk ydk;wm; aq;uk xH k ; (ARV) apmapmay;zd k Y urÇ mh usef;rma&;tzG JYBuD ; WHO
u ZG efvuk efrSm vrf ;ñTef csuf topf csrS wfvd kuf ygw,f/ ok awoejyKcsuf awG t& a&m*g ydk; &Sd olawGud k ARV aq; apm apmwdk uf&if toufydk &S nf&Snf ae&Ek d if w,f? yd k usef ;usef ;rmrm ae&Edkifw,f? wjcm;ol awG udk xyfqifhu l;pufEd kifpGr f;vnf; enf;oGm;Edkifw,f qdkwm t axmuftxm;awG YcJh ygw,f/ 'gaMumif h 2025 ck ES pfrwdk if rD rSm yd k;&Sd ol 3 oef ;avmufudk rao atmifwm;qD ;Ed k if NyD ; vl 3 oef ;
Mum;umvawGudk awmh aemuf xyf prf;oyf rI awG vkyf NyD; qHk; jzwf&rS mjzpfygw,f/
vuf&SdumvrSm iSufzsm; umuG ,f aq;trsKd ; 20 avmuf
udk okawoDawG u prf ;oyfae MuNyD ; *vuf qd k uk rÜ PD u xk wf wJh RTS,S/AS01 umuG,faq; udk tmz&duwdkufrSm uav; 15000 eJ Y prf ;oyfaeygw,f/
urÇmhusef;rma&;tzGJ YBuD;
cG Javmufudk tdyfcsftd kif AG Da&m*g xyf r&atmifwm;qD ;Ed k if rS m jzpf ygw,f/
vrf ;ñT efc suftop ft& ck cH tm;qJ vf CD4 ta&twG uf 500 (aoG ; 1 ukArDvDrDwmrSm qJvf 500) txd usoG m;NyDqdk &if aq;pçpm;&rSmjzpfygw,f/ 2010 ckES pf wH k ;u xkwfjyef cJ h wJh t&ifvrf;ñTefcsufta[mif; uawm h CD4 ta&twGuf 350 txd a&muf rS aq;pçpm;& rS m jzpf ygw,f/ tck qd k &ifurÇ mh EdkifiHpkp kaygif ;&JU 90% [m vrf;ñT ef csuf ta[mif ;ud k usif h oHk ;aeMuygw,f/ EdkifiHtenf ; i,f uawmh CD4 500 owf
rSwfcsuf udk usif hoH k;aeNyDjzpfyg w,f/
Ed k if iH wd k if ;[m vrf ;ñT ef csuf topf awG ud k trsKd ;om;usef ;rm a&; ay:vpD awGxJ aygif;pnf; NyD ; vd k tyf wJ h &if ;jrpf awG eJ Yvnf ; axmuful ay;Ed kif r,f qdk&if od omxif&S m;wJ h jynfol Yusef ;rm a&;eJY wOD ;csif ;usef;rma&; t usKd ;tjrwf awG jzpf vmvd rf h r,f vd kY WHO tpD&if cH pmu qdkyg w,f/
vrf ;ñT ef csuf topf rS mygwJ h wjcm;wd k uf wG ef ;csuf awG uawmh td yf csf td k if AG D yd k ;&S d wJ h? 5 ES pf atmuf uav;i,f tm;vHk;? udk ,f0ef aqmif tm;vHk;? EdkYwdkufrdcif
tdyfcsftd kifAG Daq;ukxH k;opf
``` ausmzH k ;rS tquf (WHO) &J U tqd k t& 2010 ck ES pf rSm iS ufzsm;a&m*gjzpf ol 219 oef;&S dcJ hNyD; vlaygif; 660000 aoqH k ;cJ h ygw,f/ iS uf zsm;wd k uf zsuf a&;twG uf a':vm 5.1 bD vD,Hvdktyf aeayr,fh wu,f
ab;toG,foG,faiGeJ Y0,ftH hzG,f½l;awmhonf(uG rf ;a&S mif MuOfa&; ynmay;oHayguf rsm;)
ab;toG,f oG,f? aiG eJ Y0,f? tHh zG,f½l;awmhonf/ oGm;ESif hyg;pyf? vGef npf ywf? csd K;uyf½kyfonf/ ½kyf qkd;vk du? uGrf;ukd p? rkcs½kyf qkd;rnf/ uGrf;aoG;axG;Mu? tusnf;wefpG? NrdKUjy&S ufaeonf/
oGm;zkH;a&m*g? cHwG if ;em? vGefpG mqkd;0g;onf/ cH wGif ;tajr§;yg;? ysufqD ;oGm;? uGrf;0g;vQifjzpfonf/ uGrf;aq;&GufBuD ;? qkd ;usdK;BuD;? BuD ;rm;ukefusrnf/ eD ukdwif;"mwf? a&m*guyf? usyf odef ;&mcsD onf/ ab;xGuf;qkd ;0g;? oGm;zkH;rsm;? xdyg;jzpf aponf/ xkH ;rsm;0ifa&muf? qk d;usd K;aESmuf? ausmufuyfysufpD;onf/ aeYpOfpm;ok H;? aiGukd jzKef; bk H;bkH ;aysmufuG,f onf/ usyfig;&mrS? ES pfaxmifAs? oGm;[vG ifh ypfonf/ uGrf;,mxnfhpm;? "gwkrsm; ? wk dif ;jcm;rS 0,fonf/ wkdif;jcm;qD okdY? aiGawGyk dY? jzKef;zkdYomjzpfonf/ xkH;ESifhESyf aq;? vuf emao;? a&mif;ay;ol jzpfonf/ eD ukdwif;aq;? &D a0ao;? olYab;pG Javmufonf/ vnfacsmif;,m;,H? acsmif;qk djyef? vQmcH xlyd ef;onf/
