Doctor Magazine January 2019 by Doctor Magazine

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

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zz Tfí iqjfi; - wfma me;=uhs ZZ

JANUARY 2019

Volume 25 • Issue 01

5 iqmqj; 8 f,v fjk wlaudj /l.kafka fufyuhs wlaudj frda.S jkafka fufyuhs wlaudfõ fïoh ;ekam;a ùu wlaudj krla ùfï wjidk woshr - isfrdaisia

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57 HIV ffjrih blauKska y÷kd .kakd mÍlaIK 62 uÿrefjda wfma f,a fndkafk kE''' yenehs uÿß,d fndkjdæ 66 WoEik wydrh orejkaf.a ojfia fyd|u wdydr fõ,hs 69 ore iïm;a m%udo jQ wUQ ieñhkag 74 .¾NKS;djfhaoS we;sjk fjkialï''' 79 Learning Related Vision Problems

28 o;a fodia;r <Õ" Wvqoe<sh

82 .eìKs ujf.a fmdaIKh

29 uOHidr fndkak tmd" î ßh Odjkh lrkak tmd

86 iu we§ug ,laùu ksid ifuys we;sjk i<l=Kq

34 HEALTH EFFECTS OF

90 wäh ;shd.kak fkdyels há m;=f,a oefkk fõokdj iq< uq,æ

40 Yíoh@ ksYaYíoho@ f>daIdj ys;g;a lhg;a nrla'''

98 iqjl< fkdyels ;;a;ajfha ms<sldjlska mSvd ú¢ frda.sfhl=f.ka W.;a mdvï

CIGARETTE SMOKING

44 fldf,iagfrda,a lshk ;rï krl kE 49 nfhdmais lrñka ysßyerhg m;a jkafka l=ugo@ wlaud frda. 52 i,a,s j,ska ñksiaiq Ôj;a lrjkak mq¨jka 54 Dilemma of the PSA test to DETECT PROSTATIC CANCER 4

JANUARY 2019 | DOCTOR MAGAZINE

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Issue 01

●

January 2019

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doctormagazine.lk

JANUARY 2019 | DOCTOR MAGAZINE

ETON

EDITOR'S

S'ROTIDE

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ZZdh;'a; u rfÜ fi!LH ''yfï f.!rjKS akhfYj uùa;m gjn alhYxdh¾dl a;fgh rdOdw 'shhkso kKfñem wOHdmkfha iq y q U q , a wjia : dfõ m% n , fi!LH mKsúv cd;s l fufyjr jd;kc jód.ui dy at Soa;jf ÿsi ïlaikjf lsk;hdw âadnfáakei uqj,QKa ejQo wdh;khhs wOHdmk óg oYl 'hú gkakj QKqhso äej ock.; akygivejlsïÍfug Ísl a; ïf. gdh';fi!LH a;yu hjr!.f aKfqns; ks,Odßkaf.a mßmd,k YlH;djfhka uq,a ld,fha fi!LH lsysmhlg HL!if hYxdh¾dl kmdHOw HL!if gú kj ow S;dmIalm hn qiqu fomd¾;fïka;=fõ uyck fi!LH wxYfha l=vd tallhla fmr wfmaa a;fgh =lhfrjIalHOw rdp%m dy kmdHOw ahfYxH;duw qKm qyT 'sljn fiajdj .ï"akokõj,g erjHojff "Hojff l,jYfhka dY dc%m "Hojl% fsh f d;a lshu dlldcjQ %m wfma fi!LH 'shof a;ywOHdmk fnf j¿=;ew akúfYa ßdO,sk HLñ!i jHQjola jffTia ;akfoia wo 'showe;s f dn,;;a a;k; akt lf os"akherqK ajhg m;aj ;sfí' t<efUk I kmdHOw l% Soõfxi jqi jd;kc ;úakui akslh,vaKu h¾dl K¾Qm s;ek s,slsiej uyck fi!LH mÍla I ljrfhl= hgf;a os i a ; %sla fi!LH osk hla fjhs ' gjn alhk;hdw kofrW glrjyfuf ,dYú ïfÍsl ke. ula;.oej ïfSke.dk; alhs,slsiej g,j a,j.f ta%ml'í lfs;l%jsha;d;a jrfhl= ta zzieka .adá rffnda dw "â HL!if a,eidwOHdmk m "HL!if dc m ul ùu" âadniyldr fáakei ktwOHla Sirei I aksl hdnl ,sk sldl 'shof dhsl q K q y q m " ï S h . e w d y K I a h f ¾ m " k m d H O w H L ! i f d , d Y H a k f a k r l ; . e r =;kgfej ßs|ew ksot dh;a;yu hg;g wdh;kh m;a ù u" f,da l fi!LH ixúOdkfha uy;a;hdZZ .ug HL!if akua;j ;úakui akwdOdr sljdkK.hgf;a Yxw Sodw '''ïÍsl akhsim;a ejï. oaljYfhka jdr.`i ZZ;meizz ahf,ñdkf 'hïf. ld¾hdxYhla njg ùu meñfKk oskhhs' vúsKm HL!if Oúú dyry HOdu hYxdh¾dl kmdHOw aiofmW jqi dkáj adyfdnf syt r;w kßydonf r;w ieka lua;á dhfnda s%l jâ |nsk akygivej wdh;ks SIAYfúqi dl ,syfjkia hfkoAkfl skï xi isÿ fj;aoS ta yd iu.dój ck;dj 'h;.¾;akw 'shrl oeKQj;a lsÍfï jevigyka o jeä oshqKQ jkakg úh' uy;a;hdg .fï hs;amd%mg+l aifjo gjd,jf kt k.fàej ßs|ew ? 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NOTE

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EDITOR'S

NOTE

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rd.u ffjoH mSGfha ldhsl frda. úfYaI{ ffjoH uydpd¾h wkqrdO oikdhl

fnda fkdjk frda. wo wfma ld,fha nrm;, fi!LH ;¾ckhla' oshjeähdj" wêl reêr mSvkh" fldf,iagfrda,a" yDo frda." ms<sld''' fï ,ehsia;=jg wlaud frda.;a tl;= fj,d' fjfiiskau Ûwlaudfõ f;,a ;ekam;a ùu¶ wo wfma ck.ykfhka jeä ixLHdjla mSvdjg m;a lrjk" wk;=f¾ fy<k frda.hla njg m;a fj,d' uq,skau fï wlaud frda. j, mej;Su .ek wjfndaOhla ,nd .ksuq' doctormagazine.lk

wlaud yd wdka;%sl Y,H" rd.u ffjoH mSGfha ffjoH uydpd¾h frdydka isßj¾Ok

cd;sl frdayf,a wjhj noaO lsrSu úfYAI{ ffjoH rejka osidkdhl

m%Yakfha os. m<, fï úosyg f;areï .ksuq

fï wlaudj frda.Ska jhia ldKAv f,i ie<l=jfyd;a <orefjla" jeäysáfhla olajd mrdihl ´kEu flfkl=g wlaudj yd ine|S frda. we;s fjkak mq¿jka' wlaud.; frda. ksid j¾Ihlg 16"000la muK rcfha frday,a j,g we;=<;a fjkjd' ful, jl=.vq frda. wfma jeä wjOdkhg ,laj ;sfnkjd' th wfma rfÜ we;eï osia;%slal j, úYd, jYfhka ck;dj wdmodjg ,la lrjk frda.hla njg m;aj ;sfnkjd' jl=.vq frda. ksid j¾Ihlg ñh hk m%udKh 2000la muK' wfma wjOdkhg t;rï ,la fkdjqK;a" wlaudj yd wlaudj wdY%s; frda. ksid;a jirlg 1800la ú;r rcfha frday,a j, ñh hkjd' fï wkQj t;rï nrla fkd;enqK;a wlaud frda. iudcfha nrm;, .eg¿jla njg m;aj ;sfnk nj fï ixLHd f,aLK wmg fmkajd fok i;Hhhs'

JANUARY 2019 | DOCTOR MAGAZINE

Medical Check up lrk úgoS wlaudfj

.eg¿jla ;sfhkjd kï wkdjrKh fjkjd' thdldrfhka fyda uq,a wjia:dfõ frda.h yªkd .kakg ,enqfKd;a wmg l< yels foa fndfydauhs' wlaud frda. yeÿfkd;a kej; iqj lsÍu myiq ldrKhla fkdfjhs' ksoka.; frda. j, we;s fï idOkSh ,laIK wlaud frda. j,g;a fmdÿhs' wgqjd àld fudlgo@ wlaud frda.;a jeä m%udKhla whs;s fjkafk zzfnda fkdjk frda.ZZ ldKAvhguhs' c.;a jHdma; ixLHd f,aLK ne¨j;a f,dal ck.ykfhka ñ,shk 50la muK ksoka.; frda. j,ska mSvd ú|skjd' ta wh w;f¾ wlaud.; wdndO j,ska mSvd ú|sk frda.Skao ie<lsh hq;= ixLHdjla isákjd' wjOdkh fhduq l< hq;= jeo.;a ldrKh kï fuhska ie<lsh hq;= m%udKhla je<elaúh yelsj ;snQ wjia:d njhs' ;j;a f,ilska lsõfjd;a wfma jeros iy.; p¾hd rgdjka fï wlaud frda. yg.kak;a fndfyda wjia:d j,oS fya;= jk njhs'

wlaudfõ meálsßh yªkd .ksuq wlaudj - YÍr wNHka;rfha ;sfnk úYd,;u bkaøsh' idudkH mqoa.,fhl=f.a th lsf,dajl=;a .a?ï 200 muK nrhs' Wor l=yrfha ol=KQ mi by< fl<jf¾ b< weg l+vqj wNHka;rfhka wlaudj msysgd ;sfnkjd'

ldhsl ffjoH úoHdKql+,j reêr .ukd.ukfha iajNdjh mokï lrf.k wlaudj fldgia wglg fnod úia;r flfrkjd' 12

JANUARY 2019 | DOCTOR MAGAZINE

wlaudfõ reêr ixirkh fiiq bkaøsh j,g jvd ;rula fjkia wlaudfõ m%Odk jYfhka fohdldrhl reêrh wka;¾.; fjkjd' idudkHfhka fjk;a bkaøsh j,g reêrh ,efnkafka Oukshlska' reêrh msg jkafka Ysrd weiqre lrf.k' ta;a" wlaudj Bg fjkia' wlaudjg Ysrdjlska fukau Oukshlska hk fome;af;kau reêrh ,efnkjd' Ouksfhka ,efnkafka ishhg 20l muK reêr m%udKhla ú;rhs' ishhg 80l ú;r reêrh ,efnkafka Ysrd u.ska' Ysrd Tiafia fï úosyg wlaudjg tkafka nvje,a j,g hk reêrhhs' wlaudjg msúiSfukaa wk;=rej fï reêrh idudkH reêr .ukd.ukhg tla fjkjd'

jl=.vq frda. ksid j¾Ihlg ñh hk m%udKh 2000la muK' wfma wjOdkhg t;rï ,la fkdjqK;a" wlaudj yd wlaudj wdY%s; frda. ksid;a jirlg 1800la ú;r rcfha frday,a j, ñh hkjd' doctormagazine.lk

wdydr cS¾Khg wjYH ms; ksmojkafka wlaudfõ'''

wlaudj frda.S jkafka fufyuhs

wlaudfj ms; yd iïnkaOfhkao uQ,sl ld¾hhla ;sfhkjd' wlaudfj ksmofjk ms; ms;a; kd, j,ska t<shg ú;a m%Odk ms;a; kd,h Tiafia nvje,a j,g tl;= ùula isÿ fjkjd' wdydr wjfYdaIKhg" nys>%dùh l%shdldß;ajhg fï ms; wjYHhs'

wlaudjg n,mdk frda. fojeoEreïj j¾.SlrKh l< yelshs'

wlaudfõ wjfYaI ld¾hhka wlaudfõ l¾;jHhka fm<.eiaula lf<d;a fï ,smsh ,shkakg bv ,>q fldg ,sùu myiq ldrKhla fkdfjhs' úoHd{hka úiska y÷kdf.k we;s wdldrhg mkaishhlg jeä lD;H i|yd wlaudj odhl jkafkah' flfia fj;;a thska uQ,sl jYfhka isÿ flfrk ld¾hhka lsysmhla muKla olajkq ßisfhñ' • fïoh" úgñk" iSks" úgñk yd wfkl=;a fmdaIl ir, fldgia njg ì| fy,Su'

flá ld,Sk wlaud frda. fix.ud,h fkdfyd;a ffjriuh fymghsáia" fvx.=" ó WK" merisgfuda,a wê ud;%djla .ekSu wdoS frda. ksid wlaudj frda.S ùu flá ld,Skj we;sjk l%shdj,shla'

os.= ld,Sk wlaud frda. wjqreoaola" folla''' wjqreÿ my oyhla ;=< wlaudj ÿ¾j, ùfuka wjidkfha isfrdaisia wdoS ;;a;ajhlg m;aùu fuysoS idlÉPd flfrkjd' wlaudfõ fïoh ;ekam;a ùu" uoHidr mdkh lsÍfuka wlaudj ydkshg m;aùu ksid we;sjk frda." ffjri iïNjhla iys;j fï os.=ld,Skj wlaud frda. yg .kakjd'

• YÍrfha hy l%shdldß;ajhg wjYH ridhk ksmoùu' ^Wod' we,aìhqñk" ms;a ix>gl& • uoHidr yd úIøjH wdoS YÍrhg úk lrk øjH ì| fy<Su • reêrfha we;s we;eï wmøjH bj;a lsÍu • Yla;sh ksmoùfï l%shdj,sh wu;r .aÆfldaia .a,hsfldcka njg m;a lsÍu yd wjYH úfgl tajd kej;;a Yla;sh njg mßj¾;kh lsÍu • reêrh leá .eiSug iydh ùu

doctormagazine.lk

• wlaudj ÿ¾j, fjkjd hehs lshkafka wlaudj ;=< we;s fymfgdihsg kï ffi, úkdY ùuhs' wêl f,i u;ameka mdkh ksid wlaudj úlD;s ù ÿ¾j, fjkjd' u;ameka fkdfndk whgo ia:Q,;djh yd fjk;a fya;= u; wlaudfõ fymfgdihsg ffi, ÿ¾j, ùula isoaO fjkjd' JANUARY 2019 | DOCTOR MAGAZINE

• fymghsáia ffjrih ksid;a wlaudj frda.S fjkjd' fymghsáia ffjrih YÍrhg we;=¿ jQ miqj th YÍrfhka bj;a lr .ekSu b;du wmyiqhs' tu ffjrih ;ekam;a ù ;sfnkafka wlaudj ;=<hs' fymghsáia B iy fymghsáia C wm rfÜ nyq,j oel.kak fkd,enqK;a fïjd ksid wlaudj frda.S ùu ngysr rgj, nyq,j oel.; yels ;;a;ajhla' • úkdYhg m;a jQ ffi, kej; ,sh,Sfï úYAñ; yelshdjla wlaudjg ;sfnkjd' ta yelshdj we;s YÍrfha m%Odku bkaøsh ;uhs wlaudj' ta;a" úúO fya;= ksid wlaudj l%u l%ufhka úkdYhg m;a jk úg th kej; ,sh,kafka úlD;s wdldrhg'

tfia ,sh¨j;a wlaudj l,ska ;snqKq wdldrhg m;a jkafka keye' túg b;sß jkafka úlD;s jQ" l=vd jqKq" yels¿Kq wlaudjla' isfrdaisia frda. fha§;a fuf,i wlaudj l=vd fjkjd' yelsf<kjd' wlaudfõ yevh fjkia fjkjd'

wlaudj frda.S ùfïoS we;sjk frda. ,laIK

flá ld,Sk wlaud frda. j,oS we;sjk fmrksñ;s fix.ud,h fkdfyd;a ffjriuh fymghsáia fvx.= ksid;a we;eï úg wlaudj frda.S fjkjd' fï whg

oeKQj;a fjkak wjia:dj ,efnk úg fjkak ;sfhk ydksh isÿù wjika ùu'

;o WK" weia ly mdg ùu" f;a lyg meyefhka uq;%d msgùu" lEu wreÑh" jukh wdoS frda. ,laIK my< fjkjd' ;;a;ajh tkak tkak ne?reï jk ksid b;du blauKska frday,a.; ùug fï whg isÿ fjkjd'

álla nrm;, f,i wlaudj frda.S jqKdu fï ,laIK my< fjkjd iuyr úg fï áflka

os.= ld,Sk wlaud frda.fha frda. ,laIK wlaudj úYd, jYfhka krla jk;=re frda. ,laIK my< fjkjd wvqhs wlaudj ishhg 70la ;rï úYd, m%udKhla krla jqK;a fuysoS lsisÿ frda. ,laIKhla we;s fkdfjkak mq¿jks' fuys we;s Nhdkl lu ;uhs fï ksid u;=j wd wk;=r .ek frda.shdg 14

JANUARY 2019 | DOCTOR MAGAZINE

wlaudj ishhg 70la ;rï úYd, m%udKhla krla jqK;a fuysoS lsisÿ frda. ,laIKhla we;s fkdfjkak mq¿jks' doctormagazine.lk

ál wlaudj krla fjk tl jir 10-15 ;siafi ú;r wkql%ufhka isÿjk fohla' weia lyùu" ll=,a bosóu" wêl f;fyÜgqj" Worh úYd, ùu" f,a jukh''' fïj ;uhs uq,skau we;s jk frda. ,laIK wjdikdj" fï frda. ,laIK my< fjkafk kej;

ms<silr lrkak neß ;rï wlaudj úkdY ùfuka wk;=rejhs' fuhu ;uhs fï os.= ld,Sk wlaud frda. fha we;s wk;=r' kej; ikSm lrkak neß ;rï frda.S jqKdu wlaudjla noaO lrkak;a isÿ fjkjd''' fï whg ;sfnk úl,amh ;uhs wlaudjla noaO lsßu' yenehs b;ska wlaudjla noaO lsßu lshkafk Tn' wm is;k ;rï f,ais ld¾hhla fkdfjhs' fï ksid ;uhs os.= ld,Sk wlaud frda. .ek wjOdkfhka isàu wjYH' tjka ;;a;ajhlg ne?reï fjkak fmr lsishï l%shdud¾.hla .ekSu wjYH' l,ska wyïfnka yß yªkd .kak ,enqfKd;a tal jdikdjla''' wlaudj krla ùu uQ,sl wjia:dfõ frda.sfhl=g uq,skau lsisu frda. ,laIKhla my< fjkafk kE fkdje' fjk;a wikSmhlg yß ialEka mÍlaIdjlg uqyqK fokakg wjia:djla ,enqfKd;a th ;uhs Tyqf. jdikdj' túg uq,a wjia:dfj frda.h wyïfnka yªk.kak mq¿jka' wlaudj krla ùu i|yd .;jk ld,h álla os.= lr.kak mq¿jka' úYd, úkdYhla fjkakg fmr lsishï ms<shula fhdokak mq¿jka'

doctormagazine.lk

fuh ;jÿrg;a úia;r lf<d;a" uoHidr mdkh lrk flfkla kï Tyq ta ÿisßf;ka uqojd .kak mq¿jka' ffjri wdidokhlska fmf<kjd kï Bg m%;sl¾u fhdokak mq¿jka' ta;a by; lS úosyg wr weia ly mdg ùu" ll=,a bosóu jf.a frda. ,laIK fmkajk wjia:dfjos kï l< yels foa b;du iSñ;hs'

wlaudfj fïoh ;ekam;a ùug m%Odk fya;=j jYfhka oeka yªkdf.k ;sfhkafka wfma fkdmsg fmr¿Kq wdydr rgdj'

JANUARY 2019 | DOCTOR MAGAZINE

wlaudj frda. ksYAph lrk frda. mrSlaIK

Total Bilirubin

reêr mrSlaIK FBC ma,Sydj úYd, ùfï m%;sM<hla f,i FBC j, mÜáld m%udKh wvq ùula fmkakqï lrkjd'

Albumin

Liver Profile tkaihsu mÍlaIK u.ska wlaudj wdidokhg ,la ù ;sfnkjdo@ th krla ù ;sfnkjdo@ hkak iel yer oek.; yelshs' we;af;kau tkaihsu iïnkaO reêr mÍlaIK Tiafia fï ;;a;ajh uq,a wjia:dfõ isgu oek.kakg yelshs' th úYd, jdishla' fndfyda úg Medical Check up j,oS fï ;;a;ajh wkdjrKh jqfKd;a th jdikdjla' uq,a wjia:dfõ frda.h yªkd .kakg ,enqfKd;a wmg l< yels foa fndfydauhs'

wlaudfõ frda. yªkd .ekSug lrk reêr mÍlaIK Liver Functions Tests

Alanine aminotransferase (ALT/SGPT) – an enzyme mainly found in the liver. Aspartate aminotransferase (AST/AGOT)

ProthrombinTime / International Normalised Ratio(PT/ INR)

wlaudfõ frda. yªkd .ekSug úi,a ld¾hNdrhla bgq lrk ialEka mÍlaIK Ultra Sound ialEka mÍlaIK lshkafka" wvq uqo,lska l< yels b;d jákd ffjoH mÍlaIdjla' ,xldfõ wo ;sfnk ;;a;ajh n,k úg wfma fm!oa.,sl u;h kï wlaudj frda.S ùfï wjodkula we;s Woúh ^u;ameka mdkh lrk wh" ia:Q, YÍr we;s wh" oshjeähdj" mjqf,a wlaud frda. b;sydih yd mjqf,a wlaud ms<sld b;sydihla we;s wh& yeu jeäysáfhlau jqK;a lr.kak tl fyd|hs' fï mÍlaIKh ksid fndfydauhla .eg¿ wmg lsishï id¾:l l%shdud¾.hla .kak yels wjia:dfõ wkdjrkh fjkjd'

m<;=re j, ;sfhk mDlafgdaia kejqï m<;=re jYfhka .ekSfï jrola kE" ta;a fldaäh,a f,i tajd mdkh lsßu kqiqÿiqhs' th g%dkaia fïoh jf.au Ndú;hg wfhda.Hhs 16

JANUARY 2019 | DOCTOR MAGAZINE

doctormagazine.lk

oeka wm lk n;a wmg wjYH m%udKhg jvd b;d jeähs' msÕdfk n;a ;sfhkak ´ks y;frka mx.=jhs' y;frka tlla t<j¿' y;frka tlla fm%daàk yd wfkla y;frka tl m<;=re' wlaudfj f;,a ;ekam;a ùu wlaud ialEka mÍlaIKfhka b;du myiqfjka y÷kd. kak mq¿jka' we;a;gu wms fndfyda fofkla fuhg ;nk ,xiqj wvqhs' zzoeka ldf, b;sx fï f;,a yefudagu ;sfhkjdfk'''' ´l ta ;rï .; hq;= fohla fkdfjhs'''ZZ wms tfyu ys;kjd' ta;a fï mÍlaIKfhka wkdjrKh jk oE weiqf¾ kshñ; m%;sl¾u fhoSu u;=jg we;súh yels nrm;, ;;a;ajhka u.yerùug w;sYhska bjy,a jk nj lsj hq;=hs' wju uÜgfï yrs f;,a ;ekam;a ùula ;sfhkjd kï ta ;;a;ajh wvq ;rfï Bg jvd uqyql=rd hk tl yß kj;ajd .kak wjYHhs' doctormagazine.lk

fu;ekska lsishï .eg¿ iy.; ;;a;ajhla wkdjrKh lr .;a;u wms B<Õ mshjr úosyg wfkl=;a ialEka yd fjk;a mÍlaIK lr.kak;a mq¿jka' wjYH;djh wkQj fï m%;sìïn mÍlaIK frda.shdf.a ;;a;ajh iïnkaOfhka ksYAÑ; bÕs imhkjd'

kùk ;dlaIKfha kjH Ndú;dj Transient Elastography Scan thg wu;rj Transient Elastography Scan hkqfjka yªkajk kùk mÍlaIKhla ;sfhkjd' Transient Elastography Scan mÍlaIKh uQ,sl wjia:dfõ wlaudfj isfrdaishdj yªkd .ekSug fhdod .kak mq¿jka' wlaudfj ;ka;= ;ekam;a ùu (Fibrosis) .Kkh lr .ekSug fï mÍlaIKh bjy,a fjkjd'

Liver Biopsy mÍlaIKfha jeo.;alu nfhdmais mÍlaIKh wlaudfj iel iys; mgl fldgila fjf;d;a th ksYAph lr.kak fhdod .kak mq¿jks' wlaudfõ mgl fldgila wrf.k wkaùlaIShj mÍlaId lsÍu ;uhs fuysoS uQ,slj isÿ jkafka' fndfyda úg fï mÍlaIKh frda. ksOdk mÍlaIK j, wjidkfhaoS .kakd mshjrla' reêr mrSlaIK j,ska ialEka mÍlaIKhlska ksYAÑ; frda. ks¾Khlg meñKSfï wjia:dj ;sfhkjd' ta mÍlaIK j,ska frda. ks¾Kh wmyiq iSñ; wjia:d j,oS muKhs fï mÍlaIKh isÿ lrkafka' we;eï úg frda.Ska nfhdmais mÍlaIK j,g hkakg ue<slula olajk wjia:d;a ;sfhkjd' ta;a úfYAI{ ffjoHjrfhla ta wjYH;djh fmkajd ÿkafkd;a thg Ndckh ùu ;uhs jvd;a iqÿiq' fï mÍlaIKh lsÍfïoS lsishï fõokdjla frda.shdg oefkkjd' frday,a.;j mÍlaIKhg Ndckh ùug;a frda.shdg isÿ fjkjd' kuq;a th úr, isÿùula' fï mÍlaIKh isÿ lrkafka th isÿ lsÍfuka frda.shdg ;SrKhla .ekSu wjYHfhkau l< hq;a;la jk úghs' tu ksid jvd;a jeo.;a jkafka tu mÍlaIKhg Ndckh ùu'

JANUARY 2019 | DOCTOR MAGAZINE

wlaudfõ

f;,a ;ekam;a ùu

wlaudj ;=< fïoh ;ekam;a ùu b;du Nhdkl ;;a;ajhla' Y%S ,xldj ;=< yuqjk fndfyda wlaud frda.Skaf.a tu frda.hg fya;=j laIKsl wdydr" ia:q,;djh" f;,a iys; wdydr" jHdhdu u|lu wdoshhs' fkdmsg fmr¿Kq cSjk p¾hdjg f.jk jkaoshla f,i fï wlaudfõ fïo ;ekam;a ùu yªkajkak mq¿jka' 18

JANUARY 2019 | DOCTOR MAGAZINE

wm YÍrfha nyq,j f;,a ;ekam;a jk ia:dk ;sfnkjd' tlla ;uhs Worh' wm ksfrda.S kï wfma wlaudfj fïoh olskakg ,efnkafka ke' wm ia:q, ùfïoS tla;rd wjia:djl Worhg wu;rj wlaudfõ" w;=KQnyka fkdfyd;a wka;%" yDoh jia;=j jfÜ''' fï wdldrfhka tu ia:dk j, fïoh ;ekam;a ùu isÿ fjkjd' th kï t;rï fyd| kE' l=vd orefjla .;af;d;a Tyqf. wlaudfj fïoh we;af;au kE' oeka jeäysáhka jeä fofklaf. wlaudfj f;,a@ wm rd.u m%foaYfha wOHhkhla doctormagazine.lk

l<d' frday, wdikakfha wjq' 45 bl=;a jQ 3000la muK ialEka lr ne,SfïoS Tjqkaf.ka ishhg 66la f.a wlaudfõ fïoh ;sfnk nj fy<sorõ jqjd' fuh wmg ys;d .kakg neß ;rï úYd, ixLHdjla' oshjeähdj" wêreêr mSvkh" ia:Q,;djh" yoj;a frda. jeksu ;;a;ajhla' by; lS frda. ;;a;ajhka j,oS;a fï wlaudfj fïo ;ekam;a ùu jeä fjkjd' fuh fnda fkdjk frda. mU .df,a ;j;a j¾OkSh wjia:djla f,i wmg i<lkakg isÿ fjkjd'

wlaudfõ fïoh ;ekam;a ùug n,mdk fya;= wdydr idOlh • wlaudfj fïoh ;ekam;a ùug m%Odk fya;=j jYfhka oeka yªkdf.k ;sfhkafka wfma fkdmsg fmr¿Kq wdydr rgdj' biair wfma fyaka f.dúfhla" fjk;a nr jev lrmq flfkla''' ta Yla;sh jeh lsÍfuka miqj .;a wdydr fõ, Bg;a jvd krl úosyg ll=,la Wv odf.k rEm fmÜáh osyd n,dk bkak flfkla" mß>klhla bosßmsg /lshd lrkafkla wkqNj lrkjd' • n;a j,g;a jvd msá jf.a fjk wdydr;a .kakjdfk' mdie,a hk orejka l%Svd lghq;= j, ksr; fjkjd wvqhs' wm wdydrhg .kakd foa Tiafia YrSrhg ,efnk Yla;sh ksishdldrj jeh lrkak l%uhla kE' fï fya;=j ksid wu;r wdydr ixÑ; fïoh úosyg wlaudfj;a ;ekam;a fjkjd' • flá wdydr wo jvd;a ckm%shhs' fïjd ,dnhs' myiqfjka ,nd.; yelshs' ld¾hnyq, cSú;fhaoS wdydr doctormagazine.lk

wjYH;djhg myiq úl,amhla' fïjdfha úfYAI;ajh ;uhs l=vd m%udK j,ska lEj;a jeä Yla;shla ,efnkjd' fï wu;rj ,efnk Yla;sh;a YÍrfha fïoh jYfhka ;ekam;a fjkjd ñi jeh ùula isÿ jkafka kE' fuys ;ka;=uh mod¾:;a kE' • orejka ia:Q, jkakg fï jeros wdydr fya;=jla' ia:Q,;djhg m;a orejka wo ishhg 20-25la ú;r bkakjd' fï wh;a wkd.;fha wlaudfõ fïo we;=¿j úúO wjodkï j,g ,la ùfï wjodkula orkjd' • g%dkaia fïoh wo wfma fïouh f;aÍu njg m;aj ;sfnkjd' tlu f;f,a kej; kej;;a neoSu ksid;a g%dkaia fïoh ksmofjkjd' tfiau i;a;ajuh udxY;a wdydr f;f,ka neo wdydrhg .ekSu;a iqÿiq kE' • meKs ri yd ri lrk ,o îu j¾. yd fjfiiskau m<;=re j, ;sfhk mDlafgdaia kue;s iSks j¾.h iqÿiq kE' m<;=re j, ;sfhk mDlafgdaia m<;=re jYfhka .ekSfï jrola kE" ta;a fldaäh,a f,i tajd mdkh lsßu kqiqÿiqhs' th g%dkaia fïoh jf.au Ndú;hg wfhda. Hhs lshk ldrKh ;uhs wo jk úg yªkdf.k ;sfnkafka' fuu wys;lr mDlafgdia wf,úhg

oeka uoHidr Ndú;fhka isfrdaisia ;;a;ajhg m;afjk frda.Skag jvd wlaudfj f;,a ;ekam;a ùfuka isfrdaishdjg ,lajk frda.Ska m%udKh jeähs' JANUARY 2019 | DOCTOR MAGAZINE

;nd we;s w;=remi" meKs îu wdosfhys iq,nj ;sfnkjd'

cdkuh idOlh

wlaudfõ fïoh ;ekam;a ùug n,mdk wys;lr idOl • Wig iß,k nrg jvd nr jeä ùu • uoHidr mdkh lsÍu

wlaudfõ f;,a bj;a lsÍug fnfy;a

cdkuh idOlh;a fuys,d ;on, fia n,mdkjd' mjqf,a isfrdaisia frda.sfhla" wlaud ms<sld frda.sfhla bkakjd kï mjqf,a wfkla wh;a ;ukaf.a wlaudfõ iqjfi; .ek ie<ls<su;a fjk tl keKj;a'

uoHidr idOlh

fï jk ;=re wlaudfõ f;,a bj;a lsÍug iqÿiq fnfy;la fidhdf.k kE' fï ksid l< hq;af;a fï frda.hg bjy,a jQ idOl bj;a lr .ekSuhs'

isref¾ nr wvq lr.kak jákd Wmfoia álla nr wvq lr .ekSu wxl tl" yeu flfklau ;ukaf.a Wig irs<k nrla mj;ajd .; hq;=hs' Y%S ,dxlslhka i|yd nyq,j mj;sk Wi lsysmhlg ;sìh hq;= nr ud ii|d lshkakï'

uoHidr j,skq;a isfrdaishdj olajd j¾Okh jkakg fmr uq,skau isÿ jkafka wlaudfõ fïoh ;ekam;a ùu' th ;uhs wkql%ufhka isfrdaishdj njg m;a jkafka' fïouh wlaudj we;s úg iEfyk ld,hla hk ;=re frda. ,laIK my< jkafka kE' b;d iq¿;rhlf.a muKla b;d iq¿ fõokdjla ol=KQ me;af;a we;s fjkak mq¿jka' 20

JANUARY 2019 | DOCTOR MAGAZINE

wlaudfj f;,a ;ekam;a jQ frda.sfhla uoHir mdkh lf<d;a Tyqg wlaudfõ ms<sld we;s ùfï wjia:dj jeähs' doctormagazine.lk

