November 2017 Doctor Magazine by Doctor Magazine

NOVEMBER 2017 Volume 23 • Issue 11

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08 NEWS 14

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DO I HAVE DIABETES?

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LIVING WELL WITH DIABETES (GDM)

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SHOCKWAVE TREATMENT FOR MAINTAIN AN ERECTION

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IS YOUR CHILD ALLERGIC TO COW’S MILK?

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EDITOR'S

NOTE

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we|sß jeàf.k tk fj,djg osojfia l+gm%dma;sh uyck fi!LH mÍlaIljrfhl= hgf;a osia;%sla fi!LH khla fjhs' wOHdmk llkl%a l, shd;auu;= l ùu" Ijrfhl= ta zziekaáfnda â fnda frda ." tal,s fjkiyldr fi!LHwOHla ;¾ck" meñfKhs' wOHdmk tall l%shfkdjk d;aul ùu" iyldr wOHlaIjrfhl= ta zziekaáfndaâ hg;g wdh;kh m;a u" f,da ixúOdkfha uy;a ; hdZZ .ug úúOm;ald,S wjYH;d u ùúfYa Is;l tafi!LH ll yd ine|S ì;a;shlg w,a,k iqÿ ;srhla u; Ñ;% áhla hs' wdh;kh ùu" k f,da l fi!LH fuka ixúOdkfha uy;a ;m hdZZ .ugfmkajhg;g wdOdr hgf;a ld¾hdxYhla njg m;aùu jYfhka meñfKk k hhs' hgf;aosúúO ld¾hdxYhla njg m;a ùujevigyka jYfhka meñfKk hhs'fha wdOdr oeKQj ;a ls Í fï j, fhoS u " ld¾h ;srfha úl=ï mdkafka ÿmam;a ñksi aiqh' t<sosmky<s wdh;ks fjkialï ck;dj isÿ fj;aoS ta yd iu.dój ck;dj iekaál fnda â lï isÿ fj;a fjkia omq S tayl yd iekaáfnda â uKav, i|yd qKÍQ iu.dój lsÍjevigyka ï" udOHfõoSka i|yd mj;ajk u<my lrk orejdf.a uqyqK nUhla ;rïh' Tyqf.awdh;ks oeKQ j;a uy;a hdg oeKQ j;a;ls Ífï.fï jevigyka o jeä osls hqKfï Q jkakg úh' o jeä oshqKQ jkakg úh' uy;a;hdg .fï iïuka;%k" zziqjießhZZ fi!LH f;dr;=re fjí wvúh wfOdauqLfhka isß isß .d jefgk;smKq fjla w;l m%udKh ;snqfKa f.!rjh nqfKa f.!rjh fuka uwOHdmk úfYa ÿrl:k" ialhs ma mKsúld¾hdxYh v fiajdjfi!LH wdoS fjhs'''' ta bosßm;a lrkafka zzmKquqiwudre woIld¾hdxYh jk úg fi!LH wOHdmk uqijk q nh Imd;S wo úgmla fi!LH fi!LH q nh mla.ek'''ZZ Imd;S wud;HxYfha yd dr wOHla Ijrfhl= hgf;a njls' Tyq mKq jYfhka úúOdx.S lD;IwOHdmk wxY Tia fiam%p fi!LH wOHdmk jákd Wmfoia uqiq l< iskud máhls zzle<e wOHdmk yd m%pdr wOHla jrfhl= hgf;a njls'' Tyq mKq WKZZ wud;HxYfha m%j¾;udkfhys cd ldhs l ffjoH" d Yd,l ffjoH" ffjoHjreka ' m%fnfy;a cd ldhslfohs ffjoH" m%cd Yd,l ffjoH" ffjoHjreka " ck;dj fnfy;a fohs ' mdpkh ld¾hdxYh fïm%crfÜ fj; fi!LH " hkqfjka ye|skajqKQ uef,aßhd jix.;h .ek" ;kffjoHjreka wOHdmk ks,W;a Odßka we;=¿m%jY k;a ,nd fohs ' shlaoka oka fi!LH wOHdmk ks,Odßka we;=¿j tka ;a ,ndoeKQ fohs"u'fi!LH ,ndoS u;g ffjoHjreka orK i" dyh xikSh fõ' .ek'''tkak;a lsÍfï jeo.;alutka .ek''' jeis ls, mQjeis ¾K l ld¾h uKav,hlska mQiuka ; ck;dj j ixfõoS jeisls,s ke;s ¾Kúld¾h uKaviq,hls ka iukaú; ck;dj iqj ixfõoS s,s ke;s wjYH jkafka wehsla@;kd.ekS hk ldrKh .ekufï wdoS jYfhka lsÍfï úYd, fufyjrlglsWrfok wdh;khla njg Wrfok wdh;khla njg f.j,a j,g jeisls,shf.j,a jeo.;a .ek Ífï úYd, fufyjrlg j,gfïjeis ls,shl la ;kd.ekS fï jeo.;a lu .ek wOHdmk ld¾hdxYhg mßK;" ienE tl, ck;djg iqa j isßtk ;aksyq rlndhls e álrka g m;ajieka ;sfá í'fnda m%fi!LH câd fi!LH" mdie,a . ld¾hY+ ls hd fohs ' ldls ks,hym;a lndhls k ieriS fndaâkk m;aj ;sfi!LH" fí' m%cwdfrda d fi!LH" mdie,ar"fi!LH" wdfrda . lshd fohs ' ldls ,ieka a ieriS tk j ixfõoS oela ufi!LH lsydkwe.hS a hqwOHdmk" ;a ïwNs jfhka Ijßhl zzieka áfnda uy;a ;hdZZ fi!LH r wêldßka m¾fha IK " mqk yqK q uy;a ;hd toskâwe|s ß uy;a jefgk;= retos .; lrkaßfka HYd,d m¾fha IKwOHla yd we.hS ï" mqyqKq ;hdyryd k tl, we|s jefgk;= e .;HYd,d lrkaffi!LH ka iqwOHdmk" ï''' wdoShka wxY .Kkdjls k a iuka ú;wxY j;au.Kkdjls kakj fi!LH .fïh' fkdñ,fha zziem;ZZ o.%.ïjeis ka i`.rdjla m;aj isáklsfï fudfydf;a udkhka Tia fiaj;a ck;dj ÿka mKs úv fõ.fhka ck;dj yzziem;ZZ Khhlr.;a f;ahols' Í.ïjeis Íï''' wdoS ka iuka ú; uka fi!LH .fïh'i`.rdjla fkdñ,fha wOHdmk ld¾hdxYh udOH yryd úúO fi!LH mKs ú v w;r fnodyßk w;r tys fndfyda jákd iq j Wmfoia fj; jvd;awOHdmk ks¾udKYS ,S f,i udOH iqj iïmf;ys úvhmKsúv ld¾hdxYh yryd úúOmKs fi!LH tl, fld¿ l=reÜgka w;r f,i fnodyßk w;r tys fndfyda jákd iqj Wmfoia ixksfkAokfhys,d iqúfYAIS jevigyka ksn|j l%shd;aul wka;¾.;h' ixks okfhys iqúfYAIhka S jevigyka n|jul%hssh'd;aul wka;¾.;h' ixksfõokh lsfÍkAug yels,dfõjdh k wmf.aksme;= je/ye,s weªï we|f.k fï jevigyka j,g l%shdYS ,Sj lrhs' lrhs' iyNd.s jQ ck;dj ;j;a ld,hla úg ? we|sß jeàf.k tk fj,djg ojfia l+ghk m%dma; sh wfma rg ? we|s ß jeàf.k tkmj;a fj,djg ojfia l+gm%dma;sh zzl,dmfha úYsIAG;u fi!LH o¾Yl kd rgZZ hk fnda fkdjk frda." l,ska l, u;=fjk fi!LH ;¾ck" meñfKhs ' fnda fkdjk " l,s ka l, u;=fjk fi!LH ;¾ck" meñfKhs ' Ñ;%máhla fmkajhs' ld,Sk wjYH;d fuka u úfYa Is; tafrda ll.yd ine|S ì;a ;shlg w,a,k iqÿforKg ;srhla u; f.!rjdorh ,la ,nd foka k g ruqhla ,a jQu; fhaÑ;% h' úúO úúO ld,S wjYH;d fukau úfYaIs; tall yd ine|S ì;a shñks lgiai w,a k miqy<s ÿ ;s máhla fmka hsÍ' fï jevigyka úúO oeKQ j;ajls j,kfhoS u" ld¾h ;s rfhamQ¾ úl= ï mdkawm fka ÿma mß; ;am;a qh',ft<s frfÜ ha fï úldj bos lrka ka fï oeKQjk;aa i|yd lsÍfïmj;a jevigyka j, fhoSu" ld¾h fha ï mdka fka ÿma mf;a.añksiaiqh' uKa t<sm fha mqyqKQ lsÍï"úúO vy<s , i|yd udOHfõoS jk u<my lrk orejdf.a;suqry qK úl= nUhla ;rïh' Tyq ck;djf.a iqj iïm;g iqúmKq fYa IS odhl;a hla olaj;rïh' k uKav,f;dr;= i|ydremqfjí yqKQ wvúh lsÍï" udOHfõoSka i|yd mj;ajk lrk orejdf.a uqym%j qK nUhla .ajießhZZ fi!LH iïuka;Tyq %k" fzziq wfOdauqLfhka isß isß u<my .d jefgk fjla w;l udKh

fkdjeïn¾ 14 oskg fhfokzz f,dal oshjeähd oskhZZ ksñ;s lrf.k fkdjeïn¾ udifha iqúfYaIS ,sms iuqÉPhla bosßm;a lsÍu Docor NOTE Magazine ld,hl isg mj;ajd f.k tk iïm%odhls'

EDITOR'S EDITOR'S

miq.sh ld,h ;=< iuia; f,dalfha fukau wfma rfÜo oshjeähd frda.Skaf.a úYd, jeäùula mej;S ikao¾Nh ;=< tu iïm%odh jvd;a wre;a .kajñka fkdjeïn¾ udifha l,dmh weiqre lrf.k mdfya fuu frda.h iïnkaOfhka mßiudma; oeKQj;a lsÍulg wm lghq;= fhdod ;sfí'

oshjeähdj md,kh l< yels frda.hls' frda. md,kh flfryS Tfí lemùfï ;rugu NOTE fmr,d Tng m%;s,dN w;am;a fjhs' hï flfkla fuh fkdi<ld yßhso@ ta ;rugu Tyqg Bg jkaoshla f.ùug isÿùu fuys we;s Nhdkl ;;a;ajhhs' ffjoHjreka mjik ldrKhla jkqfha uekúka iSks md,khg ,la lsÍfuka" oshjeähdj je<|Sfuka miqj;a wjqreÿ úis ;sia .Kkla .; jQj;a lsisÿ ixl+,;djhlska f;drj fi!LH iïmkakj cSj;a jk ñksiqka ´kE ;rï isák njhs' wmg ,ndoSug ;sfnk mKsúvh;a thuehs'

oshjeähd frda.h ;sfnk flfkla fõ oshjeähdj yd ta wdY%s;j meK ke.sh kï th uekúka md,kh lsÍug yels yels ixl+,;d iïnkaOfhka úoaj;a iEu mshjrlau .kak' fï frda.hg m¾fhaIlhka" ffjoHjreka /ilf.a jeä jeäfhka ñksiqka f.dÿre ùfu kj;u jákd Wmfoia j,ska fï ,sms wjodku i<ld ksfrda.S Tn yels;dla iuqÉPh iukawfOda ú; jk w;r ta mKq ydfjla w;l m%udKh fi!LHiïmka k f;dr;= wej;= ïwvúh mej;=ï mj;ajd iïuka ;%kú"vzziq re fjí u q L fhka is ß is ß .d jefgk fukau úfYaIBharata ÿrl:k" ial hsGunathilaka ma mKs fiajjießhZZ dj wdoS fi!LH fjhs'''' ta bosßm;a lrkafka zzmKq wudre .ek'''ZZ - Editor in Chief fuka ''' máhls ta bosß'm;a lrka fka zzmKq wudre .ek'''ZZ jYfhka úúOdx.SlD; wxY TiaufiaúfYa fi!LH wOHdmkialhsma mKsúv fiajdj wdoS jákd Wmfoia uqiq j l<fjhs isk'ud zzle<e WKZZ iïnka O fia dodhlhka /ila weiq f¾ .ks ñúúOdx.S kaI ÿrl:k" frda .hg jYfhka lD; fi!LH wxY Tiafia f.dÿre fi!LH wOHdmk fkdùug jákd uqi.ek" q l< mdpkh iskud máhls' ld¾hdxYh zzle<e WKZZ j¾;udkfhys fï rfÜ ck;dj fj; hkqfjka ye|skajqKQ uef,a ßhdWmfoia jix.;h doctormagazine.lk@gmail.com u ,ndoS ug orK W;ald¾hdxYh idyh m%YxikS h fõ' .ek'''tkak;a lsfrda Ífï jeo.;a lag uye|s .ek''' jeis ls,shßla ck;dj fj; fi!LH hkq fSk jka kajqK Q uef,a hd jix.;h mdpkh oshjeähd .ldrKh wjYHfhka uoeKQ.ek" bharata.gunathilaka@gmail.com W;a qlj¾;udkfhys kifï 'dyhosrfÜh iïnkaOfhka wjYH jkafka wehs @ hk .ek jYfhka oeKQu i ,ndoS ug jka orK W;a m%Yjeähdj xikSh fõ' .ek'''tka k;a lsÍfï fïwdoS jeo.;a lu .ek''' jeisls,shla wOHdmk ld¾hdxYhg ld¾hY+r" mßK;" ienE tl, ck;djg hym;awjYH iqj isjka ß;a fyqkarewehs lrka khk g ldrKh .ekfi!LH @j fï wdoS jYfhka jeo.;a jk m% u q L yªka d oS ï j ixfõoS a wNskjfhka wOHla zziekaáfndaâ uy;a;hdZZ yryd tl, fi!LH uIjßhl l;dny jk fi!LH wOHdmk ld¾hdxYhg ld¾hY+r" we;s mßK;" f ienE tl, ck;djg hym;awêldßka iqj isß;a yqre iqlrka kg oelaulska hq;jeäfhka j isá fï fudfydf;aiqkj udkhkaoela Tiau fls ia k ck;dj ÿka mKsúv fõ.fhkazzieka ck;dj .%y lr.;a ;a h' tl, fi!LH j ixfõoS a hq;a wNskjfhka wOHlaIjßhl áfnda âKh uy;a yryd wêldßka iïnka Ofhka f;dr;= r;hdZZ e fbos ßm;am;alr.;a ls Sukf;ag jvd;a ks mKsúvh tl, fld¿ l=reÜgkao f,i fkdjeïn¾ udifha wmf.a m;ajiqj isáiïmf;ys k fï fudfydf;a kj udkhka Tia fia ck;djmKsúvh ÿka mKsúv fõ.fhka ck;dj .%yKhfj; h¾' udKYS,S f,i ixksfõokh lsÍug yels fj; fõjdh hkakkswmf.a me;= hs' iqj iïmf;ys mKsúvh je/ye,s weªï we|f.k jevigyka j,gf,i l%shdYS,Sj jvd;a ¾ udKYS ,S u f,i tl,fïfld¿ l=reÜgka NEVER MISS;sAN ISSUE wm iyNd.s fjfiis au W;a i f í' jQ ck;djk ;j;a ld,hla hkdyhla úg wfma rg ord thhs ' ixksfõokh lsÍug yels fõjdh hkak wmf.a me;=uhs' je/ye,s weªï we|f.k fï jevigyka j,g l%shdYS,Sj zzl,dmfha úYsIAG;u fi!LH o¾Yl mj;akdGet rgZZ DOCTOR hk MAGAZINE delivered to your door every month or iyNd.s jQ ck;dj ;j;a ld,hla hk úg wfma rg

f.!rjdorh ,la forKg ,nd fokakg uq,a jQfhah' zzl,dmfha úYsIAG;u fi!LH o¾Yl mj;akd rgZZ hk fï mQ¾úldj wm bosßm;a lrkafka fï rfÜ choose to download it to your mobile or tablet. Go to subscription f.!rjdorh ,la forKg kg uq,a jQfhah' ck;djf.a iqj iïm;g iqúfYaIS odhl;a jhla ola,nd jktofoka page see our latest subscription offer.

fï mQ¾úldj wm bosßm;a lrkafka fï rfÜ Bharata Gunathilaka ck;djf.a iqj iïm;g iqúfYaIS odhl;a jhla olaj k

- Editor in Chief

doctormagazine.lk@gmail.com Bharata Gunathilaka bharata.gunathilaka@gmail.com

DOCTOR MAGAZINE

April 2017

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April 2017 DOCTOR MAGAZINE NOVEMBER 2017 | DOCTOR

April 2017

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Volume 23 ● Issue 11 ● November 2017

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NOVEMBER 2017 | DOCTOR MAGAZINE

Èhjeähd

fyhlska fï ,nk kskao meh kjhg jvd wvq fjkjd kï tu orejka oshjeähdjg k;= ùfï by< m%jK;djhla ;sfnkjd' uyd ì%;dkHfha Ydka; fcda¾ca iriúfha m¾fhaIlhka lKavdhula fï wkdjrKh isÿ lr ;sfnkjd' tys m%;sM< miq.shod Professor Christopher G. Owen kï m¾fhaIlfhl= úiska Journal Pediatrics iÕrdfjka m%ldYhg m;a lrKQ ,enqjd'

orejka ,nkafka wvq kskaola kï miq ld,fhaoS oshjeähd frda.sfhla fjkak mq¿jka'''

jhi wjqreÿ 6-12 w;r orejka idudkHfhka ojilg meh 9-12 ld,hl kskaola ,nkjd kï th Tjqkaf.a ldhsl udkisl fi!LHhg b;du fyd|hs' hï

YÍrfha fïo ;ekam;a by< hdug;a YÍr ialkaO o¾Ylh jeä ùug;a ta weiqf¾ fnda fkdjk frda. wjodku by< kexùug;a fï kskao wvq ùu fya;= fjkjd' zzwo fndfyda orejkaf.a kskao iSudldÍ idOlhlaj ;sfnkjd' fjfiiskau mdie,a jev" rEmjdyskS ne,Su jeks úfkdaodxY fï wjodku by< kxjkjd' orejkag jev jf.au ksos úfõlh;a jeo.;a' th wkd.;fha osfkl jeäysáfhl= jQ miq orejdg ,efnk fi!LH wdfhdackhlao fjkjd'ZZ uydpd¾h Tfjka jeäÿrg;a woyia olajkjd'

Èhjeähd wjodku fukau ;j;a frda. we;s lrk

fojk wdldrfha oshjeähdj jvd;au iq,n oshjeähdj wdldrhhs' ueos jhi bl=;a jQ úg yefok Latent Autoimmune Diabetes in Adults (LADA) kï jQ frda.hla fojk wdldrfha oshjeähdj hhs fndfyda úg ffjoHjreka jrojd jgyd .kakjd' fï LADA hkq fifuka j¾Okh jk frda.hla jk w;r th uq,a ld,fha bkaishq,ska u; r|k frda.hla fkdfjhs'

NOVEMBER 2017 | DOCTOR MAGAZINE

¨Kq

iaùvkfha lefrd,skaiald wdh;kh iaùvk yd *ska,ka; cd;sl m¾fhaIlhka msßila yd taldnoaOj isÿ lrk ,o m¾fhaIKhlg wkQj fuu fojk wdldrfha oshjeähdj fukau LADA kue;s frda.h we;sùug;a wêl ¨Kq wkqNjh m%n, fya;=jla fjkjd' osklg ¨KQ ñ,s .a?ï 2300 g wvqfjka ¨KQ wdydrhg .ekSfuka fï wjodku ie<lsh hq;= muKlska wvq lr .ekSug wjia:djla ie,fik w;r jeä jk iEu .a?uhlgu oshjeähdj yd LADA wjodku by< hkjd' doctormagazine.lk

Èhjeähd

nr md,kh lsÍfuka oshjeähdj imqrd u¾Okh lr.; yelshs' nr md,kh lsÍfuka oshjeähdj ld¾hlaIu f,i md,kh l< yelshs' uyd ì%;dkHfha .a,diaf.da iriúfha uydpd¾h uhsla ,Ska BMJ iÕrdjg ,smshla iïmdokh lrñka hï flfkla ;u YÍrfha nr lsf,da 15lska muK wvq lf<d;a thu oshjeähd frda.h iïmQ¾Kfhka md,khg ,la lsÍug fya;= jk nj m%ldY l<d' îgd ffi, j,g m%dKh msôk iqñysß wdydrhla - fldfldajd fojk wdldrfha oshjeähdj ;sfhk frda.Skaf.a m%Odk ,laIKhla jkafka YrSrfha bkaishq,ska ixfõoS;djh wvq ùuhs' bkaishq,ska ksmojk îgd ffi, fï whf.a fõ.fhka úkdYhg m;a fjkjd' tfiau bkaishq,ska >%djh ùu;a ld¾hlaIuj isoaO jkafk kE' fï îgd ffi, j,g jk úkdYh kej; wdmiaig yrjkak fya;=jk iqñysß wdydrhla j¾cskshdyS ì%.ï hka.a hqksjisá yS m¾fhaIlhka msßila yªkdf.k ;sfnkjd' ta ;uhs fpdla,Ü ksIamdokhg fhdod .kakd fldfldajd' fldfldajd ksIAmdokh lrk rgj,a w;r wfma Y%S ,xldj;a fmruqfKau isákjd' fldfldajd j, ;sfhk Catechin lshk *a,ejfkda,h fï fjki we;s lsÍug WmldÍ jk nj fulS úoHd{hka wkdjrKh lrf.k ;sfnkjd' oshjeähdj md,khg fhdod.kakd wdydr l¾udka;fhaoS ìhla iella ke;sj fldfldajd fhdod .kafka fldfyduo@ thska jvd;a id¾:l m%;sM< fk,d .kafk fldfyduo lshk ldrKh .ek oeka Tjqka jeäÿr m¾fhaIK isÿ flfrkjd' 10

NOVEMBER 2017 | DOCTOR MAGAZINE

zzfrda.Ska ú;rla fkdfjhs" ffjoHjreka jqK;a oshjeähdj frda.Skaf.a YÍr nr md,khg ;nk ,kaiqj uos' ta;a fnfy;a jeä lrkjdg jvd fïl yßu m%dfhda.slhs' lsishï flfkla ia:Q, kï Tyq oshjeähd fjkq;a fmf<kjd kï nr md,kh lrk tl yßu jeo.;a' thskau frda.h fu,a, l< yelshs' oshjeähdfõ YÍr nr idOlh ta ;rïu ;SrKd;aukhs'ZZ uydpd¾h uhsla ,Ska jeäÿrg;a m%ldY lrkjd' .%Ska à jeros wdydr isß;lg yqre jQjkag;a /ljrKhla imhkjd''' .%Ska à f,dalh mqrdu ck;dj ;u fi!LH ;;a;ajh m%j¾Okh lsÍu Wfoid ,nd .kak mdkhla' .%Ska à j, ;sfhk Epigallocatechin Gallate (EGCG) kue;s ridhkh bkaishqka m%;sfrdaOh wvq lrkjd' th ia:q,;djh ;sfnk whg;a isrrer flÜgq lr.kak fyd|hs' fud<hg;a wdydrhla' fjfiiskau u;l Yla;sh''' OdrK Yla;sh jeä lr.kak .%Ska à WmldÍ jk nj m¾fhaIKd;aulj ;yjqre ù ;sfnkjd' kj;u fidhd .ekSu ;uhs" fi!LHiïmkak fkdjk ngysr mkakfha wdydr j,g weíneys jQ whg .%Ska à mdkh lsÍfuka thska we;sjk wjodku fnfyúka wvq lr.kakg mq¿jka nj' r;= uia" ix;Dma; fïoh" msßmyÿ l< msIaGh wdydrhg .kakd t<¿ yd m<;=re wdosh wvqfjka .kakd whg fï .%Ska à mdkh lsÍfuka tys wj.=K hï;dla ÿrg lefmkjd'' wj.=K msß ngysr mkakfha wdydr isßf;ka ñofokak lsh, lsjjg th îß w,skag ùkd jhkjd jf.a fjk wjia:d;a ;sfhkjd' fï mKsúvh ta whghs' University in China yS College of Food Science and Engineering at Northwest Xuebo Liu, Ph.D úiska The FASEB Journal. iÕrdjg ,smshla iïmdokh

lrñka fï jeo.;a f;dr;=re wkdjrKh lrkjd' doctormagazine.lk

JICA wdh;kh" je,a,j;a; ngysr isxy iudch yd cmka ;dkdm;s ld¾hd,h wkq.%yfhka fkdjeïn¾ 18 osk je,suv jx.shl=Uqr uOH uyd úoHd,fhaoS iqj idhkhla

Velona Cuddles fj;ska

iqcd;d fijk rcfha Ndr .ekSfï <ud ksjdih fj; iqúfYaIS mß;Hd.hla'''

JICA wdh;kh" je,a,j;a; ngysr

isxy iudch yd cmka ;dkdm;s ld¾hd,h wkq.%yfhka fkdjeïn¾ 18 osk je,suv jx.shl=Uqr uOH uyd úoHd,fhaoS iqj idhkhla meje;aùug lghq;= iïmdokh lr ;sfí' fuu iqj l|jqr ffjoHjrhd iÕrdfõ ixúOdk Yla;sfhka meje;aùug kshñ;h' weia lkakdä oyilg fkdwvq ixLHdjla fnod oSu" wefia iqo Y,Hl¾u isÿ lsÍug wjYH frda.Ska yªkdf.k Tjqkag nÿ,a, uy frdayf,aoS tu Y,Hl¾u isÿ lsÍu msKsi fkdñ,fha Wiia ;;a;ajfha ldp msßkeóu" l¾Kdndê;hka i|yd wjYH mÍlaIK myiqlï iemhSu yd jákd Y%jK WmlrK ,ndoSu" oka; mÍlaId" reêr mÍlaIK we;=¿j iqj fiajdjka /ila tosk wdY%h ÿr neyer .ïudk j, ck;dj fj; ,nd oSug lghq;= lr ;sfí' ta yereKQ úg m%foaYfha wd¾Ól ÿIalr;d j,ska fmf<k orejka lsysm fofkla i|yd YsIH;aj ,ndoSu we;=¿j iudc i;aldr rdYshla tosk isÿq lsÍug kshñ;j ;sfí' fuu jevigyk iïnkaëlrKh lrKQ ,nkafka nKavdrfj, uOH uyd úoHd,hSh wdos YsIH ix.uh" jx.shl=Uqr iqNødrdu úydria:dkh yd zzjx.shl=Uqr oYlhl wmsZZ úoHd¾Ò ixioh úisks' 12

NOVEMBER 2017 | DOCTOR MAGAZINE

nKavdrfj, lS¾;su;a Velona Cuddles <ore we÷ï ksIamdolhka jk fudrgqj" ,laIm;sfha f;%â j¾laia mqoa' iud.u miq.shod nKavdrfj, iqcd;d fijk rcfha Ndr .ekSfï <ud ksjdifha fjfik orejkaf.a m%fhdackh i|yd ;u <ore weªï yd ksIAmdok mß;Hd.hla isÿ lrk ,oS' zzffjoHjrhdZZ iÕrdfõ b,a,Sulg m%;spdr f,i iajlSh iudc j.lSu wjOdrkh lrñka isÿ l< fuu mß;Hd.h miq.shod nKavdrfj, iqcd;d fijk rcfha Ndr .ekSfï <ud ksjdifha ia:dk Ndr ks,OdßkS wd¾' tï kkaodj;S uy;añh fj; Ndrfok ,oafoa zzffjoHjrhdZZ úOdhl l¾;D Ndr; .=K;s,l uy;d úisks'

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SUNSHINE HEALTH CARE LANKA LTD., 27, 4/1, York Arcade Building , York Arcade Road, Colombo 1, Phone 011 470 25 00 doctormagazine.lk

Hotline 077 377 72201799 NOVEMBER | DOCTOR MAGAZINE

International Mountain Day 2017

International Mountain day 2017 Haputale - Sri Lanka

f,dal lªlr oskh - 2017

f,dal l÷lr oskh kj jk jrg;a ymq;f,a l÷ mshiafiaoS ieuf¾''' wfma cSú; j, meje;aug iajNdjO¾ufhka ,efnkafka wkqmfïh jQ iïudoula' l÷lrh lshkafka iajNdjO¾ufha ksoka wdlrhla' wfma rg .;af;d;a wmg c,h imhk m%Odk .x.d yeu tllau wdrïN jkafka uOHu l÷lrfhka'

uyje,s" le<Ks" l¿" j<fõ hk .x.d''' iuk,lkao uqÿfK isg mek kex.d''' nEjqï ;eks;,d fy,a w;ßka ßx.d'' fïjd .,hs ñKs leg osh hg yx.d''' 14

NOVEMBER 2017 | DOCTOR MAGAZINE

mS î w,aúia fmf¾rd lsú÷ka l÷ YsLr j,ska .uka wdrïN lrk wfma .x.d .ek lú lf<a tfyu' l÷lrh jvd;a bmerKs ixialD;ska j,g ysñlï lshk ck;dj cSj;a jqK jdiN+ñ' bkaldjreka cSj;a jqK wekaäia lªjeáfh lafjpqjd" flkahdfj lsl=jd" b;sfhdamshdfj wïydrd" áfngfha hS''' wdoS YsIAGdpdr fndfydau bmerKshs' wfma rfg;a l÷lr jdiSkaf.a b;sydih fndfydau merKshs' doctormagazine.lk

¥IKh''' fï yeu tllau wmg ;¾ck njg m;a fjkjd' frda ÿla jeä fjkjd' iajdNdúl úm;a jeä fjkjd' fï wdldrhg f,dalh wmg jdihg kqiqÿiq ia:dkhla fjkak mq¿jka'

wfma rg ie<l=fjd;a l÷lrh lshkafk wmg cSjh msôk fmKy¿ lsõfjd;a ksjeroshs' lªlrh ;uhs uq¿ rfÜu cSjh r|jf.k bkafk' wdrlaIdj r|jf.k bkafk' l÷lrh úkdY jqfKd;a uq¿ rfÜu foaY.=Khg b;d wys;lr f,i th n,mdkjd' f,dalfha lª wdY%s;j cSj;a jk ck;dj ì,shkhla blaujkjd' hqfkiafldaj olajk wdldrhg f,dalfha ffcj f.da, rlaIs; 669la y÷kdf.k ;sfnkjd' thska 376lau ;sfnkafka l÷lrfha' iuia;hla jYfhka .;a úg fï lªlr ffcj f.da, rlaIs; iuia; f,dal ffcj f.da, rlaIs; j,ska ishhg 56la ksfhdackh lrkjd' fï ffcj f.d, rlaIs; wo úYd, wka;rdhlg uqyqK md ;sfnkjd' ta ñksia wdl%uK ksid' mßirh ys;+ ys;+ wdldrhg fu,a, lsÍu ;u whs;shla hhs is;d.;a ñksia i;df.ka lªlrh;a fíÍ kE' fufyu ;j ál ld,hla .sfhd;a ñksia j. fkdfjhs" i;d isõmdjd" .yfld< mjd úYd, wk;=rlg uqyqK mdkjd' kshx" c, m%Yak" mßir

