Doctor Magazine September 2019

magazine Doctor The Premier Bilingual Health Magazine in Sri Lanka Volume 25 • September 2019

ffjoHjrhd doctormagazine.lk RS 180 (VAT INCL)

yDo fmky¿ hka;%h fhdodf.k isÿlrk P. 80 nhsmdia ie;alï Tfí yoj; ;=< úoHq;a P. 42 mßm:hla@

P. 63

tflda mßlaIdj fkdfyd;a Echocardiogram ISBN-1391 1341

9 7 7 13 91 13 400 1

rdcH T!IO kS;s.; ixia:dj Wiia ;;a;ajh - wdrlaIdldÍ - m%;HlaI T!IO i`oyd rdcH Tiqi,a fj; fkdmudj mshk.kak fld<U fldgqj 63" i¾ ndfrdka ch;,sl udj; fld<U 01' ÿr( $*eli a a - 011-2328046 fldgqj ÿïßh fmd< mßY%h ÿïßh fmd< mßY%h" fldgqj' ÿr( $*elaia - 011-2336926 fnd/,a, ßÊfõ wd¾hd <ud frday,a mßY%h" fnd/,a,' ÿr( $*elaia - 011-2697660 fld<U 07 255" O¾umd, udj;" fld<U 07' ÿr( 011-2672293 $*eli a a - 011-2694716 fld<U 04 85" .d¨ mdr" fld<U 04' ÿr( 011-2587128 $*elaia - 011-2559531 kqjr 14$ta" <ud.dr udj;" kqjr' ÿr $*elaia( 081-2225175 kqjr ÿïßh fmd< ÿïßhfmd< mßY%h" kqjr' ÿr $ *elaia( 081-2225176 .d,a, 61$ta" jlaje,a, mdr" .d,a,' ÿr( $*elaia - 091-2234726 .ïmy 260" fld<U mdr" .ïmy' ÿr( $*elaia - 033-2234516 r;akmqrh 32" kkao t,a,dj, udj;" r;akmqr' ÿr( $*elaia - 045-2223014 nÿ,a, i' f;d' i' f.dvke.s,a," nKavdrfj, mdr" nÿ,a,' ÿr( $*elaia - 055-2229837 l=reKE., 28" úr;=x. f.dvke.s,a," fn!oaOdf,dal udj;" l=reKE.,' ÿr( $*elaia - 037-2230840 kqf.af.dv 151" tia o tia chisxy udj;" kqf.af.dv' ÿr( $*elaia - 011-2856641 ñkqjkaf.dv mrK k.r iNd f.dvke.s,a," fld<U mdr" ñkqjkaf.dv' ÿr( $*elaia - 011-2295120 mdkÿr 159" úúO fiajd iuQmldr f.dvke.s,a," .d¨ mdr" mdkÿr' ÿr( $*elaia - 038-2234767 wúiaidfõ,a, 40" nia kej;=ñfmd," wúiaidfõ,a,' ÿr( $*elaia - 036-2222501 wkQrdOmqr 414$4" f.dvf.a udj;" wkqrdOmqr' 025-2227488 wlalf¾m;a;=j 74" à'ã' 02" wlalf¾m;a;=j' ÿr$*elaia( 067-2057625 ms<shkao, 1tA$21" úµd, udj;" ms<shkao,' ÿr( $*elaia - 011-2613640 kdf.dv 313" u;=.u mdr" kdf.dv" l¿;r' ÿr( $*elaia - 034-2222818 fmardfoKsh 1156" .egfò fmardfoKsh' ÿr( 081 2386045

kska;jQ¾ m%Odk ú§h" kska;jQ¾' ÿr($*elaia - 067-2058208 ud;r pdßldrduh" wk.dßl O¾umd, udj;" ud;r' ÿr( $*eli a a - 041-2231871 nKavdr.u frday,a mßY%h" fydrK mdr" nKavdr.u' ÿr( $*elaia - 038-2288671 wïmdr mkai,a ykaosh" ã' tia' fiakdkhl udj; wïmdr' ÿr( $*elaia - 063-2223088 yïnkaf;dg 3" nerela ú§h" yïnkaf;dg' ÿr( $*elaia - 047-2222163 uyr.u 71$ta" w,aúia ma,did" mrK mdr" uyr.u' ÿr($*elaia - 011-2745640 Y%S chj¾Okmqr frday," ;,m;amsáh" kqf.af.dv' ÿr( $*elaia - 011-2779414 lrdmsáh 175" ysßUqr mdr" lrdmsáh ÿr( $*elaia - 091-2226947 ñ.uqj 134" uy frday, bossßmsg" fld<U mdr" ñ.uqj' ÿr($*elaia - 031-2228599 osh;,dj nia kej;=ñfmd, wi," uy úÈh" osh;,dj' ÿr($*elaia - 057-2227190 ;x.,a, 08" b|sfmdl=Kf.dv udj;" ;x.,a,' ÿr( $*elaia - 047 2241221 r;au,dk fu.d if;di" f.d¨uvu ykÈah" .d¨ mdr" r;ua,dk' ÿr( $*eliaa - 011-3043789 hdmkh wxl 149 ta lkalika;=f¾ mdr" hdmkh' ÿr($*elaia - 021-2219262 fmdf<dkakrej frday,a ykaosh" lÿrefj, mdr" fmdf<dkakrej' ÿr($*elaia - 027-2225465 rd.u 61$ta" uyndf.a mdr" rd.u' ÿr( $*elaia - 011-2955219 weô,smsáh 102" fl,ska ú§h" m,af,.u" weô,smsáh' ÿr( $*elaia - 047-2261177 fírej, iuQmldr ukaosrh" .d¨ mdr" fírej,' fg,s$*elaia( 034-2278578 fudKrd., 31" fmd;=ú, mdr" fudKrd., ÿr$*elaia( 055-2277712 .¾NKs ldk; a djkga" jhi wjrqeÿ 5g wvq orejkga" 55 bluajQ fÊIGa mrqjeihskga yd rKúre úreir jrmi%do ldâm;a yñshky a g ihs¿u rdcH Tiiq,a u.k s a fnfy;a jÜfgdrae i`oyd 5] jÜgula yñs fõ'

zz Tfí iqjfi; - wfma me;=uhs ZZ

SEP 2019 VOLUME 25 • ISSUE 09

Regular

Features

Editors Note 6

hym;a fi!LH mqreÿ iu yd kshfmd;= laIqø Ôú wdidok j,ska fírd.ksuq

Health News 8 k<ore ;dlaIKh ore iïm;a ,efnkak m%udo fjkjdo @ fkdmudj m%;sldr j,g fhduq fjkak''' idhksl l<,fõo úfYAI{ ffjoH fy<rejka mikal=udr 14

wkqkaf.a mõ lr.eiSu fkdfyd;a wl%Sh ÿï mdkh fmKy¿ ms<sld yd ;j;a frda. /ila we;s ùfï wjodku fï ksid ksielfhkau by< kexfjkjd''' 26 ridhkd.dr mÍlaId jvd;a úYAjdiodhS fïo me;slv ^fldf,iagfrda,a& mÍlaIdjla HDL fkdjk fldf,iagfrda,a wdisß ridhkd.dr fiajdfõ wOHlaI kS,a m%sh;a fcdaka 36

idhksl laIQø cSj úfYaI{ ffjoH frdaysKS jvkïNs laIQø cSj wxY m%OdkS 10

wdydrhg iqÿiqu iy,a .ek m¾fhaIK Tiafia wkdjrKh lr.;a oeKqu CIC Fragrant ndiau;S iy,a

fk;g ri÷kla jka rEmY%Shla'''oeka" ACC

by Ninewells fj;ska zzTngu ysñ Tfí fid÷re rej iïm;'''ZZ úYajdiKSh;ajfhka hqla;j Tma kxjd .kakg wm fj; meñfKkak 30 yo uvf,a ú;a;s f,dal yoj;a oskh iema;eïn¾ 29 MY HEART, for YOUR HEART, for ALL OUR HEARTS 35

Y%S ,xld iajdmkfõ§kaf.a ix.ufha iNdm;s ufkda Ñls;ail ffjoH mS'tka'úoHdl=,m;s 106

September 2019

Conduction system of the heart Tfí yoj; ;=< úoHq;a mßm:hla@ yojf;a ikakdhl moaO;sh 42

wdpd¾h wdkkao pkaøfialr 22

.s,ka uki PdhdrEmfha fmkS isá ñh.sh wdÉÑ

2

Rheumatic Heart Disease zykaÈ f,jlk" yoj; imdlk f,fâZ''' rEueál yoj;a wdndO 40

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l<,Sh yDoh yefok yeá 46 Amazing function of the heart youv, fï jf.hs 48 Heart attack yDohdndOhla y÷kd .kakd yeá yDo frda. úfYaI{ ffjoH rejka talkdhl 52

yoj; l%shdldrs;ajfha mj;soaoS yDo ie;alï isÿ lsÍug mdr lemQ Tlafgdmia ;dlaIKh kjf,dal frdayf,a yDo Wria Y,H frda. úfYaI{ ffjoH ta'cS' fchl%sIaKka 60

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SEP 2019 VOLUME 25 • ISSUE 09

yoj;a frda. mÍlaIK úuiqï ljq¿j tflda mßlaIdj fkdfyd;a Echocardiogram yDo frda. úfYaI{ ffjoH jika; fyÜáwdrÉÑ 63

lsÍgl wekacsfhda.%ï mßlaIdj Coronary Angiogram yDo frda. úfYaI{ ffjoH ,,ks lmqref.a 68

Exercise Electrocardiogram

yoj;a frda.Skag fok T!IO Cardiac Rehabilitation 96 yDo frda.hg n÷ka jQ whg Ôú;hg uqyqK§ug mkakrh ,ndfok yDofrda.Ska mqkre;a:dmkh lsÍfï jevigyk fld<U" cd;sl frdayf,a" yDo frda. tallfha fy!; Ñls;ail wêldÍ' ta'hQ'iS w;=fldar< 99

fkdfyd;a Exercise ECG mÍlaIdj yDofrda. úfYAI{ ffjoH f.daGdNh rKisxy 72

.Eiag%hsgsia f,iska jrojd jgyd .kakd yDohdndOhla .ek bÕslrk

History of ICU

wekachskd lelal=u yDo frda. úfYaI{ ffjoH kdu,a úchisxy 102

yoj;a frda.Skaf.a cSú; iqrlaIs;;djh ;yjqre l< oeä Wmia:dk tall wdrïN jQ yeá 76

On Pump Coronary Artery Bypass Graft / CABG Surgery yDo fmky¿ hka;%h fhdodf.k isÿlrk nhsmdia ie;alï kjf,dal frdayf,a fkajdisl yD;a Wria úfYAI{ ffjoH tia'm%§ma pdkaoa 80

Congenital Heart Diseases Wmf;aoSu Wreuhla lr.kakd yoj;a frda. fkdfyd;a ixcdkSh yoj;a wdndO ffjoH tia'kf¾kaøk 88

4

September 2019

wdhq¾fõoh fydañfhdam;s weÿu frda.hg fydañfhdam;s úi÷ï fydañfhdam;s ffjoH wkQId fyaul=udß 110

rEm,djKHh .ek Tn ie<ls<su;ao@ <÷ka iqr <÷ka lrk foaYSh rEm,djkH T!IOh iEis isxyf,a Tiq fjo ueÿf¾ wêm;s fy< fjo uydkdu ta' ymqf.dvf.a 114

DOCTOR MAGAZINE

fy< Tiqfjka oshjeähd iqjh Èhjeähdj iqj l< fkdyels frda. hla nj ngysr u;h jQj;a fy< Tiqfjka Èhjeähdj ksÜgdjgu iqj lrkak háhkaf;dg uyú, fjo ue÷rg mq¨jka foaYh S ffjoHY+Í" foaYudkH" uydpd¾h fya' uQ' fikr;a chiQßh nKavdr ^uyú, fjo uy;d& 118 ks, fjolfuka iqjh iok wisßu;a fjolu ikaêjd; frda. iqj lrk ÔjlhdfKda wxl=Uqf¾ chka; nKavdr fjouy;d 122 fy< fjolfï lsre, me<ª .S%ka y¾n,a wdhq¾fõo iud.u ;j;a jákd ld,Sk wjYH;d imqrk T!IO folla yÿkajd fohs .S%ka y¾n,a flaI uQ, ff;,h .S%ka y¾n,a f.da,aâ Yhska Ths,a 124 lrorldÍ ifï frda. j,ska ñfokak u.la wdhq¾fõo ffjoH rkam; rejka r;akdhl 126

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EDITOR'S NOTE yo uv, iqrlsk oeKqj;aNdjhg wfmka osh ì|l iïudoula f,dal fi!LH ixúOdkh úiska .Kka n,d we;s wdldrhg f,daljdiska f.ka ñ,shk 17l m%udKhla yoj;a frda. ksid jd¾Islj fuf,dj yer h;s' wmf.a YÍrfha Yla;siïmkaku wjhjh jk yDoh isref¾ ish¿ wjhj iudfhdackh lrk jvd;au cjiïmkak .;sl wjhjho jkafkah' yoj; iqjfi; mqoa.,fhl=f.a fi!LH iïmkakNdjh flfryS iDcqju n,mdk wjhjhla jk w;r tys wjl%shdldß;ajhg" jHqyd;aul fodaI j,g''' n,mdk fya;= uQ,slj wmg je<elaúh yels fodaI yd tfia n,mEula l< fkdyels fodaI jYfhka fohdldrhlska úia;r flfrhs' m%fõKsh" ia;%s mqreI Ndjh" jhia.; ùu wmg fjkia l< fkdyels ldrKdh' tfy;a wmf.a Wkkaÿj u; fjkia l< yels wjodkï idOlo / ila fõ' wmf.a wdydr isß;" YÍrh ksfrda.S lrk jHdhdu" ÿïmdkfhka" u;aøjH j,ska je<lS isàu"

6

September 2019

m%udKj;a kskao" wd;;sfhka f;dr ir< cSú;h''' fï wdoS Ndú;hka yoj;g fnfyúka iqñ;=reh' wfma rfÜo urK i|yd fya;=jk wxl tl idOlh yoj;a yd reêr kd, wdY%s; wdndOhkah' uQ,sl jYfhka yDohdndO yd wxYNd.ho we;=¿j ;j;a fndfyda fodaI fï ldKavhg wh;ah' Wmf;aoS we;efula yoj;a wdndO j,g f.dÿre jk w;r fndfyda fokd jhia.; jk úg ta wjodku jeä lr .kshs' úYd, jmißhla .kakd yoj;a wdndO" tajd y÷kd .ekSug lrk mÍlaIK yd tajdg fhdok m%;sl¾u ms<sn|j újrKhla zzyo uvf,a ú;a;sZZ ,sms ud,dj Tiafia Tn fj; f.k taug wm W;aidyhl ksr; ùuq' fjfiiskau lS¾;su;a yDo frda. yd yD;a Wria ffjoHjreka yd wm lrk ,o ixjdo weiqre lrf.k fï oeKQu Tn fj; f.k taug wm W;aidy .;af;a jvd;a ksrjoHj tajd Tn fj; msßkeóug wfma we;s wNs,dYh ksidfjks' 2000 jif¾ isg f,dal yoj;a f*vf¾IKh wLKavj mj;ajdf.k hk f,dal yoj;a oskhg iu.dój wfma rgjeishka oeKqj;a lrKq msKsi fujr fuu ,sms iuqÉph m< flfrhs' óg l,lg fmr kjf,dal frday,a yDo tallh fjkqfjka wm iÕrdj úiska iïmdokh lrk ,o ,sms lsysmhlao iu.ska ilia lrk ,o fuu ,sms iuqÉPfha os.=jla ^wêreêr mSvkh yd fldf,iagfrda,a iïnkaO ,sms& iu.ska fuu ld¾hh bosß l,dm lsysmhla olajdo mj;ajd .ekSfï wruqKla wmg ;sfí' yoj; iqjfi; ´kEu mqoa.,fhl=g ;SrKd;aul jk w;r ta iïnkaOfhka oeKqj;a lsÍu Wfoid wmf.a ksrka;r j.lSu wm bgqlrk nj wjOdrKh lruq'

DOCTOR MAGAZINE

Bharata Gunathilaka - Editor in Chief doctormagazine.lk@gmail.com bharata.gunathilaka@gmail.com

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The Premier Health Magazine in Sri Lanka

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Volume 25 â&#x20AC;˘ Issue 09, September 2019

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EDITOR IN - CHIEF Bharata Gunathilaka FOUNDER EDITORIAL CONSULTANT Late. K.M. Gunathilaka MANAGING EDITOR Amitha Wickramarachchi FEATURES EDITOR Shyamalee Pathirage FEATURE ASSOCIATES Dr. Roshan Zerideen Zaid Consultant Obstetrician Gynaecologist

Dr Chandana Sri Kanakaratna Geriatrician, Physician

Dr. Asanga Wijayaratne Specialist in Human Kinetics and Sports Medical Science

Dr. Samantha kumara Kitalawaarachchi Dr Palitha Bandara Subasingha Dr Nalaka Ranasingha Dr Janaka Premathilaka Dr Devinda Dayarathna Mr Sanjaya De Silva Mr S M D Senevirathna Ms Hashini Himanshika CREATIVE PRODUCTION Manjula Kumara Gamage 077 1 2424 08 WEB ADMINISTRATOR Dumindu Dissanayake PRINTING/CIRCULATION Imashi Printers, #96A, Wanatha Road, Gangodawila, Nugegoda.

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Akkaraipaththu Akurana Aluthgama Ambalangoda2 Ambalanthota Ampara Anuradhapura Attidiya Avissawella Badulla Balangoda Battaramulla Batticaloa Batticaloa 02 Beruwela Bk Majestic City Bokundara Boralesgamuwa Chilaw Chillaw2 Chunnakam Colpetty Cota Road Dalugama Dambulla Dankotuwa Deans Road Dehiwala Delgoda Delkanda Dematagoda Dharga Town Dickmans Road Duplication Ekala Elakanda Embilipitiya Eravur Ethulkotte Galewela Galle Galle 02 Gampaha Gampola Gatambe Grandpass Hambantota Hanwella Hatton Homagama Horana Jaela Jaela 02

Jawatta Kadawatha Kadawatha 2 Kaduruwella Kaduwela Kalapaluwawa Kalmunei Kalutara Kalutara North Kandana Kandy Kannaththidi Karagampitiya Karapitiya Katugastota Katugastota2 Katukurunda Kegalle Kelaniya Kesbewa Keselwatte Kilinochchi Kiribathgoda Kochchikade Kohuwala Kohuwala 2 Kolonnawa Koswatte Kotahena Kotikawatta Kottawa Kottawa 02 Kuliyapitiya Kundasale Kurunegala Kurunegala 2 Madulla Maharagama 2 Malabe Malabe 2 Manchanthoduwai Manippay Maradana Marawila Marine Drive Matale Matale2 Matara Mathugama Mattegoda Mawanella Minuwangoda Mirihana

September 2019

Moneragala Moratuwa Moratuwa Old Rd Mount Lavinia Mount Lavinia Stc Mutuwal Narammala Nawala Nawalapitiya Negombo 2 Nelliyadi Nittambuwa Norris Canal Nugegoda Nugegoda 2 Nuwara Eliya Pallekele Panadura Panadura 2 Park Road Pelawatta 02 Peliyagoda Pepiliyana Pilimatalawa Piliyandala Pitakotte Pothuvil Puttalum Ragama Rajagiriya Ratmalana Ratmalana 02 Ratnapura Seeduwa Stanly Tmw Staples Street Tangalle Thihariya Thissamaharama Trincomalee Udahamulla Vavuniya Wadduwa Warakapola Ward Place Wariyapola Weliweriya Wellawatte Wellawaya Wennappuwa Werahera Wijerama Yakkala

DOCTOR MAGAZINE

7

D•Magazine /

Health News

iqmqj;

HEALTH NEWS iqmqj; Maternal mortality on the rise in SL orejka m%iQ;sfhaoS isÿjk ud;D urK j, jeäùula - Y%S ,xld ffjoH ix.ufha f,alï ffjoH lms, chr;ak uE; ld,fhaoS orejka m%iQ;sfhaoS isÿjk ud;D urK j, jeäùula olakg ,efnk nj Y%S ,xld ffjoH ix.ufha (SLMA) f,alï ffjoH lms, chr;ak m%ldY lrhs' Y%S ,xld ffjoH ix.ufha jd¾Isl wOHdmksl ieisjdrhg iyNd.s fjñka fï nj m%ldY lf<ah'

8

September 2019

wfma rfÜ jd¾Islj ldka;djka 360"000la .eí .kshs' wmg we;s wNsfhda.h jkafka fï .eí .ekSï j,ska ;=fkka ;=fkka tllau yosis .eí .ekSï fyj;a ie,iqï fkdl< .eí .ekSï ùuhs' ie,iqï iy.; fkdjk .eí .ekSï mjq,a tallhg fndfyda .eg¿ we;s lrhs'

DOCTOR MAGAZINE

2017 j¾IfhaoS wfma rfÜ .eí .ekSï 326"000la jd¾;d jQ w;r bka ishhg 15la tkï 49"000lau jhi wjq' 35 blaujQ uõjrekaf.a .eí .ekSïh' wvq jhiska .eí .;a m%;sY;h ishhg 4'6ls' tu j¾IfhaoS orejka yg Wm; ie,iSfïoS orejka 127la cSú;laIhg m;ajQ

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w;r fï uõjrekaf.ka 28lau wkfmalaIs; .eí .ekSï fya;=fjka úm;g m;a jQjkah' wfma rfÜ újdyl ldka;djkaf.ka ishhg 35la muK lsisÿ Wm;a md,k Wml%uhla Ndú;d fkdlrk nj 2016 j¾Ifha isÿ lrk ,o wOHhkhlska Demographic and Health Survey, the UNFPA fy<sorõ ù ;sfí' fuu úm;a j<lajd .ekSug kï ud;D fi!LH fiajdjg mjq,a ie,iqï oeKQu tla l< hq;= fõ' thska wkfmalaIs; .eí .ekSï fukau wkdrlaIs; .íidjkao j<lajd .ekSug yels jkq we;' wfma rfÜ ;=reKQ ck.ykfhka nyq;rhla ,sx.slj il%sh cSú; .; lr;s' Tjqkag ks¾ndOlj ,sx.sl yd m%ckl fiajdjkaf.a Wmldrh ,eìh hq;=h' wfma rfÜ iEu ;=reKQ flfkl=gu wdrlaIs;j yd ;ukaf.a wkqoeKQu u; ;ukaf.a isrer ms<sn|j ;SrK .ekSfï wjldY mej;sh hq;=hs'

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World Breastfeeding Week uõlsß §fï i;sh wf.daia;= 1 -7

l,dmfha iqúfYaIS uõlsß §u m%j¾Okh lsÍfï mqfrda.dñhd jQfha Y%S ,xldjhs'

uõlsß oSug uõjreka fm<Uùfuys,d wfma rg fmruqfKa isákjd''' f,dal uõlsß oSfï i;sh fuu jif¾ f;audj jQfha" zfouõmshka iún, .ekaùu" uõlsß §u n,.ekaùuhs' tys wruqK jQfha udi yhla uõlsß §fuka ,efnk m%fhdack ms<sn|j foudmshka oekqj;a lsÍuhs'

wfma uõlsß m%j¾Ok jevigyfkys oshqKQj ie,ls,a,g .ksñka m%cd ffjoH úoHd,h úiska ffjoH t*a'ta' úl%uisxy foaYkh i|yd f;dard .;af;ao fuu f;audjhs' hqksfi*a ys Y%S ,xld ld¾hd,fha fiajh lrk úfYaI{ ffjoH ffjoH Oïñld frdfj,a úiska isÿ lrk ,o fï foaYKfhaoS jir úis myl uõjreka uõlsß ;u orjkag ,ndoSfuys,d isÿ lrk ,o wNsfm%ark jevigyka uekúka meyeos,s lrk ,oS'

<ore ys;ldó frday,a jevigyk wfma orejkaf.a iqrlaIs;;djh idlaId;a lrKQ jia wdrïN jQ jákd jevigykls' 1991 § <ore ys;ldó frday,a jevigyk wdrïN lsÍug;a fmr isgu fï

DM

September 2019

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9

D•Magazine /

Healthy Habits iu yd kshfmd;= laIqø Ôú wdidok j,ska fírd.ksuq

hym;a fi!LH mqreÿ

iu yd kshfmd;= laIqø Ôú wdidok j,ska fírd.ksuq idhksl laIQø cSj úfYaI{ ffjoH frdaysKS jvkïNs laIQø cSj wxY m%OdkS ,xld fydiamsg,a ridhkd.drh MBBS, MD Med Micro, Dip (Med Micro) Resident Consultant Clinical Microbiologist

p

¾uh wfma isref¾ ;sfnk úYd,u bkaøsh f,i ye¢kafõ' ifï ksfrda.S Ndjh flfkl=f.a fi!LH ms<sìUq lrk levm;la jeksh' iul wdrlaIdj ms<sn|j l;d lsÍfï§ m<uqjk ldrKh jkafka msßiqÿluhs' fojk ldrKh jkafka iu úh<Su j<ld .ekSuhs'

uDÿ inka Ndú;hg yqre jkak msßiqÿlu .ek l;d lroa§ w;a fia§u" iakdkh" weÕ fia§u wdÈh fukau fyd¢ka fidod úh,d .;a msßiqÿ we÷ï Ndú;h jeo.;a fõ' fuys§ fyd¢ka u;l ;nd .; hq;a;la jkafka Ndú;d lrk inka" lS%ï j¾." Ieïmq j¾. wdÈh b;d uDÿ ier wvq tajd úh hq;=hs' ke;fyd;a muKg jvd ier inka wdÈh ksid ifï wdrlaIl f;,a j¾." mgl" úkdY ù wêl úh<s nj ksid iu bß ;e,Su jeks ;;a;aj we;s úh yelshs' tjka iula b;d myiqfjka úIîc j,g we;=,a úh yels ;ekla fõ' ±ka Tng jegfykjd we;s fidaod.;a isrerg f;;ukh r|d ;nk uDÿ lS%ï wdf,amkhla iqÿiq nj ^Moisturizer& my; ±lafjk ldrKd j,skao m%fõYï ùu p¾u wdidok ^Infection& j,ska je<lSu i|yd b;d jeo.;a fõ' lDñ wdidok j,ska wE;a ùug mshjr .kak lDókaf.a imd lEï" ú§ï j,ska ñ§u ^Insect bytes& ^uÿrejka jeks l=vd i;=ka fukau nUreka" foUreka jeks úÈk i;=ka & oyj,a l, fyd¢ka isrer wdjrKh jk

10

September 2019

DOCTOR MAGAZINE

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we÷ï we£u" rd;%sfha uÿre ±,a Ndú;h" riakh iys; ld, j, uÿrejka yd lDóka m,jd yßk wdf,amk Ndú;h jeks Wml%u Ndú;d l< yelshs' hï úÈhlska tjka lDñfhl=f.ka ú§ulg ,lajqKfyd;a tu ia:dkh leiSu" iSÍu fkdl< hq;=hs' th b;d blauKska nelaàßhd wdidokhlg w; jekSuls' lDñfhlaf.a ú§ulg Ndckh jQ úg ^nUreka" foUreka fyda Bg iudk& lDñ ú; ^o<h& bj;a lsÍu;a <Õu we;s frday,lg hdu;a jeo.;a fõ' iuyr wh oreKq wdid;añl ;;ajhlg uqyqK mE yels ksid ^Anaphylactic shock& tjka oreKq ;;a;ajhl ,ËK my< fõ kï jyd ffjoH Wmfoia .kak' th meh lsysmhla we;=,; isÿ úh hq;=h' nelaàßhd yd È,Sr uÕska wdidok we;sùu md,kh i|yd ;=jd f¾i¾ wdÈh fmdÿfõ mdúÉÑhg fkd.; hq;=h'

hï úÈhlska ifï lemqula iSÍula jeks fohla jqjfyd;a tu ia:dkh msßisÿ lr iqÿiq wdjrK Ndú;d l< hq;=hs' ÔjdKqyß; Plaster T!IO .,ajk ,o Plaster fï i|yd iqÿiq fõ' lemqfï .eUqr fyda È." m<, jeä kï reêr jykh wêl kï jyd frday,la lrd hdu iqÿiqh' msßiqÿ wdjrKhlska jeiSu yd fyd¢ka wjfndaOh we;s whl= úiska f;rmqï iys; nekafâchla u.ska reêr jykh kej;Su jeo.;a fõ'

;jo iu wdY%s; wdid;aul;d" oo" l=IaG"^Eczema& jeks ;;a;aj iys; wh jeämqr m%fõiï úh hq;=h'

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September 2019

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iu yd kshfmd;= laIqø Ôú wdidok j,ska fírd.ksuq

Healthy Habits

by; lS ish¿ wjia:djkays§ úIîc ms<sn| wjfndaOh fkdue;s ùu ksid fndfyda fokd iu wdYs%; wdidok j,ska mSvdjg m;afõ' Cellulitis, Furunculitis ^frdau l+m wdYs%; meiùu& jeks u;=msg wdidokhkaf.ka mgkaf.k myositis osteomyelitis, fascitis hkd§ uiams`vq olajdo" wiaÓ olajdo fuu wdidok me;sr hd yelsh'

12

September 2019

DOCTOR MAGAZINE

tneúka tajd l,a we;=j yÿkd .ekSu fnfyúkau jeo.;ah' p¾u frda. ffjoHjrfhl= fyda Tnf.a mqreÿ ffjoHjrhd uqK .eiS tu wod< wdidokh we;s m%foaYfhka ierj idïm,hla f.k th mÍËKd.drhlg ,nd § wdidokh yÿkd.; yel' ksjerÈ j yÿkd.;a wdidokhla ksjerÈ m%;scSjl ,nd§" ksis f,i iqj l, yel' fndfydauhla fokd b;d l=vd ;=jd,hla ^leiSula" iSÍula" Insect bite& jeks tlla úYd, §¾> ld,Sk ;=jd,hla olajd jeä lr .kafka uQ,sl oekSu yd wjfndaOh ke;slu ksidh' fuu ,smsfha b;sß fldgi B,. l,dmfhka n,dfmdfrd;a;= jkak' DM

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September 2019

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Fertility ore iïm;a ,efnkak m%udo fjkjdo @ fkdmudj m%;sldr j,g fhduq fjkak'''

ore iïm;a ,efnkak m%udo fjkjdo @ fkdmudj m%;sldr j,g fhduq fjkak''' wo ;dlaIKh oshqKQhs''' Y=l%dKq ßfmdaÜ tl ìxÿj jqK;a jDIKfldaIh úo, Y=l%dKqjla fydhdf.k''' tfyu ke;akï Y=l%dKqfj T¨j lE,af,ka yß ksfrda.S ore iïm;la ,nd fokak wo idM<H;d ;dlaIKh iu;a WISH Fertility & IVF Clinic yS idhksl l<,fõo úfYaI{ ffjoH fy<rejka mikal=udr uy;d iu. l< idlÉPdjla weiqßKs MBBS (Sri Lanka) MD (Gyn. & Obs.) Infertility - China Pg.Dip. (Andrology) Monash,OUSL Master of Clinical Embryology Monash, Australia SLMC Reg. No. 20800

14

September 2019

u|ireNdjh hkq l=ulao @ hqj,la újdy ùfuka miqj wUqieñhka iajNdúlj tl;=ùula isÿj ;sîhoS;a jirla hk;=re ore iïm;la fkd,eîu zzu|ireNdjhZZ jYfhka wm y÷kajkjd' kuq;a fï wre;a .ekaùu t;rï ksjeros kE' wm tfyu lshkafka wehs @ u|ireNdjh uQ,sl jYfhka fohdldrhs m%d:ñl u|ireNdjh tla ore iïm;la j;aa fkd,eîu oaú;Shsl u|ireNdjh uq,a orejd ,eîfuka mia fojk ore ms<sis|Sula isÿ fkdùu ore iïm;la m%udo jqKdu jirl ld,hla l,a ne,Su''' ;j;a úosylska lshkjd kï jirl ld,hlska miq ffjoHjrfhl= uqK .eiSu iEu fokdgu tlfia yßhkafka kE' jhi wjqreÿ 35g wvq ldka;djla kï yd fjk;a frda.hla ke;akï ta hqj, i|yd jirla n,d isàu jrola fkdfjhs' DOCTOR MAGAZINE

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ta;a lsishï ldka;djlf.a jhi wjqreÿ 35 blaujd isákjd kï ta ldka;dj fï ;rï ld,hla l,a n,d isàu weh ore iïm;la ,nd .ekSug we;s bvlv wjqrk fya;=jla jkakg;a mq¿jka' jhi 35 bl=;a jQ ldka;djka ffjoHjrfhl= yuq úh hq;= ld,h idudkHfhka ldka;djl Wm;ska f.fkk äïn jir 35ka miq l%shdldÍ fkdjk ;;a;ajhlg meñfKkakg mgka .kakjd' jhi wjqreÿ 35ka újdy jqfKd;a udi yhla we;=<; ore iïm;la fkd,enqKs kï fï wUqieñhka ffjoHjrfhl= yuqúh hq;=hs' wjqreÿ 40ka újdy jQ ldka;djl kï udi ;=kloS ore ms<sis|Sula isÿ fkdjqfKd;a ffjoHjrfhl= yuqùu iqÿiqhs'

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m%ckl moaO;sfha fodaI iys; wh;a fkdmudj ffjoHjrfhl= yuq úh hq;=hs ldka;djl ;ukaf.a m%ckl moaO;sfha lsishï .eg¿jla mj;akd nj y÷kdf.k isákjd kï" Tima ùfïoS wêl fõokdjla we;sùu" wl%uj;a Tima ùu" tkafvdfuá%fhdaii s "a fmd,sisiaála

September 2019

ore iïm;la m%udo jqKdu jirl ld,hla l,a ne,Su''' ;j;a úosylska lshkjd kï jirl ld,hlska miq ffjoHjrfhl= uqK .eiSu iEu fokdgu tlfia yßhkafka kE'

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Fertility ore iïm;a ,efnkak m%udo fjkjdo @ fkdmudj m%;sldr j,g fhduq fjkak'''

´jß iskafv%dï jeks frda. ;sfnk wh újdym%dma;j udi 2-3 lska ffjoHjrfhl= yuqùu iqÿiqhs' ta ú;rla fkdfjhs" ldka;djlg oshjeähdj" wêreêr mSvkh ;sfnkjd kï" udi ;=kl wejEfuka fï wh u|ireNdjhg we;=<;a fjkjd' Bg wu;rj mqreIfhla jqK;a fï frda. ;sfnkjd kï th idM<H;djhg lsishï n,mEula we;s lrjk nj lsj hq;=hs' oeka ore iïm;a ySk nj f,dalh mqrdu mj;sk m%Yakhla u|ireNdjh .ek f,dal fi!LH ixúOdkh isÿ l< fidhd.ekSï j, yeáhg oeka ishhg 30lau hqj,j,a w;r u|ireNdjh olakg ,efnkjd' wUqieñhka oy fofkla .;af;d;a ;=ka fofklau orejka ms<sis|.ekSfï .eg¿ j,g uqyqK mdkjd' 2000 j¾Ihg fmr fï ;;a;ajhg md;% jqfKA wUqieñhka w;=ßka ishhg oyhla muKhs' jir 1015la we;=<; u|ireNdjh úYd, jYfhka jeä fj,d ;sfhkjd' fï m%jK;djh ksid ;jÿrg;a jHdma; fjkjd' 2025 j¾Ih jk úg u|ireNdjh ishhg 16

September 2019

40-50 muK úh yels njg mqfrdal:kh lr ;sfnkjd' fuh ;j úosylska Tng wjfndaO lrjkakg W;aidy lf<d;a bosß ld,fhaoS wUqieñhka fofokdf.ka tla flfkla lsishï .eg¿jlg ,laùfï wjodkula fuhska oel.; yels fjkjd' ore iïm;a fkd,efnk jro ldf.o @ ore iïm;a ke;s jqKdu jeäfhka wj,do k.kafk ldka;djkag' óg ldf,lg biair kï we;af;kau fuh yqfola ldka;djf. wm,h ksidu isÿjk wjdikdjla f,ihs ie<l+fha' ta;a úoHd;aulj i<lk úg mqreI uQ,sl fya;= ksid;a u|ireNdjh we;s úh yelshs' 1980 oYlfha úoaj;a l;sldj;a j,g wkQj ore iïm;a wysñ ùug n,mE fya;= w;f¾ ishhg 70la muK wh;a jqfKA ldka;d iïNjhla iys; fya;= úosyg' ta;a oeka ldka;d fya;=;a mqreI fya;=;a yß yßhg fuhg n,mdk nj fmfkkakg ;sfnkjd' wo ojfia u|ireNdjhg n,mdk úúO fya;= w;f¾ ishhg 50la fya;= ldka;djf.a' b;sß ishhg 50 mqreIhdf.a lsishï wvqmdvqjla fjkak mq¿jka' ta ú;rla fkdfjhs wkd.;fhaoS mqreI mdol fya;= ldka;djf.a wvqmdvqlï wNsnjd hkakg;a bv ;sfnkjd'

DOCTOR MAGAZINE

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u|ireNdjhg kùk m%;sldr ire ojia j, tl;= ùu hqj,la u|ireNdjhg m%;sldr msKsi wdju uq,skau n,kafk fï wh ire ld,fhaoS tl;= fjkjdo lshk ldrKhhs' Bg miafi ialEka mÍlaIKhla lr, äïn j, ;;a;ajh .ek ;lafiarejla lrkak mq¿jks' äïn W;af;ackhg ,la lrk tkak;la oS, äïn msgfjk ojfi iajNdúlj tl;= fjkak lsh, lshkj' fïl ir< Wmdh ud¾.hla' fï úosfya ir< Wmdhud¾. j,ska weh .eí .ekaùug W;aidy .ekSu uq,au mshjf¾os isÿ fjkjd' Time Intercourse Technique fuysoS wUqieñ iïnkaO;djhlg tlafjk fj,dj ;SrKh lrkafk ffjoHjrhd ;uhs' IUI m%;sldrh IUI lsh, ir< m%;sldrhla ;sfhkjd' fuysoS mqreIhdf.

