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vnf oabmaygufavh&SdwJh
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rvnfbJ ayghayghqqaeMu&if
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a'o? a&SUwef;e,fpyfae&mrsdK;?
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aeolawG tvkyfvkyfukdifpOf t
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rcH,&l &if touftE&m,fay;
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jzpfygw,f/ 'gaMumifh vlwkdif;
odoifhwmrkdY touftE&m,f
umuG,fEkdifMuzkdY &nf&G,fNyD; 'D
aqmif ; yg;uk d a&;ygw,f /
qufpyfaewJh ta&;ay: 0rf;
Akdufwif;rmemusifrI (Acute
Abdomen)? 0rf ; Ak d u f t wG i f ;
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jynfph o
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aMumif; (Food Tract) 25 aycefY

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aomufvkdufwJh tpm;tpmawG
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tpma&GUavsmrI (Motility Peristalsis)? tpmaMucsufrI (Digestion)? tpmacs&nftrsdK;rsdK; ppf
xkwrf I (Secretion)? tm[m&Mo
ZmeJY a&pkyf,lrI (Nutrients and
Water Absorption) tqifhqifh
ukd ausmfjzwfNyD; aemufqkH; t
ok;H r0ifwhJ tnpftaMu;awGudk
pGefYxkwfrI (Excretion) tjzpf t
qkH;owfygw,f/
tl (Intestines) tpdwt
f ykid ;f
trsdK;rsdK;tjzpf tlodrfykdif; (Small Intestine)? tlrBuD; (Large
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rSm? tltwuf[m tlrBuD;&JU pD
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tlodrfaemufqkH;ykdif; tDvD,H
(Ileum) wkYd awGYq&Hk m Ileo-caecal
tltwuf (Appendix) qkdwm Junction rSm &Sdygw,f/
bmvJ? b,frSm&SdwmvJ? &SdzkdYvkd
tltwuf (Vermiform Appovm;/
endix) qkdwm cEmukd,frSm tykd
tpmtdrf? tlvrf;aMumif; oufoufvdk jzpfaewJyh pn;f t
(GI Tract) qkdwm yg;pyfayguf pdwt
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jzifh) rSm pm;okH;wJh jruf? [if;
oD;[if;&GufawGxJu trQif
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wufwkdY&Sd&NyD; vlrSm 'Dypnf;
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abmukdaqmifwmrkdY pmtkyf?
pmayawG&JU aemufqkH;rSmygwJh
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NyD; ukd,fwGif;t*Fg tltwuf
ukd Vermiform Appendix vkdY
uGJjym;atmif ac:qkdygw,f/
(Vermiform = Worm) oefaumif
av;eJYwlvkdY Vermiform Appendix vkdY ac:wmvnf; jzpfyg
w,f/
tltwufqw
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ao;i,fNyD; twGif;rSm usOf;

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w,f/ trsm;tm;jzifh 74 &mckdif
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aemufbufrSm &SdwwfNyD; 1.5
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(Pelvis)? 0.5 &mckdifEIef;u tD
vD,H&JUtaemufbuf? 1 &mckdif
EIef;u tDvD,H&JU ta&SUbuf?
2 &mckdifEIef;rSm pDurf&JUab;
bufpojzifah wGU&wwfygw,f/
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tltwufqw
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NIGHTINGALE 1

tJ'Dtlt
wufa&mif&rf;NyD; aemufqkH;
aygufuGJoGm;wJhtcg qkd;0g;wJh
tajctaeukd a&muf&Sdygw,f/
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awmh wcsdKYu tluae twuf
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wef tE&m,feJYeD;ygw,f/
tltwuf bmaMumifha&mif&rf;&
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Egg)? wk w f a umif i ,f (Pin

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wDwkdif; ausmif;ukef;NrdKYe,frSm
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(TMO) tjzpf wm0efuscJhpOfu
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ukd jyeftrSwf&rdygw,f/
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2 NIGHTINGALE

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trSw-f 31? Zefe0g&v

D ? 2012-ckEpS f

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ar; / / c&rf;csOfoD; (Tomatoes) &JU prf;tifowdxl;eJY xufjrufykH awG

odyg&ap/
ajz / / tDwmvsH tpm;tpmwrsdK;jzpfwJh yDZm (Pizza) pm;&if
c&rf;csOfo;D aqmhpf tcsOf&nfEpS f ryg&if t&omodyNf yD; rav;euf
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t&omtvGef&Sd? csdKNrdefwmeJY BuHK&ygvdrfhr,f/
bmaMumifhvJqkdawmh rD;zkdacsmifwkdif;vkdvkdrSm &SdwwfwJh? urmh
ae&mtESHY awGY&wwfwJh c&rf;csOfoD;rSm xl;uJpGrf;tifowdawG
&SdwmaMumifhygyJ/ a&S;wkef;uawmh &omkH tmkHxl;rsdK;&,fvkdY csdK?
csOf? ief? cg;? pyfom&SdcJhayr,fh ckqkd&if *syefokawoD a'gufwm
uluGefae; tDau'g (1908) &JU &SmazGawGY &SdrIaMumifh tdkrmrD
(Umami) qkdwJh &omkHtopfwrsdK;yg xyfwkd;cJh&ygNyD/ vQmay:rSm
'Dt&omcHwahJ e&mukyd g awGY&o
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wJh tm*sDEkdrkdwkd tcsdKrIefYt&omrsdK; (tom;jyKyf&nf t&omrsdK;)
[m tkdrmrDyg/ c&rf;csOfoD;rSm tkdrmrDtrsm;BuD; yg0ifwmaMumifh
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'ghtjyif c&rf;csOo
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wJh vkdifukdyif; (Lycopene) "mwf ("mwfwkd;qefYusif ypnf; tifwD
atmufpD'ifh) awGa&m? ADwmrifpD (tifwDatmufpD'ifh) <u,f0pGm
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awGaMumifh xdckdufysufpD;rIr&Sdatmif umuG,fEkdifwJhtwGuf
aq;vdyf? pD;u&ufaomufolawG c&rf;csOfazsmf&nfwkdY? c&rf;
csOfoD;wkdY ykdrkdaomufokH;? pm;okH;Muyg/ uifqma&m*g txl;o
jzifh tlrBuD;uifqm? qD;tdrfuifqmawGukd c&rf;csOfoD;u
umuG,fEkdifw,f qkdygw,f/

ae&mukd xdawGY&if xdawGY&mzufudk rsuEf mS vSn?hf acgif;a&GUwwfyg

w,f/ aemiftcg rdcifEkdY&Sd&mukd EkdYeHY? xdawGYrIawGeJY EkdY&SmpkdYwwfzkdY
