Doctor Magazine August 2018 by Doctor Magazine

AUGUST 2018 Volume 24 • Issue 08

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08 NEWS 12

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u;ameka 21 iy ielh udhd;sr iu. 26 wo ojfia .kqfokqj CRITICAL CARE in

32 Sri Lanka the past, present & future

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41 lrk wh oek.; hq;= lreKq

fymghsáia î

45 ridhkd.dr mÍlaIK

NUTRIGENOMICS

50 AND HEALTH 54

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f,v fjk yeá DO YOU CARE ABOUT THE SUNGLASS THAT YOU BUY?

wäh ;shd.kak 66 fkdyels há m;=f,a oefkk fõokdjæ 68

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fldfyduo fyd|u 72 Baby Diaper f;dard.kafka@ 74

w¿; Wmka orejd''' ldi,a ùosh ldka;d frdayf,ka Wmfoia

yd fjk;a jeo.;a f;dr;=re

AUGUST 2018 | DOCTOR MAGAZINE

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Volume 24 ● Issue 08 ● August 2018

AUGUST 2018 Volume 24 • Issue 08

fyg oskh ch .kak orejkag .e,fmk

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ldka;djka .ek ldka;djka mjd jeä 104 fofkla fkdokakd lreKQ Tn;a úh<s iu

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AUGUST 2018 | DOCTOR MAGAZINE

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118 i|yd isÿ lrk

reêr mÍlaIK 120

YÍrfha ms<sld we;s jk yeá

127

STHAULYA (Obesity) doctormagazine.lk

ETON

EDITOR'S

S'ROTIDE

'hguÍsl ;.cdui aliyow j|ns<sm alhk;hdw kmdHOw HL!if kjfaks|ey akjfqkh hYxdh¾dl kmdHOw HL!if ow ahfYxdh¾dl HL!if Üfr ïf '''ahflYo 06-0591 hs.qim hk;hdw hSKjr!.f vúsKm HL!if ,n%m õfd:aijw a,qUqyqi ahfkmdHOw rjyfuf ls;dc kmdHOw HL!if 'shhk;hdw Qj a,qu guÍsl ;.kc lYo gó HL!if ahf,dl a,qu akhfjd;HlY k,dmßm a.fakßdO,sk glhmsysl alhllat dv=l ahfYxw HL!if kcyu õf=;akïf;¾dmof amfw rmf jdjaif kmdHOw HL!if amfw Qj lua;dhs%l akhfYj g,jõko ï. 'ífs; ja;m ghja;a;; s;ew ow aifaiT aljQKqhso lñ%l IaYfú kUfe<t HL!if als%;aiso a;fgh =lhfrjlIalÍm HL!if kcyu 'shjf alhkso wdh;khla woyila iudc.; fi!LH=lwOHdmk hfrjIalHOw rdly i "uù lua;dhms s%l<lsnl|j at km dHOw âadnfáakeils zz Í atugh' ahfkdOúxi HL!iwo f ladfi!LH ,f "uùa;m hk;hdw g ;gh guhkq . ZZf dhjka ;a;yye|s u kafjk wOHdmk ld¾hdxYh ld¾hdxYfha gjn alhYxmiq dh¾d. l sh a;f1950-60 gh rdOdw oYlfha 'shhk'so''kfï KfñrfÜ em fi!LH f.!rjKShakhfYj uùa;mwdh;kh jd;kc jód.ui dy at Soa;jf ÿsi ïlaikjf lsk;hdw âadnfáakei wjia m%fn.,gdfi!LH cd;sl fufyjr 'hú gkakj QKqhso wOHdmkfha äej oakygiveiq jy ïfqUÍq, sla a; jQKe: o dfõ ï h;a;yu mKsúv ck.; lsÍug uq,a jQ wdh;khhs wOHdmk hj'r!fi!LH .f aKfqns; óg oYl H L ! i f h Y x d h ¾ d l k m d H O w H L ! i f g ú k j o w S ; d m I a l hn qu ks,Odßkaf.a mßmd,k YlH;djfhkam uq ,aqild,fha fi!LH lsysmhlg a;fgh =lhfrjIalHOw rdp%m dy kmdHOw ahfYxH;duw qKm qyT 'sljn fmr wfma "aka erjHojff "Hojffomd¾;fïka f l,dY dc%m "Ho; jf=ffõluyck shdl dc%m fi!LH'shwxYfha of a;yfnl= f vd tallhla uHl wOHdmk .ï okõj,g j¿=;ew akßdO,sk kmjYfhka dHOw HL!il% f sh "akd;a erj ojfjQf wfma ;ako fi!LH 'shof dn , a;kakt fiajdj SoõfúfYa xi jqiIjd;kc ;l% úak slqK h,Qj vaK h¾dfliaKwo ¾Qm we;s ;;a s;ek siejm;aj ;sfí' ñuli osakh lauTia ;s, ajslhg t<efUk gjn alhk;hdw kofrW glrjyfuf ,dYú ïfÍsl e. ula;.oej ïfSke.dk; alhs,slsiej g,j a,j.f fi!LH mÍlaIljrfhl= khgf;a osia;%sla fi!LH oskhla fjhs.'adrfdw "HL!ifuyck a,eidm "HL!if dc%m 'ífs; ja;m âadnfáakei kt Sirei akslhdnl ,sk sldl 'shof dhsl ta zziekaqK áqyfnda âSh.ew dy KwOHdmk qm "ï Iahf¾m "kta mdl HOl w Hl% Lsh !id;a f du ,dl YH ùu" iyldrakfwOHla akrl ;I .jrfhl= er=;kgfej ßs|ew ksot dh;a;yu HL!if.ug akua;j ;úakhg;g ui aksljwdh;kh dkK. Yxw Som;a dw 'ù ''ïu" Íslf,dal fi!LH akhsiejixúOdkfha ï. oaljdr.`i ZZ;meizz ahf,ñdkf 'hïf. uy;a;hdZZ vúsKm HL!if Oúú dyry HOdu hYxdh¾dl kmdHOw aiofmW jqi dkáj adyfdnf syt r;w kßydonf r;w wdOdr hgf;a ld¾hdxYhla njg m;a ù u jYfhka meñfKk os k hhs ' lua;dhs%l j|nsk akygivej SIAYfúqi d,syhfkoAkfskxi 'h;.¾;akw wdh;ksl fjkialï is'shÿrlfj;aoS ta yd iu.dój ck;dj iekaáfndaâ amd%m g+l k aifgjoúh' gjd,jf kt k.fàej ßs|ew ? oeKQj;a lsÍfï jevigykao jeä oshhs;qK Q jka uy;a;hdg .fï " k c ¾ ; H L ! i f k j f = ; u , l a k s , l " . a d r f k j d k f a d n f 'shKfñem ;snqfKa f.!rjh S|eni dy llat ;sIaYfú uakuf d;HYjw kS,dl Oúú 'shjakmf alhám%;Ñ ;u alhrs; ÿqi k,a,w glhs;a;ì jk ld¾hdxYh uqiq nh mla h¾I dlmd;S "uSohf ,jwo akyg iveúg j ïffi!LH Ísl a;jQKwOHdmk eo Oúú ahfs<ymfi!LH s<t 'hqiaiskñ a;mamÿ akfakdm ï=lú ahfrs; kja;j m dy|i akSoõfwud;HxYfha HOdu "ïÍsl QKqyqm dy|i ,vaK wOHdmk ydu m%pdr wOHla a.fqyT I 'hjrfhl= ïr; alhUhgf;a n Kqyqu a.fdjero krl ym<u njls' Tyq mKq vw í' jf er=;rd;m% fc HLd !ldhs if ZZh ijqizz "k%;m% akc uï du%m l;wffjoHjreka aljfqKm kgfe"j d. ßsi ßsi akhfLquadOfw lßeffjoH" d iYd,lhKffjoH" fnfy;ahúfohs Sodw jdjaif vúsKm amshlai "k:lrÿ IaYfú uakuf ZZ'''ke. erduw qKmzz akfakrl a;mßsob at ''''shjf ;YffjoHjreka fi!LH we;= jsi <l qiqu aiofmW dkáj tkak;a ,nd kmdHfohs Ow H'L!if aioka faiT xw ;DlS.xdOúú" ak hfYj wOHdmk ZZKks W, e<Odßka elzz 'slh ám d¿ uk k úh; ixfõoS jeislHs,Ls !ke;s if ;jf jd;kcwOHdmk ÜmQ f¾ rK ïf ld¾h syhfkdwdh;khla uuKa ;¾jvh,hls Yxdhms¾< dl kpck;dj dmiudc.; "ke. hiq ;j .ls xi dhßa,feu QKqjaks|ey akjfqkh sna iuka |j woyila Íjugh' fi!LH 'wdh;khla õld¾hdxYfha f hSkixY%mls d|j ia;úYd, Wwoyila Krwo o fufyjrlg gfi!LH u Sodn, uwOHdmk QKls eoÍugh' alh s,slsihkq ej 'f''jka ke.njg ula;k.afojk ej ïfÍsl a;kakt'''ke. ld¾hdxYh ye|s Íysnfï Wrfok wdh;khla f.j,a j,g jeisls,shla ;kd.ekSfi!LH fï jeo.;a lu .ek msh < iudc.; wOHdmk akhfYoYlfha j Sodw ï'f'' k e. rfÜ l kh @ shew akfakj HYjw .sh 1950-60 fï f.!rjKS fi!LH h wOHdmk hkqmiq fjka ye|s kafjk ld¾hdxYfha m;aj ;sld¾hdxYh fí' wdh;kh m%cd fi!LH" mdie,a fi!LH" wdfrda .hKrdfi!LH lshd fohs' ldls ks, lndhlska ieriS tk iekaá fndaâwo Enei ";Kßm "r+Yh¾dl ghYxdh¾dl kmdHOw HL!if gkakrl erqy a;ßsi jqi a;myh gjd;kc ,lt wOHdmkfha iq y q U q , a wjia : dfõ m% n , fi!LH mKs ú v cd;s l fufyjr wdh;kh miq . s h 1950-60 oYlfha ' '' fï rfÜ fi!LH f.!rjKS h m¾fhaIakK uy;a;hd tosk we|sß jefgk;=re .; lrkafkalhßjIalHOw akhfHYd,d jksNw a;fi!LH qh akslualwOHdmk" eo Soõfxi jqi ßdlyd êwwe.hS HL!ifï,"lmq ty dyqK ryq ZZdh;a;yu âadnfáakeizz iqy qU dfõ nls ,si ú v 'ha;fa;.r cd;sl fufyjrjd;kc wOHdmkfha Ífi!LH ug a jQa iuka wdh;khhs 'l fi!LH faiToYl akhkls du kq,a;a wjia fwdoS dyf: dck.; uwxY f ïfm%.Kkdjls k á ja;muq,mKs Kyfi!LH %.wOHdmk jd;kc akhf.õf vúsKm akÿ Íjï''' k ú; j;a uhka .fïh' fkdñ,fha zziem;ZZ i`.rdjla o .ïjeishka aióg ck.; Íug óg oYl lssyy;smfhlg hvúsKm mls ïi jqi uqi, ,a fjQS,wdh;khhs SYKks du,¾Odßka sk a;' dfi!LH vfj.a;mßmd,k jfwOHdmkYlH;djfhka uq,a ld,fha i,ffi!LH akgÜer=l ¿dlf ,lt ld¾hdxYh udOH yryd úúO fi!LH mKs úvl.lhla w;r fnodyßk w;r tys fndfydalsjákd iqj Wmfoia , .aa wOHdmk ,xa i ysmhlg =fld,fha õ uyck fi!LH 'shu=;em ks a.fmr fmOdßka w wfma kakfh hmßmd,k djõf sleyYlH;djfhka gfomd¾;fïka uÍsl hkoõfuqsk; jS,fi!LH SYdh s%l g,jwxYfha akygivl= ejvïdftak f|ew ïªew s,ey/ej ixks okfhys ,d wxYfha iql%úshfYA I S vjevigyka d;a lj; jd;kc Qj s.dNyi wka;¾.;h' fomd¾;fïka ;=fõfkA uyck fi!LH l=l djQtawfma llhla fmr wfmaa gfi!LH r amfks wn gwOHdmk ú|j khl% alsh hfia ,dlu jYfhka d;au ja; dj .ï okõj,g kh we;s ZZgr d;;a ka;j Y¾m;a o HL jYfhka l%sh d;auIl' jQ wfmal%ñ fi!LH jdj .ï okõj,g lrhs l oshwOHdmk qKQjla Tiafia fia wo ;majl hg j!i;sffuí';GAIsYú ahfmd,lzz t<efUk úfYa 'hahfQj a,qu gkakof dn, gKrof al, hrodjr!.f oshfjhs qKQjla' Tiafia wouyck we;s ;;a ;ajhgmÍla m;aj ;sfí' t<efUk úfYa I;sh l%osñklhla ? we|sß jeàf.k tk fj,djg ojfia l+g m%dma fi!LH Iljrfhl= hgf;a osia;%sla fi!LH Üfr ïf akfakrl a;mßsob mw jdlú¾Qm ïf uyck fi!LH mÍlaIljrfhl= a;sh%sld;a a fi!LH oskhla fjhs' tall ul ta zzieka áfnda fndaâ fkdjkwOHdmk frda.hgf;a " l,s kosi a l%l, u;= jk fi!LH meñfKhs' kf jùu" alo aliyldr hja;lhwOHla do;¾ck" SIaYfIújrfhl= qi g;mïi jqi a.fjd;kc wOHdmk tall l%shd;aul ùu" iyldr wOHlaIjrfhl= ta zziekaáfndaâ

NOTE

is;ska .;ska mßirh iq/lSug odhl fjuq''' th mqkHl¾uhla njg m;a jkafka fufyuhs''' ksß; os. fudaiï iq<x il%Sh ùu;a iu. wfma fi!LH wxY ck;djg wjodkï yeÕùula ksl=;a lr ;sfí' ta fvx.= frda.h iïnkaOfhks' óg udi lsysmhlg fmr reÿre fõYfhka jHdma; jQ tfy;a NOTE miq.sh ld,fha lsishï miqnEulg ,laj ;snQ fvx.= frda.h kej;;a ysi tiùug mßirhla ks¾udKh ù we;ehs cd;sl fvx.= u¾Ok tallh wk;=re yÕjhs'

EDITOR'S EDITOR'S

idOl wmg md,kh l< fkdyels jQj;a wmg hï;dla yiqrejd,sh yels mdßißl idOl md,kh lsÍu ;ks mqoa.,hka jYfhka NOTEo" mjq,a tall jYfhkao" iuia; ck;dj jYfhkao wfma taldhk j.lSula jkafkah' fvx.= uÿrejka j¾Okh ùu je<elaùug Tng .; yels iq¿ fyda mshjrla ukqIH ixy;sfha osú .,jd .ekSfï uyd W;aidyhla njg m;a jkafka tf,ih'

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Go to subscription zzl,dmfha úYsIk AGuq;u fi!LH o¾Yl mj;a kd rgZZithk fï mQ¾úldj wm bosßm;a lrkafka fï rfÜ f.!rjdorh ,la forKg fokakour uq,latest a jQfhah'subscription offer. page ck;djf.a iqj iïm;g iqúfYaIS odhl;a jhla jto k see lrk n,j;a ;¾ckh yuq fõola,nd foa Y.=g K sl fï mQ¾úldj wm bosßm;a lrkafka fï rfÜ Bharata ck;djf.a iqj iïm;g iqúfYaIS odhl;a jhla olajGunathilaka k

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lrdmsáh YslaIK frdayf,a kj ms<sld m%;sldr tallhla ia:dms; lsÍu ioyd .súiqï w;aika flf¾ lrdmsáh YslaIK frdayf,a kj ms<sld m%;sldr tallhla ia:dms; lsÍfï wruq‚ka' Colours of Courage, National Health Development Fund yd fi!LH wud;HdxYh w;r wjfndaO;d .súiqula miq.shod w;aika lrkq ,enqjd' fï i|yd weußldkq fvd,¾ ñ,shk 5 l m%odkhla ,nd§ we;' ms<sld frda.h iu. igka lsÍu fjkqfjka 2011 j¾Ifha § wdrïN l< fuu jHdmD;sh ;=<ska f;,smamf,hs frdayf,ys ms<sld tallhla ia:dms; lrkq ,eîh' ta ioyd weußldkq fvd,¾ ñ,shk 2'6 la m%odkh l< w;r" 2014 § ia:dmkh l< fuu ms<sld frday,ska fï

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j.lSu frday,a wOHlaIjrhd ndr.; hq;=hs' j¾;udkfha lsisÿ T!IO ysÕhla keye' bkaÈhdfõ wkaød m%foaYfha ish¨u ck;djf.a f;dr;=re mß.Kl .; lr ;sfnkjd' tu mß.Kl .; lsÍu isÿ l< iud.u úiska Y%S ,xldfõ ñ,shk 21 la jk ck;djg B-fy,a;a ldâm; y÷kajd§ug fhdackd lr ;sfnkjd' tu fhdackdj,shg wkqj jHdmD;sh wdrïN l< Èk isg udi 04 la ;=< wm rfÜ ish¨u ck;djf.a fi!LH f;dr;=re we;=,;a B-fy,a;a ldâm; ksl=;a lsÍug iqodkï' tu.ska ffjoH m%;sldr lsßug úYd, myiqjla ,efnkjd'˜ fuu wjia:djg ksfhdacH wOHlaI ckrd,ajreka jk ir;a wuqKq.u" tia' iSorka" l=udr úl%uisxy iy frday,a wOHlaI wfia, .=Kj¾Ok uy;d we;=¨ úfYaI{ ffjoHjreka" ffjoHjreka" fmdÿrdcH uKav,Sh ffjoHjrekaf.a ix.ufha iNdm;s uydpd¾h jðr Èidkdhl uy;d we;=¨ úYd, msßila tlaj isáhy' jk úg;a 4500 la muK frda.Ska m%;sldr fiajdjka ,ndf.k we;' W;=f¾ isg ol=Kg lsf,daóg¾ 670 la wdjrKh lrñka 2016 j¾Ifha fkdjeïn¾ ui 2 Èk md.ukla ixúOdkh l< w;r" Bg 7000 l muK msßila iyNd.s úh' ta wkqj 250"000l mß;Hd.YS,Skaf.ka lrdmsáh ms<sld tallh ia:dms; lsÍu ioyd wjYH jQ fvd,¾ ñ,shk 5 l uqo, fidhd.kq ,eîh' lrdmsáh YslaIK frdayf,a kj ms<sld m%;sldr tallhla ia:dms; lsÍug wod,j wjfndaO;d .súiqu w;aika lrkq ,enqfõ wr,sh.y ukaÈrfha § jk w;r" fuu wjia:djg Colours of Courage yd National Health Development Fund ks,OdÍka iy fi!LH wud;HdxY ks,OdÍka tlaj isáhy' AUGUST 2018 | DOCTOR MAGAZINE

AUGUST 2018 | DOCTOR MAGAZINE

doctormagazine.lk

Hair Loss/Alopecia

ysifla ye,Su

wo ojfia ;dlaIKfha wkqyiska fldkafâ hkjdg fndfyda id¾:l m%;sldr ;sfnk nj okakjdo@ 12

AUGUST 2018 | DOCTOR MAGAZINE

ifï frda. úfYaI{ ffjoH fk¨ï úl%uisxy úisks doctormagazine.lk

ifla ye,Su fkdfy;a fldkafâ hdu .ek wo jeä fofkla l;dny lrkjd' msßñka w;f¾ iq,n''' tfy;a ldka;djka w;f¾o olakg ,efnk" fï fldKavh ye,Su .ek oek.kakg l=yq,la we;s fldhs ldg;a fï ,smsh m%fhdackj;a jkq we;s'

Tn okakjd we;eï i;=kaf.a iu jid we;s f,dï ld,hlg uq¿ukskau mdfya yef,kjd' udkjhka jk wmg tjka wlr;eínla jkafka kE' wfma ysfiys we;s flia úúO woshr j, mej;Su;a ^fï .ek wm ó<Õg idlÉPd lrkjd& jefgk flia j,g iudk flia. ia m%udKhla kej;;a ysialnf,a jefjk ksid;a iuia;hla f,i .;a l< ksfrda.S ysil flia .ia m%udKh ksh;hlaj mj;skjd'

flia .il cSjk woshr

wfma fldkavh iuia;hla f,i .;af;d;a tys m%udKh iEu l,aySu fjkila jkafka kE' thg fya;= jkafka ;sfnk fldkavh ye,Sula fkdùu fkdfjhs' idudkHfhka ´kEu mqoa.,fhl=f.a fldkavfha flia .ia 100-150la oskla we;=<; yef,kjd' ta;a th ie<lsh hq;= .eg¿jla fkdjkafka flia .ila yef,k úg w¿f;ka flia .ila tl;= jk ksihs'

wfma fldkavfha we;s flia .il meje;au .;af;d;a th woshr ;=klska úia;r lrkak mq¿jks'

Anagen wÈhr

jir 2-8l ld,hla uq¿,af,a mj;sk

idudkHfhka ´kEu mqoa.,fhl=f.a fldkavfha flia .ia 100-150la oskla we;=<; yef,kjd' ta;a th ie<lsh hq;= .eg¿jla fkdjkafka flia .ila yef,k úg w¿f;ka flia .ila tl;= jk ksihs'

doctormagazine.lk

AUGUST 2018 | DOCTOR MAGAZINE

j¾OkSh woshr fuhhs' flia .ila .; lrk oS¾>;u woshr jk fï Anagen woshr fï wkQj flia .fiys j¾OkSh woshr f,io y÷kajd fokak mq¿jks'

Catagen wÈhr

fuh jefjkafk;a ke;s" yef,kafk;a ke;s úfõlS woshrla' idudkHfhka udi 2-3lg jvd fï woshfrys flia .ila mj;skafka kE'

Telogen wÈhr

flia .il wjidkh fkdfyd;a iudma;sh iksgqyka lrk fï flia .i yef,k ld,h;a udi 4-6lg jvd w,a,kafka kE' wm uq,ska i|yka l<d ysil fï ish¿u woshr j, mj;akd flia .ia mj;sk nj' ysil we;s flia .ia j,ska idudkHfhka ishhg 85lau wh;a jkafka

flia .il cSjk woshr Anagen woshrg' wfkl=;a woshr foflau tkï úfõlS wjosfha mj;sk flia .ia yd yef,k woshf¾ mj;sk flia .ia hk foj¾.hu iuia; flia .ykfhka ishhg 15lg jeä jkafka kE'

Tfí flia yef,kjd muKg jeäo@ idudkHfhka ysfia we;s flia .ia 150 muK olajd jeàu idudkH ;;a;ajhla nj wm mejiQjd' hï flfklaf.a yef,k flia .ia m%udKh Bg jeähs kï th frda.hla' th flia ye,Sfï iqúfYAIS ;;a;ajhla f,i fidhd n,kakg isÿ fjkjd'

flia ;=kS ùu;a flia .ia ye,Sug iudk .eg¿jla flia jeàu jf.au flia ;=kS ùu;a we;eï úg

ysil we;s flia .ia j,ska idudkHfhka ishhg 85lau wh;a jkafka Anagen woshrg' tkï tajd j¾Okh fjñka mj;sk flia.ia' 14

AUGUST 2018 | DOCTOR MAGAZINE

flia .ila jefvk wdldrh doctormagazine.lk

flia ye,Sfï frda. fha ,laIKhla' ;=kS jQ flia ysil flia .ykh wvq lrkjd' tfiau flia .i ;=kS jkakg;a flia .i jefgk frda. ;;a;aju n,mj;ajkjd'

flia .ia jefgk''' flia .ia ;=kS jk fya;= mrïmrdfjka tk flia ye,Sfï frda.h we;efulag fï flia ye,Su mjq,a iïNjhla f,i odhdo fjkjd' mshdf.a md¾Yajfha fyda ujf.a md¾Yajfha jqK;a fufyu wdfrg flia yef,k ;=kS jk {d;Ska isákjd kï Tng;a tfia jkakg bvla ;sfnkjd' .eyekq msßñ fldhs ldg;a fmdÿ wdfrg flia .ia ye,Su úoHd;aulj Androgenetic Alopecia hkqfjka ye|skafjkjd' jpkd¾:fhkau fuhg fydafudak ^wekav%ck& j, lsishï n,mEula

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flia .ia ye,Su i|yd isÿ lrk úfYaI mÍlaId we;s nj yeÕ=k;a fï ;;a;ajfhaoS wekav%ck fydafudak mÍlaId lr ne,SfïoS tys widudkH;djhla fndfyda wjia:d j,oS jd¾;d jkafka kE' wekav%ck fydafudak jeä jk iq,n wjia:djla ;sfnkjd' ta ;uhs we;eï ldka;djkaf.a äïnfldaI j, ìì,s we;s jk Polycystic Ovary Syndrome (PCOS) frda.h' wfkla whf.a fydafudak idudkH f,i fndfyda ÿrg jd¾;d lrkjd' tfy;a fldkafv yef,kjd'

ys;g oefkk wdfõ.lr yd wd;;suh ;;a;aj ksid;a fldkavh yef,kak mq¿jka úNd.hlg hk úg" ie;alulg Ndckh jkakg bkak úg" lsishï ixfõoS .eg¿jla ksid ys;

AUGUST 2018 | DOCTOR MAGAZINE

ófidf;rms m%;sldrh f;daka;=jdfjka bkak wjia:d j,oS tys m%;sM<hla f,io hï ld,hla" udi ;=kla muK hk úg fldkavh yef,kak mq¿jks' ;o WK ksid;a udi ;=kla muK hk úg fldkavh yef,kjd' we;eï fvx.= frda.Ska flfrka fï ;;a;ajh olskak mq¿jka' ;j;a wh vhÜ lrkjd' Crash Diating ksid;a" ta jf.au .¾NKS;djh ksid;a fï wdldrfha fldkaavh ye,Sula fjkak mq¿jka' ljr hï fyda fida ,;ejq,a''' ixld oekSu;a fldkavh hdu;a w;r ióm iïnkaO;djhla y÷kdf.k ;sfhkjd' fï wdldrfhka wd;;suh ;;a;ajhla

flia jeàu jf.au flia ;=kS ùu;a fï flia ye,Sfï frda.fha ,laIKhla' ;=kS jQ flia ysil flia .ykh wvq lrkjd' tfiau flia .i ;=kS jkakg;a flia .i jefgk frda. ;;a;aju n,mj;ajkjd'

ksid we;sjk ysifla ye,Su idudkHfhka udi 3-6l ld,hloS kej; yßhkjd' mdol fya;=j bj;a ùu;a iu.u flia.i kej; m%lD;su;a ùu Bg fya;=jhs' we;eï wjia:d j,oS l,d;=rlska tfia fkdjk wjia:d we;s ùug lreKQ folla n,mdkjd' Bg fya;=j ksielfhkau yªkd fkd.;a úg thg ms<shï fhoSula isÿ jkafka kE' wfkla ldrKh ;uhs we;eï wd;;suh fya;= os.ska os.gu n,.ekaùu' úNd.hla ksid wd;;shg m;aj isák orefjlag tla úNd.hlska miqj wd;;sh ixisf|kakg ;sfhk jljdkqfõoS ;j;a úNd.hlg uqyqK fokakg isÿ jqfKd;a wd;;sh iukh jkakg m%udKj;a ld,hla ,efnkafka kE' /lshdj ksid wd;;shg m;a whg;a /lshdj lrk ;=re udkisl mSvkhla we;s fjkjd' os. gu m%ia;=; idOl n,.ekafjkjd'

ysifla ye,Sug n,mdk fjk;a fya;=

Platelet Rich Plasma (PRP) m%;sldrh 16

AUGUST 2018 | DOCTOR MAGAZINE

• we;eï frda. ksid;a fldkavh yef,kak mq¿jka' ;hsfrdhsv .%kaÓfha widudkH;d" doctormagazine.lk

Platelet Rich Plasma (PRP) m%;sldrfhaoS kslafIamKh lrkafka fufyuhs Systemic Lupus Erythematosus, commonly called SLE frda.h Bg ksoiqka' • fmdaIK W!K;djhka' fjfiiskau hlv W!K;djh m%Odkhs' Tima reêrh ydks ùu ksid ldka;djka fuysoS úfYAI ie<ls,a,la oelaúh hq;=hs' • ysialnf,ys we;sjk frda.' ysiafidß yd fidrhsisia jeks frda. • we;eï T!IO' os.=ld,Skj .kakd we;eï T!IO ^Wod' iageáka& fukau .kq ,nk T!IOhl ud;%dj fjkia lsÍu ksid;a ysifla yef,kak bvla ;sfnkjd' • ksYaÑ;j fya;=jla i|yka lsÍu ÿIalr ùo fldkavh hdu olakg ,efnkjd'

frda.h y÷kd .ekSu

wd;;sh ksido@ mrïmrdfjka tk ;;a;ajhlao@ ke;akï lsishï fmdaIK wvq¨yqqvq;djhlao@ fï wdldrfhka frda. hg n,mj;ajk fya;=j ksYaph fldg''' iel fkdyer y÷kd.; hq;=hs' ta i|yd Tfí ffjoHjrhd uq,skau Tfí úia;r ,nd .kakjd' th iïmQ¾K úia;r .fõIKhla' bkamiqj frda.S mÍlaIdjla isÿ lrKQ ,nkjd' fuysoS p¾u frda. ffjoHjreka úiska isÿ lrk úfYAIS; mÍlaIK lsysmhlao wjYH;djh wkQj isÿ lrKQ ,nkjd'

Hair Pull Test fldkavfha fldgila weo, wrf.k isÿ lrKQ ,nk fuu mÍlaIKfhka frda.fha iajNdjh .ek lsishï ;lafiarejla ffjoHjrhdg isÿ l< yelshs'

ysifla ye,Sug ksYaÑ;j fya;=j yªkd .ekSu Bg m%;sldr lsÍfuys,d w;sYh jeo.;a lula orkjd'

•••

doctormagazine.lk

AUGUST 2018 | DOCTOR MAGAZINE

Trichoscope Examination fuh flia.i lsishï m%udKhlg úYd,kh lr mrSlaId lr ne,Sula' tu.ska frda. ksOdkh ksjerosj fidhd.ekSug msgqjy,la ,efnkjd'

Scalp Biopsy fuysoS mgl fldgila iQrdf.k thg idhï .,ajd ridhkd.drfhaoS wkaùlaISh mÍlaIKhlg ,la lrkjd'

reêr mrSlaIK fmdaIK W!K;d" fydafudakuh fjkialï ms<Sn|j úuish hq;= jk l,ayS Bg wod, reêr mÍlaIK isÿ lrkjd'

ysifla hdug isÿ lrk m%;sldr frda. ksOdkh ksYaÑ;j y÷kd.;a miq m%;sldr l%shdj,sh myiqhs'

wfkl=;a n,.ekajQ idOl bj;a lrk m%;sldr • wys;lr f,i n,mdk idOl ;sfnkjd ku (Trigger Factors) tajd bj;a lsÍug Wmfoia iemfhkjd' fldkavh hdug n,mdk fmd;=lnr" ysiafydß jeks frda. ;;a;ajhla fõ kï thg uq,ska m%;sldr lsÍfuka ysifla hdu bfíu u¾Okh fjkjd' • u;=msáka wdf,am lrk wdf,amk mx;s m%;sldro flia ye,Sug ;sfnkjd • uqL u.ska .kakd T!IO m%;sldr • úfYAI fydafudak m%;sldr

fldkafâ hkjdg lrk úfYaIs; m%;sldr Platelet Rich Plasma (PRP) m%;sldrh ;ukaf.au reêr ksheoshl we;s mÜáld fjka lrf.k th ysia ln,g kslafIamKh lsÍu PRP fkdfyd;a Platelet rich plasma (PRP) m%;sldrh f,i ye|skafjhs' fuysoS tu mÜáld j,u we;s j¾Ol idOl (Growth Factors) weiqre lrf.k ysiflia jeãug i,iajhs' fuh wdrlaIs; m%;sldrhls' ;ukaf.au reêrh Ndú;hg .kakd ksid ixl+,;d j,ska f;drh'

Mesotherapy mÜáld fjkqjg ridhkhla fhdod .kakd fuu m%;sldrho wo f,dalfha fnfyúka ckm%shh'

f,ai¾ m%;sldr

mrïmrdjg tk

fuysoS Low Level Laser Therapy Ndú;d flfrhs' fuhska Ñls;ail WoaoSmkhla ñi wka kmqrla isÿ fkdfjhs'

fuh iqj lrkakg neß jqK;a fldKAvh ;=kS jk''' ysifla yef,k fõ.h wvq lrk id¾:l ms<shï ;sfnkjd' tajdg fhduq jkak'

fldkafâ ye,Su i|yd kjH ;dlaIKhg fndfyda úi} qï we;af;ah' fï ksid fldkavh ye,Su Tn wiykhg m;a lrjk .eg¿jla njg m;aj ;sfí kï thska ñoS iykYS,S úiªulg wj;S¾K jSfï yelshdj Tngu we;af;ah'

