Dr.0 Pdpygm Reprint

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vdk/ csDygom;ycef;om;vdk vlrsKd;eJ@awG@if'gtqef;vm;/ vlwdkif;rSm tpmtdrfSdwmyJ
[mvdk@ pum;tuyfcHrSm aocsmygw,f? avjrifhwhJolawGuawmh udk,fhrSm*wfp
-wpfSdw,ftmvfqmSdw,fvdk@ajymwwf-uygw,f? 'gvnf;tvG,fajymwmygyJ?
aocsmrrSefao;ygbl;? *wfp-wpfqdkwmu aq;ynma0g[mtaeeJ@ tpmtdrfeJ@ywf
oufw,fqdkwJh emr0daooewckyg?tmvfqmqdkwmutemyg? cE<mudk,fhJ b,f
aemrqdk jzpfay:wJhtemwdkif;udk nf!$ef;ygw,f?
*wfp-wpf tmvfqm qdkifawmh tpmtdrfrSmtemSdw,fv@kd twdtusazmf
jywmygyJ? twdkaumuftaeeJ@ *sD,l;vdk@vnf;ajym-uygw,f? tpmtdrfrSm yufyfwpf
qJvfawGSdae_yD; 'DqJvfawGrSm temjzpfifvnf;yufyfwpf tmvfqmvdk hac:ygw,f?
twdktaeeJ@yD,l;vdk hajym-uygw,f? tpmtdrfrSm uifqmvnf;jzpfwwfygw,f?
tm;vHk;[m tpmtdrfrSmjzpfay:wJh am*gawGcsnf;ygyJ?
tpmtdrf[m tpmacstzGJ@tpnf;Jh t*Fgtpdwftydkif;wckyg? tpmrsKdyGeft
qHk;uae tlodrftpydkif;txd wnfSdwJh tpmajcvrf;a-umif;Jh tpdwftydkif;jzpfygw,f?
tpmtdrfyifruae tlodrfJhtpydkif;udk qufay;xm;wJh j'Ltdk'Derfukdvnf; tpmtdrfhJ
tpdwftydkif;tjzpf owfrSwfxm;jyefygw,f? 'ga-umifh j'Ltdk'DerfrSm temjzpfifvnf;
j'Ltdk'De,ftmvfqmvdk@ac:ygw,f? 'D,l;aygh?
am*gb,jzpfay:jcif;udk avhvmr,fqdkif OD;pGm omrefobm0 zGJ@pnf;jzpfay:
jcif;udk odrSmjzpfygw,f? tpmtdrf[m +H@csJ@vdk@wJh tdwfykHomeft*Fgwckyg? tpif;r
SdwJh uGufom;awGeJ@ zGJ@pnf;xm;ygw,f? twGif;eHHudk tarS;yg;eJ@zHk;tkyfxm;_yD; tarS;
yg;JhatmufrSm qJvfrsm;/ ppfxkwfnft}udwf(*vif;)rsm;/aoG;a-umrsm;Sdygw,f?
uGufom;rsm; usKH@wGjcif;jzifh v+yfSm;aeygw,f? tpmrsKdyGefu ydk@ay;vdkufwJh tpmaysmh
zwfudkvufcH_yD; tpmacstifZdkif;rsm;/ qm;iJrD;taysmhpm;wdk@jzifh acszsufay;ygw,f?
tpmtdrfJht"duvkyfief;rSm tpmudkacszsufjcif;yif jzpfygw,f? cE<mudk,ftwGuf t"d
uavmifpmjzpfwJh *vl;udkpfho-um;"mwfudk SdwJhtxd "mwfjyKacszsufay;ygw,f? t
19
a'gufwm0vkH;
oHk;rvdkwJh/ acs zsufvdk@rwJh pGef@ypfypPnf;awGudk tlodrfqDukd rpiftjzpfeJ@ ydk@ay;vdkufyg

w,f?
ppfxkwfnfrsm;teuf iJrD;aysmhJhtatwGuf[m trsm;qHk;jzpfygw,f?
vufcHSdwJh tpmaysmhzwfudk ydkrdk ao;i,fwJh tpdwftydkif;jzpfoGm;atmif acszsufay;
zdk@[m iJrD;aysmhJhwm0efjzpfygw,f? omreftm;jzifh iJrD;aysmh[m tpmtdrftwGif;rSm
acszsufpm tpmaysmhzwfSdaeygu tpmtdrfeHHudk acszsufwdkufpm;edkifjcif; rSdygbl;?
tpmtdrf twGif;rSmacszsufpm tpmaysmhzwfenf;aer,f/ 'grSr[kwf vHk;0rSdbl;qdkif
tpmtdrfeHHudk wdkufpm;acszsufygw,f? 'DvdkeJ@tpmtdrfeHHrSm temjzpfvmygw,f? 'g
a-umifhtpmtdrfrSm temjzpfay:apwmu iJrD;aysmhhJ wdkufpm;r+a-umifh trsm;qHk;jzpf
wmvdk@ qdkEdkifygw,f? rmausm-urf;wrf;aom tpm;tpmrsm;/ ylpyfvGef;aom tpm;t
pmrsm;uvnf; tpmtdrfeHHudk wdkufpm;if; temjzpfay:apwwfygw,f? wdkufpm;yg
rsm;vGef;I qJvfwdk@Jh rlv"mwfobm0ysufpD;_yD; aemufqkH;rSm cE<mudk,fudk tEW,fjyK
wJh qJvftopfrsm;jzpfxGef;_yD; uifqmudk jzpfay:apwwfygw,f?
qm;iJrD;aysmh/ tpmacstifZdkif;eJ h ppfxkwfnfrsm; xkwfv$wfxGufSdr+[m
tmHka-umtzGJ@tpnf;u xdef;csKyfxm;ygw,f? tpmaysmhzwf0ifamufvmcsdefrSm
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Sm;csdefrSmaomfvnf;aumif;/ iJrD;aysmhudk xkwfv$wfxGufdSjcif;[m ydkrsm;vmapyg
w,f? aoG;trsKd;tpm;(at)udk ydkifqdkifolrsm;rSmvnf; iJrD;aysmhxGufSdr+[m tjcm;ol
rsm;xuf ydkrsm;vmygw,f? pdwfaomuylyefr+awG a0qmaewJhtcsdefrSmvJ ydkrdkxGuf
Sdwwfygw,f?
a,bl,stm;jzifh tpmtdrf[m tpmaysmhzwfukd acszsufz@kd twGuf acwWodk
avSmifxm;ygw,f? odkavSmifcsdef ysrf;r#ESpfemDcef@Sdygw,f? acszsuf_yD;ygu uGufom;
rsm;v+yfSm;r+jzifh tlodrfqDudkydk@aqmifay;ygw,f? 'ga-umifh ESpfemD ausmf/ oHk;emDvGef
ajrmufwJhtcgrSm tpmtdrfxJrSm tpmaysmhzwf[m xkxnfenf;yg;vmygw,f? tcsdef
-umjrifhav rSdoavmuf jzpfvmygw,f? iJrD;aysmhe@J tifZdkif;ppfxkwfnfawGuvnf;
tcsdefrSefrSefxkwfv$wf xGufSdavh Sdygw,f?
omreftm;jzifh tpmtdrftwGif;rSm tpmaysmhzwf xkxnfenf;yg;_yD; tpm
opf0ifvmr,fhtcsdefrSm xkwfvGwfxGufSd ay;ygw,f? tJ'DtcsdefrSm tpmtdrfxJrSm
tpmaysmhzwftopf[m vHkavmufpGmrSdbl;qdkif iJrD;aysmh[m tpmtdrf twGif;eHH
awGudk wdkufpm;awmhwmyJ? tJ'Dtcg tpmtdrfrSm temjzpfvmygw,f? 'ga-umifh iJ
rD;aysmhawG xkwfv$wf xGufSdvmcsdefrSm tpmtdrftwGif;rSm aysmhzwf[m vHkavmuf
wJhyrm%SdEdkifzdk@ tpmudk ESpfemDoHk;emDcef@ rSefrSefpm;ay;r,fvdk@ t-uHay;avhSd-uyg
20
a'gufwm0vkH;
w,f?
tpmtdrfJh obm0vkyfief;aqmifwmeJ@ iJrD;taysmhpm;a-umifh temjzpfay:

vmwwfwmudk odxm;if tpmtdrfrSm temrjzpfatmif *kpdkufygr,f? tpmtdrfrSm
temSdvmif Adkufatmifh Adkufemvmwwfygw,f? ysK@d tef atmf*vDqefwwfygw,f?
acgif;rl; acgif;tHkvmwwfygw,f? b,fvufjyifatmufrSm pl;xdk;atmifhwwfygw,f?
tpm pm;vdkufwdkif;rSm SdaewJhtemudk tpmaysmhzwfhJ xdawG@r+a-umifh emwwfatmifh
wwfygw,f? temJhwnfaemudk vdkuf_yD; emusifr+tcsdef[m uGmjcm;wwfygw,f?
tpmrsKdcs_yD;_yD;jcif; emvmiftem[m tpmtdrfyifrJh tay:ydkif; avmufrSmSdwwf
ygw,f? rdepf(20)0ef;usifavmufrS emvmiftpmtdrfhJ atmufydkif;avmufrSm tem
Sdwwfygw,f? emD0ufausmfavmufrS emusifr+jzpfay:vmif j'Ltdk'Derftydkif;rSm t
emSdw,fvdk@qkdyghr,f? emusifr+tcsdefudk csifhcsdef _yD;*sD,l;vm;/yD,l;vm;/'D,l;
vm;vdk@ qef;ppfygr,f? tpma[mif;rsm;ysKd@tefjcif;/ aoG;rsm;tefzwfwGifygvmjcif;/
aoG;pdrf;SifSiftefjcif;rsm;[m tpmtdrftemJh xkxnf}uD;rm; tEW,frsm;jcif;udk
azmfjyaeygw,f? 'ga-umifh Adkufem/ Adkufatmifhwmav;yJqkd_yD; ayghayghqqraeoifhyg?
tpmtdrfrSm temSdolrsm;[m ydefanmfaeavhSdygw,f?
Adkufem Adkufatmifh_yDqdkwmeJ@ omrefr[kwfawmhbl;? obm0qef@usifae_yDqdk
wm owdcsyfygr,f? tpmtdrfrSm iJrD;"mwfrsm;ae_yDqdkwm odygr,f? 'ga-umifh iJ
rD;"mwf tiftm;avsmhenf;oGm;atmif OD;pGmvkyfyghr,f? aat;udk w0}uD;aomufcs
ygr,f? aemuf iJrD;udk avsmhenf;atmif wkef@jyefapr,fh tmumvD"mwfwckckudk
pm;aomufrsKdcsay;yghr,f? vufvSrf;rSDwJh tpm;tpmxJrSm EGm;Edk@[m iJrD;"mwfudk
wkef@jyefay;pGrf;edkifqHk;ygyJ? rylwJhEGm;Edk@udk aomufyghr,f? rdepftenf;i,ftwGif;rSm
Adkufem Adkufatmifh oufomoGm;ygr,f? rylrpyfwJh tjzLxnfpm;pmrsm;udk ausnuf
pGm0g;pm;rsKdcsay;yghr,f? tpmtdrftwGif;rSm tpmaysmhzwf rjywfSdaeatmifv@kd ESpf
emDcef@w}udrf tpm;taomuf rSD0Jay;rSmjzpfygw,f? ylaom/ pyfaom/ -urf;aomt
pm;tpmrsm;udk vHk;0aSmif-uOfyghr,f? tuf/ aq;vdyfaomufjcif;udkvnf; acwWyf
em;xm;yghr,f? a'gopdwf/ aomupdwfawGudkvnf; rcHpm;atmif qifjcifaeyghr,f?
umAGef'dkifatmufqdk'f"mwfaiG@ygaom pl;StjrKwfxonfh tcsKdnfAl;rsm;udk roHk;
aqmifyg? qdk'gaq;/ qm;rsm; pm;oHk;rsKdcs jcif;vJ vHk;0rjyKvkyfwm taumif;qHk;ygyJ?
tJ'gawG[m tpmtdrfxJrSm iJrD;"mwf ydkrdkxkwfv$wf xGufSdapwma-umifhyg?
eHeufpm/ ae@vnfpm/ npm xrif;pm;aomufcsdefrsm;-um;rSm aysmhajymif;El;nHh_yD; rylpyf
aomtpmrsm;udk ESpfemD-um;wcg -um;nyfpm;ay;yghr,f? tpmtdrfaq;rsm;[m
21
a'gufwm0vkH;
rsm;aomtm;jzifh iJrD;"mwfudk wkef@jyefapwJh xHk;"mwfrsm;wJhaq;rsm;(yHkpHtm;jzifh r*~eD

