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The Voice Weekly

4 NIGHTINGALE

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rSm vlem[m bmrsm;Nzpfygvdrfh
qdkNyD; tHhtm;oifhaewJh tjzpf
awG&w
dS wfw,f/ 'g[mtouf
tEÅ&m,fay;wwfwJh ESvHk;aoG;
tvHt
k avmuf r&Ncif; (Ischaemic heart disease) a&m*g jzpf
aewwfwJhtwGufjzpfygw,f/
&ifbwfatmifw
h m (Angina)
eJY ESvHk;aoG;ravQmufwJha&m*g
(Myocardial infarct) wdkY&JU vu©
PmawG[m tawmfav;qifwl
ygw,f/ ESvHk;udk axmufyHhay;
aewJhaoG;aMumawG vHk;0 ydwf
qdkYjcif;aMumifhjzpfap? w0ufw
ysuf ydwfqdkYjcif;aMumifh jzpfap
aoG;r&awmhwhJ ESv;kH <uufom;
awGrS "mwfypön;f awG xGuaf y:
vmwJhtwGuf tm½kHaMumawG
udk vIHUaqmfNyD; emusifrI cHpm;&
jcif; Nzpfygw,f/
ESvHk;tpm;xdk;xm;wJhvlu
awmh &ifbwfatmifw
h m rcHpm;
&ygbl;/ bmNzpfvdkYvJqdkawmh
tm½kHaMumawGrS r&SdawmhwJh t
wGuf/ 'DvdkyJ aoG;csdK qD;csdKa&m
*gonfawGrSmvnf; &ifbwf
atmif h w m rod & S d w wf / 'g
aMumifh Silent infarct /
&if b wf a tmif h w m&J U t
aMumif;&if;awGukd od&zdS Ykd ta&;
BuD;wJh av;csufuawmh- tcsdef b,favmufMum
Mum atmifhwmvJ
- b,fae&mrSm atmifhwm
vJ
- b,fvdkrsdK;atmifhwmvJ

bwfatmifh oufomaq; GTN
oHk;pGJ&if oufomoGm;r,f/
(2) pHEIef;rjynfh Angina
uawmh txufazmfjyxm;wJh
oHk;csufrSm 2 csufyJ&Sdw,f/
(3) ESvHk;aMumifhr[kwfwJh
&ifbwfemjcif;uawmh oH;k csuf
rS 1 csufavmufyJ&Sdr,f 'grS
r[kwf oHk;csufpvHk; rawGYyJ&Sd
wwfw,f/
Angina uawmh vIyf&Sm;rI
vky&f ifay:vmwwfw,f qdak y
r,fh em;em;aeaeaewJh tcsed rf mS
vnf; jzpfwwfw,f/ aemuf
tdyfae&muae Ekd;avmufwJh
txd &ifbwfatmifw
h wfw,f/
touf½SLoGif; ½SLxkwfwmeJY
Angina u odyfroufqdkif/
vQmatmufrSmiHk&wJhaq;
(Sublingual nitrates) oHk;ygu
rdepfydkif;twGif; oufomapyg
w,f/ 'gayr,fh 'Daq;[m vl
emtwG u f Placebo (aq;
aMumifh r[kwfbJ pdwfaMumifh
oufomapjcif;) jzpfaewwf
NyD; tpmrsdK>yef<uufom; t
aMumqGJrI Spasm awGudkvnf;
ouf o mapwwf w ,f / 'g
aMumifh 'Daq;iHck ikd ;f NyD; oufom
&if Angina qdkNyD; uHaouHr
raNymEdkif/
Acute coronary syndrome
(ESvHk;MuGufom; aoG;ravQmuf
awmh w J h a &m*g Myocardial
infarct 'grS r [k w f ES v H k ; ud k
axmufyaHh y;wJh aoG;vTwaf Mum
awGrmS aoG;cJyw
d q
f Ykd jcif; Unstable angina) uawmh em;aewJh
tcsdefrSm &ifbwfatmifhrSmyJ/
atmif h w m tawmf j yif ; xef
w,f/ atmifhwJhtcsdefumvu
(1) pHEIef;jynfh Angina wGif vnf;Mumw,f/ wjcm;quf
1/ &if b wf a tmif h r ,f ET,af ewJh vu©PmawGuawmh
(Angina vu©PmawG pHkr,f) armr,f? pdk;&drfylyefr,f? acR;
2/ vIyfvIyf&Sm;&Sm; vkyf&if xGufr,f? ysdKUtefr,f? rl;arh
jzpfjzpf? pdwfcHpm;rIawGaMumifh owdvpfr,f/
jzpfjzpf &ifbwfatmifhr,f
ESvHk;udk axmufyHhwJh aoG;
3/ tem;,l 'grSr[kwf &if aMumawG u sOf ; vd k Y &if b wf
- &if b wf a tmif h w mud k
jzpfyGm;apNyD; ydkqdk;apwJh tcsuf
awGu bmvJ pwmawGudk ar;
jref;avh &Sdygw,f/
Angina (&ifbwfatmif)h qdk
wJh pum;udk *&daq;ynm&Sif
Heberden u 1768 ckESpfrSm
pwifoHk;pGJcJhygw,f/ 'Dpum;
vHk;[m vufwifpum;vHk;yg/
olYt"dyÜm,fu usyfawmifhNcif;
odkYr[kwf n§pfxm;jcif; jzpfyg
w,f/ vlemrSm &ifbwfeYJ vnf
rsdKawGrSm usyfawmifhNyD; n§pf
xm;ovdk cHpm;&avh&Sdygw,f/
atmifhawmifhawmifheJY rtDrom
Nzpfaewwfw,f/ emw,fqw
kd hJ
pum;vH;k xuf rtDromjzpfwm
u vlemajymwmeJY eD;pyfyg
w,f/
Angina qdkwmu atmifh
awmifhawmifhNzpfwJh cHpm;csuf
rsKd ;/ &ifbwfb,fzufjcrf;xuf
tv,frSmatmifhwm ydkodom
w,f/ tv,frSmatmifhwJht
wGuf vlemuESvHk;aMumifh r
[kwfbl;qdkNyD; xifwwfw,f/
ar;½kd;awGrSm atmifhwwfw,f/
aemufvufarmif;awGyg atmifh
vmwwfw,f/ wa,mufeJYw
a,mufu atmifw
h yhJ rmP rwl
Edkifyg/
Angina [m vIyf&Sm;rI wck
ck vkyfaewkef;rSm ay:vmwwf
w,f/ em;vdkuf&if oufom
oGm;a&m/
Angina oHk;rsdK;&Sdw,f/
(1) pHEIef;jynfh Angina
(2) pHEIef;rjynfh Angina
(3) ESvHk;aMumifh r[kwfwJh
&ifbwfemNcif;

