Human Health and Disease: Class 12 Biology Chapter 7 Hinglish mein

Agar koi kahe ki 'garam' mizaaj se fever hota hai, to tum is claim ko kaise test karoge? Insaan ki zubaan ke neeche thermometer lagao. Asal mein, purani theory of humours aise hi giri. Ancient Greece mein Hippocrates se lekar India ki Ayurvedic tradition tak, physicians health ko body fluids, yaani humours, ka balance maante the. Jaise, ek humour ki zyaadti ko 'garam' mizaaj aur fever ka kaaran maana jaata tha. Thermometer readings ne dikhaya ki jin logon ko is tarah 'garam' kaha jaata tha, unka temperature bilkul normal tha.

William Harvey ke 1620s ke experiments ne prove kiya ki blood ek closed loop mein circulate karta hai, aur isse body ki purani picture aur kamzor ho gayi. Sirf reasoning se bane ideas ki jagah experiment se test kiye gaye ideas aa gaye. Iske badle modern biology ne mind aur body ke beech ek zyaada subtle link dhoondha hai. Brain nerves aur hormones ke through immune system se baat karta hai, isliye stress, neend aur mood sach mein badalte hain ki hum disease ko kitna achchha resist karte hain.

Kisi insaan ki health ko teen bade influences shape karte hain:

• genes: woh disorders jinke saath bachcha paida hota hai ya jo use parents se inherit hote hain;
• disease paida karne wale organisms se hone wale infections;
• lifestyle: hum kya khaana aur paani lete hain, kitna rest aur exercise karte hain, aur kaun si aadatein apnaate ya chhodte hain.

Healthy hona jitna lagta hai usse bada idea hai. World Health Organization health ko poori physical, mental aur social well-being batata hai, isliye jo insaan disease se free hai par akela hai ya hamesha anxious rehta hai, woh poori tarah healthy nahi hai. Health ka fayda bhi hai: healthy log better seekhte aur kaam karte hain, jisse families aur desh aage badhte hain, woh lambi zindagi jeete hain, aur childbirth ke aas-paas kam babies aur maayein marti hain.

Healthy rehna roz ki aadaton par tika hai: balanced diet, personal cleanliness, regular exercise aur yoga jaisi practices. Yeh is par bhi tika hai ki community milkar kya karti hai: logon ko vaccinate karna, waste ko safely dispose karna, mosquitoes aur disease ke doosre carriers ko control karna, aur khaana aur paani saaf rakhna. Diseases kaise kaam karti hain, yeh jaanna, jo is chapter ka subject hai, isi toolkit ka hissa hai.

Disease body ke kaam mein gadbad hai, chahe ek organ mein ho ya kai mein. Yeh signs se pata chalti hai, jo doosre dekh sakte hain (rash, fever), aur symptoms se, jo sirf woh insaan mehsoos karta hai (dard, thakaan). Diseases do bade groups mein aati hain.

Yeh chapter isi split ko follow karta hai. Yeh common infections aur unse ladne wale immune system se shuru hota hai, phir HIV aur AIDS aur cancer par aata hai, aur drugs, alcohol aur tobacco se hone wale nuksaan par khatam hota hai.

7.1 Insaanon ki common diseases

Pathogen (रोगजनक) koi bhi organism hai jo disease paida karta hai, aur pathogens life ki lagbhag har branch se aate hain: bacteria, viruses, fungi, protozoans aur parasitic worms (helminths). Inmein se zyaadatar parasites hain jo hamare andar ya hamare upar rehte hain. Disease paida karne ke liye pathogen ko andar ghusna, survive karna aur multiply karna hota hai, aur jaise-jaise uski sankhya badhti hai, woh jin tissues mein rehta hai unka kaam bigaad deta hai.

Har pathogen ke paas body ki hostile conditions ka apna jawaab hai. Khaane ke saath nigle gaye typhoid bacteria ko stomach acid aur digestive enzymes ko jhelna padta hai. Malaria parasite liver aur blood cells ke andar chhup jaata hai, aur ringworm fungi skin ki dead outer layer mein rehte hain, jahan zyaadatar immune cells pahunch nahi paate. Neeche diye examples, har group se ek ya do, dikhate hain ki yeh routes aur tricks kitne alag-alag hain, aur section ka aakhri hissa poochta hai ki hum inhe kaise block kar sakte hain.

Bacteria se hone wali diseases

Aisa fever jo 39–40 °C tak chadh jaaye aur kai dinon tak utre nahi, saath mein headache, pet dard, constipation, kamzori aur bhookh kam lagna, yeh typhoid fever ki pehchaan hai. Iska cause bacterium Salmonella Typhi hai (purani books mein Salmonella typhi likha hai). Yeh contaminated khaane ya paani ke saath nigla jaata hai, small intestine mein basta hai aur phir blood ke through doosre organs tak fail jaata hai. Severe cases mein intestine ki wall mein ched (perforation) ho sakta hai, jo jaanleva ho sakta hai.

Ek blood test, Widal test, bacterium ke against patient ki antibodies dhoondhta hai; blood sample se bacteria ugaane par diagnosis confirm hota hai. Kuch log theek ho jaate hain phir bhi mahinon ya saalon tak bina beemar mehsoos kiye bacteria bahar nikaalte rehte hain. Agar aisa healthy carrier doosron ke liye khaana banaye, to outbreak ho sakta hai; yeh yaad dilata hai ki koi bilkul theek dikhte hue bhi disease failaa sakta hai. Typhoid ka ilaaj antibiotics se hota hai, aur ek Indian-made typhoid conjugate vaccine ab chhote bachchon ko protect karti hai.

Beemar insaan ki khaansi ke droplets ya aerosols saans ke saath andar lene se, ya uske cup se peene se, bacteria Streptococcus pneumoniae aur Haemophilus influenzae lungs ke andar tak pahunch sakte hain. Wahan woh alveoli ko infect karte hain, yaani woh chhoti air sacs jahan se oxygen blood mein jaati hai, aur sacs fluid se bhar jaati hain. Iska result hai pneumonia: fever, thand lagna (chills), khaansi, headache aur mushkil se saans lena. Jab blood tak bahut kam oxygen pahunchti hai, to honth aur naakhoon greyish-blue ho jaate hain; yeh warning hai ki beemari serious hai.

Duniya bhar mein chhote bachchon ki sabse zyaada jaan lene wali infectious disease pneumonia hai, isiliye India ke immunisation programme mein ab in dono bacteria ke against vaccines shaamil hain. Dysentery, plague aur diphtheria insaanon ki doosri bacterial diseases hain.

