peeliya

Jaundice, NOS
vargeekaran evam baahya saadhan
Jaundice eye.jpg
Yellowing of the skin and conjunctiva overlying the sclera caused by Hepatitis A.
aaiseedi-10 R17.
aaiseedi-9 782.4
dijeej-deebi 7038
medalaain plas 003243
M.iesaech D007565

raktaras mein pittaranjak (Billrubin) naamak ek rang hota hai, jiske aadhikya se tvacha aur shleshmik kala mein peela rang aa jaata hai. is dasha ko kaamala ya peeliya (Jaundice) kehte hain.

saamaanyat: raktaras mein pittaranjak ka star 1.0 pratishat ya isse kam hota hai, kintu jab iski maatra 2.5 pratishat se oopar ho jaati hai tab kaamala ke lakshan prakat hote hain. kaamala swayam koi rogavishesh naheen hai, balki kai rogon mein paaya jaanevaala ek lakshan hai. yeh lakshan nanhein-nanhein bachchon se lekar 80 saal tak ke boodhon mein utpann ho sakta hai. yadi pittaranjak ki vibhinn upaapachayik prakriyaaon mein se kisi mein bhi koi dosh utpann ho jaata hai to pittaranjak ki adhikta ho jaati hai, jo kaamala ke kaaran hoti hai.

rakt mein laal kanon ka adhik nasht hona tatha uske parinaamasvaroop apratyaksh pittaranjak ka adhik banana bachchon mein kaamala, navajaat shishu mein rakt-koshika-naash tatha anya janmajaat, athva arjit, rakt-koshika-naash-janit raktaalpata ityaadi rogon ka kaaran hota hai. jab yakrut ki koshikaaeain asvasth hoti hain tab bhi kaamala ho sakta hai, kyonki ve apna pittaranjak mishran ka svaabhaavik kaarya naheen kar paateen aur yeh vikruti sankraamak yakrutapradaah, raktaraseeya yakrutapradaah aur yakrut ka pathara jaana (kada ho jaana, Cirrhosis) ityaadi prasiddh rogon ka kaaran hoti hai. antat: yadi pittamaarg mein avarodh hota hai to pittapranaali mein adhik pratyaksh pittaranjak ka sangrah hota hai aur yeh pratyaksh pittaranjak pun: rakt mein shoshit hokar kaamala ki utpatti karta hai. agnaashaya, sir, pittamaarg tatha pittapranaali ke kainsaron mein, pittaashmari ki upasthiti mein, janmajaat paittik sankoch aur pittamaarg ke vikrut sankoch ityaadi shalya rogon mein maargaavirodh yakrut baahar hota hai. yakrut ke aantarik rogon mein yakrut ke bheetar ki vaahiniyon mein sankoch hota hai, at: pratyaksh pittaranjak ke atirikt rakt mein pratyaksh pittaranjak ka aadhikya ho jaata hai.

vaastavik rog ka nidaan kar sakane ke liye pittaranjak ka upaapachaya (Metabolism) samajhna aavashyak hai. raktasancharan mein rakt ke laal kan nasht hote rahate hain aur is prakaar mukt hua heemoglobin retikulo-endotheeliyl (Reticulo-endothelial) pranaali mein vibhinn mishrit prakriyaaon ke uparaant pittaranjak ke roop mein parint ho jaata hai, jo vistrut roop se shareer mein fail jaata hais, kintu iska adhik parimaan pleeha mein ikattha hota hai. yeh pittaranjak ek proteen ke saath mishrit hokar raktaras mein sancharit hota rahata hai. isko apratyaksh pittaranjak kehte hain. yakrut ke saamaanyat: svasth anu is apratyaksh pittaranjak ko grahan kar lete hain aur usamein glookoraunik aml mila dete hain yakrut ki koshikaaon mein se gujarata hua pittamaarg dvaara pratyaksh pittaranjak ke roop mein chhoti aaainton ki or jaata hai. aaainton mein yeh pittaranjak yoorobilinojan mein parivrtit hota hai jiska kuchh ansh shoshit hokar raktaras ke saath jaata hai aur kuchh bhaag, jo vishtha ko apna bhoora rang pradaan karta hai, vishtha ke saath shareer se nikal jaata hai.