oaEom; b0wnf;u zGHYNzdK;avhusifrIyg/
emusifrIukdodapwJh Pain Pathway awG &ufow 3 ywf
b0wnf;u pwifjzpfay:NyD; 26 ywf (6v) ausmf&if aumif;
aumif; emusifwwfaeygNyD/ a&rTm&nf prf;oyfppfaq;rI
(Amniocentesis) vkyfzkdY a&rTm&nfukd tyfeJYpkyf,lwJhtcg oaEom;
[m olYukd tyfeJYrxkd;rdatmif ykef;a&SmifwmwkdY? ae&ma&TUajymif;
ar; / / abmusw,fqkdwm b,fvkdaMumifh jzpf&wmygvJ/
vIyf&Sm;wmwkdY vkyfwwfygw,f/ rawmfwq xdrd&if ykdrkdvIyf
ajz / / vGJrSm;wJht,ltqeJY a&m*gtrnfjzpfygw,f/ jzpfoifhwm &Sm;wm? ESvkH;ckefEIef; wtm;jrefwm? aES;wmwkdY jzpfwwfygw,f/
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tlumtajr;? 0rf;wGi;f tqDjyifwYdk tm;aysmhaom 0rf;Aku
d ef &H t
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(abm-Testes) uRx
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rsm;NyD; trsdK;orD;awGrSm aygifNcHtwGif;ykdif; tluRHa&m*g (Femoral
Hernia) jzpfavh&Sdygw,f/ trsdK;om;awGrSmvnf; Femoral Hernia
jzpfwwfNyD; Inguinal Hernia eJY uGmjcm;csuu
f awmh cEmuk,
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rSm Inguinal Hernia &SdNyD; Inguinal Ligament &JUatmuf aygifNcH
twGif;ykdif;rSm Femoral Hernia Sac wnf&Sdwmyg/
0rf;Aku
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f ;D oaEu,
dk 0f ef (Hydatidiform Mole) qkw
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d cf pJG w
d f 'Pf&ma[mif;? csKyf;dk tm;aysmh awGeJY oaEom; BuD;xGm;rI ykHrSefr[kwf ajymif;vJcsdKY,Gif; BuD;
rIwkdYaMumifhvnf; tluRHusjcif;rsm; jzpfwwfygw,f/
xGm;jcif;aMumifh jzpf&wmyg/ tm&Swu
dk rf mS tjzpfrsm;NyD; i,f&,
G o
f l
trsdK;orD;ukd,f0efaqmif (touft&G,f 20 rS 40) twGif;jzpf
ar; / / rdcif0rf;Aku
d w
f Gi;f rS oaEom; (Fetus) emusiaf 0'em cHpm;odEidk f yGm;avh &Sdygw,f/ ukd,f0efaqmifumv 18 ywf rwkdifcifrSm 'D
ovm;/
ajymif;vJrI jzpfwwfygw,f/
ajz / / a&S;wkef;u aq;ynmt,ltqa[mif;awGrSm trd0rf;
oaEom;b0 MoZmoD;o@mef (Blastocyst) b0rSm aemif
wGif;u oaEom;awG[m tcsdefawmfawmfrsm;rsm; tdyfpufaeNyD; tcg tcsif; (Placenta) jzpfr,fh xkdAkdbvwfpf (Trophoblast) rS
arG;zGm;r,ft
h csed u
f o
dk m apmifph m;&if; BuD;xGm;zGYH NzdK;aew,fvYdk qkyd g aeNyD; uifqmuJhokdY tzktBudwf (Benign Tumour) wrsdK;tjzpf
w,f/ OD;aESmufaumif;pGm rzGHYNzdK;ao;vkdY emusifrIa0'em rcHpm; ajymif;vJjcif;jzpfwmaMumifh rayghqoifhygbl;/ 'Da&m*grsdK; (15
wwfao;bl;vkdYvnf; ,lqMuygw,f/
&mckdifEIef;) [m wjcm;ae&mukd rysHUESHYwwfayr,fh (5 &mckdifEIef;)
'gayr,fh ESpfq,f&mpkvGef acwfrDaq;odyH okawoeawGY [m ysUH ESYHwwfwmrkYd uRr;f usio
f l aq;ynm&Si?f q&m0ef? om;zGm;rD;
&SdcsufawGt& 'Dt,ltqrsm; vGJrSm;aMumif; ajymif;vJod&SdcJhNyD ,yfyg&*lrsm;eJY jyo? pepfwus ukorIcH,loifhwJh a&m*gyg/
jzpfygw,f/
ukd,f0efaqmif 120 OD;rSm 1 OD; jzpfwwfNyD; tjzpfenf;a'o
oaEatmifNyD; 16 &ufajrmufoaEom;b0rSm ADZvTm 3 vTm awGrSm vl 2000 rSm 1 OD;om jzpfwwfygw,f/
&JU tufw'dk rfac: tjyifvmT ykid ;f rSm aemiftcg OD;aESmufeYJ tmkaH Mum
ukd,f0efaqmifawG[m 18 ywf (4 v) ausmfwJhtcg Akduft
tzGYJ jzpfvmr,ft
h p tmkaH MumqJvv
f mT jym; (Neural Plate) jzpfay: &G,o
f m ajymif;vJBuD;vmNyD; uav;cEmuk,
d f tpdwt
f ykid ;f prf;r&
ygw,f/ &ufowav;ywf wvom;oaEom;jzpfwJhtcg OD; jzpfwm? rvIyf&Sm;wm? tvGeftrif; Akdufwtm;aysmhaeNyD; tvGef
aESmuf&JU tajccH 3 ykdif; jzpfay:aeNyD; &ufow 7 ywf (ESpfveD; ysdKUtefcsifwmjzpf&if uRrf;usifol q&m0efeJY jyowkdifyifoifhyg
yg;)rSm tmkHaMumtrsdK;rsdK;eJY ausmkd;eAfaMumrBuD; (Spinal Cord) w,f/ rayghqMuygeJY/ pAspfoD;vkH;av;awG twGJvkduf&Sdovkd
wkdY qufoG,frdNyD; tmkHcHvkyfief;awG vkyfaeygNyD/ xdodrItmkHukd arG;vrf;aMumif;uqif;&if pAspfoD;oaE (H Mole) jzpfygw,f/
&ufow 7 ywftcsdefupNyD; rsufESmykdif;u pwifod&Sdum yg;pyf
a'guw
f m okw (ZD0u)

4 NIGHTINGALE

a&mifaewJh tltwuf
U suEf mS zH;k rS
``` a&Sr

ygOD;/ usaemfh&JUOD;av;u q&m

BuD;&JUvufaxmuf (a'gufwm
pa&T0if;)yg/ usaemfwYdk &mG ukd ol
jyefvmvnf&if; usaemfAkdufem
aewmawGYNyD; prf;oyfNyD;wJht
cg 'DvkdaevkdYrjzpfbl;/ aq;xkd;
keH YJr& tjrefcpJG w
d u
f o
k rS&r,f/
Nrd K Ye,f a q;k H u k d tjref q k H ;
a&mufatmifomG ;/ igta&;BuD;
udpw
cktwGuf trkd;eJYawGYp&m
&SdvkdY awGYNyD;&if aemufuae
csufcsif;vkdufvmcJhr,f}vkdY OD;
av;u ajymygw,f/
cktcsdefrSm 'g;uacsmif;xJ
rSm aA'gyifawG usyfcsdefrkdY yJh
axmifoGm;r&/ oGm;vma&;
aESmifah ES;wwfwmaMumifh tcsdef
rqGJeJY tckcsufcsif; aq;kHukdt
csdefrDa&mufatmif oGm;ygvkdY
vnf; OD;av;u rSmvkdufyg
w,f/ usaemfwkdY tjrefqkH;
a&mufatmifvmwmawmif aA
'gyifawG vrf;rSmwtm;usyv
f Ydk
ESpef m&Dausmaf usmf Mumw,f} vkYd
vlemu usaemfhukd aq;kHukd c
&D;a&mufrqkdufrSmyJ tarmw
aum? tm;ukd;wBuD; ajym&Smyg
w,f/
vl e mu usaemf h v uf
atmufu vufaxmufq&m0ef
NrdKYe,fusef;rma&;t&m&Sdjzpfol
&JUwl/ olYOD;av;eJY vkyfief;nD
tukdcsif;rkdY ykdNyD;ulnD&r,fhvl
em/ toufu 14 - 15 ESpf
cefYt&G,f ausmif;om;vli,f/
oltrnfu zkd;vjynfh/ vlem
&mZ0ifar;vkdufawmh tdrfrSm
Akdufemaewm ESpf&uf? okH;&uf
avmuf &SdNyDwJh/ vlemukd prf;
oyfvu
dk w
f t
hJ cg olY0rf;Aku
d jf yif
wckvkH;u tkd;pnfukdom;a&
usufxm;onfhyrm wif;rmNyD;
aew,f/ 'gukd aq;ynmrSm
Board Like Rigidity) vkdY ac:yg
w,f/ a&m*gtrnf (Burst Appendix (Appendicitis) With Acute
Abdomen)/
NrdKYe,faq;k0H efxrf;awGudk
usaemfcsufcsif; ta&;ay:cGJ
pdwfcef;jyifckdif;NyD; vlemukdcGJ
pdwcf ef; (Operation Theatre) xJ

trSw-f 31? Zefe0g&v

D ? 2012-ckEpS f

use;f rma&;*sme,f

oGi;f ? 0rf;Aku
d u
f zdk iG v
hf u
dk w
f t
hJ cg
rSmawmh olY&JU0rf;AkduftwGif;?