• wä myla Wi flfkla lsf,da y;,sia y; yudrl muK nrla mj;ajd .; hq;=hs'

wlaudfõ f;,a j,ska ñfokakg fï úosyg fjkia fjuq

• wä myudrla Wi flfkl=g ;sìh hq;= nr lsf,da yegla ú;r fjkjd' • wä yhla Wi flfkla lsf,da ye;a;E fol yudrl muK YrSr nrla mj;ajd .; hq;= fjkjd' fï wkQj ;ukaf.a Wig iß,k nr ;sfnkjdo hkak .ek ie<ls<su;a jkak' fuh mqxÑ ldf, b|kau mj;ajd .; hq;= fohla' wo fndfyda fofkla ;ukaf. Wi okafk;a kE' nr okafk;a kE' Wig ;sfhkak ´ks nr okafk;a kE' ta;a fuh flfklaf. iqjfi; iïnkaOfhka b;du jeo.;a jk idOlhla' fï ksid ;ukaf.a Wig iß,k nr'''' wm YÍr ialkaAO o¾Ylh lsh, lshkjd" th .ek yeu flfklau oeKQj;aj isáh hq;=hs' Tfí Wig iß,k nrg jvd jeä nrlska hqla; kï th wdrlaIs; uÜgug f.k tkakg b,lalhla we;s lr.; hq;=hs' osßfhka thg <Õd úh hq;=hs' th kej;;a jeä fkdjkakg mshjr .; hq;=hs' doctormagazine.lk

wfma wdydr rgdj fjkia úh hq;af;a flfyduo@ • oeka wm lk n;a wmg wjYH m%udKhg jvd b;d jeähs' msÕdfk n;a ;sfhkak ´ks y;frka mx.=jhs' y;frka tlla t<j¿' y;frka tlla fm%daàk yd wfkla y;frka tl m<;=re' • meKsri mdúÉÑh wvq lrkak ´ks' msIAGh wvq lrkak ´ks' neomq uia" g%dkaia fïoh ;sfhk wdydr;a wvq lrkak ´ks' wkjYH úosyg .kak iSks m%udKh wvq lr.kak ´ks' • weÕ fkdfjfyijk flfkla''' ksoiqkla úosyg .;af;d;a ld¾hd,fha mqgqjl jdä ù rdcldß lrk flfkla mdka nd.hl wdydr jrlg .;af;d;a th iqÿiq kE' wÕ,a ndf. >klu mdka fm;a;la folla jrlg Tyqg iEfykjd' • jevqKq mqoa.,fhla ojilg iSks f;a ye|s yhlg jeäfhka .ekSu iqÿiq kE ta;a wms nr wvq lrkak ´ks kï th;a wvq lr, odkak fjkjd' ffjoHjrfhla .djg .shdu ishhg oyhlska nr wvq lr.kak lshkjd' lsf,da 80la nr flfkla lsf,da 72 nr JANUARY 2019 | DOCTOR MAGAZINE

wehs@ wlaudj krla jQ frda.sfhl=g f,a jukh hkjd' ;dr wdldrhg u< my msg fjkjd' fuh isfrdaisia frda.fha ,laIKhla' fuysoS wlaudfõ ksfrda.S ffi, fjkqjg ;ka;= ffi, we;s fjkjd' • flfkla ojilg túg wlaudj yryd jk reêr .ukd.ukh le,ß 2500l lEu fõ,la .kakjdfk' widudkHhs' tys m%;sM<hla úosyg reêrjdyskS Tfí nr b,lalhg moaO;sfha mSvkh jeä fjkjd' fjk;a ud¾. fï .dk 1500 j,ska túg reêrh .uka lrkjd' .,kd,fha olajd wvq lrkak my<u fldgfia ;sfnk reêr jdyskS j,ska fï fjkak mq¿jka' túg úosyg reêrh .uka lsÍula isÿ fjkjd' fï ksid Tn l< hq;af;a fmdaIKfõosfhla tlal .,kd,fha my, fldgfia f,a kyr bosfukjd' l;d lrf.k uf.a mdofha we;sjk wmiaÓ; Ysrd jeks ;;a;ajhla wdydr fõ, le,ß .,kd,fh;a isÿ fjkjd' tla wjia:djloS fïjd 1500 uÜgug ilia mqmqrd f,a .e,sula isÿ fjkjd' f,a jeä jYfhka lr, fokak lsõju jykh jqfKd;a f,a jukh hkjd' yenehs iq¿ ;=ka fõ,gu Tfí wyrjg fmdaIKfõoshd f,a jykhla we;s jqfKd;a ;dr jeks iajNdjhla ksielfhkau ilid orñka l¿ meyehg u<my ùula olakg foaú' we;af;kau ,efnkjd' uÜgug <Õd fjkak kï iSks mdúÉÑh w;a yßkak;a fjkjd'

lemùu ;sfhkjd kï nr wvq lr .ekSu wiSre ldrKhla fkdfjhs'

jHdhdu wms ojilg wvq ;rfï meh nd.hla úkdä 45la j;a jHdhdu lsÍfï mqroaola yod .kak ´ks' yhsfhka weúosk tl" nhsisl,hla meoSu yß lrkak ´ks' i;shlg ojia myla j;a fï jHdhdu mj;ajd .; hq;=hs'

wlaudj krla jQ frda.sfhl=g f,a jukh ;dr mdgg u<my hkafka 22

fláfhka lsõfjd;a .,kd,fha my; fldgfia we;sjk f,a .e,Sula by<ska t<shg wdfjd;a th f,a jukhla f,io" nvje,a Tiafia .sfhd;a th ;dr jeks fihla .;a u<my msgùula f,io we;s úh yelshs' wdydr ud¾.fha uq¿ os. yryd .uka lr .=o ud¾. fhka msgjk l< tys wvx.= hlv idr fldgia j, l%shdldß;ajfhka u< l¿ meyehla .kakjd' ta;a ta msg jkafka reêrhu ;uhs' fujka frda. ,laIKhla we;s jQ úg Tn blauKskau wlaudj yd iïnkaO ldhsl frda. ffjoHjrfhl= fj; fhduq úh hq;=hs' túg fuhg m%;sldr l< yelshs' kshñ; fj,djg m%;sldr fkd,enqfKd;a oreKQ f,i reêrjykhla we;sù cSú; ydkshla jqj isÿùug bv ;sfnkjd' fuysoS lrk m%;sldrh .ek;a hula mjikakï' fuu frda.Ska tkaviafldms mÍlaIdjg ,la lr reêrh jykh jk reêr jdyskS wjysr lsÍula isÿ lrkjd' thska iEfyk m%udKhlska fï ;;a;ajh md,kh lr.; yels fjkjd'

JANUARY 2019 | DOCTOR MAGAZINE

doctormagazine.lk

wlaudj krla ùfï wjidk woshr

isfrdaisia os.=ld,Skj wlaudj wl¾ukH ùu fuysoS isÿ fjkjd' fuysoS idudkH ksfrda.S ffi, úkdY ù fl|s jeks ;;a;ajhla we;s fjkjd' ta iu.u wlaudfõ l%shdldß;ajh ÿ¾j, fjkjd' os.=ld,Sk u;ameka Ndú;dj" fymghsáia B yd C jeks ffjri wdidok ksid fukau wlaudfõ f;,a ;ekam;a ùu ksido isfrdaishdj we;s fjkakg mq¿jka' krla jQ wlaudjl .;s fidndj isfrdaisia je<÷KQ wlaudjla ;o ÿUQre meyehla .kakjd' th m%udKfhka l=vd fjkjd' u;=msg isksÿ nj ke;s ù .eá;s jeks iajNdjhla ks¾udKh fjkjd' b;d iqug isksÿ wjhjhla jQ wlaudj isfrdaisia ;;a;ajhg m;a ùfïoS lsishï >k iajNdjhla .kakjd' wlaudj ÿ¾j, ùfïoS mdo bosfukafka fufyuhs''' YÍrhg wjYH lrk fm%daàk ksIAmdokh lrkafka wlaudj u.ska' wm fm%daàka wdydr .;a;;a tajd tf,iu YÍr wjYH;d i|yd mdúÉÑhg .kafk kE' ta ld¾hhg wjYH fm%daàk iudkqfhdackh isÿlr doctormagazine.lk

we,aìhqñka kue;s ridhkhla njg m;a lsÍu wjYH fjkjd' fï ridhKsl ld¾hh isÿ jkafka wlaudfõ ueosy;a ùfuka' wlaudj flfuka wl¾ukH jk úg YÍrfha we,aìhqñka m%;sY;h wvq fjkjd' reêrfha mj;sk we,aìhqñka m%udKh;a wvq fjkjd' c, wKQ reêr kd, ;=< r|jd .kakg reêr kd, j, mj;akd we,aìhqñka wjYHhs' reêr kd, j, we,aìhqñka wvq jqKdu tu c, wKQ msg;g .uka lr tys m%;sM<hla

JANUARY 2019 | DOCTOR MAGAZINE

jYfhka ll=,a bosfukjd' wlaud frda.Skaf.a nv bosóug;a fï we,aìhqñka wvqùfï lsishï n,mEula ;sfnkjd'

uoHidrh mdkh lsÍfuka we;sjk isfrdaisia ;;a;ajh ish¿u uoHidr j¾. mdkh lsÍu u.ska isfrdaisia we;s fjkjd' fï wjodku we;euqka flfryS úfYAIfhka n, .ekafjkjd' uoHidr .kakd ishhla .;af;d;a thska úis myla muK fï wjodkug ,la fjkjd' th isÿjk wdldrh .ek ;ju;a yß yeá ks.ukhla ke;s jqK;a th ksielfhkau wjodkï idOlhla nj kï meyeos,shs'

wfma rfÜ fix.ud,h ksid wlaudj frda.S jk wjia:d úr,hs Ökh" cmdkh jeks rgj, isfrdaishdj we;s fjkak jeä jYfhkau n,mdkafk fymghsáia frda.h' thskq;a fymghsáia î wdidokh' ,xldfj ;sfhkafk úfYAI ;;a;ajhla' wfma rfÜ ffjri wdidok ksid isfrdaisia ;;a;ajhg m;ajk frda.Ska yuq jkafka b;d l,d;=rlska' ta;a wlaudfj fïo ;ekam;a ùu yd uoHmdkh weiqre lr.;a wlaud frda.Ska wfma rfÜ b;d jeähs' u;ameka îfuka isfrdaisia yefok frda.Skag jvd f;,a ksid isfrdaisia yefok frda. Ska oeka jeähs óg ld,hlg by; ;;a;ajh úuiqfjd;a u;ameka mdkfhka isfrdaisia we;sjqKQ frda.Ska ;uhs wmg jeä jYfhkau yuq jkafka' ixLHd;aulj .;af;d;a ta ldKAvh ishhg 50-60 w;r m%udKhla jqKd' ta;a oeka uoHidr Ndú;fhka isfrdaisia ;;a;ajhg m;afjk frda.Skag jvd wlaudfj f;,a ;ekam;a ùfuka isfrdaishdjg ,lajk frda.Ska m%udKh jeähs' fuh we;a;gu wfma rfÜ uoHidr mdkh lrk whf.a wvq ùula jkakg nE' thg jvd fï wlaudfõ f;,a ;ekam;a ùu úYd, jHikhla úosyg me;sr hk nj ;uhs wfma w;aoelSï weiqf¾ wmg m;ajkakg isÿjk ks.ukh' 24

wfma rfÜ idudkHfhka jeä fokd fndkafk wrlal= n%ekaä" cska" úials" wrlal=''' fï fldhsfl;a idudkHfhka ishhg 40l uoHidr m%;sY;hla ;sfhkjd' tjka m%;sY;hl we;s uoHidr wms ys;uq i;shlg fnda;,a nd.hla .kakjd lsh,'''' ta ish¿ fokdgu isfrdaisia yefok wjodku ;sfhkjd' kS;s úfrdaë uoHidr >khg jefgk rd" lismamq ls;=,a rd jqK;a idudkHfhka uoHidr mdkh lrk whf.ka ishhg 30la fï isfrdaisia frda.h we;s ùfï wjodku orkjd' u;ameka fndk w;f¾ lEjo@ fkdlEjo@ lshk tl fuhg n,mEula kE' fuys Tng .kak ;sfhk mKsúvh ;uhs lsishï flfkla fï u;ameka .ekSu k;r lf<d;a ta whf.ka nyq;rhlg úYañ;j ;;a;ajh lsishï iqj ùula olakg ,efnkjd' u;ameka mdkfhka ñoSuu T!IOhla fjkjd'

isfrdaisia frda.Skag lrk m%;sldr isfrdaisia frda.h we;sùug n,mdk fya;= j,g wkQj ms<shï fhosh hq;=hs' uoHidr mdkh lrk flfkla kï Tyq bka uqojd.; hq;=hs' fymghsáia frda.h óg odhl jqKd kï thg m%;sldr ,ndosh hq;=hs' Bg wu;rj isfrdaisia ksid we;sjk ixl+,;d j,g m%;sl¾u fhoSul=;a isÿ fjkjd' yenehs fï frda.hg iïmQ¾K iqjhla ,nd oSu l< yelalla fkdfjhs' wjidk jYfhka ksÜggdjg isÿ lrkak kï wlaudjla noaO l< yelshs'

JANUARY 2019 | DOCTOR MAGAZINE

doctormagazine.lk

wlaudj noaO lsrSfï ie;alu 2010 j¾IfhaoS ,xldfõ uq,a jrg wlaudjla noaO lsÍfï Y,Hl¾uhla id¾:lj isÿ flreKd' t;eka mgka wo jk úg fï ie;alu úYd, jYfhka isÿ flfrkjd' rd.u frday," fld<U cd;sl frday, wdosfha isfrdaisia frda.h ksid cSú;fha ish¿ wfmalaIdjka w;ay< frda.Skag fuh wfmalaId f.k ÿkakd'

wlaud noaOhla lsÍug n,mdk fya;= 1' isfrdaisia frda.h ksid wlaudjg oS¾> jYfhka ydks isÿùu isfrdaisia j,oS wlaudfõ jHqyfha yd l%shdldß;ajfha ÿ¾j,;d we;s fjkjd' fï ksid we;sjk ixl+,;d frda.shdf.a cSú;dfmalaIdj wvq lrkjd' fuhg ms<shula f,i ;uhs wlaud noaOhla isÿ jkafka'

isfrdaisia ;sfnk yeu flfkl=gu wlaudjla noaO lsÍu wjYH kE' isfrdaisia ksid we;sjk ixl+,;d fya;=fjka flá ld,Skj yd os.= ld,Skj we;sjk cSú; wjodku fï noaO lsÍug fya;=jla fjkjd' tfiau isfrdaisia ;;a;ajh oeä jYfhka jeä jqKdu;a fuh isÿ l< hq;= fjkjd' MELD Score kue;s o¾Ylhla weiqf¾ ;uhs wlaud noaOhl wjYH;djh ffjoHjreka fidhd n,kafka' úfYAIfhkau fmdfrd;a;= f,aLK.;j isák frda.Ska w;f¾ m%uqL;djh fldmuK blauKska

doctormagazine.lk

frda.shdg noaO lsÍu isÿ l< hq;=o hkak .ek ;SrKhla .ekSug fuu o¾Ylh WmldÍ fjkjd'

2' fjk;a fya;= merisgfuda,a wê ud;%d YÍr.; ùu" we;eï ffjri j¾. ksid flá ld,hla ksid wlaudjg ydks isÿ ùfuka wlaud noaOhla lrd hkakg isÿjk wjia:d ;sfnkjd'

noaO lrkakg wlaudjla fidhd .kakd yeá fud<h ñh.sh frda.sfhla odhlhd fia fhdod .kakjd kï iuia; wlaudju ta i|yd fhdod .kakjd' oshqKQ jk rgj, isoaO jk wdldrh yd fm!oa.,slj ud kï jvd;a fyd|u l%uh f,i úYajdi lrkafka oeä i;aldr j, fud<h ñh .sh whf.a wlaudjka fï i|yd fhdod .ekSu' fud<h ñh .sh miq ta frda.shdg kej; cSú;hla ,efnkafka kE' hka;% iQ;% ;sfnk ;dla ;uhs fï whf.a bkaøsh mjd l%shd;aul jkafka' tjka wjia:djloS frda.shdf.a {d;Ska tu wjhj noaO lsÍu i|yd ,nd .ekSug leue;a; ,nd ÿkafkd;a túg fï wlaudj fjk;a flfklaf.a cSú;hla fírd .kak noaO lsÍug fhdod .kak mq¿jks' rd.u" W;=re fld<U YslaIK frdayf,a yd fld<U cd;sl frdayf,a isÿ lrk wlaud noaO lsÍï i|yd jeä jYfhkau fhdodf.k ;sfnkafka

JANUARY 2019 | DOCTOR MAGAZINE

l< yelshs' fuysoS m%fhdackhg .efkkafka wlaudfõ kej; mqk¾cSjkhg ,la ùfï yelshdj' wlaudfjka ;=fkka tlla ;snqK;a th ksfrda.s kï ydkshla kE' ta wkQj ksfrda.S wlaudjl ;=fkka folla olajd flfkl=g noaO lsÍu i|yd mß;Hd. lsÍfï yelshdj ;sfnkjd'

fï l%uh' tys we;s jeo.;alu frda.shdf.a md¾Yjh wjhj fidhd .ekSfï Ndr¥r ld¾hfhka ksoyia ùuhs'

mjqf, flfkla fjkqfjka wlaudfj fldgila oka fokak bosßm;a fjkjo@ ;ukaf. mjqf, flfkla fjkqfjka wlaudfj fldgila oka fokak leu;s kï th lrkakg mq¿jka' ta;a fï .ek Tn uQ,sl jYfhka wjfndaOhla ,nd .; hq;=hs' wfma rfÜ iq,nj isÿ jkafka jl=.vq noaO lsÍfï ie;alï' jl=.vq folla flfkl=g ;sfnk ksid fuysoS tla jl=.vqjla bj;a lrkjd' ta;a flfkl=g wlaud ;sfhkafk tlhs' ta;a jdikdjg wlaudfjka fldgila wrf.k th frda.S mqoa.,hdg noaO

JANUARY 2019 | DOCTOR MAGAZINE

fuh b;du ixlS¾K ie;alula' lsishï wjodkula ke;sjd fkdfjhs' ta;a fud<h ñh .sh flfkla iïuqL fjk;=re oS¾> ld,hla l,a n,kjdg jvd tfyu wjia:djla ;sfnkjd kï th m%fhdackhg f.k noaO lsÍfï ie;alu blauKska lr.kakg yelshdj ;sfnkjd' jl=.vq noaO lsÍfï oS kï odhlhd yd m%;s.%dylhdf.a jl=. vq ixlS¾K iei|Sulg ,la lrkjd' kuq;a wlaud noaOfhaoS wjYH flfrkafka reêr >k iei|Sula muKhs' ta w;ska oS¾> ieiªï l%shdj,shla wjYH jkafka kE' wlaud noaOfhaoS th úYd, jdishla'

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Y,Hl¾uh isÿ lrkafka fufyuhs m<uqj frda.Sj krla jQ wlaudj iyuq,skau bj;a l< hq;=hs' uq,skau wlaudjg reêrh iemfhk reêr kd, yd reêrh neyer flfrk reêr kd, lmd ;djld,slj wjysr lr wlaudj bj;a lrkjd' oeka iïmQ¾K wlaudj fyda wlaudfõ fldgila f.k th reêr kd, j,g iïnkaO lrkjd' oeka frda.shdg kj wlaudjla ,enqKd yd iudkhs' fldgila noaO l<;a fï wlaud mgl j,g iajhx .=Kkh ùfï úYañ; yelshdjla we;s ksid bka .eg¿jla we;s jkafka kE'

noaO l< wlaud fldgi i;s ;=kla muK jk úg ksfrda.S wlaudjla ;rug jefvkjd' • fuh ixlS¾K ie;alula' ta;a fuh isÿ lsrSfuka frda.shdg kej;;a cSú;h ,efnkjd' idudkHfhka wlaiud noaOhla id¾:lj isÿ lsÍfuka miq Tyqg ;j;a wjq' 10-15la fyda Bg;a jeä ld,hla .eg¿jla fkdue;sj .; lrkak wjia:dj ,efnkjd ' • wlaud noaO lsÍfïoSo fiiq noaO lsÍï j,oS fukau w¿;a wjhjh YÍrfhka m%;slafIAm ùu j<lajkakg m%;sYla;s (Immunosuppressants) wjysrl fnfy;a fokjd' fuhska YÍrfha m%;sYla;sh lsishï m%udKhlska wvmK fjkjd' fï wh myiqfjkau f,v frda. j,g ,laùfï yelshdjla ;sfhkjd' fï ksid Tjqka úIîc j,g ksrdjrKh fkdùug m%fõYï úh hq;=hs' Tjqkag /lshdjg" újdyhg" orejka ,eîug ndOdjla kE''

mjd fï m%;sYla;slrKh wvd, lsÍu ksid úYd, wNsfhda.hla fjkak mq¿jka' fï ksid Tjqkag uyckhd .ejfik ia:dk j, .ejfikakg bvla kE' uqL jdvï m<|skak ´ks' m<uq wjqreoao fol úfYAIfhkau fï frda.Ska fiiq wdidok j,g ,laùfuka j<lskak W;aidy .kak ´ks' bka miqj;a yels muK fï ndysr úIîc j,ska j<lskakg mshjr .eku w;sYhska jeo.;a' • Anti Rejection T!IO fï frda.Ska cSú; ld,hgu .; hq;=hs' frda.sfhla ojila" folla''' ojia lsysmhla fkdf.k isàu we;eï úg cSú; ;¾ckhla olajd jqK;a uqyql=rd hkakg bvla ;sfnkjd' fï frda.Ska hym;a fi!LH mqreÿ mj;ajd .; hq;=hs' kshu lrk wdldrhg idhk j,g meñKsh hq;=hs' kshñ; ffjoH mÍlaIK j,g kshñ; mßos iyNd.s úh hq;=hs' fï i|yd lsishï uqo,a m%udKhla jeh fjkjd' ld,h" Y%uh yd lemùu wjYH fjkjd'

wlaudfõ we;s jk ms<sld wlaudfõ we;s jk ms<sld fohdldr fjkjd'

wlaudfjka yg .kakd ms<sld

fjk;a bkaøshlska wlaudjg jHdma; jk ms<sld

• idudkHfhka iq¿ frda. ;;a;ajhla

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JANUARY 2019 | DOCTOR MAGAZINE

fjk;a rg j, wlaudfõ ms<sld we;sfjk fya;= j,g jvd wfma rfÜ wlaud frda.Skaf.a iajrEmh ;rula fjkia wdldr fjkjd' wlaudfõ f;,a ;ekam;a ùfuka ms<sld we;s fjk ms<sld ;uhs wfma rfÜ jeä jYfhka olakg ,efnkafka' f,dalfha wfkl=;a rgj, kï ffjriuh iïNjhla iys; fymghsáia B yd C ksid;a wlaudfõ ms<sld we;s ùfï m%jK;djhla ;sfnkjd' wlaudfj f;,a ;ekam;a jQ frda.sfhla uoHir mdkh lf<d;a Tyqg wlaudfõ ms<sld we;s ùfï wjia:dj jeähs' mjqf, flfkl=g wlaudfõ ms<sldjla ;sfhkjd kï Tyqg;a lsishï jeä wjodkula ;sfhkjd' oshjeähdj fkdue;s flfkl=g wlaudfj f;,a ;ekam;a ùu ;sfhkjd kï Tyqg;a oshjeähdj je<|Sfï jeä wjodkula ;sfhkjd' fïj ;uhs iq,n fya;='

fujeks frda.Skag we;sjk frda. ,laIK fï wh ffjoHjreka fj; meñfKk úg iEfyk muK Tvq ÿjd ;sîu wjdikdjla' kQ;k ffjoH úoHdjg 28

(Scientific Medicine) jqK;a ms<sldj Tvq ÿjd ;sfnk wlaudjla ;sfnk frda.sfhl=g id¾:l ms<shula fhoSu wmyiqhs' wlaudfõ ms<sld j, ;sfnk Nhdkl lu;a fuhuhs' wlaudjo we;=<;a Worfha isÿ lrk ialEka mÍlaIdj ;uhs fï iïnkaOfhka wkdjrKh lrk m%uqL mÍlaIdj' fï ksid hï flfkla wjodkï idOl fmkajkjd kï wlaudfõ ;;a;ajh .ek wjfndaOhla ,eîug;a" wlaud ms<sld wdosh lsishï ueosy;aùula l< yels wjia:djl yªkd .ekSug;a fï mÍlaIdjka j,g Ndckh ùu jeo.;a' nyq;rhlg ms<sldfõ uq,skau frda. ,laIK m%lg lrkafka kE' ta;a we;efula frda. ,laIK fmkajk wjia:d;a ;sfhkjd' • lEu wm%sh ùu • fya;=jla úia;r l< fkdyels YÍrh lDY ùu • Worfha ol=KQ me;a;g jkakg wmyiqjla fõokdjla we;s ùu • frda.h W;aikak jQ úg isfrdaisia j,oS we;sjk weia ly meye ùu" Worh úYd, ùu jeks ,laIK

fjk;a ms<sld wlaudjg me;sfrk wjia:d YÍrfha fjk;a ia:dkhl yg.kakd ms<sld ffcj fldgila wlaudj fj; meñKSfukao wlaudj ms<sldjg f.dÿre jk wjia:d ;sfnkjd' wdydr cS¾K moaO;sfha yg .kakd ms<sld iq,nj wlaudfjys me;sÍï j,g f.dÿre fjkjd' Bg fya;=j jkafka tu reêrh iDcqju wlaudj yryd YÍrfha fjkia fldgia j,g .uka lsÍuhs' wdudYh" w.akHdYh" uydnvje,a yd

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l=vdnvje,a j, we;sjk ms<sld fï wdldrhgu wlaudjg;a myiqfjka jHdma; jkakg bv ;sfhkjd' Bg wu;rj mshhqre ms<sld" fmKy¿ j, we;sjk ms<sld yd YÍrfha uiamsËq wdY%s;j we;sjk ms<sld jqK;a wlaudjg jHdma; jkakg bvla ;sfnkjd' wlaudjg we;s jk ms<sldjloS lrk m%;sldr uQ,slj ta ms<sldjg f.dÿre jQ fldgi bj;a lsÍfï Y,Hl¾uhla lrkak isÿ fjkjd' wlaudj iïmQ¾Kfhkau bj;a lrkakg isÿ jqfKd;a wlaud noaOhlg hkak isÿ fjkjd' fï m%;sldr foflka muKhs wlaud ms<sldj ishhg ishhla iqjm;a lrkakg wjia:dj Wr.dkak ,efnkafka' lSfudf;rms" rYañ Ñls;aidj jf.a m%;sldr;a fï frda.Skag ,nd fokjd' tys wruqK jkafka frda.shdg oefkk wmyiq;d wju lsÍu" cSú; ld,h jeä lsßu wdosh' fï m%;sl¾u j,ska frda.h iqj lrkak nE'

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cSú; fírd .kakd uyÕ= mqkHl¾uh - wjhj okaoSug Tfí iyfhda.h fokak foodyla muK ,dxlslhka j¾Ihlg wlaudj wl¾ukH ùfuka ñh hkjd' fuh ud kï olskafka wfma rg uqyqK md ;sfnk jHikhla úosyghs' fï wirK frda.Skag kej;;a cSú;h ,nd fokakg yels taldhk u. jeà ;sfnkafka wlaud noaO lsÍu yrydhs' fï i|yd wlaudjla oka osh hq;=hs' f,dalfha wjfYAI rgj,a" cd;Ska úIfhys n,k l< wm wka wh flfryS iydkqlïmdj we;s fY%aIAG cd;shla' wms okaoSu uekúka mqreÿ mqyqKq l< cd;shla' wfma Ndú;dj;a fuhg idlaIs imhkjd' f,dalfha wxl tfla l=Ks; ^weia& mß;Hd.YS,Ska bkafka Y%S ,xldfj' wms rgj,a 56lg weia oka fokjd' wms fï jk úg weia 76"000la oka oS ;sfnkjd' wjhj okaoSu wmg kqyqre fohla fjkak nE' Tfí ióm;ufhla lsishï wjdikdjlg uqyqK md oeä i;aldr tallfha hka;% j, msysfgka osú / lf.k bkakjd kï ta nj ffjoHjreka fmkajd ÿkafkd;a Tyqf.a wjhj ;j;a flfkl=g oka fokak melsf,kak tmd' th Tn .kakd W;alDIAG ;SrKhla' Tyqf.a wjhj ;j;a lSm fofkl=g cSú;h .eg .id .kakg wjia:dj i,idú' JANUARY 2019 | DOCTOR MAGAZINE

o;a fodia;r <Õ" Wvqoe<sh

Wmd,s lkakka.r

lSh' zzfufyu ks¾NS; flfkla uu ljod j;a oel,d keye' ug uf.a .dia;=j;a tmd' ta ú;rla fkfjhs" ;E.a.la yeáhg fï remsh,a 500;a wr.kak' flfkl=f. fõokdj hg;a lr.ekSu wo Thd ug fyd| mdvula b.ekakqjd æ˜ Èfkl o;la .e,eùu i|yd oka; ffjoH mSfrdïnia fj; .sh Wvqoe<sh m<uqj ñ, .ek úueiSh' o;a ffjoHjrhd re' 1200 hehs mejeiQ úg" mSfrdïnia ta wêl hehs is;Sh' u|la l,amkd lsÍfuka miq" fyf;u jvd ,dn l%u .ek úueiSh' oka; ffjoHjrhd fufia lS h' zzTõ" fïl lrkak mq¿jka ks¾úkaokh ke;=j' t;fldg úhou remsh,a 300 hs' yenehs fõokdj kï fndfydu ier fjhs'˜ zzyß" fvdlag¾" tfykï ks¾úkaokh ke;=j lruq"˜ hs Wvqoe<sh lSh' oka; ffjoH mSfrdïnia ks¾úkaokh fkdue;s j o; .e,eù h' fï uq¿ ld¾hh ;=< §u Wvqoe<sh ksi, j jdä ù isáfha ;rul iskydjlao kÕñks' oka; ffjoHjrhd úiauhg m;a jqKd muKla fkd j" fuh Tyq f.a is;go jeÈ‚' fyf;fï fufia 30

JANUARY 2019 | DOCTOR MAGAZINE

tÈk iekaoEfõ oka; ffjoH mSfrdïnia yg ;j;a oka; ffjoHjreka msßila yuq jQ w;r" mqÿudldr Wvqoe<sh kï frda.shd .ek fyf;u Tjqkg lshkakg wu;l lf<a ke;' t úg" tla ffjoHjrfhla keÕsg fufia lE.eiS h' zzTh Wvqoe<sh ldrhd uq,ska u wdfõ ud <Õg' uu ñksyg ks¾úkaok fí; úo,d lsõjd t<shg fj,d meh nd.hla bkak lsh,d' meh Nd.hlg miafi ñksyg l;d lrk fldg ñksyd w;=reoyka fj,dæ˜

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uOHidr fndkak tmd

î ßh Odjkh lrkak tmd uOHidr mdkh lr ßh Odjkh lsÍfuka Tn;a" uyu. ckS ckhd;a wkdrlaIs; jkafka fufyuhs

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JANUARY 2019 | DOCTOR MAGAZINE

uOHidr mdkh lr ßh Odjkh lsÍu ksid isÿjk wk;=re fï rfÜ ck;djf.a jákd cSú; ì,s .kakd m%uqL;u fya;=jla njg m;aj ;sfí' fï ;;a;ajh hgf;a ud¾. kS;sh ixfYdaOkhg ,la lrñka uOHidr mdkh lsÍug f.jk ov uqo, remsh,a 25"000la olajd by< oeóula isÿ flßK' fuh tf;la fiiq ck;djo wk;=f¾ fy<ñka isÿl< wkdrlaIs; ßh Odjlhka úYd, jYfhka wvq lrkakg fya;= jQ nj uf.a fm!oa.,sl úYAjdihhs' ta yereK úg lsishï mqoa.,fhla îu;aj isák úg Tjqkag ßhÿre fiajd iemhSfï wdh;k mjd ;odikakj wdrïN ùug fï kj kS;s iïmdokh fya;=úh' 32

uOHidr î ßh Odjkh ffcj úoHd;aulj n,mdk wdldrh u;aøjH ksjdrK ckdêm;s ld¾h idOk n,ldfha wOHlaI ffjoH iuka; l=udr ls;,jwdrÉÑ BDS (SL), MSC (Italy), MAAID (USA) úisks tfy;a ;ju;a we;efula fï kS;sÍ;s udhsï fkdlrñka îu;aj ßh Odjkfhys fhfok njg fmd,sia wdrxÑ ud¾. fy<s lrhs' tosfkod isÿjk Nhdkl ßh wk;=re idlaIs fjhs' uOHidr mdkh lr ßh Odjkh lsÍu ksid ;ukag ;uka úiska lr.kakd jrolg tyd .sh nrm;, iudc jrols' thska lsisÿ grolg odhl;ajhla fkdoelajQ fjk;a md¾Yajhla w.;shg m;aùu ljr wdldrhlska j;a idOdrKSlrKh l< yels fkdfõ' kS;s wKmk;a fï jro iïnkaOfhka fu;rï oeäj fhdod .kakgo fya;=jo fuhhs' fuu ,smsfha uf.a W;aidyh jkqfha fï uOHidr î ßh Odjkh ffcj úoHd;aulj n,mdk wdldrh fy<sorõ lsÍuhs'

wfma rfÜ yd ;j;a rgj, kS;shg yiqjk uOHidr m%udK ßhÿrka uOHidr mdkh lr ßh Odjkh lrkjdo hkak fidhd n,kakg m%dYajdi jd;fha we;s uOHidr

JANUARY 2019 | DOCTOR MAGAZINE

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m%udKh uek n,hs' ta yereKQ úg iúia;rd;aulj fï iïnkaOfhka mÍlaId lrk úg reêrfha we;s uOHidr m%udKho mÍlaId lr n,hs' wfma rfÜ kS;sh wkQj reêrfha uoH fldgia 0.08 grams per100ml m%udKhla mej;Su Maximum Blood Alcohol Concentration (BAC) level of drivers uoHidr mdkh lsÍfï jrolg fya;=jla fjhs' cd;sl ÿïfld< yd uoHidr ms<sn|j wêldßh úiska fuu m%udKh ;j;a iSud lrñka tu w.h 0.03 grams per100ml olajd wvq lsÍugo fhdackd lr ;sfí'

fl;rï mqxÑ uoHidr m%udKhla jqK;a YÍrhg lrkafka kmqrla

fl;rï mqxÑ uoHidr m%udKhla th YÍrhg wys;lr f,i n,mdhs' tu ksid ßh OdjkfhaoS th fudkhï wdldrhlska we;a; jYfhkau wfma oekg Ndú; iSudjka ;jÿrg;a fyda idOdrKSlrkh wvq l< hq;= hhs is;Su idOdrK hhs isf;a' f,dalfha fkdfõ' fjfiiskau fiiq rgj, fuu kS;sh ;jÿrg;a ne?reïj thska iudchg" jrola l%shd;aul jk fhysks' fkdl< idudkH ck;djg isÿjk n,mEu ksoiqkla f,i ´iafÜ%,shdj iy ;j;a fndfyda hqfrdamSh i<lk l< flfiaj;a rgj, fuu iSudj 0.05 grams per100ml w.h .kS' idOdrKSlrkh l< reishdfõ uOHidr î Odjkfha jrog yiqjk uOHidr fkdyel' m%udKh 0.03 grams per100mla jk w;r fkda¾fõ" iaùvkh yd Ökfha tu w.h 0.02 grams per 100ml uOHidr mdkh lsÍula ls' fï wkQj wfma ßhÿrkag fï jk úg;a zzfyd| fmd,Sish úiska Tmamq pdkaiaZZ tlla oS ;sfnkjdo@ úuish hq;a;ls lrkafka kS;sh u.ska

YÍrfha ;sfnk uOHidr m%udKhg n,mdk lreKq ;=k ßhÿfrla úIfhys n,k l< idudkHfhka reêrfha mj;sk uOHidr idkaøKhg lreKQ ;=kla n,mdhs

Tn úiska .kakd ,o uOHidr m%udKh th fl;rï fj,djla YÍr.;j mej;sfhao hk j. Tfí YÍrhg tys n,mEfuka ñfokakg .; jk ld,h ^fuh mqoa.,hdf.ka mqoa.,hdg fjkia w.hla .kS'

tfiau uOHidr mdkh lsÍfuka Tfí YÍrhg we;sjk wys;lr n,mEug ;j;a fndfyda idOl fya;= fjhs'

