Mjp Œ Mnuhf;fpak;  Œ rpwg;g[f; fl;Liu

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mbkhpf;f Kd;dhs; mjpgh; gpy; fpspz;lDf;F epa{ahh;f; kUj;Jt kidapy; fle;j 6e;njjp ig-gh!; mWit rpfpr;ir bra;ag;gl;lJ. mtUf;F fle;j rpy thu';fshfnt be";R typ kw;Wk; \r;R tpLtjpy; rpukk; ,Ue;jjhy; kUj;Jth;fs; M";rpnahfpuhk; ghpnrhjid bra;jdh;. mg;nghJ mtuJ ,jaj;jpy; gy uj;j ehs';fspy; Fwpg;gplj;jf;f mst[f;F milg;g[ Vw;gl;L fhzg;gl;lJ. ,jdhy; mtuJ ,jaj; jirfSf;F nrjk; Vw;gltpy;iy vd;whYk;/ vjph;fhyj;jpy; milg;g[ fhuzkhf uj;j ehs';fspd; Rth;fs; Kul;Lj;jdkhf khWk;nghJ khuilg;g[ mghak; Vw;gLk; tha;g;g[ cs;sJ. ,ijaLj;J mtUf;F jpl;lkpl;lgo mWit rpfpr;ir ele;jJ. ,e;j mWit rpfpr;ir btw;wpfukhf ele;jjhft[k;/ ,d;Dk; 4 my;yJ 5 ehl;fspy; mth; tPl;Lf;F mDg;gg;gLthh; vd;Wk; kUj;Jtkid tl;lhu';fs; bjhptpj:J cs;sd. mnj rkak; mth; KGikahf Fzkile;J tHf;fkhd gzpfspy; <LgLtjw;F ,d;Dk; 5 khjk; gpof;Fk; vd;W mth;fs; Twp cs;sdh;.

,ja mWit rpfpr;irfspy; gy;ntW tiffs; ,Ue;jhYk; ,d;iwa njjpf;F mjpf mstpy; bra;ag;gLk; mWit rpfpr;ir iggh!; rh;$hp jhd;. ,e;j mWit rpfpr;ir vg;go bra;ag;gLfpwJ> iggh!; bra;tjpy; cs;s Mgj;J fs; vd;bdd;d> bghJthf ,ja neha; vg;go cz;lhfpwJ> ,ja nehapd; mwpFwpfs; vd;bdd;d> ,ja neha;fis jLf;f tHp cs;sjh> vd;gJ gw;wp bjhlh;e;J tUk; fl;Liuapy; fhz;nghk;.

iggh!; rh;$hp vg;go bra;ag;gLfpwJ>

rhjhuzkhf xU rhiyapy; nghf;Ftuj;J Vnjh xU fhuzj;Jf;fhf epd;W tpl;lhy;/ my;yJ jLf;fg;gl;lhy; bry;y ntz;oa ,lj;Jf;F ntW xU ghij tHpahf Rw;wpf; bfhz;L bry;nthk; my;yth> mnj fij jhd; ,ja iggh!; rh;$hpapYk; eilbgWfpwJ. uj;j ehsj;jpy; milg;g[ cs;spl;l gy;ntW fhuz';fspdhy; uj;j bry;y Koahj epiy cUthFk; nghJ/ uj;j Xl;lj;ij epiy epWj;Jtjw;fhf ntbwhU g[jpa uj;j ehsk; bghUj;jg; gLfpwJ. mjhtJ uj;jk; iggh!; bra;ag;gLfpwJ. ,jd; \yk; ,jaj; jirfSf;F uj;jk; bjhlh;e;J fpilf;f tHp Vw;gLk;.