0rf;wGif;acgif;wckvkH;rSm jynf
ykyf? aoG;? rpiftnpftaMu;
awG[m EkdYqDAl;topfESpfbl;cefY
zGifhNyD; EkdYqDyspfyspfawG azmuf
xnfhxm;onfhES,f/
pma&;ol pdw&f n
S v
f uf&n
S f
0rf ; wG i f ; acgif ; uk d a q;aMum
a&mif&rf;aygufuGJoGm;wJh tlt
wufukd BudK;pm;jzwfawmuf
z,f & S m ;NyD ; wJ h t cg pd w f c s&
atmif 0rf;AkduftwGif;ukd ykdrkd
oefYpifNyD;wJhtcg Akdufukdydwf
vkdufygw,f/
cGJpdwfrINyD;cgeD;rS vlem&JUOD;
av; aq;kHukd a&mufvmyg
w,f/ &uftenf;i,fMumawmh
cGJpdwf'Pf&mawG usufNyD; aq;
ku
H qif;cg zk;d vjynfw
h a,muf
olY&UJ trk;d eJYtwl aexkid &f m tpk
BuD;&Gmukd jyefoGm;NyD; ausmif;
qufwufygw,f/
jzpf&yfawG ESpfaygif; (30)
ausmcf ahJ yr,fh ,aeYwidk f rarhEidk f
owd&qJyg/ u,fcw
hJ hJ touf
wacsmif;/

&m vufSdK;eJY vufxkd;jyckdif;

&if emwJhae&mukd Tefjyygvdrfh
r,f/ wu,fvkdY tltwuf&Sd
aewJ h a e&m[m Retrocaecal
jzpfcJh&if 0rf;enf;enf;avQmo
vkd jzpfwmrsdK; (Diarrhoea)?
Pelvic Position jzpfc&hJ if qD;cP
cPoGm;csiw
f mrsKd ; jzpfwwfyg
w,f/ tltwufa&mif&rf;rIukd
*krjyKrdbJ tav;rxm;cJh&if
a&mif&rf;rI wpwpykdrkdvmNyD;
ysdKYcsif? tefcsifwmwkdY jzpfwwf
ygw,f/ a&m*g&ifhav ykdrtD
romjzpfNyD; tajctaeqkd;vm
wJhtcg vlem[m acGacGav;
nmbufajcaxmuf auG;tdyf
avh&Sdygw,f/ 0rf;AkduftwGif;
rSm tltwuf a&mif&rf;&muae
aygufuGJoGm;&if bufwD;&D;
,m;tqdyf? aoG;ykyf? jynfawG
aMumifh 0rf;wGif;acgif;wckvkH;
ysHUESHYNyD; 0rf;wGif;ajr; a&mif&rf;
rIukd jzpfapygw,f/ 'Dvkd tcsdef
rsd K ;rS m vI y f & S m ;rI v k y f w k d i f ; ?
acsmif;qkd;wkdif; ykdrkdemusifcH&
cufapygw,f/
tltwufa&mif&rf;rI[m
vlem&JUukd,fcHpGrf;tm;eJY tajc
tl t wuf a &mif & rf ; a&m*guk d tae t&yf&yfay:rlwnfNyD;
b,fvadk &m*g &SmazGoEd idk o
f vJ
a&m*gtajctaeykHpH av;rsdK;t
0rf;Akdufjyifay:rSm csufukd jzpf wkd;wufajymif;vJ jzpfay:
A[kdwnfNyD; txufatmuf t Ekdifygw,f/
vsm;vkdufrsOf; ESpfaMumif; pdwf
ul;eJYq/JG csu&f UJ ab;ESpb
f ufrmS (1) a&mif&rf;rIyrmP odyfr
vnf ; a'gif v k d u f r sOf ; ES p f rsm;bJ vlem&JUtm[m&tajct
aMumif;qGJMunfh&if tuGufukd; ae? ckcHpGrf;tm; pwJhtcsufay:
uGuf? 0rf;Akdufae&m ukd;ae&m rlwnfcg wjznf;jznf; emusif
(Abdominal Areas) ay:vm rIoufom? tpm;taomuf cH
r,f/ nmbufatmufbuft wGif;vkdufvmNyD; tzsm;aiGUaiGU
pGefqkH;tuGufukd (RIF Right (37.5H C) eJY Appendicular MaIliac Fossa) vkdYac:ygw,f/
ss qkdwm jzpfay:Ekdifygw,f/
tltwufa&mif&rf;vlem[m Akdufay:uaeprf;oyf&if cyfrm
trsm;tm;jzifh jzpfcgprSm csuf rmtzktBudwftjzpf prf;oyf&
em;w0kduf 'grSr[kwf csuf Ekid yf gw,f/ prf;oyfpOf cyfwif;
atmuf qD;pyftxufem;rSm em wif;emayr,fh ESdyfMunfhNyD;jyef
wwfNyD; cyfwif;wif;emusifrI vTwf&if emwwfwJh (Guarding)
(Dull Ache) okYdr[kwf wcsuw
f
qkdwmeJY tkd;pnf? AkHawG&JUrsuf
csuf xk;d emusifrI (Midline Colic) ESm0rSm om;a&usufNyD; wif;
rsdK; &Sw
d wfygw,f/ 'Daemuf em aewmrsdK; Rigidity r&Sdyg/
&Dtenf;i,fMumNyD;wJhtcg em
usifwJhae&m[m RIF ukd a&GU (2) Appendicular Mass tzkt
oGm;ygw,f/ vlemukd emwJhae Budwftjzpfuae a&SUwqifh

wufNyD; ajymif;vJ&if Abscess

ac:wJh jynfwnfem jzpfEdkifyg
w,f/ vlem[m ukd,fvufrtD
rom? tpm;taomufysufrI?
tzsm;wufvkdufusvkdufeJY RIF
ae&mrSm emwwfygw,f/ wcg
wav tjyifuprf;oyfvkdY&ay
r,fh wcgw&H tltwufae&m
odyftwGif;ususjzpfcJh&if prf;
oyfvkdYr&ygbl;/

w,f/ tpmtdrf? tltygt0if

tonf;? o&uf&Guf? yefu&d
,? trsdK;orD;rsdK;yGm;t*Fgrsm;
pwmawG a&mif&rf;aygufuGJwJh
tcg xGuf&SdwJhroefY&Sif;aom
uk,
d w
f iG ;f t&nf (Infected Peritoneal Fluid) aMumifh 0rf;wGif;
ajr;a&mif&rf;wmukd (y,f&Dwkd
Ekdufwpf) vkdYac:NyD; tcsdefem&D
MumjrifhwmeJYtrQ tqdyftnpf
taMu;awGysHUESHYNyD; ief;zsm; (t
vGeftrif; ukd,fylcsdefjrifhwuf
zsm;jcif;) wufcg Acute Abdomen qkdwJh tajctae jzpfay:
ygw,f/
wenf;tm;jzifhqkd&&if Acute Abdomen qkdwm cEmudk,f
&JU r&Paorif; tcsufay;rI
(Death Alarm) ygyJ/ Ekd;pufukd
tdyfcsifrl;wl;eJY ydwfNyD; quf
tdyfvkdY&ayr,fh Death Alarm
Sign jzpfwJh Acute Abdomenukd
vspfvsLIayghq&if tcsdefrD rcGJ
pdw&f if aozkYd &mEIe;f rsm;ygw,f/

(3) tJ'Dtltwufjynfwnfem
uae a&mif&rf;rIjyif;xefwJht
cg aygufuGJxGufrI (Rupture /
Perforation) qkdwm jzpfay:yg
w,f/ aygufxGufcgprSm jynf?