Androgenetic Alopecia frda.h

AUGUST 2018 | DOCTOR MAGAZINE

doctormagazine.lk

PRP Therapy

The ultimate biological skin rejuvenation treatment

Proven treatment to repair and rejuvenate your skin at the cellular level with your own potent growth factors.

isÿ lrk Y,Huh fkdjk l%shdj,shls' • w;s kùk ;dlaIKh yd WmlrK weiqf¾ m%;sldrh isoq flfrhs'

ishhg ishhlau iajdNdúl maf,AÜ,Ü idr ma,iaud m%;sldrh

• Tfí wjYH;djhkag iß,k wdlD;shl m%;sldr l%uh ie,iqï flfrhs'

;ukaf.au reêr mÜáld.; ma,iaudj fhdodf.k lrk kslafIAmKh kùk f,dalfha jvdlau m%;sM<odhS iu iq/l=ï m%;sldr l%uhhs' ffi,Sh uÜgfukau Tfí iu mqk¾cSjkhg oekg we;s fyd|u m%;sldr udos,shls'

• fï l%uh b;d wdrlaIs;j" m%;sM<odhS f,i isÿ lsÍfï m,mqreoao wdh;khg we;'

PRP Therapy ldgo @ jhia.; ùfï ,laIK bj;a lr Tfí uqyqK" flia l<U oSma;su;aj osÿ,jhs' • ysifla ;=kS ùu je<elaùu • ysifla j¾Okh • iu /<s jeàu je<elaùug • iu meyem;a lr .ekSu fyaudia frday, m%;sldrh i|yd Tfí f;arSu úh hq;af;a wehs@ • m%ùK p¾u frda. úfYaI{ ffjoHjreka úiska m,mqreÿ fyo ld¾h uKav,hl iyNd.s;ajfhka

• Pú j¾Kh" oSma;sh iq/flk fia ifuys m%;Hia;;dj .=Kd;aulNdjh jeä oshqKQ lsÍu wNs,dYh lr.;a m%;sldr mx;shls' fyaudia frdayf,a wfma iy;slh''' • frda.S iqj fiajd wdrlaIKh iïnkaOfhka ,xldfõ m%:u cd;Hka;r m%ñ;slrKhg ,lajQ frday,l c.;a ;,fha /ljrKh' • b;d myiq f.ùï l%u iy wd¾Ól ÿIAlr;d j,g m%;sldrh .,md .ekSug fm!oa.,slj iydh ùug mqyqKq ld¾h uKav,hl fiajdj Call Us 0773456093 Hemas Hospital 389, Negambo Road, Waththala info@hemashospitals.com

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ks¾udxY wdydr muKla .kakd whgo losug .e,fmhs''' kjf,dal fyda,aäx.aia wkqnoaO iud. ula fukau Y%S ,xldjg FMCG iy fílß ksIAmdok fnodyeÍfï m%uqLfhl= jk BiaÜ fjiaÜ udláka iud.u úiska kj;u fjcsuhsÜ ksIAmdokh kej; jrla foaYSh fj<|fmd<g y÷kajd oS we;' fuu.ska Y%S ,dxflah mdßfNda.slhkg fn.d Öia ´iafÜ%,shd iud.u úiska ksIamdos; úgñka D iys; kj;u uqyqKQjrlska hq;a fjcsuhsÜ ri ú|Sug wjia:dj ,efnk nj tu iud.u i|yka lrhs' zzby< b,a¨ula iys; fjcsuhsÜ ksIamdokh foaYSh fj<|fmd<g bosßm;a lrkakg yelsùu ms<sn|j wm oeä i;=gg m;a fjkjd' b;d by< rihlska hq;= fuu ksIAmdokh

fïo rys; fjcsuhsÜ .a?ï 5l" le,ß 8'6la wka;¾.; jk w;r ffokslj ,nd.; hq;= ;hñka" ksheiska" iy f*da,sla wï,ho fuys wvx.=h' l%shdYS,S cSú;hlg u. mdok wu;r wdydr fõ,la i|yd Wfoa" oj,a wdydr j,g fyda flá lEulg fjcsuhsÜ ri tla/ia lr.; yelsh' ks¾udxY wdydr muKla .kakd whgo .e,fmk whqßka ksmojd we;s fjcsuhsÜ ksIamdokfha wka;¾.; wuqøjH oeä wdydr iqrlaIs;;d iy .=Kd;aul ;;a;ajhg wkq.; jk w;r ish¿ ffk;sl wjYH;do imqrd ;sfí' Y%S ,dxlsl mdßfNda.slhkg fuu ksIAmdokh m%uqL fmf<a iqmsß fj<|ie,a j,ska .a?ï 150" 220 yd 380 m%udK ;=klska oeka ñ,oS .; yel' BiaÜ fjiaÜ udláka iud.u Y%S ,dxlslhkaf.a wjOdkh yd wdorh oskd.;a g¾ls ikakduh" fn.d iy w,aurdhs Öia" m<;=re îu iy ie*a BiaÜ wdoS cd;Hka;r m%ñ;sfhka hq;a m%KS; iy .=Kd;aul ksIamdok fj<|fmd<g yªkajd oS we;'

Othello Syndrome

ielh wm ldg ldg;a we;s úh yels ufkda Ndjhls' th idudkHfhka frda. hla fkdfõ' wms fufyu ys;uq' áhqIka hk Tfí orejd f.or tkakg kshñ; iji yhg' ta;a tkafk wgg' fufyu jqKdu uõmshka jk Tng ìh;a ielh;a hk folu we;s fjkjd'

u;ameka iy ielh

kgkak" isxÿ lshkak''' cSú;h ú|skak u;ameka wjYH kE' tajd ke;sj we;af;kau cSú;h jvd;a iqkaorhs' ta;a we;euqka u;amekg f,d,a ù ;u cSú;h;a" l=gqïnh;a úkdY lr .ekSu ljr kï wNd.Hhlao@ doctormagazine.lk

wms fufyu;a ys;uq' wUqieñhka .;a úg ieñhd idudkHfhka ksfjig f.dv fjkafk iji yhg''' kuq;a ? wgg f.or wdfjd;a Tng lsishï ielhla we;s fjkak mq¿jka' fufyu fj,djg weh Tyqf.ka úuiSula lrkafk kqyqrg' wjidkfha fmdä nyska nia ùula jqK;a fjkak fï isoaêh iEfykjd' jeäÿr fkdhk fï úosfya onr wUQieñhka w;f¾ idudkH foaj,a'

AUGUST 2018 | DOCTOR MAGAZINE

lsßn;af.dv uQ,sl frdayf,a ufkda frda. ffjoH kkao l=udrkdhl

udkisl frda.hla ksid;a ielh we;s fjkak mq¿jk'' ielh we;eï úg udkisl frda.hl ,laIKhla jk wjia:d;a ;sfhkjd' Nskafkdakaudoh" oaùO%ej frda.h" we;eï fm!reI Nskak;d fuhg ksoiqka' ta;a fï ielhg ksYAÑ;j fya;=jla fidhdf.k kE' m¾fhaIlhka isÿ lrk ,o tla wOHhkhlg wkQj u;amekg weíneys jQjkaf.ka jeä fofkla ielh kue;s udkisl frda. fha jy¨ka njg m;aj we;s nj y÷kdf.k ;sfnkjd'

ielhg n,mdk fydafudakuh l%shdldß;ajhla''' os.gu mqreoaola jYfhka u;ameka .kakd flfkl=g ,sx.sl ÿn,;d we;s fjkak mq¿jka' ,sx.sl Yla;sh we;s lrk fgiagiagfrdaka fydafudakh YÍrh ;=< ksmoùu wvq fjkak mq¿jka' we;eï úg ,sx.sl Yla;sh wvq jqKdu th ;u iyldrsh fj; we;s lr.kakd ks¾oh ielhla f,i;a m%lg fjkak bv ;sfhkjd' flfkl=f.a wlaudj ;=< ,smsv ;ekam;a ù l%ufhka th wl%Sh Ndjhg m;a fjkak;a mq¿jks' wlaudj ÿ¾j, jQ úg wm YÍrfha jeämqr ksmojk Biag%cka fydafudakh ksishdldrj nys>%djh ùula isÿ jkafka;a kE' th YÍrh ;=< /f|kakg" tl;= jkakg n,kjd' Biag%cka jeämqr tl;= jk úg mqreI ,sx.sl Yla;sho wvq fjkjd' fufia 22

AUGUST 2018 | DOCTOR MAGAZINE

,sx.sl Yla;sh wvq jk úg;a ;ukaf. ielldßh foi ielfhka n,kakg we;eï msßñka fm<fUkjd'

l=uqÿf.a l;dj wms l=uqÿf.a l;djg fu;eka mgka weyqïlka fouq' l=uqÿ WmdêOdÍ .=rejßhla' weh fmardfoksh úYAj úoHd,fhA Wiia wOHdmkh ,eîfuka miqj l=reKE., m%foaYfha .=rejßhl fia m;aùula ,nkjd' wehg cSjka; yuq fjkafk hd¿fjlaf. újdy ux.,H W;aijhloS' cSjka; fm!oa.,sl wdh;khl úOdhl ks,Odßfhla' oek ye÷KQïlï u; jir foll wdor iïnkaO;djhla mj;ajd f.k wd l=uqÿ yd cSjka; wjidkfha újdm;a fjkjd' ta;a fï fofokdf.ka l=uqÿ wm yuqjkakg tkafka cSú;h tmd jQ ;eke;a;shl jYfhka' weh cSú;h ke;s lr.kak W;aidyhl ksr; jqK;a" blauKska frday,a.; lr kshñ; m%;sldr ie,iQ ksid wehg ;j;a cSj;a jkakg jdikdj ysñ jqKd' l=uqÿ wehf.a cSú; l;dj ud fj; m%ldY lf<A wehf.a ;;a;ajh hym;a lrKQ msKsi ud fj; l< fhduq lsÍul m%;sM<hla jYfhka' zzuf.a ieñhd yeuodu î, weú;a ud iu. rKavqirej,a lr .kakjd' thg fya;=j ud .ek we;s lr.kakd ielhla' ks;ru lshkafk ug fydr ñksfyla bkakjd lsh,hsZZ' zzfï <Õos f.or f,dl= m%Yakhla jqKd' uu .=rejßhla' uf.a mdif,a orefjla" Tyqf. jhi wjq' 15hs''' wfma wi,ajeisfhla jk fï orejd .Kka j.hla wy.kak f.or wdjd' tod uf.a yiankaâ f.or ysá ojila' Tyq fï orejj iïnkaO lrf.k ud .ek úYd, ielhla we;s lr .;a;d' Tyq ughs" orejghs fokakgu .eyqjd' doctormagazine.lk

fï isoaêh oeka .fu;a me;sß,d' ud W.kajk mdif,a úÿy,am;s;=ud;a udj f.kajd fï .ek m%Yak l<d' fï .ek ug úYd, ,ecacdjla we;s jqKd' fï ksid iudchg uqyqK fokak;a ,ecachs'ZZ

ielh' wef.a ieñhdf.a ielh we;s fjkak fya;= jqfKa ieñhdf.a krl mqreoaola jQ oskm;d u;ameka .ekSu' fï u;ameka .ekSfuka we;sjk udkisl frda.h Othello Syndrome hkqfjka ye|skafjkjd'

zzTng hd¿fjd keoao@ZZ zzuu biafldaf, hk ldf,;a" leïmia tflaos;a ug f.dvla hd¿fjd ysáhd' ta;a oeka kï ug ta tlu hd¿fjla j;a kE'uf.a ieñhd ud lsisu flfkla wdY%h lrkjdg leu;s kE' fldákau lshkj kï uf.a wïu ;d;a; n,kak j;a ug ;ksfhka hkak fokafk kE' Tyq iu. fldfya .sh;a uu hkafk ìu n,df.k' jeros,dj;a ug msßñfhla osyd nemqfkd;a ug todg fyd|gu .=áneg lkak fjkjd'ZZ

l=uqÿ wmg wd frda.sfhla' we;af;kau weh újdy cSú;fha reÿre ÿla fõokdjka ksid cSú;h .ek l,lsreKQ wirKshla' fï bysreKQ leoe,a, kej; tl;= lsÍu wmf.a wruqK jqKd' wm uq,skau W;aidy lf<A fï wNd.H iïmkak ;;a;ajhg mdol jQ cSjka;f.a u;ameka weíneysh k;r lsÍughs' uq,skau iEfyk W;aidyhla f.k l< W;aidyhka wid¾:l jqK;a wjidkfha osßfhka ù¾hfhka .;a W;aidyhka m%;sM< f.k ÿkakd'

zzTn fmdaka tlla mdúÉÑ lrkjdo@ ZZ zzkeye''' uf.a <Õ f*daka tlla kE' uf.a <Õ ;snqKQ f*daka y;rlau Tyq fmdf<dfj .y, l=vq l<d' f*daka tlla mdúÉÑhg .kak tl;a Tyqg ielhs' fï w;aoelSï tlal f*daka tlla ke;sju bkak tl weÕg .=Khs lsh, ysf;kjd'ZZ

cSjka; u;ameka j,ska uqojd .kakg zzúIdKQyrKhZZ kue;s m%;sldr l%shdj,sh wdrïN l<d' l=uqÿg udkisl wjmSvkhg ufkda úoHd;aul m%;sldr wdrïN l<d' fofokdu fldyqj, LIFE wdh;kfha WmfoaYKhg fhduq l<d'

zzTn ieñhd iu. ,sx.slj tl;= fjkjdo@ZZ zzoeka yqÕla wvqhs' Tyqf. ielh ksidu ug oeka Tyq wm%ikakhs' fldfydu;a ug oeka ,sx.sl wdidjka oefkkafk kE' cSú;h l,lsß, bkafk' cSú;h tmd fj,d bkafk' biair jf.a oeka ug jevla lrkak ysf;kafk;a kE' weÕg;a mkla kE' cSú;h ke;s jqKd kï fyd|hs lsh, ysf;kjd'ZZ fï l;dj wOHhkhg .ekSfïoS l=uqÿ udkisl wjmSvkh fkdfyd;a úIdohg f.dÿre ù we;ehs ks.ukh lrkak mq¿jka' frda.hg fya;=j wef.a ieñhd' ieñhdf.a wksh;

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cSjka;" ielh u;ameka ksid we;sjk udkisl frda.hla nj l%udKQl+,j f;areï .;a;d' udkisl wjmSvkhg m%;sldr .ekSu;a iu. l=uqÿg cSú;h iïnkaOfhka jQ l,lsÍu fjkia ù Okd;aul fjkila jqKd' kej;;a cSú;hg we¨ï lrkakg mgka .;a;d' fokak fouy,a,kaf. fkdfyd| fkdalalvq ixis|S leoe,a, wdorfhka msÍ .;a;d' oeka cSjka;-l=uqÿ ;u wdorKSh orejka iu.ska wdorKSh cSú;hla .; lrkjd' kgkak" isxÿ lshkak''' cSú;h ú|skak u;ameka wjYH kE' tajd ke;sj we;af;kau cSú;h jvd;a iqkaorhs' ,xldjg uq,skau u;ameka f.kdfj 1505oS wfma rg wdl%uKh l< AUGUST 2018 | DOCTOR MAGAZINE

mD;=.Siska' 1605oS mD;=.Siska mkakd wfma rg w,a, .;a; ,kafoaiska ;enEreï" f¾kaofmd< ixialD;sh jvd;a jHdma; l<d' tys l+gm%dma;sh igyka lf<A iqoaokag wfma rg hg;a jqKQ ldf,' tod fuod;=r wfma rfÜ u;ameka jHdma;sh tkak tkaku jeäjqKd' ta;a iu.u u;ameka yd ine|S ÿrdpdrhka" kS;sh lv lsÍï yd wysxilhka ;,d fm,Sï j, wvqjla jqfK kE' f,dal fi!LH ixúOdkfha ixLHdf,aLK j,g wkQj wfma rfÜ tla wfhla jirlg fndk u;ameka m%udKh ,Sgr 16'2la' fï whf.ka ishhg 55lau fndkafk fydr u;ameka" lismamq wdosh' .%dóh uÜgfï u;ameka ksIAmdokh yd fnodyeÍu lshkafka ixúOdkd;aul jHdmdrhla' tajdg m%dfoaYSh foaYmd,{hka fndfyda úg iïnkaOhs' fï rfÜ ÿisß;a j.d lrkak u;ameka yd u;aøjH úYd, msgqjy,la fjkjd' wjdikdj lshkafka ful, Tjqkaf.a m%Odk b,lalh njg wfma <ud mrmqr m;aj ;sîuhs' 24

u;ameka fndk ieñhd ;u ìß| .ek ksrka;rfhka ielfhka miqfjkjdo@ Tf;f,da iskafv%dï w.%.kH idys;HOr ú,shï fIalaiamsh¾f.a kdgH f,dal m%cdjf.a f.!rjdorhg md;% jQfha udkqIsl Ndj ksrEmkh lsÍug Tyq ;=< mej;S ksiÕ l=i,;djh ksihs' Tf;f,da úiska ;u iqkaor ìß| fviavfudakd ,df.da iu. wúkS; fm%au iïnkaOhla mj;ajkafka hhs iel lrñka wjidkfha weh urd oukafka fm%alaIlhka ixfõ.fhka m%lïmkhg m;a lrjñks' u;ameka î ;u wdorKSh ìß| iel lrk wjia:dj Tf;f,da kdglfha b;d ishqï f,i m%ldYKh jqKd' Pathological jealousy hkqfjka ffjoH úoHdkql+,j y÷kajk iqúfYAIS frda.h ÛTf;f,da iskafv%dï¶ f,i f,djl l;dnyg ,la jQfha tf,ihs' ;udf.a iyldßh wka ;eke;af;l= iu. ,sx.sl in|;djhla mj;ajkafka hhs mokï úrys;j iel lsÍu fï whf.a iajNdjhhs' we| we;sß,af,a /,a,la jQj fuhg bv i,ihs' os.ska os.g ìß|f.ka m%Yak lsÍu" wehg myr oSu" hg weªï| miqïìh wdosh mÍlaIdjg ,la lsÍuo msgia;r mqoa.,hka fhdojd T;a;= ne,Su" ryfia ieÕj n,d isàu fï whf.a iajNdjhhs' orejka mjd ;ukaf.a fkdjk njg iel lrhs' fï ksid oafõY iy.;j orejkag wvkaf;aÜgï lsÍug mjd fï wh oreKQ fõ' ;u lDr;ajh m%lg lrñka mdfmdÉpdrkh lrk f,ig n, lsÍu" we;eï úg ìß| >d;kh lrk msßñka mjd olakg ,efí' fï frda.h yd fud<fha fjkiaùï w;r iïnkaOhla y÷kdf.k ;sfí' u;ameka mdkh lsÍu iDcqju fï frda.h yd iïnkaOhla mj;S' ta yereKQ úg .xcd yd fjk;a u;aøjH Ndú;d lrk we;eï msßñkao fï frda.hg oeäj k;=j Tjqkaf.a wUqorejka wirKNdjhg m;aj isákq fmfka'

AUGUST 2018 | DOCTOR MAGAZINE

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iu. wo ojfia .kqfokqj • rEmjdysks • mß>kl ;sr • fudnhs,a ÿrl:k ;sr

AUGUST 2018 | DOCTOR MAGAZINE

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úoahq;a ;sr Ndú;h ksid we;sjk .eg¿

úoahq;a ;srhla mj;ajd .; hq;= m%Yia; ÿr wm tosfkod cSú;fha cx.u ÿrl:kh" rEmjdysksh" mß>klh''' fï wdoS jYfhka úúO wdldrfha úoahq;a ;sr Ndú;d lrkjd' ta;a fïjd wdrlaIs;j mßyrKh lrk ÿr iïnkaOfhka wjfndaOhla Tng ;sfnkjdo@ cx.u ÿrl:khla mßyrkh lsÍfïoS Tfí weig wähla j;a ÿrska tys uqyqK; ;sìh hq;=hs' mß>klhla" ,emafgdma tlla kï mßYs,kfhaoS tys ;srhg wä foll muK j;a ÿßka mß>klh mßYS,kh l< hq;=hs' rEmjdyskshla keröfïoS Tn Bg wä oyhl j;a ÿßka bkak tl ;uhs iqÿiq'

fld<U úYAj úoHd,fha ffjoH mSGfha fcHaIAG lÓldpd¾h úfYAI{ wlaIs ffjoH uOqjka;s osidkdhl

wo wfma cSú; yiqrejk fuj<ï f,i mß>klh" rEmjdksh fukau cx.u ÿrl:kh y÷kajd osh yelshs' fmdÿfõ fï ish,a, u;ska we;s lrk wlaIs fi!LH .eg¿jla fï ,smsfhka úia;r lrkjd''' doctormagazine.lk

mrs>klh bosßmsgoS iEu úgu ksjeros ia:dms;h mj;ajd .kakg W;aiql jkak' thska tng we;s úh yels .eg¿ rdYshla iukh lr .kakg wjia:dj Wod fjkjd

Watch https://youtu.be/4-FhQQBDPlk AUGUST 2018 | DOCTOR MAGAZINE

mß>klfha wdk;sh .ek ie<ls<su;a fjkak mß>klfha" rEm fmÜáfha ;srh wefya uÜgug jvd by<ska ;sîu iqÿiq kE' thska .eg¿ lsysmhla meK ke.sh yelshs' tlla ;uhs wefya wlaIs f.da,h p,kh lrk udxYfmaYs j,g úvdjla we;s ùu' wfkl" Wv n,df.k bkakg isÿ ùu ksid weismsh wdhdildÍ f,i újr lrf.k bkakg fï ksid isÿ jkak mq¿jks' fï ;srh ;sìh hq;= m%Yia; wdk;sh" wefya uÜgfï fyda Bg wxYl 15-20la weyeg my<ska msysàuhs' iEu úgu Tfí mß>klh" rEmjdysksh wefya uÜgug jvd my<ska by; wdk;sh imqrd,k fia msysgqjd .kak' thska Tfí weig úvdjla we;s fkdjk fyd|u ia:dms;h Tng ,efíú'

fmd;a lshjk úg fk;g we;sjk úvdjg jvd mß>klfhka jev lrk úg fk;g oefkk úvdj jeähs iïm%odhslj fmd;la lshjk úg wfma weia msydgq ;sfhkafk u| jYfhka jeys,d' weye t;rï msg;g n,k flfkl=g fmfkkafk;a ke;s ;rï' kuq;a mß>klh Ndú;d lsÍfïoS Bg jeä fldgila wei ksrdjrKh fjkjd' weye ´kEjg werf.k isàfuka wefya ;sfhk l÷¿ m%udKh;a jeäfhka jdIam fjkjd' fï l÷¿ ;uhs wei iafkaykh lrkafk' ta

mß.Klh bosßmsg bkak úg oDIAÀ fodaI we;s wh" ksjeros lKakdähla mdúÉÑhg yqre ùu;a jeo.;a' 28

AUGUST 2018 | DOCTOR MAGAZINE

Tiafia wei ksfrda.Su;aj ;nkafka''' wei ´kEjg jvd újr ùu ksid weig fï wdldrfhka lsishï jeä wd;;shl=;a we;s jkakg mq¿jks'

mß>klhla bosßmsg fï úosyg ksjerosj wiqka .kak mß>klhla Ndú;d lsÍfïoS Tfí weÕ bßhõ ksjerosj mj;ajd .; hq;=hs' ke;skï fï ia:dms; Tn blauKskau frda.S lrkjd' úoahq;a ;sr Ndú;d lsÍfïoS ksfrda.S nj m;d" hym;a fi!LH m;d th kerôh hq;= ksjeros ÿrla" mr;rhla ;sfhkjd' mß>klh bosßmsg isák úg mdofha l,jd yd oKysfika my< fldgi w;r wxYl 90l iDcqfldaKsl bßhõjla mj;ajd .; hq;=hs' tfiau msgfldkao yd mqgqj w;r;a iam¾Yhla mj;ajd .; hq;=hs' mß>Klhla bosßmsg isáh hq;= ksjeros bßhõ yd jeros bßhõ my; rEm j,ska oelafjkjd'

fmd;a lshjk ÿr wvq fjk Wmeia hqj,la me<|sh hq;= ldf,a''' idudkHfhka fmd;la lshùfïoS ksfrda.S flfkla fikaáóg¾ 25l muK mr;rhla ;shdf.k ;uhs th lshjkafka' yenehs flfkla jhig hk úg fï fmd; ;rula wdikakhg f.k lshjkjd' fuysoS isÿjkafka wmg fmfkk <Õu ia:dkh lsishï m%udKhlska wE;g hduhs' jhia.; ùfïoS we;sjk fï ;;a;ajh ;uhs wm zzy;,sia we|sßhZZ (Presbiopia) hkqfjka y÷kajkafka' fï wei jhi;a iu.ska ÿ¾j, jk wjia:dfõoS wm Wmeia me<|sh hq;=hs' tfia lsÍfuka wf;a ;ndf.k n,k idudkH doctormagazine.lk

mr;rfhka wmg fmd;a n,kakg wjia:dj kej; Wod fjkjd'

jhia.; jk úg y;,sia we|sßh we;s jkafka fldfyduo@ yß úosyg wdf,dalh .uka lrkak kï wefia u;=msg f;;a iajNdjhla .; hq;=hs' leurdjlska PdhdrEmhla .ekSfïoS kï tys kdNsÿr fjkia lr .ekSfï Wml%uhla ;sfnkjd' ta jf.auhs" leurdjg .=re jQ wefiys l%shdldß;ajh ne¨jdu fï meyeos,s lrk ld¾hh isÿ lrkafka wefya ldpfha >klu fjkia lr .ekSfuka' fï >klu fjkia lr .ekSfuka ÿr ;sfhk jia;= jf.au <Õ ;sfhk jia;=;a lsishï mrdihla ;=< wmg olskak mq¿jka' fï ld¾hh bgq lrkakg WmldÍ jkafka wefia ;sfnk m%;sfhdacl fmaYs' <Õ we;s fohla n,kak kï wmsg idudkHfhka m%;sfhdacl fmaYs ixfldapkh lrkakg isÿ fjkjd' we;euqka mß>kl wdY%s;j ;u uq¿ ld,hu /lshdj lrkjd' Tjqkag fuh úYd, wNsfhda.hla' os.=ld,Skj mß>klhla bosßmsg l%shd lrk wh fï ;;a;ajhg m%dfhda.slj uqyqK fokjd' wdikakfha we;s ;srh yd .kqfokqjl fhfoñka lshjk" h;=r mqjre yiqrejk whf.a m%;sfhdacl fmaYs ksrka;rfhka yl=¿jdf.k bkakg isÿùu ksid tla wjia:djloS Tjqkaf.a fmkSu fnd| ù hkakg mq¿jks' y;,sia we|sßfhaoS kï Wmeia hqj,la fkdme<|

isáfhd;a fjkafk ksrka;rfhka m%;sfhdacl fmaYs ixfldapkh lrf.k isàug isÿ ùuhs' we;af;kau fuhska m%;sfhdacl fmaYs fjfyig m;a fjkjd' úvdjg m;a fjkjd' ta ;;a;ajfhka ñfokakg ;uhs wm Wmeia hqj,la me<|sh hq;af;a'

mß>Kl weiqf¾ /lshd j, kshq;= oDIAÀ fodaI we;s whg Trifocal ldp iys; lKakdä jvd;a iqÿiqhs wjqreÿ y;,sy muK miq jqKdu we;sjk weia fmkSfï ÿ¾j,;djhg fhdod .;a; fyd|u úi÷u jqfKA Bifocal ldp iys; weia lKakdä' fuhska <Õu we;s foaj,a n,kak jf.au yd;ami n,kak iqÿiq ldp folla tlu Wmeia hqjf,a fhdod .;a;d' <Õ we;s foa n,kak Wmeia hqjf,a hg fldgi;a" yd;ami n,kak wjfYAI fldgi;a jYfhka'

biair Bifocal oeka Trifocal y;,sia we|sßfhaoS wefiys fmkSu wE;g hkafka fufyuhs doctormagazine.lk

kuq;a mß>Klh jeks kjH ;dlaIKsl WmlrK Ndú;dj iq,n jqKdg

AUGUST 2018 | DOCTOR MAGAZINE

Wmeia m<|sk fkdm<|sk fldhs ldg;a wefia we;sjk úvdjg l< hq;= foa

Tng .e,fmk ksjeros Wmeia ldph f;dard .ekSu;a yßu jeo.;a' Trifocal ldp iys; Wmeia hqj,la u.ska <Õ" uOH m%udK yd wE; we;s jia;=ka oel n,d .ekSug WmldÍ jk wdldrh ksÍlaIKh lrkak miafi <Õu we;s foaj,a jf.au uOHia: ÿrl we;s jia;=;a lKakdäfhka uekúka olskak wmg wjYH jqKd' fï wjYH;djh imqrd,kak ;uhs Trifocal Wmeia hqj, y÷kajd ÿkafka' fuysoS fhdod.kafka Verifocal lshk iqúfYaIS ldp j¾.hhs' fï kj Wmeia hqj, j,g ÿr" ueo yd w. hk fï ish,a,u uekúka o¾YKh ùfï ;dlaIKsl yelshdjla ;sfnkjd' fï ksid mß>kl weiqf¾ lghq;= lrk whg fï Verifocal ldp j,ska iukaú; Wmeia hqj,la Ndú;hg .kak tl iqÿiqhs' mß.Klh bosßmsg bkak úg oDIAÀ fodaI we;s wh" ksjeros l os.= fõ,djla úoahq;a ;sr bosßmsg isák úg iafjÉPh" l=Ks;h hk fldgia j, lsishï úh<Sula we;s fjkjd' fuhska wei u; lsishï mSvdjla we;s fjkjd' Kakdähla mdúÉÑhg yqre ùu;a jeo.;a' 30

AUGUST 2018 | DOCTOR MAGAZINE

os.= ld,hla mß>Klh" rEmfmÜáh jeks úoahq;a ;sr foi n,d isàu t;rï fyd| kE' thska m%;sfhdacl fmaYska úvdjg m;ajkjd' rEmjdyskS jeks úfkdao udOH j,g kï jdrK wmgu fhdod .kak mq¿jks' ta;a mß>kl iu. /lshdj lrk wh jf.a Woúhg Bg jvd idOdrK úiªula wjYHhs' ta iïnkaOfhka ;uhs B<Õg wm l;d lrkafka'

mß>kl wdY%s;j /lshd lrk whg msysgg tk 20-20-20 kS;sh yeu úkdä úiailg jrla wä 20la ÿr ;sfhk jia;=jla foi ;;amr 20la fj,d n,d isákak' ta fj,dfõ fyd|ska weia ms,a,ï .eiSu''' jqjuKdfjkau weia ms,a,ï .eiSu l%shd;aul lrkak ´ks' ta yereKQ úg fï kS;shg ine|S ;j;a fldgila ;sfnkjd' ta ;uhs" iq¿ fj,djla W;aidyfhka weia ms,a,ï .eiSu' fï ld¾hhka foflka uQ,slj <Õ we;s foaj,a os.= ld,hla ;siafia n,d isàfuka úvdjg m;ajQ m%;sfhdacl fmaYska bys,a lr.kak" ksoyia lr.kak lsishï wjia:djla ie,fikjd'

weys ms,a,fï fï jákd l%shdj,sh .ek Tn oek isáhdo@ idudkHfhka wms úkdählg 15-20 jrla muK weia ms,a,ï .ik tl doctormagazine.lk

l<;a" lsishï ld¾hhlg fhduq jqKdu fï weia ms,a,ï .eiSu fkdoeKqj;aju wvq fjkjd' fï úosyg wdhdifhka weia ms,a,ï .eiSfïoS iafjÉPh f;ó hk fia" weia msydgqj Wäka f.k taula fuhska isÿ fjkjd' fï úosyg .shdu ;uhs Dry Eye lshk ;;a;ajh we;s jkafka' fï ksid weia ms,a,ï wdhdifhka .id wefya úvdj ixis÷ùug l%shd lsÍu;a yßu jeo.;a'

l÷¿ ksIamdokfhys,d wefia ieleiau

wefya l÷¿ .,k ;ek wefya l÷¿ .,k ;ek ;sfnkafka Wvq weia msydgqfõ lk me;a;g fjkakg uq,af,a' m%Kd,''' ke;akï" b;d l=vd kd, rdYshl l%shdldß;ajfhka ;uhs wefia l÷¿ .%kaÓ l%shd;aul fjkafka' l÷¿ .,kafka iakdhq W;af;ackfha m%;sM<hla jYfhka' ÿlla" ìhla oeKQku fï W;af;ackh il%Sh fjkjd' ta yereKQ úg ndysßka lsishï wd.ka;=l øjHhla jegqKu" weyeg frdâvla .shdu m%;Sl pdmhla l%shd;aul ùfuka l÷¿ .,kjd' fk;= w. Wkk l÷¿ weye isidrd .uka lrkafka weia msydgq l%shdldß;ajfhka' tajd kej;;a tl;= lr.kafka kdifha uq, we;s kd,hlska kdifha msgqmi fldgig ;uhs wjidkfha fï l÷¿ tl;= jkafka'

orejkag úoahq;a ;sr Ndú;hg iSud we;s l< hq;=hs úoahq;a ;sr kùk ;dlaIKha m%;sM<hla' wo fï ;dlaIKfhka f,dalh jvd;a myiq ;ekla ù ;sfnkjd' yeu foalu fyd| jf.au krl me;a;l=;a doctormagazine.lk

