ऐसा कहते हैं कि भूख और नींद जितनी बढ़ाओ या घटाओ, उतनी बढ़ या घट जाती है ।नींद ऐसी चीज है जो किसी को पत्थर पर सोने से ही आ जाती है और किसी को मखमली बिस्तर पर भी नहीं आती । एक बार अकबर ने बीरबल से पूछा कि दुनिया में सबसे प्यारी चीज क्या है ? तो बीरबल ने बताया कि सबसे प्यारी चीज़ है, नींद। वास्तव में नींद केवल प्यारी ही नहीं है बल्कि जीवन के लिए अति आवश्यक भी है। लेकिन यह प्यारी सी चीज नींद सबके हाथ लगती कहां है? दुनिया में सैकड़ों ऐसे लोग मिल जाएँगे जो नींद के लिए तरसते हैं। नींद ने तो लोगों को कवि और शायर तक बना दिया है। अनेक कवितायें और फिल्मी गाने नींद के ऊपर लिखी गयी है। चिकित्सकों के अनुसार 18 से 40 वर्ष तक आठ घंटे की नींद और 40 से 50 वर्ष तक स्वस्थ मनुष्य के लिए 6 घंटे की नींद ज़रूरी होती है । 50 वर्ष से अधिक उम्र होने पर नींद कम आने लगती है। अनिद्रा, दुनिया भर की आम स्वास्थ्य समस्याओं में से एक है, जो हर उम्र के पुरुषों और महिलाओं में हो सकती है। एक अनुमान के अनुसार १. 35 प्रतिशत मरीज, जीवन के एक खास दौर में अनिद्रा की शिकायत करते हैं। २. 12 प्रतिशत मरीजों के लिए यह एक आम शिकायत है। ३. स्त्रियां अनिद्रा से अधिक पीड़ित रहती हैं। ४. नींद न आने की समस्या उम्र के साथ-साथ बढ़ती है। अनिद्रा के प्रमुख कारण- आयुर्वेद के अनुसार वात और पित्त बढ़ जाने से अनिद्रा की स्थिति आती है। वात-पित्त मानसिक तनाव के कारण बढ़ता है। इसके बाद कुंठित भावनाओं का स्थान आता है। तीन हफ्तों तक जारी रहने वाली अनिद्रा को ट्रांजियंट इनसोम्निया कहा जाता है। इसका मुख्य कारण मानसिक संघर्ष, अपरिचित या नया वातावरण, सदमा, प्रियजनों की मृत्यु, तलाक या नौकरी में बदलाव आदि हो सकते हैं।नींद ना आने का सबसे प्रमुख कारण टेंशन होता है|शोर-शराबे वाली जीवन शैली, अनियमित दिनचर्या, कम शारीरिक व्यायाम व कम मेहनत करना , ज्यादा शराब सेवन करने से भी नींद नहीं आती है| आधुनिक रिसर्च के अनुसार इस तरह की समस्याओं का कारण हमारी बदलती जीवनशैली भी है। हमारे पास ऐसे बहुत से मरीज आते हैं जो कहते हैं कि उन्हें नींद नहीं आती। अनिद्रा के लक्षण और इससे नुक्सान १. सुस्ती, अनिद्रा के कारण लोगों में दिखाई देने वाला एक आम लक्षण है. २. जागने के बाद आपको खुमारी या सर भारी होने का अहसास होता है. ३. जब एक व्यक्ति की रोज की नींद पूरी नहीं होती तो उसके स्वभाव में चिड़चिड़ापन होने लगता है. ४. ऐसे लोगों को बहुत जल्दी गुस्सा आने लगता है और वे धीर धीरे डिप्रेशन का शिकार हो सकते हैं. ५. उनका व्यवहार असामान्य होने लगता है। ६. अगर अनिद्रा की समस्या काफी लंबे समय के लिए हो जाय तो यह शरीर के लिए गंभीर और चिरकारी हो जाती है जिसका इलाज़ अच्छे चिकित्सक से ही करवाना चाहिए। ७. अगर एक व्यक्ति 30 दिनों से भी अधिक समय तक के लिये ठीक से ना सो पाएं तो इसका अर्थ यह है कि वह चिरकालीन अनिद्रा का शिकार है। ८. अनिद्रा के कारण साइकोसोमैटिक परेशानियां जैसे डीप्रेशन, घबराहट, आत्मबल की कमी जैसी समस्याएं भी होने लगती हैं। उपचार प्रारम्भ में हम इसका इसका उपचार बिना दवाइयों के ही करते है. इनमे कुछ आसान उपाय अपनाने होते हैं जैसे- १. नियमित व्यायाम की आदत डालें, इससे नींद अच्छी आती है, पर सोने से पहले व्यायाम नहीं करना चाहिए। २. सोने के कमरे को शांत व अंधकारमय रखना । ३. सोने व उठने की नियमित दिनचर्या बनाना। ४. शयन के समय शवासन का नियमित अभ्यास। ५. सोते समय सकारात्मक विचारों द्वारा मान को शांत रखना। रोगियों के ध्यान रखने के लिए ज़रुरी बातें १. अगर नींद नहीं आ रही हो तो अभी बिस्तर पर न जाएं। २. बिस्तर पर लेटे लेटे नींद का इंतजार न करें। तभी लेटें , जब नींद आने की फीलिंग हो। ३. हर सुबह एक निश्चित समय पर उठें। रात को निश्चित समय पर सोएं। ४. देर रात तक पार्टियों व टीवी देखने