iggh!; mWit rpfpr;irapd; nghJ ,jaj;jpd; kw;w gFjpapy; ,Ue;njh my;yJ fhypy; ,Ue;njh bky;yp uj;j ehs';fs; vLf;fg;gLfpd;wd. gpwF bfhGg;g[ kw;Wk; mjd; gok';fs; fhuzkhf FWfyhfpg; nghd uj;j ehsj;ijr; Rw;wpYk; g[jpa uj;j ehsj;ij iggh!; bra;J bghUj;jp gpd;dh; ,jaj; jirfSld; ,izj;J tpLfpwhh;fs;. ,jd;\yk; uj;j Xl;lk; epiyepWj;jg; gLfpwJ. ,g;go bghUj;jg;gLk; uj;j ehs';fis grafts vd;W miHf;fp nwhk;. ,e;j tifahd mWit rpfpr;irf;F coronary artery bypass graft RUf;fkhf CABG vd;W tH';fg;gLfpwJ. ,j;jifa mWit rpfpr;ir mbkhf;fhtpy; rh;t rhjhuzkhf eilbgWfpwJ. ,jpy; fpspz;lDf;F mspf;fg;gl;l rpfpr;ir Md;-gk;g; vd;W tH';fg;gLfpwJ.

,e;j mWit rpfpr;ir bra;a bghJthf 5 kzp neuk; njitg;gLk;. ,e;j neuj;jpy; ,jak; bray;gLtJ 30 Kjy; 90 epkplk; tiu epWj;jg;gLk;. Kjypy; be";Rf;TL vYk;gpd; eLg;gFjpapy; 6 Kjy; 8 ,";r; MHj;Jf;F xU Xl;il nghLthh;fs;. ,jaj;ij neuoahf mqFtjw;fhf ,g;go bra;ag; gLfpwJ. gpd;dh; nehahsp ,jak; kw;Wk; EiuaPuy; iggh!; ve;jpuj;Jld; ,izf;fg;gLthh;. ,jd; \yk; mWit rpfpr;ir neuk; KGikf;Fk; nehahspapd; clk;gpy; uj;j Xl;lk; eilbgWk;.

gGjhd uj;j ehs';fSf;Fg; gjpyhf ntW uj;j ehs';fisg; bghUj;jpa gpwF rpwg;g[ tah;fs; \yk; be";Rf;TLk; vYk;g[k;/ ijay;fs; \yk; ,jaKk; ijf;fg;gLfpd;wd. ,j;Jld; mWit rpfpr;ir Kot[f;F tUk;.

CABG mWit rpfpr;irapy; hp!;f; vd;gJ egUf;F egh; khWgLk;. Mnuhf;fpa khd kdpjh;fSf;F ,e;j mWit rpfpr;ir kpft[k; vspJ/ mth;fs; vspjpy; cly; njwp tpLthh;fs;. Mdhy; Vw;fdnt ntW tifahd ,ja neha;fSk;/ EiuaPuy; gpur;rpidfSk; ,Ue;jhy; mth; fSf;F ,e;j mWit rpfpr;ir hp!;f;fhd tp#ak; jhd;.

ig-gh!; mWit rpfpr;ir hp!;f;Ffs;

bjhw;Wneha;

ek;Kila fhw;wpy; epiwa Mgj;jhd ghf;Ohpahf;fs; fhzg;gLfpd;wd. ,j;jifa ghf;Ohpahf;fs; mWit rpfpr;irf;fhf ,jak; jpwf;fg;gLk;nghJ vspjpy; bjhw;wpf; bfhs;s tHp Vw;gLfpwJ.

uj;jf; frpt[

mWit rpfpr;irf;fhf Xl;ilg; nghLk; ,l';fspy; my;yJ mg{h;tkhf ,jaj;jpd; cs;ns uj;jf; frpt[ cz;lhfyhk;.

uj;j ciwt[

ig-gh!; mWit rpfpr;irapd; nghJ uj;jk; ciwe;J fl;ofs; njhd;w tha;g;g[ cz;L. Vbddpy; mWit rpfpr;irapd; nghJ nehahspapd; uj;j Xl;lk; tHf;fj;Jf;F khwhf ve;jpuk; \yk; eilbgWtjhy; uj;j ciwt[ epfH;tJ cz;L. rpy neu';fspy; ,j;jifa fl;ofs; gf;fthjj;ij cz;L gz;zp tpLk;.

