r`rh; laLdj.kfnlacj 2008

,e,l D¸kk gS\

funku] y{k.k] fpfdRLkk]Áca/ku v©j lg;®x ds Lkz®rksa ds

ckjs esa tkudkjh

;g iqfLrdk cM+s fIkzaV v©j vkWfM;®lhMh esa miyC/k gSA buesa ls fdlhHkh LOk:i ds fy,] ,e,l l®lk;Vhtkudkjh Vhe ls laidZ djsa% 00220088443388 00779999 ¼dk;Zfnol Ikzkr% 99 lsvijkà 44 cts] eaxyokj] Ikzkr% 99 lsvijkà 33 cts d® N®M+dj½ ;kiinnffootteeaamm@@mmssssoocciieettyy..oorrgg..uukk;g iqfLrdk eqfær :i esa fuEUkfyf[kr Hkk"kkv®a esa Hkh miyC/k gS% caxkyh] Q+kjlh] xqtjkrh] fganh]i®fy'k] iatkch] Lisfu'k] rqdhZ v©j mnwZA

Áfr;ksa ds fy,] www.mssociety.org.uk ij tk,¡] ;k ,e,l l®lk;Vh tkudkjh Vhe ls¼vaXkzst+h esa½ laidZ djsa% 020 8438 0799 ¼dk;Zfnol Ikzkr% 9 ls vijkà 4 cts] eaxyokj]Ikzkr% 9 ls vijkà 3 cts d® N®M+dj½ ;k infoteam@mssociety.org.uk

tkudkjh osY'k esa Hkh miyC/k gSA ,e,l l®lk;Vh fle# ls laidZ djsa% 029 2078 6676;k mswalescymru@mssociety.org.uk.

eYVhiy Ldsysj®fll ¼,e,l½ dsanzh; LUkk;q&ra= dh ,d chekjh gSA de mEkz ds o;Ldksaesa] vleFkZrk iSnk djus okyh ;g lcls vke chekjh gS] t® ;wds esa yx“x 85000 y®xksad® ÁHkkfor djrh gSA ,e,l dk funku T+;knkrj 20 ls 40 o"kZ dh mEkz ds y®xksa esag®rk gSA ¼;|fi ;g blls igys v©j ckn esa Hkh g® ldrk gS½A efgykv®a esa ,e,l g®usdh laHkkouk iq#"kksa ls yx“x nqxquh g®rh gS] v©j ;g cgqr gh nqyZ“ fLFkfr esa cPPkksa d®ÁHkkfor djrk gSA1, 2 funku g® tkus ds ckn] O¸kfä ,e,l ls thou “j XkzLr jgrk gS]ijarq fpfdRLkk v©j fo'ks"kK dh ns[kHkky ls y®xksa d® cgqr&ls y{k.kksa dk vPNh rjg Áca/kdj ldus esa enn feyrh gSA ;|fi blds dkj.k vKkr gaS v©j blds mipkj dk vHkhrd irk ugha pyk gS] vuqla/kku tkjh gSA

bl iqfLrdk esa tgk¡ Árhd fn[kkà nsrk gS] ogk¡ ,e,l l®lkbVh ;k vU¸klaxBu ml fo'ks"k fo"k; ds ckjs esa vf/kd tkudkjh Ánku dj ldrs gaS & nsf[k,ÞleFkZu v©j vf/kd tkudkjh ds Lkz®rÞA

1,e,l D¸kk gS\ © ,e,l l®lk;Vh 12/08

fo"k;&lwph

2 ,e,l D¸kk gS\

4 ,e,l dk funku dSls fd;k tkrk gS\

5 ,e,l D¸kksa g®rk gS\

5 ,e,l ds fofHké Ádkj

7 y{k.k

7 fpfdRLkk,¡

9 ,e,l ds lkFk thou fcrkuk

11 ifjokj v©j fe=

13 LOkkLF k v©j lkekftd ns[kHkky lsok,¡

13 vleFkZrk laca/kh vf/kdkj

14 dk;Z] Áf'k{k.k v©j vkfFkZd lgk;rk

15 lpyrk ds fy, lgk;d midj.k v©j nSfud thou&;kiu

16 NqfÍ;k¡

16 lg;®x ds Lkz®r v©j vfrfjä tkudkjh i

i

,e,l D¸kk gS\dsanzh; LUkk;q&ra= D¸kk dke djrk gS\

,e,l esa D¸kk g®rk gS] ;g le>us ds fy,] dsanzh; LUkk;q&ra=] t® efLr"d v©j jh<+ dhgM~Mh ls curk gS] ds dk;ksZa d® le> ysus ls enn fey ldrh gSA dsanzh; raf=dk ra=vfuok;Z :i ls efLr"d v©j es#jTTkq ls feydj cuk gSA blds lkFk gh] efLr"d lsvusd ulsa lh/ks tqM+h gqà gaS] ftUgsa Þdikyh; raf=dk,¡Þ dgk tkrk gSA buesa ÞvkWfIVdraf=dk,¡Þ 'kkfey gaS] t® vk¡[kksa d® efLr"d ls t®M+rh gaSA

efLr"d 'kjhj dh xfrfof/k;ksa] tSls vax&lapkyu v©j l®pus&fopkjus d® fu;af=r djrk gS]v©j jh<+ dh gM~Mh lans'k ds vkus&tkus dk dsanzh; ekxZ gS] efLr"d }kjk 'kjhj ds lHkhvaxksa d® lans'k Hksts tkrs gaS] ftlls lpsr v©j vpsr] n®uksa xfrfof/k;k¡ fu;af=r g®rh gaSA

LUkk;q&ra=

,e,l esa D¸kk g®rk gS\

ekbfyu ¼ek;fyu dk fuekZ.k efLr"d v©j es#jTtq esa d¨f'kdkvksa }kjk fd;k tkrk gS ftUgsav¨fyx¨MsaMª LkkbV~Lk dgk tkrk gSA ;s d¨f'kdk,¡ Lkqj{kkRed ek;fyu E;ku cukus ds fy, [kqnd¨ raf=dk rarq ¼,DLk¨ULk½ ds vkLkikLk cgqr&cgqr ckj yisV ysrs gSaA ek;fyu og xfrc<+krh gS ftLk ij ,DLk¨ULk ds LkkFk raf=dk Lkadsr ;k=k djrs gSaA ,e,Lk esa] ek;fyu Áfrj{kkÁ.kkyh Lks geys ds Áfr vLkqjf{kr jgrk gSA½ uked ,d egROkiw.kZ inkFkZ dsanzh; LUkk;q&ra= dsLUkk;q&rarqv®a ds bnZ&fxnZ yxk jgrk gS v©j mudh j{kk djrk gS v©j ;g lans'kksa d®efLr"d ls 'kjhj ds 'ks"k Hkkxksa rd 'kh?kzrk ls v©j fuckZ/k <ax ls ig¡qpus esa enn djrk gSA

2 ,e,l D¸kk gS\ © ,e,l l®lk;Vh 12/08

efLr"d

raf=dkv®a dk tky t® 'ks"k'kjhj rd v©j mlls lans'kykrk&ys tkrk gS ¼ifj/kh;raf=dk ra=½A

es#jTTkq

,e,l ,d LOkÁfrj{kd fLFkfr ¼Lor% Áfrj¨/kh fLFkfr esa] 'kjhj dk ÁkÑfrd Lkqj{kk ra=¼Áfrj{kk Á.kkyh½ 'kjhj ds vius Ård ij geyk djrk gSA ,e,Lk Lor% Áfrj¨/khfLFkfr gSA ,e,Lk esa 'kjhj x+yrh Lks ek;fyu ij geyk djrk gS] t¨ efLr"d v©jes#jTtq esa raf=dk rarq ¼,DLk¨ULk½ ds vkLkikLk Lkqj{kkRed inkFkZ gSA½ gSA bldk vFkZ ;ggqvk fd Áfrj{k.k i)fr] t® lkekU¸kr% laØe.kksa tSls j®xk.kq ls yM+us esa enn djrh gS]x+yrh ls vius gh Ård d® cSDVhfj;k tSlk ckgjh inkFkZ le> ysrh gS v©j ml ijvkØe.k djrh gSA ,e,l esa Áfrj{k.k i)fr LUkk;q&rarqv®a ds bnZ&fxnZ yxh ekbfyuij vkØe.k djrh gSA ftlls ekbfyu {kfr&XkzLr g® tkrh gS v©j LUkk;q&rarqv®a ls]va'kr% ;k iwjh rjg vyx g® tkrh gS] v©j ?kko ds fu'kku N®M+ tkrh gS ¼ftUgsa yht+u(lesions), IY©d+ ¼ (plaques) ;k Ldsysj®fll Hkh dgrs gaSA 1 eTTks d® g®us okyh;g {kfr] lans'kksa d® LUkk;q&rarqv®a ls g®dj xqtjus esa ck/kk Mkyrh gSA3 lans'kksa dh xfr/kheh iM+ tkrh gS] os fo—r g® ldrs gaS] ,d LUkk;q&rarq ls nwljs esa pys tk ldrs gaS¼'kkWVZ lfdZV g®uk½] ;k g® ldrk gS fd fcYdqy gh u ig¡qpsaA

,e,l esa D¸kk g®rk gS] ;g le>us dk lcls vklku rjhdk ;g dYiuk djuk gS fdLUkk;q&ra= ,d fctyh dk lfdZV gS v©j jh<+ dh gM~Mh ÅtkZ ds Lkz®r dk dke djrhgS v©j 'kjhj ds 'ks"k Hkkx cŸkh] daI¸kwVj] Vhoh] bR¸kkfn gaSA LUkk;q] fctyh ds dscy&tSlsgaS t® lHkh midj.kksa d® vkil esa t®M+rs gaS v©j ekbfyu bu dscyksa ds bnZ&fxnZ yxkIYkkfLVd dk j®/ku (insulation) gSA ;fn j®/ku {kfrXkzLr g® tk,] r® midj.k n®"kiw.kZg® tk,¡xs ;k Bhd ls dke ugha djsaxs v©j 'kkWVZ&lfdZV g® ldrk gSA dsanzh; raf=dkra= lHkh 'kkjhfjd xfrfof/k;ksa d® t®M+rk gS] blfy, esa dà vyx&vyx y{k.kÁnf'kZr g® ldrs gaSA fn[kkà nsus okys fof'k"V y{k.k bl ckr ij fuHkZj djrs gaS dsanzh;raf=dk ra= dk d©u&lk fgLLkk ÁHkkfor gS v©j {kfrXkzLr raf=dk dk dk;Z D¸kk gSA

3,e,l D¸kk gS\ © ,e,l l®lk;Vh 12/08

ekbfyu

uoZ Qkbcj ¼,DLku½lsy ckWMh ekbfyu

,e,l esa ekbfyu d® {kfr ig¡qpkuk ¼Mhekbfyus'ku½

uoZ Qkbcj ¼,DLku½

lsy ckWMh {kfrXkzLr ekbfyu ¼Mhekbfyus'ku½

ekbfyu

,e,l dk funku fdl rjg g®rk gS\viuh tfVyrk v©j y{k.kksa dh fofo/krk ds dkj.k] ,e,l dk funku djuk vklku ugha gSAd®Ã vdsyk uSnkfud ijh{k.k ugha gS v©j vafre funku djus ls igys ;g fuf'Pkr djukt+:jh g®rk gS fd ;g oSlh gh y{k.kksa okyh d®Ã vU¸k chekjh r® ugha gSA

,e,l ds funku esa fdlh LUkk;q&j®x fo'ks"kK d® ges'kk 'kkfey fd;k tkuk pkfg,Aikjaifjd :i ls] ,e,l dh iqf"V rHkh la“o Fkh] tc ,e,l ds y{k.k de&ls&de n® ckjfn[kkà iM+s gksaA ijarq vc fdlh O¸kfä esa ,d gh LUkk;fod y{k.k fn[kkà iM+us ds ckn ;gfuèkkZfjr djuk la“o gS fd ml O¸kfä d® ,e,l gS ;k ugha] c'krsZ tc rd fdde&ls&de ,d eghus ckn MRI LdSu ij u, ?kkoksa ¼,e,Lk esa] ?kko ¼;k VqdM+s½ efLr"d;k es#jTtq esa iSp gSa tgk¡ ek;fyu tyu ds ifj.kkeLo:i ek;fyu dh gkfu gqbZ gSA dqN?kko Lo;a dh vuk;kLk ejEer djsaxs v©j xk;c g¨ tk,¡xsA vU; –f"Vx¨pj [kjksapksa dsLFkk;h {ks= cu tkrs gSaA½ dk lcwr g®A4, 5

vke r©j ij fuEUkfyf[kr ijh{k.kksa v©j i)fr;ksa dk lcls vf/kd mi;®x fd;k tkrk gS%

• LUkk;q&j®x laca/kh tk¡p&iM+rky v©j bfrgkl

LUkk;q&j®x fo'ks"kK fiNys y{k.kksa v©j rdyhQ+ksa ds ckjs esa cgqr&ls Á'Uk iwNsaxs] ftulsorZeku y{k.kksa d® Li"V djus esa enn fey ldrh gSA blds ckn os 'kjhj&lapkyu] lgtfØ;k (reflexes), laosnu ;k –f"V ls lac) LUkk;q&ekxZ esa vlkekU¸krkv®a dk irk yxkusds fy, 'kkjhfjd tk¡p&iM+rky djsaxsA blds fy, –f"V] vk¡[kksa ds lapkyu esa ifjorZu] iSjksa;k gkFkksa dk leUOk;] larqyu] laosnu] c®yh] lgt fØ;k (reflexes) v©j ;fn det®jh dsd®Ã ladsr gksa r® mudk irk yxk;k tk ldrk gSA ;|fi LUkk;q&j®x fo'ks"kK d® blpj.k esa ,e,l g®us dh –<+ vk'kadk g® ldrh gS] ijarq funku rc rd la“o ugha g®ldrk tc rd vkxs tk¡p u g®A lewph lwpuk & y{k.k] ladsr v©j tk¡p ifj.kkeksa & d®,e,l funku ds ekunaMksa d® iwjk djus dh vko'¸kdrk g®xhA

• eSxusfVd jst+¨usal besftax (MRI)

