Feb , 13, 2014
 
Published from Palai
Issue : 49
Volume : 46
 
 
 
 
 
 
 
 

BbpcmtcmKyw
   
tUm. tPm¬ tPmÀPv Sn.
lrZbmLmXs¯ kq£n¡pI
   
A\p`h§fpsS shfn¨¯n EjnIÄ imcocnImtcmKy¯n\v tbmKmk\§fpw, ZoÀLmbpÊn\v izk\{InbIfpw ({]mWmbmaw) \ap¡v hcsa¶Xpt]mse \ÂInbncn¡p¶p. imkv{Xobamb ASnØm\apÅhbmWv ChsbÃmw. C¶p apX \mw ]cnioen¡p¶Xv tbmKmk\§fmWv. ZrVamb a\xiànsImWvSv Ch A`ykn¡Ww.
lrZbmLmXw (Myocardial Infarction) DWvSmIm\pÅ Gähpw {][m\ImcWw sImtdmWdn [a\n (lrZb¯n\v càsa¯n¡p¶ þ lrZbit]inIÄ¡v þcà¡pgÂ)bnepWvSmIp¶ t{Xmw_kv (Thrombuscà¯nsâ Hcp "I«') BWv. CXv lrZb¯nte¡pÅ cà{]hmlw XSÊs¸Sp¯p¶p. hfsc t\cw sImtdmWdn [a\n kzbw Npcp§nbncn¡p¶Xpaqehpw (Vasopasm) lrZbmLmXw DWvSmImw. càk½À±w AanXambn Ipdªp t]mIp¶Xpaqew lrZb¯nte¡pÅ cà{]hmlw Ipdbp¶Xpw lrZbmLmX¯n\p ImcWamWv.
e£W§Ä:
1. "ap³IqÀ' thZ\ (Premonitary pain)þlrZbmLmXw DWvSmIp¶Xn\p apt¶Xs¶ s\©pthZ\ tXm¶mw. icocw sNdpXmsbm¶v Bbmks¸Spt¼tgm NneÀ¡v hn{iamhØbn¯s¶tbm thZ\ tXm¶mw.
2. lrZbmLmXthZ\ (Pain of Infraction)þCSXp s\©nse thZ\ Igp¯ntet¡m tXmfntet¡m ]pdt¯t¡m CSXpIc¯ntet¡m hym]n¡mw.
3. aäp e£W§ÄþAanXamb hnbÀ¸v, £oWw, kw{`aw, AkzØX, izmkwap«v, Npa, OÀ±n, hbdpthZ\, s\s©cn¨n Chsbms¡bpWvSmImw.
]cntim[\IÄ cà]cntim[\bn lrZbmLmXapÅ ]£w lrt{ZmKkqNI§fmb (Cardiacspecific markers), CKMB, Troponin I, Troponin. T apXembh hÀ²n¨Xmbn ImWmw.
C.kn.Pn. (CeIvt{Sm ImÀUntbm{Km^v)bn A]mIXIÄ ImWs¸Sp¶p. CknPnbnse thhvkn {Iam\pKXamb amäw ImWmw.
s\©nsâ FIvkvtdbnepw lrZbw F¶ ]¼nsâ {]hÀ¯\w XIcmdnemIp¶Xnsâ e£W§Ä ImWmw (CHFConjestive Heart Failure).
lrZb¯nsâ hen¸s¯¡pdn¨pw anSn¸ns\¡pdn¨pw AdIfpsS hen¸w, `n¯nbpsS I«n, cà¯nsâ ]pdt¯¡pÅ Hgp¡v (Ejection Fraction) F¶nhsb¡pdn¨pw hyàamb [mcW \ÂIphm³ Ft¡mImÀUntbm{Km^n¡p Ignbp¶p.
FwBÀsF kvIm³; sSIv\ojyw 99 Fw ss]tdmt^mkvt^äv kvInân{Km^n; Xmenbw 201 kvInân{Km^n F¶nhbpw tcmK\nÀ®b¯n\v D]tbmKn¡p¶p.
dnkvIv ^mIvSdpIÄ (Risk Factors)þlrZbmLmX¯nte¡p \bn¡mhp¶ Nne Imcy§sfbmWv dnkvIv ^mIvSdpIÄ F¶p ]dbp¶Xv.
1. ]pIhen þ ]pIhen hfsc A]ISImcnbmWv. AXp sImtdmWdn [a\n Npcp§p¶Xn\nSbm¡pw. AXpsImWvSp ]pIhen Hgnhm¡Ww.
2. AanXh®wþAanXh®hpw A]ISImcnbmWv. AanXh®hpw Xq¡hpw Ipdbv¡Ww. BWp§fpsS Acs¡«nsâ Npäfhv 100 skâoaoädnepw s]®p§fptSXv 90 skâoaoädnepw Xmsg \n¡Ww.
