piliya dae. ved prakash garg, em. bi. bi. es., em. di. (valrd yunivarsiti sarvis helth sentar men varishth chikitsa adhikari) ankhane, nakhunon v mutra men pilapan v kamjori piliya ke samanya lakshan hain. yah rog prayah dushit jal, dushit falon ke ras pine adi se hota hai lekin inke alava yah kai anya karnon se bhi hota hai. sharir men vidyaman khun ko pani bana dene vale is rog ke karan v bachav ki jankari pane ke lie parhie yah alekh...
piliya rog nahin balki rog ka ek lakshan hai. piliya men tvacha aur ankhon ka safed bhag pile ho jate hain. yah rakt men bilirubin namak rasayan ke adhik ho jane se hota hai. sadharntya rakt men bilirubin 0.2-1.0 mi.li.tak rahta hai. iske 30 mi.li. se adhik hone par hi ankhon men piliya najar ata hai.
kin karnon se piliya hota hai?
1. sadharntya jab lal rakt koshikaen apni ayu ke 120 din pure kar leti hain tab pliha (aichsmmd) men khatm ho jati hain aur in koshikaane men se lauh tatva nikal jane ke pashchat jo tatva bacha rahta hai usse bilirubin (thapsptnaipd) ban jata hai. ise ankanjugetid bilirubin (ndabavadaranahanjamak thapsptnaipd) kaha jata hai.
2. jigar ke kai karya hote hain, jinmen vasa ko pachane hetu piÿa ;thapasamaddh ka utpadan aur rakt men maujud vijatiya padarthon ko nishkasit karna pramukh hain. bilirubin aisa hi ek vijatiya padarth hai. nishkasan se pahle bilirubin ek anya rasayan glukronik amla ke sath mil jata hai, islie ise kanjugetid bilirubin kaha jata hai.
3. bilirubin ka utpadan jyada ho, jaise himolitik enimiya.
4. kabhi-kabhi gum chot lagne se utpann rasoli ke dhulne se bhi piliya ho jata hai kyonki is rasoli men rakt jama ho jata hai.
5. jigar men shoth ;pdasinuunjapavadaddh ho, jaise vayaral hepetaitis (taptans bhmachanjpjpe).
6. sharab se hone vale rog sirosis ke karn: sharab pine se jigar men sujan a jati hai, aur bilirubin ke bahav men avrodh paida ho jata hai. dhire-dhire jigar koshikaon men charbi ikatthi hoti chali jati hai (thnjajal spaamt) aur agar itna sab ho jane par bhi sharab pina band n kiya gaya, to duniya ki koi takat janleva sirosis (bpatativepe) hone se nahin rok sakti.
7. bukhar utarne vali dava perasitamol (chntanbmjanuvasaddh se hone vala piliya jigar men pitt ke bahav men rukavat a jane se hua karta hai.
8. purana jigar rog (bitavadapab bhmachanjpjpe th vat b) hipetaitis bi tatha si se sankramit rogiyon men shuru men koi lakshan nahin milte. lanbe samay ke bad hi piliya najar ata hai, tab tak sirosis (bpatativtpe) ho chuka hota hai.
9. a a e t a e i m y u n h e p e t a i it s ;.najvpauunadam bhmachanjpjpeddh jaise praimri biliyari sirosis hona. yah jyadatar adher umra ki liya rog nahin balki rog ka ek lakshan hai. piliya men tvacha aur ankhon ka safed bhag pile ho jate hain. yah rakt men bilirubin namak rasayan ke adhik ho jane se hota hai. sadharntya rakt men bilirubin 0.2-1.0 mi.li.tak rahta hai. iske 30 mi.li. se adhik hone par hi ankhon men piliya najar ata hai. kin karnon se piliya hota hai?
10. sadharntya jab lal rakt koshikaen apni ayu ke 120 din pure kar leti hain tab pliha (aichsmmd) men khatm ho jati hain aur in koshikaane men se lauh tatva nikal jane ke pashchat jo tatva bacha rahta hai usse bilirubin (thapsptnaipd) ban jata hai. ise ankanjugetid bilirubin (ndabavadaranahanjamak thapsptnaipd) kaha jata hai.