MRI LdSuj ,d cM+k midj.k gS] t® efLr"d v©j jh<+ dh gM~Mh dh foLrr Nfo cukus dsfy, 'kfä'kkyh paqcdh; {ks«kksa dk mi;®x djrk gSA ;g cgqr lgh g®rk gS v©j ekbfyu d® gqÃ{kfr ds lgh LFkku v©j vkdkj dk Bhd&Bhd irk yxk ldrk gSA vius efLr"d v©j jh<+ dhgM~Mh dh Nfo mrjokus ds fy,] O¸kfä d® MRI LdSuj ds lqjax&tSls dsaæ esa ysVuk iM+rk gSAbl ÁfØ;k esa 10 ls 30 feuV rd yxrs gaS v©j blls d®Ã nnZ ugha g®rkA MRI LdSu,e,l ls XkzLr 95 Áfr'kr ls vf/kd y®xksa ds dsanzh; raf=dk ra= esa ifjorZu fn[kkrs gaSA

• Ikz®RLkkfgr laHkkouk,¡

blls efLr"d }kjk lans'k IkzkIr djus esa yxus okys le; dk ijh{k.k fd;k tkrk gSA ;g irkyxkus ds fy, fd t®&dqN ns[kk ;k lquk tkrk gS ml ij efLr"d dh ygjsa fdl rjgÁfrfØ;k djrh gaS] flj ij N®Vs bysDVª®M~Lk yxk fn, tkrk gaSA ;fn ekbfyu dh {kfr gqà gS]r® lans'k IkzkIr djus v©j ÁfrfØ;k,¡ djus dh xfr /kheh g®xhA ;g ÁfØ;k Hkh nnZ&jfgr gSA

• yacj iaDPkj

bls dHkh&dHkh Likbyu VSi (spinal tap) dgk tkrk gS v©j bls LFkkuh; fu'P®rd(local anaesthetic) ds varxZr fd;k tkrk gSA bls ihB ds fupys fgLLks esa jh<+ dhgM~Mh ds vklikl ds {ks= esa lqà yxkdj fd;k tkrk gS ¼;g fØ;k ,fiM~¸kwjy batsD'ku tSlhgh g®rh gS½A efLr"d v©j es#jTTkq ds pkjksa v®j Áokfgr g®us okys æo dk N®Vk uewuk ysdjmldh tk¡p dh tkrh gSA ,e,l ls XkzLr T+;knkrj y®xksa esa bl æo esa vlkekU¸k Ikz®Vhu g®rsgaS] t® ;g fn[kkrk gS fd dsanzh; raf=dk ra= esa Áfrj{kk Á.kkyh dke dj jgh gSA yacj d®igys ds leku vdlj iapj ugha fd;k tkrk v©j blds mlh fLFkfr esa bLrseky djus dhÁOkfŸk g®rh gS tc ,e,l ds funku dh vU¸k ijh{k.kksa ls iqf"V u dh xà g®A yacj iaDPkj¼dÒh&dÒh ,e,Lk funku ds fy, Á;¨x fd;k tkus okyk] dej dk iapj] ftLks jh<+ dh gÏhds VSi ds :i esa Òh tkuk tkrk gS] bLkfy, fd;k tkrk gS rkfd M‚DVj efLr"d v©jes#jTtq ds pkjksa v¨j jgus okys rjy inkFkZ dk uewuk ys LkdsaA ,e,Lk okys y¨xksa esa vdLkjbLk æo esa fo'ks"k ,aVhc‚Mh g¨rs gSa] t¨ ijh{k.k esa ^vkWfyxksDyksuy cSaM* ds :i esa Ánf'kZr g¨rsgSaA½ ds ckn y®x vdlj fljnnZ dh f'kdk;r djrs gaS v©j LUkk;q&j®x fo'ks"kK bl Áfrdwyvlj dk Áca/ku djus ds csgrjhu rjhdksa ds ckjs esa lykg ns ldrk gSA

4 ,e,l D¸kk gS\ © ,e,l l®lk;Vh 12/08

• vU¸k ijh{k.k

;g fuf'Pkr djus ds fy, fd ,e,l tSls y{k.kksa okyh ;g d®Ã v©j chekjh ugha gS] vU¸kijh{k.k fd, tk ldrs gaS] tSls jä&ijh{k.k] v©j larqyu tk¡p ds fy, dku ds HkhrjhfgLLks dk ijh{k.kA

,e,l D¸kksa g®rk gS\,e,l g®us ds dkj.k vKkr gaSA vuqla/kku ls irk pyk gS fd blds fodkl esavkuqoaf'kdh; v©j i;kZoj.k laca/kh dkj.kksa dh Hkwfedk g® ldrh gSA

thULk v©j ifjokj dk bfrgkl

,e,l lh/ks gh ekrk&firk ls ugha feyrk v©j tSlk fd dqN chekfj;ksa esa g®rk gS] ;gfdlh ,d thu ds dkj.k ugha g®rkA ,slk la“o g® ldrk gS fd dà thULk ds la;®tu lsdqN y®xksa esa ,e,l fodflr g®us dh laHkkouk vf/kd g®rh gS( ijarq ;s thULk lk/kkj.ky®xksa esa Hkh vke ik, tkrs gaSA blfy,] thULk dk dkj.k vkaf'kd :i ls gh lp gS] ,e,lg®us ls vU¸k dkj.k Hkh laca/k g®rs gaSA3

i;kZoj.k laca/kh dkj.k

,e,l mu {ks«kksa esa vf/kd vke gS t® Hkwe/¸kjs[kk ls vf/kd nwj gaSA eysf'k;k ;k bDOkkM®jtSls LFkkuksa esa oLrqr% blds ckjs esa lquk gh ugha tkrk] tcfd fCkzVsu] mŸkjh vesfjdk]dukMk v©j LdSafMusfo;k esa ;g vis{kk—r vke gSA6,7 bldk Li"V dkj.k ugha gS] ijarq] ;gla“o gS fd okrkoj.k esa e©twn fdlh pht+] 'kk;n thok.kq ;k d®Ã ok;jl] dh d®ÃHkwfedk g®A7 ,e,l esa ;®xnku djus okys fdlh vdsys ok;jl dh igpku ugha dh xà gS]ysfdu bl ckr ds lcwr c<+ jgs gaS fd cpiu dk vke ok;jl] tSls bILVhu cjZ ok;jl]Ikzkja“&drkZ ds :i esa dke dj ldrk gSA ;g er vHkh rd Áekf.kr ugha gqvk gS v©j g®ldrk gS fd cgqr&ls y®xksa d®] ftUgsa ,e,l ugha gS] ;s ok;jl yxs gksa] blfy, thu dsleku gh] bldh laHkkouk ugha gS fd os iwjh dgkuh dgsaxsA

dqN 'k®/k&dk;ksZa us foVkfeu Mh dk lq>ko Hkh fn;k gS] t® ,d dkjd g® ldrk gS] v©jt® eq[¸k :i ls /kwi esa tkus ls feyrk gSA foVkfeu Mh ds U¸kwu Lrj d® y®xksa esa vusdfofHké fLFkfr;k¡ g®us ls t®M+k x;k gS] ftlesa ,e,l 'kkfey gSA foVkfeu Mh vusd dkjdksaesa ls ,d g® ldrk gS v©j bl {ks= esa vuqla/kku py jgk gSA8

,e,l ds fofHké Ádkjpkj Ádkj ds ,e,l g®rs gaS v©j ÁR¸®d dh viuh&viuh fof'k"Vrk,¡ gaSA ÞÁdkjÞ pkgs d®ÃHkh g®] dqN y®xksa ij] muds iwjs thou esa bldk flQZ+ gYdk lk vlj jgrk gS] tcfdnwljs y®xksa esa bldk ÁHkko cM+h 'kh?kzrk ls ut+j esa vkrk gSA ,e,l ls XkzLr T+;knkrjy®x bu n®uksa pje fLFkfr;ksa ds chp dh fdlh voLFkk dk vuq“o djrs gaSA ;g ges'kkLi"V ugha g®rk fd fdlh O¸kfä d® fdl Ádkj dk ,e,l gS] [k+kldj rc] tc funkuu;k g® v©j ,e,l dk Ádkj pkgs t® Hkh g®] LOkkLF¸k ds Ikz®Qs'kuy O¸kfä y{k.kksa dkÁca/ku] vyx&vyx O¸kfä;ksa dh vyx&vyx t+:jrksa ij vk/kkfjr djsaxsA

• ,e,l fjysfILkax jsfefVax

T+;knkrj y®xksa dk ¼yx“x 85 Áfr'kr½ igyk funku fjysfILkax jsfefVax ¼relapsingremitting½ ,e,l ds :i esa g®rk gSA7 bldk vFkZ ;g gqvk fd mUgsa y{k.kksa ds n®ckjkÁdV g®us ¼okiLkh og vof/k gS tc ,e,Lk okys y¨xksa d¨ u, y{k.k dk vuqÒo g¨rk gS;k tc muds iqjkus y{k.kksa dh iqujko`fŸk g¨rh gSA okiLkh dkQ+h tYnh g¨ Lkdrh gS] t¨vke r©j ij dqN g¶rksa rd jgrh gS] ;g uje Lks xaÒhj rd g¨ Lkdrh gSA muds ckndeh dh vof/k g¨ Lkdrh gS] tc ,e,Lk okys y¨x vkaf'kd :i Lks ;k iwjh rjg Bhd g¨tkrs gSaA ,e,Lk dk funku fd, x, T;knkrj y¨xksa esa 'kq: esa ;g ^,e,Lk dh okiLkh deh*g¨rh gSA½ ;k mŸkstu ¼ftUgsa n©jk iM+uk ;k fcxM+ tkuk Hkh dgrs gaS½ g®us v©j mlds cknblls NqVdkjk feyus ¼Bhd g®us dh vof/k½ dk vuq“o g®rk gSA fjySILk ml fLFkfr d®dgk tkrk gS tc 'kjhj ds eq[¸k rkieku esa ifjorZu ;k laØe.k dh vuqifLFkfr esa u,

5,e,l D¸kk gS\ © ,e,l l®lk;Vh 12/08

i

y{k.k ÁdV g®rs gaS] ;k iqjkus y{k.k okil vk tkrs gaSA ÞfjySILkÞ ml fLFkfr esa g®rs gaStc mŸkstd d®f'kdk,¡ ekbfyu dh fof'k"V LUkk;qv®a ij vkØe.k djrh gaS] ftlls LUkk;q}kjk lkekU¸kr% fd, tkus okys dk;Z esa O¸ko/kku vk tkrk gSA mnkgj.k ds fy,] vkWfIVduoZ Qkbcj esa tyu O¸kfä lwtu ls –f"V laca/kh leL¸kk,¡ iSnk g® ldrh gaSA ÞfjySILkÞ dsfodflr g®us esa lkekU¸kr% dqN ,d fnu yxrs gaS v©j ;g fLFkfr ean ls ysdj xaHkhjrd] dà fnu] dà lIrkg ¼T+;knk vke fLFkfr esa½ ;k dà eghuksa rd jg ldrh gSAfjfe'ku ¼y{k.kksa ds geys ¼okiLkh½ ds ckn vkaf'kd ;k iwjs LokLF; ykÒ dh vof/kA½ mlfLFkfr d® dgrs gaS] tc tyu ;k lwtu ÄV tkrh gS v©j y{k.k fLFkr g® tkrs gaSAfjySfILkax jsfefVax ,e,l ds IkzkjafHkd pj.kksa esa] fjfe'ku ds n©jku y{k.k iwjh rjg xk;c g®ldrs gaSA ijarq dà fjySILksl ds ckn] ekbfyu v©j uoZ Qkbcj d® dqN vo'ks"k {kfr ig¡qpldrh gS] ftlds ifj.kkeLOk:i flQZ+ vkaf'kd NqVdkjk feysxkA

Þl©E¸kÞ ,e,Lk\Þl©E¸kÞ ,e,l dk funku dsoy dà o"kksZa rd ,e,l jgus ds ckn gh fd;k tk ldrk gSA;fn 10 ls 20 o"kZ ds ckn] fdlh dk ,e,l fcxM+k ugha gS v©j muesa v{kerk cgqr deg®rh gS ;k ugha g®rh] r® rc ,slk dgk tk ldrk gS mudk ,e,l Þl©E¸kÞ gSA lgh&lghvk¡dM+s nsuk dfBu gS] ysfdu 'kk;n ,e,l okys 10 v©j 30 Áfr'kr ds chp y®x blO¸kkid fooj.k esa vk tkrs gaS v©j mUgsa vusd o"kksZa rd d®Ã cM+h v{kerk ugha g®rhA

ysfdu Þl©E¸kÞ 'kCn dk Á;®x Hkzked g® ldrk gSA Þl©E¸kÞ ,e,l vFkZ ;g ugha gS fdfdlh dh fLFkfr iwjh rjg ls leL¸kk ls eqä g® xà gS( v©j vusd o"kksZa ds fuf"Ø;,e,l ds ckn okil y©Vuk g® ldrk gSA nqHkkZX¸k ls] vHkh Hkh fdlh ds igys g® pqdsy{k.kksa d® ns[kdj Hkh] ;g “fo"¸kok.kh djuk dfBu gS fd “fo"¸k esa ,e,l ds D¸kk y{k.k gksaxsA

x©.k Øfed ,e,l ¼lsdsaMjh Ikz®xsflo ,e,l½

cgqr&ls y®xksa esa ;g chekjh fjySfILkax jsafefVax ,e,l ds :i esa 'kq: g®rh gS] ckn esax©.k Øfed (secondary progressive) ¼Øfed ,e,Lk dk Á;¨x ,e,Lk dh mLkfLFkfr dk o.kZu djus ds fy, fd;k tkrk gS tc y{k.k yxkrkj cnrj g¨rs tkrs gSaA^izkFkfed Øfed ,e,Lk* mLk ,e,Lk dk o.kZu djrk gS t¨ 'kq: Lks gh Øfed g¨rk gSA^ek/;fed Øfed ,e,Lk* mLk ,e,Lk dk uke gS t¨ ckn esa dbZ o"k¨± ds ^ykSVus v©j deg¨us* ds ckn Øfed cu tkrk gSA½ ,e,l dgh tkus okyh fLFkfr esa fodflr g® tkrhgSA7 lsdsaMjh Ikz®xsflo ,e,l esa] fjySILk ds ckn y{k.k iwjh rjg nwj ugha g®rs] v©jvleFkZrk esa yxkrkj Ok`f) g®rh jgrh gSA ;g fuf'Pkr djus ds fy, fd O¸kfä lsdsaMjhIkz®xsflo ,e,l dh fLFkfr esa ig¡qp x;k gS] muesa de&ls&de Ng eghus rd fLFkfr dkyxkrkj fcxM+rs tkuk t+:jh gS] fjySILksl g®rs jgrs gksa ;k ughaA v©lru] fjySfILkaxjsafefVax ,e,l okys 65 Áfr'kr y®xksa esa] funku fd, tkus ds 15 o"kZ ds vanj] lsdsaMjhIkz®xsflo ,e,l fodflr g® tk,xkA9

