Doctor Magazine July 2018 by Doctor Magazine

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JULY 2018

Volume 24 • Issue 07

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08 NEWS widudkH fhdaksu. 10 reêrjyk

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JULY 2018 | DOCTOR MAGAZINE

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Volume 24 ● Issue 07 ● July 2018

doctormagazine.lk

JULY 2018 | DOCTOR MAGAZINE

JULY 2018

Volume 24 • Issue 07

fmdaIK .=Kh /flk 98

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HIDDEN HUNGER are you aware of it ! iqje;s osúhlg Tìk fm%daàk imsß

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RICE HEALTH BENEFITS AS A FUNCTIONAL FOOD

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CAPSULE BABY

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JULY 2018 | DOCTOR MAGAZINE

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ETON

EDITOR'S

S'ROTIDE

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NOTE

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.¾NdIfha ldka;djlf.a cSjfha ;sôrs f.hhs' orefjla ìys lrkakg iqÿi jk whqßka th uõ l=ioSu úlikh jk w;r oeßhl jeä úh m;a ùfuka miq th l<,hla orkakg iqÿiq wdldrfhka ilia fjhs' ldka;djlf.a wd¾;jho isÿ jkafka fulS wjYH;djhka ;Dma; lrk wdldrhgh'

widudkH .¾NdI.; reêrjykhla lshkafka''' .¾NdIfhka widudkH f,i we;sjk reêr jykhla' fï reêrh fhdaks ud¾.h Tiafia ;uhs olakg ,efnkafka' Tima pl%fha ´kEu wjia:djl th we;s fjkak mq¿jka' widudkH jYfhka jeäfhka wd¾;j reêrh jEiaiSu" oeä fõokdjla we;s lrñka Tima reêrh msgùu widudkH reêr jykhla fia i<lkjd' tfiau kshñ; ld,hg jvd wvq ld,hlska jf.au" kshñ; ld,hg Tima ùu isÿ fkdù jeä ld,hla .;ù Tima ùu;a widudkH fia ie<flkjd' Tima ùfïoS jf.au wd¾;j wNdjfhaoS;a fï widudkH f,i we;sjk reêrjyk olskakg ,efnkjd'

widudkH .¾NdI.; reêrjykhla we;s fjk fya;= iq,nhs .¾NKS ldka;djlg;a widudkH reêrjyk we;s fjkak mq¿jka' fmd,sma fkdfyd;a l=vd j¾Ol''' *hsfn%dhsâ hkqfjka ye|skafjk ;rula úYd, j¾Ol .¾NdIh weiqre lrf.k we;s jqKdu" ta ksid;a widudkH reêr jyk we;s fjkak bv ;sfhkjd' .¾NdIfha wdidokhla we;s jqKdu" ;hsfrdhsâ fydafudak j, widudkH;djhla ksid fkdtfia kï ms<sldjla ksid jqK;a fï widudkH reêr .e,Sï we;s úh yelshs' oeka Tng f;areï hdú fï .ek Tn oeKQj;a ùfuka Bg n,mE fya;=jg m%;sldr lsÍug wjia:djla ie,fik j.''' fndfydauhla fj,djg fï .eg¿jg ldka;djf.a fydafudak .eg¿ fya;= jk nj m%dfhda.slj olakg

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fldaIAG yeoSu ksid;a widudkH reêr jykhka we;s fjkakg mq¿jka' • .¾NKS;djfhaos;a widudkH reêrjykhka flfkl=g we;s fjkak mq¿jka' tjka wjia:djloS ffjoHjrfhl= yuqùu l< hq;=hs' kd, .¾N ms<sis|SuloS;a" .íid ùuloS;a reêrjyk we;s jkakg mq¿jka'

idhksl mÍlaIKhla ,efnk ldrKhla' fï ;;a;ajh .egjr úfha ;reKshka w;r;a ueos jhfia wd¾;j wNdjhg wdikak ldka;djka w;r;a iq,nhs'

widudkH reêrjykhka we;s ùug n,mdk fya;= tla tla jhia iSudjkaysoS widudkH reêrjykhka we;s ùug n,mdk fya;= .ek oeka wm ie<ls<su;a fjuq

jhi wjq' 20-30 w;r wjêfha we;sjk widudkH reêr jyk • widudkH f,i reêrjyk we;sjk ;=reKq ldka;djkag kshñ; wdldrhg" kshñ; fj,djg äïn fudapkhla isÿ fkdjk wjia:d ;sfnkjd' tfyu jqKdu" fydafudak wiu;=<s;;djhla we;s fjkjd' .¾NdI wdia;rkh ^tkafvdfuá%hu& >k fjkjd' w¿;ska jeä úh m;ajQ oeßúhka w;f¾ fï .eg¿j iq,nhs' m%udo fj,d Tima ùu isÿ jqKdu fï whf.a reêrh jeä jYfhka msg fjkjd' th fõokdldßhs' Tima pl% folla w;f¾ reêr jykhka we;s jkak;a mq¿jks' • Polycystic ovary syndrome (PCOS) hkqfjka ye|skafjk äïnfldaI j, 12

JULY 2018 | DOCTOR MAGAZINE

• we;eï Wm;a md,k Wml%u''' .s,sk fm;s ksid;a" .¾NdIfha r|jk IUD kue;s m%;sikaê ndOlhla f,i .¾NdIfha r|jk oÕr yd ndyqfõ r|jk cfv,a,d l+re ia:dms; lsÍfïoS;a tys we;sjk ixl+,;djhla f,i widudkH reêr jykhla we;s jkakg mq¿jka'

jhi wjq' 40 yd 50 uq,a ld,fha we;sjk widudkH reêr jyk wm uq,skau wd¾;jwNdjh .ek wjfndaOhla ,nd .ksuq' Tima ùu k;r ùu fuhska meyeos,s flfrkjd' fuh isÿjkafka jhi wjq' 51 oS muK' tfy;a jhi 45-55 w;r ld,fha ´kEu ld, jljdkqjl wkql%ufhka ls<s jEÍu| Tima ùu k;r ùu isÿ úh yelshs' äïnfldaI u.ska ksIamdokh lrk Biag%cka fydafudakfha Odß;dj wvq ùfï m%;sM<hla jYfhka

Tima ùu yd ine|S lreKQ rdYshla ksid widudkH reêrjyk j,g fya;= fõ doctormagazine.lk

wd¾;jh k;r ùfuka miq fhdaksfhka reêr jykhla isÿ fjkjd kï th;a widudkH f,i ;uhs ie<flkafka' tfia isÿ fjkjd kï thg fya;= fidhd.; hq;=hs' ta i|yd mÍlaIK l< hq;=hs'

widudkH reêrjykhka we;s ùug fya;= fuys oelafjk we;eï fya;= t;rï ydkslr kE' ta;a jyd wjOdkhg fhduq l< hq;= fya;=o ;sfnkjd' wm ta .ek fidhd n,uq' fmd,sma Polyps .¾NdI wdia;rkfha mj;akd mgl j,g iudk fldgia j,ska we;sjk l=vd j¾Ol jk fïjd ms<sld njg m;a jkafka ke;' fïjd .¾NdI ì;a;sfha we,S mj;shs' tlaflda .¾NdI wdia;rkfha u;=msg mDIaGfhys j¾Okh fjhs' fï ksid widudkH fyda úYd, reêr jykhka we;s ùug bv m%ia:dj mj;S' fïjd .eí f.f,ys fyda .eíf., .%Sjfhyso j¾Okh úh yel' ,sx.sl tlaùfuka miq fï fmd,sma j,ska reêrh .,hs' fïjdhska nyq;rhla wjodku wvq fia ie<flK >khg wh;a jk w;r tajd ms<sld njg m;aùfï wjia:d úr,h'

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.¾NdI wdia;rkh ;=kS ùula isÿ fjkjd' B<Õ mshjr f,i .¾NdI wdia;rKh ì|S Tima reêrh msgùu;a k;r fjkjd' fuh tlajku isÿjkakla fkdfjhs' ld,hla uq¿,af,a fuh l%ñlj isÿ fjkjd' fï;a iu.u fhdaks ì;a;sfha wdia;rko ;=kS ùula isÿ fjkjd' fï ld,h ;=< .¾NdIh wdia;rKh ì| jeàu isÿ jkafka wl%uj;aj' fï ksid widudkH fhdaksu. reêr jykhla isÿ fjkjd'

m%;sikaê ndOl Wml%u fia ie<flk .s,sk fm;s" weiqre lrf.ko widudkH reêr jyk we;súh yel' tkafvdfuá%hu b;d ;=kSNdjhg m;aùu Endometrial atrophy wd¾;j wNdjfhka miq Biag%cka fydafudakfha l%shdldß;ajh k;r ùu ksid fï ;=kS wdia;rkh widudkH reêr jykhka we;s ùug fya;= fjhs' .¾NdI wdia;rkfha tkafvdfuá%hu ;=kS njg fmrf<a' .¾NdI wdia;rkh" fhdaks ud¾.h >kNdjhg m;aùu Endometrial hyperplasia .¾NdI wdia;rkfha" fhdaks ud¾.fha mgl >k Ndjhg m;a ùuo .¾NdI.;j widudkH reêrjykhka we;s ùug fya;=jls' fm%dfciagfrdka hkq äïnfldaI j,ska ksmojk ;j;a fydafudakhla jk w;r wd¾;j wNdjfhAoS fm%dfciagfrdka fydafudakh wvq jkafka" k;r jkafka Biag%cka fydafudakhg;a l,sks' .¾NdIfha wdia;rkh ì| fy<ñka Tima reêrh ckkh lrkakg WmldÍ jkafka fï fydafudakhhs' fm%dfciagfrdka fydafudakh ysÕ mdvq fjñka Biag%cka fydafudakh wjYH m%udKhg;a jvd

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WOMEN'S WORLD

ksIAmdokh ùu fuu .¾NdI wdia;rkh >k ùug fya;=jla jk w;r th Endometrial Hyperplasia hkqfjka ye|skafjhs' fï fya;=j ksid we;eï úg .¾NdI wdia;rkh ;=< ffi, widudkH iajNdjhla .ekSugo ms<sjk' th Hyperplasia of the Endometrium f,i y÷kajk w;r tys wdldr folls' Simple Hyperplasia of the Endometrium wdldrfhaoS ke;;a Complex Hyperplasia of the Endometrium wdldrfhaoS fï ;;a;ajh .¾NdI.; ms<sldjla njg m;a ùugo bv we;s fyhska fï ;;a;ajh .ek ie<ls,a, fhduq úh hq;=h' Endometrial Hyperplasia ;;a;ajh l,a fkdyer wkdjrKh lr .ekSfuka th ms<sldjla njg m;aj cSú;hg ;¾ckh lsÍfï wjodkfuka ñosh yel' wd¾;j wNdjhg m;a ldka;djka .¾NdI ms<sld j,g ,laùfï m%Odk ,laIKho reêr jykhhs' mshhqre" wka;%" äïnfldaI fyda tkafvdfuá%hu ms<sld mjq,a b;sydihla we;s wh fuu ms<sld we;sùfï wê wjodkula orK fyhska tu ldka;djka fuu fjkialï .ek úfYAI wjOdkhla oelaùu Tfíu ys;iqj msKsi jkafkah'

widudkH reêrjykhka i|yd lrk ffjoH mÍlaIK ldka;djf.a fm!oa.,sl fi!LH ;;a;ajh" mjqf,a ffjoH b;sydih úuiSu fukau idhksl mÍlaIKhlao ffjoHjrhd úiska isÿ lrKQ ,nhs' fï yereKQ úg ksrla;sh wdY%h lr.;a reêr jykhlao hkak úuiSug reêr mÍlaIKhlao isÿ flfrhs' tfiau wjYH;djh wkQj my; mÍlaIK tlla fyda lsysmhla isÿ lrKQ we;'

JULY 2018 | DOCTOR MAGAZINE

wd¾;j wNdjfhaoS .¾NdI wdia;rk ;=kS ùfuka tys ;=kS ùula isÿ fõ Speculum examination fhdaksu. wdia;rk yd .eíf., mÍlaId lsÍu' .eíf., widudkH;d ksÍlaIKh lf<d;a mema mÍlaIKh fyda ffcfõlaId (Biopsy) mÍlaIKhla i|yd ta widudkH;d we;ehs iel lrk ,o m%foaY j,ska mgl idïm, ,ndf.k jeäÿr ridhkd.dr mÍlaIK i|yd fhduq flf¾' .eí f.f,ys we;sjk ms<sld wd¾;jwNdjfhka miq we;sjk reêr .e,Sï i|yd fya;= úh yel' w,ag%d ijqkaâ mßf,dalk mÍlaIK .¾NdIfha m%udKh" tys >klu| äïnfldaIo we;=¿j m¾hka; fldgiaj, we;sjk jHqyd;aul fjkialï iïnkaOfhka fuu mÍlaIKfhka wjfndaOhla ,nd.; yels jkq we;' wd¾;j wNdjfhka miq .¾NdI wdia;rkh b;d ;=kS jk w;r m%udKd;aulj ñ,s óg¾ 4 fkdblaujkq we;' th wfmalaIs; m%udKhg jvd tkafvdfuá%hu >klfuka jeä kï mgl idïm,hla ,ndf.k jeäÿr mÍlaIK lsÍug isÿ jkq we;' tkafvdfuá%hfï mgl wdY%s;j isÿ lrk nfhdmais mÍlaIKh Pipel Test isyska nghla we;=,a lr .¾NdI wdia;rkfha mgl kso¾Ylhla ,ndf.k ffcfõlaId mÍlaIKhlg fhduq flf¾' Sonohysterography le;Sgrhla u.ska .¾NdIhg ;r, mßudjla kslafIamKh lr w;sèjks m%;sìïn lsysmhla ,nd .kS' fï l%uhg Polyps myiqfjka doctormagazine.lk

Hysteroscopy Hysteroscope hkqfjka ye|skafjk leurd Wmdx.hla iys; isyska kd,hla fhdaksu. yryd .eíf., olajd m%fõY lr .¾NdIho iu.ska fï wjhj ksÍlaIKh flfrhs' tysoS mÍlaIdjg ,lafjk widudkH ia:dk" mgl fjf;d;a tys kso¾Yl ,nd. ekSugo fuu.ska wjia:dj ie,fia' Dilation and curettage (D&C) .eíf., újrh úYd,kh lr .¾NdI wdia;rkfhys mgl iQrd.ekSfuka fyda pQIk l%uhg bj;a lr tajd ridhkd. drfhaoS wkaùlaIShj mÍlaId lsÍug fhduq flfrhs'

widudkH reêr jykhg isÿ lrk m%;sldr frda. ks¾Kfhka ,efnk frda. ksOdkh wkQj m%;sldr ;SrKh flf¾' fhdaksu. ;=kS ùfuka we;sjk reêr jyk i|yd (Vaginal atrophy) T!IO kshu flf¾' .¾NdIfha we;sjk j¾Ol bj;a lsÍug Y,Hl¾uhla lrkakg isÿ jkq we;' .¾NdIfha >k ùï t;rï ;on, f,i fkdue;s kï fydafudak m%;sldr (Progestin Therapy) ta i|yd iqÿiqh' Hysteroscopy yd D&C mÍlaIK isÿ lrk wjia:dfõo >k Ndjhg m;aj we;s tkafvdfuá%hu fldgia bj;a l< yel' Endometrial Hyperplasia ms<sld njg m;aùfï wjodkula ;sfnk ksid l,ska l,g tu ia:dk j, ffcj idïm, wrf.k nfhdmais mÍlaIK isÿ l< hq;=h' tu ;;a;ajh iïmQ¾Kfhkau ksjeros jkf;la fuu miq úmru lrkakg isÿfõ' fï >kùï ixlS¾Kj

m%lg lrñka ms<sld wjodku ie<lsh hq;= muKlska olajk ldka;djkaf.a wjodku bj;a lsÍug .¾NdIh bj;a lsrSug (Hysterectomy-Removal of the womb) isÿ jkq we;'

ms<sld i|yd m%;sldr tkafvdfuá%hdkq ms<sldjla we;s nj ;yjqre jQ úgo .¾NdIh yd äïnfldaI bj;a lsÍu isÿfõ' .eíf., ms<sld i|ydo úia;S¾K m%;sl¾u fhoSug isÿfõ' lrKQ ,nk m%;sldr ;SrKh lrkafka ms<sldfõ woshr yd tys iajNdjh wkQjh' jvd;a me;sr.;a .eíf., yd tkafvdfuá%hdkq ms<sld i|yd úlsrK Ñls;aidj fhdod .efka'

miqjok fhdaks ud¾.fhka reêr jykhla we;sjk idudkH wdldrh kï Tima ùuhs' thska mßndysrj ldka;djlg ljr wdldrfhka fyda reêr jykhla isÿ jkafka kï th widudkH reêr jykhla' tfiau Tima ùfïoSo isÿjk wêl reêrjyk" fõokdldÍ yd l,a w,a,k reêrjyk;a idudkH reêrjyk fia i<lkafka kE' fï ksid widudkH hhs ie<flk by; úia;r l< ljr fyda wjia:djla Woa.; ù kï thg ms<shï fhdokq msKsi ffjoHjrfhl= uqK .eiSu iqÿiqhs' wd¾;jh k;r ùfuka miq fhdaksfhka reêr jykhla isÿ fjkjd kï th;a widudkH f,i ie<flkjd''' wd¾;j wNdjhg m;a ldka;djka .¾NdI ms<sld j,g ,laùfï m%Odk ,laIKho ••• reêr jykhhs'

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u;aøjH ksjdrK ckdêm;s ld¾h idOk n,ldfha wOHlaI ffjoH iuka; l=udr ls;,jwdrÉÑ BDS (SL), MSC (Italy), MAAID (USA) úisks is.rÜ fõjd''' îä fyda iqreÜgq fyda fjk hï ljr wdldrhlska fyda fõjd ÿïfld< wdY%s; ksIamdokhla bÍug .ekSfuka Tn Tfí cSú;hg lr.kafka fudk ;rï fødayS lulao@ ta .ek lsishï fyda wjfndaOhla ,ndoSu fï ,smsfha wruqKhs'

blauKg uefrkak bkak whg w;aÿgq l%uh''' ÿï mdkh lsÍfuys m%;sM<hla jYfhka jirlg f,dalfha isÿjk urK ixLHddj ñ,shk yh blaujhs' ñksia wm urKhg m;ajk fya;= w;r j<lajd.; yels wjdikdjka;u urK j,g ,la jkafkda ÿï mdkh lrkafkdah' Tn wm iEu flfklau urKhg m;aùug kshñ; ld,hla ;sfí' ta ld,h j¾I oyhlska bosßhg f.k tkakg''' j¾I oyhla l,ska urKhg m;a jkakg jqjuKdfjka miq fjkjd kï Bg fyd|u l%uh ÿï mdkfhys jyf<la ùuhs'

ÿï mdkh frda. wjodku B .il fõ.fhka by< kxjkjd''' ÿïmdkh lrkafkl=''' • lsÍgl yDo frda.hlg ,laùfï wjodku tfia fkdlrkafkl=g jvd fo.=Khl isg isõ .=Khla olajd jeähs' • wxYNd.hg ,la ùfï wjodku tfia fkdlrkafkl=g jvd fo.=Khl isg isõ .=Khla olajd jeähs' • lsishï ms<sldjla je<|Sfï wjodku 25 .=Khlska by< kexfjkjd'

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ÿï mdkh lrkafklaf.a yoj; reêrjdyskS fukau cSú;h;a wjodkfï''' yoj; yd reêrjdyskS wdY%s; frda. iuqodhlg ÿï mdkh lrkakka ksrdjrKh ùfï wjodkula ;sfnkjd' ÿï mdkh lsÍfuka reêrjdyskS >k fjkjd' tys reêr .ukd. uk jmißh isyska fjkjd' fuys m%;sM<hla f,i yoj; iamkaokh fõ.j;a ù wêreêr mSvkhg Tn ,laùfï wjodku by< hkjd' fï ksid iuia; reêr jdyskS moaO;shu wdmodjg ,laùu ÿïmdkfhka we;sjk ;j;a ydkshla' ÿïmdkh lrkakka yDohdndO j,g ,laùfï wjodku jeähs' wxYNd.h we;s jkafka fud<hg f,a .uka lrk reêrjdyskshla wjysr ùfuka' we;eï úg reêrjdyskshla mqmqrd fud<hg reêr jykhla we;s jqfKd;a ;;a;ajh jvd;a nrm;,hs' ÿï mdkh lsÍfuka f,dl=" fmdä''' iuia; reêrjdyskS moaO;shu ÿ¾j, fjkjd' fï ksid wxYNd.h we;s ùfï wjodku fnfyúka by< hkjd'

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ÿï mdkh yd Yajik frda. w;r m%n, in|;djhla''' ÿïmdkh iDcqju n,mEï lrk bkaøshhla f,i fmKy¿ ye|skaúh yelshs' hï flfkla weÿu fyda fjk;a Yajik frda.hlska fmf<kjd kï ÿï mdkh lsÍu ta frda.h nrm;, f,i jeä lrkakg ÿïmdkh ksielfhkau fya;= fjkjd' ;Sj% fn%dkalhsáia" tïmsiSudj''' fï kï j,ska ye|skafjkafka COPD kue;s ldKavhg wh;ajk frda. j,gh' fï frda." fmKy¿ w;sYhska ÿ¾j, lrñka kej; ms<silr l< fkdyels ydks Bg isÿ lrkakg iu;ah' ÿï mdkh yd ine|S Bg;a jvd Nhdkl fjk;a frda. hla biair fkdjqfKd;a fndfyda úg ÿïmdkh lrk tïmsiSud" fn%dkalhsáia frda.Ska ñh hkafka fï frda. COPD ldKavhg wh;a frda.hl m%;sM<hla jYfhks' ÿïmdkh lrkakka fï wjodkï iy.; frda. j,g ,laùfï bvlv ÿïmdkh fkdlrkakkag jvd 12-13 .=Khlska jeäh'

ms<sld j,g w; jkk ÿïmdkh ÿïmdkh YÍrfha ´kEu ;ekl ms<sldjla we;s ùfï wjodku jeä lrhs' fmKy¿ ms<sldj ms<sld w;f¾ ìhlre ms<sldjls' th ÿïmdkh lrk flfkl=g we;sùfï bvlv tfia fkdlrkafkl=g jvd 25 .=Khlska jeäh' ta yereKQ úg ÿïmdkh lrkakka w;f¾ jeä jYfhka we;sùfï ms<sld wjodkula we;s ia:dk lsysmhla fufiah' uq;%dYh" reêrh" wka;%" .=oh" .,kd,h" jl=.vq" uq;%d m%Kd," iajrd,h" wlaudj" w.akHdYh" wudYh yd ldka;djka kï .eíf.,'

ÿïmdkh lsÍu ksid we;s úh yels fjk;a .eg¿ lsysmhla''' ;d;a;, fjkak bkak whg mqreIfhl= ÿï mdkh lsÍu ksid Tyqf.a ckl Yla;sh n,j;a ;¾ckhlg ,la 18

JULY 2018 | DOCTOR MAGAZINE

fõ' Y=l%dKQ Odß;djh my; neiSu| tys pd,l;djh ySk ùu iy tajd úlD; ùfuka frda.S orejka ìyS ùug fï ksid bv we;' ÿï mdkh lrk msfhl=g odj ms<sis|.kakd l<,hla iajdNdúlj .íid ùug we;s bvlvo fndfyda jeäh' wïu, fjkak bkak whg wfma rfÜ ldka;djka t;rï ÿïmdkh lrkafka ke;' tfy;a l,d;=rlska ldka;djka tfia lrk ksid ta .eko isysm;a l< hq;=j ;sfí' ÿïmdkh lrk ldka;djkag .eí .ekSu iïnkaO .eg¿ jeäh' l=ig tk l<,h .íid ùu" yefok orejka frda.S ùu" wvq jhiska bmoSu wjodkï iy.; kd,.¾N ms<sis|Sï" úlD; ;,a, yd f;d< iys;j bmoSï fukau Wmka orejka .=ma;ckl f,i ñh hdfï wjia:do jeäh' ldka;djl ÿïîu hkq weh wehgu lr.kakd úYd,u ydkshls'

;j;a .eg¿ f.dvhs • ÿï mdkh ksid wiaÓ iúh ySk fjhs' Tiaáfhdafmdfrdaisia wdoS frda. je<|Sfï wjodku by< hhs' • o;a yd úÿreuia wdY%s; frda. we;sùfï bvlv jeäh' • ÿï mdkh lsßfuka oshjeähdj je<|Sfï wjia:d jeä fjhs' ta flfiao h;a ÿï mdkh fkdlrk flfkl=g jvd ÿï mdkh lrk flfkl= oshjeähdj frda.hg k;= jfï bvlv ishhg 30-40 lska jeäh' • ta yereKQ úg wd;rhsáia" YÍrh weiqre lr.;a fjk;a m%odysl ;;a;ajhka" wlaIs frda. wdosh yg .ekSfï by< wjodkula fõ' fï frda. tl tlla iïnkaOfhka jeä úia;r wm bosßfhaoS Tn fj; f.k tkafkuq' ••• doctormagazine.lk

u;ska ñfok u. Tfí wdorKShhka u;a W.=f,a yiq ùug fya;= oek.kak T!IO Ndú;h" ufkda ffjoH m%;sldr iy WmfoaYkh fujka u;aøjHhka i|yd weíneys jQjka bka uqod.ekSu ioyd taldnoaOj l%shd;aul lsÍu jeo.;a jk kuqÿ tjka mqoa.,hkaf.a mjqf,a idudðlhka f.a fukau ñ;=rkaf.a iydh iy Wmldrh o fï i|yd b;du;a wjYH fõ'

JULY 2018 | DOCTOR MAGAZINE

uykqjr YslaIK frdayf,a ffjoH md,s; nKavdr iqnisxy doctormagazine.lk

u;ameka" u;aøjH iy ÿïjeá hk ish,a, weíneysldrl >khg wh;a øjHhka f,i ie<fla' fïjdfha wvx.= ridhk øjHhka reêrh u.ska fud<h ;=<g mßjykh lsÍfuka wk;=rej fud<h ;=< wmf.a Ôj l%shdjka hdukh lrk iakdhq iïfma%Il ridhk øjHhka wkqÑ; f,iska Y%djh lsÍug fmd<Ujkq ,efí' we;euqkag u;aøjH i|yd we;sjk lEorlula we;s jkafka wehs@ ta wkqj fud<h ;=< zzfvdamñka˜ kï ridhkslh jeämqr ksmojkq ,efí' fuu fvdamñka u.ska mqoa.,hd ;=< i;=g okjk yeÕSula" ieye,a¨ isf;k yeÕSula we;s lrhs' isreßka

weíneysldrl bj;aùu;a iu.u t;=jla widudkH f,iska Y%djh jQ fvdamñka Y%djh ùu wvQùu ksid tu mqoa.,hdf.a isrerg wmyiq .;shla oefkk w;r kej;;a fmr ;;ajh w;alr .ekSu ms‚i tu ridhkslh isrerg ,nd.ekSu ioyd ;on, f,i wdYdjla we;s lrkq ,efí' fuh zzu;aøjH i|yd doctormagazine.lk

we;sjk lEorluZZ f,iska ye¢kaúh yelsh' we;euqka u;aøjH mdkh lsÍfuka je<lS isàug W;aidy l<o" mqkre;a:dmk uOHia:dkj, mqkre;a:dmkh jqjo kej; kej; u;aøjH Ndú;d lsÍug fm<fUkqfha fï fya;=j ksidh' u;aøjHj,g weíneysj isák hful= bka neyer lr .ekSu ioyd" u;aøjH mdkh keje;aùu ksid isrerg oefkk fkdfhl=;a wmyiq;d iukh lsÍu;a kej; kej; mdkh lsÍug fmd<Ujk u;aøjH lEorlu keje;aùu;a iu.dój isÿlsÍu wjYH fõ' fuh fud<h ;=< we;s lrkq ,nk yeÕSula ksid fuhska je<lSu ms‚i uki Yla;su;a lsÍu uQ,slju wjYH jk w;r T!IO Ndú;h u.ska th id¾:l lr .ekSug Wmldr lsÍula muKla isÿlrhs'

ÿï mdkfhka ñoSug Tng .; yels m%dfhda.sl mshjr ÿï mdkh lsÍfï§ tys weíneysldrlh jkqfha zzksfldáka˜ kñka y÷kajk ridhk øjHhhs' th keje;aùu u.ska idfmalaIj isrerg ;on, wmyiq;djhka we;s fkdlrk ksid fjk;a T!IO Ndú;d fkdlr" uki Yla;su;a lr.ekSu uÕska muKlau fuu weíneysfhka ñ§ug yelshdj we;' mdkh lrk ÿïjeá m%udKh wvq lrñka áflka ál th keje;aùug W;aidy lsÍu t;rï M,odhs fkdfõ' ÿïjeá fyda .xcd mdkh tljru kj;d oeóu jvd fhda.H jkafka tu.ska id¾:l m%;sM, jvd blauKska ,nd.; yels neú‚' l=vd igyka fmd;la f.k Woeik wjÈ jQ ú.i bÈß meh ;=< ;uka ÿï mdkh fkdlrk njg ;ukagu fmdfrdkaÿ ù w;aika lrkak' JULY 2018 | DOCTOR MAGAZINE

ta meh wjika jQ úgu B<Õ meh ;=< ÿï mdkh fkdlrk njg fmr mßÈu ,shd w;aika lrkak' ta whqßka Èkh mqrdu;a miq od tljr meh folla olajd;a" B<Õ Èkfha§ tl jr meh ;=kla wd§ jYfhka lsÍu u.ska ÿï mdkfhka ñ§ug yelshdj we;'

p¾hd;aul ufkda ffjoH m%;sldr kuq;a u;ameka i|yd weíneysjQjka bka uqojd.ekSu t;rï myiq fkdjkqfha u;ameka mdkh lsÍu keje;aùu;a iu.u Tjqkag hï hï ldhsl iy udkisl wmyiq;djhka we;sùu fya;=fjks' flfia jqj;a uki Yla;su;a lsÍu u.ska kej; u;ameka mdkhg fmd<Ujk is;=ú,s hgm;a lsÍfï p¾hd;aul ufkda ffjoH m%;sldr iu.ska u;ameka mdkh keje;aùu ioyd jk T!IO Ndú;d lsÍu u.ska fuu ;;ajfhka ñÈh yelsh' u;ameka isrer ;+< Ô¾Kh ùfï l%shdoduh w;rueÈka keje;aùu fï i|yd fhdod.kakd DISULFIRAM kï T!IOfhka isÿlrkq ,efí' túg isrer ;=< weisge,aäyhsâ kï ridhk øjH tl;=ùu ksid oeä wm%ikak yeÕSula we;sfõ' jukh iu. isrerg we;sfjk wmyiq;djh ksid u;ameka mdkfhka f;drj isàu ioyd th m%fhdackj;a fõ'

weíneyshg T!Iëh m%;sldr fyfrdhska jeks m%n, weíneysldrl i|ydo ;Èka u;ameka mdkhg fhduqjQjka ioydo tajdg we;sjk zlEorluz keje;aùu i|yd m%Odk jYfhka T!IO j¾. ;=kla Ndú;d lrkq ,efí' NALTREXONE iy ACAMPROSATE hk T!IO Ndú; fldg fud<h ;=< we;s" u;aøjHhka nef|k wdOdrlhka u; tu T!IOhka ne£ug 22

JULY 2018 | DOCTOR MAGAZINE

i,iajd tu wdOdrlhkag u;aøjH ne£u j<lajd,kq ,efí' túg fud<h ;=< zfvdamñkaz iE§u wjysrùu ksid fl;rï u;aøjH Ndú;d l<o fmr fuka zi;=g okjk yeÕSulaZ fkdoefkk ksid ta ioyd zlEorlulaz we;s fkdfõ' tfiau wmiaudr frda.hg l,l isg Ndú;d lrk TOPIRAMATE kï T!IOh u.ska fud<h ;=< iEfok fvdamñka laIKslj bj;a lsÍfï yelshdj we;s neúka tu T!IOh o u;aøjH weíneysùï j,ska uqod.ekSu ioyd id¾:lj fhdod.kq ,efí' fuu T!IO ;=fkka uq,a T!IO fol Ndú;d l< yelafla u;aøjH Ndú;h kj;ajd" isrer úI yrk ;;a;ajhg m;al< miqjh' kuq;a TOPIRAMATE T!IOh u;aøjH Ndú;d lrk w;r;=ru Ndú;d l< yelsùu úfYaI;ajhls' T!IO Ndú;h" ufkda ffjoH m%;sldr iy WmfoaYkh fujka u;aøjHhka i|yd weíneys jQjka bka uqod.ekSu ioyd taldnoaOj l%shd;aul lsÍu jeo.;a jk kuqÿ tjka mqoa.,hkaf.a mjqf,a idudðlhka f.a fukau ñ;=rkaf.a iydh iy Wmldrh o fï i|yd b;du;a wjYH fõ' flfia fj;;a tjka iyhla Tyq jgd we;s iudcfhka fndfyda úg fkd,efnk ksid" ;uka iu. u;aøjH Ndú;d l< mqoa.,hka olsk úg" wdY%h lrk úg" u;aøjH Ndú;d l<" ñ,g .;a mßirfha Ôj;ajk úg fuu mqoa.,hka kej; u;aøjH Ndú;d lsÍug fhduqfõ' tneúka ta wh mqkre;a:dmkfhka miq tu mßirfhka o bj;alr ;eîug tkï úfoia /lshdjlg fhduqlsÍu jeks fohla lsÍfuka id¾:lj u;aøjHhkag weíneys jQjka bka uqod.ekSfï yelshdj ,efí'

