Doctor Magazine October 2019

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

ffjoHjrhd doctormagazine.lk RS 180 (VAT INCL)

fï Èkj, wfma rfÜ olakg ,efnk ffjria WK P. 30

zzksy`v ñkSurejdZZ md,kh lruq wêl reêr mSvkh

jhi;a iu.u .eyekq msßñ idM<H;djfha P. 56 we;sjk fjkialï ISBN-1391 1341

P. 36

9 7 7 13 91 13 400 1

INSIDE Regular

Features

Editors Note 6

hym;a fi!LH mqreÿ

Health News 8

;=jd, fyd|ùu l,a .; jkafka wehs@ idhksl laIQø cSj úfYaI{ ffjoH frdaysKS jvkïNs laIQø cSj wxY m%OdkS ,xld fydiamsg,a ridhkd.drh 16

ÿïmdkh ksid jekfik ;reK cSú; orejka yd ñ;=reoï meje;aùfuka fhdjqka úfha orejkag ksis ud¾.h fmkajd oSu myiqhs ffjoH Ydka; fyÜáwdrÉÑ úisks 10

Laboratory Tests Explained fldf,iagfrda,a mÍlaIKhg fmr ksrdydrj isàu wjYHo@ wdisß frday,a iuQyfha ridhkd.dr wOHlaI kS,a m%sh;a fcdaka úisks 25

jhi;a iu.u .eyekq msßñ idM<H;djfha we;sjk fjkialï idhksl l<,fõo úfYAI{ ffjoH fy<rejka mikal=udr 56

.s,ka uki .ul ldka;djka kegjQ N+;dfõYh Y%S ,xld iajdmkfõ§kaf.a ix.ufha iNdm;s ufkda Ñls;ail ffjoH mS'tka'úoHdl=,m;s 110

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October 2019

The legacy of the man who pioneered computed tomography Sir Godfrey Hounsfield ffjoH úoHdfõ wiydh fidhd.ekSula jQ CT mÍlaIK l%ufõoh fidhd.;a Y%Su;a f.dâ*%S fydakaia*S,aâ ckau Y; ixj;airh 22

Flora ksrka;rfhka wfma wdydrhg tla lr.; hq;= w;HjYH fïo wï, wdydrhg .kak myiq u.la 68 úma,d .=re;=ñhf.a wdorKSh u;lh''' .=re iur 72 Female Genital Cutting (FGC) f,dalfha újdohg ,laù we;s fndard ldka;djka fndardjrekaf.a zzlÜkdZZ pdrs;%h 76

fï Èkj, wfma rfÜ olakg ,efnk ffjria WK ;,j;=f.dv fyaudia frdayf,a fkajdisl <ud frda. úfYaI{ osÆId w;=fldard, 30

zzksy`v ñkSurejdZZ md,kh lruq wêl reêr mSvkh yDo frda. úfYAI{ ffjoH Y%S ,d,a ,shkdrÉÑ 36

mshhqre ms<sldj wfma rfÜ ldka;djka w;r jeäfhkau olakg ,efnk ms<sldj fuhhs ffjoH Yñ; oikdhl ldhsl frda. úfYaI{ 61

DOCTOR MAGAZINE

Frozen shoulder, Adhesive capsulitis whsia jf.a ñÿKq fõokdldÍ Wrysig ms<shï wkqrdOmqr YslaIK frdayf,a ikaê frda. úfYaI{ ffjoH ysuka; w;=fldar, úisks 80

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INSIDE fõokd ú|sk frda.Skag iykh i,ik iyk i;aldrh ,dxlSh ms<sld frda.Skag fukau wêl fõokdjg m;a frda.Ska nyq;rhlg;a wysñhs wdisß Y,H frdayf,a ms<sld frda. úfYaI{ ffjoH Idu .=K;s,l 84

wdhq¾fõoh jiafodia kik" wd;=rhka iqjm;a lrjk foys lems,a, wNspdr yd ffjoH l%u iïnkaO m¾fhaIl rejka .urd<f.a 114

fydañfhdam;s wiaÓ Èrdhdu j,ld,k fydañfhdam;s m%;sldr fydañfhdam;s ffjoH wkQId fyaul=udß 117

úoHd;aulj y÷kd.;a CIC Fragrant ndiau;S iyf,a .=K rd.u YslaIK frdayf,a ffjoH ckl fm%au;s,l úisks 88

ksoka.; p¾óh rla;h frda.hla yd ine|S wNsfhda. /ila p¾u frda. úfYaI{ ffjoH wcs;a lkakka.r 92 osúh mqrd ;=reKQ iula yu /,s jeàu iy t,a,d jeàu Tng m%Yakhlao@ ifï ;=reKQ fmKqu /l.kakg Tn l,afõ,d we;sj m%;sldr j,g fhduq ùfuka we;sjk m%;sM,h jeähs p¾u frda. úYI{ ffjoH f;acd oSrisxy 100

wxYNd.h frda.k S g a kej; Ôjh ,ndfok ÔjlhdfKda ikaêjd; frda. iqj lrk ÔjlhdfKda wxl=Uqf¾ chka; nKavdr fjouy;d 121 rEm,djkHfha b;sydifhka W.; yels mdvï w;S; fidnd fidªre rE iq/l=ï Tiafia iekfiuqo@iajNdjO¾uh w;ayßñka y÷kajd fok úmÍ; weiqreï" fuj<ï weiqf¾ jekfiuqo@ n,msáh wdhq¾fõo frdayf,a ffjoH bIxld u,als 123

fiug n,mdk fya;= fiug lrk m%;sldr jl=.vq iqrlsuq-osú iqrlsuq jl=.vq ke;sj wmg cSj;a fjkak nE''' jl=.vq j,ska wmg we;s M< m%fhdack .ek oeKQj;a fjuq 104

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October 2019

DOCTOR MAGAZINE

wdhq¾fõo ffjoH rkam; rejka r;akdhl 126

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EDITOR'S NOTE wkd.;hg wdfhdackhla jQ wfma uõlsß isß;

mdvqjla fjf;d;a th lsisÿ wdldrhlska kej;;a msßuid,sh yels fkdfõ' f;jekak" YÍrfha j¾Okhg" nr l%ñlj jeä lrkakgo uõlsß isß; WmldÍ jkafkah'

uõmshka ;u orejkag fifkfy is;ska fndfyda foa odhdo lr;s' ujlg ;u orejkg osh yels úYsIAG;u odhdoh jkafka uõlsßhs' th t;rïu jáfkah' cSú; ld,hgu" wdrlaIdj" /ljrKh i,ikakg ;rï n,hla ujf.a wdorh;a iu.ska jEiafik uõlsrg we;af;ah'

uq,a udi yh fjk;a wdydr j,g yqre lsÍfuka by; lS m%;s,dNhka u. yefrkjd muKla fkdj" úúO WordndO" wdidok wdoshgo orejd ,la jkakg fya;=jla jkafkah'

hqksfi*a wdh;kh;a" f,dal fi!LH ixúOdkh;a taldnoaOj udi yhla hk;=re ;u orjkg uõlsß muKlau ,nd osh hq;= hhs ks¾foaYhla lrK ,enQfha 2005 j¾IfhaoSh' uõlsß ñi" j;=rj;a tmd''' udi yhla .shdg miafi;a fjk;a wdydr ÿkak;a yels iEu wjia:dfõoSu uõlsßu fokak'''' ffjoHjrekaf.a ks¾foaYh thhs' udi yhla hk;=re uõlsß muKla fokak hkak f,dalfha ish¿u rgj,a wruqKQ lrf.k n,.ekajQ m%n, jHdmD;shla jQfha tys jeo.;alu m¾fhaIKd;aulj fudkjg meyeos,s jQ ksidh' uõlsß orejkaf.a fud<fha j¾Okhg WmldÍ jk w;r isref¾ m%;sYla;sh jvjhs' orejkaf.a fud<fha j¾Okfha ;SrKd;aul fojk wjêh jkafka orejd Wmka miq .; lrk uq,a wjqreoaol ld,hhs' fï ksid tu wjia:dj u. yeÍfuka fjk

6

October 2019

uq,a udi yhl ;=< orejdg fok uõlsfrys orejdg wjYH il,úO fmdaIKhka wka;¾.; fjhs' laIqø fmdaIl" úgñk wdosho yßhgu .e,fmk ud;%d j,skau mj;sk ksid tys lsisÿ wvqjla ke;' uõlsfrka fmdaIKh ,nk orejka jeäysáhka jQ miq wêreêr mSvkh" fldf,iagfrda,a" oshjeähdj jeks fnda fkdjk frda. j,g ,laùfï wjodkuo fnfyúka wvq fjhs' uõlsß j, uQ,sl jYfhka fm%daàk úfYAI folla fjhs' fõ fm%daàk yd flaiSk jYfhks' tajdfha ishqï wkqmd;h lsß cS¾Khg buy;a rel=,la fjhs' lsß j, we;s ,elafgdf*ßk hlv u; hefmk nelaàßhdjka ksfIAOkh lrhs' tys we;s hk bñhqfkd.af,dìhq,sk nelaàßhd yd ffjri wdidok j,ska wmj wdrlaId lrhs' tfiau uõlsfrys we;s fïoh <orejdf.a j¾Okhg wjYHu wdldrfhka mj;akd w;r th fud<fha j¾Okhgo wjYH os.= odu fïo wï, m%Njhls' orejkag uõlsß ,ndoSfuka m%;s,dN ,nkafka uõjreka muKlau fkdfõ' fï ksid uõjrekag ,efnk /ljrKho iq¿mgq fkdfõ' mshhqre ms<sld yd äïnfldaI ms<sld wo ldka;djkg buy;a ;¾ck u;= lrk Wjÿre folls' uõlsß oSfuka fuu wjodkuo wvqjk nj m¾fhaIK j,ska fy<sorõ ù ;sfí' ore Wm;a w;r mr;rhla we;s lr .ekSugo fï isß; wfma rfÜ uõjreka ishhg 99lau uq,a udi yfhaoS uõlsß muKla ,ndoSfï mKsúvh thdldrfhkau bgq lrñka f,dalhg wdo¾Yhla ù ;sfí' fï uõlsß isß;" jeäfjñka mj;sk fnda fkdjk frda. ;¾ckh yuqfõ wkd.;hg iqúfYaIS wdfhdackhla jkq we;s njo fkdlshdu neßh'

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 FEATURES EDITOR Shyamalee Pathirage FEATURE ASSOCIATES Dr. Roshan Zerideen Zaid Consultant Obstetrician Gynaecologist

Dr Chandana Sri Kanakaratna Geriatrician, Physician

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

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

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

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October 2019

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Health News

iqmqj;

HEALTH NEWS iqmqj; ;=reKq uki ishosú kid.kakg fm<fUk W;af;acl fndfydauhla iudcfha ;sfnkjd''' wms ljqre;a ishÈú ydks ydks lr.ekSug m%;sYla;slrKh fj,d keye' fï i|yd udkisl frda." úYdoh" ;ukag úi|d.; fkdyels m%Yak m%Yakhla ;sfhkjd kï oeka Ôj;a jqKd we;s lshd is;Su jeks idOl Èú f;dr .ekSug fya;= fjkjd' fujeks wjia:dj,§ wjg isák wh tjeks whg msysgqúh hq;=hs' zzwo ;reK msßia uqyqKq fmd;g muKla iSud ù ;sfnkjd' flfkla tlal yßhg l;d lrkafka keye' u;=msáka muKhs ikaksfõokh' ;ukaf.a y~d jefgk ÿl wkqkag lshkak nhhs' ióm iïnkaO;d j, f,dl= wvqjla ;sfhkjd'

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October 2019

fma%u iïnkaO;d ;sfhkafka SMS j,ska' yuqùï isÿ jkafka keye' ;ukaf. ysf;a ;sfhk foa jpk j,g fmr,kak okafk kE' ta woyia fmd;l ,shkak okafk kE' fï yeu foalgu uq,afj,d ;sfhkafk ikaksfõokfha wvqj'ZZ cd;sl udkisl fi!LH fi!LH úoHdh;kfha ufkda ffjoH ufkda ffjoH úfYaI{ ffjoH mqIamd rKisxy uy;añh tfia m%ldY l<d' fld<U 7" úfÊrdu udjf;a" fylag¾ fldínElvqj lDIs m¾fhaIK yd mqyqKq lsÍfï wdh;kfha bl=;a 6 jeksod cd;Hka;r ishÈú ydks lr.ekSu je<elaùfï Èkh fjkqfjka meje;s udOH yuqfõ§ ufkda ffjoHjßh fï nj i|yka l<d' miq.sh j¾Ihg idfmalaIj fï j¾Ifha ishÈú ydkslr

DOCTOR MAGAZINE

.ekSï j, hï lsis wvqjla olakg ,efnk nj;a fï jif¾ ish Èú ydkslr. ekSï wgoyia mkaishla olajd wju lr .ekSug yelsù we;af;a 1926 wxlhg cd,.; ùu ksid nj;a fuys§ l;dnyg ,la jqKd' kj fhdjqka úfha orejkaf.a ishÈú ydkslr yd lr .ekSfï W;aidyhla ms<sn|jo fuu yuqfõ§ l;dnyg ,la jqKd' fï iqúfYaIS ldKavfha ishÈú ydkslr ydks lr .ekSfï W;aidyhka ms<sn|j úfYaI{ ufkda ffjoH chka; fld;,dj, uy;d woyia olajñka''' zzkj fhdjqka orejka úYd, m%udKhla ish Èú ydkslr .ekSug W;aidy lrkjd' kuq;a Tjqkaf.a Ôú; wysñ jkafka kE' thg fya;=j

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Tjqka udrdka;sl l%u Ndú; fkdlsÍuhs' Tjqka ish Èú ydkslr .ekSug jeämqru ;e;a lrkafka ;shqKq wú wdhqO Ndú;h' wdhqOj,ska lmd .ekSu isÿ lr.kakg Tjqka W;aidy lrkjd' tfiau T!IO wêud;%d Ndú;d lrkjd' .ïno m%foaYj, ;shqKq wdhqOj,ska w; fyda l,jd m%foaYh lmd.ekSfuka ishÈú ydkshg fm<fUkjd' 60] 80] l orejkag y÷kd.; fkdyels udkisl ;;a;aj ;sfnkjd' wdor iïnkaO;d ì| jeàu" mdif,a§ ñ;=rka iu. we;sjk .egqï" úúO w;jr" fouõmsh .egqï wdÈh fuhg uq,aù ;sfnk nj lsj hq;=hs' iEu <uhs mia fofklaf. ka tla <ufhlau udkisl ueÈy;aùula wjYH mßirhl Ôj;a fjkjd' jhi wjqreÿ yfhka miqj fï ;;ajhg m;aùfï yelshdjla ;sfnkjd' iaud¾Ü fmdaka ,emafgdma jeks WmlrK orejka ks;r Ndú;d lrk ksid ldkaish fukau yqfol,dj we;sjk njo úfYaI{ ufkda ffjoH chka; fld;,dj, uy;d m%ldY l<d' iqñ;%fhda ixúOdkfha iNdm;skS l=uqÿkS o is,ajd tu ixúOdkfha m%j¾Ok ks,OdßkS bkaÈrd úfÊfialr" cd;sl udkisl

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fi!LH úoHdh;kfha úfYaI{ ffjoH lms, úl%ukdhl uy;d fuys§ jeäÿrg;a woyia m%ldY l<d'

T!IO ysÕh je<elaùug ms<shï uE;§ fndfyda rcfha frday,aj, mej;S T!IO ysÕh mshjd .ekSug rch wfmalaId lrk neúka fi!LH wud;HdxYh úiska l,a fkdhjd f;dr;=re ,nd .ekSu i|yd frday,a i|yd myiqlï ie,iSu i|yd ÿrl:k wxlhla Èh;a lrkq we;'

fvx.= frda.Skaf.a jeäùula fï jif¾ udrdka;sl fvx.= frda.fha ;shqKq jeäùula olakg ,efí' fi!LH wud;HdxYfha jix.; frda. úoHd tallfha ixLHdf,aLkj,g wkqj miq.sh jif¾ wf.daia;= isg udi wg olajd ld,h ;=< fvx.= frda.Ska 44"000 lg jeä ixLHdjla jd¾;d ù ;sfí'

wud;HdxYhg wkqj" rcfha frday,aj,g 0766474777 wxlfhka fuä flda,a kï ÿrl:k wxlhg weu;sh yels w;r" ysÕhla we;s jqjfyd;a Ôú;drlaIl T!IO fukau yÈis T!IO ,nd .; yelsh'

jd¾;d jQ fvx.= frda.Skaf.a ixLHdj miq.sh jirg idfmalaIj fï jif¾ ud¾;= udifha isg by< hdug mgka f.k ;sfí' wf.daia;= udifha§ o;a; j,ska fmkS hkafka frda.Ska 8"883 la jd¾;d ù we;s njhs' miq.sh jif¾ wf.daia;= udifha§ jd¾;d ù we;af;a frda.Ska 4"293 la mu‚' flfia fj;;a" fï jif¾ fvx.= frda.Ska jeä jqjo" jir folu iqmqreÿ WÉpdjpkhka fmkakqï lrhs' kvq ckjdßfha§ my; jegqKq w;r uehs udifha isg jeä jQ w;r wf.daia;= olajd by< .sfhah' fudaiï jeis iuÕ fvx.= frda.Ska ;jÿrg;a jeäúh yels nj ffjoHjrekaf.a woyihs'

weu;=ï wxlh u.ska isÿlrk wjYH;d wkqj wjYH T!IO ,nd §u" T!IO ñ,§ .ekSu i|yd uqo,a fnod yeÍu fyda Èkla we;=<; .=jka NdKav u.ska T!IO wdkhkh lsÍu i|yd mshjr .ksñka isák nj wud;HdxYh jeäÿrg;a i|yka lrhs' ffjoH iemhqï wdh;k wdrxÑ ud¾. j,g wkQj" wjYH úfgl fnod yeÍu i|yd ms<sld T!IO j¾. 20 la we;=¿ ñ, wêl T!IO j¾. 200 la muK oekgu;a .nvd lr we;' DM

October 2019

DOCTOR MAGAZINE

9

D•Magazine /

Smoking behaviour

ÿïmdkh ksid jekfik ;reK cSú;

Smoking behaviour among young adults: beyond youth prevention ÿïmdkh ksid jekfik ;reK cSú; orejka yd ñ;=reoï meje;aùfuka fhdjqka úfha orejkag ksis ud¾.h fmkajd oSu myiqhs ÿïmdkh lsÍu i|yd jeä jYfhka fm<fUkafka kj fhdjqka úfha§ nj fï jkúg ikd: ù ;sfí' hy¿jkaf.a fm<Uùu u; fyda fujeks fohlg weíneys jkafka orejdg ksis wjfndaOhla fkdue;slu ksidh' ffjoH Ydka; fyÜáwdrÉÑ úisks

10

October 2019

orejdg b;d wdorfhka <xù fuys wdoskj fmkajd oS orejd bka uqojd .ekSug lghq;= l< hq;=hs'

DOCTOR MAGAZINE

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ÿïmdkh wmf.a YÍr fi!LHhg m%n, ;¾ckhla t,a, l< yels wys;lr mqreoaola nj mqk mqkd m%ldY l,;a Èfkka Èk ÿï mdkh i|yd weíneys jk msßfia wvqjla kï olakg fkd,efnk nj ixLHd f,aLk wkqj wmg fmkS hk ldrKhls' úfYaIfhka ÿï mdkh i|yd fhduq jk msßfika nyq;rhla ;reK orejka ùu b;d lK.dgqodhl ;;a;ajhls' kj fhdjqka úfha ÿïmdkhg fm<öug fya;= ÿïmdkh lsÍu i|yd jeä jYfhka fm<fUkafka kj fhdjqka úfha§ nj fï jkúg ikd: ù ;sfí' fuu jhia uÜgfï § we;sjk l=;=y,h ÿrelr .ekSug" hy¿jkaf.a fm<Uùu fyda wkqlrKh yd w¨;a jeäysá iudc lKavdhï iuÕ tlaùu ;=<ska kqmqreÿ w;aoelSï ,eîug fujeks lghq;a;lg jeä fofkla fhduq jk nj fmkS f.dia ;sfí' nrm;, ldrKh jkafka fï jhia uÜgfï § flfkl= ÿï mdkh i|yd fhduq jQ úg th mqreoaola jYfhka jeäysá wjêh f;la /f.k .shfyd;a nrm;, fi!LH m%Yak .Kkdjlg f.dÿre ù wjdikdjka; brKulg f.dÿre ùfï oeä wjodkula mej;Suhs'

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;=ka oyilg wêl úI lkaordjla ÿïjeáhla ;=< ksfldáka we;=¿ ridhksl øjH ;=kaoyilg ^3000& wêl ixLHdjla wka;¾.;h' fï w;r nrm;, ms<sldldrl mjd wvx.= ù ;sfí' flfkl= fof;d, u; ;nd Wrk iEu ÿïjeáhla ;=<skau wys;lr ridhksl øjH rdYshla YÍr.; ùu flfiaj;a j<lajd,sh fkdyel' ÿïmdkfhka iuia; f,dalhgo" wm rggo isÿjq yd isÿfjñka mj;sk ydksh b;d úYd,h' oekgu;a f,dj jirla

October 2019

DOCTOR MAGAZINE

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D•Magazine /

ÿïmdkh ksid jekfik ;reK cSú;

Smoking behaviour

fmKy¿ ms<sld

ÿïmdkfhys wys;lr m%;sM<

Yajik frda.

oshjeähdj

mßoka;sl frda.

mdid ÿï fndkakka ñ,shk mylg wêl ixLHdjla ñh hkafka;a" ÿï fkdfndkakka yh ,laIhlgo urK ysñjkafka;A ÿïmdkh ksidh' ÿïmdkh ksid cSú; úkdY jkafka fufyuhs kj fhdjqka wjêfha orefjl= il%sh fyda wl%Sh ÿï mdkhg f.dÿre ùu ;=,ska by;ska i|yka l< ksfldáka we;=¿ ;=ka oyilg wêl ridhksl øjH YÍr.; ùu ksid ysi isg fom;=, olajd ish¨u wjhjhka j,g n,mEï we;s l< yel' fï ksid ;reK wjêfha

12

October 2019

yoj;a frda.

orejka ,eîfï wvqmdvqlï wlaIs wdndO

mgkau ysiflia j, yd isrer ÿ¾.kaOh" kdihg kshñ; mßÈ .| iqj| fkdoekSu" yu /,s jeàu" o;a ÿ¾j¾K ùu" úÿreuia Èhùu" Èjg ri fkdoekSu yd isref¾ fndfyda ;ekaj, ms<sld we;sùu we;s úh yelsh' úfYaIfhka uqLh" fof;d," W.=r" .,kd,h" wlaudj" jl=.vq wd§ m%Odk bkaøshka ta w;ßka m%Odkhs' Bg wu;rj nrm;, frda.S ;;ajhka .Kkdjla ÿïmdkh lsÍu ;=<ska yg .; yelsh' fhdjqka úfha§ ÿïmdkhg nrm;< f,iska weíneysùu ;=<ska ,sx.sl fn,ySk;djh" u|ire nj" isref¾ m%;sYla;sh wvqùu yd yDohdndO yg .ekSu isÿ úh yelsh' ffjoH úoHdfõ isoaOdka;hla jkafka ÿïmdkh lrk oy fofkl=f.ka tla wfhl= fmky¿ ms<sldj,g f.dÿre jk njhs' ÿï mdkfha we;s ìhlre nj y÷kd .ekSug fuu ldrKh muKlau m%udKj ÿïmdkhg weíneys jQ wfhl=g ,sx.sl ÿn,;d we;sùfï wjldYh 85] la ;rï by< m%;sY;hla ;sfí' fï ksid orefjl= ÿï mdkh i|yd fhduq ù we;akï

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b;du;a blauKska thska uqojd .ekSug lghq;= lsÍu jeäysáhkaf.a j.lSula fiau hq;=luls'

orejdg meyeÈ,s wruqKla we;s úg flfkl=f.a fm<Uùu u; fyda fujeks krl mqreÿj,g weíneys ùug we;s bvlv b;d b;d iSud iys;h' úfYaIfhkau orejka ndysr lghq;=" ks¾udKd;aul lghq;= yd l%Svd l%shdldrlï j,g fhduqlrùu ;=<ska u;aøjH Ndú;hg fhduq ùug we;s wjia:djka u. yerúh yelsh'

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kj fhdjqka orejkag uõmshka ñ;=frl= úh hq;=hs u;aøjH yd ÿïjeáj,g weíneys jQ fndfyda orejka miqld,fha§ mjikafka wïud ;d;a;d fidhd fkdneÆ ksid tu mqreoaog weíneys jQ njhs' tfiau weíneys jQ y;rfofkl=f.ka ;=kafofklau bka ñfokakg leu;s nj iólaIK uÕska fy<sù ;sfí' ta ksid wjYH fudfydf;a ksis u.fmkaùu ,nd §u jeäysá foudmsh ieuf.a j.lSuls' orejka w;r hyñka uqo,a yo,a .ejfik úg fujeks ÿrdpdrj,g myiqfjka fhduqúh yel' fï ksid orejkag wjYH;d i|yd uqo,a ,nd ÿkafkd;a tajd úhoï lrkafka l=uk ldrKd i|ydo hkak foudmshka úiska orejd ;=< wúYajdihla f.dvkef.k mßÈ fidhd ne,sh hq;=h'

October 2019

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ÿïmdkh ksid jekfik ;reK cSú;

Smoking behaviour

úfYaIfhkau hy¿jkaf.a fm<Uùu u; fyda fujeks fohlg weíneys jkafka orejdg ksis wjfndaOhla fkdue;slu ksidh' wOHdmkh ,eîug ;sfnk fï jákd wjia:dj wruqKlska f;drj úkdY lr oeuqjfyd;a uq¿ Ôú; ld,h u w÷re úh yel' tfia ùfï wjika m%;sM,hla jkafka orejd iudchg mjq,g lsisu jevlg ke;s frda.Sfhl= ùuhs' ta ksid lsishï orejl= ÿïmdkh i|yd weíneys ù ys£ kï foudmshka úiska fyda orejd ms<s. kakd jeäysáfhla" ióm .=rejrfhla ,jd ÿïmdkfha wd§kj ta;a;= .ekaúh hq;=h'

kj fhdjqka úfha miqjk orejka fujeks lghq;a;lg fhduqù we;s nj foudmshka yg oek.kakg ,enqKfyd;a tljru tljr ;rjgq lrkakg hEu fkdl< hq;=h'

orejdf.a iqNisoaêh m;d .;yels mshjr rdYshls ksfldáka j, n,mEu ksid ÿïjeáj,g weíneys jq flfkla tlajru thska uqojd .ekSu ;rula wmyiqh' úfYaIfhkau ÿïjeáh ;=<ska ,nk YÍßl W;af;ackh fya;= fldgf.k th laI‚lj w;a yeÍug wlue;s úh yelsh' fï ksid fuhg fi!LHdrlaIs; úl,am l%u i,id § bka uqojd .ekSug m%dfhda.sl l%u Ndú;d l< hq;=h' úfoia rgj, kï ksfldáka W;af;ackh fjk;a úl,am pqhska.ï" Èjhg ;nd .kakd fm;s" iaál¾ fukau isref¾ w,jk ma,diag¾ j¾. jYfhka úúO ksIamdok wf,úfha ;nd ;sfí' kuq;a wfma rfÜ ÿïmdkhg mkaoï fok fj<| m%pdrK yer by; T!IO f.kaùu fyda furg ;=< ieliSug jevms<sfj<la fkdue; th b;d lK.dgqodhl ;;a;ajhls' ;rjgq lrkak tmd''' ta fjkqjg''' kj fhdjqka úfha miqjk orejka fujeks lghq;a;lg fhduqù we;s nj foudmshka yg oek.kakg ,enqKfyd;a tljru tljr ;rjgq lrkakg hEu fkdl< hq;=h' orejdg b;d wdorfhka <xù fuys wdoskj fmkajd oS orejd bka uqojd .ekSug lghq;= l< hq;=h' ;ukag th isÿ l< fkdyels kï WmfoaYkh i|yd fhduqúh hq;=h' WmfoaYkfhka id¾:l m%;sM, ,nd.; fkdyels kï ffjoH m%;sl¾uhka i|yd fhduq lr,Su b;d jeo.;ah' orejdg meyeÈ,s wruqKla we;s úg flfkl=f.a fm<Uùu u; fyda fujeks krl mqreÿj,g weíneys ùug we;s bvlv b;d b;d iSud iys;h' úfYaIfhkau orejka ndysr lghq;=" ks¾udKd;aul lghq;= yd l%Svd l%shdldrlï j,g fhduqlrùu ;=<ska u;aøjH Ndú;hg fhduq ùug we;s wjia:djka u. yerúh yelsh' foudmshka jYfhka l< hq;af;a ta i|yd ksis uÕfmkaùula ,nd §uh' DM

ilia lf<a uOqjka; niakdhl

14

October 2019

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Healthy Habits

;=jd, fyd|ùu l,a .; jkafka wehs@

hym;a fi!LH mqreÿ

;=jd, fyd|ùu l,a .; jkafka wehs@ idhksl laIQø cSj úfYaI{ ffjoH frdaysKS jvkïNs laIQø cSj wxY m%OdkS ,xld fydiamsg,a ridhkd.drh MBBS, MD Med Micro, Dip (Med Micro) Resident Consultant Clinical Microbiologist

16

October 2019

DOCTOR MAGAZINE

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m

iq.sh l,dmfhka wm isrer fiaoSug .; hq;= inka j¾. .ek;a" lDñ wdidok j,ska wdrlaId ùug .;hq;= mshjr iunkaOfhkq;a l;dnyl ksr; jqfKuq' tfiau ifuys m¿ÿ" ;=jd, we;sùug n,mdk fya;= iunkaOfhka ú.%yhl fhÿfKuq' fujr tu l;dny bosßhg'''' fjfiiskau ;=jd,hla iqjùug we;s lr.kakd ndOd .ek úuiuq'

;=jd, l=vd fyda úYd, fyda Y,Hl¾uhlska miq we;s jQjla kï i;shla folla we;=,; iqjùu ksfrda.S iula we;s whg Nd.Hhls'' kuq;a jerÈ l%u Ndú;h" wkjYH f,i Èhr j¾. wdf,amkh lsrSu wdÈh ksid fndfyda fokdf.a ;=jd, iqjùug È.= l,la .; jk wjia:d fjhs' tu ;=jd, ksid w;mh fldrfjk" úYd, le<e,a we;s lrk ;;a;aj olajd jeä ÈhqKq lr .kafka ksjerÈ wjfndaOh yd oekqu u| ksidfjks' iajdNdúlj ;=jd,hla iqj jkafka fï wdldrhghs Y,Hl¾uhlska miqj;a" msßisÿ lemqï ;=jd,;a Ôjdkqyß; ;;a;aj hgf;a ueyqï oeófuka Èk 7-14 we;=<; iïmQ¾Kfhkau iqj fõ' iuyr whf.a tfia fkdjkafka Èhjeähdj" ifï frda." fkdtfia kï ukaofmdaIK ;;a;ajh" YÍrh úIîcj,g Tfrd;a;= §u wvq jk fya;= (Immune Suppressed) ksidfjks' ta wh y÷kd.;a úg úfYaI ie<ls,a,lska ;=jd, i|yd Wmfoia iy l%shdldrlï ie,iqï lsÍu wjYH fõ' tfia lsisu ndOdjla fkdue;s úgoS;a we;euqka ;=jd, meijd .kafka my; i|yka w¥ro¾YS l%shd ksidh' ;=jd, iqj ùug l,a .;jk" krla fjk fya;= wkjYH f,i b;d ier fnfy;a wvx.= ieryqï Ndú;h fïjd ksid ;=jd,h wdY%s; iu ;eïîu u.ska ;=jd,h iajdNdúlj iqj ùu l,a hhs' tfiau ;eïnqKq ffi, ueÍ laIqøÔùkag iqÿiq ;;a;ajhla f.dvkÕhs' túg ;=jd,h meijhs' wmsßisÿ ;=jd, fia§ug hï hï Èhr Èhr oekqula iys;j fhdod .; yels jqj;a m%udKhla" wjYH;djhla fkdoek ys;=uf;a tajd fjf<|fmdf<ka .kakd fnfy;a j¾. .e,aùu ksid fyd| fõf.k tk ;=jd, jk lr.ekSug fya;=jla úh yelshs' ish¨‍u ieryqï j,g .kakd úIîc kdYlj,ska laIqøÔùka úkdY lrkakdla fukau wfma ffi, j,go w.=K yd úI úh yels nj u;l ;nd .kak' kùk ieryqï iuyrla meijQ ;=jd, j,g fhÈh yels jk fia (Nano particle release) ilid we;s wjia:d ;sfí' tajdo" ta ms<sn| ukd oekqula we;s ffjoHjrekaf.a Wmfoia u; muKla Ndú;d lsÍu Tfí fi!LHhg ys;lrh' ier wvq úIîc kdYl (Diluted) j,ska iE¥ miq úh,s ;=jd, j,g Ôjdkqyß; fia,hska ieryqul=;a f;; ;=jd,

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October 2019

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Healthy Habits

j,g úh,s ieryqu m%udKj;a jk w;r frda.shdf.a iajdNdúl ffi, j¾Okhfhka ;=jd,h fkdmeijd iqj fjhs' ;=jd,fha wef,k ieryqï oeóu fuu ieryqï .,jk úg jefvñka ;snQ ffi, .e,ù hdu ksid ;=jd,h w¨‍;a fjhs' fkdwef,k ieryqï ta i|yd f;dard.; hq;=hs' hï úÈylska we,S we;s ieryqï bj;a lsÍfï§ Ôjdkqyß; fia,hska j,ska fmdÕjd ydksh wju lr.; yelshs' fnfy;a ouk jdr .Kk jeäùu ffjoH WmfoaYhlska f;drj Èkm;d kej; kej; ieryqï fh§fï§ ;=jd,fha jefvk ffi, j,g wjldYhla fkdue;s ùu ksid ;=jd,h f,dl= ùu yd iqj ùu m%udo ùu isÿ fõ' iajNdúlj ;=jd,hla fyd| ùug wjYH idOl ieflúka .;fyd;a iajNdúlj ;=jd,hla fyd| ùug fyd| f,a .ukd.ukh" fyd¢ka fmdaIKh jqK YÍrhla" ^iula& msßisÿ jd;dY%h" YdÍßl msßisÿ nj" fyd| jHdhdu hk fï ish,a,u wjYHhs' úIîc j,g muKla wjOdkh fhduq lr wkjYH f,i iu fi!LH ySk lr .ekSfuka tajdg jvd fjk;a laIqøÔúka u.ska úYd, wdidok we;súh yelshs'

18

October 2019

DOCTOR MAGAZINE

iu yd kshfmd;= j,g n,mdk È,Sr frda. iu yd kshfmd;= j,g n,mdk kdkdúO È,Sr frda. .ek oeka wms l;d lruq' wfma rfÜ WIaK foaY.=Khla" jeä wd¾ø;djhla (Humidity) ksid úYd, m%udKhl È,Sr frda. wfma rfÜ ;shkjd' wfma rfÜ Ndú;d lrkak lr ;=jd, fidaok ødjK ish,a,u mdfya l%shdlrkqfha nelaàßhdjkaghs' tfyhska hï hï wh ier inka" ier nelaàßhd kdYl (Antiseptics) Ndú;d lroa§ tajdg Tfrd;a;= fok È,Sr ifï b;sß fjhs' tu È,Sr

doctormagazine.lk

hïlsis ;eklska iug we;=¿ ù wdidok wdrïN lrhs' fndfydaúg lsys,a," bls,sh jeks iu uDÿ ;ekaj,;a" we÷ï j,g ;o ù iSfrk bK jeks ia:dkj,;a fuu È,Sr wdidok mgka .efkhs' rE iq/l=ug .kakd we;eï mshjr ksid wm wjodkulg jefgk wjia:d ;sfhkjd È,Sr frda. iug;a jvd b;d jeä m%udKhlska wm olskafka kshfmd;= yd wdY%s;jhs' thg m%Odk fya;=jla ù ;sfnkafka úúO wdf,amk yd iïndyk (Manicure and Pedicure) j,§ kshfmd;= uDÿ lrk Èhr jeämqr Ndú;h fukau kshfmd;= iug iïnkaO jk ;ek ;=jd, ùuhs' wmßlaIdldÍ f,i kshfmd;= lemSu ksid;a fufia ;=jd, we;sù È,Sr me,ùu isÿù kshfmd;a; .e,ùug we;s wjia:d fndfydah' fndfydauhla È,Sr jdhqf.da,fha" mfia ¥ú,af,ka yd f;;ukh we;s mßir mßirj,ska we;=¿ ù tu wdidokh we;s lrhs' fndfyda fokdf.a ll=f,a kshfmd;= wdidokh jk w;r .Dy‚hkaf.a w;aj, kshfmd;=o os,Srj,ska úkdY fõ'

fudkhï fyda laIqøÔù wdidok" nelaàßhd" ffjri yd È,Sr y÷kdf.k m%;sldr ksjerÈj .; hq;=hs' fujka frda. oek.;a ú.i ffjoHjreka uqK .eiS ksjerÈ idïm, ,nd§ frda.h b;d ksje/Èj y÷kdf.k ksÜgdjgu iqjlr iqjlr .ekSug Tn ish¨‍ fokd ie,ls,su;a úh hq;=hs'

.DyKshkag we;sjk .eg¿ yd Bg úi÷ï ks;r ks;r inka yd Èhr Ndú;d lsÍfuka uq¿;ekaf. hs jev lsÍu;a frÈ fiaoSu isÿ lsÍu;a ksid fufia È,Sr j,g jeä jYfhka n÷ka fjhs' w;ajeiqï oud

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October 2019

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Healthy Habits

jeros wdldrfhka lrk m%;sldr ksid we;eï úg w;mh ¨yqj;a lsÍug isÿùu fukau cSú;fhka jkaos f.ùug mjd isÿúh yel'

tu lghq;= lsÍfukao f;; ud;a;= l< ú.i wdrlaIdldÍ Moisture tlla .e,ùfukao tu ;;a;ajhka j<lajd .; yel'

20

October 2019

úIîc wdidok j,oS ffjoH Wmfoia j,g wkQj lghq;= lrkak by; i|yka fudkhï fyda laIqøÔù wdidok" nelaàßhd" ffjri yd È,Sr y÷kdf.k m%;sldr ksjerÈj .; hq;=hs' fujka frda. oek.;a ú.i ffjoHjreka uqK .eiS ksjerÈ idïm, ,nd§ frda.h b;d ksje/Èj y÷kdf.k ksÜgdjgu iqjlr iqjlr .ekSug Tn ish¨‍ fokd ie,ls,su;a úh hq;=hs' ,xld fydiamsÜ,a laIqøÔj úoHd ridhkd.drfha iqúfYaIS fiajdjka wm ,xld fydiamsÜ,a laIqøÔj úoHd ridhkd.drh wx.iïmQ¾K fiajd /ilska iukaú;h' b;d ksjerÈ jd¾;d Tng ,nd fokafka b;d Wiia ;;as;aj md,khla hgf;a Tng úK lrk frda.ldrl laIqø Ôùka b;d blaukska y÷kd y÷kd .ekSug iydh fjñks' fndfyda È,Sr frda. frdamKh i|yd l,la .; jqK;a kshfmd;= yd ifï fldgia mÍlaIdlr (Direct Smear) È,Sr we;s ke;s nj 24 mehla we;=,; Tng oekqï fokq ,efí' fi!LHfha levm; jk iu wdrlaId lrf.k ksfrda.Sj Ôj;a Ôj;ajkakg wfmka iydh' Tng iqN me;=ï' DM