IkzkFkfed Áxfrijd ,e,l

IkzkFkfed Áxfrijd ,e,l dk de Ápfyr :i gS & t® ,e,l dk funku fd, x,yx“x 15 Áfr'kr y®xksa d® ÁHkkfor djrk gSA9, 10 bldh ÁOk`fŸk cM+h mEkz ds y®xksa esafunku dh g®rh gS] ftudh vk;q vke r©j ij pkyhl o"kZ ;k vf/kd g®rh gSA IkzkFkfedÁxfrijd ,e,l okys y®xksa esa] 'kq: ls gh] yxkrkj fcxM+rs gq, y{k.kksa v©j vleFkZrk esaOk`f) dk vuq“o g®rk gSA y{k.k fdlh Hkh le; fLFkr g® ldrs gaS ;k mudk fcxM+uktkjh jg ldrk gSA ,e,l ls XkzLr yx“x 10 ls 15 Áfr'kr y®xksa esa IkzkFkfedÁxfrijd LOk:i ik;k tkrk gSA 5 fjySfILkax jsafefVax ds foijhr] iq#"kksa esa bl Ádkj ds,e,l ds fodflr g®us dh laHkkouk mruh gh gS ftruh efgykv®a esaA11

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6 ,e,l D¸kk gS\ © ,e,l l®lk;Vh 12/08

y{k.k,e,l vuques; gSA vyx&vyx O¸kfä;ksa esa blds y{k.k vyx&vyx g®rs gaS] ftldsifj.kkeLOk:i y{k.kksa ds LOk:i O¸kkid gaS] ftuesa ls d®Ã Hkh ,e,l ds fy, vf}rh; ughagSA cgqr&ls y®x flQZ Fk®M+s&ls y{k.kksa dk vuq“o djrs gaS v©j bldh laHkkouk cgqr degS fd fdlh Hkh O¸kfä esa lHkh y{k.k fodflr gksaA y®xksa esa fofHké le; esa fofHké y{k.kns[kus d® fey ldrs gaS v©j ;|fi dqN y{k.k cgqr gh vke gaS] ,slk d®Ã Hkh fof'k"VÁfr:i ugha gS] t® gj ,d ij ykxw g®rk g®A dqN vke y{k.k gaS%

• FkdkoV dh vR¸kf/kd vuqHkwfr t® 'kkjhfjd v©j ekufld xfrfof/k;ksa d® dfBu v©j] dqNy®xksa esa] vla“o cuk nsrh gSA

• Larqyu dh leL¸kk v©j pôj vkuk & pyus esa fnôrsa] leUOk; djus dh fnôrsaA

• n`f"V laca/kh fnôrsa & èk¡q/kyk ;k n®&n® fn[kkà nsuk] ,d ;k n®uksa vk¡[kksa ls Fk®M+h nsj dsfy, dqN Hkh fn[kkà nsukA

• lqUu g®uk ;k >qu>qukgV & vke r©j ij gkFkksa v©j iSjksa esaA

• nnZ & dHkh gYdk] dHkh xaHkhjA

• ekalisf’k;ksa esa 'kfä v©j {kerk dk gzklA

• dBksjrk v©j ,saBu ¼,saBu ,sLkk Lkkewfgd uke gS t¨ dÒh&dÒh ekaLkisf'k;ksa dh ,saBu v©jdB¨jrk d¨ fn;k tkrk gSA 'kjhj esa ekaLkisf'k;k¡ t¨M+s esa g¨rh gSa t¨ foijhr fn'kkvksa esa[kÈprh gSaA vke r©j ij tc ,d fLkdqM+rh gS] r¨ nwLkjh QSyrh gSA ,saBu esa n¨uksa ekaLkisf'k;k¡,d gh Lke; esa fLkdqM+rh gSaA ;s vuSfPNd Lkadqpu d"Vnk;d v©j nqcZy djus okys g¨ LkdrsgSaA½ & [k+kl&[k+kl ek¡lisf'k;ksa ds lewgksa dk l[+r g® tkuk ;k muesa dB®jrkA

• cspSuh] volkn ;k eu%fLFkfr esa mrkj&p<+koA

• Kku&cks/k dh leL¸kk,¡ & LEkj.k&'kfä v©j ,dkXkzrk dh leL¸kkA

• cksyh dh leL¸kk,¡ & vLi"V mPPkkj.k] c®yus dh xfr esa /khekiu ;k LOkj ;k /Okfu esa ifjorZuA

• ey&ew= dk osx j®d ikus esa vleFkZrk & ew=k’k; ;k eyk'k; ds dk;ksZa ij fu;a=.k esa dehA

• lsDl laca/kh leL¸kk,¡ & dkesPNk dh deh] f'k'Uk esa ruko vkus dh fnôrsaA

,e,l ds y{k.k gYds ls xaHkhj] laf{kIr ls LFkk;h rd g®rs gaSA dqN y{k.k] tSls pyus esafnôr] nwljs y®xksa d® Li"V fn[kkà nsrs gaSA vU¸k y{k.k] tSls nnZ ;k FkdkoV] Li"V ughag®rs v©j mUgsa vdlj] fNis gq,] v–'¸k ;k [kke®'k y{k.k dgk tkrk gSA ,e,l lsvifjfpr y®xksa ds fy, fNis gq, y{k.k le>uk vf/kd dfBu g® ldrk gSA ,e,ll®lk;Vh] ,e,l ls lacaf/kr y{k.kksa ds ckjs esa vf/kd tkudkjh miyC/k djk ldrh gSA

fpfdRLkk,¡,e,l ls mRié gqà leL¸kkv®a ls fuiVus ds fofHké rjhds gaSA chekjh ÄVkus okyhv©"kf/k;k¡ fjySILksl dh ckjackjrk v©j xaHkhjrk d® de djus esa enn dj ldrh gaS] tcfd,e,l ds cgqr&ls y{k.kksa dk] dà rjg dh fpfdRLkkv®a ds mi;®x ls] ÁHkkoh <ax lsÁca/ku fd;k tk ldrk gSA

fo'ks"kK] tSls vkWD¸kwis'kuy FksjfiLV~Lk] fQft;® FksjfiLV~Lk] dkWfUVusULk lykgdkj v©jeu®oSKkfud] xfr'khyrk] leUOk;] ey&ew= R¸kkxus esa la;e] v©j LEkj.k'kfä ;k ,dkXkzrkdh leL¸kkv®a esa enn dj ldrs gaSA ,e,l ls XkzLr y®xksa d® viuh fpfdRLkk ds fodYiksav©j fparkv®a ds ckjs esa] LOkkLF¸k dh ns[kHkky ls lac) mfpr is'ksoj O¸kfä;ksa ls ppkZdjuh pkfg,] t® miyC/k lcls vPNh fpfdRLkkv®a d® igpkuus esa enn dj ldrs gaSAGP Hkh mfpr jsQsjYLk dj ldrs gaSA uS'kuy baLVhV~¸kwV QkWj DYkhfudy ,DLksysal(NICE) us] ,e,l ls lac) LOkkLF¸k dh ns[kHkky ds lHkh igyqv®a ds fy, loksZŸkeDYkhfudy Iz©fDVl ij ,d funsZf'kdk Ádkf'kr dh gSA12 ;g funsZf'kdk] ,e,l ls ÁHkkfory®xksa d® Li"V :i ls crkrh gS fd baXYkSaM v©j osYLk esa NHS ls fdl fpfdRLkk dhvis{kk dh tk ldrh gSA

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ekpZ 2005 esa] nh?kZdkfyd chekfj;ksa ds fy, uS'kuy lfoZl ÝseodZ (NSF) vkja“ fd;kx;k%13 ,e,l tSlh chekfj;ksa ls XkzLr y®xksa ds fy,] baXYkSaM esa LOkkLF¸k v©j lkekftdns[kHkky lsokv®a esa lq/kkj ds fy, ,d nl&o"khZ; dk;ZØeA le; ds lkFk] NSF d®baXYkSaM esa v©j vf/kd laxr lsok is'k djuh pkfg,A

LdkWVyaSM esa LOkkLF¸k esa lq/kkj ykus ds fy,] csgrj LOkkLF¸k] csgrj ns[kHkky dk;Z&;®tukLdkWfV'k ljdkj dk CYkwfIkzaV gS] v©j LdkWVyaSM esa yach vof/k dh fLFkfr;ksa ds fy,LOk&Áca/ku j.kuhfr cnyko ds fy, vfrfjä Áfrc)rk nsrh gSA14 osYLk esa] thou ds fy,cuk;k x;k] j.kuhfr LOkkLF¸k lsokv®a esa cnyko ds fy, Ikzsjd 'kfä gSA15 mŸkjh vk;jyaSMesa v©j LOkLFk “fo"¸k lfgr vusd igyksa us lq/kkj ds fy, blh rjg dh j.kuhfr;k¡fuèkkZfjr dh gaSA16

chekjh ÄVkus okyh v©"kf/k;k¡

fiNys dqN o"kksZa esa] ,slh fpfdRLkk,¡ fodflr dh xà gaS t® ,e,l dh fn'kk d® ÁHkkfordj ldrh gaS & xaHkhjrk de djus dk dke djrh gaSA ,slk ekuk tkrk gS fd os esaek;fyu ds f[k+ykQ+ Áfrj{kk ÁfrfØ;k d® nck nsrs gaSA gky¡kfd j®x la'k®/ku nok,¡ dkbykt ugha gaS] ysfdu ;s ds geyksa dh la[¸kk v©j xaHkhjrk de djus dk dke djrh gaSA

lcls vf/kd vke bLrseky dh j®x la'k®/ku nok,¡ gaS chVk baVjQ+sjkWu ¼vo®usDLk]chVkQ+sjkWu v©j jsfcQ+ O¸kkikj ukeksa ds lkFk rhu nok,¡½ v©j XY©fVjkesj ,lhVsV ¼O¸kkikjuke d®ikDLk®u½A

chVk baVjQsjkWu v©j XY©fVjkesj ,lhVsV lHkh d® yk“ ugha ig¡qpkrha] ysfdu os ,e,lokil y©Vus esa n©jksa dh ckjackjrk d® v©lru yx“x 30 Áfr'kr de dj nsrh gaSAfDYkfudh; ijh{k.kksa us x©.k Áxfrijd ,e,l okys y®xksa ds fy, dqN yk“ fn[kk;k gSysfdu dsoy ogha tgk¡ c<+ jgh fodyakxrk dk dkj.k okil y©Vuk gSA nqHkkZX¸k ls vcrd dh 'k®/k us bu nokv®a ls IkzkFkfed Áxfrijd ,e,l okys y®xksa ds fy, d®Ã yk“ugha fn[kk;kA17

iwjs ;wds esa] ,e,l okys t® y®x bykt ds fy, ekunaM iwjk djrs gaS ¼e®Vs r©j ij dgktk, r® fiNys n® o"kksZa esa n® ckj okil y©Vuk v©j pyus esa l{ke½ os bu nokv®a dsfy, ,u,p,l ij ;®X¸k gaSA

vHkh gky gh esa] j®x la'k®/ku nok usVkfyt+qeSc ¼O¸kkikj uke fVlkfCkz½ d® ,e,l ds fy,ykblsal fn;k x;k gSA okilh dh la[¸kk d® de djus ds lkFk gh] n® lky dsfDYkfudh; ijh{k.k esa usVkfyt+qeSc ysus okys dqN y®xksa esa vis{kk ls de fodyakxrk dkfodkl gqvkA18

NHS ij lHkh u, mipkj ds ykHkksa dk ewY¸kkadu djus okys laxBu] NICE dk dgukgS fd usVkfyt+qeSc ls fodflr g® jgs] xaHkhj okil y©Vus ls XkzLr ,e,l okys y®xksa dsfy, miyC/k g®uh pkfg, & os y®x ftuesa lky esa n® ;k vf/kd v{ke djus okyh okilhgksa v©j ftuesa MRI LdSu u, ,e,l uqd+lku fn[kkrs gksaA19

,e,l ulZ ;k U¸kwj®ykWftLV bl ckjs esa v©j tkudkjh Ánku dj ldrs gaS fd bu lHkhnokv®a ds ik= d©u gaS] buds laHkkfor yk“ v©j la“o nq"IzkHkko D¸kk gaSA eq¶+r ,e,ll®lkbVh iqfLrdk j®x la'k®/ku nok,¡ v©j gekjh osclkbV ij Hkh tkudkjh miyC/k gSA

fjySILk ds fy, LVsjkW;M~Lk

tc fdlh O¸kfä d® fjySILk dk vuq“o g®] r® mlds LOkkLF¸k yk“ dh xfr c<+us esa enndjus ds fy,] LVsjkW;M~Lk dh ,d fuèkkZfjr ek=k nsus ij fopkj djuk mfpr g® ldrkgSA20

;|fi LVsjkW;M~Lk ls chekjh dh yach vof/k dh fn'kk ugha cnyrh] ij os dsanzh; LUkk;q&ra=esa lwtu o tyu ÄVk ldrs gaSA21 ijarq] MkWDVj LVsjkW;M~Lk dh flQ+kfj'k flQZ+ mlhvoLFkk esa djrs gaS] tc fjySILksl vleFkZrk ykus okys nnZukd v©j nq[kn gksaA mUgsa]fjySILk vkja“ g®us ds ckn ;Fkk’kh?kz f'kjk esa ¼jä&/kkjk esa fMªi ds tfj,½ ig¡qpk;k tkrk gS;k e¡qg }kjk fn;k tkrk gS ¼vke r©j ls x®yh ds :i esa½A12

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mipkj dh vof/k vke r©j ij rhu v©j iakp fnuksa ds chp jgrh gSA ;wds esa vf/kdrjU¸kwj®ykWftLV ,d lky esa fuèkkZfjr LVsjkW;M ds d®lZ dh la[¸kk lhfer djus dh d®f'k'kdjrs gaSA21

,e,l l®lkbVh ds eq¶+r Ádk'kuksa ,e,l vfuok;Z 01 esa LVsjkW;M v©j okilh ds mipkjds ckjs esa vf/kd tkudkjh nh xà gS% okilh dk Áca/k djuk v©j tsch vkdkj dh ,e,lokilh Áca/kuA