Viruses se hone wali diseases

Colds classrooms aur offices mein tezi se failte hain kyunki unke viruses bahut aasaani se travel karte hain. Khaansi ya chheenk ke droplets seedhe saans mein ja sakte hain, ya phone screen, lift button ya bus ki railing par gir sakte hain, jahan se haath unhe naak tak le jaate hain. Common cold zyaadatar rhinoviruses se hota hai, jo naak aur upper airway ko infect karte hain par lungs ko nahi. Teen se saat din tak insaan ki naak band rehti hai ya behti hai, gala kharaab, aawaaz bhaari, khaansi, headache aur thakaan hoti hai.

Isse do practical baatein nikalti hain. Antibiotics bacteria par kaam karte hain, isliye cold par unka koi asar nahi hota; phir bhi unhe lene se bas antibiotic-resistant bacteria ko failne mein madad milti hai. Aur kyunki sau se zyaada tarah ke rhinovirus ghoomte hain, ek se theek hone ke baad bhi tum agle se bache nahi rehte, isliye log baar-baar cold pakadte hain.

Protozoans se hone wali diseases

Malaria hazaaron saalon se insaanon ko pareshaan karta aaya hai. Yeh protozoan Plasmodium se hota hai; species P. vivax, P. malariae aur P. falciparum har ek thodi alag beemari paida karti hai. Inmein P. falciparum sabse khatarnaak form, malignant malaria, paida karta hai, jo brain aur kidneys ko nuksaan pahuncha sakta hai aur jaldi ilaaj na ho to jaan le sakta hai.

Parasite ko do hosts chahiye (Fig. 7.1). Yeh insaan mein sporozoites ke roop mein ghusta hai, yaani patli infective cells jo female Anopheles mosquito ki saliva ke saath inject hoti hain. Sporozoites blood ke through liver tak pahunchte hain aur ek se do hafte tak bina symptoms ke liver cells ke andar multiply karte hain. Phir hazaaron naye parasites bahar foot kar nikalte hain aur red blood cells par hamla karte hain.

Red blood cells ke andar parasites phir se multiply karte hain, aur infected cells synchronised waves mein phatte hain. Har wave naye parasites ke saath haemozoin bhi chhodti hai, jo digest kiye haemoglobin se bacha ek dark pigment hai, aur parasite ka baaki kachra bhi. Inse body ka fever response shuru hota hai: patient pehle thand se kaanpta hai, phir tez fever se jalta hai. P. vivax mein yeh cycle lagbhag har 48 hours mein repeat hota hai, P. malariae mein lagbhag har 72 hours mein.

Blood ke kuch parasites iske badle gametocytes ban jaate hain, jo sexual stages hain. Infected insaan ko kaatne wali female Anopheles apne blood meal ke saath unhe choos leti hai. Uske gut mein male aur female gametes fuse hote hain, aur zygote gut wall par badh kar ek cyst banta hai jo hazaaron sporozoites chhodta hai. Yeh uski salivary glands mein chale jaate hain, agle bite ke liye taiyaar. Is tarah mosquito ek host bhi hai, jahan sexual stage hota hai, aur vector (रोगवाहक) bhi, jo parasite ko ek insaan se doosre tak le jaata hai.

Ek ghar ki makkhi jo faeces par chalti hai aur phir khule khaane par baithti hai, apni taangon aur body par ek aur protozoan, Entamoeba histolytica, le ja sakti hai. Makkhi khud infected nahi hoti, isliye woh sirf ek mechanical carrier hai. Lekin zyaadatar infections seedhe faecal matter se contaminated paani ya khaane se aate hain. Parasite large intestine mein rehta hai aur amoebiasis, yaani amoebic dysentery, paida karta hai: pet mein dard aur marod, constipation, aur stools mein bahut zyaada mucus aur blood. Yeh faeces ke saath body se bahar nikalta hai, cycle phir se shuru karne ke liye taiyaar.

Worms se hone wali diseases

Helminths kaafi bade pathogens hain. Common roundworm Ascaris ke eggs infected insaan ke faeces ke saath bahar aate hain aur mitti, paani aur paudhon ko contaminate karte hain. Ganda paani peene wala ya bina dhoye sabzi ya phal khaane wala bachcha unhe nigal sakta hai. Worms intestine mein badhte hain aur ascariasis paida karte hain; heavy infection se internal bleeding, muscle pain, fever, anaemia aur yahan tak ki intestine block bhi ho sakti hai. Bachchon ko bachaane ke liye India saal mein do baar National Deworming Day manaata hai, jab schools aur anganwadis har bachche ko deworming drug albendazole ki ek single dose dete hain.

Mosquitoes, khaas kar Culex, filarial worms ke larvae ko ek insaan se doosre tak le jaate hain. Worms, Wuchereria bancrofti aur usse juda Brugia malayi (pehle naam Wuchereria malayi), phir lymphatic vessels mein, aam taur par legs ki, bas jaate hain aur wahan saalon tak rehte hain. Vessels mein lagaataar inflammation rehti hai, lymph drain nahi ho paata, aur limb dheere-dheere sooj kar mota ho jaata hai; iska result lymphatic filariasis hai, jise elephantiasis naam se zyaada jaana jaata hai. Genital organs bhi bure tarah affect ho sakte hain.

Fungi se hone wali diseases

Naam ke bawajood ringworm ka worms se koi lena-dena nahi hai. Microsporum, Trichophyton aur Epidermophyton genera ke fungi skin, naakhoon aur baalon ki dead outer layer mein ugte hain. Jahan bhi skin garam aur geeli rehti hai, jaise groin aur pair ki ungliyon ke beech ki jagah, wahan yeh khoob badhte hain. Yeh sookhe, papdidaar, bahut khujli wale patches banate hain, jo aksar ring jaise hote hain aur beech mein saaf hote hain. Log inhe mitti se, pets se, ya kisi infected insaan ke saath towel, kapde ya kanghi share karke pakadte hain.

Infectious diseases ko rokna

Upar ke har pathogen ko body mein ghusne ka ek raasta chahiye, aur infection ke against zyaadatar tareeke usi raaste ko block karke kaam karte hain (Fig. 7.2). Achchhi personal hygiene ka matlab hai body ko saaf rakhna, saabun se haath dhona, aur sirf saaf, safe khaana aur paani lena. Public hygiene mein community milkar kaam karti hai: waste aur sewage ko safely dispose karna, water tanks, reservoirs aur pools ko saaf aur disinfect karna, aur jahan bhi khaana banta aur parosa jaata hai wahan hygiene lagu karna. Yeh steps typhoid, amoebiasis aur ascariasis ke against sabse zyaada maayne rakhte hain, jinke pathogens hamare khaane-peene ke saath travel karte hain.