bufwD;&D;,m;rsm;? csd K;uyfoGm;? rsm;pGmck datmif ;onf/ oGm;zkH;a&mifjcif;? oGm;usOfjcif;? xefjyif ;'ku© rS D/ qD;oGm;cufum? ausmufwnf vm? a&m*g0,fMuonf/ pG Jvef ;pdwf rsm;? tNrJ pm;? oem;pzG ,fjzpfonf/ vnfacsmif;uif qm? yg;uifqm? vQmuifqmjzpfonf/ tpmtdrfuifqm? tluifqm? uifqm>yef jzpf onf/ cH wGif ;uifqm? qkd;0g;pG m? urÇmrS mjzpf onf/ rsdK;pk Huif qm? jzpfvkd &m? pm;yguGrf ;tvDvD/ uGrf;ukdpGefYcGm? aiGpk yg? Opö mwk d;awmhrnf/ &T ifvef;usef ;rm? touf&Snf&m? jyifygtcsd efrD/
qvk dif ;a&T vif ;
tm;vHk;udk CD4 ta&twGuf b,favmuf& Sd&Sd ? ARV aq; wd kufzdkY jzpfygw,f/ 'ghtjyif vif r,m; od kYr[k wf vdifquf qH zuf cspf ol wwG J rS m wa,muf u tdy fcs ftd kif AGD ydk ;& SdN yD; w a,mufu r&S dao;&if vnf; yd k; &SdwJ h Muifazmftm;vHk;ud k aq; wd kufzdkY? wDbD odkYr[kwf toJ a&mif bD ydk ;&S dwJh tdyf csftdkifAGDydk ; &S d ol tm;vH k ;ud k vnf ; ARV aq; wd kuf zdk Y ajymygw,f/
aemuf ta&;BuD;wJh vrf; ñT efcsufuawmh aq;pçpm;wJh vl BuD ;tm;vHk ;[m tenofovir +
lamivudine (or emtricitabine) +
efavirenz oHk;r sKd;aygif ;aq; yrmPwrsKd;wnf ;udkbJ waeY wvH k;pm;zdkY jzpfygw,f/ t&if vd k udk,f 0efaqmif twGuf? NrD; aumif ayguf vl i,f twG uf? vl BuD ;twG uf qd k NyD ; aq;tcsd ef t q rcGJawmhygbl; (uav;t wG uf bJ aq;avQmh ay;ygw,f )/
2012 ckESpftukefrS m vl aygif ; 9.7 oef ;[m ARV aq; awG pm;oH k;aeMuygw,f/ 'D xJ rS m *vd k b,f vf zef &ef yH k aiGtzGJ Y BuD ;u Ed kif iH aygif ; 151 Ed kif iH rSm a&m*gyk d;&S dol 4.2 oef;udk aq; ay;aeygw,f/
WHO
&ef yHk aiG&wmu w0ufbJ&Sdvdk Y oef;aygi f;rsm ;pGmaomvlawG twGuf umuG,f a&;? prf;oyf ppfaq;a&;eJY ukoa&;wdk Yudk vufvSrf ;rrS Djzpfaeygw,f/
BBC
aoG ;wd k ;
q&m0efu aq;cef;vmjywJ h vl em&JU tom;ta&ud kMunfh NyD ; ]xl ;xl ;jcm;jcm;ud k aoG ;a&mif vQrf ;aewmbJ} vd kY rS wf csuf cs vd k uf awmh vl emujyef ajzygw,f/ ]aoG;wd k ;bJa'gufwm/ us aemfh rdom;pkqDu &vmwm/}
]tazbufuvm;? tarbuf uvm;As/}]r[k wfbl;cifAs} vdkYvlemujyefajzw,f/ ]usaemfhrdef;r rd om;pk qD u&wm}
][m? r[k wf wmAsm/ rd ef ;rbuf urd om;pk uae cif Asm;qD aoG ;wk d;a&m*g b,fvdk a&muf Ed k if rSmvJ}
vl emu ouf jyif ;csNyD ; ajzw,f ]a'guf wm olwdk YeJ Y wcg avmufvmaeMunf hygvm;Asm}
b,fvf*sD,rfEdkifiH tajc pdkuf urÇmhaysmf &Tifjcif; a'wm abhpf tzG JY&J U avh vmpl ;prf;csuf t& vlawG &JUaysmf&T if rI[m b0 &nf rS ef;csuf awG? b0t"d yÜ m,f awGeJY rqd kif bl;vdk Y qd kygw,f/ b0&J Ut"d yÜ m,f? b0&J U yef ;wd k if pwJh 'óeawG udk pOf ;pm;ae r,fhtpm; wuf<uvIyf &Sm;rI&Sd aewJh b0u aysmf&T ifrI yd k ay;wm
aysmf&Tifjcif;Ed kifiH awGY&w,f vd kY ygarmu© 0def;[dk 0ifu ajymygw,f/
a'wmabh pf tzG J Y&JU avhvm csufrsm ;t& vlawG&JUb0rSm aysmf &T if rI &S d zd k Y wjcm;vd k tyf wJ h t csuf awG u- - td rf axmif od k Yr[k wf cspf ol b0 ouf wrf;&SnfMumjcif;? - Ed kif iHa&;rSm wuf <upGm yg 0if aqmif&G ufaejcif;?