pratyek dasha mein rogi ki aaainkh (safedavaala bhaag Sclera) ki tvacha peeli ho jaati hai, saath hi saath rogavishesh kaabhi lakshan milta hai. vaise saamaanyat: rogi ki tilli badh jaati hai, paakhaana bhoora ya mitti ke rang ka, jyaada tatha chikna hota hai. bhookh kam lagti hai. muainh mein dhaatu ka svaad bana rahata hai. naadi ke gati kam ho jaati hai. vitaamin 'ke' ka shoshan theek se na ho paane ke kaaran tatha raktasanchaar ko avaruddh (haemorrhage) hone lagta hai. pittamaarg mein kaafi samay tak avarodh rahane se yakrut ki koshikaaeain nasht hone lagti hain. us samay rogi shithil, ardhavikshipt aur kabhi-kabhi poorn vikshipt ho jaata hai tatha mar bhi jaata hai.

kaamala ke upachaar ke poorv rog ke kaaran ka pata lagaaya jaata hai. iske liye rakt ki jaaainch, paakhaane ki jaaainch tatha yakrut-ki kaaryashakti ki jaaainch karte hain. isse yeh pata lagta hai ki yeh rakt mein laal kanon ke adhik nasht hone se hai ya yakrut ki koshikaaeain asvasth hain athva pittamaarg mein avarodh hone se hai.

peeliya ki chikitsa mein ise utpann karne vaale kaaranon ka nirmoolan kiya jaata hai jiske liye rogi ko aspataal mein bharti karaana aavashyak ho jaata hai. kuchh mirch, masaala, tel, ghi, proteen poornaroopen band kar dete hain, kuchh logon ke anusaar kisi bhi khaadyasaamagri ko poornaroopen na band kar, rogi ke oopar hi chhod diya jaata hai ki vah jo pasand kare, kha sakta hai. aushadhi saadhaaranat: tetraasaaikleen tatha niyomaaisin di jaati hai. kabhi-kabhi kaartikositraayad (Corticosteriod) ka bhi prayog kiya jaata hai jo yakrut mein faaibrosis aur avarodh utpann naheen hone deta. yakrut apna kaarya theek se sanpaadit kare, iske liye davaaeain di jaati hain jaise liv-52, hipaaliv, livomin ityaadi. kaamala ke pittaranjak ko rakt se nikaalne ke liye kaainetomin (Kinetomin) ka prayog kiya jaata hai. kaamala ke upachaar mein laaparavaahi karne se jab rog puraana ho jaata hai tab ek se ek badhkar nai pareshaaniyaaain utpann hoti jaati hain aur rogi vibhinn sthitiyon se gujarata hua kaalakavalit ho jaata hai.

peeliya rog


vaayaral haipetaaitis ya jondis ko saadhaaranat: log peeliya ke naam se jaante hain. yeh rog bahut hi sooksh‍aam vishaanu (vaairas) se hota hai. shuroo mein jab rog dheemi gati se va maamooli hota hai tab iske lakshan dikhaai naheen padate hain, paran‍aatu jab yeh ugr roop dhaaran kar leta hai to rogi ki aankhe va naakhoon peele dikhaai dene lagte hain, log ise peeliya kehte hain.

jin vaairas se yeh hota hai uske aadhaar par mukh‍aayat: peeliya teen prakaar ka hota hai vaayaral haipetaaitis A, vaayaral haipetaaitis bi tatha vaayaral haipetaaitis naan A va naan bi.

rog ka prasaar kaise?

yeh rog j‍aayaadaatar aise s‍aathaano par hota hai jahaaain ke log v‍aayaktigt va vaataavaraneeya safaai par kam dh‍aayaan dete hain athva bil‍aakul dh‍aayaan naheen dete. bheed-bhaad vaale ilaakon mein bhi yeh j‍aayaada hota hai. vaayaral haipataaitis bi kisi bhi mausam mein ho sakta hai. vaayaral haipataaitis A tatha naae va naan bi ek v‍aayakti se doosare v‍aayakti ke najadeeki sam‍aapark se hota hai. ye virus rogi ke mal mein hotein hai peeliya rog se peedit v‍aayakti ke mal se, dooshit jal, doodh athva bhojan dvaara iska prasaar hota hai.

aisa ho sakta hai ki kuchh rogiyon ki aankh, naakhoon ya shareer aadi peele nahi dikh rahe hon paran‍aatu yadi ve is rog se gras‍aat ho to an‍aaya rogiyo ki tarah hi rog ko faila sakte hain.

vaayaral haipataaitis bi khoon va khoon va khoon se nirmit pradaartho ke aadaan pradaan evam yaun kriya dvaara failata hai. ismein vah v‍aayakti ho deta hai use bhi rogi bana deta hai. yahaaain khoon dene wala rogi v‍aayakti rog vaahak ban jaata hai. bina ubaali sui aur sireinj se in‍aajek‍aashan lagaane par bhi yeh rog fail sakta hai.

peeliya rog se gras‍aat v‍aayakti virus, nirog manush‍aaya ke shareer mein prat‍aayaksh roop se anguliyon se aur aprat‍aayaksh roop se rogi ke mal se ya makkhiyon dvaara pahoonch jaate hain. isse s‍aavas‍aath‍aaya manush‍aaya bhi rog gras‍aat ho jaata hai.

rog kahaaain aur kab?

