The Premier Bilingual Health Magazine in Sri Lanka Volume 29 • November 2020
ffjoHjrhd
fgksia fkd.yk whg;a yefok fgksia t,afnda
oshjeähdj yefokakg fmr thska j<lskakg mshjr .ekSuhs jeo.;a .¾NsKS ujg we;sjk .¾NsKS oshjeähdj
ISBN-1391 1341
9 7 7 13 91 13 400 1 RS 180 (VAT INCL)
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INSIDE Editors Note 6
Theme of the Month
Health News 8
oshjeähdj yeÿKQ wh fyd|ska md,kh lr.ksuq fkdyeÿKQ wh yefokakg we;s bvlv wjqruq 30
State-of-the-art drug manufacturing initiative jir mylska wfma rg iajfoaYSh ngysr T!IO j,ska iajhxfmdaIs; lsÍug oeka fjä kQ, m;a;= lr wjika T!IO ksIAmdok" iemhqï yd kshduk rdcH wud;H uydpd¾h pkak chiquk 12
wdorKSh Tfí orejdg fvx.= yeÿfKd;a WKla yeÿfKd;a we| úfõlh ,nd .kak" fyd|ska j;=r mdkh lrkak j;=msáj, uQ,sl frdayf,a <ud frda. úfYaI{ ffjoH ufyaIl úfcaj¾Ok 15
Rise in colon cancer affecting more adults… uyd nvje,a ms<sld wfma rfg;a uyd úkdYhla lrk ,l=Kq Y,H frda. úfYaI{ ffjoH m%fudaoa pkaøisxy 19
oshjeähdj yefokak fmr thska j<lskakg mshjr .ekSuhs jeo.;a''' oshjeähdj úfYaI{ ffjoH fkdfh,a fidauiqkaorï 31
oshjeähdj ksid we;sjk ixl+,;d fydafudak iy wka;rdid¾. frda. úfYaI{ ffjoH m%idoa lgq,kao 35
Èhjeähdj frda.fhaoS Ndú;hg .efkk reêr mÍlaIK ksrdydr reêr iSks mÍlaIdj ffjoH os,laId lkaof.a 42
November 2020
Everything You Need to Know About Gestational Diabetes .¾NsKS ujg we;sjk .¾NsKS oshjeähdj l=reKE., YslaIK frdayf,a ks¾Kd, frda. úfYAI{ ffjoH iuka;s l=f¾ 56
Diabetes and pregnancy oshjeähdj ;snqK;a ore iqr;,a n,uq idhksl l<,fõo úfYaI{ ffjoH fy<rejka mikal=udr 64
oshjeähd frda.Ska .; hq;=''' fkd.; hq;= wdydr .ek Tng wjfndaOhla ,nd fok Glycemic Index
Glycated Hemoglobin (HbA1c) mrSlaIKh
l%Svd ffjoH rdcs; .=Kj¾Ok 70
úfYaI{ ffjoH .hd lgq,kao 45
oekaj;a jHdhduhlg fhduq fjkjd fyd|hs''' oshjeähd frda.Ska l< hq;= jHdhdu
OGTT mÍlaIKh úfYaI{ ffjoH .hd lgq,kao 47
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RBS - Random Blood Sugar wyUq reêr mÍlaIdj 54
fld<U úYaj úoHd,hSh ffjoH mSGfha lÓldpd¾h ffjoH p;=rx. rKisxy 74
Urine for microalbumin test oshjeähd frda.Skaf.a jl=.vq iqjfi; úuik uq;%d uhsfl%dwe,aìhqñka mÍlaIdj
r;= iqj| iy,a Red Fragrant Rice
wdisß frday,a iuQyfha ridhkd.dr wOHlaI kS,a m%sh;a fcdaka 50
rd.u YslaIK frdayf,a ffjoH ckl fm%au;s,l 80
DOCTOR MAGAZINE
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INSIDE Bypass Surgery for Lower Extremity Limb Salvage mdo lmkak Tkak'' fukak''' frda.Skag n,dfmdfrd;a;=j f.k wd ie;alu
wdhq¾fõoh
uydpd¾h ukaosl úfcar;ak 84
fydañfhdam;s ffjoH wkQId fyaul=udß 104
Lateral Epicondylitis fgksia fkd.yk whg;a yefokjd''' fgksia t,afnda Ys% ,xld cd;sl frdayf,a jD;a;sh Ñls;ail ksud,s w¨;aj;a; 92
Homeopathy for Wellbeing fõokdldÍ fi,shq,hsáia iqj lrk fydañfhdam;s m%;sldr
ysiflia ksfrda.Sj ;nd .kak iqkaor flia l<Ul ryi l%sñrdc T!IOd,h wêm;s uydpd¾h" ffjoH iquKr;ak wur;=x. 108
Traditional Chinese Medicine: What You Need To Know ... ngysr ffjoH úoHdj yd lrg lr úialï olajk Ökfha iïm%odhsl ffjoH úoHdj 98
ffjoHY+Í foaYudkH uydpd¾h fya uQ fikr;a chiQßh nKavdr 120
Y%S ,xld iajdmk úoHdfõ§kaf.a ix.ufha j;auka iNdm;s ufkda Ñls;ail" ffjoH mS'tka' úoHd,l=,m;s 100
foaYSh ms<sld fjolu ms<sld frda.Skaf.a fmdaIKh .,s.uqj wdhq¾fõo ixrlaIK iNdfõ iNdm;s mdrïmßl foaYSh ms<sld ffjoH ta ta iqu;smd, 112
November 2020
le,‚h úYajúoHd,hSh .ïmy úl%udrÉÑ wdhq¾fõo úoHdh;kfha iyldr mqia;ld,hdêm;s l=i,d iÔjkS 116
uOqksud uyú, ,sms irKsh oshjeähdfjka ksÜgdjg iqjh i,ik mdrïmßl fjouy;auhd
ufkda Ñls;aid wiïu;hg fmï n¢k iu,sx.slfhda .hksf.a l;dj
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úl%udkaú; úl%udrÉÑfha fjo mrmqr tl¿ l< ird i| mKaä; úl%udrÉÑ fjo rd,ydñ
DOCTOR MAGAZINE
Èhjeähd frda.fhka mSvdjg m;aù isák Tng Èhjeähd md,khg mdrïmßl T!IO fy< mdrïmßl Tiq jÜfgdare.;j ms<sfh< lrñka Tng myiq wdldrfhka ,ndoSu wfmka isÿ fjkjd''' wdhq¾fõo ffjoH rkam; rejka r;akdhl 125
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EDITOR'S NOTE ;SrKd;aul fydardfõ Tfí iudc j.lSu bgq lrkak ñKqjkaf.dv n%ekaälaia weÕ¨ï l¾udkaYd,dj wdY%h lrf.k ks¾udKh jQ zzfldúâ fmdl=rZZ fï jk úg rg kej;;a iSrefjka ;nd we;' f;uil ld,hla ;=< iudcfhka lsisÿ fldúâ frda.sfhl= jd¾;d fkdùu;a iu.u ksrdhdifhkau ,sys,a cSjk rgdjlg yqre jQ iudch fï jk úg kej;;a má ;o lrf.k isà' fjfiiskau fujr kS;sho iúu;aj ;sfnk ksid fï jix.;fhka ñoSfï l%shdud¾.''' tkï uqyqKQ wdjrK me<|Su fukau iudc ÿria:Ndjh mj;ajd .ekSuo ldKav jYfhka talrdYS ùu wffO¾h lsÍuo fmrg jvd myiqjlao ;snqK;a ;ju;a wkdrlaIs; f,i lghq;= lrk whf.ao wvqjla ke;' fi!LH wud;HxYfha jix.;fõo tallfha m%Odk jix.;fõoS úfYAI{ ffjoH iqo;a iurùr fï jk úg fuu ffjrifha lsishï fjkiaùul wjodkula u;=j ;sfnk njg m%ldY lrhs' fjfiiskau fujr n,.ekaù ;sfnk ñKQjkaf. dv fldúâ fmdl=r fõ.fhka jHdma; jk njlao fmfka' ffjoHjrekaf.a woyi jkafka fï rfÜ l,ska jHdma; jQ fldúâ-19 ffjrihg jvd fujr ffjrifha Virus Load tl jeä njhs' fujr ffjrih jvd;a wdl%uKYS,S tlla ùug fuu fya;=jo n,mEula jkakg we;'
,laIKhla fkdfmkajñka frda.h jHdma; ùu jvd;a ydksodhlh' fï miqìu ;=< wfma jDoaO ck.ykhg;a" ksoka.; frda. j,ska fmf<k ck;djg;a we;s wjodku neyer,Sug wmg fjfiia W;aidyhla .ekSug isÿfõ' flfia fj;;a fujr m%n, fmdl=rla ñi iudcfha fjk;a ;eka j,ska frda.Ska fï ,shk fudfyd; jk úg;a jd¾;d fkdùu wmg we;s úYd,;u iykhhs' wjdijkdjka; isÿùula fkdjQfjd;a fuu fmdl=f¾ jHdma;sh i;s lsysmhl wejEfuka wju jk w;r t;eka isg fyda ksjeros fi!LHrlaIl l%u wkq.ukh lrñka Tn;a" rg;a fï uyd úmf;ka .,jd .ekSfï mqoa., j.lSula Tn wm ish¿ fokdgu fõ' wm wu;l fkdl< hq;= ldrKh jkafka fï jk úg f,dalfha jeäu jHdma;sh iys; frda.Ska wfma wi,ajeis bkaosjhdfjka jd¾;d ùu yd bkaoshdj yd Y%S ,xldj w;r ksrka;rfhka ixprkhka isÿ jk wjodkuhs' fï jk úg;a fï fldúâ-19 uev mj;ajkakg id¾:l T!IOhla fidhdf.k ke;' f,dal fi!LH ixúOdkh mjik wdldrhg fldúâ jHdma;shg kej;Sfu ;s; ;eîu wruqKQ lr.;a tkak;a 10la muK wjika mÍlaIK woshf¾ mj;akd w;r ;j;a wOHhk 30la muK m¾fhaIlhka úiska ,ys ,ysfha isÿ lrk nj;a jd¾;d fjhs' tfy;a fï jk f;lu fï lsisjl ie<lsh hq;= id¾:l;ajhla w;a jQ njla fkdfmfka' fï t<T we;af;a ;SrKd;aul jQ fydardjls' täfhka" j.lSfuka hq;=j iudcfha iEu mqrjeisfhlau fï frda.h md,kh lsrSu i|yd bgq l< hq;= j.lSula ;sfnk njo fï fudfydf;a wka ljrodg;a jvd ta fjkqfjka Tn lemúh hq;= njo wjOdrkh fjhs' DM
WK" leiai" fiïm%;sYHdj yd Yajik wmyiq;d fuu frda.h je<|Sfï ,dlaIKsl frda. ,laIK jQj;a fndfyda fofkl=g lsisÿ frda.
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November 2020
DOCTOR MAGAZINE
Bharata Gunathilaka - Editor in Chief doctormagazine.lk@gmail.com bharata.gunathilaka@gmail.com
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EDITOR IN - CHIEF Bharata Gunathilaka FOUNDER EDITORIAL CONSULTANT Late. K.M. Gunathilaka MANAGING EDITOR Amitha Wickramarachchi FEATURE ASSOCIATES Dr. Roshan Zerideen Zaid Consultant Obstetrician Gynaecologist
Dr Chandana Sri Kanakaratna Geriatrician, Physician
Dr. Asanga Wijayaratne Specialist in Human Kinetics and Sports Medical Science
Dr. Samantha kumara Kitalawaarachchi Dr Palitha Bandara Subasingha Dr Nalaka Ranasingha Dr Janaka Premathilaka Dr Devinda Dayarathna Mr Sanjaya De Silva Mr S M D Senevirathna Ms Hashini Himanshika Maheshani Bandara CREATIVE PRODUCTION Manjula Kumara Gamage 077 1 2424 08 WEB ADMINISTRATOR Dumindu Dissanayake PRINTING/CIRCULATION Imashi Printers, #96A, Wanatha Road, Gangodawila, Nugegoda. WAIDYAWARAYA Doctor Magazine is a intellectual property of Healthwatch Publications Viharakele, Diyatalawa. TEL: 057 22 29040 | FAX: 057 22 29040 E-MAIL: doctormagazine.lk@gmail.com HOTLINE: 077 3149084
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Akkaraipaththu Akurana Aluthgama Ambalangoda2 Ambalanthota Ampara Anuradhapura Attidiya Avissawella Badulla Balangoda Battaramulla Batticaloa Batticaloa 02 Beruwela Bk Majestic City Bokundara Boralesgamuwa Chilaw Chillaw2 Chunnakam Colpetty Cota Road Dalugama Dambulla Dankotuwa Deans Road Dehiwala Delgoda Delkanda Dematagoda Dharga Town Dickmans Road Duplication Ekala Elakanda Embilipitiya Eravur Ethulkotte Galewela Galle Galle 02 Gampaha Gampola Gatambe Grandpass Hambantota Hanwella Hatton Homagama Horana Jaela Jaela 02
Jawatta Kadawatha Kadawatha 2 Kaduruwella Kaduwela Kalapaluwawa Kalmunei Kalutara Kalutara North Kandana Kandy Kannaththidi Karagampitiya Karapitiya Katugastota Katugastota2 Katukurunda Kegalle Kelaniya Kesbewa Keselwatte Kilinochchi Kiribathgoda Kochchikade Kohuwala Kohuwala 2 Kolonnawa Koswatte Kotahena Kotikawatta Kottawa Kottawa 02 Kuliyapitiya Kundasale Kurunegala Kurunegala 2 Madulla Maharagama 2 Malabe Malabe 2 Manchanthoduwai Manippay Maradana Marawila Marine Drive Matale Matale2 Matara Mathugama Mattegoda Mawanella Minuwangoda Mirihana
November 2020
Moneragala Moratuwa Moratuwa Old Rd Mount Lavinia Mount Lavinia Stc Mutuwal Narammala Nawala Nawalapitiya Negombo 2 Nelliyadi Nittambuwa Norris Canal Nugegoda Nugegoda 2 Nuwara Eliya Pallekele Panadura Panadura 2 Park Road Pelawatta 02 Peliyagoda Pepiliyana Pilimatalawa Piliyandala Pitakotte Pothuvil Puttalum Ragama Rajagiriya Ratmalana Ratmalana 02 Ratnapura Seeduwa Stanly Tmw Staples Street Tangalle Thihariya Thissamaharama Trincomalee Udahamulla Vavuniya Wadduwa Warakapola Ward Place Wariyapola Weliweriya Wellawatte Wellawaya Wennappuwa Werahera Wijerama Yakkala
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Health News iqmqj;
Health News iqmqj; rEm,djkH ksmehqï kshdukh kqÿf¾oSu n,.ekafjkjd''' T!IO ksIAmdok" iemhqï yd kshduk rdcH wud;H uydpd¾h pkak chiquk
uydpd¾h pkak chiquk
2015 j¾IfhaoS n,.ekajqKQ T!IO mkf;a rEm,djkH øjH kshdukhg m%;smdok kE' fï ksid nd, re iq/l=ï ksid úYd, wjodkulg ck;dj ksrdjrKh jqKd' nd, ksIAmdok''' kshñ; m%ñ;sfhka f;dr ksIAmdok fj<|fmd<g meñKSfï wjodkula we;s jqKd'
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November 2020
ud miq.shod cd;sl T!IO kshduk wêldßh (NMRA) fj; fï iïnkaO kj mk;l uQ,sl flgqïm;la ilik f,i Wmfoia ÿkakd' we;a;gu th oeka iïmdokh fj,d ;sfnkjd' fï iïnkaOfhka lghq;= lrk úúO md¾Yaj j,g fï flgqïm; oekgu;a bosßm;a lr, ;sfhkjd' rcfha ffjoH ks,Odßkaf.a ix.uh (GMOA) rEm,djkH ksIAmdolhkaf.a ix.uh (Cosmetic Manufacturers’ Association) wdoS jYfhka' Tjqkaf.a ksÍlaIK ,nd .ekSfuka miqj ,nk jif¾ m<uq ld¾;=j jk úg fï rEm,djkHhg wod, mK;a flgqïm;a lr n,.ekaùug wmg fndfyda úg yels jkq we;s'
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.egjrhka w;r tAâia wjodkula ,sx.dY%s; frda. yd taâia u¾ok jevigyfka wOHlaI úfYaI{ ffjoH ridxc,S fyÜáwdrÉÑ
úfYaI{ ffjoH ridxc,S fyÜáwdrÉÑ
fï jk úg idudkH iudch ;=< y÷kd fkd.;a tÉ'whs'ù' wdidÈ;hka 1600la muK isák neúka rd;%s iudc Yd,dj, /lshd lrkakka" ,sx.sl Y%ñlhka" furg ùid b,a¨ï lrk úfoaYslhka yd reêr mß;Hd. lrkakka we;=¿j wjodkï ;;a;ajfha miqjk mqoa.,hka jyd
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wdidÈ; msßñka ishhg mkia yhlg jhsrih wdidokh ù we;af;a wkdrlaIs; iu,sx.sl iïnkaO;d meje;aùu fya;=fjks' ta w;r mdi,a <uqka nyq;rhla jk njo weh fmkajd ÿkakdh' is.rÜ melÜgqfõ rEml ih uilg jrla w¿;a fjhs ÿïfld< yd uOHidr ms<sn| cd;sl wêldßfha iNdm;s ffjoH iudê ví,sõ' rdcmlaI wod< reêr mÍlaIdjka isÿlr.; hq;= nj ,sx.dY%s; frda. yd taâia u¾ok jevigyfka wOHlaI úfYaI{ ffjoH ridxc,S fyÜáwdrÉÑ mejiqjdh' fï jkúg weia;fïka;= fldg we;s furg isák taâia frda.Ska ixLHdj 3"600la muK jk w;r thska 2"000la muK y÷kdf.k ;sfí' y÷kd fkd.;a msßi ksoe,af,a yeisÍfuka iudcfha isák ksfrda.S mqoa.,hkago fuh je,£fï wjodku jeä neúka fmr lS mqoa.,hka mÍlaIdjg ,laúh hq;= nj weh i|yka l<dh'
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jir my yhl ld,hl isg jhi wjqreÿ 15g jeä msßñka w;r HIV wdidokh ùfï jeäùula fmkakï q lrk njo ffjoHjßh lSjdh' 2020 jif¾ cqks udih jkúg kj wdidÈ;hka 185 fokl=;a jd¾;d ù ;sfí' bka úis;k = a fokl= jhi wjqreÿ 15" 24 w;r jhia ldKavhg wh;a njo weh i|yka l<dh' 2019 jif¾§ furáka kj wdidÈ;hka ;=ki a h s tla fokl= jd¾;d ù we;' ffjoHjßh i|yka lrk mßÈ furg ;reK msßñkag tÉwhsù wdidokh jeäùug m%Odk fya;j = iu,sx.sl iïnkaO;dh' 2019 jir ;=<§ w¨;ska jd¾;d jQ HIV
ffjoH iudê ví,sõ' rdcmlaI
is.rÜ melÜgqfõ ishhg 80l m%udKhl we;s rEmuh fi!LH wjjdo iEu udi yhlgu j;djla w¨;a lsÍu bÈßfha§ b;d oeäj l%shd;aul lrk nj ÿïfld< yd uOHidr ms<sn| cd;sl wêldßfha iNdm;s ffjoH iudê ví,sõ' rdcmlaI uy;d miq.shod mejiSh'
November 2020
DOCTOR MAGAZINE
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D•Magazine /
Health News iqmqj;
2006 wxl 27 ork ÿïfld< yd uoHidr ms<sn| cd;sl wêldßh mkf;a fï ldrKh igyka ù we;s we;s nj;a 2015 j¾Ifha§ is.rÜ melÜgqfõ igyka úh hq;= rEmuh fi!LH wjjdo ms<sn| ÿïfld< yd uOHidr ms<sn| cd;sl wêldßh úiska ;SrKhla f.k ;snqK o th fï jk ;=re l%shd;aul ù ke;s nj;a ta uy;d i|yka lf<ah'
fydañfhdam;s ffjoH iNdj n,d;aul fjhs fydañfhdam;s ffjoH iNdj bÈß jir ;=kl ld,iSudj i|yd kej; ia:dms; lsÍu miq.shod foaYSh fjolï m%j¾Ok" .%dóh yd wdhq¾fõo frday,a ixj¾Ok yd m%cd fi!LH rdcH weue;s isisr chfldäf.a m%Odk;ajfhka mej;S /iajSuloS ;SrKh flrsK'
tlu rEmuh wjjdoh i|yka lsÍfuka tu wjodku ms<sn| ck;dj ne?reïj fkdis;k neúka ;j ;j;a tajdg weíneysùu je<elaúh fkdyels nj;a ÿïfld< Ndú;h je<elaùug yd ck;dj w;r ÿïfld< Ndú;h ms<sn| ienE ;;a;ajh fmkajd§ug tu ixl,amh jeo.;a nj;a rdcmlaI uy;d lSh'
wjika jrg meje;s fydañfhdam;s ffjoH iNdj 2016 jif¾ ia:dms; l< w;r 2018 jif¾ th kej;;a úiqrejd yßk ,§' wk;=rej th kej; ia:dms; lsÍfï§ .eg¨ldÍ ;;a;ajhla Woa.;j ;snQ fyhska fï olajd Bg idudðlhka m;a lr .ekSug fkdyels úh'
rEmuh wjjdohla f,i hïlsis mqoa.,hl=g ÿïfld< yd uOHidr Ndú;h keje;aúh hq;= kï thg wjYH Wmfoia ,ndfok Rcq wxlhla i|yka lsÍugo bÈßfha§ lghq;= lrk nj mejiSh'
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November 2020
bka§h rcfha iyfhda.h we;sj fydañfhdam;s ffjoH Wmdêh yodrk ,o isiqka rdYshla fydañfhdam;s ffjoH iNdjla fkdue;s ùu fya;=fjka ffjoHjreka jYfhka ,shdmÈxÑ ùug fkdyelsj isá nj
DOCTOR MAGAZINE
foaYSh fjolï m%j¾Ok" .%dóh yd wdhq¾fõo frday,a ixj¾Ok yd m%cd fi!LH rdcH weue;s isisr chfldäf.a
weue;sjrhd tys§ i|yka lf<ah' ish¨u jD;a;Sh iqÿiqlï imqrd jir lsysmhla .; jqjo ffjoH m;aùï ,nd. ekSug tu msßig fkdyels jQ neúka ckdêm;sjrhdg iy w.ue;sjrhdg meñ‚,s l< nj;a ta wkqj Tjqkf.a Wmfoia u; läkñka fuu msßig m;aùï ,nd§ug wjYH jk fydañfhdam;s ffjoH iNdj ia:dms; l< nj;a weue;sjrhd jeäÿrg;a i|yka lf<ah' fuu ffjoH iNdj idudðlhka tfldf<dia fokl=f.ka iukaú; jk w;r bÈß i;sfha§ Bg ks,OdÍka f;dard m;a lr .ekSug kshñ;h' DM
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D•Magazine /
Pharmaceuticals jir mylska wfma rg iajfoaYSh ngysr T!IO j,ska iajhxfmdaIs; lsÍug oeka fjä kQ, m;a;= lr wjika
State-of-the-art drug manufacturing initiative jir mylska wfma rg iajfoaYSh ngysr T!IO j,ska iajhxfmdaIs; lsÍug oeka fjä kQ, m;a;= lr wjika ms<sld frda.Skaf.a T!IO we;=¿j wmg wjYH ish¿u T!IO fï fmdf<dfõu ksIAmdokh lsÍu j;aukq rcfha wruqKhs - T!IO ksIm A dok" iemhqï yd kshduk rdcH wud;H uydpd¾h pkak chiquk
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November 2020
DOCTOR MAGAZINE
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rdcH T!IO ksIAmdok kS;s.; ixia:djg (SPMC) r;au,dfka oekg l%shd;aul T!IO ksIAmdokd.drhla ;sfhkjd' ta yereKQ úg fm!oa.,sl iud.ï lsysmhl=;a fï rg ;=< hï T!IO m%udKhla ksmojkjd'
Ndr; .=K;s,l úisks jd¾Islj remsh,a ì,shk 130l w;suy;a OkialkaOhla jeh lrñka wfma ck;djg wjYH lrk T!IO fï rgg wdkhkh lrkjd' fuh wfma rfÜ jd¾Isl T!IO wjYH;djfhka ishhg 85la' tys f;areu ;uhs wfma rgg wjYH lrk T!IO j,ska wfma rfÜ ksmojkafka ishhg 15l fidÉpula ú;rla ùu' wfma fi!LH fiajdfõ fm!oa.,sl wxYh ;=< kshu lrk T!IO j,ska ishhg 96lau wdkhksl T!IO lshk ldrKh;a wm wu;l lrkak krlhs'
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T!IO ksIAmdok" iemhqï yd kshduk rdcH wud;H uydpd¾h pkak chiquk
wmg wjYH lrk T!IO" jir myl läkï jevigykla hgf;a wfma rfÜu ksIAmdokh lsÍu ;uhs j¾;udk rcfha wruqK' zzwfma frda.Skag wjYH lrk T!IO wfma rfgkauZZ tal ;uhs j;auka rcfha oelau' ta wruqK idlaId;a lr.kakg T!IO ksIAmdok" iemhqï yd kshduk rdcH wud;HxYh Wmdhsl l%shdud¾. /ila fï jk úg wrf.k ;sfnkjd' wo fygu l¾udka;Yd,d /ila Tiq" Y,H WmlrK ksmehqï wdrïN lrkjd udi 24l ld,hla ;=< wfma SPMC ksIAmdokd. drfha ksIamdok Odß;dj by< kxjk ie,iqul wm bkakjd' wlaIs ldp (Intaocular lenses)" úl,dx. WmlrK (Orthopaedic Implants) jf.au ;j;a w¿;a T!IO
/ilau wNskjfhka ksIAmdokh lrkakg fï ksid wmg wjia:djla ,efnkjd' foaYh S yd úfoaYh S fm!oa.,sl wdfhdaclhka yd taldnoaOj yjq,a iud.ï we;s lsÍu flfrySo rch fï jk úg wjêkh fhduq lr ;sfnkjd' fï iïnkaOfhka oekgu;a wm uQ,l s idlÉPd wjika lr ;sfnkjd' ta i|yd wNsu;h ,nd .ekSu (Call expressions of interest) bosß ld,fhaoS isÿjkq we;s' kj T!IO ksIm A dokd.dr /ila fï jk úg;a jev wdrïN lr ;sfnkjd' bosß ld,fhao; S a tjka T!IO ksIm A dokd.dr lsym s hlau ;u ksIm A dok wdrïN lrKQ we;s' fia,hsk"a m%;c s j S l T!IO yd ks¾úkaok T!IO l¾udka;Yd,d bosß ih udih ;=< wdrïN jkjd we;s'
November 2020
DOCTOR MAGAZINE
13
D•Magazine /
Pharmaceuticals jir mylska wfma rg iajfoaYSh ngysr T!IO j,ska iajhxfmdaIs; lsÍug oeka fjä kQ, m;a;= lr wjika
fyaudia fyda,aäx.aia iud.fï wkqnoaO iud.ula jk fudrsikaia mSt,aiS wdh;kfha kj T!IO ksIAmdokd.drh wNskjfhka w.%dud;H uyskao rdcmlaI uy;d úiska újD; lrk ,o wjia:dj'
fydaud.u" msámk Y%S ,xld kefkda ;dlaIK WoHdkfha msyá s fuu l¾udka;Yd,dj fudßika iud.fï fojk ksIm a dok l¾udka;Yd,d mßY%hhs' fudßika iud.u úúO T!IO ixfhda. 75 la ksIm a dokh lrk w;r úfYaIfhka fnda fkdjk frda. i|yd wjYH T!IOj,g we;s YS>% b,a¨u imqrd,Sug bÈß jir lsym s h ;=< lghq;= lsÍug wfmalI a d lrhs' fuu kj l¾udka;Yd,djg jd¾Islj T!IO fm;s ì,shk 5la ksIm a dokh lsÍfï yelshdj we;s w;r oaú;aj jevuqr hgf;a Wmßu Odß;djfhka T!IO fnda;,a ñ,shk 10 la ksIm a dokh lsÍfï yelshdj mj;S'
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November 2020
T!IO l¾udka; l,dm folla j¾;udk rch úiska T!IO ksIAmdokh i|ydu fjka flreKQ l¾udka; wdfhdack l,dm folla msysgqjkjd' wlalr 400lska hq;a tla T!IO ieliqï l,dmhla yïnkaf;dg msysgqjkq w;r fuys m%uqL wjYH;djh jkafka úfoaYhkag T!IO wmkhkh lsÍuhs' bosß jir lsysmh ;=< wfma rfgka .=Kd;aul T!IO wmkhkh lsÍfï wNs,dIh wmg ;sfnkjd' yïnkaf;dg T!IO ksmehqï l,dmfha ;u l¾udka;Yd,d n,.kajkakg oekgu;a f,dalfha m%uqL fmf<A lS¾;su;a T!IO iud.ï rdYshla fï jk úg;a ;u leue;a; m<fldg ;sfnkjd'
DOCTOR MAGAZINE
;j;a uOH mßudk T!IO ksIamdok lïy,a l,dmhla wkqrdOmqrfha Thduvqj m%foaYfha msysgqjkjd' tys jmißh wlalr 100la' jir mylska wms wfmau T!IO j,ska iajhxfmdaIs;hs wjqreÿ ;=kl ld,hla hk úg wfma rgg wjYH lrk T!IO yd Y,H WmlrK j,ska yß wvlau fï rfÜ ksmojkq we;ehs wud;HxYh úYajdi lrkjd' ta ú;rla fkdfjhs" isõjk wjqreoao jk úg wmg wjYH lrk T!IO wfma rfÜu ksIAmdokh lrkjdh hk b,lalh imqrd,kakg fï jevms<sfj, iu;a jkq we;s'fï T!IO ksIAmdok l,dm fol ú;rla kj /lshd 5"000la wfma rfÜ ìys lrKQ we;s' DM
doctormagazine.lk
D•Magazine /
Dengue fever in children wdorKSh Tfí orejdg fvx.= yeÿfKd;a
DENGUE FEVER IN CHILDREN
wdorKSh Tfí orejdg
fvx.= yeÿfKd;a
WKla yeÿfKd;a we| úfõlh ,nd .kak" fyd|ska j;=r mdkh lrkak j;=msáj, uQ,sl frdayf,a <ud frda. úfYaI{ ffjoH ufyaIl úfcaj¾Ok
doctormagazine.lk
November 2020
DOCTOR MAGAZINE
15
D•Magazine /
Dengue fever in children wdorKSh Tfí orejdg fvx.= yeÿfKd;a
idudkH WK yd fvx.= WK fjkalr yªkd .kak tl myiq kE''' fï fldhs wjia:dfõos;a uq,os fmkajk frda. ,laIK iudkhs' mdpkh" fiïm%;sYHdj''' WK;a tlal fvx.= WK;a tkak mq¿jka' fvx.= WK je<ªKdg thska cSú; wjodkula we;s lrk fvx.= lïmk wjia:djg flfkla m;a jkafka l,d;=rlska' ishhg 99lau mdfya idudkH WKloS jf.a osk lsysmhlska iqjm;a fjkjd' biairyg tkafk jeys ldf,' jeys ldf,;a tlalu jeäfjk fvx.= wjodku .ek oeka fldhs ljqre;a okakjd' Wia ñálï fkdi<lk fvx.= uÿrejd Tfí wdorKSh orejdg oIAG lf<d;a orejd iqjm;a lr.kakg jeo.;a jk Wmdh ud¾. fï ,smsfha oelafjkjd' fvx.= frda.h we;s lrkafka ffjrihla' ta ffjrih /f.k hkafka uÿrefjla' Aedesaegypti yd Aedesalbopictus hkqfjka ye|skafjk uÿre úfYaI folla ñksiqkag fvx.= frda.h we;s lrkakg odhl fjkjd' wfma rfÜ fvx.= frda.h we;s lrkakg úfYaI ffjrifha Wm úfYaI y;rla n,mdk nj m¾fhaIKd;aulj yªkdf.k ;sfnkjd' fvx.= jrla yeÿfKd;a B<Õ j;dfj fvx.= frda.h we;s fkdjkakg m%;sfoay isrer ;=< yefokjd' ta;a fï úosyg ffjrifha Wm wdldr y;rlau ;sfhk ksid jrla fkdfjhs isõ j;djla tlu mqoa.,fhl=g fvx.= frda.h je<f|kak mq¿jka'
16
November 2020
DOCTOR MAGAZINE
fvx.= frda.fhaoS we;sjk WK widOH njg m;a jkafka kE' WK widOH jkafka fvx.= rla;md; ;;a;ajhloShs' b;d l,d;=rlska flfkla fvx.= lïmk wjia:djg Dengue Hemorrhagic Fever (DHF) m;a fjkak mq¿jka' fuh kï Nhdklhs' cSú; wjodkula we;s lrkjd' fï ksid ;uhs uq,skau frda.Ska y÷kd.ekSu jf.au ióm wëlaIKh;a" frda.S l<uKdlrKh;a w;sYhska jeo.;a jkafka' fvx.= frda.fha fï úia;r flfrk ;SrKd;aul wjia:dj (Critical phase) doctormagazine.lk
hï flfkla m;a jqKdu Tyqg i;aldr lrk wdldrhla ;sfnkjd' fï iqúfYAIS ;SrKd;aul wjia:djg m;a jqKdu tu wjia:dj miq lrk f;la frda.shd iómj wëlaIKh l< hq;= fjkjd' idudkHfhka orefjl=g yefok WK iqj w;g yefrk úg orejdf.a iajNdjho hym;a w;g yefrkjd' ta;a fvx.= rla;md;fhaoS WK nei .sh;a orejd u,dksl iajrEmhla" fmKqula orKjd' fuh fvx.= WfKys olakg ,efnk úfYaI;ajhla' fvx.= frda.S orejd ;SrKd;aul wjia:djlg m;a fjkjdo@ reêr.; mÜáld m%udKh 100"000g jvd wvq ùu;a reêrfha >k;ajh jeäùu;a weiqf¾ ;uhs ffjoHjreka fï nj uQ,slj y÷kd .kafka' reêrfha >klu n,kafk FBC mÍlaIKhl Haematocrit lshk idOlh by< hdu úuid ne,Sfuka' fï woshf¾oS orejdg l<hq;= i;aldr folla ;sfnkjd' 1' frda.shd iómj wëlaIKh lsÍu 2' Tyqg wjYH ;r, mßudj oS we;s Wmfoia wdldrfhkau YÍr.; jkakg ie,eiaùu doctormagazine.lk
iómj wëlaIKh lsÍfuka orejdf.a ffcj ridhKsl l%shdldß;ajh;a" frda.shdf.a idhksl ;;a;ajh;a iSrefjka mÍlaId lrñka jy jyd mshjr .ekSug wjia:dj ie,fikjd' ;r, mßudj ,nd fokafka .Kkh lsÍulska' fï m%udKh wvq jqfKd;a isref¾ wjhj wlrKShg Organ failure m;a fjkakg;a lïmk wjia:dj Shock we;s fjkakg;a mq¿jka' wfkla w;g jeäfhka j;=r ÿkafkd;a yoj; wlrKsh (Heart failure) jf.a Nhdkl m%;sM< we;s fjkakg mq¿jka' fï ;SrKd;aul woshf¾oS orejdg wNHka;ßl reêrjyk (Internal bleeding) we;s fjkakg" jl=.vq yd wlaudj ÿ¾j, jkakg;a (Liver and kidney failure) isys l,amkdj fjkia jkakg;a Altered consciousness (encephalopathy) lsishï wjodkula ;sfnkjd' b;ska fï wkQj ffjoHjrhdg yd fyo ld¾h uKAv,hg frda.shd iqjm;a lsÍug we;s j.lSu fldhs ;rï ne?reïo hk ldrKh oeka Tng jegfykjd we;s fkao@ orefjlag WKla yeÿfKd;a th fkdi<ld yeÍu nrm;, jroaod .ekSula iuyr fj,djg we;eï orefjd we;=,a lrkafk;a fï lshk Nhdkl woshf¾os' WK .eKQkyu ta .ek t;rï ;elSula fkdlr isàu ;uhs fï Nhdkl je/oaog fya;= jkafka' jeä wjodkula orK orefjd
November 2020
DOCTOR MAGAZINE
17
D•Magazine /
Dengue fever in children wdorKSh Tfí orejdg fvx.= yeÿfKd;a
lsh, ia:Q,;djh iys; orejka jl=.vq yd wlaud wdndO wdoS ksoka.; wdndO ;sfnk orejka i<lkjd' fï wh mqxÑ WK fyïìßiaidjla yeÿK;a ta .ek fjfiia wjOdkhla .; hq;=hs' orejkag lrkak fohla kE' ta ksid fï mKsúvh orejkaf.a wïu,d" ;d;a;,d fyd|Ska ysf;a Odrkh lr.kak' iudc j.lSu .ek úuis,a,;a jeo.;a weyeg fkdfmfkk ffjrihla''' uÿrejka yd .ejfik ffjrihla fïid úkakeyshlg uq,a fjk nj Tng ug ys;d .kak;a wudrehs' ta;a ienEj talhs' fï ksid wm cSj;ajk mßirh uÿrejka fnda fkdjk ia:dk fia mj;ajd f.k hdfï iudc j.lSu fï wjia:dfõ wm ;oska is;g .; hq;=hs'
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November 2020