Pneumonia aur common cold jaise air-borne infections ke liye aur zyaada chahiye. Beemar logon se doori rakhna, khaansi aur chheenk ko dhakna, kamron mein hawa aane dena aur beemar insaan ka cup ya towel share na karna madad karta hai. Malaria, filariasis aur doosri vector-borne diseases mein target mosquito hai. Use breed karne se roko: matkon, purane tyres aur naaliyon mein paani khada mat rehne do, aur har hafte desert coolers ko khaali karke sukhao. Jahan larvae badhte hain wahan insecticide spray karo, aur ponds mein Gambusia jaisi fish daalo jo larvae khaati hain. Use kaatne se roko: nets ke andar soya karo, aur doors aur windows par wire mesh lagao.

Jab se dengue aur chikungunya Indian towns aur cities mein fail rahe hain, yeh measures aur bhi zaroori ho gaye hain. Dono viral diseases hain jo Aedes mosquitoes failaate hain; yeh saaf khade paani ke chhote gaddhon mein breed karte hain aur Anopheles ke ulat, zyaadatar din mein kaatte hain.

Biology ne hamein powerful hathiyaar bhi diye hain. Vaccination ne itne immune systems ko train kiya ki smallpox khatam ho gaya: World Health Organization ne 1980 mein use eradicated declare kiya. Tab se vaccines ne polio, diphtheria, tetanus, measles aur pneumonia ko peeche dhakela hai, aur India ko 2014 mein polio-free certify kiya gaya. Antibiotics aur doosri medicines kai bacterial aur protozoan infections theek karti hain, aur biotechnology, jo tum Chapters 9 aur 10 mein padhoge, nayi aur zyaada safe vaccines banaati rehti hai.

7.2 Immunity

Pichhle saal tumhe jitne infections hue, gino: shaayad ek-do cold. Ab un laakhon microbes ke baare mein socho jo tumne unhi mahinon mein saans ke saath liye, nigle ya chhooe. Zyaadatar ko kabhi jagah nahi mili, kyunki body hamesha apni defence karti rehti hai. Is protection ko immunity (प्रतिरक्षा) kehte hain: immune system jo kuch bhi pathogens ko disease paida karne se rokne ke liye karta hai, uska total. Yeh do layers mein kaam karti hai, innate immunity, jiske saath hum paida hote hain, aur acquired immunity, jo particular pathogens se milne par banti jaati hai.

7.2.1 Innate Immunity

Defence ki pehli line ko kisi training ki zaroorat nahi. Innate immunity janam se hamare saath hai aur non-specific hai: cut se jo bhi andar aaye, streptococcus ho ya staphylococcus, use same defences milti hain. Iske tools chaar groups mein aate hain (Fig. 7.3).

• Physical barriers entry block karte hain. Bina kati skin, apni sakht dead outer layer ke saath, sabse bada barrier hai. Andar, chipchipa mucus airways, gut aur urogenital tract ko dhakta hai, aur airways mein chhote baal jaise cilia phanse hue microbes ko upar aur bahar ki taraf saaf karte hain.
• Physiological barriers conditions ko hostile banaate hain. Stomach acid kai nigle hue microbes ko maar deta hai, aur tears aur saliva mein lysozyme hota hai, ek enzyme jo bacterial walls ko tod deta hai.
• Cellular barriers microbes ko dhoondh kar khatam karte hain. Blood mein neutrophils, jinhe polymorphonuclear leucocytes (PMNL) bhi kehte hain, aur monocytes, aur tissues mein macrophages, phagocytosis se microbes ko nigal kar digest karte hain. Natural killer cells, jo ek tarah ke lymphocyte hain, infected ya abnormal body cells ko khatam karte hain.
• Cytokine barriers warning aage pahunchaate hain. Virus se infected cell interferons naam ke proteins chhodta hai, jo uske uninfected padosi cells ko virus ke against resistant bana dete hain.

7.2.2 Acquired Immunity

Jin bachchon ko measles ho chuka hai, unhe yeh lagbhag kabhi dobaara nahi hota, chahe school mein outbreak fail jaaye. Yeh lambi protection acquired immunity ka kaam hai, jiski do pehchaan hain: yeh specific hai, yaani sirf ek pathogen par nishaana, aur iske paas memory hai. Kisi pathogen se pehli mulaqaat primary response shuru karti hai, jo dheere banta hai (ek-do hafte) aur size mein chhota hota hai. Usi pathogen se baad ki mulaqaat par secondary, yaani anamnestic, response milta hai: pehle round se bache memory cells kuch hi dinon mein, aur kahin zyaada strongly, react karte hain (Fig. 7.4).

Acquired immunity ke specialists do tarah ke lymphocytes hain, B lymphocytes (B cells) aur T lymphocytes (T cells). B cells door se ladte hain: woh antibodies (प्रतिरक्षी) chhodte hain, yaani proteins jo blood mein ghoomte hain aur pathogen ya uske toxin par maujood ek particular molecule, antigen (प्रतिजन), par lock ho jaate hain. T cells koi antibodies nahi chhodte. Helper T cells B cells ko shuru karne ka signal dete hain, aur doosre T cells khud infected cells par attack karte hain.

Antibody ko dhyaan se dekho to chaar polypeptide chains se bana ek Y milta hai: do identical lambi heavy chains aur do identical, chhoti light chains, jo disulfide (S–S) bonds se judi hain (Fig. 7.5). Iska shorthand, ${\mathrm{H}}_2{\mathrm{L}}_2$, bas inhe ginta hai. Dono arms ke tips ek antibody se doosre mein alag hote hain aur do identical antigen-binding sites banaate hain, isliye ek antibody do antigen molecules ko pakad sakti hai aur pathogens ko ek saath guchchha bana sakti hai.

Acquired immunity ki do arms ke naam is par rakhe gaye hain ki woh kahan kaam karti hain (Fig. 7.6). Antibodies body fluids mein kaam karti hain, jinhe kabhi 'humours' kaha jaata tha (is chapter ki shuruaat yaad karo), isliye antibody wali arm humoral immune response hai. Doosri arm cell se cell kaam karti hai: cell-mediated immunity (CMI) mein killer (cytotoxic) T cells infected ya foreign body cells ko pehchaan kar seedhe khatam karte hain. Helper T cells dono arms ko coordinate karte hain.

