Doctor Magazine March 2018

Volume 24 • March 2018

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fifkyiska wehg msfok ,sms irKsh cd;Hka;r ldka;d Èkh - 2018

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MARCH 2018

Volume 24 • Issue 03

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MARCH 2018 | DOCTOR MAGAZINE

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MARCH 2018 Volume 24 • Issue 03

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Eight Things Your Eyes are Trying to Tell You About Your Health

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Co-operate Health News

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THE PROBLEM WITH Metformin

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" l,sld¾hdxYhla ka l, u;=fnjg jk fi!LH ;¾ck" meñfKhs' wOHdmk l l%shd;auwffO¾h l ùu" iyldr wOHla Iug jrfhl= zzieka áÍ;s fndaâ l%shieka wdh;ks l fjkia ÿ fj;a ydliu.dój ck;dj fnda lslïÍ h ine|S ld¾hNdrhla bgq ck;dj Bgw,afmd<Ujñka " tauy;a kS ;;mshdZZ ltaâlúúO ld,Sk wjYH;d fuka u is úfYa IidOKS s;oS ta tal yd ì;a;shlg ,k iqÿ ;srhla u; Ñ;% áhla fmkajhsd;a ' áu hg;g wdh;kh f,da .ug oeKQ jl;a fi!LH lsÍfï ixúOdkfha jevigykao jeä oshqKQ jkakg úh' uy;a ;hdg .fï m;aùu" úúO oeKQ j;anjg lsÍfï j,u;a fhoSø u"jH ld¾h ;srfha úl= ï mdkafkagÿmayels m;a ñks iï ai qh'fkdìhj" t<smosy<s f'ha wdOdr hgf;a ld¾hdxYhla m;aùjevigyka um jYfhka meñfKk khhs lrk u;a eka yd ksjdrK ckdêm;s lrk ks , orejka k ;snqfKa f.!rjh l, ï is ÿ fj;amq oSy taqK ydQ ls iu.dój ck;dj ka i|yd mj;ajk iekaá fndaâ Tyqf.a wdh;ksl fjkia uKa v i|yd Í ï" udOHfõoS u<my lrk orejdf.a uqyqK nUhla ;rïh' wo jk úg fi!LH wOHdmk ld¾hdxYh fi!LH uqiq nh mlaImd;S oeKQj;a lsÍiïuka fï jevigyka o jeä os hqKQ jka kgn,ldh úh' uy;af; hdg .fï ;%k " zziq jießhZZ fi!LH re yd fjí wvúhhgf;a wfOdauqL, fhka isß isß .dIjefgk mKq jla m%unjls dKh ld¾h idOk wfkl= ;a inqoaêl fkdmels j ixf;da ï ,ndoS u gw;l ;e;a wud;HxYfha wOHdmk ydf;dr;= m%pdr wOHla Ijrfhl= ' Tyq mKq nqfKa f.!rjh fuka úfYa ÿrl:k" ialhs úvffjoH" fiajdjffjoHjreka wdoS fjhs'''' ta bosßm;a lrkafka zzmKq ;swudre .ek'''ZZ fnfy;a fohs m%cId ldhs l ffjoH" m%m cda mKs Yd,l " ' u wOHdmk wo jk; úgs fi!LH ld¾hdxYh fi!LH uqiq nh mlaImd;Sm%; ixúOdko iu.s kwOHdmk a w;ajkswOHdmk e,a bosßfhaoS lrñka u;= fkdj yels kï rfgys s m ;a okam%;pdr ffjoHjreka " fi!LH , Odßkane|f.k we;=¿j úúOdx.S l D; I wxY Tiaf ia fi!LH k;a ,ndjYfhka fohs ' jákd Wmfoia uqiq l< iskud máhls ' 'zzle<e wud;HxYfha wOHdmk yd wOHla jrfhl= hgf;a njls Tyq mKqWKZZ tka ¾j¾;udkfhys K ld¾h uKaffjoHjreka v,hls ka iuka ú; ck;dj iqfi!LH j ixfõoS jeis s,s ke;s fï rfÜ fj; u hkqfjka ye|sk ajqK Q uef,aBg ßhd jix.;h .ek" m%ka cdlldhs l ld¾hdxYh ffjoH" m%cfï dmQYd,l ffjoH" " ck;dj fnfy;a fohs ' mdpkh iïnka O fhka ;S r Kd;a l oeKQ j ;a lsÍfï iïmdolhka o mjd fu,a , lr.ks ñ ' '' lsÍufï njg j,g l jeis s,shkla;a;kd.ekS ïlajeo.;a u .ek oka; l ffjoHjreka fi!LH wOHdmk ,Odßka we;=m% ¿Wrfok jxikShwdh;khla tka ,nd oeKQu" ,ndoS g úYd, orKksfufyjrlg W;a idyh Y fõ' .ek'''tkak;a lsÍf.j,a fï jeo.;a u l.ek''' jeisfohs ls,f'sh m;a j ;súf; í'ck;dj m%cd fi!LH" mdie,a fi!LH" wdfrda. h fohsldrKh ' ldls ks, lndhls kwdoS a ieriS tkmQ¾ieka áfndaâuKav,hlsk ld¾h a iuka iqj fhoS ixfõoS jeis ls,fï s ke;s wjYH lr jkafka.ks wehslsñ @ dka hk .ek jYfhka ld¾hNdrhl ug Wm ;SrKh lr isáuq' wjk; fï fj<|du l%sh d;a uKfl HYd,d fi!LH wOHdmk" m¾fhaIK yd we.hSï" mqyqKq ;hd tosfkïwe|s ß jefgk;= kaúYd, fufyjrlg lsÍfï Wrfok wdh;khla njg f.j,a j,g jeisls,uy;a shla ;kd.ekS jeo.;a lu .ekre .; lrka ld¾hdxYhg ld¾hY+ r" mßK;" ienE tl, ck;djg hym;a iqfkdñ,fha j isß;a yq re lrka kg o .ïjeishkafi!LH wOHdmk Íï''' wdoS wxY wdfrda .Kkdjls ka iukaú; j;auka fi!LH zziem;ZZ i`.rdjla m;a'j ;sfí' m%cd fi!LH"lsmdie,a fi!LH" . lshd fohs ' ldls ksiEu , .fïh' lndhls ka ieriSutk iekau áfnda â lsÍug Tjq ka we|s Wml% hla fhdojhs iqjwOHdmk" ixfõoSwOHdmk oelaIuK ls k ;a wNs k jfhka wOHla Ijßhl zzieka fnda ; hdZZ yryd wêldßka fi!LH m¾fha yda hq we.hS ï"udOH mqy qKyryd q ld¾hdxYh úúO fi!LH mKsúv uy;a;áhd tosâk uy;a ß jefgk;= re .;tl, lrkatys ffi!LH ka fndfyda w;r fnodyßk w;r jákdHYd,d iqj Wmfoia isákixks fï fudfydf;a kj udkhka Tiafiaksnck;dj ÿka mKs úv fõ.fhka ck;dj Kh lr.;a f;ah' lsÍï''' wdoS m;a wxYj.Kkdjls kfa kA iuka ú; j;a kaúfYA fi!LH .fïh' fkdñ,fha zziem;ZZ i`.rdjla.% oy .ïjeis hka okfhys ,d uiq IS jevigyka |j l%shd;aul wka;¾.;h' wOHdmk ld¾hdxYh udOH yryd úúO fi!LH mKs ú v w;r fnodyßk w;r tys fndfyda jákd iq j Wmfoia fj; jvd;a ks ¾ udKYS , S f,i iq j iïmf;ys mKs úvh tl, fld¿ l=reÜgka f,i lrhs' hym; fjkqfjka wkd.; rfÜ mrmqf¾ kA; okfhys ,f d õokh iqúfYAIS ls jevigyka ksnfõjdh |j l%shd;a ulk wmf.a me;=uhs' wka;¾.;h' ? we|sß jeàf.k tk fj,djg m%fdma sh ixks Íug yels hka je/ye,s weªï we|f.k fï jevigyka j,gojfia l%shdYSl+ixks ,gSj fnda fkdjk frda. " l,skf a l, u;=fúoa jk fi!LH meñfKhs ' l< hk wdrla Idj fjkq jka j;a ;¾ck" jD;a;slhka fuysiyNd.s f;jkq j i|yka m%m%; ;a;rg s lrhs' jQ ck;dj ;j;a ld,hla úgsmwfma ? we|sß jeàf.k tk fj,djg ojfia l+ g d ma ; s h úúO ld,Sk wjYH;d fukau úfYaIs; tall yd ine|S shlg w,ao¾Yl ,k iqÿ mj;a ;srhla Ñ;%hk máhla fmkajhs' zzl,dmfha AGì;a ;u;fi!LH kdu; rgZZ fnda fkdjk kúúO a l, oeKQ u;=fyd fi!LH ;¾ck".fhka meñfKhs' úYsI jjk ;a ls Ífï jevigyka j, fhoSWla u" ld¾h iyfhda ; ioa wdh;k ;srfhawjk; úl=ï mdkaf;r ka ÿmam.ekS ;a ñksiu aiqhg ' t<s my<s fha frda." l,s/ila iïmdolhka mjd f.!rjdorh ,la forKg ,ndÑ;% foka kgfmka uq,a jQ úúO ld,Sk wjYH;d fuka Is; tamqlylqKyd ì;a;shlg w,a, k iqu<my ÿ ;srhla u; máhla hsf ' hah';rïh' uKauvúfYa , i|yd Q lsine|S Íï" udOHfõoSka i|yd mj;ajk lrk orejdf.a uqyqKjnUhla Tyqf.a úúO oeKQj;a lsÍfï jevigyka j, fhoSu" ld¾h ;srW;a fha ïdyh mdka fkabos ÿma mm;a ;a ñks iai. qhf' sh t<sod my<srfÜ fha mQ¾úl= úldj wm ß lrka ka fï yd fï iïnka fhka l%sh l jk ish¿ oerEfï i wm miq fudkjg w;a iïuka;%k" zziqjießhZZOfi!LH f;dr;= red;a fjíuwvúh wfOdauqLfhka isß isß .d jefgk mKqfjla w;l m%udKh uKa v , i|yd mq y q K Q ls Í ï" udOHfõoS k a i|yd mj;a j k u<my lrk orejdf.a uq y q K nUhla ;rïh' Tyq f .a ck;djf.a iqj iïm;g IS odhl;a hla ola jk .ek'''ZZ fukau úfYaI ÿrl:k" ialhsma mKsúv fiajdj wdoS fjhs'''' taiqú bosfYa ßm;a lrkafkajzzmKq wudre

EDITOR'S

EDITOR'S

NOTE

NOTE

iïuka;%k" zziqjießhZZ fi!LH f;dr;= re fjí wvúh isß m isßeka .d y jefgk mKqfjla w;l ;nk m%udKh wdh;k yd mq owxY a.-,hka yd tla j fï ld¾hh úkafwfOda ouqu'qLfhkau;a ,a újD;j úúOdx.S Tiafia fi!LH jákd uqiq l< iskud máhls' fj,djka zzle<e fukauWKZZ úfYaBharata I ÿrl:k" jYfhka ialGunathilaka hsma mKs úv fial jD; dj wdoS fjhs'''' ta bosßm;a lrka fkaWmfoia zzmKq wudre .ek'''ZZ Editor inwOHdmk Chief ld¾hdxYh j¾;udkfhys fï rfÜ ck;dj fj; fi!LH hkqis fjka ye|s kaj' qK Q uef,aWKZZ ßhd jix.;h jYfhka .ek" mdpkh úúOdx.SlD; bos wxY Tia fia fi!LH wOHdmk Wmfoia uqiq u;= l< kud máhls zzle<e ß hg f.k hdu wNs oS¾>jákd ls Í fuka f kdj ldka ; djka mjd Bg oeKQ ,ndoS ug orK W;a idyhwfma m%YxikSh fõ',dIh jk w;r .ek'''tka k;a lsÍfï.ek" jeo.;a lu .ek''' ld¾hdxYh jeisls,shladoctormagazine.lk@gmail.com j¾;udkfhys fïu rfÜ ck;dj fj; fi!LH hkqfjka ye|skajqKQ uef,a ßhd jix.;h mdpkh wjYH jka fka.ek''' wehs @jeis hk .ek fï wdoS jYfhka u ,ndoS ug orK mdGl W;aidyh m%Y xikShks fõ'ielfhkau tu .ufkaoS wm .ek'''tkak.;a ;a lsÍfï jeo.;a lW;a u ls,ldrKh sh la bharata.gunathilaka@gmail.com Tn fhoùug wuk i dyh jH¾: jQoeKQ fha fï fi!LH wOHdmk ld¾hdxYhg ld¾hY+r" mßK;" ienE ck;djg hym;a iqjjYfhka isß;a yqre lrkakg wjYH jkafka wehs @tl, hk ldrKh .ek fï wdoS iqj ixfõoS lsne|.ka ka hq; a wNskjfhka wOHlawmf.a Ijßhl mru zzieka fnda ;hdZZ tl, fi!LH wêldßka fi!LH wOHdmk ld¾hdxYhg ld¾hY+ r" u mßK;" ienE ck;djg hym;a iqjáck;dj isß;aâ yquy;a re lrka kgyrydy`vg yd w;a joela e,a kd nj rfÜtl, iú[a { Ks l ke.+ fï j is k fï wOHla fudfydf;a kj udkhka Tiafia ck;dj úvtl, fõ.fhka lr.;a f;ahoela ' ulska hqm;a j ixfõoS ;a wNs ká jfhka Ijßhl zziekaáfndaâ uy;a;ÿka hdZZ mKs yryd fi!LHck;dj wêldßka.%yKh iq j isák fï fudfydf;a kj udkhka fia , ck;dj fj; jvd;a ks¾Tia udKYS S f,i iqj iïmf;ys mKsúvh mKsúv fõ.fhka ck;dj .%l= yKh lr.;a f;ai h' dfjksm;a tl, fld¿ reÜgka f,i úYA j dihhs ' rfÜÿka ckdêm;s j rhd lka ÿka ks ' jvd;a ks¾ ,Sixks f,ifõokh iqj iïmf;ys úvh tl, fld¿ l=reÜgka f,i weªï we|f.k fï jevigykafj; lsÍug mKs yels fõjdh hkak wmf.a me;=uhs' je/ye,s j,g l%shdYS ,udKYS Sj fõokh je/ye,s weªï we|f.k fïjQjevigyka j,g ld,hla l%shdYS,Sjhk úg iyNd.s ck;dj ;j;a wfma rg lsÍug yels fõjdh hkak wmf.a me;=uhs' NEVER MISS ixks AN ISSUE iyNd.s jQ ck;dj ;j;a ld,hla rg o¾Yl mj;akd rgZZ hk zzl,dmfha úYshk IAGúg ;u wfma fi!LH DOCTOR delivered to your door every month or zzl,dmfha úYsIAG;u fi!LH o¾Yl kGet d rgZZ hkfokakg uqMAGAZINE f.!rjdorh ,lamj;a forKg ,nd ,a jQfhah' f.!rjdorh ,la forKg foka kgbos uqß ,choose a jQfhalrka h' fka fï mQ¾,nd úldj wm m;a rfÜ tofï download it to your mobile or tablet. Go to subscription fï mQ¾úldj wm bosck;djf.a ßm;a lrkafiq kajfï rfÜ iïm;g iqúfYa IS odhl;ajhla olajk page ck;djf.a iqj iïm;g iqúfYaIS odhl;ajhla olajto k see our latest subscription offer.

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April 2017

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Volume 24 ● Issue 03 ● March 2018

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B-pek,ska Tiafia oeka Tng wejeis T!IO T!IO ksjigu f.kajd .kak Tiafia weKjqï lr ksjigu f.kajd .ekSfï myiqlu ie,fihs' ffjoHjreka pek,a lsÍu i|yd ,xldfõ mj;sk úYd,;u iy mqfrda.dóu fiajh jk B-pek,ska fiajh MyMed iuÕ tlaj frda.Skag wjYH T!IO iy fjk;a ffjoH WmlrK ksjigu f.k §fï fiajhla weröug lghq;= lr ;sfí' oekg fld<U iy wdikak k.r mkyl muK l%shd;aul fuu fiajh u.ska" ffjoH ks¾foaY u; ,nd.; hq;= T!IO" ffjoH ks¾foaYh wkjYH T!IO iy wfkl=;a ffjoH WmlrK wka;¾cd,h

ldi,a frday,g IVF m%;sldr uOHia:dkhla zu|ireNdjhZ fyj;a z.¾NsŒNdjh Wod lr.ekSug wfmdfydi;a ùu" i|yd m%;sldr lsÍfï wx. iïmQ¾K fiajd uOHia:dkhla ldi,a ùÈh ldka;d frdayf,ys ia:dms; lsÍug rch ;SrKh fldg we;' fuys fojk uOHia:dkh .d,a, lrdmsáh kj ud;D frdayf,ys ia:dmkh lsÍug fukau

f,dal fi!LH Èk cd;Hka;r W;aijh fk¿ï fmdl=K rÕyf,a § f,dal fi!LH Èk cd;Hka;r W;aijh ckdêm;s ffu;%Smd, isßfiak uy;df.a iy w.%dud;H rks,a úl%uisxy uy;df.a m%Odk;ajfhka iy fi!LH" fmdaIK yd foaYSh ffjoH wud;H fodia;r rdð; fiakdr;ak uy;df.a iyNd.S;ajfhka fld<U fk¿ï fmdl=K rÕyf,a § meje;aùug kshñ;h' wfma%,a ui 07 Èk oji mqrd tu W;aijh meje;afjk w;r" tÈk miajrefõ wkd.;

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fuu fiajfhys l%shdj,sh b;d myiq tlls' .kqfokqlre úiska l< hq;af;a ffjoHjrhd úiska ,ndfok ;=Kavqfjys PdhdrEmhla tlalr wka;¾cd,h Tiafia weKjqu ;yjqre lsÍuhs' úYajikSh;ajh by< kexùu ms‚i fuu weKjqï mßlaId flfrkafka ,shdmÈxÑ T!IOy,a u.ska mu‚' fï i|yd f.ùu wka;¾cd,h Tiafia fyda wod< weKjqu ndr fok wjia:dfõ§ fyda l< yel' ;=kajk wÈhr hgf;a wfkl=;a iEu m<d;lu tjeks m%;sldr uOHia:dkhla ne.ska ia:dmkh lsÍug;a fi!LH" fmdaIK yd foaYSh ffjoH wud;HxYh n,dfmdfrd;a;= fõ' ta wkqj lD;%su ixfiapkh ^IVF& iy äïn$ l<, wêYS; lsÍu jeks kùk m%;sldr l%uo ie,iSug yels mßÈ fuu uOHia:dk bÈjkq we;' Y%S ,xldfõ wUqieñ hqj< w;ßka 15]lg jeä msßila uqyqK fok .eg¨jla njg zu|ireNdjhZ fyj;a z.¾NsŒNdjh Wod lr.ekSug wfmdfydi;a ùuZ mj;sk nj y÷kd.kq ,en ;sfí' kdhlhska ìys lsÍfï wruq‚ka isiq yuqjlao fld<U § meje;aùug lghq;= fhdod we;' W;aijh fjkqfjka iure uqoaorhla ksl=;a lsßug o ;SrKh flre‚' fuu W;aijhg f,dal fi!LH ixúOdkfha wOHlaI ckrd,a Dr Tedros Adhanom Ghebreyesus iy tu ixúOdkfha ol=Kq iy kef.kysr wdishdkq rgj, wOHlaIsld mQkï fpÜg%md,a isx uy;añh we;=¨ rgj,a /il fi!LH wud;Hjreka iyNd.s ùug kshñ;h'

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bv ;sfhkjd f,a ysÕ fj,d' wms w¾nqohla we;sfj,d úi÷ï fidhkjd fkfjhs" we;súh yels w¾nqohlg fmr iqodkï fjkjd'˜

ysÕhla je<elaùug f,a oka fokak(ck;dj fj; b,a,Sula wfma%,a udih jk úg oeä f,a ysÕhla we;súh yels neúka ;jÿrg;a f,a okafok f,i cd;sl reêr mdrú,hk uOHia:dkh ck;djf.ka b,a,d isà' iEu jirlu uq,a udi 4 ;=< f,a oka§u wvq nj ksßlaIKh ù we;s nj mjik cd;sl reêr mdrú,hk uOHia:dkfha wOHlaIl ffjoH relaIdka fn,a,k ue;sjrK iuhl§ th ;j;a wvqjk nj i|yka lf<ah' —iïm%odhdkql=,j lghq;= lf<d;a wms wfma%,a fjoa§ oeä w¾nqohlg ,lafjkak

fï jk úg reêrh /ialsÍfï uOHia:dk 102 la rg mqrd f,a tl;= lsßu isÿlrk w;r ksfrda.S ´kEu mqoa.,hl= ;ukag <Õ uOHia:dkhla lrd hdfuka f,a myiqfjka oka§ ;j;a ðú;hla fírd.ekSug yelshdjla we;' jhi 18 ;a 60 ;a w;r nr lsf,da.%Eï 50 g jeä frda.dndO j,ska f;dr mqoa.,hkaf. ka tf,i f,a ,nd.ekSu isÿlrhs' ksfrda.S mqoa.,hl= yg jirlg isõ j;djla muK f,a okaosh yels nj cd;sl reêr mdrú,hk uOHia:dkh mjihs' f,a oka§u .ek ´kEu f;dr;=rla 0112369931-4 hk ÿrl:k wxlj,ska ,nd.; yel'

"Wolbachia" nelaàßhdj Y%S ,xldjg y÷kajdfohs Y%S ,xldj ;=< fvx.= ffjrih me;sÍu je<elaùu wruqKQ lr .ksñka ´iafÜ%,shdfõ fudkEIa úYajúoHd,h úiska y÷kajd § we;s nelaàßhdj Y%S ,xldjg y÷kajd§fï wjfndaO;d .súiqulg w;aika ;eîu fi!LH" fmdaIK yd foaYSh ffjoH wud;H f,alï ckl iq.;odi uy;df.a iy ´iafÜ%,shdfõ Y%S ,xld uy flduidßia fí%ia yÜika hk uy;ajreka úiska miq.shod isÿ lrk ,È' Wolbachia nelaàßhdj" iuyr uÿre úfYaIo we;=¿j f,dalfha lDñ úfYaI 60] lg jeä m%udKhl YÍrh ;=< yd iajdNdúlj Ôj;ajk nelaàßhdjls' Wolbachia nelaàßhdj YÍrh ;=< wvx.= jQ úg fvx.= ffjrih iïfma%IKh isÿ fkdfõ' tfy;a fuu nelaàßhdj m%Odk fvx.= jdyl uÿre úfYaIh jk Aedesaegypti uÿrejkaf.a YÍrh ;=, iajdNdúlj yuq fkdfõ' tneúka Wolbachia nelaàßhdj

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MARCH 2018 | DOCTOR MAGAZINE

lD;suj y÷kajd §fuka" Aedesaegypti uÿrejka u.ska fvx.= ffjrih me;sÍu j<lajhs' fvx.= frda.h me;sÍu je<elaùu i|yd Wolbachia nelaàßhdj wdidos; Aedesaegypti uÿrejka ksoyia lsÍu ´iafÜ%,shdj" úhÜkduh" bkaÿkSishdj" n%iS,h iy fldf,dïìhdj hk rgj, fï jk úg id¾:lj isÿfjñka mj;S' fuu jHdmD;sh Y%S ,xldfõ f;dard.;a m%foaY j, lafIa;% uÜgfï wOHhkhla isÿ lsÍu i|yd wjYH ;dlaI‚l oekqu yd iyfhda.h ,nd §ug ´iafÜ%,shdfõ fudkEIa úYaj úoHd,fha World Mosquito Programme ^WMP& leue;a; m< fldg we;' Wolbachia nelaàßhdj wdidos; Aedes uÿrejka ksoyia lsÍfï kshduk jHdmD;sh Y%S ,xldj ;=< fvx.= frda. jHdma;sh je<elaùfï §¾>ld,Sk l%fudamdhls'fuu jHdmD;sh i|yd uQ,Huh wdOdr ,efnkqfha ´iaÜ%f,shdkq rch u.sks'

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u; wmg úk lák yeá

n%Ekaâ tl fudlla jqK;a" fudk ;rï ñ,la f.j, .;a;;a lfÜ y,d.;a;u YÍrh th y÷kd. kafka uoHidrh lsh, ú;rhs' u;aøjH ksjdrK ckdêm;s ld¾h idOk n,ldfha wOHlaI ffjoH iuka; l=udr ls;,jwdrÉÑ úisks wrlal=" ìh¾" n%ekaä" úials" lismamq —fndl= Èrdia˜ - fï l=uk kulska ye¢kajqj;a ñksiqkaf.a YÍrh wvmK lrk" ñksiqkaj jHikhg m;alrk uoHidrj, wvx.= jkafka t;s,a

we,afldfyd,a ^C2H5OH& keue;s ixfhda.hhs' l=uk n%Ekaâ tflka .;a;;a uqLh yryd YÍrhg we;=¿ jk úg YÍrh th y÷kd.kafka t;s,a we,afldfyd,a f,i muKhs' tfia fkdue;sj" wdudYhj;a wka;%hj;a th l=uk n%Ekaâ tfla" l=uk ñ,l uoHidr j¾.hla oehs fkdy÷khs' tfia kï fï l=uk fohla ìõj;a YÍrh l%shd lrkqfha" m%;spdr olajkqfha tl f,ighs' ta YÍrh ;=<g wys;lr øjhla jQ" t;s,a uoHidr we;=¿ jQ úg th ^úI øjhla jQ& úIyrKh lsÍu i|yd isÿjk l%shdoduhla f,igh' fuu t;s,a we,afldfyd,a ^C2H5OH& YÍrhg we;=,a jQ miq th Ô¾Kh i|yd ^Ethanol Oxidative Metabolism& m<uqj we,afldfyd,a äyhsfv%dcfkaia tkaihsuho ^Alcohol Dehydrogenase&"

​ oHidr hqfrdamShhkag u jvd wmsg ydksodhl nj fojkqj we,aäyhsâ äyhsfv%dcfkaia ^Aldehyde Dehydrogenase ALDH& tkaihsuho wjYH fõ' m<uq tkaihsuh u.ska t;s,a we,afldfyd,a weisge,aäyhsâ ^Acetaldehyde& njg m;afõ' fojk tkaihsuh u.ska fuu weisge,aäyhsâ keue;s ixfhda.h weisfÜÜ ^Acetate& njg m;afldg YÍrhg wys;lr fkdjk ;;a;ajhg m;alrhs' fï m%;sl%shd i|yd wlaudj uy;a l¾;jHhla isÿlrhs' th fuu úIyrKh i|yd b;du;a ixl+, yd wêl l%shdldß;ajhlg ffi, Ndckh lrñka fjfyfik w;r bka wlaudj úkdY ùulg Ndckh fõ' m¾fhaIK u.ska wm f;areï .; hq;= tla i;Hhla ;yjqre fldg ;sfí' iqoafola jf.a fndkak ys;df.k" ta jf.a udkisl;ajhla T¿jg wrf.k uoHidr mdkh lsÍfuka iudcfha Wiia ;ekla ysñ lr .; yels hehs udkisl ;Dma;shla ,enqjo we;af;kau hqfrdamshhkaf.a fuka fkdj wdishd;slhskaf.a fuu we,aäyhsâ ^Aldehyde Dehydrogenase& tkaihsuh we;af;a wl%Shjhs' wrlal=" ìh¾ iud.ï úiska wmsj rjgñka" f.dkdg wkaojñka ä%kala tlla .kafka jeo.;a wh" iudcfha Wiia wh njg mqyq udkisl;ajhla f.dvk.d we;;a" we;af;kau wdishd;slhka jk wmg uoHidrj,ska isÿjk ydksh jeähs' m¾fhaIlhka úoHd;aulj ikd: fldg we;s wdldrhg wm m<uqj i|yka l< t;s,a uoHidr Ô¾Khg wjYH ^Oxidative Metabolism& m<uq we,afldfyd,a äyhsfv%dcfkaia

Tn okakjdo@

^Alcohol Dehydrogenase& tkaihsuh wdishd;slhska ^Y%S ,dxlslhska& ;=< ;sfí' kuq;a" th weisge,aäyhsâ njg m;aù weisfÜÜ njg m;a lsÍug wjYH fojk tkaihsuh ;=< fkdue;' th ;sfnkafka wl%Sh ;;a;ajhlhs' ^Inactive Form& fï ksid YÍrh ;=< weisge,aäyhsâ ^Acetaldehyde& m%udKh wêl f,i by< hhs' tys § jukh" T¿j lerls,a," oyäh oeóu wd§ fkdfhl=;a wm%ikak ;;a;ajhka" m%;sl%shdjka YÍrhg isÿ fõ' fuu weisge,aäyhsâ ^Acetaldehyde& reêrfha wêl ùu" fud<fha ffi,j, isg YÍrfha ish¨u bkaøSh moaO;Skag b;du;a wys;lr f,i n,mdkq ,nhs' fï ksid uoHidr mdkh l< miq fndfyda fofkla b;d wmyiq YdÍßl yd udkisl ;;a;ajhkag m;afõ' fuh iqÿ cd;slhkaf.a YÍrfha we;s ALDH tkaihsuhg jvd wfma YÍrfha we;s tu tkaihsuh wl%Sh ;;a;ajfha ;sîu ksid isÿjkakls' ta ksid ffjoH úoHd;aulj meyeÈ,s lr we;s fï uoHidr wfma YÍrfha l%shd;aul jk wdldrh nqoaêu;aj f;areï.; hq;=j we;' Y%S ,dxlslhka muKla fkdj wdishd;sl rgj, ñksiqka fndfyda fofkl=g fuu ;;a;ajh fmdÿ ldrKhls' tneúka fï uoHidr iud. ïj, ñ:Hdfjka ñ§ wrlal=" ìh¾ we;=¿ ish¨?u uoHidrj, lsis÷ i;=gla ke;s nj jgyd .ekSu;a" YÍrhg isÿjk wys;lr n,mEu jgyd .ekSu;a" ta ms<sn|j nqoaêu;aj yeoEÍu;a Tng whs;s fohla æ

•••

wdishd;slhka jk wmg uoHidrj,ska isÿjk ydksh jeähs' thg fya;=j m¾fhaIlhka úiska úoHd;aulj ikd: fldg ;sfnkjd' fï ksihs" jukh" T¿j lerls,a," oyäh oeóu wd§ fkdfhl=;a wm%ikak ;;a;ajhka" m%;sl%shdjkag wfma wEfhd jeämqr ,la jkafka''' ta ú;rla fkdfjhs fï cdk.; fjkialu ksidu wmg úYd, ydkshl=;a isoaO fjkjd''' 12

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mdkh lrk wh wekafokafka fufyuhs

wähla .id lshk flreï flreï j, úoHd;aul miqìu 14

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uoHidrh fud<h flfryS l%shd;aul jkfka fufyuhs

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úúO kï j,ska" úúO yev;, we;s weiqreï j,ska irid fj<|fmd<g tk uoHidrh m%cdj flfryS we;s lrk n,mEu úúOdldrh' fndfyda mqoa.,hkaf.a idudkH úYajdih jkqfha uoHidr Ndú;h i;=g f.kfok l%shdj,shla njh' .S .hñka" kgñka" úfkdao fjñka u;ameka msrjQ ùÿre tlsfkl .eàfuka iõÈh mqrñka TjqyQ úfkdao fj;s' idudkH Ôú;fha§ b;d ksYaYío mqoa.,hka u;ameka ksid fodvu¿ fj;s' iïmQ¾Kfhkau fjkia yeisÍï rgdjka Tjqkaf.ka ms<sìUq fjhs' uoHidrh fkdue;s W;aijhla kï tys iÔù njla ke;ehs hk woyi wo iudc.; ù ;sfnk fya;=ka i,ld ne,Su jeo.;a fjhs' uoHidrh ksid Ndú;d lrkakd flfrka WoaoSmkh jQ l%shdYS,s;ajhla m%lg jk nj neÆ ne,aug fmfkkakg ;sfí' uoHidrfha n,mEu we;sjkafka fud<h yryd nj meyeÈ,s lreKls' tfia kï uoHidrh fud<fha lsishï W;af;ackhla we;s lrkjdo@ doctormagazine.lk

u;ameka idohla ie,iqï lrk wjia:dfõ isg idohl§ u;ameka ùÿrej w;g .;a ú.iu muKla fkdj uoHidr fnda;,h újD; lrk fudfydf;a§u mqoa.,hd W;af;ackh jk wjia:d wm w;aoel ;sfí' tkhska n,k l<" uoHidrh ienúkau W;af;aclhla o@ ke;fyd;a th fud<fha l%shdldß;ajh ÿ¾j, lrk wjmSvlhlao@ fuh meyeÈ,s lr.ekSug úoHd;aul lreKq úuish hq;=h' uoHidrh m%Odk iakdhq moaO;shg ;Èka n,mdk wjmSvlhls' úoHd;aul idOl wkqj uoHidrh fud<hg ;Èka n,mEï we;s lrk b;d m%n, wjmSvlhla ^CNS depressant& ñi fud<hg W;af;aclhla we;slrk ridhkslhla fkdfõ' tfia kï fud<fha l%shdldrs;ajh wvmK lrk uoHidrh Ndú;fhka mqoa., W;af;ackhla we;sjkafka flfiao@

cS¾Kl l%shdj,sh u;aøjH weiqf¾ isÿjk wdldrh u;a j;=rla Ndú;d l< jydu Tjqka kgkafka .hkafka yeisÍï fjkia jkafka flfia o@ fuu lreKq ie<ls,a,g Ndckh úh hq;=h' uoHidrfha ienE n,mEu fud<hg we;sjkafka flf,i o@ úoHdkql+, wOHhkh wkqj YÍr.; jk uoHidrh wdudYh iy nvje,a u.ska wjfYdaIKh ùfuka miqj wlaudj yryd isÿflfrk nys>%dù l%shdj,sh u.ska uoHidr úYd, m%;sY;hla bj;a lrkq ,nhs' u;a Ndú;h ksid wlaudjg ydks isÿjkafka MARCH 2018 | DOCTOR MAGAZINE

15

m%pKav;ajh yd kshd¿ lu folu Tyq ;=< mj;S

úoHd;aul idOl wkqj uoHidrh fud<hg ;Èka n,mEï we;s lrk b;d m%n, wjmSvlhla ñi fud<hg W;af;aclhla we;slrk ridhkslhla fkdfõ' tfia kï fud<fha l%shdldrs;ajh wvmK lrk uoHidrh Ndú;fhka mqoa., W;af;ackhla we;sjkafka flfiao@ fuu fya;=j ksidh' fuf,i wlaudj u.ska uoHidr jeä m%udKhla bj;alsÍu ksid reêrfha uoHidr idkaøKh j¾Okh ùu laI‚lj isÿfkdfõ' ta i|yd wvqu jYfhka úkdä 30 la muK .;jk neúka fud<h lrd uoHidr .uka lsÍug úkdä 30 lg jvd jeä l,hla .;jk nj úoHdkql+, ms<s.ekSuhs' fï wkqj uoHidrh îu weröu;a iu.u mqoa., yeisÍu fjkia jkafka uoHidrfha ienE n,mEu ksid jkafka flfia o@ fuu yeisÍï rgdjg n,mdkafka uoHidrh we;s lrk ienE ldhsl n,mEuo@ ke;fyd;a mqoa.,hdf.a uki iu. ne§ we;s wdl,amuh ms<s.ekSula ksid o hkak i,ld ne,sh hq;= fõ'

16

MARCH 2018 | DOCTOR MAGAZINE

u; ksid kgk .hk muKla fkdj m%pKavldÍ f,i yeisfrk mqoa.,hska o úr, fkdfõ' Tjqkaf.a yeisÍï rgdj laI‚lj fjkia jk wjia:d ljf¾ o@ îu;ska m%pKavj wYsIag f,i yeisfrk mqoa.,fhl= fmd,sia ks,Odßfhl= bÈßfha§ jydu fjkia jk fuu yeisßï rgdj kej; m%pKavldß jkafka ìß| iy orejka bÈßfha§ ;u ksjfia§h' tu m%pKav;ajhg ienE fya;=j uoHidrh kï mqoa.,hd uqyqK fok mßirhg wkq.dój YÍr.; uoHidr idkaøKh fjkia úh hq;=h' ;j;a iudc.; woyila jkqfha ,Êcdj" ìh ke;s lrk yeisÍïj,g fya;=j jkqfha yeisÍï md,kh lrk fud<fha we;ehs lshk hï úfYaIs; l,dm ^Inhibition Centres& j,g we;sjk wjmSvl n,mEu ksid njh' tfy;a úoHdkql+,j fuu woyi iïmQ¾Kfhkau m%;slafIam lrkqfha yeisÍï md,kh lsÍfï tjka l,dmhla fud<fha ke;s neúks' fuu mg,eú,s iajNdjh meyeÈ,s lr.ekSu i|yd lreKq lsysmhla i,ld ne,sh hq;= fõ' tkï reêrfha uoHidr idkaøKh fjkila fkdù uoHidrfha n<mEu wdmiq yerfjk wjia:d we;s jkafka flfia o@ úoHdkql+,j idOKSh lreKqj,g mgyeks f,i uoHidrh reêr.; ùug fmr tys n,mEu úoHudk jkafka flfiao iy b;d m%n,j fud<hg wjmSvlhla we;slrjk ridhkslhla jk uoHidrh W;af;aclhla f,i yeisfrkafka flfiao hk lreKq ms<sn| meyeÈ,s úh hq;=h'

doctormagazine.lk

.eg¿j ksrdlrKh l< reishdkq úoHd{f.a lS¾;su;a wOHhkh tu lreKq ;yjqre lsÍu i|yd reishdkq úoHd{fhl= jk whsjka meõf,da ^Ivan Pavlov& óg Y;lhlg muK fmr§ n,a,l= wdOdrfhka isÿlrk ,o mÍlaIKhla Wmfhda.S lr.ekSu WÑ;h' th —bf.kSu˜ ^Learning& kï jk ufkda úoHd;aul ixisoaêhla jk w;r fuu isoaê wOHhkh isÿjkafka ;j;a hï l%shdjla yd iïnkaO lsÍfuks' tu mÍlaIKh isÿlr we;af;a meõf,daf.a mÍlaIK.drfha§ n,af,l= Wmldrfhks' m<uqj iSkqjla kdofldg bkamiqj n,a,dg uia lene,a,la fok ,§' fuh kej; kej; isÿ lrk ,o w;r iSkqj iy uia lene,a, w;r iïnkaO;djh yryd n,a,df.a yeisÍï ksÍlaIKh wruqK úh' iSkqj kdofldg uia lene,a, ÿkaúg n,a,df.a láka fl< msgúh' ál fõ,djlg miqj uia fkd§ iSkqj kdo l< mu‚ka n,a,df.a láka fl< msgúh' iSkqj kdo lsÍu iy n,a,df.a fl< .e,Su tl úg isÿjQfha iSkqj kdoùu;a iu. uia ,efnkjd hk woyi n,a,d bf.kf.k ;snQ ksidh' bkamiqj uia ke;sj jqjo iSkqj kdo jQ úg fl< .e,Su isÿúh' iSkqj kdoùu iy fl< .e,Su lsysm jrla tljr isÿùu ksid iSkqj kdojQ úg fl< .e,Su n,a,d mqreÿjQ wÆ;a yeisÍuhs' fï wkqj wÆ;a yeisßï muKla fkdj wÆ;a Ñ;a;fõ.hkao bf.k .ekSug yelsfõ' fuu ixisoaêh uoHidrhg .,mkafka flfiao hkak i,ld n,uq' WmkaÈk fyda fjk;a úfYaI wjia:d ieuÍug idohla ms<sfh, flfrk wjia:dj,§ doctormagazine.lk

we;s W;aijdldr miqìu ix.S;h" ri wdydrmdk" ñ;=re ñ;=ßhka" ieris,s we;slrkafka is; mskdhk miqìuls' tjka miqìula ;=<§ mqoa.,hd ;=< we;sjkafkao m%ikak úfkdaoldó udkisl;ajhls' fujka mßirhlg uoHidrh tla l< úg we;sjkafka fujka iólrKhls'

uoHidrh ¬ W;aijh } i;=g ta wjia:dfõ§ we;sjk i;=g úfkdaoh ienE úkaokhls' mßirh ksid mqoa.,hd ;=< W;af;ackhla we;sfõ' fuys§ uoHidrh iSkqjg iudk jk w;r fud<fha W;af;ackh iudk l< yelafla n,a,df.a fl< .e,Sugh' we;a; jYfhkau fuys§ mqoa.,hd yeisfrkqfha fud<h úiska ,ndÿka W;af;ackh ksidh' thg fya;=j wod< mßirh úkd uoHidrh fkdfõ'

whsjka meõf,da úoHd{hdf.a úoHd.drfha n,a,d ljqo@ uoHidr.;a mqoa.,hd meõf,daf.a n,a,d f,i yeisfrk w;r iSkqj jkafka uoHidrhhs' fl< .e,Su u;ameka îfuka miqj isÿlrk úldr yeisÍï jk w;r meõf,da hkq uoHidr l¾udka;hhs'

mßj¾;kh( ks,dks úfÊisxy" Y%S ,xld iqñ;%fhda fu,a ueÿr" fld<U 7

fld<T úYajúoHd,fha fcHIaG lÒldpd¾h úfYaI{ ufkda ffjoH ufyaIa rdciQßhf.a (WHY PEOPLE SING & DANCE AFTER ALCOHOL) hk ,smsh wkqidrfhks' ••• MARCH 2018 | DOCTOR MAGAZINE

17

lsß o;a wdrlaId lr .ekSu

yßu jeo.;a lsß o;a .e,ùu iqÿiq kE'''

World Oral Health Day

orejkag wdorh lrk uõmshka orejkaf.a lsß o;a .ek wjYHfhkau o; hq;= foa'''

f;dr;=re oelaùu fld<U ßcafõ wd¾hd <ud frdayf,a oka; Y,H ffjoH wd¾' fla' .=Kj¾Ok ñh 18

MARCH 2018 | DOCTOR MAGAZINE

World Oral Health Day (WOHD) is celebrated every year on 20 March.

