Medicine

MEDICINE

2 Jaundice-5.1

Jaundice- Gi cÖKvi †iv`My‡jv wK wK?

RwÛm mvaviYZ wZb ai‡Yi n‡q _v‡K| †hgb-

 

1.         Hemolytic Jaundice (‡n‡gvjvBwUK RwÛm)

AwZwi³ †jvwn` KwYKv fv½‡bi Rb¨ †h ai‡bi RwÛm †ivM n‡q _v‡K, Zv‡K †n‡gvjvBwUK RwÛm e‡j|

 

2.         Hepatocellular Jaundice (†ncv‡Uv‡mjyjvi RwÛm)

wjfv‡ii †Kvl aŸs‡mi d‡j †h ai‡bi RwÛm †ivM n‡q _v‡K, Zv‡K †ncv‡Uv‡mjyjvi RwÛm e‡j| (mvaviYZ g`¨cvb, †dbwmwWj, wKQz Jlya ej‡Z c¨vivwmUvgj, wUwe †iv‡Mi Jlya) (wicvgwcwmb, AvB‡mvwbqvwRW) Ges e¨_v Dckg Kvix Jlya cÖ‡qv‡Mi Kvi‡bI GB ai‡bi RwÛm n‡q _v‡K|

 

3.         Obstuvtibve Jaundice (AevmUªvKwUf RwÛm)

wcË _wj ev wcË bvjx‡Z †Kvb cv_i ev wUDgvi n‡j wcËim PjvP‡j evav m„wó nq, hv‡K AevmUªvKwUf RwÛm e‡j|

 

Jaundice-‡iv‡Mi KviY j¶Y¸wj wK wK?

‡ncv‡Uv‡mjyjvi RwÛ‡mi j¶Yt

wjfvi e„w× n‡Z cv‡i, Aí Aí R¡i, kixi e¨_v, gv_v e¨_v, kxZkxZ fve Ges ¶zavg›`v Pj‡Z _vK‡e 1 †_‡K 2 mßvn ch©š—| Gi c‡iB ïi~ nq ewg ewg fve A_ev ewg Kiv, AiƒwP Ges cvZjv cvqLvqbv BZ¨vw` j¶Y

†`Lv w`‡e| Zvi ci †h mKj j¶Y cÖKvk cvq Zv n‡jv cÖmªv‡ei is njy` Ges Mvp †`Lv‡e| ‡Pv‡Li gwbi Dc‡ii mv`v Ask ev evjevi KbRv¯‹UvBfv (Bulbar Conjunctiva) Ges nv‡Zi Zvjy I Pvgov njy` is avib Ki‡e|

 

‡n‡gvjvBwUK RwÛ‡mi j¶Yt

†ek eo n‡e, cÖmªve Ges cvqLvbvi is †ek njy` eY© †`Lv‡e|

 

AevmUªvKwUf RwÛ‡mi j¶Yt

cÖmªv‡ei is jvj Ges cvqLvbvi is d¨vKv‡k †`Lv‡e, kix†i wewfbœ As‡k PzjKvwb n‡Z cv‡i, Lv`¨ †L‡Z Ai~wP jvM‡e Ges kix‡ii IRb Kg‡Z _vK‡e| wcËbvjx‡Z cÖ`vn n‡q R¡i, Kvucybx I e¨_v n‡Z cv‡i|

 

Investigation (j¨ve cix¶v)t

1.  Serum Bilirubin Test

djvdjt  ¯^vfvwe‡Ki †P‡q †ekx n‡e|

(Normal Value: 0.8 to 1 mg%)

2.   HBsAg Test (Hepatitis-B surface antigen)

djvdjt Positive

3.   SGPT Test (Serum Glutamic Pyruvic Transaminase)

djvdjt ¯^vfvwe‡Ki †P‡q †ekx n‡e|

(Normal Value : 9 to 32 I.U)

4.  SGOT Test (Serun Glutamic Oxaloaceic Transaminase)

djvdjt ¯^vfvwe‡Ki †P‡q †ekx n‡e|

(Normal Value : 10 to 40 I.U)

 

 

 

 

Jaundice-‡iv‡Mi wPwKrmv wK ?

1.       ‡ivMx †`‡L, cÖmªve I i³ cix¶v Ges U1trasonogram of Hepatobi1iary  cix¶v K‡i wjfv‡ii Ae¯’v I Rw †mi KviY †R‡b wPwKrmv Kiv †kªq |

2.      ‡ivMx‡K wekªv‡g _vKv, weï× cvwb cvb Kiv Ges LvwU me ai‡bi Lvevi LvIqvi civgk© w`‡Z n‡e |

3.      Av‡Li im Ges êy‡Kv‡Ri mieZ A‡b†K LvIqvi Rb¨ civgk© w`‡q _v‡Kb| wVK bq KviY GB ai‡bi Lvevi †cU duvc‡Z cv‡I Ges ewg fve evov‡Z cv‡i |

4.      Pwe© RvZxq Lvev‡ii cwigvb ekx n‡j e`nRg n‡Z c‡i |

5.      AwfÁ Wv³v‡ii civgk© e¨ZxZ RwÛm †ivMx‡K hLb ZLb Jla †`Iqv wVK bq| KviY AwaKvsk Jla wjfv‡i wecvK wµqv m¤úbœ nq| we‡kl K‡I Ny‡gi Jla Ges c¨vivwmUvgj RvZxq Hla bv †`Iqv †kªq|

1. Dexaqua 1000ml Saline- Gi mv‡_ 25% Glucose Gi 4-5wU fv‡qj wg‡k‡q wkiv c‡_ 5-7  w`b w`‡Z n‡e|

2. Inj. Fidaplsx gvsm‡ckx A_ev wkic‡_ 7-8 w`b †`Iqv †h‡Z cv‡i|

3. R¡i _vK‡e Amoxicillin 500 mg, every 6 hourly for 7 days. cÖ‡qvR‡b AwfÁ Wv³v‡ii civgk©©© wb‡Z n‡e|

4. Cap. Spi-C 500mg (Spirulina) CMSS 2wU K‡i K¨vcmyj w`b 2-3 evi Lvevi c~‡e©|

Serious patients should in no circumstance be treated under self custody.

(†Kvb g‡ZB RwUj ‡ivMx wb‡Ri Awa‡b wPwKrmv Kiv wVK bq)

 

Hepatitis-5.2

Hepatitis-ej‡Z wK eySvq ?