Y=l%dKQ idïm,hla wrf.k fyd| Y=l%dKQ ál f;dar, äïn tk fj,dj ialEka tflka n,, ldka;djf.a .¾NdIfha ;ekam;a lrkjd' fïj ir< m%;sldr uq;a fïjd;a isÿ lrk iSudjla ;sfnkjd' wjia:d 3-4-5 g jvd lrk úg ia;%shf.a ;sfnk îc bjr fjkak mq¿jka' .¾NdIh we;=<g úIîc .syska mef,damSh kd,h wjysr fjkak;a we;eï úg mq¿jka'

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ir< m%;sldr fjkqjg wê;dlaIKsl m%;sldr mÍlaIK lr, lsishï ksYaÑ; fya;=jla fydhd. kak neß jqfKd;a" tfyu fj,djg wê ;dlaIKsl m%;sldr j,g hkj' mqreIhdf. Y=l%dKQ;a fyd|hs' ldka;djf.a mÍlaIK m%;sM<;a fyd|hs' ta;a ore iïm;la msysgkafk kE' fufyu jqKdu" ir< m%;sldr úosyg iajNdúlj tl;= fjk wjia:d yhla muKla n,kjd' IUI Cycle ;=kla muK lrkjd' ta;a ms<sis|Sula isoaO fjkafk kE' fuh Unexplained Infertility f,i ffjoH úoHdfõ ye|skafjkjd' we;af;kau fï uQ,sl mÍlaIK j,ska fya;=jla fidhd. kak neyehs lshkafk fya;=jla fydhd.kak keyehs lshk ldrKh fkdfjhs' ir< l%u j,ska ta mdol fya;=j fydhd. kak neyehs lshk tlhs' uQ,sl mÍlaIK j,ska fya;=jla fidhd.kak nE' kuq;a cdk mÍlaIK wdosfhka" ;rula ixlS¾K mÍlaIKfõohka fhdodf.k u|ireNdjhg fya;=j fidhd.kak mq¿jks'

September 2019

DOCTOR MAGAZINE

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Fertility ore iïm;a ,efnkak m%udo fjkjdo @ fkdmudj m%;sldr j,g fhduq fjkak'''

ksYaÑ; fya;=jla fidhd. ekSug fkdyels ùu wê ;dlaIKsl m%;sl¾u j,g fhduqjk fya;=jla wfï úosyg mdol fya;=jla iïnkaOfhka fmrhSï fkdl< yels wjia:dfõoS B<`. mshjr úosyg wê ;dlaIKsl fufyhqï j,g fhduq fjkjd' fïjd id¾:l ùfï yelshdj f.dvla jeähs' ikaikaokd;aulj ne¨fjd;a uQ,sl m%;sldr j,ska id¾:l ùfï yelShdj ishhg 15 kï wê;dlaIKsl l%u Tiafia id¾:l;ajh ,nd.ekSfï yelshdj ishhg 65-70la muK olajd fjkjd' my; frda. ;;a;aj j,oS;a wê ;dlaIKsl m%;sldr j,g fhduq ùu iqÿiqhs wfkla ;;a;ajh ;uhs fmd,sisiaála frda.h' fuysoS äïn fudarkafk kE' tkafvdfuá%fhdaisia ;sîu;a idM<H;djhg m%Yakhla' tkafvdfuá%fhdaisia j,os wNHka;r wjhj tlg we,S ;sfnkjd' Th Chocolate Cyst lshkafk;a tjka ;rula ixlS¾K ;;a;ajhla' fï wh;a wê;dlaIKsl l%u j,g fhduqùu iqÿiqhs'

18

September 2019

mqreIhkaf.a u|ireNdjhg ms<shï biair kï Y=l%dKQ jd¾;dfj yeáhg Y=l%dKQ m%udKj;a ixLHdjla ke;akï zzTng nfnla yokak nE''ZZ lshkjd' ta;a wo ojfia kï ;;a;ajh fjkia' jd¾;dfj tl Y=l%dKQjla j;a ke;s jqK;a jDIK fldaIh isÿre lr, yex.=k Y=l%dKqjla fidhdf.k thska orefjla cks; lrjk ;rug wo ;dlaIKh oshqKQ fj,d ;sfhkjd' ir<j lsõfjd;a ishhg 99'99lau msßñkag ;ukaf.au Y=l%dKQ j,ska ore iïm;la ,ndoSug wo idM<H;d ;dlaIKhg yelsù ;sfnkjd' jDIKfldaIh b;du l=vd jqK;a tal úo, Y=l%dKQjla fydhdf.k" iuyr úg Y=l%dKQfõ T¿j lE,a, ú;rla wrf.k thska äïnh úo, jqK;a ore iïm;la we;s lr.kak mq¿jka' Pisa/Tisa lshk úldYh fj,d ;sfhkafk fujka wreu mqÿu fufyhqï Tiafia wUQieñ hqj, fj; ore iïm;la ,nd fokak' Tjqkaf.a wdorKSh n,dfmdfrd;a;=j bgqlr fokakg' ldka;djf.a jhi ore iïm;a ,ndoSug ;SrKd;aulhs msßñkaf.ka kï jhi wjqreÿ 65 ú;r fjklï ore iïm;la ndOdjlska f;drj ,nd .ekSfï ckl Yla;sh ;sfnkjd' ta;a ldka;djkaf.a ;;a;ajh Bg fjkia'

DOCTOR MAGAZINE

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mqreIhdf. udi ;=klg fmr yeÿKQ Y=l%dKqjla ;uhs wo t<shg tkafk' kuq;a ldka;djlf.a kï wïuf. l=ifha uq,a udi 2-3 ;rï ldf,os yeÿKQ äïn ;uhs wef.a m%ckkhg wjYH ckldKQ njg m;a jkafk' ld,h;a iu.u fï äïn j, cdk fjkiaùï isÿ jkak mq¿jka' .=Kd;aul;djh ySk fjkak mq¿jka' ms<sis|. ekSu iïnkaO .eg¿ ú;rla fkdfjhs" we;eï úg Wmosk orejka mjd úúO fi!LH .eg¿ j,g ueosùfï wjodkula ;sfnkjd' iajNdúl k< ore ;dlaIKh fuysoS YÍrfhka msg;oS äïnhla jgd Y=l%dKQ ksheoshla oud ixfiapkhla isÿ fjkakg bv yßkjd' fuysoS tla Y=l%dKQjla muKla äïnh isÿre lr ixfiapkhg ,la fjkjd' ICSI ;dlaIKh msfmÜgqjlska msyskñka mj;sk Y=l%dKQjla w,a,df.k äïnhla isÿre lr ixfiapkhla isÿ lrkjd' mqreIhkaf.ka ishhg 99'99lgu orefjl=f.a cSj úoHd;aul mS;D;ajh ,nd.ekSug yels jQfha fï ;dlaIKhg msx isÿ jkakghs' idM<H;djh i|yd ffjoH úoHdfõ úiªï fiùfï .ufka fndfyda úma,ùh fjkialï isÿ lsÍug iu;a jQ ;dlaIKh fï ICSI ;dlaIKhhs' jhi wjqreÿ 60-70 muK jQ jhia.; ldka;djkaf.a äïn W;af;ackhg ,la lrùug" msìoùug fï ;dlaIKh ksid yels ù ;sfnkjd' IMSI yd PICSI ;dlaIKh fïjd;a by< uÜgfï ffcùh ;dlaIKhla fhdod.kakd m%;sldr l%u' fuysoS yefok orejkaf.a .=Kd;aulNdjh b;d by<hs' fyd|u Y=l%dKQj ksYAÑ; jYfhkau fuysoS f;dard.kakjd' IUI ;dlaIKfhaoS ore iïm;la ,nd. ekSfï m%;sY;h ishhg 30-35 w;r w.hla .kakjd' kuq;a fï IMSI yd PICSI fhdod.ekSfï mshjf¾oS ishhg 65-70-75 jf.a by< id¾:l;ajhla m%lg lsÍu;a úfYAI;ajhla'

biair jf.a ñ,shk .Kkska oeka fï wê ;dlaIKfha jQj;a weiqr ,nd .ekSug úhoï hkafk kE' ,laI y;rla y;r yudrla ú;r ;uhs fï Wiia l%ufõohka weiqre l<;a jeh jkafk' Capsule Baby ;dlaIKh fhdod.kakjd kï Bg;a wvqhs' ,laI ;=kla ú;r ;uhs iuia;hla f,i Bg jeh jkafk' fndfyda fokd ys;k wdldrhg fuh yqfola uqo,a iïnkaO .Kqfokqjlau fkdfjhs' uqo,a ke;sju jqK;a fï ;dlaIKfh weiqr ,nd.kak wjia:dj wo wUqieñhkag ,eî ;sfnkjd'

PICSI ;dlaIKfhoS orejd ksfrda.Sj jefvkjo" lsishï frda.hla ;sfnkjo fidhd n,kak yeÿKq l<,fhkaa

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September 2019

DOCTOR MAGAZINE

19

D•Magazine /

Fertility ore iïm;a ,efnkak m%udo fjkjdo @ fkdmudj m%;sldr j,g fhduq fjkak'''

ffi,hla msg;oS .,jkjd' mqf;lao ÿfjlao hk j." mrïmrdfjka Wreu jk cdk.; f,vfrda. ;sfnkjdo lshk ldrKh" fï l<,fhka ffi,hla .,jd mÍlaId lsÍu PGD (pre genetic diagnosis) f,i ye|skafjkjd' fuysoS ffi,hla bj;a lsÍfuka orejdg lsisÿ ydkshla isÿ jkafka kE' fuu.skq;a ishhg 75l muK id¾:l;ajhla w;am;a lr.kakg yelshdj ;sfnkjd' Capsule Baby ;dlaIKh fï .ek wm miq.sh l,dm j, iúia;rd;aulj l;d nyl ksr; jqKd' ldka;djf.a YrSrh ;=<u iajdNdúl ;;a;aj j,g b;du ióm mrsir ;;a;ajhloS fuysoS ixfiapkh isÿ fjkjd' uq,au ojia lsysmh .; lrkjd' bkamiqj jvd;a iqÿiq îch l=i ;=< ;ekam;a lrkjd' fuys oS isÿ flfrkafka fhdaks ud¾.fha ;ekam;a l< yels úfYaIs; l=vd ma,diaála r|jkhl cSjhla wdrïN ùug wjYH idOl ,ndoSuhs' wvq úhoulska jvd;a iajdNdúl ;;a;ajhka hgf;a ore iïm;la ,nd. ekSug yelsùu ksid Capsule Baby ;dlaIKh ful, w;sYhska ckm%shhs' ore iïm;la ,nd.ekSug hk úhou biair jf.a ñ,shk .Kkska oeka fï wê ;dlaIKfha jQj;a weiqr ,nd .ekSug úhoï hkafk kE' ,laI y;rla y;r yudrla ú;r ;uhs fï Wiia l%ufõohka weiqre l<;a jeh jkafk' Capsule Baby ;dlaIKh fhdod.kakjd kï Bg;a wvqhs' ,laI ;=kla ú;r ;uhs iuia;hla f,i Bg jeh jkafk' fndfyda fokd ys;k wdldrhg fuh yqfola uqo,a iïnkaO .Kqfokqjlau fkdfjhs' uqo,a ke;sju jqK;a fï ;dlaIKfh weiqr ,nd.kak wjia:dj wo wUqieñhkag ,eî ;sfnkjd' äïn ke;s ldka;djlg ;ukaf. äïn mß;Hd. lsÍfuka ;ukaf.a orejd;a yodf.k ;j;a flfkl=g orefjla yokak ms<sirK ùfuka wê;dlaIKh i|yd úhoula fkdue;sju ore iïm;la ,nd .kakg;a wjia:djla ;sfnkjd' DM

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September 2019

DOCTOR MAGAZINE

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;f % ha m<mqreÿ wfma jD;a;h S iydh ,nd oSug wm b;d leue;af;ka isáuq' wmg l;d lrkak' fukak wfma wxlh

077 291 4526 wmf.a ,smskh WISH Fertility & IVF Clinic 393$6" li.yj;a; mdr" mrK fldÜgdj mdr" Wvyuq,a, kqf.af.dv

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Thisakya Design Studio

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Health benefits of Red rice wdydrhg iqÿiqu iy,a .ek m¾fhaIK Tiafia wkdjrKh lr.;a oeKqu

wdydrhg iqÿiqu iy,a .ek m¾fhaIK Tiafia wkdjrKh lr.;a oeKqu CIC Fragrant ndiau;S iy,a wdpd¾h wdkkao pkaøfialr úisks PhD (Human Nutrition) (Sydney University) ananda.ch@icloud.com

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September 2019

DOCTOR MAGAZINE

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iyf,a we;s .=Kj;a msIAGh r;= iy,a hhs wm idudkH jyf¾oS mjikafka tys we;s meyeh r;a meyehla .kakd ksidh' m%;sTlaisldrl .=Kfhka hq;a wekaf;dihkska kï ridhKslh iy,a wegfha r;a meyehg fya;= fõ' iy,a j, msIagh wdldr folla mj;S' weuhsf,daia iy weñf,dfmlaáka hkqfjks'

"

fmda

IK .=Kfhka by< l=reÜgla fkdfyd;a msg; wdjrKhla we;s ksid r;= iy,a" iqÿ iy,a j,g jvd fmdaIK .=Kfhka wkQk hhs ie<fla' m%;sTlaisldrl .=Kdx.hkaf.ka hqla; mhsfgdridhk iy wdydruh fl|s /ila r;= ydf,a ;sfí' ksoka.;j we;sjk yD;a frda." oshjeähdj iy ms<sld we;=¿j frda. /ilska wmj uqojd .ekSfï yelshdjla r;= iy,g ;sfí'

r;= iy,a hhs wm idudkH jyf¾oS mjikafka tys we;s meyeh r;a meyehla .kakd ksidh' m%;sTlaisldrl .=Kfhka hq;a wekaf;dihkska kï ridhKslh iy,a wegfha r;a meyehg fya;= fõ'

iyf,a fmdaIKSh jákdlu jeäjk yeá ndiau;S jeks os.= weg iys; OdkH j, jvd;a we;af;a weuhsf,daiah' n;a ál uDÿj;a úh<sj;a msi.kakg fï yd,a jeä bvla ,nd fohs' ;dhs ceiañka" cmka yd úhÜkdï iyf,a wegh os.ska jeä ke;' uOHu m%udKh' wef,k iq¿ iajNdjhla orK weñf,dfmlaáka msIagfhka idr fï iy,a cmka" ;dhs wdydr nqoSfï isß;g;a losug .e,fma' fï wef,k iq¿ ldKAvfha wdydr j, .a,hsisñla doctormagazine.lk

September 2019

DOCTOR MAGAZINE

23

D•Magazine /

wdydrhg iqÿiqu iy,a .ek m¾fhaIK Tiafia wkdjrKh lr.;a oeKqu

Health benefits of Red rice

o¾Ylh jeäh' ^blauKska reêr iSks m%udKh by< kxjhs'& tneúka tajd t;rïu fi!LHdrlaIs; fkdfõ' ndiau;S iy,a idhkslj ;yjqre lrk ,o fmdaIH .=Kfhka wkQk iy,la jk Fragrant ndiau;S iy,a wkqNjfhka reêr.;j we;s iSks úi,a mrdihlska fjkia jkafka ke;' tksidfjkau 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'

"

idhkslj ;yjqre lrk ,o fmdaIH .=Kfhka wkQk iy,la jk Fragrant ndiau;S iy,a wkqNjfhka reêr.;j we;s iSks úi,a mrdihlska fjkia jkafka ke;' tksidfjkau oshjeähd frda.Skaf.a reêr iSks uekúka md,khg WmldÍ fjhs'

24

September 2019

tfiau wfma rfÜ Ndú;d jk wjfYAI ndiau;S iy,a j,g jvd m%;sTlaisldrlhla jk *sfkda,sl ixfhda. ixhq;sfhka fnfyúka fmdfydi;ah' .a,hsisñla o¾Ylh mokï lr.;a wdydr .; hq;af;a wehs @ wdydr úfYAIfhkau oshjeähd frda.Ska i<lK l< Tjqka ks;ru .; hq;af;a .a,hsisñla o¾Ylh wvqfjka we;s wdydrh' tu wdydr u.ska .aÆfldaia ixfõoS;djh by< kxjk w;r ffi,Sh l%shdldß;ajho by< kxjhs' ta yereKQ úg reêr.; fldf,iagfrda,a uÜguo wvq lrhs" iaurK yla;sh m%j¾Okh lrhs' my< .a,hsisñla w.hla m%lg lrk iy,a ms<sn|j ful, m¾fhaIK mq¿,a ù ;sfí' iy,a weghl .a,hsisñla w.h ;SrKh lrk idOl .Kkdjla fjhs' iy,a wegfha m%udKh" weuhsf,daia yd weñf,dfmlaáka hk msIaG w;r wkqmd;h" msIAGfha jHqydj" ù wegfhka iy,a ,nd.ekSfï l%shdj,sfhaoS th mdysk m%udKh" n;a msiSfï l%ufhõoh fukau iy,a wegfha wka;¾.; fm%daàk" fïoh iy laIqø fmdaIl j, m%udKh wdoS jYfhks' óg fmr i|yka l<dla fuka Fragrant ndiau;S iy,a j, we;af;a os.= isyska wvq .a,hsisñla o¾Ylhla m%lg lrjk iy,a weghls' DM

DOCTOR MAGAZINE

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D•Magazine /

Second-hand smoke wkqkf a .a mõ lr.eiSu fkdfyd;a wl%h S ÿï mdkh

The evidence is clear that second-hand smoke can cause lung cancer and other health problems like heart disease. It may also increase the risk of some other types of cancer too. Most harmful tobacco smoke is invisible, but travels through the air and lingers. It can also build up on surfaces and clothes.

wkqkaf.a mõ lr.eiSu fkdfyd;a wl%Sh ÿï mdkh fmKy¿ ms<sld yd ;j;a frda. /ila we;s ùfï wjodku fï ksid ksielfhkau by< kexfjkjd'''

ÿ

ï mdkh lsÍu fi!LHhg wys;lrhs' th wka flfklaf.a is.rÜgqjlska kef.k ÿula jQj;a wys; lr nfjys" wjodkfuys wvqjla kï kE'

hï flfkla ÿï mdkh lrk úg ta ;eke;a;df.a fmky¿ j,g hkafka ÿfuka iq¿ m%udKhla' b;sß ÿï ish,a, jd;fha /f|kjd' tajd wd>%dKh lrkafka ÿï

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September 2019

DOCTOR MAGAZINE

mdkh fkdlrk wh' fï wdldrfhka wks;a whf.a ÿu ;uka ;uka wd>%dKh lsÍu zzwl%sh ÿïmdkhzz fkdfyd;a Secondhand smoke hkqfjkao y÷kajkjd' úfYaIfhkau ÿïmdkh lrk flfkla mjqf,a idudðlhl= jQ úg úYd, jYfhka tu mjqf,a wfkla ish¿ fokdu fï ÿï wl%Sh jYfhka mdkh lrkjd' úi ridhk ydroyilg jeä ixLHdjla ÿïjeáfhys ;sfnkjd ÿï mdkh lsÍu ksid úI iys; ridhk øjH 4000 lg jeä ixLHdjla wd>%Kh fjk nj y÷kdf.k ;sfnkjd' fï ridhksl øjH j,ska wvq ;rñka foish mkylg jeä ixLHdjla hï wmg hï frda.dndO we;s lsÍug rel=,la fjk nj ryila fkdfõ' m¾fhaIKj,ska y÷kdf.k we;s wdldrhg fuu wl%sh ÿïmdkh ksid fmky¿ ms<sld je<£fï wjodku wjodku 30] lska by< hkjd' ta wdldrfhkau ;j;a

doctormagazine.lk

fndfyda ms<sld we;sùfï wjodku by< hkjd' ta jf.au yDoh jia;=j ÿ¾j, ùu ;j;a fndfyda f,v frda. fuh wl%Sh ÿïmdkh ksid flfkl=g we;s fjkak mq¿jka' reêrh wef,k iq¿ Ndjhg m;alsÍu ÿï mdkfhys tla wksgq m%;sM,hla' ks;r ks;r wl%Sh ÿï mdkhg ,la ùfukq;a fï isÿùuu fjkakg mq¿jka' fuys m%;sM<hla f,i reêrfha fldf,iagfrda,a uÜgu" úfYaIfhkau krl fldf,iagfrda,a uÜgu by< hkjd' reêr kd, u; fïoh ;ekam;a

doctormagazine.lk

fjkjd' fï ksid yDohdndO fukau wxYNd. ;;a;ajh we;sùfï wjodkuo by< hkjd' wl%Sh ÿï mdkh ksid jvd;au wjodkug ,la jkafka l=vd orejka' ta whf.a fkdfïrE YÍrhg jvd fõ.j;aj ÿfuys we;s krl øjH wjfYdaIKh fjkjd' fï ksid orejkag we;s úh yels wjodkï iy.; ;;a;aj lsysmhla my; olajkakï' ² fya;=jla lsj fkdyels yÈis ñhhdu ñhhdï Sudden infant death syndrome ² iajik wdndO fn%dkalhsáia fukau weÿu ksõfudakshd wd§ ;;a;aj we;sùfï jeä wjodkula we;sfjkjd ² lfka we;sjk wdidok ² È.=ld,Sk leiai kQmka orejdg wl%Sh ÿïmdkh b;d wys;lrhs ldka;djlf.a .¾NŒ wjêfha§ ÿï mdkh lsÍu fukau wl%Sh ÿïmdkhg ,laùuo b;d krl m%;sm, we;s lrkjd úfYaIfhkau fuys úI fldgia kQmka orejdg wjfYdaIKh ùu b;du wys;lrhs fï ksid wvq nr ore

September 2019

DOCTOR MAGAZINE

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D•Magazine /

wkqkaf.a mõ lr.eiSu fkdfyd;a wl%Sh ÿï mdkh

Second-hand smoke

Wm;a we;sùu" fkdfïrE ore Wm;a we;sùu" orejdf.a ufkdaNdjhkaf.a ;=<s;;djh ì| jeàu wd§ jYfhka È.= ld,Skj krl m%;súmdl /ila we;s lsÍug wl%sh ÿïmdkh fya;=fjkjd

ta wkqj Tnf.a fi!LH ;;a;ajh iqrlaIs;j mj;ajd .ekSug Tngo iudc j.lSula ;sfnkjd'

fï ksid ldka;dj ÿï mdkh fkdlr isáh;a ;ukaf.a ieñhd ÿï mdkfha fhfokjd kï" úfYaIfhkau .¾NŒ wjêfha§ we;sjk ÿï mdkfhys krl m%;sM, j,ska ñ§ug fjfiiskau ÿïfndk ieñhdg wdikakfha fkdisg ksielfhkau Wmfoia ,ndÈh hq;=hs'

yenehs wl%sh ÿïmdkh wmrdOhla Bg fya;=j jkafka fï Tfí ÿisß; ksid wk;=rg jefgk Tn muKla fkdfjk ksihs' Tn wdikakfha isák flkdo Tn ksid wk;=rg jefgk ksihs'

l=vd orejka yd .eì‚ ldka;djka wdikakfha ÿï mdkh lsÍu úYd, wmrdOhla Tfí iajdñ mqreIhd" Tfí mshd" Tfí ifydaorhd ksfjfia isg ÿï mdkh lrkjd kï Tyqg ÿïmdkfhka ñfokakg fkdyels kï wvq ;rfï wka wh wdikakfha isg ÿïmdkfhys fh§fuka j,lskakg fyda Wmfoia ,nd fokak' úfYaIfhkau l=vd orejka yd .eì‚ ldka;djka wdikakfha ÿï mdkh lsÍu úYd, wmrdOhla' ÿï mdkh lsÍu ksid ms<sld we;sjk ia:dk lsysmhla iajrd,h" W.=r" kdih" fldagrl" fud<h" uq;%dYh" .=oh" wdudYh iy mshhqre ÿï mdkh ksid orejkag we;súh yels ms<sld lsysmhla ,sïf*daudj" ,shqflañhd" wlaud .; ms<sld ta jf.au fud<fha ms<sld ÿïmdkh mdkh lrk Tn lrkafka b;d jeros jevla ÿïmdkh mdkh lrk idudðlhka isák mjq,aj, orejka ks;r ks;r wikSm jk njo m¾fhaIlhka úiska y÷kdf.k ;sfnkjd' ;j;a flfkl=f.a ;nd ;udf.a fi!LHh j;a wk;=frys fy,Su jrola' úfYaIfhkau wo fi!LHh fjkqfjka rch úYd, uqo,la jeh lrkjd' kuq;a ck;djg ish¨‍ fi!LH fiajdjka ,nd fokafka fkdñ,fha' Tn fÉ;kdkaú;ju Tfí fi!LHh wk;=f¾ fyÆ úg Tng m%;sldr lrkakg ck;djf.a nÿ uqo,a wjYH fjkjd'

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September 2019

DOCTOR MAGAZINE

úfYaIfhkau ksjfia§" jevfmdf<a§ Tn ÿïmdkh ÿï mdkh lrkjd kï fï Tnf.a ÿisß; ksid wk;=rg jefgkafka Tfí Nd¾hdj" orejka" ujqmh s ka" ifydaor ifydaoßhka ke;akï Tnf.a ys;j;=k'a fï ksid m<uqfldgu ÿïmdkh lsßfï ÿisßf;ka je<lSug Tn is;g .kak' Tng th l< fkdyelsu fohla kï muKla wvq ;rfï Tfí Nd¾hdjka Nd¾hdj" orejka" ifydaor ifydaoßhka <Õu ys;ñ;=rka ys;ñ;=rka''' fï whg tys wys;lr n,mEu we;s ùfuka j<lajd .ekSug Tfí ÿïmdkh Tjqka ke;s ;ekl isg j;a lrkakg yqre fjkak' DM

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Aesthetic & Cosmetic Center fk;g ri÷kla jka rEmY%Shla''' oeka" ACC by Ninewells fj;ska

fk;g ri÷kla jka rEmY%Shla''' oeka" ACC by Ninewells fj;ska

zzTngu ysñ Tfí fid÷re rej iïm;'''ZZ úYajdiKSh;ajfhka hqla;j Tma kxjd .kakg wm fj; meñfKkak

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September 2019

DOCTOR MAGAZINE

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ud

;D yd <ud i;aldr iïnkaOfhka khskafj,aia frday,g we;af;a úYsIAG jQ lS¾;s kduhls' ljo;a ks¾udKYS,S m%fõYhka Tiafia Y%S ,dxflah ck;djg úÿyqre ffjoH ;dlaIKfha kj udkhka y÷kajd fok khskafj,aia frday, ;j;a iqúfYAIS w;aoelSula Tn fjkqfjkau ;s<sK lsÍug oeka wjia:dj Wod lrf.k ;sfí' ta Tiafia Tfí fidªre rej iïm; jvd;a Tma kxjd .ekSug" ta Tiafia Tnf.a iudcYS,S cSú;h iy wd;au úYAjdih mokï lr.;a ia:djr mokul msysgd .; lrkakg Tng wdkkaokSh jQ wjia:djla i,iñks'

iqkaor;ajh m%j¾Okh yd rEm,djKH ms<sn|j uOHia:dkh Aesthetic & Cosmetic Centre by Ninewells (ACC by Ninewells) khskafj,aia mjqf,a kj;u idudðlhd''' oeka Tn fjkqfjkau iqúfYAIS jQ fiajdjl fhoSug oeka fmruqK f.k isà' ACC by Ninewells ;=<ska iqkaor;ajh jeä lsÍu yd rEm,djKH yd ldh ieliqu iïnkaO kQ;k ks¾udKd;aul l%ufõohka j,ska ysiflia" iu iy iuia; YÍrh i|ydu mßmQ¾K m%;sldr mrdihla Tn fj; ,nd fohs' iqkaor;ajh Tma kxjk yd rEm,djKH m%;sl¾u yd ie;alï j, wruqK jkafka ifï iquqÿ‍ nj" /<s" le<e,a" bkakka" j¾Kl iy liver spots jeks jhia.; ùfï i,l=Kq wju lsÍu i|yd rEm,djKHfõoh iydhg .ekSuhs' YÍrfha wu;r fïoh" fi,shq,hsÜ" isref¾ wkjYH ia:dk j, we;sfjk flia" iu wjmeye .ekaùu iy kyr .eg.eiSu i|yd m%;sldr lsÍfï§o th ;SrKd;aul jQ ld¾hNdrhla bgq lrhs' ACC by Ninewells úiska Y,Huh fkdjk m%;sldr yd Y,Hl¾u fukau iu i|yd Wiia ;;a;ajfha m%;sldr fukau Body contouring yd YÍrfha nr wvq lr .ekSfï m%;sldr i|ydo kjH jQ myiqlï imhhs'

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cd;Hka;r mqyqKqj ,;a ffjoHjreka iy úfYaI{ ma,diaála Y,H ffjoHjreka Plastic Surgeon, p¾u frda. úfYAI{ ffjoHjreka Dermatologists fukau ukd mqyqKqj ,;a ld¾h uKav,hla iuÕ úYsIAG;u m%;sldr ,nd §ug lemù isá;s'

fuu ish¨‍ m%;sl¾u jvd;a ie<ls,af,ka f;dard fírd.;a wdrlaIdldÍ m%;sldr jk w;r ;u is;eÕs mßos Tngo f;dard .ekSfï úi,a mrdihla ;sfí' fï rEm,djKH l%shdud¾. Tiafia Tfí Ôjk ;;a;ajh" udkisl hymeje;au iy iudcYS,S l%shdldß;ajh ie<lsh hq;= f,i jeä ÈhqKq l< yelsh' wm fuys Y,Huh fkdjk l%shd mámdá hkqfjka oelafjk m%;sldr l%u (Non-invasive or minimally invasive) ks¾úkaokhlska f;drj fyda ysß jeÜgùulska muKla isÿ l< yelsh'

September 2019

DOCTOR MAGAZINE

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D•Magazine /

fk;g ri÷kla jka rEmY%Shla''' oeka" ACC by Ninewells fj;ska

Aesthetic & Cosmetic Center

ACC by Ninewells Y,Huh fkdjk m%;sldr ² Chemical Peel ñh.sh ffi, bj;a lr ;reK yd fi!LH iïmkak iula ,nd .ekSu fuu.ska isÿ flf¾' thg fhdod .kafka ffjoH úoHd;aulj ilid .;a wdrlaIdldÍ ødjKhls' fuu m%;sldrh l=re,E iy l=re,E le<e,a" ksh iy iu wjmeye .ekaùï i|yd b;d fhda.H fõ' ² Botox fndfgdlaia - iug wj,iaikla f.k fok ishqï f¾Ld$ifuys /<s wvq lsÍug fhdod. kakd wdrlaIdldÍ m%;sldrhls' tkak;a u.ska fuu m%;sldrh ,nd fohs' ² Fillers msrjqï - uqyqKg iß,k mßudjla iy msßmqka njla tla lsÍug fuu Fillers fya;= fjhs' fuh ;=kS f;d,a" uqyqfKa fkd.eUqre m%foaY iy /<s bj;a lsÍug mjd Ndú;d lrk m%;sldrhls'

ie;alï (Plastic surgery) we;=<;a fõ' ² uqyqK - Blepharoplasty ^weismsh i|yd lrk ie;alï&" f*aia ,s*aÜ" rhsfkdma,diaá “Nose Job” f,i idudkHfhka ye¢kafõ" oaú;aj kslg wvq lsÍu (Double Chin Reduction)" kslg ;ekam;= lsÍï iy lïuq,a ;ekam;= (Chin implants and Cheek Implants) ² Neck Lift

² Y,H fkdjk fjk;a l%shd mámdá w;rg Micro Needling" kyr .eg .eiSu i|yd m%;sldr lsÍu" l=re,E fukau l=re,E le<e,a j,g m%;sldr lsÍu" uqyfKA" iu u; bkakka bj;a lsÍu fuysoS isÿ lrKQ ,nhs'

² Body Contouring procedures ,hssfmdilaIka" mshhqre Tijd ;eîu" mshhqre j, m%udKh jeä lsÍu iy wvq lsÍu (Breast Lift, Breast Augmentation and Reduction)" “Tummy Tuck” f,i idudkHfhka y÷kajk Worh isyska lrk ie;alu" ks;U fmKqu jeä lsÍu (Buttock Augmentation) yd n;a flkavd m%foaYh fmKqu jeä lsÍu (Calf Augmentation)'

ACC by Ninewells Y,Huh m%;sldr rEm,djKH Y,Huh m%;sldr w;rg m%Odk jYfhkau uqLh yd yKq wdY%h lr.;a ie;alï (Oral and maxillofacial surgery)" YÍrh m%;sks¾udKh lsÍfï ie;alï (Reconstructive surgery) iy ma,diaála

² ldka;djka i|yd .¾NKSNdjhg fmr mej;S YÍrhg kej; meñŒug lrk m%;sl¾u (Mummy make over)

² Laser Procedures f,ai¾ m%;sldrh - uqyqfKa iy YÍrfha wkjYH frdau bj;a lsÍu" Tatoo bj;a lsÍu" Wmka ,m bj;a lsÍu" ifuys le<e,a bj;a lsÍu" uqyqfKa fmKqu Tma kexùfuka kejqï iula ,nd .ekSu we;=<;a fõ' ² Platelet Rich Plasma (PRP) mÜáld iys; ma,diaud m%;sldrh - ;ukaf.au reêrh fhdod .kshs' ifï fyda ysialnf,a .eg¿ iys; m%foaYj,g tkak;a lrkq ,efí' fuu m%;sldrh úfYaIfhka ysiflia yd ifï fmKqu hym;a lsÍu" /<s" l=re,E le<e,a wju lsÍu iy ysiflia j¾Okh Èßu;a lsÍu i|yd fhdod .kS'

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doctormagazine.lk

² kdßfõoh yd ine|S m%;sks¾udK ie;alï (Gynae cosmetic procedures) ² Gynaecomastia corrections msßñkaf.a jeäfhka j¾Okh jQ mmq m%foaYh wvq lsÍu ACC by Ninewells kùk ;dlaIKh rej m%j¾Okh yd rEm,djKH fuj<ï i|yd f,dj iqm%isoaO fj<| ikakduh jk Lumenis f,ai¾ ;dlaIKh yd WmlrK Ndú;d lsÍu isÿ flf¾' ACC by Ninewells u.ska fuu Wiia ikakduhka muKla Ndú;d lrkafka Tng úYAjdiodhS yd jvd;a mßmQ¾K fiajdjla iy" Tfí is;eÕs j,g;a jeä fiajdjla iy;sl lrKQ msKsih' ACC by Ninewells jD;a;ShfõoS ld¾huKav,h cd;Hka;r mqyqKqj ,;a ffjoHjreka iy úfYaI{ ma,diaála Y,H ffjoHjreka Plastic Surgeon, p¾u frda. úfYAI{ ffjoHjreka Dermatologists fukau ukd mqyqKqj ,;a ld¾h uKav,hla iuÕ úYsIAG;u m%;sldr ,nd §ug lemù isá;s' doctormagazine.lk

ACC by Ninewells fiajh iïnkaO iqúfYAI;d wmf.a fiajdodhlhskaf.a fm!oa.,sl;ajh iy ryiHNdjh iy;sl lsÍu" wju fmdfrd;a;= ld,hla idlaId;a lsÍu" m%N+ úfYaIs; m%fõYhla" ì,am;a f.ùï i|yd mßY%fhaoSu wjia:dj ie,iSu (In room bill Payment)" w;s iqfLdamfNda.S jgmsgdjl isg fiajd iemhSu" miq úmrï wdoS iqúfYAIS fiajdjka /ila fj;ska ,nd.; yels jkq we;' fi!LHiïmkak iy ksfrda.su;a Ôjk rgdjla mj;ajd .ekSu ieuúgu mqoa.,fhl=g i;=áka msß Ôú;hla .; lsÍug;a" iuia;hla jYfhka ;reK fmKQu os.=ld,Skj wdrlaId lr.ekSug;a WmldÍ jk w;r tuÕska ksfrda.S YÍrhla" meyeÈ,s ukila iy w,xldr uk nkaokSh fmKqula ,efnkq we;' Aesthetic & Cosmetic Centre by Ninewells u.ska Tfí ieÕjqKQ w,xldrh Tma kxjñka úYajdikSh;ajhlska hqla;j Tfí rEm fYdaNdj mßmQ¾K;ajhlg f.k tkakg''' kjH jQ fmKQulska Tfí osúh wre;anr lr.kakg Tng wk.s wjia:djla Wod lrhs' DM jeä úia;r i|yd wu;kak