aoG;ykyf? tnpftaMu;awGeJY
wif;aewJhtltwuftwGif; zd
tm;avsmhoGm;wmaMumifh wif;
rmemusifrI cPwm oufom
ygw,f/ 'Dtcsed rf mS vlemawGt
aeeJY a&m*goufomoGm;NyD/
aumif;oGm;NyD/ odyfta&;rBuD;
bl;vkYdxifNyD; cyfayghayghaewwf
Muygw,f/ tJ'gtE&m,f&Sdyg
tltwufa&mif&rf;vuPmrsm;
w,f/
pjzpfcgprSm csufw0kdufem
(4) tltwufa&mif&rf; ayguf NyD; aemufykdif;rSmawmh RIF ae
uGJxGufNyD; bufwD;&D;,m; ykd; &mrS m ajymif ; a&G U NyD ; emr,f /
S cf sKyfwhJ tyfcsKyfo
rTm;tqdyfawG? aoG;ykyf? jynf? abmif;bD&n
rpifawG 0rf;wGif;acgif;xJukd rm;awG prf;Munfhavh&SdwJh cg;
ysHUESHYoGm;wJhtcg tqkd;0g;qkH; ab;buftkd;zk (ASIS= Antetajctaejzpf w J h 0rf ; wG i f ; rior Superior Iliac Spine) ae&m
acgif;tajr;a&mif&rf;rI (Perito- uae csufae&mukd pdwfrSef;eJY
nitis) eJY ta&;ay: 0rf;Aku
d w
f if; rsOf;waMumif;qGJMunhfyg/ tJ'D
rmemusifrI (Acute Abdomen) pdwful;rsOf;aMumif;&JU atmuf
qkdwJh t ouftE&m,ftwGuf ykdif; () eJY txufykdif; () qkH
tvGeftrif;pkd;&drf&wJh tajct wJhae&mukd MuufajccwfNyD;
aeukd a&muf&Sdygw,f/ aq; rSwfom;yg/ tJ'Dae&mukd ruf
buf q k d i f & m usef ; rma&;t bm;ae;^rufbm;eD;trSwf (Mc
ultnD t vG,fwulr&EkdifwJh Burney's Point) vk d Y ac:NyD ;
ae&m? tcsdefrDcGJpdwfrIrjyKEkdif&if ta&;BuD;wJh trSwjf zpfygw,f/
tJ'Dae&mrSm tltwuf cGJpdwf
aoqkH;Ekdifygw,f/
jzwfawmufzkdY "m;csufae&m
Peritonitis eJY Acute Abdomen (Mc Burney's Gridiron Incision)
ukd trsm;tm;jzifh ay;avh&SdvkdY
qkdwmbmvJ/
0rf;AkduftwGif;eH&HeJY tl? t yg/ tltwufae&mvnf; ykHrSef
pmtdrf pwJh 0rf;wGif;acgif;t tm;jzifh tJ'Dae&mteD;tem;rSm
wGi;f &Sd uk,
d w
f iG ;f t*FgawGudk zk;H &Sdwwfygw,f/
tl t wuf a e&m[m RIF
tk y f x m;wJ h t ajr ; yg;? tjzL
a&mif (okdY) aiGa&mifajymifacsm ae&mrSmr[kwfbJ wcgwav
acsmukd (y,f&w
D edk ,
D )H vkYd ac:yg wjcm;ae&mrSm &Sdwwfwm&,f?

a&mif&rf;NyD; aygufuGJw,fvkdY
taotcsm twnfrjyKEkid cf &hJ if
Acute Abdomen tajctae[m
taMumif;trsdK;rsdK;aMumifh jzpf
Ekid w
f mrkYd csuaf b;rSm a'gifvu
dk f
ajrmifNyD; Paramedian Incision
eJY "m;csufay;NyD; AkdufukdzGifhavh
&Sdygw,f/
a&m*g&SmazGrIrSm pepfwus
wwfajrmufwJh aq;ynm&Sif
q&m0efwkdif;[m vlem&mZ0if
(Patient's History)? ukd,fcEmukd
pepfwus prf;oyfppfaq;rI
(Physical Examination) NyD;rSvkd
tyf&if ukd,fh&JUorm;pGrf;&nf
a&m*g&SmazGrIukd twnfjyKzkdY
(Confirmtory Diagnostic Investigations) qkdwmawGukd vkyf&yg
w,f/ X-Ray? Ultrasound? CT
Scan? MRI pwmawGaygh/ 'g
ayr,fh uRrf;usifvdrm? tawGU
tBuH K rsm; 0g&if h o l (orm;
awmf? cGpJ w
d q
f &m0ef) awGq&dk if
prf;oyfu&d ,
d mawGrvkb
d J rdr&d UJ
aq;twwfuRrf;usifrI (Clinical Skills) awGeJYwif tltwuf
a&mif&rf;wm? tpmtdrfayguf
wm? tlaygufrI? oaEvrf;
aMumif; vGJwnfNyD; aygufuGJrI
pwmawGudk odEidk yf gw,f/ odyf
tawGYBuHKrsm; 0g&ifhol (cGJpdwf
aeus cGJpdwfq&m0ef Skilfull
Surgeon) qk&d if olY&UJ vufzsm;
xdyfu txl;tmkHodrIeJYukd tl
twufa&mif? ra&mifayguf?
rayguf odEkdifygw,f/
cEmukd,fprf;oyfppfaq;rI
(Physical Examination) rS m
MunfhIavhvmrI (Inspection)?
vufeYJ xad wGYprf;oyfrI (Palpation)? vufacsmif;eJYacgufMunfh
toHukdem;axmifrI(Percussion)?
