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Beriberi usawmh wjcm;ESvkH;a&m*gjzpfwJholawGvkdyJ a&m*gvu© r[kwyf J t&ufenf;enf;xrif;[if;t&Gurf sdK;pkeH YJ toD;tESaH wGudk aumf rwD u ajymygw,f / ESpfpOfay;aewJh u@pHk Ekdb,f
PmawGu qifwlygw,f/ ajcvufawG azma,mifr,f? armyef; tm[m& jynfph aHk tmifpm;ay;r,fq&dk if t&uf&UJ qk;d usKd ;oufa&muf r rsdK;Oukd,ljyD; cE¨mudk,f qkawGtwGuf aq;odyu HÜ kd tNrJ
r,f? ESv;Hk ckew
f mvnf; wtm;jrefqefw,f? nqk&d if odyaf rmMuyf rI'Pfukd odyfrxdEkdifbl;aygh/ 'Davmufqkd;0g;wJh tEÅ&m,fawG ay; tjyifrSm oaE¨atmifatmif wrf; yxr aMunmavh &Sdyg
vmNyD; tdyfvkdYr&bl;/ tqifroifh&if aoG;aygifawG wtm;xkd;us Ekid pf rG ;f &SNd yD; vlom;awGtwGuf aumif;usdK;ray;wJt h &ufudk vlawG vkyfay;jyD;awmhrS tJ'DoaE¨udk w,f/ VOA, Oct 4, 2010
10 NIGHTINGALE use;f rma&;*sme,f ESihf wGjJ zpfygu i,fxyd o f nf
ykHrSef jzpfaeEkdifonf/
- tm&kHaMum jyóemrsm; (Ne-
urological Disorders)
- rSdef;jcif; (Drowsy)
- tdyfcsifaejcif; (Sleepy)
- w0ufwysuf owdvpfae
jcif; (Stupor)
- owdarhaejcif; (coma)
- wufjcif; (Convulsion)
- tvif;a&mifukd aMumufjcif;
(Phonophobia)? toH u k d
vnf; aMumufjcif;
- ta&jym;uk d tNrJ w rf ; ppf
aq; Munfhyg/
aoG ; puf a jymuf B uD ; rsm;
(Purpura) okdYr[kwf aoG;puf
aNymufi,frsm; (Petechial rash)
- ukd,ftav;csdefusjcif;/
trSw-f 24? pufwifbm? 2010-ckEpS f
- emwm&Snf tzsm;tenf;i,f
&Sdjcif;/
- wjznf;jznf; OD;aESmuf t
ajr§;yg;a&mifjcif;\ a&m*g
vu©Pmrsm; ay:vmjcif;/
toufi,faom vlemrsm;
wGif uk, d wf jcrf;taMumao
jcif;(Hemiplegia) ukd,fcE¨m
atmufykdif; taMumaojcif;
(Parap-legia)
atmufygtcsufrsm;&Sdygu þ
a&m*gjzpfEkdifonf[k oHo,jzpf
yg/
- uav;umuG,faq; rxkd;
xm;jcif;/ (okdYaomf uav;
onf BCG umuG,af q;xk;d
xm;aomfvnf; jzpfEkdifao;
QID (tifyDpDvif) taMum^
tom; waeY(6) em&D jcm; (4)
Budrf + Cefotaxime (pufzkdw
Zif;) IV/IM 50mg/kg BID-QID
+ Gentamicin (*sifwmrDpif) IV/
IM 4mg/kg OD waeYwBudrf
txufyg aq; (3) rsdK;
aygif;tm; (14-21) &uftxd
ay;&rnf/ Gentamicin aq;
tm; wywfay;NyD;ygu &yf&
rnf/
tu,f í Ceftriaxone
aq;0g;r&&Sdygu ...
