Gurdyaan dee bamari bari paihri

Main ik wari saun laga tay meray mayday ch aini keh peedh hoi keh
menu paseena ah ghia. menu pukka ho ghia keh main apnay akhri
sahnwaan tay aan. Eh peedh ik minute hoi. Othoon baad kadeen
kadeen peedh da chubka jehya paina tay hut jaana. Eh menu meray
gurday keh rehay see keh koi kharabi ho ghai ah tay toon doctor kol
jah. Main vee aidaan eeh kitta jidaan saday aam lok kerday ah tay
main doctor kol nehn ghia. Main bed tay lama pia hoyaan tay menu
peedh phay hoi jehri keh pasena kehdnay wali nehn seetay ik minute
rehai. Do tin minute baad phay peedh da attack hoya tay khattam ho
ghia. Teesra attack phay hoya tay khattam hunday ee main car tay
baitha tay hospital dee emergency ch chala ghia.. Authay ohna nay
mera muttar tay blood pressure check kitta. Doctor nay mera x ray
kerwaya.. Ohna nu koi vee cheez nehn lubhi .

Meray her rose kadeen kadeen peedh da chubka pai jaana. Main ik
din hospital day diagnostic department ch ghia tay ohna nu gal samjai
tay ohna nay meri ultra sound scanning kitti jehday ch vee koi cheez
nehn lubhi. Phay ohna nay mera Mori kitta tay main kidney specialist
day koll baithghia jidoon oh computer screen tay meray Mori image
nu check ker rehya see. Jiwain jiwain oh check ker rehya see tay
menu vee ohnay chungi tarran samjhaya. Eh vee mera ik ajeeb
experience see. Aus waqat tay koi cheez nehn lubhi tay main sochya
keh kidney nu chungi tarran study karaan. Menu ohnay eh kehya keh
ho sak da ah eh qabaz day pahroon peedh paindi howay. Ik sowal
jehra menu patta naa honay dee wajah toon nehn puchya oh eh see
keh agar glass da koi chota jeha tuckra gurday ch chala jaway tay kia
ohnu ultra sound yaan Mori detect ker lainda? Jay tuseen kittay es
stage tay scanning kerwao tay ohna koloon eh gal zaroor pucho. Agar
 tay tuseen es field naal talaqrakh day ao tay main tuwaday comment da
welcome karaan gha. Menu hospital waliyaan nay constipation khatam
kernay wastay duwai ditti. Tin char haftay tay meray peedh day kadeen
kadeen chubkay painday rehay. Hon menu eh chubkay painay band ho
ghaiay ah. Gurda kih ah ? aam aseen jidoon deekh day aan tay aidaan
eh mass (meat) da tuckra lag da ah pehr eh tay ik choti jehi machine ah
tay jehray eh kum kerda ah deekho tay tuseen haran reh jaanday ao.
Hor  menu jehri harani eh hoi keh eh choti jehi natural machine ah. jay
tuseen eh natural choti machine da kum dialysis machine naa karo tay
oh machine da pahr 40 kilo day lagay tay howay gha. Eh saday gurday
250-300 grams da hunda. Eh dialysis machine aini wadi hunday hoay vee
aina complicated kum nehn kardi jina sadi natural machine gurda
kumkerda ah. Kehnday ah wailay dee namaz tay kuwailay diyaan
tuckraan eh tay gal tuseen zaror suni hoay ghi. Agar tuwanu koi vee
apni seht day barray ch koi problem aah tay doctor nu mil kay ohnu
theek kernay dee koshish karo. Eh buht sasta rehnda ah.
Kadeen vee homeopathic , desi hakeemaan yaan taweez gunday
kernay walyaan day chuker ch na pawo oh es wastay keh aina ch
koi development nehn hoi tay eh authay ee ah jethon shroh hoay see.
Jidoon bamariyaan shreef tay ainiyaan complicated nehn hundiyaan see
aus waqat tay aidaan day allaj yaan totkay kum ker jaanday see pehr
hun tay bamariyaan vee taran taran diyaan aa ghiayaan aan.Es wastay
tuwanu meri eh ee salah ah tuseen sidday doctor kol jaa kay allaj kerwao.
Main tuwanu do cases day baray ch dasaan gha tay agay tuwadi marzi ah .

Mera cousin jehra meri omar da eeh see nearly middle aged oh diabetic
see. Ohday gurday fail ho ghaiay. Ohda allaj homeopathic desi tay
taweezan naal kitta ghia. Oh dar da rehya dialysis kerwaun toon. Jidoon
kissay homeopathic desi hakeem tay peer day tuweezaan nay kum nehn
kitta tay faisal hoya keh hun dialysis kerwai jaway. Ohda aina kay kum
bigar chukya see keh pind toon dialysis wastay lajanday hoay ee ohdi
death ho ghai. Paisay vee buht kharach kittay perh kih faida hoya?
Haan faida ohna lokaan nu hoya jehray lokaan nu hazaran saal paranay
totkian day chuker ch paa kay lut day ah tay tuwaday marnay da zariya
ban day ah. Agar homeopathic allaj aina ee chunga see tay jithoon eh
shroh hoya germany ch eh kiyoun allowed neh. Haan allowed hai germany
ch oh es shart naal jay tuseen real doctor ao tay tuseen naal hpmeopathy
dee vee dowai mareezan nu day sakday ao. Younani jehnu desi allaj vee
kehnday ah eh Greece toon shroh hoya tay halat eh ah keh Greece ch
eh allaj dee practice allowed nehn ah. Ohna nay eh chud kay doctri allaj
apna liay.
Yaad rakho aj kal da zamana krishmiyaan tay mojziyaan da nehn. Agay
bamariyaan vee shreef hundiyaan see tay thoriyaan see. Es wastay
totkay taweez wagaira kum ker jaanday see.Dosra waqia vee meray 
ik hor cousin da ah. Ohnu kitay falaj da attack ho ghia tay ohday kahr 
waliyaan nu kissay nay dasya keh falan hakeem falaj da allaj ker da ah. 
Hakeem nay ohnu ik malsh wastay tay ik khanay wastay duwai ditti. 
Naal taweez wee karwaiay. Bari malash kitti tay duwai khadi pahr koi 
arram n na aya tay hospital ch lai kay ghaiay. Hospital waliyaan nay 
kehya ik do din hor naa aithay aundha tay terra eh passa permanent 
mazoor ho jaana see. Main 
Pakistan ghia hoya see tay oh vee kitay pind jaanda hoya saday ah ghia 
tay ohday naal molaqaat ho ghai. Main ohday koloon puchya keh terri ik 
side nu kih hoya? Ohnay menu phay sari apni aap beeti sanai tay kehya
keh meray allah nay menu hospital paigh kay meri eh side bacha lai. 
Hajjay fully recover tay neh hoi pehr doctor kehnday keh ainu theek 
honay ch time lugay gha. Main machester ch ik maulvi kol baitha hoya 
see tay ohnay menu gallan ch dasya mashalla mera tin wari heart da bi 
pass ho chukya. Main bura haraan tay khush vee hoya maulvi saab dee 
gal sun kay tay sooch rehya see keh saday pind ch tay kissay nu heart 
attack ho jaway tay sher puhnch day punhch ee ohda kum ho jaanda. 
Agar qisma thori chungi howay tay hospital puhnch ghia pehr agay vee ohdi
 kismet chungi ah?  Doctor hospital ch hazar tay ah? Yaan ohnu kissay hor 
sher lajana pau gha.

Gurday kih kerday ah

Gurday jehray  keh bean shaped hunday ah. Aam lokaan day jusay ch do 
gurday hunday ah tay ik gurda moth day size da hunda ah.Gurday saday 
pichay puth day thalay hunday ah. gurday rehr dee huddi (spine) day sajjay 
tay khabay hunday ah. Gurday ik galoon bhut ee chungi insani jism dee
machine ah jehri keh her roj 200 quarts day lag pagh khoon nu filter ker 
kay ehday chon 2 quarts day lagay shagay kachra (waste products)  tay 
ziyad paani kehd day ah. Eh kachra(waste products) tay ziyada paani 
mutar ban jaanda ah tay naliyaan jehna nu ureters kehnday ah choon ho 
kay masanay (bladder) ch challa jaanda. Masana mutar nu audhoon tak 
apnay ch rakh da jidoon tak aseen  mutar neh ker day

Kachra saday khoon ch active tissues i.e muscles  tay khorak dee tut 
pahj  toon aunda ah. Sada jusa khurak  nu taaqat wastay tay apni 
maramat wastay wart da ah. Jusay nu jehri cheej khorak choon chai 
dee hundi ah wart kay rehnda hoya kachra khoon nu phaij dainda ah. 
Agar gurday eh kachray nu khoon chon filter naa kern tay eh khoon ch 
jamaa honday rehnday ah tay saday jusay nu  kharab kerday ah.