3. sImfkvt{SmÄþ AanX sImfkvt{SmÄ lrZb¯n\p lm\nIcamWv. aäv AkpJ§Ä H¶panÃm¯bmÄ¡v 200 anÃn{Kmw % hscbmImw. {]talw t]msebpÅ aäv AkpJ§fpÅbmÄ¡v 150 anÃn{Kmw% IqSnbm¯s¶ A]ISamWv.
4. hymbmaanÃmbvaþCXv A]ISIcamWv. AXn\m \S¯w, ssk¡nÄ Nhn«Â, j«n _mUvanâ¬Ifn, shÅwtImcÂ, ]d¼nse ]Wn apXemb GsX¦nepw Hcp hymbmaw AXymhiyamWv.
5. `£W{Iaw þ Cd¨n, ap«, ao³ hdp¯Xv, F®¸elmc§Ä apXemb sImgp¸pw F®abhpw IqSpXepÅ `£Ww Hgnhm¡Ww. lmw_ÀKÀ, ]nÊ, tlm«vtUmKv, jhÀa apXembhbpw s]]vkn, sIm¡t¡mf apXemb ]m\ob§fpw A[nIw ]mSnÃ.
6. Dd¡w þ \à Dd¡w In«m\mbn {i²n¡Ww. Znhtk\ 6 aWn¡qsd¦nepw XpSÀ¨bmbn cm{Xnbn¯s¶ Dd§Ww.
7. im´amb a\Êv þ a\Êns\ im´am¡n hbv¡Ww. sS³j³ DÅhÀ BÂ{]mIvkv (ALPRAX), tkmw\nb (Zomnia), ¹mknU (PLACIDA) apXemb acp¶pIfn GsX¦nepw Ign¡Ww. sS³j³ AIäWw.
NnInÕþs\©pthZ\ DÅ tcmKnsb F{Xbpw s]s«¶v ASp¯pÅ Bip]{Xnbn F¯n¡Ww. {]mYanIip{iqjbv¡ptijw lrt{ZmKhnZKv[sâ ASps¯¯n¡Ww.
tcmKn¡v HmIvknP³ \ÂIp¶tXmsSm¸w Bkv]ncn\pw t¢m]ntUm{K (Clopidogrel), {]mkps{K (PRASUGREL) F¶nhbn Hcp acp¶pw \ÂtIWvSXv AXymhiyamWv.
dos]À^yqj³ NnInÕ (Reperfusion Therapy)þ CXnsâ Dt±iyw XSÊs¸«pt]mb sImtdmWdn càtbm«w ]p\xØm]n¡pIbmWv. CXv cWvSp hn[¯nepWvSv.
1. sImtdmWdn B³Pntbm{Km^n sNbvXn«p "_eq¬' D]tbmKn¨p sImtdmWdn [a\n hnIkn¸n¨v càtbm«w icnbm¡pI. CXn\v ANGIOPLASTY F¶p ]dbpw. hoWvSpw [a\n Npcp§mXncn¡m³ STENT Dw CSmw. PLAIN STENT Dw MEDICATED STENT Dw DWvSv.
2. t{Xmwt_mfnänIv NnInÕ (Thrombolytic Therapy)
ChnsS t{Xmw_kv([a\nbnse cà¡«) Aenbn¨p Ifbp¶ STREPTOKINASE, ALTEPLASE, RETEPLASE, TENECTEPLASE apXemb acp¶pItfsX¦nepw Ip¯nh¨v Aenbn¡p¶p. A§s\ càNw{IaWw ]p\xØm]n¡p¶p.
thZ\bIäm\pÅ SORBTRATE (\m¡nsâ ASnbn CSp¶Xv), _oäm t»m¡À, ss\t{SäpIÄ F¶nhbmWv aäp {][m\NnInÕIÄ.
lrZbmLmXw h¶hcn lrZbXmfw sXäp¶ amcIamb Ventricular Fibrillation hcm³ km[yXbpWvSv. AsXmgnhm¡m³ LIDOCAINE F¶ acp¶v {Un¸neqsS sImSp¡mw. saUn¡Â NnInÕ ^en¡m¯hÀ¡v Coronary bypass Surgery sN¿mw.
hnes¸« Bdp aWn¡qÀ!
s\©pthZ\ tXm¶n¡gnªm AXp \nÊmcambn¡mWmsX F{Xbpw s]s«¶p tUmIvSdpsS ASps¯¯pI. BZys¯ 6 aWn¡qÀ hfsc \nÀWmbIamWv. 6 aWn¡qdn\pÅn NnInÕ XpS§nbm tcmKn c£s¸Sm\pÅ km[yX GsdbmWv. 6 aWn¡qÀ Ignªm Xncn¨pw. ]ns¶ tcmKn ]cn{`an¡mXncnt¡WvSXpw AXy´mt]£nXamWv. F´ph¶mepw Ipg¸anà F¶ at\m`mhamIWw tcmKn¡v. tcmKnbpsS _Ôp¡fpw sh{]mfw ImWn¡msX im´ambn s]cpamdWw. AXp tcmKn¡v Bßhnizmkw \ÂIpw.

