Doctor Magazine | November 2016 Online

magazine Doctor The Premier Bilingual Health Magazine in Sri Lanka Volume 22 • November 2016

ffjoHjrhd doctormagazine.lk

fkdfouq ch''' Èhjeähdjg

ISBN-1391 1341

9 7 7 13 91 13 400 1

sytear

R

it W

Laboratory

Fecal Occult Blood Test on P. 84 Colorectal Cancer

Fertility

P. 133

RANDED

hE um XT RA 16 Pages B

P. 116

orejka ke;s wUqieñhkg msysgg tk kj;u Capsule Baby ;dlaIKh

EB

21

Sex Life

pe r Is sue

Èhjeähd frda.h md,khg úfYaI{ ffjoH Wmfoia P. 10

Shockwave treatment for maintain an erection

RS 150 (VAT INCL)

Theme

Sex & Relationship

PAIN DURING SEX What Causes Painful Sex in Women?

P. 98

Gourmet Low GI 54

Red Basmathi Rice

Clinically proven as low GI by the BAKER IDI HEART & DIABETES INSTITUTE of AUSTRALIA

Diabetic Check Up oshjeähdj ffjoH mÍlaIK • ksrdydr reêr mrSlaIKh FBS • wdydr .ekSfuka miq reêr mrSlaIKh PPBS • udi ;=kl reêr iSks iudf,dapk mrSlaIKh HbA1C • iïmQ¾K fïo mrSlaIKh Lipid Profile • wlaud mrSlaIKh Liver Profile • jl=.vq mrSlaIKh Renal Profile • uq;%d laIqo% we,aìhqñka mrSlaIKh Urine Microalbumin • B'iS'cS mrSlaIKh" oaúudk tflda mÍlaIKh iy fg%âñ,a mÍlaIKh ECG, 2DECO, TMT • ;hsfrdhsâ fydafudak mrSlaIKhTSH • iïmQ¾K uq;%d mrSlaIKh UFR • iïmQ¾K reêr mrSlaIKh" B'tia'wd¾' mÍlaIKh" hlv wjfYdaIKh mÍlaIKh yd reêr.; b12 úgñk ksudk mÍlaIKh FBC, ESR, Iron, B12 • mqriaÓ;s ms<sld ial%Ska mÍlaIKh fyda äïnfldaI ms<sld ial%Ska mÍlaIKh PSA or CA 125 • wdka;%sl ms<sld ial%Ska mÍlaIKh" W,an ;r, mßlaIKh w.akHdY.; ms<sld fijqï mÍlaIKh CEA, Alfafetoprotein, CA 19-9 • u< mÍlaIKh Stools FR • mmqfõ úlsrK mÍlaIKh yd ta iïnkaO jd¾;dj Chest X Ray with Report • wlaIs mÍlaIKh Eye Surgeon • fmdaIKfõoS Wmfoia Diatician • Physical Examination & Report Discussion ish¿u jd¾;d iudf,dapkh ldhsl frda. ffjoHjrfhl= úiska isÿ flf¾'

wdisß Y,H frday, 21" lsßuKav, udj; fld<U 5 Fax No. 0114 626439 www.asirihealth.com doctormagazine.lk

ffjoH mrSlaIK i|yd úuiSï Asiri Surigcial Hospital PLC – Wellness Center General Line : 4524400 Ext: 2603 Direct Lines : 4524431 & 4524433 Asiri Central Hospital - Wellness Center General Line : 4665500 Ext: 5150 & 5151 Direct Lines : 4524431 & 4524433

wdisß fikag%,a fydiamsÜ,a 14" fkdßia lek,a mdr" fld<U 10 Fax No. 0114 665544 www.asirihealth.com November 2016

DOCTOR MAGAZINE

1

NOV' 2016 iqúfYaIS f;audj oshjeähdj

oshjeähdj yefokak fmr thska j<lskakg mshjr .ekSuhs jeo.;a''' 10

oshjeähdj frda.h iïnkaO uQ,sl lreKQ 36 cd;Hka;r oshjeähd f*vf¾Ikh

CONTENTS oshjeähd jl=.vq wdndOh .ek oek.ksuq 65 fudKrd., osia;%sla uy frdayf,a ldhsl frda. úfYaI{ ffjoH ksfrdaO o is,ajd

ks¾Kd,fõoh yd oshjeähdj úfYaI{ ffjoH fkdfh,a fidauiqkaorï

oshjeähdj msgqolskakg cSj;afjk úosfya fjkila olsuq''' 15 oshjeähdj iy fydafudak frda. úfYaI{ ffjoH m%idoa lgq,kao

oshjeähdj we;s Tng iqÿiq wdydr 40 úfYaI{ ffjoH j¾Kl=, l=iqï o wdnDD

oshjeähd frda.Ska i|yd bkaishq,ska tkak;a lsÍug Wmfoia 44

reêrfha iSks md,khg wo ojfia Tng fhdod.; yels fuj<ï iy fyg ojfia Tfí myiqjg tla fjk fuj<ï 22 oshjeähdj iy fydafudak frda. úfYaI{ ffjoH m%idoa lgq,kao

2

November 2016

orefjl=g oshjeähdj ;sfnkjd kï uõmshka l< hq;= ksjerosu foa oek.ksuq''' 52 ßcafõ wd¾hd <ud frdayf,a <ud fydafudak frda. úfYaI{ ffjoH kfjdaod w;m;a;=

fld<U úYAj úoHd,hSh ffjoH mSGfha NSI.afõo fomd¾;fïka;=fõ fcHaIAG lÓldpd¾h" ldhsl frda. úfYaI{ ffjoH pduÍ ùrr;ak úisks

oshjeähd frda.Skaf.a mdo j,g we;sjk wk;=r 58

oshjeähdjg w; jkk mQ¾j oshjeähdj 48

oshjeähdj yd iïnkaO p¾u.; frda.

ldhsl frda. úfYaI{ ffjoH ã tï iS .uf.a úisks

oshjeähdj ksid we;sjk wlaIs wdndO 28

ffjoH kd,l .=KjxY

71

moúh uQ,sl frdayf,a jevn,k p¾u frda. úfYaI{ ffjoH ,laud,s m;srdc úisks

wlaIs Y,H úfYaI{ ffjoH tï tia wur;=x. úisks

DOCTOR MAGAZINE

doctormagazine.lk

doctormagazine.lk

November 2016

DOCTOR MAGAZINE

3

NOV' 2016 Feature Articles

wdka;%sl-.=o ms<sld frda. ,laIK yd tu ms<sldj fõ,dikska y÷kd.kakd Fecal Occult Blood Test (FOBT) mrSlaIKh 84 wdf,am lrk fnfy;a mdúÉÑ lrk ksjeros wdldrh oek.kak 94

CONTENTS

jl=.vq noaO lrk ,o frda.Skaf.a ffjri frda. y÷kd.ekSfï mÍlaIK oeka ffjoH m¾fhaIKdh;kfhka''' 82

Advertorials

,sx.sl tlaùuloS we;sjk fõokdj 98

iqj|j;a nj ksid uy;a b,a¨ula we;s" fmdaIH .=Kh ksid ffjoHjrekaf.a f.!rjdorhg md;% jQ r;= ndiau;S iy,a 25

wfma rfÜ jefjk l=re÷ ksfrda.S iqjh m;k f,dal m%cdjf.a wxl tfla f;aÍula''' 77

iqmsß nj ;yjqre lr .kak oshjeähdj mrojkak 75

fldagrl m%odyh we;sjk yeá yd thg lrk m%;sldr 105 oshjeähdj iïnkaOfhka wdhq¾fõou;dkql+, úuiqula 128

English Section

Decoding Baby's Cries

108

Aging in Sri Lanka: High Time for a Scientific Intervention 112 SLMC Between a Rock and Hard Place over the SAITM Issue 111 Shockwave treatment for maintain an erection 116 What You Need to Know About Giving Birth by Cesarean Section 121 4

November 2016

Medi-Gadgematics we| ;=jd, j<lajk hg we÷ula''' 89

Regular

News

80

Ask Your Doctor

90

Fertility orejka ke;s wUqieñhkg msysgg tk kj;u Capsule Baby ;dlaIKh 133 Health & Fitness iqj;djh yd ksfra.S;djh Wfoid i;=áka cSú;h fjkia lr .ksuq 138

DOCTOR MAGAZINE

The Life through Clips

126

Thousand words in one image 96

doctormagazine.lk

doctormagazine.lk

November 2016

DOCTOR MAGAZINE

5

EDITOR'S A change for the betterment for your lives Dear Reader, With great pleasure and enthusiasm, here I am announcing that ‘ ffjoHjrhd’ the first ever health & Medical journal in Sri Lanka has published since 1995, has taken another major leap by re branding as "Doctor Magazine" with a make over as Sinhala - English bilingual magazine. Together with this change we are introducing our innovative health portal www.doctormagazine.lk and Face Book public page "doctormagazine" for your awareness on Health Matters absolutely with Sri Lankan touch.

The re-branding of the first medical monthly in the island and launching a state-of-the-art website-the most innovative in Sri Lankan media history! Together with this change We, the Pioneers in Health Literature in Sri Lanka addressing almost all the segment of the population in the country.

NOTE A regular content for the English speaking reader is a long felt need. Most of the readers inquisitive about us. We, the editorial believed that fulfilling your ambitions is our duty as the pioneers in Medical Literature in the country.

Together with this novel change I am sure more and more readers will attract the journal without any discrimination.

"Doctor Magazine" is always impressed readers with sophisticated design, typography, stunning photographs and video clips, and ultimately exceptional presentation with credible contribution by eminent doctors and other health professionals in the country.

Heraclitus, a Greek philosopher, is quoted as saying "change is the only constant in life."

That’s certainly true for all our lives. The fact is a eternal truth and Lord Buddha’s followers known how this truth feel for every one. After twenty years successful journey become Doctor Magazine to serve country better.

Enjoy the harvest, its yours. As always we welcome your comments. You may reach us at doctormagazine.lk@gmail.com or do not hesitate to write us asWe are always ready to change according to your most valued suggestions.

Happy reading!

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

NEVER MISS AN ISSUE Get 'Doctor Magazine' delivered to your door every month or choose to download it to your mobile or tablet. Go to subscription page to see our latest subscription offer.

6

November 2016

DOCTOR MAGAZINE

doctormagazine.lk

The Premier Health Magazine in Sri Lanka Volume 22 • Issue 11, November 2016

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

Dr Chandana Sri Kanakaratna Geriatrician, Physician

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

Dr Palitha Bandara Subasingha Dr Nalaka Ranasingha Dr Janaka Premathilaka Dr Devinda Dayarathna Mr Sanjaya De Silva Mr S M D Senevirathna CREATIVE PRODUCTION AD-MIRE Creative WEB ADMINISTRATOR Dumindu Dissanayake PRINTING/CIRCULATION Imashi Printers, #96A, Wanatha Road, Gangodawila, Nugegoda.

WAIDYAWARAYA Doctor Magazine is a intellectual property of Healthwatch Publications Viharakele, Diyatalawa.

TEL: 057 22 29040 | FAX: 057 22 29040 E-MAIL: doctormagazine.lk@gmail.com HOTLINE: 077 3149084

doctormagazine

lshjk i`.rd w;r tlu ms<smosk i`.rdj fï udifha jd¾Isl odhl;ajh ,ndf.k foieïn¾ DOCTOR magazine fkdñf,a ,nd.kak Tfí mjqf,a ish¿ fokdf.au hym; fjkqfjka oeka jvd;a yrnr lreKq iu.ska ixialrKh jk ffjoHjrhd DOCTOR magazine odhl;ajh fkdmudj ,nd.kak' Tn l< hq;af;a my; l+mkh fyda ta wdldrhg ilia l< f,aLKhl l+mkfha wvx.= úia;r mqrjd ta iu. wod, uqo,a f.jQ nexl= ,ÿm;" uqo,a weKjqu fyda fplam; my; ,smskhg tùuhs' ku''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''' ''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''' ,smskh'''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''' ''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''' ''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''' ÿrl;k wxlh''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''' úoahq;a ,smskh''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''' jd¾Isl odhl;ajh remsh,a 2200'00 ih uil odhl;ajh remsh,a 1100'00 uqo,a weKjqu l<uKdlre" fy,a;afjdÉ ,xld ^mqoa'& iud.u hkqfjka olajd f.jk ld¾hd,h osh;,dj f,i i|yka lrkak' fplam;a fy,a;afjdÉ ,xld ^mqoa'& iud.u hkqfjka ,shd f¾LKh lr tjkak' ,xld nexl=fõ osh;,dj YdLdfõ fy,a;afjdÉ ,xld mqoa.,sl iud.u wxl 9324332 .sKQug ´kEu nexl= YdLdjlska fyda wka;¾cd,h Tiafiao uqo,a ;ekam;a l< yel' uqo,a ;ekam;a l< l=ú;dkaish" uqo,a weKjqu fyda fplam; iu.ska Tfí ,smskh tùfïoS ,shdmosxÑ ;emE, fhdod.ekSu jvd;a iqÿiqh' jeä úia;r i|yd 0773149084 wxlfhka úuikak'

doctormagazine

www.doctormagazine.lk

doctormagazine.lk

Not Read But Follow

Healthwatch Lanka Private Limited 132/4, Viharakele, Diyatalawa Hot Line 0773149084 E Mail: doctormagazine.lk@gmail.com November 2016

DOCTOR MAGAZINE

7

fkdfouq ch''' Èhjeähdjg oshjeähd frda.h md,khg úfYaI{ ffjoH Wmfoia zzc.;a oshjeähd oskhZZ fjkqfjka oshjeähd frda.h iïnkaOfhka úfYaI{ ffjoHjreka oi fofkl=f.a úoaj;a woyia j,ska iukaú; mßiudma; oshjeähd ,sms iuqÉPhla fï iu. Tn fj; ;s<sK jkq we;' fuys we;s lreKQ kjH oeKQfuka ikakoaOj ir< iq.u nia jyrlska bosßm;a lsÍug iqúfYaIS m%h;akhla .kakd ,o w;r tys m%;sM<hla jYfhka fuf;la furg jdr m%ldYKhlska bosßm;a fkdlrk ,o ;rfï idr.¾N f;dr;=re iïmsKAvkhla zzoshjeähdj frda.hZZ iïnkaOfhka bosßm;a lsÍug ,eîu wmf.a wdkkaohg fya;= jk nj lsj hq;=h' fjfiiskau oshjeähd frda.S ish¿ fokdgu cSú;h ;rïu jeo.;a mKsúv rdYshla fï ;=< wka;¾.; jk w;r oshjeähdfjka mSvd fkdú|sk ish¿ fokdgo fï frda.fhka imqrd wE;aj cSú;h yeviú lr.eksug wjYH jk Wmfoia j,ska fuu ,sms iuqÉPh iukaú; jkafkah' Ndr; .=K;s,l Editor In Chief - Doctor Magazine

8

November 2016

DOCTOR MAGAZINE

doctormagazine.lk

doctormagazine.lk

November 2016

DOCTOR MAGAZINE

9

D•Magazine /

Theme

oshjeähdj yefokak fmr thska j<lskakg mshjr .ekSuhs jeo.;a'''

oshjeähdj yefokak fmr thska j<lskakg mshjr .ekSuhs jeo.;a''' cSjk rgdfõ jeros ksid wfma ck;dj jeä jeäfhka oshjeähdjg k;= fjkjd''' 10

November 2016

DOCTOR MAGAZINE

Y%S ,xld oshjeähd ix.ufha iNdm;s" fld<U cd;sl frdayf,a ks¾Kd,fõoh yd oshjeähdj úfYaI{ ffjoH fkdfh,a fidauiqkaorï MBBS, MD, FRCP, FCC, FSLCE iu. l< idlÉPdjla'''

doctormagazine.lk

fld<U wjg ck;djf.ka 20]lg Èhjeähdj ;sfnk nj' ta jf.au 60]la muK ;rndre wh bkakjd' wfma rfÜ whg fuh je<f|kafka cdk fjkialï j,g jvd Ôjk rgdfõ fjkialï ksid njhs fmfkkakg ;sfnkjd''' www.doctormagazine.lk

,xldfõ jf.au ol=Kq wdishdfõ ck;djf.a cdk iïnkaO m%Yakhla oshjeähdj fu;rï iq,n lsÍug fya;= jk nj;a fmfkkak ;sfnkjd''' wfma rfÜ uqia,sï m%cdj w;r;a ;rndrelu iy Èhjeähd wjodku jeä nj fmfkkjd' Tjqkaf.a wdydr rgdj yd Ôjk rgdj fuhg fya;= úh yelshs' reêr iSks uÜgu 90mg/dlg jvd jeäjkafka kï mßiaiï úh hq;=hs' HbA1C lshk reêr mÍlaIdj 5'4g jeä w.hla .kafkakï th mQ¾j Èhjeähd ;;a;ajh f,i y÷kajkjd'

uks" idlÉPdjg m%fõYhla úÈhg Èhjeähdj Q ffjoH;= lshk frda.h .ek lsishï ye¢kaùula lf<d;a'''

A

Èhjeähdj lshk frda.h fï jk úg ,xldj mqrdu wêl f,i oelsh yelshs' wms miq.sh Èkj, lrmq iólaIKhlska fy<sjqKd fld<U wjg ck;djf.ka 20]lg Èhjeähdj ;sfnk nj' ta jf.au 60]la muK ;rndre wh bkakjd' Tjqkag;a Èhjeähd wjodku jeähs' tfiau oeka wmg fmfkkakg ;sfhkjd uy; whg jf.au flÜgq whg;a fuh je<¢h yels nj''' wfma YÍrfha cdkj, fjkialï ksid Èhjeähdj je<f|kjd' kuq;a wfma rfÜ whg fuh je<f|kafka cdk fjkialï j,g jvd Ôjk rgdfõ fjkialï ksid njhs fmfkkakg we;af;a' óg wjqreÿ ishhlg muK fmr wm iudcfha ;snqKq Ôjk rgdj yd j;auka Ôjk rgdj w;r we;af;a úYd, fjkila' wdydr mqreÿ" le,ß mßfNdackh" YÍrh fjfyijk m%udKh hkd§ ish¨ foa ld,h;a iuÕ fjkia ù ;sfnkjd' fï fya;=j ksid ;uhs wmsg jeämqr Èhjeähdj iy wfkl=;a fnda fkdjk frda. je<f|kafka'

je<£ug jeä wjodkula we;af;a Q Èhjeähdj fudk jf.a whgo@

A

,xldfõ Èhjeähdj je<f|k wdldrh foi ne¨jdu wmg lshkak mq¨jka ,xldfõ jf.au ol=Kq wdishdfõ

doctormagazine.lk

ck;djf.a cdk iïnkaO m%Yakhla we;s nj' w;S;fha isg wfma YÍr yqre ù we;af;a wvq Yla;s m%udKhla ,ndf.k jeäfhka jev lsÍughs' kuq;a oeka fï ;;a;ajh fjkia ù ;sfnkjd' oeka wfma le,ß mßfNdackh wêlhs' kuq;a Yla;sh jeh lrkjd wvqhs' fuh wfma Èhjeähd wjodku jeä ùug tla fya;=jla' uu uq,ska i|yka l< wdldrhgu ;rndre whg;a Èhjeähd wjodku jeähs' tfukau" jhia.;ùu;a iu. Èhjeähdj je<£fï m%jK;dj jeäfjkjd' ta jf.au wfma rfÜ uqia,sï m%cdj w;r;a ;rndrelu iy Èhjeähd wjodku jeä nj fmfkkjd' Tjqkaf.a wdydr rgdj yd Ôjk rgdj fuhg fya;= úh yelshs' ta yereKq úg" .¾NKS iufha Èhjeähdj je<÷Kq ldka;djkag yd Polycystic Ovary Syndrome hk frda.S ;;a;ajh je<÷Kq ldka;djkag;a miqld,Skj Èhjeähdj je<£fï wjodku jeähs'

November 2016

DOCTOR MAGAZINE

11

D•Magazine /

oshjeähdj yefokak fmr thska j<lskakg mshjr .ekSuhs jeo.;a'''

Q

ffjoH;=uks" Èhjeähd ;;a;ajh l<ska y÷kd.ekSug l<yels mÍlaIK ;sfnkjdo@

A

Tõ''' idudkHfhka wms Èhjeähd ;;a;ajh we;sjqKd hehs i<lkafka reêr iSks uÜgu 126mg/dl hk w.hg jvd jeä jQ úghs' th wmg ksrdydr reêr iSks mÍlaIdjlska oek.; yelshs' ta jf.au HbA1C lshk reêr mÍlaIdfjka udi ;=kl reêr iSks md,kh .ek oek.; yelshs’ Èhjeähd ;;a;ajh tlajru we;sjkakla fkdfjhs' th ld,hla ;siafia YÍrh ;=< we;sjkakla' b;ska hï flfkl=g bkaishq,ska m%;sfrdaë;d ,laIK" tkï Worh fkrd tau" wlaudfõ f;,a ;ekam;a ùu" fn,a, m%foaYfha yu l¿ meye ùu jeks ,l=Kq we;akï ie<ls,su;a úh hq;=hs' .eyekq whg .¾NKS iufha Èhjeähdj fyda Polycystic Ovary Syndrome je<£ ;sfíkï Tjqkao wjOdkfhka isáh hq;=hs' reêr iSks uÜgu 90mg/dlg jvd jeäjkafka kï mßiaiï úh hq;=hs' HbA1C lshk reêr mÍlaIdj 5'4g jeä w.hla .kafka kï th mQ¾j Èhjeähd ;;a;ajh f,i y÷kajkjd' tn÷ wh Èhjeähdj je<£ug wdikak ;;a;ajhg m;aù we;s njhs thska lshefjkafka'

Q A

Èhjeähd frda.h j<lajd .; yelso@ ke;fyd;a th je<£fï wjodku wvq lr.ekSug yelshdjla ;sfío@ Tõ" mQ¾j Èhjeähd ;;a;ajhg m;ajQ flfkl=g" .¾NKS iufha Èhjeähdj fyda Polycystic Ovary Syndrome je<£ ;snQ flfkl=g fyda ;rndre flfkl=g jqj;a oshjeähdj we;sùu j<lajd .; yelshs' Ôjk rgdfõ lrk fjkialï ;=<ska ishhg yeglg oshjeähdj wvq lr.ekSug yelshs' wms lEu .kak wdldrh fjkia lsÍu wjYHhs' ta lshkafka fi!LHu;a lEufõ,la .; hq;=hs' wfma lEu fõf,a ;sfnk t<j¿ m%udKh jeä lsÍu;a fm%daàka ;j fmdä m%udKhlska jeä lsÍu;a" ta jf.au msIaGh yd

12

November 2016

DOCTOR MAGAZINE

"

Theme

Èhjeähd ;;a;ajh tlajru we;sjkakla fkdfjhs' th ld,hla ;siafia YÍrh ;=< we;sjkakla' b;ska hï flfkl=g bkaishq,ska m%;sfrdaë;d ,laIK" tkï Worh fkrd tau" wlaudfõ f;,a ;ekam;a ùu" fn,a, m%foaYfha yu l¿ meye ùu jeks ,l=Kq we;akï ie<ls,su;a úh hq;=hs'

iSks m%udKh wvq lsÍu;a lrkjd kï Èhjeähd frda.h iE§u j<lajd .; yelshs' tfukau jHdhdu lsÍu;a jeo.;a fjkjd' Èkm;d ojilg meh nd.hlaj;a jHdhdu lrkjd kï fyd|hs' fõ.fhka weú§u fyda fiñka Èùu (Jogging) jeks jHdhduhla jqj;a iqÿiqhs' ;rndrelu ;sfnk flfkla kï nr wvq lr.ekSu;a wjYHhs' fnfy;a j,skq;a frda.h j<lajd .ekSu l<

doctormagazine.lk

miq.sh jif¾ f,dal oshjeähd oskhg iu.dój w;s.re ckdêm;s;=ud" fi!LH wud;H;=ud iu. Y%S ,xld oshjeähd fmvf¾IKfha ffjoHjreka uyck;djo iu. md .ukl fhÿKq wdldrh

Q

› ,xldfõ ck.yKfhka ie<lsh hq;= fldgilg Èhjeähd wjodkula mj;sk nj Tn;=ud m%ldY l<d' Èhjeähd frda.h iïnkaO lS¾;su;a úfYaI{jrhl= f,i Tn;=ud wjidk jYfhka wfma mdGlhkag ,ndfok m‚jqvh l=ulao@

A

Èhjeähdj j<lajd. ekSu mgka.; hq;af;a l=vd ld,fha isguhs' ,xldfõ ish,a,kagu fï wjodku mj;sk ksid l=vd ld,fha isgu fi!LHu;a Ôjk rgdjlg orejka yqre lsÍu wjYHhs' wjqreÿ ;syg jeä ish,a,kau reêr iSks" fldf,iagfrda,a iy reêr mSvkh hkdÈh mÍlaId lr.ekSu ;=<ska Èhjeähdj yd wfkl=;a nrm;, frda. dndO /ilska je<lSug yelshdj ,efnkjd' frda.h je<÷kq miq m%;sldr .kakjdg jvd th j<lajd .ekSu ;uhs jeo.;a' tu ksid wms frda.h j<lajd .ekSug uq,a;ek Èh hq;=hs lshk foa ;uhs ug fokak ;sfhk m‚jqvh jkafka' DM

yelshs' Metformin, Acrabose jeks fnfy;a th j,ska ishhg y;<sylg muK wvq l< yels nj m¾fhaIK j,ska fmkaj,d ;sfnkjd' kuq;a Ôjk rgdj fjkia lsÍu ;uhs jvd;a id¾:l l%uh jkafka'

uks" Tn;=ud › ,xld Èhjeähd ix.ufha iNdm;s Q ffjoH;= jYfhka lghq;= lrkjd' wfma rg ;=< Èhjeähdj j<lajd .ekSu iïnkaOfhka tu ix.ufha odhl;ajh fln÷ o@

fï jk úg;a fndfyda foa lrf.k hkjd' iEu A wms jirlu fkdjeïn¾ 14 cd;Hka;r Èhjeähd Èkh ieuÍu;a iu. úúO jevigyka ls%hd;aul lrkjd' fï jif¾;a Èhjeähd Èkh ckdêm;s;=udf.a iyNd.s;ajfhka iurkjd' ck;dj oekqj;a lsÍfï wruq‚ka fkdjeïn¾ 13 jeksod ksoyia p;=rY%fha isg nKavdrkdhl iïuka;%K Yd,dj olajd Èhjeähd md .ukl=;a mj;ajkjd' leu;s whg ta i|yd iyNd.s jk f,i;a wms wdrdOkd lrkjd' ta jf.au wms ,xldfõ fndfyda m%foaY wdjrKh jk f,i frda.h y÷kd.ekSfï jevigyka mj;ajkjd' ta;a iu.u fi!LHu;a f,i wdydr ms<sfh< lsÍu .ek;a jevigyka ls%hd;aul lrkjd' ,xldj mqrdu mdi,a <uqkaf.a oekqu j¾Okh lsÍu Wfoid rpkd iy Ñ;% ;r.hla o mj;ajkjd' Bg wu;rj wm ix.uh fi!LH wud;HxYh iu. tlaj cd;Hka;r Èhjeähd ix.ufha wdOdr ,ndf.k" fi!LH m%j¾Ok jevigykla l%shd;aul lrkak n,dfmdfrd;a;= fjkjd" fmdÿ ck;dj oekqj;a lsÍu" mdi,a <uqka oekqj;a lsÍu iy fi!LH fiajlhka mqyqKq lsÍu fuu jevigykg we;=<;a' doctormagazine.lk

idlÉPd lf<a¦ ixch o is,ajd

November 2016

DOCTOR MAGAZINE

13

14

November 2016

DOCTOR MAGAZINE

doctormagazine.lk

D•Magazine /

Theme

oshjeähdj msgqolskakg cSj;afjk úosfya fjkila olsuq'''

oshjeähdj msgqolskakg cSj;afjk úosfya fjkila olsuq''' th oshjeähdj fkdfjhs fndfyda frda. j,skao wmj wdrlaId lrkjd'''

w

oshjeähdj iy fydafudak frda. úfYaI{ ffjoH m%idoa lgq,kao

fma cSjk p¾hdj miq.sh flá ld,hla ;=< fndfyda fihska fjkia fj,d' biair kï wfma .eyekq msßñ fldhs ljqre;a lh fjfyfik jevj, oskm;d mdfya ksr; jqKd' lh fjfyid n; iß lrk /lshdjka wo ld,fha msßñka lrkjd wvqhs' f.orfodf¾ jqK;a ñßia wUrk tl" ù jkla fldgdf.k n;a Whk tl ldka;djka w;ska ks;s isoaO jqK;a wo ta jev ish,a, hka;% j,g ndr oS,d' tosfkod ld¾hhka i|yd tod wm YÍrh fjfyijQ m%udKh wo jk úg ishhg 90lska muK wvqfj,d' wo wms úfkdao fjkafk rEmjdysksh n,ñka''' orefjd jqK;a wïuf. ;d;a;f. fudnhs,a fmdaka tl wrf.k úfkdaohla ,nkjd' ta yeá fi,a,ula" jHdhduhla kE''' fï úmÍ; jqK cSjk rgdj oshjeähdj" wêreêr mSvkh" ms<sld jeks fnda fkdjk frda. we;s fjkak m%n, fya;=jla''' ta;a áflka ál fkdfjhs" oshjeähdj miq.sh ld,h ;=< jix.;hla jf.a jeäfj,d ;sfnkjd' fï jeäùfï fõ.h uú;h okjk iq¿hs' tal tfyu fjkafk wehs @ fï .eg¿j wm bosßfha ;sfnkjd'

www.doctormagazine.lk

doctormagazine.lk

fufyu fohla tl mdru fjkak ñksiqka jk wfma cdk fjkiaùula @ cdk fjkiaùula fï ;rï flá ld,hlska fjkak úosyla kE' ix;;shl''' i;a;aj fldÜGdYhl cdk fjkilg ,la fjkak kï jir oyia .Kkla .; fjkak ´ks' tal ;uhs mßKdóh cSj úoHdfõ uq,anei.;a isoaOdka;h' ta;a fndfydau flá ld,hla ;=< .=fKda;a;r fY%aKshl rgdjg oshjeähdjg ñksiqka k;= fj,d''' @

November 2016

DOCTOR MAGAZINE

15

D•Magazine /

oshjeähdj msgqolskakg cSj;afjk úosfya fjkila olsuq'''

Theme

oeka fï .ek w¿;a u;hla ;sfnkjd''' fï ldf, ñksiaiqkaf. cdk fjkia fj,d kE' ta;a cdk jev lrk úosfy fjkila fj,d ;sfhkjd' cdk u.ska fm%daàk ksIamdokh lrkjd' we;eï fm%daàk l%shd lrkafk YÍrh jeãug''' fndfydauhla fm%daàk l%shdldß;ajhg n,mj;ajk fm%daàk' tkaihsu lshkafk;a fï wdldrfhka YÍrfha lD;H i|yd WmldÍ jk fm%daàk úfYaIhla' fï fm%daàk l%shd;aul jQ wdldrfha fjkila we;sj ;sfnk nj fï jk úg y÷kdf.k ;sfnkjd' fuh úoaj;=ka Epigenatics hkqqfjka y÷kajkjd' wdydr md,khlska f;drj oshjeähdj md,kh lsÍug is;Su uq,djla''' oshjeähdj frda.Ska ú;rla fkdfjhs wm fldhs ljqre;a wdydr .ekSfïoS wm wmf.a YÍrfha Yla;s wjYH;djhg wkQj wdydr .; hq;=hs' wm wkqNj lrk wdydr wfmka jeh jk Yla;shg iudk úh hq;=hs' .kak wdydr m%udKh jeh lrk Yla;shg jvd jeä jqfKd;a wdydr isref¾ ixÑ; fjkjd' isref¾ fïoh" nr jeä fjkafk wkjYH m%Yak rdYshlg uQ,drïNhla fjñka' 16

November 2016

DOCTOR MAGAZINE

úfYaIfhkau oshjeähd frda.k S a kï msIG a ckl wdydr md,khla ;sìh hq;h = 's wm tl ;ek isákjd kï jeä jYfhka wdydr .ekSu iqÿiq kE' l=i.skk a we;s jqKd lsh, wdydr j,g .scq fjkak;a fyd| kE' wdydr .ekSfïoS Yla;h s jeä wdydr j,g t;rï ;ekla fokak tmd'

doctormagazine.lk

fï ksid úfYaIfhkau oshjeähd frda.Ska kï msIaGckl wdydr md,khla ;sìh hq;=hs' wm tl ;ek isákjd kï jeä jYfhka wdydr .ekSu iqÿiq kE' l=i.skak we;s jqKd lsh, wdydr j,g .scq fjkak;a fyd| kE' wdydr .ekSfïoS Yla;sh jeä wdydr j,g t;rï ;ekla fokak tmd' ta fjkqjg Yla;sh" le,ß w.h wvq wdydr jf.au c,h jeä jYfhka mdkh lrkak' ngysr rgj, m%p,s; lshukla ;sfhkjd' osklg t<j¿ yd m<;=re jeäfhka wvx.= wdydr fõ,a myla lkak lsh,' ta;a msIaGh jeä t<j¿ ;sfhkjd' iSks jeä m<;=re ;sfnkjd' fïj muK oek wkqNjhg tla lr.; hq;=hs' wm fkdoek lr.kakd jeroSï ksid wdydr md,kh wfmka .s,syS hkjd''' iuyreka nr wvq lr.kak .kak wjxl W;aidyhka wid¾:l fjkjd' ta wehs @ zzuu f.dvla n;a lkafk kE''' msá lEu lkafk kE''' ta;a uf.a nr tkak tkak jeä fjkjd'ZZ flfkla tfyu lshkjd' ta;a tfyu fjkak Tyq fkdokak fya;=jla ;sfnkjd' flfi,a j, ;rula iSks ;sfnkjd" mefmd,a" rUqgka jeks meKsri m<;=re j,;a tfyuhs' fï úosfya m<;=re jeäfhka wkqNjfhka YÍrfha iSks md,kh ì| jefgkjd' t<j¿ m<;=re jqK;a f;dard .ekSfïoS wm keKj;a úh hq;=hs' .ïj, yefok we;eï iSks wvq m<;=re .kak tl fyd|hs' fjr¿ f.ä" ngysr rgj, T,sõ f.ä j,g iudkhs' wkqNjfhka fodila kE''' weU/,a," ldurx. jf.a m<;=re hï m%udKhlg wdydrhg tl;= lr.ekSfï jrola kE' flfi,a" mefmd,a jf.a meKsri jeä m<;=re lkj kï .dklg" md,khlg lkak ´ks' lrsú," f;nqfld< j, iSks wvq lrk ridhk øjH .ekSfïoS muKg jvd iSks wvq ùfuka wk;=rla we;s ùfï wjodkula ;sfnkjd' fï ksid tajd wêlj .ekSu fyd| kE' fïjd .kakjd kï fjfiiska ie<ls<su;a úh hq;=hs' mdkamsá wdydr yels muK wvq lrkak ´ks' n;a kï r;= ydf,ka''' iqÿydf, n;a iSks uÜgu by< kexùfï m%jK;djhla ;sfnkjd' wdydr j, .a,hsisñla o¾Ylh .ek wjfndaOhla we;sj wvq .a,hsisñla w.hla iys; wdydr j,g yqre ùu iSks md,khg fyd|hs'

doctormagazine.lk

wm yefudagu jHdhdu wjYHhs' oshjeähdfjka fmf<k wh jvd;a Wkkaÿfjka fï we`. fjfyijk lghq;= j, ksr; jkak' thska ksielfhkau reêr iSks md,khg msgj q y,la ,efnkjd'

November 2016

DOCTOR MAGAZINE

17

D•Magazine /

oshjeähdj msgqolskakg cSj;afjk úosfya fjkila olsuq'''