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DM

History of CT Scan zykaÈ f,jlk" yoj; imdlk f,fâZ''' rEueál yoj;a wdndO

The legacy of the man who pioneered computed tomography Sir Godfrey Hounsfield ffjoH úoHdfõ wiydh fidhd.ekSula jQ CT mÍlaIK l%ufõoh fidhd.;a Y%Su;a f.dâ*%S fydakaia*S,aâ ckau Y; ixj;airh

CT udkj ixy;sfha wdrlaIdj fjkqfjka lemjQ wiuiu fidhd .ekSula CT mÍlaIK wo wfma rfÜ iEu osia;%slalhlu mdfya frda.Skaf.a iqjfi; msKsi l%shd;aul fjhs' Y%Su;a ú,afy,aï fldxrâ frdkaÜcka m%:u jrg YÍrdNHka;rh ksÍlaIKh lsÍug Wml%uhla ^tlaia lsrKh& fidhd .ekSfuka miq tys fojk úma,jh fia ie<flkafka mrs>Kl.; mßf,dalkh ke;fyd;a CT fkdfyd;a CAT mÍlaIK l%ufõoh 1972oS yªkd.ekSuh' wo ;;a;ajh úuik úg CT mÍlaIK fkdue;s ffjoH úoHdjla .ek is;kakg j;a neßh' ta ;rugu CT mÍlaIK wo iuld,Sk ffjoHjreka w;r Ndú;djlaj mj;S' kQ;k ffjoH úoHdj ;=< wo ojfia fïid jeo.;alula orK fulS úYAjl¾u fidhd.ekSu isÿ lf<A tx.,ka;fha fkdáxyeï yS Wmka wmQ¾j .Ks;{fhls' 22

October 2019

DOCTOR MAGAZINE

f.dâß ksõfnda,aâ fydakaia*S,aâ kï udkj ixy;sfha m%.uKhg w;sYhska bjy,a jQ fidhd.ekSula l< fï lS¾;sOr úoaj;df.a ckau Y; ixj;airh fjkqfjka fujka fyda iaurKhla isÿ fkdfldg fldfyduo@ ;%sudKrEmS ñksia isrer tla yev;,hlg ke;fyd;a fiahdrE iu;, mg,hlg .ksñka ñY% m%;sìïnhla weiqf¾ frda. ks¾Khg yqre jQ hq.hl ksYaÑ;j y÷kd.;a ia:dkhla tys Wäka yd háka jk wjhj j,ska f;drj m%;sìïn .; lr.; yels l%uhla jYfhka CT mÍlaIK ir<j ye|skaúh yel' fuh ffjoH m¾fhaIlhka fl;rï Woaoduhg m;a l< fidhd .ekSulao h;a 1979 j¾IfhaoS fN!;fõoh yd ffjoH úoHdj ms<sn|j fkdafn,a ;Hd.fhka mqo ,eîugo tu isÿùu iu;a úh' l=vd ld,fhaoS wm olajk iqúfYaIS ukdmhka wmf.a wkd.;fha yevyqrej olajk bÕs njg m;a jkafkah' fkdáxyeïyS l=vd orejd nd, ikaosfhaoS leue;a;la oelajQfha .=jkaúÿ,s hka;%"

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ksuejqug fmr Y%Su;a f.dâ*%s fydakaia*S,aâ is;a;ï l< igykla

Y%Su;a f.dâ*%s fydakaia*S,aâ

Trf,daiq" úÿ,s Wmdx. w;m; .dkakgh' fkjdla yS ue.akia mdif,a fN!;sl úoHdj b.ekajQ fâúâ weia;ka Tyqf.a m%sh;u .=rejrhd úh' miq lf,l fydakaia*S,aâ úiska ;u <ud úh wjf,dalkh lrñka l< i|yka j,g wkQj Tyqf.a b.ekaùï ;u cSú;fha miqld,Sk ch.%yK i|yd úYd, wNdIhla iemhSh' tkuqÿ ksiÕfhkau ;u bf.kSfï lghq;= j,g t;rï ukdmhla fkdoelajQfjl= jQ ksidfjkau jhi oyifhaoS mdif,ka msguka jkakg isÿ jQfha lsisÿ iqÿiqlula iïmQ¾K fkdlr .ksñks'

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fï ;odikak ld,fha fojk f,dal hqoaOfha .sks is¿ weúf,kakg jQ w;r .egjrfhl= jQ fydakaia*S,aâ f¾vd¾ WmfoaYljrfhl= f,i ud;DN+ñfha hqo fiajhg tla úh' ksiÕfhka mej;S yelshdjka ksidfjkau thd¾ jhsia ud¾I,a leisä" bf,laá%la fudagr iïnkaOfhka jeäÿr yodrkakg fydakaia*S,aâg 1946oS m%odkhla ,nd ÿkafkah' ta lS¾;su;a *erfâ yjqia wdh;kfha wOHdmkh fjkqfjks' 1949 j¾IfhaoS kej;;a Tyq f¾vd¾ yd mß.Kl iïnkaOfhka /lshdj l< EMI wdh;khg iïnkaO jQ w;r tf;la Ndú;fha mej;S mß.Kl j,g jvd oyia ixLHd; m%n, jQ mß.Kl udos,shla ksmoùfï m¾fhaIlhka lKavdhula fufyhùfï j.lSu Tyq Wr u; megúk' g%dkaisiag¾ yd pqïnl fgdfrdhsv weiqf¾ EMIDEC 1100 kue;s mß.Klh ks¾udKh lsÍug fï mÍlaIK bjy,a úh' f,dalh mßj¾;khlg ,la lrk fndfyda fidhd. ekSï isÿjkafka wyUq w;aoelSul m%;sM<hla jYfhks' CT fkdfyd;a CAT mÍlaIK l hka;%ho tjka wyUq w;aoelSul isÿùula úh' jrla Tyq .sïydk ksjdvqjlg msáir m<d;lg .sfhah' ysñosßfha m<;=re l+vhlao iu.ska mßjdr ñ;=rka iu.ska ksfjiska kslau .sfha mßirfha wisßh ú|sskq msKsih' ,o ksfïIhloS l=yqf,ka m<;=re l+vh October 2019

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DM

History of CT Scan zykaÈ f,jlk" yoj; imdlk f,fâZ''' rEueál yoj;a wdndO

foi úms<sir jQ Tyqf.a is; ta Tiafia isref¾ b÷rka iumd; lrñka tajd úfNaokh lrk ;dlaIKhl wxl=r is;sú<s isf;ys me,moshï jkakg úh' ksõfnda,aâ fydakaia*S,aâ ffjoH úoHdfõ u<fmdf;a wl=rla oek isáfhla fkdùh' Tyqf.a yqrej ;snqfKA fN!;sl úoHdjgh' ta jk úg f,dalfha Ndú;fha mej;S úlsrK ;dlaIKh iajlSh wxl=r is;sú<s yd uqyqka lrñka ñksia isrer ishqïj úfNAokh lrñka m%;sìïn.; lsÍfï kj udkhka fiùug orK W;aidyhla njg m;a lsÍug fï wyUqj fya;= úh' 24

October 2019

Tyq ;u m<uq CT mßf,dalk hka;%h úlsrK ffjoHjrekag bosßm;a lf<A 1967 j¾IfhaoSh' tys t;rï jákdlula y÷kd .ekSug uq,a úlsrKfõoSka iu;a fkdjq njo lsj hq;=h' kuq;a iajlSh zzta;a;= .ekaùfï W;aidyhZZ Tyq w;ayf,ao ke;' flfia fj;;a fi!LHh fomd¾;fïka;=j fï m¾fhaIK i|yd lsishï m%odkhla uqod y, w;r 1971 j¾IfhaoS frday,l ia:dms; hka;%hla weiqf¾ fud<fha f.ähla ksYAph jYfhkau fy<sorõ lr .ekSu ksõfnda,aâ fydakaia*S,aâ ,o wkfmalaIs; ch.%yKhla úh' bka miqj iuia; YÍrhu mßf,dalkh i|ydo fï ;dlaIKh fhdod .kakd ,o w;r l%u l%ufhka mßf,dalkfha ls;a hii uyd ì%;dkHfha u;= fkdj fjk;a rgj,o me;sr hkakg úh' ksõfnda,aâ fydakaia*S,aâ úiska isÿ l< fï fidhd .ekSug 1979 j¾IfhaoS fkdafn,a ;Hd.h ysñ jQ w;r 1984 j¾IfhaoS uy /csk úiska khsÜ kduhlao msßkeóh' DM

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Laboratory Tests Explained fldf,iagfrda,a mÍlaIKhg fmr ksrdydrj isàu wjYHo@

fldf,iagfrda,a mÍlaIKhg fmr ksrdydrj isàu wjYHo@ kj wOHhk u.ska fldf,iagfrda,a mrSlaIdfõ m%;sM< iudf,dapkhg ,la flf¾

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

iageáka T!IO fkd.kakd whg ojfia ´kEu fj,djl fldf,iagfrda,a mÍlaId l< yelshs@

Tfí yDofha iy reêr jdyskSj, iqjfi; iïnkaOfhka úuiSfï§ fldf,iagfrda,a mÍlaIKhg ,efnkafka wkqmfïh jQ jeo.;a luls' idudkHfhka fldf,iagfrda,a mßlaId lsÍug fmr Èk rd;%sfha ksrdydrj isàug ffjoHjreka kshu lrhs' ksrjoH m%;sM< i|yd th wjYHfhkau imqrd,sh hq;= wjYH;djhla nj fndfyda frda.Ska mjd okakd ldrKhls' zzl,los jyÆ" l,los ry fjkjdÆ'''ZZ lshuk isysm;a lrñka ksrdydrj fkdj wdydr .ekSfuka miqjo fldf,iagfrda,a mÍlaIdj isÿ lr.; yels hhs oeka oeka u; m< flfr;s' fuf;la mej;s l%ufõoh jQfha reêrfha fldf,iagfrda,a mÍlaIKhg fmr Èk rd;%sfha ksrdydrj isàuh' kuq;a fï ksrdydr j isàu frda.shdg fukau ffjoHjrhdgo lsishï wd;;shla we;s lrjk l%shdj,shls' fndfyda frda.Ska ksrdydrj isg reêrh mÍlaId lsÍug lsishï ue,slula olaj;s' l%shdldÍ ñksiqka" orejka fukau Èhjeähdj jeks

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October 2019

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fldf,iagfrda,a mÍlaIKhg fmr ksrdydrj isàu wjYHo@

Laboratory Tests Explained

úúO frda. iys; mqoa.,hkag ksrdydrj isàu ;rula ÿIalr lghq;a;ls' ksrdydrj isàu fldf,iagfrda,a mÍlaIK l%shdj,sfha úêúOdkhla jqjo kshñ; meh .Kkla ksrdydrj fkdisàfuka ,efnk m%;sM,h m%;sM,h fodaI iy.; fõ' túg ffjoHjrekago ksjerÈ frda. ks¾Khla isÿ lsÍu ;rula ÿIalr lghq;a;la jkq we;' ksrdydr reêr mÍlaIdjla fldf,iagfrda,a j,g wehs@ ,smsv mÍlaIdj mÍlaIdjl§ ksrdydrj th isÿlsÍug fya;= idOl jk lreKq folls' 1' wdydr .ekSfï § reêr.; ,smsv w.hka fjkia jk ksid m%;sM, ksrjoH;djh fjkqfjka ksrdydrj isàug isÿ fõ' 2' LDL fldf,iagfrda,a .Kkh lsÍug ksrdydrj isákakg isÿùu fojeks ldrKhhs' .Ks;uh wdfmdaykhka weiqf¾ isÿ lrk LDL mÍlaIdfõoS fï uQ,sl w.hka .; hq;af;a ksrdydrjh' kuq;a fuf;la Ndú;fha mej;s tu iïu;hka ;jÿrg;a tfiau mj;ajd .ekSu ksjerÈo hkak iïnkaOfhka m¾fhaIK m%cdj iudf,dapkh lrñka isáhs'

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October 2019

DOCTOR MAGAZINE

fï iïnkaOfhka woyia olajk kQ;k m¾fhaIlhkaf.a u;h jkafka fldf,iagfrda,a j, m%fNao ;=fkys m%;sM, ,nd .ekSfï§ wdydr .ekSfï idOlh t;rï jeo.;a fkdjk njhs' Total Cholesterol, HDL yd LDL Cholesterol mÍlaIdjka i|yd wdydr .ekSu fyda fkd.ekSu n,mdkafka iaj,am jYfhks' tfy;a wdydr .ekSfuka miqj g%hs.a,sirhsv uÜgu meh lSmhla we;=<; by< hhs' g%hs.a,sirhsv uÜgu iïnkaOfhka úuiqula l< hq;= jkafka ksrd ksrdydrj fkdisg isÿlrk mÍlaIKhl§ o g%hs.a,sirhsv uÜgu by< mj;sk úghs' os.=ld,Sk m¾fhaIK Tiafia fldf,iagfrda,a mÍlaIKfha yerjqï ,laIhla §¾> ld,hla ;siafia isÿ lrk ,o m¾fhaIK j,g wkqj yDohdndO" wd>d;h jeks frda. we;s ùfï wjodku úuiSu i|yd ksrdydrj fkdisg isÿ lrk fldf,iagfrda,a mÍlaIdjo idhksl jeo.;a lula orhs' we;af;kau wdydrhla .ekSfuka miqj isÿ lrk fldf,iagfrda,a mÍlaIKh ,smsv uÜgï y÷kd .ekSfuys,d jvd;a M<odhS jk njgo we;eï m¾fhaIlhka lreKQ

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olajhs' idudkH Ôú;fha wm jeä jeä fj,djla .; lrkafka ksrdydrj fkdfõ' fï wkqj jvd;a idOdrK m%;sM,hla i|yd reêrh ,nd .; hq;af;a o wdydr ,nd.ekSfuka miqjh hk u;hla m¾fhaIK m%cdj w;r iudc.; fjñka mj;S'

fkdfõ' Tfí is;eÕs mßÈ ´kEu fj,djl lrk reêr mÍlaIKhlska fldf,iagfrda,a w.h uek n,d.; yel'

uE;ld,Skj ,smsv mek, i|yd jk ud¾f.damfoaYkh j,g wkqj ksrdydrj fkdisg isÿlrk isÿ lrk fldf,iagfrda,a isÿ lrk fldf,iagfrda,a mÍlaIK i|yd jeä ukdmhlaa úoHd;aul m%cdj fj;ska ,eî ;sfí'

ksrdydr reêr idïm,hla wjYH ksid fndfyda úg fldf,iagfrda,a mßlaIK isÿlrkafka WoEikh' flfia fj;;a kj ud¾f.damfoaYk wkqj ojfia ´kEu fj,djl fldf,iagfrda,a mÍlaIKhg Ndckh ùug Tng wjia:dj ;sfí'

ksrdydrj isg isÿlrk mÍlaIK g%hs.a,sirhsv iïnkaOfhka kï ;jÿrg;a bÈßhg f.k hd hq;=h' Èhjeähdj i|yd jk iq,n mÍlaIK mj;ajkafkao ksrdydrj isgh' Èhjeähdj frda.h i|yd o i|ydo HbA1c mÍlaIKh isÿlsÍug ksrdydrj isàu wjYH fkdfõ'

Tn fï jk úg;a fldf,iagfrda,a i|yd T!IO ,nd .kakd flfkla fkdfõ kï fï wkqj ó<Õ fldf,iagfrda,a mÍlaIKh i|yd Tn ksrdydrj isàu wjYH fkdúh yel' flfia fj;;a fï iïnkaO ksYaÑ;j ;SrKh lsÍu Ndr jkafka Tfí ffjoHjrhdgh' tfia u mÍlaIKhg reêrh ,nd.ekSug meh úis y;rlgfmr uoHidr ,nd.ekSuo kqiqÿiqh' uoHidr úiska g%hshs.a,sirhsv w.hka fjkia lrk fyhsks'

fï miqìu ;=< Tfí ó<Õ fldf,diagfrda,a mÍlaIdj isÿ lsÍfï§ Tn ksrdydrj isàu wjYHo hkak Tfí ffjoHjrhdf.ka úuikak' iïm%odhka fjkia lsÍug ld,hla .; fõ' kuq;a úoHdj m¾fhaIKd;aulj ikd: lrk l,ayS iy th wmg myiqjlaokjk l,ayS fuh zziqmqj;laZZ fkdjkaafkao@ fldf,diagfrda,a hkq fldf,diagfrda,a hkq wfma YÍrfha iajNdjfhkau ksmofjk øjHhls' wm .kakd we;eï wdydr j¾. j,o fldf,iagfrda,a hyñka ;sfí' wfma YÍrfha ksjerÈ l%shdldß;ajh i|yd fï fldf,iagfrda,a ke;sj neßh' tfiau tajd kshñ; m%udKhg jeäfhka ;sîfuka yDohdndO iy wd>d; wjodkula we;s fjhs' fï wjodku ksid Tfí YÍrfha ;sfnk fldf,iagfrda,a uÜgu .ek oek isàu fi!LH iïnkaO isß;la njg m;afõ' wefußldkq ffjoH ix.ufha ks¾foaY wefußldkq ffjoH ix.uh úiska ks¾foaY lr we;s wdldrhg jhi wjqreÿ 20 oS iEu mqoa.,fhl=u jir yhlg jrla j;a fldf,iagfrda,a mÍlaIKhla isÿ lr .ekSu iqÿiqh' hï flfkla ;ukag fldf,iagfrda,a wêlj ;sfnk njg y÷kd.; fyd;a Tyq tu mÍlaIdjg ks;r ks;r Ndckh úh hq;=h' weußldkq yDo ix.ufha kj;u ud¾f.damfoaYk j,g wkqj Tn fldf,iagfrd,a i"yd iageáka T!IO .kakd flfkl= fkdjkafka kï fldf,iagfrda,a uÜgu uek ne,Su i|yd ksrdydr reêr mÍlaIKhlg ,laùu wjYH

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fldf,iagfrda,a mÍlaId lrkafka Lipid Profile hkqfjka y÷kajk mÍlaIKh yrydh' fuhska ,efnk m%;sM,h we.hSug kï fuu mÍlaIdfjka uek n,k úúO ,smsv j¾. iïnkaOfhka Tng lsishï wjfndaOhla ;sìh hq;=h' idudkH uÜgu" wjodkï iy.; uÜgu iy iaj,am jYfhka wjodkï uÜgu wd§ jYfhks' ta iïnkaO úia;rhla my; olajñ'

October 2019

DOCTOR MAGAZINE

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D•Magazine /

fldf,iagfrda,a mÍlaIKhg fmr ksrdydrj isàu wjYHo@

Laboratory Tests Explained

,smsv mÍlaIKfhka ,efnk m%;sM,h ksfrda.S mqoa.,hl=f.a mrdih ;=< mej;Su Tfí wfmalaIdjhs' fldf,iagfrda,a mÍlaIKfha m%;sM<h iaj,am jYfhka fyda ie,lsh hq;= uÜgulska jeä kï ksfrda.S mrdihlg th f.k taug Tnf.a wdydr j," jHdhdu isßf;a wd§ jYfhka cSú;fha fjkialï lsÍug isÿfõ' we;eï úg Tfí fi!LH ;;a;ajh i,ld n,ñka ta i|yd T!IO .ekSugo ffjoHjreka kshu lrhs' flfia fj;;a fldf,iagfrda,a mÍlaIKh ;jÿrg;a yDo frda." wxYNd.h wd§ frda. we;sùu j<lajd.ekSu úIfhys isÿlrk fufyh kï wmßñ;h' Total cholesterol fuhska woyia lrkafka fTfí reêrfha we;s ish¿ fldf,diagfrda,a m%udKhhs' Your total cholesterol number is the overall amount of cholesterol found in your blood.

• Acceptable: Below 200 mg/dL (milligrams per deciliter) • Borderline: 200 to 239 mg/dL • High: 240 mg/dL or higher non-HDL-C levels (in terms of risk) • above 220 mg/dL ( 5.7 mmol/L) is considered very high • 190 – 219 mg/dL ( 4.9 – 5.6 mmol/L) is considered high • 160– 189 mg/dL ( 4.1 – 4.8 mmol/L) is considered borderline high • 130 – 159 mg/dL ( 3.4 – 4.0 mmol/L) is considered near ideal • below 130 mg/dL (below 3.4 mmol/L) is considered ideal for people at risk of heart disease • below 100 mg/dL (below 2.6 mmol/L) is considered ideal for people at very high risk of heart disease LDL is the cholesterol that blocks your blood vessels and increases your risk of heart disease • Acceptable: Below 70 if coronary artery disease is present • Below 100 mg/dL if at risk for coronary artery disease or have a history of diabetes • Borderline: 130 to 159 mg/dL • High: 160 mg/dL or higher • Very high: 190 mg/dL and above HDL fldf,diagfrda,a hkq fyd| fldf,diagfrda,a j¾.hls'

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DOCTOR MAGAZINE

fïjd jeä jk ;rug yoj;g iqjodhSh'fuhg reêrjdyskS.; jeäuk;a fldf,diagfrda,a bj;a l< yel' HDL is also called good cholesterol and helps protect you from heart disease. This type removes excess cholesterol from your blood, helping to prevent buildup. The higher your HDL levels are, the better.

• Acceptable: 40 mg/dL or higher for men and 50 mg/dL or higher for women • Low: 39 mg/dL or lower for men and 49 mg/dL or lower for women • Ideal: 60 mg/dL or higher Triglycerides by< g%hs.a,sirhsv uÜgï yd LDL fldf,diagfrda,a tla ùfuka yoj;a frda. wjodku jeäfõ' High triglyceride levels coupled with high levels of LDL raise your risk for heart disease • Acceptable: 149 mg/dL or lower • Borderline: 150 to 199 mg/dL • High: 200 mg/dL or higher • Very high: 500 mg/dL and higher DM

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

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

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

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

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Child Health fï Èkj, wfma rfÜ olakg ,efnk ffjria WK

fï Èkj, wfma rfÜ olakg ,efnk ffjria WK ;,j;=f.dv fyaudia frdayf,a fkajdisl <ud frda. úfYaI{ osÆId w;=fldard, MBBS (Colombo), MD (Paediatrics) Diploma in Child Health

fï Èkj, <uqka w;r nyq,ju olakg ,efnk idudkH ffjria WK ms<sn|j jeo.;a lreKq lSmhla wo wms l;d lruq' fuu ;;a;ajh olakg ,efnkafka l=uk jhfia orejka w;ro@ fuu ffjria WK idudkHfhka ´kEu jhil orejl=g je<¢h yelshs' kuq;a nyq,ju fmr mdi,a yd mdi,a hk <uqka w;r olakg ,efí' jhi wjqreÿ 3- 10 ;a w;r orejka w;r nyq,ju oelsh yel' thg fya;=j fuu ;;a;ajh tla orejl=f.ka ;j orejl=g b;d blaukska me;sÍ hEu ksidh' tfukau mjqf,a idudðlfhl=g fuu ;;a;ajh je<÷kfyd;a wfkla whgo me;sÍhdug bvlv jeäh' fuu ffjria wdidokfha frda. ,laIK fudkjdo@ WK m<uq Èk foflaoS b;d ;o WK ^101-103 F& ;;a;ajhla mjd we;s úh yel' tfukau meh 6la blauùug fmro kej;;a WK we;súh yel' ² leiai

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² ² ² ²

W.=r ߧu lEu wreÑh ysiroh yd weÕ ß§u jukh yd iuyr orejkag nv nqre,g hEu ² fjkod fuka l%shdldÍ fkdùu idudkHfhka fuu WK ;;a;ajh Èk 2 - 3 l§ iukh jk w;r" iuyr orejkag Èk 4 - 5 la olajd WK mej;sh yel' WK iukh ùu;a iu.u orejdf.a lEu reÑh yd l%shdldß;ajh l%u l%ufhka idudkH ;;a;ajhg m;aùug mgka .kS' kuq;a leiai" fyïìßiaidj jeks ,laIK i;shla fyda Bg;a jeäfhka mej;sh yel' fuu ;;a;ajh we;s jqjfyd;a l< hq;af;a fudkjdo@ ² orejdg WK iEÿKq ú.i nrg wkqj kshñ; merisgfuda,a ud;%dj ,ndÈh hq;=h' ² idudkHfhka meh 4-6 la muK .sh miq kej;;a WK ;sfí kï" B<. merisgfuda,a ud;%dj ,ndÈh yel'

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² merisgfuda,a yereKq úg ;o WK wvq lsÍug fok fjk;a T!IO ^Ibuprofen, Mefenamic acid& Ndú;d fkdl< hq;=h' ² fuhg fya;=j" by; lS frda.S ,laIK fvx.= WK ;;a;ajfhao we;sjk frda. ,laIK j,g iudk ksid" fuu ;o WKg fok wfkl=;a T!IO orejdg fvx.= ;;a;ajh ;sfí kï YÍrhg b;d wys;lr f,i n,mE yel' ² orejdg wjYH muKg Èhr cd;s ,nd§u' ² orejdg fjkod fukau idudkH wdydr fõ, ,nd§u' fuys§ orejdg lEu wreÑh ;sfí kï" orejd leu;s wdydrhla Tyqg $ wehg ,ndÈh yel' ² úfõlh ,ndÈu ^mdie,a fkdheùu" ndysr mx;s fkdheùu& orejd ffjoHjrhl=g fyda frday,lg /f.k hd hq;= o@ ² orejd meh 48la muK ;o WK mej;sfha kï ffjoHjrfhl=

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D•Magazine /

fï Èkj, wfma rfÜ olakg ,efnk ffjria WK

Child Health

fyda frday,la fj; /f.k hdu iqÿiq fõ' fuhg m%Odk;u fya;=j fuu ;;a;ajh idudkH ffjria WK o tfia ke;skï fjk;a wikSm ;;a;ajhlao ^úfYaIfhkau fvx.= WK" YÍrhg fjk;a úIîchla hEu& hkak meyeÈ,s lr .ekSu i|ydh' ² tfiau orejdg È.ska È.gu jukh hEu' lEu$îu .ekSug iïmQ¾Kfhkau m%;slafIam lsÍu fyda WK nei.sh wjia:dfõ§ o u<dksl ù isàu jeks frda. ,laIK ;sfí kï m%udo fkdlr jydu ffjoHjrfhl=$frday,la fj; /f.k hd hq;=hs' fujeks frda. ,laIK ^ idudkH ffjria WfKys tk frda. ,laIK ^idudkH WfKys tk frda. ,laIK& fujeks frda. ,laIK oelsh yels fjk;a frda. fudkjdo@ ² fvx.= WK$fvx.= rla;md; ;;a;ajh ² W.=f¾ fyda lfKa wdidok ² uQ;%d wdidok ² YÍrhg úIîchla we;=¿ ùu ² fmkyM j, wdidok by; lS frda. ;;a;ajhka j,oSo uq,ska lS frda. ,laIK we;súh yels by; lS frda. ;;a;ajhka j,§o uq,ska lS frda. ,laIK mej;sh yels kuq;a" thg we;s m%jK;djh fnfyúka wvqh' flfia kuq;a ielhla we;s kï ffjoHjrfhl=g fmkaùu jvd;a iqÿiq fõ' f,a mÍlaIK wjYHo@ fuu ffjria WK ;yjqre lsÍug f,a mÍlaIK l< hq;=o@ ² orejdg meh 48la muK ;o WK meje;sfha kï ffjoHjrhd úiska orejdj mÍlaIdlr wjYH kï f,a mÍlaIKhlg fhduq lrkq we;' ² fuu f,a mßlaIK j, m%Odk mrud¾:h kï fvx.= frda.hg m%jK;djla we;s oehs iel yer oek. ekSuhs tfukau idudkH ffjria wdidokhla o tfia ke;s kï by; lS fjk;a frda.hlao hkak fuu f,a jd¾;dj,ska woyila .; yel ² idudkHfhka uQ,slj lrkq ,nk mÍlaIK kï Full blood count, Dengue Ag, CRP yd wjYH kï Urine Full Report hk mÍlaIKhhs

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² by; mÍlaIK j, we;s widudkH;d wkqj jeäÿr mÍlaIK l< hq;=oehs ffjoHjrhd ;SrKh lrkq we;' flfia fj;;a idudkH ffjria WK ,laIK we;s iEu orefjl=gu f,a mßlaId lsÍu w;HjYH fkdfõ' WK nei .sh miq orejd fyd¢ka isà kï lEuîu idudkH f,i .kafka kï l%shdldÍ kï f,a mÍlaIK lsÍu w;HjYH ke;' flfia fj;;a lsishï ielhla fyda .eg¨jla foudmshkag we;akï ffjoHjrfhl=g orejdj fmkaùu jvd;a iqÿiqh' ffjria WK ksid we;súh yels ixl+,;d fudkjdo@ ² ffjria WK iEfok orejkaf.ka b;du;a jeä m%;sY;hlg lsisu ixl+,;djhla we;s fkdfõ' ² kuq;a WK j,smamqj we;sùug m%jK;djla we;s orejkag fuu ;;a;ajh iuÕ WK j,smamqj we;súh yel' ² tfukau jukh" wdydr fkd.ekSu" nv nqre,g hEu jeks frda. ,laIK we;s orejkag úc,kh

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ffjria WK j<lajd .ekSug wkq.ukh l< yels mqreÿ fudkjdo@ ffjria WK me;srhdu je<elaùug ² w;a fia§u" lysk úg lsúiqï hjk úg f,akaiqjla Ndú;d lsÍu ² WK ;sfnk orejdj mdi,g"fmr mdi,g fkdheùu ² ksfjia yd jgmsgdj msßisÿj ;nd .ekSu ² wêl fik. .ejfik ;ekaj,g l=vd orejka /f.k fkdhEu ffjria WK iïmQ¾Kfhkau je<elaùug úfYaI tkak;la fkdue; tfukau fuu ffjria WK ;;a;ajh úúO ffjria j¾. u.ska fnda úh yels ksid tla jrla yeÿko kej; jrla tu orejdg fuu ;;a;ajh we;s úh yel YÍrfha iSks uÜgu wvqùu hk wd§ ixl+,;d we;s úh yel' ² l,d;=rlska fufia ffjria wdidokhg f.dÿre jQ orejl=g th msggu fojkqj nelaàßhd wdidokhla we;s úh yel (Secondary bacterial infection) ² by; i|yka l< ixl+,;d we;s jqjfyd;a frday,l fkajdislj m%;sldr .ekSu jvd;a iqÿiq fõ' ² fuys§ merisgfuda,a j,g wu;rj ffjoHjrhd úiska orejdf.a ;;ajh wkqj fjk;a m%;sldr ,nd§ug lghq;= lrkq we;' WodyrK wêl jukhg - T!IO fia,hska ,nd§u fojkqj nelaàßhd wdidokh - m%;sÔjl T!IO ^kuq;a idudkH ffjria WK ;;a;ajhl§ orejdg m%;sÔjl T!IO ,ndÈh hq;= ke;'&

doctormagazine.lk

úfYaIfhkau fmr mdi,a hk orejkag udi 1-2 lg jrla úúO wikSm ^WK leiai fyïìßiaidj& iE§u idudkH fohla jk w;r foudmshka tu ksid wkjYH f,i l,n, úh hq;= ke;' jhiska jeä ùu;a iu. tu f,v frda. j,g f.dÿre jk m%jK;dj l%ufhka wvq úh' DM

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zzksy`v ñkSurejdZZ md,kh lruq

wêl reêr mSvkh yDo frda. úfYAI{ ffjoH Y%S ,d,a ,shkdrÉÑ

oekg f,dalfha úfYaIfhkau ÈhqKq rgj, urKhg fya;=ldrl jk m%Odk idOlhla f,i yDoh wdY%s; frda. jeo.;a ia:dkhla .kS' fuu ;;a;ajh oeka oeka ÈhqKq fjñka mj;akd Y%S ,xldj jeks rgj,go me;sr hk nj fmfkkakg we;' fufia Ôú; úkdY ùug fya;=ldrl jk yDo yd reêr kd, wdY%s; frda. f,i wxYNd.h yd yDoh wl%Sh Ndjh kï lr oelsh yel' by; i|yka frda.j,g f.dÿre ùu i|yd fya;= ldrl idOlhla f,i zzwêl reêr mSvkhzz ye¢kaúh yel' 36

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wêl reêr mSvkh iys; frda.Skaf.ka jeä fokl=f.a reêr mSvkh md,kh fkdù mj;skjd f,dalfha wfkl=;a rgj, úúO wdh;k úiska lrk ,o m¾fhaIK j,ska wêl reêr mSvkh md,kh lsÍfuka ,efnk jdis fudkjg meyeÈ,s lr ;sfí' tfy;a fuu meyeÈ,s lsÍï fldf;l=;a ;snqK;a f,dalfha isák wêl reêr mSvkh iys; frda.Skaf.ka jeä fokl=f.a reêr mSvkh md,kh fkdù mj;sk nj fidhdf.k ;sfí' fuh ÈhqKq rgj,g mjd mru i;Hhla ù ;sfí' weußldfõ iEu wêl reêr mSvkh iys; frda.Ska f.ka ishhg yeg wgla ;uka wêl reêr mSvkh kue;s frda.S ;;a;ajfhka fmf<k nj okakd kuq;a uq;a ishhg 54la thg m%;sldr o ,nk uq;a reêr mSvkh idudkH m%udKhg md,kh ù ;sfnkafka ishhg 27 f.a mu‚' ,xldfõ ;;a;ajho óg fojeks fkdfõ'

2' wêl reêr mSvkh úfYaIs;jQ frda. ,laIK j,ska f;drj mj;sk neúka ;ukag frda.hla ke;ehs hk yeÕSu ksid T!IO Ndú;fhka je<lS isàu

md,kh fkdjQ wêl reêr mSvkhg fya;= fuhg fya;= jYfhka idOl lsysmhla f.k yer oelaúh yel'

wêl reêr mSvkfha§ frda.sfhl=g we;sjk frda. ,laIK wm idudkHfhka fnfy;la" Wmfoila .kakg ffjoHjrfhl= yuqùug hkafka wmg lsishï frda. ,laIKhla hï wmyiq;djla we;s jQ úghs' túg frda.shd mjik oE fyda olajk frda. ,laIK iu.skau ffjoHjrhd frda.shd mÍlaId lr ;j;a iuyr ,laIK fidhd.kS' fïjd Signs hk bx.%Sis kdufhkao y÷kajhs' idudkHfhka ta ta frda.j,g wdfõ‚l frda. ,laIK ;sfnk kuq;a reêr mSvkhg wdfõ‚l úfYaIs; frda. ,laIK fkdue;s w;r tfia we;sjk frda. ,laIK mjd b;d iq¿ iy úfYaIs; Ndjfhka f;drh' (Mild & Non specific)

1' frda.shdf.a wêr reêr mSvk frda.fha we;s oreKq iajNdjh fukau th md,kh lr .ekSfuka ,efnk jdis ms<sn|j ksje/È jegySula fkd;sîu

doctormagazine.lk

fuu ,smsh u.ska wm woyia lrkqfha zzwêl reêr mSvkhZZ kue;s frda.h iy tys ixl+,;djhka yd th md,kh lr .ekSfuka Tng w;am;a jk jdis ms<sn|j Tnj oekqj;a lsÍuh' wêl reêr mSvkh hkq l=ulao@ reêr mSvkh hkq yDoh kue;s iajNdúl fmdïmhla u.ska reêrh reêr kd< ;=<g ;,a¨‍ lsÍfïÈ reêr kd, ì;a;s u; we;s lrk mSvkhhs' reêr mSvkh uekSu ;=<ska yDohg fl;rï wdhdihlska ;u ld¾hh bgq l< hq;=oehs jegySula wmg ,nd .; yel' tkï reêr mSvkh wêl kï thska woyia jkafka yDohg we;sjk wd;;sh jeä njhs' reêr kd,''' úfYaIfhkau Ouks >k ùu iy isyska ùu isÿ jQ úg ^idudkHfhka fuh jhia.; jQ úg isÿjk l%shdj,shls& tu kd, ;=< reêrh fmdïm lsÍfï§ jeä wd;;shlg uqyqK §ug isÿfõ' fuys§ ksrdhdifhkau reêrfha mSvkh by< hhs' wêl reêr mSvkh - úfYafhka oek.; hq;= lreKQ fndfyda úg reêr mSvkh jeäùu frda. ,laIK ,laIKj,ska f;dr jqj;a Nhdkl ixl+,;d we;s lrhs' tu ksid wêl reêr mSvkh zzksYaYío ñkSurejdZZ (Silent Killer) hk wre;skao y÷kajhs' fndfyda fndfyda fokl= wê reêr mSvkfhka fm,qk;a ta nj Tjqka mjd okafka ke;' fï ksid wêl reêr mSvkh .ek óg jvd jeä jYfhka wm ie<ls,a,la oelaúh hq;= fõ'

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Blood Pressure wêl reêr mSvkh zzksy`v ñkSurejdZZ md,kh lruq

wêreêr mSvkh hkq Tfí yDoh yd reêrjdyskS lsishï wd;;shlska l%shd;aul jk njg jk yeÕùuls' fuhg m%;sldr fkdie,iSfuka reêrjdyskS wjysr ùu yd yD;a wlrKsh wdoS wjodkï ;;a;aj j,g m;a úh yel'

jhi wjqreÿ 40g jeä wh wju jYfhka frda. ,laIK ;snqK;a ke;;a j¾Ihlg tla jrla j;a jrla ffjoHjrfhl= ,jd ;u reêr mSvkh ;;a;ajh ;;a;ajh mÍlaIdjg ,la lr .; hq;=hs' wêl reêr mSvkfhka fmf<k frda.shl= kï wju jYfhka udihlg jrla j;a ;u reêr mSvkh mßlaId lr .; hq;= fõ'

kshñ; m%udKhg jvd úYd, jQ yDoh yD;a wlrKsh reêrjdyskS wjysr ùu

wêl reêr mSvkh iys; frda.Ska úfYaIfhkau oek.; hq;= lreKla kï wm by; i|yka l< mßÈ fuu frda.Ska nyq lsisÿ frda. ,laIKhla fkdfmkaùuhs' iuyrúg wêl reêr mSvkh we;sj fkdoekqj;aju jir 10-15la jeks wêl ld,hla mjd .; ù ;sîug mq¿jk' fjk;a fya;=jla ksid ffjoH mÍlaIKhlg ,la jk wjia:djl§''' WodyrKhla jYfhka / lshdjlg f.dia lrk ffjoH mÍlaIKhloS reêr mSvkh uek n,k úg wêl reêr mSvkh iys; frda.Ska yuqfõ' fï wkqj wêl reêr mSvkh we;s nj oek.ekSug frda. ,laIK flfrySu úYajdih ;eîug fkdyels nj fmfka' fï ksid wêl reêr mSvkh fidhd .ekSug kï reêr mSvkh uek ne,sh hq;=uhs'