qD,rfqmvfzdwf/ *sJvfvruf/ 'dkif*sif; aq;0g;rsm;)jzpf-uygw,f? ,if;wdk@udkvnf;
atmifhemcsdefrSm aat;rsm;rsm;eJ@ oHk;=av;jym; 0g;pm;edkifygw,f? tmHka-umudk t
usKd;oufamuf_yD; iJrD;"mwfxkwfv$wfr+udk xdef;wJhaq;0g;awGudkawmh rdrdoabmeJ@
oHk;aqmifefroifhyg? u|rf;usifwJh usef;rma;0efxrf;rsm;eJ@ wdkifyifaqG;aEG;oifhygw,f?
Adkufatmifh Adkufemwm[m tpmtdrfrSm temSdv@kd vJjzpfwwfygw,f? tpm
tdrftygt0if vrff;a-umif;rSm wkwfydk;rsm;/ oefaumifrsm; rsm;jym;aeifvnf; jzpf
wwfygw,f? 0rf;csKyfvdk h pjrif;xdk;ifvnf; Adkufemwwfygw,f? tpmtdrftwGif;rS iJ
rD;"mwfrsm;ifjzpfjzpf/ AufwD;D;,m;ydk;r$m;rsm; omrefxufykdrsm;ifjzpfjzpf txufudk
avqef_yD; avtefwwfygw,f? tpm;taomuf rsm;oGm;aomtcgvnf; avut
xufudkqef_yD; tefwwfygw,f? avcsOf wufwwfygw,f?
tpm;taomufusL;_yD; tpmtdrf[mwppus,f_yD; }uD;xGm;vmwwfygw,f?
'g[mvJ obm0r[kwfwJhtwGuf tpmtdrfam*gwrsKd;ygyJ? Achalasia vkd@ac:ygw,f?
tpmtdrfam*g[m wcgESdrfHkeJ@ryg? am*g_yD;wJhol/ am*gjzpfbl;wJholawGt
aeeJ@ woufvHk; qifjcifaexdkifoGm;rSmyg? owdvGwfwmeJ@ ayghayghqqaevdkufwmeJ@
tpmtdrfam*g[m jyefay:vmwwfygw,f? t"duuawmh iJrD;"mwf tatwGuf
eJ@ tpmaysmhzwfyrm%wdk h rr#wwJh tcsdefrsKd;awGrSmaygh? moDOwk taeeJ@awmh at;
csrf;wJh aqmif;moDrSm tjzpfrsm;ygw,f? tat;"mwfukd cHEdkifpGrf;Sdatmif cE<mudk,f
u tyl"mwfudk ydkxkwfay;zdk@twGuf tpm;rsm;rsm;udk vdktyfawmif;qdkr+a-umifhyg?
tpmtdrftem tao;av;udk *kwpdkufeJ h -uyf-uyfrwfrwf rukpm;bl;qdkif tem
[m }uD;xGm;vmwwfygw,f? temjyif{d,m }uD;xGm;aeifjzpfjzpf/ aoG;v$wfa-um
udkxdcdkuf_yD; aoG;,dkpD;r+ rsm;aeifjzpfjzpf/ tem[m tpmtdrfeHHukd xdk;azguf_yD; tjyif
udk aygufxGufoGm;ifjzpfjzpf ta;ay:cGJpdwfukoygw,f? temjzpfaewJh tEWm,f
ay;aewJh tpmtdrfJhtpdwftydkif;udk jzwfxkwfypfygw,f? tpmtdrftemudk cGJpdwf
uko_yD;aomfvnf; tpmtdrfam*g xyfrjzpfawmhbl;vdk@ rajymedkifyg? xyfjzpfwwfyg
w,f? cGJpdwfjzwfxkwfcHvdk h tpmtdrfao;ao; usefwJholrsm; tpmtdrfam*g xyfjzpf
if tajctaeb,fvdk qdk;0g;r,fqdkwm awG;-unfhEdkifygw,f?
'ga-umifh rD;udkravmifcifuwm;yg? avmifaewJhrD;udk tcsdefrDS_idrf;owfyg? _idrf;
owfwJhtcg rD;uGif;rD;p rusefatmif Sif;vif;ypfygr,f?
tmam*sH
yrH
vmbH
22
a'gufwm0vkH;
23
a'gufwm0vkH;
pdwfaysmfif raemvSygw,f? pdwfysKdif udk,fEkygw,f? vlhcE<mudk,f[m raem

qdkwJhpdwfeJ@ um,qdkwJh udk,fwdk@aygif;zGJ@xm;wmyg? 'ga-umifhvJ vlwdkif;[m pdwfcsrf;
omzdk@ udk,fusef;rmzdk@ qkawmif;-uw,f? qENjyK-uw,f? udk,fusef;rm_yD; pdwfcsrf;om
wm/ pdwfcsrf;om_yD; udk,frusef;rmwm,fvdk@ wGJzuf_yD;rSdwwfyg? udk,frusef;rmif
pdwfcsrf;omr+vJ rjynfhpHkygbl;? udk,fcE<mJhcsKd@,Gif;csufa-umifh a0'emcHpm;vmif pdwf
vJuoduatmifhjzpf_yD; r$ifrvef;jzpfvmwmygyJ? pdwfxJrSm aomuAsmyg'awG yGm;_yD;
pOf;pm;pmawGaxGum tawG;awGrsm;vmif pdwfyifyef;vmygw,f? udk,fcE<mvJ EGrf;
e,fvmygw,f?
pdwfJhvkyfief;udk OD;aESmufeJ@tmHka-umawGu wm0ef,lxm;ygw,f? cE<mudk,f
Jh v+yfSm;r+udkawmh taoG;tom;/ tGwfta-um/ tarG;tr#ifrsm;u xrf;aqmifay;
ygw,f? pdwfJhtpDtrHudk cE<mudk,fu aqmif-uOf;ay;ygw,f? cE<mudk,f[m pdwfhJckdif;
apr+a-umifh v+yfSm;r+rsKd;pHkudk vkyfaqmifay;if; pGrf;tifrsm;udk toHk;csygw,f? v+yfSm;
r+pGrf;tifzdk@ cE<mukd,fJh"mwfypPnf;rsm; jyefvnfjznfhqnf;zdk@/ t*Fgtpdwftydkif;rsm;
pGrf;tifjyefjynfhzdk@ cE<mudk,fudk tem;ay;ygw,f? pdwfukdarS;puf_idrf;at;apygw,f?
'ga-umifh owW0gwdkif;rSm tem;,lwm/ tdyfpufwmwd@k ukd Sdygw,f?
tdyfpufem;aejcif;enf;yg;if/ rSdif cE<mudk,fyifyef;EGrf;e,fr+xuf OD;aESmufeJ@
tmHka-um yifyef;um tm;tif ukefcrf;r+uydkygw,f? npOf SpfemDtdyfcsdefSdrSmvdk@
vltawmfrsm;rsm;[m vufcHem;vnfxm;-uygw,f? tdyfcdsef[m touftG,fvkduf
_yD;ajymif;vJygw,f? vlJhtusifhpdkufudkvdkuf_yD; vdktyfygw,f? twdtustcsdeftwm
udk owfrSwfay;vdk@ rEdkifygbl;?
uav;i,frsm;[m wae@SpfemDxuf ydktdyfavhdSygw,f? tcsKd@olrsm;[m
tdyfcsdefav;emDeJ@yJ vHkavmuf wwfygw,f? txl;ojzifh wm0ef}uD;}uD;xrf;aqmif
olawG/ pD;yGm;a;vkyfief;}uD;awG vkyfaqmifolawGrSm tdyfcsdef enf;wwfygw,f? tdyf
csdefenf;wmeJ@ tdyfa;r0wmeJ@[m odyfroufqdkifygbl;? tcsdK@olawGuawmh wae@
tdyfcsdef SpfemDeJ@ rvHkavmufedkifyJ ttdyfykwfwwfygw,f? wu,fwrf;u wae@Spf
emDxuf ykdtdyfwwfwJhvli,fydkif;eJ@ touftG,famufolawGrSm xdkif;r+dif;wmwdk@/
24
a'gufwm0vkH;
^m%fnfpGrf;tm;enf;yg;wmwdk@/ xHkttEdkifvmwdk@ jzpfay:wwfygw,f? vlwOD;eJ@wOD;

tdyfusifhpdkuf(sleeping rythm)rwlwma-umifh tdyfcsdefudkawmufav#muf ESpfESpf
_cdKuf_cdKufeJ@ ajcmufemD qufwdkufr,fqdkif cE<mudk,fvJ usef;rm_yD; pdwfvJ$ifvef;yg
w,f? raemvJvSygw,f? t-uHtpnfrsm;vJ aumif;pGmay:xGuf wGufqcsifhcsdefEdkifyg
w,f?
vltcsKd@[m vG,fvG,fululeJh tdyfarmruswwfygbl;? tcsK@d [m ttdyfqwf
_yD; tdyfaepOfr-umc%Edk;wwf_yD;/ jyeftdyfwJhtcgrSmvJ acgif;cswmeJ@ tdyfaysmfoGm;wwf
ygw,f? ttdyfqwfayrifh vG,fvifhwuljyeftdyfEdkifwmuvJ omreftaetxm;ygyJ?
wcsKd@[mtdyfcsdeftwGif;rSm wa;Edk;wwfygw,f? tayghtyg;xoGm;wwfygw,f? jyef
tdyfwJhtcgvJ ESpfESpf_cdKuf_cdKufeJ@ tdyfaysmfoGm;wwfygw,f? 'g[mvJ rSefuefwJh tdyf
usifhpdkuf(sleeping rhythm)ygyJ?
wcsKd@[m ta-umif;trsKd;rsKd;a-umifh tdyfcsdefrSmrSdwfpdrSdwfaomfvJ tdyfraysmfyJ
c%c% xwwf_yD;/ [dkvl;onfvGef@eJ@ wu,fwrf;tdyfcsdef ESpfemD/ oHk;emDavmuf
yJ Sdwwfygw,f? 'DvdktcgrsKd;rSm tdyfa;r0bl;/ tdyfcsdefrvHkavmuf bl;vdk@ ajymEdkifyg
w,f? ,m,Dtdyfa;r0wm/ tdyfcsdefrvHkavmufwm[m wcgwHaSmifv$JryJ awG@-uHK
wwfygw,f? pdwfylyefr+/ aomursm;r+/ ajcaxmufuGufwwfr+/ tdyfmajymif;vJtdyf
r+/ qlnHaom ylaom at;vGef;aomtcef;rsm;wGif tdyfpufr+/ oHk;pGJaomaq;rsm;
a-umifh tdyfraysmfEdkifr+pwJh ta-umif;rsm;a-umifhjzpfygw,f? ESpfuf/ oHk;ufrS wywf
cef@txd -uHKawG@wwfygw,f?
wv odk@r[kwfonfxuf ydk-umaomumv twdkif;twmeJ@ ae@pOftdyfr
aysmf/ tdyfcsdefenf;_yD; tdyfa;r0 jzpfvm&ifawmh tdyfraysmfaomam*gvdk@ qdkygr,f? 'D
vuQ%muawmh pdwfusam*gtygt0if pdwfa0'em/ ESvkH;am*g/ emwmSnf/ tqkwf
eJ@ESvHk;am*geJ@ tdyfpOftouf+-uyfam*grsm;a-umifh jzpfay:vmygw,f?
tdyfa;r0yJ ESpfESpf_cdKuf_cdKuf tdyfcsdefenf;yg;vmif armyef;vmjcif;/ pdwfyg0if
pm;tmHkpdkufr+ tm;enf;yg;vmjcif;/ pdwfusam*geJ@ rSdukd tSdxifwhJpdwfam*g (Hall
-ucinations)rsm; jzpfay:vmwwfygw,f?
okawoejyKcsufrsm;t tG,famufvli,frsm;[m pmusufjcif;/ ygwD
aysmfyGJrsm;wuf-ujcif;/ uGefjyLwmavhvmjcif;/ tcsdefykdif;tvkyfvkyfjcif;wd@k a-umifh eH
eufESpfemDudk n(11)emDvdk@ xifaewwfygw,f? 'ga-umifheHeuf pmoifcef;rsm;rSm
tdyfidkufaewwfol trsm;tjym;udk awG@wwfygw,f?
rnfonfhta-umif;a-umifhjzpfap tdyfcsdefenf;r,f/ tdyfa;r0bl;/ tdyfraysmf
wJhnawG toacsFjzpfvmr,fqdkif cE<mudk,fJhzGH@_zdK;wdk;wufr+ ,dk,Gif;vmHkru/ usef;
25
a'gufwm0vkH;
rma;udkxdcdkufvmr,f/ xdcdkuf'%fmvmr+awGrsm;r,f? touftEWm,feJ -h uHKawG@