;sfhkjd' fï úoahq;a ;sr ksid we;sjk wksgq m%;sM<o rdYshla ;sfnkjd' ta .ek idlÉPd lrkak fï fj,dj fkdfjhs' ta;a iudma;s igyk jYfhka tla Wmfoila fokakï' orejka fïjdg jqjuKd m%udKhg jvd fhduq lrjkak tmd' thska isÿjk wksIAG m%;súmdl rdYshla ;sfhkjd' fï ksid wjYHfhkau osh hq;= wjia:dfõ ñila ks;r ks;r mß.Kl" rEmjdyskS yd cx.u ÿrl;k Ndú;hg orejka fhduq lrkak tmd' ojilg Wmßuj mß>klh" rEmjdysksh fï ish,a, meh 2lg jvd mßyrKh lrkakg Tfí orejdg bv i,ikak tmd' th Tfí orejdf.a hym;g .; yels mshjrla' wjqreÿ folg wvq orejkag kï fïjd lsisfia;a Ndú;d lrkak fokak tmd fïjdg orejd wiSudka;slj fhduq ùfuka miq ld,fhaoS orejdf.a ÿr ne,Sfï Yla;sh wvq fjk njg (Myopia) kue;s fmkSfï fodaIh we;s jk njg m¾fhaIK j,ska fy<sorõ ù ;sfnkjd' •••

AUGUST 2018 | DOCTOR MAGAZINE

CRITICAL CARE in Sri Lanka

the past, present & future

By Prof. Vasanthi Pinto

Dr Bimal Kudavidanage

AUGUST 2018 | DOCTOR MAGAZINE

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A major milestone in medical history in Sri Lanka will be celebrated on June 15, marking the inauguration of the first Intensive Care Unit (ICU) at the Colombo General Hospital back in 1968, spearheaded by Consultant CardioThoracic Anaesthesiologist Dr Thistle Jayawardene. The second ICU was established in 1976 as the recovery unit, once again at the Colombo General Hospital to accommodate general surgical and medical patients, with the third ICU being set up at the Peradeniya Teaching Hospital in 1980. Most ICUs in the country function as semi-closed systems, with a lead specialist in-charge of ICU care Thereafter, from 1995, there followed many ICUs and the country now has 100 adult ICUs of Level 3 (with the ability to provide basic and advanced respiratory support and support for a minimum of two-organ systems). There are 36 such ICUs in the Western Province, 15 in the Central Province, 11 in the Southern Province, nine in the Northern Province, eight in the North Western Province, seven in the Eastern Province, five each in the North Central and Uva Provinces, and four in the Sabaragamuwa Province. The rapid establishment of ICUs followed the expansion and extension of medical services to the various provinces. During this period, anaesthesia emerged as doctormagazine.lk

a leading speciality in the country, with dedicated specialists manning the ICUs. Their responsibilities included administration, providing a 24-hour service seven days a week, including weekends and public holidays, advising the Health Ministry on the range of equipment required, leadership and training of Medical Officers (MOs) and paramedical personnel. The post-graduate curriculum prepared by the Board of Study in Anaesthesia, meanwhile, included an essential and comprehensive component of intensive care, the inclusion of which increased the range of skills and knowledge of the specialists in anaesthesia. Initially, general ICUs (43%) were established outside Colombo for multi-disciplinary care where the administration of the unit was by a consultant anaesthetist (95%). However, care was always shared by the admitting clinician and the anaesthetist, permitting a wide range of patients from different specialties to receive care. An increasing trend towards specialisation across all specialties resulted in the establishment of specialised ICUs to provide specific care for specific patient groups such as medical (14%), surgical (13%), maternal (5%), accident and emergency (5%) and other specialties (20%) such as cardiac, oncological and neurosurgical care. Most ICUs in the country function as semi-closed systems. In this model, AUGUST 2018 | DOCTOR MAGAZINE

a lead specialist is in-charge of ICU care, but the patient’s referring physician actively participates in this care and contributes to patient management, along with the ICU lead. Hence, the primary physician is not unheeded. In Sri Lanka, the lead specialists in the ICUs are anaesthetists (in nearly 83% of the ICUs). The extent of care provided to seriously ill patients within a hospital is reflected by the ratio of the hospital beds to ICU beds. At present, this value ranges from 76% in district general hospitals to 93% in hospitals which are dedicated to maternal patients. Internationally, the norm is to dedicate 10-40 beds per 1,000 patients. However, in Sri Lanka, this ratio ranges around 12. This could be attributed to the rapid increase of hospital beds in the past two decades. However, the increase in ICU beds did not occur concurrently, possibly due to financial constraints. Often considered more relevant to the degree of care is the ratio of the number of beds per 100,000 population, which displays the availability of specialised care and reflects the development of the speciality in the country. No standard requirement was agreed upon across countries. Sri Lanka has an average of 2.42 beds per 100,000 population. Internationally, available reports reveal a range from 1 to 30 ICU beds per 100,000 34

AUGUST 2018 | DOCTOR MAGAZINE

people. (United Kingdom — 3.36.6/100,000 and Germany — 24.029.2/100,000.) A detailed analysis in Sri Lanka revealed that in the most-populated Western Province (5.8 million), the beds per 100,000 were 3.27, in contrast to the least-populated Northern Province (nearly 1.1m) where there were 4 beds per 100,000. [Figures from across the country with regard to the number of beds per 100,000 population: Central Province (2.5m) -- 2.42 beds per 100,000; Southern Province (about 2.5m) -- 2.28; North Western Province (2.4m) -- 1.54; Sabaragamuwa Province (nearly 2m) -- 1.3; Eastern Province (about 1.6m) – 2; North Central Province (about 1.3m) -- 1.76; and Uva Province (about 1.3m) -- 1.61] There are 1,037 MOs serving as Senior House Officers in intensive care providing a patient to MO ratio of 3.30-4.24 in different categories of hospitals. The international recommendation is that the ICU residents/patient ratio should not exceed 1:8. The figure of 1:5 in Sri Lanka is indicative of an adequate level of care in the country. When considering the paramedical specialities involved in ICU care, 4.5 nurses per ICU bed indicate that in Sri Lanka, the minimum international target of 3 nurses per ICU bed has been exceeded with the provision of an extra quota of 50%.

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team during the assessment of ICU patients. However, this practice does not occur in Sri Lanka probably due to the inadequate number of trained pharmacists. There is also a general dearth of nutritionists in the country, thus the ICUs are often deprived of their specialised input. To ensure that services are internationally acceptable and recognised, there was a need to upgrade the equipment in ICUs, which was carried out under the guidance and advice of the College of Anaesthesiologists and Intensivists by the Health Ministry and other relevant authorities.

Dr Thistle Jayawardene pioneered in the inauguration of the first Intensive Care Unit (ICU) at the Colombo General Hospital in 1968.

Ideally, a minimum of 50% of registered nursing staff should have had post-registration training in critical care nursing. In 69% of the ICUs, the Nurse-in-Charge has been trained as recommended. However, the other nurses who have had training in ICU care is low (27%) and there is a necessity to improve these numbers. Despite a general shortage of physiotherapists, their availability for ICU patients appears to be adequate. With critical care pharmacy and pharmacist services being essential for ICUs, pharmacists should collaborate regularly with the clinical care doctormagazine.lk

Meanwhile, renal support is mandatory in an ICU and even though availability is satisfactory at the hospital level, improvements are needed in this area. The College of Anaesthesiologists & Intensivists has a dedicated structured programme for the training of specialists, MOs and other allied field professionals in intensive care. The postgraduate training in anaesthesia includes a 13-month period to provide the required knowledge, skills and attitudes to the trainees for Surgical and Medical ICUs and specialised ICUs. The MD examination conducted by the Postgraduate Institute of Medicine (PGIM) includes foreign examiners from the Royal College of Anaesthetists & Intensive Care, United Kingdom (UK).

AUGUST 2018 | DOCTOR MAGAZINE

Following success at the MD in Anesthesiology examination, trainees are required to undergo a period of advanced training in the general intensive care and specialised ICU care as Senior Registrars in Sri Lanka and overseas. Most of these trainees obtain the FRCA (Fellowship of the Royal College of Anaesthetists) or FCARCSI (the equivalent qualification from Ireland) from the UK and are board certified as specialists in anaesthesia with a special interest in intensive care. Under this programme, nearly 50 specialists have been board certified over the last few years. In 2013, with a need for specialists only in Intensive Care, the College of Anaesthesiologists and the PGIM’s Board of Study in Anaesthesia initiated a training programme, with senior registrars from post-MD Anaesthesia and General Medicine being recruited for a two-year training in Sri Lanka and a mandatory 36

one-year training in critical care in the UK. The Royal College of Intensivists, UK exempted the Sri Lankan post-graduate trainees from training in the Part 1 Fellowship of Critical Care Medicine (FCCM), an indication of the quality of training in Sri Lanka. They are board-certified as Specialists in Critical Care Medicine after obtaining the Fellowship. Currently, under this scheme, the PGIM has board-certified three Intensivists and more than 30 Senior Registrars. Meanwhile, since 2009, the College and the Board of Study provide facilities for senior grade MOs (as a training of non-specialist grade MOs) to qualify for a Diploma in Critical Care. These MOs are released by the Health Ministry for a year to undergo training and return to service on completion. The MOs affiliated to hospital ICUs are also trained in critical care by Consultant Anaesthetists, while the college conducts regular workshops and training sessions for MOs and postgraduates in critical care. Among the eight state medical faculties, Peradeniya has a Department of Anaesthesiology and Critical Care and Colombo and Ruhuna have separate departments. All these medical faculties have training in anaesthesia and critical care for the undergraduates. In the university system, there are two professors and 11 senior lecturers and lecturers. The curriculum for Allied Health Professionals also includes a mandatory period of teaching and training in intensive care. The college also participates in the training of nursing officers emphasising the multi-disciplinary concept of care. (Prof. Pinto is Professor of Anaesthesiology and Critical Care and Dr Kudavidanage is a Consultant in Anaesthesia with a special interest in critical care) •••

AUGUST 2018 | DOCTOR MAGAZINE

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ENT Procedures

yÈisfha we;sjk

Y%jKdndO iqj l< yelso@

lKg c,h we;=¿ ùfï m%;sM<hla jYfhka" bá" l<d÷re isr ùfuka fyda ueo lK ;=< mSvk fjkila we;sùu ksid Y%jK ;;a;ajfha fjkila we;súh yelshs' 38

AUGUST 2018 | DOCTOR MAGAZINE

W.=r lk kdih ms<sn|j úfYaI{ ffjoH iS;d l=udß wrfòfmd, úisks

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yosisfha we;sjk iakdhq ydkshla kï jydu m%;sldr l< hq;=hs' m%;sldr lsÍu wiSre kE' ta;a m%udo jQfjd;a thska whym;a m%;s<< w;a jkakg bv ;sfnkjd' wmg úúO wjia:d j,oS Y%jK ÿ¾j,;d" Y%jKdndO we;s úh yelshs' m%;sldrhla fkdue;sju jqK;a we;eï tajd iqj lr.; yelshs' we;eï wjia:d j,oS fïjdhska iqjh ,eîug ffjoHjrfhl=f.a iydh" m%;sldr .kakg isÿ fjkjd' ;j;a fldgilg m%;sldr .;a;;a fï we;sjk Y%jKdndO iqj lr .kakg fkdyels jk w;r tjeks wjia:d j,oS Y%jKh h:d ;;a;ajg m;a lr .kakg Y%jKdOdrl j, msysg m;kakg isÿ fjkjd' Y,Hl¾u j,g fhduq jkakg isÿ jk wh;a fï w;r bkakjd'

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zzksh fmd;af;ka lvkak ;sfhk foa fmdfrdfjka lmkak tmd'''ZZ lsh, l;djla wfma ck jyf¾ ;sfhkjd' fï l;dj tosfkod cSú;fhaoS wmg fl;rï m%fhdackj;a fjkjdo@ l¾K.;j we;sfjk we;eï iq¿ wdndO ;;a;aj ksjerosj y÷kd.;af;d;a fndfydu f,aisfhka tajd ixlS¾K frda.dndO njg m;aùfï wjodkfuka neyer jkakg mq¿jka' tfiau fï ix{d .ek j. úNd.hla ke;sj" .Kka fkdf.k isàfuka we;s úh yels ne?reï ;;a;aj;a ;sfnk nj Tn oek.; hq;=hs'

jhia.; ùu;a iu.u we;sjk .eg¿ fï ldKAvhg wh;a kE''' jhi;a iu. we;sjk l¾KdndO .ek fkdfjhs wm fï mjikafka' wm yefudau jhia.; jk úg wjfYaI bkaøsh jf.au lK;a úúO ÿ¾j,;djhkag m;a fjkjd' tfia fkdù yosisfha we;sjk fï ;;a;aj .ek kï Tn oeä fia úuis<su;a úh hq;=hs'

yosisfha tla lkl muKla weiSfï wvqjla oekSu fuh b;d blauKska ffjoHjrfhl= yuqùug isÿjk ;;a;ajhla' yosisfha we;sjk iakdhq ydkshla (Sudden sensori neural hearing loss -SSHL) ksid fujka ;;a;ajhla we;s úh yelshs' iakdhq ydkshg m%;sldr ;sfhkjd' ksis fj,djg ffjoHjrhd yuq jqfKd;a kùk m%;sldr ;sfhkjd' th tu m%;sl¾u

AUGUST 2018 | DOCTOR MAGAZINE

fhoSfuka myiqfjka h:d ;;a;ajhg m;a lr.; yelshs'

laIKslj we;sjk Y%jKdndOhla lKg c,h we;=¿ ùfï m%;sM<hla jYfhka" bá" l<d÷re isr ùfuka fyda ueo lK ;=< mSvk fjkila we;sùu ksid fï ;;a;ajh we;súh yelshs' fï wdldrfha weneoaoshla ksid Tng iaÓrj ydksjk ;;a;ajhla" Y%jKdndOhla we;s jkakg bvla kE' kuq;a yosis iakdhq ydkshla we;s ùu yd by; ;;a;ajh fjkalr y÷kd. ekSu b;du jeo.;a' tfia fkdlr l,a yeÍfuka fojkqj lS iakdhq ydkshla n,.ekaù ;snqfKd;a th frda.shdg wys;lr fia n,mdkakg mq¿jka' fï ksid laIKslj we;sjk Y%jKdndOhloS;a Tn ffjoHjrfhl=g ta iajNdjh fmkajd Tfí wdrlaIdj ;yjqre lr .ekSu kqjKg yqrehs' tysoS ffjoHjrhd úiska isÿlrk idhksl Y%jK mÍlaIK Tiafia Tfí iqrlaIs;;djhg mshjr .kakjd'

iakdhqjla wdmodjg m;ajQ úg we;sjk wk;=r Y%jKhg n,mj;ajk iakdhqjla ydkshg m;ajQ úg ffjri wdidok" nelaàßhd wdidok" Yíoh fyda wk;=rla fya;= fldgf.k we;sjk lïmk fud<h ;=< .eá;s" f.ä j, m%udKh fjkia ùu wdosh isÿúh yel'

Y%jKdndO j,oS isÿ lrk mÍlaIK we;eï úg Brain MRI

mÍlaIKh lsÍug kshu lrk w;r fuu m%;sìïn u.ska lK wNHka;rh uekúka mÍlaIdjg ,la lrñka ksjeros frda. úksYaphla lsÍug wjia:dj ie,fia'

AUGUST 2018 | DOCTOR MAGAZINE

uQ,sl wjia:dfõ ,nd .kakd idhksl b;sydih u; Y%jK mÍlaIKh mokï lrf.k laIKsl iakdhq ydkshla y÷kd.;fyd;a Bg m%;sldr jYfhka ,ndosh hq;= T!IO jÜfgdarejla wka;¾cd;sl ks¾Kdhl j, olajd ;sfí'

tkak;a u.ska lrk m%;sldr we;eï úg ffjoHjrhd úiska lka fnrh yryd ueo lKg tkak;la kslafIamKh lrkakg isÿjk wjia:do fõ' fuu tkak; ,ndoSug kshu jQ l,ayS ta iïnkaOfhka wksh; ìhla we;s lr.; hq;= fkdjk w;r m<mqreÿ ffjoHjrfhl= úiska kshñ; myiqlï we;s idhkhloS th b;d iqmßlaIdfjka ,ndfok w;r fuh oekg Ndú; b;d id¾:l m%;sl¾uhla njo i|yka lsÍug leue;af;ñ' wo ojfia kjH ffjoH Ys,amSh fufyhqï Tiafia fndfyda .eg¿ ksrdlrKh lr.ekSfï wjia:dj Tng ,eî ;sfí' ••• doctormagazine.lk

Mental Health

udkisl frda.hlg

fnfy;a mdúÉÑ lrk wh oek.; hq;= lreKq fyo ks,OdÍ ixch o is,ajd úisks BN (Malaysia), Dip. in Psychology (SL)

doctormagazine.lk

AUGUST 2018 | DOCTOR MAGAZINE

wo jk úg iEu udkisl frda.hlau fyd¢ka md,kh lsÍug yels T!IO wmg ;sfnkjd iqjhla oekqKq úg fnfy;a .ekSu k;r lrkak tmd udkisl frda. lshkafk;a wmg je<f|k Èhjeähdj" wê reêr mSvkh fyda yDohdndO jeks frda. jf.au ;j;a tla frda. ldKavhla' wfkl=;a wikSmj,§ wfma YÍrh frda.S fjkjd jf.a udkisl frda.hla je<÷kdu frda.S fjkafka wfma ukihs' wfkla wikSm j,g jf.au udkisl frda. j,g;a fnfy;a ;sfhkjd' fï fnfy;a ksis f,i mdúÉÑ lrkjd kï udkisl frda. fyd¢ka md,kh lrf.k idudkH Ôú;hla .;lrkak mq¨jka'

biair udkisl frda. j,g fnfy;a ;snqfKa kE''' udkisl frda. j,g ,ndfok fnfy;a .ek l;d lsÍfï§ tajdfha b;sydih .ek;a hula oek.ekSu jákjd' j¾I 1950g fmr udkisl frda. i|yd fnfy;a fkd;snqKq nj Tn okakjdo@ ta ld,fha hï flfkl=g Nskafkdakaudoh jeks nrm;, udkisl frda.hla je<÷k úg Tyqj fyda wehj udkisl frday,la fj; f.k f.dia Ôú; ld,hu tys r|jd ;eîuhs isÿjqfKa' ^w;S;fha mej;s tn÷ ia:dk ye¢kajQfha Asylum ke;fyd;a Wkau;a;ld.dr hk kñka' tajdfha isÿjqfKa frda.Skaj isrlr ;eîu muKhs' T!IO ke;s ksid iqjhla ,enqfKa;a keye' tu ksid fndfydauhla frda.Skag urKh f;la tu frday,aj,u isákakg isÿjqKd'

fjkila isÿ l< fidhd .ekSula kuq;a 1952 jif¾§ muK 42

AUGUST 2018 | DOCTOR MAGAZINE

Chlorpromazine kue;s T!IOh fidhd.ekSu;a iuÕ fï ;;a;ajh iïmQ¾Kfhkau fjkia jqKd' fuu T!IOfhka fndfyda frda.Skag iqjhla ,enqKq ksid Tjqkag kej; ish ksfjia lrd hdug o yels jqKd' miq ld,fha§ ;j;a T!IO fidhd.ekSu;a iuÕ udkisl frda.Skag hym;a ld,hla WodjqKd' wo jk úg iEu udkisl frda.hlau fyd¢ka md,kh lsÍug yels T!IO wmg ;sfnkjd' tu T!IO .ek Tng jeo.;a úh yels f;dr;=re iaj,amhla l;d lrkakhs fï iQodku'

udkisl frda.Ska i|yd ,nd fok T!IO ldKav

udkisl frda.Ska yd wmiaudr frda.Ska i|yd rEmfha oelafjk wdldrhg fud<h isÿre lrk m%;sldr l%uhla Ndú;d jQ w;r th Engravings hkqfjka ye|skaúK' doctormagazine.lk

udkisl frda. i|yd ,nd fok T!IO ldKav lsysmhlg fnod olajkak mq¨jka m%;súYdol T!IO (Antidepressants) úYdoh i|yd ,ndfok Sertraline, Venlafaxine, Amitriptyline jeks T!IO fï j¾.hg wh;a jk w;r tu frda.fha§ we;sjk wêl lK.dgqj jeks ufkdaNdjhka md,kh lsÍu fïjdhska isÿ flfrkjd' ufkdaNdj ia:dhSldrl T!IO (Mood Stabilizers) m%Odk jYfhkau fï .Khg wh;a jkafka oaúO%ej ufkdaNdj frda.fha§ ,ndfok Lithium, Carbamazepine yd Sodium Valproate jeks T!IOhs' fuuÕska isÿjkafka Wkaudoh yd úYdoh w;r foda,kh jk ufkdaNdjhka ia:djr lsÍuhs'

Clonazepam jeks T!IO fï j¾.hg wh;a fjkjd' fï T!IO j,ska fndfydaúg ksÈu;la we;s lrjkjd' W;af;acl T!IO (Stimulants) wjOdkh wvq wêl%shdldÍ frda.fhka fmf<k whf.a wjOdkh jeä ÈhqKq lsÍug ,ndfok Amphetamine jeks T!IO W;af;acl kñka y÷kajkjd' udkisl frda. i|yd T!IO Ndú; lsÍfï§ ie<ls,su;a úh hq;= lreKq fudkjdo@ ffjoHjrhd fuu T!IO kshu lrkafka frda.shdj fyd¢ka mÍlaId lr n,d frda. úksYaph lsÍfuka wk;=rejhs' tu ksid iqÿiqlï ,;a ffjoHjrhl=f.a ks¾foaYhlska f;drj fuu T!IO lsisjla mdúÉÑ fkdl< hq;= nj u;l ;nd .kak' tla tla T!IOh i|yd wod< úfYaI Wmfoia Tnf.a ffjoHjrhd" fyÈh fyda T!IOfõÈhd úiska ,ndfokq we;' tu Wmfoia fyd¢ka ms<smÈkak' udkisl frda. i|yd T!IO mdúÉÑ lsÍfï§ fmdÿfõ ms<smeÈh hq;= Wmfoia lsysmhla my; i|yka lrkjd' tajd Tng m%fhdackj;a fõú' •

iEuúgu ffjoH kshuh mßÈ T!IO ,nd.kak' ys;=uf;a T!IO mdúÉÑ lrkak tmd' kshñ; ud;%dj kshñ; fõ,djg ,nd .kak'

m%;sihsfldaiSh T!IO (Antipsychotics) Nskafkdakaudoh jeks frda. ;;a;ajhkays§ ,ndfok Clozapine, Olanzapine, Chlorpromazine jeks T!IO fuhg wh;a' ldxidkdYl T!IO (Anxiolytics) ldxid ;;a;ajhkaj,§ ,ndfok Diazepam, doctormagazine.lk

udkisl frda.Skag iqjh ie,ish fkdyelsh hkqfjka ;SrKh jQ hq.hl Tjqkag ;u cSú; ld,hu Wkau;a;ld.dr j, úiSug isÿ úh'

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•

Tng iqjhla oekqKq úg fnfy;a .ekSu k;r lrkak tmd' ffjoHjrhd úiska kj;ajk ;=re tu T!IO È.gu mdúÉÑ lrkak' ke;skï frda.h kej; biau;= fjkak mq¨jka'

•

iuyr T!IOj, hï w;=re m%;sM, ;sìh yelshs' ksÈu; .;sh" jeämqr fl< >%djh ùu" u<noaOh jeks ;;a;ajhka iq<n w;=re m%;sM, f,i olajkak mq¨jka' T!IO mdúÉÑ lrk w;r;=r fun÷ .eg¿ we;s jqjfyd;a ta nj ffjoHjrhdg okajkak' túg ffjoHjrhd ta i|yd ms<shï fhdokq we;'

•

m%;sihsfldaiSh T!IO .kakd w;r;=r wêl WK" isysl,amkdj wvqlu" udxY fmaIsj, ;o .;sh hk ,laIK we;s jqjfyd;a jydu ffjoHjrhd yuqjkak'

•

iuyr T!IO mdúÑÑ lrk w;r;=r úúO mÍlaIK lrjd. ekSu wjYH fjkjd' ^Wod( Clozapine mdúÉÑ lrk wh f,a j, iqÿ reêrdKq uÜgu mÍlaId lr.; hq;= w;r Lithium T!IOh mdúÉÑ lrk wh f,a j, ,s;shï uÜgu mÍlaId lrjd .; hq;=hs'& ffjoHjrhd úiska kshu lrk ,o Èkhg tu mÍlaIK lrjdf.k tys jd¾;d ffjoHjrhdg fmkaùu b;d jeo.;a'

•

Lithium kue;s T!IOh mdúÑÑ lrk úg mdpkh" jukh yd WK jeks ;;a;ajhka we;s jqjfyd;a jydu Tnf.a ffjoHjrhd yuqjkak' AUGUST 2018 | DOCTOR MAGAZINE

•

Tn .¾NŒ kï fyda .eí .ekSug n,dfmdfrd;a;=fjka isákafka kï udkisl frda. i|yd T!IO ,nd.ekSfï§ ta nj ffjoHjrhdg mjikak'

•

Tn fjk;a wikSmhlg m%;sldr .ekSug hk úg§ udkisl frda.hg .kakd T!IO ms<sn| jd¾;do /f.k f.dia tajd wod< ffjoHjrhdg fyda fyÈhg fmkajkak'

•

udkisl frda.hlg fnfy;a .kakd w;r;=r u;aøjH mdúÉÑ lsÍfuka j<lskak' T!IO iuÕ u;aøjH .ekSfuka wys;lr m%;sM, we;sjkak mq¨jka'

•

T!IO iïnkaOj lsishï .eg¿jla ;sfí kï Tnf.a ffjoHjrhd" fyÈh fyda T!IOfõÈhdf.ka úuiSug miqng fjkak tmd'

fï w;r iuyr frda.Ska ;udg udkisl frda.hla we;ehs ms<sfkd. kakd ksid T!IO .ekSu m%;slafIam lrkjd' ke;skï fnfy;a fndk nj wka whg fmkajd fnfy;a iÕjd miqj úislr oeóug jqjo fm<fUk wjia:d ;sfnkjd' b;ska tn÷ flfkl=g fnfy;a ,nd §fï§ Tyqf.a $ wehf.a <Õskau isg ksis f,i fnfy;a fndkafkaoehs ksÍlaIKh l< hq;=hs' udkisl frda.hlg fnfy;a mdúÉÑ lsÍu ms<sn| fï lreKq Tng jeo.;a jkakg we;ehs wms is;kjd' tfukau Tn ,nd.;a fï oekqu fuu fnfy;a mdúÉÑ lrk ;j;a flfkl=g ,ndÈh yels kï th tu mqoa.,hdg;a uyÕ= Wmldrhla jkq we;s' ••• doctormagazine.lk

Laboratory Tests Explained

Hepatitis B: laboratory diagnosis and some other information

fymghsáia î

ridhkd.dr mÍlaIK yd fjk;a jeo.;a f;dr;=re

fymghsáia taâia j,g;a jvd oreKQ f,i ck;dj .s, .kakd fi!LH wjodkula''' wdisß ridhkd.dr fiajdfõ wOHlaI kS,a m%sh;a fcdaka úisks fuys uq,a fldgia" miq.sh l,dm j, m< úh' fujr tys wjika fldgi oelafõ doctormagazine.lk

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fymghsáia î frda.h wo wfma rfÜ muKla fkdj f,dal jHdma;j u;=j we;s n,j;a fi!LH ;¾ckhls' frda.fha uQ,sl lreKQ yd ridhkd. dr.;j fï frda.h ks¾Kh lrk wdldrh iïnkaOfhka uQ,sl wjfndaOhla miq.sh l,dmfhka Tng ,efnkakg we;' tys iúia;rd;aul ridhkd.dr mÍlaiK úia;r fuu ,smsfhka oelafõ' 46

ksoka.; fymghsáia î wdidokh Chronic hepatitis B infection wdidos; jeäysáhka yd orejkaf.ka ishhg 1-10 w;r ixLHdjlg ksoka.; wdidokhla mej;Sfï bvlv mj;S' ksoka.;j we;sjk fï wdidokfhaoS m%;sYla;sh ÿ¾j, ùula idudkHfhka we;s fkdfõ' kuq;a tfia jQ we;eï wjia:dj,oS wdidok iq,n fõ' kjckau orejka" jhi wjqreÿ ;=kg wvq orejka yd fï frda.hg k;= jQ orejkag Wm; ,nk orejka hk fï orejkaf.ka ishhg 85-95 ixLHdjla frda. jdylhka njg m;a fjhs' orejka m%;sYla;slrK jYfhka ÿ¾j, ksid;a l<,fha isák úg HBsAg u.ska we;sjk n,mEu ksid;a fï lK.dgqodhl ;;a;ajh Woa.; fõ hhs ie<fla' cSú;fha uq,a ld,fha fujka ffjrihl wdidokhg ,lajk fï orejka ksoka.; l,a w,a,k (Chronic Persistent) fyda ksoka.; l%shdldÍ fymghsáia (Chronic Active Hepatitis) frda.Ska njg m;a úh yel' ridhkd.dr Ys,amSh ms<s.ekSug wkQj udi yhl ld,hla uq¿,af,a HBsAg mej;Su hkq th ksoka.; fymghsáia wdidokhls' w¿;ska wdidos; kï wlaudfõoS ffjri .=Kkhla isÿ fjñka mj;akd flfkls' ;Sj% wdidokfhka udi .Kkdjla uq¿,af,a" ke;fyd;a jirla .; jk ;=re fï whf.a HBsAg yd HBV DNA reêrfha mj;S' os.= ld,hla uq¿,af,a fuu ffjrifha wdidokfhka fmf<k wh wjidkfha reêrfha ffjri .=Kkh wvq fjñka mj;akd woshrlg m;a fõ' fï ;;a;ajhg m;a ùug kï anti-HBe m%;sfoay ksmoùu" wdidos; hdlD; ffi, j,ska viral DNA ksoyia ùu Tiafia HBsAg yd HBV DNA reêrfhka bj;a úh hq;=h' HBsAg j,ska ksoyia ùug iajNdjfhkau hdka;%Khla YÍrfhka n,.ekafõ' th jir lsysmhla uq¿,af,a isÿjk w;r l%shdldÍ fymghsáia frda.h ^we;eï úg frda. ,laIKo''' & we;eï ld, j,oS wvq fjhs' fuh m%;sfoay ksmofjk ;=re isÿ jkakls' fï iajdNdúl frda.h ySk ùfï woshr we;s fkdjk frda.Ska isfrdaisia yd wlaud.; ms<sld j,g ,laùfï by< wjodkula mj;S'

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PRIMARY MARKERS FOR THE DIAGNOSIS OF ACUTE HEPATITIS B INFECTION HBV Antigens