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flfia fj;;a wêl reêr mSvkh we;s úg u;=jk frda. ,laIK ke;af;au fkdfõ' fndfyda úg fuu frda. ,laIK oreKq fkdjk w;r tajd wêl reêr mSvkhg úfYaI;ajhlao fmkakqï fkdlrhs' wêl reêr mSvkfha § we;sjk iuyr frda. ,laIK ysiroh ysfia we;sjk ߧu fyda f.,ys msgqmiska we;sjk oreKq fõokdj fuh we;s jkafka b;d l,d;=rlska reêr mSvkh wêl f,i by< .sh úg§h' lrleú,a, wjg mßirh

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lrleú,a,la fuka oekSu' jefÜúo jefÜúo hk ielfhka weú§ug ìh ùu fuys ,laIK fõ' úvdj w,i núka jefvys ksr; ùu" lïue,s .;sh we;sùu fmkSu wvqùu fmkSu wvqùu fyda fmkSu fnd|ùu fuys§ we;súh yel' Bg wu;rj reêr mSvkh u.ska fkdfhl=;a wjhj j,g ydks ùï ksid fkdfhl=;a frda. ,laIK we;súh yel' wêl reêr mSvkh ksid we;súh yels wjhj ÿ¾j, ùu • yDohdndO • yDoh wl¾uKH ùu • jl=.vq wl¾ukH ùu • wxYNd.h • weig isÿjk ydks ksid weia weia ÿ¾j, ùu fuu ixl+,;d ms<sn|j wm §¾> f,i idlÉPd lruq reêr mSvkh uekSu iy tys idudkH w.hka mSvk udkfha frÈ Wrh je<ñgg u|la by<ska wf;a ndyqj jg lrkq ,nk w;r bkamiq thg iïnkaO nqnq,la u.ska jd;h fmdïm flf¾' bkamiq fjo k,dj je<ñg ;=< we;s Ouks u; ;nd fmdïm lrk ,o jd;h fiñka nei hdug i,iajhs' túg

doctormagazine.lk

m<uqfjkau k,dj ;=<ska f,a .uk mgka .kak Yíohla wefik w;r ta wjia:dj zzixfldapk mSvkhZZ fkdfyd;a Systolic Blood Pressure hkqfjka ye¢kafõ' fufia ;jÿrg;a jd;h nei hdug ie,eiaùfï § weiqK Yíoh tla wjia:djl§ kEiS hhs' tu wjia:dj o igyka lr .kakd w;r th zzúia;drK mSvkhZZ fkdfyd;a Diastolic Blood Pressure hkqfjka y÷kajkq ,nhs' ixfldapk mSvkh Systolic Blood Pressure yDoh u.ska reêrh reêr kd, ;=<g ;,a¨‍ lrk wjia:dfõ§ reêr kd, ì;a;s u; we;slrk mSvkh zzixfldapk mSvkhZZ f,i y÷kajkq ,nk w;r fuu w.h 120$140 mm Hg ^reêr mSvkh ukskq ,nkafka riÈh ñ,sóg¾ hk tallh fhdod .ksñks'& w;r ;sîu idudkH ;;a;ajhla hhs ms<s.ekqk;a uE;lÈ mgka cd;Hka;r jYfhka ms<s.; kj;u jd¾;djg wkqj fuu w.h 120$139 mm Hg w;r mj;skafka kï th zzfmr reêr mSvk ;;A;ajhlaZZ (Pre Hypertension) f,i y÷kajkq yÿkajkq ,nk w;r fuu mqoa.,hka wkd.;fha§ reêr mSvkhg ,la ùfï m%jK;djh jeä fõ' tu ksid fuu jd¾;d j,g wkqj fujeks mqoa.,hka ;ukaf.a reêr mSvkh .ek ie,ls,su;a úh hq;=hs' úia;drK mSvkh Diastolic Blood Pressure reêr mSvkh igyka lsÍfï§ yuqjk fojk mdGdxlh úia;drK mSvkh fkdfyd;a Diastolic Blood Pressure hkakhs' yDofha tla ixfldapk wjia:djla wjidkfha isg wfkla ixfldapk wjia:dj mgka .ekSu olajd jQ ld,h ;=< ^yDoh úfõlSj ;sfnk wjia:dj& reêr kd, wefok iq¿ .;sh ksid (Elasticity) we;sjk mSvkh úia;drK mSvkhhs' fuh idudkHfhka 90mm Hg j,g jvd wvq úh hq;=hhs ms<sf.k ;snqK;a by; i|yka l< kj;u jd¾;d j,g wkqj fuu w.h 80mm Hg j,g jvd my< w.hla .; hq;= fõ' fuh 80-90mm Hg w;r uÜgul mj;S kï ta zzfmr reêr mSvk ;;a;ajhlaZZ jYfhka ie,fla' wêl reêr mSvkhg fya;= wm úfYaIfhkau oek .; hq;= lreKla jkafka ishhg wkqjla muK wêl reêr mSvkh iys; frda.Skag reêr mSvkh i|yd jQ úfYaIs; fya;= ldrlhla fkdue;s ùuhs' tu ksid fuu Primary of Essential Hypertension hkqfjka y÷kajkq ,nhs'

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Blood Pressure wêl reêr mSvkh zzksy`v ñkSurejdZZ md,kh lruq

flfia fj;;a fj;;a úfYaIs; fya;= ldrl idOlhla fkdue;s jqj;a we;eï idOl wêl reêr mSvkh flfrys n,mdhs' flfia fj;;a ishhg 5-10 olajd frda.Skaf.a reêr mSvkhg fya;= ldrl idOlhla fidhd .; yels ;;a;ajhl mj;S' tu ksiduh Secondary Hypertension hkqfjka y÷kajkq ,nhs' fuys§ l< hq;= jkafka tu fya;= ldrl idOlhg m%;sldr lr th bj;a lsÍuhs' túg reêr mSvkh idudkH w.hlg m;afõ' wêreêr mSvkhg n,mdk iuyr fya;= iuyrla • wêjDlal .%kaÓh wdY%s;j we;sjk f.ä • jl=.vq wdY%s;j we;sjk wdndO • msáhqgß .%kaÓfha iy wêjDlal .%kaÓ j,ska >%djh jk fydafudak j, oeä l%shdldß;ajh • mjq,a ixúOdkh i|yd .kq ,nk tkak;a iy fm;s wêl f,i u;ameka Ndú;h • ;hsfrdhsâ .%kaÓ W!K;djh 40

October 2019

DOCTOR MAGAZINE

Primary fkdfyd;a Essential Hypertension hk ishhg wkQjlg muK je<f|k wêl reêr mSvk ;;a;ajhg mdol jk úfYaIs; jQ fya;=jla ke;s jQj;a thg jl%dldrj n,mdk fya;= ldrl lsysmhla y÷kdf.k ;sfí' fufia fya;= ldrl idOl w;r fjkia l< fkdyels idOl Non Modifiable Risk Factors iy fjkia l< yels idOl Modifiable Risk Factors f,i foj¾.hla y÷kd.; yel'

doctormagazine.lk

mqo. a ,hl=f.a reêr mSvkh uksk iEu wjia:djl§u mdfya 140$90 mm Hg g jvd reêr mSvkh jeä kï ta mqo. a ,hd wêl reêr mSvkfhka fmf<a hehs i,ld reêr mSvkhg m%;l s dr l< hq;h = 's fjkia l< fkdyels fya;= ldrl idOl Non Modifiable Risk Factors jhi flfkl= jhia.; ùfï§ tu mqoa.,hdg wêl reêr mSvkh je<£fï je<£fï m%jK;djh jeähs' fuh fndfydaúg Atherosclerosis fyj;a jhia.; ùfï§ we;sjk reêr kd, >k ùu ksid we;s fõ' ckj¾.h weußldfõ lrk ,o m¾fhaIKhlg wkqj wm%sldkq iïNjhla iys; mqoa.,hka" l¿ cd;slhka w;r iqÿ cd;slhkag jvd wêl reêr mSvkh je<£fï m%jK;djhla we;s nj fidhd f.k we;' kuq;a fuh ,xldj jeks >¾u l,dmSh rgj,g .e,fma oehs fidhd ne,Sug m¾fhaIK ;jÿrg;a l< hq;=h iudc wd¾Ól ;;a;ajh wêl reêr mSvkh je<£fï § m%jK;djh iudc ;;a;ajhla wvq iy wOHdmk ;;a;ajfhka ySk Less educated and lower social economic mqoa.,hka w;r wê reêr mSvk wjodku jeä nj fidhdf.k we;'

doctormagazine.lk

mrïmrdkq.; hïlsis mqoa.,hl=f.a mjqf,a flfkl=g fuu frda.h ;sfí kï tu mqoa.,hdgo wêl reêr mSvkh je<£fï m%jK;djh jeähs' tu ksid ;u mjqf,a wh w;r" f,a kEhskag fuu frda.h mj;S kï tjeks mqoa.,hska ks;r ks;r ;u reêr mSvkh ms<sn|j ie,ls,su;a úh hq;=hs' wmg fjkia l< yels fya;= ldrl idOl udkisl wd;;sh ks;ru wêl f,i udkisl wd;;shg n÷ka ùu ;=<ska wêl reêr mSvkh je,¢h yelshs' tu ksid yels iEu úgu udkisl wd;;sfhka ñ§ isàug W;aidy .; hq;= w;r iqr;,a i;=ka we;s lsÍu" ix.S;hg ijka §u jeks l%shd ;=<ska udkisl wd;;sh ixis÷jd .; hq;=h' wêl ;rndre lu ia:q,Ndjhg m%Odk fya;=j f,i ie,flkafka muK blaujk wdydr wkqNjhhs' mqoa.,hl= ;rndre f,i y÷kajkafka tu mqoa.,hdf.a Wi iy jhi wkqj ;sìh hq;= nrg jvd ishhg ;sylska nr m%udKhlska by< .sh úghs' idudkHfhka ;sìh hq;= nrg jvd jeä jk iEu lsf,da .%Eï 10 lgu reêr mSvkh riÈh ñ,sóg¾ 3 lska by< hk nj fidhdf.k ;sfí' ta wkqj ;rndre mqoa.,fhl= wêl reêr mSvkfhka fmf<kafka kï nr wvq l< iekska ta mqoa.,hdf.a reêr mSvkho wvqfõ' uE;l§ lrk ,o mÍlaIK j,g wkqj ;rndre nj iy wêl reêr mSvkh w;r b;d <Õ iïnkaO;djla we;s nj fidhdf.k we;' ;udf.a nr m%udKh ;udg ;sìh hq;= nr m%udKh ishhg myf,djla w;r ;nd .ekSu iqÿiqhs' ÿï mdkh lsÍu ÿïmdkh lsÍu wêl reêr mSvkh je<£ug iDcqju n,mdhs' ÿïfld< ÿfuys we;s ksfldáka kï ridhkslh reêrhg Wrd .;a úg wêjDlal .%kaÓ .%kaÓ W;af;ackh ù reêr mSvkh jeä lrk fydafudak >%djh ùu jeä fjhs' ta wkqj iEu ÿï W.=rla mdidu ÿïfndkakd f.a reêr mSvkh by< hhs'

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Blood Pressure wêl reêr mSvkh zzksy`v ñkSurejdZZ md,kh lruq

tla is.rÜgqjlg reêr mSvkh riÈh ñ,sóg¾ 10 lska muK by< oeñh yels nj fidhdf.k we;' uq,§ fuu by< hdu ;djld,sl jqj;a miqj fuu by< hdu tfiau mj;S' th iodld,sl ù wêl reêr mSvk ;;a;ajh we;s fjhs' Bg wu;rj tla is.rÜgqjlg mqoa.,hl=f.a wdhq ld,h ñks;a;=jlska wvq l< yels njo fidhdf.k we;' ÿïmdkfha ;j;a b;d jeo.;a ixl+,;djhla jkafka reêr kd, ì;a;s u; fldf,iagfrda,a ;ekam;a ù reêr kd, >k ùuhs' fuho reêr mSvkh by< hdug ;=vq fok ;j;a tla fya;=jls' tfukau fujeks mqoa.,hkag yDohdndO (Myocardial infarction or heart attack) je<£fï m%jK;djh b;d by< uÜgul mj;S' wêl f,i ¨‍Kq Ndú;d lsÍu wêl f,i ¨‍Kq Ndú;h wêl reêr mSvkhg fya;= ldrl jk ;j;a jeo.;a wjodkï idOlhls' ¨‍Kq Ndú;h wvq lsÍfuka iq¿ jYfhka we;s reêr mSvk ;;a;aj wju lr.; yels fõ' idudkHfhka mqoa.,fhfhka mqoa.,fhl=g ks¾foaY lr we;s ¨‍Kq m%udKh Èklg .%Eï yhla muK fõ' fuh jvd m%dfhda.slj i,ld neÆ úg Èklg f;a yekaolg jvd wvq m%udKhla Tn úiska Ndú;d l< hq;=hs'

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October 2019

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ojilg mdßfNdackh lrk ¨‍Kq m%udKfhka ishhg 25-33 olajd m%;sY;hla wvq l< úg 40-50 mmol wêl reêr mSvkh iys; frda.Skaf.a reêr mSvkh riÈh ñ,s óg¾ 4 isg 6 olajd;a" idudkH mqoa.,hskaf.a reêr mSvkh riÈh ñ,sóg¾ 1 isg 2 olajd;a wvq fjk nj mÍlaIKj,ska fy<sù we;' ;uka mßfNdackh lrk ¨‍Kq m%udKh 40 m mol j,ska wvq l< úg mqoa.,hkaf.a reêr mSvkh wvq w.hl mj;skd fukau ta mqoa.,hkaf.a yDoh wdY%s; frda.dndO j,ska je<flk njo fidhdf.k we;'

doctormagazine.lk

fuys§ jeo.;a jkafka wêl f,i ¨‍Kq Ndú;h wvq lsÍuhs' n;a j,g ¨KQ oukjd kï bka j<lskak' ¨KQ wêl f,i we;s wdydr ks;r mßfNdackh lsÍfuka j<lskak' ^lrj," yd,aueiaika" áka l< ud¿" fidaia j¾." jd‚cHj ilia l< uia iy uia ksIamdok" ne|mq ¨‍Kq oeuQ rglcq wdÈh .ekSfuka j<lskak' ÈhqKq rgj, oeka flfuka flfuka jd‚cHj ilia l< wdydr j,g ¨‍Kq tl;= lsÍu wvq lrf.k hhs' Tn jd‚cj ilia lrk ,o wdydr ks;r ks;r Ndú;d lrkafka kï tu wdydrj, we;s f,an,a (Food label) .ek ie,ls,su;a jkak' tajdfha tla fmdaIKa tlla ke;akï serving tll tla mqoa.,hl= Ndú;d lrk m%udKfha we;s ¨‍Kq m%udKh i|yka lr we;' Tn ks;ru jd‚cHj ilia l, wdydr .kafka kï tla Portion tll we;s ¨‍Kq m%udKh ñ,s .a?ï 300 wvq wdydr ñ,§ .ekSug ie,ls,su;a jkak' fmdgEishï le,aishï iy ue.akSishï wvx.= wdydr wvqfjka .ekSu fmdgEishï wvx.= wdydr wvqfjka wkqNj lrk mqoa.,hska w;r wêl reêr mSvkh we;sùfï

doctormagazine.lk

we;sùfï m%jK;djh jeähs' iuyr mÍlaIK j,ska le,aishï iy ue.akSishï W!K;djho wêl reêr mSvkhg n,mdk lreKq f,i fidhdf.k we;s w;r fuu lreK ixjdohg ;=vq § we;s jqj;a fuu øjH jeämqr wvx.= wdydr jeämqr .ekSfuka wjevla fkdfõ' fï wkqj wêl reêr mSvkh iys; frda.sfhl= wêl ¨‍Kq iys; wdydr Ndú;h wvq lsÍfuka iy fmdgEishï iy wfkl=;a Lksc ,jK wvx.= wdydr Ndú;h jeä lsÍfuka reêr mSvkh md,kh lr .ekSu fyda th j<lajd .ekSug wjia:dj Wod fõ' u;ameka Ndú;h wêl f,i u;ameka mdkh lsÍfuka wêl reêr mSvkh je<£ug bv ;sfí' wêl f,i u;ameka Ndú;h ksid YÍrfha (Sympathitic Nervous System) iakdhq W;af;ackh ùu ksid fï ;;a;ajh we;s fõ' ;jo u;ameka Ndú; lrk úg wêl reêr mSvkh md,kh lsÍfï§ ÿIalr;d we;s fõ' tu ksid wêl reêr mSvkh iys; frda.sfhl= jqj;a fkdjqj;a fkdjqj;a u;ameka mdkh md,kh l< hq;=hs' u;ameka fyd| kE''' ta;a .kaku ´ks kï'''@ idudkHfhka msßñfhl=g ks¾foaY lrkq ,nk u;ameka m%udKh ñ,s ,Sg¾ ;syla ( 30ml or 1 Oz) fyda Bg wvq m%udKhls' .eyekq Woúhg tfia fkdue;s kï YÍrh nfrka wvq (Low body weight) msßñkag fuu m%udKh ñ,sñg¾ myf<djla fyda wjqkai nd.hla f,i ks¾foaY lr we;' msßisÿ uoHidrh ñ,s óg¾ ;syla úials ñ,s ,Sg¾ yegla f,io ìh¾ ñ,s ,Sg¾ 720 f,io ie,lsh yelsh' a wkqj Tn fyda frda.sfhl= fyda wêl reêr mSvkh iys; frda.sfhla fkdjqj;a Èklg by; i|yka m%udKh blaujd fkdhd hq;= w;r yels iEu úgu u;ameka j,ska je<lSu jvd;a iqÿiq foh nj wm wjOdrKh lruq' Wm;a md,k fm;s iy tkak;a j¾.

Wm;a md,k fm;s fyda tkak;a j¾. ,nd .kakd ldka;djkag wêl reêr mSvkh je<£fï je<£fï m%jK;djh jeäh' tu ksid tjeks Wm;a md,k l%u Ndú;d lrk ldka;djka ks;r ks;r ;u reêr mSvkh mÍlaId lr.; hq;=hs' tys jeäùula fmkakqï lf<d;a tjeks l%u w;ay< hq;=hs'

October 2019

DOCTOR MAGAZINE

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Blood Pressure wêl reêr mSvkh zzksy`v ñkSurejdZZ md,kh lruq

yoj; ixfldapkh jk l,ayS we;sjk mSvkhhs

ikHia; mSvkh

úkHia; mSvkh

yoj; bys,aj mj;sk wjia:dfõ we;sjk mSvkhhs

reêr mSvkh hkq reêrjdyskS Tiafia mßjykh jk reërh u;ska tu jdyskS ì;a;s u; we;s lrk mSvkhhs

wêl reêr mSvkh ksid we;sjk ixl+,;d wm by; i|yka l<dla fuka wêl reêr mSvkh ksYaYío ñkSurefjls' ke;fyd;a Silent Killer f,i th y÷kajhs' fufia ye¢kaùug fya;=j wêl reêr mSvkh md,kh fkdù mej;=fKd;a YÍrfha b;du jeo.;a wjhj jk yDoh" fud<h" jl=.vq" wei hk wjhj j,g iodld,sl ydks isÿúh yels ùuhs' wm oeka tu wjhj j,g jk ydks iy th j<lajd .; hq;= wdldrh i,ld n,uq'

iuyr T!IO j¾. iuyrla T!IO j¾. ks;r ks;r Ndú;d lsÍfuka wêl reêr mSvkh je<¢h yels w;r ;j;a iuyrla T!IO Ndú;fha§ reêr mSvkh md,kh lsÍug lsÍu ÿIalr fõ' úfYaIfhka fõokdkdYl Non-steroidal analgesic drugs fï w;r jeo.;a ;ekla .kshs'

jl=.vq iy reêr mSvkh jl=.vq iy reêr mSvkh w;r b;d lsÜgq iïnkaO;djla mj;S' jl=.vq frda. ksid reêr mSvkh we;súh yels w;r reêr mSvkh ksid fyd¢ka l%shd;aul jQ jl=.vq wl%sh Ndjhg m;afõ' fufia wl%Sh Ndjhg m;aùu fya;=fldgf.k ;j ;j;a reêr mSvkh wêl ù reêr mSvkh md,kh lsÍu wmyiq fõ'

tu ksid T!IO j¾. Ndú;fha§ ks;ru ffjoH Wmfoia ms<smeÈh hq;= w;r tlu fnfy;a jÜfgdarej ffjoH wkque;shlska f;drj ks;r ks;r Ndú;h wk;=reodhlhs'

fï wkqj frda.sfhla jl=.vq frda.hlska fmf<kafka kï ;u reêr mSvkh .ek ie,ls,su;a

we;eï .eìks ldka;djkag o .eì‚ iufha reêr mSvkh by< hdula fmkajhs' fndfyda wjia:dj,§ ore m%iQ;sfhka miq fuu ;;a;ajh u. yeÍ hk w;r iuyrlaf.a reêr mSvkh wêl f,i È.gu mj;S' fï ksid tjeks frda.Skao ks;r ks;r ;u reêr mSvkh .ek ie,ls,su;a úh hq;=hs'

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October 2019

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doctormagazine.lk

úh hq;=hs' tfukau wêl reêr mSvkfhka fmf<kakka ;udf.a jl=. vq .ek ie,ls,su;a úh hq;=hs'

jvd;a ie,lsh hq;= lreKla jkafka hï mqoa.,hl=g Èhjeähdj iu. wêl reêr mSvkh ;sfí kï tjeks mqoa.,hka ;u wei .ek b;du;a úmrñka ie,ls,su;a úh hq;= ùuhs' fuu frda. folu we;s úg weig jk ydks b;du;a ;shqKqh'

fk;= hq., iy wêl reêr mSvkh mqoa.,fhl=f.a isrer ;=< we;s Ouks iy Ysrd oel .ekSfï lÈu levm;la f,i oDIaáú;dkh i|yka l< yel' wêl reêr mSvkh ksid YÍrfha we;s Ouks j,g isÿjk ydks lÈug oDIaáú;dkh Retina wOHhkh lsÍfuka fidhd.; yel'

fud<h iy wêl reêr mSvkh wêl reêr mSvkh ksid úfYaIfhkau wl%Sh Ndjhg m;a jkafka wmg Ôj;a ùug b;du jeo.;a bkaøsh jk fud<hhs' wêl reêr mSvkh wêl f,i fndfyda l,la mj;sk úg fud<fha we;s b;d ishqï Ouks yÈisfha mqmqrd hhs' fuhska f,a .e,Sula isÿfjhs' ta ksid wxYNd.h frda.h we;sfjhs' fuu frda.Skag isÿjk wjysr;djh (Disability) ;SrKh jkafka fud<fha fud<fha l=uk m%foaYhg ydks meñKù ;sfí o hkak wkqjh'

md,kh fkdù mj;sk wêl reêr mSvkh ksid weig ydks meñfKa' fuh Hypertensive retinopathy kqfjka y÷kajkq ,nhs' fuh fmkSu ÿ¾j, ùfï isg iïmQ¾Kfhkau wkaO Ndjh olajd jQ mrdihl fjkialï jYfhka j¾.SlrKh lrKq ,en ;sfí' óg l,lg fmr kï" wêl reêr mSvkh ksid frda.Ska ie,lsh hq;= m%udKhla fofk;a w|Ndjhg m;aùfï wjdikdjg uqyqK ÿka kuq;a miq ld,fha§ fi!LH fiajdfõ ÈhqKqj fya;=fjka mQ¾j y÷kd. ekSfï l%u iy reêr mSvkh md,kh lsÍfï w¨‍;a T!IO j¾. ksid weig isÿjk ydks wju lr .ekSug yelsù ;sfí'

doctormagazine.lk

fud<fha tla me;a;lg iïmQ¾Kfhkau ydks meñfKk úg tu m%foaYfhka md,kh jk YÍrfha wkqhd; fldgia wvmK fjhs' ta wkqj tla me;a;l ll=,a mK ke;sj hdu" l;d lsÍfï lsÍfï fkdyelshdjla we;sùu wd§ ixl+,;d we;sfõ' wxYNd.h frda.h (Stroke) je,÷Kq miq hï muKl iqjhla ,enqK;a we;eï ÿ¾j,;djhka iuyr úg Ôú;h mqrdu mj;S' th frda.shdg fukau frda.shdf.a mjqf,a whgo - úfYaIfhka frda.shd ;reK jhfia iy frda.shdf.ka hefmkakka we;s úg buy;a n,mEula we;s fjhs' iuia;hla jYfhka .;a úg th rfÜ wd¾Ólhgo úYd, n,mEula we;s lrhs' tu ksid wxYNd.h j<lajd .ekSu j<lajd .ekSu b;du jeo.;a jk w;r wxYNd.h i|yd uQ,sl uQ,slu idOlh jk wêl reêr mSvkh j<lajd .ekSfuka" th md,kh lr .ekSfuka fï ;;a;ajh myiqfjka u j<lajd .; yel' yDoh iy wêl reêr mSvkh wêl reêr mSvkh ksid yDohgo fndfyda Nhdkl ixl+,;d we;s fõ' bka m<uqjekak kï" yDoh wêl mSvkhg tfrysj reêrh fmdïm lsÍfï lsÍfï§ úfYaIfhkau jï fldaIsldfõ ì;a;s (Left Ventricular Hypertrophy) >k ùu isÿfjhs' fufia ì;a;s >k ùu ksid tys l%shdldß;ajhg wêl f,i reêrh wjYH jk w;r iemhqu wvmK jQ úg yoj; wl¾uKH;djhg (Heart Failure) m;afõ'

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Blood Pressure wêl reêr mSvkh zzksy`v ñkSurejdZZ md,kh lruq

tmd lshkak ÿï isß;g''' ms<s.kak ksfrda.S" fi!LHiïmkak cSú;h''' wëreêr mSvkfhka fmf<k flfkla ÿï mdkh lsÍu Tyqg úYd, cSú; wjodkula f.fkk nj Tn oek isáhdo@

wêl mSvkh ksid yDohg we;sjk wfkla ydksh kï" yDofha l%shdldß;ajhg reêrh imhk reêr kd, - lsÍgl Ouks (Coronary Arteries) >k ùfï m%jK;djh by< hduhs' fï wkqj n,k l< wêl reêr mSvkh fl;rï oreKq iy iuyr úg iodld,sl ixl+,;d we;s lrk frda.hla nj Tng jegfykq we;' oeka wms lsishï mqoa.,fhl= wêl reêr mSvkfhka fmf<k oehs fidhd .kakd wdldrh meyeÈ,s lr .ksuq' wêl reêr mSvkfhka fmf<kafkaoehs úksYaph lr.kakd ms<sfj, reêr mSvkh iEu úgu tlu uÜgul fkdmj;S' wm kskaog .sh úg fyda úfõlSj bkakd úg§ reêr mSvkh wju uÜgfï mj;sk w;r hïlsis jevl ksr; jk úg" tfia;a ke;akï ;s.eiaula we;s jqjo reêr mSvkh by< hhs' tfiau lef*aka wvx.= îula mdkh" ÿïmdkh lsÍfuka miqjo wfma rfÜ kï úfYaIfhka nq,;a úgla ÿïfld< iu. yemSfuka miq reêr mSvkh by< hhs' fuh idudkH ;;a;ajhla jk w;r fujeks wjia:dj,§ reêr mSvkh wêlj ;sîu wêl reêr mSvkh f,i ms<sfkd.kS' tu ksid ffjoHjrfhl= reêr mSvkh mßlaId lrkafka frda.shd wju jYfhka úkdä 15-20 w;r ld,hla úfõlSj .; lsÍfuka miqjh' 46

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doctormagazine.lk

fufia mßlaId lrk wjia:dfõ§;a reêr mSvkh u| jYfhka by< f.dia we;akï muKla bÈß i;s fol ;=k ;=<§ ks;r ks;r ;u reêr mSvkh mßlaId lr .ekSug Wmfoia fokq ,efí' fufia úfõlSj isák iEu wjia:djl§u reêr mSvkh wêl f,i jd¾;d fjhs kï''' ^140$90 g jvd jeä kï& Tyq reêr mSvkfhka fmf<k frda.shl= f,i ye¢kaúh yelshs' fuu w.h 120$80 iy 139$89 w;r w.hla .kafka kï Tyqf.a fmr reêr mSvkh fyj;a Pre Hypertention kue;s ;;a;ajfhka fmf<kafka f,i kï lrkq ,efí' fï ms<sn|j jeä úia;r wm my; j.=fjka olajd isáuq' reêr mSvk j¾.SlrKh

ixfldapk mSvkh Systolic

úia;drK mSvkh Diastolic

tÈfkod Ôú;fha lghq;= j, fjkialï wjYHo hk nj Life Style Modifications

idudkH

120 wvq

80 g wvq

jvd;a fhda.Hhs

fmr wêl reêr mSvkh

120

80-89

Tõ

mshjr 1 Stage 1

140-159

90-99

Tõ

wêl reêr mSvkh mshjr 2 Stage 2

160g jeä

100g jeä

Tõ

ta wkqj mqoa.,hl=f.a reêr mSvkh uksk iEu wjia:djl§u mdfya 140$90 mm Hg g jvd reêr mSvkh jeä kï ta mqoa.,hd wêl reêr mSvkfhka fmf<a hehs i,ld reêr mSvkhg m%;sldr l< hq;=hs' wêl mSvkhg m%;sldr mgka .kakd w;r iEu reêr mSvk frda.sfhl=gu iuyr uQ,sl ridhkd.dr mÍlaIK lrkq ,efí' wêl mSvkhg frda.sfhl=gu ;lrk uQ,sl ridhkd.dr mÍlaId • ECG mÍlaIKh • uq;%d mÍlaIK • reêrfha iSks uÜgu • reêrfha l%sheákska uÜgu • fidaähï iy fmdgEishï w.hka • iïmQ¾K fldf,iagfrda,a mÍlaIdj Bg wu;rj frda.shdf.a reêr mSvkh wêl f,i mj;S kï fyda md,kh fkdù mj;S kï thg fya;=j fidhd.ekSug ;j fkdfhl=;a ixlS¾K mÍlaIK isÿlrkq ,efí' doctormagazine.lk

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Blood Pressure wêl reêr mSvkh zzksy`v ñkSurejdZZ md,kh lruq

wêl reêr mSvkhg m%;sldr lsÍfï§ m%Odk m%;sldrfõohka folla f.kyer oelaúh yelshs' 1' Ôjk rgdfõ we;slr.; hq;= fjkialï Life Style Modifications fïoh u.ska Ouks ì;a;s wjysr ùu fmkajk ióm igykla

wêl reêr mSvkhg isÿ lrk m%;sldr by; wm i|yka l< lreKq wkqj wêl reêr mSvkh hkq oreKq tfy;a b;d myiqfjka md,kh l< yels frda.hla nj Tng jegyS ;sfnk nj wmf.a yeÕSuhs' wêl reêr mSvkhg m%;sldr lsÍfuka wm n,dfmdfrd;a;= jkafka l=ulao@ mqoa., jYfhka hï mqoa.,hl=f.a YÍr fi!LH ;;a;ajh fï ksid by< kexfjk w;r yoj;a frda." jl=.vq frda." weig isÿjk ydks iy wxYNd.h jeks frda. j,ska wdrlaId fõ' ta wkqj iudcuh jYfhka .;a úg iuia; iudchu frda. iE§fï m%jK;djh wvq ùu ksid iudchg we;sjk mSvkh ,sys,a fõ' fukhska n,k l, reêr mSvkh md,kh lr .ekSu ;ukag muKla fkdj uq¿ uy;a iudchgu fi;la ie,fik nj meyeÈ,sh' wêl reêr mSvkh wvq lsÍfuka ,efnk jdis úoHd;aul mÍlaIK j,ska fudkjg meyeÈ,s lr we;' WodyrKhla f,i olajkafka kï wêl reêr mSvkh md,kh lsÍu u.ska ishhg 35-40 la olajd jQ wxYNd.h je<£fï wjodku" ishhg 20-25 olajd jQ yDohdndO je<£fï yd ishhg 50 la yoj; wlrKshg m;aùfï wjodku ie<lsh hq;= uÜgulska wvq lr.; yel'

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2. T!IO u.ska isÿ lrk m%;sldr Ôjk rgdfõ we;slr.; hq;= fjkialï Life Style Modifications ;u reêr mSvkh u| jYfhka jeä jQj;a (Mild Hypertension) wêl f,i jeä jQj;a (Severe Hypertension) iEu mqoa.,fhl=u tÈfkod Ôú;h fjkialï j,g Ndckh úh hq;=hs' túg idudkH m%udKhg we;s reêr mSvkh iïmQ¾Kfhka j<lajd .; yels jk w;r wêl f,i we;s reêr mSvkh myiqfjka md,kh lr.; yelsfõ' ta w;ru reêr mSvkh rys; mqoa.,hskq;a fïjd ms<sme§fuka reêr mSvkh je<£u j<lajd .; yel' ta wkqj n,k l, ;uka wêl reêr mSvkfhka fm¨k;a" ke;;a fuu ir, Ôj;a ùfï rgdj

doctormagazine.lk

wkq.ukh lsÍu ieug jdisodhl fõ' cSjk rgdfõ we;s lr.; hq;= fjkialï lsysmhla .ek óg by;ska i|yka lr ;sfí' wfkl=;a lreKq .ek oeka wm i,ld n,uq' cSjk rgdfõ we;s lr.; hq;= fjkialï lsysmhla Wig iß,k nr m%udKh mj;ajd .ekSu iy ks;r lh fjfyid jHdhdu j, fhoSu iEu mqoa.,hl=gu jHdhdu fkdfyd;a lh fjfyid jev jevm,j, fh§u w;HjYH ldrKhls' fuh yoj; Yla;su;a lrkakg yoj;g je<f|k frda. mSvdÈh wvq lrkakg fukau fmky¨‍ j, ukd l%shdldß;ajhg b;du;a bjy,a fjhs' fndfydauhla mqoa.,hka ;u /lshdj Tiafia ksrka;rfhka jHdhdu ,nhs' ,shqï fnokakd" m;a;rlre" lïlre" ëjr iy f.dú uy;=ka fï ldKavhg wh;a fjhs' fujeks mqoa.,hkag úfYaIs; jHdhdu wjYH kE' jHdhdu úfYaIfhkau wjYH jkafka ld¾hd, j,g ù ;u /lshdj lrk mqoa.,hkaghs' jHdhdu wvq mqoa.,hka ;u Ôjk rgdjg jHdhdu isß;la wkq.; lr .;fyd;a th jvd;a myiq fjkjd'

doctormagazine.lk

jHdhdu wvqfjka ,efnk whg tosfkod cSú;fha we;s lr.; hq;= mqreÿ lsysmhla • ks;r úÿ,s fidamdk Ndú; lrkafka kï kï th Ndú;d fkdlr ;rmamq fm< Ndú;d lrkak' • niar:fhka .uka lrkafka kï ;ukag wjYH ia:dkhg fmr nifhka nei b;sß ál mhska hkak' • nhsisl,hla mÈkak yqre fjkak' • ;u f.j;af;a jevodhl ld¾hhl ksr; jkak' ;u jdykh fidaod msßiqÿ lr .kak' l%Svd lrkak' jHdhdu lrkak' • óg wu;rj msyskSu" Èùu" weú§u iy jHdhdï i|yd jQ nhsisl,hla Ndú; lsÍu l< yel' jHdhdu lsÍfï§ tlajru ;Èka jHdhdu lsÍu iqÿiq ke;' Tn fndfyda l,la jHdhdu j, fkdfhÿk flfkla kï w¨‍;ska jHdhdu wdrïN lsÍug mgka .kafka kï uq,skau ir, ‍jHdhdu j, wvq fj,djla fh§ l%ufhka jHdhdu ;Sj%;djh jeä lr.kak' wêl reêr mSvkh yd yDo frda. j,ska fmf<k wh jHdhdu j, fh§ug fmr ffjoH Wmfoia ,nd.kak' jHdhdu j, fhoSfuka we;sjk jdisodhl m%;sM, jHdhdu u.ska jeämqr le,ß m%udKhla jeh ù YÍrfha nr wvqjk w;r tu.ska udkisl wd;;sho wvqfõ' jHdhdu j, uq,skau wvq fj,djla fh§ l%ufhka jeä lr.kak' • jHdhdu u.ska jeämqr le,ß m%udKhla jeh ù YÍrh nr wvqjk w;r tu.ska udkisl wd;;sh o wvqfõ • jHdhdu u.ska YÍrfha fldf,iagfrda,a m%udKfhao fkdfhla fjkialï isÿfõ' iïmQ¾K fldf,iagfrda,a m%udKh wvq fjhs' YÍrhg ys;lr fldf,diagfrda,a jeä fjhs' • ia:q,;djh wvqùu ksid g%hs.a,sirhsv kue;s wka;rdhodhS fldf,iagfrda, m%udKho wvq fõ' wêl f,i ia:q,Ndjh we;s úg YÍrfha bkaishq,ska kue;s reêr iSks m%udKh idudkH uÜgñka ;nd .kakd fydafudakh l%shdldß;ajh ySk (Insulin Resistance) fõ' fï ;;a;ajho yDo frda. we;sùu flfryS n,mdk w;r jHdhdu u.ska ia:q,;djh wvq ùu;a iu.u

October 2019

DOCTOR MAGAZINE

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D•Magazine /

Blood Pressure wêl reêr mSvkh zzksy`v ñkSurejdZZ md,kh lruq

ia:q,;djhg m%;sldr jYfhka fjf<| fmdf<a T!IO j¾. úlsŒug ;sfnk w;r fujeks T!IO Ndú;ho iuyr úg Nhdkl w;=re wdndOj,g fya;=jla úh yelshs'

jl=.vq frda.Ska reêr mSvkh uekúka md,kh lr.; hq;=h' tfiau wêreër mSvkh we;s wh jl=.vq iqjfi; .ek fjfiia wjOdkhla fhduq l< hq;=h'

bkaishq,ska fydafudakfha l%shdldß;ajh idudkH m%udKhg m;a fjhs' fï wkqj jHdhdu j, fh§fuka yDofrda. jeäùfï m%jK;djh iEfyk ÿrg wvqlr .; yelshs' tfukau fndfyda fofkl= úuik lreKla kï idudkHfhka jHdhdu fldmuk fõ,djla lr .; hq;=o hkakhs' wefußldkq yDo ix.uh (American Heart Association) wkqu; lr, ;sfhkafka wvqu jYfhka úkdä ;sylaj;a ojila wer ojila jHdhdïj, fh§u yDo l%shdldß;ajh i|yd w;sYhska bjy,a jk njhs' wêl ia:q,;djfhka ñ§u fmr i|yka lr we;s mßÈ wêl ;rndrelu fyj;a ia:q,Ndjh o ;u Ôjk rgdj fjkia lr .ekSfuka wvq lr.; yelshs' ia:q, Ndjfhka ñ§ug kï hful= YÍrhg .kakd le,ß m%udKhg jvd jeä le,ß m%udKhla jHdhdu u.ska fyda tosfkod l%shdldrlï u.ska jeh l< hq;=hs' wêl f,i wdydr j,ska je<lSu (Crash Diets) t;rï .=Kodhl fkdjk w;ru iuyr úg oreKq M, úmdlo we;s l< yelshs'