- tvk yf rS mjzpf ap? tvk yf tm; csd ef rS mjzpf ap wuf <uzswf vwf aejcif;? - npmud k tjyif xG uf pm;jcif ;? - oli,fcsif;rdwf aqGt&if; tcsmrsm;&S d jcif ; (ol i,f csif ;rsm; av aysmf &T if avawmh r[k wf yg)? - t&uf toif h twif h aomuf ol awGu vH k;0raomufol awG xuf yd kaysmf&Tifjcif;? - trsKd;orD;awG wef;wlt cGif hta&;ydk &wJh vl YabmifrSm t rsKd;om;awGu yd kaysmf&Tifjcif ;? - ½kyfacsmw,fvd kY tajymcH& wJ h trsKd ;om;awG u vS w,f vd k Y tajymcH&wJh trsK d;or D;awG xuf yd kaysmf&Gifjcif;? - rd rd uk d ,f rd rd ½k yf acsmw,f vd k Y ,lqolawG[m trSefwu,f ½kyfacsmolawGxufydk aysmf&Tif jcif;? - om;orD ;&S d&if aysmf&TifrI t qifh usqif;vmNyD ; olwkd YBuD; jyif ;t&G ,f a&mufvdk Y td rfcG J oG m; wJhtcg aysmf&TifrItqifh jrifh wufvmjcif;?
- tvkyf oGm;&mrSm ,mOfpD ;& csd ef enf ;&if yd k aysmf &T if jcif ; (,mOf pD;&csdef MumNyD ; vpmrsm;vnf; yd k raysmf &T if)? - tvkyfwaeukef wyifw yef ;vk yf NyD ;oG m;&if bD ,maomuf wm od k Yr[k wf yuf vuf uk vm; xd k if rS mxd k if NyD ; wD AD -AD 'D ,d k Munf h wmxuf tm;upm;avhusif h cef ;vkyfwmu ydkaysmf&T if jcif ;? - aeYpOf vk yf ief ;awG xJ rS m bm vk yf &if yd k aysmf w,f? bmvk yf &if raysmf bl ; rSwf om;xm;NyD ; aysmf wJh tvky fuav;awGy dkvkyf? ray smfwJh tvkyfuav;awG avQmhvk yfjcif ;?
a'wmabh pf tzG JY&JU okaw oejyKcsuft& vl awG rSm 0rf; enf ;rI [mvnf ; toH k ;0if w,f? vd ktyfw,f? tysufbuf trl tusifh udk [efYwm;zd kY rD ;eDjywJh oabmjzpfw,fvdk Y od&yg w,f/ vl awG[m tcsdef 10% avmuf 0rf ;enf ;wm vuf awG Y rS m tusKd ;&S d w,f vd k Y qd k ygw,f/
BBC
[m;aq;cef ;
5/Ad kif ;&yf pf yd k ;BuD ;&if h vmNyD ;aemuf xyf
CD4qJ vf rsm;xJusL;ausmf 0ifa&muf
vmjcif ;
HIV ydk ; b0oHo&m
HIVAd kif ;&yf pf yd k ;
HIV Ad kif ;&yf pf yd k ;
CD4 qJ vf
1/Ad kif ;&yf pf yd k ;u
CD4 qJvfudk wG,f
quf vd kuf NyD ; azmuf
0ifjcif ;
2/Ad kif ;&yf pf yd k ;awGyG m;rsm;vmjcif ;
3/ Ad kif ;&yf pf yd k ;uCD4qJ vf ud kwd k ufcd k uf zsufqD ;jcif ;
4/CD4 qJ vf xJ u
yd k ;i,fxG uf vmjcif ;
7/27/2019 Nightingale Health Journal (September-2013)
http://slidepdf.com/reader/full/nightingale-health-journal-september-2013 15/16
usef ;rma&;*sme,ftrS wf-37? puf wifbmv? 2013-ckES pf NIGHTINGALE 15
NAd wd oQaq;ynm*sme,f rS m ygwJh avhvmcsuft& 1996 ck rSm topfxk wfvkyfoH k;pG JcJhwJh Muufn§macsmif;qdk; umuG,f aq;[m xda&mufrI enf;w,f vdkY od&ygw,f/
tar&duefEd kifiHrSm touf 11 ES pf txuf vl aygif ; 32000 udk 2010 ck eJ Y 2011 ckwHk ;u umuG ,f aq;xd k;NyD ; avh vmwJh tcg 668 a,muf Muuf n§m acsmif;qd k;a&m*gjzpf wm awGYcJh ygw,f/
Muufn§macsmif;q dk; um uG,faq;eJY wG Jay;wJh ar;cdkif umuG,faq;eJY qHkqdk Yemum uG,faq;awGuawmh 100 &m EIef;jynf heD ;eD; xd a&mufrI &S dwm awGYcJ h ygw,f/ 'gawG eJ Y ,S Of&if Muu fn§ mumuG , faq ;u 53% uae 64% txdbJ xd a&muf cJh ygw,f/
Muufn§ macsmif;qd k;umuG,faq;rxda&muf 1996 ck rwd k if cif uoH k ;cJ h wJ h