ÿrl;k( 0112049907 Facebook( khskafj,aia frday, Instagram: ninewells_acc_lk Email( aes.coscentre@ninewellscare.com ,smskh( 10 jk uy," khskafj,aia frday," 55$1" lsßuKav, udj;" kdrfykamsg" fld<U 05'

September 2019

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doctormagazine.lk

yo uvf,a ú;a;s iEu jirlu iema;eïn¾ 29 zzf,dal yoj;a oskhZZ f,i kï lr ;sfí' cSj;a ùug wjYHfhkau jeo.;a jk zzcSj bkaøsh jk yoj; - f,dalfha jeäu urK ixLHdjlg fya;=jk bkaøsh njgo m;aj ;sfí' cSú;hg;a" urKhg;a folgu tl fia jeo.;a jk zzyoj;ZZ iïnkaOfhka uQ,sl wjfndaOhla ,nd oSug wm .;a mßY%uhls fï'''

f,dal yoj;a oskh iema;eïn¾ 29 MY HEART, for YOUR HEART, for ALL OUR HEARTS zzyDo frda. wo f,dalfha wxl tfla urK j,g fya;=jhs' kuq;a th fï wdldrfhka úh hq;= ke;' wmf.a Ôú;j, iq¿ fjkialï lsysmhla lsÍfuka" wmf.a yDo frda. wjodku wju lr .; yels w;ru wmf.a Ôjk ;;a;ajh jeäÈhqKq lr B<Õ mrïmrdjg fyd| wdo¾Yhla ,ndosh yelsh' th Tngu" Tn .ek ie,ls,su;a jk mqoa.,hskag iy f,dj mqrd isák mqoa.,hskag" —uf.a yoj; iy Tfí yoj; /ln,d .ekSug ug oeka l=ula l< yelso@˜ fuh fujr yoj;a oskfha f;audjhs'

D•Magazine /

Laboratory Tests Explained jvd;a úYAjdiodhS fïo me;slv ^fldf,iagfrda,a& mÍlaIdjla

Non HDL Cholesterol jvd;a úYAjdiodhS fïo me;slv ^fldf,iagfrda,a& mÍlaIdjla HDL fkdjk fldf,iagfrda,a wdisß ridhkd.dr fiajdfõ wOHlaI kS,a m%sh;a fcdaka úisks

Lipid Profile hkqfjka m%p,s;j we;af;a wo iq,nj Ndú;fha mj;sk reêrjdyskS.; fïo m%udK y÷kdf.k tu.ska yDo frda. wjodku fmrhSfï mÍlaIKhhs' ridhkd.dr ffjoH úoHdj flfuka mßKduh jkakls' lafIA;%fha kj mrdñ;ska flfryS m¾fhaIlhka ksn|ju ie<ls<su;a jk w;r jvd;a ksjerosj yDo frda. wjodku fmrhSug iu;a hhs y÷kd.;a kj fïo mÍlaIdjla oeka flfuka m%p,s; fjñka mj;S' ta Non HDL Cholesterol mÍlaIKhhs' we;eï m¾fhaIlhkaf.a woyig wkQj fuu kjH mÍlaIKfhka Lipid Profile mÍlaIdfõ wx.hla jk LDL muKla uekSug jvd yDo frda. we;sùfï wjodku jvd;a ksjerosj ;lafiare l< yels njhs' Tng by< g%hs.a,sirhsv (High triglycerides) uÜgula ;sfí kï fuh úfYaIfhka i;H fõ' Tfí iïmQ¾K fldf,iagfrda,a (Total cholesterol) j,ska Tfí HDL fldf,iagfrda,a (HDL cholesterol) wvq lsÍfuka Tfí HDL fkdjk fldf,iagfrda,a (Non HDL Cholesterol) uÜgu fidhd.; yelsh' ia:q,;djh" Èhjeähdj iy mßjD;a;Sh iskafv%dauh jeks fnda fkdjk frda. ful, fnfyúka by< w.hlska jd¾;d jk ksid thska we;súh yels yoj;a 36

September 2019

DOCTOR MAGAZINE

doctormagazine.lk

fldf,iagfrda,a mÍlaIKhla (Lipid Profile) i|yd Tfí reêrh ,nd .;a úg ,efnk jd¾;dfõ idudkHfhka ldKAv y;rl m%;sM< oelafõ'

frda. ixl+,;djfhka ñoSug reêrfha HDL fkdjk fldf,iagfrda,a uÜgu wvq lsÍu jv jvd;a jeo.;a b,lalhla njg m;afjñka ;sfí' fï i|yd Ôjk rgdfõ we;s lr.kakd fjkialï jákd ld¾hNdrhla isÿ lrhs' m¾fhaIK j,ska fy<sorõ ù we;s wdldrhg non-HDL cholesterol md,kh lsÍu u.ska yd T!IO m%;sldr Tiafia fï wjodku id¾:l f,i md,kh lsÍug wjia:dj ;sfí' fuu non-HDL-C mÍlaIKh isÿ lsÍu i|yd ksrdydr reêr idïm,hla fasting sample wjYH fkdùu jdishls' g%hs.a,sirhsv w.h > 200 mg / dl jk úg non-HDL-C oaú;shsl b,lalhla f,i wvq lsÍug kj;u ud¾f.damfoaY u.ska ks¾foaY lr ;sfí'

Non HDL Cholesterol mÍlaIdj wo fndfyda rgj, mD:q,j ckm%h s ;ajhg m;a mÍlaIdjls

doctormagazine.lk

wvq >k;aj ,sfmdfm%daàka Lowdensity lipoprotein (LDL) cholesterol wê >k;aj ,sfmdfm%daàka Highdensity lipoprotein (HDL) cholesterol g%hs.a,sirhsv triglycerides iy iïmQ¾K fldf,iagfrda,a Total Cholesterol

yoj;a frda. iïnkaOfhka jvd;a ksrjoH mqfrdal:k imhkjd

Total Cholesterol hkq Tfí LDL iy HDLys tl;=jla hehs Tn is;=j;a" thg b;d wvq >k;aj ,sfmdfm%daàka Very-low-density lipoprotein (VLDL) o we;=<;a fõ' fuu VLDL wxY= g%hs.a,sirhsv mgl fj; f.k hk w;r wjidkfha LDL njg m;afõ' LDL fukau"

September 2019

DOCTOR MAGAZINE

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D•Magazine /

jvd;a úYAjdiodhS fïo me;slv ^fldf,iagfrda,a& mÍlaIdjla

Laboratory Tests Explained

fï mÍlaIKh isÿ lsÍug ksrdydrj isàugo wjYH fkdfõ'''

fyd| fldf,iagfrda,a yd krl fldf,iagfrda,a reêr kd, ;=< yeisfrkafka fohdldrhlg nj fuu igyfkka meyeos,s jkq we;

VLDLo Ouks wNHka;rfha fldf,iagfrda,a iE§ug fya;= jk w;r Ouks wjysr jkksid fï folu kqiqÿiq hehs ie,fla" tneúka VLDL iy LDL w.hka jeä jk ;rug yDo frda. we;sùfï wjodku jeä fõ' VLDL fldf,iagfrda,a uekSug ir," iDcq l%uhla fkdue;" tneúka th idudkH fldf,iagfrda,a mÍlaIdjl§ ksYAÑ; w.hla f,i igyka fkdfõ' tkuq;a VLDL fldf,iagfrda,a idudkHfhka Tfí g%hs.a,sirhsâ w.fhys m%;sY;hla f,i .Kka n,d we;' we;a; jYfhkau" LDLiDcqju ueksh yels jqjo" fndfyda ridhkd.dr fï flfryS t;rï ie<ls<su;a jk ihla fkdfmfka' ta fjkqjg" Tjqka Tfí wfkl=;a ,smsv w.hka u; mokï jQ ir, iQ;%hla Ndú;d lrñka LDL .Kkh lrhs' fndfyda mqoa.,hska i|yd" .Kkh lrk ,o LDL iDcqju uksk ,o LDL ms<sn| fyd| ;lafiarejla imhhs' kuq;a reêrfha g%hs.a,sirhsv jeä jk úg .Kkh lrk ,o LDL j, ksrjoH;djh wvqh' úfYaIfhka 400 mg/ dLg jvd ^mg/ dL&" g%hs.a,sirhsv jeä jk úg ksjerÈ ñkqula ,nd .; yels tlu l%uh LDL fl,skau uekSuhs' ^tu w.h b;d by< hehs ie,fla' idudkH g%hs.a,sirhsv w.h 150 mg/dL g jvd wvq úh hq;=h'&

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tjeks wjia:dj,§ g%hs.a,sirhsv j, reêr uÜgu Tn wdydrhg .;a fõ,dj iy fõ,dj wkqj fjkia fjhs' fï ksid fndfyda fldf,iagfrda,a mÍlaIK isÿ lrkq ,nkafka mqoa.,fhl= wju jYfhka meh 12 la ksrdydrj isàfuka miqjh' flfia fj;;a" Non HDL Cholesterol .Kkh lsÍu g%hs.a,sirhsâ w.h u; r|d fkdmj;sk neúka ksrdydrj isàug wjYH;djhla fkdue;' Tn ksrdydrj isáh;a ke;;a m%;sM< iudk fõ' ;jo" Non HDL Cholesterol w.h yDo frda. i|yd jeä wjodkula iuÕ iïnkaO ù we;s ish¨‍u m%Odk ,hsfmdfm%daàk ms<sìUq lrhs' kj;u wOHhk j,g wkQj" Non HDL Cholesterol Èhjeähdfjka fmf<k msßñka iy ldka;djka ;=< fud<fha reêr jdyskS.; wjysr;d ms<sn| m%n, mqfrdal:khla fjhs' DM doctormagazine.lk

Asiri Hospital Holdings PLC The Central Hospital Asiri Surgical Hospital PLC Centres & Labs

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

181, Kirula Rd, Narahenpita, Col-5 011 - 4523355/356/357 prlab@asiri.lk 114, Norris Canal Rd, Col-10 011 - 4665500 / 077 - 2092847 chllab@asiri.lk 21, Kirimandala Mw,Col-5 011 - 4524400 / 48 microlab@asiri.lk

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

Address

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

Telephone

E-Mail

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

DM

Rheumatic Heart Disease zykaÈ f,jlk" yoj; imdlk f,fâZ''' rEueál yoj;a wdndO

Rheumatic Heart Disease zykaÈ f,jlk" yoj; imdlk f,fâZ''' rEueál yoj;a wdndO A condition in which the heart valves have been permanently damaged by rheumatic fever. The heart valve damage may start shortly after untreated or under-treated streptococcal infection such as strep throat or scarlet fever.

rE

uál WK wfma rfÜ orejka w;r nyq,j olakg ,efnk frda. ;;a;ajhla' thg fkdmudj m%;sldr .; hq;=hs' tfia fkdjqKfyd;a l,la hk úg fï frda.h ksid yoj; f,v fjkjd' yojf;a lmdg ÿ¾j, fjkjd' jeäfhkau ydkshg m;a jkafka jï fldaIsldfõ isg jï l¾Ksldjg reêrh f.k hk oaú;=Kav lmdgh fyj;a uhsg¾ lmdghhs' frda.h mj;akd úg fï lmdg j, mshka m;a m%odyhg k;= ù bÈuqulg ,la fjkjd' mshkam;a >K ùula isÿ fjkjd' fï lmdg ÿ¾j, jQ úg reêrh kshñ; mßÈ .ukd.ukhl fhfokafka kE' tu;=o fkdfjhs" f,a

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wdmiq .e,Sug;a by<ska we;s jï l¾Ksldj u; reêr mSvkh jeä ùug;a fya;= fjkjd' lmdg ÿ¾j, jQ úg lrk m%;sldr miqjg ±lafjk ksid ±ka wms fï rEuál WK yd ine|s lreKq ye±Íula lruq' rEuál WK yokakg fya;= jkafka nelaàßhdjla' tu nelaàßhdfõ ku iafg%mafgdfldlia' we;eï orejkag fï WK msg oukakg fmr fiïf.ä bÈóula" W.=r ne/Kaä ùula we;s úh yelshs' nelaàßhd isrerg we;=`M ùfuka miq isrer ;=< we;sjk wdid;añl;djhla óg uq,ajk njg u;hla ;sfnkjd' flfia fj;;a frda.h mgka .kafka ykaÈ wdY%s; fõokdjla" r;ameye .ekSula yd bÈóula jYfhka oKysi" uekslalgqj yd j<¨lr jeä jYfhka bÈuqug ,la fjkjd' iEu ykaÈhlau bÈfukafka tlmdrgu fkdfjhs' yqiau .ekSfï wmyiqjla fyda mmqfõ fõokdjla we;s jkafka fï frda.h yoj;a j,g me;sr we;s ksihs'

doctormagazine.lk

idudkH yoj;a lmdghla

fï frda.hg f.dÿre jQ <uhskaf.a YÍrfha úfYaIfhkau uqyqfKa Èfõ yd w;aj, wiajdNdúl p,k we;s úh yelshs' fï frda.h zykaÈ f,jlk" yoj; imdlk f,fâZ f,i ye|skafjkjd' ykaÈ j,g fõokd f.k fokjd' tA;a bka iaÓridr ydkshla kE' tA;a" yoj; kï imd lkjd' thhs j<lajd.; hq;af;a'

wdidokhg ,lajSfuka ydkshg m;a jQ yoj;a lmdghla

rEuál yDo frda.h

uyd Ouksl lmdgh idudkH fmKqu

wdidokhg ,laùfuka úkdYhg ,lafjk lmdgh yoj; yrialv igykla

rEueál yoj;a frda.h ksid lmdg ydkshg m;a jk yeá yojf;ys jïmig jkakg we;s lmdg fï reueál yoj;a frda.h ksid fjfiiska ydkshg ,la fjhs

;%S;=kav lmdgh wdidokhg ,laùfuka ydkshg m;ajQ ;%S;=kav lmdgh

doctormagazine.lk

rEuál WK we;s jQ miq úlsrK PhdrEm" ECG igykla ,ndf.k uQ,sl we.hSula lrkjd' fõokd iykhg weiam%ska wd§ fnfy;a fokjd' jrla je<÷kq miq kej; kej;;a rEuál WK we;súh yels ksid thg úiÿula f,i fnkai;ska fmksis,ska kslafIamKh ,nd fokjd' yDo lmdg j,g ydks isÿ ù we;s frda.Ska Èú we;s f;lau fmksis,ska tkak; ,nd.; hq;=hs' tfia fkdjqj;a lmdg bÈuqula fyda ,lajqKs kï hg;a msßfihska jir 25 la iïmQ¾K jk;=re j;a tkak;a udislj ,nd.; hq;= fjkjd' yDo lmdg j,g n,mEula isÿ ù fkdue;s kï jhi wjqreÿ 18 iïmQ¾K jkf;la fyda jir myl ld,hla m%;sldr ,nd.; hq;= fjkjd' DM

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Conduction system of the heart yojf;a ikakdhl moaO;sh

CONDUCTION SYSTEM OF THE HEART

Tfí yoj; ;=< úoHq;a mßm:hla@

yojf;a ikakdhl moaO;sh

T

n okakjdo yoj; l%shd;aul jkafka úoHq;a mßm:hlska lsh,d@ tfyu lSjdg" ish,a,kaf.au yoj; ;=, jh¾ lE,s" negß ;sfhkjd lsh,d ys;kak tmd' fuu mßm:h ke;fyd;a —yDo ikakdhl moaO;sh˜ ^Conduction system of the heart& wmf.a yoj; ;=< úoahq;a wdfõ. l%udkql+,j fnod yer" l¾‚ld yd fldaIsld ßoauhdkql+,j ixfldapkh lsÍu isÿ lrhs' tu.ska yoj; M,odhS reêr fmdïmhla njg m;a lrhs' fuys ksjeros l%shdldß;ajh wmg wjYHfhkau jeo.;a fõ' th wvmK ùfuka wmf.a urKh mjd isÿúh yelsh'

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yDo ikakdhl moaO;sh iE§ ;sfnkafka úfYaIs; yDo ffi, udos,shla weiqßks' kuq;a ta .ek l;d lrkak fmrd;=j yojf;a we;s udxY fmaYs ffi, fyj;a yDo ffi, .ek hula lsj hq;=hs' yoj;a ffi, úYañ;hs''' fï tys ,laIK udxY fmaYs ffi, j, úfYaIKh jQ ffi, úfYAIhla' fï tys iqúfYaIs;d' 01' welaáka ^Actin& yd ufhdaiska ^Myosin& hk fm%daàk msysàu u.ska yDohg ixfldapkh ùug yelsùu' ^yDoh .efykjd lshkafka fuu ixfldapkh ùughs&' 02' iajdhla; Woa§ma;H;djh ^Intrinsic Excitability&" tkï ndysr wdfõ. hlska f;drj ixfldapkh ùfï yelshdj' idudkH udxY

doctormagazine.lk

^Pacemaker& wdfõ. ckkh lr yoj; mqrd fnod yer" uq¿ yoj;u tljr ßoañlj ixfldapkh lsÍug fï wka;ria;dms; uv, WmldÍ fõ' i;aj ffi, j, úfYaIs; ffi, j¾. jk iakdhq ffi, j, wdfõ. ckkh yd yd udxY fmaYS ffi, j, ixfldapkh isÿ jkafka b;d l=vd úÿ,s Odrdjla ffi, u.ska ckkh lsÍfuks' th ffi, mg,h yryd fidaähï ^Sodium) yd fmdgEishï ^Potassium& whk yqjudre lr úoahq;a úNjhla ^Electric potential& we;s lsÍfuka lrkq ,nhs' fmaYs ixfldapkhg" tu udxY fmaYs ffi, iakdhqjla u.ska úoahq;a wfõohla ,nd Èh hq;=fõ' kuq;a yDo ffi, iajhxl%Sh ßoañlj ixfldapkh ùfï yelshdjla we;' fuu ßoauh md,kh i|yd muKla iakdhq wdfõ. yd fydafudak WmldÍ fõ' 03' yDo ffi, we;s .ema ikaê ^Gap Junctions& j,ska ieÈ wka;ria;dms; uv, ^Intercalated discs& wdOdrfhka úoahq;a wdfõ. tl ffi,hl isg wfklg iïfma%IKh l< yels ùu'

doctormagazine.lk

yoj; ñákaa f.k isÿjk osú iqrlsk úÿ,s ckkh i;aj ffi, j, úfYaIs; ffi, j¾. jk iakdhq ffi, j, wdfõ. ckkh yd yd udxY fmaYs ffi, j, ixfldapkh isÿ jkafka b;d l=vd úÿ,s Odrdjla ffi, u.ska ckkh lsÍfuks' th ffi, mg,h yryd fidaähï ^Sodium& yd fmdgEishï ^Potassium& whk yqjudre lr úoahq;a úNjhla ^Electric potential& we;s lsÍfuka lrkq ,nhs' yojf;a iEu ffi,hlgu fjk fjku jQ iakdhq iemhqula ke;s w;r" yDo .;slrh

úÿ,s ckkfha oudrïNh iksgqyka lrk SA .eá;a; fuu moaO;sfha wdrïNl ,laIHh f,i ie,flkafka ihskqtaà%h fkdavh ^Sinoatrial node& fyj;a SA fkdavhhs' fuh msysgd ;sfnkafka W;a;r uyd Ysrdj" ol=Kq l¾‚ldjg we;=,a jk ia:dkhg wdikakj" ol=Kq l¾‚ldj ;=<hs' fuys we;s ffi, ñks;a;=jg 60-100 jdrhla olajd wdfõ. ckkh lsÍug yelshdjla orhs' yojf;a wks;a ish¨‍ yDo ffi, j,g jvd jeä fõ.hlska SA fkdav ffi, wdfõ. ckkh lr th yoj; .efyk fõ.h md,kh lrk ksid yDofha

September 2019

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yojf;a ikakdhl moaO;sh

Conduction system of the heart

yojf;a we;s fmaYs iqúfYaIS wkqj¾;khls

.;slrh ^Pacemaker& f,i ye¢kafjkjd' SAfkdavfha wdfõ. ckk fõ.h iakdhq iemhqu u.ska yd úúO fydafudak j, n,mEu u.ska md,kh flf¾' SA .eá;af;a ld¾hh Ndrh SA fkdavh ;=, ckkh jk wdfõ." ikakdhl ud¾. ;=kla u.ska ol=Kq l¾‚ldj ;=<go" nlauka nKav,h ^Buchmann’s bundle& u.ska jï l¾‚ldj fj;go f.k hhs' tu.ska l¾‚ld j, ixfldapkh ùu isÿfõ' by; i|yka ol=Kq l¾ksldfõ ikakdhl ud¾. ;=k u.ska tá%fhdajkaá%lshq,¾ fkdavh ^ Atrioventricular node& fyj;a AV fkdavh

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September 2019

fj; wdfõ. f.k tauo isÿfõ' AV fkdavh wka;¾ l¾‚l fldaIsl ì;a;sfha msysgk w;r ^by; rEmh n,kak&" fldaIsld fj; wdfõ. .uka lsÍu md,kh lrkq ,nkafka fu;eksks' idudkH l%shdldÍ yoj;l" fuu AVfkdavh u.ska wdfõ. fldaIsld fj; ksl=;a lsÍu mrlal= lsÍula isÿ lrhs' tys m%;sm,h jkafka fldaIsld l¾‚ld j,g miqj ixfldapkh ùuhs' fuys jeo.;alu kï l¾‚ld ixfldapkh ù tys we;s reêrh fldaIsld j,g ,ndÿka miqj muKla fldaIsld j, ixfldapkh wdrïN ùu isÿ lsÍuhs' AV fkdavhg miq wdfõ. ysia nkav,hg ^Bundle of His& .uka lrk w;r fuh folg fn§ jï yd ol=Kq fldaIsld fj; .uka lrhs' tu nKav, j,ska mk k.sk l=vd mlskafÊ ;ka;= ^Purkinje fibers& fldaIsld ì;a;shg wdfõ. imhd fldaIsld j, ixfldapkh isÿ lrhs' W!j m%N+jreka fï úia;r l, ms<sfj,g yoj; ;=< úoahq;a wdfõ. .uka lsÍu yd yDo iaMkaokh isÿùu wm ffjoH úoHdfõ§ ihskia‌ßoauh ^Sinus Rhythm& f,i y÷kajuq' fuhska úhqla; jk ßoauhla —weßoañhdjla˜ ^Arrhythmia& fkdfyd;a wiamkaohla f,i ye¢kafõ' DM Source: https://dostharamama.wordpress.com

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Fetal Heartbeat

l<,Sh yDoh yefok yeá

21 days after fertilization - the heart begins to beat. By 4 weeks, the heart typically beats between 105 and 121 times per minute.

l<,Sh yDoh yefok yeá uõl=i ;=< isák iufha§ l<,hl yDoh ks¾udKh jkafka ms<sis|Sfuka fkdfnda l,l§uh' ore .eng udi folla jk úg yDoh iïmQ¾Kfhkau ks¾udKh ù wjikah' m¾fhaIK j,g wkqj ixcdkSh yoj;a wdndO kï" m%;sikaêh isÿ jQ uq,a jljdkqfõ§u isÿ jkakla nj y÷kdf.k ;sfí' l<,hl yDoh l%shdldß;ajfha§ tys fmKy¿ j,g we;s iïnkaOh Ndú;d lrkafka ke;' jeäysá yoj;l kï fï wkqj jeäysáhl=f.ka yDoh ol=Kq miska fmky`M j,g flfrk reêr ixirKh l<,Sh yoj;lg wh;a lghq;a;la fkdfõ' orefjl= .¾NdIh ;=< .; lrk l<,rEmS iufha§ l¾Ksld fol w;r ysveila ;sîu wjYHhs' fï újrh foraman ovale f,i y÷kajk w;r orejd bm§fuka miq fmky`M jd;fhka msÍu;a iu.u fï isÿr idudkHfhka bfíu jeiS hkjd' tfia fkdjqkq úg th Patent Foraman Ovale f,i y÷kajkjd' Ductus Arteriosus hkq mqmamqiSh Ouksh yd uyd Ouksh hd lrñka fmky¿.; reêr .ukd.ukh fjkqjg

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l<,h fhdod .kakd úl,am reêr ixirKhg fhdod .kakd újrhhs' orejd bm§ meh lsysmhl isg Èk .Kkdjla we;=<; fï újrh jeiS hkafka Yajikh wdrïN lsÍu;a iu.hs' tfia fkdù Ductus arteriosus isÿr tf,u mej;Su Patent Ductus Arteriosus kñka yeÈkafõ'

l=i ;=<oS yoj; .efyk yeá ² uq,skau l=i ;=< l<,hl yoj;

doctormagazine.lk

.efykak wdrïN jkafka ms<sis§fuka osk 21loS muKh' ta jk úg yoj; w,afmfk;a;s ysilg jeä fkdfõ' t;eka mgka .;jk i;sh ;=< yoj; ñ,s óg¾ tll isg foll bkaøshla njg m;a jkafka oaú;aj jQ j¾Ok fõ.hla r|jd .ksñks' ² i;s yhl l<,hl yoj; úkdählg jdr 125la muK iamkaokh fjhs' th ;j;a i;shla muK .; jk úg úkdählg jdr 150l muK iamkao fõ.hla r|jd .kS' fï iamkao fõ.h ;j ÿrg;a by< kexfjñka wgjk i;sfhaoS úkdählg jdr 180l muK iamkao fõ.hla ,nd .kshs' bka miqj flfuka my< jefgk yoj; iamkao fõ.h l<,hg i;s 16la muK jk úg úkdählg jdr 120-160l muK ia:djr fõ.hla w;am;a lr .kshs' fï fõ.h orejd Wmosk ;=re yojf;ys mj;akd fõ.hhs'

uõl=ifhaoS l<,hl we;sjk uQ,sl bkaøshhla jkafka yDohhs' th áflka ál úlikh fjñka cSjh mj;ajd .ekSug WmldÍ jk whqre krUkak'

https://youtu.be/R93gu6OgENg

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Amazing function of the heart yoj; wmsg ys;d.kak;a neß ;rï w;s úYd, jdr .dKkla jev lrk yeá' fï wdldrfhka uefrk ;=rejg l%shd;aul jk wdldrhg th ksueù we;s wdldrh .ek Tn fudfyd;lg j;a is;=jdo@ we;af;kau tys ieleiau" l%shdldß;ajh .ek wmg wjfndaOhla ;sìh hq;=uhs' fï t i|yd wm .kakd ks¾udKYS,S W;aidyhla'

youv, fï jf.hs

Amazing function of the heart youv, fï jf.hs ñksia yoj; yeu ñks;a;=jlg jdr 60-100 olajd jdr .Kkla iamkaokh fjkjd' ojilg kï 100"000 jdrhla ú;r .efykjd' iamkaokh fjkjd' th jirlg ne¨‍fjd;a ñ,shk 30lg;a jvd jeähs' uq¿ Ôú; ld,h ;=< yojf;a iamkaokh ì,shk 2'5lg;a jvd jeähs' f,ais myiq kE' n,kak tl fmaIshla jk

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September 2019

DOCTOR MAGAZINE

yoj; ;sfhkafka <fha fu;ekhs wfma isrer mqrdjg reêrh fmdïm lrk yoj; kue;s fmdïmh msysg,d ;sfhkafka wmf.a Wria l+vqj ^Rib Cage& ueo" álla ú;r jï me;a;g nrj' jfÜgu b,weg ^Ribs& j,ska wdjrKh jQ" b;d wdrla‍Is; ;ekl ;ud fuh msysg,d ;sfhkafka' wmf.a mK yoj; u.ska imhkjd kï th fyd¢ka wdrlaId fj,d ;sfhkafka ´kfka' Tnf.a yoj; fldÉpr f,dl=o lsh,d ys;,d ;sfhkjd kï" idudkHfhka th ñg fud,jd .;a úg Tfí wf;a m%udKhg b;d iómhs'

doctormagazine.lk

youv, wNHka;r ieleiau úYañ;hs bÈßfha isg wmf.a yoj; ndysßka n,k úg fudgjQ w.%hla we;s fla;=jl yevhla .kakjd' th u;=msg yoj;g reêrh imhk lsÍgl Ouks yd Ysrd ^Coronary Arteries and Veins& oelsh yelshs' tajf.au yoj;g YÍrfha isg reêrh f.k tk uyd Ysrdo ^Superior Vena Cava and Inferior Vena Cava&" fmky¿ j,ska yoj;g reêrh f.k tk mqmamqYSh Ysrdo ^Right and Left Pulmonary Arteries& yoj;g msgqmiska msysgk w;r" yojf;a by, fldgiska wmf.a isrer fj; reêrh f.k hk uyd Ouksh ^Aorta) yd fmky¿ fj; reêrh f.k hk mqmamqYSh Ouksh ^Pulmonary Artery& oel.; yelsh' by; rEmfha oelsh fkdyels jqjo wm yoj; jg lrñka ;=kS

doctormagazine.lk

yDo w.%h ndysßka b;d ir, iajrEmhla .;a;o yoj; b;d ixlS¾K ieleiaula we;s b;d úfYaIs; wjhjhls' wmf.a yoj; yria lvl f.k ne¨‍jfyd;a th fldgia$l=àr y;rlg fn§ ;sfnkjd' ta jï yd ol=Kq l¾‚ld ^Left Atrium and Right Atrium& folla f,ig iy jï yd ol=Kq fldaIsld ^Left Ventricle and Right Ventricle& folla f,ighs'

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youv, fï jf.hs

Amazing function of the heart

mg, folla msysgkjd' tu mg, yDoh mg,h$fmßld¾ähu ^pericardium& f,i ye¢kafjk w;r tajd w;r we;s ysvei ;r,hlska ^Pericardial fluid& msÍ ;sfí' fuh yoj; iamkaokh ùu myiq lrk ,sysis øjHhla ^Lubricant& f,i l%shd lrk w;ru yoj;g wdrlaIdjo ,nd foa' yojf;a l=àr yDo w.%h ndysßka b;d ir, iajrEmhla .;a;o yoj; b;d ixlS¾K ieleiaula we;s b;d úfYaIs; wjhjhls' wmf.a yoj; yria lvl f.k ne¨‍jfyd;a th fldgia$l=àr y;rlg fn§ ;sfnkjd' ta jï yd ol=Kq l¾‚ld ^Left Atrium and Right Atrium& folla f,ig iy jï yd ol=Kq fldaIsld ^Left Ventricle and Right Ventricle& folla f,ighs' yojf;a ol=Kq mi isref¾ we;s Tlaiscka wvq reêrh ,ndf.k th Tlaiscka ,nd .ekSu i|yd fmky¿ fj; fmdïm lrk w;r jï mi fmky¿ j,ska ,efnk TlaisckSlD; reêrh kej; isrer

50

September 2019

mqrd fmdïm lrkq ,nhs' fufia fldgia j,g fn§u u.ska yoj; ;=, Tlaiscka wvq reêrh" Tlaiscka jeä reêrh yd ñY% ùu je<lafõ' yojf;a isÿrla ;sfnkjd hehs lshkqfha fuu l¾‚ld w;r fyda fldaIsld w;r widudkH újr ùula we;akïh' ol=Kq l¾‚ldjg uq¿ isref¾u isg kej; meñfKk reêrh ,nd fok W;a;r yd wOr uyd Ysrdj ^Superior and Inferior Vena Cava& újD; fõ' jï mi l¾‚ldjg fmky¿ j,ska kej; meñfKk reêrh ,nd fok mqmamqYSh Ysrd ^Pulmonary Veins& újD; fõ' ol=Kq fldaIsldfõ isg fmky¿ fj; Èfjk mqmamqYSh Ouksh ^Pulmonary Artery& wdrïN jk w;r jï fldaIsldfõ isg uq¿ isrergu TlaisckSlD; reêrh ,ndfok uyd Ouksh ^Aorta& wdrïN fõ' yojf;a lmdg j, l%shdldß;ajh yoj; ;=, reêr .ukd.ukh md,kh lsÍug fodrgq ke;akï lmdg ^Valves& lsysmhla msysgd ;sfnkjd' tu lmdg u.ska yDo l=àr ixfldapkh ù reêrh fmdïm l, miq" kej; tu l=àrh fj; reêrh wdmiaig meñKSu j,lajhs' ol=Kq mi l¾‚ldj yd fldaIsldj w;r fldgia$m;%sld ;=klska ieÈ ;%s;=kav ^Tri-cuspid valve& lmdgho ol=Kq fldaIsldj yd mqmamqYSh Ouksh w;r wvi| lmdgho msysghs' tf,iu jï mi l¾‚ldj yd fldaIsldj w;r fldgia$m;%sld follska ieÈ oaú;=kav ^Bi-cuspid valve& lmdgh yd fldaIsldj yd uyd Ouksh w;r wvi| lmdgh msysgd we;' fuu wvi| lmdg ^Semi-lunar valves& j,g tu ku ,eî we;af;a tajd w¾O jD;a;dldr fldgia ;=klska ie§ we;s ksihs' by; rEmh n,oa§ Tng m%Yakhla we;s fjkak we;s lKavÍh rÊcq lshkafka fudkjdo lsh,d' tajd l=vd /yeka úfYaIhla jk w;r fldaIsld j, isg oaú;=kav yd ;%s;=kav lmdg j, m;%sld j,g nef|a' tu.ska tu m;%sld j,g jeä Yla;shla ,efí' DM

Source: https://dostharamama.wordpress.com

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Heart attack

yDohdndOhla yรทkd .kakd yeรก

HEART ATTACK yDohdndOhla yรทkd .kakd yeรก 52

September 2019

DOCTOR MAGAZINE

doctormagazine.lk

w

o f,dalfha fndajk frda.j,g jvd jeÙ fõ.hlska fnda fkdjk frda. we;sùfï m‍%jK;djla mj;sk nj Tn wm uekúka okakd lreKla' Èhjeähdj" wêl reêr mSvkh" yDohdndO" ms<sld fukau ia:q,;djho m‍%Odk fnda fkdjk frda. w;ßka lsysmhla'

yDo frda. úfYaI{ fjoH rejka talkdhl

f,dj mqrd yDohdndOj,g f.dÿre jkakka f.a ixLHdj iS>‍%fhka by< hñka mj;skjd' yDohdndO hkq hym;a fi!LH yqre mqreÿ fukau ksje/È Ôjk rgdjla mj;ajd .ekSfuka j<lajd .; yels frda.hla' yDohdndOhla yoj;g reêrh imhk Ouks kd< fyj;a lsÍgl Ouks ;=< fïoh ^f;,a& ;ekam;a ùfuka tu Ouks k< we;=<; reêrh .,d hdug we;s bvlv weysfrhs' tfia f;,a ;ekam;a ùfuka Ouks ì;a;s mgq ùfuka miq lf,l ta kd< ;=< reêrh leá .eiSula we;sfõ' tfia lsÍgl Oukshla ;=< reêr leáhla we;s jQ úg yDoh jia;=j fj; reêrh iemehqu wvd< fjhs' tfyhska tu reêr leáfhka Wjÿrg m;a yDoh m‍%foaYh ñh hhs' ta ;;a;ajh ye¢kafjkqfha zzyDohdndOhlaZZ f,ihs' la‍I‚l yDohdndOhla reêr kd< ;=< we;s jQ f;,a ;ekam;= yÈisfha u msmsÍug ,la fjhs' msmsreKq f;,a ;ekam;=jla u; reêrh jydu leá .efihs' ta i|yd ;;amr lsysmhlg jvd .; fkdfõ' la‍I‚l yDohdndOhla hkqfjka ye¢kafjkqfha tu ;;a;ajhhs' fndfyda úg tjeks la‍I‚l yDohdndOhla yg.kakd frda.Skaf. ka 60] la muK Bg fmr mmqfõ fõokdjla fyda yDohdndOhl fmr ,l=Kq my< fkdlr;s' yDohdndOhl m‍%Odk ,la‍IK mmqfõ we;sjk iEu fõokdjlau yDofhka we;sjk fõokd fkdfõ' mmqj u;= msg we;s ifuka"

doctormagazine.lk

yDohdndOhla we;s jkafka fufyuhs' yDohdndOhla we;s jk wdldrh olajk weisosis rEm fm< krUkak Tfí iaud¾Ü fmdaka tflka fuu QR fla;h Click lrkak

https://youtu.be/bw_ Vv2WRG-A

D•Magazine /

yDohdndOhla y÷kd .kakd yeá

Heart attack

reêr kd, wNHka;rfha fïoh ;ekam;a fjhs Ouks ì;a;s

reêrh ksishdldrfhka fkd,eîfuka ydu;a jk yDo mgl uefrhs

uia ms~qfjka b< wegj,ska maÆrdfjka yd fmKye,af,ka we;sjk fõokdjkao wmg oefkkafka mmqfõ fõokdjla f,isks' yDohdndOhloS we;sjk fõokdj fï wdldrhs mmqfõ ueoska werfò' th mmqj f;rmkakd n÷h' uy nrla ;enqjd jeksh' b;d oeäh' jï w; fyda ylal foig fyda úys§ hd yelsh' msg me;af;a Wrm;= weg fol w;rgo Èj hd yelsh' nfâ oeú,a,la f,i we;s úh yelsh'