11. jigar ke kai karya hote hain, jinmen vasa ko pachane hetu piÿa ;thapasamaddh ka utpadan aur rakt men maujud vijatiya padarthon ko nishkasit karna pramukh hain. bilirubin aisa hi ek vijatiya padarth hai. nishkasan se pahle bilirubin ek anya rasayan glukronik amla ke sath mil jata hai, islie ise kanjugetid bilirubin kaha jata hai.
12. bilirubin ka utpadan jyada ho, jaise himolitik enimiya.
13. kabhi-kabhi gum chot lagne se utpann rasoli ke dhulne se bhi piliya ho jata hai kyonki is rasoli men rakt jama ho jata hai. jigar men shoth ;pdasinuunjapavadaddh ho, jaise vayaral hepetaitis (taptans bhmachanjpjpe).
14. sharab se hone vale rog sirosis ke karn: sharab pine se jigar men sujan a jati hai, aur bilirubin ke bahav men avrodh paida ho jata hai. dhire-dhire jigar koshikaon men charbi ikatthi hoti chali jati hai (thnjajal spaamt) aur agar itna sab ho jane par bhi sharab pina band n kiya gaya, to duniya ki koi takat janleva sirosis (bpatativepe) hone se nahin rok sakti.
15. bukhar utarne vali dava perasitamol (chntanbmjanuvasaddh se hone vala piliya jigar men pitt ke bahav men rukavat a jane se hua karta hai.
16. purana jigar rog (bitavadapab bhmachanjpjpe th vat b) hipetaitis bi tatha si se sankramit rogiyon men shuru men koi lakshan nahin milte. lanbe samay ke bad hi piliya najar ata hai, tab tak sirosis (bpatativtpe) ho chuka hota hai.
17. a a e t a e i m y u n h e p e t a i it s ;.najvpauunadam bhmachanjpjpeddh jaise praimri biliyari sirosis hona. yah jyadatar adher umra ki mahilaon men dekha gaya hai. yah rog barhte-barhte janleva ho jata hai. thakan rahna, khujli bane rahna adi is rog ke lakshan hain.
18. jigar men padarthon ya avanchit koshikaon ka jama hona jaise lauh tatva, tanba adi. kanjugetid bilirubin barhne ke karan jigar ke andar, pitt ke bahav men avrodh ho jae ya fir jigar ke bahar avrodh jaise pitt thaili men pathri ya pitt thaili ya painnakriyaj kainsar ho jae.
19. painkriyaj shoth ;chndbtmane pdasinuunjpvdae chndbtmanejpjpeddh se bhi piliya hota hai, jiska karan sharab ka sevan ya fir pitt nali men pathri ka hona hai.
20. piÿa nali men avrodh hona jaise piÿa ki thaili men pathri. ajakal aksar dekhne men ati hai. is pathri se pitt thaili men shoth ;pdasinuunjapavadaddh ho jata hai ya fir sankraman bhi ho sakta hai.
21. painkriyaj granthi ka kainsar ya fir jigar ka kainsar, piÿa thaili men kainsar ityadi.
piliya kab hota hai?
1. bilirubin ke adhik matra men banne se piliya hota hai. himolitik enimiya (bhnuvasalajapab .damaupan) rog men lal rakt koshikaon ke nasht hone ki raftar tej ho jati hai. aisa in koshikaon ki ayu kam ho jane se hota hai.
2. himolitik enimiya ke karan, vanshanugat sfirosaitosis (bhmatamakapajantal aichimtvbljvepe) thelasimiya (jinssanemaupan) sikla koshika rog (aipbasam bmasas kapemanem) ya fir glukoj -6- fasfetej dihaidrojenej ki kami (lan6nchnkn kampibpmdbl) ho sakte hain. in sabhi karnon se hone vala piliya 5-6 mi.gra. se jyada nahin barh pata hai.
3. jigar men koi vikar ho jae aur yah bilirubin ko rakt men se nikal n pae.