miqigyk fvx.= frda.h uev,k tkak;la iïnkaOfhka fndfyda m¾fhaIK isoaO fhjkjd' fï jk ;=re id¾:l;ajhla ke;;a th wkd.;fhaoS id¾:l fkdfj;ehs is;kakg;a nE' tfyu jqfKd;a thska nd," ;reK jf.au jeäysá ck.ykhg;a úYd, / ljrKhla bka ,efnhs' tf;la wm ish¿ fokdu wdrlaId úh hq;=hs' WKla yeÿKu we| úfõlh ,nd .; hq;=hs' ÿjkak" mkskak fyd|kE' jeäysáhka kï /lshd j,g hkak;a fyd| kE' ;=ka fodylg jvd WK ;sfhkjd kï" reêr mÍlaIdj isÿ lrf.k WfKys iïNjh yªkd .ekSu w;sYhska jeo.;a' fvx.= we;eï úg udrdka;sl wjodkulg Tn f.k tkjd' ta;a l,afõ,d we;sj .kakd l%shdud¾. we;=f<A Tng úYd, /ljrKhla ;sfnkjd' DM
DOCTOR MAGAZINE
Source: Daily Mirror, Health Capsule ffjoH mqkakñ wurisxy
doctormagazine.lk
D•Magazine /
Colon Cancer uyd nvje,a ms<sld
Rise in colon cancer affecting more adults… uyd nvje,a ms<sld
Y,H frda. úfYaI{ ffjoH m%fudaoa pkaøisxy
wfma rfg;a uyd úkdYhla lrk ,l=Kq
uyd nvje,a j, we;sjk ms<sld iïnkaOfhka wm w;r mj;akd ÿ¾u;hka lsysmhla bj;,Sug oeka ld,h meñK ;sfí'
oeka" oeka ;reK whg;a jeä jeäfhka yefokjd ;jÿrg;a th ngysr rgj,g iSud jQ ms<sldjla fkdfjhs''' ms<sldfjka .e,fjkak kï frda. ,laIK .ek úuis<su;a ùu wjYHhs wjodku we;s wh Y,H ffjoH idhkhg hkak fidfiacia''' yeï''' fílka wdydrhg .ekSu fyd| kE''' ia:Q,;djh ksid;a wm jeäfhka ms<sld j,g k;= fjkjd'''
doctormagazine.lk
óg fmr wm w;r mej;S u;hla jQfha fï uyd nvje,a j, we;sjk ms<sldj ngysr rgj, ck;dj w;r iq,nj olakg ,efnk ;;a;ajhla njhs'
November 2020
DOCTOR MAGAZINE
19
D•Magazine /
Colon Cancer uyd nvje,a ms<sld
yeïn¾.¾" meiagd lk ngysr rgj, ck;dj uyd nvje,a j, we;sjk ms<sldjg jeä jYfhka k;= jk fihla óg fmr jd¾;d ù ;snqKs' kuq;a oeka wfma rfÜo uyd nvje,a j, we;sjk ms<sld b;d iq,nj olakg ,efí' fjfiiskau jhia.; jkakg fmr jhi y;,sia .Kka j, wh w;f¾ mjd uyd nvje,a j, ms<sld .ek oeka oeka wikakg ,efí' jeä jeäfhka frda.Ska jd¾;d ùu;a ta w;f¾ ie<lsh hq;= ;reKhka ixLHdjla jd¾;d ùu;a .;jqQ jir oyhl muK ld,h ;=< olakg ,enqKQ wjdikdjka; ;;a;ajhls'
fï wkQj uy nvje,a ms<sldj ;jÿrg;a uy,a,kaf.a ms<sldjla f,i is;Sfï jroskao wm wE;a úh hq;=h' uy nvje,a ms<sld frda.Ska jeä jYfhka jd¾;d ùu ksid fï ms<sldj .ek f,dalh mqrdu wjOdkh fhduq fj;aoS wfma rfÜo b;d oefkk iq¿ frda.Ska ixLHdfõ j¾Okhla" fï whf.ka ie<lsh hq;= m%udKhla ;=reKQ jhfiaoSu jd¾;d ùu wmo fï iïnkaOfhka jeä wjOdkhla fhduq lrk miqìulg wmj ;,a¨ lrhs' uynvje,a ms<sldj - Tfí wjOdkhg fhduq úh hq;= frda. ,laIK uydka;%h yd .=oud¾.h wdY%s; ms<sld wdrïN jkafka uydnvje,a j, we;=<; ì;a;sfha mglhla uq,a lrf.kh' fuh uydka;%h mqrd me;sr hk w;r hdno wfkl=;a wjhj j,go me;sr hhs' m%d:ñl j¾Okfhka miqj jid moaO;sh yd reêrh yryd iuia; YÍrhgu jqj me;sr hd yel' uq,a wjia:dfõ frda.h y÷kd .ekSfuka m%;sldr lr iqjm;a lsÍu b;d myiqh' frda.h uq,a wjia:dfõ yªkd .ekSug my; frda. ,laIK WmldÍ fjhs'
uy nvje,a ì;a;sfha fmd,sma kue;s j¾Olhla ms<sldjla njg m;a jk wdldrh' fuys uq,a wjia:d y;r ljr woshrloS fyda bj;a lsÍfuka miqld,Skj th ms<sldjla njg m;aùfuka j<lajd .; yels w;r ta i|yd fldf,dfkdiafldms mÍlaIKfhka ,efnk msgqjy, wmuK fjhs
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November 2020
DOCTOR MAGAZINE
doctormagazine.lk
² .=o ud¾.fhka f,a msgùu ² jeisls,s hdfï wl%uj;a nj' jeisls,s hk jdr .Kk jeäùu" u<noaOh fyda nvt<sh hdu wdoS jYfhka jeisls<s hk mqreÿ fjkia ùu ² nfâ my;ska we;sjk fõokd" lelal=ï
th ms<sldjla njg m;a fjkjd' fï fmd,sma tl wms zzfldf,dfkdiafldmsZZ mÍlaIdj lrk úg ta mÍlaIdj w;r;=f¾oSu bj;a lr ms<sld wjodku iïmQ¾Kfhkau ke;s lrkjd' túg wkd.;fha th wdka;%sl ms<sldjla''' uy nvje,a ms<sldjla we;s jkakg bvla kE'
ta yereKQ úg ld,hla .; jQ úg nfâ msmSu" wdydr wreÑh fï ms<sldj we;s jQ úg we;sfõ' tla j;djla fyda f,a u<my .sfhd;a''' .=o ud¾.fhka tla j;djla fyda f,a msgùula isÿ jqfKd;a th iq¿fldg ;lkakg tmd' wm fndfyda fokd fï ;;a;ajh w¾Yia úosyg i<ld ,>q lrkjd' ffjoHjrfhl=g fmkaùug mjd ue<s fjkjd' Tng w¾Yia ;sfhkak mq¿jka' tal idudkH ;;a;ajhla' wfma iudcfha ishhg 15lg muK idudkHfhka w¾Yia ;sfhkjd' ta;a f,a msgjqfKA ms<sldjla fyda tys uq,a wjia:dfõ mj;akd fmd,sma jeks j¾Olhla ksid;a fjkakg mq¿jka' fï ksid ljr ;;a;ajhla ;=< fyda u<my iu. f,a msgùula we;s jQjfyd;a jydu ffjoHjrhl= uqK .efikak'
tfyu n,k úg fï fldf,dfkdiafldms mÍlaIdj b;d úYd, jákdlula we;s Ñls;aiSh mÍlaIdjla' th uq,a wjia:dfõoS'' tfyu;a ke;akï frda. ,laIKhla u;=fjk wjia:dfõoSu isÿ lf<d;a zzTfí osú iqrlsk mÍlaIdjlaZZ úosyg;a y÷kajkakg mq¿jka'
uy nvjef,a we;sjk fmd,sma miqj ms<sldjla njg m;a fjkjd uyd nvje,a j, we;sjk ms<sld j,ska ishhg 80la jf.a id;sYh nyq;rhla uq,skau we;s jkafka zzfmd,smaZZ hkqfjka yªkajk j¾Olhla ^uiajeoe,a,la& úosyg' th ms<sldjla fkdfjhs' ta;a th bj;a fkdlf<d;a miqj uy nvje,a ms<sld wjodkï idOl
jhia.; ùu
doctormagazine.lk
mjq,a b;sydih
wêl fïo iys; wdydr
jHdhdu ke;s cSú;h
November 2020
ÿï mdkh iy u;ameka
DOCTOR MAGAZINE
21
D•Magazine /
Colon Cancer uyd nvje,a ms<sld
uq,skau y÷kdf.k iqjm;a l< yels ms<sld w;rg fï uynvje,a ms<sldjo whs;shs ms<sld iïnkaO m%;sldrfõofha ms<sldjla we;s fjkakg fmr th k;r lrkak mq¿jka ms<sld úfYAI lsysmhla muKhs ;sfhkafk' ² mshhqre ms<sldj l,a fõ,d we;sj y÷kd .;af;d;a th iqjm;a lrkak myiqhs' uefuda.%Eï mÍlaIKfhka lrkafk ta foa' ² .eíf., ms<sldj;a zzmema ;ejreuZZ lshk Screen mÍlaIKfhka ms<sldjla ùug fmr wjosfhaos y÷k.;af;d;a wdfh me;sÍula fjkafk kE' t;ekskau frda.h wyjrhs' ² wkak ta ldKAvhg whs;s f;fjks ms<sldj ;uhs" uyd nvje,a j, we;sjk ms<sldj' fïl;a uq,a wjia:dfõoS" ta lshkafk fmd,sma lshk woshf¾os yªkd.;af;d;a fldf,dfkdiafldms mÍlaIKfhka tkaviafldamh fhdodf. ku bj;a lrkak mq¿jka' t;fldg fmd,sma tl wdka;%sl ms<sldjla njg m;a jkakg bvla kE'
22
November 2020
uy nvje,a ms<sldjl woshr
fuys oelafjk ljr wjia:djloS jqj ms<sldj uev,Sug ffjoHjreka wk,iaj mshjr .ekSu uy nvje,a ms<sldfõ úfYAI;ajhhs
fmd,sma tl yªkd .kafka fufyuhs fmd,sma tl uy nvjef,a jï me;af; ia:dk.; fj,d ;sfhkjd kï u<my iu. f,a hkjd' uy nvje,a ì;a;sfha iEu f,a .e,Sulau fldf,dfkdiafldms mÍlaIdjlska fyda is.afudhsviafldms mÍlaIdjlska úuiqug ,la lrkakg Y,H ffjoHjreka l%shd lrkjd' ta ksid Tn bosßm;a jqfKd;a fmd,sma tl u. yefrkak bvla kE' fmd,sma tl u. yerefKd;a ;;a;ajh krl w;g''' ta jf.auhs reêrjykhla isÿjk wjia:dffõ wmg fmd,sma tl u. yerefKd;a jir .Kkdjla hk úg th ms<sldjla jkakg bv ;sfnkjd' fmd,sma tl ;sfhkafk nvjef,a jï me;af; kï wr uq,ska lS m%Odk ,laIK ;%s;ajh''' .=o ud¾.fhka f,a msgùu" jeisls,s hk jdr .Kk fjkia ùu yd nfâ my;ska we;sjk lelal=ï fõokd lshk ;;;ajh we;s fjkakg mq¿jka' yenehs fï fmd,sma tl ;sfhkafka Worfha ol=Kq me;af; kï Th lshk frda. ,laIK idudkHfhka fmkajkafka kE' túg f,a ysÕlu fkdfyd;a weksñhdj" Worfha fõokdj jf.a ,laIK we;s jqKdu Tfí Y,H
DOCTOR MAGAZINE
doctormagazine.lk
f,dal m%lg Black Panther Ñ;%mgfha m%Odk pß;h ksrEmkh l< m%lg wefußldkq k¿jd Chadwick Boseman uyd nvjef,ys ms<sldjlska jhi wjq' 43oS urKhg m;aùu f,dalhu i,s; l< isÿùula úh' fuh uynvje,a ms<sld iïnkaOfhka f,dalh mqrd lsishï ;e;s .ekaula we;s lsÍug mjd m%n, úh' wefußldfõ wdka;%sl-.=o ms<sld ksid fï jk úg 140"000la muK jd¾Islj ñh hk w;r l%ufhka by< hk fï wjodku f;lrïo h;a 2030 jk úg tu ixLHdj fo.=Khla jkq we;ehso" Bg;a fkdfnda l,lskau isjQ.=Khla njg m;a jkq we;ehso mqfrdal:kh fjhs' fï ixLHdf,aLK j,ska ;e;s .;a fi!LH wêldßka wefßldkqjka fï frda.hg k;=ùfï wjodku iïnkaOfhka mÍlaId lrk jhi wjq' 50 isg 45 olajd wdikakhg f.k taug mshjr .;af;ah'
ffjoHjrhd fldf,dfkdiafldms mÍlaIKhla isÿ lr wjodkfï jdish frda.shdg w;am;a lr fokjd'
lshk ldrKh úksYaph lrkakg mq¿jks'
uyd nvje,a j, ms<sld we;s fjkjdo lsh, fidhd n,k u<my mÍlaIK ;sfhkjd' Th Stool Based Screen Tests lshkafk;a ´jg ;uhs' Occult Blood, M2PK wdoS úúO mÍlaIK uyd nvje,a j, we;sjk ms<sld iïnkaOfhka bÕs imhkjd' ta;a fldf,dfkdiafldms mÍlaIKh ksYAÑ; mÍlaIKhla' thg jvd;a ksjerosj Tfí wka;%fha ms<sldjla" ms<sldjla we;sùfï wjodkula n,.ekafjkjdo
wefußldfj jhi wjq' 45 fjkúg yeu mqrjeisfhlaf.au fldf,dfkdiafldms mÍlaIdjla lr.kakg ks¾foaY lrkjd' tx.,ka;fha;a Th fjk;a mÍlaIKhlska
doctormagazine.lk
November 2020
DOCTOR MAGAZINE
23
D•Magazine /
Colon Cancer uyd nvje,a ms<sld
bÕshla ,enqfKd;a oaú;Shsl mshjrla úosyg ta yefudagu fldf,dfkdiafldms mÍlaIKhla lrkjd' yenehs wfma rfÜ tfyu nvje,a ms<sld úuikak wksjd¾h Screen mÍlaIKhla flfrkafk kE' mshhqre ms<sld j,g" .eíf., ms<sld j,g iuia; ck.ykh wdjrKh jk wdfõlaIKhka isÿ jqK;a ;ju;a wdka;%sl ms<sld iïnkaOfhka tjka jev ms<sfj,la kE' th úYd, jYfhka uqo,a jehjk iïm;a jehjk Ndr¥r lghq;a;la jk w;r oshqKq fjñka mj;sk wd¾Ólhla ;sfhk wfma rgg orkakg ;rula wudre lul=;a ;sfhkjd'' ta;a frda. ,laIK tlal tk yeu frda.sfhlagu wms fï iïnkaO mÍlaIdjka lrkjd' jhi wjq' 45g jeä kï wms fldf,dfkdiafldms mÍlaIdj tu frda.Ska fjkqfjka isÿ lrkjd' 45g wvq whg Flexible Sigmoidoscopy lshk mÍlaIdj isÿ lrñka nvjef,a jï me;a; ksÍlaIKh lrkjd'
24
November 2020
uq,a wjia:dfõ we;s fmd,sma bj;a lrk l%ufõoh Snare Polypectomy
,xldfj ishhg 80lg muK nvjef,ys we;sjk ms<sld we;s jkafka nfâ jï me;af;' fï ksid Sigmoidoscopy mÍlaIKhlska jqK;a tajd myiqfjka yªkd.; yelshs' wfma rfÜ f;jekshg olskakg ,efnk ms<sldj uynvje,a ms<sld ms<sld wfma rfÜ iq,n;djh .;a l< f;jeks ia:dkfha ;sfnk ms<sldjhs' ta;a fï ldKAvfha ms<sld ful, fõ.fhka jHdma; jk keUqrejla ;sfhk ksid fï ia:dk bosß ld,fha bosßhg meñKSfï bvlao ;sfnkjd' uy nvje,a ms<sldj - iqj lrkak jeä wjia:djla we;s ms<sldjla we;eï ms<sld iïnkaO m%;sldr j,oS tu ms<sldj fiiq bkaøsh j,g me;sr f.dia ;sfí kï ms<sldfjka frda.shd .,jd .kakg .kakd W;aidyh ÿ¾j,hs' túg ffjoHjreka isÿ lrkafka fõokd iuk m%;sldrhs' (Palliative Care) ta;a lshkak i;=gqhs fï uy nvje,a ms<sldj lsishï wjhjhlg jHdma; jqK;a W;aidyh w;ayßkafka kE' wlaudjg" fmKy¿ j,g hf:dala; ms<sldj me;sr .sh;a ffjoHjreka m%;sldr lrkafka frda.shd fyd| lrkakhs''' iqjm;a lrkakhs' (Curative Treatment)
DOCTOR MAGAZINE
doctormagazine.lk
úlsrK Ñls;aidj fmdÿfõ Ndú;d fkdflf¾
mqreIhka w;r iq,nh
we;sjk wjia:d fnfyúka iudkh
ia;%s" mqreI fomd¾Yajhgu fmdÿh
iudkh m%fõKsl iïNjhla ;sfí
wjodkï idOl
Y,Huh md,kh wmyiq fkdfõ
iudkh frda. ,laIK
myiqfjka fjk;a wjhj j,g me;sr hhs
iqjm;a lsÍu ÿIAlrh
ÿï yd u;ameka mdkh uy nvje,a ms<sld yd .=o ms<sld ixixokd;aul ú.%yhla
ms<sldj iqjm;a lrkakg isÿ lrk m%;sldr ms<sldjg lrk uQ,sl m%;sldrh Y,Hl¾uhhs' bkamiqj ms<sldj uev meje;aùfï wNs,dIfhka my; m%;sldro wjYH;djh wkQj ffjoHjrhd úiska ie,iqï lrkjd' ² Radiotheraphy ² Chemotheraphy ² Imunotherapy fuhska f;jekak tla tla mqoa.,df.a iqúfYaIS ;;a;ajhka iudf,dapkh lrñka isÿ lrk kjH m%;sldr l%uhla' wjodkï idOl .ek oeKQj;a fjuq uynvje,a ms<sld we;s jkakg fya;= /ila n,mdkjd' wm ta .ek;a wjfndaOhla .ksuq'
doctormagazine.lk
ia:q,;djh uQ,sl wjodkula ia:Q,;djh uynvje,a ms<sld ú;rla fkdfjhs" fjk;a fndfyda ms<sld j,g;a''' fjk;a fnda fkdjk frda. j,g;a ia:q,;djh w; jkkjd' fï ksid ksis YÍr nrla mj;ajd .ekSu flfryS fjfiia wjOdkhla fhduq lrkak' úfYAIfhkau wo ld,fha orejkao úYd, jYfhka ia:q,;djfhka fmf<kjd' fï wh bosßfhaoS wjodkï iy.; frda. j,g f.dÿre ùfï wjodku jeähs'
November 2020
DOCTOR MAGAZINE
25
D•Magazine /
Colon Cancer uyd nvje,a ms<sld
fï ksid mqxÑ ld,fhaoS hym;a wdydr mqreÿ" jHdhdu wdosh mqreÿ lrñka ys;lr YÍr nrla mj;ajd .ekSug uõmshkS Tn Bg mshjr .kak'
uy nvje,a ms<l s dj uq,a wjia:dfõ y÷kd.;fyd;a myiqfjka u¾Okh lrkakg mq¿jka ms<l s djla' th me;sr .sh;a ffjoHjreka Bgo ms<h s ï fhoSug isák ksid fï ms<l s dj wo kùk ;dlaIKh;a iu.ska id¾:lj yeisrúh yels ms<l s djla njg m;aj ;sfnkjd' ta;a ms<l s djla lshkafka fi,a,ula fkdfjhs" th uev meje;aùug ixlS¾K m%;l s ¾u fhdokjdg jvd uq,a wjia:dfõoSu wjYH md,kh we;s lsÍuhs jvd;a jeo.;a'
26
November 2020
uy nvjef,a isÿ lrk ie;alï
ieliQ wdydr-fidfiacia" yeï fílka ieliQ wdydr (Processed Food) Ndú;h;a uyd nvje,a ms<sld we;=¿j" ms<sld j,g iDcq iïnkaO;djhla ;sfnkjd' fidfiacia" yeï fílka b;d wjodkula orKjd' fïjd ks;r ks;r wdydrhg .kak tmd' úfYaIfhka fï ieliQ wdydr Tfí orejdg yqre lrkak tmd' ² ÿïmdkh isÿ lrkjd kï thska ñfokakg mshjr .kak' ² u;ameka j,ska ñfokak mq¿jka kï th;a fndfydu fyd|hs' ² fl|s iys; wdydr jeäfhka wdydrhg .kak' t<j¿ yd m<;=re j, ;ka;= wka;¾.;h jeähs' ² Tfí mjqf,a ióm;ufhla fï nvje,a ms<sldjg óg fmr k;=ù isákjd kï Tn;a jeä wdrlaIdjla fhdod .kak' ueos jhfiaoSu mÍlaIK j,g Ndckh jkak' fï frda.hg cdk.; iïnkaOhlao mj;akd nj m¾fhaIK j,ska fy<sorõ ù ;sfnkjd' uy nvjef,a ms<sldjla we;s úg isÿ lrk ie;alï uy nvjef,a lrk ie;alï wo b;d oshqKQ uÜgulg meñK ;sfnkjd' uy nvjef,a lrk ie;alï j,g
DOCTOR MAGAZINE
doctormagazine.lk
t;rï leue;a;la fkdolajk fya;=jla ;sfnkjd' uynvje, fldgila bj;a l< miq ndysßka u< fldgia r|jd .kakg isÿfõo hk ldrKh'
nvjef,ys fldgila bj;a lsÍfuka miq kej;;a th iqyqre f,i hd lrñka .=oud¾.h Tiafia isÿlr ie;alu ksudjg m;a lrjk (TaTME) ie;alu' fï ksid iafgdaudjla Tiafia YÍrhg mßndydßka u< r|jd .ekSu isÿ l< hq;= ke;'
kuq;a wo jk úg nvje,a hd lsÍfï ;dlaIKh fï jk úg b;d oshqKQhs' Staplers u.ska nvje,a msßoaoSu fukau kjH ie;alï ;dlaIKhka ksid tjka wjia:d we;s jkafka wvqfjka' isÿ lrk ie;alu ;SrKh lrkafka msysà ia:dkh yd th jHdma;j we;s m%udKh mokï lrf. khs' Polypectomy uq,a wjia:dfõoS kï fmd,sfmlagñ lshk ie;alu isÿ lrkjd'
TaTME ie;alu i|yd .=oud¾.h Tiafia m%úYAG jk wdldrh
frda.S fldgia bj;a lsÍfuka miq kej; wka;% fldgia mqreoaok Stapler tl
doctormagazine.lk
Hemi/Segmental colectomy fuysoS ffjoHjrhd úiska ms<sldj wvx.= Tfí nvjef,a jï me;af;a fyda ol=KQ me;af;a fldgila lmd bj;a lrhs' nvjef,a fyda .=o ud¾.fha ksfrda.S fldgia kej; iïnkaO lsÍug fndfyda úg yels fõ' fuh ,emfrdiafldms l%uhgo fndfyda úg isÿ l< yels ùu buy;a jdishls'
November 2020
DOCTOR MAGAZINE
27
D•Magazine /
Colon Cancer uyd nvje,a ms<sld
ms<sldfõ mej;Su i<ld n,ñka uyd nvjef,a ueo fldgi bj;a lsÍu g%dkaiaj¾ia fldf,lagñ hkqfjkao" is.afudhsâ fldgi bj;a lsÍu is.afudhsâ fldf,lagñ hkqfjkao" .=o ud¾.fha by< fldgi lmd bj;a lsÍu wekaàßh¾ ßfilaIka hkqfjkao yªkajkjd' Trans Anal Surgery (TaTME) fuu ie;alu .=o ud¾.h yryd isÿ lrk w;r id¾:l f,i kej; lemqï mqreoaokakg yels jk fia jeä oshqKQ l< ;dlaIKlska hqla; ùu fuys we;s úfYAI;ajhla' fndfyda fofkla nvje,a j, ie;alula lsõju lsishï pls;hla olajkjd' fydh, n,k úg Bg fya;=j meyeos,shs' zzTmf¾Ika tflka miafi u< nE.a tl r|jf.k bkak fjhso okafk kE''ZZ nvje,a lemqju we;eï jsg iafgdaud újrhlska fldf,diagñ nE.a tlla r|j.kak fjkjd' ta;a oeka fï ie;alï fndfydauhla fj,djg fldf,diagñhla ke;sju uq,a wjia:dfj mqreoaok taj' ;djld,sl odkak jqK;a ta nE.a tl blauKska whska lrkjd' fï ksid uynvje,a ie;alug bosrsm;a fjkak lsisfia;au pls;hla we;s lr.; hq;= kE''
28
November 2020
DOCTOR MAGAZINE
miqigyk uy nvje,a ms<sldj uq,a wjia:dfõ y÷kd.;fyd;a myiqfjka u¾Okh lrkakg mq¿jka ms<sldjla' th me;sr .sh;a ffjoHjreka Bgo ms<shï fhoSug isák ksid fï ms<sldj wo kùk ;dlaIKh;a iu.ska id¾:lj yeisrúh yels ms<sldjla njg m;aj ;sfnkjd' ta;a ms<sldjla lshkafka fi,a,ula fkdfjhs" th uev meje;aùug ixlS¾K m%;sl¾u fhdokjdg jvd uq,a wjia:dfõoSu wjYH md,kh we;s lsÍuhs jvd;a jeo.;a' yenehs" fï uy nvje,a ms<sldj yefokakg we;s wjia:d wju lrñka ms<sld wjodkfuka ñfokakgo úmq, wjia:djla Tng ;sfnk nj;a Tn lsishï fudfyd;l fyda wu;l l< hq;= kE''' lk fndk foa" cSú;h .; lrk úosy fjkia lr.kak'''' th cSú;h id¾:l lr.kakd u. ue lSfjd;a ksjeroshs' DM
doctormagazine.lk
Theme of the Month
World Diabetes Day November 14 oshjeähdj yeÿKQ wh fyd|ska md,kh lr.ksuq fkdyeÿKQ wh yefokakg we;s bvlv wjqruq iEu j¾Ihlu fkdjeïn¾ 14 osk zzf,dal oshjeähd oskhZZ jYfhka kïlr ;sfí' f,dal ck.ykfhka ñ,shk 425l ck;djla oshjeähdfjka fmf<k w;r 2016 j¾IfhaoS fï frda.fha ixl+,;d ksid ñheÿKQ ixLHdj ñ,shk 1'6ls' oshjeähd frda.Ska oeKQj;a lsÍu yd jvd hym;a m%;sldr ,ndoSu wruqKQ lrf.k f,daljdiSka fuu oskh iurhs' fuu fldúâ 19 wNsfhda.d;aul iufhaoS fï oskh iïnkaO uyck l%shdldrlï iSud lrkakg isÿjk fyhska oeKQj;a ùfï jevigyka i|yd m%uqL;ajhla ,nd oS ;sfí'
2006 j¾Ifha isg fkdjeïn¾ 14 zzf,dal oshjeähd oskhZZ jYfhka tlai;a cd;Skaf.a ixúOdkh jYfhka kï lr ;sfí' reêrfha iSks hdukh lrk bkaishq,ska iïnkaOfhka uq,skau fidhd.;af;a Y%Su;a f*âßla nekaáka yd pd,aia fniaÜ hk m¾fhaIlhka úisks' fkdjeïn¾ 14 osk zzf,dal oshjeähd oskhZZ jYfhka kï flrefKA fuys m%uqL m¾fhaIK ld¾hhl ksr; jQ Y%Su;a f*âßla nekaáka ckau oskh toskg fhoSu uq,a lrf.k Tyqg Wmydrhla jYfhks
30
November 2020
DOCTOR MAGAZINE
oshjeähd frda.Ska iqjm;a lsÍfuys,d fyo mrmqf¾ lemùï iy.; ld¾hNdrhg f.!rjhla fjñka 2020 f,dal oshjeähd oskh f;audj jYfhka NURSES MAKE THE DIFFERENCE hkak fhdodf.k ;sfí'
doctormagazine.lk
D•Magazine /
Diabetes oshjeähdj yefokak fmr thska j<lskakg mshjr .ekSuhs jeo.;a'''
oshjeähdj yefokak fmr thska j<lskakg mshjr .ekSuhs jeo.;a'''
cSjk rgdfõ jeros ksid wfma ck;dj jeä jeäfhka oshjeähdjg k;= fjkjd''' oshjeähdj úfYaI{ ffjoH fkdfh,a fidauiqkaorï MBBS, MD, FRCP, FCC, FSLCE
doctormagazine.lk
November 2020
DOCTOR MAGAZINE
31
D•Magazine /
Diabetes oshjeähdj yefokak fmr thska j<lskakg mshjr .ekSuhs jeo.;a'''
fld<U wjg ck;djf.ka 20]lg Èhjeähdj ;sfnk nj' ta jf.au 60]la muK ;rndre wh bkakjd' wfma rfÜ whg fuh je<f|kafka cdk fjkialï j,g jvd Ôjk rgdfõ fjkialï ksid njhs fmfkkakg ;sfnkjd''' ,xldfõ jf.au ol=Kq wdishdfõ ck;djf.a cdk iïnkaO m%Yakhla oshjeähdj fu;rï iq,n lsÍug fya;= jk nj;a fmfkkak ;sfnkjd''' wfma rfÜ uqia,sï m%cdj w;r;a ;rndrelu iy Èhjeähd wjodku jeä nj fmfkkjd' Tjqkaf.a wdydr rgdj yd Ôjk rgdj fuhg fya;= úh yelshs' reêr iSks uÜgu 90mg/dlg jvd jeäjkafka kï mßiaiï úh hq;=hs' HbA1C lshk reêr mÍlaIdj 5'4g jeä w.hla .kafkakï th mQ¾j Èhjeähd ;;a;ajh f,i y÷kajkjd' ffjoH;=uks" idlÉPdjg m%fõYhla úÈhg Èhjeähdj lshk frda.h .ek lsishï ye¢kaùula lf<d;a''' Èhjeähdj lshk frda.h fï jk úg ,xldj mqrdu wêl f,i oelsh yelshs' wms miq.sh Èkj, lrmq iólaIKhlska fy<sjqKd fld<U wjg ck;djf.ka 20]lg Èhjeähdj ;sfnk nj' ta jf.au 60]la muK ;rndre wh bkakjd' Tjqkag;a Èhjeähd wjodku jeähs' tfiau oeka wmg fmfkkakg ;sfhkjd uy; whg jf.au flÜgq whg;a fuh je<¢h yels nj''' wfma YÍrfha cdkj, fjkialï ksid Èhjeähdj je<f|kjd' kuq;a wfma rfÜ whg fuh je<f|kafka cdk fjkialï j,g jvd Ôjk rgdfõ fjkialï ksid njhs fmfkkakg we;af;a' óg wjqreÿ ishhlg muK fmr wm iudcfha ;snqKq Ôjk rgdj yd j;auka Ôjk rgdj w;r we;af;a úYd, fjkila' wdydr mqreÿ" le,ß mßfNdackh" YÍrh fjfyijk m%udKh hkd§ ish¨ foa ld,h;a iuÕ fjkia ù ;sfnkjd' fï fya;=j ksid ;uhs wmsg jeämqr Èhjeähdj iy wfkl=;a fnda fkdjk frda. je<f|kafka'
32
November 2020
DOCTOR MAGAZINE
Èhjeähdj je<£ug jeä wjodkula we;af;a fudk jf.a whgo@ ,xldfõ Èhjeähdj je<f|k wdldrh foi ne¨jdu wmg lshkak mq¨jka ,xldfõ jf.au ol=Kq wdishdfõ ck;djf.a cdk iïnkaO m%Yakhla we;s nj' w;S;fha isg wfma YÍr yqre ù we;af;a wvq Yla;s m%udKhla ,ndf.k jeäfhka jev lsÍughs' kuq;a oeka fï ;;a;ajh fjkia ù ;sfnkjd' oeka wfma le,ß mßfNdackh wêlhs' kuq;a Yla;sh jeh lrkjd wvqhs' fuh wfma Èhjeähd wjodku jeä ùug tla fya;=jla' uu uq,ska i|yka l< wdldrhgu ;rndre whg;a Èhjeähd wjodku jeähs' tfukau" jhia.;ùu;a iu. Èhjeähdj je<£fï m%jK;dj jeäfjkjd' ta jf.au wfma rfÜ uqia,sï m%cdj w;r;a ;rndrelu iy Èhjeähd wjodku jeä nj fmfkkjd' Tjqkaf.a wdydr rgdj yd Ôjk rgdj fuhg fya;= úh yelshs' ta yereKq úg" .¾NKS iufha Èhjeähdj je<÷Kq ldka;djkag yd Polycystic
doctormagazine.lk
2020 c.;a oshjeähd oskfha f;audj jkafka zzfyoshka we;s lrk fjkiZZ NURSES MAKE THE DIFFERENCE hkakhs' f,dalfha fi!LH ld¾h uKAv, j,ska yß wvlg;a jeäfhka ksfhdackh lrkafka fyoshkah' frda.S Wmia:dkfhys,d tod fuod ;=r wkNsNjkSh ld¾hNdrhla isÿ lrk fyo mrmqr oshjeähd frda.Ska iqjm;a lsÍfuys,d o isÿ lrk jákd fufyjr fujr oshjeähd oskfhaoS fjfiiskau f,dal m%cdjf.a f.!rjdorhg m;% jkq we;'
Ovary Syndrome hk frda.S ;;a;ajh je<÷Kq ldka;djkag;a miqld,Skj Èhjeähdj je<£fï wjodku jeähs' ffjoH;=uks" Èhjeähd ;;a;ajh l<ska y÷kd. ekSug l<yels mÍlaIK ;sfnkjdo@ Tõ''' idudkHfhka wms Èhjeähd ;;a;ajh we;sjqKd hehs i<lkafka reêr iSks uÜgu 126mg/dl hk w.hg jvd jeä jQ úghs' th wmg ksrdydr reêr iSks mÍlaIdjlska oek.; yelshs' ta jf.au HbA1C lshk reêr mÍlaIdfjka udi ;=kl reêr iSks md,kh .ek oek.; yelshs’ Èhjeähd ;;a;ajh tlajru we;sjkakla fkdfjhs' th ld,hla ;siafia YÍrh ;=< we;sjkakla' b;ska hï flfkl=g bkaishq,ska m%;sfrdaë;d ,laIK" tkï Worh fkrd tau" wlaudfõ f;,a ;ekam;a ùu" fn,a, m%foaYfha yu l¿ meye ùu jeks ,l=Kq we;akï ie<ls,su;a úh hq;=hs' .eyekq whg .¾NKS iufha Èhjeähdj fyda Polycystic Ovary Syndrome je<£ ;sfíkï Tjqkao wjOdkfhka isáh hq;=hs' reêr iSks uÜgu 90mg/dlg jvd jeäjkafka kï mßiaiï úh hq;=hs' HbA1C lshk reêr mÍlaIdj 5'4g jeä w.hla .kafka kï th mQ¾j Èhjeähd ;;a;ajh f,i y÷kajkjd' tn÷ wh Èhjeähdj je<£ug wdikak ;;a;ajhg m;aù we;s njhs thska lshefjkafka'
doctormagazine.lk
Èhjeähd frda.h j<lajd .; yelso@ ke;fyd;a th je<£fï wjodku wvq lr.ekSug yelshdjla ;sfío@ Tõ" mQ¾j Èhjeähd ;;a;ajhg m;ajQ flfkl=g" .¾NKS iufha Èhjeähdj fyda Polycystic Ovary Syndrome je<£ ;snQ flfkl=g fyda ;rndre flfkl=g jqj;a oshjeähdj we;sùu j<lajd .; yelshs' Ôjk rgdfõ lrk fjkialï ;=<ska ishhg yeglg oshjeähdj wvq lr.ekSug yelshs' wms lEu .kak wdldrh fjkia lsÍu wjYHhs' ta lshkafka fi!LHu;a lEufõ,la .; hq;=hs' wfma lEu fõf,a ;sfnk t<j¿ m%udKh jeä lsÍu;a fm%daàka ;j fmdä m%udKhlska jeä lsÍu;a"
November 2020
DOCTOR MAGAZINE
33
D•Magazine /
Diabetes oshjeähdj yefokak fmr thska j<lskakg mshjr .ekSuhs jeo.;a'''
ta jf.au msIaGh yd iSks m%udKh wvq lsÍu;a lrkjd kï Èhjeähd frda.h iE§u j<lajd .; yelshs' tfukau jHdhdu lsÍu;a jeo.;a fjkjd' Èkm;d ojilg meh nd.hlaj;a jHdhdu lrkjd kï fyd|hs' fõ.fhka weú§u fyda fiñka Èùu (Jogging) jeks jHdhduhla jqj;a iqÿiqhs' ;rndrelu ;sfnk flfkla kï nr wvq lr.ekSu;a wjYHhs' fnfy;a j,skq;a frda.h j<lajd .ekSu l< yelshs' Metformin, Acrabose jeks fnfy;a th j,ska ishhg y;<sylg muK wvq l< yels nj m¾fhaIK j,ska fmkaj,d ;sfnkjd' kuq;a Ôjk rgdj fjkia lsÍu ;uhs jvd;a id¾:l l%uh jkafka' ffjoH;=uks" Tn;=ud › ,xld Èhjeähd ix.ufha iNdm;s jYfhka lghq;= lrkjd' wfma rg ;=< Èhjeähdj j<lajd .ekSu iïnkaOfhka tu ix.ufha odhl;ajh fln÷ o@ wms fï jk úg;a fndfyda foa lrf.k hkjd' iEu jirlu fkdjeïn¾ 14 cd;Hka;r Èhjeähd Èkh ieuÍu;a iu. úúO jevigyka ls%hd;aul lrkjd' fï jif¾;a Èhjeähd Èkh ckdêm;s;=udf.a iyNd.s;ajfhka iurkjd' ck;dj oekqj;a lsÍfï wruq‚ka fkdjeïn¾ 13 jeksod ksoyia p;=rY%fha isg nKavdrkdhl iïuka;%K Yd,dj olajd Èhjeähd md .ukl=;a mj;ajkjd' leu;s whg ta i|yd iyNd.s jk f,i;a wms wdrdOkd lrkjd' ta jf.au wms ,xldfõ fndfyda m%foaY wdjrKh jk f,i frda.h y÷kd.ekSfï jevigyka mj;ajkjd' ta;a iu.u fi!LHu;a f,i wdydr ms<sfh< lsÍu .ek;a jevigyka ls%hd;aul lrkjd' ,xldj mqrdu mdi,a <uqkaf.a oekqu j¾Okh lsÍu Wfoid rpkd iy Ñ;% ;r.hla o mj;ajkjd' Bg wu;rj wm ix.uh fi!LH wud;HxYh iu. tlaj cd;Hka;r Èhjeähd ix.ufha wdOdr ,ndf.k" fi!LH m%j¾Ok jevigykla l%shd;aul lrkak n,dfmdfrd;a;= fjkjd" fmdÿ ck;dj oekqj;a lsÍu" mdi,a <uqka oekqj;a lsÍu iy fi!LH fiajlhka mqyqKq lsÍu fuu jevigykg we;=<;a' 34
November 2020
DOCTOR MAGAZINE
› ,xldfõ ck.yKfhka ie<lsh hq;= fldgilg Èhjeähd wjodkula mj;sk nj Tn;=ud m%ldY l<d' Èhjeähd frda.h iïnkaO lS¾;su;a úfYaI{jrhl= f,i Tn;=ud wjidk jYfhka wfma mdGlhkag ,ndfok m‚jqvh l=ulao@ Èhjeähdj j<lajd.ekSu mgka.; hq;af;a l=vd ld,fha isguhs' ,xldfõ ish,a,kagu fï wjodku mj;sk ksid l=vd ld,fha isgu fi!LHu;a Ôjk rgdjlg orejka yqre lsÍu wjYHhs' wjqreÿ ;syg jeä ish,a,kau reêr iSks" fldf,iagfrda,a iy reêr mSvkh hkdÈh mÍlaId lr.ekSu ;=<ska Èhjeähdj yd wfkl=;a nrm;, frda.dndO /ilska je<lSug yelshdj ,efnkjd' frda.h je<÷kq miq m%;sldr .kakjdg jvd th j<lajd .ekSu ;uhs jeo.;a' tu ksid wms frda.h j<lajd .ekSug uq,a;ek Èh hq;=hs lshk foa ;uhs ug fokak ;sfhk m‚jqvh jkafka' DM idlÉPd lf<a¦ ixch o is,ajd doctormagazine.lk
D•Magazine /
Diabetes oshjeähdj ksid we;sjk ixl+,;d
Diabetes increases your risk for many serious health problems. The good news? With the correct treatment and recommended lifestyle changes, many people with diabetes are able to prevent or delay the onset of complications.