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September 2019

ta yd iu. w;=re frda. ,la‍IK lsysmhla we;súh yelsh' tajd kï ² wêlj oyÈh oeóu ² jukh yd Tlaldrh ² mmqfõ .eiau ² ysi lrleú,a, ² yqiau .ekSfï wmyiqj yDohdndO we;s ùug n,mdk wjodkï idOl ² ÿï îu ² reêrfha fldf,iagfrda,a wêl ùu ² ia:q,;dj ² wêl reêr mSvkh ² Èhjeähdj ² ldhsl jHdhdu wvq ùu ² udkisl wiykh ² ckau m‍%fõ‚h ² wm‍%Odk idOl jkafka ² Wm;a md,k fm;s Ndú;h ² wêl fldams mdkh ² Wm;a nr wvq ùu

DOCTOR MAGAZINE

doctormagazine.lk

f.," yKQ" ndyq" Wrm;a;" msgqmi fõokdjla we;sùu

mmqfõ we;sjk fõokdj

nv mmqj msÉfpk iajNdjh

oyäh oeóu

yDohdndOhl ,laIK yqiau .ekSfï wmyiqj

fuu wk;=reodhl wjodkï idOlj,ska neyer ùfuka yDohdndO j<lajd.; yelsh' ta i|yd ñksid f.a wdydr mdk iy Ôjk p¾hdjka fjkia lr .ekSu jeo.;a fõ' yDohdndOhla yg.ekSug tla wjodkï idOlhla fkdj wjodkï idOl lsysmhla tla úh hq;=h' tfyhska hï mqoa.,hl= ;=< by; oelajQ wjodkï idOl lsysmhlau fõ kï ta mqoa.,hdg yDohdndO yg .ekSfï wjodku by<h'

doctormagazine.lk

tlajku we;sjk lr;eú,a,

Tlaldrh" jukh

widudkH fjfyilr nj

ÿïjeá yd yDohdndO w;r iïnkaOh bÍu yDohdndO j,g Rcqju n,mdk fya;=jla ÿïjeá Wrkakka yoj;a frda.j,ska ñh hEfï m‍%jK;dj tfia fkdjkakka fuka fo;=ka .=Khlska by<h' is.rÜj, we;s ksfldáka fya;=fjka we;sjk wjodku ² yDo iamkaokh jeä fjhs' ² reêr mSvkh by< hhs' ² f,a leá .eiSï jeä fjhs' ² reêrfha fldf,iagfrda,a uÜgu by< hhs' ² reêrfha ys;lr LDL wxY= wvq fjhs' ² reêr leá .eiSfï idOlh jeä fjhs' ² yoj;g f,a iemehqu wvq fjhs' ² wxYNd.h je<£ug bv we;' ² .d;‍%dj, reêr kd< isyska ù reêr ySk;dj fya;=fjka ll=,a j, ;=jd, we;s fõ' ² yDo frda. i|yd fokq ,nk T!IOj, n,h wvqfõ'

September 2019

DOCTOR MAGAZINE

55

D•Magazine /

yDohdndOhla y÷kd .kakd yeá

Heart attack

yDoh ksfrda.S Oukshla

wjysr jQ Oukshla

wjysr jQ lsrSgl reêr iemhqula

by; lreKq wkqj ÿï bÍu yDo frda. hla i|yd fldmuK n,mEula lrkafkaoehs is;d .; yelsh' tfyhska ÿï îfuka je<elSu yDohdndO j<lajd .ekSug we;s fyd|u ms<shuls' idudkHfhka ldka;djkag jvd mqreI mla‍Ihg yoj;a frda. we;sùfï jeä m‍%jK;djla we;' ldka;djka f.a isrefrys ksmofjk Biag‍%cka fyda¾fudakh ksid;a wd¾:j pl%h ksid;a yoj;a frda. wjodku iajNdúlju fndfyda ÿrg md,kh fõ'

56

September 2019

yDohdndO j,g w; jkk idOl y÷kd.kak u;ameka îuo yDohdndOj,g fya;= fõ' wêl u;ameka Ndú;h YÍrfha fndfyda bkaøshhkg ydksodhl fõ' yDofha jï fldaIsldj bÈófuka yDofha l%shdldÍ;ajh wl%uj;a ùu fukau la‍I‚l yDohdndO we;s ùugo u;ameka Ndú;h fya;= fõ' reêrfhys fldf,iagfrda,a uÜgu by< hdu yDohdndO yg .ekSug fya;= fõ' reêr fldf,iagfrda,a uÜgu my< oud .ekSu i|yd úfYaIfhka u fldf,iagfrda,a iys; f;,a iys; wdydr .ekSu iSud l< hq;=h' j¾;udkfha l=vd orejka f.a isg ;reK msßi w;ro reêrfha fldf,iagfrda,a uÜgu wêl ;;a;ajhla oelsh yelsh' me/‚ iqmqreÿ wdydr fõ,a fjkqjg la‍I‚l lEu j¾. f;,a yd iSks wêl msIagh iys; wdydr mßfNdackhg yqre ùu fï ;;a;ajhg fya;= fõ' wdishd;sl rgj, ck;dj yqre mqreÿ ù isákafka jeämqr msIagh iys; n;a" mdka" frdà" msÜgq iy w, j¾. jeks wdydr m‍%Odk wdydr f,i ,nd .ekSugh'

DOCTOR MAGAZINE

doctormagazine.lk

;=ka fõ,gu n;a lEu;a yeu úgu n;a jeä m‍%udKhla wdydrhg .ekSu;a reêrfhys ix;Dma; fïo jeä ùug fya;= fjhs' tfyhska Èklg tla fõ,la muKla n;a wdydrhg .ekSu jvd iqÿiqh' n;a lEug .kakd úg n;a l=vd m‍%udKhla iy t<j¿ m<d j¾. jeämqr wdydrhg .ekSu jvd iqÿiqh' fïo iys; ng¾ fjkqjg ud.ßka j¾. Ndú;d lsÍu iqÿiq hehs fndfyda fokd is;;s' tfy;a i;H kï ishÆ ud.ßka j¾.j, o ix;Dma; fïo wvx.= jk njh' tfyhska ud.ßka j¾. jqjo ,nd.; hq;af;a uOHia: m‍%udKj,sks' .sf;,a" kï fkdlrk ,o t<j¿ f;,a" i;a;aj f;,a fukau fmd,a f;,aj, o ix;Dma; fïoh nyq,h' fmd,af;,a ydkslr fkdjqKo tuÕska yDo frda. we;sùu je<elaùfï yelshdjla ke;'

"

ta wdydr j¾.j, we;s msIagh ;=< oeù iSks njg;a fïoh njg;a m;afõ' úfYaIfhkau wm m‍%Odk wdydrh f,i ,nd.kakd zn;a wo udrlhla njg m;a fjñka we;ehs lsj yelsh'

idudkHfhka ldka;djkag jvd mqreI mla‍Ihg yoj;a frda. we;sùfï jeä m‍%jK;djla we;' ldka;djka f.a isrefrys ksmofjk Biag‍%cka fyda¾fudakh ksid;a wd¾:j pl%h ksid;a yoj;a frda. wjodku iajNdúlju fndfyda ÿrg md,kh fõ'

"

ydkslr reêr fïoh ^LDL& bj;a lrñka wdydrhg rih yd fmdaIH .=Kh tla lsÍu i|yd nyq wix;Dma; fïo iys; ;, f;,a" T,sõ f;,a" nvbß.= f;,a" fidahd f;,a yd iQßhldka; f;,a j¾. iqÿiqh' nyq wix;Dma; f;,a j¾. YS; WIaK;ajfha § idudkHfhka fkdñfohs' tfy;a fï f;,a j¾. jrla Ndú;d l< miq kej; kej; Ndú;d lsÍu kqiqÿiqh' nyq wix;Dma; ud.Íkaj, nyq wix;Dma; f;,a b;d by< uÜgul mj;sk fyhska tajd Ndú;d l< hq;af;a b;d iSud iys;jh' Èklg fujeks fïo j¾. f;a ye¢ tllg jvd Ndú;d lsÍu ydksodhlh' ishÆ j¾.fha weg j¾. uOHia: m‍%udKj,ska .ekSu ys;lr fõ' lcq" rglcq" fldÜgïnd jeks weg j¾.j, we;s fïoh yDoh ys;lrh' tfy;a Èkm;d fïjd muKg jvd wdydrhg .ekSu iqÿiq ke;' ì;a;r i;shlg jrla fyda folla .;a;dg jrola ke;' tfy;a ly uoh bj;a fldg .ekSu jvd iqÿiqh' lsß Ndú;fha § fïo rys; lsß jvd iqÿiqh' f;a fldmuK îj;a lï ke;' tfy;a Èklg fldams fldamam ;=klg jvd îu iqÿiq ke;' ljr mdkhla jqjo iSks Ndú;d fkdlsÍu jvd iqÿiqh' ud¿ jvd;a iqÿiqh' ud¿j, we;s ´fï.d-3 fïo wï,h yDohg jvd;a ys;lrh' reêr fldf,diagfrda,a wvq lr yDohdndOhlska wdrlaId ùug ´fï.d-3 ix>glh WmldÍ fõ' ieuka" yqre,a,d" id,hd jeks l=vd ud¿j, fïo j¾.h nyq,j ;sfí'

D•Magazine /

yDohdndOhla y÷kd .kakd yeá

Heart attack

iu bj;a lrk ,o l=l=¿ uia t;rï ydkslr fkdfõ' tfy;a ks;r .ekSu iqÿiq ke;'

m,;=re hqI fjkqjg m,;=re f,i wdydrhg .ekSu jvd iqÿiqh' isis,a îu" fpdla,Ü yd fldfldajd îu isrerg ys;lr fkdfõ' tjeks mdkj¾. yels ;rï iSud l< hq;=h'

fl¢ iys; t<jq¿ o m,;=re o jeämqr wdydrhg tl;= lr .kak' m,d j¾. fukau rks, weg j¾. o jvd;a iqÿiqh'

iun, wdydr fõ,la .ekSu fukau l%shdYS,S Èú fmfj;la .; lsÍu o yDofrda. j<lajd .ekSug ufydamldÍ fõ' ta i|yd jHdhdu w;HjYH fõ' j¾;udk ñksid b;d ld¾hnyq,h' tfy;a ksfrda.S Èúhlg wjYH ;rï jHdhdu Tyqg ,efnkafka ke;' ta i|yd jeh lsÍug ld,hla o fndfyda fokdg ke;' tfyhska l< hq;af;a ;u ffoksl lghq;= w;f¾u isrer fjfyid lghq;= lsÍuhs' ksoiqkla f,i /lshdjg hk mqoa.,hl= fudag¾ r:fhka fyda jdykfhka hd hq;= ia:dkhg u|la fmr jdykfhka nei weúo hdu' úÿ,s fidamdkh fjkqjg msh.eg fm< ke.Su" ld¾hd,hSh lghq;=j,§ ;u ld¾hhka i|yd iydhlhl= f.a iydh fkdf.k ;udu ys| isá ;ekska ke.sg f.dia tu ld¾hh lr.ekSu jeks lghq;=j,g yqreùu jà'

iqÿÆkq iy Ækq yDohg ys;lr fõ' tajdfhys reêrh leá .eiSfï yelshdj wvq lsÍfï .=Khla o mj;S' iqÿÆkq wuqfjka lEu iqÿiq ke;' nfå oeú,a, we;s úh yels neúks' Èklg iqÿÆkq .‍%Eï 50la muK jHxckhla f,i msi lEfuka reêr.; fldf,diagfrda,a m‍%udKh wvq fjhs' ÆKq Ndú;h o wvq l< hq;=h' muKg jvd ÆKq oeuQ lg.eiqï" neÿï" iy flá lEu j¾. .ekSu yels;dla wvq l< hq;=h' msmdihg iqÿiqu mdkh msßiqÿ c,h hs' WKqlr ksjd.;a c,h ke;s kï we,aj;=r Èklg fnda;, yhlaj;a mdkh lsÍu jeo.;ah' ;eô,s o iqÿiq mdkhls' iSks tl;= l< úg m,;=re hqIj, o .=Kh ySk fjhs' tfyhska

58

September 2019

jHdhdu fjkqjg kegqï fyda l%Svdj, fh§u jeä fokd m‍%sh lrkq we;' mdi,a úfhys mgkau l%Svdj,g fhduq lsÍu o" kegqï jeks úfkdaodxY fj; fhduq lsÍu o l< hq;=h' ix.S;hg ijka§u ukig fukau yoj; o iqjm;a lrhs' ix.S;hg wkqj keàu YÍrhg jHdhduh o ys;g i;=g o f.k fohs' frda.Skg fukau ksfrda.S mqoa.,hkg o jHdhdu lrkakg úOdkh lrkq fjkqjg ßoauhdkql+, k¾;khg fhduq lsÍu jv;a M,odhS fjkq we;' j¾;udkfha yoj;a frda. i|yd n,mdk m‍%Odk idOlhla f,i zudkisl wd;;sh’ y÷kd f.k ;sfí' ffoksl Ôú;fha§" mdif,a§ fukau ld¾hd,fha § o udkisl wd;;sfhka f;drj lghq;= l< yels mßirhla ilid .; hq;=h' ta i|yd mjqf,a ieu o /lshd ia:dkj, n,OdÍka o tlfia Wkkaÿ úh hq;=h' by; lreKq ish,a, tla;eka jQ l, yoj;a frda.j,ska j<lskakg úfYaI jHdhduhla wjYH fkdjkq ksielh' DM

DOCTOR MAGAZINE

doctormagazine.lk

D•Magazine /

Octopus OPCAB

yoj; l%shdldrs;ajfha mj;soaoS yDo ie;alï isÿ lsÍug mdr lemQ Tlafgdmia ;dlaIKh

There was no difference in safety outcomes between Octopus OPCAB and CPB-CABG

kjf,dal frdayf,a yDo Wria Y,H frda. úfYaI{ ffjoH ta'cS' fchl%sIaKka MS, FRCSI, FRCS (CTh) úisks

yoj; l%shdldrs;ajfha mj;soaoS yDo ie;alï isÿ lsÍug mdr lemQ Tlafgdmia ;dlaIKh

Ndckh lr;a§ fï yojf;a ld¾hh hka;%hlg Ndrfohs' Heart Lung Machine f,i y÷kajkafka yojf;a ldßh ie;alu w;r;=r§ ndrf.k bgqlrk bkaøshhhs'

znhsmdia ie;aluZ hkq Y,Hl¾u w;r ixlS¾K Y,Hl¾uhls' fuysÈ m%ia;=; jk bkaøsh fkdlvjd .efyk yoj;uehs' Yd,l fufyhqu l< hq;= bkaøsho fï yoj;uehs' fujka yoj;la Y,Huh l%shdj,shlg

Heart - Lung ueIsulg fï ld¾hh Ndr fkd§ yoj; l%shd;aul fjñka mj;soa§u

60

September 2019

DOCTOR MAGAZINE

doctormagazine.lk

yD;a Y,Hfõoh ;=< uE;l§ ÈhqKj q g m;a kj;u l%ufõohla jkafka frda.h s d isyf s hka isáh§u Y,Hl¾uh isÿ lsÍuhs' ixlS¾K Y,Hl¾uhla fia ie<flk yD;a ie;alula iïnkaOfhka fuh uú; lrjk iq`M lreKla jqj;a Wria fmfoi wdikakfhka fhdok ks¾úkaok tkak;la u.ska wdod, m%foaYh ysßjeÜàfuka miq fuys§ ie;alu isÿ flf¾'

yDo ie;alu isÿ lrk úma,jldÍ l%uhla ms<sn|j óg l,lg fmr isg f,dalfha wjOdkh fhduq úh' ta yoj;a ie;alfuys nqj,a,d l%ufõohhs' jvd;a úÿyqre f,iska úia;r lf<d;a Octopus Tissue Stabiliser kï yqrenqyqá fuj,u fhdodf.k Y,Hl¾uhg m%ia;=; fldgi muKla wl¾uKH lr mßjdr yD;a wjhj l%shd lroa§u nhsmdia ie;alu isÿlrk Y,Hl¾uhhs' nQj,a,d hkq ;u w`vq úysÿjd tajd w;f¾ f.dÿr isrlrf.k th wdydrhg .kakd if;ls' nQj,a,df.a fuu f.dÿr .s,.ekSfï l%uh yeoEÍfuka ixlS¾K yoj;a ie;alï jvd;a m%dfhda.sl myiq wÈhrlg m%fõY lsÍug uq,skau iu;a jQfha ´,kao cd;sl ffjoHjrfhls' ieneúkau th úma,jldÍ fidhd .ekSula úh' fuh nhsmdia ie;alfuys§ frda.shdg we;sjk wjodku" úhou fukau Y,Hl¾ufhka miq iqjh ,eîug .;jk ld,ho b;d úYd, jYfhka wvq lr,ñka yD;a ie;alï ck;djg jvd;a ióm lrjkakg fya;= úh' yDoh l%shd;aul j;a§ ie;alu lsÍu ÿIalr wehs@ ksn| l%shd;aul fjñka fláld,Sk wdj¾; j,g wkql, + j iamkaok jk yoj; úIh lr.;a ie;alï isÿlsÍu myiq ld¾hhla fkdfõ' wfkla w;g yojf;ys msgm q i reêrjdyskS úIfhys ie;alu isÿ l< hq;= jq úg fuu yoj; ia:dk.; msyg s f q uka u|la by<g Tijd ta ldßh lrkakg isÿfõ' m%dfhda.l s j fï ld¾h isoO a lsßfï§ frda.h s df.a reêr mSvkh Nhdkl f,i my;g jeàfï wjodkulao we;s fõ' fï ksid ie;alu w;r;=f¾§ yoj; fjkqjg ta ldßh bgq lrk lD;%su Heart Lung hka;%hlg ta fufyjr isÿlsÍug Ndr flf¾' flfia fj;;a we;eï frda.Skg" úfYaIfhkau uy¿ úfha§" jl=.vq yd fmKy¿.; wdndO yd ;on, f,i Èhjeähdj mj;sk úg fï hka;%hg isrer iïnkaO lsÍfuka úúO .e¿Mo mek k.S' Tlafgdmia mgl iageí,hsirh yoj;a-fmKy¿ hka;%hlg yojf;ys ldßh Ndrfokq fjkqjg yoj; l%shdldÍ ;;a;ajfhka mj;soa§u ie;alu isÿ lsÍug ufydamldÍ jk l%uhla f,i fï zTlagmia wdY%s; nhsmdia ie;aluZ ye|skaúh yel'

doctormagazine.lk

fuys§ wod, kyrfha ^kd,fha& fofldk l=yrdldr ye`v,hla u.ska iïnkaO flf¾' ta u; l=vd fldamam f,i we;s jHqy u.ska fhdok pQIKh (suction) Tiafia yDofha wka fldgia yd mj;akd reêr iïnkaO;djh ì|S hhs' tfiau fï fuj,u u.ska o< jYfhka riÈh ñ,s óg¾ 400 l muK ;sj%;djhlska isÿjk pQIK l%shdj,sh u.ska wod, yD;a md¾Yajhg lsis÷ p,khlska f;dr ksYap, msysàu we;sfõ' fï fuj,u b;d ieye,a¨h' tfiau yoj; u; msysgqúh yels jk úYsIaG kuH;djhlska hqla;h' È.= ld,Sk m%;sM, j,ska ikd: jQ lreKq yoj; u; fldgila fï

September 2019

DOCTOR MAGAZINE

61

D•Magazine /

yoj; l%shdldrs;ajfha mj;soaoS yDo ie;alï isÿ lsÍug mdr lemQ Tlafgdmia ;dlaIKh

Octopus OPCAB

wdldrhg ;djld,slj wjysr flreK;a fï ksid È.= ld,Sk jYfhka lsis÷ wka;rdhla isÿ fkdjk nj m¾fhaIK j,ska ikd: ù ;sfí' tfiau fï ksid lsis÷ wdldrhl reêr mSvkfha wvqùula isÿ fkdùuo úfYAIs; jdishls' wjysrj we;s kd,sld tlla folla fkdj wjYH kï y;rla myla jqj mqreoaod,Sug fuhska wjia:dj ie,fia' yD;a ie;alï j,§ fhdod.kakd nQj,a,d ie;alu yereKq úg uqyqÿ cSùkag iudk p¾hd olajk Y,H fuj,ï fhdodf.k isÿlrk ;j;a fufyhqï ;sfí' Star Fish Heart Positioner hkq yDoh Y,Hl¾uh myiq jk fia yDoh Tijd ;nk fuj,uls' th .=re fldg f.k we;af;a Star Fish kï u;aiHhdf.a msysàuhs' Urchin hkq uqyqÿ blsßhd y÷kajk kuhs' fukñka hq;a Urchin Positioner hkq o yDoh Y,Hl¾uhlg Tìk fia msysgqúug fhdod .kakd Wml%uhls' fuu fuj<ï Ndú;h fya;= fldg f.k yDo ie;alï jvd;a ir, njg m;aj ;sfí' tfiau ie;alñka miqj 62

September 2019

id¾:l;ajh jvd;a by< kxjñka È.=ld,Sk iqjh idlaId;a lr ;ssfí' wekacsfhdama,diaá yd iafgkaÜ kñka y÷kajk kd, wNHka;rfha jdfka ±,la t<Su u.ska isÿ lrk l%shdj,sh È.=ld,Sk m%;sM< ,nd fkdfok l,ayS fuu Tlafgdmia wdY%s; nhsmdia ie;alu jvd;a m%fhdackj;ah' úfYAIfhkau yojf;ys i:dk lsysmhl wjysr;d we;s úg ta yeu ;eklgu iafgkaÜ ±óu úhou úYd, jYfhka by< ;nhs' tjka wjia:dj,§ wekacsfhdama,diaá ie;alu fjkqjg Tlafgdmia l%ufha nhsmdia ie;alu isÿlsßu úl,amhhs' fuu frda.Ska i|yd yD;a - fmky¿ hka;%hla fhdod fkd.ekSu Tjqkaf.a blauka iqjhgo fya;=jls' fujka frda.Skaf.a ie;alñka miq reêrjykh;a" lD;%Su cSú;dOdrl (Ventilator) fhdod .ekSula wjYH flfrkafka ke;' Y,Hl¾ufhka miqj jvd;a fõ.fhka iqjh ,nk frda.shd blauKska ksjigo hdug wjia:dj i,id .kS' kjf,dal frdayf,a§ Tlafgdmia l%uhg .efyk yoj; wdY%s;ju nhsmdia ie;alï isÿlsÍu wdrïN lf<a 2000 jif¾§h' th fldf;la úYd, id¾:l;ajhla w;am;a lr .;af;ao h;a" kjf,dal yDo wdh;kfha§ isÿ lrkq ,nk iEu ie;alulau mdfya fï kúk Ys,aml%u j,g msx isÿjkakg ir< ù we;af;ah' isysh ;sfn;a§ nhsmdia ie;alu isÿ lsÍu yD;a Y,Hfõoh ;=< uE;l§ ÈhqKqjg m;a kj;u l%ufõohla jkafka frda.shd isysfhka isáh§u Y,Hl¾uh isÿ lsÍuhs' ixlS¾K Y,Hl¾uhla fia ie<flk yD;a ie;alula iïnkaOfhka fuh uú; lrjk iq`M lreKla jqj;a Wria fmfoi wdikakfhka fhdok ks¾úkaok tkak;la u.ska wdod, m%foaYh ysßjeÜàfuka miq fuys§ ie;alu isÿ flf¾' ie;alu isÿ lrk w;f¾§ frda.Shdg ffjoHjreka yd l;d lrñka isáh yelsh' fuys§ frda.shd csú;dOdrl hka;% (Ventilator) j,g iïnkaO lrkafkao ke;' fmky¿ wdY%s; .eg¨ iy.; ;;a;aj j,g uqyqK md isák frda.Skag fuh úmq, M, ,ndfoa' DM

DOCTOR MAGAZINE

doctormagazine.lk

D•Magazine /

Echocardiogram yoj;a frda. mÍlaIK úuiqï ljq¿j

An echocardiogram uses sound waves to produce images of your heart. This common test allows your doctor to see your heart beating and pumping blood. Your doctor can use the images from an echocardiogram to identify heart disease.

yoj;a frda. mÍlaIK úuiqï ljq¿j

yDo frda. úfYaI{ ffjoH jika; fyÜáwdrÉÑ úisks

doctormagazine.lk

tflda mßlaIdj fkdfyd;a Echocardiogram September 2019

DOCTOR MAGAZINE

63

D•Magazine / Echocardiogram

yoj;a frda. mÍlaIK úuiqï ljq¿j

yDo frda. ffjoHjrfhl= frda. ksOdk fiùu i|yd ks;r ks;r Ndú;d lrk mßlaIK w;r ztflda mßlaIKhZ uq,a ;ekla .kS' tflda mßlaIKhla hkq l=ulao@ thska wfmalaId lrk f;dr;=re fudkjdo@ th isÿ lrkafka flfiao@ fï wdÈ .eg¿ /ilg ms<s;=re fï ,smsfhka ,nd.; yels jkq we;' zialEka lsÍuZ hk joka ±ka wm w;r iq,nh' YÍrdka;fha we;s jHqyhla" m%;sìïnhla ke;fyd;a kshu jHqyfha ms<sìUqjla f,i ±laùu ffjoH ;dlaIKfha iq,nh' CT, MRI hk hka;% u.skao fï ms<sìUq" m%;sìïn ke;fyd;a Scan Image ,ndfoa' .¾NKS ldka;djkaf.a l=i ;=< orejd ksÍlaIKh lrkakg Ndú;d lrkafka èjks ;rx. h' tfyhska tu mßlaIKh Ultra Sound Scaning f,i ±lafjhs' yDo frda. ksßlaIKh i|yd fhdod.kafkao fï ;dlaIKhuh' th yDo wOHhk úIfhys fhdod .kakd l< Ecocardoigram f,i ye|skaùug wms yqre ù isáuq' Ecocardoigram hkak jvd;a myiqjg y÷kajkafka ECHO hkqfjks'

l%shdldß;ajhl fhÈfï§ yoj; thg fudk uÜgulska Tfrd;a;= fokjdo@ lsßgl Ouks.; wjysrùula we;sùfï bvla ;sfnkjdo@ hkak úuiSugo hï flfkl=g ,ndfok Ñls;ail$ffjoHuh l%shdj,sh m%;sM< we.hSugo fï mßlaIKh fhdod .efka'

úúO wdldrfha ECHO mßlaIK

Transoesophageal Echocardiogram (TEE) mmqj u;=msáka g%dkaiaähqirh ;nd ,nd .kakd m%;sìïn j,g jvd meyeÈ<s m%;sìïn ,nd .ekSug wjYH jQ úg TEE fkdfyd;a Transoesophageal Echocardiogram fhdod.kS" Oesophagus ^.,kd,h& ;=<g fuys§ g%dkaiaähqirh iSrejg m%fõY flf¾' mmqfjka yd úfYAIfhkau fmky`¿j,ska yD;a m%;sìïn wjysr ùu fï ksid je<flhs'

Transthoracic Echocardiogram fuh jvd;au iq,n mßlaIK wdldrhls' wêl ixLHd;hlska hq;a Yío ;rx. WmlrKhla th Transducer kï fõ - mmqj u; ;nd bka cks; jk Yío ;rx. m%;sìïn njg mßj¾;kh lr ;srhla u;g ,nd .kS'

Stress Echocardiogram yDo frda.Ska i|yd lrk Sress Test tkï Treadmill kï úfYaI nhsisl,fha tl ;ek

ECHO mßlaIKh b,a,d isák wjia:d

• yDofha iuia: l%shdldß;ajh ms<sn| we.hSula lsÍug' • yDoh fodaI we;s$ke;s nj ±k.ekSug ^lmdg fodaI" yD;a fmaYsfodaI" fmßldähu fodaI" yDo.; w¾nqo yd ixcdkSh yD;a wdndO& • lmdg fodaI wdÈh ld,h;a iu.u fjkia jk" iqj jk wdldrh ksÍlaIKh lsÍug' • isÿlrk ,o m%;sldr" Y,Huh l%shdldrlï wdÈfhys id¾:l;ajh we.hSug'

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September 2019

DOCTOR MAGAZINE

doctormagazine.lk

g%dkaiaähqirh mmqj u; ;nd bka cks; jk Yío ;rx. m%;sìïn njg mßj¾;kh lr ;srhla u;g ,nd .kakd mÍlaIdj Transthoracic Echocardiogram

Odjkh j;a§ frda.shd ta u; ;nd lrk mßlaIdj w;f¾ yDo m%;sìïn ,nd.ekSu Stress Echocardioaram f,i ye|skafõ' fï l%shdldrlfï§ yDoh jeä l%shdldß;ajhlg fkdfyd;a wd;;shlg ,lafõ' fï wjia:dfõ§u ,nd.kakd m%;sìïn u.ska yD;a ì;a;s j, .;sl l%shdldß;ajho" fmdïm lsÍfï l%shdj,sho" fyd|ska úodrKh l< yel' wfkl=;a mßlaIK j,§ ta ;rï fyd|ska ±lsh fkdyels reêr iemhqï ySk jk fmfoia Stress mÍlaIdfõ§ jvd;a fyd|ska ksÍlaIKhg ,la l< yels fõ' Dobutamine or Adenosin Stress Echocardiogram Treadmill hka;%hl ke.S yoj; wd;;shg ,la lsÍu wiSre jk frda.Skag ta fjkqjg T!IOhla ,nd§ ta u;ska yoj;g wd;;shla ,nd§ isÿlrk tflda mÍlaIdj Dobutamine or Adenosin Stress Echo kï fõ fuh lD;%Suj yoj;g wd;;shla ,nd§uls' l%shdldß;ajhl fhÈfï§ yoj; thg fudk uÜgulska Tfrd;a;= fokjdo@ lsßgl Ouks.; wjysrùula we;sùfï bvla ;sfnkjdo@ hkak úuiSugo hï flfkl=g ,ndfok Ñls;ail$ffjoHuh l%shdj,sh m%;sM< we.hSugo fï mßlaIKh fhdod .efka'

doctormagazine.lk

Intravascular Ultrasound Cardiac catheterization hkqfjka ye|skafjk Y,Huh l%shdldrlï w;r;=f¾§ ,nd.kakd ióm tflda m%;sìïn fukñka ye|skafõ' bls,sh fmfoiska m%fõY lrk le;Sgrhg g%dkaiaähqirh iïnkaO lr iDcqjg yDofha reêr kd, fj; f.k f.dia m%;sìïn ,ndfok ksid jvd;a i¾j iïmQ¾K m%;sìïn fuys§ ,nd.; yel'

ECHO mßlaIdjg fmr iqodku úsfYAI iqodkula ke;' Tfí lEu" îu" T!IO iqmqreÿ wdldrhgu ,nd .kak'

mßlaIKh w;r;=f¾È Tfí wjfndaOh Tng fuu mrSlaIKh i|yd úfYAIfhka ms<sfh, l< we÷ula fokq we;s' Tfí mmqfõ fc,a ødjKhla .e,ajQ bf,lafg%dav ;=kla iú flf¾' yDofha úoahq;a ikakdhkh .%yKh lr.kq jia fhdod .efkk fï bf,lafg%dav j, wfkla wka;hka we;af;a hka;%fhah' Tfí jï mig we,ù wef|ys È.djk f,i ffjoHjrhd okajhs'

September 2019

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65

D•Magazine / Echocardiogram

yoj;a frda. mÍlaIK úuiqï ljq¿j

fc,a u; g%dkaiaähqirh p,kh lrñka wjYH m%;sìïn ksßlaIKh lrkafka bka miqjh' wjYH lrk bßhõ j,§ ksYap, m%;sìïn ,nd .kS' èjks ;rx. fhdodf.k m%;sìïn ks¾udKh l<;a mßlaIKh w;r ;=f¾È wmg ta lsis÷ Yíohla wefikafka ke;af;a fhdod.kakd ixLHd;h wm Y%jK mrdihg f.dapr fkdjk ksidh'

jvd;a meyeÈ<s m%;sìïn ,nd .ekSug fhdod.kakd ;dlaIKh

Stress ECHO mÍlaIdj i|yd úfYaI ms<sfh, ùï ² mÍlaIKh isÿ lsÍug kshñ; fõ,djg meh 4 la ;sìh§ wdydr wkqNjh fyda lsisjla mdkh isÿ lrkak tmd' ² úfYaIfhkau Tfí ffjoHjrhd kshu lrkq ,enqjfyd;a ñi Beta-blockers, Iso sorbide mononitrate, Nitroglycerine hk yD;a T!IO .ekSfuka j<lskak'

yDo frda.Ska i|yd lrk Sress Test w;f¾ yDo m%;sìïn ,nd.ekSu Stress Echocardioaram

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September 2019

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² Tn Èhjeähdj i|yd T!IO ,nd.kakd frda.sfhla kï ta nj ffjoHjrhdg okajd ta ms<sn|j úfYaIs; iQodkï ùfï Wmfoia ,nd .kak'

doctormagazine.lk

Dobutamine Echocardiogram mÍlaIdj i|yd úfYaIs; ms<sfh, ùï

hka;%hl ke.S yoj; wd;;shg ,la lsÍu wiSre jk frda.Skag ta fjkqjg T!IOhla ,nd§ ta u;ska yoj;g wd;;shla ,nd§ isÿlrk Dobutamine or Adenosin Stress Echo mÍlaIdj

Intravascular Ultrasound- Cardiac catheterization mÍlaIKh w;r;=f¾§ ,nd.kakd ióm tflda m%;sìïn

doctormagazine.lk

² wka;¾ Ysrd (IV Line) iïnkaOfhka T!IOh kslafYamKh lsÍug ,nd§ mÍlaIKh isÿ lsÍug fmr Dobutamine wka;¾ YsrdkslafYamKh ,nd fohs' ² fodaI rys; yDohla iïnkaOfhka kï yDo jHqyh fodia rys; njo yD;a l=ár yd yD;a lmdg ;=<ska hym;a reêr .ukd.ukhla isÿ jk njo olakg ,efí' ² yDofha jHqyfha yd yDo ls%hdldß;ajh ifodia ;sfí kï tho fï mßlaIdfjka y÷kd.ekSug yelsfõ' úfYaIfhkau" ² yD;a fmaYs j, >klu jeäùu" fjfiiskau jï fldaIsldfõ we;sjk >kùï Thickening ² yD;a fmaYs wdYs%; widudkH p,k' ² yD;a lmdg Tiafia reêrh wdmiq .e,Su (regurgitation) ² yD;a lmdg Tiafia reêrh .e,Sfï wvq ùula (Stenosis) fjf;d;a tflda ldäfhd.%ï mßlaIdj ta neõ ;yjqre lrhs' DM

September 2019

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67

D•Magazine /

Coronary Angiogram lsÍgl wekacsfhda.%ï mßlaIdj

A coronary angiogram is a procedure which looks closely at your coronary arteries to see if they are narrowed or blocked. It uses a special type of X-ray dye.

yoj;a frda. mrSlaIK úuiqï ljq`Mj

lsÍgl wekacsfhda.%ï mßlaIdj Coronary Angiogram yojf;ys l%shdldß;ajh uekúka úodrKh jk wdldrfhka X - lsrK Wmfhda.s lrf.k isÿrk mÍlaIdjla ;sfí' th Coronary Angiogram kñka y÷kajk mßlaIdjhs' lsÍgl Ouks.; frda.hla y÷kd.ekSug WmldÍ jk uyÕ=;u mßlaIdj f,i i<lkafka fuhhs' hï flfkla lsÍgl Ouks.; wdndOhlska fm<k nj muKla fkdj tu wjysrh mj;akd ia:dkho wjysrh fya;=fldg f.k isÿjk ydksfha 68