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fujr f,dal lªlr oskfha cd;Hka;r f;audj zzl÷lrh wjodkul''' foaY.=Kh" id.skak yd ixl%ukhZZ hkakhs' (Mountains under Pressure: Climate, Hunger, Migration.) ñksid úiska isÿ lrk ,o ydks ksid wo f,dalfha WKQiqu by< f.dia ;sfnkjd' mdkh lrk c,h laIh fjñka ;sfnkjd' l÷lrfha úkdYh tf;la tys jeishkag ÿka wdydr laIh fjñka Tjqka mjq,a msáka ydu;a lr ;sfnkjd' lªlr jdiSka" Y%uh fjfyid lghq;= l< msßñka k.r fj; wefoñka isákafka ;jÿrg;a ;u Wmka .ï ìï j, jdih lsÍu ÿIalr jQ ksihs' fï ksid l÷lrfha cSú;h tkak tkaku ÿIalr This year's theme is Mountains under Pressure: Climate, Hunger, Migration. wfma rfg;a l÷lr jdiSkaf.a b;sydih fndfydau merKshs' n,kaf.dv udkjhd udkj YsIaGdpdrfha uq,au hq.hg wh;a udkj YsIAGdpdrhl f;dr;=re olajkjd' n,kaf.dv ;ekakg udhsï fj,d ;sfhkafk;a o¾YKSh l÷ j<,a,la' uE;loS w;sYh fm!rdKsl YsIaGdpdrhla jYfhka yªkd.;a fidr.=fKA" y,aÿïuQ,a, m%foaYh ymq;f,a l÷ j<,af,ka wdjrKhj ;sfnkjd' f,dalfha ck;dj w;f¾ jkaokSh jQ isoaOia:dk /ilau msysgd ;sfnkafk;a l÷ YsLr j,' iuka foõrcqka wê.Dys; iïnqÿ md myiska jkaokSh jQ iuk, lkao wfma rfÜ tla WodyrKhla muKhs' NOVEMBER 2017 | DOCTOR MAGAZINE

fjñka mj;skjd' tlai;a cd;Ska úiska fujr fï .eg¿j ms<sn|j l;sldj;la we;s lsÍu fujr lªlr oskfha f;audj fjkjd' f,dal l÷lr oskh ksñ;s lrf.k fï rfÜ meje;afjk m%Odk W;aijh iEu j¾Ihlu ymq;f,a k.rdikakfha wä 5790 muK Wi ymq;f,a lkafoaoS W;aijdldrfhka iurkjd' ljo;a fï rfÜ mßirh iqrlaId lsÍug rdcH wdh;k j,g jvd mßir ys;ldó ixúOdk bosßfhka isáhd' f,dal lªlr oskh iïnkaOfhka wjosu;a fjñka uOHu l÷lrfha mßirh wdrlaId lsÍug ymq;f,ka ìysjQ zzm%Nj ixúOdk cd,hZZ iqúfYAIS fufyjrla isÿ lr ;sfnkjd' l÷lrfha isÿjk jHik j,oS ;u wdOdr Wmldr i,iñka" i;d isõmdjd" .yfld< úkdY lrk n,fõ.hka fjf;d;a tajdg tosßj ks¾Nhj bosßm;a fjñka" ck;dj oeKQj;a lsÍfï jevuq¿ mj;ajñka fï ld¾hh 2010 jif¾ isg mj;ajdf.k tkq ,nkafka m%Nj ixúOdk cd,h úiska' m%Nj ixúOdkfha ks¾ud;D wixl m%Nd;a r;akdhl" rxcs;a l=udr we;=¿j mßir ys;ldóka /ila úiska fujr zzcd;Hka;r lªlr oskhZZ fjkqfjka ixúOdkh lrk lª ke.Sfï l|jqr yd ymq;f,a lª YsLrfha mj;ajk W;aijhg ymq;f,a k.r iNdj we;=¿j rdcH yd fm!oa.,sl wdh;k /il iydh ,efnkjd' f,dal lªlr oskh fjkqfjka foieïn¾ 9 jk osk ysñosßfha meje;afjk l÷ ;rKhg zzffjoHjrhd iÕrdjZZo tla jkafka iajlSh iudc j.lSu wjOdrKh lrñks' fï .fõIKd;aul pdrsldjg wm yd w;aje,a ne|.kakd f,i zzffjoHjrhdZZ mdGlhkaf.ka b,a,d isákjd'

NOVEMBER 2017 | DOCTOR MAGAZINE

iuia;hla jYfhka .;a úg lªlr ffcj f.da, rlaIs; iuia; f,dal ffcj f.da, rlaIs; j,ska ishhg 56la ksfhdackh lrkjd' f,dal l÷lr oskh ksñ;s lrf.k ymq;f,a lkao ;rKh lrñka mj;ajk fï iqúfYaIS l|jqrg iyNd.s ùug Wkkaÿjla olajk mßir ys;ldóka 076 7484 118 yd 070 3005 951 ÿrl:k wxl j,g l:d lr jeä úia;r ,nd .kakd f,i;a" fï ms<sn|j jeäÿrg;a oeKQj;a ùug wjYH wh www.prabhawa.org fjí wvúhg msúfik f,i;a l|jqre ixúOdhlhka mßir ys;ldó m%cdj fj;ska b,a,Sula lrkjd'

l÷;rKh úia;r wdrïNh 2017 foieïn¾ 09 osk fmrjre 8'00g ymq;f,a k.rfhka úuiSï m%Nd;a 076 7484 118 rxcs;a 070 3005 951 fjí msgqj www.prabhawa.org B fï,a prabhawa.org@gmail.com f*aianqla Kandukaraya Haputale doctormagazine.lk

Èhjeähdj

md,kh lruq

ldhsl frda. yd ks¾Kd, frda. úfYAI{ ffjoH jreK .=K;s,l

NOVEMBER 2017 | DOCTOR MAGAZINE

ld¾ólrKh yd kd.ÍlrKh ksid wo ojfia ñksia cSjk rgdj w;sYhska ixlS¾K ù ;sfí' wdydr rgdj fukau tosfkod l%shdldrlï flfrySo tys n,mEï we;sù ;sfí' fï ksid oshjeähdj" wêreêr mSvkh" yDo frda." ms<sld wdoS fnda fkdjk frda. w;sYhska iq,n ù ;sfí' uq,a ld,fha tla;rd iudc me<eka;shla w;r doctormagazine.lk

muKla meje;S fï frda. wo jk úg uq¿ uy;a iudcfhau ms<s,hla fia me;sr hdu uy;a wjdikdjls' fnda fkdjk frda. je<÷Kq miq iqj lsÍu W.ygh' fï ksid wm úiska l< hq;af;a frda.h we;sùfuka je<lSu;a" frda.h je<|S wfhla fõ kï ixl+,;d" we;súh yels Wmøj yels;dla wju lr.ekSu;ah'

oshjeähdj hkq l=ulao@ oshjeähdj hkq fnda fkdjk frda.hls' fuysoS frda.shdf.a reêr.; iSks uÜgu idudkH mej;sh hq;= w.hg jvd by< w.hla .kS' ksfrda.S wfhl=f.a ksrdydr reêr iSks uÜgu 70-110 mg/dL w;r w.hl mj;S' iSks hkq isrerg wjYH Yla;sh ksmoùu i|yd fhdod.kakd bkaOkhhs' idudkHfhka Tnf.a isrer u.ska Tn .kakd wdydrfha we;s msIaguh ix>gl .aÆfldaia kï iSks j¾.h njg ì| fy<hs' tu iSks reêrhg tl;= fõ' fuu iSks YÍrfha mgl" ffi, ;=<g we;=¿ ù oykh ùfuka Yla;sh ksmojhs' w.akHdYfha ksmofjk bkaishq,ska kue;s fydfudakh ffi, j,g iSks j,g we;=¿ ùug WmldÍ fjhs'

reêr.; iSks uÜgu by< hdug fya;= reêr.; iSks uÜgu by< hdug uQ,sl fya;= ;=kls'

w.akHdYfha ffi, úkdY ùu ksid bkaishq,ska fydafudakh >%djh fkdùu'

w.akHdYfha fi, j,ska m%udKj;a f,i bkaishq,ska >%djh fkdùu'

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ffi, j,ska bkaishq,ska j,g olajk m%;sfrdaOh ksid .aÆfldaia ffi, ;=<g we;=¿ fkdù reêrfhau mej;Su'

oshjeähdj wdldr oshjeähdj m%Odk jYfhka wdldr folls' 1'

m<uq j¾.fha oshjeähdj

fojk j¾.fha oshjeähdj

(Type 1 Diabetes) (Type 11 Diabetes)

m<uq j¾.fha oshjeähdj l=vd <uqka w;r nyq,h' ;reK yd jeäysá jhfia Woúh w;r iq,nj olakg ,efnkafka fojk j¾.fha oshjeähdjhs' fuhg wu;rj .¾NsKS wjêfhaoS y÷kd.kakd oshjeähdj (Gestational Diabetes) ;;a;ajhlao mj;S' ore m%iQ;sfhka miqj fuu oshjeähdj fndfyda úg iqj jk w;r miqld,Skj fï ldka;djkg fojk j¾.fha oshjeähdj we;sùfï wjodkula mj;S' fojk wdldrfha oshjeähdj f,dj mqrd nyq, jYfhka olakg ,efnkafka fojk wdldrfha oshjeähdjhs' fuu frda.Skaf.a bkaishq,ska uÜgu by< hdug bkaishq,ska j,g ffi, olajk m%;sfrdaOh (Insulin Resistance) fyda ksmojk bkaishq,ska m%udKh m%udKj;a fkdùu uQ,sl jYfhka fya;= fjhs' fudjqkaf.a reêr iSks uÜgu md,kh i|yd fnfy;a fm;s mdúÉÑh" cSjk rgdfõ fjkialï isÿ lsÍu yd bkaishq,ska tkak;a lsÍu isÿfõ'

reêr iSks - isrerg lrk ydks isref¾ ffi, j,g we;=¿ fkdù reêr.;j bkaishq,ska mej;Su ksid

NOVEMBER 2017 | DOCTOR MAGAZINE

uQ,sl jYfhka .eg¿ folla meK k.S' 1'

Tn fl;rï wdydr .;a;;a Tnf.a isref¾ ffi, wjYH ;rï Yla;sh ksmojkafka ke;' tu ksid isref¾ nr wvq fjhs' Tn blauKska fjfyig m;aùuo isÿfõ'

os.=ld,Skj reêr.; iSks uÜgu by< w.hl mej;Su ksid Tfí weia" jl=.vq" iakdhq" yoj; wdoS bkaøshhkag ydks isÿúh yel'

oshjeähdj we;sùfï wjodkï idOl ¡

Wig iß,k nrg jvd nr jeäùu bK jg m%udKh fnfyúka jeä ùu msßñkaf.a bK jg m%udKh fi'ó' 90$w`.,a 35g wvq úh hq;=h' ldka;djkaf.a fi'ó'80$w`.,a 32 g wvq úh hq;=h'

wjq' 25g jeäùu

ol=Kq wdishd;sl iïNjhla ;sîu'

mjqf,a ióm {d;sfhl=g oshjeähdj ;sîu'

wêreêr mSvkh" yDo frda. je<|Su'

.¾NKS ld,h ;=< oshjeähdj je<|Su fyda ls'.a' 4'5 g jeä orefjl= m%iQ; lsÍu'

¡ iqj fkdjk ;=jd,

udkisl frda.hlska fm,Su'

oshjeähdj y÷kd.ekSu i|yd isÿ lrk mÍlaIK

oshjeähdj j<lajd .kafka flfiao@

ksrdydr reêr iSks mÍlaIdj

ksjeros wdydr md,kh'

(Fasting Blood Sugar)

.a,hsfldisf,agâ ysfud.af,dìka mÍlaIdj (HbA1C)

jHdhdu yd YdÍßsl l%shdldrlï j¾Okh lsÍu'

´r,a .aÆfldaia fgd,rkaia mÍlaIdj (OGTT)

kshñ; T!IO kshñ; ud;%djg .ekSu'

udkisl iunr;djh mj;ajd .ekSu'

reêr.; iSks uÜgu" reêr mSvkh iy reêr.; fldf,iagfrda,a kshñ; uÜgul mj;ajd .ekSu ;=<ska by; .eg¿ j,ska ñoSug fyda tajd l,a oud .ekSug mq¿jk' fojk wdldrfha oshjeähdj b;d fiñka j¾Okh jk ;;a;ajhls' yeoSf.k tk úg y÷kd.ekSu i|yd fjfiia ,laIK fkdue;' oshjeähdj frda.h we;sùfïoS my; ,laIK we;súh yel' ¡

wêl msmdih

wêl wdydr reÑh

fjfyilr nj

wêlj" úfYAIfhkau rd;%S ld,fhaoS uq;%d msgùu

fmkSu fnd| ùu

NOVEMBER 2017 | DOCTOR MAGAZINE

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ldurx.d lkafka n,df.khs'''

jl=.vq" Èhjeähd frda.Skag ldurx.d iqÿiq kE''' tajd jl=.vq l%shdldß;ajh ÿ¾j, lrkjd''' fld<U úYAj úoHd,fha fÊHIaG l:sldpd¾h" jl=.vq frda. ms<sn| úfYaI{ ffjoH trx. tia úfcaúl%u ck;dj oeKQj;a lrhs'

ldurx.d f.dvla lEu iqÿiq ks;r ks;r ldurx.d lk flfkla kï ffjoHjrfhl= yuqù reêr mÍlaIKhla lrf.k ;ukaf. jl=.vq j, ksfrda.SNdjh iïnkaOfhka jd¾;djla ,nd .ekSu iqÿiqhs' 22

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ldurx.d wfma rfÜ irejg jefjk rij;a m<;=rla' wfma wE; tmsg .ïudk j, bfí jefjk m<;=re w;f¾ ldurx.d;a w;sYh ckm%shhs' ta;a" wo ojfia ldurx.d j,g jvd jeä jákdlula ,eî we;af;a tajd b;d fyd|ska reêr.; iSks uÜgu md,kh lrk njg we;s u;h ksihs' fï ksid oshjeähd frda.Ska fï m<;=r wdydrhg .kakg jeä leue;a;la olajk njo fmfkkjd' fld<U úYaj úoHd,fha m¾fhaIlfhl= jk úfYaI{ ffjoH trx. úfcaúl%u miq.shod fï rfÜ ck;dj fj; jákd fy<sorõjla l<d' ta w;sYhska .=Kj;a m<;=rla uq;a ldurx.d jl=.vq frda.Ska yg w;sYhska wys;lr nj'

ldurx.d j, ;sfnk Tlai,sla wï,h jl=.vq j,g ydkslrhs ldurx.d j, Tlai,sla wï,h ;sfnkjd' Caramboxin kue;s ix>glh;a tys ;sfnkjd' jl=. vq j, .,a ;sfnk wh" jl=.vq j, l%shdldß;ajh ÿ¾j, wh yd vh,hsisia lrk whg fï Tlai,sla wï,h yd Caramboxin øjH folu wys;lrhs' úfYaI{ ffjoH trx. tia úfÊúl%u uy;d mjik wdldrhg Tlai,sla wï,h jDlaldKq j, ;sfhk ishqï kd, j,g ydks f.k tkjd' jDlaldKQ lshk fï ishqï kd, rdYshla jl=.vqfõ ;sfnkjd' taj yryd ;uhs reêrh msßisÿ ù

wmøjH f,i uq;%d neyer lrkafka' fï kd, wjysr jqKdu f,a j, ;sfhk wmsßisÿ foa fmß, uq;%d j,g tl;= jkafk kE' tajd reêrfhau /f|kjd' neyer úh hq;= wmøjH" hQßhd jf.a foaj,a reêrfha /|Su ydkslrhs' fï ksid ldurx.d f.dvla lEu iqÿiq kE' f.dvla fkdfjhs flfkl=g we;eï úg tl f.ähla lEj;a ydks isoaO fjkak mq¿jka' iuyre ksrka;rfhka ldurx.d wkqNjhg .kakjd' ta wh fï wjodkug ,la ùfï by< bvla ;sfhkjd'

f;areï.; fkdyels wosis fya;=ka ksid;a we;euqkaf.a jl=.vq ÿ¾j, fjkjd fï jl=.vq frda.Skaf.a ldurx.d idOlh .ek fidhd n,kak ffjoH úfcaúl%u fhduq lf<A frda.Ska mÍlaId lsÍfuka ,o w;aoelSïuhs' cd;sl frday,g tk jl=.vq frda.Skaf.ka fldgila ksoka.; jl=.vq frda.Ska (CKD) f,i jl=.vq ÿ¾j,;djhg m;a jqKQ wh' oshjeähdj" úI j¾. YÍr.; ùu wdoS ldrKhla ksid oaú;Shsl m%;sM<hla f,i jl=.vq ÿ¾j, jqKQ wh;a ;j;a fldgila wkdjrKh fjkjd' yenehs ;j;a fldgilg tjka frda. hla we;s fjkak n,mdk ksYaÑ; ldrKhla fmkajkak nE' tfyu jqKdu ffjoHjreka úúO m%Yak wy, fï whf.a wdydr rgdj" cSj;ajk l%uh

wdosh úuikjd' tjeks m%Yak lsÍï j,oS we;eï frda.Ska ldurx.d wdydrhg .ekSula fyda ldurx.d hqI mdkh lsrSula frda.h je,|Sug fmr lr we;s nj ;yjqre jqKd' fï wkQj ffjoH úfcaúl%u fï iïnkaO iudf,dapkhl fhfokak ;SrKh l<d' m¾fhaIK jd¾;d mßYS,kfhaoS ldurx.d jl=.vq flfryS wys;lr f,i n,mdk nj ;yjqre lr.;a;d' ta .ek wOHhk jd¾;d /ila mßYS,kh lsÍfuka jf.au ;uka yuqjg wd frda.Ska iïnkaOfhka isÿl< ksÍlaIK weiqf¾ Tyq fï wjodku idlaId;a lr.;a;d' fuh ;yjqre lr .ekSug iuyr frda.Ska mgl mrSËKhlg (Biopsy) ,la lsrSug isÿjqKd'

ldurx.d jeämqr lE wh jl=.vq mÍlaId lr.ekSu iqÿiqhs ó<Õ mshjr úosyg ffjoH trx. úfÊúl%u wfma rfÜ ck;dj oeKQj;a lsÍug mshjr .;af;a fï wjodku ms<sn|j ixfõoS fjñka' Tyq lshk úosyg fï m<;=r lEfuka lsishï ydkshla isrerg isÿ jqfKd;a ta m<;=frka je<lSfuka''' tfia;a ke;akï kshñ; m%;sldr .ekSfuka frda. ;;a;ajh iqj w;g m;a lr.kak mq¿jka' ta;a jl=.vq j, jDlaldKQ wdmodjg ,la jqfKd;a tajd iïmQ¾Kfhkau m%lD;s ;;a;ajhg m;a lsÍu t;rï myiq ldrKhla fkdfjhs' fï ksid ks;r ks;r ldurx.d lk flfkla kï ffjoHjrfhl= yuqù reêr mÍlaIKhla lrf.k ;ukaf. jl=.vq j, ksfrda.SNdjh iïnkaOfhka jd¾;djla ,nd .ekSu iqÿiqhs'

fï wh ldurx.d lEu fyd| kE'''

ldurx.d l=,hg wh;a ì,sx j,;a Tlai,sla wï,h hyñka ;sfnk ksid tajd;a ks;r ks;r wkqNjh kqiqÿiqhs' ffjoH trx. úfcaúl%u jl=.vqjla ;sfnk wh" jl=.vqjla noaO lr.;a wh yd lsishï wdldrhl jl=.vq frda.hla mj;sk wh ldurx.d wdydrhg .ekSu iqÿiq kE'

ysianv ldurx.d lEu;a iqÿiq kE ta yefrkak ldf,lg miafi ldurx.d m<;=rla Tng msßkeuqfjd;a th jyla ÿkakd fya m%;slafIam lrkak wjYH kE' w;=remila úosyg mqxÑ lE,a,la lEjg lula kE' ta;a ysianv ldurx.d lEu kï iqÿiq kE' tfyu jqKdu wdydr fkdue;s wdudYfha Tlai,sla wï,h iDcqju wjfYdaIKh ù tys n,mEu wys;lr f,i n,.ekaùug ;sfnk bvlv jeähs'

fï ms<sn| ;j;a m¾fhaIK wjYHhs ldurx.d lk ish¨u mqoa.,hska jl=. vq frda.j,g ,lajk nj fuhska woyia fjkafka kE' by; i|yka l< oekgu;a jl=.vq wdndO mj;sk whg ldurx.d wdydrhg .ekSu ksid we;súh yels wjodku jeähs' kuq;a tjeks fmr wjodkula ke;s iuyr wh;a jl=.vq wdndOhg ,lajqK wjia:d ;sfhkjd' ta ksid ldurx.d ksid jl=.vq wdndO we;sùu ms<sn|j ;j;a m¾fhaIK meje;aùu w;HjYHhs'

oshjeähdj ;sfnk wh Wm;skau tl 24

NOVEMBER 2017 | DOCTOR MAGAZINE

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Amazing Health Benefits Of Canola Oil

yoj;g ñ;=re oshjeähd frda.Skag;a iqÿiq

lefkda,d Ths,a

wou Tfí wdydr msiSug f;dard .kak oekg f,dalfha jeäfhkau Ndú;d jk jvd;a fi!LHiïmkak t<j¿ f;,a j¾.h fuhhs lefkda,d f;,a wo f,dalfha iq,nju Ndú;fha we;s t<j¿ f;,a j¾.hhs' fiiq f;,a wNsnjd lefkda,d f;,a mdßfNda.sl wdl¾YKh oskd .kkakg iu;a ù we;af;a tys iajNdjfhkau mj;akd yoj; iqñ;=re .=Kdx.hs' YÍrfha wys;lr fldf,iagfrda,a wvq lsÍu" iu meyem;a lsÍu" ffi, ì;a;s iúu;a lsßu yd ms<sld je<elaùu lefkda,d f;, i;= ;j;a jákd .=Kdx. lsysmhla muKs' lefkda,d f;,a ksIamdokh lrkafka Rape (Canola) kue;s YdLfha weg j,sks' msiskakg .kakd wjfYaI ;rÕldÍ f;,a j¾. fldf;l=;a ;snqKo lefkda,d f;,a ta w;f¾ iqúfYaIS mdßfNda.sl wdl¾YKhla oskdf.k we;af;ao tys we;s fi!LHiïmkakNdjh ksidh'

úYsIAG;u fïo j,ska idrhs lefkda,d f;,a j, YÍrfha iajNdjfhka lefkda,d f;,a j, tal, wix;Dma; fïo wï,h we;s ksid th reêrfha iSks uÜgu hdukh lsÍug uekúka WmldÍ fjhs' ksiel bkaishq,ska md,khla we;s lrk ksid oshjeähdj we;sùfï bvlv wiqrd,hs' doctormagazine.lk

NOVEMBER 2017 | DOCTOR MAGAZINE

ksmoùula fkdue;s tfy;a Tng w;HjYH fïo ldKav folla wka;¾.; fjhs' yDohdndO yd wd>d; ;;a;ajhkaf.ka Tnj wdrlaId lrk Tfï.d 3 fïo wï, ldKavhg wh;a Alpha-linolenic acid (ALA) fud<fha l%shdldß;ajhg yd <orejkaf.a YÍr j¾Okhg w;HjYH Tfï.d 6 fïo wï,hla fia ie<flk Linoleic acid (LA) fï Tfï.d 6 yd Tfï.d 3 hk fïo wï, ldKAv fol lefkda,d f;,a j, we;af;a 2:1 wkqmd;fhks' fuh fmdaIKSh jYfhka mej;sh hq;=u jk úYsIAG;u wkqmd;h jk w;r nyqwix;Dma; fïo wï, ldKAvhg wh;a y÷kd.;a úYsIAG;u fïo wï, ldKAvhla jYfhka ie<fla' ta yereKq úg lefkda,d f;,a j, fldf,iagfrda,a j, krl ix>glh jk LDL wvq lrk yoj;g ñ;=re Monounsaturated Fatty Acid mj;S'

wjodkï iy.; fïo wï, wE;a lrhs fj<|fmdf<a we;s fjk;a t<j¿ f;,a j,g idfmalaIj udkj iqjfi;g wjodkula we;s lrk ydkslr fïo j¾. wE;a lr ;eîug lefkda,d f;,a WmldÍ fjhs' yoj;a frda. we;s lsÍug odhk jk ix;Dma; fïoh T,sõ Ths,a j, we;s m%udKhg;a jvd wvlskau wvqh'

fldf,iagfrda,a wvx.= ke; lefkda,d f;,a j, fldf,iagfrda,a wvx.= ke;'

NOVEMBER 2017 | DOCTOR MAGAZINE

úgñka E iq,nj wka;¾.;h lefkda,d f;,a tla jHxckhlg fhdok m%udKh ;=< Tng osklg wjYH flfrk úgñka E j,ska y;frka tlla wvx.= fõ' YÍrfha ;sfnk fïo yd fm%daàk fldgia uqla; LKavl yd l%shd lsÍfuka isÿ úh yels n,j;a ydksh wjysr lrkafka úgñka E h' fï ksid yoj;a frda. yd ms<sld we;sùfï wjodku wvq lrhs' iaurK Yla;sho jeäfõ' Canola oil has the least amount of saturated fat and no trans-fat or cholesterol, making it the healthiest cooking oil among its peers. Canola oil is rich in monounsaturated fat, reducing the risk of coronary disease and a rich source of omega-6 fatty acid, essential for growth and development of the brain in individuals. It is also a rich source of omega-3 fatty acid that protects the body against strokes and heart attacks. Clinical trials and studies reveal that consuming Canola oil instead of other cooking oils impacts the body favourably and offer the individual significant health improvements and increased metabolism.

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GESTATIONAL DIABETES

.¾NKS iufha we;sjk Èhjeähdj

oUfoksh uQ,sl frdayf,a m%ij yd kdß úfYaI{ ffjoH yßkaø rKùr úisks

Tn Èhjeähd frda.sfhla kï .¾NsKS;djhg m;a fjkakg fmr ffjoHjrfhl= yuqù reêr iSks uekúka md,khlg ,la lr.; hq;=h' 28

NOVEMBER 2017 | DOCTOR MAGAZINE

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.¾NKS iufha we;sjk iq,n;u frda. ;;a;ajh jkqfha .¾NKS oshjeähdjhs' Y%S ,xldj yd wfkl=;a wdishd;sl rgj, fï ;;a;ajh idfmalaIj jeä uÜgul mj;skjd' .¾NKS iufha we;sjk oshjeähdj y÷kd.ekSu" ksishdldrj md,kh lsÍu yd je<elaùu fjfiiskau jeo.;a jkqfha oshjeähdj" ujg yd orejdg hk fofokdgu flá ld,Sk yd os.= ld,Sk jYfhka whym;a m%;sM< /ila we;s lsÍug fya;=jla úh yels ksihs' .¾NKS iufha we;sjk oshjeähdj hkq l=ulao@ we;eï uõjrekaf.a kshñ; idudkH reêr iSks uÜgug jvd jeäfhka reêr iSks uÜgu mej;Su uQ,sl jYfhka fuysoS isÿ fõ' .¾NKS;djfhaoS fndfyda úg uq,skau fï ;;a;ajh olakg ,efnk w;r nyq;rhla .¾NsKS ldka;djkag ore m%iQ;sfhka miq th idudkH ;;a;ajhg meñfKhs' .¾NKS;djhg fmr oshjeähd ;;a;ajhla ;snqfKa kï th fuu .¾NKS iufha we;sjk oshjeähdj

ldKavfhys,d i<lkafka ke;' Tn oshjeähd frda.sfhla kï .¾NsKS;djhg m;a fjkakg fmr ffjoHjrfhl= yuqù reêr iSks uekúka md,khlg ,la lr.; hq;=h'

.¾NKS iufha we;sjk Èhjeähdj we;sùfï wjodkïiy.; idOl ¡ jhia.;j .¾NsKS;djhg m;aùu ¡ ia:q,;djh ¡ ujg" mshdg fyda mjqf,a ióm {d;sfhl=g oshjeähdj mej;Su ¡ mQ¾j .¾NKS;djhloS l=i ;=< orejd ñh.sh ldka;djka ¡ jeä Wm;a nrla iys;j orejka ìys l< uõjreka' ^fuu ;;a;ajh ksido l=i ;=< orejka úYd,j jeãug yel& ¡ Polycystic Ovarian Syndrome we;s ldka;djka ¡ reêrfha iSks uÜgu jeä lrk iafgfrdhsv T!IO .kakd ldka;djka

flfia jQjo .¾NKS iufha we;sjk oshjeähdj we;sjk uõjreka miq ld,fhaoS oshjeähdj frda.hg f.dÿre ùfï jeä wjodkula mj;S'

.¾NKS iufha we;sjk Èhjeähdfõ frda. ,laIK

.¾NKS ÈhjeähdfõoS we;súh yels wys;lr n,mEï

¡ nyq;rhla .eìKs ldka;djka lsisÿ frda. ,laIKhla m%lg lrkafka ke;'

¡ .¾NKS iufha oshjeähdj we;sjk ujlf.a l<,fha idudkH j¾Okhg jeä j¾Okhla isÿ fõ' orejdf.a nr fõ.fhka jeäùu yd ta ksid we;súh yels ixl+,;d iq,nh' ksoiqkla f.k n,uq' orejd ìys ùfïoS orejdf.a Wrysia m%foaYfhka orejd isrùu isÿ úh yel' (Shoulder Distocia) ¡ fujeks uõjreka isfiaßhka ie;alug jeä jYfhka fhduq lsÍugo isÿ úh yel' ¡ fkdfïrE orejka f,i ore Wm; isÿ úh yel ¡ orejd Wmka ú.i yqiau .ekSfï wmyiqj ¡ iSks md,kh ÿ¾j, jQ úg l=i ;=< orejd ñh hdfï wjodku ¡ orejd Wmka ú.i orejdf.a iSks uÜgu wvqùu ksid we;súh yels ixl+,;d ¡ orejd jgd mj;sk j;=r nE.h leã fhdaks ud¾.fhka oshr .e,Sfï bvlv ¡ ore Wm;ska miq wêl reêr jykhla we;s ùfï wjodku

¡ we;eï úg n,j;a msmdidj uQ,sl frda. ,laIKhla fia m%lg lrhs' ¡ jeämqr uq;%d hduo we;s úh yels uq;a idudkHfhka .eìKsNdjfhaoS jeä jYfhka uq;%d msg lrk ksid th frda. ,laIKhla jYfhka fkdie<fla'

ffjoHjrfhl= yuqfõoS''' fuysoS isÿ lrk reêr mÍlaIK Tng .¾NKS iufha we;sjk oshjeähdj we;sùug we;s wjodkfï m%udKh wkQj fjkia fjkjd' m<uq ffjoH yuqfõoSu Tfí ffjoHjrhd úiska fï ms<sn|j frda. b;sydih úuid ne,Su yd thg wod, reêr mÍlaIK isÿ lsÍug kshu lrkjd' OGTT hk reêr mÍlaIKh isÿ lrkjd' fuysoS .aÆfldaia oshrhla mdkh lsÍug i,iajd bka ld,hlg miq reêrfha iSks uÜgu mÍlaIdjg ,la lrkjd'

.¾NKS iufha we;sjk oshjeähdj .¾NKS;djhg we;s lrk n,mEu .¾NKS;djfhaoS" m%iQ;sfhaoS yd bka miqjo fuu frda. ;;a;ajh ujg yd orejdg hk fofokdgu wys;lr f,i n,mEï lsÍug bv we;'