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Diabetic Retinopathy

Èhjeähdj iy wei Èhjeähd wlaIs frda. y÷kd .ekSug kï wlaIs Y,H ffjoHjrfhl= u.ska wefiys lKksldj úYd, lr wei wNHka;rh mßlaId lrjd.; hq;=h'''

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JULY 2018 | DOCTOR MAGAZINE

Èhjeähdj hkq YÍrfha .aÆfldia mßjD;a;sh l%shdj,sfha ÿ¾j,;djhka ksid wêl .a,hsisñla ^iSks& uÜgula mej;Suhs' Èhjeähdj m%Odk jYfhka j¾. folla mj;sk w;r Y%S ,xldfõ m%Odk fi!LHh .eg¿jla njg Èhjeähdj m;aj we;' Èhjeähdj we;s iEu mqoa.,fhlau Èhjeähdj fya;=fjka isÿjk wlaIs wdndOhkag f.dÿre úh yel' fuh Èhjeähd fráfkdm;s ;;a;ajhla f,i y÷kajk w;r wkaONdjhg m%Odk;u fya;=jla f,io fuh oelaúh yel' l,ska y÷kd.ekSfuka fuu frda.S ;;a;ajh md,kh lr.; yels fõ' Èhjeähd frda.hg YÍrfha wfkl=;a wjhj j,g fukau wefiys iEu fldgilgu ydks l< yel' fráfkdm;s ;;a;ajhg wu;rj wefiys iqo" .a,qfldaud jeks ;;a;ajhkao we;s úh yel' ksfrda.S oDIaá ú;dkhla uQ,sl jYfhka jvd;a fyd| fmkSula i|yd fya;= fõ' oDIaá ú;dkh wdf,dal ixfõ§ ffi, yd iakdhq j,ska iukaú; ia:rhla jk w;r th wefiys msgqmi 24

oshjeähd wlaIs wdndOh ksid oDIaÀú;dkfha we;sjk fjkialï fldgfiys msysgd we;' fuys we;s reêr jdyskS oDIaá ú;dkhg wjYH fmdaIKh imhkq ,nhs' ld,h;a iu. wê reêr mSvkh" wêl .a,hsisñla uÜgu oDIaá ú;dkfhys we;s ishqï reêr jdyskS j,g ydks isÿ lrhs' tu.ska reêrjdyskS j, we;s reêrh oDIaá ú;dkh u.ska fmkSu iïnkaO fldgia wjysr lsÍu fya;=fjka jvd;a fyd| fmkSula ,eîug ndOd we;s fõ' oDIaá ú;dkfha we;s iakdhq ia:r bÈóu" reêr leá;s mej;Su jeks fya;=ka ksid fmkSu wvqùu md,kh l< fkdyels ;;a;ajhla olajd jqjo j¾Okh úh yel' uq,sl wjia:dfõ frda. ,laIK fkdue;s w;r jvd;a W.% wjia:djla olajd meñŒfuka miq fndfyda frda.Ska m%;sldr i|yd fhduq fõ' fuh wkaO Ndjhg uq,sl fya;=jla fõ' Èhjeähd wlaIs frda. y÷kd .ekSug jvd;a iqÿiqu l%uh jkafka iqÿiqlï ,;a wlaIs Y,H ffjoHjrfhl= u.ska wefiys lKksldj úYd, lr wei wNHka;rh mßlaId lsÍuhs' wo jk úg fuu frda.S ;;a;ajhkag jvd;a .e,fmk yd m%Óm, iy.; m%;sl¾u we;' Èhjeähd wlaIs frda. wkaONdjh we;sùug fmr md,kh l< yels w;r frda.Ska ta ms<sn| oekqj;a ù jvd;a wjfndaOfhka yd j.lSfuka lghq;= lsÍu jeo.;a fõ' jirlg jrla weia mÍlaId lr.ekSu uQ,sl jk w;r md,kh jQ Èhjeähd uÜgula mej;Su u.skao wlaIs wdndO j,ska je<lsh yel' wê reêr mSvkh" wêl .a,hsisñla uÜgu oDIaá ú;dkfhys we;s ishqï reêr jdyskS j,g ydks isÿ lrhs' •••

JULY 2018 | DOCTOR MAGAZINE

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WOMEN'S WORLD

úh<s iug Tìk i;aldr

úh<s iug ys;=uf;a wdf,amk .e,aùu iqÿiq kE''' wdrhg tk úh<s Ndjhg m%;sldr f,i os. gu wdf,amk .e,aùug isÿ fjkjd''' uDÿ inka ñi ier inka j¾. .Eu;a iqÿiq kE' ifuys úh<s Ndjh .ek jo fjk msßia wo ojfia ÿ,n kE''' ta ;rugu úh<s iu wfma iudcfha fndfyda fokdg jo fok .eg¿jlaj ;sfnkjd' úh<s iu iïnkaOfhka Tng m%fhdackj;a jk lreKQ iïmsKavkhla fï iu. f.k tkjd'

JULY 2018 | DOCTOR MAGAZINE

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úh<s iu we;sùug jhila kE' b;d l=vd <orejdf. isg" fl<sf,d,a orejka" ;reK ;reKshka''' jhia.; Woúh''' fï fldhs ldg;a úh<s iula we;s úh yelshs'

l=vd ld,fha isg we;sjk úh<s iu wdrhg tk tlla l=vd ld,fha isgu úh<s iula we;s fjkjd kï th fndfyda úg wdrhg tk ;;a;ajhla úh yelshs' we;eï orejkg nd, ikaosfha isgu fï ;;a;ajh we;s fjkjd' ke;akï jhi wjq 6-7 ld,fha isg bosßhg we;súh yelshs' wdrhg tk''' l=vd ld,fha isgu we;sjk ifuys úh<s nj frda.hla fkdfõ' tfy;a tfia we;s wh tu ;;a;ajfhka ñoSug ks;s wdf,amk .e,aùug isÿ fjkjd' tfia fkdjqKfyd;a fï ;;a;ajh jeä j¾Okh ù oo (Eczema) jeks p¾u frda. njg tajd m;aùfï wjodkula ;sfnkjd'

jeäysáhkaf.a iu ysá wäfha úh<s Ndjhg m;a fjkjd kï th wjOdkhg ,la úh hq;= ldrKhla'''

njla we;s fjkjd kï thg lsishï frda.S ;;a;ajhla n,mEfõo hkak .ek úuis<su;a úh hq;=hs' hlv W!K;djh jeks fmdaIK wvq¨yq`vq;d ksido iu úh<s Ndjhg m;aúh yelshs' ;hsfrdhsâ .%kaÓfhA W!K;d" jl=.vq frda. fukau wlaud frda. ksido fï úosyg jeäúh m;a jQ whf.a iu úh<s Ndjhg m;a úh yels neúka fï .ek ffjoHjrhdg mjid tfia fkdjk njg ;yjqre lr .ekSu Tfí wdrlaIdjghs' fjk;a frda. ksid we;sjk úh<s Ndjh uq¿ YÍrh mqrdu mej;Su iajNdjhhs' fldf,iagfrda,a wvq lsÍug ,nd .kakd T!IO yd fjk;a we;eï T!IO ldKAv ksido iu úh<s Ndjhg m;aùfï yelshdjla ;sfnkjd'

úh<s Ndjh we;s whg wdf,amk .e,aùug Wmfoia ifuys úh<s nj ke;s lrkakg iï wdf,amk wdf,amk ys;=u;fha .e,aùu iqÿiq kE' tajd .e,aúh hq;af;a ffjoH Wmfoia wkQjhs' we;eï whf.a YÍrh mqrdu úh<s Ndjh ;snqK;a yefudagu tfyu kE' we;efulaf.a uqyqfKa úh<sNdjhla ;snqK;a fiiq ia:dk j, tfia ifuys úh<s Ndjhla kE' w;amdj, ú;rla úh<sNdjhla orK wh;a wm w;r isákjd' fï úosyg ifuys úh<sNdjh tl tlaflkdg ;sfnkafk úúO iajrEmfhka' fïjdg wdf,amk .e,aùfïoS ta úh<sNdjh we;s ia:dk .ek;a ie<ls<su;a úh hq;= fjkjd'

ta;a" we;eï úg we;efulaf.a iu úh<s Ndjhg m;a jkafka ueos jhfiaoS' uy¿ wjêfhaoS iu úh<s Ndjhg m;aùu iq,nh' th jhig hdu;a iu. olakg ,efnkakls' tfy;a" ysá yeáfha' jhi wjqreÿ 40-50 muK ld,fhaoS tlajku ifuys úh<s

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JULY 2018 | DOCTOR MAGAZINE

WOMEN'S WORLD

fmardfoksh úYaj úoHd,fha lÓldpd¾h p¾u frda. úfYaI{ ffjoH ixcSjkS f*dkafiald

WOMEN'S WORLD

p¾u frda. ffjoHjreka ;u frda.Skg wdf,amk .e,aùug Wmfoia ,nd fokafka my; lreKQ iïnkaOfhka i<ld n,ñka' •

frda.shdf.a jhi

•

ifuys úh<s iajNdjh ljr m%udKhlgo hkak

•

wdf,amkfha >k;ajh

wdf,amk .e,aùfuysoS wkq.ukh l< hq;= fmdÿ Wmfoia lsysmhla YÍrfhys úh<s Ndjh we;s ia:dkh .ek úuis<su;a fjñka wdf,amk f;dard.; hq;= fjkjd' weia jgd" uqyqK wdoS ia:dk j,g wdf,amk .e,aùfïoS fukau l=vd <uhskag wdf,amk .e,aùfïoS tys wvq >k;ajhla ;sìh hq;=hs' >k;ajh (Thickness) jeä wdf,amk Tjqkag iqÿiq kE' wdf,amk .e,aùfïoS tays ñ, wkQj ;SrK .kak tmd' flfkl=g wvq uqo,lg wf,ú lrk wdf,amkhla jQj;a iqÿiq úh yelshs' ñ, .Kka wkQj tys m%;sM<odhS nj ;SrKh lsÍu iqÿiq kE' úh<s iug wdf,amk .e,aùfïoS fldfydu;a uq,skau wvq uqo,la jeh lr ñ,oS .; yels wdf,amkh Ndú;d lsÍu iqÿiqhs' fï wdf,amk flá ld,hla .,ajd k;r lsÍfuka kej;;a úh<sNdjh we;s fjkjd' fï ksid os.gu wdf,amk .e,aùug isÿ fjkjd'

wdf,amk .e,aúh hq;= wdldrh iEu úgu wdf,amk .e,aúh hq;af;a ifuys frdau j¾Okh jk me;a;ghs' tkï Wv ys|ka hgghs' ksoiqkla f,i úh<sNdjhg m;a wf;a wdf,amk .e,aùug isÿ jQjfyd;a Tn w;aj, ndyqj''' je<ñg fmfofia isg my<g'''" mdoj, kï by< isg my<g wdf,amk .e,aúh hq;=hs' Bg m%;súreoaO osidjg wdf,amk .e,aùfuka jvd;a ld¾hlaIuj tys m%;sM<h ,nd .ekSug ndOd meñfKkjd'

wdf,amk .,ajk jdr .Kk th;a ;SrKh jkafka úh<s Ndjh fl;rï ÿrg ;sfnkjdo hkak wkQjhs' t;rï nrm;, fkdjk idudkH ;;a;ajfha úh<s iulg kï osklg jdrhla muKla .e,aùu m%udKj;a jkakg mq¿jka' th hï ysßyerhla we;s lrjk uÜgulg ;sfnkjd kï ojilg fojrla muK wdf,amk .e,aùug isÿ fjkjd' oeä úh<s njla ;sfnk wh osklg f;jrla j;a wdf,amk .e,aùfuka ifuys f;; .;shla we;s lr .kak mq¿jka'

úh<s iug WÑ; inka idudkHfhka úh<s iula we;s úg iq,n inka j¾. .e,aùu iqÿiq jkafka kE' ta whg jvd;a iqÿiq uDÿ inka ^fíì inka& j¾.hs' fï whg .e,fmk Soap free Soap hkqfjka wf,úhg ;nd we;s inka j¾.;a fj<|fmdf<a ;sfnkjd' kuq;a tajd ;rula ñf,ka wêlhs' fï ksid wm úh<s iula we;s whg myiqfjka fj<|fmdf<ka ñ,oS .; yels uDÿ inka .ekSug Wmfoia fokjd' •••

JULY 2018 | DOCTOR MAGAZINE

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o;a .e,ùu

oeka oka; ffjoH úoHdfõ ;ykï jpkhla jeksh

oka; ixrlaIKhg osß fok kùK oka; ffjoHjreka jeä jeäfhka o;a wdrlaId lr.kakd f,i ck;djg Tjoka fo;s 30

JULY 2018 | DOCTOR MAGAZINE

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lsß o;a isÿ lrk uy;a fufyh

.,akEj m%dfoaYSh frdayf,a oka; Y,H ffjoH uyskao m%shxlr jksiqkaor wm ljqre;a okakd mßÈ udkjhdg o;a uqLfha we;s jk ld, jljkq wkqj fldgia folls' 1'

lsß o;a ^Milk Teeth, Decidous Teeth&

2' §¾> ld,Skj mj;sk o;a (Permanent teeth&

lsßo;a fuh .Kkska 20ls' ienúkau fuu o;a jhi wjq 11" 12 iy 13 hk jhia j,§ iajdNdúlju uqLfhka bj;a fõ' fuu iajdNdúl bj;a ùug wms hï fyhlska ndOd meñKqjfyd;a uqLfha isÿjk iajdNdúl l%shdj,sh wl¾ukH ù <uhd j¾Okh ùu;a iuÕ o;a iy uqL wdY%s; .eg¿ we;s lrhs'

doctormagazine.lk

fuu lsß o;a blauKska jefgk ksid fndfyda fouõmshka ta ms<sn|j jeä ie<ls,a,la fkdolaj;s' fï fya;=j ksid b;d l=vd jhia j, <uqka fndfyda fofk;a oka;dndO j,ska fmf<;s' úfYaIfhka Tjqka o;a Èrdhdfï frda.hg f.dÿre ù isá;s' <uhd frda.SjQ wjia:d j,§ fõokdfjka lE.eiSu jk úg lrorfhka fíÍu i|yd lsß o;a .,jd oeóug ffjoHjrekag n, lr isá;s' wld,fha lsß o;a orejkag wysñùfuka isÿjk whym;a m%;sM, fndfyda fouõmshka fkdoks;s'

fmdl=re o;a we;s ùfuka we;sjk .eg¿ lsß o;a iaÓr o;a j,g hd hq;= uÕ lshdfok nj;a wld,fha wysñ ùfuka isÿ jk msgqmi we;s úfYaIfhka pd¾jl o;a bÈßhg ;,a¨ùu ksid wfkl=;a o;a j,g ;sfnk bv weysÍfuka fmdl=re o;a we;sùug uÕ mdok nj fouõmsfhda fkdoks;s' ;jo fmdl=re o;a we;sùfuka ksis f,i uqLh msßisÿ lr .ekSug wfmdfydi;a ùfuka úÿre uia frda.o we;sùug iy W;aikak ùug fya;= mdol jkq we;' ;jo fuu fmdl=re o;a we;s ùfuka orefjda lkiai,a,g m;a fj;s' fï ksid Tjqkf.a wOHdmk lghq;= j,go n,meula isÿfõ' ksis f,i jpk WÉpdrkhg iy uqLh iïnkaO udYfmaYs j¾Okhg lsß o;a fnfyúka Wmldr fõ' bÈßmi o;a Èrd .sh úg <uqka wfkl=;a <uqka w;r Wmydihg ,laùugo mq¿jk fuys§ —mKq fldgdZZ wdoS jYfhka Wiq¿ úiq¿ lsÍuo iq,n jQ ;;a;ajhls' ta ksid wld,fha lsß o;a .ef,õfjd;a jev jrÈk nj fouõmshka oek .ekSu b;d w;HjYH jq ldrKhls'

udi ;=klg jrla j;a orejd o;a fodia;r fj; /f.k hdu iqÿiqhs fï ksid l=vd <uqkaf.a uqLh mÍlaId lr .ekSug wvqu ;rñka udi 3lg jrla o;a oka; Y,H ffjoHjreka fj; /f.k hd hq;=h' tys§ b;d l=vd ;;a;ajfha mj;sk o;a l=yr m%;sldr j,g ,la lr wld,fha o;a wysñ ùug hk l%shdj,sh k;r lr JULY 2018 | DOCTOR MAGAZINE

nj fouõmshka oek isáh hq;=hs' ixrlaIKh fkdl<fyd;a bÈßfha we;s jk ixl+,;d i|yd m%;sldr lsßug jeä úhoula rchg fukau mqoa.,sl wdh;k j,go úfYaIfhka úl,dx. oka; Y,H ffjoH m%;sldr ,nd .kafka kï frda.shdg wêl úhoula oeÍug isÿ fõ'

wld,fha lsß o;a .ef,õfjd;a jev jrÈk nj fouõmshka oek .; hq;a;ls' oeñh hq;=h' fõokdj wd mu‚ka lsß o;la .,jd .ekSug ffjoHjrekag n, lsÍu iqÿiq ldrKhla fkdjk nj fouõmshka is;a ;nd .; hq;=hs' o;l fõokdj we;s jkafka o;a Èrdhdu" l,al l=yrh olajd me;sr .sh úghs' iuyr úg —oka;skh˜ fldgi olajd me;sß .sh úg o;a ysßjeàu jeks ixfõ§;djhla we;s jk nj fouõmshkag okajd isàug <uqka ue<s fj;s' tfy;a iuyr <uqka oka; Y,H m%;sldr j,g nh ksid frda. hla we;s nj fyda o;a j, hï lsis wmyiq;djhla we;s nj fouõmshkag fyda ffjoHjreka fj; .sh úg m%ldY lsßug ue<s fj;s'

fõokdj we;s o;a jqK;a /l.; hq;=hs''' .e,ùu Bg úi÷u fkdfõ''' fndfyda <uqka o;a l=yr we;s úg ysá .uka wdydr .ekSu m%;slafIam lsßug bv we;' túg <uqka oka; ffjoHjrhl= fj; fhduq lr o;a j, l=yr we;s nj fyda ke;s nj ;yjqre lr .; hq;=hs' flfia fj;;a l=vd <uqkaf.a fõokdj we;s" o;ao ixrlaIKh l< yels 32

JULY 2018 | DOCTOR MAGAZINE

orejkag isÿ lrk kùk oka; ixrlaIK m%;sldr flfia fj;;a o;a l=yr fõokdfjka msrek úg l,al l=yrh bj;a lr Formocresole Ndú;d lr ^Pupeotomy& hk m%;sldrh lsÍfuka kshñ; jhi f;la o; wdrlaId lr .; yel' ierj f.ä we;sjQ o;a mjd ierj f.ä ke;s lr oka; Y,H fjoHjrekag m%;sldr l< yels nj okajd isáñ' fuu wjia:dfõ§ of;a l=yrh b;d úYd, kï fldmqjla oeófuka o;g wjYH Yla;sh ,nd §u ffjoHjrhdg l< yel' ^Crown oeóu& hï fyhlska of;ys msgqmiu we;s lsß o; tkï pd¾jl lsß o; wld,fha .e,ùug isÿjqj fyd;a háka tk iaÓr o;g ud¾.h wdrlaId lr §u ms‚i ta o;a w;r Space maintainer isÿ l< hq;=h' túg fmdl=re o;a we;sùu fndfyda ÿrg j<lajd .; yel' fujeks ixlS¾K m%;sldr lsßug isÿjk úg orejd b;d fjfyilr ;;a;ajhlg m;a fõ' fï ksid Tjqka l=vd l, isgu mjqf,a okak Y,H ffjoHjrhl= fj; /f.k f.dia oka; Y,Hd.drh iy oka; Y,H ffjoHjrhd iy WmlrK ms<sn| ìhla iy ielhla we;sùu j,lajd .ekSug mq¿jk'

iaÓr o;a wld,fha flfkl=f.a we;s iaÓr o;a doctormagazine.lk

o;la .,jkakg isÿ jqfKd;a l< hq;= foa'''

l=vd <uqkaf.a uqLh mÍlaId lr .ekSug wvqu ;rñka udi 3 lg jrla o;a oka; Y,H ffjoHjreka fj; /f.k hd hq;=h .,jd oeóug fya;= mdol jkafka o;a Èrdhdu iy úÿreuia frda.hs' tajd wmg iajdNdúlju ,eî we;af;a Èú we;s f;la wdrlaId lr ;nd .ekSughs' —o;a ke;sod Wla ovq .s‚ ;mskako˜ hkqfjka m%isoaO lshukla we;' flfia fj;;a wmg wld,fha o;a wysñ jqjfyd;a nrm;, udkisl wmyiq;djhkg uqyqK §ug isÿ fõ' úfYaIfhka uqLfha bÈßmi o;a wysñùu i|yka l< yel' Tyq fyda weh iudcfha by< ;,hl /lshdjla lrkafka kï fuh ;Èkau n,mdhs'

oka; ixfõ§;djhg mdr lmk jeros Ndú;hla''' wms Wv wekafoa o;la úfYaIfhka msgqmi ^mqria pd¾jl iy pd¾jl& .,jd oeuqjfyd;a Bg úreoaOj we;s ^.,jd oeóug úreoaOj& o; ld,h;a iuÕ biaiSulg fyda we§ulg ,laùfuka o;a uq,a me§ug mgka .kS' fï ksid l%ufhka flfkl=g oka; ixfõ§;djh we;sùug mq¿jk' ;jo" o;a w;r mj;sk iajdNdúl isÿr úYd, ùfuka tu isÿre w;r wdydr len,s isrùfuka nelaàßhd l%shd lsÍu ksid ÿ¾.kaOhlao hdno o;a Èrd hdugo úfYaIfhka fya;= úh yel' doctormagazine.lk

.,jd oeuQ o; yels blauKska oud .ekSug W;aidy .kafka kï fuu ixl+,;djfhka ñoSug Tyqg fyda wehg yels fõ' ;jo .,jd oeuQ o; me;a;g wfkl=;a o;a fhduq ùfuka Midline Shift fjkia ùfuka wj,iaik o;a ms<sfj,la we;s fõ' we;eï úfgl bÈßmi o;a fol w;r fukau wfkl=;a o;a w;ro isÿre we;s ùfuka o;a wekao wj,laIK fõ' úfYaIfhka .eyekqq orejka fï ms<sn|j ie<ls,a,la olaj;s' yKq j, msgqmi o;a wld,fha .,jd oeófuka Wvq yKqj iy há yKqj iïnkaO lrk ikaêh f,v ùug mq¿jk ^TMJ& fuh jhig h;au oek.kakg mq¿jk fndfyda msgqmi o;a wysñ jQ úhm;a frda.Ska fuu .eg¿jg uqyqK md;s' iuyr whg fkdfhl=;a fõokd kdYl .;a;;a ;;a;ajh iukh lr .ekSug fkdyels fõ' ;j;a iuyr wh fuu fõokdj we;s jkqfha ms<sldjla ksid hehs ìh fj;s' frda.Ska wkjYH Y,Hl¾u mjd isÿ lr .ekSug fm<fU;s' frda.ska f.a há ykqfõ bÈßmi o;a muKla b;sß jQ úg wdydr len,s iemSug tajd Ndú; l< ksid jeämqr f.ù hdug bv ;sfnk w;r fï ksid o;a wj,laIK ùu fukau oka; ixfõ§;djh we;sùug ms<sjka fõ' fndfyda fofkla is;d isákafka o;a .e,ùu m%Yakhg úi÷ula njhs' tfy;a —wld,fha iaÓr o;a .,jd .ekSfuka jev jrÈk nj˜ fndfyda fofkla fkdokakd ldrKd w;r fõ' fï ksid uq,sl wjia:dfõ§u frda. y÷kdf.k m%;sldr lr .ekSug W;aiql ùu Tn ieuf.a iqj fi;g fya;= mdol jk nj fuys§ i|yka lrñ' ••• JULY 2018 | DOCTOR MAGAZINE

Premature Ejaculation

laIKsl fudapkh wdorKSh yuqj fÄojdplhla ùu ksid hq.osúh tmdjQ wUqieñhka fofofkla

msßñka uqyqKmdk ,sx.sl .eg¿ w;r jeä yßhla fokd uqyqKmdk .eg¿j 34

JULY 2018 | DOCTOR MAGAZINE

doctormagazine.lk

fïjdhska ,efnk oekqu yeu úgu úoHd;aul kE' úoHd;aul fkdfjk ;rug Tjqka fkdhl=;a ñ;Hdjkag f.dÿre ù jerÈ m%;sldr j,g fhduq fjkjd' mjq,a iïnkaO;djhka lvd jeà Èlalidofhka fl<jr jk ;ekgu m%Yak Wvq ÿjkakg mq¿jka' tka l=udrkdhl ufkda frda. ffjoH lsßn;af.dv uQ,sl frday,

,sx.sl cSúf;a yd Bg wod, lreKq wUqieñhka fyda mjq,a w;r idlÉPdjg Ndckh jkafka b;du;au wvqfjka' óg m%Odku fya;=j ,eÊcdju fkfuhs''' ta ms<sn|j ;sfnk úYajdi iy wdl,amhs' mjq, ;=< fuh ieÕù hk ud;Dldjla ksidu orejkag ,efnk oekqu;a b;du;au w,amhs' Tjqka oekqu ,nd .kak W;aidy lrkafka ndysr mßirfhka" hy¿ ñ;%hkaf.ka''' tfyu;a ke;akï wka;¾cd,h iy udOH u.skah' doctormagazine.lk

hq. osúfha wysñ jQ iykh fuys tk msh,af.a l;dj óg lÈu ksoiqklah' ,sx.sl m%Yakhla ksid cSú;h wjq,a jqK msh,a wm fj; fhduq jk jg ish,a, lKmsg fm/<S" ;u wdorKSh ìß|f.ka fjka ùugo ;SrKh lr ;snqKd' msh,a Tyqf.a l;dj fufia wmg mejiqjd' zzuf.a jhi wjqreÿ 28hs' rcfha úOdhl fYa%‚fha ks,Odßfhla' újdy fj,d wjqreÿ folla fjkjd' ;ju wmg orefjd keye' ìß| iu. yßhg ,sx.slj tl;= fj,;a keye' wms újdy jqfKa wjqreÿ ;=kla wdorh lr,' hd¿fj,d bkak ldf,a ,sx.sl ixi¾. fha fhÿfka ke;s jqK;a fjk l%u j,ska i;=gq jqKd'

msh,ag ;snq m%Odku .eg¨jla kï ,sx.sl;ajh ms<sn|j ;snqK wdl,am yd oeä wd;;shhs' Tyq ;=reKQ úfha ,enQ w;aoelSula Tyqf.a uki jHdl+, lr wjidkfha hq. osúh;a tmd lrjkakg fya;= ù ;snqKd''' JULY 2018 | DOCTOR MAGAZINE

wfma yksuqka tl ojfia we;s jqKq ,sx.sl .eg¿j;a tlal ;uhs fï ish¿u m%Yak mgka .;af;a'ZZ zztod isÿ ùu .ek ug fyd|g u;lhs' wms wdorfhka ism je<|f.k isáhd' uf.a YsIaKh fhdaks ud¾. hg we;=¿ lrkak yok fldgu Y=l%dKq msg jqKd' yßhgu lSfjd;a úkdähla j;a .sfha keye' uu tl;= fjkak yeÿfõ yßu wdYdfjka' yenehs nhl=;a ;snqKd' ug yßhg lr .kak neß jqfKd;a th msßñlug;a ,ecacdjla lsh,d ug ys;=Kd' tl;= fjkak l,ska uf.a mmqfõ fmdä .eiaul=;a ug ;snqKd' b;ska fï isÿùfuka miafia uf.a ìß|f.a uqyqK;a fjkia jqKd' wef.a weia j, l÷¨ msreKd' uu wid¾:l mqoa.,fhla lsh,d ug ys;=Kd' ug ux .eku ;ryla we;s jqKd'ZZ zzfï úosyg" wms fokakd ,sx.sl weiqfrka wE;a jqKd' uu yeÿfõ fndfyda úg uf.a je/ oao uf.a ìß| msg mgjkak' wms fokakd ks;ru rKavq jqKd' uf.a wïuhs" ;d;a;hs ks;ru weyqjd wehs WU, fokakd ks;ru rKavq 36

fjkafk lsh,d' ta;a b;ska uu fïl fldfydu lsh,d lshkako@ZZ zzfï w;r ldf,§ uf.a fouõmshka uf.a flakaorh wrf.k idia;rlrefjla ,Õg .shd' Tyq lSjd wms fokakgu tardIaGlhla ;shkjd lsh,d' ;j uf.a hd¿fjla lSjd fïl fudayKfhka ikSm lrkak mq¿jka lsh,d' ta wkqj wms fudayKhg b;d m%isoaO mqoa.,fhla ,Õg;a .shd' Tyq lSjd fudayK jdr oyhlg iyNd.s jqjfyd;a laI‚lj fudapkh ksÜgdjg ikSm fjkjd lsh,d' tl fudayK jdrhlg /msh,a 2750la .;a;d' lsisu iqjhla jqfKa kE' fujeks fydre lS fofklag wms wyqfjkak we;ao lsh,d ysf;kjd'ZZ msh,af.a ,sx.sl Ôú;h .ek ;j;a f;dr;=re úuiqjd' Tyq fufiao lSjd' uu t;fldg jev lf<a wkqrdOmqf¾' t;dfldg ug lsisu ,sx.sl w;aoelSula ;snqfKa kE' wkqrdOmqr k.rfha .‚ld ksjdi msß,d' ud;a tlal tlg jev lrmq uf.a fyd|u hd¿jd ksu,a' Tyq ;ud biafi,a,du udj .‚ld ksjdihlg tlalf.k .sfha' uu ta ksjdih we;=,g .sfha fndafydu nfhka' NS;ska folla ug we;s jqKd' ljqreyß oelafld;a fudkjd ys;hso lsh,d ug ys;=Kd' ,sx.sl w;aoelSula ke;s ug yßhg ldßh lr.kak neß fjhs lsh,;a ug nhla we;s jqKd' fï nh;a tlalu ;ud uu ta ;re‚h;a tlal ysgfha' tod Sex lrkak;a biair fj,d ug Y=l%dKq msg jqKd' fufyu yh y;a j;djla muK fï ksjig .shd' ta yeu ojilu ug Sex lr .kak neß jqKd' laI‚lju Y=l%dKq msg jqKd'

laI‚l fudapkh we;s jkafka fï úosyghs lshkafka fï ufkda ffjoH úoHdj wkqj msh,af.a .eg¿j laI‚l fudapkh ^Premature Ejaculation& f,i y÷kajkjd' laI‚l fudapkh y÷kd .ekSug my; ,laIK ;sìh hq;=h' • ;u iyldßh iu. tl;= ùfïÈ úkdählg m%:u Y=l%dKq msg ùu' • tl;= jk fndfyda wjia:d j,§ ^75] jvd& by; wdldrhg laI‚lj fudapkh isÿ ùu'

JULY 2018 | DOCTOR MAGAZINE

doctormagazine.lk

• udi yhlg jeä ld,hla fï ;;a;ajh mej;Su • lsishï T!IOhla fyda u;aøjHhla fyda fjk;a frda.S ;;a;ajhla ksid fuh isÿ fkdúh hq;=h' wm ,Õg fhduq jQ msh,a iy ìß| yxis ufkda ffjoH m%;sldr j,g fhduq flreKd' msh,ag ;snq m%Odku .eg¨jla kï ,sx.sl;ajh ms<sn|j ;snqK wdl,am yd oeä wd;;shhs' Tyq wkqrdOmqrfha§ ,enq fkdfïrE ,sx.sl w;aoelSu fuu wd;;shg m%Odku fya;=jhs' msh,a ks;ru ysáfha ,sx.sl ld¾hh id¾:lj lr.ekSug fkdyels fõhehs hk ìfhks' fuu NS;sh ^Performance Anxiety& laI‚l fudapkhg m%Odk fya;=jla úh' id¾:l m%;sldr moaO;shlska .eg¿j úi|d.;a yeá fldyqj, life wdh;khg fhduq jq msh,a iy Tyqf.a ìß| my; i|yka l%shdldrlï j,g fhduq fl/Kd' • fofokdf.a ,sx.sl wd;;sh wvq lrk doctormagazine.lk

iam¾Yh uq,a fldg .;a ^Sensate Focus Exercise& iïndyk l%uh' • laI‚l fudapkh mud lsÍug YsIaKfha udxYfmaYs l%udkql+,j ,sys,a lsÍfï l%ufõohg mq/ÿ lsÍu' • ,sx.sl;ajh yd ,sx.sl ld¾hh ms<sn|j mqyqKqjla ,nd §u' • msh,af.a oeä wd;;sh yd laI‚l fudapkh ke;s lsÍug úoHd;aul T!IO ,nd §u' fufia ufkda úoHd;aul m%;sldr j,g fhduq jq msh,aj i;s 8la hdug fmr laI‚l fudapkh keue;s ;;a;ajfhka ñoSug yels jqKd' th bysfrkakg .sh leoe,a,la kej; tla lrkakg iu;a jqKd' wo msh,a yd yxis wdorKSh wUqieñhka fia Tjqkaf.a cSjk ;S¾: hd;%dj i;=áka f.jkjd' laI‚l fudapkh msßñka nyq, f,i f.dÿre jk ,sx.sl .eg¿jla' msßñka uqyqK fok ,sx.sl .eg¿ w;r 50]lau laI‚l fudapkhhs' fuh fifrdgkska keue;s iakdhq W;af;aclh ks¾udK lrk cdk ^Serotonin Transported Gene& j, úlD;s iajNdjhla ksido we;s úh yels nj úfYaI{ u;hhs' iudc NS;sldfjka fmf<k mqoa.,hkao fï ;;a;ajhg fndfyda fihska f.dÿre jk nj fidhdf.k we;' ••• JULY 2018 | DOCTOR MAGAZINE

rej

/l=ug fmdaIŒh w;aje,la wfkal rE iq/l=ï m%;sldr j,g hkakg m<uqj ksfrda.S nj i,ik lEu fõ,la .kak''' th rE iq/l=fï m%:u woshrhs'''

osklg l=reÜg iys; OdkH j¾. folla j;a .kak'

iEu m%Odk wdydr fõ,lgu úúO t,j¨ yd m<d j¾. ,nd .kak'

me‚ri lEu fjkqjg m,;=re" t,j¨ iqma" fld<le|" n;a le| jeks .=Kodhl foa f;dard .kak'

wêl f,i f;,a yd tl;= lrk ,o lEu tmd'''

iSks iys; yd lD;S%u wdydrmdk j,ska wE;a jkak fmdaIKfõÈkS .hks r;akdhl wdisß frday, ud;r