Muufn§mumuG,faq;[m ydk xda&muf ayr,f h ab;xG uf qdk ; usKd;awG&SdvdkY umuG,faq;t opf ud k wD xG if cJ h wmjzpf ygw,f/ ok awoDtzGJ Yacgif;aqmif udk if Zmxm0& umuG ,f aq;avh vm a&;Xmeu 'g½kdufwm a'guf wm a&m*smbuf qf wmuawmh vuf &SdumuG,faq;xuf ydk xd a&muf wmudk xkwfvk yfzdkY aq; uk rÜPDawGud k wkduf wGef;vdk uf ygw,f/
'gayr,fh NAd wd ef Ed kif iH usef ; rma&;OD;pD;Xmeuawmh Muuf n§macsmif;qkd;umuG,faq;udk ud k,f 0ef aqmifrd cifawG xd k ;ay; wm[m ]]tvG ef YtvG ef tusKd ;&S d w,f}} vd k Y ajymvd k uf ygw,f/ vl BuD ;aw GrS mvn f; Muu fn§ m acsmif ;qk d; jzpfwwf NyD ; touf tEÅ&m,frpd k;&drf &ayr,f h arG;p
uav;awG ud k Muufn§ macsmif; qdk; umuG,fay;Edki fzdkY rdcif avmif ;awG ud k xd k ;ay;wm jzpf yg w,f/ arG ;puav;awG[m ES pf vom;t&G,fusrS umuG,f aq;xd k ;&wmjzpf vd k Y 'D uG uf vyf ud k rd cif buf uae jznf h ay;wm jzpfygw,f/
udk,f0efaqmifumv 28 ywfeJ Y 38 ywfMum;rSm Muuf n§mumuG ,faq; xdk;ay;jcif; jzifh jzpfay:vmwJh y#dypö nf;antibody awG [m tarqDuae
om;td rf xJ u uav;qD a&muf oGm; NyD; arG;pvawGr Sm um uG ,fay;wmjzpfygw,f/ 'D vdk umuG,faq;xdk;twGuf arG ;p uav;awG Muufn§mjzpfEIef; [m 2 vtwGif; 40 &mcdk ifEIef; avmuftxd usqif;oG m;cJh yg w,f/
New York Times / BBC
t*F vef Ed k if iH rS m td yf csf td k if AG D yd k ;ul ;puf cH ae&wJ h vl i,f wcsKd U [m c&pf,mef"r®q&mawGu bk&m;ocif udkbJ ,HkMunftm; udk;zdkY w&m;a[mvdk Y pm;aewJh aq;0g;awG ud k &yf ypf vd k uf Muyg w,f/
tckvdka[majym zdtm;ay;
wm t"d utm;jzifh Pentecostal yif wD aumh pfw,fvf c&pf,mef *dk Pf;u "r® q&m tenf;pkjzpf NyD; 'D *dk Pf;[m qkawmif;wmeJY wef cd k ;jym#d [mud k tjyif ;txef ,HkMunfwJ h tpGef;a&muf*d kPf ; wck jzpfygw,f/
uav;tdyfcsftdkifAGDtoif; [m a&m*gyd k ;&S d uav;awG eJ Y vl i,f awG ud k uk oaewJ h q&m0ef? olem jyK 19 OD;u dk ppfwrf; aumuf avhvmcsuf t& tck tjzpf tysuf awG ud k od vm&wm
jzpf ygw,f/ NyD;cJ hwJh 5 ES pft wGif; vlem 29 OD ;udk aq;rpm; bJ bk&m;ud kbJ qkawmif;tm; udk;zd kY "r®q&mawGuajymcJhNyD ; 11 OD;[m ajymwJ htwd kif ; vdk uf emcJ h Muw,f vd k Y q&m0ef 10 OD ; u owif;ay;ygw,f/
wjcm;q&m0ef awGeJ Y olem jyKawG? usef ;rma&;vk yf om;awG
tdyfcsftd kifAG Dvlembk&m;ud ktm;ud kygwJ h uvnf; w&m;a[mq&mawG u olw dkYvlemwc sK dUu dk qk awmif ; odkYr[kwf y&dwfa& aomuf &if a&m*gaysmuf r,f vd k Y ajymcJ hw,f vdk Y qd kygw,f/ 'D vd k eJY wcsKd UrdbawG[m om;orD; awG ud k attm&f wD aq;rpm;cd k if ; awmhwm jzpfuk efygw,f/ w
csKdU Edk Ywdk uf rd cif awG vnf ; aq; qufrpm;awm hbJ bk&m;q k awmif ;wmbJvk yf ovd k 18 ES pf rjynfhao;wJ h vli, fawGu vnf ;ud k ,f h oabmeJ Yud k ,f aq; &yfypfvd kufwmawG jzp fcJh yg w,f/
oif ;tk yfq&mu w&m; a[mpif jrif h xuf uaeNyD ; ]a[m 'D jrif hjrwfoefY&Sif;aom y&dwf a&ud k b,fESpf&uf aomuf &if a&m*gaysmuf r,f}vd k Y ajyma[m aewm bk &m;&S d cd k ;ausmif ; awmf
awmfrsm;rsm;rSm awG Y&w,fvdk Y touf 16 ES pf &S datmf vD Am (t rnf&if;r[kwfyg) u ajymyg w,f/ atmfvD Amh tar[m tHh zG ,f wef cd k ;awmf eJ Y a&m*gaysmuf ovdk jzpfoG m;wm awGYc JhNyD ; aemuf atmf vD Amuvnf ; aq; rpm;bJ&yfvdk uf vd kY tdyf csftdk ifAG D tajctae w[kefxkd ;qdk;0 g;