.¾NKS iufha oshjeähdj we;sjk ujlf.a l<,fha idudkH j¾Okhg jeä j¾Okhla isÿ fõ' 30

NOVEMBER 2017 | DOCTOR MAGAZINE

ìhm;a fkdjkak''' täfhka wjodku ch .kak .¾NKS iufha we;sjk oshjeähdj ;;a;ajh uekúka md,kh lr ksfrda.S ore Wm;la Tng Wreu lsÍu i|yd Tfí ffjoHjrhd we;=¿j fi!LH ld¾h uKav, wk,iaj lghq;= lrkjd we;' ¡ uq,skau Tng yd Tfí orejdg fï wdY%h lr.;a lsishï ixl+,;djhla we;sù ;sfíoehs ialEka yd wfkl=;a mÍlaIK u.ska fidhd ne,Sula isÿ lrKQ we;' ¡ bkamiqj iSks md,k l%shdud¾. jYfhka uq,skau isÿ lrKqfha wdydr md,kh lsÍu iïnkaOfhka ksjeros doctormagazine.lk

ud¾f.damfoaYK ,ndoSuhs' ¡ wju jYfhka osklg meh nd.hla jYfhka j;a ks;sm;d jHdhdu lsÍug weúoSug wdoS jYfhka Wmfoia imhhs' ¡ wdydr md,kh u.ska muKla Tfí reêr.; iSks uÜgu md,kh lsÍu fkdyels jk úg Bg iqÿiq T!IO ffjoHjrhd úiska kshu lrKQ ,efí' fuysosS fm;s jYfhka ,nd.kakd fuÜf*dñka yd kslafIamK jYfhka ,nd .kakd bkaishq,ska iq,n jYfhka ks¾foaY flf¾' fï T!IO lsisfia;au l=i ;=< jefvk l<,hg ydkshla isÿ lrkafka ke;'

.¾NKS iufha we;sjk oshjeähdj we;s uõjreka ksfrda.S ore Wm;la i|yd .; hq;= l%shdud¾. fudkjdo@ ¡ Tfí ffjoHjrhd kshu lrk m%;sldr tmßoafokau ,nd .ekSu uq,skau wjYHfhkau l< hq;= ld¾hhs' ¡ ksjeros wdydr rgdjlg fhduq ùu" jHdhdu uekúka ,efnk fia ffoksl ld¾hhka mj;ajd .ekSu wdoS ldrKd kshñ; mßos imqrd,sh hq;=hs' ¡ kshu lrk ,o ld, jljdkq j,oS reêr iSks mÍlaId lr .ekSuo jeo.;a' Tnf.a oshjeähd ;;a;ajh yd .¾NKS;djh l<uKdlrkfhao th b;d jeo.;a idOlhls'

.¾NKS iufha we;sjk Èhjeähdj we;s Tn jyd ffjoHjrfhl= yuqjg hdhq;= wodkï wjia:d fudkjdo@ ¡ wêl msmdih ¡ wêl uykaish ¡ jukh

ore m%iQ;sh yd bka wk;=rej f.fjk cSúf;a''' ffjoHjrhd úiska Tfí iSks uÜgu md,khg ,la lr Tfí ore m%iQ;sh ie,iqï lrKQ we;' orejd ìysjk ld,h ;=< yd bka miqjo Tfí iSks uÜgu ms<sn|j fyo ld¾h uKav,h wjOdkfhka miqjkq we;' idudkHfhka .¾N oshjeähd ;;a;ajh ore m%iQ;sfhka miq idudkH ;;a;ajhg meñfKk w;r b;d l,d;=rlska os. gu oshjeähdj mej;Sugo wjodkula mj;S' flfia jQjo .¾NKS iufha we;sjk oshjeähdj we;sjk uõjreka miq ld,fhaoS oshjeähdj frda.hg f.dÿre ùfï jeä wjodkulao mj;S' fï ksid jhi wjqreÿ 40 blaujQ úg uekúka iSks md,kh lrñka reêr iSks uÜgu md,kh lrñka jvd;a fi!LHiïmkak cSú;hla .; lsÍug W;aiql jkafka kï th wdrlaIdjg iqÿiqh'

SUNSHINE HEALTH CARE LANKA LTD., 27, 4/1, York Arcade Building, York Arcade Road, Colombo 1, Phone 0114702500 doctormagazine.lk

Hotline 077 3773172 99

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Èhjeähdj iy .¾NsKSNdjh

.¾NsKS oshjeähdj lshkafka l=ulao@ .¾NKSNdjhg m;aùfuka miq flfkl=f.a reêrfha iSks uÜgu idudkH w.hka blaujd by< hdu .¾NsKS oshjeähdj hkqfjka ye|skafjhs'

7 in 1

f,dalfha Wmosk orejkaf.ka yf;ka tllau Wmoskafka .¾NKS oshjeähdj ys; uõjrekagh

3/4

Èhjeähdj frda.Skaf.ka y;frka ;=klau jdih lrkafka wvq yd uOH wdodhï ,nk rgj,h

.¾NsKS ldka;d urK j,g m%Odk fya;=jla f,i .¾NKS oshjeähdj y÷kdf.k ;sfí'

fï ksid w¿f;ka Wmosk orejka úúO fi!LH .eg¿ j,go uqyqK mEfï wjodkula mj;S

wvq yd uOHu m%udK wdodhï ,nk rgj, .¾NsKS ldka;djka iuia; .¾NsKS oshjeähd ldka;djkaf.ka ishhg 85la muK ksfhdackh l<o Tjqka .¾NKS oshjeähdj i|yd mÍlaIK j,g kshñ; mßos Ndckh lrkafka ke;' 32

NOVEMBER 2017 | DOCTOR MAGAZINE

ujo" bmÿKq orejdo miqld,Skj ia:q,;djh" wêl reêr mSvkh" oshjeähdj wdoS frda. j,g k;= ùfï jeä wjia:djla mj;S

iEu .eìKs ldka;djlu reêr iSks iïnkaOfhka mÍlaIdj,g ,la lsÍfuka

mjqf,a ish¿ fokdgu wdrlaIdjla hym;a cSú; Wreu fõ' wjodkï iy.; ;;a;ajhka i|yd mQ¾j wdrlaIdjla ,nd .ekSfï wjia:djla Wod fõ' doctormagazine.lk

ore iïm;a

,eîug ndOd we;s lrjk Èhjeähdj

WISH Fertility & IVF Clinic ys idhksl l<,fõo úfYaI{ ffjoH fy<rejka mikal=udr MBBS (Sri Lanka) uy;d iu. l< idlÉPdjla weiqßKs MD (Gyn. & Obs.) Infertility - China Pg. Dip. (Andrology) Monash, OUSL Master of Clinical Embryology Monash, Australia SLMC Reg. No. 20800

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NOVEMBER 2017 | DOCTOR MAGAZINE

reêrfha iSks uÜgu md,kh lsÍfuka fndfyda .eg¿ md,kh lr.; yelshs oshjeähdj ;sfnk iEu flfklau mdfya th lsishï md,khlg k;= lr .ekSug W;aiql úh hq;=h' fjfiiskau reêrfha iSks w.hka ojfia iEu wjia:djlu mdfya ys;lr w.hka ;=< mj;ajd .ekSu b,lalh úh hq;=h' tfia fkdjk úg we;sjk ixl+,;d w;f¾ jeä fofklaf.a l;dnyg t;rï ,la fkdjk''' tfy;a iqúfYAIS jeo.;alula we;s ldrKhla jkafka idM<H;djh fkdfyd;a orejka ,eîug we;s yelshdj ySk ùuhs' oshjeähdj ldka;djka yd mqreIhka fomd¾Yajfhau idM<H;djh ySk lrhs' oshjeähdj Tfí .¾NKS;djh ;¾ckhg ,la lrk uq;a thska ñoSug wjYH mshjr .ekSfuka th ie<lsh hq;= muKlska wvq lr.; yelsh' wdydr-mdk" úfõlh" T!IO yd kshu lrk ms<sfj,g ffjoHjrhd yuqù ta fok Wmfoia ms<smeoSu fuysoS jeo.;a fjhs'

Èhjeähdj ;sfnk ldka;djkaf.a we;sjk idM<H;d .eg¿ .eí .ekSug;a''' .eí .;a miq orejdf.a ksfrda.S Ndjhg;a n,mEï l< yelshs oshjeähdj ldka;djlf.a idM<H;djhg we;s lrk n,mEu fohdldrj úia;r l< yel'

NOVEMBER 2017 | DOCTOR MAGAZINE

1' reêrfha by< .aÆfldaia ^iSks& uÜgula ;sfnk úg th idM<H;djhg'''tkï ore iïm;a ,eîug wjYHfhkau kshñ; l%shdldß;ajfhka ;sìh hq;= Biag%cka" fm%dfciagfrdka yd fgiagiagfrdka wdoS fydafudak j, >%djh ùu ySk lrhs' túg .eí .ekSula we;sùug th ndOdjls' 2' oshjeähdj iys; ldka;djl .eí .;a úg th .íid ùfï wjodku by< hhs' .¾NsKS;djh yd ine|S fjk;a .eg¿o we;s ùfï wjodkula mj;S'

oshjeähdfjka fmf<k ldka;djka .eí .ekSfïoS uqyqK mdk .eg¿ iuyrla 1 'fmd,sisiaála ´jß iskafv%dï kue;s frda. ;;a;ajh Polycystic ovary syndrome (PCOS) äïnfldaI j, ;=jd, we;sùu' fuysoS .eí .ekSfï wjia:d wvq fjhs' wd¾;jh iïnkaO .eg¿ /ila meK ke.Sug bv ;sfí' widudkH Tima ùu" Tima isÿ fkdùu fï w;r m%Odkh' fï frda. fhaoS wêl f,i isrer uy;a ùulao isÿ fõ' 2' Tima pl%h iïnkaO .eg¿ widudkH Tima ùu (Oligomenorrhea)" Tima isÿ fkdùu (Secondary amenorrhea) fï w;f¾ m%Odkh' ojia 35lg jeä ld,dka;rhlska Tima ùu Oligomenorrhea hkqfjka ye|skafjk w;r ld,hla kshñ; mßos Tima ùu isÿ ù yh udihlg muK jeä ld,hla ;siafia Tima ùu isÿ fkdùu Secondary amenorrhea hkqfjka ye|skafjhs' doctormagazine.lk

3' kshñ; ld,hg fmr wd¾;jwNdjh isÿ ùu 4' jhi wjq' 40 g fmr wd¾;jh k;r ùu Premature menopause

oshjeähdj ;sfnk ldka;djl uqyqKmdk .¾NsKS;djh yd iïnkaO .eg¿ orejka Wm;a úlD;s;d j,g ,laùfï wjodku oshjeähdj ;sfnk úg ms<sis|.;a orejd lsishï úlikd;aul ÿn,;djhlg ,laù Wmf;aoS úlD;shla we;sùfï wjodkula we;s fõ' fuhg fya;= jkafka reêrfha iSks uÜgu yd lSfgdak uÜgu wêl f,i by< hduh' fndfyda wÕmiÕ úlikd;aul j¾Okhlg ,la jk ld,h fuh ksid .¾NKS;djfha uq,au i;s yh fuys,d w;sYhska ;SrKd;aulh' b;d uekúka reêr iSks md,khg k;= lr.; hq;af;a fï fya;=fjks' ta yereKQ úg ióm ffjoH wëlaIKhlg k;= fjñka ksfrda.S iïmkak .¾NKS;djhla idlaId;a lr.; hq;=h'

orejd m%udKfhka fukau nfrkao jeä ùu ujg oshjeähdj ;sfnk úg l=i ;=< j¾Okh jk orejd m%udKfhka fukau nfrkao jeä fjhs' tho .¾NKS;djh ixl+,;djhlg ,la lrhs' iajdNdúl m%ijhla fjkqjg isfiaßhka ore Wm;lg mdr lmhs' ta yereKQ úg orejd ;=<o bkaishq,ska m%;sfrdaOhla we;s ùug yd fjk;a fi!LH .eg¿ we;sùug lsishï wjodkula we;s fjhs'

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oshjeähdfjka fmf<k ldka;djka idM<H;d .eg¿ wju lr .ekSug .; hq;= mshjr ¡ ksfrda.S YÍr nrla mj;ajd .kak' ¡ Tfí reêrfha iSks m%udKh ksr;=re mÍlaIdjg ,la lrkak' Tn .eí f.k isà kï Tfí ksrdydr reêr iSks m%udKh 80-110 mg/dL w;r w.hl mej;sh hq;=h' wdydr .ekSfuka meh follg miq iSks m%udKh 100-155 mg/dL w.hl ;sìh hq;=h' ¡ ksr;=re jHdhdu j, fhosh hq;=h' tfy;a Tn isÿ lrk jHdhdu w;sYh fjfyilr tajd fkdùug j. n,d.; hq;=h' ¡ fi!LHiïmkak wdydr j,g fhduq úh hq;=h' fï i|yd Tfí ffjoHjrhdf.a$fmdaIKfõoshdf.a u.fmkaùu ,nd .kak' ¡ Tn .kakd lsishï T!IOhla fõ kï tajd ffjoHjrfhl=f.a mQ¾K wkqoekqu u; muKla ,nd.; hq;=h'

oshjeähdj ;sfnk mqreIhkaf.a we;sjk idM<H;d .eg¿ ¡ Y=l% ;r,h uq;%dYhg tl;= ùu Y=l% ;r,h iajNdjfhka fudapkh ù msg;g meñKsh hq;= uq;a oshjeähdjj iys; msßñkaf.a tajd uq;%dYfha tla/ia jk wjia:d we;' Retrograde ejaculation hkqfjka ye|skafjk fuh nrm;, frda. hla f,i fkdie<fla' kuq;a th msßñfhl=f.a idM<H;djhg n,mEula we;s l< yel' túg úl,amh jkqfha idM<H;d ;dlaIKh NOVEMBER 2017 | DOCTOR MAGAZINE

weiqf¾ iyldßh .eí .ekaùuhs' ¡ oshjeähdj ;sfnk úg mqreIhkaf.a Y=l%dKQ j, DNA ydkshg ,laùfï wjia:d jeäh' oshjeähdj ;sfnk msßñkaf.a Y=l%dKq DNA j, j¾Kfoay wdY%s;j fN!;sl ì|jeàula we;sù DNA fragmentation kue;s ydksh isÿ ùug bv ;sfí' ¡ Y=l%dKQ j, .=Kd;auh ySk ùu Low sperm quality

id¾:l .eí .ekaùulg Y=l%dKQjl wjYHfhkau mej;sh hq;= .=Kdx. folla fõ. Sperm Quality& Motility f,i tajd ye|skafjhs' Y=l%dKQjlg äïnhla yUd hdug we;s yelshdj Motility f,i y÷kajk w;r oshjeähd frda.Skaf.a tu yelshdjg fjfiiska ydks ùula isÿ fkdfõ' Y=l%dKQjla id¾:l .eí .ekaùulg Tìk iïmQ¾KNdjfhka''' .=Kd;aufhka mej;Su Sperm Quality kï fjhs' oshjeähd frda.Skaf.a Y=l%dKQ j, .=Kd;aulNdjh ySk úh yelsh' fuhg iïnkaOj mj;akd Y=l%dKQ j, ksfrda.S njg" .=Kd;auhg wys;lr f,i n,mEï lrk ;j;a fya;=jla jkqfha ia:q,;djhhs' ¡ fgiagiagfrdaka ixhq;sh ySk ùu Low Testosterone (Hypogonadism)

flfkla flfuka jhia.; jk úg Bg iudkqmd;slj Tyqf.a m%uqL ,sx.sl fydafudakh fia ie< flK fgiagiagfrdka fydafudakho ;=kS ùula isÿ fjhs' oshjeähdj iys; mqreIhkaf.a fgiagiagfrdaka ;=kS ùu fnfyúka jeäh' fuh m%;sldr lsÍfuka iqjh ,nd.; yels ;;a;ajhla fkdfõ' tfy;a Tfí fydafudak uÜgu by< ouk jl% yelshdjla ;sfí' cSjk p¾hdfõ 36

NOVEMBER 2017 | DOCTOR MAGAZINE

fjkialï" fmdaIKh yd T!IO ueosy;aùï" fjfiiskau nr wvq lsÍu fï hg;g .efka' ¡ fgiagiagfrdaka fydafudak uÜgu my; neiSu ksid ,sÕ=fõ l=vd reêr kd, j, fi!LHhg wys;lr n,mEula we;s fjhs' th ,sÕ=j ,sx. slj tla ùfïoS iDcq lsÍu kshñ; mßos isÿ fkdùug fya;=jla fjhs' ¡ fgiagiagfrdaka fydafudakh ,sx.sl WoaoSmkhla''' jqjuKdjla we;s lsÍug n,mj;ajk fydafudakhhs' th wvq uÜgulska mej;Su ,sx.sl wdYdj wvq ùug fya;=jls' Y=l% Od;= fudapkhg fya;=jk iakdhq ÿ¾j, ùfuka myfjk >%dj mßudjo wvq úh yel' fï wdldrfhka ia;%ska fukau mqreIhkao oshjeähdj ksid orejka ,eîfï .eg¿ j,g uqyqK mE yels uq;a kshñ; Wmfoia yd ffjoH m%;sldr j,ska we;súh yels ixl+,;d yd wjodku wju lr.; yel'

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 lafIA;%fha m<mqreÿ wfma jD;a;Sh iydh ,nd oSug wm b;d leue;af;ka isáuq' wmg l;d lrkak' fukak wfma wxlh ( 077 972 8799

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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

DOCTOR MAGAZINE

DO I HAVE

DIABETES?

Am I at Risk? Diabetes is a serious, yet common medical condition. If you have diabetes, you need to manage your blood sugars and regularly monitor them to be sure they are within their target range. 38

NOVEMBER 2017 | DOCTOR MAGAZINE

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There are a few types of diabetes, though the main two types are type 1 and type 2 diabetes.

Warning signs of diabetes Diabetes symptoms may occur over time or they may appear quickly. Some general warning signs of diabetes are: ¡

extreme thirst

dry mouth

frequent urination

a yeast infection in a prepubescent girl

flu-like symptoms, including nausea, vomiting, breath that smells like fruit, problems breathing, and loss of consciousness

¡ hunger ¡ fatigue ¡

irritable behavior

blurred vision

wounds that don’t heal quickly

skin that itches or is dry

yeast infections

Other warning signs of type 1 Type 1 diabetes is generally diagnosed in children and young adults, though it can occur at any age. A child may experience these additional symptoms: ¡

sudden, unintentional weight loss

wetting the bed after a history of being dry at night

Other warning signs of type 2 ¡

persistent infections or a slowhealing wound

complications that are associated with prolonged high blood sugar levels, such as numbness or tingling in your feet

heart problems

Who is at risk for diabetes? There are certain risk factors for both type 1 and type 2 diabetes. TYPE 1 • children •

young adults

•

those with an immediate relative with type 1 diabetes

TYPE 2 •

those over age 45

•

those who are overweight

•

those who are inactive

•

those who smoke

•

those who have a family history of diabetes

•

those who have high blood pressure

•

those who have abnormal triglyceride or HDL cholesterol levels

•

those with a history of insulin resistance

Oral glucose tolerance (OGTT): This test takes 2 hours. Your blood glucose levels are tested initially and then 2 hours after consuming a specific sweet drink.

Random plasma glucose test: You can have this test any time and do not need to be fasting.

Treatment Diabetes can be treated in several ways. Diet, physical activity, and careful monitoring are important if you have diabetes, no matter which type of diabetes you have.

You may experience one or more of the warning signs associated with diabetes. If you do, contact your doctor for an appointment.

If you have diabetes, you will need to carefully track your diet to prevent blood sugar levels from getting too high. This generally means watching carbohydrate intake as well as limiting over-processed, low-fiber foods.

Your doctor will ask you questions about your symptoms and may decide to run some tests.

Your doctor will work with you to develop a treatment plan to help you control your blood sugar levels.

Diagnosis

There are several tests to diagnose diabetes: ¡ HbA1C: This shows what your blood glucose level has averaged for the last 2 or 3 months. This does not require you to fast or drink anything. ¡

The article is sponsored by,

Fasting plasma glucose (FPG): You will need to fast for at least 8 hours before this test.

NOVEMBER 2017 | DOCTOR MAGAZINE

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DIABETES f,dalh mqrd

ñ,shk 422 l ck;djla oshjeähdfjka mSvd ú|s;s

jd¾Islj ñ,shk 3'7l ck;djla oshjeähdj ksid cSú;h yer h;s

1 PERSON IN 11 f,dalfha jeäysá ck;djf.ka iEu 11 fofklafg.ka tla wfhlau oshjeähdj frda.sfhls

Èhjeähdj m%Odk wdldr TYPE 1 DIABETES YÍrh m%udKj;a f,i bkaishq,ska ksmojkafka ke;

oshjeähdj ksid we;sjk ixl+,;d oshjeähdj YÍrfha fndfyda wjhj j, ixl+,;d we;s lrjk frda.hls' fï ksid wvq jhiska cSú;hg iuq oSugo isÿ fõ'

wxYNd.h wkaONdjh

TYPE 2 DIABETES YÍrh úiska bkaishq,ska ksmojhs' tfy;a tajd ksjerosj m%fhdackhg .efkkafka ke;'

yDohdndO jl=.vq wlrKsh

GESTATIONAL DIABETES .eìKs ldka;djkag we;sjk ;djld,sl tfy;a fjfiia wjOdkh fhduq úh hq;= reër iSks by< hk ;;a;ajhls' 42

NOVEMBER 2017 | DOCTOR MAGAZINE

mdo lmd oeóug isÿ ùu doctormagazine.lk

fmd,alsß j,

uyÕ= .=K

fmd,alsß ksIAmdok l%shdj,sh wkQj tys .=Kh fjkia jk nj Tn okakjdo@ Y%S chj¾Okmqr úYaj úoHd,fha fmd,su¾ ridhk wxYfha úY%du ,;a wdpd¾h t,a tï fla ;s,lr;ak úisks

NOVEMBER 2017 | DOCTOR MAGAZINE

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wm tosfkod wjYH wdydr ms<sfh, lsÍfïoS Ndú;d lrk w;HjYHu øjHhls fmd,alsß' .d .;a fïrE fmd,a c,h iu. ñY% fldg ñßld ,nd .kakd fmd,alsß b;d iqúfYaIS .=Kdx. j,ska iy úYd, T!Iëh .=Khlska hqla; fõ' fmd,alsß j,g wdfõKsl jQ wfkla m%Odk;u .=Kdx.h jkqfha fmd,alsß j, wvx.= fïo u.ska wdydr øjH" uia udxY iy T!IO me<Eá j, b;d wxY=ud;% j,ska wvx.= jk rildrl yd T!Iëh ixfhda. ksiaidrKh lr .ekSug we;s yelshdjhs' fmd,alsß j, ieÕjqKQ uyÕ= .=Khla wo ridhk úoHdfõ ksr;=re Ndú;d lrKQ ,nk i;a;aj yd me<Eá øjH j, iq¿ jYfhka wvx.= ridhk øjH ksiaidrKh lr.ekSu msKsi Ndú;d lrKQ ,nk fïo u.ska ksiaidrKh lrk l%uh y÷kajd oS we;af;ao fuu fmd,alsß u.ska wdydr øjH j, rildrl ksiaidrKh msKsi iy wdhq¾fõo Ydia;%fha Ydl fldgia j, wvx.= wxY=ud;% j, fldgia ksiaidrKh lsÍug Ndú;d lrKQ ,nk fuu l%shdj,sh wkq.ukh lsÍfuka nj fmkS hhs' hï flfkl=g úIla YÍr.; jQjfyd;a m%:udOdrhla f,i .eñhka fmd,alsß fokafkao fï fya;=j ksidh' wfma .eñhka w;f¾ m%p,s; lshukla jkafka we;eï fmdä ud¿ j¾. lsisu rila ke;sjd jQjo tu ud¿ msisk doctormagazine.lk

,o lsß w;sYhska rij;a jk njhs' fuhg fya;= jkafkao tu ud¿ j, we;s rildrl ffi, ;=< ieÕù we;s neúka tajd wkqNjfhaoS osjg rila fkdoefkk uq;a tajd lsrg msiSfïoS ffi, ;=< wvx.= ridxY= fmd,alsß j, wvx.= fïo u.ska msg;g f.k fydoao rij;a lsÍuh' fmd,alsß j, wvx.= f;,a j,g me<Eá j, yd udxY øjH j, wvx.= ieÕjqKQ rildrl yd T!IOldrl ksiaidrKh lsÍug we;s yelshdj fuhskao ikd: fjhs' ;jo" t<lsß j, wvx.= ix;Dma; fïoh fuka fkdj fmd,alsß j, wvx.= ix;Dma; fïoh ñksia isrerg yd cS¾K moaO;shgo b;d ys;lrh' tfyhska msá l< lsß fjkqjg wdydr msiSug fmd,alsß Ndú;h YÍrhg we;sjk frda. wjodku wju lr.ekSug bjy,a fjhs' ;jo fmd,alsß Ndú;d lsÍfuka wm YÍrhg wjYH úgñk yd LKsc ,jKo ,efí'

fmd,alsß j, iqúfYAIS .=Kdx. fmd,alsß j, wvx.= wk.s;u ix>glh jkqfha lsß úfYAI w;ßka fmd,alsß j, muKla wvx.= jk isrerg b;d ys;ldó f,daßla wï,hhs' f,daßla wï,h fud<h j¾Okhg fya;= jk w;r wiaÓ j¾Okhgo thska yelshdj ,efí' f,daßla wï,h isref¾ m%;sYla;slrKh jvhs' reêrjdyskS moaO;sh iqir lr fldf,iagfrda,a wju lrhs' YÍrhg wys;lr nelaàßhd yd ffjri j¾. igka lr tajd wvmK lsÍugo f,daßla wï,hg we;af;a ksiÕ jQ yelshdjls' fmd,alsß j,g ms<sld u¾Ok lsÍfï .=Khlao we;s nj úoHd{hka y÷kdf.k ;sfí' fmd,alsß j, úgñka î" iS yd B wvx.= jk w;r ue.alkSishï yd ;=;a;kd.ï we;=¿j LKsc ,jKo úYd, m%udKhla

NOVEMBER 2017 | DOCTOR MAGAZINE

wo wf,úhg ;nd we;s fmd,alsß ksIamdokh lrkafka by< WIAK;ajhla ;=< fmd,alsß úh<khg ,la lsÍfuks' tu l%shdj,sfhaoS fmd,alsß j, we;s uy= fmdaIKSh fldgia úkdY ùula isÿfõ' tfiau wys;lr fldgia W;amdokh ùulao isÿfõ' ysrukfha .d .;a fmd,a w;ska ñßlsfïoS we;sjk wjdish jkqfha tys wvx.= fïofhka ishhg 40-50 ;rï úYd, m%udKhla wmf;a hduhs' íf,kavrfhka ñßlSfïoS jákdu ;ka;=uh fldgia úkdY fjhs' wka;¾.;h' ue.akSishï yDo iamkaokfha ßoauh mj;ajd .ekSug WmldÍ jk ridhkhls' fmd,alsß j, we;s uex.kSia reêr iSks hdukhg fya;= fjhs' tkhska fmd,alsß reêrfha iSks ys;lrj mj;ajd .ekSugo m%fhdackj;a fjhs' fmd,alsß j, wvx.= fmdgEishï reêr mSvkh ys;lr w.h mrdihl mj;ajd .ekSug bjy,a fõ' Ceylon Medical Journal iÕrdjg imhk m¾fhaIK jd¾;djl fmd,alsß mßfNdackh ksid ie|E iufhaoS ms<sld yd we,aIhsu¾ jeks frda. we;sùu j<lajd .ekSg WmldÍ jk nj i|yka fõ' fmd,alsß j, wvx.= iajdNdúl m%;sTlaisldrl YÍrh uy¿ ùu yd iu /<s jeàu wju lsÍug WmldÍ fjhs'

fmd,alsß ilia lrk l%ufõoh wkQj tys .=Kh fjkia fjkjd''' fujeks uyÕ= .=Kdx.hkaf.ka hq;a fmd,alsß wo úúO ksIamdok f,iska fj<|fmdf<A wf,úhg ;nd we;'

NOVEMBER 2017 | DOCTOR MAGAZINE

ld¾hnyq, .DyKshkag fmd,a .d" fmd,alsß ñßld .ekSug we;s ndOdjka ksid tajdg fyd| b,a¨ulao we;sù ;sfí' wo wf,úhg ;nd we;s fmd,alsß ksIamdokh lrkafka by< WIAK;ajhla ;=< fmd,alsß úh<khg ,la lsÍfuks' tu l%shdj,sfhaoS fmd,alsß j, we;s uy= fmdaIKSh fldgia úkdY ùula isÿfõ' tfiau PAH jeks wys;lr fldgia W;amdokh ùulao isÿfõ' ysrukfha .d .;a fmd,a w;ska ñßlsfïoS we;sjk wjdish jkqfha tys wvx.= fïofhka ishhg 40-50 ;rï úYd, m%udKhla m%fhdackhg fkdf.k wmf;a hduhs' íf,kavrfhka ñßlSfïo fodila we;' fmd,alsß j, we;s jákdu ;ka;=uh fldgia úkdY ùula thska isÿ jkafkah' fï ksid ksjerosj ms<sfh, lr we;s fmd,alsß wdydr ms<sfh, lsÍfïoS fhdod .ekSu w;sYh jeo.;a lreKla jkafkah' YÍrhg wys;lr ridhk øjH j,ska f;dr kshñ; m%ñ;skag wkQj ilia lr wiqrk fmd,alsß Tfí f;aÍu úh hq;=h' fuysoS Bg ,eî we;s ;;a;aj iy;sl fukau l,a bl=;a jQ oskho ie<ls,a<g n÷ka úh hq;=h' f,an,h lshjd thskao .=Kd;aul fmd,a lsß yªkd.; yel' fmd,alsß jákd osú iqrlsk ridhk wvx.= wdydrhla nj ienú' tfy;a ksIamdok l%shdj,sh fi!LH iïmkakj isÿ lrk by< .=Kd;auhla we;s ksIamdokhla fkd.;af;d;a Tfí uqo,a oS orK m%h;akh" fi!LHiïmkak .=Khla thska ,nd .ekSu .`.g bks lemSula jeksh' fmd,a lsß ñ,oS .ekSfïoS nqoaêu;aj fyd|u fmd,alsßu muKla ñ,oS .kak'

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fnda fkdjk frda. ;¾ckfhka .e,ùug fï úosyg lghq;= lrkak''' flfuka jeä jk fnda fkdjk frda. ;¾ckh wìuqj wfma rg'''' miq.sh ld,h ;=< fï rfÜ ck;dj fnda fkdjk frda. j,g ck;dj b;d iS>%fhka k;= jqKd' óg oYlhlg fmr ixLHdf,aLK ne¨j;a oeka frda.Ska jd¾;d ùfï meyeos,s jeäùula olakg ,efnkjd' fnda fkdjk frda. we;s fjkak ksYaÑ; jhila kE' ck j¾.h''' ia;%s$mqreINdjh''' fï fldhs foa j;a fkdi<lñka ´kEu flfkl=g ´kEu fudfyd;loS fnda fkdjk frda.hla je<f|kak mq¿jks' oshjeähdj" yDo frda." ms<sld wdosh oeka b;d jeäfhka ck;dj w;r me;sr ;sfnk njla fmfkkakg ;sfnkjd'

fnda fkdjk frda. fïid by< hkakg n,mdk fya;= ck;dj fï wjodkug m;a jkakg fya;= lsysmhlau n,mdkjd' wdydr .ekSfïoS wm isÿ lrk jeros" weÕ fjfyiSula ke;sj lïue,s cSú;hlg yqre ùu" udkisl 48

