শুধুই এপেন্ডিক্স; এপেন্ডিসাইটিস নয়

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ধরুন, দু’একদিন ধরে আপনার পেটের ডানপাশে চিনচিনে ব্যথা অনুভূত হচ্ছে । আমরা যেহেতু অধিকাংশ ক্ষেত্রেই ডাক্তারের পরামর্শ না নিয়ে “যেকোনো ব্যথায় প্যারাসিটামল দুইবেলা” এইনীতি মেনে চলি এবং নিকতটস্থ ফার্মেসী থেকে সেই মোতাবেক প্যারাসিটামল কিনে এনে ডাক্তারের ফী বাঁচাই, তাই ধরে নিলাম এইবারও আপনি প্যারাসিটামল খেয়েই ব্যথা নিরাময়ের চেষ্টা করলেন । অথবা আপনার পরিচিত কেউ হয়তো এটাকে “গ্যাস্ট্রিক” এর কারণজনিত ব্যথা আখ্যা দিয়ে গ্যাসের ওষুধ খাওয়ার পরামর্শ দিল। আপনি তাই গ্যাসের ওষুধও খেলেন । কিন্তু দেখা গেল,সাময়িকভাবে কিছুক্ষণের জন্য ব্যথা চলে গেলেও কিছুক্ষণ পরেই তা আবার প্রকট আকার নিয়ে ফিরে এল । এখন তো আর উপায় নেই । তো আপনি ছুটলেন (আসলে তখন আপনি একা ছুটতে পারবেন না, দ্বিতীয় কারও সাহায্য লাগবেই লাগবে) নিকটস্থ হাসপাতালে । ডাক্তার আপনার অবস্থা দেখে বললেন, “দেরি হয়ে গেছে,এপেন্ডিক্স এই ফাটলো বলে।  এখনই অপারেশন করে এপেন্ডিক্স বের করা লাগবে । এছাড়া এখন আর গতি নেই।” আপনার মাথায় তো তখন প্রায় আকাশ ভেংগে পড়ল । বলে কি!!! ‘হাল্কা’ পেটের ব্যথা, তার জন্য একেবারে অপারেশন!!!
যেহেতু আপনার নিজের দেহের সম্পত্তি, তাই আপনার মনে প্রশ্ন আসার পূর্ণ অধিকার আছে যে, কি এই এপেন্ডিক্স? তো, তখন অপারেশন টেবিলে ডাক্তারকে প্রশ্ন করলে উনি হয়তো উত্তর নাও দিতে পারেন। তাই আমি এখানে এ সম্পর্কে একটি ধারণা দেওয়ার পূর্ণ চেষ্টা করছি।

Interior human body marked appendix
Interior human body marked appendix
source: anatomybodysystem.com

উপরের ছবিটির বামপাশে নিচের দিকে লেজের মত অংশটি দেখতে পাচ্ছেন? কালো বৃত্তে ঘেরাও করা যে ,এর নাম হচ্ছে এপেন্ডিক্স। যা আপনাদের সবার ভিতরেই আছে (যদি আপনি সেই বিরল ব্যক্তি না হয়ে থাকেন আরকি)। আমাদের শরীরের তথাকথিত কোনো গুরুত্বপূর্ণ অংশ না হওয়ার দরুন এটা লাস্ট বেঞ্চে বসা ছেলেটার মতই অবহেলিত হয়ে থাকে (বিদ্রোহ করবার আগ পর্যন্ত)। আপনি যদি কাউকে জিজ্ঞেস করেন এপেন্ডিক্স সম্বন্ধে, তবে বেশিরভাগ ক্ষেত্রে এপেন্ডিসাইটিস (appendicitis) সম্পর্কে উত্তর পাবেন। উইকিপিডিয়াকে (www.wikipedia.com) এপেন্ডিক্স  সম্বন্ধে জিজ্ঞেস করার পর তার উত্তর ছিল এইরকম, “The appendix (or vermiform appendix; also cecal [or caecal] appendix; vermix; or vermiform process) is a blind-ended tube connected to the cecum, from which it develops in the embryo. The cecum is a pouch like structure of the colon, located at the junction of the small and the large intestines.” তো, এত প্যাঁচালো টার্মে না গিয়ে যথাসম্ভব সহজ ভাষায় এপেন্ডিক্সের পরিচয় দেয়ার চেষ্টা করছি।

surgically removed inflamed appendix
surgically removed inflamed appendix source: http://web.med.unsw.edu.au

