nightingale health journal (july-2013)

7/27/2019 Nightingale Health Journal (July-2013)

http://slidepdf.com/reader/full/nightingale-health-journal-july-2013 1/16

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rrSe fuefwJ h usef; rma& ; apmi fha&S muf rI

vlrItqifhtwef;awG[m usef;rma&; rnD rrQrI awGeJU eD; eD;uyf uyf qufEG,frI &Sdaeyg w,f/ usef ;rma&;tajctae r aumi f;wJ holawG[m qif;&J wGif;oufqif;Mu&NyD; qif;&J wJholaw Gu use f;rma&; r aumif ;Muygbl ;/ urÇ mh usef;rm a&;tzG J UBuD ;&J U avh vmrI t& ed rf h

uswJh vlrIpD ;yGm;a&;tvTmawG &SdwJ h wdk if;jynfawG twG if ;rSm tqdk;qHk;usef;rma&; tajct aeawG awGU&w,fvdkY qdkyg w,f/ usef;rma&;[m ynm a&;eJY owif;tcsuftvuf & ,l Ed k if rI awG eJ Y quf pyf aewJ h vl rI tpd wf tydk if ;w&yf vnf ; jzpfyg

w,f/ usef ;rma&;eJY ywfouf NyD ; qif ;&J jcif ;qd k wm[m 0if aiG enf;yg;rI? ynma&;e drfhusr I? vl rI a&;oD ;jcm;jzpf aerI eJ Y obm 0ywf0ef;usifqdkif&m ,dk,Gif; ysufpD ;rIawG tygt0if jzpfae ygw,f/ wdkif;jynftrsm;pku qif;&J om;awG [m qif;&J jcif; u aygufyGm;ay;vdk uf wJh usef; rma&;raumif;rI eJ Y raumif ;wJ h usef;rma&;u aygufyG m;ay; vdkufwJ h qif ;&jcif;qdkwJh oHo &mrS m vnfaeMuygw,f/

usef ;rma&; uG m[csuf rsm; vl rI pD ;yG m;a&;tqif h tajc

taeu usef;rma&;e,fy,f oH k ;ck rS m ouf a&muf rI &S d ygw,f/ a,bk, s use f;rma&;apmi fh a&SmufrI? obm0ywf 0ef;usif 'Pfc H& jcif ;e JY usef ;rma&; aqmif ½G uf yH kawG yg/ tar&d uef jynf axmif pk twG if ; uav;ol i,f usef;rma&;ppfaq;rIvk yf &mrS m 0if aiG enf ;wJ h rd om;pk awG u uav;awGeJY ynmrwwf

wJ hol awG&J U usef ;rma&;[m t qd k ;qH k ;jzpf w,f qd k wm awG U&S d cJ h & ygw,f/ vlrIpD;yGm;a&;tqifh tajctaewd k;wufvmwmeJY a,bk,susef;rma&; tajct aevnf; jrif hwufvmwmygyJ/ tvm;wltajctaeud k tmz&d uef? tar&duefuav;awG eJU vufwiftar&du uav;awG rSmvnf; awGU&ygw,f/

0ifai GeJY ynma& ;tqif h wd k;wufvmwmeJ Y usef ;rma&; vnf ; wd k ;wuf vmwmygyJ/ t ar&d uef jynf axmif pk twG if ;u t& G, fa&muf Ny D;olawGtz dk Y vnf ; use f;rma&;tqi fhe JY touf wm[m ynma&;tqif h eJY 0ifaiGwd k;wuf vmwmeJYtrQ wd k ;wuf vmwm awG U&ygw,f/

qif ;&J jcif ; qif;&Jjcif;eJY a&m*gb,

awG[m taMumif;wcku w jcm;taMumif ;wck ud k axmuf yif h ay;NyD ; yl ;uyf wG J zuf aeygw,f/ qif;&Jom;awGudk tajccHtm; jzifh ½dk ufcwfaewJh a&m*gb, awGu ydkNyD; qif;&JwGif;euf oGm;ap? tajctaeudk ydkNy D; qd k;0g;oG m;apygw,f/ qif ;&J jcif;u vlawGudk qif;&Jr IeJY qufEG ,f aewJ h a&m*gb,awG a&SmifvTJ zd kYcuf cJatmif vkyfay;