की आदत छोड़ें। ५. दिन में नहीं सोयें ताकि रात में अच्छी नींद आये। ६. सोने से पहले व्यायाम करके भोजन करें। सोने से पहले हाथ, पैर धोयें या स्नान कर लें। ७. सोने से पहले रात को इक सेब का मुरब्बा गरम दूध के साथ लें. ८. तीन ग्राम ताज़े पोदीने के पत्ते २०० ग्राम पानी में २ मिनिट तक उबालने के बाद छान लें. इसमें दो चम्मच शहद मिलाकर गुनगुना गुनगुना रात को सोने से पहले पी जाएँ. ३-४ हफ्ते इसे आजमायें फिर देखिये. ९. कुछ धार्मिक रोगियों से बात करने पर पता चला कि भगवान का भजन कर लें या कोई मंत्र जैसे-गायत्री मंत्र का जपकर लें तो भी नींद आ जाती है। योग चिकित्सा नींद लाने के लिए कई आसान उपाय बताये गये हैं। भारत में योग उनमें से एक उपाय है। पश्चिमी देशों में संगीत को महत्व दिया गया है। अनिद्रा दूर करने का एक तरीका ध्यान भी है। सुबह और शाम लगभग 20 मिनट तक किए गए योगासनों के जरिए शरीर को उतना ही लाभ पहुंचाया जा सकता है, जितना आठ घंटे की नींद लेने से होता है। योगासन हमारे शरीर के तंत्रिका तंत्र को सक्रिय बनाते हैं। ये तनाव से राहत दिलाने में मदद करते हैं, जोकि अनिद्रा का सबसे आम कारण है। शवासन एक ऐसी मुद्रा है जो हमें तनाव से मुक्त कर अनिद्रा से छुटकारा पाने में मदद करती है। इसे केवल 20 मिनट कीजिये; आपको अवश्य ही आराम मिलेगा ऐसा हमारा अनुभव है. इसलिए आपको सलाह दी जाती है कि अगर आप सामान्य उपचार द्वारा ठीक नहीं हो पा रहे हैं तो इसके विशेषज्ञ से मिलकर रोग को जल्दी से जल्दी दूर करने का प्रयास करें जिससे आपकी सेहत अच्छी हो सके. अगर आपकी जानकारी में भी इस रोग से पीड़ित है तो उसे ये जानकारी देकर एक ज़िम्मेदार नागरिक होने का कर्तव्य निभाएं. “सर्वे भवन्तु सुखिनः सर्वे सन्तु निरामयाः । सर्वे भद्राणि पश्यन्तु मा कश्चिद्दुःखभाग्भवेत् ॥“ शेष अगली पोस्ट में..... प्रतिक्रियाओं की प्रतीक्षा में, आपका अपना, डॉ.स्वास्तिक चिकित्सा अधिकारी (आयुष विभाग, उत्तराखंड शासन ) (निःशुल्क चिकित्सा परामर्श, जन स्वास्थ्य के लिए सुझावों तथा अन्य मुद्दों के लिए लेखक से Drswastikjain@hotmail.com पर संपर्क किया जा सकता है )

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Mamma...mia.!!!! Since Times Immemorial Breasts Have Always Held The Fascination Of Mankind Irrespective Of The Age. And The Fact Is Just As True Today As It Was Many Years Ago. But The Only Thing That Has Changed Is The Fact That Women Themselves Also Are Starting To Take Notice Of Them. So Let Us Examine And Learn A Few Things About Breast Augmentation Or As It Is Fondly Called " A Boob Job!" Who Undergoes A Breast Augmentation….?. Is It The Celebrities Or Routine People?? What Drives Them To Get The Operation? Do They Understand The Risks Involved And About The Procedure??? For The First Question The Answer Is No! It Is Not Only The Celebrities, But Routine People, The Housewife, The Teacher, The Software Engineer, The Doctor… People From All Walks Of Life Who Undergo The Procedure. What Drives Them To Get The Procedure Done?? Well A Few Have Pathological Problems In The Chest Area And Hence Have To Go In For An Augmentation. But, Majority Of The Women Undergo The Procedure Because Either The Volume Was Less To Start Off With Or Decreased With Age And Multiple Pregnancies Or Sudden Weight Loss. What Drives Them Is The Fact That Breasts Are A Sign Of Femininity And These Women Feel That The Decreased Volume Of The Breasts Affects The Way They See Themselves. First Of All Let Us Understand Some Facts Regarding Breasts : 1. Breast Size Is