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tu ksid fi!LH iïmkak iy jvd;a l,a mj;sk ia:Q, Ndjfhka ñ§ug yels tlu u. fiñka fiñka jHdhdu iy wdydr l%udkql+,j md,kh lr .ekSfuka YÍr nr wvqlr .ekSuh' idudkHfhka fuh i;shlg .%Eï 225450 la olajd m%udKhla kï iEfya' ia:Q,Ndjfhka ñ§ug wm wdydrhg tla lr .; hq;= oE idudkHfhka ta ta mqoa.,hdf.a Wi yd nr wkqj fï i|yd fmdaIKfõ§kaf.ka (Nutritionists) Wmfoia ,nd.; hq;= w;r my; i|yka jkafka b;d ir, f,i ieug wkq.ukh l< yels lreKq wdydr ud¾f.damfoaYKhls' 1' f;,a ixhq;sh iy le,ß ixhq;sh wvq wdydr f;dard .kak (Low fat & low calorie diet)

doctormagazine.lk

fï i|yd my; i|yka wdydr øjH j,ska je<lsh hq;=hs' ng¾" ud.ßk"a f;,a iys; iy iy r;=mdg uia ^t¿uia" yrlauia" W!re uia& l=l=,a uia j, iu iys; fldgia" iïmQ¾K fhdoh iys; lsß" Öia" f;,ska msisk ,o wdydr" whsial%Sï" flala" fndfydauhla ìialÜ j¾. iy fílß ksIamdok (Fast Foods) fï fjkqjg my; i|yka wdydr j¾. Ndú;hg tl;= lr.kak' l=l=¨ iy iy l¨‍l=ï uia" ^yu bj;a lrk ,o iy f;f,ka fkdne¥& ud¿" fhdoh rys; lsß" fïoh iy ÆKq wju f,i wvx.= Öia" (low fat cheese) m,;=re" t<j¿" r;= lel=¿ n;a" mdiagd" OdkH j¾. ^uqxweg" lv," lõms" l=ryka" bßÕ=‍& yels iEu wjia:djlu laI‚l wdydr øjHhkaf.ka ñfokak' yels iEu úgu ixlS¾K ldfndayhsfâ%Ü (Complex Carbohydrates) iy fl|s j¾. wvx.= (Diatary Fiber) wdydr u f;dard .ekSug ie,ls,su;a jkak thg fya;=j fujeks wdydr j, nyq, jYfhka úgñka j¾. iy Lksc ,jK wvx.= ùuhs' m,;=re" t<j¿" OdkH j¾. n;a wdÈh ksoiqkah' ;uka lEug .kakd wdydr m%udKh yels iEu úgu wvqfjka ;nd.kak' úfYaIfhkau wêl ixhq;sfhka hq;= wdydr wvqfjka wkqNj lrkak' fndfydaúg ld¾hnyq, Woúh lrk fohla ;ud Wfoa lEu fõ, fkdf.k oj,a iy rd;%shg wêl lEu fõ,la .ekSu fyd| mqreoaola fkdfjhs yels iEu úgu wdydr m%udKh fõ,a ;=ku fnodf.k wkqNj lsÍu fyd|hs'

wêreêr mSvkhg .kakd fnfy;a cSú; ld,hguh' ffjoH Wmfoia j,ska f;drj T!IO fjkia lsÍu k;r lsÍu fkdl< hq;a;ls

doctormagazine.lk

ika;Dma; fïo iys; wdydr j,ska je<lSu iy ta fjkqjg wix;Dma; fïoh Ndú; lsÍu fuh wm tÈfkod Ôú;fha§ wdydr úfYaIfhka fïoh iys; wdydr f;dard .ekSfï§ ie,ls,su;a úh hq;= ldrKhls' wm wdydrhg .kakd f;,a j¾." fïoh m%Odk jYfhka fldgia ;=klg fnÈh yelsh' tajd kï kï ix;Dma; fïoh" nyq wix;Dma; fïoh" tal wix;Dma; fïoh hkqfjks' fïo iy fïo wï, j¾. ix;Dma; fïoh fmd,af;,a$t<j¿ f;,a lsß ksIamdok wdÈh wika;Dma; fïoh nyq wix;Dma; fïo tal wix;Dma; fïoh Omega-3 u;aiH fïoh (Fish Oil) 2-Linoleic Oil fidahd f;,a Omega-6 fidahd f;,a nv bßÕ=‍ f;,a iQßhldka; f;,a Omega-6 T,sõf;,a rglcq lefkda,d f;,a fuu fïo j¾. w;ßka wm úiska wdydrfhka bj;a l< hq;= øjH kï ix;Dma; fïohhs' ix;Dma; fïoh u.ska ;shqKq n,mEula wêl reêr mSvkh flfryS we;s fkdjqj;a ix;Dma; fïo wêl f,i wdydr .ekSfuka YÍrfha fldf,iagfrda,a uÜgu

October 2019

DOCTOR MAGAZINE

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D•Magazine /

Blood Pressure wêl reêr mSvkh zzksy`v ñkSurejdZZ md,kh lruq

nyq wix;Dma; fïoh wvx.= wdydr Ydl fïoh - fidahdfndaxÑ f;,a" nvbßÕ=‍ f;,a" ika*a,j¾ f;,a u;aiH fïoh Fish oil ´kEu u;aihl=f.a fuu fïoh wvx.= fõ wdydr md,kh ;=<ska iEfyk muK reêr mSvk md,khla w;am;a lr.; yels njj Tn o; hq;=h'

tal wix;Dma; fïoh wvx.= wdydr T,sõf;,a" lefkda,df;,a" w,s.egfmar iy weg j¾. ^rglcq fyai,a kÜ& fuys§ wm úiska úfYaIfhka jgyd .; hq;= ldrKh jkafka wm .kakd wdydrh fïouh fldgia iEu úgu ys;lr fïofhka hqla; úh hq;= njhs'

oDIAÀú;dkh Tfí mßjyk moaO;sh iïnkaO legm;ls

wêl ù yDo lsÍgl Ouks wdY%s; frda. yd wxYNd.h iE§fï m%jK;djh jeä fõ' tu ksid wm úiska úfYaIfhka ix;Dma; fïoh wvx.= wdydrj,ska je<lsh hq;= w;r ta fjkqjg nyq wix;Dma; yd tal wix;Dma; fïoh wvx.= øjH wdydrhg tla lr.; hq;=h' ix;Dma; fïoh wvx.= wdydr i;aj wdydr - W!reuia" yrlauia" t¿uia" ovuia" f;,a iu iys; l=l=¿ uia lsß iy lsß wvx.= wdydr - ng¾" Öia" whsial%Sï" lsß iy lsß ksIamdok Ydl fïoh - fmd,af;,a" t<j¿ f;,a" mdï ´hs,a

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October 2019

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fj<|fmdf,a we;s /já,a,la fj<|fmdf,a we;s úYd, /já,a,la kï fmd,af;,a iy t<j¿ f;,a wvx.= Ndckj, fldf,iagfrda,a rys; hk f,an,h iys; ùuh' we;a; jYfhkau tlu f;,a j¾.hl j;a fldf,iagfrda,a wvx.= jkafka ke;' tkuq;a ix;Dma; fïoh wvx.= f;,a j¾. Ndú;fha§ YÍrfha fldf,iagfrda,a ksIamdokh ùfï iS>%;dj jeä ù wêl f,i reêr fld,iagfrda,a uÜgu

doctormagazine.lk

by< hhs' tkï fmd,af;,a iy t<j¿ f;,a hkqfjka ye¢kajQj;a th i;H jYfhkau t<j¿ fkdfjhs' th mdï .fia f.äfhka ksmojd .kakd f;,a j¾.hls' fïjd Ndú; lsÍfuka YÍrfha fldf,iagfrda,a idkaøKh wêl f,i by< hhs'

wdydr øjH f;dard .ekSfï§ fï .ek ie,ls,su;a jQ úg yDohg ys;lr øjH f;dard .ekSu b;d myiq jkq we;'

nyq wix;Dma; iy tal wix;Dma; fïo Ndú;fha§ reêrfha fldf,iagfrda,a uÜgu my< hk w;r tu.ska yDo frda. je<£fï wjodku wvq fjhs' thg wu;rj lsjhq;= fohla kï t<j¿ f;,a fyda fmd,af;,a folgu we;af;a tlu ixhq;shhs' fuu foj¾.fhau wêl f,i we;af;a ika;Dma; fïohhs' tuksid fmd,a f;,aj,g jvd jeä ñ,la f.jd t<j¿ f;,a Ndú; lsÍu kqjKe;s l%shdjla fkdfõ'

ta wkqj Tn f;dard.; hq;af;a''' • ika;Dma; fïoh wvqfjka wvx.= • nyq ix;Dma; iy tal ix;Dma; fïo jeä jYfhka wvx.= • fldf,iagfrda,a rys; fyda wvq m%udKhla wvx.= iy fl¢ jeä m%udKhla wvx.= wdydr fõ

ñ,oS .ekSfïoS wdydr f,an, n,kak yqre fjkak fuys§ idudkH ck;djg we;sjk .eg¨‍jla kï ;ukag wjYH fi!LHhg ys;lr wdydr mdk f;dard .ekSfï§ we;sjk wmyiq;djhhs' ÈhqKq rgj, iEu jd‚cHj ilia lrk ,o wdydr j, úfYaIs; jQ wdydr f,an,a (Food Label) we;' ta iu.u ta ta wdydr tu rfÜ yDo ix.ufhka yDo frda.Ska i|yd iqÿiqo hkak i|yka lr we;' kuq;a ÈhqKq fjñka mj;sk wm jf.a rgj, oekg fujeks ;;a;ajhla fkdmj;S' tfy;a wm rfÜ o fndfyduhla jdkscHj ilia lrk ,o wdydr øjHj, tu wdydrfha ixhq;sh iys; (Food Label) olakg we;'

doctormagazine.lk

ta wkqj Tn jd‚cHuh f,i ilia l< wdydr øjHhla ñ,§ .kakd iEu wjia:djloSu fuu wdydr f,an,h lshùug mqreÿ ù ta wkqj wdydr f;dard .ekSug ie,ls,su;a jkak'

October 2019

DOCTOR MAGAZINE

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D•Magazine /

Blood Pressure wêl reêr mSvkh zzksy`v ñkSurejdZZ md,kh lruq

tjeks wdydr f,an,hl wvx.= lreKq my; oelafõ • energy • protein • total fat • saturated fat fï fidahd fndaxÑ f;,a iys; fnda;,hla wdydr f,an,fha ls fuys ix;Dma; fïoh 14'25 la wvx.= jk w;r b;sß ish,a, u wix;Dma; fïoh fõ u;aiH fïoh Fish oils fuys§ u;aiH fï foh .ek o lreKq lsysmhla meyeÈ,s l<fyd;a jvd;a iqÿiq hehs yefÕa iqÿiq hehs yefÕa' fuhg fya;=j fndfyda frda.Ska iEu f;,a j¾.hlg ìhla oelaùuhs' wm fyd¢ka isys ;nd.; hq;= lreKla jkafka wm wdydrhg .kakd f;,a j¾. j,ska fndfyduhla f;,a j¾. YÍrhg ys;lrhs' fujeks ys;lr f;,a tla j¾.hla u;aiH fïohhs' u;aiH fïofha (Fish oils) wvx.= jkafka (Omega-3 ) hk nyq wix;Dma; .Khg jefgk fïoh j¾.hhs' fuu fïo j¾.h wdydrhg tla lr .ekSu b;d jdisodhl jk w;r uE;l§ lrk ,o úoHd;aul .fõIK uÕska th fudkjg meyeÈ,s lr we;' tu jdisodhl lreKq iuyrla kï" • yDo frda. je<£fï je<£fï m%jK;dj wvq ùu • tl jru urKhg m;aùu wjodku wvqùu' tljr Ôú; ydks isÿjkafka yDofha .eiau wl%ñl;djhg m;a ùu ksihs' (Arrthymias) • u;aiH fïoh uÕska fujeks yDoh wl%Ssh f,i iamkaokh ùu j<lajhs' reêrfha g%hs.a,sirhsâ kï fïo j¾.h wvq lsÍu tu ksid u;aiH f;,a wkqNjh yDo frda. j,ska frda. j,ska je<lS isàug WmldÍ jk w;r idudkH mqoa.,fhl=g i;shlg jrla j;a iy yDo frda.j,ska fmf<kakkag i;shlg fojrla j;a u;aiH ksIAmdok .ekSu .=Kodhl nj fidhd.; yel'

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October 2019

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wêl ¨‍Kq m%udKhla iys; wdydr iSud lsÍu iy fmdgeishï iy wfkl=;a Lksc ,jK wvx.= wdydr jeä jYfhka .ekSu fuysoS ¨KQ jYfhka wm y÷kajkafka fidaähï kue;s uQ, øjHhhs' fuys§ fmdgeishï kue;s uQ,øjHh ms<sn|j jeä úia;rhla lsÍu Tng jeo.;a jkq we;s' fidaähï wvx.= wdydr j,ska je<lSu iy ta fjkqjg fmdgEishï wvx.= øjH wdydrhg tlalr .ekSfuka wêl reêr mSvkh j<lajd .ekSug ux ie,fia' wêl f,i fmdgEishï wvx.= wdydr j,g WodyrK lsysmhla kï''' w¿;a t<j¿" îÜrEÜ" f.dajd" ;lald,s w¿;a m<;=re flfi,a" flduvq" fmar" cïnq Èklg fmdgEishï ñ,s .a?ï 1600 2000 olajd ,efnk fia wdydr ilia lr.; yels kï th reêr mSvkh md,kh lsÍug uy;a fia bjy,a jkq we;'

doctormagazine.lk

my; j.=fjka wm tosfkod Ndú;d lrk wdydr øjHj, wvx.= fmdgEishï m%udKh .ek o< jYfhka woyila ,nd.; yelsh' wdydr øjH

fmdgEishï m%udKh

r;= lel=¿ n;a fldamamhla

ñ,s .%Eï 150

áka ud¿ wjqkai ;=kl

ñ,s .%Eï 340

;rula wuq ;lald,s f.ähl

ñ,s .%Eï 400

msiQ lerÜ fldamamhl

ñ,s .%Eï 340

lsß fldamamhl

ñ,s .%Eï 400

fodvï hqI fldamamhl

ñ,s .%Eï 500

flfi,a f.ä tll

ñ,s .%Eï 400

fïoh wvq me‚ fyda fc,s tla fkdl< fhda.Ü fldamamhla

ñ,s .%Eï530

;eïnQ w¾;dm,a f.ähl

ñ,s .%Eï 645

w,s.egfmar f.ähl

ñ,s .%Eï 500

wêl reêr mSvkhg T!IO m%;sldr fndfydauhla frda.Ska yg ;u wêl reêr mSvkh md,kh lr .ekSug T!IO Ndú; lsÍug isÿ fõ' Tng Èh hq;= mKsúvh jkafka Tng Èh hq;= jeo.;a m‚úv lsysmhla fõ' 1' fudk hï T!IO Ndú; l<;a tÈfkod Ôjk p¾hdfõ we;s lr.; hq;= fjkialï w;HjYH fõ' túg wvq fnfy;a ud;%djlska fyda wvq fnfy;a j¾. ixLHdjlska reêr mSvkh md,kh lr .; yels fõ' 2' iEu úgu ffjoH Wmfoia wkqj T!IO Ndú; l< hq;=h' fuys§ ie,lsh hq;= lreKla jkafka reêr mSvkh hkq iïmQ¾Kfhkau iqjlr bj;a lr yels frda.hla fkdj md,kh l< yels frda.hla muKla ùuhs' reêr mSvkh idudkH uÜgug meñKS miqj;a ;ud T!IO os.gu .ekSu l< hq;= fõ' iuyr frda.Ska ;u reêr mSvkh idudkH uÜgug meñ‚ úg reêr mSvkh iqj ù hhs is;d T!IO .ekSu kj;ajd ouhs' ffjoH Wmfoia uÕ yer lsis úfglj;a fufia T!IO keje;aùu fkdl< hq;=h' 3' iEu wêl reêr mSvk frda.sfhl=u wvq ;rñka udihlg jrla j;a ;u reêr mSvkh iqÿiqlï ,;a ffjoHjrfhla ,jd mÍlaIdlr .; hq;=h' DM

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October 2019

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D•Magazine /

Fertility jhi;a iu.u .eyekq msßñ idM<H;djfha we;sjk fjkialï

jhi;a iu.u .eyekq msßñ idM<H;djfha we;sjk fjkialï jhi;a iu.u idM<H;djho ke;fyd;a orejka ,eîfï yelshdj flfuka wvqfõ' fuh ore iïm;a m;k hqj, oek.; hq;= b;d jákd ldrKhls' jhi;a iu.ska orejka ,eîfïoS we;sjk .eg¿ wm fï ,smsfhka wjOdkhg fhduq lruq'

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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jeäúh meñŒfuka miq msßñ iy .eyekq fldhs ldg;a ore iïm;la ,eîfï cSj úoHd;aul iqÿiqlu ysñ fõ' ldka;djkaf.a kï jeäúh m;aùu hkq weh ujl ùug iqÿiqlï ,enqfõh hk ixfla;hhs' fï lvbfuka wdrïN jk wehf.a idM<H;d yelshdj weh wd¾;j wNdjhg m;ajk f;la mj;S' tfy;a jhig idfmalaIj weh .eí .ekSug we;s yelshdj wvq fõ' úfYaIfhkau weh wd¾;j wNdjhg wdikakfha ie<lsh hq;= .eí .ekSfï fkdyelshdjla iajNdjfhkau wehg ysñ jk ksid cSú;fha ueos jhfiaoS j;a orejka ,eîu flfryS ldka;djka ie<ls<su;a úh hq;=h' wo ore iïm;a wysñ wUq ieñhka fjk;a ld,j,g jvd fnfyúka iq,nh' wOHdmkh fyda wd¾Ól ;;a;aj ksid fndfyda ldka;djkaf.a újdyh l,a hhs' weh fjkodg jvd fi!LH .ek úuis<su;a jQj;a zzjhi idOlhZZ wehf.a ore iïm;a flfryS wNsfhda.hla úh yels nj wjfndaO lr.; hq;=h' jhia.; jk úg wef.A äïnfldaIfha we;s äïn ixLHd;auljo" .=Kd;auljo wvqùula fmkajhs' äïnfldaIh iy Tima pl%h m%ckk ld,h ;=< iEu udihlu ks;sm;d äïn fudapkhla isÿùu ksfrda.S Tima pl%hl ,laIKhls' Follicle hkqfjka ye¢kafjk ;r,fhka msreKq b;d l=vd f.da,hla we;=<;

DOCTOR MAGAZINE

doctormagazine.lk

äïn fkdfyd;a ì;a;r mßK; fõ' fï äïnfldaI W;af;ackhg n,mdkafka fud<fha we;s Folliclestimulating hormone (FSH) kue;s fydafudakhhs' oyia ixLHd; jk Follicle j,ska tla l+mhla muKla mßK;shg ,la lr ixfiapkhg iqÿiq jk fia uqod yeÍu fuu FSH fydafudakh u.ska isÿ lrhs' il%Sh äïnh ñi wfkla l+m W;af;ackhla fuysoS isÿ fkdùuo úfYaI;ajhls' ,sx.sl iyjdihlska .eí .ekSula jQjfyd;a th l<,hla njg úlikh fjhs' tfia fkdjqfKd;a Tima ùula isÿ ù reêrh msg;g .,d hhs' fndfyda fh!jKshkaf.a jeäúh m;a ld,h wdrïNfha Tima pl%h wl%uj;ah' tfy;a jhi wjq' 16 muK jk úg th l%ñl Ndjhlg m;a fjhs' fï Tima ùu idudkHfhka jir 26-35 w;r ld,hla l%uj;aj mj;S' jhi jYfhka .;fyd;a idudkHfhka y;,sia .Kka j;a jk ;=re fï l%ñl Ndjh mj;shs' tfy;a jhia.; jk úg wd¾;j pl%h fláh' wl%uj;ah' hï ld,hla wl%uj;aj isÿ fjñka mj;akd Tima pl%h iïmQ¾Kfhkau weKysg jirla .; jQ úg weh wd¾;j wNdjhg (menopause) m;a jQ f,i j¾.SlrKh fjhs' ldka;djka jhia.; jk úg isÿjk foa ldka;djka jhia.; jk úg äïnfldaI j,o we;sjk fjkialï fya;=fldg f.k idM<H;djh ySk fjhs' doctormagazine.lk

msßñka kï jhia.; jQj;a ksmofjkafka kejqï Y=l%dKqh' kuq;a ldka;dj tfia fkdfõ' udifhka udihg mßK;shg ,la jQj;a wehf.a iuia; äïn m%udKhu weh Wmosk úgo wehg ysñh' jhia.; jk úg" fï äïn jhia.; fjhs' weh .; lrk cSú;fhaoS wehg uqyqK mdkakg isÿjk ye, yemamSï j,g wef.a äïn nexl=jo uqyqK fohs' Wmf;aoS iEu ldka;djlgu äïn ñ,shkhl muK ixLHdjla ysñh' weh jeä úh m;a jk úg tu ixLHdj ,laI ;=klg muK wvq fjhs' wef.a iuia; wd¾;j cSú;h ;=<oSu fudapkh jkafka wdikak jYfhka 300l muK äïn ixLHdjls'

October 2019

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D•Magazine /

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

fï wkQj wef.a äïn ixÑ;fhka id;sYh nyq;rhla m%fhdackhg fkd.kakd nj meyeos,s fõ' fï 300l ixLHdjla yer fudapkhg ,la fkdù iajNdjfhkau äïn úkdY ùu iEu ldka;djlf.au äïn ixÑ;hg w;ajk fkdje<elaúh yels brKuhs' fuh Atresia hkqfjka ffjoH úoHd;aul jyf¾oS ye|skafjhs' (Atresia is a degenerative process that occurs regardless of whether you are pregnant, have normal menstrual cycles, use birth control, or are undergoing infertility treatment.) jhig hk .eyekq idM<H;djh ldka;djlf.a fyd|u m%ckk ld,h we;af;a wef.a jhi úis .Kkaj,oSh' úfYaIfhka jhi wjqreÿ 35 ka miq idM<H;djh l%ufhka wvq fõ' jhi wjq' 30 .Kka j, ldka;djl kï weh .eí .ekSug orK W;aidyhloS th id¾:l ùfï ishhg 20l bvlvla mj;S' ;j f,ilska lsjfyd;a fï jhfiaoS ldka;djka ishhla .eí .ekSfï W;aidyhl ksr; jQjfyd;a m<uq Tima pl%fhaoSu úiaila fokd .eí .ekSulg ,la fjhs' fï whf.ka ;jÿrg;a W;aidy .; hq;af;a 80la muKs'

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kuq;a jhi wjq' y;,sfyaoS fï W;aidyh .;af;d;a id¾:l ùfï jdikdj w;am;a jkafka ishhg mylg muKs' ishhla .;af;d;a mia fofkla yer b;sß 95u kej; kej;;a W;aidyfha fhosh hq;=h' ta ;jÿrg;a fõ.fhka úhelS hk .eí .ekSfï yelshdjl wjodkuo orñks'' ldka;djl wef.a wd¾;j wNdjh olajd orejka ,eîfï yelshdj mj;ajd .kafkao ke;' fndfyda ldka;djka jhi wjq y;,sia .Kka j,oSu .eí .ekSfï yelshdfjka wE;a fjhs' fuh iajdNdúl ixfiapkhg fukau

doctormagazine.lk

idM<H;d m%;sldr weiqf¾ lrk W;aidyhka i|ydo tlfia i;Hh' mqreIhkaf.a idM<H;djh yd jhi ldka;djkaf.a ;rugu jhi;a iu.u .=Kd;aulfha wvqùula mqreIhkaf.a îc j, isÿ jkafka ke;' jhia.; jk úg Y=l%dKq j, Yla;sh ySk fõ' .=Kd;aulNdjh wvq fõ' kuq;a th isÿ jkafka Tyq jhi wjq' 60 ;rï jhig m;a jQ úgh' th ldka;djkaf.a muKg o¾YSh jYfhka isÿjk mßj¾;khla fkdfõ' ta yereKq úg mqreIfhl=g mS;D;ajh ,nd.; yels jhia iSudjlao fkdfõ' úhm;a mqreIhka f,i mS;d;ajh ,enQjka i|yd fndfyda ksoiqka we;' mqreIhka jhia.; jk úg Tjqkaf.a jDIK lsishï l=vd ùula olakg ,efí' tfiau uDÿ Ndjhlgo m;a fõ' yevh iy pd,l;djh wvq fõ' óg wu;rj" Tjqkaf.a Y=l%dKqj, cdk fodaI we;sùfï ;rula jeä wjodkula we;' jhia.; msßñkag Tjqkaf.a ,sx.sl yd m%ckk l%shdj,shg wys;lr f,i n,mdk ffjoHuh frda. we;súh yelsh' iEu msßñfhlau jhia.; jk úg m%ckl fyda ,sx.sl l%shdldß;ajfha ie,lsh hq;= fjkialï w;aú¢kafka ke;' úfYaIfhka jir .Kkdjla mqrd hym;a fi!LHhla mj;ajdf.k hk msßñka' ,sx.slj fndfyda l%shdldÍ f,i isáñka fyd| id¾:l;ajhla w;am;a lr .KS' ì;a;rfha .=Kd;aulNdjh jhia.; jk úg ldka;djka .eí .ekSug we;s bvlv wvq jk w;r .íid ùug we;s bvlv jeäh' äïn j, .=Kd;aul Ndjho wvq fõ' fuu fjkialï jvd;a lemS fmfkkafka weh 30 oYlfha ueo Nd.fha isg w. Nd.h olajd <Õd jk úgh' tuksid" ldka;djlf.a jhi hkq wef.a ckldkq fkdfyd;a idM<H äïn ms<sn| jvd;a ksjerÈ mÍlaIKhhs' äïn j, .=Kd;aul Ndjfha jeo.;a fjkila jkafka wekQmaf,dhsä hkqfjka ye|skafjk ì;a;rfha j¾Kfoay jeäùu fyda wvq ùuh' idudkH äïnhlg j¾Kfoay 23 la ;sìh hq;= w;r th ;j;a j¾Kfoay 23 la we;s Y=l%dKqjla yd ixfiapkh jQ úg we;sjk l<,hg j¾Kfoay 46 la ,efí'

doctormagazine.lk

iajdNdúl f,i we;s lr.kakd iyjdihloS jirla we;=<; .en .ekSfï bvlv jhi;a iu.u wvq jkafka fufyuhs' DM

ljr idM,H;d .eg¿jlska fm¿K;a oeka Tng ore iïm;a ,nd .ekSu wreuhla fkdfõ' fjk hï ljr fodaIhla u; Tfí uõmsh isyskh fnd| ù ;snqK;a th h,s mqnqÿjd,Sfï yelshdj wmg ;sfí' Tfí .eg¿j l=ula jQj;a th .ek yDohx. uj l;dny lsÍug wm iQodkïh' Tng jvd;au .e,fmk úi÷u ,nd.ekSug fï lafIA;f % ha m<mqreÿ wfma jD;a;h S iydh ,nd oSug wm b;d leue;af;ka isáuq' wmg l;d lrkak' fukak wfma wxlh

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

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Thisakya Design Studio

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Breast Cancer mshhqre ms<sldj

mshhqre ms<sldj wfma rfÜ ldka;djka w;r jeäfhkau olakg ,efnk ms<sldj fuhhs l,afõ,d we;sj y÷kd.;fyd;a iqjh ,eìh yelshs iEu ldka;djlau udihlg j;djla iajhx mshhqre mÍlaIdjl fhosh hq;=hs f,dalfha ldka;djka w;r jvd;au iq,n ms<sldj l=ulao@ th wka lsisjla fkdj mshhqre ms<sldjhs' ,xldfõ ;;a;ajh .;a;;a ldka;djkaf.ka y÷kd.kakd ms<sld w;=ßka ishhg 27lau ksfhdackh lrkafka fï ms<sldjhs'

ffjoH Yñ; oikdhl ldhsl frda. úfYaI{ MBBS (J'Pura) MD (Col) MRCP (UK) Consultant Physician Castle Street Hospital for Women

doctormagazine.lk

mshhqre ms<sld we;sùfï wjodku jeäfhkau orK ldka;djka • mshhqre ms<sld fyda äïnfldaI ms<sld iïnkaO mQ¾j b;sydih • orejka ke;slu • uq,a orejd jhi wjq' 35 bl=;a ù ,eîu • orejdg uõlsß fkdoSu fyda ál ld,hla muKla uõlsß ,ndoSu • jhi wjq'55g miqj isÿjk wd¾;j wNdjh • jhi wjq' myla fyda Bg;a jeä ld,hla Wm;a md,k fm;s ,nd .ekSu • wd¾;j wNdjfhka miq we;sjk ia:q,;djh • jeä jYfhka i;a;aj udxY wkqNjh • jHdhdu u|lu • uoHidr mdkh

October 2019

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61

mshhqre ms<sldjla yÕjk ,laIK y÷kd.ksuq • ifuys fjkiaùula • ifuys meyefha fjkiaùula • ifuys fmKqfï fjkiaùula • ;kmqvq .s,S hdula • fodvï f.ähl f,,a, jeks iajNdjhla mshhqre j, we;sùu • mshhqf¾ we;sjk ;=jd,hla$ jk ùula • ;kmqvqfjka Y%djh .e,Sula • mshhqfrys >kùula • jid .%kaÓ bosóula

"

• ÿïmdkh fyda wl%Sh ÿï mdkh • úlsrKhg ksrdjrKh ùu

;reK ldka;djkaf.a mshhqre ms<sld úuiSfïoS uefuda.%Eï j,g;a jvd bosßfhka isákafka w,ag%dijqkaâ mÍlaIKhhs'

l,afõ,d we;sj y÷kd .;af;d;a iqj l< yelshs mshhqre ms<sld l,afõ,d we;sj y÷kd .;af;d;a th iïmQ¾Kfhkau mdfya iqjm;a lsÍfï wk.s bvla we;' y÷kd.ekSu m%udo jQjfyd;a iqj lsÍu wmyiq jkakgo bv ;sfí' wOHhk j,g wkQj wfma mshhqre ms<sld

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doctormagazine.lk

frda.Skaf.ka ishhg 50lau fï frda.h y÷kd.kafka fndfyda m%udo ùfuka miqjh' mshhqre ms<sld y÷kd.kafka fldfyduo@ • fi!LH fiajlfhl= úiska isÿ lrk idhksl mshhqre mÍlaIdjlska • ;uka úiskau isÿ lr.kakd mshhqre mÍlaIdjlska

mshhqre ms<sldjl ,laIK

w;g yiqjk .eghla

;kmqvqfjka >%djh .e,Sula

;kmqvqfõ .s,Sula

mshhqf¾ fyda ;kmqvqfõ we;sjk fõokdjla

;kmqvqfõ we;sjk m%;sl%shdjla

r;ameye .ekaùula

mshhqfrys ifuys we;sjk fjkiaùula

jid .eá;s j, fjkia ùula

bosóula

• uefuda.%Eï mÍlaIKhlska • w,ag%dijqkaâ mÍlaIKhlska iajhx mshhqre mÍlaIKfha wx. fidaosish yd iam¾Y lsÍu fuys i|yka fojkqj oelafjk iajhx mshhqre mÍlaIKfha fldgia folls' fidaosish yd iam¾Y lsÍu hkqfjks' mshhqre ukdj msßlaiñka tys fmrlS wdldrfha wjodkï iy.; fjkialï fõoehs úuiSu fidaosishhs' wf;ys weÕs,s fhdodf.k mshhqre yd yd;ami iam¾Y lrñka oefkk wdldrh Tiafia fjkialï ksÍlaIKh lsÍu fojekakhs' wfma rfÜ cd;sl ks¾foaY j,ska wjq' 20g jeä iEu ldka;djlu ;ukaf.a mshhqre udihlg jrla

doctormagazine.lk

mÍlaId lsÍug Wmfoia oS ;sfí' rch u.ska isÿ lrk mÍlaIdjka iqjkdß idhk wo osjhsk mqrd l%shd;aul jk w;r fïjdg iyNd.s ùfuka mshhqre ms<sld mÍlaIdjka isÿ lr.; yel' uefuda.%ms yd w,ag%dijqkaâ mÍlaIK fuu mÍlaIK idudkHfhka isÿ lrk

Screening mÍlaIdjloS fukau mshhqre ms<sld iïnkaOfhka ielhla u;= jQ úg jeäÿr frda. ks¾Kl mÍlaIdjla jYfhkao fhdod.kS' uefuda.%ms yd w,ag%dijqkaâ mÍlaIK iel lghq;= fjkialula fjf;d;a th jeäÿrg;a wOHhkhg fhdod .kakd mÍlaIKhla jYfhkao fhdod.kS'

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D•Magazine /

mshhqre ms<sldj

Breast Cancer

ksfjfiaou ;ukau isÿ lrk mshhqre mÍlaIdj

iEu udihlgu jrla iajhx mshhqre mÍlaIKh l< hq;=hs

iïmQ¾Kfhkau mshhqr yd lsys,a, m%foaYh mÍlaId l< hq;=hs

fuysoS wf;ys weÕs,s ;=vq uDÿ f,i fhdod.kak

mshhqf¾ by< isg my<g

w¾O ljdldr jYfhka

ljdldrj

lkakdähla bosßmsg ysgf.k weig fmfkk fjkialï fjf;d;a mÍlaIdldÍ jkak

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ifuys fyda ieliqfuys fjkila

;kmqvq j, fjkialula''' yevfha fyda widudkH >%djhla

doctormagazine.lk

mshhqre wdY%s;j lrk uefuda.%Eï mÍlaIKhloS ,nd .kakd m%;sìïn

jhiska uqyql=rd h;au uefuda.%eï mÍlaIKfha ksrjoH;djh by< hhs' jhi wjq' 40g wvq ldka;djkg w,ag%dijqkaâ mÍlaIKfhkao jvd;a ksrjoH f,i frda. ks¾Khla isÿ lsÍug wjia:djla ie,fia' ;reK ldka;djkaf.a mshhqre ms<sld úuiSfïoS uefuda.%Eï j,g;a jvd bosßfhka isákafka w,ag%dijqkaâ mÍlaIKhhs' mshhqre ms<sld iïnkaOfhka ks¾foaYs; mÍlaIK l%ufõoh • jhi wjq' 20 isg iEu fh!jKshlau" ldka;djlau udihlg jrla j;a ;ukaf.a mshhqre mÍlaIdjg ,la lr.; hq;=hs' • jhi wjq' 20-40 jhia ldKAvfha ldka;djka iEu jir ;=klgu jrla fi!LH fiajlfhl= úiska isÿ lrk idhksl mshhqre mÍlaIKhlg Clinical Breast Examination (CBE) iyNd.s úh hq;=hs' • jhi wjq' 40 ,eîug fmr mshhqre ms<sld" äïnfldaI ms<Sld j,g k;= jQ whf.a mjqf,a ióm idudcslhka jd¾Islj idhksl mshhqre mÍlaIK l< hq;=hs' • jhi wjq' 50-69 jhia ldKavfhaoS weh b,a,d isákafka kï jir follg jrla uefuda.%ms mÍlaIKhla isÿ lr.; yel'

doctormagazine.lk

• mshhqre ms<sld fyda äïnfldaI ms<sldjlska fm¿Kq {d;sfhla isák mjq,aj, idudcslhka jhi wjq' 35 blaujQ miq jd¾Isl uefuda.%ms$w,ag%dijqkaâ mÍlaId j,g ,laùu ks¾foaYs;h' • jhi wjq' 35g wvq ldka;djka i|yd uefuda.%Eï fjkqjg w,ag%dijqkaâ mÍlaIK iqÿiqh' • mshhqre wdY%s; fjkialï iys; msßñkao fõ kï Tjqka Y,H idhkhg fhduq l< hq;= fõ' mshhqre ms<sld j,g lrk m%;sldr m%;sldr ;SrKh lrkafka

October 2019

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D•Magazine /

mshhqre ms<sldj

Breast Cancer

uq,a woshr j,oS myiqfjka iqjh ,eìh yels uq;a wjika woshr j,oS lrk m%;sldr ld¾hlaIu;djfhka wvqh

mshhqre ms<sldjl woshr

ms<sldfõ wdldrh" fl;rï ÿrg jHdma;j ;sfío@ wdoS ldrKd iudf,dapkfhks' uQ,sl jYfhka m%;sldr udos,s ;=kla fõ' • Y,Hl¾u • úlsrK Ñls;aidj yd • lSfuda Ñls;aidj mshqfrys iSñ; m%foaYhl muKla me;sr mj;sk ms<sldjla kï tau fldgi muKla bj;a l< yel' iïmQ¾K mshhqru bj;a lrk wjia:do ;sfnk w;r th Mastectomy hkqfjka ye|skafjhs'

hkqfjka lshkafka fuhhs' úlsrKh ,ndoSfuka yd;ami ffi, j,g wju ydkshla jk fia ms<sld ffi, jõlsrK iuia:dksl weiqf¾ úkdY lsÍula isÿ flfr' ;jÿrg;a me;sr hdu je<elaùu fuys wruqKhs' lSfudf;rms hkqfjka yeoskafjkafka T!IO m%;sldrhls' kslafIAmK jYfhka fuu T!IO ,ndoSfukao ms<sld ffi, u¾Okh lsÍu wfmalaId lrk w;r fuu m%;sldrh isÿ lsÍfïoS ysifla hdu" lEu wreÑh jeks ixl+,;d ;djld,slj we;s fõ' mshhqre ms<sld frda.sfhl= ffjoH Wmfoia m%ldrj lghq;= lsÍu b;d jeo.;a fõ' iEfyk ld,hla hk ;=re idhk j,g iyNd.s úh hq;= w;r tajd k;r lsÍfuka fyda ffjoH Wmfoia j,g mgyeksj fjk;a m%;sldr j,g fhduqùfuka cSú;h úYd, wjodkulg ,la jk njo lsj hq;a;ls' DM

Y,Hl¾uh isÿ lsÍfuka miq úlsrK Ñls;aidj isÿ flf¾' idudkH jyf¾ zzlrkaÜ w,a,kjdZZ

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jeä úia;r i|yd wu;kak

ÿrl;k( 0112 049 949 ,smskh( khskafj,aia frday," 55$1" lsßuKav, udj;" kdrfykamsg" fld<U 05'

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Nutrition ksrka;rfhka wfma wdydrhg tla lr.; hq;= w;HjYH fïo wï, wdydrhg .kak myiq u.la

ksrka;rfhka wfma wdydrhg tla lr.; hq;= w;HjYH fïo wï, wdydrhg .kak myiq u.la wfma ck;djf.a iqjfi; m;d fmdaIKfõ§ka ksrka;rfhka ,nd fok m‚úvhla jkafka yels muK ys;lr fïoh wdydrhg tlalr .kakd f,ihs' YÍrfha l%shdldß;ajhg fïoh ke;sju neßh' tfy;a we;eï fïo j¾. .ekSfuka úúO wjodkï j,g wm ksrdhdifhka ,la jk w;r isrerg ys;lr fïo j¾.o ;sfnk nj wjfndaO lr.; hq;=h' fyd| fïo j¾. .ekSfuka fyd| m%;sM, ,eîu fukau krl fïo j¾. .ekSfuka krl m%;sM, ,eîuo fkdje<elaúh yelalls'