oGm;cJhygw,f/ 'geJY aq;jyef aomufcJhNyD; tckawmh bk&m; tay:,HkMunfrIudk aq;0g;eJY aygif ;pyf zd k Yvd k w,f vd k Y cH ,l aeyg NyD/
yif wDaumhpf w,fvf oif; tk yf q&mawG [m bmom0if vl emawG&JU toufawGudk tEÅ
&m,f jzpfatmifvk yf aew,f vd k Y uav;tx l;ukq&m0efBuD; a'gufwmwdke Dwefu ajymyg w,f/ bk&m;0wfjy KyGJawGrSm aq;pm;wm&yfz dkY ajyma[m wdkufwGef;wm tifrwef rSm; ,G if ;w,f vd k Y ol uajymygw,f/
ta&S Uydk if ;vef 'efc&pf,mef ausmif;awm fu yifwDaumhp f w,f vf oif;tk yf q&m pwDAdk twefem½Iduawmh olY toif; awmfxJ rSm rsuf rjrifawG rsuf pd jyefjrif wm? em;rMum;olawG
em;jyefMum;wm? uifqmvlem ESv Hk ;a& m*gvl emawG vHk ;0 aysmufuif;oGm;wm&Sdw,fvdkY ajymygw,f/ aq;rpm;eJY? q &m0ef qD roG m;eJ Yvd k Y ol wd k Y wcgrS rajymcJ hbl;vdkYvnf; jiif ;yg w,f/ yif wD aumh pf w,fvf "r® q&mtjzpf uae ES pf jcif ;toif ; awmfq&mtjzp f bmomul; ajymif;cJhol tpö &,fvftdkavmh zif *smemuawmh bk &m;ocif ud k ,HkMunfMu? aq;0g;udk r,Hk Munf MueJ Yvd k Y ajyma[mwmawG
&Sd cJ hw,f vdk Y qd kygw,f/ yifwD aumhpfw,fvf c&pf ,mef*d kPf;[m 2005 ckaemuf ydkif;rS m toif;om; ESpf qwdk; vmc Jhy gw, f/ txl ;ojzifh Ed k if iH a&T Uajymif ;ul ;0if vmwJ h tm z&du vlrnf; c&pf,mefawG tay: ydk vTrf ;rd k;rI &S dygw,f/
BBC
ta&S Utv,f yd k if ;touf ½S L vrf ;aMumif ;a&m*gpkodk Yr[k wf rm;pfa&m*g (Middle East Res-
piratory Syndrome or MERS)
[m uk vm;tk yf awG qD uvmwm jzpfEd k ifw,f vdk Y vif;quf aq;
ynm*sme,f rS m ok awoD awG u azmf jyvd k uf ygw,f/ rm;pfa&m*gaMumif h Mo*kwf
9 v,ftxd vlaygi f; 94 a,muful;pufcJhNyD ; tJ 'DxJrSm 47 a,muf touf qHk;cJhyg
rm;pfa&m*gZmpfjrpf w,f/ a&m*gydk ;[m vlvlcsif; ul;pufwm&Sdayr,fh wd&pämef wrsKd;r sKd;qDuvnf; ul;puf vmwmjzpf Ed k if w,f vd k Y ok awoD awG u ,l qNyD ; EG m;? od k ;? qd wf? ukvm;tkyf wd kYud k avhvmcJhyg
w,f/ ok awoetzG J Yacgif ;aqmif e,fomvefEdkifiHu ygarmu© rm&D ,Gefukyfrif;pfu ta&SUt v,f yd k if ;rS maygrsm;wJ h bd k YwvH k ; ukvm;tkyf awG rSm rm;pfAdkif;&yf
pfydk;&JU y#d ypönf ; antibody awG awGYcJh w,f vk dY ajymygw,f/ 'gh tjyif vif ;Ed k YrS mvnf; Ad k if ;&yf pf yd k ;ud k awGYcJh w,f vd k Y tar&duef ok awoDawGu ajymygw,f/
rm ;p fa &m *g tE Å& m,f aMumif h 2013 ck atmuf wdkbm vrSm [mh*sfbk&m;zl;oGm ;r,fh
rGwfpvifawGu dk aqmf'Dtm a&;As usef ;rma&;0ef BuD ;Xmeu owday;xm;NyD; touf 65 ESpftxuf vlBuD;awG? touf 12 ESp f atmufuav;aw G? udk ,f 0ef aqmif awG? emwm&S nf a&m*gonfawG ? udk,fc Htm; enf;olawGeJY uifqmvdk vrf; qH k;a&m*g&Sd olawG 'DESpf bk&m; zl;rvmzd kY wdkufwGef ;xm;yg w,f/ tar&due fEdki fiH a&m *gxdef;csKyfa&;eJY umuG,fa&; A[d kXme CDC uvnf ; aqmf'D
tma&;Asudk bk&m;zl;oGm;r,fh ol awG qifjcifzdkYeJ Y wudk ,fa& oefY&Sif;a&;? umuG ,fa&;awG vk yf Muzd kY tMuHjyKwd kufwGef ;ae ygw,f/
BBC/CDC
``` ausmzH k ;rS tquf