NIGHTINGALE 9

use;f rma&;*sme,f

atmif h w muawmh Stable
angina /
em&D0uftxuf atmifrh ,f
qd&k if Stable angina xufpm&if
acute coronary syndrome jzpfzdkY
rsm;w,f/ aeYpOf&ufqufqdk
ovdk atmifhae&ifawmh ESpfrsdK;
pvHk;rNzpfEdkif/
&ifbwfatmifhwJh wjcm;t
aMumif;&if;awGu rsm;w,f/
touf ½ S L oG i f ; vd k u f & if
atmifhwmydkqdk;&if tqkwft
arS;yg;a&mifvdkY jzpfwm/ Adkif;
&yfpfydk;awG0ifwmu yxr t
qkwftarS;yg;a&mif/ aemuf
bufwD;&D;,m;aMumifh tqkwf
a&miferdk;eD;,m;jzpfNyD; tqkwf
tarS;yg;a&mifwwfw,f/ t
qkwftarS;yg;a&mifvdkY atmifh
wmu vIyv
f yI &f mS ;&Sm;vkyw
f meJY
rqdkif/ atmifhvm&if rwfrwf
xdkif 'grSr[kwf udk,fcE´mudk
ta&SUzufuikd ;f vdu
k w
f meJY ouf
omapw,f/ 'Dvkd atmifw
h mu
a&mif&rf;aewJh tqkwftarS;
yg;awGeJY ESvHk;ywfywfvnf t
arS;awGeJY yGwfwdkufvdkYyg/
&ifbwfatmifh aemufxyf
taMumif;&if;wcku &ifbwfeH
&HawGemwm/ wae&mwnf;rSm
em? pl;atmifh? touf½SLoGif;
½SLxkwf&if atmifh? vufarmif;
vIyf&Sm;&if atmifh? puúefYenf;
enf;yJMumr,f/
vnfyif;t½kd;ESifhtay:ydkif;
ausm½kd;awG a&m*gjzpf&if vIyf
&Sm;rIaMumifhemwwfw,f/ t
aemufzufrSm t&ifemNyD; &if
bwfta&SUydkif; a&mufvmwwf
w,f/
aoG;vTwfaMumrBuD;azmif;
MuGut
JG ufa&m*gqd&k ifawmh &if
bwfatmifhwm tawmfqdk;&Gm;
ygw,f/ pjzpfumpqdk&if tem
qHk;NzpfNyD; ausmbufawGyg ysHU
ESHY emusifygw,f/ emusifyHk
&,f? jrefjrefqefqef jzpfymG ;vm
wm&,f? ausmzufatmifhwm