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fi!LH wud;HxYfha fnda fkdjk frda. iïnkaO wOHlaI ffjoH ;s,la isßj¾Ok doctormagazine.lk

wd;;sh" u;ameka yd u;aøjH mdúÉÑhg yqre ùu jf.a ldrKd ksid fnda fkdjk frda. we;sùfï jeä wjodkula we;s fjkjd'

f,i mdúÉÑh;a iqÿiq kE' g%dkaia fïoh jeks wys;lr fïo fldgia Ndú;h;a ksfrda.S fi!LHiïmkak cSú;hlg iqÿiq kE'

wm .kak wdydr fõ, osyd ne¨fjd;a jeä jYfhka iSks Ndú;d lsÍu frda. /ilg w; jkkjd' ¨Kq wêl

n;a áll=;a t<j¿ jeäfhkq;a wkqNjhg yqre fjkak ta ú;rla fkdfjhs wm wdydr .kakd m%udKh .ek;a wm fjfiiskau ie<ls<su;a úh hq;=hs' wm mqreÿ fj,d ;sfhkafk n;a f.dvla tlal t<j¿ álla lkak' kuq;a we;a; jYfhkau úh hq;af;a t<j¿ hyñka .kakd w;f¾ ldfndayhsfâ%Ü wka;¾.;h wvq lsÍuhs' n;a jqK;a jeämqr wkqNj l<du taj wjidkfhaos ixÑ; fjkafk iSks úosyg" msIaGh úosyg' idudkHfhka wfma o¾YSh wdydr msÕdkl msIaGh ^m%Odkj& n;a ishhg 70la muK ;sfhkjd' t<j¿ ishhg 30hs' fï msIaGh ishhg 50 lg jvd ^ishhg 25-30 olajd wvq lr.kak mq¿jka kï fyd|hs&

25%

50% fi!LHiïmkak cSú;hlg fhda.H o¾YSh wdydr fõ,la Bg iudkqmd;slj t<j¿ Ndú;dj by< oeïfud;a th úYd, ch.%yKhla' ta ksid úYd, fi!LH m%;s,dNhla ta isß;g fhduq jQ ;eke;a;dg ,efnkjd' kuq;a wms okakjd fuhg úYd, jYfhka wdl,amuh fjkila isÿ úh hq;=hs' mqxÑ fjkila fyda uq,ska isÿ lr.;af;d;a l%u l%ufhka fï b,lalhg hdu wiSre ldrKhl=;a fkdfjhs' wfma wdydr isß; fjfiiskau mßj¾;khlg ,la úh hq;=hs'

ks¾foaYs; iSks m%udKh jf.a fo.=Khla wm mdúÉÑ lrkjd iSks úYd, fi!LHuh wjodkulg mdr yokjd' ms<sldo we;=¿j iEu fnda fkdjk frda.hlgu wêl iSks wkqNjh fya;=jla fjkjd' ks¾foaY wkQj osklg .; hq;= iSks m%udKh .a?ï 30g wvq úh hq;= jqK;a wOHhk j,ska fy<sorõ ù we;s wdldrhg wfma rfÜ flfkla idudkHfhka .a?ï 60l iSks m%udKhla wmkqNj lrkjd' th ks¾foaYs; m%udKh jf.a fo.=Khla' wfma ore mrmqr;a jeä jeäfhka fï wjodkug ,la jk nj fmfkkakg ;sfnkjd' oshjeähdj iys; orejka úYd, jYfhka jd¾;d fjkjd' <ud 50

NOVEMBER 2017 | DOCTOR MAGAZINE

ia:q,;djh wka ljr ld,hlg;a jvd jeähs' wo mßirh;a yev .eiS ;sfnkafka orejka fï frda. j,ska wdrlaId lrkak fkdfjhs' jeä jeäfhka orejka wk;=f¾ fy<kakg' ujl fjkakg m%d¾:kd lrk wjêfha b|kau ldka;djka fi!LHiïmkak cSú;hlg lem úh hq;=hs' Tjqkq;a fyd| YÍr fi!LHhla mj;ajd .ekSu jeo.;a'

orejkaf.a ksfrda.SNdjfha uq,au j.lSu we;af;a uõmshkaghs uõl=fia bkak ldf, fi!LH iïmkak l<,hlaj j¾Okh ùu tu orejd bmÿKQ miq wkd.;fha jeäysáfhla jQ miq ksfrda.S cSú;hla .; lrkak fya;= jk nj yªkdf.k ;sfnkjd' oeka orefjlaf.a wkd.;h fjkqfjka zzm<uq osk oyiZZ hkqfjka ixl,amhla f.dv ke.S ;sfnkjd' m<uq osk oyi lshkafka Wmka miq osk oyila fkdfjhs' orejd ms<sis|.;a od isg osk oyihs' fl<sf,d,a úfha orejka yg wo fi,a,ï ld,hla ke;s ;rï' ny f;dark ldf, b|kau orejka rEmjdyskshg yqre lrjkjd' Bg miafi fudnhs,a fmdaka" f.aï'''' orefjd cSjk p¾hdj j.d lr.kafk w;aoelSï yryd' wms ta whg mqreÿ lrk foaj,a ;uhs ta whf. Ndú;dj fjkafk' krl lEu mqreÿ lf<d;a cSú;hgu krl lEu' krl wej;=ï mej;=ï mqreÿ lf<d;a cSú;hgu krl wej;=ï mej;=ï' ;ukaf. orejd ksfrda.S fi!LHiïmkak orfjla" jeäysáfhla lrkak moku ie,fikafk uõmshkaf.kauhs fkao@ fï wkQj b;du meyeos,shs" orejkaf. fi!LHiïmkakNdjh iïnkaOfhka'''' ojil jeäysáhka fjk <ud mrmqr iïnkaOfhka ta wh ksfrda.S mqrjeishka lsÍfï f,dl=u j.lSu ;sfnkafk ta orejkaf. uõmshkag nj'

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Èhjeähd frda.Ska

.; hq;='''fkd.; hq;= wdydr .ek Tng wjfndaOhla ,nd fok Glycemic Index

ffjoH YdLH wurfialr úisks

NOVEMBER 2017 | DOCTOR MAGAZINE

oshjeähd frda.Skaf.a wdydr .ekSu ie,iqï lsÍug fhdod.kakd Glycemic Index (GI) kï l%uh iïnkaOfhka fï oskj, úYd, Woafhda.hla we;sj ;sfnk nj fmfka' fï .ek wjfndaOhla ,eîu fldhs ldg;a jeo.;a fõ' ukao" oshjeähdj ke;s jqK;a Glycemic Index (GI) w.h wvq wdydrhla .ekSu fjfiiskau Glycemic Index (GI) jeä wdydrhla .ekSug jvd Tfí iqj iïm; /l .ekSug bjy,a jk neúks' doctormagazine.lk

m%drïNl jYfhka úuiSfïoS Glycemic Index (GI) hkq .aÆfldaia fyda iqÿmdka j,g idfmalaIj ldfndayhsfâ%g idr wdydr reêrfha iSks uÜgu jeä lsÍu mdol lrf.k fm< .iajk mßudKhls' Tn ldfndayhsfâ%g iys; wdydrhla wkqNj lrk úg tys ;sfnk iSks .aÆfldaia njg ì| fy<kq ,efnhs' th wjik Yla;sh f,i YÍrfha ixÑ; fõ' wm wdydr .kakd úg reêr.; .aÆfldaia uÜgu ks;ekskau jeä fjhs' hï wdydrhlg reêr.; .aÆfldaia uÜgu by< kexùug we;s yelshdfõ fõ.h Glycemic Responce kñka y÷kajkq ,efí' fï Glycemic Responce idOlh úúO idOl /ila u; fjkia fjhs' wm fl;rï wdydr m%udKhla .kakjdo@ tu wdydr fl;rï ld,hla YÍrh ;=< ì| fyf<kjdo@ tu wdydr l=uk wdldrhlg ms<sfh, lr ;sfío wdoS idOl mjd Bg n,mdhs' ksoiqkla f,i meiagd u| riakfhka msiQ úg ;sfnkjdg jvd jeä Glycemic Responce w.hla jeä fj,djla msiQ úg ,efnkafkah' m¾fhaIKd;aul o;a; j,g wkQj wvq Glycemic Index (GI) w.hla we;s wdydr f;dardf.k wkqNjfhka reêr uÜgu uekúka mj;ajd .; yels jk w;r 2 jk wdldrh jYfhka ye|skafjk oshjeähdj we;s ùfï bvlv fnfyúka wvq fõ'

Glycemic Index (GI<55) wvqfjka

we;s wdydr fhdoh rys; lsß" fhda.Ü" fidahd mdk j¾." wem,a" uqoaorm,ï" fodvï" ´Ü" ksjqâv iys; wdydr" ´Üó,a" ^fifuka msisk ´Üia& ;ïnmq iy,a" u,aáiSâ fn%â" ;, wdoS OdkH ñY% lrk ,o mdka&" meiagd ^uDÿ&" oU, úfYaI (Lentils / Kidney/Baked beanns, Chick peas, Green Gram)

Glycemic Index (GI=56-69)

uOHu m%udKfhka we;s wdydr flfi,a" wkakdis" w¿;a w¾;dm,a" friskaia" fmdmafldaka" iams,sÜ ^uE&" .%Ska mS ^fld< uE&" iqma" ÿUqreiy,a" ndiau;S iy,a" ;srs`.=OdkH" ;srs`.= mdka ^Whole wheat bread&" rhs mdka

Glycemic Index (GI=56-69) jeä

w.hla .kakd wdydr oshflduvq" rgb|s" ;ïnd fmdä l< w¾;dm,a" fíla lrk ,o iqÿ w¾;dm,a" laIKsl n;a" fkaÉ hsia" whsia l%Sï" iqlafrdaia (Table Sugar)

oskm;d wdydr fõ,g wvq Glycemic Index wdydr .ekSug Wmfoia ¡ by< GI w.hla iys; wdydr fjkqjg wvq yd uOHu m%udK GI

SUNSHINE HEALTH CARE LANKA LTD., 27, 4/1, York Arcade Building, York Arcade Road, Colombo 1, Phone 0114702500

Hotline 077 377 72 99

w.hla iys; wdydr f;dard.kakg W;aiql jkak' ¡ úgñk" LKsc ,jK iy ;ka;= j,ska idr mßiudma; fmdaIKh .ek wdydr .ekSfïoS ie<ls<su;a jkak ¡ uOHia; GI w.hla mj;ajd .ekSug by< GI w.hla we;s wdydr wvq GI w.hla we;s wdydr yd l,jfï .kakg W;aiql jkak' ksoiqkla f,i mdka ^by< GI w.h& iu. fhdoh bj;a l< lsß ùÿrejla ^my< GI w.h& .ekSfïoS uOia: GI m%;sM<hla iys; wdydr fõ,la iïmQ¾K fõ' fldaka *af,alaia iu. ^by< GI w.h&" All Bean f;a yekaola iy ^my< GI w.h& iafg%dafnß ^my< GI w.h& iys; wdydrhla iqÿiqh' ¡ ieliQ wdydr" msIAGh iys; wdydr iSud lrkak' fïjdfha ;ka;=uh mod¾: wvqh' wfkl=;a fmdaIl wvqh' ta uosjdg by< GI w.hlska hqla;h' wvq GI w.hlska hqla; OdkH wdydr fndaxÑ" oU, yd rks, wdydr j,ska ieliQ wdydr fyd|hs' ¡ iQma yd i<do wdosh wdydr isß;g tl;= lr .kak' ¡ OdkH" ´Ü" ksjqâfvka ye¥ mdka .ekSu iqÿ mdka j,g jvd fi!LH iïmkak fõ' ¡ kejqï t<j¨ yd m<;=re wkqNjhg .kak'

¡ i<do j,g l%Sï .;sfhka hqla; v%iska fjkqjg úkdlsß fhdod .kak' th fïo wvq f;dard.ekSuls' tfiau úkdlsß j, wdï,sl;djh u.ska cS¾Kl l%shdj,shg jeä ld,hla .kS' iuia;hla f,i fuh wdydrfha GI w.h wvq lsÍug bjy,a fõ' ¡ wdydrfha GI w.h fkdie<l=jo" .kakd wdydr m%udKh jeä kï th reêr iSks uÜgu by< kexùug odhl jkafkah' wdydrhla .ekSug fmr;a wdydr .ekSfuka mehla fyda meh follg miq;a reêr iSks uÜgu uek .ekSfuka Tfí isrer tu l%shdj,sh hdukh lsÍug olajk mßph .ek Tngu wjfndaOhla ,nd.; yels jkq we;' ¡ wdydr ie,iqï lsÍfïoS fmdaIKfõosfhl=f.a fyda oshjeähdj wOHdmk ks,Odßfhl=f.ka Wmfoia ,nd .kak'

Glycemic Index hkq ksjeros

wdydr ms<sfj;l tla wx.hla muKs' Tfí wdydr isß;g my; .=Kdx. tl;= lr.kak' ¡ kshñ; ld, wka;rhka ;=< wdydr .kakg yqre fjkak' ¡ iEu wdydr ldKAvhlau wdjrKh jk fia úúO;ajhlska hq;a wdydr fõ,la .kak'

¡ t<j¨ iy m<;=re j, we;af;a wvq GI w.hls' fïjd iSks njg YÍrfha ì| fy<Sfï l%shdj,sfhaoS m;a ùug jeä ld,hla .; fõ'

¡ meKs ri iy iSks j,ska yels;dla wE;a fjkak'

¡ wdydr msrñvhg wkQj osklg t<j¿ yd m<;=re jdr 5-10 w;r jdrhla .; hq;=h'

¡ Tfí wdydr fõ,g ;ka;=uh wdydr jeäfhka tl;= lr.kak'

¡ laIKsl iy,a fjkqjg ;ïndmq fyda ÿUqre yd,a fhdod.kak' 54

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¡ Tn wkQNj lrk f;,a m%udKho yels;dla wvq lrkak'

¡ ¨Kq wvq lrkak' uOHidr yd lef*aka wvx.= mdk j¾. j,skao j<lskak' doctormagazine.lk

CIC frâ ndiau;S iy,a

Èhjeähd frda.Skag

w;sYhska iqÿiq nj m¾fhaIKd;aulj ;yjqre ù ;sfí'''

W;=re fld<U YslaIK frdayf,a ffjoH ckl fm%au;s,l úisks 56

Èhjeähdj fukau fjk;a fnda fkdjk frda.o ful, b;d jeä jYfhka jd¾;d fjñka ;sfí' wo orejka mjd úYd, ixLHdjla ia:q,;djh wdoS wjodkï idOl u;ska frda.Ska njg m;a fjñka isà' wfma wjr.srg .sh wdydr isß; fndfyda wjodku j,g fya;=jla nj ikd: jQ lreKls'

NOVEMBER 2017 | DOCTOR MAGAZINE

doctormagazine.lk

fï wjodkfuka ñoSug W;aidy lrk wm fldhs ljqre;a uQ,sl jYfhka l< hq;af;a wfma wdydr fõ, fi!LHiïmkak wdydr fõ,la njg m;a lr .ekSuhs' wfma m%Odk wdydr f;aÍu - n;a iïnkaOfhka i<lK l< r;= ndiau;S iy,a Tfí f;aÍu lr.kafka kï thska Tng b;d jákd m%;sM< rdYshlau ,efnKQ we;' fï ,smsh r;= ndiau;S ydf,a wkQmfïh jQ fmdaIK .=Kh''' Ñls;ail .=Kh''' iïnkaOfhka Tfí wjOdkh fhduq lsÍug ksielfhkau iu;a jkq we;' fldf,iagfrda,a yd g%dkaia fïoh wvx.= ke; r;= ndiau;S iy,a j, úgñka úYd, m%udKhla" LKsc ,jK rdYshla wka;¾.;h' tfy;a mdysk ,o iy,a j,g jvd" wfkl=;a r;= yd,a j,g;a jvd le,ß w.h wvqh' fï ksid fmdaIK úoHd;aulj r;= ndiau;S iy,a fjfiia jákdlula orhs' ;jÿrg;a fï .ek l;d lf<d;a" r;= ndiau;S iyf,a ldfndayhsfâ%g fukau fidaähï o idfmalaIj wvqfjka wka;¾.;h' fï wkQj YÍrhg wjodkula f.k fok wvqúh hq;= foa wvq lrñka jeäfhka wvx.= úh hq;= foa jeäfhka wka;¾.; lrñka m%Yia; fmdaIKSh l%shdldß;ajhl fhokakg r;= ndiau;S iy,a iu;ah' w;sYhska wys;lr fïoh ldKavhla fia ie<flk g%dkaia fïoh r;= ndiau;S iy,a j, wvx.= ke;' fldf,iagfrd,a wvx.= ke;' .aÆáka wjodkula ke;' doctormagazine.lk

wekaf;dihkska wvx.= ksid ks;r wkqNjfhka jdis /ila w;am;a fõ''' r;= ndiau;S iy,a i;= uy`.= fmdaIKSh .=Kdx.hka w;f¾ tys fmd;af;a we;s r;ameye wekaf;dihkska j¾Klfha we;af;a buy;a fmdaIKSh jákdluls' YÍrhg ksfrda.S nj we;s lrk" úI yrkh lrñka YÍrhg Pú j¾Kh" úhm;a fkdùu wdoS .=Kdx. ,enfok m%;sTlaisldrl yd msfkda,sl ixfhda. fï wekaf;dihkska j, wka;¾.;h' m%;sTlaisldrl ful, b;d .eUqre f,i úoH{hkaf.a wjOdkhg ,laù ;sfí' m%;sTlaisldrl .=Kdx. iys; wdydr ffi,Sh uÜgfuka jk ydksùï mQrkh lrhs' ffi, mqk¾cSjkhg ,la lrhs' t<j¿ yd m<;=re j, we;s mhsfgd ridhk j, we;s .=Kdx. j,skao fuh msßmqkah'

oshjeähdj frda.Skaf.a reêr iSks uÜgu md,kh lrhs''' oshjeähdj ke;s whf.a ohjeähd frda. wjodku wE;a lrhs wm .kakd wdydr u.ska reêrfha iSks uÜgu lsishï by< hdula isÿ lrhs' th jy jyd by< hdu wys;lrh' l%udKql+,j''' ld,hla wrf.k iq¿ jYfhka tu reêr iSks md,khla we;sj by< hdu fi!LHiïmkakh' r;= ndiau;S iy,a wvq .a,hsisñla w.hla iys; wdydrhls' ta ksid tlajku wjodkï w.hka olajd reêr.; iSks w.hka by< kexùula isÿ fkdù wdrlaIs; w.hkayS uekúka reêr iSks md,kh lsÍug fya;= fjhs' fï ksid oshjeähd frda.Skag b;d iqÿiq wdrlaIs; iy,a j¾.hls' NOVEMBER 2017 | DOCTOR MAGAZINE

wvq .a,hsisñla w.hla iys; CIC frâ ndiau;S iy,a f;dard.ekSfuka w;ajk m%fhdack ¡ reêr iSks iy bkaishq,ska ukdj md,kh lrhs' tu.ska YÍrfha bkaishq,ska wjYH;djh wvq fjhs' ¡ YÍrfha Yla;s uÜgï uekúka md,kh fjhs' YrSrh wvq GI w.hla iys; wdydr cS¾Kh lrkafka fyñks' fï ksid l%shdldÍ fmaYs j,g wkjr; Yla;s iemhqula iy;sl lrhs' ¡ oshjeähdj" yDo frda." ms;a;dY frda. yd mshhqre ms<sld wdosh we;sùu j<lajhs' wvq .a,hsisñla w.hla iys; wdydr j, wdydruh ;ka;= m%udKho jeäh' ¡ oshjeähdj je<÷KQ frda.Skaf.a .aÆfldaia yd ,smsv uÜgu m%j¾Okh lsÍug wvq .a,hsisñla w.hla iys; wdydr WmldÍ fõ' ¡ YÍrfha fyd| fldf,iagfrda,a uÜgu by< kxjhs' krl fldf,iagfrda,a uÜgu my; fy<hs' yoj;a frda. wjodku fï ksid wvq fjhs' ¡ wvq .a,hsisñla w.hla iys; wdydr .ekSfuka wdydr reÑh wvqfjhs' bkaishq,ska m%;sfrdaOh we;sùfï wjodkuo neyer fjhs' fï ksid ia:q,;djh wvq fjhs' ¡ wvq fõ.hlska YÍrhg Wrd.kakd ldfndayhsfâÜ u.ska fmaYs j,g ksh; Yla;s m%udK ,efnhs' l%Svd fl!Y,Hh yd ord.ekSfï yelshdj j¾Okhg fuh bjy,a fjhs'

NOVEMBER 2017 | DOCTOR MAGAZINE

CIC frâ ndiau;S iy,a j,

fmdaIKSh .=Kdx.

¡ mQ¾K OdkHuh wdydrhls'' .a,hsisñla ixÑ;h wvq w.hla .kS' ¡ wdydruh ;ka;= j,ska b;d by< fmdaIH .=Khla we;' ¡ *e,efjdkhsv" wekaf;dihkska ' m%;sTlaisldrl wdoS mhsfgdridhk wvx.=h' ¡ leâñhï" Bhï wdiksla wdoS jYfhka jQ ner f,day wvx.= ke;' ¡ r;= ndiau;S iy,a iajNdjfhkau r;= mdg jk w;r tfia jkafka iyf,ys wvx.= mSfkda,sla ridhk yd wekaf;dihkska fya;=fjks' idhkslj ;yjqre lrk ,o fmdaIK .=Kfhka wkQk iy,la jk CICfrâ ndiau;S iy,a wkQNjfhka oshjeähd frda.Skaf.a reêr iSks uekúka md,khg WmldÍ fjhs' th fldf,iagfrda,a wvq lsÍugo" ia:q,;djh md,kh lsÍugo WmldÍ jkafkah' tfiau wfma rfÜ Ndú;d jk wjfYaI ndiau;S iy,a j,g jvd m%;Tlaisldrlhla jk mSfkda,sl ixfhda. fnfyúka by, ixhq;shla CIC frâ ndiau;S iyf,ys we;' r;= ndiau;S iy,a wvq .a,hsisñla w.hla iys; wdydrhls' ta ksid oshjeähd frda.Skag b;d iqÿiq wdrlaIs; iy,a j¾.hls' úI yrkh lrñka YÍrhg Pú j¾Kh" úhm;a fkdùu wdoS .=Kdx. ,enfok m%;sTlaisldrl yd msfkda,sl ixfhda. iys; wekaf;dihkska frâ ndiau;S iy,a j, wka;¾.;h' doctormagazine.lk

bkaishq,ska úo.kakd frda.Skag Wmfoia YÍrhg wjYH bkaishq,ska zzfm;sZZ úosyg ,ndoSu l< fkdyelalls' fï ksid kslafIamK jYfhka bkaishq,ska ,nd.ekSug wmg isÿ fjhs' fï i|yd oshjeähd frda.Ska isßxchla Ndú;d lrhs' mEkla fia neÆ ne,aug osiajk bkaishq,ska fmka hkqfjka ye|skafjk WmlrKho ;ukagu bkaishq,ska kslafIAmKh lr.ekSug fhdod.; yels myiqfjka yeisrúh yels WmlrKhls' wm fï bkaishq,ska l=mamsh fkdfyd;a bkaishq,ska .nvd lrk fnfy;a l=mamsh .ek;a tajd kslafIAmKh msKsi fhdod.kakd fuj<ï iïnkaOfhkq;a oek.ksuq'

bkaishq,ska isßxch

ffjoH foaúkao ohdr;ak úisks 60

NOVEMBER 2017 | DOCTOR MAGAZINE

Tn oel we;s fndfyda isßkac j,g jvd fïjdfha n| isyskah' tfiau tys lgqjo wjfYAI lgq j,g jvd l=vdh' lgqfõ m%udKh Gauge 29" 27 wdoS jYfhka olajd ;sfí' fõokdj wju lsrSug jvd;a fhda.H jkafka Gauge tl 31 jk isßxchhs' Tfí wf;a iug háka ;sfnk fïouh mglhlg isßxcfhka bkaishq,ska tkak;a lrhs' doctormagazine.lk

neÆ ne,aug fuh Tfí ,sùug .kakd mEkla fia fmkquh' yqrenqyqáh' fjkilg we;af;a tys w. ishqï lgqjla ;sîuhs' we;eï tkak;a lgq fjkqjg w¿;a tajd udre l< yel'

bkaishq,ska fmdïm úúO m%udK j,ska bkaishq,ska isßxc ;sfí ¡ Tn bkaishq,ska tall 30la fyda Bg wvq ud;%djla tkak;a lr.kafka kï Unit 30 isßxchla ta i|yd Ndú;d lrkak' ¡ Tn bkaishq,ska tall 50la fyda Bg wvq ud;%djla tkak;a lr.kafka kï Unit 50 isßxchla ta i|yd Ndú;d lrkak' ¡ Tn bkaishq,ska tall 100la fyda Bg wvq ud;%djla tkak;a lr.kafka kï Unit 100 isßxchla ta i|yd Ndú;d lrkak'

bkaishq,ska mEk

m<uq wdldrfha oshjeähdj ;sfnk frda.Skg ,nd fok bkaishq,ska fmdïmh u.ska meh úis y;r mqrdu b;d l=vd ud;%d j,ska isrerg bkaishq,ska tkak;a lrhs' fuh idudkHfhka fojk wdldrfha oshjeähdj we;s frda.Ska i|yd Ndú;hg fkd.efka'

bkaishq,ska l=mamsh Ndú;d lsÍug Wmfoia ¡ bkaishq,ska ñ,oS .ekSfïoS Tn fj; ffjoHjrhd úiska kshu lr we;s ksjeros bkaishq,ska T!IOhu ,efnk njg iy;sl lr.kak' ffjoHjrhd úiska kshu lrk ,o ¡ bkaishq,ska j¾.h (Type) ¡ idkaøKh (Strength) ¡ ksmehqu (Brand) Tn fj; ,efnk njg iy;sl jkak' ¡ Tng kshu lrk ,o bkaishq,ska j¾.h ñ,oS .ekSfï wmyiqjla fõ kï Tiqif,a ;sfnk bkaishq,ska

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Hotline 077 3776172 99

NOVEMBER 2017 | DOCTOR MAGAZINE

Injection Technique

Pinch-up technique is required Pinch up your skin, taking care to fold the top layers and not pull muscle into the fold. Inject straight into the skin fold or at an angle to avoid injecting into the muscle tlla /f.k tkjd fjkqjg kej; ffjoHjrhd fj; f.dia Tyq fok ixfYdaê; m%f,aLK m;%hg .e,fmk ksjeros T!IOhu ,nd .kak' ¡ Tn Ndú;hg .kakd bkaishq,ska l=mamsh fyda mEk l=vd fmÜáhl nyd Ys;lrKh ;=< ;nkak' th mj;ajd .; hq;af;a fikaáf.%aâ wxYl 2-8 mrdifhah' th lsis úfgl wêYS;lrKfha fyda YS;lrKfha fodf¾ ;ekam;a fkdlrkak' bkaishq,ska tkak;a lsÍug meh ld,lg fmr YS;lrKfhka bj;a lrkak'

2 3

Wfoa" oj,a yd rd;%S wdydrhg úkdä 15-30lg fmr bkaishq,ska úo.kak'

m%Odk wdydr fõ,a j,g wu;rj oyj,a" iji yd rd;%S kskaog fmr iq¿ wdydr m%udKhla isß;la f,i ,nd.kak'

bkaishq,ska ud;%dj jeä jqKd kï fyda wdydr wvqfjka .;a;d kï" jeäfhka jHdhdufha fhÿKd kï wjuOqrla;h we;sù la,dka;h" isys uq¾Pdj we;s úh yel' oyäh oeóu" yDoh fõ.fhka .eySu" isys l,amkdj wvqùu wdoS ,laIKhla we;s jQjfyd;a .aÆfldaia wyqrla fyda meKsri lEula wdydrhg .kak' Tn úo.;a bkaishq,ska ixfYdaOkhla isÿ lsÍug wjYH úh yels neúka ffjoHjrhd yuq fjkak'

ffjoH Wmfoia j,g mgyeksj bkaishq,ska úoSu k;r lrkak tmd'

Tng wdydr wreÑh fyda jukh we;s jQjfyd;a jydu ffjoHjrhd yuqù Wmfoia ,nd.kak'

bkaishq,ska úo.kakd Tng m%fhdackj;a Wmfoia lsysmhla

bkaishq,ska u.ska reêrfha .aÆfldaia ^iSks& uÜgu my; fy<ñka YÍrfha iSks hdukh lsÍula isÿ lrhs'

Tn Ndú;hg .kakd bkaishq,ska l=mamsh lsis úfgl wêYS;lrKfha fyda YS;lrKfha fodf¾ ;ekam;a fkdlrkak' bkaishq,ska tkak;a lsÍug meh ld,lg fmr YS;lrKfhka bj;a lrkak'

NOVEMBER 2017 | DOCTOR MAGAZINE

bkaishq,ska úoskafka iu hg fïo ia:rhgh' wf;a ndyqj" l<jd" kdNsh yd ;Ügï bkaishq,ska úoSug iqÿiq ia:dk fõ'

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TYPE 1 DIABETES

m<uq j¾.fha Èhjeähdfõ frda. ,laIK oshjeähdj hkq orejka w;f¾ jeäfhkau we;sjk fnda fkdjk frda.hhs

´kEu wvq jhfia orefjl=g jqj Èhjeähdj je<|sh yels nj Tn okakjdo@

Tng fkdi<ld fkdyeßh yels wjodkï ix{d • wêl msmdidj • tlajku isref¾ nr wvqùu • ks;r ks;r uq;%d msgùu • fmkSu fnd| ùu • wêl úvdnr iajNdjh • ufkdaNdjhkayS we;sjk fjkialï

• • • • •

ks;r we;sjk l=i.skak Tlaldrh$jukh ks;r we;sjk wdidok Worfha we;sjk fõokdjka yqiau iu. we;sjk weisfgdak .kaOh

fujka frda. ,laIK ksÍlaIKhg ,la jQfjd;a Tyq jydu ffjoHjrfhl= fj; /f.k f.dia oshjeähdj we;s ke;s nj ikd: lr.kak'