যদিও যথাসম্ভব নিরীহ দর্শন ছবি দেয়ার চেষ্টা করেছি, তবুও এই ছবিটি দেখে গা ঘিনঘিন করা স্বাভাবিক।

‘Vermiform’ শব্দটি একটি ল্যাটিন শব্দ। যার অর্থ হলো পোকার ন্যায় বা পোকা আকৃতির। মূলত এটি একটি টিউবের মত। যদি বোতলের অবস্থাটা কল্পনা করেন তাহলে বুঝতে আরও সুবিধা হবে। মানে যার ভিতরে ঢুকা আর বের হওয়ার রাস্তা মাত্র একটাই। এটি টিউব সিকামের (cecum) সাথে সংযুক্ত থাকে। মানুষের এপেন্ডিক্স ৯ সে.মি. থেকে ২০ সে.মি. পর্যন্ত হতে পারে। যদিও ক্রোয়েশিয়ায় “জাগ্রেভ (Zagreb)” নামক এক ব্যক্তির শরীর থেকে ২৬ সে.মি. দীর্ঘ একখানা এপেন্ডিক্স আলাদা করা হয়েছে । এটাই এখন পর্যন্ত পাওয়া সবচেয়ে দীর্ঘ এপেন্ডিক্স । এর ব্যাস ৭ -৮ মি.মি.। আগেই বলেছি এপেন্ডিক্স সিকামের(cecum)সাথে লেজের মত সংযুক্ত থাকে । তবে অবস্থানটা সকলের বুঝার জন্য বাইরে থেকে প্রথমে একটা ধারণা দিচ্ছি । সহজ করে বলতে গেলে এবং বাইরে থেকে বিবেচনা করলে আমাদের নাভির নিচে সর্বডানে, ডান হিপ-বোনের (hip bone) পাশে এর অবস্থান । কিন্তু কিছু ক্ষেত্রে ব্যতিক্রম হিসেবে এটি বাম পাশেও পাওয়া যায় । মাঝে প্রকৃতি ব্যতিক্রম পছন্দ করে (যেমনঃ মাঝে মাঝে অনেকের হার্ট (heart) বাম দিকের পরিবর্তে ডান দিকে থাকে)। কিছু ক্ষেত্রে হুবহু জমজ দ্বয়ের(mirror image twins) মাঝে এমন ব্যতিক্রম দেখা যায় । আগেই উল্লেখ করেছি বিরল কিছু ব্যক্তির কথা । এমন ১০০,০০০ জনে ১ জন পাওয়া যায় ,যার কোনো এপেন্ডিক্সই থাকে না ( আমার টা এখনো চেক করিনি । আপনি করেছেন তো? ) । কোনো বিজ্ঞানীর মতে এপেন্ডিক্স একটি গুরুত্বহীন অংশ । আবার কোনো বিজ্ঞানী বলেন এটা উপকারী ব্যাক্টেরিয়ার আবাসস্থল, যারা নানা রকম পেটের অসুখের সময় বা পরে অন্ত্রের স্বাভাবিক পরিবেশ ফিরিয়ে আনতে সাহায্য করে । যদিও কিছু কিছু উন্নত দেশে শিশু জন্মের সময়ই এপেন্ডিক্স কেটে ফেলে দেয়া হয় । মাঝে এপেন্ডিক্সের মুখ সিস্টের (cyst) কারণে অথবা পরিপাককৃত অংশ জমে বন্ধ হয়ে যায় । এর ফলে ভেতরে ইনফেকশন শুরু হয় । তখন একে বলা হয় “এপেন্ডিসাইটিস (appendicitis)”। তো একে আমরা এই এপেন্ডিক্সের বিদ্রোহ হিসেবে উল্লেখ করতে পারি । আমেরিকায় প্রতি ১৫ জনে ১ জন এপেন্ডিসাইটিসের শিকার হয় । যার কারণে তাদের জন্মের সময়েই এপেন্ডিক্স কেটে ফেলা হয়ে থাকে (অধিকাংশ ক্ষেত্রে ) । যদিও এটা যে কোনো বয়সেই আক্রমণ করতে পারে , কিন্তু ২ বছরের নিচের বয়েসীদের সাধারণত ক্ষমা করে দেয় । কিন্তু ১০ বছর থেকে ৩০ বছর বয়েসীরা এই ক্ষমার দাবীদার না হওয়ায় তারাই সাধারণত আক্রান্ত হয়ে থাকে । লক্ষণ হিসেবে নাভির ডান পাশে ব্যথা,বমি বমি ভাব (অনেক ক্ষেত্রে লাগামছাড়া বমি হয় ), ক্ষুদামন্দা, জ্বর (৯৯ -১০৩ ), গ্যাস নিঃসরনে অপারগতা (বুঝে নেন) ইত্যাদি দেখা যায়। পরিস্থিতি যখন খুবই জটিল আকার ধারন করে ( নইলে কিছুক্ষেত্রে এপেন্ডিক্স আক্ষরিক অর্থেই বিস্ফোরিত হয়) তখন দরকার হয় বিচ্ছেদের । রাষ্ট্রদোহী বিদ্রোহীদের যেমন সরকার দেশ থেকে বের করে দেয়,অথবা মৃত্যুদন্ড দেয়, তেমনি এর ক্ষেত্রেও তাই ঘটে। তবে এই ক্ষেত্রে কাজটা করে থাকেন অভিজ্ঞ সার্জন । অবশ্যই উপযুক্ত যন্ত্রপাতির সাহায্যে । কিন্তু যদি হাতের কাছে যন্ত্রপাতি না থাকে তখন কি করা হয়? তখন “intravenous antibiotics” ব্যবহার করা হয়ে থাকে। এতে করে ইনফেকশান ছড়াতে পারে না। যার ফলে অস্ত্রপাচারে খানিক বিলম্ব করলেও রোগীর ক্ষতি হয়না। এটা প্রয়োগের ফলে কিছু ক্ষেত্রে এপেন্ডিসাইটিস ঠিক হয়ে যায় । তবে এটা খুবই কম ঘটে ।

