Dil ki sehat

Yahan dil ki sehat se muraad dil aur khoon ki naaliyan donon hain: dil ka daura (heart attack), angina aur faalij (stroke), aur woh cheezein jo aahista aahista in ki taraf le jati hain, jaise high blood pressure, cholesterol aur sugar.

European Menopause and Andropause Society (EMAS) kehti hai ke auraton mein dil ki beemari par ab bhi bohat kam tehqeeq hoti hai, yeh aksar pakri nahin jati aur is ka ilaaj bhi kam hota hai.

Pakistan Menopause Society Pakistan mein menopause ki ausat umar 45 se 49 saal ke beech batati hai, jo safaid faam European auraton se kam hai.

EMAS woh khatre batati hai jo sirf auraton ko hote hain: hamal ke dauran high blood pressure, sugar ya eclampsia (hamal mein daure parna), aur waqt se bohat pehle menopause.

PMS ki sifarishaat aik ehtiyaat bhi batati hain: doctor yeh taassur na dein ke darmiyani umar ki har beemari estrogen kam hone se aati hai, kyunke umar, rehan sehan aur doosri beemariyan, sab ka apna hissa hai (Table 1).

PMS ki sifarishaat menopause ki mulaqat ko bachao ka mauqa samajhti hain. Woh yeh ginwati hain:

• Muaine: blood pressure, BMI aur ho sake to kamar ka naap, aur umar, khatre aur kharch ki gunjaish ke hisaab se khali pait sugar ya HbA1c aur cholesterol ka test (Table 2 aur 4).
• Sawal: khandan mein kisi ko dil ki beemari ya khoon ka lothra (blood clot) hua ho ya nahin, aur aurat ko khud sugar, blood pressure ya faalij hua ho ya woh cigarette peeti ho ya nahin (Table 2).
• Harkat: baqaida jismani sargarmi, jis ke baare mein sifarishaat kehti hain ke dil ko bachane ke saboot maujood hain (4.2.2). Cardio warzish dekhein.
• Khana: woh meethe mashroobat aur cola ko pait ke gird wazan aur metabolism se jure khatre ko barhane wala kehti hain, aur daalon, chane, saag, methi aur saabit anaaj ki hausla afzai karti hain (Table 5). Safaid chawal aur safaid double roti ke baare mein Women's Health Concern kehta hai ke sehatmand khane mein un ki bhi jagah hai aur unhein chhorne ki zaroorat nahin, albatta nishasta daar cheezon mein zyada hissa saabit anaaj ka hona chahiye.
• Tambaku: cigarette, naswar aur shisha chhorna, jo un ke mutabiq dil ki beemari ka khatra kam karta hai. Woh likhti hain ke shishe ko aksar kam nuqsan deh samjha jata hai, aur doctoron se kehti hain ke phir bhi is par baat karein (Table 7). Cigarette, naswar aur shisha dekhein.

HRT (hormone ki dawa) aur dil par NICE NG23 do baatein kehta hai.

Pehli, HRT dil ki dawa nahin: sifarish 1.6.4 kehti hai ke yeh dil ki beemari se bachao ke liye na di jaye, aur doctoron ko dil ka khatra kam karne par alag hidayat ki taraf bhejti hai.

Doosri, jo auratein apni alamaat ke liye HRT le rahi hain, un ke liye NICE ki fawaid aur khatraat ki table kehti hai ke mushtarka HRT se dil ki shiryanon ki beemari (coronary heart disease) ka khatra nahin barhta. Yahi table kehti hai ke mushtarka HRT se dil aur khoon ki naaliyon ki beemari se maut ka khatra bhi nahin barhta. Faalij ke baare mein yahi table kehti hai ke khatra kuch had tak is par munhasir hai ke estrogen goli ki shakal mein liya ja raha hai ya jild ke zariye.

PMS ki sifarishaat is ka zikr karti hain jise woh timing hypothesis kehti hain, yani yeh khayal ke faide aur khatre ka tawazun sab se behtar tab hota hai jab HRT 60 saal se pehle ya menopause ke das saal ke andar shuru ki jaye, khaas taur par dil ke liye (section 5). The Menopause Society, jo is ke saboot ko mazboot batati hai, waqt ke baare mein yehi kehti hai, aur yeh bhi ke der se shuru karne wali auraton ko dil ki beemari, khoon ke lothre aur faalij ka asal khatra zyada hota hai, is liye 60 ke baad shuru karne se pehle aurat ke apne faide aur khatre ko ehtiyaat se tolna chahiye.

Jin auraton ko pehle se dil ki beemari hai, un ke baare mein British Menopause Society ki doctoron ke liye hidayat kehti hain ke HRT ko aam taur par zyada khatre wala samjha jata hai aur pehle baghair hormone ka ilaaj aata hai. Woh yeh bhi kehti hain ke dil ki beemari ho chuki ho to bhi shayad HRT ka raasta poori tarah band na ho, aur yeh faisla mil kar hona chahiye, aurat ki alamaat ko us ke khatre ke saath tol kar. PMS ki sifarishaat dil ke zyada khatre ko un wajoohaat mein ginti hain jin par aurat ko menopause ke specialist ke paas bheja jaye (3.4).

Agar kuch saalon se aap ka blood pressure, blood sugar ya cholesterol check nahin hua, to agli appointment par keh dein.

Kuch alamaat appointment ka intezaar nahin kar saktin. PMS ki sifarishaat seene mein dard, aik taang mein soojan, achanak saans phoolna, asabi alamaat, ya naya aur shadeed sar dard ko khatre ki alamaat mein ginti hain jin ki jaanch ya referral zaroori hai (2.3). In mein se koi bhi ho to aam appointment ka intezaar na karein.

Dil ki dharkan tez hona agar seene mein dard ya achanak saans phoolne ke saath ho, to woh bhi inhi khatre ki alamaat mein aata hai.

Khandan ki beemariyon ka pata lagana woh aik test hai jo aap ghar baithe kar sakti hain. Apni ammi, khalaon aur phuphiyon se poochein ke kis ko dil ka daura, faalij ya sugar hui, aur kaun blood pressure ki goliyan leta hai, aur jawab apne doctor ke paas le jayen, jis se PMS ki sifarishaat yeh likhne ko kehti hain (Table 2).

Ramzan mein blood pressure, cholesterol ya sugar ki dawa lene wali auratein aksar poochti hain ke sehri aur iftar ke aas paas dawa kab lein, ya roza rakhein bhi ya nahin. Roze ka sawal kisi mustanad aalim se poochne ka hai; dawa ka sawal us se jo dawa likhta hai, Ramzan shuru hone se pehle.