JULY 2018 | DOCTOR MAGAZINE

doctormagazine.lk

wo jk úg f,dalh mqrd ldka;djka fiau msßñkao ;u rej flfryS fhduq lrkafka úfYaI wjOdkhls' úúO wdf,amk Ndú;fha isg ie;alï isÿlsÍu olajd fkdfhl=;a rEm,djKH fjkialï isÿlsÍug wo wm fm<ö isákjd' kuq;a fndfyda fofkl=f.a wjOdkh fhduq fkdjKq w;sYh jeo.;a lreKla jkafka rej jvjd .ekSug YÍr wNHka;rhg ,ndfok fmdaIKh fï ish,a,gu jvd jeo.;a jk njhs'

fm%daàka( Tfí iu" ksh yd ysiflia iE§ we;s uQ,sl ix>Glh f,i fm%daàk ye|skaúh yelshs' fld,ecka" b,diaàka yd flràka tjeks fm%daàka j¾.hs' ifuys m%;Hdia;;dj" ;reK nj mj;ajd f.k hdug" ffi, ia:r w¨;ajeähdjg" ksh Yla;su;a ùug yd ysiflia ye,Su wju ùug fm%daàk wjYHhs' fm%daàk hyñka wvx.= fi!LHu;a wdydr f,i ud¨" yu bj;a l< l=l=¨ uia" ì;a;r yd lsß yeÈkaúh yelshs' Tn ks¾udxY wfhla kï úúO j¾.fha udxY-fNda. ^mßmamq" lv," ljqms" uqx-weg" fidahd fndaxÑ jeks& wdydr fõ,a j, wvx.= úh hq;=hs'

w;HjYH fïo-wï,( w;HjYH fïo-wï, hkq Tnf.a iqkaor;ajh mj;ajdf.k hdug yd jeä lsÍug wjYH Tn wjYHfhka .; hq;= fmdaIK ix>Gl folls' ukao h;a" tajd ñksia isrer ;=< ksmoùug fkdyels ksidhs' tu fïo wï, kï jYfhka Tfï.d-3 yd Tfï.d-6 fïo wï, fõ' ifï ksjerÈ wdydr rgdjlska Èÿ,k iajNdjh we;s lsÍug" l=re<E md,khg" Tng wjYH ish¨ ysialn,g wjYHh f;;ukh rojd ;nd .ekSug fmdaIK wjYH;d imqrd jeks fndfyda foa fï fïo wï, j,ska isÿlrhs' .ksñka kSfrda.S Èúhla w;HjYH fïo-wï,j, we;s m%;s m%odysl .=Kh ksid .; lsÍug yd Tfí rej Tnf.a ifuys we;s fndfyda wdidÈ; ;;a;aj wvq ukdj mj;ajdf.k hdug lr.ekSug WmldÍ fõ' Tfï.d-3 nyq,ju wvx.= yelshdj ,efnkjd' wdydr f,i l=vd ud¨ ^yqre,a,d" ieuka" uelr,a" idäka jeks& ye|skaúh yels' Bg wu;rj w,s.egfmar" rej jvjk wdydr .ek wjfndaOhla ,nd iqßhldka; f;,a" jÜglald weg" fidahd fndaxÑ jeks wdydr j,o w;HjYH fïo-wï, wvx.= fõ'

.ksuq

rEmh ms,sno l;dny lrk úg m%:ufhka u;lhg tkafka iu" ksh yd flia l,Uhs' tajd ksfrda.Sj mj;ajdf.k hdug úfYaIfhka jeo.;a jk fmdaIK ix>Gl yd wfkl=;a ix>gl lSmhl=;a" tajd wvx.= wdydr ms<snoj;a fuu ,smsfhka Tng wjfndaOhla ,nd.ekSug yelshs' doctormagazine.lk

hlv( rej ms<sno i<lk úg hlvo wu;l l< fkdyel' hlv wvq jQ úg iEfok kSrla;sh ksid iu iqÿue,s ùu" ysiflia leãu$.e,ù hdu" kshfmd;= ÿ¾j, ùu jeks ,laIK u;=úh yelshs' hlv nyq,j wvx.= wdydr fudkjdoehs weiQúg fndfyda fokd mjikafka ksú;s jeks m<d j¾.j, lshdhs' kuq;a Tn okakjdo@ YÍrhg myiqfjkau Wrd .kakd hlv jeämqru wvx.= jkafka i;a;aj wdydr j, nj''' YÍrhg Èklg wjYH hlv ,nd .ekSug Tn úfYaIfhka ud¨o Bg wu;rj yu bj;a l< l=l=¨ uia" ì;a;ro wdydrhg tl;= lr .; hq;=hs' m<d j¾.j, we;s hlv wjfYdaIKh jeä lsÍug tajd ilik úg foys" Wïn,lv tl;= lrkak' JULY 2018 | DOCTOR MAGAZINE

iajdNdúl m%;sTlaisldrl( fmdaIKuh jk ix>Gl fiau fmdaIKuh fkdjk ix>Glo m%;sTlaisldrl f,i l%shd lrhs' m%;sTlaisldrl u.ska iug ydks lrjk —Free-Radicals˜ kï ixfhda. j,g úreoaOj igka lr iu úhm;a ùfï fõ.h wvq lrhs' tfiau ysiflia yd kshfmd;=j, m%dKj;a yd Yla;su;a nj mj;ajd .ekSug;a fïjd jeo.;ah'

tjka m%Odk m%;sTlaisldrl lSmhla yd tajd nyq,j wvx.= wdydr lSmhla Tfí wjOdkhg fhduq lrkakï' îgd-lefrdáka hkq ifï j¾Kh jeä lsÍug yd ysre t,sfhka jQ ifï ms,siaiqï wvqlr .ekSug Wmldr lrk ix>Glhls' ly iy ;eô,s meye;s t,j¨" m,;=rej,;a ;o fld, meye;s ksú;s jeks m<d j¾.j,;a fïjd nyq,j wvx.=hs' úgñka C hkq ;j;a jeo.;a m%;sTlaisldrlhls' ifï m%;Hdia;;dj mj;ajd .ekSug wjYH lrk fld,ecka kï fm%daàkh ksmoùug úgñka C wjYH fõ' ifï taldldr meyem;a njla mj;ajdf.k hdug" ifï yd ysialnf,a f;;ukh mj;ajdf.k hdugo úgñka C WmldÍ fõ' fodvï" wU" kdrx" fk,a,s" foys jeks m,;=re j, úfYaIfhka úgñka C wvx.= fõ' tfiau úgñka E hkq rej ms,sno i,lk úg jeämqru l;dny lrk m%;sTlaisldrlhls' iug ydkslrk úúO ndysr idOlhkaf.ka iu wdrlaIdlr .ekSug" ysiflia j¾Okh fõ.j;a lsÍug" flia w. fmdaIKh lsÍug úgñka E wjYH fõ' iajNdúlj úgñka E wvx.= wdydr f,i iQßhldka; f;,a" wdukaâ f;,a" w,s.egfmar" lcq j¾." l=reÜg iys; OdkH yeÈkaúh yelshs'

fmd,s*Sfkda,sla —Polyphenolic˜ m%;sTlaisldrl ^Resveratrol, Flavonoids& úfYaIfhka Tfí iu úhm;a ùu j,lajd .ekSug WmldÍ jk nj kj;u fidhd .ekSï j,ska fy,sù we;' nyq,j wvx.= wdydr f,i f;a" fldams" T,sõ f;,a" l=re÷ ioyka l< yelshs' m,;=re j¾.j,o wvq-jeä jYfhka fïjd wvx.= fõ' óg wu;rj m%;sTlaisldrl nyq, iajNdúl wdydr f,i yß; f;a ^Green tea&" l=¨nvq j¾." ;lald,s" îÜ rEÜ" iqÿ Ækq" fo¨ï" ñÈ" iafg%dafnß jeks t,j¨ m,;=reo kï l< yel' kuq;a ish¨ iajNdúl wdydrj, úfYaIfhka t,j¨" m,;=re" OdkH j¾.j, by;a lS-fkdlS m%;sTlaisldrl úúO m%udKhkaf.ka wvx.= fõ' tajd ish,a, isrerg ,nd .ekSug Tn l< hq;af;a úúO;ajhlska hq;=j ;ukaf.a ffoksl wdydr fõ, ilialr .ekSuhs' tkï l=reÜg iys; OdkH j¾." wju jYfhka Èklg folla j;a úúO m,;=re j¾." iEu m%Odk wdydr fõ,lgu úúO t,j¨ yd m<d j¾.;a" úúO udxY fNda.;a" i;a;aj wdydr f,i jeä jYfhka l=vd ud¨;a ;u wdydr j,g tlalr .ekSuhs' Tn .kakd flá-wdydr f,i laI‚l wdydr" me‚ri lEu fjkqjg m,;=re" t,j¨ iqma" fld<le|" n;a le| jeks .=Kodhl foa f;dard .kak' tfiau wêl f,i f;,a yd tl;= lrk ,o iSks iys; lD;S%u wdydrmdk j,ska wE;a ù by; ioyka Tfí iug ysiflia yd ksh j,g fmdaIKh imhk iajNdúl wdydrj,g keUqrejkak' túg Tng úúO ñ, wêl wdf,amk" wdydr w;sf¾l yd ie;alïj,ska f;drj iqkaor rEimqjla ysñlr .ekSug fkdwkqudkj yelshdj ,efnkq we;' •••

JULY 2018 | DOCTOR MAGAZINE

doctormagazine.lk

ksfrda.S osúhlg mdr lshk wfma rfÜ jefjk

w, j¾.

☛ rdc w, ☛ oï w, ☛ lyg w, ☛ /jq,a w, ☛ lgq w, ☛ l=l=,, ☛ ys`.=r, ☛ lSvdrï ☛ lsß w, ☛ .y, ☛ rg, ☛ nq;airK

Èhjeähdj" úúO ms<sld j¾." yDo frda. jeks fnda fkdjk frda. iEoSu j<lajd .ekSfïoS;a tajd md,kh lsÍfïoS;a fuu w, fnda. m%fhdackj;a fjhs'

☛ yq,xlsßh

JULY 2018 | DOCTOR MAGAZINE

wdydr j¾. w;r ldfndayhsfâ%g m%Njhla f,i w, fnda. fofjks jkafka OdkH j,g muKs' mia ;=< ;sfnk Ydl wjhj jk l|ka iy uq,a ;=< wdydr .nvd lsÍu w, fnda. j, úfYAI;ajh fõ' w¾;dm,a" uhsfhdlald iy n;, jeks msIAGuh w, fnda. m%Odk jYfhka wo fj<|fmdf,a ks;r olakg ,efí' tfia jqjo .=Kfhka wkQk jQ kuqÿ W!K Ndú; w, fnda. rdYshla wfma uq;=ka ñ;a;kaf.a wdydr isßf;ys jeo.;a ia:dkhla w;am;a lr.;a neõ Tn okakjdo@

Y%S ,xld fmdaIK úoHd ix.ufha iNdm;sks jhU úYAj úoHd,hSh jHjydßl fmdaIK úoHd wxYfha uydpd¾h wfkdaud pkaøfialr doctormagazine.lk

Yla;sh yd ;ka;=h fldgiao cSj l%shdldÍ ixfhda.o wfma bmerKS w, j¾. j, fkdwvqju we;''' Y%S ,xldfõ úúO fmfoia j, jefjk iy j.d l< yels W!K Ndú; w, j¾. rdYshls' tu w, fnda. WoaNso úoHd;aulj úúO l=,hkag iy Ydl j,g whs;s jk w;r úúO fmdÿ kduhkaf. ka yªkajhs' fuu w, fnda. w;r rdc w," oï w," ls`v," lyg w," /jq,a w," lgq w," l=l=,," ys`.=r, w, wdosh vhiafldßhd .Khg wh;a fõ' lSvdrï" lsß w," .y," rg," nq;airK" yq,xlsßh jeks w, fnda. úúO l=, j,g wh;a ,xldfõ me;sÍ we;s w, j¾.hs' úgñk yd LKsc ,jK j,ska fmdfydi;a m%Njhla fkdjqjo" Yla;sh iy wdydr ;ka;= imhk uQ,dY% f,i fuu w, fnda. jeo.;a fõ' tfiau úúO cSj l%shdldÍ ixfhda.o w, fnda. j, wka;¾.; fõ' doctormagazine.lk

if*dkska" *fkda,sl ixfhda." *hsála wï,h" .a,hsfldf,dhsâ" lefrdáfkdhsv iy weiafldìla wï,h ta w;r fõ' w, fnda. j.dfõoS tajd ñY% fnda. f,i fhdod .ekSug we;s yelshdj" wju lDIsld¾ñl wuqøjH wjYH;djh iy mSvdldÍ j.d ;;a;aj j,g id¾:lj uqyqK oSfï yelshdfjka hqla; ùu úfYAI ,CIK fõ' oshjeähdj" úúO ms<sld j¾." yDo frda. jeks fnda fkdjk frda. iEoSu j<lajd .ekSfïoS;a tajd md,kh lsÍfïoS;a fuu w, fnda. jeo.;a jk neõ m¾fhaIK j, o;a; u.ska meyeos<s fõ' W!K Ndú; w, j¾. m%;sTlaisldrl ixfhda. j,ska fmdfydi;a fõ' tajd u.ska YÍrh ;=< mj;sk ksoyia md,kh lsÍfï yelshdj we;' tfukau fuu ixfhda. wmf.a foayh ;=< iajNdúlj mj;sk m%;sTlaisldrl tkaihsu j, l%shdldß;ajh jeä oshqKQ lsÍugo WmldÍ fõ' tfiau fnda fkdjk frda. md,kfhaoS wmf.a reêr.; úúO fïo w.hka ksis mßos mj;ajd .ekSugo WmldÍ fõ' frda. iEoSfïoS fjkia jk tkaihsu l%shdldß;ajhka kej; h:d ;;a;ajhg m;alr .ekSu i|ydo iuyr w, fnda. j¾. j,ska úfYAIfhka vhiafldßhd l=,hg wh;a w, fnda. j,ska msgqjy,la ,efí' mss<sld ffi, .yKh ùu je<elaùug fndajk frda. j,ska wdrCId ùug" YÍrfha m%;sYla;slrK moaO;sh iún, .ekaùug" úúO nelaaàßhd j¾. i|yd m%;scSjl f,i l%shdldÍ ùu" reêr.; iSks uÜgu my; fy,Sfï yelshdj" reêr.; fldf,iagfrda,a uÜgu wvq lsÍu fï w;r úfYAI fõ' fkdfhla meyefhka" rifhka" jhkhlska hqla; jk fuu W!K Ndú; w, fnda. wmf.a wdydrfha úúO;ajhla we;s lrhs' iajNdúl ;;a;aj hgf;a j.dl< yels w, fnda. i|yd lDIs ridhksl fhoSu wjYH jkafka ke;' ldnksl fmdfydr Ndú;fhka muKla Wiia wiajkq ,nd .ekSfï yelshdfjka wkQk fõ' ji úI ke;s wdydr ,nd .ekSug W;aiql jk Tng fuu W!K Ndú; w, j¾. uy;a wdYs¾jdohla jkq we;' ••• JULY 2018 | DOCTOR MAGAZINE

wdydrfha

fïo idOlh yDohg ys;lr fïoh ms<sn| Tn oekqj;ao@ Y%S ,xld jhU úYAj úoHd,fha jHjydßl fmdaIK wOHhkdxYfha wxY m%OdkS$lÓldpd¾h wdpd¾h l=udß u,aldka;s r;akdhl

JULY 2018 | DOCTOR MAGAZINE

doctormagazine.lk

fïoh bgq lrk fufyh kQ;k iudcfha fïoh ms<sn|j we;s wkjYH ìh fya;=fjka fïoh wvx.= wdydr wj m%udK j,ska Ndú;d lsÍu fmdÿ Ndú;hla ù yudrh' wdydrfha wvx.= w;HjYH fïo wï, YÍrfha hymeje;au yd ksfrda.S nj i|yd b;d jeo.;a fufyjrla bgq lrk w;r fïo ødjH úgñka YÍrhg wjfYdaIKh i|yd fïoh w;HjYH fõ' m%;sTlaisldrl f,i l%shd lrk iuyr fïo ms<sld frda. yd fkdfhl=;a ksoka.; frda. yd fnda fkdjk frda. we;s ùfï wjodku wvq lrhs' tfukau wdydrfha uDÿ nj we;s lsÍug" rih yd iqj|j;a nj jeä oshqKQ lsÍu i|yd fïoh uyÕ= ld¾hhla bgq lrk ,nk w;ru wdydrfha reÑl;ajho by< kxjhs'

doctormagazine.lk

fïoh iEos we;s uQ,sl ridhksl ix>glh jkafka fïo wï,hs' úúO wdydr j, wvx.= fïo wï, j, úúO;ajh u; isrerg ie,fik m%;sM, j, hym;a nj fyda whym;a nj ;srKh fõ' tneúka wkjYH ìhlska f;drj wmf.a ksfrda.S nj Wfoid wmf.a wdydr fõ,g fïoh wvx.= wdydr f;dard .ekSfïoS ie<ls,su;a ùu w;HjYH fõ'

wix;Dma; fïoh fukau" ix;Dma; fïoh;a hï m%udKhla isrerg wjYHhs fïo wï, ie<lSfïoS ix;Dma; fïo wï, yd wix;Dma; fïo wï, f,i m%Odk fldgia follg fnosh yel' fï w;ßka ix;Dma; fïo wï, isrerg wys;lr nj;a wix;Dma; fïo wï, isrerg ys;lr nj;a fndfyda fokdf.a fmdÿ ms<s.ekSuh' tkuq;a isref¾ ksfrda.S nj Wfoid wjYH m%udK j,ska tu j¾. foflysu wjYH;djhka ;sfí' ix;Dma; fïo wï, wmf.a wdydr fõ,g tl;= lr.; hq;af;a Yla;s m%udKfhka 10]g jvd wvq m%udKhls' kQ;k úoHd;aul m¾fhaIK j,g wkqj ix;Dma; fïo wï,h wvx.= wdydr reêrfha we;s wys;lr fldf,iagfrda,a (LDL) uÜgu by< kxjk nj y÷kdf.k we;' uia" uia wdY%s; ksIAmdok" ìialÜ" flala" fmd,a" fmd,alsß" fmd,a f;,a wdoS wdydr j¾. j, nyq, jYfhka ix;Dma; fïo wï, wvx.= nj fmkajd oS we;'

wix;Dma; fïo wï, wvx.= wdydr YÍrhg ys;lr fldf,iagfrda,a uÜgu by< kxjhs'

JULY 2018 | DOCTOR MAGAZINE

ix;Dma; fïo wï,h wvx.= wdydr reêrfha we;s wys;lr fldf,iagfrdaa,a by< kxjhs' YÍrhg ys;lr wix;Dma; fïo wï, wvx.= wdydr tf,iskau wix;Dma; fïo wï, wvx.= wdydr mßfNdackh lsÍu ;=<ska YÍrhg ys;lr fldf,iagfrda,a uÜgu by< kxjk njo" wys;lr fldf,iagfrda,a (LDL) my< ouk njo fidhdf.k we;' YÍrhg ys;lr wix;Dma; fïo wï, wvx.= wdydr f,i lcq" rglcq" ;," f;,a iys; weg j¾. (Nuts)" lefkda,d" w,sfmar" T,sõ" ;, f;,a Ndú;d l< yel' ix;Dma; fïo wï, iu. ixikaokh lrk úg wix;Dma; fïo wï, wvx.= wdydr jeämqr mßfNdackh lsÍu ;=<ska rij;a" fmdaIKfhka wkQk fi!LHu;a wdydr fõ,la ri ú|Sug wjldYh ie,fia' tfukau jeämqr ix;Dma; fïo wï, wvx.= wdydr wkq.ukh ksid we;sjk wys;lr n,mEïo wju lr.; yel'

isrerg ke;sju neß Tfï.d 3 yd 6 fïo wï, nyq wix;Dma; fïo wï, jk Tfï.d 3 yd 6 isrerg w;HjYH jk w;r YÍrh ;=< ksmojd .; fkdyels neúka msg;ska wdydr f,i ;nd.; hq;= fõ' kQ;k úoHd;aul m¾fhaIK j,g wkQj Tfï.d 3 wvx.= wdydr jeämqr tl;= lr .ekSfuka reêrfha wys;lr fldf,iagfrda,a uÜgu wvqlr yDo frda. wjodku wvq fjhs' Tfï.d 3 wvx.= wdydr f,i fïoh iys; ud¿ j¾. ^n,hd" yqre,a,d" id,hd" fnda,a,d iy ieuka& oelaúh yel'

JULY 2018 | DOCTOR MAGAZINE

tf,iu Tfï.d 6 wvx.= wdydr" wdydr fõ,g tlalr .ekSfukao wys;lr fldf,iagfrda,a uÜgu wvq lsÍu ;=<ska yDo frda. i|yd we;s wjodku wvql< yels nj fidhdf.k we;' Tfï.d 6 wvx.= wdydr f,i iQßhldka;" fidahd f;,a" nv bß.= f;,a yd ;, f;,a Ndú;d l< yel'

isrerg wys;lr g%dkaia fïoh g%dkaia fïoh isrerg wys;lr fïofha tla ixrplhls' wix;Dma; fïo wï, by< WIAK;ajhlg r;a lsÍfïoS g%dkaia fïoh ksmojhs' g%dkaia fïoh wvx.= wdydr jeämqr mßfNdackh lsÍfuka yDo frda. wjodku jeä fõ' mdï f;,a jeks t<j¿ f;,a ^wix;Dma; fïo wï, iys;& .eUQre f;f,a neo wdydr ms<sfh, lsÍu ;=<ska g%dkaia fïoh doctormagazine.lk

úYd, jYfhka isrer ;=<g msúfihs' tfukau wix;Dma; f;,a kej; kej; Ndú;hg .ekSfïoS wdydrfha wvx.= g%dkaia fïo m%udKh by< hhs' fmd,a f;,a ix;Dma; fïo wï, j,ska iukaú; jk neúka .eUQre f;f,a neoSu i|yd fhdod .ekSu t<j¿ f;,a j,g idfmaCIj iqÿiq fõ' g%dkaia fïoh u.ska imhk fïoh ffoksl Yla;s wjYH;djfhka 1] fkdblauúh hq;=h' Y%S ,dxlslhkaf.a wdydr fõf,ys m%Odk fïo m%Njh fmd,ah' fndfyda úg fmd,a lsß yd fmd,a f;,a wdldrhg mßfNdackh flf¾' mia fofkl=f.ka iukaú; jk mjq,lg osklg uOHu m%udKfha fmd,a f.ähla Ndú;d lsÍu ;=<ska fmd,a mßfNdackh lsÍu" fmd,aj, ix;Dma; fïoh u.ska isrerg we;sjk wys;lr n,mEu wju lsÍug u. mdohs'

fhda.Ü fyd|hs''' lsß yd lsß wdY%s; ksIAmdok j, ix;Dma; fïoh nyq, jqj;a lsßj, wvx.= w;HjYH fm%daàka" le,aishï jeks Lksc ,jK jeks fmdaIK ix>gl doctormagazine.lk

fï ldKAv foflysu fïoh isrerg hï muKlska wjYH jkafkah''' fya;=fjka tajd wkjYH muKg iSud lsÍula wjYH fkdfõ' fm%danfhdáka yd m%snfhdála (Pro & Prebiotic) j,ska fmdfydi;a jQ m%ñ;shg wkql+,j idok ,o fhda.Ü Tfí fmdaIKhg wk.s f;aÍuls' tu.ska isref¾ wka;% ;=< jQ ys;lr nelaàßhd j¾Okh osß .kajk w;r uyd wka;%h yd iïnkaO frda. wju lrhs' tfukau fïjd yDohg ys;lr njo kj fidhd .ekSï ;=<ska wkdjrKh ù ;sfí'

osklg .; hq;= iuia; fldf,iagfrda,a m%udKh mqoa.,fhl= wdydr u.ska osklg ,nd .kakd fldf,iagfrda,a m%udKh ñ,s.%Eï 300lg jvd wvqúh hq;=h' tkuq;a Tn yDofrda. fyda fldf,iagfrd,aa iïnkaO frda. j,ska f;dr ksfrda.S wfhla kï ta i|yd wkjYH f,i iSud we;s fkdlr.; hq;=h' fjfiiskau" ì;a;r mßfNdackh wdosh iSud fkdl< hq;=h' idudkH m%udKfha ì;a;rhl fldf,iagfrda,a ñ,s.%Eï 250 muK wvx.= fõ' tneúka wkjYH f,i iSud lsÍfuka fuu wjYH lrk fmdaIl ysÕmdvq jkakgo bv ;sfí' by; lreKQ i<ld ne,SfïoS fïoh wvx.= wdydr mßfNdackh flfryS wkjYH ìhla we;s fkdlr .; hq;= nj meyeos<sh' kQ;k fmdaIKh yd ine|s uq,O¾u j,g wkqj wm l< hq;af;a muK blaujd fyda muKg wvqfjka mßfNdackh fkdj iqÿiq foh iqÿiq m%udKhg WÑ; wjia:dfõoS mßfNdackh lsÍfuka ksfrda.S osú fmfj;lg wä;d,u ilid .ekSuhs' kQ;k úoHd;aul m¾fhaIK j,g wkQj Tfï.d 3 wvx.= wdydr jeämqr tl;= lr .ekSfuka reêrfha wys;lr fldf,iagfrda,a uÜgu wvqlr yDo frda. wjodku wvq fjhs' .eUQre f;f,a neoSu i|yd t<j¿ f;,a j,g jvd fmd,af;,a fhdod .ekSu iqÿiqh' ••• JULY 2018 | DOCTOR MAGAZINE

wd¾;jyrKhhs iy

Tfí fmdaIKhs hym;a fmdaIKhla ,eîfuka y;rlska l,a oud.; yelshs'''

wd¾;jyrkh

jir

Èklg iSks f;a ye¢ 3-4 l Wmßuhlg jvd .kak tmd' ;sß.= msá wdY%s; fílß ksIamdok iy laI‚l wdydr Ndú;h yels ;dla wju lrkak' Èklg úkdä 20 muK j;a t<suyfka''' wjqfõ jHdhdu j, ksr; jkak' 48

JULY 2018 | DOCTOR MAGAZINE

doctormagazine.lk

wd¾;jyrKh hkq iEu ldka;djlgu ish Èúfha§ uqyqK mEug isÿ jk iajNdúl Ôj úoHd;aul ixisoaêhls' wdishd;sl ldka;djkaf.a wd¾;jyrKh isÿ jk idudkH jhi wjqreÿ 50 - 52 w;r fõ' ldka;djlf.a ksis fmdaIK ;;a;ajh ish iajNdúl wd¾;jyrKh" jir y;rlska m%udo lsÍug iu;a jk nj kj;u úoHd;aul u;hhs' ;jo ksis fmdaIK uÜgu iy hym;a Èú meje;au ;=,ska ldka;d Tng we;s jk wd¾;jyrKfha iq,n w;=re úmdl id¾:lj u. yrjd .; yelshs' wd¾;jyrKfha uq,a wjêfha isgu Tfí fmdaIK ;;a;ajh iy fi!LHh ms<sn|j ie,ls,su;a ùfuka fuu ixisoaêhg id¾:lj uqyqK foñka ;jÿrg;a Tfí l%shdYS,S iy fid÷re ldka;d Èúh ksfrda.Sj mj;ajd .; yelshs'

Ôjk§ fyÜáwdrÉÑ fmdaIKfõ§ iy wdydrfõ§" lÓldpdßkS" jHjydßl fmdaIK wOHhkdxYh" Y%S ,xld jhU úYaj úoHd,h'

iúu;a wiaÓ moaO;shla Wfoid''' •

lsß iy lsß wdY%s; wdydr Èklg 2-3 j;djla j;a wdydrhg tla lr .kak' fïo rys; lsß f;dard .ekSu Tfí yoj;a fi!LHg fukau isref¾ ksis nr mj;ajd .ekSugo jeo.;a'

•

oskm;d Tfí wdydr fõ,g lgq iys; l=vd ud¿ j¾. tla lr .kak'

•

Èklg wju jYfhka m<d j¾. iy ;o fld< meye;s t<j¨ .a?ï 100 - 150 w;r m%udKhla .kak'

•

Èklg úkdä 20 muK j;a t<suyfka''' wjqfõ jHdhdu j, ksr; jkak' thska Tfí úgñka D wjYH;djho imqrd .; yel'

lEu fïifha iqÿ N+;hka''' fïjd muK oek ,x lr .kak ksfrda.S ldka;djla" Èklg iSks f;a ye¢ 3-4 l Wmßuhlg jvd .kak tmd' me‚ ri" le,ß nyq, wdydr ^fgd*s" fpdl,Ü" me‚ îu j¾." me‚ rie;s lsß îu j¾.& ks;r Ndú;fhka j<lskak' Tn wêl ;rndre nfjka fyda Èhjeähdj jeks frda.S ;;a;ajhlska fmf<kafka kï" fmdaIKfõÈfhl=f.a Wmfoia m;kak'

iSks

Tfí ffoksl ¨Kq Ndú;fha Wmßuh" fïi ¨Kq

fï i|yd Tng my; lreKq WmldÍ jkq we;'

doctormagazine.lk

JULY 2018 | DOCTOR MAGAZINE

¨Kq

.a?ï 5 lg iSud úh hq;=h' lD;%Su ri ldrl fhÿ" wêl ¨Kq iys; wdydr Ndú;h md,kh lrkak' ¨Kq iy ri ldrl fhdod wdydr ri lrkq fjkqjg l=re÷" .ïñßia" f.drld jeks l=¿nvq Ndú;hg yqre fjkak'

ksis wdydr rgdfjka ieye,a¨" ksfrda.S isrerla''' Biag%cka fydafudak uÜgu wvq ùu;a iu. fndfyda ldka;djkaf.a isref¾ wkjYH f,i fïo ;ekam;a ùfï iïNdú;djh jeä fõ' Tfí Wig iß,k ksis nr ms<sn| oekqj;a ùug;a l%uj;a wdydr md,kh iy jHdhdu ;=<ska tu b,lalh lrd ,Õd ùug iy th È.= ld,Skj mj;ajd .ekSug;a fuu jhia ldKavfha ldka;djka W;aidy .; hq;=h' wkjYH f,i wdydr fõ,a u. yeÍu fjkqjg" m%Odk wdydr fõ,a 3 iy w;r ueÈ wdydr fõ,a ksis fõ,djg .ekSu;a" ta i|yd l=vd wdydr fõ,a f;dard .ekSu;a isref¾ nr fi!LHdrlaIs; f,i wvq lr .ekSug WmldÍ fõ' ;sß.= msá wdY%s; fílß ksIamdok iy laI‚l wdydr Ndú;h yels ;dla wju lr ta fjkqjg iy,a msá" wdgd msá" lv, msá" W¿ÿ msá wdY%s; ksIamdok f;dard .ekSu;a" t<j¨ iy m<d j¾." i;aj wdydr" mßmamq" lv," uqx weg jeks udY fnda. hka iy m,;=re j,ska iukaú; úúO;ajfhka hq;= wdydr fõ,la Èkm;d .ekSfuka Tfí fmdaIK wjYH;djhkao uekúka imqrd .; yel'