Organ transplantation mein sabse badi rukaawat cell-mediated immunity hai. Har cell surface par identity molecules hote hain jo har insaan mein alag hote hain. Donor ki kidney patient mein lagao to patient ke T cells un molecules ko non-self samajh kar attack karte hain, aur graft reject ho jaata hai. Isliye transplant se pehle doctors blood groups aur tissue types ko jitna ho sake utna match karte hain, aur baad mein patient T cells ko kaabu mein rakhne ke liye immunosuppressant drugs leta hai, aam taur par zindagi bhar. Phir bhi jab heart, liver ya kidney fail ho jaaye, to transplant hi jaan bachaane ka akela option ho sakta hai; kisi animal ya unmatched donor ka organ jaldi reject ho jaayega.

7.2.3 Active aur Passive Immunity

Bachaane wali antibodies ghar ki bani bhi ho sakti hain aur udhaar ki bhi. Active immunity ghar ki bani hai: antigen se milne ke baad tumhare apne B cells antibodies banaate hain, chahe natural infection mein ho ya vaccine mein. Ise banne mein ek hafta ya zyaada lagta hai, lekin yeh memory chhod jaati hai aur saalon tak chal sakti hai.

Passive immunity udhaar ki hai: ready-made antibodies body mein daali jaati hain. Yeh turant kaam karti hai par hafton ya mahinon mein khatam ho jaati hai, kyunki body ne woh antibodies khud banana nahi seekha. Nature ise newborns ko bachaane ke liye use karti hai. Pregnancy ke dauraan maa ki IgG antibodies placenta cross karke foetus tak pahunchti hain. Janam ke baad colostrum, yaani pehle kuch dinon ka gaadha peela-sa doodh, IgA se bharpoor hota hai jo baby ke gut ki raksha karta hai. Yeh ek wajah hai ki jaldi breastfeeding shuru karne ko kaha jaata hai.

7.2.4 Vaccination aur Immunisation

Vaccine (टीका) ek rehearsal hai. Yeh immune system ke saamne pathogen ke antigens aisi form mein rakhti hai jo disease paida nahi kar sakti. Yeh mare hue ya kamzor kiye poore microbes ho sakte hain, purified proteins jaise harmless tukde, ya inactivated toxins. Body waise hi react karti hai jaise asli infection par karti, antibodies banaati hai aur, sabse zaroori, memory B aur T cells bhi. Agar baad mein asli pathogen aaye, to memory cells use kuch dinon mein pehchaan kar ek bada secondary response shuru karte hain jo aam taur par koi bhi symptom aane se pehle use saaf kar deta hai. Neeche lab mein alag-alag timelines try karo.

Kabhi-kabhi active response ka intezaar karne ka samay nahi hota. Tetanus toxin kuch hi dinon mein asar karta hai. Isliye jis insaan ko gehra, ganda ghaav hai aur jiske vaccinations up to date nahi hain, use vaccine dose ke saath antitoxin (tetanus immunoglobulin) diya ja sakta hai, yaani toxin ke against ready-made antibodies. Snakebite ka ilaaj bhi aise hi hota hai: Indian hospitals mein use hone wale antivenom mein horses mein banaayi gayi antibodies hoti hain jo desh ke sabse common khatarnaak saanpon ke venom ko neutralise karti hain. Is tarah ready-made antibodies se kisi ko protect karne ko passive immunisation kehte hain.

Recombinant DNA technology (Chapters 9 aur 10) se scientists pathogen ke ek antigen ka gene bacteria ya yeast mein daal kar woh protein bade paimaane par nikaal sakte hain. Hepatitis B vaccine aise hi banti hai, un yeast cells se jinmein hepatitis B surface protein ka gene hota hai. Isme kuch bhi infectious nahi hota, isliye aisi vaccines safe hain, aur unhe national programmes ki zaroorat jitni bahut badi quantities mein sasta banaya ja sakta hai.

7.2.5 Allergies

Kya kabhi kisi ke dhool bhare kamre mein jhaadu lagaate hi tumhe chheenkein aane lagi hain, ya phoolon wali ghaas ke paas aankhon se paani behne laga hai? Kai log aisi cheezon par strongly react karte hain jo doosron ke liye harmless hain. Allergy environment ki aisi cheez ke against ek zyaada badha-chadha immune response hai, aur us cheez ko phir allergen kehte hain. House-dust mites, pollen, animal dander (skin aur baalon ke chhote flakes), kuch foods aur insect stings common allergens hain.

Allergen se pehle contact par sensitive insaan ke B cells IgE class ki antibodies banaate hain. Yeh mast cells se chipak jaati hain, jo skin mein aur naak, lungs aur gut ki linings mein hote hain (Fig. 7.8). Jab allergen wapas aata hai, to woh mast cells par lagi IgE se bandh jaata hai, aur cells histamine aur serotonin jaise chemicals chhodte hain. Inse chhoti blood vessels leak karne lagti hain aur airways sikud jaate hain, jisse chheenkein, behti naak, aankhon se paani, khujli aur asthma wale logon mein saans lene mein dikkat hoti hai.

Culprit dhoondhne ke liye doctors skin ko likely allergens ki bahut thodi maatra se expose karte hain (skin-prick test) aur chhoti soojan dekhte hain. Antihistamines, steroids aur adrenaline (epinephrine) symptoms mein jaldi aaraam dete hain; adrenaline anaphylaxis ka emergency treatment hai, jo ek rare aur severe poori body ka reaction hai. Indian cities ke bachchon mein allergies aur asthma badh rahe hain. Polluted hawa isme hissa deti hai. Ek aur explanation, hygiene hypothesis, abhi test ho rahi hai: iske hisaab se jo bachche bahut saaf maahaul mein bade hote hain aur shuru mein microbes se kam milte hain, unka immune system zyaada over-react karne wala banta hai.

7.2.6 Auto Immunity

Higher vertebrates mein evolve hua memory-based immune system 'self' aur 'non-self' mein farak karne par tika hai. Yeh pehchaan itni baareek hai ki ek single foreign protein ko bhi chun sakti hai, isiliye immunology experiments mein purified molecules ko antigens ki tarah use kiya ja sakta hai. Kabhi-kabhi, genetic aur aise doosre kaaranon se jo poori tarah samjhe nahi gaye, system body ke apne cells par hi palat jaata hai. Iska result autoimmune disease hai, jo autoimmunity ka example hai. Rheumatoid arthritis mein, jo ek common example hai, immune cells joints ki lining par attack karte hain, jisse dard bhari soojan hoti hai; type 1 diabetes mein woh pancreas ke insulin banaane wale cells ko khatam kar dete hain.