Theme

oshjeähd frda.Ska ;u isref¾ nr ys;lr mrdihl mj;ajd .ekSu flfryS W;aidyj;a úh hq;=hs' fuh reêr iSks md,khg fya;=jk ldrKhla' tosfkod jev lrk w;f¾;a wmg jHdhdu ,nd.kak mq¿jka wo wms mqreÿ fj,d ;sfhkafk fndfydau lïue<slug cSj;a fjkak' nia fyda,aÜ tfla ÿr lShg j;a mhska hkak leu;s kE''' nia tl ke;akï mqxÑ ÿrla hkak;a ;%S frdao r:hg w; oukjd' uy,a f.dvke.s,a,l mäfm< osyd weyela wer, n,kafk kE''' yeu fj,dfju by< my< hkak úÿ,s fidamdkh ´ks' fuhska wmg fkdñ,fha" bfíu lrkak ;sfhk jHdhdu ál;a ke;s fjkjd' wm yefudagu jHdhdu wjYHhs' oshjeähdfjka fmf<k wh jvd;a Wkkaÿfjka fï we`. fjfyijk lghq;= j, ksr; jkak' thska ksielfhkau reêr iSks md,khg msgqjy,la ,efnkjd' Tfí orejdg l=vd ld,fha isgu jHdhdu j,g osß .kajkak' Tyq l%Svd j,g iyNd.s lrjkak' oyäh ouk fi,a,ï i;=áka lrkakg bv yßkak' ke;akï Tjqkq;a fï úosfya frda. j,g myiqfjkau f.dÿre fõú' u;l ;nd.kak' Tjqkaf.a wkd.;fha ksfrda.Snjg wä;d,u oeñh hq;af;a;a uõmshka jk Tnu ;uhs' rd;%Shg ir< wdydrhla .ekSfuka ukd reêr iSks md,khla we;s fjkjd''' rd;%shg wvq wdydr m%udKhla .ekSfuka oshjeähd frda.Skag fyd| iSks md,khla we;s fjkjd' th wm m%dfhda.slj w;aÿgq i;Hhla' rd;%S wdydr fõ,g msIaGh" ldfndayhsfâ%Ü wvq wdydr mßudjla f;dard.kak' Yla;sh wvq t<j¿ jeämqr ;snqKg lula kE' lh wvqfjka fjfyfijk wh úfYaIfhkau msIaGh" w, j¾. wvqfjka .kak'

18

November 2016

DOCTOR MAGAZINE

nqÿka jykafia NslaIQkag meKjQ úkh kS;sh ;d¾lslhs" mokï iys;hs br uqÿka jqKdg miafi wdydr j<|kak tmd lsh, úkh kS;shla nqÿkajykafia tl, NslaIqkajykafia,dg mefkõjd' we;a;gu tys b;d jákd ;d¾lsl mokula ;ssfnkjd' lh fkdfjfyik Woúh wkqNj lrk wdydr m%udKh wvq l< hq;=hs' thska ksfrda.S nj wdrlaId fjkjd' ke;akï th ksfrda.S nj ke;s lrkjd' we;a;gu nqÿka oji h;sjrhka jykafia,d wo ld,hg jvd fjfyiqKq nj fmfkkakg ;snqKd' fhdÿka .Kka u. f.jñka O¾u m%pdrfha ksr; jqKd' úúO ÿIalr l%shd isÿ lrñka Y%uK cSú;h .; l<d''' ta;a rd;%shg wdydr j<|kak wlemhs' th udye`.s wdrlaIl Wmfoila' fjfiiskau todg jvd myiq cSú; .; lrk wo ojfia meúos W;=ukag ú;rla fkdfjhs" .syshkag;a fuhska jákd mKsúvhla fok njhs uf.a kï woyi'

doctormagazine.lk

oshjeähd frda.Ska we;s lr.; hq;= wosgk''' oshjeähdfjka fmf<k frda.Ska yeu úgu fojeoEreï wêIAGdkhlska lghq;= l< hq;=hs''' isysm;a jqK fj,djg fkdfjhs' yeu úgu''' 1' oshjeähdj ksid we;sjk wfkal ixl+,;d je<elaùug wêIaGdkYS,S úh hq;=hs' 2' wfma wdhqI oshjeähdj ksid laIh fkdùug j. n,d.; hq;=hs' reêrfha iSks uÜgu uekúka md,kh lr.; hq;=hs' thska fï wjodkï foflkau ñoS ksfrda.S cSú;hla .; lrkakg wjia:dj Wod fjkjd' oshjeähd frda.Ska ksrka;rfhka ;u reêr iSks m%udKh uek ne,sh hq;= fjkjd' idhkhg hk úg ridhkd. dr jd¾;djla f.k hdu fyd|hs' tfy;a ta w;f¾;a reêr iSks .ek wjfndaOhla ,nd.; hq;= fjkjd' úfYaIfhkau iSks uÜgu idudkHhg jvd fnfyúka we;s ùfuka uq¾Pd ;;a;ajhg m;a ùfï wjodkula ;sfnkjd''' iSks uÜgu jeä hhs ielhla we;s jQ úg ta ms<sn|j uQ,sl wjfndaOhla ,nd .ekSu;a jeo.;a''' fï ksid wo fndfyda oshjeähd frda.Ska ;ukagu reêr iSks mÍlaId l< yels .a¨fldógrhla mdúÉÑ lrkjd' reêr iSks md,kh weiqf¾u l<uKdlrkh lr.; hq;= frda.hla uq,skau frda.Skag oshjeähdg fnfy;a lf<a uq;%d j, ri n,,' ke;akï uq;%d j,g tl;= fjk l+ôkaf.a m%udKh foi ksÍlaIKh lr,' ta;a wo wm okakjd" oshjeähdj lshkafk uq;%d.; frda.hla fkdfjhs' uq,au ldf, jf.a fnkälaÜ ødjKh weiqf¾ uq;%d mÍlaId lrkafk kE' wo ojfia oshjeähdj md,kh iïmQ¾Kfhkau isÿ lrkafka reêrfha ;sfnk iSks m%udKh iudf,dapkh lsÍfuka' ksrdydr iSks mÍlaIKh yereKQ úg Glycosylated Haemoglobin lshk mÍlaIKh;a fuysoS b;d jeo.;a fjkjd' ta yereKq úg udi ;=fka reêr.;j iSks j, idudkH úuik HbA1c mÍlaIKh;a oshjeähd frda.Ska fjkqfjka isÿ lrkjd' HbA1c ;uhs wdldr foflau oshjeähdj md,khg fhdod.kakd m%Yia;;u mÍlaIKh' HbA1c w.h 7g jvd wvq úh hq;=hs' th tu iSudfõ ;nd.ekSu w;sYhskau jeo.;a'

doctormagazine.lk

oshjeähd frda.sfhl=f.a ys;lr iSks w.hka WoEik ksrdydrj .kakd reêr idïm,hloS 80-120 fyd| w.hla' 120g jvd ks;ru jeä kï th;a t;rï fyd| kE' iSks w.h jvd;au wvq ùu;a fyd| kE' th 70g jeä w.hla ùu ;uhs fyd|' wdydr .ekSfuka miq 140 wdikakfha mej;Su fyd|gu fyd|hs' wdydr .ekSfuka meh follg miq lrk reêr iSks mÍlaIKhlao ;sfnkjd' th Post Prandial Blood Pressure hkqfjka ye|skafjkjd' fuh isÿ lrkafka wdydr .ekSfuka miq YÍrh fl;rï ÿrg iSks md,kh jkjdo hkak úuid ne,Sughs' bkaishq,ska .kak frda.Skag fuu mÍlaIKh isÿ lsÍfuka ta .kakd bkaishq,ska fl;rï ÿrg iSks md,khg WmldÍ fjkjdo hkak fidhd n,kjd' meh foflka miq iSks w.h 140g ú;r ;sfhkjd kï fndfydu fyd|hs' th 180g jeä w.hla .kakjd kï f.dvla krlhs' FBS tlla lrk ksjeros l%uh oshjeähd frda.Ska ksrdydr reêr mÍlaIKhg hdfïoS lrk jrola ;sfnkjd' we;eï ridhkd. dro frda.Skag jeros Wmfoia fok wjia:d wm oel ;sfnkjd' FBS

November 2016

DOCTOR MAGAZINE

19

D•Magazine /

oshjeähdj msgqolskakg cSj;afjk úosfya fjkila olsuq'''

Theme

mÍlaIKh isÿ lrkak meh wgla ksrdydrj isàu m%udKj;a' fï ld,h ;=< j;=r mdkh lsÍfï jrola kE' PPBS mÍlaIKh lrk úg we;eï ridhkd.dr j,ska f.dvla ld, tkak lshkjd' th;a jeroshs' wm mÍlaId l< hq;af;a idudkHfhka Tn .kakd wdydr fõ, ;=< reêr iSks j, yeisÍu ñi widudkH wdydrhl reêr iSks yeisÍu fkdfjhs'

jkafka kE' we;eï fj,djg jeä fj,djla ksrdydrj isàfïoS fjk;a tkaihsu ksid we;sjk n,mEfuka reêr iSks uÜgu by< kxjkj wjia:d mjd ;sfnkjd' hï fyhlska lD;%Suj iSks w.h jeäùula isÿj we;ehs is;=fKd;a HbA1cw. hka iudf,dapkfhka ffjoHjrhd ta .ek ksjeros ;lafiarejla lrkjd' iSks fnfyúka wvqùu frda. ,laIK

fï wdldrfhka by; lS wdldrhg Wmfoia ms<m s osñka wosgklska hql; a j frda.h md,kh lsÍug Tn W;aidy .; hq;h = 's thska ksielfhkau frda.h msgq olskk a g Tng wjia:djla Wod fjkjd'

iSks iu. fldf,iagfrda,a mÍlaIKh;a (Lipid Profile) lrkjd kï folu tlg .ekSfuka f,dl= fjkila we;s

20

November 2016

(Hypoglycemia) • wêl l=i.skak • oyäh oeóu • we`.g la,dka; .;sh • yDo iamkaokh jeäùu • w;a fjõ,k .;sh frda.shdg fuysoS t;rï oekSula fkdfjkak mq¿jka' ta;a n,df.k bkak whg Tyqf. fjkila oelsh yelshs' frda.shd lshk lrk foaj,a f;areula ke;s fjkak mq¿jka' wms lshk foa f;afrkafk kE' widudkH ksosu;' u<dksl .;sh' ta fj,djg ksfjfia reêr mÍlaIdjla l< yels kï fyd|hs' fuysoS Tn jydu l< hq;af;a

DOCTOR MAGAZINE

blauKska wjfYdaIKh l< yels .aÆfldaia jeks hula j;=r j, oshlr ,ndoSu fyd|hs' .aÆfldaia ke;skï iSks álla lfÜ odkak' meKsri fohla fokak' bkaishq,ska .kak fj,dj bkaishq,ska j¾. lsysmhla ;sfnkjd' Short Acting Insulin j, wruqK jkafka wdydrfhka miqj iSks w.h by< hdu je<elaùuhs' fuh ,nd fokafka lEug fmrhs' lEug meh nd.hlg muK fmr .kakjd kï f.dvla fyd|hs' Glargine, Detemir jeks b;d fiñka jevlrk bkaishq,ska kï ´ks fj,djl .;a;g lula kE' T!IO .kak fj,dj fuÜf*dñka jeks T!IO wdydrfhka miq .; hq;=hs' wfkla fndfyda T!IO wdydrhg fmr iqÿiqhs' ke;akï wdydrh;a iu.u .ekSfï jrola kE' flfia fj;;a Tn .kakd T!IOh .; hq;af;a ljr wdldrhgo hkak Tfí ffjoHjrhdf.kau wid oek.kak' DM

doctormagazine.lk

doctormagazine.lk

November 2016

DOCTOR MAGAZINE

21

D•Magazine /

Theme

reêrfha iSks md,khg wo ojfia Tng fhdod.; yels fuj<ï iy fyg ojfia Tfí myiqjg tla fjk fuj<ï

reêrfha iSks md,khg wo ojfia Tng fhdod.; yels fuj<ï iy fyg ojfia Tfí myiqjg tla fjk fuj<ï

re

êrfha iSks uÜgu mÍlaId lsÍug wo ojfia Tn mßyrkhg .kakd .a¨fldógrh .ek;a" fyg ojfiaoS Tng iydhg meñfK;ehs wkqudk lrk ngysr rgj, oekgu;a fhdod.kakd kjH reêr iSks hduk fuj<ï .ek;a f;dr;=re''' .a¨fldógrhla ksjerosj Ndú;d lsÍug Wmfoia fyd| .a¨fldógrhla ñ,oS .; hq;=hs' mÍlaIKfha ksrjoH;djhg th b;d jeo.;a' ta i|yd ffjoHjrhdf.a Wmfoia ,nd.ekSu jeo.;a' FDA wkque;sh ,enQ" ke;fyd;a hqfrdamSh ix.ufha wkque;sh ,enQ .a¨fldógr ukd m%ñ;shlska hqla; tajd nj uQ,slj lshkak mq¿jka' fïjd ksjerosj l%shd;aul lsÍfï yelshdjo Tng ;sìh hq;=hs' we;eï wdh;k ksfjigu meñK fï foaj,a W.kajkjd' ta whf.a Wmldrh ,eîu Tng msgqjy,la fjkjd' ta jf.au we`.s,a, úoskakg fmr iam%S;= fhdod msßisÿ lsÍuo wjYHhs'

oshjeähdj iy fydafudak frda. úfYaI{ ffjoH m%idoa lgq,kao úiska lrk ,o idlÉPdj;a weiqßKs

22

November 2016

.a¨fldógr u.ska ,ndfok iq,n mdGdxl folla ;sfnkjd' wfma rfÜ iq,nj fhdod.kafka fvis ,Sgrhg ñ,s .a?ï (mg/dl) lshk mdGdxlh' ta yereKq úg ñ,s fuda,a (mmol) j,skao iSks w.h ukskjd' fndfyda .a¨fldógr fï tall foj¾. fhka Tng ßis wdldrhg udre lr.kakg;a mq¿jks' tfia neß kï mmol/L hkak mg/ dl lrkak 18ka tu mmol/Lw.h jeä l< hq;= jkjd'

DOCTOR MAGAZINE

doctormagazine.lk

Tfí .aÆfldógrh ksrjoH w.hka ,nd fok tllaoehs n,d.kakd yeá .a¨fldógrfhka ,nd.kakd w.h;a ridhkd.drfhaoS ,nd.kakd reêr idïm,fha;a w.h w;r fjkila we;s ùu fndfyda fofkl=g m%Yakhla' ta;a cSj;aj isák iEu mqoa.,fhl=f.au reêr iSks w.h fudfydf;ka fudfyd; fjkia jk nj Tn o; hq;=hs' fï ksid wjia:d folloS mÍlaId lrk úg fjkila we;sùu WmlrKfha fodila f,iu i<lkakg nE' Tfí .a¨fldógrh ksjerosj l%shd;aul jkafkaoehs oek.ekSug fyd| l%uhla ;sfnkjd' ta ;uhs ridhkd.drfhka reêrh ,nd.kakd fudfydf;au .a¨fldógrh;a wrf.k .syska ta fudfydf;au ,efnk w.h jd¾;dj iu. iei|Suhs' thska Tn Ndú;d lrk .a¨fldógrh ksrjoH tllaoehs fidhd.kak mq¿jka' ridhkd.drfhka ,nd.kakd reêrfha;a" .a¨fldógrfhka ,nd.kakd reêrfha;a uQ,sl fjkialï folla ;sfnkjd' ridhkd.drfhaos mÍlaId lrkafk Ysrd.; reêrh' (Venous Blood) .a¨fldógrfhka n,kafk flaYkd,sld reêrh' (Capillary Blood& Ysrd.; reêrfha iSks m%udKh idudkHfhka flaYkd,sld.; reêrhg jvd mdGdxl 10-15la wvqhs' f.oros .aÆfldógrfhka n,k úg ,efnk w.hg jvd ridhkd.dr jd¾;dfõ reêr iSks w.h 10-15 lska wvqùu fï wkQj idOdrKSlrkh fjkjd'

1960 oYlfhaoS oshjeähd frda.Skag bkaishq,ska ,ndoSug fhdod.;a me<| hd yels bkaishq,ska fmdïmh' fuh wefursldfõ wd¾fkda,aâ läIa kï ffjoHjrfhl=f.a ks¾udKhls' wfkla miska we;af;a uq,au ld,fha bkaishq,ska fmdïmhl ióm oiqkls'

.a¨fldógrhla Ndú;d lrkafka frda. úksYaphgu fkdfjhs' iSks uÜgu wvqùfï m%jK;djhla ;sfnkjdo @ tfia ke;akï jeäùfï m%jK;djhla ;sfnkjdo @ fï .ek o< woyila ,nd .ekSug ksfjfiaoS lrk iSks mÍlaIK WmldÍ fjkjd' reêr iSks md,khg fyg Tfí mßyrkhg tl;= jk fuj<ï jvd ld¾hlaIu reêr iSks hduk fuj<ï kqÿf¾oSu Tfí mßyrkhg;a tla fõú''' wo oshqKQ rgj, .aÆfldógrh blaujd .sh w;s kùk ;dlaIKsl fuj<ò oshjeähd frda.Skaf.a reOsr iSks mrSlaId lsrSug fhdod .kakjd' ta .ek wjfndaOhla ,nd.kakg Tn leu;s fjkjd we;s'

doctormagazine.lk

doctormagazine.lk

November 2016

DOCTOR MAGAZINE

23

D•Magazine /

Theme

reêrfha iSks md,khg wo ojfia Tng fhdod.; yels fuj<ï iy fyg ojfia Tfí myiqjg tla fjk fuj<ï

CGM (Continuous Glucose Monitoring ) devices fuh wef`.a iú lr ;sfnk fuj<ula' ojfia meh 24 uq¿,af,au reêrfha iSks uÜgu .ek wjOdkfhka isákjd'

fkdlvjd bkaishq,ska iemhqula idlaId;a lsÍug fhdod.kakd CGM WmlrKhla

Insulin Pump ta yereKq úg bkaishq,ska ,nd.kakd frda.Skag bkaishq,ska tkak;a lrk fmdïmhla wo Ndú;fha ;sfnkjd'

kùk bkaishq,ska fmdïmhla

Why is CGM used?

Fingersticks only show glucose levels at certain points in time. Fingerstick testing is like seeing photos of glucose levels to get a sense of what happened that day. In contrast, CGM shows the ups and downs of glucose levels around the clock. It’s like watching a movie of glucose levels. Information about glucose trends helps users take steps to keep blood glucose levels in a safe range. Users can share reports from the CGM system with their health care team to guide any adjustments to their diabetes management plan.

24

November 2016

DOCTOR MAGAZINE

fï iSks mÍlaId lrk WmlrKh;a bkaishq,ska tkak;a WmlrKh;a íÆgQ;a ;dlaIKh wdY%fhka tlsfkld w;r woyia yqjudrejla lrf.k iSks uÜgu wvq jqKdu wjYH m%Yia; m%udKh wfma wkqoeKqulska f;drju YÍr.; lrkjd' .sksfmÜáhl ;rï m%udKfha fujka kùk ;dlaIKsl WmlrK ksid oshjeähd frda.Skaf.a cSjk ;;a;ajh wo ie<lsh hq;= muKlska Wiia fjkjd' fuh lD;%Su w.akHdYhla f,i ffjoHjreka y÷kajd fokjd' ;j ál ld,hla hk úg fï w;s kùk fuj<ï ,xldfõ;a Tfí Ndú;hg meñfKkq we;s' DM

doctormagazine.lk

D•Magazine /

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

Advertorial Red Basmathi Nutrition & Diabetixcs

RED BASMATHI NUTRITION & DIABETES iqj|j;a nj ksid uy;a b,a¨ula we;s" fmdaIH .=Kh ksid ffjoHjrekaf.a f.!rjdorhg md;% jQ r;= ndiau;S iy,a

ú

úO iy,a j¾. w;f¾ ljo;a ndiau;S iy,g ,enqfKA b;d by< ia:dkhls' fmdaIH .=Kh w;skao" ishqï iq.kaOj;aNdjh fkdfyd;a wefrdaud .=Kh ksido ndiau;S iy,a iy,a w;f¾ Wiiau ;;a;ajfha iy,la f,i ms<s.ekSug ,laúh' th zziy,a w;f¾ / cskZZhk úreodj,sfhkao msÿï ,nd ;sfí' ndiau;S iy,g wdfõKsl iq.kaOh we;s fjkafka tys ;sfnk 2-acetyl-1pyrroline kï ridhkh ksidh' fuu iq.kaOj;a WoaoSmlh ndiau;S iy,a fldgia ì,shkhl 90la ;rï by< ixLHdjla ;sfnk nj fy<sorõ ù ;sfí' th wfkl=;a iy,a yd ixixokd;aulj úuiSfïoS 12 .=Khl ;rï by< w.hls' r;a meye iy,a w;f¾o r;= ndiau;S iy,a j, fmdaIH .=Kh wjfYaI iy,a blaujd hhs' tys iq,nj mj;akd ;ka;=uh fl|s wdydr cS¾Kfha iqug njg iDcqju n,mdhs' r;= ndiau;S iy,a j, we;s ;ka;=uh fl|s m%udKh wfkl=;a r;= iy,a j,g jvd ishhg 20lska jeäh'

doctormagazine.lk

November 2016

DOCTOR MAGAZINE

25

D•Magazine /

RED BASMATHI NUTRITION & DIABETES

Advertorial

iy,a wegh .;a l< tys jvd;au fïoh we;af;a l=reÜg yd N%EKfmdaIfhah' úgñka E jeks fïofhaa oshjk jákd úgñk we;af;ao fï fldgfiah' fuys we;s f;,a .;sh ksid fkdmdysk ,o iy,a uekúka fmd,sIa lrk ,o iy,a ;rï l,a ;nd .ekSug fkdyelsh' ksIamdolhka ;u iy,a f;d. jeä jYfhka fmd,sIa lsÍug fuu wdhq ld,ho fya;=jla lr.kshs' tfy;a ienúkau fuh fmdaIKSh jYfhka uy;a jQ ydkshls' ù ;ïnd flàu wfma we;eï m%foaY j, ;sfnk ;j;a isß;ls' fï ksid ù wegfha ndysrg jkakg we;s î úgñkh tys uOHhg tkï endosperm fj; .uka lrhs' fï ksid ;ïnk ,o iy,a fmdaIH .=Kfhka jvd;a by< njo lsj hq;af;ah' r;= ndiau;S iy,a j, we;s iqúfYaIS .=Kdx. • iajNdjfhkau fldf,iagfrda,a yd g%dkaia fïofhka f;drh' • iajNdjfhkau fidaähï iy ,jK j,ska f;drh' • iajNdjfhkau .a¨áka wvx.= ke;' • *a,efjdkhsâ" wekaf;dihkska hk m%n, m%;sTlaisldrl j,ska fmdfydi;ah' • wdydruh ;ka;= j,ska fmdfydi;ah' • .a,hsisñla o¾Ylh wvq wdydrhls' oshjeähd frda.Skag iqÿiq wdydrhla oshjeähd frda.Ska wdydr .ekSfïoS reêrfha iSks uÜgu kshdukh lrk w.kd o¾Ylhla ;sfí' ta .a,hsisñla o¾Ylhhs' .a,hsisñla o¾Ylh by< wdydr j,ska wE;a ùuo" wvq .a,hsisñla o¾Ylhla iys; wdydr j,g k;= ùuo reêr iSks md,kfhys,d jeo.;a fjhs' iuia;hla f,i ndiau;S iy,a wh;a jkafka uOH yd wvq .a,hsisñla o¾Ylhla iys; wdydr f,ihs' tfy;a r;= ndiau;S iy,a úfYaIh' tys .a,hsisñla o¾Ylh wh;a jkafka wvq ldKavhgh' tfyhska oshjeähd frda.Ska r;= ndiau;S iy,a wkqNj lsÍu jvd;a iqÿiqh' tys fmdaIH .=Kh yd ;ka;=uh wê ixhq;sh wfkl=;a wdydr j,g jeä jákdlula i,iajhs' .a,hsisñla o¾Ylh oshjeähd frda.sfhl=g Wmldrhla jk yeá .a,hsisñla o¾Ylh fkdfyd;a GI hkafkka ldfndayhsfâ%Ü wka;¾.; wdydrhla Tfí reêrfha iSks m%udKh by< kxjk wdldrh ms<sn|j lsishï wjfndaOhla ,nd fohs' 26

November 2016

DOCTOR MAGAZINE

fï GI o¾Ylh u.ska tlS wdydrh oshjeähd frda.sfhl=f.a mßyrkhg fl;rï iqÿiqo hkak .ek lsishï ud¾f.damfoaYkhla i,ihs' idudkHfhka .a,hsisñla o¾Ylh wvq wdydr f,i ie<flkafka GI w.h 55g wvq wdydrh' 56-69 w;r GI w.hla orK wdydr uOH m%udKfha GI w.hla iys; wdydr f,i ie<flK w;r GI w.h 70g jeä wdydr by< GI w.hla iys; hhs oelafjhs' oshjeähd frda.sfhl= wdydr f,i ks;s .; hq;af;a wvq .a,hsisñla o¾Ylhla orK wdydrh' uOH m%udKfha wdydr u| jYfhkao by< .a,hsisñla o¾Ylh wdydr .ekSfuka je<lSuo fhda.

Hh' .a,hsisñla o¾Ylh oshjeähd frda.sfhl=f.a wdydr isß; yev .ekaùfuys,d wkqmfïh jeo.;a lula orhs' r;= ndiau;S iy,a fukau wvq .a,hsisñla w.hla iys; wdydr ;j;a fndfyda we;' DM

fï iïnkaOfhka oek isàu oshjeähd frda.Ska yg muKla fkdj" iEu jeäysáfhl=gu mdfya jeo.;a jk ksid iúia;rd;aul ú.%yhla ,nk l,dmfhka bosßm;a lruq'

doctormagazine.lk

rdcH Tiqi,a cd,h

fld<U 07 255" O¾umd, udj; fld<U 07 ÿ'w 011 2672293 *e'w 011 2694716 fld<U 04 85" .d¨ mdr" fld<U 04 ÿ'w$ *e' w 011-2587128 011-2559531 kqf.af.dv 151" tia ã tia chisxy udj;" kqf.af.dv ÿ'w$ *e'w 011 2856641 kqjr 14ta" ,ud.dr udj;" kqjr ÿ'w$ *e'w 081 2225175 ñkqjkaf.dv merKs hQ iS f.dvke.s,a, fld<U mdr" ñkqjkaf.dv ÿ'w$ *e'w 011 2295120 .d,a, 61 ta" jlaje,a, mdr" .d,a, ÿ'w$ *e'w 091 2234726 mdkÿr 159" tï'mS'iS'tia f.dvke.s,a, .d¨ mdr" mdkÿr ÿ'w$ *e'w 038 2234767 r;akmqr 32" kkaod t,a,dj, udj; r;akmqr ÿ'w$ *e'w 045 2223014 wúiaidfõ,a, 40" niakej;=ïm, wúiaidfõ,a, ÿ'w$ *e'w 036 2222501 nÿ,a, iS'ví'B f.dvke.s,a, nKavdrfj, udj;" nÿ,a, ÿ'w$ *e'w 055 2229837

lrdmsáh Tiqi, 175" ysßUqr yria mdr" lrdmsáh

ud;r pdrsldrduh wk.drsl O¾umd, udj; ud;r ÿ'w$ *e'w 041 2231871

r;au,dk Tiqi, fu.d i'f;d'i f.d¨uvu ykaosh .d¨mdr" r;au,dk ÿ'w$ *e'w 011 3043789

wïmdr mkai, ykaosh ã'tia fiakdkdhl ùoSh wïmdr ÿ'w$ *e'w 063 2223088

rd.u 61$ta" uyndf.a udj; rd.u ÿ'w$ *e'w 011 2955219

l=reKE., 28" ùr;=x. f.dvke.s,a, fn!oaOdf,dal udj; l=reKE., ÿ'w$ *e'w 037 2230840 yïnkaf;dg 3" ne/la ùosh" yïnkaf;dg ÿ'w$ *e'w 047 2222163 wkqrdOmqr 98" nexl= fmfoi wkqrdOmqr ÿ'w$ *e'w 025 2222181 uyr.u 71$tA" w,aúia *a,did" mrK udj;" uyr.u ÿ'w$ *e'w 011 2745640 Y%S chj¾Okmqr Y%S chj¾Okmqr uQ,sl frday," chj¾Okmqr ;,m;amsáh" kqf.af.dv ÿ'w$ *e'w 011 2779414 lrdmsáh 132" m<uq mgqu`. ms<sld frday, udj; udbáfm" lrdmsáh ÿ'w$ *e'w 091 2226947 ó.uqj 134" uyfrday, bosrsmsg fld<U mdr" ó.uqj ÿ'w$ *e'w 031 2228599 osh;,dj kj niakej;=ïm< m%Odk ùosh" osh;,dj ÿ'w$ *e'w 057 2227190

hdmkh 149ta" fla'fla'tia udj; hdmkh ÿ'w $ *e'w 021 2219262 fmdf<dkakrej frday, ykaosh" lÿrefj, mdr" fmdf<dkakrej ÿ'w$ *e'w 027 2225465 ;x.,a, b|sfmdl=Kf.dv udj; ;x.,a, ÿ'w 047 2241221 ÿ'w$ *e'w 011 2779414

AD-MIRE Creative

fld<U 01 63" i¾ ndfrdaka ch;s,l udj;" fld<U 01 ÿ'w$ *e'w 011-2328046

nKavdr.u frday,a fmfoi fydrK mdr" nKavdr.u ÿ'w $ *e'w 038 2288671 fnd/,a, <ud frday,a mrsY%h fnd/,a, ÿ'w $ *e'w 011 2697660 weô,smsáh 102" fl<ska ùosh" m,af,.u" weô,smsáh ÿ'w $ *e'w 047-2261177 fldgqj ÿïßhfmd< mßY%h ÿïßhfmd<" fldgqj ÿ'w $ *e'w 011-2336926

ISO iy;sl

,;a rdcH T!IO kS;s.; ixia:dfõ ;;a;aj ridhkd.drfha ;;a;aj mÍlaIdjkag ,la jk Wiia ;;a;ajfha" wdrlaIdldß" m%;HlaI T!IO SPC kñkau b,a,kak'

Y%S ,xld rdcH T!IO kS;s.; ixia:dj" 75" YS%u;a ndfrdka ch;s,l udj;" fld<U 01' ÿ'l' 011- 2320356-9 *elaia' 011-2447118

doctormagazine.lk

November 2016

DOCTOR MAGAZINE

27

D•Magazine /

Theme

oshjeähdj ksid we;sjk wlaIs wdndO

28

November 2016

DOCTOR MAGAZINE

doctormagazine.lk

ffjoH Wmfoia wkQj frda.h md,kh lr.;af;d;a oshjeähdj wdY%s; ixl+,;d fndfyda fihska j<lajd .; yelshs

È wlaIs Y,H úfYaI{ ffjoH tï tia wur;=x. úisks

hjeähdj fya;=fldg f.k wefia l%shdldß;ajfhys úúO fjkialï yg.kS' fï .ek wm oeKqj;a fjuq'

fmkSfï ;djld,sl fjkialï iSks wvq jeä jk úg wefiys fmkSfï ;djld,sl fjkialï we;sfõ' fïjd j¾;k fodaI (Refractive errors) hkqfjka ye|skafõ' wm olsk jia;=j ksishdldrj wefiys kdNs.; fkdùfuka we;sjk fodaI zj¾;k fodaIZ f,i oelafõ' iSks jeäjk úg ÿr we;s jia;=ka meyeos,sj oelsh yels fkdfõ' fmkSu fnd| fõ' tfiau iSks wvqjk úg wmeyeos,s jkafka <`.ska we;s jia;+ka meyeos,sj oelSfï yelshdjhs' fï wdldrfhka wefya fmKqu iïnkaO .eg¿ j,g uqyqKmdk oshjeähd frda.Ska we;eï wjia:d j,oS reêr iSks md,khlg ,lajQ úgo wefya fmKqu ÿ¾j, jk njg meñKs<s lr;s' fujka j¾;k fodaI weia lKakdähla me<|Sfuka ksjeros lr.; yelshs' wou Tfí wlaIs ffjoHjrhd yuqù mÍlaIdjla lrf.k iqÿiq lKakdähla ks¾foaY lr.kak'

doctormagazine.lk

doctormagazine.lk

oshjeähdj ksid wefia iqo fõ,dikska we;súh yelshs wefia iqo (Cataract) hkq wefia ldph fkdfyd;a wm olsk jia;=j kdNs.; jk ia:dkh wdY%s;j yg.kakd November 2016

DOCTOR MAGAZINE

29

D•Magazine /

oshjeähdj ksid we;sjk wlaIs wdndO

Theme

fodaIhls' fuysoS wm n,k rEmfhys meyeos,s nj ke;sù n,k jia;=fjys j<dl=<la jeks iajNdjhla wmeyeos,s" fnd| iajNdjhla oeÍu isÿfjhs' fuhg m%;sl¾uh jYfhka fï fodaI iys; ldph bj;a lr lD;%Su ldphla wefia ;ekam;a lsÍu isÿ flf¾' oshjeähdj we;s úg fï wefia iqo we;s ùfï m%jK;djh jeäh' tfiau wefia iqo ;;a;ajh blauKska j¾Okh ùulao isÿ jkafkah' oshjeähd wlaIs wndOh fuh Diabetic Retinopathy hkqfjka ye|sskafjk frda. ;;a;ajhhs' wm oDIaÀ ú;dkh .ek idudkH jyf¾oS y÷kajkafka zwefya isúhZ hkqfjks' wefya isúfha we;sjk .eg¿ j,g l,g fõ,djg ms<shï fkdfhoSfuka wei wkaO úh yel' oshjeähd frda.Skaf.a wefya isúh fkdfyd;a oDIaÀ ú;dkh wk;=rg ,laùfï bvlv jeäh'

30

November 2016

DOCTOR MAGAZINE

wfma ishqï fmKqug" j¾K ye|skSug WmldÍ jk ly ,mh wm zly ,mhZ hkqfjka wmf.a y÷kajk ishqï fmKqug WmldÍ jk oDIaÀ ú;dkfha we;s ;j;a fldgilgo fï ksid n,mEula we;s jkafkah' ly ,mh ishqï fmKqug fukau jia;=jl we;s j¾K thdldrfhka .%yKhgo Woõ jk fldgihs' ;r, ldkaÿ ùuloS ly ,mh bosóulg ,laù wE; isák flfkla y÷kd.ekSug we;s yelshdj" wl=re lshùug we;s yelshdj wdosh ySk lrhs'

doctormagazine.lk

In diabetic retinopathy, the weakened blood vessels may begin to leak blood or fluid vessels and develop tiny, fragile branches and fragile branches and scar tissue that can blur your vision or distort the information that the retina sends to your brain.

ly ,mh fufia ÿr fmKqu yd j¾K m%;s.%yKhg WmldÍ fj;aoS oDIAÀ ú;dkfha wjfYaI fldgia wjg fmKqu fkdfyd;a yd;ami ksÍlaIKhgo" w÷f¾ jia;= oelSugo WmldÍ fjhs' oshjeähdj ksid fï l%shd iEu tllgu mdfya ydks isÿúh yel'

Diabetic Eye Examinations www.sacramentoeyeconsultants.com

ly ,mh leurdjl fiahd mg,h jf.ahs oDIaÀ ú;dkh wefya msgqmig fjkakg msysgd we;s wjhjhls' tys ueo fldgi ly ,mh (Macula) kï fldgihs' weila leurdjg iudk lf<d;a oDIaÀ ú;dkh leurdfõ fiahd mg,hhs' wm hula foi n,k úg tys m%;sìïnhla oDIaÀ ú;dkfha ;ekam;a fjhs' ta hál=re iajrEmfhks' thska wk;=rej fud<h wdY%s; iakdhql l%shdj,shla n,.ekaù fmkSu kue;s ixfõokh kshudldrfhka wmg w;aú|skakg i,iajhs'

doctormagazine.lk

Blood ocular barrier ÿ¾j, ùfuka oDIaGs js;dkh ÿ¾j, fjkjd''' wefia f,a kyr ieliS we;af;a hï úfYaIs; wdldrhlgh' oDIaÀ ú;dkhg wjYH lrk fmdaIKh ,ndoSug iu;a fï f,a kyr j, isg oDIaÀ ú;dkhg reêr iemhqu ,nd fokafka Blood ocular barrier kï mdr.uH mg,hla" ndOlhla yrydh' oshjeähd frda.Skaf.a fï Blood ocular barrier tl l%u l%ufhka ÿ¾j, fjhs' tys m%;sM<hla jYfhka f,a j, ;sfhk f;,a" j;=r wdosh oDIaÀ ú;dkhg ldkaÿ fjhs' oDIaÀ ú;dkfha úh<s nj yeuúgu jeo.;a''' oDIaÀ ú;dkh iEu úgu ;sìh hq;af;a úh<s iajrEmhlsks' th wms íf,dáka fmam¾ tll ksoiqklska myod.kakg W;aidy lruq' mdúÉÑ fkdl< íf,dáka fmam¾ tlla úh<sh' f;; hula ta u; iam¾Y jQ úg ta f;; íf,dáka fmam¾ tlg Wrd.kS' thska tys úh<s iajNdjh ke;sfõ' md,kh fkdl< oshjeähd

November 2016

DOCTOR MAGAZINE

31

D•Magazine /

oshjeähdj ksid we;sjk wlaIs wdndO

Theme

frda.Skaf.a wefia oDIaÀ ú;dkfhao úh<s Ndjh ke;sjkafka fï wdldrfhks' fufia oDIaÀ ú;dkfha yqremqreÿ úh<sNdjh ke;sùfuka l%udKql+,j wefia fmKqu ÿ¾j, jkafkah'