oshjeähdj ksid we;sjk ixl+,;d fydafudak iy wka;rdid¾. frda. úfYaI{ ffjoH m%idoa lgq,kao
doctormagazine.lk
November 2020
DOCTOR MAGAZINE
35
D•Magazine /
Diabetes oshjeähdj ksid we;sjk ixl+,;d
oshjeähdj wmf.a fjfiia wjOdkh oskQ frda.hla njg m;a jkafka th ksid we;súh yels fjk;a frda. ksihs' isref¾ úúO wjhj j,g we;s úh yels wys;lr n,mEu ksihs' oshjeähd frda.sfhl=g we;súh yels fï ixl+,;d fojeoEreïj oelaúh yelshs' tlla zzoshjeähdj ksidfjkau we;s úh yels ixl+,;dZZ wm fuh Microvascular Complications hkqfjka yªkajkjd' Microvascular Complications oshjeähdj fya;=fldg f.k jl=.vq j, l%shdldß;ajh ÿ¾j, ùu (Diabetic Nephropathy)" oshjeähdj ksid iakdhq ydkshg m;a ùfuka we;sjk ;;a;ajh (Diabetic Neuropathy) oshjeähdj ksid weia j,g fjfiiskau weia j, oDIAÀú;dkh ydkshg m;a fjkakg mq¿jka (Diabetic Retinopathy) ta yereKQ úg we;euqkaf.a mdo,g ydks isÿ fjkak mq¿jka' mqxÑ ;=jd,hla iqj fkdfuka ta ;=jd,h krla ù mdoh lmk ;;a;ajhg mjd m;a fjkakg mq¿jka' fï lshk ,o frda. ish,a,u wka lsisÿ fya;=jla ksid fkdfjhs yqfola oshjeähdj ksidu we;sjk ixl+,;d'
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November 2020
Macrovascular Complications Bg wu;rj oshjeähdj frda.Skag w;sjk ;j;a ixl+,;d ldKAvhla ;sfhkjd' tajd Macrovascular Complications hkqfjka ye|skafjkjd' óg fmr i|yka lrk ,o ixl+,;d ish,a,u we;s jkafka b;d l=vd flaYsl reêr kd, j,' fï fojkqj lshk ,o ixl+,;d oshjeähd frda.Skag ú;rla we;s fjk taj fkdfjhs" ´kEu flfkl=g we;s fjkakg mq¿jka' ta;a oshjeähdj frda.sfhl=g fï lshk ixl+,;d jeä jYfhka we;s fjkakg mq¿jka' fudkjo ta lshk ixl+,;d''' yDohdndO" wxYNd.h" úYd, Ouks wjysr jk Peripheral Vascular Disease lshk ;;a;ajh' fï ish,a,gu n,mdkafka isref¾ ;sfhk idfmalaIj ;rula úYd, Ouks wjysr ùu' oshjeähdj ksid iakdhq ÿ¾j, jk yeá oshjeähdj ;sfnk úg l%u l%ufhka wfma iakdhq wvmK fjkjd' tys hï wjia:djloS oekSï ^ixfõok& wmg fkdoekS ;sfhkak mq¿jka' .,l ll=, jeÿK;a ßfokafk kE' im;a;=jg lems, .syska úYd, ;=jd,hla ;sfhkjd' ta;a okafk kE' .sks uoaoyfk .,a ;,djl hkfldg
DOCTOR MAGAZINE
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,laIKhla fmkakqï fkdlrñka oDIAÀú;dkfha ishqï flaY kd,sld ydks fj,d" taj wjysr fj,d úYd, ydkshla fjkak mq¿jka' wefia ldph yd oDIAÀú;dkh w;r fldgila wïuh rih (Vitreous) hkqfjka ye|skafjkjd' fï fldgfia tlajku f,a .e,Sula we;sfj,d (Vitreous Haemorrhage) weye fmkSu ke;s fj,d hkak mq¿jka'
ll=,g riafk oefkka ´ksfk' ta;a Tjqkag tfyu oefkkafk;a kE' wka;sfïos ll=, msÉfpkjd' fï úosyg ixfõok wvq jqKdu fkdoekqj;aju mdo j, ;=jd, isÿ fjkjd' fï ia:dk j,g reêrh iemhSu ÿ¾j, ùu ksid ;=jd, iqj ùu m%udohka nrm;, úosyg we;s fjkjd' f,a j, iSks jeä jqKdu m%;sYla;slrK yelshdj;a wvq fjkjd' fï ksid;a ;=jd, iqj ùu l,a hkjd' iuyr oshjeähdj frda.Skag fï lsisjla fkdù f,dl= f,a leáhlska reêr .ukd.ukh wjysr jkakg;a mq¿jka' tfyu jqKdu mdo fõ,s,d jf.a .syska weÕs,s tfyu ye,s, hkak mq¿jka' Auto Amputation fuh Ischemic Gangrene hkqfjkao ye|skafjkjd' oshjeähdj fofk;a j,g n,mdkafka fldfyduo@ wms idudkHfhka oshjeähdj ;sfhkfldg wjqreoaolg j;djla wlaIs ffjoHjrfhla yuqfjkak lsh, frda.Skag Wmfoia fokjd' zzfvdlag¾" ug weia j, lsisu je/oaola kE''' fyd|gu fmakjd' uu kï b;ska lKakdähla j;a odkafk kE'''ZZ tfyu lsh, ffjoH yuqj u. yßkjd' fuh frda.S Tn Tngu lr.kak úYd, jrola' oshjeähdj ksid weia wkaO fjklï Tng lsisu frda. ,laIKhla msg;g fkdoefkkak mq¿jka' lsisÿ wk;=reodhl doctormagazine.lk
wfkl ;uhs ld,hla ;siafia we;sjk f,a .e,Sï ksid oDIAÀú;dkh >k ùu' tfyu >k fj,d yels¨kdu iuyr ;ekaj,ska .e,ú,d hkak mq¿jka' fuh Retinal Detachment f,i ye|skafjkjd' fï ksid mQ¾Kj fmkSu ke;s fjkak mq¿jka jf.au we;eï fj,djg oDIaGs m:fha fldgil fmkSu fï ksid ke;s fjkakg bv ;sfhkjd' wdf,dal Odrd hkj" ;srhla yria fjkj jf.a ,laIK fuysoS frda.shdg we;s fjkjd' oshjeähdj ;sfhkjd kï wlaIs ffjoHjrhd uqK .efykak Tng wefya fodaIhla ;sfhkak wjYH kE' jirlg jrla j;a Tn wlaIs ffjoHjrhd yuq úh hq;=uhs' jl=.vq j,g n,mdk oshjeähdj oshjeähd jl=.vq wdndOfhao; S a nrm;, úosyg ydksh fjklï Tng lsiu s oekSula fkdfjkakg mq¿jka'
November 2020
DOCTOR MAGAZINE
37
D•Magazine /
Diabetes oshjeähdj ksid we;sjk ixl+,;d
fuys uq,a wjia:dfõoS laIø Q m%udKfhka uq;d% msg fjkakg mq¿jka' fuh Micro Albumin mÍlaIKfhka muKhs oek.; yels jkafka' fï wjia:dfõoS ta nj oekf.k uekúka iSks md,kh lf<d;a" f,a j, reêr mSvkh md,kh lf<d;a Tng fuhska .e,fjkak mq¿jka' úfYAIfhkau lsj hq;h = "s f,a j, fm%dà a k ldkaÿ ùu j<lajk úfYAI fnfy;a ;sfhkjd' fï woshr mekafkd;a fm%dà a k úYd, jYfhka ldkaÿ jk wjia:dfõoS Macro albuminuria fï wjia:dfõoS jeisl, s s hk úg fmk jf.a we;s fjkjd' bka miqj mdo bosfuk wjia:dj ;sfnkjd' uqyK q bosfukjd' nrm;, f,i jl=.vq ydkshg m;a fjkjd' oshjeähdj ksid ,sxf.akø a h s j,g we;sjk .eg¿ oshjeähdj ksid ,sxf.akø a h s j,g we;sjk .eg¿ w;r mqreIhkaf.a ,sx.sl ÿn,;d m%Odkhs' ,sx.sl wm%dKsl;ajh fuysoS we;s fjkakg mq¿jka' fuhg fya;= folla ;sfnkjd' ld,dka;rhla ;sif a ia we;sjk iakdhq ÿ¾j, ùu fuhg n,mdkjd' oekSu ixfõok we;s lrk iakdhq ÿ¾j, ùfuka lsih s ï n,mEula we;s fjkakg mq¿jka'
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November 2020
iSks úYd, jYfhka jeä jQ úg os,Sr wdidok we;s fjkjd' ;=jd, yg .ekSu" fmr iu me,Su jeks ;;a;ajhka we;súh yelshs' iSks md,kh;a kshñ; T!IO .ekSu;a fuysoS jeo.;a fjkjd' iakdhq moaO;sfha fojeoEreï jQ l%shdldß;ajhla ;sfnkjd' tlla wfma wkqoeKQu we;sj isÿ lrk l%shdjka' w; tiùu" hula wyq,d .ekSu wm lrkafk ta úosyg' yDoh .eiau" Yajikh jeks l%shdjkag;a iakdhql n,mEula ;sfnkjd' kuq;a th isÿ jkakg wm n,mEula lrkafk kE' fï ldKAv foflau iakdhq oshjeähdj ksid ydkshg m;a fjkjd' ,sx.sl jYfhka m%dKj;a nj we;s jkakg fya;=jk iakdhq;a fuysoS wvmK fjkjd' túg ,sx.sl ld¾hhg wjYH ,sxf.akaøsh m%dKj;a Ndjh fkd,efnkakg mq¿jka' fuh wksÉPdkq. l%shdldß;ajhla jYfhka ta ksid wm yªkajkjd'
DOCTOR MAGAZINE
doctormagazine.lk
fï ksid oshjeähdj frda.k S a wfkla whg jvd yoj;a frda. j,ska iq/ flkakg ´ks' yoj; ñ;=re l%u j,g hkak ´ks' oshjeähd frda.k S g a ffjoHjreka úfYAI wdrlaIl Wmdhud¾. wkq.ukh lrkjd ffjoHjreka jYfhka wm;a oshjeähdj ;sfnk úg frda.k S g a fjfiia wdrlaIl l%h s dud¾. .kakjd' idudkH flfkla yg fldf,iagfrda,a fnfy;a mgka .kafk LDL uÜgu 16-190 ú;r jqKdu' ta;a Tyq oshjeähdj frda.f s hla kï LDL w.h 100 bl=;a jqKdu wms fldf,iagfrd,a T!IO wdrïN lrkjd'
fï .eg¿j fndfyda ÿrg újD;j l;dnyg ,la fkdjk ldrKhla' fndfyda fokd ryfia ,;fjk ldrKhla' ta;a tfia úh hq;= fkdjk nj ud m%ldY lrkak leu;shs' oeka fï flafIA;%fha fndfyda fjkialï isoaO fj,d ;sfnkjd' fï iïnkaOfhkau ms<shï fhdok ffjoHjreka isákjd' fkdfhl=;a T!IO" m%;sldr l%u ;sfnkjd' reêr kd, wjysr jqKdu taj bj;a lrkak" uekúka j¾Okh lrk m%;sldr mjd oeka ;sfhkjd' fï ksid oshjeähdfjka fmf<k Tng Tfí ,sxf.akaøsh iïnkaOfhka lsishï .eg¿jla ;sfnkjd kï Tfí ffjoHjrhd iu. ta .ek újD;j l;d lrk f,i wm b,a,d isákjd' oshjeähdj frda.Skag we;súh yels yDohdndO wjodku oshjeähdj frda.Skag we;súh yels yDohdndO wjfYAI mqoa.,hkag we;sjk yDohdndO j,g jvd ;rula fjkia jkjd' tlla ;uhs oshjeähdj frda.Ska yg wvq jhiska yDohdndO we;sùfï wjodkula ;sfhkjd' wfkl ;uhs oshjeähdj frda.Skaf.a lsÍgl Ouks tlla folla fjkqjg úYd, m%udKhla wjysr ùu''' tfiau lsisu frda. ,laIKhla ke;sj fï whg yDohdndOhla we;s fjkakg mq¿jka' iuyr frda.k S a bkakjd''' wm <Õg tk wjia:dj jk úg yDo wjysrùï lsym s hlau fmr we;s fj,d ;sfhkak mq¿jka'
doctormagazine.lk
wjq' 55-60 ú;r jk úg wêlreêr mSvkh" fldf,iagfrd,a ;sfnkjd kï f,a leá .eiSu wvq lrk'' mÜáld tl tl ne|Su wvq lrk weiamß s ka" laf,dmsfvdf.%,a jeks T!IO yDohdndO je<elaùu wruqKQ lrf.k ,nd fokjd' wefußldkq oshjeähdj ix.ufha ud¾f.damfoaYK j,g wkQj wjq' 40 mekmq yefudagu''' fldf,iagfrd,a we;;a ke;;a fldf,iagfrd,a T!IO ,ndoSfuka yDohdndO wvq lrkakg th msgj q y,la jk nj m%ldY lr ;sfnkjd' oshjeähd frda.Skaf.a wxYNd. wjodku oshjeähd frda.Skag wxYNd. wjodku;a fiiq whg idfmalaIj fndfydu
November 2020
DOCTOR MAGAZINE
39
D•Magazine /
Diabetes oshjeähdj ksid we;sjk ixl+,;d
jeähs' yoj;a frda. j,ska je<flkakg fhdok ta Wmdhud¾.u fuysoS wxYNd.h je<elaùug;a iEfykjd' ÿïmdkh .ek fuysoS fjfiiskau u;la l< hq;=hs' oshjeähd frda.sfhla kï is.rÜ fndkj fkdfjhs is.rÜ fndk flfkla <Õj;a bkak tmd' ta ;rugu fï isß; oshjeähd frda.Ska yg ydkslrhs' iSks uÜgu úYd, jYfhka wvqjùfï wjodkula oshjeähd frda.Skaf.a wdydr" T!IO wdosh kshñ; m%udK j,ska fkd.;af;d;a fï whf.a iSks fnfyúka my; jeàfï ;;a;ajhl=;a meK k.skak mq¿jka' fuh zzyhsfmd.a,hsisñhdZZ jYfhka yªkajkjd' oyäh oeóu" la,dka;h jeks wñysß w;aoelSï rdYshlg fuysoS frda.shd uqyqK mdkjd' fuhg blauKska ms<shï fkdfhÿfKd;a isys
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November 2020
uq¾Pdùula olajd jQj;a hkakg mq¿jka' oshjeähdj ksid we;sjk isys uq¾Pd ùï folla ;sfnkjd' iSks fnfyúka wvq ùfuka we;sjk isys uQ¾Pd ùu yd iSks fnfyúka jeäùfuka we;sjk isys uQ¾Pd ùu' fï folu fyd| kE' fï ksid Tfí W;aidyh úh hq;af;a ksrka;rfhka reêr.; iSks w.hka ys;lr w.hlu mj;ajd .ekSuhs' u;la l< hq;= iqúfYAIs lreKla ;sfnkjd' yhsfmd.a,hsiSñhdfõoS wms jydu iSks álla" meKs ri álla lkakg fokjd' ta;a isys uQ¾Pd jqKdu tfyu lrkak tmd' túg l< hq;af;a jy jyd frda.shd frday,lg f.k hduhs' oshjeähdj frda.Ska fï ixl+,;d j,ska ñfokak ksrka;rfhka iSks md,khla we;s lr.kak ´ks' ysf;k ysf;k wdydrmdk .kak fyd| kE' Tfí frda.hg .e,fmk úosyg lEu rij;aj lkak;a wjia:dj ;sfhk tfla krl foaj,a lkak tmd' ffjoHjrhd Wmfoia fok wdldrhgu T!IO mdúÉÑhg .kak' kshñ; idhk j,g iyNd.s ùu jf.au Wmfoia fok wdldrhg mÍlaIK j,g Ndckh ùu;a yßu jeo.;a' Tfí wej;=ï-mej;=ï''' p¾hdjka ksishdldrj mj;ajd .ekSu;a fuysoS w;sYhska jeo.;a fjhkjd' oshjeähdjg ÿïmdkh fyd|u kE' uoHidr wêlj mdkh lsÍu;a fyd| kE' DM https://youtu.be/5vfMkRw3ltg
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D•Magazine /
Diabetes Test Èhjeähdj frda.fhaoS Ndú;hg .efkk reêr mÍlaIK
Èhjeähdj frda.fhaoS Ndú;hg .efkk reêr mÍlaIK Fasting Blood Sugar Test
ksrdydr reêr iSks mÍlaIdj ffjoH os,laId lkaof.a Fasting Blood Sugar (FBS) ke;akï ksrdydr reêr iSks mÍlaIKh ljqre;a okak ffjoH mÍlaIKhla' f,a j, iSks m%udKh uek ne,Su ;uhs fï mÍlaIKfhka flfrkafka' f,a j, iSks jeäùu tfyu;a ke;akï Èhjeähd frda.h úksYaph ^Diagnosis& i|yd;a" Èhjeähd frda.sfhl= f,i y÷kd.;a mqoa.,fhl=f.a m%;sldr j,g wkqj f,a j, iSks uÜgu md,kh ùu oek.ekSu i|yd;a fï mÍlaIKh fhdod.kakjd'
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November 2020
DOCTOR MAGAZINE
doctormagazine.lk
oshjeähd frda.sfhl= jYfhka lsishï ;eke;af;l= yªkd .ekSug n,mj;ajk ks¾Kdhl lsysmhla fuys oelafõ'
fï i|yd wju jYfhka meh 8la fyda Wmßu meh 12la ksrdydrj isàu wjYH fjkjd' ta w;r;=r c,h mdkh lrkak mq¿jka' FBS test tfla w.h ,nd fokafka fvis ,Sgrhg ñ,s .%Eï ^mg/dl& fyda ,Sgrhg ñ,s ujq, ^mmol/l& lshk tall j,ska' jeäysáfhl= i|yd FBS w.hka my; mßÈ oelafjkjd' idudkH ^Normal& 70-100mg/dl-100mg/dl g jvd wvq& ^4'1-5'6 mmol/l& mQ¾j Èhjeähdj ^Pre diabetes& 100-125mg/dl ^5'6-6'9 mmol/l& Èhjeähdj^Diabetes& 126mg/dl ^7mmol/l& fyda Bg jeä wêl msmdih" wêl nv.skak" nr wvqùu" rd;%s ld,fha§ kskafoka wjÈù jßka jr uq;%d lsÍu jeks Èhjeähdfõ frda. ,laIK we;s mqoa.,fhl=f.a FBS
doctormagazine.lk
November 2020
DOCTOR MAGAZINE
43
D•Magazine /
Diabetes Test Èhjeähdj frda.fhaoS Ndú;hg .efkk reêr mÍlaIK
meh 8-12la ksrdydrj isàfuka miqj ,nd .kakd reêr idïm,hla weiqf¾ ksfrda.S ;;a;ajhka" mQ¾j oshjeähdj yd oshjeähd frda.Ska yªkd .kakjd
w.h 126mg/dl fyda Bg jeä jk m<uq jd¾;dfjkau Èhjeähd frda. úksYaph isÿ l< yels w;r tu frda. ,laIK fkdue;s mqoa.,fhl=f.a tjeks jd¾;djla ,enqkq úg FBS mÍlaIKh kej; jrla isÿlr tho by< w.hla .kafka kï frda. úksYaph isÿlrkq ,nkjd' Èhjeähd frda.sfhl= i|yd m%;sldr wdrïN lsÍfuka miq f,a j, iSks uÜgu jßka jr mÍlaId lrk w;r th 80-130mg/dl ^4'4-7'2mmol/l& w;r mj;ajd .ekSu m%udKj;a fjkjd'
FBS test tl .ek Tng oeka hï wjfndaOhla we;s' kuq;a frda.S m%;sldrh frda. b;sydih ^History&" frda.shd mßlaId lsÍu ^Physical examination&" mÍlaIKd.dr jd¾;d ^Investigations& iy fjk;a frda.shdf.ka frda.shdg n,mdk lreKq u; fjkia jk ksid lsisúgl jd¾;djla muKla ie,ls,a,g f.k ;ukau T!IO ,nd .ekSu" T!IO fyda ud;%dj ^dose& fjkia lsÍu ^self medication& iqÿiq jkafka kE' ta i|yd ffjoHjrfhl=f.ka Wmfoia ,nd .; hq;= fjkjd' DM
44
November 2020
DOCTOR MAGAZINE
doctormagazine.lk
D•Magazine /
Diabetes Test Èhjeähdj frda.fhaoS Ndú;hg .efkk reêr mÍlaIK
Èhjeähdj frda.fhaoS Ndú;hg .efkk reêr mÍlaIK úfYaI{ ffjoH .hd lgq,kao MBBS, Dip Path, MD (Chem Path), DipRCPPath (UK) jHdêfõo úfYaI{ ffjoH ffjoH m¾fhaIKdh;kfha ffcj ridhk wxY m%Odk
Glycated Hemoglobin (HbA1c) mrSlaIKh Èhjeähdj y÷kd.ekSug isÿ lrk ;j;a reêr mÍlaIKhls HbA1c. fï i|yd ksrdydrj isàu wjYH fkdfõ' fuu mÍlaIKh uÕska f.ù .sh udi ;=kl ld,h we;=<; reêrfha iSks uÜgï ms<sn| woyila ,nd.; yels fõ' Glycated Hemoglobin (HbA1c) hkq l=ulao@ ySfud.af,dìka hkq Tlaiscka YÍrh mqrd mßjykhg WmldÍ jk fm%daàkhls' fuu fm%daàkh reêrfha we;s .aÆfldaia iu. ne|S mj;S' fufia ne|S mj;sk ksidu fï .aÆfldaia y÷kajkafka 'glycated' hkqfjks' fuu Glycated Haemoglobin (HbA1c) j, w.hka uek ne,Sfuka ld,hla uq¿,af,a mej;S reêr iSks m%udKfha idudkH uek ne,Su fuu mÍlaIKfha uQ,O¾uhhs'
doctormagazine.lk
oshjeähd frda.Ska yg fuh w;sYh jeo.;a jkafka fuu w.hka jeäùug iudkqmd;slj oshjeähdj ksid we;súh yels ixl+,;d o by< hk fyhsks' HbA1c mÍlaIKh reêr.; iSks w.hkayS idudkH ksrEmkh jk nj mjikafka wehs@ idudkHfhka r;= reêrdKQ w¿;ajeähdjg fmr i;s 8-12l muK ld,hla YÍrfha mj;S'
November 2020
DOCTOR MAGAZINE
45
D•Magazine /
Diabetes Test Èhjeähdj frda.fhaoS Ndú;hg .efkk reêr mÍlaIK
HbA1c uÜgu f;uil ld,dka;rhl iSks uÜgfuys yeisÍu úoyd olajkjd' fï m%;sM< Tiafia ixl+,;d wjodku iudf,dapkhg yelsùu HbA1c mÍlaIKfha fjfiia jdishla
fï reêrdKQ j,g ne|S we;s ySfud.af,dìka ke;fyd;a Glycated Haemoglobin j, ixLHd;aul w.h uek ne,Sfuka tu r;= reêrdKq j, ne|S we;s reêr iSks m%udKh ksjerosj uek ne,sh yels fjhs' i;s 8-12l ld,hla uq¿,af,a w.hka fuhska ksrEmKh jk ksid fuu w.h tu ld,h uq¿,af,a reêr mSvkfha idudkH f,i ksjerosj wre;a olajkakg yels jkafkah' oshjeähd ixl+,;d md,khg bjy,a jk mÍlaIdjls HbA1c w.hka my; fy<Sfuka úYd, jYfhka oshjeähd ixl+,;d wjodku my; fy<sh yels fjhs' fuu w.h tllska wvq lsÍfuka Reeducing HbA1c by 1% (or 11 mmol/mol) laIqø reêrjdyskS.; frda. (Microvascular complications) ishhg 25l ;rï úYd, m%udKhlska my; fy<Sug bjy,a fjhs' laIqø reêrjdyskS frda. >khg oshjeähd wlaIs wdndOh (Retinopathy)" oshjeähd iakdhq wdndOh (Neuropathy) fukau jl=.vq wdndOo (Diabetic nephropathy) we;=<;a fjhs' .¾NsKS oshjeähdj we;s ldka;djkgo jeo.;a fõ .¾NsKS oshjeähdj we;s ldka;djkgo ;u frda.h iïnkaOfhka fukau tys m%;sM<hla jYfhka we;s úh yels ixl+,;d iïnkaOfhka wjfndaOhla ,nd .ekSug fuu mÍlaIKfhka ,efnkafka wkqmfïh jQ fiajhls' fï wkQj wo ojfia oshjeähd frda.h mÍlaIdjg ,la lsÍug yd tu frda.Ska l<uKdlrKh úIfhys mÍlaIdj thg we;s fyd|u mÍlaIdj fia ie<flhs' flfia fj;;a fuys idudkH ksfrda.S uÜgu iïnkaOfhka úúO u;su;dka;r fï jk úg;a mj;S' DM 46
November 2020
DOCTOR MAGAZINE
doctormagazine.lk
D•Magazine /
Diabetes Test Èhjeähdj frda.fhaoS Ndú;hg .efkk reêr mÍlaIK
Èhjeähdj frda.fhaoS Ndú;hg .efkk reêr mÍlaIK
OGTT mÍlaIKh úfYaI{ ffjoH .hd lgq,kao MBBS, Dip Path, MD (Chem Path), DipRCPPath (UK) jHdêfõo úfYaI{ ffjoH ffjoH m¾fhaIKdh;kfha ffcj ridhk wxY m%Odk
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
November 2020
DOCTOR MAGAZINE
47
D•Magazine /
Diabetes Test Èhjeähdj frda.fhaoS Ndú;hg .efkk reêr mÍlaIK
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'
48
November 2020
DOCTOR MAGAZINE
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
doctormagazine.lk
.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 .kakd ld,dka;ro fjkia wdldr j,ska oelafjhs' ldhsl frda. ffjoHjreka" m%ijfõoSka yd oshjeähd 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'
doctormagazine.lk
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 140 – 199 Pre-diabetes > 200 Diabetes Mellitus DM
November 2020
DOCTOR MAGAZINE
49
D•Magazine /
Urine For Microalbumin Test oshjeähd frda.Skaf.a jl=.vq iqjfi; úuik uq;%d uhsfl%dwe,aìhqñka mÍlaIdj
URINE FOR MICROALBUMIN TEST oshjeähd frda.Skaf.a jl=.vq iqjfi; úuik uq;%d uhsfl%dwe,aìhqñka mÍlaIdj uQ;%d j, b;d iq¿ m%udK j,ska reêr fm%daàka ^we,aìhqñka& mj;skafkao hkak fidhd ne,Sug isÿ lrk mÍlaIKh uq;%d uhsfl%dwe,aìhqñk mÍlaIdj (Urine Microalbumin Test) hkqfjka ye|skafõ' jl=.vq ydkshg m;aùfï jeä wjia:djla iys; Woúhf.a jl=.vq ydkshg m;aùula isÿ jkafkao hkak l,afõ,d we;sj fidhd oek.ekSug fuu uq;%d uhsfl%dwe,aìhqñka mÍlaIdj WmldÍ fjhs' ksfrda.S jl=.vq j,ska reêrh fmÍug ,la lr;aoS we,aìhqñk jeks fm%daàk reêrfhysu r|jd.ekSula isÿ lrk w;r wmøjH muKla uq;%d iu. neyer lrhs' jl=.vq krla fjk úg reêr.; fm%daàko uq;%d j,g ldkaÿ fjhs' jl=.vq thdldrfhka ydkshg m;ajk úg uq;%d j,g tl;= jk m%udKd;aulj uekSug yels fm%daàkhla jYfhka we,aìhqñka ie<lsh yel'
50
November 2020
DOCTOR MAGAZINE
doctormagazine.lk
wdisß frday,a iuQyfha ridhkd.dr wOHlaI kS,a m%sh;a fcdaka úisks
ie<lsh hq;= iq¿ m%udK j,ska uq;%d j,g we,aìhqñka tla/ia ùu Microalbuminaria hkqfjka ye|skafõ' fuh .=ÉÑld fmÍï l%shdj,sfhys ;djld,sl wêOdß;djhla ksido we;súh yel' muK blaujd l%Svdj, ksr; ùu" WK wdoS ;;a;aj ksido oshjeähdj wdoS frda. ksido fï wdldrfhka uq;%dj, we,aìhqñka mej;Sula isÿ ùug bv ;sfí' uq;%d j, wvx.= we,aìhqñk m%udKh uekSu jl=.vq j,g isÿj we;s ydksh .ek wjfndaOhla ,nd .ekSug m%fhdackj;a idOlhls' jl=.vq wdmodjg m;a ùfuka jl=.vq frda.h we;sù jl=.vq wl%Sh ùu olajd th j¾Okh ùug bv ;sfí' fï wdldrfhka jl=.vq l%shd fkdlrk úg tu ld¾hh lD;%Suj isoaO lsÍug frda.shdf.a reêrh
doctormagazine.lk
lD;%Suj msßisÿ lsÍu fkdfyd;a ldkaÿlrkhla isÿ lsÍug (Dialysis) mshjr .ekSug isÿfõ' fï wdldrfhka jl=.vq úYd, jYfhka ydkshg m;aùug fmr frda.h wkdjrKh lr.;af;d;a jl=.vq j,g isÿjk ydksh wju lr .ekSug mshjr .ekSug (Slow the progression) wjia:djla b;sß fjhs' oshjeähdfjka fmf<k ishhg 20-40 w;r frda.Ska ixLHdjla uqyqK mdk .eg¿jla jYfhka oshjeähdj wdY%s; jl=. vq frda.h (Diabetic nephropathy) ye|skaúh yel' Microalbuminaria hkq fuu frda.fha uq,au ix{djhs' tfiau fuh u;= we;súh yels yDoh.; frda.hl wjodkï fmrksñ;a;la jYfhkao Cardiovascular disease (CVD) ie<lSug isÿfõ' uq,skau we;s jkafka Microalbuminaria ;;a;ajhhs' miqj th Macroalbuminaria jYfhkao B<Õg jl=. vq wlrKsh Renal Failure yd wjidkfha wjidk woshf¾ jl=.vq wlrKsh (End stage of renal disease) hk wjia:djgo th j¾Okh fõ'
Tn wêreêr mSvkfhka fmf<kafkla kï Tfí ffjoHjrhd úiska wdrlaIl mshjrla jYfhka fuu Urine Microalbumin mÍlaIKh isÿ lsÍug Wmfoia ,nd fokjd we;' mÍlaIKh i|yd ms<sfh, jk wkaou fuu mÍlaIKh idudkH uq;%d mÍlaIKhls' idudkH wdydr isß;la mÍlaIKhg fmr mj;ajd .ekSu jrola fkdfõ' idudkH uq;%d ksheoshla ,nd osh yel' we;eï fj,djg meh 24la uq¿,af,a tl;= lrk ,o uq;%d idïm,hlska uq;%d ,ndfok f,i b,a,d isáfhd;a muKla tfia isÿ lrkak' Urine Microalbumin mÍlaIKfha fojeoEreï wdldr ydkshg ,lajQ úg Tfí uq;%d fmk iys; iajNdjhlska mshú weig osiafõ' ta yereKQ úg Tfí w;amd" Worh yd uqyqK boSóula olakg ,efí' uq;%d j, we,aìhqñka olakg ,eîu Albuminaria hkqfjka
November 2020
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51
D•Magazine /
Urine For Microalbumin Test oshjeähd frda.Skaf.a jl=.vq iqjfi; úuik uq;%d uhsfl%dwe,aìhqñka mÍlaIdj
wêreêr mSvkh
oshjeähdj
ia:q,;djh yd mrsjD;a;Sh frda.
m%fõKsl jl=.vq frda.