awGu 'Da&m*g&JUxl;Ncm;csuf 3
rsKd ;/ aoG;vTwaf MumrBuD;tay:
ydik ;f rSmNzpf&if ta&SUzuf&ifbwf
awGatmifhr,f/ atmufydkif;
aoG;vTwfaMumrBuD;rSm Nzpf&if
vufjyif½kd;ae&mawGrSmemr,f/
aoG;wdk;a&m*gonfawGeJY t
jcm; wGufqufwpf½SL;a&m*g
onfawGrSm 'Da&m*gjzpfEdkifajc
rsm;w,f/
tqkwfaoG;aMumtwGif;
aoG;qDvHk;rsm;Nzpfvmygu &if
bwfcsufNcif;atmifhvmr,f?
owdvpfvJusr,f? armr,f?
jymESrf;r,f/
&ifacgif;twGi;f avatmif;
a&m*gNzpfvmygu emusifNyD;
tvGeftrif;armyef;r,f? pl;&S
jyif;jywJh emusifrINzpfNyD; &if
bwfae&mtwdtusrSm jzpfymG ;
w,f/
tpmrsdK>yefrS tpmtdrft
csOf&nf NyefwufNcif;a&m*g
aMumifv
h nf; &ifbwfatmifw
h m
eJYwlwJh emusifrI NzpfyGm;w,f/
tpmpm;NyD;aemuf 'grSr[kwf
a&ylawG a&at;awG aomufNyD;
&ifbwfatmifhwmudkvnf; ES
vHk; aoG;ravQmufawmhwJha&m
*geJY rSm;wwfw,f/ 'Da&m*grSm
tpmrsdK&cufwmawG &SdwmeJY
cGJNcm;Edkifygw,f/
onf;ajctdwfa&mif&rf;&if
vnf; 'DvdkawG jzpfwwfyg
w,f/ nmzufAdkuftay:ydkif;
emusifrI&SdwmyJ uGmwmyg/
wjcm; tjzpf e nf ; wJ h t
aMumif ; &if ; awG v nf ; &S d y g

[m

;

a

q

w,f/
&ifbwfatmifhvlemvm&if
q&m0efeJYusef;rma&;vkyfom;
awG ar;jref;pHpk rf;&r,fh ar;cGe;f
rsm;udk wifNy&if; aqmif;yg;udk
tqHk;owfygw,f/
1/ tck a tmif h a ewmu
b,fvdkatmifhwmvJ/ atmifh
awmifah wmif/h zdxm;ovdk usyf
awmifhawmifhvm;/
2/ b,ftcsdefu pNzpfwm
vJ/ tvdkvdkae&if;Nzpfvmwm
vm;/ vIyf&Sm;aewJhtcsdefrSm
jzpfwmvm;/ tpmpm;NyD; avh
usifhcef; vkyfrd&if ydkqdk;vmo
vm;/
3/ b,favmufMumMum
atmifhwmvJ/
4/ b,fae&mrSmatmifhwm
vJ/
5/ 'Dvdkatmifhvm&if vIyf
&Sm;rIawGudk &yfypfvdkuf&o
vm;/
6/ vIy&f mS ;rIawGukd &yfvu
kd f
wJhtcsdefrSm oufomoGm;o
vm;/
7/ em;ae&if odkYr[kwf
enf;enf;vIyfwmeJY atmifhwm
vm;/
'Dtcsufuawmh ESvHk;udk
axmufyahH y;wJh aoG;vTwaf Mum
awGrSm aoG;cJydwfqdkYNcif; (Unstable angina) qdkwJh ta&;ay:
odkYr[kwf tEÅ&m,f&SdwJh jy
óemudk od&SdapzdkY Nzpfygw,f/
8/ t&ifu atmifhzl;vm;/
'DvdkrsdK;atmifhwmvm;/
a'guw
f mwifah ZmfO;D