,Jjtpu khuilg;g[/ ,jaj;jpd; ,af;fj;jpy; tpnehjkhd khw;w';fs;/ rj;j';fs; kw;Wk; rpy neu';fspy; caphpHg;g[ Tl Vw;glyhk;. ,Ug;gpDk; kw;w ,ja mWit rpfpr;irfSld; xg;gpLk; nghJ ig-gh!; rpfpr;ir ghJfhg;ghdJ jhd;.

mWit rpfpr;irf;Fg; gpwF Fzk;

mWit rpfpr;irf;Fg; gpwF nehahspfs; kaf;f epiyapnyh my;yJ MH;e;j J}f;f epiyapnyh ,Ug;ghh;fs;. fhh;oahf; ,d;ld;rpt; nfh; a{dpl;oy; rpy kzp neu';fs; fle;j gpwF rhjhuz thh;Lf;F khw;wg;gLthh;fs;. mjd;gpwF 1 thuk; fHpj;J tPl;Lf;F mDg;gp itf;fg;gLthh;fs;. ,jd;gpwF nehahspfs; j';fs; ,jaj;jpd; gzpfis tHf;fk;nghy khw;wpf; bfhs;s kUj;Jth;fs; brhy;Yk; mwpt[iufis filg;gpoj;J tu ntz;Lk;.

,ja neha; vd;why; vd;d>

,ja neha; vd;gJ coronary artery disease vd;W kUj;Jth;fshy; miHf;fg;gLfpwJ. mjhtJ ,ja uj;j ehs';fspy; milg;g[fs; cz;lhtij jhd; ,g;go Fwpg;gpLfpwhh;fs;. milg;g[ Vw;gLk; nghJ ,jaj;Jf;F bry;Yk; uj;jj;jpd; mst[ FiwfpwJ. nghJkhd uj;jk; fpilf;fhj gl;rj;jpy; ehh;kyhd ,af;fj;Jf;F njitahd Mf;!p$Dk;/ rj;Jg; bghUl;fSk; fpilf;fhky; ,jak; jpz;lhl bjhl';fp tpLfpwJ.

,ja neha; vg;go cz;lhfpwJ>

,ja uj;jf; FHha;fs; ePs; cUis totpy; fhzg;gLk;. ,tw;wpd; cl;g[wk; kpUJthdjhft[k;/ ePl;rp jd;ik cilajhft[k; ,Uf;Fk;. ,jd; tHpahf jhd; uj;jk; gha;fpwJ. Od; V$; fhyj;Jf;F rw;W Kd; bjhl';fp ,e;j uj;j ehs';fspy; bfhGg;g[ bghUl;fs; nru Muk;gpf;fpd;wd. ,jdhy; uj;j ehs';fspd; Rth;fSf;F nrjk; cz;lhfpwJ. ,ij Fzg;gLj;Jtjw;fhf gy;ntW ntjpg;bghUl;fis clk;g[ Ruf;fpwJ. Mdhy; me;j ntjpg; bghUl;fs; Rth;fis cWjpj; jd;ika[ld; khw;wp tpLfpwJ. ,jdhy; ePl;rpj; jd;ik bky;y bky;y Fiwe;J bfhz;nl ,Uf;Fk;. ,e;j neuj;jpy; uj;jf; FHha;fs; tHpahf bry;Yk; g[nuhl;Od; fhy;rpak; kw;Wk; nehia Fzg;gLj;Jk; bry;fs; cWjpjd;ikia nkYk; nkYk; mjpfhpj;J bfhz;nl ,Uf;Fk;. ,it bfhGg;g[ld; nrUk; gl;rj;jpy; uj;jf; FHha;fspd; cs;ns jLg;g[fs; plaque njhd;Wk;. ,e;j jLg;g[fs; uj;jf; FHha;fis RUf;fp tpLk;. ,j;jifa jL;g;g[fspy; bgUk;ghyhdtw;wpy; btspg;g[wk; fuL Kulhdjhft[k;/ cs;g[wk; bfhH bfhHg;ghdjhft[k; fhzg;gLk;. ,jdhy; uj;jr; Rth;fs; fpHpe;J my;yJ nrjk; mile;J jLg;g[fs; tYthdjhf khwp tpLk;. uj;jf; frpt[k; Vw;glyhk;. ,e;j rkaj;jpy; uj;j ciwt[f;F fhuzkhd uj;j jl;Lf;fs; m';nf te;J nrUfpd;wd. mit jLg;g[fs; kw;Wk; milg;g[fis Rw;wpYk; r{H;e;J bfhs;tjhy; uj;j bry;tjw;fhd tHp nkYk; RU';fp nghfpwJ.