pd k ;aevif ;





olwdk Ywd kif;Nynf awG u (t aemufwdk if ;) aq;ynm pw,f qdkawmh usaemf wdkYrS m ol wdkY&J U tac:ta0:rsm;udk odrS q&m 0ef Nzpf Ed k ifw,f/

wywfNyD;wywf pmar;yGJ

awGtMum;rS usaemfwdkY vleJY awmi f rw lawm h/ txkt axmif; oG ef oif qH k ;rrI cH&NyD ;rS om q&m0ef Nzpf vmMuwmyg/ oif wef ;av; 3- 4 ES pf avmuf wuf/ &mxl ;awG &qd kovdk rsdK; r[k wf/ ck ES pf ES pf ck ES pf rd k ; pmoif Mu&w,f/ &nf ;pm;xm;csif wm awmif tcsdefr&/ tJ... usaemf uvnf; ½kyfuqdk;qdkawmh ydk qd k ;/ ausmif ;wuf wm ck ES pf ES pf/ BudKufr,fhvl wa,mufrSudk ay:rvm/ xm;/

aemuf q&m0efcsufNcif; rNzpf/ tvk yf oifu wES pf/ t ½dku fcHv dkuf&wJhvuf/ vuf axmuf q&m0ef jzwf &r,f h Mud K; ud k cPcPvk jzwf vd k Y/ ausmif ; om;b0uwnf ;u tck xd zwf vd k uf &wJ h pmawG/ 'D b0 vl jzpf &

ADAM'S APPLE qd konfrS m vnfZvkyfjzpfygonf usdK; reyf/

'k wd ,ES pf MB rS m tm'rf wd k Y tmcd vd wdk YeJ Y qH k cJh &w,f/ wwd ,ES pf MB rS mwk ef ;u usaemf wd k Y yd k ;rT m;aA'awG oif &w,f/ tJ 'D rS m Ziehl wd k Y Neelsen wdk YeJ Y qH k cJ h

w,f/ aemufawmh qHk vdkuf wJh q&mBuD;awG rsm;rSrsm;/ pdwf awmif npfw,f/ olwdkYemrnf csnf ; usufae&w,f/ usaemf wdkYwdkif;jynfuom t&ifawGY Munf h/ vG ,f vG ,f av; jzpf aerS m aygh/

tJ usaemfwd kY q&mawG r[kwf ayr,fh q&mawGygyJ/

aq;ynm&SifawGu wckck awGY&SdNyD qd kygu olwdk Ytrnf wyf *k Pf NyKac:qd kcH&w,f/ tJ 'gaumif;w,f/ raumif;wm u usaemfwd kY ol wdkYtrnfawG ud k vdk ufusuf ae&wmyJ/

qdk ygpdk Y/ cE¨maA'bmom&yfrSm q

&mu vnfaphudk axmufNyD; bmvJ/ &Sif;Ny- ar;r,f/ bm t½dk;vJ ar;r,f/ vnfZvkyf

vnfZv kyf odyfray:w Jh t ajcmuf awGu &Sdao;w,f/

usaem fxy faw G;rdwmu a,musF m;awG rS Zvk yf ay:NyD ; t

rsd K;orD ;awG rS m bmaMumif h ray: vJ/ jzpfEdkifvm; rjzpfEdkifvm;

awmhrod/ yHkjyifav; wyk'f awmh Mum;zl;w,f/ urÇ mOD;u bk&m;oci fu vla,musf m; tm'rfeJY vlrdef;r {0 wdkYudk zef qif ;cJ h w,f/ azazmf 0g&D 14 &ufvm;awmhrod/ bk&m;u yxrqHk;vlom;pHkwGJudk wck awmh rS mxm;owJ h/ O,sOf txJ rSm&S daewJh opfoD;awG Bud Kuf wmpm;/ tJ yef ;oD ;awmh rxd eJ Y wJh/

waeY {0 csOfjcif;wyfNyD; yef ;oD;udk cdk;Nrd Krdw,f/

rsd KvdkYaumif ;vd kufwm 'rf&,f/ vnfacsmif ;xJ avQmueJyJ/

tm'rfudk yef;oD;wvH k; cl;

tm'rf yef;oD ;udk pNyD; rsdK aewk ef ;rS m bk &m;ocif bGm;u eJ ay:vmowJh/

(tm'rf wd k Y yef ;oD ;ud k ud k uf

pm;&rSef; rodao;/ "mwfajr MoZmawG ray:ao;qdkawm h yef;oD;av;u enf;enf;ao; yH k&w,f/)