Tfí jhi" YÍr nr" .eyekq msßñ Ndjh" Tfí mßjD;a;Sh iS>%;djh" Tn mdkh lrk uOHidr m%udKh" Tn mdkh lrk uOHidr j¾.h" Tn Bg fmr wdydr jYfhka .;a oE fïu Tfí wd;;sh uÜgu mjd óg n,mdhs'

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iïu; l< wdrlaIl uÜgula wNsnjd hdula jYfhks' uOHidr ta ;SrKh lrk m%udKhg jvd wvq m%udKhlska ;snqfKd;a Tyq jrolrefjla fkdfõ' óg by;ska fmkajd ÿka mßos oekgu;a wfma rfÜ ßhÿrkag wdrlaIs; uÜgu iïnkaOfhka ,nd oS we;af;a zzf,dl= pdkaiaZZ tlls' fï wkQj kS;shg yiq lr .ekSfuyso zzjdishlaZZ uOHidr mdkh lrk mqoa.,hdg wfma rfÜ oekgu;a ,efnkafkao hk ielh u;=fõ'

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isÿjk OdjkhloS ßhÿfrl=g ;sìh hq;af;a Wl=iafil=f.a ;shqKQ fmkSuls' kuq;a fï ish¿ wdrlaIdjka uOHidr iu.ska Tfnka .s,syS hkq we;'

uOHidr mdkh lr ßh Odjkfha fhoSu kqiqÿiq jkafka fï ksihs m%;spdr oelaùfï ld,h oS¾> fjhs Slow reaction time uoHidr wmf.a m%;spdr oelaùfï ld,h wvq lrhs' yosisfha flfkla mdr mekafkd;a fï ksid Tn iefklska ;sßx. fhoSug wiu;a fjhs' uyu. mosl udre j,oS" fjk;a jdyk Tnj wNsnjd hdug ;e;a lsÍfïoS Tnf.a Odjkh wkdrlaIs; jkafka ks;eksks' Tfí bªrkayS iqyqre l%shdldß;ajh ì| jefghs Lack of Coordination ßh Odjkfhao Tfí weia" w;a yd mdo iudkqfhdackhla iajhxlD;j we;s fõ' th isÿjkafka Tn;a fkdoekSu Tfí pd,l iakdhq l%shdldß;ajh uekúka isÿùu fya;=fjks' uOHidr mdkfhka fï tlsfkl iïnkaO;d meje;aùfï yelshdj úYd, jYfhka ÿ¾j, fjhs' th ´kEu fudfyd;l Tnj wk;=f¾ fy<kakg fya;=jls' Ñka;k Yla;sh wvq fjhs Reduce concentration fl;rï l=vd uoHidr m%udKhla mdkh l<;a thska Tng is;akkg we;s bvlv nrm;, f,i iSud fjhs' ßh OdjkfhaoS Tng fl;rï foa is;kakg fjkjdo@ ßh Odjkh lrk fõ.h" ud¾. ix{d" moslhka" uyu. wfkl=;a jdyk wdosh .ek Tfí ishqï wjOdkh fhduq l< hq;= fjhs' tfy;a uoHidr fï m%cdkk yelshdjka b;d nrm;, f,i iSud lrk ksid Tn wdrlaIs; ßhÿfrla jkafka ke;' fmkSu ;shqKQ ke; Decrease Vision uOHidr mdkh lsÍfuka fmkSu fnd| ùu iq,n fohls' ta yereKQ úg Tfí wlaIsp,k ÿ¾j, jk w;r ÿr fmfkk mrdih wvq fjhs' ;shqKQ fmkSu ßh OdjkfhaoS fl;rï ;SrKd;aulo@ úfYAIfhkau rd;%S ld,fhaoS 34

JANUARY 2019 | DOCTOR MAGAZINE

;SrK .ekSfï yelshdj ÿ¾j, fjhs Inhibit judgment Tfí fud<h yosis wjia:d j, ;rK .ekSug wkQmfïh jQ ld¾h Ndrhla bgq lrhs' Tn ksjerosj uyu. Odjkfha fhÿk;a Tng wkfmalaIs; wNsfhda. j,g uqyqK mdkakg isÿfõ' flá ld,hlska .kakd ;SrKh jerÿfKd;a tys m%;sM<h úkdYhla jkakg mq¿jk' Tn .kakd ksjeros ;SrKh cSú; iqrlS' úlD;s jQ ukilska ksjeros ;SrK .kafka flf,io@ uoHmdkh Tfí cSú;hg buy;a .eg¿ f.k tk ÿYApß;hls' th wm wkqu; lrkafka ke;' hï flfkla uoHir mdkh lr ßh Odjkfha fhfokakg W;aidy lrkjd kï th Tng Tn úiska lr .kakd wk;=r wNsnjd Tfí ìß|" orejka" kE ys; ñ;=rka u;= fkdj l=ÿ uy;a iudcho wk;=f¾ fy<Sula nj fkdlshdu neßh'

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HEALTH EFFECTS OF

CIGARETTE SMOKING

Dr. Amitha Fernando MD (Colombo) FRCP (London) Consultant Chest PhysicianÂ

JANUARY 2019 | DOCTOR MAGAZINE

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Use of tobacco is the chief preventable cause of deaths worldwide. The cumulative number of deaths due to the use of tobacco for the 20th century was 100 million. Of the 1.1 billion current smokers in the world 70% are in developing countries. The World Health Organization (WHO) attributes 4 million deaths per year to tobacco, this is about one in 10 of all adult deaths. By 2020 annual deaths due to smoking is projected to rise to 8.4 million per year, 70% of these deaths will be in the developing world. Based on current smoking trends there will be 10 million deaths per year, about one in 6 of all adult deaths by 2030. Of this 7 out of all 10 deaths will be in the developing world. Half a billion of the worlds population alive today will be killed by a smoking related disease, half of them will be between the ages of 35-69 years. doctormagazine.lk

Most begin use of tobacco before the age of 18 years. Recent trends suggest an earlier age of starting smoking and a rising smoking prevalence among children and adolescents. Younger the age of starting smoking higher the chance of addiction and greater the risk of dying from smoking related diseases. Sri Lanka took part in The Global Youth Survey in 1999. The survey was in 84 schools in children aged 13-15 years with 2896 students participating. 12% of the children surveyed had smoked during the 30 days prior to the survey.

TOXIC SUBSTANCES IN CIGARETTESÂ Cigarettes contains over 4,000 chemicals - 200 are poisons, 63 of which cause cancer. Nicotine compounds found in tobacco are the source of addiction. Over the years harmful toxcins build up in the body with the potential to harm virtually any organ in the body. Tar causes cancer stains teeth and nails metals such as arsenic, cadmium and lead causes cancer, vinyl chloride, used to make vinyl products on short-term exposure causes dizziness, headaches and tiredness. Long-term exposure can lead to cancer and liver damage. Creosote, a component of tar, when inhaled

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can cause irritation of the respiratory tract. Formaldehyde , a preservative substance used in dead bodies causes cancer in humans. Polonium 210, a radioactive substance cause cancer of the liver and bladder, stomach ulcers, leukaemia amongst other diseases. Carbonmonoxoid displaces oxygen from red blood cells starving vital organs such as the heart and brain of oxygen. Hydrogen cyanide damages the lining of the lung and defences against infections exposing the lungs to repeated infections. Infections such as tuberculosis is commoner among smokers. Ammonia, is a pungent colourless gas used in any cleaning products such as window or glass cleaner. Acetone is the main component of nail varnish remover. Acrolein - an extremely toxic

substance used to manufacture acrylic acid irritates the lungs. Bidis consists of 0.2-03grams of sun-cured tobacco. Wrappers have low porosity and poor combustibility. The smoker has to puff longer and harder to keep the bidi alight and products of poor combustibility are absorbed deeper into the lungs and circulation. A higher content of tar is also delivered by bidis putting smokers of bidis at a higher risk.

CIGAR AND PIPE SMOKERS Cigars go through a long aging and fermentation process. During the fermentation process, high concentrations of cancer causing compounds are produced. Cigar and pipe smokers are at an increased risk for lip, mouth, tongue, and throat cancers. Cigars produce high exposures to nonsmokers of many toxic compounds (including 38

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carbon monoxide, hydrocarbons, ammonia, cadmium and other substances) than a cigarette.

MAINSTREAM AND SIDESTREAM SMOKEÂ Mainstream and sidestream (smoke that escapes the end of a burning cigarette) smoke both contain a huge number of toxic, poisonous and carcinogenic substances. Sidestream smoke contains much higher concentrations of many of the chemical compounds. Particles that make up sidestream are smaller than those of mainstream smoke. Cadmium, a known lung cancer causing substance, is found in concentrations that are six times higher in the smoke that is inhaled by passive smokers as opposed to the smoke that is inhaled directly by the smoker through the cigarette.

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THE IMPACT OF SMOKING ON DIFFERENT ORGAN SYSTEMS IN THE BODYÂ Heart and the circulatory system Free radicals in cigarettes smoke causes damage to the lining of heart and blood vessels causing cholesterol and atherosclerosis. This results in hardening of the walls and narrowing of the inner opening of blood vessels. Smoking also causes an increase in blood pressure and heart rate, in the clotting substances in blood. Such blood clots can block already damaged and narrowed blood vessels. Smokers are five times more likely to have heart attacks than nonsmokers and are 4 times more likely to die while having a heart attack. If smokers have other risk factors such as increased cholesterol, diabetes or high blood pressure the risk of a heart attack is 10 times more. Changes in circulation to the brain can result in "strokes" damage large parts of the brain can result in death or serious disability. Long standing changes in the circulation of the brain can give rise to dementia.

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Other vital organs can be similarly damaged due to impairment of blood flow to them. Disturbed blood circulation to the legs will result in cramps and pain on walking ending up even in gangrene of toes and amputation. Impotence will result if blood flow to the penis is disturbed. Lungs and airways. Smoking is responsible for 90% of lung cancer in men and 80% lung cancer in women. Men who smoke are 23 times more likely to develop lung cancer than non-smokers. Irritants in tobacco smoke damages the inner linning of breathing tubes and the distal most parts called air sacs of the lung. Eye Smokers are at risk of blindness due to developing cataracts, macular degeneration breakdown of the retina (light sensitive layer of the eye), diabetics who smoke develop diabetic eye complications at an earlier age. Skin Cigarette smoke causes wrinkling of facial skin and premature aging. Teeth & Mouth Nicotine and tar causes staining of teeth, impairs sense of taste and caused disease of the gums.Smokers and those who chew tobacco are at increased risk of mouth, throat and cancers of the gullet (oesophagus). Change in voice may indicate a throat or cancer of the lung. Other important organs in questio too Smokers are at increased risk of bladder, kidney, cancer of the penis, womb and stomach cancers. Blood cancers such as leukamias are also commoner in smokers. Stomach ulcers are commoner and osteophorosis manifests at a younger age. About half of all smokers die from smokingrelated diseases.

increases the risk of: Miscarriage. Complications of pregnancy, including bleeding during pregnancy, detachment of the placenta, premature birth, and ectopic pregnancy and low birth weight.

TOBACCO CHEWING AND USERS OF SNUFF (SMOKELESS TOBACCO) Tobacco chewers increase their risk of cancers of the oral cavity, throat, larynx and esophagus when compared to people who do not use tobacco products. Leukoplakia, oral lesions that appear as white patches on the cheeks, gums or tongue, are commonly found in tobacco chewers. Chewers of betel leaf and arecanut have a higher risk of damaging their gums and acquiring cancer of the mouth, pharynx, esophagus and stomach.

Smoking in pregnancy Smoking in pregnancy 40

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NDB Bank is a member of the NDB Group, the largest financial services conglomerate in Sri Lanka.

Why Silence is Vital for Our Brains?

Yíoh@ ksYaYíoho@ f>daIdj ys;g;a lhg;a nrla''' ksYAYío;djh ys;;a lh;a iqjm;a lrkjd

ffjoH YdLH wurfialr úisks

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zzfyd|u Yíoh ksYaYíoh'''ZZ hkqfjka m;, lshukla ;sfí' ksy`v;djh fl;rï jákd fohlao hkak wmg mila jkafka wm lka lrÉp,hlg ueosjQ úgh' nia r:fhaoS nf,ka isxÿ wykakg isÿjQ úg wmg oefkkafka fudk ;rï wmyiqjlao@ wd;;shlao@ mSvkhlao@ ys;g iykhla wejeis fudfyd;l" .;g úfõlhla wejeis fudfyd;l ksYaYío;djh wfma ukia Ndj iuj;a iqjfhka ikyhs' Yíoh lk jel=KQ miq th fud<hg hkafka úoahq;a ix{d wdldrfhks' wjosj isák fudfydf;a muKla fkdj wm kskafoka isáh;a fï Yío ;rx. fud<fha Amygdala kï m%foaYh lsishï W;af;ackhlg ,la lrkjd' tfia isÿù wd;;sh we;s lsÍug n,mdk fydafudak >%djh ùula isÿ lrkjd' Amygdala hkq wfma fud<fha iaurkh yd yeÕSï j,g n,mdk l,dmhhs' os.ska os. gu f>daIdldÍ Yíohla lk jelSu hkq wd;;shg n,mdk fydafudak os.ska os. gu jEySug fya;=jk doctormagazine.lk

lkalrÉp,fha m%;sM<hla jYfhka yDohdndO j,g ,laj fuf,dúka iuq.;a ixLHdj muKla 3000 blaujhs' ldrKhls' Noise hkafkys idudkH wre; jkafka wkjYH Yío hkakhs' th ,;ska niska ì|S wd jokls' jpkfha mßiudma; w¾:hu f>daIdfõ uysuh lshdmdhs' zzTlaldrhZZ fyda zzjukhZZ f,i th ,;ska niska wre;a .ekafjk w;r Noise hkafkka ì|S wd Noxia hkak wre;a .ekafjkafka ydksh" wdmodj jYfhks' 2011 j¾IfhaoS f,dal fi!LH ixúOdkh úiska ngysr hqfrdamfha ñ,shk 340l iqúi,a ck ixLHdjla fhdodf.k Yíofha wdoskj iïnkaOfhka wOHhkhla isÿ lrk ,oS' tys m%;sM< wkQj Yíoh cSú;fha iduldó njg fndfyda wjmi n,mEï we;s lrk w;r lkalrÉp,fha m%;sM<hla jYfhka yDohdndO j,g ,laj j¾Ihlg fuf,dúka iuq. kakd ixLHdj muKla 3000 blaujhs' wfkla w;g ksYaYío;djh b;d m%n, yd Okd;aul f,i fud<h yd .kqfokq lrk w;r Imke Kirste

Tn okakjdo@ hqfrdamfha muKla wêl Yíoh ksid oioyila fokd ñh hkjd'' hqfrdamd mßir ksfhdacs;dh;kh m%ldY lrk wdldrhg hqfrdamfha mqoa.,hka oi oyila fokd wêl Yíofhys m%;sM<hla jYfhka we;sjk yoj;a wdndO j,ska wld,fha ñh hkjd' Yío ¥Ifhka kskaog wêl f,i ndOd meñfKk w;r th mqoa.,fhl=f.a m%cdkk yelshdjka fudg lrkjd' fjfiiskau wêl Yíoh yDo frda. j,g iDvq iïnkaOhla fmkajkjd' jdhq ¥IKh yereKQ úg mqoa.,fhl=f.a fi!Lhg wys;lr fia n,mj;ajk fojeks idOlh jkafka Yío ¥IKhhs' JANUARY 2019 | DOCTOR MAGAZINE

Yíoh fldhs ;rï lkalrÉp,hlao@ lkalrÉp,h ksid Y%jKhg we;ls jk ydkshg n,mdkafka Yíofha ;Sj%;djh fukau tu Yíoh mjl;akd ld,h wkQjh'fvisn,a 80-90 blaujk iEu Yíohlau lkg iaÓr ydks muqKqjk nj ffjoH úfYAI{hkaf.a u;hhs'

jeys ìª jefgk Yíoh

idudkH l;dny

kd.ßl fyhd v%h¾ jdyk ;ono wjia:dj

kï cSj úoHd{fhla mjik wdldrhg osklg fomehl ld,hla ksYAYío;djfha oeyeka.; ùfuka fud<fha ysfmdleïmia m%foYfha ie<lsh hq;= ffi, j¾Okhla we;s lsÍug iu;a fjhs' ysfmdleïmih hkq misªrkaf.a l%shd;aulNdjhg f.dapr jk fud<fha jvd;au wjos nj iqrlsk m%foaYhhs' f>daIdj ysf;a iduh ke;s lrhs' ksYAYío;djh ysf;a iduh cks; lrhs' f>daIdj wmf.a m%cdkk yelshdjka fudg lrhs' ksYAYío;djh wfma ks¾udKd;aul mßphka Silence heals, silence takes us deeply into ourselves, and silence balances the body and mind. Now science is saying the same thing.

JANUARY 2019 | DOCTOR MAGAZINE

frdla ix.S;h

breï mÜg,h

Wmßu Yíofhka whsfmdâ tlg weyqïlka oSu

.=jka hdkhla .=jhka.; ùu

fjä ;eîu

l=¿ .kajk w;r ishqï Ndj m%ldYKfhys,d fud<h iqir lrhs' f>daIdffjka fndfyda ldhsl udkisl w;jrhka isÿ úh yels w;r tajd lsishï wdldrhlska iukh lsÍug ksYAYío;djfhys lsishï ld,hla t,an isàu fya;= fjhs' f.!;u nqÿka jykafiao we;=¿j mqrdk fhda.djprhka ksYAYío;djfhys uysuh fndfyda m%Yxid;aulj foaYKd l< fial' th wmj iqjm;a lrjk njo" wfmau udkisl hy meje;aug fya;= jk njo jvd;a W;a;Í;r jQ OHdk M, ,eîug uq,a mshjr ksYaYío;djfha oeyeka.; ùu njo w;S;fha foaYKdjkayS wre; úh' fMRI wdoS kjH úoHd;aul Ndú;djka Tiafia wo úoHdjo ;yjqre lrkafka thuh' https://upliftconnect.com/sciencesays-silence-is-vital-for-our-brains /?fbclid=IwAR3f6Ymv3FwHho5bx kX-1rbDcNU8mPvV86ckA5yN7JDxGjZAB28tjH5LiE

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CONTROVERSY

fldf,iagfrda,a lshk ;rï krl kE wefußldj lshhs

fldf,iagfrda,a wefußldfõ kj;u wdydr ks¾foaY j,skq;a oekgu;a bj;a lr,d''' Ndr; .=K;s,l úisks 46

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reêrfha fldf,iagfrda,a ixhq;sh jeä lrk wdydr''' ienúkau wm fï lshk ldKavfha wdydr j,g olajkafka buy;a ìhls' ;e;s .ekSuls' zzl,los jyÆ''' l,los fyd| fjkjdÆ'''ZZ hk lshuk ienE lrñka fldf,iagfrda,a wêl wdydr iïnkaOfhka jk u;jdoh lkmsg yefrñka ;sfí''' blauka fjkak tmd''' ng¾''' Öia''' f;,a hyñka ;sfhk uia udxY wdydrhg .kakg kej;;a l,n, fjkak;a tmd''' thg ;ju;a l,a jeähs' tfy;a" óg oYl lsysmhlg fmr fldf,iagfrda,a iïnkaOfhka mej;S u;jdo ful, lsishï mßj¾;khlg ,la jk nj fmfkkakg ;sfnkjd' zzfldf,iagfrda,a NS;sldjZZ lrmsákau lrmskakdf.k .sh u;h fjkia lsÍfuys,d fï jljdkqfõ lrk lshk l;dnia fï ,smshg m%ia;=; ù ;sfí' doctormagazine.lk

oYl y;rlg jeä ld,hla ;siafia fldf,iagfrda,a krl njg ms<s.;a;d''' fldf,iagfrda,a jeäfhka we;s wdydr wkqNjh b;d krlh hk ms<s.ekSu uq,skau we;sjQfha 1970 oYlfhah' yßhgu oYl y;rl muK ld,hla uq¿,af,a uekúka uq,a nei.;a fï zzfldf,iagfrda,a idr wdydr NS;sldjZZ oeka Bg fjkia u;hlao mq¿,a f,i ixjdohg ,lajk nj Tn okakjdo@ w¿f;kau wkdjrKh jk lreKQ j,g wkQj fldf,iagfrda,a iïnkaOfhka mej;S th buy;a NS;sh okjk ì,af,lehs hk u;hg tosß msßilao fï jk úg lr<shg nei isà' wefursldj fjkia jk f,dal ;;a;ajhka hgf;a ish mqrjeishkaf.a iqjfi; iïnkaOfhka w;sYhska ie<ls<su;a jk rdcHhls' trfÜ mqrjeishka úiska .; hq;= wdydr iïnkaOfhka ud¾f.damfoaYK ,ndoSfï n,h,;a wdh;kh tlai;a ckmofha lDIsl¾u fomd¾;fïka;=j jk w;r iEu jir myla i|ydu tu ks¾foaY m%ldYhg m;a lrkafka tjlg mj;akd kj;u úoHd;aul oeKQu mokï lr .ksñks' U Turn tlla .;af;a fufyuhs tlai;a ckmofha lDIsl¾u fomd¾;fïka;=j wjika jrg trfÜ jeishka i|yd jk wdydr ks¾foaY 2015 j¾Ih i|yd ,nd fok úg wdydr u.ska ,nd .kakd fldf,iagfrda,a j,g we;s iSudjka bj;a lf<ah' JANUARY 2019 | DOCTOR MAGAZINE

fuh tf;la mej;S u;su;dka;r yd ikaikaokh lrk l< w;sYh úma,ùh fjkia lula úh' th U Turn tlla fkdfyd;a tf;la mej;S ks¾foaY j, imqrd wdmiaig hdula f,i ye|skaùfï fodila ke;' óg fmr 2010 j¾IfhaoS wdydr ks¾foaY bosßm;a lrk úg tlai;a ckmo lDIsl¾u fomd¾;fïka;=j u.ska wefußldkq mqrjeisfhl= úiska ojilg wdydr u.ska ,nd.; hq;= fldf,iagfrda,a m%udKh ñ,s .a?ï 300lg iSud úh hq;= njg oeä ks¾foaY mkjd ;snqKs' fujka cSú;h ksfrda.Sj mj;ajd .ekSug w;sYh ;SrKd;aul hhs mekjQ ks¾foaYhla fï wdldrfhka bj;a lsÍfï fya;= i<ld ne,sh hq;=uh' ta i|yd wm kej;;a 2015 wefußldkq wdydr ks¾foaY j,g fhduq fjuq' tu ks¾foaY j,g wkQj wm wdydr u.ska .kakd fldf,iagfrda, ffjoHjreka reêr kd, u; ;ekam;a fj;ehs olajk ffldf,iagfrda,a j,g iDcq iïnkaOhla''' fuf;la wjodkï iy.; hhs is;+ wdldrfha iïnkaOhla fkdolajkafkah' 48

reêr.; fldf,iagfrda,a uÜgu wvq lsÍug .kakd iageáka ldKavfha T!IO iïnkaOfhkao kej;;a ixjdohla n,.ekaù ;sfí' tfy;a fï iïnkaOfhka lsishï ks.ukhlg meñKSug ;ju;a l,a jeäh' udOH yrU ;snQ muKska úoHd;aul ks.uk wdmiaig yerùug yosiaisldrhka ùu keKj;a ;SrKhlao fkdfõ'''

úoaj;=ka mjik wkaoug reêr kd, u; fldf,iagfrda,a ;ekam;a ùug n,mdk idOl fufia fm<.eiaúh yel'

YÍrfha nr

YÍr l%shdldß;ajh

m%fõKsh flmuK ix;Dma; yd g%dkaia fïoh m%udKhla ,nd .kafkao hk j.

jhi

,sx.sl;ajh

lS¾;su;a ffjoH wdh;ko fldf,iagfrda,a Ndú;hg mekjQ iSud bj;a lsÍug úreoaO fj,d kE''' tfy;a kj;u ks¾foaY j, oelafjk wdldrhg wdydr j,ska ,nd.kakd fldf,iagfrda,a m%udKh reêr kd, u; fldf,iagfrda,a ;ekam;a ùug fl;rï iDcq iïnkaOhla olajkafkao hkak m%ldY lsÍug m%udKj;a idlaIs fkdue;' “Adequate evidence is not available for a quantitative limit for dietary

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cholesterol specific to the Dietary Guidelines." úYañ; ldrKh yd ck;djf.a wjOdkhg md;% úh hq;= iqúfYaIS ldrKh jkafka fuu ks¾foaY iïnkaOfhka American Heart Association yd American College of Cardiology hk lS¾;su;a ffjoH wdh;ko lsisÿ úreoaO;djhla fkdoelaùuhs' fï ;SrKhg wkQj ;jÿrg;a fldf,iagfrda,a wêl jYfhka mj;sk wdydr iïnkaOfhka wefußldkq ck;djg wk;=re yeÕùï isÿ fkdlrk w;r ta fjkqjg iSks mßfNdackhg we;s bvlv ;jÿrg;a wyqrd ;sfí' fuu jd¾;dfõu tf;la iSks mdßfNdackh iïnkaOfhka jQ ks¾foaY blauka fjkak tmd''' ng¾''' Öia''' f;,a hyñka ;sfhk uia udxY wdydrhg .kakg kej;;a l,n, fjkak;a tmd''' thg ;ju;a l,a jeähs' tfy;a" óg oYl lsysmhlg fmr fldf,iagfrda,a iïnkaOfhka mej;S u;jdo ful, lsishï mßj¾;khlg ,la jk nj fmfkkakg ;sfnkjd' doctormagazine.lk

lS¾;su;a TIME iÕrdj u;=j wd ixjdohg odhl jQ wdldrh

;jÿrg;a jeä lr ;sfnk w;r iSks jeäfhka wdydrhg .ekSfuka fndfyda nrm;, fi!LH Wjÿre we;s jk njg ;okdka;rj m%ldYhg m;a ffjoH m¾fhaIK j,ska jk wkdjrKhka fï mshjrg fya;= jQ nj wod, jd¾;dfõ i|ykah' fldf,iagfrda,a .ek we;a; wfma YÍrfha we;s fldf,iagfrda,a j,ska jeä yßhla wfma wlaudfõ ksmojqKQ tajdh' Tfí fud<h .;af;d;a tys we;s mod¾: jeä yßhl ksuejqu fldf,iagfrda,a jkafkah' iakdhq ffi, j, l%shdlß;aajhg fldf,iagfrda,a j, l%shdldß;ajh ke;sju neßh' wfma YrSrfha l%shd;aul jk Biag%cka" fm%dfciagfrdka" fldaáfldaiafgfrdhsâ we;=¿j ish¿ wdldr iaàfrdhsv fydafudak j, moku i,ikafkao fï fldf,iagfrda,auh' YÍrfha fldf,iagfrda,a m%udKj;a f,iska mj;skafkah hkak Tyqf.a fyda wlaudj hy l%shdldß;ajhlska mj;akd njgo idOlhla jkafkah' lS¾;su;a *%ñka.ayï wOHhk u; mokï jQ kj wkdjrK Framingham Study hkq c.;a ;,fha m;, yDo wOHhk$m¾fhaIK lKavdhuls' wefußldfõ uefipqfiÜiayS *%ñka.ayï k.rfha mqrjeishka fhdod .ksñka uq,skau 1948 j¾IfhaoS fuu wOHhk uq,a jrg wdrïN flreKs' tod fuod ;=r *%ñka.ayï wOHhk oYl .Kkdjla uq¿,af,au lS¾;su;a m¾fhaIlhka úiska isÿ lrk ,o w;r tajd w;sYh úoHd;aul mokul msysgd isÿ lrk m¾fhaIK f,i f,dalfhau f.!rjdorhg ,laj ;sfí' JANUARY 2019 | DOCTOR MAGAZINE

fldf,iagfrda,a by< kxjk wm iSud l< hq;= wdydr

fldf,iagfrda,a - Y;j¾Ifha úYd,;u uq,djo@ Dr. George V. Mann M.D. fï wOHhk j, ksr; lS¾;su;a m¾fhaIlfhls' fï m¾fhaIK lKavdhï m%Odksfhls' Incidence and prevalence of cardiovascular disease (CVD) and its risk factors states kñka isÿ l< wOHhkh wjik Tyq fï iïnkaO újdohg ;=vq ÿka jd¾;djla ilia lrkakg fhÿfKah' zzfï Y;j¾Ifha úYd,;u uq,dj kï fldf,iagfrda,a YÍrhg w.=K hhs" tajd wdydrhg .ekSu fjfiiska Nhdkl hhs" mj;sk u;dka;rhhs' iuyr úg .;jQ Y;j¾Idêl ld,hla uq¿,af,a iudc.;jQ úYd,;u ffjoH úoHd;aul uq,dj fuu u;h jkakgo ms<sjk' krl fldf,iagfrda,a lshd fohla fkdue;s nj fï m¾fhaIK m%;sM< Tiafia b÷rdu lshkakg isÿj ;sfí' wdydr j,ska .kakd fldf,iagfrda,a yDohdndO we;s lrkakg fya;=jla fkdjk w;r yDohdndO j,g ,lajQ fndfyda fofkla idudkH fldf,iagfrda,a ixhq;shla reêr.;j isá whhs'ZZ Dr. George V. Mann fï jd¾;dfjka m%ldY lf<ah' wfma isref¾ mßjD;a;Sh l%shdj,ska i|yd osklg fldf,iagfrda,a ñ,s .a?ï 90la wjYH flfrk w;r tajd jeä yßhla wlaudj úiska imhkq ,nhs' wm oskm;d .kakd wdydr j,ska fï wjYH;djhg imhkafka ishhg 15l odhl;ajhla muKs' wm wdydrhg .kakd fïo m%udKh ;rï fkdjqfKd;a fï mßjD;a;Shg wjYH lrk fldf,iagfrda,a m%udKh imhkq msKsi wlaudj jeä jev Odß;djl ksr; fjhs' Tfí isref¾ hyñka fldf,iagfrda,a ;sfnkjd 50

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úYañ; ldrKh yd ck;djf.a wjOdkhg md;% úh hq;= iqúfYaIS ldrKh jkafka fuu kj wdydr ks¾foaY iïnkaOfhka American Heart Association yd American College of Cardiology hk lS¾;su;a ffjoH wdh;ko lsisÿ úreoaO;djhla fkdoelaùuhs' kï thska fok wfkla jeo.;a mKsúvh kï Tfí wlaudj fhfylska l%shd;aul jk njhs' tlsfklg mriamr m¾fhaIK jd¾;d kï ful, ks;ru mdfya t<soelafjñka ;sfí' fldf,iagfrda,a iïnkaO fï kj;u wefußldkq fudv,fha u;su;dka;rh tfia m¾fhaIK lKavdhul yqÿ ys;¿jla fkdù oekgu;a ta rfÜ ck;djf.a wdydr ks¾foaY j,go we;=<;aj ;sfí' tfiau c.;a jHdma; ffjoHjreka yd m¾fhaIlhka w;f¾ fï iïnkaOfhka l%shd;aul ixjdohla fï jk úg;a f.dv kexù ;sfnk w;r wefußldfjka ;gq ,o fï l=Kdgqj fjk;a ljr rgj,a isidrd hñka jHdma; jkafkaoehs wmo úuis<su;aj isáh hq;= fkdjkafkao@ ••• doctormagazine.lk

nfhdmais lrñka ysßyerhg m;a jkafka l=ugo@

wlaud frda.

y÷kd.ekSfuys úma,ùh fidhd .ekSu TRANSIENT ELASTOGRAPHY SCAN

oeka j;a;, fyaudia frdayf,ka'''

wfma rfÜ m%Odk jYfhka wlaud.; frda. we;sùug n,mdk fya;= folla fjhs' uoHmdkfhka f;drj we;sjk wlaudfõ f;,a ;ekam;a ùu NAFLD yd u;ameka mdkh lsÍu ksid we;sjk wlaud frda. hkqfjks' oshjeähdj fukau mßjD;a;Sh iy ,laIKh (Metabolic Syndrome) hkqfjka ye|skafjk frda. tluq;=j fya;=fjka fï wlaud.; frda. iq,n jk nj fmfkkakg ;sfí' wlaudfõ fïoh we;sùu u;=jg we;súh yels frda." wjodkï / il wdrïNh fjhs' fïo we;sùfuka wdrïN ù isfrdaisia" wlaudj iïmQ¾Kfhkau wlrKshg m;aùu''' olajd uqyql=rd hk wlaud.; frda. m%;sldr lr iqj l< yels ;;a;ajhka fkdfõ' wlaudj iïnkaOfhka ffjoHjreka fok mKsúvh jkafka uq,a wjia:dfõu kshñ; m%;sldr yd m%;sl¾u .kakd f,ihs' wYajhd bia;df,ka mek .shdg miq bia;d,h jid oeófï w¾:hla ke;' Liver Fibrosis hkqfjka ye|skafjkafka wlaudfõ ffi, m%odyhg m;a

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ùfuka wkaùlaISh jYfhka we;sjk fjkialïh' u;ameka .ekSu ksid wdmodjg m;afjk wlaud ffi, úiska fuu ;;a;ajh we;s lrhs' ta yereKQ úg u;ameka fkdîjo we;eï wjodkï idOl n,.ekaùu ksid fï wdldrfhka wlaudfõ wkaùlaIShj fjkialï we;sjk w;r l,ah,a we;sj ms<shï fh¥fjd;a ñi fï ksid ;;a;ajh j¾Okh ùfuka kej; wdmiq yerúh fkdyels isfrdaishdj jeks nrm;, ;;a;aj j,g mjd t<ôh yel' fyaudia frdayf,a wNskjfhka ia:dms; l< kj mrïmrdfõ Transient Elastography SCAN mÍlaIKh wlaud.;j fïo ;ekam;a ùfuka mSvdjg m;ajQ frda.Ska yg wmuK úYd, wiajeis,a,ls' iïm%odhsl w;sèjks mÍlaIK wlaudfõ fïoh yªkd .eksug iu;a uq;a th isfrdaishdj jeks uqyql=rd .sh frda. ;;a;ajhka iïnkaOfhka mßiudma; úia;rhla imhkafka ke;' fuu kjH mßf,dalk l%ufõoh Tiafia wlaudj wNHka;rfha ixhq;sh iïnkaOfhka jvd;a iúia;rd;aul f;dr;=re ffjoHjrhdg ,nd.; yels jk w;r uq,a wjia:dfõoSu jvd;a iqyqre wdldrfhka frda.fha iajNdjh iïnkaOfhka wjfndaOhla ,nd .ekSug yels jkq we;' th frda.