HBV DNA

Anti-HBV Antibodies

HBsAg

HBeAg

IgM

Total Ig

early

late

Acute HBV

Anti-HBc

Anti-HBe

Anti-HBs

Resolving

Immune vaccination

past infection

PRIMARY MARKERS FOR THE DIAGNOSIS OF CHRONIC HEPATITIS B INFECTION Diagnosis

HBV Antigens HBsAg

HBV DNA

HBeAg

Anti-HBV Antibodies Anti-HBc IgM

Anti-HBe

Anti-HBs

Total Ig

HBeAg positive chronic hepatitis B

HBeAg negative chronic hepatitis B

+/++

HBe antigen m%;sckl i|yd negative m%;sM< jd¾;d lrk ksoka.; fymghsáia wdidokh HBe antigen negative chronic hepatitis B wjdikdjlg fï kHdh i|yd jHd;sf¾Lhkao mj;S' we;eï wh" úfYAIfhkau cSú;fha uq,au jljdkqfõ fymghsáia wdidokhg ,lajk whf.a reêrfhka iïmQ¾Kfhkau HBV ^ffjrih& bj;a jkafka ke;' wdodhlhdf.a m%;sYla;slrK moaO;sfha n,mEu u; HB ffjrifha úlD;s wdldr wdidos; wlaud ffi, j,ska f;dard .ekSula isÿ fõ' HB ffjrifha DNA W;amdokh fuysoS fkdkj;ajd isÿ fjhs' HBsAg fkdue;sj yd anti-HBe mej;Sula we;s ;;a;ajhla hgf;a fuh ishhg 30la muK wdidos;hkaf.a fkdkj;ajdu isÿ fjhs' doctormagazine.lk

m%dfhda.slj fymghsáia î mÍlaIdj isÿjk whqre Testing patients for hepatitis B in practice ffjrifha fm%daàk yd m%;sckl y÷kd.ekSu i|yd jvd;au iq,nj isÿ flfrkafka Enzyme Immunoassays (EIA) mÍlaIdjhs' ixLHd;aulj HBV

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DNA y÷kd.ekSu i|yd Molecular Hybridisation assay mÍlaIKh fuysoS Wmfhda.S lr.kakd w;r uia;= j, b;d iaj,am m%udK j,ska mj;akd HBV DNA y÷kd.ekSu i|yd Polymerase Chain Reaction (PCR) mÍlaIKh Wmfhda.S lr .efka' HBsAg m%;sM, ,efnkafka Positive fyda Negative jYfhks' Hepatitis B specific core IgM mÍlaIKfha m%;sM<o fï wdldrfhkau Positive fyda Negative jYfhka ,nd fohs' Positive m%;sM<hla kï" uE; ld,hl we;sjQ wdidokhla .ek bÕs lrhs'

oSfuka frda.fhka úúO ixl+,;d j,g m;aùu;a frda.Ska urKhg m;aùu;a md,khlg ,la lsÍug wjia:dj ie,fia' fi!LH fiajlhka yd wjodkï iy.; jD;a;ShkayS ksr; jk who fuu tkak; ,nd .ekSu iqÿiqh'

HBsAg yd fyda HBV DNA Positive ùu hkq b;d jeäfhka wdidos; jdylhkah' reêrfha wvq m%udK j,ska HBV DNA mej;Su yd idudkHfhka HBe mej;Su wvq m%udKhl wdidokhla m%lg lrk l%shdldÍ fkdjk jdylhka f,i fjkalr .kshs'

kej; tkak;a lsÍu

jdylhkaf.ka ishhg 10-20l m%udKhla wjidkfha HBsAg j,ska ksoyia fjhs' ;Sj% wdidokhlska iqjh ,nk frda.Skag iudk wdldrhlska fï wh anti-HBs m%;sfoay ksmoùulao isÿ lrhs' iqjh ,nk frda.Skaf.a HBsAg yd HBcAg i|yd IgG m%;sfoay mj;S' tkak;a ,enQ frda.Skaf.a reêrfha we;af;a HBsAg i|yd jk m%;sfoay muKs' anti-HBs i|yd jk titre idudkHfhka m%ldY flfrkafka IU/mL j,sks' titre of 10 IU/mL hkq HBV ffjrifhka wdrlaId ùug mej;sh hq;= wju iïu; m%udKhhs'

fymghsáia frda.fhka wdrlaId ùu i|yd tkak;a lsÍu iy kej;;a tkak;a lsÍu wdidos; ujf.ka orejdg fymghsáia je<|Su je<elaùug we;s fyd|u Wml%uh jkafka bmoSfuka meh 24la .; ùug u;af;ka fymghsáia î jelaiskh ^tkak;& ,nd .ekSuhs' fï tkak; ,nd fkd.ekSfuka orejkaf.ka ishhg 90lau ksoka.;j fymghsáia wdidokhg ,laùfï wjodkula mj;S' ksoka.; fymghsáia frda.Ska jeä fofkla Wmf;aoSu frda.hg ksrdjrKh jQjkah' HBV fymghsáia j,ska wdrlaId jk tkak; y÷kajd 48

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tkak; ,nd.ekSfuka miqj i;s 6-8 w;r ld,hla ;=<oS >100 IU/mL m%;sfoay ;sr .ekaùula isÿ fõ' wOHhk j,g wkQj tkak; fya;=fjka HBsAg wekaáck i|yd m%;sfoay wdprKh jir y;lg;a jeä ld,hla uq¿,af,a mj;S' frda.Skaf.a reêrhg ksrdjrKh ùfuka wê wjodkula orK jD;a;SkayS ksr; jk wh jir mylg jrla kej; tkak; ,nd.; hq;=h' ••• jeäÿr meyeos,s lsÍï i|yd dl@asiri. lk yd neilpriyath@ yahoo.com Tiafia fuu f,aLlhd wu;kak'

úfYAI ia;+;sh lsre, mdr" wdisß ridhkd. drfha ridhkd.dr ld¾ñl i|ud,s fufkúhg doctormagazine.lk

CONTACT DETAILS OF ASIRI LABS & COLLECTION CENTRES Asiri Hospital Holdings PLC 181, Kirula Rd, Narahenpita, Col-5 011 - 4523355/356/357 prlab@asiri.lk The Central Hospital 114, Norris Canal Rd, Col-10 011 - 4665500 / 077 - 2092847 chllab@asiri.lk Asiri Surgical Hospital PLC 21, Kirimandala Mw,Col-5 011 - 4524400 / 48 microlab@asiri.lk Centres & Labs

Matara Kandy Kalubowila Negambo Ragama Kurunagala Jaffna Battittcaloa Anurudhapura Badulla Homagama Kalutara Gampaha Matale Pelawatta Wellampitiya Kadawatha Wattala Gampaha Horana Kiribathgoda Kotahena Wellawatta Awissawella Rathmalana Kaduwela Peradeniya Bogambara Katugastota Warakapola Avissawella Marawila Panadura Kada 50 Waththegama Nawalapitiya Dehiwala Kuliyapitiya Malabe Bandarawela Ja-Ela Embilipitiya Kegalle Nugegoda Tangalle Gampola Maharagama Akurana Kottawa Piliyandala Athurugiriya Nittambuwa Badulla IDH Pilimathalawa Mattakkuliya Moratuwa Beruwala Pitakotte Makola Pannipitiya Mawanella Kandana

Anagarika Dharmapala MW 67/7,William Gopallawa MW 5, S De S Jayasinghe MW 155,Colombo Road 39 A, Kadawatha Road 199 / 1, Colombo Road 546,Hospital Road 39/1, Central Road 280 A, Maithreepala Senanayaka Mw, 18,Darmadootha Road 20, Katuwana Road 21,Chamly Gunawardena Mawatha 06, Asoka Gardens,Colombo Road 87/A,Kandy Road 730 B , Pannipitiya Road 100,Kumaradasa Place 134 H, Jaya Mawatha 122, Negombo Road Queen Maryâ&#x20AC;&#x2122;s Road Anguruwatota Road Kandy Road,Dalugama Pickerings Road Manning Place Gemland,Kudagama Road Galle Road Avissawella Road Peradeniya Road Keppitipola Road Katugastota Road 92, Main Street 48, Seethagama A Moodukotuwa 159,Galle Road Bandaranayake MW,Anuradhapura 45,Mathale Road 119,Kothmale Road 190 A,D.B.Jayathilake Mw (Hill Street) 95, Hettipola Road 877, Athurugiriya Road 276,Badulla Road 67, Gamini Road 29 / A, New Town Road 325, Main Street 584, Highlevel Road, Gangodawilaa 187, Matara Road 36C,Â T.B.Panabokke Mawatha 152, Piliyandala Road 91E, Mathale Road, Akurana 197/1,Horana Road,Kottawa 148A, Horana Road,Piliyandala 1/1 E, Borella Road, Athurugiriya 584 , Kandy Road , Nittambuwa 13C, Bandarawela Road , Badulla 34/4 D, Kollonnawa Rd , Gothatuwa New Town 197/1,Daulagala Road,Pilimathalawa 77, Mattakkuliya Church Rd 56/D,Galle Road,Moratuwa City Arcade , 201B, Galle Road, Beruwala 155 B, Pagoda Road , Pita Kotte 96A/5,Makola Road,Makola South, Makola 92, Borella Road, Depanama , Pannipitiya No 209, Colombo Road , Mawanella No. 47 Ganeulla Road, Hapugoda,Kandana

Address

041 - 4390900 081 - 7389022 011 - 7389701 / 704 031 - 7388010/011/ 012 011 - 7389753/754/755 037 - 7220110/111/112 021 - 7389389 / 392/93 065 - 7755400/401/402 025 - 7800850/851/852 055 - 7634020 011 - 7519583/585/586 034 - 7634005/010/009 033 - 7634139/ 148/323 066 - 4501011 011 - 7634035 011 - 7519581 011 - 7617180 011 - 7581598 033 - 7500598 034 - 7877200 011 - 7782704 011 - 7782702 011 - 7782706 036 - 7637611 011 - 7782708 011 - 7782710 081 - 7634010 081 - 7389011 / 13 081 - 7634002 035 - 7634011 036 - 7634 008 032 - 7634010 038 - 7634011 025 - 7800854 081 - 7634008 054 - 7634012 011 - 7634096 037 - 7634003 011 - 7654039 057 - 7634008 011 - 7634186 047 - 7634008 035 - 7634014 011 - 7634098 047 - 7634007 081 - 7634013 011 - 7634182 081 - 7634009 011 - 7634159 011 - 7634188 011 - 7634312 033 - 7634004 055 - 7634011 011 - 7634310 081 - 7634015 011 - 7634314 011 - 7634198 034 - 7634007 011 - 7634318 011 - 7634226 011 - 7634217 035 - 7634000 011 - 7634344

Telephone

E-Mail

infoasirimatara@asiri.lk kandylab@asiri.lk kalubowilalab@asiri.lk nglab@asiri.lk ragamalab@asiri.lk kurunegalalab@asiri.lk jaffnalab@asiri.lk batticaloalab@asiri.lk anuradhapuralab@asiri.lk badullalab@asiri.lk homagamalab@asiri.lk Kalutharalab@asiri.lk gampahacc@asiri.lk matalelab@asiri.lk pelawattalab@asiri.lk wellampitiyalab@asiri.lk kadawathalab@asiri.lk wattalalab@asiri.lk gampahalab@asiri.lk horanalab@asiri.lk kiribathgoda.lab@asiri.lk kotahena.lab@asiri.lk wellawatte.lab@asiri.lk avissawella.lab@asiri.lk ratmalana.lab@asiri.lk kaduwela.lab@asiri.lk peradeniyalab@asiri.lk bogambaralab@asiri.lk katugasthotalab@asiri.lk warakapolalab@asiri.lk avissawella.lab@asiri.lk marawilalab@asiri.lk panaduralab@asiri.lk kadapanahalab@asiri.lk wattegamalab@asiri.lk nawalapitiyalab@asiri.lk dehiwalalab@asiri.lk kuliyapitiyalab@asiri.lk malabelab@asiri.lk bandarawelalab@asiri.lk Jaelalab@asiri.lk embilipitiyalab@asiri.lk kegallelab@asiri.lk nugegodalab@asiri.lk tangallelab@asiri.lk gampolalab@asiri.lk maharagamalab@asiri.lk akuranalab@asiri.lk kottawalab@asiri.lk piliyandalalab@asiri.lk athurugiriyalab@asiri.lk nittambuwalab@asiri.lk badullacc@asiri.lk idhlab@asiri.lk pilimathalawacc@asiri.lk mattakkuliyacc@asiri.lk moratuwacc@asiri.lk beruwalacc@asiri.lk pitakottecc@asiri.lk makolacc@asiri.lk pannipitiyacc@asiri.lk mawanellacc@asiri.lk kandanacc@asiri.lk

NUTRIGENOMICS AND HEALTH Bioactive dietary components in the application

Dr. Ananda Chandrasekara Department of Applied Nutrition, Wayamba University of Sri Lanka

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NUTRIGENOMICS

is a novel application of nutrition practice and research, the study how genetics interact with the foods we eat, the knowledge of understanding how nutrition influences metabolic pathways, how the change is affecting on the development of noncommunicable diseases such as diabetes, cardiovascular diseases and certain types of cancers. Sequencing Human genome by decoding of the DNA allows scientists to spot biomarkers that impact on the metabolism of certain nutrients. It is a tool can be effectively employed in clinical practice to balance the physiology and control or prevent diet-related diseases by using specific nutrients to target improved patient outcomes. It is possible to study the variations in genes that influence intake and metabolism of specific nutrients and predict dietary interventions. Nutrigenomics has a potential of providing better nutritional consultations or personalized nutritional counselling to the public since it requires a deep understanding of nutrition, genetics and biochemistry.

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I no longer feel that the solution to all the world’s problems is better drugs—I think it actually happens to be better nutrition. The dietary guidance that’s targeted to your precise genetic makeup is the wave of the future. Prof. Jeffrey Blumberg (Nutrition scientist, Tufts University)

SAFE AND EFFECTIVE DIETARY INTERVENTIONS AGAINST NCDS Nutrients are communicating with the cells throughout the body, fostering negative or positive

AUGUST 2018 | DOCTOR MAGAZINE

genetic (phenotypic) expression. Negative gene expression may lead to premature ageing and certain diseases. What we eat have a direct impact on our health. The understanding of nutrient and gene interactions will aid the customized dietary recommendation suits to the genotype. This approach will allow to treat the existing diseases or to prevent future illnesses more particularly Non-communicable diseases (NCDs). Nutritionists can facilitate their clients to make informed decisions that impact their health by offering therapeutic lifestyle changes (TLC). TLC is a holistic approach to lifestyle activities includes physical activity, behavioural activity and nutrition that incorporate customize nutrigenomic principles based on patient response and specific nutritional needs. Nutrigenomics may provide the strategies for the development of safe and effective dietary 52

interventions against NCDs such as obesity, Type 2 -diabetes mellitus and CVD.

THE NEW ERA IN NUTRITION Nutrient bioactive components including vitamins, phytochemicals, flavonoids, polyphenols, fatty acids affect the physiology in a different way and can change regulations by modifications to the DNA molecule and the proteins bound to it, not mutations (gene can lead to produced faulty protein and potentially cause diseases). These modifications triggering to â&#x20AC;&#x153;turn on and off â&#x20AC;&#x153;of gene expression, studying this phenomenon is called epigenetics which leads to the realization that many NCDs such as cancers, diabetes, obesity, CVD are related to these disorders. Bioactive dietary components can alter physiologic and pathologic process through epigenetic gene expression. There is enough evidence to support that the effectiveness of bioactive components in green tea and cinnamon in blood sugar management. Essential oils of cinnamon have been shown to increased insulin sensitivity by activating insulin receptor kinase and inhibiting dephosphorylation of the insulin receptor, leading control in type 2 diabetes mellitus. Bioactive component of epigallocatechin gallate (EGCG), the most

AUGUST 2018 | DOCTOR MAGAZINE

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abundant form of catechin in green tea, a bioflavonoid shown to protect pancreatic islet cells and enhance insulin sensitivity.

the progression any such diseases or preventing these diseases.

FOLIC ACID DURING PREGNANCY

• Allen, L.R. and Kelly, B. B. (2015). Transforming the Workforce for Children Birth Through Age 8: The Interaction of Biology and Environment. A Unifying Foundation. Washington (DC): National Academies Press (US); 2015 Jul 23. 3.

Folic acid (folate) is recommended before and during pregnancy to prevent congenital malformation of the fetus. Deficiency of folic acid creating epigenetic changes affecting DNA methylation and control of gene expression resulting abnormalities of the foetal nervous system, neural tube defects such as spina bifida. Folate is found naturally in food, such as green leafy vegetables, enriched in bread and breakfast cereals, or available as supplements. Nutrigenomics could also explain that having a healthy diet can protect from diseases such as cancer. It has been found that the bioactive components such as sulforaphane (found in cabbages), lycopene (in tomatoes) can naturally inhibit the molecular modification of proteins bound to DNA, would prevent certain cancer-specific genes from being able to express themselves. Currently using genomic studies, it is possible through a blood to predict individual at-risk diseases such as obesity, diabetes or cancers. Nutrigenomics could provide a way possible to advise an appropriate diet, a tailor-made prescription to slow down/control

Reference

• Francis C. L., Manashi, B., Chandan, S., Sashwati and R., Debasis,B. (2008) Nutrigenomic Analysis of Diet-Gene Interactions on Functional Supplements for Weight Management. Current Genomics, Volume 9, Number 4, June 2008, pp. 239-251(13) • Mьller, M. & Kersten, S. Nutrigenomics: goals and strategies. Nature Reviews Genetics. 4, pages 315– 322 (2003). • Sales, N. M. R., Pelegrini, P. B. and Goersch, M. C. (2014) Nutrigenomics: Definitions and Advances of This New Science, J Nutr Metab. 2014; 2014: 202759. •

Wang DD1, Hu FB2. Precision nutrition for prevention and management of type 2 diabetes.

• 2018 May;6(5):416-426. •••

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jl=.vq

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AUGUST 2018 | DOCTOR MAGAZINE

doctormagazine.lk

wfma YÍrh l¾udka; Yd,djla n÷h' f,dalfha we;s ixlS¾K;u l¾udka; Yd,djg;a jvd w;s úYd, ixlS¾K njla ñksia YÍrh ;=< mj;S' th t;rïu ixúOdkd;aulh' l%shdldÍh' jl=.vq wfma YrSrhg w;HjYH fiajd /ila lrk bkaøshhla''' fï lïyf,a ;sfnk úYd, jev fldgila isÿlrk hka;% w;ßka tla hka;%hla jkafka jl=.vqh' fuh msysgd we;af;a wfma isref¾ l| fldgi msgqmig jkakgh' yDoh jia;=j u.ska isref¾ wfkla iEu fldgilg fiau jl=.vqj,g;a reêrh fmdïm lsÍu isÿfõ' fï reêrh .uka lrkafka jDlaldkq kue;s fmrk tall (Filtering Unit) yrydh' doctormagazine.lk

jl=.vqjl l%shdldß;ajh jDlalSh Ouksh Tiafia reêrh" wmøjH yd c,h jDlaldkq j,ska fmÍug we;=,a fjhs' msßisÿ jQ reêrh wu;r c,h jDlalSh Ysrdj Tiafia msg;g hhs'

wu;r c,h" úI wmøjH uq;%d ud¾.h Tiafia bj;a flfrhs fï fmrk tall ,laI .Kka jl=.vqj, mj;S' jDlaldkq yryd hk fuu reêrfha wmøjH iy j;=r jDlaldkq j,g weo .kakd w;r tys§ fyd| fldgiq;a meñK ;snqfKd;a tajd kej;;a reêrhgu uqod yeÍuo jDlaldkq j, ld¾hhls' isref¾ ,jK" wï, iy wksl=;a foaj,a iu;=,s;j ;nd .ekSug jDlaldkq mß.Klhla fuka ls%hd lrhs' jDlaldkqj,ska meñfKk wmøjH jk uq;%d jDlaldkq kd,hg meñfKhs' tu kd,h uq;%dYhg iïnkaOh' uq;%d .nvdj jkafka uq;%dYhhs' tu .nvdj msreKq miq wmg uq;%d lsÍfï wjYH;djh we;s jkafka tu .nvdj ysia lsÍu i|ydh' úI hkq wï, j¾.hkah' ta wï, cd;s YÍrfha jeä jqfKd;a YÍrfha ffi, j, m%;sls%hdj ksis mßÈ isÿ fkdfjhs' fï úI øjH iu. c,ho msg lrhs' wm fndk c,h u.ska muKla fkdj isrer ;=<u iEfok c,h jeä

mjqf,a flfkl=g jl=.vq frda.h;a ;sfnkjd kï tfiau jl=.vq wdndOhla ksid jhi wjqreÿ 50 g fmr ñh .sfha kï ;ukag;a jl=.vq wdndOhla ;sfnkjdo hkak mÍlaId lr n,d ±k .ekSu b;du jeo.;a fõ' AUGUST 2018 | DOCTOR MAGAZINE

m%udKhla jl=.vqj,ska msg lrhs' fï c,h msg kQfKd;a fmKy¿" fud<h jeks bkaøshhka j,g c,h tl;= ùu isÿ fjhs' túg wmg Ôj;a úh fkdyel' tksid jl=.vqj,ska jeä m%udKhla c,h msg lsÍu isÿfõ'

jl=.vqjlska ld¾hhka

isÿjk

fjk;a

reêr mSvkh md,kh lrk fydafudakh ksmoùu fï w;ßka tla jeo.;a ld¾hla jkafka ßkska (Renin) kue;s fydafudakh ksmoùuh' wfma YÍrfha reêr mSvkh md,kh lsÍug fï ßkska fydafudakh b;d jeo.;a fõ' reêr mSvkh wêl jqfKd;a kd, mqmqrhs' wvq jqfKd;a reêrh fyd|ska .uka lrkafka ke;' tksid reêr mSvkh tl uÜgulg ;nd .; hq;= fjhs' fï i|yd Woõ jkafka ßkska fydafudakhhs' wê reêr mSvkfhka fmf<k jeä fofkl=g Bg fya;=j jkafka ßkska fydafudakh wvq jeä ùuhs' jl=.vq j,ska ksmojk ;j;a fydafudakhla jkafka tßf;%dafmdháka (Erythro-poitin) h' wfma YÍrfha Tlaiscka f.k hkafka r;= reêrdkq u.sks' r;= reêrdkq ksIAmdokhg fya;=jk fydafudakh ksmoùu r;= reêrdkq ksmojk f,i wegñÿ¿ j,g úOdkh fokafka tßf;%dafmdháka fydafudakh u.sks' tneúka fï fydafudakh wvq jqfKd;a r;= reêrdkq ksmoùuo wvq fjhs' úgñka D ksIAmdokhg msgqjy,la ùu ;j;a YÍrhg jeo.;a fydafudakhla jkafka úgñka D h' wfma YÍrfha wiaÓ fï ;;a;ajfhka ;nd.ekSug bjy,a jk úgñka j¾.hla jk fï úgñka D uq,skau iEfokafka ifïh' ifï yefok úgñka D jl=.vq lrd f.dia th 56

AUGUST 2018 | DOCTOR MAGAZINE

ls%hdldÍ jkakg kï úgñka D" njg m;a úh hq;=h' fï ld¾hh isÿ jkafka jl=.vq ;=<h' jl=.vq ls%hdldrs;ajh ke;akï úgñka D iE§u isÿ fkdjk w;r túg wiaÓ Èrdm;a fjhs'

jl=.vq frda.S jk yeá jl=.vq frda. .ek ne¨fjd;a tajd oyia .Kkla we;' fï yeu frda.hla u.skau jl=.vq wls%h lrk ;;a;ajhg hdfï bvlv mj;S' Èhjeähdj ksid Èhjeähd frda.h jl=.vqj,g wys;lr f,i n,mE yel' tu.ska l%u l%ufhka jir .Kkla hk úg jl=.vq wls%h ùu isÿùug yelshdj mj;S' wêl reêr mSvkh ksid jl=.vq j,g ydks isoq lrk ;j;a frda.hla jkafka wêl reêr mSvkhhs' fkmarhsáia jl=.vq bÈóu fyj;a fkmarhsáia (Nephritis) frda.h ;j;a tjka frda.hls' fï ms<sn|j wms iúia;rd;aulj úia;r álla l;d lruq' fkmarhsáia frda.h y÷kd.ksuq fkmarhsáia yefokafka isref¾ yefok m%;sfoayj, ls%hdldß;ajh jeä jQ úgh' m%;sfoay jeä jQ úg th úIîcj,g fukau isref¾ wjhj j,g;a myr §ug mgka .kS' fï wkqj m%;sfoayj,ska myr lk jl=.vq álska ál krla ùu isÿ fjhs' fuys§ ;sõr fkmarhsáia (Acute Nephritis) u.ska b;d flá l,lska ^Èk lSmhlska jqj& jl=.vq

ks;r ks;r fiï f.ä yd fydß je<f|k whg fuh je<|sh yel' doctormagazine.lk

wl%Sh jk w;r l,a.; jk fkmarhsáia (Chronic Nephritis) u.ska m%;sfoay ls%hdldß;ajh jeä ùu ksid álska ál jl=.vq úkdY fjhs'

ifï frda.hla jQ fydß ksid;a jl=. vq bÈóug mq¿jk' kuq;a fuh isÿjkafka uq;%d wdidok jeks fohla ksid fkdfõ' ks;r ks;r je<f|k fiï f.ä ksid;a jl=.vqj, bÈóula we;s úh yel' fiï f.ä we;sjkafka W.=rg úI îchla we;=¿ ùfuks' fydß yg .kafka iug úIîchla we;=¿ ùu ksidh' fujeks frda. je<f|k úg frda.shdf.a YÍrfhys tu úIîc úkdY lsÍu i|yd m%;sYla;sh we;sfõ' fuu m%;sYla;sh fldhs;rï n,j;ao lsjfyd;a thska YÍrfha wksla wjhj j,g;a wys;lr n,mEï we;sùug mq¿jk' fuh yßhgu hqoaOhl§ i;=rkag wu;rj idudkH jeishkq;a ñh hkakdla n÷ fohls' fuu m%;sYla;sh ksid jeäu wys;lr n,mEï isÿjkafka jl=.vq j,gh' fuho fkmarhsáia frda.h fõ' ks;r ks;r doctormagazine.lk

wjika woshf¾ jl=.vq frda.sfhla ldkaÿlrKhg ,la lrñka reêrh msßisÿ lrk wjia:dj fiï f.ä yd fydß je<f|k whg fuh je<|sh yel' kuq;a fiïf.ä yd fydß je<f|k iEu fokdgu fkmarhsáia je<f|a hehs jrojd is;sh hq;= ke;' idudkHfhka fï wdldrhg fkmarhsáia je<f|kafka jhi 18ka my< whgh' kuq;a jeäysáhkag;a fï foflkau fkmarhsáia je<|sh yels nj wu;l l< hq;= ke;'

fkmarhsáia - frda. ,laIK idudkHfhka fydß we;s ù i;s 2la blau .sh miq fyda fiï f.ä iqj ù i;s 2 lg miq Wfoa wjÈ jk úg uqyqK bÈó ;sîug mq¿jk' iuyr úg oj,a jk úg ta bÈuqu wvqjkakg fyda È.gu mj;skakg bv we;' mdo o bÈfï' uq;%d f;a lyg meyefhka msgfõ' fun÷ ,laIK mj;S kï jydu ffjoHjrhl= yuqúh hq;=h' Æmia frda.h Æmia frda.h fyj;a SLE (Systemic Lupus Erythematosis) o fkmarhsáia j¾.hls' fuho jl=.vqj,g n,mdk frda.hls' uq;%d wdidok jl=.vq wls%h lrjk ;j;a frda.hla jkafka uq;%dj,g úIîc hdu fyj;a uq;%d wdidokhhs' úfYaIfhka jhi wjqreÿ 10g jvd wvq orejkag je<f|k uq;%d wdidok miqld,Skj jl=.vq wdndO we;s ùug n,mdhs'

jl=.vq wls%h ùu wfma isrerg ±fkkafka ke;' È.= ld,Sk wls%h ùul§ jqj frda. ,laIK isrerg ±fkkafka jl=.vqj,ska 75] la we;eï úg 90] la muK krla jQ úgh' AUGUST 2018 | DOCTOR MAGAZINE

.af,dußhqf,dfkmarhsáia frda.fhaoS fï wdldrfhka mdo bosóu isÿ fõ uq;%d .,a uq;%dj, .,a fyj;a jl=.vq j, .,a iE§u ;j;a frda.hls' jl=.vqj,g reêr jl=.vqj,g reêr ;j;a wjia:djls'

iemhqï iemhqï

wvqùu wvqùu

fï ish¨u frda. ;;a;ajhka §¾> ld,Sk f,i jl=.vqj,g n,mEï we;s lrhs' flá ld,Skj tkï Èk lsysmhlska jqj jl=.vq wls%h ùug n,mdk ;j;a frda. ;;a;ajhka fõ' ñka tlla jkafka by; lS ;sõr fkmarhsáia frda.hhs' jl=.vqj,g úI we;=¿ ùu B<Õ lreK jl=.vqj,g úI we;=¿ ùuhs' i¾m úI wm rfÜ fï wdldrfhka jl=.vq krla ùug n,mdk iq,n ;;a;ajhls' khd| ;s;a fmd<Õd" or fmd<Õd" lrj,d jeks i¾mhkaf.a úI u.ska b;d blauKska jl=.vq wls%h ;;a;ajhg m;a fjhs' th fl;rï fõ.hlska isÿfõ ±hs lsjfyd;a meh lsysmhlska jqj jl=.vq wls%h úh yel' ó WK wfkla frda.h jkafka ó WKhs' fuys Leptopirosis nelaàßhdj fyda Hantaan Virus kue;s ffjrih hk úIîc j¾. foflka l=ula fyda we;=¿ jqfKd;a jl=.vq wls%h úh yel' uef,aßhd iy fvx.= WK uef,aßhd iy fvx.= WK ksid o we;eï úg jl=.vq wls%h fjhs' 58

AUGUST 2018 | DOCTOR MAGAZINE

we;eï fõokd kdYl T!IO os.=ld,Sk mdúÉÑh iuyr fõokd kdYl T!IO È.= ld,Skj .ekSu jl=.vq frda. j,g n,mdhs' fjk;a fya;= m,audks lalï" lmqre fnda," merfldÜ jeks úI øjH YÍr .; ùu o jl=.vq wls%h ùug fya;= fjhs' wk;=re ;j;a fya;=jla jkafka isrer úYd, wk;=rlg nÿkaùuhs' fuys § udxY fmaYskaj,g jeäfhka ydks isÿjqfKd;a udxY fmaYs j,ska ufhd. af,dìka kue;s øjH reêrhg úYd, f,i msg ùu ksid ufhd.af,dìka jl=. vqj,g w;=,a ùu u;ska jl=.vq wls%h ùu isÿ fõ' reêrfha mSvkh wvq ùu reêrfha mSvkh wvq ùu u.ska jl=.vqj,g reêrh iemhqu wvqùu ksido jl=.vq wls%h ùu isÿfõ' jl=.vq u;=msg nqnq¿ we;sùu mrïmrdfjkau tk jl=.vq frda. hla jk Polysistic Kidney Disease ksid o jl=.vq wls%h jkq we;' fuh foudmshkag ;sfí kï orejkaf.ka 50] lgu je<f|hs' fï frda.fha § isÿjkafka jl=.vq u;=msg nqnq¿ iE§ jl=.vqj, jDlaldkq krla ùuhs' fï frda.h ,xldfõ iq,nj ±lsh yel'

doctormagazine.lk

wfma rfÜ jl=.vq frda.S ùu ksid jl=.vq noaO lsÍug úYd, frda.Ska ixLHdjla isák w;r fud<h uereKQ miq ;u wjhj okaoSug leue;a; m%ldY lrk whf.a jl=.vq we;=¿j bkaøsh noaO lsÍug fhdod .ekSfï fï jevigyko fï frda.Skg buy;a fia msysg fjhs cdk u.ska we;sjk fuu jl=.vq frda. hg wu;rj ;j;a lSmhlau we;;a th l,d;=rlska we;sjk fohls' ta ksid ta ms,sn|j fuys l;d fkdflf¾' mjqf,a flfkl=g jl=.vq frda.h;a ;sfnkjd kï ie<ls<su;a ùu jeo.;a''' by; lS jl=.vq frda.h je<÷Kq frda.Ska jirlg y;la wgla muK fyda we;eï úg Bg jvd ug uqK.eiS we;' fuys frda. ,laIK jkafka reêr mSvkh jeäùu" uq;%d iu. reêrh msgùu