JULY 2018 | DOCTOR MAGAZINE

fï .ek;a is;kak''' .eUqre f;f,a nÈk ,o wdydr Tfí yoj;a fi!LHhg wys;lrhs' f;,a wêl flá lEu j¾. ^fmaiaá%" lÜ,Ü" jfâ" neomq lv,& ks;r Ndú;fhka j<lskak' f;ïmrdÿ lsÍug f;,a j¾.hla f;drd .ekSfï§ jvd;a fi!LH wdrlaIs; wix;Dma; fïo wï, wvx.= fidahd f;,a" iQßhldka; f;,a" bß.= f;,a" T,sõ f;,a" lefkd,d f;,a jeks f;,a j¾. j,g m%uqL ia:dkhla ,nd fokak' Èklg Tfí fmd,a Ndú;h uOHu m%udKfha fmd,a f.ählska 1$5 lg iSud lrkak' Èklg wju jYfhka j;=r ùÿre 8la j;a mdkh lrkak' óg wu;rj Tfí hy meje;aug ndOd jk YdÍßl fjkia ùï ms<sno ksrka;r wjOdkfhka miq jkak' wd¾;jyrKh frda.hla fkdj iEu ldka;djlgu fmdÿ b;d iajNdúl isÿ ùula nj iy isÿ úh yels ldhsl iy udkisl fjkiaùï wjfndaO lr .ekSu;a" wjYH wjia:djkays iqÿiq ffjoH fyda fmdaIK Wmfoia lrd fhduq ùu;a u.ska fuu ;;a;ajhg id¾:lj uqyqK §ug Tn;a nqoaêu;a jkak' ••• doctormagazine.lk

ljqre;a okakd

n;,

j, fkdokakd fmdaIK .=K n;, lE hq;af;a fmd;a;;a iu.hs''' ;ka;=uh fl|s;s ;sfhk ksid w;sYh fmdaIKSh wdydrhla''' fnda fkdjk frda. j,ska wdrlaId jkakg fyd| wdydrhla'''

fï foaYSh n;, úfYAI .ek Tn okakjdo@ n;, lshQ mu‚ka wm rfÜ fndfyda fokd y÷kkafka r;= n;, iy ly n;, f,i n;, j¾. folla muKs' tfia jqj;a Y%S ,xldj ;=, n;, j¾. 15 lg;a jeä m%udKhla oekg y÷kdf.k ;sfnkjd' ta w;r msg fmd;a; r;= meyehla .kakd n;, j¾. /ilau y÷kd .; yels w;r tajdhska iuyrl we;=,; iqÿ meyehla .kakd w;r b;sß j¾. j, we;=,; ly meyehlska hqla; jkjd' tfiau iuyr j¾. msg fmd;a; fukau we;=,; meyeho iqÿ meyehlska hqla; jkjd' msg fmd;a; r;= meye jk iy we;=,; iqÿ meye j¾.hla f,i Tng iq,nju fj<|fmdf,a§ yuqjk jdßhfmd< r;= kï n;, j¾.h iy fydaäu,S jeks n;, j¾. y÷kd .; yelshs' tfiau msg fmd;a; iqÿ meyejk we;=,; ly meye;s j¾. f,i wud" CARI 09, CARI 273, CARI426 iy rKìu jeks n;, j¾. /ilau y÷kd .; yelshs' iqÿ meyefhka hq;a n;, j¾. 52

JULY 2018 | DOCTOR MAGAZINE

wE; w;S;fha isgu Y%S ,xlsl wmg yqremqreÿ wdydrhla f,i n;, y÷kajd Èh yelshs' fj<|fmdf,a wvq uqo,lg Tng ñ,§ .; yels n;," f,dalfha wdydr ysÕlug úi÷ula f,i," myiqfjka Yla;sh $lfndayhsfâ%%g imhk wdydrhla f,io y÷kdf.k we;' kuq;a wo jk úg fndfyda fokd n;, .ek ork wdl,am kï t;rïu i;=gqodhl uÜgul ke;' thg fya;=j wfkl=;a w, j¾. j,g idfmalaIj n;, j, mj;sk fmdaIH.=Khka iïnkaOj t;rï wjfndaOhla fnfyda fofkl=g fkdue;s ùuhs' wo ojfia fmdaIK úoHd{hka isÿ lrk m¾fhaIK weiqf¾ n;, iïnkaOfhka fndfyda jákd f;dr;=re / ila fy<sorõ lr .ekSug wmg yelshdj ,eî ;sfí' doctormagazine.lk

ksmqks khk;rd

f,i jdßhfmd< iqÿ" .kafkdrej iqÿ" Oj," Ydka;s iy Ñ;%d wd§ j¾. lsysmhlau y÷kd .; yelsh' fujdg wu;rj fndfyda fofkl= fkdokakd oï meye;s n;, j¾.hlao Y%S ,xldj ;=< ;sfnkjd' th —udl÷r m¾m,a˜ f,ig kï lr ;sfí' fufia úYd, úúO;ajhlska hq;a n;, j¾. /ilau Y%S ,xldfõ§ y÷kd .ekSug Tng yelshdj ,efnkjd'

ishqï ñysß me‚ ri iajNdjh ksid n;, ld w;r;a ckm%shhs w, j¾.hla f,i y÷kd.kakd fï n;, rifhka wfkl=;a w, j¾. j,g jvd fjkia jkafka tys mj;sk ishqï ñysß me‚ ri iajNdjh ksihs' rifhka muKla fkdj fmdaIKh w;ska n,k úgo n;, j, fndfyda fofkl= fkdokakd fmdaIK .=Khka /ilau j¾;udkh jk úg isÿ lrkq ,nk m¾fhaIK j,ska y÷kd f.k ;sfnkjd' wfkla fndfyda wdydr j¾. fukau n;, j,o 80] la muK wvx.= jkafka c,hhs ^moisture&'

fmdaIKSh f;dr;=re tys wvx.= fmdaIl fldgia ms<snoj i,lk úg" iEu n;, j¾.hlu m%Odk jYfhka ldfndayhsâ%f¾g mj;sk ksid ñksia isrerg wjYH Yla;sh imhk wdydrhla f,i n;, y÷kajd Èh yelsh' tfiau n;, j, úh,s nfrka 2] - 3 ] muK fm%daàka iy 3] -5] muK fïoh wvx.= nj m¾fhaIK j,ska fidhdf.k we;' fï doctormagazine.lk

w;ßka b;du jeo.;a lreK f,i y÷kd .; yelafla fï iEu n;, j¾.hlu úh,s nfrka 10] lg jvd jeä m%udKhla ;ka;= ^Dietary fibers& wvx.= ùuhs' fï wkqj Y%S ,dxlslhka iq,n jYfhka wdydrhg .kakd w¾;dm,a" u[af[dlald fukau ;j;a fndfyda w, j¾. j,g idfmalaIj n;, fmdaIH.=Kh w;ska fukau ;ka;=uh fldgia m%udKfhkao by< nj m¾fhaIKd;aulju ikd: lr ;sfí' by;ska i|yka l, úúO j¾Kfhka hq;a n;, j¾. w;ßka ly n;, j, úgñka A nyq,j mj;sk nj y÷kdf.k we;s w;ru oï meye;s n;, j¾.fha m%;sTlaisldrl ixfhda. /ilau mj;sk njo y÷kdf.k ;sfnkjd' fïjd ms<sld jeks fndfyda fnda fkdjk frda. j,ska wdrlaId ùug Tng Wmldr fjkjd' tfiau wfkl;a iEu n;, j¾.hlu úgñka" Lksc ,jK fukau m%;sTlaisldrl ixfhda. mj;sk nj m¾fhaIKd;aulj fidhdf.k ;sfnkjd' flfia kuq;a jeä jYfhkau fujeks fmdaIl mj;skafka n;, j, fmd;af;a ksid fyd¢ka msßisÿ lr wju jYfhka fmd;a; bj;alrk ,o n;, wdydrhg .ekSfuka Tng ta fmdaIl fldgia jeä m%udKhla Tfí isrerg ,nd .ekSug yelshdj ,efnk nj u;l ;nd .; hq;=hs' úfYaIfhkau jefvk wjÈfha miqjk l=vd orejkag" YÍrh ÿ¾j, jQ fyda YÍr Yla;sh wjYH whg fukau l%Svlhskago wjYH fmdaIK .=Kh iu.u Yla;sh ,nd .ekSug n;, b;du iqÿiq wdydrhla nj jeä ÿrg;a i|yka l< yelshs' jefvk wjÈfha miqjk l=vd orejkag" YÍrh ÿ¾j, jQ fyda YÍr Yla;sh wjYH whg fukau l%Svlhskago wjYH fmdaIK .=Kh yd Yla;sh n;, ••• imhkjd''' JULY 2018 | DOCTOR MAGAZINE

.¾NsKS

fmdaIKh

wïu flfkla fjkak bkak Tng iqÿiq wdydr ujf.a tosfkod l%shdldß;ajhg wjYH Yla;sh ,nd fokafka ldfndayhsfâ%ghs'

udl÷r" f.dakú," › ,xld jhU úYaj úoHd,hSh mY= iïm;a" ëjr yd fmdaIK mSGfha fcHIaG lÓldpd¾h kdu<S ;laIs,d wêldß

JULY 2018 | DOCTOR MAGAZINE

doctormagazine.lk

.¾NKS wjêfha fmdaIK wjYH;djhkaa idudkH kSfrda.S ldka;djlf.a fmdaIK wjYH;djhkag jvd jeäfõ'

fukak Bg fya;=

j¾Okh jk l<,h ioyd wjYH Yla;sh yd wfkl=;a fmdaIH ix>gl ,ndoSug wehg wjYHh'

.¾NdI mgl yd ujf.a mshhqre j¾Okh ùug fmdaIKh wjYHh'

orejd ìysùfuka miqj uõlsß ioyd wjYH fmdaIK ix>gl .nvd lr ;eîu ioyd fï fmdaIKh ;SrKd;aulh'

doctormagazine.lk

.¾NKs iufha§ wehf.a fmdaIl j, wjYH;djh by< hhs' fïjdfha hï W!K;djhla we;s jqjfyd;a th ujg fukau bm§ug isák orejd flfrySo wys;lr n,mEï we;s lrk ksid ish¿u fmdaIK ix>glhka wvx.= wdydr wjYH m%udK j,ska wdydrhg .ekSu ujg fukau l=i ;=, j¾Okh jk l<,hgo b;d jeo.;ah' fmdaIK wjYH;djhka ksis mrsos ,Õd lr.ekSug ffoksl wdydr fõ,a ish¿u fmdaIH ix>gl wvx.= iu;=,s; wdydr fõ,a f,i ilia lr .; yel' .¾NKS wjêfha§ fmdaIK wjYH;djhkaa jeäjk ksid tla tla wdydr ldKav j,ska osklg .;hq;= wdydr m%udKhkA jeä l< hq;= w;r tu m%udKhkA my; j.=fõ olAjd we;' .¾NKS wjêfhaoS tla tla wdydr ldKav j,ska .; hq;= ffoksl wdydr m%udKhkA wdydr ldKav

wdydr m%udK

n;a" OdkH" msIAGh ^msá& iys; wdydr w," n;, iy msá iys; t<j¿

m%udK 7-11

m,;=re

m%udK 3-4

t<j¿

m%udK 4-5

lsß yd lsß wdydr

m%udK 1-2

ud¿" ì;A;r" uia" msh<s yd weg j¾.

m%udK 2-3

f;,a nyq, weg yd îc j¾. ^fmd,a" lcq" rglcq&

m%udK 2-4

JULY 2018 | DOCTOR MAGAZINE

wdydr zm%udKhlaZ hkq l=ulao@ iEu wdydr ldKavhlskau fldmuK m%udKhla oskm;d Tnf.a wdydr fõ,a j, wvx.= lr.; hq;= oehs hkak ms<sn| wjfndaOhla fuu.ska ,ndfohs' fuh ksjfia Ndú;d lrk úúO ñkqï WmlrK u.ska uek .ekSug mq¿jk' mSßis fldamam" fïi yeos" f;A ye|s .¾NKS wjêfha ,nd.; hq;= w;HjYH fmdaIlhka bgqlrk ld¾hhka yd tu fmdaIlhka wvx.= wdydr

fudar ud¿ jeks wdydr wdydrhg tla lr .ekSfuka w;HjYH fïo wï,hka ,nd .; yels fõ'

msIagh$msá iys; wdydr ^Yla; ckl wdydr& OdkH ^n;a" ;sß`.="

hlv .¾NKS ld,fhaoS l<,fha

nv bß`.=&" yd,a yd ;sßÕ= msá wdY%s; ksIamdok ^mdka" b¢wdmam" frdá" msÜgq& w, ^n;," uCoafCodlald" bkak," lsßw," w¾;dm,a& msIagh wvx.= t<j¿ ^fldia" fo,aa& hk wdydr j, msIagh wvx.= jk w;r fuu.ska ffoksl l%shd i|yd wjYH Yla;sh yd .¾NKs wjêfha jeäjk Yla;sh ,nd fohs'

fm%daàk ^j¾Ol wdydr& uia" ud¿" lsrs" ì;a;r jeks udxYuh wdydr yd rks, fnda. ^lv," lõms" uqx weg" mrsmamq" fidahdfndaxÑ& fm%daàk nyq, wdydr fõ' fuu wdydr l<,fha iy ud;D mgl j, j¾Okh yd w¿;ajeähdj ioyd;a ujf.A nr m%Yia; uÜgul mj;ajd .ekSu i|yd;a jeo.;a fõ¡

w;HjYH fïo wï, (EPA & DHA) w;HjYH fïo wï, wdydrhg tlalr .ekSu orejdf.a fud<fha iakdhq j¾Okhg yd wlaIs j¾Okh ioyd;a YÍrfha mgl yd ffi, ì;a;s iEoSu ioyd;a weiaj, iy fud<fha ls%hdldrs;ajhg wjYH fydafudak ksIamdokh i|yd;a jeo.;a fõ¡ lsrs" fhda.Ü" uqojmq lsß " fld< meye;s m<d j¾. yd ieuka" id,hd" 56

JULY 2018 | DOCTOR MAGAZINE

j¾Okh i|yd reêr iemhqu jeäfõ' ta i|yd r;= reêrdKq jeäfhka ksmoúh hq;=h' tneúka uia" ud¿" ì;a;r lyuoh" i;aj wlaud ^mSl=ÿ&" rks, fnda." m<d j¾." hlv wvx.= lrk ,o lsrs wdosh wdydrhg tlalr .eksfuka Tnf.a ffoksl hlv nksc ,jK wjYH;djh imqrd .; yel' Ydl wdydrj, we;s hlv isrerg wjfYdaIKh lr .ekSug úgñka iS nyq, meÕsrs iys; m,;=re ^fodvï" kdrx" cïfnda,&" fmar" fk,a,s" lcq mqyq,ka wdydrhg .ekSu jeo.;a fõ'

iskala ^;=;a;kd.ï& hlv yereKq úg ;j;a wjYH fmdaIH mod¾:hls iskala' iskala jefvk l,,fha ffi, j¾Okh yd fud<fha j¾Okh i|yd jeo.;a fõ' uia" uqyqÿ ud¿" biaika yd,aueiaika yd l=reÜg iys; OdkH j¾. iskala nyq, wdydr fõ' le,aishï le,aishï hkq jefvk orejdf.a wiaÓ j¾Okh yd Tnf.a wiaÓ iqrelSu i|yd w;HjYHu jk Lksc ,jKhls'

w;HjYH fïo wï, orejdf.a fud<h" iakdhq yd wlaIs j¾Okhg fya;= fjkjd''' doctormagazine.lk

lsrs iy lsrs wdY%s; ksIamdok ^fhda.Ü" uqojmq lsrs&" yd,aueiaika" l=vd ud¿" ieuka ud¿" ;," lcq" l;=re uqrex.d" f.dgqfld< jeks m<d j¾. osjq,a jeks m<;=re wdydrhg tlalr .eksfuka Tnf.a ffoksl le,aishï wjYH;djh imqrd.; yels fõ'

úgñkA A uia" ud¿" ì;a;r lyuoh" i;aj wlaud ^mSl=ÿ& jeks i;a;ajuh wdydr" ly meye;s t<j¿ ^lerÜ" ly n;," jÜglald&" m,;=re ^.ia,Uq" wU" ,djq¨& jeks úgñkA A nyq, wdydr .ekSu Tfí iy Tfí orejdf.a ffi, yd mgl j, j¾Okhg" ukd m%;sYla;slrKhg ^frda. j,ska wdrlaId ùug& yd weia fmkSug jeo.;a fõ' úgñka C úgñka C nyq, meÕsrs iys; m,;=re ^fodvï" kdrx" cïfnda,&" fmar" fk,a,s" lcq mqyq,ka" ldurx.d" weïnere,a,d yd t<j¿ wdydrhg .ekSfuka Tnf.a úgñka C wjYH;djh imqrd.ekSug yels fõ' Tn .kakd Ydl wdydr j, wvx.= hlv isrerg wjfYdaIKh lr.ekSugo ukd m%;sYla;slrKhgo ^frda. j,ska wdrlaId ùug& úgñka C jeo.;a fõ' f*da,sla wï, úgñkh .¾NKS iufha uq,a wjêh ;=, t<j¿" fld< meye;s m<d j¾." m,;=re" ksõâv iys; OdkH" ì;a;r" rks, fnda." j, wvx.= f*da,sla wï, úgñkh ,nd.; hq;=h' tuÕska w¿; Wmosk orejdf.a iakdhq kd, wl%ñl;d we;sùu j<lajhss'

úgñka D osklg lsrs ùÿre folla fyda fjk;a lsrs wdydrhla ^fhda.Ü" uqojmq lsrs& ,nd.ekSu Tnf.a ffoksl úgñka D yd le,aishï wjYH;djh imqrd .ekSug WmldrS fõ' ì;a;r lyuoh" l=vd ud¿" OdkH" rks, doctormagazine.lk

ujf.a;a orejdf.a;a mgl j¾Okhg fm%daàk wdydr ke;sj fldfyduo fnda." úgñkA D wvx.= wdydr fõ' ysre t<sh u.skao úgñka D ,nd.; yel' le,aishï isrerg wjfYdaIKh lr .ekSug;a orejdf.a yd Tnf.a wiaÓ j¾Okh yd wiaÓ iqrelSu i|yd;a jeo.;a fõ'

c,h osklg c,h ùÿre wgla oyhla (8 -10) wju jYfhka mdkh lrkak' Tnf.aa nr lsf,da .%Eï (kg) 1 lg c,h ñ,s ,sgr 30 jk f,i osklg c,h mdkh lrkak' .¾NKS wjêfha fmdaIK wjYH;djhkaa ksis mrsos ,Õdlr .ekSug Wmfoia • osklg m%Odk wdydr fõ,a ;=kla iy w;rueos wdydr fõ,a folla kshñ; m%udK j,ska ksis fõ,djg ,nd .ekSu b;du jeo.;a fõ' • iEuúgu Tnf.a fmdaIK wjYH;djhka wdydr j,ska muKlau ,nd.ekSug W;aidy lrkak' • .¾NKS iufhaoS u<noaOh ^u<my lsßfï wmyiq;dj& nyq,j we;súh yels w;r thska je<lSu i|yd fl|s nyq, wdydr jk m,;=re yd t<j¿ oskm;d wdydrhg Mlalr .ekSu fukau c,h wjYH m%udKhg mdkh lsßu jeo.;a fõ' • lsisÿ úgl ffjoH Wmfoia fkdue;sj úgñkA fm;s fyda lr,a jYfhka ,nd.ekSug W;aidy fkdlrkak' th Tng fukau Tfí orejdg wys;lr fi!LH m%ÓM, f.k osh yel' ••• JULY 2018 | DOCTOR MAGAZINE

ie|E iuhg

fmdaIKSh w;aje,la jfhdajDoaO Tfí ujg''' mshdg''' {d;shdg''' wdydr ms<sfh< lsÍug Wmfoia

fÊHIaG lÓldpd¾h ;s,xld rK;=x. 58

JULY 2018 | DOCTOR MAGAZINE

doctormagazine.lk

ffjoH úoHdfõ ÈhqKqj;a iu.u wo fndfyda rgj, ñksiqkaf.a wdhq wfmalaIdj jeä ù ;sfnk w;r ck.ykfha jfhdajDO mqoa.,hkaf.a m%;sY;h idfmalaIj by< f.dia ;sfnk nj Tn okakjd we;s' fï ksid tu mqoa.,hkaf.a fmdaIK wjYH;d .ek wmg úfYaIfhka l;d lsÍug isÿù ;sfnkjd' úhm;a jqjka''' jhi wjqreÿ 60- 65 muK blaujQ wh ;u wdydr mqreÿ ilid .; hq;af;a flfiao hkak i,ld ne,Su fuu ,smsfha wruqKhs' wm iEu fokdgu jfhdajDoaO wdorKShhka isák ksid;a" Tjqka wdorfhka /ln,d .ekSu wfma hq;=lula jk ksid;a fuh iudcfha jeä fofkl=g m%fhdackj;a jkq we;s'

doctormagazine.lk

jhig hkúg isref¾ we;sjk Ôj úoHd;aul fjkia ùï jhig hdu;a iu. isref¾ we;sjk Ôj úoHd;aul fjkia ùï lsysmhla ksid jhia.; jqjkag úfYaI wdydr wjYH;d mj;S' tu fjkia ùï fudkjo hkak uq,skau fidhd n,uq' YÍrfha udxY fmaYS Èhù hdu ksid l%shdYS,S;ajh wvqùu" YÍr iunr;dj mj;ajd .ekSug fkdyels ùu jhia.; jqjkg we;sjk m%Odk .eg¿jla' fuys§ YÍrfha fm%daàk fldgi wvqù fïo m%udKh by< hñka YÍr ixhq;sfha fjkia ùula isÿfõ' ;jo fydafudak j, isÿjk fjkia ùï ksid wiaÓ j, wvx.= Lksc ,jK m%udKh wvqù wiaÓ Yla;su;a nj wvq ù hñka wiaÓ leã hdfï yelshdj j¾Okh ùuo ;j;a ,laIKhla' óg wu;rj wdydr ud¾.fha udxY fmaYsj, ixp,k yelshdj wvq ù hk ksid wdudYh ysiaùug jeä fj,djla .;ùu ksid wdydr wreÑh j¾Okh ùu ;j;a .eg¿jla' wdudYfha wdï,sl ;dj wvqùï" m%;sYla;s lrK yelshdj wvqùu" iu /,s jeàu wdÈho fmdaIK wjYH;d flfryS n,mdk ;;a;ajhka'

uy¨ úfhaoS úfYaIfhka ,nd osh hq;= fmdaIl by; úia;r l< fya;=ka ksid uy¨ úfha miqjkakka úfYaIfhka wjOdkh fhduq l< hq;= fmdaIl .ek ó,Õg l;d lruq'

le,aishï le,aishï fï w;ßka m%Odk fmdaIlhla' wiaÓ moaO;sh Èhù hdfï fõ.h wvqlr .ekSug le,aishï wvx.= wdydr Èkm;d tla lr .ekSu w;HjYHh' l=vd ud¿" yd,aueiaika" lsß" fhda.Ü jeks lsß ksIamdok ^wvq fïo ksIamdok jvd iqÿiqh&" m<d j¾." f.dajd jeks t<j¨" fidahd ksIamdok" fmar" Èjq,a" fodvï jeks m,;=re j, le,aishï wvx.= fõ' Ydluh wdydr j,g jvd i;aj ksIamdok j, we;s le,aishï myiqfjka wjfYdaIKh lr.; yels nj mejfia'

JULY 2018 | DOCTOR MAGAZINE

úgñka D YÍrhg le,aishï Wrd .ekSug iyh ùug wjYH jk ksid;a iu ;=, úgñka D ksIamdokh lsÍfï yelshdj wvqùu;a ksid uy¨úfha miqjkakg úgñka D úfYaI fmdaIlhla fõ' lsß iy lsß ksIamdok" ì;a;r" ìïu,a" uia" ud¿ jeks wdydr .ekSu;a" i;shg Èk 3-4 úkdä 15 - 30 w;r m%udKhla ysre t,shg ksrdjrKh ùu u.ska úgñka D ,nd .; yel' kuq;a ysre t,sh u.ska iu ;=< ksmoúh yels úgñka D m%udKhg jvd wydr j,ska ,efnk úgñka D m%udKh b;d wvq nj fidhdf.k we;'

jeo.;a úgñkhla' ta ukao h;a" úhm;a ùu;a iu. wudYfha wï, ksmoùu wvq ùu ksid fuu úgñka wjfYdaIKh wvd, fõ' wm .kakd wdydr Ô¾Kfhka miq Yla;sh uqodyeÍug B12 wjYH fõ' uia" ud¿" lsß iy lsß ksIamdok" ì;a;r j, úgñka B12 wvx.= fõ' fmdaIlhla f,i fkdie,l=j;a wm wdydrhg .kak Ydlu wdydr j, wvx.= fl|s o ^Dietary Fibers& jfhdajDO mqoa.,hkag b;d jeo.;ah' wdydr Ô¾K moaO;sfha .eg¿ u. yrjd .ekSug;a yoj;a frda." wêreêr mSvkh" Èhjeähdj jeks frda. we;sùug we;s yelshdj wvq lr .ekSug;a fuu fl|s b;d jeo.;ah'

iun, wdydr fõ,la ,ndoSug WmldÍ jk m%Odk wdydr ldKav by; úia;r l< fmdaIl fldgiao we;=,;aj wfkl=;a fmdaIl o ,efnk f,i iun, wdydr fõ,la ,nd .ekSu i|yd m%Odk wdydr ldKav j,ska wdydr f;dard .kakd wdldrh ó,.g i,ld n,uq' my; remfha wdldrhg wm wdydr ldKav yhlska wfma wdydr fõ,g wdydr f;dard .; hq;=h' flfia fj;;a uy¨ wh ;rndre ùug we;s bv lv jeä ksid wdydrfhka ,nd .kakd Yla;s m%udKh

úgñk B12 úgñk B12 o uy¨ úfha miqjkakkag 60

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doctormagazine.lk

wvqúh hq;=h' fï ksid .=fKka jeä m%udKfhka wvq wdydr fõ,la ilid .ekSu jeo.;a fõ'

m%udKhla fjk fjku .;a l, tla fõ,la f,i i,lhs'

f;,a wvq wdydr j¾. f;dard .kak msßmyÿ fkdl< msá j,ska wdydr idod .kak n;a" mdka we;=,;a msá iys; wdydr ldKavh .ek ie<lSfï§ uy¨ úfha miqjk wh ie<ls,su;a úh hq;= lreK jkafka msßmyÿ fkdl< msá j,ska wdydr idod .ekSughs' mdka ñ,§ .ekSfï§ o yels muK mr¿ mdka ^Brown Bread& f;dard .ekSug j. n,d .kak' msßmyÿ l< iqÿ meye;s yd,a fjkqjg ;ïnk ,o yd,a f;dard .ekSu jvd .=Kodhl jkq we;' w, n;, u[af[dlald jeks wdydro fuu ldKavhg we;=,;a jk ksid tajdo wdydrhg .ekSug wu;l fkdlrkak'

t<j¨" m<d j¾. iy m,;=re uy¿ úfhaoS w;sYhska jeo.;a t<j¨" m<d j¾. iy m,;=re ldKAvfha wdydr j, wdydruh ;ka;= wvx.= ksid uy¨ úfha miqjkakkag b;d jeo.;a wdydr ldKavhls' wdydrfha we;s le,ß uÜgu by< fkdhk f,i jeä úgñka iy Lksc ,jK m%udKhla fuu wdydr u.ska YÍrhg ,nd .; yel' YÍrfha ksmojk fyda mßirfhka YÍrhg we;=,;a jk úI j¾. úkdY lsÍugo fuu wdydr LKavh b;d jeo.;ah' Èklg fuu LKavhg wh;a wdydr fõ,a wju jYfhka jdr 5 la j;a wdydrhg .; hq;=hs' msiQ t<j¨ fïi ye¢ 3la" m<d j¾. fldamam nd.hla" flfi,a" fmar jeks f.ä jYfhka we;s m,;=re 1la" mefmd,a flduvq" wkakdis jeks m,;=re uOHu m%udKfha fm;a;la" fk,a,s" f,dú ñ§ jeks m,;=re w; ñg mqrjd ,nd .;a doctormagazine.lk

uia ud¿ iy weg j¾. ^udY fnda.& we;=,;a wdydr ldKavh .ek ie,lSfï§ f;,a wvq wdydr j¾. f;dard .ekSu b;d jeo.;ah' YÍrfha m%;sYla;slrKh we;s lsÍug jeo.;a fmdaIlhla jk Tfu.d 3 kue;s fmdaIlh ud¿ j, wvx.= jk ksid ud¿ wdydrhg tla lr .ekSu jeo.;a fõ' uy¨ úfha miqjk flfkl=g b;d jeo.;a fmdaIlhla jk B12 wvx.= ùu ksid o fuu wdydr ldKavh Tjqkg b;d jeo.;ah' W!re uia" yrla uia jeks uia j, YÍrhg wys;lr j¾.fha f;,a jeä m%udKhla wvx.= ksid tajd iSud l< hq;=h' fuu ldKavhg wh;a wdydr Èklg fj,a 2-3la muK tl;= lr.; hq;= hehs ks¾foaY flf¾' ì;a;r 1la" idudkH m%udKfha ud¿ fyda uia lene,a,la" msi.;a uqx weg" ljqms" lv, jeks wdydr fldamam nd.hla fjk fjku .;a l, tla wdydr fõ,la f,i ie,fla' i;aj wdydr fkd.kakd wh ljqms" lv," oU," mßmamq" uqx wg jeks wdydr jeämqr ,nd.; hq;=h'

fhdoh iys; lsß fjkqjg fhdoh bj;a l< lsß .e,fmkjd lsß iy lsß ksIamdokj, le,aishï wvx.= iy úgñka D wvx.= jk ksid tajdo b;d jeo.;ah' kuq;a iïmq¾K fhdoh iys; lsß fjkqjg ^whole milk& fhdoh bj;a l< lsß ^Skimmed milk& f;dard .ekSu jvd fhda.H jkq we;s' fhda.Ü" Öia" ólsß o fuu ldKavhg we;=,;a jk w;r f,an,h mÍlaId lr n,d fïoh wvq ksIamdok f;dard .ekSug j. n,d JULY 2018 | DOCTOR MAGAZINE

.; hq;=h' Èklg fuu ldKavfha wdydr fõ,a 2-3 muK m%udKj;a nj mejfia' lsß ùÿre 1la" fhda.Ü" ólsß fldamam 1la" 40-50g muK Öia lene,a,la fjk fjku .;a l, tl fõ,la f,i ie,fla' ;," lcq" rglcq| w,s.egfmar jeks wdydr o ;j;a wdydr ldKavhla f,i ie,flk w;r tajdfha YÍrhg hym;a fïo j¾. we;=,;a fõ' b|ysg fuu wdydro tl;= lr .ekSug j. n,d .kak'

osklg m%udKj;a c, mßudjla ,efnk njg iy;sl jkak by; úia;r l< wdydr ldKav j,g wu;rj m%udKj;a ;rï c,h mdkh lsÍu;a uy¨ jhfia mqoa.,hkag b;d jeo.;ah' wdydruh ;ka;= jeäfhka mßfNdackh lsÍu;a iu. YÍrfha c, wjYH;dj jeäjk w;r" fkdfhl=;a bkaøshhka j, l%shdldß;ajh wvq ùu;a ksid YÍrhg jeäfhka c,h wjYH fõ' Èklg j;=r ùÿre 6-8 muK mdkh lsÍu fhda.H nj ioyka fõ'

¨Kq iy iSks b;d wvqfjka uy¨ úfha miq jk Woúh ¨Kq iy iSks b;d wvqfjka mßfNdackh lsÍu b;d jeo.;ah' yoj;a frda." wê reêr mSvkh" Èhjeähdj jeks frda.j,g we;s yelshdj wvq lr .ekSug th jeo.;ah' idudkHfhka Èklg tla wfhl=g ¨Kq 6g muKla ^f;a ye¢ tlla& wdydrhg tl;= lr