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hg myiqfjkau m%;sldr m%;sl¾u isÿ lsÍugo fya;=jla jkq we;' lsishï frda. ;;a;ajhla we;s nj yªkd.;a l,ayS" wlaudfõ iqjfi; iudf,dapkfhys,d iaj¾Kuh mÍlaIdj f,i fuf;la fhdod .ekqfka Liver Biopsy mÍlaIKhhs' ksjeros frda. úksYAphla yd l<uKdlrKhla i|yd fl;rï m%udKhlska wlaud ffi, ksfrda.So hkak yªkd.ekSu m%;sldr l%shdj,sfhys,d w;HjYH lreKla jq w;r Liver Biopsy u.ska bgq jQfha ta wjYH;djhhs' tfy;a fï i|yd fhdod.;a l%ufõoh frda.shdg ;rula wmyiq fõokdldÍ úh' fjk;a miq.dó ;;a;ajo lsysmhla fï Ndú;dj ;=< úh' thg úl,amhla f,i lsisÿ fõokdjla" ysßyerhla frda.shdg f.k fkdfok l%uhla f,i fï Transient Elastography wdlddrfha mÍlaIK Ndú;djg wdfõ 2003 ;rï ld,fhah' tys wkjr; oshqKQj by<u Ndú;dj iksgqyka lrñka wo ojfia Ndú;d jk Transient elastography ialEka mÍlaIKh oeka wlaud frda. y÷kd. ekSfuys,d f,dalfha doctormagazine.lk

Transient Elastography ialEka mÍlaIKh iqúfYAIS jkafka wehs@ • mÍlaIKfhaoS lsisÿ fõokdjla fkdoekSu Wiia ffjoH wdh;k úiska fhdod .kakd w;r ta myiqlï ,xldfõoSo ,nd .ekSug oeka fyaudia frday, ,dxflah mqrjeishkg wjia:dj i,id ;sfí' frda.shdg b;d iqj myiqj f.k fok yqÿ ialEka mÍlaIdjlska fndfyda mßiudma; we.hSula isÿ lsÍug fï Tiafia wjldY újr lr oS we;'

• ndysr frda.sfhl= jYfhkau mÍlaIdjg Ndckh úh yels ùu • m%;sM<h tiekskak ,nd.; yels ùu • ksrjoH;djh • kej; kej;;a úksYaph mÍlaIdjg ,la l< yels ùu • iSudjlska f;drj ish¿ wdldr frda.Ska yg Ndú;d l< yels ùu • m%;sldr miq úmrugo fuu mÍlaIKh fhdod.; yels ùu

lS¾;su;a fmf¾rdjreka fofofkl=f.a mhqre mdidku wjos l< u;lh''' Û1999 È fvdlag¾ iqks,a fmf¾rd ug uqK .eyqkd" Tyq uf.ka Woõjla b,a¨j¶ cd;sl frdayf,a thdf.a fjdaâ tfla ÿú,a, ksid jirlg frda.Ska 500la uefrkjd fjdaâ tfla ÿú,a, bj;a lf<d;a urK ixLHdj 250g f.akak mq¨jka lsõjd'''

i,a,s j,ska

ñksiaiq

Ôj;a

ux tod ;ud oek.;af;a i,a,s j,ska ñksiaiq Ôj;a lrjkak mq¨jka nj'''

mq¨jka

oeka uu fï Èkj, W;aidy lrf.k hkjd IMB- watson ,xldjg f.akak"

lrjkak

f,dafla lsisu rgl ms<sld frda.skag filkaâ TmSkshka tl Free foka kE" th ñ< wêlhs'

Ûux ,xldfõ ms<sld frda.Skag tal *%S fokak oeka l;d lrf.k hkjd'''''''¶

uu udi ;=fkka fjdaâ iïmq¾K w¨;a jeähd lr,d AC yhs lr,d ghs,a lr,d ÿkakd''' fjdaâ tl ´mka lrk ojfia fvdlag¾ uf.ka fufyu weyqjd'

ffjoH iqks,a fmf¾rd uy;d

ÛThd ug lrmq Woõjg uu fudkdo Thd fjkqfjka lrkak ´k¶ lsh,d

wfma ñksiaiq odkhla ÿkak;a fnr .y,d tal fokafka" ienE Okm;sfhda Charity lrkafka fnr .y,d fkfjhs" yefudau oelafla Oïñlf.a ld¾ tl ú;rhs Tyq ksyvj lrk iudc fiajd ljqrej;a oelafla kE tal ;ud we;a;''''

ux lsõjd" Ûfvdlag¾

wrl ;ud Woõj lsh,d" ñka miq urkak mq¨jka 250 hs¶

B<. jif¾ fvdlag¾ ug ixLHd f,aLK j,skau fmkakqjd ueß,d ;snqfka 275 hs lsh,d'''''

jHdmdßl Oïñl fmf¾rd uy;d

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Wmqgd .kakd ,§ -

Shashi Bimal prabath doctormagazine.lk

PROSTATE CANCER

Dilemma of the PSA test to

DETECT PROSTATIC CANCER

When you are over 40, the doctorsâ&#x20AC;&#x2122; advice you to have a PSA test to check and record the number as your base, for future comparisons. If there is a history of prostate cancer in the family, you are advised a test yearly. If you do not have a family history and your first PSA test is low, then your doctor will advise you to get a test done every three years. 56

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Written by:

Dr. Harold Gunatillake

FRCS, FICS, FIACS, MB, BS, AM (Sing)Health writer If the first reading is high or subsequent readings reveal a progressive increase in the numbers, the problems arise. It is a dilemma for the patient, family doctor and the specialist to evaluate and manage such cases.

Normal & Abnormal Readings assumed in PSA The normal PSA levels on a single blood test giving less than 4 ng/ ml are considered normal, and you need to thank God or Karma for it. Recent studies, some recommend lowering the cut-off levels less than 2.5 or 3ng/ml. as normal. PSA values are low in younger people as their prostate glands are smaller. If the number is higher than 3ng/ml in a younger patient that would be a cause for concern. The doctors wouldnâ&#x20AC;&#x2122;t be concerned if the number is borderline or above on the first reading. But, on successive tests, if it is going up progressively over a period of years, then it would be a concern. Keep in mind that with age the prostate gland does get bigger and more Prostatic-Specific Antigen (PSA) is secreted under normal conditions. This also has to be considered in

pinpointing prostatic cancer. The test is done on a sample of blood taken usually from the arm. This is called a screening test for cancer.

Clinical Dilemma Now there is a difference between statistical findings and treating individuals for prostatic cancer. Statistics seem to reveal that doing PSA screening tests and treating or when the test is not done and not been treated the death rates donâ&#x20AC;&#x2122;t differ very much, or the difference is marginal. So why should patients go through painful biopsies of the gland with needles through the anal canal, grading the cancers and further being treated with operation, radiotherapy, and chemotherapy respectively, if there is no difference as far as the statistics reveal without such procedures? There also have been unnecessary operations being done on PSA values alone when prostatic cancer was not found with lab results.

A US Example The United States Prevention Services Task Force (USPSTF), a non-governmental expert panel that produces guidelines for primary care providers proposed new recommendations advising doctors to perform the PSA test only for

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older men after discussing the pros and cons and further management and intervening through consent with the patients. It is considered important that the patient is warned in doing a PSA screening test on clinical suspicion.

A Cancer there is no Evidence in its Origin In the early stages, there are no symptoms to detect prostate cancer clinically from the history of symptoms and signs. Enlarged prostate which is normally detected clinically or otherwise on per rectal (PR) examination may also give symptoms common to both situations, but in cancer, it is more likely to get pain during ejaculation and blood in urine or semen, in addition to difficulties in passing urine. Pain behind the scrotum is a sure sign of inflammation or early cancer of the prostate gland.

Controversial Recommendation Against PSA In 2012 USPSTF released a controversial recommendation against PSA testing at any age. It was based on a large US study showing no decrease in prostatic cancer deaths among men screened using the PSA test. Many cases were diagnosed having cancer on the PSA test alone and unnecessarily treated with surgery or radiation

On the other hand, there was another large study in European men showed a small decrease in prostate cancer deaths after more than 10 years follow-up who were treated.

My Opinion My view is that PSA test should be done on every patient who asks for it, and those having a family history, yearly. The younger people less than 60 diagnosed on progressive PSA tests need further surgical intervention and surgery. Those elderly people diagnosed on PSA screening could wait without any further intervention other than observation regularly. They would live for a considerable period with or without surgery. You need to discuss with your doctor and you need to make a decision when it comes to prostate cancer diagnosis on the screening test. Very difficult decision for you to face.

What is the PSA test? The PSA test is a blood test that measures the amount of prostate specific antigen (PSA) in your blood. PSA is a protein produced by normal cells in the prostate and also by prostate cancer cells. Itâ&#x20AC;&#x2122;s normal to have a small amount of PSA in your blood, and the amount rises as you get older and your prostate gets bigger. A raised PSA level may suggest you have a problem with your prostate, but not necessarily cancer.

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LABORATORY TESTS EXPLAINED

HIV Diagnosis and Treatment through Advanced Technologies

HIV

ffjrih

blauKska y÷kd .kakd mÍlaIK

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

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miq.sh l,dmfhka''' iuia; f,dal ;;a;ajh ii|k l< wfma rg wvqfjka taâia frda.Ska jd¾;d jk rgla jYfhka y÷kdf.k ;sfí' wfma rfÜ taâia frda.Ska ydroyila muK isák njg wjkudk lrk w;r idhkslj y÷kd.;a frda.Ska isákafka 2"766ls' foieïn¾ udihg fhfok f,dal taâia oskh ksñ;af;ka miq.sh l,dmfhka taâia frda.Ska yªkd.ekSfuys,d ;dlaIKfha m%.;sh oelaùfï ,smshla m< lf<uq' fujr fuu ,smsfhka tu jákd úia;rfha iudma;sh iksgqyka flfrKQ we;' 60

Rapid Tests HIV frda.Ska i|yd isÿ lrk laIKsl mÍlaIK Western Blot Assay mqoa.,hska wdfõlaIKh Screening lsÍu i|ydo .,md.;a HIV mÍlaIK jqjuKdh' Western Blot Assay u.ska fï wjYH;dj imqrd,hs' fuh idfmalaIj .;a l< ixlS¾K Ndú;djkaf.ka f;dr laIKsl mÍlaIKhls' Western Blot mÍlaIKh iEu ffjri fm%daàkhlu iajNdjh tl tlla jYfhka úuik mÍlaIKhls' fï ld¾hh bgq flfrkafka Polyacrylamide Gel Electrophoresis l%ufõoh Tiafia wKQl nrg wkQj iEu ffjri fm%daàkhlau Nitrocellulose Membrane/strip weiqf¾ fm< .eiaùfuks' frda.shdf.a reêrh fï Nitrocellulose membrane/ strip m%;sldrlh yd uqyqka ù reêrfha we;s úfYAIs; m%;scklh yd m%;sl%shdfjka tu ;Srej u; j¾K nEkaâ tlla fia rgdjla we;s fjhs' ksIAmdolhkaf.a msßú;r yd iSyqï lsÍfuka fuu j¾K rgdj ishqï f,i ksÍlaIKfhka m%;sM<h ilia flfrhs' uq;%d fukau uqL >%dj jQj;a mÍlaIKhg fhdod.; yelsh' fï ksid tu mÍlaIKh zz/ljrk mÍlaIKhZZ “Point of Care” test f,iskao kï lr ;sfí' wfkl=;a mÍlaIK ;rï ixfõoS ke;s fï mÍlaIKh úkdä 15-30 ;rï flá ld,hla ;=< m%;sM, ,nd fohs' fï jk úg Ndú;dfõ mj;sk Western blot assay u.ska p24 ffjri m%;sfoay ^;=kajk mrïmrdfõ HIV mÍlaIKh& yªkd.ekSu isÿ flfrhs'

Western blot assay mÍlaIdfõ m%;sM, iudf,dapkh lrkafka fï wdldrfhks

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m%;sfoay ksIAmdokh l%shd;aul fjhs' my; oelafjk wdldrhg fï ;;a;ajhka o¾YSh jYfhka l%shd;aul fõ'

weÕs,af,ka" ndyqfjka fyda uqLfhka mÍlaIdj i|yd ffcj idïm, ,nd .kS' m%d:ñlj HIV je<÷KQ whg we;eï úg fuu mÍlaIKh u.ska fodaIiy.;j (False negative Results) m%;sM< ,ndoSu fuysoS uqyqK fok .eg¿jls' tu ksid laIKsl mÍlaIKh ie<flkafka bosß mÍlaIK j,g udj; fy<s lr oSula isÿ lrk mÍlaIdjla jYfhks' iïu; Wiia mÍlaIKhla u.ska ,efnk m%;sM< ikd: l< hq;= fõ' yosis wjia:djloS kï fuu mÍlaIKh isÿ lrkafka zzm%uqL;d mÍlaIdjlaZZ f,isks' m%iQ;hg iQodkï lrk ujlg kï fuh HIV wdidos; fyda tfia fkdjk nj ksYAph lrk fõ.j;a mÍlaIdjls' Diagnostic Window ffjrih YÍr.; jQ wjia:dfõ isg m%;sfoay" ffjri f.fkdauh fyda m%;sckl (p24) fï wdoS jYfhka ljr fyda ffcj úoHd;aulg frda.h yªkd.; yels idlaIshla ffcj idïm, j,ska ,nd.; yelsjk f;la ld,h hkqfjka ye|skafjhs' ffjrih iïfm%aYkh ù i;s follska

iq,n taâia mÍlaId iy tajdfha m%;sM, ,nd .ekSug .;jk ld,h doctormagazine.lk

CASES (%)

TIME PERIOD (IN WEEKS)

60–65

After 4

After 8

80 95

After 6 After 12

Seroconversion we;s ùug osk mylg fmr m%;sckl (p24) u.ska frda.Ska yªkd.; yels fõ' fï wkqj y;rjk mrïmrdfõ mÍlaIK u.ska m%;sfoay" ffjri f.fkdauh fyda m%;sckl (p24) fhdod .ksñka frda.h fy<sorõ lr .ekSfï ld,h ie<lsh hq;= m%udKhlska wvq lr.; yel' kuq;a p24 m%;scklh ksIamdokhg fmr Ndú;hg .; yels jkafka m<uq marker jkafka viral RNAh' HIV mÍlaId lsÍu i|yd EIA 1980 j¾Ifha taâia frda.h i|yd mÍlaIK lrkakg wdrïN jQ od isg ixfõoS yd iajhxlD; mÍlaIKhla jYfhka EIA f.!rjh oskdf.k isákafkah' fuu.ska frda.h ieÕjf.k isák ld,h (window period) ie<lsh hq;= muKlska wvq lrhs' wjdish

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jkafka we;eï úg frda.S fkdjk who frda.Ska jYfhka jd¾;d ùug (false positive results) we;s bvlvhs' fï wkQj EIA mÍlaIKh lsÍfuka miqj frda.sfhla hhs yªkd .;fyd;a Western Blot wdoS fjk;a ;yjqre lsÍfï mÍlaId fjfiiskau isÿ l< hq;= fjhs' p24 m%;sckl mÍlaIK fuh EIA mÍlaIKh mokï lr.;a mÍlaIdjls' wekaáckh y÷kd.kafka m%;sfoay weiqßKs' frda.Ska hhs yªkd.;a úg fuysoSo Neutralization test u.ska th ;yjqre lr.; hq;= fõ' mqoa.,hdf.ka m%;sfoay yªkd. ekSug fmr fuu p24 m%;sckl mÍlaIKfhka y÷kd.; yels ùu fuys úfYaI;ajhls' frda.shd oeä f,i frda. ,laIK m%lg lrñka EIA mÍlaIKh Negative m%;sM, jd¾;d lsÍu yd Western Blot mÍlaIKfhka Positive m%;sM< jd¾;d lrk úg fuu mÍlaIKh isÿ lsÍu úksYaphlg fnfyúka bjy,a fõ' p24 m%;sckl mÍlaIKh lsÍfuka miqj frda.sfhla hhs yªkd .;fyd;a fjk;a ;yjqre lsÍfï mÍlaId 62

ffjrih YÍr.; ùfuka miq mÍlaIdj,g yiqjkafka fï úosyghs fjfiiskau isÿ l< hq;= fjhs' Qualitative PCR ffjrifha kHIaGsh nyq.=KSlrKhg ,la lsrSfuka PCR l%uhg ffjri y÷kd .ekSu fuysoS isÿ flfrhs' PCR mÍlaIdfõ by< ixfõoS;djh ksid l=vd ksheoshlska jqjo wfmalaIs; mÍlaIKh isÿ lr.; yel' HIV wdidos; uõjrekag Wm; ,nk orejka udi 15la muK .; jk ;=re m%;sfoay orhs' HIV m%;sfoay mÍlaIK t;rï ksrjoH fkdfõ' fï whg jvd;a iqÿiq jkafka PCR mÍlaIdjla u.ska úksYaphg Wmldr ,nd .ekSuhs' Quantitative RNA PCR and Genotyping HIV je<÷KQ frda.Ska yªkd .ekSu i|yd ART, RNA PCR mÍlaIK isÿ lsÍug fmr fukau bka miqjo fuu mÍlaIdj fhdod.; yel' CD4 count iu.ska frda. m%;sldr wdrïNhg fmr fuu ART, RNA PCR mÍlaIdjka isÿ flfrhs' T!IO j,g lsishï m%;sfrdaë;djhla olajkafkao hkak .ek úuiSug Genotyping mÍlaIK isÿ lrhs' tfiau T!IO ljr ldKAv fï frda.ska yg M<odhSj m%;sldr lsÍug iqÿiq jkafkao (what combination of drug therapy should be used.) hkak .eko fuhskau wjfndaOhla ffjoHjrhdg ,nd.; yels jkq we;' Quantitative PCR frda. ksOdk fiùfï mÍlaIKhla jYfhka fhdod .kafka ke;' thska false positive and negative m%;sM< ,eîfï jeä wjia:djla ;sîu Bg fya;=jhs'

JANUARY 2019 | DOCTOR MAGAZINE

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

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

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

Address

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

Telephone

E-Mail

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

Nothing ruins an outdoor activity like invading mosquitoes. Find out what makes them flock to you.

uÿrefjda wfma f,a fndkafk kE''' yenehs

uÿß,d fndkjdæ

fï f,dalfha ukqIH cSú;hg wNsfhda. lrk oreKQu i;a;ajhd .ek fuf;la Tn oek fkdisá f;dr;=re 64

JANUARY 2019 | DOCTOR MAGAZINE

doctormagazine.lk

uÿre jix.f;a wm uqyqKmdk nrm;, fi!LH .eg¿jla''' uef,aßhdj''' ly WK''' biair wfma ck;djg fndfydu ysßyer l<d''' oeka fvx.='''' fudk ;rï ffjoH úoHdj oshqKQjg m;a jqK;a fvx.= wm uqyqK fok b;d nrm;, fi!LH m%Yakhla''' ta l;dfj jrola kE''' uÿrefjd wmg oIaG lrk yskaohs fï Tlafldu uÿre jix.;' úoHd;aul idlaIs u; mdolj fkdjqK;a iudcfha fukak fufyu u;dka;rhla ;sfhkjd' doctormagazine.lk

Û.eìKs ldka;djkag;a tfyuhs' fudk ;rï indjl ysáh;a uÿrej tkafk nv ore wïuj fidhdf.k'¶

ÛidfmalaIj .;a;u we;eï whf. isref¾ uÿrefjd jyk tl jeähs'¶

ÛúfYaIfhkau orejkaf. isrefr jykjg jvd jeäysáhkaf. isrefr uÿrefjd jykak W;aidy lrkj jeähs'¶

úoHd;aul wdfõlaIK u; mokï fkdù jqK;a we;s lr.;a by; lS Wml,amk j, we;a;la ;sfnk nj úoHdfjka ;yjqre ù ;sfnkjd' uÿrejka we;af;kau ;ukaf. ovhug YÍr f;dard fírd.ekSula isÿ lrkjd' miqld,Skj m¾fhaIlhka yªkd.;a wdldrhg uÿrejka jeäfhka ovhï lrkak W;aidy lrk YÍr .ek''' tfyu;a ke;akï oIagkhla isÿ lsÍug Wka fjfiiska ie<ls<su;a jk YÍr .ek ldrKd fufyuhs'

uÿrejka oIaG lsÍug jeä ukdmhla olajkafka fï whghs • f;;ukh uÿrejkag wjYHhs' uÿrejka fndaùug;a f;;ukh w;HjYH idOlhla' oIaG lsÍfïoS uÿrejka oyäh iys; iul jykak jeä ukdmhla olajkjd' • we÷u .ek;a uÿrejka ie<ls<su;a fjkjd' Tjqka l¿ meye;s iy w÷re meye;s weªï we| isák

JANUARY 2019 | DOCTOR MAGAZINE

Woúhf.a YÍr u; jikakg jeä ukdmhla olajkjd' • ¨Kq" fmdgEishï yd ,elaála wï,h fj; Wka wdl¾Ykh fjkjd jeähs' iu u; fï lsisjla ;sfnkjd kï Bg;a wdl¾Ykh jeähs' ifï oyäh" w;=re M,hla f,i ksmofjk ,elaála wï,h jf.au flfi,a" w,s.egfmar wkqNjfhka ixÑ; jk by< fmdgEishï m%udK;a uÿrejka wdl¾IKh lrk idOl' • uÿrejkq;a fikaÜ mqhr j,g leu;shs' fkdakhs uy;a;hhs tl <`. bkak fj,djg uÿrefjd fkdakf. isrefr wdYdfjka jykj kï Tkak Bg fya;=j''' • uOqú; mdkh lrk msßñka w;f¾;a uÿrefjd .ejfikj jeähs' uoHidr mdkh lsÍfuka miq YÍrfhka ksl=;a fjk ridhkhlg uÿrejka wdl¾Ykh fjkjd' ;j;a fya;=jla''' uOqú; f;d,.Efuka YÍrfha WIaK;ajh u|la by< hkjfka' WKqiQï YÍr j,g oIaG lrkak;a uÿrejka wdihs' • wfma isref¾ ;sfnk reêr ldKAvh .ek;a uÿrejka ie<ls<su;a jk nj úoHd{hka fidhdf.k ;sfnkjd' O ldKAvfha reêrh

uÿrejka fndajk ia:dk md,kh lsrSu uÿre lrorfhka ñoSfï fyd|ul%uhhs 66

JANUARY 2019 | DOCTOR MAGAZINE

Insect reproductive biology specialist Laura Sirot, PhD ;sfhk Woúh uÿrejkaf.a m%ydrhg ks;r ks;r ,la fjkjd' • .¾NsKSNdjh fkdue;s ldka;djlg idfmalaIj .eí.;a ldka;djla uÿre oIaGkhlg ,laùfï bvlv fo.=Khlska by< hkjd' iajNdjfhkau .eìKs ldka;djla m%dYajdifhaoS jeä ldnkavfhdlaihsâ jdhq mßudjla msg lrkjd' th uÿrejka wdl¾YKh lrk m%n, fya;=jla' ta yereKQ úg uehf.a YÍrfha WKQiqï nj idfmalaIj jeä ùu;a jeä YÍr.; reêr ixirkhla ksid weh flfryS uÿrejka nef|kjd jeähs' doctormagazine.lk

uÿrejdf.a cSjk pl%h jeäysá uÿrejd

ì;a;rh

,djd

ms,õ

• óg fmr lSjdla fia WKqiQï iajNdjh orK YÍr j,g oIaG lsÍug uÿrejka W;aidy .kakjd jeähs'

uÿrejkaf.a cSúf;a .ek fy<sorõ lr.;a wm%lg f;dr;=re iuyrla''' lDñ m%ckl cSj úoHd{jßhl jk f,dard isfrdÜ uÿrejka .ek úYañ; f;dr;=re /ila wkdjrkh lrkjd' f,dalfha uÿrejka úfYaI 3000la muK jd¾;d fjkjd' Wka iuyrla f,a fndkafka kE' ;j;a iuyfrla ñksia f,a fndkafka kE' wmg .eg¿j we;af;a ñksia f,a fndk uÿrejka iïnkaOfhkqhs' fldfydu jqK;a fï f,dalfha isák ish¿u i;a;ajhka w;=ßka ñksiqka urd oeóug jeäfhkau j. lshkafka uÿrejdhs' fï wkQj fï f,dalfha isák Nhdklu i;d f,i uÿrejd i<lkakg wmg isÿ fjkjd' f,a fndkafk uÿrejdf. .eyekq i;d muKhs' ta lshkafk uÿß,d''' muKhs' Wkag ì;a;r odkak f,a j, ;sfhk fmdaIl veye.ekSu wjYHhs' fldfydu jqK;a uÿrejkag'' wd jerÿKd''' uÿrejkaf. .eyekq i;a;ajhkag" uÿß,dg''' f,a îfuka ;ukaf. YÍr nr fo.=Khla olajd jeä lr.kak mq¿jka' i| we;s rd;%sfhaoS uÿrejkaf.a l%shdldß;ajh mia .=Khlska muK by< hk nj;a m¾fhaIKd;aulj doctormagazine.lk

y÷kdf.k ;sfnkjd' uÿrefjl= oIaG lrk úg ta wjia:dfõu tu reêrh leá .eiSu j<lajk ridhkhla úoskjd' fï ksid oIaGkfhka fõokdjla oefkkafka kE' ta;a Tn wm fyd|ska w;aú| we;s leiSu we;s lrkakg fï ridhkh iu;a' wkqNjhg .e,fmk f,a ;sfnk nj''' ukqIHfhla <`. bkak nj uÿrejd oek.kafka wm msglrk ldnka vfhdlaihsâ jdhqj bj lsÍfuka' wä 75l ÿßka bkak ukqIHfhla jqK;a ksjerosj y÷kd.kakg fï uÿre bj iu;a' fï f,dalfha isák ish¿u i;a;ajhka w;=ßka ñksiqka urd oeóug jeäfhkau j. lshkafka uÿrejdhs' fï wkQj fï f,dalfha isák Nhdklu i;d f,i uÿrejd i<lkakg wmg isÿ fjkjd' uÿrefjl= oIaG lrk úg ta wjia:dfõu tu reêrh leá .eiSu j<lajk ridhkhla úoskjd' fï ksid oIaGkfhka fõokdjla oefkkafka kE' ta;a Tn wm fyd|ska w;aú| we;s leiSu we;s lrkakg fï ridhkh iu;a'

JANUARY 2019 | DOCTOR MAGAZINE

WOMEN'S WORLD

hy.=K msß ksfrda.S ore mrmqrla i|yd .=Kiïmkak wdydr

WoEik wydrh

orejkaf.a ojfia fyd|u wdydr fõ,hs WoEik wdydr fõ, u. yßkak fokak tmd'''

wdmkYd,dj, wf,ú lrk lEu ñ,oS .kak fokak;a tmdæ

<ud frda. úfYaI{ ffjoH oSmd,a fmf¾rd úisks

JANUARY 2019 | DOCTOR MAGAZINE

ojfia fyd|u wdydrh ÛWoEik wdydrh¶ hhs woyila mj;S' th we;af;kau woyila muKlau fkdfõ'''' ys;¿jlao fkdfõ' WoEik wdydrh Tn ys;kjdg;a jvd" Tn okakjdg;a jvd m%n, wdydr fõ,ls' we;af;kau WoEik wdydrh ojfia Tfí l%shdldß;ajfha moku i,ik jákdu wdydr fõ,hs' th fmdaIKfõoSka úiska m¾fhaIKd;aulj idlaId;a lr we;s w;r wka ljrodg;a jvd fuu ojfia uq,au wdydrfha we;s jákdlu ;yjqre ù ;sfí'

Tn orejdg yenEjgu wdof¾ kï orejd flfryS Tfí we;s fifkyi''' wdorh''' w¾:j;a lsÍug Tng ojfia uq,skau ,efnk wjia:dj jkafka hy.=K msß fmdaIKSh WoEik wdydrhla Tfí orejd fjkqfjka ,nd oSuhs' doctormagazine.lk

WoEik wdydrh yefok orejkaf.a ldhsl yd udkisl l%shdldß;ajh iïnkaOfhka úYd, ld¾hNdrhl ksr; jk w;r th jvd;a ie,iqï iy.;j yd ffokslj''' meyer fkdyer ,ndosh hq;= wdydrhhs' WoEik wdydrh ie,eiaulg wkQj mßmQ¾Kj ,nd. kakd orejka ksfrda.S nfjka hqla; jk w;r ia:Q,;djh''' ukaofmdaIKh wdoS fmdaIKSh wka; j, wjodkï iy.; frda. j,g ksrdjrKh fkdjk nj fy<sorõ ù doctormagazine.lk

;sfí' WoEik wdydrh uÕyßk orejka frda. j,g ksrdjrKh jk wjia:d jeäh' Tjqkaf.a YÍrfha m%;sYla;sh ÿ¾j,h' ta yereKQ úg bf.KSfï lghq;= j,oS miqnEula fmkakqï lsÍug bv ;sfí' kej;;a''' WoEik wdydrh fyd|ska .kakd orejka bf.kSfïo iud¾:hka jk w;r kfjda;amdolhka" ks¾udmlhka njg Tjqka m;aùfï bvlv jeä nj m¾fhaIlhka''' yªkdf.k ;sfí' WoEik wjos jQ miq f.or hqo msáhl isß .kS' uq¿;ekaf.hs lEu msiSu" orejka mdie,a hkakg iQodkï lsÍu''' uõmshka fiajd ia:dk j,g hkakg ,l ,eyeia;s ùu ksid fï l,n,ldß;ajh we;sù ;sfí' WoEikoS fndfyda f.j,a j,g ld,h hkq iSudldÍ idOlhls' fï ;;a;ajh ;=< .=Kj;a fi!LH iïmkak wdydr fõ,la orejkag ,nd fokjd fjkqjg we;eï uõjrekaf.a f;aÍu jkqfha myiqfjka msiskakg yels wdydr fõ,ls' Wfoag;a" oyj,g;a jYfhka fofõ,lg wdydr msiSfïoS fndfyda úg ,>q jkafka WoEik wdydr fõ,hs' fï ksidu orejka WoEik wdydrh mdif,aoS wkqNj lrkafka ´,dßl ufkda Ndjhlsks' orejdf.a lEu fmÜáfhka wvlau''' ke;fyd;a Bg;a jvd b;sß fjkafka fï ksidh' u;l ;nd .kak' Tfí orejd lEu fmÜáfha we;s lEu wkqNj fkdlrkjd kï uõmshka jk Tno Bg j.lsj hq;af;ah'

orejkag lv lEu tmd''' orejka fï wdldrfhka WoEik wdydrh m%;slafIam lrk úg uõmshka B<Õg ;sfnk zzkrlu jrogZZ wkqn, fohs' wdmkYd,dfjka iakelaia" f;f,ka ne¥ frda,aia" fmaiaá% lkakg orejkag uqo,a fohs' fï wdmkYd,d wdydr fõ,g meKs îu tllao wh;ah' f.oßka /f.k hk fmdaIKSh wdydrh fjkqjg msá" f;,a msß wdydrhla l=i.skakg wkqNj lr meKs îu tlla fndkakg orejka jvd leu;sh' meKs îu fnda;,hlg fhdok iSks m%udKh f;a tllg" lsß tllg fhdok iSks m%udKh fuka oy .=Khlska muK jeäh' fï wdldrfhka ksfjiska mßndysrj imhd. kakd lEu wkqNj lrk orejkaf.a mßjD;a;Sh l%shdj,sh fkdfnda osklskau úlD;s Ndjhg m;a fjhs' úfYAIfhkau YÍrfha .aÆfldaia mßjD;a;Sh JANUARY 2019 | DOCTOR MAGAZINE

WOMEN'S WORLD

iuia;hla jYfhka wm ldg;a fmdÿ fï WoEik wdydrfha jákdlu orejka iïnkaOfhka .;a l< jvd;a jeo.;a fjhs' jvd;a w¾:iïmkak fjhs' fldhs ldg;a jeo.;a jk zzWoEik wdydrhZZ orejkag kï kshudldrfhkau ,ndoSu uõmshka meyer fkdyeßh hq;= hq;=luls' j.lSuls' Tn orejdg yenEjgu wdof¾ kï orejd flfryS Tfí we;s fifkyi''' wdorh''' w¾:j;a lsÍug Tng ojfia uq,skau ,efnk wjia:dj jkafka hy.=K msß fmdaIKSh WoEik wdydrhla Tfí orejd fjkqfjka ,nd oSuhs'

WOMEN'S WORLD

widudkH fjhs' orejka ful, jeä jeäfhka oshjeähdj jeks frda. j,g k;= jkakg fï msáka .kakd wdydr yd meKs îu fya;= jk nj meyeos,s ldrKhls'

WoEik wdydrh orejkaf.a fyd|u wdydrh úh hq;af;a wehs@ wm WoEik wdydrhg b|.kafka rd;%sfha meh 8-10l muK ld,hla wdydr j¾cs;j isàfuka wk;=rejh' rd;%sfhaoS fï wdldrfha úfõlhla wjYH jkjd fukau wk;=rej WoEik t<efUkafka jefvys ksr; jk B<Õ meh 12-16l muK ld,hla i|yd wjYH fmdaIKfha moku i,ik wdydr fõ,ls' WoEik wm ,nd. kakd wdydrfhka YÍrh fndfyda oE wfmalaId lrhs' cjiïmkak osjd ld,hl úúO YdÍßl l%shdldrlï i|yd wjYH uq,au Yla;s wjYH;djhka" ksjeros .aÆfldaia mßjD;a;Shla i|yd moku i,ik fmdaIKSh wdydrhl wjYH;djh''' wdydr wjfYdaIKfha laIQø fmdaIl yd uyd fmdaIl wjYH;djhka ta w;f¾ m%Odkh' WoEik

wdydrh yßhg ke;skï oji uq¿,af,a YÍrfha ;dkh mj;ajd .ekSug ndOd meñfKhs' th YÍrfha ÿ¾j,Ndjhla''' l=iS; njla WodiSk njla we;s ùugo fya;=jls' ufkda Ndjhka" OdrKh u;l ;nd .ekSu yd iaurKh wdoS l%shdjkago WoEik wdydrfha iDcq n,mEula ;sfí'

WoEik wdydrhl ;sìh hq;= wx. fudkjdo@ ojfika ;=fkka tllg wjYH le,ß w.hka yd fmdaIKSh wjYH;djhka msßuikafka WoEik wdydrhhs' fï ksid ksielfhkau WoEik wdydrh mßiudma; fmdaIKhlska fyì wdydrhla fia ilia lsÍug uõmshka ie<ls<su;a úh hq;af;ah' WoEik wdydrhg OdkH wvx.= úh hq;af;a tfyhsks' fm%daàk''' ;ka;=uh wdydr j,ska fï WoEik wdydrh fyì úh hq;=jdla fukau hyñka t<j¿ m<;=reo Bg tla fjkjd kï fyd|h' fï wdldrfhka ish¿ fmdaIKSh wx. j,ska hqla; WoEik wdydrhla orejd fjkqfjka ie,iqï úh hq;=h'