It is an international day to celebrate the benefits of a healthy mouth and to promote worldwide awareness of the issues around oral health and the importance of oral hygiene to looking after everyone old and young. doctormagazine.lk

orefjl=g bia biafi,a,du tk o;a j,g wm lshkafk lsrs o;a lsh,''' orejdg jhi udi myla yhla muK fjk ld,fhaoS orejdg o;a uq,skau fudaÿ fjkjd' th orejdf. uõmshka kï i<lkafka wisrsu;a isÿùula jYfhka' lsrs o;a úÿreufyka fudaÿ fjkak fï lshk ld,h .; jqK;a lsrso;a nndf. úÿreuyg tkafk orejd uj .eíf.k hka;ï i;s 6-8 jk ld,fhaoSuhs' uq,skau idudkHfhka lsß o;a fudaÿ fjkafk há wekafo bosßmi' wjqreÿ 2-3la ú;r jk úg lsß o;a úiaila uqfjys yg .kakjd' fï o;a m;kh jk fkdfyd;a iaÓr o;a j,g wjldY i,ikq jia jefgk o;a úosyg ;uhs mj;skafka'

isÿ l< hq;af;a orejd fifkyiska ;=re¿ lrf.k th orejdg ysßyerhla fkdjk wdldrfhkqhs' doctormagazine.lk

uq,au ikaosfha o;a ueoSu yqre lsßug fhdod .kakd fuj<ula'''

orefjl=g lsß o;a u;= fjk ldf,a we;s fjk .eg¿''' o;a fudÿ jk m%foaYh r;a meye .ekSu;a" lsishï fõokdldÍ njla oekSu;a idudkHfhka we;s úh yels isÿùïh' we;eï úg fï ld,fhaoS WK .kakjd' jeä jdr .Kkla u<my msg fjkak mq¿jka' lsishï fya;=jla ksid orejd fõokdfjka fmf<kjd kï ffjoH m%;sldr .ekSu iqÿiqhs'

lsß o;a j, wdrlaIdj yßu jeo.;a''' lsß o;a ál ldf,lska .e,fjkj jqKdg ta lsß o;a wm b;d fyd|ska wdrlaId lr.; hq;=hs' orejkaf.a lsßo;a wdj ojfia b|,d tu o;a fyd¢ka ueo úIîcj,ska wdrlaId lr.; hq;=hs' tfyu fkdjqfKd;a tu lsß o;a b;d blauKsska krla fjkjd' lsß o;a krla ùu Rampant Caries f,i y÷kajkjd' fuu wjia:dfõ§ orejkaf.a lsß o;a l¿ meye .ekaú,d krla ùu isÿfj,d ;sfhkafk' tksid b;d myiqfjka úÿreuia úIîc wdidokhg ,lafjkjd' láka ÿ.|la jykh fjkjd' o;aj, fõokdj we;s fjkjd' úÿreuia bÈfukjd' Bg miafi o;a .e,fjkak mgka .kakjd' MARCH 2018 | DOCTOR MAGAZINE

19

ÿ¾j, uqL fi!LHh ksid l=vd orefjl=f.a o;a krlaj ;sfnk wdldrh

uq,au ldf, o;a uosk yeá orejdf.a lsß o;a ueoSu o;la folla fudaÿ jQ ojfia isgu l< hq;a;la' uq,a ld,fhaoS msßisÿ c,h iu. o;a ueoSu iqÿiqhs' weÕs,a,g ouk o;a nqreiqjla fyda l=vd ysila we;s o;a nqreiqjlskq;a o;a ueoSu wdrïN lrkak mq¿jks' fï lghq;a; isÿ l< hq;af;a orejd fifkyiska ;=re¿ lrf.k th orejdg ysßyerhla fkdjk wdldrfhkqhs' ke;skï fjkafk o;a ueoSu lsÍug orejd m%;sfrdaOhla oelaùuhs' idudkHfhka jhiq wjq' y;rla muK jk ;=re orejdg ;ksju o;a uoskak nE' lsishï yqrejla mßphla orejd oelajQj;a orejdg wjqreÿ 8-10 ú;r fjklï fï o;a msßisÿ lsÍfï l%shdj,shg uõmshkaf.a wëlaIKh wjYH fjkjd'

l=vd orejkaf.a lsßo;a /l .kak l< hq;= tlu l%shdj o;a fyd¢ka msßisÿ lsÍuhs' iEu lsß fõ,lgu iy wdydr fõ,lgu miq orejkaf.a o;a ueo msßisÿ l< hq;=hs' 20

MARCH 2018 | DOCTOR MAGAZINE

wo we;eï foudmshka ;uqkaf.a mqxÑ orejkaf.a o;a krla jQ úg tys fõokdj yg.;a úg oka; ffjoHjreka fj; tkafka lsßo;a .,jd oeófï n,dfmdfrd;a;=fjka' kuq;a lsßo;a .e,ùfuka we;sjk wys;lr jQ n,mEu tu foudmshka okafka keye' lsßo;a .,jkak fyd| keye' tajd .e,jqjfyd;a bkamiq tk iaÓr o;aj, msysàu wl%uj;a fjkjd' wo fndfyda foudmshka ;uqkaf.a mqxÑ orejkaf.a o;a krla jQ úg tys fõokdj yg.;a úg oka; ffjoHjreka fj; tkafka lsßo;a .,jd oeófï n,dfmdfrd;a;=fjka' kuq;a lsßo;a .e,ùfuka we;sjk wys;lr jQ n,mEu tu foudmshka okafka keye' tksid orejka isák iEu foudmsfhlau ;u orejkaf.a lsß o;a wdrlaId lr.kak jeä wjOdkhla fhduq l< hq;=hs'

lsßo;a /l .ekSug .;hq;= mshjr l=vd orejkaf.a lsßo;a /l .kak l< hq;= tlu l%shdj o;a fyd¢ka msßisÿ lsÍuhs' iEu lsß fõ,lgu iy wdydr fõ,lgu miq orejkaf.a o;a ueo msßisÿ l< hq;=hs' úfYaIfhkau rd;%shg orejkaf.a o;a msßisÿ lsÍu l< hq;=hs' tfiau orejkago rd;%S kskaog fmr o;aue§u yqre l< hq;=hs' l=vd orejkag me‚ ri lEu ks;r fokak tmd' tajd m%%Odk wdydr fõ,la iu. fokak' wu;r wdydr fõ,la fia fgd*s" fpdla?Ü wd§ me‚ ri wdydr §fuka orejkaf.a o;a b;d blauKska krla fjkjd' ••• doctormagazine.lk

;=kal,a oelaul ysñldßh'

INTERNATIONAL

W MEN'S DAY SPECIAL#2018

zzb;aÓ NdKAvdk uq;a;uxZZ mqreIhd i;= W;Au iú{dKl iïm; ia;%sh hhs jodf<a f.!;u nqÿka jykafiah' zzNd¾hdj mrud iNd'''ZZ mqreIhdf.a fyd|u fhfy<sh f,io m;sl=,fha ysñldrsh f,io ye|skaùug nqÿkajykafia miqng kqjQjdh''' l=, ia;%Ska yd l=udrsldjka Wiia fldg i<lk ;dla oshqKQj ue ñi mrsydkshla fkdu jk nj wm f.!;u nqÿrcdkka jykafia ima; wmrsydks O¾u úia;r lruska ,sÉPù rc orejkag O¾uh foaYKd l< nj wx.=;a;r ksldfha i|ykah'''

wo jeks ld,hl kï fujka oelaula flfkl= m< l<fyd;a tys t;rï wreuhla ke;' tfy;a mqrd;k Ndr;h muKla fkdj uq¿ f,dalfhau óg jir fooyia yhiShlg tyd ;;a;ajh w;sYhska fjkia iajrEmhla f.k ;sìK' ia;%sh zzNdKAvhlaZZ njg m;aj ;snQ w;r zziuD;sZZ kï ffjosl idys;Hhg wkQj bmerKs bkaoshdfõ kï wehg ysñ jQfha ksfjfiaoS jqj jy<shlf.a ;;a;ajhhs''' W;=ï Ydia;D oyu ia;%sh ms<sn|j c.;a m;, ioa ms<s.ekSula m;, lsrSug m%ia;=; jQfõh'

International Women's Day 2018 Rural women and their organizations represent an enormous potential, and they are on the move to claim their rights and improve their livelihoods and wellbeing. They are using innovative agricultural methods, setting up successful businesses and acquiring new skills, pursuing their legal entitlements and running for office.

wef.a cSú;h fï jf.hs''' wkdrlaIs; ,sx.sl tlaùï j,ska je<fluq''' wd¾;jh yd iene|S f;dr;=re jl=.vqjlska isÿ flfrk ld¾hh reêrldkaÿlrKh isÿ lrk l%u *siaáhq,djla doctormagazine.lk

On 8 March, join activists around the world and UN Women to seize the moment, celebrate, take action and transform women’s lives everywhere. The time is NOW. UN Women is the UN organization dedicated to gender equality and the empowerment of women. A global champion for women and girls, UN Women was established to accelerate progress on meeting their needs worldwide.

MARCH 2018 | DOCTOR MAGAZINE

21

EMPOWERING WOMEN'S WORLD

How Normal is Your Period Pain?

Tfí Tima ùu Tima ùfuys idudkH iy widudkHh

Tfí Tima fõokdjka idudkHo@ widudkHo@

INTERNATIONAL

W MEN'S DAY SPECIAL#2018

Tima ùfïoS oeä fõokdjla we;sjk ldka;djka l< hq;af;a l=ulao@

m%ij yd kdßfõo úfYaI{ ffjoH frdaIka fihsßäka fihsâ kjf,dal frday, Dr. (Mrs) Roshan Zeirideen Zaid MBBS (CEY) MRCOG (UK), DFSRH (UK), CCT (UK), FMAS (India) Board Certified (UK) Resident Consultant Obstetrician and Gynaecologist

22

MARCH 2018 | DOCTOR MAGAZINE

doctormagazine.lk

ldka;djkaf.ka ishhg 90lau fï Tima reêrh msgùu yd ine|sj fõokdjla YdÍßl wmyiq;djhlg m;ajk nj olakg ,efí'

fldgia follg whs;s fjkjd' tlla ;uhs m%d:ñl Tima fõokdj' th" Primary Dysmenorrhea hkqfjka ye|skafjkjd' wfkl oaú;Shsl Tima fõokdj' th Secondary Dysmenorrhea f,i úia;r lrkjd'

m%d:ñl Tima fõokdj Primary Dysmenorrhea

we;af;kau Tima fõokdj idudkH ;;a;ajh l=ulao@ ffjoH wjOdkhg fhduq úh hq;= widudkH Tima fõokdj l=ulao@ fï .ek oek.ekSu ldka;djkg w;sYhska m%fhdackj;a jk w;r ffjoH wjOdkhg fhduql< hq;=" ms<shï fhosh hq;= ;;a;ajhka uqyql=rd f.dia we;eï úg úYd, ydks wehg isÿ ùugo bv ;sfnk ksid fï .ek ,nd. kakd wjfndaOh iEu ldka;djlgu w;sYhska jeo.;a jkq we;'

uQ,sl jYfhka fuh Tfí Tima l%shdj,sh fya;=fldg f.k we;sjk fõokdj jYfhka w¾: olajkak mq¿jka' idudkHfhka osfka <x fjkfldg fldkafo wudrejla" ll=,aj, wudrejla tlal Tima ùu we;s fjkak mq¿jka' udia Y=oaêh yeos, ojia fol ;=kla wmyiq;djh ;sfhkjd' Bg miafi fõokdj áflka ál wvq fj,d hkjd' thhs idudkH ;;a;ajh' tys iq¿ jYfhka fjkialula jqKdg iuia;hla úosyg Tfí;a Tima oskj, yeisÍu fï jf.a kï ta .ek jo fjkak ´ks kE' th Tfí idudkH Tima fõokdjhs'

udia Y=oaêfhaoS we;sjk fõokdjka úúO iajrEmhka .;a;;a fï ish,a,

Tima ùfïoS we;sjk idudkH fõokdj fïlhs'

Tima fõokdj - idudkH yd widudkHh

Tima oskj,§ fõokdj oefkk fya;=j fuhhs .¾NdIfha ì;a;sh uDÿ fmaYs j,ska iukaú; wjhjhls' fuys ixfldapk we;sùu idudkH iajNdjhhs' fndfyda úg fï ixfldapk ksid fõokdjla oefkkafka ke;' tfy;a" wd¾;jfhaoS fï ixfldapk ;rula m%n, iajrEmhla .kS' .¾NdIhg ne|S we;s reêrfhka ieliqkq ì;a;sh ì| fy<Su fï m%n, ixfldapk j, wruqKhs' ta ksid thska fõokdjla we;súh yel' fï ixfldapk we;sùfïoS .¾NdIh wdia;rkh lrk reêrjdyskS wjysr ùula isÿfõ' fï wkQj .¾NdIhg doctormagazine.lk

m%udKj;a Tlaiscka iemhqula ,efnkafkao ke;' fuys m%;sM<hla f,i .¾NdIfhka ksl=;a flffrk fydafudakhla u.ska .¾NdI.;j fõokdjla we;s lrhs' fï fõokdj W;amdokh lrk ridhkh ;j;a wu;r ld¾hhlao isÿ lrhs' ta wka lsisjla fkdfõ''' fõokdj ;j;a jeälrk fm%diafgd.a,ekaäka kï fydafudakhla ksIamdokh lsÍug osß oSuhs' fm%diafgd.a,ekaäka fydafudakh u.ska .¾NdIh ixfldapk j,g ,la lrñka fõokdj ;Sj% lrhs'

MARCH 2018 | DOCTOR MAGAZINE

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EMPOWERING WOMEN'S WORLD

udia Y=oaêh we;sjk úg lsishï fyda fõokdjla fkdú|sk ldka;djl isào hkak iel iys;h' ta ;rugu udislj isÿjk Tima ùu yd zzfõokdjZZ w;r iïnkaOh iq,nh' ;sridrh'

EMPOWERING WOMEN'S WORLD

oaú;Shsl Tima fõokdj' Secondary Dysmenorrhea fuys úfYaI;ajhla ;sfnkjd' Tima oskj, we;sjk fõokdj ;uhs' ta;a fuysoS fõokdj we;sjk fõokdj ;rula oeähs' ke;akï f.dvdla jeähs' tlafld osk 2-3g jvd" we;eï úg i;s .Kkdjla fõokdj w,a,kjd' reêrh msgùu;a we;eï úg oS¾>ld,Sk isoaO fjkjd' uQ,sl jYfhka fufyu jkafk wehg fjk;a frda.hla ;sfhk úg' ta frda.h;a tlal Tima ùu;a isoaO fjkjd' th fõokdldßhs'

m%;sldr l< hq;= ;;a;ajhla''' oeä fõokdldÍ Tima ùug kï m%;sldr .; hq;= fjkjd' ms<shï fhosh hq;= fjkjd' ksis ms<shï ksis fj,djg fkdfhÿfKd;a wehg úYd, ydkshla fjkak mq¿jka' we;eï fj,djg orejka ,eîfï bvlv ySkùu" we;eï úg bkaøsh ydkshg m;a ùu''' fïjd iq¿fldg ;lkak nE''' ldka;djg we;s fjk;a ffjoHuh .eg¿ fya;= lrf.k udiaY=oaêh fõokdldÍ jk wjia:d

úgo udiaY=oaêh fõokdldÍ fjkjd' Tima ùfïoS we;sjk fõokdjka iukh lrkakg u`.la ;sfí' Tng we;af;a bis,sh fkdyels widudkH fõokdjla kï thg jy jyd ms<shï fhosh hq;=h' lsisu ldka;djl Tima ùfïoS we;sjk idudkH fõokdj blaujQ fõokdjla ú|skafka kï wehg thska ñoSug u`. fy<sorõ l< hq;=h'

fõokdfjka iykh ,nk u. ldka;djl ;u udia Y=oaêfhaoS we;súh yels fõokdj blaujd widudkH fõokdjlska mSvd ú|skafka kï wehg ta i|yd n,mj;ajk fya;=j y÷kd.; hq;=h' ta i|yd ffjoHjreka mÍlaIK kshu lrk w;r tysoS wjYH;djh wkQj isÿ lsÍug isÿjk mÍlaIK lsysmhla fufiah' • w;s èjks mßf,dalk ^ialEka& mÍlaIKh • ,emriafldms mÍlaIKh • MRI mÍlaIKh we;sjk fõokdj Tima pl%h yd ine|S fõokdjla ñi fjk;a ffjoHuh ldrKhla fya;=fldg

• tkafvdfuáfhdaisia • *hsfn%dhsâ • fY%daKs m%odysl frda.h (PID) • weäfkdufhdaisia • IUD • ,sx.dY%s; wdidok fï yereKQ úg Worfha we;sjk fõokd" Irritable bowel syndrome hkqfjka ye|skafjk WordndOh wdoS wjia:dj,oS fukau uq;%d wdidok we;s 24

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wd¾;j l%shdj,sh ieflúka''' doctormagazine.lk

frda.h fiùug idOdrK W;aidyhla .; hq;=hs jrla jhi wjqreÿ 18l ;reKshla wef.a oeä wd¾;j fõokdj ksid Bg ms<shula fhdod .ekSug ud fj; meñKsfhah' weh fj; fjk;a fï yd ine|S wikSmhla fkdue;s nj ;yjqre lsÍug MRI mÍlaIKhla lsÍug ud fhdackd lf<ñ' zztÉpr f,dl= mÍlaIKhla fudlgo@ZZ fïl ta ;rï mÍlaIK ´ks fohlao@ fï uõmshkaf.a laIKsl m%;spdrh úh' Tima fõokdfjka iykhla ,nkq msKsi Oral Contraceptive Pills ,ndoSu ir< úi÷uls' zzwhsfhda''' fï bf.k.kak <uhskag Wm;a md,k fm;s fokjo@ .fï ñksiaiq oek.;af;d;a wmsg ,ecacd lrdú'''ZZ fï tjka wjia:djl Tjqka m%;spdr olajk úosyhs' zznekaou Tlafldu yßhdúZZ zzorefjla yod.;a;yu Tlafldu yßZZ fï úosyg m%;sldr isÿl< wjia:dfõ th u.yrsk úg wjidkfhaoS doctormagazine.lk

isÿjkafka uyd fÄojdplhls'

EMPOWERING WOMEN'S WORLD

f.k wd fõokdjla fkdjk nj mila lr.ekSug kï tu iel lrk ffjoHuh ;;;ajhka fkdue;s nj ;yjqre lr.; hq;=h' ksoiqkla f,i tkafvdfuá%fhdaisia fkdue;s nj ;yjqre lr.ekSug kï ,emriafldms mÍlaIKhla isÿlr.; hq;=h' tkafvdfuá%fhdaisia hkq we;súh fkdyelallehs ,>q lr.; yels frda. ;;;ajhla fkdfõ' iEu ldka;djka 10 fofkl=f.ka tlaflfklau fï frda. fhka mSvd ú|shs'

lsishï m%;sldr .;hq;= ffjoHuh ;;a;ajhla ;sfnkjd kï th l,a fkdhjd m%;sldr .; hq;=h' tfia fkdjk úg weh kej; ms<shï fhosh fkdyels ixlS¾K woshrlg frda.h m;a ùfuka wehg uy;a jQ wjdikdjlg uqyqK mdkakg isÿúh yelsh'

Tima fõokdjg isÿ lrk m%;sldr hï ldka;djla ;u udia Y=oaêh fya;=fldg f.k wiSñ; fõokdjla ú|skafka kï thg ffjoHuh ueosy;a ùula wjYHuh' fuysoS ffjoHjrhd úiska ;u m%;sldrh ie,iqï lsÍfïoS my; ks¾Kdhl flfryS ie<ls<Su;a jkq we;' • fõokdjg fya;=j ta yd ine|S frda. ;;a;ajhlao hk j.' ksjeros frda. ksOdkh y÷kd .ekSu' • fõokdfõ m%udKh' fl;rï fõokdldÍo hkak wkQj m%;sldrd;aul Wmdh ud¾. yªkd. efka' • tla tla mqoa.,hdg wdfõKsl frda. b;sydih yd frda. ;;a;ajh wkQj fï wdldrfhka ksjerosj wef.a .eg¿j y÷kdf.k wehg iykh i,ik úi÷ula ,ndoSu ksielfhkau l< hq;a;ls' wef.a Tima fõokdjg kshñ; ms<shï fhoSfuka wef.a cSú;fha .=Kd;aulNdjh ks;ekskau jeä jkq we;' ta wef.a m%ckl l%shdldß;ajh" ,sx.sl cSú;h" /lshdj" f..orfodr wef.a ne|Sï wdoS fulS fkdlS wef.a iuia; l%shdldß;ajfhau Okd;aul ••• fjkila iu.sks' MARCH 2018 | DOCTOR MAGAZINE

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EMPOWERING WOMEN'S WORLD

INTERNATIONAL

W MEN'S DAY SPECIAL#2018

jhia.;j m;sl=,hg .sh;a ore iïm;a ,nd.kak k< ore ;dlaIKh iydh fjkjd WISH idM,H;d

idhkfhka jhia.; ù ore iïm;a m;kakkag iykh orejka ,eîfï yelshdj fõ.fhka jhi;a iu.u ySk fjhs' jeäu n,mEu we;af;a ldka;djkagh' msßñkao fï ffcj úoHd;aul kshduhg wkq.; fkdfjkjd fkdfõ' wo ld¾h nyq, iudcfha fjfiiskau wOHdmkhg" mjqf,a j.lSï j,g Wrfok fndfyda fokd fï wjodkug uqyqK fok wdldrh iïnkaOfhka wm miq.sh l,dmfhka l;dnyl fhÿKd Tng u;l we;' ia;%s" mqreI ckldKQ j, .=Kd;aulNdjh fidhk wdldrh" m%udo ù ore iïm;a m;k Woúhg ore iïm;a ,eîug k< ore ;dlaIKh msysg jk wdldrh .ek wm miq.sh l,dmfhka úia;r lf<uq' jhia.; wUq ieñhka ore iïm;a wfmalaId lsÍfïoS fjfiiskau fï .eg¿jg ldka;djka uqyqK fok úg k< ore ;dlaIKh Bg msysgg tk wdldrh .ek fujr ,smsfhka lreKQ oelafjkq we;'

WISH Fertility & IVF Clinic yS idhksl l<,fõo úfYaI{ ffjoH fy<rejka mikal=udr uy;d iu. l< idlÉPdjla weiqßKs MBBS (Sri Lanka) 27

doctormagazine.lk

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EMPOWERING WOMEN'S WORLD

ldka;djlf.a îc m%udKh ySk jk yeá ldka;djlf.a jhi;a iu. wvqjk îc m%udKh uekSu i|yd úfYAI jQ l%u mj;S' ldka;djlf.a jhi wef.a Wreu îc m%udKh iïnkaOfhka wk.s;u o¾Ylhhs' kuq;a weh l=vd ikaosfhaoS ,nd. kakd fmdaIKh" weh ,nd.;a úúO T!IO yd ;j;a úúO idOl u; wehg fYAI jk ia;%S îc m%udKh ;SrKh jkafkah' fyd|ska fmdaIKh ,eîu .eyekq orefjl=g w;sYhskau jeo.;a jkafkao fï ksidh' äïn fïÍug ,nd.kakd T!IO Clomiphene citrate ld,dka;rhla .ekSfukao îc ixLHdjg n,mEula fõ' ialEka mÍlaIK u.ska äïnfldaIj, m%udKh ;SrKh lsÍu;a (Ovarian Diameter) äïnfldaI ;=< reêr Odjkh .Kkh lsÍu;a fukau äïnfldaI ;=< we;s îc m%udKh .Kkh lsÍu;a (Antral follicle count) u.ska ldka;djlg ;ukaf.a îc u.ska orefjl= yod .ekSug ;sfnk yelshdj ;lafiare lr.;a yel' 28

îc m%udKfha iM,;djh úuik fjfiia mÍlaIK úfYaIs; jQ reêr mÍlaIK lsysmhla u.ska fï yelshdj ;jÿrg;a we.hSug ,la lrk w;r ta úia;D; reêr mÍlaIK my; mßosh' • D3 FSH • E2 Levels • Anti mullerian hormone (AMH) • nhibin A/B levels • Clomiphene changine levels (CCH) kùk úoHdj u.ska y÷kdf.k ;sfnk DHEA kue;s T!IOh ldka;djkaf.a îc m%udKh yd tys .=Kd;aul;djh flfryS w;sYh jeo.;a fufyjrla bgq lrk nj wkdjrKh ù ;sfí' IVF ;dlaIKfhaoS Ndú;d jk PGD (Peri implantation Genetic Diagnose) kue;s l%uh u.ska cdk fjkia jQ îc j,ska iEfok úlD;s jQ l<, y÷kd.ekSfï yelshdj ksid ksfrda.S orefjlau yod.ekSfï wjia:dj Tng Wreuh'

jhia.; wUq ieñhka i|yd IVF ;dlaIKfha iqúfYAIS Ndú;

jhia.;ùu ksid fyda ;ukaf.a ckl îc wvqùu

MARCH 2018 | DOCTOR MAGAZINE

doctormagazine.lk

fuysoS äïnh ,nd.kafka jhi wjq' 35g wvq orejka isák ldka;djlf.ks' th iffiapkh lrkafka ridhkd. drfhah' ta wdldrfhka idod /l n,d. kakd hqla;dkqj iSrefjka orejka ke;s ldka;djf.a l=i ;=< ;ekam;a lrKQ ,nhs' fuh y÷kajkafka odhl l<, l%uh fkdfyd;a Donor Embryo Method hkqfjks' fuysoS ksjqka fyda nyq ore Wm;a we;sùfïo yelshdjla ;sîu fï wUq ieñhkg m%S;sckl ldrKhls'

fjk;a ldka;djlf.a l=ifha ;ukaf.au orefjla" Surrogate Pregnancy we;eï ldka;djlg we;sjk .eg¿j jkqfha orefjl= yod .ekSug fkdyels jHqyd;aul fodaI j,ska .¾NdIh hqla; ùuhs' kùK idM,H;d ;dlaIKh kï úYAuhcklh' fujka wirK ldka;djka ;j;a ldreKsl ldka;djf.a l=ifha ;u orejd úlikh lrñka ore Wm;la ,nd oSugo fï ;dlaIKh ;=< wjldY we;' orejd Wmka miq ks;HdKQl+,j ;ukaf.a orefjl= jYfhka yod .ekSug .súi .ksñka ;j;a ldka;djlf.a l=ifha ;ukf.a orejd ìys lsÍu Surrogate Pregnancy hkqfjka ye|skafjhs'

fjk;a flfkl=f.a Y=l%dKQ j,ska ;ukaf.au orefjla fï wdldrfhkau ;ukaf.a Y=l%dKQ ffi,j, fodaI we;s úg ;j;a f;dard. kakd msßñfhl=f.a Y=l%dKQ fhdodf.k doctormagazine.lk

mS;D;ajfha jrm%idoh ysñ lr .ekSfï Wodyrko wm iudcfhau ;sfí'

l=i ;=< jefvkafka ksfrda.S orefjlao fidhk mÍlaIK fï wdldrfhka úoHdfõ wkqyiska Wmosk orejkaf.a kSfrda.SNdjh ms<sn|j wUq ieñhka ks;r ;efjhs' jo fjhs' ta;a ksfrda.S orefjl=f.a m%iQ;sh fõ,dikskau idlaId;a lsÍugo fï kjH idM<H;d ;dlaIKhka iu;a nj Tn okakjdo@ l<,h l=i ;=< ;ekam;a lsÍug fmr tys ksfrda.S nj úuik úÿyqre ;dlaIKhka fukau ;ekam;a l<,hla i;s 10l muK wejEfuka fhfylska jefvkjdo hkak úuik ;dlaIKhkao wo ojfia wm fj; mj;S' ljr idM,H;d .eg¿jlska fm¿K;a oeka Tng ore iïm;a ,nd .ekSu wreuhla fkdfõ' fjk hï ljr fodaIhla u; Tfí uõmsh isyskh fnd| ù ;snqK;a th h,s mqnqÿjd,Sfï yelshdj wmg ;sfí' Tfí .eg¿j l=ula jQj;a th .ek yDohx.uj l;dny lsÍug wm iQodkïh' Tng jvd;au .e,fmk úi÷u ,nd.ekSug fï flafIA;%fha m<mqreÿ wfma jD;a;Sh iydh ,nd oSug wm b;d leue;af;ka isáuq' •••

wmg l;d lrkak' fukak wfma wxlh

077 186 21 17 wmf.a ,smskh WISH Fertility & IVF Clinic 393$6" li.yj;a;mdr mrK fldÜgdj mdr Wvyuq,a," kqf.af.dv

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EMPOWERING WOMEN'S WORLD

ksid fyda fudkhï fya;=jla ksid fyda îc we;s fkdùu ksid we;sjk .eg¿jgo ms<shula ;sfí' fjk;a flfkl=f.a äïn ,nd.ekSfï (Donor egg) fï l%uho w;sYhska ckm%shh'

EMPOWERING WOMEN'S WORLD

IN VITRO FERTILISATION FOR EGG DONOR SURROGACY USING INTENDED PARENT(S) SPERM Fresh Sperm

Od;= fudapkhlska osk 2-5 w;r ld,hloS kej;;a Y=l% Od;= idïm,hla ,nd .ekSug isÿ fjhs'fuh úYaf,aYKh lr mÍlaIdjg ,la flfrhs'

USING INTENDED PARENT(S) SPERM OR DONOR SPERM Frozen Sperm

YS;kh lrk ,o Y=l%dKQ kï äïnh Wlyd .kakd oskfhaoS YS; ;;a;ajfhka bj;g .efkhs'

OVARIAN STIMULATION FOR EGG DONOR a. Stimulation

uqod yßkq msKsi äïn iQodkï lrKQ jia T!IO u.ska äïn l+m W;af;ackhg ,la flfrhs' b. Control

l+m j, úYd,;ajh yd m%udKh kshdukh lsÍug w,ag%dijqkaâ yd reêr mÍlaIK fhdod .efkhs' c. Egg Release

äïn j, wjika woshf¾ mßK;sh yd l+m ì;a;sfhka äunh uqod yeÍu myiq lrKQ jia hCG kslafIamKhla ,nd fohs' EGG RETRIEVAL d. Egg Retrieval

kslafIamKfhka meh 35-38lg miq äïnh w,ag%d ijqkaâ wëlaIKh hgf;a bj;a flfrhs' FERTILISATION e. Insemination

kejqï fyda YS;k ;;a;aj hgf;a wdrlaId lr.kakd ,o Y=l%dKQ ICSI tkak;la u.ska äïnh bj;a lrf.k meh lsysmhlska ridhkd.drfhaoS tkak;a flf¾'

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f. Fertilisation

ixfiapkhg ,la lsÍfuka meh 16-18lg miqj ixfiapkh id¾:l ùoehs mÍlaId lr bkalshqfígrhl ia:dk.; flfrhs'

MARCH 2018 | DOCTOR MAGAZINE

g. Culture

osk 2-5 ridhkd.drfhaoS frdamkh fjhs'

h. Vitrification

yªkd .kakd ,o Wiia ;;a;ajfha N%eK Ys;khg ,la lr wdrlaId iys;j ;ekam;a lrhs' fïjd udi yhl muK ld,hla ksfrdaOdhk mÍlaId j,g ,la flfrhs' ksfrdOdhk ld,fhka miq m%fhdackhg .; yel'

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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

AD-MIRE Creative

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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flia l<U

ksfrda.Sj ;nd .ekSug l< hq;= i;aldr iakdkh lsßfïoS Ieïmq fhdod .ekSu wfma rfÜ ck;djf.a iq,n Ndú;djla' ysifla j, /÷KQ f;,a" l=Kq yd ¥ú,s wdosh bj;a lr flia l<U msßisÿ lsÍug Ieïmq wk.s fufyhla bgq lrkjd'

rEm,djKH Ys,amS wdpd¾h fm%auisß fyajdjiï

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doctormagazine.lk doctormagazine.lk

yefudagu yeu Ieïmq j¾.hlau .e,fmkafk kE' fj<|fmdf<a ;sfhk fkdfhla Ieïmq j¾. ñ,oS f.k Ndú;dfjka ysiflia .e,fjkak mq¿jka' m¿ÿ fjkak mq¿jka''' úúO wdmod j,g ,la fjkak mq¿jka' úh<s l,dmfha we;euqkaf.a flia ;U meyehg yqre j¾Khla orkjd Tn;a oel we;s' oeä ysre rYañh fï whf.a flia .fiys iajdNdúl j¾Kh fjkia lrkjd' fï wh f;dard.; hq;af;a fm%daàka wvx.= Ieïmq j¾.hla' flia.fiys úh<s nj wvq lr osÿ,k

oSma;shla ,nd .ekSug lkaäIk¾ fhdod .kakjd' Ieïmq oeófuka ysiflia j, újr jQ lshqál,a jeiSu fukau flia .ig wdrlaIdjla ,nd oSu lkaäIk¾ j, ld¾hhla' th flia.i oSma;su;aj nen,Sugo WmldÍ fjkjd' ysiflia fidaod f;; fldkavfhys ;=jdh t;Suo uekúka oekf.k l< hq;= fohla' Wrapping your hair in a towel turban th ksjerosj lsÍug Tn W;aiql úh hq;=hs'

ysiflia j, f;,a .e,aùu ksfjfia ys|.kakd fmd,af;,a ysfiys .e,aùug WÑ;u f;,a j¾.hhs' W¿yd,a" uql=Kqjekak" lSlsßosh" W¿yd,a wdosh tu f;,a j,g uqiq lsÍfuka thg T!Iëh .=Khlao tl;= lr.; yel' f;,a ysig oeóug fmr u|la r;a lrkak' bkamiqj thg úgñka E lr,la odkak' miqj weÕs,s ;=vq j,ska f;,a f.k ysia lnf,ys .,ajd weÕs,s ;=vq j,ska ysia ln, uDÿj iïndykh lrkak' fï iïndykh ñks;a;= oyhl muK ld,hla isÿ lsÍfuka miq Ij¾ lema tllska ysi wdjrKh lr WKqiqï j;=frka fmdÕjd.;a ;=jdhla thg Wäka T;d.kak' fuhska frdau l+m újr ù f;,a Wrd .ekSula isÿ fõ' Ij¾ lema tlla fkdoud f;; ;=jdh t;Su kqiqÿiqh'fï wdldrfhka ñks;a;= 5-10la ;sfnkakg yer Ieïmq oud ysi fidaod. kak'' bka miqj flia l<U lkaäIk¾ lrkak' •••

http://tharunaya.com/sinhalaarticlesHair_New-1492768526.html doctormagazine.lk doctormagazine.lk