Gi evsjv A_© wjfv‡ii cÖ`vn| wjf†ii ¯^vfvweK Kvh©µg n«vm †c‡q cÖ`vn n‡q _v‡K| cwiev‡i GKRb Avµvš— n‡j Kg‡ekx mK‡j Avµvš— n‡q _v‡K| mwVK mgq Ges mwVK fv‡e wPwKrmv Ki‡j †ivMx Av‡ivM¨ jvf Ki‡Z cv‡i| wPwKrmv µzwU n‡j wjfv‡ii †Kvl¸‡jv aŸsm n‡Z _v‡K Ges wjfv‡ii Kvh©kxjZv m¤úyY©iƒ‡c n«vm †c‡q †ivMx wbwðZ g„Zy¨i w`‡K AMªmi nq|

Hepatitis-Gi KviY wK ?

K) `xN© w`b a‡i Avgvkq fywM‡j|

L) g¨v‡jwiqv, UvBd‡qW,wbD‡gvwbqv BZ¨vw` R¡‡i `xN©w`b|

M) `~wlZ cvwb,AwZwi³ g`¨cvb, aybcvb, AwZwi³ Pwe© RvZxq Lv`¨ MÖnY BZ¨vw`|

N) fvBivm Ges e¨vK‡Uvwiqv RxevYy KZ©„K cÖ`vn|

Hepatitis-Gi j¶Y wK ?

K) Lv`¨ MÖnY AiƒwP|

L) ewg ewg fve Ges ewg Ki‡e|

M) ivBU nvB‡cvKwÛªqvK wiR‡b e¨_v Ki‡e|

N) †cU dvucv _vK‡e|

O) †KvóKvwVb¨ †`Lv w`‡e|

P) wjfvi e„w× cv‡e|

Q) †Pv‡Li gwb Dc‡ii mv`v Ask (Bulbar Conjunctiva) Ges nv‡Zi Zvjy mnKv‡i mg¯— njy` eY© aviY Ki‡e|

R) cÖmªv‡ei is njy` eY© aviY Ki‡Z cv‡i|

S) 102 of-104 of R¡I ‡`Lv w`‡Z cv‡i|

Hepatitis- Gi RwUj DcmM© ¸‡jv wK wK ?

K) Liver Abcess n‡Z cv‡i|

L) Cirrhosis of Liver n‡Z cv‡i|

M) Liver Cancer n‡Z cv‡i|

Investigation (j¨ve  cix¶v) t

All investigations to de done as for jaundice (stated above)

Hepatitis- Gi wPwKrmv

1.  5% Dexaqua 1000ml Saline- Gi mv‡_ 25% †W·‡Uªv‡Ri †QvU 4-6 wU †evZj wgwk‡q cÖwZ wgwb‡U 40-60 †dvuUv wkivq cÖ‡qvM Kiv hvq|

2. Inj. Fidaplex 2ml (Vitamin-B Complex) 1wU K‡i G¨v¤úyj ˆ`wbK 1-2 evi gvsm‡ckx‡Z A_ev wkivc‡_ e¨envi Ki‡e 5-7 w`b|

3. Syp. Avolac (Lactulos- j¨vKUz‡jvR) (‡KvôKvwVb¨ _vK‡e)

gvGvt cÖvß eq¯‹‡`i Rb¨ 15 wgwjwjUvi w`b 2 evi|

Acªvß eq¯‹‡`i Rb¨ 10 wgwjwjUvi w`b 2 evi|

1-5ermi wkï‡`i Rb¨ 5 wgwjwjUvi w`b 2 evi|

1 ermi wb‡P wkï‡`i Rb¨ 2.5 wgwjwjUvi w`b 2 evi|

4.  Cap. Fimoxy 500mg (Amoxicillin) (R¡i _vK‡j)

500mg every 6 hourly for 7-14 days.

5.   Cap. Spi-C 500mg (Spirulina) CMSS

2wU K‡i K¨vcmyj w`b 2-3 evi Lvevi c~‡e© cÖ‡qvR‡b AwfÁ Wv³v‡ii civgk© wb‡Z n‡e|

 

Hypertension-6.1

 

Hypertension ej‡Z wK eySvq ?

Hypertension ej‡Z D”P i³Pv‡c‡K eySvq| cÖvß eq¯‹ †jv‡Ki ¯^vfvweK i³ Pv‡ci †P‡q hw` Diastolic Pressure 100mmHg  Ges Systolic Pressure 130-140mmHg  Gi Dc‡i AbeiZ Pj‡Z _v‡K, ZLb Zv‡K D”Pi³ Pvc ejv nq| eqm evovi mv‡_ mv‡_ i³PvcI e„w× cvq| †Kvb †Kvb mqg e¨_v, gv_v †Nvov, †Pv‡L Svcmv †`Lv Ges ey‡K aoco Kiv I Awb`ªv BZ¨vw` Amyweav n‡q _v‡K| hw` i‡³i Pvc AZ¨vwaK †e‡o hvq Zvn‡j gv‡qvKvwW©qvj Bb‡d«vKkb (nvU© GUvK), gw¯—‡Ki i³¶iY (†÷ªvK), AÜZ¡, wKWbx †dBwjD‡ ch©š— n‡Z cv‡i|

 

Hypertension Gi KviY wK?

 

v   eskMZ Kvi‡Y D”P i³Pvc n‡Z cv‡i|

v   AZ¨vwaK `ywðšÍvi Kvi‡YI D”P i³Pvc n‡Z cv‡i|

v   AwZwi³ aygcvb I g`¨cv‡bi Kvi‡YI B”P i³Pvc n‡Z cv‡i|

v   AwbqgZvwš¿K R¤§wbqš¿b ewo ev Bb‡RKkb e¨envi Ki‡j|

v   AwZwi³ jeY Ges Pwe© RvZxq Lv`ª MÖnY Kwi‡j|

v   ‡c‡U AwZwi³ M¨vm Ges GwmW †ewk Rwg‡j|

v   kix‡i IRb †ekx e„w× †c‡j|

v   n`wcÛ,dzmdzm Ges wKbx‡Z †Kvb RwUjZv †`Lv w`‡j D”P i³Pvc n‡Z cv‡i|

Hypertension Gi j¶Y¸‡jv wK ?

v   gv‡S gv‡S gv_v e¨_v Ki‡e Ges e¨_v gv_vi wcP‡bi As‡k Ki‡e|

v   gv_v Nyiv‡e Ges †Pv‡L Svcmv †`Lv‡e|

v   eyK aido Ki‡e Ges K¬vwš— ‡`Lv‡e|

v   ivwÎKvwjb cÖwikª‡g K¬vš— n‡q co‡e|

v   cvwbi Z…òv †e‡o hv‡e Gs kixi Nvgv‡Z _vK‡e|

Treatment- wPwKrmv t

 