7.2.7 Body mein Immune System

Immune system poori body mein faila hai. Yeh lymphoid organs aur tissues, kai tarah ke cells, aur antibodies jaise soluble molecules se bana hai. Ise khaas yeh banaata hai ki yeh foreign antigen ko pehchaan sakta hai, uske against response khada kar sakta hai aur future ke liye uska record rakh sakta hai. Yahi abilities allergies, autoimmune diseases aur transplants ke rejection ke peeche bhi hain.

Lymphoid organs (लसीकाभ अंग) woh jagah hain jahan lymphocytes bante hain, mature hote hain aur multiply karte hain (Fig. 7.9). Primary lymphoid organs, yaani bone marrow aur thymus, mein immature lymphocytes particular antigens ko pehchaanne laayak bante hain. Phir mature lymphocytes secondary lymphoid organs mein jaate hain, jahan woh antigens se milte hain, multiply karte hain aur effector cells bante hain. Yeh hain spleen, lymph nodes, tonsils, appendix aur small intestine ki wall mein Peyer's patches.

• Bone marrow saare blood cells banaata hai, lymphocytes bhi. B cells bhi yahin mature hote hain, aur young T cells thymus ke liye nikal jaate hain.
• Thymus: breastbone ke neeche, heart ke paas ek lobed organ, jahan T cells mature hote hain. Infancy mein yeh kaafi bada hota hai, puberty ke baad sikudta hai aur adults mein zyaadatar fat se replace ho jaata hai.
• Spleen: lymphocytes aur phagocytes se bhara ek bada, bean-shaped organ. Yeh blood ko filter karta hai, usmein aaye microbes ko phansa leta hai, ghise-pite red blood cells ko hataata hai aur blood cells ka reserve rakhta hai.
• Lymph nodes: lymph vessels ke saath-saath chhote solid bodies. Yeh tissues se aane wale lymph ko filter karte hain aur usmein ke microbes aur doosre antigens ko phansa lete hain; phanse hue antigens wahan intezaar kar rahe lymphocytes ko activate karte hain. Gala kharaab hone par gardan ke soojhe nodes isi kaam ki nishaani hain.
• MALT (mucosa-associated lymphoid tissue): airways, gut aur urogenital tract ki linings mein lymphoid tissue, jismein tonsils aur Peyer's patches bhi shaamil hain. Body ke kul lymphoid tissue ka lagbhag aadha yahi hai.

7.3 AIDS

AIDS ka matlab hai acquired immunodeficiency syndrome. Har shabd ka matlab hai. Deficiency acquired hai: yeh insaan ki zindagi ke dauraan banti hai, inherit nahi hoti ya janam se nahi hoti. Yeh immunodeficiency hai, kyunki immune system ab body ko protect nahi kar paata. Aur yeh syndrome hai, yaani symptoms ka set jo ek saath aate hain. Doctors ne AIDS ko pehli baar 1981 mein describe kiya. Tab se duniya bhar mein 40 million se zyaada log AIDS se judi beemariyon se mar chuke hain; aaj lagbhag 40 million log HIV ke saath jee rahe hain, jinmein se lagbhag 25 lakh India mein hain.

AIDS human immunodeficiency virus (HIV) ke infection ka late stage hai. HIV ek retrovirus hai: iske genes RNA ke roop mein ek protein core ke andar hote hain jo lipid envelope mein lipta hota hai, aur host cell ke andar pahunch kar yeh us RNA ko DNA mein copy karta hai.

HIV kaise failta hai

HIV kuch body fluids (blood, semen, vaginal fluid aur breast milk) mein rehta hai aur tabhi failta hai jab inmein se koi use doosre insaan ki body mein le jaaye. Aisa chaar main tareekon se hota hai. Do hain infected insaan ke saath bina condom ke sex, aur infected blood ya blood products ka transfusion. Baaki hain needles aur syringes share karna, jaise drugs inject karne wale logon mein, aur infected maa se uske baby tak pregnancy, birth ya breastfeeding ke dauraan pahunchna. Isliye untreated HIV wali maaon ke babies, baar-baar transfusion chahne wale log, drugs inject karne wale log aur kai sexual partners wale log zyaada risk par hain.

Kyunki HIV chhoone ya aam social contact se nahi failta, isliye HIV ke saath jee rahe logon ko alag karne ki koi wajah nahi hai, na medical na moral. Unhe bahar kar dena unki physical aur mental health ko nuksaan pahunchata hai aur logon ko test karwaane se darata hai, jisse virus ko failne mein madad milti hai.

Infection aur beemari ke beech ek lamba gap hota hai. Bina treatment ke aam taur par infection aur AIDS ke pehle signs ke beech paanch se das saal guzarte hain, jismein insaan kaafi theek mehsoos kar sakta hai phir bhi virus aage failaa sakta hai. Yeh sirf test se pata chal sakta hai.

HIV immunity ko kaise kamzor karta hai

Body ke andar HIV macrophages aur helper T cells (${\mathrm{T}}_{\mathrm{H}}$ cells) ko infect karta hai, jin par ek surface protein, CD4, hota hai jise virus docking site ki tarah use karta hai (Fig. 7.10). Cell mein enzyme reverse transcriptase, jise virus apne saath laata hai, viral RNA ko DNA mein copy karta hai. Yeh viral DNA host cell ke apne DNA mein jod diya jaata hai, aur tab se cell ki machinery use padh kar naye virus particles banaati hai. Infected macrophages zinda rehte hain aur lambe samay tak virus chhodte rehte hain, ek reservoir ki tarah kaam karte hue.

Naye viruses aur helper T cells ko infect karte hain, jo bade paimaane par marte hain, aur saal-dar-saal helper T-cell count girta jaata hai (Fig. 7.11). Kyunki helper T cells B cells aur killer T cells dono ko on karte hain, poori acquired immunity kamzor ho jaati hai. Insaan ko baar-baar fever, diarrhoea aur weight loss hota hai. Phir opportunistic infections, yaani woh jinhe healthy immune system aasaani se control kar leta, jad pakad lete hain: Mycobacterium se hone wali tuberculosis, doosre bacterial, viral aur fungal infections, aur Toxoplasma jaise parasites. Aakhir mein body apni defence nahi kar paati.

Testing, treatment aur prevention

HIV infection ka diagnosis blood tests se hota hai. ELISA (enzyme-linked immunosorbent assay) blood sample mein HIV ke against antibodies, ya viral antigens, detect karta hai, aur positive result ko hamesha aur tests se confirm kiya jaata hai. India mein testing confidential hai aur government centres par free hai.