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f v
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vlemu
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10 NIGHTINGALE use;f rma&;*sme,f

trSw-f 39? 'DZifbmv? 2013-ckEpS f

aoG;
(1)
usaemfhtaru tNrJqHk;r
w,f/
aeYwdkif;rSm ukodkvf? Opöm?
ynm wckc&k atmif pkaqmif;yg
wJh/
[kwfw,f/ usaemf pdwf
npf&if tNrJvkyfjzpfwmwck&Sd
w,f/ tJ'gbmvJqdk aoG;oGm;
vSLvdkufwmbJ/ b,fawmhao
rSef;rodwJh 'Dudk,fcE¨mxJu
aoG;eJYvlwa,muf &Sifoefyg
apqdkwJh pdwfeJYyg/
tck Ed0k ifbm (6) &ufaeYrmS
usaemfhwlrav; arG;aeY&,f/
usaemf c spf & wJ h wpH k w &mt
wGuf&,f/ 'DaeY aoG;vSLbPf
udk a&mufcJhw,f/
(2) twdwf
usaemfyxrOD;qH;k aoG;vSL
jzpfwJhumvuawmh awmfawmf
MumcJhygNyD/ usaemfpdwfxif
aq;ausmif;om;b0jzpfr,f
xifw,f/
usaemfhtcspfqHk;oli,fcsif;
a'gufwmvif;atmif? olYtudk
t&if ; usaemf w d k Y eJ Y twl w l
abmvHk;upm;azmf upm;zuf
udkNidrf; ½kwfw&uf vluD;rD;
,m;jzpfwJhtcsdefaygh/
udkvif;u bDaoG;vdkw,f
qdkawmh raMumufr&GHU vSLjzpfcJh
w,f/

tJ ' D r S m oH a 0*vnf ; &
w,f/ twlwl abmvHk;uef?
pm;aomuf? vlaumif;b0u
ae csufcsif;aooGm;wwfyg
vm;qdkwJhtodudk&vdkufw,f/
tckxdvnf; udkNidrf;&JU cyfat;
at;rsufESmudk owd&ygw,f/

aZmf0if;xGwf

aoG;vSLjcif;qdak omtvkyu
f kd pGJ
vmygonf/
usaemfcspfaom q&mBuD;
rsm;jzpfaom orm;awmfBuD;
q&mae0if;? t½kd;txl;ukBuD;
q&mBuD;pdk;vSaemifwdkY ajym
ovdk aZmf0if;xGwaf oG;oGi;f &if
tdkaubJ? arYaq;ay;p&mrvdk
(3)
bl;qdak om aemufajymifaom p
Aef;armf? 2007
um;rsm;ESifh aoG;vSLjcif;udk pGJ
xdkxdktcsdef Aef;armfc½kdif vmonfh 'Dq&m0ef/
aq;½HkBuD;onf aoG;vSL&Sif&Sm;
yg;NyD; tvGefac:&cufygonf/
(4)
aoG ; vd k o nf h v l e mrsm; 'k u ©
2009/
a&mufonfudk 'Dta&;ay: wm
vHk;cif;? zm;uefY wdkufe,f
0efusq&m0efonf awmfawmf vufaxmuf q&m0efb0wGif
pdwfqif;&Jygonf/ rajymvdk vnf; 'Dq&m0efonf aoG;vSL
aom raumif;w&m;rsm;vnf; jcif;udkpGJonfh tusifhuaysmuf
rsm;pGm&Sdonf/
roGm;/
xk d x d k t csd e f pd w f t vG e f
vlemursm;? cGJpdwfwmu
qwf? a'gotvGefBuD;? rSef rsm;/ q&m0efESpfa,mufwnf;
w,f x if & if bmrS * ½k r pd k u f jzpfaomaMumifh NrdKUe,fq&m0ef
aom 'Doaumifhom;twGuf usaemfh tcspfqHk; q&mBuD;
aeYwdkif; tukodkvfrsm;wJhum a'gufwmausmfxGef;OD;? wdkuf
vrsm;jzpfygonf/ xdktcsdef & e,f q&m0efa'gufwmrsKd;vGif?
aomvpmonfvnf; ravmuf wdkufe,fq&m0ef a'gufwm
icJhyg/
atmifudkudk/ olwdkY wm;onfh
xdkxdk pdwfnpftukodkvf Mum;u ud k , f w d k i f a oG ; vS L ?
umvrsm;wGif 'Daumifonf ig udk,fwdkifcGJ? udk,fwdkifuk vkyfcJh
bmvSLEdkifvJMunfhvdkufaomt ygonf/ iSufzsm;aygaom a'
cg rdrdudk,fxJrSaoG;udk oGm; o? arG;vlem? zsuv
f el m? xdcu
kd f
jrifygonf/ xdYk aMumifh xdt
k csed f 'Pf&maygaoma'oESifh aoG;
umvrsm;wGif awmufavQmuf vSLjcif;udpk aJG eonfh q&m0efwYkd
av;vwBudrf aoG;vSLjzpf&mrS tH0ifcGifusjzpfcJhygonf/
usaemfah oG;ESihf &Sio
f efomG ;
aom vlemrsm;udkMunfhNyD; yDwd
jzpfcJh&aom umvrsm;jzpfyg
onf/