Khoon choon kachray dee filtration gurdiyaan day ander chotay units 
jehna noon nephron kehnday ah naal hundi ah. Ik gurday ch das lakh 
day lago phag nephrons hunday ah. Nephron ch ik glomerulus  - jehri  
choti blood vessel or capillary ah jehri interwines hundi ah choti muttar 
(urine) katha kernay wali naal (tube) naa jehnu tubule kehnday ah. 
Glomerulus filtering unit da kum ker da ah tay normal proteins and 
cells nu blood stream ch rakh da ah Es process ch ziyada maya tay
 kachra pass ho jaanda. ah. Aithay ik chemical process hunda ah 
jehday ch kachra tay paani khoon chon nikal  kay masanay ch chala 
jaanda ah.

Sub toon pehlay chemicals naal milya kachra tubules ch aunda ah jehday 
choon  jusaa jo kuch wart sakda ah. Gurday chemicals nu i.e. sodium, 
phosphorus tay potassium naap day ah. Eh chemicals nu wapas khoon 
ch phaij dainday ah jusay day wartnay wastay. Es taran gurday ehna 
chemicals da tanasab barqarar rakh day ah. Ehna chemicals da theek 
tanasab zindgi (life) wastay zarori ah.

gurday khoon chon kachra tay paani dee safai kernay toon alawa ik hor 
kum ve kerda ah. Gurday tin kisam day zaroori hormones chud day ah.

Erythropoietin,  yaan  EPO jehri hadiyan day guday (bone marrow) nu 
stimulate ker dee ah red blood cell banaunay wastay.

Renin – jehri blood pressure nu theek (Regulate) rakh day ah.

Calcitriol – The active form of  vitamin D, jehra hadiyaan wastay calcium 
nu maintain rakh da ah tay body wastay dosray chemical da balance be 
rakh da ah.

Renal function kih ah

Renal da lafaz gurdiyan wastay wartia jaanda ah.  “Renal function” tay 
“kidney function” da ik matlab ah. Seht day naal taalaq rakhnay walay 
lok (health professionals) jidoon “renal function dee term wart day ah 
ehda matlab eh hunda ah keh tuwaday gurday kina chungi taran khoon 
saaf kerday ah. Jehray lokaan day do theek gurday ah tay ohna da 100%
 kidney function hunda ah.Chota yaan thora  kidney function as much as 
30-40% da aina patta nehn lagda. Kidney function khoon day namonay 
(blood sample) toon ik formula wart kay kadhya jaanda ah jehnu 
estimated glomeruler filtration rate (eGFR)  kehnday ah. eGFR da matlab 
hunda tuwaday gurday kinay fee sad (%) kum ker day ah.

Kai lok ik gurday naal jam day ah tay oh aam tay seht mand zindgi gazar 
sakday ah. Her saal hazaraan lok apna ik gurda dainda ah as donation  
transplantation wastay. Kai lok apnay dostan yaraan tay ristay daraan nu 
ik gurda day dainday jehna day gurday kharab ho jaanday ah.agar tay 
guardian day day 25% too kath jaaway tay eh serious hunda ah. Jay 
kidney function 10-15% toon kaht jaway tay aidaan day bandyaan nu 
Blood cleansing treatments wastay jaana chai da yaan kidney transplant 
wastay tah keh oh zinda reh sakan.

Gurday  kiyoun fail hunday ah

Gurdayaan dee bamariyaan  nephron tay hamla kerkay ohna dee 
filtering dee khasyet nu khatam ker daindiyaan. Nephron nu naqsan 
buht jaldi ho sakda yaan tay zakhmi hon naal yaan poisoning naal..
 Aksar gurdyan diyaan bamariyaan nephron nu holi holi naqsan tay 
khmoshi naal tabah ker diyaan. Salaan tay wariyaan baad nephron day
 damage honay da pata lag da. Gurdyaan dee bamari dee aam wajah 
Diebetes  tay high blod pressure ah. Jehray lokaan che gurdiyaan dee 
bamari khandani ah ohna nu lagnay day buht chances hunday ah.

Diabetic Kidney disease

Diabetes bamari ch jehri sugar jusay nu wartni chai dee ah nehn wart da  

tay oh khoon day naal gurdyaan ch ah jaandi ah. Eh gurdyaan wastay  

zehr ah. Nephron nu khoon ch  istmaal na hoi sugar  naal jehra naqsaan 

hunda ah ohnu gurdyaan dee sugar aalli yaan diabetic kidney disease 

kehnday ah. khoon ch sugar (glucose) level nu kaht rakhnay naal tusee 

es bamari nu delay ker sakday yaan bach sakday ao. Dowaiyaan 

angiotensin-converting enzyme (ACE) inhibitors yaan angiotensin receptor 

blockers (ARBs) nu high blood pressure day allaj naal tuseen eh diabetic

kidney disease nu delay yaan wadhnay toon rook sak day ao.

High blood pressure

High blood pressure gurdyaan ch chotiyaan khoon vessels nu naqsaan 
pucha sak da ah.jehna khooni vessels nu nuksaan puhn ch da ah oh jehra 
ohna nu khoon chon kachra kahdna hunda h oh nehn kadh diyaan. 
Tuwada Doctor ho sakda ACE inhibitors tay ARBs tuwaday blood 
pressure wastay likh kay daway jehriyaan dekhya ghia ah gurdyaan nu 
dosriyaan duwaiyaan nalon bachaun diyaan aan tay blood pressure nu 
theek level tay rakh diyaan aan. The National heart, lung, and Blood 
Institute (NHLBI) wallay recommend kerday  ah jehray lok diebetic ah 
yaan  jehna da  reduced kidney fuction ah oh apnay blood pressure nu 
130/80 toon kath rakhan.

Glomerular Diseases

Kai kissam diyaan gurdyaan diyaan bamariyaan ehday ch ah jaandiyaan 
aan., i.e autoimmune diseases, infection related diseases, and scleroric 
diseases.Jiddaan naa toon patta lagda glomerular diseases tiny blood 
vessels (glomeruli ) tay attack ker diyaan gurday day wich. Ziyada tay 
bunyaadi glomerular  bamariyaan ch membranous nephropathy, IgA 
nephropathy tay focal segmental glomerulosclerosis ah. Glomerular 
bamari dee pehli nashani aam tor tay  proteinuria ah, jehra keh muttar 
ch buht zida protein da auna. Ik hor aam  nishani  hematuria ah  jehday
ch khoon da muttar ch auna. Kai lookaan  no donu  proteinuria tay 
hematuria ho sak diyaan. Glomerular  bamariyaan gurday  day function 
nu holi holi tabah ker sakdiyaan. Blood pressure tay control ehna 
gurdyaan diyaan bamariyaan nu control tay wadhnay toon rockney wastay  
buht zaroori ah.  Glomerular bamariyaan da patta  biopsy day naal laya
jaand ah.  Biopsy eh ik gur ah jehday ch piece of kidney tissue lia jaanda 
microscope day naal check kernay wastay. Glomerular bamariyaan wastay 
immunosuppressive drugs yaan steroids duwaiyaan wartyaan jandiyaan 
sauj tay proyeinuria kathaunay watay. Eh bammari tay depend kerda kehri 
ah tay aus hasab naal duwai likh kay ditti jaandi ah.

Microscopic image of PKD

Inherited and Congenital Kidney Diseases
Kai gurdyaan diyaan bamariyaan warasat ch mil diyaan.  Masaal day
 tor tay Polycystic Kidney disease (PKD) ik genetic disorder ah 
jehday ch gurday ch buht phinsyaan (cysts) Nikal aundiyaan.  PKD 
cysts can slowly replace much of the mass of the kidneys, Ehday naal 
kidney function kaht jaanda tay ik stage tay gurday fail ho jaanday ah.
 Kai kidney problems da patta lag jaanda jidoon bacha hajay womb 
ch hunda. Masaal day tor tay autosomal recessive 
PKD, a rare form of  PKD, and other developmental problems that 
interfere with the normal formation of the nephrons. Bachiyaan ch 
gurdiyaan diyan bamariyaan da kai taran pata lagaya jaa sakda. Agar 
bacha aam bachyaan dee taran grow na howay yaan ultiyaan kerda 
rehway  tay ho sakda ehnu koikidney dee bamari howay. Ehda check
 up doctor keray gha tay patta lag jao gha. Doctor bachay da blood 
pressure dekhay gha tay red blood cells dekay gha keh kaht tay nehn 
je anemia, proteinuria, hematuria. Agar doctor nu eh problems nazar 
aun tay oh hor tests keray gha blood tay urine day tay ho sakda ultra 
sound yaan mori recommend karay. Kai cases ch doctor biopsy 
kerday ah jehday. Tuwadat gurday da ik inch tissue lei kay  microscope
 day naal check keray gha.
Bachyaan diyaan kai  kidney bamariyaan da patta nehn lagda jawan
 honay tak. 
Most common type of kidney disease PKD nu pehlay adult pkd
 kehnday see  keh high blood pressure tay renal failure aam tor 
twenties and thirties  toon baad hunday ah. Now advances in science
 doctors can find kidney cysts earlier kissay nashani zahar honay
 toon pehlay

Gurday dee bemari dee hor wajah

Poisons and trauma (zehr tay sadama shock to kidneys) jehday ch
 kidney nu direct sat lugnay naal vee kidney diseas ho sakdi ah. Kai
 over the countermedicines hundyaan jehriyaan kidney wastay zehr 
ah. Agar tuseen koi vee pain killer laga tar wart day ao tay apna 
doctor naal mashwra karo ehday side effects day barray ch.