4. piÿa nali (thapasam knabaja) men avrodh ho jane se piÿa ka bahna kam ho jane ke karan kainsar, piÿa ki thaili men pathri ya fir piÿa nali men sankraman hota hai. piliya se kya pareshani ho sakti hai?
5. piliya tvacha ya fir ankhon ke safed bhag ko pila karne ke alava jyada kuch nahin karta, bas mutra bahut adhik pila ane lagta hai. iske atirikt mal ka rang halka ya fir mitti jaisa bhi ho sakta hai.
6. kuch logon ko khujli (chtanatapajape) hone lagti hai. yah kabhi-kabhi itni tivra ho jati hai ki tvacha ko khujlate-khujlate rogi us par ghav bana lete hain.
7. jis rog se piliya ho raha hota hai, usse rogi ko pareshani hoti hai jaise raktalpata, jigar ka sankraman ya fir sirosis (bpatativepe).
anya hanikarak davaen: khasakar garbhanirodhak istrojan dava se piliya ho jata hai. kintu dava band karne ke kuch saptah ke andar yah thik ho jata hai. paidaishi vikar jaise kriglar najar ;btapahahasamat chanhantaddh rog. is rog men bilirubin ko nishkriya karne vala enjain hi nahin rahta. anya paidaishi vikar hain dubin jaensan aur rotar vikar, jo bilirubin ke aniyamit srav se hote hain. in rogon ka koi ilaj nahin hai.
1. gilrbat ;lapsaimatajaddh vikar: karib 7 pratishat jansankhya ko yah vikar hota hai. gilabart rog ;lapsaimataj kpemanemaddh men bilirubin thora hi barhta hai. kintu jigar sucharu rup se karya karta rahta hai. is rog ke sath sharirik tanav hone, ya adhik din tak upvas karne ya fir anya koi rog hone par piliya jyada ho jata hai. is rog men jyadatar logon ko khas pareshani nahin hoti hai. atah unhen ilaj ki avashyakta nahin hoti. piÿa nali men paidaishi vikar rahne se ismen rasoli, jise kolidoklsist ;bivsmkvbins balejaddh kahte hain, ban jati hai.
garbhavastha men piliya: garbhavastha men yah rog kam hi hota hai. yah keval tisri timahi men ho sakta hai. ismen khasakar khujli hone lagti hai aur kisi-kisi ko piliya bhi ho jata hai. kuch khas mahilaon men yah jyada hota hai. skaindeneviya aur chili ke vasiyon men is rog ka karan istrojan ;vmejatavahamadaddh namak harmon ko mana jata hai. ekyut faitti jigar ;.
banajam thnjajal spaamataddha: yah un garbhavati mahilaon ko ho jata hai jinhen eklempsiya ;mbasanuchepanddh ho gaya ho. is rog men jigar kam karna band kar deta (spaamat nipsntm) hai. iska ilaj bachche ko turant man ke garbh se nikalna hai. agar aisa n karen, to bachche ki maut ka bhi khatra ho sakta hai.
shishu men piliya: yah janm ke kuch dinon ke andar ho jata hai. sabhi navjat shishuon men se karib adhe bachchon ko piliya ho jata hai. kintu jyadatar kuch pareshani paida nahin karta. iska karan navjat shishu ke rakt men pae jane vale fital himoglovin ;thvamjans bhnmauvhsvaipadaddh ka tivrata se nasht hona hai. navjat shishu ka jigar itna paripakva nahin hota ki itna sara kam jaldi ya asani se kar sake. kintu 2-3 saptah men svatah hi shishu bina kisi upchar ke thik ho jata hai. kuch navjat shishuon men man ka dudh pine ke bad piliya ho jaya karta hai. ismen 2 saptah men piliya najar ata hai aur ek saptah bad kam hote-hote do tin saptah men khatm ho jata hai. man ke dudh men koi aisa tatva maujud rahta hai jiske karan bilirubin ko jigar nishkriya nahin kar pata hai.