,g;gobahU epiyik cUthdt[ld; ,jak; g[jpa uj;j ehs';fis jhkhfnt cz;lhf;fpf; bfhz;L mjd; tHpahf uj;j Xl;lj;ij epiyepWj;j Kaw;rp vLf;Fk;. Mdhy; ,tw;why; ,ja jirfSf;F nghJkhd mst[f;F Mf;!p$ida[k;/ uj;jj;ija[k; rg;is bra;a KoahJ. rpy rkak; uj;j ciwthdJ/ uj;jf; FHha;fis Kw;wpYkhf milj;Jf; bfhs;tjhy; fLikahd be";R typa[k;/ khuilg;g[k; cz;lhFk;.

,ja uj;j ehs nehapd; mwpFwpfs;

ehs;gl;l ,ja uj;j ehs neha;fSf;F mwpFwp vd;why; Angina vdg;gLk; typia jhd; Fwpf;Fk;. Angina vd;why; mrt[fhpak;/ mGj;jk;/ milj;Jf; bfhs;jy;/ typ czh;t[/ be";irg; gpHptJ nghd;w czh;t[ nghd;w mwpFwpfs; bjd;glyhk;. ,tw;iw rpyh; be";brhpr;ry;/ $Puzkhftpy;iy vd;W jtwhf vLj;Jf; bfhs;fpwhh;fs;. m";irdh typahdJ be";rpy; jhd; tu ntz;Lk; vd;w mtrpak; ,y;iy. ,lJ njhs;gl;il/ iffs;/ fGj;J/ jhil/ bjhz;il Mfpa ,l';fspYk; tuyhk;.

,ja uj;j neha;fSf;fhd kw;w mwpFwpfs;

1. \r;R jpzwy;
2. tHf;fkhd yg;-lg; rj;Jj;Jf;Fg; gjpyhf g[jpa mnj rkak; FHg;gkhd xypa[ld; Toa ,jaj; Jog;g[
3. ntfkhd ,jaj;Jog;g[
4. jiyRw;wy;/ fpWfpWg;g[
5. the;jp/ mUtUg;g[
6. tpah;it kiHahf bfhl;Lk;

,ja neha;fSf;fhd fhuzpfs;

,ja neha;fSf;F gy;ntW fhuzpfs; cz;L. ,tw;wpy; rpytw;iw fl;Lg; gLj;j Koa[k;. rpytw;iw fl;Lg;gLj;j KoahJ. ,jpy; fl:Lg;gLj;j Koahj fhuzpfs; tUkhW-

