cÖkœgvjv Avcbvi g‡ZvB fz³‡fvMx‡`i KvQ †_‡K msM„nxZ| Avcwb Ô†R‡bwUK †U÷ KxÕ wk‡ivbv‡gi wjd‡jUwUI GK bRi †`‡L wb‡Z cv‡ib| Avcbvi cÖkœ, Avcbvi D‡ØM ev Avcbvi Kv‡Q MyiyZ¡c~Y© †h †Kv‡bv welq Avcwb wb‡q Avm‡Z cv‡ib Ñ cv‡Q wRÁvmv Ki‡Z fz‡j hvb, ZvB Avcbvi wRÁvm¨My‡jv wj‡L †djyb| Avcbvi hw` †`vfvlxi cÖ‡qvRb nq Zvn‡j c~‡e©B Rvbvb| GwU A¨vgwbqwmb‡_wmm wel‡q mvgvb¨ GKwU MvBW gvZª| wb‡gœi wVKvbvmg~n †_‡K AviI Z_¨ Avcwb †c‡Z cv‡ib: A_ev Avcbvi ¯_vbxq †R‡bwUK wK¬wbK|

Abyev`K Abul Kalam Azad, MBBS; PhD Ontario Cancer Institute Applied Molecular Oncology Princess Margaret Hospital Toronto, Ontario, M5G 2M9 Canada

†deªyqvwi 2009 February 2009 MvBR GÛ †m›U Ugvm nmwcUvj, jÛb, hy³ivR¨ †_‡K cÖ —̄yZK…Z wjd‡jU‡K mvgvb¨ cwieZ©b K‡i; iq¨vj K‡jR Ae Aem&‡UwUªwkqvbm GÛ MvB‡b‡Kv‡jvwR÷m, hy³ivR¨ www.rcog.org.uk/index.asp?PageID=625; Ges jÛb AvBwWBGGm (AvBwWqvR) †R‡bwUK b‡jR cvK©, hy³ivR¨ Ñ G‡`i gvb I ˆewkó Abyhvqx cÖ —̄yZK…Z | G KvR BD‡iv‡Rb‡U÷ KZ©„K mgw_©Z hv BD‡ivwcqvb BDwbqb Ñ Gdwc6 mgw_©Z †bUIqvK© Ae G·wm‡jÝ Ñ †hvMv‡hv‡Mi b¤̂i 512148

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BD‡iv‡Rb‡U÷

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A¨vgwbqwmb‡_wmm

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• Avcwb GKRb eq¯‹ gv (35 eQi ev D‡™a©) n‡j Avcbvi wkkyi g‡a¨ wRbNwUZ ˆewkó, †hgb WvDb wmb‡Wªvg, cvIqvi SzuwK †ewk _v‡K|

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• Avcbvi ev Avcbvi cvU©bv‡ii cwiev‡i wRbNwUZ Ggb †Kv‡bv AevwÃZ Ae¯_v Av‡Q hv Avcbv‡`i wkkyi g‡a¨ AbycÖ‡ek Ki‡Z cv‡i|

• Gi c~‡e© Avcbvi wkky AevwÃZ wRbNwUZ mgm¨v wb‡q Rb¥MÖnY K‡iwQj|

2 A¨vgwbqwmb‡_wmm Kivi e¨vcv‡i wm™avš — MÖnY

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• †h mg —̄ A¯̂vfvweKZvi Rb¨ †U÷ Kiv‡Z n‡e| • †h ai‡Yi wRb msKªvš— A¯̂vfvweKZv Avcbvi mš—v‡bi g‡a¨ Avk•Kv

K‡i G †U÷ Avcwb Kiv‡Z Pv‡”Qb| • †U÷ msKªvš— Z_¨vejx Ges G †U÷ Avcbv‡K Kx m¤ú‡K© AewnZ

Ki‡e| • G †U÷ K‡ZvUv wbf©i‡hvM¨| • AwbwðZ djvdj cvevi K‡ZvUv Avk•Kv _v‡K hvi Rb¨ cybivq †U÷

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Av‡Q| • G ai‡bi cwiw¯_wZ Avcbvi I Avcbvi cvU©bv‡ii gvbwmK Ae¯_v‡K

Kxfv‡e cÖfvweZ Ki‡Z cv‡i| GMywj w`‡q Avcbv‡K mvgvb¨ aviYv †`qv n‡jv †h A¨vgwbqwmb‡_wmm Kivi wm™avš— †bevi c~‡e© Avcwb Kx RvZxq welq we‡ePbv Ki‡eb| Avcwb ÔcÖvqk wRÁvwmZ cÖkœÕ wk‡ivbv‡gi wjd‡jUwUI †`L‡Z cv‡ib, †mLv‡b AviI wKQz cÖkœ m¤ú‡K© ejv Av‡Q hv Avcwb Avcbvi Wv³vi‡K wRÁvmv Ki‡Z cv‡ib| G

