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Bihar ke vibhinn hospitals mein Acute Encephalitis Syndrome (AES) ki wajah se 400 se adhik bachcho ko bharti karaaya gaya hai

Chamki Bukhar Kya Hai | Kaise Litchi Se Ho Rahi Hai Maute

Kahani abb tak: Bihar ke Muzaffarpur, Vaishali aur poorvi jilon mein Acute Encephalitis Syndrome (AES) ne ab tak 100 se adhik bachchon ke jeevan ka daava kiya hai. (AES) ki wajah se 400 se adhik bachche vibhinn hospitals mein bharti karaaya gaya hai adhikaansh mauton ko low blood sugar level (Hypoglycaemia) ki wajah se jimmedaar thaharaaya gaya hai.

Acute Encephalitis Syndrome kya hai?

(AES) kam shabdo aur saral bhasha mein, yeh ek aisi stithi hai jismein bachho ko neurologic manifestions, maanasik bhram, bhatkaav, aakshep, pralaap ya coma shaamil hain.

Virus ya bacteria ke kaaran hone vaala meningitis, virus ke kaaran hone vaala Encephalitis (jyaadaatar jaapaanee Encephalitis), bacteria ke kaaran hone vaala Encephalitis, cerebral maleriya aur skrab typhus ko saamoohik roop se Acute Encephalitis Sindrome kaha jaata hai.

Jabaki rogaanu sabhee sthitiyon ka kaaran banate hain, encephalopathy mool mein jaiv raasaayanik hai, aur iss liye baaki hisson se bahut alag hai. Vibhinn prakaar ke encephalopathy hain. Vartamaan maamale mein, encephalopathy Hypoglycaemiase judee hai aur iss liye ise Hypoglycaemic encephalopathy kaha jaata hai.

Kya Encephalitis Hypoglycaemic encephalopathy se alag hai?

Haan. Dono sthitiyon mein bahut alag lakshan aur clinical manifestations dikhaee detee hain.

Brain mein dysfunction shuroo hone se pahale 1 din bukhaar Encephalitis ke lakshanon mein se ek hai. Jabaki bachchon mein Hypoglycaemic encephalopathy ke maamale mein bukhaar dekha jaata hai, bukhaar hamesha brain kee dysfunction (vaastav mein brain kee dysfunction ke kaaran) kee shuruaat ke baad hota hai. Aur sabhee bachche bukhaar ka pradarshan nahin karate hain. Kuch bachchon ko bukhaar nahin hai, jabaki kuch ko halka ya bahut tej bukhaar ho sakata hai.

Encephalitis vaale bachchon mein aam taur par blood sugar ka star saamaany hota hai lekin Hypoglycaemic encephalopathy vaale bachchon mein kam hota hai.

Encephalitis ke maamale mein, ek ya do din ke liye bukhaar (virus ke infection ke kaaran) ke baad brain prabhaavit hone ke lakshanon kee shuruaat hotee hai. Haalaanki, Hypoglycaemic encephalopathy mein, bachche bina kisee beemaaree ke bistar par chale jaate hain lekin agale din subah jaldee (4 baje se 7 baje ke beech) ulti, ainthan aur ardh-chetana jaise lakshan prakat karate hain. Uss samay, blood sugar ka star kam hota hai, iss liye naam Hypoglycaemic encephalopathy hai. Dono ke beech sabse mahatvapoorn antar cerebrospinal fluid mein white blood cells kee upasthiti hai. Encephalitis mein, cerebrospinal fluid kee prati ikaee maatra mein adhik white blood cells hotee hain, jo brain mein soojan ka ek pratibimb hai. Iske vipareet, Hypoglycaemicencephalopathy mein white blood cells mein koee vrddhi nahin dekhee jaatee hai kyonki brain mein koee soojan nahin hotee hai. 

Bihar mein kitane bachche maare gae?