]a[h olcd k;awG} tm'rf rS m yef ;oD ;BuD ; rsd Kvdk Y

wef;vef;/ cdk;xnf cdk;xkyfeJY rda&m/ vnfyif;r Sm tzkBuD; xvd kY/

aemufawmh Adam’s apple

qdkNyD; trnfwGif cJh owJh/ tJ'gu ta&;rBuD;/ usaemfwdk Y aq;ausmif ;

wu fawm h vnfZvky fu d k Adam’s apple [k ac:ygonf? Adam’s apple qdkonfrS m vnfZvkyf jzpfygonf [k pmawG

usuf ae&a&m/ awmfawmf qdk ;wJh tm'rf/ (bdk ;awmf? ab;awmf? bD

awmf? bifawmf? ...awmfrsm ; trd kuftrJav;u dk cGi fhvTwf awmfrl Muyg/)

tm'rf NyD;awmh tmcd vdpff vmygNyD/ tmcd vdpf um; ol&J aumif ;/ t*Fvd yfvd k Achilles / ( A aemufwG if r tu©&m ryg wmudk owdNyKyg) acgrol&J

aumif;? ewfbk&m;om;awmf? aoewfNyD;w,f/ wckawmh&Sd w,f/ wae&mrS m [muGuf&Sd w,f/ olYtaru ol Uom; ao ewfNyD;&ef ewfa&uefrSm ajcz aemif h aMum (Achilles tendon) ud k ud k if um a&ES pfNyD ; pGrf ;tm;jznf h ay;w,f/ udkifxm;wJhae&mu ewf a&eJ Y rxd vd k uf &/ tJ 'D ae&m uawmh aoewfrNyD;awmh/ odk Y aomfxd k vQd KU0S uf csuf ud k rnf ol rS rodMu/

ppfyG Jwdk if;Ed k if w,f/

waeY x½dG KifppfyGJjzpfawmh ol vnf ; 0if wd k uf a&m/ ol Yrd ef ;r ud k &efolawG vmbf xd k ;NyD; [m uG uf ud k &atmif ,l w,f/ rd ef ;r cspfvS wJh ol&Jaumif ;BuD; vQKdU 0Suf csuf udk ajymjyrdw,f/

ol cH vd k uf &w,f/ wd k uf yG J w ckrSm &efolu olYajczaemif h aMumud k aoewf eJ Y ypf NyD ; tEd k if ,lvd kuf w,f/ ol aooG m;a&m/ aemufqHk; ajczaemifh t½Gwf aMumonf Ach ill es tendon

tjzpf urÇmausmfoG m;a&m/ cE¨maA' tac:ta0:rsm; [m ordkif;aMumif;av;awG udk,fpDeJ Y/ aemufxyf Oyrm av;awG qufavh vmMunhf yg/

Adie’s pupil: ol i,f tdrfqd k wm Pupil / tvif ;a&mif wnf h wnf h xd k ;rd ygu wk ef Yjyef rI tNzpf csufcsif;yJ oli,ftdrf usOf; oGm ;&r,f / vltaoqdk&if awmh b,fvdk tvif;a&mif ay;ay; ol i,f td rf rusKH Uawmh? rusOf;awmh/ qdkvdkwmu t vif ;a&mif ud k rwk ef Yjyef Ed k if awmh/ 'gud k Pupil is dilated ol i,f td rf us,faeNyDqdkNyD; q&m0efawG a&;Muw,f/

vl t&S if awGa&m taoawG a&m "mwfrD;awGxdk;NyD; Munfh

Munfhvmvdkufwm 1886 rSm arG ;zGm;cJ hwJh NAd wd oQorm;awmf BuD; W.J.Adie u wckoG m;awG Y w,f/ rsuf vHk;tm½k HaMum csdKU ,Gif;rIaMumifh oli,ftdrf t vif;a&mifudk rwkefYjyefEdkifwJh a&m*g/ 'D vd k ol i,f td rf tvif ; wke fY jyef cs dK U,G if ;a& m*gud k