Abhi bhi iska koi cure nahi hai, kyunki viral DNA lambe samay tak jeene wale cells ke andar chhupa rehta hai. Lekin anti-retroviral therapy (ART), yaani drugs ka combination jo reverse transcriptase aur doosre viral enzymes ko block karta hai, virus ko multiply karne se rok deta hai. Zindagi bhar roz lene par ART helper T-cell count ko wapas badhne deta hai, AIDS banne se rokta hai aur zyaadatar logon ko lagbhag normal lifespan deta hai (Fig. 7.11). Jis insaan ka treatment blood mein virus ko undetectable rakhta hai, woh sex ke through HIV aage nahi failaata. India 2004 se ART free mein de raha hai.11Purani textbooks ART ko sirf thoda effective batati hain. Modern combination therapy, agar jaldi shuru ki jaaye, HIV ko itna achchha control karti hai ki ab ise long-term condition ki tarah manage kiya jaata hai, lekin yeh abhi bhi virus ko body se nahi nikaal sakti.

HIV ke against abhi tak koi vaccine nahi hai, isliye naye infections rokna prevention par tika hai. India mein National AIDS Control Organisation (NACO) state agencies aur kai non-governmental organisations ke saath yeh kaam lead karta hai, jabki World Health Organization aur UNAIDS duniya bhar mein programmes chalaate hain. Main measures yeh hain:

• donated blood ki har unit ko use karne se pehle screen karna
• hospitals, clinics aur jahan bhi injections diye jaate hain, wahan sirf naye, sterile needles aur syringes use karna
• condoms aur safer sexual behaviour ko promote karna, aur condoms free mein uplabdh karaana
• zyaada risk wale logon ki regular testing, taaki jo bhi infected ho woh jaldi ART shuru kar sake
• saari pregnant women ki testing aur HIV wali maaon ka treatment, jisse unke babies tak transmission lagbhag khatam ho jaata hai
• drugs inject karne wale logon ki counselling, saaf needles aur addiction ke treatment se madad karna

Rejection ke darr se infection chhupaana bas use failne mein madad karta hai. HIV ke saath jee rahe logon ko support chahiye, doori nahi, aur Indian law unhe protect karta hai. HIV and AIDS (Prevention and Control) Act, 2017, jobs, schools, housing aur health care mein unke saath discrimination ko mana karta hai. HIV ko control karna tabhi kaam karta hai jab communities, families aur health workers milkar kaam karein.

7.4 Cancer

Bahut kam shabd logon ko 'cancer' jitna darate hain. Duniya bhar mein lagbhag har chhah mein se ek maut iski wajah se hoti hai, aur India mein har saal lagbhag 15 lakh naye cases record hote hain. Normal cell cancer cell kaise banta hai, is change ko oncogenic transformation kehte hain, ise samajhne ne dashakon ki research ko aage badhaya hai, aur saath mein disease ko detect, treat aur prevent karne ke behtar tareeke bhi diye hain.

Dish mein skin cells ugao to woh failte hain jab tak ek single layer mein neeche ki poori surface dhak na lein, phir ruk jaate hain: padosiyon ko chhoone se division off ho jaata hai. Yeh contact inhibition un kai controls mein se ek hai jo har tissue ko sahi size aur shape mein rakhte hain. Cancer cell in controls se bach nikla hai. Woh tab divide karta hai jab use nahi karna chahiye aur bheed mein bhi divide karta rehta hai, aur uske descendants jama hokar ek mass, yaani tumour, bana dete hain (Fig. 7.12).

Tumours do tarah ke hote hain. Benign tumour apni jagah rehta hai, aksar ek capsule mein lipta, aur body ko mainly tab nuksaan pahunchata hai jab kisi zaroori cheez par dabaav daale. Malignant tumour asli cancer hai. Iske neoplastic ('new-growth') cells padosi tissue mein ghus kar use khatam karte hain aur nutrients ke liye usse competition karte hain. Iski sabse khatarnaak trick hai metastasis: single cells toot kar alag hote hain, bloodstream ya lymph ke saath kisi door ke organ tak jaate hain aur jahan bhi atak jaayein wahan naya tumour bana dete hain.

Cancer ke causes

Jo agents normal cells ko cancer cells bana sakte hain, unhe carcinogens kehte hain. Yeh teen groups mein aate hain, aur inmein se zyaadatar DNA ko nuksaan pahuncha kar kaam karte hain.

Cancer paida karne wale viruses, yaani oncogenic viruses, mein viral oncogenes naam ke genes hote hain. Hamare apne cells mein inse milte-julte genes hote hain, proto-oncogenes ya cellular oncogenes (c-onc), jo normally cell growth control karte hain. Jab koi carcinogen inhe mutate kar deta hai ya galat samay par on kar deta hai, to yeh uncontrolled division chala sakte hain. Aam taur par ek cell ke cancerous banne se pehle usmein aise kai changes jama hone chahiye, aur yeh ek wajah hai ki zyaadatar cancers zindagi mein baad mein dikhte hain.

Cancer detect karna

Jaldi pata chal jaaye to kai cancers cure ho sakte hain, isliye detection maayne rakhta hai. Standard tareeka biopsy hai: shak wale tissue ka chhota tukda nikaala jaata hai, patle sections mein kaata jaata hai, stain kiya jaata hai aur pathologist microscope ke neeche dekhta hai (histopathology). Leukaemias, yaani blood banaane wale cells ke cancers, blood aur bone-marrow tests mein white cells ke abnormal counts ke roop mein dikhte hain. Doosre tools hain:

• Radiography, yaani X-ray images, jo bones aur lungs ke liye useful hain.
• CT (computed tomography), jo alag-alag angles se li gayi kai X-ray images ko jod kar internal organs ke cross-sections aur three-dimensional views banaata hai.
• MRI (magnetic resonance imaging), jo strong magnetic field aur harmless radio waves use karta hai, bina ionising radiation ke, aur soft tissues ke baareek changes dikhata hai.
• Antibodies jo sirf kuch cancer cells par milne wale antigens se bandhti hain, jinhe blood tests mein aur tumours ki location dhoondhne mein use kiya jaata hai.
• Un inherited gene changes ke liye molecular tests jo particular cancers ka risk badhaate hain, jaise breast aur ovarian cancer ke liye BRCA1 aur BRCA2. Jin logon mein yeh hote hain, woh zyaada baar check-ups karwa sakte hain aur un carcinogens se bach sakte hain jinke liye woh sabse zyaada sensitive hain, jaise lung cancer ke liye tobacco smoke.