A prakaar ka peeliya tatha naan A va naan bi peeliya saare sansaar mein paaya jaata hai. Bhaarat mein bhi is rog ki mahaamaari ke roop mein failane ki ghatanaayein prakaash mein I hain. haalaanki yeh rog varsh mein kabhi bhi ho sakta hai paran‍aatu agas‍aat, sitm‍aabar va ak‍aatoobar mahinon mein log is rog ke adhik shikaar hote hain. sardi shuroo hone par iske prasaar mein kami aa jaati hai.

rog ke lakshan:-

 A prakaar ke peeliya aur naan A va naan bi tarah ke peeliya rog ki chhoot lagne ke teen se chh: sap‍aataah ke baad hi rog ke lakshan prakat hote hain.
 bi prakaar ke peeliya (vaayaral haipetaaitis) ke rog ki chhoot ke chh: sap‍aataah baad hi rog ke lakshan prakat hote hain.

peeliya rog ke kaaran hai:-

 rogi ko bukhaar rahana.
 bhookh na lagana.
 chiknaai vaale bhojan se aroochi.
 ji michlaana aur kabhi kabhi ultiyaaain hona.
 sir mein dard hona.
 sir ke daahine bhaag mein dard rahana.
 aankh va naakhoon ka rang peela hona.
 peshaab peela aana.
 at‍aayadhik kamjori aur thaka thaka sa lagana 

rog kise ho sakta hai?

yeh rog kisi bhi avas‍aatha ke v‍aayakti ko ho sakta hai. haaain, rog ki ugrata rogi ki avas‍aatha par jaroor nirbhar karti hai. garbhavati mahila par is rog ke lakshan bahut hi ugr hote hain aur un‍aahe yeh j‍aayaada samay tak kash‍aat deta hai. isi prakaar navajaat shishuon mein bhi yeh bahut ugr hota hai tatha jaanleva bhi ho sakta hai.

bi prakaar ka vaayaral haipetaaitis v‍aayaavasaayik khoon dene vaale v‍aayaktiyon se khoon praap‍aat karne vaale v‍aayaktiyon ko aur maadak davaaon ka sevan karne vaale evam anajaan v‍aayakti se yaun sam‍aaban‍aadhon dvaara logon ko j‍aayaada hota hai.

rog ki jatiltaaऍn:-

j‍aayaadaataar logon par is rog ka aakraman saadhaaran hi hota hai. paran‍aatu kabhi-kabhi rog ki bheeshanata ke kaaran kathin leevar (yakrut) dosh ut‍aapan‍aan ho jaata hai.

bi prakaar ka peeliya (vaayaral haipetaaitis) j‍aayaada gam‍aabheer hota hai ismein jatiltaaen adhik hoti hai. iski mrut‍aayu dar bhi adhik hoti hai.

upachaar:-

 rogi ko sheegra hi dauk‍aatar ke paas jaakar paraamarsh lena chaahiye.
 bis‍aatar par aaraam karna chaahiye ghoomana, firna naheen chaahiye.
 lagaataar jaaainch karaate rahana chaahiye.
 dauk‍aatar ki salaah se bhojan mein protin aur kaarboj vaale pradaartho ka sevan karna chaahiye.
 neeboo, santare tatha an‍aaya falon ka ras bhi is rog mein gunakaari hota hai.
 vasa yuk‍aat garish‍aath bhojan ka sevan ismein haanikaarak hai.
 chauval, daliya, khichdi, thooli, ubale aaloo, shakarakandi, cheeni, g‍aalookoj, gud, cheekoo, papeeta, chhaachh, mooli aadi kaarbohaadet vaale pradaarth hain inka sevan karna chaahiye

rog ki rokathaam evam bachaav

peeliya rog ke prakop se bachane ke liye kuchh saadhaaran baaton ka dh‍aayaan rakhana jaroori hai:-