Microalbuminaria frda.hg fya;=
ye|skafõ' uq;%d j, fm%daàk ix>gl iaj,am jYfhka jeäfhka olakg ,eîu Microalbuminaria hkqfjka oelafõ' uq;%d j, úYd, jYfhka we,aìhqñka olakg ,eîu Macroalbuminaria hkqfjka ye|skafõ' Microalbuminaria mÍlaIKfhka ,efnk m%;sM<h oelafjkafka milligrams (mg) hk tall j,sks' tys m%;sM< u; frda. iudf,dapkh my; wdldrfhks' 30 mgg wvq idudkH ys;lr mrdih 30-300mg Microalbuminaria 300mgg jeä Macroalbuminaria
52
November 2020
Tfí fuu mÍlaIK m%;sM< iudf,dapkh lsÍfuka miqj lsishï widudkH m%;sM<hla oek.;a ú.i Tfí ffjoHjrhd kej; mÍlaIKhla isÿ lsÍug kshu lsÍu fyda jHdê.; ;;a;ajh ;yjqre lr.;a miq Bg iqÿiqu m%;sldr ie,iSug mshjr .kakjd we;' Random urine test fuysoS ´kEu fj,djl wyUQ f,i ,nd .kakd uq;%d ksheoshla mÍlaId lsÍu i|yd ,ndosh yel' fuh frda.shdf.a l%sheákska mÍlaIdfjka ,efnk m%;sM< yd iudf,dapkh lrñka mÍlaIdjg ,la lrKq we;' WoEik uq;%d
DOCTOR MAGAZINE
idïm,hla fyda flá úfõlhla ,nd .ekSfuka miqj ,nd .kakd uq;%d idïm,hla ,nd .ekSug Wmfoia fok l,ayS ta wdldrhg lghq;= lsÍu uekú' 24-hour urine test fuysoS meh 24la mqrd msg lrk uq;%d ish,a, fok ,o Ndckhl tl;= lr YS;lrkhl ;nd.; hq;= fõ' Tn fldmuK ld, mrdihlg jrla mÍlaIKh isÿl< hq;=o@ th ;SrKh jkafka Tng ljr wdldrfha frda.hla mj;skafkao@ Tfí jl=. vq ljr wdldrhlg wdmodjg m;aj ;sfío@ wdoS lreKQ u;hs' DM
doctormagazine.lk
Asiri Hospital Holdings PLC The Central Hospital Asiri Surgical Hospital PLC Centres & Labs
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D•Magazine /
Diabetes Test Èhjeähdj frda.fhaoS Ndú;hg .efkk reêr mÍlaIK
Èhjeähdj frda.fhaoS Ndú;hg .efkk reêr mÍlaIK
RBS - Random Blood Sugar wyUq reêr mÍlaIdj fuh ´kEu wjia:djl isÿ l< yels reêr mÍlaIKhls' RBS isÿ lsÍug wdydr .;a fõ,dj i,lkq fkd,efí' ridhkd.drhla u.skao isÿl, yels w;r" ;j;a myiq ir, yd blauka l%uhla jkafka .a¨fldógrfhka lrk mÍlaIdjhs'
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November 2020
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Post Prandial Blood Sugar Test fuh wdydr f.k meh follg miqj isÿ lrk mßlaIKhls' fuuÕska reêrfha iSks md,kh y÷kd.; yel' Fructosmine Test fuu mßlaIKh uÕska miq.sh" tfia;a ke;skï f.ù .sh ojia 20 ;=< reêrfha iSks uÜgï ms<sn| woyila ,nd .ekSug yelshdj mj;S. úfYaIfhkau iSks md,kh lr .ekSu wiSre ;;a;ajhka j, isák msßia i|yd fuu mÍlaIKh wdOdrfhka f.ù .sh Èk 20 l ld,fha reêr.; iSks uÜgu ms<sn|
doctormagazine.lk
oek .ekSfï yelshdj mj;S' fuu mÍlaIKh .eìks ujqjreka yg fndfydaúg isÿ lrk mÍlaIKhls' Èhjeähdj ksid ydks úh yels isref¾ wfkl=;a wjhj ms<sn| fidhd ne,Su i|yd isÿ lrk mÍlaIK Èhjeähdj fya;=fjka reêrfha fldf,iagfrda,a" g%hs.a,sirhsâ wdÈfha jeä ùula isÿúh yel' th yDohdndOj,g fya;=jls' ,smsâ fm%d*hs,a mÍlaIKh uÕska fïjdfha uÜgï ksisf,i mj;skafka oehs ksÍlaIKh lsÍfï yelshdj mj;S' Èhjeähdfjka jl=.vqj,go ydks isÿúh yel' ta wkqj jl=.vq j, l%shdldß;ajh ne,Sug reêr mÍlaIK isÿ lsÍu wjYH fõ' tjeks wjia:dj, reêr idïm, wdOdrfhka reêrfha l%shgkska uÜgu uek ne,su isÿ lrhs' tuÕska jl=.vq uÕska reêrh fmrk fõ.h y÷kd .ekSu isÿjk w;r tys hï fjkila we;akï wod< m%;sldr i|yd fhduq ùu wjYH fõ' Bg wu;rj jl=.vqj, l%shdldrs;ajh y÷kd .ekSug uq;%dj, we,aìhqñka fyda uhsfl%d we,aìhqñka uÜgu ksÍlaIKh lrhs' tuÕska jl=.vq j, hï fjkila fmkakqï lrkafka kï wod< m%;sldr j,g fhduqúh hq;= w;r uq;%d idïm,hla wdY%fhka th isÿ lrhs'
doctormagazine.lk
;jo Èhjeähdj iuÕ wlaud .eg¨ we;s ùfï iïnkaOhlao mj;S' úfYaIfhka *eà ,sj¾ ;;a;ajhlg Èhjeähdj yd iïnkaOhla ;sìh yel' ta i|yd isÿ lrk reêr mÍlaIK yryd wlaud tkaihsu tkï (AST yd ALT) mÍlaId lsÍfuka ta nj ;yjqre lr .eksfï yelshdj mj;S' oshjeähd frda.sfhl= jYfhka lsishï ;eke;af;l= yªkd .ekSug n,mj;ajk ks¾Kdhl lsysmhla fuys oelafõ' meh 8-12la ksrdydrj isàfuka miqj ,nd .kakd reêr idïm,hla weiqf¾ ksfrda.S ;;a;j a hka" mQ¾j oshjeähdj yd oshjeähd frda.k S a yªkd .kakjd' DM
November 2020
DOCTOR MAGAZINE
55
D•Magazine /
Gestational Diabetes .¾NsKS ujg we;sjk .¾NsKS oshjeähdj
Everything You Need to Know About Gestational Diabetes
.¾NsKS ujg we;sjk .¾NsKS oshjeähdj wdydr" jHdhdu fukau we;eï úg T!IO;a fï ;;a;aj md,khg bjy,a fjkjd''' fndfyda uõjreka ore m%iQ;sfhka miq reêr iSks idudkH w.hlg meñfKkjd'''
l=reKE., YslaIK frdayf,a ks¾Kd, frda. úfYAI{ ffjoH iuka;s l=f¾ MD, MRCP Endocrinology & Diabetes
reêrfha .a,Qfldaia ^iSks& m%udKh jeäùu oshjeähdjhs' .aÆfldaia wfma YÍrhg wjYH Yla;sh imhk m%Odk uQ,dY%hla jkafkah' wm wdydrhg .kakd ldfndayhsfâ%g ldKAvhg wh;a mdka" n;a" OdkH" meiagd" m<;=re" msIAGh idr t<j¿" lsß yd fhda.Ü wdosh .aÆfldaia isrerg ,efnk l%uhhs' wdydr cS¾Kh ùfuka miq tajd reêrhg tl;= fjhs' fufia tl;= fjk .aÆfldaia ffi, j,g wjfYdaIKh ù Yla;sh njg fmr<Sug kï ;j;a ridhkhla wjYH fjhs' ta bkaishq,skah' .aÆfldaia ffi, j,g wjfYdaIKh ù Yla;sh njg fmr<Sug wjYH bkaishq,ska >%djh jkafka w.akHdYfhks' .¾NsKS ikaosfha oshjeähdj kfuys oelafjk wdldrhgu .eìKsNdjfhaoS we;sjk frda.S ;;a;ajhls' .eìKs ldka;djkaf.ka ishhg 15la muK .efnys 24-28 i;s j,oS fï ;;a;ajhg uqyqK mdhs' jeoEufyka ksmofjk we;eï fydafudak u.ska
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November 2020
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doctormagazine.lk
.¾NsKshf.a bkaishq,ska j, l%shdldß;ajhg ndOd f.k ths' fujka ;;a;ajhloS reêrfha .a¨fldaia uÜgu ys;lr w.hl mj;ajd .ekSug bkaishq,ska jeäfhka m%fhdacH lsÍug wjYH fjhs' w.akHdYhg fï iemhSu ,ndoSug fkdyels jQ úg ks;ekskau reêrfha .aÆfldaia idkaøKh by< hk w;r .¾NsKS oshjeähdj hkqfjka yªkajkafka fï ;;a;ajhhs' fï frda. ;;a;ajhg uqyqKmdk fndfyda ldka;djka ore m%ijh iu.ska reêrfha iSks w.hkao idudkH uÜgug meñfKk w;r b;d iaj,am fofkl=g muKla th ksjeros fkdùfuka fojk wdldrfha oshjeähdj frda.sfhl= jYfhka jeäÿrg;a ffjoH Wmfoia me;Sug isÿ fjhs' .¾NsKS oshjeähdj we;sùfï jeä wjodku fï whghs ² jhi wjq' 35g jeä ldka;djka ² mjqf,a ióm;ufhl= fojk ldKAvfha oshjeähdfjka fm<Su fyda uj fyda fidhqßhla .¾NsKS oshjeähdfjka fm<Su ² YÍrfha nr jeä ùu
doctormagazine.lk
.¾NsKS ld,fhaoS reêr.; iSks uÜgu idudkH blaujd hk úg tu .aÆfldaia jeoEuy Tiafia orejdgo wjfYdaIKh fjhs' fuys m%;sM<hla f,i orejdf.a YÍrh úYd,;ajfhka jeä fjhs' fuh iajdNdúl m%ijhg ndOd f.k foa' orejd wvq jhfika m%iQ;sh ,eîug fukau isfiaßhka ie;alula isÿ lsÍugo jkakg mq¿jk'
November 2020
DOCTOR MAGAZINE
57
D•Magazine /
Gestational Diabetes .¾NsKS ujg we;sjk .¾NsKS oshjeähdj ujf.a reêr iSks jeäùu orejdg n,mdk wdldrh
ujf.a reêrfha iSks uÜgu jeäùu .aÆfldaia jeä jYfhka orejdg ,efnhs
1' ujf.a wu;r .aÆfldaia orejdg ,efnhs 2' fï jeä .a¨Qfldaia m%udK iudfhdackhg orejd jeämqr bkaishq,ska ksmojhs 3' fï wu;r .aÆfldia fïoh jYfhka l<,fha ;ekam;a ùfuka l<<h idudkHhg jvd úYd, fjhs
² óg fmr reêr iSks w.hka jeäùu ² óg fmr .¾NsKS;djhloS .¾NsKS oshjeähdfjka fm<Su ² fmd,sisiaála ´fõßhka frda.fhka fm<Su ² fmr m%ijhloS jeä nr ^lsf,da .a?ï 4'5g jeä& orefjl=g Wm; ie,iSu ² m%;sihsfldaishd fyda iafgfrdhsv T!IO ,nd .ekSu ² m<uq ;=ka udifhaoS fõ.fhka isref¾ nr jeäùu
.¾NsKS oshjeähdj ;yjqre lrkafka fufyuhs .¾NsKS jkakg fmr oshjeähdj we;s njg ;yjqre jQ .eìKs ldka;djka yereKQ úg wka ish¿u .eìKs ldka;djka m<uqj uq,a udi ;=k we;=<;;a" fojkqj ore .eng i;s 24-28 w;r ld,fhaoS;a .¾NsKS oshjeähdj iïnkaOfhka mÍlaIdjg ,la l< hq;= jkafkah'
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November 2020
DOCTOR MAGAZINE
² fï i|yd fhdod .kafka Oral glucose tolerance test (OGTT) mÍlaIdjhs' ridhkd.drfhaoS isÿ lrk fï mÍlaIKhg fmr osk rd;%sfha Tn ksrdydrj isáh hq;=h' Tfí ksrdydr .aÆfldaia uÜgu (Fasting blood glucose level) mÍlaId lsÍug uq,skau reêr ksheoshla ,nd .kshs' ² bka miqj meKs îula mdkh lsÍug i,iajd kej;;a fydardjloS" fydard folloS reêr ksheos ,ndf.k .aÆfldaia i|yd mÍlaId flfrhs' ² mÍlaIK w;r;=r ld,h b|f.k bkakg Wmfoia iemfha'
Tfí reêr .aÆfldaia uÜgu ksrdydr" meh yd meh fol mÍlaId j,oS idudkHhg jvd jeä kï" Tn .¾NsKS oshjeähdj ;sfnk ldka;djl jYfhka ie<fla' .¾NsKS oshjeähdj md,khg ,la l< hq;af;a wehs@ .¾NsKS ld,fhaoS reêr.; iSks uÜgu idudkH blaujd hk úg tu .aÆfldaia jeoEuy Tiafia orejdgo
doctormagazine.lk
ksrdydr yd wdydr .ekSug fmr
wdydrfhka meh follg miq
f;uil reër iSks yeisÍu fkdfyd;a A1c
fï úosyg reêr iSks uÜgu md,kh lr.kak
wjfYdaIKh fjhs' fuys m%;sM<hla f,i orejdf.a YÍrh úYd,;ajfhka jeä fjhs' fuh iajdNdúl m%ijhg ndOd f.k foa' orejd wvq jhfika m%iQ;sh ,eîug fukau isfiaßhka ie;alula isÿ lsÍugo jkakg mq¿jk' tfiau orejd Wm; ,eîuka miqj reêrfha iSks uÜgu fnfyúka my; jeàfï wjodkugo ,la fjhs' .¾NsKS oshjeähdj ;sfnk úg ta ld,h ;=< reêr mSvkh by< hdfï wjodkulao n,.ekafjhs' .¾NsKS oshjeähdj md,kh lrkafka fldfyduo@ fï wjia:dfõoS ffjoHjrhd" fmdaIKfõoSka fi!LH wOHdmk ks,Odßka Tng msysgg tkq we;' fï wh Tn wdydr .; hq;= wdldrh" fi!LHiïmkakj .eìKs ld,h .;rk wdldrh iïnkaOfhka Tnj oeKQj;a lrKQ we;' reêrfha iSks hdukh i|yd Tng fjfiiska ieliQ zzwdydr ie,eiaulaZZ w;HjYH fõ' jHdhduh''' YdÍßl l%shdldß;ajho iSks uÜgu ys;lr w.hl mj;ajd .ekSug wñ, odhl;ajhla olajk fyhska ta .eko Tn wjOdkh fhduq l< hq;= fõ' .¾NsKS iufhaoS isref¾ nr lsishï jeäùula isÿ úh hq;=h' fï ud¾f.damfoaYK Tfí isref¾ nr jeäùu kshñ; mrdihka ;=< mj;ajd .ekSugo WmldÍ fjhs' we;eï wjia:dj,oS oshjeähd fnfy;a ^fuÜf*dñka& fyda bkaishq,ska tkak;a .ekSug ks¾foaY lrk w;r tajd kshu wdldrfhka .ekSu Tfí hym;guh' l=i ;=< orejd jefvk ld,fha Tn wdydr .; hq;af;a fufyuhs ² ldfndayhsfâ%g fi!LH iïmkak .eìKshlg wjYHfhkau ;sìh hq;=h' fïjd .; hq;af;a ksjeros m%udK j,sks' wdydr f;dard.; hq;af;ao reêr iSks hdukhg WmldÍ jk wdldrfhks'
doctormagazine.lk
November 2020
DOCTOR MAGAZINE
59
D•Magazine /
Gestational Diabetes .¾NsKS ujg we;sjk .¾NsKS oshjeähdj
ujg oshjeähdj ;sfnk úg we;s úh yels wjodku
Wm;a nr jeä ùfuka m%ijh ÿIAlr ùu
reêr mSvkh by< hdfuka we;sjk wjodkï ;;a;ajhls
reêr iSks uÜgu w;sYhska my< neiSu
² iEu wdydr fõ,lgu" mjig fndk mdkhloSu ldfndayhsfâ%Ü wvx.= wdydrhlao .ekSug wu;l fkdlrkak' .a,hsisñla o¾Ylh wvq yd ;ka;= m%udKh wêl wdydr Tfí f;aÍu úh hq;=h' ² Tn .kakd ldfndayhsfâ%g m%Odk wdydr fõ,a ;=klg yd w;=re iakelaia follg fnod.kak' Tfí Yla;s wjia:d wkjr;fhka imqrd,k w;f¾ .aÆfldaia hdukh kshñ; mßos mj;ajd .ekSug fuh bjy,a fjhs' ´kEu wjia:djl .kakd úYd, m%udK ldfndayhsfâ%g reêr iSks m%udKh úYd, jYfhka by< kexùug fya;= fjhs ² Tng .e,fmk ldfndayhsfâ%g m%udK .ek Tfí fmdaIKfõoshdf.ka úia;r wid oek.kak' ² iSks jeä jYfhka tl;= l< wdydr yd mdk j¾. mdúÉÑfhka j<lskak' meKsîu" fldaäh,a" flala" ìialÜ yd fpdla,Ü j, iSks fhdod ;sfnkjd jeäh'
ix;Dma; fïoh fh¥ wdydr iSud lrkak ² iu bj;a l< l=l=,a uia" lsß ksIAmdok wdydrhg .kak' ieliQ wdydr .ekSfuka j<lskak' ² T,sõ f;,a" lefkda,d f;,a" ¨KQ fkdfh¥ lcq" w,s.egfmar wdydrhg tla lr.kak wdyr úúOdx.slrKh .¾NsKS ld,h hlv" f*daf,ag yd wu;r fmdaIKh wjYH ld,hls' orejdf.a j¾Okhgo th wjYHfhka jeo.;a fjhs' fï ksid Tn t<j¿" m<;=re" fm%daàk wvx.= wdydr" lsß ksIAmdok''' wdoS jYfhka úúO mrdihl wdydr .; hq;=h'
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November 2020
DOCTOR MAGAZINE
doctormagazine.lk
.¾NsKS oshjeähdj wyr jgl iqúfYAIS ,laIKhla jkafka reêrfha iSks uÜgu ys;lr mrdihl ;nd .ksñka ore.en fmdaIKh lsÍuhs
oskm;d YdÍßl l%shdldß;ajh uekúka mj;ajd .ekSu;a jeo.;a Tfí reêrfha iSks uÜgu hdukhg" ys;lr uÜgul YÍr nr mj;ajd .ekSug fukau orejd fi!LHiïmkakj m%iQ; lsÍug kï Tn l%shdYS,Sj fï mßÉfPaoh .; l< hq;=h' mmqj oeú,a," u<noaOh yd fldkafoa wudrej jeks .¾NsKS ld,hg fmdÿ úúO .eg¿ j,ska ñoSugo YdÍßlj l%shdYS,Sj isàu jeo.;a fjhs' Tn lsishï jHdhduhl fhfokakg woyia lrkafka kï m<uqj Tfí ffjoHjrhdf.ka ta iïnkaOfhka Wmfoia ,nd.kak' .¾NsKS oshjeähdj ;sfnkjd kï Tn jHdhduhl ksrka;rfhka fhoSu w;sYhska jeo.;a fõ' weúoSu" ye,afï osùu" msyskSu" fhda.d" pilates, ydâqua fitness classes wdosh Tng iqÿiq jHdhdu lsysmhls' jHdhdu lsÍfuka Tng fl;rï id¾:l f,i reêr iSks md,khg msgqjy,la jkafkao hkak Tfí oshjeähdj wOHdmk ks,Odßhdf.ka úuikak' reêr iSks md,kh Tn Tfí reêrfha iSks uÜgu .aÆfldógrhlska uek ne,Sug mqreÿ úh hq;=h' WoEik wjos jQ ú.i reêr idïm,hlla mÍlaId lsÍu iqÿiqh' wdydr .ekSfuka mehlg" follg miqj ne,Suo jeo.;ah' fïjd jvd;a iqÿiq fõ,djkah' ksrka;rfhka reêr iSks uÜgu uek ne,Sfuka wdydr" jHdhdu Tiafia iSks md,khg ,efnk msgqjy, iïnkaOfhka Tngu wjfndaOhla ,nd.; yels jkq we;' tfiau th Tfí ffjoHjrhdgo Tfí reêr iSks md,khg iydh jkq wee;' oshjeähdjg .kakd T!IO Tfí reêr.; iSks m%udKh idudkH w.hka blaujd hhs kï Tng th md,kh i|yd T!IO kshu flf¾' fndfyda oshjeähd T!IO j¾. .¾NsKS ld,hg iqÿiq ke;' kuq;a fuÜf*dñka .eìKs ldka;djkago fhda.H oshjeähd md,k Tiqjls' doctormagazine.lk
November 2020
DOCTOR MAGAZINE
61
D•Magazine /
Gestational Diabetes .¾NsKS ujg we;sjk .¾NsKS oshjeähdj
oskm;d l%shdYS,Sj lghq;= lsÍu yd ffjoH Wmfoia j,g wkQj jHdhduhl ksr; ùug .¾NsKS oshjeähdfjka fmf<k uõjrekag úfYaI Wmfoia iemfha
kuq;a we;eful=g fï iSks md,kh i|yd bkaishq,ska tkak;a lsÍug isÿfõ' fufia tkak;a lr.kakd bkaishq,ska orejdg lsisÿ ydkshla lrkafka ke;' Tn .; hq;= bkaishq,ska ud;%dj ksrka;rfhka ffjoHjrhd úiska iudf,dapkhg ,la l< hq;= w;r bkaishq,ska tkak;a lr.kakd wdldrh Tng ffjoHjrhd lshd fokq we;' .¾NsKS ld,fhaoS nr jeäùu l=i ;=< orejd jefv;au ujf.a nro l%ufhka jeä jkq we;' Tnf.a nr fldmuK m%udKhlska jeä jkafkao hkak ks¾Kh lrkafka .¾NsKS jkakg fmr Tnf.a YÍrfha nr wkQjh' Tng Wmldr lrkafkda .¾NsKS osheähdj md,kh lsÍu yqfola iduqysl W;aidyhl m%;sM<hls' Tn''' Tfí mjqf,a idudcslhka" fi!LH ld¾huKAv, Bg wh;a fjhs' fi!LH ld¾huKAv,fha my; ffjoHjrekaf.a ld¾hNdrh fuysoS jeo.;a fõ' ldhsl frda. ffjoHjrhd" ks¾Kd, ffjoHjrhd" m%ij ffjoHjrhd yd fyosh yd fi!LH ks,Odßksh ta w;r m%Odkh' orejd Wmka miq''' orejd Wm; ,nd i;s 6-12 w;r ld,fhaoS Oral glucose tolerance test (OGTT) mÍlaIKhla Tn úiska isÿ l< hq;=h' fuhska Tfí reêr iSks w.hka idudkH ;;a;ajhg meñK ;sfío hkak oek.; yels fõ' Tng n,.ekaù ;sfnk wjodkïidOl j,g wkQj weh iEu jir 1-3 ld,h ;=< oshjeähdj ;sfío hkak iïnkaOfhka mÍlaId l< hq;=h' wehg wkd.;fha we;sjk .¾NsKS;djhkaysoSo oshjeähdj je<|Sfï wjodkula ;sfnk w;r ta yefrkakg wehg 2 ldKAvfha oshjeähdj we;s ùugo lsishï wjodkula ;sfí'
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November 2020
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doctormagazine.lk
fï wjodku wvq l< yelafla flfiao@ ² ys;lr YrSr nrla mj;ajd .ekSfuka ² ys;lr wdydrmdkdosh .ekSfuka ² oskm;du YdÍßlj l%shdYS,S cSú;hla .; lsÍfuka Tng fojk wdldrfha oshjeähdj miqld,Skj we;s jQjfyd;a l,afõ,d we;sj yªkdf.k Bg ms<shï fhoSug mshjr .; hq;= jkafkah' .¾NsKS oshjeähdfjka fm¿KQ uõjrekag Wmosk orejka wkd.;fha ia:Q,Mdjhg m;aùfï yd oshjeähdjg k;= ùfï jeä wjodkula mj;S' fï ksid hym;a wdydr isß;a" ia:Q,;djh wvq lsÍu" YdÍßl l%shdldÍ nj wdoS cSjk u. fjkialï we;s lr .ekSfuka fï wjodku fnfyúka wvq lr.; yel' orejkag uõlsß fkdjrojd fokak oshjeähdj .¾NsKS ld,fhaoS we;sjQ uõjreka muKla fkdfõ''' iEu ujlu ;u orejkag uõlsß j,skau fmdaIKh ie,ish hq;=h' th w¿; Wmka orejdg ;sridr cSjk wdrïNhla ,ndfok w;r orejdg fukau ujg;a úYd, wdrlaIdjla" / ljrKhla i,ihs' orejdf.a j¾Okh" m%;sYla;slrK moaO;sh Yla;su;a ùu" orejd yd uj w;r wdorKSh jQ iïnkaOhla we;sùu ta w;r fõ' fï ksid uj yd orejd fofokdu wkd.;fha oshjeähd frda.Ska njg m;aùfï wjodku wvq lrhs' wo ojfia ud¾f.damfoaYK j,g wkQj w¿; Wmka orejd udi yhla hk ;=reu" tkï >k wdydr yªkajd fok ;=reu fmdaIKh ie,ish hq;af;a uõlsfrks' bkamiqjo tu isß; jirl muK ld,hla j;a mj;ajd.; hq;=h' fufia uõlsß oSfuka orejd oshjeähdjg k;=ùfï wjodku fnfyúka wvq fjhs' DM
doctormagazine.lk
November 2020
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63
D•Magazine /
Diabetes and Pregnancy oshjeähdj ;snqK;a ore iqr;,a n,uq
DIABETES AND PREGNANCY ksjeros ie,eiaulska ksfrda.S orefjla fuf,dj Wm; ,nkjd''' oshjeähdj ;snqK;a ore iqr;,a n,uq 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
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November 2020
ldka;djl" oshjeähdfjka fmf<kjd kï wehg orefjla jokakg fkdyelsh hk u;hla iudcfha mej;S hq.hlao úh' fjfiiskau ffjoHjrekao oshjeähdj ;sfnk ldka;djka yg .eí .ekSu kqiqÿiq hhs m%ldY l< ld, jljdkqjla wmgo ;sìK' tfy;a weh oshjeähdfjka fm¿K;a wehg ksfrda.S ore iïm;la ,eîu wo .eg¿jla fkdfõ' ta i|yd wjYHfhkau jeo.;a jk wjjdo" ud¾f.damfoaYk fuys,d jeo.;a ld¾h Ndrhla bgq lrk nj fkdlshdu neßh' wehg oshjeähdj ;sfnkjd kï ore iïm;la wfmalaId lrk wehg uQ,sl jYfhka mj;akd wNsfhda. ;=kls' 1' ms<sis|.ekSu 2' .¾NsKS;djh mj;ajd .ekSu yd 3' ksfrda.S orefjl=g W;am;a;sh ,ndoSu
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doctormagazine.lk
oshjeähdj ;sfnk úg mqreIhdf.a Y=l%dKQ j,g bka ydks isÿ jkakg mq¿jk' iylreg fyda iyldßhg oshjeähdj we;s úg .eí .ekSugo ndOd we;sùu úh yelalls' tfiau .eí .;a;;a th .íid ùugo we;s bvlv ;rula jeäh' tfiau wehg oshjeähdj ;sfnk úg fkdfïrE orefjl= jYfhka orejd ìys ùugo" wvqmdvqlï iys; orefjl= we;s ùug we;s bv m%ia:djo tfia fkdjk flfkl= yd ii|k l< ;rula jeäh' fï ish¿ wjodkï iy.;Ndjhka úuis<su;a nj yd mÍlaIdldÍ nj fukau iïm ffjoH wëlaIKho Tiafia u.yrjd .; yels w;r ta iïnkaOfhka j.lSfuka lghq;= lsÍu iEu oshjeähdj iys; ujl ùug fmreï mqrk ldka;djlf.au j.lSuls' oshjeähdj" idM<H;djhg n,mdk wdldrh .ek jegySula ,nd .ekSug kï fï frda.fha wdldr fol .ek uQ,sl wjfndaOhla ;sìh hq;=h' m<uq j¾.fha oshjeähdj frda.sfhl=f.a isref¾ fldfy;au bkaishq,ska ksmofjkafka ke;' doctormagazine.lk
fojk wdldrfha oshjeähdj fojk wdldrfha oshjeähdj we;s úg lsishï bkaishq,ska m%udKhla ksmojQK;a th m%fhdacH lsÍfï" Ndú;hg .ekSfï wvqmdvqlï we;s úh yel' wef.a fydafudak l%shdldß;ajh iqir ùu w;sYh jeo.;a ldka;djl .eí .;a úg wef.a ffcj ridhKsl l%shdldß;ajh fukau .¾NsKS;djho flfryS n,mdkafka wef.a isref¾ ksmofjk fydafudakh' .¾NsKS;djh yd iïnkaO
November 2020
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65
D•Magazine /
Diabetes and Pregnancy oshjeähdj ;snqK;a ore iqr;,a n,uq
.¾NsKS;djfhaoS fydafudak fjkia jk wdldrh
fydafudak /il l%shdldß;ajh fuysoS ;SrKd;aul fjhs' tfiau cS¾Kl l%shdj,shg iïnkaO bkaishq,ska fydafudakfha hy meje;auo uQ,sl wjYH;djhla fjhs' oshjeähdj we;s úg" bkaishq,ska fydafudakfha l%shdldß;ajh úp,Hh jk úg .¾NKS ld,h uq¿,af,a isrerg tu fydafudakh wvq;a ke;sj" jeä;a ke;sj mj;ajd .ekSu uQ,sl wjYH;djhla njg m;a fjhs' fï ksid hï oshjeähdj ldka;djl .eí .ekSug wfmalaId
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November 2020
lrkafka kï th ie,iqï lrk ld,fhau ffjoHjrhd uqK .eiS Bg wjYH lrk Wmfoia ,nd.; hq;=h' wehf.a .eí .ekSu" orejd ksfrda.Sj l=i ;=< j¾Okh ùu fukau ksis l, jhia j,oS ksfrda.S orefjl= m%iQ; lsÍu i|yd uQ,sl wä;d,u fuysoS iemfhkq we;' fuysoS .¾NKS;djh uq¿,af,au iómj wehf.a ;;a;ajh wëlaIKhg ,la úh hq;af;ah' ixfiapkhla isÿ jQj;a wêfrdamkhla isÿ fkdùu oshjeähdj we;s ldka;djka w;f¾ iq,nh' fï ksid .eí .;a uq,a ld,fhau .íid we;s ùfï bvlv jeäh' tfiau oshjeähdj ;sfnk ldka;djlf.a .¾NdIfha m%;s.%yk yelshdj wvqh' (The uterus of a diabetic woman is less receptive.) fï ksid .eí .ekSula we;s ùug lsishï ld,hla .;jkq we;' m<uq wdldrfha oshjeähdj we;s úg we;súh yels oaú;Shsl ;;a;ajhla jkafka FSH fkdfyd;a Thyroid Stimulating Hormone n,mEuhs' fï ksid iajhx m%;sYla;slrK moaO;shg wys;lr n,mEula we;s bvlvo fuysoS wjOdkhg fhduq flf¾'
DOCTOR MAGAZINE
doctormagazine.lk
oshjeähdj ;sfnk úg u;=jk úúO ixl+,;d fya;=fjka iajdNdúl m%ijhla we;s fkdùugo bv ;sfí' túg úl,amh jkqfha isfiaßhka ie;aluhs' isfiaßhka ie;alu iajdNdúl ore m%iQ;sh fuka fkdfõ' wdidok wjia:d by<h' lemqï ;=jd, iqjùug lsishï ld,hla wjYH fjhs'
² Y=l%dKq .=Kd;auh wvqùu REDUCED SPERM QUALITY: Y=l%dKQ m%udKh wvq ùu REDUCED SEMEN: ² DNA j, úlD;s;d we;s ùu' DNA: DAMAGE: fuh oshjeähdj iys; flfkl=g we;s úh yels jvd;au n,mj;ajk ydkshhs' fï ksid Wm;a ÿ¾j,;d iys; orejka ìys ùug bv we;' oshjeähdj ksid kQmka orejdg we;súh yels wjodku Macrosomia: orejd l=i ;=<oS idudkH m%udKhg jvd úYd, ùu' fï ksid isfiaßhka ie;alulska m%ijh isÿ lsÍug isÿúh yel'
oshjeähdj we;s úg ;rula úYd,j orejka Wmoskakg we;s wjia:dj jeäh' fï ksid iajdNdúlj ore m%iQ;sh isÿ fjkjd fjkqjg isfiaßhka ie;alulska m%ijh isÿlsÍug we; wjia:dj jeäh
iylreg oshjeähdj we;súg u;= úh yels fi!LH .eg¿ iuyrla ² ,sx.sl wm%dKsl;ajh we;sùug we;s bvlv ERECTILE DYSFUNCTION: ² iyjdifhaoS fhdakshg Y=l% Od;= fudapkh jkjd fjkqjg uq;%dYhg my ùfuka .eí .ekSug ndOd meñKSu' RETROGRADE EJACULATION: fuh isÿ jkafka iakdhq wdmodjg m;a ùfuks' ² Y=l% Od;= fudapkh m%udo ùu DELAYED EJACULATION: ² Y=l% Od;= ksIamdokfha m%uqL ld¾h Ndrhla bgq lrk fgiagiagfrdaka fydafudakh wvq ùu LOW TESTOSTERONE:
doctormagazine.lk
Hypoglycaemia: bkaishq,ska by< uÜgï fukau .aÆfldaia uÜgu my; jeàï ksid reêrfha iSks m%udKh my; jeáh yel' Preeclampsia: fuh m<uq wdldrfha oshjeähdj we;s úg iq,nh' l=i ;=< i;s 20l muK wejEfuka we;sjk fï wjodkï ;;a;ajh ksid orejdf.a wlaudj" jl=.vq wdmodjg m;a ùugo reêrh leá .eiSï yd fmKy¿ j, j;=r msÍugo bv we;'
November 2020
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67
D•Magazine /
Diabetes and Pregnancy oshjeähdj ;snqK;a ore iqr;,a n,uq
iajdñmqreIhdg oshjeähdj we;s úg Y=l%dKQ j, DNA j, úlD;s;djhka we;s úh yel' tys m%;sM<hla jYfhka Wm;a úlD;s;d iys; orejka ìysùug we;s wjia:dj ;rula jeäh