Edkifygw,f? txl;ojzifh um;armif;pOfrSm tvGeftEWm,f}uD;Edkifygw,f?
tdyfpufjcif;,EWm;[m rdepf(90)vnfywfr+eJ h v+yfSm;oGm;aew,fvdk@ okaw
oejyKcsufrsm;uqdkygw,f? omreftdyfpufjcif;udk rsufvkH;vsifjrefpGmv+yfSm;r+(Rapid
Eye Movement~REM)tdyfpufjcif;uvdkufvmygw,f? 'gurdepf(90)twGif; jzpf
ysufr+yg? aemufwcg rdepf(90)vnfywfr+u jyefay:vmygw,f? omrefESpf_cdKufpGm tdyf
pufjcif;u rsm;jym;ygu tdyfrufrufjcif;enf;yg;w,fv@kd qdkygw,f? ESpf_cdKufpGm tdyf
aysmfEdkifbdk@ pdwfudktem;ay;r+(Mental Relaxation)Sdbdk@ txl;vdktyfygw,f?
tdyfcsdefrwdkifrD (6)emDuwnf;u auzif;yg0ifwhJ aumfzDw@kd / eDudkwif;yg0ifwJh
aq;vdyfwdk@udk raomufoHk;if tdyfrufqdk;rsm;rufjcif;/ tdyfIraysmfjcif;rsm; rSdbl;vdk@
qdkygw,f? tdyfraysmfI aq;rsm;udkrSD0Jif acwW,m,Dom aumif;EdkifayrJh aSnfr-um
c%aomuf oHk;efroifhyg?
tdyfcgeD;wGif tawG;rrsm;jcif;/ pOf;pm;pmrsm;av#mhjcif;/ rdrdodxm; xm;
aom*gxmrsm;/ bkm;Sdcdk;rsm;GwfzwfoZ,fjcif;/ oabmwm;uawmh tmHkwckck
udk tav;teuf0ifpm;jcif;jzifh pdwfudktem;ay;/ tm;arG;jcif; (Mental Relaxing
Regeneration)udk usifhay;ygr,f? tdyfraysmfjcif;rS vHk;0uif;a0;ygr,f?
tdyfm0ifcgeD; EGm;Ekd haEG;aEG;aomufjcif;/ udk,fvufoef@Sif;jcif;/ naeydkif;wGif
avhusifhcef;wckck vkyfjcif;wdk huvJ tdyfraysmfjcif;udk umuG,fay;ygao;w,f?
ESpfESpf_cdKuf_cdKuf tdyfpufjcif;jzifh tdyfaysmfygupdwfvJramf raemvJvSrnfjzpf
onf?
tmam*sH yrH vmbH
26
a'gufwm0vkH;
27
a'gufwm0vkH;
awG;xdyfwJhxl;csufoabmrSm
aq;vdyfeJ h ul;pufa&m*g
ul;pufam*g
vlwOD;rSwOD;/ owW0gwckrSwck/ owW0gwckrSvlwOD;pDo@dk am*gjzpfapaomydk;r$m;rsm;
ul;pufamufdSvmum am*gjzpfyGg;jcif;ukd ul;pufam*g[kowfrSwf=uygonf? am*g
rsm;ul;pufjcif;teuf avwGifjyef@vGifhvmaom am*gydk;rsm;a=umifh ul;pufjcif;onf
tvGefvG,fulpGmul;pufEdkifaomvrf;a=umif;jzpfygonf?
tqkwfvrf;a=umif;ul;pufam*g
tqkwfam*ga=umifh ESmacs/ acsmif;qkd;/ ovdyf[wf/ wHaxG;axG;jcif;rsm;a=umifh t
qkwfemam*gykd;rsm; avwGifjyef@vGifhI am*gul;pufjcif;ukdjzpfay:apygonf? xdk@a=umifh
tqkwfemam*gul;pufjyef@yGm;jcif;onf tjcm;ul;pufam*grsm;jyef@ESH@jcif;xuf ykdrdkvsif
jrefonf[k qkdEdkifygonf? wkyfauG;am*g ul;pufjyef@yGm;jcif;ukd avhvm=unfhygu T
tcsufrSefuefa=umif; xifSm;pGmodjrifEdkifygrnf?
am*gjzpfapaomydk;r$m;rsm;a=umifh tqkwfwGif tat;rdESmap;acsmif;qkd;jzpfapaom
wkyfauG;am*grStp erdk;eD;,m;tv,f acsmif;qkd;aoG;yg wDbDam*gtqkH; ul;pufEdkif
aomam*grsm;jzpfwwfygonf? am*gykd;rsm; tqkwftwGif;ok@d 0ifvmvifhupm; t
qkwf.usef;rma;tiftm;aumif;rGefaeum/ vl.ukd,fcHtiftm; awmifhwif;aejcif;dS
28
a'gufwm0vkH;
aeygu tqkwfwGifam*gul;pufjzpfay:r_ jzpfEdkifeftcGihftvrf;enf;ygonf? tqkwf

tiftm;csdeJ@+yD; vl.cHEdkifnfpGrf;tm;avsmhenf;csKd@wJhaeygu ul;pufvmaomam*gydk;
rsm;a=umifh tqkwfwGif temam*grsm; jzpfyGm;apwwfygonf?
aq;vdyfa=umifh tqkwfvrf;a=umif;wGif ul;pufam*gjzpf

ay:jcif;
tqkwfwGif tiftm;csdeJ@um vl.cHEdkifnfpGrf;tm;enf;yg;apaomta=umif;if;rsm;
rsm;pGm dSygonf? ,if;wkd@teuf aq;vdyfaomufjcif;onfvnf; ta=umif;wyfjzpfyg
onf? aq;vdyfaomufjcif;onf aq;Guf}uD;/ oeyfzuf/ aq;dk; ponfrsm;ukd rD;d_@I
jzpfay:vmaom taiG@ukd tqkwfESifh0rf;acgif;twGif; _dufoGif;um tomcHaomuf
okH;jcif;jzpfonf? _dufvdkufaomt"du"mwfaiG@rSm umbGef'dkifatmufqkd'f jzpfygonf?
aq;vdyfwGif vlukdtEWm,fjzpfapaom"mwfaygif;rSm edukdwif;jzpfygonf? aq;vdyfudk
rD;d_@d_ufvdkufjcif;a=umifh "mwfaiG@rsm;pGm tqkwftwGif;/ 0rf;acgif;twGif;rSwqifh vl
.aoG;rsm;twGif;pdrfh0ifamufdSoGm;ygonf? cE<mukd,ftwGif; ysH@ESH@oGm;ygonf? ,if;
"mwfaiG@rsm;onf vl.cE<mukd,fwGif;Y cHEdkifnfpGrf;tm;ukd jzpfxGef;apaomvkyfief;ukd
vGefpGm'kuQay;ygonf? cHEdkifnfpGrf;tm; jzpfxGef;apaom ,EWm;ukd tenf;ESifhtrsm;
zsufqD;ypfygonf?
d_ufvdkufaomaq;vdyfaiG@onf tmacgif/ ESmacgif;/ toufvrf;a=umif;/ tqkwf/
tpmrsKdyef/ tpmtdrfwkd@ukd tyl"mwfvnf; wkdufdkuf xdawG@apum/ ,if;wk@d tm; zkH;
v$rf;xm;aomtajr;yg;.qJvfrsm;ukdvnf; ysufpD;apygonf? Todk@jzifh aq;vdyf
aomufjcif;jzifh vl.cHEdkifpGrf;tiftm;rsm; avsmhyg;jcif;/ qJvfrsm;ysufpD;apjcif;jzifh ul;
pufam*gykd;r$m;rsm; tvG,fwul0ifamufum am*gb,rsm;jzpfay:vmapef zefwD;
ay;xm;ygonf? xdk@a=umifh aq;vdyfa=umifh qufEG,fdSapaom am*gb,rsm;wGif
tqkwfY jzpfay:aomul;pufam*gonf trsm;qkH;jzpfygonf?
aq;vdyfaomufjcif;vnf;ul;pufonf
aq;vdyfaomufjcif;ukd vlrsm;pGmonf tvG,fwuljyKusihfwwf=uonf// twkjrif t
wwfoifonfh oabmjzifh aq;vdyfudkprf;oyfaomuf=unfhmrS tavhtxjzpfoGm;
29
a'gufwm0vkH;
wwfonf// kyfSifjyZmwf}unfhmwGif kyfSifokyfaqmifrsm; [efxkwf omefvkyf

aomufjyjcif;rsm;rS tm;usum twk,l pwdkifxkwf aomuf=ujcif;rsm;SdmrS aq;vdyf
aomufwwfvm=ujcif;rsm;vnf;Sdonf? Tonfudk=unfhjcif;tm;jzifh aq;vdyf
aomufjcif;tavhtxrSmvnf; ul;pufvG,fa=umif;cef@rSef;Edkifygonf? tdyfcsifIorf;
a0jcif;onf ul;pufouJhokd@ aq;vdyfaomufjcif;onfvnf; ul;pufvG,fygonf?
aq;vdyfaomufokH;olrsm;
aq;vdyfaomufolrsm;wGif 80onf touf 18 ESpfrwdkifrDu aq;vdyf pwif
aomufcJh=uonf? ae@pOftouf 18 ESpfatmuf vli,f(usm; am r yg) 4 axmiffcef@
onf olwdk@. yxrqkH;aq;vdyfukd pwifaomufvsufSdonf? TE_ef;twkdif;om aq;
vdyfaomuf=uygu 64 oef;aom ,ae@vli,fwkd@onf tcsdefrwkdifrD aq;vdyfa=umifh
qufEG,faomam*grsm;a=umifh taoapm=urnfjzpfonf?
aq;vdyfaomufokH;jcif;ukd trsKd;om;rsm;omru trsKd;orD;rsm;vnf; pGJpGJrufruf
aomuf=uygonf? aq;vdyfukd qif;Jom;rsm;u ykdrkdaomuf=uonf[k 2004 ckESpf
urBm@aq;vdyfraomufae@ (arv31) wGif xkwfjyefaom urBm@usef;rma;tzGJ@csKyf.
a=unmpmwrf;wGifazmfjyxm;ygonf?
qif;Jjcif;ESifh ul;pufam*g
ul;pufam*gonf qif;JEGrf;yg;olrsm;wGif ykdrkdjzpfavhSdygonf? qif;JEGrf;yg;olrsm;wGif
usef;rma;pHcsdefrSDef t[m"mwf jynfhjynfh00 0,f,lpm;okH;Edkifef aiGa=u;rwwfEdkif
=uyg? am*gyaysmufuif;pifatmif aq;0g;ukoEdkifef aiGa=u;rjynfhpkH=uyg? ul;puf
am*grjzpfatmif }udKwifumuG,fwm;qD;Edkifef vkdtyfcsufrsm;jznfhqnf;bdk@ aiGtif
tm;rdS=uyg? xkd@a=umifh qif;JEGrf;yg;oltrsm;pkrSm t[mcsK@d wJhjcif;/ usef;rm;a; A[k
okwacgif;yg;jcif;/ usef;rma;vdkufpm;ef ynmru,f0jcif;/ oef@Sif;aom ywf0ef;usif
ukd xdamufpGm rzefwD;Edkifjcif;/ am*gjzpfvmv#if tjrpfjywfatmif ukoEdkifr_ rdSjcif;
wkd@a=umifh ,if;wkd@onf ul;pufam*gtvG,fwul 0ifamufjcif;cHaom vlwef;pm;
rsm;jzpfae=uonf? qif;JI am*gxl/ am*gxlIqif;J [lonfh oHomrSm csm
csmvnfae=uonf? qif;Jjcif;rS vGwfuif;ef t}uH^m%fxkwfef aq;vdyfuav;
aomufI awG;OD;rS qkdonfhpdwful;jzifh aq;vdyfukdzGm tawG;ukdjzmvsuf csrf;omjcif;
30
a'gufwm0vkH;
enf;vrf;Smwwf=umrS aq;vdyfaomufjcif;om pGJusefvsufdSygonf?
aq;vdyfaomufjcif;. oG,f0kdufaomenf;jzifh
ul;pufam*gESifh qufEG,fr_
aq;vdyfaomufokH;jcif; tqkwfvrf;a=umif;wGif ul;pufam*gjzpfapef zefwD;ay;jcif;/
vl.cHEdkifnfpGrf;tm;ukd avsmhenf;apjcif;jzifh vlwGiful;pufam*gjzpfapjcif;rsm;ukd jzpf
ay:aponfhtjyif tjcm;oG,f0kdufaomenf;rsm;jzifhvnf; ul;pufam*gjzpfxGef;r_ukd
tm;ay;vsufdSygonf?
aq;vdyfukd pGJvrf;pGmaomufjcif;jzifh
aq;vdyfaomufef aq;vdyfzkd;ukefusjcif;
aq;vdyfaomufjcif;jzifh cHEdkifnfpGrf;tif avsmhyg;jcif;

pGrf;tifavsmhyg;ojzifh vkyftm;usqif;jcif;
aq;vdyfaomufjcif;a=umifh qufEG,fdSvmaom am*grsm;cHpm;jcif;
am*gum emrusef;jzpfI aq;ukopdwf ukefusjcif;
wdk@jzifh aq;vdyfaomufokH;jcif;onf vlrsm;ukd qif;JwGif;ok@d ykd@aqmifay;aeyg

onf? qif;JwGif;xJusv#if ul;pufam*gwkd@. zdpD;jcif;ukd tvG,fwul r_rvS cH=u
rnfrSm {uefrvGJay?
aq;vdyfaomufjcif;ab;tEWm,f
aq;vdyfaomufjcif;onf urBmay:wGif aojcif;twGuf 'kwd,ta=umif;if;jzpfonf?
urBmw0Srf;vkH;wGif aq;vdyfaomufjcif;onf vlG,f 10 a,mufwGif wa,ufukd ao
apaeonf? (ESpfpOf 5 oef;cef@ aq;vdyfa=umifhaoqkH;ae=uonf),if;ES_ef;twdkif;om
aq;vdyfaomufoGm;=uygu 2005 ckESpfvGefv#if ESpfpOf 10 oef;cef@ aq;vdyfa=umifh
aoqkH;=urnfjzpfonf?
urBmay:wGifam*gjzpfay:apaom ta=umif;rsm;teuf aq;vdyfaomufjcif;
31
a'gufwm0vkH;
a=umifh am*gjzpfyGm;jcif;onf pwkwWaemwGifdSonf? aq;vdyfaomufjcif;

a=umifh ukefus aiGrSmvnf; tHhrcef;jzpfonf? aq;vdyfa=umifh qufEG,fjzpfyGm;aom
am*grsm;ukopdwf/ jynfol@usef;rma;bmaiG rsm;pGmukefonfhtjyif aq;vdyf
aomufjcif;a=umifh tG,faumif;vkyftm;Sifrsm;ukdaoa=uapojzifh rdom;pktwGuf
/ EdkifiHtwGuf vkyftm;crsm;qkH;H_;=uygonf? raoao;onfhwdkif aq;vdyf
aomufokH;olrsm;wGif usef;rma;csKd@wJhr_a=umifh vkyftm;rsm;jynfhjynfh00 rdSEdkifI
xkwfvkyfr_tiftm;us qif;um 0ifaiGxdcdkufapygonf? 1994 ckESpfwGif aq;vdyf
aomufokH;r_a=umifh ESpfpOfurBm@0ifaiG tarduefa': vm oef; 2 odef;cef@ qkH;H_;cJh
onf[kqdkygonf?
aq;vdyfaomufjcif;ESifh qif;Jjcif;onfqufEG,fvsufSdygonf? 0ifaiGenf;
aomEdkifiHrsm;dS tqif;JqkH; tdrfaxmifpkrsm;onf olw@dk 0ifaiG. 10ukd aq;vdyf
aomufjcif;wGifjzKef;wD;ypfonf[k avhvmcsufrSwfwrf; rsm;uqkdygonf? wenf;tm;
jzifhqkdaomf xkdrdom;pkrsm;onf olwdk@twGuftajccHvdktyfaom tpm;tpm/ ynma;
ESifh usef;rma;apmifhaSmufr_rsm;twGuf aiGtenf;tusOf;r#om okH;=uonf? aq;
vdyfaomufjcif;onf usef;rma;ukd wdkufdkufxdcdkufaponfhtjyif t[mcsKd@wJhjcif;/
usef;rma;pdwf }uD;xGm;apjcif;ESifh tG,frwdkifrD taoapmjcif;wd@k ukdjzpfay:aponf?
ynma;twGufokH;pGJrnfhtpm; aq;vdyfaomufjcif;wGifaiGokH;pGJjcif;a=umifh ynmrJh
twef;tpm; rsm;jym;atmif aq;vdyfaomufjcif;u azmfaqmifay;vsufSdaeygonf?
aq;vdyfykdaomufI usef;rma;csKd@wJh- ynmrJh- 0ifaiGenf;I qif;J/ qif;JI aq;
vdyfydkaomuf ToHomrSm vnfvsuf aq;vdyfaomufjcif;a=umifh qif;JwGif;euf
aeygawmhonf?
aq;vdyfaomufjcif;a=umifh wdkufdkufjzpfay:aomam*grsm;
Cancers:
uifqmam*grsm; -
Lip, Oral Cavity