September 2019

DOCTOR MAGAZINE

doctormagazine.lk

iajNdjho ms<sn| ksiel f;dr;=re fuu wekacsfhda.%ï mßlaIdjla u.ska ,nd.; yelsfõ' tu frda.shd flfrys ljrdldr ueÈy;aùula isÿl< hq;=o hkak ms<sn|j ;Skaÿ lr.ekSug fï wkqj bv ie<fia' wekacsfhda.%Eï mßlaIdj u.ska yD;a fmaYs" yD;a lmdg" wdY%s; widudkH;djhla fukau lsÍgl Ouks wjysr ùï y÷kd.; yel' fuu mßlaIdj isÿlrkq ,nkafka zle;a ,eíZ kñka ye|skafjk Y,Hd.drhg ióm ta i|yd úfYaIs; myiqlï iys; tAllhl§h' bls,s fmfofia we;s Femoral Artery kï Ouksh Tiafia m%fõY lrk le;Sgrhla yDofha isg msßisÿ reêrh msg;g f.k hk uyd Oukshg;a bka Tífnys jQ lsßgl Ouksj,g;a hjkq ,efí' bkamiqj tlaia-f¾ PdhdrEm j,g fyd|ska o¾Ykh jkq jia úlsrK mdrdkaO ridhkhla Femoral Artery yryd kslafYamKh lr tlaia-f¾ m%;sìïn ,nd .efka' fuu l%shd ms<sfj, y÷kajk ;j;a kula kï Cardiac Catheterisation h' wekacsfhda.%ï mßlaIdjlska y÷kd.; yels fodaI yojf;ys l%shdldß;ajh i|yd Bg wjYH reêrh ,efnkafka lsßgl Ouks j,sks' fï lsÍgl Ouks isyska jqjfyd;a fyda wjysr jqjfyd;a m%udKj;a wï,lrh$fmdaIl fkd,eîfuka yDoh ydu;a fjhs'

yDo frda. úfYaI{ ffjoH ,,ks lmqref.a úisks

ta ;;a;ajh lrk fldg f.k we;sjk fõokdj zwekachskdZ f,i kï flf¾' fï wdldrfhka mj;akd fodaI iy.; lsßgl Ouks yereKq úg Aneurysm f,i ±lafjk yD;a ì;a;s u; msïîï we;sjk ia:dko" wiamkao fkdfyd;a wl%uj;a yDo .eiau fya;= fldg f.k we;sjk Arrhythmia

Coronary Angiogram mßlaIdj - mshjr

bls,sh fmfoiska m%fõY lrk le;Sgrhla yojf;ys uydOuksh olajd /f.k ia:dms; flf¾'

doctormagazine.lk

le;Sgrfha ;=v jï lsÍgl Oukshg muqKQjhs

vhs j¾.hla kslafIAmkh lr yojf;ys lsÍgl Ouks m%;sìïn ,nd.kS

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D•Magazine /

lsÍgl wekacsfhda.%ï mßlaIdj

Coronary Angiogram

;;a;ajo W;am;a;s.; yDoh fodaI wdÈh ms<sn|jo fï mßlaIdfjka f;dr;=re ,nd.; yel' wekacsfhda.%ï mßlaIdjg fmr''' fuu mßlaIKhg Ndckh ùug fmr ffjoHjrhd úiska Tn iïnkaOfhka ie<ls,su;a jk lreKq lsysmhls' l Tfí mQ¾j ffjoHuh b;sydih( weÿu" jl=. vq widudkH;d fyda wid;añl;d we;s nj' l hï T!IOhla úIfhys wid;añl;d fmkajkafkao hkak' wekacsfhda.%ms mÍlaIdj lrk ms<sfj, mÍCIKhg fmr Èk frday,a .; úh hq;=hs' úfYAI m%;smQ;s; (Antiseptic) inka j¾.hla YÍrfha .,ajd iakdkh l< hq;=hs' bls,sh fmfoi l=vd ;ekla frdau bj;a jk fia f¾irhlska .E hq;=hs' le;a ,eí - ta i|yd úfYAIfhka ieliQ Y,d. dr ldurfha§ úfYAI ihkhl È.d jQ miq yD;a iamkao igyka lsßfï hka;%hlg bf,lafg%dav j,ska frda.shd iïnkaO flf¾' bls,sh fmfoiska 70

September 2019

le;Sgrh reêrjdyskS moaO;shg iïnkaO jkafka fï wdldrhghs

m%fõY lrk le;Sgrh rEmjdysks ;srhl wëlaIKh hgf;a yDohg m%fõY flf¾' reêrjdyskS j, t;rï idrj;a iakdhq iemhqula ke;s ksid fõokd ±kSula ke;' le;Sgrh kshñ; ia:d.; lsßug iSreudre jQ miq úlsrK u.ska o¾Ykh l< yels jkfia idhï j¾.hla tkak;a flf¾' fï idhï j,ska b;d fyd|ska yojf;ys lsÍgl reêr kd, o¾Ykh l< yels ksid hï wjysrhla fõ kï th wmQrejg ,nd.kakd m%;sìïnh weiqf¾ ±lsh yelsh' wekacsfhda.%ms mÍlaIdj lsÍfuka miqj ² mSvkhg ,la l< ieryqula mÍlaIK ia:dkh u;ska ;nd th meh lsysmhla t;eku ;sfnkakg ie,iaùu' ² reêr mSvkh" kdä .eiau" Yajikh yd fPaokh lrk ,o fmfoi ksn| mÍlaIdjg ,la flf¾'

DOCTOR MAGAZINE

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"

yoj;

wekacsfhda.%ms mßlaIdfõ m%;sM, we.hSu i|yd kej;;a ffjoHjrhd yuqúh hq;=h' m%;sldr ;SrKh lrkafka frda. úksYaph u;h' isyska ù we;s Ouks ms<silr lsÍu wekacsfhda.%ms mÍlaIKh w;r;=r§u isÿ l< yel

le;Sgrh

bls,sfha isg yoj; olajd iïnkaOh

W!¾èj Ouksfha isg lsÍgl Ouksh olajd .ukau.

le;Sgrh lsÍgl Oukshg m%fõY jk whqre

² wdydr .ekSug" mdkhg iSudjla ke;' tfy;a flá ld, iSudjlg wka;¾ Ysrd kslafIamKhla ,ndfohs' ² meh 3-4 la hk;=re wef|a È.dù bkakg kshu flf¾' bka miqj jdäúh yel' ² B<`. oji jk;=re wef|ka niskakg bvla fkd,efí' ² fldf,iagfrda,a wvq wdydr .ekSug kshu flf¾' fndfyda Y,Huh l%shdoduhka yS§ olakg ,efnkjdla fuka wekacsfhda.%ï mßlaIdfõ§ o hï hï ixl+,;d we;s úh yel ² wl%uj;a yDo wiamkao we;súh yel' ² yojf;a fmßldähï u; wu;r ;r, ;ekam;a ùfuka we;sjk pericardial tamponde kï ;;a;ajh' ² b;d l,d;=rlska ±lsh yels Myocardial infarction fyda wd>d; (stroke) ;;a;aj' ^f,a leá fyda plaque lsßgl fyda fud<fha reêrkd, u; wjysr ùu fya;=fjka& vhs tkak;a lsÍfuka miq yojf;a lsÍgl ixirkh o¾Ykh jkafka mgqùï yd wjysr;d wdosh iïnkaOfhka f;dr;=re imhñks

doctormagazine.lk

wekacsfhd.%ms mßlaIdfjka miq ksjfia§ ie<lsh hq;= lreKq ² yels muK úfõlSj isákak' ² jrlg jeä ld, iSudjla isgf.k b§fuka j<lskak' ² n/;s oE tiùfuka j<lskak' ² wdidok we;sùfï bvlv ms<sn| ms<sn|j mßlaIdldÍ jkak' m%;sM, we.hSu wekacsfhda.%ms mßlaIdfõ m%;sM, we.hSu i|yd kej;;a ffjoHjrhd yuqúh hq;=h' m%;sldr ;SrKh lrkafka frda. úksYaph u;h' isyska ù we;s Ouks ms<silr lsÍu wekacsfhda.%ms mÍlaIKh w;r;=r§u isÿ l< yel' ^wekacsfhdama,diaá ,smsh n,kak& wfkla úl,amh jkafka lsÍgl Ouks nhsmdia ie;aluhs' DM

September 2019

DOCTOR MAGAZINE

71

D•Magazine / Exercise Electrocardiogram

Exercise ECG mÍlaIdj

yoj;a frda. mÍlaIK úuiqï ljq¿j A STRESS TEST, SOMETIMES CALLED A TREADMILL TEST OR EXERCISE TEST, HELPS A DOCTOR FIND OUT HOW WELL YOUR HEART HANDLES WORK.

Exercise Electrocardiogram fkdfyd;a Exercise ECG mÍlaIdj

72

September 2019

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oj; l%shdldß;aj wOHhk l%ufõohkayS iq,n mßlaIdjla f,i jHdhdu B'iS'cS' mßlaIdj fkdfyd;a Exercise ECG mÍlaIdj y÷kajd Èh yel' fuu mÍlaIKfha wruqK Yßrfha .;sl l%shdldß;ajh ke;fyd;a fjfyi ùu;a iu. yoj;g we;sjk n,mEu wOHhkh lsÍuhs' ta Tiafia fuu mÍlaIKh u.ska yDofha fi!LH iïmkakNdjh ms<sn|j jeo.;a f;dr;=re /ila ,nd.kakg

doctormagazine.lk

yDofrda. úfYAI{ ffjoH f.daGdNh rKisxy úisks

mq¿jka' fï i|yd fhdod .kakd Terminal hka;%h u; frda.shdg weú§ug i,iajk w;r" tu jHdhdu lrk wjia:dfõ§ yDofha l%shdldß;ajh ECG. ud¾.fhkq;a ^yDofha iamkaokh& reêrfha mSvkh" ms<sn|j;a we.hqï lrkq ,nkjd' tu.ska yDofha l%shdldß;ajh ms<sn| úksYaphla$;SrKhla ,nd.ekSu isÿ l< yelshs' Stress/Exercise isÿ lrk wdldr I. Exercise Tredmill Stress Test (ETT) fuu mßlaIdfõ ksrjoH;djh - 60%70% II. Stress Echocardiography - fuys§ Tredmill hka;%h u; jHdhdu lsÍug i,iajd Echocardiography mßlaIdj lrkq ,nkjd' fuu mßlaIdfõ ksrjoH;djh - 70%85% III. Nuclier Test - fuys§ Tredmill hka;%h u;

doctormagazine.lk

Exercise Tredmill Stress Test (ETT) mßlaIdj

jHdhdu lsÍug i,iajd úlsrKYS,s iuia:dksl j¾.hla wka;¾Ysrd kslafIamKhla f,iska YÍr.; lr yDofha l%shdldß;ajh we.hqï lrhs' fuu mßlaIdfõ ksrjoH;djh - 90% jHdhdu B'iS'cS b;sydih 1918 j¾Ifha Bousfield úoHd{hd lsÍgl Ouks.; frda. mj;akd frda.Skaf.a ST depresion wdldrfha E.C.G. ix{djla we;sfjk nj fidhd .kakd ,§' 1931 j¾Ifha§ Wood & Wolferth hk úoHd{hka yoj; reêr .ukd.ukhkaf.a wvq¨yq`vq;d yd lsÍgl Ouks.; frda. we;s nj wkdjrKh lr .ekSu i|yd fuu mÍlaIKh fhdod .; yels nj fidhd .kakd ,§' tod isg fï olajd úúO wdldrfhka ÈhqKq lr kùk ;dlaIKh fhdod wo ;sfnk mßlaIK l%uh olajd ÈhqKq lr we;'

September 2019

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D•Magazine /

Exercise ECG mÍlaIdj

Exercise Electrocardiogram

Stress Echocardiography mßlaIdj - hka;%h u; jHdhdu lsÍug i,iajd .kakd tflda mÍlaIdjls

Exercise Tredmill Stress (ETT) úfYAI;d ² fuh Tng nyq,j olakg ,efnk m%d:ñl j¾.fha (Stress ECG. Test - Basic type of stress test.) udÈ,shhs' ² fuu mÍlaIKh blauka" wdrlaIdldÍ" ,dNodhl mÍlaIKhla' fuys§ jHdhdu i|yd fhdod.kakd hka;%h Tredmill machine f,i y÷kajk w;r" ta u; frda.shd .uka lrk wjia:dfõ yDofha l%shdldß;ajh ECG u.ska" reêr mSvkh" yDo iamkaoh 74

September 2019

ksÍlaIKh lrkq ,nkjd' iEu úkdä 3lgu jrla hka;%fha fõ.h jeä lrk w;r" tys wdk;sho jeä lrkq ,nkjd' ² iïmQ¾K mßlaIKh isÿlsÍug úkdä 12-15 w;r muK ld,hla .kS' ² fuu mßlaIKh flfrk w;r;=r yDohg fõokdjla" la,dka; .;shla" ±Kqkfyd;a th ffjoHjrhdg ±kaúh hq;= w;r" Tnf.a fi!LH ;;a;ajh mßlaId lr n,d ffjoHjrhdg th wjYH úfgl keje;aùu ;SrKh l< yelsh' ² fufia lsisu wmyiq;djhla ixl+,;djhla we;s fkdjqKfyd;a mÍlaIKh È.gu lrf.k hkq ,nk w;r" frda.shdf.a jhig iß,k yDo iamkao fõ.h ,nd.;a úg (Target Heart Beat) mÍlaIKh wjika lrkq ,nkjd' ta ksid iEu frda.sfhl=f.au ksjerÈ jhi ,nd§u jeo.;a' ² tfukau m<mqreÿ ld¾huKav,hla u.ska yDo frda. ffjoHjrhdf.a wëlaIKh hgf;a fuh isÿ lrkq ,nkjd'

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mßlaIKhg Ndckh jk frda.shdf.a j.lSu ² jHdhdu lsÍu i|yd myiq we÷ulska ieriS meñKSu' ² frda. úksYaph jd¾;d" we;=¿ ish¿u jd¾;d mÍlaIKhg meñfKk úg /f.k tAu' ² frda.shdf.a ksjerÈ jhi ffjoHjrhdg mejiSu' ^mÍlaIKfha§ jhig iß,k yDo iamkao fõ.h ,nd. kakd ksid& ² Tn .kakd ish¿u T!IO idudkH mßÈ ,nd.; hq;= ùu' iuyr úg Tnf.a yDo frda. ffjoHjrhdf.ka Wmfoila ,enqKfyd;a we;eï T!IO mÍlaIKhg Èk follg l,ska k;r lsÍu& fuu mÍlaIKh u.ska ,nd.; yels f;dr;=re ² Chest Pain - úúO fya;= ksid yDofha fõokd we;sfõ' ^yDo fmaYsfha" ms;a; wdï,sl;djh" lsÍgl Ouks.; frda.& tksid l=uk fya;=jla ksid we;sjk fõokdjla±hs ksYaÑ;j y÷kd .ekSug' ² yDoh.; frda. hlg fokq ,nk m%;sldr j,§ isÿlrk we.hSï i|yd' T!IO" Y,Hl¾u yd iafgkaÜ ±óu jeks ld¾hhka ys§ tajdfha id¾:lNdjh we.hSug'

doctormagazine.lk

úlsrKYS,s iuia:dksl j¾.hla wka;¾Ysrd kslafIamKhla f,iska YÍr.; lr yDofha l%shdldß;ajh we.hqï lrk Nuclier Test

² yDofha l%shdldß;ajh we.hSug" lsÍgl Ouks.; frda. ;sj%;djh yd tys msysàu we.hSug" yDo lmdg.; frda. fjf;d;a tajd wkdjrKh lr.ekSug" Stress heart failure kï ;;a;aj we.hSug' Stress ECG Test isÿ lsßug kqiqÿiq frda.Ska ² pd,l kshqfrdak.; frda. ;;a;aj' ² ;on, f,i mj;akd uyd Ouksh isyska ùu' ² yD;a wlrKsh' ² yD;a fmaYs .; fodaI' ² ;on, yd md,kh l< fkdyels wê reêr mSvkh' ² ;on, f,i frda.S njg m;a whg' ² md,khla ke;s mmqfõ fõokdj (Unstable prograssive angina) ² I jk yd II wÈhf¾ yDo wjysr;d (Heart block) iys; frda.Ska' Special Medical Invasive Test fuu mßlaIKh Ndckh ùug ;rï YÍr Yla;shla fkdue;s frda.Ska i|yd tu jHdhdu ;sj%;djh lD;%Suj we;s lrk T!IO ,nd§ mßlaIKh isÿ flf¾' DM

ilia lf<a pkaÈ fikr;a hdmd

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DM

History of ICU yoj;a frda.Skaf.a cSú; iqrlaIs;;djh ;yjqre l< oeä Wmia:dk tall wdrïN jQ yeá

fld<U uydfrda.HYd,dfõ osjhsfka m%:u oeä Wmia:dk tallh tjlg fi!LH wud;Hjrhdj lghq;= l< B t,a fiakdkdhl uy;d úiska újD; l< wjia:dj' fuu ft;sydisl PdhdrEmfha jfï isg ffjoH mS wd¾ wkaf;daksia" ffjoH tka jf,dams,af,hs" ffjoH ta ;sia,a ví,sõ mS chj¾Ok" ffjoH tï ùrfiak yd udKav,sl fyos uqokakdhl uy;añh isà'

yoj;a frda.Skaf.a cSú; iqrlaIs;;djh ;yjqre l< oeä Wmia:dk tall wdrïN jQ yeá 76

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;S

ka; Tnd mEklska ,shk ,o úia;r lsÍula iys; fï PdhdrEmh fndfyda bmerKs b;sydihla wjf,dalkh lrkafkah' ffjoH úoHdj w;sYhska oshqKQjg m;a ful, wfma merKs ffjoH jxYl;dj yodrkafkl=g fuys we;af;a úmq, jeo.;aluls'

doctormagazine.lk

wfma rfÜ ffjoH b;sydifha m%:u jrg fld<U uydfrda.HYd,dfõ Y,H oeä Wmia:dk tallhla ia:dms; l< oskh b;sydifha iksgqyka lsÍu fï PdhdrEmh .ekSfï ksñ;a;hs' ta 1968 cqks 15jkodh' fmd,af;,a mykla o,ajñka fï oeä Wmia:dk tallh újD; lrkafka tjlg fi!LH wud;H Oqrh oerE B t,a fiakdkdhl uy;dh' Y,H ffjoH mS wd¾ wkaf;daksia" ks¾úkaok ffjoH ;sia,a chj¾Ok" ffjoH t,a jf,dams,af,hs" ffjoH ta mS chj¾Ok" ffjoH tï ùrfiak yd udKav,sl fyos uqokakdhl hk wh fï ft;sydisl fiahdrefjys fmkS isà' fld<U uydfrda.HYd,dj újD; yoj;a Y,Hl¾u isÿ lsÍu uq,skau wdrïN lrk ,oafoa 1965oSh' fï yoj;a ie;alï jvdmD:Q,j isÿ lsÍug kï úfYAIs; mqyqKQjla ,eîu jeo.;a jkafkah hk woyiska rdcH fomd¾;fïka;= úiska wfma iajfoaYSh ffjoHjreka mia fofkla wefußldfõ fjdIskagka kqjr yqiagka yd ufhda la,sksla hk lS¾;su;a ffjoH wdh;k fj; fhduq lrk ,oS' tu lKavdhug ta à tia fmda,a" à ã tia fmf¾rd" hk yDo Wria ffjoHjrekao" ;sia,a chj¾Ok" fla iS m%kdkaÿ hk ks¾úkaok ffjoHjrekao ú,a*â fmf¾rd iydh Y,H ffjoHjrhdo yDo fmKy¿ hka;%h l%shd lrjk fcda kï fyosho we;=<;a úh' fï lKavdhu wefußldfõoS iqúffYAIS mqyqKQjla ,enQ w;r fjfiia isÿùula jQfha yoj;a Yd,l ;dlaIKh iïnkaOfhka kjuq w;aoelSï ,nk w;f¾ wefußldkq ffjoHjrekao fï ,dxflah ffjoHjrekaf.a úYAñ; w;aoelSï yqjudre lr .ekSuhs' fï ms<sn|j w;S; u;lhka wjos lrjk ffjoH ;sia,a chj¾Ok mjik wdldrhg ySfud.af,dìka uÜgu .a?ï 5g wvq wh ks¾úkaolh lsÍula tl, wefußldfõ isÿ fkdúks' tfy;a ksremøs;j tjka frda.Ska 500la muK ks¾úkaokh l< id¾:l;ajfha

doctormagazine.lk

osjhsfka m%:u oeä Wmia:dk tallh msysgqùu iïnkaOfhka ;;= iqrlaIs;j ;nd.;a ffjoH ta ;sia,a ví,sõ mS chj¾Ok' fu;=ud fuu úIh iïnkaOfhka úfYAI mqyqKqjla ,eîug wefußldjg hejQ lKavdhugo we;=<;a úh

ryi tod wfma ks¾úkaok ffjoHjreka tod fï .ufkaoS wefußldkqjka yg W.kajkakg iu;a úh' fï mqyqKQ ixpdrfhka miqj kej;;a furgg meñKS ffjoH lKavdhug furg újD; yoj;a ie;alï lsÍug wjYH myiqlï i,id fok ,oafoa tjlg fi!LH fiajd wOHlaI ckrd,a ffjoH .=Kfialr úisks' jydu ta i|yd wjYH

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DM

History of ICU yoj;a frda.Skaf.a cSú; iqrlaIs;;djh ;yjqre l< oeä Wmia:dk tall wdrïN jQ yeá

yoj; k;r jQ frdaa.sfhl=f.a yoj; kej; mk .ekaùug fhdod.kakd Defibrilator WmlrKhla Ndú;d lrk wdldrh osjhsfka m<uq oeä Wmia:dk tallfha fyoshl úiska fmkajk wdldrh

isf,daka Tlaisck iud.u ì;a;s yryd k, t,ñka wï,lr jdhqj iemhSug lghq;= lf<ah' fï uq,au Y,Hd.drfha mßyrkh i|yd my; hka;% iemhsk'

ventilators yd Morgan Pulmonary Function Machine hka;%hla Wiia ;dlaIKsl WmlrK jYfhka fuys Ndú;fha úh' fuh mqmamqiSh l%shdldß;ajh uek ne,Su i|yd rgg ;snqKQ tlu fuj<u jQ ksid fjk;a m%foaY j, frda.Ska i|ydofuu WmlrKh msysg úh' fuys ia:dms; lrk ,o Radiometer pH yd Blood gas machine hk hka;% osjhsfka tu ffcj l%shdldß;ajhka úuiSu i|yd ia:dms; lrk ,o m%:u hka;% ùuo úfYAI;ajhls'

BiScS fudksgrhla reêr mSvkudkhla uOH Ysrd udmlhla YrSr WIAK;ajh n,k WmlrK óg wu;rj Y,Hl¾u j,g Ndckh ùug kshñ; frda.Ska ksÍlaIKh Wfoid Bennet Pressure cycled

oeä Wmia:dk.; frda.Ska yg m%;sldr lsÍfï b;sydih jvd;a wudrefjka cSú;h .eg .id .kakd frda.Ska yg fjkuu

Y,H oeä i;aldr tallh we;=¿j fjk;a myiqlï imhkakehs b,a,d isáñka Tyq úiska ;ukag jákdlu i|yka fkdlrk ,o fplam;la tod ,nd ÿkakehs ta w;S;h isysm;a lrñka ffjoH ;sia,a chj¾Ok lshhs' tjlg fld<U uydfrda.HYd,dj" o fidhsid ud;D ksjdih" ßcafõ wd¾hd <ud frday, hk fï frday,a ish,a,u md,kh flrefKA tlgh' ;sia,a chj¾Ok uy;df.ao .=rejrhd jQ m%Odk ks¾úkaok ffjoH Wu.s,sh uy;d fï m%:u oeä Wmia:dk tallh ia:dms; lsÍug ud¾f.damfoaYl;ajh ÿka w;r m%Odk Y,Hd. drfhau mfilska Y,Huh oeä Wmia:dk tallh msysgqùug mshjr .kakd ,oS'

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doctormagazine.lk

m%;sldr lsÍu fkdfyd;a oeä Wmia:dk frda.Ska i|yd i;aldr lsÍfï w;S;h úuik l< th oYl yhlg jeä fkdfõ' kuq;a fï oeä m%;sldr wjYH frda.Skag úfYAI i;aldr l< hq;=h hk ixl,amh f,dj ìys jQfha wkdosu;a ld,hl isgh' tys ,sÅ; b;sydih 1850 ;rï wE;g osfjhs' l%sñhdkq hqo iufhaoS *f,darkaia khsáxf.a,a - fyos fiajdfõ mqfrda.dñksh jvd;a wudre frda. ;;a;aj we;s wh ffjoHjreka wdikakfha ;eìh hq;= nj fmkajd ÿkafkah' 1923 j¾IfhaoS fjda,ag¾ B vkaä kï ffjoHjrfhla wefußldfõ fcdakaia fydmalskaia úYAj úoHd,hSh frdayf,a Y,Hl¾u j,g Ndckh jQ iakdhq wdndO iys; frda.Ska i|yd fjku we|ka ;=kla fjka lsÍu oeä Wmia:dk tall msysgqùfï m%:u kQ;k wdo¾Yh úh' oeä Wmia:dk tallhla fia ie<lsh yels m%:u m%;sldr tallh ìysjQfha 1930 j¾IfhaoSh' ta c¾uksfha gqì. ka iriú frdayf,a Y,H tallfhah' udáka l%sIAk¾ kï ffjoHjrfhl= fuys,d mqfrda.dó úh' 1952-53 j¾I j, we;sjQ fmda,sfhda jix.; ;;a;ajfhaoS Ventilation myiqlï iys; oeä Wmia:dk tall we;eï rgj, wdrïN úh' 1953 j¾IfhaoS ífcda¾ka bífika kue;s ffjoHjrfhl= úiska jeä oshqKQ lrk ,o udos,sfha cSú;dOdrl myiqlï oeä Wmia:dk tall j,g y÷kajd ÿkafkah' 1960 j¾Ifhka miq Y,Hd. drhg mfilska oeä Wmia:dk tallhla l%shd;aul lsru idudkH isÿ ùula úh' Y%S ,xldfõ oeä Wmia:dk.; frda.Skaf.a m%;sldr úldYh fld<U uydfrda.HYd,dfõ m%:u jrg Wria m%;sldr tallhla wdrïN flrefKA 1952 j¾IfhaoSh' frda.shdg iïnkaO l< ECGfudksgrhla iu.ska fuh l%shd;aul úh' 1960 uq,a Nd.fhaoS East Radcliffe udos,sfha fjkaáf,ag¾ hka;%hla tys i:dms; flßK' uydfrda.

HYd,dfõ újD; yoj;a ie;alï wdrïN lsÍu;a iu.ska oeä Wmia:dk tallhla ixúOdkd;aulj msysgqùug

doctormagazine.lk

uQ,sl jQfha ks¾úkaok úfYAI{ ffjoH ;sia,a chj¾Okh' uydfrda.

HYd,dfõ Y,Hd.drhg wdikakfhka ie;alfuka isysh ,nk frda.Ska i|yd tallhla msysgqùug uq,a jQfha tl, frday,a lñgqfõ m%Odkshd jQ ffjoH B tï úfcardu uy;dh' ta;a iu.u Y,Huh fkdjk frda.Ska i|ydo we|ka folla fjka flreKQ w;r tajd lsÍgl yD;a frda.Ska úIfhys m%fhdackhg .kq ,eìK' fld<T uydfrda.HYd,dfõ Y,H oeä Wmia:dk tallh wdrïN flrefKA 1968 cqks 16 jkodh' fld<ôka msg m%:u oeä Wmia:dk tallhla m%:u jrg wdrïN flrefKA 1980oS fmardfoksh frdayf,aoSh' 1984 j¾IfhaoS hdmkfha oeä Wmia:dk frda.S tallhla wdrïN flßK' wo osjhsk mqrd frday,a 100l muK oeä Wmia:dk tall l%shd;aul flfrk w;r cSú;hg jákdlula tla lsÍu i|yd iqúfYAIS wdldrhlska l%shd;aul jk fïjdfhka ck;djg we;s M< m%fhdack kï buy;ah' DM 1 ATWP Jayawardene. A history of Intensive Care Medicine in Sri Lanka. Sri Lankan Family Physician, 2007, 28, 39-44.

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D•Magazine /

CABG Surgery

yDo fmky¿ hka;%h fhdodf.k isÿlrk nhsmdia ie;alï

Coronary artery bypass grafting (CABG) is a type of surgery that improves blood flow to the heart.

Surgeons use CABG to treat people who have severe coronary heart disease

On Pump Coronary Artery Bypass Graft / CABG Surgery yDo fmky¿ hka;%h fhdodf.k isÿlrk nhsmdia ie;alï znhsmdia l%uhg nhsmdia ie;alu lrkjdZ fudllao nhsmdia ie;alu lshkafka' ta ie;alu nhsmdia lrkjd lshkafka wehs@ fï l;dj uq,skau úi|d .ksuq'

kjf,dal frdayf,a fkajdisl yD;a Wria úfYAI{ ffjoH tia'm%§ma pdkaoa úisks

80

September 2019

uq,ska lSj znhsmdiaZ jofkka wre;a fokafka CABG fkdfyd;a Coronary Artery Bypass Grafting kue;s ie;aluhs' Coronary Artery fkdfyd;a lsÍgl Ouks lshkafka yoj; l%shdldß;ajh msKsi reêrh imhk Ouks' t;fldg fuh yoj; wdY%s; nhsmdia ie;alula .ek lshefjkakla' t;fldg fï nhsmdia ie;alu nhsmdia lrkjd lshkafka l=ulao@' nhsmdia ie;alula isÿ lsÍfï§ yoj; yd fmky¿ u.ska isÿlrk f,a msßisÿ lsÍfï l%shdj,sh thska bj;a lrjd-ke;fyd;a nhsmdia lrjdtys l%shdldß;ajh yDo fmKy¿ hka;%hg Ndr§ fï ie;alu

DOCTOR MAGAZINE

doctormagazine.lk

"

isÿ lsÍu ;uhs fuhska woyia lrkafka' wm hula Bypass lrkjd lshkafka kshñ; ud¾.h fjkqjg úl,am ud¾.hla fhdod .ekSuhs' lsÍgl Oukshla wjysr jqKdu ta wjysr jQ ia:dkh uÕ yrjñka fjk;a ud¾.hla Tiafia reêrh yDoh fj; ,efnkakg i,iajk ie;alu nhsmdia ie;aluhs' fï ie;alu lsßfï§ ;djld,sl jYfhka yDoh yd fmKy¿ l%shdldß;ajh hka;%hlg NdrÈu fojkqj lS bypass tlhs' Bypass surgery on bypass lshk f;arú,a, ±ka Tn f;darkak okakjd' nhsmdia ie;alu isÿ lrkafka wehs@ yDofha lsÍgl Oukshla wjysr jqfKd;a t;ekska tydg reêrh hkafka kE' túg wjysrhg Tífnka jQ yD;a fmaYs ydu;a fjkjd' fï wjysrh we;s lrkafka reêr kd, fïoh ;ekam;a ùfuka th y÷kajkafka we;afrdialaf,frdisia (Athrosclerosis) hkqfjka'

doctormagazine.lk

lsÍgl Oukshla wjysr jqKdu ta wjysr jQ ia:dkh uÕ yrjñka fjk;a ud¾. hla Tiafia reêrh yDoh fj; ,efnkakg i,iajk ie;alu nhsmdia ie;aluhs'

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D•Magazine /

yDo fmky¿ hka;%h fhdodf.k isÿlrk nhsmdia ie;alï

CABG Surgery

noaO lsÍug fhdod.;a fldgi lsÍgl Oukshg iïnkaO flfrhs

yojf;ys msysàu mdofhka ¨yqj;a lr.;a reêr kd,h uyd Ouksh yd lsÍgl Oukshg iïnkaO flf¾

wjysr jQ lsÍgl Ouksh

yoj;

Internal Mammary Artery Graft kej; msysgjQ fldgi

lsÍgl Ouks noaO lsÍug fhdod.;a kd,h yDofha ia:dms; lrkafka fufyuhs

nhsmdia ie;alu isÿ lrk m%Odk l%u nhsmdia ie;alu isoaO lrk l%u folla ;sfnkjd' On Pump fkdfyd;a yDo fmKy¿ hka;%h weiqf¾ lrk nhsmdia ie;alu zidïm%odhsl nhsmdia ie;aluZ f,i wre;a olajkafka fï On pump udÈ,sfha ie;aluhs' fuys§ wka;¾Ysrd u.ska ,ndfok úfYAI Tiqjla (cardioplegia) fhdodf.k yDo l%shdldß;ajh wl¾ukH lrkjd' ta fjkqjg isrerg wjYH 82

September 2019

flfrk reêrh fmdïm lsÍu zyDo-fmKy¿ hka;%hZ kï úfYAI hka;%hlg Ndr lrkjd' ±ka ffjoHjrhdg ksoyfia ie;alu isÿ l< yelshs' Off pump fkdfyd;a Beating Heart nhsmdia ie;alu Heart Surgery fuys§ iuia; yDoh wl¾uKH lrkafka kE' yDoh u.ska reêrh fmdïm lsßfï l%shdj,sh;a" fmKy¿ fhdodf.k reêrh wï,slD; lsßfï l%shdj,sh;a fkdlvjd

DOCTOR MAGAZINE

isÿ lrkjd' yDofha Y,Hl¾uhg m%ia;=; jk fldgi muKla hï wdldrhl .%yKhlg (stabilizing) wrf.k th ms<silr lrkjd' fï ie;alï l%shdj,sh z.efyk yoj;a nhsmdia ie;alïZ fkdfyd;a Beating Heart Bypass Surgery f,i ±lafjkjd' nhsmdia ie;alï lrk ;ek@ fï Y,Hl¾u folu Y,Hd.drfhaoS frda.shd id¾j ks¾úkaokhg ,lalrñka isÿlrk Y,Hl¾u' doctormagazine.lk

Internal Mammary Artery fhdod.;a w;=reu.

yoj; wjysr;djhg fhdod.kakd w;=re ux wjysr;djh Saphenous Vein fhdod.;a w;=reu. wjysr;djh

ie;alug .;jk ld,h ie;alï ld,hg n,mdk idOl /ila ;sfnkjd' reêr jdyskS lShla nhsmdia l< hq;=o@ ie;alu isÿ lrkafka yDofha l%shdldß;ajh wjysr lrñka fkdfyd;a Off pump l%uhgo@ ke;fyd;a yDo fmKy¿ hka;%hg fkdue;sj Beating heart Y,Hl¾uhla isoaO lrkjdo@ frda.shd yd ine|s fjk;a frda. ;;a;aj ;sfnkjdo@ wd§ idOl u; ie;alï ld,h fjkia úh yelshs' kuq;a

doctormagazine.lk

idudkHfhka fï ie;alï i|yd meh 3-6 w;r ld,hla .; úh yelshs' CABG fkdfyd;a On Pump nhsmdia ie;alfï mshjr yojf;ys lsÍgl Ouks.;j we;sjk fï ie;alu u`. yrjk nhsmdia ixl,amh jvd fyd|ska f;aerï .ekSug wms m%lg fld<U-. d¨ mdf¾ ud¾. wjysrh ksoiqklg .ksuq' fï wjysrhla we;s jqjfyd;a kshñ; .uk hdug Bg hdnÈka yd Bg iudka;rj

"

w;=re u.la Tiafia reêr ixirkh h:dj;a lr we;s wdldrh

zidïm%odhsl nhsmdia ie;aluZ f,i wre;a olajkafka fï On pump udÈ,sfha ie;aluhs' fuys§ wka;¾Ysrd u.ska ,ndfok úfYAI Tiqjla (cardioplegia) fhdodf.k yDo l%shdldß;ajh wl¾ukH lrkjd'

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D•Magazine /

yDo fmky¿ hka;%h fhdodf.k isÿlrk nhsmdia ie;alï

CABG Surgery

wï,lrh ysÕ reêrh yojf;ka bj;aj hka;%hg iïnkaO flfrhs

wï,lrh idr reêrhyoj; yd fmKy¿ u. yßñka isref¾ bkaøsh j,g meñfKhs

kd,

uyd Ouksh

reêrhfmKy¿ yd yD;a l=àr u. yßñka .uka lrhs

yoj; msysá ia:dkh

yoj;a fmKy¿ hka;%fhaoS reêrhg wï,lrh uqiq fjhs

yoj;a fmKy¿ hka;%h weiqf¾ lrk nhsmdia ie;alu

we;s vqma,sflaIka ud¾.h fhdod .kafkuq' ksjfia c, ud¾.h wjysr jQ úgo wm ta wjysr jQ fldgi u`y yßñka fjk;a k, ud¾.hla t<kafkuq' nhsmdia ie;alul§ isÿ lrkafkao tjekaklauh' yDo.; wjysrh ms<silr lsÍfuys,d mshjr my; mßoafoks' • kj kd,hla ta i|yd fhdod.; hq;=h' • ie;alu isÿ lsßug myiq jk fia yDofha l%shdldß;ajh k;r lr 84

September 2019

ta fjkqjg ta jev fldgi yDo fmKy¿ hka;%hlg Ndr Èh hq;=h' • kj kd,fha wjysr u. yefrk fia lsÍgl Ouks j,g iïnkaO l< hq;=h' • fï kd,h uyd Oukshg iïnkaO l< hq;=h' • yDo fmKy¿ hka;%h ¨yqj;a lr kej;;a reêrh fmdïm lsÍfï ld¾hh yoj;g Ndr Èh hq;=h'

DOCTOR MAGAZINE

nhsmdia ie;alu hkq fï tl tla b,lal imqrd,k fia lghq;= lrñka lsÍgl Ouks reêr iemhqu m%;sIaGdmkh lsßuhs' wms ±ka fï tla tla mshjr iúia;rd;aulj yodruq' nhsmdia lsßug fhda.H reêr kd,hla imhd .ekSu nhsmdia lsrSug fhda.H reêr kd,hla ilid .ekSu - Vein Harvesting fï i|yd fhdod.kakd iq,n reêr kd,hla kï mdofha Saphenous vein doctormagazine.lk