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uq,skau wms fïofha fyd| krl úuiuq wmg ys;lr fïo yd wmg wys;lr fïo uQ,sl jYfhka fïoh ldKav follg j¾.SlrKh fõ' ix;Dma; fïoh yd wix;Dma; fïoh jYfhks' ix;Dma; fïoh wm i,lkafka YÍrhg wys;lr fïo ldKavh jYfhks' wix;Dma; fïoh YÍrhg ys;lr fïo ldKavh jYfhka y÷kdf.k ;sfí' fïoh YÍrhg ys;lro" wys;lro hkak mokï ù we;af;a th YÍrh flfrys olajk m%;sl%shdj uq,alrf.kh' ix;Dma; fïoh reêrfha fldf,iagfrda,a uÜgu by< kxjhs' iEu mqoa.,l=gu hï m%udKhlg fldf,iagfrda,a ;sìh hq;= jqj;a th muK blaujd mej;Sfuka yDo frda." wxYNd.h jeks frda. we;sùfï wjodku by< hhs' fï ksid fmdaIKfõ§ka fukau ffjoHjrekaf.ao u;h jkafka yels;dla ix;Dma; fïoh iys; wdydr j,ska wm wE;a úh hq;= njhs' ta fjkqjg wm <x lr.; hq;af;a wix;Dma; fïoh iys; wdydrhs' Trans Fat hkq Trans Fat hkqfjka ye¢kafjk ;j;a fïo úfYaIhlao wfma fi!LHhg wys;lr f,i n,mdk nj y÷kdf.k ;sfí' wix;Dma; fïoh fi!LHhg ys;lr hehs wm l;d lf<uq' we;af;kau Trans Fat lshkafkao ix;Dma; fïo ldKavhls' tfy;a fï Trans Fat kï ix;Dma; fïohg;a jvd krlh' wys;lrh' lsß fïoh iy uiaj, b;d iq¿ jYfhka Trans Fat we;' iqj ixfõ§j is;k m;k Tn fï wkqj Trans Fat, ix;Dma; fïoh wdÈfhka yels ;dla wE;a úh hq;= w;r wix;Dma; fïoh iys; wdydrj,ska Tfí YÍrfha fïouh wjYH;d iïmQ¾K lr.; hq;=h' fndfyda fokd ng¾ fjkqjg" uDÿ f;,a (Soft Oil) fhdodf.k ksmojQ fïo ;ej/ï (Fat Spread) Ndú;hg wNsreÑhla olaj;s'

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Ydluh fïoh fhdodf.k ksIamdokh lrk Flora Tfï.d-3 yd Tfï.d-6 fïo wï, j,ska iukaú;h' Tfï.d- 6 fïo wï,h ld¾hlaIu f,i reêrfha fldf,iagfrda,a wvq lrk nj m¾fhaIKd;aulj ;yjqre ù ;sfí'

ng¾ yd fïo ;ejreï (Fat Spread) ng¾ yd fïo ;ejreï hk folu isrerg w;HjYH fmdaIl isrerg Wrd .ekSug WmldÍ jk ckm%sh ksmehqï fõ' ng¾ yd fïo ;ej/ï (Fat Spread) w;r m%Odk fjki jkafka fïo ;ejreï (Fat Spread) i|yd Ydl iïNjhla iys; f;,a fhdod .ksoa§ ^lefkda,d iy iQ¾hldka; f;,a& ng¾ ksIamdokhg lsß Wmfhda.S lr .ekSuhs'

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Nutrition ksrka;rfhka wfma wdydrhg tla lr.; hq;= w;HjYH fïo wï, wdydrhg .kak myiq u.la

fndfyda fokd ng¾ fjkqjg fïo ;ej/ï (Fat Spread) Ndú;hg wNsreÑhla olaj;s' YS;lrKhl ;enqj;a ta iefKlska Ndú;d lsÍug we;s yelshdj;a myiqfjka ;ejÍug we;s yelshdj;a ksidfjks' wiuiu f;aÍu Flora m%Œ; rihla we;s myiqfjka ;jrd .; yels" ish,a,gu jeäfhka fi!LH iïmkak fïo ;ejreula fjf<| fmdf<ka ñ,§ .kakg W;ail q jk Tng Flora wiuiu jQ f;aÍuls' Ydluh fïoh fhdodf.k ksIm a dokh lrk Flora Tfï.d-3 yd Tfï.d-6 fïo wï, j,ska iukaú;h' Tfï.d- 6 fïo wï,h ld¾hlaIu f,i reêrfha fldf,iagfrda,a wvq lrk nj m¾fhaIKd;aulj ;yjqre ù ;sfí' Flora j, we;s úgñka A, D yd E j,ska YÍrhg ,efnk fmdaIKho wiSñ;h' úgñka A YÍrfha m%;Y s la;l s rK moaO;sh fõ.j;a lrk w;r fmkSuo ;shK q q lrhs' D úgñkh o;a yd wiaÓ j¾Okhg WmldÍ fjhs' th YÍrfha fmaYs l%h s dldß;ajho uekúka mj;ajd .ekSug fya;= fjhs' ffi, Tlail s rK l%h s dj,sh uev,ñka frda. j,ska YÍrh wdrlaId lsÍug E úgñkh fya;= fjhs' Flora fïo ;ej/u mjqf,a ish¨ fokdf.a f;aÍu úh hq;f a ;a wehs@ • Flora j, we;af;a fi!LHhg ys;lr f;,a yd fïohhs' • Flora isref¾ l%h s dldß;ajhg w;sYhska WmldÍ jk jákd fïo wï," LKsc yd m%;T s lail s drl /ilska iukaú;h' • Flora myiqfjka mdka" frdà ´kEu wdydrhl ;jrd.; yel' • Flora YS;lrKfhka .;a iefklska Ndú;hg .; yel' ish,a,gu jvd wdishdfõ" hqfrdamfha yd wefußldfõ mdßfNda.l s hkaf.a ;yjqre jQ úYAjdih yd m%K; S rih ksid Flora j,g iu wka ;ejreula fõo@ wka ñysrla fõo' DM 70

October 2019

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Memories úma,d .=re;=ñhf.a wdorKSh u;lh'''

úma,d .=re;=ñhf.a wdorKSh u;lh''' .=re iur

.=rejrhl=g úúO;ajfhka hq;= mka;s ldur w;aoelSï ljo;a iqkaor h' u;lho iqkaorh' ta 1991 j¾Ihhs' mdi, nKavdrfj, uOH uyd úoHd,hhs' ta ksielfhkau 13 C mka;shhs' úúO oialï mE <uqka w;r Tyq ksrka;r lemS fmkqk <uhl= úh' úfYaIfhkau tfia jQfha l=ula fyda úIh lreKla wid .kakg ks;r iskduqiq uqyq‚ka .=re ldurh fj; ÿjf.k tk mqreoaola Tyq fj; ;snQ neú‚'

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wfkl iEu jdr úNd.hlgu by<u ,l=Kq ,nd .ekSfï jqjuKdjla fï orejdg úh' úNd. ms<s;=re m;%j,g ,l=Kq wvqlrkakg ;ekla kï Tyqf.a ms<s;=re m;%fha fkdùh' iEu úgu mdfya ishhg ishhla Tyqf.a ms<s;=re ksje/È úh' Tyqg wj,dohlao úh' ,l=Kq jeäfhka ,enqKo Tyq ,shk wl=re le; nj Tyq woyi úh' ,iaik fnda, wl=re fkdjQj;a Tyq ,shQ oE lshjd .ekSu wmg wmyiqjla jqfha ke;' ta;a Tyq ta .ek ks;r lkiai¨‍ jQ ksid uu Tyqg msgm;a ,sùu ÿkakd ug u;lh' th Tyq b;d jqjuKdfjka ,shdf.k wdjdo u;lh' fndfyda nqoaêu;=kaf.a wl=re le;hs lS úg Tyq iskdiqkdo ug fyd|ska u;lh' uu Tyqf.a i;a;aj úoHd .=re;=ñh ùñ'

wx. iïmQ¾K frday,l Y,Hd.dr" ridh.dr fmkajkakg Tyq legqj .sh ud yg" uf.a reêr idïm, mÍlaId lrk whqre isheiska n,d.kakg bv ie,iQ Tyq ta .ek jeä úia;r b.ekakqfõh' óg jir úis wglg fmr ud tajd b;d ir,j Tyqg b.ekakqjd fkdfõoehs lshñka wms iskdiqfkuq'

"

"

doctormagazine.lk

Tyq úNd.h fydÈkau iu;aù ffjoH úoHd,hg we;=<;a jk ld,h" uu uf.a mYapd;a Wmdêhla i|yd wOHhk ksjdvq f.k úYaj úoHd,hg we;=<;a jQ ld,hla jQ neúka wm uqK.eiqfka ke;s ;rï úh' Tyq ffjoHjrhl= jQ miq ug uqK.eiqfka ke;;a Tyq .ek ;snQ wdorŒh yeÕSu" Tyqf.a u;lh ud ;=< b;sßj ;sîug fya;= úh'

October 2019

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úma,d .=re;=ñhf.a wdorKSh u;lh'''

Memories

ud fjkqfjka fnfyda foa leml< ohdnr §md,a ^Tn ;du;a leu;s" Tng fvdlag¾ fkdlshd §md,a lshkjdg neúka tfia wu;ñ&' Ôúf;a fï ieoE iufha b;d ;Dma;su;a iqkaor;ajhla tla l<dg fnfyúkau ia;=;shs'

"

"

zzTyqj olskakg we;akï'''ZZ hk is;=ú,a, iuyr wjia:dj, uf.a isf;a we;sjQ njo ienEh' b;d iqkaor wyïnhla l%shd;aul ù wjqreÿ úiswglg miq Tyq ug uqK.efikafka uqyqKq fmd; yrydh' l;d lrkakg jpk ke;s ;rï jQ ta wyïnh b;d jákdu tlla úh' ud Tyqg b.ekajQ uq,au ojfia weiQ i;a;aj úoHd úIfha m%Yakh o" ta i|yd Tyq ÿka ms<s;=ro Tyq ug ,shd tõfõ uqyqKq fmd; yrydh' úYauhckl f,i th ;du;a Tyqg u;lh'

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jfrl ÿrl:kfhka ud weu;+ Tyq lshd isáfha" .=rejreka Tyq .ek ;enQ n,dfmdfrd;a;= ish,a, Tyq wo w;am;a lrf.k we;s njh' ud fjkqfjka Tyq l< hq;=u fohla we;ehso Tyq lshd isáfhah' ta Tyqf.a ffO¾hfhka b¢l< Tyqf.a fm!oa.,sl frday,g ud le|jd uf.a ffjoH mÍlaIK ish,a, lr§u;a" udj weúÈkakg tlal hdu;ah' uf.a wdorŒh isiq orejd" tfia fkdue;skï l¿;r *eñ<s flhd¾ frdayf,a ^Family Care Hospital& wêm;s" iudc

doctormagazine.lk

fiajd lghq;= fjkqfjka foaYnkaOq iïudkfhka mqo ,o" ffjoH §md,a úfÊiQßh h<s ug yuqjkafka tf,ih' Tyqf.a b,a,Su bIag lrkakg" ke;skï Tyqf.a zz.=re WmydrhZZ ndr. kakg m%udo jqfha uf.A ld¾h nyq,;ajhhs' miq.sh i;sfha fld<Ug meñ‚ Tyq" ud fjkqfjkau ud isá ksji fidhdf.k ú;a uq,skau ud /f.k hkafka fld<U kj idmamq ixlS¾Kh ⁣^Colombo City Center& fj;h' wE;ska fmfkk .x.drduh iy fld<U mqrjrfha isß keröfuka miq" úúO rgj, fndcqkay,aj, úúO;ajfhka msß Èjd wdydr fõ,la ug imhd §ug Tyqg jqjukd úh' tÈk yjia hdufha" Tyqf.a frday, bÈßmsg ud isáfha" iEu ienE .=rejrhl=f.au isyskhla ienEùfï fudfyd;l wisßh ú| .ksñks'

wx. iïmQ¾K frday,l Y,Hd.dr" ridh.dr fmkajkakg Tyq legqj .sh ud yg" uf.a reêr idïm, mÍlaId lrk whqre isheiska n,d.kakg bv ie,iQ Tyq ta .ek jeä úia;r b.ekakqfõh' óg jir úis wglg fmr ud tajd b;d ir,j Tyqg b.ekakqjd fkdfõoehs lshñka wms iskdiqfkuq' Ôú;h iqkaorh' B<Õ Èkfha Tyqf.a mjqf,a wdorŒhhka iuÕ weúÈkakg .sfhñ' ta .ufka§ ;j;a úfYaI;ajhla isÿúh' ud b.ekajQ mdif,a fkdjQj;a tl, uf.ka i;a;aj úoHd úIh bf.k .kakg ud fj; ál l,lg meñ‚ yeuodu;a uf.a u;lfha /§ isg jir .Kkdjl g miq h<s uqyqKq fmd;ska yuqù ud ,shkd foa by<skau w.hk" ffjoH ,sh,a wfma ixpdrfhaÈ" ud n,kakg .d¨‍ fldgqjg meñŒuhs' ksjig meñfKkak hehs Tn l< wdrdOkh ms<s.ekSug ld, fõ,d uÈùu .ek lK.dgqhs' wdorŒh ,sh,a ia;=;shs Tng;a' ud fjkqfjka fnfyda foa leml< ohdnr §md,a ^Tn ;du;a leu;s " Tng fvdlag¾ fkdlshd §md,a lshkjdg neúka tfia wu;ñ&' Ôúf;a fï ieoE iufha b;d ;Dma;su;a iqkaor;ajhla tla l<dg fnfyúkau ia;=;shs' wdorŒh Tng;a Tfí mjqf,a ieug;a' ta jf.au ud fj; fifkyi oelajQ frday,a ld¾h uKav,hg;a' tfukau uf.a isiq orejl=jk Tfí fidhqre ffjoH Ñka;lo isysm;a lrñ'' b;ska Tn fjkqfjka fï wdorŒh iure igyk ;nñ'

frday, ;=< iqj myiq ldurhl kjd;eka f.k ffjoH mÍlaIK" ish,a, bgqúh'

b;ska fï yuqjkafka wmg wm fkdfõ §md,a''' ˜‍;ukag ;uka yuqùu˜‍ hehs uu úYajdi lrñ'

úma,d fk,a,sfy, uy;añhf.a zzuqyqK fmd;ZZ

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October 2019

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75

DM

Female Genital Cutting (FGC) f,dalfha újdohg ,laù we;s fndard ldka;djka fndardjrekaf.a zzlÜkdZZ pdrs;%h

f,dalfha újdohg ,laù we;s fndard ldka;djka fndardjrekaf.a zzlÜkdZZ pdrs;%h What is the real purpose behind Khatna for girls? The Bohra community has been practicing this hidden ritual of female circumcision, also known as Female Genital Cutting (FGC), for centuries, with no public discussion on its need.

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rgj,a y;,syl fndardjreka 21"000lf.a iyNd.s;ajfhka meje;ajQ fndard iuq¿j fï rfÜ ck;djg kjuq w;aoelSï tla lf<ah' mdial= bßod m%ydrfhka miqj fï rfÜ mej;S úYd,;u úfoia yuqj ùu ksid th id¾:l;ajhg m;a lsÍug md,kdêldrho uy;a fjr ùßhla orKQ ,eîh' fjfiiskau iduldó wd.ka;=l i;aldrhg ys;e;s cd;shla jYfhka ,dxflah m%cdj ÿrd;S;fha mgkau kula /ka¥ w;r fï iuq¿j iïnkaOfhkao rfÜ nyq;rhla ie,l+fha jákd ixialD;sl isoaêhla jYfhks'

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fj<|dug Wmka cd;shla fndard hkafkys w¾:h zzfj<|duZZ hkakhs' fj<|du ue iajlSh cSjk jD;a;Sh lr.;a fndardjreka wka wh hgf;a /lshd lsÍug fkdleue;a;la olajhs' ;u wd.u fjkqfjka lemùug kï fyd| wd¾Ól ;;a;ajhla ;sìh hq;=h hk woyi ;oska ldjeoS ;sfnk fyhska Tjqka ienúkau iuDoaêu;a cd;shls' u;ameka yd ÿï mdkfhka

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f;drj cSú; .; lrk fndardjreka nyq;rhla oeä wd.ñl úkhlao mj;ajd .ekSug ue<s fkdfj;s' f,dalfha fndfyda rgj, iq¿ cd;shla jYfhka úisr isáh;a foaYmd,khg t;rï leue;a;la ke;' fndardjrekaf.a wdOHd;añl kdhlhd 53 jeks fihsh ­ ­oakd­;=ud jk 73 jeks úfha miq jk uq*d­oao,a fihs*q­oa§ka ^Suedna Abu jafarussadig Aligadr Mufaddal Saifuddin& bia,dï O¾uh ms<s­n| Wmd­ê­Od­ß­ fhls' Tyq ,xldfõ kjd­;eka f.k isáfha nïn­,­ms­áfha msysá fndard m,a,s­fhah' fur­gg iem;a jk fihs­h­oakd­ j­reka Wfoid iqfLda­m­fNda.S f,i ilia l< fldg­ila tys fjka lr we;' fndard­j­reka ;ukaf.a wd.­ñl kdh­l­hd;a ck fldgfia mß­md­,k kdh­l­hd;a f,i i,­lkq ,nkafka fihs­hoakd hk kdh­l­hdh'

"

fndard i¿ms<s fndard msß­ñkaf.a cd;sl we÷u —flda ñ,s­ndia˜ kñka ye¢­kafjk iqÿ meye­fhka hqla; jk w;r Tjqka ysi m,­¢k f;dmamsh ye¢­kafjkafka —fgdams˜ kñks' w;ska f.d;d rka kQf,ka jev oud we;s tu —fgdams˜ f;dmams­fhka fndard­j­ rekaf.a fmdfyd­i­;alu m%o­¾Y­kh fõ' fndard ldka;d­jkaf.a we÷u ye¢­kafjkafka —ßod˜ hkq­fjks' ldka;d­jkag m,a,s hEug wj­ir fok tlu uqia,sï wd.u fndard­j­rekaf.a wd.­uhs' fndard cd;s­l­hkaf.a m,a,sfha msß­ñ­kag;a . eye­kq­kag;a fjka fjka ia:dk we;'

,sx.sl i;=g jeãu yd msßisÿlu lsõj;a lfï wkQj fï isß;g n÷qka jk ldka;djkaf.a iajdNdúl l%shdldß;ajh md,kh lsÍula fï l%shdfõ ieÕj we;s nj fndfyda m¾fhaIlhka mjikjd'

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fndard ldka;djkag ,sx.sl cSú;hg ksoyila ;sfhkjdo@ fndard ldka;djka fndfyda úg .; lrkqfha mjq, uQ,sl lr.;a cSú;hls' orejka jeoSu" /ln,d .ekSu fukau ;u l=gqïnhg lemùu wd.udkql+,j Tjqkag ,enqKQ Wreuhka fõ' wjfYAI uqia,sï m%cdj fuka fkdj lsishï wd.ñl ksoyilao N=la;s ú|sk fndard ldka;djka zzlÜkdZZ hkqfjka ye|skafjk wd.ñl isß;la mj;ajd f.k hhs' fndard ldka;djl fjf;d;a wehf.a ,sx.sl wjhjfha lsishï fPaokhla isÿ lsÍu zzlÜkdZZ kï fjhs' oek W.;a cd;shla jYfhka f,dal m%cdjf.a f.!rjhg md;% jQ iq¿ ck fldÜGdYhla jYfhka rgj,a /il

October 2019

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77

DM

Female Genital Cutting (FGC) f,dalfha újdohg ,laù we;s fndard ldka;djka fndardjrekaf.a zzlÜkdZZ pdrs;%h

ix.%yhl fï lÜkd pdß;%h msßisÿlu yd wd.ñl mokula iys; pdß;%hla jYfhka y÷kajd oS ;sfnkjd'ZZ Da’im al-Islam kS;s ix.%yfha tk ldrKd ;jÿrg;a ú.%y lrñka fndard m%cdfõ fcHaIAG kdhlfhl= yskaÿ m;%hg m%ldYhla ,nd foñka fufia m%ldY l<d' zzfï pdß;%h ksid ldka;djkaf.a uqyqK meyem;a fjkjd' osÿ,kjd' ta ú;rla fkdfjhs" mqreIhkag jeä úkaokhla ,ndoSug ldka;djkag fï ksid yelshdjla ,efnkjd' (Increase the radiance on the face of the woman and the pleasure with that of her husband.)

jHdma;j osú f.jk fndardjreka fujka újdod;aul pdß;%hl ksr; jkafka wehs@ zzlÜkdZZ pdß;%h iïnkaOfhka miq.sh ld,fha tjka u;jdohla we;sjQ fyhska fndardjrekaf.a wdOHd;añl kdhlhd uq*d­oao,a fihs*q­oa§ka u 2016oS Bg W;a;r n|skakg bosßm;a úh' zzlÜkd - wms wd.ñl mdßY=oaO;djh uq,a lrf.k isÿ lrk pdß;%hla' fuh wd.ñlj wmg kshu lr, ;sfhk pdß;%hla' 10 jk Y;j¾Ifha iïmdos; Da’im al-Islam kï kS;s

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"

uu fndard ldka;djla' uu lÜkd pdß;%hgw;sYhska úreoaOhs

jrla wefußldfõoS ldka;djka ;sfofkla w;awvx.=jg .kq ,enQfha oeßúhkaf.azz,sx.sl wjhjhg ysxid lsÍu hk fpdaokdj isÿ lrñka' ta wjia:dfõoS fndard iudcfhau we;eï ldka;djka iudc udOH cd, yryd tu w;awvx.=jg .ekSug tfrysj ke.S isáhd' zzth wd.ñl pdß;%hla ;uhs' ta;a úoHd;aulj;a" ffjoH kHdhka wkQj;a bka w.;shla jk njg idlaIshla kE' fuhska isÿ lrkafka N.uksfha Wvq yfï mqxÑ lemSula fhdok tl' ngysr rgj,;a fufyu pdß;% ;sfhkjd''''ZZ

msßñkag jeä ,sx.sl ;Dma;shla ,ndoSug fï isß; bjy,a jk nj lSj;a fï iólaIKhg wkQj n<,d u,af,ka t<shg meñK ;sfnkjd' ldka;djkaf.a wkqrd.h lsishï md,khlg ,la lsÍug fï bkaøsh fPaokh bjy,a fjkjd@

"

flfia fj;;a fï pdß;%h mrïmrdfjka mrïmrdjg bosßhg f.k hkakg fndard m%cdj oeä Wkkaÿjla . kakd nj fmfkkjd' frfykd .dãfh,s kï uydpd¾hjßhla All for Izzat kue;s mqj;am;g ,smshla iïmdokh lrKQ msKsi jrla fndard ldka;djka 50la

DOCTOR MAGAZINE

doctormagazine.lk

fndard ldka;djkaf.a ,sx.sl fPaokfha m%uqL w¾:h wef.a ,sx.sl wdYdjka u¾Okh lsÍu nj úia;rd;aulj olajd ;sfnkjd'

iïuqL idlÉPdjlg ,la l<d' fuysoS m%ldYs; woyia wkQj fï isß; bosßhg mj;ajd .ekSug fm< .efik fya;= m%uqL;djh wkQj fufyuhs' 1' wd.ñl ne|Su 2' iïm%odh yd 3' ,sx.sl wdYdjka oukh lsÍu msßñkag jeä ,sx.sl ;Dma;shla ,ndoSug fï isß; bjy,a jk nj lSj;a fï iólaIKhg wkQj n<,d u,af,ka t<shg meñK ;sfnkjd' ldka;djkaf.a wkqrd.h lsishï md,khlg ,la lsÍug fï bkaøsh fPaokh bjy,a fjkjd@ ;j;a ldrKhla ,sx.sl tlaùuloS fhdaksfhys WoaoSmkhg ,la jk fldgi N.ukshhs' (Clitoris) fndardjreka fuhg wkaj¾: kduhla ,ndoS ;sfnkjd' “haraam ni boti” hkqfjka' tys wre; zzmõldr udxYhZZ hkakhs' fndard jd.a fldaIfhys mqreI ,sx.hg tjka wj,dod;aul wkaj¾:hla ,ndÿka njg idlaIshla kE' m%shd f.diajdñ Ñ;%má wOHlaIjrfhla' Tyq Pinch of Skin hk kñka miq.sh ld,fhaoS ks¾udKh l< Ñ;%mghg lreKQ fidhkakg fï isß; iïnkaOfhka úia;rd;aul wOHhkhk ksr; jqKd' fuysoS Tyq úiskaos.= ld,hla ;siafia isÿ lrk ,o m¾fhaIK j,ska

doctormagazine.lk

,sx.sl i;=g jeãu yd msßisÿlu lsõj;a lfï wkQj fï isß;g nÿka jk ldka;djkaf.a iajdNdúl l%shdldß;ajh md,kh lsÍula fï l%shdfõ ieÕj we;s nj fndfyda m¾fhaIlhka mjikjd' fndardjreka m%shukdm c.;a f.!rjdorhg md;% jQ ck fldÜGdYhla' tfy;a Tjqka zzlÜkdZZ jeks pdß;% yuqfõ ;ukaf.au ìßkaoEjreka" ke.Kshka yd oeßúhka lsishï ,sx.sl pdß;%hlg isrr.; lrk njg f,dalfhka kef.k fpdaokdj neyer l< yelso@ DM

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Frozen shoulder, Adhesive capsulitis whsia jf.a ñÿKq fõokdldÍ Wrysig ms<shï

FROZEN SHOULDER, ADHESIVE CAPSULITIS Frozen shoulder is a condition that limits the range of motion in your shoulder. Find out if you're at risk and learn about treatment options.

whsia jf.a ñÿKq fõokdldÍ Wrysig ms<shï 80

October 2019

DOCTOR MAGAZINE

wkqrdOmqr YslaIK frdayf,a ikaê frda. úfYaI{ ffjoH ysuka; w;=fldar, úisks

Wrysia fõokdfjka Tn wmuK mSvdjg m;aù we;ao@ fuu ,smsh Wrysig n,mdk f*%daika fYda,av¾ (Frozen shoulder) ;;a;ajh iy ;j;a fõokdldÍ ;;a;ajhka ms<sn|jhs'

doctormagazine.lk

ñoSug ,lajQ Wrysia ikaêh ñoSug ,lajQ Wrysia ikaêh

idudkH Wrysiaikaêh

>k Ndjhg m;ajQ yd ñÿKq lemaishq,h

lemaishq,h Wrysia wia:sh

m%.Kavh

f*%daika fYda,av¾ ;;a;ajh jeäysá jdf.au ;reK úfha§;a w;aúÈkakg jk iq,n frda.hls' úfYaIfhkau Èhjeähdj" ;hsfrdhsâ .%kaÓfha fjkialï iy Wrysig isÿjk wk;=re j,ska miqj fuu frda.h u;=fõ' ;ks Wrysila muKla fkdj fome;af;au fuu fõokdj u;=úh yel'

fuf,i iajNdúlj iqjùug jir fol ;=kla .; úh yelsh' m%;sldr ,nd§u ;=<ska wm n,dfmdfrd;a;= jkafka iqjùu jvd;a fõ.j;a lsÍuhs'

Wrysfia fõokdj tkafka f*%daika fYda,av¾ j,ska muKlao@ tfia ke;skï fjk;a frda. Wrysi wdY%s; .eg¨‍ we;s lrkjdo@ fuu frda.fha ,laIK fudkjdo@ fuu frda.h iqj l< yelso@ fï ish¨‍ .eg¨‍ j,g úi÷ï my; úia;r lrñ' Wrysig n,mdk ;;a;ajhka úiailg;a wêl ixLHdjla we;' f*%daika fYda,av¾ j, fndfydaúg mshjr y;rla Tiafia frda.h u;=ù myj hhs' m<uq mshjr kï" Wrysia fõokdjhs' fojekqj Wrysfia fõokdjg wu;rj ;o$ysr .;shla we;sfõ' fuu ;o .;sh frda.shd wdndê; ;;a;ajhg m;alrhs' ulaksido h;a" w; YÍrfhka bj;g fi,ùug fkdyelsj tla;rd uÜgulg miqj w.=¿ jeàula jeks fohla frda.shdg oefkk neúks' f;jekqj ;o .;sh fyda ysr .;sh È.gu ;sìh§ fõokdj l%ufhka myj hhs' isõfjkqj ;o .;sho myj f.dia frda.h flfuka iqjfõ'

doctormagazine.lk

Wrysia wmyiq;d we;s lsÍug n,mdk fya;= my; i|yka ;;a;ajhkao Wrysia wmyiq;d we;s lsÍug fya;=fõ' • Tiaáfhdawd;rhsáia ;;a;ajh Wrysi we;=¨‍j wfkl=;a ikaê j,go n,mdk ;;a;ajhls' uo úfõlfhka miqj ikaê j, ;o.;sh iy fõokdj Tiaáfhdawd;rhsáiaj, olakg ,efí' fuh Wrysfia l%shdldß;ajh;a iu. wvqfõ'

October 2019

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whsia jf.a ñÿKq fõokdldÍ Wrysig ms<shï

Frozen shoulder, Adhesive capsulitis

ñoSug ,lajQ Wrysil wiaÓuh ksrEmkh

• iafmdkaäf,daisia keue;s frda.h fn,af,a lfYareld w;r we;s ;eá j, fodaI ksid yg.kS' fuys§ we;sjk frda. ,laIK fn,a,g muKla iSud fkdfõ' iakdhq f;rmSu ksid yg.kakd .eg¨‍ Wrysfia iy w; Èf.a hk fõokdjla we;s l, yel' fuh tljr w;a folgu n,mE yel' • Wrysfia udxY fmaYs p,kh ùfï§ isrùu we;=¨‍ ld¾ñl fodaI j,ska we;sjk ;;a;ajhla f,i ií wefl%dñh,a n¾ihsáia ye¢kaúh yel' fuys§ tla;rd iSudjlska Tíng w; tiùu fõokdjg fya;=fõ' • reufgdhsâ m%odyho ^ke;skï reufgdhsâ wd;rhsáia& j,ska ysñÈßfha Wrysia we;=¨‍ ikaê .Kkdjl fõokdj iu. ;o .;sh we;s lrhs' w;aj, weÕs,s j, fuu frda.h u;=úh yel' ;jo fmd,sïhe,aðhd keue;s ;;a;ajfh§ Wrysia foflysu fõokdj yg.;a yel' fmd,sïhe,aðhd jhi wjqreÿ mkyg jeä frda.Skag iEfok frda.hls' f*%daika fYda,av¾ yefokafka wehs@ fuf,i ys;kak' Wrysia ikaêh iukaú; jkafka wiaÓ folla iy th jgd we;s udxY fmaYs .Kkdjlsks' fuu

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ikaêh jgd mg,hla ;sfnk w;r th u.ska ikaêh wdjrKh ù we;' fuu mg,h w; fi,ùfï§ fyd¢ka wefok iq¨‍ rn¾$b,diaála jeks jHqyhla úh hq;h = 's hïlsis mßndysr fya;j = la ksid fuu mg,fha rn¾ .;sh ke;sù th >k iajNdjhlg m;ajf Q õ kï Wrysi$w; fi,ùu b;d ÿIalr ld¾hhhla fjkq fkdwkqudKhs' fuu ;;a;j a h túg f*%di a ka fYda,v a ¾ f,i y÷kajkq ,efí' f*%di a ka fYda,v a ¾ y÷kd. kafka flfiao@ by; i|yka wdldrhg Wrysi mshjr lsym s hla Tiafia úfYaIfhkau

doctormagazine.lk

fuys§ ikaê j,g fjkila isÿl< yels iy fkdyels fnfy;a j¾. f,i m%Odk j¾. folla we;'

ñoSug ,lajQ Wrysil ldh jHÉfPaod;aul ksrEmkh fjkiaùug ,lajQ Wrysiaikaê lemaishq,h

Wrm;= wegh

.a,Sfkdhsv l=yrh

m%.Kav wiaÓh ikaêfha we,Sug ,lajQ fldgia

Èhjeähd frda.k S f a .a fõokdj f.kfokafka kï wmg f*%di a ka fYda,v a ¾ .ek is;d mÍlaId l< yel' m%:ufhka frda.h ms<n s | úia;r .kq ,efí' ikaê frda. iïnkaO úfYaI{ ffjoHjrhd Tnf.a Wrysia p,k mrdih n,kq we;' úfYaIfhkau w; tiúh yels m%udKh" w; Ndú;d lr ysi msgm q i we,a,u S iy msg we,a,u S jeks ÿIalr ld¾hhhka frda.h s dg fld;rï iSudjla iys;j isÿl< yelso hkak fuys§ i,ld n,kq ,efí' f*%daika fYda,av¾ y÷kd .ekSug we;s mÍlaIdjka ljf¾o@ we;a;gu fuu ;;a;ajh i|yd wm úfYaIs; jQ mÍlaIK lsisjla Ndú;d fkdlruq' frda. uQ,h jgyd .ekSug wmyiq kï iy fjk;a ^by; i|yka& ;;a;ajhka ms<sn| fydavqjdjka we;akï muKla reêr mÍlaIK iy tlaia f¾ jeks oE ks¾foaY lrñ' uu ieuúgu Èhjeähdj ms<sn|j frda.Skaf.ka úia;r wiñ' f*%daika fYda,av¾ i|yd m%;sldr m<uqj isÿl< hq;af;a frda.Skaf.a fõokdj iukh lsÍuhs'

doctormagazine.lk

wm fyd¢ka okakd merisgfuda,a" fud¾*Ska g%eufvda,a jeks fnfy;a fõokdj mylsÍu muKla isÿlrhs' tfy;a fkdka iafgfrdbâ wekaá bka*a,fïgß fnfy;a (NSAID) ikaê bÈuqugo .=KodhS fõ' fuh;a iu.u p,k mrdih jeälsÍu i|yd ksji ;=< isÿl< yels úfYaIs; jHdhdu ks¾foaY lsÍu isÿl< hq;=hs' fuf,i l%ufhka fõokdj iy ;o .;sh u.yefrk úg bka*%rd frâ (Infra Red) fyda fYda¾Ü fõõ (Short Wave) m%;sldr mgka.; yel' we;eï frda.ska yg iafgfrdhsv fm;s j¾. b;d id¾:l fõ' lsisÿ fm;s j¾.hlg iqj fkdfõ kï ir, tkak;a j¾.o wm ks¾foaY lruq' §¾> ld,Sk ;;a;ajhka yg" úl,dx. Y,H ffjoHjrfhl= yryd" iq¨‍ ie;alï j¾.o we;' ieuúgu frda. ,laIK werUqkq úg m%;sldr ,nd.ekSu WÑ;hs' DM

October 2019

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Palliative care

fõokd ú|sk frda.Skag iykh i,ik iyk i;aldrh

fõokd ú|sk frda.Skag iykh i,ik iyk i;aldrh ,dxlSh ms<sld frda.Skag fukau wêl fõokdjg m;a frda.Ska nyq;rhlg;a wysñhs oeka oshqKqjg m;a rgj, iyk i;aldr fyd|ska l%shd;aul jkjd''' oshqKQ fjñka mj;sk rgj,;a fï i|yd fyd| keUqrejla ;sfnkjd''' ms<sld frda. jix.;hla fuka f,dj mqrd fõ.fhka jHdma; jk njg fyd|u ksoiqk jkqfha wka;¾cd;sl jd¾;djkag wkqj f,dalfha isÿjk iEu ñksia urK wglska tllgu fya;=j ms<sld frda. ùuh' ms<sld frda. iïnkaOfhka m¾fhaIK mj;ajk wka; cd;sl tackaishg (International Agency for Research on Cancer) wkqj 2012 j¾Ifha§ f,dalh mqrd wÆ;ska y÷kd .;a ms<sld frda.Ska m%udKh ñ,shk 4'1 ^14"100"000& la jQ w;r tu jir ;=< ms<sld ksid ñh .sh m%udKh ñ,shk 8'2la ^8"200000& úh' fuu ms<sld we;sùfï m%jK;djh fkdfjkiaj mej;=kfyd;a weia;fïka;=j,g wkqj 2030 jir ;=< w¨‍;ska ìys jk ms<sld frda.Ska m%udKh ñ,shk 21'7 la jk w;r tu jir ;=< ms<sld ksid ñh hd yels frda.Ska .Kk ñ,shk 13ls' wñysß i;Hh jkqfha ms<sld we;sùfï m%jK;djh jirla mdid jeäùuh'

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wdisß Y,H frdayf,a ms<l s d frda. úfYaI{ ffjoH Idu .=K;s,l

wm wo ojfia uqyqK md we;s wNsfhda.h f,dal fi!LH ixúOdkfha m%ldYhkag wkqj ms<sld iy wksl=;a ksl=;a ksoka.; frda. È<s÷ rgj, ck;dj w;r iq,n fjñka mj;sk w;r Tjqkg tajd b;d wvq jhil§ yefok njo ksÍlaIKh lr we;' ;jo tu frda. ksid tu frda.Ska fndfyda ld,hla mSvd ú¢k w;r b;d lk.dgqodhl ldrKh jkafka tfia tu frda.Ska mSvdjg m;a lrkq ,nk ixl+,;d fndfydauhla j<lajd .; yels ùuh' fï fya;=j ksidu frda.Skaf.a ksid fuu frda.Ska f.a Ôú;j,g ;¾ckhla t,a, l< yels ms<sld iy wfkl=;a ksoka.; frda. md,kh lsÍu i|yd uQ,sl jk m%;sldr l%ufõohkag wu;rj tu frda.Ska iy Tjqkaf.a mjq,aj, whf.a Ôú;j, .=Kd;aul nj jeä lrkq ,nk zziyk i;aldrhZZ (Palliative Care)

doctormagazine.lk

m%;l s dr m%;l s drhkaf.a ienE fjkila isÿúh hq;= nj wehg jegyS .sho wog jvd fnfyúka fjkia jQ tod tx.,ka;h ;=< fyoshl f,i lsis úfgl;a fuh isÿl< fkdyels nj jgyd .;a weh wm%;y s ; ffO¾hfhka lghq;= lr ;u wruqKq iM, lr .ekSu i|yd 1957 § ffjoHjßhl njg m;ajkakh S '

kï m%;sldr l%ufõohla f,dalh mqrd m%p,s; jkakg úh' uq,skau fï ms<sld frda.Ska i|yd muKla iSud jqjo l%u l%ufhka th wksl=;a wfkl=;a ksoka.; frda.j,ska mSvd ú¢k frda.Skago úYd, iykhla f.k §ug iu;aj ;sfí' iyk i;aldrh b;sydih iyk i;aldrh m%:ufhkau wdrïN jQfha zz.s,dk .sukay,aZZ ^Hospice& jHdmdrhla f,igh' flfia kuq;a wo ojfia th .s,dk fiajd frday,aj, fkajdisl frda.Skago" ndysr frda.S wxY frda.Skago" m%cdj ;=< id;a;= ksjdi fukau frda.shdf.a ksji ;=<o ,nd.ekSfï wjia:dj f,dalfha ÈhqKq rgj, fukau we;eï ÈhqKq fjñka mj;sk rgj,a ;=<o i,id we;' isõjk Y;j¾Ifha§ Hospice uq,skau fhdodf.k ;snqfKa ixpdrlhkag úfõl .ekSu i|ydh' kuq;a 19 jk Y;j¾Ifha § wh¾,ka;fha§ iy tx.,ka;fha ,kavkays§ we;eï wd.ñl mQcl msßia úiska ñhefoñka isák ñksiqka i|yd .s,dk .sukay,a ia:dms; lrf.k ;snq‚' kuq;a kùk .s,dk .sukay,a óg jvd fjkia kj ixl,amhla jk w;r 1967 § uyd ì%;dkHfha idka; l%siafgdam¾ .s,dk .sukayf,a wdrïNh;a iu. we;s jQjls' óg uQ,l s jQfha isi, s s fidakv a ¾ia ue;sKh s jk w;r kùk .s,dk .sukay,a jHdmdrfha ks¾ud;Djrsh weh jkakh S ' j¾I 1944oS fyÈhl f,i ,kavkays idka; f;dauia frdayf,a fiajhg tlajk weh Ôú;hg ;¾ckh f.k ÿka ms<l s d wd§ frda.j,ska mSvd fjñka isá frda.k S g a msyg s fjñka w;aoelSï /ila ,nd .kakh S ' fuu frda.k S g a ,ndfok

doctormagazine.lk

bka wk;=rej ffjoH isi, s s fidakv a ¾ia ;udf.au .s,dk .sukay,la wrUk w;r tf;la ksis fõokd kdYl fkd,nñka wêl fõokdjkaf.ka mSvd ú¢ñka Ôú;fha wjika ld,h f.jñka isá frda.k S a úYd, m%udKhlg msyg s ùu wrUk ,§' fuf,i Wm; ,o zzkùk iyk i;aldrhZZ b;d fifuka f,dj mqrd m%p,s; jQ w;r wo jk úg f,dalfha ish¨‍u ÈhqKq rgj,;a" iuyrla ÈhqKq fjñka mj;sk rgj,;a b;d fyd¢ka jHdma;j we;' kjSk iyk i;aldrh l%shd;aul jkafka fufyuhs iyk i;aldrh ,xldj ;=< fldf;la jHdma; we;aoehs fidhd ne,Sug m%:u kùk iyk i;aldrh hkq ieneúkau l=ulaoehs f;areï .ekSug W;aidy lruq' f,dal fi!LH ixúOdkfha w¾: w¾: oelaùï j,g wkqj iyk i;aldrh jkdys Ôú;hg ;¾ckhla f.k fok ksoka.; frda. hkaf.ka fmf<k frda.Ska Tjqkaf.a mjq,aj,