em;usyfeJY em;axmifMunfhrI
(Auscultation) qkdNyD; av;qifh
&Sdygw,f/
History
Akdufemygu csufw0kdufrSm
pNyD;emwm vlemtawmfrsm;
rsm; owd j yKrd M uygw,f /
Retrocaecal Position jzpfcJh&if
0rf;ysufrI? wifyqkHkd;uGif;t

tlumtajr;eJY &pfywfvHk;zGJUaewJh
tzktBudwfoPmef tltwuf

trSw-f 31? Zefe0g&v

D ? 2012-ckEpS f
wuf&Sd&mae&mw0kdufrSm odod
omom Tenderness, Rebound
Tenderness wkdY &SdwmawGY&yg
w,f/
b,fbufatmufqkH; t
jyifqkH;tuGuf (LIF) rSm zdwJht
Inspection
cg nmbuf (RIF) rSmvmem&if
aoaocsmcsm tmkHpl;pkduf Rovsing's Sign Positive jzpf
NyD; Munfh&if toufSLwm w,fvkdYac:NyD; tltwufa&mif
&ifacgif;ykdif;t"dueJY SLae wm aocsmoavmufygyJ/
wwfNyD; 0rf;Akdufykdif; odyfrvIyf
&Sm;wm awGY&ygvdrfhr,f/
Guarding Sign
0rf;Akduf ay:vufz0g;wif
Palpation
NyD; tomt,m vufacsmif;
vufaumuf0wfaoG;ckefrI av;awG auG;vkdufwmeJY 0rf;
(Pulse/Heart Rate)? tltwuf AkdufaMum kwfw&uf qGJwif;
a&mif&rf;cgprSm ukd,ftylcsdefeJY wJh vuPmyg/ 'gqkd&if 0rf;
Pulse wkdY ykHrSef &SdaewwfNyD; wGif;ajr;a&mif&rf;aeygNyD/
tpuwnf;u *kwpkdufrSwf
wcgwav 'Dvkdprf;&ufeJY
om;wkdif;xGm ppfaq;aecJh&if rS odyfrodom raocsm&if ae
tltwuf ykrd adk &mifvmwmeJY t &mrsdK;pkHrSm &SdaewwfwJh tlt
rQ aoG;ckefrI? ukd,fylcsdefwkdY w wufae&maMumifh ptkdtwGif;
jznf;jznf;jrifw
h ufvmygw,f/ vufEu
dI
f jzpfap? rde;f ruk,
d t
f
Pulse Rate ykrH eS u
f ae w&Sed x
f ;dk wGi;f vufacsmif;xnfNh yD;jzpfap
jrif h w uf v mwm tl t wuf prf;oyfavh&Sdygw,f/
wGif; tltwufae&m&SdrI[m
Pelvic Position jzpfcJh&if qD;
rMumcP oGm;csifrIqkdwJh &mZ
0ifawG vlemrsm; ajymjyavh&Sd
ygw,f/

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rsdK;yg/ tcsdefrD cGJpdwfukorS t
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cJw
h hJ prf;oyfenf;awGeYJ prf;oyf
NyD; tltwufa&mif? ra&mif r
aocsmao;&if wjcm;prf;oyf
enf;awGjzpfwhJ Psoas Test, Iliacus Test, Obturator Test qkdwm
awG prf;oyfppfaq;&ygw,f/
aocsmoxuf aocsmatmif
a&m*gtwnfjyKzkdY 'grSr[kwf
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wul &SmazGawGYEkdifNyD; odEkdifyg
w,f/ a&;a&;uav; ay:NyD;&Sd
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(1) wcsdKYtltwufa&mif&rf;vl
emawG[m uHaumif;axmufr
pGmeJY olwkdY&JU cEmukd,fckcHpGrf;

acwfay: aomhaygufcGJpdwfenf;

a&mif&rf;rI'D*&D qkd;vmaewm
ukd TefjyNyD; Pulse wtm;jrifh
wufNyDqkd&if tltwufayguf
aewwfygw,f/
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xufrSmqkdcJhwJh 0rf;Akdufae&m
owfrSwfrI ukd;uGuf) rSm b,f
buftay:qkH;tuGuf (Left
Hypochondrium) uae wuGuf
NyD;wuGuf vufz0g;eJY tom
t,mzdESdyfprf;oGm;&if; vlem&JU
tajctaeeJY rsuEf mS trlt&mukd
Munf&h ygw,f/ zdvu
dk w
f ahJ e&m
wif;wif;rmrm emwmukd Tenderness &Sdw,fvkdYajymNyD; zd
xm;wJhvufjyefvGef<uvkdufwJh
tcg emwmukd Rebound Tenderness vkdY ac:ygw,f/ 'Dvkd
prf;&mrSm vufacsmif;xdyfeJY
0rf;Akdufukd wtm;xkd;pkdufprf;
wmrsdL; rvky&f ygbl;/ vkycf &hJ if
a&mifaewJhtltwuf rayguf
aygufatmif vkyo
f vkrd sdK;jzpfyg
w,f/ 'gaMumifh vufz0g;t
jym;vkdufcsNyD;om prf;oyf&yg
w,f/
tltwufa&mifcJh&if trsm;
tm;jzifh RIF okdYr[kwf tlt

tltwufa&mif&rf;a&m*geJY qif
wl,;dk rSm; rSm;wwfwJah &m*g rsm;eJY
cGJjcm;pdppfrI (Differential Diagnosis)
qifwlkd;rSm;a&m*gwcsdKY &Sd
wwfwmrkdY tJ'gukdvnf; a&m
*g&SmazGa&;rSm xnfo
h iG ;f pOf;pm;
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tJ'gawGuawmh touf
>yeftay:ykdif;eJY wGefq,ft
Budwaf &mif&rf;rI (URTI) eJY (Tonsilitis, GE, Typhoid, Ileocaecal
TB, tpmtdrftemaygufjcif;?
tlydwfjcif;? oaEvrf;aMumif;
vGw
J nfjcif; pwJt
h ajctaeawG
yg/
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awG&JU rsufESm0rSm qGJwif;cg
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'DvuPmawG prf;oyfawGY&Sd&
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pkd;&drfp&m jzpfaeygNyD/ Acute
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0rf;Akduftajctae/ cGJpdwfruk
o&if rjzpfawmhwJh tajctae

tm;pepfuvnf; aumif;&if tl
twufa&mifwm ykdrqkd;vmbJ
ta&mifavsmhNyD; obm0ukpm;
rIeJY a&mifaewJhtltwuf Appendicular Mass ukd tlumt
ajr; (Omentum) eJY &pfywfv;Hk zGYJ
NyD; tzktBudwfo@mefjzpfvm
rI) jzpfay:cJh&if apmifhMunfhuk
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(Oschner Sherren's Regime)
qkdwmukd jyKvkyfygw,f/ buf
wD;&D;,m;ykd;awG aoaMuysuf
pD ; ? a&mif & rf ; rI a vsmh a tmif
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Signs ac:wJh ukd,ft ylcsdef (T)?
toufEIef; (R)? vufaumuf
0wf aoG;ckefEIef;(P)? aoG;aygif
(BP) wkdYukd rjywfapmifhMunhf
tem;,lapwJh cGJpdwfrIrjyKwJh
ukoenf;yg/ tajctaeapmifh
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aq;kHuaomufzkdY aq;0g;ay;
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'gayr,fh 4P Signs (Danger
Signs) ac:wJh Pain, Pulse,
Pyrexia (Fever), Palpable Mass
qkdwJh 4 csuf ykdrkdqkd;0g; BuD;

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h ufvmcJ&h ifawmh apmifh
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csufjcif;ta&;ay: cGJpdwfuk
orI jyK&ygw,f/

NIGHTINGALE 5

(2) cGJpdwfukoenf; (Surgical

Treatment)
orkd;us 0rf;AkdufzGifhuko
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w,f/ tltwufaocsmNyDqkdrS
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(Invagination) jyKvkyfjrKyfNyD;
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(N / Saline t&nfjzifh) jyKvkyf
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6 NIGHTINGALE

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8 NIGHTINGALE

trSw-f 31? Zefe0g&v

D ? 2012-ckEpS f

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usef;rma&;*sme,fodkY pmrlay;ydkYvdkvQif ...

t,f'DwmtzGJU
Edkufwifa*;vfusef;rma&;*sme,f
pmMunfhwdkuf? r,fawmfaq;cef;
rJaqmufNrdKU/
P.O.Box (156), Mae Sot, 63110
Tak Province, Thailand
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Ph :

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Dr Lun Swe - 0812841418

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

wGif zwfIvdkygvQif ...