JULY 2018 | DOCTOR MAGAZINE

.; hq;=hs ks¾foaY flf¾' fuys§ wys;lr hehs mejfikafka ¨Kq j, wvx.= fidaähï kue;s Lksc ,jKhhs' tu Lksc ,jKh msá ksIamdok j,§ fhdok wdmam fidavd j,o wvx.= ksid wdydrhg ¨Kq tla lsÍfï§ ie,ls,su;a úh hq;=h' rïfm" lrmsxpd" iqÿ¨kq" wfkl=;a l=¿nvq iy foys fhdod wdydr rij;a lsÍfuka ¨Kq Ndú;h wvq lr .; yel'

fï ldrKd;a w;sYh jeo.;a''' fuf,iu iSks" me‚ ri" flá lEu" iSks fhÿ mdk j¾. b;d wvqfjka wdydrhg tla lr .; hq;=h' f;,a o yels ;rï wvqfjka wdydrhg .ekSu uy¨ whg b;d jeo.;ah' wdydr msiSfï§ f;,a Ndú;h wju l< hq;= w;r ;eïîu" yqud,fhka ;eïîu" fíla lsÍu" Micro Wave hka;%hla Ndú;d lsÍu jeks foa u.ska f;,a Ndú;h wvqlr .; yel' fj<|fmdf,ka wdydr j¾. ñ,§ .ekSfï§ f,an,h n,d ix;Dma; fïoh wvq wydr f;dard .ekSu jeo.;ah' fuu ,smsfhys úia;r lr we;af;a jhi wjqreÿ 60 - 65 muK blaujQ idudkHfhka ksfrda.S mqoa.,hl= wydr rgdj mj;ajd .; hq;= wdldrh b;d fláfhks' kuq;a hful= Èhjeähdj" yoj;a frda." wlaudj yd jl=.vq frda. jeks frda. ;;a;aj j,ska fmf<kafka kï Tjqkg úfYaIs; jQ wydr wjYH;d we;s ksid m<mqreÿ fmdaIKfõÈhl=f.a Wmfoia ,nd .; hq;=h' ;jo hful= wdydr .; fkdyels f,i ÿ¾j, ù we;akï Tyqf.a fyda wehf.a fmdaIK ;;a;ajh .ek mÍlaIKhla fldg wdydr w;sf¾l ^Dietary Supplements& ,nd .; hq;= jk w;r ta i|ydo m<mqreÿ fmdaIKfõÈhl=f.a Wmfoia wjYH jkq we;' ••• doctormagazine.lk

uydpd¾h f¾Kql is,ajd jHjydßl fmdaIK wOHhkdxYh Y%S ,xld jhU úYAj úoHd,h

wêreêr mSvkh" fldf,iagfrda,a iy oshjeähdj md,khg bia;rï'''

oshjeähdj frda.Skag úmq, M, f.k fohs

f,dalfha mrisÿ bia;rïu l=re÷ ksmofjkafka Y%S ,xldfõh' l=re÷ j, we;s fi!LHiïmkakNdjh ms<sn|j úúO m¾fhaIK ksn|ju isÿ fjñka mj;S' wdydr msiSfïo fhdod .kakd l=¿nvqjla f,i muKla fkdj" l=re÷ fhda.Ü" flala yd ìialÜ jeks wdydr iu. ñY% lr fyda ;ks jYfhka îug .kakd mdkhla f,i Ndú;hg .ekSuo wo ojfia fnfyúka ckm%shh'

fldf,iagfrda,a wvq lrkjd''' yoj;g ñ;=rehs''' m¾fhaIK j,g wkQj l=re÷ oshjeähd frda. Skaf.a reêr iSks uÜgu my; fy<K njo" isref¾ mßjD;a;Sh l%shdj,skaf.a ys;lr fjkialï we;s lsÍug fya;= jk njo''' tfukau reêrfha fldf,iagfrda,a yd wfkl=;a reêr fïo w.hka my; fy<k njo fy<sorõ ù ;sfí' doctormagazine.lk

oshjeähdjg m%Odk fya;=jla jkafka reêrfha iSks uÜgu md,kh lrk bkaishq,ska kue;s fydafudakh >%djh ùu wvqùu fyda tys l%shdldß;ajh wvq ùuhs' fï ksid reêrfha iSks

,xldfõ jefjk l=re÷ j, wys;lr fia ie<flK zzl=ußkaZZ kue;s ridhkh wka;¾.; jkafka u| jYfhks'

JULY 2018 | DOCTOR MAGAZINE

uÜgu iS>%fhka by< hhs' oshjeähdj ksid tosfkod cSú;fha idudkH l%shdj,ska fukau fláld,Skj yd os.=ld,Skj isÿjk whym;a m%;sM< j,g uqyqK mEug isÿfõ'

f,dj úYsIaG;u ,xldfõ jefjk l=re÷ l=re÷ j,''' úfYaIfhkau ,xldfõ jefjk l=re÷ j, wvx.= we;eï l%shdldÍ ixfhda. bkaishq,ska l%shdldß;ajh l%udkql+, lrk njo" y÷kdf.k ;sfí' l=re÷ j, wka;¾.; fmd,s*sfkda,a ixfhda. m%;sTlaisldrl jYfhka l%shd lrhs' m%;sTlaisldrl u.ska isref¾ we;sjk wksgq l%shdldÍ ixfhda. j, l%shdldß;ajh ksfIaOkh lrhs' tfukau ,xldfõ jefjk l=re÷ j, wys;lr fia ie<flK zzl=ußkaZZ kue;s ridhkh wka;¾.; jkafka u| jYfhks' f,dal fj<|fmdf<ys wvq ñ, .Kka j,g wf,ú jk zzÖk l=re÷ZZ j, fuu zzl=ußkaZZ fnfyúka wvx.= jk w;r th wlaudjg wys;lr nj y÷kdf.k ;sfí' óg wu;rj l=re÷ j, we;s fmd,s*sfkda, u.ska fldf,iagfrda, reêr kd, j, ;ekam;a ùu wju lrk njo fy<sorõ ù ;sfí' l=re÷ yDohdndO j<lajk" yoj;g ñ;=re wdydrhla fia ie<flkafka tneúks'

,dxflah m¾fhaIK u.ska fy<sorõ jQ lreKQ Y%S ,xld jhU úYaj úoHd,fha jHjydßl fmdaIK wOHhkdxYh m¾fhaIlhka lKavdhula miq.sh ld,fha l=re÷ j, we;s jákdlï iïnkaOfhka m¾fhaIKhla isÿ lrk ,oS' u| jYfhka reêr mSvkh jeä lKavdhulg osklg l=re÷ .a?ï 64

JULY 2018 | DOCTOR MAGAZINE

l=re÷ j, we;s fmd,s*sfkda, u.ska reêr kd, j, fldf,iagfrda, ;ekam;a ùu wju lrkjd 6la WKQ c,fha oshlr mdkh lsÍug i,iajk ,oS' fudjqyQ i;s wgla tu l=re÷ mdkh lrk ,o w;r i;s wg wjidkfha Tjqkaf.a reêr mSvkh ie<lsh hq;= w.hlska my; nei ;snqKs' ;jo Tjqkaf.a reêr fïo uÜguo ^g%hs.a,sirhsv yd isrerg wys;lr LDL fldf,iagfrda,a& ie<lsh hq;= muKlska my; nei ;snqKs' bkaishq,ska l%shdldß;ajfhao ie<lsh hq;= j¾Okhla olakg ,enqKs' óg wu;rj isref¾ m%;sTlaisldrl w.hkayS jeäùulao" lemS fmfkk f,i ;ekam;a fïofha wvqùulao olakg ,enqKs' Y%S ,xldfõ m%:u j;djg isÿ l< fuu udkj m¾fhaIKh u.ska wfma rfÜ jefjk l=re÷ iïnkaOfhka tod fuod ;=r ,enQ oeKQu iïNdrhg ;j;a fndfyda Okd;aul lreKQ tl;= lrKQ ,eîh' l=re÷ fjku mdkhla f,i fyda uq¿;ekaf.hs ms<sfh, lrk jHxck j,g tl;= lsÍfuka fuu hym;a m%;sM< ,nd.; yelsoehs m¾fhaIK lsÍug wm n,dfmdfrd;a;= jkafkuq' l=re÷ Ndú;h wêreêr mSvkhg" yDohdndO yd oshjeähdj je<elaùug fukau ms<sldfjka ñoSugo fya;= jkafka hhs m¾fhaIKd;aulj m%;HlaIfhka ikd: ù ;sfí' fï .ek .DyKshka fukau wfma jeäysá m%cdjo ie<ls<su;a jkafka kï th Tjqkaf.a ys; iqj msKsiu fkdjkafkao@ ••• doctormagazine.lk

yevldr fh!jKfha ksfrda.S nfj;a moku i,id .uq

wêl f;,a" ¨kq iy iSks fya;=fjka kj fh!jkhka wkd.;fha§ fnda fkdjk frda. /ilg f.dÿre ùfï wjodkula mj;S'

fh!jKfha

ksfrda.S wdydr isß;

JULY 2018 | DOCTOR MAGAZINE

doctormagazine.lk

kj fhdjqka úh hkq mqoa.,hl=f.a Ôú;fhys b;d jeo.;a wjêhla fõ' f,dal fi!LH ixúOdkh úiska kj fh!jkhka f,i jhi wjqreÿ 10-19 w;r msßi y÷kajd § we;' tu wjêfha§ ldhsl udkisl fukau idudchsl fjkialï rdYshlg uqyqKmEug iy kj wNsfhda." w;aoelSï rdYshla Ôú;hg tla lr .ekSug isÿfõ' tu ksid kj fh!jkhl=g hym;a fi!LHhla ;sîu fuu wjêfha§ jeo.;a b;d idOlhla jk w;r th Tyqf.a wkd.; fi!LHh ;;a;ajh i|ydo jeo.;a fõ' fi!LHh yd b;d iómj ne÷Kq idOlhla f,i fmdaIKh ie<lsh yel' kj fh!jkhkaf.a fmdaIKh ms<sn|j uE;l§ f,dj mqrd isák úoHd{hkaf.a úfYaI wjOdkh ,la jQ w;r ksjerÈ fmdaIK mqreÿ we;s lr .ekSu j¾;udk fukau wkd.; fi!LHh i|ydo jeo.;a jk nj Tjqkaf.a u;hhs' doctormagazine.lk

Y%S ,xld jhU úYaj úoahd,hSh mY= iïm;a ëjr yd fmdaIK mSGfha" jHjydßl fmdaIK wOHhk wxYfha fla' ta' iS' uOqud,s ksjerÈ wdydr mqreÿ we;s kj fh!jkhl=g ndOdjlska f;drj bf.kSu" l%Svd lghq;=j, ksr; ùu fukau úNd. wdÈfhka ch.%yK ,eîugo uxfm;a újr fõ' kuq;a whym;a wdydr mqreÿ we;s kj fh!jkhl=g j¾;udkfha§ fukau wkd.;fha§ o úúO fi!LHh .eg¨j,g uqyqK mEug isÿfõ' Tjqkag wkd.;fha§ ia:q,;djh" Èhjeähdj" wê reêrmSvkh" wêl reêr fldf,iafgfrda,a iy ms,sld jeks b;d oreKq frda. /ilg f.dÿre ùfï wjodkula we;' tu ksid ksjerÈ wdydr mqreÿ we;s lr .ekSu;a jerÈ wdydr mqreÿ j,ska wE;a ù isàu;a Tn wo isgu l< hq;= fohls' kj fhdjqka úfha§ wêl j¾Ok iS>%;djhla mj;sk neúka ta i|yd wjYH Yla;sh iy fmdaIH mod¾: m%udKj;a f,i .; yels f,i wdydr f;dard .ekSu l< hq;=h' ish¿u wdydr ldKav we;=,;a tkï OdkH" rks, Ydl ^lv," lõms" uqx" uE" fndaxÑ&" t<j¿" m,;=re" uia $ ud¨$ ì;a;r iy lsß$ lsß ksIamdok wvx.= iunr fõ,la .ekSug Tn j. n,d .; hq;=h' wdydr .ekSfï§ Èklg m%Odk wdydr fõ,a ;=k iy ;j;a wu;r l=vd wdydr fõ,a folla j;a .ekSfuka kj fhdjqka úfha ffoksl fmdaIK wjYH;d imqrd,Sug yelshdj we;' fmdaIH mod¾: w;ßka fuu jhia ldKavfha <uqka i|yd Yla;sh" fm%daàk" w;HjYH fïo wï," hlv" le,aishï" úgñka ta iy úgñka ã m%Odk ;ekla .kS' fuu wjêfha§ udxY fmaYs j¾Okh iy wiaÓ j¾Okho iS>%fhka isÿjk neúka fm%daàk iy le,aishï ksis f,i .; hq;=h' tfia fkdjqkfyd;a ksis YÍr Wila ,nd .ekSug iy ksfrda.Su;a isrerla ,nd .ekSug fkdyels fõ' uia" ud¨" lsß" ì;a;r j, iy rks, Ydl j, fm%daàk nyq,j mj;sk w;r

ndOdjlska f;drj bf.kSu" úNd. wdÈfhka ch.%yK ,eîug ksjeros wdydr mqreÿ fya;= fjhs' JULY 2018 | DOCTOR MAGAZINE

ksjerÈ wdydr mqreÿ fukau m%udKj;a jHdhduo fh!jKfhaoS b;d jeo.;a fõ' l=vd ud¨" lsß$lsß ksIamdok iy ;o fld, meye;s t<j¨ j, le,aishï nyq, fõ' tfiau hlv nyq, wdydr i|ydo jeä wjOdkhla fhduq l< hq;=h' ldhsl iy udkisl jYfhka iS>% j¾Okhla fmkakqï lrk fuu wjäfha§ u,ajr ùu;a iuÕ Tima ùu wdrïN ùfuka .eyekq <uhl= i|yd hlv wjYH;djh tu jhfia msßñ kj fh!jkshlg jvd jeä fõ' i;aj wdydr ^uia iy ud¨& b;d fhda.H hlv nyq, wdydr f,i ie,fla' Bg wu;rj ;o fld, meye;s fld< t<j¿ j¾.o hlv nyq, wdydr f,i .; yel' kuq;a Ydl wdydr j, we;s hlv wjfYdaIKh ÿ¾j, neúka tjeks wdydr j,g Wïn,lv fyda foys tla lr .ekSfuka Ydl m%Nj j, we;s hlv wjfYdaIKh by< kexúh yel' fuu wdydr j¾. iy t<j¿ iy m,;=re ksis f,i úúO;ajhla we;sj Èkm;d .ekSfuka kj fh!jkhkaf.a fndfyda fmdaIK wjYH;d imqrd .; yels fõ' tfukau udxY wdydrhg fkd.kakd Ydl wdydr muKla m%sh lrk kj fh!jkfhl= i|yd kï wdydr f;dard .ekSfï§ fnfyúka ie<ls,su;a úh hq;=h' tys§ úúO j¾.fhka hq;= rks, Ydl iy t,j¨ m<;=re jeä úúO;ajhlska hq;=j .; hq;=h' tfia fkdue;s jqjfyd;a tjeks wh fmdaIK W!K;djhkag f.dÿre ùfï jeä wjodkula mj;S' hym;a wdydr mqreÿ we;s lr .ekSu fukau whym;a wdydr mqreÿ j,ska wE;a ù isàuo ksis fi!LHhla ,eîug buy;a msgqjy,la fõ' kj fh!jkhka w;r we;s b;d iq,n whym;a wdydr mqreÿ jYfhka ks;r wdydr fõ,a u. yeÍu" laI‚l wdydr ^frda,aia" meáia" 68

JULY 2018 | DOCTOR MAGAZINE

fmaiaá% jeks oE& iy wjkay,a j,ska .kakd wdydr ^*arhsâ rhsia" fld;a;=" nqßhdks jeks oE& ldnkSlD; ìu j¾. ^me‚ îu& ksrka;rfhka .ekSu i|yka l< yel' fujeks wdydr j, we;s wêl f;,a" ¨kq iy iSks fya;=fjka kj fh!jkhka wkd.;fha§ by; i|yka l< fnda fkdjk frda. /ilg f.dÿre ùfï wjodkula mj;S' tfukau fujeks wdydr j,g weíneys ùfuka fmdaIH .=Kfhka by< wdydr .ekSu wju jk neúka úúO fmdaIK W!K;d we;s jk w;r Tjqkaf.a j¾Okho wvd, fõ' fï ksid kj fh!jk wjêfha miq jk <uqkaf.a wOHdmksl lghq;= wvd, ùu iy Tjqkaf.a wfkl=;a ffoksl lghq;= ksis f,i lr.; fkdyels ùu;a fya;=fjka Tjqka udkisl jYfhkq;a miqnEulg ,lafõ' ksjerÈ wdydr mqreÿ fukau m%udKj;a YdÍßl ls%hdldrlï j, ksr; ùuo b;d jeo.;a fõ' Èkm;d ie,iqï lrk ,o jHdhuhl kshe,Su fyda fjk;a YÍrh fjfyijd lrk l%Svdjl kshe,Su mqreoaola lr.; hq;=h' tu.ska YÍr nr md,kh" fnda fkdjk frda. je<|Su wju ùu fukau hym;a udkisl fi!LHhlao mj;ajd .; yel' Tn;a kj fh!jkhl= kï ke;fyd;a Tnf.a orejd kj fhdjqka úfha miq jkakl= kï by; lreKq .ek .ek ie<ls,su;a ù ksis wdydr mqreÿ we;s lrf.k kj fhdjqka úfha we;s jk fndfyda fmdaIK .eg¨ j,ska ñ§ ksfrda.su;a Èúhla f.ùug uxfm;a i,id .kak' kSfrda.S kj fhdjqka mrmqrla ìys lsÍfuka j¾;udkfha fukau wkd.;fha§ o frda. j,ska f;dr kSfrda.S iudchla we;s lsßug Tnf.a odhl;ajh ,nd fokak' • • • doctormagazine.lk

fmdaIK .=Kh /flk mßos

wdydr ilid .kafka flfiao@ Y%S ,xld jhU úYAj úoHd,hSh mY= iïm;a ëjr yd fmdaIK mSGfha jHjydßl fmdaIK wOHhkdxYfha fca ta ud,sld i|ud,s

doctormagazine.lk

JULY 2018 | DOCTOR MAGAZINE

wdydr ieliSu fukau wdydr msiSuo wE; w;S;fha isgu wm úúO l%u Ndú;d lrñka isÿ lrkq ,nhs' kuq;a tu l%shdj,s j,oS wdydr hkq yqfola l=i mqrjd .ekSu i|ydu mj;skakla fkdj YÍrhg w;HjYH fmdaIl øjH ,ndfok m%Odk udOHh njo isys;nd .ksñka lghq;= lsÍu w;HjYH lreKla fjhs' ulaksido h;a" wdydr ieliSfïoS iy msiSfïoS úúO wjia:d j,oS wdydr øjH j, mj;sk fmdaIl úkdY ù yels neúks' tf,i fmdaIl øjH úkdY ù hd yels wjia:d iy tajd u. yrjdf.k fmdaIl øjH wdrCId lr.; yelafla flfiao hkak wms oeka i<ld n,uq' 70

ksõâv b;sß jk fia ilia l< wdydr j,ska n;a msiskak Y%S ,dxlsl wm ieuf.a m%Odk wdydrh jk n; ilid .ekSug wm fhdod.kq ,nk iyf,a fmdaIK .=Kh" ù fldgd.;a wdldrh wkqj fjkia fõ' ù flàfïoS ù wegfhys fmd;a;g háka mj;sk ksõâv fldgi uq¨ukskau bj;ajk fia ilid .;fyd;a tu fldgfia mj;sk jákd fmdaIl rdYshla wmg wysñ fjhs' î úgñka j¾." fm%daàk iy iuyr LKsc ,jK wysñ ù hhs' tf,iskau ;ka;= j¾.o bj;a ù hhs' fuu ;ka;= whska ùu ksid wdydr osrùfï ld¾hh myiq jqjo th reêr iSks uÜgu (Blood Glucose) blauKska jeä lsÍug fya;= fjhs' tu iy,a Ndú;h oshjeähd frda.Skag wfhda.H njg m;a fjhs' tu ksid iy,a mEySfïoS yels;dla ksõâv b;sß jk fia th isÿlr .ekSu u.ska jeä fmdaIl m%udKhla r|jd.; yelsh' tfukau fuu iy,a mEySfïoS isÿjk fmdaIl øjH ydksùu j<lajd .ekSug ;ïnmq iy,a ^Wod (-kdvq iy,a& ksIAmdok l%shdj,sho b;d M,odhs f,i Wmfhda.S lr.; yelsh' fuu iy,a oshjeähd frda.Skaf.a Ndú;h i|ydo fhda.H fõ'

ksjeros wdydr ieliSfï iy msiSfï l%u wkq.ukh lrkak ksjeros iy,a j¾.h f;dard .ekSu fukau ksjeros wdydr ieliSfï iy msiSfï l%uo tajdfha fmdaIK .=Kh i|yd n,mEï we;s lrhs' úfYAIfhkau t<j¿ j¾. ;ïnd .ekSfïoS tajdfha mj;sk úgñk iy LKsc ,jK j¾. tu ;eïîug fhdod .kakd c,hg ldkaÿ ùu isÿ fõ' tu ksid wm tu c,ho mßfNdackhg .; hq;= fõ' tuksid t<j¿ iqma f,i ilid wdydrhg .ekSu iy fydos iys;j ms<sfh, lr.;a t<j¿ j, fydos ish,a, wdydrhg tl;= lr .ekSu u.ska wmg jeä fmdaIl m%udKhla ,nd.; yelsh' wdydr msiSug m%:u wm uq,skau t<j¿ fidaod" miqj lemSu isÿ l< hq;=h' tfukau yels ieu úgu b;d l=vd len,s j,g fkdj" u|la úYd, f,i t<j¿ lmd.; hq;=h' fuu.ska msi.kakd t<j¿fjka ydksjk î úgñka m%udKh wvq lr.; yelsh'

JULY 2018 | DOCTOR MAGAZINE

doctormagazine.lk

i,do wdldrhg ilid .kakd wdydr fmdaIK .+Kfhka by<hs t<j¿" m<;=re j, mj;sk fmdaIl wdrCId lr .ekSug iqÿiqu l%uh kï yels iEu úgu i,do wdldrhg tajd ilid .ekSuhs' m,;=re i,do iy t<j¿ i,do f,i wdydrhg .ekSuhs' i,do ilid meh nd.hla we;=<g wdydrhg .ekSu jvd;a WÑ; fõ' ula ksido h;a" msiSfïoS WIAK;ajh ksid;a" lemQ t<j¿" m<;=re jd;hg ksrdjrKh ù ;sîu ksid;a tajdfhys mj;sk iS úgñk úkdY ù hd yels neúks'

wdydr ieliSfïoS ms<siaiSu t;rï iqÿiq kE''' wm uia ud¿ jeks wdydr ilid .ekSug úúO l%u Ndú;d lrkafkuq' bka tla l%uhla jk frdaialr .ekSu (Roosting) hk l%shdj,sh" tysoS Ndú;d jk wêl WIAK;ajh ksid fm%daàk j, mj;sk weuhsfkda wï, wmf.a YÍrhg wjfYdaIKh lr .ekSug wmyiq ;;a;ajhg m;aùug fya;= fõ' frdaia lsÍfïoS uia fyda ud¿ len,s l=vd len,s j,g fkdj ;rul úYd, len,s j,g lmd .ekSfuka fuu wjdisodhl ;;a;ajh wvqlr .; yelsh'

WIAK;ajh hgf;a tl os.g oS¾> fõ,djla wdydr neo .ekSug fhdod .ekSu fyda jrla mdúÉÑ lrkq ,enQ f;,a kej; kej; m%fhdackhg .ekSu yªkajd osh yelsh' fujeks f;,a j, ksmofjk wys;lr ridhksl øjH u.ska yDohdndO fyda ms<sld we;sùfï wjodku jeä lrhs'

úI bj;a lsÍug iajdNdúl l%u Ndú;d lrkak iajNdúlju wdydr j, mj;sk úI øjH bj;a lsÍu i|ydo úúO ieliSfï iy msiSfï l%u Ndú;d l< yelsh' WodyrKhla f,i lõms" uqxweg jeks udxY fnda.j, mj;sk úI ridhksl øjH (Trypsin inhibitors, Cyanogenic Glucosides, Antivitamins) my; l%shdj,sh u.ska bj;a lr .; yel' meh 24 isg 36 olajd c,fha fmÕùu" uDÿj msßueo msg; fmd;a; bj;a lr .ekSu iy wjYH m%udKhg c,h fhdod m%udKj;a mßos ;ïnd .ekSu'

wêl WIAK;ajh hgf;a wdydr neoSu;a fyd| kE'''

;jo u[af[dlald wdydrhg .ekSfuka YÍrhg tl;= úh yels ihkhsv ^ihkhsv" YÍrh mqrd Tlaisckaa mßjykhg ndOd we;s lrhs& wdydrhg .ekSug m%:uj my; mßos bj;a lr.; yelsh' u[af[dlald w, j, fmd;a; bj;a lr fyd|ska fidaod .ekSu" l=vd fldgia j,g lmd .ekSu" c,fha fmfÕkak ;nd bkamiq jeämqr c,h iys; újD; n÷kl mehla ;ïnd .ekSu'

wdydr j, fmdaIK .=Kh /flk mßos wdydr msi .ekSu muKla fkdj tysoS YÍrhg wys;lr ix>Gl wdydrhg tl;= fkdùugo wm j.n,d .; hq;=h' tfia wdydrhg wys;lr øjH tl;= úh yels tla wdydrhla f,i" f;,a j¾. ^Wod(-fmd,a f;,a& wêl

fuf,i wdydr ilid .ekSfïoS iy msi .ekSfïoS fmdaIK .=Kh /flk mßos fukau YÍrhg wdrCIdldÍ wdydr fõ,la njg th m;alr .ekSu i|ydo wm wmf.a ksrka;r wjOdkh fhoúh hq;=h' •••

doctormagazine.lk

JULY 2018 | DOCTOR MAGAZINE

ksfrda.S iqjhg

fld;a;u,a,s

fld;a;u,a,s weg j, nyq, jYfhka YÍrhg w;HjYH wï," ;ka;=" hlv" le,aishï" fmdgEishï" ue.akSishï wvx.=hs' 72

JULY 2018 | DOCTOR MAGAZINE

fmdaIKfõ§ iy wdydrfõ§ fla bf¾Id fiõjkaos

doctormagazine.lk

Y%S ,dxlSh wdydr iïm%odh fndfyda ÿrg r|d mj;skafka wdydr j,g fhdod .kakd l=¿ nvq j¾.hka ksidh' w;S;fha isgu Y%S ,dxlSh ckhd úúOdldr jQ l=¿nvq wdydr j¾. j,g tl;= lrñka wdydrfha .=Kh;a rih;a ksr;=rej /l .;af;dah' kuq;a j¾;udkfha wêl l,n,ldÍ osú meje;au ksid l=¿nvq lsysm j¾.hla muKla Ndú;d lsÍug .DyKshka mqreÿj isà' wo fuu ,smsfhka l;d lsÍug n,dfmdfrd;a;= jkafka zldf.a;a u,a,SZ hk f;arú,s mofhka l=vd ld,fha isgu wms yªkd.;a fld;a;u,a,s ms<sn|jh' j¾;udkfha Y%s ,dxlSh wdydr iïm%odhg fld;a;u,a,s we;=<;a jkafka fndfyda w,am jYfhks' kuqÿ fld;a;u,a,s fndfyda úg fiïm%;sYHdjg m%;sl¾uhla f,i Ndú;d lrhs' fld;a;u,a,s Ydlfha úoHd;aul kduh jkqfha Coriandrum Sativum ;jo" fuu fld;a;u,a,s Cilantro iy phskSia mdia,s jYfhka yªkajkq ,nkjd' fld;a;u,a,s Ydlfha iEu fldgilau wdydrhg iqÿiq jqjo wdydr iïm%odh ;=< jeä jYfhka fhdod .kq ,nkafka fld;a;u,a,s weg iy fld;a;u,a,s fld<h' Y%S ,dxlSh wdydr iïm%odh ;=< fld;a;u,a,s weg j,g m%uqL;ajh ,efnkjd' fmdÿfõ .;al< fld;a;u,a,s weg j, nyq, jYfhka YÍrhg w;HjYH wï, ^Wod (,sfkdf,hsla" Tf,hsla" mdñála& ;ka;= ^.%Eï 100l 41.9g wdydrhg .; yels ;ka;= wvx.= fõ&" hlv" le,aishï" fmdgEishï" ue.akSishï wvx.= fõ' fld;a;u,a,s weg j, thg wdfõKsl jQ iqj|la we;s ksid wdydrhg fjku doctormagazine.lk

fld;a;u,a,s YÍrfha

iSks uÜgu md,kh lrkjd"

krl fldf,iagfrda,a uÜgu wvq lrkjd''' iqj|la iy rij;a Ndjhla ,nd foa' ;jo" fld;a;u,a,s weg u.ska YÍrfha iSks uÜgu md,kh lr.; yel' ;jo" fld;a;u,a,s YÍrhg fyd| ke;s fldf,iagfrda,a uÜgu wvq lrk w;r YÍrhg fyd| fldf,iagfrda,a uÜgu (HDL) jeä lrkjd' fld;a;u,a,s j, wvx.= rhsfndf*af,ñka" úgñka A" ksheiska" lefrdáka" f*da,sla wï,h m%;sTlaisldrl f,i l%shd lrhs' tys wvx.= le,aishï iy úgñka K iajNdúlju Tiaáfhdfmdfrdisia ;;a;ajh md,kh lrkq ,nhs' ;jo fld;a;u,a,s wegj, wvx.= fn%dksT,a (broneol) yd ,sfkdÆ,a (linalool) ksid wcS¾K ;;a;ajhkao Cileol, Limonene ksid mdpk ;;a;ajhkao md,kh lr.; yel' ;jo udisl Tima fõokd" wei wdY%s; frda. JULY 2018 | DOCTOR MAGAZINE

tys iq,n ys;lr ridhk ksid frda. /ilg Tiqjla fjkjd''' j,g" wd;rhsáia" rla;ySk;djh jeks frda. i|yd fld;a;u,a,s weg fhdod.; yel' fï i|yd fld;a;u,a,s weg wdydr j,g tl;= lsÍu yd fld;a;u,a,s weg fmÕjQ j;=r /hla ;nd mdkh lsÍfuka fyd| m%;sM, ,nd.; yelsh' fld;a;u,a,s fld< weg fuka Y%S ,dxlslhka w;r Ndú;d fkdlrhs' fld;a;u,a,s fld< T!IOhla f,io" l=¿nvq f,i iy wdydr w,xlrKhg Ndú;d lrkq ,nhs' fld;a;u,a,s fld< foys iy ;s;a; rie;s njlska hqla;h' fld;a;u,a,s weg fiau fld;a;u,a,s fld<;a úgñka C" fi,skshï" úgñka A" hlv" YÍrhg w;HjYH fïo wï," ;U nyq,j wvx.= fõ' fld;a;u,a,s fld< Ndú;fha jdis fndfydauhla fõ' fld;a;u,a,s fld< wcS¾Kh" mdpkh" .Eiag%hsáia" w¾Yia" jukh hk ;;a;ajhka md,kh lsÍug fhdod .kshs' ta i|yd fld;a;u,a,s j, wvx.= Borneol ridhkh WmldÍ fõ' ;jo" th fyd| m%;sTlaisldrlhla f,i l%shd lrhs' fld;a;u,a,s fld< wfma iu wdrCId lsrSu i|yd jeo.;a fõ' ;jo tuys wvx.= úgñka C" E" Caffeic acid iy Ferolic ksid th m%;sms<sldrlhla f,i l%shd lrhs' ;jo th reêr mSvkh wvq lrk w;r YÍrhg fyd| ke;s flf,iagfrda,a m%udKh wju lrk w;r YÍrhg wjYH fldf,iagfrda,a (HDL) jeä lrkq ,nhs' fld;a;u,a,s fld< wdydrhg .ekSfuka

rla;ySk;djh wju lr.; yelsh' ;jo weia j, fi!LHhg" jl=.vq .,a i|yd" udisl Tima fõokd j,g" uqL ;=jd, j,g" YÍrfha we;s úI bj;a lsÍug" kskao fkdhEu jeks ;;a;aj fld;a;u,a,s fld< wdydrhg .ekSfuka u.yrjd .; yel' fld;a;u,a,s fld< fndfyda úg wdydrhg .kq ,nkafka i,do j,g iy jHxck j,g tl;= lsÍfuks' iEu fohlu .=K iy w.=K o ;sfí' tf,ig m%udKh blaujd fld;a;u,a,s wdydrhg .ekSfuka yoj; wdY%s; frda." reêr mSvkh iy iSks uÜgï m%udKh blaujd wvqùu" iu jeä jYfhka ixfõo ùu ksid iu wdY%s; frda." wcS¾K ;;a;ajhka we;súh yel' .¾NkS ldka;djka fld;a;u,a,s fld< wdydrhg .ekSfïoS ie<ls,su;a úh hq;=h' fld;a;u,a,s Ndú;fha jdis fukau wjdiso ;snqKo fuu l=¿nvq j¾.h wdydrhg tl;= lsÍu wfma fi!LHu;a cSú;h by< kxjd .ekSug Wmldr lrhs' •••

JULY 2018 | DOCTOR MAGAZINE

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fmr mdie,a úhg

ksis fmdaIKh orejkaf.a YslaIKfha moku i,ik ld,fha fmdaIKh .ek Tn oeKQj;ao@

75 JULY 2018 | DOCTOR MAGAZINE doctormagazine.lk

Y%S ,xld jhU úYAj úoHd,fha jHjydßl fmdaIK wOHhkdxYfha lÓldpd¾h *d;sud isrdid

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osklg m%Odk wdydr fõ,a ;=kla yd ta w;r;=r iq¿ lEu fõ,a folla ,nd fokak oskm;d wvqu ;rfï m<;=re j¾. folla yd t<j¿ ;=kla j;a ,nd oSug W;aidy lrkak ;snyd yeÿKQ fõ,djkaysoS yels iEu úgu c,h mdkh lsßug orejd Wkkaÿ lrjkak wdydr .kakd w;r;=roS rEmjdysksh keröug orejdg bv ,nd fkdfokak

ohdnr fouõmshks" Tfí orejdg iunr wdydr fõ,la ,nd osh hq;af;a wehs@

orejdf.a YÍr j¾Okhg" meje;aug yd l%shdldrs;ajhg wjYH Yla;sh yd fmdaIl ,nd .ekSug'

2 3

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Tn úiska ksjfia mßfNdackh lrk wdydr ms<sn| .kakd ;SrK ksid'

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Tn úiska wdydr ilikafka flfiao hkak ;SrKh lrk ksid'

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orejdg kj wdydr ,nd fok úg ta ms<sn|j Tjqkaj oeKqj;a lsÍug Tng yelshdj we;s ksid'

f,v frda. j,ska wdrCId ùug'

fi!LH iïmkak yd l%shdYS,S cSú;hla mj;ajd .ekSug'

<ore úfhaoS Tyqf.a$ wehf.a wdydr rgdj flfryS n,mEï lrk úfYAIs; mqoa.,hska w;r Tn m%uqL jkafka''''

orejdf.a udkisl j¾Okhg'

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Tn fï .ek okakjdo@ )

mjq,la f,i tlg tlaù wdydr .ekSfuka Tfí orejdf.a fmdaIK uÜgu iy wOHdmksl l=i,;djhka jeä oshqKq jk nj''' doctormagazine.lk

ksfrda.Sj Tfí orejd fmdaIKh lsÍug kï •

m%Odk wdydr fõ,a ;=kla yd ta w;r;=r iq¿ lEu fõ,a folla ,nd fokak

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iq¿ lEu fõ,a i|yd fmdaIH .=Kfhka hq;= flá wdydr j¾. ^iakelaia& ,nd fokak' Wod(-;eïnQ OdkH j¾. ^lv," lõms" uqxweg& jeks" kejqï m<;=re" t<j¿ tla l< iekaâúÉ" ;eïnQ t<j¿ fyda t<j¿ iqma" fhda.Ü" lsß

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foaÿkakla fuka úúO j¾Kfhka hq;= t<j¿ iy m<;=re ,nd fokak'

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oskm;d wvqu ;rfï m<;=re j¾. folla yd t<j¿ ;=kla j;a ,nd oSug W;aidy lrkak'

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t<j¿ iy m<;=re j, Wmßu .=Kh ,nd .ekSug tajd lemSug fmr fidaokak

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jeä fmdaIK .=Khla ,eîu i|yd wuq fyda wvqfjka msiQ t<j¿ ,nd fokak

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orejdg .; yels whqrska t<j¿ iy m<;=re ksjfia /ialr ;nkak

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mdka" b|swdmam" f;dafia jeks wdydr .kakd úg ta iu. fmdaIHodhS jHxckhla ,nd fokak

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le,ß wêlj imhk ìialÜ" flala" fpdla,Ü jeks wdydr ñ<oS .ekSfuka yd tajd ksji ;=< wkjYH f,i /ialr ;nd .ekSu yels;dla ÿrg iSud lrkak

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orejdg ,nd oSu i|yd msg;ska wdydr ñ,oS .ekSfïoS wêl f,i f;,a iys; flá lEu j¾." fm%Aiaá% j¾." nhsÜia j¾." wêl ¨Kq wvx.= wdydr j¾. yd wêl meKsri lEu j¾. ñ,os .ekSu yels;dla ÿrg isud lrkak

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lssß fyda lsß ksIAmdok osklg tla jrla j;a ,nd fokak

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;snyd yeÿKQ fõ,djkaysoS yels iEu úgu c,h mdkh lsßug orejd Wkkaÿ lrjkak

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orejdg ;Hd. f,i wdydr ,nd oSfuka j<lskak' ta fjkqjg Tjqkag fmd;la fyda fi,a,ï nvqjla ,nd fokak

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wdydr .kakd w;r;=roS rEmjdysksh keröug orejdg bv ,nd fkdfokak

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wdydr ms<sfh, lsÍfïoS orejdo thg iyNd.s lrjd .kak

• wdydr ñ,os .ekSug orejdo iyNd.s lr .kak' tysoS fmdaIHodhS wdydr f;dard .ekSug orejd fhduq lrkak ••• JULY 2018 | DOCTOR MAGAZINE

Hidden hungeR are you aware of it !