¨                  kix‡i IRb Kgv‡Z n‡e

¨                  mxgve× jeY Lv‡e

¨                  Pv wmMv‡iU Kwc cwinvi Ki‡Z n‡e

¨                  ‡g`hy³ Lv`¨ cwinvi Ki‡Z n‡e |

¨                  ]wbqwgZ e¨qvg  kixi MVb wVK ivL‡e Ges i³Pvc Kgv‡e |

¨                  gv‡S gv‡S i³Pvc gvc‡Z n‡e |

¨                  Tab. Sedil 5 mg (Diazepam)

one tablet once daily at bed time

(idf there is anxiety)

 

b. (Mild Hypertention)

1.Tab . Tenoloc 50/100 mg ( Atinolol)

(Betabloca- n ‡eUvej Kvi  RvZxq Jla) ‰`wbK 50 wg. MÖv Gi GKwU K‡i †Ue‡jU  Pj‡e |

c. (Moderate Hypertension)

1. Tab .Amlocard Plus ( Atinolol 50 mg + Amlodipin 5 mg) Drug

2. Tab. Laxis 40 mg ( Frusemid) (ZxeªZvi   e¨envi Kiv †h‡Z cv‡i  ) cªwZw`b   mKvj ‡ejv 1 wU K‡i †Ue‡jU 5 †_‡K 10 w`b |

3. cÖ‡qvR‡b AwfÁ Wv³v‡ii civg‡k© mv‡_  Betabloca  uRvZxq &Jla  †`Iqv  †h‡Z cv‡i|

d.(Severe Hypertension)

Referred to Cardiologist or Hospital .

4. Zxeª `k~j nVvr  ey‡Ki evg cv‡k e¨_v Ki‡Z jvM‡j

Tab.Angised 0.5mg (NITROGLYCERIN )

or  Tab. Nitromiint Rtd 2.6mg

‡h †Kvb 1 wU †Ue‡jU wRnŸvi wb‡P 1 †_‡K 2evi e

or Spray Nitrocontin/Spray Nitromint

1 ‡_‡K 2 evi wRnŸi  wb‡P †¯úª K‡i gyL eÜ K‡i ivL‡Z n‡e v

wb¥wjwLZ Kvi‡Y  D”P i³Pvc †`Lv  w`‡j Aek¨B AwfÁ wPwKrm‡Ki civgk© wb‡Z n‡e A_ev iyMx‡K  `yªZ nvmcvZv‡j cvVv‡Z n‡e |

*Hypertention in  Pregnancy

* Hypertention  of heart failure

* Hypertention  after stroke

* Hypertention   and Renal failure

* Hypertention  with Diabetes

Investigation:

Serum Creatinine  Test

Blood Creatinine

Urine for Albumin Test                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    

E . C.G (Electro Cardio -graphy)

 

Serum Cholesterol পরীক্ষা কেন করা হয় ?

স্বাভাবিক অবস্থায় প্রতি ১০০ মিলি রক্ত রসে (Serum) ১২০ থেকে ১২৫ মিলিগ্রাম Cholesterol    থাকে।  অথাৎ সিরাম কোলেস্টরল  এর   Normal Value 120 to 125mg% কিন্তু উচ্চরক্ত চাপ রুগীদের ক্ষেত্রে এর চেড়ে বেশি ফলাফল আসবে ।

Blood Creatinine –

Blood Creatinine- হচ্ছে প্রোটনের  বজ পদাথ  যাহা লিভারে সৃষ্টি হয়  এবং স্বাভাবিক মাত্রার  অতিরিক্ত রক্তের  এই  বজনিয়  পদাথ  প্রস্রাবের সাথে শরীর  থেকে বের হয়ে আসে ।কিন্তু  উচ্চরক্ত চাপ  রুগীদের ক্ষেত্রে এর চেডে বেশি  () ফলাফল আসবে ।

 

Albumin-এলবুমিন পরীক্ষা কেন করা হয় ?

এর অ_© n‡jv †cÖvwUb hvnv cÖmªv‡e (NiL\l) _v‡Kmv| i‡³i mv‡_ _v‡K Ges Gjeywgb i³Pvc wbqš¿Y iv‡L| D”Pi³ Pvc i“Mx‡`i †¶‡Î Albumin cix¶vq djvdj Avm‡e|

 D”P i³Pvc Gi d‡j  †h mKj mgm¨v n‡q _v‡K...........

 

 

 

Pneumonia

 

Pneumonia ‡iv‡Mi KviY wK?

k¦vm Z‡š¿i Aew¯’Z dzmdz‡m †óªc‡UvK°vm wb‡gvwb, wn‡gvwdjvm Bbd¬z‡qÄv RwbZ gvB‡Kvc­vRgv wbD‡gvwb, B, †KvjvB BZ¨vw` Rxevby `xN© mgq a‡i Ae¯’vb K‡i dzmdz‡m cÖ`vn m„wó K‡i, hv‡K dzmdz‡m Pneumonia- cÖ`vn K‡i|

1.                   Broncho- Pneumonia dzmdzm I k¦vm bvjxi cÖavb Ask hLb cÖ`vn nq, ZLb Zv‡K Broncho- Pneumonia e‡j|

2.                  Lobar- Pneumonia dzmdz‡mi wfZ‡I Aew¯’Z evq~ †Kv‡m Hky cÖ`vn nq, ZLb Zv‡K  Lobar- Pneumonia  e‡j|

 

 

Pneumonia †iv‡Mi j¶¸‡jv wK wK?