touf (2) vtxuf uav;
rsm;ESihf vlBu;D rsm;twGuf
Chloramphenicol IV/IM
25mg/kg QID ay;yg/
tu,fí vlemtajctae

OD;aESmuftajr§;yg;a&mifa&m*g
OD;aESmuftajr§;yg;a&mifa&m
*g (Meningitis) [m touf (5)
ESpaf tmuf uav;rsm;wGif awGU
&wwfaom a&m*gwckjzpfyg
w,f/ uav; touf (3) v
uae (5) ESpfavmuftwGif;rSm
jzpfwJh OD;aESmuftajr§;yg;a&mif
a&m*gawG&JU (50) &mckdif;EIef;
avmuf [ m Haemophilus
Influenzae Type B (Hib) vkdYac:
wJh bufwD;&D;,m;ykd;aMumifh
jzpfygw,f/ tcsKd YrmS Streptococ
cus pneumoniae, Neisse ria
meningitidis eJY Meningo cocci
bacteria wkdYaMumifhvnf; OD;
aESmuf tajr§;yg;a&mif a&m*g&
wwfygw,f/ wDbD (TB) ykd;
aMumifhjzpfwJh OD;aESmuf tajr§;
yg;a&mifa&m*gtjyif Akdif;&yfpf
yk d ; aMumif h v nf ; aumif ; ? OD ;
aESmufxJ iSufzsm;ykd;0ifjcif;
aMumifhvnf;aumif; 'D a&m*g
&wwfygw,f/ ckct H m;usqif;
wJh vlemwcsKd YwiG v f nf; Crypto-
coccal meningitis vdkY ac:wJh OD;
aESmuftajr§;yg;a&mif a&m*g
tjzpfrsm;wmukdvnf; awGU&
wwfygw,f/
'Da&m*gawG&JUobm0t&
aoaysmufrEI eI ;f uawmh jzpfymG ;
ol (100) rSm (10) &mckdifEIef;
uae (20) &mckdifEIef;txd &Sd
Ekdifygw,f/ raobJeJYtouf
&Sifusef&pfwJh uav;awGrSm
vnf; (30) &mckdif EIef;avmuf
txd qGUH tem;rMum;wmwkYd ? OD;
aESmuftwGif; a&tdwfBuD;NyD;
acgif ; BuD ; wm (Hydrocepha
lus)? ÓPf&nfcsdKYwJhwm? rpGrf;
roefjzpfwm pwJh aemufquf
wGJqkd;usdK;awG usefwwfwJht
wGuf jzpfjzpfcsif; xdxda&muf
a&muf uko&r,fh ta&;BuD;wJh
a&m*gwckjzpfygw,f/
OD;aESmuftajr§;yg;a&mifa&m
*gqkdwm OD;aESmufukd zkH;tkyf
rif;ol&ed f
xm;wJhtajr§;yg; ½kwfw&uf
a&mifjcif; (okdY) a&m*gykd;0if
a&muful;pufjcif;aMumifhjzpfyg
w,f/ OD;aESmuftajr§;yg; (Me
ninges) - A[kdemAfaMumtzGJU
(Central Nervous System)
jzpfwJh OD;aESmufeJYausm½kd; emAf
aMumrBuD; (Spinal Cord) ukd
vT r f ; NcH K xm;wJ h tajr§ ; yg;
rsm;jzpfw,f/ A[kdemAfaMumt
zGJUeJY tvTmrsm;tMum;wGif t
&nfwcsdKY&SdNyD; ¤if;ukd OD;aESmuf
emAfaMumrt&nf (Cerebro-
Spinal Fluid - CSF) [kac:yg
w,f/ ¤if;t&nf[m A[kdemAf
aMumtzGJUukd umuG,frIay;NyD;
tm[m&vnf; jznfhwif;ay;
ygw,f/
uREkfyfwkdY rnfuJhokdY OD;aESmuf t
ajr;§ yg;a&mifa&m*g jzpf&oenf;
tvGefao;i,faom ykd;rTm;
rsm; (tPkZ0D yk;d rsm;) tajr§;vTm
rsm;xJokdY xkd;azmuf0ifa&muf
aomtcgü jzpfwwfygw,f/
- 'Pf&m&SdrIaMumifh tajr§;rsm;
ysufpD;&mrSwqifh 0ifa&muf
jcif;/
- avxJ&Sd trIefrsm;? wHawG;?