a';&S if ;u 0if ygvmygNyD/ azmX ztm½Hkudk e*dktwdkif;&Sdapr,fh od kYr[k wf ydk aumif ;oGm;apr,fh rsKd ;quf opfuG ef 'G rf wD xG if azmf xkwfEdkifol udk tenf;qH k; a':
vm 1 odef;uae 1 oef;txd csD;jr§ ifh r,f h Nyd Kif yGJ BuD ; usif ;yae ygNyD / pm&if;ydwfwJhtcsdefrS m Nyd Kif yG J 0if ol 500 &S d oG m;wJ h *d wf pf NydKifyGJ u tEd kif &ol awG udk 'DESpf aqmif ;OD ;rS m aMunmrS m jzpfyg w,f/
uG ef 'G rf uRrf ;usif ol wOD ;jzpf wJh umvDzdk ;eD;,m; rdom;p k usef;rma&;aumifpDu 'k OuúX &G ef z&J ZD ,J a&;uawmhtck tcsd ef xd vHk ;0 tvSnfh tajymif ; jzpf oGm;apr,fh uGef 'G rf rawG Yao; bl;vdk Y qd kygw,f/ tar&duef tpdk;& jynfyulnD a&;XmeUS-
AID u rsKd ;quf yGm;usef ;rma&; qdkif&m tBuD;wef;enf;ynm tBuHay; *sufzfpyD,Jvm;u vnf; tck bD vf*d wfpfvkyfwJh tBuHtpnfudk t&ifuvnf; vkyfcJh Muzl ;w,f? ratmifjrif cJ h bl;/ t&ifu ratmifjrifcJhay r,f h tckwacguf atmifjrifzdkY arQmf vifh w,fvd kY bD vf *dwf pfudk pm vS rf ;a&;cJ h ygw,f/ uG ef 'G rf eJ Y vdif qufqHwmu uGef'Grf ryg bJ vd if qufqH wmxuf ydk t& om&S d zd k Yvd k w,f? rd k ;umtusÐ 0wf NyD ; a&csKd ;&ovd k rjzpf zd k Yvd k w,f vdkY *sufpyD,J vm;u rSwfcsuf csygw,f/
tdE´d, cGJpdwfukq&m0ef a'gufwmtv’m&uf'Du xl; jcm;wJ h uG ef 'G rf awGwD xG if xm;&m
rSm wif;MuyfrIeJY yGwfwdkufrI avsmhenf;atmif vkyfEdkifcJhyg w,f/ pGyfxm;vsufeJ Y vnf ywf a&G U&Sm;Ed kif atmif vk yf xm; ygw,f/ aemuf uG ef 'G rf wrsKd ;u awmh &mbmeJ Yrvk yf bJ ay:vD ,l
&Dodef;qdk wJh yvyfpwpfzdk ifbm wrsKd ;eJ Y vkyf xm;vd k Y pGyf wJ h tcg b,fbufup GyfpGyf&w,fvdkY qd k ygw,f/ 'gayr,f h ay:vD ,l &Dodef;[m &mbmavmuf qef Y tm;us KHUtm; ½kef;jyeftm; r aumif ;yg/ ratmifjrif wJh uGef 'GrfwrsKd;uawmh a&csKd;wJhtcg qHyifrp dk atmif aqmif ;w Jh acgif ;pGyfuav;vd k xdyfzs m; av;wGifpGyf &wJh uGef'Grf jzpf yg w,f/ cPcPuRwfxGufae vdk Y a&mif ;rpGHcJhyg/
pya&;Al ;eJY &mbmt&nf zsef ;NyD; uG ef 'G rf jzpf oG m;wJ h enf ; udk vnf; pOf ;pm;cJhMuygw,f/ 'gayr,f h ok wf &nf xm;od k zk Yd ae &m rygwm&,f? jyef cRwf &if cuf wm&,faMumifh tvkyfrjzpfcJh ygbl;/ tvm;tvm&S dwJh uGef 'GrfwrsdK ;uawm h y&Gefwdk 4 puúefYuGef'Grfjzpf NyD ; 4 puúefYt
wGif; pGyfvdkY&wJh Al;eJYvmwm jzpf ygw,f/ vl Yta&jym;eJ Y yd k wl w,fqdkwJh qDvDuGefeJYvkyfwJh atmf&D*grDuGef'Grfuawmh t aumf'D,Hvdk twGefYtacguf av;awG ygNyD ; wif;Muyf raebJ
acsmif acsmif csd csd vI yf om&S m;om &Sdovdk aygufNyJr,fhtEÅ&m,f vnf ; r&Sd? b,fbufupGyf pG yf &NyD; 1 puúefYtwGif ; pGyf vdkY& w,f qdkygw,f/ atmf&D*grD ukrÜPD[m trsKd;orD;uGef'Grf awGvnf; xkwfvk yf ayr,f h vl Bud Kuf enf ;ygw,f/ urÇmh yx rqHk; ptdkqufqHa&;uGef'Grf? yg;pyf quf qH a&; uG ef 'G rf awG ud k vnf ; xkwfvkyf ygao;w,f/
avmavmq,fr Sm awmh a,muf sm;awG uG ef 'G rf oH k ;atmif]aphpyfaqG;aEG;enf ;} ud k rdef ;r
awG ud k oif ay;wm? uG ef 'G rf ynm ay;oDcsif;awG tqdktuawG umwGef;awGeJY qGJaqmifwm? uGef'GrfAl;awGudk ½SLaq;Al;vdk vk yfNyD; rod omatmif zHk ;uG,f ay;wmawG vk yf&if ; qG Jaqmif ae&ygw,f/
New York Times
7/27/2019 Nightingale Health Journal (September-2013)