Pharynx
Esophagus
Pancreas
Larynx
E_wfcrf;/ tmcHwGif;
tmcHwGif;
tpmrsKdyGef
yefud, (rkwfcsKd)
toHtkd;
32
a'gufwm0vkH;
Lung
Bladder
Other Urinary
Kidney
tqkwf
qD;tdwf
tjcm;qD;vrf;a=umif;uifqmrsm;
ausmufuyf
Cardiovascular Diseases: ESvkH;ESifhaoG;a=umam*grsm;

Coronary Heart Disease aumfdkemD ESvkH;am*g
Cerebrovascular Disease OD;aESmufESifh aoG;a=umam*g
Other Circulatory Disease tjcm;aoG;vnfywfr_qkdifmam*grsm;
Respiratory Diseases:
Chronic Bronchitis emwmSnftqkwfyGefamifam*g
Emphysema
tqkwfuspfxljypfam*g
umuG,fa;
aq;vdyfraomufjcif;onf zsm;emjcif;rsm;ESifh tcsdefrwdkifrD taoapmjcif;twGuf xd
amufpGmumuG,fxdef;csKyfEdkifaom wckwnf;aom ta=umif;jcif;mjzpfonf[k urBm@
usef;rma;tzGJ@csKyfESifh tarduefusef;rma;XmeuowfrSwfvsuf aq;vdyfaomuf
jcif;rS umuG,fa;enf;aygif;pkHukdcsrSwfusifhokH;vsufSdygonf?
aq;vdyfaomufjcif;rSumuG,fEdkifef atmufygt}uHjykcsufrsm;ukdvkdufemoifhygonf?
1?
? rnfonfhaq;vdyftrsKd;tpm;ukdr# wvdyfr#raomufrdatmifaeyg?
wae@v#if aq;vdyftatwGuftenf;i,faomufv#ifyif usef;rma;ukd xd
cdkufapEdkifygonf? aq;vdyfukd vkH;0rjzwfyJ wae@tenf;i,fr#omaomufrnf
[k }udK;pm;ygaomfvnf; aemufqkH;wGif rlvtatwGuftwdkif; jyefvnf
aomufrdrnfjzpfonf?
uwWmenf;aom edukdwif;yg0ifr_enf;onfh aq;vdyfukd wqifhcs av#mh
aomufOD;awmh usef;rma;ukd enf;enf;ESifhwjznf;jznf; xdcdkufaprnfrSm t
rSefjzpfonf? tb,fa=umifhqkdaom edukwif;onf aq;pGJjcif;ukdjzpfapojzifh
edukdwif;enf;yg;onfhaq;vdyfukdaomufapumrl aq;vdyfzGmjcif;ukd ESpfoufpGJ
33
a'gufwm0vkH;
vrf;aeI aq;vdyfjywfrnfr[kwfyg? rsm;rsm;ESifh jyif;jyif;zGmvkdpdwfrsm;vm

rnfjzpfonf? pdwftcsqkH; aq;vdyfjzwfjcif;rSm jynfhjynfh0
0 ,wdjywf jzwfcsjcif;yifjzpfygonf?
2? ?bma=umifhaq;vdyfjzwfvkdonfh ta=umif;rsm;ukdcsa;yg?
wdk;wufr_rsm;twGuf b0ukdxdef;csKyfvkdr_jzpfay:vmaoma=umifh
ykdrkdaumif;rGefaom usef;rma;ukdvdkvm;aoma=umifh
rdrduav;rsm;twGuf erlemaumif;tjzpf pHxm;apcsifaoma=umifh
rdom;pk0ifrsm;ukd wqifhcH aq;vdyfaiG@d_ufolrsm;tjzpfrS uif;a0;ap
vkdaoma=umifh
aq;vdyfjzwfmwGifatmifjrifEdkifef aq;vdyftrSefwu,fjzwfvkdaomqENonf t
vGefta;}uD;aom tcsufjzpfonf? aq;vdyfa=umifh qufEG,fjzpfay:aom ESvkH;am
*gcHpm;+yD;onfh aq;vdyform;rsm;onf aq;vdyfjzwfjcif;ukdatmifjrifpGmpGrf;aqmifEdkif
=uonf? aq;vdyfjzwfvkdaomta=umif;ukd ykdifykdifEkdifEkdif qkH;jzwfcsufcsI ,wdjywf
aq;vdyfjzwfoifhygonf?
3?
?aq;vdyfjzwfjcif;onf tusKd;dSrnfqkdonfukdoabmaygufyg?
edukdwif;onf aq;vdyfaomufjcif;tavhtxukdqJaG qmifonf? aq;vdyf

jzwfjcif;ukd w0ufatmifjrifapjcif;rSm aq;vdyfudk jzwfrSjzpfrnfqkdonfukd
odxm;jcif;jzpfonf? ,if;okd@odxm;+yD; aq;vdyfjzwfv#if }uHKawG@rnfh aq;
vdyfjzwfjcif;a=umifhjzpfay:vmrnfh vuQ%mrsm;ukd }uHh}uHhcHEdkifaprnfjzpfyg
onf? edukdwif; tpm;xkd;ypPnf;rsm;ukdokH;pGJIjzwfv#ifjzpfap/ uGrf;pm;jcif; yD
au0g;jcif; ponfrsm;jzifhjzpfap aq;vdyfjzwfaomfvnf; pdwfcdkifrmpGmqkH;jzwf
jyXmef;jcif;rdSv#if vkH;0jywfEdkifrnfr[kwfyg?
34
a'gufwm0vkH;
4?
?tG,famuf+yD; aq;vdyfaomufolw0ufausmfonf aq;vdyfjzwf
Edkifv#if oifvnf; aq;vdyfjzwfEdkifygonf?
,if;onf owif;aumif;jzpfygonf? pD;uufraomufyJESihf b0ukd touf

Sififqkdifaeol oef;aygif; rsm;pGmdSaeygonf? usef;rmpGmoufSifaexkdifef
twGuf aq;vdyfjzwfjcif;jzifh taumif;qkH;ajcvSrf; pwifjcif;jzpfygonf?
5?
?aq;vdyfjzwfvkdI tultnDvkdygu ,lyg?
aq;vdyfjzwfEdkifeftwGuf tultnDay;rnfh tkyfpk/ tzGJ@tpnf;rsm;/ tifwm

eufpmrsufESmrsm; dSaeygonf?
oif.usef;rma;twdkiftyifcHqm0efrsm;ESihfvnf;aq;vdyfjzwfa;aqG;aEG;
wdkifyifyg?
Reference :
WHO world no tobacco day press release (2004)
Tobacco Information and Prevention Source
Centers for Disease Control and Prevention
WHO Tobacco Free Initiative
35
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2004 ckZGefv 21 rS 23 txdusif;yaom

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36
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aygufSmmqkd+yD; tpav;vkyfvdkufmu 0gifhorm;}uD;awGjzpfoGm;wwf=uygw,f?
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aomufol(heavy smoker)awGr[kwf=uygbl;? ayghayghwefwefaomufol(light
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qkdwwf=uygw,f? 'ga=umifh olwkd hrSm aq;vdyfeJ hqufEG,fwJh am*g awG rEdkifbl;vkd h
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rsm;cJI aoG;a=umif;qkd hvmwm ykdrdkjzpfay:jcif;ukd tHh=opGmawG hdSvmw,fvkd h 'def;rwf
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vdyf 3 vdyfrS 5 vdyftwGif;omaomufolrsm;ESifh zGgkHomzGgwm aq;vdyfaiG hr+duf
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38
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jywf jzwfEdkifrSmjzpfygw,f? pdwfcdkifckdifeJ haq;vdyfjzwfif jywfygw,f?
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39
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41
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txl;ojzif@ ywf0ef;usifrSm rnfolr#rdScsdef qdwfuG,fmrSm wukd,fwnf;dSpOf jzpfay:
avhdSygw,f? teD;tem;wGif vloHvldyfdSvmygu rlvpdwfjyef0ifvmwwfygw,f? ol
r[kwfovkdyJ taetxm;jzpfaeygw,f? 'Dpdwfa0'em[m pdwfupif@ uvsm;am*g
(Schizophrenia)eJ@uGmjcm;ygw,f? MPD ukdvdkufpm;okawoejyKcsdefwGif Schizophrenia
ukd ykH}uD;csJ@wmvdk@ tjiif;yGm;olawGSdcJ@ygw,f? MPD am*gonfwOD;wGif pdwfaygif; 99
pdwftxdjzpfay:cJ@a=umif; awG@dScJ@ygw,f? 'Davmuf pdwfyGm;rsm; jzpfaeol am*g
onfyif ukpm;Iaysmufuif;oGm;a=umif; aq;ynmrSwfwrf;rsm;u azmfjyxm;ygw,f?
um,uHSifukd,fwkdifu pdwfa0'emcHpm;aea=umif; rdrdudk,fwkdifoddSvm,if am*g
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MPD a0'emonfrsm;[m emusnf;pdwfrsm;ukd pdwful;,OfmrS =urf;wrf;aom
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us jyoppfaq;mrS awG@dSjcif; enf;aeygao;w,f?
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42
a'gufwm0vkH;
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Dr. 0vkH;
43
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for Advancement of Science u onftywfrSm ajymqkdvdkufygw,f? csrf;omEdkifiHrsm;
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wufqJEdkifiHrsm;rSm onfamg[m tpm;vGefjcif;a=umif@xuf tpmapmcsKd@wJ@jcif;
a=umif@jzpfyGm;w,fvdk@ ,lqw,fvdk@qdkygw,f? t0vGefjcif;am*gwkd;yGm;vmjcif;[m
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a=umif@ qufEG,fjzpfyGm;vmrJ@am*grsm;vJ wdk;yGm;vmum urBm@usefrm;a;tqif@t
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45
a'gufwm0vkH;
u t0vGefjcif;am*g ysH@ES@Haejcif;ukdowdxm;vmygw,f? International Obesity

Task Force qkdwJ@tzGJ@ukdzGJ@pnf;ap+yD; owif;tcsuftvufrsm;pkaqmif;apcJ@ygw,f?
onftzGJ@[m University of Sidney eJ@yl;aygif;+yD; t0vGefjcif;eJ@ ukd,ftav;csdef wdk;jcif;
wkd@tay: urBm@pD;yGm;a;J@tusKd;oufamufr_rsm;ukd avhvmcJ@ygw,f? University of
Auckland eJ@wGJ+yD;vJ urBm@wajy;nDacwfrSDa;(Globalization)eJ@ pD;yGm;a;wkd;wufr_
[m u,fvkdDrsm;aomtpm;tpmrsm;ESif@ pnf;pdrfcHvlaer_b0udkjzpfxGef;apojzif@ t0
vGefjcif;ukdjzpfapaom( Obesogenic )ywf0ef;usifukd zefwD;aejcif;tm; avhvmcJ@yg
w,f?
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rsm;jym;vmaewmawG@ygw,f? 1999 ckESpfrSm wkwfEkdifiHrSm 10u ae 15txd 3
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0vGefolawG wkd;wufrsm;jym;aeygw,f?txl;ojzif@ +rdK@aetrsKd;orD;rsm;rSm t0vGefae
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rsm;uawG@dSw,fqkdygw,f? okawoejyKr_awGt t0vGefjcif;[mcsrf;omqif;JraG;
a'owdkif;rSm vsifjrefpGmysH@ES@Haewmukdazmfjyxm;ygw,f? okawoewckrSmawmh
awmiftmzduEdkifiH udyfawmif;+rdK@rSm vlrnf;trsKd;orD; 44[m t0vGefjcif;am*g
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wkdif;ykHpH vlaer_b0ukdajymif;vJvmwmeJ@tr# t0vGefjcif;[mvJ wdk;yGm;vmw,fqdkyg
w,f? ypdzdwfu|ef;rsm;jzpfwJ@ taemufqmrdktm eJ@ wGef* wk@d rSm t0vGefolrsm;[m t
rsKd;om;wGif 65 eJ@ trsKd;orD;rsm;wGif 77 dSaeygw,f? ,if;wd@k rSm 0zdki@f jcif;omru
cE<mukd,ftcsKd;tpm;yg wkd;aew,fvkd@ qdkygw,f?
University of Rhode Island rS ygarmuQ rpP Marquisa La Velle u t,ifwkef;u
qif;JwJ@EdkifiHrsm;rSm iwfrGwfacgif;yg;jcif;eJ@ykd;r$m;ul;pufam*grsm;[m usef;rma;t
wGuf jy\em}uD;cJ@ayrif@ tcktcgrSmawmh t0vGefjcif;[m ole@J qufEG,faewJ@ qD;csKd/
uifqm/ ESvkH;eJ@ jyif;xefwJ@tpmvrf;a=umif;am*grsm;ukd jzpfyGm;E_ef;ykdvmap cJ@w,f
vkd@qkdygw,f?
WHO
46
a'gufwm0vkH;
t0vGefjcif;rSm tqDrsm;wdk;yGm;vmjcif;omru cE<mukd,ftcsKd;tpm;yg wdk;wuf