,e,l dh fpfdRLkk ds iwjd v©j oSdfYid Á;kl

iwjd v©j oSdfYid bykt djokus esa dqN y®xksa d® csgrj eglwl g®rk gSA fuf'Pkr :ils] ,e,l ds fy, fn'kkfunsZ'k lq>ko nsrs gaS fd fj¶YksDLk®ykWth] ekfy'k] paqcdh; {ks=fpfdRLkk] U¸kwjy Fksjfi ;®x] rkÃ&ph] eNyh ds rsy v©j iwjd fpfdRLkkv®a ds la;®tu¼ftls eYVh&ekWMy Fksjfi dgrs gaS½ ls dqN yk“ ig¡qp ldrk gSA12

ijarq] vf/kdak'k oSdfYid fpfdRLkkv®a dh ÁHkkodkfjrk ds ckjs esa cgqr de oSKkfud Áek.kmiyC/k gaSA tcfd dqN oSdfYid fpfdRLkkv®a ls y{k.kksa ls NqVdkjk ikus esa enn feyldrh gS] y®xksa d® mu fpfdRLkkv®a ls lko/kku jguk pkfg, t® cM+s&cM+s okns djrs gaSfd os foKku }kjk Áekf.kr gaS] ;k ,e,l d® Bhd dj nsaxsA ,slh fpfdRLkk,¡ le; v©j/ku dh cckZnh g® ldrh gaS v©j dqN esa r® laHkkfor [k+rjs Hkh g® ldrs gaSA blfy,] blckr dh t®jnkj flQ+kfj'k dh tkrh gS fd y®xksa d® pkfg, fd d®Ã iwjd fpfdRLkkvktekus ls igys mUgsa LOkkLF¸k dh ns[kHkky djus okys fdlh is'ksoj O¸kfä ls ijke'kZdjuk pkfg, ¼D¸kksafd os ÞijaijkxrÞ uqL[ks ds fy, gksaxs½ v©j ;g fd ekU¸krk IkzkIr mipkjksadk Á;®x fd;k tkrk gSA vf/kd tkudkjh ,e,l l®lkbVh ds Ádk'ku] iwjd v©joSdfYid mipkj esa fey ldrh gSA

,e,l ls XkzLr thou fcrkuk,e,l g®us dk vFkZ gS vfuf'Pkrrk ds lkFk thou fcrkuk v©j cnyrs jgus okyhfLFkfr;ksa ds vuqlkj vius vkid® <kyukA dqN y®x] funku ds ckn NqVdkjk eglwldjrs gaS] D¸kksafd var esa os vius y{k.kksa d® le> ysrs gaS v©j mUgsa viuh chekjh dk ,duke fey tkrk gS] ijarq] vk?kkr] Mj] 'k®d ;k Ø®/k Hkh fcYdqy LOkkHkkfod ÁfrfØ;k,¡ gaSv©j bu Hkkoukv®a d® fLFkj g®us esa dà eghus yx ldrs gSA ,e,l ls XkzLr thou dsvuq:i vius vkid® <kyus esa dqN le; yx ldrk gS] v©j vusd y®xksa ds fy, blesale>©rk djuk v©j vuqdwy g®uk 'kkfey gS] ysfdu lk/kkj.kr% ldkjkREkd eu®“ko v©jLOkkLF¸k dh mfpr ns[kjs[k v©j lkekftd ns[kHkky ls T+;knkrj y®x viuh chekjh d®vPNh rjg ls fu;af=r dj ldrs gaSA

tkudkjh

v|ru] lgh v©j fu"i{k tkudkjh miyC/k g®] r® ,e,l ls XkzLr y®xksa d® mfpr fu.kZ;ysus v©j LOkkLF¸k o lkekftd ns[kHkky ls lacaf/kr is'ksoj y®xksa ds lkFk ÁHkkoh <ax lsckrphr djus esa enn fey ldrh gSA ,e,l l®lk;Vh ds Ádk'ku oSKkfud v©j esfMdyÁek.kksa ij vk/kkfjr g®rs gaS] v©j os ,e,l ls lacaf/kr cgqr ls eqÌksa d® doj djrs gaSA ,e,ll®lk;Vh dh osclkbV ls Áfrfyfi;k¡ Mkmuy®M djsa ;k bUQ‚esZ'ku Vhe ls laidZ djsaA

baVjusV ,d v©j Lkz®r gS ftldk mi;®x ,e,l ls ÁHkkfor y®xksa }kjk O¸kkid :i lsfd;k tkrk gSA ijarq tkudkjh v©j lg;®x ds bl egROkiw.kZ Lkz®r dk yk“ mBkus esa]cgqr cM+h ek=k esa miyC/k x+yr tkudkjh ls ck/kk vk ldrh gSA ;g t+:jh gS fd y®xksad® bldh tkudkjh g®] v©j ;fn mUgsa Mkmuy®M dh xà tkudkjh dh oS/krk v©j lR¸krkds ckjs esa d®Ã fpark g®] r® ,e,l l®lk;Vh ;k LOkkLF¸k dh ns[kHkky djus okys fdlhis'ksoj O¸kfä ls enn ek¡xsaA

vkus okys o"kksZa esa] ljdkj dk LOkkLF k foHkkx mfpr tkudkjh rd y®xksa dh ig¡qp esa lq/kkjykus ds fy, ;®tuk,¡ 'kq: djsxkA buesa fo'Okluh; lwpuk Ánkrkv®a d® ÞdkbV ekdZÞ djus dsfy, lwpuk Áek.ku ;®tuk v©j Þlwpuk dk uqL[kkÞ 'kkfey gS ftlls fd vkidh LOkkLF¸kns[kHkky Vhe vkid® vkidh t+:jr dh tkudkjh tYnh v©j vklkuh ls ns ldsA

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LOk&Áca/ku

,e,l ls XkzLr vusd y®x dgrs gaS fd os vius [kqn ds LOkkLF¸k dk Áca/k djds] tgk¡ Hkhos dj ldrs gaS & mnkgj.k ds fy, mudh [kqjkd v©j O¸kk;ke] os csgrj thou fcrk ikrsgaSA bl LOk&Áca/ku d® ,d dne vkxs ys tkdj] dqN y®xksa d® yach vof/k dh fLFkfr;ksaokys y®xksa ds fy, ,DLkiVZ is'ksaV }kjk pyk, tkus okys ikB¸kØeksa esa mifLFkr g®ukennxkj yx ldrk gSA os y®xksa d® vius y{k.kksa v©j HkkoukREkd ifjorZuksa ij fu;a=.kdjus esa enn dj ldrs gaS v©j y®xksa d® viuh nSfud xfrfof/k;k¡ tkjh j[kus ds fy,vko'¸kd ;®X¸krk,¡ IkzkIr djus esa enn dj ldrs gaSA ,DLkiVZ is'ksaV dh vkids {ks= esaikB¸kØeksa dh osclkbV fyfLVax gS% www.expertpatients.co.uk

,e,l l®lk;Vh] ,e,l ls XkzLr y®xksa ds fy, LFkkuh; tkudkjh l= pykus ds mÌs'¸kls] LOkkLF¸k dh ns[kHkky djus okys is'ksoj O¸kfä;ksa ds lkFk Hkh feytqydj dke djrh gSAbu ikB¸kØeksa esa ,e,l ds ckjs esa rF¸k] v©j FkdkoV] O¸kk;ke] vkgkj v©j j®t+xkj ds ckjsesa tkudkjh g®rh gSA vf/kd tkudkjh ds fy,] ,e,l l®lk;Vh dh fdlh LFkkuh; 'kk[kk;k fdlh ,e,l fo'ks"kK ulZ ls laidZ djsaA

LOkLFk Hk®tu

,e,l ls XkzLr y®xksa d® larqfyr vkgkj ls] ftldh flQ+kfj'k lkekU¸kr% vke y®xksa dsfy, Hkh dh xà gS] yk“ ig¡qprk gSA lkekU¸kr% bldk vFkZ g®rk gS de lspqjsV dh gqÃolk] vf/kd rkt+k Qy] lfCTk;k¡ v©j js'ks okys Hk®tu [kkukA pchZ&jfgr eakl] de olkokys nqX/k&mRikn v©j] pkWdysV v©j rys gq, vkyw dk lsou de djds lspqjsV dh gqÃolk dk mi;®x de fd;k tk ldrk gSA

,slk ekuk x;k gS fd vko'¸kd QSVh ,flM~Lk] t® ikWyh vulspqjsVsM olk esa ik, tkrs gaS]LOkLFk LUkk;q&ra= cuk, j[kus esa egROkiw.kZ Hkwfedk fuHkkrs gaSA22 ;s QSVh ,flM] lwjteq[khv©j l®;k ds rsyksa] chtksa ¼tSls lwjteq[kh] vylh ;k fry ds chtksa½] iŸksokyh gjhlfCTk+;ksa] nkyksa v©j eNyh ds rsy esa ik, tkrs gaSA yk;u®yhd ,flM ,d [k+kl QSVh,flM gS] ftlds mi;®x ds ckjs esa] NICE ds fn'kk&funsZ'kksa esa dgk x;k gS fd ;g ,d,slh fpfdRLkk gS t® ,e,l ds vleFkZrk ykus okys ÁHkkoksa d® de djus esa enn djldrh gSA12

lHkh LOkkLF¸k is'ksoj v©j vuqla/kkudrkZ ;g LOkhdkj ugha djrs fd ;g lp gS] ysfdublesa d®Ã lansg ugha fd yk;u®yhd ,flM LOkLFk vkgkj dk ,d egROkiw.kZ vax gSA vxj[kqjkd dkQ+h gS] r® iwjd dh t+:jr ugha gSA

,e,l ls XkzLr y®xksa d® cgqr&ls vkgkj csps tkrs gaSA ;s dqN Hk®tu&lewgksa d® lhferdjrs ;k gVk nsrs gaS] ;k pkgrs gaS fd dqN iwjd vkgkj fy, tk,¡A ,sls vkgkj eg¡xs g®ldrs gaS v©j [k+rjukd Hkh] ;fn mUgsa dM+h esfMdy fuxjkuh ds fcuk fy;k tk,A dqyfeykdj] bu *,e,l vkgkj* ds nkoksa d® leFkZu nsus ds fy, cgqr de oSKkfud Áek.kmiyC/k gaSA blfy,] d®Ã fo'ks"k vkgkj vkja“ djus ls igys] ,e,l ls XkzLr y®xksa d®]LOkkLF¸k dh ns[kHkky djus okys fdlh mfpr is'ksoj ls ijke'kZ djuk pkfg,A

,e,l l®lkbVh iqfLrdk [kqjkd v©j i®"k.k esa vf/kd tkudkjh gSA

,e,l ls y®xksa d® vYd®gy dk vkuan ysus esa ck/kk ugha vkuh pkfg,A ijarq] vf/kdek=k esa lsou dqN y{k.kksa d® vLFkk;h :i ls v©j vf/kd fcxkM+ ldrk gS] tSls ew=k’k;]eyk'k;] larqyu ;k c®yh dh fnôrsaA

mfpr O¸kk;ke

'kkjhfjd O¸kk;ke ls lHkh d® yk“ ig¡qprk gSA ;g 'kjhj v©j fnekx+ ds fy, vPNk g®rkgS] jä&pki de djus esa enn djrk gS] ot+u fu;af=r djus esa enn djrk gS v©jruko ds Lrj ÄVkrk gSA

,e,l ls XkzLr y®xksa ds fy,] fu;fer v©j gYds O¸kk;ke djuk vfrfjä Qk;ns nsrk gSA23

blls gfÏ;ksa v©j eaklisf'k;ksa d® et+cwr djus esa enn feyrh gS v©j yphykiu c<+rkgSA blls fjySILksl ls g®us okyh vleFkZrk ÄV ldrh gS v©j ek¡lisf'k;ksa dh nh?kZdkfyd{kfr v©j 'kkjhfjd&eqnzk laca/kh leL¸kk,¡ nwj dh tk ldrh gaSA

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oS;fäd t+:jrksa ds mi;qä ,d mfpr O¸kk;ke&fodYi pquuk egROkiw.kZ gSA y®xksa d®,e,l dh xaHkhjrk v©j foLrkj v©j fdlh vU¸k lac) y{k.k dk /¸kku j[kuk pkfg,AO¸kfä dh mEkz] O¸kfäxr ilan v©j LOkHkko v©j] lkFk gh] O¸kk;ke v©j fpfdRLkk ds Áfrmudh ÁOk`fŸk ij fopkj djuk pkfg,A

flQ+kfj'k dh tkrh gS fd ,e,l ls XkzLr y®x] d®Ã u;k O¸kk;ke vkja“ djus ls igysv©j fjySILk ds n©jku] tc de O¸kk;ke djuk ;k vkjke djuk t+:jh g® ldrk gS] r®LOkkLF¸k dh ns[kHkky djus okys fdlh is'ksoj O¸kfä ls ijke'kZ djsaA