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Avcbvi †U‡÷i djvdj cÖ —̄yZ n‡q †M‡j Wv³v‡ii mv‡_ Avjv‡ci Rb¨ Avcbv‡K WvKv n‡e, A_ev Ab¨ †Kv‡bvfv‡eI Avcbv‡K djvdj †`Iqv †h‡Z cv‡i, †hgb †Uwj‡dv‡bi gva¨‡g| G wel‡q †U‡÷i w`bB Avcwb Wv³v‡ii mv‡_ Avjvc K‡i †R‡b wb‡eb| Wv³viMY Avcbv‡K Avcbvi I wkkywUi g•M‡ji Rb¨ mwVK wm™avš— wb‡Z mvnvh¨ Ki‡eb |

M‡f©i wkkywUi hw` A¯̂vfvweK †R‡bwUK Ae¯_v aiv c‡o Z‡e Kx n‡e? djvd‡j hw` M‡f©i wkkywUi A¯̂vfvweK †R‡bwUK Ae¯_v aiv c‡o Z‡e Wv³vi ej‡eb †h †m A¯̂vfvweKZvwU Kx ai‡Yi, Ges GwU wkkywUi Dci Kx ai‡Yi cÖfve †dj‡Z cv‡i| Wv³vi Avcbv‡K GUvI Rvbv‡eb †h H Ae¯_vi Rb¨ †Kv‡bv e¨e¯_v ev wPwKrmv Av‡Q wK bv; H Ae¯_v‡Z Avcbvi Rb¨ Kx Kx c_ †Lvjv Av‡Q; bvwK M‡f©i mš—vb‡K bó K‡i †dj‡Z n‡e| Wv³vi Avcbv‡K GI Rvbv‡eb, Avcbvi I Avcbvi mš—v‡bi Rb¨ †KvbUv mePvB‡Z g•MjRbK| KLbI KLbI G †U‡÷ †KªvgR‡gi wKQy wKQy AmvgÄm¨c~Y© web¨vm aiv c‡o wKš—y wkkyi Ic‡i Gi cÖfve m¤ú‡K© Lye †ewk wKQy Rvbv †bB| GBPAvBwf msKªgY

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6 • Mfv©e¯_vq Avcwb Ab¨ †Kv‡bv cix¶v Kwi‡q‡Qb (†hgb,

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Kxfv‡e A¨vgwbqwmb‡_wmm Kiv nq? A¨vgwbqwmb‡_wmm Kivi Rb¨ gvZ…M‡f© †h A¨vgwbqwUK Zij c`v‡_©i g‡a¨ wkky Ae¯_vb K‡i Zv †_‡K mvgvb¨ Zij c`v_© msMÖn Ki‡Z nq| G KvR Kivi Rb¨ cÖ_‡g AvjUªvmvDÛ w`‡q M‡f©i wkky I Zvi dz‡ji (c−¨v‡m›Uv) Ae¯_vb m¤ú‡K© †R‡b wb‡Z nq| Zvic‡i Rivqy eivei †c‡Ui Pvgov A¨vw›U‡mcwUK mjy¨kb w`‡q cwi®‹vi K‡i wb‡q wmwiÄ I wbW&j-Gi mvnv‡h¨ Rivqyi ga¨ †_‡K (cÖvq 15 wgwjwjUvi ev 3 Pv-PvgP cwigvb) A¨vgwbqwUK Zij c`v_© †U‡b Avb‡Z nq| GB Zij c`v‡_©i g‡a¨ wkkyi Z¡‡Ki wKQy †Kvl (†mj) cvIqv hvq hv j¨ve‡iUwi‡Z cix¶v K‡i wkkyi wRb I †KªvgRg m¤ú‡K© Rvbv hvq| GKevi wbW&j cÖ‡ek Kwi‡q cÖ‡qvRbg‡Zv Zij c`v_© cvIqv bvI †h‡Z cv‡i, †m †¶‡Zª wØZxqevi wbW&j cÖ‡ek Kiv‡Z nq, Z‡e Ggb cwiw¯_wZi Avk•Kv wbZvš—B Kg|

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A¨vgwbqwmb‡_wmm KLb Kiv nq? Mf©avi‡Yi 15 mßvn c‡i mvaviYZ A¨vgwbqwmb‡_wmm Kiv nq|

A¨vgwbqwmb‡_wmm wK †e`bv`vqK? AwaKvsk gwnjvi Kv‡Q A¨vgwbqwmb‡_wmm A¯̂w —̄Ki, wVK †e`bv`vqK bq| GB A¯̂w —̄i ¯_vwqZ¡ mvavibZ K‡qK wgwbU| Aek¨, wKQy gwnjv Rivqyi Dci GKcÖKvi Pvc Abyfe K‡ib, Avevi wKQy gwnjv GK w`‡bi Rb¨ mvgvb¨ e¨v_vI Abyfe K‡ib, Z‡e Gme A¯̂vfvweK bq|