 khaana banaane, parosane, khaane se pehle va baad mein aur shauch jaane ke baad mein haath saabun se ach‍aachhi tarah dhona chaahiye.
 bhojan jaaleedaar alamaari ya dhak‍aakan se dhak kar rakhana chaahiye, taaki makkhiyon va dhool se bachaaya ja sakein.
 taaja va shudv garm bhojan karein doodh va paani ubaal kar kaam mein lein.
 peene ke liye paani nal, hain‍aadapam‍aap ya aadarsh kuon ko hi kaam mein lein tatha mal, mootr, kooda karakat sahi s‍aathaan par gadhdha khodakar dabaana ya jala dena chaahiye.
 gande, sade, gale va kate huye fal naheen khaayein dhool padi ya makkhiyaaain baithi mithaaiyaaain ka sevan naheen karein.
 s‍aavach‍aachh shauchaalaya ka prayog karein yadi shauchaalaya mein shauch naheen jaakar baahar hi jaana pade to aavaaseeya bas‍aati se door hi jaayein tatha shauch ke baad mitti daal dein.
 rogi bach‍aachon ko dauk‍aatar jab tak yeh na bata dein ki ye rog muk‍aat ho chooke hai s‍aakool ya baahari naheen jaane de.
 in‍aajek‍aashan lagaate samay siren‍aaj va sooi ko 20 minute tak ubaal kar hi kaam mein lein an‍aayatha ye rog failaane mein sahaayak ho sakti hai.
 rak‍aat dene vaale v‍aayaktiyon ki poori tarah jaaainch karne se bi prakaar ke peeliya rog ke rogavaahak ka pata lag sakta hai.
 anajaan v‍aayakti se yaun sam‍aapark se bhi bi prakaar ka peeliya ho sakta hai.

s‍aavaas‍aath‍aaya kaaryakarta dh‍aayaan dein

yadi aapke kshetr mein kisi parivaar mein rog ke lakshan wala v‍aayakti ho to use dauk‍aatar ke paas jaane ki salaah dein.

kshetr mein v‍aayaktigt safaai va taataavaraneeya s‍aavach‍aachhata ke baare mein bataaye tatha panchaayat aadi se kooda, kachara, mal, mootr aadi ke nish‍aakaasan ka in‍aatajaam karaane ka prayaas karein.

rogi ki dekhbhaal theek ho, aisa parivaar ke sadas‍aayon ko samajhaayein.

rogi ki seva karne vaale ko samajhaayein ki haath ach‍aachhi tarah dhokar hi sab kaam karein.

s‍aavaas‍aath‍aaya kaaryakarta seerinj va sui 20 minit tak ubaal kar athva dispojebal kaam mein lein.

rogi ka rak‍aat lete samay va surgery karte samay das‍aataane pahanein va rak‍aat ke sam‍aapark mein aane vaale aujaaron ko ach‍aachhi tarah ubaalein.

rak‍aat va sam‍aabandhit shaareerik drav‍aaya pradaartho par keetaanunaashak daal kar hi un‍aahe upayuk‍aat s‍aathaan par feinke athva nash‍aat karein.

jara si saavadhaani-peeliya se bachaav

anukram

saamaanya shareer kriya vigyaan

chitr:Jaundice-types.png
peeliya ke prakaar

peeliya ke parinaamon ko samajhne ke liye, peeliya utpann karne waali rogaatmak prakriyaaon ko avashya samajhna chaahiye. peeliya apne aap mein koi beemaari naheen hai, balki yeh kai sambhav moolabhoot rogaatmak prakriyaaon ka ek lakshan hai jo bileeroobin ke chayaapachaya ke saamaanya shaareerik kaaryon ke kram mein kabhi utpann hota hai.