Variable In People And There Is No Fixed Size Which Is The Norm. Several Deciding Factors Like The Amount Of Breast Tissue, Heredity, How Fat The Person Is And The Fact That Whether The Person Has Been Pregnant Before All Contribute To Breast Size. And Of Course Age Is A Contributing Factor As Always 2.there Is Nothing Like A Perfect Breasts.usually Perky Breasts Without A Sag And Nipples Pointing Forwards And A Little Laterally Are Acceptable As The Norm But They Vary With The Size. Small Perky Breasts Look Good If The Person Is Thin But Not On A Well Built Female. So Its All About Proportion. 3. 99.9% Women Have Asymmetrical Breasts The Left Usually Being Larger Than The Right. The Nipples May Be Erect, Flat, Inverted, The Areola May Be Large Or Small, With Or Without Few Hairs Growing Long, Or The Areola May Be Bumpy All Of Which Are Normal. Regarding Understanding The Procedure And The Risks Involved, I’m Sad To Say That Though Most Of The Patients Are Educated Women, Hardly 10% Of Them Really Know About The Procedure And The Risks Involved. Broadly There Are Two Categories Of Women Undergoing The Procedure. The First Category Or Age Group Is The Young Women Who Are In Their 20's Who Want To Increase Their Bust Size Because They Have Underdeveloped Breasts. The Second Category Or Age Group Of Patients Are Those In Their 30's Who Are Usually Mother's Who Have Finished With Their Families And Now Have Their Children Off To School And Have Done With Their Responsibilities And Want To Get Back Into Shape And Feel They Way They Used To Maybe 10 Years And Two Children Back. This Section Of Patients Has Seen A Steady Increase And I'm Sure We Are Going To See More Of Them. But In This Group Many A Times They Might Require Certain Ancillary Procedure Along With A Breast Augmentation Which Is Usually A Breast Lift Or A Areola Reduction Or The Such. Breast Augmentation Surgery Was First Performed In 1962 By A Texas Plastic Surgeon Who Used Silicone Breast Implants To Enhance The Size Of A Woman’s Breasts. 1997 Hbo Film "breastmen" Starring David Schwimmer And Chris Cooper Shows A Cinematic Representation Of The Introduction Of The Concept Of The Breast Implant To Increase Breast Sizes And The Early Days Of Breast Augmentation Surgery And Its Pitfalls. Breast Augmentation Surgery Has Come A Long Way Since Then With Lots Of Advancements In The Type Of Implants And Techniques, Though The Basic Methods Remain The Same. A Common Fear Amongst Women Is The Fear Of Cancer With Implants. This Is Totally Unfounded As Per Research Done By Various Medical Fraternities. Recently Even In The Us, The Fda Has Cleared The Use Of Silicone Gel Implants. Otherwise, Silicone Gel Implants Are Used Widely All Over Europe, South America, And Asia, Though Saline Implants Are Also Equally In Vogue Though More In North America.. Implants Are Commonly Filled With Saline Or Silicone Gel. Both Implant Types Have Advantages And Disadvantages. The Saline Implants Are Silicon Bags Into Which Saline Is Injected To Fill It Up. The Advantage Of This Is That Smaller Incisions To Place The Implant Can Be Used And The Sizes Can Be Increased Or Decreased In Case Of Volumetric Discrepancies Between The Right And