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ESifh

www.ntg.zwekabin.org

wGif zwfIEdkifygonf/

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wGuf tqifajy aqmif&u
G Ef idk zf Ydk
eJY tem*wfvkyfief;pOfrsm;t
wGufvnf; tm;BudK;rmefwuf
taumiftxnfazmfEkdifMurSm
jzpfygw,f/ usaemfwYdk[m wOD;
eJYwOD; awGYqEHk w
I q
f ufMupOfrmS
aeaumif;vm; (okdY) usef;rm
a&;aumif;&JUvm;qkdwJh ar;cGef;
ukd ar;wwfMuygw,f/ 'Dae&m
rSm tvsOf;oifhvkdY usef;rma&;
(okdY) usef;rmjcif;qkdwJh pum;
vkH;&JU a0g[m&ukd tenf;i,f
wifjyvkdygw,f/ usaemfwkdY vl
awmfawmfrsm;rsm;[m cEmuk,
d f
xdckdufysufpD;rIr&Sd? tema&m*g
b,uif;pifae&if usef;rmNyD
vkdY ,lqxm;Muygw,f/ w
u,fawmh vlwOD;wa,muf
use;f rmzkYdqw
dk m pdwyf idk ;f qkid f &m
(Psycho)? cEmukd,fykdif;qkdif&m
(Physical) eJY vlrIaygif;oif;
qufqaH &; (Social) pwJh tcsuf
okH;ckpvkH; aumif;rGef jynfhpkHNyD;
usef;rmaezkdY vkdtyfygw,f/
,ckaqG;aEG;wifjycsiw
f mu
awmh pdwfusef;rma&;eJY ywf
oufwJhtaMumif;t&myJ jzpfyg
w,f/ urmay:rSm&SdwJhvlOD;a&
&JU 70 &mckdifEIef;[m pdwfr
usef;rmrIukd wenf;r[kwfw
enf;eJY cHpm;ae&ygw,f/ zGHYNzdK;
wkd;wufwJh tar&duefjynf
axmifpkrSmawmif pdwfykdif;qkdif
&m jyemawG & S d a ewmuk d
vufcHxm;Muygw,f/ txl;
ojzifh tmPm&Sifqefqef tkyf
csKyfwJh wkdif;jynfatmufrSm&SdwJh
vlxak wG[m pdwzf pd ;D rIawGudk ykd
NyD;cHpm;wwfMu&ygw,f/ ,ck
vuf&dS jrefrmEkid if eH YJ xkid ;f jrefrm
e,fpyfrmS &Sw
d hJ a&TUajymif;tvkyf

rdk;ndK (CC)
orm;awGqDrSm pdwfzdpD;rIawG
[m ododomom cHpm;aeMu&
ygw,f/ pdwfzdpD;rIawG jzpfay:
vm&wJhtaMumif;&if;uawmh
wk d i f ; jynf r Nid r f o uf r I ? a&T U
ajymif;aexkdifrI? qif;&JrGJawrI?
ppfyGJtajctaersm;? nif;yef;
EdyS pf ufc&H rIEiS hf vkNH cHKa&;tajct
aersm; pojzifh taMumif;&if;
rsm;ay: tajccHum cHpm;csuf
ESifh pkd;&drfylyefrIvuPmrsm;rSm
vnf; rwlujJG ym;vmwwfMuyg
w,f/ usaemfwkdY jrefrmjynfvl
xktokdif;t0kdif;rSm pdwfa0'em
cHpm;ae&wJh vlwa,mufudk l;
oGyfw,f? a*gufrrSefbl;? usyf
rjynfhbl; pojzifh ac:a0:o
rkwfavh &SdwwfMuygw,f/ w
u,fawmh 'Dvkd rjzpfoifhyg
bl;/ tJ'Dvkd cHpm;ae&wJh vlw
a,muf[m vlom;jzpfwmrkYd us
aemfwYdkoYl udk vlYtokid ;f t0kid ;f u
ae rypfy,foifyh gbl;/ 0kid ;f 0ef;
az;rNyD; ESpfodrfhtm;ay;Mu&rSm
jzpfygw,f/ 'Dvrdk rS [kw&f if ol
&JU cHpm;rIa0'emukd ykdqkd;oGm;
atmif wGef;ykdY&ma&mufygvdrfh
r,f/ vlwa,muf[m pdwzf pd ;D
rI cHpm;ae&csdefrSm az;rulnD
r,fhol (okdY) xGufaygufwckck
ukd &SmwwfMuygw,f/ tJ'Dt
csdefrSm vrf;p&SmrawGYawmh r
avsmf u ef w J h tawG ; awG q D
a&mufomG ;wwfygw,f/ wcsdKU
qkd&if Substance Abuse vkdYac:
wJh t&ufeJYrl;,pfaq;tvGJokH;
rItxdjzpfomG ;wwfMuygw,f/
Mental Illness vkdYac:wJh
pdwfykdif;qkdif&m emrusef;jzpfrI
awG[m pOf;pm;awG;ac:rI? cH
pm;csufeJY twdwfujzpf&yfawG
tay:rlwnfNyD; a&m*gvu
PmpkawGvnf; rwluGJjym;avh
&S d y gw,f / tJ ' gawG u awmh
pdwfzdpD;rI (Stress)? pkd;&drfylyefrI
(Anxiety)? pdwf"mwfusqif;rI

(Depression)? pdwt
f wuftus
a&m*g (Bipolar)? pdwfupOfhu
vsm;a&m*g (Schizophrenia)?
P.T.S.D vkdYac:wJh pdwf'Pf&m&
NyD;aemuf pdwfzdpD;rIa&m*gtkyfpk
rsm; pwmawGtjyif tjcm;cEm
ukd,ftpdwftykdif; xdckdufrIeJY
OD;aESmufwiG ;f a&m*gyk;d wckck 0if
a&muf NyD;aemufykdif;awGrSm
vnf; pdwfa&m*gvuPmawG
jzpfay:avh &Sdwwfygw,f/ Oy
rmtm;jzifh tusOf;axmift
wGif; tusOf;usolrsm;ukd tm
Pmykdifrsm;rS OD;acgif;ukd vQyf

tJ'DvlawGrSmawmh pdwf'Pf&m
temw&awGeJY pdwfzdpD;rIawG
[m tNrJwrf; usef&Sdaewwf
ygw,f/ taMumif;uawmh ol
wkdY[m twdwfujzpf&yfawGukd
rMumcP jyeftrSwf&aevkdYyg
yJ/ txufrmS azmfjycJo
h vkyd gyJ/
cHpm;csufeJY tawGYtBuHKtjzpf
tysuaf wGtay: rlwnfNyD; a&m
*gvuPmawG[mvnf; om
reftaetxm;eJY jyif;xefraI wG
[m uGm[wwfygw,f/
usaemfwYdk vlawmfawmfrsm;
rsm;rSm pdwfzdpD;rIawG[m w
BudrfBudrfrSmawmh &SdwwfpNrJyg/
wcsdKUMuawmh ukd,fhukd,fukd
pdwzf pd ;D rIjzpfaewmukd jyefNyD;o
wdrjyKrdwwfMuygbl;/ usaemf
wkYd &UJ cEmuk,
d [
f m aeYpOfeYJ trQ
pOf;pm;awG;ac:rI? cHpm;csufeJY
cEmukd,fjyKrlvIyf&Sm;rIawG[m
qufpyfaeygw,f/ Oyrm orD;
rde;f uav;wa,mufa,mufudk
olYrdbu kdufvkdufw,f/ t
kdufcH&wJh rdef;uav; olrbm
jzpfrvJ/ olr&JU cHpm;csufu
0rf;enf;r,f? pdwfnpfr,f/
aemufolr&JUtjyKtrlawGu ikd
r,f? rIdifawGa0jzpfr,f? tdyf&m