WoEik wdydrfha OdkH j, N=ñldj wdydrfha uyd fmdaIl f,i ie<flK ldfndayhsfâ%g yd msIAGh wjYH;djhka imqrd,Sug OdkH j,ska iukaú; m%Odk wdydrh fya;= fjhs' fï ksid rih fukau .=Kho wka;¾.; jk fia n;a álla" fjk;a OdkH wdydrhla uqx weg" lõms wdoS weg wdydr ,ndoSu iqÿiqh' OdkH wdydr orejdf.a fmdaIKSh wjYH;djhka imqrd,k w;f¾ Woafhda.fhka oji .; lsÍug" ks¾udKYS,s;ajh wjos lsÍug fukau OdrK Yla;sh jeãugo WmldÍ fjhs' fï ksid msßmyÿ l< msá j,ska ;ekQ wdydr fjkqjg OdkH wdydr ,ndoSu iqÿiqh' wjik t<j¿ m<;=re lene,a,lao lEug yqre fjkjd kï jvd;a fyd|h' WoEik wdydrh ojfia moku i,ik jákdu wdydr fõ,hs' thg ful, uõmshka ;nd we;s nr u| nj fmfka' úúO rihkaf.ka hqla;j úúO iQm l%u wkq.ukh lrñka orejdf.a msßh jvk WoEik wdydr fõ,la Tnf.a orejd fjkqfjka ms<sfh, lsÍug uõmshka oekg jvd W;aiql úh hq;=h' túg Wfoa wdydrh i;=áka ,nd. kakg orejka ksrdhdifhka fm<fUkq we;'

JANUARY 2019 | DOCTOR MAGAZINE

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WOMEN'S WORLD

Fertility

ore iïm;a m%udo jQ

wUQ ieñhkag idM<H;d uOHia:dkhloS lghq;= flfrk ms<sfj, iïnkaO ye|skaùula

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WOMEN'S WORLD

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

k< ore ;dlaIKh yd cdk ffjoH úoHdj wo ojfia kSfrda.S ore iïm;a ,nd .kakg mdr yok yeá ldka;dj fukau mqreIhd;a fuysoS mÍlaIdjg ,la flfrkjd' mqreIhd iïnkaOfhka isÿ flfrk mÍlaIdjka yd ta Tiafia lsishï fodaIhla yªkd .;fyd;a túg .kq ,nk l%shdud¾. .ek fuhska úia;r lruq' 72

mqreIhdg fuysoS ;sfnkafka ir< l¾;jHhla' Y=l%dKq idïm,hla ,nd oSu ;uhs fuys m%Odk mshjr' idudkHfhka mqreIhd iïnkaOfhka lrk mÍlaIK j,oS Anti Sperm Antibody mÍlaIKh lr, fodaIhla ;sfhkjdo lshk ldrKh fidhd n,kjd' m%ckk ld¾hfhaoS ;ud fld;eko bkafka lshk ldrKh iïnkaOfhka fuysoS ;lafiarejla lr.kakg wjia:dj ie,fikjd' mÍlaIK j,g wkQj Y=l%dKq iïnkaO m%;sM<h fyd|hs kï wê;dlaIKsl m%;sldr j,g fkdfjhs ir< m%;sldr j,g fhduq jkakg mq¿jka' Y=l%dKQ

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uyd ixfiapk ix.%duh tl mqreIfhlaf. .;a;u fï Y=l%dKQ ñ,shk .Kkdjla ;sfhkjd' wmg ´ks lrkafk tlhs' Y=l%dKQ tlla f;dard .kak fldaá ixLHd; Y=l%dKQ tlsfkld mrhñka uyd ix.%duhl ksr; fjkjd' ta wehs@ m%udKh iaj,am jYfhka wvqùula kï IUI l%uhg fhduq fjkak mq¿jka' .¾NdIfha Y=l%dKQ ;ekam;a lsÍu ;uhs fuysoS isÿ jkafka' fuh fomdrla ;=ka mdrla jqK;a lrkak mq¿jka' th wid¾:l kï IUTPI lshk l%uh''' tkï Y=l%dKq mef,damSh kd,h we;=f, ;ekam;a lsÍfï W;aidyhl fhfokak mq¿jka' Y=l%dKQ mef,damSh kd,fha mqrjk l%uhl=;a ;sfhkjd' fï tlla j;a ishhg ishhla id¾:lhs lshkak nE' ishhg 15- 20- 35 wdoS jYfhka ;uhs id¾:l ùfï bv m%ia:dj ;sfhkafka' fï ish,a, wNHka;ßlj Y=l%dKQ yd äïn ixfiapkhg .kakd ñf,ka wvq m%h;akhka' id¾:lNdjh;a ishhg 35la muK olajd ;sfhkjd' t;ekska Tíng .;af;d;a k< ore ;dlaIKh weiqf¾ jeä iïNdú;djl id¾:l;ajhlg fhduq jkak mq¿jka' ICSI l%uh yo,u ;sfhkafka Y=l%dKQ wvq mqreIhkag ore iïm;a ,nd.kak ms<shula úosyghs' Y=l%dKQ j, úmÍ; yevhka ksid" tajd msyskk fõ.h wvq ùu ksid wdoS fodaI j,ska fmf<k mqreIhkag mS;D;ajh i,ikak fï ;dlaIKh msysgg tkjd' Y=l%dKQfj ;sfhk ÿ¾,;djhla ksid äïnh midre lrf.k iajdNdúlj ixfiapkhla isoaO lr.kak neß jqKdu thg iydh ùu ;uhs fuysoS isÿ jkafka' fuh jeä oshqKq lrñka wo IMÚI yd PICSI hk ;dlaIKhka Ndú;dfj ;sfhkjd' cdkuh jYfhka fyd| Y=l%dKQj hï m%udKhlg f;dardf.k äïnhlg we;=,a lsÍu ;uhs fuys wNsm%dh' doctormagazine.lk

idudkHfhka id¾:l .eí .ekaùula lrkak fya;= jk Od;= mßudjl Y=l%dKQ fldaá tl yudrla ;sfhkjd' fuhska .eí .ekaùulg wjYH jkafka tlu tl Y=l%dKQjla muKhs' ta;a f,dl= ix.%duhla isoaO fj,d ;uhs wr fldaá tl yudrla Y=l%dKQ j,ska tlu tla Y=l%dKQjla ch.%yKh ,nkafka' fuh iajNdjO¾uhd úiskau yªkajd ÿka iajdNdúl jrk l%uhla' thg fya;= úuik úg fï ldrKdj tfia isÿ jkak fya;=j uekúka meyeos,s fjkjd' fhdaks ud¾.h osf.a Y=l%dKQj .uka lrk úg Y=l%dKQ ,laI ixLHd; m%udKhla úkdY fjkjd' ta w;f¾ úkdYhg m;a Y=l%dKQ u;ska fiiq Y=l%dKQ

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WOMEN'S WORLD

msßñ wm yefudau fuf,dj Wmoskakg oskQ

WOMEN'S WORLD

n,weKs igka joskjd' fï äïnh yUd hk Wml%ñl ix.%duhl ksr; jk Y=l%dKQ .;af;d;a tajd tl tl m%udKfhka hqla;hs' flfkla ÿ¾j,hs' fyñysg msyskkafk' y;s jeá, uefrk wh;a bkakjd' flfkla fõ.fhka msyskkjd' Yla;s iïmkakhs' fï ÿ¾j, yd Yla;su;a yeu Y=l%dKQjlau igkg wj;S¾K fjkjd' f¾ia tl hkfldg;a úúO weneoaos fjkjd' yosiaisldrfhd wk;=re;a we;s lr .kakjd' fõ.fhka .sh;a ì;a;rfh lgqj úo.kak neßj wiu;a jk wh;a bkakjd' fï Y=l%dKQj j, yevh .;a;;a tl tl úosyhs' T¿j rjQï Y=l%dKQ" T¿j fjkia Y=l%dKq" T¿ fol fol ;sfhk Y=l%dKq" j,a. lsysmhla ;sfhk Y=l%dKq''' fï úosyg tl tl úosfya Y=l%dKq ;rÕhg wj;S¾K fj,d äïnfha lgqj wdikakhg tk ch.%dylhska lsysm fofkla bkakjd' ta;a igk bjr fjkak kï ;j;a wNsfhda.hla ch .kak ´ks' tla flfkla f;dard .kak ´ks wks;a yeu flfklau mroskak ´ks' thg fï jvd;a Yla;sjka;hkaf.ka 74

tla flfkla''' äïnh wdikakhgu meñKS tla flfkla äïnh midre lrf.k we;=<g jefokak ´ks' tfyu äïnh midre lrf.k hï Y=l%dKQjla we;=<g jeÿkdo@ Tyq ;uhs f¾ia tfla ch.%dylhd' ta ch.%yKh jvd;a Yla;sjka;hd ,nd.;a;g miafi fiiq ish¿ fokdu mrdchg m;a lrñka ix.%duh wjika fjkjd' wka Y=l%dKQ ish,a,u cSú;laIhg m;a fj;aoS äïnh yd uqyqka jQ Y=l%dKQj kj cSjhla ìys lsÍfï wisßu;a l¾;jHhg Wr fokjd'

ljr idM,H;d .eg¿jlska fm¿K;a oeka Tng ore iïm;a ,nd .ekSu wreuhla fkdfõ' fjk hï ljr fodaIhla u; Tfí uõmsh isyskh fnd| ù ;snqK;a th h,s mqnqÿjd,Sfï yelshdj wmg ;sfí' Tfí .eg¿j l=ula jQj;a th .ek yDohx.uj l;dny lsÍug wm iQodkïh' Tng jvd;au .e,fmk úi÷u ,nd.ekSug fï flafIA;%fha m<mqreÿ wfma jD;a;Sh iydh ,nd oSug wm b;d leue;af;ka isáuq' wmg l;d lrkak' fukak wfma wxlh 077 3273 866 wmf.a ,smskh WISH Fertility & IVF Clinic 393$6" li.yj;a;mdr mrK fldÜgdj mdr Wvyuq,a,"kqf.af.dv

JANUARY 2019 | DOCTOR MAGAZINE

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fodafr .,k ore fifkyi

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

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

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

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

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

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WOMEN'S WORLD

SWEET HEART

.¾NKS;djfhaoS we;sjk fjkialï''' .¾NsKS;dj uq¿,af,a m%lg jk wmyiq;d" fõokd lelal=ï y÷kd.kak

wkqrdOmqr YslaIK frdayf,a m%ij yd kdßfõo úfYaI{ ffjoH l=udr osidkdhl úisks MBBS,MD,MRCOG(UK).

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fuf,dj ldka;djlg ,efnk w;s W;alDIaGu jQ moúh uõ moúhhs' ffjoH úoHd;aulj úuik l< fuh YÍrfha fjkialï rdYshla isÿjk wjêhls' .¾NKS;djh we;sfjk l<" .¾NKS;djh uq¿,af,a YÍrfha w;sjk fjkialï fudkjdoehs wm úuiuq' doctormagazine.lk

m<uq udi

m<uq udi ;=kl ld,h ;=< .eìKs ujl flfrka we;sjk fjkialï

udia Y=oaêh k;rùu .eìKsNdjhg m;ajk ldka;djl w;a olsk m<uq isoaêh jkqfha wef.a Tima ùu k;rùuhs' udihlg j;djla udia Y=oaêhg ,lajk ldka;dj .eí.;a miq Tima ùfï k;r ùula w;a ú|skjd'

Tlaldrh yd jukh Tlaldrh yd jukh .eìKs ldka;djlf.ka oel.; yels ;j;a .eìKs nfjys uQ,sl ,laIKhla' idudkHfhka .eí .ekSfuka i;s follska muK miq Tlaldrh yd jukh we;s úh yelshs' we;euqkag

.¾NKS;djh uq¿,af,au mshhqre wdY%s;j fjkialï we;sjk w;r tys mrsudj fjkia jkafka fufyuhs JANUARY 2019 | DOCTOR MAGAZINE

WOMEN'S WORLD

.¾NKS;djfhaoS ujlf.a isrer ;=< fjkialï rdYshla we;s fjkjd' fï fjkialï .ek .eìKs uj oeK.; hq;=hs' ukao@ fkdtfia kï th frda.hla fia jrojd jgyd .ekSug weh W;aiql fjkjd' wfkla w;g w;s W;=ï jQ ud;D;ajhg ms<sfh, ùfïoS wehf.a .eìKsNdjh .ek weh ksielfhkau oeKQj;a úh hq;=uhs'

WOMEN'S WORLD

• úvdj$uykaish • ysfia lelal=u • fldkafoa lelal=u • ks;r uq;%d lsÍfï wjYH;djh

.¾NKS;djh uq¿,af,a wef.a isrer fjkia jkafka fufyuhs fï Tlaldrh yd jukh fl;rï mSvdldÍ f,i oefkkjdo h;a we;eï úg wehg frday,a.;j m%;sldr ,eîug mjd isÿ fjkjd'

mshhqre j, we;sjk fjkialï .eìKs Ndjhg m;a ùu;a iu.u mshhqre j, mqmqre .ik iajNdjhla" fõokdjla we;s úh yelshs' fï ldka;djkaf.a mshhqre m%udKfhka úYd, ùulao fuysoS we;súh yelshs' Bg wu;rj my; ,laIK lsysmhla fyda ish,a, .eí .ekSulska miqj uq,a ld,fhaoS .eìKs ujlg we;s úh yelshs'

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• uqfjka u<lv rihla oekSu$;s;a; rihla we;sùu • lEu wreÑh

udi

3-6 udi ;=k isg yh olajd ld,h ;=< .eìKs ujl flfrka we;sjk fjkialï uq,a udi ;=k ;=< m%lg flreKQ jukh" lEu wreÑh yd wfkl=;a

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Worh l%ufhka úYd, ùu Worh l%ufhka úYd, ùu wdrïN jkafka fï ld,fhaoS' fu;eka mgka Worh l%u l%ufhka úYd, ù weh .eìKshl f,i msg;g fmfkkafka fï jljdkqfõoS'

orejdf.a p,k ore .eng i;s 20 l muK ld,hla iïmQ¾K fjk úg NDK p,k tkï orejd úiska we;s lrk p,k ujg oefkkakg mgka.kakjd' fuh ujl úiska w;aú|sk wisßu;a w;aoelSula'

u<noaOh fï ld,fhaoS ujlf.a isrefrka jEfyk fm%dfciagfrdaka fydafudakfha jeäùula olakg ,efnkjd' tys m%;sM<hla f,i wehg u<noaOh we;súh yelshs' fï wjia:dfõoS Bg ms<shula f,i oshr j¾. jeämqr mdkh lsÍu" fl|s iys; wdydr jeä jYfhka fndcqkam;g tla lr.ekSu flfryS .eìKs uj W;aidy l< hq;=hs'

fndfyda ldka;djka ;ukaf.a l=ifyd;a lsßleáhkaf.a p,k ore .eng i;s 16-24 w;r ld,fhaoS w;aú|shs' th mhska .EiSula''' frda,a ùula''' ljrfyda p,khla úh yel' .¾NKS;djh bosßhg hk úg orejdf.a p,ko fjkia uqyqKQjrla .kq we;'

uf.a orejd p,kh jkafka fldmuK fj,djlskao@ tfyu fj,djla lshkak nE''' Tfí orejdf.a p,k Tyqgu wdfõKsl uqyqKQjrla .kakd w;r ta .ek lsisfjl=g fmrhSï l< fkdyel' idudkHfhka i;s 16-24 w;r ld,fhaoS fï N%EK p,k flfuka jeä jk w;r th i;s 32la muK olajd mj;S" bkamiqj we;sjk p,k ;rula taldldÍh'

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.¾NKS;djfha wjidkfha wvqfjka p,k we;s fjkjd hk lshufkys i;Hhla ke;'

fï p,k.ek orejd Wm; ,nk ;=re fkdlvjd ie<ls,af,ka isáh hq;=h'

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WOMEN'S WORLD

fndfyda fjkialï udi y;f¾ isg flfuka wvq fjkjd' ta fjkqjg fï fojk w¾Ofha udi ;=kg ,dlaIKsl fjkialï /ila we;s fjkjd'

WOMEN'S WORLD

hánfâ wmyiq;djh fï ld,fhaoS wehg hánfâ wmyiq;djhla" fõokdjla we;s úh yelshs' ir< fõokd kdYlhla wjYH l,ayS .ekSu yereKq úg wka ueosy;aùula fuysoS wjYH jkafka kE' udi

6-9

udi yh isg kjh olajd ld,h ;=< .eìKs ujl flfrka we;sjk fjkialï

.¾NsKS ld,fha wjidk f;ui ;=< uj orem%iQ;shg iQodkï jk ld,h f,i ye|skaúh yelshs'

YÍrh l¿ meye .ekaùu fï ld,fhaoS" fjfiiskau wjidk i;s lsysmh ;=<oS wef.a YÍrh l¿ meyehla .ekSug bv ;sfnkjd' we;eï ,m j¾.o ifuys we;s jkakg bv ;sfnkjd' fuh .¾NKS;djfhaoS we;sjk yqÿ fjkialula muKhs' tfy;a l,d;=rlska wjia:djloS .¾NsKS;djhg wdfõKsl ifï frda.S ;;;ajhkao ;sfnkjd' fï wjia:dfõoS kï Bg ffjoH m%;sldr wjYH fjkjd'

mdofha yd j<¨lr wdY%s;j we;sjk bosuqu mdofha j<¨lr wdY%s;j we;sjk bosuqula we;eï .¾NsKSka flfrka fï ld,fhaoS oel.; yelshs' fuh idudkH ;;;a;ajhla' tfy;a wêreêr mSvkh iu. mdofha bosóu" uqyqK" w;a bosóu we;sjk m%Stla,eïmaishd (Preeclampsia) kï frda. ;;a;ajhlao we;eï úg we;euqkag we;s fjkak mq¿jka' fuysoS uõjreka ffjoHjreka fj;ska Wmfoia yd m%;sldr ,nd.; hq;=uhs'

ueKsla lgqj wdY%s; fõokdj wjidk udi lsysmh ;=< we;sjk ;j;a wmyiq;djhla kï ueKsla lgqj wdY%s; fõokdj iy bosóuhs' fuh (Carpal Tunnel Syndrome) hkqfjka ye|skafjhs' fuysoS w;a, ysßjeàu" uymg.s,a," onr.s,a, iy ueo.s,a, ysß jeàu oelsh yels w;r rd;%S ld,fhaoS ;;a;ajh oreKQ fõ' wf;a 80

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iakdhq /yeka lsysmhla ueKslalgqj wdY%fhaoS ;oùu óg fya;=jhs' idudkH ;;a;ajhla jQj;a fuysoS oeä fõokd my< jk úg m%;sldr .ekSu iqÿiqh' jHdhdu u.skao ;;a;ajh md,kh lr.; yelsh' .¾NskS;djfhaoS fï f;uia ld, jljdkq ;=fkysoS we;sjk úúO ,laIK .ek iEu ujlu wjfndaOhlska isáh hq;=h' fjfiiskau .¾NsKSNdjh yd iïnkaO;djhla fkdolajk fjk;a frda. ;;a;aj we;s jqfKd;a tajd fjkafldg y÷kd. ekSuo jeo.;ah' flfia fj;;a ljr frda. ,laIKhla we;s jqK;a" ljr wmyiq;djhla we;s jqK;a th oS¾> ld,Skj mj;skafka kï Tfí m%ij ffjoHjrhd fj; tys iajNdjh .ek oekaùuo jeo.;ah'

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JANUARY 2019 | DOCTOR MAGAZINE

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WOMEN'S WORLD

SWEET HEART

.eìKs ujf.a fmdaIKh 1

.¾NŒ iufha fofofkl=g iEfyk f,i wdydr .; hq;= keye

2 3

Wfoa wdydrh fkdjrojdu ,nd.kak

f*da,sla wï,h jefvk orejdf.a fld÷ weg fm, iïnkaO iakdhq moaO;sh iy fud<fha j¾Okhg w;HdjYH úgñkhla'

jeämqr iSks iys; iy neomq wdydr .ekSu t;rï iqÿiq keye

wdydr wvq lsÍu iy wêl jHdhdu lsÍu .¾NŒ ujlg iqÿiq keye

W;=re fld<U YslaIK frdayf,a m%ij yd kdßfõo úfYAI{ ffjoH pdñkao udf;dg 84

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ore m%iQ;shlg iQodkï jk ujla tu wjia:dj jk úg fyd| fi!LH ;;a;ajhlska isàug .¾NŒ iufha fmdaIKh fukau .eí .ekSug fmr ;snQ fmdaIK ;;a;ajh;a n,mdkjd' tu ksid ore ms<sis| .ekSulg n,dfmdfrd;a;= jk ldka;djka ;ukaf.a fmdaIKh .ek úfYaI wjOdkhla fhduq l< hq;=hs' fmdaIK ;;a;ajh uek n,k m%Odk o¾Ylhla jkafka Wig iß,k nrla ;sîu' Wi iy nr wkqj BMI ^Body mass index& w.h .Kkh lsÍfuka Tfí fmdaIK ;;a;ajh .ek oek .kak mq¿jka' ksjerÈ mrdifha Wi iy nr ;sîu muKla iEfykafk keye' óg wu;rj" .¾NŒ ujlg iqÿiq iy kqiqÿiq wdydr .ek ie,ls,su;a ùu;a jeo.;a'

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.eìKs Tng wdydr Wmfoia Tn .¾NŒ kï Tnf.a wdydr rgdj fi!LH iïmkak wdydr rgdjlg fjkia lr .ekSug fï Wmfoia ms<smÈkak'

m%Odk wdydrh f,i ksjqvq n;a fyda weg j¾.hla yels iEu úgu f;dard .kak' tfia ke;skï n;a" mdka" kQâ,aia jeks msá iys; wdydrhla .kak'

m,;=re fyda t<j¿ yels ;rï wdydrhg tla lr .kak' tu.ska fïo nyq, yd wêl le,ß iys; wdydr m%udKh wvq lr .; yelshs'

Tn .kakd le,ß m%udKh fyda fïo m%udKh .¾NŒ iufha jeä l< hq;= keye' jeämqr iSks iys; iy neomq wdydr .ekSu t;rï iqÿiq keye' me‚ îu" me‚ ri w;=remi" flala" ìialÜ iy wêl f;,a iys; wdydr j,ska je<lSu jeo.;a'

m<d j¾. iy fm%daàka nyq, wdydr jeämqr tla lr .kak' uia" ì;a;r" ud¿" lrj," jeks wdydr fukau mßmamq"

fndaxÑ" fidahd jeks wdydr j,skq;a wjYH fm%daàka m%udKh tla lr .kak mq¿jka'

ksjqvq n;a" weg j¾." fld< meye;s t<j¿ iy m<d j¾. jeks ;ka;= nyq, wdydr ks;ru .ekSu iqÿiqhs'

lsß wdydr u.ska le,aishï ,nd.; yelshs'

Tn .kakd wdydr m%udKh .ek ie,ls,su;a ùu jeo.;a' .¾NŒ iufha fofofkl=g iEfyk f,i wdydr .; hq;= keye' uq,a udi yh ;=, fndfyda ldka;djkag idudkH m%udKhg jvd le,ß m%udKhla wjYH jkafka keye' bka miqj jqj;a .¾NŒ nj ksid jeämqr wjYH jkafka Èklg le,ß 200la ;rï iq¿ m%udKhla' fuu jeämqr le,ß m%udKh idudkHfhka mdka fm;s follska ,efnk le,ß m%udKhg iudkhs'

Wfoa wdydrh fkdjrojdu ,nd.

kak'

m%Odk wdydr fõ,a ;=kg wu;rj Woh jrefõ iy yjia

JANUARY 2019 | DOCTOR MAGAZINE

WOMEN'S WORLD

.¾NŒ ujlf.a fmdaIKh .ek yefudau ie,ls,su;a fjkjd' .eìks ldka;djg iqÿiq wdydr mdk .ek úúO u; mj;sk ksid" ta .ek oekqj;a ùu jeo.;a'

WOMEN'S WORLD

jrefõ wu;r iq¿ wdydr fõ,a folla .ekSu iqÿiqhs' kuq;a fuu.ska oji ;=, .kakd iïmQ¾K le,ß m%udKh jeä fkdúh hq;=hs'

.¾NŒ iufha Tfí nr .ek ie<ls<su;a fjkak Tfí nr kshñ; w.fha ;sfí oehs YÍr ialkaO o¾Ylh ^BMI& u.ska oek .; yelshs' tu w.h 18'5 wvq kï Tnf.a nr m%udKj;a keye' 25g jvd jeä kï Tnf.a nr jeähs' nr jeä kï .¾NŒ iufha ixl+,;d we;s ùug jeä wjodkula ;sfnkj' kuq;a fï nr wvq lr .ekSug iqÿiq ld,hla fkfuhs' wdydr wvq lsÍu iy wêl jHdhdu lsÍu .¾NŒ ujlg iqÿiq keye'

.¾NŒ ujg wjYH lrk úgñk wfma YÍrhg wjYH úgñk j¾. ,efnkafka wms .kakd wdydr j,ska' úgñka D muKla ysre t<sfhka ,efnkjd' fndfyda ldka;djkaf.a wdydr mqreÿ ksid iuyr úgñkhka wjYH m%udKhg YÍrhg ,efnkafka keye' tu ksid iuyr úgñk wu;rj ,nd.ekSug isÿ fjkjd' ñka m%Odk;u úgñkh jkafka f*da,sla wï,hhs' .¾NŒ ujlg Èklg wu;r f*da,sla weisâ uhsfl%d .%Eï 400la muK wjYHhs' fuh fm;a;la jYfhka ,nd .; yelshs' f*da,sla wï,h jefvk orejdf.a fld÷weg fm< iïnkaO iakdhq moaO;sh iy fud<fha j¾Okhg w;HdjYH úgñkhla' idudkHfhka .eí .ekSug fmr isg i;s 13la olajd ld,h ;=, fuu úgñkh Èkm;d ,nd .ekSfuka fud<fha iy iakdhq moaO;sh iïnkaO widudkH;d we;s orejka ìys ùu wvq lr.; yelshs' 86

JANUARY 2019 | DOCTOR MAGAZINE

wêl ;rndre lu" Èhjeähdj" wmiaudrh i|yd T!IO Ndú;h" ;e,iSñhd jeks frda. ;;aj iy mjqf,a flfkl=g fyda orefjl=g spina bifida kue;s ;;a;ajh ;sîu jeks wjodku jeä wjia:djka j,§ iakdhq moaO;sh iïnkaO widudkH;djhka we;s ùug jeä wjodkula ;sfnkjd' túg f*da,sla wï,h jeä ud;%djlska ^5mg& ks¾foaY lrkj' úgñka D ysre t<sfhka ,efnk ksid ,xldj jeks rgj, W!K;d we;sùu úr,hs' kuq;a wêl ;rndre nj" fndfyda úg f.dvke.s,s ;=,u ld,h .; lsÍu" lsß wdydr fkd .ekSu jeks fya;= u; úgñka D wu;rj ,nd .ekSu ks¾foaY lrkjd' úgñka K f,a leá .eiSu ksis f,i mj;ajd .ekSug jeo.;a úgñkhla' fuh wvq ùfuka WmÈk orejdf.a reêr jyk we;sùfï wjodku jeä fjkjd' Tn wmiaudrhg T!IO .kafka kï fyda wlaudfõ frda. ;;a;ajhla we;akï fuu úgñkh wu;rj ,nd .ekSug wjYH fjkak mq¿jka' úgñka A w;sßla; f,i ,nd .ekSu jefvk orejdg ydkslr fjkak mq¿jka' tfukau wksl=;a úgñk j¾. wu;rj ,nd.ekSu idudkHfhka ks¾foaY lrkafka keye'

,xldfõ fndfyda ldka;djka hlv W!K;djfhka fmf<kjd' tu ksid hlv fm;s f,i ,nd .ekSu ks¾foaY lrkjd' kuq;a reêrfha ysfuda.af,dìka uÜgu idudkH kï fuh ,nd .ekSu wksjd¾h keye' uq,a udi ;=fkka miqj hlv fm;s ,nd .ekSu jvd;a iqÿiqhs' doctormagazine.lk

WOMEN'S WORLD

iu we§ug ,laùu ksid

ifuys we;sjk i<l=Kq

fï ;;a;ajh ffjoH úoHd;aulj y÷kajkafka Striae Distensae hk kñks' fïjd fõokdldÍ fkdfõ'

iu weoSug ,laùu ksid ifuys we;sjk i<l=Kq

iu weoSug ,laùu ksid ifuys we;sjk i<l=Kq fnfyúka iq,nh' 88

JANUARY 2019 | DOCTOR MAGAZINE

fï ;;a;ajh hïlsis frda. hla ;sfnk njg fmkajk wjia:d b;du;au úr,h'

iq,n jYfhka we;s jkafka .¾NsKS ldka;djkag iy ;rndre ldka;djkagh' doctormagazine.lk

fndfyda fokd mSvd ú|sk .eg¿jla fyhska ta ;rugu úi÷ïo mj;S' kuq;a Tn l,amkdldÍ úh hq;=fõ' m%;HlaI hhs lSjdg fndfyda m%;sldr wfmalaIs; mrud¾:h bgq lrkafka ke;' ifuys wj,laIK i<l=Kq bj;a lrkafka ke;' keKj;aj is;d n,d .e,fmk úi÷u flfryS fhduq ùu nqoaêu;a Tng Ndrh' doctormagazine.lk

ffjoH rYañld fiõjkaos r;akdhl úisks

b;du;au iq,nj Stretch Marks we;s jkafka .¾NKS;djfhaoSh' .eìKs iufhaoS úYd, jYfhka nr jeäùu" ksjqka orejka ord isàu" ;rula úYd, orefjl= l=i ;=< jeãu yd l<,jdßl ;r, mßudj by< w.hla .kakd úgoSo fï i<l=Kq ;rula jeäfhka olakg ,efí' tfy;a u;l ;nd .kak' fïjd ;snqKdg" orejka ,eîfuka miqj lsß fok uõjreka ta ld,fhaoS lsisÿ wdf,amkhla fkd.e,aúh hq;=h' iu weoSug ,laùu ksid tys i<l=Kq we;sjkafka wehs@ jpkd¾:fhkau fuys uQ,sl isÿùu jkafka iu hïlsis weoSulg ,la ùuhs' tfia weÿkq iu uq,a msysàug fkdmeñK ld,hla weoSug ,laù ;sîu ksid th wdYs%;j iaÓr weoSula we;sfõ' tfia weÿKq iu uq,a ifuys j¾Kh" jhkh mj;ajd .kafka ke;' tys m%;sM<hla jkafka ta fldgi fjkuu o¾Ykh ùuhs' fndfyda úg fuhska ifuys iajdNdúl iqkaor;ajhg ndOd muqKqjhs'

p¾uh wmsp¾uh

fld,ecka ;ka;= ñá

iug háka mj;sk fïo ia:rh ^iómj weiqreKq iïnkaOl mgl&

weoSï i<l=Kq we;s jk yeá JANUARY 2019 | DOCTOR MAGAZINE

WOMEN'S WORLD

ifuys we;sjk úúOdldr .eg¿ w;f¾ iu weoSug ,laùu ksid tys i<l=Kq we;sùu fkdfyd;a Stretch Marks fndfyda fokd mSvdjg m;a lrjk ;;a;ajhls' fï p¾u.; ;;a;ajhg fndfyda fokd cSú;fha ljr wjia:djloS fyda ,lajkq we;' .eìKs ldka;djkaf.ka ishhg 90lau" kj fh!jkfha ldka;djka ishhg 70la muK" ;reK msßñka ishhg 40la muK iu weoSug ,laùu ksid tys i<l=Kq we;sùu kue;s p¾u.; wj,laIKNdjhg uqyqK fo;s' cd;s fNaohla ke;''' fï .eg¿j yefudaguh'

WOMEN'S WORLD

v¾fud frda,¾ u.ska weoSï i<l=Kq j,g id¾:lj m%;sldr l< yel iu weoSulg ,lajk wjia:d • .¾NsKSNdjh • ia:q,;djh • YÍrfha nr wvqùu • YÍrfha iS>% j¾Okhla isÿjk .egjr wjêh

ienEjgu iu wNHka;rfha isÿjkafka fuhhs widudkH f,i iu weoSu ksid ifuys wdOdrl jHqyhka f,i mj;akd fld,ecka yd b,iaáka ì|fy<Sulg ,la fjhs' tajd bÍulg" m¿ÿ ùulg ,la fjhs' Tfí iu hg weÿKq rn¾ nEkaâ tlla ;sfnkjd hhs is;kak' iug ta iúh ,nd fokafka rn¾ nEkaâ tl weoS mj;sk ksidh' iu weoSulg ,la jqfKd;a tla;rd wjia:djloS rn¾ nEkaâ tl lefvhs' túg frda,a jqKq rn¾ nEkaâ tl iu hg msysàu fjkia lrhs' th ;jÿrg;a kshñ; wd;kH nj fkdfyd;a wefokiq¿ nj mj;ajd .kafka ke;' weoSï i<l=KloS isÿjkafkao fuhuh' tysoS o`.r .efik rn¾ nEkaâ tl jkafka iufys wefokiq¿ b,iaákah'

weoSï i<l=KQ j,g m%;sldr

uq,a msysàu 90

m%;sldr lsÍfuka miqj

JANUARY 2019 | DOCTOR MAGAZINE

Tn oek.; hq;= i;Hhla ;sfí' iu weoSug ,laùu ksid tys i<l=Kq we;sjkafka u;=msgh' kuq;a yenEjgu ydksh isÿ jkafka ifï Tn fkdolsk wNHka;rfhah' fï ksid iu weoSug ,laùu ksid tys i<l=Kq we;sùu hkq rEm,djKHuh .eg¿jla f,i p¾ufõofha ie<flkafkao ke;' tfyhskau thg m%;sldr lsÍfïoS yqÿ m%pdrd;aul wf,úlrK Wml%u j,g Tn .%yKh fkdúh hq;=h'

wid¾:l m%h;akhka .ek oeKqj;a fjkjd" fyd|hs''' iu iïndykh lsÍfuka Stretch Marks ke;s l< fkdyel' Dermal

jpkd¾:fhkau fuys uQ,sl isÿùu jkafka iu hïlsis weoSulg ,la ùuhs' tfia weÿkq iu uq,a msysàug fkdmeñK ld,hla weoSug ,laù ;sîu ksid th wdYs%;j iaÓr weoSula we;sfõ' doctormagazine.lk

WOMEN'S WORLD

Rollers hkqfjka ye|skafjk fuj<ula iu u; hkakg i,iajd tys we;s ishqï lgq úfYaIhla u.ska iu wNHka;rhg isÿ lrk m%;sldrhla .eko lshefõ' m¾fhaIKd;aulj tho id¾:l njg Tmamq ù ke;' Microdermabrasion kñka ;j;a m%;sldr l%uhla .ek wikakg ,efí' tys kï iq¿ id¾:l;ajhla we;s nj fmfkkakg ;snqK;a iu weoSug ,laùu ksid ifuys we;sjk i<l=Kq uq,sKqmqgd oukakg kï thgo yelshdjla ke;' u;=msáka wdf,amkh lrk wdf,amk jeä fofkl=f.a f;aÍu nj fmfkkakg ;sfí' ksjeros l%ufõohla Ndú;d lrñka" ksjeros msßú;r wkq.ukh lrñka ksIamdokh lrk ,o u;=msáka wdf,amkh lrk wdf,amk muKla ñ,oS .kakg Tn W;aiql úh hq;=h'

.¾NsKS ld,fhaoS fï weoSï i<l=KQ we;s fjkjd jeäh

iu weoSug ,laùu ksid ifuys we;sjk i<l=Kq jeä jYfhka we;sjk ia:dk • Worh • ;Ügï • l,jd • Wl=< • mshhqre

.eìKs iufhaoS iu weoSug ,laùu ksid ifuys we;sjk i<l=Kq b;du;au iq,nj Stretch Marks we;s jkafka .¾NKS;djfhaoSh' fjfiiskau ldka;djl .eìKshl njg m;aùu;a iu.u Worh l%u l%ufhka úYd, jYfhka weoSulg ,lajk ksid;a ta weoSu os.= ld,hla mj;akd ksid;a Worfha fï i<l=Kq we;sùfï bvlv fnfyúka jeäh' ta yereKq úg mshhqreo we;=¿j ;j;a fndfyda ia:dk j, .eìKs ldka;djkaf.a we;s fõ' we;s jk ,l=Kq tla tla ldka;djf.a ifï meyeh wkQj fjkia fjhs' frdai" ÿUqre" r;= ÿUqre wdoS jYfhks' m%ijfhka miq hï ;rulg fï i<l=Kq ;=kS ùula isÿ jqK;a iïmQ¾Kfhka bj;a jkafka ke;' .eìKs iufhaoS úYd, jYfhka nr jeäùu" ksjqka orejka ord isàu" ;rula úYd, orefjl= l=i ;=< jeãu yd l<,jdßl ;r, mßudj by< w.hla .kakd úgoSo fï i<l=Kq ;rula jeäfhka olakg ,efí' orejka ,eîfuka miqj lsß fok uõjreka ta ld,fhaoS lsisÿ wdf,amkhla fkd.e,aúh hq;=h' JANUARY 2019 | DOCTOR MAGAZINE

wäh ;shd.kak fkdyels

há m;=f,a oefkk fõokdj iq< uq,æ ikaê frda. rla;jd; iy mqkre;a:dmkh ms<sn| úfYaI{ ffjoH ffjoH ysuka; w;=fldar, MBBS (Colombo) MD

há m;=f,a ú¨U hg wkskjd jdf.a mSvkh$YÍr nr iu. tk fuu fõokdj fndfyda fofkla mdo foflysu w;aú¢kjd' we;eï whf.a ;djld,sl ;;a;ajhla jk fuh hï lsis ld,hlg miqj blauKska iqj úh yel' fuu ,smsh ZZma,dkagd *eisháiazz iïnkaOfhks'

há m;=, .ek hula wiaÓhla rn¾ máhla wdldrfha LKavrdjla ^,s.ukaÜ tlla& iu. iïnkaO jk ia:dkhlska fuu fõokdj yg .kakjd' Tfí mdofha LKavrd keue;s má j¾.hla we;' LKavrd mdohg muKla iSud fkdfõ' wiaÓ we;s ´kEu ;ekl fuu LKavrd ;sfí' fïjdfha rn¾ máhla f,i wefok iq¨ Ndjh hï ;rulg ;sfí' wiaÓ ;rula ÿrg fi,ùug ie,eiaùu LKavrd j, wruqKhs' ta jdf.au wiaÓ w;r ;on, nkaOkhla mj;ajd .ekSu LKavrd j, ld¾hh fõ' fuu ksidu LKavrd j,g zznkaOkS wiaÓZZ hehso lshkq ,efí' mdofha LKavrd j,ska isÿ lrkafka hám;=f,a jl% fyda keñ kshñ; wdldrhg mj;ajd .ekSuhs' keñ j¾.