ovdyfwkdYwGif ygvmaom
a&m*gyk d ; rsm; aoG ; xJ o k d Y
a&muf&Sd&mrS wqifho,f,l
vmjcif;/
- teD;tem;&Sd t½kd;a&m*grS
0ifa&mufjcif; (Mastoid)? t
½kd;a&mifjcif;? xdyfcyfemjzpf
jcif; (Sinusitis)? emwm&Snf
em;jynf,kdjcif; (Chronic Oti-
tis) ponfwkdYrSwqifh 0if
a&mufjcif;/
rsm;aomtm;jzifh t&G,f
a&mufvli,frsm;ESifh uav;
rsm;wGif OD;aESmuftajr§;yg;
a&mif a&m*gjzpfavh&Sdygw,f/
¤if;a&m*g[m jyif;xefaom
ul;pufa&m*gwckjzpfNyD; OD;
aESmufukd &moufyefysufpD;ap
wwfygw,f/ okdYr[kwf vlem
&JU usefoufwrf;wavQmuf
vkH;rSm tm½kHaMumcsdKY,Gif;rI jzpf
apwwfygw,f/
a&m*gtoGit f jyif
OD ; aES m uf t ajr§ ; yg;a&mif
a&m*g[m ½kwfw&ufjzpfaom
a&m*gjzpfNyD; em&Dtenf;i,f
twGif; (okdY) &uftenf;i,f
twGif;ü jzpfay:vmygw,f/
a&m*gjyif;xefrI[m jzpfyGm;ap
aom a&m*gyk;d eJY vlem&JUtouf
t&G,af y: vk;H 0rlwnfygw,f/
a&m*gvu©Pmrsm;
- ukd,fyljcif; (tjyif;zsm;NyD;
ukd,ftylcsdef 39 'D*&D pifwD
*&dwfxuf ausmfvGefjcif;)
- acgif;ukdufjcif;/
- t½Sdefjzifh jyif;xefpGm tef
jcif ; (Strong & Powerful
Projectile Vomting)
- vnfyif;aMum awmifhwif;
jcif;/
*½kjyK&ef
touf(12-18)v atmuf
uav;rsm;ü
- vnfyif;awmifhwif;rI r&SdbJ
aysmhaeEkid Nf yD; taxGaxGwif;
tm;avsmhjcif;&Sd/
- i,fxyd u f dk MunfNh yD; prf;oyf
ygu i,fxdyfonf a&mifí
tay:okdY azmif;aernf/ okdY
aomf ukd,fyljr§ifhNyD; tefjcif;
aMumifh t&nf"mwfqkH;½IH;rI
&Sd^r&Sd ppfaq;Munfhyg/ (aoG;
pufaNymufi,f-teDa&mif t
pufrsm;jzpfNyD; rDeifukdaumh
ukdif; OD;aESmuftajr§;yg;a&mif
a&m*gwGif cE¨muk, d af tmufyidk ;f
ESifh ta&jym;tcsdKifhrsm;Mum;ü
awGYEkdifonf/
OD;aESmuftajr§;yg;a&mifa&m
*gESifh aoG;pufajymufBuD; rsm;
yl;wGJawGUygu tvGefYtvGef
ul;pufEkdifonf/ tvGefjyif;
xefonf/ vlemukd vG,fulpGm
aoapEkdifonf/
xl;jcm;aom tajctae rsm;
uav;rsm;wGijf zpfaom OD;aESmuf
tajr;§ yg; a&mifa&m*g
- tpmrpm;csifjzpfjcif;
- ikdoHtm;aysmhjcif;
- taxGaxG <uufom; wif;
tm; avsmeh nf;jcif; (General
Hypotonia)
rDeifukdaumhukdif;aMumifh