Cancer ka treatment

Doctors aam taur par cancer ke type aur stage ke hisaab se kai treatments mila kar dete hain. Surgery mein tumour kaat kar nikaal diya jaata hai. Radiotherapy mein radiation ki beams tumour cells ko maarti hain aur aas-paas ke healthy tissue ko jitna ho sake bachaati hain. Divide hote cells ko maarne wale drugs chemotherapy mein use hote hain, jinmein se kuch particular cancers ke liye specific hain. Kyunki yeh normal divide hote cells ko bhi maarte hain, isliye baal jhadna, anaemia aur ji machalna jaise side effects common hain. Aakhir mein, immunotherapy patient ke immune system ki madad karti hai, jisse cancer cells aksar bach nikalte hain, taaki woh tumour ko dhoondh kar khatam kare. Is tarah ka ek purana approach biological response modifiers deta hai, jaise α-interferon, taaki immune system tumour ke against jaag uthe.

7.5 Drugs aur Alcohol Abuse

India aur doosri jagahon ke surveys dikhate hain ki drugs aur alcohol ka use badh raha hai, aur sabse chinta ki baat yeh hai ki young logon mein. Yeh jaanna ki yeh substances body ke saath kya karte hain, aur inhe chhodna itna mushkil kyun hai, young logon ko khud ko bachaane aur pressure se nipatne ke healthier tareeke dhoondhne mein madad karta hai.

Sabse zyaada abuse hone wale drugs teen groups mein aate hain: opioids, cannabinoids aur coca alkaloids. Zyaadatar flowering plants se aate hain, aur kuch fungi se.

Opium poppy, Papaver somniferum, opioids ka source hai. Iske kachche seed capsules se ek latex rista hai jisse morphine nikaala jaata hai, aur morphine ko acetylate karne se diacetylmorphine milta hai, jo street par heroin ya 'smack' ke naam se bikta hai: ek kadva, bina gandh ka, safed crystalline powder. Opioids central nervous system aur gut ke opioid receptors par kaam karte hain. Heroin aam taur par sungha ya inject kiya jaata hai. Yeh ek depressant hai jo saans, heart rate aur body ke doosre functions ko dheema karta hai, isiliye overdose se saans poori tarah ruk sakti hai.

Cannabis sativa plant cannabinoids deta hai. Iske inflorescences (phoolon wale upar ke hisse), patte aur resin, alag-alag tareekon se mila kar, marijuana, hashish, charas aur ganja dete hain. Smoking ya khaane se liye gaye cannabinoids cannabinoid receptors par kaam karte hain, jo mainly brain mein hote hain. Yeh perception aur memory ko bigaadte hain aur heart aur circulation ko affect karte hain, jaise heart rate badha kar. Kuch athletes ne inka galat use kiya hai, aur competitive sport mein yeh banned hain.

Teeno groups mein sabse powerful stimulant cocaine hai, jo South America ke native shrub Erythroxylum coca ki pattiyon se milne wala alkaloid hai. Aam taur par sungha jaata hai, aur yeh us transport ko block karta hai jo normally neurotransmitter dopamine ko nerve endings se hataata hai, isliye dopamine jama ho jaata hai aur user euphoria aur energy se bhar jaata hai. Badi doses hallucinations paida karti hain aur heart attacks la sakti hain. Hallucinogenic effects wale doosre plants mein Atropa belladonna aur Datura hain, jinke beejon se India mein kai accidental poisonings hoti hain.

Kuch substances jinka sach mein medical use hai, unka bhi galat use hota hai. Morphine sabse effective painkillers aur sedatives mein se ek hai, surgery ke baad bahut kaam ka. Barbiturates, benzodiazepines aur amphetamines neend na aana, anxiety aur attention disorders jaisi problems ke liye prescribe kiye jaate hain. Mind badalne wale effects wale plants, phal aur beej sadiyon se folk medicine aur religious rituals ka hissa bhi rahe hain. Aisa substance beemari ke ilaaj ke alawa kisi aur wajah se lena, ya itna zyaada ya itni baar lena ki woh body ya mind ke kaam ko nuksaan pahunchaane lage, drug abuse hai.

Tobacco

Tobacco India mein sabse zyaada use hone wala addictive substance hai. Ise cigarettes aur bidis ke roop mein piya jaata hai, gutkha ya khaini ya paan mein chabaaya jaata hai, ya snuff ki tarah liya jaata hai, aur yeh lagbhag chaar sadi pehle India pahuncha. Kai young logon ke liye yeh pehla addictive drug hota hai jo woh try karte hain, aur jaldi tobacco shuru karna baad mein doosre drugs ke use se juda hai.

Tobacco mein hazaaron chemicals hote hain, jinmein ek alkaloid nicotine bhi hai. Nicotine adrenal glands se blood mein adrenaline aur noradrenaline chhudwata hai, aur dono hormones blood pressure aur heart rate badhaate hain. Smoking lung, gale aur urinary bladder ke cancers ka risk badhaati hai, saath hi bronchitis, emphysema, coronary heart disease aur gastric ulcers ka bhi. Tobacco chabaana mouth cancer ka risk bahut badha deta hai, jo Indian purushon ke sabse common cancers mein se ek hai.

Smoke mein carbon monoxide ($\mathrm{C}\mathrm{O}$) bhi hota hai. Haemoglobin $\mathrm{C}\mathrm{O}$ ko oxygen se lagbhag 200 guna zyaada mazbooti se bandhta hai, isliye smoker mein haemoglobin ka kuch hissa hamesha $\mathrm{C}\mathrm{O}$ se bhara rehta hai aur tissues tak kam oxygen pahunchti hai (Fig. 7.13).

India mein bikne wale har tobacco pack par badi pictorial health warning aur ek quit-line number hota hai, phir bhi young aur buzurg dono mein tobacco ka use common hai. Kyunki nicotine itna addictive hai, sabse pakka bachaav hai kabhi shuru hi na karna; jo log chhodna chahte hain, unke liye counselling aur medical support sabse achchha kaam karte hain.

7.5.1 Adolescence aur Drug/Alcohol Abuse

Adolescence (lagbhag 12 se 18 saal ki age; World Health Organization 10 se 19 use karta hai) zindagi ka woh hissa hai jismein bachcha physically, emotionally aur socially adult banta hai. Brain ke reward systems un regions se pehle mature hote hain jo risks tolte hain, isliye teenagers naturally naye experiences ki taraf kheeche jaate hain. Yeh healthy hai, lekin isse adolescence mental aur emotional development ke liye ek vulnerable samay bhi ban jaata hai.