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EMPOWERING WOMEN'S WORLD

ta;a" yefudagu yeu Ieïmq j¾.hlau .e,fmkjdo@

EMPOWERING WOMEN'S WORLD

m%iQ;shla i|yd frday,a.; jk Tng m%ij yd kdßfõo úfYaI{ Wmfoia m<uq ore m%iQ;shg iQÞkñka isák ´kEu .eìks ujl ;=< ;on, ìhla pls;hla fkdikaiqka lula we;s ùu iajNdúl ;;a;ajhls' orejl= ìys lr w;a±lSula fkd;sîu fiau m%iQ;sfha§ we;sjk fõokdj iy úúO ixl+,;d ms<sn| we;s ìh jeks oE fuhg m%Odk jYfhka fya;=fõ'

m%ij yd kdßfõo úfYaI{ ffjoH wd¾'tka'Ô'rdcmlaI 34

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INTERNATIONAL

W MEN'S DAY SPECIAL#2018

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• Èk .Kka iïmQ¾K ù idudkH wdldrhg ore m%iQ;sh isÿùu i|yd • isfiaßhka ie;alu lsÍug wjYH nj ffjoHjrhd úiska ;SrKh l< miq tA i|yd • wêl reêr mSvkh" .¾N Èhjeähdj" reêr jykh" ;r, msgùu" orejdf.a j¾Okh wvqùu" ;on, Wor fõokdj jeks fya;=jla we;s jQ úg wd§ jYfhks' fuys§ idlÉPd lrkafka idudkH ore m%iQ;shla i|yd .eìks ujla frday,a .; ùu iïnkaOjhs' fuys§ wm wjOdkh fhduq lrkafka rcfha frday,lg we;=¿ ùu ms<sn|j nj úfYaIfhka i|yka l< hq;=h'

wkjYH ìhla we;s lr fkd.ekSu frdayf,a§ isÿjk foa ms<sn| Tng uQ,sl wjfndaOhla ;sìh hq;=h' Tn jdÜgqjg we;=¿ úh hq;af;a we|la n,dfmdfrd;a ;=fjkau fkdfõ' rcfha frday,aj, ;sfnk ;onoh fya;= fldg f.k by; lS frda. ;;a;aj we;s whg we|la ,nd §fï§ m%uqL;djh ysñ fjhs' fï ksid we|la ke;s jqKd lshd Tn wd;;shla we;s lr .; hq;= ke;' Tn frday,a.; jkafka udi oyhla ;siafia Tfí l=i ;=< we;s ±ä fjñka ys¢k orejdf.a

uqyqK n,kakgh' w¨;a idudðlhd Tfí mjq,g tl;= lr .kakgh' Tfí m%Odk i;=g úh hq;af;a thhs' ta i;=g is; ord .;a úg ndysr wksl=;a .eg¨ Tng wu;l l< yels jkq we;'

ffjoHjreka we;=¿ frday,a ld¾h uKav,hg Tfí iyfhda.h ,nd§u Tnj mÍlaId lsÍug ffjoHjrhdg iyfhda.h ,nd fokak' ffjoHjreka fiau fyÈhka" mjq,a fi!LH fiaúldjka we;=¿ wksl=;a ld¾h uKav,h ys¢kafka Tng Woõ lsÍu i|yd njg iqnjd§ yeÕSï we;s lr .kak' tA wh ukd w;a±lSï we;s msßils' w;a±lSï wvq wh fujeks Ndr¥r ld¾hhka i|yd rcfha frday,aj, idudkHfhka fhdokafka ke;' w;S;fha ks;ru frda.Skag neKjÈk fiajl msßia rcfha frday,aj, isáh;a ±ka tjeks wh wvqh' tA ksid Tfí orejdj fuf,djg cks; lr,Su i|yd Tng Woõ lrkakg ie§ meye§ isák Tjqkg

idudkH m%iQ;sh hï .eìks ujlg iqÿiq nj m%ij yd kdßfõo úfYaI{ ffjoHjrhd úiska ;SrKh lf<a kï Tn thg iQÞkï úh hq;=h' isfiaßhka tlla wjYH nj lshñka lror lrkakg hdfï§ m%iQ;sh ;j;a jHdl+, ùu isÿfjhs' doctormagazine.lk

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EMPOWERING WOMEN'S WORLD

.eìks ujla frday,a .; lrk fya;= lsysmhla ;sfí'

EMPOWERING WOMEN'S WORLD

w;S;fha ks;ru frda.Skag neKjÈk fiajl msßia rcfha frday,aj, isáh;a ±ka tjeks wh wvqh' tA ksid Tfí orejdj fuf,djg cks; lr,Su i|yd Tng Woõ lrkakg ie§ meye§ isák Tjqkg Tfí me;af;ka Èh yels iyfhda.h Wmßufhka ,nd fokak' Tfí me;af;ka Èh yels iyfhda.h Wmßufhka ,nd fokak'

isfiaßhka ie;alula i|yd n, lrkak tmd fndfyda ldka;djka ;=< m%iQ; fõokdj ms<sn|j we;af;a ±ä ìhls' tA ksidu jdÜgqjg we;=¿ jQ fudfydf;a mgka isfiaßhka ie;alula isÿ lrk f,i b,a,ñka ffjoHjrhdg lror lrk uõjre j¾;udkfha fndfyda fj;s' kuq;a uj b,a,d isá m<shg isfiaßhka ie;alï lsÍu rcfha frday,aj, idudkHfhka isÿ fkdfõ' thg tla;rd l%shd mámdáhla we;' fya;= rys;j isfiaßhka ie;alï isÿ lrkafka ke;' idudkH m%iQ;sh hï .eìks ujlg iqÿiq nj m%ij yd kdßfõo úfYaI{ ffjoHjrhd úiska ;SrKh lf<a kï Tn thg iQÞkï úh hq;=h' isfiaßhka tlla wjYH nj lshñka lror lrkakg hdfï§ m%iQ;sh ;j;a jHdl+, ùu isÿfjhs' tksid Tn ujl ùug ±ä wdidjlska miqjk ldka;djl f,i m%iQ;s fõokdjg Tn uqyqK Èh hq;=h'

m%iQ;sh fõokdldÍ fkdùu i|yd T!IO w;S;fha fuka fkdj j¾;udkfha m%iQ;s fõokdj wju lsÍu i|yd m%iQ; fõokd wdrïN jk wjia:dfõ§u ±ka fm;sãka kue;s T!IOh .eìks ujg fokq ,efí' fuh rcfha iEu frday,lu mj;sk w;r fï T!IOh ksid m%iQ;sfha§ we;sjk fõokdj wvqjkq we;' 36

MARCH 2018 | DOCTOR MAGAZINE

f;dard.;a ore m%iQ;sj,g muKla m%iQ; fõokd ke;slsÍug tmsähqr,a l%uh Ndú;d flf¾' kuq;a fuh iEu rcfha frday,lu fkdue;'

m%iQ; fõokd mudùu kshñ; Èkj,§ ujg m%iQ; fõokd we;s fkdjqjfyd;a fhdaks ud¾.hg T!IO fyda isyska rn¾ nghla we;=,alsÍu ;=,ska fõokdj we;slsÍug lghq;= fh§u isÿfõ' fuh ìh úh hq;= ;;a;ajhla fkdfõ' fõokdj we;s jQ miq iQ;sld. drhg uj /f.k hkq we;' iQ;sld.drh ;=< idudkHfhka meh 10 12l muK ld,hla orejd ìysjkafkao hkak .ek mÍlaIdfjka ys¢kq we;' .eíf., l%ufhka újr jkafka kï idudkH ore m%iQ;shla n,dfmdfrd;a;= úh yelsh' kuq;a ffjoHjrhd úiska ;SrKh l< ld, iSudj blaujd .shfyd;a tkï m%udo jqjfyd;a isfiaßhka ie;alula lsÍug isÿúh yelsh' tksid wkjYH ìhla we;s lr.; hq;= fkdfõ' m%iQ;s fõokdj wdrïN jQ fõ,dj" .eíf.< újr jk wdldrh" orejdf.a ysi my;g tk wkaou" orejdf.a yDofha Yíoh hk fï ish¨ fohu fuys§ ksÍlaIKh flf¾' fïjdfha hï .eg¨ iy.; ;;a;ajhla we;s nj fmkqfKd;a isfiaßhka ie;alula isÿlrkq we;' tksid ore m%iQ;sh hkq w;S;fha ;rï Nhdkl w;a±lSula f,i fldfy;au ie,lsh hq;= fkdfõ' ••• doctormagazine.lk

EMPOWERING WOMEN'S WORLD

What Every Woman Needs to Know about

MENOPAUSE In Sri Lanka, a woman is believed to reach menopause when her periods cease for more than six months and she is over 40 years of age.

Many women are happy when their periods cease. However, there are many changes in their body due to the hormonal changes which occur with the change in the estrogen levels in their body. A reduction of estrogens occurs in the years before and during the onset of menopause.

An awareness and knowledge of the changes which occur are helpful for women to understand how best they could overcome the symptoms associated with these changes and carry on a healthy and happy life.

The Menopause Society of Sri Lanka aims to spread this knowledge and awareness.

By Dr M. Sathanandan

INTERNATIONAL

W MEN'S DAY SPECIAL#2018

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Premature menopause: Cessation of periods under 35 years which is associated with specific problems: increased incidence of heart disease, osteoporosis, Alzheimer’s disease.

Climacteric: ongoing changes and symptoms from 40 years onwards up to menopause which may last for 15 to 20 years (40 to 60 years) Late menopause: Menstruation persisting after 55 years of age.

Common causes are obesity and fibroids. This is associated with a slight increase in the risk of uterine and breast cancer.

SYMPTOMS Early symptoms are experienced when the periods become irregular and erratic. These include hot flushes, night sweats, anxiety, irritability, loss of interest in sex, itchiness of the skin, insomnia, mood changes, loss of memory, loss of confidence and self-esteem, headache, dry vagina, genital itching and painful sex.

Intermediate symptoms: These mainly affect the bladder and genitalia and occur after the period stops i.e. late perimenopause.

Symptoms during this period include vaginal dryness, pain doctormagazine.lk

on intercourse, genital itching, urgency, frequency and burning sensation on passing urine, loss of bladder control, generalized muscle aches and pains, thinning of skin and hair.

Late symptoms: occur over the age of 60. These include high blood pressure and angina indicating arterial and heart disease and risk of stroke related to atherosclerosis and general aches and pains, backache, joint stiffness and swelling and bone fractures – all related to osteoporosis.

COMMON SYMPTOMS OF MENOPAUSE Hot flushes These occur in 85% of women. The degree and frequency vary. During a hot flush, a woman can perspire profusely, her skin temperature will rise, her heart will beat faster and she may experience palpitations.

Very occasionally she may faint. Hot flushes can be aggravated by hot weather.

Wear loose clothing and discover ways of cooling down, as well as keep the rooms well ventilated.

Limit food and drinks which trigger hot flushes i.e, eat plenty of citrus foods (orange and lime) which contain bioflavonoids. Vitamin E taken with C & B are useful.

Medical therapy with hormone replacement therapy (HRT) is 98% helpful.

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THERE ARE MANY TERMS ASSOCIATED WITH MENOPAUSE:

EMPOWERING WOMEN'S WORLD

Night sweats (Hot flushes in the night)

common among menopausal and postmenopausal women.

You may wake up, feeling hot and drenched in perspiration.

Keeping the bedroom fairly cool and wearing light night clothes and using light linen may help.

Kegels exercise i.e. stopping the flow of urine midstream when emptying the bladder will help.

Draw up the vaginal muscles, hold for a count of five and then relax.

Repeat the process 5 times. The whole routine should be done at least 10 times a day.

Relaxation is therapeutic as is meditation and yoga. HRT is beneficial.

Vaginal and urinary symptoms Anatomically the vagina and lower urinary tract (bladder and urethra) lie very close, separated by just a few layers of cells. They both respond to lack of estrogen by becoming thin and dry.

Urinary symptoms typically include discomfort in passing urine, frequent and urgent urination with a small amount of urine in the bladder.

Some dribbling due to the sphincter muscle at the bladder neck becoming weak due to lack of estrogen i.e. stress incontinence.

Genital dryness Vaginal soreness during or after intercourse, because the vagina fails to lubricate, is also 40

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Wear loose cotton underwear to prevent irritation of urogenital tract.

Avoid using perfumed additives in your bath.

Medical treatment Hormone replacement therapy is the final answer. In 25% of cases, systemic HRT is not sufficient and vaginal creams / vaginal tablets are needed.

MUSCLE AND JOINT SYMPTOMS Collagen is the protein that provides the scaffolding for every tissue in the body. When collagen disintegrates at menopause, muscles lose their bulk, strength and coordination, and joints become stiff.

Muscles become more prone to soreness and stiffness after doctormagazine.lk

Carpel tunnel syndrome occurs due to fluid retention in the wrist pressing on the nerve to the hand and fingers.

Osteoporosis causes aches and pains all over the body especially upper back due to the thinning of the vertebral bones.

General fatigue may be common.

Besides under-used muscles and joints, other causes of chronic fatigue include low blood sugar, anaemia, an underactive thyroid.

Maintain muscle tone through aerobics, stretching, weightbearing, and yoga. Complementary treatment may include HRT.

Skin, hair and nails Estrogen deficiency causes disintegration of collagen and weakening of the protein elastin which gives connective tissue its strength and suppleness. Lack of collagen leads to a decrease in skin thickness and suppleness, dry hair, brittle nails, sore eyes, mouth dryness, gum shrinkage and increase in joint stiffness.

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Reduction in the blood flow in the skin and subcutaneous tissues contributes to the loss of skin firmness, as does shrinkage of underlying muscles.

Deterioration of the nerve endings in the ageing skin can lead to itchiness and a condition called formication. Formication is common in 20% of women within 12 to 34 months after menopause.

It eventually disappears but the mechanism not known.

Moisturizing the skin is important.

Avoid soaps that will strip the natural oils and use special cleansing oils and lotions. Guard your skin against the sun. A multivitamin/mineral complex is useful. The ultimate treatment is hormone replacement therapy.

Lack of sleep Lack of sleep is common if you are depressed, anxious, or suffering from night sweats. Women who have normal levels of estrogen, or who take HRT fall asleep faster than women who donâ&#x20AC;&#x2122;t. Without estrogen, we can sleep for a whole night but still feel tired on waking.

A walk or exercise before bed may help

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exercise, and joints may swell so that their mobility becomes restricted.

EMPOWERING WOMEN'S WORLD

important as is a healthy diet with plenty of fruits, vegetables and less starch and fats. By eating healthy food and exercising regularly, one can control weight gain.

Emotional changes Mood changes, anxiety and irritability are common. Treatment includes yoga, exercise and hormone therapy.

BREAST SYMPTOMS Mastalgia (Breast pain and discomfort) Breast pain (Mastalgia) is common in 70% of women at some stage in life over the age of 40 before menopause. Breasts become hard, tender and extremely painful, especially the nipple. The commonest reason is the abnormal sensitivity of breast tissue to the fluctuation of the female hormone estrogen at the menopause.

Women with pain tend to have lower levels of unsaturated fatty acid and high levels of saturated fatty acids in their blood.

Wearing a good supporting bra and cutting down on the fat consumed may help. If there is no improvement, medical help should be sought.

Weight gain This is common after menopause, Exercise is thus extremely

You may forget where you put something, miss appointments, and things that used to be easy to remember can suddenly require enormous effort.

Ability to concentrate also becomes diminished, making it hard to carry out work that involves complex assessments and major decisionmaking. Even minor decisions can sometimes be quite paralyzing.

Any sort of work or study will go a long way to preserve your intellectual ability. It’s never too late to get a job. Many universities provide employment retraining.

Vitamin B complex, calcium and potassium are taken together will help.

Most intellectual skills improve with HRT. You will feel more confident about making decisions be more assertive and better able to concentrate.

By Courtesy, Medi Scene, The Sunday Times •••

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VG FRESH Tn Èkm;d msßisÿj iqj|j;aj bkafka fldfyduo lshk tl .ek Tn udkisl mSvdfjkao bkafka@ Tn okakjdo" inka j,ska fï i|yd ms<s;=rla fkd,efnk nj''' inka ksid ldka;djhkaf.a ryia m%foaYfha pH w.h 7 blaujd hhs' ta i|yd Tng we;s iqkaoru úi÷u VG FRESH idhkslj iy úoHdkql+,j ;yjqre lrk ,o kshñ; VG fresh iunr;djfha w.h jk 3.5 – 4.5 iys; VG FRESH ikSmdrlaIl Èhrfhys we;s fmk ke.=ï ldrlh iu ;=<g ldje§ f;,a iys; wmú;% fldgia bj;a lrhs' tfukau tys we;s TEA TREE OIL m%;sTlaisldrlh u.ska È,Sr we;=¿ doctormagazine.lk

ffjoH Wmfoia rEm,djkH ffjoH chrejka nKavdr 071 812 7693 wys;lr laIqø cSùka u¾Okh lr iu Èrdhdu j<ld oji mqrd iqmsßisÿ iqj|j;a njla ,nd fohs'

ldka;d iqkaor;ajfha ryi msßisÿ luhs msßisÿlu .ek ljqre;a l;d fjkjd' ta jf.au fndfyda fokd msßisÿlu .ek jeä wjOdkhla ,nd fokjd' tfiau ;uhs msßisÿj bkak flfkla lshkafka fyd| fi!LH iïmkak flfkla úÈhg y÷kajkak;a mq¿jka' fndfyda fofkla msßisÿlu lsh, y÷kajkafka o;a MARCH 2018 | DOCTOR MAGAZINE

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EMPOWERING WOMEN'S WORLD

iqrEmS ,shka hqj;shka fkdlshk ryilg iqkaor úi÷ula

EMPOWERING WOMEN'S WORLD

ue§u" uqyqK fia§u" lEug fmr iy jeisls<s .sh miq w;a fia§u iy iakdkh jf.a foaj,a' kuq;a msßisÿlu lshkafka fï ál ú;rlau fkfjhs' ndysßka fmfkk foa ;=< ;sfhk msßisÿlu .ek ys;kjd jf.au Tfí ryia m%foaYfha we;s msßisÿlu .ek;a ys;kaku ´fka' t;fldg msßisÿ flfkla njg ks;ekskau m;afjkjd' ldka;djla kï Tn fï .ek jeä wjOdkhla ,nd Èh hq;=u fjkjd' ldka;djla lshkafka b;du iqokaor m%shukdm flfkla' ta jf.au ,iaikg iqkaorj bkak wêl ñ, .Kka úhoï lr,d jqK;a ksIamdok j¾. ñ,§ .kak Tn fm<ô,d;a we;s' kuq;a Tn Tfí ryia m%foaYhkayS" ^,sx.dY%s; m%foaYh& msßisÿlu .ek is;=jdo@ ldka;djla úÈhg Tn Tfí ryia m%foaYhkays ^,sx.dY%s; m%foaYh& msßisÿlu .ek is;Su ;=<ska Tn ksfrda.S flfkla fjkjd jf.au Tn ukd fm!reIhla ysñ ;eke;a;shla njgo m;a fjkjd'

Tn;a Tfí ryia m%foaYfha ^,sx.dY%s; m%foaYh& msßisÿlu .ek is;k flfklao@ iuyr úg Tn fï .ek oekgu;a wjOdkh fhduq lr,d;a we;s' kuq;a Tn ;ju;a ryia m%foaYhkays ^,sx. dY%s; m%foaYh& msßisÿlu fjkqfjka Ndú;d lrkak mqreÿ fj,d bkafka inka j¾.hla fjkak;a mq¿jka' ta;a Tn mdúÉÑ lrkak inka j," úúO ødjk j¾.j, jqj;a wdï,sl;djh NdIañl;djh fkd.e,mSu ksid Tfí ryia m%foaYfha iajNdúlj iajdNdúlj wdrlaId lrk wdrlaIK moaO;shg ydks isÿùug mq¿jka' ta ksid úúO wdidOk iu u;=msg iy wNHka;rhg ^fhdaksud¾.fha fyda fu!;% ,sx.sl moaO;sfha& isÿúh yelshs' 44

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ryia m%foaYhkayS ^,sx.dY%s; m%foaYh& msßisÿ lr .ekSug Ndú;d l< hq;= ksIamdokhla f;dard .ekSfï§ ie<ls,su;a úh hq;= lreKq • Tn Ndú;d l< hq;af;a ,sx. dY%s; m%foaYh wdrlaId lrk iajNdúl laIqø cSúka úkdY fkdjk ridhksl øjHhla ùu w;HdjYHhs' • ta jf.au ;ud Tn mdúÉÑ lrkaafka LACTIC ACID, TEA TREE OIL iy SEA BUKTHORN OIL ;sfhk ksIamdokhla kï wr l,ska i|yka l< ldka;djf.a isref¾ iajNdúlj ksmofjk ys;rlr laIqø cSùkag;a cSj;a úh yelshs' ta jf.au YÍrhg ys;lr kshñ; idkaøKfhka hq;= ksIamdokhla kï laIqø cSùkaf.a meje;aug iqÿiq jk ksid bka Tng hym;a m%;sM, Wodlr .; yelsh' • kshñ; pH w.h 3.5 – 4.5 w;r ikSmdrlaIl Èhrhla kï jvd;a fyd|hs' ifï ksfrda.S nj j¾Okh lrk ffY, wdrlaId lrk øjH wvx.= ksIamdokhla ùuo w;sYh jeo.;a' ta jf.au ;ud tÈfkod idudkH cSú;fha§ jf.au ldka;djkaf.a udisl Tima Èkj, § mjd mdúÉÑ l< yels iqÿiq msßisÿ ldrlhla f;dard .ekSu;a jeo.;a' Tn Ndú;d lrk ksIamdokh f,fyisfhka fidaod bj;a lr .; yels ksIamdokhla kï jvd;a fhda.Hhs' Tfí ryia wjhjj, kSfrda.S Ndjh ukd fm!reIhlska hq;=j idudcSh lghq;= lsßug bjy,a jk neúka ta ms<sn|j ie,ls<su;aj lghq;= lrkak' ••• doctormagazine.lk

WATTALA

fyaudia - j;a;, frday, mshhqre ms<sld u¾Okh fjkqfjka fmrg meñfKhs mshhqre ms<sldj l,ska y÷kd.ekSug kùk myiqlï iys; mshhqre ms<sld wdrlaIK iy m%;sldr tallhla y÷kajd fohs INTERNATIONAL

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Y%S ,xldfõ fukau f,dalfhao w;s úYd, ldka;djka ixLHdjla uqyqK md isák ms<sld wjodkula f,i mshhqre ms<sldj ye¢kaúh yel' flfia fj;;a fuu ms<sldj tys uq,a wjêfha§ y÷kd.;fyd;a ksis ffjoH m%;sldr Tiafia ksÜgdjgu iqj lr.ekSug yelshdj ;sfí' cd;sl ms<sld md,k jevigyk úiska t<soelajQ zms<sld jHdma;s jd¾;dj 2010Z wkqj furg ldka;djka wg fofkl=f. ka tla wfhl= mshhqre wdY%s; lsishï ixl+,;djhlska fmf<;s' tu ixl+,;djhka y;<sylska tlla mshhqre ms<sldjla ùu ieneúkau wjodkï ;;a;ajhls' doctormagazine.lk

—fyaudia frday,a cd,h ksrka;rju ish wdh;ksl iudÔh j.lSïiy.; Ndjh ms<sn|j Wmßuj ie<ls,su;a fjkjd' wms fuu mshhqre wdrlaIK iy m%;sldr uOHia:dkh l%shdjg kxjkafka tys ;j;a bÈß mshjrla yeáhghs' jhi wjqreÿ 35g jeä fyda wvq ldka;d m%cdjg úfYaIfhkau Tjqkaf.a mjqf,a b;sydifhys mshhqre ms<sld frda.Ska isà kï" wmf.a mÍlaIK fiajdfjka m%fhdack .kakd f,i uu b,a,d isákjd' ta fjkqfjka úfYaI{ mqyqKqj ,;a ld¾huKav,hla wm i;=hs˜ - ffjoH ,ika; lreKdfialr" fyaudia j;a;, frdayf,a wOHlaI$idudkHdêldÍ

ldka;djka mshhqre ms<sldj ms<sn| oekqj;aNdjh wvq ùu ksid iy mshhqre ms<sldj u¾Okh i|yd ksis ms<sfj;a wkq.ukh lsÍu b;du;a wju ;;a;ajhl mej;Su ksid fyaudia frday, tu nrm;, ;;a;ajh ms<sn|j iqúfYaI wjOdkhla fhduqlrk ,§' mshhqre wdY%s; ixl+,;djhkaf. ka fmf<k ldka;djka fjkqfjka fkdñf,a mshhqre ms<sld y÷kd. ekSfï uQ,sl ffjoH mÍlaIK fiajd ,nd §ug fyaudia j;a;, frday, lghq;= lr ;sfí' doctormagazine.lk

mshhqre ms<sldfõ wys;lr n,mEfuka ldka;djka wdrlaId lrùu i|yd mshhqre ms<sldj mQ¾jfhka y÷kd.ekSfï ish¿u myiqlï iys; m%;sldr uOHia:dkhla wdrïN lsÍug fyaudia j;a;, frday, lghq;= lf<a mshhqre ms<sldj kue;s ksy~ urejdf. ka ldka;d m%cdj .,jd.ekSfï wruq‚ks' ldka;dj ujla" ifydaoßhla" Èh‚hla jeks úúOdldr j.lSï rdYshla bgqlrk w;r mjqf,a fukau rfÜ wd¾Ólfhao iqúi,a j.lSï iïNdrhla Wiq,kakSh' j;a;, fyaudia frday, i;= mq¿,a mrdihl myiqlï iys; mshhqre iqrlaIs;;d uOHia:dkfha fiajdj ,nd .ksñka mshhqre wdY%s;j ;ukag we;s lsishï ixl+,;djhla ms<sn|j fkdñf,a mÍlaIKhla isÿlr.ekSu ldka;djkag b;du;a jákd wjia:djla

MARCH 2018 | DOCTOR MAGAZINE

47

jkq we;' uQ,sl mÍlaIKhkaf.ka miq mshhqre wdY%s; ixl+,;d l,ska y÷kd.ekSu i|yd isÿlrk w,ag%dijqkaâ ialEka iy uefuda.%Eï mÍlaIK Bg wh;a fõ' mshhqre ms<sldjla fyda ta wdY%s; lsishï ixl+,;djhla tu mÍlaIK u.ska fidhd. ekSug yels jqjfyd;a úfYaI{ ms<sld ffjoHjreka" úfYaI{ úlsrKfõ§ka" Y,H ffjoHjreka" mglfõo úfYaI{hska iy ufkda ffjoH úfYaI{hska we;=¿ úYsIag ffjoH uvq,a,lf.a iydfhka wjYH iqÿiqu m%;sldr ,nd .ekSfï wjia:djo fuu mshhqre ms<sld wdrlaIK uOHia:dkfhka ,nd .ekSug yelsh' j;a;, fyaudia frdayf,a mshhqre ms<sld wdrlaIK uOHia:dkh i;=j f,dalfha kj;u ms<sld m%;sldr ;dlaIKhka mj;sk w;r ta yryd úYsIag frda.S i;aldrhla ,nd §ug lghq;= lrhs' mshhqre ms<sld m%;sl¾u i|ydu úfYaIfhka mqyqKq lrk ,o úfYaI{ fyo fiajd lKavdhulao th i;=h' idhksl b;sydih iy mÍlaIdj" úlsrK mÍlaIK ;yjqrelrKh iy ffi,$mgl fõo ;yjqrelrKh hk 48

;%s;aj mÍlaIK mshjrhka Tiafia mshhqre ms<sldjla je<£ ;sfío hkak ksYaÑ;j ;yjqre lr.ekSug yelshdj ;sfí' ksis wjia:dfõ§ mshhqre ms<sldj y÷kd .ekSug ,eîu ksid kshñ; m%;sldr ,nd .ekSfuka mshhqre ms<sldfjka .e,ùu i|yd 95]la wjia:dj ;sfí' —ÈhqKq rgj, ldka;djka mshhqre ms<sldj ms<sn|j oekqj;aNdjhlska hqla;j isàu ksid Tjqka ks;ru iajhx mshhqre mÍlaIdjka isÿlrk w;r mshhqre ms<sldjg f.dÿre fkdù isàu i|yd thska wjia:dj ,efnkjd' kuq;a Y%S ,xldfõ ldka;djka ta ms<sn|j oekqu u|lu ksid tu frda.hg f.dÿre ùfï keUqre;djh jeähs' j;a;, fyaudia frdayf,a mshhqre wdrlaIK uOHia:dkh i;=j Bg wkkH úfYaI fiajl uvq,a,la isákjd' Tjqka fï j¾Ih mqrd Tng mshhqre wdY%s; .eg¿ i|yd fkdñf,a uQ,sl mÍlaIK isÿlrñka mshhqre ms<sldfjka je<lS isàug wjYH Wmßu iyfhda.h ,nd §ug iQodkñka isákjd˜ -Y,H ffjoH ksiaixl chj¾Ok fyaudia j;a;, frdayf,a mshhqre wdrlaIK iy m%;sldr uOHia:dkh iy thska ,efnk mÍlaIK myiqlï ms<sn|j jeä úia;r oek.ekSu i|yd 0777865027 hk ÿrl:k wxlh wu;kak' ke;s kï www.hemashospitals.com fj; msúfikak' fyaudia frday,a ^mqoa.,sl& iud.u fyaudia iuQy jHdmdrfha mQ¾K wkqnoaê; iud.uls' fyaudia iud.ï iuQyhg wh;a iud.ï FMCG" fi!LHdrlaIK" m%jdyK" ixpdrl iy l%fudamdhsl wdfhdack hk lafIa;%hkays jHdmdr lghq;=j,g iïnkaOj l%shd;aul fõ' nyq úfYaI{;djhka iys; frday,a ;=klska iukaú; fyaudia frday,a cd,fhys YdLdjka j;a;," .d,a, iy ;,j;=f.dv msysgd ;sfí' wx.iïmQ¾K kùk úoHd.dr 34la iys; fyaudia frday,a cd,h fld<ôka neyer l%fudamdhsl jeo.;alñka by< m%foaYhkayS ish YdLd msysgqjñka frda.S i;aldrhg lghq;= lrhs' cd;Hka;r by< ms<s.ekSula iys; iqrlaIs;;d m%ñ;Skag wkql+,j frda.Skag m%;sldr ,nd fok fyaudia frday,a cd,h lS¾;su;a we.hqï wdh;khla jk fi!LHdrlaIK m%ñ;Ska i|yd jk ´iafÜ%,shdkq ljqkais,h úiska we.hSug ,la l< m%:u yd tlu ••• Y%S ,dxlSh frday,o fõ'

MARCH 2018 | DOCTOR MAGAZINE

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EMPOWERING WOMEN'S WORLD

Facts & Figures

INTERNATIONAL

W MEN'S DAY SPECIAL#2018

wkdrlaIs;

,sx.sl tlaùï j,ska je<fluq wkdrlaIs; .íid ksid ldka;djka úYd, m%udKhla fuf,dúka iuq .kakjd oekg f,dalfha orejka ,eìh yels jhia ldKavfha ldka;djka''' tkï jhi wjq' 15-44 ldKavfha ldka;djka ì,shk 1'38la muK isákjd' idudkHfhka fï ldka;djkaf.ka w;s nyq;rhla orejka jeosh yels jhfia miq jQj;a ta whg orefjl=f.a wjYH;djh keye' tlaflda Tjqka

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MARCH 2018 | DOCTOR MAGAZINE

orejka ,eîug wjYH hhs is;k ld,hg ;ju t<ö kE' tfyu ke;akï orejkaf.a wjYH;djh iïmQ¾K lrf.k wjidkhs' idudkHfhka oshqKQjg m;a rgj, ldka;djkaf.ka ishhg 77lau jhi 20 iïmQ¾K jk úg ;u m%:u ldhsl iïfNda.h mj;ajd wjika' Wm iyrdkq wm%sldkq rgj, fï m%;sY;h ishhg 83la ;rï by< kexfj;aoS ,;ska wefußldkq rgj, tu m%;sY;h ishhg 53la muK olajd my; jefgkjd'

doctormagazine.lk

oshqKQ f,dalh ie,iqïiy.; fkdjk .eí .ekSï osß fokafka kE' flfkl=g orefjla wjYH fkdfõ kï wkdrlaIs; ,sx.sl tlaùï we;s lr.ekfuka weh je<lsh hq;=hs' .íidjla isÿ lsÍu cSú;hla úkdY lsÍula' Y%S ,xldjo we;=¿j fndfyda rgj, kS;sh .íidjg wjldY i,ikafka kE' fï ikao¾Nh ;=< fndfyda ldka;djka .íid isÿ lsÍug wkdrlaIs; Wml%u i,id .ekSug W;aidy .kakjd' thska ujf.a;a" kQmka orejdf.a;a hk fofokdf.au cSú; wjodkulg jefgkjd' .íid lsÍu wdY%s;j f,dalh mqrd f,duq oeye .kajk úia;r álla Tfí wjOdkhg fhduq lrkakï' doctormagazine.lk

ldka;djka .íid j,g fhduqjk fya;= ;ukag wjYH orejka m%udKh iïmQ¾K ùu" B<Õ ore Wm; m%udo lsÍug wjYH ùu" wvq jhia .eí .ekSï" ¥IKhlg ,laùu • iEu j¾Ihlu f,dj mqrd ldka;djka oi,laI 46la muK .íid j,g fhduq fjkjd' Tjqkaf. ka ishhg 78la fjfikafka wm jeks ixj¾Okh fjñka isák rgj,h' wfkla ishhg 22 oshqKQ rgj, fjfik ldka;djka' • iEu j¾IhloSu orejka ìys l< yels jhfia miqjk ldka;djka iEu oyilgu 35la .íid j,g ,lajk nj wkdjrKh fjkjd' jeäfhkau .íid j,g ,lajk ldka;djka isákafka refïkshdj" lshqndj yd úhÜkduh hk rgj, m%udKh j¾Ihlg ldka;djka oyilg 7883la' wvqfjkau .íid j,g ,lajk ldka;djka isákafka fn,acshu" fko¾,ka;h" c¾uksh yd iaùÜi¾,ka;h hk rgj,' m%udKh j¾Ihlg ldka;djka oyilg 10g wvq m%udKhla' • wkdrlaIs; .íid ksid j¾Ihlg 78"000l muK ldka;djka m%udKhla ñh hkjd' • wkjYH .eí .ekSï j,ska wdrlaId ùug kï ldka;djl id¾:l m%;sikaê ndOl Wml%uhla fhdod.; hq;=uhs' tla orefjl=g iSud fjk mjq,l kï idudkHfhka jir 20l muK ld,hla ldka;dj Wm;a md,k l%uhla wkq.ukh l< hq;= fjkjd' • f,dalh mqrd újdyl ldka;djka ishhg 58la ljr fyda Wm;a md,k l%uhl msysg m;kjd'

wfma rfÜ ;;a;ajh wfma rfÜ osklg .íid 600la muK isÿjk nj;a fï ksid uõjreka 10-15 w;r ixLHdjla ñhefok nj;a jd¾;d fjkjd' ujf.a cSú;h wjodkulg jefgkafka kï ñi wfma rfÜ .íidj kS;sfhka ;ykï lr ;sfnkjd' 1883 j¾IfhaoS n,.ekajqKQ .íid kS;sh ld,hg .e,fmk mßos ixfYdaOkh lsÍug .;a W;aidyhka /ilau je<lS .sh;a ienúkau th ixfYdaOkhg ,laúh hq;=h hk l;sldj;la fï jk úgo n,.ekaù ;sfnkjd' ••• MARCH 2018 | DOCTOR MAGAZINE

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EMPOWERING WOMEN'S WORLD

f,dal ;;a;ajh ie<lSfïoS .¾NKS Ndjhg m;a jk ldka;djka y;frka tllau ms<sis|. kafka orefjl=f.a wjYH;djhla ke;sjhs' ie,iqï iy.; fkdjk .eí .ekSï ldKAvhg fï .eí .ekSï whs;shs' ie,iqï iy.; fkdjk .eí .ekSï j, we;s m%Odk .eg¿j kï tajd .íid f,i wjika lsÍug fndfyda ldka;djka fm<öuhs'

EMPOWERING WOMEN'S WORLD

wef.a ta iqúfYaIS Èk lsysmh''' wd¾;jh yd iene|S f;dr;=re

1

idudkHfhka ldka;djl ;u cSú; ld,h ;=< osk 3"500la Tima ld,h f,i .; lr;s'

2

;u cSú; ld,h ;=< tla ksYAÑ; jhia iSudjloS

wd¾;jh wjika ùulg ,lajk i;a;aj úfYAI y÷kdf.k we;af;a ;=kla muKs' ñksid yereKQ úg w,skao" yïmanela kï ;,auiqka úfYAIhl .eyekq i;a;a;ajhkao wd¾;j wNdj (menopause) ld,hla .; lr;s'