jzpfaom OD;aESmuftajr§;yg;
a&mif j cif ; (Meningococcal
Meningitis)
- rDeifuadk umhuidk ;f (ac:) buf
wD ; &D ; ,m;yk d ; aMumif h jzpf
onf/
- ta&jym;twG i f ; ok d Y aoG ;
xGufjcif;aMumifh aoG;puf
ajymufBuD;rsm; jzpfaponf/
vsifjrefpGm aoqkH;Ekdifonf/
- xkdYaMumifh ta&jym;ukd ppf
aq;yg/
wDbyD ;dk aMumifjh zpfaom OD;aESmuf
tajr;§ yg;a&mifjcif;(TB Meningitis)
- þa&m*gonf wjznf;jznf;
pjzpfonf/
onf/)
- rd o m;pk w G i f wD b D a &m*g
&Sdjcif;/
- tm[m&csdKYwJhrI&Sdjcif;/
aumif;rGeNf yD; tzsm;usvmygu
pm;aq; ajymif;ay;yg/ aq;t
csdetf qukd 12.5mg/kg QID EIe;f
pkpak ygif; (10) &uf jynfh atmif
Akid ;f &yfpyf ;dk aMumifh OD;aESmuf tajr;§ ay;yg/
yg;a&mifjcif; (Viral Meningitis) Chloramphenicol aq;
bufwD;&D;,m;ykd;aMumifh tm; ukd,f0efaqmifrdcifrsm;ukd
jzpfaom OD;aESmuftajr§;yg; ray;&yg/
a&mifa&m*gESifh qifwlonf/ uk,d 0f efaqmifrcd ifrsm;twGuf
okdYaomf y#dZD0aq;rsm;ESifh uk Ampicillin IV 2g QID (10)
oygu xda&mufrIr&Sdyg/ olY &uf ay;yg/
a&m*gjzpfpOftwkid ;f qufjzpfrnf/ Dexamethasone ('ufpmrD
a&m*gtrnfowfrw S jf cif; (Diag- omZkH;) IV 0.15 mg/kg QID (4)
nosis) &ufqufay;yg/
- a&m*gvu©PmtoGiftjyif taxmuftuljyK ukorIrsm;
t&vnf;aumif; (Supportive Treatment)
- OD;aESmufemAfaMumr t&nf - tzsm;usap&ef Aspirin (okdY)
(CSF) ukd (Lumbar Punct- Paracetamol ay;yg/
ure) cg;qpf½kd;rS azmuf,lNyD; - wufjcif;twGuf Diazepam
"mwfcGJcef;wGif prf;oyfppf 0.5mg/kg rectally (ptkdvrf;
aq;jcif;t&vnf;aumif; aMumif;rS) trsm;qkH;10mg
- vlemwGif iSufzsm;ykd; &Sd^r&Sd (okdY) 0.3 mg kg IM ay;yg/
aoG;azmufppfaq;jcif; (Mal- - a&"mwfqkH;½IH;jcif; rjzpfap
aria smear)t&vnf;aumif; &ef t&nf r sm; (Fluids)
a&m*gtrnf owf r S w f ay;yg/
onf/ iSufzsm;ykd; OD;aESmuf - aumif;aom tm[m& ay;
xJ 0ifygu OD;aESmuftajr§; yg/ vkdtyfygu ESmacgif;rS
yg;a&mifa&m*gyg yl;wGjJ zpfEidk f tpmtdrfykduf (Naso-gastric
onf/ Tube) ukd tokH;jyKyg/
ukocsuf (Treatment) - owdarhaeygu - touf