 

1. Broncho- Pneumonia

k¦vmbvjx‡Z cÖ`vn †`Lv w`‡e Ges Nb Nb k¦vm-cÖk¦vm eB‡Z _vK‡e R¡i 101-202 wWMÖx e„w× †c‡Z cv‡I bvoxi M‡Z e„w× †c‡q cÖwZ wgwb‡U 96 †_‡K 112 evi n‡Z cv‡i k¦vm-cÖk¦v‡mi MIZ cÖwZ wgwbwU e„w× c‡q 24 b‡_‡K 30 evi n‡Z cv‡i R¡i nVvr bv n‡q ax‡i ax‡i e„w× cv‡e Ges ax‡i ax‡i Kg‡Z _vK‡e R¡i evovi m‡Ä bvoxi MwZ `ª“Z e„wa cv‡e ïK‡bv Kvwk Ges gv‡S gv‡S mv`v cÖ‡Ri gZ Kc n‡Z cv‡i|
2. Lobar- Pneumonia

nVvr K¤ú w`‡q R¡i G‡mB 204-105 wWMÖx R¡i DV‡Z cv‡i 120-140 evi bvoxi MwZ e„w× ‡c‡q Lye `ª“Z P‡j cÖwZ wgwb‡U k¦vm-cÖk¦vm 30-40 evi n‡Z cv‡i ey‡K cÖej e¨_v, k¦vmKó Ges Nb Nb ïK‡bv Kvwk †`Lv w`‡q _v‡K cÖmªve K‡g hvq Lb Nvp njy` e‡b©i cÖmªve n‡Z cv‡i †`‡ni AMÖfvK ¸wj mvqv‡bvwmm (Cyanosis)  ev bxj e‡Y©i n‡Z cv‡i|

Teatment of Pnmeumonia.

 

  1. Rest in bed.
  2. O2 ­­­­­(Oxygen) inhalation for all hypoxaemic patients.
  3. Mild analgesic such as paracetamol.
  4. Tab. Levocin  ­­­­­(Livofloxacillin) 250/500mg

Abult: 500mg tablet daily for 14 days.

Vhild: 250mg tablet daily for 14 days.

 

Or Tab. Fimaoxyclav ­­­­­(Co-Amoxiclav 375/625mg or 1gm)

­­­­­(Amoxyclillin trhydrate 250mg + Clavulanic acjd 125mg as potassium salt) Dosage: By mouth, adults and childrenover 12 years, the usual dose is co-amoxiclav 375mg 8 hourly taken with or before meals.

For swvere infections, Co-amoxiclav 625mg 8 Hourly or 1mg 12 hourly before meals.

For children below 12 years 5ml to 10ml suspendion 8 hourly according to age and severity of infection.

By injection, adult, co-amoxiclav a.2mg 8 / 12 hourly by i.v injection over 3-4 minutes or slowly by i.v infsion.

Or Tab. Zimax 250/500mg ­­­­­(Azithromycin) Square

Dosage: 500mg tablet once daily for 5-7 days.

Or Cap. Dalacin 300mg ­­­­­(Chindamycin)

Adult dosage: The usual dose 300mg every 6 hourly for 10 days.

 

  1. Hospitalization-when there is more severe infection.

 

Diabetes

 

Diabetes- ej‡Z wK eySvq?

 

Diabetes- Wvqv‡ewUm Gi evsjv A_© gay‡gn ev eûg~Î| GKRb my¯’ †jvK hLb wKQz Lvevi Lvq, †m Lvevi kvixwiK cÖwµqvi d‡j kK©iv (Glucose) ev M­y‡Kv‡R cwiYZ n‡q i‡³ P‡j Av‡m| ZLb c¨vbwµqvm ev AMœvkq n‡Z Bbmywjb bvgK ni‡gvb RvZxq im wbtmiY n‡q i³ †_‡K AwZwi³ M­y‡KvR †ei K‡i wb‡q kix‡ii Kv‡R jvMv‡Z mvnvh¨ K‡i| d‡j i‡³ M­y‡Kv‡Ri gvÎv me mgqB GKwU mnbkxj gvÎvi g‡a¨ _v‡K|

GB wbtm„Z Bbmywj‡bi gvÎv Kg ev †ekx n‡j Kv‡e©vnvB‡W©U, †cÖvwUb, d¨vU (cvwb I B‡jK‡Uªvjv‡Ui) Lv‡`¨I wecvK Kv‡R cÖev c‡o| GB cÖfve RwbZ RwUjZvi d‡j eûg~Î †iv‡Mi m„wó nq| GB eûg~·K Diabetes ev gay‡gn ev eûg~Î e‡j

Diabetes- Gi †kªbx wefvM¸‡jv wK wK?

Diabetes-Gi KviY Ges j¶Y Abyhvqx wbgœwjwLZfv‡e †kªbxweb¨vm Kiv nq|

Type 1:Bbmywjb wbf©ikxj Wvqv‡ewUm wgwjUvm (Insulin- Dependent Diabetes Mellitus- IDDM)

UvBc-1 Wvqv‡ewU‡mi kix‡ii Bbmywjb ‰Zix Kivi ¶gZv G‡Kev‡I bó n‡q  hvq| hvi d‡j i“Mxi M­y‡Kv‡Ri cwigvY wba©vwiZ cwigvb †_‡K A‡bK A‡bK †e‡o hvq| GiKg Ae¯’vq i“Mx‡`i G‡Kev‡i wPwKrmvi cÖ_g Ae¯’vq †_‡K Bbmywjm Bb‡RKkb †bevi cÖ‡qvRbxqZv †`Lv †`q|

Type 2:Bbmywjb wbf©ikxj Wvqv‡ewUm wgwjUvm (Non-Insulin- Dependent Diabetes Mellitus- IDDM)

GB ai‡bi Wvqv‡ewUm `„yU Kvi‡Y n‡Z cv‡i|

1| kixi Bbmywjb ˆZix K‡i, Z‡e Zv ch©vß bq A_vr kixi  Ach©vß Bbmywjb     ˆZix K‡i|

2| kixi ch©vß cwigvY Bbmywjb ˆZix K‡i, Z‡e Bbmywjb Zvi KvR (A_vr i³ †_‡K M­y‡KvR mwi‡q †bqv) Ki‡Z e¨_© nq|

Ab¨vb¨ KviYt

K)                 c¨vbwµqvm ev AMœvk‡q cÖ`vn A_ev wUDgvi RwbZ KviY|

L)                  eskMZ KviY (evev, gv, `v`v, `v`xi A_©vr es‡ki c~‡e© cyi“l‡`i hw` _vK‡j

M)                  ‡g`eûj kixi (hv‡`i kix‡i cÖPzi mwÂZ Pwe© _v‡K| †Kvb kvixwiK cÖwikªg K‡i bv| eqm Ges D”PZvi Zzjbv kix‡ii IRb me mgq A‡bK †ekx _v‡K Zv‡`i †¶‡Î Wvqv‡ewUm nIqvi m¤¢ebv _v‡K)

N)                  K‡Zb Jla e¨env‡I KviY (`xN©w`b †÷i‡qw Øviv wPwKrmv ev †÷i‡q‡Wi Ace¨envi GKwU KviY)

O)                  gvbwmK KviY (cÖwZwbqZ wPwš—Z, DwØMœ I †Ubkv‡b _vK‡j GB †iv‡Mi m¤¢vebv _v‡K)

P)                  ‡ivMe¨vwai KviY(`xN©w`b wecK wµqvi †Mvj‡hvM AMœvk‡qi cÖ`vn ev  RxevY~  I fvBivm msµg‡Yi d‡j GB †ivM †`Lv w`‡Z cv‡i)

Q)                  Lv`¨ I †bkv RvZxq cvwb cvb Kivi KviY (†ekx cwigvY †bkv †meb, kK©iv ev wPwb RvZxq Lv‡`¨I cÖfve, i‡³i D”P gvÎvq K‡j÷‡ji cÖfve, D”P i³Pvc Ges eqm)

Diabetes- G j¶Y wK?