Adie’s pupil vdkY ac:w,f/ Auerbach’s plexus: wenf ;

tm;Nzih f Myenteric plexus vdk Y ac:w,f/ tlawG&JUvIy f&Sm;rI(Peristalsis) udk xdef;ay;wJ h t

rSwf 10 Vagus tm½kH aMumBuD; &J U tm&kH aMumudk if;cG Jrsm; tpk t a0;udk ac:wm/ 1825 ckESpf rSm arG;zG m;cJh wJh *smref vlrsd K; cE¨m aA'ynm&Sif L.Auerbach u awG Y&Sd cJ hwm Nzpf w,f/

Barrett ’s oesophagus:

Oesophagus qd kwmu tpmrsd K

>yef/ NAd wd oQcG J pd wf q&m0ef BuD ;N.R. Barrett (1903 arG ;-1973

rS mqH k ;yg;) u tpmrsd K>yef &S d wpf &SL;rsm; ajymif ;vJjcif ;a&m*gw ckud k awGY&S dcJhw,f/ tpmtdrft xJut&nfawG tpmrsd K>yef txd wufxufvmNyD; tpmrsd K >yef a&mif &rf ;vm&mrS aemuf qH k ; tpmrsdK>yefwpf&S L;awG ajymif; vJ oGm;wJ h a&m*gyg/ 'gaMumifhBarrett’s oesophagus qdkN yD;

urÇmausmf oGm;w,f/Bartholin’s glands: 1655

rS marG ;zG m;cJ h wJ h 'd ef ;rwf cE¨ maA' ynm&S if C. Bartholin uawmh arG;vrf;aMumif;eJ Y rdef ;rudk,f pyf Mum;rS m *vif ;wpH k ud k awG Y&S d cJ h w,f/ *vif;awGu t&nfppf xk wfay;wJ htwG uf rdef ;rud k,f ud k acsmqDvl;ay;ovdk Nzpfap w,f/ oH0gojy KwJhtcs defrSm usm;vdifw H0ifa&muf jcif ;udk acsmarG Uapygw,f/

rdef;rud k ,f t0rS mvnf ; yd k rd k ao;i,fwJ h *vif;awG &Sdyg w,f/ 'gawGudk Lesser vesti-

bular glands vd kY ac:w,f/Bartholin awGYwJh *vif;awGu

enf;enf;ydkBuD;awmh Greater

vestibular glands wenf;Bartholin’s glands /

qufygOD;rnfa'guf wmwif haZmfOD ;

NyD; jynfol vlxk&JU pGrf;aqmif &nf avsmhenf ;rI udk jzpf ay:ap ygw,f/ qif ;&J wJh Edk if iH awG rS m a&m*gtrsm;pkeJY qufpyfao qHk;rIawG[m umuG,fvdk Y&wJh?

pepftwGif ; aq;0g;eJ Y jyKpk uk orI&EdkifwJh a&m*gawGaMumifh jzpf aeygw,f/ qif;&Jjcif;[m jzpf&yftawmfrsm;rsm;rS m tJ'D a&m*gawG &&dS rI EIef ; jrifh rm;ap wJh wckwnf;aom pdk;rdk; t aMumif ;tcsuf wck jzpf ygw,f/ nHhzsif;wJ h oef Y&Sif ;rI? usef;rm

a&;eJY qufEG ,fynma&; tod r&Sd rI? pd wf cs&wJ h aomuf oH k;a& r&&S d rI eJ Y rvk H avmuf wJ h tm[m &"mwf ? tdrfwGif;npfnr f;rI awG[m qif ;&J rIaMumif h ydk qdk; oG m;apwh J t&mawG jzpf ygw,f/