jrefrme,fpyfvrf;nTeft& ½SLvrf;aMumif;ukd &Si;f yg/ vkd
(Burmese Border Guidelines) tyfvQif atmufp*D sif ay;yg/
- csufcsif; aq;½kHwifyg/ yg;pyf? rsufpdukd oefY&Sif;yg/
- y#dZD0 (Antibiotics) aq;0g; tdy&f mem (Bed sore) rjzpfap
rsm; ay;yg/ &ef vlemtm; (2) em&Djcm;
- yxrOD;pm;ay; aq;0g;rsm; wcg vSnfhay;yg/
(First Choice Drugs) umuG,fjcif;
(2) vtxuf uav;rsm;ESifh vl ,cktcg r,fawmfaq;cef;
BuD;rsm;twGuf wGif OD;aESmuftajr§;yg;a&mif
pufx&D,mZkH; (Ceftriaxo a&m*gtwGuf umuG,faq;r
ne) taMum^tom;aq; IV/IM xkd;ay;ao;yg/ avmavmq,f
50mg/kg/day BD waeY 2 Budrf q, af &m*grul;puf&eftwGuf
(or) 100 mg/kg/ day OD waeY vlemukd oD;oefYcx JG m;yg/ vlem
wBudrf \ aqGrsdK;rsm;ESifh xdawGUrdol
(Oyrm-uav;50mg/kg rsm;ukd umuG,f&eftwGuf u
BD, vlBuD; 2 gBID waeYESpf av;rsm;tm; Ciprofloxacin
Budrpf )D 15mg/kg stat ESihf vlBuD;twGuf
(2) vatmuf uav;i,frsm; 500 mg stat csufjcif; yg;pyfrS
twGuf wkdufyg/
Ampicillin IV/IM 50mg/kg rif;ol&ed f
 trSw-f 24? pufwifbm? 2010-ckEpS f
uk,d pdv
f ;k aevif
ufv; yI &f mS ;upm;rI
usef;rma&;tusdK;aus;Zl;rsm;
ukd,fvufvIyf&Sm; tm;u
pm;rI[m tusdK;aus;Zl;taeeJY
ukd,ftav;csdef xdef;csKyfEkdifrI
xuf trsm;BuD;ykdvGef;ygw,f/
usef;rma&;apmifha&SmufrI ok
awoeawGu ykHrSefukd,fvuf
vIyf&Sm;avhusifhcef;awG[m vl
awGukd a&m*gtawmfrsm;rsm;
jzpfyGm;EkdifwJh tEÅ&m,fuae
avsmhyg;oGm;apEkid o f vkd vlawG
&JUusef;rma&;tajctaeeJY b0
&JU wckv;Hk qkid &f m t&nftaoG;
ukdvnf; wkd;wufaumif;rGef
vmapEkid w f ,fqw dk mukd jyaeyg
w,f/ ykHrSefukd,fvufvIyf&Sm;
avhusifch ef;vkyw f m[m cifAsm;
wkdYukd atmufrSmazmfjyxm;wJh
usef;rma&;jyóemawGukd um
uG,fwJhae&mrSm taxmuftyHh
jzpfapygw,f/
ESv;Hk a&m*geYJ ½kwwf &uf avjzwf
jcif;/
aeYpOf ukd,fvufvIyf&Sm;rI
avhusifhcef;u vlawG&JU ESvkH;
<uufom;awGukd oefpGrf;vm
apjcif;? aoG;zdtm;ukd avQmhcs
ay;jcif;? odyfonf;jcif;jr§ifh
vpfykdy½kdwdef; (HDL) vkdY ac:wJh
aumif;rGefwJh aumfvufpx
a&m tqifhukd jr§ifhwifay;jcif;?