Adhikaansh maamalon mein, bachchon kee mrtyu Hypoglycaemic encephalopathy ke kaaran huee. Ek Press Information Bureau (PIB) kee release (18 june) ke anusaar, Hypoglycaemia(low bloodsugar ka star) Muzaffarpur mein marane vaale bachchon ke "high percentage" mein bataaya gaya tha. Hypoglycaemic encephalopathy ke vipareet, Encephalitis low bloodsugar ke star ka kaaran nahin banata hai, iss liye bachchon kee high percentage mein maut Encephalitis ke kaaran nahin ho sakatee hai.

Iska asar keval chhote bachchon par hee kyon pada hai?

Yeh ek manaaya gaya tathya hai ki 2 se 10 varsh ke kuposhit bachche beemaar pad jaate hain aur Hypoglycaemic encephalopathy ke kaaran mar jaate hain. Yeh gyaat nahin hai ki bade bachche ya bade log ussi tarah se peedit kyon nahin hote hain. Umar se yah spasht bhedbhaav bhee ek kaaran hai ki beemaari ka kaaran virus nahin ho sakata hai. Ek virus umar se bhedbhaav nahin karta hai, aur do saal se chhote bachche bhee Japaani Encephalitis se prabhaavit hote hain.

Yeh bhee pralekhit kiya gaya hai ki beemaar padane vaale adhikaansh bachche phalon ki katai karne ke liye baagon mein dera jamae parivaaron se hain. Yeh bachche jameen par gire phalon ko ikattha karke khaate hain.

Hypoglycaemi cencephalopathy ka prakop Aprail-July tak seemit hai, jiss mein June mein aakde badh jaate hain. Aisa iss liye kyonki is dauraan litchi ki kataee ki jaatee hai. 

Kya litchi phal Hypoglycaemic encephalopathy paida karane ke liye jimmedaar hai?

2012-2013 mein, vaayarolojist Dr. T. Jacab John ke netritva mein 2 sadasyeey team ne sandeh kiya aur agale saal pushti kee, litchi ke phal mein paaya jaane vaala ek vish jo Hypoglycaemic encephalopathy paida karane ke liye jimmedaar tha. 2017 mein, ek India-US team ne methylene cyclopropyl glycine (MCPG) naamak vish kee bhoomika kee pushti kee.

Subah-subah blood sugar ka, bina bhojan ke kaee ghanton ke baad kam hona saamaany hai. Raat mein bina bhojan kiye sone vaale alpaposhit bachche Hypoglycaemia ka vikaas karte hain. Brain ko blood mein glucose ke saamaany star kee aavashyakata hotee hai. Liver jaroorat kee aapoorti karane mein asamarth ho jata hai. Toh glucose sanshleshan ka vaikalpik maarg, jise fatty acid oxidation kaha jaata hai, chaaloo hai. Wah maarg MCPG dvaara block hai.

Litchi achchhee tarah se poshit bachchon mein koee nukasaan nahin pahunchaatee hai, lekin keval kuposhit bachchon mein, jinhonne pichhale din litchi phal khaaya tha aur khaalee pet bistar par chale gae the.

Alpaposhit bachchon ke liye vish adhik khataranaak kyon hai?

Achchhi tarah se poshit bachchon mein, aarakshit glucose ko glycogen ke roop mein liver mein sangraheet kiya jaata hai. Jab bhi glucose ka star neeche jaata hai, glycogen glucose mein toot jaata hai aur upayog ke liye blood mein parichaalit hota hai. Lekin kuposhit bachchon mein paryaapt glycogen reserve ki kami hoti hai. Iss liye, alpaposhit bachchon mein natural mechanism blood mein glucose ke star ko theek karane mein asamarth hai, jisse Hypoglycaemia ho sakata hai.

Aam taur par, jab liver mein glycogen reserve samaapt ho jaata hai ya paryaapt nahin hota hai, to shareer fatty acid (non-carbohydrate energy source) ko glucose mein parivartit karta hai. Lekin litchi vish kee upasthiti mein, glucose mein fatty acid ke roopaantaran ko beech mein rok diya jaata hai. Nateeja yeh hota hai ki, koi bhi glucose utpann nahin hota hai aur low blood glucose ka star shareer dvaara sahi nahin kiya jaata hai. 