1. Non-Proliferative Diabetic Retinopathy 2. Proliferative Diabetic Retinopathy Non-Proliferative Diabetic Retinopathy ;;a;ajh wvq wjodkula iys; wk;=r

fkdjeo.;a reêrjdyskS we;sùfuka isÿjk wk;=rla oDIaÀ ú;dkh bosófïoS uq,skau isÿ jkafka ishqï f,a kyr wjysr ùuhs' fuys m%;sM<hla f,i oDIaÀ ú;dkfha ffi, j,g Tlaiscka jdhqj m%udKj;aj iemfhkafka ke;' fï ksid oDIaÀ ú;dkfha jHqyd;aul fjkila isÿjk w;r th Neovascularization jYfhka ye|skafõ' fï ksid kj jdyskS w¿;ska we;sjk w;r kj mgl úfYaI ìys ùulao isÿfõ' wNskjfhka we;sjk fï jdyskS yd mgl j, we;s úfYAI;ajhla jkafka tajd Yla;sfhka ÿ¾j, ùuhs' reêr jdyskS mqmqrd f,a .e,Sï isÿ úh yelshs' mgl kï yels,S hd yelshs' fuys we;s úNùh wjodku jkafka fï wdldrfhka oDIAGÀú;dkh ÿ¾j, ù th .e,ù hdug (Retinal detachment) we;s wjodkuh' oshjeähd wlaIs wdndOh Diabetic Retinopathy oshjeähd wlaIs wdndOh uQ,sl jYfhka fojeoEreïh'

32

November 2016

DOCTOR MAGAZINE

uQ,sl wjia:dfõ ixl+,;djhls' fuysoS oDIaÀú;dkfha we;s ishqï reêr kd, j,ska reêrh ldkaÿ ùula isÿfjhs' tys m%;sM<hla jYfhka oDIaÀú;dkh bosóu iy ta u; ;ekam;= we;sùu fkdje<elaúh yelalls' fuu ;;a;ajhg m;a frda.Ska i|yd m%Odk m%;sldrh jkafka f,ai¾ lsrK we,a,Suhs' weye ;=<g T!IOhla tkak;a lsÍuo isÿ lrKq ,nhs' fï m%;sldr j,ska id¾:l;ajhla w;am;a lr.ekSu ÿIalr jQ úg Trans pars plana vitrectomy kï Y,Hl¾uhla u.ska fï fodaIh ksjeros flf¾' ixl+,;d wjia:dj oDIaÀú;dkh u; w¿;ska reêrjdyskS yd mgl we;sùu Proliferative

doctormagazine.lk

retinopathy hkqfjka ye|skafjhs' oDIaÀú;dkh u; w¿;ska reêrjdyskS yd mgl we;s jQ úg lrk m%;sldr 1' f,ai¾ lsÍu fuysoS uQ,sl jYfhka isÿ lrkafka f,ai¾ m%;sldrhhs' f,ai¾ lsÍu ie<flkafka Destructive Procedure tlla jYfhks' fuysoS m%ia;=; ia:dkfha ffi, úYd, ixLHdjla f,ai¾ loïnhla u.ska úkdY lrKQ ,nhs' túg tu ia:dkfha ;sfnk iuia; ffi, ixLHdfõ wvqùula isÿjk ksid ;sfnk wvq mßudjlska hqla; wï,lr ke;fyd;a Tlaiscka jdhq m%udKh fYaI ù ;sfnk ffi, j, kshñ; l%shdldß;ajhg m%udKj;a jkafkah' ;eïnQ ì;a;rfha WmyerKh ì;a;rhla ;eïnQ úg tys oshr iajNdjfhka ;sfnk iqÿuoh >k fjhs' fï wdldrhgu f,ai¾ lsÍu ksid oDIaÀú;dkfha we;s mgl >k ùula isÿ fõ' túg ta ia:dkfha we;af;a cSù ffi, fjkqjg wcSù ffi, modihls' tys cSù .;s ,laIK fkdue;' f,ai¾ lsÍfuka oDIaÀ ú;dkfha isÿjk fuu l%shdj,sh Panretinal photocoagulation kñka ye|skafõ'

doctormagazine.lk

What can you do to protect your vision? www.nei.nih.gov/diabetes

f,ai¾ lsÍfuka fmkSu wvq fjkjdo @ fï wdldrhg f,ai¾ lsÍfuka hï ffi, m%udKhla wl¾ukH lsÍu ksid fmKqug ie<lsh hq;= ydkshla isÿjkafka ke;' ta;a f,ai¾ m%;sldrh ;rula jeä jYfhka isÿ lsÍfïoS kï yd;ami fmKqfï" fome;a; ne,Sfï ÿ¾j,;djhka we;súh yel' 2' kslafIamk m%;sldrh uqod yefrk ridhk WodiSk lrkakg T!IO kslafIamkh lsÍu ;j;a m%;sl¾uhls'

November 2016

DOCTOR MAGAZINE

33

D•Magazine /

oshjeähdj ksid we;sjk wlaIs wdndO

Theme

3' Y,Hl¾uh wefia ;sfnk ;r,hg (vitreous) ñY% ù we;s reêrh bj;a lr fmkSu iqmeyeos,s lrKq msKsi fhdod. kakd fuu Y,Hl¾uh y÷kajkafka Trans pars plana vitrectomy (TPPV) hkqfjks' oDIaÀ ú;dkh wdrlaId lr .ekSug .;hq;= mshjr oDIaÀú;dkhg we;sjk wdmodj,ska j<lskf a ka flfiao @ oDIaÀú;dkh wdmod j,g ,la jkafka uQ,sl jYfhka Tnf.a iuia; fi!LH msßySug ,laùfuks' fï ksid my; mshjr .ekSu ;=<ska fï wjodku fnfyúka wvq lr.; yel' 1' YÍrfha reêr iSks uÜgu uekúka md,kh lr.kak' 2' YÍrfha fldf,iagfrda,a w.hka iEu úgu ys;lr mrdihl mj;ajd .kak' 3' reêr mSvkh ys;lr mrdihl mj;ajd .kak' jirlg j;djla j;a wlaIs ffjoHjrfhl= yuq ùu wksjd¾hhs oshjeähdfjka mSvd ú|sk mqoa.,hka jirlg j;djla j;a wlaIs ffjoHjrfhl= yuqúh hq;=h' th wdrlaIdfõ uQ,sl mshjrla jYfhks'' hï fyhlska wlaIs ffjoHjrhd úiska tu ld,iSudj ;jÿrg;a flá lrKq ,enqfjd;a" Tyq fok Wmfoia wkQj Tfí ffjoH yuqj ie,iqï lr.; hq;= fõ' wlaIs ffjoHjrfhl= jYfhka uf.a w;aoelSu os.= ld,hla ;siafia frda.Ska weiqre lsÍfuka ud ,o w;aoelSulao fuysoS Tng ikaksfõokh lsÍu iqÿiq hhs isf;a' ud okakd iuyr Woúh wjqreÿ ;syla ;siamyla ;siafia oshjeähd frda.Skah' tfy;a fï wh b;d fyd| fmkSulska hqla; fj;s' lsisÿ wlaIs wjodkulao Tjqkg fmfkkakg ke;' tys ryi l=ulao @ fï whf.a hy meje;auhs' Tjqka oshjeähdj md,kh lrkakg fyd|ska ffjoHjreka fok Wmfoia ms<smos;s' wdydr YslaIKh" kshñ; ffjoH mÍlaIK Tiafia ish¿ wNsfhda. ch.kakg Tjqka iu;aj isá;s' ta ksjeros YslaIKhl" hy meje;aul wreuhhs'

34

November 2016

DOCTOR MAGAZINE

iSks jeä jqKq uq,a wjia:dfõoSu l%shd;aul jkak YÍrfha iSks jeä jqKdg fndfyda fofkla ta .ek uq,a wjia:dfõu jo fjkafka ke;' Tyq frda. md,khlg wjYH mshjr .kafka hïlsis .eg¿jla meK ke.=Kq úgh' túg .eg¿j n,.ekaù wjikah' túgo hula l< yelsh' hï id¾:l;ajhlao w;am;a lr.; yelsh' tfy;a túg we;s lr.kakd md,kh" uq,skau we;s lr.kakd frda. md,kh muK id¾:l tlla fkdfõ' YslaIKfhka cSú;h ch .ksuq fï ksid oshjeähdj md,kh lr.kakg;a" ta ksid miqld,Skh we;sjk wf;darla ke;s w;jrhkaf.ka ñoSug;a fok ffjoHjrhd ,ndfok Wmfoia uq,a wjia:dfõoSu ms<smeosh hq;=h' frda.h uev meje;aùfuys,d hïlsis YslaIKhla we;s lr.; hq;=h' fï ms<sfj;a Tiafia Tng id¾:lj oshjeähdj frda.h md,kh lsÍug losu wjia:djla ysñ jkafkah' th Tn mK fukau iq/ lsh hq;= fofk;a hq.,o rlaId lrfok fya;=jlau fkdjkafkao @ DM doctormagazine.lk

WE ARE MOVING INTO NEW LOCATION

Country office

Brien Holden Vision Institute Foundation

731, Negombo Road, Mabole, Wattala Tele- +9411 2 982 360 Fax- +9411 2 982 350 Mobile +9471 4 255 072 www.brienholdenvision.org wCIs fi!LH ms<sn`oj ±kqj;a lsÍfï m%cd jevigyka

fldf,dkakdj - 011 2 547 885'" jrldfmd, - 035 2 267 052'" háhkaf;dg - 036 2 270 158'" Eyedoctormagazine.lk Clinic, SLOA m%Odk ld¾hd, f.dvke.s,a, - 011 3 021 486'" 2016 ±rKsDOCTOR h., MAGAZINE - 036 3 79635222'" November j;a;, - 011 2 982 984'

D•Magazine /

Theme

oshjeähdj frda.h iïnkaO uQ,sl lreKQ

oshjeähdj frda.h iïnkaO uQ,sl lreKQ fld<U 5" kdrdfyakamsg" lsßuKav, udjf;a wdisß Y,H frday, bosßm;a lrhs' oshjeähdj hkq l=ulao @ YÍrfha reêr iSks m%udKh mej;sh hq;= idudkH w.hg jvd by< hdu oshjeähdj hkqfjka ye|skafõ' reêrfha iSks m%udK md,kh lrkafka w.akHdYfhka ksmofjk bkaishq,ska fydafudakhhs' w.akHdYfhka bkaishq,ska ksmoùfï wvq¨yq`vq;djhla ksid fyda ksmofjk bkaishq,ska yß yeá l%shd;aul fkdùu ksid fï wdldrfhka reêrfha iSks uÜgu by< kexfjhs'

oshjeähdj ksÜgdjg iqj lsÍu fkdl< yel' tfy;a th uekúka md,kh l< yels frda. hls' th tfiau úh hq;a;ls' hï fyhlska reêrfha iSks m%udKh md,kh fkdjqfKd;a ixl+,;d /ila we;sùfï wjodku we;s jkafkah' yDoh frda." jl=.vq wdndO" iakdhq wdndO fï w;r m%Odk fõ' oshjeähdj wdldr • fojk wdldrfha oshjeähdj • m<uqjk wdldrfha oshjeähdj • .¾NsKS oshjeähdj oshjeähdj f,dal ;;a;ajh oshjeähdj ful, b;d fõ.fhka jHdma; jk frda.hls' f,dalfha ck;djf.ka ñ,shk 415la oshjeähdjg f.dÿre ù isà' 2015 j¾IfhaoS ksl=;a lrk ,o IDF oshjeähd is;shug wkQj wfma rfÜ oshjeähd frda.Ska ixLHdj ñ,shk 1'16ls'

36

November 2016

DOCTOR MAGAZINE

doctormagazine.lk

ck.ykfha m%;sY;hla f,i .;a l< th 8'5 ls' iEu fodf<dia fofklaf.ka tla wfhlau oshjeähd frda.sfhls' flfia fj;;a fuu ixLHd f,aLK ;jÿrg;a by< kexfjk nj úoaj;=kaf.a woyihs' m<uq wdldrfha oshjeähdj Juvenile-onset diabetes hkqfjkao y÷kajkq ,nhs' fuu frda.h we;sùug fya;=j iajhx m%;sYla;slrK m%;spdrhla hhs ie<fla' fuysoS YÍrfha m%;sYla;slrK moaO;sh u.ska bkaishq,ska ffi, j,g myroSula isÿ lrhs' fuh isÿjk wdldrh ms<sn|j iïmQ¾K lreKq y÷kdf.k ke;;a fï frda.Skaf.a bkaishq,ska ksIamdokh fnfyúka wvd, jk nj y÷kdf.k ;sfí' iEu jhilu flfkl=g m<uq wdldrfha oshjeähdj we;súh yel' tfy;a fndfydaúg orejkag we;sjkafka fuu wdldrhhs' fuu m<uq wdldrfha oshjeähdj we;s úg reêrfha ;sfnk bkaishq,ska hdukh msKsi oskm;d bkaishq,ska tkak;a lsÍug isÿ fõ' fï wdldrfhka bkaishq,ska ,ndoSug wiu;a jQjfyd;a frda.shdg ñh hdug isÿjkq we;' fojk wdldrfha oshjeähdj fï frda.Ska Non-insulin dependent diabetes fyda Adult-onset diabetes hkqfjkao ye|skafjhs' oshjeähdj frda.Skaf.ka ishhg 90la muK wh;a jkafka fuu fojk wdldrfha oshjeähdjgh' bkaishq,ska fydafudakhg YÍr mgl olajk m%;sfrdaOhla ksid fyda m%udKj;a ;rï bkaishq,ska ksmoùula isÿ fkdjk ksid fuu frda.h we;s úh yel' fuh we;s jkakg jhia iSudjla ke;' frda.h y÷kd fkdf.k iEfyk ld,hla bkakg isÿjk wjia:do fõ' fjkhï wikSmhlg m%;sldr msKsi hk úg wyïfnka fuka fï frda.h we;s nj y÷kd.kakd frda.Skao isà' ia:q,;djh we;s wh fojk wdldrfha oshjeähdj we;s ùfï jeä wjodkula orhs' fï frda.Ska iuyrlg wdrïNfhaoS wdydr md,kfhka yd YdÍßl jHdhdu wdosh m%udKj;aj isÿ lsÍfuka iEfyk md,khla we;s lr.; yel' m<uq wdldrfha oshjeähdj fukau fojk wdldrfha oshjeähdjo tlfia Nhdklh' hka;ï oshjeähdj ;sfnkjd lshd frda.hla ke;' fï m%fNao folu ksid YÍrfha iEu bkaøshlu mdfya ixl+,;d we;sùfï wjodkula meK k.sk fyhska reêr iSks md,kh lsÍu fï frda.Skaf.a uqLHd¾:h úh hq;af;ah'

doctormagazine.lk

.¾NsKS oshjeähdj .¾NsKS;djhla orK iufhaoS reêrfha wêl .aÆfldaia w.hka jd¾;d ùu .¾NsKS oshjeähdj hkqfjka ye|skafjhs' f,dalh mqrd .¾NsKS ldka;djka úis mylska flfkla .¾NsKS oshjeähdjg ,la fj;s' fuu ;;a;ajh ksid ujg fukau Wmoskakg isk orejdgo úúO ixl+,;d we;s úh yels ksid reêr iSks uÜgu md,kh lsÍug fkdmudj ms<shï fhosh hq;= jkafkah' fï uõjreka fukau orejkao miq ld,fhaoS oshjeähdjg k;= ùfï jeä wjodkula orKQ we;'

oshjeähd frda.f s hl= tfia fkdjk mqo. a ,fhl=g idfmalI a j iajlSh mdo lmkakg isÿùfï 25 .=Khl jeä wjodkula orhs' tfia jQj;a kùk fi!LdrlaIl Wmdhud¾. wkq. ukh lsÍfuka fï wk;=ßka ñoSug Tng wjia:dj ie,fia'

November 2016

"

DOCTOR MAGAZINE

37

D•Magazine /

oshjeähdj frda.h iïnkaO uQ,sl lreKQ

Theme

oshjeähdj wdrïNfhaoS we;súh yels wk;=re ye`.ùï ,laIK • YÍrfha nr wvqùu fyda jeäùu • l=i.skak jeäùu • msmdidj • ks;r ks;r uq;%d msg lsÍfï ´kElu • wêl úvdnr .;sh iy YÍrfha l=iS; nj • fmkSu fnd| ùu • uq;%d" ,sxf.akaøsh.; yd iu wdY%s; wdidok ks;r u;=ùu ;=jd, iqjùu m%udo ùu • w;a yd mdoj, ysßh • msßñkaf.a ,sxf.akaøsh iDcq fkdùfï ÿn,;d oshjeähdj - y÷kd.ekSfï mÍlaIK ksrdydr reêr mÍlaIdj Fasting Blood Sugar (FBS) meh oyhl ld,hla ksrdydrj isg WoEik ,nd.kakd reêr idïm,hlska tys we;s iSks m%udKh ridhkd. dr mÍlaIKhlska y÷kd.ekSu' 126mg/dLblaujQ iSks w.hla jd¾;d ùu oshjeähdj ;yjqre lrhs' HbA1C fuho wdydr idOlfha n,mEula ke;sj ojfia ´kEu fj,djl isÿ lr.; yels mÍlaIKhls' udi ;=kla we;=<; YÍrfha YÍrfha iSks md,kh ms<sn|j wjfndaOhla ,nd.; yel' ishhg 7g wvq m%;sM<hla ,eîu fyd|h' Oral Glucose Tolerance Test (OGTT) uq,skau meh 10la ksrdydrj isáh hq;=h' .aÆfldaia .a?ï 75la mdkh lsÍug i,iajd meh follg miqj iSks uÜgu n,kq ,efí' 2-Hour Oral Glucose Tolerance Test (OGTT)

38

Glucose Level

Less than 140 mg/dL ( 7.8 mmol/L)

Indication Normal glucose tolerance

From 140 to 199 mg/dL ( 7.8 to 11.1 mmol/L)

Prediabetes (impaired glucose tolerance)

Equal to or greater than 200 mg/dL ( 11.1 mmol/L) on more than one testing occasion

Diabetes

November 2016

DOCTOR MAGAZINE

oshjeähdj ksid we;sjk ixl+,;d oshjeähdfjka fmf<k frda.Ska úúO ixl+,;d j,g Ndckh ùfï by< wjodkula mj;S' yDoh" reêrjdyskS" iakdhq" weia" jl=.vq'''wdoS jYfhks' ta yereKq úg oshjeähd frda.Ska úúO wdidok j,g ,laùfïo jeä wjia:djla mj;S' fndfyda rgj, yDohdndO" wkaONdjh" jl=.vq frda." mdo lmkakg isÿùu wdoS fndfyda ixl+,;d j,g uQ,sl jkafka oshjeähdjhs' wêreêr mSvkh" fldf,iagfrda,a" reêr iSks wdosh idudkH w.hg m;a lr.ekSu fyda ta wdikakhg .ekSfuka oshjeähdj ksid we;súh yels ixl+,;d l,a oud.; yel' k;r lr.; yel' fï ksid oshjeähd ;sfnk frda.Ska ks;sm;d ;u frda. ;;a;ajh mÍlaId lr.; hq;af;ah' yDo frda." yoj; yd reêr jdyskSj, we;sjk fjkialï ksid udrdka;sl ixl+,;d we;sùfï wjldY ;sfí' yDohdndO yd wxYNd.h jeks frda. fï hg;g .efka' oshjeähdj doctormagazine.lk

wêreêr mSvkh iy fldf,iagfrda,a uÜgu by< hdu fuu wjodku úYd, jYfhka jeä lrhs' wefia iqo" .aÆfldaudj" oDIaÀ ú;dkfha we;sjk fodaI wdoS jYfhka wlaIs.; frda. /ila we;s ùfï wjodku fuysoS we;s fõ'

frda.Ska urKhg m;aùfï uQ,sl wjodku we;af;ao fï frda. weiqf¾h' wêl iSks" wê reêr mSvkh iy fldf,iagfrda,a hk wjodkï iy.; idOl fya;=fldgf.k fï wjodku mek k.sk ksid tajd yels muK md,khg ,la lr .ekSug Tn W;aiql úh hq;=h' jl=.vq frda. jl=.vq j, ;sfnk l=vd reêr jdyskS wdmodjg ,laùfuka jl=.vq krla ùu isÿfõ' fuysoS jl=.vq l%shdldß;ajh wvqùu fyda jl=.vq l%shdldß;ajh k;r ùu jQj we;súh yel' reêr.; iSks uÜgu ys;lr w.hl fyda Bg wdikak w.hl r|jd .ekSfuka fï wjodku fnfyúka wvq lr.; yel' iakdhq wdndO reêr.; iSks iy reêr mSvkh jeäùu ksid YÍrh mqrdu ;sfnk iakdhq j, wdmodjka we;súh yel' cS¾Kl úIu;d we;sùug" mqreIhkaf.a ,sx.sl iDcqlrKh wvd, ùug wdoS jYfhka fuysoS úúO ixl+,;d we;súh yels uq;a ta ish,a,gu jvd iq,nj olakg ,efnkafka mdo j,g jk reêr iemhqfï wvd, ùuhs' fï ksid mdo .,l yemqk;a fõokdjla fkdoefka' ks;r ks;r ysß jeàu we;sfõ' ;=jd,hla we;s jQ úg th iqj ùug l,a .;fõ' ksis m%;sl¾u l,g fõ,djg fkdfhÿfKd;a mdoh lmkakg mjd isÿ úh yel' fï ksid oshjeähd frda.Ska ;u mdo fi!LHdrlaIs;j mj;ajd .ekSu flfryS buy;a wjOdkhla fhduq l< hq;=h' wlaIs frda. oshjeähdj ;sfnk fndfyda frda.Ska weia j, fmkSu wvqjk lsishï wlaIs wdndOhlg ,lafõ' we;efula fofk;a w|Ndjhg m;aùfï wk;=rgo ,la fjhs' ksrka;rfhka reêrfha .aÆfldaia uÜgu by< hdu"

doctormagazine.lk

.¾NsKS oshjeähdj .¾NsKS jQ miq reêr.; iSks ïÜgu by< hdu ksid ujg;a orejdg;a hk fofokdgu bkaøsh wdmodjg m;aùfï wjodkula we;sfõ' oshjeähdj ;sfnk uõjrekao .¾NsKS;djhg m;aùfïoS ;u reêr iSks w.hka uekúka md,khlg ,la lr.; hq;=h' .¾NsKS ld,fhaoS ujf.a reêr iSks uekúka md,khg ,la fkdùfuka bmfok orejd jeä nrla iys;j bmoSug bv m%ia:djla we;af;ah'fuh ore m%iQ;sh ixl+, lrjk fya;=jls' tfiau fï ksid orejd Wmka miq tlúgu reêr .aÆfldaia uÜgu my; jeàugo fya;=jla úh yel' os.= ld,hla ;siafia ujf.a l=i ;=<oS by< .aÆfldaia uÜgulg ksrdjrKh ùu ksid fï orejka wkd.;fhaoS oshjeähd frda.Ska njg m;aùfï lsishï wjodkulao mek k.S' DM

Source: International Diabetes Federation

November 2016

DOCTOR MAGAZINE

39

D•Magazine /

Theme

oshjeähdj we;s Tng iqÿiq wdydr

oshjeähdj we;s Tng iqÿiq wdydr wdydr md,kh oshjeähd md,kfha uQ,sl ld¾hhhs úfYaI{ ffjoH j¾Kl=, l=iqï o wdnDD

Èhjeähdj we;s whg lEug fhda.H fndfyda wdydr ;sfí' fïjdhska iuyrla jeämqr lEug .; yelsh' m%udKhlg .;hq;= wdydro ;sfí' iuyrla wdydr .ekSu kqiqÿiq jk w;r tajdfhka je<lSfuka Tng Tfí reêr iSks m%udKh uekúka md,khlg ,lalr .ekSug wjia:djla ie,fia' 40

November 2016

jeämqr .; yels wdydr lerÜ jïfndgq ,Slaia lelsß msms[a[d jÜglald mf;da, fldys, m<d j¾. uqrex.d nKavlald w¿ mqyq,a rdnq fndaxÑ fkdafld,a jegfld¿ idudkH m%udKhg .ekSu iqÿiq fl|s iys; wdydr • r;= yd,a n;a ojd,g fldamam 1-3 olajd" ?g wvqfjka' yefok <uhskag iy we`. fjfyid jev lrk whg jeä n;a m%udKhla wjYH fõ' • n;a lk m%udKh ;ukaf.a nr wkQj iy reêrfha .aÆfldaia md,kh u; ks¾Kh lrkak' Tfí nr m%udKh jeä kï fõ,lg .kakd n;a m%udKh wvq lrkak'

DOCTOR MAGAZINE

• yd,a msá" l=rlalka msá iy fidahd msá j,ska iE¥ wdydr mdka msá iy wdgd msá j,ska iE¥ wdydr j,g jvd iqÿiqh' • msisk ,o mßmamq" lv," uqx weg" lõms iy fidahd fndaxÑ jeks fm%daàk wêl wdydr fldamam 1$2-1 m%udKhla • msisk ,o w¾;dm,a" w¿ flfi,a" îÜrEÜ fïi ye|s 1-2 m%udKhla • fldia" fo,a" u[af[dlald" n;, jeks wdydr lEug m%sh kï n;a j,ska fldgila fjkqjg tajd iq¿ m%udKhla b|ysg lEfuka w.=Khla ke;' ^.¾NsKS oshjeähdj we;s Woúhg kï Tjqkaf.a reêr .aÆfldaia uÜgu b;d fyd|ska md,kh lr.; hq;= neúka fulS wdydr ks¾foaY fkdflf¾'& • yd,amsá j,ska iE¥ wdydr ,nd.ekSug wmyiq kï mdka" mdka msá iy wdgd msá j,ska iE¥ wdydr fl|s .;sh jeä mßmamq jeks jHxckhla iu. lEug .ekSfuka reêrfha .aÆfldaia jeäùu ;rula md,kh fõ'

doctormagazine.lk

m%udKhla we;sj lEug iqÿiq m<;=re • tla fõ,lg tla m<;=re j¾.hla fyda m<;=re j¾. fol ;=kl ñY%Khla ^m<;=re i,dohlska fldamam 1$2-1 w;r m%udKhla& • ´kEu flfi,a j¾.hla ^jrlg tla flfi,a f.ähla f,dl= wdkud¿ nd.hla" f,dl= flda,sl=Ügq nd.hla" r;a flfy,a 1$3-1$2& ndf.g bÿKq flfi,a jvd;a iqÿiqh'

wU f.ähla fodvï f.ähla wkakdis lene,a,la .ia,nq lene,a,la ños f.ä lsysmhla wem,a f.ähla w,s.eg fmar 1$4la ^fikaáógr 10l muK f.ähla'& fldamam 3$4 iSks ke;s m<;=re hqI • m<;=rla lEu" m<;=re hqI îug jvd iqÿiqh' m<;=re j, we;s fl|s .;sh m<;=re hqI j, we;s fl|s .;shg jvd jeä neúks' • rgb|s lEug iqÿiq ke;' tajdfha wêl iSks m%udKhla wvx.=h' • m<;=re jQjo m%udKhg jeäfhka .ekSfïoS YÍrfha nr jeäfõ' reêrfha .aÆfldaia md,kho wmyiq fõ' • jl=.vq wl%Sh ù we;s

doctormagazine.lk

whg fmdgEishï ,jKh jeä jYfhka wvx.= ù we;s ksid m<;=re lEu iy ;eô,s îu w.=Kh' msálsß j¾.

• reêrfha fldf,iagfrda,a m%udKh jeä kï fïoh rys; lsß Ndú;d lrkak' oshjeähdj we;s flfkl=f.a ksrdydrj .;a reêrfha Total Cholesterol m%udKh fvis ,Sgrhg ñ,s .a?ï 185g jvd wvq úh hq;=h'

• fuda,aÜ msá j¾. j, wêl f,i iSks wvx.= neúka îug iqÿiq ke;' idudkH wdydr .ekSug wmyiq frda.S ;;a;ajfha isák whg fuu msá j¾. ffjoHjrhdf.a ks¾foaYh u; .ekSu ks¾foaY flf¾' • wfkl=;a îu j¾. ;eô,s j;=r fndkjd kï iqudkhlg jrla fyda fojrla tla ùÿrejla ne.ska .ekSu m%udKj;ah' • meleÜ l< mDlafgdaia îu iqÿiq ke;'

November 2016

DOCTOR MAGAZINE

41

D•Magazine /

oshjeähdj we;s Tng iqÿiq wdydr

Theme

¨Kq wêl wdydr • uduhsÜ" lrj," ¨Kq iys; rglcq iy úiaflda;= wdosh ks;r ks;r .ekSu md,kh fkdjQ wêreêr mSvkh iy nr jeä whg iqÿiq ke;' fm%daàka wvx.= i;a;aj wdydr • l=l=,a uia lEug wjYH kï iu bj;a lr msi. kak' • yrla uia" W!reuia yd t¿ uiaj, fïo m%udKh jeä neúka lEug iqÿiq ke;' fldf,iagfrda,a wvx.= ksid ì;a;r lyuoh w.=Kh' ud¿ lEug wjYH kï l=vd ud¿ iy áka ud¿ jvd;a iqÿiqh' ks¾udxY wdydr meje;au • ks¾udxY wdydr meje;au oshjeähd frda.Skago iqÿiqh' • ks¾udxY wdydr meje;au u.ska oshjeähdj ksid we;sjk jl=.vq wdndO j<lajhs' f;,a j¾.

• ´kEu j¾.hl f;,a ^fmd,af;,a" ika*,j¾" fidahd" fldaka'''& wvq

42

November 2016

lrkak' jeä nrla iys; wh fï f;,a fjfiiskau wvq l< hq;= fõ' • ´kEu j¾.hl f;,a wvx.= wdydr ksid YÍr nr jeä fõ' ;jo f;,a lEu .ekSfuka YÍrfha fldf,iagfrda,a uÜguo by< hhs' oshjeähdj we;s wh fjkqfjka ksIamdos; úfYaI lEu j¾.

• vhfnála cEï" vhfnála fpdla,Ü wdoS jYfhka we;s fuu lEu j¾. ks¾foaY

DOCTOR MAGAZINE

fkdflf¾' fuu wdydr .ekSfuka YÍrfha nr jeäù .aÆfldaia md,kh wmyiq fõ' oshjeähd frda.Ska fkd.; hq;= wdydr • iSks ákalsß whsial%Sï ´kEu j¾.hl yl=re mqäx j¾. cEï fc,s flala meKsri ìialÜ j¾. fpdl,Ü fldaäh,a j¾. rgb|s fgd*s iy iSksfnda, fnda;,a meKsîu áka l< m<;=re ^isrma j, nydÆ& lejqï w;sri hkdoS rileú,s

doctormagazine.lk

YÍr ialkaO o¾Ylh Tfí nr .ek ks;s ie<ls<su;a fjkak

fud<h" jl=.vq hkdoS wjhj j,g reêrh iemhSu wvqfõ'

nr wvq lr .ekSfuka reêr .aÆfldaia md,kh jvd;a myiq fõ' Tfí Wig iß,k nr wkqmd;h 18'5 isg 22'9 g lsf,da .a?ï$^óg¾&2 hk w.hka w;r ;nd.kak' fuu w.h 22'9 g lsf,da .a?ï$^óg¾&2 g jeä kï Tfí nr jeäh' fuu w.h 25g;a jvd jeä kï Tn ;rndre ^ia:, q &h'

wdydr mej;=ï iïnkaO ks¾foaY

oshjeähdj ke;s wh jQj;a ;ukaf.a YÍr nr 18'522'9 w.h ;=< ;ukaf.a YÍr ialkaO o¾Ylh mj;ajd .kak' oshjeähdj we;s wh iSks fyda meKs ri Ndú;d fkdl< hq;af;a wehs @ iSks fyda meKsri iq¿ m%udKhlska fyda Ndú;d l< úg b;s blauKska reêrfha .aÆfldaia uÜgu by< hhs' reêrfha we;s wêl .aÆfldaia YÍrhg wys;lrj l%shd lr Tn fkdoeKqj;aju YÍrfha weia" iakdhq" yDohjia;=j" jl=.vq hkdoS wjhj iy mgl j,g ydks muqKqjhs' fufia iq¿ m%udKhla fyda meKsri lEfuka miq we;sjk YÍrfha wêl .aÆfldaia ;;a;ajh mgl j,g lrk ydks ksid úúO ixl+,;d we;s fjhs' wvqfjka iSks Ndú;d l<;a fuu ixl+,;d we;s fõ' doctormagazine.lk

fl|s .;sh jeä wdydr .ekSfuka we;sjk m%fhdack fudkjdo @ • fl|s .;sh jeä wdydr u.ska wdydr cS¾Kh m%udo lr reêr .aÆfldaia uÜgu by< hdu md,kh fjhs' • wdydr j, we;s f;,a .;sh we`.g Wrd. ekSu wvqlr reêr fldf,iagfrda,a ugAgu by< hduo md,kh fjhs' reêrfha wêl fldf,iagfrda,a ;;a;ajh ksid we;sjk ydks fudkjdo @ reêrfha wêl fldf,iagfrda,a ;;a;ajh ksid reêrjdyskS j, fïoh ;ekam;a ù yDoh"

• reêrfha .aÆfldaia uÜgu md,kh lr .ekSug wdydr .ekSu iïnkaOfhka ksjeros ms<sfj;la wkq.ukh lrkak' túg ixl+,;d we;sùfï wjodku wju lr.ekSug ms<sjk' • iSks" meKsri lEu iy meKsri îu w;ayßkak' f;a" fldams jeks îu iu. iSks fyda yl=re wkqNjh w;a yßkak' • mdkamsá iy wdgd msá j,ska ;ekQQ wdydr .ekSu wvq lrkak' • msá wdydr .ekSfïoS fl|s .;sh nyq, r;= ydf,a n;a" l=rlalka msá" fidahd msá yd yd,a msá wdosfhka wdydr ilid .kak' • fïoh wvx.= wdydr wvq lrkak' f;ïmrdÿ wdydr iy f;f,a nosk ,o lÜ,Ü" frda,aia jeks wdydr msiSfïoS f;,a Ndú;h yels;dla wvq lrkak' • m<;=re fl|s .;sfhka jeäh' m<;=re .=Kodhl jQjo tajd;a iSñ; m%udKhlg muKla .kak' • kshñ; fj,djg wdydr .ekSfuka" reêr .aÆfldaia uÜgu m%udKhg jvd wvq ùfï wjodku j<ld.; yel' DM

November 2016

DOCTOR MAGAZINE

43

D•Magazine /

Theme

oshjeähd frda.Ska i|yd bkaishq,ska tkak;a lsÍug Wmfoia

oshjeähd frda.Ska i|yd bkaishq,ska tkak;a lsÍug Wmfoia bkaishq,ska tkak;a lsÍu i|yd ksmojd we;s úfYaI isßkach yd lgqj bkaishq,ska tkak;a lsÍu i|yd ksmojd we;s úfYaI isßkach (Insulin Syringe) my;ska oelafõ' tys mßudj ñ,s ,Sgrhls' ( 1 ml) tys tall 100la (Unit) olajd i<l=Kq lr ;sfí' lgqj isßkachgu iúlr we;' bkaishq,ska tkak;a lsÍug ks¾foaY lr we;s lgqfõ m%udKh jkqfha 29 Gauge h' fuu m%udKfha isßkac fkdue;s kï muKla 27 Gauge m%udKfha isßkac Ndú;d l< yel' bkaishq,ska l=mamsh (Insulin Vial) bkaishq,ska l=mams j¾. lsysmhla my; igyfkys oelafõ' tys tl ñ,s ,Sgrhl mßudjl bkaishq,ska hqksÜ 100la wka;¾.; lr we;'

fld<U úYAj úoHd,hSh ffjoH mSGfha NSI.afõo fomd¾;fïka;=fõ fcHaIAG lÓldpd¾h" ldhsl frda. úfYaI{ ffjoH pduÍ ùrr;ak úisks

bkaishq,ska tkak;a lsÍu bkaishq,ska tkak;a lr.ekSu i|yd ksjerosj iu msßisÿ lr.kafka fufiah' Tn ksjfiaoS inka yd c,h Wmfhda.S lrf.k iu msßisÿ lr.; yelsh' iakdkfhka fyda we`. fidaod .ekSfuka wk;=rej bkaishq,ska tkak;a lr.ekSu jvd;a iqÿiqh' bkaishq,ska fnda;,a iQodkï lr.kakd wdldrh • Tn Ndú;d lrk bkaishq,ska l=mamsh l=vd fmÜáhl nyd Ys;lrKh ;=<