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fõokd ú|sk frda.Skag iykh i,ik iyk i;aldrh

Palliative care

wh iy Tjqka /ln,d .kakd Wmia:dhlhskf a .a Ôú;j, .=Kd;aul nj by< ouk l%u fõohls'

whg zznhfjkak tmd Tlafldu yßhhsZZ zzál ojilska fyd| fjhsZZ hk idjoH m%ldYk ksl; = a fkdl< hq;h = ' frda.h ms<n s | wjxl ksjerÈ f;dr;=re zzwiqn wdrxÑhlaZZ ksjerÈj ,nd§fï l%ufõohla wkq.ukh lrñka ,nd Èh hq;h = '

fuys§ l,a;nd y÷kd .ekSu;a ksjerÈj tajd wOHhkh lsÍu;a ;=<k s a tu mSvdfjka yels ;rï wE;a ùu je<elaùug;a" tfia fkdyels kï ksis m%;l s dr u.ska tajdfhka Tjqka uqojd .ekSu;a isÿ lrkq ,efí' fuys§ Tjqkf a .a fõokdj we;=¿ ldhsl m%Yk a ;a udkisl iudchSh iy wdOHd;añl .eg¿j,g msyg s ùu isÿ lrkq ,efí' fuu m%;l s dr l%ufõoh weröug frda.h s df.a Ôú;fha wjika ;;amrh <Õd jk;=re n,d fkdisáh hq;= w;r frda.h ksYp a h l< jydu frda.h iqj iqj lsÍu b,lal lr .;a m%;l s dr ,nd §u werôh hq;h = '

fuys§ isÿjk ixjdo ffjoHjrhd úiska muKla m%Yk a wik tla ÈYdjlg muKla fhduq jQ idlÉPdjla fkdúh hq;h = ' frda.h" frda.h s d iy Tjqkf a .a mjqf,a wh iïnkaOfhka ffjoHjrhdg;a f;dr;=re Tjqkg a wjYH m%udKfhka ,nd §ug;a ;uka fkdo;a f;dr;=re Tjqkf a .ka ,nd .ekSug;a frda.h s d iy mjqf,a whg ;u frda.h iy ;uka .ek ;ud fkdo;a lreKq ;ukag wjYH m%udKhg ffjoHjrhdf.ka oek.ekSug;a" ;ud .ek iy ;u frda.h ms<n s | ffjoHjrhd fkdo;a lreKq Tyqg ,nd §ug;a''' fï fomsßigu m%Yk a wid .eg¨‍ ksrdlrKh lr.; yels wjxl idlÉPdjla úh hq;h = '

frda.h s d ush .sh;a Wjgeka l< whgo Wmldr wjYHhs hï f,ilska frda.S ;;a;j a h ksidu frda.h s d ñh .sho iyk i;aldrh wjika fkdjk w;r fuf;la l,a ;u {d;shdf.a frda.S ;;a;j a h ksid mSvd ú¢ñka isá {d;Skg a o" Wjgeka l< Wmia:dhlhskg a o wjYH jk ld,hla olajd ta ,nd Èh hq;h = ' fujeks i;aldr fiajdjla b;d fyd¢ka ,nd§ug kï i;aldrl lKavdhu;a frda.h s d iy mjqf,a wh;a w;r wjxl ixjdohla isÿ úh hq;u = h' iqj l< fkdyels frda.S ;;a;j a hl miqjk frda.f s hl=g iy tu mjqf,a

86

October 2019

fï i|yd m%udKj;a ld,hla lem lsÍug isÿjk w;r ,xldfõ ms<l s d frda.h s l=g fujeks m%udKj;a ld,hla iu.ska wjxl idlÉPdjla úia;r oek.ekSu i|yd ,efnkafka oehs ;SrKh lsÍu mdGl Tn i;=h' iyk i;aldrhg jeä nrla fkd;enQ wfma rfÜ frda.k S a ,xldfõ ms<l s d frda.k S g a ,efnk iyk i;aldrh .ek jegySula ,nd .ekSug tla WodyrKhla muKla i|yka lsÍu iEfya hehs yefÕa' zzTreat the painZZ kï wka;¾cd;sl jd¾;djg wkqj j¾I 2012 iy 2013 w;r ld,fha § ,xldj ;=< ms<l s d ksid isÿù ;snQ urK .Kk 13"950 la jQ w;r HIV ffjri wdidok ksid jQ urK .Kk 100 ls' by; urKj,ska ms<l s d ksid isÿjQ tajdhska 80% o HIV ffjri wdidok ksid jQ urK j,ska 50%o isÿù ;snf q Ka Tjqkf a .a fõokdjka i|yka ksis m%;l s dr fkdue;sjh' fufia ñh .sh whf.a {d;Ska óg fyd¢ka idlaIs orkq we;' fuu frda.k S f a .a fõokdjka iukh lsÍug Èh hq;j = ;snQ wju fuda*k s a m%udKh lsf,da.E% ï 69 jqjo ,xldj ;=< taa ld,fha mdúÉÑ lr ;snf q Ka lsf,da .%Eï 16'8 lg jvd fnfyúka wvq m%udKhls' fujeks lk.dgqodhl brKula tu frda.k S g a w;aùu .ek fi!LH ld¾h uKav, muKla fkdj iuia; m%cdju j.lsj hq;h = ' fyg oji iqnhs kuq;a wkd.;h .ek hï ;rulg fyda iqn fmr ksñ;s my< ù we;' iyk i;aldrh .ek ffjoHjreka" fyÈhka fukau wfkla fi!LH ld¾huKav, oekqj;a lsÍfï l%uj;a jevms<f s j<la oeka bÈßm;a ù ;sfí' tneúka ,dxlSh ms<l s d frda.k S g a fmr fukaa mSvdjka ú£ug isÿ fkdjkq we;' DM

DOCTOR MAGAZINE

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D•Magazine /

Health benefits of Red rice úoHd;aulj y÷kd.;a r;= ndiau;S iyf,a .=K

úoHd;aulj y÷kd.;a CIC Fragrant ndiau;S iyf,a .=K

rd.u YslaIK frdayf,a ffjoH ckl fm%au;s,l úisks

r;= ydf,a hlv jeä jYfhka wvx.= fõ' hlvh reêrfha r;= reêr ffi, ksIamdokhg bjy,a fjhs'

r;= yd, m%;sTlaisldrl .=Kfhka b;d by<hs

r;= ydf,a we;s fmdaIKSh fldgia .ek oeKqj;a fjuq

wfma rfÜ isÿ lrk ,o tla;rd wOHhkhlg wkqj wm wkqNjhg .kakd r;= yd,a j, b;d m%n, Tlaisldrl .=Khla mj;S' wm .kakd wdydr j,g of Tlaisldrl .=Khla wjYH jkafka wehs@ ffi,Sh jYfhka we;sjk mßydksh wfma isrer úúO f,v frda. j,g k;= lsÍug mdr lshhs' úfYaIfhkau fnda fkdjk frda. ms<sld wdÈhg fuh fya;= fõ fya;=fõ' fï ksid m%;sTlaisldrl wdydr wdrlaIl l%shdj,shl ksr; fjhs'

r;= yd, ;ka;=uh fldgia j,ska jvd;a fmdfydi;ah' fï ;ka;=uh fldgia fyj;a fl|s;s iys; wdydr j,ska wfma wdka;%sl l%shdldß;ajh hym;a fjhs' reêr.; fldf,iagfrda,a uÜgu my; fy<hs' reêrfha iSks hdukhla isÿ lrk ksid oshjeähd frda.Skago jvd;a iqÿiqh' tfiau ia:q,;djh md,kh lrkakg isák whgo fuu l=reÜg iys; iy,a j,ska wfmalaIs; m%;sM< ,nd.; yel'

oshjeähdjg iqÿiq by< .a,hsisñla w.hla we;s r;= ndiau;S iy,a fmdaIK .=Kfhka wkQk hhs fmdaIK úoHd{hka wújdofhka mji;s' ndiau;S iyf,a fmdaIKh

w

fma rfÜ jeä fofkla mqreÿ ù isákafka iqÿ ydf,a n;a lkakgh' tfukau r;= ydf,a n;a lEj;a jeäfhka fmd,sIA l< r;= ydf,a n;a lkakgh' fmd,sIA lrkjd lshkafka yd,a wegfha l=reÜg bj;a lsÍughs' l=reÜg bj;a lrk ,o iy,a fl;rï ckm%sh jQj;a fmdaIK.=Kh w;ska th ySkh' l=reÜg hhs wm bj;a lrkafka iy,a wegfha we;s jvd;au fmdaIKSh jQ fldgiah'

88

October 2019

DOCTOR MAGAZINE

doctormagazine.lk

.ek lsisÿ újdohla ke;' kuq;a iqÿ meye;s iy,a fjkqjg r;a meye;s iy,a jvd;a iqÿiq hhs mjikafka wehs@ we;af;kau r;= ndiau;sh tys iqÿ meye iy,g jvd fmdaIKfhka by< hhs mjikafka wehs@ úuish hq;a;ls'

yd,aa mEySfuka jk ydksh m¾fhaIK j,g wkQj yd,a mEySfuka úkdY jk fmdaIl w.hka fufiah' B3 ishhg 67 B1 ishhg 80 B6 ishhg 80 uex.kSia ishhg 60 fmdiamria ishhg 50 hlv ishhg 60

wfkla w;g ÿUQre iy,a wvq .a,hsisñl w.hla mj;ajd .ekSfï úfYAI yelshdjlska hqla;h' tajd wkqNjfhka reêrfha iSks uÜgu laIKslj jeäùula isÿ fkdjk ksid reêr iSks hdukhla iajNdjfhkau we;s fjhs'

fï wkQj wfma m%Odk wdydrh jk n; ieliSfïoS tys l=reÜg mdysñka iy,a wegh ms<sfh, lsÍu fmdaIKSh jYfhka wjevodhl isß;la nj meyeos,sh' jvd iqÿiq jkafka yels muK l=reÜg wdrlaId lr .ksñka iy,a wegh ilid .ekSuh' doctormagazine.lk

October 2019

DOCTOR MAGAZINE

89

D•Magazine /

úoHd;aulj y÷kd.;a r;= ndiau;S iyf,a .=K

Health benefits of Red rice

fmdaIKSh jYfhka b;d by< jeo.;alula we;s r;= ndiau;S yd, fï ish¿ wjYH;d iïmQ¾K lrk wo ojfia m%n, ;¾ckhlaj we;s fnda fkdjk frda. wjodkugo losu úl,am imhk wdydrhla nj lsj hq;=h'

Fragrant ndiau;S iy,a .=K wfkla w;g ÿUQre iy,a wvq .a,hsisñl w.hla mj;ajd .ekSfï úfYAI yelshdjlska hqla;h' tajd wkqNjfhka reêrfha iSks uÜgu laIKslj jeäùula isÿ fkdjk ksid reêr iSks hdukhla iajNdjfhkau we;s fjhs'

r;= iyf,a meyeh f.fkk wekaf;dihkska r;= iy,g tys meyeh ,efnkafka m%n, fi!LHiïmkak m%;sTlaisldrlhla fia ie<flk wekaf;dihkska ksidfjks' m%;sTlaisldrlhla jYfhka wekaf;dihkska .ekSfuka ,efnk wdrlaIl m%;sM< rdYshls' m%odysl ;;a;ajhka" wdid;añl;djhkaf. ka Tnj wE;a lrhs' ms<sld we;s ùug ;sfnk bvlvo fï ksid ÿria fjhs' YrSrfha ksiel nr md,khla we;s fjhs' 90

October 2019

mßjD;a;Sh l%shdj,sh iqir lrk uex.kSia r;= yd,a j, we;s ;j;a wdrlaIl ridhkhla jYfhka uex.kSia ye|skaúh yel' isref¾ mßjD;a;Sh l%shdj,sh iqir lsÍug fya;=jk fuu ridhkh fya;=fldg f.k reêr mSvkh hym;a w.hlg m;a lrñka yoj;g ys;e;s hdka;%Khla n, .ekafjhs' brejdroh jeks frda. j,g tfrysj l%shd lrhs'

le,aishï r;= iy,a j, we;s ;j;a LKschls le,aishï' le,aishï yd ue.akSishï l%shdldß;ajh Tfí wiaÓ iqjfi; wdrlaId lrhs' wd;rhsáia" Tiaáfhdafmdfrdaisia wdoS frda. we;s ùug ;sfnk bvlv wjqrd,k w;r o;a Yla;su;a lsÍugo WmldÍ fjhs'

fi,skshï fuys we;s fi,skshï ksid frda." wdidok we;sùug ;sfnk bvlv weysfrhs'

úYañ; reêr.; iSks hduk yelshdj r;= iy,a wkqNjfha ;j;a úfYAIs; jdishla jkafka ta ksid cS¾Kl l%shdj,sh fiñka isÿ ùuhs' thg fya;= jkafka fuys hyñka w;s ;ka;=uh mod¾:h' ldfndayhsfâ%g mßjD;a;Sfhka reêr.; iSks njg m;aùuo wvqfjka isÿ ùu ksid hym;a reêr iSks hdukhla ksielfhka we;s fjhs' r;= iyf,a wvq .a,hsisñla w.hla w;s ksid oshjeähdj md,khg iqÿiq hehs ffjoHjreka mjikafka fï fya;=j ksidh' DM

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D•Magazine /

Atopic dermatitis/ Atopic eczema ksoka.; p¾óh rla;h frda.hla yd ine|S wNsfhda. /ila

14, September 2019 Atopic eczema is much tougher on patients than people understand. It seriously impacts patients’ lives beneath the surface of the skin and can severely affect an individual’s health and overall wellbeing.

ksoka.; p¾óh rla;h frda.hla yd ine|S wNsfhda. /ila p¾óh rla;h hkq l=ulao@ p¾óh rla;h hkq ksoka.;" leiSu iys; ifï frda.hla jk w;r th <uqka ;=< nyq,j olakg ,enqKo ´kEu jhil flfkl=g we;s úh yels ;;a;ajhls' fuh zzooZZ iy zzwefgdmsla ooZZ f,io ye¢kafjk w;r l,ska jHjydr jQfha fniaksh¾ mqßf.da ^Besnier prurigo & f,isks' th p¾óh m%odyfha jvd;au iq,n wdldrhhs'

92

October 2019

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doctormagazine.lk

wmsp¾uh fkdfyd;a ifuys wdikak ia:rh

p¾u frda. úfYaI{ ffjoH wcs;a lkakka.r úisks iafÜ%gï fldakshu iafÜ%gï ¨isähu iafÜ%gï .%ekshqf,daiu

wefgdmsla v¾ueghsáia idudkHfhka we;sjkafka zwefgdmsla m%jK;djlaz we;s mqoa.,hska ;=<h' fuhska woyia lrkafka Tjqkag my; ioyka ;;A;ajhka ;=fkka ´kEu tlla fyda ish,a,u we;súh yels njhs¦ tajd kï" ² ksoka.; rla;h" ² weÿu iy ² mSkihs ^Allergic rhinitis&' fndfyda úg fuu ;;a;ajhka fouõmshka" mjqf,a orefjl= fyda ifydaor ifydaoßhla ;=< olakg ,efí' <orejka ;=< wefgdmsla v¾ueghsáia frda. úksYaph i|yd weÿu" oo fyda mSki ms<sn| mjq,a b;sydih úfYaIfhkau m%fhdackj;a fõ' doctormagazine.lk

iafÜ%gï iamhsfkdaiu iafÜ%gï nefif,a mdou mdr.uH mg,h p¾uh

wefgdmsla v¾ueghsáia yg.kafka cdk yd mdßißl idOl j, ixlS¾K wka;¾l%shd ksidh' fuys§ ÿ¾j, p¾óh iïndOl l%shdjka f.a ^Defects in skin barrier function & m%;sM,hla f,i inka iy fjk;a iam¾Yl úLdolhkaf.a iy ld,.=Kh" WIaK;ajh jeks mdßißl idOl j, widudkH Woa§mkhka iu u; jeä wjodkula we;s lrhs' wefgdmsla v¾ughsáia oelsh yelafla ljr iajrEmhlskao@ mqoa.,hka w;r wefgdmsla v¾ughsáia úúO iajrEmj,ska oelsh yel' jfrl m%odyhg ,laj wêl f,i r;= jQ;a" iuyr úfgl Èhr .,k iajrEmfhka hq;a j;=r ìì,s f,i;a fuu p¾u frda.h oelsh yel' fuf,i frda.h biau;= ùu jßka jr isÿjk w;r ta w;r ld,h ;=< ifuys idudkH iajNdjh fyda úh<s leiSu iys; r¨‍ ksoka.; ;;a;ajfhka mSvd ú§u isÿúh yel'

October 2019

DOCTOR MAGAZINE

93

D•Magazine /

ksoka.; p¾óh rla;h frda.hla yd ine|S wNsfhda. /ila

Atopic dermatitis/ Atopic eczema

wefgdamsla p¾uodyh we;s ùug fya;= yd bka we;sjk n,mEu fmd;= .e,ùu ÿ¾j, iï wdrlaIKh laIqøcSùka

wdid;añl;dldrl

m%;sYla;slrK widudkH;d fjk;a p¾u frda. j,g fya;= ùu

frda.fha iajNdjh fjkia lrk idOl wdidok" wfkl=;a p¾óh ;;a;ajhka" úúO wdf,amkhka" frda.shdf.a jhi wjqreÿ Tjqkaf.a jd¾.sl iïNjh yd wfkl=;a idOl ksid wefgdmsla v¾ughsáia j, iajrEmh fjkia úh yel' flfia fj;;a n,mEug ,lajQ mqoa.,hdf.a jhi wkqj YÍrfha wefgdmsla v¾ughsáia olakg ,efnk idudkH rgd lsysmhla ;sfí'

94

October 2019

mqoa.,hdf.a jhi wkqj YÍrfha wefgdmsla v¾ughsáia frda.fhys olakg ,efnk fjkialï <orejka ² jhi wjqreoaog wvq <orejkaf.a fndfyda úg wefgdmsla v¾ughsáia nyq,j jHdma; ù mj;S' iu fndfyda úg úh<s" ^iuyr úg fldrfmd;= iys;& fyda r;= meyefhka hqla; jk w;r ;shqKq <ore kshfmd;= j,ska we;sjQ

DOCTOR MAGAZINE

fndfyda úg wefgdmsla v¾ughsáia mdi,a wjÈfha§ iqj w;g jeä fjkila fmkajk w;r th fh!jk wjêfha§ iïmQ¾Kfhkau ke;sj hd yel'

doctormagazine.lk

l=vd iSÍï i,l=Kq iys;h' ² <orejkaf.a lïuq,a fndfyda úg wefgdmsla v¾ughsáia j,ska mSvd ú¢k m<uq ia:dkh fõ' ² <ore ikSmdrlaIl ;=jdj, f;;ukh r|jd ;nd .ekSu ksid tu m%foaY m%odyhg f.dÿre ùu wvqh' kuqÿ tu ;=jd j, È.= fõ,djla f;; b;sß jqjfyd;a u<" uq;% /§ mej;shfyd;a wfkla <orejkag fuka Tjqkgo ikSmdrlaIl ;=jd ksid we;sjk p¾óh m%odyhka we;súh yel' <ore wefgdmsla v¾ughsáia l=vd orejka iy fmr mdi,a hk orejka ² orejka tyd fuyd .uka lsÍug mgka .kakd úg" tafgdmsla v¾ughsáia frda.h YÍrfha iuyr ia:dk j,g iSud fõ' l=vd orejkaf.a leiSu b;d oeä ksid iu iSÍug ,laj Tjqka b;d wmyiq;djhg m;aj isákq oelsh yelsh' ² fuu jhia ldKavfha tafgdmsla v¾ughsáia úfYaIfhka ue‚la

doctormagazine.lk

lgqj" je<ñg" j<¨‍lr iy oKysi ikaê j, úia;drl ^msg;& ^extensor& m%foaY j,g fukau ,sx.sl wjhj j,go n,mdhs' ² orejd jhiska jeä j;au fuu rgdj tu ikaê j,u kefuk ia:dk ^creases& j,g n,mdk w;r iu fndfyda úg —,hslk˜ iajNdjhlg m;afõ' ^tkï ksrka;rfhka isÿjk iSÍï yd we;s,a,Su ksid ifuys úh,s >k iajNdjhla olakg ,efí'& ² kuqÿ iuyr orejka ;=<" tafgdmsla v¾ughsáia úia;drl ^extensor& rgdj f,iu miqld,Sk <ud ld,h olajdu mj;S' mdi,a jhfia orejka ² jeäysá orejkaf.a wefgdmsla v¾ughsáia rgdj jkafka th fndfyda úg je<ñg iy oKysi ikaê kefjk ia:dk j,g n,mEuhs' wfkl=;a wjodkug ,laúh yels m%foaY jkafka" weys msydgq" lka fm;s" fn,a, iy ysialn, jeks ia:dkhs ' ² Tjqkaf.a w;a," m;=, iy weÕsä j, ksr;=re

we;sjk j;=r ìì,s iajNdjh iys; p¾óh m%odyh fmdïfmd,slaia ^Pompholyx eczema& f,i yeÈkafõ' ² fndfyda orejka ;=< wefgdmsla v¾ueááia j, rjqï wdldr rgdjlao fmkakqï lrhs' fuh YÍrh mqrd úisÍ mj;sk l=vd ldis f,i olakg ,efí' fuu jgl=re úh<s" r;= me,a,ï leiSu we;s lrk w;r th È,Sr wdidok f,i jrojd jgyd .; yelsh' ² fndfyda úg wefgdmsla v¾ughsáia mdi,a wjÈfha§ iqj w;g jeä fjkila fmkajk w;r th fh!jk wjêfha§ iïmQ¾Kfhkau ke;sj hd yel' kuqÿ ifï ÿ¾j, p¾óh iïndOl l%shdjka ^Defects in skin barrier function & lsis úfgl;a idudkH ;;a;ajhg m;a fkdfõ' jeäysáhka ² wefgdmsla v¾ughsáia" jeäysáhkaf.a úúO wdldrj,ska fmkakqï lrhs' ² Tjqkaf.a fuu frda.h YÍrfha mD;=,j mj;sk jHdma; rgdjla we;s w;r frda.hg ,lajQ

October 2019

DOCTOR MAGAZINE

95

D•Magazine /

ksoka.; p¾óh rla;h frda.hla yd ine|S wNsfhda. /ila

Atopic dermatitis/ Atopic eczema

iu <uhskag jvd úh<s yd ,hslkuh iajNdjhla iys; fõ'

jeäysáhka ;=< wefgdmsla v¾ughsáia

² idudkHfhka jeäysáhkaf.a fuu p¾u m%odyh wLKavj mj;sk úfYaIs; jQ ia:dk j,g iSud ù we;s w;r fndfyda úg th w;a" weiamsydgq" kuHYS,S ia:dk" ;kmqvq fyda fï ish¨‍ m%foaYj,g iSud fõ'

wefgdmsla v¾ughsáia ioygu mj;skafkao@ wefgdmsla v¾ughsáia <uqkaf.ka ishhg 1520lg n,mdk kuq;a jeäysáhka w;r th nyq,j olakg fkd,efí' fuu p¾óh m%odyh ;ksju iqj fõo keoao hkak wkdjels lsj fkdyel'

² ksr;=re we;sjk iage*sf,dfldl,a wdidok ^Staphylococcal infections& lemS fmfka' ² wefgdmsla v¾ughsáia hkq jD;a;Sh úLdol p¾óh m%odyh ^Irritant contact dermatitis& i|yd m%Odk odhl idOlhls ' c,h" äg¾ckaÜ iy $fyda ødjl j,g ksrdjrKh jk w;a j,g fuh fndfyda úg n,mdhs' ² <uqka yd jeäysáhka w;r wefgdmsla v¾ughsáia ;sîu iam¾Y wid;añl p¾óh m%odyh neyer fkdlrhs' ² w;a yd iïnkaO jeäysá wefgdmslaia v¾uááia ifï >k nj iy úh,s iajNdjh we;s lrk w;r iuyr ìì,s f,io u;=úh yel'

ixfõ§ iu Ôú; ld,h mqrdu mj;skq we;' frda. hg ,lajQjka 110"000 lg jeä m%udKhla we;=,;a fugd úYaf,aIKhlska fy<s jQfha wefgdmsla

lik iajNdjh fuysoS ,dlaIKslh

96

October 2019

DOCTOR MAGAZINE

doctormagazine.lk

v¾ughsáia we;s <uqkaf. ka 20] lg jir 8 lg miqj;a l%shdldÍj mj;sk frda. ;;a;ajh mj;akd njhs' wjqreÿ 20 lg miqj;a 5] lg;a jvd wvq msßilg wLKavj frda.h ;sìh yel' jhi wjqreÿ 2 g fmr fuu frda. ;;a;ajh yg.;a orejkag jvd <ud úfha§ fyda kj fhdjqka úfha§ frda.h yg.;a <uhskag th wLkavj mej;Sfï yelshdj jeäh' udi y;rlg fmr <orefjl=g wefgdmsla v¾ueghsáia frda.hg f.dÿre ùu widudkH fohla jk kuq;a óg fmr Tjqka <ore fifnda¾fydahsla v¾ueghsáia fyj;a iafkay .%kaÓ wdY%s; m%odyh fyda fjk;a p¾óh m%odyhka j,ska j,ska mSvd ú¢kakg mq¿jk'

fol;a y;r;a w;r oreKq jk kuq;a th idudkHfhka miqj iqj w;g jeä ÈhqKq jk w;r fh!jk wjÈfha§ th iïmQ¾Kfhkau bj;aj hd yel' f.dú;ek" fldKavd fudaia;r oeóu" .Dyia: yd ld¾ñl msßisÿ lsÍï" .Dyia: rdcldß iy frda.S /ljrKh jeks we;eï jD;a;Ska u.ska iu úúO úLdolhka iy fkdfhl=;a wdid;añl ldrlhkag ksrdjrKh fõ' fuh wefgdmsla v¾ughsáia W.% lrhs' jD;a;Sh úl,am i,ld ne,Sfï§ fuh u;lfha ;nd .ekSu kqjKg yqreh - tneúka th miqj fjkia lsÍug jvd wdrïNfha isgu jvd;a iqÿiq /lshdjla f;dard .ekSu iqÿiqh' wefgdmsla v¾ueghsáia i|yd m%;sldr wefgdmsla v¾ughsáia m%;sldr i|yd udi .Kkdjla fyda iuyr úg jir .Kkdjla wjYH úh yelsh'

frda.fha lsishï jHdma; ùula

jhi wkQj wefgdmsla v¾ueghsáia yefok yeá wefgdmsla v¾ueghsáia wdrïNh idudkHfhka jhi wjqreÿ follg fmr jqjo th m<uq jrg jeäysá mqoa.,hska ;=< jqjo fmkakqï l< yelsh' wefgdmsla v¾ughsáia fndfyda úg jhi wjqreÿ

doctormagazine.lk

October 2019

DOCTOR MAGAZINE

97

D•Magazine /

ksoka.; p¾óh rla;h frda.hla yd ine|S wNsfhda. /ila

Atopic dermatitis/ Atopic eczema

jhia ldKav wkQj wefgdamsla v¾ughsáia we;sjk ia:dk

frda.Ska iEu úgu ms,smeÈh hq;= lreKq ² yels iEu ;eklu fma%rl idOlj,g ksrdjrKh ùu wvq lsÍu ² ks;sm;d bfud,shkaÜ ^fudhsiaprhsi¾& .e,aùu ² w;rueÈ idkaø iafgfrdhsâ wdf,amkh iuyr wjia:d j,§" my; i|yka wdf,amkhka m%;sldr j,g we;=<;a úh yelsh( ² Calcineurin inhibitors - pimecrolimus fyda tacrolimus ndysr wdf,amk ² Crisabarole ointments ² m%;sÔjl T!IO ² m%;sysiageñk ² wdf,dal lsrK Ñls;aidj ² uqL fldaáfldiafgfrdhsâ

98

October 2019

DOCTOR MAGAZINE

È.=ld,Sk yd m%;sfrdaë m%odyhka i|yd m%;sYla;slrk moaO;s u¾Ok ldrlhka iuÕ m%;sldr l< yelsh' ² Methotrexate ² Ciclosporin ² Azathioprine Ôj úoHd idhksl T!IO ² Dupilumab

doctormagazine.lk

fojk jd¾Isl f,dal p¾óh rla;h Èkfha" m%Odk wruqKq ² p¾óh rla;h iuÕ Ôj;a jk ck;djf.a Ôú; jeä ÈhqKq lsÍu i|yd jQ fjkila i|yd f.da,Sh jHdmdrhla f.dvke.Su msKsi úúO wxY iy nyqcd;sl m%cdjka n,.ekaùu'

fuf,i j¾Kfha úmÍ; ùula jqj we;súh yelshs

Skin Sri Lanka mKsúvh f,dal p¾óh rla;h Èkh - 2019 iema;eïn¾ 14 ñksiqkaf.a idudkH f;areï .ekSug jvd frda.sfhl=f.a p¾óh rla;h m%n,h' th iu u;=msgg háka jQ frda.Skaf.a Ôjk .ukg fukau mqoa.,fhl=f.a fi!LHhg yd iuia; hy meje;aug oeä f,i n,mdhs' ;jo" p¾óh rla;h fjk;a fi!LH .eg¿ .Kkdjl flakaøhhs' th iEu úgu mdfya Ôú;h iSud lrhs¦ udkisl fi!LHhg n,mEï lrhs¦ fjk;a frda. j¾Okh ùug u. mdohs' p¾óh rla;h ms,sn|j frda.Ska oekqj;a lsÍu iy Tjqka i|yd /ljrKh ie,iSu fuu Èkfha uQ,sl yrh fõ' f,dj mqrd isák frda.S lKavdhï iuÕ tlg jev lrñka" wms p¾óh rla;h frda.Skag /ljrKhla jkq msKsi tlg ke.S isáuq' 2019 iema;eïn¾ 14 jk Èk fojk f,dal p¾óh rla;h ÈkhZZ f,i iksgqyka jk w;r" wms jißka jir wmf.a ixúOd;aul Wmfoia ,nd §u iy w;aoelSï fnod.ekSu È.gu lrf.k hkafkuq' fï jif¾§ f;audj jYfhka" iu u;=msgg p¾óh rla;hg háka jQ frda.sfhl=f.a Ôú;hg iy tys n,mEï foig yeÍ n,uq'

doctormagazine.lk

² frda.Skaf.a Ôjk ;;a;ajh flfrys fuu frda.h n,mdk wdldrh ms<sn| wjfndaOh jeä lsÍfuka zzp¾óh rla;h hk ud;Dldj foig idudkH ck;dj iïnkaO lr .ekSu' ² fmdÿ m‚úv iy øjH imhd §ï u.ska frda.Ska ioyd l%shd;aul" lKavdhï iún, .ekaùu' ² p¾óh rla;h frda.Skag iy Tjqkaf.a /ln,d .kakkag iydh iy ksis f.!rjh ,nd§u' DM

October 2019

DOCTOR MAGAZINE

99

D•Magazine /

Aesthetic & Cosmetic Centre

by Ninewells yu /,s jeàu iy t,a,d jeàu Tng m%Yakhlao@

osúh mqrd ;=reKq iula yu /,s jeàu iy t,a,d jeàu Tng m%Yakhlao@ ifï ;=reKq fmKqu /l.kakg Tn l,afõ,d we;sj m%;sldr j,g fhduq ùfuka we;sjk m%;sM,h jeähs Laser Resurfacing Laser Skin Tightening Thread Lifting p¾u frda. úYI{ ffjoH f;acd oSrisxy MBBS, MD (Dermatology) Felloship in Aesthetic & Regenerative Dermatology, USA

w

m jhig hk úg l%ufhka wfma iu /,s jeàug mgka .kshs' tu fjkialï uqyqfKa iy fn,af,a jeämqr fmfkkakg .;a úg wm ÿlg m;afõ' ;j ld,hla m%;sldr w;ayeßfhd;a wm iu t,a,d jeàu msg;ska fmfkkakg;a mgka .kS' tu fjkialï uqyqfKa yd fn,af,a jeämqr fmfkkakg .kS' Tn tu fjkialï oel ÿla fjkjdo@ fjki ord .; fkdyelsj <; fjkjdo@ ÿla ù ,;fjkjdg jvd kùk ffjoH úoHdfjka Tng msysg ,nd.; yelshs' úfYaI{ p¾u frda. fjoHjrekaf.a wkque;sh u; l< yels fndfyda kùk m%;sldr oeka Tng wfma rfܧu ,nd.; yelshs' f,ai¾ ßi¾*siska (Laser Resurfacing) f,ai¾ Skins Tightening (Laser Skin Tightening) f;%â ,s*aáka (Thread Lifting)

100

October 2019

DOCTOR MAGAZINE

doctormagazine.lk

hk fulS m%;sldr l%u uqyqfKa iu /,s jeàu iy iu t,a,d jeàu wvq lsÍug we;s kùk p¾u ffjoH m%;sldr fõ'

fmfkkakg .;a miq m%;sldr lrk úg ,efnk m%;sM, j,g jvd jeä m%;s,dNhla wjqreÿ 25-30 § isg tu m%;sldr fj; fhduqùfuka Tng ,nd.; yel' Tfí ;reK fmkqu /l .ekSu fï wkqj m%Yakhla fkdjkq we;'

tu m%;sldr .ekSug iqÿiq jhila ;sfío@ by; m%;l s dr iqÿiq jhi ;=< .ekSu b;du jeo.;a fõ' wmf.a iu ;=< fld,ecka ksmoùu yd w¨‍;a ùu wvqùu wjqreÿ 25-30la miqjk úg mgka .ksh's iu /,s jeàu" t,a,d jeàu fmfkkakg mgka .kS' tu ksid by; m%;l s dr i|yd wjqreÿ 25-30 miq jQ úg l%udkql, + j kshu ld, mr;rhla we;sj f,ai¾ m%;l s dr yd Thread Lifting m%;l s dr uqyK q g ,nd. ekSfuka Tfí iu ifï ;reK fmkqu /l .ekSu Tng m%Yk a hla fkdjkq we;'

iu jhig hk úg hk úg olskakg ,efnk fjkialï fudkjd o@ ifï f;,a .%kaÓ j, újr" isÿre jeämqr úYd, ù fmfkkakg .kS' >Klu jeä fjhs' isyska /<s u;= fõ' iu t,a,d úàu jeä jeäfhka fmfkkakg .kS'

jhia.; jQ miq" jhia.; ùu ifuka u;= ù

doctormagazine.lk

by; fjkialï isÿ jkafka wehs@ ifï ;o .;sh" ;reK nj r|d mj;skafka tys ;sfnk fld,ecka ;ka;= j, Yla;su;a nj m%udKh yd me;sÍu u;hs' jhig hdu;a iuÕ wfma ifï fld,ecka ksmoùu wvq fjhs' tneúka iu /,s jeàu yd iu t,a,d jeàug fya;= fjhs' by; i|yka m%;sldr j,ska isÿ jkafka l=ulao@ Laser Refreshing iy Thread Lifting j,ska isÿ lrkqfha Wvq iug lsisÿ ydkshla isÿ fkdlrñka há yfï fld,ecka ;ka;= w¨‍;ska ksmoùu W;af;ackh lsÍuhs' fld,ecka ;ka;= ksIamdokh jeä lsÍug iqÿiq miqìula yá yu ;=< we;s fld,cka ;ka;= w;r we;s lsÍuhs' tuÕska udi ;=kla yhla w;r ld,hla mqrd kj fld,ecka ksmojd iu Yla;su;a lsÍug Woõ fõ' Thread Lifting j,§ ,efnk m%;sM, ;j;a jeähs'

October 2019

DOCTOR MAGAZINE

101

D•Magazine /

yu /,s jeàu iy t,a,d jeàu Tng m%Yakhlao@

Aesthetic & Cosmetic Centre by Ninewells

f,ai¾ ßi¾*siska

tu.ska iu t,a,d jeàu je<elaùuo isÿfjhs' há iu ;=< fld< fld,cka ;ka;= w;r /£ isáñka wjqreÿ 2-3la mqrd kj fld,eck ksmoùug Woõ fõ' ifï ;reK fmKqu §¾> ld,hla r|jd .ekSug Woõ fõ'

by; m%;sldr w;=re wdndO we;s lrhso@ fuu m%;sldr j,ska miq Tng w;=re wdndO we;s fkdjk ;rïh' tu ksid wkjYH ìhla we;s lr.; hq;= ke;' tu m%;sldr isÿ l< ú.i jqjo Tng tÈfkod idudkH jev lghq;=j, fhÈh yelshs' miqÈku jqjo iqmqreÿ mßÈ /lshdjg hd yelshs' wõ wdjrK wdf,am Ndú;fhka ysre t<sfhka wdrlaId ùfuka ,efnk m%;sM, jeä ld,hla r|jd .; yels jkq we;'