±ka ±ka jhi úis;sia .Kkaj, whg;a Èhjeähd frda.h je<f|kq ±lsh yelshs' fï wh fyd|sska frda.h md,kh fkdlf<d;a jhi 45 § muK tkï Ôú;fha fyd|s jhfia§ jl=.vq frda.shl= ùug yelshdj mj;S' doctormagazine.lk

wdÈhhs' jhi wjqreÿ 30ka miqj 30 – 40 ;a w;r ld,fha§ fun÷ frda. ,laIK we;s úh yel' mrïmrd.;j we;s jk fun÷ jl=.vq frda. j<lajkakg fkdyel' tneúka mjqf,a flfkl=g jl=. vq frda.h;a ;sfnkjd kï tfiau jl=.vq wdndOhla ksid jhi wjqreÿ 50 g fmr ñh .sfha kï ;ukag;a jl=.vq wdndOhla ;sfnkjdo hkak mÍlaId lr n,d ±k .ekSu b;du jeo.;a fõ' jhi wjqreÿ 20 – 25 ld,fha§ fufia ffjoHjrhl= ,jd mÍlaId lrjd .; hq;=h' fï l=uk frda.hla ksid jqjo ;sõr jl=.vq wls%h;djhla fyda È.=ld,Skj isÿ úh yels jl=.vq wls%h;djhla isÿùug mq¿jk' ñka fláld,Sk jl=.vq wls%h;djhlska fmf<k 90] lf.a muK kej; flá l,lska jl=.vq h:d ;;a;ajhg m;a lr .; yel' AUGUST 2018 | DOCTOR MAGAZINE

kuq;a §¾>ld,Skj jl=.vq wdndO j,§ l%u l%ufhka jl=.vq wls%h ùu isÿjk ksid th h:d ;;ajhg m;alr .ekSug yels fkdjkq we;' jl=.vq noaO lsÍug isÿ jkafka tnÿ frda.Skagh'

jl=.vq wl%Sh ùu frda. ,laIK jl=.vq wls%h ùu wfma isrerg ±fkkafka ke;' È.= ld,Sk wls%h ùul§ jqj frda. ,laIK isrerg ±fkkafka jl=.vqj,ska 75] la we;eï úg 90] la muK krla jQ úgh' tksid jhi 30 ka miq ´kEu flfkla Urine full report iy Urine micro albumin hk mÍlaIK fol lrjd .ekSu b;du jeo.;a fõ' tu.ska jl=.vq j, frda. ;;a;ajhka we;s o hkak ±k .ekSug mq¿jk' uq;%d iu. f,a hdu jl=.vq wls%h ùug wod, tla frda. ,laIKhla jkafka uq;%d iu. f,a hduh' kuq;a tla jrla muKla f,a msg ùu t;ekskau k;r jkakg;a mq¿jk' tneúka tl jrla fyda uq;%d iu. f,a msg jqfKd;a ffjoH Wmfoia me;Su w;HjYH fohls' uq;%d iu. we,aìhqñka ^fm%daàka& msgùu ;j;a frda. ,laIKhla jkafka uq;%d iu. we,aìhqñka ^fm%daàka& msgùuhs' fuh y÷kd.; yels ,laIKh jkafka uq;%d iu. wêlj fmk tauhs' isrer bÈóu isrer bÈóu ^fomd weia jgd wdÈh& ;j;a frda. ,laIKhls' wêl reêr mSvkh wêl reêr mSvkh we;s ùu o frda. ,laIKhls' úfYaIfhka ;reK whg fuh yg.;fyd;a thg fya;=j jl=.vq wdndOhla ±hs fidhd ne,Su w;HjYHhs'

jl=.vq frda. W;aikak jQ úg we;sjk ,laIK jl=.vq frda. W;aikak jQ úg lEu wreÑh" jukh" wêl ksÈ u;" jevla 60

AUGUST 2018 | DOCTOR MAGAZINE

yßhdldrj lrkakg neß lu" wefÕa ÿn,;djh| wi,lu jeks ,laIK yg .kS' fndfyda fokl= is;kafka fldkafoa lelal=u ks;r we;s ùug fya;=jla jl=.vq wdndOhla úh yels njh' tfy;a iuyr jl=.vq frda. j,g fldkao lelal=u we;s jqK;a fndfyda Nhdkl jl=.vq frda. j,g fldkao lelal=u yg .kafka ke;' tfukau iuyr wjia:dj,§ uq;%d j, m%udKh jeäfhka hdu rd;s%hg 3-4 jrla uq;%d lsÍfï wjYH;djho frda. ,laIK f,i u;= jqj;a we;eï whg tn÷ ,laIK u;= ùu o isÿ fkdfõ'

jl=.vq m%;sldr

frda.j,g

isÿ

lrk

jl=.vq frda.Skaf.a jl=.vq wls%h ùu je<elaùu ffjoHjrekaf.a W;aidyhhs' ta wkqj È.=ld,Skj jl=.vq wls%h;djhla ;sfí kï th yels;dla je<elaùug W;aidy lsÍu;a hï fyhlska jl=. vq kej;=fKd;a thska lrk ld¾hh lD;s%uj fjk;a hka;%hla u.ska lrkak ie,eiaùula isÿfjhs' fufia lD;s%uj flfrk ld¾hh ldkaÿlrKh (Dialysis) hkqfjka ye|skafõ' kuq;a ldkaÿlrKh hkq jl=.vq frda.hg m%;sldrhla fkdfõ' iajNdúlj jl=. vq ls%hd lrk ;;a;ajhg m;ajk ;=re ldkaÿlrKh u.ska jl=.vqj,ska lrk ls%hdj,sh lsÍu fuys iajNdjhhs' wms by; i|yka l< ;Sõr jl=.vq wls%h;dj,§ tkï fláld,Skj isÿjk jl=.vq wls%h;dj,ska th Èk lSmhlska h:d ;;a;ajhg m;a jk ;=reu fuu ldkaÿlrKh lsÍu wjYH fjhs'

Èhjeähd frda.Ska th md,khg ksis mshjr .kak jl=.vq frda.j,g m%;sldr lsÍfï m%Odku ld¾h jkafka jl=.vq wls%hùu je<elaùuh' ta wkqj Èhjeähd frda.Ska doctormagazine.lk

th md,kh lsÍu i|yd ksis mßÈ m%;sldr .; hq;=h' • wêreêr mSvk frda.Ska th md,khg ksis mshjr .kak • wêreêr mSvkh we;s wh Bg ksis mßÈ m%;sldr .; hq;=h' Èhjeähdj iy wêl reêr mSvkh furg nyq,u frda. ;;a;ajhka folls' tfukau fuh ksis mßÈ md,kh lr fkd.ekSu ksid l,la .; jk úg jl=.vq wls%h ùu isÿúh yel' Èhjeähdj ksis f,i md,kh fkdl<fyd;a jir 10 – 15 la hk úg áflka ál jl=.vq krla ùu isÿ ùug bv we;' kuq;a ;udg Èhjeähdj we;s nj fidhd .kakd úg th je<|S jir .Kkla .; ùug jqjo yelshdj ;sfí' tksid ;udg jl=.vq wdndOhla ;sfío" keoao hkak frda.shd fkd±k ys|skakg mq¿jk' tksid iEu Èhjeähd frda.shl=g jirlg jrlaj;a jl=.vq mÍlaIKhla lr ne,Su jeo.;a fõ' fï i|yd uq;%dj, iïmQ¾K mÍlaIKhla tkï Urine full Reort iy uq;%dj, Urine micro albumin mÍlaIKhla lr ne,Su m%udKj;ah' doctormagazine.lk

fï rfÜ flfuka jeäjk jl=.vq frda.Skag fiajd ie,iSu g oeka mq¿,a jevigykla l%shd;aul jk w;r ud,s.dj;af;a jl=.vq frday, ta hgf;a wdrïN flreKQ uq,au wdh;khls jl=.vq frda.hg uq,la ;sfío hkak tu.ska ±k .ekSug mq¿jk' jl=.vq krla ùu yeÿfKd;a l< yelafla th fõ.fhka isÿ ùu je<elaùuhs Èhjeähd frda.h ksid jl=.vq frda. yefokak mgka .;fyd;a th m%;sldr u.ska k;r l< fkdyel' túg lrkq ,nkafka th fõ.fhka isÿùu je<elaùu yels;dla md,kh lsÍuhs' Èhjeähd frda.h we;s wh th T!IO u.ska uekúka md,kh lr .ekSu w;HjYH nj wm wjOdrKh lrkafka tneúks' ±ka ±ka jhi úis ;sia .Kkaj, whg;a Èhjeähd frda.h je<f|kq ±lsh yelshs' fï wh fyd|sska frda.h md,kh fkdlf<d;a jhi 45 § muK tkï Ôú;fha fyd|s jhfia§ jl=.vq frda.shl= ùug yelshdj mj;S' • tfukau uq;%dj, .,a we;s wh;a thg ksis m%;sldr ,nd .; hq;=h' • i¾m úIla we;=¨ jqjfyd;a thgo ksis m;sldr jydu ,nd .; hq;=fõ' fï wdldrhg by; o i|yka l< mßÈ ;ukag ;sfnk ish¨ frda.j,g ksis mßÈ m%;sldr .ekSu ;=<ska jl=.vq wls%h ùu j<lajd .ekSfï yelshdj ;sfí' ••• AUGUST 2018 | DOCTOR MAGAZINE

DO YOU CARE ABOUT THE SUNGLASS THAT YOU BUY?

Senaka Premalal, Optometrist, Vision Care Optical Services. 62

AUGUST 2018 | DOCTOR MAGAZINE

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We can buy various types of sunglasses from the market. But remember, it is not a good thing buying a sunglass like choosing cloth and shoes. Many people have not been aware of the damage to the eye by wearing low-quality sunglasses. First of all, let us look at the benefits of using a sunglass. doctormagazine.lk

01 02 03 04

Wearing sunglasses in a fashion. To reduce the inconvenience sunlight. To protect the eye from ultraviolet radiations from the sun. To protect the eye from external hazards.

According to the above, any sunglass in the market can use for fashion, can reduce inconvenience sunshine and can protect from external hazards. But to protect the eye from UV rays, it is necessary to use a sunglass with UV blocking lenses. In addition, the sunglass lenses production method also occasionally gives us sunglasses with low-quality lenses. One way of produce lenses, the colourful flat glasses curved by excessive heating and fitting to the sunglasses. Due to minor changes in the curvature of such lenses, the images visible to the eye can be somewhat blurred. Also, these lenses are not capable of blocking UV light.

LESS UV RAYS Small pupil in Sun light without Sunglass AUGUST 2018 | DOCTOR MAGAZINE

The second method of producing sunglass lenses is the production of sunglass lenses directly. These lenses do not have the above-mentioned defects. With these lenses, the UV blocking lens is also best suited for use as sunglasses.

MORE UV RAYS Large pupil with low quality Sun glass

Some people are used to wear any sunglass that ignores the quality. It is not bad for the eye to cut off excessive sunlight. But most do not know that they will have to get worse than the comfort they have. It can be explained in the following way. Anyone who knows that a normal eye is exposed to the sun, the pupil of the eye may become smaller. Then a small number of sun rays go into the eye. In view of this, the UV rays also decrease But when we wear a sun glass, the pupil gets bigger and more light comes in to the eye. In this case, if we will wear a cheaper sun glass more UV 64

BLOCK UV RAYS Large pupil with UV blocking Sunglass rays go in to the eyes. If it is a UV blocking Sunglass we can protect our eyes from harmful rays. Some people choose sun glasses with polarized lenses. Polarization is not an essential option of the sun glass. This will help to reduce unnecessary glares. But, ultimately UV blocking is more important than polarization. If we are buying a sun glass from a responsible place, we should not consider its quality. Alternatively, a sun glass cannot be selected for a good quality, description of the label show in the sun glass. Low quality sun glasses also label indicating that 100% UV blocking. The above information, I believe, will help you to choose the right sun glass. •••

AUGUST 2018 | DOCTOR MAGAZINE

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PLANTER FACIATIS

wäh ;shd.kak fkdyels

há m;=f,a oefkk fõokdjæ 66

AUGUST 2018 | DOCTOR MAGAZINE

doctormagazine.lk

ikaê frda. rla;jd; iy mqkre;a:dmkh ms<sn| úfYaI{ ffjoH ysuka; w;=fldar,

zzWfoa mdkaor ke.sg, wäh ìu ;shkak nE' bkak ysákak nE' hám;=f,a lelal=u we;s fjkjd' ú¨U ;shkak neßfldg fkdoeKQj;aju weúoskak jf.a weÕs,s j,ska'''ZZ

fï úosfya w;aoelSula Tng ,enqKdo@ ueoshï yd uy¿ jhfia ;rula iq,n fï frda.h ma,dkag¾ *eisháia hkqfjka ye|skafjkjd' hám;=f,a ú¨U hg wkskjd jdf.a mSvkh$ YÍr nr iu. tk fuu fõokdj fndfyda fofklaf.a mdo foflysu w;aú¢kjd' wiaÓhla rn¾ máhla wdldrfha ,s.ukaÜ tlla ^LKavrdjla& iu. iïnkaO jk ia:dkhlska fuu fõokdj yg.kakjd' doctormagazine.lk

,s.ukaÜ j,ska isÿlrkafka há m;=f,a jl% fyda keñ kshñ; wdldrhg mj;ajd .ekSuhs' fuu keñ ÿkq wdldrhg l%shdlsÍu ksid mdo yryd hk lïmk ;rx. wju ùu isÿjkjd'

fuu fõokdjg m%;sldr .Kkdjla ;sfnkjd' uqL u.ska fok T!IO ,nd fokjd' th ;uhs uq,skau lrk m%;sldrh' NSAIDS ldKavfha T!IO fï frda.Skag ffjoHjreka ,nd fokjd' yS,a mEâ keue;s ir, Wmdx.h mdjyka ;=<g oeóuo id¾:l l%uhla' tu.ska mdo j,ska tk oeä fõokdj wju lrkakg mq¿jks' ,xldfõ t;rï m%p,s; fkdjqk;a iag%Ñka.a jHdhduh fuu frda.Skag jvd;a iqÿiqhs' frda.Skag ksjfia§ isÿlsÍug fuu m%;sldrh lshd fokjd' thskja jvd;a fyd| m%;sM< frda.Ska i,id .kakd nj uu w;aoelSfuka okakjd' we;af;kau fuu jHdhduh ma,dkag¾ *eisháia ;;a;ajhg ngysr rgj, kï m%:ufhka ,ndfok fohla' w,ag%d ijqkaâ m%;sldrho fuhg rel=,la jkjd' tkak;a u.skao we;eï frda.Skag §¾> ld,Sk iqjh ,efnkjd' fï úosyg ú¨U hg oeä fõokdjla we;s lrk frda.hg m%;sldr /ila ;sfnkjd' fï ksid tu fõokdfjka mSvd ú|sk frda.Ska thg hg úh hq;= kE' l< hq;af;a ffjoHjrfhl= yuqù Bg Tng iß,k m%;sldrhla ,nd.ekSuhs' ••• AUGUST 2018 | DOCTOR MAGAZINE

WOMEN'S WORLD

SWEET HEART

ì<s÷

u,noaOh orefjlaf. i;=g ;uhs" t orejf. ujf.;a mshdf.;a úYd,;u fidïki' ì<sª i;=g ke;s lrjk fya;= w;f¾ nv ßoSï" nv fõ,jd oeóï m%Odkhs' Tfí ì<s|d fï wiSre;djfhka .,jd.kakg fï ,smsh w;aje<la jkq we;s' ì<sf|l= u,my lsÍug wmyiq njla olajñka ta i|yd oeä fjfyila orhs kï thg fya;=j nvfõ,Su fyj;a u,noaOh f,i úh yelshs' fuu frda. ;;a;ajh ks.ukh lsßu i|yd u,myj, iajNdjh iy u,my lsÍï w;r mj;akd mr;rh hk lreKq fol fhdod .; yelsh' 68

AUGUST 2018 | DOCTOR MAGAZINE

doctormagazine.lk

wdudY wdka;%sl frda. úfYaI{ Y,H ffjoH rks,a chfiak uy;d úisks

u,noaOfhaoS u,my iajNdjh fndfyda fia >k jq úh,s u,my len,s b;d wiSrefjka neyer lsÍu fuysoS oelsh yelsh'

u,noaOfhaoS u, my lsÍï w;r mr;rh ì<s|d idudkHfhka .; lrk fuu mr;rh blaujd hdu fuysoS oelsh yelsh idudkHfhka th meh 24 la mjd blaujd hd yelsh u,my lsÍu meh 48 la hk ;=rej;a isÿ fkdjqfha kï th ffjoH Wmfoia me;sh hq;= ;;a;ajhla f,i ie,lSu wjYHh'

u,noaOh we;sùug fya;= • ì<sfol= yg u,noaOh we;sùug n,mdk m%Odku fya;=j kï wjYH m%udKfhka c,h fkd,eîu iy u,my j, iqug;djh we;s lsÍu wjYH jk ;ka;= ^fl|s& iys;

doctormagazine.lk

• u,noaOh jeämqru w;a jkafka lsß jrk ld,h f,i ye|sskafjk ujqlsrg wu;rj w;sf¾l wdydr ,ndfok ld,fhaoSh ujqlsfrka muKlau fmdaIKh ,nk ì<s÷ka tu ld,fhaoS u,noaOhg fhduqjkafka b;du;a l,d;=rlska' tfy;a yßyeá" l%uj;aj ksis wdldrfhka w;sf¾l wdydr ,nd fkdoSu ksid lsßjrk iufhaoS fï ;;a;ajh we;sùug bv ;sfí' fuysoS <orejkag fyd|sska yd blauKska cS¾Kh jk wdydr ,ndoSu jeo.;ah'

fyd|ska fidaod msßisÿ l< m<d j¾. iy fmdä l< w, jeks wdydr ,ndoSu iqÿiqh' • ì<sÿ u,noaOhg fya;= jk ;j;a lreKla kï iuyr T!IO j¾. ì<sodg ,ndoSuhs fuysoS m%;scSjl T!IO" fõokdkdYl iy WK wvq lrk T!IO .ek úfYaIfhka ie<ls,su;a ùu wjYHh' • ly, ud¾.h ^wdydr ud¾.h& wjika fl<jr me,Shdu ksid u,noaOh we;sùug bv ;sfnk

AUGUST 2018 | DOCTOR MAGAZINE

WOMEN'S WORLD

wdydr iy m<;=re m%udKj;a ;rñka fkd,eîu oelaúh yelshs'

WOMEN'S WORLD

u<noaOh we;s úg l< hq;= foa'''

w;ru u,noaOh ksid ly, ud¾.h fl<jr mqmqrd hdugo bv ;sfí tjeks úfgl ffjoH Wmfoia ,nd.ekSu w;HjYHh iuyr T!IO .ekSfï fya;=fjkao fuu msmsßu isÿ úh yelsh tu ;;a;ajh ffjoHjreka —tak,a *sI¾˜ (Anal Fissure) f,i y÷kaj;s'

l,d;=rlska u,noaOhg uq,ajk fya;= • u,noaOh we;s lsÍug l,d;=rlska uq,ajk fya;=kao mj;shs tajd w;r ;hsfrdhsâ .%kaÓfha ;hsfrdlaiska fyda¾fudakh ksIamdokh wvqùu - tys nrm;<u ;;a;ajh fl%àk;djh f,i ye|sskafjhs' • tfia uy nvjef,a wl%ñl;d" —isiaála *hsífrdaisia˜ f,i ye|skafjk ;;a;ajh" w.akHdY widudkH;djh ksid w.akHdY tkaihsu >%djh ùfï fjkialï ksido u,noaOh we;s fjhs' • mdhk ld,fhaoS ì<s÷ka úc,khg m;aùuo u,noaOhg fya;=fjhs'

u,noaOh iys; orejl= m%lg lrk ,laIK u,noaOh iys; orejl= u,my lsÍug hdfïoS wmyiqjg yd fõokdjg m;afjhs y`vhs lE .ihs —fld,sla fmaka˜ f,i ye|sskafjk fõokd foñka nv fldrùfï ;;a;ajhg ,lafjhs úh,s >k u, len,s iq¿ m%udKhla msgùu fuysoS oelsh yelsh' 70

AUGUST 2018 | DOCTOR MAGAZINE

ì<s|dg wdydr fok úg muKla fkdj ta w;r;=r c,h mdkhg oSu" wdydrhg fyd|ska fidaod .;a w¨;a t<j¿ iy w, len,s lr iy fmdälr wdydrhg ñY% lsÍu" ì<s|d úc,khg m;a fkdjk fia ks;r c,h mdkhg oSu' T!IO .kakd úg u,noaOh we; úk ì<sf|l= kï ta nj ffjoHjrhdg mjid iqÿiq mQ¾j-m%;sl¾u fhoSu" yd u,noaOh os.ska os.gu mj;S kï w;a fnfy;a fyda m%;sld¾u fyda fkdlr ffjoH Wmfoia me;Su - úfYaIfhkau ly, u. fl<jr mqmqrd .sh —tak,a *sI¾˜ ;;a;ajhla kï ffjoH Wmfoia ,nd .ekSug mud fkdùu fuysoS b;d jeo.;ah'

fïjd fkdl< hq;=hs u,noaOfhka fmf<k ì<sf|l= yg ys;=u;fha fnfy;a j¾. oSu úfYaIfhkau nv nqre,a lrk ke;skï —,elaiáõ˜ f,i y÷kajk úf¾l fnfy;a ,ndoSu lsisÿ úfgl fkdl< hq;=h' ••• doctormagazine.lk

WOMEN'S WORLD

,,kd iqjfi;

FEMINA

fldfyduo fyd|u Baby Diaper ksIamdokhla f;dard.kafka@ ujla‌ ne,sh hq;= m%Odk lreKq fudkjdo@ lreKq ;=kla wms i,ld n,uq' ksIamdokh bÈßm;a lrk wdh;kh Tfí orejdg <ore Diaper ksIamdokhla f;dard .ekSfï§ ne,sh hq;= m%Odk lreKla jkafka" th bÈßm;a lrk ksIamdolhd'th b;d jeo.;a lreKla jkafka wehs@ th b;d jeo.;a lreKla jkafka ksIamdokh ms<sn| úYajdihla ;eîug;a ksIamdolhd fyd| kula Èkd ;sîu;a h'tfukau ksIamdolhdj myiqfjka Tn‍g iïnkaO lr.ekSfï yelshdj ;sìh hq;=hs'ksIamdokh ms<sn| ´kEu úia;rhla oek .ekSug ta ;=<ska wjia:djla Tng ,efnkq we;' tu ksid lsisª ìhlska f;drj tu 72

ksIamdokh Tnf.a orejdg Ndú;d lsÍug Tng yelsjkq we;'

ksIamdokfha we;s úfYaIdx. wêiqiqï miq mi wdjrKh ^Ultra Breathable Back-

Sheet&

jd;h ukd wkaoñka ixirKh jk miqmi wdjrKh ^backsheet& u.ska orejdf.a iu úh<sj ;nd .ekSug iyh fõ'tu.ska iu u;=msg we;súh yels wid;añl;djhka j<lajd .ekSug yels ù we;' f;;uk o¾Ylh ^Wetness Indicator& f;;uk o¾Ylh u.ska lsisu wmyiq;djhlska f;drj vhmrh udrelsÍug wjYH fõ,dj yÿkd.; yels jk w;r ta ;=<ska orejdg b;d iqjmyiqjla f.k fokq we;'orejd wvk f;lau n,d isàug wjYH fkdfõ'

AUGUST 2018 | DOCTOR MAGAZINE

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iajdNdúl fldaudßld ;Sre yd úgñka E orejdf.a iu fmdaIKh lrk w;r ì<sÿ iu b;d ixfõ§ neúka iu u;=msg we;s úh yels nelaàßhd wdidOk yd Diaper RASH j<lajd .ekSug wmg yels ù we;' b,diaála bkmáh ^Elastic Waist

Band&

orejdf.a bkg myiqjk whQßka vhmrhg fjkia ùug yd orejdf.a l%shdYS,s;ajhg ndOdjla fkdjk whQßka vhmrh ieliSug b,diaála West band tl iyh fõ' tu.ska orejdf.a Wor m%foaYh wkjYH f;rmsulska f;drj orejdg iqjmyiqjla f.k §ug fuu úfYaIdx.fhka yels fõ'

ksIamdokh i|yd we;s ;;a;aj iy;sl <ore Diaper ksIamdokhla f;dard .ekSfï § ne,sh hq;= m%Odk lreKla jkafka"th b;d Wiia ;;a;ajhlska hq;= ksIamdokhla o hkakhs'ukao" Baby Diaper tlla ksid Tfí orejdg úYd, ydkshla isÿùug we;s yelshdjhs' ;;a;ajfhka Wiia ksIamdokhla Ndú;d lsÍfuka tu wjOdku Tn‍g uÕ yrjd .; yel'oekg f,dalfha we;s ;;a;aj iy;slhka lsysmhla .ek fidhd n,uq' FDA- fuu ;;a;aj iy;slh weußld tlai;a ckmofhka Wiia ksIamdokhka i|yd ,nd fok ;;a;aj iy;slhls' BRC-fuu ;;a;aj iy;slh ì%;dkH tlai;a rdcOdksfhka wdrla‍Is; ksIamdokhlg" ksIamdok l%shdj,shg doctormagazine.lk

yd tu ksIamdok l%shdj,sh cd;Hka;r ;;a;aj iy;slhka g yd ks;Hdkql+,j isÿ lrk tlla njg iy;sl lrhs' SGS- fuu ;;a;aj iy;slh ,nd fokafka tu ksIamdok l%shdj,sh yd ksIamdokh cd;Hka;r ;;a;aj iy;slhka g wkqj mj;ajd f.khdu ksihs' fuu ;;a;aj iy;slhka ;=ku ,nd fokafka tu ksIamdokhka cd;Hka;r ;;a;aj iy;slhkag wkqj yd ñksia mßfNdackhg iqÿiq whqßka ksIamdok l%shdj,sh mj;ajd f.khdu ksihs' by; ioyka ;;a;aj iy;sl we;s Diaper ksIamdokhla Tfí orejdg f;dard .ekSu b;d jeo.;a' bÈßfha§;a fujeks jeo.;a f;dr;=re rdYshla fnod .ekSug wms n,dfmdfrd;a;=fjka isáuq' bÈß l,dmfhka Diapers f;dard .ekSfï§ laf,daÍka rys; ^Chlorine Free& Baby Diaper tlla f;dard .; hq;af;a wehs@ hk lreK .ek f;dr;=re fnod. ekSug wms n,dfmdfrd;a;=fjka isáuq' ••• www.facebook.com/ velonacuddles HOT LINE - 071-2360050

THREAD WORKS (PVT) LTD. VELONA CUDDLES

wmf.a j.lSu Tnf.a orejdg fyd|u foa ,nd§uhs igyk - ksrdÊ m%kdkaÿ úOdhl ks,OdÍ AUGUST 2018 | DOCTOR MAGAZINE

WOMEN'S WORLD

fldaudßld iy úgñka E ^Aloe Liners & Vitamin E&

WOMEN'S WORLD

SWEET HEART

w¿; Wmka orejd''' fï lshk ix{d Tfí orejd flfrka m%lg jkafka kï" Tn ffjoHjrhd yuqúh hq;=hs

ldi,a ùosh ldka;d frdayf,ka

Wmfoia

AUGUST 2018 | DOCTOR MAGAZINE

doctormagazine.lk

• yqiau .ekSfï wmyiq;djhla ^Yajik fõ.h úkdählg jdr 60 lg jvd jeä kï& fyda orejdf.a weÕs,s fyda f;d,a ks,a meyehg yeÍ mj;S kï' • yqiau .ekSfï§ Wria m%foaYh we;=<g we§hdula olakg we;akï'

• fmlksfhka ly meye;s Y%djhla .e,Su fyda ta wjg iu r;= meye ùu' • l%ufhka jeä ù hk wdldrfhka YÍrh fyda wefia iqÿ meye fldgi ly meye ùu' • jukh • mdpkh - orejkaf.a u,my lsÍfï rgdjkayS fndfyda fjkialï we;s ksid fuh y÷kd.ekSu wmyiq úh yel' ie<lsh hq;= f,i u,my lrk jdr .Kk jeä ùu" u, iu. reêrh fyda fij, msg ùu fyda msglrk uq;%d m%udKfha wvqjla olakg we;akï ffjoH Wmfoia ,nd .kak' • Èklg uq;%d 4 jrlg;a jvd wvqfjka msgùu' • T¨fõ we;s f;,aj, m%foaYfha we;s .s,d hdula fyda by,g b,smamSula' • lsß Wrdîu m%;slafIam lsÍu' • widudkH f,i ksÈu; .;sfhka hqla; ùu'

• yqiau .ekSu fyda msg lsÍu iu. Yíohla msg jkafka kï'

• widudkH f,i weÕ mk ke;s ùu w;mfha we;sjk fjõ,s,s iajNdjh'

• lsys,s m%foaYfha YÍr WIaK;ajh wxYl 99F g jvd jeä kï fyda 96F g jvd wvq kï'

• widudkH f,i ye`ãu iy k,jd .ekSug wmyiq ùu'

• È.gu mj;sk leiai'

• w;l" ll=,l" YÍrfha me;a;l fyda uq¿ YÍrfhau we;sjk ßoauhdkql+, .eiaula'

• kdifhka f,a .e,Su' • wefika ly fyda fld< meye;s Y%djhla msgùu'

doctormagazine.lk

ldi,a ùosh ldka;d frdayf,a fi!LH wOHdmk ld¾hdxYh m%ldYKhlska Wmqgd .eksk' ••• AUGUST 2018 | DOCTOR MAGAZINE

WOMEN'S WORLD

uõmshkag we;s nrm;, .eg¿jla jkafka l=vd orejka yeisÍfuys olajk fjkialï j,ska l==ula idudkHo''' l=ula widukHo hkakhs' fuys§ Èh yels wjjdoh jkafka Tng wjfndaO jk wdldrhg orejdf.a l=uk fyda widudkH;djhla we;akï ffjoH Wmfoia ,nd .ekSu fhda.H njhs' m%iQ;fhka wyjr" Tfí orejd ksjig /f.k wdmiq hï wdldrlska my; frda. ,laIK fmkajkafka kï jydu ffjoH Wmfoia ,nd .ekSug l%shd lrkak'

WOMEN'S WORLD

SWEET HEART

fyg oskh ch .kak orejkag .e,fmk

ksfrda.S wdydr rgdj

<ore úfhka <ud úhg md ;nk orejkaf.a fmdaIK wjYH;d 76

AUGUST 2018 | DOCTOR MAGAZINE

doctormagazine.lk

by< hk Yla;s wjYH;djhkag iß,k fia orejkaf.a wdydr rgdj yeviú lsÍu jeo.;a''' <ud frda. úfYaI{ ffjoH oSmd,a fmf¾rd orejka iy fmdaIKh" f,dl= l;djla fldfyduo lshkafka" fld;kskao mgka. kafka lshk tl álla wudre ud;Dldjla' Tn wms yefudau okakjd orejka lshkafka msfhl=g ujlg we;s jákdu iïm;la" b;ska thd,f.a wdydr iy fmdaIKh .ek;a uõjreka mshjreka w;sYhskau ie,ls,su;a fjkjd' fï ksid uE; ld,Skj orejka f.a fmdaIKh .ek fkdie,ls,su;a jqK wjia:d .ek jd¾;d fjkafka b;d wvqfjka' kuq;a" ksis oekqula iys;j ksis wjfndaOhlska hq;=j fuu ld¾hfha ksr; fjkafka fndfyda wvq msßila' wm fï ,smsfhka Tnj oekqj;a lrkafka uq,slju <uqkaf.a wdydr mßfNdack rgdj ksjerÈ lrk wldrh ms<sn|jhs' doctormagazine.lk

l=vd wjÈfha§ <uqka fõ.fhka j¾Okh iy úlikh fjkjd" ta ksid thd,f.a Yla;s wjYH;djh iy fmdaIK wjYH;djho b;d by, w.hla .kakjd' fï ksid <uqka fmdaIHodhs wdydr j,g fï ld,fha isgu yqre lrúh hq;=hs' tf,i yqre lrùu u.ska Tjqkaf.a jeäysá wjÈfha§ we;súh yels frda.dndO /ilska je<lSfï yelshdj Tjqkag ,efnkjd' idudkHfhka jhi 1-5;a w;r <uqkaf.a l%shdYS,s;dj" Wi nr jhi iy m%fõKs.; idOl u;o" Tjqkaf.a ffoksl fmdaIK wjYH;d fjkia fjkjd iy fudjqkaf.a wdydr reÑh;a ojila we;=,; fjkia fjkak mq¿jka" ta ksid úúO wdydr j¾. ojfia lsysm úgla ,nd §u isÿ l< hq;= fjkjd'

<ore" <ud jhfia wjYH;djhkag .e,fmk wdydr jeäukla OdkH iy msá iys; wdydr" m<;=re" t<jÆ" ud¿ uia iy msh,s weg j¾. iy lsß iy lsß iys; wdydr j¾. ,nd Èh hq;= fjkjd' fï wjêfha§ ÆKq iy iSks jeäukla wka;¾.; wydr isud l< hq;= fjkjd' thg fya;=j kï wms Tjqkag ,nd fok iSks fyda ÆKq m%udKh u; Tjqkaf.a tu rihkag ;shk foay,Sh w.h fjkia fjkjd' fjk úÈhlg lsõfjd;a" iSks fyda ÆKq jeämqr lkak mqreÿ jqfKd;a Tjqka jhig hk úg ÆKq iy iSks jeämqr wdydrhg .kak yqre fjkjd' fudlo jeä m%udK j,ska wdydrhg .ekSfuka ta rihg yqre ùu ksid' fuh

