
gambhir bimari polyneuropathy

gambhir bimari polyneuropathy (see. aaee. pee.) aur gambhir bimari myopathy (see. aaee. aim.) gambhir roop seey beemar rogiyon mein honey vaale fail, samamit, shithil maanspeshiyon kii kamjori key ativyaapi syndrome hain aur isamen sabhi chhor aur kapaal kii nason key saapeksh chhoot key saath diaphram shamil hain. sip aur sima mein samaan lakshan aur prastutiyaan hoti hain aur aksar vishesh electrophysiologic pareekshan yaa maanspeshiyon aur tantrika biopsy key aadhar parr alag-alag hoti hain. sip aur sima key kaaran agyaat hain, halanki unhein pranaaleegat soojan pratikriya syndrome kii sambhaavit tantrika sambandhi abhivyakti maanaa jaataa haye. corticosteroids aur neuromuscular blocking agent, joe vyaapak roop seey gahan dekhbhal mein upayog kiye jaate hain, sip aur sima key vikas mein yogdan curr sakate hain, jaisa kii rakt sharkara mein vriddhi hoe sakati haye, joe aksar gambhir roop seey beemar rogiyon mein hoti haye.
sip kaa varnan pahali baar charles aff ney kiya thaa. paanch rogiyon kii ack shrinkhala mein boult.
sanyukt sip aur sima kaa varnan pahali baar nikola latronico dwara 24 rogiyon kii ack shrinkhala mein kiya gayaa thaa.
sanket aur lakshan.
sip/sima vaale logon mein failati, samamit, shithil maanspeshiyon kii kamjori hoti haye. sip/sima aamtaur parr ack gambhir bimari aur sthirikaran kii setting mein vikasit hotaa haye, isaliye sip/sima vaale rogiyon koo aksar gahan dekhbhal ikai (aaee. see. yuu.) mein upchaar praapt hotaa haye.
kamjori (motor kii kamee) shareer key ack kshetra mein shuru honey aur failane key bajaay saamaanyikrit tareeke seey hoti haye. anga aur shwasan (diaphram) maanspeshiyaan vishesh roop seey prabhaavit hoti hain. chehare kii maanspeshiyon koo aamtaur parr bakhsha jaataa haye, lekin durlabh mamalon mein, aankho kii maanspeshiyaan kamjor hoe sakati hain, jisase netra roga hoe sakata haye.
pasaliyon (intercoastal) key beach kii maanspeshiyon key ksheen honey, diaphram maanspeshiyon key ksheen honey aur diaphram (franic tantrika) koo uttejit karane vaali tantrika key apakshay key kaaran shwasan sambandhi kathinaaiyaan hoe sakati hain. yeh ack vyakti koo saans lene kii machine (yaantrik ventilation) seey baahar nikaalane mein lagane vaale samay koo 7-13 dinon taka badhaa sakata haye.
gahare tendon reflex khou sakate hain yaa cumm hoe sakate hain, aur baahon aur pairon kaa dwaipaakshik samamit shithil pakshaghat hoe sakata haye. tantrika tantra kii abhivyaktiyaan aam taur parr paridhiya tantrikaon taka seemit hoti hain, kyonki kendriya tantrika tantra aamtaur parr aprabhaavit hotaa haye.
kaaran.
sip aur sima key kaaran agyaat hain, halanki unhein pranaaleegat soojan pratikriya syndrome kii sambhaavit tantrika sambandhi abhivyakti maanaa jaataa haye.
pathology.
tantrika biopsy akshatantu tantrika vikriti dikhaayega, lekin yeh abb sanketit naheen haye. gambhir bimari myopathy kii ack manspeshi biopsy maanspeshiyon mein motee tantuon key chayanaatmak nuksan koo dikhaayegi, joe myosine key nuksan aur maanspeshiyon kii koshika mrityu (necrosis) kii upasthiti koo pradarshit karati haye. jaba maanspeshiyaan neurons seey uttejana khou detee hain, tou way apakshay seey gujar sakati hain. haalaanki, jaba gambhir bimari myopathy hoti haye, tou yeh kewal maanspeshiyon key srijan key nuksan key kaaran naheen hoti haye. gambhir bimari myopathy key saath, maanspeshiyon key apakshay kaa koee anya kaaran naheen paaya jaa sakata haye.