Wqv‡ewUm †iv‡Mi g~j 3wU j¶Y-

Polydipsia cwjwWcwmqv-Nb Nb Z…òvi jvM‡e|

Polyphagin cwj‡cwRqv-Nb Nb Ly`v jvM‡e|

Polyuria cwjBDwiqv-Nb Nb cÖmªve Ki‡e|

UvBc-01

v    evi evi Z„òv cvq|

v    Nb Nb cÖmªve Kiv, we‡kl K‡i iv‡Î|

v    ZvovZvox IRb K‡g hvIqv|

v    Nb Nb Bb‡dKkv‡b f~wM‡Z _v‡K| †hgb- Pvgov dvsMvm ¶Z, †dvov, PzjKvwb|

v    Kixi `~e©j Ges g¨vR g¨vR Kiv| cvwb k~b¨Zv () _v‡K|

v    Nb Nb k¦vm-cÖk¦vm _vK‡Z cv‡i|

v    nVvr gvbwmK Aw¯’iZv Ávbk~b¨ n‡q co‡Z cv‡i|

UvBc-02

v    kix‡ii ¯’yjZv ev †gvUv nIqv we‡kl K‡I †c‡U mwÂZ Pwe© Rvgvi Kvi‡Y|

v    i‡³ D”P gvÎvq wjwcW _vK‡Z cv‡i|

v    ‡Pv‡Li Qvwb cov I `„wó kw³i µzwU _vK‡Z cv‡i|

v    nvZ,cvq Ges gvsk‡ckx `~e©jZv I wSb wSb Ki‡Z cv‡i|

v    KzPwK ev c‡q Nv †`Lv w`‡Z cv‡i|

v    A‡bK mgq nvZ I cv‡q cvj&m cvIqv hvq bv|

v    UvBc-02 Wvqv‡ewU‡mi g~j j¶Y n‡jv i‡³ M­y‡Kv‡Ri cwigvY wba©vwiZ ¯^vfvwe gvÎvq †P‡q †ekx n‡q ‡`Lv †`q|

m¤¢ve¨ cix¶v (Investigation)

v    RBS Test (Rondom Blood sugar)

Normal Value: 125mg-160mg/dl or 6.9 to 8.9m mol/L Result: 250mg/dl or 14 mmol/l

Adv:

v    G.T.T Test (glucose Tolerance test) (G.T.T test `y-fv‡M Kiv nq) †hgb-

 I.                  FBS Test (Fasting blood sugar)

(Normal Value: 80-120mg/dl or 4.4 to 6.6 mol/L

ii.         ABF Test (2 hours after break fast)

(Normal Value: 125-160mg/dl or 6.9 to 8.9 mol/L

Result: <6.9 to 8.9m mol/L       Nib Diabetes

Or <8.9 to >10.1m mol/L          IGT (Impaired Glucose Tolerance)

Or > 11.1m mol/L                     Diabetes Mellitus

 

v    HbA1c Test (M­v‡KvmvB‡iU wn‡gv‡M­vweb)

Avgv‡`i i‡³i †jvwnZ KwYKvq i‡q‡Q wn‡gv‡M­web bvgK GKwU ivmvqwbK Dcv`vb| GB wn‡gv‡M­web †M­vweb bvgK †cÖvwU‡bi mv‡Z i‡³i wKQz M­y‡KvR ax‡i ax‡i mshy³ nq| GB fv‡e †h ¯’vqx c`v_©wU ‰Zix nq Zvi bvg M­vB‡KvmvB‡jU wn‡gv‡M­vweb A_ev wn‡gv‡M­vweb G1 wm (HbA1c)

Wvqv‡ewUm †ivM wbqš¿‡Y bv _vK‡j i‡³ M­y‡KvR †e‡o hvq mv‡_ mv‡_ †e‡o hvq wn‡gv‡M­vweb G1wm (HbA1c)

Avi GKUv ¸i“Z¡c~Y© welq n‡jv i‡³i †KvwYKv¸‡jv M‡o 120 w`b †eu‡P _v‡K †m Rb¨ wn‡gv‡M­vweb G1wm (HbA1c) Avgv‡`i weMZ 3-4 gv‡mi i‡³i M­y‡Kv‡Ri gvÎvi Mo wnmve  e‡j †`q| ZvB cÖwZ 3 gvm ci ci wn‡gv‡M­vweb G1wm (HbA1c) cix¶v Kiv †k¨q| mvaviYZ wn‡gv‡M­vweb G1wm (HbA1c) ¯^vfvweK gvb 7.0% | Gi †ekx n‡jv Wvqv‡ewUm Av‡Q e‡j eyS‡Z n‡e|

*          Benedict’s Solution Gi gva¨‡g Urine for Sugar Test Ki‡Z n‡e| Urine ofr Sugar Test Gi cÖ‡qvRbxq DcKiYmgyn

 

HEADACHE

cÖt Headache ej‡Z wK eySvq?

Dt Headache Gi evsjv A_© gv_v e¨v_v| gv_v e¨v_v †Kvb †ivM bq A_©vr †Kvb †iv‡Mi DcmM© nj gv_v e¨v_v|

cÖt wK wK Kvi‡Y gv_v e¨v_v n‡Z cv‡i?

