tivra damaa

tivra gambhir damaa, jyala sthitee damaa asehi mhanatat, haah damacha tivra udrek aahe joou bronchodilators (inhailer) aanee corticosteroidschya pramanit upcharanna pratisad dett nahee. dumm haah anek janukanmule hoto, kahincha snrakshak parinam asato, pratyek janukavar paryavaranacha prabhav padanyachi swatachi pravrutti asate, jaree tivra damyala karanibhoot honara anuvanshik sambandh adyap adnyat aahe. chhatit ghattapana, vegane vadhanara dyspania (shwas ghenyas tras), korada khokala, sahayak shwasan snayuncha vapar, jalad aanee/kinwa shwas ghenyas tras hone aanee tivra gharghar hone hii lakshane aahet. haah vayumargatil adthalyacha jivghena bhag aahe aanee vaidyakeey aapatkalin kaal manla jaato. guntaguntinmadhye hriday aanee/kinwa shwasan bund honyacha samavesh hoto. etopi aanee damache vadhate praman adyap spasht jhalele nahee parantu shwasan vishanunchya sansargamule asoo shakate.
chinhe aanee lakshane.
damyachi tivrata vadhane (hallah) shwas ghenyas tras hone aanee khokala (anekada ratri adhik white) yasah damyachi lakshane bighadane mhanoon anubhavale jaate. tivra damyachya tivra avasthet, shwas ghenyas tras itka tivra asoo shakato qee kahee shabdanpeksha jaast bolane ashakya aahe (vakye purn karnyat asamarthata).
tapasani kelyavar, shvasochavasacha darr vadhu shakato (prati minit 25 peksha jaast shwas) aanee hrudayache thoke jalad asoo shakatat (prati minit 110 thoke kinwa adhik vegwan). auxigen sampruktatechi patali qamee hone (parantu 92 takkyanhun adhik) anekada aadhalate. stethoskopadware fuffusanchya tapasanimule havetil pravesh qamee jhalela aanee/kinwa vyapak gharghar disun yeu shakate. shvasochavasacha sarvoch pravah antharunavar mojala jaau shakato; tivra damyachya tivra avasthet, pravah vyaktichya samanya kinwa andajit pravahachya 50 takkyanpeksha qamee asato.
atyant tivra damaa (jyala jiwala tatkal dhoka asalyane 'pranghatak' mhatale jaate) heey 33 takkyanpeksha qamee andajit kamal pravah, 92 takkyanpeksha qamee auxigen saturation kinwa cyanosis (sahasa othancha nila rung), chhativar aikoo yenyajoga shvasochavasacha aavaj naan yene ('shant chhati': teey nirman karnyasathi pureshi havechi halchal naslyamule gharghar aikoo yet nahee), shwasan prayatna qamee hone aanee drishyaman thakwa kinwa tandri heey vaishishtya aahe. hrudayache thoke aniyamit asane aanee raktadabat asamanya ghat disun yeu shakate.
damyachya tivra hallyamule khaleel lakshane disu shakatatah 
kaaran.
damyachya tivra hallyanche kaaran adyap adnyat aahe aanee kahee andaj asale taree, tadnyanna heey dekhil khatri nahee qee teey qaa vikasit jhaale aanee damyachya vishisht upcharanna teey qaa pratisad dett naheeh 
yantrana.
damyatil jaljal heey suruvatichya tappyat eosynophilscha ogh aanee shevatchya tappyat (kinwa dirghakalin) pratikriyedarmyan eosynophils, mast peshi, lymphocytes aanee neutrofilschi banaleli mishra peshi ghuskhori dware darshavile jaate. damachya allergychya dahasathiche sope spashtikaran pramukhyane sahayyak sahayyak lymphocyte-chalit, rogpratikarak vatavaranachya ulat, sahayyak sahayyak lymphocyte-chalit, rogpratikarak vatavaranachya vikasapasoon suru hote, jeey kadachit aayushyachya suruvatichya kalat vishisht prakarchya rogpratikarak uttejananmule hote. tyanantar anuvanshikdrushtya sanvedanshil vyaktimadhye ellergiesonya sampark yeto.
vishisht ellergiesonya sampark (udaa.jee., dhoolyukt sukshmajiv) heey sahayyak tii. tii. peshinchya prabhavakhali tyaa ellergiesonsathi vishisht asalelya immunoglobulin eae (aay. jee. eae.) pratipindanche bii-lymphocyte vistar karatat. aay. jee. eae. pratipind vayumarg shleshmal mast peshinvaril prushthbhagachya receptorsna jodale jaate. eka mahattvacha prashna assa aahe qee damaa asalelya atopic vyaktinmadhye, damaa nasalelya atopic vyaktinchya ulat, shleshmal akhandatet dosh asato qaa jyamule tyanna shleshmalamadhye allergykarak padarthanchya praveshas sanvedanaksham banato.