wm0efcHumvwGifvnf; pdwf
npfp&maygif;rsm;pGm qHpk nf;NyD;
usef;rma&;uus/ ydkufqHur
avmuf/
xdkxdktcsdefwGifvnf; jrpf
BuD;em;aq;½HkBuD;wGif ppfAHk;
aygufvlemrsm;tm; oGm;aoG;
vSLjcif;jyKcJhygonf/
tJ'gaemufqHk;ygbJ/ 211-12/ aemufq;kH qdw
k t
hJ wkid ;f
usef;rma&;usvmwmeJY rvSL
jzpfbl;/

(6)
Opöm? ynm? ukodkvfwckck
&&rnfqdkwJhpum;twdkif; 'DaeY
aoG;vSLudv
k LS r,fvYkd q;kH jzwfyg
w,f/
[efeD ac: cspfwlrav;
arG ; aeY & ,f / ud k , f u H q d k ; ae
wm&,f/ tar&dum;vdkEdkifiHrSm
awmif 2 puúeYf wa,muf vdak e
wJhaoG;twGuf aoG;vSL&Sifrsm;
vdt
k yfaew,fqw
kd m&,f/ rdcif
awG aoG;vGefaoqHk;wwfwm
awG ud,
k af wGYBuHKzl;wm&,f/ NyD;
wpHkw&mtwGuf&,f/
'DaeY &efukef aoG;a&m*gXm
eodkYa&mufonf/ oyf&yfoefY
&Sif;vGef;aomaq;½HkBuD;/ aoG;
vSLcsifvdkYygqdkawmY tm;vHk;ysK
ysLiSmiSmESihf emrnfar;NyD; a'guf
wmqdkwmeJY t&ifaoG;vSLzl;
vm;wJh/
[kwfuJh/ 11 BudrfvSLzl;yg
w,fvdkYqdkawmh/
emrnfrSwf/
q&mb,ftzGUJ tpnf;uvJ
qdkawmh/
usaemfu &,fNyD; b,ftzGYJ
(5)
tpnf;urS r[kwfao;ygbl;?
csDazGq&m0efBuD;b0/
csaD zGNrdKUa&muf jynfwiG ;f ppf wudk,fawmfygAsmqdkawmh &,f
umv 2012 'ku©onfpcef; ygonf/

[k w f w ,f A s/ t0if 0 u
wnf;u tzGJYtpnf;vdkufpkNyD;
aoG;vmvSLwmawGawGY&w,f/
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ckbJ/
vmvS L wJ h t xJ r S m vnf ;
rdef;uav;i,fi,fav;awG?
vli,fav;awGawGYw,f/
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MunfEl;w,fAsm/ wu,fyg/
NyD;wmeJY/
aoG;vSL&Sifwdkif; jznfh&wJh
pm&Gufay:rSmjznfh/ aoG;aygif
wdkif;/ aoG;vSL&SifvufaAGudk
uGefjyLwmxJxnfh/ oyf&yf
oefY&Sif;vGef;aom aoG;vSLcef;
xJrSm q&mrrsm;u aoG;wvHk;
xkwfay;w,f/
'Dae&mrSm pdwfraumif;
jzpfp&muawmY oyf&yfvGef;
aom qdzk mukwiftrsm;BuD;ay:
rSm emrnfwck/
usaemfwdkY&JU cspfvSpGmaom
cGJpdwftxl;ukq&m0efBuD;em
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vSLtwef;&ufa&maom q&m
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awG *,ufxcH&wJh q&mBuD;/
q&mBuD;a&/ q&mBuD;udk
wdkufcdkufcJYaom vlawG? vl
awG/ ud,
k Yf tukov
kd u
f kd ud,
k rf
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104
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110
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125
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123
127
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