On Pump fkdfyd;a yDo fmKy¿ hka;%h weiqf¾ lrk nhsmdia ie;alu

h' fï kyrh ^kd,h& bj;a lr .ekSug kï bls,sh fmfofia isg j<¨lr olajd fPaokh lsÍug isÿ fjhs' nhsmdia ie;alug ,lajQ frda.sfhl= Y,Hl¾ufhka miq fõokdjkag m;afjk m%Odk fya;=jls fï È.= fPaokh' kuq;a fï hq.fha fuu fPaokh i|yd tkafvdiafldms ;dlaIKh fhdod .ekSfuka fï fõokdjka wju l< yelsj ;sfí' úfYaIfhkau fuu tkafvdiafldms ;dlaIKh Ndú;fha§ fhdok lemqu w`.,a 2-3 lg jeä fkdfõ'

doctormagazine.lk

Arterial Bypass w¿;ska ilid.;a kd,h yDohg iïnkaO lsÍug iq,nj fhdod .kafka LIMA fkdfyd;a Left internal mamory artery fõ' RIMA fkdfyd;a Right internal mamory artery fhdod .ekSfï§ we;s m%Odk jdishla kï mmqfõ yDoh mdod .ekSug fhdod .kakd lemqfukau fuu kyrho iïnkaO lr.; yels ùuhs' l,d;=rlska wjia:djl§ fï ld¾hh imqrd,kq jia Radial artery ^w; hg& fyda gestroepiploic ^wdudYh wi,& fhdod .kS'

Donor Saphenous vein Y%S ,xldfõ Ndú;d fkdlrk fuu udÈ,sfha we;s jeo.;alu kï reêr >khg .e,mqï l< kd,hla fjk;a wfhl=f. ka ,ndf.k th mgl nexl=fõ YS;k ;;a;aj hgf;a .nvd lr wjYH ;kays§ m%fhdackhg .ekSuhs' yDo fmky¿ hka;%hg yDofha fufyjr Ndr§u Cardiopulmonary bypass yDoh" reêrh fmdïm lsÍfï l%shdj,sfha;a" r;= ffi, u; Tlaiscka iemhSfï l%shdj,sfha;a ld¾hh yD;a fmKy¿

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yDo fmky¿ hka;%h fhdodf.k isÿlrk nhsmdia ie;alï

"

CABG Surgery

w;=re u. f,i fhdod .kq msKsi noaO lrk kyrhla bj;a lr.kakd wdldrh

hka;%h fkdfyd;a pump - oxygenator fj; Ndr fjhs' fuu hka;%hg iïnkaO lsÍu i|yd wjYH lghq;= isÿ lsÍu perfusionist f.a ld¾h Ndrhhs' fuu hka;%hg yDoh u.ska isÿlrk reêrh wï,.; lsÍu fukau ldnkavfhdlaihsâ bj;a lsÍuo u;= fkdj isref¾ mgl j,g wdï,sl reêrh yd fmdaIl iemhSu msKsi tu reêrh Ouks moaO;shg mßjykh lsÍfï yelshdjo ;sfí' yDoh fmKy¿ hka;%h u.ska yDofha$fmky¿ j, ffcùh ld¾h

86

September 2019

Ndrh Ndr.;a miq Y,H ffjoHjrhdg p,kh fkdjk" reêr .,kfhka ndOdjla fkdjk mßirhl ;u Y,Huh ld¾h Ndrh bgq l< yel' fuu wjYH;djh i,ikq msKsi Y,H ffjoHjrhd úiska uq,skau uyd Oukshg by<ska fhdok újrhla Tiafia l=vd ma,diaála áhqnhla Aortic cannula m%fõY lrkq ,efí' bkamiqj yDofha wmsßisÿ reêrh tl;= lrk l=àrhg ;j;a nghla - Venous cannula iïnkaO flf¾' fïjd ksjerÈj ia:dk

DOCTOR MAGAZINE

Y,Huh l%shdj,sfha ish¿ mshjr iïmQ¾K jQ wk;=rej yDofha l%shdldß;ajh kej;;a n, .ekafõ' yDoh .eiau;a" fmKy¿ msßisÿ lsÍfï l%shdj,sh n,.ekaùug iudkqmd;sl jk fia mshjfrka mshjr yDo-fmKy¿ hka;%h ¨yqj;a flf¾'

doctormagazine.lk

.; lsßfuka miq tajd yDo fmKy¿ hka;%hg iïnkaO lrk È.= kd, oaú;ajhl mqreoaokq ,efí' ±ka yDofhka isÿ lrk reêrh fmdïm lsßfï l%shdj,sh;a" fmKy¿ j,ska isÿ lrk TlaisckSlD; lsrSfï l%shdj,sh;a wk;=rej kej; tajd isrerg fnodyeÍfï l%shdj,sh;a Heart Lung Machine ke;fyd;a Cardiopulmonary Bypass (CPB) hka;%hg Ndrfõ' kj reêr kd, wjysr jQ ;ekg iïnkaO lsÍu uq,skau noaO lrkafka wjysrfhka Tíng jQ wka;fha kyrhhs' Distal Anastamosis kï fï msßoa§fuka miq ueyqï fhdod tu ld¾hh wjika flf¾' uyd Ouks.; wka;fha kyrh msßoa§u w¿;ska iïnkaO lrk ,o reêr kd, uyd Oukshg iïnkaO flf¾' Proximal Anastamosis kï fï l%shdj,sh u.ska kj kyrhg uyd Ouks.; reêrh iïnkaO flf¾' ie<lsh hq;= - Sutureless Anastomic Device we;eï wjia:dj,È

doctormagazine.lk

msßoa§u fjkqjg noaO lsßug Wmfhda.S lr .kakd f,dalkSh Ysrdfõ (saphenous vein) wka;h uyd Oukshg iDcqju iïnkaO flf¾' yDo fmKy¿ hka;%h ¨yqj;a lsÍu Y,Huh l%shdj,sfha ish¿ mshjr iïmQ¾K jQ wk;=rej yDofha l%shdldß;ajh kej;;a n, .ekafõ' yDoh .eiau;a" fmKy¿ msßisÿ lsÍfï l%shdj,sh n,.ekaùug iudkqmd;sl jk fia mshjfrka mshjr yDo-fmKy¿ hka;%h ¨yqj;a flf¾' CABG Y,Hl¾ufhka miq yDoh nhsmdia ie;alfuysÈ mek ke.sh yels ixl+,;d nhsmdia ie;alfuys§ n,.ekafjk Cytokine activation kue;s l%shdj,sh fya;=fldg f.k my; m%odysl ;;a;ajhka we;súfï wjodkula mj;S' • Red cell damage and haemoglobinuria • Thrombocytopenia • Clotting abnormalities • Reduced pulmonary gas exchange • Cerebrovascular accidents

yoj;a ie;alu i|yd mmq wegh Y,H fuj,ulska lmd yDoh olajd újr lsÍula isÿ fõ' ie;alfuka miq isÿlrk jeiSfï§ fhdod.kakd Steel wire tf,iu mj;skakg i,iajhs' fmaYs" fïoh yd iu isrerg Wrd.kakd ueyqï fhdodf.k jikq ,efí' hï reêr jykhla we;s jqjfyd;a tajd wdrCIs;j msg;g ldkaÿ lr.kq msKsi mmqfõ isg msg;g we;s ng tlla$lsysmhla fnda;,hlg iïnkaO flf¾' frda.shd oeä i;aldr tAllfha .; lrk uq,a Èk fol ;=<§ muK fï ng bj;a l< yel' tfiau ;j;a yoj;g iïnkaO jir lsysmhla pacemaker kï lD;%su úoahq;a iamkao W;amdok hka;%hlg iïnkaO flf¾' wjYH jqjfyd;a yD;a úoahq;a ikakhkhg yDohg wdOdr WmldÍ ùu tu pacemaker hka;%fha ldßhhs' ta yefrkakg" b;d úYd, jYfhka wdmodjg m;a yDoh iys; frda.Ska ie;alulg Ndckh lsÍfuka miq IABP fkdfyd;a Intra Aortic Ballon Pump kï úfYAI Wml%uhlg iïnkaO lrk wjia:d fhfoa' DM

September 2019

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Congenital Heart Diseases ixcdkSh yoj;a wdndO

88

September 2019

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doctormagazine.lk

ffjoH tia'kf¾kaøka úisks

Congenital Heart Diseases

h

Wmf;aoSu Wreuhla lr.kakd yoj;a frda. fkdfyd;a ixcdkSh yoj;a wdndO

ï wfhl= Wm; ,nk fudfyd; jk úg yDofha mj;akd frda.hla fjf;d;a th ixcdkSh yoj;a frda.hla (Congenital Heart Disease) fia wm y÷kajuq' yoj;g reêrh f.k hk kd," yojf;ka msg;g reêrh .k hk kd, yd l=àr w;r mj;akd lmdg''' fï wd§ ljr ;efkl fyda fodaI iys;j ore Wm;la isÿùug mq`Mjk'

yoj;g reêrh f.k hk kd," yojf;ka msg;g reêrh .k hk kd, yd l=àr w;r mj;akd lmdg''' Wmf;aoS fodaI iy.; jk yeá

yojf;ys Wmam;a;sfha§ we;sjk we;eï fodaI t;rï nrm;, fkdfõ' fï ksid Wmf;a§ fyda l=vd ld,fha§ ta nj y÷kd .kakg ,efnkafkao ke;' ydkslr fkdjk yoj;a j, ziq`M fodaIZ iys; úYd, ixLHdjla mqoa.,hska lsis÷ w;=re wka;rdhlska f;drj iqjfia fjfikqo olakg ,efí'

doctormagazine.lk

September 2019

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ixcdkSh yoj;a wdndO

Congenital Heart Diseases

yojf;a by<ska we;s l=àr oaú;ajh w;r we;sjk isÿr' fuh ASD f,i y÷kajhs' wï,lrh idr reêrh fï ÿn,;djh ksid wï,lrh ysÕmdvqj mj;sk reêrh yd ñY% fjhs

yojf;a my<ska we;s l=àr oaú;ajh w;r we;sjk isÿr' fuh VSD f,i y÷kajhs' wï,lrh idr reêrh fï ÿn,;djh ksid yD;a wNHka;rfha mSvkh by< kexfjk w;r isrerg wï,lr jdhqj ,eîfuyso wvqmdvqlï we;s fjhs'

kuq;a we;eï yDo fodaI fl;rï ie<lsh hq;= uÜgul mj;skafkao h;a Wmka iefklskau" iuyr úg ore Wm; isÿùug;a fmr ffjoHjrhdg th y÷kd.kakg wjia:dj ie,fia'

;yjqre lsrSug fjk;a mÍlaIdo ;sfí' ta .ek fuys miqjg úia;r flfrkq we;'

mmqjg iafg;iafldamh ;nd yDoh mßlaId lsÍfï§ widudkH iamkao rgdjla we;s ùu fujka y÷kd.ekSulg bv ie,fik m%:u wjia:djhs' widudkH yDo iamkao zzwiamkaoZZ fkdfyd;a Arrhythmia f,i y÷kaj;s' tfia uq,a jrg y÷kd.kakd fodaI iy.; ;;a;ajhka

fï wjodkï iy.; idOl w;r" m%fõKsl w`vq¨yq`vq;d" .¾NKS iufhaÈ ,nd .kakd we;eï T!IO" uOHidr yd u;aøjH weíneysh" .¾NkS iufha§ refn,a,d jeks ffjri wdidok we;sùu m%Odk ;ekla .kS' Èhjeähdj iys; ujqjrekag WmÈk orejka ixcdkSh yoj;a wdndO j,g ,la ùfï mia .=Khl by< iïNdú;djhla mj;S' Transposition of great arteries fï ixcdkSh wdndOh we;sùug m,sfndaO kdYl bjy,a jk nj ffjoH m¾fhaIK j,ska y÷kdf.k ;sfí' úNskak ;,a,$f;d, (Cleft lip/Cleft palate) iys; orejka yDoh.; fodaI j,skao fm<Sfï

90

September 2019

W;am;a;s.; yoj;a fodaI we;s jkafka wehs@ fndfydauhla fokdg kï óg ksYaÑ; fya;=jla y÷kd.; fkdyel' tfy;a m¾fhaIK j,ska y÷kdf.k we;s wdldrhg we;eï ldrKd ixcdkSh ^W;am;a;s.;& yoj;a fodaI j,g mdr lmhs'

DOCTOR MAGAZINE

doctormagazine.lk

Tetralogy of Fallot fodaIh iys; yDoh

ksfrda.S yoj; mqmamqYSh Ouksh uyd Ouksh

yoj; jïmi we;s wï,lrh idr reêrh

uyd Ouksfha jeä Odß;djhlska reêrh msgùu

ol=Kq fldaIsldfõ isg fmKy¿ fj; hk reêrfha wjysrùula isÿùu fldaIsldj úNskak ùfï fodaIh (VSD)

ol=Kq l¾Ksldj

yoj; ol=Kqmi we;s wï,lrh ysÕ reêrh

ol=Kq fldaIsldfõ >kùu

by< m%jK;djhla olajk uq;a thg fya;=j ;ju;a y÷kdf.k ke;' ixcdkSh yoj;a wdndO y÷kd .ekSug m%fõYhla ixcdkSh wdndO wvq;rfï ixLHd;aulj myf<djla j;a fõ' fodaIh mj;akd ia:dkh wkqj;a fodaIfha ;sj%;djh wkqj;a tajd j¾.SlrKh flf¾' yDoh iqug l%shdldß;ajh i|yd iïudoï jk m%Odk yD;a jHqyhka fufiah' ² isref¾ mj;akd reêrh yoj;g f.k tk Ysrd' ² yoj;g msúfik reêrh tla/ia lr.kakd by<ska msysà l¾Ksld oaú;ajh' ² yojf;a reêrh isrer ;=< wjfYaI lrk my;ska msysà fldaIsld' ² reêrh ksYaÑ; ÈYdjlg muKla ixirKh jkq msKsi ksuejqKq lmdg p;=¾:h' Tricuspid Valve - ol=Kq l¾Ksldj yd ol=Kq fldaIsldj w;r" Pulmonic Valve - ol=Kq fldaIsldj yd mqmaMqiSh

doctormagazine.lk

Ouksh w;r" Mitral Valve - jï l¾Ksldj yd jï fldaaIsldj w;r" Aortic Valve - jï fldaIsldj yd uyd Ouksh w;r" ² jï fldaIsldfõ isg isref¾ wjhj j,g wï,slD; reêrh mßjdr wjhj j, isg fmky`M lrd hk mqmaMqiSh Ouksh (Pulmonary Artery) Wmf;aoS yojf;ys we;súh yels m%Odk fodaI ² Defects in the Wall septum fkdfyd;a l¾Ksld yd fldaIsld

September 2019

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ixcdkSh yoj;a wdndO

Congenital Heart Diseases

w;r reêrh ñY% ùfuka we;sjk fodaI' ² Stenosis or Atresia lmdg isyska ùu fyda lmdg iïmQ¾Kfhkau jeiS hdu Insufficiency or Regurgitation lmdghlska reêrh .uka lsÍfï§ ta uq,a l=árhg reêrh ldkaÿ ùu' ² Ysrd m%Odk Ouks yd yDoh w;r widudkH iïnkaO;djhla ùu' fuys m%;sM<h jkafka Tlaiscka j,ska idr reêrh fjkqjg ñY% reêrh mgl j,g ,nd .ekSug isÿùuhs' ² Ysrd fyda OukS isyska ùu' ² fmaYs.;j we;sjk ÿ¾j,;d' ixcdkSh yDo fodaI j, frda. ,laIK Cyanosis - fndfydauhla frda.j,§ Cyanosis kñka ye|skafjk frda. ,laIK - tkï ifuys ks,a meyehg lsÜgq meyehla olakg ,eîu úfYAIfhkau tu ,laIK f;d,a" kshfmd;= háka yd Èfjys olakg ,efí' fmKy¿ lrd m%udKj;a f,i reêrh fkdiemhSu" Tlaiscka idr yd Tlaiscka ySk reêrh iïñY%Kh ùu fujka ,dlaIKsl ks,a

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September 2019

meyehg fya;=jhs' orejkaf.a fï ;;a;ajfha§ fõ.j;a Yajikhla olakg ,efí' jeäysáhkaf.a kï myiqfjka fjfyig m;ajkq olakg ,efí' fmky¿ j,g we;s reêr iemhqu ySk lrk ixcdkSh frda. ;;a;aj iuyrla Pulmonary Stenosis Pulmonary Atresia Tetralogy Fallet Tricuspid Atresia Ebsteins Anomaly Tlaiscka idr reêrh yd Tlaiscka ySk reêrh iïñY%Kh lrk frda. ;;a;aj iuyrla Transposition of the great arteries.

Hypoplastic left heart syndrome.

Total anomalous pulmonary venus return.

oaù;=kav uyd Ouks lmdgh isyska ùfï ixcdkSh wdndOh

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doctormagazine.lk

yDo wlrKsh (Heart Failure) we;slrk ixcdkSh frda. ;;a;aj iuyrla Ventricular Spetal Disease. (VSD) Atrial Septal Disease.

(ASD) Hypoplastic Left Heart Syndrome (HLHS) AV Septal Disease iudk kï (atrioventricuar canal defect or endocardial cushior defeat) Trancus Arteriosus.

Interrupted Aortic Arch. yDofhys jHQyhka isyska ùug (Stenotic Defects) n,mdk ixckSh ;;a;aj iuyrla Aortic Stenosis Pulmonary Stenosis Coarctation of the Aorta Peripheral Pulmonary Artery Stenosis ixcdkSh wdndO y÷kd. ekSug fhdod.kakd mÍlaIK ECG fkdfyd;a bf,lafg%daldäfhda.%Eï mßlaIdj Echocardiogram fkdfyd;a tflda mßlaIdj' Chest X-Ray fkdfyd;a mmqfõ úlsrK mßlaIdj' Pulse Oximeter we`.s,a,la fyda lka fm;a;l ixfõolhla r|jd

Patent Ductus Arteriosus (PDA) mqmamqiSh Ouksh;a uyd Ouksh;a w;r mj;akd iïnkaOhla Wmf;ka miqj jeiS fkdhdfuka we;sjk fodaIh' fï ksid wdï,slD; reêrh fmKy¿ j,g ixirKh úh yel'

reêrfha Tlaiscka idkaøKh fiùfï mßlaIdj' XMR : MRI mßf,dalk fhdod.ksñka yDofha ;%sudKrEmS m%;sìïn ,ndf.k ta wkqidrfhka reêr ixirKh yd yDo iamkao mßlaId lsÍu' Patent Ductus Arteriosus (PDA) l<,Sh cSú;hla f.jk iufha§ mqmamqiSh Ouksh;a uyd Ouksh;a w;r mj;akd iïnkaOhla Wmf;ka miqj jeiS hd hq;=h' tfia fkdùfuka wdï,slD; reêrh fmKy¿ j,g ixirKh úh yel' fuh fkdfïrE <orejka w;r iq,nh' Atrial Septal Defect (ASD) yDofha by<ska we;s l=àr fol l¾Ksld fol w;r reêrh iïfm%aYKh ùula isÿfjkjd' fuu isÿr ksid yDofha jï mi isg ol=Kq mig reêrh .e,Sula

D•Magazine /

ixcdkSh yoj;a wdndO

Congenital Heart Diseases

"

m%fõKsl w`vq¨yq`vq;d" .¾NKS iufhaÈ ,nd .kakd we;eï T!IO" uOHidr yd u;aøjH weíneysh" .¾NkS iufha§ refn,a,d jeks ffjri wdidok we;sùu m%Odk ;ekla .kS' Èhjeähdj iys; ujqjrekag WmÈk orejka ixcdkSh yoj;a wdndO j,g ,la ùfï mia .=Khl by< iïNdú;djhla mj;S'

isÿfjkjd' fuh jeiS hdula isÿ fkdjqfKd;a ie;alula u.ska tu isÿr jeish yelshs' Ventricular Septal Defect (VSD) yDofha my;ska ;sfnk l=àr fol-fldaIsld fol w;r isÿrla we;s ùu' fï ksid m%n, mSvkhla iys; jï mi isg ol=Kq mig reêrh .,d f.dia wjik ta ksid fmKy¿ u;g wu;r mSvkhla fhfokjd'

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September 2019

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Atrioventrioular canal (AVC fyda AV Canal) fuh ixcdkSh fodaI /ila we;s l< yels ixlS¾K frda. ;;a;ajhls' ASD yd VSD hk isÿr we;sùu fukau ;%s;=Kav yd uhsg¾ lmdg ksis whqßka l%shd;aul fkdùuo fï ksid isÿ úh yel' Tricuspid Atresia ol=Kq l¾Kslfõ isg ol=Kq fldaIsldj fj; reêrh imhk ;%s ;=Kav lmdgh iE§ ke;s úg Pulmonary Atresia mqmaMqiSh lmdgh msysgd we;af;a ol=Kq fldaIsldfõ isg mqmaMqiSh Ouksh w;rhs' fï lmdgh

doctormagazine.lk

tla ÈYdjlg muKla reêrh ixirKh jkq jia úfYaIs; m;% ;=klska hqla;h' Pulmonary Atresia kï ;;a;ajfhaÈ fï m;% kshñ; ld¾hCIu;djh fkdolajhs' m%;sM,h jkafka ol=Kq fldaIsldfõ ;sfnk reêrh fmky`M fj; kshñ; mßÈ f.k hdug wfmdfydi;a ùuhs' Transposition of Great Arteries fuh m%Odk Ouks msysáï fjkia ùu ksid isÿjk wlr;eínhls' uyd Ouksh ol=Kq fldaIsldfjka weröu ksid reêrfhka jeä yßhla fmky`M.; ù wï,lrh ,nd .ekSulska f;drj YÍrh mqrd .uka lrhs' mqmaMqiSh Ouksh jï l¾Ksldfjka weröu ksid fmky¿ j,ska yDohg msúfik reêrfhka jeä yßhla kej;;a fmky¿ j,g msúfihs' Tetralogy of Fallot fuh fodaI iy.; fya;+ka y;rla ksid we;sjkafkah' tajd my; mßÈh' ol=Kq fldaIsldfõ isg jï fldaIsldjg reêrh iïñY%Kh jk ASD isÿrla we;sùu'

doctormagazine.lk

mqmaMqiSh lmdgh my;ska reêr kd,fha isyska ùula we;s ù yDofha ol=Kq mi we;s reêrh fmky`M j,g hdu wjysr ùu' ol=Kq l¾Ksldj idudkH muKg jvd fmaYsuh iajNdjhla ±Íu' VSD isÿr we;s ;ekg by<ska uyd Ouksh msysàu' Double Outlet Right Ventricle (DORV) uyd Ouksh;a" mqmaMqiSh Ouksh;a hk Ouks oaú;ajhu ol=Kq fldaIsldjg iïnkaO mej;Su' Truncus Arteriosus uyd Ouksh;a" mqmaMqiSh Ouksh;a hk folu tlu ;eklska weröu' bka miqj th fjk fjku bÈßhg hhs' Coarctation of the Aorta fuys§ uyd Ouksh isyska ùula we;sù isref¾ my; fldgig jk reêr iemhqug ndOd meñfKhs' ore Wmf;a§u frda. ,laIK my< fkdjQj;a i;shl muK wejEfuka orejd flfryS frda. ,laIK my< fõ' reêr mSvkh by< hdu yd yoj; wlrKsh we;s jqjfyd;a Y,Hl¾uhlg iqodkï l< hq;=h' Aortic Stenosis (AS) jï fldaIsldj;a uyd Ouksh;a w;r uyd Ouks lmdgh kshñ; mßÈ ksueùula isÿ fkdfõ' idudkHfhka fu;ek lmdgfha m;% ;=kla we;s uq;a fuu ÿ¾j,;djfha§ olakg ,efnkafka tla m;%hla (unicuspid) fyda m;% fofla (bicuspid) lmdghls' fï ksid isref¾ wx. m%;Hdx. j,g reêrh iemhqug ndOd we;sfõ' Hypoplastic Left Heart Syndrome (HLH) yojf;ys m%Odk kd,j, we;sjk fodaI /il tl;=jls' fuysÈ fndfyda úg jï fldaIsldj" uhsg¾ lmdgh' uyd Ouksh yd uyd Ouksl lmdgh m%udKfhka l=vd ùu yd wmßK;j ks¾udKh ùula olakg ,efí' fuhg m%;sldr fkdlf<d;a ;;a;ajh Nhdkl úh yel' DM

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DOCTOR MAGAZINE

95

D•Magazine /

Drugs for Heart Patients yoj;a frda.Skag fok T!IO

There are many effective medicines to treat heart disease. Medicines can reduce your risk of heart attack, angina, stroke, or heart failure. They can help manage symptoms by controlling high blood pressure and high blood cholesterol, and improve your quality of life.

yoj;a frda.Skag fok T!IO yoj;a frda. j,g ,lajQ frda.Ska ;ukag ,nd fok T!IO iïnkaOfhka lsishï jQ uQ,sl wjfndaOhla ,nd ;sîu jeo.;a fõ' fï ta iïnkaOfhka m%fõYhls' weiam%ska (Aspirin) fuh reêr mÜáld j, wef,k iq`M .;sh wvq lsÍug WmldÍ fjhs' mÜáld hkq f,a leá .eiSug WmldÍ jk ffi, úfYaIhls' weiam%ska noaO lrk ,o reêr kd, ;=< f,a leá .eiSu j<lajd,hs' Tn uq¿M cSú; ld,h mqrdu Èkm;du weiam%Ska fm;a;la .; hq;=hs' idudkHfhka Èklg wjYH ñ' .%Eï 300 l fm;a;ls' Tng fuu.ska nv ±ú,a, .;shla we;sfõ kï th Èklg ñ'.%E' 75 olajd wvq l< yel' fkdue;s kï wdydr iu. .ekSug mq`Mjk'

96

September 2019

DOCTOR MAGAZINE

doctormagazine.lk

weÜfkdf,d,a (Atenolol) fuh by; fm%dmekf,da,a j,g iudk T!IOhls' kuq;a fuh .; hq;af;a Èklg jrla muKls' fjd*ßka (Warfarin) yoj;a lmdg noaO lsÍfï ie;alulska miq tu lmdg wjg f,a leá .eiSfï we;s yelshdj wju lsÍu i|yd idudkHfhka fjd*aßka T!IOh kshu lrkq ,efí' fjd*aßka T!IOh f,a leá .eiSug ;=vq fok

doctormagazine.lk

"

fm%dmekf,da,a (Propanolol) fndfyda úg Tn ie;alug fmr fuu fnfy;a mdúÉÑ lrkakg we;' ie;alñka miqj;a yDo l%shdldß;ajh wvq lsÍu i|yd fuu T!IOh fhdod .efka' fuu fnfy; Ndú;h yÈiaisfha k;r lsÍu yDo fõ.h jeä ùug;a" ßoaufha widudkH;djhla" we;sùug;a fya;=fõ' ie;alñka miq idudkHfhka .;hq;= fnfy;a m%udKh l=vd jk w;r th udi 2-3 miq k;r flf¾' Tn wêl reêr mSvkfhka fmf<a kï Bg;a jeä ld,hla tu fm;s .; hq;af;a Èklg jrla muKs'

yoj;a lmdg noaO lsÍfï ie;alulska miq tu lmdg wjg f,a leá .eiSfï we;s yelshdj wju lsÍu i|yd idudkHfhka fjd*aßka T!IOh kshu lrkq ,efí'

idOl ;=rka lsÍug iu;a jk ksid yojf;a we;sjk f,a leá .eiSula j<lajd,Sug th bjy,a fõ' fuu T!IOh mdúÉÑ lsÍu u.ska w;ajk m%;sM, frda.shdf. ka frda.shdg fjkia jk w;r" T!IO mdúÉÑfha§ we;sjk f,a leá.eiSu j<lajk l%shdj,sho Èfkka Èk fjkia fõ' ta ksid ish¿ frda.Ska ffoksl msßlaiqulg ,la lsÍfuka wk;=rej T!IO ud;%dj ks.ukh lsÍu fhda.H jk nj meyeÈ,sh' fuys§ whs'tka'wd¾' (International Normalised Ratio) kñka ye|skafjk mÍlaIKh u.ska f,a mÍlaId lr n,d ksjerÈ l%shd ms<sfj,la T!IO ud;%d kshu lsÍfï§ wkq.ukh isÿ flf¾' fuu (INR) mÍlaIKh m<uq i;s lSmh ;=<§ wvq jYfhka i;shlg fojrla fyda ;=kajrla isÿ l< hq;= w;r Bg miq uilg jrla fyda fouilg jrla frda.shd mÍlaIKhg Ndckh lsÍu isÿ jkq we;' f,a leá .eiSu wju lrk T!IO mdúÉÑ lsrSfï§ iuyr úg kdifhka f,a jykh ùula ±lsh yel' iq¨ lemqï ;=jd,hl§ jqj;a ;Èka f,a .e,Sula isÿ ùug bv ;sfnk w;r" ;reK ldka;djkaf.a udia Y+oaêh isÿjk wjia:djkayS§ wêl reêr jykhla isÿ ùuo úr, fkdfõ' kdifhka f,a .,kq ,nk wjia:dfõ ñks;a;= 10 l muK ld,hla kdih ;Èka f;rmd ysrlrf.k isàuo lemqï ;=jd,hl§ kï ñks;a;= myl muK ld,hla lemqKq ia:dkh ;olrf.k isàfukao f,a .e,Su k;r jkq we;' f,a .e,Su È.gu mj;S kï ffjoH Wmfoia me;Su fhda.H fõ'

September 2019

DOCTOR MAGAZINE

97

D•Magazine /

yoj;a frda.Skag fok T!IO

Drugs for Heart Patients

fjda*ßka mdúÉÑ lrk wjia:dj,§ weiam%ska wvx.= T!IO .ekSfuka je<lS isàug j.n,d .; hq;=h' INR f,a mÍlaIKh m%;sM< yd fjda*ßka T!IOh .kq ,nk ud;%d igyka ;nd .ekSu i|yd ms<sfh, lrk ,o igyka fmd;la Tn fj; ,nd fokq ,efí' Tn úiska fuu igyka fmd; kej; f,a mÍlaIKh i|yd frday,g meñfKk úg /f.k wd hq;=h' Tn hïlsis wdndOhlg fyda wikSmhlg fjk;a ffjoHjrfhl= yuqjk iEu wjia:djl§u tu ffjoHjrhdg Tn fjda*Íka T!IOh mdúÉÑ lrk nj mejish hq;= 98

September 2019

w;r" f,a leá .eiSu j<lajk igyka wvx.= igyka fmd;o Tyqg fmkaúh hq;=uh' äfcdlaiska (Digoxin) fuu T!IO Tfí yDo fõ.h wvq lsÍug;a w;sf¾l iamkaokhka keje;aùug;a fhdod .efka' Tfí yDo iamkaok fõ.h úkdählg 55 g wvq kï fuu fm;s keje;aùug wjYH úh yels neúka ffjoH Wmfoia ,nd .kak' T!IOh m%udKhg jvd jeä ùfuka jukh hdula we;s úh yelsh' tjeks ;;a;ajhla we;s jQ úgo ffjoH Wmfoia ,nd.kak' *areiuhsâ (Frusemide) ìhqßfklaia (Burinex) fuu T!IO iudk l%shdldß;ajfhka hqla;h' th Tfí jl=.vq u.ska jeäfhka uq;%d fmrSula we;s lrhs' isref¾ c, m%udKh wêl ù yDofha ld¾hCIu;djh wvq ùug fya;=fõ' tf,iu ie;alu ksu úu;a iu.u isrefrys c,h muKg jvd jeä fkdùu yojf;a ukd l%shdldß;ajh msKsi fõ' fuu T!IO uq;%d iu. isrefrka jeä fmdgEishï m%udKhla msgùug fya;=jk fyhska tu fmdgEishï isrerg ,nd §ug m<;=re wdydrhg .kak' DM

DOCTOR MAGAZINE

doctormagazine.lk

D•Magazine /

Cardiac Rehabilitation yDofrda.Ska mqkre;a:dmkh lsÍfï jevigyk

CARDIAC REHABILITATION

fld<U" cd;sl frdayf,a" yDo frda. tallfha fy!; Ñls;ail wêldÍ' ta'hQ'iS w;=fldar< uy;añh úisks

If you have heart disease, your doctor may encourage you to participate in a cardiac rehabilitation (rehab) program, which is designed to help you exercise safely and maintain a heart-healthy lifestyle.

yDohdndOhla je<£fuka miq fndfyda úg isÿjkafka iafgkaÜ tlla ±óu u.ska m%;sldr lsÍu fyda frda.h ;rula W;aikak ;;a;ajhg meñKs úg nhsmdia ie;alu u.ska m%;sldr lsÍuh' flfia fyda fuu m%;sl¾uhka foflys§u óg fmr Wmfoia fokq ,enQfha frda.shd udi lsysmhla we|gu ù úfõlS iqjfhka l,a.; l< hq;= njh' kuq;a j¾;udk ;;a;ajh Bg fndfyda fihska fjkia ù we;' ta wkqj wo f,dalfha fndfyda rgj, yDo frda.Skg iqÿiq m%;sldr isÿ lsÍfuka miq fmr mqreÿ Ôú;hg yqreùu i|yd mqkre;a:dmk jevigyka l%shdjg kexfõ'

yDo frda.hg n÷ka jQ whg Ôú;hg uqyqK§ug mkakrh ,ndfok yDofrda.Ska mqkre;a:dmkh lsÍfï jevigyk

ó

g l,lg by;§ kï yDohdndOhla je<÷Kq wfhl= kej; fuf,dj Ôj;a ùug jdikdjka; jQfha b;du;a l,d;=rlsks' kuq;a wo jk úg kùk ffjoH úoHdfõ n, uysufhka fidhd .kakd ,o id¾:l m%;sldr l%u ksid w;S;hg idfmalaIj yDohdndO we;sùu ksid Ôú;h wysñ jkafka b;d iSñ; msßilg muKs'

doctormagazine.lk

wm rg ;=<o cd;sl frday, uQ,sl lr .ksñka yDo frda.Ska mqkre;a:dmkh lsÍfï

September 2019

DOCTOR MAGAZINE

99

D•Magazine /

yDofrda.Ska mqkre;a:dmkh lsÍfï jevigyk

Cardiac Rehabilitation

jevigyka jir oy wglg wêl ld,hla id¾:lj l%shdjg kexfjk w;r ta ;=<ska yDo frda.hg n÷ka jQ oyia .Kkla frda.Ska ldhsl udkisl jYfhka fmr .; l< Ôú;hg yqre lsÍug lghq;= i,id ;sfí' fuh fnfyúkau w.h l< hq;= lghq;a;ls' yDo frda.Ska mqkre;a:dmkh lsÍfï fuu jev igyk yDo frda. úfYAI{ ffjoHjrfhl=" udkisl frda. úfYaI{ ffjoHjrfhl=" fN!; Ñls;ailjrfhl=" fyÈhl" fmdaIKfõÈhl= yd T!IOfõÈhl= we;=¿ lKAvdhulska iukaú; fõ' fuu mqkre;a:dmk jevigyka m%Odk wÈhr y;rla hgf;a l%shd;aul flf¾' tA wkqj m<uq wÈhf¾§ frda.shd ±ä i;aldr tallfha isg jdÜgqjg /f.k tau;a" bka miqj l%udKql+,j wef|ka neiaiùu ms<sn|j;aa ±kqj;a lsÍu isÿ flf¾' ó,`. wÈhf¾§ isÿjkafka {d;Ska yg ksjfia§ frda.shd /ln,d

100

September 2019

.kakd wldrh ms<sn|j wjfndaOhla ,nd§uh' ;=kajk wÈhf¾È isÿjkafka ndysr frda.sfhl= f,i fuu mqkre;a:dmk jevigykg iïnkaO ùuh' yDohdndOhlg ,laùfuka miq iafgkaÜ tlla ±uQ frda.sfhl= i;s follg miqjo nhsmdia ie;alulg uqyqKÿka frda.sfhl= udihlg miqjo" ;=kajk wÈhr hgf;a fuu mqkre;a:dmk jevigyk fj; le`ojkq ,efí' bka miqj Èk wglA ;=< jev igyk yd iïnkaO úh hq;= fõ' i;sfha nodod mia jrefõ yd fikiqrdod Wfoa jrefõ fuu jevigyk ls%hdjg kexfõ'