A¨vgwbqwmb‡_wm‡mi c‡i Kx NU‡e? cix¶vwU gvZª K‡qK wgwbU mgq †bq| Z‡e cix¶vi Rb¨ Avmvi mgq Avcbvi mv‡_ _vKvi Rb¨ GKRb m•Mx wb‡q Avmv fvj| cix¶vi c‡i K‡qK w`‡bi Rb¨ Avcbv‡K wKQy Amyweav ev evav-wb‡la mnRfv‡e wb‡Z n‡e| fvix wKQy D‡Ëvjb ev KwVb †Kv‡bv e¨vqvg Kiv hv‡e bv| Avcwb hw` 24 N›Uvi AwaK Kvj †c‡Ui A¯̂w —̄‡Z †fv‡Mb, ev hw` R¡i Av‡m, ev hw` †Kv‡bv A¯̂vfvweK †hvwbR wbtmiY ev i³¶iY nq, Z‡e Aek¨B Avcbvi Wv³vi‡K Rvbv‡Z n‡e| A¨vgwbqwmb‡_wm‡m Avc` Kx Kx? A¨vgwbqwmb‡_wm‡mi Kvi‡Y 100 R‡bi g‡a¨ 1 Rb (1%) gwnjvi Mf©cvZ n‡Z cv‡i| Ggb †Kb nq Zv Avgiv wVK Rvwb bv| Z‡e, 100 R‡bi g‡a¨ 99 R‡bi (99%) Mfv©e¯_v mwVKfv‡eB Pj‡Z _vK‡e| G Qvov Avgv‡`i Kv‡Q Avi †Kv‡bv cÖgvb †bB hv w`‡q ejv hv‡e †h A¨vgwbqwmb‡_wmm Avcbvi wkkyi Rb¨ SzuwKc~Y©|

4 A¨vgwbqwmb‡_wmm wK wbf©i‡hvM¨? Avcbvi Wv³v‡ii mv‡_ civgk© K‡i Av‡MB Avcbv‡K †R‡b wb‡Z n‡e †h, wVK †Kvb †R‡bwUK †U÷wU Avcbvi Kiv‡Z n‡e| GwU G Rb¨ Riywi †h, wfbœ wfbœ †U‡÷ wfbœ wfbœ dj cvIqv hvq| †Kv‡bv †Kv‡bv mg‡q (100wUi g‡a¨ 1wU) †`Lv hvq †h A¨vgwbqwmb‡_wmm †_‡K msM„nxZ bgybvq h‡_ó cwigvb †Kvl †bB hv w`‡q cix¶vwU m¤úbœ Kiv hv‡e| Ggb Ae¯_vq Avcbv‡K AewnZ Kiv n‡e, Ges cybivq †Uó Kivi Rb¨ AvnŸvb Rvbv‡bv n‡e| A¨vgwbqwmb‡_wmm Øviv wK me ai‡Yi †R‡bwUK mgm¨v mbv³ Kiv m¤¢e? †h Kvi‡Y †U÷wU Kiv n‡q‡Q †Kej †mwUi m¤ú‡K© Z_¨ Rvbv hvq| Aek¨, H djvdj †_‡K Ab¨ †Kv‡bv welqI †ewi‡q Avm‡Z cv‡i| wKš—y, Ggb †Kv‡bv mvaviY †U÷ †bB hv †_‡K mKj cÖKvi †R‡bwUK Ae¯_v m¤ú‡K© Rvbv hvq| A¨vgwbqwmb‡_wm‡mi djvdj †c‡Z K‡Zv mgq jv‡M? djvdj †c‡Z K‡Zv mgq jvM‡e Zv wbf©i K‡i †U‡÷i ai‡Yi Dci| †Kv‡bv †Kv‡bv †U‡÷i Rb¨ 3 w`bB h‡_ó, Avevi †Kv‡bv †Kv‡bv †U‡÷i djvdj †c‡Z 2-3 mßvn †j‡M hvq| Z‡e, mgq †ewk jvM‡jB Ggb fveevi †Kv‡bv KviY †bB †h, A¯̂vfvweK wKQy NU‡Q| GgbI n‡Z cv‡i †h, †KvlMy‡jv †e‡o DV‡Z mgq †ewk wb‡”Q| hw` Avcbv‡K †Kv‡bv A¯̂vfvweK †R‡bwUK Ae¯_vi Rb¨ A¨vgwbqwmb‡_wmm Kiv‡Z n‡q _v‡K Z‡e Wv³v‡ii Kv‡Q c~‡e©B †R‡b wbb Avcbvi †U‡÷i djvdj †c‡Z K‡Zv mgq jvM‡Z cv‡i|

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