Gurday kiddan fail hunday ah
Kai cheejan jehriyaa kidney failer nu taiz kerdiyaan ohna da hajay 
pura patta nehn.. science daan hajay taak study ker rehay ah keh 
diet ch protein tay cholesterol levels  kidaan kidney function tay 
effect ker day
Acute Kidney Injury
Kai kidney problems buht jaldi ho jaanday ah. Agar accident ch 
kidney zakhmi ho jaway. Buht khoon da zaya ho jaanay naal kidney
failer ho suk di dee ah. Kai Duwaiyaan  tay zehr gurdyaan day kum 
nu band ker dainday ah. Achanak kidney day function ch drop honey 
nu  Acute kidney Injury (AKI) kehnday ah. Kai doctor ehno Acute
renal failure (ARF) vee kehnday ah. AKI ch ho sakda keh kidney
function khatam ho jaway. Agar kidneys seriously damage neh hoay
tay acute kidney disease may be reversed.
Chronic Kidney Disease
Ziyada kidney problem holi holi hunday ah. Ik admi nu ho sakda 
saalan toon “silent” kidney disease howay. Gradual loss of  kidney 
function  is called  Chronic Kidney disease  
(CKD) or chronic renel insufficiency. Jehray lokaan nu CKD  hundi 
ah ohnay gurday permanent fail honay da khatra Honda ah.. Ehna no 
death by stroke or heart attach da vee khatra hunda ah.
End-stage Renal Disease
Total yaan nearly total tay permanent  kidney failure is called End 
Stage renal disease (ESRD). Jehray lokaan nu ESRD ah ohna nu 
dialysis wastay yaan taransplant wast foran jaana chai da zinda rehn 
wastay.

Chronic Kidney disease (CKD) diyan nishaniyaan

Jehna lokaan nu CKD shroh hundi ah ohna nu pata vee nehn lagda 
keh oh bamar ah pehr jena lokaan dee bamari wadh jaandi ah ohna nu
 ehna nishaniyaan toon patta lag sak da

i    Ohna nu buhta pashab aunda yaan kath aunda

ii   Thakawat lag dee ah

iii   Pukh kath jaandi yaan nausea hunda tay ultiyaan aundiyaan

iv   Hathaan tay pairan tay sauj pai jaandi ah

v    Khujli lag dee ah (feel itchy) yaan sunnay  hoay (numb)

vi   Susti lag dee ah tay tuwaja nehn rakh sakday

vii  Chumri da rung gahra (Darkened Skin) ho jaanda ah

viii Have Muscle cramps (khichaan painiyan)

 

Gurdyaan dee bamari wastay test

Kai lokaan nu pata nehn lagda keh auhna nu gurday dee bamari tay 

Doctor sub toon pehloon khoon tay pashaab nu test kerda ah. 

National kidney foundation kehndi ah keh gurday dee bamari da 

patta launay wastay eh test kerwao

1 Blood pressure dee pamaish

2 pashaab da test protein yaan albumin da patta launay wastay

3 Glomeruler filtration rate (GFR) da hasab (calculation) based on 

serum creatinine  measurement. Urea nitrogen dee khoon ch  

measurement naal hore patta lagda ah

Dialysis

Saday jism ch gurdiyaan da kum ah keh jehra aseen liquid peenday 
an ohday chon Pashab tay khoon nu saaf kerna 
Insaani jism ch uraemia day sign hon tay  ehda matlab ah sadday 

gurday theek kum nehn kerday jindaan kerna chahi da  yaan kum 
kerna chud ghaiay Greek lafaz Haemodialysis toon pata lagda ah 
keh eh bamari da lokaan nu ehda allaj lubnay toon buht pehlay  
es mar dainay wali bamari da pata see.

Haemodialysis allaj es bamari wastay saray jahan ch munniya jaanda 
ah tay ehday ch buht developments hoyaan dialyser technology ch tay 
hollow fibre membranes (filter). Pehlaoon cellulose fibre dee membranes
wartiyaan ghaian tay tajarbay kittay ghaiay Andaza ah keh her saal 
40-50 people per million lokaan nu eh bamari lug dee ah. Eh tay ohna
mulkaan ch hunda pehr agar paani yaan khorak saafnehn tay ehna 
mulkaan ch look ziyada es bimmari da shaker hunday ah. i.e Pakistan,
India, Srilanka, Afghanistan,Nepal Bhutan , Middle east , South 
America tay African countries.

CAPD yaan  Continuous Ambulatory Peritoneal  Dialysis alaj da 
nawaan gur ah jehday ch peritoneal cavity ch catheter laa ditta jaanda
 tay pertitoneum nu exchange barrier wastay wartya jaanda. Es allaj 
day gur no her roj (everyday)  wartya jaanda  holi holi tay lagatar paani
 tay gund  kahdnay wastay. Ehday ch mareez nu aam taran safar ker 
sakda kum ker sakda tay car drive ker sakda while continuing dialysis 
da allaj kahr yaan hor kittay

IPD yaan Intermittent peritoneal dialysis semi automatic system ah. 
Eh gur mareez wastay kath dukh wala tay aram alla kiyou keh mareez
 haftay ch 3-4 wari  dialysis kerda with shorter  gaps  allaj day 
wachalay. Ehda mareez nu faida eh ah keh oh fluid ziya pee sakday ah 

Haemodialysis mareezan  naloon, kiyoun keh allaj frequent hunda tay
fluid day katha honay wastay kaht time. IPD ch waqfay chotay ah perh
actual dialysis da waqat ziyada. Pait ch  catheter dee fitting zarori ah perh
aina aramdeh nehn jidoon nauhna howay . IPD kahr ch wartnay wastay
buht chunga perhehday wastay sterilisation  tay home environment buht
suitable honi chai dee ah.

Haemodialysis: 

.Oh mareez jehna nu Haemodialysis allaj chai da hunda ohna da hospital
 day Renal unit ch allaj hunda ah. Mareez day fistula fit kitta jaanda as 
access point jehhday ch artry tay vain nu joor ditta jaanda tay sui ehday
ch laa kay blood nu dialyse tak tay dialyser toon(aam tor tay hollow fibre
 filter) jehra dialysate ik passay tay khoon dosray passay, khoon Reverse
 osmosis choon pass kerkay waste kahdi jaandi aah treatment day waqat.
 Haemdialysis es taran kum ker da ah tay sari duniyaan ch aidaan ee kitta 
jaanda ah.

References

Cotran, RS S.; Kumar, Vinay; Fausto, Nelson; Robbins, Stanley L.; Abbas, 
Abul K. (2005). Robbins and Cotran pathologic basis of disease. St. Louis, 
MO: Elsevier Saunders

http://science.howstuffworks.com/life/human-biology/kidney.htm

Kasoor kehda

 Main jidoon ME ch ghia tay main ik latifa banaya oh eh see keh kissay arabi nay India toon  ik mechanic bolaya apni company wastay. Raat noo apnay dostaan ch baitha hoya tay bariyaan tarifaan keray keh ohnay India da buht chunga jehya mechanic magaya ah.

Eh arabi day dostaan nu ve bari khushi hoi keh ohna day dost nu chunga mechanic labh ghia ah. Jidaan saday uk ch kai dakanaan aan authay her cheez pound dee hundi ah ais tarran ME ch aisiyaan dakanaan ah jehnaan ch her cheez 100 fils dee hundi ah. Eh arabi apnay Indian mechanic nu 100 fils alli dakaan tay lai ghia tay kehn lugga aidaan ker aithoon jehray tainu apnay kum wastay tools chai day ah oh aidaan ker wadhiyaa toon wadhiya pasand ker kay lai la. Oh Indian mechanic nay jehray ohnu tools chungay lugay ohnay lailay. Raat nu eh arabi apnay dostaan ch baitha tay auchi auchi dasay keh oh aj mechanic nu tools khreed nay wastay lai kay ghia. Main ohnu kehya paisay dee fiker naa ker tay chungay tay sub toon wadhiya tools khreed. Eh Indian mechanic nay vee chungi taran tuh tuh kay chungay tay wadhiya tools pasand kittay. Allah dee mehrbaani naal hun kum shroh ho jaana ah.

