isÿ flfrk m¾fhaIKhka fudkjdo@
fuu frda.h ms<sn|j wm ,nd isák fndfyda ±kqj;aùï" ,eî we;af;a m¾fhaIk fj;sks' fud<h wvmKùug wod< kj fya;=ka iy wjodkï we;sùFï idOl y÷kd.ekSu" oro~qùug iy uia;sIal .eiau we;slrk fmaYSka md,kh lsÍug iu;a T!IO fidhd .ekSu iy tajd jvd;a ksjerÈ l%uj;a wdldrfhka ,nd§u" wiaÓ iy fmaYSkays úmÍ;;dj ksj/È lsÍfï ÈhKq;u Y,H ;dCIKhka iy fud<h wmK ùu l<, ixj¾Okfha ;SrKd;aul wÈhrhkays§ fud<hg ydks isÿ jkafka flfiao yd tfia isÿjkafka l=ula ksid±hs buy;a wjfndaOhla we;s lr .ekSu Bg we;=<;a fõ'
fuu ;;ajh Woa.; jk <uqka ie<lsh hq;= ixLHdjl fud<h ixj¾Okfha uq,a wjÈfha § md;%jk weneoa§" Bg fya;=ldrl jkafkahehs fndfyduhla úµd{hkaf.a ms<s.ekSu ù ;sfí' Tjqyq fud<fha kshqfrdak ^iakdhq ffi,hka& úfYaI{;dj ,nñka fud<fha fjk;a ffi,hka ksjerÈj y÷kd f.k iïnkaO;d we;s lr .kafka flfia±hs úNd. lrñka isá;s' tfiau Tjqka" fud<h ixj¾Okh idudkH l%shj,sfha § th ì|fy<Sfï idOl je<elaùfï ms<sfj;a fidhd n,ñka isá;a'
cdkuh wvqmdvq
fud<fha úmÍ;;dj yd úlD;Ska ;=<ska firsn%,a fmda,ais frda.sS ;;ajh we;sjsSu flfrys cdkuh wvqmdvq we;eï úg n,mEula we;s lrhs' cdkuh wvqmdvq mj;akd whf.a yd Tjqkaf.a mjq,aj, whf.a DNA wï, idïm,hka tla/ia lr .ekSu u.ska iy cdk f;dard fírd .ekSfï ;dCIKhka Ndú;d lrñka úµd{fhda mqoa., cdk iy ksYaÑ; j¾.hl cdkhkays mj;akd úmÍ;;dj w;r in|;djh fidhd .ekSug ksr; ù isá;s' uQ,sl jYfhka tfia lrkqfha ;sr.; lsÍfï ;dCIKhka Ndú;d lrñks' fuu l%shdj,sfhys,d ixj¾Okh jk fud<fhys § kshqfrdakhka Wm; ,;a ;ek isg kshqfrdak mßm:hka fj; tajd ixl%uK ù ;ekam;a jk ^kshqfrdak ixl%Kh ùuhhs y÷kajkq ,nk& wdldrhhs úµd{fhda f,a .e,Su" wmiaudr j,smamqj" wdYajdi m%dYajdi iy reêr Odjk .eg¿ wdY%s; isoaëka iqmÍCIdldÍj fidhd n,kqfha" fud<h wvmK ùug fya;=jk ridhksl uqodyeÍula isÿ lsÍug iu;a jkakd jQ ydkshla isÿfõ ±hs ksYaph lr .ekSu i|yd fõ' WodyrKhla jYfhka kshqfrdakhg ix;sfõokh lsÍug WmldÍjk ridhkslhla jk .a¨gfïÜ kue;s wï,hka buy;a m%udKhla Nhdkl wdldrfhka uqodyeÍula ;=<ska fud<fha f,a .e,Sfuka isÿjk uj. m¾fhaIKhka u.ska fmkajd § we;' tfia jqjo" muKg jvd .a¨gfïÜ wï,hka kshqfrdakhka ±ßh fkdyels ;rug W;af;ackh lsÍu yd úkdY lsÍu;a isÿlrhs' idudkH iajNdjfhka WmldÍ jk fud<fha ridhkhka" Nhdkl wdldrfhka úI njg m;ajkafka flfia±hs bf.kSfuka" tajdfha ydkslr úmdlh je<elaúh yels mßÈ yerùug iu;ajkakd jQ T!IOhka jeäÈhqKq lr .ekSug úµd{hl=g wjia:djka Wodjkjd we;'