44

November 2016

DOCTOR MAGAZINE

doctormagazine.lk

20C-80C w;r WIaK;ajhl ;ekam;a lr.kak' lsisúfgl wêYS;lrKhl fyda YS;lrKfha fodfrys bkaishq,ska ;ekam;a fkdlrkak' • bkaishq,ska ;ekam;a lsÍug meh ld,lg fmr bkaishq,ska fnda;,h YS;lrKfhka bj;g .kak' • fnda;,fha rn¾ uQäh iam%S;= (Surgical Spirit) iys; msßisÿ mq¿ka lene,a,lska msi msßisÿ lr.kak' • Tn Ndú;d lrkafka lsß mdg bkaishq,ska j¾.hla kï Tfí fow;a, u; fnda;,h ;nd lsysm ierhla iSrefjka fnda;,h fmr<Su lrkak' Soluble bkaishq,ska fyj;a Regular Insulin meyeos,s wj¾K ødjKhls' fuu bkaishq,ska j¾.h Ndú;fhaoS fufia isÿ lsÍu wjYH ke;'

• oeka bkaishq,ska fnda;,fha rn¾ jeiau ;=<ska lgqj fnda;,hg we;=,a lrkak' ^rEmh 2& • rEmigyfka olajd we;s mßos bkaishq,ska fnda;,h hál=re jk mßos ;nd isßkacfha ma,kacrh we;=<g ;o lsÍu u.ska isßkachg weo.;a jd;h fnda;,hg we;=¿ lrkak' bkaishq,ska fnda;,h ;=<g jd;h we;=¿ l< miq isßkach ;=<g bkaishq,ska .ekSu jvd;a myiq jkq we;' ^rEmh 3& • bka wk;=rej ma,kacrh my<g weoSu u.ska Tng wjYH bkaishq,ska ud;%dj isßkacrh ;=<g we;=¿ lr.kak' • lgqj fnda;,h ;=< ;sfnk w;r;=roSu isßkach ;=<g bkaishq,ska iu. jdhq nqnq¿ we;=¿ ù ;sfí kï tajd bj;a lrkak' • bka wk;=rej bkaishq,ska fnda;,fhka bj;g .kak'

Tng wjYH bkaishq,ska ud;%dj (Insulin Units) isßkach ;=<g we;=,a lr.kakd yeá

• rEmigyfkys olajd we;s mßos Tng .ekSug kshu lr we;s tall .Kk (Insulin Units) oelafjk b,lalu jk f;la ma,kacrh (Plunger) my<g weoSfuka isßkach ;=<g jd;h we;=¿ lrkak' ^rEmh 1&

doctormagazine.lk

bkaishq,ska tkak;a lsrSug iqÿiq ia:dk bkaishq,ska tkak;a lsrSug fhda.H ia:dk fuys oelafõ' tla ia:dkhla ;=< tkak;a lrk ia:dkh wkqms<sfj,ska fjkia lrñka osk lsysmhla Ndú;d lsrSfuka wk;=rej fjk;a ia:dkhlg tkak;a lsrSu wrUkak'

November 2016

DOCTOR MAGAZINE

45

D•Magazine /

oshjeähd frda.Ska i|yd bkaishq,ska tkak;a lsÍug Wmfoia

Theme

bkaishq,ska tkak;a lr.ekSug Wmfoia iu w,a,d .kakd wdldrh iy ksjerosj lgqj w,a,d.kakd wdldrh

• rEm igyfkys olajd we;s mrsos ifuys /,a,la Tijd w,a,d .kak' isyska isrerla we;s wfhl= kï fufia lsrSu jvd;a m%fhdackj;a fõ'

• oeka ma,kacrh isrskach ;=<g f;rmSu u.ska yels blauKska bkaishq,ska tkak;a lrkak' • wk;=rej" ifï /,a, uqod yer ;;amr 5-10la muK lgqj mgl ;=< r|jd ;nkak' • wk;=rej blauKska lgqj ifuka bj;g .kak' bkaishq,ska tkak;a lsrSfïoS fõokdj wju lr.kafka flfiao @ • bkaishq,ska tkak;a lsÍug meh ld,lg fmr bkaishq,ska fnda;,h YS;lrKfhka msg;g .ekSu'

• wxYl 90l wdk;shla iys;j bkaishq,ska isrskacfha lgqj iu u; ;nkak' isyska isrerla we;af;l= kï wxYl 45 l wdk;shla iys;j lgqj ;nkak' • wk;=rej blauKska iu ;=<ska lgqj Bg háka we;s f;,a ia:rhg we;=,a lrkak' 46

November 2016

DOCTOR MAGAZINE

• 29 Gauge lgqjla iys; bkaishq,ska isßkachla Ndú;d lsÍu' • bkaishq,ska tkak;a lsÍfïoS iu ;=<g lgqj we;=¿ lsÍu iy ifuka msg;g .ekSfïoS th blauKska isÿ lsÍu' • jvd;a ishqï lgqjla ( 31 Gauge) iys; bkaishq,ska mEkla Ndú;d lsÍu' DM

doctormagazine.lk

doctormagazine.lk

November 2016

DOCTOR MAGAZINE

47

D•Magazine /

Theme

oshjeähdjg w; jkk mQ¾j oshjeähdj

oshjeähdjg w; jkk mQ¾j oshjeähdj ie<ls<su;aj mshjr .;fyd;a wdrlaId úh yelshs fkdi<ld isàfuka oshjeähdj frda.sfhla njg njg m;a úh yelshs 48

November 2016

DOCTOR MAGAZINE

ldhsl frda. údfYaI{ ffjoH ã tï iS .uf.a úisks

mQ

¾j oshjeähdfõoS Tfí ksrdydr reêr mÍlaIKhla (FBS) isÿ lf<d;a th idudkHhg jvd jeäh' tfy;a oshjeähd frda.sfhl= f,i m%;sldr lsÍug ;rïu jeä iSks uÜgula ke;' zzmQ¾j oshjeähdjZZ Prediabetes hkqfjka y÷kajkafka fuu ;;a;jhhs' doctormagazine.lk

we;af;kau wjYH mshjr .;fyd;a" Tn wêIaGdkYS,S kï th fndfyda wE;g''' Tng lsisod oshjeähd fkdyefok ;rï udkhlg l,a ;nd.; yel' tfy;a fï wjia:dj fkdi<ld yeßfhd;a Tn ksielfhkau oshjeähd frda.sfhl= njg m;a jkafkah' th udi lsysmhlska úh yel' wjqreoaolska follska úh yel' mQ¾j oshjeähd we;s wh uqyqKmdk ;j;a wk;=rla jkafka yDohdndO yd fjk;a lsÍgl Ouks.; frda. we;sùfï jeä wk;=rhs' fï ksid mQ¾j oshjeähd frda.Skao oshjeähd frda.Ska muKgu m%fõYï úh hq;= fõ' wdrlaIl mshjr j,ska ikakoaO úh hq;=h' mQ¾j oshjeähdj ;sfnk wh we;s lr.; hq;= fjkialï my; wdldrfhks' • fi!LH iïmkak wdydr isß;lg yqre ùu' • YÍrh fjfyijk jHdhdu isß;lg yqre ùu' • YÍrfha nr wvq lr.ekSu' mQ¾j oshjeähdj we;s ùfï wjodkï idOl mQ¾j oshjeähdj we;s ùfï wjodkï idOl fndfyda ÿrg oshjeähdj wjodkï idOl j,g iudkh' • ia:q,;djh • reêr mSvkh by< hdu • fldf,iagfrda,a uÜgu jeäùu

mQ¾j oshjeähd yd bkaishq,ska l%shdldß;ajh fuysoSo isÿ jkafka bkaishq,ska kue;s fydafudakh Ndú;d ùfï wvq¨yq`vq;djhls' mgl j,g .aÆfldaia mßjykh lrkafka bkaishq,ska u.sks' mQ¾j oshjeähdfõoSo tlaflda fï ld¾hhg wjYH jk muKg bkaishq,ska ksmoùula isÿ jkafka ke;' ke;fyd;a ksmojqK;a tajd kshñ; mßos m%fhdacH ùula" Ndú;hg .ekSula isÿ jkafka ke;' fuu ;;a;ajh zzbkaishq,ska m%;sfrdaOhZZ kñka ye|skafjhs' mQ¾j oshjeähd ;;a;ajh mj;S oehs y÷kd.ekSug lrk reêr mÍlaIK folla fjhs'

oshjeähdj hkq áflka ál we;sjk frda.hls' mQ¾j oshjeähdj wjia:dfõoS Tfí reêr .aÆfldaia m%udKh ;sìh hq;= idudkH w.hg jvd u|la jeäfhka ;snqK;a" lsisÿ frda. ,laIKhla m%lg lrkafka ke;'

ksrdydr reêr mÍlaIKh Fasting Blood Sugar (FBS) meh 10la ksrdydrj isg WoEik isÿ lrk reêr mÍlaIKfhaoS .aÆfldaia w.h 100 yd 125mg/dL w;r w.hla .ekSu mQ¾j oshjeähd ;;a;ajhla f,i ie<fla' fuu w.h blaujQ úg Tyqg oshjeähd frda.sfhl= f,i i<ld m%;sldr ie,eiafõ'

fï wjia:dfõoS Tng we;eï úg we;s úh yels YdÍßl ,laIK lsysmhla fufiah' • fjkodg jvd l=i.skak we;s ùu' • m%udKj;a fmdaIKhla ,enqK;a YÍrfha nr wvq ùu' • ks;r ks;r uq;%d lrkakg hdu' • fjkodg ke;s úvdnr njla oekSu'

.aÆfldaia oeÍfï reêr mÍlaIKh Oral Glucose Tolerance Test (OGTT) fuysoS uq,skau ksrdydr reêr mÍlaIKfha

oshjeähdj we;s ióm {d;sfhl= isák úgo m%fõKsl jYfhka mQ¾j oshjeähdj we;sùfï wjodku by< hhs' ta yereKQ úg fmd,sisiaála ´jß iskafv%dï" .¾NsKS oshjeähdj hk frda. j,g ,lajQ ldka;djka yd jeä nr orejka m%iQ; l< uõjrekao mQ¾j oshjeähdj we;sùfï by< wjodkula orhs'

doctormagazine.lk

November 2016

DOCTOR MAGAZINE

49

D•Magazine /

oshjeähdjg w; jkk mQ¾j oshjeähdj

Theme

wdldrhg f,a idïm,hla ,nd .efka' wk;=rej .a?ï 75 .aÆfldaia ødjKhla mdkh lsÍug i,iajd kej;;a Tfí reêr idyïm,hla ,ndf.k mÍlaId flf¾' meh foll wejEfuka fuys w.h 140 and 199mg/dL iSudj blaujd hkafka kï th mQ¾j oshjeähd wjia:djla f,i ie<fla' fuu w.h 200 blaujd jd¾;d fjhs kï th oshjeähdj hhs i<ld m%;sldr l< hq;=h' mQ¾j oshjeähdj - m%;sldr mQ¾j oshjeähdj iys; hhs y÷kd.;a úg Tyqgo oshjeähd frda.sfhl=g wdldrfhkau wdydr" jHdhdu wdosh kshu flfrhs' YÍrfha nr wvq lsÍugo b,lal ;efnhs' fï Woúhg yoj;a frda. wjodkula we;s ksid wêreêr mSvkh yd fldf,iagfrda,a uekúka md,khg ks¾foaY flf¾' wdydr md,kh uq¿ wdydr m%udKfha wvqjla fukau" fïo wdydr wvq lsÍuo fuysoS jeo.;a fjhs' úfYaIfhkau wêl f;,a iys; wdydr" wdmkYd,d j,ska f.kshk wdydr wvq lsÍug Wmfoia iemfhk w;r ffokslj .kakd iSks m%udKho yels;dla wvq lsÍug W;aiql úh hq;=h' flala" ng¾" ìialÜ Ndú;ho w;sYhska iSud l< hq;=h' wdydr .ekSfïoS .a,hsisñla o¾Ylh wvq wdydr .; hq;=h' ks;s YÍrh fjfyfik l%shdldrlï j, ksr; jkak jHdhdu lsÍu fyda fjk;a YÍrh fjfyid lrk l%shdldrlï j,oS mgl úiska ld¾hlaIuj bkaishq,ska wjfYdaIKh lsÍula isÿ fõ' tfiau th Tnj l%shdYS,Sj yd ksfrda.Sj ;nd .ekSugo WmldÍ jkafkah' osklg wju jYfhka meh nd.hla j;a jHdhduhg fjka lrkak' wdúoSu" ye,afï osùu ldg;a l< yels jHdhduh' jHdhduhla lshd fjfiiska hula lrkakg neß jqK;a Tn mhska weúof.k .uka hkjd kï" úÿ,s fidamdkh fjkqjg mäfm< mdúpÉÑ lr Tfí wjYH;djhg ld¾hd,hg hkjd kï" j;a; msáfha jevm< j, ksr; fjkjd kï tajdo YÍrhg ksfrda.S nj f.k fok jHdhdu fõ'

50

November 2016

DOCTOR MAGAZINE

mQ¾j oshjeähd frda. ,laIK we;s ug oshjeähd frda.fhka je<lsh yelso @ .aÆfldaia mßjD;a;Sh wvd, ùu hkq oshjeähdj fkdfõ' kuq;a fï ;;a;ajh we;súg tkï mQ¾j oshjeähd we;súg Tn oshjeähd frda.sfhl= njg m;aùfï bvlv 10-20 .=Khlska by< kexfjhs' ;u wdydr fõ, ffjoH Wmfoia m%ldrj yev iú .kajd .ekSfuka yd jHdhdu iys; cSjk rgdjlg yqre ùfuka mQ¾j oshjeähdj ;snqK;a Tn oshjeähd frda.sfhl= fkdù isàug ishhg 58l m%n, yelshdjla ;sfnk nj m¾fhaIlhka wjOdkh lr isà' fuhska Tng fokafka b;d m%n, fi!LH mKsúv hls' tkï Tn oeäj wosgka lr.;af;d;a ksielfhkau uy;a wjodkï f.k tk oshjeähdfjka ñoSug iEfyk wjia:djla Wod jkafkah' l%shd;aul jkak''' wou fi!LHiïmkak osú fmfj;lg yqre jkak' DM

doctormagazine.lk

doctormagazine.lk

November 2016

DOCTOR MAGAZINE

51

D•Magazine /

Theme

<ud oshjeähdj

CHILDREN AND DIABETES <ud oshjeähdj

orefjl=g oshjeähdj ;sfnkjd kï uõmshka l< hq;= ksjerosu foa oek.ksuq'''

ßcafõ wd¾hd <ud frdayf,a <ud fydafudak frda. úfYaI{ ffjoH kfjdaod w;m;a;=

È

hjeähdj jeäysáhkaf.a frda.hla f,i fndfyda fofkla is;kafka thska mSvdjg m;a nyq;rhla jeäysáhka jk ksidfjks' tfy;a wo orejka w;f¾o oshjeähdj frda.Ska ie<lsh hq;= úYd, ixLHdjla olakg ,efí' orejka oshjeähd frda.hg k;=jk m%jK;djh oeka fndfyda fia olakg ,efnk ksid ta je<elaùug mshjr .ekSu w;sYhska jeo.;a fjhs' ´kEu wdldrhl oshjeähd m%fNaohla orejkag;a we;s úh yelshs Type 1 yd Type 2 wdldr foflau oshjeähdj orejkag je<|sh yel' <ore jhfia" ÿjmek fi,a,ï lrk" .egjr jhfia wdoS jYfhka ´kEu jhia ldKavhl orejka oshjeähdjg k;=úh yel'

52

November 2016

DOCTOR MAGAZINE

doctormagazine.lk

orejkag tl ;ek bkak cSú; j,g yqre lrjkak tmd' oshjeähdj ;sfnk orejdg;a l%h s dYS,j S cSú;h .; lrkak bv yßkak' thska orejdf.a lh uki folu ksfrda.S lr.kak uy;a msgj q y,la ,efnkjd'

oshjeähdj wm wNsfhda. hla f,i i<lkafka tys we;s ixl+,;d we;s lsÍfï yelshdj fkdfyd;a YlH;djh i<lñks' jhi wjqreÿ 40-50 jhfiaoS oshjeähdj je<÷k flfkla ie<l=fjd;a Tyq jir 40-50lau cSú;h .;lr wjidkh' Tyq md,khla we;slr.; hq;af;a cSú;fha b;sß ld,h fjkqfjks' tfy;a l=vd ld,fhaoS orefjl=g oshjeähdj je<÷KQ úg Tyqf.a cSú;h wdrlaId lroSug" cSú;fha .=Kd;aulNdjh /lfokq msKsi we;s j.lSu fndfyda fihska jeäh' fï wkQj ;ju;a bosßhg ;sfnk cSú;

ld,h mqrdjgu orejdf.a cSjk rgdj ksjerosj yev.eiaùfï wNsfhda.h uõmshka bosßfha jkafkah' ksfjfia ;j;a orejka iu. oshjeähd orejd isák úg fï oshjeähdj orejd úIfhys iqúfYaIS b,lal ;eîu wfma uõmshka lrk jrols' zzoshjeähdj ;sfnk úg iSks fyd| ke;''' ^th kï yß''& ta;a iSks ;sfnk wdydr wks;a whg fok úg th ryfia l< hq;=h'ZZ zzfï orejkag fjku ms<sfh< l< wdydr osh hq;=h'''ZZ fï wfma fndfyda uõmshka is;k úosyhs' fïjd jerosiy.; wdl,amh' thska orejdg isÿjk hym;la ke;''' isÿ jkafka wjevlauh' oshjeähdj we;s ke;s ksfjfia yefudau iSks j,ska wE;a jkak iSks we;af;a fndk lsß ùÿrefõ muKlau fkdfõ''' ìialÜ tfla''' flala lene,af,a" fgdmsfha" fpdla,Ü tflao iSks ;sfí''' iSks fyd| ke;af;a oshjeähdj ;sfnk orejdg ú;rlau fkdfõ''' orejka ldg;a iSks w.=Kh' ìialÜ" flala" mqäx''' w.=Kh' tfykï f.or fldhs ljqre;a oshjeähdj ;sfnk orejd ksid fkdfjhs" hym;a iqj isß;la jYfhka fï wdydr j,ska wE;a jkak'

doctormagazine.lk

November 2016

DOCTOR MAGAZINE

53

D•Magazine /

<ud oshjeähdj

Theme

f.or ish¿ fokdu iSks j,ska yels;dla wE;a ùfuka oshjeähdj ;sfnk orejdg fjkia ie<ls,a,la lsÍu u.yrjd .; yel' th mjqf,au iqjh idlaId;a lrk wk.s wjia:djlao mjq,g Wod lrKQ we;' oshjeähdj iys; orefjla bkakd ksfjil uõmshka WmdhYS,Sj wdl,am mßj¾;khla we;s lr.kak' th iqNjdoS wkd.;hla fjkqfjka lrk wdfhdackhla njg m;a lr .kak' orejka w;f¾ jvd;a iq,n oshjeähd wdldrh yd ;rndrej ksid fldhs ldg;a ´kEu wjia:djl je<|sh yels oshjeähdj wdldrh orejka w;f¾ jvd;au iq,n jkafka Type 1 wdldrfha oshjeähdjhs' fï wdldrfha oshjeähdfõ olakg ,efnk úfYaI;ajhla jkafka frda.h ;sfnk nj oek.kakg ,efnkafka w.akHdYfha ;sfnk bkaishq,ska ksIamdokh lrk îgd ffi, ie<lsh hq;= m%udKhla úkdY jQ miqjh' fï orejkaf.a úIfhys frda.h md,kh lsÍug my; mshjr .kq ,efí' • ksjeros wdldrhg fmdaIKh ie,iSu • orejdf.a YdÍßl l%shdldß;ajhg wjYH ksis mshjr .ekSu • bkaishq,ska kslafIamkh$T!IO ,ndoSu • reêr iSks mÍlaId lsÍu • reêr iSks fnfyúka wvqùfï wjia:d u.yerùu

Type 2 wdldrfha oshjeähdj iys; orejka w;=ßka jeä fofkl=f.a mjqf,a ujg" mshdg jYfhka mjqf,a idudcslhkg oshjeähdj je<|S ;sfnk nj fmfkkakg ;sfí' fuu frda. jHdma;sfhys uQ,sl mshjr jkafka zzbkaishq,ska m%;sfrdaOhZZ hkqfjka ye|skafjk reêrfha ;sfnk .aÆfldaia uÜgu md,khg wjYH flfrk bkaishq,ska m%udKh tkak tkaku jeä ùuhs' tfy;a miqj w.akHdYh u.ska bkaishq,ska ksmoùuo iSud lrk nj fmfka' Type 2 wdldrfha oshjeähdj iys; orejkago bkaishq,ska kslafIamKh yereKQ úg by;ska oelajQ wfkl=;a mshjr ish,a,u mdfya l%shd;aul lsÍug isÿfõ' oshjeähdj ;sfnk orejkag wdydr fokafka fufyuhs oshjeähdj ;sfnk orejkag ,nd fok fmdaIKfha olakg ,efnk idOKSh fjkialï lsysmhla ;sfnk w;r ta .ek uõmshka oeKQj;a úh hq;=h' fï orejkag jeäysáhkag fuka Diabetic Diet tlla ,ndoSula isÿ lrkafka ke;'

54

November 2016

DOCTOR MAGAZINE

doctormagazine.lk

oshjeähdj ;sfhk orejg fjku lEu yokak tmd' f.or bkak yefudau fi!LHiïmkak lEu fõ,lg yqre fjkak'

Insulin Injection Sites www.international-diabetes-association.com

tfy;a fok wdydr j, lsisu úfgl iSks wka;¾.; fkdlrkakgo j.n,d .ekSula isÿfõ' iSks ;sfnkafka meKs ri lEu j, ú;rlau fkdfõ' n;a álla" mdka lene,a,la fukau w, j¾.hla lEj;a tys ;sfnk msIaGh iSks njg mßj¾;kh jkafkah' fï ksid orejd wdydr .ekSfïoS reêr iSks m%udKh wka;rdhldÍ uÜgï j,g <`.d fkdjk fia lghq;= l< hq;=h' Tfí orejdgu .e,fmk úfYaIs; Wmfoia ffjoHjrhd <`. ;sfnkjd orefjl=f.a oshjeähdj l<uKdlrKfhaoS ta orejdgu úfYaIs; l<uKdlrK udos,shla wkq.ukh l< hq;=h' jhi wjq' 4 orejdg fok Wmfoia jhi wjq' 8 yd wjq' 12 orejdg iqÿiq jkafka ke;' tfiau tlu orejdgo j¾Okh;a iu.u fjkia Wmfoia ,eìh hq;=h' fï ksid ffjoHjrfhl=f.a wëlaIKh fï orejdg w;HjYH jkafkah' m;a;rfhka fok Wmfoia fjk;a whf.a Wmfoia ms<smoskakg .sfhd;a jefgkafka uy wudrejlh' fï ksid Tfí orejdf.a frda.h l<uKdlrKh <ud frda. ffjoHjrfhl=f.a Wmfoia wkQju isÿ lrkakg W;aiql úh hq;=h' iqÿ n;a fjkqjg r;= n;a oSu jvd fyd|hs orejkag n;a fok úg r;= n;a oSu jvd fyd|h' tys jeäfhka ;ka;= ;sfnk ksid iSks md,khg Wmldrhla jkafkah' kuq;a t<j¿ lsysmhla iu.u iqÿ ydf,a doctormagazine.lk

n;la b|ysg ÿkakdg jrola ke;' n;a iu. t<j¿ lsysmhla wdydrhg .kakjd kï r;=h" iqÿh lshd ta yeá fjkila ke;' wdydr fõf,a n;a j,g uqiq lr.kakd t<j¿ m%udKh jeä lr.kak' th reêrfha iSks md,kh lrk b;d hym;a mshjrls'

doctormagazine.lk

November 2016

DOCTOR MAGAZINE

55

D•Magazine /

<ud oshjeähdj

Theme

ks¾udKYS,S m%fõYhla Tiafia orejd tl`. lrjd .ekSfï l,dj uõmshka m%.=K l< hq;=hs fï orejka yodjvd .ekSfïoS tosfkod meK k.sk m%Yak keKj;aj úi|d .ekSug Tng yelshdj ;sìh hq;=h' <`. bkak hd¿jd ÿka cEï ;ejrE mdka fm;a;la wkqNj lsÍu ksid Tyqg nek jeoSu iqÿiq ke;' fï orejd <ud ld,fha úÑ;%;ajh w;a ú|sk jhfia miqjkafkls' we;eï fj,djg mx;sfha bkak orefjlaf.a Wmka oskhod ,efnk flala lene,a, m%;alafIAm lrkafka fldfyduo @ fï úosfya wjia:dj,oS j, orejdg ;rjgq lsÍfuka isÿjkafka orejd fouõmsh md,kfhka .s,syS hduhs' thska miq TfNA md,kfhka ñoS ysf;k ysf;k foa lEfjd;a orejd uy;a wjodkï wkd.;hlg uqyqK fohs' zzmqf;a f.or wrka tkak'' uu tal Thdg fyd| úosyg lkak fokakïZZ Tng lshkak mq¿jk'''zzTh whsiska ;Ügqj krlhs" ry;a kE''' Thd ta ál whska lr, Thdg fok flala lE,a, lkak''' yenehs u;l we;=j f.kshk lEu ál;a ta;a tlalu lkak'ZZ orejdg myod ÿkafkd;a úYajdikSh;ajfhka orejd ta ldßh bgq lrhs' Tn l< hq;= foa yd fkdl< hq;= foa''' f.org wuq;af;la f.fkk fpdla,Ü tflka fm;a;la fokafk fldfyduo @ fkdoS;a fldfyduo @ ;Srkh Tn <`.hs' zzwhahg fyd| kE'''fmakafk ke;s ;eklg .syska lkak'''ZZ fpdla,Ü melÜ tlu oS kx.sg tfyu lshk tl jerosh' zzwhahg;a fokafk tl lE,a,hs''' kx.sg;a fokafk tl lE,a,hs' wms fldgyla w,a¨ f.or iqmqkag;a fouq''' ke;akï wrka ;sh, fjk fj,djl luq''''ZZ ta f.or orejd kï ljqre;a ke;s fj,djg fydfrka fpdla,Ü lkafka ke;' orejdg fjku lEu yokak tmd''' oshjeähdj ;sfhk orejg fjku lEu yokak tmd' f.or bkak yefudau fi!LHiïmkak lEu fõ,lg yqre fjkak' túg Tfí wdorKSh orejdf.a mqxÑ ys;

56

November 2016

DOCTOR MAGAZINE

j;a uõmshka jk Tnf.a ys;a j;a ßfokafk kE''' l%shdYS,Sj cSú;h .; lrkak wjia:dj i,ikak orejkag tl ;ek bkak cSú; j,g yqre lrjkak tmd' oshjeähdj ;sfnk orejdg;a l%shdYS,Sj cSú;h .; lrkak bv yßkak' thska orejdf.a lh uki folu ksfrda.S lr.kak uy;a msgqjy,la ,efnkjd' fï orejka lh fjfyik m%udKh wkQj fok wjYH lrk lEu m%udKh lEu ii|kak mq¿jka' ta i|yd Tng Tfí ffjoHjrhd u. fmkajkq we;s' oyäh msgfjkak we`. fjfyi l<du ìialÜ tlla oSfï jrola kE' orejka yeu ojilu we`. fjfyid lrk fi,a,ï j,g yqre lrjkak' w,ij cSú;h .; lrkak bv yßkak tmd' l%shdYS,Sj cSj;a fjk yeá orejdg W.kajkak' rEmjdysksh" fudnhs,a fmdaka wdosh iSñ;j Ndú;d lrkak bv yßkak' tajdg weíneys jkakg bv ;nkak tmd'''

doctormagazine.lk

m¾fhaIKd;aulj w;aÿgq i;Hhla'

orejkag bkaishq,ska úoskak nh fjkak tmd''' Type 1 wdldrfha oshjeähdj ;sfnk orejkag bkaishq,ska úoskak fjkjd' iuyr úg ojilg j;djla" foj;djla" ;=kaj;djla fyda isjQ j;djla wdoS jYfhka' th ;SrKh lrkafka orejdf.a iSks m%udKh wkQjhs' Tfí orejdg bkaishq,ska úosk ksjeros l%uh ffjoHjrhdf.ka wid oek.kak' Tfí orejdg wjYH bkaishq,ska ,nd fokak ìh fjkak tmd' bkaishq,ska ,ndoSfuka we`.g ydkshla isÿ jkafk kE' jl=.vq krla jkafk kE''' ta ydks isoaO fjkafk" jl=.vq krla fjkafk fï fnfy;a .;af; ke;s jqKduhs'

iuyre orejdg kshñ; fuÜf*dñka fnfy; fokak nhhs' jl=.vq krla fjkj lsh, ' fuÜf*dñka î, jl=.vq krla fjkj lsh, fldfyj;a fydhdf.k kE' ta;a fuÜf*dñka" fjk;a T!IO oshjeähd frda.Ska fkdf.k b|Sfuka jl=.vq krla fjkak mq¿jka' th kï

doctormagazine.lk

www.youcaring.com/blog/2015/child-medical-expenses

Type 1 diabetes is one of the most common chronic childhood illnesses.

Based on statistics from the American Diabetes Association, 208,000 children under age 20 have been diagnosed with diabetes, which is 0.25% of that population. Annual medical expenses for children with diabetes is six times higher than annual medical expenses for children without diabetes, as those without diabetes have annual healthcare costs of around $4,000 compared to the $15,000 in annual healthcare costs for children with diabetes.

yeu orejkagu .e,fmk oshjeähd md,k iQ;%hla lsh, fohla kE' reêr iSks md,k b,lal" reêr iSks uksk ld,iSudj" bkaishq,ska wdldrh" fok ud;%dj" th fok úosy" fnfy;a fok úosy" orejdf.a fmdaIKh''' fï yeu fohlau ta ta orejdg úfYaIhs' Tfí orejdg fyd|skau .e,fmk oshjeähd md,k Wmfoia ud,dj Tfí ffjoHjrhdf.ka ,nd.; hq;af;ao ta ksiduhs' DM

November 2016

DOCTOR MAGAZINE

57

D•Magazine /

Theme

oshjeähd frda.Skaf.a mdo j,g we;sjk wk;=r

oshjeähd frda.Skaf.a mdo j,g we;sjk wk;=r m¾hka; reêrjdyskS frda.h

È

ffjoH kd,l .=KjxY MBBS MS MCh (UK) úisks jdysksl" wkaf;dajdysksl yd wjhj noaOlsÍu iïnkaO úfYaI{ Y,H ffjoH cd;sl jl=.vq yd ldkaÿlrK wdh;kh" cd;sl frday," fld<U

58

November 2016

hjeähdj wo f,dalh mqrd ck.ykfhka ishhg 10 la muK fokd mSvd ú|sk frda. hls' os.= ld,hla ;siafia oshjeähdfjka mSvd ú|SfïoS we;sjk úYd,;u wNsfhda.h jkafka th YÍrfha ish¿u wjhj j,g mdfya wk¾:hla isÿ lsÍuhs' jl=.vq ydkshg m;aùu" reêrjdyskS.; frda." weia wdY%s; ixl+,;d wdoS jYfhka ;j;a úYd, frda. ixLHdjla we;sùfï wjodku fuysoS neyer l< fkdyel' oshjeähdj ksid lsÍgl OukS wdY%s;j we;sjk ixl+,;d fya;=fjka yDohdndO we;s úh yel' oshjeähdj ksid mdo j,g yd fud<hg jk reêr iemhqu wjysr ùu y÷kajkafka Peripheral Arterial

DOCTOR MAGAZINE

doctormagazine.lk

Disease (PAD) hkqfjks' fud<hg jk reêr iemhqu wjysr ùfuka fuysoS wd>d;h fkdfyd;a wxYNd. ;;a;ajh we;súh yel' mdo j,g wjYH jk reêr iemhqu wjysrhg ,laùfuka mdo bj;a lrkakg mjd isÿfõ' fï ixl+,;d j,g ,lajk nyq;rhla fokd ueos jhfia miqjkakkah' Tjqka mjqf,a;a" rfÜ;a wd¾Ólhg Wr fokakkah' tjka flfkla fujka wka;rdhlg ,laùu tfyhskau uy;a fÄojdplhlao jkafkah' Peripheral Arterial Disease (PAD) frda. ,laIK Peripheral Arterial Disease fkdfyd;a m¾hka; reêrjdyskS frda.fha uq,a wjia:dfõoS lsisÿ frda. ,laIKhla m%lg lrkafka ke;' fï ksid fndfyda úg fuh y÷kd.kafka oshjeähd frda.Skaf.a mdo j, kdä .eiau mÍlaIdjg ,la lsÍfuks' iEu jirlgu j;djla j;a oshjeähd frda.Ska ;u mdoj, reêr iemhqu mÍlaId lr.; hq;=h' hï fyhlska tu kdä jeàfï wvqjla fmfkkakg ;sfí kï uq,a wjia:dfõoSu Bg kshñ; T!IO m%;sldr isÿlr bosßhg úh yels wjodku md,kh lsÍug fuu.ska wjia:djla Wod fõ'

doctormagazine.lk

uq,skau we;s jkafka weúosk úg we;sjk fõokdjhs PAD frda.fhaoS uq,skau we;s jkafka weúosk úg n;aflKavd m%foaYfha fyda l,jd j, we;sjk flKavd fmrf<k iajNdjhhs' fuh Intermittent Claudication hkqfjka ye|skafjhs' weúosk úg ú;rla we;sjk fuu ;;a;ajh ksfid,aufka isák úg úkdä 1-2 loS ke;sù hhs' fõokdjla ke;sj hd yels ÿr fuysoS fndfyda ÿrg iudk fjhs' úfõlhla wrf.k kej; weúosk úg kej; fõokdj we;s fjhs' B<`. woshf¾oS kslka bkak fj,djgo fõokdj we;s fjkjd''' fuys ixlS¾K woshr j,oS .uka fkdlrk úgo" kslka bkak fj,djgo fõokdj we;s fjhs' iqj fkdjk ;=jd, we;s fjhs' jk we;s fjhs' we`.s,s l¿meye .ekafjhs' fï mgl ydkshg m;ajk woshrhs' fï wdldrfhka ixlS¾K woshf¾ ixl+,;d fmkaùu Critical Limb Ischemia (CLI) hkqfjka ffjoH úoHd;aulj ye|skafjhs'

A diabetic foot is a foot that exhibits any pathology that results directly from diabetes mellitus or any long-term (or "chronic") complication of diabetes mellitus.