3

.eyekq oeßhl Wmosk úg weh ika;l uq¿ äïn ixLHdju wef.a isref¾ msysghs' ixLHdfjka th ñ,shk foll muK äïn m%udKhls' weh uõ l=i bkakd ld,fha fï äïn ixLHdj ñ,shk y;la muK jk w;r weh jeä úh m;ajk úg th 40"000g wvq fjhs' fuhska mßK;j uqod yefrkafka 500l muK ixLHdjls'

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MARCH 2018 | DOCTOR MAGAZINE

doctormagazine.lk

6 8

5

“catamenia,” hkq wd¾;jh i|yd fhdod .kakd ;j;a tnª jokls' fuh .%Sl niska ì|S wdjla jk w;r (kata = by + menia = month) hkqfjka th wre;a .ekafjhs' “catamenia cup” hkq Tima reêrh tla lr.ekSug fhdod.;a kuHYS,S fldamamhls'

äïnh ñksia isref¾ we;s úYd,;u ffi,hhs' we;af;kau th mshú weig oel.; yels tlu ffi,ho jkafkah'

7

oeßhl uq,a jrg Tima reêrh msg lrkafka jhi wjq' 10-16 w;r ld,fhaoSh' wehf.a Tima ùu jhi wjq' 16 bl=;a ù;a isÿ fkdjkafka kï kdß ffjoHjrfhl= yuqùu iqÿiqh'

Tima ùu k;rù wd¾;j wNdjh

we;s jkafka jhi wjq' 51oS muKh' tfy;a Bg jir .Kkdjlg fmr ta yd ine|S wmyiq;d we;s fjhs'

10

9

vTima ld,h ngysr cd;Ska úúO kï j,ska yªkaj;s' Aunt Flo, On the Rag, I’m at a Red Light, Surfing the Crimson Tide, Checked into Red Roof Inn, Curse of Dracula, Leak Week, My Dot, and Monthly Oil Change. thska iuyrls'

hqfoõ" yskaÿ yd bia,dï

,íêlhka Tima iufha ,sx.slj tlaùu jdrKh lr;s'

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11

wNHdjldYhg ldka;djka heùfïoS Y=kH .=re;ajh ksid weh urKhg m;afõfoda hk ielhla uq,a ld,fhaoS kdid wdh;khg we;s úh'

MARCH 2018 | DOCTOR MAGAZINE

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EMPOWERING WOMEN'S WORLD

4

wd¾;jh yd iene|S úfYAI kï ;sfí' ta ld,h “period” hkqfjkao y÷kaj;s' uq,skau “period” hk jpkh fï i|yd fhdod .;af;a 1822 j¾IfhaoSh' ta úfõlS ld,h hk wre;sks'

Amazing Benefits of Sunflower Oil

ika*a,j¾ f;,a wdydr msiSug we;s úYsIaG;u f;,a j¾.hla

ffjoH foaúkao ohdr;ak úisks

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MARCH 2018 | DOCTOR MAGAZINE

doctormagazine.lk

wdydr msiSug iqÿiq f;,a j¾. .ek ful, we;af;a nrm;, ixjdohls' lEug ys;lr f;,a j¾. .ek úuik l, ika*a,j¾ f;,a b;d fi!LHiïmkak f;,a j¾.hla jYfhka wújdofhka ie<flhs' ika*a,j¾ f;,a tjka lS¾;s kduhla ,nd .ekSug mdol jQ lreKQ .ek fï ,smsfha úia;r flf¾' wdydr msiSug iqÿiq f;,a j¾.hla .ek ie<lSfïos tal, wix;Dma; fïoh yd nyq wix;Dma; fïoh hk fïo j¾. folu úYsIAG f;,a j¾.hl wvx.= úh hq;= nj fmdaIKfõoSkaf.a woyihs' ika*a,j¾ f;,a ie<l+ úg tys ishhg 80lau wka;¾.; jkafka tal, wix;Dma; fïohhs' yoj; iqjfi; wk;=f¾ fy<k wix;Dma; fïoh ika*a,j¾ f;,a j, we;af;au ke;' fjk wka ljr f;,a j¾.hl j;a ke;s ;rï úgñka B ixhq;shla mej;Su;a" fjfiiskau Tfï.d - 6 fïo wï,h hyñka wka;¾.; ùu;a ksid ika*a,j¾ f;,a wfkla lEug iqÿiq f;,a w;f¾ iqúfYAIS jákdlula Wiq,hs' doctormagazine.lk

ika*a,j¾ f;,a ksIAmdokh lrkafka w,xldr" iqúi,a ika*a,j¾ mqIAmfhks Asteraceae kue;s l=,hg wh;a ika*a,j¾ .fiys úoHd;aul kduh Helianthus annuus jkafkah'

ika*a,j¾ f;,a j, .=Kdx. yoj;g iqj i,ihs wo f,da jdiS fndfyda fofkla yoj;a frda. wjodkug w; jkhs' we;efula Wmoskafkau ÿ¾j, yDoh jia;=jla iys;jh' lk fndk wdydr''' tosfkod osú mej;=ï ksido yojl frda.S ùfï wjodkug uqyqK mdk Woúh úr, fkdfõ' f,vla we;sjQ miq thg fí;afya;a yd m%;sldr fidhkjdg jvd keKj;a mshjr jkafka tajd meK fkdk.sk wdldrhg ;u cSjk rgdj fjkia lr .ekSuhs' ika*a,j¾ f;,a j, mhsfgdridhk kï jákd ix>glh ;sfí' tal, wix;Dma; fïoh fukau nyq wix;Dma; fïoho b;d fi!LHiïmkak wkqmd;hlska ika*a,j¾ f;,a j, ;sfí' fï .=Kdx. ish,a, yoj;g buy;a /ljrKhla i,ik nj lsj hq;=h' ta yereKQ úg" tys we;s fif,akshï u.ska hdlD;sl fi!LHh iqir lrk w;r fmr<d thska yoj;g iqñ;=re wdrlaIl / ljrKhlao w;am;a fjhs'

YÍrfha fïoh wvq lrhs ika*a,j¾ f;,a j, fldf,iagfrda,a we;af;au ke;' wix;Dma; fïoh ukd wkqmd; j,ska hqla;h' zzf,is;skaZZ kue;s ridhKslh n,mEfuka HDL fldf,iagfrda,a ixhq;sh wvqlr fldf,iagfrda,a j, ukd md,khla we;s lrhs' MARCH 2018 | DOCTOR MAGAZINE

55

iu ksfrda.S lrhs

m%odysl ;;a;ajhka md,kh lrhs

ika*a,j¾ f;, i;= m%n, m%;sTlaisldrl .=Kh fya;=fldg f.k uqla;LKavl j, úkdYldÍ n,mEfuka iu wdrlaId lr .kshs' iu kejqïj ;nhs' úgñka B hyñka we;s ksid iu mqk¾cSjkhg ,la lrhs'

m%odysl ;;a;ajhka wfma YÍr fi!LHhg t,a, lrk ;¾ck iq¿mgq fkdjkafkah' ikaê.; lelal=ï yd fõokd" weÿu jeks Yajik frda. j,g uq, fï m%odysl ;;a;ajhs' ika*a,j¾ f;,a isrer ;=< m%odysl wdprK ÿ¾j, lr isrer flfryS wdrlaIl l%shdj,shla n, .ekafjhs'

ms<sld we;sùu j<lajhs ika*a,j¾ f;,a j, we;s ;j;a wdrlaIl ixfhda. hls" fgdfldfmfrda,a' úgñka B u.ska ifuys wdrlaIdj i,ikjd jeks wdldrhlgu fgdfldfmfrda,a u.ska mgl yd ffi, j,g /ljrKh imhhs' YÍrfha n,.ekafjk wys;lr uqla;LKavl hdka;%Khg tfrysj l%shd;aul jk ksid ms<sld ffi, uev,Sug th bjy,a jkafkah'

úIîc yd igka lrhs ika*a,j¾ f;,a wfma m%;sYla;slrK moaO;sh flfrySo wdrlaIl l%shdj,shl fhfohs' fuu.ska m%;sYla;slrK moaO;sh ;sr flfrk w;r úúO jHdêckl øjH isrer wdl%uKh lsÍug we;s wjia:djka u¾Okh flfrhs'

ika*a,j¾ f;,a wdydrhg .ekSfuka we;súh yels ;j;a m%fhdack /ila .ek úoaj;=kaf.a wjOdkhg fhduq ù ;sfnk w;r tajd ieflúka bosßm;a lruq' • YÍrh úhm;a ùu md,kh lrhs • flaY l,dmh ksfrda.S lrhs' • ì<s÷kag wdrlaIdj$/ljrKh imhhs • Athlete’s Foot kue;s mdoj, we;sjk os,Sr wdidokhg m%;sldrhls' • wdydr cS¾Kh iqiqr lrhs

Sunflower Oil Nutritional Profile Nutrition

mg/g Percentage

Calories(884 Cholesterol 0mg 0% Total fat 100g 153% Monosaturated fat 46g Polysaturated fat 36g Saturated fat 13g 65% Total carbohydrates 0g 0% Sodium 0mg 0% Calcium 0% Iron 0% Dietary fiber 0% Vitamin A 0% Vitamin C 0% Magnesium 0% Vitamin D 0% Vitamin B-6 0% Vitamin B-12 0% •••

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MARCH 2018 | DOCTOR MAGAZINE

doctormagazine.lk

jl=.vq frda. j,ska ñfokakg oeKQj;a fjuq''' wms wdrlaId fjuq

Èkh | ud¾;= 8 WORLD KIDNEY DAY - 8 MARCH 2018 f,dal jl=.vq oskh - ud¾;= 8 fujr f,dal jl=.vq oskfha f;audj f,i fhdodf.k ;sfnkafka zzjl=.vq iy ldka;djZZ Kidneys Women’s Health: Include, Value, Empower hkakhs' f,dj mqrd ldka;djka ñ,shk 195lg wdikak ldka;djka ixLHdjla jl=.vq frda. fhka fmf<k w;r j¾Ihla ;=<oS ñh hkixLHdj 600"000 muK fjhs' Y%S ,xldj fjfiiska jl=.vq frda. j,ska mSvd ú|sk rgla jk w;r wfma jl=. vq frda.Ska wdrlaId lsÍu Wfoid úYd, jevigyka m%udKhla n,.ekaù we;' jl=.vq frda.fhaoS wehg w;aú|skakg isÿjk iqúfYAIS .eg¿ iïnkaOfhka fujr jl=.vq oskfhaoS f,dalfha fjfiia wjOdkh fhduq lrKQ we;' doctormagazine.lk

KIDNEYS AND WOMEN’S HEALTH Include • Value • Empower World Kidney Day is celebrated worldwide, bringing together millions of people in over 150 countries and uniting them to produce a powerful voice for kidney health awareness. Every year, countless local and national events are organized by kidney health stakeholders, healthcare professionals, healthcare authorities, and individuals who want to make a difference.

MARCH 2018 | DOCTOR MAGAZINE

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KIDNEYS & WOMEN’S HEALTH:

Èkh | ud¾;= 8

Y%S chj¾Okmqr uy frdayf,a jl=.vq frda. ms<sn| úfYaI{ ffjoH Ñka;k .,ysáhdj 60

jl=.vq frda.h we;sùug n,mdk lreKQ yd bka je<lSug .; hq;= ls%hdud¾.

ld,sl jl=.vq wlr‚h hkq l%u l%ufhka ld,h;a iu. jl=.vq l%shdldß;ajh my< neiSuhs' fuh ffjoH úoHd;aulj Chronic Kidney Disease (CKD) f,i ye¢kafõ' fuys úfYaI;ajh jkafka ydks jQ jl=.vq m%;sldr l%u u.ska kej; m%lD;s ;;a;ajhg m;a lsÍug we;s fkdyelshdjhs' b;d fiñka jir .Kkdjla mqrd isÿjk fuu jDlal wvmK ùu idudkHfhka frda. ,laIK fkdfmkajhs' frda. ,laIK my< jkafka jl=.vq j,ska 90] muK wl¾uKH jQ miqjh' ld,sl jl=.vq frda.h ksy~ udrhl= f,i (Silent Killer) wka;¾cd;sl jl=.vq ix.uh y÷kajkafka tu ksihs'

MARCH 2018 | DOCTOR MAGAZINE

doctormagazine.lk

fnda fkdjk frda. w;ßka ld,sl jl=.vq wlr‚h m%Odk ;ekla .kS' wo jk úg f,dal ck.ykfhka 10] lg fuu ;;a;ajh je<£ we;s njg .Kkh fldg we;' fuu ;;a;ajh wdishdkq iy wm%sldKq rgj, hqfrdamhg jvd W.% fõ' jhia.; ùfï§ iajNdúlju jl=. vqj, l%shdldß;ajfha hï wvqùula olakg ,efí' jeäysá ck.ykh ;=< ld,sl jl=.vq wlr‚h jeä m%;sY;hlska olakg ,efí' uE;l§ lrk ,o iólaIK jd¾;d wkqj jhi wjqreÿ 65-74 w;r msßñka f.ka 20] lg;a" ldka;djkaf.ka 25] fuu ;;a;ajh we;s njg fmkS f.dia we;' jhi wjqreÿ 75 blaujQjka f.ka 50] lg ld,sl jl=.vq wlr‚h we;s njg fuu jd¾;dj ;jÿrg;a fy<s lrhs' jir 2010 jk úg f,dal ck.yKfhka ñ,shk 2'6 la ;Sj% jl=.vq wlr‚h ksid reêr ldkaÿlrKh ^Haemodialysis& ,nd. ksñka isg we;' fuu ixLHdj jir 2030 jk úg ñ,shk 5'4 olajd by< hkq we;s njg wkqudk flf¾' Y%S ,xldfõ ld,sl jl=.vq wlr‚h i|yd n,mdk m%Odk;u frda. jkafka Èhjeähdj" wêl reêr mSvkh" uq;%d wdY%s; .,a" jl=.vq m%odyh

Èhjeähdj iy wêreêr mSvkh ksis f,i wdydr jHdhdu iy T!IO u.ska md,kh lr .ekSu;a ffjoHjreka kshu lrk ld, jljdkq j,§ jl=.vq mÍlaId lr .ekSu;a ld,sl jl=.vq frda.h je<£u wju lr .ekSug WmldÍ fõ' doctormagazine.lk

^Glomerulonephritis& jl=.vq nyq fldaIaG ^Polycystic Kidney Disease& frda.h" uq;%d wdidok iy W;=re ueo m%foaYfhka uq,ska y÷kd.;a ;ju;a ksYaÑ; fya;=jla y÷kd fkd.;a jl=.vq wlr‚hhs'

jl=.vq frda.h wE;a lsÍug .; hq;= mshjr Èhjeähdj iy wêreêr mSvkh ksis f,i wdydr jHdhdu iy T!IO u.ska md,kh lr .ekSu;a ffjoHjreka kshu lrk ld, jljdkq j,§ jl=.vq mÍlaId lr .ekSu;a ld,sl jl=.vq frda.h je<£u wju lr .ekSug WmldÍ fõ' jl=.vq m%ody ;;a;ajh uq;%d .,a iy uq;%d wdidokj,g ksis f,i frda. úksYaphlska miqj úfYaIs; jl=.vq idhk u.ska m%;sldr ,nd.ekSu l< hq;=h' nyqfldaIaG jl=.vq frda.h iy wfkl=;a m%fõ‚.; jl=.vq frda. i|yd;a kshñ; idhkj,g iyNd.s fjñka kshñ; m%;sldr §¾>ld,Skj ,nd.ekSu u.ska ld,sl jl=.vq wlr‚h ;Sj% ùu j<lajd .ekSug yels fõ'

ia:Q,;djh jl=.vq frda. j,g w; jkkjd ksfrda.S jl=.vq i|yd fi!LH iïmkak Èúfmfj;la hkak osú u;=rls' tys jeo.;alu i<ld tu woyi uq,a lrf.k miq.sh jif¾ f,dal jl=.vq oskh iurkq ,eîh' fuys§ jeämqr wjOdkh fujr fhduq lrkq ,nkafka YÍr ia:q,;djh ms<sn|jhs' ia:q,;djh hkq widudkH f,i YÍrfha fïo mgl tla/ia ùuhs' 2014 jir jk úg f,dalh mqrd ñ,shk 600 la ia:q,Ndjfhka fmf<ñka isg we;' ia:q,;djh ld,sl jl=.vq frda.

MARCH 2018 | DOCTOR MAGAZINE

61

KIDNEYS & WOMEN’S HEALTH:

jl=.vq frda.h - f,dal jHdma; .eg¿jla

KIDNEYS & WOMEN’S HEALTH:

je<£fï m%jK;djh jeä lrk nj ;yjqre ù we;' iólaIK u.ska ia:q, mqoa.,hkaf.a ld,sl jl=.vq wl¾uKH;dj je<£fï iïNdú;dj ia:q, fkdjk mqoa.,hkag jvd 83] lska jeä nj ;yjqre ù we;' ia:q, orejkaf.a jl=.vq frda. ;Sj% ùu ia:q, fkdjk orejkag jvd jeäh'

lsysmhla flfrySo wjOdkh fhduq flf¾' tkï jl=.vq frda. je<£fï wjodku jeä mqoa.,hka y÷kdf.k Tjqka jirlg jrla mÍlaIdjkag Ndckh lsÍfuka Tjqkaf.a frda. uQ,sl wjia:dfõ§u y÷kdf.k m%;sldr i|yd fhduq lrùuhs' fuu wjodkï ldKavhg wh;a jk mqoa.,hka kï

ld,sl jl=.vq frda.hg m%Odk;u fya;= ldrl jk Èhjeähdj yd wê reêr mSvkh je<£uo ;rndre nj ksid jeäfõ' tfyhska ia:q,Ndjh md,kh lr .ekSfuka ld,sl jl=.vq frda. je<£fï yelshdj wvqlr .; yels w;r Èhjeähdj iy wêreêr mSvkh je<£u o wvqfõ' fuhg wu;rj by; frda. j, md,kh o ;rndre nj wvq lsÍfuka <Õdlr .ekSug mq¿jk'

1' ish¨ Èhjeähd frda.Ska"

fi!LH iïmkak Èúfmfj;la i|yd kshñ; iun, wdydr fõ,la iy l%shdYS,S Èú fmfj;la ks¾foaY flf¾' fuu.ska Tnf.a YÍr ia?lkaOh ksis mßÈ mj;ajd .; yels jk w;r Èhjeähdj iy wê reêr mSvkh jeks frda. je<£fï wjodkuo wvqfõ' fï i|yd úúO jQ YÍrh l%shdldÍ jk t<suyka l%Svdj, ksr; ùuo" ksr;=rej l%shdYS,S ùuo iqÿiq fõ' fuys§ fiajd ia:dkj,§ fukau ksjfia§ o läir ùu iy fõ.fhka .uka lsÍuo ks¾foaY l< yel' tlu ia:dkfha tlu bßhõfjka jdä ù isàu j<lajd .; hq;=h' nhsisl,a me§u" msyskSu" t<suyfka ye,afï Èjhdu wdÈh ueÈúfha yd jeäysá mqoa.,hka yg b;du;a fhda.Hh'

jl=.vq frda. je<£fï wjodku jeä mqoa.,hka ñka Tíng hkakd jQ ;j;a lreKq 62

MARCH 2018 | DOCTOR MAGAZINE

2' ish¨ wê reêr mSvk frda.Ska" 3' <Õ f,a {;Skag jl=.vq frda. we;s mqoa.,hka 4' ÿïmdkh lrkakka" 5' jhi wjqreÿ 50 blaujQ ish¨ fokd wh;afõ'

jl=.vq /l .ekSug .; hq;= l%shdud¾.

1 2 3 4 5 6

reêr iSks uÜgu ksis f,i md,kh lr .ekSu reêr mSvkh ksis f,i md,kh lr .ekSu c,h fyd¢ka mdkh lsÍu

ÿï mdkh fkdlsÍu

ffjoH Wmfoia fkdue;s T!IO Ndú;fhka je<lSu

iun, wdydr wkqNjh u.ska YÍr ialkaOh ksis mßÈ mj;ajdf.k ia:q,Ndjh je,elaùu

7 8

l%shdYS,S Èúfmfj;la .;lsÍu

by; i|yka l< wjodkï mqoa.,hkaf.a jl=.vq mÍlaIdjg ,la lsÍu' ••• doctormagazine.lk

jl=.vq ÿ¾j, nj oek.; yels

frda. ,laIK

Tng jl=.vq frda.hla je<|S ;sfío@ keoao@ hkak ms<snoj frda. ,laIK u.ska iel yer oek .ekSug úYd, ld,hla .;fõ' doctormagazine.lk

MARCH 2018 | DOCTOR MAGAZINE

63

KIDNEYS & WOMEN’S HEALTH:

Èkh | ud¾;= 8

KIDNEYS & WOMEN’S HEALTH:

m%Odk frda. ,laIK u;=jkakg mgka .kafka fndfydaúg Tnf.a jl=.vq 80]la muK ydks jQ miqjhs' my; frda. ,laIK oek. kakg ,enqK úg ta .ek jvd;a ie<ls,su;a ù ffjoH Wmfoia fj; fhduqùu jvd;a jeo.;a fjhs' uykaish" YÍrfha Yla;sh uo .;shla oekSu yd udkisl tald.%;djh mj;ajd .ekSug wmyiq ùu jl=.vqj, l%shdldrs;ajh ÿ¾j, ùu;a iu. YÍrfha ksmojk úI øjH yd wfkl=;a wmøjH YÍrfhka neyer fkdù tla/iaùu ksid Tng uykaish oefkkjd jdf.au" udkisl tald.%;djh mj;ajd.ekSu wmyiq fjkjd' tf,iu jl=.vq j, l%shdldrs;ajh ÿ¾j, ùu;a iu. reêrfha we;s r;= reêr ffi, yd ysfud.af,dìka m%udKh wvq ùu ksid;a YÍrfha ÿ¾j, njla fukau uykaish oefkkakg;a mgka .kakjd'

ksod .ekSfï wmyiq;djhka we;s ùu jl=.vq ksis f,i l%shdldÍ ù YÍrfha ksmojk wmøjH uq;%d yryd YÍrfhka bj;a fkdjk ksid YÍr wNHka;rfha tl;=jk úI øjH Tfí kskaog ndOd we;s lrkjd' 64

MARCH 2018 | DOCTOR MAGAZINE

msg fldkao m%foaYfha we;s jk fõokdjka wmf.a YÍrfha jl=.vq msysgd we;af;a fld÷weg fm<g fomiskqhs' ta ksid jl=.vq ÿ¾j,ùfï frda. ,laIK msg fldkafoa we;sjk fõokdjla f,i wmg oefkkak mq¿jka'

iu úh,s iajdNdjhla .ekSu YÍrfha c, md,kh fukau Lksc ,jK yd fmdaIH mod¾: md,kh lsÍu;a jl=.vq u.ska isÿfjkjd' jl=. vqfõ l%shdldß;ajfha m%Yak ksid we;s jk Lksc ,jK yd fmdaIl mod¾: m%udKfha wiu;=,s;;djhka ksid Tfí iu úh,S bß ;e,Su jeks ;;a;aj we;s fjkak mq¿jka'

úáka úg uq;%d my lsÍug wjYH ùu úfYaIfhka rd;%S ld,fha§ úáka úg uq;%d my lsÍug wjYH ùu we;eï úg jl=.vq frda.S ;;a;ajhl frda. ,laIKhla fjkak mq¿jka' jl=.vq j, l%shdldß;ajh wju uÜgug m;ajk úg uq;%d msgùu b;du;a wvq fjkjd' tfiau we;eï úg uq;%d wdidok fyda mqreIhkaf.a kï mqria: .%kaÓ b§óu jeks frda.S ;;a;ajhla ksid;a fjkak mq¿jka' doctormagazine.lk

idudkHfhka jl=.vq u.ska uq;%d ksmoùfï l%shdj,sfha§ r;=reêr ffi, jl=. vq yryd fmfrkafka keye' kuq;a jl=.vqj,g ydks isÿjQ úg r;= reêr ffi,;a fmÍ uq;%d j,sg tlaùfï yelshdj mj;sk ksid uq;%d msgùfï§ f,a msg fjkak mq¿jka' ta jf.au uq;%d wdidok" jl=.vqj, .,a fyda ms<sld ;;a;ajhka ksid;a fï úÈhg f,a msgfjkak mq¿jka'

uq;%d lrk msg fmk we;s ùu uq;%d lr wjika jQ úg fmk iys; iajNdjhla Èia ùfuka lshefjkafka uq;%d iu. fm%daàka msgjk njhs' uq;%d lr wjika ù j;=r .eiQ miq;a tu fmk bj;a fkdjkafka kï ta ms<snoj oeä ie<ls,a,la oelaúh hq;= fjkjd'

È.ska È.gu weia jgd we;sjk bÈuqu jl=.vq j,g ydks isÿùu wdrïNfha isgu jdf.a uq;%d iu. fm%daàka msgùu isÿfjkak mq¿jka' ta ksid YÍrfha we;s fm%daàka m%udKh wvqùu ksid fujka ;;a;ajhla we;s fjkak mq¿jka'

hám;=, yd j<¨lr m%foaYfha we;s jk bÈuqu jl=.vqj,g ydks isÿùu;a iu. idudkH m%udKhg jvd jeä fidaähï doctormagazine.lk

,jK m%udKhla YÍrfha tla/ia ùu isÿfjkjd' ta fya;=fjka ffi, j,g weo.kakd c, m%udKh jeä ùu;a iu. fï úÈhg há m;=, yd j<¨lr m%foaYfha bÈfukak mq¿jka' tfiau jl=.vq frda.S ;;a;ajhla ke;sj yoj;a frda.S ;;a;ajhla ksid" wlaudfõ frda.S ;;a;ajhla ksid fukau ll=f,a f,a kyrj, we;s frda.S ;;a;ajhla ksid;a fï wdldrfha bÈóu;a isÿfjkak mq¿jka'

wdydr .ekSug we;s leue;a; wvqùu jl=.vq ÿ¾j, ùu;a iu. YÍrfha tla/ ia jk úIøjH ksid fï ;;a;ajh we;s fjkak mq¿jka' idudkHfhka fï frda. ,laIKh fndfydauhla jl=.vq frda.Skaf.a oel. kak mq¿jka'

jukh YÍrfha tla/ia jk úI øjH m%uKh jeä ùu;a iu. jukh jeks frda. ,laIK we;s fjkak mq¿jka'

flKavd fmr,Su jl=.vq j, l%shdldß;ajh ÿ¾j, ùu;a iu. we;sjk ,jK m%udKfha wiu;=,s;;djh ksid fuf,i flKavd fmr,Su isÿfjkak mq¿jka' ••• MARCH 2018 | DOCTOR MAGAZINE

65

KIDNEYS & WOMEN’S HEALTH:

uq;%d iu. f,a msgùu

KIDNEYS & WOMEN’S HEALTH:

frda.shd vh,hsisia lrk wjia:dj

Èkh | ud¾;= 8

jl=.vq frda.Ska frda.fha iajNdjh wkQj j¾.SlrKh jk yeá 66

MARCH 2018 | DOCTOR MAGAZINE

eGFR w.h 8g wvq jk úg jukh" wdydr wreÑh jeks frda. ,laIK (Uremic Symptoms) we;s fjhs' fuh frda.shd ldkaÿlrKhg ^vh,hsisia& ,la lsÍug isÿjk wjia:djhs' vh,hsia lrkakg fmr vh,hsia hka;%hg frda.shd iïnkaO lrk Ouksh mdod .ekSfï l%shdj,sh fï wjia:dfõoS ldkaÿlrKhla isÿ lsÍug kï Bg fmr ishqï Y,Hl¾uhla u.ska ldkaÿlrK hka;%hg frda.shdf.a reêr m%jdyh iïnkaO lsÍu i|yd AV Fistula tlla oukakg isÿ fõ' doctormagazine.lk

mokï lr.;a jl=.vq frda.fha woshr

KIDNEYS & WOMEN’S HEALTH:

eGFR w.h

uykqjr uy frdayf,a jl=.vq frda. tallfha fcHaIaG f,aLldêldÍ ffjoH ffu;%S m%kdkaÿ

AV Fistula kue;s Ouksh mdod .ekSfï l%uh

frda. woshr j¾.SlrKh eGFRml/min/1.73m2

STAGE 1 eGFR w.h 90g jeä jk uq;a ta iu.ska uq;%d jd¾;dfõ we,aìhqñka$fm%daàka $reêrh olakg ,eîu

STAGE 2 eGFR w.h 90-60 w;r mej;Su

STAGE 3 eGFR w.h 60-30 w;r mej;Su fuh Stage 3A yd Stage 3B jYfhkao Wm j¾.SlrKhlg ,la fõ'

STAGE 4

AV Fistula hkq mß;dk ldkaÿlrKfhaoS YÍrfha reêrh lD;%Suj msßisÿ lrKQ msKsi vh,hsia hka;%hg iïnkaO lsÍu i|yd YÍrfha Oukshla Y,Hl¾uhla u.ska Ysrdjlg iïnkaO lsÍu' fï Y,Huh Wml%uh ia:dms; l< ú.iu ldkaÿlrKhg frda.shd ,la lsÍu isÿ l< fkdyelalls' vh,hsia lgq iïnkaO lsÍug iqÿiq jk ;rug reêr kd, uy;a ùug i;s yhl ld,h wjYH fjkjd' tu ksid eGFR w.h 20 muK jk úg tu AV Fistula oeóug lghq;= iïmdokh lsÍu jeo.;a fjhs'

Vascath kue;s f., wdY%s;j Ouksh mdod .ekSfï l%uh

eGFR w.h 15-30 w.hl mej;Su

STAGE 5 eGFR w.h 15g wvq w.hl mej;Su doctormagazine.lk

MARCH 2018 | DOCTOR MAGAZINE

67

KIDNEYS & WOMEN’S HEALTH:

fï *siaáhq,dj oeóu u.yeÍ yosis ;;a;ajhla u; frda.shdg mß;dk ldkaÿlrKhla lsÍug isÿjQfjd;a ta i|yd úl,amhla jYfhka oukakg isÿ jkafka Vascath fkdfyd;a f., Tiafia reêrh msßisÿ lsÍu k,hla u.ska hka;%hg iïnkaO lsÍuls' fuys wka;hla iïnkaO jkafka yoj;gh' lsishï wdidokhla we;s jQjfyd;a th b;d wjodkï ;;a;ajhla we;s lrhs' fï ksid eGFR w.h 20 muK jk úg Arm Fistula tlla oeóu jvd;a iqÿiqh'

Tfí jl=.vq j, jev lrk m%udKh .ek wjfndaOhla ,nd .kak oshjeähdj yd jl=. vq wdndOh hk frda. ;sfnk flfkla iEu úgu ;ukaf.a jl=.vqj fl;rï m%udKhla jev lrkafkao hkak ke;skï eGFR tl ffjoHjrhdf.ka úuid

68

eGFR tl ,nd.ekSug Ndú;fha we;s iaudÜ fmdaka wema tlla oek.; hq;=h' eGFR tl ,nd.ekSug l%sheákska m%udKh yereKQ úg .eyekq msßñNdjh" jhi fukau ckjd¾.slNdjh idOl lrf.k fhdok .Ks;uh wdfmdaykhlska ;SrKh jkakls' ful, kï iaudÜ fmdaka tfla wema tllska iefklska ffjoHjrhdg Bg ms<s;=r ,nd.; yel' l%sheákska m%udKh úuiSfï mÍlaIKh;a iu.ska úfoaYhkayS kï fï eGFR tl iEu úgu ,nd fohs' wfma rfÜ m%isoaO ridhkd.dr lsysmhl muKla fuu fiajdj l%sheákska mÍlaIKhg fkdñ,fha tla lr ;sfí' th jvd;a jHdma;j iEu flfklau fï l%sheákska jd¾;dfõ jl=.vq l%shdldß;ajh eGFR jYfhka i|yka lrkafka kï jvd;a fyd|h' eGFR tl ,nd.ekSug l%sheákska m%udKh yereKQ úg .eyekq msßñNdjh" jhi fukau ckjd¾.slNdjh idOl lrf.k fhdok .Ks;uh wdfmdaykhlska ;SrKh jkakls' •••

MARCH 2018 | DOCTOR MAGAZINE

doctormagazine.lk

KIDNEYS & WOMEN’S HEALTH:

Èkh | ud¾;= 8

jl=.vq frda.Ska

.;hq;= iy fkd.; hq;=

wdydr

ud<s.dj;a; cd;sl jl=.vq uOHia:dkfha idhksl fmdaIK ffjoH fla'tï'tia' tka'fla' msßia doctormagazine.lk

MARCH 2018 | DOCTOR MAGAZINE

69

KIDNEYS & WOMEN’S HEALTH:

wo ojfia Y%S ,dxlsl ck;djf.a m%Odku fi!LH .eg¨jla njg m;a ù we;af;a jl=.vq frda.hhs' W;=re ueo m<df;a fukau fiiq lDIs ld¾ñl Y=Ial m%foaYj,go jHdma; ù we;s uQ,h y÷kd fkd.;a jl=.vq wlrKh ^CKDU& frda.h je<ÿk frda.Ska muKla fkdj Èhjeähdj" wê reêr mSvkh hkdÈ fya;= mokï lrf.k fiiq m%foaYj, fjfik jl=.vq frda.Ska fndfydafokd Tjqkag ,nd.; hq;= ksis fmdaIKh ms<sn| ksis wdldr oekqula ,nd ;sfnkjd oehs iel iys;h' fndfydaúg Tjqkag fmdaIKh ms<sn| .eg¨j,g uqyqK mdkakg isÿ ù we;s w;r frda.shd ,nd.kakd fm%daàka iy wksl=;a Lksc ,jK wvq jeä ùu u; jl=.vq frda.h W;aikak ùug mjd bv we;' tneúka ksis fmdaIKh ,nd .ekSu i|yd fï Wmfoia ud,dj jvd;a jeo.;a jkq fkdwkqudkhs'

70

jl=.vq frda.Skaf.a isref¾ meje;au Wfoid fm%daàka wjYH jqjo" m%udKh blaujd fm%daàka YÍr.; jqjfyd;a jl=.vq ;jÿrg;a ydkSúu je<elaúh fkdyelalls' tneúka fm%daàka fukau wksl=;a ,jK j¾. o isrerg ,nd.; yelafla iSud iys;jh'

jl=.vq frda.Skag osklg ,nd.; hq;= fm%daàk m%udK jl=.vq frda.h wÈhr mylska hqla; fõ' m<uqjeks wÈhf¾ isg 3 jeks wÈhr olajd( jl=.vq frda.h uq,a wjÈfha mj;sk frda.ska - Èklg YÍr nr lsf,da .a?uhlg fm%daàka .%Eï 0'75 ne.ska ,nd.; hq;= fõ' wÈhr 4 fyda wÈhr 5 fï jl=.vq frda.fha nrm;, ;;a;ajhhs' fï wjia:dj jkúg frda.shd reêr ldkaÿlrKh isÿ lrk fyda fkdlrk ;;a;ajfha mj;S' reêr ldkaÿlrKh fkdlrk frda.Skag Èklg YrSr nr lsf,da .a?uhlg fm%daàka .%Eï 0'6 ne.ska ,nd.; hq;= fõ' reêr ldkaÿlrKh isoq lrk l%u folls' ta reêr ldkaÿlrKh iy mß;dK ldkaÿlrKh hk l%u folhs' reêr ldkaÿlrKhg ,lajkfrda.Skag ,ndfok fm%daàka m%udKh úfYaIfhkau reêr ldkaÿlrKfha§ fm%daàka jeä m%udKhla isrefrka bj;a fõ' tneúka jeämqr fm%daàka m%udKhla frda.shdg ,nd Èh hq;=j we;' ks¾foaYs; m%udKh jkafka Èklg .%eï 1'2 isg 1'4 olajd fõ' mrs;dk ldkaÿlrKhg ,lajk frda.Skag ,ndfok fm%daàka m%udKh fï whg Èklg YrSr nr lsf,da .a?uhlg .%Eï 1'2 - 1'3 w;r fm%daàk m%udKhla ,ndÈh hq;= fõ' jl=.vq frda.fha ;sfnk ;j;a .eg¨ldÍ ;;a;ajhla jkafka fm%daàka jeämqr ,nd §fï§ jl=.vqj,g ydks isÿùu yd fm%daàka wvq ùfï§ isref¾ ;sfnk udxY fmaYs Èhù frda.shd ÿ¾j, ùug we;s yelshdjhs' túg m%;sYla;slrKh o wvq fõ' fï fya;=j ksid fjk;a frda. je<|Sugo bv we;'

MARCH 2018 | DOCTOR MAGAZINE

doctormagazine.lk

1

Èklg Yla;sh wjYH m%udKh ,nd Èh hq;=h' wvq fmdaIK ;;a;ajhg m;aùu k;r l< hq;=h'

2 3

fm%daàka wjYH m%udKh ,ndoSu wjYhfhka l, hq;a;ls'

jl=.vq wÈhr 4 -5 isák frda.Skaf.a fmdgEishï wêl wdydr iSud lsÍu' uq,a wjia:dfõ isg wÈhr 3 olajd( iuyr frda.Skaf.a wdydr md,kh l< hq;=h'

4 5

fmdiamria md,kh lsÍu'

ix;Dma; fïoh iSud lsÍu - ¨Kq m%udKh wju lsÍu' ¨Kq Èklg ks¾foaYs; m%udKh fkdblauùu'