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Hotline 077 377 72 99

iSks ke;sj;a

iqñysß rihla ,nd fok

ue,snka Iq.¾ *%S ìialÜ ta yereKQ úg ;j;a fndfyda wjodkï iy.; fi!LHuh idOl n,.ekaùug iSks iDcq odhl;ajhla olajk nj m¾fhaIK j,ska yªkdf.k ;sfí' fï wkqj iSks wkqNjh iSud lsÍug ck;dj osßu;a lsÍu oeka wfma rfÜ cd;sl fi!LH m%;sm;a;s j,o iqúfYAIS wx.hla ù we;' ljo;a fi!LHiïmkak wdydr iemhSfuys mqfrda.dó jQ ue,snka ksji

iSks - u;la jk úg iqñysß yeÕ=ula oeKQk;a oeka oeka iSks .ek wikakg ,efnk f;dr;=re t;ru ñysß fkdfõ' reêrfha bkaishq,ska m%;sfrdaOh we;s lsÍug hyñka iSks wkqNjho fya;=jla jk w;r doctormagazine.lk

ljo;a ;u mdßfNda.slhkg fi!LHiïmkak wdydr ,ndoSfuys,d mrisÿ kula oskd we;s zzue,snka ksjiZZ iSks mßfNdackh iSud lsÍug W;aiql jk tjka iqj ixfõoS mdßfNda.slhkg tu mrud¾: Wiiau wdldrfhka uqÿka muqKqjd .; yels ìialÜ j¾.hla zzue,snka Iq.¾ *%S ìialÜZZ hk kñka fj<|fmd<g yªkajd oS ;sfí' fi!LHhg wys;lr hhs yªkd.;a iSks j,ska f;drj ksIAmdokh lsÍu ue,snka Iq.¾ *%S ìialÜ j, NOVEMBER 2017 | DOCTOR MAGAZINE

y÷kdf.k we;af;a iSks fjkqjg fhdod.; yels jvd;a fi!LHiïmkak iSks wdfoaYlhla jYfhks' fuys le,ß Yla;sh iSks j,g jvd wvlskau wvqh' reêr iSks by< keùu flfryS iSks j, we;s iDcq n,mEu fuda,aáfgda,a j, iEfyk muK ÿ¾j, lr we;' iSks fuka o;a osrd hdu j¾Okh fkdlrk njo m¾fhaIK j,ska fy<sorõ ù ;sfí' iSks úl,am iïnkaO m¾fhaIK j,g wkQj fuda,aáfgda,a jvd;a fyd| úfYaI;ajhhs' Tng yqre mqreÿ iSks fkdue;s jQjo" wreue;s rihla''' ñysßhdjla''' ,nd foñka Tng ienE úkaokSh fmdaIKhla we;s lrk ìialÜ j¾.hla f,i ckm%sh;djh wdrlaId lr.kakg ue,snka Iq.¾ *%S ìialÜ iu;a ù ;sfí'

ue,snka Iq.¾ *%S ìialÜ fi!LH iïmkakj Tn w;g m;a jkafka fufyuhs uQ,sl jYfhka fuys wk.s ;ka;=uh mod¾: ixhq;shla ;sfí' fuu ;ka;=uh wka;¾.; ksid blauKska reêr isks uÜgu by< hdfï wjodkulao we;s fkdfõ' tfiau myiqfjka l=i mqrjd,k .=Khlskao hqla; ksid úYd, wdydr m%udKhla fkd.;a;dg l=i .skak myiqfjka m<d hhs'

iSks fjkqjg fuda,aáfgda,a fjfiiskau oshjeähd frda.Skago fndfyda frda. j,ska mSvdjg m;a whgo iSks meKs rih iqÿiq fkdjk ;j;a fndfyda fokdgo iSks fjkqjg fuda,aáfgda,a kue;s iqúfYAIS meKsrildrlh ix>glhla fia fhdodf.k ilia lr we;s ksid jvd;a fi!LHiïmkakh' fuda,aáfgda,a 66

NOVEMBER 2017 | DOCTOR MAGAZINE

úl,amhla jYfhka y÷kdf.k ;sfí' fyd|ska yefmk" rij;a ue,snka Iq.¾ *%S ìialÜ wfma rfÜ muKla fkdj ´iafÜ%,shdj" wefußldj yd hqfrdamfhao mdßfNda.slhkaf.a úYajdih oskdf.k ;sfí'

ue,snka Iq.¾ *%S ìialÜ .ekSfuka Tng w;ajk jdis ¡ iSks Ndú;fhka wE;a úh hq;af;a oshjeähd frda.Ska muKla fkdfõ' wêl f,i iSks wdydrhg .ekSfuka we;sjk bkaishq,ska m%;sfrdaOh u;= osfkl oshjeähdj we;=¿j mßjD;a;Sh frda. /ilg fya;=jla úh yel' ue,snka Iq.¾ *%S ìialÜ wjodku neyer,ñka fmdaIKh i,ik ìialÜ úfYaIhls' ¡ iSks ke;;a ue,snka Iq.¾ *%S ìialÜ ìialÜ j, fi!LHiïmkak fuda,aáfgda,a we;s ksid tys rifhys ySk ùula fkdfõ' ienúkau th b;d rij;a wdydrhls' ¡ ue,snka Iq.¾ *%S ìialÜ j, we;s ;ka;=uh mod¾: iq,nh' fï ksid cS¾Kl moaO;sh iqir lsÍug WmldÍ fjhs'

doctormagazine.lk

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Hotline 077 377 72 99

LIVING WELL WITH DIABETES (GDM)

Èhjeähdj iu. iqjfia cSj;a jk yeá Tn;a oshjeähdj frda.fhka fmf<k flfklao@ oshjeähdj ;snqK;a thska cSú;hg ydkshla fkdue;sj ksfrda.S fi!LHiïmkak cSú;hla .; lsÍu i|yd Tn l< hq;= foa'''

jeä jeäfhka t<j¿" m<;=re wdydrhg .kak' iSks yd ¨Kq Ndú;h yels;dla wvq lrkak'

l%shdYS,S cSú;hla .; lrkak' i;shlg wvq ;rfï ñks;a;= 150l j;a lh fjfyfik lghq; j,$jHdhdu j, ksr; jkak'

l,ska l,g kshu lr ffjoH yuq j,g$mÍlaIK j,g iyNd.s jkak'

kshñ; mßos kshu lrk ms<sfj,g Tfí reêr iSks mÍlaIK isÿ lr .kak'

oshjeähdjg fok T!IO kshu lrk ms<sfj,gu ,nd .kak'

ABC ms<smoskak A A1C mÍlaIKh isÿ

lr.kak'

B 140$90g wvqfjka reêr

mSvkh mj;ajd .kak'

C fldf,iagfrda,a uÜgu

Tn okakjdo@

md,kh lr.kak' ÿï mdkfhka w;a ñfokak'

fi!LHiïmkak cSú;hla .; lsÍfuka oshjeähdj wdY%s;j we;sjk ixl+,;d uekúka md,kh lr.; yel' 68

NOVEMBER 2017 | DOCTOR MAGAZINE

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Èhjeähdj ksid

weia isúfha we;s jk fodaI

jirlg jrla weia mÍlaId lr.ekSfuka l,a fõ,d we;sj Tfí weia wdrlaId lr.; yel

GOLDEN KEY

HOSPITALS LIMITED

rdc.sßh f.da,avka lS frdayf,a wlaIs Y,H úfYaI{ ffjoH id,sh m;srK úisks 70

NOVEMBER 2017 | DOCTOR MAGAZINE

doctormagazine.lk

oDIaÀ ú;dkh wfma idudkH jyf¾oS nyq;rhla l;d lrkafka zwefya isúhZ hkqfjks' fï wefya isúh ;=< we;sjk .eg¿ ksis fj,djg ms<shï fkdfhÿfjd;a th fl<jr jkafka wjdikdjka; f,i wei wkaO ùfuks' tfy;a Tn oekqïj;a jqfKd;a" ksis fj,djg ksis ms<shï fhÿfjd;a Tng Tfí fk;a wdrlaId lr .ekSfï wjia:djla ysñ fõ' fï ,smsfha mrud¾:h ta oekqj;aNdjh Tng ,ndoSugh' ta Tiafia mK fuka jákd fofk;a fírd .ekSug fuu oekQu w;aje<la ùuhs'

oshjeähd wlaIs wdndOh

leurdjg iu wefiys l%shdldrs;ajh

vhfnála fráfkdm;s frda.fhaoS isÿjkafka wefia ishqï reêr kd, wjysr ùuhs' tys m%;sM,hla f,i weig .,k f,a m%udKh ie<lsh hq;= uÜgulska wvq jkafkah' tjka isÿùuloS YÍrh lsishï yev .eiSula isÿ fjhs' fuysoS isÿ jkafka ishqï úl,am reêr kd< w¨;ska ks¾udKh ùuhs' ta yereKq úg weig ydkslr jkakd jQ ridhkhla W;amdokh ùuo isÿ fjhs' fï ridhkh Vascular Endothelial Growth Factor hkqfjka y÷kajhs'

oDIaÀ ú;dkh wefia msgqmig jkakg msysgd we;s b;du ishqï jQ mg,hls' ly,mh ^uelshq,d& hkq j¾K iy ishqï fmKqu ,ndfok wefiys ueo fldgihs' weyela ieu úgu iudk lrkafka leurdjgh' weye leurdjg iu jkafka kï wefya isúh fkdfyd;a oDIaÀ ú;dkh leurdfõ fiahdmg,h jeksh' jia;=jla foi wm fk;= fhduk úg tys m%;sìïnh oDIaÀ ú;dkh u; igyka jkafka h' ta m%;sìïnh Wvq hál=re lrjñks' fuf,i m;s; jk m%;sìïnh oDIaÀ iakdhqj Tiafia fud<h fj; .uka lr rEmh ia:dms; lsÍfuka miq kshu ms<sfj,g há Wvql=re lr olskakg ie,eiaùfuka fï l%shdj,sh wjika fjhs' wefia isúh fkdfyd;a oDIAÀ ú;dkh flfryS n,mj;ajk frda. /ila ;sfí' tajd wm oek.; hq;=h'

thska jvd;au iq,n frda. ;;a;ajh jkafka oshjeähd wlaIs wdndOh fkdfyd;a Diabetic Retinopathy kï frda.hhs' oshjeähdj je<+oSfuka YÍrh mqrdu reêr mßjykhg n,mEï we;s úh yelsh' weigo thska ñosh fkdyelaflah' weig reêrh f.k hkafka tla reêr jdyskshls' th flaYkd,sld f,i wei we;=f,aoS fnoShhs' wefiys reêr flaYkd,sld wjysr ùula isÿ jQjfyd;a th Nhdkl M<úmdl we;s lrjkakls'

msgq oelsh hq;= w¨;ska yefok reêr kd, fï l%shdj,sh ffjoHjreka olskafka weig hym;la f.k tk ;;a;ajhla jYfhka kï fkdfõ' f.dhï yefok l=Uqf¾u j,a me<Eáo yefokakd fia wefia fï wdldrfhka w¨;ska yefok reêr kd, wefia fmkSu iqir lsÍug Woõjla jkafka ke; w¨;ska ydkslr reêrjdyskS yeoSu yereKQ úg ;j;a we;s úh yels ydkslr isÿùula jkafka oDIaÀú;dkh yels,Suhs'

f,ai¾ m%;sldrfhaoS isÿlrkafka ydkshg m;a m¾hka; ia:dk f,ai¾ Odrd j,g ,lalr wl%Sh lrñka ueo fldgi" tkï uelshq,dfjka muKla oDIAÀh mj;ajd .ekSug rel=,a oSuhs' doctormagazine.lk

NOVEMBER 2017 | DOCTOR MAGAZINE

fuysoS oDIaÀú;dkfha f,a .e,Sïo isÿ úh yels w;r ta wdldrhg wefiys uOH l=yrhg isÿjk f,a .e,Sula b;d ydkslr úh yelsh' th wkaONdjfhka fl<jr úh yelalls'

Diabetic Maculopathy oDIaÀú;dkh mdol lrf.k we;s úh yels fojk frda. ;;a;ajh kï tys ueo fldgfia we;s uelshq,d kï jvd;au jákd fldgi bosóug ,laùuhs' fuh" Diabetic Maculopathy f,i yÿkajhs' fï ;;aa;ajh f,vdg oefkkakg fmr wlaIs mÍlaIdjloS wlaIs ffjoHjrhdg yÿkd.; yelshs' oshjeähd frda.Ska iEu jirlgu wvq ;rfï tla j;djla j;a weia mÍlaId lr.; hq;af;a fufia wkaONdjhg Tn ,laúh yels wdndO j,ska Tn uqojd .ekSug tu ffjoH yuqj fya;= jk ksihs'

oshjeähdj md,kh lsrSu jeo.;a fï ;;a;ajh we;sùfï wNsfhda.h yuqfõ jeo.;au WmfoaYh jkafka ;ukaf.a oshjeähd ;;a;ajh md,kh lr .ekSuhs' ta yereKq úg ksis l,g isÿ lrk f,ai¾ m%;sldr j,skao frda.h md,kh lr.; yel'

f,ai¾ m%;sldrh

,lalr wl%Sh lrñka ueo fldgi" tkï uelshq,dfjka muKla oDIAÀh mj;ajd .ekSug rel=,a oSuhs' fuysoS oDIAÀh fkdfyd;a fmkSu ,nd.ekSug bjy,a jk oDIaÀ lafIa;%h Visual Field iSudldÍ jk uq;a thska ;u oDIaÀ wjYH;d iïmdokh lr .ekSug frda.shdg wjia:djla ie,fia'

tkak;a ,ndoSu w¨;ska we;sjk ydkslr reêr kd,sld j, j¾Okh wvmk lsÍug fuh b;du id¾:l l%uhls'

zwjidk m%h;akh - Y,Hl¾u Y,Hl¾u u.skao ;;a;ajh ms<silr lsÍug fya;= jk wjia:d fõ' wefia l=yrhg f,a .,d taula isÿ ù kï" ke;fyd;a" oDIaÀú;dkh .e,ù ;sfí kï ta jgd we;s fc,suh udOHh bj;a lr we,ùu ieflúka lsjfyd;a fuysoS isÿ flfrk ld¾hhhs' kuq;a fuh b;d iQlaIauj isÿ l< hq;= Y,Hl¾uhla jk w;r th ishhg ishhlu ksrjoH;djhlska l< hq;=h' iq¨ jeroSulg fyda bvla ;eìh hq;= ke;' b;d iQlaIau wkaùlaI yd Y,Huh WmlrK fhdod.; hq;=h' tu ksid fuu myiqlï kshudldrfhka we;s ia:dkhloS m<mqreÿ ffjoHjreka hgf;a tu Y,Hl¾u isÿ lr.; hq;=fõ'

f,ai¾ m%;sldrfhaoS isÿlrkafka ydkshg m;a m¾hka; ia:dk f,ai¾ Odrd j,g

SUNSHINE HEALTH CARE LANKA LTD., 27, 4/1, York Arcade Building, York Arcade Road, Colombo 1, Phone 0114702500 72

NOVEMBER 2017 | DOCTOR MAGAZINE

Hotline 077 377 72 99 doctormagazine.lk

DIABETIC NEPHROPATHY

Èhjeähd frda.Skaf.a

jl=.vq frda. we;s ùfï wjodku

Èhjeähd frda.Skaf.a

Life Line tl Albumin to Creatinine Ratio (ACR)

mÍlaIKhhs doctormagazine.lk

NOVEMBER 2017 | DOCTOR MAGAZINE

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; Repaet UFR mÍlaIKhla lsÍfuka th iaÓrj mj;sk ;;a;ajhlao@ ke;so hkak ikd: lr.kakjd' 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 Albumin to Creatinine Ratio (ACR) mÍlaIKh iEu

Èhjeähd frda.sfhlau jirlg j;djla j;a isÿ lr.; hq;=hs'

NOVEMBER 2017 | DOCTOR MAGAZINE

Protein + fyda ++ fyda +++ wdoS

jYfhka jd¾;d fjkjd kï th jl=.vq lsishï wdmodjlg ,laj ;sfnk njg flfrk bÕshla' 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'

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'

doctormagazine.lk

ACR mÍlaIKfha m%;sM< < 30

idudkH ksfrda.S w.h

30 - 300 uQ,sl wjêfha fm%daàka ldkaÿ ùu > 300

ksfrda.S jl=.vqjla yd oshjeähd frda.h ksid frda.S jQ jl=.vqjla

fï Albumin to Creatinine Ratio (ACR) mÍlaIKh iEu oshjeähd frda.sfhlau jirlg j;djla j;a isÿ lr.; hq;=hs' yenehs fï mÍlaIKh isÿ lsÍfï myiqlï rcfha frday,a j, kE' fm!oa.,sl wxYfhka th isÿ lr .ekSfïoS o< jYfhka remsh,a 1,200/= 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=.vqj,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'

doctormagazine.lk

Macroalbuminuria wêl f,i fm%daàka ldkaÿ ùu

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

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' NOVEMBER 2017 | DOCTOR MAGAZINE

w,a,d.kak .e,fmk mÍlaIKhla fkdfjhs' uq,au wjia:dfj f,fâ w,a,. kak kï iqÿiqu fï mÍlaIKh Albumin to Creatinine Ratio (ACR) mÍlaIKhhs' ta ksid ;uhs" iEu oshjeähd frda.sfhlau jirlg j;djla j;a mÍlaIKh isÿ lsÍug w;HjYH jkafka' 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' fm%daàk ldkaÿ

ùu blauKska y÷kd .kakd ;rug m%;sM<h id¾:lhs' ¡ 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 76

NOVEMBER 2017 | DOCTOR MAGAZINE

.=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'

frda. woshr j¾.SlrKh eGFR millilitres per minute STAGE 1 per 1.73m2, w.h 90g jeä jk uq;a ta iu.ska uq;%d jd¾;dfõ we,aìhqñka$fm%daàka$reêrh olakg ,eîu

STAGE 2

STAGE 3

STAGE 4

eGFR w.h 90-60 w;r

mej;Su eGFR w.h 60-30 w;r

mej;Su

fuh Stage 3A yd Stage 3B jYfhkao Wm j¾.SlrKhlg ,la fõ'

STAGE 5

eGFR w.h 15-30 w.hl

eGFR w.h 15g wvq w.hl

STAGE 6 STAGE 7

mej;Su mej;Su

frda.shd vh,hsisia lrk wjia:dj 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' 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 doctormagazine.lk

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 vh,hsisia lrk wjia:dj

AV Fistula tlla oukakg isÿ fõ' 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' 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

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' 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 fmdka 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'

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

fï jeros ;SrKh .kak tmd''' miq;eú,s fjkak isÿ fõú''' 1 Tng oshjeähdj ;sfnkjd''' 2 uq;%d iu. fm%daàk ldkaÿ fjkjd'''

oshjeähdj ;sfnk frda.sfhl= wêreêr mSvkfhkao fmf<a kï Tyqg$wehg reêr mSvk md,kh fuu frda.S ;;a;ajh Tvq osùu md,kh lsÍug T!IO jYfhka ksielfhkau oshjeähd jl=.vq wdndO md,kfhyso ld¾hlaIuj l%shd;aul jk ACE Inhibitors fyda Angiotensin II Receptor Blockers

hk T!IOhla ,nd osh hq;=h'

NOVEMBER 2017 | DOCTOR MAGAZINE

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' doctormagazine.lk

frda.sfhla mß;dk ldkaÿlrKhg ,la lrjk yeá ldkaÿlrKhg frda.shd ms<sfh, lsÍu

Arm Fistula tlla oeóu

Vascath fkdfyd;a f., Tiafia reêrh

msßisÿ lsÍu

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 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'

oshjeähd jl=.vq frda.h i|yd m%;sldr ^uq;%d iu. fm%daàk msgùu i|yd m%;sldr& oshjeähd jl=.vq frda.h je<elaùu i|yd''' jl=.vq ;jÿrg;a ydkshg ,laùu ie<lsh hq;= m%udKhlska wvq lsÍu i|yd ,nd fok T!IO ldKav folls' fï foflka tlla Tfí ffjoHjrhd fokq we;' doctormagazine.lk

-ACE Inhibitors (AngiotensinConverting Enzyme Inhibitors) -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' 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 Angiotensin II Receptor Blockers hk T!IOhla ,nd osh hq;=h'

NOVEMBER 2017 | DOCTOR MAGAZINE

T!IO ,nd .ekSfï ud¾f.damfoaYK ¡ fï ksid by; ACIE, ARB T!IO .ekSug fmr Electrolyte 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 jeäùug bv ;sfhkjd' fï ksid reêrfha fmdgEishï uÜgu i;shlg miqj mÍlaId lr.; hq;=hs'

oshjeähd frda.sfhl= ACR fyda UFR mÍlaIKfhka uq;%d iu. fm%daàk msg fjk nj oek.;a úg tkï oshjeähd jl=.vq wudrej iEÿKQ úg fmdgEishï uÜgu wêl ke;skï ACE Inhibitors fyda Angiotensin II Receptor Blockers .; hq;=h' fuh reêrfha iSks uÜgu md,kh lsÍuo fuu frda.S ;;a;ajh W;aikak ùu j<lajd .ekSuo i|yd .; hq;= m%Odku l%shd ud¾.hla jkafkah' fï nj kùk mÍlaIK j,ska fy<sù we;' 80

NOVEMBER 2017 | DOCTOR MAGAZINE

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 ACEI ldKavfha T!IO - Enalapril, Ramipril ARB ldKavfha T!IO - Losarton, Telmisartan, Valsartan

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UFR mrSlaIKhloS uq;%d fm%daàk meje;Su

fuÜf*dñka iïnkaOfhka we;s ñ;Hd m%;sfrdaOh neyer úh hq;=uh'

oshjeähd frda.Skag fuÜf*dñka ,nd fok yeá 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' 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' 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 fjoHjreka 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'

SUNSHINE HEALTH CARE LANKA LTD., 27, 4/1, York Arcade Building, York Arcade Road, Colombo 1, Phone 0114702500

Hotline 077 377 72 99

LABORATORY TESTS EXPLAINED | SERUM CREATININE

jl=.vq j, l%shdldß;ajh fidhd n,k

l%sheákska mÍlaIKh

wdisß ridhkd.dr fiajdfõ wOHlaI kS,a m%sh;a fcdaka úisks 82

NOVEMBER 2017 | DOCTOR MAGAZINE

doctormagazine.lk

jl=.vq frda. wfma rfÜ ck;djg buy;a wNsfhda.hla jk fi!LH ;¾ckhla jk w;r fï ksidfjkau ta iïnkaOfhka fmdÿ ck;djf.a buy;a l=yq,lao we;sù ;sfí' jl=.vq frda. iïnkaOfhkao ta frda. yªkd.ekSfuys,d l%sheákska mÍlaIKfha we;s jeo.;alu iïnkaOfhkao fï ,smsfhka wm úuiuq'

jl=.vq j,ska isÿjk fufyh wfma jl=.vq úiska YÍrfha tla/ia jk jeä c,h fukau wmøjHo neyer lsÍu isÿ lrhs' uQ;%d ksmojkafka fï øjH j,sks' jl=.vq reêr mSvkh uekúka mj;ajd .ksñka YÍrh wdrlaId lsÍfï fufyjrl ;j;a wdldrhlskao ksr; fjhs' jl=.vq j, fï fmÍfï l%shdj,sh wvmK lrk''' wvd, lrk''' frda.S ;;a;aj wm zzjl=.vq frda.ZZ hkqfjka fmdÿfõ y÷kajuq' jl=.vq j, l%shdldß;ajh wvd, ùu ksid jl=.vq j,ska bj;a úh hq;= fldgia tfia neyer ùula isÿ fkdù YÍrfhau tla/ia ùfuka YÍrh ;=< úI iys; ;;a;ajhla ks¾udKh fjhs' fï úkdYh fndfyda fofkl=g isÿ jkafka fiñka fiñka jir .Kkdjl isgh' oshjeähdj fukau wêreêr

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mSvkh ;sfnk wh w;r fï ;;a;ajh nyq,h' ld,Sk jl=.vq wdndOh (Chronic Kidney Disease) hkqfjka ye|skafjkafka fï ;;a;ajhhs' hï flkl=g yosis wk;=rla" wdmodjla ksid fyda lsishï frda.hla ksid ysáyeáfha jl=.vq l%shdldß;ajh ÿ¾j, jQ úg th ;Sj% jl=.vq wdndOhla (Acute Kidney Disease) f,i yªkajhs' ksfrda.S jl=.vq l%shdldß;ajha ;snqKQ flfkl=g jQj;a jl=.vq j, frda. ;;a;ajhla ;snQ flfkl=g jQj;a wdoS jYfhka ´kEu flfkl=g fuï yosis jl=.vq frda.S ùu we;s úh yel' jl=.vq wdndO wfma rfÜ muKla fkdfõ f,dalfha fndfyda rgj, flfuka nrm;, .eg¿jla njg m;a fjñka ;sfí' cd;sh" ,sx.sl;ajh" jhi''' fï ljr ldrKhla jQj fkdi<lñka ´kEu flfkl=g ´kEu wjia:djloS jl=.vq frda. we;sùfï wjodku mj;S'

jl=.vq frda. we;sùfï wjodku jeä lrk idOl ¡ oshjeähdj ¡ wêl reêr mSvkh ¡ yDo.; frda. ¡ jl=.vq wdndO we;sùfï mjq,a b;sydih fï ish¿ wjodkï we;s úg jl=.vq wdmodjg ,la jkafka fiñks' jir .Kkdjla ;siafiah' wfma rfÜ fõ.fhka me;sr hk''' úfYaIfhka rcrg ck;dj fj,d.;a jl=.vq frda.hg uq,a jQ fya;=j ;ju;a yßyeá yªkdf.k ke;' fï ksid th NOVEMBER 2017 | DOCTOR MAGAZINE

Kidney Disease of Unknown Origin

hkqfjkao ye|skafjhs'

ne¨fjd;a l%sheákska j,o we;af;a ksh; w.hls'

uq,a wjia:dfõ lsisÿ frda. ,laIKhla fkdfmkajk frda.hls

reêrfha l%sheákska mÍlaIdj isÿ lsÍfï wre;

ksid jl=.vq wdndOhl uq,a wjia:dfõoS lsisÿ frda. ,laIKhla fmkajkafka ke;' th kej; ms<silr l< fkdyels ;rï úkdYhla isÿjQ l,ayS ta iïnkaO frda. ,laIK fmkakqï lsÍu ksid fndfyda fofkla wirK Ndjhg m;a jkafkah'

tkaihsóh l%uhg l%sheákska w.hka ne¨fjd;a idudkHfhka kSfrda.S mqoa.,fhl= ;=< mej;sh hq;af;a (0.5 – 1.2 mg/dl) w;r w.hls' fï w.hka blaujd hdu lsishï jl=.vq frda.hl ,laIK lshd mdhs' fï wdldrfhkau jl=.vq j, l%shdldß;ajh .ek wjfndaOhla ,eîug WmldÍ jk ;j;a mÍlaIKhla ;sfí' Cystatine C hkqfjka ye|skafjk tu mÍlaIKh isÿ lsÍug oeßh hq;= msßjeh u|la jeäh'

jl=.vq frda.hla we;s ke;s nj oek.ekSug we;s myiq yd fyd|u l%uhla kï reêr yd uq;%d kso¾Yl lr.;a ridhkd.dr mÍlaIKhs' reêr mÍlaIK u.ska fmryka lsÍfï iS>%;djh .ek wjfndaOhla ,nd .kakd w;r l%sheákska mÍlaIK isÿ lrkafka fï wjfndaOh uQ,sl jYfhka ,nd. kq msKsih' l%sheákska mÍlaIKh jl=.vqj, l%shdldß;ajh úmrï lr ne,Sfï m%;sM<odhS mÍlaIKh jYfhka ye|skaùfuys jrola fkdfõ'

l%sheákska lshkafka fudllao@ fmaYs mßjD;a;Sfhys neyer flfrk ^l%sheákska& wKqjla jYfhka uQ,sl jYfhka fï ridhKslh ye|skaúh yel' YÍrfha Yla;s wjYH;djhka imqr,Sfuys,d WmldÍ jk l%sheáka oaú;Shslj l%sheákska njg mßj¾;kh fjhs' YÍrfha iuia; l%sheáka m%udKfhka l%sheákska njg m;a jkafka ishhg 2la muKs' fï l%sheákska reêr ixirkh yryd jl=.vq j,g meñfKk w;r tajdhska jeä fldgila uq;%d iu. neyer fjhs' wfma YÍrfha fmaYs ialkaOh iEu ojilu mdfya ksh;hlaj mj;S' tfyhskau oskm;d w.hka 84

NOVEMBER 2017 | DOCTOR MAGAZINE

ljr fya;=jla ksid fyda jl=.vq j, l%shdldß;ajh ÿ¾j, jQ úg reêr.; l%sheákska uÜguo by< kexfjhs' jl=.vq u.ska l%sheákska fmÍu ÿ¾j, ùu thg fya;=jhs' fï ksid iïu; jl=.vq l%shdldß;ajh we.hSfï reêr mÍlaIKh jYfhka l%sheákska mÍlaIdj isÿ lsÍug ffjoHjreka j. n,d.kS'

Glomerular Filtration Rate for Creatinine Clearance jl=.vq u.ska ljr m%udKhl l%sheákska mßudjla bj;a lrkafkao hk w.h u; mokï jQ jvd;a ksrjoH we.hSula isÿ lrKQ ,nhs' Creatinine Clearance hkqfjka ye|skafjk tu we.hSfïoS jl=.vq j, fmÍfï l%shdj,sh isÿ lrk ishqï jHqydjka jk .=ÉÑld ;=<oS tu fmÍu isÿjk iS.%;djh uek ne,Sula isÿ lrk w;r th Glomerular

doctormagazine.lk

Filtration Rate, or GFR) hkqfjka

ye|skafjhs' tu wjidk w.hka reêr l%sheákska m%;sM< iu. isÿ lrk .Ks; wdfmdaykhla u.ska .Kkh lr ,nd .ekSula isÿfõ' ta i|yd frda.shdf.a nr" jhi wdosho fhdod.kS'

uq;%d mÍlaIk yd reër mÍlaIK folu fhdodf.k lrk we.hSu meh 24l uq;%d idïm, tl;= lr isÿlrk mÍlaIKhla u.skao reêr kso¾Ylhla ,nd .ekSfukao isÿlrk iDcq mÍlaIK l%ufõohlao fjhs' fuysoS uq;%d j,o" reêrfhao we;s l%sheákska w.hka ixikaokd;aulj we.hSula isÿ flf¾' ridhkd.drfhka ridhkd.drhg idudkH w.hka iaj,am jYfhka fjkia úh yels jQj;a tys o< idudkH fufia oelaúh yel

88-128 mL/min

97 - 137 mL/min

nelaàßhdkq wdidok ksid uE;loS orejkaf.ao l%sheákska w.hkayS by< hdula ksÍlaIKh jQ w;r ta wdldrfhkau mqriaÓ;s ms<sld wjodku iys; jQ mqreIhkaf.ao fï wdldrfhau l%sheákska w.hkayS by< hdula wjOdkhg fhduq úh'

l%sheákska mÍlaIKhla isÿ lsÍug n,mj;ajk wjia:d jl=.vq frda.hl ,laIK my< jQ úg Tfí ffjoHjrhd úiska l%sheákska mÍlaIKh isÿ lsÍug Wmfoia imhhs' doctormagazine.lk

ta wdldrfha mÍlaIKhlg bv i,ik frda. ,laIK lsysmhla fufiah' ¡ úvdnr .;sh" kskaog ndOd we;sùu ¡ wdydr wreÑh ¡ uqyqK" ueKslalgqj" j<¨lr" Worh bosóu ¡ jl=.vq wdY%s;j we;sjk fldkafoa wudrej ¡ uq;%d Odß;dfjys yd isÿ lrk jdr .Kfkys fjkila isÿ ùu ¡ wêreêr mSvkh ¡ os.= ld,Sk oshjeähdj' ¡ Tlaldrh$jukh Calcium Dobesilate ldKavhg

wh;a fckaguhsiska jeks we;eï T!IO .ekSfukao we;euqkag jl=.vq mßydkshg m;ajk nj y÷kdf.k ;sfí' fujka T!IO ,nd.kakd whg fok WmfoaYh kï fï fya;=fldg f.k Tfí jl=.vq j,g lsishï ydkshla fkdjk njg iy;sl jkq msKsi l,ska l,g l%sheákska mÍlaIKh isÿ l<hq;= ùuhs'

idudkH mqoa.,fhl=f.a l%sheákska w.hka l%sheákska mÍlaIKfha m%;sM< Milligrams per Deciliter fyda Micromoles per Lite hk wdldrhlska ,nd fohs' ksfrda.S mqoa.,fhl=f.a l%sheákska w.hka fufiah' 0.84 to 1.21 milligrams per deciliter 74.3 to 107 micromoles per liter