Aglay din eh arabi apnay mechanic nu kum tay lai kay ghia tay dasya keh toon hun machinaa theek kerniyaan. Eh Indian mechanic nay apnay namay nakour tools kahd kay rakhay tay ik machine nu hath paa liah. Eh machine day paich kholan dee koshsh karay tay oh khulan da naa na laian. Oh samajia keh eh tay kissay nay buht ee tight kitay hoay ah. Eh mechanic nay jehray vee daisi tariqay see wartay  tay spray vee mari pehr paich naa khulan. Arabi kittay ohnu daikh da see tay oh aa ghia. Kehn lugga keh kum kidaan jaa rehya. Mechanic nay kehya keh eh machinaan day tay screw ee buht tight kittay hoay ah.Ohnay  kehya aidaan ker meray samnay khol kay dakhaa. Arabi nay kehya screw driver press and then oben (open). Khair paich naa khulay. Raat nu apnay dostaan ch baitha tay kehway mechanic tay chunga liyanda pehr machinaan day paich ainay ziyada tight keetay hoay ah keh mechanic koloon nehn khulay. Allah da kerna keh mera audhroon lahngnaa hoya tay sochya eh arabi paiyay nu salam ker challaan. Main andher ghia tay kaffee look baithay hoay. Eh Arabian ch vee saday punjabiyaan taran raat nu look baith day ah baithak ch. Hall chaal puchya tay kehn lugga keh India toon buht chunga mechanic magaya tay ohday koloon paich nehn khulay. Main puchya tools chungay ah? Kehn lugga keh tools tay ohnay wadiyah toon wadiyah pasand ker kay khareeday. Main kehya keh tools tay menu vee kahr wastay chai day ah tay menu dakaan da pata das.

Aglay din main ik arabi naal lia tay oh dakaan tay ghia . Menu tay patta nehn see tay authay her cheez ee 100 fils dee ah. Main kuch tools khreeday tay meray dekha daikhi jehra arabi  marray naal see ohnay vee audaan day laiay. Oh vee aglay din apnay dostaan nu dasay keh main buht wadiya tools khreeday ah tay England toon aiay hoay bunday day salah mushwaray naal khreeday ah.

Aglay din main eh screw driver wartnay dee koshish kitti tay bari muskal naal paich khulay tay main oh arabi nu phone kitta keh oh mamya aidaan ker kissay chungi dakan tay jah tay authon tools khreed tay apai paich khulan lag pain ghay. Uk ch pound da screw driver khreedo tay oh tay waisay ee phur jaanda yaan kahs jaanda. Eh 100 fils (20p) walay phay vee pound walay naloon chungay see.

Main jehra pehla DIY (Do it yourself) kahr da kum jidoon kahr liyaa tay kitta. Audoon kahr wastay kitchen khareediya tay ohnu assemble kerkay kahndaan naal fit kerna see.

Eh jidoon kitchen fit kerna see audoon pound shops dee bajaiay 50 pence dakanaan hundiyaan see. Audoon main do yaa tin screw driver khreeday. Kitchen tay aukhay saukhay ho kay fit ker ditta pehr eh patta lug ghia keh tools khreedo tay chungay khreedo.

Eh vee khiyal rakho keh koi zarori nehn keh mehngi cheez ee chungi hundi aah

Agar tuseen theek taran Eh tools wart lawo tay 50% tuwadi mechanky ho jaandi ah.

Gal shroh kitti see mechanic day latifay toon jehra keh ik fictional ah tay hun main non fictional wal aundaan. Meray kol ik Pakistani mechanic aah ghia jehda naa ik- baal howay. Eh Karachi da rehnay wala see tay  government unemployment office day through aya. Menu apnay certificate dakhaiay  tay main sochya keh Pakistani ah tay aithay mangaitar ban kay aya es wastay ehnu mauqa dewo. Main eh vee nehn sochyaa keh Pakistan ch tay certificate jinnay marzi bana lawo. Kum tay ohnay auna shrooh kitta tay her rose away tay machines theek ker kay rakhi jaaway. Ik din meray koll ve koi thok da gahk aah ghia.tay main ohnu eh bhaiay nay jehriyaan machines theek kerkay rakhyaan see check kerwaun lag pia. Ik machine check kitti naa chulli dosri kitti naa chulli taisree kitti naa chulli . Main eh gahk nu kehya ik minute menu dahy. Main eh bhaiay naal telephone malaya tay kehya toon kum tay naa aya ker. Jehray teray passay ban day ah main oh da cheque phaij dawaan  gha jehra main aunoo cheque phaij ditta. Eh gahk nu farag kitta.  Kaffi dair baad tobay da ik banda meray kol aiyaa tay kehn lugga keh auday kahr auna main tuwaday naal ik  gul kerni ah. Main raat nu auhday kahr ghia tay cha sha pitti tay kehn luggay tuseen ik- baal bhiay nu jaan day au. Main puchya keh kiyoun kih gal ah? Kehn lugga  main plumber lahb rehya see tay Ik- baal naal mulaqat ho ghai. Main ohnu kehya apnay kahr ch central heating launi ah tay kehn lugga gal ee koi nehn oh laa daway gha. Bhia tools laia kay aah ghia tay wawa thok thak shroh ker ditti. Jethay dewar chon 15mm dee pipe lagauni see ohnay ik foot day maghore ker dittay. Ik din aunay pata nehn kih kitta kah oh paani leak honay shroh ho ghia. Paani aina leak hoya keh sada teh khana paani naal pehr ghia. Ohnu samaj naa away oh kih karray pehr barri mushkal na paani leak kerna band keeta tay pump lia kay the khanay chon paani kehdiya. Eh pahiay nay kehya main Ik-baal bhiay nu batha lia tay ohda chungi taran interview kitta tay aunay tuwada reference ditta. Main eh bhiay nu farag ker ditta. Eh gal kern toon baad main ohdi heating fit kitti hoay dekhni shroh kitti tay oh tay aini keh paihry kay koi hasab na. Jaga jaga tay kahndaan ch foot foot day maghore kitay hoay. Pipe day bend vee sehi nah kitta hoay jehray bend see phisay hoay. Main ohnu salah ditti keh agar main howaan tay piping main dobara kerwa maan.

Main gas meters wastay ik almari banaunay wastay kissay nu labh rehya tay kissay nay joiner da telephone number ditta. Main telephone kitta tay banda bhia. Main kehya ik gas meters wastay almari  banauni ah tay bana sakda? Kehn lugga keh hai tay buht busy pehr main tuwady almari pehlay bana daway gha. Main ohda naa puchya tay kehn lugga Ik-baal. Menu phay ohdi chungi taran yaad ah ghai. Jannay menu ohda phone number ditta see main ohnu sari gal baat dasi tay kehn lugga keh Ik-baal nay tay kai janan waliyaan day kitchen fit kitay ah.

Aseen koshish kerdain aan keh kum sasta ho jaway pehr hunda eh aah keh eh sastay lok tuwanu buht mehngay pai jaanday ah. Aseen ik makaan nu flats ch convert kerna see tay ik Pakistani jehra Punjabi see. Ohda naa howay Lia-kut naal gal hoi tay sara ohday naal written contract bana lia. Eh banda thora thora kum kerda rehya tay naal naal paisay lainda rehya. Kahr da sara plaster, floor boards, skirting boards, joists ceilings waghaira lah ditta. Ethay tak kum puhnchya tay oh £60000 labour cost lai chukya see. Aseen daikhya eh tay bahanay kerkay paisay lai jaa rehya tay kum adha vee nehn hoya. Aunoo baitha kay kehya aseen hon hor paisay nehn dainay jidoon tak toon kum khatam naa karain. Eh gal kernay tay kehn lugga keh auno paisay dee buht zarorat ah tuseen ohnu paisay dawo. Aseen kehya kum tay toon aina kitta nehn tay ainay paissay lai chukyaan tay kum khatam karain gha tay tera hasab nabairan ghay. Eh gal hoi tay oh aglay din naa aya tay na ee audhay banday. Jehri makaan dee halat hoi oh aitaan da dhancha lagay. Samaj naa away kih keryay. Jehra ainay kum lurkai rekhya oh karai da naksan.Agar saal vee aunay sada zaiya kitta tay ik saal da kara ee £32000 ban jaana see. Eh banda tay ghaib ho ghia. Ik din naal day makaan walay naal milna hoya tay puchan lugga keh hon lia-kut nehn aunda. Main puchya tuseen ehnu jaan day ao? Kehn lugga haan main ehday koloon kum kerwaya see kum theek kernay dee bajaiay kharab kerkay chala ghia.