6

c,h ksis m%udKhg mdkh lsßu yd mdkSh c,hg wu;rj mdk j¾. j,ska isrerg tl;= jk c,h ms<sn| ie<ls,su;a ùu'

wjYH muKg úgñka" Lksc ,jK ^SUPPLIMENT& j¾. ,nd .ekSu' úfYaIfhkau frda.shdf.a reêrfha fmdgEishï m%udKh wêl fõ kï fmdgEishï wêl wdydr wju l< hq;=h' ¨Kq iys; wdydrj,ska je<lsh hq;= fõ' fj<|fmdf<a we;s fmdgEishï iys; ¨Kq wdfoaYl øjH fukau y¾n,a ima,sukaÜ j¾. iy T!IO j¾. .ekSuo keje;aúh hq;=h' we;eï m,;=re" t<j¿ j¾.j, fmdgEishï ie<lsh hq;= m%udKhla we;' fmdgEishï hkq c,fha Èhjk ,jKhls' tneúka fmdgEishï nyq, wdydr wkqNj lsÍfï§ t<j¿ l=vd doctormagazine.lk

len,sj,g lmd oi .=Khla muK c,h oud meh 2la muK ld,hla ;eìh hq;=h' fmdgEishï c,fha Èhjk neúka fuf,i lsÍfï§ fmdgEishï m%udKh Èh ù hhs' fmdgEishï jeäfhka mj;sk t<j¿ fõ kï l=vd len,sj,g lmd ñks;a;= 5 -10 muK fõ,djla ;ïnd j;=r fmrd bj;a lr wdydrhg .; yel'

fmdgEishï wvq t<j¿ j¾. f.dajd" f.dajd u,a" lelsß" msms[a[d" rjqï jïngq" fndaxÑ" r;ÆKq" iqÿÆKq" mf;da,' jegfld¨" weU/,a,d ^wuqfjka fyd| ke;& msisk ,o weU/,a,d" lerÜ ^wuqfjka fyd| ke;& msisk ,o lerÜ

fmdgEishï wvq m,;=re fld< meye;s wem,a" fmhdia" lsf,da fmar" ñÈ f.ä 3la Èklg wkakdis f.ä 1/8la fj<|fmdf<a ñ,§ .; yels wem,a hqI fyd| ke;' kuq;a kejqïj ksjfia§ ms<sfh, lr .kakd wem,a hqI Ndú;h fyd|hs' fmdgEishï nyq, m,;=re mefmd,a" flfi,a" wU, rgb¢" w," n;," w¨ flfi,a" ksú;s" ;lald,s" jÜglald wdÈfha fmdgEishï jeä neúka tajd w.=K fõ' m<d j¾. m<d j¾.j, fmdgEishï nyq,j ;sfnk neúka frda.Skag m<d j¾. iqÿiq fkdfõ'

ìh¾ iy ish¨u u;amekaj, fmdiamria wvx.= neúka Ndú;h iqÿiq fkdfõ'

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KIDNEYS & WOMEN’S HEALTH:

jl=.vq frda.sfhl=f.a fmdaIKhg n,mdk m%Odk idOl

KIDNEYS & WOMEN’S HEALTH:

fmdiamria frda.Skaf.a isref¾ fmdiamria m%udKh jeä jQ úg" reêrfha fmdiamria m%udKh jeä ù fydafudak l%shdldß;ajh ksid wiaÓj,ska le,aishï reêrhg we;=,aùu isÿ ù wiaÓ ÿ¾j, ùug mgka .kakd w;r reêrfha le,aishï jeä ùu ksid le,aishï yDo jia;=fõ iy jl=.vqj, ;ekam;a úh yel'

fm%daàka - i;aj wdydr i;aj wdydr j, fm%daàka m%udKh jeä neúka wju f,i Ndú;d l< hq;=h' úfYaIfhka ì;a;r ly uofha fmdiamria jeä ksid Ndú;h iqÿiq ke;' kuq;a ì;a;r iqÿ uofha fmdiamria wvq neúka wdydrhg .ekSu fhda.Hh' fmdiamria" ´.ksla iy bka´.ksla hkqfjka j¾. follg wh;a fõ' úfYaIfhka m<;=re hqI l,a ;nd mj;ajd .ekSug l,a;nd .ekSfï øjHh fhdod ;sfí' úfYaIfhka fujeks l,amj;akd hqIj, bka´. ksla fmdiamria wvx.=j we;' fïjd mdkh lsÍfï wjdish jkafka f,a j,g fmdiamria 90% Wrd .ekSuhs' ;jo OdkH j¾.j, ksjqâv iys; yd,a j, o fmdiamria m%udKhla we;' kuq;a ksjqâv iys; yd,a wkqNj l< úg bka´.ksla fmdiamria reêrhg Wrd .kafka 40% - 60% olajd mu‚' jl=.vq frda.Ska wdydrhg .; hq;af;a ;ïnmq yd,ah' yd,a ;eïnQ úg bka fmdiamria fldgi bj;a fõ'

fidahd óÜ" fidfiacia" óÜfnda,aia" y;= j¾." fldkaâî*aa, l+ksiafida" biafida" oe,af,da ll=¿jka wdÈfha fmdiamria m%udKh jeä neúka wdydrhg kqiqÿiqhs" 72

MARCH 2018 | DOCTOR MAGAZINE

≈ix;Dma; fïoh fujeks frda.skag fmd,af;,a" fmd,alsß fyd| ke;' fojeks lsfrka wdydr msiSu l< hq;=h' ;jo l=l=,a uia fyda fjkhï uila wdydrhg .ekSfï§ iu bj;a lr wdydrhg .; hq;=h' thg fya;=j jkafka ix;Dma; fïoh jeä wdydrj, krl fldf,iagfrda,a m%;sY;h jeä jk neúka fujeks frda.Ska fndfyda fofkl=g yDohdndO we;s ùug bv we;s neúks' we;eï wjia:dj, th urKfhka fl<jr fõ'

lsß lsß j¾. wdydrhg .kafka kï kka*eÜ yd f,da*eÜ lsß wdydrhg .; hq;=hs' jl=.vq frda.Skag úfYaIs; jQ lsß j¾. fj<|fmdf,ka ñ,È .; yel'

¨Kq jl=.vq frda.Skag ¨Kq Ndú;h iqÿiq fkdfõ' ¨Kq isrefrka bj;a flfrkqfha jl=.vqj,sks' kuq;a ¨Kq m%udKh blaujd .;aúg fidaähï m%udKh jeä fõ' túg isrer bÈóu" wê reêr mSvkh jeäùu fukau yojf;a l%shdldß;ajh wju ùu isÿ fõ' m<uq yd ;=kajeks wÈhf¾ isák jl=.vq frda.Skag ¨Kq f;a yekaola iEfyk w;r wÈhr 4-5 isák frda.Skag ¨Kq Ndú;d l< hq;af;a f;a ye¢ 1/2ls' fidaia uduhsÜ" fiajß ìialÜ" laI‚l wdydr kj;d oeñh hq;=h' tfiau wÉpdre" fmdfÜfgda Ñmaia kqiqÿiq fõ'

c,h ldur WIaK;ajfha Èhjk iEu wdydrhlau Èhr iajNdjfhka mj;S' tfiau wdydr msisk úg fydÈ" c,h iys; neúka tajd ks;e;skau isrerg ,efnk neúka mdkh lrk c,h ms<sn| jvd;a ie<ls,su;a úh hq;=h' úfYaI ia;+;sh §ma;s f*dkafiald uy;añh fj;

•••

doctormagazine.lk

KIDNEYS & WOMEN’S HEALTH:

Èkh | ud¾;= 8

jl=.vq frda.h yd jl=.vq ydkshg m;ajq miq isÿ lrk

reêr ldkaÿfmrKh .ek jeäÿr f;dr;=re uydpd¾h ffjoH lukS jks.iQrsh

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doctormagazine.lk

ñksia isref¾ ksmofjk wmøjH bj;a lsÍu we;=¿j cSú;h mj;ajd .ekSug w;HjYH jQ ld¾hhka lsysmhlau bgq lrk jeo.;a hq., bkaøshls' úúO fya;= ksid jl=.vq l%shdldß;ajh ÿ¾j, fjhs' wjidkfha l%shd;aul ùu kj;shs' fkdfyd;a wlrKshg m;a fjhs' wfma rfÜ úYd, jYfhka jl=.vq frda.Ska yuqjk fï hq.fha tfia wlrKshg m;a jl=.vq j,ska flfrk ld¾hh bgq lsÍug lD;%suj reêrh msßisÿ lrk wdldrh .ek f;dr;=re fï ,smsfhka úia;r fõ'

yosisfha we;sjk jl=.vq wlrKsh iy fiñka we;sjk jl=.vq wlrKsh lsishï fya;=jla ksid jl=.vq ydkshg m;ajQ úg fuu l%shdj,sh ì| jefghs' th yosisfha we;sjk ;;a;ajhla tkï ;Sj% ;;a;ajhla ^ó WK" i¾m oIAGk" T!IO úIùï wdosh ksid we;s úh yel'& ksid fukau oS¾> ld,hla ;siafia áflka ál we;sjk ÿ¾j,;djhla ksid úh yelsh' fufia oS¾> ld,hla ;siafia jl=.vq ÿ¾j, ùug oshjeähdj" wêl reêr mSvkh wdoS frda. fya;= fjhs' fufia iïmQ¾Kfhka jl=.vq úkdY jQ úg mßjD;a;Sh l%shdj,ska ksid ksmofjk wmøjHo reêrfhau / f|hs' fuh b;d ydkslrh' urKhg mjd th fya;= úh yelsh' fï ksid ;jÿrg;a jl=.vq j,g l< fkdyels ld¾hh" tkï f,a msßisÿ lsÍu lD;%Suj fyda lrkakg isÿ fjhs' yosisfha we;s jk jl=.vq ì|

jl=.vq wlrKshg ,lajQ wjia:djl reêrh ;=< we;s hQßhd" hQßla wï,h" we;=¿ wmøjH bj;a lsÍu reêr ldkaÿ fmrKh fkdfyd;a vh,sisia lsÍu f,i y÷kajhs' reêrldkaÿlrKh isÿ lrk l%u doctormagazine.lk

MARCH 2018 | DOCTOR MAGAZINE

75

KIDNEYS & WOMEN’S HEALTH:

jl=.vq

úoahq;a úPAfPaoH iy ;r, ;=,s;;djh wdrlaId lsÍu jl=.vq j,ska flfrk uQ,sl ld¾hhls' wfkla ld¾hh wmøjH neyer lsÍuhs' yDofhka ksl=;a flfrk uq¿ reêr m%udKfhka mfyka mx.=jlau fhduq fjkafka jl=.vq wdY%s; by; ld¾hhkagh' jl=.vq j,g tk reêrfha wvx.= fidaähï" fmdgEishï" le,aishï" weuhsfkda wï," .aÆfldaia" yd c,h YÍrfha wjYH;d i|yd muKla h,s Wrd .ksñka fm%daàk ì|Sfuka we;sjk khsg%cka fldgia hQßhd f,io" wkjYH LKsc øjH" úI øjH" T!IO yd c,h uq;%d f,i YÍrfhka neyer lsÍu i|yd fmÍu jl=.vq u.ska isÿ flfrhs'

KIDNEYS & WOMEN’S HEALTH:

jeàuloS h,s th m%lD;su;a jk;=re lD;%suj f,a msßisÿ lsÍu lrkakg isÿ jQj;a ld,sl" tkï os.= ld,hla ;siafia isÿjk jl=.vq ydkshloS lsishï osfkl jl=.vq noaO lsÍula isÿ lrk f;la úáka úg f,a msßisÿ lrkakg isÿ fjhs' fufia jl=.vq j,ska lrk ld¾hh lD;%suj hka;%hla yryd isÿ lsÍu reêr ldkaÿ fmrKh f,i ye|sskafjhs'

reêr ldkaÿ fmrKh reêr ldkaÿfmrKh frday,a j,oS ta fjkqfjkau msysgqjd we;s úfYAI tall ;=<oS isÿ flfrkakls' tla frda.sfhl=g reêr ldkaÿfmrK l%shdj,shla i|yd meh 4-6 l ld,hla .; fjhs' uq,a wjia:dfõoS i;shlg jrla muKla ldkaÿfmrKh isÿ flfrhs' miqj th i;shlg 2-3 jrla olajd jeä lsÍug isÿ fjhs' ldkaÿfmrKhg ,lajQ miq ;u lghq;= idudkH f,i isÿ lr .ekSffï wjia:dj ysñ jk w;r jl=. vqjla noaO lrk ;=re .=Kd;aul cSú;hla .; lsÍfï wjia:djo ysñ jkafkah'

uq,a mshjr - l=,a,sldj fyj;a *siaáhq,h ieliSu reêr ldkaÿlrKh wjYH ;;a;ajhl iaÓr f,i jl=.vq wl¾uKH jQ ;;a;ajhl frda.shd isák nj ks.ukh l< miq ffjoHjreka úiska m<uqj frda.shdf.a wf;a lemqula isÿ lr reêr kd, folla iïnkaO lrk l=,a,sldjla fyj;a *siaáhq,djla ilihs' ta myiqfjka reêr .ukhg ióm jkq msKsih' fuu l=,a,sldj fhdokqfha iug háka ksid frda.shdg wmyiqjla ke;' tosfkod lghq;= isÿ lsÍug ndOdjlao ke;' bka miqj fuu l=,a,sldjg we;=¿ lrk lekshq,d hq.,hla reêr ldkaÿlrkh isÿlrk 76

MARCH 2018 | DOCTOR MAGAZINE

vh,sisia hka;%hg iïnkaO lrhs' l=,a,sldfjka wdrïN flfrk lekshq,djla iys; isyska kd,hla reêr ldkaÿlrk hka;%hg iïnkaO lrk w;r ta ;=< msßisÿ jk reêrh ;j;a kd,hlska l=,a,sldj yryd reêr mßjyk moaO;shg iïnkaO flfrhs' reêrh hka;%h ;=<oS msßisÿ ùu isÿ jkafka ishqï w¾O mdr.uH mg, iuQyhl wdOdrfhks' fuu mg, tla mfilska frda.shdf.a reêrho wfkla miska úreoaO foig .uka lrk zzvh,hsfiaÜZZ kï úfYAI ødjKhlskao iukaú;h' th c,h iy ridhKsl øjH ñY%Khls' ødjK <`.ska .uka lrk úg reêrfha we;s wmøjH" fmdgEishï wdoS wu;r LKsc fmdaIl ødjKh ;=<g úirKh ùu u.ska frda.shdg kej; msßisÿ jQ reêrh ,efí'

*siaáhq,h ieliSu m%udo jk l,ayS" lekshq,dj yosisfha ldkaÿ fmÍula wjYH iaÓr jl=.vq ydkshla ;sfnk frda.sfhl=g fyda ;djld,slj jl=.vq wl¾ukH jQ frda.sfhl=g fufia *siaáhq,djla fhoSug ;rï ld,hla fkdue;s jQ úg reêrh ,nd .kakd jQ úfYaI lekshq,djla wdOdrfhka reêr kd, ldkaÿlrK hka;%hg iïnkaO l< yelshs' reêr kd, tla lr iug háka

jl=.vqjlska isÿ flfrk ld¾hh doctormagazine.lk

ta i|yd Tjqka frda.Skaf.a reêrh mÍlaId lr tys wvx.= l%sheákska w.h iy ta u; ilia lrk G.F.R. w.h u.ska u.fmkaùula ,nd.kshs' ta w;r ;o lEu wreÑh" fomd bosóu" we`. msmqKq .;sh wdoS ,laIKo fï we.hSu i|yd iydh lr .kshs' óg fmr i|yka l< mßos iSrï l%sheákska w.h" G.F.R. w.h fukau frda.,laIKo jl=.vqfõ m%udKho mokï lrf.k jl=.vq frda. ;;a;ajh woshr j,ska oelaùug ffjoHjrekg mq¿jk' T!IO j,ska muKla frda. ;;a;ajh md,kh lsÍug wfmdfydi;a jQ úg ldkaÿ fmÍulg hdfï ;SrKh .ekSug isÿfõ'

reêr ldkaÿfmrKhg ,lajk uq,a wjia:dj reêr ldkaÿfmrKhg ,lajk uq,a wjia:dfõoS iuyrekg lrleú,a," ysiroh" fõokdj iy jukh we;s jQj;a flfuka yqrejk úg tu ,laIK myj hhs' ldkaÿfmrKh isÿjk meh 4-6 ld,h ;=<oS frda.shdg fmd;la m;la lshùu" rEmjdysksh keröu jeks foa isÿ l< yelsh' vh,sisia fyj;a ldkaÿfmrK l%shdj,sh b;d úhoï iy.;h' fndfyd afm!oa.,sl frday,aj, fukau rcfha frday,a lsysmhlo fuu fiajdj mej;sho frda.Ska ixLHdj osfkka osk jeä jk nj fmfka' tfukau ldkaÿfmrKhg wjYH lrk uqo,a fidhd.; fkdyelsj i;shlg 2-3 doctormagazine.lk

j;djla fjkqjg i;shlg jrla muKla f,a msßisÿ lr.kakd frda.Skaf.a wkqfõokSh;ajh wm mila lrf.k isáuq'

u¾Okh lsÍug mshjr .ekSfï jeo.;alu fï fya;=ka ksid iaÓr jl=.vq wl¾ukHùug n,meje;aúh yels lreKQ y÷kdf.k tu ;;a;ajhka md,kh lsÍug mshjr .ekSu ldf,daÑ;h' oshjeähdj iy wêl reêr mSvkh jl=.vq frda. j,g m%Odk fya;=jls' ykaosm;a frda. j,g fok T!IO ffjoH Wmfoia j,ska f;drj oS¾>ld,Skj ,nd .ekSuo" fmd,sisiaála jl=.vq frda.h iy l=vd ld,fhaoS uq;%d ud¾.fha wdidok j,g ks;r ks;r ,laùuo wdoS fya;=ka /ila jl=.vq frda. j,g uQ,sl úh yelsh' tfiau rcrg yd ;j;a osjhsfka m%foaY lsysmhl iq,nj jl=.vq frda.Ska we;s ùu fkdfhl=;a mdßißl fya;= ksid isÿjk nj meyeos,s fjñka mj;S' iaÓr jl=.vq frda.Ska i|yd jvd myiqfjka" wvq uqo,lg reêr ldkaÿfmrK fiajdj ,nd.; yels mßos myiqlï mq¿,a lsÍu ld,Sk wjYH;djhls' tfiau oshjeähdj" wêl reêr mSvkh wdoS jl=.vq frda. hg w; jkk idOl uekúka md,kh l< hq;=h' wosis" ke;fyd;a fya;=jla fkdy÷kk jl=.vq frda.Skaf.a tu pQos; fya;=jo jydu ksYAph lr.; hq;=h' wfma oehu fj,d.;a jl=.vq frda.Ska fjkqfjka ksis m%;sldr ie,iSu fukau fukau fuu frda.hg bosßfhaoS k;= ùug kshñ; frda.Ska ixLHdjo wju lsÍug wk,iaj lghq;= lsÍu wm ieuf.a j.lSuls'

idlÉPd lr ilia lf<a ;=is; u,,fialr MARCH 2018 | DOCTOR MAGAZINE

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KIDNEYS & WOMEN’S HEALTH:

ilia l< *siaáhq,djla Ndú;d lsÍfïoS udi 2-3la mK .; fõ' tfyhska iaÓr jl=.vq frda.Ska i|yd l,a we;sj reêr ldkaÿfmrKh isÿlsÍug wjYH fmr iQodku we;s lr .ekSu ffjoHjrekaf.a isß;h'

KIDNEYS & WOMEN’S HEALTH:

Diabetic Nephropathy

Èhjeähdj

frda.Skaf.a jl=.vq frda. we;s ùfï

wjodku æ

Èhjeähd frda.Skaf.a Life Line tl Albumin to Creatinine Ratio (ACR) mÍlaIKhhs 78

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doctormagazine.lk

uykqjr uy frdayf,a jl=.vq frda. tallfha fcHaIaG f,aLldêldÍ ffjoH ffu;%S m%kdkaÿ

oshjeähdj mj;sk frda.Ska ;u jl=.vq ydkshg m;aùfuka we;súh yels wjodku iïnkaOfha úfYaI ie<ls,a,la oelaúh hq;=h' jl=.vq ydkshg m;ajk" jl=.vq wlrKshg m;ajk frda.Skaf.ka jeäu ixLHdjla oshjeähdj frda.Ska ùu Bg fya;=jhs' oshjeähdj je<÷KQ frda.sfhl= fõ kï Tyqf.a jl=.vq iqrlaIs;j wdrlaId lr.kq msKsi" jl=.vq iqjfi; /l.kq msKsi .; hq;= l%shdud¾. iïnkaOfhka fï ,smsfhka úia;r fõ' oshjeähdj ;sfnk flfkla jl=.vq iïnkaOfhka wjfndaOhla ,nd .ekSu msKsi isÿ lrk mÍlaIK / ila ;sfnkjd' thska jvd;au iq,n yd uQ,sl mÍlaIKh UFR fkdfyd;a Urine Full Report kï mÍlaIKhhs' fm%daàk + fyda + fyda + wdoS jYfhka jd¾;d fjkjd kï th ;SrKd;aul ;;a;ajhla' Trace ;;a;aj kï we;eï úg yosisfha ´kEu flfkl=g we;s úh yelshs' túg kej; Repeat UFR mÍlaIKhla lsÍfuka th iaÓrj mj;sk ;;a;ajhlao@ ke;so hkak ikd: lr.kakjd' Protein + fyda ++ fyda +++ wdoS jYfhka jd¾;d fjkjd kï th jl=. vq lsishï wdmodjlg ,laj ;sfnk njg flfrk bÕshla' doctormagazine.lk

jl=.vq ydkshg ,lajk uq,au wjia:dfõoSu th .%yKh lr.; yels mÍlaIKh fïlhs ta;a fï UFR uq;%d mÍlaIdj uQ,sl wjia:dfõ jl=.vq ydks hg m;aùu fmkakqï lrk mÍlaIKhla fkdfjhs' meh 24l ld,hla ;=< ñ,s .a?ï 300 blaujk fm%daàka m%udKhla uq;%d j,ska ldkaÿ jqfKd;a ú;rhs UFR mÍlaIKfhaoS fm%daàk + jkafka' fï ksid jl=.vq j,g uq,a wjia:dfõoS ydkshla isÿ jkafka oehs oek.ekSu th ms<silr lsÍug b;du jeo.;a' ta i|yd jvd;a ixfõoS mÍlaIKhla wjYHhs' fï jl=.vq ydkshg m;afjk uq,a wjia:dfõoSu th yªkd.; yels mÍlaIKhla ;sfnkjd' th Albumin to Creatinine Ratio (ACR) hkqfjka ye|skafjkjd' fuh jl=.vq ydkshla n,.ekafjk wjia:dfõ jqK;a ta nj y÷kd .kakg iu;a ixfõoS mÍlaIKhla' fï Albumin to Creatinine Ratio (ACR) mÍlaIKh iEu oshjeähd frda.sfhlau jirlg j;djla j;a isÿ lr.; hq;=hs' yenehs fï mÍlaIKh Albumin to Creatinine

Ratio (ACR) mÍlaIKh iEu oshjeähd frda.sfhlau jirlg j;djla j;a isÿ lr.; hq;=hs' ACR mÍlaIKfha uQ,sl wruqK jkafka jl=.vq j,g úYd, jYfhka ydks meñKsug fmr jl=.vq frda.h y÷kd.ekSuhs' MARCH 2018 | DOCTOR MAGAZINE

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KIDNEYS & WOMEN’S HEALTH:

uq;%d iu. fm%daàka msgùu Proteinurea f,i y÷kajk w;r oshjeähd frda.sfhl=f.a fï wdldrhg uq;%d iu. fm%daàk msgùu Diabetic Nephropathy hkqfjka ye|skafjhs'

KIDNEYS & WOMEN’S HEALTH:

isÿ lsÍfï myiqlï rcfha frday,a j, kE' fm!oa.,sl wxYfhka th isÿ lr .ekSfïoS o< jYfhka remsh,a 1200/= l muK uqo,la jeh fjkjd' th rcfha frday,a j,o isÿ lrk l%uhla yefokjd kï b;du iqÿiqhs' ACR l< hq;af;a uq;%d j, fm%daàk ke;akï muKhs uq;%d j, fm%daàka ;sfnkjd kï fï Albumin to Creatinine Ratio mÍlaIKh lsÍfï M,la kE' fudlo@ UFR j,;a fm%daàka fmkakqï lrkjd thska woyia lrkafka tu ;eke;a;d oshjeähd jl=.vq wdndOhg (Diabetic Nephropathy) ,lajQ flfkla njhs' fï ACR mÍlaIKfha uQ,sl wruqK jkafka jl=.vq j,g úYd, jYfhka ydks meñKsug fmr jl=.vq frda.h y÷kd .ekSuhs' fï ksid UFR mÍlaIKfhka - ^fk.áõ& f,i m%;sM<h wd úg jeä mßiaiug lsishï uQ,sl jl=.vq wdmodjla ;sfnkjdo hkak fidhd ne,Suhs fuu mÍlaIKfha wruqK'

Tfí reêrfha mj;akd iSks m%udKh ksrka;rfhka by< w.hla .kakd úg Tfí jl=.vq j,g reêrh fmÍfï l%shdj,sh i|yd jeä Yla;shla fhoùug isÿ fjhs' fï wu;r jev Odß;dfõ m%;sM<hla f,i jl=.vq j,oS fmÍ kej;;a reêrhg tla úh hq;= fm%daàka jeks wxY= uq;%d j,g ldkaÿ fjhs'fuh oshjeähd jl=.vq wdndOfhys m%:u ,laIKhhs'

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MARCH 2018 | DOCTOR MAGAZINE

wYajhd bia;df,ka mek, .shdo@ l%sheákska mÍlaIdj - jl=. vq j,g fndfyda ydkshla isÿjQ miqj m%;sM<h olajk mÍlaIKhla' fndfyda fofkla jl=. vq iïnkaOfhka iudf,dapkhla lsÍug l%sheákska mÍlaIdj;a lrk nj Tn okakjd' kuq;a fï mÍlaIKh iïnkaOfhkq;a lshkak ;sfhkafka l%sheákska j,ska ydkshla fmkajk úg frda.h iEfyk muK Tvqÿjd yudr njhs' idudkHfhka jl=.vqjlska ishhg 50la''' tkï wvlau jf.a úkdY jqKdu (Renal Mass) ;uhs l%sheákska uÜgu idudkH w.hka blaujd by< hkafka' túg iEfyk wdmodjla isÿù yudrhs' fjkak ´ks ydksh fnfyúka isÿù yudrhs' fï wkQj UFR mÍlaIKh j;a Creatinine mÍlaIKh j;a uq,a wjia:dfõoS jl=. vqjg isÿjk ydksh w,a,d. kak .e,fmk mÍlaIKhla fkdfjhs' uq,au wjia:dfj f,fâ w,a,.kak kï iqÿiqu fï mÍlaIKh Albumin to Creati- nine Ratio (ACR) mÍlaIKhhs' ta ksid ;uhs" iEu oshjeähd frda.sfhlau jirlg j;djla j;a mÍlaIKh isÿ lsÍug w;HjYH jkafka' doctormagazine.lk

Angio- tensin II Receptor Blockers

hk T!IOhla ,nd osh hq;=h' ACR mÍlaIKfha m%;sM< < 30 idudkH ksfrda.S w.h 30-300 uQ,sl wjêfha fm%daàka ldkaÿ ùu >300- Macroalbuminuria wêl f,i fm%daàka ldkaÿ ùu ACR mÍlaIKh isÿ lsÍfuka miq

kshñ; m%;sldr f,i f;dard .kakd ,o T!IO ,ndoSfuka frda.shdg w;am;a jk m%;s,dN iuyrla

• jl=.vq j,ska fm%daàk ldkaÿ ùu tu ydksfha uq,au wjia:dfõ y÷kd .kakg ,enqfKd;a jl=.vq frda.fha wjika woshr End Stage Renal Failure (ESRF) j<lajd .kak mq¿jka' túg vh,hsia lsÍï" jl=. vq noaO lsÍï jeks ixlS¾K m%;sldr j,g fhduq ùfï wjYH;djhla meK k.skafka kE' th frda.shdg ,efnk úYd, m%;s,dNhla' • fï T!IO m%;sldr ,ndoSu ksid jl=.vq flfuka flfuka úkdY ùu iEfyk muK wvd, lrkak (Delaying chronic kidney disease progression) mq¿jka' doctormagazine.lk

• tfiau fï T!IO .ekSu ksid ;jÿrg;a l%sheákska jeäùu yd fm%daàka msgùu md,khlg ,la lsÍug wjia:dj ie,fikjd' • jl=.vq ÿ¾j, jQ úg yoj;a frda. wjodku;a by< hkjd' fï T!IO m%;sldr ,eîfuka fï yDo frda. wjodku;a my; jefgkjd'

jl=.vq frda.sfhla i|yd m%;sldr lsÍfïoS frda.fha ljr woshrl .; lrkafklao hk ldrKh jeo.;a fjkjd' fï woshr ;SrKh lrkafka .=ÉPsld Tiafia fmÍu isÿ jk wdldrh wkqjhs' Glomerular Filtration Rate (GFR) jvd;a ksjeros ksudKhla i|yd''' wfma rfÜ fhdod .efkkafka IDMS-traceable version kue;s iïu; l%sheákska ks¾Kl ridhkd.dr l%ufõohhs' fuysoS meh 24la ;=< l%sheákska ksoyia ùfï w.hka .kakjd fjkqjg Estimated l%uhg eGFR weiqre lr.;a w.hka u; jl=.vq frda.shdf.a frda.fha woshr ;SrKh lrkjd'

oshjeähdj yd jl=.vq wdndOh hk frda. ;sfnk flfkla iEu úgu ;ukaf.a jl=.vqj fl;rï m%udKhla jev lrkafkao hkak ke;skï eGFR tl ffjoHjrhdf.ka úuid oek.; hq;=h'

MARCH 2018 | DOCTOR MAGAZINE

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KIDNEYS & WOMEN’S HEALTH:

oshjeähdj ;sfnk frda.sfhl= wêreêr mSvkfhkao fmf<a kï Tyqg$wehg reêr mSvk md,k T!IO jYfhka ksielfhkau oshjeähd jl=.vq wdndO md,kfhyso ld¾hlaIuj l%shd;aul jk ACE Inhibitors fyda

fm%daàk ldkaÿ ùu blauKska y÷kd .kakd ;rug m%;sM<h id¾:lhs'

KIDNEYS & WOMEN’S HEALTH:

Diabetic Nephropathy we;sùu osß. kajk wjodkï idOl md,kh lrk b,lal

fï jeros ;SrKh .kak tmd''' miq;eú,s fjkak isÿ fõú'''

• reêr mSvkh md,kh lsÍfï b,lal

oshjeähd frda.sfhl=" reêr mSvkfhkao fmf<a kï Tyq oshjeähd jl=.vq wdndOhg ,laùfï wjodku jeäh' Tyq iEu úgu ;u reêr mSvkh 140-90mmHg w.hg wvqfjka mj;ajd.; hq;=h'

• oshjeähd frda.shdf.a uq;%d iu.

Microalbuminurea 30- 300 uÜgfï fm%daàka ldkaÿ ùulao olakg ,efí kï reêr mSvkfha jvd fyd| md,khla tkï 130-80mmHg w.hg wvqfjka mj;ajd .; hq;=h' • oshjeähd frda.shdf.a ACR mÍlaIKfha Microalbuminurea >300 m%;sM<hla oelafjkafka kï ;jÿrg;a reêr mSvkfha md,khla ;sìh hq;=h' th 125- 75mmHg g jvd wvq w.hl mj;ajd .ekSug W;aiql úh hq;=h' • oshjeähd frda.sfhl= iEu úgu reêr iSks w.h yels;dla md,khg ,la lr.; hq;=h' iEu úgu HbA1C w.h 7g wvq mrdihl ;nd.; hq;=h' tu oshjeähdjg ,lajQ ;eke;a;d ;reK flfkla kï HbA1C w.h 6'5 g wvq w.hl mj;ajd .ekSug W;aidy .; hq;=h' • oshjeähd frda.sfhl= ÿï mdkh lrk úg jl=.vq wdmodjg ,laùfï oeä wjodkula f.k tk ksid thska iïmQ¾Kfhkau je<lsh hq;=h' • nr uekúka md,kh lr.; hq;=h' ia:q,;djh we;s fjkakg bv ;nkak tmd' • wvq ¨KQ wkqNjlg yqre úh hq;=h' yels;dla wdydr j,g ¨KQ fhoSu iSud l< hq;=h' • reêr.; fldf,iagfrda,a uÜgu ksfrda.S w.hl mj;ajd .ekSu;a jeo.;a 82

MARCH 2018 | DOCTOR MAGAZINE

-Tng oshjeähdj ;sfnkjd''' -uq;%d iu. fm%daàk ldkaÿ fjkjd''' neÆ ne,aug th oshjeähd jl=.vq wdndOh (Diabetic Nephropathy) úh hq;=hs' tfia jQj;a th ,>q l%u j,g ikd: lr.ksñka oshjeähd jl=.vq wdndOhg m%;sldr .ekSug blauka fjkak tmd' fï idOl folu n,.ekajQj;a th oshjeähd jl=.vq wdndOh fkdùugo lsishï bvla ;sfnkjd' túg tfia is;d .;hq;= ksjeros T!IO ,nd fkd.;af;d;a frda.shd ksielfhkau jl=. vq frda.sfhla fjkjd' fjk;a frda.hla ksid we;sjQ ;;a;ajfhka iqjh ,nkakg we;s wjia:djo u. yefrkjd' fï ksid jDlalfõosfhl=g kshñ; idhksl mÍlaIK Tiafia ta ;SrKh .ekSug Ndr lrkak' oshjeähd jl=.vq wdndOh f,i wkqudk lr thg m%;sldr lrkak j;a fjk;a ffjoHjrfhl=g tfia lrkakg bv yßkak j;a tmd''' ta flfia fj;;a wefia oDIAÀ ú;dkfha ishqï doctormagazine.lk

m%udKhlska wvq lsÍu i|yd ,nd fok T!IO ldKav folls' fï foflka tlla Tfí ffjoHjrhd fokq we;'

oshjeähd jl=.vq frda.h i|yd m%;sldr

oshjeähdj ;sfnk frda.sfhl= wêreêr mSvkfhkao fmf<a kï Tyqg$wehg reêr mSvk md,k T!IO jYfhka ksielfhkau oshjeähd jl=.vq wdndO md,kfhyso ld¾hlaIuj l%shd;aul jk ACE Inhibitors fyda Angio- tensin II Receptor Blockers hk T!IOhla ,nd osh hq;=h'

• ACE Inhibitors (angiotensin-converting enzyme inhibi- tors) • Angiotensin II Receptor Blockers fuu T!IO zzoshjeähdj wdY%s; jl=.vq wdndOh i|yd fok m<uq fm< m%;sldrZZ jYfhka wújdos;h' fïjd wdrlaIs; T!IO jYfhka ie<flK w;r b;d uekúka fm%daàk msgùu wvqlr oshjeähd jl=.vq wdndOh md,kh lrhs' by;ska oelajQ T!IO .ekSfïoS wjOdkhg ,laúh hq;= m%Odku ldrKh jkafka fï T!IO .ekSfuka fmdgEishï uÜgu by< hdfï wjodkuhs' fmdgEishï w.hka wiSudka;sl f,i by< hdu yDo iamkaokfha widudkH;d we;s lrk ksid" úfgl th urKh jQj le|ùug fya;=jla jk ksid reêr.; fmdgEishï uÜgu wmf.a ióm wëlaIKhg fhduq úh hq;= lreKls'

oshjeähd jl=.vq frda.h je<elaùu i|yd''' jl=. vq ;jÿrg;a ydkshg ,laùu ie<lsh hq;=

oshjeähd jl=.vq wdndOh uq;%d j, fm%daàk fm%daàk ldkaÿ mej;Su ùu

reêr kd, úia;drkh ùu

yels,Sug ,lajQ reêr kd, oshjeähd jl=.vq wdndOhg ,lajQ jl=.vq doctormagazine.lk

ksfrda.S jl=.vq

MARCH 2018 | DOCTOR MAGAZINE

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KIDNEYS & WOMEN’S HEALTH:

flaYsl kd, j,g ydkshla fjk ,laIK m%lg fjkjd kï (Diabetic Retinopathy) mdo j, ysß jeàï wdoS jYfhka (Diabetic Neuropathy) olakg ,efnkjd kï" fldákau Micro Vascular Changes wefia''' mdoj,''' wdoS jYfhka YÍrfha fjk;a ia:dk j, ;sfnkjd kï th oshjeähd jl=.vq wdndOh fjkak fndfyda ÿrg mq¿jka' ta;a frda.h ksYaÑ; jYfhkau ikd: lr .ekSug jDlalfõosfhl=f.a iyfhda.h ,nd.ekSu Tfí hym;guhs'

KIDNEYS & WOMEN’S HEALTH:

T!IO ,nd .ekSfï ud¾f.damfoaYK • fï ksid by; ACIE, ARB T!IO .ekSug fmr Electro- lyte mÍlaIKhla fukau l%sheákska mÍlaIKhlao isÿ lr i;shla T!IO .ekSfuka miq tys wjodkï iy.; jeäùula isÿj we;aoehs kej;;a tu mÍlaIKu isÿ lrñka ksÍlaIKh l< hq;=h' • l%sheákska uÜgu ishhg 30lska by< hdu wjodkula fia i<lkjd' tfiau fmdgEishï 5'5g wvq w.hl mj;ajd hq;=h' fï w.hka blaujk wjodkula mek ke.=fKd;a" ACE Inhibitors fyda Angiotensin II Receptor Blockers

hk T!IO ,ndoSu keje;aúh hq;=h' by; T!IO Ndú;d lsÍfuka miqj;a fm%daàk ldkaÿj ;sfnkjd kï fojk fm< T!IO f,i Diltazium fyda Verapamil hk T!IO j,ska tlla kshu flf¾' • fmdgEishï w.h 4'5g jvd wvq kï yd ;ju;a uq;%d iu. fm%daàk ldkaÿ fjkjd kï Spironolactone kue;s T!IOh oshjeähd jl=.vq wdndOhg ,nd oSu l< yelsh' fufia fuu T!IOh ACIE fyda ARB g tl;= lsÍfuka fmdgEishï uÜgu jeäùula ;sfhkjd' fï ksid reêrfha fmdgEishï uÜgu i;shlg miqj mÍlaId lr.; hq;=hs' eGFR w.h my; jefgñka jl=.vq j, fmÍï l%shdj,sh ÿ¾j, ùu;a fmdgEishï w.h by< hdu;a w;f¾ wúfhdackSh in|;djhla mj;skjd'

hï frda.sfhl=f.a eGFR w.h 45g wvq jQ úg tu frda.shdf.a fmdgEishï uÜgu .ek wjOdkfhka isáh hq;=h' tfiau fmdgEishï idr wdydr wvqfjka ,ndoSu flfryS wjOdkh fhduq l< hq;=h' oshjeähd jl=.vq wdndOh ;snqK;a fmdgEishï w.hka muK blaujd jeä fkdjkafka kï fmdgEishï idr .=Kj;a m<;=re wdosh iSud lsÍfï wjYH;djhla meK k.skafka ke;'

oshjeähd jl=.vq wdndOh yd fuÜf*dñka fuÜf*dñka zzfojk wdldrfha oshjeähd frda.Skaf.a úYsYaG;u m<uq fm< T!IOhZZ (Metformin Remains Best First-line Therapy for Type 2 Diabetes) jYfhka wújdofhka

ie<fla' tfy;a fndfyda fofkla fuÜf*dñka flfryS olajkafka oeä ìhls' l=;=y,hls' zzfuÜf*dñka î, jl=.vq krla fjkj'''ZZ lshk u;jdohla iudcfha ck.; ùfuka fndfyda frda.Ska oshjeähdjg ksis m%;sldr fkdf.k tajd nrm;, ;;a;ajhka lrd Tvq osùfuka wka; wirK Ndjhg m;a fjkjdg ksoiqka tugh' jl=.vq krla jQ frda.Ska yg tla;rd wjia:djloS fuÜf*dñka ,ndoSu w;aysgqjhs' túg we;efula ys;kafk zzfuÜf*dñka yskao jl=.vq krla jqK ksid ;uhs fuÜf*dñka keje;ajQfhaZZ lshdh' fï zzfuÜf*dñka NS;sldjZZksid frda.Skag nrm;, w.;shla isÿjk neúka fuÜf*dñka iïnkaOfhka we;s ñ;Hd m%;sfrdaOh neyer úh hq;=uh' •••

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doctormagazine.lk

KIDNEYS & WOMEN’S HEALTH:

Èkh | ud¾;= 8

frda.Ska wdrlaId lrk vh,hsisia m%;sldrh lshkafka fudllao@ vh,hsisia m%;sldrh lshkafka fudllao@ ph,hsisia ^ldkaÿlrK& m%;sldrfhka isÿjkafka wmf.a YÍrfha we;s idudkH ksfrda.S jl=. vq j,ska isÿjk ld¾hhg iudk ld¾hhla' jl=.vq frda.S jQ úg jl=. vq j,ska idudkHfhka isÿjk ldßh isÿfjkafka ke;s ksid tu l%shdj,sh hka;%hla u.ska isÿlsÍu ;uhs vh,hsisia m%;sldrfha§ isÿjkafka'

vh,hsisia m%;sldrh wjYH jkafka l=uk wjia:dfõ§o@ jl=.vqfõ l%shdldß;ajh 85] - 90] muK m%udKhlska ke;sù .sh úg vh,hsisia m%;sldrh ioyd fhduq ùug isÿfjkjd' idudkHfhka GFR w.h 15 wvq jQ úg;a vh,hsisia m%;sldrh ioyd fhduq ùug ld,h meñK we;s nj wmg oek.kakg mq¿jka' flfia fyda Tnf.a ffjoH mÍlaIK j, m%;sM, fï wjia:djg meñŒug 86

MARCH 2018 | DOCTOR MAGAZINE

doctormagazine.lk

vh,hsisia m%;sldrfha§ isÿjkafka fudllao@ YÍrh ;=, f.dvkef.k yd wm .kakd wdydr u.ska YÍrfha /ia jk wmøjH" ,jK j¾." w;sßla;

c,h yd úúO ridhksl øjHhka YÍrfhka neyer lsÍu ;uhs jl=. vq j, ld¾hh jkafka' kuq;a jl=. vq j,g kshñ; wdldrfhka ta ld¾hh isÿlsÍug fkdyels jQ úg ta l%shdj,sh hka;%hla Ndú;fhka isÿ lsÍu fuys§ isÿfjkjd'

vh,hsisia m%;sldrh isÿlrkafka fldfyaÈo@ idudkHfhka fuh isÿjkafka frday,l we;s vh,hsisia tallfha§hs' Bg wu;rj úfYaIs; wjia:djka j,§ ksjfia§ isÿlr .; yels vh,hsisia m%;sldr l%u;a ke;=jdu fkdfõ' cd;sl frday," Y%S chj¾Okmqr frday," uykqjr YslaIK frday," lrdmsáh YslaIK frday," wkqrdOmqrh frday, jeks rcfha frday,a j, m%Odk jYfhka vh,hsisia m%;sldrh isÿlrk w;r mqoa.,sl frday,a fndfydauhl;a vh,hsisia m%;sldrh ,nd §u isÿfjkjd'

vh,hsisia isÿlrk úg jl=.vq frda.S ;;a;ajh iqjùula fjkjdo@ keye' fuu m%;sldrh u.ska isÿjkafka jl=.vq u.ska isÿlrk ld¾hhka hka;%hla u.ska isÿlsÍu muKhs' tu.ska jl=.vq frda.S ;;ajh iqjùula isÿjkafka keye' jl=.vq noaO lsÍula isÿlrkafka ke;akï Ôú;dka;h olajd vh,hsisia m%;sldrh isÿlsÍu l< ••• hq;= jkjd' By courtesy, kidneyinfolk.com doctormagazine.lk

MARCH 2018 | DOCTOR MAGAZINE

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KIDNEYS & WOMEN’S HEALTH:

wdikak ùfï§ YÍrfha we;s jk úúO fjkialï yd wmyiq;djhka ksid vh,hsisia m%;sldrh ioyd óg jvd l,ska fhduq ùug isÿfjkak;a mq¿jka'

KIDNEYS & WOMEN’S HEALTH:

#Èhjeähd#jl=.vq wdndOh yd

fuÜf*dñka fuÜf*dñka zzfojk wdldrfha oshjeähd frda.Skaf.a úYsYaG;u m<uq fm< T!IOhZZ (Metformin Remains Best First-line Therapy for Type 2 Diabetes) jYfhka wújdofhka ie<fla' tfy;a fndfyda fofkla fuÜf*dñka flfryS olajkafka oeä ìhls' l=;=y,hls' zzfuÜf*dñka î, jl=.vq krla fjkj'''ZZ lshk u;jdohla iudcfha ck.; ùfuka fndfyda frda.Ska oshjeähdjg ksis m%;sldr fkdf.k tajd nrm;, ;;a;ajhka lrd Tvq osùfuka wka; wirK Ndjhg m;a fjkjdg ksoiqka tugh' jl=.vq krla jQ frda.Ska yg tla;rd wjia:djloS fuÜf*dñka ,ndoSu w;aysgqjhs' túg we;efula ys;kafk zzfuÜf*dñka yskao jl=.vq krla jqK ksid ;uhs fuÜf*dñka keje;ajQfhaZZ lshdh' fï zzfuÜf*dñka NS;sldjZZksid frda.Skag nrm;, w.;shla isÿjk neúka fuÜf*dñka iïnkaOfhka we;s ñ;Hd m%;sfrdaOh neyer úh hq;=uh' 88

MARCH 2018 | DOCTOR MAGAZINE

uykqjr uy frdayf,a jl=.vq frda. tallfha fcHaIaG f,aLldêldÍ ffjoH ffu;%S m%kdkaÿ doctormagazine.lk

eGFR w.h 45-30 w;r mrdihl ;sfnkjd kï l,ska fuÜf*dñka .;a; frda.Ska yg os.gu fuÜf*dñka .; yelshs' tfy;a Wmßuj .; hq;af;a ñ,s .a?ï 500 fm;s tl ne.ska ojilg fojrla muKs' fuysoS reêr iSks md,kfha wfmalaIs; b,lal lrd meñKSug fjk;a T!IO ,nd .ekSugo isÿ úh yel'

zzfuÜf*dñka î, jl=.vq krla fjkj'''ZZ lshk u;jdohla iudcfha ck.; ùfuka fndfyda frda.Ska oshjeähdjg ksis m%;sldr fkdf.k tajd nrm;, ;;a;ajhka lrd Tvq osùfuka wka; wirK Ndjhg m;a fjkjdg ksoiqka tugh' kuq;a fuÜf*dñka zzfojk wdldrfha oshjeähd frda.Skaf.a úYsYaG;u m<uq fm< T!IOhZZ (Metformin Remains Best First-line Therapy for Type 2 Diabetes)

nj Tn okakjdo @ doctormagazine.lk

eGFR w.h 45g jeä kï fojk

wdldrfha oshjeähdfjka fmf<kjd kï yd ia:q,;djho ;sfnk úg fuÜf*dñka kshñ; iïmQ¾K ud;%dj kshu lsÍu isÿ fõ' fuysoS kshñ; iïmQ¾K ud;%dj f,i ie<flkafka ojilg ñ,s .a?ï 2550ls' th ñ,s .a?ï 850 fm;a; osklg ;=ka j;djla lEfuka miq jYfhka ,nd.; yel' ^fuÜf*dñka ñ,s .a?ï 850 fm;a; rdcH wdfrda.HYd,d j, fkdue;'& m%dfhda.sl jYfhka .a?ï tlla''' tkï iq,n ñ,s .a?ï 500 fm;s folla osklg fojrla ne.ska lEug miq jYfhkao ,nd.; yel' w¿;skau T!IO wdrïN lrk frda.Ska iïnkaOfhka''' w¿;skau T!IO wdrïN lrk frda.Ska iïnkaOfhka mj;akd u;jdo folls' fuhska tla úoHd;aul u;jdohlg wkQj fuÜf*dñka tu frda.Skag ,ndoSula isÿ fkdflf¾' tfy;a wfkla u;jdoh fuÜf*dñka ;jÿrg;a ,ndoSu wffO¾h fkdlrk w;r Wmßuj fuÜf*dñka ñ,s .a?ï 500 ne.ska ojilg foj;djla muKla ,nd .ekSu ks¾foaY lrhs' ,xldfõ ffjoHjreka fï T!IO l<uKdlrk l%ufõo folu is;eÕs mßos isÿ lrKQ ,nhs' eGFR w.h 30g wvq kï fuÜf*dñka .ekSu k;r lsÍu wksjd¾h fjhs' kuq;a fuysoSo fuÜf*dñka k;r lrkafka thska jl=.vq j,g ydkshla isÿjk ksid fkdfõ' mj;sk ;;a;ajh u; fjk;a wjhj j, we;eï ixl+,;d we;s lsÍug fuÜf*dñka fya;= fõ hhs i<lñks' fï wkQj fuÜf*dñka lsis úfgl;a jl=.vq j,g i;=re T!IOhla fia ie<lSfï ñ;Hdfjka neyer úh hq;af;ah' ••• MARCH 2018 | DOCTOR MAGAZINE

89

KIDNEYS & WOMEN’S HEALTH:

oshjeähd frda.Skag fuÜf*dñka ,nd fok yeá

Èhjeähd frda.Ska i|yd

mdo id;a;=j Èhjeähd frda.Ska ;u fomd uqyqK jdf.a /l.kak

f;dr;=re iïmdol Y%S ,xld Èhjeähd ix.uh cd;sl Èhjeähd uOHia:dkh" rdc.sßh

Èkm;d Tfí fomd fyd¢ka mÍlaId lrkak' weÕs,slre" hám;=< wdÈh fjk;a flkl= ,jd mÍlaId lrjd .kak' 90

MARCH 2018 | DOCTOR MAGAZINE

doctormagazine.lk

Diabetic Neuropathy

Èhjeähd frda.Ska i|yd úfYaI mdo id;a;=jla wjYHjkafka wehs@ Diabetic neuropathy refers to the damage that affects the nerves of the body in people who have diabetes. It is a progressive disease, and symptoms worsen over a number of years. People who do not control their blood sugar levels and those who have high blood pressure, high blood cholesterol, or who are overweight are more susceptible. doctormagazine.lk

Èhjeähd frda.Skaf.a mdoj,g reêr iemhqu idudkHfhka wvq ksid" iq¿ ;=jd,hla jqKo we;eï úg iqj fkdjk ;;a;ajhla oelsh yelsh' iakdhq úkdY ùu ksid mdoj, ysßjeàu fya;=fjka mdoj, we;sjk ;=jd, ms<sn| oekSu wvq fõ' fï ksid hám;=,a jeks ia:dkj, we;súh yels lsishï ;=jd,hla jqjo Èhjeähd frda.shl=g fkdoekS nrm;, úh yelsh' fufia ;udg fkdoekS we;sjh yels ydksodhl ;;a;aj fudkjdo hkak fyd¢ka úuid ne,sh hq;= fõ'

MARCH 2018 | DOCTOR MAGAZINE

91

;=jd,hla we;s jQjfyd;a fyd¢ka fidaod msßiqÿ lr ffjoHjrhl=g fmkajk f;la msßiqÿ zf.daiaZ lene,a,lska jid ;nkak' lsisúfgl má t;Su" nekafâÊ lsÍu fyda ;ojk f,i ma,diag¾ fh§u fkdlrkak' fomd ueo WKqiï j;=f¾ fidaod úhf<kakg yßkak' .,a ;e¨ï" im;a;=j,g lemSï wdÈh ÈhmÜgd tau$,S fldagq lïì le,s jeks foaj,a wekSfuka

92

isÿjk ;=jd, weÕs,s lre w;r jkùu ^Èhñáhka lEu& ms<siaiqï ;=jd, we;eï ia:dkj, je§ mdo ;=jd, ùu ^.,auq,aj, mh je§u wdÈh ksid & kshfmd;= lmk úg ifï we;sjk lemSï $ iSßï jeks foaj,ska we;s jk ;=jd, wdÈh idudkHfhka we;sjk ydksodhl ;;a;ajhka fõ'

Èhjeähd frda.shl=f.a mdofha ;=jd,hla yg.;a úg l=ula isÿfõ o@ ;=jd,h isÿ jQ m%foaYhg reêr iemhqu iïmQ¾Kfhkau k;r ùu ksid ;=jd, m%foaYfha we;s mgl ñh hdug mgka .kS' tu ñh.sh mgl kej; m%lD;s ;;a;ajhg m;al< fkdyelshs' tneúka iqjùu m%udo fjhs' wjidkfha§ tu ñh .sh fldgia lmd bj;a lsÍug isÿfjk wjia:d we;'

MARCH 2018 | DOCTOR MAGAZINE

doctormagazine.lk

Èhjeähd frda.shl=f.a fomd /l n,d.; hq;af;a flfia o@

1

Èkm;d Tfí fomd fyd¢ka mÍlaId lrkak' weÕs,slre" hám;=< wdÈh fjk;a flkl= ,jd mÍlaId lrjd .kak' fkdfmfka kï fyda fkdyels kï lKakdähla bÈßfhka ;nd mÍlaId lr .; yelsh'

2

ifï j¾Kfha fjkila" bÈuqula" .,a;e¨ula ìì,la" me,a,ula" ;=jd,hla fyda we;sùfï i<l=Kla ^r;=ùula& fyda ÿgqúg jydu ffjoHjrhl=g fmkajd Wmfoia .kak'

3

l=vd ;=jd,hla fyda ;sfí kï fyd¢ka fidaod msßiqÿlr ffjoHjrhl=g fmkajk f;la msßiqÿ zf.daiaZ lene,a,lska jid ;nkak' lsisúfgl má t;Su" nekafâÊ lsÍu fyda ;ojk f,i ma,diag¾ fh§u fkdlrkak' fomd ueo WKqiï j;=f¾ fidaod úhf<kakg yßkak' weÕs,slre f;; ud;a;= lr ;nkak' l%Sïj¾. weÕs,slre w;r fkd.,ajkak'

4

kshfmd;= È.g jeùu lrkak tmd' kshfmd;= yria w;g fl,ska

doctormagazine.lk

wdrlaIs;j lmkak' fofl<jr iu we;=<g tfnk fia rjqï lr lemSu fkdlrkak' mdjyka fkdue;sj t<suyfka weúoSfuka j<lskak'

5

Èkm;d fïia m<£ kï msßisÿ lmqfïia muKla m<Èkak' b,diaála iys; fïi me<e£u whym;ah'

6

ks;r im;a;= m<§ kï mehlg follg jrla im;a;= fïia .,jd mdo ,sys,aj ;nd.kakg mqreÿ jkak'

7

wêl WKqiqï iy wêl YS;, u;=msgj, yd wdjrK fkdue;sj weú§fuka j<lskak'

8

ÿïîug mqreÿj isà kï wksjd¾hfhkau ÿïîu w;ayeÍu l< hq;=h'

9

fï whqßka Èhjeähd frda.shl=f.a fomd b;d m%fõiñka /l .ekSu l< hq;= fõ' Tyqg fyda wehg ta i|yd ;u mjqf,a idudðlhkf.ka fukau iudcfhkao ksn|ju w;ys; ,nd§u hq;=lula fukau uyÕ= mqKHl¾uhlao jkjd we;' ••• MARCH 2018 | DOCTOR MAGAZINE

93

fomhg wdrlaIdj" is;eÕs ú,dis;djkaf.ka'''' iEu ;;a m r 20lgu jrla f,da l fha fld;ekl fyda Èhjeähdj ks i d ll= , la lemS u g is ÿ fõ' Tn;a ta brKug f.dÿre fõo@ ls i s f ia ; a u ke;' fyd| foa ms < s m eoS f uka iy jeros foa u.yeÍfuka Tng fomd iq / ls h yels h ' Tfí fomd /l.ekS f ï j.lS u Tn i;= h ' wms tA i|yd Tng u. fmka j ka f kuq '

re( 999'90$- is g by<g f;da r d.;a

m% o ¾Ykd.drj,s k a ñ,§ .; yel'

)ks f rda . s mdjyka fm<" mdohka y s ;= j d, rys ; os h jeähd frda . S k a yg muKla iq ÿ iq fõ'

zzúIka flhdZZ whs la,sksla oeka .,alsiafia§'''

úis mia jirla mqrd Y%S ,xldfõ m%uqL;u oDIAÀ fiajd imhkakd jk zzúIka flhd Tmaál,a i¾úiiaZZ wdh;kh u.ska y÷kajd ÿka zzúIka flhd whs la,sksla oeka Y%S ,xldjdiS ieug úfYaI{ ffjoH fiajdjka iemhSug .,alsiai" wxl 102 orK ia:dkfha újD;j we;'

fuu idhk j,ska wkdjrKh lr.; yels ieÕù ;sfnk frda. fudkjdo@

fuysoS Y%S ,xldfõ úYsIAG;u úfYAI{ wlaIs ffjoHjrekaf.a yd iqÿiqlï ,;a oDIaÀ mÍlaIljrekaf.a fiajdj Tng ,nd.; yel'

fuu frda. y÷kd .ekSu;a iu. m%;sldr l%u wdrïN lsÍu fhda.H jk w;r we;eï frda. ;;a;aj ksid oDIaÀ mrdih wvqùu fukau we;eï úg fmkQu ke;s ùugo yelshdjla we;'

zzúIka flhd whs la,skslaZZ wdh;kh i;= iqúfYAIS fiajdjka ì|la

.aÆfldaudj hkq l=ulao@

• úfYAI{ wlaIs ffjoH idhkh • W.=r" lk kdih ms<sn|j úfYAI{ ffjoH idhkh • úfYAI wlaIs mÍlaIK • oshjeähd frda.S wlaIs ffjoH idhkh • l=vd orejka i|yd wlaIs ffjoH idhkh • wju oDIAÀl;ajh i|yd úfYAI WmlrK • f,ai¾ m%;sldr • Y%jK mÍlaIK (Hearing Tests/ Hearing Aids) • l:k Ñls;aidj (Speech Theraphy)

• .aÆfldaud (Glaucoma) • wefia iqo (Cataract) • oshjeähd iïnkaO wlaIs wdndO (Diabetic Retinopathy) • Macula Hole/ Macula Oedema

wefia we;sjk oDIAÀl iakdhqfõ ;ka;= úkdY ùfuka wkaONdjh olajd jHdma; jk frda. ;;a;ajhls' wefia mSvkh jeäùu fuysoS we;sjk tla idOlhls' .aÆfldaud ;;a;ajh uq,a wjia:dfõoSu y÷kd .eksu wefiys oDIaÀ mrdih wdrlaId lr .ekSug WmldÍ jkafkah'

.aÆfldaud ;;a;ajhg mdol úh yels wjodkï idOl • jhi wjq' 40g jeäùu • mjqf,a flfkl= .aÆfldaud ;;a;ajhg f.dÿre ù isàu • ÿr fkdfmkSu fkdfyd;a wú¥r oDIaÀl;ajfhka fmf<kafkl= ùu

• oS¾>ld,Skj iaàfrdhsv ldKAvfha T!IO Ndú;d lsÍu • wlaIs mSvkh (Eye Pressure) idudkH w.hg jvd jeä ùu ^20mmHg j,g jvd jeäùu& • oshjeähd frda.sfhl= ùu

wefia iqo hkq l=ulao@ wefia ldph mdrNdIs; ùfuka ta Tiafia wdf,dalh .uka lsÍfï yelshdj wju ùu wefia iqo we;sùu f,i y÷kajhs'

wefia iqo y÷kd.; yelafla flfiao@ • óÿulska jeiS we;s fia fmkSu • j¾K yªkd .ekSfï wmyiq;djh • weia fmkSu ;Sj%;djfhka wvqùu • wdf,dal ixfõoS;djh fjkia ùu

wefia iqo we;s úh yelafla flfiao@ • Wm;ska fyda ksoka.; frda.hla ksid • jhi wjq' 40 blauùu • mdrcïnQ, lsrK j,g ksrdjrKh ùu • oshjeähdj

Tomography) fuh wefiys isÿ lrk ialEka mrSlaIKhls' • Visual Field oDIAGs mrdih uekSfï mrSlaIKhhs' • IOP/l=KS;fha >klu uekSu zzúIka flhd whs la,skslaZZ u.ska f,ai¾ wdY%s; m%;sldro wdrïN lr we;s w;r úfYAI{ wlaIs ffjoHjrfhl= úiska tu mÍlaIK isÿ lrhs' oshjeähdj frda. fhka fmf<k mqoa.,hkag yd wefia iqo bj;a lsÍfuka miqj isÿ lrk m%;sldro fuu wdh;kfhka isÿlr .; yel'

fuu wlaIs fiajdjkag wu;rj zzúIka flhd whs la,skslaZZ ysoS ,nd.; yels wfkl=;a fiajdjka fudkjdo@ • W.=r" lk kdih ms<sn|j úfYAI{ ffjoH yuqj fuu ffjoH yuqj u.ska Tng lfka wdidok" Y%jKdndO" W.=r" lk yd kdih iïnkaO wdidok ;;a;ajhka yªkd.; yel' Tng wjYH Y%jK mÍlaIK fukau Y%jKdOdro fuysoS ,nd .ekSfï myiqlï we;' • l:k Ñls;aidj Speech Theraphy

• weig isÿjk wk;=re • we;eï T!IO j¾. Ndú;h ksid fuu frda. ;;a;ajhka l,ska y÷kd .ekSfuka wjodkï ;;a;ajhg m;aùu md,kh lr.; yels w;r fï i|yd kùk ;dlaIKfhka hqla; úfYaIs; WmlrK úIka flhd wdh;kh i;=j mj;S'

úúO frda. ;;a;aj yªkd .ekSu i|yd úIka flhd whs la,sksla wdh;kh i;= kùk ;dlaIKsl WmlrK u.ska isÿ lrk úfYaI mÍlaIK fudkjdo@ • OCT Scan (Optical Coherence 96

MARCH 2018 | DOCTOR MAGAZINE

l:k wmyiq;d we;s l=vd orejka ;reK yd jeäysá mqoa.,hka i|yd m%;sldr lrk w;r iakdhq frda.dndO u.ska we;sjk l:k wmyiq;d i|yd fuu.ska m%;sldr flf¾' fuu m%;sldr j,g wu;rj zzúIka flhd whs la,skslaZZ fj;ska fuu idhk j,g meñfKk mqoa.,hka i|yd idudkH wlaIs mÍlaIdjka isÿ lrk w;r weia lKakdä ñ,oS .kafka kï ta i|yd úfYAI jÜgï iys; ñ, .Kka wh flf¾'

jeäÿr úia;r i|yd wu;kak 011 2715161 ilia lf<A oDIaá úfYaI{ pq,x. fmf¾rd doctormagazine.lk

Laboratory Tests Explained

.%kaÓfha we;sjk frda. iy ta i|yd isÿ lrk reêr mÍlaIK iudf,dapkh

98

MARCH 2018 | DOCTOR MAGAZINE

doctormagazine.lk

TSH m%;sM< iudf,dapkh

wdisß ridhkd.dr fiajdfõ wOHlaI kS,a m%sh;a fcdaka úisks

;hsfrdhsâ .%kaÓh wdY%s; frda. j,g wod, reêr mÍlaIK iïnkaOfhka yd tajd weiqf¾ frda. ksOdk fiùu iïnkaOfhka f.k tk ,sms ud,dfõ fojekak fuhhs' ;hsfrdhsâ .%kaÓfha l%shdldß;ajh fukau ta iïnkaO reêr mÍlaIK iïnkaO uQ,sl yeoEÍula miq.sh l,dmfhka isÿ lrk ,o w;r fujr TSH, T3 yd T4 m%;sM< iudf,dapkh lrk wdldrh iïnkaOfhka úia;r lsßula isÿ flf¾' doctormagazine.lk

TSH mÍlaIKfha iïu; mrdih TSH mÍlaIKfha iïu; mrdih" tkï ksfrda.S mqoa.,fhl=f.a oelsh yels TSH mrdih 0.4 to 4.0 milli-international units per liter fõ' Tn oekgu;a ;hsfrdhsâ .%kaÓh wdY%h lr.;a frda.hlg m%;sldr ,nd .kafka kï fï w.hka 0.5 to 3.0 iSudfõ mj;ajd .ekSu iqÿiqh'

idudkH mrdih blaujd by< w.hka jd¾;d ùu fuu idudkH mrdih blaujd by< w.hka jd¾;d ùu ;hsfrdhsâ .%kaÓfha l%shdldß;ajh wvQ nj lshd mdhs' ;hsfrdhsâ .%kaÓh wvqfjka l%shd lrk úg ;hsfrdhsâ .%kaÓhg fydafudak jeäfhka ksIamdokh lsÍug rel=,a fokq msKsi msáhqgß .%kaÓh jeäfhka TSH fydafudak ksmojhs' idudkH mrdih blaujd my< w.hka jd¾;d ùu idudkH w.hg jvd wvq w.hla ,efnkafka ;hsfrdhsâ .%kaÓh wêl%shdldÍ jQ úgh' ;hsfrdhsâ .%kaÓh muK blaujQ l%shdldß;ajhl ksr; jk úg th wvqfjka W;af;ackh lrKQ msKsi TSH >%djh wvq lsÍu msáhqgß .%kaÓfha l%shdl,dmhhs'

T4 m%;sM< iudf,dapkh T4 hkq ;hsfrdhsâ .%kaÓfhka jEiafik m%Odk

fydafudakhhs' fuh iajNdjfhka fmrfudakhla jk w;r tkuqÿ tys we;af;a wju cSj l%shdldß;ajhls' T4 mÍlaIKfha iïu; mrdih jeäysá mqoa.,fhl=f.a ksfrda.S Total T4 w.hka 4.5 to 11.2

micrograms per deciliter (µg/dL). mrdihla .kS' free T4 hkqfjka lrk mÍlaIKfhaoS jeäysáfhl=f.a ksfrda.S Fre T4 mrdih 0.9 to 2.4 nanograms per deciliter (ng/dL) w;r w.hla .kS' TSH yS idudkH w.hg jvd wvq

w.hla ,efnkafka ;hsfrdhsâ .%kaÓh wêl%shdldÍ jQ úgh' ;hsfrdhsâ .%kaÓh muK blaujQ l%shdldß;ajhl ksr; jk úg th wvqfjka W;af;ackh lrKQ msKsi TSH >%djh wvq lsÍu msáhqgß .%kaÓfha l%shdl,dmhhs' MARCH 2018 | DOCTOR MAGAZINE

99

T4 mÍlaIKfha widudkH w.hka

,eîu fuysoS ,efnk widudkH w.hka weiqf¾ muKla lsishï frda. ks¾Khlg meñKSu l< fkdyel' ta i|yd T3 yd TSH hk mÍlaIK j, w.hkao iudf,dapkh l< hq;= fõ'

,eîu u; ;hsfrdhsâ .%kaÓh wdY%s; lsishï widudkH ;;a;ajhla we;ehs ks.ukh lsÍu l< fkdyelalls' mßiudma; újrKhla i|yd T4 yd TSH hk mÍlaIK j, w.hkao iudf,dapkh l< hq;= fõ'

T4 w.hka widudkH f,i by<

T3 mÍlaIKfha widudkH w.hka

kexùug fya;= jk ldrKd iuyrla • reêrfha úYd, jYfhka fm%daàk mej;Su • YÍr.; whäka ixhq;sh by< kexùu • ;hsfrdhsv fydafudak isrerg ,ndoSug isÿ lrk wê m%;sldr • Trophoblastic disease, a group of rare pregnancy-related tumors

• Germ cell tumors T4 w.hka widudkH f,i my< jeàug fya;= jk ldrKd iuyrla

• whäka W!K;djh" ukaofmdaIKh jeks fmdaIK W!K;d • YÍrfha fm%daàka uÜgu fjkia lrk m%;sldr • ;hsfrdhsâ .%kaÓfha wjl%shdldß;ajh • msáhqgß .%kaÓfha widudkH ;;a;ajhla • lsishï wikSm ;;a;ajhlska fm<Su

T3 m%;sM< iudf,dapkh T3 mÍlaIKfha iïu; mrdih

jeäysá mqoa.,fhl=f.a ksfrda.S T3 w.hka 100 to 200 nanograms per deciliter (ng/dL) mrdihla .kS' fuu mÍlaIKh iïnkaOfhkao idudkH w.hka ,eîu u; ;hsfrdhsâ .%kaÓfha widudkH;djhla ke;ehs ks.ukh lsÍu fyda widudkH w.hka 100 MARCH 2018 | DOCTOR MAGAZINE

,eîu fuysoS ,efnk widudkH w.hka weiqf¾ muKla lsishï frda. ks¾Khlg meñKSu l< fkdyel' ta i|yd T4 yd TSH hk mÍlaIK j, w.hkao iudf,dapkh l< hq;= fõ'

T3 w.hka widudkH f,i by<

kexùug fya;= jk ldrKd iuyrla • f.%aõiaf.a frda.h • ;hsfrdhsâ .%ka:sfha wêl%shdldß;ajh • Thyrotoxic periodic paralysis • Toxic nodular goiter

T3 w.hka widudkH f,i wvq ùug

fya;= jk ldrKd iuyrla

• ydu;aj isàu ksido ;hsfrdhsâ .%kaÓfha wjl%shdldß;ajh ksido idudkHhg jvd wvq T3 w.hka ,eîug fya;= fõ' • tfiau wikSmhlska oS¾>ld,Skj mSvd ú|sk úgo fuf,i wvq T3 w.hka jd¾;d ùug bv ;sfí'

;hsfrdhsâ mÍlaIK jd¾;d iudf,dapkfhys,d bjy,a jk ud¾f.damfoaYK iïnkaOfhka yd ;hsfrdhsv frda. yd ridhkd.dr reêr mÍlaIK j,ska widudkH w.hka ,eîug n,mdk lreKQ we;=<;a fuu ,sms ud,dfõ wjika fldgi ,nk l,dmfhka n,dfmdfrd;a;= jkak'

•••

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How to Use a Glucosemeter

.a¨fldógrhla ksjerosj Ndú;d lrkafka fufyuhs .a¨fldógrhla ksfjfia ;nd .ekSu oshjeähd frda.sfhl=g w;sYhska jeo.;a jkafka wehs@

ffjoH m¾fhaIKd.dr ld¾ñl úoHd{ chka; úfcaùr úisks

102 MARCH 2018 | DOCTOR MAGAZINE

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´kEu flfkl=f.a reêrfha iSks m%udKh .;af;d;a ojfia úúO wjia:d j,oS th úúO w.hka .kshs' wdydrhla .;a miq th jeä fjk w;r bkamiq l%ufhka wvq fjhs' oshjeähd frda.sfhl=f.a reêr iSks w.hka .;a l< Tyqf.a reêrfha ;sfnk iSks m%udKh wka whg jvd jeäh' frda.fhka nrm;, f,i mSvd ú|sk whf.a fuu w.hka wjodkï iy.; uÜgulg jQj jeä úh yel' úfgl tu iSks w.hka b;d wvq w.hka j,g my; jeàuo oshjeähd frda.sfhl= flfrka oelsh yels wjodkï l%shdldß;ajhls' fuho b;d wjodku iy.;h' fï wdldrfhka jeäfhka reêrfha iSks uÜgu by< hdu" wk;=reodhl uÜgug th my; jeàu oshjeähd frda.fha iajNdjhhs' doctormagazine.lk

fï whf.a oshjeähd frda.h l<uKdlrKh hkq yqfola ys;lr uggul reër iSks w.hka mj;ajd .ekSu ñi wka fohla fkdfõ' fjfiiskau fï i|yd Tyqf.a reêrfha iSks ^.aÆfldaia& w.hka ksn|ju mÍlaIdlsÍu l< hq;af;ah' reêr idïm,hla ,ndf.k th ridhkd.drfhaoS mÍlaId lsÍfï iïm%odhg kj fjkila tla lf<a .aÆfldaógrhhs' .aÆfldaógrh ksid oshjeähd frda.sfhl=g ksfjfia isgu ;ukaf.a reêr iSks m%udKfha wvq jeäùï iïnkaOfhka wjfndaOhla ,nd .ekSug yels jk w;r th frda.shdg we;súh yels wjodku iy.; wjia:djka u. yerùug;a" frda.h ksishdldrfhka l<uKdlrKh lsÍug;a uy;a msgqjy,la jkq we;' .aÆfldógrh weiqre lrf.k reêrfha iSks m%udKh ueksu i|yd wjYHfhkau Wmldß jk ud¾f.damfoaYKhla iemhSu fï ,smsfha wruqK fjhs'

.aÆfldógrhla Ndú;hg .ekSfïoS Tng wjYH jk øjH • .a¨fldógrh • Lancet fkdfyd;a weÕs,a, isÿre lsÍug fhdod .kakd ishqï lgqj fh¥ lancing device tlla • mÍlaIK ;Sre (Test strips) • weÕs,a, msßisÿ lsÍug we,afldfyd,a fh¥ ^i¾csl,a iam%S;=& mq¿ka lene,a,la • mdGdxl igyka ;eîug mEkla" lvodishla'

.a¨fldógrhla ksjerosj Ndú;d lrk wdldrh

1

uq,skau Tfí oE;a fyd|ska fidaod .kak' bka miqj .a¨fldógrh mfilska ;nd .kak' .a¨fldógrh" ,ekaiÜ tl" mÍlaIK ;Sre tla ;ekl' i¾csl,a iam%S;=" mq¿ka lene,a,la fjku mfil'''' ia:dk.; lr.kak'

2

idudkHfhka f,a .; hq;af;a wvqfjka ixfõoS ia:dkhlsks' jvd;a iqÿiq weÕs,a,l ;=vqjhs' weÕs,s ;=vqfjka f,a .ekSu myiq jk msKsi tu MARCH 2018 | DOCTOR MAGAZINE 103

w

eÕs,s ;=vmsßuoskak" WKqiqï lrkak' WKQ j;=r n÷kl weÕs,a, .s,ajd ;eîfukao tlS ia:dkfha reêr ixirkh iqug fjhs'

.a¨fldógrhla Ndú;fhaoS ie<lsh hq;= lreKq

oeka ksjeros osYdjg ^Tng myiq lrKq msKsi fï i|yd ud¾f.damfoaYK B ysia rEml .a¨fldógrfha fukau mÍlaIK ;Srefõo we;'& mÍlaIK ;Srej .a¨fldógrhg we;=,a lrkak' túg .a¨fldógrh iajhxl%Shju n,.ekafõ'

Tfí .a¨fldógrhg wjYH úfgl m%fhdackhg .; yels jk fia wu;r negß lÜg,hla <Õ ;nd .kak'

Tn m%fhdackhg .kakd mÍlaIK ;Sre l,a bl=;a jQ tajd fkdúh hq;=h' l,a bl=;a jQ mÍlaIK ;Sre j,ska ksjeros mdGdxl ,efnkafka ke;'

4

.a¨fldógrh n,.ekaùfuka miq iSreudre ùï wjidkfha f,a mÍlaIKhg .a¨fldógrh iQodkï nj oelafjhs' ^th f,a ìxÿjla ;srfha osiaùfuka m%lg lrhs'&

mÍlaIK ;Srejla n÷fkka bj;a l< iekska uQäh jid oukak' fiiq ;Sre ysre t<shg" f;;ukhg ksrdjrKh ùfuka ydkshg m;a úh yel'

5

Lancet úúO f.aca j,ska ñ,oS .; yel' jeä w.hla .kafka isyska lgqh' 21 f.ach iys; lgqjlska úoSu 30 f.ach iys; lgqjlska úoskjdg jvd fõokdldÍh'

Lancet tl iug ls|d nysk .eUqr wkQj wxlkh lr ;sfí' 1 yd 2 wxl wvq .eUqrla iug we;s lrk iSreudrejhs' th fkdiEfya kï muKla Bg jeä wxl j,g lancing device tl iSre udre lr .kak'

3

oeka weÕs,s ;=v ,ekaigfhka isÿre lrkak' túg reêr ì÷jla u;= fjhs' f,a ì÷j iam¾Y fkdjk fia wjg iu iSrejg ñßlSfuka msg;g mksk f,a Odß;dj jeä lr.; yel'

6

f,a ì÷j ksjerosj mÍlaIK ;Srefõ ixfõoS fmfoig <x lsÍfuka miq f,a wjYH m%udKhg mÍlaIK ;Srejg pQIKh fjhs' ^weo .kshs'&

7

bka miqj ksfïIhlska mdGdxlh ;srfha osia fjhs' l%shdj,sh kshñ; wdldrhg isÿ fkdjQfjd;a fuu mdGdxlh ,efnkafka ke;'

8 9

bkamiq mq¿ka lene,a,la iu isÿre l< ia:dkfha ;nkak'

,efnk mdGdxlh oskh fhdod igyka lr.kak'

bj;,k lancing lgq yd mÍlaIK ;Sre m%fõYfuka je<,Sug lghq;= fhdokak'

Tfí .a¨fldógrh mÍlaIK ;Sre wdosh msßisÿ úh<s ia:dkhl ;nkak'

fu mdGdxl osk jYfhka ;nd Tfí ó<Õ ffjoH yuqfõoS ffjoHjrhdg fmkajkak' ••• 104 MARCH 2018 | DOCTOR MAGAZINE

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fyd| m,;=re y÷kd .kafk fldfyduo@ kejqï m,;=re .=Kfhka fukau wdrlaIdfjkao msßmqkah''' Why Fruits and Vegetables are Vital?