Kuch adolescents tobacco, alcohol ya drugs kyun shuru karte hain? Aam kheenchne wali wajahein yeh hain:

• curiosity aur adventure ki chaah: yeh jaanne ki ichchha ki kaisa lagta hai;
• ummeed kiye fayde: yeh maanna ki drink ya drug relax karega, energy dega ya group mein fit hone mein madad karega, aur baad mein problems se bhaagne ke liye use karna;
• stress: school aur competitive examinations mein achchha karne ka pressure;
• image: films, advertising aur social media se faila yeh idea ki smoking ya drinking 'cool' ya grown-up hai;
• peer pressure: use karne wale dost, aur akele chhoot jaane ka darr;
• ghar ka maahaul: unstable ya support na karne wali family, ya ghar ke bade jo yeh substances use karte hain.

7.5.2 Addiction aur Dependence

Log drugs aur alcohol baar-baar isliye lete hain kyunki unhe lagta hai ki isse kuch milta hai. Jo unhe aata hua nahi dikhta, woh hai in substances ki addictive power. Seedhe shabdon mein, addiction (व्यसन) us feeling ki ek strong mental craving hai jo substance deta hai, yaani high ya chinta se thodi der ka chhutkaara. Yeh craving unhe tab bhi use karte rehne par majboor karti hai jab woh mazedaar nahi rehta aur unki health bigaad raha hota hai.

Baar-baar use body ko bhi badal deta hai. Jo nerve cells baar-baar kisi drug ke contact mein aate hain, woh un receptors ki sankhya ya sensitivity kam kar dete hain jin par drug kaam karta hai; is change ko tolerance kehte hain. Ab same dose ka kam asar hota hai, isliye user zyaada leta hai, jisse change aur gehra ho jaata hai (Fig. 7.14). Ek baar drug try karna bhi yeh chakkar shuru kar sakta hai, aur bina guidance ya counselling ke isse bahar nikalna bahut mushkil hai.

Dependence tab dikhti hai jab drug hata liya jaata hai. Body drug ke saath itni poori tarah adjust ho chuki hoti hai ki achaanak band karne par uska balance bigad jaata hai. Iska result withdrawal syndrome hai (bechaini aur anxiety, kaanpna, ji machalna aur paseena) jo drug dobaara lene par gayab ho jaata hai. Yeh raahat khud ek jaal hai. Alcohol aur kuch sedatives mein withdrawal se seizures aa sakte hain aur jaan ko khatra ho sakta hai, isliye band karna medical care mein hona chahiye. Dependent insaan drug ke liye paise jutaane ke chakkar mein social norms bhi chhod sakta hai, jisse family life aur dosti par tanaav aata hai.

7.5.3 Drug/Alcohol Abuse ke Effects

Short term mein drug aur alcohol abuse laaparwaah behaviour, tod-phod, violence aur accidents ke roop mein dikhta hai. Overdose se coma aur maut ho sakti hai, saans ya heart ke fail hone se, ya brain mein bleeding se. Drugs mila kar lene, ya unhe alcohol ke saath lene se, jaanleva overdose ka chance kahin zyaada ho jaata hai. Koi young insaan drugs ya alcohol ka galat use kar raha ho, iske warning signs aksar chaar jagah dikhte hain:

• school mein: girte marks aur bina wajah absences
• ghar par: neend, bhookh aur weight mein changes, aur personal hygiene ki anadekhi
• mood mein: udaasi, thakaan, chidchidapan, ya aggressive aur rebellious gussa
• logon ke saath: family aur purane doston se door hona, baar-baar jhagde, aur hobbies mein interest khona

Nuksaan user se aage tak failta hai. Jo drugs ke paise nahi de sakta, woh chori ki taraf mud sakta hai, aur poori family mental aur financial pareshaani jhel sakti hai. Drugs inject karne aur needles aur syringes share karne wale logon ko HIV aur hepatitis B aur C jaise serious infections ka risk hota hai, jo sexual contact aur infected blood se bhi failte hain. Saalon ki heavy drinking ya drug use nervous system aur liver (cirrhosis) ko nuksaan pahunchata hai. Adolescence mein drinking adult life mein heavy drinking ka chance badhaati hai, aur pregnancy ke dauraan liye gaye alcohol ya drugs badhte foetus ko nuksaan pahuncha sakte hain.

Kuch athletes performance badhaane ke liye drugs ka galat use karte hain: narcotic painkillers, muscle bulk aur strength badhaane wale anabolic steroids, diuretics, aur hormones. Aisi doping banned hai, aur India mein National Anti-Doping Agency (NADA) athletes ko test karti hai. Anabolic steroids ke serious side effects hote hain, jo lambe use se permanent ho sakte hain.

7.5.4 Prevention aur Control

Yahan sach mein prevention cure se behtar hai, kyunki smoking, drinking aur drug use aam taur par adolescence mein shuru hote hain. Maqsad hai un situations ko pehchaanna jo young insaan ko in substances ki taraf dhakelti hain, aur jaldi kadam uthaana. Parents aur teachers ki khaas zimmedaari hai, aur studies dikhati hain ki pyaar bhari, support karne wali parenting aur consistent rules milkar substance abuse ka risk kam karte hain. Yeh measures madad karte hain:

• Expectations realistic rakho. Apni abilities se zyaada achchha karne ka pressure, marks, sport ya kisi aur cheez mein, us stress ka bada source hai jise drugs jhoothe taur par kam karne ka waada karte hain. Har young insaan ke apne interests aur raftaar ki izzat honi chahiye.
• Coping skills banao. Education aur counselling young logon ko stress manage karne, setbacks ko zindagi ka hissa maanne, aur sport, music, reading ya yoga mein santosh dhoondhne mein madad karte hain.
• Baat karte raho. Jo young log parents ya bharose ke doston se khul kar baat kar sakte hain, unhe jaldi guidance milti hai aur apni chinta aur guilt rakhne ki jagah milti hai.
• Signs pe dhyaan do. Jo parents, teachers aur dost warning signs pehchaanein, unhe kisi bharose ke bade se baat karni chahiye; yeh madad hai, dhokha nahi.
• Expert help lo. Psychologists, psychiatrists, aur de-addiction aur rehabilitation centres substance use ko ek health problem ki tarah treat karte hain, jo yeh hai. Support aur lagan se log theek hote hain aur poori, healthy zindagi jeete hain.