Presence of several characteristic diabetic foot pathologies such as infection, diabetic foot ulcer and neuropathic osteoarthropathy is called diabetic foot syndrome. en.wikipedia.org/wiki/Diabetic_foot

oshjeähd frda.Skaf.a mdo j, we;sjk ;=jd, oshjeähdj ld,hla ;siafia mj;sk úg ksoka.; ;=jd, fkdfyd;a os.= ld,hla ;siafia iqj fkdjk ;=jd, olakg ,efnhs' os.= ld,hla ;siafia mej;Su iajNdjh uq;a fïjd kï b;d m%fõYfuka m%;sldr lr iqj lr.; hq;af;auh' ke;skï th wjika jkafka mdoh lmd bj;a lrk uÜgug <`.d ùfuks' fï wdldrhg mdo j, ;=jd, wjodkï iy.; woshrg t<efUkafka mdofha m¾hka; iakdhq ydkshg m;a ùfuks' (Diabetic Peripheral Neuropathy)

November 2016

DOCTOR MAGAZINE

59

D•Magazine /

oshjeähd frda.Skaf.a mdo j,g we;sjk wk;=r

Theme

we;frdialaf,frdaisia fkdfyd;a Ouks wNHka;rfha ;ekam;= we;sùu

ksfrda.S Ouksh

;ekam;=

reêr mßjykh

Ouks wjysr jk yeá slideplayer.com/slide/9225564/

ye`.Sula" oekSula fkdue;s ùu f.fkk wjodku nrm;,hs fuh isÿjkafka pd,l" ixfõol yd iajhxidOl hk ldKav ;=fkau iakdhq ÿ¾j, ùfuks' oekSu we;s lrk iakdhq úkdY ùfuka mdoj,g isÿjk fõokdjka fkdoekS hhs' .,l yemqk;a mdohg j.la ke;' fï wdldrfhka kej; kej; tlu ia:dkh wk;=rg ,laùfuka uyd ;=jd,hla we;s fjhs' kuq;a frda.shd th .ek okafka ke;' pd,l iakdhq o fï wdldrhgu mdofha l=vd m%udK wdmod h,s h,s;a we;s lrhs' thska mdofha we;eï iqúfYaIS ia:dk j, wdmod we;s fjhs' wfma wkqoekqula fkdue;sj l%shd;aul jk iajhxidOl iakdhq j, ÿn,;djh ksid oyäh oeóu" ic,kh wdoS hdka;%Khka wvmK fjhs' tys m%;sM<hla f,i iu mqmqre .ihs" úhef,hs" wjidkfhaoS ;=jd,hla we;s fjhs' fudk wdldrfhka fyda oshjeähd frda.sfhl=f.a mdofha ;=jd,hla we;sùu Tyqg f.k tkafka iq¿mgq wjodkula fkdfõ'

60

November 2016

DOCTOR MAGAZINE

reêr kd, wjysr jk yeá reêr Ouks j, ì;a;s wNHka;rfha fïouh ;ekam;= we;sù" tys jg m%udKh iSudjg ,laù reêr .ukdukh wjysr ùu Atherosclerosis hkqfjka ye|skf a jhs' oshjeähd frda.k S a w;f¾ fujka reêr kd, wjysr ùï j,g jeä bvla we;' Bg wu;rj oshjeähd frda.k S f a .a OukS le,aiN s jkh ùfuka tajdfha iqug l%h s dldß;ajh ÿ¾j, ùfï wjodkulao fõ' fï ish,af,a m%;M s <h jkafka mdohg ,eìh hq;= reêr m%udKh ySk ùfuka ;=jd," jk we;sùu iy tajd iqjm;a fkdù ydkslr ¨yqj;a ùï j,g wjldY ie,iSuhs' wdidok we;s ùfï wjodku by< hhs oshjeähd frda.Ska wdidok j,g ,laùfï wjodku ksfrda.S whg jvd jeäh' tfiau Tjqkag oshjeähdj ke;s frda.Skag muK Yla;su;a m%;sYla;slrK moaO;shlao fkdue;'

doctormagazine.lk

Taking Care of your feet in diabetes www.chihealth.com/diabetes

mdohg we;s iajdNdúl /ljrKh wysñ fjk yeá by; úia;r lrk ,o ish¿u wjodkï idOl ish,a, mdo iqjfi; flfryS wys;lr f,i n,mdkafkah' fï wdldrfhka wjidkfha isÿjkafka mdohg we;s iajdNdúl wdrlaIl /ljrKh wysñ ùuhs' tys m%;sM<hla jYfhka mdo wk;=rg ,laùfï wjodku by< hhs' reêr iemhqu ySk fjhs' mdo mgl j,g Tlaiscka jdhqj iemhquo ie<lsh hq;= uÜgulska wvqjk ksid yefok ;=jd,hla myiqfjka iqj jkafkao ke;' fï ksid mdo b;d wka;rdhldÍ wjodkulg ,la jk w;r iq¿ ;=jd,hla jQj;a fkdmudj wjYH mshjr fkd.;fyd;a ta ;=jd,h fõ.fhka j¾Okh ù mdo bj;a lsÍug mjd isÿ úh yelsh'

doctormagazine.lk

iEu jirlgu j;djla j;a oshjeähd frda.k S a ;u mdoj, reêr iemhqu mÍlaId lr.; hq;h = ' hï fyhlska tu kdä jeàfï wvqjla fmfkkakg ;sfí kï uq,a wjia:dfõoSu Bg kshñ; T!IO m%;l s dr isÿlr bosßhg úh yels wjodku md,kh lr.; hq;h = '

November 2016

DOCTOR MAGAZINE

61

D•Magazine /

oshjeähd frda.Skaf.a mdo j,g we;sjk wk;=r

Theme

PAD frda.h y÷kd.kakd yeá ffjoHjrhd úiska frda.shd idhkslj mÍlaId lsÍfuka PAD frda.h yªkd.; yel' ks;sm;d mdofha reêr iemhqu n,k kdä mÍlaIKh fuh l,afõ,d we;sj y÷kd.ekSfï m%Odk mshjrhs' fuh ´kEu ffjoHjrfhl=g isÿl< yels mÍlaIKhls' wu;r mÍlaIK jYfhka Doppler Scan yd Duplex Scan mÍlaIKo fhdod.; yel' ta yereKq úg wjYH kï wekacsfhd.%Eï mÍlaIKhlskao fuys wjysrùï uekúka y÷kd.ekSug wjldY ;sfí' fuu wu;r mÍlaIK isÿ lrkafka frda.shd CLI hkqfjka ye|skafjk kd, wjysr ùfï W.% frda. ,laIK m%lg lrkafka kï iy thg ms<shula jYfhka lsishï Y,Huh ueosy;aùula isÿ lrkakg mQ¾j.dójh' PAD frda.h i|yd lrk m%;sldr reêrjdyskS wjysr;djfha m%udKh u; lrk m%;sldr fjkia fjhs'

62

November 2016

mdohl wjysr jQ reosrjdyskS fmkajk wekacsfhd.%Eï m%;sìïnhla

• lsisÿ frda. ,laIKhla fkdfmkajk uq;a mdo mÍlaIKfhaoS reêr iemhqu lsishï wvd, ùulg ,laù ;sfnk nj wkdjrKh jQjfyd;a Tyq wêreêr mSvkh" fldf,iagfrda,a uÜgu jeäùu yd ÿïmdkh jeks fjk;a fï wjodku by< kxjk wjodkï idOl j,g ysñlï lshkafka kï tajd md,kh lsÍug mshjr .; hq;af;ah' ta yereKq úg frda. ,laIK md,kh lsÍug weiamsßka" fldf,iagfrda,a wvq

DOCTOR MAGAZINE

lrk T!IO wdosh wjia:dkql+,j ,nd osh hq;=h' • Intermittent Claudication hkqfjka ye|skafjk n;a flKavd" l,jd wdY%s; fõokdfjka fmf<k who uQ,sl jYfhka fmrlS wu;r wjodkï idOl uekúka md,khg ,la lr.; hq;=h' ta yereKq úg reêr iSks md,kh" ÿï mdkfhka je<lSu jeks mshjr j,g wjYHfhkau <`.d úh hq;=h' thska frda.

doctormagazine.lk

,laIK W.% ùu fukau ixl+,;d we;sùuo md,khg ,la lr.; yel' ta yereKQ úg fï wjia:dfõoSo T!IO m%;sldr ffjoHjrhd úiska kshu lrKQ we;' • fuys B<`. ne?reï wjia:dj jk tosfkod lghq;= j,g ndOd meñfKk ;rï fõokdjla we;sùu" úfõlSj bkak úgo lelal=u we;sùu" ;=jd, we;sùu yd mgl ueÍfuka tajd l=K ùu wdoS ;;a;aj j,oS m%;sldrd;aul l%shdj,shla wjYHfhkau l< hq;= fjhs' fuysoS wjysr;djh we;sj ;sfnk ia:dkh y÷kd. ekSug" isÿj we;s ydksh ;lafiare lsÍug m%;sl¾u jYfhka .;hq;= mshjr ie,iqï lsÍug iy kej; mdo j,g reêr iemhqu ia:dms; lrKq msKsi (Revascularization) by;ska úia;r l< wdldrfha mßf,dalk (Scan) mÍlaIK isÿ l< hq;= jkafkah' mdofha reêr iemhqu kej; ia:dms; lsÍug isÿlrk Y,Huh ueosy;aùï Revascularization hkqfjka ye|skafjk mdofha reêr iemhqu kej; ia:dms; lsÍu isÿ

doctormagazine.lk

lrkafka Peripheral Angioplasty fyda nhsmdia ie;alula u.sks' ie;alulg YdÍßlj fhda.H fkdjk whg isÿ lrk Peripheral Angioplasty Peripheral Angioplasty ie;alu fndfyda úg isÿ lrkafka Y,Hl¾u j,g t;rï fhda.H fkdjk yd t;rï ie<lsh hq;= cSú;dfmalaIdjla wfmalaId l< fkdyels frda.Ska ygh' fuysoS isÿ lrkafka wjysr jQ kyrhg kd,hla m%fõY lr th neÆkhla wdldrhg msïîug ie,eiaùfuka Ouksfha reêrh .uka lsÍug we;s mßudj úYd, lsÍuhs' l,d;=rlska wjia:djloS fuysoSo wjysr;d j,ska f;drj mßjyk l%shdj,sfha fhoSu idlaId;a lrk w;r ta yereKq úg fõokdldÍ frda. ,laIK wvq lsÍu;a" ;=jd, fõf,kakg bv ie,iSu;a wfmalaId flf¾' iaÓridr ms<shï i,ik" wfmalaIdiy.; Surgical Bypass ie;alu Surgical Bypass ie;alu PAD frda.Ska i|yd jvd;a wfmalaIdiy.; yd id¾:l Y,Huh ueosy;a ùuhs' fuysoS wjysr jQ Ouksh fjkqjg fjk;a reêr jdyskshla noaO lr

mdohg id¾:l reêr iemhqula ,nd fohs' fuysoS noaO lsÍug

oshjeähd frda.k S a wêreêr mSvkh" fldf,iagfrda,a uÜgu jeäùu yd ÿïmdkh jeks fjk;a fï wjodku by< kxjk wjodkï idOl j,g ysñlï lshkafka kï tajd md,kh lsÍug mshjr .; hq;f a ;ah' fndfyda ÿrg fhdod .kafka frda.shdf.au Ysrdjls' fuh wekacsfhdma,diaá ie;alug jvd id¾:lh' m%;sM< os.= ld,Skh' fuu ie;alu isÿ lsÍfuka mdohg wjysrhla fkdue;sj wjYH reêrh ,eîu ksid mdo wjodkug ,laùu g ms<shuls' mdo bj;a lsÍfuka ñoSug''' PAD frda.Skaf.a fï wdldrhg reêr iemhqu h:d ;;a;ajhg m;a lsÍfuka" wjodkï iy.; idOl ksis md,khg ,la lsÍfuka mdo j, reêr iemhqu wvd, ùu id¾:l f,i h:d ;;a;ajhg m;a flf¾' th mdoj, ;=jd, myiqfjka iqj lsÍugo u. i,ihs' mdo bj;a lsÍfuka ñoSug ;sfnk

November 2016

DOCTOR MAGAZINE

63

D•Magazine /

oshjeähd frda.Skaf.a mdo j,g we;sjk wk;=r

Theme

m<uq iy jeo.;au mshjr jkafkao fuhhs' kuq;a PAD frda.fhka ñoSug Tn .;hq;= wjidk l%shdud¾.h fuh fkdfõ' mdo j,g wjysrhlska f;drj reêr iemhqula ,efnk njg idlaId;a ùug iy h,s h,s;a ;=jd, we;s ùfï wjodkfuka je<lSug Tng my; mshjr .ekSug isÿ jkq we;' Caring for Your Feet

www.diabetes.org > Living With Diabetes > Complications > Foot Complications

There are many things you can do to keep your feet healthy.

• Take care of your diabetes. Work with your health care team to keep your blood glucose in your target range.

• Check your feet every day. Look at your bare feet for red spots, cuts, swelling, and blisters. If you cannot see the bottoms of your feet, use a mirror or ask someone for help.

• Be more active. Plan your physical activity program with your health team.

• Ask your doctor about Medicare coverage for special shoes.

• Wash your feet every day. Dry them carefully, especially between the toes.

• Keep your skin soft and smooth. Rub a thin coat of skin lotion over the tops and bottoms of your feet, but not between your toes.

• If you can see and reach your toenails, trim them when needed. Trim your toenails straight across and file the edges with an emery board or nail file.

• Wear shoes and socks at all times. Never walk barefoot.

Wear comfortable shoes that fit well and protect your feet.

Check inside your shoes before wearing them. Make sure the lining is smooth and there are no objects inside.

• Protect your feet from hot and cold. Wear shoes at the beach or on hot pavement. Don't put your feet into hot water. Test water before putting your feet in it just as you would before bathing a baby. Never use hot water bottles, heating pads, or electric blankets. You can burn your feet without realizing it.

• Keep the blood flowing to your feet. Put your feet up when sitting. Wiggle your toes and move your ankles up and down for 5 minutes, two (2) or three (3) times a day. Don't cross your legs for long periods of time. Don't smoke.

• Get started now. Begin taking good care of your feet today.

Set a time every day to check your feet.

64

November 2016

DOCTOR MAGAZINE

mdo wdrlaId lr.ekSfï iaj¾Kuh Wmfoia ud,dj • oshjeähd T!IO yd oshjeähdfjka mek ke.sh yels ixl+,;d j,ska ñoSug ffjoHjrhd úiska kshu lrk ,o weiamsßka" reêr mSvkh wvq lrk T!IO" fldf,iagfrda,a j,g .kakd T!IO wdosh Wmfoia oS wdldrhgu .; hq;=h' • ÿï mdkfhka ñoSu fukau wfkl=;a wjodkï iy.; p¾hd j,ska ñosh hq;=h' • mdjyka fkdue;sj weúoSu iqÿiq ke;' Tfí wdrlaIdj fjkqfjka úfYaIfhka ieliQ mdjyka hq., ^ke;skï th ffjoH Wmfoia u; ilia lr.kak' m<|skak' • Tfí ffjoHjrhd$Y,H ffjoHjrhd Wmfoia fok wdldrhg kshñ; mßos ffjoH yuqjg hkak' fuysoS u;=jg we;súh yels wjodkula fõ kï th l,afõ,d we;sj y÷kdf.k wdrlaIdldÍ mshjr .ekSug wjia:dj Tng Wod fjhs' DM doctormagazine.lk

D•Magazine /

Theme

oshjeähd jl=.vq wdndOh .ek oek.ksuq

Èhjeähd jl=.vq wdndOh .ek oek.ksuq

oshjeähd frda.Skaf.ka ishhg mkylau jir úiaila we;=<;oS oshjeähd jl=.vq wdndOhg ,la fjkjd''' oshjeähd frda.Skaf.ka ishhg oyhlf.a muK jl=.vq krla ù vh,hsia lrkak isÿ fjkjd'''

w

fma rfÜ ck.ykfhka wvq ;rfï ishhg oyhla oshjeähdfjka fmf<k nj fy<sorõ ù ;sfí' fï ishhg oyhl ck.yk me;slv oshjeähdj wdY%s; jl=.vq wdndO j,g ,laùfï bvlv úuiSfïoS jir úiaila we;=<; fï oshjeähd frda.Skaf.ka yß wvlau oshjeähd jl=.vq wdndOhg Diabetic Nephropathy ,lajk nj fmfka' wo wfma rg jl=.vq wdndO j,ska b;d oreKq f,i neglk rgls' ksoka.; jl=.vq wdndO Chronic Kidney Disease (CKD) fkdfyd;a ld,hla ;siafia jeä fjñka mj;sk jl=.vq wdndO hkqfjka ye|skafjkafka fï wNsfhda.hhs' ksoka.; jl=.vq wdndO j,g ,lajk iuia;fhka ishhg 30lau oshjeähd frda.Skah'

doctormagazine.lk

fudKrd., osia;%sla uy frdayf,a ldhsl frda. úfYaI{ ffjoH ksfrdaO o is,ajd

November 2016

DOCTOR MAGAZINE

65

D•Magazine /

oshjeähd jl=.vq wdndOh .ek oek.ksuq

Theme

fuh fome;a;lska neg lEuls' oshjeähdj mej;Su jl=.vq frda.hg w; jkk idOlhla jk w;r jl=.vq frda.Skaf. ka ie<lsh hq;= m%udKhla oshjeähd frda.Ska ùuo oshjeähdj yd jl=.vq frda. w;r ì|sh fkdyels in|;djhla fmkajd fohs' wjdikdj kï fï oshjeähd jl=.vq wdndO iys; frda.Ska ishhg 10lau vh,hsia fkdfyd;a reêr ldkaÿlrKfhka cSú;h .eg .id. kakd wirK Ndjhg m;a fjhs' fï ;;a;ajh y÷kajkafka End Stage Renal Failure (ESRF) hkqfjks' fï wdldrfhka ,efnk ixLHd f,aLK úu¾YKd;aulj ne,SfïoS wfma rfÜ iuia; ck.ykfhka iEu ishhg tla wfhlau vh,hsia m%;sldrh wjYH jl=. vq frda.sfhl= jk ìhlre jd;djrkhla fmfkkakg ;sfí' oshjeähd jl=.vq wdndOh Diabetic Nephropathy hkq l=ulao @ reêrfha widudkH iSks j, by< hdu ksid jl=. vq wdmodjg ,laùu oshjeähd jl=.vq wdndOh

66

November 2016

hkqfjka ye|skafjhs' reêrh fmÍu uQ,sl lr.;a b;d l=vd reêrjdyskS j,ska jl=.vq iukaú; jk w;r fï reêrjdyskS oshjeähdj fya;=fldg f.k lsishï wdmodjlg ,laúh yelsh' oshjeähd jl=.vq wdndOh we;s njg y`.jk fya;= • uq;%d iu. fm%daàk msgùu (proteinuria) • .=ÉÑld fmryka iS.%;djh (GFR) wvqùu • reêr mSvkh jeäùu frda.h ksjerosj y÷kd.ekSfïoS fuys uq,skau i|yka lrk idOl foflys mej;Su flfryS ffjoHjrekaf.a jeä wjOdkh fhduq flf¾' idudkHfhka ksfrda.S uq;%d idïm,hl fm%daàk wvx.= jkafka ke;' tfia wvx.= ùu Proteinuria hkqfjka y÷kajk w;r th jl=.vq lsishï wdmodjg ,laj ;sfnk njg idlaIshls' Diabetic nephropathy Diabetic nephropathy (or diabetic kidney disease is a progressive kidney disease caused by damage to the capillaries in the kidneys' glomeruli. It is characterized by nephrotic syndrome and diffuse scarring of the glomeruli. It is due to longstanding diabetes mellitus, and is a prime reason for dialysis in many developed countries. It is classified as a small blood vessel complication of diabetes.

jl=.vqjl l%shdldß;ajfha wvqùu fl;rïo hkak y÷kd.ekSug we;s fyd|u mÍlaIdj GFR - glomerular filtration rate hs' frda.shdg m%;sldr lsÍfuys,d fuu m%;sM< jeo.;a fjhs' idudkHfhka w¿; Wmka orefjl=f.a GFR 100ls' jl=.vq wlrKshloS (Renal Failure) th 60la muK jk w;r GFR w.h 10g wvq frda.Skag ldkaÿlrKh fkdfyd;a vh,hsia lsÍu wjYH jkafkah'

DOCTOR MAGAZINE

doctormagazine.lk

oshjeähd jl=.vq wdndOh - frda. ,laIK • uq;%d msg lsÍfïoS fmk wdldrfhka olakg ,eîu • mdo bosóu • idudkH uÜgul ;snqKq reêr mSvkh tlajku by< hdu • weia fmkSfï .eg¿ u;=ùu

ACR hkqfjka ye|skafjk fuu mÍlaIKfhka oshjeähd jl=.vq wdndOh y÷kd.kq ,enQjfyd;a Bg kshñ; T!IO m%;sldr .ekSu ksid thska frda.h j¾Okh ùu iEfyk muK wvd, lr.; yel' Microalbuminuria mÍlaIKh i|yd óg by;oS meh 24l uq;%d tla/ia lr.; jQj;a oeka tfia isÿ lsÍu wjYH ke;' ´kEu fudfyd;l .kakd uq;%d idïm,hlska mÍlaIKh isÿ lr.; yels jk fia l%shdj,sh ir< ù ;sfí'

"

tfy;a fuysoS uq;%d idïm,h ksjerosj ,nd.; hq;=h' fodaI iy.; m%;sM< u.yer ksrjoH jd¾;djla ,ne. ekSu i|yd my; mshjr wkq.ukh lrkak'

hï flfkl=g oshjeähd jl=.vq wdndOhla ;sfnkjd kï Tyqf.a wdhqI wjqreÿ 10-15lska muK wvq jk nj idudkH ms<s.ekSuhs'

fï úia;r l< tla frda. ,laIKhla fyda olakg ,enqfKd;a oshjeähd jl=.vq wdndOh ;sfíoehs ;yjqre lsÍfï mÍlaIK wdrïN flfrhs' idudkHfhka yDohdndOhla" wxYNd.h jeks ;;a;ajhlg md;% jQ frda.Ska iïnkaOfhka fidhd ne,SfïoS Tjqka ie<lsh hq;= m%udKhla fuu oshjeähd jl=.vq wdndOhg ,laj we;s wh nj fmfkkakg ;sfí' oshjeähd jl=.vq wdndOh lsishï ixlS¾K woshrlg m;a jQ miq fujka wdndOo we;sùu oel.; yels fõ' oshjeähd jl=.vq wdndOh y÷kd.kafka flf,io @ ta i|yd we;af;a b;d ir< uq;%d mÍlaIKhls' Bg jeh jkafka b;d wvq uqo,ls' Microalbuminuria fkdfyd;a

doctormagazine.lk

Microalbuminuria mÍlaIKh i|yd uq;%d idïm,h ,nd .ekSfïoS wkq.ukh l< hq;= lreKQ • uq;%d wdidokhla ke;s wjia:djl uq;%d idïm,h ,nd.; hq;=hs' • uq;%d iu. f,a fkdhk wjia:djl uq;%d idïm,h ,nd.; hq;=hs' • lekaävhisia wdoS wdidok fya;=fjka uQ;%l fmfoi leis,a, fkdue;s wjia:djl uq;%d idïm,h ,nd.; hq;=hs'

November 2016

DOCTOR MAGAZINE

67

D•Magazine /

oshjeähd jl=.vq wdndOh .ek oek.ksuq

Theme

• WK ;sfnk úg idïm,h fkd.; hq;=hs' • oeä jHdhdu isÿ fkdlr úfõlSj ys| idïm,h fkd.; hq;=hs' • YÍrfha iSks fkdjeä wjia:djl idïm,h fkd.; hq;=hs' • yoj; wlrKsh we;súg (Heart Failure) idïm,h fkd.; hq;=hs'

jl=.vq wdndOh we;s úg 130$85 g wvq b,lalhla imqrd,Sug b,lal ;nKq ,efí' • ¨Kq wkqNjh yels;dla iSud l< hq;=h' • ,nd .kakd fm%daàk m%udKh iaj,amhla wvq l< hq;=h' idudkHfhka YÍr nr lsf,da .a?uhlg .a?ï 1 l muK b,lalhla ,nd fohs' • yDohdndO" wxYNd. wjodku wvq lsÍug rd;%S weiam%Ska yd iageáka T!IO oskm;d ,ndoSula isÿ flf¾'

WoEik uq,au uq;%d ksheosh wrf.k mÍlaIKh isÿ lsÍu jvd;a iqÿiqh' fuu mÍlaIKfha m%;sM< zzfmdisáõZZ kï mÍlaIKh kej; j;djla isÿ l< hq;=hs' thskao tu m%;sM<hu ,efí kï frda.h l<uKdlrKh i|yd ms<shï fhosh hq;=h' oshjeähd jl=.vq wdndOh l<uKdlrKhg .; hq;= mshjr Microalbuminuria fmdisáõ jk wjia:dj • reêr iSks uekúka md,khlg ,la lr.; hq;=hs' • reêr mSvkh uekúka md,khg ,la lr.; hq;=hs' idudkH mqoa.,fhla i|yd reêr mSvk md,k b,lalh jkafka 140$90 h' tfy;a oshjeähd

68

November 2016

• frda.h md,khg ,ndfok T!IO Angiotensinconverting enzyme (ACEs) inhibitors ldKavhg wh;a tk,m%s,a jeks T!IOhla fyda Angiotensin II receptor blockers (ARBs) ldKavhg wh;a f,didgka jeks T!IOhla .ekSfuka fuu wjodku fndfyda fihska md,khg ,la lsÍug yels fõ' ta yereKq úg yDohdndO yd wxYNd. wjodku wju lsÍugo fuu T!IO WmldÍ jk nj wOHhk j,ska fy<s ù ;sfí' oshjeähd jl=.vq wdndOh - woshr j¾.SlrKh jl=.vq j, uq;%d fmÍu jeäjk wjia:dj' Glomerular hyperfiltration bkamiqj jir myla muK hk;=re ksy`v ld,hla mj;S' fï ld,fhaoS Microalbuminuria mÍlaIKhla l<;a m%;sM<h fk.áõ fõ'

DOCTOR MAGAZINE

doctormagazine.lk

"

hï flfkla fuÜf*dñka j,g we;s ìh ksid fuÜf*dñka m%;sldrhla f,i fkd.kafka kï Tyqg kï jl=.vq krla ùfï wjodku kï jeä jk nj lsj hq;=h' oy fofklaf.ka tla flfkl=g jl=.vq frda.h we;s jQ úg wfma iudch ys;kafka fuÜf*dñka .ekSu ksid Tyqf.a jl=.vq krla jQ njhs' kuq;a ienEj jkafka wfk;a kj fokd jl=.vq frda.fhka wdrlaId ùug fuÜf*dñka fya;= jQ njhs'

f;jk woshf¾oS Microalbuminuria mÍlaIKh fmdisáõ jk wjia:dj' fï wjia:dfõoS GFR w.hka iaj,amhla my; jefghs' uq;d% fm%dà a k 30- 300 mg/g w.hla .kS' Macroalbuminuria hkqfjka y÷kajk isjQjk woshf¾oS reêr mSvkh by< kexfjhs' GFR w.h my; jefghs' uq;%d fm%daàk 300 mg/g blaujd hhs' jl=.vq wlrKsfha wjidk woshr End Stage Renal Failure hkqfjka ye|skafjkafka miajeks woshrhs' fï wjia:dfõoS osú .eg.id .ekSug frda.shdg ldkaÿlrkh wjYH fõ' ke;fyd;a úl,amh jkqfha kj jl=.vqjla noaO lsÍuh'

fï woshr j,g wkQj lrk m%;sldr úúOh' lkaola ke.Su yd neiSu hk WmyerKh weiqf¾ wm fï woshr my úia;r lruq' lkao k.sk wjia:dfõ frda.h y÷kd.;fyd;a frda.h j¾Okh ùu j<lajd.; yel' fhdok m%;sl¾u Tiafia fyd| md,khla we;s lr.; yel' m<uq" fojk yd f;jk mshjr ;=ku lkao k.sk wjia:djh' fuysoS jir 6-15 w;r ld,hla ;siafia mj;sk Proteinuria hkqfjka y÷kajk wjia:dj Tfí oshjeähd jl=.vq wdndOh md,khg we;s fyd|u wjia:djhs' tu wjia:dfõ frda.h md,kh lsÍug ksis mshjr fkd.;fyd;a" Macroalbuminuria wjia:dfõoS yd ldkaÿlrkh isÿ lrk wjia:dfõ frda.h md,kfhka neyerh'

Diabetic nephropathy symptoms

doctormagazine.lk

November 2016

DOCTOR MAGAZINE

69

D•Magazine /

oshjeähd jl=.vq wdndOh .ek oek.ksuq

Theme

l< yels foa iSñ;h' lkao neyef.k hk úg cSú;ho m,a,ï nyskjd úkd thg /ljrKhla ke;' oshjeähd jl=.vq wdndOh woshr tla tla woshrg wkql=,j GFR w.h ySk jk wdldrh Silant Stage ysoS GFR w.h wvq ùu jirlg ñ,s ,Sg¾ 1 Microalbuminuria Stage ysoS GFR w.h wvq ùu jirlg ñ,s ,Sg¾ 3 Macroalbuminuria Stage ysoS GFR w.h wvq ùu jirlg ñ,s ,Sg¾ 7 fï wkQj oshjeähd frda.Ska ksr;=reju ffjoH wëlaIKh hgf;a frda.h md,khg mshjr .; hq;= w;r úfYaIfhkau oshjeähd jl=.vq wdndOh we;sùfï wjodku úáka úg mÍlaIdjg ,la lrñka th md,kh l< yels wjêhloS frda.h y÷kd.ekSug W;aiql úh hq;=h'

fuÜf*dñka .ekSfuka jl=.vq krla fjkjdo @ wo iudcfha fndfyda fokd w;r fujka u;hla we;s ù ;sfí' oshjeähd 70

November 2016

frda.Skaf.a ksis frda. l<uKdlrKhg fï u;h iudc.; ùu buy;a ;¾ckhla ù we;s ksid fï l;dfõ we;a; ke;a; úuid ne,sh hq;= fõ' fuÜf*dñka oshjeähd frda.Skag ,nd fok fyd|u T!IOhls' th oshjeähdj frda.Skag ,nd fok m<uq T!IOh (First line agent) jYfhkao ie<fla' fuÜf*dñka u.ska Tfí isref¾ mgl u.ska jvd;a myiqfjka bkaishq,ska Wrd .ekSug i,iajhs' wlaudfõoS .aÆfldaia ksIamdokh wvd, lsÍugo fuÜf*dñka fya;= fjhs' 1950 oYlfha isg fuÜf*dñka oshjeähd frda.Skaf.a m%;sldr msKsi fhdod.kakd w;r ta iïnkaOfhka fuf;la f,dj mqrd isÿ flreKq m¾fhaIK ixLHdj oyia .Kkls' fï lsisÿ m¾fhaIKhlska fï ;dla fuÜf*dñka jl=.vq j,g wys;lrh hk ldrKh Tmamq ù ke;' ienúkau fuÜf*dñka .ekSfuka reêr iSks md,kh yereKq úg ;j;a fndfyda m%fhdack w;am;a jk nj kï fï m¾fhaIK j,ska fy<sorõ ù ;sfí' hï flfkla fuÜf*dñka j,g we;s ìh ksid fuÜf*dñka m%;sldrhla f,i fkd.kafka kï Tyqg kï jl=.vq krla ùfï wjodku kï jeä jk nj lsj hq;=h' oy fofklaf.ka tla flfkl=g jl=.vq frda.h we;s jQ úg wfma iudch ys;kafka fuÜf*dñka .ekSu ksid Tyqf.a jl=.vq krla jQ njhs' kuq;a ienEj jkafka wfk;a kj fokd jl=.vq frda. fhka wdrlaId ùug fuÜf*dñka fya;= jQ njhs' jl=.vq krla jQ whg ffjoHjreka fuÜf*dñka ,ndoSu w;aysgqjhs' th isÿ lrkafka jl=.vq ÿ¾j, ùu ksid fok fuÜf*dñka wef`.a tl;= fjñka YÍrhg wys;lr m%;sM< we;sùu j<lajd,Sfï wNs,dYfhks' fuh jeros wdldrfhka T¿jg wrf.k zzfodia;r uy;a;h fuÜf*dñka keje;a;=fj jl=.vq j,g krl yskaohs'''ZZ hkqfjka jrojd jgyd .kakd wjia:do wm w;f¾ fõ' fuÜf*dñka hkq wfma jákd jl=.vq wdrlaId lrk jákdu fnfy;ls' DM

DOCTOR MAGAZINE

doctormagazine.lk

D•Magazine /

Theme

oshjeähdj yd iïnkaO p¾u.; frda.

oshjeähdj yd iïnkaO p¾u.; frda.

È moúh uQ,sl frdayf,a jevn,k p¾u frda. úfYaI{ ffjoH ,laud,s m;srdc úisks

hjeähdj isref¾ ish¿u wjhj j,g mdfya n,mEï we;s lrjk frda. ;;a;a;ajhla' oshjeähdj ksid iug we;súh yels n,mEu fï ,smsfhka úia;r flfrkjd'

oshjeähdj ;sfnk flfkl=g iu wdY%s;j frda. we;sùfï wjodku idudkH ksfrda.S flfkl=g jvd ishhg 30lska muK jeä fjkjd' ksfrda.S flfkl=g idfmalaIj oshjeähdj frda.sfhl=f.a m%;sYla;slrK moaO;sh ;rula ÿ¾j,hs' fï ksid Tjqkg úúO wdidok we;sùfï bvlv jeähs' nelaàßhd" ffjri wdidok fukau os,Sr wdidoko oshjeähdj frda.Skag fï fya;=j ksid we;sùfï jeä bvlvla ;sfnkjd' Candida os,Sr wdidok uqL l=yrh yd osfjys lsß leá jeks iajNdjhla" ld,hla mj;sk fõokdjla oelsh yels fjkjd' kshlkak bosófï frda.ho (Chronic Paronychia) fï ksid we;súh yelshs' oshjeähdj fyda fjkhï m%;sYla;slrK W!K;djhla we;s úg lekaävd wdidok we;sùfï jeä bvlvla ;sfnkjd' ldka;djlf.a kï ryi`. wdY%s;j lsß leá jeks iqÿ meye >%djhl=;a" msßñkaf.a kï YsIaKh fl<jr bosó r;ameye .ekSul=;a oelsh yels jkjd' tfiau mshhqre hg" we`.s,s lre w;r jeks iu tlsfkl iam¾Y jk ia:dk j, bosuqKq" r;a meyehla we;sjqKq jeks iajNdjhlao fuysoS oelsh yelshs' (Intertrigo) tfiau Cellulitis jeks nelaàßhd wdidoko fujeks frda.Ska w;r iq,nhs' fuysoS isÿjkqfha b;d iq¿fjka fyda ;=jd," iSÍula we;s ia:dkhlska wod, nelaàßhdj iug we;=,a ùuhs' fï ;;a;ajh b;d m%n,j we;s jkafka mdoj, jk w;r túg mdoh r;=ù" bosó fõokd iy.; Ndjhg m;a jkafkah' isref¾ WIaK;ajh by< hduo fuysoS isÿúh yelsh'

doctormagazine.lk

doctormagazine.lk

November 2016

DOCTOR MAGAZINE

71

D•Magazine /

oshjeähdj yd iïnkaO p¾u.; frda.

Theme

ll=,aj, bosßmi" oKysig u|la my<ska oelsh yel' lsys,s" bls,s iy fn,a, l¿ meye .ekaùu fuh Acanthosis Nigricans kñka ye|skafõ' fuys l¿ meye iajNdjhla we;s jkafka iu kefjk ia:dk j,h' fuh oshjeähd frda.Ska yereKQ úg wêl ;rndrej" ms<sld ;;a;aj j,oSo oelsh yel'

fujeks wdidok j,g wu;rj oshjeähd frda.h ksidfjkau ifuys yg.kakd we;eï frda.o ;sfí' Diabetic Dermopathy (Shin Spots) ll=,a j, oKysfika my< fldgfia yg.kS' oshjeähd frda.Skaf.ka ishhg 30lg muK fuu ;;a;ajh we;sjk w;r fuh yg.kakd wjia:dj jk úg idudkHfhkka oshjeähdj ksid we;sjk wlaIs frda.o yg .kakg bv ;sfí' mdofha fï ;;a;ajfhaoS is.rÜgqjlska ms<siaiqkdla fuka l¿" ÿUqre meye;s le<e,a yg.kS' Diabetic Bullae fuh oshjeähd frda.Skaf.a w;a yd mdo j, yg .kakd ;;a;ajhls' j;=r msreKq úYd, osh nqnq,a fuysoS u;= úh yel' iu >k ùu Diabetic Cheiroarthropathy fuu ;;a;ajh msßñka w;f¾ iq,nh' fuysoS fjfiiskau msfÜ iu >k jQ iajNdjhla olakg ,efí' Granuloma Annulare fuysoS l=vd rjqï uqÿ fyda j<¨ yeve;s ifï meyefhkau b,smamqkq iajNdjhla oelsh yels ùuhs' fuh ksfrda.S whf.a fukau wfkl=;a frda. ;;a;aj j,oSo oelsh yels w;r oshjeähdjg muKlau wdfõKsl fkdfõ' tfiau fuh ydksodhl m%;sM< we;s lrjk frda.hlao fkdfõ' Necrobiosis Lipoidica fuho l,d;=rlska oshjeähd frda.Ska ;=< olakg ,efnk ;;a;ajhls' fuysoS ly ÿUqre meyefha b,smamqKq me,a,ï

72

November 2016

DOCTOR MAGAZINE

oshjeähd frda.Skaf.a mdo id;a;=j mdo j, we;sjk ;=jd, oshjeähd frda.Skaf.ka ishhg 15la muK mdo j, we;sjk ;=jd, ksid mSvd ú|S' oshjeähdj ksid mdo j, iakdhq ÿ¾j, ùu iy wfkl=;a fya;=kao fï i|yd n,mdhs' mdo kshñ; mßos /l n,d .ekSfuka fuu ;=jd, we;sùu j<lajd .; yel' iSks ;;a;ajh uekúka md,kh lsÍu yd mdo j,g mdjyka me<|Su oshjeähd frda.Ska wksjd¾hfhka l< hq;=h' oskm;d mdo fiaoSu" .,a;e¿ï ;=jd, j,ska mdo wdrlaId lr.ekSu ksrka;rfhka l< hq;=h' Tng uekúka mdo mÍlaId l< fkdyels kï fjk;a wfhl=f.a iydh ,nd.kak' m;=,a j, b;d f.dfrdaiq ;eka fyd|ska fmf`.kakg yer fyd|ska w;=,a,kak'fyd|ska fõ¿Kq miq kshfmd;= fl,ska w;g lmkak' DM

doctormagazine.lk

doctormagazine.lk

November 2016

DOCTOR MAGAZINE

73

74

November 2016

DOCTOR MAGAZINE

doctormagazine.lk

doctormagazine.lk

November 2016

DOCTOR MAGAZINE

75

76

November 2016

DOCTOR MAGAZINE

doctormagazine.lk

D•Magazine /

Nutrition

l=re÷ i;= uy`.= .=Kh oek.kak

Cinnamon is one of the most delicious and healthiest spices on the planet. It can lower blood sugar levels, reduce heart disease risk factors, and has a plethora of other impressive health benefits. Just make sure to get Ceylon cinnamon, the best kind in the world...