102

October 2019

f,ai¾ u.ska iu jer.ekaùu

rEm,djKH ms<sn| úfYaI úfoaY mqyqKqj ,;a p¾u frda. úfYaI{ ffjoHjreka hgf;a ,xldfõ§u by; m%;sldr ,nd.ekSug fhduqùfuka Tn jeh lrk uqo, yd ld,h lsisfia;au wmf;a hdula isÿ fkdfõ' kshñ; m%ñ;shlska f;drj Tn ,nd.kakd úúO rEm,djKH l%u wkq.ukh lsÍug hdfuka ifï jHqyhg jk ydksh Tng oel.; yelafla wjqreÿ lsysmhla .;ùfuka miqjh' tneúka m%ñ;shlska f;dr wkq.ukh fkdlr ifï ;=reKq fmKqu wjqreÿ 10lska muK ;reK f,i mj;ajd .ekSug bjy,a jk by; i|yka f,ai¾ m%;sldr (Laser Therapy)" f;%â ,s*aáka (Thread Lifting)" hk Wiia m%ñ;sfhka hqla; rEm,djKH j,ska flfrk fufyh w;suy;ah' Aesthetic & Cosmetic Centre by Ninewells u.ska Tfí ieÕjqKQ w,xldrh Tma kxjñka úYajdikSh;ajhlska hqla;j Tfí rEm fYdaNdj mßmQ¾K;ajhlg f.k tkakg''' kjH jQ fmKQulska Tfí osúh wre;anr lr.kakg Tng wk.s wjia:djla Wod lrhs' DM

DOCTOR MAGAZINE

jeä úia;r i|yd wu;kak

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

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D•Magazine /

Renal Health jl=.vq ke;sj wmg cSj;a fjkak nE''' jl=.vq j,ska wmg we;s M< m%fhdack .ek oeKQj;a fjuq

jl=.vq iqrlsuq-osú iqrlsuq jl=.vq ke;sj wmg cSj;a fjkak nE''' jl=.vq j,ska wmg we;s M< m%fhdack .ek oeKQj;a fjuq

r;akmqr uy frdayf,a jl=.vq frda. úfYaI{ ffjoH cd,sh ;skakwdrÉÑ úisks

cSj;a jkakg wjYHfhkau jeo.;a jk wjhj

w

mg cSj;a fjkak wjYHfhkau jeo.;a jk (Vital Organs) b÷rka lsysmhla YÍrfha ;sfnkjd' tajd ke;sj fudfyd;la j;a wms lsisu flfkl=g cSj;a fjkak nE' fuhska tlla ;uhs yoj;' yoj; Wmf;a isgu fkdlvjdu iamkaokh fjkjd' hï fudfyd;l yoj; .eiau k;r fjkjdo@ ta iefklska wfma wjidkh;a <Õd fjkjd' wlaudj;a fmKy¿;a ta jf.hs' yqiau .kak fmKy¿ j, l%shdldß;ajh yßu ;SrKd;aulhs' hq., bkaøshhla jk jl=.vq;a osú .eg .y.kak ke;sju nE' fï wjYHfhkau l%shd;aul úh hq;= b÷rkayS iqjfi; flfklaf.a cSú;hg yßu jeo.;a' fïj ish,a, kshñ; mßos l%shd;aul fjkj kï fï tl tlla .ek wuq;=fjka fydhd n,kak wmg wjYH jkafk kE' ta;a m%Yakh ;sfhkafk tajd fodaI iy.; jk úg tajd iqrlskakg oeKQu wjYHhs' t;fldg ;uhs wvq jeä jYfhka yß fïjd yels muKska .eg .yf.k cSú;h osla lr.kak wjia:djla ie,fikafka' fï osú .eg .y.kak yßhgu l%shd;aul úh hq;= bkaøsh weiqf¾ wm fujr l,dmfha mgka jl=.vq iïnkaOfhka úfYAI l;dnyl ksr; fjkjd' thg

104

October 2019

DOCTOR MAGAZINE

iqúfYaIS jQ fya;=jla ;sfhkjd' Tn;a okakd mßos zzjl=.vq frda.hZZ lshk frda.hla .ek wfma rfÜ fndfydau .eUqßka l;dny fjkjd' jl=.vq j,g úfYAI biamsß;d, l,ska ;snqfK kE' ta;a" oeka tfyu jl=.vq biamsß;d,;a yefokjd' jl=.vq idhk lsh, úfYAI idhk;a jl=.vq tall j, yer fjk;a ;eka j, ;snqfk kE' oeka jl=.vq idhk;a wfma rfÜ iq,nj l%shd;aul fjkjd' jl=.vq mÍlaIK ks;ru frday,a j, isÿ flfrkjd' ckdêm;s;=ud;a jl=.vq frda.Ska .ek úfYAIfhka ie<ls<su;a fjkjd'

doctormagazine.lk

ckdêm;s ld¾hd,h ;sfhkafk rfÜ md,khg Wmfoia fokak' ta;a ckdêm;s ld¾hdf,;a jl=.vq j,g fjku tallhla l%shd;aul fjkjd' fï ldrKd;a tlal b;du meyeos,s fjk fohla ;sfnkjd' wfma rg oeka jl=.vq frda. wjodkul bkakjd' ta ksidfjkau rch" fi!LH wxY jf.au uyck;dj;a fï .ek úfYaI Wkkaÿjlska l%shd lrkjd' jl=.vq frda. .ek fï ;sfhk Wkkaÿj fï rfÜ

doctormagazine.lk

jl=.vq frda. je<elaùu lshk taldhk wruqK fjkqfjka l%shd;aul fjkakla' wm y÷kdf.k ;sfhk wdldrhg jl=.vq frda. ;¾ckfhka ñfokakg kï wmg fï zzjl=.vq frda. hZZ .ek yß wjfndaOhla ;sìh hq;=hs' fï jl=.vq wdrlaId lr.kakg ;sfnk ;¾ck .ek wms oeKQj;a úh hq;=hs' thska j<lskakg .; hq;= l%shdud¾. .ek;a wmg wjfndaOhla ;sìh hq;=hs' túghs fï wk;=ßka ñfokak Wmdhud¾. .ekSug wmg yels jkafka' fu;eka mgka iEu uilu wm ta wruqK fjkqfjka lem fjkjd' wfma fldhs ldg;a fï wk;=r y÷kd .kakg" fï wk;=ßka ñfokakg wejeis oeKQu wm ,nd fokjd' wm ldreKslj b,a,d isákjd" mdGl Nj;=kaf.ka" wm;a iu. tlaj fï oeKQu" fï wjfndaOh ,ndf.k Tn;a ksfrda.s fjkak' Tn okakd lshk whg;a fï iqmqj; lshdoS Tjqkag;a ta ksfrda.S nfjys mKsúvh ,nd fokak'

October 2019

DOCTOR MAGAZINE

105

D•Magazine /

Renal Health

jl=.vq ke;sj wmg cSj;a fjkak nE''' jl=.vq j,ska wmg we;s M< m%fhdack .ek oeKQj;a fjuq

wmøjH uq;%d f,i uq;%dYfha /ia fjhs

isref¾ we;s reêrh jl=.vq j,g tl;= fjhs jl=.vq uq;%d kd, msßisÿ jQ reêrh kej; isrer mqrd mßjykhg tla fjhs

uq;%dYh

reêrh msßisÿ ù wmøjH bj;a fjhs

jl=.vq j,ska bgq flfrk fufyh ñksia isref¾ we;s bkaøsh w;ßka wmg ke;sju neß bkaøshhla jkafka jl=.vq hq.,hhs' jl=.vq wmg fl;rï kï jeo.;a jkjdo lsh;fyd;a jl=.vqj,ska flfrk ld¾h wvmK jqfKd;a th wm f.a Ôú;h wkdrlaIs; lsÍug ksiel fya;=jla jkafkah' wo wfma rgg buy;a wNsfhda.hlaj we;s" wfma ck;djg buy;a wk;=rlaj we;s zzjl=.vq m%YakhZZ .ek wms oekqj;a fjuq' jl=.vq j,ska wmg ,efnk m%fhdack • wmg jl=.vq hq.,hla ;sfnkjd' uQ,sl jYfhka wmf.a nys>%dùh wmøjH bj;a lsÍug fï jl=.vq hq.,h l%shd;aul fjkjd' • wmf.a YÍrfha ;r,uh iu;=,s;;djh mj;ajdf.k hdu;a isÿ flfrkafka jl=.vq j,ska' • reêrh ;=< mj;akd whk idkaøKh iu;=,s;j mj;ajd .ekSu;a jl=.vqj,ska flfrk ;j;a ld¾hhla

106

October 2019

DOCTOR MAGAZINE

• wfma YÍrh úúO mßjD;a;Sh l%shdj,s fya;=fjka ie,lsh hq;= wï, m%udKhla YÍrfhka YÍrfha ksIamdokh fjkjd' fufia ksmofjk wï, WodiSk njg m;ajkafka;a jl=. vq l%shdldß;ajh fya;=fjka' • fydafudakh ld¾hhl=;a jl=.vq j,ska isoaO flfrkjd' úfYAIfhka r;= reêrdKQ ksIamdokh lsÍug fya;=jk tß;%dfmdhsáka fydafudakh ksmoùug jl=.vq odhl;ajhla

doctormagazine.lk

msßisÿ reêrh wmøjH iys; reêrh Nephron jDlal

uq;%d f,i wmú;% oE uq;%dYfha ;ekam;a fjhs

Glomerulu .=ÉÑld Tubule kd,sld

jl=.vqjlska f,a msßisÿ lrkafka fufyuhs

imhkjd' jl=.vq frda.h W;aikak ù wjidk wÈhf¾§ fï fydafudakh ksIamdokho wekysákjd' túg r;= reêrdKQ ksmoùu weKysákjd' msáka tkak;a mjd ,nd §ug isoaO fjkjd' wiaÓ fi!LHiïmkakj ;nd.ekSug WmldÍ jk fydafudak iy reêr mSvkh kshdukh lrk fydafudak ksmoùu jl=.vq j, ;j;a m%uqL ld¾hhla'

doctormagazine.lk

jl=.vq ydkshg m;aùu j¾. lsÍu jl=.vq ydkshg m;aùu m%Odk wdldr follska j¾. lsÍu isoaO fjkjd' 1' ;djld,slj jl=.vq ydkshg m;aùu 2' iaÓr jYfhka isÿjk jl=.vqj wl¾uKH ùu ;djld,slj j, isÿjk jl=.vq wl¾uKH;djh i¾mhka oIag oIaG lsÍu oIag lsÍfuka" úI YÍr.; ùu" we;eï fnfy;a j¾. wêl ud;%d j,ska YÍr.; ùu" ó WK je<£u wd§ úúO fya;= ksid flfklaf.a jl=.vq ;djld,slj wl¾uKH jkakg mq¿jka' wêl f,i jukh fyda nvt<sh hdu jeks fya;= u; YÍrh wêl f,i úc,kh ùfukao YÍrhg úIîc we;=¿ ùfuka we;sjk fimaisia (Sepsis) ;;a;ajh u.skao ;djld,slj jl=.vq wl¾ukH úh yelshs'

October 2019

DOCTOR MAGAZINE

107

D•Magazine /

jl=.vq ke;sj wmg cSj;a fjkak nE''' jl=.vq j,ska wmg we;s M< m%fhdack .ek oeKQj;a fjuq

Renal Health

02 01

05

msßisÿ lsÍug kshñ; reêrh jl=.vq j,g meñfKhs'

jl=.vq j, we;s ishqï jDlaldKq u.ska f,a msßisÿ lrhs' úIøjH yd wmøjH uq;%d f,i tl;= fjhs'

msßisÿ jQ reêrh jl=.vq j,ska mßjykh msKsi bj;a fjhs'

03

04

f,a msßisÿ lsÍfuka miq jl=.vqfõ we;s jHqyd Tiafia uq;%d tla/ia ùu isÿfjhs'

uq;%d uq;%d kd, Tiafia uq;%dYhg tla/ia fjhs'

óg wu;rj uq;%d kd, j, fyda uq;%dYfha we;sjk wjysr ùï (Obstruction& ksido ;djld,slj jl=.vq wl¾ukH úh yelshs' l,d;=rlska wjia:djl§ fufia we;sjk jl=.vq wl¾uKH ùu §¾>ld,Sk jl=.vq wdndOhla olajd j¾Okh ùug wjia:dj we;suq;a uq;a ;djld,slj isÿjk jl=.vq wl¾uKH ùu fndfydaúg kej;;a m%lD;su;a lrkakg yelshdjla ;sfnkjd' fuys§ jl=.vq wl¾uKH ùug n,mdk fya;=j ksje/Èj y÷kdf.k ksis m%;sldr ,nd§fuka kej;;a jl=.vq h:d ;;a;ajhg m;a lr.kakg mq¿jks' fï frda.Skag;a f,a msßiqÿ lsÍu úks m%;sldr ^;djld,slj& lrkakg isÿ jk wjia:do ;sfnkjd' frda.Ska iqjm;a jk;=re idhk j,§ miq úmrulao isoaO lrkjd' §¾>ld,Skj jl=.vq wl¾uKH ùu jl=.vqjl jHqyd;aul fyda l%shdldß;ajfha fjkila udi ;=klg jeä ld,hla mej;=kfyd;a th oS¾>ld,Sk jl=.vq wl¾ukH ùUla fia ie<flkjd' idudkHfhka f,dal ck.ykfhka ishhg 7-10 ;a w;r m%udKhlf.a jl=.vq wdY%s;j frda.

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doctormagazine.lk

;;a;ajhka mj;sk njg oek.kakg ;sfnkjd' wdhq wfmalaIdj jeä jk úg jl=.vq frda.Ska jeä ùu iajdNdúlhs' fuu oS¾>ld,Sk jl=.vq wl¾ukH ùï j,ska ;=fkka follg jvd fya;= jkafka oshjeähdj yd wêreêr mSvkhhs' jl=.vq ÿ¾j, ùug n,mdk uQ,sl frda. lsysmhla ;sfnkjd' ta w;ßka Èhjeähdj m%Odkhs' wfma rfÜ ck.yKfhka ishhg ishhg 8'5l ixLHdjla Èhjeähdfjka fmf<k whhs' reêr.; iSks uÜgu fyd|ska md,khg ,la jqfKa ke;akï jir 10la muK hk úg jl=.vq j, ÿ¾j,;d we;s ùfï wjodkula ;sfnkjd'

Èhjeähdj" wê reêr mSvkh jl=.vq frda. j,g w; jkk frda.' óg ld,hlg fmr wfma rfÜ ck;djg uqyqK fokakg isÿ jqfKa fnda fjk frda. j,g' ta;a miq.sh oYl lsysmh ;=< wfma rfÜ fnda fjk frda. fjkqjg jeks fnda fkdjk frda. úYd, jYfhka jeä ùula olakg ,enqKd' fnda fkdjk frda. ldKavhg Èhjeähdj" wêl reêr mSvkh" ms<sld" yDo frda. wdÈh ye¢kaúh yelshs' Èhjeähdj jl=.vq frda. j,g uQ,sl fya;=jla' jl=.vq frda. j,oS we;sjk frda. ,laIK fudkjdo@ idudkHfhka jl=.vq frda. uq,sl wjia:dfõ§ frda. ,laIK fkdfmkajk w;r we;eï úg frda. ,laIK u;=jkafka frda.h b;du W;aikak jQ úgh' tuksid jl=.vq frda. je<£fï wjodku we;s mqoa.,hska l,ska l,g reêrh iy uq;%d mÍlaIK lr.; hq;=h' jl=.vq frda. j, we;eï ,laIK jkafka' 1' wêl reêr mSvkh' 2' uqyqK ^úfYaIfhka weia jgd& iy fomdj, j<¨‍lr wjg bÈóu' 3' uq;%d msg lrk úg wêl f,i fmK we;sùu' 4' uq;%d iu. reêrh msgùu' 5' rd;%S ld,fha mjd ks;ru uq;%d msglsÍug wjYH ùu' 6' uq;%d msg lsÍu wmyiq ùu iy uq;%d wvq m%udKhla msgùu' 7' wdydr wreÑh"jukh iy f;fyÜgqj' 8' y;sh' 9' wêl f,i iu leiSu' doctormagazine.lk

jl=.vq frda. je<£fï wjodku we;af;a ldgo@ Èhjeähdj iy wêl reêr mSvkh we;s frda.Skag jl=.vq frda. je<£fï wjodku jeäh' Bg wu;rj mjqf,a {d;sfhl=g jl=.vq frda. hla ;sfí kï wka whg jl=.vq frda. je<£fï wjodku jeäh' ;jo y÷kdfkd.;a jl=.vq frda.h mj;sk m%foaY j, mqoa.,hkag jl=.vq frda. je<£fï wjodku wo ojfia wfma rfÜ jeäfhkau l;d nyg ,la jkafka W;=re kef.kysr m%foaYj, mj;sk zzfya;=jla y÷kd fkd.;a jl=.vq frda.hZZ kue;s ;;a;ajh .ekhs' (Chronic Kidney Disease of Unknown Etiology) ta;a" Bg;a jvd jeä jYfhka ishhg yegla muK frda.Ska jd¾;d jkafka Èhjeähdj" reêr mSvkh fya;=fjka jl=. vq krla ùfï ;;a;ajhg uqyqK mE frda.Skah' fuu fnda fkdjk frda. ixl+,;d mdol lr.;a jl=.vq frda.Ska ,xldfõ iEu m<d;lu olskakg ,efnkjd' we;af;kau fï ;;a;ajh oeka ,xldfõ jix.;hla fia me;sr hk nj;a lshkakg mq¿jka' DM

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Dissociative Disorders .ul ldka;djka kegjQ N+;dfõYh

.ul ldka;djka kegjQ N+;dfõYh hd;sldj n,kak weú;a isá ldka;djka lÜgçhdf.a fnr mohg kgkak mgka .;a;d''''

o

l=Kq,l tla;rd ksjilg ks;r ks;r lror tkakg úh' ta ksidu Tjqyq Bg úi÷ï fidhkakg jQy' foajd, .dfka hdu" Ndrydr ùu" fkdfmkk n,fõ. msgqmi Èùu fudjqkag w¨‍;a fohla fkdùh' ta w;r" hï whl= ud¾.fhka tla;rd lÜgähl= fudjqkag y÷kd .ekSug yels úh' fudyqf. ka fyda hula lr.; yels hehs is;+ Tjqyq tu lÜgähd f.kajd Ydka;s l¾uhla lsÍug ;SrKh lr.;ay' bkamiq Tyq le|jd wjYH nvqndysrdÈh ,Eia;s lrf.k Ydka;sl¾uh iQodkï flß‚' Ydka;sl¾ufha Èkh Wod úh' Wofhau meñ‚ fuu lÜgähd ;u iydhlhska o iu.

Ydka;sl¾uh i|yd wjYH oE iQodkï lf<ah' wjYH ;gq" mkaoï wdÈh ilia lr rd;%sh jkúg hd.h wdrïN flß‚' Tyq uka;r lshñka" cm lrñka" kgñka Ydka;sl¾uh WKqiqï flß‚' fnr Yíoh;a uka;r Yíoh;a uqiqù wuq;=u jgmsgdjla .fuys Èiaúh' fuf,i t<sjk ;=re Ydka;sl¾uh lr ksjfia Wmøj ÿreù we;s nj mjid weÿrd bj;aj .sfhah' Tyqf.a C%shdldrlï uyd n,iïmkak nj .u mqrd me;sr .sfha ,eõ .skakla fuks' oßø;djfhka fmf<k wfkl=;a ñksiqkago fuu lÜgähdf.a fiajh wjYH jkakg úh' lÜgähdg ire ld,hls' fndfyda ksfjiaj,g meñK Ydka;sl¾u lrfok fuka fndfydafokd fudyqf.ka b,aÆy' tys§ tla;rd ksjilg meñK Ydka;s l¾uhla lsÍug lÜgähd Ndr.;af;ah' Tyq iydhlhska o iu. meñK Ydka;sl¾uh wdrïN flß‚' ksjfia fodaIhla fjkqfjka isÿl< fuu Ydka;sl¾uh w;r;=r§ tla;rd úYauhckl

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Y%S ,xld iajdmkfõoSkaff.a ix.ufha iNdm;s ufkda Ñls;ail ffjoH mS tka úoHdl=,m;s fohla isÿjkakg úh' ksjfia isá oykj yeúßÈ is;drd tlajru .efykakg mgka .;a;dh' tu .eiau tkak tkaku jeä úh' n,d isá ish¨‍ fokdf.au wjOdkho f;dú,hg jvd fhduq jQfha is;drd foigh' is;drdf.a .eiau iy ysfia meoa§u wvq jk mdgla ke;' ta wi,g meñ‚ lÜgähd úiska wehf.a ysig w; ;nd ke.sg ;ud foig meñfKk foig úOdk ÿ‚' .eiafik isreßka hq;= is;drd o fndfydau wudrefjka ke.sg lÜgähd foig meñ‚hdh' zzWfò weÕg lõo jy,d bkafka@ lÜgähd weiqfõh' kuq;a is;drdf.ka ms<s;=rla fkdùh' ;ju;a is;drd ta fï w; meoafoñka .efyhs' zWUg;a mq¿jka ud;a tlal kgkak lshñka is;drd o iu.ska lÜgähd kgkakg úh' uyd mqÿuhlsæ fuf;la

doctormagazine.lk

zfudllao fï fjkafk' fyd|g wdmq .Ekqkag fudk hfllao fï jeyqfK@

l,la lsis÷ .egÆjlska f;drj Ôj;a jQ is;drd o lÜgähd iu. kgkakg jQjdh' ta jkúg .fï ñksiqka fndfyda fofkla o Ydka;sl¾uh ne,Sug tu m%foaYhg meñK isáhy' ta w;ßka ;j;a ;re‚hla o áflka ál .efykakg mgka .;a;dh' n,d isákjqkag fuh uy;a m%Yakhla úh' fõ,dj rd;%S fod<yg wdikakh' fuu ;re‚hf.a o .eiau ke;sjk mdgla kï ke;' ta wi,g meñ‚ lÜgähd tu ;re‚hf.a ysig o w; ;nñka rÕ uv,g le|jd wehgo ;ud iu. kgk f,i úOdk ÿ‚' tu ;re‚h o fnr Yíoh wkqj ñksiqka bÈßfha kgkakg jQjdh' fuf,i .;jQfha iq¿ fudfyd;ls' ;j;a ldka;djka lSmfofkl=gu tu .eiau we;s úh' iuyre N+;dfõIfhka T¿j ta fï w; lrlj;s' ;j;a ldka;djka w;afol Tijd ;udf.a bfkkau jghg lerfla' ;j;a ldka;djla i¾mhska .uka lrkakdla fuka ìu Èf.a nv.dhs' ta w;r isá fjk;a whla fkdokakd NdIdjla l;d lrñka úldrfhka oÕ,ñka lÜgähd miqmi .uka lrkakg úh' fuf,i ixLHdj ldka;djka wglg oyhlg wdikak úh' lÜgähd úiska fudjqkaf.a ysig w; ;nñka ;ud iu. rÕ uvf,a keàug wdrdOkd l< w;r fndfyda ldka;djka Tyq iu. kgkakg úh' n,d isákjqkag iy tu ldka;djkaf.a mjqf,a Woúhg isÿjqK isÿùï is;d.kakg mjd neßúh'

doctormagazine.lk

ñksiaiq ta fï w; l;d lrkakg jQy' we;euqka nfhka ìrdka; ù isÿjqK foa weismsh fkdfy<d n,disáfhdah' mehla yudrla ;siafia Tjqka lÜgçhd úiska ;u ;ukaf.a YÍrj,ska tu n,fõ. bj;a jk f,i mjid úOdk ÿ‚' tu úOdkh;a iu. ldka;djkaf.a kegqï l%u l%ufhka wvq úh' kuq;a ldka;djka lSmfofkl=f.a kegqu ;ju;a mej;sK' tu ldka;djka fj; meñ‚ lÜgçhd tu ldka;djkaf.a flia jeáfhka w,a,df.k zoeka f;dmsg jeyqK Wka m,h,a,d' lshñka Tjqkag fmd,au,a lsks;a;lska myr § we;euqkag oe,ajQ mkaoula <xlr zfï YÍr

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.ul ldka;djka kegjQ N+;dfõYh

Dissociative Disorders

w;yer m,h,a,d' ke;akï ux mqÉpkjd' lshñka Tjqkag mkaou <x lf<ah' áflka ál ldka;djkaf.a N+;dfõIhka Tjqkaf.a YÍr w;yer oud bj;aj hk njla fmksK' kuq;a we;euqkag isysh meñ‚ho ;ju;a kshu isysl,amkdjla ke;s ;rïh' kuq;a ;;a;ajh iqj w;g yefrk ksid Tjqkaf.a Ndrlrefjda Tjqka /f.k ksfjia n,d msg;a jQy' fuf,i Ydka;s l¾uh wjika lr lÜgçhd yd iydhlhska tu ksjiska msg;a ù .shy' miqod Wodúh' fmrÈk rd;%sfha N+;dfõIhg m;a we;eï ldka;djkag fydakaÿudkaÿ .;shla we;súh' ksÈu;hs" weia werf.k bkak wudrehs" Tjqyq mejiQy' fudk ;rï W;aidy l<;a kskaou hhs' we;euqkag weia mshd.;a úg ;uka fkdoekqj;aju T¿j lrlefõ' tla wfhla ;ju;a N+;dfõIh ;sfnk f,i úldr lshñka wy, my<g nekjÈñka yeisfrkq fmfka' fuu ;;a;ajh bj;a lr.ekSug jydu by; lÜgçhdu /f.k tkakg .ïuqka ;SrKh lf<dah' fï neõ .fï wfhl= f.dia lÜgçhdg mejiQ miq Tyqf.a woyi jQfha fï .ug n,mdkakd jQ woDIHudk n,fõ.hla fï .fuys mj;sk njhs' zug fïl bj;a lrkak mq¿jka' Th jf.a jevo

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October 2019

uu lr, ;sfhkafka" hkqfjka ;ukaf.a Wcdrej mejiQ lÜgçhd iydhlhska iu. kej; tu .ug meñ‚fhah' Tyq iómhg by; Èkfha Ydka;sl¾uh w;r;=r N+;hska jeiqKq ldka;djka ish¨‍ fokdu /f.k tk ,§' Tyq úiska kej;;a tu ldka;djka uyd ojdf,au kgjkakg úh' fuh wdrxÑ jQ wi, .ïj, Woúh o jev rdcldß mfil ouñka fuu wreu mqÿu isoaêh oeln,d .ekSug tu m%foaYh fj; wefokakg úh' tf,i ldka;djka ish¨‍ fokdu kgjñka Tjqkaf.a ysig w; ;nñka Tjqkaf.a YÍrj,ska N+; n,fõ.h bj;a lrkakg lÜgçhd fjfyfikakg úh' kuq;a t;k§ o iqj jQfha lSmfofklag mu‚' wfkla ldka;djkaf.a keàï k;r fkdùh' fuys§ o lÜgçhd Tjqkag ;dvk mSvk lrñka Tjqkaf.a YÍrhg mkaou <xlr mqÉpkjd f,i ìh lrñka Tjqkag myr foñka Tjqkaf.a YÍrfha isák wukqiaihska bj;a lrkakg fjfyiq‚' kuq;a m%;sM,h t;rï id¾:l fkdùh' lÜgähdf.a u;h jQfha tu iqj fkdjQ ldka;djkaf.a YÍrj, isák N+;hska oreKq wukqiaihska njhs' Tjqka bj;a lrkakg kï óg jvd f,dl= Ydka;sl¾uhla l< hq;= nj;a ke;akï fuu ldka;djkag th bÈßhg m%Yakhla jk nj;a h' fuf,i iq¿ iykhla ,nd§ Tjqkag ;SrKhla .kakd f,i mjid lÜgçhd kslau .sfhah' ienE f;dú,h .fï we;sjqfKa ñka miqjh' lÜgçhd bj;aj .sho ldka;djkaf.a keàu jßka jr we;s úh' fuf,i l%u l%ufhka we;s jQ keá,a, jeä ù lÜgçhd ke;sj o ysi lrljkakg" úldr lrñka kgkakg" úldr lshjkakg mgka .;af;dah' lÜgçhd o jßka jr meñK fkdfhla foa isÿl< o fkdak,df.a keàu wvqjla ke;' neßu ;ek fuu fkdak,d ál .fï mkai, fj; le|jdf.k hkakg .ïuqka ;SrKh lf<dah' tf,i .;a ;SrKh wkqj Tjqka mkai, lrd f.k .sfhdah' mkaif,a§ keàu k;r úh' ;kslr uq¿ .uu fï jkúg wuq fidfydkla ù yudrh' orejkag mdi,a hdug úÈhla ke;' msßñkag jevg hdug úÈhla ke;' we;eïyq nfha ìrdka; ù isá;s' fkdfhla fokd fkdfhla u; mji;s' .uu ;kslr wmdhls' flfia fyda mkaif,a§ fyda fudjqkaf.a keàu k;r jQ nj is;d yduqÿrejkaf.a o leue;a; wkqj fudjqka ksfjia lrd msg;a lr heúK' uyd mqÿuhls' mkaif,a§ f.aÜgqfjka fudjqka t<shg hkjd;a iu.u kej; N+;dfõIh meñkq‚' we;eïyq kg;s' we;eïyq T¿j lrlj;s' we;eïyq úldr lshj;s' fmr isá ;;a;ajhgu Tjqyq fjkia jQy' l< yels fohla fkdue;s ksid kej; mkai, fj;u fudjqka /f.k tkq ,eìK' mkai,g we;=¿

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doctormagazine.lk

jkjd;a iu.u fudjqkaf.a tu n,fõ.h bj;aj hkakg úh' fuf,i lSmjrla mkaif,ka t<shg hEug ;e;a l< fndfyda wjia:dj,§ mkaif,a f.aÜgqfjka t<shg hkjd;a iu.u fudjqkaf.a isrerg n,fõ.h we;=¿ úh' fuh ñksiqkag is;d .; fkdyels ;;a;ajhla úh' fï w;r" fuu ;;a;ajh ckudOH Tiafiao rgmqrd me;sr .sfhah tu .fï isá nqoê a u;a .=rejrhl=f.a woyi óg fjkia úh' zfïlg Th úldr lr, jevla keye' ´lg ffjoHjrfhlaf.ka úi÷ï ,nd.ksu'q hhs Tyqf.a u;h úh' ta wkqj fuh úi£u i|yd úÿ, wê ufkdaúoHd m¾fhaIK ix.ufha j;auka iNdm;s ffjoH mS'tka' úoHdl=,m;s uy;df.ka fï i|yd iykhla .ekSug Tjqyq ;SrKh l<y' Tjqkaf.a oekqïj;a ùu u; úÿ, wê ufkdaúoHd m¾​f‌haIK ix.ufha idudðlhska o uydpd¾h mdf;a.u [d‚iair ysñhka o iu. úoHdl=,m;s tu .eg¨‍j we;s jQ .ug <Õd úh' ta jkúg yekaoEfõ yhyudr y; muK ù we;' fudjqka uq,skau .uka lf<a mkai, fj;h' ta jkúg mkaif,a fndfyda ckldhla jgù we;' .fï ñksiqka f.dia lÜgçhd o mkai, fj; le|jd .fï ñksiqkaf.a wdfõ.h u; lÜgçhdg .=á neg fokakg o .fï ñksiaiq fm<UqKy' .fï we;eï ñksiqka" mdf;a.u [d‚iair ysñ iy úoHdl=,m;s uy;df.a;a ueÈy;a ùfuka lÜgçhdg ysßyerhla fkdlr fírd hjd isÿùu ms<sn|j fyd¢ka ish¨‍ ;;= úuikakg úh' úoHdl=,m;s uy;d;a mdf;a.u [d‚iair yduqÿrefjda;a .eg¨‍j ksrdlrKh lsÍu wdrïN l<y' m<uqj N+;dfõIhg ,laj isá ldka;djka úoHdl=,m;s uy;d úiska fjk fjku f.k lreKq wid Tjqkaj fudayk ksødjg meñ‚hy' ffjoHjrhd úiska Tjqkaf.a isrerg tu N+;dfõIh meñfKk f,i mejiSu;a iu. fmr mßÈu Tjqyq kgkakg jQy' we;eïyq úldrfhka lshjkakg jQy' we;eïyq oÕ,kakg jQy' zTng fuu we;s jQ ;;a;ajh i;H f,iu w;aN+; whl= we;=¿ùu ksid yg.;a ;;a;ajhla fkdfõ' fuh Tfí há ysf;a ;snqKq úYajdi iy lÜgçhdf.a úOdk u; Tnf.a is;a ;=< we;s jQ ;;a;ajhla muKhs' hkqfjka úoHdl=,m;s uy;d mjid tu ufkda Ndjh Tnf.a is;aj,ska fï fudfydf;a isgu bj;a jk nj;a h<s;a lsisu Èfkl we;s fkdjk nj;a mjid fudayk ksødfjka wjÈ flre‚'

doctormagazine.lk

bka miqjo ál Èkla hkf;la fudjqka i|yd udkisl wNHdi ,nd§ Tjqkaf.a uki iqjm;a lf<ah' uydpd¾h mdf;a.u [d‚iair ysñ úiska ñkamiq nqÿ oyu wkqj Ôj;a jk f,ig;a ñ;Hd úYajdij,ska bj;a jk f,ig;a wjjdo flßK'

fuhska miqj fkdak,dg jeiS ;snQ N+;dfõI kej; yg.;af;a ke;' fuu isÿùu ms<sn|j ffjoH úoHdl=,m;s uy;d úiska fuf,i myod ÿkafkah' we;a;gu fuu ;;a;ajh w;aN+; n,fõ.hla fkdfõ' fuh Dissociative Disorders f,i ke;fyd;a ysiaàßhd f,i y÷kajk ;;a;ajhla' tu ;;a;ajh .u mqrd me;sÍu Mass Hysteria f,i y÷kajkak mq¿jka' wjqreÿ oyihla jhie;s lsisÿ oekqula fkdue;s lÜgçhd úiska lrmq lmá l%shdj,ska th jeäjqKd Tn l< hq;af;a fujeks l%shdj,g yiq fkdù nqoaêfhka jev lsÍuhs' fujeks fohla ÿgqjfyd;a ufkda ffjoHjrhl=" ufkda úoHd{hl=" ufkda Ñls;ailhl=f.a iydh me;Su wksjd¾hh' DM

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

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wdhq¾fõoh jiafodia kik" wd;=rhka iqjm;a lrjk foys lems,a,

jiafodia kik" wd;=rhka iqjm;a lrjk

wNspdr yd ffjoH l%u iïnkaO m¾fhaIl rejka .urd<f.a

foys lems,a,

tu l%uj,g tl, kd.ßl iudch ;=<o lsishï ;ekla ysñ jqKd'

we

´x Tõjdhska .e,fjkav ;ud b;sx foys lemSu" weia jy msÉÖu wd§ Ydka;sl¾u l,t<s niskafka' tajdhska Th weiajy" lgjy yÈ yQkshïj,ska fíÍug yels jqKd wfma .eñhdg'''

ia fol''' we;a;gu weia lshkafka uyd mqÿudldr wúhla' lg lshkafk;a uyd Nhxldr fome;a;u lefmk wúhla' fï wú folskau msßmqka ñksia l=,fha wms fï wú folu wfudardf.k ikakoaO ù ;uhs yeuúg bkak osú f.jkafka'

ta;a yefudaug fï weia j,skqhs" lfgkqhs kshu m%fhdack .kak;a nE''' ta;a wfma .x ;=,dk j, kx fï weia j,skqhs" lfgkqhs m%fhdack .ksmq wh wkka;j;a bkakjd' Th zzweia jy lgjyZZ lshkafka wdx talgfk' iuyrekag .yl f.ähla oelal;a we;s' w;= msáka ;ud lvx jefgkafka' iuyre lg fyf,õfjd;a we;s " w.;shlauhs fjkafka''' fïjdhska w;añÈ,d wfma Ôjk .uk fydÈka hkak ;ud wfma .eñfhda biair b|kau tl tl wmQre l%u j,g yqre jqfka'' Th foys lems,a,;a wdx ta jf.a wmQre jevla' ´x" weiajy''' lgjy fyda wf~dajeähd fodaI .ek fndfyda fokl=g we;af;a ìhlafka' zz.f,ka .eyqfjd;a fífrkak mq¿jka" weiaj,ska .eyqfjd;a fífrkak nE'''ZZ lshk oñ< lshukg wkqj tys nrm;<lu fldf;lao hkak y÷kd.; yelsfka' flfia kuq;a weiajy" lgjy fodaIhkag ;uka f.dÿre fõh''' hkak;a" ;u ÈhqKqjg wkqka wl=,a fy<kafkah''' hkak;a fndfyda ÿrg we;euqka ;=< we;s u;s ukd;a;rhla' fuu fodaIhkag ms<shïo .eñ iudcfha u ;shkj wr ux lsõdjfya'''

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foys lemSu fyda weiajy msÉÖu u.ska mqoa.,hl=f. ka t,a, jk wys;lr lsrK u¾Okh ù ys;lr lsrK j¾Okh jkafka hehs úYajdihla mj;skjd' tys§ hym; wfmalaIdj jk w;r úkhka" nkaOk fõ kï tajdo ¥ßx ÿÍN+; lsÍfï n,hla fï ;=< we;ehs úYajdi lrkjd' ta ksid weiajy msÉÖu lrkjd' weiajy mqÉpkak wjYH jk øjH;a fjku ;sfhkjd fmd,algq" wn" .ïñßia" Ækq" ;=xux ykaÈfh mia" ñÿf,a mia" foysfld<" f.a w;=.dmq l=Kq" ;ukaf.a we÷ïj, kQ,a oud weiajy lgjy fodaI ÿre lrk nj hleÿrka lshkjd'

doctormagazine.lk

foys lemSug f;dard.; hq;af;a bÿKq fyda meiqKq foys fkdj zmeÕsß foys fyj;a foys .eghs' foys lemSu .ek lshoa§ tl keÜfÜ foys lemSu olakg ,efnkjd' Th ;shkd m%n, wk úK fldä úk i|yd tl keÜfÜ foys f.ä ;=kla lmkjd' fuys§ m<uqj wd;=rhdg hï nkaOkhla isÿfldg we;aoehs iel yer oek.; hq;=hs' fuu l%shdj ksñ;s n,kjd hehs y÷kajkjd' tys§ hï fodaIhla we;aoehs úksYaph lsÍug yelsh' oekq;a wfma wh ksñ;s n,kjd' úoHdkQl+,j .;a l<o isref¾ ;sfnk fodia weo .ekSfï mqÿudldr n,hla foys f.ähl ;shkjd'

foys lmk wia:dfõ§;a" Bg wod< iaf;da;%hla lshd foys lemSfuka Ydka;sh Wodfjk njo hleÿrkaf.a úYajdihhs' foys úIîc kdYl .=Kfhka by<hs ;=kafodia ksjkak" weiajy lgjy fodaI iukh lrkak foys lemSfuka yelshdj mj;sk njg .eñhka w;f¾ úYajdihla ;sfhkjd' fï ta .ek i|yka mqrdK l;dkaorhla biair ldf,a isá Tâäis kf¾kaøhdf.a w. ìijqka jykafiag l< Ydka;sl¾uhla .ek i|yka fjkjd' Bg foys f.kdfõ kd. f,dalfhka nj lshefjkjd' foys lmk úg wd;=rhdf.a w.=K lemqfKa kï tu foys j;=rg oeuQ úg hg .sf,kjd' Èh u; mdfjkafka kE' ysfia isg mdodka;h olajd iaf;da;% uka;% uquqKñka foys lmkjd'

msßiqÿ lsÍfï .=Kh" ls<s fkdje§fï n,h yd úIîc kdYl .=Kh w;ska .;a;;a foys iqúfYaIhs' foysj, .=ma; n,hla ;sfhk nj mqrdK ld,fha isgu tk ms<s.ekSula wd;=rhl=f.a fodia iukh lrkak foys lmkjd kï tal úfYaI .srhlskau l< hq;=hs lsh,dhs lshkafka' ksjerÈj foys lemqfjd;a iefKlska m%;sM, ,nd .kak mq¿jka hehs úYajdihlao ;sfhkjd' ta;a ta m%ia;=; YÍria:dkh ndysr lsis flkl=g oek .kakg bv fkd;eîu b;d jeo.;a'

túg ;=kafodia weúiafikjd lshd u;hlao ;shkjd bka woyia lrkafka ke;s f,v we;sfõh hkakhs' u;=rd ly kQ,a oeóu" Wfoa f.org ÿï w,a,d wn" ñßia msÉÖu wogo isÿ lrkjd' foajd, j,g f.dia fmd,a .eiSu ñßia weUÍuo wog;a oelsh yelsh' hï whl=g úk fodaIhla we;akï ,S mqgqjl flfi,a fld<hla w;=rd nq,;a fld< kjhla iy mqjla u,a f.k th y;/ ia fldgqjla f,i msysgk fia w;=rkq ,nkjd' miqj u,amyka" y÷kal+re o,ajd ly j;=frka fidaod m~qre 9la ;ekam;a lrkjd' ly j;=frka fia¥ foys .eg 21 la fmr lS mqgqj u; ;ekam;a fldg ;sirK iys; mkais,a iudokaj kj wryd§ .d:dj 9 jrla .dhkd fldg" uka;%hla u;=rñka foys lemSu l< hq;=h lsh,dhs lshkafka'ææ fuu.ska wd;=rhd fyj;a frda.shd iqjm;a jkq we;ehs úYajdi lrkjd'ææ foys lemSu i|yd f;dar.; hq;= foysf.ä ixLHdj iy foysj, iajrEmho b;d jeo.;aæ' foys f.ä y;la ^7&" oyy;rla ^14&" úis tlla ^21& jeks zyf;a .=Kdldr ixLHdjla Bg fhdod .kakjd' tfy;a .Dy wdrlaIdjla fyda N+ñ wdrlaIdjla i|yd fufia ixLHdjla ;SrKh l< fkdyelafla hï fodaIhla mj;S kï th wjika jk ;=reu foys lemSu isÿ l< hq;= ksidhs'

doctormagazine.lk

foys lemSfï Ydka;sl¾uh yßhg lf<d;a l<duhs' fkdtfia kï th .Õg bks lemqjdla fuks l=vd orejkag iy .¾NŒ ud;djkag foys lemSï fkdl< hq;= w;r Ydia;%h fkdoek lrkakka jdf,a foys lmkak .sfhd;a fodia iukh ùu flfia fj;;a isoaO fjkafka ;jÿrg;a fodia W.% ùu njo