NOVEMBER 2017 | DOCTOR MAGAZINE

fuu w.hka ridhkd.drfhka ridhkd.drhg iaj,am jYfhka fjkia úh yel' ta yereKQ úg ia;%S-mqreI Ndjh" jhi wdosho n,mdhs' l%sheákska YÍr ialkaOh mokï lr.;a idOlhla jk neúka jeä fmaYs ialkaOhla iys; ksid msßñkaf.a l%sheákska w.h ldka;djkag jvd u|la jeäh' Estimated Glomerular Filtration Rate (eGFR) uek ne,Su ir<"

fõ.j;a yd ksrjoH jl=.vq mÍlaId lsÍfï mÍlaIKhla jYfhka fhdod .efka' Creatinine-based eGF fhdod .ekSfï we;s tla .eg¿jla jkafka fuysoS l%sheákska mÍlaId lsÍug we;s l%ufõohka mD:q, mrdihla .ekSuhs' úYaf,aYKd;aulj l%sheákska j, we;sjk iq¿ fjkialula eGFR yS úYd, mrdihl fjkialulg u. mdohs' fuh jl=.vq frda.Ska mdol lr.;a eGFR frda. we.hSuloS úi,a .eg¿jla jkafkah'

jvd ksrjoH m%;sM< i|yd Enzymatic Assays

flfia fj;;a jl=.vq frda. we.hSfuys,d l%sheákska mÍlaIKh orkafka wkqmfïh jQ jeo.;aluls' 1970 oYlfha isg fï i|yd tkaihsóh mÍlaIKo (Enzymatic Assays) fhdod. kS' fïjd iïm%odhsl mÍlaIK j,oS we;sjk úp,H;djhka ie<lsh hq;= muKlska wvq lrk ksid jvd ksrjoH mÍlaIK l%ufõohla jYfhka ie<fla' fï i|yd ;rul msßjehla oeÍug isÿjk ksid Jaffe Assays fyda Compensated Jaffe Aassays hk mÍlaIK i|ydo ful, ;rul b,a¨ula mj;S' Enzymatic Assays mÍlaIK isÿ lsÍfïoS tys m%;sM<h fjkia lsÍug fya;= jkafka hhs yªkd.;a tlu T!IOh oshjeähd wlaIs wdndOh iys; frda.Skaf.a flaYsl mdr.uH;djh wvq lsÍug fhdod .kakd Calcium Dobesilate kue;s Tiqjhs'

wdisß frdayf,a ridhkd.dr ld¾ñl rx. m%Nd;a uy;dg úfYaI ia;+;sh ysñ fõ'

DISCOUNT

ku ,smskh ÿrl;k wxlh

wdisß n,h,;a ksfhdacs; ;ekf.a m%fhdackh i|yd mÍlaIKh whlrk uqo, 5% jÜgu iu.ska wh lrk uqo, 86

NOVEMBER AUGUST 2017 2017 | DOCTOR | DOCTOR MAGAZINE MAGAZINE

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MedEx Health and Beauty Expo 2017

lkao Wvrg oejeka;u ffjoH iy iqjfiajd m%o¾YKh foieïn¾ ui 15 iy 16 hk foÈk ;=< uykqjr lekaä isá fikag¾ mßY%fha§ f,dafl Ôj;a fjk wm yefudaf.u n,dfmdfrd;a;=j i;=áka Ôj;a ùu' b;ska i;=áka Ôj;a fjkak kï ksfrda.S Ôú;hla ùu w;HjYH fjkjd' wo f,dalh fld;rï ÈhqKq fjñka bÈßhg .uka l<;a w;s kùk fi!LH myiqlï iy fidhd.ekSï Èfkka Èk jeä jqj;a ta ms<sno oekqj;a ùula isÿ fkdjkafka kï tys lsisÿ m%fhdackhla fkdjkq we;' lkao Wvrg ck;djf.a ffjoH iy iqjfiajd we;=¿ fmdÿfõ fi!LH ms<sno oekqu jeälsÍfï wruqfKka — MedEx Health and Beauty Expo 2017˜ foieïn¾ ui 15 iy 16 hk foÈk ;=< uykqjr lekaä isá fikag¾ mßY%fha§ meje;aùug ie,iqï fldg we;' isf,daka tlaIsìIkaia wdh;kh úiska ixúOdkh lrkq ,nk fuu m%o¾YKh uykqjr meje;afjk m%:u iy tlu ffjoH iy iqjfiajd m%o¾YKhhs' fuys§ ffjoH iy iqjfiajd wxYhg wod, fiajd imhk mqoa.,sl iy rdcH wxYfha wdh;k úiska m%o¾Yk 88

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l=á bÈßm;a flfrkq we;' tys§ úfYaIfhkau mqoa.,sl frday,a" fyo iy idhksl fiajd" ffjoH ridhkd.dr fiajd" T!IO" fi!LH iïmkak wdydr" fmdaIKh" mjq,a ie,iqï" Ôú; rlaIK ie,iqï" jHdhdu WmlrK" rem,djkH fiajd" wdhq¾fõo fiajd iïnkaO wdh;k u.ska ck;dj oekqj;a flfrkq we;' tfiau kùk ffjoH m%;sldr iy mÍlaIK l%u ms<sno iÔù w;aoelSula ,nd .ekSug uyc;djg yels jkq we;' ffjoH iy iqjfiajd ms<sno f;dr;=re wfmalaId lrk lkao Wvrg ;reK" jeäysá" nd," uy¿ ish¨ fokdgu fuu m%o¾YKh jákd wjia:djla jkq fkdwkqudkhs' úuiSï 077 666 99 57 iy 077 00 33 083 doctormagazine.lk

EAR INFECTION IN PATIENTS WITH DIABETES MELLITUS

lfKys

wdidok jHdl+, lrk Èhjeähdj Tn fyd|ska okakd wdldrhg lK fldgia ;=klska hqla; jk w;r tajd msg; lK" ueo lK yd we;=¿ lK f,i ye|skafjhs' thska msg; lK yd ueo lK wdidok j,g ksn|j k;= jk ia:dk folla fjhs' msg; lfKys wdidok fukau ueo lfKys wdidok ksis m%;sl¾u fhoSfuka iqj lr.; yels jk w;r tajdfha ixl+,;d olakg ,efnkafka tajdg ksishdldrj ms<shï fhoSu m%udo lf<d;a muKs'

rdc.srsh f.da,avka lS frdayf,a W.=r" lk" kdih ms<sn|j úfYaI{ ffjoH fcaHIaaG lÓldpd¾h ffjoH iS;d l=udß wrfòfmd, úisks

NOVEMBER 2017 | DOCTOR MAGAZINE

GOLDEN KEY

HOSPITALS LIMITED

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Èhjeähdfjka fmf<k úg lfkys wdidok j, ixl+,;d we;sùfï bvlv jeähs kuq;a oshjeähd frda.fhka fmf<k úg m%;sl¾u fhoSu u|la wmyiq jQjo wêl f,i ixl+,;d we;sùfï wjodkula we;' tf,i m%;sl¾u l<o reêrfha iSks m%udKh ksis f,i md,kh fkdjqKfyd;a tu frda.shdg ixlS¾K ixl+,;d we;s úh yel'

§¾>ld,Skj T!IO tkak;a ,nd§ug isÿjk Malignant Otitis Externa msg; lfKys we;sjk wdidok w;r nelaàßhd yd os,Sr wdidok" lfKys kd,h ;=< we;s úh yels w;r oshjeähdj md,kh fkdjk wjia:djl fujeks wdidok we;sjQ úg tu wdidokh lK wjg udxY fmaYskag me;sßh yels w;r tys oreKqu ;;a;ajh jkafka wdidokh wiaÓ lrd me;sÍuhs' tysoS wêl fõokdjla we;sjk w;r fkdkj;ajd oshr .e,Sula" iakdhq ÿ¾j,;d ksid uqyqfKa mK ke;sùï we;s ùug;a we;s yelshdj wêlh' Malignant Otitis Externa f,i y÷kajk fuu ;;a;ajh md,kh lsÍu b;d wiSre ld¾hhla jk w;r cSú;hg mjd ydks úh yel' fuysoS oS¾>ld,Skj T!IO tkak;a ,ndoSug isÿjk w;r wjodku wju lsÍug we;eï úg oS¾>ld,Skj frday,a.; lr m%;sldr lsÍug isÿfõ'

ueo lK wdY%s; wdidok ueo lK wdY%s; wdidok jQjo fndfyda úg wju m%;sldr ie,iSfuka ixl+,;djhkaf.ka f;drj iqjh doctormagazine.lk

,eîfï yelshdj we;s uq;a oshjeähd frda. ;;a;ajfha md,khla fkdue;s úg tu frda.Skago ie<lsh hq;= ixl+,;d we;s fõ' fuu wdidokh wjg we;s wiaÓ lrd me;sfr;au tys wdidok (Mastoiditis) fyda ierj f.ä (Mastoid Abscess) we;s úh yel' tmuKla fkdj f.f,ys udxYfmaYs j,o ierj f.ä (luc's abscess) we;s úh yel' b;d wjodkï ixl+,;d f,i wm i<lkafka fuu wdidokh fud<h lrd f.dia tu mgl ;=< wdidok (Meningitis) kue;s ierj f.ä we;s ùuhs' (Cerebral Abscess) túg wxYNd.h hkqfjka ye|skafjk wd>d;hka fukau fjk;a fud<fha ydksùï o we;s úh yel'

fï ish,af,ka meyeos,s jkafka Tng oshjeähdj we;s úg b;d fyd| reêr iSks md,khla mj;ajd.; hq;= njhs' tfiau lK iïnkaOfhka i<lk l< l=vd wdidokhla jQjo uekúka y÷kdf.k ksis ms<Shï fhosh hq;= njo Tn is;ayS Odrkh lr.; hq;a;ls'

NOVEMBER 2017 | DOCTOR MAGAZINE

Èhjeähd frda.Skaf.a

mdo wdrlaIdj m¾hka; reêrjdyskS frda.fhka j<lsk yeá'''

ffjoH kd,l .=KjxY

MBBS MS MCh (UK) úisks

jdysksl" wkaf;dajdysksl yd wjhj noaOlsÍu iïnkaO úfYaI{ Y,H ffjoH cd;sl jl=.vq yd ldkaÿlrK wdh;kh" cd;sl frday," fld<U 92

NOVEMBER 2017 | DOCTOR MAGAZINE

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oshjeähdj ksid mdo j,g yd fud<hg jk reêr iemhqu wjysr ùu y÷kajkafka Peripheral Arterial Disease (PAD) hkqfjks' mdo j,g wjYH jk reêr iemhqu wjysrhg ,laùfuka mdo bj;a lrkakg mjd we;eï úg isÿfõ' fï ksid oshjeähd frda.Ska ;u mdo wdrlaId lr.ekSu flfryS úfYaI ie<ls,a,la oelaúh hq;=h' Peripheral Arterial Disease (PAD) frda. ,laIK Peripheral Arterial Disease fkdfyd;a m¾hka; reêrjdyskS frda.fha uq,a wjia:dfõoS lsisÿ frda. ,laIKhla m%lg lrkafka ke;' fï ksid fndfyda úg fuh y÷kd.kafka oshjeähd frda.Skaf.a mdo j, kdä .eiau mÍlaIdjg ,la lsÍfuks' iEu jirlgu j;djla j;a oshjeähd frda.Ska ;u mdoj, reêr iemhqu mÍlaId lr.; hq;=h' hï fyhlska tu kdä jeàfï wvqjla fmfkkakg ;sfí kï uq,a wjia:dfõoSu Bg kshñ; T!IO m%;sldr isÿlr bosßhg úh yels wjodku md,kh lsÍug fuu.ska wjia:djla Wod fõ'

¡ uq,skau we;s jkafka weúosk úg we;sjk fõokdjhs ¡ B<`. woshf¾oS kslka bkak fj,djgo fõokdj we;s fjkjd'''

oshjeähd frda.Skaf.a mdo j, we;sjk ;=jd, oshjeähdj ld,hla ;siafia mj;sk úg ksoka.; ;=jd, fkdfyd;a os.= ld,hla ;siafia iqj fkdjk ;=jd, olakg ,efnhs' os.= ld,hla ;siafia mej;Su iajNdjh uq;a fïjd kï b;d m%fõYfuka m%;sldr lr iqj lr.; hq;af;auh' ke;skï th wjika jkafka mdoh lmd bj;a lrk uÜgug <`.d ùfuks'

wdidok we;s ùfï wjodku by< hhs oshjeähd frda.Ska wdidok j,g ,laùfï wjodku ksfrda.S whg jvd jeäh' tfiau Tjqkag oshjeähdj ke;s frda.Skag muK Yla;su;a m%;sYla;slrK moaO;shlao fkdue;'

iEu jirlgu j;djla j;a oshjeähd frda.Ska ;u mdoj, reêr iemhqu mÍlaId lr.; hq;=h' hï fyhlska tu kdä jeàfï wvqjla fmfkkakg ;sfí kï uq,a wjia:dfõoSu Bg kshñ; T!IO m%;sldr isÿlr bosßhg úh yels wjodku md,kh lr.; hq;=h'

n,k kdä mÍlaIKh fuh l,afõ,d we;sj y÷kd.ekSfï m%Odk mshjrhs' fuh ´kEu ffjoHjrfhl=g isÿl< yels mÍlaIKhls' wu;r mÍlaIK jYfhka Doppler Scan yd Duplex Scan mÍlaIKo fhdod.; yel' ta yereKq úg wjYH kï wekacsfhd.%Eï mÍlaIKhlskao fuys wjysrùï uekúka y÷kd.ekSug wjldY ;sfí' fuu wu;r mÍlaIK isÿ lrkafka frda.shd CLI hkqfjka ye|skafjk kd, wjysr ùfï W.% frda. ,laIK m%lg lrkafka kï iy thg ms<shula jYfhka lsishï Y,Huh ueosy;aùula isÿ lrkakg mQ¾j.dójh'

mdohg we;s iajdNdúl /ljrKh wysñ fjk yeá

mdo wdrlaId lr.ekSfï iaj¾Kuh Wmfoia ud,dj

by; wjodkï idOl ish,a, mdo iqjfi; flfryS wys;lr f,i n,mdkafkah' fï wdldrfhka wjidkfha isÿjkafka mdohg we;s iajdNdúl wdrlaIl /ljrKh wysñ ùuhs' tys m%;sM<hla jYfhka mdo wk;=rg ,laùfï wjodku by< hhs' reêr iemhqu ySk fjhs' mdo mgl j,g Tlaiscka jdhqj iemhquo ie<lsh hq;= uÜgulska wvqjk ksid yefok ;=jd,hla myiqfjka iqj jkafkao ke;' fï ksid mdo b;d wka;rdhldÍ wjodkulg ,la jk w;r iq¿ ;=jd,hla jQj;a fkdmudj wjYH mshjr fkd.;fyd;a ta ;=jd,h fõ.fhka j¾Okh ù mdo bj;a lsÍug mjd isÿ úh yelsh'

¡ oshjeähd T!IO yd oshjeähdfjka mek ke.sh yels ixl+,;d j,ska ñoSug ffjoHjrhd úiska kshu lrk ,o weiamsßka" reêr mSvkh wvq lrk T!IO" fldf,iagfrda,a j,g .kakd T!IO wdosh Wmfoia oS wdldrhgu .; hq;=h'

PAD frda.h y÷kd.kakd

yeá ffjoHjrhd úiska frda.shd idhkslj mÍlaId lsÍfuka PAD frda.h yªkd.; yel' ks;sm;d mdofha reêr iemhqu 94

NOVEMBER 2017 | DOCTOR MAGAZINE

¡ ÿï mdkfhka ñoSu fukau wfkl=;a wjodkï iy.; p¾hd j,ska ñosh hq;=h' ¡ mdjyka fkdue;sj weúoSu iqÿiq ke;' Tfí wdrlaIdj fjkqfjka úfYaIfhka ieliQ mdjyka hq., ^ke;skï th ffjoH Wmfoia u; ilia lr.kak' m<|skak' ¡ Tfí ffjoHjrhd$Y,H ffjoHjrhd Wmfoia fok wdldrhg kshñ; mßos ffjoH yuqjg hkak' fuysoS u;=jg we;súh yels wjodkula fõ kï th l,afõ,d we;sj y÷kdf.k wdrlaIdldÍ mshjr .ekSug wjia:dj Tng Wod fjhs' doctormagazine.lk

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'

Èhjeähd frda.Skag

we;súh yels udkisl wd;;sh uE; ld,fha udkisl wd;;sh .ek fndfyda fokd l;d lrkq wms wid we;af;uq' we;af;kau wd;;sh hkafkka woyia lrkq ,nkafka ndysr mßirfhka we;sjk wk;=rla yÕjk W;af;ackhlg ñksid úiska olajk ldhsl yd udkisl m%;spdrhhs'

úfYaI{ ufkda ffjoH ud,sld ùrisxy úisks

hï mqoa.,fhl=g lsishï wk;=rla we;ehs yeÕ=K úg Bg uqyqK §u ioyd YÍrh ;=< ridhksl yd fydafudak l%shdldß;ajfha fjkialï isÿfõ' W;af;ackh flá ld,sk kï fuu fjkialï miqj idudkH ;;a;ajhg m;a fõ' kuq;a .eg¿ldÍ jkafka È.= ld,Skj mj;sk wd;;shhs' fuh udkislj fukau YdÍßljo nrm;, fi!LHh .eg¿ we;s ùug fya;=jla úh yel'

NOVEMBER 2017 | DOCTOR MAGAZINE

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§¾> ld,sk wd;;sh oshjeähdjg mdr lshkjd''' udkisl wd;;sh we;s ùug úúO fya;= n,mE yel' mjqf,a .eg¿" uq,Huh .eg¿" /lshd ia:dkfha .eg¿" È.= ld,sk yd nrm;, ldhsl frda. wdÈh ñka lsysmhls' mqoa.,fhl= wêl wd;;sfhka fmf<k úg Tyqf.a isrer ;=< isÿjk fjkialï ksid fldaáfida,a kï fydafudakfha jeä ùula isÿfõ' fuh reêrfha iSks uÜgu jeä ùug fya;= fõ' Èhjeähdj we;s ùug cdkuh n,mEu we;s wfhl= §¾> ld,sk wd;;sfhka mSvd ú|S kï fï fya;=fjka Èhjeähd frda.fha uq,sl ,laIK we;s úh yel' wfkla w;g oekgu;a Èhjeähdfjka fmf<k wfhl=f.a reêr iSks uÜgu md,kh wmyiq ùugo udkisl wd;;sh n,mdhs' Èhjeähdj hkq §¾>ld,Skj T!IO .; hq;= yd ðjk rgdfõ fndfyda fjkialï we;s lr .; hq;= frda.hls' hï wfhl= wêl udkisl wd;;sfhka fmf<k úg ksjerÈ ;SrK .ekSfï yelshdj wvq fõ fõ' tfukau ;u YdÍßl fi!LHh iqÿiq mßÈ mj;ajd .ekSug we;s Wkkaÿj wvq fõ' tfukau wd;;sh md,kh lsÍfï l%uhla f,i kqiqÿiq wdydr mqreÿ j,go fhduq úh yel' fï ish,a, Èhjeähdj ksis f,i md,kh lsÍug ndOdjka fõ' ;j;a iuyre udkisl wd;;sfhka ñ§ug ÿï mdkh" u;ameka mdkh jeks

wys;lr mqreÿ j,g fhduq fõ' kuq;a fïjd Èhjeähdjg fojkqj we;s úh yels yDo frda. jeks ixl=,;d we;s ùfï yelshdj jeä lrhs' ;jo wd;;sfhka fmf<k úg blauKska ;ry hdu ksid mjqf,a wh yd .eg¿ we;s ùfuka frda.h md,kh lsÍug Tjqkaf.ka ,efnk iyh wvq úh yel'

Èhjeähd we;s nj uq,skau oeK.;a úg;a ufkda jHdl+,;djhla we;s úh yelshs Èhjeähd frda.h uq,a jrg y÷kd .ekSuo mqoa.,fhl=f.a udkisl wd;;sh we;s l< yels idOlhls' frda.h md,kh iïnkaOfhka l< hq;= fjkialï" mjq,g yd /lshdjg we;s n,mEu yd wkd.;h .ek we;s jk ìh óg fya;= fõ' fï ksid uq,a wjia:dj,§ iuyr mqoa.,hska frda.h fkdi<ld cSú;fha wfkl=;a lghq;= j,g uq,a ;ek fokq o wms oel we;af;uq' fuh wkqu; l< fkdyel'

;udg Èhjeähd frda.h we;s uq,skau oek .;a úg ´kEu wfhl= n,j;a Ñ;a; mSvdjlg m;a úh yel' kuq;a l%ufhka ksis Wmfoia ,ndf.k Bg yqre jQ úg tu msvdj wkql%ufhka u. yeÍ hhs'

by; lreKq i,ld ne,Sfï§ udkisl wd;;sh yd Èhjeähd frda.h w;r we;s ixlS¾K iïnkaO;djh f;areï .; yel'

udkisl wd;;sfha ,laIK y÷kd .kak udkisl wd;;sfha ,laIK y÷kd .kakd wdldrh' wms oeka i,ld n,uq' uq,sl jYfhka w;;sfha ,laIK YdÍßl" udkisl yd yeisÍï jYfhka j¾. l< yel' wd;;sfha YdÍßl ,laIK jkafka ks;r we;sjk ysiroh" udxY fmaYs$ykaÈ lelal=ï" w,i nj" nv fõ,Su" ks;r f,v ùu wdÈhhs' ks;r lkiaif,ka isàu" l,amkd lsÍu" kqreiaikiq¨ nj" wu;l ùu" wd;au Yla;sh wvq ùu wdÈh wd;;sfha udkisl ,laIK fõ' tfiau wd;;sh fya;=fjka yqol,d ùug leue;a;la we;sùu" wka;¾ iïnkaO;d j, .eg¿" fkdie<ls,su;a nj ksid wk;=re we;sùu yd wys;lr lEu mqreÿ" u;ameka$u;aøjH j,g weíneys ùï wdÈ yeisÍfï .eg¿o we;s úh yel'

wd;;sh md,kh lsÍfuys,d Wml%uYS,Sj lghq;= lrkak wd;;sh hkq YdÍßlj we;sjk l%shdj,shla jqjo ta ms<sno ksjerÈ

§¾> ld,sk wd;;sh úIdoh yd ldxidj jeks ufkda ffjoH .eg¿ j,go fya;=jla úh yels neúka wjYH kï ffjoH Wmfoia ,nd .ekSu jeo.;a fõ'

NOVEMBER 2017 | DOCTOR MAGAZINE

wjfndaOhla ,nd .ekSfuka wd;;sh md,kh lr .ekSfï yelshdj we;' tneúka Èhjeähd frda.h je<|Sug jeä yelshdjla we;s ^cdkuh n,mEula we;s& wh fukau frda.h je<ÿKq mqoa.,hskao wd;;sh ksjerÈj md,kh lrf.k iunr ukila mj;ajd .ekSug Wkkaÿ ùu jáhs' uq,skau wd;;sh Tng fl;rï n,mdkafkao hkak f;areï .kak' ðú;fha tÈfko jev lghq;= j,§ wd;;sh jeä lrk wjia:d yÿkd .kak' tu wjia:d u. yeßh fkdyels kï fjkia l< yels oehs fidhd n,kak' fndfyda úg mqoa.,hska lsishï .eg¿jla$wjia:djla .ek Tn is;k whqre fjkia lsÍfuka thska we;sjk wd;;sh wvq lr .; yel' Tng i;=gla f.k fok l%shdldrlu ksr; ùuo wd;;sh wvq lr .ekSfï tl u.ls' mSvdldÍ is;=ú,s ks;r ks;r is;ñka isàu fjkqjg úYajdiodhs mqoa.,fhl= yd l;d lsÍu iqÿiqh' ;udg .e,fmk ðjk rgdjlg yqre ùuo wd;;sfhka ñ§fï u.ls' iqÿiq jHdhdu j, fh§u" fhda. wNHdi wdÈh wd;;sh wvq lr .ekSug WmldÍ fõ' ;udg Èhjeähd frda.h we;s uq,skau oek .;a úg ´kEu wfhl= n,j;a Ñ;a; mSvdjlg m;a úh yel' kuq;a l%ufhka ksis Wmfoia ,ndf.k Bg yqre jQ úg tu msvdj wkql%ufhka u. yeÍ hhs' frda.h foi Tn n,k whqreo wd;;sh wvq fyda jeä ùug fya;= úh yel' Okd;aulj ta ms<sno is;Sfuka frda.h md,kh lsÍug myiq jkjd fukau fi!LH ld¾h uKav,h yd mjqf,a whgo Tng Wojq lsÍu myiq lrhs'

doctormagazine.lk

Innovative Treatment for Impotence First Time in Sri Lanka

Shocks of Rigidity Shockwave Treatment for

MAINTAIN AN ERECTION

Three years ago, sex became "very stressful" for Mr Ranjan because of his inability to maintain an erection.

By Bharata Gunathilaka doctormagazine.lk

The 45-year-old sales executive, who did not want to give his real name, said: "I did not know if sex that night was going to be satisfactory or if I would be a party pooper."

NOVEMBER 2017 | DOCTOR MAGAZINE

Mr Ranjan, saw a general practitioner and found relief in "yellow and blue pills" that he popped an hour before sex. Well-known by their trade names, Viagra, Cialis or Levitra, these pills belong to a class of medication known as phosphodiesterase-5 (PDE5) inhibitors, which block the PDE-5 enzyme found in blood vessel walls. Those miracle drugs the smooth muscles of the penis to relax and increase blood flow to the organ, but are also associated with side effects such as headaches and flushing.

A misery unexpected But one years ago, the pills stopped working after Ranjan had an angioplasty procedure to unblock an artery, so he was totally upset on his sex life. "We always tried to plan for sex and, even then, I always had doubts about my erections." said Ranjan.

New hope One year ago he was offered fresh hope by senior consultant urologist at CDEM Hospital, Norris Canal Road, Colombo, where a special innovative technique called lowintensity extracorporeal shock wave therapy, for the inability to maintain an erection was established, first time in Sri Lanka. Twice a week, for three weeks, Ranjan had low-intensity shock waves delivered to five areas of his penis to stimulate new blood vessels to grow.

latest advancement in erectile dysfunction The exact mechanism of the low-intensity extracorporeal shock wave therapy remains unclear, but the aim is to restore the erectile mechanism for natural 100 NOVEMBER 2017 | DOCTOR MAGAZINE

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These days, he has sex twice a week, but hopes to "rev this up to six times a week", he declared.

Age immaterial, Suffer everywhere... Most men are able to maintain an erection for five to seven minutes, which is the average time for ejaculation. or spontaneous erections. It is the latest advancement in erectile dysfunction (ED) treatment since pharmaceutical giant Pfizer launched Viagra in 1998.

Sheer outpatient procedure The outpatient procedure does not require any downtime or anesthesia. The technique itself use no drugs administered along with shockwave, so that no any adverse effect of pharmacopia. Ranjan returned to work after each 20-minute session, which left him with only a tingling sensation. He said his sex life has been "good so far" and is close to what he was able to achieve in his 20s.

While older men often have a physical cause for their impotence, such as blocked arteries or hormonal imbalances, psychological issues are more likely to plague younger ED sufferers. These can range from work and money woes, stress because of couple issues to performance anxiety from trying to make a baby during the wifeâ&#x20AC;&#x2122;s ovulation period. Most of the young males are facing ED too.

Stressful and ego-hurting phenomena Speaking on the condition, Dr Lasantha Malavige, Consultant in Sexual Medicine and a visiting Consultant practicing in CDEM Hospital Colombo, said his inability

to perform was very â&#x20AC;&#x153;stressful and ego-hurtingâ&#x20AC;?. Dr. Malavige, a visiting academic at the Oxford University has been appointed as the next President of the South Asian Society of Sexual Medicine for a term of two years commencing 2017. The largest international conclave for experts in the field of sexual medicine. Many males was in guilt from being unable to satisfy their partner and psychological stress from quarrels and the loss of intimacy.

Risk factors Dr Malavige pointed out that risk factors such as diabetes, high blood pressure, high cholesterol and obesity. Urban lifestyle diseases previously more commonly seen in older adults, are now also affecting younger men. One of the youngest patients treated in CDEM hospital for ED is a 22-year-old diabetic, whose girlfriend had shunned him when he was unable to perform in bed. He was devastated, but eventually resolved his ED with counselling, treatment of his diabetes and use of medication.

Sending shock waves Shock waves are acoustic waves that carry energy and can be used to affect a selected anatomical region. High-intensity shock waves have been used for years to pulverize 102 NOVEMBER 2017 | DOCTOR MAGAZINE

urinary stones so that they are small enough to be passed out naturally. Only about 18 per cent of this energy is needed to treat erectile dysfunction (ED), said senior consultant urologist Peter Lim, who last year visited Colombo, CDEM hospital to popularize the technique to the Sri Lankan counterparts. He held a awareness seminar to the general public and another professional briefing for the doctors, both held in auditorium, CDEM hospital, Colombo. The energy is used to cause very minor injuries to genital tissues to stimulate growth factors - proteins that prompt more blood vessels to grow. Shock wave therapy for ED provide new hope for the suffered. Its a new generation intervention. Result oriented initiative. CDEM Hospital proudly announcing the first and only Sri Lankan hospital having low-intensity shock wave treatment for males who are having inability to maintain an erection.