JANUARY 2019 | DOCTOR MAGAZINE

doctormagazine.lk

;=kla uQ,sl jYfhka mdofha we;' fuu keñ ÿkq $iam%ska.a wdldrhg l%shd lsÍu ksid mdo yryd hk lïmk ;rx. wju ùu isÿjkjd' YÍrfha nr mdoh yryd hk úg" úfYaIfhkau ÿjoa§ fuu keñ wm ld yg;a b;d jeo.;a jkjd' jeä nrla mdoh ;=,ska fmdf<djg iïfma%IKh jk úg ÿkak wdldrfha fï keñ È. yefrk w;r" mdoh fmdf<dfjka bj;g .; úg kej; fuys m%;súreoaO ld¾hh isÿjkjd'

fhfok wjia:d j,§ úfYaIfhkau weúÈk ÿjk wjia:d j,§h' flá ÿr Odjk Y+rfhla Èj hk úg fuu LKavrd yryd lsf,da 300 muK wd;;shla we;s jk nj fidhdf.k we;' fuu ksid LKavrd myiqfjka wk;=rg ,laúh yels nj Tng mila jkjd we;'

;s.eiau wju lrk fuu LKavrd yd keñ ksid mdoh fyda fldkao ;=< we;s wiaÓ f.ùu wju jkjd' fuh Èkm;d oyia j;djla uq¨ Ôú; ld,fha§u isÿjk nj u;l ;nd .kak'

ma,dkag¾ *eisháia ;;a;ajh we;sjk wh iuyrlf.a mdofha wdndO l,la ;siafia mej;s tajd úh yelsh' mdofha ;sìh hq;= keñ fkdue;s ùu me;,s mdo ;;a;ajh f,i yeÈkafõ' tfiau mdofha jl% wêl f,i ;sîu zzfmia flajiaZZ (Pes Cavus& f,i yeÈkafõ'

há m;=f,a fõokdj we;s jkafka

ma,dkag¾ *eisháia fjk;a frda.

flfiao@ kej; ma,dkag¾ *eisháia fj; fhduq fjuq' fuys§ fõokdj f.kfok ia:dkho Èkm;d we§ug ,lajk wiaÓhla LKavrdjla iu. iïnkaO jk ia:dkhls'

j, m%;sM,hlao@ ma,dkag¾ *eisháia fjk;a frda. iu. u;=úh yel' úfYaIfhkau úIîc fjk;a .%kaÓhla wdidokh lr Èk lsysmhlg miqj fuh u;=fõ' tfukau iafmdkaäf,da wd;rhsáia kï fld÷ wegfm< wdY%s; wd;rhsáia j, m%;sM,hla f,i fuh yg.; yel'

fuys§ fõokdj oefkk wdldr .Kkdjla w;=ßka há m;a,g mSvkh fhfok úg ;Sj% fõokdjla we;s fõ' mSvkh tf,i fhfokafka mdohg nr

fuhg m%;sldr l< yelafla flfiao@ fuu fõokdjg m%;sldr .Kkdjla we;' uQ,sl jYfhka uu fuu ms<shï ldKav follg fn§ug leue;af;ñ' fnfy;a wdY%s; m%;sldr iy fnfy;a

,xldfõ t;rï m%p,s; fkdjqk;a uu frda.Skag ksjfia§ isÿlsÍug ,ndfokafka iag%fÑka.a jHdhduhs' ma,dkag¾ *eisháia ;;a;ajhg fuh ngysr rgj, kï m%:ufhka ,ndfok m%;sldrhla' fõokdj ;sfnk ia:dkh fifuka we§u iy tu.ska th u;g tk mSvkh wju lsÍu fuys wruqKhs' doctormagazine.lk

JANUARY 2019 | DOCTOR MAGAZINE

isÿl, yelsh'

ú¨fò we;s máhla wdldr LKavrdjla mdo p,kfhaoS we;sjk wd;;s" .eiaiSï j,oS tajdg Tfrd;a;= fok fia l%shd lrhs' wiaÓ tlsfkl ;sr lrf.k há m;=f,a jl%h uekúka mj;ajd .ekSu fuys ld¾hhls' fuh ÿ¾j, jkakg" bosfukakg fukau m%odyhg m;a jkakgo mq¿jk' weúosk úg ysgf.k bkak úg fõokdjla tkafka túgh' ma,dkag *eisháia iq,n há m;=, wdY%h lr.;a frda.hls'

wod, fkdue;s m%;sldr jYfhks' fnfy;a j,ska NSAIDS m%uqL;ajhla .kakjd' NSAIDS j,ska fõokdj muKla fkdj bÈuqu mjd wvqjk w;r hïlsis ksYaÑ; ld,hla fuu fnfy;a mj;ajdf.k hd hq;=hs' we;eï wjia:d j, iafgfrdhsâ j¾.fha fm;s fuhg ,ndfokjd' yS,a mEâ keue;s ir, Wmdx.h id¾:l l%uhla' yS,a mEâ j,ska fõokdj yg.kakd ia:dkfhka msg;g$fjk;a ia:dkhlg mSvkh fhduq lrKjd' fuu Wmdx.h mdjyka ;=<g oeóu fyda we,ùu

m%;sldrhla jYfhka fhdod .kakd w,ag%d ijqkaâ m%;sldrh ir,h" fõokd rys;h' ta yereKQ úg fuhska iykh ,eîug ;j;a fndfyda m%;sl¾u ;sfí' 94

JANUARY 2019 | DOCTOR MAGAZINE

;jo ,xldfõ t;rï m%p,s; fkdjqk;a uu frda.Skag ksjfia§ isÿlsÍug ,ndfokafka iag%fÑka.a jHdhduhs' ma,dkag¾ *eisháia ;;a;ajhg fuh ngysr rgj, kï m%:ufhka ,ndfok m%;sldrhla' fõokdj ;sfnk ia:dkh fifuka we§u iy tu.ska th u;g tk mSvkh wju lsÍu fuys wruqKhs' uyd ì%;dkHfha idhk j,g iyNd.S jk frda.Ska yg wm fuh m<uqj isÿ lr n,kjd' w,ag%d ijqkaâ m%;sldrho fuhg rel=,la jkjd' weÕg fkdoefkk lïmk ;rx.hla ma,dkag¾ *eisháia we;s ;ekg fhduq lsÍu fuys uQ,O¾uhhs' úfYaIs; mdjyka me,£u ;j;a ms<shuls' mß>Kl wdOdrfhka mdofha mSvkh fhfokd ia:dk uek wvq mSvk ia:dkj,g mSvkh kej; fnodyßk mdjyka ksIamdokh lsÍu wm rg ;=, oeka isÿl, yelshs' 3ã *qÜ ialEka kñka fuh ye¢kafõ' ta yereKQ úg iafgfrdhsâ tkak;a u.skao we;eï frda.Skag §¾> ld,Sk iqjh ,efnkjd' ia:dkj,g mSvkh kej; fnodyßk mdjyka ksIamdokh lsÍu doctormagazine.lk

GOODNESS OF FRAGRANT RED BASMATHI RICE

iqj|

r;= ndiau;S iy,a wfkl=;a r;= yd,a j¾. j,g;a jvd fmdaIK .=Kfhka wkQk jkafka wehs@

JANUARY 2019 | DOCTOR MAGAZINE

doctormagazine.lk

iqj| r;= ndiau;S iy,a ful, wfma rfÜ mdßfNda.slhka w;r iS>%fhka ckm%sh fjñka ;sfí' iqÿ yd,a j,g jvd r;= yd,a fmdaIH .=Kfhka wkQkh hk ldrKdj wfma rfÜ ck;dj w;r uq,a nei.;a u;hls' w;sYh úoHd;aul ienEjla jQ fï u;h thskq;a Tíng f.k .sfhd;a'''@ iïm%odhsl r;= yd,a j,ska iqj| r;= ndiau;S iy,a fjka jkafka flfiao@ ndiau;S iy,a iy,a j, ixixokd;aul fmdaIHuh jákdlï fudkjdo@ fï ,smsfhka ta iïnkaOfhka Tng wjfndaOhla ,nd.; yels jkq we;'

doctormagazine.lk

l=reKE., YslaIK frdayf,a ffjoH kd,l rKisxy úisks

iqj| r;= ndiau;S iy,a j, úgñka úYd, m%udKhla" LKsc ,jK rdYshla wka;¾.;h' tfy;a mdysk ,o iy,a j,g jvd" wfkl=;a r;= yd,a j,g;a jvd le,ß w.h wvqh' fï ksid fmdaIK úoHd;aulj iqj| r;= ndiau;S iy,a fjfiia jákdlula orhs' ;jÿrg;a fï .ek l;d lf<d;a" iqj| r;= ndiau;S iyf,a ldfndayhsfâ%g fukau fidaähïo idfmalaIj wvqfjka wka;¾.;h' fï wkQj wvqúh hq;= foa wvq lrñka jeäfhka wvx.= úh hq;= foa jeäfhka wka;¾.; lrñka m%Yia; fmdaIKSh l%shdldß;ajhl fhokakg iqj| r;= ndiau;S iy,a iu;ah' w;sYhska wys;lr fïoh ldKavhla fia ie<flk g%dkaia fïoh iqj| r;= ndiau;S iy,a j, wvx.= ke;' fldf,iagfrd,a wvx.= ke;' .aÆáka wjodkula ke;' wdydruh fl|s iys; wdydr wmf.a wdydr rgdjg jeä jYfhka tla lr.; hq;= wdydr ix>glhla fia fmdaIK úoHd{hka y÷kdf.k we;' tajd wkqNjfhka l=i msfrkjdg jvd .=Kd;aul jYfhka wdydr cS¾Kl ud¾.h ksfrda.Sj ;nd .kshs' iqÿyd,a fukau fkdmdysk ,o wfkl=;a ksjqâv iys; yd,a j,g;a jeä ;ka;=uh fl|s úYd, m%udKhla iqj| r;= ndiau;S dietary fibre j, wvx.= fõ' wm wdydr jYfhka .; hq;af;a OdkHuh wdydrhs' tajd .ekSfuka oshjeähdj" yDo frda. fukay we;eï ms<sld j¾.o we;sùfï ux wiqrd.; yels jkq we;'

JANUARY 2019 | DOCTOR MAGAZINE

iqj| r;= ndiau;S iy wfkl=;a iy,a w;r fmdaIKd;aul ixixokh iqj| r;= mdysk ,o ksjqâv iys; ndiau;S iqÿ iy,a r;= iy,a Yla;sh lsf,da le,ß

347

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0'54

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jákd" m%;sTlaisldrl yd msfkda,sl ixfhda. 98

JANUARY 2019 | DOCTOR MAGAZINE

iqj| r;= ndiau;S iy,a i;= uy`.= fmdaIKSh .=Kdx.hka w;f¾ tys fmd;af;a we;s r;ameye wekaf;dihkska j¾Klfha we;af;a buy;a fmdaIKSh jákdluls' YÍrhg ksfrda.S nj we;s lrk" úI yrkh lrñka YÍrhg Pú j¾Kh" úhm;a fkdùu wdoS .=Kdx. ,enfok m%;sTlaisldrl yd msfkda,sl ixfhda. fï wekaf;dihkska j, wka;¾.;h' m%;sTlaisldrl ful, b;d .eUqre f,i úoH{hkaf.a wjOdkhg ,laù ;sfí' m%;sTlaisldrl .=Kdx. iys; wdydr ffi,Sh uÜgfuka jk ydksùï mQrkh lrhs' ffi, mqk¾cSjkhg ,la lrhs' t<j¿ yd m<;=re j, we;s mhsfgd ridhk j, we;s .=Kdx. j,skao fuh msßmqkah' wm .kakd wdydr u.ska reêrfha iSks uÜgu lsishï by< hdula isÿ lrhs' th jy jyd by< hdu wys;lrh' l%udKql+,j''' ld,hla wrf.k iq¿ jYfhka tu reêr iSks md,khla we;sj by< hdu fi!LHiïmkakh' iqj| r;= ndiau;S iy,a fï l%shdj,sh flfryS n,mj;ajk wdldrh iïnkaOfhka m¾fhaIK fndfyda isÿ lr ;sfí' ta w;f¾ wm mdGlhkg jeo.;a hhs ie<flk y÷kd.;a iqj| r;= ndiau;S iy,a i;= úfYaI;d iïnkaOfhka ,nk l,dmfhka oeKqj;a fjuq' doctormagazine.lk

iqjl< fkdyels ;;a;ajfha ms<sldjlska mSvd ú¢

frda.sfhl=f.ka W.;a mdvï wdisß Y,H frdayf,a ms<sld frda. úfYaI{ ffjoH Idu .=K;s,l

100 JANUARY 2019 | DOCTOR MAGAZINE

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ud fiajh lrkq ,nk mqoa.,sl frdayf,a pek,ska ldurfha fodfrka we;=<g wd fyf;u jhi wjqreÿ 65l muK jQ flfkls' Tyq iuÕ meñ“ tu jhfiau fmkque;s ldka;dj Tyqf.a ìß| jQ w;r wfkla ;reK ldka;djka fofokd jeäuy¨" orejka fofokd úh' pek,ska ldurh ;=<g we;=¿ fkdù msg;ska isá ;reKfhl=o ug ksÍlaIKh jQ w;r mjqf,a nd, orejd jQ Tyqo ud ldurh ;=<g le|jd .;sñ' doctormagazine.lk

frda.shd iu. m<uq jpkh l;d lrkakg;a m%:u jeäuy¨ Èh‚h hehs iel is;sh yels ldka;dj uf.a lkg fld÷rd zzfvdlag¾" ;d;a;d f,fâ okafka kE' thdg f,fâ .ek fudl=;a lshkak tmd'''ZZ hehs uf.ka ne.Em;aj b,a,Sula l<dh' wehf.a b,a,Sug wjk; jQ njla fmkajñka uu" fïih u; ;enQ frda. jd¾;d ,sms f.dkq tlska tl lshjd n,kakg ùñ' bka wk;=rej frda.shdf.a wirK fofk;a foi n,ñka zzThdg oeka fldfyduo@'''ZZ lshd weiqfjñ'

Ûlshkak ;rï fyd|la kE fvdlag¾''' ug kï oeka Ôúf;a tmd fj,d bkafka¶ zzwehs tfyu lsõfõ'''ZZ uu fmr<d weiqfjñ'

Ûtkak tkaku wudre jeä fjkjd' lsisu fyd|la lshkak kE'''¶ zzThdg ;sfhk wudre ug lshkak mq¨jkao@ZZ

Ûnv mef,kak jf.a lelal=uhs' tfyka fld÷kdráh mqmqrkak jf.a' T¨j fyd|gu nrhs''' ;Èkau' i;s .dklska yßyuka kskaol=;a kE'''¶ fufia lshdf.k hk Tyqf.a fofk;a ;=,ska l÷¿ fífrkakg úh' zz;d;a;d nh fjkak tmd" wms fvdlag¾ .djg wdfõ f,fâ ikSm lr .kakfk'''ZZ fufia lshñka nd, Èh‚h mshdf.a ysi w;.dñka Tyqj ikikakg jQjdh' jir follg muK fmr Tyqf.a mqriaÓ .%kaÓfha ms<sldjla we;s nj fidhdf.k ;snq‚' fndfyda m%;sldrhkag ,lajQ uq;a Tyq ;udg we;s frda.h .ek jeä hula oek isáfhao ke;' miq.sh udi fol ;=k ;=<§ tu frda.S ;;a;ajh kej; W;aikak ù ;snQ w;r isrer mqrdjgu''' wiaÓj,g;a wlaudjg ^fuh widudkH me;sÍuls'& ms<sldj me;sÍ ;snq‚' fï f;dr;=re ud fidhd .;af;a frda.h ms<sn|j Tyq i;=j ;snQ jd¾;d j,sks' flfia fj;;a ysfia lelal=ug fya;=j fidhd ne,Sug fkdfhl=;a mÍlaIK lr ;snqKo" ta lsisjlg Bg fya;=j fidhd .ekSug fkdyels ù ;snqfKa uf.a Wml,amkhg wkqj kï wfkalúO mSvdjkaf.ka fõokd ú¢ Tyqg ksis m%;sldrhla fkd,eî ;snQ ksid we;sjQ oeä Ñ;a; mSvdj fuf,i oeä ysfia lelal=ula f,i ndysrg ksrEmkh jkakg we;s njhs' JANUARY 2019 | DOCTOR MAGAZINE 101

zzThdf.a fõokdj uu wvq lr,d fokakï' wmsg fmdâvla yÈis m%;sldr tll hkak fjkjd'''ZZ uf.a m%ldYh .ek oeä úYajdihla Tyq ;=< olakg fkdùh' tfia kuq;a yÈis m%;sldr tallh ;=< § fuda*ska T!IOh iug háka fok tkak;la f,ig Tyqg ,nd ÿksñ' .;jQfha ;;amr lsysmhls' frda.shd mqÿufhka fuka ud foi;a Tyqf.a isrer foi;a udrefjka udrejg n,kakg úh' oeka lelal=u fldfyduo@ uu Tyqf. ka weiSñ' Ûfvdlag¾" ug fïl woy.

kakj;a nE' uf. fõokdfjka iShg wiQjla ú;r fldfyka .shdo lsh,d ys;d .kakj;a nE'¶ fufia mejiQ Tyqf.a uqfjys oeka kï hï i;=gl fiahdjla /£ ;sfnkq ug Èia úh' zzyß Thd fmdâvla fu;kg fj,d bkak uu Thdf.a f.or whg fmdâvla l;d lr,d tkakïZZ fufia mejiQ uu Tyqf.a ìß| iy orejka ;sfokd mfil ys÷jd Tjqka iu. l;d lrkakg jQfhñ'

Ûta fldfyduo fvdlag¾'''¶ zz´kEu ukqiaifhla ;udg fuf;la jqfka fudllao@ oeka fudloao fjkafk@ bÈßfha§ fudkjo fjkak ;sfhkafka@ lsh,d oek.kak leu;shs' úfYaIfhkau Thd,f.a ;d;a;d oeka bkak ;;a;ajh jf.a bkak flfkla' kslug ys;kak" wmsg fufyu fohla jqfKd;a''' wks;a wh wmsg we;a; iÕjkak yokfldg wmsg fudk ;rï mSvdjla we;s fjkjdo lsh,d'ZZ zzta;a fvdlag¾" ;d;a;d fïl oek.;a; lsh, thdg fjk jdish fudllao@ Ôú; ld,h wvqhs lsh,d oek.;a;u ÿlla ú;rhsfka we;sfjkafka'''ZZ ZZThf.d,af,da yß" thdg f.dvla ÿl ysf;kak mq¿jka' óg l,ska thdg fï jf.a ÿlla we;sfj,d keoao@ZZ zzthdf.a f,dl= mq;d welaisvkaÜ tllska ke;s jqKdu thdg wdmq ÿl ;=kS lr.kak udi lSmhlau .shdZZ

zzThf.d,af,d''' ;d;a;dg frda.h .ek lshkak wlue;s wehsZZ uu weiSñ'

zzyd" ta fj,dfj ta ÿl wvq lr.;af; fldfyduo@ZZ

ish,af,dau u|lg ksy~j isá w;r ksyeçhdj ì¢ñka jeäuy,a Èh‚h fufia mjikakg úh'

zzwms Tlafldu thdg ÿl wvqlr .kak Woõ l<d' <Õskau ysáhd' thdg tal f,dl= yhshla jqkdZZ

zz;d;a;d oeka f.dvla jhihs' thdg fï jf.a fohla lsõfjd;a f.dvla ÿl ysf;hs' ord.kak neßfjhs' talhs wms lshkak wleu;s'ZZ

zzyßhgu yß" wkak ta jf.a f,dl= Woõjla thdg oeka Thd,f.ka ´ks lrkjd' iuyr úg todg;a jvd jeäfhka' iuyr úg wfmkq;a f.dvla Woõ ´ks fjkak mq¿jka' wms Tlafldu tl;= fj,d thdg Woõ lruq" ÿl ;=kS lr.kakZZ

Thf.d,a, ;d;a;g f.dvla wdof¾ nj fmakjd' ta ksid ;uhs fuÉpr uykais fj,d thdf.a fõokdj wvq lr, fokak yokafka' yenehs we;a; oek.kak neßj ;d;a;g f,dl= mdvqjla widOdrKhla fjkjd lsh,d Thd,g ysf;kafk keoao@ZZ 102 JANUARY 2019 | DOCTOR MAGAZINE

zzfvdlag¾" f,fâ we;a; ;;a;ajh oek .;a; lsh, thdg fudllao ;sfhk jdish@ZZ zzneßfj,dj;a Thf.d,a,kag fï doctormagazine.lk

jf.a ;;a;ajhla ;sífnd;a@ ta .ek oek.;a;u" Thf.d,af,da fudk jf.a fohla lrhso@ZZ u| fj,djla l,amkd lrñka isá Tjqka fufia mjikakg Wkd' zzwmsg kï lrkak f.dvla foaj,a ;sfhkjd' bjr lr.kak neß Wk jev fldÉpr ;shkjo@ZZ zz;d;a;g;a tfyu ;uhs' thdg b;=re fj,d ;sfhk ld,h fldfyduo .; lrkafka lsh,d ie,iqï lr.kak mq¿jka' bjr lrkak neß fj,d ;snqKq jev bjr lr.kak thdg wjia:djla ,efnkjd' yeu ukqiaifhl=gu j.lSï lsh, fohla ;sfhkjfka' wms yefudagu mq¿jka bkak ldf, thdf.a wruqKQ bIaG isoaO lr.kak thdg Woõ lrkak'ZZ ZZwfma ;d;a;d ta j.lSï yeu tllskau ksoyia' wms Tlafldu nkao,d §, ;sfhkafka' u,a,s ú;rhs ;j b;=re fj,d bkafka' th;A .eKQ <ufhla tlal hd¿fj,d bkafk' wfkl" foafmd<;a Tlafldu fno, §,d ;sfhkafkaZZ zzukqiaifhlaf.a cSúf;a j.lSï lsh, lshkafk <uhska lido nkaok tlhs" foafmd< fno,d fok tlhs ú;rlauo@ wmg f,dl=jg fmfkkafk ke;s jqKdg yeu flfkl=gu bjr lrkak ;j jev f.dvla ;sfhkak mq¿jka' ;uka wdi lrk ;eka n,kak hkak' ys;j;=ka iu. wjika iuq.ekSu lrkak''' fï úÈyg wms fkdys;k f.dvla foaj,a ;sfhkak mq¿jka'ZZ zzwfka ukaod'''ZZ fufia lshñka orejka iy ìß| tlsfkld foi n,d .;a;d' zzyß fvdlag¾" tfykï fyñysg lsh,d n,kakflda' yenehs thdg ord. doctormagazine.lk

kak mq¿jka úÈyg" ál ál lshkak'ZZ ZZfndfydu ia;+;shs' Thd,f.a ;SrfKag' f,vdg krlla fjk lsisu fohla uu lshkafka kE'''ZZ fufia mjiñka frda.shdf.a mjqf,a wh iu.u frda.shd isáh ;ekg .sfhñ' zzoeka Thdg fldfyduo@ZZ zzmqÿu iekiSula ;sfhkafk" fvdlag Thdg f.dvla msx'''ZZ azzThdf. f,fâ .ek Thdg fudlla yß uf.ka oek. kak ´kso@ZZ zzwfka fvdlag¾" msx isoaO fjhs' ug lshkak' lsisu flfkla uf.ka l,ska fufyu wy, kE'ZZ zzThdg ysf;kafka" Thdg fudk jf.a f,vla ;sfhkjd lsh,o@ZZ zzl,ska fvdlag¾, kï lsõfj uq;%d fndlalg háka f.ähla ;sfhkj lsh," m%;sldr l<du fyd| fjhs lsh,;a lsõj' nh fjkak tmd lsh,;a lsõjd'ZZ zzThdg ysf;k úÈhg ;sín f.äh fudk jf.a tlla lsh,o ysf;kafk@ ZZ zzwfka fvdlag¾" uu fï we;a;uhs lshkafk' ug uq, b|,u f,dl= ielhla ;sín' fïl kslïu f.ähla fjkak nE' wksl ug fnfy;a lrmq jdÜgqfõ ysá Tlafldu ms<sld f,âvq' wksl uu fïl fldfyduo uf.a f.or whf.ka wykafka' ta wh nh fjhs lsh,d ys;=kd' fvdlag¾ia,f.ka wykak lsh,d lSm j;djlau W;aidy lrd' ta;a talg ta whf.ka fj,djla .kak ug neß jqKd' yenehs oekakï ug f,dl= ielhla ;sfhkjd" fïl kslï f.ähla kï fjkak nE' ug ;sfhkafk ms<sldjla fkao@ lula kE" nh ke;=j lshkak uu nh fjkafka kE' ú¢kak ´k ÿla lkaord Tlafldu

JANUARY 2019 | DOCTOR MAGAZINE 103

uu ú|,d bjrhs' fvdlag¾g mskaisoao fjkak uu oeka iekis,af,ka bkakjfk'ZZ zzThd ys;mq foa yß' Thdg ;sfhkafk mqriaÓ .%kaÓfha ms<sldjla'ZZ zyefudau ksyeçhdjlska isáhd' B<Õ fudfydf;a isÿ fjkafka l=ulaoehs iEu iEu fokdu ;=< ;snqfKa oeä ielhls' zzfvdlag¾" ug we;a; lshkak" ug f.dvla ld,hla kE fkao@ lula kE fvdlag¾" ug we;a;u lshkak'ZZ Tyqf.a fofk;ska l÷¿ je.sfrkakg úh' wi, isá ìß| yd orejkao l÷¿ j.=rejkakg úh' ieuf.a fYdalh m%ldY lsÍfï whs;sh iy wdldrh uekúka wjfndaO lrf.k ;snQ ud wjYH ;rï ld,h Tjqkag ta i|yd ,nd ÿkafkñ' frda.shd ;u l÷¿ Wrysiska msi ouñka ;u fYdalh m%ldY lsÍug ;ud ,o ld,h m%udKj;a nj ;u bßhõj,ska ud yg wjfndaO lrùh' zzThd ys;kafk fldÉpr ld,hla ;sfhkjd lsh,o@ ZZ uu fmr<d frda.shdf.ka weiqfjñ' u| fõ,djla ksy`vj isá Tyq ksye`ähdj ì|,ñka uDÿ niska fufia mejiSh' zzjeä ld,hla kï fjkak nE' ug oeka mgka .;a; ldf, jf.a fkfjhs f.dvla wudrehsfkZZ zzTõ" ug;a tal yßhgu lshkak nE' ld,h f.dvla wvqhs' f.dvla fj,djlg tal flá udi .Kkla fjkak mq¿jka' yenehs wjqreoaola jf.a ld,hla miqlrk tl ug ys;d.kak f.dvla wudre fohla' fïl oek.;a;u Thdg fudllao ysf;kafk@ZZ zzfudkj ys;kako fvdlag¾" fj,dj wdju ´fku flfkla hkak ´ksfk' tal j<lajkak ldgj;au nE' ta;a uu oeka talg nh kE' uf.a Ôúf;a f.dvla jev uu bjr lr,d ;sfhkafka'ZZ zz;j;a fudkjd yß úfYaI fohla" wdi lrk fohla lrkak b;=refj,d ;sfhkjdo@ZZ uo fõ,djla l,amkd l< Tyq fufia mejiSh' zzo<od ud,s.dj je| .kak ;snqfkd;a fyd|hs lsh, ysf;kjd'''ZZ tu b,a,Su m%dfhda.slj bgqlr Èh yels whqre f.or wh iuÕ idlÉPd lr ie,iqï lsÍfuka 104 JANUARY 2019 | DOCTOR MAGAZINE

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wk;=rej Tyqg ksfjfi § .ekSug wjYH fuda*ska fõokd kdYl fm;s o wfkl=;a T!IO iy Wmfoiao imhd Tjqka msg;alr yeÍñ' fï l;dfjka úia;r lrkafka ,xldfõ mqoa.,sl frday,la ;=< m%Yia; uÜgfï iyk i;aldrl fiajdjla (Palliative care service) ,ndÿka wdldrhlah' by; l;dj lshùfuka wmg W.; yels foaj,a fudkjdo@

cSú; ld,h iSud lrñka Ôú;hg ;¾ckhla f.k fok ms<sld jeks frda.j,ska mSvd ú¢k frda.Ska fukau Tjqkaf.a mjq,aj, whgo ;u frda.S ;;a;ajh iy ta ms<sn|j i;H f;dr;=re wjxl ikaksfõokh ;=<ska oek .ekSfï oeä wjYH;djhla we;' fï i|yd Tjqka fjkqfjka m%udKj;a ld,hla ,nd §u b;d jeo.;ah'

ms<sldjla jeks frda.hla je,£ iqj l< fkdyels ;;a;ajhg m;ajQ frda.sfhl=f. ka tu i;H f;dr;=re jika lrk fuka kEoE ys;ñ;=rka b,a,Sï lrkafka tu frda.shd flfrys we;s oeä wkqlïmdj ksidh' tjka wjia:djl f;dr;=re oek.ekSug frda.shd oeä leue;a;lska isà kï Tyqg ta i|yd we;s whs;sh b;d ixfõ§ f,i mjqf,a whg wjfndaO lr§u m%;sldr lrk ffjoHjrhdf.a hq;=lula fukau j.lSulao jk w;r ta i|yd oeä bjiSula ;¾lkfha ukd ksmqk;djhla" .eg¨ ksrdlrKh lsÍfï m%Yia; yelshdjla iy ikaksfõokfha msßmqka njla Tyq i;= úh hq;=h'

,xldfõ .=Kd;aul urK o¾Ylh (Quality of Death Index) b;d my< w.hl mj;S' j¾I 2015 Economic Intelligence Unit jd¾;djg wkqj ,xldjg ta i|yd ,eî we;s w.h ishhlska 27'1ls' f,dalfha by<u .=Kd;aul urK o¾Ylh uyd ì%;dkH i;= jk w;r th 2015 j¾Ifha§ 93' 9 ls' frda.Skag ;u frda.S ;;a;ajhka ms<sn|j Tjqkaf.a b,a,Su u; ksjerÈ f;dr;=re imhd iqjl< fkdyels frda.Ska f.a Ôú;fha ;ukag b;sßj we;s ld,h ukdj ie,iqï lsÍug Wmldr lr ukd iyk i;aldr fiajdjla ;=,ska frda.Skaf.a fõokdj we;=¿ ldhsl mSvdjkago udkisl wdOHd;añl iy iudchSh mSvdjkag m%dfhda.sl úi÷ï ,nd§ Tjqka iykhg m;alsÍu ;=,ska Tjqyq fuu ;;a;ajh Wodlrf.k ;sfí'

doctormagazine.lk

iqjl< fkdyels frda.S ;;a;ajhkaf.ka oeä mSvdjka ú¢k frda.Skaf.a oeä ldhsl fõokdjkag ÈjHuh T!IOh jkafka fuda*skah' ;;amr lsysmhlska ldhsl fõokdj uev,Sug Bg yels jQ whqre fï l:dfjka meyeÈ,s úh' wjdikdjlg ,xldfõ fujeks frda.Ska fndfydauhlg fuda*ska T!IOh ;u fõokdjka uev,Sug ,nd.ekSfï yelshdj b;d wvqh' tneúka fndfydauhla fujeks frda.Ska ;u Ôú;fha wjidk ld,h .; lrkqfha b;d oeä fõokdjkaf.ka wiSñ; f,i mSvd ú¢ñks' fujeks frda.Ska i|yd fõokd kdYkh Wfoid fldmuK fuda*ska m%udKhla Ndú;d lr we;ao hkak tu rfÜ fi!LH ;;a;ajh uek n,k m%Odk ñkqï oKavla f,i Ndú;d lrkq ,efí' ta w;ska ,xldj b;d my;a uÜgul isák w;r tu ;;a;ajh fjkia lr m%Yia; fõokd kdYlhla Wfoid lghq;= lsÍu ish¨u fi!LH ld¾huKav, rfÜ foaYmd,k kdhlhska fukau m%cdj i;= j.lSula jkafkah'