vmum uav;rsm;wGif toufeJ@rr#atmif udk,fcE<mzG@H +zdK;jcif;a=umif@ uav;rsm; t
oufwkdvmonfukdawG@w,fvdk@ ygarmuQ vm A,fvD u qkdygw,f?
t0vGefjcif;ysH@ES@Hr_[m usef;rma;ukdomru ywf0ef;usifudkyg =oZmoufamuf
r_dSaeygw,f? csrf;om acsmifvnfvmwJ@vlrsm; tpm;taomufykdrkdpm;vm+yD; u,fvdk
Drsm;wJ@wdp>mefykdwdef;rsm;ukdpm;okH;wmukdydkrdk ESpfoufvmygw,f? 'ga=umif@ pD;yGm;
a;wkd;wufvmwJ@ wkwfjynfrSm t"duvdktyfwJ@ [if;oD;[if;Gufpm;muae w
kwfvlrsKd;rsm;[m tom;rsm;rsm;pm;jcif;tavhukd ajymif;vJvmwmawG@ygw,f?
ukd,fcE<mawG tcsKd;tpm;wkd;yGm;vmwmeJ@tr# }uD;xGm;vmwJ@cE<mukd,ftwGuf u,f
vdkDrsm;rsm; ydkpm;vm=uygw,f? ydkvkd@ 0 vm=uygw,f?
t0vGefjcif;ul;pufysH@ES@Hjcif;[m pufr_wdk;wufjcif;vlaer_b0ukd ajymif;vJvmjcif;
a=umif@jzpfwmawG@+yD; tpm;taomufykHpHajymif;vJvmaomfvnf; ukd,fvufcE<m
v_yfSm;jcif;rsm; avsmhyg;vmygw,f? usef;rma;wefbdk;xm;olrsm;om ukd,fvufcE<m
v_yfSm;r_avhusif@cef;rsm;vkyfayrif@ trsm;pk[m avhusif@cef;,lr_enf;yg;ygw,f? ydkae
wJ@tqDrsm;ukd jzKef;wD;ypfjcif;rdS=uyg? 'ga=umif@ 0 vlrsKd;awGrsm;vmwmjzpfygw,f?
ae@pOf ukd,fvufv_yfSm;tm;upm;ukd rSefrSefavhusi@f b@kd ta;}uD;aeyg+yDvdk@ yg
armuQ vm A,fvD u ajymygw,f?
vl@cE<mukd,ftwGuf tiftm;vdktyfjcif;ukd tqDrsm;tjzpf okdavSmifay;ygw,f?
ukd,f0efaqmifcsdefeJ@ uav;ukdEdk@wdkufcsdefrSm tiftm;ydkrdkvkdwma=umif@ trsKd;orD;rsm;
rSm trskd;om;rsm;xuf tqDokdavSmifxm;jcif; ydkygw,f? wom;arG;+yD; waoG; 0 vm
rSmukdowdxm;rSmjzpfygw,f?
vlwa,mufJ@ 0 jcif;ukd Body mass index t!$ef;eJ@azmfjyygw,f? ukd,ftav;
csdefuDvdk*rfukdwnf+yD; tyftjrif@rDwmeJ@pm;vdk@wJ@udef;[m tJ'D@t!$ef;jzpfygw,f?
t!$ef; 25 eJ@ 30 twGif;dSolrsm;ukd udk,f tav;csdefykduJolrsm;tjzpfowfrSwf+yD; 30
xufausmfvGefrsm;olukdawmh t0vGefam*gaeolrsm;vk@d owfrSwfygw,f? t0vGef
jcif;am*g[m toufukdtEWm,fjyKrJ@ ESvkH;am*g/ uifqmeJ@ qD;csKdam*gtrSwf-2wkd@ukd jzpfay:r_wkd;yGm;apygw,f? GLOBESITY ul;pufysH@ES@Hjcif;a=umif@ tJ'D@ qD;csKdam
*golrsm;[m 2005 ckESpfrSmoef; 300 ausmfdSvmr,fqdkygw,f?
GLOBESITY ukdjzpfay:apwJ@t"dutcsuf 2 ckuawmh tpm;rsm;rsm;pm;jcif;eJ@
ukd,fvufv_yfSm;avhusifhr_ enf;yg;jcif;wkd@ jzpfwmukd tpOfowdjyKif; tmam*sH yrH
vmbH ? Dr.0vkH;
(2002-2-2)
47
a'gufwm0vkH;
48
a'gufwm0vkH;
taumif;vm; tqkd;vm; pdwf=uGEdk;=um;jcif;

wefaq;vGefab;qkdwmukd pm;aomufrSD0JwmawGrSm okH;wmom vlodrsm;
ygw,f? pdwfcHpm;r_rSm wef aq;vGefab;dSwmukdawmh vlodenf;=uygvdrfhr,f?
csrvm; - ajy;rvm;taetxm;ukdjzpfapwJ@pdwfudk pdwfvef@Ekd;=um;jcif; vkd@yJ
qkd=uygpkd@? STRESS aygh? rsm;aomtm;jzif@ kwfwufrajrmfvif@yJ uHawG@vkdufwJ@
jzpfyfta=umif;tmawGrSm jzpfay:vmwJ@ pdwftvsOf cHpm;r_jzpfygw,f? a,bl,s
tm;jzif@ vef@a=umufoGm;jcif;uae cE<mukd,frSm ajymif;vJjcif;taetxm;jzpfpOfawG
p+yD;ay:aygufvmygw,f?
pdwfuGEdk;=um;jcif;a=umif@ cE<mukd,frSm jzpfpOf 3 yfay:aygufvmygw,f?
(1) csufjcif;
(2) umv=umrS
(3) emwmSnf
[lwJ@tqifh 3 rsKd;jzpfvmygw,f?
csufjcif;jzpfpOfwGif jyifyrSvH_@aqmfxm;aom ajcmufvSe@f jcif;ukdifqkdifbdk@ cE<m
ukd,fJ@qdkifmvkyfief;aygif;pkHrSm tiftm;ESif@vsifjrefr_tm;ukd tqifoifhjzpfapygw,f?
pdwfvef@Edk;=um;jcif;v_H@aqmfr_u cE<mukd,f emusifr_ rdSatmifumuG,fEkdifb@dk OD;
aESmufudk owday;xm;ygw,f? pOf;pm;jcif;eJ@rSwf^m%fukd wkd;wufaumif;rGefapyg
w,f? rsufpdrSm tjriftm;ydk=unfvifvmatmif oli,ftdrfukd yGif@us,fvmapygw,f?
tqkwfrSm atmufpD*sif"mwfukd ykd,lEdkifygw,f? tonf;u *vkdufudk*sif"mwfawGukd *
vl;ukd@pfo=um;"mwfawGtjzpf ykdrkdzdcGJay;ygw,f? ESvHk;rSm aoG;rsm;twGif; atmufpD
*sifeJ@o=um;"mwfawG ykdrkdpD;0ifap+yD; tiftm;awGjzpfapbk@d toif@zefwD;ay;ygw,f? ES
vkH;ckefE_ef;jrefap+yD; aoG;aygifvnf;jrif@wufapygw,f? t+'Devif*vif;rsm;(adrenaline
glands)ucsrvm;-ajy;rvm;(fight or flight)a[mfrkef;jzpfwJ@ t+'Devif;(adrenalin)
(tufyDeufzif; -epinehrine vkd@vJac:ygw,fw,f)udk xkwfay;ygw,f? oufGuf
rsm;u aoG;qJvfopf rsm;pGmukdxkwfay;+yD; uGufom;rsm;xH atmufpD*sifykdrkdamufdS
atmif o,f,lykd@aqmifay;ygw,f? tpmtdrfu tpmacszsufjcif;vkyfief;rsm;ukd vkH;0
yfqkdif;ay;xm;+yD; uGufom;tm;vkH; tiftm;tvkH;pkHoHk;Edkifbdk@ pDpOfay;xm;ygw,f?
49
a'gufwm0vkH;
'DjzpfpOfawGu pdwfuGEdk;=um;jcif;umvrSm cE<mukd,fwGif;rSmay:aygufvmwJ@

jzpfpOftaetxm;awGyg? wcsdefwnf;rSmyJ tarG;tjrif qHyifrsm;[m axmifxvmyg
w,f? cE<mukd,fukd tjrifrSm}uD;xGm;oa,mifa=umufvef@bG,ftoGifukdjzpfapygw,f?
tajym;rSm tarG;tdwfrsm;uGwufvmvdk@ =uufoD;arG;!if;rsm;jzpfay: apvmygw,f?
umv=umrSay:aygufvmwJ@jzpfpOfawGuawmh csrvm; - ajy;r
vm;(fight or flight)wkef@jyefr_twGuf jyifqif+yD; rdepftenf;i,ft=umrSm cE<ukd,f
ukd rlvtaetxm;amufatmif jyefvnfyjyifajymif;vJr_rsm;ukd pDrHvkyfaqmifay;
jcif;rsm;jzpfygw,f?
OD;aESmufeJ@rSwf^m%foif=umif;A[kd[m pdwfvef@Ekd;=um;jcif;twGuf tqifoif@
jzpfatmif v_yfSm;apygw,f? ckcHr_pHepf[m ykd;r$m;rsm;ukdwdkufcdkufjcif;wGif avsmhenf;ae
+yD; tiftm;awGtoif@dSeftwGuf tvkyfrsm;aeygw,f? tonf;uvJ tqD"mwf
awGukd tokH;yEdkifrJ@avmifpmpGrf;tiftjzpf ajymif;vJay;vsufdSaeygw,f? ausmuf
uyfJ@t+'Devif*vif;[mvJ ZD0urReJ@ckcHr_pHepfwkd@J@vkyfief;rsm;ukdxdef;odrf;wJ@ aumf
wufpf(cortex)J@ aumfwDZkef;(cortisone) a[mfrkef;ukdppfxkwfay;ygw,f? 'Da[mfrkef;
[m tcsdef=umvmif tqdyfjzpfygw,f?
emwmSnfjzpfpOfawGuawmh pdwfvef@Edk;=um;jcif;c%c%jzpfvmif
OD;aESmuf/ ESvkH; eJ@ ckcHr_pHepfawGrSm tEWm,fjzpfapvmygw,f? wefaq;vGefab;aygh? OD;
aeSmufJ@qJvfrsm;ukd aumfwDZkef;a[mfrkef;u tqdyfjzpfapwma=umif@ owdrSwf^m%f
pGrf;nfukd t"du xdcdkufapygw,f? armvG,fjcif;/ a'go}uD;jcif;/ pdwfusjcif;rsm; ykdrkd
jzpfay:vmygw,f?
pdwfuGEdk;=um;jcif; c%c%jzpfay:jcif;a=umif@ ckcHr_pHepfrSm am*gwkdufzsufw@J
qJvfrsm;tm; csKyfxdef;r_ukd tzefzefvkyfaevdk@ am*gumuG,fpGrf;tm;awG usqif;
vmygw,f? tpmtdrfvrf;a=umif;aoG;pD;qif;vSnfhywfr_ enf;vmjcif;a=umif@ tpm
vrf;a=umif;J@tajr;yg;rSm temrsm;jzpfapbkd@ vG,fulaeapygw,f? aoG;vSnfhywfr_t
zGJ@rSmvnf; aoG;aygifwkd;jrif@jcif;eJ@ ESvkH;ckefjrefjcif;wk@d [m aoG;a=umrsm;J@ uH@Edkifqef@Edkiftm;ukd avsmhyg;vmapyg w,f?
pdwfvef@Edk;=um;jcif;[m jzpfpc%rSmyJ aumif;wmukdawG@+yD; aSnfrSmqkd;usKd;
awGukdomjzpfapwm awG@ygw,f? wefaq;vGefab; oabmygyJ? pdwfvef@Edk;=um;jcif;
(Stress)[m tonf;i,f( pdwfEk/ pdwftm;i,f) wwfolawGrSm r=umc%jzpfwwf
ygw,f? vdyfjymrvkHolawGrSm tjzpfrsm;wwfygw,f? pdwfroef@olawGrSmtjzpfrsm;
wwfygw,f?
50
a'gufwm0vkH;
pdwfvef@Edk;=um;jcif;jzpfpOfawGrSm trsKd;om;rsm;u trsKd;orD;rsm;xuf aoG;aygif

wufr_ ykdrdkrsm;wwfygw,f? pdwfvef@Edk;=um;jcif;tawG@tuHukdawmh trsKd;orD;rsm;u
ykdrdkjzpfay:cHpm;wwfjcif;rsm;ygw,f?
uav;b0rSm pdwfvef@Edk;=um;jcif;ukd r=umc%awG@uHif uav;J@OD;aESmuf
[mysufpD;wwfygw,f? ^m%fnf^m%faoG; !H@zsif;wwfygw,f? 'ga=umif@ uav;rsm;
ukdajcmufvSef@jcif;rybkd@ pdwfynmSifrsm;u wm;jrpfav@Sdygw,f? uav;rsm;ukd o
bm0jzpfpOfrsm;tm; vGwfvyfpGmavhvmoif=um;Edkifatmif vrf;!$efbdk@ukdom tm;
ay;=uygw,f?
pdwfvef@Edk;=um;jcif;jzpfpOfukd tcsKd@olrsm;u yifudk,ftm;jzif@ cHEdkifnfdS=uyg
w,f? tJ'dolrsm;[m pdwf"mwfwnf+idrfr_/ orm"dtm;aumif;r_awG dS=uygw,f? pdwf
vef@Edk;=um;jcif;ukd cHEdkifnfdSygrSvJ cE<mukd,fJ@vkyfief; aqmifwmawG ysufpD;,kd,Gif;
jcif;rS uif;+idrf;rSmjzpfygw,f?
pdwfvef@Edk;=um;jcif;ukdcHEdkifnfdSbdk@uawmh
pdwfukdavhusifhysKd;axmifay;yghr,f?
pdwfwnf+idrfr_dSatmif urRXmef;pD;jzef;jcif;/ wm;xkdifjcif;/ orxtm;xkwfjcif;/
taumif;jrifjcif;/ ukd,fcsif;pmemjcif;/ rp>d,pdwfryGm;jcif;/ avmbowfEdkifjcif;/
wkefv_yfr_enf;yg;jcif;/ a'gor}uD;jcif; pwJ@ pdwfydkif;qdkifm ESvHk;oGif;r_rsm;xm;dSyghr,f?
pdwfvef@Edk;=um;jcif;ukd cHEdkifnfrdSygu ESvkH;am*g+yD; OD;aESmufJ@qifjcifpOf;pm;
jcif;tm;enf;yg;vmum rSwf^m%ftm; avsmhvmrSmjzpfygw,f?
oif@twGuf pdwfvef@Edk;=um;jcif;[m taumif;vm;tqkd;vm; qkdwm rdrdukd,f
ykdifpdwf"mwf}uH@cdkifr_tay: rsm;pGmrlwnfygw,f?
tmam*sH y&HrH vmbH