NUTRITION BENEFITS OF CINNAMON wfma rfÜ jefjk l=re÷ ksfrda.S iqjh m;k f,dal m%cdjf.a wxl tfla f;aÍula''' l=re÷ i;= uy`.= .=Kh oek.kak

doctormagazine.lk

November 2016

DOCTOR MAGAZINE

77

D•Magazine /

l=re÷ i;= uy`.= .=Kh oek.kak

Nutrition

bosß oYl lsysmh ;=< fõ.fhka ysi Tijkq we;ehs fm/ hSï lr we;s frda. w;r äfukaIshdj m%Odk ia:dkhla .kS' ;j;a oYl lsysmhlska wfma jeäysáhka iEu i;r fofklaf.kau flfkla fï frda.hg f.dÿre jkq we;ehs ffjoHjreka lsh;s' uE; ld,Sk u;lh wjysr lrñka ldhsl" udkisl úmßkduhla we;slrjk äfukaIshdj ksid fndfyda jeäysáhkag w;ajkafka ÿlaLodhl urKhls' fud<fha ffi, urKhg m;a ùfuka we;sjk frda.hla ksid äfukaIshdjg fnfy;a ke;' frda. ,laIK l,a ouk Wmdhud¾. yereKQ úg ie<lsh hq;= m%;sldrhla ngysr ffjoH úoHdfõ ;ju;a y÷kdf.k ke;' fud<fha ksmofjk weñf,dhsâ îgd kue;s fm%daàkhla fya;= fldgf.k fuysoS fud<fha ffi, urKhg m;a fjhs' äfukaIshdfõoS" we,aIhsu¾ frda.fhaoS isÿjkafka fuhhs' fud<fha ffi, wdrlaId lrk l=re÷ miq.shod wreu mqÿu mqj;la ì%;dkHfhka wikakg ,enqfKah' ta fud<fha ffi, j,g ydks lrk weñf,dhsâ îgd fm%daàk j, l%shdldß;ajh w;aysgqjd äfukaIshdj k;r lsÍug l=re÷ iu;a jk njhs' fuh b;d ft;sydisl fidhe .ekSula jkafka tjka ymkalula isÿ flrefKd;a th iuia; udkj j¾.hdf.au fyg oji flfryS wdrlaIKhla tla lrk ksihs' T!Iëh .=Kfhka hq;a ienE l=re÷ Cinnamomum verum jefjkafka Y%S ,xldfõ muKs' tajdg uq¿ f,dalfhau we;af;a buy;a b,a¨uls' wfma l=re÷ ñf,kao wêlh' fï ksidu Ökfha jefjk vqma,sflaÜ l=re÷o Cinnamomum aromaticum Ndú;hg meñK ;snqK;a tajdfha T!Iëh .=Kh wfma .=Kj;a l=re÷ j, y;r udhsug j;a fkdue;s nj ngysr m¾fhaIlhka fyd|dldrju okafkah' oshjeähd frda.Skaf.a l=re÷ Ndú;dj l=re÷ jvd;a m%isoaOj we;af;a oshjeähdjg m%;sldrhla jYfhks' ta yereKQ úg fldf,iagfrda,a wvq lrkakgo l=re÷ iu;a fjhs' l=re÷ .arEï 1-6 l muK m%udKh osk 40la ;siafia tl os.g mdkh lsÍfuka reêr iSks w.h ishhg 24l muK úYd, mrdihlska wvq lr.; yel' reêrfha fldf,iagfrda,a uÜguo ishhg 18l muK m%udKhlska wvq lr.; yel' fuh úYd, b,lalhls' fu;rï m%;sM<hla ,eìh yels T!IO wef;d;a ta l,d;=rlsks' Y%S ,xld jhU úYaj úoHd,fha wdpd¾h f¾Kql is,ajd oshjeähdj u¾Okhg l=re÷ l%shd lrk wdldrh fuf,i meyeos,s lrhs' zz l=re÷ j, we;s we;eï ixfhda. bkaishq,ska j, Wmfhda.S;djh jeä lsÍug iu;ah' tfiau bkaishq,ska 78

November 2016

DOCTOR MAGAZINE

One tablespoon of ground cinnamon contains: 19 calories 0 grams of fat, sugar, or protein 4 grams of fiber 68% manganese 8% calcium 4% iron 3% Vitamin K

Y%S ,xld jhU úYaj úoHd,fha wdpd¾h f¾Kql is,ajd

wffO¾h lrk idOl hgm;a lrk ixfhda.o l=re÷ i;= fjhs' fmd,smsfkda,a tjeks jákd ixfhda.hls' m%;sTlaisldrlhls' fï yereKQ úg ;j;a jákd ixfhda. /ilau l=re÷ j, wvx.=h'ZZ fï jákd ixfhda. we;af;a l=re÷ fmd;af;a ñi l=re÷ f;,a j, fkdjk njo Tyqf.a woyih' l=re÷ i;= idOKSh .=Kdx. úuiSu i|yd m¾fhaIK /ila fï jk úg osh;a ù we;s nj wdpd¾h f¾Kql is,ajd jeä ÿrg;a m%ldY lrhs'

doctormagazine.lk

oshjeähdjg w; jkkafka YÍrfha nr jeäùu" mßjD;a;Sh ixl+,;d wdosh Tiafia YÍrh ;=< l%shd;aul jk bkaishq,ska m%;sfrdaë hdka;%Khhs' l=re÷ fï bkaishq,ska m%;sfrdaOh j<lajhs' ta wkQj l=re÷ m%;sldr lrkafka frda.hg fkdfõ" frda.fha uQ,hgh' ta yereKq úg .aÆfldaia reêrh Tiafia YÍrhg Wrd.kakd we,kska wdoS tkaihsu /ila l=re÷ u.ska wjysr lr reêr iSks m%udKh uekúka hdukh lrk nj m¾fhaIK j,ska fy<sorõ ù ;sfí' oshjeähdj yereKq úg ;j;a fndfyda frda.dndO j,go l=re÷ ukd T!IOhla fõ' fï ksid ksiaidrKh lr.;a l=reª weiqf¾ ilid.;a T!Iëh mdk Ndú;hg ck;dj yqreù isà'

l=re÷ i;= uy`.= .=K w;f¾ f;dard.;a lsysmhla''' � f,dalfha ;sfnk yhfjks m%n, m%;sTlaisldrlh jkafka l=re÷h' fmd,smsfkda," msfkda,sl wï, yd *a,efjdkhsv we;=¿j w;s m%n, wdrlaIl ridhk 41 lska l=re÷ fmdfydi;a nj y÷kdf.k ;sfí' � l=re÷ j, w;s m%n, *a,efjdkhsv muKla m%fNao y;la ;sfí' yDohdndO" ms<sld fukau fud<fha l%shdldß;ajh ÿ¾j, lrk l%shdldß;ajhka wvd, lsÍug fuys we;s zzw;s m%n, m%;sm%odysl .=KhZZ WmldÍ fjhs' � l=re÷ u.ska fldf,iagfrda,a iy wêreêr mSvkh my; fy<hs' reêr ixirkh iqir lrhs' reêrh leá .eiSu j<lhs' fuys we;s mgl mqk¾ckkSh l%shdj,sh yD;a udxYfmaYs w¿;ajeähd lrhs' � fuys we;s m%n, m%;sTlaisldrl .=Kdx. ksid DNA wdmodjg ,laùu j<lajhs' th isref¾ we;súh yels ms<sld j<lajk hdka;%Khls' fjfiiskau nvje,a j, iqjfi; flfryS l=re÷ ;SrKd;aul jk nj m¾fhaIlhkka y÷kdf.k ;sfí' � uqLfha ÿ¾.kaOh iukh lrhs' ksiaidrKh lr.;a l=re÷ f;a,a l=re÷ jYfhka l%shd;aul fjhs' � lekaävd yd wfkl=;a os,Sr wdidok j<lajhs' ifï oeú,a," wdidok yd wdid;añl;d j<lajhs' fï l=re÷ f;,a j, jákd m%fhdackhls' ifuys iqjfi; kxjd,hs' DM

fi!LHiïmkak cSú;hla Wod lrk'''

iskuka wekaâ .%Ska à LIYANAARACHCHI CINNAMON & GREEN TEA

b`.=re" l=re÷" .%Ska f;a" rKjrd we;=¿ ishhg 100la wdhq¾fõo T!IO tlalr Wiia m%ñ;shlg wkQj ilia lr we;s LIYANAARACHCHI CINNAMON & GREEN TEA Tn;a mdkh lr w;sYhskau ;¾ckd;aul my; i|yka frda. cSú; ld,hgu j<lajd .kak' • oshjeähdj • wd>d;h • yDohdndO • fiï frda. wêl • wêreêr mSvkh • ms<l s d • ;rndrej • .eiagh % á s ia • wd;rhsáia • o;a osrd hdu • fldf,iagfrda,a • uqL frda. • lg .| .eiSu fuu jákd mdkh oskm;d .ekSfuka ksfrda.S cSú;hlg moku i,id .kak' ,shkwdrÉÑ bkagkeIk,a bkaviaá% | ÿïßhfmd< mdr" jrldfmd, ÿrl:kh 035-5671799, 0775209098, 0716143360 Bfï,a www.cinnamonliyana@gmail.com doctormagazine.lk November 2016 DOCTOR MAGAZINE fjí www.cinnamonliyana.lk

79

News iqmqj;

fi!LH" fmdaIK yd foaYSh ffjoH wud;HxYfha mqj;a irKsh reishdkq" bkaoshdkq iud.ï folla fï rfÜoS wfma T!IO ksIAmdokhg .súiqï w;aika lrhs fi!LH" fmdaIK yd foaYSh ffjoH wud;H ffjoH rdcs; fiakdr;ak uy;df.a Wmfoia u; Y%S ,xldjg wjYH T!IO furgoSu ksIAmdokh lsÍfï jevms<sfj, i|yd w;aje,a ne|f.k isák foia úfoia iud.ï 28ka iud.ï folla .súiqï w;aika lsÍu miq.shod isÿ úh' reishdfõ T!IO ksIamdok iud.ula yd bkaoshdfõ T!IO ksIAmdok iud.ula w;r .súiqï w;aika lsÍu rdcH T!IO ksIAmdok kS;s.; ixia:dfõ iNdm;s ffjoH ihqre iuriqkaor uy;df.a ueosy;aùu u; miq.shod isÿ flreKQ w;r tu wdfhdack j, jákdlu wefußldkq fvd,¾ ñ,shk 10ls' zzuf.a orjdf.a T¿j ug mK jf.a'''ZZ fi!LH wOHdmk ld¾hdxYfhka iaàl¾ jHdmD;shlaosjhsk mqrd jd¾Islj isÿjk 270"000la muK jk <ud wk;=re wju lsÍu ms<sn|j fi!LH" fmdaIK yd foaYSh ffjoH wud;HxYfha wjOdkh fhduq ù ;sfí' orejka wk;=re j,ska wdrlaId lsÍu i|yd wdrlaIs; ysia jeiqï me<|ùu flfryS fouõmshka oeKQj;a lsÍfï jevigykla l%shd;aul jk w;r fi!LH wOHdmk ld¾hdxYh úiska zzuf.a orejdf.a t¿j ug mK jf.aZZ hkqfjka i|yka jk iaàlrhla fï hgf;a y÷kajd oS ;sfí'

80

November 2016

DOCTOR MAGAZINE

iud.ï j,g" ys;+ ys;+ f,i ñkamiq frday,a j,g mß;Hd. isÿ lrKQ nE''' úúO fj<| iud.ï úiska fkdfhl=;a j¾.fha ridhkd.dr mÍlaIK hka;%" WmlrK frday,a j,g mß;Hd. lsÍfïoS ta i|yd fi!LH fiajd wOHlaI ckrd,ajrhdf.a wkque;sh ,nd.ekSu ñkamiq wksjd¾h jk nj fi!LH" fmdaIK yd foaYSh ffjoH wud;HxYh úiska oeKQï oS ;sfí' miq.sh jljdkqfõ frday,a j,g mß;Hd. l< tjka hka;% m%fhdackhg .ekSu i|yd mdßfNdacH øjH yd m%;sl%Shl ødjK by< ñ< .Kka hgf;a tu wdh;k j,skau ñ,oS .ekSug isÿùu ksid w;s úYd, OkialkaOhla tu iud.ï fj; fhoùug isÿùu fï ;SrKh .ekSug n,md ;sfí' zzúIka 2020ZZ jevigyk hgf;a meie,a orejkag fkdñf,a weia lKakdä úIka 2020 jevigyk hgf;a fld<U

doctormagazine.lk

osia;%slalfha wlaIs wdndO j,ska fmf<k ore oershka 1000 lg weia lKakdä ,ndoSu fi!LH fiajd wOHlaI ckrd,a úfYaI{ ffjoH md,s; uySmd, uy;df.a m%Odk;ajfhka miq.shod fnd/,a, ffjoH m¾fhaIKd.drfhaoS isÿ flßK' fi!LH" fmdaIK yd foaYSh ffjoH wud;HxYh hgf;a l%shd;aul flfrk zz2020 jevigykZZ hgf;a fï jk úg osjhsk mqrd wlaIs wdndO j,ska fmf<k orejka ,laI 3lg weia lKakdä ,nd oS ;sfí' yDo frda.Ska i|yd fkdñ,fha ,ndoSug f.kd iafgkaÜ wjNdú;fha fhoùfuka j<lskak - weu;s ffjoHjrekaf.ka b,a,Sula lrhs

yDo frda.Skaf.a Y,Hl¾u i|yd fkdñ,fha ,ndoSug wdkhkh l< iafgkaÜ wjNdú;fha fhoSug we;s wjia:d wiqrk f,i fi!LH" fmdaIK yd foaYSh ffjoH wud;H ffjoH rdcs; fiakdr;ak uy;d yDo frda. úfYaI{ ffjoHjrekaf. ka úfYaI b,a,Sula lf<ah' ta miq.shod fi!LH wud;HxYfhaoS yDo frda. úfYAI{ ffjoHjreka yd mej;S úfYAI idlÉPdjloSh' yDo frda.Ska i|yd fkdñ,fha fnod oSug f.kajk ,o 500 lska hqla; m<uq iafgkaÜ f;d.h miq.shod osjhskg <`.d úh' iafgkaÜ tll ñ< rems' 75"000 la muK

doctormagazine.lk

jk w;r 2017 j¾Ih i|yd yDo frda.K S g a wjYH iafgkaÜ rdcH T!IO kS;. s ; ixia:dj úiska oekgu;a weKjqï lr ;sfí' l=reKE.,g yd hdmkhg kj yDo frda. wdh;k folla l=reKE.,g yd hdmkh frday,a j, wNskjfhka yDo frda. wdh;k folla msysgqùug kshñ; w;r tys boslsÍï lghq;= 2017 j¾IfhaoS wdrïN lsÍug kshñ;h' fujr ffjoH úoHdj i|yd jk fkdfn,a ;Hd.h cmdkfha fhdIsfkdßg 2016 jir i|yd jk ffjoH úoHdj iy ldhsl úoHdj i|yd jk fkdfn,a ;Hd.h cmdk cd;sl fhdIsfkdaß Tiqñ fj; msßkeñK'

ñksia isref¾ ffi, m%;spl%SlrKh iy wjl%uKh ms<sn|j jD;a;Sfhka ffi, cSj úoHd{fhl= jk fhdIsfkdaß úiska isÿlrk ,o m¾fhaIK fjkqfjka Tyqg fï iïudkh ysñ ù ;sfí' fï iïnkaOfhka fya;= mdG olajk fkdfn,a lñgqj m%ldY lr we;af;a ñksia isref¾ ffi, úlD;s ùU isÿjk wdldrh;a" mdlskaika" oshjeähdj" ms<sld yd iakdhq uQ,sl frda. je<|SfïoS ffi, Bg k;=jk wdldrh wjfndaO lr.ekSug fhdIsfkdaßf.a m¾fhaIK uy;a msgqjy,la jk njhs' DM

November 2016

DOCTOR MAGAZINE

81

D•Magazine /

Research News

jl=.vq noaO lrk ,o frda.Skaf.a ffjri frda. y÷kd.ekSfï mÍlaIK oeka ffjoH m¾fhaIKdh;kfhka'''

Research News jl=.vq noaO lrk ,o frda.Skaf.a ffjri frda. y÷kd.ekSfï mÍlaIK oeka ffjoH m¾fhaIKdh;kfhka'''

[

frda.Skaf.a reêr idïm, ñkamiq rg heùfï wjYH;djhla meK k.skafka kE'''

[

jl=.vq noaO lsÍu oeka wfma rfÜ iq,n Y,Hl¾uhla njg m;aù ;sfí' úfYaIfhkau y÷kd fkd.;a iïNjhla iys; jl=.vq frda.Ska jeä jYfhka jd¾;d ùu ksid iqÿiq odhlhka fhdodf.k jl=.vq noaO lsÍu wfma rfÜ iq,nj isÿ fjhs' 82

November 2016

DOCTOR MAGAZINE

jl=.vq noaO lsÍfï l%shdj,sfhaoS yd Y,Hl¾ufhka miqjo m%;sYla;slrK moaO;sh fn,ySk lsÍula isÿfjhs' ta w¿f;ka YÍrhg y÷kajd ÿka jl=. vqj m%;slafIam lsÍfï hdka;%Kh wvmK lsÍugh' fï ksid noaO lrk ,o frda.Skag ÿ¾j, m%;sYla;slrKhla iys;j hï ld,hla cSj;a jkakg isÿfõ' fï ld,fha Tjqka uqyqKmdk iqúfYaIS .eg¿j jkafka myiqfjkau f,v frda. j,g ,laùfï m%jK;djhhs' fï frda.Skag iqúfYaIS ffjri folla ksid nrm;, ydkshla isÿúh yel' noaO lrk ,o jl=. vqj fï ffjri j, l%shdldß;ajh ksid

doctormagazine.lk

fnd/,a, ffjoH m¾fhaIKd.drfha ffjri frda. úfYAI| ffjoH cQâ chuy

m%;slafIam úh yel' ta CMVffjrih yd BKV hk ffjrihs' uy;a W;aidyfhka" fjr ùßfhka jl=.vqjla''' ta i|yd oyiska ne|s msh<s fidhdf.k Y,Hl¾uh isÿ lsÍfuka miq tu jl=.vqj m%;slafIam ùfï ;¾ckhg ,la jqfKd;a th nrn;, .eg¿jls' wmrdOhls' thg fya;=j iajlSh YÍrh úiska iajdNdúlju jl=.vqj m%;slafIam lsÍulao @ fkdtfia kï by; i|yka lrk ,o ffjri j, l%shdldß;ajh fya;=fjka kj jl=.vqjg m%;slafIam ùfï wNsfhda.hla we;s jkafkao hkak y÷kd .ekSu w;sYh jeo.;ah'

doctormagazine.lk

fï i|yd fhdod.kakd Real Time PCR kue;s wKQl laIqø cSj úoHd mÍlaIKh isÿ lsÍfï myiqlï uE;la jk ;=re wfma rfÜ ;snqfKa ke;' ta ksid frda.Skg fuu mÍlaIKh bkaoshdfjka isÿ lr .ekSug isÿ úh' l+ßh¾ .dia;= iu.ska ie<lsh hq;= uqo,la fï i|yd jeh lrkakg wfma frda.Skg isÿ úh' wd¾Ól ÿIalr;d j,ska fmf<k frda.Skg fuh n,j;a mSvkhla ÿka njo ryila fkdfõ' kuq;a oeka m%:u j;djg fï mÍlaIKh fnd/,a, ffjoH m¾fhaIKd. drh úiska isÿ lsÍug mshjr f.k we;' ta i|yd uq,a jQfha ffjri frda. úfYAI| ffjoH cQâ chuy m%uqL úoaj;=ka lKavdhul m¾fhaIK m%;sM<hla jYfhka fuu fiajdj rdcH wxYh ;=< ia:dms; lsÍuhs' oekgu;a fuu mÍlaIK idïm, 200lg jeä ixLHdjla ffjoH m¾fhaIKdh;kh ;=< isÿ lr ;sfí' rfÜ ck;djf.a ck cSú;hg noaO jQ m¾fhaIKhla The research is a breakthrough in medical history of the country as until now the BK Virus was not detected in kidney transplanted patients.

jl=.vq noaO lsÍug ,lajqKq frda.Ska w;f¾ BKV ffjrifha me;sÍu iïnkaOfhka ffjoH cQâ chuy yd ffjoH bIdrd fm%au;s,l hk m¾fhaIlhka úiska isÿ lrk ,o m¾fhaIKhg Y%S ,xld laIqø cSj úoHd{hkaf.a ix.uh úiska 2016 jif¾ mj;ajk ,o m¾fhaIK ieisfhaoS fyd|u m¾fhaIKhg ysñ iïudkho msßkeuqKQ w;r fï m¾fhaIK m%;sM< weiqf¾ tys Ndú;dj fï wdldrfhka rfÜ ck;djf.a iqNisoaêhg l,a fkdyeru fhdojd .ekSu iïnkaOfhka by; m¾fhaIlhkag cd;sfha nqyquka ysñ úh hq;=h' DM

November 2016

DOCTOR MAGAZINE

83

D•PLUS /

Laboratory Fecal Occult Blood Test on Colorectal Cancer

FECAL OCCULT BLOOD TEST ON COLORECTAL CANCER cSú; iqrlsk mÍlaIKhla''' wdka;%sl-.=o ms<sld frda. ,laIK yd tu ms<sldj fõ,dikska y÷kd.kakd Fecal Occult Blood Test (FOBT) mrSlaIKh ka;%sl .=o ms<sldj uq,a wjia:dfõ frda. ,laIK m%lg fkdlrk ms<sldjls' tfy;a fï ms<sldj uq,a wjia:dfõu ,>q jYfhka oek.ekSug reêr mÍlaIKhlg yelshdj ;sfí th y÷kajkafka Fecal Occult Blood Test (FOBT) hkqfjks'

wd

84

November 2016

DOCTOR MAGAZINE

osh;,dj uQ,sl frdayf,a ffjoH foaúkao ohdr;ak úisks

doctormagazine.lk

doctormagazine.lk

loveyourcolon.org

Ways to Be Screened for Colorectal Cancer

"

.=o ud¾.fhka f,a .e,Su isÿjk fya;= /ils' ta fya;= w;f¾ jvd;au wjOdkhg fhduq úh hq;= fya;=j fï wdka;%sl-.=o ms<sldjhs' u< fldgia ridhkd.dr mÍlaIKhlg ,lafldg tys reêrh ;sfnk nj oek.;af;d;a frda.shd jeäÿr mÍlaIK j,g fhduq lrñka frda.h ksielfhka y÷kd .efkhs' hï fyhlska

fï ld,fha ms<sld frda.Skaf.ao jeäùula fmfkkakg ;sfí' frda. ,laIK m%lg lrkakg fmr uq,a wjia:dfõoSu y÷kd.;fyd;a wdka;%sl-.=o ms<sldjlao iqj lsÍfï by< wjia:djka ysñ fõ'

"

November 2016

DOCTOR MAGAZINE

85

D•PLUS /

thg fya;=j ms<sldjla kï fï ye|skSu lrkafka frda. ,laIK msg;g oeóug l,skah' túg ms<sldjg ms<shï fhdod frda.shdf.a cSú;h wdrlaId lsÍug fï wkQj wk¾> wjia:djla ysñ fõ' fï wkQj Fecal Occult Blood Test (FOBT) hkq osú iqrlsk mÍlaIKhla nj lsjukdh'

A colonoscopy sandythepa.wordpress.com

wdka;%sl .=o ms<sldj flfkl=g ;reK ld,fhaoSu;a we;s fjkak mq¿jka' Bg fya;=j W;am;a;sfhaoSu we;sjk cdk úlD;s;djhls' wm lkfndk foaj, we;s wys;lr oE''' mdrsirsl W;af;ack wdosh ksid fïjd u;=ùu blauKska isÿ jkakg;a mq¿jks' ;j;a flfkl=g wdka;%sl .=o ms<sldj we;sjkafka jhig .shdu''' fï fldhs wdldrfhka fyda fï ms<sldj fudaÿ jqKdu uydnvje,a yd .=ofha fjkialï we;s lrñka ms<sldj me;sfrkjd' Tn oekgu;a okakd wdldrhg uyd nvje,a lshkafk wm wkqNj lrk wdydr cS¾Kh fj,d wjika jYfhka

86

November 2016

*

FECAL OCCULT BLOOD TEST ON COLORECTAL CANCER

Laboratory

neyer l< hq;= fldgia .nvd lr.kakd bkaøshhs' wjidkfhaoS u< fldgia isrefrka neyer flfrkafka .=oh yrydhs'

.=o ms<sldj j,ska fm¿Kd kï Tn;a th je<|Sfï jeä wjodkula orkjd' •

ÿï mdkh lrk Woúh" ks;ru uia lk Woúh" ieliQ wdydr lEug yqre jQ Woúh yd ;ka;=uh wdydr wvqfjka wkqNj lrk Woúhg;a wdka;%sl .=o ms<sldj we;sùfï m%jK;djh jeähs'

•

jhig hk úg;a wjodku jeä fjkjd' úfYAIfhkau jhi wjqreÿ 50 bl=;a jqKdu' wdka;%sl .=o ms<sldj ;sfnk whf. ka ishhg 90lau jhi 50 bl=;ajQ whhs'

wdka;%sl .=o ms<sldj we;s ùfï jeä wjodkula we;af;a ldgo @ • fï ms<sldj jrla we;s jQ whg kej;;a th we;sùfï bvlv jeähs' tfiau äïnfldaI" tkafvdfuá%hdkq fyda mshhqre ms<sld je<÷KQ ldka;djkag;a fï ms<sldj we;sùfï ;rul jeä wjodkula ;sfnkjd' •

DOCTOR MAGAZINE

Tfí mjqf,a hï flfkla wdka;%sl

doctormagazine.lk

*

wdka;%sl .=o ms<sld we;s frda.Ska flfrka oelsh yels frda. ,laIK •

•

u<my lsÍfï ms<sfjf,a fjkila we;sùu' ^nv nqre,g hdu" u<noaOh wdoS jYfhka& wdudYh iïmQ¾Kfhkau ysia fkdjk njg we;sjk ye`.Su

• u<my iu. oSma;su;a r;a meye;s fyda ÿUqre meye;s u< msgùu •

idudkHfhka fjkod msgjk u<my j,g jvd m%udKfhka l=vd m%udKfha u< msgùu

•

Worfha we;sjk fmaYs fmr,Sï" nv mqrjd oeóu

•

fya;=jla fkdue;sj isref¾ nr wvqùu

•

YÍrfha oeä fjfyildÍ iajNdjh

•

Tlaldrh yd jukh we;sùu

fndfyda úg by; frda. ,laIK wdka;%sl-.=o ms<sldjla ksid fkdjkakg mq¿jk' fjk;a frda. we;s úgo by; oelajQ wdldrfha frda. ,laIK we;sfõ' úfYaIfhkau fuu ms<sldj uq,a wjia:dfõoS frda.shdg fõokdjla we;s lrkafkao ke;' flfia fj;;a ielhla u;= jQ úg ffjoHjrfhl= yuqù th ksielfhka fidhd ne,Su iqÿiqh' fï ld,fha ms<sld frda.Skaf.ao jeäùula

doctormagazine.lk

fmfkkakg ;sfí' frda. ,laIK m%lg lrkakg fmr uq,a wjia:dfõoSu y÷kd.;fyd;a wdka;%sl.=o ms<sldjlao iqj lsÍfï by< wjia:djka ysñ fõ' Fecal Occult Blood Test (FOBT) fuh wdydr cS¾Kl moaO;sfha lsishï frda.hla we;s nj m%d:ñl jYfhka b`.s lrk mÍlaIKhls' wdudYfha fyda .%yKsfha w;sjk jk ^;=jd,&" wka;% j, we;sjk l=vd j¾Ol ^fmd,sma&" nvje,a m%odyhg m;aùu" ;=jd, ùu ,dlaIKsl lr.;a w,aif¾áõ fld,hsáia" .=o ud¾.fha me¿ï" w¾Yia" fl%dkaia frda.h wdoS frda. fukau nvje,a j, ms<sld ksido f,a .e,Sï we;sfõ' Fecal Occult Blood Test mÍlaIKfhaoS isÿ lrkafka mshú weiska olskakg fmr u< j,g tl;= jk lsishï reêr fldgila fõo hkak wkaùlaIShj úuisuhs' fuysoS u< kso¾Yl 2-3la ,nd .efka' fufia lsysm jrla .kafka ms<sldjla ksid reêrh .,kafka kï th úáka úg jk reêrjykhla ksid th uekúka .%yKh lr .ekSugh' fuu mÍlaIKfhka reêrh .e,Sula isÿjk nj ;yjqre jqjfyd;a fldf,dfkdiafldms mÍlaIKhla u.ska ;jÿrg;a tu f,a .,k ia:dkh yd thg mdol fya;=j y÷kd .ekSug mÍlaIK lrKq we;'

idudkHfhka wjqreÿ 50 bl=;a jQ wh fuu Fecal Occult Blood Test mÍlaIKhg úáka úg fhduq ùu iqÿiq nj ffjoHjrekaf.a woyihs' we;eï rgj, fï ueos jhi blaujQ mqoa.,hkag jir follg jrla Fecal Occult Blood Test isÿ lrkakg ks¾foaY mjd ,ndoS ;sfí' wdka;%sl .=o ms<sld iïnkaO wfma rfÜ ;;a;ajh •

wfma rfÜ ck.ykh ie<l+ úg ldka;djka ,laIhlg 3'2la yd msßñka ,laIhlg 4'9la wdka;%sl .=o ms<sldjg f.dÿre jkafkah' fï wkQj fuh msßñka w;r ;rula iq,n nj fmfka'

•

iuia;hla jYfhka ie<l+ úg wjqreÿ yeg wdikakfhaoS frda.h y÷kd.kakd wjia:d jeäh'

• fï ms<sldjg k;=jk frda.Skaf.ka ishhg 28la jhi wjqreÿ 50g wvq wh fõ' •

m%;sldr uekúka ,nd.;fyd;a fï frda.Skaf.ka ishhg 69la jir follg jvd cSj;a fjhs' ishhg 52la wjqreÿ myg jvd cSj;a fjhs'

•

urKhg m;ajk frda.Skaf.ka jeä yßhla fojirla ;=< fuf,dj yer hhs' DP

November 2016

DOCTOR MAGAZINE

87

88

November 2016

DOCTOR MAGAZINE

doctormagazine.lk

D•Magazine /

Medi Gadgematics we| ;=jd, j<lajk hg we÷ula'''

MediGadgematics we| ;=jd, j<lajk hg we÷ula''' Electronic Underwear Preventing Bed Sores yefrkak" fmrf<kak ;rug YÍr fi!LHhla ke;s frda.Ska" we|g iSudù isák úhm;a Woúh uqyqKmdk m%Odk wNsfhda.hla jkafka we| ;=jd,hs' osk .Kkla" i;s .Kkla wef|au bkak úg reêr ixirkh ÿ¾j,j mj;sk ksid;a" ta wdY%s; mgl mSvkhg ,laj ;sfnk ksid;a we| ;=jd, (Bed Sores) we;sfõ' ffjoHjrekgo úYd, wNsfhda.hla ù we;s fï .eg¿jg ms<shula f,i lekvdfõ Project SMART yS Sean Dukelow kï m¾fhaIlfhla wmQ¾j hg we÷ula ks¾udKh lr ;sfí' iEu úkdä oyhlgu jrla ishqï úoahq;a Odrdjla fuu.ska W;amdokh lrk w;r th frda.shd p,kh jk fudfyd;loS we;sjk mgluh n,mEu we;s lrhs' thska wefnk jHdhduh we| ;=jd, j,ska je<lSug fyd|gu m%udKj;ah' oekgu;a ffjoH flafIa;h % fha úoaj;=ka w;r wjOdkhg ,la ù we;s fuu ks¾udKh blauKskau frda.Skaf.a we| ;=jd, wNsfhda.h ch.ekSu msKsi Ndú;hg tla jkq we;' The effect is the same as if the patient was moving on their own—it activates muscles and increases circulation in that area, and effectively eliminates bed sores, thereby saving lives. DM

doctormagazine.lk

November 2016

DOCTOR MAGAZINE

89

D•Magazine /

Ask Your Doctor Tfí ffjoH .eg¿jg wfmka ms<s;=re'''

ASK YOUR

DOCTOR

Tfí ffjoH .eg¿jg wfmka ms<s;=re''' iajdñmqreIhd ;e,iSñhd jdylfhla''' @ bkak orejd''' @ B<`. nnd''' @ uf.a mq;d ;=ka yeúßosh' WK frda.hlg m%;sldr msKsi reêr mÍlaIKhla lsÍfuka miq Tyq ;e,iSñhd jdylfhl= nj mjid ;e,iSñhd tallh fj; fhduq lf<ah' uf.a;a iajdñ mqreIhdf.a;a reêr mÍlaIdfjka iajdñmqreIhdo ;e,iSñhd jdylfhl= nj wkdjrKh úh' uf.a orejd fjkqfjka osh yels wdrlaIdj l=ulao @ ;j;a ore iïm;la ,eîu wk;=reodhlo @ - kkaokS" yd,swe, ;e,iSñhdj hkq uõmshkaf.a cdk u.ska orejkag Wreu jk fnda fkdjk frda.hla' reêrfha ySfud.af,dìk j, ;sfnk we,a*d yd îgd hk .af,dìka kue;s fm%daàk foj¾.h kshñ; wdldrhg ixiaf,aYKh fkdùu ksid ;e,iSñhdj we;s fjkjd' reêrfha ysfud.af,dìka wKqjla ;=< we,a*d .af,dìka odu folla iy îgd .af,dìka odu folla ne.ska mj;skjd' we,a*d .af,dìka iEoSu i|yd cdk i;rla iy îgd .af,dìka iEoSug cdk folla wmf.a j¾Kfoay ;=< ;sfnkjd' fï cdk j,ska tlla fyda lsysmhla fkdue;s ùu" úlD;s ùu ksid widudkH ySfud.af,dìka wKq ixiaf,aYKh ùu ksid fï ;e,iSñhd frda. ;;a;ajh we;s fjkjd'

90

November 2016

DOCTOR MAGAZINE

ffjoH md,s; nKavdr iqnisxy ixialrkh lrhs

ujf.ka w¾Ohla jYfhka yd mshdf.ka w¾Ohla jYfhka wmg cdk Wreuh ,efnkjd' hï flfkl=g ujf.ka yd mshdf.ka hk fofokdf.kau tlu fm%daàkhla iEoSu i|yd wjYH jk cdk úlD;sj ,efnhs kï tu orejd ;=< tlS fm%daàkh kshñ; mßos ixiaf,aYkhla isÿ jkafka kE' thska orejd frda.sfhl= fjkjd' kuq;a uõmshkaf.ka tla wfhlaf.ka muKla úlD;s cdkhla ,eî wfkla flkdf.ka ksfrda.S cdkhla ,efnkjd kï orejd frda.S jkafka kE' ta;a frda.h we;s lrk úlD;s cdk tlla isrer ;=< wka;¾.; ùu ksid orejd jdylfhla ker;fyd;a frda.h me;srùfï yelshdj orkafkla njg m;a fjkjd' Tyq ;j;a jdylfhl= iu. újdy jqfKd;a Tjqkag odj Wmosk

doctormagazine.lk

orejka ;e,iSñhdj frda.h Wreu lr .ekSfï ishhg 25l iïNdú;djhla orkjd' ksfrda.S orejka ,eîfï iïNdú;djho ishhg 25la fjkjd' orejka jdylhka fkdfyd;a B<`. mrïmrdjg úlD;s cdk imhkakka ùfï ishhg 50l iïNdú;djhla ;sfnkjd'