jab laal rakt koshikaaen lagbhag 120 dinon ka apna jeevan kaal poora kar leti hain, ya jab ve kshatigrast ho jaati hain, to unki jhilliyaan kamjor ho jaati hain aur unke katane-fatne ki sambhaavana ban jaati hain. jab pratyek laal rakt koshika jaaleeyaant:kala pranaali se hokar gujarati hai, to iski jhilli koshika atyadhik kamjor hone ke kaaran ise dhaaran naheen kar paati hai aur koshika jhilli kat-fat jaati hai. heemoglobin sahit koshika ki antarvastu ko baad mein rakt mein sraavit kar diya jaata hai. heemoglobin ka maikrofej ke dvaara jeevaanu bhakshan kiya jaata hai aur yeh iske hemi (alparaktakanaranjak) aur globin (raktagolika) bhaagon mein vibhaajit hota hai. globin wala bhaag, jo ek proteen hota hai, ameeno amlon mein avakramit hota hai aur peeliya mein iski koi bhoomika naheen hoti hai. tab heeme anu ke saath do pratikriyaaen hoti hain. pratham okseekaran pratikriya laghunetraguha sambandhi (maaikrosomal) enjaaim heeme okseejinej ke dvaara utprerit hoti hai aur iske parinaamasvaroop bileevardeen (harit pittavarnak), loha aur kaarban monooksaaid utpann hote hain. agala kadam hai koshika dravya ke enjaaim bileevardeen ridktej ke dvaara bileevardeen ka ek peele rang ke tetraapaairaul varnak bileeroobin mein apachayan. yeh bileeroobin "asanyugmit," "mukt" ya "apratyaksh" bileeroobin hota hai. pratidin prati kilogram lagbhag 4 mileegraam bileeroobin utpann hota hai.[1] inmein se adhikaansh bileeroobin mrut laal rakt koshikaaon se hemi (alparaktakanaranjak) ke tootane se abhi bataai gayi prakriya se aata hai. haalaanki lagbhag 20 pratishat anya hemi (alparaktakanaranjak) sroton se aata hai, jismein aprabhaavi laal rakt koshikaaon ki utpatti aur anya heeme yukt proteen, jaise ki maanshapeshi sambandhit maailoglobeen aur saaitokrom ka tootana shaamil hai.

yakrut sambandhi ghatnaaen

fir asanyugmit bileeroobin rakt pravaah se hokar yakrut mein pahunchata hai. kyonki yeh bileeroobin ghulanasheel naheen hota hai, tathaapi, yeh rakt ke maadhyam se seeram annsaar (albumin) tak pahunchaaya jaata hai. ek baar yakrut mein pahunch kar yeh jal mein adhik ghulanasheel banane ke liye glukuronik aml ke saath sanyugmit hota hai (bileeroobin daaiglukooronaaid, ya sirf "sanyugmit bileeroobin" ka nirmaan karne ke liye). yeh abhikriya enjaaim yoodeepi-glukuronaaid traansaferej (UDP-glucuronide transferase) dvaara utprerit hoti hai.

yeh sanyugmit bileeroobin yakrut se sraavit hokar pitt ke hisse ke roop mein pittanali aur mootraashayik naaliyon mein pahunchata hai. aant sambandhi jeevaanu bileeroobin ko yoorobileenojen mein parivrtit karta hai. yahaaain se yoorobileenojen do maarg apna sakta hai. yeh ya to iske baad sterakobilinojen mein parivrtit ho sakta hai, jo fir sterakobilin mein okseekrut ho jaata hai aur mal mein chhod diya jaata hai ya aant ki koshikaaon dvaara yeh pun: avashoshit kar liya ja sakta hai, gurdon mein rakt mein pahuncha diya jaata hai aur okseekrut utpaad yoorobilin ke roop mein mootr mein chhod diya jaata hai. sterakobilin aur yoorobilin utpaad kramash: mal aur mootr ke rang ke liye jimmedaar hote hain.

kaaran

jab koi rogaatmak prakriya chayaapachaya ke saamaanya kaarya mein hastakshep karti hai aur bileeroobin ke utsarjan ki soochana sahi dhang se di jaati hai, to iske parinaamasvaroop peeliya ho sakta hai. rogaatmak kriya dvaara prabhaavit hone vaale shaareerik tantr ke angon ke aadhaar par peeliya ko teen shreniyon mein baanta ja sakta hai. teen shreniyaan hain:

shreni paribhaasha
yakrut mein pehle se hone waali rog sambandhi kriya (paithaulauji) jo yakrut mein pehle se ho rahi hai.
yakrut mein hone waali rog sambandhi kriya jo yakrut (jigr) ke bheetar paayi jaati hai.
yakrut ke baahar hone waali rog sambandhi kriya jo yakrut mein bileeroobin ke sanyog ke baad dekhi jaati hai.