Dt gv_v e¨v_v n‡Z cv‡I | D‡jøL‡hvM¨ gv_v e¨v_vi KviY –

K) `ywðšÍv RwbZ gv_v e¨v_v                           Headache due to Tension

L) D”P i³Pvc RwbZ gv_v e¨v_v                     Headache due to Hypertension

M) gvB‡MÖb RwbZ gv_v e¨v_v                          Headache due to Migraine

N) K¬vóvi‡n‡WK                                          Cluster Headache

O) mvBbymvBwUm RwbZ gv_v e¨v_v                    Headache due to Sinusitis

P) †eªbwUDgvi RwbZ gv_v e¨v_v                      Headache due to Brain tumor

Q) gw¯Í‡®‹I i³ÿiY RwbZ gv_v e¨v_v               Headache due to Brain Stroke

R) †Pv‡Li mgm¨v RwbZ gv_v e¨v_v                  Headache due to Eye problem

S) gvwm‡Ki mgm¨v RwbZ gv_v e¨v_v                Menstrual Headpain

T) cwi‡ekRwbZ gv_v e¨v_v                          Environmental Headpain

gv_v e¨v_vi AviI D‡jøL‡hvM¨ KviY i‡q‡Q|

 

Headache due to tension

 

KviYt    AZ¨vwaK kwiixK Ges gvbwmK Kv‡Ri Pvc I mve©¶wbK `ywðb—v, nZvk, welYœZv BZ¨vw` Kvi‡Y gv_v e¨_v n‡Z cv‡i| hv‡K ejv `ywðZv RwbZ gv_v e¨v_v|

j¶Yt  K) gv_vi Deq cv‡kB e¨_v n‡e|

L) ewg ewg fve n‡e|

M) A‡jv A_ev k‡ãi cÖwZ AwZ ms‡e`bkxjZv A_©vr e„wØ cv‡e|

N) gvbwmK `ywðš—v e„w× cv‡e|

General treatment of Headache:

1.       Tab. Renova (Pharacitamol 500mg + Caffeine 65mg) opsonin

1-2 tab. 3 times daily after food.

2. Tab. U4 (Flupenthixol 0.5mg + meliracen hydro. ) Orion (if there is anxiety)

1 tablet in the morning.

or Tab. Francis (flupenthixol 0.5mg + melitracen hydro) Bexemco

1 tablet in the morning

 

 

Cluster Headache

KviY:-      K¬v÷vi †n‡WK bvgK gv_v e¨_v mvaviYZ cyiæl‡`i †ekx n‡q _v‡K| GB ai‡bi e¨_vi mwVK   KviY GL‡bv Rvbv hvqwb| Z‡e GB ai‡bi e¨_vq iæMxi gw¯Í‡¯‹ AwK&ª‡R‡bi Aefve †`Lv †`q|

jÿY:           K) GB ai‡bi gv_v e¨_v cªvq iv‡Îi †ejv †ekxi fvM n‡q _v‡K|

L) e¨_vi mv‡_ mv‡_ †PvL jvj n‡q _v‡K|

M) A‡bK mgq †PvL †dvjv Geq †PvL w`‡q cvwb Si‡Z _v‡K|

N) Aw·‡R‡bi Afv‡e ¤¢vm-cÖmv‡ki Amywe`v †`Lv †`q|

O) e¨_v ¯^íKvwjb mgq n‡q _v‡K|

P) gy³ evZv‡m Ges AwK&ª‡Rb MÖn‡Y e¨_v wbivgq n‡q _v‡K|

 

Treatment of cluster:

 

1.      Oxygen though nasal catheter.

2.      Tab Ecosprine  75/300mg ( Aspirin) Acme 300mg stat then 75mg 3 times daily in water.

or .Tab rolac 10mg ( ketorolac) renata

Adults : 10mg tablet every 6 hourly.

 

Headache due to Brain Stroke

 

KviY: gw¯Í®‹ ev †eª‡bi †Kvb i³bvjx hw` †d‡U hvq  ev cÖwZeÜKZvi wkKvi nq | ZLbB gw¯Z‡®‹ i³ RgvU A_ev i³  iY n‡q  _v‡K |hv‡K CVD (Cerebral vascular diseases ) ev   Stroke  ejv nq | ‡óvª‡Ki  c~‡e© gvB‡MÖb e¨_v n‡Z cv‡i | Avi GB ai‡bi  e¨_v mv‡_ hw` Kbfvcjkb ev wLuPzwb †`Lv  †`q Z‡e Riyix wPwKrmvi Rb¨ iæMx‡K `yªZ nvmcvZv‡j cvVv‡Z n‡e |

jÿY  K) Zxeª gv_v e¨_v Ki‡e|

L) gv_v Nyiv‡e, ewg Ki‡e|

M) gv_v e¨_vi mv‡_ wLuPzwb †`Lv w`‡e|

N) `„wókw³ n«vm cv‡e|

O) A¯úó K_v ej‡e Ges RoZv †`Lv w`‡e|

P) †h †Kvb GKcvk Aek n‡Z cv‡i Ae‡k‡l Ávb nvwi‡q †dj‡e|

Treatment:

1.      Referred to Hospital.

2.      Tab. Clonas (Aspirin 75mg + Clopidogrel 75mg) Opsonin

Dosage: One tablet daily.

VERTIGO

 

Vertigo is defined as an abnormal perception  of movement of the environment or self .

causes:-

1.Benign paroxysmal positional vertigo (BPPV)

2. Manure’s disease - + tinnitus +deafness

3. Labyrinthitis- severe  vertigo e vomiting and unsteadiess

4. Transient vertigo precipitated by movement ( typically rolling into

the  bed) Usually self limiting over a few weeks or months.

Rx.

Cinnarizine, prpchlorperazine ,betahistine

 

Whooping Cough/ Pertussis

 

9t is upper respiratory tract infection. Cause Bacteria Bordetella   Pertussis One Of the most Communicable Diseases  aft Chorizo (The Common Cold). Usually Short lived. Highly Contagious.

 

Clinical features :-

Ø  General Malaise                  

Ø  Nasal discharge (typical)      

Ø  Sneezing                              

Ø  Cough- even months

Ø  Sore throat

Ø  Wheeze

Diagnosis Confirmed By :-  Bacterial cuhure

 

Ø  Rx:-           Azithromycin              Eromycin

Clarithromycin

Ø  Prevention:- By Vaccinatation  DPT on infancy

Diphtheria

Organism Coryhebacteirium  diphtheria Most Commonly in the upper respiratory treat .

Spread by droplet infection.

Clinical Featuring :-

Ø  Incubation period - 2-4 days

Ø  Sore throat (libt symptoms)

Ø  Modest fever

Ø  Tachycardia

Ø  Grayish green membrane on the tonsil

Ø  Swelling of neck and tedher enlargement of lymph nodes

Other:-

Ø  Laryngeal obstruction- Death

Ø  Myocarditis-  Death

Ø  Peripheral neuropathy

 

(Rx in isolation)

Ø  Rx:-  Diphtheria antitoxin

Ø  Penicillin or amoxicillin - 2 weeks

Ø  Erythromycin

 

Prevention:- DPT in infancy

Anti Allergic Drugs

1)  Cetrizine – Atatrol  10mg syrup Cetizin.