xJ tdyfaer,f/ NyD;awmh olr&JU
tawG;awGu ]taruighukdr
cspfbl;/ tEkdifusifhw,f} vkdY
awG;aer,f/ 'guawmh olr&JU
tusdK;rjzpfxGef;wJh tawG;awG
aMumifh pdwfzdpD;rIukd jzpfay:ap

usaemfwkdY jrefrmjynfvlxktokdif;t0kdif;rSm pdwfa0

'em cHpm;ae&wJh vlwa,mufukd l;oGyfw,f? a*guf
rrSefbl;? usyfrjynfhbl; pojzifh ac:a0:orkwfavh&Sd
wwfMuygw,f/ wu,fawmh 'Dvkd rjzpfoifhygbl;/ tJ'D
vkd cHpm;ae&wJh vlwa,muf[m vlom;jzpfwmrkYd usaemf
wkdYolYukd vlYtokdif;t0kdif;uae rypfy,foifhygbl;/ 0kdif;
0ef;az;rNyD; ESpfodrfhtm;ay;Mu&rSm jzpfygw,f/ 'DvkdrS
r[kw&f if ol&UJ cHpm;rIa0'emukd ykq
d ;dk oGm;atmif wGe;f yk&Yd m
a&mufygvdrfhr,f/

]]

}}

ppfvIdif;jzifhwkdYNyD; nif;yef;ESdyf
pufc&H olrsm;? Cerebral Malaria
vkdYac:wJh OD;aESmufwGif; iSuf
zsm;yk;d 0ifa&mufxm;NyD; oltcsdKU
rSmvnf; jzpfay:avh&Sdygw,f/
tjcm;wckuawmh P.T.S.D vkdY
ac:wJh pdwf'Pf&m&NyD; aemuf
ykdif; pdwfzdpD;rIawGukd cHpm;&wJh
a&m*gtkyfpkawGuawmh ajc
vuft*Fg jzwfawmufcHxm;&
olawG? jyif;xefqkd;&Gm;wJh ppfyGJ
tajctaeawGukd BuHKawGYcHpm;
cJh&olawG? touftE&m,f
Ncdrf;ajcmufrIeJY xdwfvefYwkef
vIyfp&m tjzpftysufawGukd
ukd,fwkdifcHpm;cJh&olawG? t
usOf;axmifwGif; enf;rsdK;pkHjzifh
ni;f yef;ESyd pf uf owfjzwfraI wG
ukd jrifawGYcHpm;cJh&olawGrSm
trsm;qkH; awGY&wwfygw,f/

ygw,f/ aemufwcku vlw

a,mufoed ;f xDaygufw,fqydk g
pkdY/ tJ'Dvl[m bmjzpfr,fxif
vJ/ olt&rf;aysmf&Tifr,f? x
atmfr,f? ckefaygufr,f/ NyD;
awmh ]ig[m uHaumif;wJholyJ}
qkdNyD; awG;aer,f/ 'gaMumifh
usaemfwkdY[m tawG;? cHpm;
csufeJY tjyKtrlawG[m tNrJ
wrf;qufpyfaew,fqkdwmukd
owdjyKrdzkdY vkdygvdrfhr,f/ vl
awG[m omrefpdwfzdpD;rIjzpfwJh
tqifhrSmawmh vuPmawGu
armr,f? &ifwkefr,f? acgif;
uku
d rf ,f? oufjyif;csr,f? tdyf
raysmfjzpfr,f? tpm;taomuf
ysufr,f? tmkHpl;pkdufrIenf;
r,f? ajcvufxkHusifr,f po
jzifh jzpfay:avh &Sw
d wfygw,f/
'DtqifhavmufrSmawmh usaemf

NIGHTINGALE 13

wkdY ukd,fhukd,fukd owdjyKrdNyD;

ykdrqkd;oGm;atmif umuG,frI
awGeJY Relaxation vkdYac:wJh
tem;,lraI wGeYJ oufomatmif
vkyfvkdY&ygw,f/ tJ'gawGu
awmh Breathing toufjcif;?
Imagery tmkHwGifjrifa,mif
Munfhjcif;? Progessive Muscle
Relaxation vkYd ac:wJh <uufom;
rsm;ukd wjznf;jznf;ajzavsmh
jcif;tjyif tjcm;enf;vrf;rsm;
jzpfwJh oDcsif;em;axmifjcif;?
[mokyf&Sifum;Munfhjcif;? ol
i,fcsif;wa,mufa,mufeJY p
um;ajymjcif;? tm;upm;wckck
vkyfjcif;? rdrdukd;uG,faom bm
omtvkduf w&m;usifhjcif; p
aom enf;vrf;rsm;jzifh pdwfzd
pD;rIawGukd ajzavsmhoGm;atmif
jyKvkyfzkdY tBuHjyKwkdufwGef;csif
ygw,f/
wcsdKUvlawGrmS awmh qk;d &Gm;
aom pdwfxdckdufp&m tjzpft
ysufawGukd BuHKawGUcHpm;&NyD;
aemufykdif;rSm jyif;xefwJh vu
PmawGygwGJNyD; jzpfay:vm
wwfygw,f/ tJ'gawGuawmh
ESvkH;ckefjrefjcif;? tvG,fwul
aMumifhvefYjcif;? toufjref
jcif;? rl;a0jcif;? tvGeftMuL;
pkd;&drfylyefjcif;? tdyfrufqkd;rsm;
rMumcPrufjcif;? ntcsdef
vefYEkd;jcif;? vltrsm;ESifhpum;
rajymjcif;? wa,mufwnf;oD;
jcm;aexkdifjcif;? tm;tifcsdeJYo
vkd cHpm;&jcif;? rdrdukd,fukd xd
cku
d t
f emw&jzpfatmifvyk jf cif;?
olwyg;ukd&efvkdjcif;? *PSmr
Nidrfjzpfjcif;? trSefwu,fr&Sd
onft
h &mrsm;ukd Mum;jcif;? jrif
a,mifjcif; pojzifh jyKrlvm
wwf M uygw,f / wcsd K UrS m
vuPmwckEpS cf o
k mjyavh&NdS yD;
wcgw&HrSmawmh vuPmawG
[m wckxufru IyfaxG;ae
wwfygw,f/ xkdvuPmrsm;
eJY tjyKtrlawGukd awGU&SdcHpm;
vm&&ifawmh eD;pyf&m aq;kH
aq;cef;awGeJY wufuRrf;em;
vnfwJh pdwfusef;rma&;0ef
xrf;awG? Psychiatric vkdYac:wJh
pdwfa&m*guk q&m0efawGeJY
oGm;a&mufjyoNyD; wkdifyifaqG;
aEG;zkdY vkdtyfygvdrfhr,f/ bm
aMumifhvJqkdawmh usef;rma&;
owif ; tcsuf t vuf a wG e J Y
aemufaMumif;&mZ0iftjzpftysuf
awGukd avhvmod&SdzkdY vkdtyfo
vkd tcsdKUa&m*gawGu Anti-Psychotic vkdaq;awGeJY ukozkdYvkd
tyfygw,f/ 'Dae&mrSm usaemf
wkdY jynfolvlxktaeeJY a&m*g
ykdrqkd;oGm;apzkdYeJY rvkdvm;tyf
wJh t,ltqvGJrSm;rIawGukd r
jyKvkyfrdzkdY xyfrH tBuHjyKvkdyg
w,f/ bmaMumifv
h q
J adk wmh w
csdKUrdom;pkawG[m raumif;qkd;
&Gm;zrf;pm;wmawG? zkwf0ifwm

awG? twdwfuHraumif;cJhvkdY p
ojzifh xifa,mifxifrSm; jzpf
wwfavh&Sdygw,f/ 'gaMumifhrkdY
txufygcHpm;csuf? tjyKtrl
vuPmawG awGY&SdNyDqkd&if ykdrkd
owdjyKrdMuzkdYeJY aq;qkdifrsm;rS
rdrb
d momaq;0,faomufjcif;?