Tnf.a .eg¿j wkQj Tnf.a iajdñmqreIhd;a" orejd;a zzfrda. jdylhkaZZ f,i y÷kdf.k ;sfnkjd' reêr mÍlaIKfhaoS Tn jdylfhl= fkdjk nj y÷kdf.k ;sfí kï Tnf.a u;= Wmosk orejkag nrm;, .eg¿jla we;s jkafka kE' Tnf.a orejka frda. jdylhka ùfï iïNdú;dj ishhg 50la jkjd' tfiau ksfrda.S orefjl= ùfï iïNdú;dj;a ishhg 50hs' frda.S cdk iys; hhs yªkd.;a orejka wkd.;fha osfkl újdy jk úg wksjd¾hfhkau iylref.a$iyldßhf.a reêrh mÍlaId fldg Tyq fyda weh ;e,iSñhdj jdylfhl= fkdjk nj iel yer oek.; hq;= fjkjd' hï fyhlska újdyfmalaIlhdo ;e,iSñhd jdylfhl= kï ;e,iSñhdj fmdfrdkaou .e,fmkafk kE' ta oS.h w;ayßkjd fyd|hs'

doctormagazine.lk

biamsß;df, fnfy;a yßhkafk kE''' tfyu fjkafk fldfyduo @ cSú; ldf,gu lfvka fnfy;a .kak fjhso @ ud jhi wjqreÿ 45l újdyl ldka;djlañ' óg l,lg fmr isg Myxedema kue;s ;hsfrdhsâ fydafudak W!K;djfhka fmf<k ksid udi yhlg jrla reêrh mÍlaId lrñka ;hsfrdhsâ fydafudakh ,nd .ksñ' frdayf,ka ,nd.kakd fydafudak fm;s j,g ;hsfrdlaiska fydafudak m%udKh m%;spdr fkdolajhs' fï ksid tajd *duisfhka ñ,oS .kakg isÿfõ' Generic Drugs m%j¾Okh lrk fï iufha fujka .eg¿jla u;= jkafka wehs @ - Wmd,s" kdj,msáh rcfha frday,ska ,ndfok ;hsfrdlaiska j,g Tnf.a reêrfha ;hsfrdlaiska m%udKh by< fkdhk nj Tn mjikjd' fj<| kduhlska ,nd.kakd ;hsfrdlaiska j,g reêrh idudkH ;;a;ajhg m;ajk w;aoelSu Tng ;sfnkjd' fï ksid frdayf,a fnfy;a mdúÉÑ lrkjd fjkqjg fnfy;a ñ,oS .kakjd' T!IO ksIamdokfhaoS wl%Sh l,a;nd .ekSfï øjH Inactive Preservatives thg tl;= lrkjd' ta i|yd hk msßjeh ksid ñ, jeä fjkjd' tu T!IOfha il%Sh ix>gl j,g lsisÿ ydkshla fkdlrñka ksIAmdos; oskfha isg l,a bl=;a jk oskh olajd jir 3-4la fï wdldrfhka ;nd.; yels fjkjd' fj<| kdufhka Tiqi,aj, úlsKSug ;nd we;s T!IO iajlSh fj<| kduhg ydkshla fkdjk fia Wiia wuqøjH fhdodf.k ksmojkjd' úfYaIfhka f,dj m%uqL fmf<a U!IO ksIamdok iud.ï iajlSh msßú;r wdrlaId lsÍug W;aiql fjkjd' T!Iëh kdufhka T!IO ksIamdokfhaoS fgkav¾ i|yd bosßm;a lrk T!IO i|yd tjka m%ñ;shla oeäfia wkq. ukh lsÍula olakg ,efnkafka kE' fuysoS T!IO iud.ï uq,skau bosßm;a lrk idïm, mÍlaId lsÍfïoS by< m%ñ;shla ;snqK;al,a bl=;a ùu wdikakfhaoS fïjdfha iM,;djh ÿ¾j, fjk nj m%dfhda.slj olakg ,efnkjd' miq m%ñ;s mÍlaIdfõoS tys .=Kd;aul Ndjh ySkù we;s nj ikd: jqjfyd;a tajd frdayf,a Ndú;fhka bj;a lsÍu idudkH l%ufõohhs'

November 2016

DOCTOR MAGAZINE

91

D•Magazine /

Tfí ffjoH .eg¿jg wfmka ms<s;=re'''

Ask Your Doctor

Tnf.a .eg¿j wkQj frday,ska ,ndfok T!IOhg Tnf.a reêrfha ;hsfrdlaiska uÜgu m%;spdr fkdolajkafka kï iy Tiqif,ka ,nd.kakd T!IOhg ,efnk m%;spdrh hym;a kï lreKdlr ta iïnkaOfhka idhkfha ffjoHjrhdg meñKs<s lrkak' túg Tyq ta i|yd mshjr f.k wod, kshdul wdh;k yryd tu T!IO mÍlaIdjg ,la lrKq we;' Tng oeßh yels ñ,lg tu T!IOh ndysßka ñ,oS .; yelskï iy th jvd;a iqÿiq nj Tng ye`.S hkafka kï uuo th wkqu; lrñ' nnd uia" ud¿ wkqNjh m%;slafIam lrkjd''' l< hq;af;a l=ulao @ 12 yeúßos uf.a mq;d uia" ud¿ wkqNjh m%;slafIam lrhs' flala lene,a,la ÿkak;a fïjdfh ì;a;r ;sfnkjdo @ m%Yak lrhs' mdif,aoS th wffO¾h lsÍu Bg fya;=jhs' fï wdydr fkd.ekSu ksid orejdg fm%daàk W!K;djhla we;s fjhso @ - bf¾Id" ms<shkao, kj fhdjqka úfha orejkag ish isrer iS>%fhka j¾Okh jk fï wjêfhaoS ukd fm%daàk iemhqula ,ndoSu yßu jeo.;a' ñksia isrer ks¾ñ;j we;af;a i¾jNlaIl i;a;ajfhl= wdldrhgh' i;a;aj wdydr j, fmdaàk úYd, jYfhka wvx.= fjkjd' uia" ud¿" lsß" ì;a;r fï ´kEu fohl Wiia ;;a;ajfha fm%daàk wvx.= fjkjd' we;eï .=rejreka" mdie,aoS fï wdydr .ekSu orejkag wffO¾h lrkafka ljr mokula u;o @ wju jYfhka lsß iy ì;a;r wkqNjh u.ska i;=ka ueÍula isÿ jkafka kE' úlsKSug we;s *dï ì;a;r hkq lsls,shf.a äïnhls' tys l=l=,a megjl= we;af;a kE' tu ì;a;r wkqNjfhka mõ isÿjkakg t;ek cSjhla kE' flfia fj;;a orejka i;a;aj fm%daàk wvx.= wdydr m%;slafIam lrkafka kï Tjqkag fm%daàk iq,n ìïu,a iy rks, wdydr ksr;=reju ,ndoSug mshjr .; hq;=hs'

Tnf.a 12 yeúßos mq;dg fï iïnkaOfhka myod oS wju jYfhka lsß mdkhg fyda ì;a;r wdydrhg .ekSug fyda Tyqj leu;s lrjd.kakg W;aidyhla .kak' Tyq Bg;a wleue;s kï ìïu,a" uE weg" .%SkamSia" rglcq jeks rks, wdydr jeämqr" ksrka;rfhka Tyqf.a wdydrhg tl;=

92

November 2016

DOCTOR MAGAZINE

lrkak' ñksia isrerg i;a;aj fm%daàk w;HjYH fkdjk ksid by; wdldrfhka YdL fm%daàk fyda y÷kajd oSfuka fm%daàk WK;djfhka ñoSug yelshdjla ,efnkjd' flfia kuq;a msßñ orefjl= ksid fm%daàk nyq, wdydrhla jQj;a fidahd ksIamdok muK blaujd ,ndoSuo kqiqÿiqhs' fidahd ksIamdok j, ldka;d Biag%cka fydafudakhg iudk øjHhka wka;¾.; jk ksid jeämqr Ndú;fhka Tyqf.a ,sx.sl mßK;shg wys;lr n,mEula we;súh yelshs' Tng we;sjk fi!LH .eg¿ j,g ms<s;=re imhk Ask Your Doctor úfYaIdx.h i|yd Tfí .eg¿j;a fhduq lrkak' wfma ,smskh Ask Your Doctor fy,a;afjdÉ mqoa.,sl iud.u" úydrlef,a osh;,dj. palitha.subasinghe@ gmail.com hk úoahq;a ,smskhgo Tfí .eg¿ fhduq l< yel' yi, w;aoelSï iys; ffjoHjrfhl= úiska Tfí .eg¿ iudf,dapkh lsÍu;a wjYH wjia:dj,oS wmf.a WmfoaYl uKav,hg wh;a úfYaI{ ffjoHjrekaf.a iudf,dapkhg Tfí .eg¿j fhduq lsÍu;a fuu fiajdfõ úfYaI;ajh jkafkah' DM

doctormagazine.lk

doctormagazine.lk

November 2016

DOCTOR MAGAZINE

93

D•Magazine /

Skin & Beauty

What's The Difference Between An Ointment, A Cream And A Lotion?

What's The Difference

Between An Ointment, and

A cream

A lotion? wdf,am lrk fnfy;a mdúÉÑ lrk ksjeros wdldrh oek.kak yug .,ajk wdf,amk Cream, Oinment, Lotion, Gel jYfhka úúO iajrEm .kS' fï tl tlla w;r we;s fï fjkialï .ek Tn fuf;la oek isáhdo @ wdf,am lrk fnfy;a j¾. j, m%Odk ix>gl folla fjhs' moúh uQ,sl frdayf,a jevn,k p¾u frda. úfYaI{ ffjoH ,laud,s m;srdc úisks

94

November 2016

1' T!IOh 2' th wvx.= lr we;s mdol ix>glh fuu mdol ix>glfhao hïlsis T!Iëh jákdlula ;sfnkakg mq¿jk' wdf,am lrk T!IOfha fN!;sl iajNdjh ;SrKh lrkafka fuhsks'

DOCTOR MAGAZINE

doctormagazine.lk

Cream and gel are water-based, while ointment is oil-based.

Some creams are oilfree, but other creams and ointment contain a mixture of oil, water and thickening agents.

Any of these can be used with different over-the-counter products or drugs, depending on whether your skin is dry or oily.

And so you want to ask your dermatologist if you have a prescription medication, which of these formulations is best for you.

OINMENT f;,a iys;h' wef,kiq¿ .%Sia jeks .;shla we;' ifï .%kaÓ wjysr lrhs' wdf,am l< ia:dk os,sfik .;sfhka osiafõ' b;d úh<s" os.= ld,hla mj;sk ifï frda. i|yd Ndú;d fjhs'

ta wkQj wdf,am lrk wdf,amk j¾. lsysmhls'

LOTION oshruh .;sh jeäh' iu u; myiqfjka me;sÍ iug isis,la i,ihs' ifï frdau iys; ia:dk j,g jvd;a iqÿiqh'

CREAM l%Sï j¾. wdf,am lr ksrdjrKh f;,a .;sh kqiqÿiqh'

GEL fïjdfha l%Sï j,g jeä c,h m%udKhla wka;¾.; fõ' uqyqK jeks ia:dk j, wdf,amhg jvd;a iqÿiqh' DM

fïjd iug fyd|ska Wrd.kshs' tu ksid we;s nj mjd fkdfmfka' fï ksid wef`.a jQ ;ekaj,g jvd;a iqÿiqh' fuys we;s idfmalaIj wvq fyhska b;d úh<s iulg

doctormagazine.lk

November 2016

DOCTOR MAGAZINE

95

Thousand words in

neimage l;d lrk msx;+r

1

ñys;,fha fmKye<s jkka;r" .ia" me<Eá''' fïjd wm yqiau .kakd Tlaiscka jdhqj W;amdokh lrhs'''tajd fï ñys;,fha fmKye,shs''' tajd úkdY lsÍfuka úkdY jkafka wmuhs''''

2 96

November 2016

ffjoH YsIHhdf.a wdor yiqk

DOCTOR MAGAZINE

3

iEu fyoshlf.au isyskh'''

doctormagazine.lk

4

wdrïNh yd wjidkh cSú;fha wdrïNh iy wjidkh iudk jk wmQrej''' ta w;r ld,fhka Wmßu M< fk,d .ksuq'

5

msßñlu mrdcs;j Wlg,S jk úg isysm;a lr.kak''' Tn fmrosfkl ,laI ixLHd; Y=l%dKQ w;f¾ fõ.j;au" Yla;su;au Y=l%dKQjla f,i ysáhd'''

6

7 uiqrka lshqï''' uqúka .s,sfykakg fmr jpk;a ri ne,sh hq;='''

doctormagazine.lk

November 2016

DOCTOR MAGAZINE

97

D•PLUS /

Sex & Relationship Pain During Sex -My Secret

Pain During Sex

My Secret

wdorKSh;ajfha iqkaor w;aoelSu wmd ÿlla jk yeá

,sx.sl tlaùuloS we;sjk fõokdj

kdß yd m%ijfõo úfYaI{ yd ,emriafldms úfYaI{ ffjoH frdaIka fihsâ kjf,dal frday,

98

November 2016

ldka;djka r`yfia <;fjk" mSvd ú|sk ldhsl fõokdldrS ;;a;ajhka w;f¾ ,sx.sl tlaùuloS we;sjk fõokdjg ,efnkafka m%uqLia:dkhls' ldka;djka y;r fofkla .;af;d;a fï whf.ka ;=ka fofklau ;u cSú; ld,h ;=< ljr wjia:djl fyda ,sx.sl ld¾hh ksid fõokd ú|s;s' we;af;kau fuhg jhfia n,mEulao ke;' weh ;=reKq jhfia" ueos jhfia .; l<;a''' úhm;a Ndjhg m;aj isáh;a fï fõokdjg uqyqKmdk wjia:d ;sfí' we;eï úg ldka;djl fï fõokdjg uqyqK fokafka iajlSh m<uq ,sx.sl w;aoelSfïoSuh' m<uq udih ;=<oS" jir .Kkdjlg miq" we;eï úg wd¾;jwNdjh;a iu.u jYfhkao wfhla fï w;aoelSug uqyqK mE yel'

DOCTOR MAGAZINE

doctormagazine.lk

WHEN SEXUAL INTERCOURSE CAUSES PAIN TO THE WOMEN Pain disorders are female sexual dysfunctions, which significantly affect the sexual life of the couple. When the woman pain during intercourse, the possibility to feel sexual pleasure is small.

,sx.sl tlaùu wid¾:l jk úg iajdñmqreIhdf.ka ,efnk m%;spdr fuys we;s wjdikdj kï fõokdldÍ ,sx.sl w;aoelSï wef.a tosfkod cSú;hg''' fukau iuyr úg mjq,a cSú;hg mjd n,mEï we;s lsÍug ;sfnk wjia:djhs' iajdñmqreIhd wys;la ys;dú hk ìh ksid" ke;fyd;a ielh ksid b;d mSvdldÍ w;aoelSï ryfia ú|sñka iajdñmqreIhdf.a ukfod, imqrd.ekSug bvyrsk ldka;djka tugj;a isá;s' hï fyhlska we tlaùu m%;slafIam l<fyd;a tla tla iajdñmqreIhka fujka wjia:d j,oS yeisfrk wdldrh fjkiah' flfkla fldam .kS' ;j;a flfkla fkdukdmh olajhs' ;u Nd¾hdjg ;sfnk wdorh ksid fï iïnkaO;d k;r lrk ieñhkao fï w;f¾ ke;sjd fkdfõ''' we;eï ldka;djlg ,sx.slj tlaùu fldfy;au wudreh' ud okakd tla;rd hqj,la udi lsysmhla ;siafia ,sx.sl iyjdih mj;ajd .ekSug uy;a fjfyila oerefõh' tfy;a ta tlu wjia:djl j;a W;aidyh id¾:l jQfha ke;' tfy;a wjidkfhaoS doctormagazine.lk

weh .eìKshla njg m;aúh' orejd iu.ska fï ÿIalr;djhg ms<shula ,eîug ud fj; meñKS wUqieñhka w;f¾ n,j;a miq;eú,a,la ;snqKd ug isysm;a fõ' id¾:l ldhsl iïnkaO;djhla mj;ajd .ekSug fkd,eîu ksid ;u wdorKSh Nd¾hdj w;ayer wka ldka;djka fj; hk ieñhka o wm oel ;sfí' jir 10-12 muK .;jQ miq oslalido jk wUqieñhka .eko wikakg ,efí' fujka oslalidoùuloS thg úúO fya;= f,dalhd

November 2016

DOCTOR MAGAZINE

99

D•PLUS /

PAIN DURING SEX -MY SECRET

Sex & Relationship

ÿkak;a we;a; l;dj okafka ta brKug uqyqK ÿka wUqieñhka fofokd muKs' fï ksid ldka;djka ryfia ,;efjk" mjq,a cSú; j, ne|Sï ;¾ckhg ,la lrk fï w;aoelSu ms<sn|j újD; ixjdohl fhoSu uekjhs kdß frda. ffjoHjrfhl= jYfhka ud úYajdi lrñ' f;jeoEreï fõokdjka w;f¾ Tng we;af;a ljr fõokdjlao @ ldka;djl yd msßñfhl= ldhslj tlaùfïoS ldka;djg fõokdjla we;sùu Dyspareunia hkqfjka ffjoH úoHd;aulj ye|skafjhs' fï fõokdj mqreI ,sx.h wef.a fhdakshg m%úYaG lsÍfïoSo" fhdaksh wNHka;rfhaoSo ke;fyd;a ldßh wjika ùfuka miqjo jYfhka wjia:d ;=kloS we;súh yel' tfiau we;sjk fï fõokdjo úúO iajrEmfhka we;sfõ'we;eful=g we;sjk fõokdj ,sx. dY%s; m%foaYh oeù hkakdla n÷ fõokdjls' b;d ;shqKQ fõokdjka"

100

November 2016

wkskakdla n÷ fõokdo flfkl=g we;súh yel' ,sx.sl tlaùula id¾:l lr.ekSug ,sx.sl W;af;ack wjYHuhs wdorKSh ne|Sula wjik ,sx.sl ld¾hhg fhduq jkak ,sx.sl tlaùula id¾:l ùug imqrd,sh hq;= fN!;fõoSh hdka;%Khla ;sfí' ldka;d ,sxf.akaøsh msìoSula isÿ fkdù id¾:l m%fõYhla we;s lr .ekSu wiSreh' fï i|yd wdorKSh mßirhla we;s lr.; hq;=h' ism .ekSï" nod .ekSï wdosh m%fõYhg mQ¾jfhka we;s lr.; hq;af;auh' weh msìoSug ,la lrjk wdorKSh ,sx.sl l=¿.ekaùï Tiafia wef.a ,sxf.akaøsh iafkaykh fõ' th ,sx.sl m%fõYh jvd;a myiq lrhs' m%S;sckl lrhs' we;eï msßñka ksos hykg wd ieKska ;u ldßh jy jyd lr .ekSug we;af;a mqÿu ;oshuls' ldka;djlf.a ,sx.sl tlaùu i|yd wjYHfhkau weh ta i|yd ldhslj fukau udkisljo iQodkï l<

DOCTOR MAGAZINE

hq;=h' thg mshjr fkd.ekSfuka" weh ,sx.sl W;af;ackhg ,la fkdlsÍu ;=<ska id¾:l tlaùula we;s fkdfõ' fjfiiskau mqreIhd úiska wehg buy;a mSvdjla" fõokdjla f.kfok wdl%uKldÍ l%shdj,ska je<lsh hq;=h' ;u Nd¾hdjg wiSñ; fõokd f.k foñka i;=gq jk msßñkao l,d;=rlska uq;a isà' we;eï fj,djg ,sx.akaøsh ;e,Sfuka we;sjk iSÍï fukau iq¿ f,a .e,Sï mjd we;euqkag we;s fõ' Foreplay In human sexual behavior, foreplay is a set of emotionally and physically intimate acts between male and female meant to create sexual arousal and desire for sexual activity.

we;eï fj,djg iajdñmqreIhd Tyq ,nk ,sx.sl w;aoelSfuka i;=gq fjhs' tfy;a zzwehZZ i;=gq lrñka iduqysl i;=gla ,nkq msKsi wkq. ukh l< hq;= wkql%uh

doctormagazine.lk

.ek Tyqg wjfndaOhla ke;' fuysoS ,sx.sl tlaùu wehg wjYH fohla fkdjkakg mq¿jk' wehf.ka ksis iyfhda. hla fkd,efnk úg Tyqgo ;Dma;shla ,eîu W.ygh' ,sx.sl l%shdj,shla id¾:l lr.kq jia isÿ l< hq;= mQ¾j ,sx.sl msìoSï l%shdj,sfha wvqmdvqlï yereKq úg ,sx.sl tlaùula wid¾:l ùug" i|yd n,mdk ;j;a lreKq /ilao fõ'

,sx.sl tlaùfïoS ldka;djg fõokdj we;s jk fya;= • ,sxf.akaøsh kshñ; mßos iafkaykh fkdùu jhig hdfïoS we;s úh yel' mQ¾j ,sx.sl l%shd m%udKj;a fkdùfukao ia;%S ryi`. úh<sNdjhg m;aù ,sx.sl l%shdj,sh fõokdldÍ tlla njg m;a fjhs' ;reK jhfia wUqieñhka ;u yosish ksido ,sxf.akaøsh iafkaykhg fmr m%fõYh ,nd. kakg f.dia .eg¿ we;slr .kS' • wmiaudr T!IO" udkisl frda. i|yd .kakd T!IO wdoS we;eï T!IO ,sx.sl iyjdihg ndOd f.k ths' oshjeähdj ksid msßñka yg ;u ,sx.h iDcq lr.ekSug fkdyels úh yel' • l,d;=rlska wjia:djloS ldka;djkaf.a fhdaks újrh ;rula l=vdh' ;j;a we;eful= ryi`. n,j;a fia ixfõoS úh yel' túg mqreIhdg ,sxf.akaøsh m%fõY lrKQ ;nd <x lsÍu fyda wiSre lghq;a;ls' we;euqkaf.a úYd, YsIaKh .¾NdIfha mdofï jeoSfukao fõokdjla we;s úh yel'

http://imop.gr/en/infographic/sex

doctormagazine.lk

ksido flfkl=g ,sx.sl tlaùu fõokdldÍ úh yel' fhdaks ud¾.h l,d;=rlska flfkl=f.a l=vd ùu tla WodyrKhls' • we;efula fï lghq;af;a ksr; fjkafka ys; ;=< lelEfrk ;ryjla há ysf;a ;nd f.kh' th ld iu. we;s tlla jQj;a thska wfmalaIs; ldhsl tlaùug ndOd meñfKa' tlsfkld w;f¾ l=¿m.Ndjhla" ióm njla ke;s úgo fujka .eg¿ mek k.S' HOW CAN PAINFUL SEX IN WOMEN BE TREATED? Some treatments for painful sex in women do not require medical treatment.

For example, painful sex after pregnancy can be addressed by waiting at least six weeks after childbirth before having intercourse.

Make sure to practice gentleness and patience. In cases in which there is vaginal dryness or a lack of lubrication, try waterbased lubricants.

• ixcdkSh jYfhka ,sxf.akaøsh wdY%s;j we;sjk widudkH;d November 2016

DOCTOR MAGAZINE

101

D•PLUS /

PAIN DURING SEX -MY SECRET

Sex & Relationship

újdy jQ w¿; fujka wjia:d iq,nh' • orejka iómfha ,sx.slj tlaùu wd;;shlg fya;= fjhs' túgo ,sx.sl tlaùu ÿIalrh' yosisfha fhdod.kakd Wml%u we;eï úg oeä YdÍßl fõokdjg fya;=jla fjhs' • l=vd ld,fhaoS ,sx.sl wvkaf;Ügï" ¥IKhg ,laùu ksido miqld,fha iajdñmqreIhd yd in|;d meje;Aùug ndOd we;sfõ' fï wm%ikak w;aoelSï fya;= fldgf.k udkislj we;sjk n,mEula ksid ,sxf.akaøsh ;o lrñka m%;sfrdaOhla olajk wjia:d oelsh yel' l=vd ld,fhaoS .eyekq orejkaf.a ,sf.akaøsh wi, lemqula fhoSfï pdß;%h wfma rfÜo ryfia isÿjkakls' fï ksido úúO ixl+,;d we;sjk w;r fï ksid miqld,Skj újdy ùfuka miq ,sx.sl tlaùfïoS oeä fõokd ú|sk ldka;djka .ek wfma rfgkao jd¾;d fjhs' • .¾NsKS;djh yd ine|S ixl+,;d

102

November 2016

we;eï ffjoHjrfhla fhdaks mÍlaIKh lsÍfïoS n,j;a mSvkhla ta m%foaYhg fhdojhs' tfiau ore m%iQ;sh" tysoS fhdok ueyqï ksid hï ld,hla hk ;=re ,sx.sl tlaùu fõokdldÍ jkakg mq¿jk' • orejdg uõlsß fok wjêfhao fhdaksh úh<Sula isÿùu iajdNdúlh' • ldka;dj fhdaksud¾.h wdY%s; Y,Hl¾u j,g ,laùu" ta wdY%s; fmfoi úlsrK Ñls;aidjg ,la lsÍu ksid fukau ore m%iQ;sfhaoS iSi¾ ie;alug Ndckh ùu" Wor.; Y,Hl¾u j,g ,laùu' • .¾NdIfha we;=f,a ;sfnk mgl .¾NdIfhka mrsndysrj msysàu ksid we;sjk tkafvdfuá%fhdaisia ;;a;ajh" äïnfldaI j, we;sjk j;=r ìì,s fkdfyd;a ´fõßhka isiaÜ yd uxYfmaYs yd ;ka;=j,ska ieÿï,;a .¾NdIfha yefok f.ä fkdfyd;a *hsfn%dhsâ jeks frda. ksid' ,sx.slj tlaùfuka miq" udisl Y=oaêfhka miq fujka fõokd we;sùu

DOCTOR MAGAZINE

•

•

•

•

by;ska oelajQ lsishï frda.hla wkqudk l< yels wjia:djls' we;eï ldka;djka ,sx.sl tlaùuloS ;u wkqoekqulska f;drj iajlSh fhdaks fmaYs yels,Sula isÿ lr.kakjd' (Vaginismus) fuúgo ,sx.sl tlaùu fõokdld¾ w;aoelSula njg m;a fjkjd' we;eï wh úúO øjH WmlrK fhdakshg m%fõY lr.kakjd' fï whg;a ,sx.sl w;aoelSï fõokdldÍ fjkak mq¿jka' we;eï ldka;djka fldkavï j,g wdid;añl;d olajkjd' fuysoS we;sjk wdid;añl;djfha m%;sM<hla f,i ,sx.sl tlaùï fõokdldÍ jkakg mq¿jks' .¾NdI.; fkdjk fjk;a frda. ksido ,sx.sl tlaùu fõokdldÍ w;aoelSula úh yelshs' Wor.; frda." bßgn,a nj,a" uq;%dY.; frda." fY%daKs.; wdidok yd ,sx.dY%s; wdidok Bg ksoiqka fjkjd' doctormagazine.lk

http://imop.gr/en/infographic/sex

1' iajdñmqreIhd yd Nd¾hdj w;r we;s iïnkaO;djfha .eg¿ 2' ldhsl wdndO fyda widudkH;d 3' udkisl úhjq,a uq,skau ,sx.slj tlaùug we;s ndOdjka y÷kd.; hq;= fjkjd' th iajdñmqreIhdf.a fyda Nd¾hdjf.a .eg¿jla fjkak mq¿jka' th wUqieñhka w;r in|;djfha ÿ¾j,lula kï Bg kshñ; ms<shï fhosh hq;= fjkjd'

doctormagazine.lk

"

,sx.sl tlaùfïoS we;sjk fõokdjg ms<shï''' by; oelajQ úúO ndOl ;;a;ajhka ldKav ;=klg j¾. l< yelshs

id¾:l ldhsl iïnkaO;djhla mj;ajd .ekSug fkd,eîu ksid ;u wdorKSh Nd¾hdj w;ayer wka ldka;djka fj; hk ieñhka o wm oel ;sfí' jir 10-12 muK .;jQ miq oslalido jk wUqieñhka .eko wikakg ,efí' fujka oslalidoùuloS thg úúO fya;= f,dalhd ÿkak;a we;a; l;dj okafka ta brKug uqyqK ÿka wUqieñhka fofokd muKs'

th wmyiq ldrKhla fkdfjhs' W;af;ack yqjudre lr.ekSfuka miq ,sx.sl l%shdj,shg t<öu" orejka ndOlhla fkdjk fia ld,h fjkalr .ekSu" fofokd w;r wd.ka;=l nj" ÿria;r nj wvq lr .ekSu wdoS ndOlh y÷kdf.k fhdok ms<shï Tiafia fï ndOdj u. yrjd.; yelshs' we;eï frda." wdidok fya;=fldgf.k we;sjk ;;a;aj" ixcdkSh wdndO wdosh i|yd mdol fya;=j bj;alr; hq;=hs' fï i|yd ffjoHjrfhl=f.a iydh wjYH jk úg th fkdmudj ,nd .ekSug W;aiql úh hq;=hs' frda. hla ;sfí kï thg m%;sldr .ekSu l< hq;a;lauhs'

November 2016

DOCTOR MAGAZINE

103

D•PLUS /

PAIN DURING SEX -MY SECRET

Sex & Relationship

http://imop.gr/en/infographic/sex

úhjq,a iy.; nj jeks ufkdaNdj W;aidyfhka" ixhufhka u.yrjd.; yelshs' www.waidyawaraya.lk

ufkda uQ,sl .egC fya;=fjkao fndfyda fokd mSvd ú|skjd' ,sx.sl fmfofia wjhj yels,ùu" ¥IKhg ,laùu jeks wm%ikak w;aoelSulg uqyqK oSfuka miq we;sjk ;;a;aj wdoshg WmfoaYKhla wjYH úh yelshs' iajdñmqreIhdf.a wdorh yd lreKdj u;skao weh áflka ál iqmika f,i ,sx.sl m%fõYhla ,nk wjia:d ;sfnkjd' ;ry" 104

November 2016

fï wdldrfhka ,sx.sl tlaùuloS we;sjk fõokdj iodld,sl fõokdjla fkdù jy jyd bka ñoSug wjia:dj ;sfnkjd' ta i|yd Tng ffjoHjrfhl=f.ka losu ud¾f.damfoaYKhlao ,nd.; yels nj wu;l lrkak tmd''' cSú;fha i;=g wdfh;a <`.d lr.kak mq¿jka''' ljr fya;=jla ksid fyda cSú;fha fï iqñysß w;aoelSu Tng;a bis,sh fkdyels fõokdjla fjkjd kï ;j;a <; fjkak tmd''' ys;ska"

DOCTOR MAGAZINE

.;ska ÿla ú|skak tmd''' Tfí ne|Sï wjodkulg ,la lr.kak;a tmd''' Tn fofokdu iqÿiqlï iys; ffjoHjrfhl= fj; meñK Wmfoia ,nd.kak' ;kshu tkak;a tmd''' fuh fofokdu tlaj úi|d.; hq;= ;;a;ajhla' Tfí cSú;fha cSú;fha w;sYh fm!oa.,sl i;=g''' wdorfhka ne÷KQ Tn fofokdg muKlau Wreu ,sx.sl w;aoelSu wdYajdockl u;lhla f,iu mj;ajd .kakg fï wNsfhda.h fofokd tlaj tldjkaj ch.kak' DM

doctormagazine.lk

D•Magazine /

ENT

ug ihskia yeos,d''' kE''' ug ihskihsáia yeos,d'''

SINUSITIS ug ihskia yeos,d''' kE''' ug ihskihsáia yeos,d''' fldagrl m%odyh we;sjk yeá yd thg lrk m%;sldr fkú,a m%kdkaÿ YslaIK frdayf,a W.=r lk kdih ms<sn|j úfYaI{ ffjoH fcHaIaG lÓldpd¾h iS;d l=udß wrfUfmd, úisks

doctormagazine.lk

Tn ksr;=rej wid we;s frda. ;;a;ajhla ms<sn|j oeKQj;a ùug wm fï ,smsfhka n,dfmdfrd;a;= fjuq' ysiroh" kdifha wjysr;djhla yd yqiau .ekSfï wmyiq;djhla we;s jQ úg zzug ihskia yeos,d'''ZZ ta úosyg lshkjd'''fï l;dj ffjoHjreka jYfhka wmg ks;ru wykakg ,efnkjd''' fïl fl;rï .e,fmk Ndú;djlaoehs fï ,smsh wjidkfhaoS Tngu ta;a;= hkjd we;s'

November 2016

DOCTOR MAGAZINE

105

D•Magazine /

ug ihskia yeos,d''' kE''' ug ihskihsáia yeos,d'''

ENT

Have you ever felt like you had a cold that wouldn’t go away? If it hangs around for more than 10 days, or gets worse after it starts getting better, there’s a good chance you have sinusitis, a condition where infection or inflammation affects the sinuses.

uq,skau meyeos,s l< hq;a;la ;sfí' zzihskiaZZ hkqfjka frda.hla fkdue;' Sinus hkqfjka hula wfma ysia lnf,a kï mj;S' fïjd ysfia" kdih wjg yd k<, wdY%s;j msysgd we;s jdhq l=àr lsysmhls' fï jdhq l=àr y÷kajkafka zzfldaGrlZZ hkqfjks' fuu fldaGrl wdY%s;j m%odyhla" fjk hï frda.S ;;a;ajhla we;s jQ úg wm th y÷kajkafka Sinusitis fkdfyd;a zzfldaGrl m%odyhZZ hkqfjks' tfiau yqÿ fiïm%;sYHdj" ke;fyd;a ysirohla we;s

106

November 2016

jQ úg th fldaGrl m%odyh hehs jrojd jgydf.k fnfy;a lsÍuo iqÿiq ke;' fuysoS frda.h ksjerosj y÷kd.ekSfï we;af;a iqúfYaIS jeo.;aluls' ks;r ks;r fiïm%;sYHdj je<|Su yd mSkia .;sh ksid fldaGrl m%odyh we;s fjkjd''' fldaGrl m%odyhg u`. i,iajk fya;= lsysmhla ;sfnk w;r ta .ek oek isàu WÑ;h' ks;r ks;r fiïm%;sYHdj je<|Su yd mSkia .;sh fuhg fya;= jk nj fmfkkakg ;sfí' ta yereKq úg fldaGrl we;=<; we;sjk jHqyd;aul fjkialï fukau we;eï frda.o (Cystic Fibrosis& fuhg fya;= jk nj fmfka' kdih wjg yd ysi ;=< msysà ysia jd;fhka msÍ ysig ieye,a¨jla f.k osh hq;= fldaGr ;=< >k oshr yd uiao¿ wdosh tl;= ùu fï m%odyhg uq,ajk fya;=jhs' fuhska fldaGrl m%odyh we;s jk ;j;a fya;=jla .eko b`.s lrhs' tkï nelaàßhd" ffjri yd os,Sr wdidoko fldaGrl m%odyhg fya;= jk njhs' frda.h y÷kd .ekSug fhdod.kakd l%ufõoh • frda. b;sydih ie<ls,af,ka ksÍlaIKh lsÍu • tkafvdiafldms mÍlaIKh • CT mÍlaIKh frda. b;sydih úuiSfïoS WK" ;o ysiroh" kdifha wjysr;djhka" >k fiu kdifhka W.=rg .e,Su" .| iqj| fkdoekS hdu" uqyqfKa fõokdjla we;sùu iy kdifhka f,a .e,Su hk lreKQ ;sfío hkak fuysoS uQ,slj i<ld nef,hs' frda.h mj;sk ld,h úuiSu frda. l<uKdlrKhg jeo.;a''' by; lS frda. ,laIK osk lsysmhla ^Wod' osk 10lg wvq ld,hla& mej;S th iqj fõ kï th ffjria wdidokhla f,i;a" Bg jvd os.= ld,hla mj;sk úg th nelaàßhd wdidokhla f,i;a y÷kd .efkhs' kuq;a fï frda. ,laIK f;uilg jeä ld,hla mj;sk úg th osÍ>ld,Sk fldaGrl m%odyh f,i i<ld m%;sldr ie,ish hq;= jkafkah'

DOCTOR MAGAZINE

doctormagazine.lk

frda.h jeäoqr mrSlaId lsrSug fhdod.kakd mrSlaIK tkaviafldms mÍlaIKhla''' fojk mshjr f,i by; lS frda. ,laIK we;s úg tkaviafldms mÍlaIKhla lsÍu jeo.;a jkafkah' tu.ska kdih ;=<g újr jk fldaGrl ukdj wOHhkh lsÍug;a fndfydauhla jHqyuh fjkialï ^Wod' uiao¿" mrK fiï fidgq& wdosh uekúka yªkd. ekSug;a wjia:djla Wod fjhs' CT mÍlaIKh;a jeo.;a f;dr;=re imhkjd''' tjeks fjkialï ÿgq úg CT mÍlaIKhlg frda.shd fhduq lsÍug ffjoHjrhd ;SrKh lrKQfha ta iïnkaOfhka iúia;rd;aulj wjfndaOhla ,nd. ekSug fukau Y,Hl¾uhla wjYH jQjfyd;a thgo fï wOHhkhka ukd f,i m%fhdackj;a jk fyhsks' fldaGrl m%odyhg uQ,sl m%;sldr fuf,i y÷kd.;a fldaGrl m%odyhg m%d:ñl ms<shï jYfhka m%;scSjl" kdih fiaoSu" kdihg T!IO ìxÿ oeóu isÿ lrk w;r ixlS¾K wjia:dj,oS iy oS¾> ld,hla mj;sk frda.S wjia:d j,oS frda.shd Y,Hl¾uhlg jQjo Ndckh lsÍug isÿ jkq we;'

doctormagazine.lk

Y,Hl¾uhla wjYH jk úg''' T!IO j,ska wfmalaIs; m%;sM< fkd,efnk l,ayS tkaviafldms ;dlaIKh weiqf¾ isÿ lrk Y,Hl¾uhla isÿ lsÍu wjYH fõ' fuysoS wdidos; fldaGrlhla ;=<g leurdj we;=,a lr Functional Endoscopic Sinus Surgery - FESS wjYH msßisÿ lsÍu isÿlr" uiao¿ ;sfí kï tajdo bj;a lr kej; h:d ;;a;ajhg m;a lsÍula isÿfõ' fuu Y,Hl¾ufhaoS ndysßka fmfkk lsisÿ lemqula fyda ;=jd,hla we;s fkdlsÍu úfYaI;ajhls' fuf,i wjYH fj,djg wjYH m%;sl¾u fhoSu w;sYhska jeo.;a jk w;r tajd u.yer isàfuka fldaGrl m%odyh ksid uqyqfKa úlD;s;djhka we;sùu" wiaÓ osrdm;aùu yd fud<fha wdidokhka jQj we;sùfï wjodku mj;S' DM

November 2016

DOCTOR MAGAZINE

107

Dâ&#x20AC;˘Magazine /

Kids Health

Decoding Baby's Cries

Decoding Baby's Cries

Could Your Baby's

Crying Be

Colic?