Kehn lugga jay tuseen ehday koloon kum kerwauna see tay meray koloon  ee puch lainday. Main kehya ik tay sanu towada pata nehn see tay naa ee eh patta see keh ehnay tuwada kum bagaria ah.. Khair eh Pakistani kum bagaar kay chala ghia tay paisay vee lai ghia. Hon saday kol ainay paisay nehn see tay aseen sari family nay lungotay kas laiay tay 3 banday kum kernay walay naal laa laiay. Khair kum nabair kay flats karaiay tay dittay.

Pakistan ch lut mar walay halat day thathaan mar day samunder da assar  uk ch rehn walay lokaan tay vee hoya. Pehlay jehray lok uk ch aiay baray mehnti tay shareef hunday see. Jidaan da ohna nay Pakistan chon mahaul chadiya see audaan da mahaul uk ch vee rakhya. Jehra raila Pakistan day halaat kharab hunay too baad aiya ohda kuch naa pucho. Drugs, jaali credit cards hera phairi aa kay aithay vee shroh ker ditti. Ho sakda tuseen saoch day howo keh main apnay pakistaniyaan day khalaf likh daan yaa ohna day khalaf aan. Kadeen tuseen apnay aap nu meri jaggah rakh kay sauchoo tay tuseen kih kahwoo ghay. Phaira kum phaira ee ah. Jeray lok phaira kum kerday ah oh phairay lok ah. Eh see saday punjabian tay pakistanian dee sauch. Saday culture da sauchi samaji scheme naal genocide kitta ghia. Hun tay sadi eh hallat ho ghai keh aseen chor nu chor kehnay wastay tiyar nehn. Ehda andaza tuseen ais waqia toon laa sak day ao.

Ik bacharay gharaib Pakistani  nu koi chakar day kay £60 lai ghia tay menu bara dukh hoya,  Main ohnu kehya police nu report ker day kiyoun keh teray paisay naa ve milay tay ehday naal hor lokaan day bachan day chances ah. Ohnay police nu report kernay dee koshish kitti tay oh dar ghia kittay oh banda aa kay ohnu mar  na kahday. Main eh gal tin char pakistanian nu dasi tay oh eh ee kehnday ah keh galti paisay dainay allay dee ah. Main bari koshish kitti samajaunay dee keh kai lok assay ve hunday ah jehna nu tuseen bari asani naal lut sak day ao. Hun eh position sadi ho ghai ah keh aseen juram karnay walay nu mujram kehnay dee bajaiay jehra juram da nashana banya ohda qasoor kahd day aan. Ik darzi see main ohnu vee gal sanai oh kittay tabligi jamaat daa see. Oh tay hadisaan pehr kay sanaun lag pia tay kehya qasoor dainay walay daa ah. Main kehya kissay naal fraud hoya ehday naal mazhab da kih taalaq . Tuseen kiyoun mazhab nu her cheez ch dha dainday ao.

Kehn lugga aseen muslmaan aan tay sada her kum mazhab naal ah.

Where is my dad?

Main aj jaldi saun ghia tay adhi rateen meri akh khul gai . Akh vee kih khuli keh menu aj ik bari ajeeb jehi khawb aiee. Main kitay jahaz tay safar ker rehyan tay announce hoya keh ohna nay kuch swariyaan lauhniyaan cairo ch. Eh  paihri jehi air lines da jahaz see. Cairo ch jahaz nay land ker ditta tay pilot nay kehya keh tuseen saray bahr dee howa khori ker lowo jedoon tak oh jo vee ohnay official karvai kerni ah ker laway. Jidoon jahaz toon autray oh aidaan luga jidaan ik buht waday footpath tay khara kitta hoya hunda. samnay aidaan luggay jes tarran koi bay abad jehya bus station. Main eh daikh kay pilot nu kehya keh jahaz airport tay buht auter day dekhay pehr kadeen eh nehn daikhya see jahaz busaan day adday tay leh ghia howay. Menu pilot kehn lugga eh tay main jahaz bahar lahya main aday day andher vee lah sakda see. Main kehya eh bus ah yaan jahaz kehn lugga arabi ch “Aqeed haadah jahaz” jehda matlab ban da yaqqeenan  eh equipment ah. Hon soch rehyaan keh arabi ch tay her cheez nu eh lok jahaz keh dainday ah. Pehr eh pilot nay jehra lafaz wartya oh jahaz da see jehra Punjabi ch ah. Eh air line vee koi pehri jehi see naa tay ohna nay chaa da puchyaa tay naa ee khanay da. Main eh jahaz landing kernay toon pehlay sooch rehya see keh ais air line tay phair safar nehn kerna kiyoun keh eh tehl sewa nehn kerday. Arabi boli jenaan nay vee banai ainay lafaz nehn banaiay jidaan saday Punjabi ch ah keh her cheez wastay wakhra wakhra lafaz kahd kay rakho keh saddiyaan dheeyaan pehnaan maanwaan tay buddiyaan time lugga tay wartan ghian tay apnay juwakaan nu vee sakhaun ghian.

Eh jahaz toon autar kay aseen howa khori kern luggay tay oh daftar lahb rehay aan jethay pilot ghia see. Eh pilot nu labh day labh day aseen kisaay hor jaga puhnch ghaiay tay meri akh khul ghai. Main ghari tay time waikhiya tay adhi raat toon ziyada see. Main chaa bana kay thermos ch pai, adhi tandoor dee roti tay cottage cheese rakh kay roll bana liyah tay ik malta khada. Main computer no on kitta tay main ik article lubhna shroh ker ditta jehra main kai mehanay pehlay likhya see tay likh kay save kern lugga tay koi hor key dabaa ditti jehday naal oh save nehn hoya. Main eh labh rehya see keh koi rescue yaan recover daa tariqa howay pehr  eh nehn ho sukya tay sochyaa ehnu main Punjabi ch likh daindaan.

Meri cousin apnay bachyaan naal aiee hoi see tay meri aisai taran buht taraqay eh akh khul ghai. Main apna laptop chukya tay thallay ah kay gas fire on kitti tay subah dee namz da time ho ghia. Kichen ch jaa kay cha banai mug ch tay naal ik toast banaya. Eh toast tay shahd laa kay khadah. Chaa day mug lai kay main laptop lai kay gas fire day lagay baith kay internet tay browsing shroh ker ditti. Kai cheejaan hondiyaan buht jaldi phul jaandiyaan pehr kai nehn. Eh gal do saal pehlay dee ah pehr hajay tak meray damg tay chahri hoi ah.Main internet tay see tay hajay chungi taran din nehn charaya see tay cousin dee choti dhee jehri 4-5 saal dee see. Oh autoon akhaan malday hoay meray kool aa kay baith ghai tay menu “good morning uncle” kehya.  Main jawab ditta tay puchya keh naind chungi aiee.  Menu puchan luggi uncle can I ask one question? Main kehya sure.tay kehn luggi “could you tell me where is my dad?” main kehya ho sakda ah keh oh long holidays tay howay. Hor koi jawab tay  meray koloon nehn ban sakya.

Hun dekhya keh ohda “dad” baap kon aah ? menu tay nehn patta sawaiay das molakataan day. Ohna chon ve 4 molaqataan ohno airport toon liyaunay day chud kay auna kiyoun keh airport day lagay rehwo tay eh tay faida hund keh jehray rishtay dar nehn vee milna chaunday ohna day naal vee molaqaat ho jaandi ah. Merri family walay vee baray milnay julnay wallay ah tay oh eh rishtay dari honay dee wajah toon chungi tarran ohna nu jaan day ah.

Saday Punjabi muslims ch eh rishtay kernay  khas tor tay larkiyaan wastay buht masla ah. Ohdi ik waja eh vee ah ehday naal jehaiz,  dosra larki dee naukari, larki day naqash naian, family tay caste system etc. Phay agar tay tuseen bahr rehnday au tay Pakistan jehray lok bahr jaanay wastay her taran da herba wart day ah. Kithay tuseen lakhaan kharach ker kay bahr jaana eh tay bahr jaana bilkul free ho jaanda. Aidaan jaanay naal tuwanu uk arrival tay vip da treatment vee milda ah pawaan oh thori dair ee howay. Naa rehn wastay koi kamray yaan makan dee zaroorat tay naa ee visay da chukker. Cousin da rishta labhna shroh kitta ohda vee ik aisay banday naal wah paiay ghia jehra Pakistan toon uk auna chaunda see. Agar tay anpahr howay tay aina dukh nehn hunda pehr agar koi pehrya likhya oh vee doctor karay tay  buht dukh hunda. Jehray aidaan day lok ah ohna nu allah daa khof nehn aundah keh agar auna dee pehn naal aidaan koi karray tay ohna da kih reaction howay gha.