2)  Chlorphenamine  - Histacin(Jasonpharma).

3)  Desloratadine – Deslor 5mg ,des-Tab/syrup  -Neocilor

4)  Diphenhydramime-  Phenadryl 10mg /5mg /8mg

5)  Fexofenadine –Fenadin, Fexofast, Fexo, Fixal , Telfast-60,120,m180,mg

6)  Ketotifen – Tofen, Rb , syrup ,Finite , Alarid /1mg,

7)  Levocetrizine-        Allcet 1mg -Seasonix 5mg.

8)  Loratadine –Loratin/10mgss- Lora din/tab,Oradin/syrap

9)  Promethazine – Phenergen, Phenerex-Avomine-tab

10) Pheniramine-  Avil

CHOLERA

Organism- Vireo Cholera(Bacteria)

Causes acute watery diarrhea

Infection spread via the stools or vomit of symptomatic cases .

Transmission is normally through infected drinking water , food contaminated by flies , or on the hands of carriers (preventable) .

Clinical  features:-

Severe diarrloea .

Abdominal pain.

Vomiting

Typical rice water material is passed .

Shock

Oliguria

Rx:- 1) Solution

C/S

Hartsol

2)Tetracycline,  Doxicycline, Ciprofloxacine

 

Diphtheria

Organism Coryhebacteirium  diphtheria Most Commonly in the upper respiratory treat .

Spread by droplet infection.

Clinical Featuring :-

Ø  Incubation period - 2-4 days

Ø  Sore throat (libt symptoms)

Ø  Modest fever

Ø  Tachycardia

Ø  Grayish green membrane on the tonsil

Ø  Swelling of neck and tedher enlargement of lymph nodes

Other:-

Ø  Laryngeal obstruction- Death

Ø  Myocarditis-  Death

Ø  Peripheral neuropathy

 

(Rx in isolation)

Ø  Rx:-  Diphtheria antitoxin

Ø  Penicillin or amoxicillin - 2 weeks

Ø  Erythromycin

Prevention:- DPT in infancy

 

Pellagra-‡c‡jMÖv

cÖkœt-1/ †c‡jMªv ej‡Z wK eySvq ?

DËit-Vitamin B Complex Gi Ab¨Zg Dcv`vb wb‡KvwUwbK GwmW  (Nicotinie Acid (B3) Kg n‡j GB †ivM nq |

 

j¶Yt- ‡c‡jMÖv‡K I D ejv nq| A_v©r j¶Y My‡jv n‡”Q

D = Dermalitis ( Wvgv©UvBwUm) Pg©‡ivM

D = Diarrhoea (Wvqwiqv) D`vivgq

D = Demenlia (wW‡gbwkiv) gvbwmK kw³ n«vm

(1) Dermalitis- Pg©‡ivM

(K) kix‡ii wewfbœ RvqMvq Z¡‡Ki †Pnviv †`‡L g‡b nq †hb †iv‡`ª cy‡o Kv‡jv n‡q‡Q| GB †ivM †`‡ni  me©GB n‡Z cv‡i Z‡e Mjvi w`‡K †ekx †`Lv hvq|

(L) wRf  Ges †Vvu‡Ui †Kvbvq †d‡U wM‡q ¶Z n‡Z cv‡i|

(M) Z¡‡Ki dvUj, im wbtmb Ges ¶Z m„wó n‡Z cv‡i|

(2) Diarrhoea-D`vivgq A_v©r cwicvK Z‡b&ª Ai~wP, ewg fve; Ges wRnŸvi cÖ`vn, Kv‡jv nIqvi Ges Wvqwiqv n‡Z cv‡i|

(3) Demenlia-wW‡gbwjqv ‡ivMx A‡bK w`b hveZ GB †iv‡M Kó †c‡Z, gvbwmK `„wó kw³ nvwi‡q †d‡j| mœvqxK `y©ejZv †`Lv †`q| fyj e‡K BZ¨vw` RwUj j¶Y †`Lv †`q|

wPwKrmvt-

(1) Tab. Nicoson 50mg (Nicoticacid) (Jayson) 2wU K‡i 6 N›Uv cici|

(2)Cap. Spi-e 500mg (Spirulina)  2wU K‡i w`b 2 evi Lvevi c~‡e©

 

Scurvy-¯‹vwf©

cÖkœt-(1) -¯‹vwf© ej‡Z wK eySvq?

DËit-        Gi Afv‡e ¯‹vwf© †ivM †`Lv †`q|

cÖkœt-(2) GB †iv‡Mi j¶Y ¸‡jv wK wK ?

DËit-(K) `uvZ e¨_v nq, `uvZ bo‡Z _v‡K Ges gvwU w`‡q i³ c‡o|

(L) kixi `~e©j n‡q c‡o|

(M) b‡Ki wb‡P †Pv‡Li †Kvbvq Ges bvK w`‡q i³¶iY n‡Z cv‡i|

(N) `xN© w`b Pj‡Z _vK‡j i‡³i k~Y¨Zv †`Lv †`q|

wPwKrmvt-(1)  Ascorbie Acid RvZxq Jlya †`Iqv nqv †hgb-Tab . Ceevit 250mg (Square)  1wU K‡i w`b 2-3 evi| ‡ekx gvGv A_ev Bb‡RK‡kb e¨envi Kiv nq †iv‡Mi ZxeªZvi Dci wbf©i K‡i|‡hgb-Inj . Ascoson 500mg/5ml; 1wU K‡i w`b 1-2evi wbiv c‡_ e¨envi Kiv †h‡Z cv‡i|

(2) AwZwi³ i³cvZ n‡Z _vK‡j-Tab . Anaroxyl 2.5mg (Aderenochrome monoscmi-carloagone)- (GwWª‡bvµg g‡bv‡mwb-KvievRg)

(3) AwZwi³ ¶Z ev cuyR _vK‡j-Cap. Safrad 250/500mg-20 1wU K‡i 6 N›Uv cici|

 

Systemic Hypertension (HTN)

 

Persistent rise of blood procure above normal range in respect to age and sex of the individual.

Normal blood prelature

 

Systolic-100-139 its.

Diastolic-60-89 its.

 

Hypertension  KLb n‡e:-

 

British : (Grade I (mild)- 140—159—90-- 99.

Hypertension: (Grade II (Moderate)—160—179—100—109.

Society          : (Grade III (severe)—180—110.