Eating a diet rich in fruits is important for good health. Find out why experts say it contains better nutrients than supplements.

106 MARCH 2018 | DOCTOR MAGAZINE

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Y%S ,xld uyck fi!LH mÍlaIljrekaf.a ix.ufha iNdm;s .euqKq id,sh fmf¾rd

hula ÿ,n nj mejiSug wfma ck jyf¾ fhfokafka" zzl¿ ksl fidhkjdg jvd wmyiq'''ZZ njh' wo ji úfika f;dr m,;=rla fjf<| fmdf<ka ñ,§ .ekSu o t;rï u wmyiqh' fldhs ljqre;a m,;=re wkqNj lrkafka" úfkdaohg fyda l=i.skakg fkdfõ' tys we;s uyÕ= fmdaIŒh yd T!Iëh .=Kh ksidh'

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fjf<| fmdf<ka ñ,§ .; yels ridhksl øjH fh¥" lD;%su boùug ,la fkdjk m,;=rla f,i me‚ flduvq i|yka l< yels h' tys r;a meyehg fya;= jk ,hsfldîka kue;s Ydl ridhkh" isrerg b;d ys;lrh' tfia kï mj;sk fjf<|fmd< jd;djrKh yuqfõ" fï wNsfhda.h ch .kafka flfiao@ ta i|yd we;s fyd|u úie÷u" m<;=re jdrhg tajd nyq,j wdydrhg .ekSuh' wU jdrfha§ wU jeäfhka .; yelsh' kdrx furg jjk fodvx" cukdrx we;=¿ meÕsß l=,fha m,;=re jdrfhaoS wkqNj l< yelsh' m<;=re w;sßla;hla mj;sk úg" lD;%su bojQ m,;=re úlsŒula fkdjk ksid" lD;%su ridhksl øjH wju m,;=re ñ,§ .ekSug m<;=re jdrh fyd| wjia:djls' fndfyda úg wm m,;=rla .ekSfï§ wjOdkh fhduq lrkafka" ridhksl øjH fhdod bojQ tajdo hkak ms<sn|h' tajd YÍr.;ùfuka jk ydksh .ekh' tfy;a" m,;=rl T!Iëh .=Kd;aul jákdlu by< hkafka" th iajNdúlj b§ug ,la lsÍfuks' ffcj ridhksl l%shdj,shla uÕska bfok m,;=rl we;s .=Kh" laI‚lj lD;%su f,i boùug ,la lrk m,;=rl oelsh fkdyelsh' ta fjkqjg tys wka;¾.; jkafka" YÍrhg wys;lr njls' fndfyda fokd fkdi,ld yßk ldrKh o thh' fï i|yd wmg wkq.ukh l< yels fyd|u úl,amh" fjf<|fmdf<a we;s bÿKq m,;=re ñ,§

MARCH 2018 | DOCTOR MAGAZINE 107

m,;=rla hkq" úYd, T!Iëh .nvdjls' isref¾ kSfrda.S njg fya;= jk T!Iëh .=K fndfydu by<ska m,;=rej, wka;¾.; fõ' tfiau" úúO frda.dndO i|yd ÈjHuh Tiq fia .=K m,;=re o we;' .ekSu fjkqjg" fyd¢ka fudard" meiqKq ;;a;ajfha we;s m,;=re ksfjig /f.k hEu h' túg laI‚l lD;%su b§ulg ,la fkdjk ksid" l%udkql+,j bÿKq miq wdydrhg .ekSfuka" Tn n,dfmdfrd;a;= jk T!Iëh yd fmdaIŒh .=Kh ,efí' m,;=rla hkq" úYd, T!Iëh .nvdjls' isref¾ kSfrda.S njg fya;= jk T!Iëh .=K fndfydu by<ska m,;=rej, wka;¾.; fõ' tfiau" úúO frda.dndO i|yd ÈjHuh Tiq fia .=K m,;=re o we;' fjf<| fmdf<ka ñ,§ .; yels ridhksl øjH fh¥" lD;%su boùug ,la fkdjk m,;=rla f,i me‚ flduvq i|yka l< yels h' tys r;a meyehg fya;= jk ,hsfldîka kue;s Ydl ridhkh" isrerg b;d ys;lrh' th ms<sld" yoj;a frda. we;=¿ fndfyda frda.dndOj,g .=K fok T!Iëh .=Kfhka by< h' ;lald,s" r;= meye fmar" .ia,nq wdÈfhys o fï ,hsfldìka iy úgñka" m%Odk úgñka j¾. úYd, m%udKhla wka;¾.;j we;' Tn fj<| fmdf<ka uqo,a f.jd ,nd .kakd lD;%su ridhksl wvx.= lsf,da fmarj,g jvd" 108 MARCH 2018 | DOCTOR MAGAZINE

.fï t<j¿ wïud <Õ we;s" tfjf,au fk<d.;a fmar f.ähla .=Kodhlh' ´kEu m,;=rla .=Kh jvd jeäfhka ,efnkafka" th fk<d.;a fudfydf;a kejqïj wkqNj lrk úgh' ld,h .;ù mrK ùu;a iuÕ" fmdaIŒh yd T!Ië .=Kh l%u l%ufhka my< jefÜ' iqmsß fjf<|ie,aj,ska wm fndfydaúg ñ,§ .kafka wem,a" fmhd¾ia" ñÈ" fodvï wdÈhhs' tfy;a" tu m,;=re wjuj Ndú; lrñka" lD;%su ji úfika f;dr njg úYajdifhka Ndú; l< yels mefmd,a" Èjq,a" fn,s" fjr¿" W.=/iai wd§ wfma .y fldf<a yefok m,;=re yels ;rï wkqNjhg yqre fjkjd kï" th kSfrda.S Èú fmfj;lg uÕ mdohs' wU" mefmd,a jeks ly j¾Kfhka hq;= m,;=rej, nyq,j wvx.= îgd lefrdáka ¨Üka kï ta úgñka h' m%fNaohka iug b;d ys;lrj l%shd lrhs' /<s jeàu wju lrñka" ifï meyeh /l fohs' lgq wfkdaod" uq;%d .,a" .eiag%hsáia" jl=.vq frda. wdÈh i|yd b;d ys;lrh' f,dú" cïnq wdÈh" b;d úYsIag .=Kfhka wkQk m,;=reh' tajd nyq,j we;s wjia:dj,§ pÜks iE§u" jHdxck f,i wdydrhg .ekSu l< yelsh' miq.sh ld,fha§ hdmkfha ñÈj,g by< b,a¨ula we;sjQ miq" b,a¨ug wjeis iemehqu fjkqfjka ridhksl øjH fndfyda fia fh§h' tfiau" foys wjdrfha§ .eg foysj,g t;%,a fhdod ly meye fldg úl=Khs' je,afodvï wjdrfha§ o ta wdldrfhka u lD;%suj .eg ly meye .kajd úl=Khs' fï ksid" fjf<|fmdf<ka m,;=re ñ,§ .kakd Tn" fï lreKq .ek oekqïj;a úh hq;=uh' ••• doctormagazine.lk

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,xld fydiamsÜ,aia mßY%h ;=<u msysgd we;s mQ¾K myiqlï iys; yoj;a frda. m%;sldr uOHia:dkh yDo frda. /ilg wod< m%;sl¾u yd ie;alï isÿlrhs' Èjhsfka m%uqL;u ffjoHjrekaf.a u.fmkaùu hgf;a" iykodhS .dia;= iu.ska úYsIag;u m%;sldr fiajdjka ,nd§u fuu uOHia:dkfha úfYaI;ajh fõ'

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fuu ;;a;ajhg ms<shula jYfhka rcfha fiajlhkag rcfha frday,a j, fmdfrd;a;= f,aLk j, /£ isàfuka f;drj fm!oa.,sl frday,a j,ska wod< ie;alï lrjd .ekSug w;aje,la ùu i|yd cd;sl rlaIK Ndr wruqo, Tiafia w.%ydr rlaIK l%uh y÷kajd §ug rch lghq;= lr ;sfí' fuu miqìu hgf;a Y%S ,xldfõ m%:u jrg w.%ydr rlaIK ysñ mqoa.,hkag yoj;a nhsmdia ie;alï i|yd ia:djr .dia;= l%uhla y÷kajd §ug ,xld fydiamsÜ,aia lghq;= lf<ah'

rcfha fiajlhkag w.%ydr rlaIK l%uh hgf;a iyk ie,iSu i|yd cd;sl rlaIK Ndr wruqo, iu. w;aje,a ne|.ekSug ,xld fydiamsÜ,aia óg jir 8 lg fmro lghq;= l< w;r tf,i tu wruqo, iu. yjq,aldß;ajhlg t<UqKq m%:u fm!oa.,sl frday,o ,xld fydiamsÜ,aia úh' rcfha jevigyka i|yd m%uqL;u f;aÍula jQ ,xld fydiamsÜ,aia w.%ydr rlaIK ysñhka fjkqfjka úfYaI fi!LH fiajdjka rdYshla oekgu;a y÷kajd § we;s w;r uE;l§ Tjqka fjkqfjka LASIK wlaIs ie;alï iy wefia iqo bj;a lsÍfï ie;alï fjkqfjka úfYaI l%ufõohla y÷kajd §ugo lghq;= lr ;sfí' • • • MARCH 2018 | DOCTOR MAGAZINE 109

Things Your Eyes Are Trying to Tell You About Your Health 1

PERMANENT STY Based on materials from dailyhealthpost

If you’ve ever had a sty, you know the pain and irritation it causes. A lump on the eyelid appears due to a blocked sebaceous gland and usually goes away within a few days, but it may persist, causing serious inconveniences.

If a sty pops up often or persists for a long time, it can be a symptom of sebaceous gland carcinoma. If you notice that it doesn’t heal or appears in the same place, it’s time to visit a doctor.

110 MARCH 2018 | DOCTOR MAGAZINE

We are decided to share these observations with you doctormagazine.lk

An old saying claims that the eyes are the windows of the soul. No one knows where this phrase came from, but nevertheless today we know for sure that eyes can tell a lot about us and show our health condition

2

EYEBROW LOSS

There are lots of reasons for eyebrow loss: aging, stress, or nutrient deficiency. Alopecia areata, or spot baldness, can be another reason, though it affects no more than 0.1% of the population.

A more plausible reason for eyebrow loss is hypothyroidism â&#x20AC;&#x201D; an acute shortage of thyroid hormones that in extreme cases can lead to hair loss.

So if your hair is thinning, itâ&#x20AC;&#x2122;s better to visit your doctor and check the state of your thyroid gland. doctormagazine.lk

MARCH 2018 | DOCTOR MAGAZINE 111

3

BLURRED VISION

It’s always frightening to notice a blind spot in your vision. This may pretty often point at a migraine with aura, especially if the picture you get is accompanied by sparkling dots or wavy lines. Typically, blind spots go together with headaches.

Many of us spend hours on computers at home or at work, which causes burning eyes or blurred vision. Nowadays this situation occurs so often that there’s a special term in medical practice that describes vision problems connected with prolonged computer, cell phone, or e-book use: “digital eye strain“ or ”dry eye syndrome." If you recognize these symptoms, discuss with your doctor the ways to solve this problem.

4

BLIND SPOTS

If such symptoms sound even too familiar to you, call your doctor to learn what triggers the problem.

5

BULGING EYES

We have all had times when our eyes seemed to betray us. We rub them or blink several times, and our vision seems to become clear again. But if you constantly feel some sort of expansion in your eyes, it can be a symptom of thyroid (or Graves) eye disease. It means your thyroid is overactive.

Difficulties closing the eyes is one of the symptoms which can make the eyes appear to bulge. It occurs in 30% of cases, so if you see something like that, call your doctor immediately.

112 MARCH 2018 | DOCTOR MAGAZINE

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6

YELLOW WHITES

Every day we spend time looking in the mirror, so it’s unlikely we can miss this problem.

Both adults and newborns with undeveloped liver function may face jaundice. It may also be connected with the state of a gallbladder or bile ducts. So if you see your whites becoming yellow, don’t ignore it — rush to find the reason.

People with diabetes have to pay special attention to their health, and vision is one of the things they keep tabs on. One such problem is diabetic retinopathy — a state caused by damage to blood vessels in the photosensitive retina tissue.

It may be the reason of "cloudy" vision. This problem should be taken seriously: one should contact a specialist at the onset of symptoms.

8

7

CLOUDY VISION WITH DIABETES

IMPAIRED OR CLOUDY VISION, VISION LOSS Any vision change is an alarm bell that requires an instant response.

And if you notice your vision suddenly impaired, clouded, or even disappearing for a moment, seek medical help immediately because these symptoms are often the first signs of a stroke.

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MARCH 2018 | DOCTOR MAGAZINE 113

Co-operate Health News

Nawaloka Hospitals installs second MRI scanner

A comprehensive extended service from the Radiology Department first time in Sri Lanka Sri Lankaâ&#x20AC;&#x2122;s pioneer private healthcare provider, Nawaloka Hospitals recently installed the second MRI scanner to offer more accurate and efficient diagnostic and imaging services which will avoid waiting times for their patients.

delivering facility for a reasonable cost, e-mailing reports to patients, special patient care within the department whilst offering a homely atmosphere and less time for examinations.

Diagnostic imaging is central to disease management because it helps to detect and determine treatment. In that regard, Nawaloka Hospital has invested substantially in upgrading its radiology facilities, staying true to their pledge towards ensuring a healthier Sri Lanka.

Another first, Nawaloka Hospitals has implemented a Picture Archiving and Communication System (PACS) at the Radiology Unit installing workstations for every scan room and connecting all modalities (MRI/ CT/XRay/Ultra-Sound/Mammogram) to the system to make all reports centrally accessible to consultants.

This allows radiologists to prepare a more comprehensive report referring to patientsâ&#x20AC;&#x2122; history which makes detection and treatment of conditions increasingly easy.

The Radiology Department offers some special benefits like report

With the implementation of the new system, the number of films has been

114 MARCH 2018 | DOCTOR MAGAZINE

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minimized and in future, Nawaloka Hospitals radiology department will issue a CD for every patient in a bid to go completely paperless.

Each radiologist has been issued an e-signature and they are able to do remote-reporting, another first in Sri Lanka, by using the PACS as a platform.

The hospital preserves scanned details of every patient up to five years and these records are accessible by ICUs, Medical Officers and consultants via any authorized computer. Patients also have the option of getting their reports emailed to them and relevant consultants at no extra cost.

Durdans Hospital laboratory network offers high convenience and reliability Medical laboratory investigations guide clinicians in their diagnosis were accurate, reliable and timely reports with quality checking are sought after by all. With a history of over two decades in medical laboratory diagnostics, Durdans Laboratory comprises an established network of over 55 Durdans owned locations and over 2,500 partner collection centers island-wide, dedicated to supporting medical specialists and patients with convenience.

Dedicated to serving patients with care and promptness, medical laboratory technicians and support staff work around the clock to collect, transport, analyze and report results under the guidance and scrutiny of an eminent panel of a consultant pathologist. Furthermore, Durdans Laboratory further enhances convenience and patient care by enabling mobile sample collection service in most parts of Sri Lanka. doctormagazine.lk

“We have a panel of over 700 laboratory investigations in the areas of Biochemistry, Heamatology, Clinical Pathology, Immunology, Special Chemistry, Microbiology, Histopathology and Molecular Biology and are committed to constantly introduce new investigations that support the areas of preventive and curative medicine,” says Mahanil Perera, Head of Laboratory.

Furthermore, high safety and quality standards are maintained by Durdans Laboratory; evidently being awarded the Gold Seal of Approval by Joint Commission International (JCI) by the world’s leading accreditation organization based in the US. In addition, Durdans Laboratory has ISO 15189 accreditation by the Sri Lanka Accreditation Board (SLAB) for Conformity Assessment which is the National Accreditation Authority for Sri Lanka.

MARCH 2018 | DOCTOR MAGAZINE 115

Kiddies & Toys International (KTI) opens Farlin Baby Store at Ninewells Hospital

Kiddies & Toys International (KTI), Sri Lanka’s leading distributor of premium mother and childcare brands, in partnership with Ninewells Hospital recently unveiled their latest showroom Farlin Baby Store by Cool Kidz at the hospital for easy access by new families.

Designed specifically to meet the needs of pregnant mothers and infants, the exclusive showroom brings together an exceptional range

of products from premium brands like Farlin, Chicco, Leap Frog, and Fisher price as well as the company’s own Kids Joy. Founded in 2005, Ninewells Hospital is a pioneering maternity and child health hospital that provides their patients with comprehensive care including fertility services ranging from counseling, ongoing antenatal services to labour and delivery, surgery and critical care services. • • •

Henrietta Fore becomes new UNICEF Executive Director 116 MARCH 2018 | DOCTOR MAGAZINE

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Henrietta Fore has taken office as UNICEF’s seventh Executive Director. Fore brings to the role more than four decades of private and public sector leadership experience.

“I am honored to be joining such a remarkable organization, which I have known and admired for many years, and look forward to continuing UNICEF’s work to help save children’s lives, fight for their rights and help them realize their potential,” Fore said.

United Nations Secretary-General Antonio Guterres appointed Fore as UNICEF Executive Director after consultation with UNICEF’s governing board.

Fore has a Bachelor of Arts in History from Wellesley College and a Master of Science in Public Administration from the University of Northern Colorado. She is married and has four children. Fore official took up office on 1 January 2018.

•••

Canada announces support to UNFPA for promotion of sexual and reproductive health and rights in Sri Lanka High Commissioner of Canada to Sri Lanka, David McKinnon, announced a Government of Canada contribution of CAD$900,000 to the United Nations Population Fund (UNFPASri Lanka) to help address sexual and gender-based violence in Sri Lanka.

Canada’s CAD$900,000 contribution to UNFPA through 2020 will strengthen the capacity of the Sri Lankan Ministry of Women and Child Affairs (MWCA) and other relevant government departments to address sexual and gender-based violence (SGBV).

Speaking about the project, UNFPA Representative Ritsu Nacken stated that, “We will work closely with doctormagazine.lk

the Ministry of Women and Child Affairs, other public institutions, and Civil Society Organisations, to ensure the rights of women and girls are upheld in Sri Lanka.

UNFPA is the UN’s lead agency towards promoting sexual reproductive health and reproductive rights, and in addressing sexual gender based ••• violence.

MARCH 2018 | DOCTOR MAGAZINE 117

VELONA CUDDLES WET WIPES

fjf<fmdf,a we;s fíì fjÜ jhsmaia yd VELONA CUDDLES WET WIPES

w;r we;s fjfki yd Wet wipes ksIamdokhka ñ,§ .ekSfï§ Tn ie,ls,su;a úh hq;= lreKq lsysmhla ms,snoj wms idlÉPd lsÍug leue;af;uq' Wet wipes ksIamdok u.ska Rcqju orejdf.a iu u;=msg iam¾I lrk fyhska .=K;ajfhka nd, ksIamdok Ndú;d lsÍu ;=<ska orejdg úh yels ydksh b;d nrm;,h' tau ksid Tn ksIamdokhla ñ,§ .ekSfï§ ;;ajfhka Wiia yd ms<s.; yels ksIamdolfhla úiska bÈßm;a lrk ksIamdokhla ñ,§ .ekSu b;d jeo.;a fõ'fuys§ ksIamdolhdf.ka f;dr;=re úuiSfï yelshdj b;d jeo.;a fõ ' 118 MARCH 2018 | DOCTOR MAGAZINE

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VELONA CUDDLES WET WIPES ksIamdokfha we;s úfYaIdx. lsysmhla wms i,ld n,uq' CAMMOMILE EXTRACT • Cammomile hkq T!I§h .=Khla we;s u,lska .kakd idrhls' •

fuu.ska iu u;=msg we;s jk wdi;añl;djka u. yrjd .ekSug yd iu isksÿ lsÍfï yelshdjo we;'

•

l=vd orejkaf.a iu u;= msg we;s jk r;= ,m md,kh lsÍugo Cammomile idrh b;d fhda.H fõ'

•

ixfõ§ ì,sÿ iu wdrlaId lsÍu ioyd Cammomile b;d fhda.H T!Iohla fõ'

Cammomile idrh iys; ksIamdok Ndú;d lsÍu ;=<ska orejdf.a iu u;=msg we;sjk wdid;añl;djhka md,kh lr .ekSug yels fõ'

fldaudßld iy úgñka E fldaudßld fldaudßld u.ska iu u;=msg we;sjk nelaàßhd yd úIîc md,kh lsÍu ioyd Wmfhda.S fõ' fuh úfYaIhka <ore ifï we;s jk wdid;añl;djhka j<lajd .ekSug Ndú;d lrhs'

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úgñka E úgñka E u.ska orejdf.a iu úh<Su iy iu u;=msg wdid;añl;d we;s ùu j<lajd .kS' tfukau iu fmdaIKh lsÍu ioydo fnfyúka WmldÍ fõ'

uoHidr ^Alcohol Free& iqjo ú,jqka ioyd Ndú;d lrk we,afldfyd,a uoHidrh ì,sÿ iug b;d wys;lr ridhksl øjHla jk w;r tu.ska iu u;=msg úúO wdid;añl;djka we;s lrhs'tu ;;ajh u. yrjd .ekSug fjf,dkd lâ,aia Wet wipes ioyd uoHidrh rys;j ksIamdokh lr we;'

i;a jrla msßisÿ lrk ,o c,h Wet wipes ksIamdok j, we;s m%odk;u wuqøjHla jk c,h u.ska úúO wid;añl;djhka we;s ùug bv we;' úfYaIfhkau c,h iu. yg.kakd mqia ^Fungus& we;s ùfï wjOdkula we;' tu.ska isÿ úh yels ydksh u. yrjd .ekSu ioyd wm ksIamdok j, Ndú;d lr we;s c,h úfYaIs; msßisÿ lrk l%uhla u.ska i;a j;djla msßisÿ lr we;' tu.ska c,fha we;s wkjYH nelaàßhd yd ,jK j¾. bj;a lr m%Yia; PH w.hla mj;ajd .ekSug;a" tu.ska we;s úh yels wid;añl;djhka j,lajd .ekSug;a jkq we;' ••• MARCH 2018 | DOCTOR MAGAZINE 119

Caring for someone with a mental health disorder

udkisl frda.sfhl=

/l n,d.kakd yeá ldr ,enqjfyd;a ´kEu udkisl frda.sfhl=g idudkH yd M,odhS Ôú;hla .; l< yelshs ufkda úfYaI{ ffjoH .dñKS chj¾Ok ffjoH fkú,a m%kdkaÿ frday, ud,fí

ilia lf<a fyo ks,OdÍ ixch o is,ajd Bachelor of Nursing (Malaysia MBBS, MD ( Psychiatry) Diploma in Psychology (SL) 120 MARCH 2018 | DOCTOR MAGAZINE

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iudch úiska idudkH hhs ms<s.;a yeisÍug jvd fjkia p¾hdjka we;s ùu mdol lr.;a frda. iuQyhla wm udkisl frda. jYfhka y÷kajuq' udkisl frda. wm ys;kjdg jvd wm ck iudch w;r mj;S' tajd mq¿ jmißhlao .kS' we;eï ;;a;aj w;sYhska fkdie<lsh yels ;rïh' jvd;a ie<ls,a,''' fjfiikau ksjeros ud¾f.damfoaYK m%;sldr ,eìh hq;= ;;a;ajo ke;sjd fkdfõ''' doctormagazine.lk

udkisl frda. hkq ukqIHfhl=g je<f|k Èhjeähdj, wêreêr mSvkhjeks jq ;j;a frda. ldKavhls' fjki jkafka wfkl=;a frda. j,ska lhg n,mEï lsÍu;a udkisl frda. j,ska ukig n,mEï lsÍu;ah' ´kEu udkisl frda.sfhl=g idudkH yd M,odhS Ôú;hla .; l< yels nj w;r ta i|yd ksis mßÈ frda.shd / ln,d .ekSu yd ksis fyo id;a;=j o thg we;=<;ah' udkisl frda.sfhl= /ln,d .ekSfï§ jeo.;a jk lreKq ms<sn|j iïnkaOfhka Tnj oeKQj;a lrKQ msKsi bosßm;a lrk ,smsfha m<uq fldgi miq.sh l,dmfha m< flßK' fï tys wjika fldgihs' udkisl frda.sfhl= /ln,d .ekSfï§ jeo.;a jk miq.sh l,dmfha iúia;rd;aulj meyeos,s l< lreKQ

.shd uekúka f;areï 1 frda .kak Tyqg wjYH wdrlaIdj 2 imhka k oS we;s ms<sfj,g 3 Wmfoia T!IO ,nd.kakd njg iy;sl jkak

4 wdydr yd fmdaIKh fuys wfkl=;a ie<lsh hq;= lreKQ my;ska iïmsKAvkh flf¾'

l iajia:;dj$ 5 mqikSoa.m,sdrla Idj frda.shdf.a mqoa.,sl iajia:;dj ms<sn| fidhd ne,Su udkisl frda.sfhl= / ln,d .ekSfï§ b;d jeo.;ajk MARCH 2018 | DOCTOR MAGAZINE 121

wo jkúg ´kEu udkisl frda.hg mdfya m%;sldr mj;shs' ksis m%;sldr ,enqjfyd;a ´kEu udkisl frda.sfhl=g idudkH yd M,odhS Ôú;hla .; l< yels nj ;ju;a fndfyda fokd fkdokakd i;Hhls' wx.hla fõ' Nskafkdakaudoh (Schizophrenia)" oaúO%ej udkisl frda. (Bipolar – Affective Disorder) jeks frda.S ;;a;ajhka j,§ iuyr frda.Ska ish msßisÿlu .ek Wkkaÿ fkdùu oelsh yel' wmsßisÿ nj ;j;a fi!LH m%Yakj,g fya;= fõ' tu ksid tn÷ frda.Ska Èkm;d iakdkh" o;aue§u" we÷ï me<÷ï fidaod .ekSu jeks lghq;= j,g Wkkaÿ l< hq;= fõ' frda.shd úiska tu lghq;= oeäj m%;slafIam lrkafka kï Tyq$weh WrK fkdjk whqßka l%udkql+,j tajdg fhduq lsÍu iqÿiqh' frda.shd tu lghq;= lr.kakd úg tAjd w.h lsÍu u.ska Tyq $ weh ;jÿrg;a ta i|yd fm<Uùu isÿl< yel'

úfõlh yd 5 l%kskshdldrlï" ao úIdoh fyda Nskafkdakaudofha RK ,laIK iys; frda.Ska idudkHfhka wvq l%shdldÍ fõ' tu frda.Syq fndfyda úg tÈfkod l%shdldrlï ms<sn|jo Wkkaÿjla fkdolajk w;r we|gu ù ld,h .; lsÍug fm<fU;s' fun÷ frda.Ska tÈfkod l%shdldrlïj, fhoùu wjYH fõ' Tjqkag l< yels uÜgfï jev lghq;= ^f.a fodr w;=.Eu" we÷ï fidaod .ekSu" ir, wdydrhla ms<sfh< lsÍu" u,a jeùu wdÈh& mejÍu tla;rd wdldrhl 122 MARCH 2018 | DOCTOR MAGAZINE

m%;sldrhls' tu jev lghq;= mejÍfï§ tajd ksÍlaIKh lsÍu;a" wk;=re j,ska f;dr mßirhla ilid ;sîu;a jeo.;ah' u.fmkaùu yd w.h lsÍuo wjYHfhkau l< hq;=h' f.orfodr l%shdldrlï fukau fmd;am;a lshùu" ix.S;hg ijka§u" l%Svd lsÍu jeks úfkdaodxY o yqre l< hq;= fõ' wvq l%shdldÍ frda.Ska fukau udkisl frda. fya;=fjka wê l%shdldÍ jk frda.Skao we;' Wkaudoh (Mania) jeks frda. ;;a;ajhka j,§ frda.Ska wêl f,i l%shdldß úh yel' iuyr úg fudjqyq YÍrh wêl fjfyig m;ajk ;=re k¾;kh" jHdhdu jeks l%shdldrlïj, fhfo;s' rd;%S ld,fha§ ksÈ j¾ð;j mjd fun÷ l%shdldrlï lr;s' fuu frda.Skag úfõlh wjYH fõ' ffjoH Wmfoia mßÈ frda.shd ikaiqkaj ;eîug T!IO ,nd§u;a l< yel' tfukau" udkisl frda.Skag kskao w;HdjYH fohls' tfy;a iuyr frda.Skag rd;%sfha kskao fkdhEu nrm;, m%Yakhla njg m;afõ' tn÷ frda.Skag ndysr Yío fyda fjk;a ndOdjkaf.ka f;drj iqj myiq f,i ksod.ekSug wjYH jd;djrKhla idod Èh hq;=fõ' kskao fkdhdu È.gu mj;S kï ffjoH Wmfoia ,nd.; hq;=h'

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re wjia:djkag uqyqK 7 wiS §u

fi!LH ms<sn|j 8 Tnf.a ie<ls,su;a ùu;a jeo.;a'''

udkisl frda.sfhl= /ln,d .ekSfï§ Tng úúO w¾nqoldÍ wjia:djkag uqyqK§ug isÿúh yel' WodyrK f,i frda.shd l<n,ldÍ fyda m%pKav f,i yeisÍu" u;aøjH Ndú;d lsÍu" ksjfika m<d hdu jeks wjia:d oelaúh yel' fun÷ wjia:djka ks;r Wod fkdjk kuq;a tjeks ;;a;ajhla we;s jqjfyd;a lghq;= l< hq;= wdldrh .ek oekqj;aj isàu jeo.;ah'

;udf.a ióm;uhl=g udkisl frda. hla je<£u fndfyda fofkl=g lrorldÍ w;aoelSula fõ' §¾>ld,Skj frda.shd /ln,d .ekSug isÿùu ;jÿrg;a wd;;sh okjk lreKla úh yelsh' tfia jqjo" frda.shd fyd¢ka /ln,d .ekSug kï Tnf.a fi!LH ;;a;ajho hym;aj ;sìh hq;=h' tu ksid ks;ru ;udf.a YdÍßl yd udkisl fi!LH ms<sn|j ie<ls<su;a ùu jeo.;a fõ'

tn÷ wiSre wjia:djka i|yd fmr iqodkula ;sîu b;d hym;a fõ' frda.shd u;aøjH Ndú;hg weíneys jqjl= kï tajd je<elaùug wjYH lghq;= fh§u" f.oßka m<d hdug bv we;s frda.sfhl= kï mÍlaIdldÍj isàu hkdÈh l< hq;=h' frda.shd l< hq;= fkdl< hq;= foa ms<sn|j iSud mekùuo wjYH úh yelsh' frda.shd kqreiakd iajNdjhla fmkakqï lrhs kï Tyqj$wehj ;jÿrg;a l=ms; lsÍfuka je<lS iduldó jd;djrKhla mj;ajd.ekSug W;aiy l< hq;=h' hï f,ilska frda.shd m%fldamldÍ jkafka kï l<n, fkdù uDÿ f,i l;d lsÍu uÕska Tyq$ weh ikaiqka lsÍug W;aidy l< hq;=h' wêl m%pKavldÍ njlska yeisfrkafka kï frda.shd md,kh lsÍug ffjoH Wmfoia yd udkisl fi!LH lKavdhul msysg me;Sug isÿúh yel' tn÷ wjia:djl Tjqkaj iïnkaO lr.ekSug wjYH ÿrl:k wxl hkdosh <Õ ;nd .ekSu úYd, myiqjla jkq ksielh'

ksis wdldrj wdydr .ekSu" kskao yd úfõlh ,nd.ekSu hk lreKq frda.shdg fukau Tyqj$ wehj /l n,d.kakd Tngo tl f,i wjYH fõ' tfia ke;fyd;a fjyilr nj ksid Tfí fi!LH msßySug m;aúh yel' fï w;r;=r wd¾Ól" idudÔh .eg¿ we;s jqjfyd;a tksido flfkl=g udkisl wd;;sh jeks ;;a;ajhka we;súh yel' Tn tn÷ ;;a;ajhlg m;ajk njla yefÕa kï ufkdaúoHd;aul WmfoaYkh ,nd.ekSu iqÿiq fõ'

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udkisl frda.sfhl= /l n,d.ekSfï§ wjOdkh fhduq l< hq;= uQ,sl lreKq lsysmhla wms by; idlÉPd lf<uq' fïjd l%shd;aul lsÍfï§ ;ekg iqÿiq f,i m%dfhda.slj lghq;= lsÍu b;d jeo.;ah' udkisl frda.hlska fmf<k Tnf.a ióm;uhdg ukd id;a;=jla yd /ljrKhla ,ndÈh yelsjkafka túghs' fuys§ kej; kej;;a u;la l< hq;= lreK jkafka ksis T!IO m%;sldr iuÕ by; whqßka Tnf.a wdorKSh id;a;=j o tlajQ úg Tnf.a ióm;uhdg kej; idudkH Ôú;hla .; lsÍug yelshdj we;s njhs' ••• MARCH 2018 | DOCTOR MAGAZINE 123

THE PROBLEM WITH

Metformin

A Good Advice from DR HAROLD GUNATILLAKE

124 MARCH 2018 | DOCTOR MAGAZINE

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side effects of

metformin

Fatigue

Reduced Appetite

Weight Gain

Anxiety

Diarrhea

Blurred Vision

Stomach / Abdominal Discomfort

Tingling in the Palms & Feet

Hair Loss

Muscle Pain

Are you taking metformin for your diabetes?

It is prescribed for over 120 million people worldwide.

Do you have any frequent digestive problems such as diarrhoea, flatulence, heavy feeling in your lower abdomen? These symptoms may be due to taking metformin for years. These gastrointestinal problems start years after being on metformin.

There is two forms of metformin: regular and extended release. Most problems are with the regular one.

You should always take your metformin with food and also drink plenty of water. Your the doctor will start on a lower dose and increase gradually until the blood sugar level is controlled. doctormagazine.lk

I am writing this information because my wife has been complaining of occasional bloating of her tummy and heavy feeling in the lower abdomen. Recently a pelvic ultrasound done revealed nothing to worry about.

I then asked her to stop metformin which she has been taking for years.

The symptoms disappeared and now she is more cheerful and tummy distension has disappeared So, if you have regular or irregular digestive problems your doctor will investigate you for chronic bowel diseases such as Crohn’s disease, Ulcerative colitis, Irritable bowel syndrome and so on.