1. Mz; ,dk;
2. taJ
3. ,ja neha; gw;wpa FLk;g ghuk;ghpak;
4. bkndhgh!; fl;lj;Jf;Fg; gpwF
5. fWg;g[ ,dkh> bts;is ,dkh>
(bts;is ,dj;jth;fisf; fhl;oYk; fWg;g[ ,dj;jth;fSf;F ,ja neha; Mgj;J ,aw;ifahf mjpfkhf ,Uf;fpwjhk;)

fl;Lg;gLj;jf; Toa fhuzpfs; epiwa cs;sd. mtw;iw fl;Lf;Fs; itj;Jf; bfhs;s Kiwahd Kaw;rpfis nkw;bfhs;Sk; nghJ ,ja neha; Mgj;Jk; FiwfpwJ. ,dp fl;Lg;gLj;jf; Toa fhuzpfs;

1. g[ifg;gpoj;jy;
2. vr;ovy; ey;y bfhGg;g[/ vy;ovy; bfl;l bfhGg;g[
3. vy;iy kPwpa uj;j mGj;jk;.
4. cly; gapw;rpapd;ik
5. cly; gUkd; (ehh;ky; vilf;F nkny 20 rjtPjk; TLjyhf ,Ue;jhy;)
6. ePuHpt[
7. nfhgk;/ kd mGj;jk;

,ja neha; Mgj;ij Fiwf;f vd;d bra;ayhk;>

ek;Kila md;whl thH;f;if Kiwapy; njitahd khw;w';fis bra;J bfhz;lhy; ,ja neha; Mgj;J Fiwa[k;. mnj rkak; ,tw;iw filg; gpog;gjhy; ,ja neha; Mgj;J Kw;wpYk; tuhJ vd;W nfuz;o bfhLf;f Koah tpl;lhYk; cly; ,af;fk;/ kdf; fl;Lg;ghL cs;spl;l tp#a';fs; c';fSf;F ntW tifapy; ed;ikfis Vw;gLj;Jk;. Vbddpy; rpy Mgj;jhd fhuzpfs; kw;w fhuzpfSld; bjhlh;g[ bfhz;Ls;sjhy; ,jpy; xd;iw rhpg;gLj;Jk; nghJ/ kw;wjpYk; mjd; gyid mDgtpf;f Koa[k;.

,ja nehia Mgj;ij Fiwf;Fk; rpy tHpKiwfs;

g[ifg;gpoj;jiy iftpL';fs;

g[ifg;gpof;fhjth;fSld; xg;gpLk; g[ifg;gpog;gth;fSf;F ,ja neha;fs; tUtjw;F 2  kl';F TLjy; tha;g;g[ cs;sJ. xUntis mth;fSf;F khuilg;g[ gpur;rpid ,Ue;jhy; ghjpg;g[ ,d;Dk; mjpfk;. g[ifg;gpof;Fk; gHf;fj;ij iftpLtJ mtuth; ifapy; jhd; cs;sJ. Kad;why; KoahjJ xd;Wkpy;iy. mnj rkak; ,e;jg; gHf;fj;ij epWj;jp tpl;L jpUk;gt[k; bjhl';fpdhy; Mgj;J ,d;Dk; caUk; vd;gij kwe;J tpl ntz;lhk;.

bfhy!;l;uhy; rkhr;rhuk;

bfhGg;gpy; ey;y bfhGg;ghd vr;ovy;/ bfl;l bfhGg;ghd vy;ovy; vd 2 tiffs; cs;sd. ,jpy; ey;y tp#ak; mjpfkhft[k;/ bfl;l tp#ak; Fiwthf ,Uf;Fk;go ghh;j;J bfhs;s ntz;Lk;. ,jw;fhd itj;jpaj;ij rhg;gpLk; cztpy; ,Ue;nj filg;gpof;;f ntz;Lk;. bfhy!;l;uhy; rj;Jf; Fiwe;j/ mnj rkak; clk;g[f;F ghjpg;g[ Vw;gLj;jhj bfhy!;l;uhy; epiwe;j (Saturated) czt[fis ghh;j;J rhg;gpl ntz;Lk;.