DOCTOR MAGAZINE

yDo mqkre;a:dmk jevigyk meje;afjk Èk wg ;=< jevigyka wgla isÿ lsÍug ie<iqï lr ;sfí' tA wkqj jevigykg iïnkaOjk m<uq Èkfha frda.shdf.a wjodkï idOl ms<sn|j úfYaI wjOdkhg ,la flf¾' ta wkqj frda.h s dg úkdä yhl ld,hla weú§ug i,iajd Ejection Fraction w.h i,ld nef,a' ta u`.ska frda.shdg uykaish ±fkk wdldrh ms<sn|j ks.ukhkag meñfKa' bÈßfha§ frda.h s dg jHdhdï isÿlsÍfï uÜgu ms<sn| fuu mÍlaIdfjka miqj ;SrKh flf¾' bka miqj frda.Ska iuQyhla f,i f.k jHdhdu jevigykg

doctormagazine.lk

wm rg ;=< cd;sl frday, uQ,sl lr .ksñka yDo frda.Ska mqkre;a:dmkh lsÍfï jevigyka jir oy wglg wêl ld,hla id¾:lj l%shdjg kexfjk w;r ta ;=<ska yDo frda.hg n÷ka jQ oyia .Kkla frda.Ska ldhsl udkisl jYfhka fmr .; l< Ôú;hg yqre lsÍug lghq;= i,id ;sfí' fuh fnfyúkau w.h l< hq;= lghq;a;ls'

yDo frda. mqkre;a:dmk jevigykl uQ,sldx.

jH d

Wm ldr

h

l< ;s wd;

uK

fm daI h K

u hd

dl rK h

hï avd lK

iyNd.s lrjkq ,efí' tys§ jHhdï lsÍu ;=<ska n,dfmdfrd;a;= jk m%ÓM, ms<sn|j frda.Skg wjfndaOhla ,ndfoa' ;ukaf.a kdä jeàfï fõ.h ;ukagu .Kkh lr .ekSug ±kqu ,nd§u uq,skau isÿflf¾' fuys§ isÿ lrk jHdhdu m%Odk jkafka iajdhq jHdhduhkah' Bg wu;rj lsf,da.%Eï 1-1'2 jeä nrla tiùfuka isÿlrk ks¾jdhq jHdhdïo we;=<;ah' tu`. ska n,dfmdfrd;a;= jkafka oE;a iy YÍrfha Wv fldgi Yla;su;a lsÍuh' tu.ska yDohg jeä nrla fkd±fkk mßoafoka frda.shdg jeä jev fldgila lr .ekSug mqyqKq flf¾' bka miqj È. we§fï jHdhdu isÿ l< hq;=h' fuu ish`M jHdhï isÿ lsÍug m%:u wksjd¾hfhka u we`. WKqiqï lsÍfï jHdhdï isÿ l< hq;=fõ' fuu mqkre;a:dmk jevigykg we;=<;ajk wOHdmksl jevigyfka§ yDofha l%shdldß;ajh iy ;ukag we;sù ;sfnk frda.h ms<sn|j ksis wjfndaOhla ,nd§ug l%shd flf¾' udkisl m%;sldr jevigyk yDofrda. mqkre;a:dmk jevigykg we;=<;ajk iqúfYaI wx.hls' fuys§ udkisl wd;;sfhka f;drj ieye,a¨fjka Ôú;hg uqyqKfok wdldrh ms<sn|j úfYAI kHdhsl iy m%fhda.sl jevigyka l%shdjg kexfõ' ksjerÈ f,i iy fkdlvjd T!IO .ekSfï we;s jeo.;alu ms<sn|j T!IOfõÈfhl= úiska

doctormagazine.lk

frda.Skg ±kqj;a flf¾' tfiau yDo frda.shdf.a tÈfkod wdydrfõ, flfia ilia úh hq;=o hkak fmdaIKfõÈhd= úiska ±kqj;a lrkq ,efí' frda.shd iu`. mjqf,a wfhl=o fuu jevigyk yd iïnkaO ùu b;d jeo.;ah' ta ;=<ska b;d flá l<la ;=<§ yDo frda.hg f.dÿre jQ wfhl= idudkH wfhl= fuka bÈß Ôú;hg uqyqK§ug ldhsl udkisl jYfhka ikakoaO lrùu fuu mqkre;a:dmk jevigyfka wruqKh' th id¾:l lr .ekSug frda.shdf.a wjxl lemùu w;HjYHh' DM idlÉPd lf<a ( uOqjka; niakdhl

September 2019

DOCTOR MAGAZINE

101

D•Magazine /

Angina

.Eiag%hsgsia f,iska jrojd jgyd .kakd yDohdndOhla .ek bÕslrk wekachskd lelal=u

.Eiag%hsgsia f,iska jrojd jgyd .kakd yDohdndOhla .ek bÕslrk

wekachskd lelal=u

yDo frda. úfYaI{ ffjoH kdu,a úchisxy

fuh fndfyda úg we;sjkafka mmqfõ yß ueo ysrùula n÷ lelal=ula f,ih' tfia;a ke;akï mmqfõ Wv f,dl= nrla ;enqjd jeks fõokdjls' mmqfõ fõokdjla úáka úg we;s jk úg .eiag%hsáia ksid" jd;h ksid wd§ jYfhka úúO fya;= olajñka fkdfhl=;a ;djld,sl ms<shï fh§ug wms mqreÿ ù isáuq' kuqÿ úáka úg we;s jk mmqfõ lelal=u yDohdndOhla we;sùu flfrys bÕslrk wekachskd lelal=u ùug fndfyda ÿrg we;sjk ffjoH ks.ukhhs' fï ksid úáka úg we;sjk mmqfõ lelal=u fldi,ld yeÍu Nhdkl m%;sM, w;aú£ug isÿúh yels fya;=jla ùug mq¿jk'

102

September 2019

DOCTOR MAGAZINE

doctormagazine.lk

wekachskd (Angina) lelal=u hkq lsÍgl Ouks wjysr;djh ^Coranary artery disease& we;s frda.Skg nyq,j we;sjk ;;a;ajhls' fuh fndfyda úg we;sjkafka mmqfõ yß ueo ysrùula n÷ lelal=ula f,ih' tfia;a ke;akï mmqfõ Wv f,dl= nrla ;enqjd jeks fõokdjls' fuu lelal=u fn,a,g fyda jï fyda ol=Kq Wrysia iy ndyqj,g .uka lrk w;r ñks;a;= lsysmhla úfõlSj ys£fuka fyda Èj hg ;nd .kakd T!IO Ndú;d lsÍfuka miqj flfuka wvqù hd yelsh' wekachskd lelal=u we;sjkafka fufyuhs kuq;a we;eï frda.Skag wekachskd lelal=u we;sjkafka by; i|yka l< idudkHfhka we;sjk lelal=ug jvd fjkia wdldrhghs' tys§ mmqfõ lelal=u yß ueo fkdj mmqfõ fjk;a ia:dkhl we;súh yelsh' tfiau lelal=u mmqfõ we;s fkdù fn,af,a" yKqfõ fyda jï fyda ol=Kq ndyqj, we;s ùugo mq¿jk' fï wdldrhg ta ta ;eke;a;d i|yd lelal=u we;sjk wdldrh wdfõKsl jk w;r

doctormagazine.lk

Tjqkg fuu lelal=u kej; we;sjkafka uq,a wjia:dfõ we;sjQ wdldrhguh' wdudYfha m%odyh fyj;a fndfyda fofkla w;aú¢k .eiag%hsáia ;;a;ajh ksid mmqfõ yd nfâ ±ú,a,la we;sùu iq,n ;;a;ajhls' fufia we;sjk ±ú,a,la wekachskd lelal=ula we;eï wjia:dj,§ fjka lr y÷kd .ekSu frda.shdg muKla fkdj ffjoHjrhdgo wmyiq úh yel' fï ksid ks;r we;sjk .eiag%hsáia fõokdj iuyr úg wekachskd lelal=u iuÕ meg,Su ;=<ska wk;=reodhl ;;a;ajhkag uqyqK mEug isÿúh yelsh' wekachskd lelal=u jeä jYfhka we;sjkafka uykais ù jevla lrk úg" ìhg fyda fldamhg m;aùu jeks is; l<n, jQ wjia:djl fyda wêl iS; ld,.=Ksl ;;a;ajhla we;s wjia:djka j,hs' tkuqÿ we;eï frda.Skag úfõlSj isák wjia:djka ys§ mjd wekachskd lelal=u we;sùug mq¿jk'

September 2019

DOCTOR MAGAZINE

103

D•Magazine /

Angina

.Eiag%hsgsia f,iska jrojd jgyd .kakd yDohdndOhla .ek bÕslrk wekachskd lelal=u

wekachskd lelal=u we;sjkafka yDofha lsÍgl Ouks j, reêrh .ukd.ukhg wjysr;d we;sùu ksid yDofha reêr iemhq wvd, jQ úgh' Ouks ;=< fldf,diagfrda,a ;ekam;aùu ksid iuyr ;eka wjysr ùug mq¿jk' by;ska i|yka l, yDofha ls%hdldrs;ajh jeä jk " yDo fmaYshg jeä reêr m%udKhla wjYH úgl lsÍgl Ouks j, wjysr;dj ksid reêr iemhqu wvd, jk úg wekachskd lelal=u we;sfõ' lsÍgl Ouks b;d ;on, f,i wjysr ù we;s wjia:djl b;d iq¨ fjfyiùul§ fyda úfõlSj isák wjia:djl§ mjd fuf,i wekachskd lelal=u we;súh yelsh' uQ,sl mÍlaIdj ECG wekachskd lelal=u y÷kd .ekSug isÿ lrk uQ,sl mÍlaIdjla jkafka B'iS'Ô' ^ECG& mÍlaIdjhs' máfha we;sjk fjkialï j,ska hï wfhl=f.a mmqfõ lelal=ula lsÍgl Ouks wjysr;djhla ksid we;sjk wechskd lelal=ulao hkak y÷kd .ekSug mq¿jk' kuqÿ wekachskd lelal=u we;s iEu frda.sfhlau B'iS'Ô'^ECG& mÍlaIdjla uÕska y÷kd .ekSug fkdyels wjia:djo we;' oreKq lsÍgl Ouks wjysr;djhla we;s frda.sfhl=f.a jqj;a úfõlfhka isák wjia:djl ,nd.;a ECG máfha lsis÷ fjkialula igyka fkdù ;sîug mq¿jk' wekachskd lelal=ula y÷kd .ekSug l< yels jeo.;au mÍlaIdjla jkqfha jHhdu ECG mÍlaIdjhs' fuys§ isÿ lrkqfha frda.S ;;ajhla we;ehs is;k wfhl= weú§fï hka;%hla u; weú§ug i,iajd weú§fï fõ.h jeä lsÍu u.ska frda.shdf.a yDo iamkaok jdr .Kk l%u l%ufhka jeä lsÍuh'

104

September 2019

DOCTOR MAGAZINE

frda.shdf.a lsÍgl Ouks wjysr;djhla ;sfí kï túg yDo fmaYshg wjYH reêr m%udKh fkd,eîfï fya;=fjka wekachskd lelal=u we;súh yelsh' hï mmqfõ lelal=ula lsÍgl Ouks wjysr;djhla ksid we;sjk wekachskd lelal=ulao ke;skï .eiag%hsáia fyda fmaYskaj, fõokdjlao hkak ksYaÑ;j y÷kd.; yels jeo.;au mÍlaIdj jkafka jHdhdu B'iS'Ô' mÍlaIdjhs' wekaðfhda.%dï mÍlaIdj hful=g lsÍgl Ouks wjysr;djhla we;a±hs ksYaÑ;ju ±k .ekSug we;s mÍlaIdj wekaðfhda.%dï mÍlaIdjhs' wekaðfhda.%dï mÍlaIdfjka ,efnk m%;sM, j,g wkqj frda.shdf.a lsÍgl Ouks iqúl¾h;djh ^Coranary Angiography& fyda nhsmdia ie;alï jeks úfYaIs; m%;sldrhla wjYHo hkak ;SrKh lrkq ,efí' wekachskd lelal=u i|yd ,ndfok T!IO wekachskd lelal=u i|yd ,ndfok T!IO lelal=u we;sjQ úg

doctormagazine.lk

,nd.kakd T!IO iy lelal=u we;sùu j<lajd.ekSu i|yd mdúÉÑ lrk T!IO f,i fldgia follg fnod ±laúh yelsh' ta wkqj lelal=u we;sjQ úg th iukh lsÍug fhdod. kakd m%Odk T!IOh khsfÜ%Ü ^Nitrate& kñka ye¢kafõ' GTN kñka y÷kajk fuu T!IOh Èj hg ;nd.kakd fm;s uÕska fyda l=vd WmlrKhla uÕska Èj hgg ú§fuka úkdä lsysmhla ;=< lelal=u iukh fõ' wfma rfÜ fndfyda rcfha frday,a j, ,nd fokafka fï wdldrfha Èj hg ;nd. kakd GTN fm;sh' fuu fm;s TNT f,iskao ye¢kafõ' wekachskd lelal=u je,f|k frda.Ska fuu fm;s ksr;=reju <Õ ;nd .ekSu b;du;au jeo.;a fõ' wekachskd lelal=u we;sùu je<elaùug ,ndfok fm;s w;r khsfÜ%Ü wvx.= fm;s m%Odk fõ' GTN fm;s j,g T!IOh fnfyúka iudk T!IOhls' fjkilg we;af;a fïjd .s,sk fm;s ùu yd ta .s,Sfuka miq YÍrhg

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Wrdf.k meh .Kkla hk;=re YÍrh ;=< ls%hd;aul ùu u.ska wekachskd lelal=u we;sùu je<laùu ls%hd lsÍuh' fuu fm;s Èkm;d mdúÉÑ l< hq;= jk w;r lelal=u we;sjq wjia:djl mdúÉÑ lsÍu uÕska iqjhla ,nd.ekSu wmyiqh' khsfÜ%Ü wvx.= me,eia;r we,ùuo fï i|yd id¾:l ms<shuls' fuu me,eia;rfha wvx.= T!IO iu yryd YÍrhg Wrd .ekSu isÿfõ' óg wu;rj wekachskd lelal=u we;sùu md,kh lsÍu i|yd ffjoHjrhd úúO T!IO ks¾foaY lrkq ,nhs'

frda.Ska b;d Wkkaoqfjka ms<smeÈh ldrKd wekachskd lelal=u we;s frda.Ska T!IO Ndú;hg wu;rj ms<smeÈh hq;= ;j;a úyrKuh fya;= rdYshla ;sfí' bka m%Odk jkafka ÿïmdkfhka je<lSuhs' Bg wu;rj fldf,diagfrda,a iy fïoh iys; wdydr wvq lsÍu" flfrys wjOdkh fhduq l< hq;=h' wêl reêr mSvkh" reêrfha fldf,diagfrda,a wêl ùu Èhjeähdj wd§ frda. ;;a;ajhka we;s wh T!IO ,nd.ekSu u.ska tu frda.S ;;a;ajhka ukdj md,kh lr .ekSug lghq;= l< hq;=h' tfiau ks;sm;d jHdhdu lsÍu" YÍrfha nr wvq lr .ekSug lghq;= lsÍu" u;ameka mdkh yels;dla wvq lsÍu yd udkisl wd;;sh wvqlr ieye,a¨ osú fmfj;lg yqre ùu b;d jeo.;ah' fï wdldrhg ksis m%;sldr ,nd.ekSfuka iy ksjerÈ Ôjk rgdjlg yqreùu ;<ska yDohdndOhla we;sùfï wjodku fndfyda fihska wvq lr .ekSug;a fmr .; l< kSfrda.S Ôú;h kej;;a Tng w;aú£ug;a yelsjkq we;' DM

idlÉPd lf<a(- uOqjka; niakdhl

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Mental Disorders

PdhdrEmfha fmkS isá ñh.sh wdÉÑ

PdhdrEmfha fmkS isá

ñh.sh wdÉÑ N+;" fm%a;" hlaI" l=ïNdKav wd§ wukqIHhka weiqf¾ wmg wikakg ,efnk l;dkaor fndfydah' tajd lsysmhla fyda Tn wid we;=jdg iel ke;' N+;hska .,a .eiSu" u,jqka wdrEV ùu" f.j,a .sks ;eîu" nvq tyd fuyd lrùu" ksok wefoka ìug weo ±óu" we| msáka tiùu" f.dïufka§ fmkS isàu" fm%a; N+; l=ïNdKav ne,au jeàu" újdyh m%udo lrùu" újdy lvdlmam,a lrùu hkdÈh wm iudcfha uq,a nei.;a úYajdihkah' yqfolau ñ;Hd úYajdihkah' fïo tjka isÿùuls' ksmqks" l=vd l,u isgu ye§ jevqfka wehf.a wdÉÑ iy iShd ,Õh' ksmqksf.a foudmshka /lshdjlg f.dia ksjig meñfKkafka ? fnda ù ksid wehj n,d lshd .ekSug ljqre;a fkdisáhy' fï ksidu ksmqksj wdÉÑf.a ksjfia keje;aùug;a i;s wka;fha ksjig /f.k hdug;a ksmqksf.a foudmshka lghq;= l<y' ksmqksf.a fyd|u ñ;=rd;a ñ;=ßh;a jQfha iShd;a wdÉÑ;ah' foudmshkag jvd ±ä fifkyila weh wdÉÑg;a iShdg;a ±lajQjdh' wdÉÑ yd iShd o ksmqksg buy;a fifkyila ±laùh' i;sfha ojia mylau weh fuf,i ye§ jevqfka wdÉÑ" iShd ,Õh'

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Y%S ,xld iajdmkfõ§kaf.a ix.ufha iNdm;s ufkda Ñls;ail ffjoH mS'tka'úoHdl=,m;s úisks

ksmqks w'fmd'i' idudkH fm< úNd.ho fyd|ska iu;a úh' weh w'fmd'i' Wiia fm< úNd.hgo fmkS isáh;a úYaj úoHd, jrï ,nd.ekSug ,l=Kq m%udKj;a fkdùh' ;jÿrg;a wOHdmk lghq;= j,u kshe,Sug ksmqksg leue;a;la fkdùh' ta ksidfjkau weh mdGud,djla yeoEÍug is;d .;a;dh' ta wkQj weh mß.Kl ämaf,daud mx;shlg .shdh' tys§ wehg úi,a yuqúh' úi,a flf¾ wdorKSh is;la we;s jQ ksmqks flfrys úi,af.a isf;yso wdorhla we;súh' fofokd tlu mß.Kl mx;sfha wOHdmkh ,enQ neúka Tjqka wdfõ .sfha tlguh'

doctormagazine.lk

ksmqks wdÉÑg;a iShdg;a úi,a .ek ish¨ úia;r lshd isáhdh' fï jk úg;a wehf.a fyd|u ñ;=ßh yd ñ;=rd jQfha Tjqkah' tf,i úi,a ksmqksj mß.Kl mx;sh fj; /f.k hdu i|yd wdÉÑf.a ksjig meñKsfhah' fufia ld,h .; jQ w;r" úi,a /lshdjlg .sfhah' ksmqks o /lshdjlg b,a¨ï l, w;r" wehgo mß.Kl wxYfha /lshdjla ,enqKs' Èk i;s udi f.fjñka úi,a yd ksmk q s újdy úh' fofokdu /lshdjlg .sh;a wd¾Ól wmyiq;d we;s úh' fï ksidu fofokdu úfoaY /lshdjla i|yd hdug ;SrKh l<dh' ta wkQj Tjqka

doctormagazine.lk

vqndhs rdcHfha /lshdjlg .shy' tys ksjila l=<shg f.k tys mÈxÑ ù fofokdu /lshdjka j, kshe¨ks' jir foll ld,hla vqndhs rfÜ fiajh l, ksmqks yd úi,a ;u foudmshka ne,Su i|yd ,xldjg meñKshy' ta jk úg;a ksmqksf.a wdorKSh wdÉÑ wïud frda.d;=rj isáhdh' ksmqksf.a wdÉÑ ks;ru lsõ fohla jQfha uefrkak fmr wehj tla j;djla fyda vqndhs tlalf.k hk f,ihs' th ksmqksg ks;ru isysm;a úh' zzwfka ±ka wdÉÑj ux fldfyduo tlalf.k hkafk' wdÉÑ fyd|gu f,äkafkZZ ksmqks ÿlaúh' udihla muK wdÉÑj n,d.;a ksmqks" úi,a iuÕ vqndhs n,d msg;a úh' jir foll ld,hla frda.d;=rj isá wdÉÑ ñh .shdh' wdÉÑ ñh hk úg ksmqks weh ,Õ fkdisáhdh' ksmqksg wdÉÑ ñh.sh mqj; wehf.a foudmshka úiska ±kaùh' flfia fyda wdÉÑf.a u<.ug hd hq;= nj wÈgka lr.;a ksmqks úi,a iuÕ u<f.or meñKshdh' ;u wdÉÑ ;ud fld;rï fyd¢ka n,d.;a;do" fld;rï fifkyila mEjdo" ;uka yqr;,a jQfha wdÉÑ wïud tlal fkdfõo hkak ksmqksg u;la fjù weh ye~qjdh' wehg ÿl Wyq,d .ekSug fkdyels ksid weh ye~qjdh'

September 2019

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PdhdrEmfha fmkS isá ñh.sh wdÉÑ

Mental Disorders

ojia myla muK u<f.or isá ksmqks;a úi¨;a kej; vqndhs n,d msg;a úh' ta;a ksmqksf.a ÿl wvqjla fkdùh' fï w;r i;a ojfia odkhg l,ska od mqÿu isÿùula úKæ tÈk rd;%S y;g yduqÿrejka jev nK lshd wjika jQ miq meñKs whg ix.%y lsÍug nq,;a mqjla ;nd ;snqfka wdÉÑf.a ldurfhah' wdÉÑ ñh.sh miq ldurh iqoao mú;% fldg ;snqKs' nq,;a úgla f.k tkakg tla ±ßhla wdÉÑf.a ldurh fj; .shdh' tlajru weh zzwfka wïfï ueßÉp wdÉÑ bkakjdZZ lshñka lE .idf.k ÿjf.k wdjdh' u<f.or meñKs ish,af,dau ÿjf.k .sfha wdÉÑf.a ldurh fj;h' kuq;a tys lsisjl=;a fkdùh' l=vd ±ßh mjikafkau uereK wdÉÑ ldurfha ìu ydkais ù isá njhs' ish¨ fokdu ±ßúh wiajeiqfõ zuereK flfkla tfyu fmakak tkafka keyeZhs lshñks' kuq;a ;j;a msßilf.a u;h jQfha ñh.sh whj¨ka y;aojfia meñfKk njh' tfia fmfkkakg meñKs wjia:d we;s nj;a Tjqka lshd isáhy' wdÉÑ N+uodk l< fidfydk idod ;snqfKao wdÉÑf.a ksjfia j;af;auh' mdkaor folg muK ldka;dfjda lEu Whkakg úh' tlajru wdÉÑf.a fidfydk foiska zznqÿ wïfudaZZ lshd lE .ik y~la weiqKs' tflfKysu tla ueÈúfha ldka;djla ksji foig ÿjf.k wdjdh' weh wdÉÑf.a {d; fidfydhqßhlf.a ÈhKshls' zzwfma kekaod fidfydk Wv b|f.k bkakjdZZ hehs weh ish,a,kagu mejiqjdh' ish¨ fokdu Nhska ìrdka;j fidfydk foig .sh;a tys lsisjl=;a fkdùh' fufia Èk lsysmhla .;úh' ñh.sh wdÉÑ fidfydk ,Õ" lvq,a, ,Õ" ldurfha" l=iaisfha iy <s| ,Õ isá nj we;eï wh ±l ;sfí' fï w;r" ksmqks yd úi,a újdy ù jir myla msÍu ksñ;af;ka vqndhs rfÜ ñ;=re ñ;=ßhka yg idohla meje;aùh' tys§ PdhdrEm .ekSuo yd ùäfhda lsÍuo isÿúh' W;aijh ksud ù Èk lSmhlg miq ksmqks yd úi,a mß.Klhg oud .;a PdhdrEm n,kakg úh' tla PdhdrEmhl wuq;= fohla ;snqKs' ksmqks muKla tu PdhdrEmhg fmkS isá w;r" mfilska óÿula iuÕ r;= meye;s me,a,ula jeks fohla fmfkkakg ;snqKs'

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fuu r;= meye;s me,a,u l=ula±hs ne,Sug PdhdrEmh úYd, l<y' tys jhil l=ÿ ldka;djlf.a Pdhdjla jeks fohla fmfkkakg úh' fuh ldf.a fyda Pdhdjla o ke;fyd;a ñh.sh wdÉÑ o hkak Tjqkg ielhla we;s úh' ñh.sh wdÉÑ lsysmfofkl=gu o¾Ykh jQ nj fudjqkag o ±k.ekSug ,eî ;snqKs' ta ksid fï PdhdrEmfha bkafkao ñh.sh wdÉÑ hkak fudjqka is;+y' ksmqks yd úi,a ,xldjg meñKshy' ;ukaf.a miq wjqreÿ ixj;airfha PdhdrEmo /f.k tkakg ksmqks wu;l fkdl<dh' tu PdhdrEm ;u foudmshkag yd {d;Skag fmkajQ miq zzTõfka fï bkafka wïudfka fï bkafka wdÉÑfka fï bkafka kekaodfka ZZ hkqfjka PdhdrEmhl l=ÿ .eyqKq jhil ldka;djlf.a hehs is;sh yels Pdhdj n,d ish¨ fokd lshkakg úh' iuyfrla mejiqfõ ksmqksg wdofrka isá wdÉÑ ksmqks ne,Sug vqndhs hkakg we;s lshdh' ;j;a wfhla mejiqfõ Ôj;aj isáh§ vqndhs hkakg leue;af;ka isá ksid;a wehg hkakg wjia:djla fkd,enqKq ksid;a ñh.sh miq wdÉÑ ksmqks isák ;ekg hkakg we;s njhs'

doctormagazine.lk

fï w;r ksmqks tlajru wikSm jQ w;r" m%;sldr l,o iqjhla fkdùh' weh wdÉÑf.a iajrEmfhka l;d lrkakg úh' wdÉÑ ksmqksg wdrEV ù we;' ish,af,da is;+y'

fkdokakd ryia ffjoH mS'tka' úoHdl=,m;s uy;d wehf. ka úuiqfõh' ksmqksg tys§ W;a;r fokakg fkdyels úh' weh fndre mjikakg úh'

ta wkQj lÜgçhl= f.kajd ksmqksf.a YÍrfhka wdÉÑ heùug lghq;= lf,ah' Èk ;=kla idudkH ;;a;ajfhka isá ksmqksg kej;;a wdÉÑ wdrEV úh'

;;a;ajh tfia kï" .fï wh wdÉÑj ±lal nj" wdÉÑ fmkS isá whqre" wdÉÑ vqndhs .sh whqre fïjd i;H fkdfõo@ fïjdg ffjoHjrhd ÿka ms<s;=re fufiah'

wdÉÑf.a wj;drh ;eka ;ekaj, fmkS isàu;a ksmqksf.a YÍrhg wdrEV ùu;a ksid ksmqksf.a mjqf,a wh wirK ;;a;ajhlg m;a jkakg úh' fuh lsisjl=g;a n,d isákakg fkdyels jQ neúka fï iïnkaOj Y%S ,xld iajdmk úoHdfõ§kaf.a ix.ufha j;auka iNdm;s ufkda Ñls;ail" ffjoH mS'tka' úoHdl=,m;s uy;d fj;g ksmqksj fhduq lsÍug jeäysá wfhla lghq;= lf<ah' ffjoH mS'tka' úoHdl=,m;s uy;d ksmqksj fudayk ksødjg m;a lf<ah' zzuu ±ka ;=kg .Kka lrkjd' ;=k lshkjd;a iuÕ wdÉÑ Tfí isrerg tkjdZZ hkqfjka lshd ffjoHjrhd tfla isg ;=kg .Kka lf<ah' ksmqks wdÉÑ fuka l;d l<dh' ksmqks wdÉÑ iïnkaOfhka

doctormagazine.lk

zzTng wdÉÑ jeyS keye' fuh Tfí isf;a we;s jQ u;hla muKhsZZ lshñka ffjoHjrhd weh fudayk ksødfjka wjÈ lf<ah'

hfula ìhlska fyda udkisl jeàulska isák úg fyda ;o úYajdihlska isák úg fyda Tjqkg ta foaj,a ±fkkag mq¿jka' ueù fmfkkakg mq¿jka' th ufkda N%dka;shls' oDIaá udhdjls' tfia kï PdhdrEmhg fmkqfka l=ulao@ PdhdrEmh f.kajd iqmßlaIdldÍj th neÆ ffjoH mS'tka' úoHdl=,m;s uy;d tho meyeÈ,s lf<ah' hful= ìhlska fyda udkisl jeàulska fyda ;on, úYajdihlska fyda isák úg ta ish,a, tfia fmfkhs' th oDIaá udhdjls' ufkda N%dka;shls' PdhdrEmh .ekSfï§ leurdj bÈßfha ÿula fyda ÿUqre mdg hula ;sî we;' th PdhdrEmh .ekSfï§ wdf,dalh mrdj¾;kh ù fuf,i fmkS ;snqKd úh yelshs' PdhdrEm úYd, lr n,k úg fïjd úúO yev;, f,i olskakg yels fjkjd' oDIaá udhdjla ñi ñh.sh wfhl= mshú weig fmkSisàug flfiaj;a yelshdjla keye' ñh.sh mqoa.,hka f.kaùu" l;d lsÍug o l< fkdyelshs' tajd fndreldrhkaf.a ig lmg jev muKhs' ffjoH mS'tka' úoHdl=,m;s uy;d meyeÈ,s lr ÿkafkah' bkamiq lsisu ojil fï jkf;la ñh.sh wdÉÑ ksmqksg wdrEV fkdùh' .fï lsisjl=gj;a {d;sjrekagj;a ñh.sh wdÉÑ bkamiq fmkS isáfha ke;' i;a;lskau ñh.sh wdÉÑ olskakg lsisjl=gj;a fkdyelsh' DM Y%S ,xld iajdmkfõ§kaf.a ix.ufha iNdm;s ufkda Ñls;ail ffjoH mS'tka'úoHdl=,m;s

ÿrl:k wxlh ( 0718 30 30 30 September 2019

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Homeopathy Medicine weÿu frda.hg fydañfhdam;s úi÷ï

iufm; weiqf¾ iqjfi;''' weÿu frda.hg fydañfhdam;s úi÷ï A basic belief behind homeopathy is “like cures like.” In other words, something that brings on symptoms in a healthy person can - in a very small dose - treat an illness with similar symptoms. This is meant to trigger the body's natural defenses. weÿu wo ojfiafndfyda fihska m%p,s; frda.hls' weÿu frda.h we;s jQ úg yqiau .ekSfï wmyiq;d we;s ùu m%Odk ,laIKhls' tu ksid fmky¿ ÿ¾j,;djhg m;aùu fya;=fldg tajdfha l%shdYS,s;ajh wvqùuo" <uqkaf.a wOHdmk ÿ¾j,;d we;sùuo" jhig hdfï§ jhig jvd ÿ¾j,j isàu fuys oelsh yels wksis m%;sM, fõ' tu ksid fydañfhdam;s T!IO weiqf¾ weÿu frda.hg m%;sldr lsÍu .ek fï ,smsh ;=<ska Tn oekqj;a flf¾'

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doctormagazine.lk

fi!LH"fmdaIK yd foaYSh ffjoH wud;HxYh foysj, rcfha fydañfhdam;s ffjoH uOHia:dkfha ia:dkNdr ffjoH ks,Odßks" fydañfhdam;s ffjoH wkqId fyaul=udr úisks

weÿu frda.h ´kEu jhil flfkl=g we;s fjkak mq¨jka' l=vd orejkag iy ldka;djkag je<fok m%udKh idfmalaIj jeähs' fuh fndfyduhla wid;añl;djh ksid we;s jkakls' iajdikd, jHqyfha uQ,slj fjkialï we;s fjhs' wid;añl;djhg fya;= ² weo ul=Kka yd ÿú,s lsvEjkaf.a wmøjH' ² n,a,ka iy n<¨kaf.a f,dï$fgäfíhd¾ ÿú,s' ² u,af¾Kq wdYajdi u.ska YÍr.; ùu' ² foaY.=Kh ksid we;sjk fjkialï' ² wêl is;, jdhq iukh' ² is.rá ÿu" úI ÿï iys; mßirh' ² we;eï l¾udka; ridhksl øjH'

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² iqj| ú,jqka' ² mqoa.,hd wkqjo we;eï wdydr wid;añl;djhg fya;= fjkjd' ² lsß" fodvï"foys mdkhka" u;ameka" ìh¾" fgd*s" fpdl,Ü" rglcq' ² jHdhdu iy l%Svdj' ² wêl f,i iskdiSu ² is;a ;ejq,a ² ffjria widokh" fiïm%;sYHdj" ² mSkih ² .eiag%hsáia ² ldka;djkaf.a w¾;jykh idudkH mqoa.,fhl=f.a YÍrhg fujd we;=,a jqjdg lsisÿ m%;sl%shdjla olajkafka ke;' kuq;a wdid;añl;d olajk mqoa.,hkag fïjdg tfrysj YÍrh ;=,skau úreoaO m%;sl%shd we;s fjkjd' tfia m%odyl ;;a;aj we;sù weÿu frda.hg n,mdkjd' fï l%shdodufha§ iajdikd, r;= meyeù bÈóug ,lajkjd' fï wkqj yqiau .ekSfï wmyiq;djh we;s fjkjd' mmqfõ Yíohla" mmqj ;o lrkakdla fuka iajikhg ndOd we;s fjkjd' tfiau jeämqr uykais úh fkdyels f,i y;sh yefokjd' tjeks wjia:d j,oS wdhdifhka yqiau .eksu l< hq;=h' fï ;;a;ajh wms zzy;shZZ lsh,d yÿkajkjd' iajdikd, bÈfuk úg tu kd, jfÜ ;sfnk udxYfmaYs ixfldapkh ù iajdikd, ;o ùu isÿfjkjd' túg leiai we;sùu isÿfjkjd' fuh rd;%S ld,fha jeämqr oelsh yel' wm yqiau .kakd úg jd;fha we;s l=Kq ÿú,s úIîc wdÈh wdÈh iajik ud¾.h ;=<g hdug fkdÈ wmj wdrlaId lsÍu fiu f,i y÷kajk >%djh u.ska isÿ lrkjd' mdßißl" wdydruh" p¾hd rgd fukau ffjria nelaàßhd úiîc wdidokh ùu ksid;a YÍrh ;=< ÿjk m%;sYla;slrKh hgf;a m%;sM,hla f,i iajdikd, j, fuu >%djhka jeä ù fiu jeäùu isÿfjkjd' YÍrhg we;=¿ jk úIîc u.ska fuu

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weÿu frda.hg fydañfhdam;s úi÷ï

Homeopathy Medicine

weÿu frda.fha frda. ,laIK ² yqiau .ekSfï wmyiqj ² leiai ² lsúiqï hdu iy W.=f¾ fiu meg,Su ² mmqfõ ysr .;sh ² yqiau .ekSfï§ iy msg lsÍfï§ Yíohla u;= ùu ² yqiau .ekSfï wmyiqj ksid kskao fkdhEu ² l;d lsÍfï§ wmyiqjla oekSu' fï ksid fndfyda weÿu frda.Ska kj;ajñka l;d lrkq olakg ,efí ² f;d,a iy kshfmd;= wj meye ùu ² yDo iamkaokh fõ.j;a ùu

iy ÿú,s rys;j ;nd .kak' ² ffjoH m%;sldr ,nd .kak miqng jkak tmd' kshñ; ffjoH Wmfoia ms<smÈkak' ² mdkaor wjÈ ùfuka iy rd;%sfha ksÈ ueÍfuka j<lskak' ² ÿfuka" mskafkka" óÿfuka wdrlaId jkak' ² WoEik iS;, wdydr .ekSfuka je<lSu' - ^yS,a n;a" lsß n;a" l=reïnd" ;eô,s" idrK" ksú;s& ² ier wdydr j¾. ,nd .ekSfuka j<lskak' - ^yrla uia" t¿ uia" oe,a,ka" biaika" yqre,a,ka& ² wõj we;s úg muKla iakdkh lsÍu ² c,fha .s,S kEfuka je<lSu ² WKqj;=r mdkh ² WKq j;=frka jdIam we,a,Su' WKq j;=rg úh<s w;a;k fld< fhdod ÿï we,a,Su iqÿiqh' ² ÿï mdkfhka j<lskak ² lsß msá wêl f,i mdkh fkdlrkak' ² ÿú,s wêl ia:dk j,§ iy ksji msßisÿ lrk wjia:dfõ§ frÈ lvlska kdih iy lg jid .kak' weÿu frda.fha wys;lr m%;sM, ² tÈfkod jev lghq;= j,g ndOd we;s ùu ² YÍrh flÜgq ùu ² weÿu frda.h je<÷kq orejkaf.a j¾Okh nd, fõ" u;l Yla;sh wvqùu' ² weÿu W;aikak ùfuka urKh mjd isÿ ùug bv we;'

"

jeäjk fiu meiùulg ,laùu" Wl= jeä ùfuka msg;g f.k tau wmyiq ù iajdik ud¾.h wjysr ùu isÿfjkjd' ta fya;=fjka jd;fha .uka lrk fï ishqï kd, wjysr jkjd' túg yqiau .eksfï§ rdx"rex jeks Yíohla msgfjkjd' fujeks ;;a;ajhlg wms zzweÿuZZ f,i yªkajkjd'

weÿu frda.Ska mßiaiï úh hq;af;a fldfyduo @ ² ;uka Ôj;a jk ia:dkh" we|we;sß,s iy fldÜgd Wr ksrka;rfhka msßisÿj 112