It will take a long time to realize that the culprit is metformin after evaluation. If you have these problems see your doctor, soon ••• MARCH 2018 | DOCTOR MAGAZINE 125

ENT Procedures

What is ear wax Why do we have it

lfkys

l<d÷re fyj;a bá ksid

we;sjk .eg¿

126 MARCH 2018 | DOCTOR MAGAZINE

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W.=r lk kdih ms<sn|j úfYaI{ ffjoH fcHaIaG lÓldpd¾h ffjoH iS;d l=udß wrfòfmd, úisks rdc.sßh f.da,avka lS frday,

lfkys l<d÷re we;sùu Tn we;eï úg l;dnyg ,lalrK jeo.;a fi!LH .eg¿jla jkafkah' fndfyda fofkl=g fuh l,d;=rlska we;sjk ysßyerhla jQj;a l,d;=rlska flfkl=g lfKys we;sjk l<d÷re wmuK mSvd f.k fok njo ryila fkdfõ''' l<d÷re hkq iajNdjfhkau lfKys msg; kd,h ;=< msysgk bá .%kaÓ''' fkdtfia kï iqúfYaIS oyäh .%kaÓ j¾.hla u.ska ksmojk øjHhls' j¾Kh iy idkaøKh wdoS fN!;sl lreKQ l<d÷re iïnkaOfhka mqoa.,hdf.ka mqoa.,hdg fjkia iajNdjhla .kakd uq;a tys ixhq;sh fldhs ldf.;a iudkh'

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lfKys l<d÷re wdrlaIl ld¾hNdrhl ksr; jk nj Tn okakjdo@ l<d÷re j, mj;akd ridhKsl ixhq;sh lfKys f;;aNdjh /l.ekSug;a lK úIîc j,ska wdrlaId lr .ekSug;a WmldÍ fjhs' iajNdúl l%shdoduhla ;=<ska lfKys ksmojk bá ^Ceramin& bá msg;g meñfKk neúka wdhdihlska th bj;a lsÍug W;aidy lsÍu iqÿiq fkdfõ' kuq;a fulS iajdNdúl l%shdj,sh ;=< we;sjk wiu;=<s;;d ksid bá ksid lK wdY%s;j úúOdldr jQ .eg¿ / ila we;s ùfuka tys m%;súmdlhka f,i W.=r" lK kdih ffjoHjreka fj; meñfKk frda.Skaf.ka nyq;rhla lfKys l<d÷re yd ine|S .eg¿ ksid mSvd ú|sk nj fmfkkakg ;sfí'

lfKys l<d÷re ksid we;súh yels .eg¿ iuyrla''' weiSfï ÿ¾j,;d we;sùu lfKys wêl jYfhka l<d÷re tl;= ùu ksid;a" we;eï úg lK ;=<g j;=r we;=¿ ùfuka" l<d÷re bosófuka flfkl=f.a weiSu wvqfõ' tfiau lK MARCH 2018 | DOCTOR MAGAZINE 127

msßisÿ lsÍug mq¿ka l+re jeks wkjYH oE fhdod .ekSfïoS l<d÷re lK ;=< ;jÿrg;a isrfõ' fufia isrjk l<d÷re j, n,mEfuka Y%jKh ÿ¾j, úh yel' fuysoS ffjoHjrfhl= úiska iSrejg l<d÷re bj;a lsÍu wjYH m%;sldrhhs'

lfKys wêl fõokdjka we;sùu lfKys l<d÷re wdidokh ùu ksid lfKys bosóula yd mSvkhla we;s ùfuka wêl fõokdjlao we;eï úg we;s úh yel' wdidokhg wjYH m%;scSjl ,ndoSu yd lfKys l<d÷re bj;a lsÍu fuysoS l< hq;=h' we;eï úg l<÷re idhkfhaoS bj;a l< fkdyels jk w;r Y,Hd.drfhaoS th isÿ lsÍug isÿjk wjia:do mj;S'

lfKys uiao¿ we;s úg''' Wax Keratosis l<d÷re yd lfKys iu w;r m%;sl%shd isÿùfïoS lfKys uiao¿ ;;a;ajhla we;s l<d÷re u,a,l wdldrfha mg,hla u.ska b;d ;oska lK yd ne|Sula

lfKys we;sjk l<d÷re bj;a lrkakg fldÜka nâia fhdod .ekSu fkdl< hq;a;ls 128 MARCH 2018 | DOCTOR MAGAZINE

lfKys uiao¿ we;s ùu Wax Keratosis we;s lr .ekSu;a fuysoS isÿfõ' ksis frda. úksYaphlska miqj" wjYH m%;sl¾u ,ndoSu;a l<d÷re bj;a lsÍu wjYH jk w;r fndfyda úg th Y,Hd. drfhaoS isÿ lsÍug jkakgo mq¿jka' fujeks úúO .eg¿ rdYshla l<d÷re ksid we;s jQjo ksrka;rfhka lK msßisÿ lsÍu wjYH fohla fkdfõ' hï flfkl=g wjysrhla we;s jk fia lfKys l<d÷re mj;S kï l,ska l,g T,sõ f;,a ìxÿ lsysmhla ne.ska lKg oeóu u.ska thska lK uDÿ fldg msg;g meñKSu blauka l< yel' w;HjYH wjia:djloS myka ;srhla fia ilid .;a msßisÿ bá fros lene,a,lska lK msßisÿ lr .ekSuo isÿ l< yel' ••• doctormagazine.lk

doctormagazine.lk

MARCH 2018 | DOCTOR MAGAZINE 129

msßisÿ lsÍug mq¿ka l+re jeks wkjYH oE fhdod .ekSfïoS l<d÷re lK ;=< ;jÿrg;a isrfõ' fufia isrjk l<d÷re j, n,mEfuka Y%jKh ÿ¾j, úh yel' fuysoS ffjoHjrfhl= úiska iSrejg l<d÷re bj;a lsÍu wjYH m%;sldrhhs'

lfKys wêl fõokdjka we;sùu lfKys l<d÷re wdidokh ùu ksid lfKys bosóula yd mSvkhla we;s ùfuka wêl fõokdjlao we;eï úg we;s úh yel' wdidokhg wjYH m%;scSjl ,ndoSu yd lfKys l<d÷re bj;a lsÍu fuysoS l< hq;=h' we;eï úg l<÷re idhkfhaoS bj;a l< fkdyels jk w;r Y,Hd.drfhaoS th isÿ lsÍug isÿjk wjia:do mj;S'

lfKys uiao¿ we;s úg''' Wax Keratosis l<d÷re yd lfKys iu w;r m%;sl%shd isÿùfïoS lfKys uiao¿ ;;a;ajhla we;s l<d÷re u,a,l wdldrfha mg,hla u.ska b;d ;oska lK yd ne|Sula

lfKys we;sjk l<d÷re bj;a lrkakg fldÜka nâia fhdod .ekSu fkdl< hq;a;ls 130 MARCH 2018 | DOCTOR MAGAZINE

lfKys uiao¿ we;s ùu Wax Keratosis we;s lr .ekSu;a fuysoS isÿfõ' ksis frda. úksYaphlska miqj" wjYH m%;sl¾u ,ndoSu;a l<d÷re bj;a lsÍu wjYH jk w;r fndfyda úg th Y,Hd. drfhaoS isÿ lsÍug jkakgo mq¿jka' fujeks úúO .eg¿ rdYshla l<d÷re ksid we;s jQjo ksrka;rfhka lK msßisÿ lsÍu wjYH fohla fkdfõ' hï flfkl=g wjysrhla we;s jk fia lfKys l<d÷re mj;S kï l,ska l,g T,sõ f;,a ìxÿ lsysmhla ne.ska lKg oeóu u.ska thska lK uDÿ fldg msg;g meñKSu blauka l< yel' w;HjYH wjia:djloS myka ;srhla fia ilid .;a msßisÿ bá fros lene,a,lska lK msßisÿ lr .ekSuo isÿ l< yel' ••• doctormagazine.lk

doctormagazine.lk

MARCH 2018 | DOCTOR MAGAZINE 131

fuys we;af;a YouTube yryd ,ndfok jákd ùäfhda jd¾;djka lsysmhla' Tfí cx.u ÿrl:kfha QR Code tl il%Sh lrf.k fï ùäfhda krUkakg Tng yelshdj ;sfnkjd'

Watch

Watch this amazing short videos. It connects interesting medical facts, groundbreaking medical research and modern medical practices helping us to entertain healthy and happy life. https://youtu.be/lEXBxijQREo

iSks fud<hg lrk kmqr''' meKs rihg wm jeä fofkla leu;shs' fgdms" fpdla,Ü" rileú<s'''' fï ri lEu fldhsl;a iSks ke;sj yokak nEfk'''' ta;a uE; ld,h ;=< iSks wdydrhg .ekSu iïnkaOfhka úYd, wjodkï yeÕùï ksl=;a jqKd' iSks wkqNjh wm ys;kjdg jvd fndfyda wjodkï''' iSks wkqNjfhka YÍrhg we;sjk n,mEu fkdfjhs''' wfma fud<hg n,mdk wdldrh .ek wm uú; lrjk f;dr;=re fï ùäfhdaj keröfuka Tng ,nd.; yelshs' iSks j,ska wE;a fjkak fï ùäfhdaj;a Tng m%n, fya;=jla jkq ksielhs' https://youtu.be/QQ3ki1dCcnw

weia iqrlsk jHdhdu wms jákd foaj,a /l.kafk weia fol jf.a''' we;a;gu wms weia fol /l.; hq;af;a fldfyduo @ weia jhig hk úg;a''' úúO fya;= ksid;a ÿ¾j, fjkak mq¿jka' ta;a Tn okakjdo" ksjeros jHdhdu weiaj, iqjfi;g m%n, f,i Okd;aul n,mEula we;s lrkjd' weia j, ksfrda.S nj /l .ekSug n,mdk wm ldg;a myiqfjka l< yels jHdhdu lsysmhla fï ùäfhdafjka úia;r fjkjd'

132 MARCH 2018 | DOCTOR MAGAZINE

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jefvk orejkag

uia ud¿

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Ydl wdydr muKla .kakd jefvk orejl=g fndcqkam;g ie<ls,af,ka fm%daàk wdydr tl;= l< hq;=h doctormagazine.lk

Wmfoia fmdaIK úfYaI{ ffjoH f¾Kqld ch;siai

MARCH 2018 | DOCTOR MAGAZINE 133

idudkHfhka .sksfmÜáhl m%udKfha f,dl= ud¿ lene,a,l wvx.= fm%daàk m%udKh ,eîug mßmamq kï fïi ye¢ 6 la wdydrhg .; hq;=fõ' yd,aueiaika 10lska ,efnkafka;a fï fm%daàka m%udKhuh' ì;a;r kï tlls' wfma rfÜ ck;dj jeämqru .kakd wdydrh jkafka n;ah' tA wkqj wfma fm%daàk wjYH;djfhka 50] wms wksl=;a wdydrj,skao imqrd .kafkuq' fm%daàk wmg b;du;a jeo.;a jkafka wehs @ m%Odk jYfhkau udxY fmaYsj, j¾Okhg iy YÍrh Wi hdug fm%daàk w;HjYH fmdaIH mÞ¾:hls' orejl=f.a YÍrfha Wmßu j¾Okh isÿ jkafka jhi wjqreÿ 10-19 w;r ld,fha§h' msßñ orejl=f.a kï jeãu j¾Okh jkafka wjqreÿ 16-19 w;rh' jefvk jhig wkqj fm%daàkj, wjYH;djh jhi wjqreÿ 10-12 olajd .%e 45' jhi wjqreÿ 12-16 olajd .%e' 55 jhi wjqreÿ 16-19 olajd .%E' 65 jhi wjqreÿ 10-12 olajd .%e' 45 jhi wjqreÿ 12-16 olajd .%e' 65 jhi wjqreÿ 16-19 olajd .%e' 85 fm%daàk nyq, wdydr f,i uia udxY j¾. m%Odk jYfhkau ie<flk w;r YdLuh wdydr fndfydauhl o fm%daàk wvx.= fõ' tA w;r lv," uqxweg" lõms" mßmamq" fidahd wd§ OdkH wdydr;a''' lsß" fhda.Ü wdÈ lsß wdydr;a uQ,sl jYfhka ±laúh yels w;r ;j;a fkdfhl=;a wdydrj, fm%daàk hï hï m%udKj,ska wvx.= jk nj lsj hq;=h' wjqreÿ 16-19 w;r msßñ orejl=f.a fm%daàk wjYH;djh Èklg .%E' 85la 134 MARCH 2018 | DOCTOR MAGAZINE

nj by; ±laùuq' fï .%E' 85 ka o< jYfhka 10]la muK n;aj,ska ,eìh yelsh' uia udxY fyda Ydl wdydr j,ska imqrd.; hq;=j we;af;a b;sß 50]l m%udKhls' idudkHfhka .sksfmÜáhl m%udKfha f,dl= ud¿ lene,a,l wvx.= fm%daàk m%udKh ,eîug mßmamq kï fïi ye¢ 6 la wdydrhg .; hq;=fõ' yd,aueiaika 10lska ,efnkafka;a fï fm%daàka m%udKhuh' ì;a;r kï tlls' Ydl wdydr muKla .kakd flkl= ;ukaf.a o< fm%daàk wjYH;djh imqrd .ekSug Èklg .; hq;= wdydr m%udKh fufia ±laùug mq¿jk' • • • • • •

n;a mSßis fldamam 6 hs fidahd .%E' 70 lõms fyda uqxweg fïi ye¢ 3 hs mßmamq fïi ye¢ 3 lsß ùÿrejla fhda.Ü fldamamhla

fï wkqj n,k úg uia udxY wmg w;HjYHu hehs lsj fkdyelsh' kuq;a udxY iq¿ m%udKhlska ,efnk fm%daàka m%udKh tA whqßkau ,nd .kakg Ydl wdydr jeä m%udKhla .kakg isÿfõ' tneúka Ydl wdydr muKla .kakd jefvk orejl=g uy;a ie<ls,a,lska hq;=j fm%daàk wdydr ,nd §u b;d jeo.;ah' fuf,i fm%daàk wjYH;djh ksis mßÈ iïmQ¾K fkdùu ;=<ska orejdf.a udxY fmaYs j¾Okh nd, jk w;r Wi hdu wvqfõ' bkamiq wjqreÿ oy wg bl=;a ùfuka miqj Wi hkakg lshd ffjoHjrekaf.ka fnfy;a b,a,d isàfuka m%;sM,hla fkd,efnkq we;' uia udxY wmg w;HjYHu hehs lsj fkdyelsh' kuq;a udxY iq¿ m%udKhlska ,efnk fm%daàka m%udKh tA whqßkau ,nd .kakg Ydl wdydr jeä m%udKhla .kakg isÿfõ'

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doctormagazine.lk

MARCH 2018 | DOCTOR MAGAZINE 135

Unravelling the world of the autistic child

y÷kd.kafka flfiao@

mÿï ã' hdmd Dip. OT, SROT (UK) 136 MARCH 2018 | DOCTOR MAGAZINE

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iEu udihlu wfm%a,a 2 osk Táiï frda.h iïnkaOfhka oeKQj;a lsÍfï oskh jYfhka kï lr ;sfí' ta tlai;a cd;Skaf.a ixúOdkh úisks' Táiï orejka f,dalfha fldhs l,dmfha;a isà' fï orejka yªkd .ekSu" ksis l,g m%;sldr j,g fhduq lsÍu Tiafia Táiï orejkaf.a cSú; .=Kd;aul jYfhka jeä oshqKQ l< yel' f,dal Táiï oskh iu.dój wm ,sms folla ilia lr isáuq' m<uq jekak fï iu. m< lrk w;r f,dal Táiï oeKQj;a lsÍfï oskh fhfok wfm%a,a udifha l,dmfha tys fojk ,smsh m%ldYhg m;a flreKQ we;'

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Táiï hkq kq;k iudcfha jeäfhka wikakg ,efnk" <uqka w;r nyq,j mj;sk jHl+, ;;a;ajhla jk w;r fud<fha ls%hdldß;ajfha wms<sfj, fya;=fjka <uhd wka wh iu. iïnkaO ùfïoS" woyia yqjudre lr.ekSu i|yd fhdod .kakd l%u j, wvmK ùula f,io úia;r l< yelshs' (Limitation to the communication) fï ;;a;ajh Tjqkaf.a <ud úfhaoS m%:ufhkau olakg ,efnk w;r l%ufhka ixlS¾K ;;a;ajhg m;afõ' fï ksidu Tjqkag f,dalh" jgmsgdj ksjerÈ whqßka jgyd .ekSug fkdyels jk w;r Tjqkaf.ka iuyre l:d lsÍfï W!K;djhlao olajhs' tfiau fï w;f¾ iuyreka i;=j úfYaI yelshdjka o mj;S' ieu <uhska 68 lg tla wfhl= Táiï nfnl= úh yels w;r .eyekq <uqkag jvd mia .=Khlska msßñ <uqka w;f¾ fï ;;a;ajh mj;S' orejdf.a yeisßu foi l%udKql+,j ksÍlaIKh lsßfuka Táiï ,laIK Tyqg ;sfí±hs Tng y÷kd.; yelsh' fujeks orejka fndfyda úg udi 18-24 w;r ld,fha§ fï ,laIK úoyd mdk w;r wjq(3 ka miqj Tjqka i;= ksmqK;d" yelshdjka ish,a, o weKysák ;;a;ajhg m;a fõ'

MARCH 2018 | DOCTOR MAGAZINE 137

uq,sl wk;=re y`.jk ,laIK ieu <uhska 68 lg tla wfhl= Táiï nfnl= úh yels w;r .eyekq <uqkag jvd mia .=Khlska msßñ <uqka w;f¾ fï ;;a;ajh mj;S'

idudkHfhka uq,a wjqreoafoa§ idudkH <orejka fndfyda iudcYS,S .;shlska isák w;r fï wjêfha Táiï <orefjl= ;ud wjg f,dalh iu. iïnkaO ùfï§ olajk wvqmdvq fya;=fjka myiqfjkau fï fomd¾Yjfha fjki f;areï .; yelsh

Táiï orejka flfrka olakg ,efnk ,laIK iuyrla

Táiï <orefjla

• tlu wdldrfha p,khka kej; kej; lsÍu ^meoafok" lerflk Rocking & Spinning) • wfkl=;a wh iu. l:d lsÍfï§ weia .eàu j<lajd .ekSu (Eye Contact) iy YdÍßlj .eàu (Physical Contact) u.yer .ekSu • l:d lsÍfï yelshdj m%udo ùu • tlu jpkh fyda jpk fldgila kej; kej; m%ldY lsÍu (Echolalia) • iq¨ fohlska lkiai,a,g m;aùu • wka wh iu. iïnkaO ùfï§ idudkH <uqka fhdod .kakd rgdjka fmkaùu iyd fhdod .kakd ix{djka Ndú;d fkdlsÍu by; i|yka ,laIK Táiï ;;a;ajfha ke;s idudkH <orefjl=g jqjo ;sìh yels neõo fuys§ i|yka l< hq;=h' tu ksid Táiï frda. úksYaph i|yd m%ùK ffjoHjreka fukau úfYaI Ñls;ailjrekaf.a iydh w;HdjYHfhkau .;hq;= njo isysm;a lrñ

• ;u ujf.a lg yvg m%;spdr fkdolajhs • ;udf.a kñka l:d l< úg§ m%;spdr fkdolajhs • wka wh foi fl,ska ne,Sfuka j<lshs • wka whf.a ls%hdj,g" ix{dj,g isky ùula fyda m%;spdrhla fyda fkdolajhs • jhi wjqreoaol ì<sf|l= fuka l:d lsÍu;a (Babbling) oE;a fmkakd hula fmkakd §u;a fkdlrhs' <orejdf.a Táiï ,laIK fojeks wjqreoafoa§ fyd|ska ksßlaIKh l< yelsh' idudkH <orejka Tjqkaf.a l:d lsÍfï uQ,sl jpk m%ldY lrñka" tfiau ;udg wjYH foa fmkakSfuka yeisfrk w;r Táiï <orejd fï ish,a, wysñ lrf.k wE;a ù isáhs'

Táiï <orejdf.a fndfyda úg my; ,laIKo olakg yel • udi 16 È;a lsisu jpkhla m%ldY fkdlrhs • udi 16 È;a lsishï ls%vdjlg fkdfm<fò • udi 16 §;a tljr jpk folla m%ldY l< fkdyelshs

138 MARCH 2018 | DOCTOR MAGAZINE

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Táiï orejka uq,a ld,fhaoSu yªkd .ekSfuka uq,a wjêfha isgu m%;sldr ,ndoSu i|yd fhduq lsÍu ksid Tyqf.a fyda wehf.a miqnEï wju lr .; yels w;r ÈhqKqjg úYd, rel=,la" w;aje,la jk nj meyeÈ,sju i|yka l< hq;=h' • NdIdj ms<sno ±kSula fkdue;s ùu • jeäysáfhl= fyda ljqre;a fyda ms%hukdm jk hula fmkakQ úg ta ms<snj Wkkaÿjla fkdolajhs

Táiï <orejka i;= wfkl=;a YdÍßl frda. ,laIK wdydr Ô¾K moaO;sh iïnkaOj m%YaK" kskao hefï wmyiq;d" jeisls,s hEfï wmyiq;djhka" Èùug iy ke.Sug wdOdr jk úYd, udxY fmaYskaf.a ÿ¾j, iudcfhda cl;djhka''' tfiau iuyrekag we;sjk seizure ;;a;ajhka'''

Táiï - fud<hg n,mEï lrkafka flfiao@ fud<fha iuyr fldgia u.ska ye`.Sï (Emotions) ikaksfõokh (Communication) YdÍßl fldgia j, p,khka (Body Movements) md,kh lrkq ,nk w;r fï fldgia j, ls%hdldß;ajhg fl,skau Táiï ;;a;ajh n,meï t,a, lr tu lghq;= ÿ¾j, lrhs'

Táiï frda.h uq,a wjosfhau y÷kd .eksSfï jákdlï <orejka jeäfofkl=f.a fuu Táiï ;;a;ajh uq,a wjosfha§ y÷kd fkd. ekSu ^fmr mdi,a wjêfha fyda Bg doctormagazine.lk

fmr& ksid ta i|yd myiqfjkau m%;sldr wdrïN lsÍug we;s wjia:dj .s,syS hhs' fuh <orejdf.a bÈß ðú;hg n,mdk w;r uQ,sl l=i,;d (Basic Skills) m%udo jk iEu <orefjlau udi 18" udi 24 oS y÷qkd.ekSfï mßlaIKhlg Ndckh l< hq;= fõ' tfiau iuyr fjkia yeisÍï rgd we;s jqjfyd;a l:d lsÍug wmyiq ;;a;ajhla fyda <orejd isák mjqf,a ióm;u flfkla Táiï ;;a;ajfhka fmf<hs kï fyda tjeks <orejkao fufia frda.h ks¾Kh lr.ekSfï mÍlaIdjlg ,la l< hq;= fõ' fjk;a frda. i|yd fuka tla ksßlaIKhlska iaÒrju fï Táiï ;;a;ajh ksßla IKh l< fkdyels w;r úúO l=i,;d j, miqnEï fidhd .ekSu i|yd <orejka tlsfkldg fjkia wdldrfha mßlaIdjlg ,la l< hq;= fõ' Wod(- <orejdf.a yeisßï rgdj i|yd" ikaksfõok ffY,sh i|yd fufia y÷kd.;a <uqka ^wju jYfhka wjq'3 ùug l,ska j;a& uq,a wjêfha isgu m%;sldr ,ndoSu i|yd fhduq ùfuka Tyqf.a fyda wehf.a miqnEï wju lr .; yels w;r ÈhqKqjg úYd, rel=,la" w;aje,la jk nj meyeÈ,sju i|yka l< hq;=h' fuu f,aLlhd rd.u mqkre;a:dmk frdayf,a ysgmq jD;a;sh Ñls;ail wêldß jYfhka lghq;= lrk ,o w;r YS% ,xld jD;a;sh fõÈkaf.a jD;a;sh Ñls;ail ix.ufha f,alï yd f,dal jD;a;sh Ñls;ail ix.ufha YS% ,xld ksfhdacs; jYfhka lghq;= lrhs' ••• MARCH 2018 | DOCTOR MAGAZINE 139

AYURVEDIC

fy< wdhq¾fõo fjolfï úYañ; m%;sldr

mdrïmßl fjolfuka

jdhqf.ä ksÜgdjg iqj lrk yeá

fydaud.u isoaOdoS fjo ueÿf¾ ffjoHdpdßkS pdkaokS úl%udrÉÑ

jdhq f.ä fn,a, wdY%s;j we;sjk frda.S ;;a;ajhls' fn,af,a we;s ;hsfrdhsv .%kaÓh m%udKfhka úYd, ùu" fn,af,ka bosßhg fkrd tau fyda YÍrh we;=<g fkrd hdu jeks frda. ,laIK j,ska jdhq f.ä we;sùu y÷kd.; yel' jdhq f.ä frda.h wfma mdrïmßl ffjoH l%ufha zz.,.KavhZZ fia ye|skafjhs'

140 JANUARY 2018 | DOCTOR MAGAZINE

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YrSrh ;=< Yla;sh ksmoùu yd tu Yla;sh m%fhdackhg .ekSu hk lreKQ fol l%shd;aul jkafka uQ,slj" ;hsfrdhsâ .%kaÓfhys ksIamdokh jk ;hsfrdlaiska yd wfkl=;a fydafudak lsysmhla u.skah' YÍrh ;=< muKg jvd wêlj fydafudak ksIAmdokh jkjd kï YÍrh ;=< úúO úm¾hdi ygf.k frda. ixl+,;d /ila we;s fjkjd' tu fydafudak ksmoùu ÿ¾j, jQj;a fujka frda. ixl+,;d /ila we;súh yelshs' jdhq f.ä we;sùu fndfyda úg whäka W!K;djh ksid we;s jkakls' whäka wka;¾.; wdydr ysÕmdvq ùfuka jdhqf.ä we;sùug ux ie,fia' úfYaIfhkau uqyqÿnv m<d;aj,g jvd rg wNHka;rfha fjfik rgjeishka whäka W!K;d frda. j,g jeä jeäfhka uqyqK fohs'

wfma mdrïmßl fjolfï fï ;hsfrdhsâ frda. j,g iaÓridr m%;sldr mj;S' fï frda.Ska úYd, jYfhka ud fj; meñK iqjm;aj hk nj ud ksYAÑ;ju lsj hq;= fjñ' ;hsfrdhsâ .%kaÓh wdY%s;j we;sjk frda. y;rla uQ,slj yªkdf.k ;sfí' 1' Hashimoto Thyroiditis frda.h 2' Graves Thyroiditis frda.h 3' .,.Kavh fyj;ajdhqf.ä frda.h (Goitre) 4' ;hsfrdhsâ .eá;s frda.h Hashimoto Thyroditis frda. ;;a;ajh W.% jid .eá;s ;hsfrdhsâ frda. ;;ajh f,i y÷kajk fuu frda.h je<f|kakg ksYaÑ; jhia doctormagazine.lk

jdhq f.ä we;sùu fndfyda úg whäka W!K;djh ksid we;s jkakls' whäka wka;¾.; wdydr ysÕmdvq ùfuka jdhqf.ä we;sùug ux ie,fia'

JANUARY 2018 | DOCTOR MAGAZINE 141

AYURVEDIC

wka;rdid¾. moaO;shg wh;a fydafudak >%djh lrk bkaøshhka weiqf¾ m%uqL jk ;hsfrdhsv .%kaÓh msysgd we;af;a f.f,ys bosßmig jkakghs' wka;rdid¾. moaO;shg wh;a fydafudak >%djh lrk bkaøsh ukqIH YÍrfha meje;aug lrk n,mEu iq¿mgq fkdfõ' thska" ;hsfrdhsâ .%kaÓfhka >%djh jk ;hsfrdlaiska fydafudakh mßjD;a;Sh l%shdj,ska md,kh lsÍug m%uqLj bjy,a jk fydafudakhls'

AYURVEDIC

iSudjla ke;' kuq;a ueosúfha ldka;djka w;f¾ fuu frda.h iq,nh' YÍrfha m%;sYla;sh ;sr lsÍug fya;=jk reêr ffi, ;hsfrdhsâ .%kaÓfha hy l%shdldß;ajhg ndOd f.k tñka tu .%kaÓh úkdY lsÍug l%shd;aul ùu fï frda.fhaoS isÿ fjhs' tys m%;sM<hla f,i .%kaÓfhka ;hsfrdlaiska we;=¿j fydafudk ksmoùu wvd, ù tys m%;sM<hla jYfhka frda.S Ndjhg m;a fjhs' frda.fha wdrïNl wjia:dfõoS frda. ,laIK t;rï m%lg jkafka ke;' th ;hsfrdhsâ .%kaÓh ;=< uq,a neif.k os.= l,la mj;skakls' fuysoS we;sjk frda. ,laIK fjk;a frda. j,oSo meK ke.sh yels jk fyhska ndysßka flfrk ,>q frda. úksYaphlska frda.h y÷kd .ekSu W.ygh'

Hashimoto Thyroditis frda. ;;a;ajh we;s jQ úg m%lg flfrk frda. ,laIK • wêl fjfyi • iu úh<Su • iq¿ jYfhka YÍrfha nr jeäùu • u<noaOh • wd;;sh • ysiflia úh<s iajNdjhg m;aùu • uqyqK bosó ÿ¾j, iajNdjhla .ekSu • ;hsfrdhsâ .%kaÓh bosóu • Tima reêrh m%udKh blaujd msgùu • Tima pl%fha wl%uj;a Ndjhla we;sùu Hashimoto Thyroditis frda.h je<|S we;súg ta nj ksjerosj oek.ekSug kï ffjoHjrfhl=f.a Wmfoia u; TSH kue;s reêr mÍlaIKh isÿ lr.; 142 JANUARY 2018 | DOCTOR MAGAZINE

hq;=h' ngysr ffjoH úoHdfõ fuu frda.hg T!IO fkdue;' ;hsfrdlaiska fm;suqL u.ska ,nd fokjd yefrkakg wka hula isÿ fkdfõ' wfma mdrïmßl fjolfï fï frda.hg iaÓridr m%;sldr mj;S' fï frda.Ska úYd, jYfhka ud fj; meñK iqjm;aj hk nj ud ksYAÑ;ju lsj hq;= fjñ' fï frda. i|yd lrk mdrïmßl m%;sldr .eko úia;r iys;j fuys úia;r fkdlrk ,o ;hsfrdhsâ fydafudak.; fjk;a frda. iïnkaOfhka ,nk l,dmfhka lreKQ mjikakï' jir 300lg jvd merKs kj.uqfõ mdrumßl isxy, fjo mrmqf¾ ksfhdackhla jQ ;,x.u fyf,akd fmf¾rd ue;sKshf.a ñKsìßh jk fydaud.u pdkaokS úl%udrÉÑ ffjoHdpd¾h;=ñh ish¿ iakdhq frda." uq;%dYfha .,a" oshjeähdj"ms<ld" wxYNd.h" weÿu" mSki" isfrdaisia" wd;rhsáia" fldf,iagfrda,a" .eiag%hsáia" weiafjolu" fmd;=lnr" nhsmdia ie;alug kshñ; frda.Ska yd fjk;a yDo frda. wdosh i|yd ishhg 100la foaYSh m%;sldr lrKQ ,efí' fkdñf,a Wmfoia ,nd .ekSug ÿrl:k wxl 0713464276$075906177 wxlj,g l;d lrkak' isoaOdoS fjo ueÿrg tk .uka ud¾.h fydaud.u isg lvqfj, olajd meñfKk 697 nia r:fhka meñKzzWK m÷r ykaosfhkaZZ nei zzk.r iSud udjf;aZZ óg¾ 200la muK ÿr wd hq;=hs' isl=rdod yd fmdah Èkj, yd m%;sldr fkdlrk nj ffjoH;=ñh okajd isà'

igyk wñ; úl%uwdrÉÑ

••• doctormagazine.lk

AYURVEDIC

wef.a ÿlg fya;=jk iqo hdu Yafõ; fhdaks ud¾.fhka iqÿ meye >%djhla msgùu''' wefÕa m%orh''' mf;a fõokdj" ryiÕ iuyr fj,djg fidau frda.h fõokdj''' ryiÕ f;;aùu wdoS frda.

IK iuqodhla u;ska tk lshkafka;a fï ,la ldhsl frda.hla .ek we;eï f,fâguhs''' ldka;djka jo fjkjd'''' wdhq¾fõo ffjoH rkam; rejka r;akdhl iu. l< idlÉPdjla weiqßKs'''

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fï lshmq ,laIK thdldrfhkau fkdfjhs" we;eï fj,djg fjkia fjkak;a mq¿jka''' >%jfha iqÿ meyeh fjkqjg th ÿUqre meye''' j¾Khla .ekSu''' th >k iajNdjhlska msgùu fukau by; úia;r l< wfkl=;a frda. ,laIKo fjkialï we;sj we;s fjk wjia:djla wdhq¾fõofha úia;r fjkjd' ta m%or frda. hkqfjka''' JANUARY 2018 | DOCTOR MAGAZINE 143

AYURVEDIC

m%or hkafkys wre; zz.,d hduZZ hkakhs' .,d hdula ksid we;sjk frda. tkhska zzm%orZZ f,i kï ,nkjd' m%or frda. folla .ek uQ,sl jYfhka wdhq¾fõofha l;d lrkjd' ta zzYafõ; m%orh iy zzrla; m%orhZZ hkqfjkqhs' Yafõ; m%orh wo fndfyda ldka;djka ú|jk frda.hla' úfYaIfhkau fï frda. ,laIK ffjoHjrfhl=g lshd mEfï ÿIalr;djfhkq;a fndfyda fofkla fmf<kjd' f,v frda. ffjoHjrfhl=g fkdj<yd fkdlshd ldg kï mjikako @ ta;a fï Yafõ; m%orh fkdfyd;a fidau frda.h ksid kï ryfia <;efjk ldka;djka ixLHdj iq¿mgq keye' fï ryfia ú|jk''' <;efjk''' iqjyila ldka;djka fjkqfjka Yafõ; m%orh''' fkdfyd;a iqo hdu kue;s frda.h .ek wm l;sldj;l fhfokjd' wdhq¾fõo ffjoH rkam; rejka talkdhl wo fï frda.h .ek úia;r lrkafka ta fkdoeKQj;aNdjfhka wehj uqojd.kq ms‚ihs'

Yafõ; m%orh kue;s frda.h l=ulao@ wmg ta .ek lsishï wjfndaOhla uq,skau ,nd ÿkafkd;a@ fhdaks ud¾.h wjg f;;a jQ iajNdjhla mej;Su idudkHhla' .¾NdIh ieliS ;sfnkafka ore .enla ord isàfï wjYH;djh ms‚ihs' ldka;djlf.a .¾NdIh fukau ta yd ine£ bkaøshhka fï wjYH;djh fjkqfjka ksrka;rfhka ilia fjkjd' >%djhka je.sÍu ta yd iïnkaO l%shdj,shla' iqo hdu ta 144 JANUARY 2018 | DOCTOR MAGAZINE

m%ckl l%shdj,shg iïnkaO kE' ta;a iqohdfï§ tu >%djh wêl jYfhka fhdaksfhka je.sfrkjd'

ldka;djlg Yafõ; m%orh we;s jQ úg olakg ,efnk fjki ljrdldro@ ire ld,h ;=<§ äïn ksl=;a jk wjia:dj,§ fhdaks ud¾.fhka msg lrk >%djhka j¾Khla fyda .kaOhla orkafka kE' lsß meyehg" uqojdmq lsß j, iajNdjhg ;rula Wl=jg fï iqohdu we;súh yelshs' fmd,al=vq jeks iajNdjhlska iqÿ meye;s len,s;s f,io we;euqkag iqo hdu we;s fjkjd' r;a meyeh" ,d r;a meyehg fukau ly meyefhkao iqo hdu olakg ,efnkjd'

Yafõ; m%orh ksid ldka;djg we;sjk wmyiq;djhka fudkjdo@ fuys§ fhdaks ud¾.h wjg lik iajNdjh" ;=jd, we;sùu" bls,s wdY%s; m%foaYh leiSug ,laùu" ks;r ks;r we;sjk uq;%d wdidok iq,n jYfhka oelsh yelshs'

Yafõ; m%orh i|yd n,mdk fya;= fudkjdo@ WIaK wêl WIaK wdydr ksid zziqo hduZZ fkdfyd;a zzYafõ; m%orhZZ we;s úh yelshs' ;reK jhfia ldka;djka wuq wU" wkakdis" ì,sx" weU/,a,d wÉpdre jeks foaj,a wdydrhg .ekSu;a lD;%Su wdydrmdk j,g fhduq ùu;a ksid Tjqkaf.a YÍr j, WIaK;ajh wêl fõ' wdydr Ô¾Kfhys wdY%h lr.;a wdydr wreÑh" u<noaOh" u< wl%uj;a ùu wd§ ,laIKo fuys§ we;súh yel' YÍrh lDY ùu" m¿ oeóu wdY%h lr.;a ifuys frda."

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fï yereKQ úg my; fya;= u;o we;euqkag fï frda.h we;sùfï bvlvla mj;skjd' • ikSmdrlaIdj iïnkaOfhka olajk wvq ie<ls,a, • l%sñ wdidok ^mKq frda.& • ,sx.sl p¾hdjkaf.a we;eï ;;a;aj • nr bis,Su • fmdÿ jeisls<s Ndú;h • nyq mqreI fiajkh • iudc frda.

Yafõ; m%orh i|yd lrk m%;sldr fudkjdo@ fï frda. ;;a;ajh;a iu. meK ke.=KQ by; lS frda.dndO j,g fjka fjka jYfhka m%;sldr lsÍula isÿ fkdfõ' frda.shd mÍlaId lsÍfuka miq frda. uQ,h wjfndaO lr.;a m%;sldr mx;shla frda.shd fjkqfjka ks¾foaY flf¾'

§¾>ld,Skj fï frda.h mej;Sfuka we;súh yels .eg¿ ld,hla .;ùu;a iu. .¾NdI.; frda. we;sùfï wjodkula mek k.S' ;reK jhfia ldka;djka kï fï ms<sn|j úfYaIfhka ie<ls<su;a úh hq;af;a fï ksid ore iïm;a ,eîug ndOd meK ke.Sfï we;s bvlvhs' ,sx.sl ixi¾.h wdY%s; .eg¿o fuys§ meK ke.sh yel' flfia fj;;a frda.h uekúka y÷kdf.k ksis wdhq¾fõo m%;sldr ,nd§fuka frda.h ksÜgdjgu iqj lr.; yel' wo ojfia fndfyda ldka;djka m%;sldr ,nd .ekSfï leue;a;lska miq jQjo wúfõlh fyda fjkï fya;=jla ksid l,g fõ,djg m%;sldr fkd,nd isàfuka frda.h W;aikak jk ;=re isák nj fmfka' Yafõ; m%orh i|yd myiqfjka ,nd.ekSug yels T!IO wmg ,ndÈh yel' fï ksid l,a fkdyer Tfí fï frda.hg ksis m%;sldr ,nd.kak'

wdhq¾fõo ffjoH rkam; rejka r;akdhl rkam; fjo ueÿr 663" kqjr mdr" mE,shf.dv wdhq',s'm'wxlh 13869 071 300 9088 | 011 434 4599 mÜáh ykaosh fchrdca m%kdkaÿmq,af,a .=jka md,u wi,

ffjoH rkam; rejka r;akdhl fjoeÿre;=uka ysiroh" .eiag%hsáia" w¾Yia" mSkia frda." fiï frda." jd;rla;" yDo frda. iy wêreêr mSvkh ^fm%I¾& brejdroh" m¿ oeóu"leiSï yd iu iïnkaO frda." ,sx.sl ÿn,;d" ldka;d frda. yd .¾NdI frda. /ilg Tng iykh i,ihs' wo iudcfha iq,nj olakg ,efnk oreM< m%udo ùu" mqreI Yla;sh ÿ¾j, ùu wdoshgo fu;=ud m%;sldr lrKQ ,nhs'

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JANUARY 2018 | DOCTOR MAGAZINE 145

AYURVEDIC

mSkia frda." w¾Yia" ysi lelal=uo" YÍrh wm%d‚l .;sh" wêl flaka;sh jeks ,laIKo we;s úh yelshs' ks;r ks;r u< nqre,aj msgùu fukau u<noaOho we;euqkag ,dlaI‚lh' fï ish¿ frda. Yafõ; m%orh wdY%s;j we;súh yel'

144

April 2017

DOCTOR MAGAZINE

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148 JANUARY 2018 | DOCTOR MAGAZINE

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