gillion baire syndrome key vipareet, ack anya tantrika sambandhi vikaar joe kamjori kaa kaaran banata haye, gambhir bimari polyneuropathy vaale rogiyon mein myelin aavaran kaa nuksan naheen hotaa haye joe aam taur parr neurons (demillination) koo gherta haye.
nidan.
sip aur sima aaee. see. yuu.-arjit kamjori (aaee. see. yuu. oh.) kaa ack pramukh kaaran hain. vartamaan dishanirdesh chikitsa anusandhaan parishad (aim. aar. see.) yog ank yaa haath pakad dynamometry key upayog key saath maanspeshiyon kii taakat kaa manual roop seey pareekshan karke kiye gaye iq key naidaanik nidan kii sifarish karate hain.
sip/sima kii pehchaan aksar taba taka naheen kii jaati haye jaba taka kii ack rogi koo yaantrik ventilator seey safaltapurvak doodh chhodane mein asamarth naheen kiya jaataa haye. iss sthiti kaa jaldi pataa lagaana mushkil haye, kyonki yeye rogi aksar behosh aur intubated hotey hain, aur iss prakaar poori tarah seey tantrika-peshi shaaririk pariksha mein sahyog karane mein asamarth hotey hain. paaramparik tantrika chaalan adhyayanon kaa upayog samay lene vaalaa haye aur isake liye vishesh karmiyon kii aavashyakta hoti haye; haalaanki, saralikrit electrophysiological parikshanon kaa upayog gambhir roop seey beemar logon mein see. aaee. pee./see. aaee. aim. kii pushti karane yaa usey baahar karane key liye screening upkaran key roop mein kiya jaa sakata haye. peroneal tantrika pareekshan ack maanya, uchch-samvedansheelta, nyuntam aakramak, gair-swaichhik aur twarit naidaanik pareekshan haye joe parinam samanya honey parr sateek roop seey sip/sima koo baahar curr sakata haye. isake alawa, anupayogi shosh aur maanspeshiyon kii vikriti vaale rogiyon key samanya electrophysiological pareekshan hotey hain, bhale hii maanspeshiyon kii taakat gambhir roop seey cumm hoe jaae, isaliye yeye pareekshan maanspeshiyon kii kamjori key kaaran koo paribhaashit karane key liye mahatvapurna hain aur roga kaa nidan karane mein sahayak hoe sakate hain.
prayogshala moolya.
seeram creatin phosphokinase (see. pee. key.) koo halka badhaaya jaa sakata haye. jabaki cpk aksar maanspeshiyon key ootak koo nuksan key liye ack achchha marker hotaa haye, yeh sip/sima mein ack sahayak marker naheen haye, kyonki sip/sima ack kramik prakriya haye aur isamen aamtaur parr mahatvapurna maanspeshiyon kii koshika mrityu (necrosis) shamil naheen hoti haye. isake alawa, aggar necrosis maujood haye, tou bhee yeh sankshipt hoe sakata haye aur isaliye aasaani seey chhoot jaataa haye. yadi ack cutty chhidra (reedh kii huddy kaa null) kiya jaataa haye, tou mastishk reedh kii huddy key taral padaarth mein protein kaa star samanya hoga.
screening.
sip/sima key liye praarambhik jaanch maanspeshiyon kii taakat key liye ack vastunishth scoring pranali kaa upayog karke kii jaa sakati haye. chikitsa anusandhaan parishad (aim. aar. see.) score ack aisaa upkaran haye, aur kabhi-kabhi shodh adhyayanon mein see. aaee. pee./see. aaee. aim. rogiyon kii pehchaan karane mein madad karane key liye upayog kiya jaataa haye. aim. aar. see. score mein oopari aur nichale donon chhoron key daahine aur baaen taraf 3 manspeshi samoohon mein taakat kaa aaklan karna shamil haye. pratyek maanspeshiyon kaa pareekshan 0-5 kaa score diyaa jaataa haye, joe kull 60 kaa sambhaavit score detaa haye. 48 seey cumm aim. aar. see. score sip/sima kaa sujhaav detaa haye. haalaanki, upkaran key liye rogiyon koo jaagate aur sahyog karane kii aavashyakta hoti haye, joe aksar aisaa naheen hotaa haye. saath hii, jaanch upkaran gair-vishisht haye, kyonki yeh kissy vyakti kii maanspeshiyon kii kamjori key kaaran kii pehchaan naheen kartaa haye.