<ud úfhaoS iSks fyda ÆKq jeämqr lkak mqreÿ jqfKd;a Tjqka jhig hk úg ÆKq iy iSks jeämqr wdydrhg .kak yqre fjkjd' ta úÈhg yqre fjk flfkla wêl ÆKq iy iSks mßfNdackh ksid jeäysá wjÈfha§ wd;;sh" Èhjeähdj jeks frda. /ilg f.dÿre ùfï wjodkulg ,lafjkjd' AUGUST 2018 | DOCTOR MAGAZINE

WOMEN'S WORLD

jhi 1-5;a w;r <uqka yg úúO wdydr j¾. ojfia lsysm úgla ,nd §u isÿl< hq;= fjkjd'

WOMEN'S WORLD

t;rï fyd| fohla fkfuhs" ta úÈhg yqre fjk flfkla wêl ÆKq iy iSks mßfNdackh ksid jeäysá wjÈfha§ wd;;sh" Èhjeähdj jeks frda. /ilg f.dÿre ùfï wjodkulg ,lafjkjd'

<ore yd <ud úhg wjYH Yla;sh iy fm%daàk Yla;sh iy fm%daàk j, wjYH;djho fï wjêfha§ b;d jeähs' tksid m%Odk wdydr fõ,a ;=kg wu;rj" flá wdydr fõ,a folla muK ,nd§u u.ska fuu Yla;s wjYH;djh iïmq¾K lr.; yelshs' msá iys; wydr u.ska wjYH Yla;sh ,nd fokjd" uia ud¿" lsß ì;a;r" iy msh,s OdkH wdydr u.ska fm%daàk wjYH;djh imqr. kak mq¿jks' óg wu;rj t<jÆ j¾. lsysmhla" iy m,;=re wdydrhg tl;= lsÍu u.ska YÍrhg wjYH lrk Lksc ,jK iy úgñk jeks laIqø fmdaIl ,nd Èh yelshs'

le,aishï iy hlv l=vd l, isgu w;HjYH iy ksis f,i ,nd Èh hq;= fohla ;uhs le,aishï iy hlv" fïjd;a laIqø fmdaIl ldKavhgu wka;¾.; jqk;a" wkd.;fha§ we;s úh yels ixl=,;d ^Wod' Tiaáfhdafmdfrdaisia& wju lr .ekSug le,aishï iy hlv wka;¾.; wdydr .ekSu jeo.;a fjkjd' le,aishï m%Odk jYfhka" lsß iy lsß iys; wdydr j, iy" lgq

mdie,a hk Tfí orejdg iun, WoEik wdydr fõ,la iy" mdi,a úfõlfha§ .ekSug fi!LH iïmkak flá wdydr fõ,la ,ndoSu iEu uõmshkaf.au j.lSula''' 78

AUGUST 2018 | DOCTOR MAGAZINE

iys; l=vd ud¿ j, nyq,j wka;¾.; fjhs' hlv" i;aj wydr ^uia" ud¿& iy fld< meye;s t<jÆ j, nyq,j wka;¾.; fjhs'

wdydrhlska miq úgñka m<;=rla .kakd isß;o jeo.;a''' wdydrhlska miq úgñka C nyq,j wka;¾.; wdydrhla ,nd§u u.ska hlv YÍrhg wjfYdaIKh by, kxjhs' úgñka C wka;¾.; wdydr f,i" weUq,a rihlska hq;= fndfyda m,;=re Wod' fk,a,s" fmar" foys" fodvï" iy fjr¿o ;o fld< meye;s t<jÆ j¾.o ie,lsh yel' mdie,a hk Tfí orejdg iun, WoEik wdydr fõ,la iy" mdi,a úfõlfha§ .ekSug fi!LH iïmkak flá wdydr fõ,la wjqreÿ my;a oyh;a w;r <uqka l%ñl j¾Okhlg ,laùu isÿ fjkjd' ;jo fudjqka f.a l%shdldß;ajh mdi,a hdu" YdÍßl l%shdldrlï u; fjkia fjkjd' iun, WoEik wdydr fõ,la iy" mdi,a úfõlfha§ .ekSug fi!LH iïmkak flá wdydr fõ,la ,nd §u w;HjYH fjkjd' laIKsl wdydr" wêl iSks iys; wdydr j,g yqre ùug bv fkd;eîug fouõmshka j. n,d.; hq;=hs' ukao''' bka jk ydksh ydks mq¾Kh l, fkdyels ksidfjks'

orejdf.a Wig iß,k nrla ;sfnkjdo@ ;jo j¾Okhg wod,j Wi iy nr ksis f,i we;aoehs ;yjqre lsÍu u.ska" Tjqkaf.a j¾Okh ms,sn| ;lafiare lr.; yels fjkjd' hï fyhlska j¾Okh nd, ù ;snqkfyd;a ksis fmdaIKfõ§kaf.a iy ffjoH iydh me;sh hq;= fjkjd' ••• doctormagazine.lk

WOMEN'S WORLD

SWEET HEART

we;eï wdydr j¾.

.eìks iufha § kqiqÿiq wehs@ i;=áka .; hq;= wdydr yd fldfydug;a fkd.; hq;= wdydr

m%ij yd kdßfõo úfYaI{ ffjoH wd¾ tka Ô rdcmlaI úisks 80

AUGUST 2018 | DOCTOR MAGAZINE

doctormagazine.lk

WOMEN'S WORLD

.eìks uõjreka fndfyda úg wdydr mdk j¾. .kafka f;dard fírd f. kh' iuyr wdydr j¾. m%;slafIam lrkafka tAjd flfryS reÑhla ke;slu ksidh' ;j;a iuyr wdydr j¾. .ekSug jeäysáfhda bv fkdfo;s' tA tu.ska l=fia isák orejdg ydks fõ hehs Tjqka úYajdi lrk ksidh' wms tjeks újdod;aul wdydr j¾. lsysmhl we;s ys;lr wys;lr Ndjh ms<sn|j úuid n,uq'

.ia,nq t;rï iqÿiq kE .ia,nq fyj;a mefmd,aj, mefmaka ^Papain& kue;s tkaihsuhla wvx.h' fïjd nyq,j .eìks ujlf.a YÍr.; jQ úg Biag%cka fm%dfciagfrdaka uÜgu wvq ùfï yelshdjla mj;S' ñka l=fia isák l<,hg n,mEula we;sùug mq¿jk' kuq;a fï mefmaka wvx.= jkafka wuq iy ndf.g bÿKq .ia,nq j,h' tfia jqjo fyd¢ka bÿKq .ia,nq jqj;a jeämqr .ekSu t;rï iqÿiq ke;'

uq,a udi ;=fkaoS wkakdis .ekSfuka ore .eng ydks isÿúh yelshs wkakdisj, wvx.= fm%diag.a,ekaäka ^Prostaglandin& kï ixfhda.h ksid .eìks ujf.a .¾NdIfha ixfldapk we;s ùfï wjldYh we;' fïjdo iq,nj mj;skafka wuq iy ndf.g bÿKq wkakdisj, ksid .eìks iufha § úfYaIfhka uq,a ;=ka udih ;=< wkakdis wuqfjka fiau msi jHxckhla f,i .ekSfuka mjd je<lSu iqÿiqh' fïjd iïnkaOfhka ;jÿrg;a úoHd;aul m¾fhaIK isÿ fjñka mj;S'

AUGUST 2018 | DOCTOR MAGAZINE

WOMEN'S WORLD

n, ud¿ lEfuka wdid;añl;d msg oeñh yelshs n, ud¿ we;=¨ l¿ meye;s ud¿j, ysiagñka ^Histamin& ixfhda.h wêlj wvx.=h' fïjd ksid .eìks uj ;=< wid;añl frda. ;;a;aj we;s úh yelsh' isrer leiSu" weÕ ±ú,a," m¿ ±óu" isref¾ WIaK .;sh" ysi lelal=u jeks wmyiq;d ñka m%Odk fjhs' tneúka .eìks uõjrekg iqÿiq iqÿ meye;s ud¿h'

fÞvï ;eô,s jeks mdk j¾. iS;, wdydr f,i wfma me/kakka fukau wdhq¾fõo yd foaYSh fjolfï o y÷kajk fun÷ wdydr ksid we;eï .eìks uõjrekag fiu jeä ùu;a" tksidu yqiau .ekSfï wmyiq;d jqj we;s ùug;a bv ;sfí' tneúka tjeks wid;añl ;;a;ajhka yg .kakd wh fun÷ wdydrj,ska je<lS isàu iqÿiq fõ'

w¾;dm,a fkdjk fjk;a w, j¾. .kafka m%fõYfuka biaika - ll=¿jka wkqNjfhka we;súh yels ;;a;aj fïjdfhys widudkH fm%daàk j¾. mj;shs' tA fm%daàk ksid wid;añl;d ^Allergy& we;s ùug bvlvla we;' tA wkqj nv nqre,a ù hdu fyj;a mdpk ;;a;ajh" yqiau .ekSu wmyiq ùu jeks ;;a;ajhka o we;s ùug mq¿jk' .eìks ujlg fujeks ;;a;ajhka we;s ùu ys;lr fkdfõ' tksid .eìks iuh wjika jk ;=re fiau ì,s|dg uõlsß fok iufha;a fun÷ wdydr j,ska je<lS isák ;rug fhda.Hh' fujeks wdydr .eìks ujla .;a miq tys we;s widudkH fm%daàk j¾. l=fia ys¢k orejdf.a isrerg we;=¿ ùu fya;=fjka orejd ìys jQ miq miqld,Skj fya;=jla ke;sju orejdg wid;añl;d yg .; yels nj o wkdjrKh ù we;' tksid fun÷ wd.ka;=l fm%daàk j¾. iys; wdydr .eìks ujlg iqÿiq fkdfõ' 82

AUGUST 2018 | DOCTOR MAGAZINE

lsß w, wd§ jQ úúO w, j¾. iuyreka ;=< wid;añl;d we;s lrhs' tjeks whg fun÷ w, j¾. .eìks iufha§ iqÿiq ke;'

iuia; wdydr mKsúvh .eìKs iufha weh wdydr .; hq;af;a keK kqjKsks' wkqNjfhka ljr fyda kmqrla jk njg w;aoelSï ,efnkafka kï tjka wdydr j,ska je<lsh hq;=h' u<noaOhg fya;= jk wdydr j,ska je<lsh hq;=h' fjfiiskau j¾Kl" l,a;nd .ekSfï øjH wka;¾.; wdydr j,ska imqrd je<lsh hq;=h' f;,a wdydr" f;ïmrdÿ l< neomq wdydr jeä jYfhka wkqNjh iqÿiq fkdfõ' t<j¿ m<;=re fndcqkam;g tlalr.; hq;=h' oji mqrd ksis fmdaIKhla ,nd .ekSug yeu úgu weh W;aiql úh hq;=h' ••• doctormagazine.lk

,,kd iqjfi;

.eìks iufha§

nyq,j we;sjk ldhsl wmyiq;d iy tajdg fhdok ms<shï

doctormagazine.lk

AUGUST 2018 | DOCTOR MAGAZINE

WOMEN'S WORLD

FEMINA

WOMEN'S WORLD

m%ij yd kdßfõo úfYaI{ ffjoH tia î taalkdhl

ldka;djla .eìKshl ùu hkq wef.a isref¾ fjkialï rdYshla we;s jk cSjk fjkils' fuu fjkialï ldhslj muKla fkdj udkisljo we;s fjhs' .eìKs njg fndfyda úgu wdfõKsl jk fuu ixl+,;d fndfydauhla bfíu u. yeÍ hk w;r we;eï wjia:dj,§ ffjoH Wmfoia me;Sug isÿúh yelsh' 84

we;eï wdydrj,g ±ä ms%h;djhla ±laùu .eñ jyf¾ zzfod<ÿlZZ kñka y÷kajk fï ;;a;ajfha§ fndfyda .eìks uõjreka weUq,a rie;s wdydr flfrys ±ä reÑhla olaj;s' idudkHfhka weUq,a m,;=re iy t<j¨ .ekSug wu;rj iuyr .eìks uõjreka biaika" ±,a,ka" n, ud¿ka" fo,a jeks wdydrj,go reÑhla ±laùu iq,n ;;a;ajhls' kuq;a tjeks ysiagñka wvx.= wdydr .eìks uõjreka fkdf.k isàu hym;ah' .¾NKS ld,fha we;sjk wdydr reÑh ms<sn|j l;d lsÍfï§ ±lsh yels úfYaI ,laIKhla jkafka l,ska b;d leue;af;ka .;a iuyr wdydr fï ld,h jk úg m%;slafIam lsÍuh isref¾ fydafudak j, isÿjk fjkialï u; we;s jk fï ;;a;ajh ore m%iQ;sfhka miq idudkH w;g yefrkq we;' kuq;a fuys§ i‘oyka l< hq;= úfYaIu foh jkafka .eìks ujg lsß wdydr iy weh ms%h lrk wdydrj,ska fmdaIHodhl wdydr fï ld,h ;=<§ fyd|ska ,nd §u wjYH njhs'

we;eï .eìks uõjreka widudkH wdydr j,g olajk ±ä reÑh idudkH flfkl= flfiaj;a lEug fkd.kafk ueá" wÕ=re" .,a jeks foaj,a lEug ms%h lrk .eìks uõjre o isá;s' fun÷ foaj,a ksid ore .eng úYd, ydks isÿúh yelsh' tksid hï .eìks ujla tjeks wdydr ms%h lrhs kï jydu ffjoH Wmfoia ,nd §u iqÿiqh'

ks;r uq;%d lsÍfï wjYH;djh ±kSu iy uq;%d wdidok .eìks iufha§ jl=.vq fj; .uka lrk reêr m%udKh idudkH ld,hg jvd wvlska muK jeäfjhs' fï fya;=j ksid fukau fm%dfciagfrdak fydafudakj, n,mEfuka uq;%d ud¾.fha fmaYsj, jeämqr isÿjk bys,a ùu fya;=fjkao fï ;;a;ajh we;s fjhs' tfiau fï fya;= u; .¾NKS ld,fha§ uq;%d wdidok we;s ùuo jeäh' fujeks wdidok ksid jDlalodyh kue;s ;;a;ajhka we;s ùug bv we;s neúka uq;%d

AUGUST 2018 | DOCTOR MAGAZINE

doctormagazine.lk

u<noaOh fuh fndfyda .eìkshka ;=< ±lsh yels ;;a;ajhls' fï ksid u< >k njg m;a jk úg u<my lsÍfï§ ±ä fõokdjla we;s úh yelsh' fuhgo by; i|yka l< wkaoug doctormagazine.lk

WOMEN'S WORLD

lrk úg fõokdjla we;s ùu fyda uq;%d iu. iq¿fjka fyda reêrh msgùu jeks ;;a;ajhka ;sfí kï ffjoHjrfhl= yuqùu b;d jeo.;a fõ' fï fndfyda uq;%d wdidok jeämqr c,h mdkh lsÍu u.ska j<lajd .; yelsh' msmdih ±fkk ;=re fkdisg meh Nd.hlg muK jrla ne.ska j;=r ál ál fyda mdkh lsÍu b;du;a w.fkah'

fyd|ska c,h mdkh lsÍu m%;sl¾uhla fõ' tfiau .eìks iufha§ b;du jeo.;a fohla jk m,;=re wdydrhg .ekSu fuf,i u<noaOh j<lajd .ekSugo fnfyúka jeo.;a jkq we;' ta yereKq úg t<j¿" m<d fyd|ska wdydr fõ,g tl;= lr .ekSu ;=<ska o u<noaOh j<ld .; yels fjhs'

fomdj, uia ms`vqq fmr<Su kskafoa§ iq,nj we;s úh yels uiamsvq fmr<Su b;du;a fõokdldÍ w;a±lSuls' isrerg wjYH le,aishï iy fmdgEishï wvq jk úg uia ms`vq fmr<Su isÿ úh yels w;r ffjoH Wmfoia u; tu fmdaIK øjH wvx.= T!IO ,nd .ekSu fhda.H fjhs' flfia jqjo .eìks iufha§ we;s jk fun÷ úúOdldr jQ ixl+,;d .eìks njg wdfõKsl jQ tajd úh yelsh' tfia fkdjk wjia:do l,d;=rlska fyda fhfok neúka fun÷ ,laIK ks;r ks;r yd ;Èka we;s jkafka kï ffjoH Wmfoia me;Su iqqÿiq fõ' .¾NKS ld,fha§ uq;%d wdidok we;s ùï jeäh' fujeks wdidok ksid jDlalodyh kue;s ;;a;ajhka we;s ùug bv we;s neúka uq;%d lrk úg fõokdjla we;s ùu fyda uq;%d iu. iq¿fjka fyda reêrh msgùu jeks ;;a;ajhka ;sfí kï ffjoHjrfhl= yuqùu b;d jeo.;a fõ' isrerg wjYH le,aishï iy fmdgEishï wvq jk úg uia ms`vq fmr<Su isÿ úh yels w;r ffjoH Wmfoia u; tu fmdaIK øjH wvx.= T!IO ,nd .ekSu fhda.H fjhs' ••• AUGUST 2018 | DOCTOR MAGAZINE

WOMEN'S WORLD

SWEET HEART

nnd,dg

mKq fnfy;a fok yeá fifkyi mokfï ks¾ud;D mjq,a fi!LH ks,OdßkS" udOHfõoS YHdu,S m;srf.a

AUGUST 2018 | DOCTOR MAGAZINE

doctormagazine.lk

nndg mKq fnfy;a fokak mgka .kafka ljodo@ idudkHfhka orejl= wu;r wdydr ,nd .ekSu mgka .;a;g miqj ´kEu wjia:djl mKq frda.hla iEÈh yel' kshñ; fi!LH mqreÿ wkq.ukh lrkafka kï udi 18la muK jk f;la mKq fnfy;a ,nd ,nd §u wjYH fkdfjhs' kuq;a l=vd orejka ks;r ìu w;m; .Eu .d w; lfÜ rejd .ekSu isÿ lsÍu ksid lsß mkq wdidok jeks wdidok we;sùfï fndfyda bvlv mj;S' fï ksid frda. ,laIK hï lsis uÜgulska fyda m< lrkafka kï mKq fnfy;a ,nd ,nd §u iqÿiqhs' mKq fnfy;a j, w;=re wdndO fkdue;s ;rï nj fuysoS isysm;a l< hq;af;ah'

mKq frda.hla we;s nj yÕjk wkqudk ,laIK • lEu wreÑh • u,dksl nj • flÜgq ùu • orejd fkdikaiqka ùu • miqmi m%foaYh rd;%shg leiSu fyda tjeks bßhõ oelaùu

AUGUST 2018 | DOCTOR MAGAZINE

WOMEN'S WORLD

mKq frda. hkq l=vd orejkag b;du;a nyq,j je<f|k iq,n frda. ;;a;ajhla' fuh iq¿fldg ;elsh yels frda. ;;a;ajhla fkdjkafka orejka b;d wmyiq;djhkag m;a lsÍug;a fmdaIŒh wvq¨yq`vq;d we;s lsÍug;a mKq frda. fya;= jk ksihs' mKq frda. .ek;a''' mKq frda. je<elaùug fok mKq fnfy;a .ek;a wfma wïu,dg .eg¿ fndfydauhs' fï ,smsfhka Tng we;sjk .eg¿ rdYshlg ms<s;=re iemfhkq we;'

WOMEN'S WORLD

• Tlaldrh • mdpkh • WordndO

Albandazole 400mg jhi wjqreÿ 2 g jeä orejkag' ksis f,i mKq fnfy;a ,nd .ekSfï l%shd mámdáh

• úgñka W!K;d • ksrla;sh • uQfka iqÿ mdg mq,a,s • wefÕa m¨ oeóu • ks;r mj;sk leiai • o;añá lEfï ;;a;ajh • uq;%d oeú,a, iy ks;r uq;%d hdu • rd;%Shg .=o ud¾.h jgd leiSu • kskao fkdhdu • u,my iu. f,a msgùu • l,d;=rlska isÿjk mkqjka jukh • §¾. ld,Skj mKq frda. we;s kï yqKq" mia jeks foa lEug m%sh;djhla oelaùu

orejkag ,ndfok mKq fnfy;a fudkjdo@ Mebandazole 100mg Wfoa iji Èk ;=kla .ekSu lsß mKq wdidok i|yd kï muKla 500mg tlaÈk m%;sldrh Pyrantel fm;s iy Syrup jYfhka we; jhi wjqreÿ 2 isg 9 olajd isrma f;a yeÈ 1 jhi wjqreÿ 9 g jeäkï kï f;a ye¢ 2 ^nr wkqj ,nd fohs'& wiqrkfha Wmfoia$ud;%d i|ykaj we;'

AUGUST 2018 | DOCTOR MAGAZINE

mKq frda. hkq b;d myiqfjka orejkag fnda úh yels frda.hls' úfYaIfhka l=vd orejka w;r nyq,ju yuq jk lsßmKq frda.fha ì;a;r iq,Õska mjd jHdma; fjhs' we| we;sß,s" l=Ika" fldÜg-fuÜg" ;=jd" we÷ï j, ;ejÍ myiqfjka fnda fjhs' fïksid mKq fnfy;a .ekSfï§ my; l%shd mámdáh wkq.ukh l< hq;=uh' tfia ke;fyd;a kej; kej; mKq wdidokh we;s fjhs'

mKQ fnfy;a fï úosyg .kak • mjqf,a idudðlhka iEu fokd tlu Èkhl § mKq fnfy;a ,nd .ekSu • we| we;sß,s ;=jd ish¨ foa fidaod msßiqÿ lsÍu yd yels kï kgk j;=f¾ oud ;ïnd .ekSu • úfYaIfhka hg we÷ï kgk WKq j;=f¾ oud ;ïnd .ekSu ' • fldÜg fuÜg ;o wõfõ oud fõ,Su • i;s 2 lg miqj kej; jrla mKq kdYl T!IO ,nd .; hq;=hs'

mKq fnfy;a î miq nv úf¾l wjYHo@ iuyr úg ngysr ffjoHjreka mKq fnfy;a ,nd ÿka miq úf¾pk T!IOo ,nd fohs' wdhq¾fõofha i|yka jk wkaoug" .=o ud¾.fha /£ we;s mKq ì;a;r fyda mKqjka isà kï th bj;a lr .ekSug úf¾l ,nd .ekSu iqÿiqh' doctormagazine.lk

mKq frda. iy wdhq¾fõoh

tfia ld, mr;rhla ;nd mKq fnfy;a §u wjYH jkafka ke;' frda. ,laIK my< jqjfyd;a muKla mKQ fnfy;a §u m%udKj;a' kuq;a udi yhlg muK jrla mKq fnfy;a fõ,la §fï .eg¿jlao ke;'

mKq frda. ioyd mer‚ wdhq¾fõofha i|yka

mKq m%;sldr ,nd .;a úg kEu kqiqÿiqo@ fuh ñ;Hd u;hls' mKq m%;sldr ,nd.;a .;a úg wksjd¾hfhkau kEu fyda weÕ fia§u jeks foa isÿ l< hq;=hs' msßisÿj isáh hq;=hs'

mKq m%;sldr ,nd.;a úg f;,a wdydr weUq,a wdydr kqiqÿiqo@ fuys úoHd;aul i;Hd;djhla ke;' fndfyda l,lg fmr Ndú;d l< iuyr mKq fnfy;a j,g f;,a iys; wdydr .ekSfï" weUq,a wdydr .ekSfï .eg¨ we;s jqjo kùk T!IO j,g tjeks .eg¨jla ke;'

mKq frda. orejdf.ka ioygu ;=rka l< .; yelso@ orejka mßirfha isák úg myiqfjka mKqjka YÍr.; fjhs' fï ksid mKq frda. ksÜgdjg iqj lsÍu fyda j| lsÍu l< fkdyel' ksis fi!LH ms<sfj;a /lSu yd je<÷kfyd;a ksis f,i m%;sldr .ekSu;a u.ska je<lS isáh yel'

mKq frda. j,ska je<lS isàug we;s lr.; hq;= fi!LH ms<sfj;a • wdydr ms<sfh, lsÍug fmr" wdydr .ekSug fmr iy jeisls,s hdfuka miq w;a inka oud fyd¢ka fia§u" fi,a,ï lrk úg w;a lfÜ oud .ekSfuka je<lSug Wmfoia §u' • fi,a,ï lsÍfuka miq w;a fia§ug yqre lsÍu' • mdjyka Ndú;hg yqre lsÍu' • ksh flá jk fia lmd msßiqÿj ;nd .ekSu'

l=Uqre weg lidh wjYH lrk øjH l=Uqreweg uo" iqÿÆKq" wr¿ j<Õiy,a" l¿ÿre" t<ngq uq,a" lgqje,a ngq fï ish,a, l<|hs uxpdä 10 ne.ska f.k" j;=r m; 8 wg tlg is| jrlg m; Nd.h ne.ska ó me‚ f;a ye¢ Nd.hla oud Wfoa yji mdkh lrkak fokak' orejkag ñka nd.hla iEfya' fï lidh jä ;=kla fyda y;rla muK .ekSu mKQ frda. u¾Okhg iEfya'

• jeisls,sh ksis wdldrj mßyrKh lsÍu' doctormagazine.lk

AUGUST 2018 | DOCTOR MAGAZINE

WOMEN'S WORLD

udi yfhka yh fyda kshñ; ld, mr;rhla w;r mKq fnfy;a ,nd Èh hq;=o@

WOMEN'S WORLD

SWEET HEART Fertility

fï frda. ;sfhk ldka;djka újdyh" orejka ,eîu l,a oukakg tmd''

fmd,sisiaála ´fõßhka frda.h ;sfhk ldka;djkag k< ore ;dlaIKh b;du iqÿiqhs'

AUGUST 2018 | DOCTOR MAGAZINE

doctormagazine.lk

WOMEN'S WORLD

WISH Fertility & IVF Clinic yS idhksl l<,fõo úfYaI{ ffjoH fy<rejka mikal=udr uy;d iu. l< idlÉPdjla weiqßKs MBBS (Sri Lanka)

MD (Gyn. & Obs.) Infertility - China, Pg. Dip. (Andrology) Monash, OUSL, Master of Clinical Embryology Monash, Australia, SLMC Reg. No. 20800

fï wkQj yqfola ldka;djf.a fodaI ksidu ore iïm;a ,eîu ÿIalr fjkj lsh, ldgj;a weÕs,a, osla lrkak nE' ta ú;rla fkdfjhs" bosßfhaos ;j;a jir lsysmhla hk úg ore iïm;a m%udo ùfï fodaI w;=ßka ldka;d fodaI wNsnjd mqreI fodaI jeä fjk njg;a mqfrdal:kh fj,d ;sfhkjd' ta fldfydu jqK;a ldka;djka ;ukaf.a fodaIhla ksid ore iòm;a m%udo fjk nj y÷kd.;a miq ta wh Bg l,a fõ,d we;sj iQodkï ùu jeo.;a' wo .eg¿ wNsnjd ms<s;=re bosßhg meñKs ld,hla' ljr .eg¿jla jqK;a úi|d.kak fyd| bv m%ia:djla ;sfnkjd' l< hq;af;a Bg Tfí jqjuKdj yd iQodkï ùuhs' doctormagazine.lk

hï fyhlska újdyh m%udo fjkjd kï äïn ixrlaIKh lr fyda ;nkak ldka;djkaf.a u|ireNdjhg fya;= ore iïm;a j,g n,mdk fydafudak wdY%s; .eg¿ ldka;djf.a orejka ,eîu m%udo ùug" fkdtfia kï ore iïm;a wysñ ùug n,mdk fya;= ms<sn|j fujr ,smsfhka újrKhl fhfouq' yenehs" ldka;dj muKgu msßñhdf.a fodaI ksid;a ore iïm;a m%udo fjkakg" wysñ fjkakg bv ;sfnkjdh hk újD; jQ ukiska hqla;j' uq,skau ldka;djf.a m%ckl moaO;sh ne¨fjd;a mqreIhdg idfmalaIj úYd, m%ckl moaO;shlg weh Wreu lshkjd' th wdrïN jkafk fud<fhka' yhsfmd;e,uih" msáhqgß .%kaÓh yryd tk fydafudak äïnfldaI" .¾NdIh" fhdaksud¾.

fmd,sisiaála ´jrs iy,laIKh - k< ore ;dlaIKh fï ldka;djkag b;d iqÿiqhs AUGUST 2018 | DOCTOR MAGAZINE

WOMEN'S WORLD

fha l%shdldß;ajhg n,mdkjd' Bg wu;rj fïjdfha l%shdldß;ajh uekúka mj;ajd .kakg ;hsfrdhsâ .%kaÓh;a jeo.;a fjkjd' fï fudlla yß .%kaÓhl fydafudak l%shdldß;ajfha .eg¿jla wdfjd;a th ore iïm;a ,eîug ndOdjla jkakg bvla ;sfhkjd' we;eï ldka;djkaf.a fud<fha fydafudak >%djh ÿ¾j, fjkjd' fuh Wmf;kau we;s fjkak;a mq¿jka' tfyu ke;akï miqj wjia:djloS fjkak;a mq¿jka' t;fldg fuysoS m%ckl moaO;sfha ÿ¾,;djhla ksid fkdfjhs" fud<fha fydafudak >%djfha .eg¿jla ksihs fï ore iïm;a m%udo ùu isÿ jkafka' iuyr ldka;djka bkakjd" iqj| oefkkjd wvqhs' fïl wms tÉpr i<lkafka ke' kuq;a fï wdldrfha ldka;djka

iuyr ldka;djka bkakjd" iqj| oefkkjd wvqhs' fï wdldrfha ldka;djka we;eï fj,djg u|ire;djhg ,la ùfï jeä bvla ;sfnk nj Tn okakjdo@ 92

tkafvdfuá%fhdaisia - ,ys ,ysfha újdyh''' ore iïm;a .ek ys;kak u|ire;djhg ,la ùfï jeä bvla ;sfnk nj Tn okakjdo@ fud<fha ia:dkhlg iïnkaO iakdhq /yeka fodaIhla we;sfj,d fydafudk >%djfha wvq¨yq`vq;djhla we;s ùfuka oreM< M< m%udo fjkakg mq¿jks' äïn fudarkafk ke;s fjkak mq¿jka' m%ckl moaO;sh ksishdldrj mßK;shg ,la fkdù ;sfhkakg mq¿jka' we;eï fj,djg ;hsfrdhsâ .%kaÓfha fydafudak >%djh wvq fjkak mq¿jka' l%shdldß;ajh jeä fjkak;a mq¿jka' tfyu fj,djg tu fydafudak >%djh ksjeros lrkak ´ks' jl=.vq j, uqÿfk;a fydafudak .%kaÓ ;sfhkjd' fï fodaI fmdä foaj,a' fïjd ksjerosj yªkd .ekSu ;uhs jeo.;a' túg fydafudak ,ndoS, ta wvqmdvqj ksjeros lrkakg mq¿jka' tl j;djla wmg ldka;djla wdj' ore iïm;a ke;s tl .ek fydhd n,k úg wka;sug jl=. vq krla fj,d' wdfj tl ldrKhlg' fj,d ;sfhkafk yd;amiskau fjkia fohla' mqxÑ .eg¿jla fjkak we;s' ta;a kshu ldf,g m%;sldr ,enqfK kE' wka;sfïos jl=.vq noaO lrkak isoaO jqKd' fldfydu;a fï l;dfj wjidkh jdikdjka;hs' jl=.vq noaO l<dg miafi fï ldka;dj ore iqr;,a n,kakg;a yelshdj ,enqKd' flfkl=g m%Yakhla we;s fjkak mq¿jka' jl=.vq noaO l<dg miafi nfnla yokak neßo@ neß kE' mq¿jks' fï whg ióm wëlaIKh hgf;a ksjeros l<uKdlrkhla isÿ lf<d;a ore iïm;a ,nkak yelshdj ;sfnkjd'