is prakar ka piliya samay se purva janme shishuon ;chtamaunjanatam chamuivtdeddh men hi jyada hota hai. kuch shishuon men agar rakt men bilirubin jyada matra men barh jae tab upchar ke lie fototherepi (chivjvjimtanchl) ya fir eksachenj transfyujan (mgabindaham jtandeniepvd) bhi karna par sakta hai. ek aur janleva karan ho sakta hai navjat shishu men piliya ka, jise navjat ka himolitik rog (bhnuvasalajapab kpemanem v ichmu thavtd) kahte hain. is rog ka karan ar. ech. negetiv (tin chamhanjpam) man ke garbh men ar. ech. paejitiv (tin chvepjpam) bachche ka hona mana jata hai.
adhunik chikitsa suvidhaon ke rahte hue is karan se navjat shishuon men piliya dekhne men nahin ata hai, kyonki pahle bachche paida hone ke 24 ghante ke andar ek injekshan, jise enti di (.dajap k) kahte hain, man ko laga diya jata hai. jigar shoth ka karan hipetaitis (e) vayaras dvara sankraman hai. vayaras sharir men dushit pani, ganne ke ras ya dushit bhojan ke sevan se hota hai. is rog men rogi ko pahle kuch din bukhar aur pet men dard rahta hai aur ultiyan ati hain. fir bukhar utar jane ke pashchat ankhon ka safed bhag pila ho jata hai aur mutra gahre pile ya fir sarson ke tel ke rang ka ane lagta hai.
vairal hepetaitis bi ka sankraman jyadatar dushit sirinj, dushit ;bvadjanupdanjamakaddh rakt adi se hota hai. isse sankraman ke karan 50 se 150 din ke andar ya fir isse bhi der bad piliya najar ata hai. iska nidan tabhi sanbhav hai jab rakt men aestreliya aintijan ;bhiai.haddh maujud ho. piliya ke nidan mutra ki janch: mutra ka sarson ke tel ki tarah atyadhik pila hona aur usmen bilirubin ka hona piliya men piliya dekhne men nahin ata hai, kyonki pahle bachche paida hone ke 24 ghante ke andar ek injekshan, jise enti di (.dajap k) kahte hain, man ko laga diya jata hai. jigar shoth ka karan hipetaitis (e) vayaras dvara sankraman hai. vayaras sharir men dushit pani, ganne ke ras ya dushit bhojan ke sevan se hota hai. is rog men rogi ko pahle kuch din bukhar aur pet men dard rahta hai aur ultiyan ati hain. fir bukhar utar jane ke pashchat ankhon ka safed bhag pila ho jata hai aur mutra gahre pile ya fir sarson ke tel ke rang ka ane lagta hai.
vairal hepetaitis bi ka sankraman jyadatar dushit sirinj, dushit ;bvadjanupdanjamakaddh rakt adi se hota hai. isse sankraman ke karan 50 se 150 din ke andar ya fir isse bhi der bad piliya najar ata hai. iska nidan tabhi sanbhav hai jab rakt men aestreliya aintijan ;bhiai.haddh maujud ho. piliya ke nidan mutra ki janch: mutra ka sarson ke tel ki tarah atyadhik pila hona aur usmen bilirubin ka hona piliya labh hota hai.
anya rogon se hone vale piliya, jaise pitt ki thaili ki pathri, ka ilaj pitt ki thaili ka aepreshan kar pathri ko nikal kar kiya jata hai. janmajat vikar: gilbart vikar, dubin jaensan rog, krigalar najar tatha rotar vikar adi se grast rogi ka ilaj sanbhav nahin hai. davaon ke sevan se hone vala piliya dava band karne se thik ho jata hai.
bachav: ih p e t a i it s ‘ e ’ (bhnchanjpjpesh.sh) se bachne ke lie dushit pani aur ganne ka ras n pien tatha dushit bhojan n karen. hipetaitis ‘bi’ se bachne ke lie dushit sirinj (bvadjanupdanjamak ailtpdhm) tatha dushit rakt se bachen. in donon rogon se bachav vaiksin ke tike lagvakar bhi kiya ja sakta hai.
janm kundli ke vishleshan ke lie bat karen desh ke prasiddh jyotishiyon se keval fyuchar point par