Birth Defects: Wm;a ÿ¾j,;d we;s ùfuka Yajikh yd yD;a wdndO wdosh we;sùug mj;akd m%ia:dj Miscarriage: i;s 20ka miqjo .en .íidjg ,la ùfï wjodkula mek k.S oshjeähdj we;s ldka;djka .eí .ekSug fmr ;ukaf.a reêr.; iSks m%udK ys;lr w.hka fj; muqKQjd .ekSu m%uqL wjYH;djhls' m<uq wdldrfha oshjeähdj ;sfnk úg w.akHdYfha bkaishq,ska ksmofjkafka ke;' Tjqka iSks md,kh i|yd bkaishq,ska tkak;a ud¾.fhka ,nd.; hq;=h' fojk wdldrfha oshjeähdj p¾hd;aul wvq¨yqvq;d fya;=fldg f.k we;sjk frda.hla fia ie<fla' ys;lr YÍr nrla mj;ajd .ekSu" fyd| wdydr mqreÿ we;s lr .ekSfuka isref¾ bkaishq,ska uÜgu hdukhg fyd| wjia:djla fudjqkg Wod fjhs' oshjeähdj we;s ldka;djl .eí .ekSug fmr fhdod.; hq;= Wmdh ud¾. ² ia:Q,;djhg m;a fkdùu yd isref¾ nr ys;lr uÜgï j, mj;ajd .ekSu ² reêrfha fkdfyd;a f;uil iSks md,kh ;;a;ajh idlaId;a lr .ekSu ² iSks mßfNdackhg .kakd m%udKh wvq lsÍu DM
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November 2020
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ljr idM,H;d .eg¿jlska fm¿K;a oeka Tng ore iïm;a ,nd .ekSu wreuhla fkdfõ' fjk hï ljr fodaIhla u; Tfí uõmsh isyskh fnd| ù ;snqK;a th h,s mqnqÿjd,Sfï yelshdj wmg ;sfí' Tfí .eg¿j l=ula jQj;a th .ek yDohx. uj l;dny lsÍug wm iQodkïh' Tng jvd;au .e,fmk úi÷u ,nd.ekSug fï lafIA;f % ha m<mqreÿ wfma jD;a;h S iydh ,nd oSug wm b;d leue;af;ka isáuq'
wmg l;d lrkak' fukak wfma wxlh
077 291 4526 wmf.a ,smskh WISH Fertility & IVF Clinic 393$6" li.yj;a; mdr" mrK fldÜgdj mdr" Wvyuq,a," kqf.af.dv
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• • • • •
AD-MIRE Creative
• 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
No.393/6, Kasagahawaththa Road, Old Kottawa Road , Udahamulla, Nugegoda Tel: 077 9728 799 E mail: wishiuiivf@gmail.com | wishiuiivf.com
D•Magazine /
Glycemic Index oshjeähd frda.Ska .; hq;=''' fkd.; hq;= wdydr
oshjeähd frda.Ska .; hq;=''' fkd.; hq;= wdydr .ek Tng wjfndaOhla ,nd fok Glycemic Index l%Svd ffjoH rdcs; .=Kj¾Ok
È
hjeähd frda.Skaf.a reêr.; iSks hdukh flfryS Tyq .kakd wdydr j,ska ,efnkafka fkduo msgqjy,ls' reêr.;j iSks uÜgu jeä fkdùug .; hq;= wdydr fukau" .ekSu wffO¾h lrk wdydro u| jYfhka .; hq;= wdydro .ek fmdaIKfõoSka mjihs' fï zzwdydr idOlhZZ úoHd;aulj úuikafka .a,hsisñla o¾Ylh wdY%fhks' .a,hsisñla o¾Ylh .ek wjfndaOhla ,eîu iEu oshjeähd frda.sfhl=gu jvd;a hym;a reêr iSks hdukhla i|yd msgqjy,la jkq we;' m%drïNl jYfhka úuiSfïoS Glycemic Index (GI) hkq .aÆfldaia fyda iqÿmdka j,g idfmalaIj ldfndayhsfâ%g idr wdydr reêrfha iSks uÜgu jeä lsÍu mdol lrf.k fm< .iajk mßudKhls' Tn ldfndayhsfâ%g iys; wdydrhla wkqNj lrk úg tys ;sfnk iSks .aÆfldaia njg ì| fy<kq ,efnhs' th wjik Yla;sh f,i YÍrfha ixÑ; fõ' wm wdydr .kakd úg reêr.; .aÆfldaia uÜgu ks;ekskau jeä fjhs' hï wdydrhlg reêr.; .aÆfldaia uÜgu by< kexùug we;s yelshdfõ fõ.h Glycemic Response kñka y÷kajkq ,efí' fï Glycemic Response idOlh úúO ldrKd /ila u; fjkia fjhs' ² wm fl;rï wdydr m%udKhla .kakjdo@ ² tu wdydr fl;rï ld,hla YÍrh ;=< ì| fyf<kjdo@ ² tu wdydr l=uk wdldrhlg ms<sfh, lr ;sfío@ wdoS idOl mjd Bg n,mdhs'
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November 2020
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doctormagazine.lk
ksoiqkla f,i meiagd u| riakfhka msiQ úg ;sfnkjdg jvd jeä Glycemic Response w.hla jeä fj,djla msiQ úg ,efnkafkah' m¾fhaIKd;aul o;a; j,g wkQj wvq Glycemic Index (GI) w.hla we;s wdydr f;dardf.k wkqNjfhka reêr uÜgu uekúka mj;ajd .; yels jk w;r 2 jk wdldrh jYfhka ye|skafjk oshjeähdj we;s ùfï bvlv fnfyúka wvq fõ' Glycemic Index ( GI<55 ) wvqfjka we;s wdydr fhdoh rys; lsß" fhda.Ü" fidahd mdk j¾." wem,a" uqoaorm,ï" fodvï" ´Ü" ksjqâv iys; wdydr" ´Üó,a" ^fifuka msisk ´Üia& ;ïnmq iy,a" u,aáiSâ fn%â" ;, wdoS OdkH ñY% lrk ,o mdka&" meiagd ^uDÿ&" oU, úfYaI(Lentils/Kidney/Baked beanns, Chick peas, Green Gram) Glycemic Index ( GI=56-69 ) uOHu m%udKfhka we;s wdydr flfi,a" wkakdis" w¿;a w¾;dm,a" friskaia" fmdmafldaka" iams,sÜ mS^uE&" .%Ska mS ^fld< uE&" iqma" ÿUqreiy,a" ndiau;S iy,a" ;srs`.= OdkH" ;srs`.= mdka ^Whole wheat bread&" rhs mdka Glycemic Index ( GI=56-69 ) jeä w.hla .kakd wdydr oshflduvq" rgb|s" ;ïnd fmdä l< w¾;dm,a" fíla
doctormagazine.lk
wdydrfha GI w.h fkdie<l=jo" .kakd wdydr m%udKh jeä kï th reêr iSks uÜgu by< kexùug odhl jkafkah' wdydrhla .ekSug fmr;a wdydr .ekSfuka mehla fyda meh follg miq;a reêr iSks uÜgu uek .ekSfuka Tfí isrer tu l%shdj,sh hdukh lsÍug olajk mßph .ek Tngu wjfndaOhla ,nd.; yels jkq we;'
lrk ,o iqÿ w¾;dm,a" laIKsl n;a" fkaÉ hsia" whsia l%Sï" iqlafrdaia (Table Sugar)
November 2020
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71
D•Magazine /
Glycemic Index oshjeähd frda.Ska .; hq;=''' fkd.; hq;= wdydr
² iQma yd i<do wdosh wdydr isß;g tl;= lr .kak' ² OdkH" ´Ü" ksjqâfvka ye¥ mdka .ekSu iqÿ mdka j,g jvd fi!LH iïmkak fõ' ² kejqï t<j¨ yd m<;=re wkqNjhg .kak'
.a,hsisñla o¾Ylh by< yd my< w.hla .kakd wdydr j¾.hg wkQj iSks m%udK
oskm;d wdydr fõ,g wvq Glycemic Index wdydr .ekSug Wmfoia ² by< GI w.hla iys; wdydr fjkqjg wvq yd uOHu m%udK GI w.hla iys; wdydr f;dard.kakg W;aiql jkak' ² úgñk" LKsc ,jK iy ;ka;= j,ska idr mßiudma; fmdaIKh .ek wdydr .ekSfïoS ie<ls<su;a jkak ² uOHia; GI w.hla mj;ajd .ekSug by< GI w.hla we;s wdydr wvq GI w.hla we;s wdydr yd l,jfï .kakg W;aiql jkak' ksoiqkla f,i mdka ^by< GI w.h& iu. fhdoh bj;a l< lsß ùÿrejla ^my< GI w.h& .ekSfïoS uOia: GI m%;sM<hla iys; wdydr fõ,la iïmQ¾K fõ' fldaka *af,alaia iu. ^by< GI w.h&" All Bean f;a yekaola iy ^my< GI w.h& iafg%dafnß ^my< GI w.h& iys; wdydrhla iqÿiqh' ² ieliQ wdydr" msIAGh iys; wdydr iSud lrkak' fïjdfha ;ka;=uh mod¾: wvqh' wfkl=;a fmdaIl wvqh' ta uosjdg by< GI w.hlska hqla;h' wvq GI w.hlska hqla; OdkH wdydr fndaxÑ" oU, yd rks, wdydr j,ska ieliQ wdydr fyd|hs'
72
November 2020
DOCTOR MAGAZINE
² t<j¨ iy m<;=re j, we;af;a wvq GI w.hls' fïjd iSks njg YÍrfha ì| fy<Sfï l%shdj,sfhaoS m;a ùug jeä ld,hla .; fõ' ² wdydr msrñvhg wkQj osklg t<j¿ yd m<;=re jdr 5-10 w;r jdrhla .; hq;=h' ² laIKsl iy,a fjkqjg ;ïndmq fyda ÿUqre yd,a fhdod.kak' ² i<do j,g l%Sï .;sfhka hqla; v%iska fjkqjg úkdlsß fhdod .kak' th fïo wvq f;dard.ekSuls' tfiau úkdlsß j, wdï,sl;djh u.ska cS¾Kl l%shdj,shg jeä ld,hla .kS' iuia;hla f,i fuh wdydrfha GI w.h wvq lsÍug bjy,a fõ' ² wdydrfha GI w.h fkdie<l=jo" .kakd wdydr m%udKh jeä kï th reêr iSks doctormagazine.lk
Glycemic Index hkq ksjeros wdydr ms<sfj;l tla wx.hla muKs'
,hsisñla o¾Ylh 0-55 wvq
.a,hsisñla o¾Ylh 56-69 uOHia;
.a,hsisñla o¾Ylh 70g jeä by<
uÜgu by< kexùug odhl jkafkah' wdydrhla .ekSug fmr;a wdydr .ekSfuka mehla fyda meh follg miq;a reêr iSks uÜgu uek .ekSfuka Tfí isrer tu l%shdj,sh hdukh lsÍug olajk mßph .ek Tngu wjfndaOhla ,nd.; yels jkq we;' ² wdydr ie,iqï lsÍfïoS fmdaIKfõosfhl=f.a fyda oshjeähdj wOHdmk ks,Odßfhl=f.ka Wmfoia ,nd .kak'
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Tfí wdydr isß;g my; .=Kdx. tl;= lr.kak' ² kshñ; ld, wka;rhka ;=< wdydr .kakg yqre fjkak' ² iEu wdydr ldKAvhlau wdjrKh jk fia úúO;ajhlska hq;a wdydr fõ,la .kak' ² meKs ri iy iSks j,ska yels;dla wE;a fjkak' ² Tn wkQNj lrk f;,a m%udKho yels;dla wvq lrkak' ² Tfí wdydr fõ,g ;ka;=uh wdydr jeäfhka tl;= lr.kak' ² ¨Kq wvq lrkak' uOHidr yd lef*aka wvx.= mdk j¾. j,skao j<lskak' DM
November 2020
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World Diabetes Day 2020 oshjeähd frda.Skag w;sYhskau jeo.;a jk mKsúvhla
World Diabetes Day 2020 The Family and Diabetes
oekaj;a jHdhduhlg fhduq fjkjd fyd|hs''' oshjeähd frda.Ska l< hq;= jHdhdu oshjeähd frda.Skag wjYHfhkau jeo.;a jk jHdhdu Aerobic exercise Training (AT) and Resistance exercise Training (RT) reêrfha iSks md,kh we;s lr.kakg myiq u.la''' yoj;a frda. wjodkug fyd|u úl,amhla ixl+,;d wju ù cSú;h ksfrda.S fjkjd''' ,dxflah ck iudch jHdhdu flfryS ;ju;a orK wdl,amh t;rï ys;lr tlla fkdfõ' zzfnfy;=;a fndkakï''' lEu;a fjkia lrkakï'''' ta;a jHdhdu lrkafk fldfyduo@ZZ wm nyq;rhla jHdhdu idOlh iïmQ¾Kfhkau mdfya wu;l lrk w;r thg wvq ,xiqjla ;eîu kqjKg yqre fkdfõ' kuq;a jHdhdu cSú;hg fl;rï jeo.;ao@ fjfiiskau oshjeähd frda.sfhl=g tu frda.h md,kh lsÍug jHdhdu fl;rï msgqjy,la jkjdo@ hkak .ek Tn yß yeá wjfndaOhg .;a;d kï jHdhdu iïnkaOfhka Tng we;s fï miq.dó nj" ta is;sú,a, mjd jydu fjkia jkjd we;' jHdhdu isß; p¾hdjla lr .ekSu ienúkau ieugu jeo.;ah'
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November 2020
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we;af;kau oshjeähd frda.sfhl=g mKsúvhla fokjd kï thg we;=,a úh hq;=u ud;Dldjla jkafka jHdhduhs' ukao@ th t;rïu Tyqg jeo.;a jk fyhsks' cSú;h yd ne|S ;sfnk ldrKhla jk fyhsks' jHdhdu lsÍfuka l%u ;=klg reêrfha iSks md,kh fjkjd' 1' YÍrfha w;sßla;j ;ekam;a ù we;s Yla;sh oykh isÿ lrkjd' 2' bkaishq,ska fydafudakh u.ska reêr.; iSks md,kh lrkjd' m%Odk jYfhka iSks ffi, j,g Wrd.ekSu isÿ lrkjd' jHdhdu lsÍu u.ska fuu l%shdj,sh jvd;a ld¾hlaIuj isÿ lrkjd' tysoS wvq bkaishq,ska m%udKhla jeä iSks m%udKhla Wrdf.k Yla;sh ksmoùu yd .nvd lsÍu isÿ lrhs' 3' oshjeähd frda.Skaf.a udxYfmaYs j, mßjD;a;Sh yd .=Kd;aulNdjh idfmalaIj wvqh' iSks Wrd.ekSu isÿ lrkafka udxYfmaYs u.sks' jHdhdu u.ska udxYfmaYs j, m%udKh yd .=Kd;aulNdjh jeälr th mßjD;a;Sh l%shdj,sh jvd;a ld¾hlaIu lsÍug WmldÍ fjhs' oshjeähd frda.Skag jvd;a .e,fmk jHdhdu oshjeähdj md,khg WÑ; hhs y÷kd.;a jHdhdu ldKAv folla fjhs' 1' iajdhql jHdhdu ^Aerobic Exercises& fkdfyd;a yD;ajdysksl jHdhdu ^Cardiovascular Endurance Exercises& 2' Yla;s j¾Ol jHdhdu ^Strength or Resistance Training& jYfhks' iajdhql jHdhdu Aerobic Exercises ksfrda.S cSú;hla m%d¾:kd lrk ´kEu flfkl=g tosfkod myiqfjka l< yels jHdhdu ldKAvh hg;g .efkkafka iajdhql jHdhduhs' fmKy¿ fukau yDoho Yla;su;a lrkakg fïjd fya;= jk ksidfjka tajd yD;ajdysksl jHdhdu (Cardiovascular Endurance Exercise) hk kñkao ye|skafjhs' fuu jHdhdu j,oS yqiau fyd|ska by< my< .ksñka ßoauhdkql+,j udxYfmaYs p,kh lsÍula isÿ lrhs' iajdhql hkq YÍrfha Yla;s oyk l%shdj,sh Tlaiscka
doctormagazine.lk
fld<U úYaj úoHd,hSh ffjoH mSGfha lÓldpd¾h ffjoH p;=rx. rKisxy MBBS (Col), D.Sp.Med.(Col), PhD (Aus) Lecturer, Department of Allied Health Sciences Faculty of Medicine,University of Colombo,Sri Lanka Specialist in Sports and Exercise Medicine Visiting fellow, School of Exercise and Nutrition Sciences
jdhqj m%Odk jYfhka fhdod .ksñka isÿ lsÍuhs' fmKy¿ yd yDoh Yla;su;a lsÍug yd ld¾hlaIu lsÍug fï jHdhdu WmldÍ fjhs' YÍrfha ord.ekSfï yelshdj oshqKQ fjhs' iajdhql jHdhdu lsÍfuka ,efnk hym;a m%;sM, iajdhql jHdhdu isÿ lsÍfuka jeä yDo iamkaok fõ.hlska" È.= fõ,djla úêu;aj reêrh fmdïm lsÍug yDoh jia;=jg yelshdj ,efí' reêrfha iSks j, md,khla we;sùu yereKQ úg reêr mSvkh" fldf,iagfrda,a md,kho w;am;a jkq we;' Tfí isref¾ Yla;sh yd ord .ekSu oshqKq fjhs'
November 2020
DOCTOR MAGAZINE
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D•Magazine /
World Diabetes Day 2020 oshjeähd frda.Skag w;sYhskau jeo.;a jk mKsúvhla
Tng .e,fmk iajdhql jHdhdu fyd|ska yqiu a by< my< .ksñka YÍrfha udxYfmaYs ßoauhdkql, + j p,kh lrñka isÿ lrk jHdhdu fï hg;g .efka' ² weú§u ² Èùu ² msyk s u S ² nhsil s ,a me§u ² k¾;kh ² meismkaÿ" fjd,sfnda,a neâñkagka" fgksia jeks l%v S d ² mäfm<la ke.Su ² lkaola ke.Su ² j;af;a fjfyiS jev lsÍu
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fï úosyg iajdhq jHdhdu j, fhfokak meh nd.hla ne.ska osk myla j;a wju jYfhka úkdä 10 fldgia f,i jHdhdu isÿ l< yel' jeo.;a jkafka Tn jHdhdu fkdlr isákafka kï th lsÍug mgka .ekSuhs' úkdä 10 fldgia f,i uq,skau mgkaf.k l%ufhka tajd jeä oshqKQ l< yel'
"
tuksid" ks;m s ;d iajdhq jHdhdu lrk Tfí isrerg wmQ¾j iqjodhl njla oefkkq we;'
ks;sm;d l=vd m%udKhkaf.ka fyda jHdhdu lsÍu osk 1-2la jeämqr jHdhdu lsÍug jvd fhda.H fõ'
oskm;d m%udKj;a f,i c,h mdkh lsÍu" jHdhdufhka fmr yd miqj m%udKj;a ic,khla mj;ajd .ekSu fukau tlajku iSks wvqùula isoaO jqjfyd;a ta wjia:dfõoS m%fhdackhg .; yels meKs rila wdikakfha ;nd .ekSuo Tfí wdrlaIdjgh' fï ish,a, w;f¾ jHdhdu l%uh hï ld,hla mj;ajd f.k hk úg Tfí isref¾ cjiïmkak nj we;sù kej;;a ukd frda. md,khlao we;s jk whqre Tngu w;aú|sh yels jkafkah'
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idudkH ;Sj%;djhl isg oeä ;Sj%;djhla olajd j¾Okh jk jHdhdu (Moderate-to-vigorous intensity Exercises) osklg meh nd.hla ne.ska i;shlg osk myla j;a l< hq;=h'
Yla;s j¾Ol jHdhdu lsÍfuka ,efnk hym;a m%;sM, 1' Yla;s j¾Ol jHdhdu j, fhoSu u.ska isref¾ wu;r fïoh laIh ù" fïoh rys; udxY fmaYs j¾Okh jk w;r" tu.ska Tfí isref¾ wu;r fïo oykh ;jÿrg;a ld¾hlaIu fõ' tfukau" jhia.; ùfï§ isÿjk udxY fmaYs laIh ùu je<elaùugo (Sarcopenia) Yla;s j¾Ok jHdhdu j,g yelshdj we;'
idudkH ;Sj%;djhl isg oeä ;Sj%;djhla olajd j¾Okh jk jHdhdu (Moderate-to-vigorous intensity Exercises)
2' YÍrfha bkaishq,ska ixfõoS;djh j¾Okh lrk ksid reêr iSks w.hka my; oeóug fuu jHdhdu fya;= fjhs' fmaYs mßudj jeä jk úg jeäfhka Yla;sh oykh ùula isÿ fjhs' Tfí YÍrh ksfid,aufka ;snqK;a fï jdish w;am;a lr.; yel' Due to Increased Basal Metabolic Rate (BMR)
Yla;s j¾Ok jHdhdu Strength or Resistance Training Yla;s j¾Ok jHdhdu m%;sfrdaO mqyqKq jHdhdu hkqfjkao y÷kajhs' udxYfmaYs j,g m%;sfrdaOhla oelaùu fuu ldKavfha jHdhdu u.ska isÿl< yel' Yla;s j¾Ol jHdhdu 1' fuu.ska YÍrfha udxYfmaYsj, Yla;sh" m%udKh yd .=Kd;aulNdjh jeäfõ' 2' YÍrh kshñ; nrl mj;ajd .ekSug WmldrS fõ' (Waight Management and maintainance during weight reduction process) 3'YÍr mßjD;a;Sh fõ.h jeäfõ' Increased Basal Metabolic Rate (BMR)
doctormagazine.lk
Tng .e,fmk Yla;s j¾Ol jHdhduh f;dard.kak ² nr tiùfï jHdhdu hka;% ^Weight machines& ² Resistance bands ² ksoyia nr tiùu ^Lifting free weights Dumbells etc.& ² YrSrfha nr (Body Weight) m%;sfrdaOhla jYfhka fhdod .ksñka lrk jHdhdu' (Push ups) Yla;sh m%Odk jYfhka oshqKq jkafka Strength Training jHdhdu ud,d j,ska jk w;r Tfí isref¾ m%Odk udxY fmaYs ldKav b,lal lr.ksñka osk foll mr;rhla we;sj fuu jHdhdu isÿ lrkak' fuu ldKAvfha Wmßu m%;sM, ,nd.ekSu i|yd i;shlg fojrla fyda ;=kajrla Yla;s j¾Ok jHdhdu isÿ lrkak' fï ldKAv foflau jHdhdu oshjeähd frda.Skag fyd|hs wfma fcHaIaG mqrjeishka lh fjfyid jev lsÍu hï muKlg lrk uq;a th fi!LHiïmkak nj fmroeß lr.;a wNs,dIhlska isÿ lrkakla fkdfõ' jHdhdu isÿ lrk iq¿;rhla jQjo weúoSu" mäfm<la ke.Su jeks ir< iajdhql jHdhduhlg jeä hula isÿ lrkafka ke;' oshjeähd frda.sfhla ie,eiaula iys;j fï ldKav foflysu jHdhdu isÿ lsÍfuka jvd;a hym;a m%;sM, ,nd.; yels jk w;r fjfiiskau óg l,ska jHdhdu ke;s fi!LHiïmkak fkdjk cSú; .; l< whg id¾:l m%;sM, ,nd .ekSug fya;=jk u.la jkafkah' fuu jHdhdu taldnoaOj lsÍfuka miq udi ;=kl reêr iSks j, yeisÍu iïnkaOfhka f;dr;=re
November 2020
DOCTOR MAGAZINE
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World Diabetes Day 2020 oshjeähd frda.Skag w;sYhskau jeo.;a jk mKsúvhla
olajk HbA1c mÍlaIKfhka fyd| oshjeähd md,khla we;sjk nj ikd: l< yel' jHdhdu isÿ lsÍug fmr ffjoH wkque;sh ,nd .ekSug wu;l lrkak tmd''' oshjeähd frda.sfhl= jHdhdu lsÍug fmr ffjoHjrfhl= úiska Tyqf.a fi!LH ;;a;ajh ms<sn|j iudf,dapkhl fhoSu wjYHfhkau l< hq;a;ls' fuysoS Tyqf.a yoj; iqjfi; iïnkaOfhka fjfiia ie<ls,a,la oelaùu isÿ flfrhs' reêr mSvkh ;sfí kï" we;eï úg Tyqf.a reêr kd,hla wjysrhg m;aj ;sfí kï ffjoHjrhd fj;ska mQ¾j wdrlaIl Wmfoia ,nd.; hq;=h' tfiau wlaIswdndOh" iakdhq wdndOh we;=¿j fjk;a ixl+,;d n,.ekaù ;sfío hkak .ek fidhd n,d wdrlaIl Wmfoia ,nd.; hq;=h' oshjeähdj ;sfnk wh jHdhdufha fhoSfïoS mdjyka me<|Sug wu;l fkdl< hq;=h' jHdhdu isÿ lsÍfïoS imqrd,sh yels b,lal
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November 2020
;nd .ekSu (Setting realistic goals) wjYHfhka l< hq;a;ls' Tn uE; ld,h ;=< t;rï jHdhduhl fkdfhÿKQ flfkla kï Tn fjfyilr jHdhdu j,g tlajru fkdhd hq;=h' iqÿiqlï ,;a jHdhdu mqyqKQlrefjl=f.a fiajh ,nd .ekSu jvd;a iqÿiqh' jHdhdu mqyqKQlrejka yereKQ úg wo l%Svd yd jHdhdu iïnkaO ffjoHjrekao isák w;r Tng wjYH kï Tjqkaf.a Wmfoiao ,nd .ekSug wjldY ;sfí' jHdhdu lsrfïoS úfYaIfhka isys ;nd.; hq;= lreKq oskm;d m%udKj;a f,i c,h mdkh lsÍu" jHdhdufhka fmr yd miqj m%udKj;a ic,khla mj;ajd .ekSu fukau tlajku iSks wvqùula isoaO jqjfyd;a ta wjia:dfõoS m%fhdackhg .; yels meKs rila wdikakfha ;nd .ekSuo Tfí wdrlaIdjgh' fï ish,a, w;f¾ jHdhdu l%uh hï ld,hla mj;ajd f.k hk úg Tfí isref¾ cjiïmkak nj we;sù kej;;a ukd frda. md,khlao we;s jk whqre Tngu w;aú|sh yels jkafkah' DM Dr. Chathuranga Ranasinghe Queensland University of Technology, Brisbane, Australia. fld<U úYaj úoHd,hSh ffjoH mSGfha lÓldpd¾hjrfhl= jYfhka lghq;= lrhs' l%Svd iy jHdhdu ffjoH úoHdj iïnkaOfhka wdpd¾h Wmdêhla ysñ fyf;u fuu úIhg tjka iqÿiqlula iemsrE tlu Y%S ,dxlslhdo fjhs' Tyq úiska isÿ lrk ,o zziajdhq jHdhdu yd Yla;s j¾Ol jHdhdu isÿ lsÍfuka oshjeähd frda.h md,kh lsÍug ,efnk iïudouZZ iïnkaOfhka isÿl< wOHhkh furg oshjeähd frda.Skaf.a cSú; j,g kj wdf,dalhla imhhs' fnda fkdjk frda. u¾okh iïnkaOfhka fjfiia wOHhk j, ksr; jk ffjoH p;=rx. rKisxy ´iafÜ%,shdfõ ì%iafnkays laùkaia,kaâ fglafkdf,dcs úYaj úoHd,fha jHdhdu yd fmdaIK wOHhk iïnkaOfhka lÓldpd¾hjrfhl= jYfhkao lghq;= lrhs'
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uqo,a weKjqu l<uKdlre" fy,a;afjdÉ ,xld ^mqoa'& iud.u hkqfjka olajd f.jk ld¾hd,h osh;,dj f,i i|yka lrkak' fplam;a fy,a;afjdÉ ,xld ^mqoa'& iud.u hkqfjka ,shd f¾LKh lr tjkak' ,xld nexl=fõ osh;,dj YdLdfõ fy,a;afjdÉ ,xld mqoa.,sl iud.u wxl 9324332 .sKQug ´kEu nexl= YdLdjlska fyda wka;¾cd,h Tiafiao uqo,a ;ekam;a l< yel' uqo,a ;ekam;a l< l=ú;dkaish" uqo,a weKjqu fyda fplam; iu.ska Tfí ,smskh tùfïoS ,shdmosxÑ ;emE, fhdod.ekSu jvd;a iqÿiqh' jeä úia;r i|yd 0773149084 wxlfhka úuikak' Healthwatch Lanka Private Limited 132/4, Viharakele, Diyatalawa Hot Line 0773149084E Mail: doctormagazine.lk@gmail.com
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Red Fragrant Rice Èhjeähd frda.Skag b;du;a .=Kodhl r;= iqj| iy,a
r;= iqj| iy,a Red Fragrant Rice Èhjeähd frda.Skag b;du;a .=Kodhlhs rd.u YslaIK frdayf,a ffjoH ckl fm%au;s,l úisks
fmdaIK .=Kfhka by< l=reÜgla fkdfyd;a msg; wjrKhla we;s ksid r;= iy,a" iqÿ iy,a j,g jvd fmdaIK .=Kfhka wkQk hhs ie,fla' m%;sTlaisldrl .=Kdx.hkaf.ka hqla; zmhsfgdridhkZ iy wdydruh flÈ /ila r;= iqj| iy,aj, ;sfí' Èhjeähdj we;=¿ ksoka.; frda. /ilska wmj uqojd .ekSfï yelshdjla fuu r;= iqj| iy,a j,g ;sfí' r;= iy,a hhs wm idudkH jyf¾§ mjikafka tys we;s meyeh rka meyehla .kakd ksidh' m%;sTlaisldrl .=Kfhka hq;a wekaf;dihkska kï ridhkslh iy,a wegfha rka meyehg fya;= fõ' iy,a j, msIagh wdldr folla mj;S' weuhsf,daia iy weñf,dafmlaáka hkqfjka' Èhjeähd frda.Ska ks;ru .; hq;af;a .a,hsisála o¾Ylh wvqfjka we;s iy,ls' tu n;a wydrhg .;aúg .aÆfldaia ixfõ§;djh by< kxjk w;r ffi,Sh l%shdldß;ajh o by< kxjhs' ta yereKq úg reêr.; fldf,iagfrda,a uÜgu o wvq lrhs' iaurK Yla;sh m%j¾Okh lrhs' idhkslj ;yjqre lrk ,o .a,hsisñl w.h 48 jk r;= iqj| iy,a fmdaIK .=Kfhka wkQk iy,la ksid wkqNjfhka reêr.;j we;s iSks úi,a mrdihlska fjkia jkafka ke;' tksid fukau Èhjeähd
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November 2020
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frda.Skaf.a reêr iSks uÜgu uekúka md,khg WmldÍ fõ' tmuKla fkdj fldf,iagfrda,a wvq lsÍug o ia:q,;djh md,kh lsÍug o WmldÍ jkafkah' r;= iqj| iyf,a ^Red Fragrant Rice& we;af;a m%KS; rihls' ta yereKq úg thgu ,dlaIKsl jQ
doctormagazine.lk
r;= iqj| iy,a ^Red Fragrant Rice& ful, wfma rfÜ mdßfNda.slhka w;r iS>%fhka ckm%sh fjñka mj;S' iqÿ iy,a j,g jvd r;= iy,a fmdaIK .=Kfhka wkQkh hk ldrKdj wfma rfÜ ck;dj w;r uq,a nei.;a u;hla ksid fuh w;sYh úoHd;aul ienEjls'
November 2020
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Red Fragrant Rice Èhjeähd frda.Skag b;du;a .=Kodhl r;= iqj| iy,a
iq.kaohla o mj;S' fï ksidu th “The Fragrant one” hkqfjka o y÷kajk w;r wjfYaI iy,a w;f¾ iqúfYaIS ia:dkh ksidu tajd Prince of Rice hk wkaj¾: kdufhka o y÷kajhs' n; - wm fukau fndfyda rgj, m%Odk wdldrh fia ie,flhs' msIaGh iys; wdydrhla ksid n;a reêrfha iSks m%udKh by< kexùug fhduqùu fuys we;s wjdidhhs' kuq;a wo jifia iqN
82
November 2020
wdrxÑh jkafka iEu j;a j¾.hlau reêrfha iSks ixhq;sh by< kexùug fya;= fkdùuhs' r;= iqj| iy,a ^Red Fragrant Rice& ful, wfma rfÜ mdßfNda.slhka w;r iS>%fhka ckm%sh fjñka mj;S' iqÿ iy,a j,g jvd r;= iy,a fmdaIK .=Kfhka wkQkh hk ldrKdj wfma rfÜ ck;dj w;r uq,a nei.;a u;hla ksid fuh w;sYh úoHd;aul ienEjls' r;= iqj| iyf,a le,ß w.h wvqh' ldfndayhsfâ%Ü fukau fidaähï o idfmalaIj wvq w.hla we;' ;jo w;sYhska wys;slr fïoh ldKavhla fia ie,flk g%dkaia fïoh iqj| r;= iyf,a wvx.= ke;' fï ksidu wo Èkfha Èhjeähd frda.Skag b;du;a .=Kodhl iy,la jkafka ^Red Fragrant Rice& r;= iqj| iy,ah' DM
DOCTOR MAGAZINE
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doctormagazine.lk
November 2020
DOCTOR MAGAZINE
83
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Lower Extremity Bypass Surgery mdo lmkak Tkak'' fukak''' frda.Skag n,dfmdfrd;a;=j f.k wd ie;alu
BYPASS SURGERY FOR LOWER EXTREMITY LIMB SALVAGE mdo lmkak Tkak'' fukak'''