,e,l l®lkbVh ds Ádk'ku] O¸kk;ke v©j 'kkjhfjd mipkj esa vf/kd tkudkjh gSA

okrkoj.k

,e,l ls XkzLr y®x xjeh v©j vknzZrk ds Áfr vf/kd laosnu'khy g® ldrs gaS] D¸kksafd bulsmuds y{k.k vLFkk;h :i ls v©j fcxM+ ldrs gaSA ia[kksa v©j ,;j&daMh'kfuax dk mi;®xvf/kd vkjkensg okrkoj.k dk fuekZ.k dj ldrk gSA tc BaMd ig¡qpkus okys d®Ã v©j lk/kumiyC/k u gksa] r® BaMd ig¡qpkus okyh cfu;kuksa ls Hkh 'kjhj dk rkieku vkjkensg cuk, j[kus esaenn fey ldrh gSA y®xksa us vuq“o fd;k gS fd BaMk j[kus ds fy, /kwi esa gSV iguus] tschia[ks dk mi;®x djus v©j cQZ+ okys is; ihus ls Hkh enn fey ldrh gSA

laØe.k

laØe.kksa ls ,e,l ds y{k.k v©j Hkh fcxM+ ldrs gaSA ,slk vdlj cq[kkj ls lac)'kkjhfjd rkieku c<+ tkus ds dkj.k g®rk gSA bls /¸kku esa j[krs gq,] ,e,l ls XkzLry®xksa d® xaHkhj laØe.k fodflr g®us dk [k+rjk de djus ds fy, mfpr Áfrj{k.k nsuspkfg,] tSls ¶YkwA12 bl ckr ds vPNs Áek.k feys gaS fd bl Ádkj ds Áfrj{k.kksa lsfjySILksl ugha g®rsA24

fons'k ;k=k dh ;®tuk cukrs le; cgqr igys ls MkWDVj ds lkFk Vhdkdj.k ij ppkZ egROkiw.kZg®xhA ,e,l ds laca/k esa vodk'k Vhdkdj.k dk v/¸k;u ugha fd;k x;k] ysfdu vke r©j ij;g eglwl fd;k tkrk gS fd vxj d®Ã O¸kfä ,sls {ks= esa tk jgk gS tgk¡ d®Ã xaHkhj laØkedj®x py jgk g®] r® Vhdkdj.k csgrj g®xk ctk; blds fd j®x e®y ys ysuk & ftlds v©j[k+jkc ifj.kke g® ldrs gaSA blds dqN viokn gaS & mnkgj.k ds fy,] ftu y®xksa esa nok ;kvU¸k fLFkfr ds dkj.k Áfrj{kk Á.kkyh det+¨j g® xà g®] mUgsa thoar Vhdksa ls cpuk pkfg,Agekjh osclkbV] www.mssociety.org.uk] ij vf/kd tkudkjh gSA

ijke'kZ&ysuk

funku ds ckn fdlh ijke'kZnkrk ls ckrphr djus ls y®xksa d® viuh chekjh ds lkFkle>©rk djus esa enn fey ldrh gSA ,slk djuk] u, y{k.kksa ls fuiVus ds fy, mfprj.kuhfr;k¡ fodflr djrs le;] v©j ;fn ,e,l c<+rk gS] r® thou&'kSyh cnyrsle;&Hkh egROkiw.kZ g® ldrk gSA ijke'kZ djus ds fodYiksa dh fdlh thih] ulZ ;kU¸kwj®y®ftLV ls ppkZ djuk lcls vPNk jgrk gSA nqHkkZX¸ko'k] NHS ds tfj, ijke'kZlsok cgqr de miyC/k gSA fCkzfV'k ,l®fl,'ku QkWj dkmaflfyax ,aM lkbd®Fksjih] vf/k—rI©zfDV'kulZ dh flQ+kfj'k dj ldrk gSA

ifjokj v©j fe=ftl O¸kfä esa ,e,l dk funku gqvk gS] mlesa dHkh&u&dHkh fdlh lkFkh] ifjokj ;k fe=ls viuh ckr dgus dh bPNk g® ldrh gS ;k t+:jr iM+ ldrh gSA dHkh&dHkh t® y®x,e,l ls XkzLr O¸kfä ds utnhdh gaS] muds fy, chekjh dh vfuf'Pkrrk ls fuiVukeqf'dy g® ldrk gS v©j g® ldrk gS fd os muls nwjh cuk ysaA ysfdu chekjh dsvuq“oksa d® 'ks;j djus ls fe=rk esa –<+rk v©j ca/kuksa esa xgjkà Hkh vk ldrh gSA ,slhlgHkkfxrk esa] ftlesa ,d lkFkh ,e,l ls XkzLr g®] [kqyh ckrphr ,d&nwljs dh t+:jrksad® le>us v©j] tc Hkh mfpr g®] uà Hkwfedk ds lkFk le>©rk dj ysus dh d¡qth gSA

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fdlh ,slk O¸kfä ds lkFk jguk ftls ,e,l gS] ,d vf}rh; pqu©rh gSA lgHkkfx;ksa v©jifjokj ds lnL¸kksa d® chekjh ds ckjs esa tkudkjh IzkkIr djus ds fy,] v©j ;fn la“o g®]r® ifjokjksa v©j ns[kHkky djus okyksa ds fy, pyk, tkus okys ikB¸kØeksa esa 'kkfey g®usds fy, Ikz®RLkkfgr fd;k tkuk pkfg,A mfpr ikB¸kØeksa ds ckjs esa v©j vf/kd tkudkjhds fy, ,e,l l®lk;Vh ls laidZ djsa

ekr`ROk@fir`ROk

,e,l ls iq#"kksa v©j efgykv®a dh tuu {kerk ij d®Ã vlj ugha iM+rk v©j ,e,l d®g®uk] fdlh d® Hkh larku IkzkIr djus esa #dkoV dk dkj.k ugha g®uk pkfg,A ,e,l g®;k u g®] f'k'kqv®a v©j N®Vs cPPkksa dh ns[kHkky djuk FkdkoV iSnk dj ldrk gS] blfy,,e,l ls XkzLr vusd y®x 'kk;n viuh LOkkLF¸k ns[kHkky Vhe ds lkFk Fkdku ;kxfr'khyrk dh dfBukb;ksa dk Áca/ku djus ds mik;ksa ij ppkZ Hkh djuk pkgsaA

,e,l ds dkj.k] xHkkZoLFkk] tUEk v©j Lruiku esa d®Ã vlkekU¸krk ugha g®uh pkfg,];|fi ,e,l dh v©"kf/k }kjk fpfdRLkkv®a esa Qsj&cny t+:jh g® ldrk gSA vuqla/kkuv/¸k;uksa ls irk pyk gS fd tUEk ds ckn ds igys rhu eghuksa esa fjySILk g®us dk [k+rjkc<+ tkrk gS] ysfdu xHkkZoLFkk] ds n©jku de [k+rjk bls larqfyr dj nsrk gSA dqyfeykdj] cPPkk g®uk ,e,l ds fjySILk g®us dh nj esa cnyko ugha ykrkA25, 26

ekrk&firk dh fLFkfr ds ckjs esa v©j tkudkjh ds fy,] ,e,l l®lkbVh ihlsl osclkbVns[ksa www.mssociety.org.uk/pieces ;k ,e,l l®lkbVh dk Ádk'ku efgykv®a dkLOkkLF¸k ns[ksa & xHkkZoLFkk] ekgokjh] xHkZfuj®/k v©j jt®fuOk`fŸkA

vkilh laca/k v©j ;©u&laca/k

lsDLk ds vuq“o d® ,e,l dà rjg ls ÁHkkfor djrk gSA ;fn ,slk g®rk gS] r® y®xksad® Äfu"Brk v©j lsDLk&laca/kh viuh t+:jrksa ds ckjs esa ckrphr djus esa fnôr vkldrh gSA fjysV (Relate) uked laLFkk] vkilh laca/k j[kus okys v©j lsDLk laca/khdfBukb;ksa okys y®xksa d® ijke'kZ&lsok miyC/k djkrh gSA lsDLkqvy fMLQaD'ku,l®fl,'ku] mu O¸kfä;ksa d® ftuds 'kjhj ds vax lkekU¸k :i ls dke ugha djrs]tkudkjh v©j lg;®x miyC/k djkrk gSA ftu iq#"kksa esa f'k'Uk esa ruko u vkus dhf'kdk;r gS] mUgsa NICE ds fn'kk&funsZ'k] flYMsukfQy (Sildenafil) ¼ftls fo;kXkzk Hkhdgrs gaS½] ysus dh flQ+kfj'k djrs gaS] ftls fdlh thih ds tfj, IzkkIr fd;k tk ldrkgSA bu leL¸kkv®a ij ckrphr djus ds fy,] ,e,l gsYiykbu ij Áf'kf{kr deZpkjhmiyC/k gaSA

ifjokj v©j ns[kHkky djus okyksa ds lkFk lg;®x

,e,l l®lk;Vh dk ns[kHkky djus okyksa ds fy, ,d jk"Vªh; dk;ZØe gS] ftlesa tkudkjhnsuk] ns[kHkky djus okyksa dh iqfLrdk] vfHk;ku pykuk v©j vuqla/kku djuk 'kkfey gSA,e,l l®lk;Vh dh LFkkuh; 'kk[kk,¡] iFkd&iFkd ns[kHkky djus okyksa ds lkFk lg;®x djldrh gaSA dqN {ks«kksa esa ns[kHkky djus okyksa ds dsaæ Hkh gaS] ftuesa ;qok ns[kHkky djus okyksads fy, lg;®x v©j fo'ks"kK lewg Hkh 'kkfey gaSA

,e,l ls XkzLr O¸kfä dh vleFkZrk dk Lrj ;fn ,slk gS] t® mls LFkkuh; vFkkWfjVh dhlkekftd lsokv®a dk gd+nkj cukrk gS] r® mudh ns[kHkky djus okyksa d® Hkh] LOk;a viuslkFk lg;®x dh t+:jrksa dk ewY¸kkadu djuk dk vf/kdkj gSA

jkgr ((RReessppiittee)) ns[kHkky

,e,l ls xaHkhj :i ls ÁHkkfor y®xksa ds fy,] ,e,l l®lk;Vh dh ,d jkgr ns[kHkky(Respite Care) lsok gSA blesa 'kkfey gaS gekjs jkgr dsaæ v©j ,d fÁQMZ Ikz®okbMjLdhe (Preferred Provider scheme) t® iwjs ;w-ds- esa mPPk DOkkfyVh dh ns[kHkkylsok miyC/k djkus dh vko'¸kdrkv®a d® LOkhdkj djrh gSA gekjh jsLikbV ds;jMk;jsDVjh esa vkid® blds o vU¸k jkgr Ánkrkv®a ds fooj.k fey ldrs gaSA ,e,ll®lk;Vh dh LFkkuh; 'kk[kk,¡ vPNs LFkkuh; Ánkrkv®a ds ckjs esa lykg nsus esa enn v©j]dqN ifjfLFkfr;ksa esa vkfFkZd lgk;rk ns ldrh gaSA ,e,l ls XkzLr y®xksa d®] okbVykbt+(Vitalise) pSfjVh ds tfj, vodk'k lIrkg Hkh miyC/k gSA buesa ls fdlh Hkh lsok ds ckjsesa vf/kd tkudkjh ds fy,] jsLikbV ds;j Vhe ls 020 8438 0925 ij laidZ djsaA

12 ,e,l D¸kk gS\ © ,e,l l®lk;Vh 12/08

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LOkkLF¸k v©j lkekftd ns[kHkky lsok,¡LOkkLF¸k ns[kHkky lsok,¡

thih] j®tejkZ dh fpfdRLkk dk Áca/ku djus v©j fo'ks"kKksa] tSls ,e,l uls±] U¸kwj®y®ftLV~Lk]Qhft;®FksjfiLV~Lk] vkWD¸kwis'kuy FksjfiLV~Lk] ijke'kZnkrkv®a v©j dkWfUVusal&laca/kh lykgdkjksads ikl Hkstus esa lgk;rk ds fy, ft+EEksnkj gSA U¸kwj®y®ftLV funku djus v©j fpfdRLkk,¡fuèkkZfjr djus ds fy, ft+EEksnkj gS] tcfd ,e,l uls± tkudkjh] lg;®x v©j lykg dhegROkiw.kZ Lkz®r gaSA ,e,l ls XkzLr y®x] ;fn os igys ls gh viuh LFkkuh; ,e,l ulZ dslaidZ esa ugha gSa] r® mUgsa vius thih] U¸kwj®y®ftLV ;k ,e,l l®lk;Vh ls muds fooj.kek¡xus pkfg,A

,e,l dh fo'ks"kK ulksZa dh la[¸kk esa] fiNys dqN o"kksZa esa] rst+h ls Ok`f) gqà gS v©j ,e,ll®lk;Vh ;g lqfuf'Pkr djus ds fy, dk;Zjr gS fd ;g Ok`f) tkjh jgsA ,e,l l®lk;Vh;g lqfuf'Pkr djus ds fy, Hkh dk;Z dj jgh gS fd yach vof/k dh fLFkfr;ksa ds fy,vaXkzst+h jk"Vªh; lsok Qz+seodZ tSlh jk"Vªh; igysa v©j LdkWVyaSM dh csgrj LOkkLF¸k] csgrjns[kHkky & n®uksa] t® ,e,l ls XkzLr y®xksa dh ns[kHkky ds fy, ekunaM fuèkkZfjr djrs gaS]LOkkLF¸k ns[kHkky lsokv®a esa csgrj <ax ls ykxw fd, tk,¡A

baXYkSaM esa LFkkuh; is'ksUV ,M~Okkbl ,aM fy;kt+ksa lfoZl (PALS) ,e,l ls XkzLr y®xksa v©jmudh ns[kHkky djus okyksa ds Á'Ukksa] mudh leL¸kkv®a ;k fparkv®a ¼t® esfMdy laca/kh ugksa½ ds tokc ns ldrh gSA PALS dk VsyhQ+¨u uacj lkekU¸kr% fdlh MkWDVj dh ltZjh;k vLirky esa miyC/k jgrk gSA osYLk esa] vkid® viuh LFkkuh; lkeqnkf;d LOkkLF¸k ifj"knls laidZ djuk pkfg,] mŸkjh vk;jyaSM esa] lkekftd lsok ifj"kn ls] v©j LdkWVyaSM esavius LFkkuh; NHS c®MZ lsA vf/kd tkudkjh ,e,l l®lkbVh ds Ádk'ku] LOkkLF¸kns[kHkky lsokv®a dh xkbM esa fey ldrh gSA

LFkkuh; vFkkWfjVh dh lkekftd lsok,¡

baXYkSaM] osYLk v©j mŸkjh vk;jyaSM esa LFkkuh; vFkkWfjVh dk lekt lsok foHkkx v©jLdkWVyaSM esa lekt dY¸kk.k foHkkx] ,e,l ls XkzLr y®xksa v©j mudh ns[kHkky djus okyksad®] ftUgsa Äj esa gh enn dh t+:jr g®] lsok,¡ miyC/k djkrs gaSA ,d {ks= ls nwljs {ks=dh lsok esa fofHkérk g® ldrh gS v©j dqN foHkkx d®Ã Qhl Hkh ys ldrs gaSA

vleFkZrk okys v©j t+:jrean y®xksa d® vf/kdkj gS fd mudh t+:jrksa dk lkeqnkf;dns[kHkky ewY¸kkadu fd;k tk,A ns[kHkky djus okyksa d® Hkh viuh [k+kl t+:jrksa dkewY¸kkadu djkus dk vf/kdkj gSA n®uksa gh ekeyksa esa] ,d fyf[kr fji®VZ nh tkrh gS] ftlesa;g crk;k tkrk gS fd LFkkuh; vFkkWfjVh d©u&lh lgk;rk miyC/k djk ldrh gSA blesaÄj d® vuqdwfyr djuk] Äj esa lg;®x djuk v©j N®Vs Ckzsd 'kkfey g® ldrs gaSA ;fnfdlh dh t+:jrksa esa ifjorZu g® tkrk gS] r® mUgsa iquewZY¸kkadu djkus dk gd gSA ,e,ll®lk;Vh ds Ádk'ku] xsfVax fn csLV ÝkWe l®'ky lfoZlst ¼v©j LdkWVyaSM esa lkekftddk;Z ls loksZŸke IkzkIr djuk½ esa v©j Hkh tkudkjh fey ldrh gSA

vleFkZrk&laca/kh vf/kdkj1995 dk fMlsfcfyVh fMLfØfeus'ku ,DV] vleFkZrk okys y®xksa d®] ;g lqfuf'Pkrdjus ds fy, fd muds lkFk] rhu eq[¸k {ks«kksa% j®t+xkj] lkeku] lsok,¡ v©j lqfo/kk,¡miyC/k djuk( v©j t+ehu ;k laifŸk cspus ;k fdjk, ij nsus ds ekeyksa esa] vU¸ky®xksa dh vis{kk de vuqdwy crkZo ugha fd;k tkrk] dqN vf/kdkj nsrk gSA

j®t+xkj esa vf/kfu;e ds laHkkfor mYYkaÄuksa v©j lkeku] lsokv®a v©j 16 ds i'Pkkrf'k{kk ds Ikzko/kkuksa esa fodyakxrk d+kuwu lsok eq¶+r d+kuwuh lykg Ánku djrk gSA