SHOCK WAVE THERAPY FOR ED PROVIDE NEW HOPE FOR THE SUFFERED. ITS A NEW GENERATION INTERVENTION. RESULT ORIENTED INITIATIVE. doctormagazine.lk

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wfma rfÜ jefjk l=re÷ ksfrda.S iqjh m;k f,dal m%cdjf.a wxl tfla f;aÍula'''

l=re÷

i;= uy`.= .=Kh oek.kak

Èhjeähd frda.Skaf.a l=re÷ Ndú;dj 106 NOVEMBER 2017 | DOCTOR MAGAZINE

osh;,dj uQ,sl frdayf,a ffjoH pñkao úfcaisxy doctormagazine.lk

l=re÷ jvd;a m%isoaOj we;af;a oshjeähdjg m%;sldrhla jYfhks' ta yereKQ úg fldf,iagfrda,a wvq lrkakgo l=re÷ iu;a fjhs' l=re÷ .arEï 1-6 l muK m%udKh osk 40la ;siafia tl os.g mdkh lsÍfuka reêr iSks w.h ishhg 24l muK úYd, mrdihlska wvq lr.; yel' reêrfha fldf,iagfrda,a uÜguo ishhg 18l muK m%udKhlska wvq lr.; yel' fuh úYd, b,lalhls' fu;rï m%;sM<hla ,eìh yels T!IO wef;d;a ta l,d;=rlsks' Y%S ,xld jhU úYaj úoHd,fha wdpd¾h f¾Kql is,ajd oshjeähdj u¾Okhg l=re÷ l%shd lrk wdldrh fuf,i meyeos,s lrhs' zz l=re÷ j, we;s we;eï ixfhda. bkaishq,ska j, Wmfhda.S;djh jeä lsÍug iu;ah' tfiau bkaishq,ska wffO¾h lrk idOl hgm;a lrk ixfhda.o l=re÷ i;= fjhs' fmd,smsfkda,a tjeks jákd ixfhda. hls' m%;sTlaisldrlhls' fï yereKQ úg ;j;a jákd ixfhda. /ilau l=re÷ j, wvx.=h'ZZ fï jákd ixfhda. we;af;a l=re÷ fmd;af;a ñi l=re÷ f;,a j, fkdjk njo Tyqf.a woyih' l=re÷ i;= idOKSh .=Kdx. úuiSu i|yd m¾fhaIK /ila fï jk úg osh;a ù we;s nj wdpd¾h f¾Kql is,ajd jeä ÿrg;a m%ldY lrhs' oshjeähdjg w; jkkafka YÍrfha nr jeäùu" mßjD;a;Sh ixl+,;d wdosh Tiafia YÍrh ;=< l%shd;aul jk bkaishq,ska m%;sfrdaë hdka;%Khhs' l=re÷ fï bkaishq,ska m%;sfrdaOh j<lajhs' ta wkQj l=re÷ m%;sldr lrkafka frda.hg fkdfõ" frda.fha uQ,hgh' ta yereKq úg .aÆfldaia reêrh Tiafia YÍrhg Wrd.kakd we,kska wdoS tkaihsu / ila l=re÷ u.ska wjysr lr reêr iSks m%udKh uekúka hdukh lrk nj doctormagazine.lk

m¾fhaIK j,ska fy<sorõ ù ;sfí' oshjeähdj yereKq úg ;j;a fndfyda frda.dndO j,go l=re÷ ukd T!IOhla fõ' fï ksid ksiaidrKh lr.;a l=reª weiqf¾ ilid.;a T!Iëh mdk Ndú;hg ck;dj yqreù isà'

fud<h iqir lrk úYañ; n,hla''' bosß oYl lsysmh ;=< fõ.fhka ysi Tijkq we;ehs fm/hSï lr we;s frda. w;r äfukaIshdj m%Odk ia:dkhla .kS' ;j;a oYl lsysmhlska wfma jeäysáhka iEu i;r fofklaf. kau flfkla fï frda.hg f.dÿre jkq we;ehs ffjoHjreka lsh;s' uE; ld,Sk u;lh wjysr lrñka ldhsl" udkisl úmßkduhla we;slrjk äfukaIshdj ksid fndfyda jeäysáhkag w;ajkafka ÿlaLodhl urKhls' fud<fha ffi, urKhg m;a ùfuka we;sjk frda.hla ksid äfukaIshdjg fnfy;a ke;' frda. ,laIK l,a ouk Wmdhud¾. yereKQ úg ie<lsh hq;= m%;sldrhla ngysr ffjoH úoHdfõ ;ju;a y÷kdf.k ke;' fud<fha ksmofjk weñf,dhsâ îgd kue;s fm%daàkhla fya;= fldgf.k fuysoS fud<fha ffi, urKhg m;a fjhs' äfukaIshdfõoS" we,aIhsu¾ frda.fhaoS isÿjkafka fuhhs' wkd.;h fjkqfjka wdfhdackhla''' miq.shod wreu mqÿu mqj;la ì%;dkHfhka wikakg ,enqfKah' ta fud<fha ffi, j,g ydks lrk weñf,dhsâ îgd fm%daàk j, l%shdldß;ajh w;aysgqjd äfukaIshdj k;r lsÍug l=re÷ iu;a jk njhs' fuh b;d ft;sydisl fidhe .ekSula jkafka tjka ymkalula isÿ flrefKd;a th iuia; udkj j¾.hdf.au fyg NOVEMBER 2017 | DOCTOR MAGAZINE 107

oji flfryS wdrlaIKhla tla lrk ksihs' T!Iëh .=Kfhka hq;a ienE l=re÷ Cinnamomum verum jefjkafka Y%S ,xldfõ muKs' tajdg uq¿ f,dalfhau we;af;a buy;a b,a¨uls' wfma l=re÷ ñf,kao wêlh' fï ksidu Ökfha jefjk vqma,sflaÜ l=re÷o Cinnamomum aromaticum Ndú;hg meñK ;snqK;a tajdfha T!Iëh .=Kh wfma .=Kj;a l=re÷ j, y;r udhsug j;a fkdue;s nj ngysr m¾fhaIlhka fyd|dldrju okafkah'

l=re÷ i;= uyÕ= .=K w;f¾ f;dard.;a lsysmhla''' nf,dalfha ;sfnk yhfjks m%n, m%;sTlaisldrlh jkafka l=re÷h' fmd,smsfkda," msfkda,sl wï, yd *a,efjdkhsv we;=¿j w;s m%n, wdrlaIl ridhk 41 lska l=re÷ fmdfydi;a nj y÷kdf.k ;sfí' ¡ l=re÷ j, w;s m%n, *a,efjdkhsv muKla m%fNao y;la ;sfí' yDohdndO" ms<sld fukau fud<fha l%shdldß;ajh ÿ¾j, lrk l%shdldß;ajhka wvd, lsÍug fuys we;s zzw;s m%n, m%;sm%odysl .=KhZZ WmldÍ fjhs' ¡ l=re÷ u.ska fldf,iagfrda,a iy wêreêr mSvkh my; fy<hs' reêr ixirkh iqir lrhs' reêrh leá .eiSu j<lhs' fuys we;s mgl mqk¾ckkSh l%shdj,sh yD;a udxYfmaYs w¿;ajeähd lrhs' ¡ fuys we;s m%n, m%;sTlaisldrl .=Kdx. ksid DNA wdmodjg ,laùu j<lajhs' th isref¾ we;súh yels ms<sld j<lajk hdka;%Khls'

108 NOVEMBER 2017 | DOCTOR MAGAZINE

fjfiiskau nvje,a j, iqjfi; flfryS l=re÷ ;SrKd;aul jk nj m¾fhaIlhkka y÷kdf.k ;sfí' ¡ uqLfha ÿ¾.kaOh iukh lrhs' ksiaidrKh lr.;a l=re÷ f;a,a l=re÷ jYfhka l%shd;aul fjhs' ¡ lekaävd yd wfkl=;a os,Sr wdidok j<lajhs' ifï oeú,a," wdidok yd wdid;añl;d j<lajhs' fï l=re÷ f;,a j, jákd m%fhdackhls' ifuys iqjfi; kxjd,hs' l=re÷ jvd;a m%isoaOj we;af;a oshjeähdjg m%;sldrhla jYfhks' ta yereKQ úg fldf,iagfrda,a wvq lrkakgo l=re÷ iu;a fjhs' Cinnamon is one of the most delicious and healthiest spices on the planet. It can lower blood sugar levels, reduce heart disease risk factors, and has a plethora of other impressive health benefits. Just make sure to get Ceylon cinnamon, the best kind in the world... One tablespoon of ground cinnamon contains: 19 calories 0 grams of fat, sugar, or protein 4 grams of fiber 68% manganese 8% calcium 4% iron 3% Vitamin K doctormagazine.lk

Èhjeähdj iy wkd.;hg uqyqK §u

Èhjeähdj

we;s lrk udkisl wd;;sh ch .kafk fldfyduo@

fndfyda fofkla oshjeähdj i<lkafk ldhsl frda.hla úoshg ú;rhs' thska we;s lrk udkisl mSvdj .ek;a wjOdkh fhduq lr,d" Tjqkag .e,fmk úi÷ï fidhd oSu" frda.hg m%;sldr lsrSu ;rïu jeo.;aæ

pdkaosud uqkuf,a wEmd ufkdaúoHd WmfoaYsld$ ks¾udKd;aul Ñ;% m%;sldrl$ f,aÅld$ Ndjkd WmfoaYsld

110 NOVEMBER 2017 | DOCTOR MAGAZINE

ufkdaúoHdj lshkafk hï hï ;;a;ajhka flfkl=f.a Ñ;a;fõ. iy iïnkaO;d flfryS we;s lrk n,mEu;a yeisrSug we;s lrk odhl;ajh;a fidhd n,k úoHdjhs' fï whqrska mqoa.,fhl=f.a udkisl fi!LHh flfrys oshjeähd frda.h we;s lrk n,mEu .eko ie<ls,su;a ùu w;HdjYH lreKla' doctormagazine.lk

oshjeähdj lshkafk ;uka úiskau yiqrejd .ksñka" md,kh lr .; hq;= frda.hla' th oskm;du fkdlvjd isÿlr .; hq;= md,khla' fuh ffjoHjrhdg frda.shd fjkqfjka l< yels fohla fkdfjhs' frda.shd .kakd iuyr ;SrK ksid cSú;ho urKho lshd f;dard .kakg isÿ fjkjd' oshjeähd frda.hg ksis m%;sldr ,nd ÿkak;a" Bg f.dÿre jqKq flkdf.a udkisl ;;a;ajh t;rï ie<ls,a,g fkd.ekSu yd th idudkH fldg ;elSu isÿ úh yelshs' —fnfy;a ìõjdu tÉprhs" uy f,dl=jg ta .ek ys;kak ´kE kE" Thdg ú;rla yeÿkq f,vla fkfuhsfk" oshjeähdj lshkafk t;rï jo fjkak fohla fkfuhs˜ fï jf.a l;d fldf;l=;a wefykak bv ;sfhkjd' kuq;a fujeks foaa wefyoaos frda.shd ;oska fldam fjkak ners kE' —lsisu flfkla udj f;areï .kafk keyefka˜ lsh,hs Tyqg ysf;kafk' ;uka fkdis;= fj,djl fujeks frda. hlg f.dÿre ùu frda.shdf.a is;g we;s lrkafka ;on, mSvdjla' ;uka oshjeähd frda.hg f.dÿre jqKq nj oek.;a; .uka flfkl=g we;s fjkafk lsj fkdyels ;rï ;on, fõokdjla' ldhsl frda.fhka mSvd ú|sk w;r;=roSu udkislj;a oeä wmyiq;djhkag uqyqK oSug oshjeähd frda.shdg isÿfjkjd' iuyrúg ta ksidu frda.h wu;l lr oud fjk fohla jqKdfj lsh,d m%;sldr u.yer oukak;a mq¿jka' ;oska fldamùu" ;uka frda.hg f.dÿre ù we;s nj úYajdi fkdlsrSu" th úh fkdyels fohla nj mejiSu" udkisl lïmkhla we;s ùu" oeä ìhla oekSu iy udkisl wjmSvkhg m;aùu isÿfjkak mq¿jka' —yeu flfklau i;=áka tosfkod cSú;hg uqyqK fok w;fr uu fldfyduo fï jf.a f,vla tlal cSj;a doctormagazine.lk

fjkafk@ uf.a bosrs jev lr.kafk fldfyduo@ udj ljodyrs tla;eka fjhso@ ll=,a lmkak fjhso@ ug orefjd fjkqfjka hq;=lï bgq lrkak ners fjhso@ ug i<lkafk ljqo@ lshk lshk úoshg lEu cd;s yokafk fldfyduo@ wfka ug;a mjqf,a whg johla fjkak isÿ jqKdfka" fïl ug f,dl= fõokdjlaæ uu wirK fj,dæ wdid foaj,a fkdld bkafk fldfyduo@ fï cSú;h johlaæ jrskajr fï fnfy;a .ekSu yrsu lrorhlaæ uu ljodj;a fï ;rï blauKska f,fvla fjhs lsh,d ys;=fj keyeæ˜ fujeks wfhla ;ukaf. mjq," ñ;=rka" /lshd mrsirh jf.a fuf;la Tyqg iqmqreÿ jqKq in|;d j,oS uy;a myiq;djhg m;a fjkjd' wka wh weiqf¾oS ;ukaf.a iqmqreÿ cSjk rgdj fjkia lrkak Tyqg isÿfjkjd' fuh iuyr úg ;o udkisl lïmkhla fjkak mq¿jka l,la hkl,a' ;uka fjkod úfkdaoh i|yd l< foa oeka lrkak ners fjoaos oefkk udkisl fõokdj ksid iuyr frda.Ska ;u ys;j;=ka u. wrskak;a ners kE' ;u ìrs|$ieñhd iuÕ fldam fjkak mq¿jka' fjkod meje;ajQ wdorKSh in|;d u. wrskak fya;= fidhkjd fjkak;a mq¿jka' fujeks fj,djghs bjiSfuka hq;= ienEu ñ;=rkaf.a" ìrs|f.a$ieñhdf.a$orejkaf.a iydh wjYH fjkafkæ frda.hg uqyqK ÿkakq ;ukaf. ×;shd tlal tl;= fj,d oskm;du wdydrh .ek ie<ls,su;a l%uhla wkq. ukh lrkak fjkjd' zwo lkafk fudkjo@ jHdhdu lrkafk fldfyduo@ bkaishq,ska ,nd .; hq;= ;ru@ .a¨fldaia lshùu flfiao@Z''''''''''fï jf.a os. ,ehsia;=jla oskm;d frda.shd bosrsfha mj;skjd' frda.shd .kq ,nk fuu ;SrK iy ta wkqj we;s lr.kakd yeisrSu Tyqf.a cSú;fha meje;au yd NOVEMBER 2017 | DOCTOR MAGAZINE 111

frda. md,kh fjkqfjka ;SrKd;aul fjkjd' fuh f,fyis myiq lghq;a;la fkdfjhs' frda.shdg jf.au jfÜ bkak whg;a ukd Ñ;a;dfõ. md,khla we;s lr .kak fjkjd' fuu —l< hq;=u jev ,hsia;=j˜ ksid udkisl ldxidjla (Anxiety), ;uka .eku l<lsrSula" (Frustration), miq;eùula (Regression) jf.au iuyrúg n,dfmdfrd;a;= lvùula isÿ úh yelshs' we;af;kau oshjeähdj ixlS¾K ;;a;ajhla nj wm wjfndaO lr .; hq;=hs' frda.hg uqyqK ÿka flkdf.a is;sú,s" yeisrSï" in|;d kej; h:d ;;a;ajhg .ekSug Tyq yd iudkju Tyqf.a <Õska isákakkaf.a iyfhda.h jeo.;a' fï i|yd ufkdaúoHd WmfoaYk iydh ,nd .ksñka ;u wdl,am fjkia lr .; hq;= fjkjd' oshjeähdj mej;sh;a b;du fyd|ska ;u tosfkod cSú;hg uqyqK

fok" wdorfhka" i;=áka ;u in|;d mj;ajdf.k hk wh ´kE ;rï bkakjd' fjkia fjkak ;SrKh lrkak ´kE frda.hg uqyqK ÿka flkdu ;uhs' wks;a yeu foau bka miafi fyd| w;g fjkia fjk nj meyeos,sju lshkak mq¿jka' oshjeähdj mej;sh;a b;du fyd|ska ;u tosfkod cSú;hg uqyqK fok" wdorfhka" i;=áka ;u in|;d mj;ajdf.k hk wh ´kE ;rï bkakjd' fjkia fjkak ;SrKh lrkak ´kE frda.hg uqyqK ÿka flkdu ;uhs'

The writer serves in The Middle Path Counselling Service, Lake round, Kurunegala. Contact Number 0715750525 / 0776510656

iqmsß nj ;yjqre lr.kak

Èhjeähdj mrojkak

f,dal fi!LH Èkh “Stay super, beat diabetes” hk f;audjla tla Èkhlg muKla iSud lsÍu iqÿiq ke;' fi!LHu;a Èú fmfj;la Wfoid jif¾ iEu ojilau fi!LHj;a f,i .; lsrSug wms ish,a,kau j. n,d .; hq;=h' ta ksidu f,dal fi!LH Èkfha fï f;audj mokï lrf.k wjqreoao

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mqrdjgu fi!LHu;a Èú fmfj;lg w;aje,a imhñka cskafidñka wms ksrka;rfhkau Tn iñmfha isáfhuq' fujeks f;audjla f,dal fi!LH ixúOdkh ^WHO& uÕska f;dard .ekSug fya;=j úmrï lr n,uq' j¾I 2012 § f,dal ck.ykfhka ñ,shk 347 la Èhjeähd frda.hg f.dÿre ù we;s w;r" th Èfkka Èk by< hdfï m%jK;djh o by< uÜgul mj;S' úfYaIfhka wvq yd uOH wdodhï ,nk rgj,a w;r fï ;;a;ajh jeä jYfhka ±lsh yelsh' ta ;;a;ajh 2012 ;j;a j¾Okh ù Èhjeähdj ksidu f,dal ck.ykfhka ñ,shk 1'5 m%udKhla ñh f.dia we;s w;r fï ;;a;ajh m%Odk jYfhka n,md we;af;a Y%S ,xldj jeks wvq wdodhï yd uOHu wdodhï ,nk rgj,a j,gh' f,dal fi!LH ixúOdkhg wkqj j¾I 2030 § f,dal ck.ykh urK j,g n,mdk m%Odk;u fya;= w;=frka m%Odk fya;=jla jkafka" Èhjeähdjhs' Èhjeähdj fnda jk frda.hla fkdjk w;r YÍr mßjD;a;Sh l%shd iuQyhl we;sfjk ÿ¾j,;djhla ^Group at metabolic disease& jYfhka ffjoH úoHdfõ y÷kajkq ,efnhs' fuys§ wod, mqoa.,hdf.a reêr .aÆfldaia idkaøKh" w.h m%Yia; uÜgulg jvd jeä w.hla .kS' fufia isÿjkafka reêrfha iSks m%udKh md,kh lrk bkaishq,ska ^Insulin& fydafudakh ksIamdokh m%udKj;a fkdùu fyda YÍrfha we;s ffi, tu bkaishq,ska j,g ksis mßÈ m%;spdr fkd±laùu fyda fï ldrKd folu ksid úh yelsh' Èhjeähdj È.=ld,Sk frda. ;;a;ajhla fjk w;r thska reêrfha iSks m%udKh by< hhs' oshjeähdj Type 1 yd Type 2 jYfhka fohdldrfhka ±lsh yelsh' Èhjeähd frda.Skaf.ka 10% la muK

NOVEMBER 2017 | DOCTOR MAGAZINE 113

Type 1 Èhjeähdfjka fmf<k w;r

Tjqkaf.a bkaishq,ska i%djh ùula ksis mßÈ isÿ fkdfõ' Group at metabolic diseases f,i fuh y÷kajkq ,nk w;r fï >Kfha Èhjeähd frda.Ska bkaishq,ska msg;ska YÍrhg tkak;a lr.; hq;=j we;' Èhjeähd frda.Skaf.ka 90% lau fmf<kafka Type 2 >Kfha Èhjeähdfjks' fï whf.a wjYH muKg YÍrfha bkaishq,ska fydafudakh ksmofjk yd >%djh fjk w;riuyr úg tu bkaishq,ska m%udKj;a fkdùu yd kshu l%shdldß;ajhla fkd;sîu ksid fï >Kfha Èhjeähdjg f.dÿrefõ' Èhjeähdj fndfyda úg yDofha fyda reêr ixirK moaO;sfha frda. we;s ùug;a" úfYaIfhka yDohdndO" iakdhq wdndO" jl=.vq wl¾ukH;djh wkaOnj jeks Nhdkl ;;a;aj we;s ùug fya;jla fõ' f,dal fi!LH ixúOdkhg ^WHO& wkqj Y%S ,xldj jeks wvq wdodhï yd uOHu wdodhï ,nk rgj, Èhjeähdj j¾Okh ùfï jeä m%jK;djhla olskakg ,efnk w;r ksis Wkkaÿjla" ±kqj;a lula yd wjOdkhla fhduq lsÍfuka Èhjeähdfjka ñ§ugo yelshdj we;' idudkH YÍr nr mj;ajd .ekSu" ffoksl YdÍßl jHhdï j, fh§u" ksis fi!LHu;a wdydr Ndú;h wd§ foaj,ska Èhjeähdfjka wE;a ùug yelsh' ;jÿrg;a fï .ek úia;r lrk f,dal fi!LH ixúOdkh f,dal fi!LH Èkh f;aud lr.;a" Èhjeähdj mroaokak fu.d ,hs*a ihkaiia ^TiafÜ%,shdkq& iud.u y÷kajd oS we;s cskafidñka ^Ginsomin& WmldÍ fjk nj Tn ±kgu;a okakjd we;' cskafidñka yS wvx.= kshu fldßhka *ekelaia cskafika kï jQ Ydl idrhg YÍrfha ksmofjk bkaishq,ska fydafudakfha 114 NOVEMBER 2017 | DOCTOR MAGAZINE

l%shdldß;ajh j¾Okh lsßug ukd yd by< yelshdjla we;s nj mÍlaIK j,ska ikd: lr we;' fï ksid by;ska ±lajQ mßÈ bkaishq,ska ksmojQj;a tys l%shdldß;ajfha we;s ÿ¾j,;djh ksid yg .kakd Type 2 >Kfha Èhjeähdj i|yd fuu cskafidñka wk¾> Tiqjla" m%;sl¾uhla jkafkah' f,dj jgd ñ,shk .Kklf.a úYajdih ÈkQ kshu fldßhka *ekelaia cskafika wvx.= Y%S ,xld fj<|fmdf<a we;s tlu" m%:u yd m%uqL ksIamdokh cskafidñka ^Ginsomin& u muKla jk w;r" cskafidñka ^Ginsomin& Èhjeähd frda.Ska uqyqK fok ykaÈm;a reodj" úvdnr .;sh" w,i nj" ksÈu; .;sh" l,amkdj ySkùu wd§ frda. ,laIK uev mj;ajkak;a m%;HlaI nj fndfyda m%dfhda.slridhksl mÍlaIK j,ska Tmamq ù we;' cskafidñka Èklg tl lemaiQ,hla Wfoa lEug miqj Èkm;d .ekSu Èhjeähdj md,khg uyÕ= Wmldrhla jk w;r Bg wu;rj cskafidñka Ndú;h Tfí ldhsl udkisl Yla;sh" m%;sYla;slrKh j¾Okh lsßug Woõ fõ' cskafidñka udkisl wd;;sh md,kh lsßug;a" udkisl wd;;sh ksid yg.; yels fndfyda fnda fkdjk frda. j,lajd .ekSug;a bjy,a fõ' f,dal fi!LH Èkfha;a" f,dal fi!LH ixúOdkh f;aud lr.;a mßÈ iqmsß nj ;yjqre lr .kak' Èhjeähdj mrokak ish¨ fokd wÈgka lr .ksuq' ta i|yd cskafidñka Wmßu fufyhla lsÍug wo;a fyg;a Tn iu.skau /|S isákq we;' jeä úia;r 057 9011 367 / 075 7711 975/ 011 4375 364 iqmsß nj ;yjqre lr .kak' Èhjeähdj mrojkak'

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iqmsß nj

;yjqre lr.kak

Èhjeähdj mrokak

lr,l ñ, re 35$-

ðkafidñka yS m%Odk ix>glh jk kshu fldßhka mekelaia ðkafika Ydlfha uq,fhka Wlyd .kakd idrh" YÍrfha ksmojk bkaishq,ska yS ls%hdldß;ajh j¾Okhg ukd msgqjy,la jk nj fndfyda idhksl mÍCIKj,ska ;yjqre lr we;' www.megawecare.com ginsomin srilanka

uOqfïyh m%fïy frda.hls''' frda.h úia;r lrkafka m%fïy frda. hgf;ahs' m%fïyh lshkafka uq;%d ckk moaO;sh wdY%s; frda.S wjia:djla' idudkHfhka fuh frda.hla lsõjg frda. moaO;shla' m%fïyh wjia:djl§ msglrk uq;%dj, m%udKh jeäfjkjd' wks;a tl ;uhs idudkH mqoa.,fhla uq;%d msglsÍul§ msgjk wmøjH m%udKhla ;sfhkjfk" kuq;a m%fïy wjia:dfõ tu ;;a;ajh óg jvd fjkia fjkjd' tkï m%fïyfha§ uq;%d iuÕ msgfkdúh hq;= foaj,ao msgfjkjd'

fnd/,a, wdhq¾fõo YslaIK frdayf,a mxpl¾u wxYfha ffjoH §md .=K;s,l uy;añh

th wdhq¾fõofha úia;r jkafka fï wdldrhgh''' idudkHfhka ckjyf¾ tk wdldrhg Èhjeähdj tfyu;a ke;skï wdhq¾fõo ffjoH l%uh hgf;a uOqfïyh lshkafka wo iudcfha jeämqru olskakg ,efnk frda.S ;;a;ajhla' we;a;gu wms fuu 116 NOVEMBER 2017 | DOCTOR MAGAZINE

WodyrKhla úÈyg ksfrda.S mqoa.,hl=f.a uq;%d iuÕ iSks msgùula isÿfjkafka keyefk' iSks msgfjkak .;af;d;a wms lshkafka tal frda.S ;;a;ajhla lsh,hs' m%fïfha§ iuyr fj,djg reêrh msgfjkjd' ;j;a iuyrúg msIaGh msgfjkjd' Y=l% msgjk wjia:djkq;a ;sfhkjd' ta wkqj m%fïyh m%fïy frda. 20la hgf;a j¾. lr,d ;sfhkjd' taflkq;a uq;%d iuÕ uOqr mod¾: ta lshkafka iSks mod¾: ^Y¾lrd& msgùu ;uhs uOqfïyh ke;akï Èhjeähdj lsh,d y÷kajkafka' wdhq¾fõofha i|yka jk wdldrhg uOqfïyfha§ msglrk uq;%dj, meyeh" ri" .kaOh wd§ ish,a,lau óme‚j,g iudkhehso ie,flkjd' doctormagazine.lk

Èhjeähdj

wdY%s; ixl+,;d md,khg iy j<lajd .ekSug ≈T!Iëh l¿ÿre hy.=Kh Èhjeähdj j¾;udkfha iudcfha mqoa., hymeje;au iy cd;sl M,odhs;dj i`oyd iDcq n,mEula t,a, lrhs' f,dj mqrd wo wjOdkhg ,la ù we;af;a fnda fkdjk frda. ms<sn|jhs' ishhg 20]lg wêl f,daljdiSka ixLHdjla fï jk úg Èhjeähd frda.S ;;a;ajhg ,la ù we;s w;r" Y%S ,xldj ;=< th uq¿ uy;a ck.ykfhka 15] wêl ixLHdjls' fuu ;;a;ajh u`.yrjd .ekSug fi!LHu;a Ôú; rgdjla mj;ajdf.k hdu fndfyda fihska jeo.;a fõ' úúO T!IO iud.ï Èhjeähdj md,kh lsÍu i`oyd fkdfhl=;a T!IO j¾. y÷kajd § we;' tfia jqjo Èhjeähdj fyda ta wdY%s; ixl+,;d we;sùfï m%jK;djh j¾Okh ùfï wvqjla olakg fkdue;'

doctormagazine.lk

NOVEMBER 2017 | DOCTOR MAGAZINE 117

m%;sYla;slrK moaO;sh j¾Okh lsÍu tys,d m%Odk l%shdj,shls' tys we;s nyq;rhla ix>gl nd, uy¨ ldf.a;a tÈfkod Ôú;h ;=<kh lsÍug;a" wdrCId lsÍug;a jeo.;a fõ' w;S;fha isg j¾;udkh olajd ishjia .Kkla mqrd l¿ÿre T!IOhla f,i Ndú; ùuo" l¿ÿre wdrCIs;u Ydluh ksiaidrlh nj mejeiSug lÈu ksoiqka fõ'

f,dal Èhjeähd Èkh fuu jif¾ fkdjeïn¾ 14 jk Èkg fh§ we;' fuu Èkh rg mqrd úisÍ isák Èhjeähd frda.Ska" n,OdÍka" fi!LH fCIa;%fha jD;a;slhka yd m¾fhaIlhka ta i`oyd wjOdkh fhduq lsÍug;a frda.h we;s ùu md,kh lsÍug;a fhduq úh hq;= wjia:djla fõ' Èhjeähd frda.h jfrl je<÷ko th Ôú;h mqrd mj;sk frda.S ;;a;ajhls' th md,kh lsÍu yd wdY%s; ixl+,;d u`.yrjd .ekSu" wfhl=f.a Ôú; ld,h §¾> ùug uy`.= rel=,la fõ' iajNdjO¾ufhys ie`.jqKq ryia ñksia Èúhg" Èhjeähd frda.S ;;a;ajhkag úl,am m%;sl¾u úê fidhd fok w;r" th frda.S ;;a;ajhka iukh lsÍug WmldÍ fõ' w;S;fha isg j¾;udkh olajd udkj b;sydih ;=<" úúO wjia:dj,§ frda. ldrl ;;a;ajhka iqjm;a lsÍu i`oyd l¿ÿre WmldÍ ù we;' Nigella Sativa mqIamh ;=<ska yg.kakd

l¿ÿre weg ffcù ix>gl fndfydauhlska iukaú; fõ' th ksfrda.S Èúhlg;a" hym;a Ôjk rgdjlg;a uy`.= rel=,la fõ'

118 NOVEMBER 2017 | DOCTOR MAGAZINE

fuys we;s ffcj ix>glhka Èhjeähdj" fldf,iagfrda,a" wd;rhsàia" YajikdndO" jl=.vq yd wlaud wdY%s; frda. iòyd m%;sldr lsÍugo" yDo frda.j,ska ;=rka ùugo WmldÍ fõ' ksfrda.S iulg iy Èÿ,k flia l<Ulg l¿ÿre Ndú; fõ' l¿ÿre" Èhjeähdj wdY%s; ixl+,;d u. yrjd .ekSug WmldÍ fõ' l¿ÿrej, we;s m%;sTlaisldrl YÍrfha wjhj" moaO;Ska wdrCId lsÍug odhl fõ' nrld l¿ÿre f;,a" fnda;,a l< weiqreïj,skao" lemaiQ,a yd lr,a jYfhkao *duis wdhq¾fõo T!IOd.dr yd iqmsß fjf<ò ie,aj,ska ,nd.; yel' nrld ksIamdok nfhda tlaiag%elaÜ mqoa.,sl iud.u u`.ska ksmojk w;r" tlaifmda ,xld *duishQál,aia mqoa.,sl iud.ï u`.ska m%j¾Okh lrkq ,efí' GMP, HACCP, ISO 12000 iy ISO 14000 iy;sl ,;a fuu ksIamdok wdhq¾fõo fomd¾;fïka;=fõ wkque;sh ,nd f.k we;' jeä úia;r iòyd ÿrl;k wxl ( 011 7772277 doctormagazine.lk