AUGUST 2018 | DOCTOR MAGAZINE

doctormagazine.lk

fmd,sisiaála ´jß iy,laIKh lsh, ;;a;ajhla ;sfnkjd' fuh äïn fïÍfï l%shdj,sh ÿ¾j, ùu m%uqL lr.;a .eg¿jla' wef.a fydafudak moaO;sfha .eg¿ jf.au iq¿ jYfhka >%djh jk tkaihsu j, fjkialï we;s fjkjd' msßñ fydafudak wfÕa jeäfhka >%djh ùu" bkaishq,ska fydafudakfha l%shdldß;ajfha fjkialï wdosh;a fuysoS we;s fjkjd' fï ksid fï ldka;djkaf.a äïn fïÍu kshñ; mßos isÿ jkafka kE' we;eï ldka;djka okakjd" fldhs ;rï fnfy;a ÿkak;a ksishdldrj äïn fudarkafk kE' fï wh

ia:q,;djh u|ire;djhg fya;= fjkjd' we;eï fj,djg ishhg oyhlska nr wvq jqKdu iïmQ¾Kfhkau m%Yakh úif|kjd' ms<sis|Su isoaO fjkjd' doctormagazine.lk

weú,a, lshkj''' zzfvdlag uu fï fnfy; .;a;''' wr fnfy; .;a;''' ta;a äïn fïrefj kE' Bg miafi bkafclaIka .eyqj'ZZ lsh,''' fï fmd,sisiaála ´fõßhka frda.h ;sfhk ldka;djkag fï k< ore ;dlaIKh b;du iqÿiqhs' wkd.;hg;a fï whg l<, yo, ;shd.kak mq¿jka' fï whf. .¾NdI ì;a;sh fyd| ksid ore iïm;la ,eîfï by< bvlvla ;ssfhkjd' fï whg uq,skau YÍrfha ia:Q,;djh ;sfhkjd kï th wvq lsÍfï l%shdud¾. .kakjd' we;eï fj,djg ldka;djkag ;sfnk tlu m%Yakh ia:q,;djh muKhs' b;ska ;rndre ldka;djka kï fï .ek úuis<su;a fjk tl fyd|hs' we;eï fj,djg ishhg oyhlska nr wvq jqKdu iïmQ¾Kfhkau m%Yakh úif|kjd' ms<sis|Su isoaO fjkjd'

tkafvdfuá%fhdaisia tkafvdfuá%fhdaisia lshk frda.h;a ldka;djka w;f¾ u|ireNdjh we;s lsÍug ie<lsh hq;= odhl;ajhla olajkjd' fmd,sisiaála ´jß frda.h jf.a fkdfjhs fï tkafvdfuá%fhdaisia lshkafk u|ireNdjhg ne?reï fya;=jla fjkjd' wms ir< Wodyrkhla weiqf¾ fuys ne?reï lu meyeos,s lr.ksuqfld' fmd,sisiaála ´jß frda.h ;sfnk ldka;djla ore iïm;la ,eîfï m%;sY;h ishhg 70 lsh, ys;kak''' tkafvdfuá%fhdaisia ;sfhk ldka;djlf.a

*hsfn%dhsâ blauKska ore iïm;a ,nk tl fyd|hs AUGUST 2018 | DOCTOR MAGAZINE

WOMEN'S WORLD

ore iïm;a j,g n,mdk äïnfldaI wdY%s; .eg¿ fmd,sisiaála ´fõßhka frda.h

WOMEN'S WORLD

fuu n,dfmdfrd;a;=fõ m%;sY;h ishhg 40 muK olajd wvq fjkjd' tkafvdfuá%fhdaisia frda.h Grade 1-4 lsh, wjêka y;rlg fnfokjd' Grade 4 tkafvdfuá%fhdaisia wdju fpdl,Ü isiaÜ weú,a," .¾NdIfha mef,damSh kd,h we,s," nvje,a j, t;s,''' fï wdoS w,l,xÑ we;s jqKdu IUI jf.a l%u Tiafia orefjla we;sùfï yelshdj b;du wvqhs' ishhg tlg;a jvd wvqhs' fï whg ksielfhkau k< ore ;dlaIKhg hkak fjkjd' k< ore ;dlaIKhg .sh;a fï whf.a id¾:l;ajhla ,eîfï bvlv ishhg 40-50 w;r m%udKhla ;uhs' kj l%u fudk wdldrfhka wkq.ukh l<;a fï whf.a .¾NdI ì;a;shg l<,h w,a, .ekSfï .eg¿ ie<lsh hq;= uÜgulska we;s fjkjd' úfYaIfhkau tkafvdfuá%fhdaisia oek.kak ;sfnk l%uhla ;uhs" ldka;djlg Tima ùu isÿjk úg wêl Wor.; fõokdjla we;s fjkjd' fïl oeä fõokdjla' Tima reêrh msgfjkak ojilg ú;r biafi,a, mgka wrf.k ojia 3-4la 94

weäfkdufhdaisia - ffjoH Wmfoia u; lghq;= lrkak ú;r fõokdj w,a,kjd' hï ldka;djlg fï ,laIK ;sfhkjd kï ialEka mÍlaIKhlg Ndckh fj,d wjYH jqfKd;a reêr mÍlaIK ;sfhkjd' taj;a isÿ lr .ekSfuka weh tkafvdfuá%fhdaisia me;a;g nro hk ldrKh yªkd.; hq;=hs' hï ldka;djlg tkafvdfuá%fhdaisia ;sfhkjd kï weh lsisu fj,djl ore iïm;lg fhduq ùu m%udo lsÍu iqÿiq kE' th m%udo lsÍfuka wehg miqld,Skj ore iïm;a ,eîfï úYd, .eg¿ we;sùfï wjodkula ;sfnkjd' tkafvdfuá%fhdaisia frda.fhaoS .¾NdIfhka msg; f,a tl;= ùula isÿ fjkjd' fï úosyg tl;= fj,d'' tl;= fj,d''' wka;sug f,dl= leáhla we;s fjkjd' ie;alula l<;a fï .=,sh bj;a lsÍu f,fyis myiq kE' wka;sug fïflos isoaO fjk foa ;uhs .¾NdIh bj;a lrkakg isÿ ùu' wjidk jYfhka lshkak ;sfhkafk hï ldka;djla tkafvdfuá%fhdaisia ;sfhkjd kï l< hq;= foa ;uhs blauKska újdm;a ù orefjla yod .ekSu' fudlo" fuh ore iïm;a ,nd .ekSug úúOdldrfhka ndOd f.k fok frda.hla' l<,h .e,ú,d hkjd" th .¾NdIhg w,a,kafk kE''' iuyr úg udi 2-3la hkúg .íid fjkak bv ;sfhkjd' fï úosyg fkdfhla ndOdjka tkafvdfuá%fhdaisia ;sfhk úg we;s fjkak mq¿jks' újdyh isÿ lr.kak tl hï ldka;djlg

AUGUST 2018 | DOCTOR MAGAZINE

doctormagazine.lk

tkafvdfuá%fhdaisia frda.fhaoS äïn j, m%udKh jf.au tys .=Kd;aulNdjh;a blauKska ke;s fjkak mq¿jks' fï ksid újdy fjkakg m%:ufhka jqK;a ffjoHjrfhl= yuqù äïn t<shg wrf.k wkd.;h i|yd tajd iqrlaIs; lr.ekSu fyd| Wml%uhla' fïj ;uhs ;sfhk kj;u l%u' újdyh ta wjia:dfõ m%udo jqK;a ljo yß ojil weh újdy jqKdu äïnfldaIj, .=Kd;aulNdjh ÿ¾j, jqKdg m%Yakhla kE' uy;a;hf. Y=l%dKQ;a tlal wr YS;kh l< äïn t<sfh ixfiapkh lr, kej;;a orefjla yod.kak mq¿jka'

äïn ixÑ;h fõ.fhka wvqjk ldka;djka ldka;djkaf.a äïnfldaI ;=< ysrfj,d ;sfhkafka fï Wm;skau tk äïn álhs' iuyr whf. ;sfhkjd" fï äïn doctormagazine.lk

blauKska wvq fjkjd' orefjla yokak äïn ke;s fjkjd' Antral follicles are a measure of egg supply for the future (ovarian reserve) and help predict chances for successful IVF treatment. The antral follicle count is a fairly simple test to perform with high quality ultrasound equipment. It allows us to evaluate a woman's ovarian reserve - her supply of eggs for the future ... fï äïnfldaIfha mj;akd äïn m%udKh fõ.fhka wvq fjk wh;a újdyhg l,a .kak fyd| kE' ta wh;a blauKska ore iïm;la ,nd.kak mshjr .; hq;=hs' l,a .; jqfKd;a fjk;a flfklaf. äïn j,ska ;uhs l=i ;=< orefjla yod.kak isÿ jkafka'

ore iïm;a j,g n,mdk mef,damSh kd, wdY%s; .eg¿ ldka;djkaf.a mef,damSh kd, wdY%s;jo hï wjysr;djhka we;s fjkak mq¿jka' mef,damSh kd, j, f.ä ;sfhkak mq¿jka' mef,damSh kd,h os.ska jeä fjkak mq¿jka' jeäfhka flá fjkak mq¿jka' mef,damSh kd,fha bosuqula we;s fj,d ierj yefokak mq¿jka' úIîchla .syska tys l%shdldß;ajh wvq fjkak mq¿jka' Y,Hl¾uhl n,mEula ksid l%shdldß;ajh ÿ¾j, fjkakg mq¿jka' fï úosyg úúOdldr fya;= ksid ore iïm;a ,eîug ndOd jk mef,damSh kd, .; fya;= ks¾udKh fjkakg mq¿jka' fudkhïu fya;=jla ksid w¾O jYfhka fyda iïmQ¾K jYfhka mef,damSh kd,fha wjysr;djhla we;s fjkak mq¿jka' fudk fya;=j ksid .eg¿ldÍ ;;a;ajhla we;s jqK;a tajd ms<silr lsÍug .kakd W;aidyhg jvd;a ;dlaIKsl Wml%u fhdodf.k ore iïm;la ,nd .kakg W;aidy .kak tl ;uhs iqÿiq' fï wjysr;d we;s mef,damSh kd,h Wfoid úi÷ï fiùfïoS mef,damSh kd,fha orejd jefvkakg mq¿jka' th Nhdklhs'

újdyh isÿ lr.kak tl hï ldka;djlg fkdje<elaúh yels fya;=jla ksid m%udo fjkj kï weh äïn lsysmhla bj;a lrjdf.k YS;k ;;a;aj hgf.a .nvd lr.ekSula j;a lr.kak tl iqÿiqhs' AUGUST 2018 | DOCTOR MAGAZINE

WOMEN'S WORLD

fkdje<elaúh yels fya;=jla ksid m%udo fjkj kï weh äïn lsysmhla bj;a lrjdf.k YS;k ;;a;aj hgf.a .nvd lr.ekSula j;a (Egg Freezing Technology) isÿlr.; hq;=hs'

WOMEN'S WORLD

;sfhkak mq¿jka' .¾NdIhg jk reêr iemhqfuys kd,j, .eg¿jla we;s fjkak mq¿jka' fï úosyg úúO .eg¿ .¾NdIfha we;s fjkak mq¿jka'

ore iïm;a j,g n,mdk .eíf., wdY%s; .eg¿ we;eï ldka;djkaf.a .eí f., b;du ;ohs' Tima reêrhg msg;g tkakg fï whf. fmdä isÿrla ;sfhkjd' kuq;a Y=l%dKQjlg fuh yryd hdfï yelshdj ke;s fjkak mq¿jka' .eíf.f,ys we;eï f.ä j¾. we;s ùfukao ireNdjhg wNsfhda. we;s fjkak mq¿jka'

ore iïm;a j,g n,mdk fhdaks ud¾.h wdY%s; .eg¿

ore iïm;a j,g n,mdk .¾NdIh wdY%s; .eg¿ .¾NdIfha we;sjk *hsn%dhsv ksid;a ore iïm;a ySk fjkjd' .¾NdIhg wE;ska ;sfnk l=vd f.ä j,ska t;rï n,mEula we;s fkdfjkak mq¿jka' tfy;a .¾NdIhg hákau ;sfhk fyda tys m%udKh ;rula jeä kï ^fi'ó 4g jeä& thska ore iïm;a ,eîug ndOd we;s fjkak mq¿jka' *hsn%dhsv ;sfnk ldka;djkq;a thg Y,Hl¾u wdosh isÿ l< wh;a ore iïm;a ,nkak l,a ne,Su iqÿiq kE' weäfkduhsisia lsh, frda. hla ;sfnkjd' fuysoS isÿ jkafka .¾NdI ì;a;sh f,dl= ùula' tho .¾NsKS;djhg wys;lr f,i n,mEï we;s lrjk ksid ffjoH Wmfoia ,nd .ekSu iqÿiqhs' .¾NdIh we;=<; uiao¿ we;s fjkak mq¿jka' úIîc 96

AUGUST 2018 | DOCTOR MAGAZINE

fhdaks ud¾.h .;af;d;a idudkHfhka fhdaks ud¾.h NdIAñl;djhg nrhs' Y=l%dKQ wdï,sl ksid we;eï úg Y=l%dK m%;slafIAm lsÍfï yelshdj ;sfnkjd' fï whf.a pH w.h fjkia lsÍfï fnfy;a ;sfnkjd' fï ksid tjka .eg¿ we;s ldka;djka frda.h uekúka yªkdf.k ta iïnkaOfhka kshñ; m%;sldr ,nd .; hq;=hs'

kqf.af.dv" Wvyuq,a," mrK fldÜgdj mdf¾ WISH Fertility & IVF Clinic fï jákd ;dlaIKh weiqf¾ wUqieñhkaf.a ore iqr;,a isysk ienE lrk osjhsfka m%uqL idM<H;d wdh;khls' Tfí ore iïm;a ,eîfï m%udoh iïnkaOfhka we;sjk .eg¿ i|yd 0779728799 yd 0773273866 hk wxl wu;kak' doctormagazine.lk

fodafr .,k ore fifkyi

mqnqÿjd,kakg''' wjirhs''' ore iïm;a m%udo ùu ksid ;j;a ,; úh hq;= kE' wm fj; tkak' Tfí .eg¿jg úi÷u wm fidhd fokakï

wmf.a fiajdjka iuyrla • mqreI u|ire;d fodaI mßmQ¾K iudf,dapkh • ia;%S u|ire;d fodaI mßmQ¾K iudf,dapkh • .íid os.gu isÿùug m%;sldr • äïn ksIamdokfha fodaI • .¾NsKS;djfha ud¾f.damfoaYk

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ore iïm;a ,eîug wm wdh;kfhaoS isÿ lrk Wiia m%;sldr • Intrauterine insemination • IN-VITRO FERILIZATION (IVF) • Pre-implantation genetic diagnosis (PGD/PGS) • Intracytoplasmic sperm injection (ICSI) • Microepididymat and testicular sperm aspiration (MESA AND TESA) • Embryo/sperm freezing (vitrofication) • Egg freezing (vitrofication) • Social freezing • Assisted hatching • Blastocyst Transfer • FROZEN EMBRYO TRANSFER (FET) • Embryo donation program • Egg donation program • Becoming an egg donor • Fertility preservation .¾NsKS;djh iïnkaOfhka Tng we;sjk ´kEu .eg¿jloS wmf.a fiajh Tng ,nd.; yel'

´iafÜ%,shdfõ iqÿiqlï ,enQ idhksl úfYaI{ ffjoHjrfhl=f.a fiajh ,nd .ekSug 077 186 21 17 ÿrl:k wxlhg wu;kak' doctormagazine.lk

WISH Fertility & IVF Clinic No.393/6, Kasagahawaththa Road, Old Kottawa Road , Udahamulla, Nugegoda Tel: 077 9728 799 E mail: wishiuiivf@gmail.com | wishiuiivf.com April 2017

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k< ore ;dlaIKfha

kQmka orejkag flakaor ne,Su m%fõKsl frda. y÷kd .ekSug bjy,a jk mßlaIK Pre-implantation Genetic Screening (PGS) Preimplantation Genetic Diagnosis (PGD)

AUGUST 2018 | DOCTOR MAGAZINE

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fuu ,smsh Tn fj; f.k tkafka kdrdfyakamsg" lsrsuKAv, udj; wxl 55$5" Ninewells Care Mother & Baby Hospital idor wkq.%yfhks idhksl l<,fõo úfYAI{ ffjoH ySkaks,fï r;akdhl úisks ore iïm;a ,eîug k< ore ;dlaIKh fhdod .ekSu iqjyila wUqieñhkg ;u l=gqïNh imqrd,Sug msgqjy,laj ;sfnk nj ryila fkdfõ' wdrïNfhaoS oshqKQ rgj,g muKla iSud jQ fï ;dlaIKfha Ndú;djka wo f,dalfha iEu rglu mdfya jHdma;j ;sfnkafka thg l< hq;= msßjeh iEfyk muKlska wvq ùfï m%;sM<hla jYfhks' idM,H;d ;dlaIKh yd ine|S jHjydrhka úYd, jYfhka wo wUqieñhkaf.a idM,H;d .eg¿ úi|Sug bosßm;aj ;sfí' uõmshNdjh ,eîug wNsfhda. we;sjk l,ayS bka ñoSug Wmldß jk tjka .eg¿ folla úi|Sug fï ;dlaIKh msysgg tk wdldrh fï ,smsfhka úuiuq' doctormagazine.lk

Pre-implantation Genetic Screening (PGS) m%fõKslj fi!LHiïmkak l<,h wêfrdamkhg fmr y÷kd .kakd woshqreju ridhkd.drfhaoS ixfiapkhla isÿùfuka wk;=rej th l<,hla jQ miq .¾NdIfha ;ekam;a lsÍug fmr m%fõKslj mÍlaIdjg ,la lr ksfrda.S nj idlaId;a lr.;a l<,hlau wêfrdamkh i|yd f;dard .ekSu Pre-implantation genetic screening hkqfjka ye|skafõ' we;eï úg úúO wvq¨yq`vq;d we;s j¾Kfoay iycfhka Wreu jQ úg IVF Cycle tl wid¾:l Ndjhg m;a fjhs' ms<sis|.kakd l<, wjia:d lsysmhloSu .íid fjk ldka;djkao isáhs' Tjqka we;=¿j ;j;a fndfyda fokd PGS m%fõKsl mÍlaIdfjka id¾:l m%;sM< ,nhs'

Pre-implantation genetic screening (PGS) mÍlaIKh lrkakg n,mdk fya;= iuyrla iajdñmqreIhd" Nd¾hdj fyda fï fofokdgu y÷kd.;a m%fõKsl" cdk fjkialula úlD;shla y÷kd .ekSu fujka wjia:d j,oS Wmosk orejdo

we;eï úg úúO wvq¨yq`vq;d we;s j¾Kfoay iycfhka Wreu jQ úg IVF Cycle tl wid¾:l Ndjhg m;a fjhs' ms<sis|.kakd l<, wjia:d lsysmhloSu .íid fjk ldka;djkao isáhs' Tjqka we;=¿j ;j;a fndfyda fokd PGS m%fõKsl mÍlaIdfjka id¾:l m%;sM< ,nhs' AUGUST 2018 | DOCTOR MAGAZINE

WOMEN'S WORLD

IVF ;dlaIKh weiqf¾ l<,h idod.;a miq th m%fõKslj mÍlaId lrk Embryo Biopsy mÍlaIKh isÿ lrkafka fufyuhs tu cdk.; úlD;sfha úkaos;fhla" frda.sfhla jkakg iEfyk bvla ;sfí' tfy;a l<,h m%fõKsl mÍlaIdjg ,la lsÍfuka tu l<,h m%ia;=; úlD;s;djfhka fmf<k nj fyda tfia fkdjk nj ksielfhka oek.; yel' fuhska ksfrda.S l<,hlau .efnys ;ekam;a lr ksfrda.S ore iïm;la ,nd .ekSug wjia:dj Wod fjhs'

mÍlaIKh isÿ lsÍu m%;sM<odhS jkafkah'

ore .en ks;r ks;r .íidjg ,la jk úg

fuysoS uq,skau isÿ lrkafka IVF Cycle tllg ldka;dj ms<sfh< lsÍuhs' äïnfldaIfhka äïn lsysmhla tljr ,nd .ekSu i|yd äïn W;af;ackhg uq,skau kslafIamkhla ,nd fohs' bka miqj W;af;ackh ùfuka mßK;Ndjhg m;ajQ äïn lsysmhla wef.a äïnfldaIhlska bj;a lr .kS' th mqreIhdf.ka ,nd

;j;a ldka;djl ore ms<sis|Sula ,nhs' tfy;a th .íid fjhs' fï wdldrfhka 2-3-4 j;djla isÿ jkafka kï thg n,mdk m%fõKs.; fodaIhla ;sfnkakg mq¿jk' tjka ldka;djl fuu mÍlaIKhg ,la ùfuka tfia fkdjk l<,h y÷kdf.k ;u ore iïm; ksremøs;j mj;ajd .ekSfï Nd.H ysñ lr .kshs'

isÿ lrk IVF Cycle wid¾:l jk úg IVF Cycle lsysmhlg md;% jQj;a tajd wid¾:l jk wjia:do ;sfí' fï ldKAvfha wUQieñhkgo PGS

Pre-implantation genetic screening (PGS) mÍlaIKh isÿ lrk wdldrh

Tyq fyda weh ;e,iSñhd frda.sfhla" frda. jdylfhla jQ úg wfmalaIs; orejd ksfrda.S orefjla f,i ckauh ie,iSug fuu PGD mÍlaIKh fhdod.; yel' 100 AUGUST 2018 | DOCTOR MAGAZINE

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WOMEN'S WORLD IVF ;dlaIKh weiqf¾ l<,h idod.;a miq th m%fõKslj mÍlaId lrk Embryo Biopsy mÍlaIKh isÿ lrkafka fufyuhs .kakd Y=l%dKQ ksheoshla yd ridhkd. dr ;;a;aj hgf;a ixfiapkh ùug lghq;= fhdokq ,efí' fuhska osk mylg miq úlikh fjñka ilia jQ l<,fhka tla ffi,hla f.k m%fõKsl mÍlaIdj i|yd fhduq flfrhs' fuh Embryo Biopsy hkqfjka ye|skafjhs' m%fõKsl mÍlaIKfhka l<,fha frda.S ;;a;ajhla ;sfío@ ke;so@ hk ldrKh ksielfhka ksYaph lr .ekSug wjia:dj ie,fik w;r fï wdldrfhka m%fõKsl mÍlaIdjg ,lalr ksfrda.S hhs y÷kd.kakd l<,hla wêfrdamkh msKsi .¾NdIfha ;ekam;a lsÍu B<Õ mshjf¾oS isÿfõ'

fuu m%fõKsl mÍlaIKfhaoS m%;sM<h ,nd .ekSug osk folla muK .; jk w;r tf;la ixfiaÑ; l<,h ndysr mßir ;;a;aj hgf;a ;nd.; fkdyel' fï ksid wêfrdamkh lrk l<,h ms<sn|j ;Skaÿj ,nd .kakd f;la l<,h YS;khg ,la l< hq;=h' we;eï úg fufia f;dard .kakd l<,h ore iïm;la ,eîg fmr jir lsysmhla jqj fï YS;k ;;a;aj hgf;a mj;ajd .ekSug wjYH kï thgo wo ojfia myiqlï ;sfí'

Preimplantation Genetic Diagnosis (PGD) y÷kd.;a frda.hla l<,hg Wreu ù oehs yªkd .kakd mÍlaIKh fuu m%fõKsl mÍlaIKfhaoS m%;sM<h ,nd .ekSug osk folla muK .; jk w;r tf;la ixfiaÑ; l<,h ndysr mßir ;;a;aj hgf;a ;nd.; fkdyel' fï ksid wêfrdamkh lrk l<,h ms<sn|j ;Skaÿj ,nd .kakd f;la l<,h YS;khg ,la l< hq;=h'

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WOMEN'S WORLD

orejkau jYfhka fofofkla" ;sfofkla bkak wjia:d j,oS fjk;a ,sx.sl;ajhl orefjla iel fkdyer ,nd .ekSug fuu PGD ;dlaIKh fhdod.; yel'

PGS yd PGD mÍlaIK w;r fjki

,sx.sl;ajh u; n,mEula we;s fkdjk" ksfrda.S ore iïm;la ,nd .ekSug

fuyso l<,h ,nd .eKSfï l%ufõoh tf,iuh' Pre-implantation genetic screening mÍlaIkfhaoS wkq.ukh l< l<,h ilia lr.kakd l%shdj,shu fuysoS isÿ fõ' bkamiqj m%fõKsl mÍlaIdfõ wruqKQ muKla fjkia ùula isÿ fjhs' PGS mÍlaIKfhaoS y÷kd fkd.;a frda. ;;a;ajhla fy<sorõ lr .ekSu wNsm%dh lr.;a;;a fuysoS isÿ jkafka okakd frda. hla" okakd frda. jdylfhlaf.ka tu m%fõKsl frda.h l<,hg odhdo ùo hkak mÍlaId lr .ekSuhs' ielyer oek.ekSuhs'

we;eï m%fõKsl frda. we;sjkakg ,sx.sl;ajh n,mdhs' ksoiqkla f,i ysfuda*s,shdj frda.h we;s jkafka msßñkagh' tjka wjia:d j,oS frda. fhka ñÿKQ ksfrda.S ore iïm;la ,nd .ekSug fuu PGD l%ufõoh fhdod.; yel'

Preimplantation Genetic Diagnosis (PGD) mÍlaIKh lrkakg n,mdk fya;= iuyrla

iuia;hla jYfhka .;aúg fuu PGS yd PGD ;dlaIKhka yS id¾:lùfï iïNdú;djo tfia fkdlrk wjia:djkaysoSg jvd jeä fõ' tu.ska ksfrda.S ore iïm;la ,nd .ekSug we;s wjia:djo jeä jk ksid wo iq,nj fuys Ndú;djka wfma rfÜo fhdod .kakd nj mdGlhka oeKQj;a ùu uekú'

wfmalaIs; orejd ksfrda.S orefjla f,i ckauh ie,iSug iajdñhd fyda Nd¾hdj lsishï m%fõKsl frda.hl jdylfhla jk l,ayS ;u ckldKQ Tiafia l<,hgo fuu m%fõKsl frda.h Wreu ù ;sfíoehs fidhd ne,Su' ksoiqkla jYfhka Tyq fyda weh ;e,iSñhd frda.sfhla" frda. jdylfhla jQ úg wfmalaIs; orejd ksfrda.S orefjla f,i ckauh ie,iSug fuu PGD mÍlaIKh fhdod.; yel' mjq,g wjYH jk orejd ksielfhka f;dard .ekSug Family Balancing we;eï mjq,a j, msßñ orejkau" ke;fyd;a .eyekq 102 AUGUST 2018 | DOCTOR MAGAZINE

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ldka;djka .ek ldka;djka mjd jeä fofkla fkdokakd lreKQ

wef.a fudf<A mqxÑhs ldka;djkaf.a fud<hg jvd msßñkaf.a fud<h ishhg 9lska úYd,h' ldka;djf.a fud<fha we;s ffi, jvd;a <Õ <Õska talrdYS ù ;sfí' tuksid fuhska nqoaêhg wvqjeä n,mEula ke;' fï fof.d,a,kagu we;af;a tlu iakdhq ffi, m%udKhls' jhig hk úg jeäjk i;=g ldka;djkaf.a ryiÕ jvd;a ixfõoS N.ukshhs (Clitoris) N.uksh wkjr;fhka jefvhs' fï ksid weh jhi 20 .Kkaj,oS we;s lr.kakd iqr;dka;hg jeä WoaoSmkhla 40 .Kka j,oS wehg ldu iïfNda.fhaoS we;s fjhs' ol=Kq wdishd;sl rgj, wef.a wjdikdj iEu ;;amr 90lg jrlau f,dj fld;ekl fyda ldka;djla .¾NsKS;djfha" ore m%ijfha ixl+,;d fya;=fjka fuf,dj yer h;s' bkaoshdfõ yd fkamd,fha mqreIhd ñheÿKQ miq ldka;djo Tyqf.a Ñ;lhg mekSu isÿ úh' yqfola iajlSh leue;af;kau zzi;s mQcdjZZ isÿ úh hq;= jQj;a n,y;aldrfhkau ldka;dj .skakg ;,a¨ lr urd ouk wjia:do jd¾;d ù ;sfí' .eyekq <uhd jeäúh m;ajfïoS jeä Biag%cka fydafudak m%udKhla talrdYS jk ksid iu jhia msßñ <uhskag jvd fojirla fõ.fhka ldka;d fud<h mßK; Ndjhg m;a jkafkah' weh l;d u,a,la ldka;djka fodvu¿h' msßñkag idfmalaIj weh oskm;du úYd, jpk ixLHdjla jeäfhka l;d lr;s' os>dhqI we;a;S wehhs msßñkag idfmalaIj ldka;djka jeä wdhq úkaokhla ,n;s' idudkHfhka msßñkag jvd ldka;djkaf.a wdhq wfmalaIdj jir 2-3lska jeäh'

104 AUGUST 2018 | DOCTOR MAGAZINE

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lshqrv¾ï wdf,am lr fjki w;a ú|skak ;u rE imqj .ek ie<ls,su;a jk hqj;shka ks;ru lkiai,a,g m;a jk ldrKdjla jkqfha ;u ifuys mj;akd úh<s iajNdjhhs' ifï úh<sNdjh we;s jkakg fya;= jk ldrKd .ek Tn oeKQj;ao@ Tfí ifuys ishhg 64l m%udKhla we;af;a c,hhs' Stratum Corneum f,i ye|skafjk ifï ffi, j, msg; ia:rh úc,kh jk úg tys kuHYS,S nj ke;sù iu mqmqrd hdula ke;fyd;a bß ;e,Sula isÿ fõ' wk;=rej ifï fldr< jeks ;;a;ajhla we;s ù leiSula olajd th j¾Okh ùug yel' ifï .eUqre ia:rfhka ldkaÿ jk c,h r|jd ;nd .ekSug hQßhd we;=¿ iajdNdúl c,h r|jd .ekSug WmldÍ jk øjH fuu Stratum Corneum ia:rfha wvx.= fõ' hQßhd yd ,elaála wï,h Tfí fiajhg'''@ f;;ukldrlhla (Moisturizing Agent) f,i hQßhd Ndú;d lsÍfï m%fhdackh jkafka th i;= ksiÕ c,h wdl¾YKh lr .ekSfï iajNdjhhs' hQßhd iug wdf,amkh lrk úg th Stratum Corneum ia:rhg ldjeoS c,h r|jd .ekSug Woõ fõ' thska ifu f;;ukh mj;ajd .ekSug ifï Odß;djh jeä lr .ksñka úc,k ;;a;ajfhka uqojd .kS' tfukau ;j;a f;;ukldrlhla f,i ,elaála wï,fhAo iqúfYAIS jeo.;alula mj;S' Keratolytic f,i doctormagazine.lk

y÷kajk fuys ifuys msg;" tkï wmsp¾uh uDÿ lsÍfï yd uereKQ iu fmd;= .id bj;a lsÍfï yelshdjla mj;S' ifuys we;sjk ksoka.; oo Chronic Eczema ;;a;aj j,oS flráka jeäù ifï ffi, >k ù ifuys f.dfrdaiq njla yd fldr< jeks ;;a;ajhla we;súh yel' iu u;=msg ,elaála wï,h wdf,am lsÍfuka ifï jHqyfha fm%daàka fldgila fia mj;sk flráka ì| jeàulg ,la fõ' thska ifuys úh<s nj ke;sù iug uDÿ njla yd kj fmKQula ,nd fohs' lshqrv¾ï il%Sh ridhk uqiqj lshqrv¾ï fudhsiaprhsiska wdf,amkh ;=< ishhg 10la hQßhd iy ishhg myla ,elaála wï,h wvx.= neúka tlaiSud yd fjk;a ifuys wdidok ksid úh<S .sh r¿ iug uDÿ njla iy iqkuH fmKQula ,nd fohs' tu ksid lshqrv¾ï" úh<s iug" r¿ iug" miq p¾uoduyhg yd bla;sfhdaisia jeks ,m iys; iug m%;HlaI wdf,amkhla f,i iy;sl l< yelsh' lshqrv¾ï osjhsk mqrd *duis iy iqmsß fj<"i,a j,ska ,nd.; yel' ksIAmdokh iy fnodyeÍu weiafg%dka iud.u" 688" .d¿ mdr" r;au,dk ÿrl:kh 0112636741 laIKsl weu;=ï 0769142738 AUGUST 2018 | DOCTOR MAGAZINE 105

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Dry skin occurs when the skin doesn't retain sufficient moisture. Dry skin can itch, flake, crack, or bleed. Skin care tips that help to keep your skin moistured.