AdaEmaq;rsm;okH;pGJjcif;? usef;
rma&;eJYrnDnw
G af om tjyKtrl
rsm;ukdjyKvkyfNyD; tcsdefrukefap
zkdY wkdufwGef;csifygw,f/ trSef
wu,fawmh tcsdKUaq;0g;awG
[m a&m*gawGukd oufom
aysmufuif;apwmrSefayr,fh p
epfwus rSefrSefuefuef okH;pGJrI
r&Sd&if vlawGukd aemufqufwGJ
tE&m,fjzpfapwJh ab;xGuf
qkd;usdK;awGjzpfNyD; touftE
&m,fukd xdckdufEkdifygw,f/
Oyrm yg&mpDwarmvfukd a&
&Snf pGJpGJNrJNrJ okH;pGJr,fqkd&if vlY
cEmukd,f&JU tonf;ukd xdckduf
apovkdrsdK;aygh/ 'gaMumifhrkdY
pdwzf pd ;D rIawGeYJ cHpm;csuf vu
PmawGukd apmvsifpGm owdjyK
azmfxkwfNyD; pdwfusef;rma&;ukd
pdwfynmjzifh ajz&Sif;ukoEkdifrS
om aiG u k e f a Mu;usenf ; NyD ;
odomwJhusef;rma&; tusdK;jzpf
xGef;rIawGukd &&SdcHpm;EkdifMu
rSmjzpfygw,f/
pdwzf pd ;Dd rIawGudk avsmu
h sapzkYd ykrd dk
&,farmyg
&,farmwJhtcg OD;aESmuf
wGif; aoG;ykdrkda&muf&SdoGm;yg
w,f/ pdwfaysmfapwJh a[mfrkef;
Endorphins xGufvmwJhtwGuf
pdwfzdpD;rIawG usqif;apyg
w,f/
taygi;f toif;rsm;rsm;xm;yg
pd w f z d p D ; rI & wJ h t csd e f r S m
b,foleJYrS pum;rajymbJ w
a,mufwnf; aecsifMuw,f/
rdrdpdwfzdpD;rIawGukd pOf;pm;NyD;
rdrdudk,fukd raumif;jrifvmwJh
twGuf a&m*gykdqkd;vmw,f/
'gaMumifh oli,fcsif;? uav;
awGeJY pum;ajymyg/
qkH;jzwfcsufjywfom;yg
qkH;jzwfcsufr&SdwJhtwGuf
tvkyfawG rpwifEkdifygbl;/ cH
pm;ae&wJh jyemukd pm&Guf
ay:rSm a&;csyg/ NyD;&if ukd,f
vkyfEkdifwmawGukd pOf;pm;yg/
rvkyfEkdif&ifvnf; rvkyfEkdifwJh
taMumif; a&;csyg/ a&;csxm;
wmawGukdMunfhNyD; tusdK;t
jypfawGudk aoaocscsm pOf;pm;
NyD;rS bmvky&f iftaumif;qk;H vJ
qkdwmukd qkH;jzwfyg/
yGiv
hf if;rI&ydS g
cHpm;csuf? ,kHMunfcsufukd
yGifhvif;pGmajymjyyg/ rSefw,f
xifwJht&mukd ajymyg/ vlawGY
&if ukd,fupNyD; pum;ajymay;
yg/ oabmxm;rwk d u f q k d i f
wmawGukd ajymjyyg/ odvkdwJh
pmrsuEf mS (14) odYk ```

14 NIGHTINGALE use;f rma&;*sme,f

f mS (10) rS
``` pmrsuE

tdyfaysmfzdkY taxmuftyHhjzpfap
Edkifw,fvdkY xifBuygw,f/ tJ
'Dvdkaomufwmuvlwa,muf
udk cyfjrefjreftyd af rmusoGm;ap
ayr,fh t,fvfudka[mu t
tdy&f UJ t&nftaoG;udk avsmhus
oGm;apEdkifygw,f/ naESmif;
ydkif;rSm vludkEdk;vmapEdkifyg
w,f/ tJ'v
D kd rjzpfcsib
f ;l qd&k if
awmh tdyf,mr0ifcifrSm t&uf
aomufwmudk a&SmifzdkYygyJ/
- uufzif;"mwfukd avQmhcs
ay;yg/ uufzif;"mwfu rtdyf
cif 10 em&DeJY 12 em&DtwGif;
aomufxm;wJh vlwa,mufudk
tdyf,m0ifcsdefrSm jyemjzpf
f mS (13) rS
``` pmrsuE

tcsufawG ar;jref;yg/
pdwfzdpD;rIaMumifh tdyfraysmfwm
rjzpfygapeJY
vlwa,muf&JUtdyfcsdef[m

h g}rS tquf
```]qHyifajzmify

avmurSm azmfr,fvf'D[dkuf'f
aq;udk b&mZD;aq;vdkYvnf;
vlodrsm;ygw,f/
azmf r ,f v f ' D [ d k u f ' f [ m
uifqmjzpfapwmtjyif "mwfr
wnfhwmvnf; jzpfapwwfyg
w,f/ yrmPrsm;&if yef;em&if
MuyfvdkjzpfNyD; qHyifuRwfwm?
atmhtefwmawGvnf; jzpfapyg
w,f/ 'gaMumifh Oa&my? uae
'geJY MopDrSm ydwfyifxm;yg
w,f/ tar&duefuawmh yrm
Prsm;wmudkyJ ydwfvdkufwm
jzpfygw,f/ tar&duef vkyf
ief;cGifab;uif;a&;eJY usef;rm
``` ]wapvuf}rS tquf

Feedback therapy MVF) vdkY

&mrmcsef ' &ef u emrnf a y;
xm;ygw,f/ pufu&d,mqef;
qef;jym;jym;rvdk? aiGukefaMu;
usoufomwJu
h ek nf;jzpfygw,f/
2007 ckESpfrSm tar&duef
ppfwyfq&m0ef a'gufwm*suf
aqmifu ajcjywfvufjywf 22
a,mufudk 'DukxHk;eJY prf;oyf
wJhtcg xl;xl;jcm;jcm;atmif
jrifcJhygw,f/ e*dkwkef;u ,m;
wmawG? emusifwmawG[m w
vtMumrSm oufomaysmuf
uif;oGm;MuNyD; 'DukxHk;roHk;ol
awGuawmh ydkqdk;vmwm odkYr
[k w f rxl ; jcm;wmawG Y &yg

trSw-f 31? Zefe0g&v

D ? 2012-ckEpS f

apEdkifw,fqdkwmudk vlawGod
&if tHtm;oifhoGm;Edkifygw,f/
'gaMumifhaeYvnfpm pm;NyD;csdef
upNyD; uufzif;aomufo;kH wm
udk rvkyfawmhwm 'grSr[kwf
udk,fh&JU uufzif;aomufoHk;rI
udk avQmhcsypfwmrsdK;vkyfoifhyg
w,f/
nydkif;awGrSm t&nfawGt
rsm;BuD;aomufwmudk a&Smifyg/
a&? tcsdK&nf? vufzuf&nfeJY
wjcm;t&nfawG trsm;BuD;n
ydkif;rSmaomufr,fqdk&if wn
vHk; a&tdrf0ifae&ygvdrfhr,f/
uufzif;"mwfygwJt
h &nfawGqkd
qD;ydk&TifvmNyD; ydkqdk;oGm;Edkifyg
w,f/

- aq;vdyfaomufwm u
vnf; enf;vrf;trsdK;rsdK;eJY tdyf
puftem;,lwmudk taESmuft
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