The nature of malnutrition the world is facing today is complex. Developing countries like ours are undergoing a nutrition transition. From a predominantly cereal based diet with fruits and vegetables we are moving towards mixed cuisine.Â 78

JULY 2018 | DOCTOR MAGAZINE

Dr Indu Waidyatilaka Senior Lecturer Faculty of Medicine, University of Colombo.

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Nutrition transition More importantly, we are moving towards convenience-based food patterns where meals are high in salt, sugar, fat, and energy dense processed food which are poor in vitamins and minerals (micronutrients). With this shift in our dietary habits, now we are experiencing a “triple burden” of malnutrition; undernutrition, overnutrition and micronutrient deficiency. Not only in the population at large but even in a particular individual these states can coexist. To understand this well, one must understand that meals can be either energy dense but poor in nutrient density or high in nutrient density with adequate energy density. The former being a characteristic feature in most convenience and processed foods and the latter being so in whole foods that are minimally processed. One may doctormagazine.lk

eat well in terms of quantity but not so well in quality. Quality is high when we eat meals which are high in variety and consistency of all the six food groups spread through the day. Therefore, one can be normal weight or even overweight and yet have a deficiency in micronutrients. On the other hand, an undernourished child would be deficient in vitamins, minerals as well as energy. Since much has been written on over-nutrition and under-nutrition this article addresses micronutrient deficiency or “hidden hunger”.

Due to our busy lifestyle, we seek refuge in quick ready to eat foods, which are often packed with energy but low in nutrients such as vitamins and minerals. Although they are convenient and time-saving however much we eat them our body remains hungry or starving of vital nutrients. Hidden hunger is not the overt hunger that comes from a lack of food but it is the lack of essential vitamins and minerals in the diet or micronutrient deficiency. Although very often micronutrient deficiency has no identifiable warning signs and most people who suffer from this condition may not even realize that they have a problem, the health-related consequences due to this can be devastating. The main problems that contribute to micronutrient deficiencies include poor diet, increased micronutrient demand during certain stages of life such as pregnancy and lactation and also certain diseases. What are the signs that you may be having hidden hunger and what happens if you do have it? Although in most instances there are no obvious features to identify hidden hunger, you may be having a deficiency when you notice: weakness and unusual tiredness, shortness of breath, pale skin, sore tongue, frequent infections, night blindness, and goiter. JULY 2018 | DOCTOR MAGAZINE

Deficiency of vitamins and minerals may lead to a variety of health problems including anemias due to iron deficiency or folic acid or B12 deficiency, defective growth, skin disorders and disorders of the thyroid gland and digestive system. However, since these signs and symptoms, as well as the health issues they are due to, can also be due to some other diseases it is extremely important that you consult a doctor if you have these symptoms. What are the risk factors of hidden hunger? If • you do not eat adequate quantities of fresh fruits and vegetables or you over-cook your meals. • you do not consume adequate amounts of dairy products. • you are pregnant. The demand for these micronutrients is high and if you do not take adequate quantities of high-quality foods (nutrient dense) you may develop symptoms of deficiency. • you have intestinal problems which interfere with absorption of nutrients. • you take excess alcohol. Alcohol interferes with absorption of some important nutrients. • you take certain medicines. Some drugs given for cancer, seizure disorders (fits), gastritis, for high cholesterol, may interfere with the absorption of these nutrients.

a variety of foods is an effective way of sustainably preventing hidden hunger. Choose fresh whole foods over processed foods. Processed foods; packeted snacks such as murukku, salted or sugared products, French fries, Chinese rolls, pies and pastries, processed meats like ham, bacon, and sausages are processed for our convenience. However, it costs us a lot as the micronutrients are lost during the processing. Focus on including foods from the main food groups within the day. The three main meals should be based on cereals such as rice or other whole grain products. It is important to include five portions of vegetables and fruits per day, where one portion would be half a cup of cut fruit or vegetables.

How can we prevent hidden hunger? Micronutrient deficiency usually occurs when the diet lacks variety and all food groups are not represented. Having a healthy diet that includes 80

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Make sure you eat different types of vegetables. Daily consumption of all varieties

of vegetables; dark green leafy vegetables (such as gotukola, mukunuwenna, kankun, thampala, spinach etc), dark coloured or orange vegetables (such as carrot, pumpkin and sweet potato) and root and fruit vegetables (such as gourds, brinjals, ladies’ fingers, ash plantain, carrots and beets) is important. Enjoy Sri Lankan fruits like oranges, banana, mango, papaya, guava, amberalla and pineapple frequently. Include lean meat or fish or eggs and pulses, milk and dairy products daily. A hand full of nuts is a good source of many nutrients.

In addition, some foods are particularly rich in certain nutrients.

If you are lacking in any particular nutrient, you can include rich sources. Some good sources of iron are meat (especially red meat), fish such as Tuna (balaya/ kelawalla), eggs, dark green leafy vegetables such as thampala, sarana, golukola and mukunuwenna and pulses like chickpea (kadala), cowpea, mung, soya and dhal. Meat, fish, eggs, milk, dark green leafy vegetables [Kathurumurunga, thampala and spinach (nivithi)], other vegetables like carrot, sweet potato (kaha bathala), tomato and yellow pumpkin are some good sources of vitamin A.

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Most vegetables and most fruits including leafy vegetables like thampala and curry leaves (karapincha), beans, ladies’ fingers and plantain, lime, pineapple, orange and ambarella and pulses (beans, soya, chickpea and peanuts) are good sources of folate. Fruits are a good source of vitamin C. Particularly rich sources are citrus fruits (orange, lemon), nelli, guava (pera), star fruit (kambaranka), pineapple and veralu (Sri Lankan olives). Some of the vegetables that contain vitamin C are drumstick, capsicum (maalu miris), bitter gourd and tomato. Small fish such as salaya, hurulla and sprats eaten with bones are rich in iodine, calcium and vitamin B12.

Loss of nutrients during cooking

is often the cause of inadequate intake despite eating well. Simple modifications in your cooking JULY 2018 | DOCTOR MAGAZINE

practices can reduce nutrient loss. Vegetables should be cleaned before rather than after pealing and cutting. Try to prepare vegetables just before you cook them so that they are not exposed to air for long periods of time. Do not over-boil, and refrain from reheating the same food multiple times. If you are freezing cooked foods, store them in single-use proportions so that you only heat them once. Minimum storage time after cooking too will reduce micronutrient loss. Small changes in lifestyle ....... big benefits Making small changes to your eating habits could bring about huge benefits. Absorption of iron improves if taken with vitamin C (adding lime/orange or tomato when preparing) or decreases if taken with calcium (milk) or tannin (tea, coffee) within a short period of a meal. Absorption of Vitamin A, D, E and K is better with food containing fat (vegetable oil). Try baking and grilling instead of frying as most of these nutrients are sensitive to heat and are destroyed in the process of frying/deep frying. It is important to keep the baking temperatures as low as possible.

keep you well hydrated and healthy.

Include young children in food preparation so that they

learn by seeing and doing what is best. Develop your own methods of convenience: keep fruits and salads in a ready to eat manner in the fridge for snacks. Reduce buying unnecessary foods such as biscuits and savory/sweet snacks.

Reduce eating main meals while watching television. Enjoy mealtimes with family where possible, as eating slowly helps to reduce overeating and eating correctly as a group helps the whole family stay healthy and children to grow up with correct habits.

Drink plenty of water (an adult should drink 6 -8 200 ml glasses per day) to provide a medium for these nutrients to move around in your body and ••• 82

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iqje;s osúhlg Tìk fm%daàk imsß

rks, fnda. mßmamq uqxweg lõms lv, Wª fld,a¨ fidahd fndaxÑ yels iEu úgu wdydr fõ,g rks, l=,fha wdydrhla tl;= lr .kak 84

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Y%S ,xld jhU úYAj úoHd,hSh mY= iïm;a ëjr yd fmdaIK mSGfha tÉ tï wfmaCId fyar;a doctormagazine.lk

rks, fnda.''' Tfí YÍr fi!LHh m%j¾Okhg lrk fï iïudou .ek Tn oeKqj;ao@ Y%s ,dxflah wmf.a tosfkod wdydr fõ, uQ,slj mokï ù we;af;a Ydl m%Njhlska hq;= wdydr j,skah' OdkH j,g miqj jeämqr mßfNdackh lrk wdydrh f,i rks, fnda. iqúfYAIS fõ' mßmamq" uqxweg" lõms" lv," Wª" fld,a¨" fidahd fndaxÑ Y%S ,xldfõ nyq,j mßfNdackh lrk rks, fnda. fõ' fïjd WoaNs; úoHd;aul j¾.SlrKhg wkqj zzf,.shqñfkaisZZ l=,hg wh;a fõ' fuu fnda. ldKAvh b;d by< úfYaI úúO;ajhlska iukaú;h' rks, fnda.hl weghl m%udKh" msg fmd;af;ys j¾Kh wkqjo m%fNAo /ila yªkd.; yelsh' WodyrKhla f,i lõms .;al< jreKs" fndïfí" MICP1, MI 35 f,i m%fNAo /ils'

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fmdaIKSh w.h i<ld neÆ úg fuys wvx.= jk by< fm%daàka m%udKh ksid fm%daàk j,ska msßmqka Ydluh m%Njhla iys; wdydr úfYaIhla f,i ie<fla' idudkHfhka rks, fnda. j, úh<s nßka 20- 40] muK fm%daàka wvx.= fõ' úfYAIfhka Ydluh wdydr muKla .kakd mqoa.,hskaf.a ffoksl fm%daáka wjYH;dj imqrd,Sug rks, fnda. jeo.;a fõ' tkuq;a fidahd j, yer fuu fnda. j, wvx.= fm%daàk wiïmQ¾K fm%daàk f,i ie<fla' thg fya;=j jkqfha tu fm%daàk j, ixhq;sfha w;HjYH weuhsfkda wï, ^fm%daàk iEoS we;s l=vdu tallh& ish,a, wvx.= fkdùuhs' w;HjYH weuhsfkda wï, wm YÍrh ;=< ksmojd .; fkdyels ksid wksjd¾hfhkau wdydr;a iu. ,nd.; hq;= fõ' kuq;a OdkH j¾. ^n;a" mdka msá wdY%s; ksIAmdok" nv bßÕ=& jeks fnda. iu. tlaj .;a úg tu m%fNAo foflys we;s tlsfklg fjkia fm%daàk ixhq;sh ksid w;HjYH weuhsfkda wï, YÍrhg ,nd.; yels fõ' tjeks wdydr mßmQrl fm%daàk wvx.= wdydr f,i ye|skafõ' uqx lsßn;a" lõms lsßn;a" ;%sfmdaI" mßmamq" lv, jHxck iu. n;a óg WodyrK fõ' fidahd fndaxÑ iqúfYAIs rks, fnda. hla f,i ie<flkafka tys wka;¾.;fha w;HjYH weuhsfkda wï, ish,a, wvx.= jk ksidh'

fm%daàk muKla fkdfõ''' rks, fnda. j, ;j;a fndfyda fmdaIl we; óg wu;rj rks, fnda.j, ldfndayhsfâ%g" ixlS¾K ldfndayhsfâ%g ^;ka;=&" úgñka î ixlS¾Kfha úgñka j¾." LKsc ,jK ^whka" iskala" le,aishï& wvx.= fõ' tfiau rks, fnda. j, wvx.= fïo m%udKh wfkl=;a fnda. j,g idfmaCIj wvqh' j¾;udkfha olakg ,efnk ;rÕldÍ cSjk rgdj;la iu. mdka msá wdY%s;j wêl f;,a" ¨KQ" rildrl nyq, by< Yla;s w.hlska hq;= wdydr ,nd .ekSug fm<ö we;' fuhg idfmaCIj Yla;sh jeh lrk l%shdldrlï j, fhoSu wvq ksid" jeä Yla;s m%udKh ñksia isrer ;=< fïoh f,i ;ekam;a fõ' th oshjeähdj" wêreêr mSvkh" ms<sld" yDohdndO jeks úúO fnda fkdjk frda. /ilg w; jkhs'

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u<noaOh jeks frda. md,khg jeo.;a fõ'

fmdaIKh muKla fkdfõ''' wdrlaIdj yd /ljrKh;a'''

frda. u¾Okh lrk ;ka;=uh mod¾: ksid fï wdydr iqúfYaIShs rks, fnda. j, wvx.= wêl ;ka;= m%udKh ksid wdydrfha wvx.= iSks reêrhg ksoyia ùfï fõ.h wvq lrk w;r t;=<ska reêrhg iSks Wrd .ekSfï fõ.h md,kh fõ' tu ksid rks, fnda. wvq .a,hsisñla o¾Ylhlska hq;= fnda fkdjk frda. md,khg bjy,a jk wdydr ldKAvhla f,i ie<fla' wdydr j, wvx.= ;ka;= ñksidf.a l=vd wka;%h ;=<oS cS¾Khg ,la fkdù uyd wka;%h fj;g <Õd fõ' tysoS wdka;%sl CIqø cSùka ;ka;= Wmia:rhla lr .ksñka j¾Okh ù Tjqkaf.a úúO cSj l%shdj,s isÿ lrhs' tysoS iEfok ixfhda. reêr.; fldf,iagfrda,a md,kh lr.ekSug jeo.;a fõ' ñksia isrer ;=< fldf,iagfrda,a ksmoùug ms;a hqI wjYH fõ' uyd wka;%h ;=<oS fl|s u.ska ms;a hqI nkaOkh lr tajd bj;a ùu isÿfõ' th reêr.; fldf,iagfrda,a md,khg bjy,a fõ' úúO ms<sldldrl ixfhda.o fl|s iu. nkaOkh ù wdydr ud¾.fhka bj;a fõ' ;ka;= w;r c,h r|jd .ekSu ksid u<øjH j, ialkaOh jeälr tajd myiqfjka bj;a ùu isÿlrhs' th 86

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fmdaIl fldgia yereKQ úg fmdaIl fkdjk úúO Ydluh ixlS¾K ridhksl ixfhda. rks, fnda. j, nyq,j wvx.= fõ' fuu ixfhda. *sfkda,sla ixfhda." *Af,ajfkdhsâ" gekska f,i yªkd.; yelsh' tajd ñksia isrer ;=< we;sjk TlaislrK m%;sl%shd wys;lr f,i isÿùu md,kh lrhs' úúO ridhksl" wêl wd;;sh yuqfõ we;sjk TlaislrK m%;sl%shd ksid ffcùh wKQj, jHQyfha fjkialï we;sùu ;=<ska úúO fnda fkdjk frda. we;s lrhs' tjeks wjia:d j,oS by; ixfhda. m%;sTlaisldrl f,i jeo.;a fufyhla bgq lrhs'

rks, l=,fha wdydr j, fmdaIKh ;jÿrg;a by< kxjk ryila by< .=K;ajhlska hq;= jqjo fïjdfha we;s r¿ iajNdjh fndfyda fokd tajd wdydrhg .ekSug ue<slula olaj;s' úúOdldrfha msiSfï yd ieliSfï l%u wkq.ukh lsÍu ;=<ska tajdfha r¿ iajNdjh wju lr wys;lr ixfhda. bj;a lsÍuo isÿfõ' ;jo rks, fnda. m%frdayKhg ,lalsÍu ;=<ska tajdfha fmdaIK w.h by< kexúh yels fõ' fujeks uy;a jdis /ilska hq;= rks, fnda. flfryS wmf.a wjOdkh fhduq lsÍu jeo.;a fõ' Tnf.a m%Odk wdydr fõ,g wksjd¾hfhkau rks, fnda. hla tl;= lr .ekSu jeo.;a fõ' th by< hk fi!LH .eg¿ yuqfõ Tnf.a fi!LH hym;aj mj;ajdf.k ksfrda.S fyg ojilg .uka lsÍug wä;d,u imhhs' doctormagazine.lk

RICE

Health benefits as the

FUNCTIONAL FOOD

The health and wellness of human beings is largely dictated by the consumption of nutritious foods. Consumption of biologically active ingredients in food has been linked to help combat diseases such as cancer, cardiovascular diseases, obesity, and gastrointestinal tract disorders. Functional foods can be considered to be those whole, fortified, enriched or enhanced foods that provide health benefits beyond the provision of essential nutrients doctormagazine.lk

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OVERVIEW Functional food is similar in appearance to, or maybe, a conventional food that is consumed as part of a usual diet, and is demonstrated to have physiological benefits and/ or reduce the risk of chronic disease beyond basic nutritional functions”, defined by Health Canada. Growing shreds of evidence from research studies showed that plant foods can reduce the risk of getting chronic diseases such as cancer, hypertension, diabetes, and cardiovascular diseases. 88

P. Usshanthi Demonstrator, Dept. of Applied Nutrition, Wayamba University of Sri Lanka.

There are components in a plant-based diet other than the nutrients which can reduce disease risk. These components are called ‘phytochemicals’. The common functional foods are cereals, fruits, vegetables, and omega-3 fatty acids containing products which we consume in our daily life. The rice value as a functional food The rice as a cereal is a staple food for more than half of the world’s population. Rice grain is a rich source of nutrients. It provides 75 to 80% of starch, 12% water, 7% of protein, fats, B vitamins such as thiamine, riboflavin and niacin and minerals such as calcium, magnesium, phosphorus, manganese, copper, iron etc. It is also a good source of dietary fibre as a whole grain cereal.

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80%

12%

STARCH

WATER

PROTEIN

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There are other non-nutritive components identified in rice especially polyphenols. Among them, phenolic acids are abundant in whole grain rice. The rice grains with light brown pericarp contain less molecular weight phenolics rather than rice grains with dark brown or black pericarp. The main phenolics in rice grains with light brown pericarp colour are the phenolic acids.

In-depth analysis All these components act as antioxidants providing several health benefits mainly through their antioxidant mechanisms such as radical scavenging, reducing power, metal ion chelation etc. Oxidative damage to cell components like DNA, proteins, and lipids occurs with age and contributes to the degeneration of the somatic cells and to the pathogenesis of degenerative diseases. Polyphenols are potent inhibitors of LDL oxidation and this type of oxidation is considered to be a key mechanism in the development of atherosclerosis. Other mechanisms by which polyphenols may be protective against cardiovascular diseases are antioxidant, antiplatelet, antiinflammatory effects as well as increasing HDL, and improving endothelial function.

plaque. Several other mechanisms of action also have been identified for chemoprevention effect of polyphenols which include estrogenic/anti-estrogenic activity, anti-proliferation, induction of cell cycle arrest or apoptosis, prevention of oxidation, induction of detoxification enzymes, and regulation of the host immune system, anti-inflammatory activity and changes in cellular signalling. The phenolic compounds also have shown the anti-diabetic, antiageing, neuroprotective effects on human beings.

Challenges in modern day processing However, the chemical composition of rice is highly affected by several factors such as the processing techniques, fertilizer application, soil factors, altitude, climate, rainfall, length of growing season, temperature, the crop itself, variety, grain size, management practices and post-harvest handling and storage also affect the chemical composition of the rice grains. Among them, the major factors that are under critical considerations include the processing techniques and fertilizer applications.

Heart-healthy Polyphenols Polyphenols may also contribute to a stabilization of the atheroma doctormagazine.lk

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ksjerÈj f,an,h lshjd

yß wdydr .ksuq Tn fj<|fmdf<ka weiqreï lrk ,o wdydrmdk ñ,§ .kakd úg tu weiqrefuys we;s f,an,h flfryS fl;rï ÿrg mÍlaIdldÍ jkafkao@ m<uqj Tfí wei hkafka tys ñ, flfrySh' tfiau tys ñ,g iß,k wdydr øjHh m%udKhla we;soehs yd wdydrfha l,a bl=;a ùfï Èkh ms<sn|j Tn ie,ls,su;a jkjd úh yel' wm fndfyda fofkl= wdydr mdk ñ,§ .ekSug yqre ù we;af;a fï wdldrhghs' kuq;a wo jk úg Tnf.a wjOdkh wdydr f,an,fha wfkl=;a fldgffia flfrySo fhduqùfï wêl wjYH;dj u;= ù we;' ld¾h nyq,;ajfhka msß wo iudcfha fndfyda fofkl= laI‚l wdydr" ilik ,o wdydr we;=¿ úúOdldrfha wdydr j¾. wêl f,i mßfNdackhg yqre ù we;s w;r ta yd iu.u iudcfha fnda fkdjk frda. me;sr hduo YS>% f,i by< f.dia we;' fï mdßfNda.slhka jYfhka Tn Tng wjYH wdydr mdk nqoaOêu;aj f;dard .ekSug yqre ùu WÑ; jk w;r wdydr fõf,a jeo.;alu meñfKkafka fï wjia:dfõ§h' fuu f,an,h lshùu u.ska Tng Tn mßfNdackh lrk wdydrh ms<sn| fndfyda lreKq oek.; yels w;r fuu ,smfhka Tnf.a fi!LHhg jeo.;a jk lreKq lsysmhla fmkajd fokq ,efí' ta ta fla tia wfíisxy mqqyqKq fmdaIKfõ§

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f,an,fha we;s fmdaIl fudkjoehs fydÈka lshjd n,kak Tn ñ,§ .kakd wdydrh hlv" ;ka;=" le,aishï" úgñka ^A,C&" fmdgEishï wd§ fmdaIl j,ska hqla; kï tjeks wdydr f;dard .ekSu fhda. Hh' tfiau wêl fldf,iagfrda,a" yDo frda." wê reêr msvkh yd Èhjeähdj wd§ frda. j,g fya;= jk fïoh ^úfYaIfhka ix;Dma; fïoh yd fldf,iagfrda,&" fidaähï yd iSks wêlj wvx.= wdydr wju jYfhka ,nd .ekSu kqjKg yqreh' fuys§ wod, wju jYfhka ,nd .; hq;= fmdaIlh ffokslj wjYH m%;sYa;hg jvd 5] g wvq kï jvd;a fhda.H jk w;r 20] g jvd jeä kï tjeks wdydr mdk ks;r ,nd .ekSu fkdl< hq;=h' doctormagazine.lk

wdydrfha wvx.= ksIamdÈ; øjH ms,sn| ie,ls,su;a jkak ksIamdÈ; øjH f,an,fha olajd ;sfnkqfha wêl jYfhka tl lr we;s øjHfha isg wju jYfhka tlalr we;s øjH f,i wkqms<sfj,gh' fï wkqj Tng Tnf.a wdydrh fyda mdkh ;=, wvq fyda jeä jYfhka fkdfhl=;a rildrl" j¾Kl" l,aa;nd .ekSfï øjH wd§ fkdfhl=;a øjH fldmuK wka;¾.; oehs i,ld ne,sh yel'

wdydrfha wvx.= le,ß m%udKh ms<sn| ie,ls,su;a jkak le,ß wvq wdydr ,nd .ekSu Tnf.a fi!LHhg iEu w;skau fhda.H jk w;r wdydrfha tl ms<s.ekaùul ^One Serving& le,ß 400 g jev kï tjeks wdydr le,ß wêl wdydr fõ' tfiau Tn wdydrh wêl jYfhka fyda ks;r ks;r mßfNdackh lrkjd hkq Tfí YÍrhg wêl f,i le,ß m%udKhla tl lr .ekSuls' le,ß wêl wdydr ks;r wdydrhg .ekSu wêl ;rndrelug u. mdok nj fuys§ Tn u;l ;nd .; hq;=fõ'

Tnf.a fi!LHhg fhda.H wdydr f;dard .ekSug yqre jkak Tn lsishï fnda fkdjk frda.hlska miq jkafkla kï Tn Tnf.a fi!LH flfryS jvd;a ie<ls<su;aj úfYaIfhka ieliq wdydrmdk ,nd .ekSu iqqÿiq jk w;r fuys§ wdydr melÜgqfõ we;s f,an,h Tng WmldÍ jkq we;' Wod¦ Èhjeähdj - wvq iSks$ iSks rys; ksIamdok ^low sugar, salt free& wêl fldf,iagfrda,a" yDo frda.- fïo rys;" wvq fïo ksIamdok ^low fat, non-fat& wê reêr msvkh- ¨Kq wvq$rys; ^low salt, salt free, low sodium&

wêl ;rndre - iïmQ¾K OdkHuh ksIamdok ^whole grain& ñka miq Tn fj<|fmdf<ka wdydr mdk ñ,§ .kakd úg f,an,h fydÈka lshjd tlu j¾.fha ksIamdokhka ixikaokh lr jvd;a fi!LHdrlaIs; ksIamdok f;dard .ekSug nqoaOêu;a jkak' ••• JULY 2018 | DOCTOR MAGAZINE

Physiotherapy wm úiska fkdi,ld yßk we;eï ldrKd ksid uq¿ YÍrfhau .eg¨ we;s jkak mq¿jka

wejeis ;ek l,a fkdyer ,en.; hq;=

fN!;Ñls;aidfõ msysg ks;r je<f|k ysiroh" fldkafoa wudrelï" wf;a mfha wudre jeks oE wfma fndfyduhla fokd tÈfkod w;aú|sk fõokdldÍ ;;a;ajhkah' iuyr wjia:djkaj,§ fudk ;rï fõokd lelal=ï ;sfnkafkao h;a ffjoHjrhl= fj; .sh l, ;ukaf.a frda. ,laIK fld;ekska mgkaf.k fld;ekska lshd wjika l< hq;=±hs frda.shdgu is;d .kakg wmyiq ;rïh' ieneúkau fï fndfyduhla frda.j, uQ,h Tn lsisfia;au úYajdi fkdlrk wkaofï fya;=jls' 92

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jhsfí%kaÜ msIsfhda flhdyS úfYaI{ fN!; Ñls;ail ã'fla' weka;ks B.P.T.CBDN, CMT, CADN, M.P.T. (CP) wfma jeros mqreÿ yd bßhõ ksid wm frda.S jk yeá wfma mqreÿ bßhõ" yeisÍï" Ôjk rgdj yd wm ±k iy fkd±k lrk úúO jQ ls%hdldrlï ksid wfma YÍrh fndfyda lror ysßyerj,g uqyqK fohs' fuys§ YÍrh úiskau fndfyda úgu ta jerÈ" ksjerÈ lsÍu i|yd W;aidy orhs' th m¾fhaIKj,skao ikd: ù we;s fohls' kuq;a YÍrhg;a fuh neß jk wjia:d fhfoa' ta o iajNdúl ;;a;ajhls' hka;%hlska jqj;a jev .ekSug yels iSudjla mj;S' fufia wfmau YÍrhg wm úiska lrk jerÈ YÍrh úiska bjidf.k tajd ksjerÈ lrñka wmg Ôú;h mj;ajd f.k hdug Woõ l<;a" YÍrh Bg wfmdfydi;a jk

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wjia:djla Wodjkq we;' túg YÍrh úiska th wmg bÕshlska okajhs' ta bÕsh kï fõokdjhs' fuf,i fõokdjla we;s jQ úg wm lrkafka tu fõokdj u. yrjd .ekSu i|yd fõokd kdYl T!IO Ndú; lsÍuh' túg fõokdj ;djld,slj ke;s ù hkq we;' kuq;a frda. uQ,h ksremøs;j tf,iu isrer ;=< /|S ys|shs' bkamiq isÿ jkafka frda. uQ,h ojiska oji ysi Tijñka j¾Okh ù wmj ;j ;j;a frda.S lsÍuhs' fuh b;d ne?reï ;;a;ajhls' isrerg fõokdjla we;s jQ úg thg lskï fyda m%;sl¾uhla fhÈh hq;= nj ienEh' ta fõokdj ú|sñka Ôj;a ùu wiSre ksidh' kuq;a frda. uQ,h kue;s i;=rd uq¿ukska úkdY lr ±óu w;HjYH ue fõ' fN!; Ñls;aidj msysgg tk ;ek''' fN!; Ñls;aidj fyj;a Physiotherapy hkq wfma rgg w¨;a fohla fkdfõ' kuq;a fuhska frda. iqjh i|yd l< yels foa wm%udKh hkak fndfyda fofkla okafka ke;' ñksia pd,l ls%hdldß;ajh yd p,k yelshdj jeäÈhqKq lsÍu" fõokd iy frda. iukh lsÍu" ;=jd, wdndO iukh lsÍu" isrerg we;sjk fjk;a wNsfhda. j<lajd .ekSu iy ksjerÈ lsÍu hkd§ fndfyda foa i|yd jk Ñls;aidjla f,i fN!; Ñls;aidj y÷kajd Èh yelsh' fuu Ñls;aidfõ§ wfma rfÜ kï uqLfhka ,nd fok T!IO Ndú; flfrkafka ke;' fN!;Ñls;aidfõ úúO Ndú; kuq;a fN!; Ñls;aidjg wh;a bf,lafg%da f;rms m%;sldr l%ufha§ frda.shdg T!IO ,nd Èula isÿfõ' ta uqL ud¾.fhka fkdj bf,lafg%dav wdOdrfhka kshñ; T!IOh frda.shdf.a frda.h iys; ia:dkhgu heùu u.sks' whkfgdaf*darisia kñka y÷kajk fuu m%;sldr l%uh iy f*dafkdaf*drisia kñka y÷kajk w,ag%dijqkaâ jeks w;sèjks ;rx. u.ska flfrk