Dr.
0vkH;
51
a'gufwm0vkH;
tkdy,f
ouf}uD;G,ftkdrsm;twGufnDvmcHukd ukvor*~~Y {+yDv 8 ufae@u usif;ym
EdkifiHaygif; 200 ausmfrS ukd,fpm;vS,frsm; wufamufaqG;aEG;=uonf? wdSefxkd;
wkd;yGm;vmaom urBm@ouf}uD;xkonf EdkifiHwumvlr_ tokdif;t0kdif;ukd pdefac:rnfh
jy\emjzpfvmrnf[k twGif;a;r;csKyf acgzDtmeefu rde@f cGef;wGifajymqkdvkduf.?
2050 ckESpfwGif touf 60 ausmf OD;aonf 2 bDvsHausmfSdvmrnfqdk.? u
av;rsm;ESif@ trsKd;orD;rsm;twGufaxmufyH@a;pDrHcsufrsm;omdSae+yD; ouf}uD;G,ftdk
rsm;twGuf taxmuftyH@pDrHudef;rsm;rdSoavmuf enf;yg;aeonf/ ouf}uD;G,ftkd
rsm;rSm vlr_tokdif;t0dkif;. usef;rma;.vlr_a;cHpm;r_rsm;wGif cGJjcm;qufqHjcif; cHae
onf? [kwufamufvmolrsm;uaxmufjyoGm;.? aemufqkH;usif;ycJ@onfh Tokd@
aomnDvmcHukd vGefcJ@ aom tESpf 20 uusif;yay;cJ@.?
Dr.
0vkH;
52
a'gufwm0vkH;
53
a'gufwm0vkH;
wenf;a=umufpm qD;ausmufyg
qD;oGm;v#if aoG;ygwwfjcif;rSm qD;vrf;a=umif;wGifausmufwnfjcif;.vuQ%m
wyfjzpfonf?qD;vrf;a=umif;wGif emjcif; atmif@jcif;wdk@ESif@ ,SOfwGJjzpfay:wwfonf?
qD;vrf;a=umif;qdkmwGif ausmufuyfwpkH/ qD;ydk@yGef/ qD;oGm;yGefwkd@jzpf.? qD;oGm;yGef
vrf;a=umif;wGifausmufwnfaeygu qD;oGm;wdkif; emusifr_dSwwfonf?
qD;ausmufonf rsm;aomtm;jzif@ u,fvfpD,H"mwfrsm;jzif@ zGJ@pnf;xm;avh
dS.? cE<mukd,fwGif;odk@ u,fvfpD,H"mwfonf ae@pOf vG,fulpGm0ifamufvsufdSonf?
ae@pOfpm;okH;aeaomtpm;tpmrsm;wGif qm;ygSdaem/ qm;onf u,fvfpD,Huvdkdk'f
"mwfaygif;jzpfonf? xdk@a=umifh ae@pOftpm;tpmrsm;wGif qm;"mwfukdav#mhcsokH;pGJjcif;
jzif@ qD;ausmufwnfjcif;ukdumuG,fEdkifonf? qm;aygh pm;jcif; tavhtxukd jyKusif@
ay;ygu qD;ausmufwnfjcif;ukdomru u,fvfpD,H"mwfv$rf;rkd;jc,fvS,fEdkifaom ES
vkH;am*gtygt0if tjcm;am*grsm;ukdvnf; umuG,fmamufEdkifonf?
tom;rsm;rsm;pm;jcif;onfvnf; u,fvfpD,H"mwfudk cE<mudk,ftwGif; vm
amufef ADZmay;vdkufjcif;yifjzpfonf? xdk@a=umif@ u,fvfpD,H(xkH;"mwf)rsm; vkdtyf
onfxufykdrdkum cE<mukd,fwGif; amufdSaewwfI qD;ausmufwnfjcif;ukd jzpfapef
tcGihfomayonf? tom;"mwf tpm;usL;jcif;onfvnf; qD;ausmufwnfef t
a=umif;zefjcif;wpfyfjzpfonf? tom;onf ydkwdef;"mwfrsm;jzpfm qD;ausmufwnf
jcif;ukdtm;ay;aom ykdwdef;wrsKd;ygdS.? tom;pm;jcif;ukdav#mhaom tavhtusif@ukd
jyKaqmifygu qD;ausmuf wnfjcif;ukd t[ef@twm;jyKEdkifayonf?
qD;vrf;a=umif;wGif ul;pufydk;wG,f+idcsdefwGifvnf; qD;ausmufwnfef tcGif@t
vrf;omaeonf? qD;atmif@xm;jcif; =umanmif;avhdSaomolrsm;/ umvom;am
*gykd;wG,f+idaeolrsm;wGif qD;vrf;a=umif;ul;pufykd;wG,f+idam*g c%c%jzpfjcif;
(Repeated Urinary Tract Infection)a=umif@ qD;vrf;a=umif;wGif tenftESpfrsm; r=um
c%qdkovkdjzpfay:wwfI qD;ausmufwnfEdkifonf?
tjrpfr$mrsm; jzmaewwfaom qD;ausmufonf +ydKuGJyJ@xGufEkdifjcif;cufcJI cGJ
pdwfukocHI xkwfypfonf? tjrpftwufrdS aomqD;ausmufrsm;onf yJ@IxGufvm
wwfonf? qD;ausmufaysmfusef vwfqwfaomopfoD;nfrsm; rsm;rsm;aomufay;
jcif;/ aomufa tajrmuftjrm;aomufay;jcif;/ ADwmrif pD "mwf rsm;rsm;okH;aqmif
jcif;wkd@onf taxmuftulrsm;pGmjyKayonf?
54
a'gufwm0vkH;
trsKd;om;rsm;wGif qD;ausmuf+ydKuJGxGufvmygu qD;vrf;a=umif;ukd qD;ausmuf

uwkdufpm;I aoG;rsm;ygxGufdSygvmwwfonf? aoG;rsm;ygESif@twl qD;ausmufvnf;
tjyifxGufvmojzif@ ,if;jzpfyfukd (male abortion trsKd;om;ukd,f0efysufjcif;) [k
wifpm; aemufajymifwwf.?
Dr.
0vkH;
55
a'gufwm0vkH;
56
a'gufwm0vkH;
ta;rvS av#mrSm
aoG;usam*g
aoG;wdk; qdkv#ifrodol Sm;ygonf? aoG;usam*gudkawmh Za0Z0gjzpfrnfhol
rsm;ygonf? vl.usef;rma;rSm aoG;aygifcsdefu t"duusaomcef;u yg0ifygonf?
aoG;aygif ESif@ aoG;tm; ukdcGJjcm;odem;vnfbkd@vnf;vdkygonf? aoG;tm;onf qJvf
rsm;tiftm;dSef tm[m"mwfrsm;/ aoG;eDO/ aoG;jzLO aoG;nf=unfrsm; yg0ifzGJ@pnf;
r_ukd qkdvkdygonf? aoG;aygifrSm aoG;rsm; cE<mukd,ftwGif; vSnfhywfoGm;Edkifef aqmif
Gufay;onfhwGef;tm;jzpfygonf? aoG;aygifcsdefonf aoG;tm;tenf;trsm;ukd !$ef;jy
aomoauFw r[kwfyg?
aoG;aygifwGif t!$ef; 2 ckyg0ifygonf? tay:aoG;aygifESif@ atmufaoG;aygif[k
tvG,fwulokH;E_ef;ygonf? tay:aoG;aygif (Systolic Pressure) rSm ykHrSeftm;jzif@ 100
rS 140 mmHg twGif;dSygonf? atmufaoG;aygif(Diastolic Pressure)rSm ykHrSeftm;jzif@
70 rS 100 mmHg twGif;dSygonf? ,if;twdkif;twmrsm;rS ykduJjcif;/ enf;oGm;jcif;
jzpfygu omrefr[kwfawmh am*gjzpfay:jcif;[k pOf;pm;ygonf? vlwa,mufwGif
aoG;aygifcsdef 12080 mmHg dSonf[kazmfjyv#if taS@*%ef;rSm tay:aoG;aygif
120 mmHg jzpfum aemuf*%ef;u atmufaoG;aygif 80 mmHg jzpfa=umif;qkdvkdyg
onf? tay:aoG;aygif 140 mmHg xufrsm;v#if atmufaoG;aygif 100 mmHg xuf
rsm;v#if aoG;wdk;aeonf[k a,bl,sqkdEdkifygonf?
tay:aoG;aygif 100 xufenf;v#if atmufaoG;aygif 70 xufenf;v#if aoG;
aygifusam*g Hypotension [k a,bl,stm; jzif@owfrSwfEdkifygonf? aoG;aygif 400
dSonf[kqdkv#if r%rif;xH tvnfoGm;ef mE_ef;rsm;aeygonf? aoG;usam*g (0g)
aoG;aygifusam*gwGif toufukdtvkygonf? toufu,faq;rsm;jzif@ tjrefuk
pm;ygonf? aoG;wdk;am*gonf OD;aESmufaoG;a=umjywfjcif; tenf;trsm;ay:vdkufI
toufSifvsuf avjzwfjcif;omcHpm;ygonf? toufu,faq;rsm;okH;pGJefrvkday?
(av oif"kef; aov#if+AKef; aqmif;yg;ukd_yg )?
57
a'gufwm0vkH;
aoG;aygifusam*gwGif cE<mukd,fcsKd@wJ@oGm;jcif;rdSwwfyg? tcsdefrSD aq; rOD;ygu