odyfonf;jcif;ESdrfh vpfykdy½kd
wdef; (LDL) vkdYac:wJh raumif;
wJh aumfvufpxa&m tqifu h dk
ESdrfhcsay;jcif;? aoG;pD;qif;rIukd
wk;d wufaumif;rGev f mapjcif;eJY
ESvkH;&JUtvkyfvkyfrIpGrf;&nfukd
wkd;rsm;vmapjcif; pwmawG
ESifh
tm;jzifh ESvkH;a&m*geJY avjzwf
wmawGudk tumtuG,af y;Ekid f
zkdY tultnDjzpfapygw,f/ tJ
'D vkyfief;aqmifwmtoD;oD;
ukd taeawmfaumif;rGefatmif
vkyfaqmifay;Ekdifwmu wjcm;
omrefaoG;aMumqkdif&ma&m*g
awG&JU tEÅ&m,fawGukd avQmhcs
ay;Ekid wf hJ aemufqufwJG tusKd ;
aus;Zl;l awGuv dk nf; &&Sad pEkid yf g
w,f/
aoG;zdtm;jr§ifhrm;rI/ yk H r S e f
ud, k v
f ufvyI &f mS ;avhusichf ef;vkyf
wm[maoG;aMumawGxrJ mS aoG;
zd t m;jr§ i f h r m;aewJ h t qif h u k d
avQmhcsay;Ekdifygw,f/ aoG;zd
tm;jr§irfh m;vmrIeYJ qufpyfaewJh
cE¨mukd,frSm&SdwJh tqD"gwfukd
vnf; avQmhcsay;Ekdifygw,f/
oMum;"mwftrSDjyK qD;csdK/
cE¨mukd,ftqD"mwfavQmhcsay;
jcif;tm;jzifh ukd,fvufvIyf&Sm;
avhusifhcef;awGu tJ'DtrsdK;t
pm;qD;csdKa&m*gukd umuG,f
xdef;csKyfEkdifatmif tultnDt
axmuftyHhjzpfapygw,f/
t0vGerf /I ukd,fvuf vIyf
&Sm;avhusifhcef;awGu <uuf
om;xkukd wnfaqmufjcif;?
xde;f odr;f jcif;eJYu,fv&dk aD wGudk
tokH;jyKzkdY cE¨mukd,ftqD"mwf
avQmhusatmif tultnDay;
Ekdifygw,f/ ukd,fvufvIyf&Sm;
avhusifhcef;awG[m rSefuef
oifhavsmfwJht m[m&"mwfe JY
aygif;pyfEkdifcJh&if ukd,ftav;
csdefukd xdef;csKyfEkdifNyD; a&m*gt
awmfrsm;rsm;ukd jzpfapEkdifwJh
t"du tEÅ&m,fjzpfwhJ t0vGef
rIukd tumtuG,fay;Edkifyg
w,f/
cg;em/ ykHrSef udk,fvufvIyf
&Sm;avhusifhcef;awG[m <uuf
om;awG&JU tiftm;eJY cHEkdif&nf
ukd wkd;rsm;vmapjcif;? aysmh
aysmif;rIeJY ukd,fae[efxm;ukd
wkd;wufvmapjcif;tm;jzifh cg;
ema&m*grjzpfatmif tumt
uG,fay;Ekdifygw,f/
t½k;d a&m*g/ ykHrSef tav;r
avhusifhcef;u t½kd;zGJUpnf;rI
ukd aumif;rGew f ;dk wufvmapo
vkd touft&G,fBuD;&ifhvmvkdY
jzpf&wJh t½kd;qkH;½IH;rIykHpHtrsdK;
rsdK;ukdvnf; umuG,fay;Ekdifyg
w,f/
rdrdukd,fukd av;pm;wefzkd;
xm;rIeYJ pDrBH u;D Muyfr/I uk,
vIyf&Sm;avhusifhcef;&JU pdwfykdif;
qkid &f m oufa&mufraI wGudk avh
vmrIt& ykHrSefukd,fvufvIyf
&Sm;rIavhusifhcef;awG[m vl
awG&UJ pdwcf pH m;rIeYJ uk,
eJY ywfoufwJhcHpm;awG;jrifrI
awGukd wkd;wufvmapEkdifw,f
qkdwmukd jyqkdaeygw,f/ ok
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