úµd{fhda ms<sìUq lsÍfï ^imaging& ;dCIKh Wmfhda.S lr.ksñka iy kshqfrdak p¾hd mÍCIK Ndú;d lrñka orejka ;=< firsn%,a fmda,ais we;sjSug ;=vq fokakd jQ tn÷ rgdjka ms<sn|j wkdjels m< lsÍug l%shdldÍ fj;s'
fmßfjkaá%lshq,¾ ^Periventricular& m%foaYfhys YÍrfha fmaYSka lrd fud<fha isg mKsjqv f.khdug iu;a iakdhq ;ka;=ka we;=<;a ù mj;S' m¾fhaIlfhda" iqÿjka ødjH ydksh je<elaùfuys,d bjy,a jk" je<elaùfï l%fudamdhhka ÈhqKq lr .ekSfï wfmaCIdfjka lghq;= lr;s' WodyrKhla jYfhka" fud<h ;=< iqÿjka ødjH yg .ekSu flfrys fud<fhys ridhkhka bgq lrk fufyjr ms<sn|j m¾fhaIlfhda mÍCId lrñka isá;s' m¾fhaIlfhda erythropoietin kñka y÷kajkq ,nk" YÍrh ;=< iajNdúlju mj;skakd jQ ridhkhla ksisl,a msÍug fmr Wm;a <orejka ;=< fud<h wvmK ùfï ^CP& wjodkï wvq lr .ekSug bjy,a jk yelshdjla mj;S±hs fidhd ne,Sfï wOHhkhl fh§ isá;s'
m¾fhaIlfhda firsn%,a fmda,ais frda.hg ,la jQ mqoa.,hkg m%;sldr ,nd §fï § ±kg Ndú;d flfrk úl,amhka Ndú;d lr .ekSfuys,d bjy,a úh yels kj Ñls;aidjka iy kj;u ms<sfj;a fidhd ne,Sfuys fkdlvjdu ksr; ù isá;s' tajd w;r my; ±lafjk ms<sfj;a we;=<;a fõ'
fmd<Ujd .ekSug fufyùfï Ñls;aidj Constraint – induced therapy^CIT& (
firsn%,a fmda,ais frda.hg ,la jQ mqoa.,hka fjkqfjka b;d jevodhl Ñls;aidjls fï' fuu CIT Ñls;aidj u.ska wfmaCIs; wdldrfhkau Yla;su;a wjhjh" msysgùug fmd<Ujd .ekSfuys,d i;s .Kkdjl ld, iSudjla mqrd Èkm;du ±ä i;aldÍ l%shdldrlï bgq lrñka .; lsÍug ÿ¾j, ndyqj fufyhjd n, lsÍuls'
Tjqkaf.a YÍrfhys fowxYfhysu ÿ¾j,;djka mj;akd orejkaf.a Wvqlfhys msßyS mj;akd w;sÿIalr l=i,;d jeäÈhqKq lr§fuys,d ,nk idhksl wOHhkhla" mQ¾Kld,Skj kshu l< p,kh keje;aùug tfrysj w¾Old,Skj fm<Ujd .ekSug Èß.ekaùu Wfoid ffoksl mqyqKqùfï úúO ld¾h ^wNHdi& kshuhka fhdod .ekSfï yelshdj mÍCId lrf.khhs' fud<h wvmK jQ mqoa.,hkaf.a" Ôú; ld,h mqrdu iakdhq pd,l Yla;sh jeäÈhqKq lsÍug idCIs iys; m%dfhda.sl wNHdi m%u;Ska kshu lsÍug bjy,a jk ks.ukhka wOHhkhka ,nd fokjd we;'
l%shdldÍ úoaHq;a W;af;ackh Functional Electrical Stimulation^FES&