Litchi ka Vish, coma aur yahaan tak ki bachchon mein maut ka kaaran kaise banat hai?

Vish brain ko nukasaan pahunchaane ke liye do tarah se kaary karta hai aur yahaan tak ki mrtyu ka kaaran bhee banata hai. Vish ke kaaran, low blood glucose ke star ko theek karane ke liye shareer ke natural tarike ko roka jaata hai, jisse brain ko eendhan ki aapoorti mein giraavat aati hai. Yeh bahut tez nend aana, nashi ki halat jaisa hona, bhatakaav aur yahaan tak ki behoshi ki or jaata hai. Jab vish fatty acid roopaantaran ko glucose beech mein rokata hai, to amino acid jaari hote hain jo brain cells ke liye vishaakt hote hain. Amino acid ke kaaran brain kee koshikaen sooj jaatee hain jiske parinaamasvaroop brain ki oedema ho jaati hai. Nateeja yeh hota hai ki, bachche aakshep, gahari coma aur yahaan tak ki maut se peedit ho sakte hain.

Kya alpaposhit bachchon mein Hypoglycaemic encephalopathy ko roka ja sakta hai?

Haan, yah sunishchit karke ki alpaposhit bachche litchi ke phal ka sevan na karen, yah sunishchit karte hue ki ve kuchh khaen aur khaali pet bistar par na jaen. 2015 ke baad se, Dr. Jacob ki teem dvaara anushansit rokathaam rananeeti ne Muzaffarpur mein Hypoglycaemic encephalopathy se mauton ki sankhya ko tejee se kam karane mein madad ki hai. 2017 mein, India-US team ne in nishkarshon aur siphaarishon ki pushti karate hue ek paper prakaashit kiya.

Kya Hypoglycaemic encephalopathy ka ilaaj kiya ja sakta hai?

Haan, Hypoglycaemic encephalopathy ka aasaani se ilaaj kiya ja sakta hai. Ek poorn aur poorn recovery praapt ki ja sakati hai yadi Hypoglycaemic encephalopathy vaale bachche lakshanon ki shuruaat ke chaar ghante ke bheetar 10% dextrose ke saath sankramit hote hain.

10% dextrose ka upayog na keval blood glucose ko ek surakshit star tak pahuchata hai, balki amino acid ke utpaadan ko bhi rokta hai, jo shareer mein glucose mein fatty acid ko parivartit karne ke prayaas ko band karke brain cells ke liye vishaakt hai.

Dextrose ke saath milakar, 3% saline solution ko sankramit karne se brain cells ke oedema ko kam karane mein madad milati hai. Brain ki cells ke baahar taral padaarth mein ions ki concentration cell ke andar ki tulna mein adhik ho jaati hai; isse cells se taral padaarth baahar nikalta hai aur iss prakaar oedema ko kam karane aur brain cells ka nukasaan kam hota hai.

5% dextrose ka upayog karna, jaisa ki saamaany low blood sugar star ke maamalon mein aadarsh hai, Hypoglycaemic encephalopathy vaale bachchon ko Hypoglycaemiase ubarane mein madad kar sakta hai, lekin amino acid ka sanchay band nahin hota hai. Aur iss liye, yadi bachche jeevit rahte hain, to bhi unhen brain mein damage hogi.

Yadi lakshanon ki shuruaat ke chaar ghante ke bheetar dextrose nahi diya jaata, toh brain kee koshikaen theek nahin ho sakatee hain, balki mar jayengi. Nateeja yeh hota hai ki, bhale hi ve jeevit ho, bachche brain ki shati ke vibhinn pahaluon se peedit hote hain – thik se bol nahi paate, maanasik roop se badh nahi paate, maansapeshiyon mein jakadan / kamajoree aur bhi bahut kuch.

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