tyanantarchya vishisht ellergiesonya samparkamule aay. jee. eae. renunche paraspar sanyugma aanee madhyasthanchya vistrut shrenisah aanee muktisah mast peshinche sakriyakaran hote. yaa madhyasthanmadhye histamine; leucotrians leucotrians, see4 aanee eae4; aanee anek cytokinescha samavesh aahe. ektritpane, heey madhyasth shwasanaliket snayunche gulgulit aakunchan, raktavahinyanchi galatee, dahak peshi bharati (pudhil madhyasth sodanyasah) aanee shleshmal granthicha srav karatat. yaa prakriyanmule gulgulit snayunche aakunchan, vayumarganchi sooj, dahak peshincha ogh aanee intraluminal shleshmal tayar jhalyamule vayumargat adthala nirman hoto. yavyatirikt, satatchya vayumargatil jaljalamule shvasamargachi atisakriyata damache vaishishtyapurn lakshan asalyache manale jaate. vayumargatil adthala jitka gambhir asel, titka vayuvijan-sanlayan visangatimule vayoo vinimay bighadel aanee raktatil oxygenchi patali qamee hoil.
nidan.
prathamik upchar chikitsak (pii. see. pii.) dware tivra damyache nidan kele jaau shakate. eka pii. see. pii. lakshane aanee shvasochavasababat prashna vicharel; teey shwas aat kinwa baher ghetana thakwa kinwa gharghar anubhavali aahe qaa heey dekhil vichartil; aanee uchch shwasan pravah aanee auxigen sampruktata vaparoon chachani dekhil kartil.
damyavyatirikt itar tivra karananmule gharghar hote tevha damyachya sthitiche chukiche nidan kele jaau shakate. gharghar yenyachya yapaiki kahee paryayi karananchi charcha khalee kelee aahe.
bahya sankochan.
raktavahinyanchya vartule, lymphadenopathy kinwa arbudansarkhya raktavahinyanchya sanrachananpasun vayumarg sankuchit kele jaau shakatat.
hradayavikaracha adthala.
vayumarg soojmule see. etch. eff. madhye gharghar houu shakate. yavyatirikt, raktavahinyanche sankochan systole darmyan hrudayatoon baher padnyadvare vayumarg sankuchit karoo shakate, parinami hrudayachya darachya anuroop spandaniy gharghar hote. yala kadhikadhi chukun hrudayavikaracha damaa asey sambodhale jaate.
upchar.
hastakshepanmadhye antahshira (4) aushadhancha samavesh hoto (udaa.jee. magneshiyam sulfate), vayumarg vistaranyasathi erosolikrut aushadhe (bronchodilation) (udaa.jee., albuterol kinwa epratropium bromide/salbutamol), aanee yantrik vayuvijanasaha sakaratmak daab upchar. damyachya sthitiche parinam vegane ulatavanyasathi aanee vayumarganche kayamswarupi nuksan qamee karnyasathi ekach velee anek upcharpaddhati vaparlya jaau shakatat. antahshira corticosteroids aanee methyluxanthines anekada dile jaatat. damyachi tivra tivrata asaleli vyakti yantrik ventilatorvar asalyas, ketamine kinwa propopholsarkhya kahee shamak aushadhanmadhye shwasanalikela tras denare gunadharm asatat. eka naveen yadruchchik niyantran chachaninusar, tivra damaa asalelya mulanmadhye, jeey pramanit upcharpaddhatila kharab pratisad detat, ketamine aanee aminophiline dekhil prabhavi aahet.
alikadil sanshodhan.
alikadil abhyasat asey suchavale gele aahe qee yazman vayumarg upakala peshi aanee shwasan vishanu yanchyatil parasparkriya haah janmajat pratikarshakticha aanakhi eka pailu aahe joou damyacha nirnayak nirnay dekhil aahe. tivra sansargjanya aajaar aanee shwasan vishanoonmule honara junat dahak rog rokhanyasathi upakala peshi staravar vishanuvirodhi karyapradarshan kase sudharle jaau shakate yache tark dekhil prastavit karnyat aale hote.
aanakhi eka abhyasacha uddesh asey darshavine aahe qee vishanujanya sansarganantar prayogik damaa haah kaidi fuffusanmadhil paramparik dendritic peshinvar (see. dii. see.) aay. jee. eae. (eff. see. eae. aar.) sathee uchch-aakarshan receptorchya prakar 1 aay. eff. aine.-chalit up-regulationvar avalambun asato. yaa abhyasat asey aadhalun aale aahe qee vishanujanya sansargamule atopic rog honyas karanibhoot honyasathi fuffusanmadhye naveen pii. emm. aine.-see. dii. see. parasparkriya aavashyak aahe.
mahamarishastra.
damachi sthitee hii purushanmadhye thodi adhik samanya aahe aanee african aanee hyspanic moolchya lokanmadhye adhik samanya aahe. locus glutathionavar avalambun asalele ess-nitrosoglutathion (jee. ess. aine. aar.) heey januk damyachya sthitichya vikasashi eka sambhavya parasparsambandh mhanoon suchavale gele aahe.