yakrut mein pehle se hone wala

yakrut mein pehle hone wala peeliya kisi bhi aise kaaran se hota hai jo rakt-apaghatan (laal rakt koshikaaon ke apaghatan) ke dar mein vruddhi karta hai. ushnakatibandheeya deshon mein maleriya is tareeke se peeliya utpann kar sakta hai. kuchh aanuvanshik beemaariyaan jaise ki hansiya ke aakaar ki rakt koshika mein hone waali raktaheenata, golakakoshikta aur glookoj 6-fausfet dihaaidrojanej ki kami koshika apaghatan mein vruddhi utpann kar sakti hai aur isliye rudhirlaayi (raktalaayi) peeliya ho sakta hai. aamtaur par, gurde ki beemaariyaan, jaise ki rudhirlaayi (raktalaayi) yooreemiyaajanit sanlakshan se varnata bhi ho sakti hai. bileeroobin ke chayaapachaya mein vikaar hone se bhi peeliya ho sakta hai. peeliya mein aam taur par uchch taapamaan ke saath bukhaar aata hai. choohe ke kaatne se hone vaale bukhaar (sankraami kaamala) se bhi peeliya ho sakta hai.

prayogashaala ke nishkarshon mein shaamil hain:

  • mootr: bileeroobin upasthit naheen, yoorobileeroobin > 2 ikaaiyaan (shishuon ko chhodkar jinmein aant vanaspati viksit naheen hui hai.
  • seeram: badha hua asanyugmitbileeroobin.
  • pramastishkeenavajaatakaamala (Kernicterus) badhe huye bileeroobin se sambandhit naheen hai.

yakrut mein hone wala

yakrut mein hone wala peeliya gambhir yakrutashoth (haipetaaitis), yakrut ki vishaaktata aur alkohal sambandhi yakrut rog ka kaaran banta hai, jiske dvaara koshika pariglan yakrut ke chayaapachaya karne ki kshamata aur rakt ka nirmaan karne ke liye bileeroobin utsarjit karne ki kshamata kam karta hai. kam aam kaaranon mein shaamil hain praathamik pitt sootranarog, (primary biliary cirrhosis), gilbart sanlakshan (bileeroobin ke chayaapachaya se sambandhit ek aanuvaanshik beemaari jisse halka peeliya ho sakta hai, jo lagbhag 5% aabaadi mein paayi jaati hai), kriglar-najjar sanlakshan, vikshepi karkatarog (kaarsinoma) aur naaimain-pik rog, varg (type) si. navajaat shishu mein paaya jaane wala peeliya, jise navajaat peeliya kaha jaata hai, aamtaur par praaya: pratyek navajaat shishu mein hota hai kyonki sanyog aur bileeroobin ke utsarjan ke liye yakrut sambandhi rachanaatantr lagbhag do saptaah tak ki aayu ke pehle poorn roop se paripakva naheen hota hai.

prayogashaala ke nishkarshon mein shaamil hain:

  • mootr: sanyugmitbileeroobin upasthit, yoorobiliroobin > 2 ikaaiyaan lekin parivrtaneeya (sivaaya bachchon mein). pramastishkeenavajaatakaamala (Kernicterus) badhe huye bileeroobin se sambandhit naheen hai.

yakrut ke baahar hone wala

yakrut ke baahar hone wala peeliya, jise pratirodhaatmak peeliya bhi kaha jaata hai, pitt pranaali mein pitt ki nikaasi mein hone vaale avarodhon ke kaaran hota hai. sabse aam kaaran hain aam pitt nali mein pitt pathari ka hona aur agnyaashaya ke sheersh par agnaashayi Cancer hona. iske alaava, parajeeviyon ka ek samooh, jinhein "yakrut parajeevi" kaha jaata hai aam pitt nali mein rah sakte hain, jo pratirodhaatmak peeliya utpann kar sakte hain. anya kaaranon mein aam pitt nali ke srot mein avarodh, pitt avivrata, nalika sambandhi kaarsinoma, agnyaashayashoth aur agnaashayi kootakoshika (pancreatic pseudocysts) shaamil hain. pratirodhaatmak peeliya ka ek asaadhaaran kaaran mirijji sanlakshan (Mirizzi's syndrome) hai.

peele malon aur kaale mootr ki upasthiti ek pratirodhaatmak ya yakrut ke baahar hone vaale kaaran ko soochit karta hai kyonki saamaanya mal ko pitt varnak se rang praapt hota hai.

rogiyon mein kabhi-kabhi atyadhik seeram kolestraul upasthit rah sakta hai aur ve aksar gambhir khujali ya "khaaj" ki shikaayat karte hain.

koi bhi ek jaanch peeliya ke vibhinn vargeekaranon ke beech antar spasht naheen kar sakta hai. yakrut ke kaarya pareekshanon ka mishran ek nidaan par pahunchane ke liye aavashyak hai.