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jiafodia kik" wd;=rhka iqjm;a lrjk foys lems,a,

wdhq¾fõoh

fkdlshd nE' talfka lshkafka oek .sfhd;a l;r.u" kef;d;a w;ru. lshd fuhg wu;rj foys hd. Ydka;sh isÿ lrk úg lmk foys ueá fldrylg oeñh hq;= lsh,hs mqrdK kS;sh' th isÿ lrkafka úfYaI fya;=jla ksidhs' foysj,g weo .kak isref¾ fodaIhka c,hg Èhj hEu Bg fya;=jhs' bkamiq foys nE iys; c, fldry .,df.k hk Èh myrlg o oeñh hq;=uhs' oekakx foys lems,sj,§ fndfyda jxpkslhska wysxil ñksiqka uq,d lrkjd' foys lmd wk úK fldäúK iïmQ¾Kfhka keish fkdyels jqj;a bka úYd, .=Khla ,eìh yelshs' th udkisl tald.%;djhgo msájy,la' fodaI ÿre lrkak;a foys lemSu hym;a' foys lemSu fN!;slj fukau ufkda Ñls;aidjla yeáhg;a hym;a lsh,dhs ie,flkafkaææ foys lemSu w;Sf;a bokau fy<hska f,iska wmg yqremqreÿ fohla' ta ksid ;ud wfma rfÜ iEu m%foaYhlu jdf.a zfoys álla lmd.kak flfkla ysáfha' tal;a wfma wdÈ fy<hdf.a fjo id;a;rfhau fldgila' fndfyda úg mkaif,a iajdóka jykafia <Õg f.dia zmsß;a álla lshjd .kakd ;rugu zfoys álla lmd .kakgo f.dvla wfma .eñhka isß;la f,iskau lrkjd' foys lemSu .=ma; úoHdfõ kï b;du ir, l%uhla' we;eï wjia:d j, foys fjkqjg fjk;a wdfoaYl;a fhdod .kakjd' iEu fodaIhlau foys f.ä j,ska lmd wjika l< fkdyelsshs' bj;a l< yels fodia i|yd foys fhdod .kakd w;r Bg jvd jeä n,hla ,nd §u i|yd zhls kdrxZ fyj;a zhla kdrxZ o fhdod .ekSu isÿlrkjd' ;j;a wjia:djl wyq f.ä;a" ldrKdj Bg;a jvd n,j;a kï w¿ mqyq,a lemSuo isÿlrkag wfma jeäysá oekque;af;da miqng Wfka kE' wyqf.ä lemSu kx wmyiq fohlA' Bg fya;=j wyqf.ä fidhd .ekSug we;s wmyiqj iy tu f.ä Wofha fk,q úg ijia jk úg zl=KqZ ùuhsæ' foys lemSfï§ foys f.äh .srhl r|jd tu .srh YÍrfha iam¾Y jk fia f.k hd hq;=hs' foys lemSfï§ ysi uqÿk isg fom;=< olajd th f.k hd hq;= w;r foys lemSfï§ we;eï wjia:d j, ish¨‍ foys tljr Ôjï fldg .kakd w;r we;eï wjia:dj, foys f.äfhka f.äh Ôjï lrkjd' foys lemSfï§ úúO uka;% ;shkjdææ' wjia:dkql+,j tajd fhdod.kakjdææ

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tfiau zls,sz f.j,aj, ^u<f.j,a" fldgy¨‍ jeks& .sh miqj kej; ksfjig meñfKk úg ly iu. foys f.ähla YÍrfha w;=,a,d iakdkh lsÍfuka zls,sZ myjk nj wfma .eñfhda lSfõ lg lykjg fkdfõ''' i;H f,iskau .;a l< úoHd;aulj foys t;rïu úIîc kdYl .=Khla iys; wjqiohla ksid' b;ska fï foys lshkafk;a" foys lemSu lshkafka;a wkdosu;a ld,hla boka wfma ixialD;shla tlal wfma fy< fjolu;a tlal mEysÉp fohla''' fïjdhska ieneúkau wfma .eñhd" ;uqkaf.a ffoksl Ôúf;a we;s ÿla lïlfgd¨‍ wld uld .;a;dæ tajdhska ieneúkau we;s jQfha Ñ;a; Yla;sh j¾Okh ùulaææ tau.ska orejka 10la 15 la yodf.k wfma wd§ uq;=ka ñ;a;ka iemj;a jQ;a" ireidr jQ;a" uyd wdvïnrldr Ôú;hla f.õjd' wdorh" lreKdj" ffu;%Sh ta yoj;a j, me,emÈhï jqKd wo wms tlsfkldg ffjr lrñka" oafõY lrñka" m¾pia 5g 10g fldgqfjñka" ;dmam ;kñka" hdkjdyk tl;=lrñka" nexl= .sKqï ;rlrñka wjidkfha hkafka fldydg oehs ys;d .kaj;a neß wldrhg fï foaj,ska wE;afj,d'

wdhq rlaLka;= wdjvdææ úfYaI ia;=;sh iqfk;a .d,a,f.a uy;dg DM

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iufm; weiqf¾ iqjfi;''' wiaÓ Èrdhdu j,ld,k 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

,iaik ðú;hlg Wreulï lshk wms ld,h f.ù h;au jhig hkjd' jhi;a iu.

YÍrfha we;=,dka; l%shdj,ska fjkia ùu" f.ù hdu wer´u fldhs fudfyd;l fyda mgka .kakjd' fõokdj - tu fjki fmkajk frda. ,laIKhla úh yelshs' doctormagazine.lk

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wiaÓ Èrdhdu j,ld,k fydañfhdam;s m%;sldr

Homeopathy Medicine

Tiaáfhdafmdfrdaisia woshr

ffjoH;=uks wiaÓ Èrdhdu ^Tiaáfhdafmdfrdaisia&f,i y÷kajkafka l=ulao@ wiaÓj, >k;ajh wvqùfuka we;sjk frda.S ;;a;ajhla' fuhg wms —Tiaáfhda fmdfrdaisia˜lshkjd' fï jpkh ieÈ,d lshkafka Tiaáfhda iy fmdfrdisia lshk jpk fol tl;= ùfuka' .%Sl NdIdjg wkqj Tiaáfhda lshkafka wiaÓ" fmdria lshkafka isÿre we;sùu tfyu ke;akï laIh ùu lshk tlhs' wiaÓ Èrdhdu we;sjkafka fldfyduo@ wfma wiaÓ moaO;sfha wiaÓ wdrlaIdj fukau iúu;a Ndjhg wjYH úgñka" Lksc ,jK rdYshla ;sfhkjd' fm%daàka jHqyhla we;=f,a ,jK rdYshla tl;= ùfuka ,jK j¾. ;=kla ielfikjd' tajd wms le,aishï" fmdiamria yd ue.akSishï f,i y÷kajkjd' tajf.au úgñka D" úgñka K" iskala yd fmdgeishï hk wfkl=;a ,jK j¾.o mj;skjd' Tiaáfhdafmdfrdaisia frda. fha§ isÿfjkafka fï lshk fm%daàka Lksc ,jK hk foj¾.fhkau m%udKh wvqùuhs' fuhg fya;= idOl f,i wfma wiaÓ 118

October 2019

ksfrda.S wiaÓh

Tiaáfhdafmdfrdaisia

Tiaáfhdafmkshd

;on, f,i wdmodjg m;a wiaÓh

moaO;sfha we;sjk frda. ksid wiaÓ moaO;sh ÿ¾j, ùug wfma m%;sYla;slrK moaO;shg fnfyúka n,mEula we;s lrkjd' th ;j meyeÈ,s lf<d;a m%;sYla;slrK moaO;sh ÿ¾j, ùu wiaÓ moaO;Skaf.a wdrlaIs;" iúu;a jHqyh f,i l%shdlrk fm%daàk ,jK jHqyh ìo jeàu Osteoclast lshk ffi, j¾.h biau;= ù wiaÓ mgl ffi, úkdY lsÍu isÿre we;sùu isÿfjkjd' fuh m%Odk jYfhka m%;sYla;sh ÿ¾j, ùu ksid we;sjk ;;a;ajhla' wiaÓ Èrdhdu we;s ùug n,mdk fya;= idOl fudkjdo@ ldka;djkaf.a YÍrfha Biagcka fydafudakh wvqùu ksid wiaÓ u; Lksc ,jK iy fm%daàka ;ekam;a ùu wvq ùu fuys§ isÿfjkjd' fuhg m%Odku fya;=j wd¾;jyrKhhs' ldka;djkaf.a wd¾;j yrKh isÿù jir 5-7 .;jqjdg miq ldka;djkaf.a wiaÓ j,ska 20] muK wysñ ùug bvlv jeähs' ;jo rd;%shg wêl oyäh oud rd;%shg jeä WKqiqula oekSu wiaÓ ÿ¾j,;djh fmkajk ,laIKhla jkjd'

DOCTOR MAGAZINE

doctormagazine.lk

² jhia .;ùuo m%Odk fya;=jla' fuu ;;ajh ia;%S mqreI fNaohlska f;drj fomsßigu we;s fjkjd' ² wka;rdi¾. .%kaÓ moaO;sfha we;sjk fjkialï ksid ;hsfrdhsâ .%kaÓfha ;hsfrdhsâ fyda¾fudakh wiu;=,s;;djh" wiaÓ laIh ùu" Èrdhdu" fõ.j;a lrkjd' ² msáhqgß .%kaÓfha wiu;=,s;;djh' ² wiaÓ moaO;sh ksishdldrj l%shd fkdlsÍu' ² fm%âksisf,daka" fymßka jeks T!IO È.= l,la ;siafia YÍr .; ùu' ² u;ameka" ÿïjeá Ndú;h' ² wfma wiaÓ j,g jeämqr le,aishï wjYH jk jhi wjqreÿ 10-18 ld,h ksis fmdaIKh fkd,eîu fya;=fldg wjqreÿ 17-18 jeks kj fhdjqka jhfia§ jf.au wjqreÿ wjqreÿ 25-30 jeks ;reK ldka;djkag úfYaI fya;=jla fkdue;sj wiaÓ Èrdhdug ,laùug m;aùu we;sùu' úúO jQ fya;= idOl ;j;a fndfyda mj;skjd' wiaÓ Èrdhdu j, frda. ,laIK ioyka lsÍula lf<d;a ² ;o fõokdjla we;s ùu' doctormagazine.lk

² wiaÓ bÈuqu' ² wiaÓ w;r Yíoh' ² oKysia wiaÓfha nl,a ùula" ² fldkafoa wiaÓh úYd, ùula" ² fldkafoa ;o fõokdjla yg .ekSu" ² l=ÿ ùula isÿùu" ² ke.sáfï§ Wiamy;a ùfï§ wiaÓj, ;o n, fõokdjla we;s fjkjd' ² fldkafoa fõokdj" Wi wvqùu" fldkao jl=gq ùu" myiqfjka iq¿ jeàul§ wiaÓ msmsÍu frda.fha ,l=Kqhs'

idudkH wiaÓh

Tiaáfhdafmdfrdaishdjg ,lajQ wia:sh

wdmodjg m;a wiaÓhl ldh jHÉfPaod;aul jHqyh

fydañfhdam;s m%;sldr u.ska wiaÓ Èrdhdu f.dvkxjkafka fldfyduo@ wef,dam;s fyj;a ngysr ffjoH l%ufha mshd jk ysfm%dl%áia úiska l%'s mq'900 fhdackd l, uq,O¾uhlg wkqj ;uhs fydañfhdam;s ffjoH l%uh f.dvkef.kafka' —frda.hg iudk m%;sldr u.ska frda.h iqjh˜lsishï frda.hla ksid yg.;a frda. ,laIK j,g wod,j fï úYajfhau thg iudk hula we;s nj;a th l%ufhka iqj ud;%djka YÍrhg ,nd §fuka wod< frda.h iqj lrkak mq¿jka nj Tyq ysfm%dl%áiaf.a kshu u; mÍlaIK u.ska ikd: lrd' ta;=<,ska iudk fohska iudk foa iqjm;a fõ' uq,O¾uh u; 1796 c¾uka cd;sl ieuqfj,a ydfkaudka ;=ud fydañfhdam;s ffjoH l%uh fuf,djg odhdo l<d'

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wiaÓ Èrdhdu j,ld,k fydañfhdam;s m%;sldr

Homeopathy Medicine

iqúfYaIs;ajh YÍrfha ÿ¾j, jQ m%;sYla;slrKh Woa§mkh lr f.dvkexùu fuu ffjoH l%ufha iqúfYaIs;ajh YÍrfha ÿ¾j, jQ m%;sYla;slrKh Woa§mkh lr f.dvke. ula isÿlsÍuhs' ta i|yd frda.shd fmkajk frda. ,laIK m%Odk ;ekla .kakjd' ta jf.au mßlaIKd;aul me;af;ka fidaÈis lsÍula isÿ lrkjd' ^Dexa Scan" Xray" Blood Test& fydañfhdam;s kshu u; frda.shd fmkajk frda. ,laIK j, iudk ksjerÈ fydañfhdam;s T!Iêh Yla;sh YÍr.; ùfï§ ÿ¾j, m%;sYla;sh iu. biau;= ù rc lrk Tiaáfhda fmdfrdaisia we;s lrk wiaÓ mgl úkdY lrk —Tiaáfhda la,diaܘ ffi, j¾.h my; fy,ñka m%;sYla;sh

fvlaid mßf,dalkh u.ska wiaÓ .k;ajh we.hSu

fï ksid Èrd.sh" f.ù.sh ffi, mgl kej; ks¾udKh ùu fï ;=<ska isÿfjkjd' m%;sYla;sh f.dvkexùu ;=< we;sjk fï ;;a;ajh l=uk jhil isáh;a fõokdj ke;sù" Èrdhdu j,ld fndfyda iqjhla f.k§ug fydañfhdam;s ffjoH m%;sldr l%uh iu;a fjkjd' w;=re wdndO lsis;a kE''' fydañfhdam;s T!IO ;=, w;=re wdndO fkdue;sj le,aishï" ue.akSishï" fmdgEishï yd úgñka j¾. jf.au YÍr iu;=,s; ;djhg wjYH T!IO ish,a, fuu ffjoH l%ufha§ fkdwvqj we;s w;r ksjerÈ T!Iëh m%;sldr u.ska m%;sYla;slrKh f.dvkxjñka laIh ù hk wiaÓ mgl ish,a, fndfyda ÿrg f.dvkxjñka Tiaáfhdafmdfrdaisia ;;a;ajfhka ñ§ ta jf.au wfkl=;a frda. j,skao ñÈ hym;a ðú;hla .; lsÍug yelshdj Tng fuu m%;sldr l%uh ;=<ska f.k fokq we;' DM

f.dvke.Su;a iu. wiaÓ mgl f.dvkxjk" wdrlaIs;" Yla;su;aNdjh f.kfok —Tiaáfhda í,dia˜ lshk fm%daàka ffi, kej; biau;= ùu f.k fokjd'

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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

011-2731695

0718250716$17 doctormagazine.lk

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wdhq¾fõoh wxYNd.h frda.Skag kej; Ôjh ,ndfok ÔjlhdfKda

wxYNd.h frda.Skag kej; Ôjh ,ndfok ÔjlhdfKda YÍrfha tla w¾Ohla wm%dKsl ù ñksiqkaf.a ffoksl Ôú;fha ls%hdldrlï j,lfkys,slï lrk wxYNd.h fyj;a mCI>d;h hk frda.hg Èfkka Èku f.dÿre jk msßi jeäfjñka mj;sk nj wmg fmkS hhs'

uykqjr" wxl=Uqf¾ ffjoHdpd¾h chka; nKavdr

f,dal ck.ykfhka jirlg ñ,shk 5la muK fuu frda.fhka ñh hk w;r" ;j;a ñ,shk 5 la muK fuu frda.hg f.dÿre ù mSvd ú¢;s' fuu wxYNd.h frda. hg f.dÿre ù b;d wirK f,i Ôú; .;lrk frda.k S a ksfrda.N s djhg m;alrk lkao Wvrg" wxl=Uqr m%foaYfha Ôj;ajk ffjoHdpd¾h chka; nKavdr fjo uy;d iuÕ wm fuu frda.h ms<sn| lreKq úuid ne,Sug is;=fjuq' ffjoHdpd¾h ;=uks" fudllao fï wxYNd.h frda.h lshkafka@ mGú" wdfmda" f;afcda" jdhq" wdldY hk mxp uyd N+;hkaf.ka wm ñksia isrer ieliS we;' jd" ms;a" fiï hk ;s%fodaIfha we;sjk wiu;=,s;;djh ksid

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wxYNd.h frda.Skag kej; Ôjh ,ndfok ÔjlhdfKda

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uQ,slju wxYNd.h frda.h yg.kS' Bg wu;rj ñksidf.a wej;=ï" mej;=ï j, we;s .;s iajNdjho fuu frda.h i|yd fnfyúka bjy,a fõ' ffjoHdpd¾h ;=uks" wxYNd.h frda.h iE§ug n,mdk lreKq i|yka l<fyd;a@ wxYNd.h frda.h iE§ug lreKq fndfyduhla n,mdkjd' kyr ;e,Su" f,a leá.eiSu" ikaê ;oùu" kyr msmsÍu" wêl flaka;sh" fYdalh" ÿï mdkh" nq,;a úg iemSu" wêl ;rndrej" Èhjeähdj" yDo frda." wê reêr mSvkh" u;ameka mdkh" ksÈueÍu" wdydrj, .=Kd;aul nj" ks;r ks;r wdydr .ekSu" jHdhdï fkdlsÍu" wêl Nh" u< uQ;% ksis f,i neyer fkdùu fukau ud fmr i|yka l< wdldrhg jd" ms;a" fiï hk ;s%fodaIhkaf.ka yg.kakd wiu;=,s;;djh fuu frda.h yg.ekSug fnfyúka bjy,a fõ' wxYNd.h frda.h Tn;=ud iqjm;a lrkafka flfiao@ wxYNd.h frda.hg f.dÿre jk mqoa.,hkaf.a tla w;la" ll=,la wm%dKsl jk w;r" lg me;a;lg weoùu isÿfõ' tys§ Tjqkag ;u lghq;= lrf.k hdug fkdyelsj b;d wirKNdjhg m;a fjkjd' tjeks wirK frda.Skag ud ks, f;rmqu uÕska m%;sldr lr b;d flá l,lska frda.h iqjm;a lrkjd' frda.shd ud fj; meñKsh;a" ud frda.shd ne,Sug .sh úg§ jqj;a" m%;sldr wdrïN lr i;r ^04& j;djlska muK frda.shdg iïmQ¾K iqjh ,ndfokjd' tfukau úfYaIfhkau lsjhq;= lreKla ;uhs Tyq fyda weh tu frda.h iE§ug fmr isá mßÈu ud Tjqkaj iqjm;a lsÍu' lg weo ke;sj" w; mh mK ke;s iajNdjh ke;sj" Tjqka frda.h je<£ug fmr isá mßÈu frda.h iqjm;a jQ úgo Tjqka isá fia ksfrda.s iqjh ,nd§u udf.a m%;sldr j, úfYaI;ajhhs' ta ksid frda.shdf.a .; iqjm;aùu muKla fkdj is;g o oefkkqfha uy;a wiajeis,a,ls' ud tfia iqjm;a l< frda.Ska úYd, m%udKhla isákjd' Tn;a wxYNd.h fyj;a mCI>d; frda.hg f.dÿre ù we;akï chka; nKavdr fjo uy;d yuqù b;d flá l,lska mQ¾K iqjh ú|.kak'

122

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fjo uy;d yuqúh yels ia:dk fmd,af.d,a, bßod fm'j' 10'00 isg m'j' 4'00 olajd uqre;,dj ^uykqjr& bßod m'j' 4'30 isg rd;S% 7'00 olajd fmd,a.yfj, wÕyrejdod fm'j' 8'00 isg oyj,a 12'00 olajd foajdf,a.u wÕyrejdod m'j' 1'00 isg rd;S% 7'00 olajd ;,d;=Th nodod m'j' 1'00 isg rd;S% 8'00 olajd foys´úg n%yiam;skaod fm'j' 8'00 isg oyj,a 12'00 olajd wúiaidfõ,a, n%yiam;skaod m'j' 2'00 isg rd;S% 7'00 olajd wxl=Uqr isl=rdod fm'j' 8'00 isg iji 6'00 olajd fikiqrdod Èkj, fjo uy;dj fm!oa.,slju ksfjia fj; f.kajd .; yel'

úuiqï ffjoHdpd¾h chka; nKavdr kqjrmdr" rdufldgqj" wxl=Uqr" uykqjr'

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wdhq¾fõoh rEm,djkHfha b;sydifhka W.; yels mdvï

rEm,djkHfha b;sydifhka W.; yels mdvï w;S; fidnd fidªre rE iq/l=ï Tiafia iekfiuqo@ iajNdjO¾uh w;ayßñka y÷kajd fok úmÍ; weiqreï" fuj<ï weiqf¾ jekfiuqo@ n,msáh wdhq¾fõo frdayf,a ffjoH bIxld u,als

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zzrEm,djkH yd ñksia j¾.hd w;r ne£u wo Bfha we;ss jQjla fkdj §¾> b;sydihlg kElï lshkakls' rEm,djkH lshk jpkh iuÕ wo jk úg jk úg flá l%u" lD;su ridhksl hk lshuka we;=<;a jqjo" w;S; rEm,djkH ieneúkau iajNdúl mßirh yd ne÷Kq wmQ¾j pu;aldr wx.hls'

October 2019

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123

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rEm,djkHfha b;sydifhka W.; yels mdvï

wdhq¾fõoh

ta ms<sn|j ms<sn|j flá úuiqulg werhqï lf<a n,msáh wdhq¾fõo frdayf,a ffjoH bIxld u,als o is,ajd uy;añhghs' weiska olsk rej w,xlD; f,i mj;ajdf.k hdu wo Bfha my< jQjdla fkdj idOl jYfhka lsjfyd;a wÈka jir ,laIhlg;a tyd mgka úldYh jQjls' Homo Sapien udkjhd" w;S; rEm,djkH Ndú;h wm%sldkq uOH;k .,ahq.h olajd osj hkakls' t;eka isg wo olajd úúO fjkialï j,g n÷ fjñka mej; tk jákd jQ l,djls' foaYSh ffjoH úoHdfõ mqfrda.dóka jk rdjKd rcqf.a mshd jk mq,ia;s iDIsjrhd rEm,djkH l%u ms<sn| úfYaI Wkkaÿjla oelajQ nj merKs fmd;mf;ys i|yka fõ' jir 5000 l muK bmer‚ Wreulï we;s wdhq¾fõo ffjoH úoHdj ;=< rEm,djkH ms<sn| ks¾jpkh jkafka ndysr" wNHka;r fukau ryiH rEmh hk ;=ka wdldrhu ukdj yiqrejd .ksñka §¾> ld,Skj iqkaorj Ôj;a ùug bv ,nd .ekSuls' 124

October 2019

bme/‚ wdhq¾fõo rEm,djkH úIh ;=< mxpl,Hd‚hgu uQ,sl;ajh ,nd oS we;s fiau udkisl msßmqka njgo" iqkaor;ajhg fjfiia wjOdkhla ,ndoS we;' wo fhda.d wNHdi j, lshefjk iQ¾h kuialdrh w;S; Ôjk rgdj ;=<o olaKg ,enqKq njg idOl yuqfõ' Ndr; foaYfha w;S; rEm,djkH ms<sn|j úuiSfï§ ld,sodif.a fï> ¥:fh;a" wNs{dk il=ka;,h i|yka jk whqßka fiau ldu iQ;% lD;sfhao ldka;d rEm iajNdjh j¾Kkd lr we;af;a wo fuka tojio rEm,djkH flfryS ldka;d N+ñldj oela jQ w;sYh Wkkaÿj yd W;aidyhhs' ÿrd;S;fha isg mej; tk rEm,djkH l,dj fï olajd w;sYh oshqKq wjia:djlg wo ojfia j¾Okh ù we;s kuq;a" fï W;aidyfhaoS iajNdúl;ajh bj;a ùu ;=< .eg¨ldÍ ;;a;ajhlg m;aj we;'

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Bðma;= YsIagdpdrfha fmr ojfia Castor Oil, Bee Wax, Coconut Oil, Gee Oil, Olive Oil, Rose Water hk hk m%Odk ix>gl wvx.= fndfyda p¾udf,amk Ndú;d lr we;'

.jid iqmq,a lvqmq,a u,a ks,ajr, i,id Wl=¿jg risÿ< ñ‚fujq, ilid fojk yr i|fkka lr isis, fomi bisk ks,a meye fk; È.= mq¿,

w;S; frdaudkq YsIagdpdrfha wdfõ‚l LKsc øjH Ndú;d lr ilia lr.;a w÷ka fk;a w,xlD; ioyd fhdodf.k isá neõ b;sydih úuik úg yuq fõ' .%Sisfhao bmer‚ rEm,djkH Ndú;djka f,i weismsh w,xlrKhg úúO j¾Kl rdc;dka;%sl uÜgfuka Ndú; l< njg idOl we;' Ök jeishkao úúO kshu ksh j¾Kl" úúO rEm,djkH j¾K .ekaùï i|yd iajNdúl u,a Ndú; l< njg idOl yuq ù we;'

Wmka foaYh" Ôj;ajk mßirh iajNdúl ks¾udKh jQ ñksia isrerg .e<fmk rEm,djkH l%uhka fuu iajNdúl rEm,djkH u.ska ,nd. ekSug yel' ridhk ;ka;% weiqf¾ fï ;rï wdl¾YKSh f,i Ndú;d l< yels" È.= b;sydihlg o kElï lshk rEm,djkH l,dj wo jkúg lD;S%u ksmehqï" fuj<ï weiqf¾ úkdY ù hdu wNd.Hhls'

cmka jeishkao f,dj ìys jQ od isg YsIaGdpdr f,i ÈhqKq ùu;a iuÕ wdfõ‚l rEm,djkH l%ufõohka Ndú;d l< njg idOl yuqfõ' cmka jeishka úúO u,a j¾. j, fmdfydÜgq ;,d ,nd.kakd j¾K f;d,afm;s" weismsh w,xlrKhg fhdod f.k we;s njg idOl yuqfõ' iajfoaYsl wefußldkqjka ´iafÜ%,shdfõ úiQ wefndaðkshkajre hqouh wjia:d j,§ ;u uqyqK" isrer fjia j,d .ekSï lghq;= i|yd úúO j¾K fhdodf.k we;' ly" fldaudßld" iqÿy÷ka" ;,f;,a" fmd,af;,a" ó me‚ wdÈh ldka;dj rE imqj wdrlaIdjg Ndú;d l< njg wfma rfÜo idlaIs ,eî we;' toji wka;#mqr isá ldka;djka ish¨ fokdu rEm iajNdjh wdrlaId lr .ekSug fiau j¾Okh lr.ekSug W;aidy f.k we;af;a rcqkaf.ka jeä ie,ls,a,la n,dfmdfrd;a;=fjks' f;dg.uqfõ Y%S rdyq, ysñhka úiska rÑ; ie<,sys‚ ixfoaYfhys ldka;d rEimqj lúhg k.d we;s whqre yß wmQrehs'

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.; is; mskjk rEmhlg tyd .sh udkisl ixhuh o wdhq¾fõo úoHdj ;=<ska ,nd .; yel'

iajdNdúl l%u wkq. ukh lrñka ;u rej Tma kxjd .;fyd;a Tng §¾>ld,Sk ksfrda.s iqkaor mxpl,HdKshlg Wreulï lSug yelshdj ,efnkq we;' DM

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wdhq¾fõoh fiug n,mdk fya;= fiug lrk m%;sldr

fiug n,mdk fya;= fiug lrk m%;sldr isref¾ ksmofjk fiu fldagrl j, isrùfuka fndfyda fiï frda. fjk;a wikSm njg fmr<sh yel' myiqfjka m%;sldr l< yels fiï frda. .ek wdhq¾fõoSh oDIaÀfldaKfhka úuiuq'

wdhq¾fõo ffjoH rkam; rejka r;akdhl úisks

wdhq¾fõ§h ffjoH l%uhg wkqj ´kEu frda.S ;;a;ajhla i|yd m%;sldr lsÍfï§ frda. ksOdkh y÷kd.ekSu b;d jeo.;a' tfia y÷kd.;a frda. ksOdkhg m%;sldr lsÍfï§ wod< frda.S ;;a;ajhg muKla fkdj ta yd iïnkaO fiiq frda.S ;;a;ajhkao ksrdhdifhkau iukh ù hhs' tjeks m%;sldr úê wkqj iukh l< hq;= iudcfha iq,nj oel.; yels frda.S ;;a;ajhla jk fiï yd Bg iïnkaO wfkl=;a frda.S wjia:djka ms<sn| ms<sn| wdhq¾fõo ffjoH rkam; rejka r;akdhl uy;d iu. f.fkk fujr ,smsh hgf;a úuid n,uq

ÿrg oel.; yelafla k<," uqyqK wd§ m%foaY wdY%s;jhs' tu fõokdldÍ nj ksid fndfyda fokdg wjYH jkafka tfia we;sjk fiu fldgia YÍrfhka bj;a lr oeóughs' kuq;a uQ,sl jYfhka fuysoS fiu we;s ùu i|yd n,mdk m%Odk fya;=j y÷kd.; hq;=h'

fiï frda.

WIaKdêl YÍrh yd fiï frda. w;r we;s iïnkaOh

fiï frda. ms<sn| úuid n,k úg mSkia frda. uQ,sl;ajhla .kq ,nhs' WoEik wjÈ jQ úg Èhr .e,Su" lsúiqï hdu" kdifha we;sjk ÿ.|" nr .;sh wdÈh frda. ,laIK f,i y÷kajd Èh yelsh'

fiï frda. j,g n,mdk fya;= fiï mod¾: Ô¾K moaO;sfha ksmojkq ,nk w;r fiu ksid we;sjk lrorldÍ ;;a;aj fndfyda

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Y%S ,xldj jeks >¾u l,dmSh rgj, Ôj;ajk ñksiqkaf.a YÍrh fnfyúka WIaKdêlh' fuu WIaKdêl nj idudkH foay ffi,j,g

doctormagazine.lk

ord .; yels jqj;a fud<h wdY%s; ishqï iakdhq ffi,j,g ord .ekSug fkdyels fõ' tneúka YÍrh úiska Wml%uhla f,i Ndú; lrk jev ms<sfj<la (Auto cooling system) wkq.ukh lrkq ,efí' fuu l%shdj,sfha m%;sM,hla f,i fud<h úiska ksl=;a lrkq ,nk ix{d wkqj l%shd;aul jk wdydr Ô¾K moaO;sh fiu ksIamdokh lr fud<h foig .uka lrjhs' Bg fya;= jkafka YÍrfha wêl WIaK .=Kh j<lajd .ekSu yd iakdhq ffi, úh,Su j,lajd .ekSuhs' flfia fj;;a fï wdldrhg meñfKk fiï mod¾: k<, wdY%s; m%foaYfha fldagrl ^ysialn," kdih yd weia wdY%s; l=yr& ;=< tla/ia ù miqj kdih yryd ndysr mßirhg ksrdjrKh ùu fya;=fjka laIqø Ôùka wdl%uKhg Ndckh fõ' tu laIqøÔù l%shdldÍ;ajh ksid fiu meiùug ,la ù fiïm%;sYHd ;;a;ajh we;s lrkq ,nhs' túg kdifhka fidgq Èhr .e,Su wd§ fiïm%;sYHdj wdY%s; frda. ,laIK we;s lrkq ,efí' ld,h;a iuÕ fuu ;;a;ajh mj;sk úg laIqø Ôù l%shdldß;ajh ksid ÿ¾.kaOhla we;s lrkq ,efí'

YÍrfha WIaKdêl ùug n,mdk fya;= we;eï mqoa.,hkaf.a YÍr iajNdjfhkau ^Wm;skau& WIaK wêl núka hq;= jk w;r ;j;a iuyr msßilg WIaKdêl YÍrhla ysñ jkafka Tjqka ,nd.kakd jerÈ wdydr ksidh' tjeks wdydr i|yd WodyrK f,i biafida" oe,af,da" ll=¿fjda" n, ud¿ jeks WIaKdêl wdydr fukau wkakdis" ;lald,s jeks wï, wêl wdydr ms<sn| meyeÈ,s l< yelshs'

brejdroh by; frda.S ;;a;ajhkag iu.dój we;eï frda.Ska uqyqK fok ;j;a frda. wjia:djla f,i brejdroh y÷kajdÈh yelsh' fï i|yd uQ,sl fya;=j njg m;a jkafka YÍrh ;=< yg.kakd wêl jQ ms;a m%Njhkah' flfia fj;;a fï wêl jQ ms; iajNdjh ksid fud<h wdYs%; Yaf,aIau mg, j,g oeä doctormagazine.lk

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127

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fiug n,mdk fya;= fiug lrk m%;sldr

wdhq¾fõoh

f,i ydks isÿfõ' fuu frda.S ;;a;ajh i|yd o m%uqL;u fya;=j jkafka YÍrh mj;sk WIaKdêl njhs'

WIaKdêl nj iu. we;sjk fjk;a frda. ;;a;aj by; frda.S ;;ajhkag wu;rj w¾Yia jeks frda. ;;a;aj" leiSï" m¨ oeóï wdY%s; ifï frda." wêl ksÈu;" kskao fkdhdu" ;on, f,i mj;sk .eiag%hsáia ;;a;aj" u<noaOh''' we;eï úg u< nqre,g úáka úg msgùu" wêl flaka;sh wd§ frda.S ;;a;aj i|yd we;eï whg wvq jeä jYfhka uqyqK §ug isÿfõ'

úfYaIfhkau fiï frda. ;;a;ajhkag m%;sldr lsÍfïoS fndfyda frda.Skag wjYH jkafka nf,ka YÍrfha fiï fldgia neyer l< ùu jqj;a iajNdúlju YÍrh úiska tajd neyer lrk nj Tn úfYaIfhka u;l ;nd.; hq;=h' ta wkqj fuys§ l< hq;= jeo.;au m%;sl¾uh jkafka YÍrfhka fiu neyer lrùug jvd frda. frda. ksOdkh jk YÍrh WIaKdêl nj iukh lsÍuhs' flfia fj;;a by; m%;sl¾u yryd wod< frda.S ;;a;ajhka iaÓrju iqj lr.ekSug yelshdj ,efí' ta jf.au fujeks frda.S ;;a;aj j,g iq,nj uqyqK fokafka úúO /lshdjka lrk wh yd mdi,a orejka ksid b;d myiqfjka Ndú; l< yels T!IO ks¾udKh úh hq;=h' tfia wdhq¾fõ§h ffjoH úoHdkql+,j kQ;k Ys,amSh l%u yryd ksmojQ T!IO wm úiska Ndú; lrk ksid ´kEu wfhl=g lsisÿ .eg¨jlska f;drj b;d myiqfjka m%;sldr ,nd.; yelsh' DM

fiï frda. j,g lrk m%;sldr fmdÿfõ by; meyeÈ,s l< ish¨ frda.S ;;a;aj i|yd ms<shï fh§ug fmr YÍrfha WIaKdêl njg ms<shï fh§u w;HjYH fõ' YÍrh fYdaOk l¾u j,g A4 T!IO ,ndÈh hq;=h' tfiau jd" ms;a" fiï mod¾: j, iu;=,s; Ndjh we;s lrk m%;sldrho isÿ l< hq;=h'

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j;auka iudcfha nqoaêu;a úu¾YkYS,s ish,a,kau mdfya wdhq¾fõo ffjoH l%uh ms<sn| ;sridr úYajdihla f.dvkÕdf.k ;snqko fuu ffjoH l¾uhkays wuqøjH fidhd lmd fldgd ilia lrf.k lIdh ;eïîu iy fjk;a T!IO ms<sfh, lr.ekSu ksishdldrfhka isÿ lr.ekSug wmyiq ùu ksid fuu úYsIaG jQ ffjoH l%uhg wj;S¾K fkdfõ' ´kEu ld¾hnyq, wjia:djkays§ /lshdj lrk w;r;=r myiqfjka Ndú;hg .; yels f,i kshñ; m%ñ;Skag wkql+,j W;alDIaG jQ T!Iëh .=Kfhka hq;= fnda;,a f,i ms<sfh, k, lidh j¾." .=,s j¾." l,al" pQ¾k ksIamdokh lr we;af;a úúo mSvdjkaf.ka fmf<k iqjyilf.a frda. myiqfjka iaÓrju iqjm;a lsÍu Wfoiduh'

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