teJI³ hS¡³]dhqÀ tSm]vtamÌv saUn¡Â skâdnse I¬kÄ«âv ^nknjy\mWv.

BbpcmtcmKyw
tUm. FIvk¬ amXyqkv tImkvsaänIv UÀatämfPnÌv
FIvkv]m kvIn³ & tImkvsaänIv ¢n\nIv, Ipdhne§mSv
tNmZyw: 21 hbÊpÅ Hcp F³Pn\odnwKv hnZymÀ°n\nbmWv Rm³. Fsâ apJ¯p \ndsb apJ¡pcphpw ]mSpIfpw DWvSv. IkvXqcn aªÄ, Nµ\w XpS§nbh ]pc«n t\m¡n. ]e tUmIvSÀamscbpw ImWn¨p IpdhnÃ. CXpaqew F\n¡v BÄ¡msc s^bvkv sN¿m³ _p²nap«mWv. hfsc IjvSs¸Sp¶p.  

D¯cw: apJ¡pcp Sot\Pnsâ am{Xw {]iv\aÃ. 11þ55 hbÊn\nSbn apJ¡pcphcmw. tlmÀtam¬ skt_jykv {KÙnIfpambn _Ôs¸« ImcW§fmWv apJ¡pcphnsâ {]mYanIImcWw. Xebnepw F® Ipdbv¡Ww. apJ¯v Hmbn {Inw AcpXv. apJ¡pcp s]m«n¡m³ ]mSnÃ. tkm¸v, t^bvkv hmjv apJ¯v BImw. Clindamycin, Benzoyal peroxide, Tretinoin, Adapalene AS§nb te]\§Ä tUmIvSdpsS \nÀt±im\pkcWw apJ¯p ]pc«mw. Xm¦fpsS apJ¯v tUmIvSsdIWvSv ]oenwKv ssat{ImtkÀat{_j³, sUÀamtdmfÀ XpS§nbh sNbvXp apJ¡pcphpw ]mSpIfpw \¶mbn Ipdbv¡mhp¶XmWv. KpfnIIÄ Ipd¨p]tbmKn¡m\pw klmbamIpw. apJ¯v Aimkv{Xobamb Hcp te]\hpw D]tbmKn¡cpXv.


  tUmIvStdmSp tNmZn¡mw: tNmZy§Ä Abbvt¡WvS hnemkw: FUnäÀ, BbpcmtcmKyw, Zo]\mfw hmcnI, ]memþ686575
 

Chief Editor : Fr. Augustine Peedikamalayil
Managing Editor : Fr. Joseph Thadathil
Palai, Kottayam, Kerala, . 686575.
Ph : 04822 . 212842, Fax : 04822 . 212842
Email :
editor@deepanalam.com

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kIpSpw_w
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