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dk;Z] Áf'k{k.k v©j vkfFkZd lgk;rkdk;Z

,e,l ls XkzLr cgqr ls y®x] funku fd, tkus ds ckn Hkh dà o"kZ rd iwjs le; dkedjrs jgrs gaSA dqN y®x va'kdkfyd ;k Äj ls dke djds vuqdwyu djrs gaSA

,e,l ds funku ds ckjs esa fu;®äk d® lwfpr djus dh d+kuwuh ck/¸krk ugha gS] c'krsZLOkkLF¸k v©j lqj{kk dk [k+rjk u g® & ;k tc rd ;g vuqca/k esa u fy[kk g®A bldh tk¡pdjuk mi;®xh g®xkA ijarq] ,e,l ls XkzLr O¸kfä dk fu;®äk ;fn mlls lh/ks gh Á'Uk iwNsfd fMlsfcfyVh fMLfØfeus'ku ,DV ds rgr os vius vkid® vleFkZ ekurs gaS ;k ugha] r®mUgsa *gk¡* vo'¸k djuk pkfg,A ,slk blfy,] D¸kksafd ,e,l dk funku fd, tkus okysÁR¸®d O¸kfä blls doj g®rs gaSA

fMlsfcfyVh fMLfØfeus'ku ,DV] ,e,l ls XkzLr y®xksa dh vleFkZrk ds dkj.k muds lkFkHksnHkko fd, tkus ls j{kk djrk gS] v©j fu;®äkv®a ds fy, ;g t+:jh gS fd O¸kfävleFkZrk d® LOkhdkj djus ds fy, mfpr ,M~TkLVesUVl djsaA buesa 'kkfey g® ldrs gaS%dke djus ds fy, yphys ?kaVs] dke djus ds lIrkg esa de fnu] fu;fer Ckzsd] 'kkjhfjd:i ls ig¡qpus dh lqfo/kk,¡] tSls jsEILk ;k gaSMjsYLk( v©j vkokt+ igpkuus okys lkW¶+Vos;jA,e,l l®lkbVh ds Ádk'ku] ,e,l ds lkFk dke djuk] esa j®t+xkj ds ckjs esa v©jtkudkjh gS & fu;®äkv®a v©j deZpkfj;ksa ds fy, tkudkjhA

Áf'k{k.k v©j f'k{kk

,e,l dk g®uk] Áf'k{k.k ikB¸kØeksa esa 'kkfey g®us ;k vkxs i<+kà djus esa ck/kd ugha g®ukpkfg,A oLrqr% dqN y®x u, Áf'k{k.k IkzkIr djds] ,e,l ls XkzLr thou fcrkus ds fy,vf/kd mi;qä] fdlh uà thouOk`fŸk dk vkuan ysrs gaSA mfpr ikB~¸kØe v©j f'k{kk ;kÁf'k{k.k dh lgh laLFkk pquuk dkQ+h Qk;nsean g® ldrk gSA fdlh fo'ks"k v/¸k;u dk;ZØeds fy, opuc) g®us ls igys] bu eqÌksa ij fopkj dj ysuk vPNk jgsxk% vkfFkZd lgk;rk(fo|kFkhZ lg;®x lsok,¡( ikB¸kØe dh fo"k;&oLrq ¼Á;®xkREkd v©j 'kkjhfjd vko'¸kdrkv®alfgr½( v/¸k;u ds dk;ZØeksa esa yphykiu( ig¡qp ldus dh lqfo/kk v©j d®Ã fo'ks"kvko'¸kdrkA fLdy (Skill) ,slh laLFkk gS] t® v©j tkudkjh ns ldrh gSA

vkfFkZd lgk;rk

ftu y®xksa esa ,e,l ds dkj.k vleFkZrk vk xà gS] os dqN ljdkjh “Ÿks ikus ds ik= g®ldrs gaSA buesa 'kkfey gS% fMlsfcfyVh fyfoax ,ykmal( j®txkj v©j lgk;rk “Ÿkk( ds;jlZ,ykmULk( v©j VSDLk ØsfMV~LkA ukxfjd lykg C¸kwj®] yk“ iwNrkN ykbu v©j DIAL UKd® “Ÿks IkzkIr djus dh ik=rk ds ckjs es tkudkjh Ánku djuh pkfg,A

“Ÿks cnyrs gaS v©j] y®x “ys gh mUgsa IkzkIr dj jgs gksa] ;k muds fy, igys vkosnu fd;kg® v©j lQy u gq, gksa] ;g ns[kus ds fy, fd ik=rk esa d®Ã ifjorZu gqvk gS ;k ughamudh fu;fer :i ls tk¡p djrs jguk vPNk jgrk gSA ,e,l l®lk;Vh dh LFkkuh;'kk[kkv®a ds dY¸kk.k vf/kdkjh] LFkkuh; lg;®x ds ckjs esa lykg v©j dHkh&dHkh vkfFkZdlgk;rk ns ldrs gaSA vf/kd tkudkjh ds fy,] ,e,l l®lkbVh dk Ádk'ku] yk“ v©j,e,l ns[ksaA

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14 ,e,l D¸kk gS\ © ,e,l l®lk;Vh 12/08

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lpyrk ds fy, lgk;d midj.k v©j nSfud thou&;kiuMªkbo djuk

ftu Mªkbojksa dk ,e,l ds fy, funku gqvk gS] os Mªkboj ,aM okfgdy ykblsaflax ,tsalh(Driver and Vehicle Licensing Agency) (DVLA) d® viuh chekjh ds ckjs esalwfpr djus ds fy, d+kuwuh r©j ij ck/¸k gaSA ;fn d®Ã MkWDVj bl ckr dh iqf"V dj nsrkgS fd O¸kfä Mªkbo djus ds fy, mi;qä gS] r® mudk Mªkbfoax ykblsal igys&tSlk ghjgsxk ;k mldk ,d] ;k rhu o"kksZa ds fy, uohdj.k fd;k tk,xkA vusd fpfdRLkkfLFkfr;ksa esa ;g vke gS tgk¡ le; ds lkFk fLFkfr;k¡ cny ldrh gaSA fodYiLOk:i] ,dvuqdwfyr okgu ds fy, ykblsal fn;k tk ldrk gSA e®Vj chek ikfyfl;ksa esa D¸kk&D¸kkcrkuk gS] bldh Hkh vPNh rjg tk¡p dj ysuh pkfg, v©j Mªkbojksa ds fy, ;g mfpr g®xkfd os viuh chek daiuh d® vius funku ds ckjs esa crk nsa] rkfd fuf'Pkr g® lds fd osvHkh Hkh doj fd, tk jgs gaSA e®Vj chek ikWfylh dk uohdj.k djkrs le; fdlh HkhO¸kfä d® ifjfLFkfr;ksa esa ifjorZu ds ckjs esa tkudkjh miyC/k djuk t+:jh g®xkA

T+;knkrj dkjksa d® vleFkZrk okys O¸kfä;ksa ds vuqdwy cuk;k tk jgk gS] v©j fHké t+:jrksaokys O¸kfä;ksa ds fy, fo'ks"k :i ls fMt+kbu dh xà dkjsa Hkh miyC/k gaSA ftu y®xksa d®vleFkZrk “Ÿkk feyrk gS] os dkj [k+jhnus ;k yht+ ij ysus esa enn ds fy,] e®fcfyVhLdhe (Motability Scheme) ds ik= g® ldrs gaSA e®fcfyVh dkj Ldhe (MotabilityCar Scheme) ls laidZ djds ik=rk dh tk¡p dj ysuk vPNk jgsxkA

blds vfrfjä] lpyrk dh leL¸kk okys O¸kfä;ksa d®] ;qj®fi;u CYkw dkMZ] t® ikfdZax dsdqN Áfrcaèkksa ls NwV nsrk gS] miyC/k g® ldrs gaSA xfr'khyrk dsUnz Q+¨je vkxs tkudkjhÁnku dj ldrk gSA

lkoZtfud ifjogu

fMlsfcfyVh fMLfØfeus'ku ,DV dk vFkZ gS fd ifjogu daifu;ksa d®] vleFkZrk okys y®xksad® ;k=k djus esa enn djus ds fy,] vc v©j vPNh rjg ySl g®uk pkfg,] v©j dÃlqfo/kktud ifjogu Ldhesa miyC/k gaSA bl laca/k esa vf/kd tkudkjh ds fy, LFkkuh;,e,l l®lk;Vh dh 'kk[kk] LFkkuh; ifj"kn] VªkaLi®VZ daiuh ls laidZ djsaA blds vykokvki fMlscYM ilZal VªkaLi®VZ ,Mokbtjh desVh ¼MhihVh,lh½ dh osclkbV ij Hkh tk ldrsgaSA

ifg,okyh dqflZ;k¡] LdwVlZ v©j vU¸k midj.k

,e,l ls XkzLr y®xksa d® fo'ks"k midj.kksa ls viuh vkREk&fuHkZjrk cuk, j[kus v©j viusthou dh DOkkfyVh lq/kkjus esa enn fey ldrh gSA ;fn vko'¸kd gqvk] r® th-ih-] ifg,okyh dqlhZ ;k vU¸k midj.kksa dh t+:jr okys y®xksa d®] ewY¸kkadu ds fy, fdlhvkWD¸kwis'kuy FksjfiLV ds ikl Hkst ldrk gSA

;g fo'ks"kK ewY¸kkadu djkuk egROkiw.kZ gS] D¸kksafd ifg, okyh dqflZ;k¡ dh Ádkj dà g®rh gaSv©j dqN dqflZ;k¡] NHS Oghyps;j lfoZl] okmpj flLVe ;k LFkk;h _.k ds tfj,miyC/k djkà tk ldrh gaSA ewY¸kkadu dh flQ+kfj'k ds vk/kkj ij vU¸k midj.k Hkhfu'kqYd miyC/k djk, tk ldrs gaSA ;fn Hkqxrku djuk t+:jh g®] r® O¸kfäxr mi;®x dsmidj.kksa ij VAT ugha nsuk iM+rk v©j midj.k ds lIYkk;j d® ,d NwV dk *QkWeZ*miyC/k djuk pkfg,] ftl ij lIYkk;j v©j midj.k [k+jhnus okys O¸kfä] n®uksa d®gLrk{kj djuk t+:jh gSA e®fcfyVh Ldhe (Motability Scheme) ÅtkZ ls pyus okyhifg,okyh dqflZ;ksa v©j LdwVlZ Hkh doj djrh gSA ftu y®xksa d® vleFkZrk “Ÿkk feyrk gS]os viuh ik=rk dk irk yxkus ds fy,] e®fcfyVh (Motability) ls laidZ dj ldrs gaSAmidj.kksa ds ckjs esa lgh lykg vko'¸kd gS] v©j cgqr gh laLFkk,¡] ftuesa fMlscYM fyfoaxQkmaMs'ku (Disabled Living Foundation) 'kkfey gS] enn dj ldrh gaSA

15,e,l D¸kk gS\ © ,e,l l®lk;Vh 12/08

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NqfÍ;k¡xjeh v©j vknzZrk ,e,l ls XkzLr vusd y®xksa ds y{k.k fcxkM+ ldrh gS] blfy, xarO¸k dhtyok;q ij fopkj djuk yk“nk;d g®xkA bl ckr ds vk/kkj ij fd O¸kfä dk ,e,l mlsdSls ÁHkkfor djrk gS] d®Ã opuc)rk djus ls igys y®x lqfuf'Pkr djuk pkg ldrs gaS fdvkokl ig¡qp esa gS v©j lqfo/kk,¡ mi;qä gaSA os ;g Hkh pkg ldrs gaS fd ;k=k ds fy, fo'ks"klqfo/kkv®a dk Áca/k fd;k tk,] tSls gokà vM~Ms ij ifg, okyh dqlhZ dh O¸koLFkk v©jjsyxkM+f;ksa ij ifg, okyh dqlhZ ds fy, txgA vU¸k t+:jrksa] tSls nokv®a ds fy, jsfÝtsjsVlZ]ij Hkh fopkj djuk iM+ ldrk gSA

,e,l ls XkzLr y®x® ds fy, ;g Hkh vPNk jgsxk fd os viuh ;k=k&chek daiuh d® viuhchekjh ds ckjs esa crk nsa] D¸kksafd ,slk u djus ls mudh ikWfylh voS/k g® ldrh gSA