Cousin da wiyah ho ghia doctor naal jehra Lahore day kissay hospital ch kum ker daa see tay audhi family chichawatni day lagay kissay pind dee rehnay wali howay. Kahr waliyaan dee thori jehi zameen howay yaan kissay dee thaikay tay wohnday see. Raieen baradri day log tay eh doctor ee saray khandan ch pehla perhya likhya munda howay. Causin nay ohdi chungi taran help kitti uk ch set honay wastay tay uk da doctori  imtihan pass kernay wastay. Eh saab uk ch doctor ban ghaiay.  Baray namazi perhaiz gar tay es wastay kahr ch  toilet shower lowaya taharat kernay wastay. Jethay rehnday see authay masjid ch jaana namaz perhn wastay tay maulvi naal vee chungi gup shup launi. Saal dehr saal baad doctor sahb nu allah nay ik buht piyari dhee ditti tay doctor saab kehn luggay main tay munda chaunda see eh kuri kiddaan ho ghai. Causin nay ohnu samjaya keh agar baiti chungi howay tay oh kai mundiyaan naloon wadhiyaa hundi ah. Aseen vee ohnay day barray ch koi ohna day kahr dee gal baat naa puchi tay eh ee samajia keh aapas ch khush ah. Hor saal baad doctor sahb nu allah nay ik hor baiti ditti jehri mashallah bari piyari. Eh oh baiti ah jehnay meray koloon eh suwaal puchiya keh mera baap kithay aah. Eh jidoon doctor nu doosri baiti ditti tay doctors saab tay kehn luggay keh main ethay kuriyaan dee daar nehn launi. Taqreeban dhai saal ho ghaiay see. Hun kissay day dill ch kih aah ehday barray ch kuch nehn kehya jaa sakda. Uk ch jehray mangaytar ban kay aunday ah oh agar tin saal shadi ch reh jaan tay oh British nationality wastay apply ker sakday ah. Doctor saab jewain ee tin saal hoay tay oh kahr tay bachyaan nu chud kay ghaib ho ghaiay. Main tay aina koi nehn puchya keh ohna day kahr da maamla ah tay naa ee menu eh pata keh ohna day kahr ch aapas ch  mian beevi day kih halaat see. Beevi vee perhi likhi tay oh vee uk ch wakeel.

Eh doctor dee baiti nay jidoon eh sowaal puchya tay do haftay baad main apni family naal apni cousin nu visit kern ghia tay main apni beevi nu kehya keh agar eh cousin day kahr koi cheez theek honay waali ah tay puch main oh theek ker dainda aan bajaiay wansawanay lokaan nu layaway.  Baithak ch baithay see tay main kehya keh gas fire dee service kiddoon kerwai see. Cousin nay kehya kafi dair ee ho ghai ah. Main kehya keh main ehdi service ker daindaan. Main gas fire chungi taran khol laiee tay ohday pichay ik box rakhya hoya. Main cousin nu hass kay kehya keh eh chungi storage dee jagah labhi. Kehn luggi kih matlab tay main kehya fire day pichay ik box ah. Ohnay kehya keh ohnu tay nehn patta. Khair main oh box nu kehdiya tay oh ik juicer see nawaan box ch band. Main kehya ho sak da keh eh box jehray pehlay makaan day malak see ohna nay rakhya howay. Cousin nay kehya eh fire tay jidoon doctor ayaa see odoon luwai see. Cousin nay phay dasya ho sakda doctor nay eh juicer Pakistan apni family nu paijnay wastay khreediyaa howay tay meray lakoo kay rakhya howay.  Jehra oh paijnay toon pehlay ee chala ghia.  Main kehya doctor aah tay eh tay ohdi family Pakistan choon vee khareed sakdi see. Cousin nay phay kuch galaan dasyaan keh doctor menu eh zoor launda rehya keh eh makaan meray naa kraa day yaan ehday ch mera naa as partner lakha day. Cousin nay kehya jiddon doctor kum nehn kerda see meray koloon paisay lai kay Pakistan apni family nu paigh da rehya. jidoon wiyah hoya tay saas nay kehya toon sadi hun dhee aan. Sadiyaan cheezan tairiyaan tay tairiyaan sadiyaan. Saday kol tay kuch hai eh nehn tay apniyaan cheezan sadiyaan samaj.

Kih tuseen es doctor nu jaanday ao? Koi es duniyaan ch hay jehra aidiyaan day perhay likay lokaan nu das sakay keh teriyaan baitiyaan da kih kasoor ah keh toon ohna toon ohna da baap khu liyaa. Agar tenu dheeyan nehn chai diyaan see tay aissay vee tariqay tenu pata hon ghay keh toon munday eh laia sakda see.

Eh aidaan dee ik ee kahani nehn balkay uk ch rehnay walay hazaran kahraan dee kahani aah jehday wastay ik lambi chauri research honi chahi dee ah.

Tuwaday naal vee aidaan hoya?  tuwadi  beeti, pehn yaan maan naal? oh main sonnaa chaunda aan? Tuseen Uk ch mangaiter ban kay aiay? Tuwaday wastay kih muslay banay?  Kia tuseen real wiyah kitta yaan visay wastay Please tuseen zaroor apni gal daso. Chup naa rahwo tay aidaan day fraudiyaan nu nanga  karo

Bawaseer jehnu Haemorrhoide kehnday ah

Bawaseer nu angreezi ch Haemorrhoids, piles, Punjabi urdu/ hindi arabi tay farsi ch vee ehnu bawaseer kehnday ah. Ehday ch bund day bahr tay bund day andhar lining tay tissue tay kuch swelling ho jaandi ah jehnu Bawaseer tay Haemorrhoids kehnday ah.

Ehdiyaan nashaaniyaan mukhtalf ho sakdiyaan. Chotay bawaseer day mohqay aam tor tay dard nehn kerday.. bawaseer dee aam nashani eh ah keh tatti kernay toon  baad khoon aunda yaan khoon wali tatti hundi ah. Waday mohqay naal laisla (mucous) mada discharge kerday ah., kuch dard kharash tay khujli hondi ah..Eh laisla discharge ho sakda bund ch tay bahr irritate skin nu karay.. Tuwanu aidaan lag da tuwadee bund pharee hoi ah.tay eh vee lagay keh tuseen chungi taran full tatti nehn kitti.

grade 3-4  bawaseer ch zara complication hundi ah keh haemorrhoids bund toon bahr thalley nu lamak jaanday ah. Jehra keh Blood clot (thombosis)  hunda a jehra haemorrhoids day wich ban da.. Eh aina common nehn pehr agar huway tay buht dard hundi ah.eh blood clot honay naal

Bahrli bawaseer  jehnu perianal haematoma kehnday ah

Es type dee bawaseer aini aam nehn hundi  jinni internal haemorrhoids. Eh bahrli bawaseer ik lump no kehnday ah jehra bund day mohn tay bun jaanda ah. Kai dafa ehday symptoms day vee pata nehn lagda. Agar haemorrhoids ch blood clot ban jaway (a thrombosed external haemorrhoid) tay ehday naal buht dard ho jaandi ah jehri buht jaldi tuwadi tuwaja chaundi ah. Eh thrombosed haemorrhoids dee pain peak tay hundi ah 48-72 hours. Eh dard phay holi holi 7-10 din ch chally jaandi ah. Eh baaz dafa bleed vee hundi ah tay ehtoon baad lump da size balkol kaht jaanda ah tay nishaan mungu reh jaandi ah.

Andharli Bawaseer  (Internal Haemorrhoids)

Andharli bawaseer   back passage dee opening toon 2-4 cm autay andhar hundi ah. Tay ehday ziyada tay wadah honay dee wajah toon  char grades kittay hoay ahah

Anderli bawaseer  Day darjay (grading)

Grade 1  bund dee andharli lining tay  thori sauj ah. Eh bahron dakhi tay mahsoos nehn kitti ja sak dee. Grade 1 haemorrhoids aam lokaan ch ah tay kai lokaan nu ehton wadh kay grade 2  yaan ziyada ho jaandi ah.

Grade 2 Eh bowaseer day mohqay zara wadhay hunday ah. Ho sakda eh thoray jehay bund toon bahr hoon (prolapse). Jidoon toilet jaanda au tay ohtoon baad eh andher chaley jaanday ah.

Grade 3  ehday ch bawaseer day mohqay bund toon bahr nazar aunday ah

(proplaps).Tuseen ho sakda ik do chotay lumps type  mohqay mahsoos vee karo jehray bund toon  

bahr aunday ah.. Ehna nu tuseen ungli naal  andhar dhak sak day ao.

Grade 4 Bawaseer day es qisam day mohqay buht wadhay hunday ahtay bund toon bahr niklay rehnday ah. Ehna nu tuseen bund ch nehn dhak sakday. Baaz lokaan day eh buht waday ho jaanday ah,

Bawaseer  tay ehnoo kiddaan theek keriyay

Buwaseer (haemorrhoids ) swelling da naa ah jehri bundh dee lining tay tissue tay hundi  ah. Ehday symptoms aarzi darmiyaan tay persistant  tay dard allay. Buht cases ch bawaseer day mohqay chotay hunday ah apai theek ho jaanday ah.. Agar allaj dee zarorat paway tay eh kai taran day ah.