fmaYS l%shdldÍ;ajh W;af;ackh lr§u Wfoid wvq uÜgfï úÿ,s n,h Ndú;d lsÍfï Ñls;aiduh ms<sfj; Tiafia ysg .ekSu fyda mshjr ;eîu jeks jevodhl l%shdldrlï m%lD;su;a lr .ekSfuka uia;sIal .eiafuka hq;a fmaYSka b,lal fldg Yla;su;a lr §fï ms<sfj;ls' m¾fhaIlfha FES wkq.%yh ,nd foñka" <uhskaf.a my< uÜgfï mj;akd idudkH fmaYS Yla;sh ldhsl yqre mqreÿ lsÍï u.ska jeäÈhqKq lr§ug ia:dk.;j mdmeÈ wNHdihkays fhoùfï yelshdj flf;la±hs we.hSfuys ksr;j isá;s'
frdfndaál Ñls;aidj – Robotic therapy
meoafok .uka ,S,d wjêh ;=< § ll=,g md,khk lrkq ,nk n,h fhoùfuka firsn%,a fmda,ais frda.fhka fmf<k <uqkaf.a YÍrfha nr ieliSFï wdOdrl jHdhdu ,nd fokakd jQ fkdÿjk frdao iys; hka;%hla me§fuka .=Khla i,id§ug wod< jkakls' firsn%,a fmda,ais frda.fhka fmf<k <uqkaf.a pd,l Yla;suh l%shdldrlï jeäÈhqKq lsÍug wruqKq lr.;a kj;u idhksl Ñls;aidjla lrd ,Õd jkjd we;'
fndgqhs,skï fgdlaiska Botulinum toxin^Botox& tkak; ia:dkShj ,nd §u" firsn%,a fmda,ais jeks uia;sIal iys; pd,l wdndOhkaf.ka fmf<k <uqka Wfoid iïu; m%;sldrhla njg m;a ù ;sfí' uE; ld,fha i;=ka wOHhkhg ,la lsÍfuka ,;a m%;sM, wkqj" Tjqkaf.a wg ^wiaÒka& msßySulg ,lajk nj fy<s ù we;;a" ñksiqkaf.a wiaÓk flfrys wys;lr úmdl f.kfok nj ikd:ùula wOHhk ;=<ska fuf;la ikd: ù ke;' fjk;a wOHhka fmkajd fok mßÈ ±ä núka wvq lïmkSh m%;sldr" firsn%,a fmda,ais frda.fhka fmf<k <uqkaf.a b;d ÿ¾j, mdo wiaÓkays " wiaÓ jHQyhka ÈhqKq lr .ekSug bjy,a fõ'
kj;u idhk wOHhkh ;=<ska" uia;sIal .eiau we;s firsn%,a fmda,ais frda.fhka fmf<k <uqkaf.a wiaÓ mxcrh iy wiaÓ jHQyhg Èkm;d lïmkSh m%;sldr ,nd§u iuÕu ,nd fok Botox m%;slrfha M,úmdl ks.ukh lsÍug m¾fhaIlfhda fh§ isá;s'
YÍr WIak;aj wvqjsu ^Systemic hypothermia&
md,khla iys; ffjµ m%;sldr u.ska YÍrfha idudkH WIaK;ajhg jvd isis,a fldg ;enSu fud<h wdrlaId lsÍug;a" tfiau urK wkqmd;h wvq lsÍug;a" we;eï wdndOhka iy fud<hg ydksùu flfrka yg .kakd wdndOhka wvq lsÍug o iu;ajk j. fmkS we;'
fjk;a m¾fhaIlhka ^hypothermia& iy cdkuh ødjH m%;sixfhdackhg wod< erythropoietin Ndú;d lrñka lrk ixhqla; Ñls;aid ;ks ;ksj i;aj fudv,hlg ,nd foñka iakdhq ixj¾Ok W!K;djhkg m%;sldr ,nd §fuka jvd;a M,odhl jkafka±hs mÍCId lrñka mj;sS.
firsn%,a fmda,ais frda.h Wfoid kj m%;sldr úëka fidhd .ekSfuys W;aiqlj È.gu l%shd lr f.k hdug yd fud<fhys ixj¾Okhg wod< wmf.a ±kSu jHdma; lr .ekSfï m%h;akh m¾fhaIlhka ksr;j isák neúka" fud<h wvmK jk <uqka /l .ekSu iy Ôú;fha uq,a wjÈfha § mSvdf.k fok fjk;a fndfyda wdndOhka ms<sn|j jeo.;a ÈhqKqjla wfmaCId lsÍug wmg mq¿jk'