[2]
yakrut ke pehle hone wala peeliya yakrut mein hone wala peeliya yakrut ke baahar hone wala peeliya
kul bileeroobin saamaanya/badha hua badha hua
sanyugmit bileeroobin badha hua saamaanya badha hua
asanyugmit bileeroobin saamaanya/ badha hua saamaanya
yoorobileenojen saamaanya/ badha hua ghata hua / nakaaraatmak
mootr ka rang saamaanya kaala
mal ka rang saamaanya peela
kshaareeya fausfetej star saamaanya badha hua
ailenaain (sfatikeeya emeeno aml) traansaferej aur aispaartret traansaferej star badha hua
mootr mein sanyugmit bileeroobin upasthit naheen upasthit

navajaat (shishu) sambandhi peeliya

navajaat (shishu) sambandhi peeliya aamtaur par haanirhit hota hai: yeh avastha aksar navajaat shishuon mein janm ke baad lagbhag doosare hi din dekhi jaati hai. yeh avastha saamaanya prasavon mein 8vein din tak rahati hai, ya samay se pehle janm hone par 14vein din tak rahati hai. seeram bileeroobin bina kisi aavashyak hastakshep ke nimn star tak chala jaata hai: peeliya sanbhavat: janm ke baad ek chayaapachaya aur shaareerik anukoolan ka parinaam hai. charam sthitiyon mein, mastishk ko nuksaan pahunchaane waali sthiti mastishkeenavajaatakaamala (Kernicterus) utpann ho sakti hai, jisse mahatvapoorn aajeevan apangata ho sakti hai. is baat ki chinta ki ja rahi hai ki aparyaapt khoj aur navajaat bileeroobin ki adhikta ke aparyaapt upachaar ke kaaran haal ke varshon mein yeh sthiti badhti ja rahi hai. aaranbhik upachaar mein aksar shishu ko gahan prakaashachikitsa ke sansarg mein laaya jaata hai.

peeliyaagrast aankh

kabhi yeh vishvaas kiya jaata tha ki peeliya se peedit vyaktiyon ko sab kuchh peela hi dikhaai deta tha. vistaar mein jaane par, peeliyaagrast aankh ka arth ek pakshapaatapoorn drushtikon samjha jaane laga, jo saamaanya roop se adhik nakaaraatmak ya adhik doshagraahi tha. alekjeindar Pope ne "ain ऍse on kritisijm" ("An Essay on Criticism") (1711) mein likha:" sankramit jaasoos ko har koi sankramit maaloom padta hai, jaisa ki pakshapaatapoorn drushtikon ko har jagah pakshapaat hi dikhta hai". isi prakaar 19 veen shataabdi ke madhya mein angreji kavi Lord alfred teneesan ne apni kavita lauksli hall ("Locksley Hall") mein likha: "So I triumphe'd ere my passion sweeping thro' me left me dry, left me with the palsied heart, and left me with a jaundiced eye."

asaamaanya yakrut falak vaale rogi ke liye naidaanik rekhaachitr

peeliyaagrast adhikaansh rogiyon mein yakrut falak (panel) asaamaanyataaon ki vibhinn poorvaanumaan yogya paddhatiyaan hongi, yadyapi ismein avashya hi mahatvapoorn parivartan hota hai. vishisht yakrut falak mein pramukh roop se yakrut se praapt enjaaimon ke rakt star shaamil honge, jaise ki emeenotraansaferej (ALT, AST) aur kshaareeya bhaasveeyed (fausfetej) (ALP); bileeroobin (jiske kaaran peeliya hota hai); aur proteen ke star, vishesh roop se, kul proteen aur shviti (albumin). yakrut ke kaarya ke liye anya pramukh prayogashaala pareekshanon mein GGT aur prothaumbin time (PT) shaamil hain.