JANUARY 2019 | DOCTOR MAGAZINE 105

f;,sosfhys úYañ; fmdaIKh

tod wfma wdos uq;=ka ñ;a;ka ksfrda.S njg bjy,a jQ úI kik

ls;=,a

uyck fi!LH mßlaIljrekaf.a ix.ufha WmfoaYl .euqKQ id,sh fmf¾rd

106 JANUARY 2019 | DOCTOR MAGAZINE

doctormagazine.lk

ls;=,a wdiksla" leâñhï úi kikjd''' WoaNso úoHd;aulj Caryota Urens hkqfjka ye|skafjk ls;=,a .fika jir fooyig;a fmr isg furg jeishka M, m%fhdck ,ndf.k we;s njg idlaIs ;sfnkjd' 1830 j¾Ih ;odikakfha furg we;sjQ ÿ¾NslaIfhaoS wfma me/kakkaf.a osú /l oS we;af;ao ls;=,a msá wdoS fy< ksmehqïh' ckl;d j, fukau merKs jxYl;d" wgqjd" àld j, fukau ;j;a fndfyda uq,dY% j, ls;=,a yd ine|S i|yka fndfydah' wdydrhla fukau T!IOhla jYfhkao ls;=,a ksmehqï m%fhdackhg .;a b;sydih wo ojfiao idlaIs we;' ls;=,a ksmehqï j, fmdaIKSh .=Kh iy T!Iëh jákdlï ms<sn|j kQ;k wkdjrKhka wm uú; lrjk iq¿h' tu wkdjrKhka Tiafia Tfí oeKQu iú .kajkakg fu;eka isg .kakd W;aihls fï'

doctormagazine.lk

ls;=,a wdiksla" leâñhï yd wfkal úi kihs wm wo ojfia wdydrhg .kakd fndfyda wdydr j, fndfyda úI we;' m,sfndaOkdYl úI" wdiksla" leâñhï" Bhï jeks ner f,day j,ska wfma wdydr úI ù we;s nj fkdryila fkdfõ' iajNdjO¾ufha YdL j,g tys we;s ridhkhkag fïjdfha we;s jiúi YÍrhg ydkshla fkdjk fia neyer,kakg úYañ; yelshdjla we;s nj y÷kdf.k ;sfnkjd' (Metal Ion chelation activity) ls;=,a f;,osfhyso fï uydkqn, iïmkak yelshdj mj;akd nj fld<U úYAj úoHd,hSh úoHd mSGfha m¾fhaIlhka msßila úiska lrk ,o m¾fhaIKhlska ikd: ù ;sfnkjd'

oshjeähdjg wdfoaYlhla hï wdydrhla oshjeähdj fkdfyd;a reêrfha .a¨fldaia idkaøKh by< kxjkakg fya;= fjkjdo hkak y÷kd .ekSug fhdod .kafka Glycemic Index hkakhs' wm Ndú;d lrk iSks j, we;af;a iqfl%daia kue;s iSks j¾.hhs' iSks iy iqÿ mdka msáj, .a,hsisñla w.hka ms<sfj,ska 70 yd 65-70 fjhs' m,;=re j, iq,nj yuqjk mDlafgdaia kue;s ir< iSks j¾.fha .a,hsisñla w.h 12-25 w;r w.hla .kS' .a,hsisñla w.h jeä wdydr wkqNjhg .ekSu oshjeähdj je<|Sug yd ;sfnk oshjeähdj frda.h W;aikak lsÍug fya;= jkafkah' ls;=,a meks yd ls;=,a yl=re j, we;af;a mDlafgdaia" iqfl%daia yd .aÆfldaia ñY%Khls' fuys .a,hsisñla w.h wdikakj 35ls' fï wkQj ls;=,a yl=re yd ls;=,a meKs ie<flkafka uOH .a,hsisñla w.hla iys; wdydr jYfhks'

ls;=,a yl=re yd ls;=,a meKs ie<flkafka uOH .a,hsisñla w.hla iys; wdydr jYfhks' JANUARY 2019 | DOCTOR MAGAZINE 107

wmg wo fï msßisÿ ls;=,a ksIAmdok fidhd .ekSu úYd, wNsfhda.hla ù ;sfí' mdrïmßlj fï /lshdjka j, ksr; Woúh mjd fï ksmehqï msßisÿj ksIAmdokh lrk wjia:d b;d úr,h' ls;=,a yoj; iqrlsk osj Tiqjls Y%S ,xld ld¾ñl ;dlaIK wdh;kh (ITT) fld<U úYaj úoHd,fha ridhk úoHd yd i;a;aj úoHd wxY taldnoaOj isÿ lr we;s wOHhkhlg wkQj ls;=,a meKs yd ls;=,a yl=re wdydrhg .ekSfuka reêrfha wys;lr fldf,iagfrda,a uÜgu iy ;j;a wys;lr fldf,iagfrda, m%fNaohla fia ie<flk g%hs.a,sirhsv uÜju iS>%fhka my< nisk nj;a ys;lr fldf,iagfrda,a uÜgu by< kexfjk nj;a y÷kdf.k ;sfí' tfiau yDo frda. we;sùu iïnkaO o¾Ylhla jk Atherosclerosis Index wkQj yDo frda. wjodkuo my; fy<k nj;a fy<sorõ ù ;sfí'

f;,sosh ^f;,scAc& i;= ms<sld kdYl .=Kh uú; lrjk iq¿hs ls;=,a uf,a idrfhka ,nd .kakd f;,sosh kï f,dj wka lsisÿ ;d, j¾.fha jDlaIhlska ,nd.; fkdyels ;rfï Yla;sckl fi!LHiïmkak mdkhls' wm jhig hdu fõ.j;a lrk" ffi, mgl wdmodjg ,la lrjk" ms<sld wdosh we;sùfï wjodku jeä lrjk uqla; LKavl hdka;%Kh (Free Radicals) md,kh lsÍu msKsi fhdok ljr fyda W;aidyhla fõ kï th ksielfhkau wmj wdrlaId lrjk W;aidyhla" m%h;akhla jkafkah' ta i|yd wmg l< yelafla wm tosfkod wdydrhg .kakd .=Kj;a wdydr Tiafia jeä m%;sTlaisldrl m%udKhla YÍr.; lr .ekSuhs' ls;=,a uf,a fï m%;sTlaisldrl .=K b;d úYd, jYfhka mj;akd nj y÷kdf.k ;sfí' ta yereKQ 108 JANUARY 2019 | DOCTOR MAGAZINE

úg weiafldìla wï,h ^úgñka iS&" msfkda,sl ixfhda. iy *a,efjdkhsvo úYd, ixhq;skaf.ka mj;sk ksid ms<sld wdos frda. j,ska ñfokakg fï f;,sosfhka ,efnkafka uy`.= jQ /ljrKhls' tfia jQj;a wmg wo fï msßisÿ ls;=,a ksIAmdok fidhd .ekSu úYd, wNsfhda.hla ù ;sfí' mdrïmßlj fï / lshdjka j, ksr; Woúh mjd fï ksmehqï msßisÿj ksIAmdokh lrk wjia:d b;d úr,h' fï ksid wm fï lshk ,o .=Khka j,ska idr ksIAmdok fidhd .ekSu myiq lreKla fkdfõ' tfia jQjo wdfrda.H iïm;a;sh .ek ie<ls,af,ka fyda .=Kj;a ls;=,a ksIAmdokh osß .ekaùug jevms<sfj,la fhoùfï ld,Sk wjYH;djh wo ojfia mek ke.S ;sfí' ••• doctormagazine.lk

COUNSELLING

lsishï odl lsishï fudfyd;l wm ldg;a m%fhdackj;a úh yels

WmfoaYkh fyo ks,OdÍ ixch o is,ajd BN (Malaysia), Dip. in Psychology & Counselling (SL)

WmfoaYkh" tfyu;a ke;skï Counselling wo ld,fha jeämqr wefik jpkhla' we;a;gu fudllao fï WmfoaYkh lshkafka@ ldgo fïl jeo.;a fjkafka@ WmfoaYkh ,nd .;hq;= wjia:d fudkjdo@ fï lreKq .ek álla l;d lrkakhs wo wfma n,dfmdfrd;a;=j' doctormagazine.lk

JANUARY 2019 | DOCTOR MAGAZINE 109

WmfoaYkh hkq l=ulao@ WmfoaYkh lshk jpkh weiqKq .uka iuyre ys;kafka flfkl=g we;s m%Yak úi|.kak Wmfoia ,nd §ula ;uhs fuys§ flfrkafka lsh,d' kuq;a we;a;gu Counselling lshk fohska woyia lrkafka tal fkfjhs' Counselling lshkafka lsishï flfkl=g ;udf.a Ôú;fha we;s m%Yakhla" .eg¿jla" ke;skï hï lsis lrorldÍ yeÕSula jeks fohla .ek wdrlaIs;" tfukau fm!oa.,sl;ajfhka hq;= mßirhla ;=< idlÉPd lsÍug bv i<id §ula' fuys§ mqoa.,hdg ;udf.a .eg¿j ms<sn|j ksoyfia l;d lrkak bv ,efnkjd muKla fkdj ta ms<sn|j fyd| wjfndaOhla ,ndf.k ;ukaf.au úi÷ula fidhd.ekSug;a Wkkaÿ flfrkjd' Counselling lshkafka uQ,sl jYfhkau —l;dny lsÍu˜ uq,a fldg.;a m%;sldr úêhla lsõfjd;a jvd;a ksjerÈhs'

WmfoaYkh wjYH jkafka udkisl frda. j,ska fmf<k whg muKla hehs Tn is;kjd kï th jerÈ woyila' wms ldg;a lsishï fudfyd;l WmfoaYkh m%fhdackj;a fjkakg mq¨jka'

´iafÜ%,shd ufkdaÑls;aid yd WmfoaYk f*vf¾Ikhg wkqj WmfoaYkh hkq iqÿiqlï,;a WmfoaYljrfhl= yd fiajd,dNshl= w;r we;sjk wdrlaIs; yd ryiHNdjfhka hq;= tluq;=jla' fï tluq;=fõ wruqK jkafka fiajd,dNshdf.a udkisl fi!LHh yd hymeje;au m%j¾Okh lsÍu" ;ud ms<sn| wjfndaOh jeäÈhqKq lsÍu yd y÷kd.;a .eg¿ j,g úi÷ï fidhd ne,Su hkdÈhhs'

WmfoaYkh wjYH jkafka ldgo@ WmfoaYkh wjYH jkafka udkisl frda. j,ska fmf<k whg muKla hehs Tn is;kjd kï th jerÈ woyila' wms ldg;a lsishï fudfyd;l WmfoaYkh m%fhdackj;a fjkakg mq¨jka' tÈfkod Ôú;fha wm uqyqKfok iudchSh m%Yak" mqoa., iïnkaO;d ms<sn| .eg¿ yd mjq,a m%Yak" /lshd m%Yak" u;aøjH iïnkaO .eg¿" wOHdmkh iïnkaO .eg¿" Ndjd;aul ^yeÕSï iïnkaO& m%Yak fyda Tnf.a ys;g jofok ´kEu .eg¿jl§ WmfoaYkh i|yd fhduqùu b;du jeo.;a' ys;g jofok m%Yakhla ysf;a ;ndf.k bkakjdg jvd ldg fyda mejiSu ;=<ska ys;g uy;a iykhla ,efnk nj Tn;a w;aoelSfukau okakjd we;s' b;ska tn÷ fohla .ek idudkH flfkl=g lshkjdg;a jvd ta ms<sn|j iqÿiqlï,;a" Tng Woõ ùfï yelshdj we;s" tfukau Tfí ryiHNdjh iqrlsk WmfoaYljrhl=g mejiSu b;d m%fhdackj;a jkq we;s'

WmfoaYkh isÿlrkafka flfiao@ WmfoaYkh ;ks mqoa., (Individual Counselling) fyda lKavdhï (Group Counselling) jYfhka isÿl< yelshs' ;ks mqoa., WmfoaYkfha§ Tn iy WmfoaYljrhd muKla l;dny lrk w;r lKavdhï WmfoaYkfha§ tl yd iudk .eg¿ we;s lsysm fofkl=f.ka iukaú; lKavdhula iuÕ WmfoaYljrhd l;dnia lrkjd' ;udg iqÿiq ljr wdldrfha WmfoaYkhla oehs f;dard.ekSug WmfoaYljrhd Tng Woõ jkq we;s' WmfoaYkfha§ isÿjkafka Tn iy WmfoaYljrhd lsishï ksYaÑ; fõ,djl§ yuqù Tnf.a .eg¿j ms<sn|j idlÉPd lsÍuhs' fuh fndfydaúg isÿjkafkA WmfoaYljrhdf.a idhkfha§ jk kuq;a úfYaI fya;=jla u; f;dard.;a fjk;a ia:dkhla jqjo fï i|yd fhdod.; yelshs' fuu yuqjla idudkHfhka

110 JANUARY 2019 | DOCTOR MAGAZINE

doctormagazine.lk

úkdä y;<syla mKyla jeks ld,hla mej;sh yelshs' fun÷ yuqùï fldmuK .Kkla isÿl< hq;= o hkak .eg¿fõ iajNdjh wkqj iy mqoa.,hd WmfoaYkhg m%;spdr olajk wdldrh wkqj fjkia úh yelshs'

WmfoaYk úê ;ks mqoa., yd lKavdhï WmfoaYkh .ek wms l<ska l;d l<d' óg wu;rj mjq,a iïnkaO;d ms<sn| .eg¿ i|yd mjq,a WmfoaYkh" <uqka iy fh!jkhkaf.a .eg¿ i|yd <ud yd fh!jk WmfoaYkh" ,sx.sl .eg¿ i|yd ,sx.sl WmfoaYkh" u;aøjH weíneysùï i|yd u;a WmfoaYkh hkd§ jYfhka WmfoaYkh úúOdldrhs' fuhska iuyr wxYhka ms<sn|j úfYaI oekqula yd mqyqKqjla we;s úfYaI{ WmfoaYljreka o isákjd' ta yereKqfldg

fiajd,dNsfhla ;ud iuÕ l;dlrk iEu fohlu ryiHNdjh yd fiajd,dNshdf.a fm!oa.,sl;ajh wdrlaId lsÍug iEu WmfoaYljrfhlau wdpdrO¾u w;ska fukau kS;suh w;skq;a ne£ isákjd' doctormagazine.lk

tla tla .=rel=,hka wkqj yd Tjqka WmfoaYkh i|yd fhdod.kakd m%fõYhka iy l%ufõohkaf.a fjkialï wkqj o WmfoaYkh j¾.SlrKh flfrkjd' fln÷ j¾.hlg wh;a jqj;a fmdÿfõ .;al, WmfoaYkfhka isÿflfrkafka mqoa.,hdf.a udkisl hymeje;au j¾Okh lrñka mqoa., ixj¾Okh ;=<ska Tyqf.a fyda wehf.a m%Yia; YlH;dj <Õd lr.ekSug Woõ lsÍuhs'

WmfoaYkh yd ryiHNdjh fndfydaúg flfkla WmfoaYkhg fhduqjkafka ;udf.a fm!oa.,sl .eg¿jla ms<sn|j idlÉPd lsÍughs' fuys§ fndfydafofkl=f.a is;g tk m%Yakhla jkafka WmfoaYkfha§ ;udf.a ryiHNdjh fl;rï ÿrg wdrlaId fõúo hkakhs' ;ud WmfoaYljrhd iuÕ l;dnia lrk w;sYh fm!oa.,sl ldrKh fjk;a flfkl= oek.;fyd;a ;udg m%Yak j,g uqyqKfokakg fyda ,Êcdjg m;afjkakg isÿjkq we;ehs Tjqka ìhg m;a fjkjd' kuq;a tf,i ìhùug wjYH jkafka keye' fiajd,dNsfhla ;ud iuÕ l;dlrk iEu fohlu ryiHNdjh yd fiajd,dNshdf.a fm!oa.,sl;ajh wdrlaId lsÍug iEu WmfoaYljrfhlau wdpdrO¾u w;ska fukau kS;suh w;skq;a ne£ isákjd' kuq;a my; oelafjk úfYaI wjia:dj,§ fiajd,dNshd .ek hï hï lreKq fjk;a md¾Yjhkag fy<s lsÍug WmfoaYljrhdg yelshdj ;sfnkjd' • fiajd,dNshd ;udg fyda wkqkag ydkshla lsÍug hk nj oek.;a wjia:djl • ;udf.a f;dr;=re fjk;a md¾Yjhlg fy<slrk f,i fiajd,dNshd úiskau b,a,d isá wjia:djl • fiajd,dNshd ms<sn| lsishï f;dr;=rla fy<slrk f,i Widú ksfhda.hla ,enqKq wjia:djl • <ud wmpdrhla iïnkaO isÿùula oek.ekSug ,enqKq úg fun÷ wjia:djl§ mjd f;dr;=re ,ndfokafka thg wod< mqoa.,hka fj; muKhs' tfia lrkafka fiajd,dNshdf.a yd wka whf.a hym; Wfoidhs' fï lreKq iaj,amh lsheùfuka Tng Counselling ke;skï WmfoaYkh .ek uQ,sl wjfndaOhla ,efnkakg we;ehs is;kjd' hïlsis fohla iïnkaOfhka Tng WmfoaYkh wjYH jqjfyd;a fï lreKq m%fhdackj;a jkq we;s' JANUARY 2019 | DOCTOR MAGAZINE 111

fydañfhdam;s ffjoH l%uh

fi,shq,hsáia iqj lrk fydañfhdam;s m%;sldr

fydañfhdam;s ffjoH wkqId fyaul=udr úisks 112 JANUARY 2019 | DOCTOR MAGAZINE

wo j;auka iudcfha fndfyda fofkl=g fkdis;= fudfyd;l we;súh yels fõokdldÍ frda.S ;;a;ajhla f,i fi,shq,hsáia frda.h yeÈkaúh yel' iq,nj mdo j, fï ;;a;ajh we;súh yels w;r fuh j<¨lßka mgkaf.k l%ufhka by<g hdula olakg ,efnk w;r fuh oKysfika by, olajdu me;sr hd yel' mqxÑ orejkaf.a uqyqfKa yg.; yel' l%shdYS,s jhfia isák orejdf.a isg uy,a,d olajdu wdidokhg f.dÿre úu ljr fudfyd;l isÿ fjkjdo ldgj;a lsj fkdyel' doctormagazine.lk

ffjoH;=ñhks" fi,shq,hsáia frda.h lshkafka l=ulao@ fi,shq,hsáia ;;a;ajh f,i yÿkajkafka iug háka we;s uDÿ mgl j, Streptococcus fyda Straphylococcus nelaàßhd wdidokh ù me;sr hduhs' fndfyda úg Èhjeähd frda.Skaf.a reêr.; isks md,kh fkdjk wjia:djkays§ o" .,a;e¨ï we;s úgo" kyr .eg .eiSï we;s úgo" mdo weÕs,s lre j, È,sr wdidok we;s úgo" i;a;aj kshfmd;= fukau ;udf.a leiSï j,§ we;sjk kshfmd;= isÍï" lïì j,g isÍï" jeàï" imd lEfuka we;s jk úimamq jeks ;;a;aj" ks;r ;=jd, we;sjk whgo" ú¨U me,Sï we;súfukao wm fkdis;k wdldrhlg úiîc YÍr.; úh yel'

ffjoH;=ñhks" fi,shq,hsáia frda.sfhl=f.a uq,sl ,laIK fudkjdo@ fi,shq,hsáia ;;a;ajh we;s jqKq frda.shl= wm y÷kd .ekSfï§ uq,sl ,laIK f,i tu ia:dkh bÈóu olakg ,efnkjd' fndfyda fofkl=f.a mdoj, fuh oelsh yel' fuu bÈuqu by,g me;sr hd yel' há m;=,o bÈuqu f.k Èh yel' u;=msáka iu r;=ùu" ,m le<e,a fukao" ;=jd, le<e,a fukao" ÈhmÜgd

fi,shq,hsáia frda.hg k;= jQ mdohl msáka n,k úg fï wdldrfha fjkialï we;s úh yel

doctormagazine.lk

f,i we;sùuo wdidokh ;;a;aj wkqj fjkia ù we;súh yel' wêl leiSula we;sùu" oeú,a,la f.k§u" mqmqre .ikjdla fuka b;d fõokdldÍ ;;a;aj f.koS weúoSug" isgf.k isàug fkdyels ùu fuys m%Odk ,laIK f,i yeÈkaúh yel' ;jo" fjõ,d WK we;sùu" is;, .;sh oekSu" reêr.; ESR, CRP w.h by< hdu fuys§ oelsh yel' fuu ;;a;ajh ksjerÈj yÿkd m%;sldrh ksjerÈj fkdjqkfyd;a Nhdkl ;;a;ajhla we;súh yel' we;eï úg urK ;¾ckSh wjia:d Wodúh yel' nelaàßhdj wdidokh jQ uDÿ mgl Èf.a reêrhg we;=¿ ù reêrh yryd uq¿ YÍrh mqrdu úiîc me;sr hd yel' tjeks wjia:djka ðú;hg ;¾ckhla úh yelsh' ;j;a ixl=,;djla jkafka uia lk nelaàßhdj fkdfyd;a Necrotizing Facilities ;;a;ajh" túg ifï ffi, fldgia" uDÿ fldgia yd Bg háka we;s udxYfmaYska mjd fuu nelaàßhdjg úkdY l< yel' túg mgl blaukska úkdY ù úYd, ;=jd, njg m;a jkjd' fuh iuyr úg mdoh lmd bj;a lrk ;;a;ajhg m;ajkakls'

fï ioyd fydañfhdam;s m%;sldrmj;skjdo@ nelaàßhd úkdY lrk T!IO fydañfhdam;s m%;sldr j, ;sfnkjd' fydañfhdam;s m%;sldr j,§ frda. ,laIK wmg b;d jeo.;a fjkjd' mqoa.,hdf.ka mqoa.,hdg mj;sk YÍr m%;sYla;sh wkqj wdidokh jk wdldrh fjkia fjkjd' fmkajk frda. ,laIK o fjkila fyda fjkiaùula olakg ,efnkjd' fuys§ ffjoHjrhdf.a olaI;djh" ksjerÈ T!IOh frda. ,laIKj,g wkqj f;aÍu jeo.;a jkjd'

JANUARY 2019 | DOCTOR MAGAZINE 113

iu r;a meye .ekSu" ia:dkfha WKqiqula oekSu" bosóu" iu >k Ndjhg m;aùu fi,shq,hsáia frda. fhaoS w;aú|skakg isÿjk ,laIK jkafkah fydañfhdam;s m%;sldr uq,O¾uhg wkqj iqj ùu isÿjkjd' fuys§ ÿ¾j, jQ YÍr m%;sYla;slrKh f.dvk.ñka úiìchg tfrysj igka lrkjd' fyd| reêr .ukd.ukla kyr ;=< we;s lrkjd' ta iu. bÈuqu ke;sj hdu" fõokdj ke;sj hdu iu. wdidÈ; ;;a;ajh myj hdu;a isÿjkjd' frda.shd úYañ; iqjhla w;aolskjd'

fjk;a frda. j,g;a fydañfhdam;s m%;sldr ;sfnkjdo@ fi,shq,hsáia jf.au ish¨u p¾u frda." wd;rhsáia" mdlskaika" fld÷wegfmf,a wdndO" iakdhqfrda." w;a md j, ysßjeàu" fjõ,su" kyr

114 JANUARY 2019 | DOCTOR MAGAZINE

.eg .eiSu" w¾Yia" y¾kshd" brejdroh" wl,g flia iqÿùu" .e,ùhdu" o;auq,a Èhùu" wdudY.; frda." u<noaOh" ,sx.sl frda." yDofrda." wlaudfrda." jl=.vq uq;%dY frda." Èhjeähdj" wêl ia:q,;djh" leiai" weÿu" mski" ish¿ ldka;d frda.''' wd§ iEu frda.hlguo fydañfhdam;s ffjoH l%uh ;=, T!IO ;=,ska iqjh ,eìh yelsjkjd' th Tng ksfrda.su;a Èúhlg Èj Tiq w;aje,la jkq fkdwkqudkh' •••

ffjoH .eg¨ ioyd úuiSï 0112 731 695 0718250716$17

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ksfrda.su;a ,dxlSh ck;djla ìyslsÍu i|yd

Èhjeähd frda.fhka j<lsuq

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JANUARY 2019 | DOCTOR MAGAZINE 115

Èhjeähdj lshkafka fudllao@ jpkfha mßiudma; w¾:h ie,l= úg o< wjfndaOhla wkqj jeäfhka c,h msgù hdu" tkï jeä jdr .Kkla uq;%d msg ù hduhs' wfma rfÜ o fndfyda jHdma;j we;s jix.; frda. w;ßka fnda fkdjk jix.; frda. >Khg wh;a m%Odk frda.h jkafka Èhjeähd frda.hhs' wdhq¾fõofha fuh ÛuOqfïyh¶ f,i y÷kajhs' iqj l< fkdyels uyd frda. wgla wdhq¾fõofha olajd we;' ñka tlla jkafka Èhjeähdjhs' Èhjeähd frda.h lsisu frda. ,laIKhla fkdfmkajd È.= ld,hla ksyËj isrer ;=< mj;S' Èhjeähdjg m%Odku fya;= jkafka msá iy iSks wêl lEu wdydrhg .ekSu yd YÍrhg wjYH jHdhdu fkd,eîuo" udkisl wd;;sho fõ' ,xldfõ Èhjeähd frda.Ska ixLHdj ishhg 10ls ;jo mQ¾K Èhjeähd ;;a;ajfhka isák ixLHdj ishhg 11la jYfhka f.k iïmQ¾Kfhka .;a l< ishhg 21la muK Èhjeähd frda.Ska isák nj weia;fïka;= lr we;' fï wkQj" wfma rfÜ iEu mqoa.,hka mia fokl=u tla wfhla Èhjeähd frda.sfhl= fõ'

yïnkaf;dg wdhq¾fõo uy frdayf,a ffjoH wkqr úfÊfialr

Èhjeähd frda.hg fya;= • w.akHdYh ksis f,i l%shdldÍ fkdùu yd bkaishq,ska fydafudakh ksmoùu wvqùu fyda ;sfnk bkaishq,skaj, l%shdldß;ajh wvqùu fyda m%udKj;a bkaishq,ska fydafudak m%udKhla ksmoùfï fkdyelshdj' • w.akHdYh ,eka.yka §msld ffi, wjfrdaO;djh fyj;a b;d isyska kd, j, ^f>%da;ia& wjfrdaO;djh' fï ksid bkaishq,ska fydafudakh ksmoùu yd >%djh lsÍfï wjfrdaO;d we;sfõ' • weÕm; fkdfjfyid jeäfhka ksod .ekSuo §lsß" uia" ud¿ wêl ud;%dfjka fNdackho w¨;a iy,a n;a lEuo me‚ ri jeä lEu j¾.o" wêl msá iys; wdydr .ekSuo Øfï frda.hg fya;= fõ' îdrd¾: ix.%yh msgqj 759& óg wu;rj udkisl wd;;sh" udkisl fkdikaiqka;djh" cdkuh fya;=" uj fyda mshdg Èhjeähdj iEoS ;sîu" úúO ld,Sk frda. i|yd fok ,o T!IO tl È.gu mdúÉÑh • wdhq¾fõo ffjoH úoHdfõ m%fïy frda. úiaila olajd we;' ksis l,g ksis m%;sldr fkdlr fkdl< l,ayS ishü m%fïy frda. l,ahdfï§ uOqfïy îSks iys;& njg meñfK;s' túg ksYapfhkau widOH fj;s' îdrd¾: ix.%yh 759 msgqj& • wdydr .ekSfï§ jerÈ mqreÿ j,ska wdydr .;a úg th Èrùug fmr ks;r ks;r wdydr .ekSuo lD;s%u rildrl" j¾Kl" wêl me‚ iys; wdydr" wêl msá iys; wdydr .ekSu hk lreKq Èhjeähd frda.hg fya;= fjhs'

116 JANUARY 2019 | DOCTOR MAGAZINE

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y÷kd fkd.;a Èhjeähd frda.fha uq,a wjia:dfõ lrk meñ‚,s

Èhjeähd frda.Skag Wmfoia

• miq.sh ojiaj, ug mqÿu msmdihla ;snqK;a fldhs ;rï j;=r ìõj;a msmdih wefrkafka kE

• Tfí f,aj, iSks m%udKh idudkH uÜgñka mj;ajd .kak

• uf.a nr tkak tkaku wvq fjkjd jf.a oefkkjd • uf.a ifï leis,a,la ;snqKd • oji mqrdu ug yßu f;fyÜgqhs' ksÈu; .;sh;a jeähs vfï ojia j, m;a;r n,k úg wl=re fnd| fj,d jf.a ;uhs fmfkkafka • ,sx.sl m%foaY wdY%s;j leis,a, iy mdoj, weÕs,s leiSu ;sfhkjd • jeä jeäfhka uq;%d msgùu yd YÍrfha oyäh j, ÿ.| nj

• Tnf.a ffjoHjrhd fok Wmfoia b;d ´kElñka ms<smoskak

• Tfí f,a j, iSks m%udKhka ksr;=reju mßlaId lr.kak' ks;sm;d jHdhdu lsÍu" Tfí f,a j, iSks m%udKh md,kh lsÍug;a ;rndre nj wvqlr .ekSug;a W;aidy jkak • YÍrfha mdo isÍï ;e<Sï ;=jd, lr .ekSu iqÿiq ke;' mdoj,g mdjyka mdúÉÑ lrkak' • Èkm;d Tfí fomd j, ;=jd, we;aoehs mÍlaId lr.kak • Tfí weia ksr;=reju mÍlaId lr.kak

• f;d, lg yßhg fõf,kjd jf.a

• udkisl mSvkh md,kh lr ys; ieye,a¨fjka ;nd .ekSug mqreÿ jkak

mdoj, oeú,a, yd weÕs,sj, lgq wkskakdla n÷ oekSu

• Èkm;d Tfí fomd j, ;=jd< iSÍï jeks oE we;aoehs mßlaId lr.kak

• ;=jd, iqj fkdùu

• weÕs,s fl<jfrys ysßh yd mdoj,g ixfõo oekSu wvq nj • úáka úg u;=jk lrleú,a, • uqLhg wêl me‚ ri oekSu iy wêl nv.skak

• udkisl mSvkh md,kh lr is; ieye,a¨fjka ;nd .ekSug mqreÿ fjkak • fl¢ iys; ixlS¾K msIaG .Kfha wdydr .ekSug mqreÿjkak

• fka;%d" l¾K" csyajd" uqL hk m%foaYj, u< wêlj mej;Su • rd;%sfha ke.sg uq;%d lsÍfï wjYH;djh

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JANUARY 2019 | DOCTOR MAGAZINE 117

ie,ls,su;a jkak fujeks wdydr Èhjeähd frda.Skag iqÿiq ke;' rileú,s fpdla,Ü" ìialÜ" fgd*s" mqäka" flala" whsiska oeuQ wdydr" whsial%Sï" fodfod,a" lejqï" uialÜ" jg,mamka" nqkaos me‚ j¾. ls;=,a me‚" fmd,a me‚" Wla.ia" ls;=,a yl=re" .aÆfldaia meKsri îu fuda,aÜ wvx.= msáj¾. j,ska ye¥ îu" fnda;,a l< ri îu" m,;=re îu j¾." .Eia fh¥ îu" lD;%Su msáj,ska iE¥ mdk u;ameka j¾. ìh¾ iy rgîu mdkamsá mdol lr.;a wdydr mdka" nksia" frdá" biamkaÑ" cEïmdia" kQâ,aia" msÜgq hk wdydr b;d l,d;=rlska .; hq;= wdydr w¾;dm,a" fldia" fo,a" w¨flfy,a" u[af[dlald" lsß w," bkak, jeks w, j¾. wvqfjka .; hq;=h

Èhjeähd frda.h md,khg ;%súO YslaId udkisl iqjh jHdhdu yd wdydr mNdjkd lsÍu mO¾ufhys yeisÍu miudc iyÔjkh mffu;%S lsÍu miskyuqiq uqyq‚ka isàu mffjrh fl%daOh w;ayeÍu mudkisl mSvkh wvqjk whqßka jev lsÍu mbjiSu mqreÿ mqyqKq lsÍu ml,a fõ,d we;sj ;u rdcldßh bgq lsÍu mO¾uh weiSu miyÔjkh miduQysl;ajh yd i;=g fnod .ekSu m;ud fukau wka wh .eko is;Su mkuHYS,S nj yd ldre‚l nj mw,xldr f,i 118 JANUARY 2019 | DOCTOR MAGAZINE

f.j;a;la ks¾udKh lsÍu mu,a j. dj miqr;,a uiqka yd iqr;,a i;=ka we;s lsÍu morejka iqr;,a lsÍu mmjqf,a idudðlhka iuÕ iqyoj idlÉPd lsÍu iy iyÔjkh mmeh myla fyda yhla fyd| ksixi, mßirhl ksod.ekSu mWoEik y;r my w;r wjÈùu mÈjd ld,fha ksod fkd.ekSu

jHdhdu lrk yeá jHdhdu .ek úfYaI jYfhka is;g .; hq;= ke;;a ;udg whs;s ffoksl jev lghq;= yd rdcldß wjia:d ksis mßÈ bgq lsÍfuka fyd| jHdhduhla ,efí' • úkdä oyhla mäfm< ke. neiSu • úkdä úiaila ksji msßisÿ lsÍu yd wdydr msiSu • úkdä úiaila wdydr msiSu • úkdä úiaila k¾;kfha fh§u b;du hym;a • weú§u b;du hym;a iajdhq jHdhduh kï weú§uhs' tl ie;mqula úkdä 12la weúÈh hq;=h' Èklg meh Nd.hla weúoafod;a th m%udKj;ah' i;shg Èk ;=k y;rla weúoaofyd;a th m%udKj;ah' weú§u Ôú;fha fldgila njg m;a lr.; fyd;a uekú' weú§u i|yd hdug ld, fõ,djla ke;' ld¾hd, j, we;s úÿ,s fidamdk Ndú;d fkdfldg mäfm< Ndú;d lrkak' fj<|ie,g" ;u wjYH;djhkag hd hq;= úg jdyk Ndú;d fkdlr ta ÿr weúof.k hkak' nia kej;=ï folla ;=kla jeks ÿrla mhska .uka lrkak' doctormagazine.lk

• tla jrlg jeäfhka jHdhdu j, fkdfhfokak' hï jHdhduhla lrk úg idudkH f,i l;d ny l< yels kï ta jHdhdu iqÿiqhs'

• wdydr .kakd úg fyd| YslaIKhla" fyd| mßirhla" ksYaYío;djhla we;sj m%shukdmj ,nd.kak'