The Left Breasts. But The Disadvantage Is That Some Of The Saline May Leak Over A Period Of Many Years And The Implant May Have To Be Replaced. The Silicone Gel Implants Are Permanent As They Do No Deflate. But They Require A Larger Incision Size. They Have A Natural Feel And The New Highly Cohesive Gel Implants Do Not Leak Even If They Are Punctured Or Cut. The Choice Of The Implant Is Usually Left To The Patient. The Implant Can Be Inserted In Three Ways Either Through The Armpit Or Through A Cut Below The Breast Or Through A Cut Around The Nipple/areola. The Approach Is Determined By The Size Of The Implant And The Individual Patient. Recently The So Called “scar Less Breast Augmentation” Has Been In Demand Also Known As The “tuba” Here A Saline Filled Implant Is Inserted Through The Belly Button And Hence The Scar Is Hidden Giving It The Name Scar Less. The Implant Can Either Be Placed In Front Of The Muscle Of The Chest Wall, “sub Glandular” Or Behind The Muscle, “sub Muscular”. Placement Of The Breast Implant Under (behind) The Pectoralis Muscle Is Preferred In Women With Anatomically Less Breast Tissue Since The Results Are More Aesthetic. Placement Behind The Muscle Does Not Stop You From Using Those Muscles, Though Body Builders And Weight Lifters Tend To Prefer Placement Over The Muscle. Placement Under The Muscle Allows For A More Natural Look And Feel Than Placement Over The Muscle. Also, The Incidence Of Capsular Contracture Is Decreased With This Placement. Placement Behind The Muscle Allows Easier Breast Self-examination And Improved Images With Mammography When Compared To Placement In Front Of The Muscle, All This Because It Is Far Away From The Normal Breast Tissue. The Common Problems After A Breast Augmentation Surgery Are Mild Pain And Discomfort After The Procedure. This Is A Little More In The Sub Muscular Placement Of The Implant. Scar Maybe A Problem If You Have An Incision Below The Breast Which Will Be Seen In The Initially But Fades Over A Period Of Time. You Might Be Required To Do Some Regular Massages For The Next 6 Months Which Your Surgeon Will Explain After The Surgery. The Most Common Cause Of Dissatisfaction Amongst Women Undergoing The Procedure Worldwide Has Been The Size Of The Implant With Most Women Feeling That They Should Have Gone In For A Bigger Implant. The Cause For This Is That Initially Because Of The Swelling The Size Looks More And As The Swelling Settles Down The Size Feels A Little Smaller . But The Size Has To Be Determined By The Amount Of Tissue She Has, The Incision , The Type Of Implant. In The End One Has To Realize That The Final Decisions Are Taken After A Proper Consultation And Examination. Also The Fact That, All Surgeries Have Their Associated Risks And Complications, Which Every Surgeon Operating On You Will Surely Address. This Article Was Aimed At Educating Women About The Procedure Of Breast Augmentation, Allay Few Fears And Misconceptions And To Help Them Make Educated Decisions Regarding The Same. Dr.surindher Www.cosmesisindia.com #note: This Article Is The Sole Property Of Cosmesisindia.com And Dr.surindher. No Part May Be Reproduced In Complete Or In Part Without Permission From Dr.surindher.