Tn;a

úh<s iu ksid mSvd ú|skjdo@ fï úosyg lrk iï i;aldr j,ska Tfí iu f;;ukh wdrlaId lr.kak

p¾u frda. úfYaI{ ffjoH ckQld .,ysáhdj

106 AUGUST 2018 | DOCTOR MAGAZINE

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iu úh¿KQ úg we;sjk fjkialï iu úh¿KQ úg''' ta;a iu.u we;sjk fjkialï rdYshla ;sfhkjd' wm ta fjkialï .ek u|la ie<ls<su;a fjuq' mifuys ;o .;sh ^fuh úfYaIfhkau iakdkfhka fyda msyskSfuka miqj olakg ,efnkjd'& •

ifuys f.dfrdaiq nj

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iu úhef<k fya;= fï wdldrfhka iu úh<s Ndjhg m;aùug fya;= jk ldrKd isõ jeoEreïj yªkdf.k ;sfnkjd' tajd my; mßosh' •

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ifuys úh<sNdjh wvq jeä ùug n,mdk idOl úh<sNdjh wvq jeä ùug n,mdk idOl /ilao n,.ekafjkjd' wm ta .ek;a u|la úuis<su;a fjuq' • YS; foaY.=Kh • b;d WKQiqï W÷ka fyda ySg¾ia j,g ksrdjrKh ùu

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WOMEN'S WORLD

iu úh<Su fndfyda fokdg n,j;a .eg¿jla' u| úh<s Ndjfha isg b;d ;on, f,i úh<Sfuka f.dfrdaiq Ndjhg m;ajQ iu olajd fï úh<sNdjh m%fNao jkjd' úh<s nj ifuys tla ia:dkhlg fyda ia:dk lsysmhlg muKla iSud jQ fyda isrer uq¿,af,au úysÿKQ iajNdjhlao .; yelshs' u| úh<s Ndjh kï fndfyda úg ;djld,sl ;;a;ajhla jkakg;a bv ;sfnkjd'

WOMEN'S WORLD

úh<s Ndjfha wjia:d • os.= ld, iSudjla ;siafia WKQ j;=r iakdkh fyda laf,daßka wêl WKQ j;=r ;gdl j, msyskSu • iu úc,khg ,laùu • ier inka fyda fidaok oshr ks;r ks;r Ndú;hg mqreÿ ùu • YÍr.; frda.S ;;a;ajhka ^;hsfrdhsâ fydafudakh wdY%s; wiudklï wdosh&

iu úh<s Ndjhg m;a lrjk T!IO we;eï T!IO mdúÉÑh ksido iu úh<s Ndjhg m;ajk wjia:d ;sfí' •

fldf,iagfrd,a wvq lsÍug fok iageáka T!IO

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udkisl frda. i|yd ,ndfok we;eï T!IO

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fráfkdhsv ldKAvhg wh;a T!IO

ifï úh<sNdjh msgq olsk ms<shï

• ifuys yg.kakd úúO frda. ;;a;ajhka

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ier inka j¾. Ndú;fhka je<lSu

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YS; foaY.=KfhaoS YÍrh wdjrKh jk fia weoSu yd w;ajeiqï me<|Su

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YÍr.; yd ifuys frda.S ;;a;ajhkag ksis m%;sldr isÿ lsÍu

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iun, wdydr fõ,la .ekSu

úh<s iu we;s lrk ifuys frda.S ;;a;ajhka iu úh<sNdjhg m;aùu ifuys wfkl=;a frda. • cdk.; frda. ^rla;hd" fldr< iys; iu& •

p¾u.; m%ody ;;a;aj ^Wod' fmd;=lnr&

108 AUGUST 2018 | DOCTOR MAGAZINE

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fï udifha odhl;ajh ,ndf.k merKs ñ, .Kka j,gu jirla iÕrdj ksfjigu f.kajd .kak

ika*a,j¾ f;,a wdydr msiSug tla lr .ekSfuka ,efnk jdis

Tn okakjdo@ úgñka E iq,n ksid iqúi,a Ñls;ail /ljrKhla ,efnk nj

rd.u YslaIK frdayf,a ffjoH pñkao fm%au;s,l

ika*a,j¾ f;,a fï jljdkqfõ wfma ,dxflah .DyKshka w;f¾ jeä wjOdkhlg ,laj ;sfí' th c.;a ;,fha mjd fï iïnkaOfhka we;s fjfiia wjOdkfha ,dxflah ksfhdackhlao@ wdydr msiskakg .kakd f;,a j¾. iïnkaOfhka ck;dj ;=< we;s u;su;dka;r ;ju;a wjikaj ke;' wo ck;dj w;r iq,nj wf,ú jk nyq wix;Dma; fïo wï, iys; f;,a j¾. fidahd" bßÕ=" lefkda,d wdoS fï f;,a j¾. ksIAmdokfhaoS cdk fjkia lrk ,o me<Eá fhdod .ekSu iïnkaOfhkao .eUqßka m¾fhaIlhkaf.a wjOdkhg ,laù ;sfí' fï ikao¾Nh ;=< ika*a,j¾ f;,a flfryS jeä wjOdkhla fhduq ùu tla w;lska idOdrKh' ika*a,j¾ YdLh wefußldkq yd hqfrdamSh foaY.=Ksl l,dmfha myiqfjka jefjk imqIaml YdLhls' idfmalaIj mshlre u,la fukau tys .ejiS.;a weg oyilg jeä m%udKhla ika*a,j¾ YdLfha we;'

ika*a,j¾ fmdaIKSh ixhq;sh mj;akd fïo wï, m%;sY;hla f,i''' ix;Dma; fïoh

11% (as Palmitic and Stearic acid)

tal, wix;Dma; fïoh 30% omega-9 fat (as Oleic acid) nyq wix;Dma; fïoh

59% omega-6 PUFAs (as linoleic acid)

úfYaI;ajhla jkafka ika*a,j¾ f;,a j, Tfï.d 3 fïo wï,h fkdue;s ùuhs' ika*a,j¾ f;,a úgñka B j,ska idrh' fï ksid th m%;sTlaisldrlhla (Antioxidant) jYfhka l%shd lrhs' ms<sld j,g fya;=jk YÍrfha n,.ekafjk uqla; LKavl hdka;%Kh (Free radicals) hgm;a lsÍug fï ksid ika*a,j¾ f;,a j,g yelshdjla we;' weÿu" wd;rhsáia we;=¿j m%odysl frda. fukau we;eï ms<sld md,kh lsÍugo úgñka B iu;a fjhs' fuys iq,nj we;s ue.akSishï LKsch fmaYs fmr,Sï we;sùu j<lajhs' Cramps, we;efula 112 AUGUST 2018 | DOCTOR MAGAZINE

yg tosfkod cSú;fha buy;a ysßyerhla we;s lrk ndOdjls' tjka wh ika*a,j¾ f;,a wdydrhg tla lr .ekSfuka fuu fmaYs wdmodjg m;aùfuka je<lsh yel' fuys we;s Tryptophan kue;s ridhkh rd;%S kskao <Õd fkdjk whf.a kskao WoaoSmkh lrhs'

ika*a,j¾ f;,a j, we;s iqúfYaIS .=K • yDo frda. j,ska ñoSug wdrlaIdjla f.k fohs' • m%;sYla;slrK moaO;sh iúu;a lrk ksid f,vfrda. j,ska /ljrKhla imhhs' • weÿu" wd;rhsáia jeks frda. md,khg WmldÍ fjhs • ysre yd úhm;a ùu ksid we;sjk iu ydkshg m;aùu j<lhs' • wdka;%sl ms<sld we;=¿j ms<sld we;sùug we;s bvlv wyqrd,hs' • ifuys fi!LHh jvjhs' • YÍrfha Yla;sh m%j¾Okh lrhs' ••• doctormagazine.lk

New Trends in Cosmetic Dentistry

rEm,djKH oka;

ffjoH úoHdfõ kj m%jK;d úl,dx. o;a ieliSu o;a w;r we;s úYd, mr;r ke;s lsrSu of;a úYd, m%udKhla leã .sh o;a iakdhq msrjqu

114 AUGUST 2018 | DOCTOR MAGAZINE

oka; maf,dafrdaishdj ksid ;o ÿUQre meye jQ o;a ieliSu wjmeye .ekajQ o;a iajdNdúl meye .ekaùu

doctormagazine.lk

SAKUKI DENTAL HOSPITAL

l=reKE., il=ls oka; frdayf,a oka; Y,H ffjoH ldxpkd ixÔjkS ls;,jwdrÉÑ l=reKE., il=ls oka; frdayf,a oka; Y,H ffjoH ldxpkd ixcSjkS ls;,jwdrÉÑ úisks iqkaor iskyj wmg fidndoyfuka ,enqKq odhdohla' tfy;a fudk hï fyda fya;=jla ksid Tfí iqkaor j; lu, iskdfik úg lsishï wj,laIKhla .kakjdo @ o;a osrd hdu" o;a jeä jdr .Kkla leã hdu o;a .e,ù hdu" o;a wjmeye .ekSu yosis wk;=re fya;= fldgf.k Tfí uqyqKg iqkaor;ajhla ÿka iqmika oika fm<u uqyqKg wj,laIKla tla lrkakgo neßjd fkdfjhs' oka; ffjoH úoHdfõ uE; ld,Sk oshqKQjg msx isÿ jkakg ;jÿrg;a Tn tjka wlr;eín j,g ,la jkafka ke;' Tfí j; luf,a iqkaor;ajh" iskyfõ wisßh tf,iskau doctormagazine.lk

o;a w;r we;s úYd, mr;r" úl,dx. o;a" idudkH l%u j,ska iqÿ meye .ekaùug fkdyels wjmeye .ekajQ o;a /l fok fjksh¾ia m%;sldrh wdrlaId lr fokakg kjH oka; ixrlaIK Ys,am l%u msysgg tk nj fuf;la Tn oek isáhdo @ miq.sh jir lsysmh ;=< rEm,djKH oka; ffjoH úoHdfõ fjkialï j,g md;% jQ lreKQ rdYshls' kùk ;dlaIKsl WmlrK y÷kajd oSu" idïm%odhsl f,dayuh msrjqï øjH fjkqjg of;a iajdNdúl meyehu orK ma,diaála msrjqï øjH (Plastic Filling Materials) Ndú;d lsÍu ta yereKQ úg wfma ck;djf.a me;af;ka .;fyd;a wd¾Ól yd wOHdmk uÜgu oshqKQ ùu" wdhq ld,h oS¾> ùu" fnd,sjqâ ke;fyd;a fyd,sjqâ iskyjla i|yd jk mdßfNda. sl b,a¨u jeks lreKQ ksid oka; ffjoH úoHdfõ''' fjfiiskau rEm,djKH oka; ffjoH úoHdj i|yd jk b,a¨u fõ.fhka jeä fjñka mj;S'

ÿ¾j, o;a yd úYd, m%udKhla wdmodjg m;a o;a jqj kej; /l.kakd l%jqkska m%;sldrh AUGUST 2018 | DOCTOR MAGAZINE 115

o;a wekafoa .e,jQ o; ksid we;s jQ ysoei lD;%Su o;lska mqrjk bïma,dkaÜ m%;sldrh rEm,djKH oka; ffjoH úoHdfõ ckm%sh m%;sldr udos,s lsysmhla .ek wo ixlaIsma;j i<ld n,uq'

Composite Binding fuh leã .sh wj meye .ekajQ fyda osrd .sh o;a w¿;ajeähdj i|yd jQ ir< tfy;a úYsIAG m%;sldr l%uhls' fndfyda úg fuh tla jdrhlska ksu lsÍug yelshdj we;' fuu l%shdj,sfhaoS of;a tku,h (Enamel) yd oka;skh (Dentine) j, iajdNdúl meyeh we;s o;a msrùfï øjHhla (Composite Material) u.ska o; ksjeros wdldrhg ilia lrk w;r by< ;Sj%;djhlska hq;a ks,a wdf,dal loïnhla u.ska o;g iú ùu isÿ fõ' fuu.ska wjg we;s o;aj, meyehg iudk jQ fi!LHiïmkak o;la yd oSma;su;a iskyjla ,nd.; yels jkq we;'

Dental Veneers uE; ld,Skj b;d ckm%sh jQ m%;sldr l%uhls' oshqKQ ;dlaIKsl WmlrK iys; ridhkd.dr (Dental Laboretories) ìysùu fï i|yd rel=,a jQ tla idOlhls' Composite fyda Porcelain fuu m%;sldr i|yd fhdod.kS' fuu.ska o;a j, we;s fndfyda ÿ¾j,;d ksjeros lr.; yel' o;a w;r we;s úYd, mr;r" úl,dx. o;a (Crooked Teeth) idudkH l%u j,ska iqÿ meye .ekaùug fkdyels wjmeye .ekajQ o;a" oka; maf,dafrdaishdj ksid ;o ÿUQre meye jQ o;a fuu kjH m%;sldr u.ska ksjeros lr.; yel'

Dental Crown of;a úYd, m%udKhla leã .sh o;a iakdhq msrjqu (Root Canal Treatment) isÿl< o;a iy o; iEoSfïoS we;sjk ixl+,;d ksid Wm;skau Yla;su;a ke;s o;a fuu m%;sldr l%uh u.ska ksjeros lr.; yel'

o;a isgqùu Dental Implants tla o;la fyda o;a lsysmhla ke;s úg fuh id¾:l ms<s;=rls' o;la fyda o;a lsysmhla .,jd bj;a lsÍu u.ska iskyj wj,iaik fjkjd fukau th uqyqfKA jHqyh (Facial Structure& iy yKQ jHqyh (Jaw Structure) fjkia ùug fya;= fõ' tu.ska jhig jvd uqyql=rd .sh fmKQula uqyqKg ,efnhs' l=vd Y,Hl¾uhla u.ska iú lrk Dental Implants fï i|yd id¾:l úi÷uls' iïmQ¾K m%;sldr i|yd udi ;=kla jeks ld,hla .; fõ' •••

116 AUGUST 2018 | DOCTOR MAGAZINE

doctormagazine.lk

COMMON BLOOD TESTS IN DIABETES, DIAGNOSIS & TESTING THE CONTROL

Èhjeähd frda.Ska

i|yd isÿ lrk

reêr mÍlaIK

jHdêfõo úfYaI{ ffjoH ffjoH m¾fhaIKdh;kfha ffcj ridhk wxY m%Odk" úfYaI{ ffjoH .hd lgq,kao MBBS, Dip Path, MD (Chem Path), DipRCPPath (UK) 118 AUGUST 2018 | DOCTOR MAGAZINE

.a,hsfldisf,agâ ysfud.af,dìka mÍlaIKh HbA1c – glycosylated haemoglobin .a,hsfldisf,agâ ysfud.af,dìka mÍlaIKh óg l,lg fmr kï oshjeähd frda.Skaf.a frda. ;;a;ajh md,kh iïnkaOfhka bÕs imhk mÍlaIKhla f,i fhdod .;a mÍlaIKhla úh' kuq;a ful, tu wjYH;djh blaujd hñka HbA1c hkqfjka ye|skafjk fuu .a,hsfldisf,agâ ysfud.af,dìka mÍlaIKh oshjeähd frda.h y÷kd.ekSfï mÍlaIdjla jYfhka mD:q, jYfhka fhdod .kS' doctormagazine.lk

fuu mÍlaIKfha m%Odk jdis folls'

Tn ks;sm;d T!IO m%;sldr ,nd .;af;a fldfyduo@

1 2

Tn tlS ld,h uq¿,af,a lsishï jHdhdu jevigyklg wkQj l%shd;aul jqKdo@

reêrh ,nd .ekSug fmr ksrdydrj isàula wjYH fkdfõ

tfiau ojfia ´kEu fj,djl Tng reêr idïm,hla ridhkd.drhg ,ndosh yel' fuh ksrdydr reêr mÍlaIKhg (FBS) idfmalaIj jeä uqo,la jeh jk mÍlaIKhla fj;;a by; oelajQ jdis u; th uqo,g iß,k jákdlula we;s mÍlaIKhla f,i ie<lSfï fodila ke;' tfiau fuu mÍlaIKhg reêrh ,ndÿka miq ta yd ine|S fojk frday,g meñKSulao wjYH fkdfõ'

HbA1c oshjeähdj y÷kd.ekSfï mÍlaIKhla f,i''' oshjeähdj frda.h y÷kd.ekSfuys,d HbA1c mÍlaIKh jvd;a iïu; mÍlaIdjla jYfhka ms<s.ekSug ,laj ;sfí' Interpretation of diabetes Diagnosing diabetes: Normal

4.3 – 5.6%

Pre-diabetes

5.7 – 6.4%

Diabetes

> 6.4%

Control of diabetes Expected level

<7%

oshjeähd frda.Ska mÍlaId lsÍu i|yd HbA1c mÍlaIKhg miq.sh udi ;=kl ld, wka;rhla uq¿,af,a mqoa.,hdf.a reêr.; .aÆfldaia uÜgfuys yeisÍu ms<sn|j iudf,dapkhla lsÍfï úYAñ; yelshdjla ;sfí' HbA1c mÍlaIKh u.ska miq.sh ;=ka uil ld,h uq¿,af,a" Tn wdydr .;af;a ljr wdldrhlgo@ doctormagazine.lk

fï wdoS jYfhka fndfyda f;dr;=re ,nd fokakg fuu HbA1c mÍlaIKh iu;a fjhs' we;eï úg flfkl=f.a ksrdydr reêr mÍlaIKfha m%;sM< j, jeä ùula jd¾;d fkdlrñka HbA1c by< w.hla fmkajkakgo bv ;sfí' fujka m%;sM<hla we;s jkakg fya;= jkafka reêr mÍlaIKhg i;shla fmr ld,fhaoS Tyq wdydr ie<ls,af,ka mßyrkh lrñka" kshñ; fnfy;a" jHdhdu kshu ms<sfj,g ,nd .ksñka isáh;a Bg;a tydg" miq.sh i;s tfld<yl muK ld,hla fï m%fõYu w;ayer ;snqKQ njhs' la,sksla tlg hkakg wdikakfha frda.Ska fujka Wml%uYS,S ms<sfj,la wkq.ukh lrñka reêr mÍlaIKfha m%;sM, j,ska iekfikakg W;aidy lrk wjia:d wfma frda.Ska w;f¾ iq,nh' fuu HbA1c mÍlaIKh tjka frda.Skago tu wdldrh ys;lr fkdjk nj fmkaùug ud¾f.damfoaYKhla i,ihs' Blood glucose level in past 12 weeks according to HbA1c HbA1c

Plasma glucose (mg/dL)

126

154

183

212

10%

240

11%

269

12%

298

AUGUST 2018 | DOCTOR MAGAZINE 119

Yร rfha

ms<sld

we;s jk yeรก

120 AUGUST 2018 | DOCTOR MAGAZINE

doctormagazine.lk

Tn ms<sld frda.fhka neg lk frda.Ska ±l ;sfío@ ta fudfydf;a Tng we;s jQ yeÕSu l=ula jqj;a zug kï fufyu fohla fjk tlla kEZ hkqfjka Tng bfígu fuka isf;kakg we;=jd ksielh' tf,i yefÕkafka ukqIH iajNdjh ksidh' zztjka frda.hla ug kï we;s fkdfõjdZZ hkak Tfí ksiel m%d¾:kh jkjd we;' flfia jqjo ms<sld udrhd fldhs fudfydf;a ljqreka f.dÿre lr .ksú ±hs ldgj;a lsj yels fkdfõ' doctormagazine.lk

ldhsl frda. úfYaI{ ffjoH Wmq,a o is,ajd

isrer ksueù we;af;a fufyuhs wfma YÍrh ks¾udKh ù we;af;a mshú weig fkdfmfkk b;d ishqï fmÜá wdldrfha ffi, fmdÈhla tl;= ùfuks' flia .ilg;a jvd b;du;a ishqï jQ fuu ffi, l=vd foa úYd, lr ne,sh yels WmlrKhl wdOdrfhka ñi mshú weilska ±l n,d .; yels fkdfõ' ujf.a iy mshdf.a ffi, folla tl;= ùfuka iEfok ;ks ffi,hlska wdrïN ù ñksia YÍrhla fï ;rï úYd,j j¾Okh jkafka ñksia isref¾ ffi, j¾Okh jk úYauh ckl wdldrh ksidh' fuu ffi, j¾Okh jk wkaou ;j ÿrg;a fufia meyeÈ,s lr .ksuq' túg Tng isref¾ ms<sldjla j¾Okh jk wdldrh jgyd .ekSu myiq jkq we;' mdka f.ähla folg lemQ úg Tng mdka nd. folla ,efí' kuq;a fï mdka nd. fol kej; iïmQ¾K mdka f.ä folla fia úYd, jkafka ke;' kuq;a ñksid ks¾udKh lrk ffi,j, ;ks ffi,hla folg fnÿKdg miq ta ffi, nd. fol kej; ;efkkafka iïmQ¾K ffi, folla f,isks'

idudkH ffi, ;=< ms<sld ffi, jefvk wdldrh AUGUST 2018 | DOCTOR MAGAZINE 121

ta ffi, o kej; kej; fn§ tfia fn§ fjka jk yeu ffi,hlau h<s h<s;a iïmQ¾K ffi, njgu m;a fjñka .=,shla wdldrhg l<,hla ks¾udKh fjhs' ta l<,h miqj ukqIH YÍrhla wdldrhg ks¾udKh ù bkamiq uõ l=fika msg;g meñK Wia uy;a ù jeäysáhl= jk ;=reu ffi, j¾Okh ta whqßkau isÿfjhs' jeäysáhl= jQ miqj t;rïu ffi, j¾Okhla isÿ jkafka ke;' tf,i ffi, j¾Okh fjkjd kï" tfia jkafka ;=jd,hla isÿ jQ úfgl fyda isref¾ hï ia:dkhla wk;=rlska leã ì§ hdula isÿ jQ wjia:djlh' túg l%u l%ufhka tu ia:dkfha ffi, j¾Okh ù th h:d ;;a;ajhg m;a ùu isÿfjhs'

ms<sldjka j¾Okh jk wjia:dj jeäysá jQ miq tf,i j¾Okh k;r ù we;s ish¨ ffi,j,ska tlla ysá yeáfha fkdkj;ajd h<s j¾Okh jkakg neßlula ke;' ms<sldjla hkq tu ;;a;ajhhs' kuq;a idudkH ffi, j¾Okh

lSfudf;rms m%;sldrh ,nk frda.sfhla jk ;rï fõ.j;a j fuh j¾Okh fkdfõ' th jefvkafka tu isref¾ whs;slregj;a fkd±fkk wkaoñka b;d fifukah' wfma YÍrfha we;eï ia:dk uq¿ YÍrhu n,d lshd .kakd jeo.;a ia:dk fjhs' ;j;a iuyr ia:dk tmuKgu jeo.;a jkafka ke;' isref¾ iuyr ;eka w;ska ;o l< úg fõokdjla ±fkk w;r ;j;a iuyr ;eka tf,i ixfõ§ ke;' fujeks t;rï ixfõ§ ke;s ;ekl ms<sld ffi, tu mqoa.,hdg;a fkd±fkk wkaoñka b;d n,iïmkak f,i j¾Okh úh yelsh' wfma YÍrfha iuyr wjhjhkag isrer ;=< ysñ ù ;sfnkafka iSñ; bv mudKhls' tjeks wjhjhl ms<sld ffi, j¾Okh jqjfyd;a ta wjg we;s idudkH ffi, f;rfmñka ;e,Sulg ,la jkq we;'

f,a kyrhla wi,ska ms<sldjla j¾Okh jQ úg hï fyhlska ms<sld ffi, ksid f,a kyrhlg ydks isÿ jqjfyd;a reêr jykhla ùug bv we;s w;r th iq¿ fyda nrm;, wdldrfha tlla ùug o bv ;sfí' f,a kyrhla wi,ska ms<sldjla j¾Okh jkakg mgka .;a úg § Bg jvd ;j;a fjkia fohla o isÿúh yelsh' ta kyrh ;=<ska reêrh .,df.k hdfï§ ms<sld ffi, o tu reêrhgu tl;= ù f,a kyrh Èf.a isrer ;=< .,d hduh' idudkHfhka ldKqjla Èf.a j;=r .,d hk úg ta iu. .,d hk l=Kq frdvq

122 AUGUST 2018 | DOCTOR MAGAZINE

doctormagazine.lk

;ukag myiq ;ekl k;r ù t;ek ;ekam;a fjhs' tmßoafoka reêrh yd tlaj .,d hk ms<sld ffi,o myiq ;ekl /f|kq we;' tfia /|Su myiq jk ia:dk w;r fud<h fmky¨" wlaudj" jid.eá;s ^l=oaoá& m%Odk fjhs' tjeks ;ekaj, ms<sld ffi, /|S tajd tys j¾Okh jk úg jg msgdfõ we;s wksl=;a idudkH ffi, ;o ùulg ,laù fkdfhl=;a .eg¨ u;= jkakg mgka .kS'

ms<sldjlska fmKy¿ mSvdjg m;ajQ úg fmky¨ wfma isref¾ ryis.; wjhjhla hehs lSu ksjerÈh' t;=< ms<sldjlg j¾Okh jkakg myiq wjldYhla ;sfí' fuys§ fmky¨j,g msáka j;=r tla /iaùula fyda Yajik ud¾.fha me;a;la wjysr ùu ksid yqiau .ekSfï§ lsishï wmyiq ;;a;ajhla mek ke.Su yer fjk;a ie<lsh hq;= frda. ,laIKhla frda.shdg fkd±fkkq we;'

wlaudfõ we;sjk ms<sld wlaudj ;=< ms<sld ffi, j¾Okh jk úg ta ;=< ms; ;o ù weia ly mdg jkakg mgka .kS' ta yer fjk;a ie,lsh hq;= frda. ,laIKhla fkdfmkaúh yelsh'

ms<sldjla .ek lshk bÕs iuyrla fuf,i iq¿ fõokdjla" ysß .;shla" leiaila" yqiau .ekSfï wmyiqjla" isref¾ wm%dKsl .;shla" reêr jykhla" jeisls,s hdfï wmyiqjla" lg y`v fjkia ùula jeks ,laIK we;eï úg isrer ;=< ryfia wdrïN ù j¾Okh jk ms<sldjla ms<sn| bÕshla ùug neß lula ke;' doctormagazine.lk

ms<sldj úiska we;s lrk frda. ,laIK fufia l,la ;siafia fydr ryfia j¾Okh jk ms<sldj miqj úYd, uia je±,a,la njg m;a fjhs' túg bka ksl=;a jk úúO úI øjH ksid YÍrfha fkdfhla wdldrfha w¾nqo yg .kakd w;r wdydr wreÑh" YÍrh flÜgq ùu" WK" wêlj oyäh ±óu" isrer wm%dKsl ùu jeks ,laIK we;s ù wk;=rej frda.shd urKhg m;a ùu isÿfõ'

ms<sld mÍlaIK fu;rï wjodkï iy.; jqjo ms<sldjla i|yd lrkakg we;s foa iSud iys;h' uq,skau lrkafka ms<sldj j¾Okh ù we;s ia:dkh" tys m%udKh iy me;sÍ we;s wdldrh y÷kd .ekSuh' fufia ms<sldj y÷kd .ekSu i|yd ms<sldj j¾Okh jk ia:dkhgu úúO WmlrK hjd tu j¾Okh jk ffi, lsysmhla msg;g f.k tajd wkaùlaIhla wdOdrfhka ksÍlaIKh lrñka tu ffi,j,g j¾K we;=¨ lrñka ms<sldj l=uk j¾.fha o hkak y÷kd .; yelsh' ta tla wdldrhls' ta yereKq úg tlaia lsrK" iSà ialEka" tï' wd¾'whs ialEka" fmÜ hka;%h hk fïjd wdOdrfhkao ms<sldj y÷kd .ekSfï yelshdj ;sfí' ms<sldj j¾Okh jk úg thska ksl=;a jk úI reêrhg tl;= jk ksid iuyr ms<sld reêr mÍlaIK u.ska o y÷kd .; yelsh'

m%;sldr lrk yeá fuu ms<sld ffi, iys; uia .=,shla jk fldgi Y,Hl¾uhla u.ska bj;a lsÍuo isÿfõ' tjeks wjia:djl ta yd AUGUST 2018 | DOCTOR MAGAZINE 123

ms<sld i|yd ,nd fok úúO m%;sldr

úlsrK m%;sldr

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iïnkaO wjhjfhka fldgila bj;a lrkakg isÿúh yels w;r tfia lrkafka ms<sldfjka jk ydksh j<lajd .kakgh' iuyr wjia:dj, ms<sldj fjk;a ia:dkj,go me;sÍ hhs' y÷kd .ekSug wmyiq ;ekl me;sÍ f.dia ;snqfKd;a th ld,hla mqrd úYd,j j¾Okh jkq we;'

úlsrK Ñls;aid m%;sldr ms<sldj u¾okh lsÍu i|yd T!IO ,nd §u iy lrkaÜ we,a,Suo isÿ lrkq ,nhs' ms<sld ffi, j¾Okh jkafka idudkH ffi, j,g jvd fifuka ksid tys j¾Okh ;j;a nd, lrjk T!IO ,nd fok wjia:d o ;sfí' ta tu frda. iajNdjhg wkqjh' fujeks T!IO ksid ms<sld ffi, j, j¾Okh nd, jkq fiau uq¿ YÍrfhau j¾Okh nd, fjhs' tfy;a jeäysáhl=f.a w;a md wdÈh j¾Okh ù wjidk ksid th w;a md wdÈhg n,mdkafka ke;' kuq;a ysiflia jeks ksrka;rfhka j¾Okh jk ffi,j,g fuhska n,mEï we;sù flia .e,ù hkakg mgka .kS' ms<sld frda.Skag m%;sldr ,nd fok úg ysiflia fiau isref¾ frdau mjd ye,S hkafka fï ksidh'

b,lal.; T!IO m%;sldr ms<sldjg lrkaÜ we,a,Su lrkafka ms<sld ffi, j¾Okh jk ia:dku b,lal lr .ksñks' flfia jqjo ms<sldjlg f.dÿre fkdù isàfï yelshdjla 100]lau wmg fkdue;' tfy;a yels muKska ms<sld ldrlj,ska ñ§ isàug yelshdj ;sfí' iq¿ fõokdjla" ysß .;shla" leiaila" yqiau .ekSfï wmyiqjla" isref¾ wm%dKsl .;shla" reêr jykhla" jeisls,s hdfï wmyiqjla" lg y`v fjkia ùula jeks ,laIK we;eï úg isrer ;=< ryfia wdrïN ù j¾Okh jk ms<sldjla ms<sn| bÕshla ùug neß lula ke;' •••

124 AUGUST 2018 | DOCTOR MAGAZINE

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STHAULYA (Obesity)

126 AUGUST 2018 | DOCTOR MAGAZINE

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Dr. Sudharma I Kodituwakku

MD (kaya)India, PGD (Food & Nutrition), National Ayurveda Teaching Hospital-Borella.

What is sthaulya? Excessive physical growth of the body in general is called sthaulya. Body mass index (BMI) of 30 or higher in males and 28.6 or more in female indicate obesity.

What are the features of it?

• Intake of heavy, sweets, cold and unctuous food

Life style causes • Lack of exercise • Day sleep • Purposeless cheerfulness • Lack of mental exercise

what are the risk factors? Life threatening • Hypertension • Diabetic Atherosclerosis

1 Excessive hunger

• Heart failure

2 Excessive thirst

• Stroke

3 Debility (low exercise tolerance )

• Renal failure

4 Sluggish movements

• Gall bladder disease

5 Short life span

• Cancer

6 Increased blood pressure 7 Psychological consequences like hesitation 8 Mild breathlessness on exertion

What are the causes of sthaulya?

Others • Menstrual abnormalities • Pregnancy complications • Weight related musculoskeletal disorders • Stress incontinence

The life style, mainly food habits contributes for obesity.

• Osteoarthritis

Heredity is also an important factor in causing obesity.

• Psychological disorders

Hormone imbalance of the body (Hypothyroidism) is also a causative factor for obesity.

Dietary habits • Over eating doctormagazine.lk

• Flat feet

How it is managed through Ayurveda? • Heavy, fatty and non-nourishing food should be avoided. • Ruksha, ushna basthi( enema of unctuous and hot drugs) AUGUST 2018 | DOCTOR MAGAZINE 127

• Body massage with unctuous herbal powders. • Drugs like Guduchi, Mustha, Harithaki, Bibhithaki, Amalaki can be used. • Thripaladi guggulu. • Bee honey, Garlic preparation. • Shilajathu preparation. • Physical and mental exercises.(Including Yoga)

Do’s (Pathya) Ayurveda advocates specific diet and life style changes for Sthaulya.

Dietary • Fresh healthy food at regular intervals. • Low fat diet. • High fiber diet. • Plenty of fresh vegetable and fruits. ( but moderately taking of banana, avocado….) • Life style • Gradually increase in night awakening. • Physical exercises (regular and moderate)

• Strong motivation and will to loose weight. • Mental exercises (Yoga meditation)

Don’ts (Apathya) Dietary • Over eating • Heavy, sweet, cold, unctuous food, milk products etc. • Fried food. • Preserved, canned food. Life style • Day sleep • Physical rest • Mental rest • Sluggish routine

Obesity increases the chance of acquiring several diseases 128 AUGUST 2018 | DOCTOR MAGAZINE

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