http://slidepdf.com/reader/full/nightingale-health-journal-september-2013 16/16
usef ;rma&;*sme,f trS wf-37? puf wifbmv? 2013-ckES pf16 NIGHTINGALE
td yf csf tk d if AD G ^td 'f pf umuG ,f a&;twGuftrsKd ;om;awG uG ef 'GrfoHk;pGJa&;[m t"duusay r,f h b,f avmuf ynmay;ay; uGef'G rfoH k;zd kY pdwf rygwJh trsKd ; om;awGu &S daewm tm;vH k;t od ygbJ/ 'gaMumif h uG ef 'G rf xk wf vkyfolawG[m uGef'Grf yHk pHrsKd ;pHk xkwfv kyfNyD; qGJaqmifMuyg w,f/
a&mifpHk'DZdkif;awGeJYuGef'Grf? iS uf aysmoD ;&eH Y? yD au&eH Y? opf cG &eHY? acsmuvuf&eHY? oD;pH k&eHY pojzifh xnfh xm;wJh uGef'G rf? rdepf 20 cH "mwfcJoHk ; wkefcg
uGif;ygwJh uGef'Grf? rdepf 30 Mum tarS mifxJ rS mvif;wJh uGef 'Grf? tdkbm;rm;yHkygwJhuGef'Grf ponf ponfjzifh trsKd;rsKd;qGJ aqmif aeMuygw,f/
'gayr,fh yG if hyG ifh vif;vif; ajym&&if ratmif jrif yg/ a,m uf sm;awG u uG ef 'G rf rBud Kuf yg/ wurÇmvHk;rSm a,mufsm; 5%
uGef'GrfawG ?vlBud Kufrsm;apzd k Y
taemufwdkif;aq;ynm&JU
zcifBuD; [pfydkca&;wD;u q &m0ef awG [m oef Y&S if ;oyf &yf NyD ; t0wftpm; aumi f;aumif; 0wf &r, f? tar T;eHYomawG vdrf;usH&r,fvd kY vG ef cJh wJh ESpf 2000 u ajymcJhygw,f/ tck acwf rS mawmh q&m0ef qd k &if &S yf tusÐ vuf&Snf? eufwd kifvnf pD ;? *sLwD uk wf tjzLeJ Y pwuf od k pukyf (em;Muyf) vnfyif;rSm csd wf xm; od k Yr[k wf yk cH k ;ay:wif xm;wJ h yH k ud k ajy;jrif Muygw,f/ 'gayr,fh NAd wdef Edk ifiHrSm 2007
ckupNyD; q&m0efawGudk 0wf
pm;qif,ifrI vrf;ñ Tefc suf topfxk wf jyef cJ h&mrSm aq;½H krS wqi fh a&m*gu l;pufr Smu dk wm;q D;umuG,fwJ htaeeJ Y aMumif vQmoD;vd k wef ;vef ;us aewJ h vnfpD ;? tusÐ vuf&Snf (&S yf jzpf ap? *sLwD uk wf jzpf ap) eJ Y vuf ywf em&D wd kYud k ydwfyif cJ hyg w,f/
tckaemufydkif;rS mawmh q &m0ef i,f awG [m aq;½H k ay:rS m wD&S yf? pyd k Y&Syf awGeJ Y vkyf ud k ifae Muvd k Y q&m0ef *k Pf od u© m uif ;
rJ h aew,f vd k Y a0zef oH awGvl em awG qDua&m? q&m0ef BuD ;awG qD uyg xG ufaeygw,f/
tar&d uef Edk if iH rS mvnf ; NAd wd efvd k pnf;urf ;csufawG xkwf zdkY pOf;pm;aewm &Sdayr,fh tck tcsdeftxdawmh *sLwDuk wf t jzLa&mif[m usef;rma&;vkyf
om;awG &J U trS wf vu© Pm jzpf aeqJ yg/ tar&d um; aq;ynm *sme,f rS m ygwJ h avh vmcsuf t& aumfwifxm;wJ h *sLwDuk wft jzL? &SyftusÐ? aMumifvQmoD; vnfpD;? pwufodkpukyf em; Muyf wd k Y 0wf pm;qif ,if xm;wJ h q&m0efud k vlem 76% u tm;udk;,HkMunfrI&SdNyD; 'kwd, qif h ,H kMunf pdwf jzpf apwmu cG J pd wf cef ;oH k ;0wf pH k jym? a0gh uif ; ½SL;eJY pwufo dkpu kwftwGJ? wwd ,qif h bJ ,H k Munf tm;ud k ;
wmu taemufwdki f;0wfpHkeJ Y pwufod kpuk yf twGJ? ,HkMunf pd wf tenf ;qH k ; (4.7%) jzpf ap wmu wD &Syf? *sif;abmif ;bD? a0gh uif ;½S L;eJ Y pwuf od k puk yf t wG J jzpfwm awGY&ygw,f/
*sLwDukwf[m aq;½Hkay: rS m vl emwa,muf qD u wjcm; wa,mufqDudk a&m*gydk;awG jzefYw,fvdk Y pG yfpGJcHae&ayr,fh vl emawGuawmh q&m0efawG ud k *sLwDuk wfeJ YjrifrS tm;udk; csifpdwfay:aeygw,f/ BBC
q&m0ef Y t0wftpm;