toufygoGm;jcif;om jzpfwwfygonf? aoG;aygifusjcif;twGuf jzpfpOf 3 rsKd;u zefwD;
ygonf? ESvkH;ykd@tm;enf;jcif; (jzpfapaomta=umif;if;rsm;rSm rlrSefr[kwfaom ESvHk;
ckefjcif;rsm;/ ESvkH;uGufom;rsm;ysufpD;jcif;-qkH;_H;oGm;jcif;-wm0efcsKd@,Gif;jcif;rsm;)/ aoG;
yrm%avsmhusjcif;(jzpfapaom ta=umif;if;rsm;rSm aoG;xGufvGefjcif;/0rf;av#mfjcif;/
ac|;xGufvGefjcif;/qD;oGm;vGefjcif;)ESif@ aoG;a=umrsm;us,fjcif;(jzpfapaom ta=umif;
if;rsm;rSm av#mhcf (Shock) ac: aoG;aygifusarharsmjcif;/ jyif;jyaomtyl'%fcHjcif;/
0rf;av#mjcif;ESif@ aoG;a=umus,fapaom aq;0g;rsm;pm;okH;jcif;)wkd@jzpfygonf?
aoG;aygifusjcif;a=umif@ acwW avmu}uD;ESif@tquftoG,fjywfjcif;(Fainting or
Syncope qifukdyD)/ aemtajymif;tvJaoG; aygifusjcif; ( Postural Hypotension/
Orthostatic Hypotension )ESif@ av#mhcf(Shock)ac: aoG;aygifusarharsmjcif; am*gw@kd udk
jzpfay:apygonf? Orthostatic Hypotension onf =um=umxkdifmrS kwfwufx
vdkufaomtcgwGifif;/ aoG;aygifusam*gukdjzpfay:aepOf aemtajymif;tvJvkyfmY
if; jzpfay:wwfygonf?
av#mhcfonf toufukdtEWm,fjyKaomtjctaejzpfygonf? av#mhcfjzpfcsdef
wGif aoG;aygifonf toufSifefrxdef;Edkifawmhaomtajctaejzpfygonf? aoG;aygif
uscsdefwGif txdkiftxjyKcsdef vJmrSxcsdefwdk@wGif acgif;xJY rdkufueJjzpfum rsufvkH;
rsm;jymI ,kdifvJusvsuf arharsmoGm;wwfygonf? wu,fukd ta;rvSyJ av#m rSm
jzpfwJ@ aoG;usam*gyifwnf;?
Dr.
0vkH;
58
a'gufwm0vkH;
59
a'gufwm0vkH;
0rf;csKyfwm twif;rvkyfygeJ@
(a'gufwm0vHk;)
ig;pdrf;jrif ig;uifypf w,f? GufEka0 Gufa[mif;auGw,f? ta[mif;
ta[mif;wdk@aemrSm topftopfwdk@ tpm;xdk;w,f qdkwJhwifpm;csufawG[m cE<m
udk,frSmSd tpmtdrfvrf;a-umif;J@ vkyfief;aqmifwmudk azmfjyw,fqkdif rSm;r,fr
xifyg? tpmtopfawGudk pm;oHk;trSD0Jwdkif; tpma[mif;udk pGe@f ypfp_rJyJav?
tpmtdrfvrf;a-umif;J h tlr}uD;[m tpma[mif;awGukd odkavSmifay;xm;yg
w,f? tpmopfopfawG0ifvmifjzpfjzpf/ cE<mudk,ftwGuf rvdktyfwJh tqdyft
awmufawG 0ifvmifjzpfjzpf/ tlr}uD;[m tpma[mif;awGudk ptdkuwqifh jyifyudk
pGef@xkwfay;ygw,f?
tpma[mif;pGef@xkwfjcif;udk 0rf;oGm;wmvdk@ ajym-uygw,f? 0rf;rSefw,f/ 0rf;
csKyfw,f/ 0rf;av#mw,fvdk@ tpma[mif; pGef@xkwfjcif;J@tajctaeudk az:jy-uygw,f?
tcsdefrSefrSefeJ@ tpma[mif;udkpGef@xkwfaeif 0rf;rSefw,fvdk@ qdk-uygw,f? wcsK@d[m
ae@pOf0rf;oGm;ygw,f? reufydkif;jzpfjzpf/ rGef;vGJydkif;jzpfjzpf/ nydkif;jzpfjzpf tcsdefrSefwwf
-uygw,f? tcsKd@[m ufjcm;0rf;oGm;wwfygw,f? wufjcm;w}udrf/ ESpfuf jcm;wcg
avmuf rSefrSef0rf;oGm;wwfygw,f? Sm;Sm;yg;yg; oHk;ufjcm; (odk@r[kwf] wywfrSm
ESpf}udrfom 0rf;oGm;avhSdolawGvJ Sdwwfygw,f? 'gawG[m0rf;rSefwJhjzpfyfawGyg?
vlwOD;eJ@wOD;J h ZD0urRvkyfief;pOfuGJjym;vdk@ tavhtusifhjcm;em;jcif;om jzpfygw,f?
rSefuefaewJhtpma[mif;pGef@xkwfr+ tavhtusifhuae aoGzDoGm;if 0rf;
av#mwm/ 0rf;csKyfwm jzpfvmygw,f? bufwD;D;,m;ydk;r$m;rsm;a-umifhjzpfjzpf/ tpm;
rSm;vdk@jzpfjzpf/ cE<mudk,ftwGuf rvdktyfwJhtqdyftawmufrsm;a-umifhjzpfjzpf 0rf;
av#m wwfygw,f? rSefrSefvkyfaqmifaewJh tpma[mif;pGef@xkwfjcif;vkyfief;[m t
csdef-umjrifhrS jzpfay:aqmifGufvmif 0rf;csKyfw,fv@kd qdk-uygw,f? tpmtdrfvrf;
a-umif;uae tpma[mif;pGef@xkwfjcif;udk xdef;csKyf-uyfrwfay;wJh tmawG Sdygw,f?
tmHka-umtzGJ@J@xdef;rwfr+ cE<mudk,fJ@axkxnfyrm%/ pm;oHk;wJhtpm;tpmawGJ@
trsKd;tpm;eJ@tatwGuf ponf wdk@jzpfygw,f?
pm;oHk;wJhaxkxnfyrm%enf;yg;if 0rf;uspf/ 0rf;rmjzpfvmwwfygw,f?
60
a'gufwm0vkH;
onftcg tpma[mif;pGef@xkwfjcif;[m -uef@-umvmwwfygw,f? 0rf;csKyfvmwwfyg

w,f? wcsKd@[m qefeJ@qefxGufypPnf;awGudk pm;oHk;aemrS *sKHe@J *sKHxGufypPnf;rsm;udk
ajymif;vJpm;oHk;vdkufygu 0rf;csKyfoGm;wwfygw,f? [if;Guf[if;oD;pm;oHk;r+ enf;yg;
ygu 0rf;rm0rf;uspf_yD; pjrif;jzpf_yD; 0rf;csKyfvmwwfygw,f? tpm;taomuftvGef
enf;oGm;ifvnf; tpma[mif;enf;oGm;vdk@ 0rf;csKyfwwfygw,f?
0rf;csKyfwJhtcg tpmtdrfvrf;a-umif;rSm tpma[mif;rsm;pk_yHKaewwfygw,f?
'gha-umifh0rf;Adkufatmufydkif;rSm uoduatmufjzpfaewwfygw,f? Adkufem Adkufatmifh
jzpfaewwfygw,f? avvnfr+vnf; enf;vmygw,f? av[mtxufudkqef_yD; teH@
qdk;wwfygw,f? vnfacsmif;emvmwwfygw,f? 0rf;csKyfwhJtcg 0rf;E+wfwm/ 0rf;csL
wmwdk@udk jyKvkyfavhSdygw,f? 0rf;E+wfwmudkawmh vltawmfrsm;rsm;[m rdrdo
abmeJ@rdrd vkyfwwf-uygw,f? -um;zl;em;0todeJ@jzpfjzpf/ zwfzl;or# A[kokweJ@jzpf
jzpf/ 0rf;E+wfaq;rsm;udk pm;oHk;rSD0Jwwfygw,f? 0rf;csLwmudkawmh rsm;aomtm;jzifh
usef;rma;0efxrf;rsm;u jyKvkyfay;avhSdygw,f? jy\emeJ@ tEWm,fu 0rf;E+wfaq;
pm;oHk;jcif;rSm wnfSdaeygw,f? 0rf;E+wfaq;rSmu taemufwdkif;aq;ynmt wD
xGifxkwfvkyfxm;wJhaq;ESifh wdkif;if;b,aq;rsm;jzifh azmfpyfxm;wJh0rf;E+wfaq;awG
,fvdk@Sdygw,f? yxrtrsKd;tpm;rSmawmh aysmhaysmif;odrfarG@pGm 0rf;oGm;wJh0rf;E+wf
aq; (Laxative) eJ@ tmHka-umawGudk Ed+;qG_yD; wGef;xkwf0rf;oGm;apwJh 0rf;E+wfaq;
(Purgative),fvdk@ Sdygw,f? onfaq;awGuawmh okawoejyK_yD; xkwfvkyfxm;wm
awGjzpfygw,f? tnef;twdkif;rSD0Jif tEW m,fenf;wwfygw,f?
wdkif;if;b,aq;rsm;eJ@ azmfpyfxm;wJh 0rf;E+wfaq;awGuawmh aocsmok
awoejyKvkyfjcif;rSm tiftm;tvGefenf;yg;w,f? rddk;zvmtpOftvmt pm;oHk;rSD
0Jjcif;vnf;Sdygw,f? aq;azmfpyfr+udkSd_yD; pD;yGg;jzpfxkwfvkyfamif;cswmrsKd;vnf; Sdyg
w,f? twdkif;tq/ yrm%/ tmedoif/ tusKd;oufamufr+/ tjypfxdamufr+ ponf
wdk@udk aocsm*epGm okawoejyKvkyfxm;r+ enf;yg;ygw,f? onfaq;awG[m rsm;
aomtm;jzifh tmHka-umudk E+d;qGwGef;xkwf0rf;oGm;apwJh 0rf;E+wfaq; (Purgative)awG
jzpfygw,f? 'ga-umifh 'D0rf;E+wfaq;awG pm;oHk;rSD0Jwkdif; 0rf;[mrsm;rsm;oGm;wwf
ygw,f? tpma[mif;awG tukeftpifavmufygoGm;wwf_yD;aemufydkif;rSm tdtGJ
awGudkyg pGef@xkwfypfwwfygw,f? tdtGJawGygwmeJ@ tykyfpifw,fv@kd xifwwf-u
ygw,f?
jrefrmtawmfrsm;rsm;[m 0rf;E+wfaq;pm;mrSm wdkif;if;aq;rsm;udk rSD0Jwm
rsm;w,f? udk,fcE<musef;rmoefpGrf;zdk@ qdk_yD; tywfpOf0rf;E+wfaq;pm;wwfolawGvnf;
Sdygw,f? 0rf;rrSefvdk@ 0rf;csKyfvdk@ 0rf;E+wfwmvnf;Sdygw,f? "rRwmrrSefvdk@ 0rf;E+wfwJh
61
a'gufwm0vkH;
trsKd;orD;tcsKd@vnf; Sdygw,f? tywfpOfvpOfqdkovdk 0rf;E+wfaq;rSD0Javh SdolawGu

awmh 0rf;awGoGm;/ tdtGJawGygoGm;ifyJ tckrSyJvlukdayghoGm;awmhwmyJvd@k auseyf
pGmcHpm;wwf/ ajymwwfavhSdygw,f? wu,fwrf;uawmh ayghoGm;wmvlr[kwfygbl;?
udk,fJ@ckcHr+tiftm; ayghoGm;avsmhoGm;/ tiftm;enf;yg;oGm;wmyg? wdkif;if;0rf;E+wf
aq;udk rSD0JvdkufwJhtwGuf tpma[mif;rsm; tukeftpifygoGm;ygw,f?
tdtGJrsm;ygoGm;wJhtwGuf tykyfawGygoGm;wmr[kwfyg? wu,fwrf;u
tdtGJawG[m tpmtdrfvrf;a-umif;udk zHk;tkyfumuG,fay;xm;wJh tarS;yg;awGyg
_ydKuGJysufqD;oGm;_yD; pGef@xkwfcHwmyg? tarS;yg;awGe@J twl aoG;a-umi,fi,frsm; ppf
xkwf*vif;rsm;vnf; ygoGm;ygw,f? ,if;wdk@ysufqD;jyKwfusoGm;wJhtwGuf tpmtdrf
vrf;a-umif;rSm acszsufumtpmudkpkyf,l_yD; aoG;a-umtzGJ@tpnf;twGif; ydk@aqmifay;
EdkifpGrf; ,m,DcsKd@,Gif;oGm;ygw,f? cE<mudk,fudk tiftm;jzpfapwJh "gwfrsm;avsmhyg;oGm;
ygw,f? tdtGJawGygvmwm aumif;wJhvuQ%mr[kwfyg? wkwfydk;rsm;tvGefygG ;_yD; t
arS;yg;rsm;udk _zdKcs_ydKuGJapum tdt GJrsm;0rf;oGm;pOfygvmwwfwhJ oabmwm;eJ@
cyfqifqifygyJ?
wbw(Tabata)rStrsKd;om;wpfOD;J h pHkprf;ar;jref;csufu tywfpOf0rf;rSefrSef
E+wfay;aeayr,fh tzsm;am*g r-umc% 0ifamuf_yD; tvkyfem;cGifh,l ,laewmbm
a-umifh ygvJ qdkygw,f? cE<mudk,frSmvJ awmifhawmifhwif;wif;SdaevsufeJ@/ tykyfvJ
pifygom;eJ@ c%c%zsm;wm[m txufuazmfjyxm;wJhtwdkif;ygyJ? 0rf;E+wfaq;
a-umifh cE<mudk,fpGrf;tm;awGenf;yg;vmvdk@ tzsm;c%c% 0ifamufvmwmyg?
zsm;csifcsifSdvdk@ 0rf;E+wfypfvdkufwJhol[mvnf; ydk_yD;zsm;oGm;wwfygw,f? t
zsm;am*g0ifvmwJhtcg 0rf;csKyfoGm;wwfygw,f? tzsm;am*gudkaysmufuif;atmif
uko_yD;if 0rf;vnf;jyefrSefvmwwfygw,f? tzsm;am*g0ifvmwm[m udk,fcE<mckcH
pGrf;tm;enf;yg;vdk@ygyJ? zsm;csifcsifjzpfvmwJhtcg 0rf;E+wfypfvkdufawmh udkomqdk;eJ@vm
wdk;awmhwmygyJ? 0rf;E+wfvdkufawmh cE<mudk,fckcHpGrf;tm;u ydk_yD;enf;oGm;wmudk;?
tDcJbkcdkdk(Ikebukuro)u trsKd;orD;wpfa,mufJ@ zsm;csifwmeJ@ 0rf;E+wfypfvdkufw,f?
tck tylcsdefwdkif;-unfhvdkufawmh 38.2 C ? tJ'gzsm;aewmyJvm; qdkwJh ar;jref;csuf
t onf tylcsdeftwdkif;qdkif zsm;aewkef;ygyJ? zsm;csifcsifSd wmudk 0rf;E+wfvkdufwhJt
wGuf ydkzsm; oGm;wmyg?
wdkif;if;0rf;E+wfaq;wrsKd;udk tufrSefrSefaomufoHk;wJh,rumvkvif t
csKd@[m ae@pOfrSD0Jygw,f? olwdk@teuf 10 a,mufudk ae@pOfrSefrSefaoG;aygifcsdef_yD; rSwf
wrf;,lxm;m tm;vHk;[maoG;aygifcsdefususvmwm awG@ygw,f? 'gha-umifh 0rf;E+wf
aq;rSD0Jjcif;udk yfqdkif;ap_yD; aoG;aygifcsdefudk ae@pOfwdkif;,lcJhygw,f? wywfausmf oGm;
62
a'gufwm0vkH;
wJhtcgrSm aoG;aygifcsdef[m yHkrSef jzpfoGm;_yD; wnfwHhaeygawmhw,f?