• msyskSu" idmamq ijdß j, fh§u" f.j;= jev iq¿ jYfhka isÿlsÍu" f.j;a;la ieliSu" ksji w,xldr f,i ilia lr .ekSu" ul=Kq oe,a leãu" msÕka fldamam fia§u" ksji w,xldr lr .ekSu jeks lreKq jHdhdu hg;g .; yel'

• wu;r wdydrhla .ksoaÈ mjd l=i.sks fj,djg muKla wdydr .kak

wdydr .; hq;af;a fufyuhs

oshjeähdj frda.Skaf.a wdydr rgdj

wm ffokslj wdydr .kakd úg my; i|yka lreKq .ek ie,ls,su;a ùu ish¨ f,v frda.j,ska ñ§ug fya;= fõ' • wdudYfha ;=fkka tlla >k wdydro" wdudYfhka ;=fkka tlla c,h yd fjk;a mdk j¾.o b;sß ;=fkka tl ysiaj ;sfnk whqßka o wdydr .ekSu jeo.;ah' • wdydr ud;%dj ms<sn|j ie,ls,su;a jkak' wêud;% YÍrfha ;rndrej we;s lrhs' ySk ud;%dj kï ud;%dj YÍrh ÿ¾j, lrhs' • nv.skak we;s úg muKla wdydr .kak' • wdydrh Èrùug fmr kej; wdydrhla fkd.kak' vfkd.e,fmk oE wdydrhg .ekSfuka j<lskak' • wid;añl wdydr" Èrùu wmyiq wdydr .ekSfuka j<lskak' • fyd¢ka meiqKq" msßisÿ" ri" .|" j¾Kh" fmkqu fjkia fkdjQ iajNdúl fmkqula iys; wdydr .kak'

doctormagazine.lk

• ueá Ndck j, wdydr msi .ekSfuka YÍrhg ji úi we;=¿ fkdfõ

Èhjeähd frda.Skag kshu lrkq ,nk wdydr jÜfgdarej jkdyS idudkH YÍr fi!LH i|yd ldg;a m%fhdackj;a jk wdydr jÜfgdarejls' meKs rifhka wE;aùu fuysuqlHd¾:hla lr.; hq;af;ah' • wdydrhg wu;rj Èhjeähd frda.Ska Èhjeähd frda.Ska jHdhdu l< hq;=h' ;rndre nj wvqlr .; hq;=h' f;,a wdydr wvqfjka .; hq;=h' • Èhjeähdj i|yd wkqu; lrk wdydr ie,eiafï uQ,sl wx. lsysmhls' iSks iys; wdydr fkd. ekSu' • msIaGh iy jeä fl¢ iys; wdydr fkd.ekSu" wvq le,ß''' wvq fïo m%udKj,ska hqla; wdydr .ekSu' • WoEik y;r my jk úg wjÈ ù fyd| msßiqÿ uo WKqiqï rKjrd fyda c,h ùÿrejla îu YÍrh msßisÿ fldg wd.ñl j;dj;aj, fh§u'

JANUARY 2019 | DOCTOR MAGAZINE 119

• Wfoag fld< le| ùÿrejla îu' fï i|yd je,a fmfk," fmd,am,d" uql=Kqjekak" úúO ñY%K fld< le| fhdod.; yel' • Wfoa wdydr f,i r;= yd,a n;a" uqx weg" l=rlalka frdá" msÜgq" ;,m" fufkaß" nvbßÕ=" lv," ljqms iqÿiqh' • Wfoa wdydrh iu. fmd,a iïfnda,hla iy fld< ue,aüla ûql=Kqjekak" lxl=x" l;=reuqrex.d" rKjrd fld<" f;nq fld<" lrmsxpd fld< Ndú;d l< yel'& ØiqÿÆkq lrmsxpd jeämqr ouk ,o lsß fydoaola fyda jHxckhla" nKavlald" jegfld¨" mf;da," oU," msms[a[d" flfi,auqj" fldys, w," fldys, o¿" fk¨ï w," ksú;s • Wfoag f;a fndk fj,djg iqÿiq wdydr bruqiq mdkh" fn,su,a mdkh" rKjrd mdkh" bÕ=re fld;a;u,a,s mdkh" fjksje,a. eg mdkh jeks mdk j¾. Ndú;d l< yel' • osjd wdydrh r;= lel=¿ yd,a n;a" fld<mdg fl¢ iys; t<j¿" fld< ue,aü" i,dohla .; yel' • m,;=re f,i fmar" fodvï" fk,a,s" fo¿ï" flfi,a f.ähla" mefmd,a" wfkdaod" l=vd wU ;Srejla" wkakdis lE,a,la" w,s. egfmar nd.hla" udox" weU/,a,d jeks m,;=re Ndú;d l< yel' • f;a fndk fj,djg jeks ieye,a¨ wdydrhla iu. by; oelafjk T!Iëh mdk j¾. Ndú;d l< yel'

120 JANUARY 2019 | DOCTOR MAGAZINE

• i;shg jrla" fojrla my; i|yka wdydr iq¿ m%udKfhka .; yel' lerÜ" r;=w," jÜglald" mßmamq" lsßw," u[af[dlald" w¾;dm,a jeks wdydr

Èhjeähdjg iqÿiq foaYSh T!Iëh Ydluh wdydr ue,a¨ï j¾. fldajlald fld<" f;nq fld," jÜglald fld<" lßú, o¨ i,do" j,a fld;a;u,a,s fld< i,do" rKjrd fld< ue,aü" fldamam fld< ue,aü" weU/,a,d o¨ i,do" ,d fldia o¿ ue,aü" lrmsxpd fld< ue,aü" l=mamfïkshd fld< ue,aü" t<ngq fld< ue,aü" ;eïfíßhd fld< ue,aü" l;=reuqrex.d fld< ue,aü" idrK fld< ue,aü' T!Iëh jHxck j¾. uqxweg jHxckh" wlalmdk fld<" wÜálald f.ä" flfi,a nv jHxckh" lrú," ;s;a; ;síngq" fldaudßld" iqÿÆkq ´¨nv jHxckh" OdkH j¾. ySká yd,a" r;= lel=¿ yd,a" l=rlalka nvbßÕ=" W÷" nd¾,s T!Iëh mdk j¾. ksÈl=ïnd ;eïnQ j;=r" rKjrd" neì, uq,a" bruqiq" fn,su,a" fld;a;u,a,s fld<" fjksje,a.eg" fk,a,s" rils|

Èhjeähd frda.Skag ks;r wdrlaIdj imhk T!Iëh me<Eá wr¿" nq¿" fk,a,s" rils|" neì," ìxfldfydU" fjksje,a" foajodr" iqÿy÷ka" bÕsks" ly" uox" fldajlald" fld;,ysUqgq" je,auog" f,d;aiqUq¿

doctormagazine.lk

udkisl .eg¿ j,g isÿ lrk

ufkda m%;sldr

Y%S ,xld iajdmk úoHdfõ§kaf.a ix.ufha j;auka iNdm;s ufkda Ñls;ail ffjoH mS' tka' úoHdl=,m;s uy;d iu. l< idlÉPdjls'

122 JANUARY 2019 | DOCTOR MAGAZINE

doctormagazine.lk

udkisl frda." udkisl .eg¿ hkq fudkjdo@

W.% udkisl frda. hkq fudkjdo@

ñksiqka YdÍßlj frda.S jkakd fia udkisljo frda.S fõ' fuys§ tu frda." udkisl frda. f,i y÷kajhs' m%Odk jYfhka W.% udkisl frda. (Psychotic) iq¿ udkisl frda. (Neurotic) jYfhka wdldr folls' óg wu;rj ufkda ldhsl frda. ^Somatoform Disorders& o fmkaúh yel' iq¿ udkisl .eg¿ f,i úúO mqoa.,hska ye¢kajqjo tajdo kshqfrdaála .Khg fhÈh yelsh'

fud<fha we;sjk ridhksl fjkiaùï u; we;sjk frda. fõ' WodyrK f,i ySkafkdakaudoh ^Schizophrenia& úYdoh ^Depression& fïkshd ^Mania& frda. iy Bipolar Disorders jeks frda. fndfyduhls'

iq¿ udkisl frda. hkq fudkjdo@

udkisl fya;+ka u; we;sjkakd jQ udkisl frda. fõ' WodyrK f,i úúO NS;sld ^Phobia& .%iaÓh" fm!reIh ^Obsessive, Compulsive, Disorder& udhd frda.h ^Dissociative, Disorder& la,u:h ^Stress, Disorder& we;eï ufkda ,sx.sl wdndO" fm!reI wl%ñl;d ^Personality, Disorders& wd§ fndfyda foa fmkaúh yel' ;jo iq¿ udkisl .eg¿ f,i úúO weíneysùï" jerÈ p¾hdjka wdÈho fmkaúh yel'

ufkda ldhsl frda. hkq fudkjdo@

doctormagazine.lk

udkisl fya;+ka u; we;sjkakd jQ ldhsl frda. fõ' WodyrK f,i f.d;h" ,sùfï§ we;sjk fjõ,Su" we;eï ysiro ;;a;ajhka" we;eï weÕm; fõokdjka yd wm%dKsl ;;a;ajhka we;eï ,sx.sl wdndO wd§ fndfydauhlS'

udkisl frda. i|yd m%;sldr ;sfío@

W.% udkisl frda. fõ kï meyeÈ,s jYfhkau T!Iëh m%;sldr i|yd fhduqúh hq;=h' bka frda.h iqj jQ miq" frda.shd iudc.; lsÍu jeks lghq;= j,§ ufkda m%;sldr o fhdod .; yelsh' iq¿ udkisl frda. kï ufkda m%;sldr fhdod .; yels w;r" wjYH úgl T!Iëh m%;sldr o iq¿ jYfhka fhdod .efka' ufkda ldhsl .eg¿ i|yd m%Odk jYfhka ufkda m%;sldr o wjYH úgl T!Iëh m%;sldr o iq¿ jYfhka fhdod .efka' JANUARY 2019 | DOCTOR MAGAZINE 123

ufkda m%;sldr hkq l=ulao@

iq¿ udkisl frda. i|yd fhdod .efkk T!Iëh fkdjk ufkda úoHd;aul m%;sldr fõ' tys§ ixhu wNHdi ^Relaxation& wfya;=jd§ is;sú,s bj;alsÍfï m%;sldr ^Rational Emotive Therapy& ufkda WmfoaYkh ^Counseling& p¾hdjd§ m%;sldr (Behaviour Therapy& tmd lrùfï m%;sldr ^Aversion Therapy& m%cdkk p¾hdjd§ m%;sldr ^Cognitive Behaviour Therapy& lKavdhï m%;sldr ^Group Therapy& ufkda kdgH ^Psycho Drama& fudayk kdgH ^Hipno Drama& fudayk úoHdj ^Hypnotism& wd§ m%;sldr rdYshls' tys§ frda. fya;=j fiùu i|yd ufkda úYaf,aIKh ^Psycho Analyze& fyda we;eï úg fudaykho fhdod .efka'

by; m%;sldr fhdod .kafka flfiao@

m<uqj udkisl .eg¿jg ,laj ;sfnk mqoa.,hd ixhuhg m;a lrhs' tys§ ixhu wNHdi fhdod .kakd w;r" l,la ;siafia ;snQ frda.shdf.a mSvkh hï ;rulska wvqùu fuys§ isÿ fõ' bkamiq ufkda úYaf,aIKh wdldrfhka udkisl .eg¿jg fya;= jQ udkisl ldrKh fidhd .kshs' we;eï wjia:dj, myiqfjka fudaykhg m;ajkafkla kï fï i|yd fudaykho Ndú;d l< yelsh' kuq;a ish¨ fokd fudaykhg m;a fkdjk fyhska ufkda úYaf,aIKh m%Odk jYfhka fhdod .kshs' bkamiq fuf,i frda.hg fya;=j fidhdf.k ta wkqj bÈß m%;sldr isÿlrhs' WodyrKhla f,i udkisl .eg¿jg fya;=j f,i fidhd .;af;a wfya;=l 124 JANUARY 2019 | DOCTOR MAGAZINE

is;=ú,a,la kï tu is;=ú,a, fjkia lsÍu i|yd R.E.T. m%;sldr fhdod .kakd w;r" ufkda WmfoaYkho ,nd§ug mq¿jk' frda.hg fya;=j jerÈ weíneys ùula kï Aversion Therapy ^tmd lrùfï m%;sldr&" Counseling ^ufkda WmfoaYkh& Behaviour Therapy ^p¾hdjd§ m%;sldr& fhdod .ekSug mq¿jk'

iq¿ udkisl frda. ir, f,iska ckhdg f;afrk f,i meyeÈ,s lf<d;a@ fuys§ wm by; úúO NS;sld ^Phobia& .ek l;d l<d' th .;a úg hïlsis mqoa.,fhla hïlsis fohla i|yd" hïlsis ls%hdjla i|yd" hïlsis úYajdihla i|yd" wd§ ´kEu fohla i|yd widudkH f,i ìhla olajkafka kï th wm Phobia ke;fyd;a wksh; ìh f,i y÷kajhs' WodyrKhla f,i hïlsis mqoa.,fhla i¾mhka we,a,Sug ìhla we;akï th idudkH fõ' kuq;a i¾mhskaf.a PdhdrEmhla fyda oelSug wêl ìhla olajkafka kï th wksh; ìhls' fuu ^Phobia& ´kEu fohla i|yd we;súh yel' kuq;a nyq, jYfhka iudc NS;sldj ^msßila bÈßhg hdug we;s ìh& lerfmd;a;ka" yQkka jeks i;=kag we;s ìh" f,a oelSug ìh" f,vfrda. we;sfõo hk ìh" Wv ke.Sug we;s ìh" w÷rg we;s ìh" c,hg we;s ìh" jeiqKq ia:dkj, isàug we;s ìh" újdyhg ìh" ,sx.sl weiqrg ìh" jdyk meoùug ìh" úNd. ìh" / lshd lsÍug we;s ìh" j.lSï Ndr. ekSug we;s ìh" úIîcj,g we;s ìh" fkdfhla ia:dkj,g we;s ìh wd§ NS;sldjka nyq,h'

doctormagazine.lk

Ô¾Kh iïnkaO .eg¿" ks;r ks;r l=uk fyda frda. ,CIK mejiSu" weÕm; wm%dKsl;ajh" weÕm; fõokd" lerleú,a, .;sh" nfâ oeú,a," weÕm; oeú,a, wd§ fkdfhla ,CIK we;sfõ’ ks;ru wY=Njd§ is;=ú,s meñfKa' fï wd§ ,CIK rdYshls' .%iaÓh fm!reIh ^Obsessive Compulsive Disorder& hk frda.h .;aúg is;g jo fok wfya;=jd§ is;=ú,s Odrdjla ks;r ks;r is;g .,d ths' tys§ tlu foa ks;r ks;r lsÍu" ks;r w;a fia§u" kEug úYd, ld,hla .ekSu" ielh wd§ ,CIK rdYshls' fuysoS ielh hkq ;uka yßyeá fohla isÿl<o th isÿ l<do keoao hkak ;udg iaÓr ke;sùu" WodyrKhla f,i rd;S% kskaog f.dia kej; kej;ke.sg fodr cfk,a jid weoaoehs mÍCId lsÍu fmkaúh yelsh' udhd frda.h ^Dissociative Disorder& .;a úg ;udf.a há isf;a ;sfnkakd jQ wNsm%dhla bIag lr.ekSug Wvq is; u.ska flfrkakd jQ hïlsis m%fhda.ldÍ ;;a;ajhls' fya;=jla ke;=j isys ke;sùu" weÕm; wm%dKsl;ajh" wd.ñl ia:dk j,§ .d:d lshk úg" fnr Yío wefik úg" msß;a wefik úg" hd;sld-Ydka;s l¾u wefik úg wd§ wjia:djkays § YÍrfha fjõ,Su" ysi lerleùu" weÕm; mK ke;s ùu" lE .eiSu" ;udf.a YÍrhg fjk;a woaN+; wfhl= we;=¿ jqkd fia yeisÍu wd§ ,CIK rdYshla fmkajhs' merKs ck iudcfha hlaI frda." wukqIH frda." wdfõI ùu f,i ms<s.;af;a fuu ;;a;ajhhs' la,u:h ^Stress Disorder& .;a úg fndfyda fokd fuh frda.S ;;a;ajhla nj fkdokS' l,la ;siafia iq¿ iq¿ udkisl mSvdjkag ,laùfuka miqj fuu ;;a;ajhg hfula m;aúh yelsh' fuys§ udkisl ,CIK f,i ÿl" l,lsÍu" tmdùu" ;ryd hdu" wu;l ùu" ys;g i;=g fkdoekSu" wksh; ìh" Ôj;aùug wdYdj wvqùu wd§ ,CIK rdYshls' tys§ ldhsl ,CIK f,i kskafoa wl%ñl;d" kskao fkdhdu fyda ksÈnr .;sh jeä.;sh" wdydr wreÑh" wdydr doctormagazine.lk

we;eï ,sx.sl wdndO .;aúg úúO jerÈ ,sx.sl yeisÍï" i;=ka iu." l=vd <uqka iu." jhia.; mqoa.,hka iu." uD;foay wd§ foa iu. ,sx.sl weiqrg leue;a;' úreoaO ,sx.slhkaf.a we÷ï fidrd.ekSug we;s leue;a;" ,sx.sl wjhj wka whg m%o¾Ykh lsÍug we;s leue;a;" ksrej;a foay foi fydfrka ne,Sug we;s leue;a; wdÈho fmkaùug mq¿jk' fuf,i ud úia;r lf<a iq¿ udkisl .eg¿j,ska fndfydu iq¿ fldgils' wo isg wdrïN jk fuu ,sms fmf<a bÈß ,sms j,ska fïjd tlsfkl fndfyda lreKq iys;j Tng f.k taug n,dfmdfrd;a;= fjñ

ÿqrl:k( 0718 30 30 30

JANUARY 2019 | DOCTOR MAGAZINE 125

Moringa has been used for centuries due to its medicinal properties and health benefits. It also has antifungal, antiviral, antidepressant, and anti-inflammatory properties. Moringa leaves, which is used successfully to treat the diabetes.

Èhjeähdj uev,k n..;= Tiqjla lshkafka fukak fï fya;= ksihs'''

Èhjeähdj wo iudcfha fndfyda fofklaf.a ksfrda.S iïm; wNsfhda.hg ,la lrjk buy;a fi!LH ;¾ckhls' wdydr mßjD;a;Sh yd ine|S frda. hla jYfhka ie<flk oshjeähdj ksid reêrfha iSks uÜgu widudkH f,i by< hhs' w.akHdYfha yefok bkaishq,ska fydafudak m%udKh m%udKj;a fkdùu fyda w.akHdYh 126 JANUARY 2019 | DOCTOR MAGAZINE

bkaishq,ska fydafudakh ksIAmdokh fkdlsÍu fufia reêrfha iSks uÜgu by< hdug n,mj;ajk w;r by< hk iSks u.ska YÍrfha iuia; reêrjdyskS j,g we;s lrk n,mEu iq¿mgq fkdfõ' oshjeähdj frda.sfhl=f.a YÍrfha weia" iakdhq" jl=.vq" yDoh wdoS iEu wjhjhlau ÿ¾j, fjkafka fï reêrfha tla/ia jk iSks u.ska tu bkaøsh fj; we;s lrk n,mEu fya;=fjks' doctormagazine.lk

oshjeähd uQ,sl wdldr fol uQ,sl jYfhka oshjeähdj frda.Ska fohdldrhlska j¾.SlrKh fjhs' m<uq wdldrfha oshjeähdj frda.Ska bkaishq,ska ndysßka ,nd.; hq;= frda.Skah' fï whf.a w.akHdY.; îgd ffi, j,g bkaishq,ska ixiaf,aYKh lsrfï yelshdjla ke;' YÍrhg wjYH bkaishq,ska msg;ska ,nd .ekSug isÿ jkafka fï fya;=fjks' <ud ld,fhaoS flfkla oshjeähdjg ,la jQjfyd;a Tyq fndfyda úg fï bkaishq,ska fydafudak ksIAmdokh wvmK ùfuka we;sjk m<uq wdldrfha oshjeähdjg md;% fjhs' fojk wdldrh hkqfjka ye|skafjkafka nyq;rhla oshjeähd frda.Ska wh;a jk ldKAvhhs' fï whf.a w.akHdY.;j hï m%udKhlg bkaishq,ska ksIAmdokh ùula isÿ flfrhs' kuq;a fï ksmofjk bkaishq,ska m%udKh YÍrfha l%shdldß;ajhg m%udKj;a ke;' fï yereKQ úg ldka;djka ;u .¾NskS doctormagazine.lk

ld,fhaoS reêrfha wêl .aÆfldaia ;;a;aj fmkakqï lrhs' fuh zz.¾NsKS oshjeähdjZZ hkqfjka y÷kajk w;r fï .¾NskS oshjeähdfjka fmf<k flfkla orem%ijfhka miq idudkH reêr iSks uÜgug m;a fjhs' tfia fkdù os.guoshjeähdj frda. fhka fmf<k iq¿;rhlao fõ' flfia fj;;a fï wdldrfhka .¾NKS ld,fha oshjeähdjg ,lajk ldka;djka miq ld,fhaoS oshjeähd frda.Ska njg m;aùfï jeä wjodkula orhs' ksjeros wdydr" fnfy;a yd ie,eiaula we;sj lrk jHdhdu Tiafia fï ldKavhg oshjeähd frda.h uekúka md,kh lsÍug wjia:djla ,efí'

oshjeähdj frda.fha iajNdjh jgyd .ksuq wm .kakd wdydr j,ska fldgila .aÆfldaia njg m;a fjhs' .aÆfldaia ffi, l%shdldß;ajh i|yd wjYH fmdaIlh jk ksid th wmg wjYH l¾;jHhls' tfy;a .aÆfldaia j,g is;eÕs mßos ffi, j,g m%úIAG úh fkdyel' ffi, ì;a;sh midre lrñka ffi, wNHka;rhg .aÆfldaia j,g m%úIAG ùug bkaishq,ska fydafudakh ke;sju neßh' fï wkqj bkaishq,ska YÍrfha .aÆfldaia mßjD;a;Sh hdukh lrk idOlh njg m;aj ;sfí' ffi, j,g .aÆfldaia j,g m%úIAG ùug m%udKj;a jk bkaishq,ska m%udKhla fkd,eî hk úg fyda bkaishq,ska ;snqK;a ta ;sfhk bkaishq,ska fï lghq;a;g iydh fkdfok''' tkï ixfõoS fkdjk wjia:djl isÿ jkafka reêr.;j iSks uÜgu by< ke.Suhs' tkï" oshjeähdj we;s ùuhs' ld,hla ;siafia md,khlska f;drj oshjeähdj mj;sk úg fï .aÆfldaia j, n,mEfuka weia" yDoh" jl=.vq" iakdhq" reêrjdyskS wl¾ukH;djhg ,la fjhs' ta tl tlla ydks ùï u; ;j;a Wmøj je,la we;s fjhs' oshjeähdj we;s lrk wNd.Hh fuhhs' fï

uqrex.d i;=j oshjeähd frda.Skag m%;sldr lsÍfï úYañ; n,hla we;ehs m¾fhaIlhka fï jk úg yªkdf.k we;' jeo.;a yd úfYAIfhkau wm osß.kajk iq¿ ldrKh jkafka uqrex.d wm jeks fmros. rgj, jefjk fyaka wdydrhla jQj;a wo tys we;s .=K iïnkaOfhka ngysr rgj, m¾fhaIK isÿ lsÍfï úfYaI Wkkaÿjla we;s ùuhs' JANUARY 2019 | DOCTOR MAGAZINE 127

ksid iEu flfklau oshjeähdj frda.hg k;= ù fkdue;s kï th u;= osfkl we;s ùUg mj;sk bvlv wjqrd .; hq;=h' oshjeähdj je<ªKQ frda.sfhla fõ kï th uekúka b;d fyd|ska md,kh lr .ekSfuka thska we;súh yels w;=re wdka;rdhkaf.ka je<lsh hq;=h' oshjeähdj frda.Ska jeä fofkla ;ukag frda.h je<|S ;sfnk nj j;a okafka ke;' tfykï fuh ksyv udrfhls' frda.h ;ukag je<|S ;sfnk nj oek.kakd úg fjkakg ;sfnk ydksh isÿù yudrh'

wdydr md,kh oshjeähdj je<elaùug orK iïudou iq¿mgq fkdfõ''' oshjeähdj frda.Ska yg frda.h md,kh lsÍug wdydrfhka ,efnkafka buy;a iïudouls' fjfiiskau msIAGh yd iSks j,ska je<lSuo ta fjkqjg ;ka;=uh ix>gl wvx.= t<j¿" m<;=re wdoshg fhduq ùuo wdydr .kakd ms<sfjf,ys fjkila we;s lr .ekSuo fuysoS uQ,slj wjYH fõ' tfiau YÍr l%shdldß;ajhg wjYH lrk laIQø fmdaIl" úgñk yd LKsc ,jKo wvqjlska f;drj ,nd oSug wm W;aiql úh hq;=h'

uqrex.d i;= oshjeähd frda.Skag m%;sldr lsÍfï úYañ; n,h uqrex.d i;=j oshjeähd frda.Skag m%;sldr lsÍfï úYañ; n,hla we;ehs m¾fhaIlhka fï jk úg yªkdf.k we;' jeo.;a yd úfYAIfhkau wm osß.kajk iq¿ ldrKh jkafka uqrex.d wm jeks fmros. rgj, jefjk fyaka wdydrhla jQj;a wo tys we;s .=K iïnkaOfhka ngysr rgj, m¾fhaIK 128 JANUARY 2019 | DOCTOR MAGAZINE

isÿ lsÍfï úfYaI Wkkaÿjla we;s ùuhs' fï iïnkaOfhka ngysr m¾fhaIlhka flmuK Wkkaÿjla olajkjdo lsh;fyd;a Tjqka fuh y÷kajkafka Elixer Tree hk wkaj¾: kdufhks' Elixer Tree hkafkys wre; YíofldaIhlska fmr<d ne¨fjd;a zzwcrdur nj ,nd fok Tiqj'''ZZ zzwuD;hZZ f,i th úia;r lr we;s wmQrej Tng oek. kakg ,efnkjd we;'

uqrex.d wuD;h yd iudko@ uqrex.d fï wdYap¾hu;a n,.;= fnfy;a .i f,v frda. 300lg fyda Bg;a jeä jk ixLHdjlg m%;HlaIfhka yªkd.;a fnfy;la jk nj mila lrf.k ;sfí' tys lerÜ j,g jvd isõ .=Khlska îgd lefrdák wvx.=h' lsß j,g jvd 17 .=Khlska le,aishï wvx.=h' ksú;s j,g jvd 25 .=Khlska hlv wvx.=h' lr,g jvd tys .=K

bkaishq,ska ksIAmdokfhys,d bjy,a jkafka hhs yªkd.;a by;ska i|yka l< wdkqmdk jeä yßhla by< ud;%d j,ska uqrex.d j, ;sfí' doctormagazine.lk

we;af;a m;% j,h' uqrex.d m;%;a fld<;a tl;=j .;a l< fmdaIl fldgia m%fNao wkQjlg jeä m%udKhla yd m%;sTlaisldrl y;,sia yhla fï jk úg m¾fhaIKd;aulj yªkdf.k ;sfí' fukhska .;a l< YÍrfha ish¿u ffcj ridhKsl l%shdldß;ajhka i|yd wjYH lrk fmdaIl uqrex.d j, fkdwvqju ;sfí'

;rï m%n, fmdaIlhla fia ie<flK w;r uqrex.d j, we;s fï úgñka B12 ksid tu wjodkuo ie<lsh hq;= muKlska neyer,Sug yels fjhs'

uqrex.d j, ix>gl jYfhka we;s fmdaIl i;= m%n, T!Iëh .=K yd tajd YrSrfha l%shd;aul ùfuka we;sjk m%;sM<

wefia ldpfha fidaìfgd,a tla/ia ùu wefia iqog fya;= fjhs' fï wdldrfhkau fm%daàk .a,hsfldisf,aIKh kï l%shdj,shla u.ska (Glycosylation of Proteins) o fuu ;sñrh we;s ùfï wjodku jeä lrhs' úgñka C tu wjodku neyer lrk fmdaIlhla f,i ks¾foaY jk w;r tho uqrex.d j, hyñka ;sfí'

bkaishq,ska >%djh l=¿.kajk úgñka D uE; ld,Skj ì%;dkHfha wOHhkhl ksr; jQ m¾fhaIlhka lKavdhula úiska w.akHdYfha ^,eka.¾yka& oSmsld wdY%s;j bkaishq,ska ksIAmdokh lsÍug úgñka D w;sYhska ;SrKd;aul ld¾hhl ksr; jk nj fy<sorõ lrk ,oS' fï wOHhkfhaoS úgñka D wvq w.hka jd¾;d jk ldKAv b;d blauKska oshjeähd frda.hg k;= jk nj yªkd .kakd ,oS'

úgñka C ;SrKd;aul ld¾hNdrhl''' fï wOHhkfhaoS uqrex.d j, ;sfnk weiafldìla wï,hgo bkaishq,ska ksIAmdokh W;af;ackh lsÍfï ksiÕ yelshdjla ;sfnk nj wkdjrKh ù ;sfí' B1, B2, B3 yd mekafgdf;ksla wï,h fukau úgñka C iu. fm%daàka yd fmdgEishï ixfhda. ùfuka bkaishq,ska ksIAmdokh l=¿ .ekaùula isÿ jk nj fy<sorõ ù ;sfí'

oshjeähd frda.Ska wefia iqo frda.hg k;= ùu yd mdo j, ;=jd, we;sùu je<elaùug fuu úgñk j, l%shdldß;ajh n,mdkjd uqrex.d j, úgñka ta b;d nyq,h' úgñka C m%n, m%;sTlaisldrlhla jk w;r th oshjeähd frda.Ska wkaO Ndjhg m;aùfï wjodku ie<lsh hq;= muKlska wvq lrhs' oshjeähd frda.Ska ld,hla hk úg mdofha iakdhq iemhqu b;d ÿ¾j, ùfuka mdo wk;=rg fy<Sfï úYd, wjodkulg uqyqK mdhs' úgñka B12 ixlS¾Kh fï wjodku wdmiaig yrjk doctormagazine.lk

úgñka E wvqùu oshjeähdjg mdr lshk fya;=jla m¾fhaIK j,g wkQj úgñka E W!K;djh yd oshjeähdg je<|Su w;ro m%n, iïnkaOhla yªkdf.k ;sfí' wjYH m%udKhg jvd wvq E úgñk m%udKhla mej;Su fya;=fldg f.k

YÍrfha ish¿u ffcj ridhKsl l%shdldß;ajhka i|yd wjYH lrk fmdaIl uqrex.d j, fkdwvqju ;sfí'

JANUARY 2019 | DOCTOR MAGAZINE 129

oshjeähdj je<|Sfï bvlv 3'9 jdrhlska by< kexfjk nj y÷kdf.k ;sfí' uqrex.d m%n, E úgñk uQ,dY%hla jk w;r uqrex.d ks;r ks;r wkqNjh fukhska n,k l< oshjeähd frda.fhka ñoSug msgqjy,la jkafkah'

ue.akSishï ffi,Sh mßjD;a;Sh by< kxjk l%shdj,shl uqrex.d j, ;j;a m%n,j we;s fmdaIlhls ue.akSishï' ue.akSishï úgñka B6 iu. tl;= ù ffi, j, mßjD;a;Sh l%shdj,sh iqiqr lrhs' .a,hsfldcka mßjD;a;Sh Tiafia uekúka isÿ flfrk mßjD;a;Sh l%shdj,sh oshjeähd frda.h md,kh lrhs'

YÍrhg úk lrk uqla; LKavl yd YÍrh wdrlaId lrk m%;sTlaisldrl b;d l%shdldÍ tfukau flá cSjk ld,hla iys; uqla; LKavl hkqfjka ye|skafjk wKQ úfYaIhla u.ska wfma YÍrfha ffi, j,g nrm;, ydks isÿ lrhs' fï ksid ffi, úkdY fjhs' fuh Oxidative Damage hkqfjka ye|skafjk w;r fï ydksh YÍrfha we;s cdk" wKQ" fm%daàk''' fï ljr jHqyhl jQj we;s l< yel' wm jhia.; fmKQula ,nkafkao fï ksidh' ms<sld wdosh we;s ùugo fuu ffi,Sh ydksh fya;=jla fjhs' uqla;LKavl j,ska isÿ lrk ydksh wvq lrk l%uhlao iajNdjO¾uh wmg yªkajd oS ;sfí' ta m%;sTlaisldrlhs' m%;sTlaisldrl wka;¾.; wdydr wkqNjfhka uqla;LKavl j, ydksodhl l%shdj,sh wvmK lrñka YÍrh wdrlaId flfrhs' uqrex.d j, we;s uqla;LKavl úkdY lrk hdka;%Kh úYañ;h' tu.ska YÍrfha m%;sTlaisldrl n,h jeä lrñka b;d m%n, wdrlaIdjla YÍrhg i,ihs' oshjeähd frda.Ska i<lk l< uqla; LKavl hdka;%Khla n,.ekaùu b;du m%;sM<odhl fjkilg u. fy<s lrhs' fjfiiskau oshjeähd ;=jd, wdosh u¾Okh lsÍugo fï m%;sTlaisldrl fya;= fjhs'

130 JANUARY 2019 | DOCTOR MAGAZINE

kej;;a wfma bmerKs wdydr isß; fj; msh k.uq wo ojfia b;d wNsfhda.d;aul fi!LH ;¾ckhla njg oshjeähdj m;aj we;af;a wfma fkdmsg fmr¿k wdydr isß; fya;=fjks' fjfiiskau wfma me/kakka wdhq wdfrda.H ie,iQ iïm%odhsl wdydr fjkqjg iSks" msá wêl wdydr" tajdg tl;= lrk ,o úúO wdl,k weiqf¾ wm úYd, fi!LH ;¾ckhlg k;=j ;sfnk w;r wkd.;fha wfma wdrlaIdjo" u;= mrmqf¾ meje;auo idlaId;a lr.; yelafla ta bmerKs wdydr rgdjg kej; fhduq ùfuka muKs' uqrex.d - ngysr jeishkau oeka oeka yªkajk wdldrhg osjHuh .=K imsß T!Iëh wdydr fï Wvq.x n,d hk wfma úma,ùh wdydr mßj¾;kfha jákd wdkqmdkhla jkafkah' fjfiiskau uqrex.d j, w;sYhskau .=KodhS fld< weiqf¾ Tng wmQ¾j ri imsß iQm jÜfgdare ilid .; yels jk w;r tjka wjia:djla fkdue;af;a kï uqrex.d j, fkdkefik .=Kh wdrlaId jk fia ilia l< uqrex.d lr,ao wo Tng lS¾;su;a ikakduhka hgf;a ,nd.; yels jkq we;' doctormagazine.lk