Bundh day andar lining ch small vains (blood vessels) da network ah Eh vains tay ehday tissue ch ziyada blood ah jaanda aam halat naloon. Eh vain stay engorged tissue dee ik swelling ho jaandi ah jehnu haimorrhoids kehnday ah.

Bawaseer honay dee sahi wajah tay hajay tak patta nehn keh eh kiyoun hundi ah. Kiyaan nut ay zahri koi wajah hundi ee nehn bawaseer honay dee. Eh khyal kitta jaanda tatti kernay day doraan bund tay jehra pressure painda ohdi wajah naal hundi ah.

:

Andaza ah Taqreeban Uk dee  adhi abadi ik stage tay ik yaan do tarran dee bawaseer da shaker hundi ah. Kai haltaan ch bawaseer honay day chances wadh jaanday ah.

Bawaseer honay dee wajah

 Qabaz  Bavaseer honay dee ik wajah wadi laindee (Large stool, Faeces) aunay nal jehri straining at the toilet. Ehday naal jehriyaan bund tay vains hundiyaan ohna tay pressure wadh jaanda tay eh aam wajah lag dee ah bawaseer honay dee.

Pregnancy.  Bawaseer pregnancy cha am hundi ah. Eh ho sakda baby day pressure  dee wajah toon howay jehday naal hormones change hunday ah. Eh aam tort ay baby day jamnay toon baad aap ee theek ho jaandi ah.

Ageing. Bund dee lining da tissue jidoon kaht support kerda jawain aseen buday hunday jaandan aan.

Warasat ch  Kuch lokaan nu bawaseer warasat ch mildee ah. Aidaan day lokaan cha am tort ay khandan dar khandan chaldi ah

Bawaseer bund dee ander wali lining tay bund day bahr mohn tay lump ban kay mohqay ban jaanay nu kehnday ah

Buwaseer day honay dee wajah da hajay tak patta nehn pehr aam khial ah keh jidoon aseen tutti kernay wastay zoor launday aan tay ehday naal kadeen  narran phul jaandiyaan. Aam tor tay eh phuliyaan hoyaan naraan apai theek hoo jaandiyan pehr kai wari eh apai theek nehn hundiyaan. Jay tay qabaz rehndi ah tay jidoon tay tutti aam  tutti naloon suki hoi hundi ah. Jes walay tutti kerday aan tay ehdi rugar naal andarli buwaseer day mohqay zakhmi ho jaanday ah jes naal khoon nakal da ah. Es wastay ehno khoni bawaseer kehnday ah.

Aam tor tay ik kissam dee bawaseer hundi ah pehr baaz dafa donu vee ho sak diyaan.

Paranay zamanay ch jidoon aini science nay taraqi nehn kitti see audoon mohqay pahwaan aam hon tay pahwaan bawaseer day ohda ik allaj hunda see. Un (wool ) da dhaga lai kay mohqay dee jerh tay buhn dainday see jehday naal muhqay nu khoon milna band ho jaanda see. Eh khoon dee muhqay nu supply band honay naal muhqa suk kay utar jaanda see. Zamanay ch thori jehi hor taraqi hoi tay dakhia un (wool) da dhaga aam na lubna tay lokaan nay ghoray day baal buhn kay kum chlauna shroh ker ditta.

Saday lokaan ch tay hun her koi apnay aap nu hakeem samaj daa ah. Kissay nu vee apna dukh yaan bamari dussu tay oh tawanu do char nuqsay zaror das dainda ah. Buwaseer saday aba jee nu see ik din meray kol ik sufi baitha hoya. Oh naa da sufi see aseen jehra thori jehi dari wadah luway ohnu sufi kehn lug painday aan. Aina pehrya likhya neh see tay namaz tay namaz pehri rakh da see. Kum tay hauna tay ohnay wajbi namaz ve pehrni hundi see. Jidoon ohnay bowaseer da naa sunyaa tay kehn lugga. Buwaseer day mohqiyaan da kih ah ehna nu phur kay khich kay bahr kadh dau. Odoon tay main ohdi gal sun lai kiyoun keh anparh lokaan naal jay tuseen gal nu wadauna shroh kar dawo tay gal kitay dee kitay upper jaandi ah.

Eh sufi nay tay keh ditta eh mohqiyaan nu phur kay khich dio pehr ohnu eh nehn pata see keh mohqay kidaan ban day ah. Mohqay khoon diyaan antaan kai jagah toon phulan naal ban day ah. Tay ais taraan day khich khchaunay toon bachu.

Main tuwanu eh ee kahwaan gha keh agar tuwanu andarli bawaseer ah tay tuseen apnay doctor koloon ehdnu check kerwao. Eh vee ho sak da keh tuwanu khoon aunay dee hor koi wajah howay. Eh doctor da kum ah keh tuwanu mashwara daway keh tawanu kih kerna chai da ah.

Her koi allaj vee neh kerwa sak da. Kai lokaan wastay allaj tay kih roti khany nu nehn labh dee. Agar aidaan howay tay tuseen apni zindgi nu kuch chunga ker sakday au khanay peenay  ch khiyaal kernay naal

1  Tuseen buhta paani peewo (din ch 2litr tak). Paani toon murad eh nehn keh paani ee         peena ah. Tuseen Jo vee peena paani chaa, lassi, dudh, yaan koi fluid peenay wala.

2  Apnay khanay ch agar tuseen fruit yaan vegetables jehriyaan kachiyaan kha sakday ao tay khawo. Moliyaan gongloo, gajraan, taraan , kheeray kharbozay, phutaan hadwanaa Agar ainay paisay nehn tay mausam da koi vee phul tay vegetables jehriyaan sab toon sastiyaan aan ohna nu khawo. Aseen pattay sit  dainday aan yaad rakhu eh pattay vee ainay ee chungay ah jinay keh savziyaan tay phul. Moliyaan day patyaan da suad moliyaan warga hunda  tay ehna nu sit kay zayaa nah karo. Pakistan tay punjaab ch tay ainay keh tariqay warat sakday ao keh tuwanu paisay kharach kernay dee lore ee nehn. Pakistan ch namauliyaan hundiyaan see jehriyaan aam luggian hundiyaan see. Eh jinyaan kay khaa sakday ao khawo. Palak day pattay saday aam tor tay paka kay khaday janday ah pehr Europe ch palak day patay jehray chutay hunday ah oh salad ch khanday ah

3  Tutti nu her rose liyaunay wastay tuseen apnay khanay ch fibre wadah dawo. Eh fibre kih ah.? Ehdi sab toon sidhi masal attay da bura ah. Saday aam kahraan ch hunda see keh atta chaan kay bura pasoaan nu paa daina yaan sukiyaan ruttiyaan naal baich daina. Ik wari main Pakistan ghia tay bibi jee rutiyaan pkaun luggay tay main kehya eh atta chunghi tarran chaan liyaa see? Kehn luggay hun tay  jidoon diyaan Chinese chukiyaan aiyaan audoon toon atta chanan da chukker eh nehn rehya. Hun tay aina kay mulk ch kum bigar ghia bura vee peeh dainday ah. Buray ch thora atta paa kay roti bana kay khawo.

Ispaghol da chilka vee ik buht chungi masal ah fibre dee. Ehnu Ispagola angreezi ch kehnday ah. Ehday khanay naal tuwadi tutti malaim ho jaandi ah tay kerday hoay bawaseer day mohqiyaan nu zakhmi nehn kerdi. Kissay zamanay ch rupiyay day sikkay hunday see jehna da wazan ik tola hunda see tay ehday naal tool kay isapghol da chilka khanday see. Eh isapghol da chilka jay tuttiyan yaan dast lug day see tay log khanday see.

Hun tay kai angreezi companiyaan nay ik tolay diyaan puriyaan bana dittiyaan tay ohna ch phulan da essence tay mitha paa ditta. Ehday ch paani paa kay tuseen ik glass sharbat bana kay pee sakday au. Ik company nay ehda naa “Fybogel” rakhya ah. Agar tuwanu qabaz rehndi ah tay ehnu hataunay wastay Ispaghol da chilka buht chunga ah. Ik tolay diyaan puryaan bana lawo tay din ch do dafa ehnu glass ch paani ch paa kay mix ker kay pee lawo. Tin char haftay wartnay naal tuwad maida tay bowl normal ho jawo gha.

4 Jidoon ve tuwanu tatti kernay deen lore paway tay ehnu jaldi ker daiwo tay dair naa karo. Eh tuwaday dair kernay naal vee kum kharab hunda ah. Baazlok nu zarorat hundi ah tay toilet nehn jaanday.  Ehday naal laindi day size chaura tay ehday ch kuch kushki ho jaandi ah.Eh ik natural cheez ah tay ehnu natrual time tay karo.