'DtjyifrSm uav;oli,f aoqH k ;rI eJ Y rd cif aoqH k ;rI awG ud k qif;& Jom;awGMum;rSm ydkjy D; tES H Ytjym; awG U&S d&ygw,f/ Oy rm aeYpOf rdcifaoqHk ;rIeJ Y om; zGm ;Ny D;aoqHk ;rI 11600 &JU 98% [m zGH UjzdK;qJEd kif iHawGrSm jzpfyG m;wmyg/

a&m*gb,rsm; ESpfpOf qif;&Jjcif;aMumi fh

jzpf &wJ h a&m*gb,awGaMumif h cefYrSef ;ajc vl 14 oef;avmuf aoqHk;aeygw,f/ tla,mif &rf;emeJY oleJYwGJjzpfwwfwJh

0rf ;avQma&m*gawGaMumif h ES pf pOf uav;oli,faygif; 1.8 oef ;avmuf aoqH k ;ae&NyD; t rsm;pk u urÇ mh tqif ;&J qH k ; Ed k if iH awGu jzpf ygw,f/

urÇmvTrf;NcHKtqifhrSm t ajccH qif;&Jjcif;eJY qufEG,f a&m*g(PRDs) 3 rsdK;u td'fpf?

iS uf zsm;eJ Y tqk wf em a&m*gawG jzpf ygw,f/ urÇ mhtES H Ytjym;rS m jzpf yGm; aewJh td'fpfa&m*g& JU 95% eJ U tqk wfema&m*g ul ; puf rI&JU 98% awGu zGH jzdK;qJ Edk ifiHawGrSm jzpfygw,f/ 'Dht

jyif iSuf zsm;a&m*gaMumif h ao qHk;&olawG &JU 90% [m tmz &d u qm[m&wd k uf i,f a'ou jzpf ygw,f/ pk NcHK&&if urÇmw 0ef; aoqHk;rI&JU 10% [m 'D a&m*g 3 ck aMumif h jzpf ygw,f/

q,fpkES pf awG eJYcsD NyD; uk o vdkY&aeayr,f h qif;&J wJh wd kif ;

jyn faw GrS m tcs dK;tpm ;rr Q atmif aoqH k;rI EIef; yd kNyD; jrifh rm;vmwmuawmh jyKpk uk ovd k Y &EdkifwJh uav;oli,fa&m*g awGygyJ/ tJ'Da&m*gawGxJrSm 0ufouf ? Muu fn§ mac smif;

qdk ;eJ Y ydkvD ,dk tygt0if jzpf yg w,f/ wjcm;a&m*g 3 rsdK;jzpf wJh

*sKd uf od k;? tqkyf tat;rd a&m*g eJY 0rf;avQm0rf;ysufa&m*gawG [mvnf; qif;&Jjcif;eJY eD;eD; uyfuyf qufpyfaewJh a&m*g awG jzpfMuygw,f/

qif ;&Jjcif;eJ Y quf EG ,f a&m *gawG urÇmw0Srf ;u tajc taeawG ud k wif jyaewmu us aemfwdkYEd kif iHrSma&m qdk wJh pOf; pm;rI aMumifh yg/ qif;&J EG rf;yg;rI wd k uf zsuf a&;qd k NyD ; yg;pyf u t

oH aumif ;[pf aeayr,f h jynf ol vl xk trsm;pkBuD; qif;&JwG if; eufaeqJjzpf wJ h usaemf wd kYEd k ifiH rSmqdk&if qif;&Jjcif;eJU quf EG,f aewJ h a&m* gb,awG aMumif h wESpfwES pf uav;ol i,fawG b,favmufrsm; ao

vd k Yom ajzMunf h/ aooG m;r,f/ eifajymrSvm; jzpfoG m;rSmaygh/ Adam’s apple ajzrS rSefr,f/ a,mus fm;r Sef&if vnfZvkyf &S d&r,f/

pum;rpyf/ usaemfonf tck tcsd ef txd tajcmuf awG ud k a,musFm;awGrS ef; ½kwfw&uf

rcG J jcm;Ed k if/ tck acwf rS D vmawmh ydkqd k;/ tvStybmom&yfawG u wdk;wuf xGef ;um;vmwm ud k ;/ (tajcmuf awG ud k awG Ywd k if ; rdrdtdrfoleJY a,musfm; rdef;r tjiif;yGm;&wm cPcP/ ol Y ud k pawG YwJ h tcsd ef wk ef ;uvnf ; a,musFm;av;vm; xifrd ao; w,f/ aemufrS rdef;rrSe f;od wm/ olu usaemfh&JUtvG Jrsm; ud k todqHk ; vl om;/)