frda.Skag n,dfmdfrd;a;=j f.k wd ie;alu Lower Extremity Bypass Surgery uydpd¾h ukaosl úfcar;ak fld<U úYAj úoHd,hSh ffjoH mSGfha Y,Hfõoh uydpd¾h yd jdysksl yd noaO lsÍï wxYdêm;s fld<U cd;sl frdayf,a jdysksl frda. úfYAI{
84
November 2020
DOCTOR MAGAZINE
doctormagazine.lk
reêrjdyskS u; fldf,iagfrda,a ;ekam;a ùfuka wjysr jQ kd,hla
úáka úg mdofha we;sjk fõokdj
neÆkhla m%fõY lr kyrfha wjysrh bj;a lsÍu
;=jd, iqj fkdùfuka nrm;, f,i mSvdjg m;ajk oshjeähd frda.Skag ;sfnk n,dfmdfrd;a;=fj ie;alula ;uhs Lower Extremity Bypass Surgery ie;alu' reêr .ukd.ukh wjysr jQ reêrjdysksh ms<silr lrñka iqugj reêrh .,d hkakg ie,eiaùug wekacsfhdma,diaá ie;alu isÿ lrkjd' fuysoS wjysr jQ ia:dkh Tiafia kej;;a reêrh .uka lrùug ie,eiaùug iafgkaÜ tlla odkjd' tfy;a" iafgkaÜ tlla oeóu mjd lrkakg fkdyels jQ úg fjk;a ia:dkhl we;s isref¾ kyrhla weiqf¾ fjk;a ud¾.hla ilia lsÍu fuu Lower Extremity Bypass Surgery ie;alfuys uQQ,sl wNsu;d¾:h fjkjd' Heart Attack yd Foot Attack iafgkaÜ odk tl''' nhsmdia ie;alula lrk tl''' wm fuf;la yoj; iïnkaOfhka wid mqreÿ ie;alï''' osú iqrlsk yoj;g jk f,a .ukd.ukh wjysr jqKdu lrk wekacsfhdma,diaá ie;alï''' iafgkaÜ ia:dms; lsÍï jf.au nhsmdia ie;alï" mdo j,g;a lrkak isÿ fjk wjia:d ;sfnkjd''' meh yh y;l ixlS¾K ie;alula jYfhka ie,iqï jk fï ie;alfïos;a b;d ishqï úosyg flaYsl kyr mjd kej; ilikak fjkjd' jeroSï j,g bvla kE''' Heart Attack tlla yeÿKu isÿlrk yoj; ixlS¾K ie;alï i|yd yD;afõoh ^Cardiology& Wiia Ndú;djka wdf,dalhla jkafka hïfiao" tmuKgu ixlS¾K ie;alula Ndú;hka" ;dlaIKhka Tfí mdoh fír .kak;a lrkakg isÿ fjkjd'
doctormagazine.lk
November 2020
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85
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Lower Extremity Bypass Surgery mdo lmkak Tkak'' fukak''' frda.Skag n,dfmdfrd;a;=j f.k wd ie;alu
iafgkaÜ tl wjysrh jQ ia:dkfh ia:dms; flfrhs
1980 oYlfha isgu fï ie;alï isÿ lsÍug mqfrda.dó jQ úúO wNsfhda.d;aul ld, jljdkq miq lrñka fï jk úg hqfrdamfha muKgu id¾:l jdysksl ie;alï isÿ lrkakg oSmkhla jQ uydpd¾h ukaosl úfcar;ak fï mdo ¨yqj;a lrkakg isÿjk wjia:dj zzmdodndOhlaZZ Foot Attack jYfhka yªkajkjd'
oYl .Kkdjla ;siafia wfma rfÜ ck;djf.a ll=,a fírd .kakg flreKq fufyjr miq.shod iqúfYAIS c.;a ;,fha we.hSulg ,la jqKd' ta jdysksl wOHhk iïnkaOfhka lS¾;su;a The European Journal of Vascular Endovascular Surgery c¾k,fhka'
fjk;a ia:dkhlska ,nd.;a kyrhla noaO lr w;=re ud¾.hla Tiafia mdo j,g reêrh ,efnkakg ie,eiaùu' fuysoS fndfyda úg mdofhysu we;s Saphenous vein kue;s kyr fldgila ,nd .kS'
86
November 2020
DOCTOR MAGAZINE
f,dalh mqrd ms<s.ekSug ,lajQ Y,Huh ld¾hhla Lower Extremity Bypass Surgery ie;alu fï jk úg;a uekúka ia:dms; ld¾hlaIu jdysksl ie;alula úosyg yªkajd fokak leu;shs' wjysr jQ ud¾.h fjkqjg w;=re u.la ilik ksidfjkau zznhsmdia ie;alulaZZ jYfhka ie<flk fulS ie;alu ks¾úkaokh hgf;a isÿ lrk m%Odk Y,Hl¾uhla jk ksid (Major surgical procedure performed under anesthesia) ie;alug fmr mQ¾K ie,eiaula yd ms<sfh, ùula lrkakg isÿ fjkjd'
doctormagazine.lk
wjysrh
isref¾ fjk;a ia:dkhlska ,nd.;a kyrh noaO lsÍu
fï ie;alug jeä jYfhka Ndckh jkafka wêreêr mSvkh" fldf,iagfrda,a jeks fjk;a ixl+,;do wvq ke;s oshjeähd frda.Ska ùu ksid fï whg yDohdndO we;sùfï wjodku" reêr leá;s reêrjdyskS j, we;sùfï wjodku jf.au wdidok we;sùfï wjodku;a wka whg jvd jeähs' ta ksid tlS wjodkï idOl .ek;a fjfiiska ie<ls<su;a ùug ffjoHjreka lghq;= lrkjd' fï ksid reêrfha >k;ajh wvq lrk weiamsßka" wêreêr mSvkh md,khg .kakd T!IO" fldf,iagfrda,a my; fy<k T!IO ie;alug fmr;a" ie;alfuka miqj;a ffjoH Wmfoia m%ldrj .; hq;=hs'
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wvq myiqlï" jeä wNsfhda. hgf;a;a wfma rfÜ fuu ie;alu id¾:l m%;sM< fmkajd ;sfnkjd wfma rfÜ fuu ie;alu isÿ lsÍu óg oYl ;=klg muK fmr fld<U cd;sl frdayf,ka wdrïN jqKd' ta;a fï ie;alï iïnkaOfhka c.;a ;,fha m¾fhaIlhka yd lreKQ fnodyod.ekSula lrkakg wmg uq,a ld,fha f,dl= wjia:djla ;snqfK kE' fï ksid ixixokd;aul m%fõYhla ,nd .kakg ;snqKQ fndfyda wjia:d wmg wysñ jqKd' ie;alï iïnkaOfhka wjfYaI f,dalh iu. fjfiiskau oshqKQ rgj,a iu. woyia yqjudrejlg wmg wjYH;djh ;snqK;a ta iïnkaOfhka uq, msÍula fyda isÿ flrefKA 2015 jf.a ;odikakhloS' fï ie;alu isÿ lrk fjk;a rgj,a j,g jvd myiqlï w;ska wm fndfydu msgqmiska bkafk' th;a lsj hq;=uhs' fï Lower Extremity Bypass ie;alfïoS ;rul wjodkula orK frda.Ska ie;alug Ndckh lrk ksid Tjqka ie;alug f;dard .ekSula isÿ lrkak;a fï ie;alu lrk Y,H ffjoHjreka mshjr .kakjd' túg id¾:l;ajh by<hs' wms ;rula fjkia cd;shla lshkjdfk' wms wfma rfÜos Wia ñálï u; frda.shd f;dard.ekSula wms isÿ lrkafk kE' ie;alug we;s úNùh fhda.H;djh yd wjodku muKla ;lafiare lrñka ie;alug frda.Ska f;dard .kakjd' b;ska tfyu jqK;a wfma cd;sl frdayf,a;a uykqjr" lrdmsáh yd wkqrdOmqr wdoS fjk;a frday,a j,;a lrk ie;alï úYd, id¾:l;ajhla
November 2020
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87
D•Magazine /
Lower Extremity Bypass Surgery mdo lmkak Tkak'' fukak''' frda.Skag n,dfmdfrd;a;=j f.k wd ie;alu
m%ia;=; ld, jljdkqj ;=< l< by; ie;alug Ndckh jQ frda.Ska 367 fofkla iïnkaOfhka .;a l< bka 131 fofkla ldka;dfjda h' jhi wjqreÿ 65 g wvq frda.Ska .Kk 201 ls' jhi wjqr eÿ 65-80 ;a w;r miqjQ frda.Skaf.a ixLHdj 30 ls' fuu frda.Ska 367 fokd w;ßka 292 fokl=u Èhjeähd frda.Ska ùu úfYaI hls' th m%;sY;hla jYfhka ishhg 80ls' fuu frda.Skaf.ka 117 fofklau ÿïmdkh yd ÿïfld< Ndú;d lrk wh fj;s'
lemqu fldf,iagfrda,a ;ekam;=j
Ouksh újD; lsÍu Ouksfhka
wjysr jQ fldf,iagfrda,a bj;a lsÍu
fndfyda fofkl=g fuhska wfmalaIs; id¾:l m%;sM< ,enqK;a we;eful=g miqld,Skj wjia:dfjdaÑ;j hï hï ms<silr lsÍï lrkakg isÿfõ' oaú;Shslj we;sjQ wjysrhla miqld,Skj bj;a lsrSu fuys oelafõ
w;am;a lrf.k ;sfnkjd' th ngysr rgj, id¾:l;ajhg fnfyúka iudku id¾:l;ajhla' hqfrdamShhka yd iu wfma id¾:l;ajh 2015 isg 2017 olajd jir ;=kl ld,h ;=< fld<T cd;sl frdayf,a isÿ lrk ,o mdoj, nhsmdia ie;alï iïnkaOfhka jd¾;d jkafka fï úosyg'
88
November 2020
DOCTOR MAGAZINE
Èhjeähd frda.Skaf.a mdo bj;a fkdlr ;=jd, iqj lsÍu i|yd isÿ lrkq ,nk nhsmdia ie;alïj,ska miqj ;;a;ajh fufiah' uq,a udih we;=<; ñh hkafka ishhg 4'5la mu‚' tfy;a j¾Ihla blauj k úg Ôj;ajk frda.Skaf.a m%;sY;h ishhg 82ls' ta wkQj frda.Skaf.a ñh hk m%;sY;h ishhg 18ls' ;j;a úÈylska lsjfyd;a frda.Ska mia fokl=f.ka 1la whl= ñh hEfï iïNdú; dj f,i th fmkajd Èh yels h' ll=,a fkdlmd fírd.kq ,enqj o fuu frda.Ska fndfyda úg ñh hkafka yDohdndO" wd>d;" wêreêr mSvkh jeks fya;+ka ksid njo wm wu;l fkdl< hq;=h' Y,Hl¾uj,ska jirlg miqj Ôj;a jk ishhg 80l f.a tkï" 1$5 l mdo wysñ ù we;s njo fy<sorõ ù we;' wfma mdo iqrlsk ie;alï c.;a nqyqukg ,lafjhs oYl .Kkdjla ;siafia wfma rfÜ ck;djf.a ll=,a fírd .kakg flreKq fufyjr miq.shod iqúfYAIS
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c.;a ;,fha we.hSulg ,la jqKd' ta jdysksl wOHhk iïnkaOfhka lS¾;su;a The European Journal of Vascular Endovascular Surgery c¾k,fhka' ‘Clinical outcomes from vein bypass surgery for amputation prevention at the University of Colombo, National Hospital of Sri Lanka’ hkqfjka m%ldYhg m;a tu Ydia;%Sh ,smsfhys oelafjk wdldrhg mdo lmkakg fkdoS wdrlaId lr.kakg isÿ lrk nhsmdia ie;alu iïnkaOfhka wvq wdodhï ,nk" uOH wdodhï ,nk rglska w;aoelSï yqjudre jQ m%:u wjia:dj fuhhs' úu;sh kï" wvqmdvqlï /ilg uqyqK mdñka ,dxflah jdysksl ffjoHjreka fï ie;alu isÿ l<;a tys m%;sM< hqfrdamfha fiiq rgj, ;rugu id¾:l ùuhs' wfma ck;dj uqyqKmdk wjodkfï miqìu wfma rfÜ ck;djf.a iuia; fmdaIK ;;a;ajh oshqKQ rgj,g idfmalaIj ÿ¾j,h' iuia;hla jYfhka wfma whf.a ySfud.af,dìka uÜguo wvqh' YÍrfha mgl j,g Tlaiscka f.k hdfï l%shdj,shg fuho wys;lrj n,mdhs' ol==KQ wdishd;sl iïNjhla iys; wfma yDohdndO wjodkuo ;rula jeäh' fï wjmig ysák ish¿u idOl fï ie;alug wNsfhda.hla jQj;a wm rfÜ isÿ lrk fuu ie;alu oshqKQ rgj, uÜgug wdikakfha mej;Su úYd, ch.%yKhla fkdjkafkao@ oshjeähd frda.Ska ljr l,g;a jvd jeä ld,hla wfma rfÜ oshjeähd frda.Skaf.a úYd, jeäùula miq.sh ld,h ;=< fmfkkakg ;snqKd' ud 1990 j¾IfhaoS fld<U cd;sl
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frday,g tk úg ishhg 50-60la jQ jdÜgqfõ oshjeähd frda.Ska ixLHdj fï jk úg ishhg 80-90la muK olajd j¾Okh ù ;sfnkjd' wfma rfÜ iEu mqoa.,hka mfyka tllau oshjeähd wjodku orkakka' f,dal ck.ykfhka ñ,shk 202la oshjeähdfjka mSvd ú|skjd' mdo j,g reêrh ksishdldrfhka fkd,eîu oshjeähdfõ m%Odk ixl+,;djhla' fï ksidu wo jeä jeäfhka oshjeähd frda.Ska mdo ;=jd, we;sùfï .eg¿jg uqyqK mdkjd' zzmdo id;a;=j iïnkaO úfYAI jD;a;slhka wmg kE' mdjyka ieliSu mjd fuys úfYAI{;djhla' reêrjdyskS iïnkaO idhï fhÿ úlsrK mÍlaIK (X-ray studies on blood vessels) wekacsfhd.%ms jf.a yosisfha wjYH fjk wjia:d ;sfnkjd' fï ndOd ueo wms tl mdfrka ie;alu iïmQ¾K lrkjd' fjk;a oshqKQ rgj, jf.a kej; ms<silr lsÍï j,g wjldYhla fï miqìu ;=< kE''' ;j;a jeo.;a ldrKhla''' frda.shd iqjm;a fj,d f.or .shdg miafi;a Tyqg bkamiq ffjoH Wmfoia ,nd. kak kï fï frday,gu tkak fjkjd' .ïno m<d;a j, jdysksl ffjoHjrfhlaf. fiajh ,nd .ekSu ÿIAlr ldrKhla'ZZ -uydpd¾h ukaosl úfcar;ak oshjeähdj ;sfhk úg ;=jd, fyd| fjkafk ke;af;a wehs@ oshjeähdj fkd;sfnk whg mdohl ;=jd,hla we;s jqKdu th iqjm;a lr.kak tl uy wudre fohla fkdfjhs' ta;a oshjeähd frda.Skaf.a
November 2020
DOCTOR MAGAZINE
89
D•Magazine /
Lower Extremity Bypass Surgery mdo lmkak Tkak'' fukak''' frda.Skag n,dfmdfrd;a;=j f.k wd ie;alu
mdo j, we;sjk ;=jd, myiqfjka iqj lrkak neß wehs@ fï ksid we;euqkag mdo wysñ jkafka wehs@ ;=jd,hla iqjm;a jkakg ta wdY%s; mgl j,g wï,lrh ^Tlaiscka& ,eìh hq;=h' oshjeähd frda.Skaf.a mdo j,g m%udKj;a reêr iemhqula fkd,eîu ,dlaIKslj olakg ,efnkakls' idudkHfhka mgl j,g reêrh ,efnk mSvk ;;a;ajh oshjeähd frda.sfhlaf.a we;s jkafka ke;' reêrh m%udKj;aj" fhda.H mSvkhlska fkd,efnk úg reêrh;a iu.u ,eìh hq;= Tlaiscka m%udKh yßhdldrj ,efnkafkao ke;' túg ;=jd, iqjm;a ùula isÿ fkdfjhs' fï frda.Ska w;r fldf,iagfrda,a frda.Skao isà' we;eï úg reêr kd, wjysr ùula ksido fï whf.a mdo j,g reêrh ,efnkafkau ke;' fuys m%;sM<hla f,i ;=jd,h iqjm;a fjkjd fjkqjg ;=jd,h l=KQ fjhs' l=KQ jQ ;=jd,h Tvqÿjd .sh úg th ksid isref¾ f,a ¥IKh ùfuka (Sepsis) cSú;h mjd wjodkulg ,la fjhs' fuu ;;a;ajh hgf;a ;=jd,h cSú;hg ;¾ckhla fkdjkq msKsi weÕs,a,la mdofha fldgila jYfhka lmkakg isÿ fjhs' mdo lmkaku ´kso@ tfia fkdlr mq¿jka kï@ lsisu frda.sfhla ;ukaf. mdoh ;nd weÕs,s fldgila j;a lmkakg leu;s jkafka kE' ffjoHjrekq;a we;af;kau Bg leu;s jkafka ke;' fï ksid tu ;SrKh .kakg fmrd;=j Tjqka frda.shd fjkqfjka mshjr /ila .kS' m%;scSjl T!IO" iq¿ Y,H yd Y,Huh fkdjk m%;sldr /i;a ta w;r fjkjd' ta Tiafia
90
November 2020
DOCTOR MAGAZINE
mdohg reêr iemhqu kej; we;s lsÍug Tjqka úúO mshjr .kakjd' tajd m%;sM< fkdÿka úg Wiia Y,Huh ueosy;a ùï j,ska tu wjysrh bj;a lrkakg W;aiql fjkjd' neÆkhla fhdod kyrh úia;drkh lr iafgkaÜ odkafk ta ksihs' ta;a tho wid¾:l jk wjia:djkaySoS óg fmr kï mdoh bj;a lrkjd fjkqjg wka úl,amhla ;snqfKA kE' ta;a Lower Extremity Bypass ie;alu furg l%shd;aul ùu ksid oshjeähd mdo ;=jd, frda.Skag tys wjidk woshf¾o ;j;a n,dfmdfrd;a;=jla tla lr ;sfnkjd' fï Lower Extremity Bypass ie;alug Ndckh ùfuka miqj Tjqka weiamsßka" fldf,iagfrda,a wvq lrk T!IO wdosh .ekSu fjfiiskau .;hq;= fjkjd' tfiau ÿïmdkh jeks wys;lr p¾hd j,ska kï ksielfhkau bj;a jkakg isÿ fjkjd' ie;alug Ndckh ùfuka miqj frda.shdg fndfyda m%fhdack ,efnkjd' tf;la ú|s fõokdjka ie<lsh hq;= muKlska wvq fjkjd' ;=jd, iqjùu fõ.j;a fjkjd' weúoSug we;s yelshdjo jeä fjkjd' mdo bj;a lsÍfï wNsfhda.fhka ñoSuu fl;rï jákdlulao@ l%shdYS,S cSú;fha wjidkh oel oel;a bka ñoSug;a .=Kd;aulj ;j;a ld,hla cSú;h mj;ajd .ekSug;a yelsùu fl;rï kï jákjdo@ DM
,nk l,dmfhka''' oshjeähd frda.Ska mdo wdrlaId lr.; hq;af;a flfiao@
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D•Magazine /
OccupationalTherapy fgksia fkd.yk whg;a yefokjd''' fgksia t,afnda
LATERAL EPICONDYLITIS fgksia fkd.yk whg;a yefokjd'''
fgksia t,afnda jeämqr yefokafk yqre w;g ldgo wjodku''' ix.S; NdKav jdolhska" l%Svlhska" f;a o¿ fk,kakkaa" ì;a;s mska;dre lrkakka" c,k, ld¾ñlhska" flala ieris,s lrkakkaa" tïfn%dhsv¾ lrkakkaa" fmof¾rejkaa" jvq ld¾ñlhska Ys% ,xld cd;sl frdayf,a jD;a;sh Ñls;ail ksud,s w¨;aj;a; BSc. OT
92
November 2020
fgksia t,afnda lshkafka''' fuh je,ñg ikaêh wdY%s;j we;s jk iq,n frda.S ;;a;ajhls' je,ñg ikaêh wêl f,i l%shdldrS ùu ksid ta wdY%s; uDÿ mgl j,g ydks ùfuka fuu ;;a;ajh Woa.; fõ' fuysoS
DOCTOR MAGAZINE
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je,ñg ikaêh wêl%shdldß;ajh ksid ta wdY%s;j we;sjk uDÿ mgl wdmodjg m;aùu fgksia t,afnda j,g fya;= fjhs
rEmfha oelafjk fmfoiska u;=jk oeä fõokdj fuys frda. ,laIKhhs
doctormagazine.lk
oE;a fjyijd fhfok /lshdj,oS f.orfodr lghq;= j,oS fukau l%SvdjkayS ksr; ùfïoSo fuu frda.S ;;a;ajh flfklag we;súh yel' ia;%S mqreI fNaohlska f;drj wjqreÿ 30-50 w;r we;euqkag iq,nj olakg ,efnkjd'
je,ñg ikaêfha Yrsrfhka msg;g msysgk fmfofia (Lateral aspect) Lateral Epicondyle kï wiaÓ fldgi wdYs%;j bosóulao iys;j oeä fõokdjla yg.kS' fuu fõokdj je,ñg ikaêfha isg by<g;a my<g;a úysoS hd yel' fuu ;;a;ajh l%ufhka fya;=fjka we`.s,s j,ska hula .%yKh lsrSu mjd wmyiq ;;ajhg m;a lrjk w;r miqld,Skj wf;ys fmAYska j, Yla;sh wvq ùugofya;=jla fjhs'
November 2020
DOCTOR MAGAZINE
93
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OccupationalTherapy fgksia fkd.yk whg;a yefokjd''' fgksia t,afnda
lrkakka" fmof¾rejka yd jvq ld¾ñlhska w;r fuu ;;ajh iq,nh' fgksia t,afnda j,g jD;a;sh Ñls;ail m%;sldr m<uqj uQ,sl mrSSCIKhla (Occupational Therapy Assessment) u.ska frda.shdf.a ixl+,;djhka y`ÿkd .kq ,efí' fuysoS'''
fï frda.Ska Brace oeófuka fõokdj;a wmyiq;djh;a bj;a jk w;r iqjm;a ùu fõ.j;a fjhs
fgksia t,afnda yefokafka wehs@ fgksia t,afnda ;;a;ajhg uQ,sl fya;=j jkafka je,ñg ikaêh os. yerSug odhl jk fmaYska wiaÓhg iïnkaO jk ia:dkh (Common Extensor Origin) wdidokhg ,la ùuhs' fufia jkafka fgksia l%SvdfõoS fuka je,ñg ikaêh ksrka;rj keùu yd os.yerSu isÿjk l%shdldrlï (Repetitive activities) j,oS fmaYs ;ka;= brSulg ,laùu njg Wml,amkh lrkq ,nhs' tfiau je,ñg ikaêh wk;=rlg ,laùuo (Sharp bang or Knock of the elbow) fuhg n,mdk ;j;a fya;=j;a úh yelshs' oE;a fjyijd fhfok /lshdj,oS f.orfodr lghq;= j,oS fukau l%SvdjkayS ksr; ùfïoSo fuu frda.S ;;a;ajh flfklag we;súh yel' ia;%S mqreI fNaohlska f;drj wjqreÿ 30-50 w;r we;euqkag iq,nj olakg ,efnkjd' idudkHfhka mqoa.,hdf.a yqre w; (Dominant hand) fuu ;;a;ajhg jeä jYfhka n÷ka fõ' ix.S; NdKav jdolhska" l%Svlhska" f;a o¿ fk,kakka" ì;a;s mska;dre lrkakka" c,k, ld¾ñlhska" flala ieris,s lrkakka" tïfn%dhsv¾
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November 2020
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1'fõokdj (Pain) 2'bosóu (Swelling) 3' je,ñg ikaêfha" ueKsla lgqj ikaêfha iy we`.s,s mqrela j, p,kh lsrSfï mrdih. (Range of motion) 4'hula .%yKh lsrSfï yelshdj (Grip strength) ms<sn`oj fjfiiska wjOdkh fhduq lrkq ,efí' jD;a;sh Ñls;ail m%;sldrh u.ska 1'fõokdj iukh lsrSu 2'wdidokh md,kh lsrSu 3'ikaêj, pd,l yelshdj by< kexùu 4'fmaYs j, Yla;su;a Ndjh jeäoshqKq lsrSu isÿ lrkq ,nkjd
doctormagazine.lk
jD;a;Sh Ñls;aidfjka wdidok md,kh yd fõokdj iukh lrk w;r os.=ld,Sk jYfhka iqjfi; mj;ajd .ekSug wjYH jHdhdu wdosh frda.shdg W.kajhs
•fõokdj W;aikak ùug fya;= jk ish¿ l%shdldrlï j,ska je,lSug oekqj;a lsrSu ² frda.shd úiska tosfkod isÿlrkq ,nk l%shdldrlï idudkH l%ufhka neyerj fjk;a l%uhg isÿ lsrSug yels wdldr ms<sn`o wjOdkh fhduq lsrSu (Modification of activities) ² Tennis elbow brace fuu.ska ikaêh p,kh ùfïoS m%;s n,hla (Countertarce) fhoSu u.ska fmaYs j,g úfõlhla ,ndfoñka fõokdj iy bosóu wvq lsrSug l%shd lsÍu
doctormagazine.lk
² je,ñg ikaêh" ueKsla lgqj ikaêh iy we`.s,s mqrela i|yd Mobilization activities y`ÿkajd oSu' ² wf;a ish¿u fmaYs Yla;su;a lsrSu i|yd Strengthening activities iy Stretching activities y÷kajd oSu
fï wdldrhg jD;a;sh Ñls;ail m%;sldr i`oyd fhduq ùu u.ska fuu frda.S ;;a;ajh iukh lr ;u cSjk ;;a;ajh hym;a lr .ekSug frda.shdg wjia:dj ie,fia' DM
November 2020
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doctormagazine.lk
November 2020
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Traditional Chinese Medicine ngysr ffjoH úoHdj yd lrg lr úialï olajk Ökfha iïm%odhsl ffjoH úoHdj
Traditional Chinese Medicine: What You Need To Know ... ngysr ffjoH úoHdj yd lrg lr úialï olajk Ökfha iïm%odhsl ffjoH úoHdj wfma rgg wjYH lrk T!IO ffjoH WmlrK imhk m%uqL rgla jkafka Ökhhs' Ökfha ngysr ffjoH úoHdj yeoEÍug jd¾Islj Ökhg hk wfma YsIHhka ixLHdjo iq¿mgq fkdfõ' tfy;a Ökh ngysr ffjoH úoHdjg fukau Tjqkaf.au Wreuhla iys; idvïnr fmros. ffjoH Ydia;%hlgo Wreulï lshk nj f,dalhg ryila fkdfõ' Ökfha lgq Ñls;aidj l,la wfma rfÜo fnfyúka m%p,s;j mej;S w;r woo th wfma rfg;a frda. iqj lsrSug Ndú;hg .efka' Ökfha iïm%odhsl ffjoH úoHdj ngysr ffjoH úoHdj fndfyda úg fhduq ù we;af;a frda. m%;sldr i|yd jqj;a Ök idïm%odhsl ffjoH úoHdj isref¾ iuia; ksfrda.SNdjh b,lal lr .ekSu úfYaI;ajh ls' th mokï ù we;af;a isref¾ ;=,s;;djh" wkqj¾;sh iy Yla;sh u;h' lgq Ñls;aidj" lma lsÍu fyj;a iu u; pQIK we;s lsÍu" iu ms<siaiSu" Ydlidr 98
November 2020
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doctormagazine.lk
W;aidy flfrkafka tajd w;r .;sl iu;=,s;djhla we;s lsÍugh' Ök idïm%odhsl ffjoH úoHdfõ jeo.;a wx.hla jkafka YÍrfha —Ö˜ ^ qi& fyj;a Ôj n,h ^jpkd¾:fhka —jeo.;a yqiau˜& ms<sn| wjfndaOhhs'—Ö˜ YÍrfha woDYHudk kd,sld yryd .,d hhs' fuu Yla;s cd,h" wjhj" mgl" kyr" iakdhq" ffi," mrudKq iy ú{dkh tlsfklg iïnkaO lrhs' YÍrfhys m%Odk kd,sld 12 la we;s w;r ta iEu tllau m%Odk wjhj 12ka tllg iïnkaO fõ' Ök idïm%o dhsl ffjoH úoHdfõ i|yka jkafka ñksia isref¾" —hska˜^yin& iy —hex˜ ^yang& hkqfjka tlsfklg m%;súreoaO n,fõ. folla mj;sk njhs' wikSmhla hkq —hska˜ iy —hex˜ iu;=,s;;djh ì| jeàfï m%;sM,hls' Ök idïm%odhsl ffjoH m%;sl dr l%u uÕska W;aidy flfrkafka tajd w;r .;sl iu;=,s;djhla we;s lsÍugh'
T!IO iemhSu" wdydr Ñls;aidj" Ndjkdj iy ;dhs Ñ hk jHdhdu tys§ fhdod .kakd m%;sldr l%u lsysmhls' Ök idïm%odhsl ffjoH úoHdfõ i|yka jkafka ñksia isref¾" —hska˜^yin& iy —hex˜ ^yang& hkq fjka wkqmQrl ^tlsfklg m%;súreoaO& n,fõ. folla mj;sk njhs' fuu n,fõ. fol w;r .egqula fkdmj;sk ;dla mqoa.,hl= ksfrda.S h' wikSmhla hkq —hska˜ iy —hex˜ iu;=,s;;djh ì| jeàfï m%;sM,hls' Ök idïm%odhsl ffjoH m%;sldr l%u uÕska
doctormagazine.lk
iqúYd, jQ T!IO lkaordjl Wreuh iu.ska''' Ök idïm%odhsl ffjoH úoHdj .ek m¾fhaIK isÿ l< úoaj;l= jQ —,S ISfika˜ ^Li Shizhen& 1578 § —Compendium of Materia Medica˜ kue;s Tyqf.a iqm%isoaO .%ka:h ;=<" T!IO 1"892 la iy ksYaÑ; frda. i|yd úêu;a fnfy;a jÜfgdare 11"000 la ,ehsia;=.; lr ;sìK' T!IO f,i fhdod f.k we;af;a Ydl yd i;a;aj fldgia iy Lksc øjHhkah' fldúâ md,khg bmerKs Ök T!IO id¾:lj fhdod .;a;d Covid-19 jix.;h md,kh lsÍu i|yd Ök ffjoHjre idïm%odhl s T!IO nyq, f,i fhdod .;ay' Covid-19 ffjria frda.k S f a .a fmky¿ msßiÿ q lsÍu i|yd Ök cd;sl fi!LH lñgj q iy idïm%odhl s T!IO cd;sl mßmd,k tlaj —Ñxf*hs mhsv˜Q ^Qingfei Paidu& kue;s iqma j¾.h ks¾foaY lr ;sfí' th ,nd .;a frda.k S f a .ka ishhg 60lf.a muK nrm;< frda. ,laIK myj .sh nj frday,a jd¾;d fmkajd fohs' Ökfha Covid-19 jix.;h id¾:lj md,kh lsÍug fuu idïm%odhl s T!IO m%;l s dr fnfyúka bjy,a ù we;' fgdrxgka wo ojfia iïm%odhsl Ök T!IO Ökfha;a cd;Hka;rj;a fnodyßk T!IOd.drh fjhs' 1723 j¾IfhaoS fhdxfIx wêrdcHhd úiska fuh rdclSh Tiqi,la jYfhka kï lrKQ ,ÿj jir 188l ld,h ;=< wêrdcHhka wg fofkl=f.a yd Tjqkaf.a mjq,aj, wdhq wdfrda.H fjkqfjka lemù l%shd lf<Ah' fï jk úg kùk ;dlaIKho uqiq lrñka iïm%odhsl ffjoH úoHdj m%p,s; lsÍug wkQmfïh odhl;ajhla olajk fgdrxgka Ökfha cd;sl ixialD;sl Wreuhla jYfhkao m%ldYhg m;aj ;sfí' DM
November 2020
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ufkda ,sx.sl .eg¿ wiïu;hg fmï n¢k iu,sx.slfhda
ufkda Ñls;aid
wiïu;hg fmï n¢k iu,sx.slfhda .hksf.a l;dj
l=
reKE., Èia;%slalfha tla;rd m%foaYhl .hks;a wef.a uõmshkq;a Ôj;a úh' .hksg jhi wjqreÿ úis folls' mjqf,a tlu orejd weh úh'
.hksf.a foudmshka .hksg ±lajQfha buy;a fifkyils' tlu orejd ùu ksidu wehg mQ¾K ksoyilao foudmshkaf.ka ,enqKs' t;rï rEu;alñka fyì ;reKshl fkdjQ weh mdi,a wOHdmk lghq;= j,g olaI;djhka ±lajQ ksidu w'fmd'i' Wiia fm< úNd.ho iu;a ù iriú jrï ,enQjdh' weh úYaj úoHd, isiqúhls' fyd|u fhfy<sh jQfha kfhdañh' kfhdaño weh iuÕu iriúfha bf.kqu ,nhs' ta ksidu Tjqka iriúhg tkafkao" hkafkao tlguh' mjqf,a ±ä wdorhla fifkyila /ljrKhla ,enqko iu jhia hy¿ fhfy<shka fidhd .ekSu fldhs ld w;skq;a isÿjkakls' kuq;a .hksg isá tlu fhfy<sh kfhdañ muKls' kfhdañgo tfiau úh' .hks;a kfhdañ;a lEfõ îfï tlguh' .uka ìuka .sfhao tlguh' lsis÷ fya;=jla ksid fuu ñ;=ou ì÷fKa ke;' iefmaÈ;a ÿflaÈ;a .hks yd kfhdañ tlsfkldg fndfyda iómj isáhy' fï neõ okakd iefjdu mejiqfõ iudchg b;d fyd| wdo¾Yhla njhs' iriúfha§ muKla fkdj" .fï lv msf<a" kdk f;dgqmf,a§" nia kej;=fï mjd fudjqkaj ÿgq úg fudjqkaf.a ne£u l;d nyg ,lajk ldrKdjla jQfõh' .hksf.a;a kfhdañf.a;a foudmshkago fuh buy;a wiajeis,a,la úh' 100
November 2020
DOCTOR MAGAZINE
Y%S ,xld iajdmk úoHdfõ§kaf.a ix.ufha j;auka iNdm;s ufkda Ñls;ail" ffjoH mS'tka' úoHd,l=,m;s