এপেন্ডিক্স
এপেন্ডিক্স
Source: Haiku Deck

কিছু বিজ্ঞানীর মতে,এপেন্ডিক্স আমাদের দেহের বিলুপ্তপ্রায় একটি অঙ্গানু । আমাদের পূর্বপুরুষদের দেহে হয়তো এর অন্য কোনো কাজ ছিল। যেহেতু তখনকার পরিবেশ ছিল অন্যরকম। আমাদের বর্তমান পরিবেশে হয়তো এর আর কোনো প্রয়োজন নেই। যার ফলে ধীরে বিবর্তনের মাধ্যমে এটি বিলুপ্ত হয়ে যাচ্ছে। হয়তো পূর্বপুরুষদের দেহে এটির কোনো অত্যন্ত কার্যকরী ভূমিকা ছিল। হয়তো তাদের রোগ প্রতিরোধ ক্ষমতা এর অবদানে অনেক বেশি ছিল। এপেন্ডিক্স নিয়ে ভাবলে অনেকগুলো “হয়তো” চলে আসে। এই সবগুলো “হয়তো”র জবাব হয়তো কখনোই জানা সম্ভব না। আবার এ নিয়ে ব্যাপক গবেষণার মাধ্যমেই হয়তো অনেক অজানা তথ্য বের করা সম্ভব, যা দিয়ে মানবজাতির ইতিহাস নতুন করে লিখতে হবে।

এখন প্রতি ১০০,০০০ জনে ১ জন এপেন্ডিক্স ছাড়া জন্ম নেয়। আর কয়েকশ বছর পরে হয়তো সংখ্যাটা কয়েক হাজারে দাঁড়াবে । হয়তো এমন একদিন আসবে, যখন সব শিশু জন্ম নিবে এপেন্ডিক্স ছাড়া ।

তথ্যসূত্রঃ 

wikipedia.com

webmd.com

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