tar&d uef aq;ynm&S if awG azmfxkwfxm;wJh iSufzsm;um uG,faq;[m ueOD;prf;oyf csuf aw Gt& tvm;tvm aumif;awG awGY&w,f vdkY ok awoDawGu od yÜ H*sme,fxJrS m azmf jyvd k uf ygw,f/
ar&D vif ;jynf e,fumuG ,f aq;okawoeXmeu a'guf wm a&mbwfqD'geYJtzGJY[m iSuf zsm;a&m*g wcgrS rjzpfzl ; ol 57 a,mufud k ac:NyD ; vl 40 udk umuG,f aq;xdk;? usef
17 a,mufudk rd k;a&bJ xd k;cJ hyg w,f/ 'D aemuf rS m iS uf zsm;ydk ;yg wJ h jciftud k uf cH apygw,f/ um uG,faq; txdk;rcH&olawGeJY umuG ,f aq;yrmP enf ;enf ; av;bJ xdk ;cH&olawG[m tm; vHk;vdkvk d iSufzsm ;jzpfc JhMuyg w,f/ 'gayr,fh aq;tcsdeft q tjrif hqHk; xdk;c H&wJh 15 a,mufrSmawmh 3 a,mufbJ iS uf zsm; jzpf wm awGY&ygw,f/
PfSPZ vd kYac:wJ h umuG ,f aq;udk azmfxkwf&mrS m "mwfcGJ
cef;xJar G;xm;wJ h jcifawGudk "mwfa&mif jcnfeJY ydk;owfNyD; jcifawG &J Uud k,f xJ u iS uf zsm;yd k; (yvmh prd k ;'D ;,rf ;z,f vf pD yg&rf ) ud k xk wf ,l ygw,f/ touf &S if ae ao;ayr,f h "mwf a&mif jcnf aMumifh tm;enf;oGm;wJ h iSuf zsm;yd k ;awG ud k a&wG uf NyD ; zef >yef awG xJ xnf h? vl YaoG ;xJ ud k wd k uf ½d kuf xkd ;oG if ;ay;cJh ygw,f/
aq;yrmPudk qH k ;jzwf zk dYeJ Y umuG,fqdk;xdk;&rnfhtBudrfeJY
tvm;tvmaumif;wJ h iSufzsm;umuG,faq;
bJ uG ef 'G rfoH k;Muygw,f/ uGef 'G rf rBudKuf MuwJ h twGuf r&nf &G ,f wJ h ud k ,f 0ef awG eJ Y td 'f pf tyg t0if vdifuwqif h ul ;pufwJh a&m*gawG jzpf vmygawmh w,f/
tckawmh 'DjyóemxJudk rd k ufu½d k aqmh zf uk rÜ PD bD vsHem ol aX;BuD; bDvf*dwfpf&J U azmif
pmrsufES m (15) odk Y ```
pmrsufES m (14) odk Y ```
Edk uf wifa*;vf usef;rma&;*sme,f od kY tBuH jyKpmrsm;? 0w¬K? uAsm? aqmif;yg;? pmrl rsm;ay;yd kY vdkvQif ...
t,f'DwmtzGJ UEdkufwifa*;vfusef;rma&;*sme,f
pmMunfhwdku f? r,fawmfa q;cef; rJaqmufNr dKU/
P.O.Box 156, Mae Sot, 63110Tak Province, Thailand
Phone : Office - 055544495
E-mail : ntg.journal@gmail.com
Edkufwifa*;vf usef;rma&;*sme,fudk tifwmeuf
wGif zwf½IvdkygvQif ...
www.maetaoclinic.org/publications ESifh
f f d f g f
iSufwkyfauG;opf vlvlcsif;ul;NyD w½k wf Ed k if iH rS may:xG uf vmwJ h rsKd;quf opf iSufwkyfauG;[m vl vlcsif;ul;pufwJ h taxmuf txm; yxrqHk ; tBudrftjzpf awGY&SdcJhw,f vdkY NAd wdoQaq;y nm*sme,frSm okawoDawGu azmfjyvdk uf ygw,f/ H7N9 iS uf wk yfauG;jzpfaewJh touf 60 t&G ,f zcif ud k jyKpk aeol touf 32 ES pft&G ,forD ;[mvnf; z cif qD u a&m*gul ;puf NyD ; ES pf OD ; pvHk; aoqH k;cJhygw,f/
tcktcsde ftxd iSufw kyf auG;opfjzpfol 133 a,muf&Sd cJ h NyD; tJ 'DxJu 43 a,muf ao cJh ygw,f / trsm;p kBuD;[m Muuf bJ aps;awG qd k if awG jcH awG uae ul;pu fcH&wm jzpf yg w,f/ wjcm;aoqHk;olawG&JU teD;uyfqH k; aqG rsKd ;awG udk ppf aq;Munf h &mrS mawmh yd k ;rawG YwJ h twGuf vlvlcsif;ul ;pufEdkif pGrf ;[m tuef Ytowf&S dyHk & w,f vd kY usef ;rma&;t&m&S d awG u ajymygw,f/ b,f vd k bJjzpf jzpf urÇmysHUuyf jzpfEd kif wJh t vm;tvmuawmh &S d aew,f vd k Y okawoDaw Gu owday;yg w,f/
H7N9 iSufwk yf auG;[m bJ awGqD uae t"duul;pufwm jzpf w,f vd k Y w½k wf ok awoD awG
Recommended