ld,hla .;úK' .hks yd kfhdañf.a .cñ;=relï iïnkaOfhka oeka iudcfha l;dny wuq;=h' fumuK ld,hla ñ;=relï .ek l;d weiqko ±ka ±ka Tjqka fofokd .ek iriúfha yd .fï l;dnyg ,la jkafka weiSug;a ,Êcd ysf;k foah' Tjqka fofokd hk tk Èyd flfkla Wmydifhka n,;s' fofokdf.a ñ;=ou Èyd fu;rï Wmydifhka ne,Sug lreKq ukao@ ld,h uejq fjkil wreuh@ oeka .hks;a kfhdañ;a wka ;reK fhfy<shkag jvd yd;amiskau fjkia .;s.=K j,ska fyì fofofkls' Tjqfkdjqka
doctormagazine.lk
kfhdañ iuÕ ;sfhk wehs fyd|hsh kj;d ouk f,ih' uj wehg wjjdo l<dh' wjidkfha /lj,a ±ïfï ksjiska t<shg hdugj;a fkdyels jk f,isks' zzfl,a, mßiï fkdlrf.k bf.k .kak fohska wyj,a fohlaoZZ uj .hksf.a mshdg lSfõ ta álh' yßhg fm%aujka;hska fiah' fï fhfy<shka fofokd tlsfkldg ,sx.sl wdl¾IKhla olaj;s' .hksf.a foudmshkag ;u oshKsh .ek fkdfhl=;a wiqN wdrxÑ wikakg ,enqKs' lkska fldkska weyqKQ foa osfkl bkaf;arefjkau wykakg ,enqfKA wkq;a;rdf. ks' wkq;a;rd iriúfha bf.kqu ,nk .hksf.a {d;s fidhqßhl jkakSh' wd .sh l;dnfyka miq weh wd ldrKhg msúishdh' zz.hkshs kfhdañhs w;r ;sfhkafka wms ys;k úêfha iïnkaOhla fkfuhs kekafo' tal fmdâvla fydh,d ne¨fjd;a fyd|hs fkaoZZ wkq;a;rdf.a uj mejiqjdh' wkq;a;rd yenúkau .hks,dg f,ka.;= {d;sjßhl jQjdh' zzt'''ta'' lshkafk fudllaoZZ .hksf.a uj l,nf,ks' zzwms ys;=jg fokakdf.a hy¿lu ñ;%;ajhla lsh,d tal tfyu fkfuhs¨' leïmia tfl;a Th .ek yßhg l;d fjkj' uyd krl foaj,aZZ wkq;a;rdg ;j;a hula mejiSug ;rï jpk f.dkq lr .; fkdyels úh' zzwfmdhs fohshfka fï fudk úkdihlao'' fï fl,af,d fokakg ula fj,do'' wfmdhs wmg;a Th jf.a wdrxÑ wdjg Bßishdjg lshkjd lsh,hs ys;=fõ' ta;a fï fudk ú,s ,eÊcd ke;slulao@ZZ l< hq;af;a l=ulao@ wehg ys;d.ekSug fkdyelsh' iji f,lap¾ia wjika ù .hks ksjig meñKsfha fndfyda f;fyÜgq njlsks' ta;a ksjig f.dv ù ál fõ,djlskau uj wehg ;¾ckd;aulj mejiqfõ doctormagazine.lk
fldmuK /lj,a ±uqjo .hks kfhdañ fidhdf.k .shdh' Tjqkaf.a ine|shdj ì| ±óu ta jk úg myiq ldrKhla fkdjQ fiah' .hksf.a flakaorh fcHda;sIfõÈfhl=g fmkajQjo tys lsis÷ wm,hla fyda .%yfodaIhla fkdue;s nj lshjqKs' tfia kï msysg me;sh hq;af;a fldyskao@ idia;r''' weh idia;rhla ne,Sug .sfha ta .ek lsis÷ úYajdihlska fkdj" l< yels wka fohla fkdue;s ksidh' foajd,fha idia;r lshk uEKsfhda bÈßfha .hksf.a uj ;ud meñKs ldrKh lSfõ ,Êcd iy.;jh' zzfï orejdg fj,d ;sfhk foa ug fmkakqï lrkjd' fïl wr oeßú fjkqfjka lrmq jYS nkaOkhla jerÈ,d fï oeßúg jYS fj,d ;sfhkafka' fï oeßúg §mq fohl=;a nfâ
November 2020
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ufkda ,sx.sl .eg¿ wiïu;hg fmï n¢k iu,sx.slfhda
;sfhkjd' ta úi;a whska lrkak fjhs nkaOkh lmkak l,ska' talg kï lidhla yo,d fokak fjhsZZ lidh uEKshka úiska idod fok nj;a nkaOkh lemSug remsh,a y;,sia oyila wjYH nj;a uEKshka okajd isáhdh' foajd,fha uEKshka ÿka lidh ìõ .hksf.a YÍrfhka úi bj;a úh' ±ka we;af;a nkaOkh lemSuhs' thg uqo,a ,Eia;s lr.;a .hksf.a foudmshka ta i|ydo lghq;= lf<ah' foajd,fha uEKshka úiska nkaOkh lmd bj;a flreKs' oeka ujg we;af;a úYd, iekiSuls' ;u weia fol fuka /ls ÈhKsh fírd .ekSug yels jqKq i;=áka miqúh' flfia fj;;a f.oßka t<shg neiSug j;a oshKshg bvla ,enqfka ke;' ;jo" .hks .ek uj b;du;a úmrfuka isáhdh' oshKsh ldurhgu uq¿.ekaù osú f.jKq fmKsk' ta w;r;=r § .hks fu;=jla l,la ryis.;j ;ndf.k isá cx.u ÿrl:kh uj w;g m;aúh' weh th msßlaid ne¨jdh' ;udf.a isysk ish,a,lau fomd uq,u ì£ úisr f.dia we;' .hksf.a jYS nkaOkh lmd bj;a l<o ta ld,h ;=< weh ÿrl:kfhka kfhdañ yd fmïnia fodvd we;' .hksf.a;a kfhdañf.a;a Tjqfkdjqka fj; hjk ,o flá mKsjqv lshjd neÆ ujg isÿù we;af;a l=ula±hs woyd.ekSugj;a fkdyels fiah' l< yels wka fohla fkdjQfhka .u w;yer wE; msáir m<d;lg hdug Tjqka is;d.;ay' ;j;a fuys Ôj;a jqjfyd;a jkafka ish¨ fokdgu fn,af,a je, od.kakgh' w¨;a ksjig mÈxÑhg wd miq .hksf.a uj miqjQfha iekiSfuks' lsis flfkl=f.ka kskaod wmydi ú£ug isÿ jkafka ke;' ,Êcdjlska f;drj .ukla ìukla hd yelsh' wy, .ï y;lj;a okakd y÷kk lsisjl= fyda fkdue;' 102
November 2020
DOCTOR MAGAZINE
udi lsysmhla .;úh' w¨; mÈxÑhg wd ksjig wdikak ksjfia isák .hksf.a jhig jvd wjqreÿ ;=kla nd, fk;=ñ iuÕ .hks b;du;a l=¿m. úh' fï wehs fyd|hsh idudkH tlla fkdjk nj;a fï ksid ;j;a orejkaf.a cSú;o wjodkug jefgk nj;a .hksf.a ujg bfjka fuka ±kqks' weh fldamdúIAG úh' weh fujr fmrg jvd oreKq úh' .hkso fmr,d ys;=jlaldr .;s fmkajkakg úh' weh mK fuka /ls fm%auh fkdue;s fidúka Ôú;h ke;s lr.kakg is;d ujf.a wikSmhlg f.kd fm;s j.hla tl f.dkakg îf.k .shdh' Èk .Kkla m%;sldr lsÍfuka wk;=rej wef.a Ôú;h fírd.ekSug ffjoHjrekag yelsúh' tfy;a ;u ÈhKsh .eyekq <uqka iuÕ we;s lr.kakd fkdukd fm%au iïnkaO;d kj;d .kafka flf,i±hs foudmshka is;kakg úh' ta wkQj Tjqkag ufkda Ñls;ail" ffjoH mS'tka' úoHdl=,m;s uy;d .ek ±k.ekSug ,enqKs'
doctormagazine.lk
.hksj fndfyda w;aoelSï we;s ffjoHjrhd fj; fhduq flßKs' ish¨ lreKq úuid neÆ ffjoH mS'tka' úoHdl=,m;s uy;d wehg m%;sldr lsÍfuka wk;=rej .hksf.a tu ;;a;ajh bj;a úh' ta iïnkaOj ffjoHjrhd fufia mejiqfõh' zzfuf,dj Wm; ,nk ñksik q a iajNdjfhkau úreoaO ,sx.slhka flfrys wdl¾IKh fj;s' úreoaO ,sx.sl weiqrg m%h s lrhs' kuq;a we;euqka fjk;a ,sx.sl wm.ukhkag ,lafõ' iu,sx.sl weiqro
doctormagazine.lk
tf,ih' fuys§ hfula úreoaO ,sx.slhkg wdl¾IKh jkjd fjkqjg iu,sx.slhkg wdl¾IKh fõ'ZZ zzfuh nyq, jYfhka msßñka w;r isÿ jqjo ldka;djka w;ro isÿfõ' .hkso tjeks wfhls' ueh m%sh lf<a wdorh lf<a ldka;djkag muKls' we;af;kau fuu iu,sx.sl ;;a;ajh ufkda m%;sldr u.ska meyeÈ,sju iqj l< yels ;;a;ajhls'ZZ wo jkúg .hks foore ujls' weh idudkH mßÈ fyd| újdy Ôú;hla .; lrhs' DM
^fuys§ frda.Skaf.a mqoa.,sl;ajh wdrlaId lsÍu Wfoid kï .ï muKla fjkia lr we;' ish¨ jd¾;d mÍlaIK ix.uh i;=j we;s we;s w;r" i;H isÿùuls'&
Y%S ,xld iajdmkfõ§kaf.a ix.ufha iNdm;s ufkda Ñls;ail ffjoH mS'tka'úoHdl=,m;s
ÿrl:k wxlh 0718 30 30 30 November 2020
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Homeopathy for Wellbeing fõokdldÍ fi,shq,hsáia iqj lrk fydañfhdam;s m%;sldr
fõokdldÍ fi,shq,hsáia iqj lrk fydañfhdam;s m%;sldr
fi!LH" fmdaIK yd foaYSh ffjoH wud;HxYh foysj, rcfha fydañfhdam;s ffjoH uOHia:dkfha ia:dkNdr ffjoH ks,Odßks" fydañfhdam;s ffjoH wkqId fyaul=udr úisks
104
November 2020
wo j;auka iudcfha fndfyda fofkl=g fkdis;= fudfyd;l we;s úh yels fõokdldÍ frda.S ;;a;ajhla f,i fi,shq,hsáia frda.h ye|skaúh yel' iq,nj mdoj, fï ;;a;ajh we;s úh yels w;r j<¨lßka mgkaf.k l%ufhka by<g hdula olakg ,efnk w;r fuh oKysfika by< olajdu me;sr hd yel' mqxÑ orejkaf.a uqyqfKa yg.; yel' l%shdYS,s jhfia isák orejdf.a isg uy,a,d olajdu wdidokhg f.dÿre ùu ljr fudfyd;l isÿfjkjdo ldgj;a lsj fkdyel'
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doctormagazine.lk
fi,shq,hsáia ;;a;ajhg uqyqK mE mdohl ndysr fmkSu
ffjoH;=uks" fi,shq,hsáia frda.h lshkafka l=ulao@ fi,shq,hsáia ;;a;ajh f,i yÿkajkafka iug háka we;s uDÿ mgl j, Streptococcus fyda Staphylococcus nelaàßhd wdidokhla we;s ù me;sr hduhs' fndfyda úg Èhjeähd frda.Skaf.a reêr.; iSks md,kh fkdjk wjia:djkays§o" .,a ;e¨ï we;s úgo" kyr .eg .eiSï we;s úgo" mdo weÕs,s lre j, È,Sr wdidok we;s úgo" i;a;aj kshfmd;= fukau ;udf.a leiSï j,§ we;s jk kshfmd;= isÍï" lïì isÍï" jeàï" imdlEfuka úimamq jeks ;;a;aj" ks;r ;=jd, we;s jk whgo''' ú¨U me,Sï we;s úfukao" wm fkdis;k wdldrhlg úIîc YÍr.; úh yel'
doctormagazine.lk
ffjoH;=uks" fi,shq,hsáia frda.sfhl=f.a uq,sl ,laIK fudkjdo@ fi,shq,hsáia ;;a;ajh we;sjqkq frda.shl= y÷kd.ekSfï § uq,sl ,laIK f,i tu ia:dkh bÈóu olakg ,efnkjd' fndfyda fofkl=f.a mdoj, fuh oelsh yel' fuu bÈuqu by<g me;sr hd yelshs' há m;=, o bÈuqu f.k Èh yel' u;=msáka iu r;=ùu" ,m le<e,a fukao ;=jd, le<e,a fukao" ÈhmÜgd f,i we;s ùuo wdidokh ;;a;aj wkqj fjkia ù we;s úh yel' wêl leisula we;sùu" oeú,a,la f.k§u" mqmqre .ikjdla fuka b;d fõokdldÍ ;;a;aj f.koS weúÈug" isgf.k isàug fkdyels ùu" fuys m%Odk ,laIK f,i yeÈkaúh yel' ;jo" fjõ,d WK we;s ùu" iS;, .;sh oekSu" reêr.; ESR, CRP w.h by< hdu fuys§ oelsh yel'
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fõokdldÍ fi,shq,hsáia iqj lrk fydañfhdam;s m%;sldr
"
Homeopathy for Wellbeing
nelaàßhd úkdY lrk T!IO fydañfhdam;s m%;l s dr j, ;sfnkjd' fydañfhdam;s m%;l s dr j,§ frda. ,laIK wmg b;d jeo.;a fjkjd' mqo. a ,hdf.ka mqo. a ,hdg mj;sk YÍr m%;Y s la;h s wkqj wdidokh jk wdldrh fjkia fjkjd' fmkajk frda. ,laIKo fjkia ùula olakg ,efnkjd'
fi,shq,hsáia frda.fha iajNdjh yªkd.ksuq
fi,shq,hsáia ;;a;ajh ksjerÈj y÷kd m%;sldrh uekúka isÿ fkdjqkfyd;a Nhdkl ;;a;ajhla lrd hdú' we;eï úg urKSh m%;súmdl Wod úh yel' nelaàßhdj wdidokh jQ uDÿ mgl Èf.a reêrhg we;=¿ ù" reêrh yryd uq¿ YÍrh mqrdu úIîc me;sr hd yel' tjeks wjia:djka ðú;hg ;¾ckhla úh yelsh'
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Necrotizing Fascilitis ;;a;ajh ;j;a ixl=,;djla jkafka uia lk nelaàßhdj fkdfyd;a Necrotizing Fascilitis ;;a;ajh" túg ifï ffi, fldgia" uDÿ fldgia yd Bg háka we;s udxY fmaYSka mjd fuu nelaàßhdjg úkdY l< yel' túg mgl blauKska úkdY ù úYd, ;=jd, njg m;ajkjd' fuh iuyr úg mdoh lmd bj;a lrk ;;a;ajhg m;a jkjd' fï i|yd fydañfhdam;s m%;sldr mj;skjdo@ nelaàßhd úkdY lrk T!IO fydañfhdam;s m%;sldr j, ;sfnkjd' fydañfhdam;s m%;sldr
doctormagazine.lk
j,§ frda. ,laIK wmg b;d jeo.;a fjkjd' mqoa.,hdf. ka mqoa.,hdg mj;sk YÍr m%;sYla;sh wkqj wdidokh jk wdldrh fjkia fjkjd' fmkajk frda. ,laIKo fjkia ùula olakg ,efnkjd' fuys§ ffjoHjrhdf.a olaI;djh" ksjerÈ T!IOh frda. ,laIK j,g wkqj f;aÍu jeo.;a jkjd' fydañfhdam;s m%;sldr uq,O¾uhg wkqj iqj ùu isÿjkjd' fuys§ ÿ¾j, jQ YÍr m%;sYla;slrKh f.dvk.ñka úIìchg tfrysj igka lrkjd' fyd| reêr .ukd .ukhla kyr ;=< we;s lrkjd' ta iu. bÈuqu ke;sj hdu" fõokdj ke;sj hdu iu. wdidÈ; ;;a;ajh myj hdu;a isÿjkjd' úYañ; iqjhla w;aolskjd' fjk;a frda.j,g;a fydañfhdam;s m%;sldr fi,shq,hsáia fukau ish¨u p¾u frda." wd;rhsáia" mdlskaika" fld÷wegfmf<a wdndO" iakdhq frda." w;a mdoj,
doctormagazine.lk
uia lk nelaàßhdj fkdfyd;a Necrotizing Fascilitis ;;a;ajh
ysßjeàu" fjõ,Su" kyr .eg .eiSu" w¾Yia" y¾kshd" brejdroh" wl,g flia iqÿùu" .e,ù hdu" o;a uq,a Èhùu" wdudY.; frda." u<noaOh" ,sx.sl frda." yDofrda." wlaud frda." jl=.vq uq;%dY.; frda." Èhjeähdj" wêl ia:q,;djh" leiai" weÿu" mski" ish¿ ldka;d frda." wd§ iEu frda.hlgu o fydañfhdam;s ffjoH l%uh ;=< T!IO ;=<ska iqjh ,eìh yels jkjd' th Tng ksfrda.su;a Èúhlg Èj Tiq w;aje,la jkq fkdwkqudkh' DM ffjoH wkqId fyaul=udr fi!LH" fmdaIK yd foaYSh ffjoH wud;HxYfha foysj, rcfha fydañfhdam;s ffjoH uOHia:dkfha ia:dk Ndr ffjoH ks,Odßksh jYfhka lghq;= lrhs
fydañfhdam;sffjoH l%uh .ek úuiSï
011 2637 740 011 2637 741 011 2637 742 071 8250 716 071 8250 717 November 2020
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wdhq¾fõoh iqkaor flia l<Ul ryi
ysiflia ksfrda.Sj ;nd .kak
iqkaor flia l<Ul ryi
uydpd¾h wdhq¾fõo ffjoH iqukr;ak wur;=x. (D.S.A.C/BA/Pg. PhD)
ñksid YsIAGdpdrfha wdrïNfha isgu ;u rE imqj .ek ukd ie,ls,a,la olajk w;r ldka;djka ta w;ßkq;a iqúfYaIS we,aula rE imqj flfryS olajkafka mrïmrdkq.;j hk ia;%S wdf¾ iïm%odhla f,isks' ia;%S rE imqj jvjk YÍrdx. w;f¾" thska isref¾ meyeh iy ysiflia j,g w;am;a jkafka iqúfYaIS ;ekls'
isref¾ meyeh iy weiaj, meyeh we;s lrkafka ñksia isref¾ mj;akd fu,kska kue;s j¾Klh u.sks' ysiflia ms<sn|j ie,lSfï§ th iE§ ;sfnkafka u;=msgg fmfkk j¾K iys; flkao iy tys m;=f,a
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doctormagazine.lk
we;s l+mh fkdfyd;a f*da,sl,h weiqßKs' iEu f*da,sl,hla we;=f,au j¾Kl ffi, wvx.= jk w;r fuu j¾Kl ffi, j,ska fu,kska kue;s ridhkslh ksmojkq ,nhs' fu,kska u.ska wmg msg;g fmfkk flia.fia j¾Kh l¿" ÿUqre fyda r;= f,i fmkakqï lrk w;r ysiflia j, j¾Kh ;o mdg fyda j¾Kj;ao hkak ;SrKh jkafkao fï fu,kska keu;s j¾Klh u.sks' jhia.; ùu;a iuÕ fï f*da,sl,h we;=f,a we;s j¾Kl ffi, l%u l%ufhka ueÍ hk w;r fï wkqj ysiflia j, j¾Kho l%ufhka wvq ù hkq we;' idudkHfhka jeäysá mqoa.,hl=f.a ysiflia j¾Okh jkafka udihlg fikaá óg¾ 1'2 la muK jQ m%udKhlsks' jhi wjqreÿ 15-30 olajd ld,fhaoS ldka;djkaf.a flia fõ.fhka j¾Okh fõ'
iqkaor flia l<Ulg mdrïmßl Wreuhka yd lS¾;s kduhla we;s l%sñrdc iud.u ksIamdokh lrk zzuyd kS,Hd§ ff;,hZZ Tnf.a ish¨u ysiflia .eg¨ j,g m%;HlaI T!IOhls'
doctormagazine.lk
ysiflia iïnkaOj we;sjk frda. ysiflia iïnkaOj we;sjk frda. ms<sn|j l;d lf<d;a ysiflia wl,g jeàu m%Odk .eg¨jls' fuh ysiafydß fuka nyq, frda.S ;;a;ajhls' ysi flia .il wdhq ld,h mj;skafka ysfia iu iy flia j, ;;a;ajh wkqjh' flia .il idudkH wdhq ld,h wjqreÿ myla muK fõ' flia .fia wdhq ld,h f.ùu;a iu.u ysi flia .i iug iïnkaO jk ia:dkh yelsf,hs' fï ksid flia.i jefghs' ke;akï ysi mSrk úg flia .e,ù hhs' udi lSmhlska tu ia:dkfha w¨;a flia .ila yg.kS' fï l%shdoduh idudkH f,i ksrka;rfhkau isÿfõ' kshu wdhq ld,hg fmr úYd, jYfhka flia .e,ù hdu isÿ fõ kï tu ;;a;ajh zzwl,g ysiflia .e,ùuZZ jYfhka ye¢kaúh yelshs' fuh ysfiys frda.S ;;a;ajhla f,i ie,lsh yel' ysiflia wl,g .e,ù hdug n,mdk fya;= ² iuyr T!IO j¾. mdúÉÑ lrk úg wld,fha ysiflia .e,ù hdu isÿ jkakg mq¿jk ² YÍrh ÿ¾j, ùfuka ysiflia wl,g .e,ù hhs' ² mSki" mdKavqj" f,a wvqlu yd udkisl mSvd jeks frda.j,§ ysiflia .e,ù hhs' ² iuyrekag mrïmrdkq.;j wdrhg;a ysiflia .e,ù hdu isÿfjhs ² v%h¾ Ndú;d lsÍu" WKq j;=frka ysi fia§u wd§ fya;+ka ksid o ysiflia wl,g jeàug fya;= úh yel'
November 2020
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wdhq¾fõoh iqkaor flia l<Ul ryi
W÷f.dõjka lEu W÷f.dõjka lEu hkq ysfia ;eka ;ekaj, ,m wdldrhg ysi flia .e,ù hduhs' W÷f.dõjka lEu ;;a;ajhg n,mdk fya;= ² fmdaIK W!k;d m%Odk fya;=jhs ² úgñka E iy f*da,sla wï,h wvqùu úfYaIfhka fï ;;a;ajhg n,mdkjd ² ysiflia j, jeãug úgñka E iy f*da,sla wï,h úfYaI jQ ld¾hNdrhla bgq lrkjd' ksfrda.S flia l<Ula mj;ajdf.k hdug .; hq;= l%shdud¾. ² ysiflia msßisÿj ;nd.ekSu ² ysfiys iug ukd fmdaIKhla iemhSu ² ysfiys ks;ru f;;ukh r|d mj;ajd .ekSu ² ysi fyd¢ka iïndykh lsÍu' fï ksid ysfiys reêr ixirKh ÈhqKqfjhs' ² wju jYfhka i;shlg foj;djla ysfiys f;,a .,ajd úkdä oyhla myf<djla muK iïndykh lsÍu ² úúO ridhksl øjH wvx.= Ieïmq j¾. Ndú;fhka wE;aùu ² jvd;au iqÿiq f;,a j¾.hla iqÿiqlï ,;a ffjoHjrfhl= fj;ska oekf.k Ndú;hg .ekSu ² l;=re uqrex.d" f.dgqfld<" ksú;s" uql=Kqjekak wd§ m<d j¾. ks;r wdydrhg .ekSu' ² fld< meye;s t<j¿ j¾. jeäfhka wdydrhg .ekSu ² fk,a,s" fjr¿ wdoS m<;=re j¾. wdydrhg .ekSu ² fld< le|" fn,s u,a" rKjrd" bruqiq jeks iajdNdúl mdkj¾. ksrka;rfhka mdkh lsÍu uyd kS,Hd§ ff;,h iqkaor flia l<Ulg mdrïmßl Wreuhka yd lS¾;s kduhla we;s l%sñrdc iud.u ksIamdokh lrk zzuyd kS,Hd§ ff;,hZZ Tnf.a ish¨u ysiflia .eg¨ j,g m%;HlaI T!IOhls' zzuyd kS,Hd§ ff;,hZZ mdúÉÑ lsÍfï§ ysiflia wl,g jeàu yd meiSu kj;S' levqKq iy ydks jQ ysiflia m%;sixialrKh lrhs' ysiflia j¾Okh blauka lrhs' biafydß" mSki" óf.a%ka wd§ 110
November 2020
DOCTOR MAGAZINE
frda. we;akï iqj lrhs' udkisl tald.%;dj we;s lrhs' iqjodhS kskaolg uÕ mdohs' ;;a;ajdkaú; yd ld¾hlaIu T!IO y÷kajd§fuka ,dxflah ck;dj w;f¾ kula /|jqï tï ã ,sfõßia wur;=x. iy iud.u foish mkylg wêl jQ l%sñrdc ksIamdok /ila fi!LH iïmkakj ksIamdokh lrñka wka;¾cd;sl ISO:9001:2015 ;;a;aj iy;slho Èkd isá' ;jo úYsIag ksIamdok mßph i|yd jk GMP iy;slho l%sñrdc iud. ug ysñj we;' DM
l%sñrdc ksIAmdok i|yd úuiSï uydpd¾h wdhq¾fõo ffjoH iquKr;ak wur;=x. (DASC, BA/PG/PhD.) weï ã ,sfõßia wur;=x. iy mq;%fhda ndf,!IOd.drh" lsßj;a;=vqj ÿrl:kh$*elaia 011 2753 889 Bfï,a krimiraja@sltnet.lk fjí ayurvedakrimiraja.com
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foaYSh ms<sld fjolu ms<sld frda.Skaf.a fmdaIKh
foaYSh ms<sld fjolu ms<sld frda.Skaf.a fmdaIKh .,s.uqj wdhq¾fõo ixrlaIK iNdfõ iNdm;s mdrïmßl foaYSh ms<sld ffjoH ta ta iqu;smd,
wfma ms<sld frda.Ska jeä yßhla ukaofmdaIKfhka fmf<kjd'''
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November 2020
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fm%daàka idr wdydr ,ndoSug jeä ie<ls,a,la oelaúh hq;=hs
doctormagazine.lk
wo iuia; f,dalfha fukau Y%S ,xldfõo ms<sld frda.Skaf.a ixLHdj Èfkka Èku by< hñka mj;skjd' uE;ld,Sk iudcfha fndfyda fofkl=f.a wjOdkh jeä fjñka mj;sk fuu frda.S ;;a;ajh yDo frda. ;rï u iq,n ù we;ehs lsõfjd;a jrola kE' tla tla ms<sld i|yd n,mdk idOl tlsfklg fjkia jQj;a ljr ms<sldjla fyda fõjd ñksid ldhslj fuka udkisljo fndfyda fia wl%Sh lrjkq ,nhs' ms<sldjla we;s mqoa.,hl=f.a y÷kd.; yels fmdaIK .eg¨ / ila we;' ta w;ßka m%Odk ;ekla .kafka ukaofmdaIKhhs' jd¾;d jk wkaoug wfma rfÜ ms<sld frda.Skaf.ka ishhg y;<sylau ukaofmdaIK ;;a;ajfhka fmf<kjd' mSvd ú|skjd' ms<sld frda.Skag we;sjk wdydr wreÑh" uqLfha ;=jd," jukh yd mdpkh jeks frda.S ;;a;ajhka ksid ms<sld frda.Ska ukaofmdaIKhg ,la fjkjd' ukaofmdaIKh ksid ms<sld frda.Skag we;sjk .eg¿ ² frda.shdf.a YÍrfha m%;sYla;slrKh my< hdula isÿfõ ² frda.shd fjk;a wdidok j,g myiqfjka f.dÿre fjhs doctormagazine.lk
² udxYfmaYs j¾Okh ÿ¾j, ùu ksid YÍrfha j¾Okh wvd, fõ fuu fya;=ka ksid ms<sld frda.Skaf.a Ôú; j, .=Kd;aul nj iy ldhsl l%shdldß;ajh wvqùula isÿùug mq¿jk' ta ksidfjkau ms<sld frda.Skaf.a fmdaIKh ms<sn|j úfYaIfhka wjOdkh fhduq l< hq;=fõ' YÍrfha m%;sYla;slrKh /l.ekSug;a" udxYfmaYs yd mgl ì|jeàu wju lr .ekSug;a" fjk;a wdidok frda. j,ska wdrlaId lr .ekSug;a fmdaIKh iïnkaOfhka fjfiia wjOdkhla fhduq l< hq;= fõ' jeä wjOdkhla fm%daàk iy Yla;s wjYH;d i|yd fhduq l< hq;=hs ms<sld frda.Ska f.a fmdaIKh ms<sn|j l;d lsÍfïoS m<uqfjkau mejish hq;= jkafka Tjqkag wjYH fm%daàk m%udKh iïnkaOfhks' Bg fya;=j jkafka Tjqkaf.a isrefrka neyer jk Yla;sh b;d by< uÜgul mej;Suhs' th imqrd .Sug fm%daàk m%Njhka m%udKd;aulj iEySulg m;a úh yels mßos ;sìh hq;= fjhs' frda.sfhl=g idudkHfhka Èklg .%Eï 80-100 w;r fm%daàk m%udKhla wdydrfhka iemhsh hq;=hs' frda.shd ukaofmdaIKfhka fmf<kafka kï fm%daàk wjYH;djh Èklg .%Eï 100-150 olajd úh hq;=hs' ta yereKQ úg my; fmdaIK wjYH;djhka flfryS Tjqkaf.a mjq,aj, {d;Ska ie<ls<Su;a úh hq;= jkjd' ² idudkHfhka jeäysá mqoa.,fhl=g Èklg le,ß 2500-3000 m%udKhla ,nd Èh hq;=hs' ² iEu wdydr fõ,lgu iq¿ m%udKj,ska fïoh wvx.= lsÍu fhda.Hhs' iq¿ m%udKhlska jeä Yla;s m%udKhla iemhsh yels uyd fmdaIlhls" fïoh' ² óg wu;rj iq¿ fmdaIl jk úgñka iy Lksc ,jKo ffoksl wjYH;djh u; ,nd §u l< hq;= jkjd' ² ms<sld frda.Skag fmdaIl fukau c,h o w;HjYH fõ' ms<sld frda.Ska fndfyda fokd jukh yd mdpkh frda. ;;a;ajhkag ksrka;rfhka ,la fjk msßila ksid isref¾ c,h úYd, m%udKhla Èkm;du bj;a ùu isoaO fjkjd tu m%udKh ix;=,kh lsÍug c,h úYd, m%udKhla wjYH fjkjd' ms<sld frda.shdf.a ffoksl c, wjYH;d m%udKh ms<sn| Tn ukd wjfndaOhlska isáh hq;=hs'
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foaYSh ms<sld fjolu ms<sld frda.Skaf.a fmdaIKh
ms<sld frda.fhka fmf<k whg tljr úYd, wdydr fõ,la .; fkdyels neúka l=vd wdydr fõ,a ks;r ks;r ,nd§ug lghq;= l< hq;= fõ' ffokslj ,nd fok wdydrfha wvx.= fm%daàka iy le,ß m%udKh Yla;sh imhd .; yels wdydr ² iïmQ¾K fhdoh iys; lsß iy lsß ksIamdok iq,nj wdydrhg .kak ² ng¾" ud.ßka Tn ,ndfok iqma j¾. j,g tl;= lrkak ² ì;a;r" ud¿ jeks fm%daàk nyq, wdydr Èkm;d ,nd fokak ² w,s.egfmar" Èjq,a" fn,s" flfi,a jeks le,ß iy fm%daàk nyq, wdydr jeä jYfhka ,nd fokak ² lv," lõms" uqxweg" mßmamq" l=rlalka iy ta wdY%s; ksIamdok wdydr f,i ,nd fokak ² n;a le|" fld<le|" nd¾,s" iõ" t<j¿ iqma wdydr jYfhka ,nd fokak ² w;rueÈ wdydr fõ,a i|yd ;," rgb¢" úh<sñÈ" lcq jeks wdydr ,nd fokak ² w¨;a t<j¿ j¾. Èkm;d wdydrhg tla lr .kak vwuqfjka dÈh yels oE tfia msßkukak
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November 2020
Tn ilia lr .kakd wdydr msßisÿjg ilia lsÍug j. n,d .kak' tajdfha .=Kd;aulNdjh ms<sn|j ie,ls,su;a fjkak' fjk;a frda.S ;;a;ajfhka fmf<kafkl=g fuka fkdj fuu frda.shdg Wmia:dk lsÍfï § úfYaIfhkau isysnqoaêfhka lghq;= l< hq;=h' ksishdldrj wdydr isß;a ms<smoskafka kï Tjqkag frda.h ksid we;s úh yels fjk;a ixl+,;d /ila j<lajd .; yels jkafkah' ms<sld frda.Skag ms<sldj me;sÍ hdug fmr uq,a wjia:dfõ§u foaYSh m%;sldr ,nd .ekSug yels jqjfyd;a b;d blauKska iqjh ,nd.; yel' jir 40 l muK ld,hl isg i¾jdx. frda. ms<sn|j yd ms<sld frda. ms<sn|j w;aoelSï yd m<mqreoao iuÕ úúO m¾fhaIKj, ksr; fjñka ud úiska ms<sld u¾Okh i|yd m%;sM<odhS T!Iëh ms<sld ff;,hla ksmojd we;' ldhsl yd udkisl ksfrda.S;djh" frda.Skaf.a urK nh l%ufhka mylr ukqIH YÍrfha yg.kakd ish¿u ms<sld frda. iqj lsÍu i|yd fuu T!Iëh mdkh iu;a ù we;' ngysr m%;sldr ,nñka isák ´kEu ms<sld frda.sfhl=g jqj;a mdúÉÑ l< yelsfõ' foaYSh Ydlidr T!IO ixfhda. muKla fhdod fuu f;, ms<sfh, lr we;' mdkSh ms<sld ff;,h w;aÿgq ÈjHuh T!IOhls' DM
mdrïmßl foaYSh ms<sld ffjoH idu úksiqre
ta ta iqu;smd,
i¾jdx. Ñls;ail ,shdmosxÑ wxlh 13297 mdrïmßl foaYSh ms<sld ffjoH uOHia:dkh fn,sfldgqj wrkaor ^.,s.uqj-wúiaidfõ,a, ud¾.h fnda.y ykaÈh&
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ukqIH YÍrfha yg .kakd ish¨u ms<sld iqjh
mdkSh ms<sld ff;,h úYañ; m%;sldrhls
ALL CANCER TREATMENT CENTRE ish¨u jl=.vq frda. i|yd
m%fïy úoajxYkS ff;,h ysfia ms<sld" fud<fha f,a leá ysrùu" fn,a," W.=r" uqLh" .,kd,h" iqiqïkdj" fmKy,a," wdudYh" wlaudj" hlD;h" ms<dj" ms;a;dYh" fm!reI .%kaÓ;sh" wfOdaud¾.h" N.kaord" uydka;%h" fldÿwegfm<" jl=.vq yd f,a ms<sld" wiaÓ ms<sld" udxY ms<sld" .eíf., ms<sld" *hsírhsâ" ,shqflañhd wd§ ishÆu ms<sld me;sÍu kj;d iykh ,nd fohs' ngysr m%;sldr ,nñka isák ´kEu ms<sld frda.sfhl=g o mdúÉÑ l<yels jk mßÈ foaYSh YdL idruh T!IO ixfhda. lr ms<sfh, lrk w;aÿgq ÈjHuh T!IOhls' wjqreÿ 40l w;aoelSï yd m<mqreoao wkqj ksmojd we;' Wfoa iji fïi yeÈ 1 ne.ska mdkh lsßu wjYH fõ' foaYSh ms<sld ffjoH uOHia:dkh