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tx.,ka;fha t,sin;a /ðkf.a iqjh ksfrda.l s u Wfoid fydañfhdam;s m%;l s dr Ndú;d lrkq ,nkafka jir .Kkdjl isgh' tu rc mrïmrdjo fydañfhdam;s m%;l s dr W;=ï jQ m%;l s drhla f,i i<l;s' rc mjq,gu fjkajQ fydañfhdam;s frday,ao tx.,ka;fha fndfyduhla we;'

"

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weÿu frda.h ioyd fydañfhdam;s m%;sldr fydañfhdam;s hqfrdamfha fndfyda rgj, fukau wdishd;sl rgj,o m%p,s; jQ w;=re wdndO ke;s úoHdKql=, uq,O¾u u; msysá ffjoH l%uhls' ´kEu frda.hla fuu m%;sldr u.ska iqj l< yel' fï i|yd mqoa.,hdg wdfõKsl jQ frda. ,laIK;a" YÍr m%;sYla;slrk moaO;sh;a b;d jeo.;a fldg i<lkjd' weÿu" y;sh jeks ;;a;aj j,g wm f.dÿre jkafka wfma YÍr m%;sYla;slrKh ÿ¾j, ùu fya;=fjks' fydañfhdam;s ffjoH l%uh ;=< frda.shdg T!IO ,nd§u isÿjkafka ÿ¾j, m%;sYla;slrKh j¾Okhg;a ta ;=<ska frda.hg uq,a jQ frda. ldrlh ke;slr frda. uq,h iy uq,skau bj;a lr,Suh' fï i|yd mqoa.,hdf.ka mqoa.,hdg fjkiaj Tjqfkdjqkag wdfõKsl jQ frda. ,laIKh b;d jeo.;a

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jk w;r fydañfhdam;s m%;sldr uq,O¾uhg wkqj frda. ,laIKhg iudk jQ ksjerÈ T!IOh mqoa.,hdg §u ;=<ska frda. ,laIKh ke;sj hkafka —iudk fohska iudk foa iqjm;a fõ ˜hk uq,O¾uhg wkql=,j fydañfhdam;s T!IO l%shdldß;ajh ÿ¾j, m%;sYla;sh j¾Okh lr YÍrh bkaøsh l%shdldß;ajh h:d ;;a;ajhg f.k tu ;=< fmky¿ ;=< yg.;a wid;añl;djh we;=¿ ish¨ frda.S ,laIK my ù frda.shd ksiel iqjh ,nkq we;' fumuKla fkdj fï ;=<ska Tyqf.a YÍrfha wfkl=;a frda.dndO iqjhgo byu;a Wmldrhla ,efnkq we;' tx.,ka;fha t,sin;a /ðkf.a iqjh ksfrda.l s u Wfoid fydañfhdam;s m%;sldr Ndú;d lrkq ,nkafka jir .Kkdjl isgh' tu rc mrïmrdjo fydañfhdam;s m%;sldr W;=ï jQ m%;sldrhla f,i i<l;s' rc mjq,gu fjkajQ fydañfhdam;s frday,ao tx.,ka;fha fndfyduhla we;' fï wkqj nd,"uy¨";reK ´kEu flfkl=g fuu fydañfhdam;s m%;sldr u.ska iqjh ,nd .; yelafla úYauh ckl f,isks' b;d ir," mdúÉÑhg myiq fuu ffjoH l%uh Tfí iqjh idlaId;a lrKQ msKsiu jkafkah' DM

ffjoH wkqId fyaul=udr fi!LH" fmdaIK yd foaYSh ffjoH wud;HxYfha foysj, rcfha fydañfhdam;s ffjoH uOHia:dkfha ia:dk Ndr ffjoH ks,Odßksh jYfhka lghq;= lrhs fydañfhdam;sffjoH l%uh .ek úuiSï

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wdhq¾fõoh <÷ka iqr <÷ka lrk foaYSh rEm,djkH T!IOh

rEm,djKHh .ek Tn ie<ls<su;ao@ <÷ka iqr <÷ka lrk foaYSh rEm,djkH T!IOh lgy`v ñysß Ndjhg m;a lrjk úfYaI .=Khla we;s ksid .dhkfhys Wkkaÿ jkakkag;a fyd|hs'''

fm

r rc l, isg fu;=jla olajd Ôj;a jk fndfyda msßia rEm,djkH i|yd fndfyda fihska keUqre ù we;snj fmkS hhs' fjfiiskau ldka;djka rE iq/lSfuys fmruqfKa isák uq;a msßñkao fï flfryS wdl¾YKhla fkdolajkjd fkdfõ'

wo jk úg fkdfhla fj<| wdh;k úiska úfoaYhkaf. ka úYd, jYfhka f.kajk í,SÑka wvx.= l%Sï j¾." mjqv¾ yd fnfy;a j¾. fj<| fmdf<a olakg ,efí' fï fjkqfjka úYd, uqo,la uyck;dj jeh lrk w;r" bka ,efnk m%;sM, kï b;d w,amh'

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iEis isxyf,a Tiq fjo ueÿf¾ wêm;s fy< fjo uydkdu ta' ymqf.dvf.a úisks

ieuod ;u mdrïmßl {dKh" yelshdj Wmfhda.s lr.ksñka uyck;djg Wiia m%ñ;sfhka yd .=Kd;aul núka hq;a T!IO ksmojk fy< fjoeÿre uydkdu ta' ymqf.dvf.a uy;d rEm,djkH flfryS Wkkaÿjla olajk fldhs ldg;a úYAñ; M, ,enfok foaYSh iajNdúl T!IOhla ksmojd we;' th Ndú;h ;=<ska ia;%S mqreI fomd¾Yjfhau Pú j¾Kh oel=ïl¿ lrñka rEmh Tma kexfjk w;r" lgyf~ys iajNdjho ñysß njg m;afõ' fuu T!IOfhka flfrk ld¾hh ms<sn|j úuid ne,Sug wm miq.shod fy< fjoeÿre uydkdu

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ta' ymqf.dvf.a uy;d yuqùuq'

,efnkjdo hkak ms<sn|j we;af;a l=;=y,hls' thska id¾:l m%;sM, ,enqK;a th b;d flá l,lg muKs'

fjoeÿrdfKks" Tn;=ud ksmojd we;s kj;u T!IOh ms<sn| meyeÈ,s lsÍula l<fyd;a@ ud l,l isg ksÍCIKh l< fohla ;uhs" ;u rEmh iqkaorj mj;ajdf.k hdu i|yd j¾;udk iudcfha Ôj;a jk ia;S% mqreI fomd¾Yjfhau fndfyda fokd úYd, uqo,a lkaordjla jeh lrñka fkdfhl=;a rEm,djkH ksIamdok ,nd.ekSug fm<ö we;s wdldrh' kuq;a úYd, uqo,la jehl<;a Tjqka n,dfmdfrd;a;= jk wdldrfha m%;sM,hla

tu lreKq ie,ls,a,g f.k uu b;d jákd §¾> ld,hla mj;sk b;d m%;sM,odhl iajNdúl T!IOhla rEm iajNdjh j¾Okh yd /l.ekSu i|yd ksmoùug l%shd l<d' fuh Ndú;h b;d ir, f,fyis myiq ksid oekg Ndú;d l< wh w;r b;d ckms%h ù we;s nj;a th fnfyúkau m%;sM,odhl nj;a lsj hq;=h'

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fuu T!IOh Ndú;h ;=<ska we;sjk m%fhdack fudkjdo@ fuu rEm,djkH T!IOh fmr rc oji úiQ ìfidajrekaf.a rE imqj Tma kxjd .ekSug Ndú;d l< ÿ¾,N .Kfha fnfy;a jÜfgdarejlska ilik ,o rEm,djkH T!IOhls' fuh mdkh lsÍug .kakd T!IOhla' ta ;=<ska YÍrfha wNHka;rfha rEm iajNdjh j¾Okh jk w;r" th §¾> ld,hla rEmfha iqkaor;ajh /l.ekSug bjy,a fõ' ndysßka .,ajk ,o wdf,amk j, m%;sM, b;d fláld,Skh' fuu rEm,djkH T!IOh Ndú;h ;=<ska rEmh Tma kexfjkjd muKla fkdj W.=f¾ mj;sk

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wdhq¾fõoh <÷ka iqr <÷ka lrk foaYSh rEm,djkH T!IOh

oekg fuu T!IOh Ndú;d lrk ,o msßif.a m%;spdrh flfiao@ b;d fyd| m%;spdr ,efnkjd' Ndú;h b;d ir, yd f,fyis myiq ksid;a" m%;sM,odhl ksid;a fnfyda fokd w;r Èfkka Èku b;d ckms%h ù mj;skjd' tfukau Ndú;d lrk ,o whf.a rEmh olsk ck;dj jrla fkdj fojrla ne,Sug fmf<fUk nj T!IOh Ndú;d lrk ,o fndfyda fokd mjikafka b;d i;=áks'

fiï iajNdjh myù f.dia ñysß lgy~la we;sfõ' l=re,E" iu t,a,d jeàï" ifuys w÷re iajNdjh my ù f.dia meyem;a iula we;s fõ' fuu T!IOh ieuod tl f,i ;u rEmh mj;ajdf.k hdug fjr orK k¿ ks<shkg fukau" ñysß lgy~la mj;ajdf.k hdug W;aiql jk .dhl .dhsldjkag o fnfyúka WmldÍ jk T!IOhls' lgyf~ys r¿ iajNdjh yd fiï.;sh myù f.dia ñysß meyeÈ,s iajr ;ka;% ksishdldrhg ls%hd;aul jk T!IOhls' fuu jákd Tiqj mdúÉÑ lrk wdldrh i|yka l<fyd;a@ fuu T!IOh tl È.g Èk myla ,nd.; hq;= w;r" bkamiq udihlg miq fojk fnfy;a jÜfgdarej .; hq;=hs' uq,a Èkfha isgu iu meyem;a fõ' ñ< .Kka o b;d idOdrKh' f,dalfha ÈhqKq p¾u ffjoHjre f,ai¾ ;dCIKh uÕska" tkak;a lsÍï jeks foa isÿlsÍu ;=<ska w;=re wdndO j,g ck;dj Ndckh lrk w;r" udf.a T!IOh Ndú;h ;=<ska lsisÿ w;=re wdndOhla we;s fkdfõ' 116

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iEis isxyf,a Tiq fjo ueÿf¾ wêm;s fy< fjo uydkdu ta' ymqf.dvf.a uy;d m%;l s dr lrk Èkhka yd fõ,djka fikiqrdod Èkj, fm'j' 8'00 isg m'j' 3'00 olajd ^ÿrl;k weu;=ula ,nd § fõ,dj fjka lrjd .kak'& iEiS isxyf,a Tiq fjo ueÿr 100$5" lu; mdr" udú,auv" uykqjr' ^o<od ud<s.dj <Õ isg ls'ñ' 4 la muK ÿßks'& úuiSï 075 5559229 $ 071 2495752 DM

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foaYSh ffjoHY+Í" foaYudkH" uydpd¾h fya' uQ' fikr;a chiQßh nKavdr

háhkaf;dg uyú, fjouy;d Èhjeähdj iqj l< fkdyels nj §¾> f,i ngysr rgj, mej;S u;h jqKd' kuq;a wo jk úg fï frda.h hï;dla ÿrlg iqj l< yels nj mejiSug Tjqkau mgka f.k ;sfnkjd' fuu m%ldYhka b;d ksjeroshs' fy< fjolu wkdÈu;a ld,hl isg m%ldY l< Èhjeähd frda.h ksÜgdjgu iqj l, yelsh hk u;h ngysßka ;yjqre lsÍula jYfhka fï fjki ye|skaúh yelshs' wfma mdrïmßl T!IO j,g iqjl< fkdyels frda.hla fkdue;s nj háhkaf;dg uyú, fjo uy;d ±ä úYajdifhka mjikjd'

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fy< fjolug we;s §¾> b;sydih m%d.a fn!oaO fM;sydisl f;dr;=re j,ska fy<sjk lreKq ikd: lrkjd' m%;HlaI uQ,sl T!IO j,ska iukaú; jQ fy< fjolu w;a±lSï uq, lrf.k isÿlsÍu ;uhs wfma ;sfhk úYsIaG;ajh' úfYaIfhka —kdä ú[a{dKh˜ fy< fjolfï frda. ksOdk uekúka jgyd .ekSu i|yd úYd, msgqjy,la' frda. ksOdkhg lrk m%;sldr - isxy, fjolfuys mokuhs frda. ksOdkh fidhd m%;sldr lsÍfï l%ufõoh wfma isxy, fjolfï uQ,sl ,laIKhhs' klaI;%h yd .=ma; úoHdj fy< fjolu <Õska weiqre lrk mrahdh úIfhdah' fï ish,af,ka mßmQ¾K jQ fy< ffjoHjrhd .fia" uqf,a" jef,a fldf<a idrh f.k fmr mqreoao" ±l mqreoao" l< mqreoao yd m<mqreoao Wmfhda.S lr .ksñka frda.Ska úksYaph fldg ukd f,i T!IO kshu lrkjd' ful, rgjeishd w;r iS>%fhka jHdma; ù ;sfnk — uOqfï.h fkdfyd;a Èhjeähdj˜frda.h ksid wo jk úg fuh lsishï iudc NS;sldjla njg m;aj ;sfnkjd' fï frda.h ksid we;sjk wmyiq;djka yd bkamiq doctormagazine.lk

we;sjk úmdl;a fya;=fjka fuu NS;sldj jvd;a j¾Okh ù we;s nj wm fj; tk oi oyia .Kka frda.Ska mjik jpk j,ska ukdjg jegfykjd' tfy;a udf.a w;a±lSï wkqj Èhjeähdj je<£ug m%:u fyda miq ffjoH Wmfoia yd m%;sldr ksis whqßka ,nd.kafka kï Èhjeähd frda.h ksÜgdjgu iqjlr .ekSu t;rï wmyiq ke;' wfma fy< Tiq ngysr Tiq j,g jvd m%;sM<odhlhs Èhjeähdj iqj l< fkdyels frda.hla njhs fndfyda msßia y÷kajd fokafka' fï msßi w;r ngysr fjolu m%uqLia:dkhla .kakjd' ngysr fjolfï fï frda.h iqj lsÍug fkdyels hehs m¾fhaIK lrñka frda.h md,khg muKla fnfy;a j¾. ksmojd ;snqK;a wfma fy< fjolñka úfYaIfhka udf.a fjowdrÉÑ mrïmrdfõ fjolñka Èhjeähd frda.h iqj lsÍu i|yd b;d m%n, T!IO ksmojd ;sfnkjd' fuh foaYSh fjolfuys we;s uyd¾> yelshdj fmkajd fok losu idlaIshla' Èhjeähd frda.S ;;ajh we;sjQ jydu ck;dj m<uqj fidhd hkafka ngysr ffjoHjrekah' Tkak b;sx uq,skau f,a mÍlaId lrkjd' .aÆfldaia uÜgu 115 g jeäfhka ;sfhkjd kï Thdg Èhjeähdj È.gu fnfy;a fndkak fjhs' ke;akï md,kh lr .kak neßfjhs'' w;=re wdndO;a we;sfjhs' wdÈ jYfhka frda.Skag mjikjd' fï m%ldY we;af;kau uu fy<d olskjd' udkisl wd;;sh oshjevshdj md,khg jsYd, ndOdjla fufia mejiSu ;=<ska frda.shd t;eka isgu fuu frda.h ms<sn|j 365 Èkfhau fufkys lrñka lsishï udkisl wd;;shg weo jefgkjd' úfYaIfhkau uu is;kjd fï udkisl wd;;shu we;s lsishï frda.hla j¾Okh ùug

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fy< Tiqfjka oshjeähd iqjh

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lshd' udf.a w;a±lSfukau lshkak mq¨jka udkisl wd;;sh Èhjeähd frda.h j¾Okh ùug tla fya;=jla nj' blauKska wm fj; wdfjd;a m%;sM<h blauKskau ud fufia mjikafka Èhjeähd frda.h ms<sn|j wfma rfÜ;a f,dalfha;a ;sfnk ;;a;ajh mss<sn|j jgyd §ughs' we;af;kau fy< fjoÿrka jk wm fj; fï frda.S ;;a;ajh we;sjQ ú.iu meñfKkjd kï wmg mq¨jka frda.S ;;a;ajh W;aikak ùug bv fkd§ w;=re wdndO we;s fkdùug WmldÍ jk T!IO ,nd§ Èhjeähd ;;a;ajh ioygu iqj lrkak' wfma fnfy;a j,ska isÿjkafka wdndOhg ,laù we;s tfyu;a ke;akï wjysr ù we;s w.akHdYh iqjm;a lsÍuhs' w.akHdYh iqjm;a fjkjd lshkafka Èhjeähdj iqjm;a jqKd lshk tlhs' fudlo w.akHdYh ;uhs YÍrhg wjYH bkaishq,ska ksmojk .nvdj' ngysr fm;s ìõjg w.akHdYh iqjm;a jkafka keye' .aÆfldaia uÜgu kï md,kh fjhs'

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Tng Èhjeähd frda.h we;sù we;akï mud fkdlr wou wm fj; meñfKkak' idudkH Èhjeähd ;;a;ajh l,a.; ùfuka — uOqfï.h˜ ;;a;ajh olajd j¾Okh jkjd' t;lï bkafka ke;sj uq,skau y÷kd.;a ú.iu fnfy;a fndkak wdrïN lf<d;a Tng b;du;a blauKska frda.h iqj lrkak mq¿jka' úoHdkql+,j ksmojd we;s wo jk úg oi oyia .Kkla frda.Ska ksÜgdjgu iqj l< T!IO j, uysuh háhkaf;dg uyú, fjo ueÿf¾§ Tng wjYH ish¿u fnfy;a T!IO ,ndfokjd' lsisÿ fnfy;a j¾.hla msg ;eklska fidhd .kakj;a ñ,§ .kakj;a wm Wmfoia fokafka keye' ud úiskau §¾> ld,hla w;ayod n,d úoHdkql+,j ksmojd we;s wo jk úg oi oyia .Kkla frda.Ska ksÜgdjgu iqj jQ — uÿksud˜ T!IO muKhs' wmf.a T!IO mdúÉÑ lrk úg ,ndfok Wmfoia ksismßÈ ls%hdjg kxjkjd kï Tng Èhjeähdj ksÜgdjgu iqj lr.kak mq¨jka nj ffjoHjrhd iÕrdjg m%ldY lrkjd' DM

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wdhq¾fõoh ks, fjolfuka iqjh iok wisßu;a fjolu

ks, fjolfuka iqjh iok wisßu;a fjolu ikaêjd; frda. iqj lrk ÔjlhdfKda

uykqjr" wxl=Uqf¾ ffjoHdpd¾h chka; nKavdr

wxl=Uqf¾ chka; nKavdr fjouy;d

wo iudcfha fnda fkdjk frda.hla fia ie,flk ikaê jd; fyj;a wd;rhsáia frda. hg f.dÿre jk ck;dj Èfkka Èku jeä fjñka mj;S' fkdfhla n,dfmdfrd;a;= ysi u; ;ndf.k Ôj;a jk Tjqka fujeks frda. hlg f.dÿre ùu ;=<ska ta ish¨ n,dfmdfrd;a;= iqka jk nj fmkS hhs' tfia ikaê jd; frda.hg f.dÿre jk frda.Skag iykhla i,iñka Tjqka iqjm;a lrk fjo uyf;l= wmg uykqjr m%foaYfhka yuq úh' t;=ud chka; nKavdr fjo uy;dhs' wm t;=ud iu. l< idlÉPdj fufia bÈßm;a lrkafkuq'

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ffjoH;=uks" ikaêjd; frda.h lshkafka fudllao@ ikaêjd; frda.h lshkafka ñksia YÍrfha ikaê j, jd;h tl;= ùu ;=<ska yg.kakd frda.S ;;a;ajhhs' fuys§ ñksidf.a ffoksl lghq;= lr.ekSug fkdyels wdldrhg Tjqkag Ydßßl fõokdj we;s fjkjd'

fuu frda.fha frda. ,CIK mejiqjfyd;a@ ikaê ;=<g jd;h meñKSu ;=<ska wegñÿ¿ úh,Sug m;afjkjd' weÕs,s mqrela" je<ñg" oKysi" j<¨lr wdÈfhys ikaê jd;h ysrùu ;=<ska bÈóug mgka .kakjd' miqj tu ia:dk weo ùu o isÿ fjkjd' ;jo YÍrhg oefkk wêl fjfyi" wdydr wreÑh" weÕ m; fõokdj" msmdih" w,i nj wdÈho frda. ,CIK jYfhka ye¢kaúh yelsh' ksishdldrj wdydr fkdÈrùu yd u<" uq;%d ksis wdldrfhka neyer fkdùu tu frda.h je<£ug fnfyúka n,mdk idOl fõ' ;jo frda.shdg we;sjk wmyiq;d w;r" fn,a, ysr ùu" w;a tiùug fkdyels ùu" Wrysi ;o ùu" weÕs,s me;a;lg weoùu yd fld÷ weg fmf<a yd ;=káfha wêl fõokdj" bls<s ;oùu" oKysi me;a;lg weoùu" ú¨U bÈóu yd ;oùu" mmqjg oefkk wêl fjfyildÍ nj wdÈhhs'

ffjoH;=uks" fuu frda.h iqjlsÍug fldmuK l,a .;fõo@ ks, Ydia;%fhka uu frda.Skag m%;sldr lr iqjm;a lrk ksid udi follska muK frda.shd iqjm;a lr§ug yelshdj mj;skjd' w;a" md weo .eiS we;s úg frda.h je<£ug fmr isá ;;a;ajhg weoh ke;slr iqj lr §ug yels fjkjd'

Tn;a ikaê jd; frda. fhka fmf<a kï chka; nKavdr fjo uy;d yuqù Tnf.a frda.h iqjlr .ekSug W;aiql jkak'

fjo uy;d yuqúh yels ia:dk fmd,af.d,a, - bßod fm'j' 8'00 - iji 4'00 olajd lvq.kakdj - i÷od yd wÕyrejdod Èkhkays § fm'j' 8'00 - iji 4'00 olajd wxl=Uqr - rdufldgqj ksjfia§ - nodod" isl=rdod" fikiqrdod Èkj, fm'j' 8'00 iji 4'00 olajd úuiqï ffjoHdpd¾h chka; nKavdr kqjrmdr" rdufldgqj" wxl=Uqr" uykqjr'

fuu frda.fhka ñ§ug frda.shd wkq.ukh l<hq;= ms<sfj;a fudkjdo@ Èkm;d fyd¢ka c,h mdkh lsÍu" bÿKq flfi,a" .ia,nq" fl¢ iys; wdydr .ekSu ;=<ska u< uq;%d fyd¢ka neyer lsÍug yelsùu" WIaKdêl wdydrmdk

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fkd.ekSu" isref¾ nr wvqlr,Su" wdydr .;a ú.i iakdkh fkdl< hq;= ùu wd§ lreKq fõ' nKavlald" OdkH j¾. wdÈh .=Kodhl wdydr fõ'

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wdhq¾fõoh jákd ld,Sk wjYH;d imqrk T!IO folla

fy< fjolfï lsre, me<ª .S%ka y¾n,a wdhq¾fõo iud.u ;j;a jákd ld,Sk wjYH;d imqrk T!IO folla yÿkajd fohs

.S%ka y¾n,a flaI uQ, ff;,h .S%ka y¾n,a f.da,aâ Yhska Ths,a

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Tn ;ju;a ridhksl vhs j¾. È.ska È.gu ysig .,ajkafklao@ Tn È.ska È.gu fï .,ajkafka fudkjd±hs u|lg úuid ne¨jdo@ PPD keue;s ridhkslh" wefudakh s d fyda yhsvc % ka fmfrdlaihsâ jeks ridhksl øjH uqil q r ksmojk fuu lD;su % vhs j¾. È.ska È.gu ysig .e,aùfuka cdk úlD;s;d we;sfõ' miqj fkdfhla w;=re wdndO we;sfõ' f,a ms,l s d" y;sh" weÿu jeks frda.S ;;a;j a j,go fuu ridhKsl Ndú;h fya;= fõ'

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wmf.a uq;=ka ñ;aa;ka iqÿ ysiflia l¿ meye .ekajQfha flfiao@ fy< fjolu iu.Ôj;ajQ me/kakkaf.a ysi flia iqÿ jQfha wjqreÿ 50;a bl=;ajQ miqjhs' ta;a iaj,am jYfhks' fya;=j ridhksl øjH ysig fkd.e,ajQ neúks' ji úi j,ska f;dr wdydr .;a neúks' Ydlidr T!Iëh f;,a j,ska ysi iy YÍrh iïndykh l, neúks' wm rfÜ mej;s fuu fy<fjolu úYd, kElula ;snQ yslalvqj YS% iqux., ysñhkaf. ka mej; tk óáhdf.dv .=rej;a; j,õfjka ìys jQ .S%ka y¾n,a wdhq¾fõo iud.u fy<hg ji úfika f;dr b;d M<odhS Tiq ksmojk T!IO ksIAmdokd.drhla .d,a, wdikakfha ia:dms; lr we;' tfukauuk nkaOkSh jgdmsgdjlska fyì kjuq w;aoelSï imhk ixpdrl ksjdvq ksfla;khlao msysgqjd we;' wo jk úg 100]la Ydlidr ksIamdok 30 lg jeäh ksmojd we;s fuu iud.u ld,Sk m%n, wjYH;d folla i|yd w¿;a ksIamdok oaú;ajhla ksmojd we;' .S%ka y¾n,a flaI uQ, ff;,h ;, f;,ska ksmojd we;s fuu l¿ meye;s f;, uÕska iqÿ ysiflia l¿ ù w¿;ska ysiflia ,ndfoa' ish¿ ysiflia m%Yak úi|hs' mqrdK doctormagazine.lk

flaY iy rEm,djkHhg msßkuk udiaflda rka;re iïudkh ysñ lr .;a .S%ka y¾n,a iud.fï iNdm;sksh ufkdaß ch;s,l ue;sKsh" 2018 §" reyqKq úYaj úoHd,h iy jHjidhl wêldrsh iu. jdKsc uKav,h fufyh jQ ol=Kq m<d;a úYsIaG;u l¾udka; iy ksIamdok wxYh úYsIAG;u jHjidhlhd nqyqufkka mqo ,o fudfyd;

iDIsjrekaf.a ryis.; jÜfgdarejla weiqf¾ fuh ksIAmdokh ù ;sfí' lsis÷ w;=re wdndO ke;s w;r f,dl= l=vd ldg;a iqÿiqhs' 200 mll ñ, remsh,a 3800$ ^;eme,a .dia;= iuÕ& .S%ka y¾n,a í,ela fyhd¾ Ths,a tlla fï iu. fkdñf,a msßkefuhs' .S%ka y¾n,a f.da,aâ Yhska Ths,a 100l ñ, remsh,a ^;eme,a .dia;= iuÕ& .S%ka y¾n,a f.d,aâ ialska 01 la fkdñf,a& .S%ka y¾n,a f.da,aâ Yhska Ths,a ksIAmdokhg j¾ðka fldlkÜ Ths,a m%Odk ù we;s w;r ;j;a ÿ¾,N iu j¾Kj;a lrk Ydlidr y;la wvx.= fõ' iu /<s jeàu kj;d meyem;a Èÿ,k iula ,ndfoa' DM fuu jákd ksIamdok oaú;ajhu fj<| fmdf,a ñ,§ .ekSug ke;' f.orgu f.kajd .; yel'

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wdhq¾fõoh lrorldÍ ifï frda. j,ska ñfokak u.la

lrorldÍ ifï frda. j,ska ñfokak u.la

me

yem;a jQ iqjm;a iula we;akï Tng fl;rï i;=gq úh yelso@ iu hkq YÍrfha msg;skau mj;sk b;d jeo.;a ld¾hhka .Kkdjla bgq lrk bkaøshhls' ifuys ls%hdldß;ajh" iu frda. j,g f.dÿreùu iy ifuys frda. j<lajd .ekSfï l%u ms<sn|j wdhq¾fõo ffjoH rkam; rejka r;akdhl fjo uy;d ±la jQ woyia fufia f.k yer olajuq' ifuka bgqjk ld¾hhka ifuka bgqjk ld¾hhka f,i isref¾ we;s wNHka;r bkaøshhka wdrlaId lsÍu" isref¾ we;eï ia:dk j,g yevhla ,nd§u" isrefrys WKqiqu ksh; uÜgul ,nd.ekSug WmldÍ ùu" YÍrhg tl;= jQ úI" wmøjH nysi%dù ls%hdj uÕska neyer lsÍu uQ,slj oelaúh yel' kuq;a úúO fya;=ka u; mek kefÕk .eg¿ldÍ ;;a;ajhka .Kkdjlska iu úúOdldr jQ frda. j,g f.dÿre fõ' th YÍrhg ndysßka meñfKk laIqø Ôú wdidokhla úh yelsh' tjeks fndajk frda. ;;a;ajhla iam¾Yfhka" ,sx.sl ls%hd u.ska" fyda wmsßisÿ llu ksido iïfm%aYKh fõ' laIqø Ôúkag myiqfjka jeãug wjYH mßir ;;a;ajhka ^WIaK;ajh yd f;;ukh& tu mqoa.,hkaf.a ldhsl wNHka;r fya;+ka uÕska we;s fõ' tjeks wjia:dj,§ msg;ska meñfKk úIîchkaf.a wdidokhka úl¾IKh l< yels tajdg Tfrd;a;= fok by< m%;sYla;Ska f.dvk.d .ekSug ÈhqKq wdhq¾fõo ffjoH l%u weiqre lsÍu fhda.Hh'

126

September 2019

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wdhq¾fõo ffjoH rkam; rejka r;akdhl úisks laIqøÔú wdidokhkaf.ka f;drj tkï fnda fkdjk ;;a;ajhka hgf;a ifï iajdNdúl ;;a;ajhg ydks muqKqjñka yg.kakd úúO ifï frda. iaÓrju iqj lr.; yels l%u w;r wdhq¾fõo l%uh fmruqfKa isà' by; lS fnda fkdjk ifï frda. we;s ùug m%Odk;u fya;=j jkafka úúO fya;+ka ksid rla;h ¥IKhg ,laùuhs' rla;h ¥IKh jk fya;= YÍr m%lD;sh Wmf;a isgu mqoa.,fhl=g Wreu jk —jd" ms;a" fiï˜ fodaIhka weiqßka ms;a fodaIh wêl jQ WIaKdêl YÍr ;;a;ajhka we;s whf.a iu meiùu nyq, jk w;r túg jd fiï fodaIj, odhl;ajfhka

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iu úh,Su" bß;e,Su" leiSu wd§ ,laIK u;= fõ' wdydr úyrKhka mßfNdackh lrk wdydr j, wdï,sl Ndjhka ^ì,sx" f.drld" ishU,d" ;lald,s" wkakdis wd§ úgñka iS mod¾: nyq, wdydr j, we;s weiafldaìla weisâ" isÜßla weisâ nyq,;ajh& fya;=fjka iy WIaKdêl wdydr ^fo,a" lsß w," biafida" ±,af,da" n,ud¿" ll=¿fjda& fl,skau rla; fodaI we;s lrhs' Bg wu;rj rd;S% ksÈ jeÍu" oyj, ksod .ekSu" ;o wõfõ .uka ìuka hdu" lE msg lEu" úreoaO wdydr mßfNdackh" u;ameka Ndú;h wys;lr ls%hdjka ksid rla; fodaI yg.kS' doctormagazine.lk

wdydr Ô¾K moaO;sfha ÿ¾j,;djhka we;eï mqoa.,hkaf.a wdydr Ô¾Kfha mj;sk ÿ¾j,;djhka ksid .kakd wdydr YÍrhg .; yels wjidk M, olajd fNaokh fkdù wjfYdaIKh ù ^fuh wdhq¾fõo ffjoH úoHdj ;=, wdurih fyj;a wuq wdydr rih f,i ±lafõ& rla;hg tl;= ùfuka ksrka;rfhka rla;h ¥IKh fõ' udkisl fya;= u; ks;r ks;r we;s lr.kakd ffjr fl%daO is;=ú,s" lkiai,a," ks;r flaka;s .ekSï" ld¾h nyq,;ajh ksid we;sjk udkisl mSvkh wd§ fya;=ka ksid rla; fodaI yg.kS' oshjeähd frda.fhka fmf<kakkaf.a reêrhg ksr;=reju úI fldgia tl;= jkafka tho wdydr Ô¾Kfha úlD;shla jk neúks' §¾>ld,Skj Èhjeähdjg bjla njla ke;sj fm;s .s,sñka tu.ska ifï frda. jeks w;=re wdndO we;s jkafka hehs ks;r ueisú,s kÕ;s' wdid;añl;d we;eï whg úúO oE iam¾Y ùu ^Ydlj, nQj" o<Uqjka wd§ jQ''''& ksid úYu jQ wdydr j¾." oIagk ^uÿrejka" ul=Kkaa& ksid isrer mqrd m¨ ±óu jeks wdid;añl;djka j,ska wdrïN ù we;eï úg oreKq mSvdjka we;s lrjk wjia:d ;sfí'

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fifkfy ke;sj isrerg úk lrk ms;a; iafkay fkdfyd;a fldf,iagfrda,a

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we;eï whg leiSu ksid fyda ijia ld,fha Èh kEu" weÕm; fia§u jeks wjia:d j, m¨ ±óu we;sfõ' uÿrejka oIaG l< úg fyda bfígu ;eka ;eka j, we;s j, l=vd ìì,s úfYaaIfhka leiSu ksid we;euqkaf.a ;=jd, yg .kS' l%ufhka fõ.j;aj fïjd me;sÍ hhs' we;eï úg f;;ajQ Èhr j.=rhs' YÍrfha ´kEu ;ekl yg.; yelsh' rla; fodaI Bg;a jvd m%n,j rla; fodaI we;s whg fomdj, oKysiska my< m%foaYj, iu mqmqrd f;; Èhr .,k wêl leiSï iys; jd;rla; wjia:djka u;=fõ' we;eï úg mdo fyda weÕs,s lre wdY%s;j ikaêj, leiSï j,ska wdrïN fõ' l=IaG frda. ifï frda.j, A4 A4 oreKq;u wjia:dj jkqfha úúOdldrfhka yg.kakd l=IaG frda. hkah' fïjd fndfydaúg fmr Nj j,§ lrk ,o wl=i, l¾uhkaf.a n,mEï u.ska we;sjk mSvdldÍ wjia:djkah' 128

September 2019

ifï frda. iu.ska we;sjk fjk;a .eg¿ ifï frda. we;sjk fndfyda wjia:dj,§ tu frda.j,g iu.dój we;sjk úúO jQ fjk;a ldhsl frda.o yg .kS' weÿu" mSki" w¾Yia" nv mqrjd ±óu" u<noaOh" nv.skak wdYS%; Ô¾K moaO;sfha fodaI" .eiag%hsáia" ysfia lelal=u" kskao fkdhdu" wêl ksÈu;" wêl f,i flaka;s hdu" weia lka leiSu" W.=f¾ fiu weúiaiSu wd§ fndfyda frda. ,laIK wjia:dkQl+,j ta ta mqoa.,hkag wdfõksl f,i m%uqL fõ' ifï frda. j,ska ñfok wdhq¾fõoSh u. úu¾YkYS,Sj wdhq¾fõo ffjoH úoHd;aul Í;skag wkqj frda. iqjm;a lsÍfï kshef,kakkag tl úg frda. ;;a;ajhla fyda ,laIKhla ms<sn| muKla i,ld ne,Sulska f;drj by; ish¿ frda. ,laIKhka fyda frda. ;;ajhka ms,sn|j mq¿,aj fidhd n,d ie,iqï iy.;j m%;sldr lsÍfuka tjka jQ fndfyda frda. iaÓrju iqjlr .; yelsh' DM j;auka iudcfha nqoaêu;a úu¾YkYS,s ish,a,kau mdfya wdhq¾fõo ffjoH l%uh ms<sn| ;sridr úYajdihla f.dvkÕdf.k ;snqko fuu ffjoH l¾uhkays wuqøjH fidhd lmd fldgd ilia lrf.k lIdh ;eïîu iy fjk;a T!IO ms<sfh, lr.ekSu ksishdldrfhka isÿ lr.ekSug wmyiq ùu ksid fuu úYsIaG jQ ffjoH l%uhg wj;S¾K fkdfõ' ´kEu ld¾hnyq, wjia:djkays§ /lshdj lrk w;r;=r myiqfjka Ndú;hg .; yels f,i kshñ; m%ñ;Skag wkql+,j W;alDIaG jQ T!Iëh .=Kfhka hq;= fnda;,a f,i ms<sfh, k, lidh j¾." .=,s j¾." l,al" pQ¾k ksIamdokh lr we;af;a úúo mSvdjkaf. ka fmf<k iqjyilf.a frda. myiqfjka iaÓrju iqjm;a lsÍu Wfoiduh'

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