haddi aur hrudaya sambandhi kuchh vikaar ALP aur emeenotraansaferej mein vruddhi la sakte hain. isaliye yakrut sambandhi samasya se unke antar nikaalne ki disha mein pratham kadam GGT ke staron ki tulana karna hai, jo keval yakrut sambandhi vishisht sthitiyon mein badhega. doosra kadam peeliya ke pitt sambandhi (pittaruddh kaamala) ya yakrut sambandhi (yakrut mein hone wala) kaaranon aur parivrtit prayogashaala pareekshanon se antar spasht karna hai. pehla vishesh roop se ek shalya chikitsa sambandhi pratikriya soochit karta hai, jabki doosra vishesh roop se chikitseeya pareeksha ki pratikriya ka sahaara leta hai. ALP aur GGT star vishesh roop se par ek hi tareeke se badh jaaenge jabki AST aur ALT ek alag tareeke se badheinge. yadi ALP (10-45) aur GGT (18-85) star AST (12-38) aur ALT(10-45) ke oonchaai ke anupaat mein badhte hain to yeh pittaruddh kaamala ki samasya ko soochit karta hai. doosari taraf, agar AST aur ALT mein vruddhi ALP aur GGT mein vruddhi se mahatvapoorn roop se adhik hota hai, to yeh ek yakrut sambandhi samasya ko soochit karta hai. ant mein, peeliya ke yakrut sambandhi kaaranon ke beech antar pata karne mein AST aur ALT ke staron ki tulana upayogi saabit ho sakti hai. AST star aamtaur par ALT star se adhik hogi. sivaaya yakrutashoth (haipetaaitis) (vishaanujanit ya yakrutavishkaari) ke adhikaansh yakrut sambandhi vikaaron mein yahi sthiti bani rahati hai. alkohal se yakrut ko nuksaan pahunchane mein apekshaakrut roop se saamaanya ALT star dekhne ko mil sakte hain, jismein AST AST ki tulana mein 10x adhik hota hai. doosari taraf, yadi ALT AST ki tulana mein adhik hota hai, to yeh yakrutashoth (haipetaaitis) ka soochak hota hai. ALT aur AST ke star yakrut ko nuksaan pahunchane ki seema tak achhi tarah se sahasanbaddh naheen hote hai, yadyapi in staron mein bahut uchch star se sheegra kamiyaan gambhir pariglan soochit kar sakte hain. shviti (Albumin) ke nimn star ek deerghakaalik sthiti soochit karne lagte hain jabki yeh yakrutashoth (haipetaaitis) aur pittaruddh kaamala mein saamaanya roop se hota hai.

yakrut sambandhi falakon ke liye prayogashaalaaon ke parinaamon ki aksar unke antaron ke parimaan se tulana ki jaati hai na ki shuddh sankhya aur saath hi saath unke anupaaton se. AST: ALT anupaat is baat ka ek achha soochak ho sakta hai ki vikaar alkohal ke sevan se yakrut ko hone wala nuksaan (10), yakrut ka anya prakaar ka nuksaan (1 se adhik) ya yakrutashoth (1 se kam) hai. 10x saamaanya se adhik bileeroobin ke star navotpaadit ya yakrut ke andar pittasthirta soochit kar sakte hain. isse kam star yakrutakoshikeeya kaaranon ko soochit karne lagte hain. 15x se adhik AST star teevr yakrutakoshikeeya nuksaan ko soochit karne lagta hai. isse kam pratirodhaatmak kaaranon ko soochit karne lagta hai. saamaanya 5x se adhik ALP star pratirodh ko soochit karne lagta hai, jabki saamaanya 10x se adhik star aushadhi (vishaakt) prerit pittaruddh kaamala yakrutashoth ya saaitomegaalovaayaras (Cytomegalovirus) ko soochit kar sakte hain. in donon sthitiyon mein bhi ALT aur AST saamaanya 20× se adhik ho sakte hain. saamaanya 10x se adhik GGT star vishesh roop se pittasthirta ko soochit karte hain. 5-10× star vishaanujanit yakrutashoth ko soochit karte hain. saamaanya 5× se kam star aushadhi vishaaktata ko soochit karne lagte hain. gambhir (atipaati) yakrutashoth mein vishesh taur par ALT aur AST star saamaanya 20-30× (1,000 se adhik) se adhik badhega aur kai saptaahon tak mahatvapoorn roop se kaafi badha hua rah sakta hai. eseetomaainofen (Acetaminophen) vishaaktata ke parinaamasvaroop ALT aur AST star saamaanya 50x se adhik ho sakte hain.

sandarbh

  1. . | antim= paashankar (Pashankar) | pratham = D | sahalekhak= skribr, aar A (Schreiber, RA) | sheershak = bade bachchon aur kishoron mein peeliya | patrika = baal chikitsa ki sameeksha | aayatan = 22 | ank = 7 | prushth = 219-226 | taareekh = July 2001 | doi 10.1542/pir.22-7-219 | pmid = 11435623}}
  2. goljan, Edward ef., raipid riviyu paitholauji, doosra sanskaran. prushth. 368-369. 2007.

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