Causes: - 95% of cases. Cause is not found.

In 5% Capras there may be secondary cawne

4. coatectation of the aorta

5. Exercise ,Anxiety ,discomport and Unfamiliasurroundings can all lead to a transient rise in BP.(Take history)

H/O – Exercise salt intake smoking family history Alcohol

HTN Investigation:-

Urine  R/E –S. Creatinine s.electolytes

RBS- F LIPID PNFILE

ECG- TSH T3 T4

other cxr ( p/a) Echocardio sraphy

6. Drugs-

* oral contraceptives

Steroids,Nsaids

Av BP cheek is advisable every 5 years in adults.

BP READING MUST BE ACCURATE AS POSSIBLE.

Measurement of BP:-

Measurement should be made to the rearest 2 month

in the sitting position with the arm support  and repeated  after

5 minites  rest if first rewrding is high .

Remove tight clothing from arm.

Take two meaasurement at  each visit.

Treatment :-

Treatment target  At normal range

Patient  antihypertensive require follow up  at 3

month interval.

1)Non drug thraply:-

 

Marasmus-g¨vivmgvm

cÖkœt-01Ñ g¨vivmgvm ej‡Z wK eySvq ?

DËit- Bnv GK ai‡bi Acywó RwbZ †ivM| evsjv‡`‡ki j¶ j¶ wkï GB †iv‡Mi wkKvi| Avwgl, ‡¯’n, Ges kiKiv RvZxq Lv‡`¨i Afv‡e GB ai‡b †ivM n‡q _v‡K|

j¶bt-

(K) kix‡i gvsm †dkx ïwK‡q _v‡K|

(L) nvZ Ges cv wPKb †`Lv‡e, Z‡e gv_v Ges †cU †ek eo †`Lv‡e|                                  (M) eq¯‹ gvby‡li gZ kix‡ii Pvgov Sz‡j hv‡e, †ek K‡i iv‡b Ges ‡Kvg‡ii Ask|                                (N) †PvL e‡m hv‡e Ges Pvovi bx‡P Pex© †`Lv hv‡e bv|

(O) egx, cvZjv cvqLvbv n‡Z cv‡i|

wPwKrmvt-

(1) ch©vß cwigvY `ya †L‡Z w`‡Z n‡e|

(2) Syp. Aristoplex 200ml-2ph.(Bexineo) 2PvgyP K‡i w`b 2-3 evi Lvevi cici|

Ges Spi-c 500mg (Spirulina)-4ph (CMSS) eqm AYycv‡Z 1 GKwU K‡i w`b 2 evi Lvevi c~‡e©|

(3) Syp. Zine-S (Zine Sulphale) (Ambce) 1 PvgyP K‡i w`b 2†_‡K 3 evi Lvevi cici|

(4)  Ostocal 250mg (Carbonat) (SKTF) 1 wU K‡i 1-2 evi Lvevi ci|

 

Kwashiorkar-‡KvqvwkqiKi

cÖkœt-(1)-‡KvqvwkqiKi ej‡j wK eySvq ?

DËit- †cÖvwUb RvZxq Lv‡`¨i Afv‡e kix‡i cvwb Rgv mnKv‡i †dv‡j hvIqv‡K †KvqvwkqiKi „„„„„„„„„„„„„e‡j„| MÖvgvb&P‡j mvaviYZ 1-5 er†ii wkï‡`i GB ai‡bi †ivM †ekx †`Lv hvq| Zv-Qvov Wvqwiqv, nvg Ges k¦vmZ‡b&ªi msK&ªg‡b GB ai‡bi †ivM n‡Z

 

j¶Yt-

(K) mg¯Z kixi †dvjv (Oedema) †`Lv‡e|

(L) gy‡L imv‡jv mnKv‡i †dvjv †`Lv‡e|

(M) Lv`¨ †L‡Z Abxnv, e`nRg, cvZjv cvqLvbv BZ¨vw` DcmM© †`Lv‡Z n‡e|

(N) mw`© Kvwk Ges wbD‡gvwbqv BZ¨vw` k¦vmZ‡š¿i †ivM cÖvq †j‡MB _v‡K|

wPwKrmvt-

(1) gvQ, gvsm, wWg Ges `ya ch©vß cwigvY w`‡Z n‡e|

(2) wkï‡`i †¶‡G gv‡qi `ya †kªq|

(3) Cap . Spi-e 500mg (Spirulira) 4-6ph. eqm Abycv‡Z 1-2wU K‡i w`b 2-3 evi Lvevi c~‡e©|

(4) Tab . Calbo 125/500mg (Calcium Carbonat) (Square) ‰`wbK GKUv K‡i|

(5) Syp . Nid (Sulphale) (Opsonin) 2 PvgyP K‡i w`b 2-3 evi|

 

Beri Beri-‡ewi †ewi

cÖkœt-  †ewi †ewi †ivM ej‡Z wK eySvq ?

DËit- Vitamin B .Gi Afv‡e GB †ivM n‡q _v‡K| Beri Beri A_© Avwg cvwibvÕ Avwg cvwibvÕ A_v©r GB †iv‡Mi †ivMx‡K †Kvb KvR Ki‡Z ejv n‡j, Dˇi †ivMx e‡j Avwg cvwibv Ges †ivMx me mgq wflY `~e©j _v‡K|

Vitamin B ev _vqwm‡bi Afv‡e mœvq~Zb&ª `~e©j n‡q c‡o d‡j †ivMxi ¯Z…wZ kw³ _v‡K bv Ges Abvq‡m mgm¨v †`L hvq|

j¶Yt-

(K) `~e©jZv, AmoZv, k¦vmKó †`Lv w`‡e|

(L) eyK aodo K‡i, nv‡Z cv‡q e¨_v K‡i|

(M) bvwoi MwZ `ªZ Pj‡Z _v‡K|

(N) wjfvi eo n‡Z cv‡i|

(O) gyL, nvZ, cvÕmn cvwb Rg‡Z cv‡i|

(P) †PZbv kw³ Kg‡Z _v‡K, wPwKrmv bv n‡j ü`wµqv e›` n‡q gviv †h‡Z cv‡i|

wPwKrmv t-(1)Inj. Neurovit (Thiamine by also; 25mg/1ml) (Medimet) ˆ`wbK 1wU K‡i Bb‡RK‡kb gvsm †ckx‡Z cici 3 w`b|

(2) Tab .Beovit 100mg ‰`wbK 1wU K‡i 2-3 evi hZ w`b fv‡jv bv n‡e Ges ‡dvjv bv Kg‡e|

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