uj;j mGj;jk;

taJ te;j xt;bthUtUk; uj;j mGj;jj;ij fl;Lf;Fs; itj;Jf; bfhs;s ntz;oaJ kpf kpf mtrpak; MFk;. uj;j mGj;jj;jpy; 2 epiyfs; cs;sd. ,jpy; rp!;lhypf; uj;jk; mGj;jk; 140f;Fk; nkYk;/ lah!;lypf; uj;j mGj;jk; 90f;Fk; nkYk; ,Ue;jhy;/ mJ cah; uj;j mGj;jk; vd;W mh;j;jk;. uj;j mGj;jj;ij fl;Lg;gLj;j kUe;J khj;jpiufspd; g';F Kf;fpakhdJ.

RWRWg;g[

Xust[f;F nyrhdJ Kjy; kpjkhd mst[f;F clw;gapw;rp bra;gth;fSf;F Tl gy;ntW neha;fspy; ,Ue;J ghJfhg;g[ fpilf;Fk;. ,jpy; ,ja neha[k; mlf;fk;. ,g;go ,Uf;Fk; nghJ clw;gapw;rpna ,y;yhky; Rk;kh cl;fhh;e;J ,Ue;jhy; ,ja neha; Mgj;J vg;go ,Uf;Fk;> vd;W fw;gid bra;J bfhs;S';fs;. clw;gapw;rp vd;why; mjw;fhf g!;fp vLg;gJ/ btap;l; J}f;FtJ vd;W mh;j;jk; bfhs;s ntz;lhk;. rhjhuzkhd thf;fp';/ njhl;l ntiyfis bra;jhny nghJk;. clw;gapw;rp bra;gth;fSld; xg;gpLk; nghJ Rk;kh cl;fhh;e:J ,Ug;gth;fSf;F jhd; gy;ntW neha;fs; tUfpd;wd vd;gJ Fwpg;gplj;jf;fJ.

cly; vil

,ja neha;fis jLg;gjpy; cly; vil kpft[k; Kf;fpakhd tp#ak; MFk;. xt;bthU TLjy; vila[k; c';fs; ,jaj;Jf;F Mgj;ij Vw;gLj;Jk;. my;yJ ,ja neha;fSf;F J}gk; nghl;L tuntw;Fk; ePuHpt[ nghd;w neha;fSf;F fhuzkhFk; vd;gij kwe;J tplf; TlhJ. Vw;fdnt ele;Js;s gy;ntW Ma;t[fspd; \yk; ,ja neha; Mgj;ij mjpfhpg;gjpy; clk;g[ vil bghpa g';F tfpf;fpwJ vd;W bjhpa te;Js;sJ. rhpahdgo rhg;gpl;L/ rhpahdgo clw;gapw;rp bra;J te;jhy; cly; vil vd;gJ xU gpur;rpidna ,y;iy.

kd mGj;jk;

nfhg jhg';fs;/ kd mGj;jk; Mfpatw;iw \l;il fl;o itj;J tpL';fs;. Vbddpy; ,it gf;fthjk; kw;Wk; khuilg;ig tutiHf;Fk; tpUe;jhspfs; MFk;. kd mGj;jj;ij fl;Lg;gLj;j jpahdk;/ nahfhrdk; cs;spl;l gapw;rp fspy; c';fs; kdij jpUg;gp tpL';fs;.

ePuHpt[

ePuHpt[ gpur;rpidia fl:Lg;gLj;jh tpl;lhy; ,jaj;Jf;F bgUk; nrjk; Vw;gLk;. gpwbfd;d> khuilg;g[/ caphpHg;g[ nghd;w mgha';fs; xd;wd; gpd; xd;whf tUk;. ePuHpt[ nehia fl;Lg;gLj;JtJtjhy; ,ja neha; vd;gJ kl;Lkpy;yhky; rpWePuf; nfhshW cs;spl;l gy;ntW bjhy;iyfspy; ,Ue;J tpLjiy bgw Koa[k;.

Ke;ija fl;Liufs;