0rf;E+wfaq;pm;jcif;[m tEWm,fudkzdwfac:ovdk jzpfaewwfygw,f? 0rf;csKyf
wJhtcg obm0t 0rf;oGm;Edkifzdk@ 0rf;E+wfaq;tultnDrygbJeJ@ }udK;pm;vkyfaqmif
oifhygw,f? audkrsm;rsm;aomufay;jcif;/ tpm;rsm;rsm;zdpm;ay;jcif;/ EGm;Edk@tpdrf;
aomufay;jcif;/ toD;tGufrsm;rsm;pm;ay;jcif;/ rusD;azsmfnfESifh tcsnf"gwfrsm;aom
azsmfnfrsm;udk aomufay;jcif;rsm; vkyfaqmifay;wm taumif;qHk;ygyJ? tpmvnf;
aq;/ aq;vnf;tpm qdkwJhtwdkif; usifhoHk;oifhygw,f?
Dr.
0vkH;
63
a'gufwm0vkH;
64
a'gufwm0vkH;
aorif;wref aeif;jyef
owif;aumif;udk =um;/ odwmvJ r*FvmSdwmygyJ? tarduefjynfaxmif

pkJ@ usef;rma;0ef}uD;meu atmufwdkbm 7 ufae@rSm xkwfjyefvdkufwJh tpDifcHpm
[m owif;aumif;wyfjzpfygw,f? r*FvmSdygayw,f?
tarduefjynfJ@ vlawGaoqHk;jcif; aS haqmifta=umif;if; 10 ckrSm at
tdkif'Dtufpf rSdawmha=umif; tpDifcHpmrSm a=unmazmfjyxm;ygw,f? attdkif'D
tufpfam*gudk jzpfapwJh tdwfcsftdkifADGAdkif;yfpfydk;udk ESdrfeif;EdkifwJh aq;pGrf;aumif;awG pk
aygif;ukojcif; ( multidrug cocktails) a=umifhjzpfw,fvdk@ qdkygw,f? 1997 ckESpf
tajccHpmif;ppfwrf;t attdkif'Dtufpfa=umifh aoqHk;r_[m 1996 ckESpfuxuf
46avsmhenf;vmwmudkvJ nef;jyxm;w,fqdkygw,f? 'ga=umifh ,ckESpfrSmaoapwJh
ta=umif;if;trSwf 8 uae trSwfpOf 14 udkamufoGm;wmjzpfw,fwJh? onfpmif;
ppfwrf;rsm;[m ukxHk;opfrsm;J@ tpGrf;tmedoif xufjrufvmr_a=umifh tdwfcsftdkifADGydk;
ul;pufysH hESH@jcif;cHolawGJ@ oufwrf;udkvJ ydkSnfapvmwmudk azmfjyjcif;jzpfw,f vdk@
qdkygw,f? 'gayr,fh tdwfcsftdkifADGydk; ul;pufysH hESH@jcif;udkawmh ododomomavsmhenf;
atmif rvkyfEdkifao;a=umif; tarduef usef;rma;ESifh vlr_0efaqmifa;me 0ef}uD;
'GefemSmvmu tpDifcHpmrSm azmfjyxm;ygw,f?
attdkif'DtufpfeJ@ attdkif'DtufpfEG,fam*gpk (AIDS Related Complex
= ARC) [maorif;wrefawGjzpf=uw,fqdkif rrSm;ygbl;? ,cktcgrSm attdkif'D
tufpfqdkif vltawmfrsm;rsm;[m if;ESD;u|rf;0if odem;vnfae=uyg+yD? ARC udk
awmh tenf;i,fpdrf;aeygOD;r,f? od=u+yD;wJhtwdkif; attdkif'Dtufpfam*g[m tdwfcfs
tdkifADGAdkif;yfpfydk;a=umifhjzpfvmwmyg? onfAdkif;yfpfydk;[mvl@udk,ftwGif;0ifvmcGifh
wmeJ@ vlJ@umuG,fcHEdkifpGrf;tm;pHepfudk wdkufcdkufawmhwmygyJ? usef;rmoefpGrf; aewJh
cHEdkifpGrf;tm;pHepfudkawmh tvG,fwulxdk;azmufEdkifjcif; rSdygbl;? ,dk,Gif;csdeJ@aewJh cH
EdkifpGrf;tm;pHepfudkawmh tvG,fwulwdkufcdkufEdkif+yD; vludktiftm;,kwfoxuf ,kwf
avsmhapygw,f? onfhtwGuf ul;pufam*gtawmfrsm;rsm;udk jzpfvG,f+yD; omref
xufydkvGefwJham*grsm;/ uifqmrsm;jzpfyGg;um tdyfmxJbkef;bkef;vJwJhtxd attdkif
'Dtufpf[m 'kuQay;ygw,f?
1993 ckESpf. pmif;Z,m;rsm;t tarduefwGif jzpfygG ;aom attdkif'D
tufpfam*g 85[m am*gSdaewJhtrsKd;om;rsm;eJ@vdifwlqufqHwJhtrsKd;om;rsm;,f
rl;,pfaq;udk ta=umxJxdk;oGif; oHk;pGJwJhtrsKd;om;/ trsKd;orD;rSm jzpfyGg;wm awG@dSyg
w,f? usef 15uawmh uav;rsm;,f/ Adkif;yfpfydk;ygSdwJhaoG;udk oGif;rdolawGrSm,f
65
a'gufwm0vkH;
jzpfyGg;wmudk awG@w,fqdkygw,f? 'gayr,fh tmzdu/ tdENd,eJ@ wwd,urBmjzpfwJh

vlOD;axlxyf+yD; qif;JwJhEdkifiHawGrSmawmh attdkif'Dtufpfam*gu usm;/ r raG;
uef@owfcsufrxm;bJ ul;pufapygw,f? aocsmwduswJh am*gvuQ%m ray:bJ
aoG;xJrSm tdwfcsftdkifADGSdaewJhol(HIV positive)rsm;eJ@ yDjyifwJh am*gvuQ%m
ay:vGif+yD; ordk;usr[kwfwJham*grsm;/ uifqmrsm; cHpm;ae=uoltm;vHk;udk attdkif
'DtufpfEG,fam*gpk vdk@a,bl,staeeJ@ ARC owfrSwf=uygw,f?
urBmeJ@t0Srf; attdkif'Dtufpfam*g[m qif;J+yD; usef;rma; csKd@wJhaeolrsm;/
tvGefi,fG,folrsm;wGif tjzpfrsm;wmudk awG@Sdygw,f? ,if;wdk@rSm vdktyfwJhtm
[m"gwfrSdr_/ trsKd;tpm;aumif;wJh tom;/ owWKeJ@ tqD"gwfrsm;/ ADwmrifrsm; udk
vHkavmufpGmrSdr_wdk@a=umifh onfam*gudk Sdwmvd@k qkdygw,f?
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pGrf;tm;pHepfudk csdeJ@apygw,f? oGwfowWK"gwfenf;yg;r_[m am*grjzpfao;wJh tdwfcsf
tdkifADG vufcHxm;olawGudk attdkif'Dtufpfam*gtjzpfjrefapygw,f?
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avsmhenf;csKd@wJhaewm awG@Sdygw,f? trDEdktufppfawG[m tom;"gwfjzpfxGef;r_eJ@
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=uufOtESpfu jyKvkyfwJh tm[mwrsKd; (egg lipid extract = AL 721) [mtdwf
csftdkifADGqJvfawGudk umuG,fwGef;vSefay;ygw,f? ae@pOf=uufOESpfvHk; rSefrSef pm;oGm;
r,fqdkif udk,fcHpGrf;tm;usqif;r_am*gudk wzufwvrf;rS umuG,foGm;Edkifygw,f?
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wm;jyKygw,f? r=umao;rDu okawoejyKcsufrsm;t (coenzyme Q10)"gwfcsKd@wJh
aewmudk awG@Sdygw,f? ,if;[m ul;pufam*grsm;udk wGef;vSefwdkufcdkufEdkifwJh pGrf;
tifSd"gwfwrsKd;jzpfygw,f? tqD"gwfjzpfwJh zufwD;tufppf/ tvDEkdtufppf(GLA) eJ@
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amufwGef;vSefumuG,fEdkifwmudk odygvdrfhr,f? ae@pOfpm;oHk;rJhtm[m"gwfawGudk
tpm;enf;vmif cHEdkifpGrf;tm;pHepf avsmhyg;csdeJ@vmr,f? rSefuefjynfh0pGm rSD0Jr,fqdkif
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Dr.
0vkH;
67
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tpm;=uL;aomtcg owdxm;
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Mad Cow Disease( Bovine Spongiform Encephalopathy
=BSE) am*g
cGgdSowW0grsm;wGifjzpfay:aom OD;aESmufajrKyfjzpfvmjcif;am*gjzpfygonf?
1986 ckESpf t*FvefrSm pwifawG@dSonf? EGm;rsm; vrf;av#mufmwGif ykHrSefr[kwf
awmhyJ a'gif@wef;qGJum ykHysufyef;ysufvSrf;av#mufaeonfukdawG@mrS am*gSmazG
awG@dSonf? Scrapie OD;aESmufam*gdSaeaom okd;rsm;.om;uGif;om;usefESif@tdk;
rsm;ukd tr+ef@}udwfI EGm;pmtjzpf EGm;rsm;ukdausG;mrS EGm;rsm;wGif OD;aESmufam*gjzpf
ay:vmjcif;jzpfonf?OD;aESmufonf wpwp,kd,Gif;vmum aemufqkH;wGiftoufyg
oGm;.?
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onf Sm;Sm;yg;yg;jzpfwwfonf? am*gjzpfaeaom EGm;.tom; tdk;rsm;ukd pm;
aomufrdjcif;jzif@ ,if;am*g&Sdvmonf? vlwGifjzpfvmaomtcg CJD OD;aESmufam*g
[kac:.? am*gykd;rSm tylcsdefjrif@jrif@wGifyif rysufpD;oGm;ay?xkd@a-umif@ tuif/tzkwf/
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qifI am*gSmazGppfaq;mwGif tjcm;am*grsm;[ktrSwfrSm;um Zpfjrpfukd tcsdefrSD
rodEdkifay? tcsdefrSDoddSaomfjim;vnf; ukmewd aq;rdSacs? am*gjzpfaeaom tom;
tdk;/ uvDpmrsm;ukd rpm;rdatmif qifjcifaejcif;jzif@om umuG,fEdkifonf? xkd@
a-umif@ am*gjzpfonf[koHo, dSvmcsdef okd@r[kwf jzpfyGm;aeonf[k oddScsdef
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t*FvefEdkifiHwGifpwifawG@dSI tjcm;OamyEdkifiHrsm;wGifvnf;awG@dSvm.? t
rJom;wifykd@r+pD;yGm;a; xdcdkufvmonf? t*FvefwGif 1986 ckESpfrS 1992 ckESpftwGif;
69
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Denmark, France, Germany, Ireland, Italy, Liechtenstein, the Netherlands,
Portugal, Spain ESif@ Switzerland wGif 1642 aumifomjzpfyGm;onf? EGm;pmwGif wd
p>mefrsm;.tom;/tdk;ESif@uvDpmrsm; xnfhrau|;ef tjyif;txefwm;jrpfjcif;

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onf? *syefEdkifiHwGif ,ckESpfpufwifbmvwGif am*gjzpfaomEG;waumifukd aocsm
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73
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awmfjyefa&m*grsm;&dSrnfrSmrvGJay? rnfonfhEdkifiHvkyf ydefaq;rsm;udkrpm;okH;yJ 0jcif;
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tmvl;uJhokd@ haomtoD;tESH/tcsKduJwJh oGm;&nfpm/ bD,m - csL;[kduf - 0kdifrsm;
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pmrsm;/ *sKHxGufypPnf;rsm; pm;okH;jcif;/ Edk heJ hobm0opfoD;azsmf&nfrsm;ukd reufpmx
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jcif;ESifh tjcm;usef;rma&;avhusifhcef;rsm;ukd tcsdefrSefrSefjyKvkyfay;jcif;jzifh ukd,ftav;
csdefcsoifhygw,f?
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Dr.
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jcif;onf tcsuftjcmjzpfaeygonf?
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vuf [lI vufrSwqifh a&m*gydk;rsm;ul;pufygonf? vufrSwqifh ul;pufaoma&m*g
rsm;wGif tonf;a&mifa&m*g (hepatitis A)/ OD;aESmuftajr;a&mifa&m*g(meningitis)
ESifh 0rf;a&m*gwkd hyg0ifygonf?
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csm aysmufuif;rSmjzpfygw,f? aq;,Ofyg;jcif; (drug resistance) tjzpfrsm;aewJh
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Dr.
0vkH;
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jcif;rsm; avsmhyg;uif;pifoGm;ygr,f? a&m*gb,rsm; uif;a0;oGm;ygr,f?
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rsufESmopf/ ajcvufaq;a=umwmupum a&csKd;/ acs;wGef;/ oef@Sif;jzLpifwJh t0wf
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78
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yufzsef;jcif;/ rD;d_@zsufqD;jcif;wkd@jzifh rSDckdudef;atmif;aewJh ykd;r$m;rsm;ukd okwfoifSif;vif;
ypf&ygw,f? ywf0ef;usif oef@Sif;av rSDckdaexdkifwJh ykd;r$m;xk enf;yg;av uif;pifav
jzpfygw,f? 'DvkdeJ h oef@Sif;wJhywf0ef;usif[m vl&J@usef;rma&; aumif;rGefbkd@ukd t
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rma&;vJ wkd;wufvmapygw,f? usef;rmvkd@ csrf;omr,f/ csrf;omvkd@ vef;jzmr,f
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EdkifrSmjzpfygw,f? usef;rmrS csrf;oma&;ukdaqmifGufEdkifr,f/ csrf;omrS usef;rma&;
vkdtifrsm;ukd jznfh qnf;ay;EdkifrSmjzpfygw,f? Health for Wealth, Wealth for
Health jzpfygr,f?
wukd,fa&oef@Sif;r_ukd tav;jyK *kxm;aqmifGuf&if; ywf0ef;usifoe@fSif;
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usef;rma&;tp oef@Sif;=u&rSmjzpfyga=umif; pum;aESmif;yg;vkduf&ygw,f?
Health for All, All for Health
Dr.
79
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Dr. 0vkH;
2005 ck {NyD
2010 ck Edk0ifbm 12
Burma Star Group
Burma Star DTP
Burma Star DTP
MS COREL
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