5  Toilet jawo tay jaldi tuseen ehtoon farag ho jao eh nehn keh tuseen apnay naal katab yaan digest lai jawo tay tuseen perh day rehwo. Tuwada damaag tuwaday natural system nu signal dainda ah ah keh tatti bahr auni chai dee ah. Jes waqat tuseen toilet ch jaa kay pehrna shroh ker dainday ao tay tuwada damaag eh automatic signal toon hut kay jo tuseen perh day au ohnu store kern lug painda. Eh toilet ch perhna vee tuwanu qabaz honay dee ik wajah ah

6 Tuseen shower  kerday ao tay apni adapt bana lawo agar tuwanu bawaseer nehn vee tay apni bund tay tuhni nu chungi taran saban laa kay dohwo. Eh kernay naal tuseen tuhni tay bund diyaan kai bamariyaan toon bach sakday ao.

7 Apna underwear her rose badlo tay agar ho sakay tay istri ker kay pawo kiyoun keh istri kernay naal koi germs underwear ch hon tay oh mar jaanday ah.

8  Dard waliyaan oh goliyaan yaan syrup jehday ch codeine hundi ah such as co-codamol, as they are a common cause of  qabaz or constipation.

Agar tuseen eh autlay aath mashwariyaan nu warto tay  ehday naal tawanu jehra khoon aunda tay tatti kerday hoay takleef hundi ah oh kath jaiay ghi. Eh vee ho sak da keh tuwanu eh kernay naal kuch arsay baad bawaseer toon aram ah jaway tay towayday grade 1 day mohqay khatam ho jaan. Small grade 1 mohqay aam tor tay apai theek ho jaanday ah.

Waqti Allaj

Eh waqti allaj dan naa es wastay wartiyaa keh jiniyaan creams yaan mulmaan aan oh bawaseer nu theek tay nehn ker diyaan pehr khaj tay discomfort nu kaht ker diyaan jehday naal kuch rehn sehn chunga ho jaanda.

1 A bland soothing cream , ointment , or suppository may ease discomfort. Kai kisam diyaan mil diyaan baghair dotor day likhay toon. Apnay pharmacist de salah lawoo tay ehday naal wartnay da trikay naal warto.

2  oh cream  jehday ch anaesthetic hundi ah oh dard kathaun dee ah pehr tuseen eh lambay time wastay nehn wart sakday. Eh sirf tuseen thuray din wart sak day ao 5-7 din. Agar eh toon ziyad warto gay tay ho sakda ehday naal tuwadi bund tay kharash honi shroh ho jaway. Chungi gal ah jidoon eh khareed tay pharmacist koloon chungi taran puch lavo.

3  Agar tay mohqiyaan day dawalay sauj pai hoi ah tay tuwada doctor ho sakda tuwano cream jehday ch steroid likh  kay davay. Ehday naal sauj tay kharash kath jaandi ah. Aam tort ay tuwanu aidaan dee cream tuwanu ik haftay toon ziyadah nehn wartni chai dee. Ehday baray ch apnay doctor koloon pucho.

4  buht dard walay prolapsed  haemorrhoids aam neh pehr agar hon tay tuseen 15-30 min ice pack press ker kay  vee dard nu katha sakday au. Strong painkillers may bee needed.

5  Agar tay tuwan bahrli bowaseer ah tay kai lokaan nu cloitrimazol 1% cream 3 haftay wartnay naal araam aah ghia. Tuseen vee wart kay daikh lowo pehr eh sirf bahr wali bawaseer wastay ah.

6  Agar bowaseer pregnancy ch howay tay aam tor tay theek ho jaanday birth toon baad.

 ehda vee allaj autay wang ah.

Bawaseer daa Allaj

Doctors dee surgeries ch basic allaj kitta jaand jehra kay aam tor tay theek ah pehr buht kaht cases ch ho sak da perianal sepsis ho jaway

1 Rubber band ligation tajweez kitta jaanda grade 1-3 type haemorrhoids wastay. Ehday chi k plastic band mohqyaan  tay chrahya jaanda atleast 1cm above dentate line day blood supply nu cut kernay wastay. Kuch dinaan baad eh mohqay suk kay chahr jaanday ah. Agar  rubber band dentate line day buht close laa ditta jaway tay buht ziyada dard hundi ah. Ehday ch taqreeban 70% cure rate ah. Jehday ch 3% complication rate.

2  Sclerotherapy  ch sclerosing agent such as phenol da injection haemorrhoid ch laiya janda ah. Ehday naal vain walls collaps ho jaaniyaan tay haemorrhoid suckker jaanda.

Success rate four years after treatmen is more than 70% jehra keh rubber band ligatin naloon ziyada ah.

3  Kai hor taran day allaj vee dasay jaanday ah jehna nu Cauterization methods kehnday ah . Eh audoon wartay jaanday ah jidoon autlay allaj naa kitay jaa sakan. Ehna methods ch Electrocautery ,  InfraRed Radiation,  Laser surgery, or  Cryosurgery .  Infrared cauterization grade 1-2 ch kitti jaandi ah tay grade 3-4 ch dubara honay da rate buht high ah.

Surgery

Surgery day kai taraqay wartay jaanda ah tay her taraqay naal koi risk zaroor ah I .e bleeding , infection,  Anal strictures and urinary retention, kiyoun keh bladder diyaan nerves ehday buht lagay . Ho sak da small risk of fecal incotinence  khas tor tay liquid  rates reported 0-28% Mucosal ectropion ik hor condition ah jehri ho jaway after hemorrhoidectomy (often with stenosis). Eh oh ah jethay Mucosa becomes averyed from anus jehri keh very mild kisam dee rectal prolapse ah

Excisional hemorrhoidectomy eh buh ziyada serious cases ch kitti jaandi ah. Ehday operation too baad buht dard hundi ah tay 2-4 weeks recovery wastay chai day ah.. Long term ehday buhtay faiday ah grade 3 ch rubber band ligation day. Eh treatment nu thrombosedexternal haemorroids wastay recomenfd kitta jaanda.. Agar tay 24-72  ch kitta jaway tay Glyceryl trinitrate ointment kaffi madad kerdi ah dard tay theek honay ch.

Doppler-guided , transanal hemorrhoidal dearterialization is an invasive treatment jehday ch ultra sound doppler use ker kay arterrial blood inflow locate  kita jaanda. Ehtoon baad arteries nu bhun ditta jaanda. Tay prolapsed tissue nu saturate back ker ditta jaanda ehdi normal position tay.. Ehda success rate zitada ah tay kaht complications hundiyaan aan hemorrhoidectomy nallon.

Stapled hemorrhoidectomy  no stapled hemoorrhoidopexy  ik surgery da tariqa  jehday ch “Abnormaly enlarged  hemorrhoida tissue nu remove ker ditta jaanda.. baqi tissue nu normal  anatomic position tay ker dainday ah. Eh kath dard alla ah tay jaldi theek ho jaanda ah compared to complete removal of haemorrhoids.  Pehr ehday ch duparay honay day chances ziyda ah.  Es wastay es wastay ehnu grade 2-3 bawaseer wastay tajweez kitta jaanda ah.

 References and further readings

Rivadeneira, DE; Steele, SR; Ternent, C; Chalasani, S; Buie, WD; Rafferty, JL; Standards Practice Task Force of The American Society of Colon and Rectal, Surgeons (September 2011). "Practice parameters for the management of hemorrhoids (revised 2010)". Diseases of the colon and rectum   1059–64.

 Lorenzo-Rivero, S (August 2009). "Hemorrhoids: diagnosis and current management". Am Surg   635–42

Pescatori, M; Gagliardi, G (March 2008). "Postoperative complications after procedure for prolapsed hemorrhoids (PPH) and stapled transanal rectal resection (STARR) procedures". Techniques in coloproctology   7–19

Ommer, A; Wenger, FA; Rolfs, T; Walz, MK (November 2008). "Continence disorders after anal surgery--a relevant problem?". International journal of colorectal disease  1023–31

Lagares-Garcia, JA; Nogueras, JJ (December 2002). "Anal stenosis and mucosal ectropion.". The Surgical clinics of North America : 1225–31

Lorenzo-Rivero, S (August 2009). "Hemorrhoids: diagnosis and current management". Am Surg : 635–42

Ratnasingham, K; Uzzaman, M; Andreani, SM; Light, D; Patel, B (2010). "Meta-analysis of the use of glyceryl trinitrate ointment after haemorrhoidectomy as an analgesic and in promoting wound healing". International journal of surgery (London, England)  606–11

Jayaraman, S; Colquhoun, PH; Malthaner, RA (Oct 18, 2006). "Stapled versus conventional surgery for hemorrhoids". Cochrane database of systematic reviews