ack baar kamjori kaa pataa chalane key baad, maanspeshiyon kii taakat kaa mulyankan kaee baar dohraya jaanaa chaahiye. yadi kamjori bunny rahati haye, tou ack manspeshi biopsy, ack tantrika chaalan adhyayan (electrophysiological adhyayan), yaa donon kiya jaanaa chaahiye.
purvanuman.
sip/sima ack yaantrik ventilator seey ack vyakti koo chhodane mein kathinaaee kaa kaaran bunn sakata haye, aur aaee. see. yuu. mein rahane kii badhati avadhi aur mrityu darr (mrityu) mein vriddhi seey judaa huaa haye. isase bigada huaa punarvaas hoe sakata haye. choonki sip/sima seey gatishilata (andolan) mein kamee aaa sakati haye, isaliye yeh pneumonia, gahari nus ghanastrata aur fuffusiya ambolism key jokhim koo badhaata haye.
gambhir roop seey beemar loga joe komaa mein hain, way sip/sima seey poori tarah seey lakvagrast hoe sakate hain. sudhaar aamtaur parr hafton seey maheenon mein hotaa haye, kyonki maanspeshiyon mein antahkaran bahaal hoe jaataa haye. lagbhag aadhe mareej poori tarah seey thheek hoe jaate hain.
mahamari vigyaan.
jabaki sateek ghatana agyaat haye, anuman 33-57 pratishat rogiyon key beach 7 dinon seey adhik samay taka aaee. see. yuu. mein rahane kaa haye. adhik sateek detta praapt karna mushkil haye, kyonki sthiti koo paribhaashit karane mein bhinnata maujood haye.
sip aur sima key liye teen mukhya jokhim kaarak sepsis aur systemic inflammatory response syndrome (surr) aur multy-organ failure hain. sepsis aur surr vaale logon mein sip/sima kii darein 68 seey 100 pratishat taka hoti hain. sip/sima key vikas key liye atirikt jokhim karakon mein shamil hainh mahila ling, uchch rakt sharkara (hyperglycemia), cumm seeram albumin aur sthirata. bimari kii adhik gambhirta seey sip/sima kaa khatra badh jaataa haye. aise jokhim karakon mein shamil hainh bahu-anga shithilata, gurde kii viphalata, gurde pratisthaapan chikitsa, anga shithilata kii avadhi, aaee. see. yuu. rahane kii avadhi, aur kendriya tantrika viphalata.
kuchh davaaen sip/sima seey judee hoti hain, jaise kii corticosteroids, neuromuscular blocking agent, vasopressor, catacolemine aur antahshira poshan (parenteral poshan). shodh ney hypoxia, hypotension, hyperpyraxia key prabhaav aur sip/sima key jokhim parr umr mein vriddhi key liye asangat parinam diye hain. aminoglycosides kaa upayog sip/sima key vikas key liye ack swatantra jokhim naheen haye.
itihas.
sip kaa varnan pahali baar 1984 mein charles aff dwara kiya gayaa thaa. paanch rogiyon kii ack shrinkhala mein boult. iss sthiti koo "boltons neuropathy" key roop mein varnit kiya jaataa thaa.". 1996 mein, latronico aur unake sahyogiyon ney pahali baar bataaya kii sip aur sima aksar ack hii rogi mein saha-astitva mein hotey hain.
shabdawali.
gambhir bimari polyneuropathy kaa varnan karane key liye kaee shabdon kaa upayog kiya jaataa haye, aanshik roop seey kyonki ack hii vyakti mein aksar neuropathy aur myopathy hoti haye, aur iss sthiti mein tantrika aur maanspeshiyon key apakshay koo ack dusare seey alag karna mushkil hotaa haye. iss sthiti key liye upayog kiye jaane vaale shabdon mein shamil hainh gambhir bimari polyneuromyopathy, gambhir bimari neuromyopathy, aur gambhir bimari myopathy aur neuropathy (crimine). boltons neuropathy ack purana shabd haye, jiska abb upayog naheen kiya jaataa haye.