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m%;sldr l%uho fN!; Ñls;ailjrhl= úiska frda.shl=g ,nd fokafka ffjoHjrhl= úiska frda.shdj ta i|yd fhduq l< wjia:dj,§ muKs' kuq;a fN!; Ñls;aidj T!IOj,g uq,a;ek fok m%;sldr l%uhla fkdfõ' frda. uQ,hgu fN!; Ñls;aidj u.ska m%;sldr lrk w;r tlaihsia f;rms" ySÜ f;rms" yhsfv%da f;rms" v%hskSâ,ska f;rms ^fuh ngysr lgq Ñls;aidjh& welajála f;rms" w¾.fkdñla ljqkai,ska wekaâ weâjhsia iy uekqfj,a f;rms tu m%;sldr úê w;r m%Odkh' úfYaI{ fN!; Ñls;aidj úfYaI{ fN!; Ñls;aidjg wh;a wxY .Kkdjla fjhs' udxY fmaYs" wiaÓ yd úl,dx. fN!; Ñls;aidj (Orthoaedic / Musculoskeletal Physiotherapy) lS%vd fN!; Ñls;aidj (Sports Physiotherapy) yDo frda. yd fmKy¨ fN!; Ñls;aidj (Cardio – Respiratory Physiotherapy) iakdhq fN!; Ñls;aidj (Neuro Physiotherapy)

m%cd fi!LH fN!; Ñls;aidj (Community Physiotherapy) <ud yd <ud frda. fN!; Ñls;aidj (Paediatric Physiotherapy) m%ij yd kdßfõo fN!; Ñls;aidj (Ohstretic and Gynocology Physiotherapy) wdÈh ñka lsysmhls' mqxÑ .eg¿jla Tvq ÿjk yeá jdykhl frdaohl m%Yakhla we;s jqjfyd;a ld,hla .; jk úg tys peish weo ùu isÿ fjhs' tf,i YÍrfha tla ;ekl we;sjk lskï fyda fodaIhla l,la .; jk úg uq¿ YÍrhgu n,mdkq we;' ksoikla f,i uqLfha ylaflys we;s jk m%Yakhla ksid l,a.; ùfï§ uq¿ YÍrfhau ;o ùula isÿúh yelsh' tfiau wf;a we;sjk ;oùula ksid fldkafoa wudrej yg .ekSug mq¿jk' Distress kñka y÷kajk krl udkisl wd;;sh ksid udxY fmaYsj, wiu;=,s;;djhla we;sù fkdfhl=;a ldhsl wdndO we;s ùfï yelshdj ;sfí' wd;;sh fukau fmdaIK ÿ¾j,;djh bßhõj, m%Yk wfma mqreÿ hkd§ ´kEu fohla ksid udxYfmaYskaj, wiu;=,s;;djh we;sù tu.ska uq¿ Ôj hdka;%Kfhau .eg¨ we;s úh yelsh' ;j;a ir,j ±lajqjfyd;a tla iq¿ .eg¨jlska .eg¨ rdYshla ks¾udKh ùug myiq yelshdjla we;sùuhs' tksid by; o lSjdla fuka frda. uQ,h fidhd Bg m%;sldr l< hq;=h' fN!; Ñls;aidfjka l< yels fndfyda oE ;sfí' wm lsisfia;a fkdis;k fya;+ka u; yg .kakd úúO frda. we;' fïjd fndfydauhlg m%;sldr fN!; Ñls;aidj ;=< mj;shs' •••

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NEW VELONA INNOVATIONS

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iqúfYaIS mßir ys;ldó ì<sª wdrlaIdj Wmßufhka i,ik

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ì<s÷ iqjfi; iïnkaOfhka fjfiia ie<ls,a,la olajk lS¾;su;a foaYSh wdh;khla jk Thread Works (Pvt.) Ltd úiska w¿f;ka y÷kajd fok ,o ì<sª ys;ldó kfjda;amdol vhmrhla yªkajd oSu fujr wmf.a wNsm%dh fjhs' 96

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VELONA CUDDLES LOONEY TUNES ÈhqKq jk ;dlaIKh;a iu. Baby Diaper ksIamdok lafIa;%fha iS.% ÈhqKqjla fï jk úg we;sj ;sfí' fï ;=<ska b;d wdrlaIs; yd by< .=Kd;aul Ndjfhka hq;A vhmr kj;u udÈ,s j,sska yd wdl¾YkSh fmkqulska Tnf.a orejd Wfoid ,nd §ug Thread Works wdh;kh .;a W;aidyhl m%;sM,hla jYfhka Looney Tunes Diapers wo fj<om,g bÈßm;a lr lr we;'

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iqúfYaIs;d

iqmsß Wrd .ekSfï yelshdj (Super Absorbent composite Care) kùk ;dlaIKh wkqidrfhka jeä Wrd .ekSfï yelshdjla hq;=j Looney Tunes Diaper ksIamdokh lr we; '

b;d uDÿ yd úfYaI yevhlska hq;= u;=msg wdjrKh (Super Soft Pearl Embossed Top Sheet) vhmrhl u;= msg wdjrKh vhmrfha u;= msg f;;ukh ke;s lsÍug yd Wrd .ekSfï yelshdj iS.% lsÍug fnfyúka odhl jk wx.hls' Looney tunes i|yd Pearl Embosed úfYaIs; u;=msg wdjrKhla Ndú;d lr we;af;a tfyhskah'

jd;h yqjudre jk msámi wdjrKh (Ultra breathable striped back-sheet) fï i|ydo wm jd;h yqjudre jk miqmi wdjrKhla Ndú;d lr ;sfnk w;r tu.ska orejdg losu iqj myiqjla f.fkk w;r úh<s ld,.=K ;;a;ajhl§ jqj;a

orejdg lsisÿ wmyiqjla fkdoekSug th Wmldrj;a fõ '

úfYaI 3D yevh ^3D Form Fitting Design&

vhmrfha úfYaIs; yevh orejdg iqjmyiqj r|jd ;eîug ^Comfortable Fit& yd orejdf.a l%shdYS,s;ajhg ndOdjla fkdùug fya;=jla fõ'

wmf.a fuu kj;u ksIamdok ms<sno jeäÿr úia;r oek .ekSug Tn leue;a;la olajkjd kï wfmaa Facebook msgqjg msúfikak' 0712360050 fj; weu;=ula ,nd oSfukao jeäÿr úia;r oek.; yel' fï jk úg Èjhsk mqrd ish¿u n,h,;a *duis yd <ore ksIamdok fjf<oie,a j,ska fuu ksIamdok ,nd .; yels nj i;=áka oekqï fouq' VELONA CUDDLES Thread Works ( Pvt.) Ltd. úOdhl ks,OdÍ ksrdÊ m%kdkaÿ úisks

bka*aÆfjkaid frda.Ska i|yd Wmfoia

• miq.sh ld,h ;=< jHdma; jQfha bka*aÆfjkaid A ffjrihhs

bka*aÆjkaid frda.Ska i|yd Èh yels Wmfoia'''

• oeka ;;a;ajh fnfyúka md,kh fjñka ;snqK;a ;jÿrg;a Tfí wdrlaId ùu jeo.;a'''

• fikÕ .ejfik ia:dkj,g hdfuka je<lsh hq;=hs'

• WKla fyïìßiaidjla iEÿK ú.i fï bka*a¨fjkaid hehs ks.ukh l< fkdyelshs' frda. ,laIK ;o WK" leiai" W.=f¾ fõokdj" fidgq Èhr .e,Su" yqiau .ekSfï fõ.h jeä ùu" T¿j nr .;sh" weÕm; fõokdj" nv nqre,g hdu" jukh hdu jeks frda. ,laIK'

• fmdÿ m%jdyk fiajd Ndú;h wju wju l< hq;=hs' • lysk úg iEu úgu f,akaiqjla Ndú; lrkak yqre úh hq;=hs' • ks;r inka fhdod w;a msßiqÿ lr.; hq;=hs' • we| úfõlh ,nd .kak' • jeämqr uo WKqiqï Èhr j¾. mdkh lrkak' • fmdaIHodhS wdydr ,nd .kak'

ffjrih YÍr.; ùfï wjodku we;af;a'''

• óg wu;rj ffjoH Wmfoia foia wkqj lghq;= l< hq;=hs'

• jhi wjqreÿ 2 g jvd wvq orejka"

fï Èk j, ;sfnk wjodku iuÕ frda. ,laIK iys; l=vd orejka mdi,a fmr mdi,a" mdi,a heùfuka je<elaúh hq;= w;r Tjqka ms<sn| oeä wjOdkhla fhduq l< hq;=hs' Yajik wdndO iys; frda.Ska isá kï ksis ffjoH m%;sldr j,g fhduq l< hq;=hs'

• jhi 65g jvd jeä jeäysáhka" • .¾NKS uõjreka"

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.¾NdIfhka ridhkd.drhg .sh wisßu;a ñksia ixfiapkh kej;;a ridhkd.drfhka .¾NdIhg le|jdf.k tk

CAPSULE BABY;dlaIKh ldka;dj ;u äïn ,ndoSfuka miq" iajdñmqreIhd Y=l%dKq ,ndoSfuka miq wUqieñhka ksfjig hkjd' t;eka isg idM<H;d ridhkd.drfhaoS isÿ flfrkafka wê ;dlaIKsl l%shdj,shls' wUqieñhka msgia;rhkah' ridhkd. drhl cSú;fha uq,au osk lsysmh .; lrk orejd ffjoHjreka lshk oskhloS ;u .¾NdIfha fijKg tl;= lr.kakSh' ridhkd.drfha isÿ lrk fï hdka;%sl l%shdj,sh flfryS t;rï iqmika ye`.Sula fndfyda wUq ieñhkg ;snqfKa ke;' wfkla w;g k< orejka ,nd.ekSu i|yd wêl ñ,la jeh jkafkah hk woyila fndfyda fokdg ;sìK' th jeros iy.; woyilao fkdfõ' we;eï wdh;k fï i|yd úYd, ñ, .Kka wh lrñka fuh oyiska ne|s msh<s iys; mjq,a j,g muKla iSudjQ ;dlaIKhla njgo m;a lr ;sìK' doctormagazine.lk 99 JULY 2018 | DOCTOR MAGAZINE

JULY 2018 | DOCTOR doctormagazine.lk MAGAZINE 99

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

Capsule Baby ;dlaIKh fï wNsfhda. folu ch.kakg fndfyda hqj,j,g wkQmfïh wjia:djla Wod lr ÿkafkah' fuysoS orejd cSjh wrUkafka ;u ujf.a .¾NdIfhaoSuh' wef.a WKqiqu ,nñka wjYH iajdNdúl m%Yia; ;;a;aj hgf;au orejdg jefvkakg ,eîu fl;rï jdikdjlao@ Capsule Baby ;dlaIKh orejka ke;s wUq ieñhkg msysg jkafka fufyuhs fuys oS isÿ flfrkafka ldka;djf.a fhdaks ud¾. fha ;ekam;a l< yels úfYaIs; l=vd ma,diaála r|jkhl cSjhla wdrïN ùug wjYH idOl ,ndoSuhs' cSjhla wdrïN lsÍug äïn yd Y=l%dKq ;sìh hq;=h' .¾NdIfhaoS kï fï äïn yd Y=l%dKq j,g jefvkakg m%Yia; mßirhla ;sfí' ta;a ma,diaála r|jkhl ta udOH fldhskao@ fï ksid INVOcell r|jkhg uq,skau oukafka fï frdamk udOHhhs' ;j;a

f,ilska lsõfjd;a ckldKq j,g jefvkakg wjYH wdydrhs' bka miqj äïn lsysmhlao Y=l%dKQ lsishï mßudjlao thg oukq ,efí' fï ish,a, ord.;a INVOcell r|jkh .ek úfYaIfhka lsj hq;a;la ;sfí' wjg mßirh iu. ldnka vfhdlaihsâ yd Tlaiscka jdhq ixirkhg yelshdj ,efnk fia fï úYañ; WmlrKh ks¾udKh lr ;sfí' fï wdldrfhka ckldKq yd tajd ixfiapkhg wjYH frdamk udOH wka;¾.; l< iSrejg INVOcell r|jkh bkamiq .¾NdIfha ;ekam;a flfrhs' th .¾NdIfha uekúka ia:dk.; jkq msKsi ;ekam;a lrkafk ldka;d fldkavuhla fhdodf.khs' ó<`.g ;sfnkafka wisßu;a ixfiapkh''' th .¾NdIfhaoSu isÿ fjk ksid th w;sYh iajdNdúl ;;a;aj Wreu lr.;a ixfiapkhla' WIaK;ajh md,kh lrk bkalshqfíg¾ fuhg wjYH jkafka;a kE''' B<`. mshjf¾os isoaO fjk foa .ek jo fjkak ´ks;a kE' fndfydu iajdNdúl úosyg ixfiapkh isoaO fjkjd' bkamiqj isÿúh hq;= cSj úoHd;aul ixisoaêka md,s; mßirhla hgf;a fkdfjhs" ujf. isref¾ WKqyqu ú|sñkau isoaO fjkjd' fï úosyg cSjhla ìys fjkak wjYH idOl iïmQ¾K lrñka isref¾ ;ekam;a l< INVOcell r|jkh ojia mylg miafi bj;a lrkjd' bkamiqj lsishï ridhkd.dr fufyhqula isÿ fjkjd' ixfiaÑ; l<, w;ßka jvd;au ksfrda.S l<,h y÷kd.kakjd' th ;uhs ;ekam;a lrkafk' fï ksid IVF ;dlaIKfhaos jf.a nyq ore Wm;la isoaO fjkak wjia:djl=;a fuysos ,efnkafk kE' ukd úoHd;aul

100 JULY 2018 | DOCTOR MAGAZINE

.¾NdIfha ;ekam;a lrk INVOcell WmlrKh

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Capsule baby ;dlaIKfha mshjr f;aÍula isÿfjk ksid fyd|u l<,h ;uhs j¾Okh ù ore iïm;la úosyg uõmshka foda;g meñfKkafka' ó<`. mshjr ;uhs iSrefjka f;dard.;a fyd|u l<,h ujf.a .¾NdIfha ;ekam;a lsÍu' f;dard.;a l<,h ;ekam;a l<dg miafi wef.a .¾NsKSNdjh fndfydau idudkH tlla' th idudkH .¾NsKshla .; lrk úosygu .; ld¾hh jvd;a ir< lrKQ msKsi ìysjQ ;dlaIKhla' ta ksidu fï ;dlaIKh Effortless IVF hkqfjkao ye|skafjkjd' iajdNdúl l%u j,g lsÜgqfjka hk ksid id¾:l;ajh ,eîfï by< bvlvla ;sfnkjd' úhou wvqùu" ksYaÑ;j y÷kd.;a l<,h ;ekam;a lsÍug ,eîu jeks lreKq;a fï ;dlaIKfhaos jdishg ysákjd' mqreIhdf.a Y=l%dKq mßudj wvqùu ksid .eí .; fkdyels jk ldka;djka rdYshla isákjd' fï INVOcell ;dlaIKfhka Tjqkaf. .eg¿jg b;d id¾:l ms<s;=rla ,efnkjd' id¾:l .eí .ekSula i|yd mqreIfhl=f.a Y=l%dKQ m%udKh ñ,shk 40-300 w;r m%udKhla wjYH fjkjd' Tn uú;hg m;a fõú''' ñ,shk 0'3l Y=l%dKq wvq m%udKhlska jQj;a fï l%uhg ore iïm;a ,nd.kak mq¿jks' id¾:l;ajh flfryS n,mdk wjfYaI ldrKd ore iïm;la ,nd.kak idudkHfhka WmldÍ jk ldrKd ish,a,u mdfya fuysoSo id¾:l;ajhg n,mdkjd' wvq jhiska fuhg fhduq fjk úg wjia:dj jeähs' fyd| wdydr isß;la ;sîu" fi!LH iïmkak cSjk rgdj" u;ameka yd ÿïmdkh jeks ÿisß;a j,ska je<lSu id¾:l;ajfha wjia:dj jeä lrkjd' doctormagazine.lk

Capsule Baby ;dlaIKh wo k< ore ;dlaIKfha ;dlaIKsl l%shdj,sh ie<lsh hq;= uÜgulska udkqISlrKh lr ;sfnkjd' k<ore ;dlaIKfha l+gm%dma;sh iksgqyka jk fï hq.fhau ;dlaIKhg tfrysj lsishï úfrdaOdl,amhlao iudcfha f.dvke.S ;sfnkjd' th lsishï iudc l;sldj;lao fï jk úg we;s lr ;sfnkjd' fï wNsfhda. hg ms<shula f,i Capsule Baby ;dlaIKh wmQ¾j ms<s;=rla úoHdfjkau ,nd fokjd' .¾NdIfhka ridhkd. drhg .sh wisßu;a ñksia ixfiapkh kej;;a ridhkd.drfhka .¾NdIhg le|jdf.k hñka k<ore ;dlaIKfha fojk ú,ma,jh iksgqyka lrkafka fï Capsule Baby ••• ;dlaIKhhs' Capsule Baby ;dlaIKh ms<sn|j Tng we;s .eg¿ j,g oeka m%ùK l<,fõosfhl=f.ka ms<s;=re ,nd.; yelshs' fï iïnkaOfhka Tng wjYH ´kEu f;dr;=rla ,nd.ekSug wu;kak 077 9728799 ke;fyd;a mshk.kak" kqf.af.dv" Wvyuq,af,a" mrK fldÜgdj mdr" li.yj;a; mdf¾ WISH Fertility & IVF Clinic fj;'

JULY 2018 | DOCTOR MAGAZINE 101

äïn weiqf¾ jir .Kkdjlska jQj;a ore iïm;la ,nd .ekSug wjia:dj Wod fjkjd' fuh wi,ajeis bkaoshdfõ jD;a;Sh l%Säldjka w;r w;sYhska ckm%shhs' kqÿf¾oSu wfma rfÜ wfma ;dlaIKh fhdodf.k isÿ lsÍug kshñ;hs'

wd¾;jwNdjh l,a oukak;a äïn ixrlaIKfhka wjia:djla ie,fikjd ldka;djka wd¾;jwNdjhg leu;s kE' tfy;a th wjq 45-55 w;f¾ lsishï ld,hloS isÿ fjkjd' fï äïn noaO lsÍfï l%ufõoh ksid wjYH kï ldka;djkg ;u wd¾;jwNdjh;a l,a oukak mq¿jka' jhi wjq' ;sia .Kka j,oS ;u ckaudkq''' äïn ixrlaIKh lr tajd wd¾;j wNdjh wdikakfha kej;;a noaO lsÍfuka ;=reKQ äïnfldaIfhka w¿;a jdf.a äïn fudapkh fjkjd' fï ksid wehg ;u wd¾;j wNdjh isÿjk jhi jir lsysmhla bosßhg f.k hkakg wk.s wjia:djla Wod fjkjd'

äïn ixrlaIKh ld fjkqfjkao@ ms<sldjla y÷kd.;a miq m%;sldr j,g fmr fuh;a jvd;au m%;sM<odhl jkafka .¾NdIh" .eíf., wdoS m%ckl bkaøsh wdY%s;j ms<sld j,g ,lajQ ldka;djkag' ms<sldj y÷kd .ekSfuka miq lSfudf;rms" f¾äfhdaf;rms m%;sldr j,g fhduq ùug fmr fï wdldrhg äïn ixrlaIKh lsÍfuka kej;;a weh iqjm;a jQ miq orefjla yod .kakg wjia:djla Wod fjkjd' jD;a;Sh l%Säldjka jD;a;Sh l%Säldjka uqyqKmdk m%Yakhla ;uhs ;u oeä mqyqKQ ùï l%shdj,sh ;=< wef.a ffcj ridhKsl iajNdjh fjkiaùu' we;eï úg fï ksid wehg ore iïm;a ,nd .ekSu ÿIalr jkakg mq¿jka' ta;a fï ixrlaIK l%shdj,sh ksid wehg wjdishla jkakg bvla kE' iajNdjfhkau Yla;su;a úNjhla we;s wjosfhaoS ,nd.kakd 102 JULY 2018 | DOCTOR MAGAZINE

blauKska ore iïm;la ,nd .kakg fkdleue;s ldka;djka ;ukaf.a YÍrfha yevh fjkia fjhs hk is;sú,af,ka we;eï ldka;djka uq,a ld,fha ore iïm;a ,nd .kakg leu;s kE' úfYAIfhkau iqrEmS ks,shkag;a fï .eg¿j ;sfhkjd' uq,a ld,fha orejka m%iQ; lrkakg wlue;s ldka;djkag''' iuyr úg újdy jkakg ys;kakg;a fmr ;u jD;a;Sh wruqKQ Wfoid lemùï lrk úg fujka äïn ixrlaIKhla weiqf¾ ;ukag;a ydkshla fkdlrf.k ;u cSjk wruqKQ idOkh Wfoid lemjkakg;a äïn ixrlaIKfhka wk.s wjia:djla ysu fjkjd' fï wdldrfhka .eyekq" msßñ fomd¾Yajhgu wo ;ukaf.a äïn" Y=l%dKQ ixrlaIKh lrf.k u;= hï oji;" ;uka reÑ lrk cSjk lvbuloS ;ukaf.au ore iïml;la ,nd .kakg fï ckaudkq ixrlaIKh kQ;k f,dalfha msysgg tkjd' ••• doctormagazine.lk

fodafr .,k ore fifkyi

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

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

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

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

JULY 2018 | DOCTOR MAGAZINE 103 April 2017 DOCTOR MAGAZINE 91

COMMON BLOOD TESTS IN DIABETES, DIAGNOSIS AND TESTING THE CONTROL

oshjeähd frda.Ska i|yd isÿ lrk reêr mÍlaIK oshjeähdj frda.h ksYAÑ;ju ;sfíoehs ielhla we;s jQ l,ayS isÿ lrk OGTT – Oral Glucose Tolerance mÍlaIKh 104 JULY 2018 | DOCTOR MAGAZINE

jHdêfõo úfYaI{ ffjoH ffjoH m¾fhaIKdh;kfha ffcj ridhk wxY m%Odk" úfYaI{ ffjoH .hd lgq,kao MBBS, Dip Path, MD (Chem Path), DipRCPPath (UK) doctormagazine.lk

OGTT mÍlaIKh oshjeähdj frda.h i|yd fhdod .kakd iïu; mÍlaIKhla fkdfõ' ksrdydr reêr mÍlaIdfõoS idudkH w.hka olajk tfy;a oshjeähdj frda.h we;ehs iel lrk who" .¾NsKS ldka;djkao wdoS jYfhka úfYaIs; wjia:d j,oS fuu OGTT mÍlaIKh isÿ lrKQ ,n;s' fuh oshjeähdj iïnkaOfhka w;sYhska ixfõoS mÍlaIKhla f,i ie<flK w;r fuu mÍlaIKh isÿ lsÍfuka oshjeähdj je<|S isák ´kEu frda.sfhla wkdjrKh lr.; yel' fuh jeä ÿrg;a meyeos,s lf<d;a OGTT mÍlaIKfhka Negative f,i m%;sM<h ikd: jqjfyd;a Tyqg b÷rdu oshjeähdj fkdue;s nj lsj yel' doctormagazine.lk

OGTT mÍlaIKh i|yd iQodkï ùu oeä wjOdkh fhduq l< hq;= lreKla''' fuysoS Tn idudkHfhka ,nd .kakd wdydr fõ, tmßosu ,nd .ekSugo" idudkHfhka Tng yqre mqreÿ YrSr l%shdldß;ajh reêrh ,nd .ekSug fmro tf,iu mj;ajd .ekSugo ie<ls<su;a úh hq;=h' hï ;eke;af;la fuu mÍlaIKhg fmr vhÜ lf<d;a yd jeä jYfhka jHdhdu j, ksr; jqfKd;a YÍrhg tl;= jk .aÆfldaia m%udKh hdukh lsÍug isrer fkdiu;a jk w;r fï ksid Tng ,efnkafka Tn oshjeähdj frda.hg ,laj we;ehs (Falsely Positive) fodaI iy.; m%;sM<hls'

ksrdydrj isáh hq;= ld,h fuu mÍlaIKh isÿ lsÍug osk ;=klg fmr uoHidr .kakd wh thska je<lsh hq;=h' ksrdydrj rd;%sfha meh 8-10 isàfuka miqj miqosk WoEik fuu mÍlaIKhg f,a ,ndosh hq;=h' we;efula oskm;d .kakd úúO fnfy;a j¾. fjhs' weÿug .kakd T!IO" wêreêr mSvkhg .kakd T!IO" ldka;djka kï Wm;a md,k .s,sk fm;s wdoS jYfhks' fï mÍlaIKhg Ndckh ùfïoS iqmqreÿ f,i .kakd fï fnfy;a j¾. k;r lsÍula wjYH fkdfõ'

f,a .kakd wjia:d fukak fuysoS reêr idïm, .ekSu fumßos isÿ fjhs uq,skau .kafka frda.shd ksrdydrj .kakd reêr idïm,hhs' fojkqj" .aÆfldaia .a?ï 75la j;=r ñ,s ,Sg¾ 300l oshlr th ñks;a;= 5-10 ld,hla uq¿,af,a mdkh lsÍug i,iajhs'

we;euqkag we;sjk Tlaldrh we;s fjkakg fmr .; hq;= Wml%uhla .¾NsKS ldka;djka kï fïjd mdkh lsÍfuka miqj we;eï úg Tlaldr ,laIK my< lrkakg bvlv ;sfí' hï fyhlska tfia jqjfyd;a tu ;;;ajh .kakd ,o .aÆfldaia m%udKh wiudk f,i cS¾Khlg wjldY i,iñka OGTT yS fodaI iy.; w.hka ,nd oSugo bvlvla mj;S' fï wjysrfhka ñoSug ñY%Khg foys ìxÿ lsysmhla tl;= lsÍu wk.s ms<shula jkq we;' ngysr rgj, kï kshñ; m%udK j,ska ilia l< ri.kajk ,o .aÆfldaia mdkhka fokafkao tjka

JULY 2018 | DOCTOR MAGAZINE 105

Tlaldrhka mdol lr.;a wid¾:l ùï j,ska ñoSugh'

mÍlaIkh ksujk ;=re fï foaj,a lrkak tmd''' fojk reêr idïm,h ,nd .kafka by; .aÆfldaia mdkh lsÍfuka meh follg miqjh' .¾NsKS;djfhaoS kï we;eï úg mehlska miqjo ;j;a idïm,hla .kakd wjia:d fõ' fï meh fol ld,h ;=< frda.shd úfõlSj isáh hq;= w;r lsis f,ilska f.%diß j,g hdu fyda fjk;a wjYH;djhla fjkqfjka ridhkd.drfhka msg;a ùu lsis f,ilska fkdl< hq;a;ls' fï frda.Skag ld,h .; lsÍu myiq jkq jia mqj;am;a" iÕrd fukau jhs-*hs l,dmo mj;ajd .ekSug ridhkd.dr l<uKdldß;ajh lghq;= i,iajhs' OGTT mÍlaIKh isÿ lsÍfï taldhk wruqK jkafka ksrdydr reêr mÍlaIKfhka yiq lr .ekSug fkdiu;a jk oshjeähd fyda mQ¾j oshjeähd frda.Ska y÷kd .ekSuhs' iïu; .aÆfldaia ud;%djla ,ndoSfuka miq th mßjD;a;Shg ,la lsÍug .; jk ld,h weiqf¾ frda.shdf.a reêr iSks hdukh iïnkaOfhka ;lafiarejla lr .ekSug wjia:dj ie,fia'

fjkia wdldr j,ska isÿlrk OGTT mÍlaIK we;eï úg fuu mÍlaIKh uq,ska úia;r lrk ,o wdldrhg fkdj we;eï fjkialï iys;j isÿ lsÍugo fhduq lrk wjia:d fõ' fï iïnkaOfhka úúO rgj, úúO ud¾f.damfoaYK tu úoaj;=ka úiska y÷kajd oS ;sfí' mdkh lsÍug fok .aÆfldaia m%udKh fukau reêrh ,nd 106 JULY 2018 | DOCTOR MAGAZINE

.kakd ld,dka;ro fjkia wdldr j,ska oelafjhs'ldhsl frda. ffjoHjreka" m%ijfõoSka yd oooshjeähd ffjoHjreka ;u ukdmhka yd w;aoelSï u; iqúfYAIS ud¾f. damfoaYK imhhs' fï ks¾foaYhka fj; wkq.; ùu mÍlaIK isÿ lrk ridhkd.drhkayS j.lSu jkafkah' tfiau m%;sM<h ksl=;a lrk úg ta ta w.hkag iudkqmd;slj ta ms<sn|j fm/hSuo isÿ l< hq;af;ah'

orejka i|yd OGTT mÍlaIKh isÿ lsÍu we;eï úg oshjeähdj ;sfío hkak ksYaph lsÍu i|yd orejka i|ydo OGTT mÍlaIKh isÿ lrkakg isÿjk wjia:d fjhs'fuysoS orejdf.a nr wkQj fokq ,nk .aÆfldaia m%udKh ;SrKh lrk w;r fokq ,nk Wmßu .aÆfldaia m%udKh .a?ï 75 fkdblauúh hq;=h' ••• Interpretation of 2 hour value of OGTT: Fasting Plasma Glucose < 140

Normal

> 200

Diabetes Mellitus

140 – 199

Pre-diabetes

oshjeähdj wdY%s; reêr mÍlaIKhla ,nk l,dmfhkq;a n,dfmdfrd;a;= jkak''' doctormagazine.lk

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Egg and Sperm Freezing for a Future Pregnancy: What to Know

ydkshla''' wjodkula ke;sj ore iïm;a ,eîu miqjg l,a oukakg msysgg tk idM<H;d ixrlaIKh

108 JULY 2018 | DOCTOR MAGAZINE

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Google, Facebook, eBAy, Linkdin, Intel, Yahoo wdh;k ldka;djkag ,ndoS we;s wdl¾YKSh wkd.; wdfhdackh fuhhs

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wefußldfõ" is,slka ksïkfha muKla fkdfõ wo f,dalfha iEu rglu mdfya ldka;djka" fukau msßñkao wkd.;fha osfkl m%fhdackhg .kq msKsi

JULY 2018 | DOCTOR MAGAZINE 109

WOMEN'S WORLD

wefursldfõ" is,slka ksïkfha biqreu;a mß>kl iud.ï j, fï jk úg ldka;djka Wfoid wmQre jHdmD;shla l%shd;aul ù ;sfí' kj fh!jKfha cjiïmkak ld,h ;u wkd.; jD;a;Sh wruqKQ ch.ekSfï b,lal fjkqfjka lem lrk fï j<¨ ne|s oE;a j,g ;uka u;= ojil orK ore iïm;a fjkqfjka Tjqkaf.a äïn YS; lr wdrlaId lsÍug fï iud.ï jevms<sfj,j,a fhdod ;sfí' wo ldka;djka fndfydauhla wOHdmkhg" /lshdfõ wNsjDoaêhg jeä nrla ;n;aoS újdm;aj ore iïm;a ,eîu Tjqkaf.a kHdh m;% j, ;jÿrg;a bosßhg ;,a¨ fjhs' tfy;a jhi wjqreÿ ;sia .Kka w. Nd.h" y;,sia .Kka jk úg ore iïm;la ,eîu myiq lreKla fkdfõ' kuq;a ;u äïn Ys;k ;;a;aj hgf;a wdrlaId lr ;enqjfyd;a ;uka leu;s ld,hloS m%udohlska f;drj ;ukag ore iïm;la ,eîug yels jkq we;ehs idM<H;d wdh;k mjihs' is,slka ksïkh uQ,ia:dkh lr.;a Google, Facebook, eBAy, Linkdin, Intel, Yahoo fï wdoS ish¿u iud.ï ldka;djkg ;ukaf.a äïn wkd.;fhaoS m%fhdackhg .kq msKsi iqrlaIs; lrKQ i|yd ;rÕldÍ meflac y÷kajd oS ;sfí'

WOMEN'S WORLD

;u ckldKQ fï wdldrfhka iqrlaIs; lrhs' wfma rfÜo l%shd;aul fï kjH ;dlaIKh iïnkaOfhka oeKQj;a lsÍu fï ,smsfha wruqKhs'

äïn yd Y=l%dKQ ixrlaIKh kjH" tfy;a B .il fõ.fhka oshqKQ jQ ;dlaIKhla wm uq,skau äïn yd Y=l%dKQ ixrlaIKh lrk wdldrh n,uq' äïnhla fukau Y=l%dKQjla lshkafka;a icSù ffi, jkafkah' fïjd os.= ld,hla wdrlaIdldÍj mj;ajd .ekSug YS;k ixrlaIK l%shdj,shla y÷kdf.k ;sfí' fuh Cryoprotection hkqfjka y÷kajk w;r ta i|yd øj khsg%cka udOHh f,i fhdod .kshs' tfiau -196OC YS; ;;a;ajhla hgf;a mj;ajd .ekSu l< hq;= fjhs' fï wdldrfhka äïn yd Y=l%dKQ leu;s ld,hla wdrlaId lr.; yels w;r wkd.;fha wjYH osfkloS Y=l%dKQ" äïn ixfiapkhlg" ta Tiafia ore iïm;la ,nd .ekSug ms<sfh, l< yelsh' Y=l%dKQjla u;= m%fhdackhg .kq msKsi

YS;k ;;a;aj hgf;a ixrlaIKh lrk wdldrh by; úia;r l< wdldrhg Ys;k ;;a;aj hgf;a mj;ajd .ekSfuka (Cryoprotection) Y=l%dKQ ffi,fha c,h bj;a flfrhs' Y=l%dKQjla iaMÁlrKhg ,laùfuka th wdmodjg ,laùuo fuysoS k;r flfrhs' fï wdldrhg leu;s ld,hla ixrlaIKh lsrSug wjia:dj ie,fihs'