Vwfjt+~e QkWj vkWy (Tourism for All) ,slh ij®idkjh laLFkk gS] t® vleFkZrk okys y®xksad® NqfÍ;ksa dh ;®tuk cukus esa tkudkfj;k¡ nsus esa lgk;rk djrh gSA lcds fy, i;ZVuNqfÍ;ksa dh ;®tuk cukus ij fodyakx y®xksa ds fy, lykg dh ij®idkjh is'kd'k gSAfodyakx O¸kfä ifjogu lykgdkj lfefr (DPTAC) viuh osclkbV ij lHkh Ádkj dh;k=kv®a ds fy, lykg Ánku djrh gSA

lg;®x ds Lkz®r v©j vfrfjä tkudkjh,e,l l®lk;Vh ds Ádk'ku

,e,l l®lk;Vh us cgqr ls fo"k;ksa ij vius Ádk'ku fudkys gaS] ftlesa vHkh&vHkh funkufd, x, y®xksa ds fy, ,e,l dh fdLEkksa ij tkudkjh] fjysILk dk Áca/ku djuk] v©jlkekftd lsok,¡ 'kkfey gaSA Ádk'kuksa dh lwph v©j vkWMZj QkWeZ ds fy,] osclkbVwww.mssociety.org.uk ij tk,¡ ;k 020 8438 0799 ij dkWy djsa ¼dk;ZfnolIkzkr% 9 ls lk;a 4] eaxyokj] Ikzkr% 9 ls vijkà 3 d® N®M+dj½A gekjh osclkbV lsMkmuy®M djus ds fy, rF¸k&Ái«kksa dh Js.kh Hkh miyC/k gS] ;k tkudkjh Vhe d® dkWydjsaA

,e,l l®lk;Vh dh osclkbV v©j if=dk

,e,l l®lkbVh dh osclkbV www.mssociety.org.uk v©j lnL¸kksa dh if=dk] ,e,leSVlZ ds lkFk lacaf/kr lekpkj ls v|frr jgsaA ,e,l eSVlZ ds fooj.k osc ij v©j ,e,ll®lk;Vh ds Ádk'kuksa dh lwph ij miyC/k gaSA

,e,l gsYiykbu

iqjLdkj&fotsrk ,e,l gsYiykbu ,e,l ls ÁHkkfor fdlh d® Hkh x®iuh; HkkoukREkdleFkZu v©j tkudkjh Ánku djrh gS] ftlesa ifjokj] n®Lr] ns[kHkky&drkZ] gky gh esafunku fd, x, y®x ;k os y®x 'kkfey gaS t® vusd o"kksZa ls bl fLFkfr esa jg jgs gaSA,e,l ds ckjs esa lwpuk 150 ls vf/kd fofHké Hkk"kkv®a esa miyC/k gS ftlds fy, nqHkkf"k;sds }kjk gsYiykbu dk;ZdrkZ ls ckr djuh g®rh gSA fUk%'kqYd Q+ u 0808 800 8000 ij ¼l®eokj ls 'kqØokj Ikzkr% 9 & jkf= 9 rd dkWy djsa] caSd dh NqfÍ;ksa d® N®M+dj½] ;k Ãesy djsa helpline@mssociety.org.uk

,e,l l®lk;Vh us'kuy lsaVj] baQkWesZ'ku lsaVj

yanu ds ,e,l us'kuy lsaVj esa fLFkr] baQkWesZ'ku lsaVj] mu vkxarqdksa ds fy,] t® i<+uk ;kiqLrdsa v©j if=dk,¡ i<+uk ;k ohfM;® v©j MhohMh ns[kuk pkgrs gaS] ds fy, iwjh rjg lsySl gSA baQkWesZ'ku lsaVj ,d baQkWesZ'ku ykbu pykrk gS% 020 8438 0799 ¼dk;Zfnol Ikzkr% 9 ls lk;a 4] eaxyokj] Ikzkr% 9 ls vijkà 3 d®N®M+dj½] ftldk Á;®x vki ,e,l ds ckjs esa Ádk'ku] 'k®/k ys[k ;k vU¸k tkudkjh dsfy, vuqj®/k gsrq dkWy djus ds fy, dj ldrs gaSA www.mssociety.org.uk/libraryij gekjk ykbCkzsjh MsVkcsl [k®tsa

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16 ,e,l D¸kk gS\ © ,e,l l®lk;Vh 12/08

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LFkkuh; lwpuk dsaæns'k “j esa vusd LFkkuksa ij ,e,l l®lk;Vh ds LFkkuh; lwpuk v©j lgk;rk dsaæ e©twngSA bu dsUnzksa ij LOk;alsod fu;qä fd, x, gaS t® ,e,l v©j vkids {ks= esa lsokv®a dsckjs esa tkudkjh nsdj vkidh enn dj ldrs gaSA vius fudVre dsUnz ds fooj.k dsfy, 020 8438 0799 ij dkWy djsaA

LFkkuh; 'kk[kk,¡

,e,l l®lk;Vh dh] iwjs ;wds esa] yx“x 300 LFkkuh; 'kk[kk,¡ gaSA ;s 'kk[kk,¡ & ftUgsaÁf'kf{kr LOksPNklsoh pykrs gaS & ,e,l v©j LFkkuh; lsokv®a] ,e,l ls XkzLr vU¸k y®xksals feyus ds volj] v©j dà rjg dh xfrfof/k;ksa esa Hkkx ysus ds ckjs esa tkudkfj;k¡miyC/k djkrh gSA vf/kd tkudkjh ds fy,] ,e,l l®lk;Vh dh osclkbV ns[ksa ;k 020 8438 0759 ij dky djsaA

mi;®xh laLFkk,¡ AA--ZZvkWV®e®ckby ,l®fl,'ku fMlsfcfyVh gsYiykbu(Automobile Association Disability Helpline)

lg;®x v©j tkudkjh miyC/k djrh gSA

Ýh&Q+¨u 0800 26 20 50www.theaa.com

,fcfyVhusV

daI¸kwVj midj.kksa ds fy, tkudkjh v©j ewY¸kkadu miyC/k djkrh gSA midj.k yxkus]Áf'k{k.k v©j lg;®x esa enn dj ldrh gSA

gsYiykbu 0800 269 545VsDLVQ®u 01926 312 847www.abilitynet.org.uk

,M~Okkbtjh] dkWfULkfy,'ku ,aM vkfcZVªs'ku lfoZl (Advisory, Conciliation and Arbitration Service)

j®t+xkj lacaèkksa ds fo'ks"kK] vPNs vkpj.k ds ckjs esa lykg ns ldrs gaS v©j vyx&vyxekeyksa d® fuiVk ldrs gaSA

Brandon House180 Borough High StreetLondon SE1 1LWgsYiykbu 08457 47 47 47 ¼l®eokj ls 'kqØokj] Ikzkr% 8&lk;a 6½VsDLVQ®u 08456 06 16 00 ¼l®eokj ls 'kqØokj] Ikzkr% 8&lk;a 6½www.acas.org.uk

csusfQV ,aDOkk;jh ykbu (Benefit Enquiry Line)

vleFkZrk okys y®xksa] mudh ns[kHkky djus okyksa v©j muds Áfrfuf/k;ksa d® “Ÿkksa ds ckjsesa lk/kkj.k lykg miyC/k djkrh gSA

gsYiykbu 0800 88 22 00 ¼vaXkzst+h v©j osY'k esa½¼l®eokj ls 'kqØokj] Ikzkr% 8.30&lk;a 6.30] v©j 'kfuokj Ikzkr% 9&vijkà 1½VsDLVQ®u 0800 24 33 55 ¼vaXkzst+h v©j osY'k esa½ew=k'k; v©j vka= U¸kkl 0800 22 06 74VsDLVQ®u 0800 24 37 87www.dwp.gov.uk

17,e,l D¸kk gS\ © ,e,l l®lk;Vh 12/08

ew=k'k; v©j vka= U¸kkl (Bladder and Bowel Foundation)

ew=k'k; ;k vka= fu;a=.k leL¸kkv®a ls y®xksa ds fy, futh v©j x®iuh; lykgA

SATRA bUUkksos'ku ikdZ jkWfdaÄe j®MdsVfjax NN16 9JHulZ gsYiykbu 0845 345 0165ijke'kZnkrk gsYiykbu 0870 770 3246www.bladderandbowelfoundation.org

fCkzfV'k ,l®fl,'ku QkWj dkmfULkfyax ,aM lk;d®Fksjih(British Association for Counselling and Psychotherapy)

vf/k—r dkmULkylZ] lk;d®y®ftLV~Lk v©j FksjfiLV~Lk ds foodj.k lIYkkà djrk gSA

BACP House15 lsaV tkWULk fct+usl ikdZ yqVjoFkZ yhlslV'kkZ;j LE17 4HBVsyhQ®u 0870 443 52 52www.bacp.co.uk

ds;jlZ ;wds (Carers UK)

lHkh ns[kHkky djus okyksa ds fy,] tkudkjh ds yhQysV~Lk v©j lq;®X¸k] Áf'kf{krdeZpkfj;ksa }kjk pykà tkus okyh ,d jk"Vªh; gsYiykbu miyC/k djkrk gSA

20 XkzsV M®oj LVªhVyanu SE1 4LXds;jlZykbu 0808 808 7777¼cq/kokj v©j xq#okj] Ikzkr% 10 ls 12 cts v©j 2 ls 4 cts rd½www.carersuk.org

flfVt+ULk ,M~Okkbl C¸kwj® [Citizens Advice Bureau (CAB)]

dY¸kk.k ds vf/kdkjksa] vkokl v©j vleFkZrk ds ckjs esa lykg nsdj lgk;rk djrk gSALFkkuh; dh lwph VsyhQ+¨u Mk;jsDVjh esa v©j mudh osclkbV~Lk ij gSA ,d vkWu&ykbu,M~Okkbl xkbM dk Hkh lapkyu djrk gSA

www.citizensadvice.org.ukwww.adviceguide.org.uk

fMikVZesaV QkWj odZ ,aM isa'kal(Department for Work and Pensions)

chekj ;k vleFkZrk okys y®xksa ds fy, dà rjg ds “Ÿkksa v©j lsokv®a ds fy, ft+EEksnkjAosclkbV esa ,d ^^A-Z vkWQ+ csusfQV~Lk^^ 'kkfey gaSA

www.dwp.gov.uk

Mk;y & fodyakxrk tkudkjh lykg ykbu(DIAL - Disability Information Advice Line)

LFkkuh; tkudkjh lsokv®a dk usVodZ] t® fodyakxrk ds lkFk thus ds lHkh igyqv®a dsckjs esa tkudkjh v©j lykg Ánku djrk gSA

lsaV dSFkjhULkfVdfgy j®MM®UdkLVj DN4 8QNVsyhQ+¨u 01302 310 123VsDLVQ+¨u 01302 310 123 ¼vkokt+ m)ks"kd dk Á;®x djsa½www.dialuk.info

18 ,e,l D¸kk gS\ © ,e,l l®lk;Vh 12/08

fMlsfcfyVh ykW lfoZl (Disability Law Service)vleFkZrk okys y®xksa v©j muds ifjokjksa v©j ns[kHkky djus okyksa d® lkekftd dY¸kk.kv©j lekurk HksnHkko laca/kh d+kuwu ds lac/k esa ,e,l l®lk;Vh Áeq[k fu'kqYd x®iuh;]d+kuwuh lykg v©j lg;®x miyC/k djkus okyh jk"Vªh; ij®idkjh laLFkkA ,e,l l®lk;VhlefiZr ,e,l d+kuwuh vf/kdkjh ds fy, jkf'k nsrh gS t® cqfu;knh d+kuwuh lykg v©jtkudkjh Ánku dj ldrk gS v©j fo'ks"kK j®t+xkj lykgdkj ds lkFk eqykd+kr dhO¸koLFkk dj ldrk gSA

39-45 dSosy LVªhV yanu E1 2BPVsyhQ®u@VsDLVQ+¨u 020 7791 9800www.dls.org.uk

fMlsfcfyVh jkbV~Lk deh'ku (Disabled Living Foundation)

fMlsfcfyVh fMLfØfeus'ku ,DV ds ckjs esa tkudkjh v©j lykg miyC/k djkrk gS v©jtgk¡ vko'¸kd g®] fo'ks"kK laLFkkv®a dh tkudkjh nsrk gSA vleFkZrk okys y®xksa d®fu;qfä esa vPNs vkpj.k ds ckjs esa lykg Hkh ns ldrk gSA

380-384 Harrow RoadLondon W9 2HUgsYiykbu 0845 130 9177 ¼l®eokj ls 'kqØokj] Ikzkr% 10&lk;a 4½VsDLVQ®u 020 7432 8009www.dlf.org.uk

fodyakx O¸kfä ifjogu lykgdkj lfefr (DPTAC)[(Disabled Persons Transport Advisory Committee (DPTAC)]ifjogu foHkkx dh lykgdkj lfefr] t® fodyakx y®xksa ;k vkus&tkus esa ijs'kkuh eglwldjus okys y®xksa d® ;k=k lykg v©j ifjogu tkudkjh Ánku djrh gSA

VsyhQ+¨u 020 7944 8011VsDLVQ+¨u 020 7944 3277www.dptac.gov.uk

mŸkjh vk;jyaSM ds fy, lekurk v©j ekuokf/kdkj vk;®x@lekurk vk;®x[Equality and Human Rights ommission/Equality Commission forNorthern Ireland]fodyakxrk HksnHkko vf/kfu;e ds ckjs esa tkudkjh v©j lykg Ánku djrk gS] vko'¸kdg®us ij fo'ks"kK laxBuksa ds ladsr nsrk gSA fodyakx y®xksa ds j®t+xkj esa vPNh ÁFkkv®aij lykg Hkh ns ldrk gSA

baXYkSaM% VsyhQ+ u@VsDLVQ+¨u 0845 604 6610 / 6620osYLk% VsyhQ+¨u@VsDLVQ+¨u 0845 604 8810 / 8820LdkWVyaSM% VsyhQ+ u@VsDLVQ+¨u 0845 604 5510 / 5520

www.equalityhumanrights.com

mŸkjh vk;jyaSM% VsyhQ+¨u 02890 890 890www.equalityni.org

19,e,l D¸kk gS\ © ,e,l l®lk;Vh 12/08

xfr'khyrk Q+¨je dsUnz

okgu&pkyu] okgu vuqdwyu v©j okgu pkydksa v©j ;kf=;ksa n®uksa ds fy, mi;qä okguÁdkj ij O¸kkogkfjd lykg Ánku djrk gSA

v®YM okWfdaÄe j®M Ø®Fzk®u RG45 6XDwww.dft.gov.uk/access/mavis

}kjk Ikz®foMsal pSiyos;jgkWuZ,'kQ+¨MZdaSV TN26 2JXVsyhQ+¨u 0800 559 3636www.mobility-centres.org.uk

e®VkfcfyVh (Motability)

e®VkfcfyVh vleFkZrk okys y®xksa v©j muds ifjokjksa d®] ifg, okyh dqflZ;k¡] LdwVj v©jdkjsa nsdj lpy g®us esa enn djrk gSA