'gaMumif h vnfZv kyfud k vS rf;vS rf ;Munf h&w,f/ Munfh

NyD ;rS cGJv dkY&w,f/‘'D Mum;xJ

auR;w,f / (wcsdK Ur* FvmyGJ awGrSm pHkwGJawG tm'rfwdkYudk tm;usNyD; a&cJrkef YcGHYauR;ae wm awGYzl;Muyg&JU/ wu,f wrf ; yef ;oD ;auR;Mu&rS m/ tm; &S dw,fav/ a&cJrkefYu tcefYr oifh acsmif;qdk ;Edkifw,f/ n a&muf vif r,m;awG pum;r

ajymEdkifyJ acsmif;qdk;aeMu&if cuf a&m/)

bk&m;ocifu cGif hrNyKxm; bl;aemf/

[Gef; {xuf bk&m;ocifydkcspfwmaygh? rNrdK&if rkef;ypfvd kufrS maemf/

tm'rfrSm bk &m;ocif xuf rde f;rudk ydk aMumuf&wJ h t wG uf ...

(b k&m;ocif pwifze f qif;uwnf;u a,musmF ;rsm; wGif rdef;raMumuf&aomA DZ

ygvmcJh yHk &w,f)

a'guf wmwif haZmfOD ;

pmrsufESm (10) od kY ```





uif qma&m*gqd k wm jzpf NyD qd k&if tjrpf jywf atmif uk oEkd if wJ h a&m*grsKd ;r[k wf yg/ uif qmqJ vf (cell uvyfpnf ;)awG yGm;rsm;r vmatmif 'grSr[k wf uifqmtvHk ;BuD ;xGm;rI aESmifhaES;atmif uifqmowfaq;? xd k;aq;? pm;aq;ES ifh ukojcif ;? "mwf uif jcif ; ponfwkd Y[m cH pm;&ol a0'em&S ifud k oufomap&ef ulnD ay;jcif ; omjzpf NyD; uifqma&m*g wu,faysmufoG m;wmrsKd ; r[kwfyg/

tJ 'D vd k uif qma&m*gud k aysmuf uif ;atmif uk oray;Ed k if aomf vnf ; rjzpf ao;wJ h uif qma&m*gud k wu,f rjzpf atmifumuG ,f ay;Edk if wJh enf ;vrf ;rsm;awmh &Sdygw,f/ uifqma&m*g umuG ,f &mrSm txda&mufqHk ; umuG,fEdkifwJh uif qmtrsKd;tpm;uawmh]om;tdrfacgif ;} uifqmyJjzpf ygw,f/ om;td rf acgif;uif qm[mHPV

vdkYac:wJhHuman Papilloma Virus

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rJaqmufNrdKU/P.O.Box 21, Mae Sot, 63110 Tak Province, Thailand

Phone :Office - 055544495

E-mail : [email protected]

Edkufwifa*;vf usef;rma&;*sme,fudk tifwmeuf wGif

zwf½I vd k ygvQif ...

www.maetaoclinic.org/publications ESif h

www.bmahealth.org wGifzwf½IEd kif ygonf/




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BBC




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BBC

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BBC

a,mufudk oHk ;ES pfMum avhvm

csuf t& Zd k if vD awm ygonf jzpf ap rygonf jzpf ap? oMum;ryg

wJ h yD auud k 0g;vd k Y wH awG ;yd k xG uf

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wuú odkvf u a'gufwm *sd rf;pf

ab'gu qd kygw,f/

Washington Post/NYTimes

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nightingale health journal (july-2013)

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