Y=l%dKQ ixrlaIKh lrkakg isÿ jkafka ldgo@ • wk;=reodhl yd wjodkï iy.; /lshd j, fhfok ;reKhska fï wdldrhg Y=l%dKQ ixrlaIKhg fm<fUhs' l%shdkaú; rdcldß j,g hk yuqod fin¿ka" nr jdyk rshÿrka" wjodkï iy.; hkaf;%damlrk yiqrejkakka i|yd fuh wkd.;h iqrlaIs; lrk ie,eiauls' wfma wi,ajeis bkaoshdfõ yuqod idudcslhka i|yd Y=l%dKQ nexl= ;sfnk nj fuysoS isysm;a l< hq;=h' • iajdñmqreIhd jir .Kkdjla Nd¾hdj iómfha fkdisák úg" fjk;a rgl /lshdj lrk úg Nd¾hdjg ie,iqïiy.;j ore iïm;la ,eîu fjkqfjka fujka Y=l%dKQ ixrlaIKh lrk wjia:d yuq fõ' • hï mqreIfhl= yg ms<sldjla we;ehs wkdjrKh jQ úg ms<sld i|yd ,ndfok úlsrK Ñls;aid" lSfudf;rms m%;sldr j,g fmr Tyqf.a Y=l%dKQ ixrlaIKh lsÍfuka" hï osfkl Tyq iqjm;a jQ miq ta ixrlaIs; Y=l%dKQ weiqf¾ Nd¾hdjg ore iïm;la ,nd.; yel' ms<sld frda.Ska fuhska mq¿,a f,i m%fhdackhg .kakd w;r jDIK fldaI yd ckfkakaøsh wdY%s; ms<sld j,g uqyqK mE msßñkag fuh wk.s ore iïm;la ,eîfï úl;,amhla jkq we;'

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• by;ska i|yka lf<A msßñka ;u ckldKQ ixrlaIKhg fm<fUk fya;= lsysmhla muKhs' fulS fya;= fkdue;sj jqK;a jhia.; jk úg we;sjk úfYaI ÿn,;djhka" .=Kd;aul jYfhka ckldKQ j, we;súh yels msßySï i<ld wo we;euqka ;u Y=l% idïm, ixrlaIKh lsÍug fm<fUkjd' • ïn u;= m%fhdackhg .kq msKsi YS;k ;;a;aj hgf;a ixrlaIKh lrk wdldrh Y=l%dKQ kï iEu úgu w¿f;ka ksmofjkjd' ta;a äïn fkdfyd;a ia;%s îc tfia jkafka kE' l<,rEmS wjêfhau ldka;djlg lsishï äïn m%udKhla Wreu fjkjd' th Wmosk úg iEfyk muK wvq fjkjd' th jhi doctormagazine.lk

WOMEN'S WORLD

• msßñka IVF l%shdj,sfhaoS Y=l%dKQ ksheoshla ,nd osh hq;=hs' we;eï msßñka le<öug m;aùu" l,n,hg m;aùu ksid wjYH wjia:dfõoS fï ksheosh ,ndoSug fkdiu;a fjkjd' thg;a fuu ixrlaIKh wk.s úl,amhla' wjqreÿ 35 bl=;a jqKdu fndfydau iS>%fhka wvq fjkjd' ;j;a ldrKhla' ldka;djlf.a jhi;a iu.ska tu äïn j, .=Kd;aul Ndjh msßySug ,la fjkjd' tajd úNdckh ùfï ^fnoSfï& .eg¿ j,go uqyqK mdkakg isÿ fjkjd' fï wkQj ;uhs ldka;djlg fõ,dikska orejka yeoSu iqÿiq hhs lshkafka' jhi 35ka miq idM<H;djh iS>%fhka wvq fjkjd' fï wkQj äïn ixrlaIKh lsÍu ldka;djl úIfhys w;sYh jeo.;a' fndfyda wefußldkqjka" hqfrdamShhka fï i|yd jeä wjOdkhla fhduq lrkafka fï ksiduhs'

ldka;djkaf.a ixrlaIKh lrkafka äïn muKlau fkdfjhs''' äïn mgl;a ixrlaIKh lrkjd''' äïn ffi, ixrlaIKh ;uhs jeäfhka isÿ jkafka' ta yereKQ úg ldka;djkaf.a äïn mgl;a ixrlaIKh lrkjd' fuysoS äïnfldaIfhka mgl fldgila bj;a lr th ñ,s óg¾ 2 ;=kshg isyska len,s njg m;a lrkjd' bkamiq äïn ixrlaIKh lrk wdldrhg fuu mgl;a Cryoprotection l%uhg ixrlaIKh lrkjd' fï mgl weiqf¾ kej; nfnla yod .kak kï tajd kej; ldka;djf.a äïnfldaI weiqf¾ kej; ia:dms; l< hq;=hs' th noaO lsÍula (Ovarian tissue transplant) lsh,hs lshkafk\ ixrlaIKh lrk ,o äïn mglh kej;;a tu ia:dkfha ;ekam;a l<du tajdhska kej;;a ì;a;r ksmoùu wdrïN fjkjd' fï wdldrhg ixrlaIKh lrk ,o äïn mglhla weiqf¾ ldka;djl .eí .ekaùfï W;aidyh;a JULY 2018 | DOCTOR MAGAZINE 111

Laboratory Tests Explained

Hepatitis B: laboratory diagnosis and some other information

fymghsáia taâia j,g;a jvd oreKQ f,i ck;dj .s, .kakd fi!LH wjodkula wdisß ridhkd.dr fiajdfõ wOHlaI kS,a m%sh;a fcdaka úisks

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fymghsáia î frda.h wo f,dalh uqyqK mdk ;j;a nrm;, fi!LH ;¾ckhls' bkaoshdkq Wm uydoaùmfha;a" iuia; wdishdj yd wm%sldkq rgj,;a fymghsáia î nrm;, wNsfhda. hla njg m;aj we;s nj jika l< fkdyels i;Hhls' wdishdkq uydoaùmh muKla .;a;;a fymghsáia î frda. fhka j¾Ihlg ñ,shkhl ck;djla ñh h;s' taâia frda.h .ek Tng woyila we;' fymghsáia î hkq wdishdkq l,dmfha jHdma; fymghsáia î" taâia frda.h fuka f;.=Khla udrdka;slh' frda. fha ìysiqKQ nj .ek fuhskau Tng wjfndaOhla ,nd.; yels jkq we;'

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

fymghsáia frda.h jHdma;shla ,ekaiÜ ffjoH iÕrdj jd¾;d lrk wkaoug 2005 oS urKhg m;ajQ ,laI 17la jQ taâia frda.Ska ixLHdj 2013 j¾IfhaoS ,laI 13la olajd wvq w.hlg m;aù ;sfí' 2004 j¾IfhaoS f,dalfha ,laI 14la uef,aßhd frda.fhka ñh .sh kuq;a 2013 j¾IfhaoS tu ixLHdj ,laI wg yudrla muK olajd wvq ù ;sfí' laIh frda.fhaoS meyeos,s urK ixLHdfõ wvqùula olakg ,enqKs' kuq;a fymghsáia î frda.h fï wdldrfha keUqrejla fkdolajñka ñksia iqjfi;g buy;a wNsfhda. t,a, lsÍu fi!LH n,OdÍkago .eg¿jlaj mj;S'

fymghsáia î ridhkd.dr mÍlaIK ksoka.; fymghsáia î wdidokh Acute hepatitis B infection reêrfhka fukau ,sx.sl >%djo" fl< jeks fjk;a reêr ;r, fya;= fldg f.ko fymghsáia î flfkl=g wdidokh úh yel' frda. ldrl ffjrih YÍr.; ùfuka i;s 6-26;a w;r ld,h ;=< fndfyda úg frda. ,laIK my< fjhs' fuys idudkHh i;s 12la jYfhka ie<fla'

,xldfõ wm taâia frda.h lS úg buy;a ;e;s .ekaulg ,la fjuq' tfy;a fymghsáia î frda.hg wfma ck;dj t;rï ìhla olajkafka ke;af;a ukao hkak .eg¿jls' doctormagazine.lk

JULY 2018 | DOCTOR MAGAZINE 113

ridhkd.dr.; frda. ks¾Kh uia;= (Serum) j, we;s Hepatitis B Surface Antigen weiqf¾ ffjrih YÍr.;j ;sfío@ ke;ao@ ;SrKh lrhs' hï ld,hla isrer ;=< uq,a neif.k ;snQ wdidokhlao@ (Chronic) fkdtfia kï w¿f;ka we;sjQ wdidokhlao (Acute) hkak y÷kd.ekSuo Serological Markers and mÍlaIK weiqf¾ isÿ l< yel' fuu uia;= wdY%s; mÍlaIK u.ska wdidokh ixLHd;aul m%udK j,ska bosßm;a lsÍulao isÿ fõ' fuu ffcj úoHd;aul mÍlaIK wkqidrfhka frda.h m%;sldr l%shdj,sh ;=< iudf,dapkhgo wjia:djla Wodjk w;r ffjrifha úlD; (Mutant) iïnkaOfhkao f;dr;=re ,nd fohs' fymghsáia î ffjrifha wekaáckh jk HBsAg uq,skau y÷kd .ekSug wjia:dj ie,fikafka wlaudfõoS th l%shdldÍ jk îfc!IK iufhaoSh' HBsAg mej;Su u.ska Tyqg fyda wehg ta wjia:dfj fymghsáia î wdidokhla mj;akd nj fmkajhs' m%;scklh fï wjia:dfõoS úYd, jYfhka ckkh jk w;r NonInfectious Spherical yd Filamentous wdldrfha uia;=o m%lg fjhs' fymghsáia î ksoka.; wdldrfhaoS HBsAg f;uilska muK úhelS hhs' ffjrih wlaudfõoS l%shdldÍj ckkh jk (Replicate) iufhaoS HBeAg yd HBV DNA oaú;ajhu olakg ,efí' fï wjia:dfõoS fiiq uia;=uh ffjri fldgia fukau Bilirubin, Alanine Aminotransferase o Wmßu w.hlg m;a fjhs' uq,skau HBsAg j, m%;sfoay tkï m%;s HBc by< hdula fjhs' fymghsáia î i|yd jk IgM m%;sfoay y÷kd 114 JULY 2018 | DOCTOR MAGAZINE

.ekSfuka ksoka.; wdidokhl uQ,sl ,laIK lshhs' frda. ,laIK my< ùug b;du wdikakfhaoSfuh y÷kd. ekSug ,efnk w;r th udi yhla muK uq¿,af,a olakg ,efnhs' HBc fldgi kï wk;=rej osúh mqrdu reêrfha olakg ,efnkafkah' HBsAg m%;scklh blauKska úhelS hk HBe kï oaú;Shsl m%;sfoayhlao olakg ,efnhs' bkamiqj l%shdldÍ ffjri Replication l%shdj,shla ke;akï HBe m%;sfoayh ;=kS jk w;r th udi lsysmhlska fyda jir .Kkdjlska bj;a fjhs'

;Sj% wdidokfhka udi 3-6 l ld,fhka miq HBsAg i|yd jk m%;sfoay yd anti-HBs olakg ,efnkafka ke;' fuh we;af;kau frda.h iqj jk úg úhelS hhs' fuh HBV g we;sjk m%;sYla;slrkhl i<l=Kla jYfhka ie<fla' ridhkd.dr jYfhka (Serological Profile) ffjrifha úi,a mrdihla mej;sh yels neúka ks.ukhlg meñKSug iel iys; wjia:djloS lafIA;%h ;=< úfYAI{hkaf.a woyia úuiSu uekú' ksoiqkla .ksuq' HBsAg fkdue;sj frda.h iqj fjñkao mj;sk we;eï frda.sfhlaf.a m%;sfoay b;d wvq uÜgulska mej;Su fyda ridhkd.dr jYfhka mÍlaIK isÿ lsÍug ;rï fkdjk wvq uÜgulo mej;sh yel' ••• jeäÿr meyeos,s lsÍï i|yd dl@asiri.lk yd neilpriyath@yahoo.com Tiafia fuu f,aLlhd wu;kak'

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

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

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SANDIGATA VATA

THE MOST COMMON FORM OF ARTHRITIS

OSTEOARTHRITIS Sandigata Vata (Osteoarthritis - OA) is the commonest form of joint disorder affecting many people in the world. Its high prevalence; especially the elderly, and the high rate of disability related to disease make it a leading cause of disability in the elderly. It limits everyday activities such as walking, dressing bathing etc thus making a person disabled. Dr. Sudharma Kodituwakku MD (Kaya) lndia National Ayurveda Teaching Hospital Boralla

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If we go through our ancient literature, It is described in Ayurvedic texts. Acharya charaka has described it as well as Acharya Susrutha has mentioned it under vata vyadhi chikithsa chapter including its management. Both diagnostic and treatment aspects of this disease have been mentioned in all ayurvedic texts very clearly.

Now we will see what are the causes for arising the sandigatavata

According to Ayurveda: • It arises as a disease or complication of a disease. (Primary OA & Secondary OA) • Virudha Aahara sevana- (Incompatible diet/faulty lifestyle), all Dhatus undergo Kshaya (Dathu kshaya – the destruction of joint protecting mechanism) thus leading to Vataprakopa and making an individual prone to many diseases. Among them, Sandigatavata stands top in the list. • As a causative factor, it can be due to congenital. Also, it can be occurred due to not having proper treatment to the diseases like Ajeerna, Tonsillitis, Amavata, Kitibha, Constipation, piles, Grahani & Vata raktha.

As common causes - • The daily stress arising to the joints especially the weight-bearing joints. (eg. Knees, hips and ankles) • Obesity – Weight is over than the height. It causes mechanical stress in weight-bearing joints. • Trauma- Mechanical damage to the joints (Accidents or traumatic injury/ falling down) • Genetics- Significant family history (Father or mother having the arthritis)

Today Many patients are coming to OPD & IPD to take medicine for this condition. doctormagazine.lk

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• Muscle weakness • Repetitive usage of joints- Due to the Job eg. Heavy labor, Bending, Walking long distance etc. • Infection • Crystal deposition • Previous Inflammatory Arthritis – Rheumatoid Arthritis • Disorders of bones • Previous surgical procedures

What are the symptoms of osteoarthritis (OA)? Cardinal symptom is the pain of the joints esp. the weight-bearing joints. • It is a type of vatavyadhi. The vitiated vata when takes shelter in sandhisthana (Joints) causes pain, swelling, stiffness, crepitus, lack of movement or painful movement. Osteoarthritis affects certain joints yet spare others. Commonly affected joints- cervical and lumbosacral spine, hip, knee and 1st metatarsal-phalangeal joints & base of the thumb. Spared are wrist, elbow and ankle. According to the modern medicine; OA is a Degenerative disorder arising from the biochemical breakdown of articular cartilage in the synovial joints(but entire joint) and it has undergone pathological changes. (Failure of protective mechanism of the joint ) 118 JULY 2018 | DOCTOR MAGAZINE

Physical Examination: It is typically diagnosed on the basis of clinical & radiographic evidence. Physical findings in a patient with OA are mostly limited to the affected joints. It should be focused on whether Tenderness is over the joint or outside of it. Reduced range of motion and crepitus are frequently present. Inflammatory changes are typically absent or at least not pronounced. No specific laboratory abnormalities are associated with OA. ESR is not usually elevated. As the investigations; Plain radiography, MRI and CT can be done.

Management of Osteoarthritis: • Alleviation of pain, discomfort and improvement of functional status. doctormagazine.lk

• Reduce the stiffness f joints. • Stopping any further damage to the joints.

• Rasayana karma – Very effective as it slows down the process of destruction & rejuvenation of the body.

According to the Ayurvedic system of medicine, It offers modalities by way of Ahara (Diet), Vihara (lifestyle) and Aushada (medicine) based on individualized manner.

Non-pharmacological Management:

Medical management

• Heat and cold therapy

Allopathic treatment has its own limitation in managing this disease. It can provide either conservative or surgical treatment and is highly symptomatic and with lots of side effects. Some drugs like NSAIDs, Corticosteroids and Opoid analgesics are given to the patients to provide some relief, and they provide quick relief but causing more side effects.

• Weight loss (If overweight)and healthy eating habits

But sandigata vata can be better cured by management and treatments modalities mentioned in Ayurveda.

Pharmacological management: • Medicated preparations (which have appetizing & digestive properties) (DecoctiAn, pills, tablets, powers etc.) • Local application(Oil, pastes, ) • Panchakarma treatmentsSnehana (Oleation), svedana(fomentation), Sarvanga Dhara karma using suitable oil, Janu vasthi. doctormagazine.lk

• Patient Education

• Regular appropriate Exercise (Thigh muscle exercises, Straight-leg raise –sitting & lying down position, muscle stretch etc) and yoga • Physical therapy • Occupational therapy • Lifestyle changes • Protecting the joints from further injury Ayurvedic treatment of Osteoarthritis (Sandigata vata) not only prevent further deterioration of joints but also rejuvenates damaged cartilage. Vata – alleviating medicines for OA are also beneficial for lubrication and strengthening of joints. Ayurvedic treatment procedure starts with identifying the root cause of Nidana(cause) first, based on the line of treatment for individualized patients. ••• JULY 2018 | DOCTOR MAGAZINE 119

AYURVEDIC

jl=.vq wjkvqj

frda.Ska yg ms<sirK ùu wfma l<.=K o;a iudcfha m%uqL wjYH;djhla fi;aiqj wdhq¾fõo frdayf,a l,uKdldr wOHlaI ffjoH iqcSj ú;dkf.a

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wo jk úg ffjoH úoHdj b;d oshqKq ;;a;ajhl mej;sh;a w;S;fha t;rï iq,n fkdjQ oshjeähdj" wOsl reosr mSvkh" fldf,iagfrda,a" ms<sld" jl=. vq frda. wdoS fnda fkdjk frda. b;d iq,n ;;a;ajhg m;aù ;sfí' úfYaI;ajh jkafka mdie,a orejka mjd fnda fkdjk frda. j,ska mSvd ú|Suhs' fï ish,a,u wmf.a cSjk p¾hdfõ wvqmdvqlï ksid we;s jQjla nj fmfkkakag ;sfí' ta ksidfjkau fuhska ñoSugo wmu fjkia úh hq;=h' doctormagazine.lk

m%;sldr msKsi uf.a frday,g tk fndfydauhla fokd by; frda. j,ska mSvd ú|sk wh' fi;aiqj wdh;kfhka fujka frda.Ska oi oyia ixLHd; msßia fï jk úg m%;sldr ,nd isákjd' úúO jhia ldKav j, wh ta w;r fjkjd' osfkka osk jeäjk frda.Ska foi n,k úg fï keUqrej ;j ÿrg;a jeäjk fihl=;a olakg ,efnkjd' fï w;r fmdf<dkakrej" wkqrdOmqr jeks wE; fmfoia j,ska meñfKk jl=.vq frda.Ska .ek uf.a úfYaI wjOdkhla fhduq jqKd' wo ld,fha jl=.vq frda.Ska úYd, jYfhka olakg ,efnkjd' thskq;a ld,Sk jl=.vq frda.hg (Chronic Kidney Disease) f.dÿre jk frda.Ska ixLHdj fnfyúka jeähs' wfma rfÜ muKla fkdfjhs" iuia; f,dal ck.ykfhka ishhg 10la ld,Sk jl=.vq frda. fhka mSvd ú|sk nj y÷kdf.k ;sfnkjd' wdishdfõ" wm%sldfõ fukau hqfrdamfhao ld,Sk jl=.vq frda.Ska yuq fjkjd' fuu ;;a;ajh jHdl+, lrñka ;jÿrg;a fuh me;sfrk ,l=Kq fï jk úg my< ù ;sfnkjd' wfma rfg;a ld,Sk jl=.vq frda.h iS>%fhka j¾Okh jk nj ud fj; meñfKk frda.Ska ixLHdj n,k l< ugo mila jk ldrKhla' Tjqka nyq;rhla wE; tmsg .ïudk j, ÿIalr cSú; .; lrk Woúh' mjqf,a m%Odkshd frda.S jQ úg fï wh m;ajk wirKNdjh b;d fÄokShhs' cSúldj;a lrñka wirK jQ mjqf,a m%Odkshd /l .ekSu b;d úYd, wNsfhda.hla' we;a;u ;;a;ajh fï frda.Ska fndfyda fofkl=g os.gu m%;sldrhla lrkakg ;rï j;a wd¾Ól ;;a;ajhla fndfyda fofkl=g kE' fï wirKhkag yels whqßka msysg úh hq;=h hk ldrKh ud fj; oeä Ñ;a; n,mEula we;s l<d' Tjqka fjkqfjka" Tjqka <Õg f.dia ÿl iem n,kakg

JULY 2018 | DOCTOR MAGAZINE 121

AYURVEDIC

fi;aiqj frday, jl=.vq frda.Skaf.a fi;a iqjh m;d isÿ lrk udisl iudc i;aldrh

AYURVEDIC we;akï" fï whg fnfy;a álla" m%;sldrhla lrkakg we;akï''' hk is;sú,a, Tiafia uu l%shd;aul jqKd' ug ta i|yd WmldÍ jQfha ud ñ;=re Wodks ffjoHjßhhs' f.ka f.g f.dia frda.Ska yuq ùug ud wjia:dj Wod lr.;a;d' iEu ksfjilskau mdfya frda.Ska yuqùu lK.dgqodhl ldrKhla' we;efulag frda.fha nrm;,lu .ek t;rï wjfndaOhla ;snqfKa kE' fï wh jeä fofkla b;d wirK ;;a;ajhg m;aj we;s nj mila jkakg ug t;rï ld,hla .sfha kE' rgg n; imhk fudjqka jl=.vq frda.fhka wirK Ndjhg m;afjk ;=re n,d isàu fkdl< hq;a;la' úfYaIfhkau rg lrjk we;a;ka m%;sm;a;s iïmdolhka fï ldrKfhys,d jydu l%shd;aul úh hq;=hs' kuq;a oekg l%shd;aul lsisu jevms<sfj,la ìï uÜgfuka l%shd;aul ù fï wirKhkag fi;la jk fihla fyda ke;s nj lK.dgqfjka uq;a lsj hq;=hs' fï ish¿ fõokdldÍ w;aoelSï ,nñka fï wirKhka Wfoi ud uf.ka bgqúh hq;= fiajh bgq lrKQ msKsi fi;aiqj wdhq¾fõo frdayf,a uq,a mshjr iksgqyka flrefKa óg jir y;rlg fmrd;=j isgh' wm jl=.vq frda.Ska i|yd fkdñ,fha ffjoH idhkhla iEu udihlu meje;ajSug lghq;= lf<uq' ueosß.sßh m%foaYfha wU.iajej" uy;,dfld<jej wdoS .ïudk y;rla flfryS wfma uq,a wjOdkh fhduq flreKd'fï whg uyd¾. jQ m%dKcSj T!IOh we;=¿j T!IO rdYshla m%;sldr msKsi ,nd ÿkakd' mdkSh c,h" ffjoH mÍlaIK isÿ lsÍug uQ,HdOdr myiqlïo wfmka iemhqkd' fndfyda frda.Ska wfma m%;sldr j,ska m%;sM<hla ,enqjd' m%;sldr ,nd .kakd w;r;=r ;ukaf.a 122 JULY 2018 | DOCTOR MAGAZINE

tosfkod jev lghq;= lrkakg mjd yelshdjla ,eîu wmf.a wmuK i;=gg fya;= jQ ldrKhla' fï whg ffjoH .eg¿" wd¾Ól .eg¿ ch .kakg wfma iudcfha odhl;ajh ,eìh hq;=uhs' fï jákd mKsúvho iudc.; lsÍug fuh wjia:djla lr .kakjd' yefudau tldjkaj tl;= jqfKd;a fuh wiSre ldrKhl=;a fkdfjhs'fï wdldrfhka wfma rfÜ jvd;au Wmldr wjYH flfrk frda.Ska lKavdhulg wmg we;s yels wdldrfhka ms<sirKla ,ndoSug yelsùu wmg buy;a i;=gg ldrKhla' frda.Ska iïuqLj ta wh yd mhqre mdikfha fhoSfuka" kshñ; m%;sldr lsÍfuka Tjqkaf.a cSú; j,g kejqï n,dfmdfrd;a;= tl;= fjkjd' jl=.vq frda.Ska isákafka W;=re ueo m<df;a ú;rla fkdfjhs' wo jk úg fuh rg uq¿,af,au jHdma; jHikhla' wNsfhda. hla' fï ish¿ frda.Ska yg msysg jkakg" ms<sirKla jkakg iudcfha wm yeu fokdf.au wjOdkh fhduq úh hq;=hs' • • • doctormagazine.lk

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

ks;r we;s fjkjd kï" th fkdi<ld yßkak tmd

wdhq¾fõo ffjoH rkam; rejka r;akdhl iu. l< idlÉPdjla weiqßKs'''

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AYURVEDIC

ysiroh

AYURVEDIC

fiu l=ms; ùu wo jeä fofklaf.a ysirohg fya;=jhs''' wdhq¾fõofha''' foaYSh fjolfï hy.=K /l.ksñka tajd wo ld,hg .,md .kakg ffjoH rkam; rejka r;akdhl olajk mßph ksidu zzrkam; fjo uy;audf.a fjoluZZ uq¿ rfÜu m;,hs' Tyq fï rfÜ ck;djf.a oeKQu m%j¾Okh Wfoid bosßm;a lrk ,sms fmf<ys fujr l,dmfhka jvd;a iq,n frda. hla .ek l;dnyl ksr; fjkjd' ta fndfyda fofkl= ysirohla ;rï jQ YS¾I.; frda.hla jk ysiroh .ek''' 126 JULY 2018 | DOCTOR MAGAZINE

ffjoH;=uks" fudllao fï yeá yefudagu jo fok ysiroh@ zzrohZZ hkq fõokdjhs' ñksidf.a YÍrfha m%Odk;u bkaøsh jkafka fud<hhs' fud<h iakdhq moaO;sfha uQ,ia:dkhhs' thska ksl=;a jk uQ, iakdhqj l=vd fud<h Tiafia m%Odk lfYAreld mka;shg we;=,a ù lfYAreld ikaêia:dk j,ska msg;g ksl=;a ù YÍrfha ish¨u bkaøshhka yd wjhjhka lrd f.dia tajdfha l%shdldß;ajhg odhl fjkjd' tu ksid YÍrfha l=uk wjhjhl bkaøshhl fodaIhla we;s jqj;a th fud<hg n,mEï lrkjd' tu n,mEï j, WÉp;u wjia:dfõ § ysig ±fkk wmyiqlu y÷kd.kafka fõokdjla f,ihs' th idudkH jHjydrfha § zzysirohZZ lsh,hs y÷kajkafka'

fuu frda. ;;a;ajhg fya;= jk lreKq fudkjdo@ úfYaIfhkau wo ojfia m%;sldr m;d tk jeä fofkl=f.a ysfia lelal=ï ;;a;ajhkag fya;=j fiu l=ms; ùuhs' fï whqßka ysi wdYs%; l,dmfha fiï nyq, jkafka l=ula ksid±hs fidhd ne,sh hq;=hs' Bg fya;=j fndfyda fofkl= fkdis;k lreKla' fiï nyq, hhs lSj o tjeks whf.a YÍr WIAKdêl njla fmkajkjd' tu WIAKdêl nj YÍrfha ish¨u bkaøshhka yd wjhj j,g n,mEu we;s l<o fud<h wdYs%;j mj;skafka w;s ishqï iakdhq ffi, jk neúka tajd fuu WIaKdêl nj ksid úkdY úh yelsh' fuu ;;a;ajh j<lajd .kakg YÍrh úiska YS¾I l,dmhg fiu f.kajd iajhxl%Sh YS;lrK jev ms<sfj,la ^Auto Cooling System& we;s lrhs' ish¨ .eg¨ u;=jkafka bka wk;=rejhs' fufia jeä jeäfhka ysialn, ;=< tla /ia fjk fiu" kdia l=yrfhka ndysr jd;h iu. tl;=jk CIqøÔùka f.a n,mEfuka krla ùu ^fiï l=ms; ùu$fiï meiùug ,la fjkjd' tfia ¥IKh jk fiu ksid ysfia nr .;sh we;s jk w;r tu krla jQ fiu fud< l=yrfhka bj;a jk ;=re ysfia frda.dndO we;s lrkq ,nkjd' úfYAIfhka ysfia frda. w;ßka mSvdldÍ núka jeäu wjia:dj brejdrohhs' fuu ;;a;ajh doctormagazine.lk

fï yereKq úg u<noaOh" .eiag%hsáia we;=¿ wdydr Ô¾K moaO;sfha ÿ¾j,;d m%uqL fjkjd' Bg wu;rj Èhjeähdj" w¾Yia" mSki" rla;ySk;djh" wêl ksÈ u; fyda kskao fkdhdu" nv mqrjd ±óu" uq;%d frda." jl=.vq wdY%s; ÿ¾j,;d" ms;a;dYfha .,a jßka jr u;= ù ke;sù hk jd;rla; jeks ifï frda." ldka;djkaf.a .¾NdI.; frda. iy wd¾;j fodaI jeks fya;=kao we;eï T!IOhka §¾>ld,Skj Ndú;ho" ysiroh we;s ùug úúO whqßka n,mdkjd' Bg wu;rj úúO udkisl mSvkhka ksid o ysiroh we;s fjkjd'

ffjoH;=uks fuu ;;a;ajh u.yeÍug fhÈh hq;= ms<shï flfia úh hq;=o@ mj;sk fiu bj;a lsÍu yd fiu úh,Sug m%;sldr lsÍfï§ kej;;a WIAKdêl nj m%uqL ùfuka fud<h wdY%s;j mj;sk ishqï iakdhq ffi, úkdY úh yelshs' kuq;a fud<h wdY%s; l,dmh isis,kh lsÍug kï uq¿ YÍrfhau WIAKdêl nj wvq lsÍu fuys§ wm isÿ lrk m%Odk m%;sldr l%uhla' Bg wu;rj frda.shdf.a YÍrfha mj;sk wksl=;a wys;lr ;;a;ajhka fidhd n,d Bg wjia:dkql+,j ksis ms<shï fhÈh hq;=hs'

yqÕdla fofkla is;kafka ysiroh ksÜgdjgu iqjl< fkdyels jßka jr u;=jk ta fj,djg fõokd kdYlhlska hgm;a l< hq;= frda.hla f,ihs@

wm lrd tk frda.Ska f.ka jeä msßila mjik lreKla ;uhs Tn th u;= lf<a" fndfyda frda.Ska ysi lelal=ug m%;sldr ,nd .;a;;a ksis f,i iqj fkdjQ wh' fïlg fya;=j ta whf.a frda. ;;a;ajhkag m%;sldr lsÍfï § ksis f,i frda.h ms<sn| fidhd n,d frda. ksodkhkag m%;sldr fkdfh§uhs' ffjoHjrhd i;= ksjerÈ frda. mÍCIdj" tu.ska frda. ksYAph lsÍfï yelshdj iy tu y÷kd.;a ;;a;ajhg wjia:dkql+,j ksis m%;sldr lsÍu hk lreKq wkqj fuu frda. hka ksÜgdjgu iqjlr .; yelshs' kuq;a ;djld,slj fõokd kdYl j,g fhduq ùu fjk;a wk;=re wdndO iys; miq ld,Skj nrm;, .eg¿ we;s lrk ;;a;ajhla úh yelshs'

ysi lelal=u yeÿKq úg mßiaiï úh hq;= wdldrh ms<sn|j Wmfoila fokjd kï@

úúO wdldrfha ysfia lelal=ï doctormagazine.lk

úfYaIfhka fuu frda.Ska ijia ld,fha we,a Èh kEfuka je<lsh hq;=hs' ;jo wêl WIAK wdydr" u;aøjH iy ÿï mdkfhka je<lsh hq;=hs' f;,a iys; lD;%su JULY 2018 | DOCTOR MAGAZINE 127

AYURVEDIC

je<÷Kq úg fuys we;s mSvdldÍ nj ksid frda.Skaf.a ish¿ ffoksl lghq;= mjd wvmK fjkjd'

AYURVEDIC

wdydr j,ska je<lSuo hym;a nj fmdÿfõ lshkak mq¿jka'

hq;= ksihs' thg Tn;=udg Èh yels úi÷u@

jeäÿr WmfoaYhla ,nd fokjd kï Èh hq;af;a ta ta frda.Ska ms<sn|j mQ¾K mÍCIKhlska wk;=rej mj;sk ;;a;ajhg iy mqoa.,hdg wkqrEm jk f,ihs'

talg úi÷ula yeáhg ;uhs uu mQ¾K jYfhka ksIAmdÈ; T!IO frda.Skag ,nd fokafka' tajd j¾;udk ld¾hnyq, Ôjk rgdjg .e,fmk f,ig ld¾hd,fha§" jev ìul§" uÕ f;dfÜ§ jqj;a myiqfjka Ndú;d l< yels mßÈ m¾fhaIKd;aulj ÈhqKq l< T!IOhs' tu ksid myiq T!IO Ndú;h jeä fofkl= w;r w;sYhska ckm%sh fj,d ;sfhk nj ldg;a ják mKsúvhla fõú'

ffjoH;=uks" wdhq¾fõo m%;sldrhka j,g fndfyda wh ue,s jkafka lIdh j¾. j,g fnfy;a nvq fiùu lIdh ;eïîu jeks l%shdjka isÿ l<

wdhq¾fõo ffjoH rkam; rejka talkdhl rkam; fjoueÿr" 663" kqjr mdr" mE,shf.dv mÜáh ykaosh fchrdca m%kdkaÿmq,af,a md,u wi," wdhq' ,s'm 13869 071 300 90 88 $ 011 434 45 99 ffjoH rkam; rejka r;akdhl fjoeÿre;=uka ysiroh" .eiag%hsáia" w¾Yia" mSkia frda." fiïfrda." jd;rla;" yDo frda." wêreêr mSvkh" brejdroh" m¿ oeóu" leiSu" iu wdY%s; frda." ,sx.sl ÿn,;d" ldka;d frda." .¾NdI frda." oreM< m%udo ùu" mqreI Yla;sh ÿ¾j, ùu wdoshgo fu;=ud m%;sldr lrKQ ,nhs'

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