Motability Car Scheme ¼e®VkfcfyVh dkj Ldhe½ City Gate House22 Southwark Bridge RoadLondon SE1 9HBVsyhQ®u 0845 456 4566www.motability.co.uk

e®fcfyVh Oghyps;j ,aM LdwVj LdheRoute2mobilityNewbury RoadEnham AlameinAndoverHampshire SP11 6JSVsyhQ®u 0845 60 762 60www.motability.co.uk

fIkzalsl jkW;y VªLV QkWj ds;jZl(Princess Royal Trust for Careers)

LOkra= :i ls Ácaf/kr ns[kHkky djus okyksa ds dsanzksa ds vius usVodZ ds tfj;s tkudkjh]lykg v©j lg;®x miyC/k djkrk gSA ns[kHkky djus okyksa ds fy, vuqnku dh cgqr lhLdhesa Hkh gaSA

;wfuV 14] ckWuZ d®VZ lkmFksaM j®M oqMQ+¨MZ Xkzhu IG8 8HDVsyhQ+¨u 0844 800 4361www.carers.org

fjysV (Relate)

vkeus&lkeus] VsyhQ+¨u }kjk v©j osclkbV ds tfj;s] lykg] vkilh lacaèkksa ij ijke'kZ]lsDLk Fksjih] dk;Z'kkyk,¡] e/¸kLFkrk] ijke'kZ v©j lg;®x miyC/k djrk gSA

viuk ut+nhdh fjysV [k®tus ds fy,%VsyhQ+¨u 0300 100 1234 ¼LFkkuh; dkWy nj ÁHkkj½

¼l®eokj ls xq#okj] Ikzkr% 8 ls jkf= 10] 'kqØokj] Ikzkr% 8 ls lk;a 6] 'kfuokj] Ikzkr% 9 ls lk;a 5½www.relate.org.uk

20 ,e,l D¸kk gS\ © ,e,l l®lk;Vh 12/08

jkW;y ,l®fl,'ku QkWj fMlsfcfyVh ,aM fjgsfcfyVs'ku (RADAR)

vf/kdkjksa v©j lsokv®a ds ckjs esa tkudkjh v©j lykg miyC/k djkrk gSA us'kuy dhLdhe (National Key Scheme) Hkh lapkfyr djrk gS] t® vleFkZrk okys y®xksa d®yx“x 4,000 rkykcan 'k©pky;ksa dh mi;®x&lqfo/kk nsrk gSA

12 City Forum250 City RoadLondon EC1V 8AFVsyhQ®u 020 7250 3222VsDLVQ+¨u 020 7250 4119www.radar.org.uk

lsDLkq,y fMLQaD'ku ,l®fl,'ku (Sexual Dysfunction Association)

;©u j®x dk vuq“o djus okys iq#"kksa v©j efgykv®a ds fy,] v©j muds lkfFk;ksa ds fy,lgk;rkA rF¸k&i= Ádkf'kr djrk gS v©j gsYiykbu pykrk gSA

lqbV 301, ,ECkye gkmlyanu fCkzt vLirky27 Vwys LVªhVyanu SE1 2PRgsYiykbu 0870 774 3571 ¼l®eokj] cq/kokj v©j 'kqØokj] Ikzkr% 10 ls lk;a 4½www.sda.uk.net

fLdy ¼us'kuy C¸kwj® QkWj LVqMsaV~Lk fo|kfFkZ;ksa fMlsfcfyVht+½(National Bureau for Students with Disabilities)

;qok v©j o;Ld y®xksa] ftuesa fdlh Hkh rjg dh vleFkZrk g®] ds fy, 16 o"kZ dh mEkzds ckn dh f'k{kk] Áf'k{k.k v©j j®t+xkj ds voljksa d® c<+kok nsrk gSA

;wfuV 3, ry 3jsfMlu d®VZ219 ykWU?k ysuyanu SE1 4PRfUk%'kqYd Q+¨u 0800 328 5050VsDLVQ+¨u 0800 068 2422www.skill.org.uk

Vwfjt+~e QkWj vkWy (Tourism for all)

;w-ds- v©j fons'kksa] n®uksa ds vkfrF¸k lRdkj ds lHkh {ks«kksa] ftuesa vkokl] ;kf=;ksa ds fy,vkd"kZ.k] NqfÍ;ksa dh xfrfof/k;k¡ v©j jkgr ns[kHkky Áfr"Bku 'kkfey gaS] ds ckjs esatkudkjh nsdj] vleFkZrk okys y®xksa d® NqfÍ;k¡ fcrkus ds lqvolj nsrk gS ¼;fn la“o g®r® eq[¸k /kkjk ds okrkoj.k esa½A

}kjk fofVyht+'kSi j®M v©|®fxd ,LVsV'kSi j®MdsaMy LA9 6NZVsyhQ+¨u 0845 124 9971VsDLVQ+¨u 0845 124 9976www.tourismforall.info

21,e,l D¸kk gS\ © ,e,l l®lk;Vh 12/08

lanHkZ1Confavreux, C. and Compston, A. (2005) The natural history of multiple sclerosis. In: A. Compston et al. McAlpine’s Multiple Sclerosis.Churchill Livingston Elsevier. p.199.

2Orton, S. M. et al. (2007) Sex ratio of multiple sclerosis in Canada:a longitudinal study. Lancet Neurology, 6(1), 5-6.

3 Compston, A. and Coles, A. (2002) Multiple sclerosis.The Lancet, 359, 1221-31.

4 Polman, C. H. et al. (2005) Diagnostic criteria for multiple sclerosis:2005 revisions to the ‘McDonald Criteria’. Annals of Neurology, 58(6),840-6.

5McDonald, W. I. et al. (2001) Recommended diagnostic criteria formultiple sclerosis: guidelines from the International Panel on thediagnosis of multiple sclerosis. Annals of Neurology, 50(1), 1-7.

6 Compston, A. (1997) Genetic epidemiology of multiple sclerosis.Journal of Neurology, Neurosurgery and Psychiatry, 62, 553-61.

7 O’Connor, P. (ed) (2002) Key issues in the diagnosis and treatmentof multiple sclerosis. An overview. Neurology, 59, sup. 3, s1-31.

8 Ascherio, A. and Munger, K. (2008) Epidemiology of multiplesclerosis: from risk factors to prevention. Seminars in Neurology,28(1), 17-28.

9 Koch, M. et al. (2008) Factors associated with the risk of secondaryprogression in multiple sclerosis. Multiple Sclerosis, 14, 799-803.

10 Thompson, A. J. et al. (2000) Diagnostic criteria for primaryprogressive multiple sclerosis: a position paper. Annals of Neurology,47(6), 831-5.

11 Thompson, A. J. et al. (1997) Primary progressive multiple sclerosis.Brain, 120, 1085-96.

12 National Institute for Clinical Excellence (2003) NICE Clinical Guideline8. Multiple Sclerosis: Management of multiple sclerosis in primary andsecondary care. London, NICE.

13 Department of Health (2005) National Service Framework for Long-termConditions. London, Department of Health.

14 Available at www.scotland.gov.uk

15 Available at www.wales.nhs.uk

16 Available at www.dhsspsni.gov.uk

17 MS Society (2007) Disease modifying drugs (3rd ed.) London,MS Society.

18 Polman, C. H. et al. (2006) A randomised, placebo controlled trial ofnatalizumab for relapsing multiple sclerosis. The New England Journalof Medicine, 354, 899-910.

19 National Institute for Health and Clinical Excellence (2007)Natalizumab for the treatment of adults with highly active relapsing-remitting multiple sclerosis. London, NICE.

20 Tremlett, H. L. et al. (1998) Use of corticosteroids in multiplesclerosis by consultant neurologists in the United Kingdom. Journalof Neurology, Neurosurgery and Psychiatry, 65(3), 362-5.

22 ,e,l D¸kk gS\ © ,e,l l®lk;Vh 12/08

21 Barnes. D. (1998) Treatment of Acute Relapses. In C. P.Hawkinsand J. S. Wolinsky (2000) Principles of Treatments in MultipleSclerosis, Oxford, Butterworth Heinemann.

22 Dworkin, R. H. et al. (1984) Linoleic acid and multiple sclerosis:a reanalysis of three double-blind trials. Neurology, 34, 1441-5.

23 Petajan, J. H. et al. (1996) Impact of aerobic training on fitnessand quality of life in multiple sclerosis. Annals of Neurology, 39,432-41.

24 Rutschmann, O. T. et al. (2002) Immunisation Panel of the MSCouncil for Clinical Practice Guidelines Immunisation andMultiple Sclerosis. Neurology, 59, 1837-43.

25 Sicotte, N. L. et al. (2002) Treatment of multiple sclerosis withthe pregnancy hormone estriol. Annals of Neurology, 52(4), 421-8.

26 Sadovnick A. D. et al. (1994) P regnancy and multiple sclerosis.A prospective study. Archives of Neurology, 51(11), 1120-4.

23,e,l D¸kk gS\ © ,e,l l®lk;Vh 12/08

ys[kd p®y uhYM (Chloe Neild)

laiknd tsELk csyh (James Bailey)

Ikz®Q+slj MsfoM feyj d® rhljs laLdj.k esa mudh enn ds fy, v©j mu lHkh y®xksa d®/kU¸kokn ds lkFk ftUgksaus fiNys laLdj.kksa dh leh{kk dh v©j muesa ;®xnku fd;kA

i`"B 1 dk fp= & tsu QSy®l

i`"B 2 v©j 3 ds fp= & fØlsaV ykWt

fMt+kbu fØlsaV ykWt] yanu

vLOkhdj.k% geus ;g lqfuf'Pkr djus ds fy, gj la“o Á;kl fd, gaS fd bl Ádk'ku esatkudkjh lgh g®A ge fdlh =qfV ;k pwd dh t+fEEksnkjh LOkhdkj ugha djrsA d+kuwu v©jljdkjh fu;e cny ldrs gaSA lwphc) Lkz®rksa ls LFkkuh; lykg ysuk vo'¸k lqfuf'PkrdjsaA

“fo"¸k ds laLdj.kksa esa lq/kkj ds fy, lq>koksa dk LOkkxr gSA —i;k mUgsa ;g¡k Hkstsainfoteam@mssociety.org.uk

© Multiple Sclerosis Society, 2008

rhljk laLdj.k fnlacj 2008

,e,l D¸kk gS\ tc 2005 esa Ádkf'kr gqÃ] r® bls ,l®fl,'ku vkWQ esfMdyfjlpZ pSjhVht+ dk 'kh"kZ foKku lapkj iqjLdkj IzkkIr gqvk v©j fCkzfV'k esfMdy,l®fl,'ku us Hkh bldh vR¸kf/kd ljkguk dh gSA

24 ,e,l D¸kk gS\ © ,e,l l®lk;Vh 12/08

eYVhiy Ldsysj®fll l®lk;Vh

eYVhiy Ldsysj®fll ¼,e,l½ vleFkZrk iSnk djus okyh ,d cgqr gh vke raf=dh; chekjhgS] t® ;qok o;Ldksa d® ÁHkkfor djrh gS v©j ;w-ds- esa 85,000 y®xksa d® ,e,l gSA ,e,lekbfyu&dsanzh; LUkk;q ra= ds LUkk;qv®a ds js'kksa ds bnZ&fxnZ fyiVs j{kkREkd [k®y ds {kfrXkzLrg® tkus dk ifj.kke gSA ;g {kfr efLr"d ls 'kjhj ds vU¸k vaxksa esa tkus okys lans'kksa dsvkus&tkus esa gLr{ksi djrh gSA

dqN y®xksa esa ,e,l ds y{k.k g®rs gaS fofHké vof/k;ksa esa jsySgzl ¼n®ckjk g®uk½ v©j jsfelu¼NqVdkjk feyuk½] tcfd vU¸k y®xksa esa bldk LOk:i Øfed fodkl okyk g®rk gSA ;g gjfdlh ds thou d® vlguh; v©j vuques; cuk nsrk gSA

,e,l l®lk;Vh ;w-ds- dh lcls cM+h ij®idkjh laLFkk gS t® gj ml O¸kfä d® lg;®x nsusds fy, lefiZr gS] ftldk thou ,e,l ls ÁHkkfor gSA ;g jkgr] ns[kHkky] eq¶+r Q+¨uokyh ,d ,e,l gsYiykbu] Äjksa d® vuqdwy cukus v©j lpyrk esa lgk;d midj.kksa dsfy, vuqnku] f'k{kk v©j Áf'k{k.k] fo'ks"kK ,e,l ulksZa v©j dà rjg dh tkudkfj;k¡ Ánkudjrh gSA LFkkuh; 'kk[kk,¡ lHkh mEkz v©j #fp ds y®xksa dh t+:jrsa iwjh djrh gaS v©j bUgsa osy®x pykrs gaS ftUgsa ,e,l dk ÁR¸k{k vuq“o IkzkIr gSA

,e,l l®lk;Vh ;w-ds- esa 70 ls vf/kd egROkiw.kZ ,e,l vuqla/kku ifj;®tukv®a dkfoŸk&i®"k.k Hkh djrh gSA

lnL¸krk ,e,l XkzLr y®xksa] muds ifjokjksa] ns[kHkky&drkZv®a] fe«kksa v©j leFkZdksa ds fy,[kqyh gSA

vki l®lk;Vh ds dke esa bl Ádkj lgk;rk dj ldrs gaS%

• lnL¸k cudj• nku nsdj• LOkPNklsoh ds :i esa le; nsdj

laidZ ds fy, tkudkjh

,e,l us'kuy lsaVj372 Edgware RoadLondon NW2 6NDVsyhQ®u 020 8438 0700

,e,l l®lk;Vh LdkWVyaSMNational OfficeRatho Park 88 Glasgow Road Ratho StationNewbridge EH28 8PPVsyhQ®u 0131 335 4050

,e,l l®lk;Vh] mŸkjh vk;jyaSMlalk/ku dsaæ34 Annadale AvenueBelfast BT7 3JJVsyhQ®u 028 9080 2802

,e,l l®lk;Vhfle# eafnj U¸kk;ky;dSFksMªy j®MdkfMZQ CF11 9HAVsyhQ®u 029 2078 6676

us'kuy ,e,l gsYiykbuÝhQ®u 0808 800 8000¼l®eokj ls 'kqØokj] Izkkr% 9&lk;a 9½Website www.mssociety.org.uk

XkzsV fCkzVsu v©j mŸkjh vk;jyaSM dh eYVhiy Ldsysj®fll l®lkbVh baXYkSaM v©j osYLk (207495) v©j LdkWVyaSM (016433) esa iath—r ij®idkjh laLFkk gSA

GI02/1208