wdhq¾fõo ffjoHdpdhH_ ta'ta iqu;smd, lS¾;s Y%S foaYnkaÿ fjoHdNsudks bkaÈhd isoaOd¾fõo" iïudk,dNS" idu úksiqre ^lE.,a, wêlrK l,dmh&" wdhq¾fõo YsfrdauŒ" mKaä; ^iïudk,dNS&" mßirfõ§
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wdhq¾fõoh mKaä; úl%udrÉÑ fjo rd,ydñ
úl%udkaú; úl%udrÉÑfha fjo mrmqr tl¿ l< ird i|
mKaä; úl%udrÉÑ fjo rd,ydñ le,‚h úYajúoHd,hSh .ïmy úl%udrÉÑ wdhq¾fõo úoHdh;kfha iyldr mqia;ld,hdêm;s l=i,d iÔjkS keÿka.uqfõ fjo mrmqr keÿka.uqj hk ku lS mu‚kau flfkl=g isysjkafka fjo mrmqrls' keÿka.uqfõ fjo mrmqrg wh;a fjoHjreka w;r fj¿ka fmf¾rd úl%udrÉÑ fjo rd,ydñ rfÜ lS¾;su;a ffjoHdpd¾hjrfhla úh' tu ffjoH;=udg yd tu ue;skshg odj 1889 iema;eïn¾ 28 jk Èk ishkE fldar,fha ke÷ka. uqfõ§ f.aì%h,a fmf¾rd úl%udrÉÑ uy;d Wm; ,eîh' Wm;skau fjo mrmqrlg ysñlï lshQ fudyq Ôj;a jQfha o ye§ jevqfKa o ish ksfji jQ fjof.or .=re yrelï ,nñkah' fjÿkaf.a fjol= jQ mshl =g mq;aj Wmka úl%udrÉÑ uy;dg ;j;a fidfydhqfrda i;r fofkla jQy' m<uq jekakd
116
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m<df;a bvï ysñ Okjf;lah' mjqf,a fojekakd jQfha wmf.a l;dkdhlhd jk mshdf.a wämdf¾ fjo Ydia;%h /f.k .sh Ô' mS' úl%udrÉÑ uy;dh" ;=kajekakd m<df;a ku .sh fY%IaGdêlrKfha kS;s{fhls' y;r jekakd m<df;a ku .sh m%isoaO fkd;dßiajr fhla jQ w;r Tyq fkd;dßiajrekaf.a ix.ufha iNdm;s o jQjd muKla fkdj foaYSh iudc fiajl fhls' miajekakd fuda,a ysñ fjf<| jHdmdßlfhls' fï ifydaorfhda miafokdu fl;rï Wiia ;eka lrd m;a jQj o —.eñlu˜ w;a fkdyeßfhdah' fï tl;=jg tod we;eï .ïjeishka úiska zmxp ifydaor iñ;sh˜ hk ku ;ndf.k isá njo m%isoaOh' Ô' mS' úl%u drÉÑ uy;d .ïjeishka úiska y÷kajk ,oafoa —mKaä; rd,ydñ˜ hk pdï kñkah' th wdorh;a" Nla;sh ;a" f.!rjh;a tlg .eí jQ .fï .eñhka w;r Wmka .eñ W!refõ kuls' úh;a osúhlg ;enQ w;afmd; úl%udrÉÑ uy;d uQ,sl wOHdmkh ,enqfõ fyafka. u rcfha msßñ mdif,kah' tys§ .‚;h" lshùu yd ,sùu W.;a w;r Y;l fmd;a" jHildrh" jD;a;ud,dj" wurisxyh olajd f.or§ ;u mshdf.ka W.;af;ah' bka wk;=rej w.kqjr úfoHdaoh uy msßjfkys YdLdjla jQ f.dvf.or W;a;r uQ, msßfjfkys wêm;s Oqrh oerE rUqlafmd; Y%S m%{didr kdysñhka hgf;a wOHdmkh
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,eîu i|yd fld<U ud,s.dlkafoa úfoHdaoh msßfjkg we;=<;a úh' W;aidyh" úkS;lu" nqoaê l=i,;djh yd ld¾hlaIu;dj ksid fuu YsIHd .=reka is;af.k tys lemS fmfkk YsIHhl= njg m;a úh' msßfjk ;=< fudyq ye¢kajQfha —f.a%ì%f h,a fmf¾rd˜ hk kñks'
fuu mçjrhd wk.dßl O¾umd,;=ud úiska wdrïN lrk ,o isxy, fn!oaOhd m;%f hys 1914 isg 1917 olajd ld,fhys l¾;D moúh o Wiq,d we;' 1917 j¾Ifha§ fu;=ud fkd;dßia úNd.fhka iu;a úh'
November 2020
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117
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wdhq¾fõoh mKaä; úl%udrÉÑ fjo rd,ydñ
Ydiaf;%doa.yKfhys fjfiia ieureï isxy," md,s" ixialD; NdId Ydia;% yd Pkafoduxldrd§ Ydia;% o prl iqY%e;d§ ffjoH .%ka: o yodrd tajdfha m%ùK;d ,enqfõ tod jQ msßfjka wOHdmkfhys uysuh fln÷oehs meyeÈ,s lrñks' m%dÖK NdId Ydia;% yod< YsIHhkaf.a oekSu l%uj;aj yev.eiSu i|yd ilia jQ úNd. l%uhls m%dÖK úNd.h' m%drïN" uOHu" wjidk jYfhka fuu úNd.h g ms<sfj<ska fmkS isáh hq;= fldgia ;=kls' wjidk fldgiska iu;a jkakjqkag mKaä; Wmdêh ysñ úh' f.a%ì%fh,a fmf¾rd úl%u drÉÑ YsIHd o tu úNd.h iu;aj 1913 § mKaä; Wmdêh ysñlr .;af;ah' thg wod< ikaki 1915 Y%Su;a frdnÜ pduia tod isá ,xldKavqldrjrhd w;ska ysñlr .;af;ah' mqj;am;a l;=jrfhla fï mç;=ud msßiqÿ j ueo ilia lrk ,o iqfoda iqÿ frÈ fldaÜ we| iSrejg ysi mSrd fldKavh ne| keñ mkdjlska ysi ieriQ läir ;reKfhls' fuu mçjrhd wk.dßl O¾umd,;=ud úiska wdrïN lrk ,o isxy, fn!oaOhd m;%fhys 1914 isg 1917 olajd ld,fhys l¾;D moúh o Wiq,d we;' 1917 j¾Ifha§ fu;=ud fkd;dßia úNd.fhka iu;a úh' fl;rï úNd. iu;a jQjo t;=ud w.h lf<a mrïmrd Wreuh jQ iyc odhdoh jQ pl%j¾;S;ajfhys ;enqjd jQ fjoluhs' tl, rfÜ wdhq¾fõo úoHd, fkd;sn qK o fjofmd;a lshjd ,nk ,o úYd, oekqu yd
118
November 2020
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mKaäf;damdêfhka ,o NdId Ydia;%hkays oekque;sj isá fudyqg m%dfhda.sl oekqu .ekSug ffjoHrdcfhla jQ ;u mshd f.oru isáfhah' iqcd; wdNdIh yd .=reyrelï weiqf¾''' ;u mshd iuÕ WoEiku fjof.org msúfik mç;=ud ish mshd iuÕ yß yßhg fjoH Ydia;%fhys jevlghq;=j, ksr; úh' bka wk;=rej YsIH;ajhla ,en l,algdjg .sh fudyq wjqreÿ y;rla muK iqm%isoaO cdñ‚ N+IK mç;=udf.a wdhq¾fõo úoHd,fhys ffjoHYdia;%h W.;af;ah' tys§ fu;=ud jx. NdIdj o W.;af;ah' tl, l,algdfõ isg —úúOm%ix.˜ hk ud;Dldj hgf;a yd fjk;a ud;Dldj,ska zÈkñK˜ m;%hg o ,sms ,shk ,È' 1921 j¾Ifha§ ysI.ar;ak" t,a' ta' tï' tia ^f.!rj& Wmdê .;af;ah' ta iuÕu l,algd wdhq¾fõo Njkays —lúrkacka˜ hk Wmdêh o ysñlr .;af;ah' .fï l<yels f.dú;eka .ek o Tyq fkdfhla l%u fidhd rgg lshd ÿkafkah' tfukau
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fmaIl ¾uh i|yd o iajlSh Ôú;fhka fldgila lem lr ;snqKq w;r jhU m<df;ka Tyq f,dl= bvula ñ,g f.k lmq jeùu ms<sn|j w;ayod ne,Sula l< w;r tho id¾:l úh' l,la ish mshd iuÕ keÿka.uqfõ ish ksfjfiysu ffjoHl¾u lrñka isg miqj .ïmy neKaähuq,af,ys ish m%:u ffjoHd.drh újD;fldg iajm%N+;ajh we;sj tys fjolï lsÍu wdrïN lf<ah' bkamiq 1929 § .ïmy isoaOdhq¾fõo úoHd,h wdrïN lrk ,È' miqj .ïmy
úfoHdaoh úYajúoHd,fhys meje;ajqKq m%:u Wmdê m%odfkda;aijfha § wdhq¾fõo pl%j¾;S kue;s iïudk Wmdêh t;=udg ysñ jQfha Tyqf.a mdKaä;Hhg;a" Tyqf.a Ydia;%{dkhg;a" Tyqf.ka wdhq¾fõo ffjoH Ydia;%hg isÿ jQ w;s úYd, fiajhg Wmydrhla jYfhks'
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.=re l=,hl kfjdaoh úl%udrÉÑ wdhq¾fõo ffjoH úoHd,h bka wk;=rej le,‚h úYajúoHd,hg wkqnoaO .ïmy úl%udrÉÑ wdhq¾fõo úoHdh;kh njg m;a úh' úYajúoHd,hg j¾Ifhka j¾Ihg we;=¿ lr.kq ,nk YsIHhka mia wjqreÿ ld,hla f.jd fuu wdh;kfhka Wf.k" m¾fhaIKd;aul mqyqKqj o ,en fjolï lsÍfï jrï we;sj msgj hhs' úfoHdaoh úYajúoHd,fhys meje;ajqKq m%:u Wmdê m%odfkda;aijfha § wdhq¾fõo pl%j¾;S kue;s iïudk Wmdêh t;=u dg ysñ jQfha Tyqf.a mdKaä;Hhg;a" Tyqf.a Ydia;%{dkhg;a" Tyqf.ka wdhq¾fõo ffjoH Ydia;%hg isÿ jQ w;s úYd, fiajhg Wmydrhla jYfhks' wdhq¾fõodpd¾h rdurlaI mdGl Y¾uka mç;=ud úiska úl%udrÉÑ uy;d —mShqImdŒ˜ hkqfjka y÷kajhs' —mShqI˜ hkq wuD;hhs' —mShqImd‚˜ hkq —wuD; yia;˜ hkqhs' wurŒh;ajhla f.k fok w;la we;a;d hkqf jka thska lshefõ' wdhq¾ fõo ffjoH Ydia;%h ish Ôú;h lr.;a t;=udg ffjoH jD;a;sfhys kshe<Sug fj,djla l,djla fkdùh' wdhq¾ fõo ffjoH úoHdj fjkqfjka ish Ôú;hu lem l< wdhq¾fõo pl%j ¾;S mKaä; Ô' mS' úl%udrÉÑ Y%Su;dfKda 1975 ud¾;= ui 28 jk Èk ish Ôú;fhka iuq.;ay' DM
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uOqksud uyú, ,sms irKsh
oshjeähdfjka ksÜgdjg iqjh i,ik mdrïmßl fjouy;auhd
ffjoHY+Í foaYudkH uydpd¾h fya uQ fikr;a chiQßh nKavdr
uyú, oshjeähd fnfy;a .ek lshk l;d'''
120
November 2020
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Èhjeähdj ;;a;ajhka md,kh l< yelsh' ksÜgdjg iqj l< yelsh'
—oOd;s Od;af;a jd YÍr uk mafrdaKdka b;s Od;=#˜ hkqfjka uq, .%ka: j, olajd we;af;a Od;= iïnkaOfhks' by; Yaf,dal mdGfha w¾:h jkafka YÍrh" uki iy m%dKh hï lsisjlska ord isáo th Od;= hkakhs' ir,ju mjikafka kï YÍr wdlD;sh mj;ajd .ekSu iy tys fmdaIKh ksis mßÈ isÿjkafka Od;= ksidfjks' Od;= y;la .ek wdhq¾fõofha oelafõ' ri Od;=j" rla; Od;=j" udxY Od;=j" fïfoda Od;=j" wiaÓ Od;=j" uÊcd Od;=j" Y=l% Od;=j hkqfjks'
Èhjeähdj YÍr.; jQ úg my< jk frda. ,laIK u< jeämqr msglrhs ln" l÷¿" lka l,d÷re" fidgq" ln jeämqr msglrhs' uQ;% jeämqr msg lrhs' uq;%" óme‚ n÷ ÿUqre meyeh we;s fõ' uq;%d lrk ;ek l=yqUqjka" ueiaika" lähka meñK wdydrhg .kshs' weia fmkSu wvq lrhs' weia j, mq¿ka jeiqkd fia mg, we;s lrhs' YÍrh w;a md ysß .;sh we;sfõ' m;=,a oeú,a," o;a uq,a Èhùu" yDohdndO we;s ùu" iakdhq moaO;sh ÿ¾j, ùu" wêreêr mSvkh" jl=.vq ÿ¾j, ùu" wu;l ùu" l,amkd Yla;sh wvq ùu wd§ jYfhks' ;jo fuu frda.h .¾NŒ ujqjrekago yg.kS' ta ore m%iQ;sfhka miqj iqj fõ' fï yereKq úg wfkl=;a
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oekg wfma rfÜ ia;%S mqreI fomlaIhg ishhg úis y;rlgu Èhjeähdj we;s nj iólaIK j,ska Tmamq ù ;sfí' mdi,a orejkag yd fmr mdi,a orejkag ishhg oyihla Èhjeähdjg k;=ù fyda ta we;sùfï wjodku orñka isà' mdi,a orejkaf.a Èhjeähdj ksÜgdjg iqj l< fkdyels jqj;a th uekúka md,kh l< yelshs' ,xldfõ iEu mqrjeishka yh fofkl=f.ka tla wfhl=g Èhjeähd frda.h je<|S we;' uq¿ f,dalfha iEu ;;amr oyhlg jrla tla Èhjeähd frda.shl= ìysfõ' fuu frda.h je<÷Kq wh b;du flÜgq Ndjhg m;afõ m;a fõ' tfia isÿ jkafka isÿjkafka YÍrfha we;s ima; Od;=ka uq;% iuÕ msgù hdu ksihs ksihs' wdhq¾fõofha uOqfïyh kñka y÷kajkq ,nkafka YÍfha ima; Od;=ka jk uOqr fldgia uq;% iuÕ msgj hduhs'
November 2020
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121
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wdhq¾fõoh uOqksud uyú, ,sms irKsh
YÍrfha f,a j, .aÆfldaia ^iSks& uÜgu ;sìh hq;af;a 80-115mg/dL w;rh' th 115g jeä kï Èhjeähdj fõ' iuyr whg .aÆfldaia uÜgu 450-500 olajd jeä fjhs' túg jd;h" ms;" fiu fodaI njg m;afõ' isref¾ Èhjeähdj wvq jkafka isrer mqrd bkaishq,ska ;sîu u; fõ' YÍrh YÍrfha w.akHdYh bkaishq,ska .nvdjhs' tu bkaishq,ska lmdg yryd mgl Èf.a ffi, olajd fnod yßhs' me‚ ri" uOq ri" lD;su wdydr j¾. jeämqr .ekSfuka w.akHdYfha lmdg jeiS hhs' mdrïmßl ffjoH l%ufha yd wdhq¾fõofha Èhjeähdjg T!IO ,nd fokafka jeiS we;s lmdg újD; lsÍu yd fodrj,a weÍugh' bkamiq iajdNdúl bkaishq,ska lmdg yryd ffi, olajd fnod yßhs' thska Èhjeähdj ke;s fjhs' uyú, fjouy;audf.a oshjeähd fjolï .ek iqjm;a jQjka lshk l;d''' l=iqï u,afoksh uy;añh wm iu. uyú, fjo uy;df.a fnfy;a j, .=Kh mejiqfõ fuf,isks'
122
November 2020
—ug IQ.¾ yeÈ,d wjreÿ ;=kla ú;r ysáhd' bx.%Sis fnfy;a ld,hla .;a;d' ta w;f¾ wms w÷rk wjqreÿ 14l orefjlag iSks lsh,d fï fjo uy;auhd <Õg f.ksh,d fyd|gu fyd| jqKd' b;ska uu;a .shd' iSks ;sfnoa§ w;mh ßfokjd" l,kaf;a jf.a'' yß wudrehs' ug 280g iSks ;sfhoa§ .sfha' jdr y;rla fí;a .;a;d' oeka ug ta lsis wudrejla kE' iSks uÜgu 77 fj,d' yenehs tfyu fjkafka wms fjo uy;a;hd lshk úÈyg mdúÉÑ jqfKd;a ;uhs'ZZ fmdf<dkakrefõ iïm;a m%shka; uy;do fufia ksÜgdjg iqjh ,enQfjls' —ug 2010È ú;r ;uhs iSks yeÿfKa' 220 ;snqKq uÜgu wka;sfï§ 480;a mekakd' lsf,da 80g ysá uf.a nr 58la jqKd' fldÉpr fnfy;a .;a;;a fyd| jqfKa kE' weÕm; ßfokjd" flaka;s hkjd" weia fmaka ke;=j hkjd" w;mh ysß jefgkjd" ;j lshkak neß m%Yak;a ;snqKd' yßu wudrehs' miafia fjo uy;a;hd .ek úia;rhla oel,d fnfy;a .kak .shd' udi y;la fí;a .oa§ weÕ mqIaáu;a fj,d wudrelï ke;sj .shd' fjo uy;a;hd lshk l%uhgu ysáhdu blauKska iqj fjkjd' Bg miafia fí;a wefÕka bj;a lrk úÈy;a ug lsh,d ÿkakd' oeka wjreÿ yhla ú;r ug fyd|hs' ta;a ysf;a nhg ;du lrú, tfyu fyd|g lkjd' jfka jk y;=frl=gj;a yefokak tmd fï f,fâ kï' we;af;kau fï .ek lsh,d fok tl;a f,dl= mskla' fiajhla'ZZ fn,sw;a;" l=vdyskafka fÊ'î'ta' chisß uy;d wmg úfYaI jQfha Tyq fi!LH lafIa;%hg iïnkaO whl= ksidh' wfkla wh lshQ frda. ,laIK ish,af,ka Tyq oeä fia mSvdjg ,la ù isá njo mjiñka fufia lSfõh' —uu wjqreÿ wgla ú;r Èhjeähdfjka fm¿Kd' Th lshk wudrelï uÈjg ;siafiau uQ;%d lrkak ´kd' uu;a fi!LH lafIa;%hg iïnkaO ksid úgñka wvq we;s lsh,d taj;a .;a;d' ug iSks 130 mksoaÈ fyd|gu wudre fjkjd' lsf,da 12la ú;r nr;a wvq jqKd'
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mdrïmßl ffjoH l%ufha yd wdhq¾fõofha Èhjeähdjg T!IO ,nd fokafka jeiS we;s lmdg újD; lsÍu yd fodrj,a weÍugh' bkamiq iajdNdúl bkaishq,ska lmdg yryd ffi, olajd fnod yßhs' thska Èhjeähdj iqjm;a fjhs'
iEfykak ÿla úkaod' ta w;f¾ 2016 wfma%,a j, fï fjo uy;auhd .ek jevigykla oel,d uu l;d l<du úia;r wy,d udi yfhka iqj lrkakï lSjd' yenehs lEug iqÿiq kqiqÿiq foaj,a ,ehsia;=jla ÿkakd' bx.%Sis fnfy; fndk w;f¾ ;uhs ug fjo uy;a;hdf.a fnfy;a ÿkafka'ZZ zzojia 20ka 20g iSks uÜgu ukskak lSjd' áflka ál bx.%Sis fm;a; wvq l<d' fjo uy;a;hdf.a fnfy;=;a ojila wer ojila jf.a wvq lr,d ojia 10g jrla jf.a .kak lSjd' oeka ug iqjhs' w;mh ysßjefgkafka kE' wfma me;af;a lsß lkjd yßhg' b;ska iSks me‚ lefjkjd' yenehs foúhkaf.a msysfgka ug lshkak;a f,danhs oeka ta wudrelï kE' uu okakjd fïjdg úreoaOj l;d lrk iuyre fydfrka fjo uy;a;hd .djg hkjd lsh,;a' we;af;kau fï jf.a fjoeÿrka wms wdrlaId lrkak ´kd' wfkl y;= msfmkakd jf.a tk iuyr fjÿka bx.%Sis fm;s l=vq lr,d fld<j¾. l,jï lr,d fokjd' wmsg ta ry w÷kkak mq¿jka' ta;a fï fnfy;a tfyu kE lsh,d ug fyd|gu úYajdfika lshkak mq¿jka'ZZ
doctormagazine.lk
zzug 2010È ú;r ;uhs iSks yeÿfKa' 220 ;snK q q uÜgu wka;f s ï§ 480;a mekakd' lsf,da 80g ysá uf.a nr 58la jqKd' fldÉpr fnfy;a .;a;;a fyd| jqfKa kE' weÕm; ßfokjd" flak; a s hkjd" weia fmaka ke;=j hkjd" w;mh ysß jefgkjd" ;j lshkak neß m%Yk a ;a ;snK q d' yßu wudrehs' miafia fjo uy;a;hd .ek úia;rhla oel,d fnfy;a .kak .shd' udi y;la fí;a .oa§ weÕ mqIá a u;a fj,d wudrelï ke;sj .shd'aZZ
November 2020
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wdhq¾fõoh uOqksud uyú, ,sms irKsh
uyú, fjo uy;do mejiQfõ Tyq wfmau le,Ej,ska fnfy;a j¾. fidhd .kakd njhs' tys§ uyd n%yauhdg mska § ta fnfy;a me<Eá fk,d .; hq;= njo Tyqf.a u;hhs' Tyqf.a T!IOj,ska isÿjkafka w.akHdYfha jeiqKq lmdg h<s újr lrñka iajdNdúlj bkaishq,ska YÍrfha ksmofjkakg wjYH mßirh h<s f.dv keÕSu njo úia;r iys;j Tyq wmg lshd ÿkafka fi!LH mdvula fuks' —n;a-jExck lkak .;a; ojfia b|ka wms isxy, fí;a ;uhs lkafka' iQÿre" uyÿre" fld;a;u,a,s" ly" bÕ=re".ïñßia" lrmsxpd lshkafka fudkjdo@ iqoaod tajdfha ixhq;sfhka tl j¾.hla wrf.k fm;a; yo,d ÿkaku wms .s,skjd' t;fldg jl=.vq Èh fjkafka keoao@ wms iuia;h wrf.k j¾. f.dvla tlalhs fnfy;a fokafka' isxy, fnfyf;ka w;=re wdndO tkafka ke;af;a ixhq;sh jeä ksihs'ZZ
124
November 2020
Èhjeähd frda.hg f.dÿre fkdùug uOHu m%;smodjg wkqj wdydr jHdhdu wdÈh .; hq;= nj lS háhkaf;dg uyú, fjo uy;d ta i|yd myiqfjka l< yels w;afí;la o lSfõh' —Èhjeähdj ishhg 90la yefokafka udkisl m%Yak ksid' wfkl .aÆfldaia wvx.= wdydr jeämqr .ekSu;a fiï frda. ksid;a Èhjeähdj jeä fjkak mq¿jka' wjqreÿ 10g jeä ´kEu flfkla yeuodu Wfoag lelsß hqI w~q fldamam nd.hla fndkjd kï Ôúf;a ljodj;a Èhjeähdj yefokafka kE' ta jf.au lrmsxpd fld< hqI fldamamhla ne.ska i;shg fojrla îfjd;a reêr kd<j," wlaudfõ f;,a bj;afj,d" f,a iqoaofj,d" u< fyd¢ka my fj,d" p¾u frda. iqj fj,d" úI kikjd' wfkl mq¿jka ;rï fld< ue,a¨ï yeu fõ,lgu .kak' f;a fjkqjg rKjrd u,a álla fndkak' .eñ wdydrj,g mq¿jka ;rï yqre fjkak' ieu t<j¿ j¾.hlau fmdÿfõ lkak' frda.shl=g lEu fkdÿkafkd;a fyd|gu fi!LHh msßfykjd' wfma fjolu lrkafka fyd|g nv msfrkak lkak §,hs' uu lshkafka Èhjeähdj ksÜgdjg fyd| lrkak mq¿jka'ZZ DM
oekg oshjeähd frda.Ska oyia .Kkla iqjm;a lr we;s háhkaf;dg uyú, fjouy;df.a oshjeähd m%;sldr idhkh oshjeähdj m%;sldr f;dr;=re oek.kak" wmg wu;kak
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wdhq¾fõoh Èhjeähd frda.fhka mSvdjg m;aù isák Tng Èhjeähd md,khg mdrïmßl T!IO
Èhjeähd frda.fhka mSvdjg m;aù isák Tng Èhjeähd md,khg mdrïmßl T!IO fy< mdrïmßl Tiq jÜfgdare.;j ms<sfh< lrñka Tng myiq wdldrfhka ,ndoSu wfmka isÿ fjkjd'''
wdhq¾fõo ffjoH rkam; rejka r;akdhl úisks
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November 2020
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125
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wdhq¾fõoh Èhjeähd frda.fhka mSvdjg m;aù isák Tng Èhjeähd md,khg mdrïmßl T!IO
tfia ù ;sfnkafka frda.h s df.a w.akHdYh ÿ¾j, ù ;sfnk ksihs' tfia kï fidhd ne,sh hq;f a ;a w.akHdYh ÿ¾j, ùug mj;akd fya;= ljf¾o hkakhs'
fmdaIHodhS fkdjk wdydr oshjeähdjg n,mj;ajk tla idOlhla muKhs' udkisl mSvkh" ffjrh yd fl%daO lsÍu" we;eï frda.S wjia:dj,§ .kakd wêl%shdldÍ T!IO" wdydr Ô¾Kfha we;s ÿ¾j, nj yd wo ojfia iq,nj Ndú;d lrk úIldrl wdydr fukau ksÈjeÍu;a oshjeähdjg fya;= fjkjd'
Tn mrïmrd .Kkdjla wE;g úysfok ;=kajk mrïmrdjg Wreulï olajk rcfha ,shdmÈxÑ wdhq¾fõo ffjoHjrfhla' Èhjeähd frda.h ms<sn|j Tnf.a w;aoelSï wkqj flá ú.%yhla lrkak' wúfõlS Ôú;h yd udkisl mSvkh" wdydr rgdj, úIu;djfha m%;sM,hla f,i jix.; frda.hla fuka Èhjeähdj kQ;k iudch ;=< ie<lsh hq;= uÜgulska oshjeähdj by< hñka ;sfnkjd' fï ;;a;ajh iEu jhia ldKavhlgu''' k.rno yd .ïno fNaohlska f;drj iudch ;=< iS>%fhka jHdma; ùfï m%jK;djla wo jk úg olakg ,efnkjd' ld,hlg fmr kd.ßlj fjfik ck;dj w;r oshjeähdfõ iS.% jHdma;shla ;snqK;a wo jk úg .ïokõ j, mjd Èhjeähdj fkdfyd;a uOqfïyh frda.h jHdma; ù ;sfnkjd' Wia ñá fNAohlska f;drj frda.h me;sfrkjd' ffjoHjrfhla jYfhka fï ;;a;ajh .ek wmg úYd, lïmkhla ;sfnkjd' foaYSh mdrïmßl ffjoH l%u u.ska Èhjeähdjg m%;sldr ,nd fokafka fldfyduo@ fuys§ wm uq,a wjia:dfõ§u ie<ls,su;a jkafka wdhq¾fõo foaYh S ffjoH úoHd uQ,O¾u j,g wkql, + j frda. ksOdkh ms<n s |j fidhd ne,Sughs' fuu frda.S ;;a;j a h y÷kd.kakd uq,a wjia:dfõ§ frda.h s df.a reêrfha iSks uÜgu by< m%udKhl ;uhs mj;skf a ka' 126
November 2020
DOCTOR MAGAZINE
fndfyda wh ;=< ;sfnk jerÈ u;hla ;uhs w.akHdYh ÿ¾j, ùug iSks nyq, wdydr jeä jeämqr .ekSu fya;j = k nj' wmf.a w;aoelSfuka lsjhq;= jkafka iSks iys; wdydr hkq Èhjeähdj we;s l< yels tla m%Njhla muKla jk njhs' tfia kï Tn mjik wfkl=;a wjodkï idOl fudkjdo@ udkisl mSvkh" wêl wdï,sl wdydr .ekSu" WIaKdêl wdydr .ekSu" ffjrh yd fl%daO lsÍu" we;eï frda.S wjia:dj,§ .kakd wêl%shdldÍ T!IO" wdydr Ô¾Kfha we;s ÿ¾j, nj yd wo ojfia iq,nj Ndú;d lrk úIldrl wdydr fukau ksÈjeÍu;a oshjeähdjg fya;= fjkjd' fuu fya;= ksid w.akHdYh ÿ¾j, jkafka flfiao@ fuu ldrKd ksid YÍrfha ´kEu bkaøshhla ÿ¾j, ù frda.hla we;s úh
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yels nj m%:ufhka u mejish hq;=hs' fuys§ isÿjkafka wdhq¾fõofha i|yka jk mßÈ rla; ¥Is; ;;a;ajhla we;sùuhs' rla;h ^reêrh& ¥Is; jQ úg YÍrfha ´kEu bkaøshhla ÿ¾j, lsÍug n,mEï we;s l< yelshs' w.akHdYh hkq iqúi,a jQ ld¾hNdrhla isÿlrk bkaøshla ksid ks;ru fjfyig m;ajk bkaøshhla' fï ksid ¥Is; reêrfhka w.akHdYhg jeä n,mEula we;s l< yelshs' fuysoS reêrfha ;sfnk iSks md,kh lsÍfï mßjD;a;sh l%shdj,sh ksishdldrfhka l%shdjg kexùug fkdyels fjkjd' fï ksid widudkH f,i iSks uÜgu by< fyda my< hdula isoaO fjkjd' fï ;;a;ajh iukh lsÍug Tn isÿlrk ffjoH m%;sldr fudkjdo@ uQ,sl jYfhka isÿ isÿlrkafka rla; ¥IKh ksid YÍrfha fjk;a bkaøshhka frda.hg ,lajQ úg isÿ lrk wdldrhg iudka;r m%;sldr l%uhhs' wdrïNfha§ rla; fYdaOk ^f,a msßisÿ lrk& T!IO ,nd§ YÍrhg b;d myiqjla ,nd §u isÿ lrkjd' fuu T!IO ksid we;eï Èhjeähd frda.Skaf.a isref¾ mj;sk ifï frda." mSkia frda." w¾Yia ;;a;ajhka" u<noaOh" flaka;s hdu" u;l Yla;sh ÿ¾j, ùu" w;a md ysß jeàï jeks frda. ,laIK blauKskau bj;aj hk nj mejeish yelshs'
wdhq¾fõo wdkqmdk tl;= lr f.oroS T!IO ilia lsÍfï wNsfhda. fhka wm Tn uqojd .kakjd' úYsIAG m%ñ;Skag wkQj m¾fhaIKd;aulj ksIAmdokh l< T!IO Tn fj; iemhSu j;auka rkam; fjo mrmqf¾ ld¾hNdrhla
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miqj by; wys;lr ;;a;ajhka j<lajd Ô¾K moaO;sfha ÿ¾j,;djhkago m%;sldr lrk úg wdydr Ô¾K l%shdj,sh hym;a w;g m;aùu isÿfjkjd' tksidu frda.S ;;a;ajfhka fmf<k mqoa.,hka b;d blauKska ksfrda.S Ndjhg m;a fjkjd' Èhjeähdj iqj iqjm;a lsÍug Tfí l%shdms<sfj, jeäÿrg;a ú.%y lf<d;a@ rla; fYdaOk l%shdj,sh yryd YÍrfha wfkl=;a bkaøshhka iqjm;a jkakd fiau w.akHdYh iqj ùuo wdrïN fjkjd we;s' bkaishq,ska ksmojk ,eka.¾yka oSmsld ffi,j, ÿ¾j, l%shdldß;ajh kej; il%Shj l%shd lrkakg mgka .kakjd' ta ksid iajdNdúlju isref¾ bkaishq,ska ksmoùu wdrïN fjkjd' ta ;=<ska reêrfha we;s iSks uÜgu md,kh jk nj mejish yelshs'
November 2020
DOCTOR MAGAZINE
127
D•Magazine /
wdhq¾fõoh Èhjeähd frda.fhka mSvdjg m;aù isák Tng Èhjeähd md,khg mdrïmßl T!IO
fï l%shdj,sh ;=<ska ´kEu oshjeähd frda.sfhla iqj l< yelshs lshd mjikak neye' ld,hla ;siafia bkaishq,ska msg;ska .ekSu ksid mQ¾K jYfhka wl¾ukH ù .sh bkaishq,ska ffi, h:d ;;a;ajhg .ekSug fkdyels jkakg mq¿jka' kuq;a bka lshefjkafka keye" iuia; iuia; Èhjeähd frda.Ska iqjl< fkdyels nj' Èhjeähdj ksÜgdjg iqj l< iqjl< yels frda.hlao@ uf.a mdrïmßl w;aoelSï wkqj kï Èhjeähd frda.Ska jeä msßila iqj l< yelshs' wdhq¾fõo úoHd;aul l%shdj,sh ;=<ska lsis úfgl;a iqj l< fkdyelshs lshd úfõpk ;snqK;a wE; .ul fjfik mdrïmßl ffjoHjrfhla A4 A4 iqj l< Èhjeähdj yels nj mejiqfjd;a th wmrdOhla" fndrejla fyda uq,djla njg tl fy<du ks.ukh lsÍu je/Èhs' mdrïmßl ffjoHjreka ks;ru fy<s lrkafka ;ukaf.a Ndú;dfjka' fï woyia 128
November 2020
j,g úreoaO jk whg mejish hq;= jkafka wm rfÜ w;S;h ms<sn| ms<sn|j úuik f,ihs' f,dj ìysjqKq bmer‚u frday,a ixlS¾Kh yuqjkafk;a wfma rfgka' fud<fha ie;alï jeks ÈhqKq ffjoH l¾uhka mjd fuu frday,aj, w;S;fhaoS isÿlr we;s nj mqrdúoHd;aul m¾fhaIK j,ska ;yjqre lr ;sfnkjd' wfma rfÜ mdrïmßl ffjoH l%u fl;rï ÈhqKq uÜgul ;snqKdo hkak w;S;h foia fok ldrKhla'
wo iudcfha nqoaêu;a" úu¾YKYS,S ish¨ fokdu mdfya wdhq¾fõo l%uh ms<sn|j ;sridr úYajdihla f.dv k.d f.k ;snqK;a fuu ffjoH l¾uhkayS wuqøjH fidhdf.k lmd-fldgd ilia lrf.k lidh ;eïîu iy fjk;a T!IO ms<sfh, lr .ekSu ksishdldrfhka isÿ lr .ekSu wmyiq ùu ksid fuu úYsIag jQ ffjoH l%uhg ck;dj wj;S¾K fkdùu fmkakqï lrkjd' wm úiska ,nd fokafka ´kEu ld¾hnyq, wjia:djl§" úfYaIfhka /lshdj lrk w;r;=r mjd myiqfjka Ndú;hg .; yels f,i kshñ; m%ñ;Skag wkql+,j wm f.a wëlaIKh hgf;a ksIamdokh lrk fm;s j¾." l,al" .=,s j¾. yd lidh j¾.hs' tu T!IO iShg iShlau kshñ; Ydlidr wvx.= lr ksmojd ;sfnkjd' fuu T!IO m¾fhaIKd;aulj ÈhqKq lrk ksid tajdfha m%;sM, iaÓr idrhs' DM
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