Èhjeähdjg

iqÿiq foaYSh wdydr Èh;,dj wdhq¾fõo uy frdayf,a ffjoH iqika; .fkaf.dv

120 NOVEMBER 2017 | DOCTOR MAGAZINE

oshjeähd frda.Skag mdrïmßl iy,a kùk yd,a j,g jvd .=Kodhlh' tajd kj iy,a m%fNao j,g jvd ld¾hlaIuj oshjeähdj md,kh lrk nj fy<sorõ ù ;sfí''' doctormagazine.lk

oyj, wdydrh ;ïndmq r;= yd,a n;a yd tfuka fo.=Khla t,j¿$fld< ue,aü$fld< iïfnda, ^ks¾udxY ùu fndfydu .=Kodhl fõ& rd;%S wdydrh nr wvq ieye,a¨ .=K we;s wdydr" msÜgq wdmam bÈwdmam wd§ r;= iy,ska l< wdydr fyda n;a le|" l=rlalka le|" OdkH le|" l=rlalka frdà jeks ir, fohla iqÿiq fõ' iS; wdydr jegfld¿" lelsß" mf;da, wd§ msIagh rys; t,j¿ j¾. jvd;a .=Kodhl fõ' ish¿u fld< j¾. iqÿiq fõ' jvd;a iqÿiq wdydr lsysmhla uvq o¿" fldys, o¿" fmfk< fld<" lsß w.=K fld<" f;dar fld<" trnÿ fld<" je,a fodvï fld<" jÜglald o¿" jd; nx. fld<" cmka ngq o¿" l;=reuqrex.d fld<" ue,a, fld<" j,a fld;a;u,a,s fld<" ;e,a fld<" lr fld<" ksú;s" ;=U o¿" l¿ lïôßhd" rKjrd" f.dgqfld<" lxl=x" uql=Kqjekak" trnÿ o¿" idrk" i,do fld<' fldjlald fld< ue,aü" rKjrd ue,a¨ï" f.dgqfld< ue,aü" uoáh fld< ue,aü' ;s;a;; ri m<dj¾. f,i ie<flK lsß.=K" w.=K" l=ß[a{ka fld<" f;nq yd l;=re uqrex.d hk m<do oshjeähd frda.Skag jvd;a iqÿiqh' iqÿiq m<;=re weUq¨ flfi,a" .ia,nq" fmar" fk,a,s" kñkx jeks iajdNdúl foaYSh m,;=re iqÿiqh' ldurx.d oshjeähd frda.Ska yg iqÿiq m<;=rls' tajd i<do wdoS f,io rij;aj ms<sfh, lr.; yel' w;=re úmdl we;s úh yels ne.ska wkjYH ;rï ,nd fkd.ekSug m%fõYï úh hq;af;ah' Èhjeähdj j,lk mdk j¾. f;a" rKjrd" bruqiq fn,su,a" yl=re lene,a,la iuÕ .kak mq¿jks' flduvq" doctormagazine.lk

ñÈ" fodvï" kiakdrx wdÈfhys hqI mdkh l< yelshs' fld;, ysUqgq ;ïnmq j;=r o fï i|yd úfYaIs; T!IOhla o fõ' oshjeähd frda.Ska yg wêlj l=i.skak oefkk ksid wdydr fõ,a ;=kla fjkqjg myla muK .ekSfï jrola ke;' kuq;aq l=i nr fjkak wdydr .kakjd fjkqjg iq¿ wdydr fõ,a jYfhka .ekSu jvd;a iqÿiqh' Èhjeähdjg iqÿiq w;a fnfy;a Èhjeähd frda.Ska i|yd reêr iSks wvq lsÍug iqÿiq w;a fnfy;a lsysmhla ¡ rKjrd fld< u,a uq,a weg fmd;= iu iuj fõ,d l=vqlr l,jï lr f;a ye| 1la ne.ska WKq j;=r fldamam 1lg oud ksuqk miq Wfoa iji'' îu ¡ bÿKq jrld" fldiafld< 10la muK ;ïnd îu ¡ udoï fmd;= l=nqla fmd;= ;ïnd îu'' ¡ wÜálald fmd;= ;ïnd îu ¡ fn,suq,a ;ïnd îu ¡ uql=Kqjekak fldgd jkavqfõ ;ïnd ñßld îu ¡ rKjrd fld< leo" kSruq,a,sh fld< le|" fldajlald fld< le|" fn,sfld< le|" i;shlg tl j¾.hlaj;a îu îu iqÿiq fõ' ¡ udoï fmd;=" l=nqla fmd;=" udoï weg fldgd l=vq lr j;alr îu ¡ ldgÈnq,d f.ä ud¨j Whd lEu ¡ wÜálald f.ä ud¨j Whd lEu fuu w;a fnfy;a Ndú;d lsßfuka Èhjeähdj md,kh jk w;r Èkm;d fydÈka jHdhdu lsÍu iqÿiq fõ' ;jo fhda. jHdhdu jvd;a iqÿiq fõ' Èhjeähdj i|yd ksr;=reju ffjoH Wmfoia .ekSfuka iqjodhS f,i Ôú;h .; l< yel' NOVEMBER 2017 | DOCTOR MAGAZINE 121

udkisl iqjh;a úfõlh;a weiqf¾

frda. fndfydauhla iqj lr.; yelshs

ioa ffjoH wdpdrO¾u msßySfuka frda.Ska wirKNdjhg m;a fjkjd''' 122 NOVEMBER 2017 | DOCTOR MAGAZINE

ffjoH iqcSj ú;dkf.a ã'ta'tï'tia ^fld<U úYaj úoHd,h& úOdhl wOHlaI fi;aiqj wdhq¾fõo frday,a ^mqoa'& iud.u doctormagazine.lk

wdhq¾fõofha m%Odk wruqK jkqfha zzksfrda.S mqoa.,hdf.a ksfrda.Slu wdrlaId lsÍu" Yla;su;a lsÍu yd frda.S mqoa.,hd bka uqojd .ekSuhs'ZZ wdhq¾fõofha i|yka mßos mqoa.,fhl=f.a uQ,sl wNs,dIh úh hq;af;a frda.S fkdù isàuhs' ta i|yd id¾:l u.fmkaùula wdhq¾fõofha oelafõ' tys i|yka lreKQ wkq.ukh lsrSfuka losu YdÍßl yd udkisl mßmQ¾K;djhlska hqla; ;eke;af;la ìys fjhs' hï fya;=jla ksid flfkla frda.S jQ úg Tyq bka uqojd .ekSu B<Õ mshjrhs'

urK ìh we;s lrjk frday,a" frda.Ska iy frda. ixl,am j, jHdma;sh wo f,dj fld;ek;a l;d lrkafka f,v .ekh' f,vqka .ekh' thg lrk m%;sldr .ekh' fï yryd fldhs ldg;a cks; jkafka NS;sldjls' th urK NS;sldj olajd we;s ishqï is;sú<s mrïmrdjls' wo ojfia wm zzurK ìfhka ;e;sf. kZZ cSj;a jQj;a tod wfma uq;a;kag tjka ìhla oeKqfka ke;' iajNdjO¾uh iu.ska cSj;a jQ wfma uq;=ka ñ;a;kag iajNdjO¾ufhkau wmQ¾j Yla;shla cSj n,hla ,enqfKah' mßirhg" .yfld<g fukau i;d iSmdjgo wdorh lrk wd;au úYajdifhka fyì cSú;hla .; lrkakg wfma wdos {d;Skag yelsjhdjla ,enqfKah' frda. j,g Tfrd;a;= oSfï

Yla;sho tod Tjqkg losug ;snqKs' mßirh iu. .egqKQ kùk ñksid Ñ;a; úYajdiho" YÍr Yla;sho ì|.;a frda.Ska njg m;aj ;sfí'

fmr l, wfma uq;=ka ñ;a;ka mßirhg ìh jqfKa kE''' wo we;efula fnfy;a fidhkafka frda.h we;s jkakg;a fmrh' ngysr wef,dam;sl ixl,am j, isrù isák j;auka ñksid iq¿ wikSmhloS jQjo nrm;, fnfy;a''' fõokd kdYl" m%;scSjl .ekSfuka tajdg yqre ùfï''' weíneys ùfï ;;a;ajhla f.dv k.df.k isà' tod wfma we;a;ka ldh Yla;sfhka úYañ; ks¾udK f,djg odhdo lf<ah' tfy;a wo we;eï fokdg úgñka fm;s ke;sj YÍr Yla;sh mj;ajd .ekSug W.ygh' fï m%jK;djh nyqcd;sl T!IO fjf<kaokaf.a jHdmdßl Wmdhud¾. j, m%;sM<hla neõ fkdlsjukdh' w¿;a w¿;a frda. ke;akï" urK ìh ffoksl Ñ;a; ika;dkhla fkdjkafka kï'''

wfma uq;=ka ñ;a;ka .; l< <ud ld,fha wõj" jeiai" mskak" odyh''' fïjd iu. wmQre iycSjkhla ;snqfKah' .ia" .,a hg cSj;ajQ wdos ñksid tod fudk ;rï iajNdjO¾ufha .eyeg úkao;a tajd iu. wmQ¾j ñ;%;ajhlao f.dvk.d .;af;ah'

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NOVEMBER 2017 | DOCTOR MAGAZINE 123

frda.Skag uy biamsß;d, ke;akï fï wh uäh ;r lr.kafka fldfyduo@

úfõlh yd udkisl ix;=IaÀh weiqre lr.;a wdhq¾fõofha m%;sldr ixl,amh wdhq¾fõofha we;af;a Bg bªrdu fjkia ixl,amhls' wmg yefok frda. j,ska jeä m%udKhla iqj lr.kakg wjYH jkafka úfõlh yd udkisl iqjhhs' wfma YÍrh fndfyda frda. uevmj;ajd .ekSfï Yla;shlska hqla;h' iqjh msKsi m%;sldr wjYH jk frda. mx;shlao ke;af;a fkdfõ' tajdo id¾:lj fu,a, lsÍug fndfyda {dKh" T!IO yd m%;sldr úê j,ska wdhq¾fõoh fmdfydi;ah' fjfiiskau WK" fyïìßiaidj" leiai jeks frda.hloS tlajru ffjoHjrfhl= lrd hk isßf;ka wm ñosh hq;=h' idudkH .s,kaNdjhka iqjm;a lr.ekSfï jákd m%;sl¾u wdhq¾fõoh i;=h' ldhsl úfõlh yd udkisl iqjh Tiafia fndfyda frda. iqjm;a jk nj kej;;a isysm;a l< hq;af;ah' wmg Wreu fndfyda jákd zzw;a fnfy;aZZ iq¿ wikSm ukd fldg iqjm;a lsÍug msysgg isà'

zz´kEu frda.hla iqjm;a lr.ekSug ;rï Yla;shla ;ukag ;sfíh'''ZZ hk úYajdih f.dvk.d.kak wo jeiailg f;uqK;a we;efula frda.S fjhs' orejka b;d wdhdifhka mßirfhka wdrlaId lr .kakg wo fndfyda uõmshkao W;aidy orhs' jeiai" mskak'''fïjd orejkag y;=reh hk úfrdaOdl,amh orejka ;=< me<moshï lf<Ao TjqyQuh'

124 NOVEMBER 2017 | DOCTOR MAGAZINE

tfy;a wdos wfma uq;=ka ñ;a;ka .; l< <ud ld,fha wõj" jeiai" mskak" odyh''' fïjd iu. wmQre iycSjkhla ;snqfKah' .ia" .,a hg cSj;ajQ wdos ñksid fudk ;rï iajNdjO¾ufha .eyeg ú|skakg we;ao@

cSú;fha b,lal yUd hk .ufka jkaosh f.jkak fjkafka cSú;fhka''' wo wm iEu ish¿ fokdu mdfya ;rÕhlg wj;S¾K ù isáuq' orejka .;a;;a fï ;rÕfhka ñoSula ke;' meie,a ;rÕh" áhqIka ;rÕh" úNd. ch .ekSfï ;rÕh''' wdoS jYfhks' ffjoHjreka lshd.kakd we;eï wh ys;du;du frda.Ska iqjm;a lsÍu m%udo lr;s' uqo,a wruqKQ lr.;a mÍlaIK" T!IO kshu lr;s' Tjqkaf.a wNs,dYh jkafka ;ukag ,efnk ,dNh ñi frda.shd iqjm;a lsÍu fkdfõ' fï kï kshu ffjoHjreka fkdfõ' l+g fj<÷kah' urK ìh we;s lrñka" f,fvla f,i ikakdu.; lrñka Tyqf.a ukig iDKd;aul is;sú<s we;s lsÍu .=Kj;a ffjoHjrfhl=f.a isß;la fkdfõ' wfma iudcfha lreKd fmroeß ffjoHjreka w;f¾ fujka fj<ªkao isák nj ryila fkdfõ' frda.hla je<|Su cSú;h ms<sn| wfmalaIdjka wdmiaig ;,a¨ lrk ldrKhla fkdfõ' flfkla zzf,fvlaZZ f,i ikakdu.; lsÍfuka Tyqg cSú;hg uqyqK fokakg we;s osßh" wd;au úYajdih ì| jefÜ' ienE ffjoHjrhdf.a wruqK jkafka ljr frda.S ;;a;ajhloS jQj frda.shdf.a wfmalaIdjka ì| fkdjefgk fia l%shd lsÍuhs' wd;au úYajdih we;s lsÍfuka frda.shd Okd;aul is;sú<s Tiafia iqjh ,eîu blauKska isÿ fjhs' doctormagazine.lk

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NOVEMBER 2017 | DOCTOR MAGAZINE 127

Is your child

ALLERGIC

to cow’s milk?

Dr Guwani Liyanage

Cow's milk is a common cause of food allergy in infants. Most children outgrow cow's milk allergy by the age of 3-5 years, in some cow's milk allergy may not resolve. Not all reactions to cow’s milk are due to allergy. Some children will have sensation of mucus or phlegm in the throat after taking milk. Researchers have shown it is due to the thickness of the liquid and not due to an allergy. Rarely, certain babies will develop profuse watery diarrhea with breast milk or cow’s milk. This is called lactose intolerance and not an allergy.

128 NOVEMBER 2017 | DOCTOR MAGAZINE

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What are the symptoms? Children with cow’s milk allergy will present in many ways. Some will react to milk or milk products as soon as they ingest and some will develop symptoms after hours or days. ¡

Rapid onset reactions usually occur within 15 minutes and sometimes up to 2 hours after exposure to cow's milk or other dairy products. Symptoms can include any one or more of the following: hives (urticaria), swelling of the lips, face or eyes, abdominal pain, vomiting, diarrhoea, noisy breathing or wheeze, swelling of the tongue, swelling or tightness in the throat, hoarse voice, change in consciousness and floppiness in infants or young children. Allergy tests to cow’s milk are usually positive for these reactions. Delayed reactions are uncommon. Symptoms may include an increase in eczema (dry, itchy skin rash) or vomiting and/or diarrhea (sometimes with mucus and blood) 2-8 hours after consumption of cow’s milk or other dairy products. Allergy tests to cow’s milk may be negative for these reactions.

How is it diagnosed? Diagnosis of rapid onset allergic reactions to cow’s milk is usually

obvious. This can be confirmed by your doctor after taking a history and using allergy tests (skin prick tests or blood allergen specific IgE tests). When symptoms occur several hours or days after having cow’s milk, diagnosis of cow's milk allergy is usually very obvious and allergy tests to cow’s milk are often not useful in these cases.

What is the treatment? Management of cow's milk allergy involves removal of cow's milk and other dairy products from the diet. Most children who are allergic to cow's milk will be allergic to other animal milks (goat, sheep or horse/mare). To avoid cow’s milk and other dairy products it is therefore important to read all ingredient labels and avoid any food which contains these milks, unless otherwise advised by your doctor. However, cooked or baked cow’s milk in cakes or biscuits is tolerated by most children with cow’s milk allergy. However, unless you are already certain that cooked or baked cow’s milk products is tolerated you should not give them to your child without doctor’s advice. If your child is allergic to cow’s milk you should have an action plan for timely management of the allergic

reaction. Some people with cow’s milk allergy may be prescribed an adrenaline (epinephrine) autoinjector

by a specialist. This adrenalin injection can be given to your child by an adult in an emergency. Older children will learn to inject it by themselves, in case of an emergency. Make sure that you have discussed the action plan with your doctor. Avoidance and reintroduction of cow's milk and other dairy products should only be undertaken with advice from a doctor, particularly in cases with severe allergic reactions (anaphylaxis). If long-term exclusion is required, children require an alternative source of calcium and protein to ensure adequate nutrition and growth. Dietary exclusion during breastfeeding is rarely required on doctor’s advice. Alternative milks that can be given to your child, ¡

Soy protein formula: Most infants with cow's milk allergy can tolerate soy-based formula. However, in infants allergic to soy, it is not a suitable substitute.

130 NOVEMBER 2017 | DOCTOR MAGAZINE

Extensively hydrolysed formula: This is a product of cow’s milk that has been treated with enzymes to break down most of the cow’s milk proteins.

Amino acid formula: When some infants will react to above, amino acid formula is advised.

Partially hydrolysed formula (commonly labelled ‘HA”) is not a suitable for infants with cow’s milk allergy. Goat’s milk formula, sheep milk formula and lactose free formula are NOT suitable for children with cow’s milk allergy and may cause severe allergic reactions.

Will it resolve? 80% children will grow out of their cow’s milk allergy by the age of 3-5 years. Depending on the history and severity of the original reactions, this may require further allergy testing and food challenges, which are usually performed in hospital clinics and requires assessment by a Paediatrician/Specialist.

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Èhjeähdfjka

ñfokakg frda.h md,kh lrkakg uq,a jkafka

wfma cSjk rgdjuehs''' w;S; fy< cSjk rgdfjka wmg lshd fok lÈu mdvu

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132 NOVEMBER 2017 | DOCTOR MAGAZINE

wo f,dalfha iq,nj jHdma; jk frda.hls" oshjeähdj' nd," ;reK" uy¿''' ia;%S" mqreI''' wdoS lsisÿ fNaohlska f;drj fldhs ljqre;a lsisÿ fNaohlska f;drj oshjeähdjg uqyqK mEu fuys úfYaI ,laIKhhs' doctormagazine.lk

,xldfõ iuia; ck.ykfhka ishhg 12la oshjeähdfjka fmf<k nj lshefõ' ck.ykfhk iEu mia fofklaf.ka tla wfhlau oshjeähdfjka fmf<k njo ;j;a woyils' wE; w;S;fha ksfrda.S ck;djla jYfhka wfma rg jeishka cSj;a jQj;a wo jk úg wfma mqrjeishka úYd, frda. .Kkdjl wjodkfuys uqj úgg <Õd ù isà' úfYAIfhkau fnda fkdjk frda. jYfhka ye|skafjk frda. iuqodhla wfma ksfrda.SNdjh meyer .ksñka isà' fkdmsg fmr¿KQ wdydr isß;" jHdhdu wvqùu yd wêl udkisl wd;;sh fndfyda f,v frda. j,g mdr lmk nj fmfka'

tod fujka f,v frda. iq,nj ;snqfKa kE''' wm fukau fndfyda wdishd;sl rgj, ÿrd;S;fha mgkau mej;sfhA lDIsl¾udka;h uQ,sl lr.;a w¾: l%uhls' lh fjfyid jev lsÍfuka ;u cSúldj imhd.;a ck;dj ta Tiafia ;u cSjk rgdjo yev. iajd .;af;ah' iduqysl;ajh" iyfhda.Sj lghq;= lsÍu fukau fyd| ufkdaNdjhlska hqla;j ir< cSú;hlg yqre ùuo tod wfma wdos uq;=ka ñ;a;kag Wreu úh' ld¾ólrKh;a iu.ska we;sjQ iudc úm¾hdihkaf.a m%;sM<hla f,i wOHdmkhg" /lshdjg" iudc ;;a;ajhg ks¾udKh jQfha ;rÕldÍ jgdmsgdjls' fï ksid ldhsl fukau udkisl ksfrda.SNdjh msßySug ,la jQ w;r fnda fkdjk frda. jix.;hla ;rug ck;dj fj,d .;af;a fï ikao¾Nh ;=<h'

frda.h we;s jQ miq md,kh lsÍu .kakd mshjr w;sYhska jeo.;a oshjeähd frda.h je<|Sfuka wk;=rej ksis wdldrfhka md,kh fkdlr.; fyd;a frda.shd nrm;, Wmøjhkag ,laúh yel' we;efula fï frda.h ;sfnk nj oek.kafka tjka ixl+,;djhla we;sjQ úgh' jl=.vq frda." iakdhq wdndO" wkaONdjh" ,sx.sl ÿn,;d" wxYNd.h" yDohdndO wdoS ixl+,;d oshjeähdj ksid we;sùug bv ;sfí'

frda.h we;sjQ miq th md,kh lsÍug mshjr .kakjdg jvd wm fjfiia wjOdkhla fhduq l< hq;af;a frda. fhka je<lS isàugh' ir< cSjk rgdjla ;=<ska hym;a fmdaIK isß;a we;s lr .ekSu" jHdhduh yd

úfõlh wdoS lreKQ oshjeähdj u¾Okhg w;sYhskau bjy,a jkafkah' <ud ld,fha .kakd jeros wdydr" jeros úyrK ksid we;efula <ud ld,fhauo" ;j;a wh ;reK yd jeäysá wjêfhao oshjeähdjg f.dÿre fj;s' l=vd ld,fha isgu ksjeros wdydr .ekSug;a fi!LHiïmkak cSú;hlg wkq.; ùug;a ljqre;a bgd.; hq;=h'

zziajia:iH iajia:H rlaIKï wd;=riH frda.S m%.ukxZZ wdhq¾fõo ffjoH úoHdfõ m%Odk wruqKQ folla fjhs' ksfrda.S mqoa.,hdf.a ksfrda.S nj wdrlaId lsÍu fukau frda.shdf.a frda.SNdjh ÿre lsÍu bka woyia fjhs' frda.hla we;sùug fmr bka wdrlaId ùug mshjr .ekSu iïnkaO ixl,amh oeka jir oyia .Kklg jvd merKSh' wdhq¾fõofha iajia:H ixrlaIK l%u tkï ksfrda.SNdjh wdrlaId lr.ekSfï l%ufõohla olajd we;' ksfrda.S osú meje;aula i|yd mqoa., oskp¾hdj ilia úh hq;= wdldrh yd wkq.ukh l< hq;= ms<sfj;a ms<sn|j iajia:H jD;a; hgf;a oelafjhs' WoEik wjos ùfï isg rd;%S kskaog hdu olajd wm úiska isÿ lrk l%shdjka ksis mßos mj;ajd .ekSu ms<sn|j iúia;rj olajd ;sfí' tjeks cSjk rgdjlg yqreùu fndfyda frda." Wmøjhkaf.ka wdrlaId ùug fya;= fjhs'

cSjk rgdfõ we;s lr.kakd fjkialï" kshu lrk ms<sfj,g T!IO Ndú;d l< hq;=h' reêrfha iSks uÜgu ksfrda.S w.hlg f.k tau ;=<ska fndfyda .eg¿ úi|d.; yels jk w;r thu oshjeähdfõ ixl+,;d j,ska wE;a ùfï uÕo jkafkah' 134 NOVEMBER 2017 | DOCTOR MAGAZINE

cSú;h yeviú lr.; hq;af;a fufyuhs l%shdYS,S cSjk rgdjlg l=vd l, isgu yqre úh hq;=hs' wo wm fndfyda úg w;a ú|skafka taldldÍ cSjk rgdjls' tysoS ksrka;rfhka isÿ jkafka taldldÍ ffoksl lghq;= /il isrùuhs' fuys m%;sM<hla f,i l%shdYS,S fkdjk isrerla yd wúfõlS ukila iys; cSú;hla Wreu ù ;sfí' wm wo ojfia cSú;h myiq lsÍug .kakd fuj<ïo fï ;;a;ajh jeä j¾Okh lrhs' tosfkod cSú;fha wm .; lrk iEu l%shdldÍ wjia:djlau iajdNdúlj ,efnk jHdhduhla fia i<ld lghq;= l< hq;=h' mßirh iu. cSj;a ùu;a" fjfyilr YdÍßl wNHdihka fjkqjg ßoauhdkql+, ir< jHdhdu j,g wkq.; ùu;a w.fkah' fhda.d jHdhduo cSú;hg wk.s m%;sM< i,ik jHdhdu l%uhls' tu.ska isref¾ .%kaÓ W;af;ackh ù jvd;a fyd|ska isrer l%shdldß jk njo iqir jk njo fy<sorõ ù ;sfí' jHdhdu- oshjeähdj ksjdrKh flfryS w;sYh n,mEula lrk nj idlaId;a ù ;sfí' ksjeros wdydr mqreÿ yd p¾hd rgd l=vd l, isgu wkq.ukh l< hq;=h' túg cdkuh in|;djhla we;s frda.hla jQj tys ;Sj%;djh wvq lr .eksug yelshdj ,efí' frda.h je<÷KQ miq thska Woa.; úh yels ixl+,;d j,ska wdrlaId ùug ksis mshjr .; hq;=h' cSjk rgdfõ we;s lr.kakd fjkialï" kshu lrk ms<sfj,g T!IO Ndú;h l< hq;=h' reêrfha iSks uÜgu ksfrda.S w.hlg f.k tau ;=<ska fndfyda .eg¿ úi|d.; yels jk w;r thu ixl+,;d j,ska wE;a ùfï uÕo jkafkah' wdhq¾fõofha m%fïy frda. yg .kakd wdldrh" Ñls;aidj yd Wmøj i|yd Ñls;aid wdoS f,i mq¿,aj ú.%y fldg we;' fuu m%;sldr úê u.ska id¾:lj frda.h md,kh l< yels nj m%;HlaI ldrKhls' doctormagazine.lk

fud<fha Èhjeähdj fkdfyd;a ;=kajk wdldrfha Èhjeähdj jYfhka kï ,enQ

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we,aIhsu¾ frda.h yd oshjeähdj w;f¾ ióm in|;d /ila wkdjrKh fõ''' 136 NOVEMBER 2017 | DOCTOR MAGAZINE

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;rndre nj yd fojk wdldrfha oshjeähdfjka fmf<kjd kï wkd.;fhaoS we,aIhsu¾ frda.h we;s ùfï wjodku jeähs ffjoH YdLH wurfialr úisks

óg jir ishhlg muK fmr Alois kï jQ iakdhql jHdêfõo ffjoHjrfhla fud<fha we;eï ffi,j, ia:dkh fjk;a fm%daàk úiska wdl%uKh lrk neõ y÷kd .kakd ,oS' tfy;a tod Bg thg fya;=j ksielfhka y÷kd.ekSu ÿIalr ldrKhla úh' tfy;a bkaishq,ska ysÕmdvq ùu ksid fud<fha ffi, u; Beta Amyloid fm%daàk ;ekam;a jk nj y÷kd .ekSug yelsj ;sfí' doctormagazine.lk

wm okakd wdldrhg oshjeähdfõ wdldr we;af;a ;=kla muKs' we,osfjka fkdfyd;a w.akHdYfhka bkaishq,ska >%djh ùula fkdue;s ùu ksid we;sjk m<uq wdldrfha oshjeähdj" bkaishq,ska >%djh JQj;a tys Wmfhda.S;djfha ÿ¾j,;djhla ksid we;sjk fojk wdldrfha oshjeähdj yd .¾NsKS ld,fha we;sjk oshjeähdj wdoS jYfhks' tfy;a ful, ;=kajk wdldrfha oshjeähdjla .eko wikakg ,efí'''

we;a;gu ;=kajk wdldrfha Èhjeähdj hkqfjka frda.hla ;sfnkjdo@ fï l;djg moku ie,iqfka M. de la Monte, M.D yd Jack R. Wands, M.D hk ffjoHjreka fom<la úiska Journal of Diabetes Science and Technology kï iÕrdjg 2008 j¾IfhaoS imhk ,o m¾fhaIK ksnkaOkhls' ia:Q,;djh yd fojk wdldrfha oshjeähdfjka fmf<k wh ;=< we,aIhsu¾ frda.h we;sùfï wjodku by< hk nj Tjqka tu ,smsfhka fmkajd ÿkafkah' th kejqï fidhd .ekSula jQj;a fnfyúka ;d¾lsl yd m%dfhda.slj tu l;dfõ mokula ;sfnk nj úoHd;aul iudch wjfndaO lr.;s' fï iïnkaOfhka jeä jeäfhka m¾fhaIK n,.ekajQfha tys m%;sM<hla jYfhks' ta yd ;odikakfha my; lreKQ flfrySo úoHd;a{hkaf.a wjOdkh fhduq úh'

NOVEMBER 2017 | DOCTOR MAGAZINE 137

¡ we,aIhsu¾ frda.fhaoS fud<fha buy;a bkaishq,ska ysÕ;djhla we;s fõ' bkaishq,ska m%;sfrdaOhlao fuysoS ks¾udKh fõ' ¡ ffcj ridhKsl uÜgfïoS yd wKQl cSj uÜgfïoSo we,aIhsu¾ frda.h yd fojk wdldrfha oshjeähdj w;r fndfyda iudklï we;' ¡ ueos jhfiaoS ;rndre YÍr ;sfnk wh w;r miqld,Skj we,aIhsu¾ frda.h we;sùfï f;.=Khl wjodkula tfia fkdjk wh yd ixixokfhaoS mj;S' ia:q, wh fï wjodkug ,laùu ;j;a jeäh' we,aIhsu¾ frda.Ska urKhg m;ajQ úg Tjqka foay úYaf,aIKh lsÍfuka ''' fjfiiskau Insulin, IGF (insulin-like growth factor) 1 and 2, wdoS ridhKsl fldgia úYaf,aIKfhka fï in|;dj idlaId;a lrk fndfyda f;dr;=re wkdjrKh lr.ekSug yels úh' fï wkQj oshjeähdj we;sùfuka YÍrfha we;sjk l%shdj,shg iudk isÿùula we,aIhsu¾ frda. fhaoS fud<fhao isÿjk nj fy<sorõ lr.kakd ,oS' ffcj ridhKsl jYfhka fuysoS isÿjk fjkialï oshjeähdjg olajk iudklï i<ld we,aIhsu¾ frda.h zzfud<fha oshjeähdjZZ fkdfyd;a zz;=kajk wdldrfha oshjeähdjZZ jYfhkao y÷kajhs' 138 NOVEMBER 2017 | DOCTOR MAGAZINE

Alois Alzheimer

^1864'06'14-1915'12'19& wef,daIshia we,aIhsu¾ fkdfyd;a wef,dhsia we,aIhsu¾ kñka m;, lS¾;shla ,enQ c¾udkq cd;sl iakdhq jHdêfõo{$ufkda ffjoHjrhd tñ,a fl%ma,ska kï m¾fhaIK iydhsldjl iu. fud<fha ffi, wdmodjg m;aùfuka we;sjk äfukaIshd frda.h" (Presenile Dementia)

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AYURVEDIC

Tn Èhjeähdjg id¾:lj m%;sldr lrk foaYSh ffjoHjrfhla'''@ wdhq¾fõo ffjoH l%uh frda. ksÜgdjg iqj lrk ffjoH Ydia;%hla' tafl ndf.g iqjm;a lsÍï kE' frda. ksOdkh uekúka y÷kdf.k thg m%;sldr lrkjd' oshjeähdjg;a tfyuuhs' fï m%;sldr j,ska oshjeähd frda.Ska iqjh ,nkjd'

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142 NOVEMBER 2017 | DOCTOR MAGAZINE

m%uqL W;aidyh' kuq;a wdhq¾fõofha wm wjOdkh fhduq lrkafk frda. ksOdkhg m%;sldr lsÍug' wfma T!IO w.akHdYh mqk¾ckkh uQ,sl lr.;a m%;sldr l%uhla'

Tfí m%;sldr l%uh ms<sn|j wmg ye|skaùula l< yelso@ uq,ska lS uQ,O¾uh" ÿ¾j, jQ w.akHdYh m%lD;su;a lsÍu ;uhs uf.ka isoaO fjkafk' wfma T!IO u.ska w.akHdYfha mqk¾ckkSh fjkila isÿ fjkjd' tu.ska th wvd, ùulska f;drj bkaishq,ska ksmoùula isÿ lrkjd' ta;a tlalu ksmojk bkaishq,ska mgl yryd úêu;aj .aÆfldaia hdukh lsÍug;a fï T!IOu l%shd lrkjd'

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AYURVEDIC

Tn wï,ms;a;h .ek;a fjfiiska i|yka lrkjd'''@

144

April 2017

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