A

ll babies are crying, but some babies crying a lot. Crying is your baby's way of expressing ideas. It's the only communication tool in her early life.

There may be times of the day when your baby tends to cry a lot and can't be comforted. Early evening is the most common time for this to happen. This can be hard for you, as it's often the time when you're most tired and least able to cope.

Dr.Hashir Ariff MBBS(Lond.)

DCH(UK) CCS(UK) FRCPCH(UK) Consultant Pediatrician Ninewells Care Mother & Baby Hospital (Pvt) Ltd, Kirimandala Mawatha, Colombo 5

108

November 2016

Always realize the more intense the hunger, the more body language you will see. ... There are two distinct cries, one being a cry of pain and the other being a cry of hunger. ...

Sometimes screaming baby had more than 'just a hunger.

Crying escalated from a few tears to a scared, inconsolable screeching.

Ever child gets stomach-ache at some time or another, even if it is only because her bowel is about ready to empty itself vigorously. The trick is to distinguish serious problems from things that will go away on their own, then to know what you can safely do about the pain while it lasts. First observe

DOCTOR MAGAZINE

doctormagazine.lk

Apart from various theories such as changes in the level of hormones controlling gut muscle and an abnormal balance of the gut bacteria, the cause of colic remains unknown.

Babies who cry or fuss a lot and can’t be settled are often described as having ‘colic’. We don’t know what causes colic, but we do know it can be hard to handle.

What is Baby Colic Colic is where a newborn baby has repeated episodes of crying for no apparent reason as if in pain. By definition a baby crying for three hours a day, for more than three days a week for at least three weeks. The baby is otherwise well.

doctormagazine.lk

TIPS TO SOOTHE COLIC IN BABY Mom’s aren’t the only one suffering when a baby has colic. Colic is due to the fact that something is wrong with your baby. Usually not something that can be fixed by a doctor. Some babies just have more sensitive stomachs.

But there are a few options you can take to help sooth a colic baby.

Hold your baby. Cuddling helps some babies.

Keep your baby in motion. Sometimes just rocking or gently bouncing baby in your arms can soothe.

Sing to your baby. Some babies respond well to music.

Sometimes it is simply baby needs to hear mom’s voice in a gentle lullaby.

Use gentle heat or touch. A warm bath and a gentle baby massage can help ease baby.

Swaddling. Make baby nice and cozy by creating a tight intrauterine-type environment with a swaddling blanket.

Bicycle legs. Lay baby down and gently bicycle baby’s legs forward and backward, and try pushing his or her knees to the chest, repeating several times. This will help ease any gas issues that could be causing colic

November 2016

DOCTOR MAGAZINE

http://busycreatingmemories.com/colic-survival-guide/

carefully everything about the kind of pain the child have.

109

D•Magazine /

DECODING BABY'S CRIES

Kids Health

These bouts typically occur in the evenings when the usual methods of comforting do not work very well.

However, it can occur at anytime of the day The baby may refuse feeds and may pull up his/her knees. A rumbling sound may come from the tummy. He may eventually fall asleep after bouts of colic. Between these bouts, the baby appears well and feeds normally.

The severity can be variable with some babies only having periods of restlessness in the evenings.

What causes colic?

Apart from various theories such as changes in the level of hormones controlling gut muscle and an abnormal balance of the gut bacteria, the cause of colic remains unknown. There has been a large amount of research looking in to what causes infantile colic.

The diagnosis is made by excluding other causes of crying in babies. It is important to note that babies with colic are well otherwise.

The Treatment There is no treatment that cures colic. The following can help reduce symptoms: It is important to remember that it is nothing you have done to cause it.

• Reducing anxiety: Babies pick up on their parents’ anxiety and this can contribute to worsening of symptoms.

• Probiotics • (Luke warm) hot water bottle • Try baby massage • Positioning and movement: babies may settle when taking a ride in the car or a pram. Walking with the baby in a sling or baby carrier may help too.

• Swaddle: swaddling the baby in a blanket can help • Noise or quietness: some babies prefer some background white noise such as that made by washing machines etc. others prefer absolute silence.

110

November 2016

DOCTOR MAGAZINE

• Medicine: A drug called Simeticone can help.

Some people find gripe water helpful, but its use is not supported by research.

Recovery The symptoms of colic usually peaks at about 9 weeks and settle by 3-4 months of age.

Is colic harmful ?

No, colic won’t harm your baby. It may be more painful for you and your partner to cope with your baby’s constant crying.

The best thing to do is to stay as calm as possible and remind yourself that he’ll grow out of this phase.

High-pressured situations caused by relentless crying can lead to frustration and anger or depression. In rare cases, some parents have been known to take actions that are dangerous and that they regret, such as shaking their baby.

If you're struggling to cope, don't be afraid to seek help from your doctor. This phase will pass. Just give it time. DM

doctormagazine.lk

D•Magazine /

Controversy SLMC Between a Rock and Hard Place over the SAITM Issue

Medicine is one of the most sought after professions in the world. However, opportunities for students to realise this dream are few, particularly due to the competitive nature of university entrance examinations. There are differing perspectives on these developments, among medical professionals as well as the public. The writer challenges the SLMC - the regulatory body governing healthcare services in the country.

SLMC BETWEEN A ROCK AND HARD PLACE OVER THE SAITM ISSUE

By Harsha Subhashana

In the eyes of the common man, SLMC is the regulatory body for healthcare services in the country. So they represent the public interest of healthcare. This is why in some countries, the medical council is consisted of not only healthcare professionals but also the respected citizens who are not medical professionals.

As per the law passed, post establishment of the SAITM, medical schools in the country needs an approval from the professional body of medical doctors before their formation. Bending this law, SLMC is trying to convince the legal authorities & public that the SAITM needs SLMC approval as they are the professional body for medical doctors.

If they are the professional body for medical doctors, how could they be the regulatory body of healthcare at the same time? This has a clear conflict of interest!

A professional body would obviously work for the interest of the professionals. Means, to get better benefits for their members. They would represent their professionals and fight for their members’ rights. So if they insist that they are the professional body for medical doctors, they cannot appear at the same time for public interest of healthcare, where the public needs of healthcare would sometimes maywork against the benefits of the professionals. Eg: Public would need quality healthcare at a lesser price but professionals would need a higher price. So if SLMC is a professional body, they would obviously work for the ‘higher price’.

But if they say they are not a professional body but a regulatory body, they can’t not fight against SAITM over the recent law passed on ‘taking prior permission when starting a medical school from the professional body of medical doctors. DM doctormagazine.lk

November 2016

DOCTOR MAGAZINE

111

D•Magazine /

Caring for Elders

Aging in Sri Lanka: High Time for a Scientific Intervention

Caring for Elders and Geriatric Medicine

Aging in Sri Lanka: High Time for a Scientific Intervention

B

irth of a child brings so much hope and happiness to a family. Growth of that child becomes the pride in the eyes of parents.

This little human being has begun the journey through the arduous path of life with many challenges and opportunities yet to deal with.

Whatever or whoever he or she becomes they are faced with the inevitable truth of AGEING, the process which links the growth of a child through the youth to the declining silver ages. Hence, achieving a healthy old age is largely a result of one’s thoughtful deeds, habits and exposed events from a young age.

Dr Chandana Sri Kanakaratna

Geriatrician, Physician Nawaloka Hospital Colombo 2

112

November 2016

Aging poses may challenges Older people are a special group of individuals. With ageing, body’s physical and psychological functions decline at a speed unique to the individual. This leads to a different or even a sub-optimal response to diseases. They also tend to develop many chronic diseases such as high blood pressure, diabetes, heart diseases, cancers and are

DOCTOR MAGAZINE

doctormagazine.lk

Medical care for elders should be unique There for medical care of elders become unique in many different ways. They may suffer with many noncommunicable diseases at one given time. They may also be subjected

doctormagazine.lk

"

also more susceptible for infections. They can also lose the ability to maintain other bodily functions such as balance and independent walking, bladder and bowel functions, memory and other cognitive functions interfering with the quality of life and independent living in the community.

Geriatric Medicine is a very new concept to Sri Lanka though the uniqueness of caring for elders had been a subject of discussion in the science of Medicine from the time of Hippocrates.

to polypharmacy (taking many tablets/ medications at one given time). Managing their illnesses with out coordination is very common these days and may lead to confusion and anxiety, and sometimes, harm to patients. Secondary issues such as balance and walking issues, falls, confused states, incontinence of urine , loss of independence that may result from the primary illness may be very much overlooked.

Need of a holistic approach For this reason it is important that the medical illnesses

November 2016

DOCTOR MAGAZINE

113

Dâ&#x20AC;˘Magazine /

AGING IN SRI LANKA: HIGH TIME FOR A SCIENTIFIC INTERVENTION

Caring for Elders

of elders managed holistically where not only the primary illness but also the other secondary issues resulting from it are sought, assessed and managed appropriately.

Managing the primary illness is essential. It may be necessary to involve other specialists to assess other accompanying issues.

easily forgotten. This attitude interferes with the opportunity to help them in the right way. All above issues and many more are not inevitable accompaniments of normal ageing though they are more commonly seen with it.

They all can be helped in some way. It is important to look for medical advice in such situations.

For instance if there is a heart issue a heart specialist may be involved. If there is a balance issue a physiotherapist may be involved. But none of them should be working in isolation.

They should all be working to achieve the same goal agreed between them coordinated by a physician, preferable a geriatrician, a physician specializing in older people. This way unnecessary stress and confusion to the patient minimized while preventing polypharmacy and associated complications. In addition person will receive

Geriatric Medicine explained There is a medial science designed specifically to understand the medical, psychological and functional issues of older people and it is called Geriatric Medicine or the Care of the Elderly Medicine. Physicians who practice it are called geriatricians. This is a very new concept to Sri Lanka though the uniqueness of caring for elders had been a subject of discussion in the science of Medicine from the time of Hippocrates.

114

November 2016

optimum care achieving best possible quality of life Issues in elderly warrants special attention Elders may have to face with many challenges just for the sheer fact they are ageing. Things can be taken for granted.

Issues such as falls, states of confusion, memory impairments, balance and walking issues, incontinence may be taken as a part of getting old, and

DOCTOR MAGAZINE

Over the last few centuries much work had been done on this subject. It has been doctormagazine.lk

If there is a heart issue a heart specialist may be involved. If there is a balance issue a physiotherapist may be involved.

But none of them should be working in isolation. They should all be working to achieve the same goal agreed between them coordinated by a physician, preferable a geriatrician, a physician specializing in older people.

doctormagazine.lk

practiced in the west over a century. First geriatric unit in the World came about in 1940s.

Since then it had been evolving massively in way to encompass many domains of the life of elders. Great Britain, with a population of only 3 times that of Sri Lanka, has got over 1200 practicing geriatricians at this moment of time and many thousands of nurses and allied health staff serving the older population. This is the trend in the world in response to rapidly expanding older population which Sri Lanka has to take up soon.

Sri Lankan perspective Sri Lankan older population is growing very fast too. Our Life expectancy at birth is over 75 years and still continues to increase.

Over 60 group will comprise up to 20% of the population in the next decade or so. We have a challenge in our hand to deal with the rapidly expanding older population and addressing their needs to optimize healthy, independent life with best possible quality of life.

doctormagazine.lk

Sri Lanka has developed many services for ageing population through departments of health and social services. There are many services devolved by other private and public organizations. It is important that the public is aware of them and utilize them in the hour of need. Coordination between these services will lead to better outcomes to elders.

However There is a huge need to improve the services for elders in social and health care systems through understanding of their needs and, applying appropriate methods to improve them with best possible results.

The Author is a Geriatrician physician with particular interest in Parkinsonâ&#x20AC;&#x2122;s disease. Experience in working Sandwell and Rowley Regis Hospitals UK for years. DM

November 2016

DOCTOR MAGAZINE

115

Dâ&#x20AC;˘Magazine /

Sex Life

Shockwave treatment for maintain an erection

Latest treatment to improve Erection, Now in Sri Lanka

Shocks of Rigidity Shockwave treatment for maintain an erection

By Bharata Gunathilaka Three years ago, sex became "very stressful" for Mr Ranjan because of his inability to maintain an erection.

The 45-year-old sales executive, who did not want to give his real name, said: "I did not know if sex that night was going to be satisfactory or if I would be a party pooper."

116

November 2016

DOCTOR MAGAZINE

Mr Ranjan, saw a general practitioner and found relief in "yellow and blue pills" that he popped an hour before sex.

Well-known by their trade names, Viagra, Cialis or Levitra, these pills belong to a class of medication known as phosphodiesterase-5 (PDE-5) inhibitors, which block the PDE-5 enzyme found in blood vessel walls. Those miracle drugs the smooth doctormagazine.lk

doctormagazine.lk

muscles of the penis to relax and increase blood flow to the organ, but are also associated with side effects such as headaches and flushing.

A MISERY UNEXPECTED But one years ago, the pills stopped working after Ranjan had an angioplasty procedure to unblock an artery, so he was totally upset on his sex life.

"We always tried to plan for sex and, even then, I always had doubts about my erections." said Ranjan.

NEW HOPE Three months ago he was offered fresh hope by senior consultant urologist at CDEM Hospital, Norris Canal Road, Colombo, where a special innovative technique called low-intensity extracorporeal shock wave therapy, for the inability to maintain an erection was established, first time in Sri Lanka.

Twice a week, for three weeks, Ranjan had low-intensity shock waves delivered to five areas of his penis to stimulate new blood vessels to grow. doctormagazine.lk

November 2016

DOCTOR MAGAZINE

117

Dâ&#x20AC;˘Magazine /

SHOCKWAVE TREATMENT FOR MAINTAIN AN ERECTION

Sex Life

Ranjan returned to work after each 20-minute session, which left him with only a tingling sensation. He said his sex life has been "good so far" and is close to what he was able to achieve in his 20s.

Since 2005, Cardiologists have proven that shockwave technology works in stimulating the growth of new blood vessels, leading to an increased myocardial blood supply. The same shockwave therapy is now being used to similar effect on the blood vessels in the cavernous bodies of the penis.

The shockwaves are focused onto the area to be treated creating new blood vessels in penile tissue, enabling patients to achieve and maintain firm spontaneous erections.

LATEST ADVANCEMENT IN ERECTILE DYSFUNCTION The exact mechanism of the low-intensity extracorporeal shock wave therapy remains unclear, but the aim is to restore the erectile mechanism for natural or spontaneous erections. It is the latest advancement in erectile dysfunction (ED) treatment since pharmaceutical giant Pfizer launched Viagra in 1998.

SHEER OUTPATIENT PROCEDURE The outpatient procedure does not require any downtime or anesthesia. The technique itself use no drugs administered along with shockwave, so that no any adverse effect of pharmacopia.

118

November 2016

DOCTOR MAGAZINE

These days, he has sex twice a week, but hopes to "rev this up to six times a week", he declared.

AGE IMMATERIAL, SUFFER EVERYWHERE...

Most men are able to maintain an erection for five to seven minutes, which is the average time for ejaculation.

While older men often have a physical cause for their impotence, such as blocked arteries or hormonal imbalances, psychological issues are more likely to plague younger ED sufferers.

These can range from work and money woes, stress because of couple issues to performance anxiety from trying to make a baby during the wifeâ&#x20AC;&#x2122;s ovulation period.

Most of the young males are facing ED too. doctormagazine.lk

Causes of Impotence

Dr Lasantha Malavige, Consultant in Sexual Medicine

STRESSFUL AND EGO-HURTING PHENOMENA Speaking on the condition, Dr Lasantha Malavige, Consultant in Sexual Medicine and a visiting Consultant practicing in CDEM Hospital Colombo, said his inability to perform was very â&#x20AC;&#x153;stressful and ego-hurtingâ&#x20AC;?. Dr. Malavige, a visiting academic at the Oxford University has been appointed as the next President of the South Asian Society of Sexual Medicine for a term of two years commencing 2017. The largest international conclave for experts in the field of sexual medicine.

Many males was in guilt from being unable to satisfy their partner and psychological stress from quarrels and the loss of intimacy.

RISK FACTORS Dr Malavige pointed out that risk factors such as diabetes, high blood pressure, high cholesterol and obesity. Urban lifestyle diseases previously more commonly seen in older adults, are now also affecting younger men.

One of the youngest patients treated in CDEM hospital for ED is a 36-year-old diabetic, whose girlfriend had shunned him when he was unable to perform in bed. doctormagazine.lk

November 2016

DOCTOR MAGAZINE

119

D•Magazine /

SHOCKWAVE TREATMENT FOR MAINTAIN AN ERECTION

Sex Life

“He was devastated, but eventually resolved his ED with counselling, treatment of his diabetes and use of medication,” said Mr Amal Gajamange, Head of Marketing at CDEM hospital.

SENDING SHOCK WAVES Shock waves are acoustic waves that carry energy and can be used to affect a selected anatomical region.

High-intensity shock waves have been used for years to pulverize urinary stones so that they are small enough to be passed out naturally.

Only about 18 per cent of this energy is needed to treat erectile dysfunction (ED), said senior consultant urologist Peter Lim, who recently visited Colombo, CDEM hospital to popularize the technique to the Sri Lankan counterparts. He held a awareness seminar to the general public and another professional briefing for the doctors, both held in auditorium, CDEM hospital, Colombo.

120

November 2016

DOCTOR MAGAZINE

The energy is used to cause very minor injuries to genital tissues to stimulate growth factors - proteins that prompt more blood vessels to grow.

Shock wave therapy for ED provide new hope for the suffered.

Its a new generation intervention. Result oriented initiative.

CDEM Hospital proudly announcing the first and only Sri Lankan hospital having low-intensity shock wave treatment for males who are having inability to maintain an erection. DM

doctormagazine.lk

Dâ&#x20AC;˘Magazine /

Pregnancy What You Need to Know About Giving Birth by Cesarean Section

Recovering from a

caesarean section What You Need to Know About Giving Birth by Cesarean Section This article describes what happens after a caesarean section procedure and what to do for fast recovery.

By: Dr InduAsanka Jayawardane MBBS, MD(O&G), MPhil (Nottingham-UK), CTHE (Col), MRCOG. Consultant Obstetrician & Gynecologist Ninewells Care Mother & Baby Hospital Kirimandala Mawatha, Colombo 5

doctormagazine.lk

Almost one-third of women will have a Cesarean birth. ... pregnant women end up having a Cesarean or C-section delivery.

Here's everything you need to know about after care of C-sections

surgery may be the safer way to give birth. Since it is the commonest major abdominal surgery performed, we will look at some questions you may wish to be answered regarding this operation.

Although considered less safe than a vaginal delivery in populationbased data, for some women, caesarean

You should discuss why, how, when and alternatives with your doctor regarding any proposed surgery.

November 2016

DOCTOR MAGAZINE

121

D•Magazine /

WHAT YOU NEED TO KNOW ABOUT GIVING BIRTH BY CESAREAN SECTION

Pregnancy

You shouldn’t feel any pain at all during the operation, though you may be aware of some sensations.

Some women describe the feeling as ‘like having someone doing the washing-up in your tummy’.

122

November 2016

Recovery Phase Experiance You will stay in the operation theatre for 2-4 hours. This is to do close observation for bleeding, pulse, blood pressure, breathing and oxygen saturation. Urine output will be measured and there will be a catheter and bag to drain urine.

You will receive IV fluids through a small plastic tube placed on your hand.

• Remember to take deep breaths. Shallow breathing due to pain can increase the risk of chest infections.

DOCTOR MAGAZINE

• Breast feed, cuddle, enjoy company of baby and partner.

• Remember that your legs are still numb (spinal or epidural), therefore no mobility.

• You may be allowed sips of fluids if mouth is dry.

Moving early, Benefited You Mostly Begin to move as quickly as you can. Request help from nursing staff as legs are still recovering from numbness. Move a lot. Splint the incision with a pillow held over.

You may feel that your “insides are coming out” doctormagazine.lk

Types of Cesarean Section www.medindia.net

• You may have vaginal bleeding/discharge for up to 5-8 weeks.

Catheter is removed as soon as you are comfortably mobile.

Rest is very important.

So is the time you spend with the baby. Keep visitors to a minimum.

If the baby has arrived early or you are having difficult recovery time, discuss with your doctor about a “No visitors allowed” board. Your visitors will understand - after all they are the friends and family!!!

Have a look at the incision. It is important to keep it clean and dry.

If staples or sutures are there they generally come out in D5-7

Discharge from Hospital When you are fully mobile and is comfortable in feeding the baby- usually on day 2.

• You may have pressure when urinating or frequent urination.

Wound may look red and bruised. There may be numbness or itching.

Inform your doctor if it is too uncomfortable.

Normal Course After Surgery • Incision may be tender for 3-4 weeks, but usually no drainage of blood, fluid or pus.

but the wound has good strength with multiple layers of sutures.

Moving early improves circulation, reduces risk of blood clots, reduces haematoma and wound infection

doctormagazine.lk

• You may have slight headaches for 3-4 weeks.

• You may have aches in pelvic area for 3-4 weeks.

• You may have swelling around the rectum or vagina for 2-3 weeks.

• You may be very tired and easily fatigued for the first 3-4 weeks.

• You may have slight depression, moodiness, irritability, or rare hot flashes for a few weeks.

November 2016

DOCTOR MAGAZINE

123

D•Magazine /

WHAT YOU NEED TO KNOW ABOUT GIVING BIRTH BY CESAREAN SECTION

Pregnancy

You may gradually increase your activities as your strength and comfort permit. T

• You may have numbness (loss of feeling) around the incision for 12 weeks or longer.

• Expect swollen legs after a cesarean (dependent swelling).

Beware of Danger Signs – Call/ Return to hospital if they Occur: • A fever of more than 100.4.

• Heavy bleeding, more than a normal period.

• Severe pain, unrelieved by normal medication.

• Shortness of breath, difficulty breathing or chest pain.

• Painful or burning urination.

• Severe back pain.

• Painful swelling or redness in legs.

• Drainage or pus from the wound.

• Foul smelling vaginal discharge.

Restrictions on Lifting/ Return to Work C- Section operation has evolved significantly in history of modern medicine. There is a paucity of good quality evidence to base post operative advices on 124

November 2016

return to work, lifting, driving etc and current advice is based on operator opinion and common sense.

Abdominal pressure with lifting weights and climbing stairsis comparatively less when compared to a cough or standing from seated.

(The latter two cannot be restricted anyway!)

No restriction needed for lifting weights. The wound and sutures are very strong. Use common sense. Why would you want to lift 30 kilos ? Care of baby - no restrictions enjoy yourself.

Driving - delay until there is no tenderness ( 4 weeks) on seat belts and you can do an emergency stop without pain.Your insurance may not cover you before this period.

You may be a passenger

DOCTOR MAGAZINE

with seat belts for short trips before 4 weeks.

No tampons, douching or intercourse for 6 weeks.

Household work- no restrictions- however 51% is to be done by the partner!!!

Things to Do: • Keep your postoperative checkup appointment as scheduled.

• Avoid constipation • Take medications as prescribed.

• You may shower, but don’t rub the incision.

• You may drive a car after being home for 4 weeks if the incision is healing without problems.

• You may be a passenger in a car for short trips only after being home 1 week.

• You may begin to exercise in moderation after your 6 week checkup and your physician gives you the OK. • Eat a balanced diet.

Drink at least 6 glasses of fluids a day.

• Rest frequently; take a nap each day for 1-2 hours the first 2-3 weeks after going home. doctormagazine.lk

No tampons, douching or intercourse for six weeks.

General instructions for Mothers General Activity - You may gradually increase your activities as your strength and comfort permit. The first week you return home, you should rest and care for only yourself and your newborn. Avoid heavy chores, straining or prolonged standing.

Walking, however, will help prevent many postoperative complications and assist in healing. You may walk up and down stairs if necessary, but go slowly and hold the handrail for support. Avoid intercourse until cleared by your physician at your follow-up visit.

Bathing - You may shower and wash your hair. Avoid tub baths.

Keep the incisions clean and dry.

Care of the Incision â&#x20AC;&#x201C; Abdominal incisions heal gradually. Gently cleanse

doctormagazine.lk

the incision with soap and water in the shower.

Pat the incision dry with a clean towel. Do not rub.

No dressing is necessary, but you may choose to keep a loose dressing over the wound to avoid staining your clothing with secretions during the healing process. Keep it dry.

Returning to Work/ Excersise Will to some extent depend on the nature of the work you do.

A regular aerobic and muscle toning exercise program is a MUST for a smooth recovery from the surgery. You MUST speak to your doctor regarding advice on exercise.

Follow-up Appointment â&#x20AC;&#x201C; Your first post-operative appointment should be 1-2 weeks after surgery.

Call for an appointment if not already scheduled.

You will be seen for your post-partum appointment 6 weeks after delivery.

Problems or Questions - Do not hesitate to call if you have any problems or questions.

Promptly report any of the following problems: fever (temperature >100.5

degrees), problems with the incision, heavy bleeding, severe pain or nausea, or any other unusual problems you may be experiencing.

Dr Indu Asanka Jayawardane MBBS (Colombo), MD (O&G), MPhil (Nottnigham- UK), MRCOG Senior Lecturer in Obstetrics and Gynaecology, Faculty of Medicine, University of Colombo; Honorary Consultant Obstetrician and Gynaecologist, De Soysa Hospital for Women and National Hospital, Sri Lanka.

Former assistant secretary and member, Sri Lanka College of Obstetricians and Gynaecologists Research interestsDiabetes in Pregnancy, Obstetric Cholestasis, Fetal Heart, Emergency obstetric care. DM

November 2016

DOCTOR MAGAZINE

125

D•PLUS /

Videos

The Life through Clips

The Life through

Clips cSú; iqrlskakg ffjoH úoHdj .kakd W;aidyfha fndfyda isÿùï Tng wkdjrKh fkdjkafka tajd Tfí udkfhka wE;aj ;sfnk ksihs' tjka ÿ¾,N rEm fm<yrla Tfí ÿrl:kfha QR Code Reader App tl msysgqjd f.k my; wm uqøKh lrk fla;h Scan lsÍfuka oeka Tng;a w;aú|skak mq¿jka''''

fï ùäfhdaj n,k flfkla wdfh is.rÜ fndkj fndre''' ÿï fndk flfklaf.hs" ÿï fkdfndk flfklaf.hs fmKy¿ j, fjki''' https://www.facebook. com/113659508659976/ videos/1291899884169260/

126

November 2016

PLUS DOCTOR MAGAZINE

doctormagazine.lk doctorplus.lk

nv we;=f< mqxÑ *hsÜ tlla''' whsh, u,a,s, f.oros onr lr.kak tl idudkH fohla' ta;a Tn uú;hg m;a fõú' l=i ;=< bv fnod.kak;a ksjqkakq onr lrkjd''' fndre lsh,o lshkafk''' tfykï fï ùäfhdaj n,kak''' wms fndrejla lsõfj kE lsh, Tn t;fldg f;areï .kSú' https://youtu.be/K1cBHkyjaZ4

fï fodia;r uy;a;hf.ka .y.kak bkafclaIka ßfokafk kE''' orefjd biamsß;df,os wykak wlue;su jpkh ;uhs bkafclaIka''' ta;a orej ikiñka" b;du wdorfhka fï ffjoHjrh bkafclaIka tl orejdg .yk úosy uú; lrjk iq¿hs' https://youtu.be/vdjk_9nUaZI

yoj; nhsmdia lrk Y,Hl¾uhla'''' https://youtu.be/e1PUec4i0G0videos/ 1139715496054367/

ma,diaála ie;alï Made easy https://youtu.be/rQA2CNJV-Kk

doctormagazine.lk doctorplus.lk

November November 2016 2016 DOCTOR DOCTOR MAGAZINE PLUS

127

D•Magazine /

wdhq¾fõoh frda.hg fkdj frda. ksOdkh n,d lrk m%;sldr udos,shla wdhq¾fõofha wmg ;sfnkjd'''

frda.hg fkdj frda. ksOdkh n,d lrk m%;sldr udos,shla wdhq¾fõofha wmg ;sfnkjd''' oshjeähdj iïnkaOfhka wdhq¾fõou;dkql+, úuiqula j¾I 1903 j¾Ifha uq,aNd.fha osfkl wefußldfõ iañ;afidakshka wdh;kfha uydpd¾h ,x.a,S úoaj;=ka lKavdhula wu;d foaYKhla meje;aùh' .=jkahdkhla ks¾udKh lrKQ msKsi rcfha wruqo,ao fhdodf.k isÿ l< W;aidyhla ksr¾:l ùu Bg m%ia;=; úh' uydpd¾h ,x.a,S iajlSh l;dfjka fufia m%ldY lf<ah' zziq<`.g jvd nr fohla iq<f`.a md lr yeÍug fkdyelshs' ta ksid .=jka hdkhla ksmoùu lsisod fkdl< yelalla'ZZ hhs Tyq fmkajd ÿkafkah' tfy;a tu j¾Ifhau foieïn¾ 12 jkod ´¾j,a yd ú,anÜ hk rhsÜ fofidfydhqrka tl;= ù .=jka hdkhla wiig kexjQfhah' oshjeähdj iqjlrkakg neßh''' hk u;dka;rhg wNsfhda. lrñka oshjeähd frda.Ska úYd, ixLHdjlf.a frda. md,khg u. ie,iQ wdhq¾fõo ffjoHjrfhla wdhq¾fõo u;dkql+,j fï frda.h úuik whqre fu;eka mgka fm< .iajhs' Tyq rkam; rejka r;akdhl fjo uy;audhs'

128

November 2016

DOCTOR MAGAZINE

wdhq¾fõo ffjoH rkam; rejka talkdhl iu. l< idlÉPdjls'''

mrïmrdfjka ,o Wreuhg kQ;k ffjoH úoHdfõ oeKQuo uqiq lr.ksñka wdhq¾fõo ffjoH úoHdfõ uQ,sl mrud¾: wkqhñka" tys we;s m%dfhda.sl wmyiq;do u.yrjñka fï wdldrfhka uOQfïyhg id¾:lj m%;sldr lrkafka mE,shf.dv" fchrdca m%kdkaÿmq,af,a md,u wi< iajlSh fjoueÿr ck;djf.a n,dfmdfrd;a;=fõ iqjueÿr lr.;a rkam; rejka talkdhl fjo uy;audhs' Tn oshjeähdjg id¾:lj m%;sldr lrk foaYSh ffjoHjrfhla''' @ wdhq¾fõo ffjoH l%uh frda. ksÜgdjg iqj lrk ffjoH Ydia;%hla' tafl ndf.g iqjm;a lsÍï kE' frda. ksOdkh uekúka y÷kdf.k thg m%;sldr lrkjd' oshjeähdjg;a tfyuuhs' fï m%;sldr j,ska oshjeähd frda.Ska iqjh ,nkjd'

doctormagazine.lk

kuq;a oshjeähdj lshkafk ksÜgdjg iqj l< fkdyels frda.hla' isÿjkafka md,khla ú;rhs''' @ ksjeros m%;sldr" ksjeros wdydr yd ksjeros úyrk j,g m;a jqKdu oshjeähdj;a kej; we;s fjkafk kE''' fï .ek ;jÿrg;a úia;r lrkak mq¿jkao @ oshjeähd frda.fhaoS fndfyda úg isÿ jkafka w.akHdYh ÿ¾j, ùu' w.akHdYfhka isÿ flfrk uQ,sl l¾;jHh ;uhs bkaishq,ska kue;s fydafudakh ksIamdokh lsÍu' reêr ma,diaudfj ;sfnk .aÆfldaia m%fhdackhg .kak fï bkaishq,ska wjYHuhs' zz.aÆfldaia mßjD;a;ShZZ lshkafka;a fï l%shdj,shguhs' .aÆfldaia mßjD;a;Sh wvd, ùfuka fï .aÆfldaia foay ffi, j,g we;=,a ù tys Yla;sh yd fmdaIKh iemhSfï l%shdj,sh wvd, jkjd' fï wjia:dfõoS reêr ma,iaudfõ jeä jeäfhka .aÆfldaia tl;= fjkjd' fuhhs zzoshjeähdjZZ f,i wre;a oelafjkafka' f,a j, ;sfnk .aÆfldaia wvq lsÍu ;uhs wo ojfia mj;sk ffjoHl¾u j, m%uqL W;aidyh' kuq;a wdhq¾fõofha wm wjOdkh fhduq lrkafk frda. ksOdkhg m%;sldr lsÍug' wfma T!IO doctormagazine.lk

w.akHdYh mqk¾ckkh uQ,sl lr.;a m%;sldr l%uhla' Tfí m%;sldr l%uh ms<sn|j wmg ye|skaùula l< yelso @ uq,ska lS uQ,O¾uh" ÿ¾j, jQ w.akHdYh m%lD;su;a lsÍu ;uhs uf.ka isoaO fjkafk' wfma T!IO u.ska w.akHdYfha mqk¾ckkSh fjkila isÿ fjkjd' tu.ska th wvd, ùulska f;drj bkaishq,ska ksmoùula isÿ lrkjd' ta;a tlalu ksmojk bkaishq,ska mgl yryd úêu;aj .aÆfldaia hdukh lsÍug;a fï T!IOu l%shd lrkjd' w.akHdYh m%lD;su;a lsÍug Tn lghq;= lrk wdldrh wmg úia;r lr fokak mq¿jkao @ uOqr rih nyq, iSks wdoS meKs ri j¾." msIaGh iys; wdydr .;aúg ksrdhdifhka reêrfha iSks uÜgu jeä fjkjd' th ;=<kh lrkak kï jeä jYfhka bkaishq,ska ksmoùu wjYHhs' ta;a oshjeähd frda.sfhl=f.a w.akHdYh kshñ; ld¾hlaIu;djfh;a kE' fï ;;a;ajh ;=< jqK;a ksIAmdokh jeä lsÍug .kakd W;aidyfhaoS w.akHdYh ;jÿrg;a ÿ¾j, ùula fjkak mq¿jks' ta yefrkakg w.akHdYh ÿ¾j, fjkakg n,mdk

wfmka m%;sldr .kak wh ;ukaf.

YÍrfha tf;la mej;S ;o nj" r¿ nj" nr .;sh bj;a fj,d kskao fkdhdu" ks;r mj;sk ksosu; wdoS ;;a;ajhka u. yefrk nj mjikjd' ysfia lelal=u" nv mqrjd oeóu" we`.mf;a wudre" flaka;s hdu" kqreiakd.;sh jf.a ;;a;ajhka neyer fj,d ldhsl udkisl iqjhla we;s lrkak wdhq¾fõo fnfy;a iu¾: fjkjd' ;j;a fya;= ;sfnkjd' uoHidr" wï, rie;s wdydr" WIAKdêl wdydr" úúO rildrl" j¾Kldrl''' fïjd;a wys;lrhs' fïjd wï,ms;a;h fkdfyd;a .eiag%hsáia we;s lrkjd' wdydr cS¾Kl moaO;sfha úIu;d we;s lrkak uq,a fjkjd' Tn wï,ms;a;h .ek;a fjfiiska i|yka lrkjd''' @ oshjeähdjg jf.au ldhsl frda. úYd, m%udKhlg wdydr cS¾Kl moaO;sfha úIu;d n,mdkjd' wdydr cS¾Kl

November 2016

DOCTOR MAGAZINE

129

D•Magazine /

frda.hg fkdj frda. ksOdkh n,d lrk m%;sldr udos,shla wdhq¾fõofha wmg ;sfnkjd'''

wdhq¾fõoh

hqIhkayS fjkiaùu fyda wkqmd;hka fjkiaùu ksid wm .kakd wdydr yßyeá osrjkafk kE' .eiag%hsáia lshkafk;a fï wkQj we;s jk frda.hla' fï ksid YÍrhg wjYH ksishdldr fmdaIKh fkd,eî hkjd ú;rla fkdfjhs úIu f,i fyda w¾O jYfhka cS¾Kh jQ wdydr YÍrhg úIla f,i l%shd lrkjd' fï ksid ld¾hnyq, wjhjhla jk w.akHdYh ÿ¾j,Ndjhg m;aùfï wjia:d ;jÿrg;a by< kexfjkjd' .eiag%hsáia jeks ;;a;ajhka fï ksid l,a fkdyer iqjm;a lr.; hq;=hs'

130

November 2016

Tn;=udf.a m%;sldr l%shdj,sh .ek hï úia;rhla lf<d;a''' @ wdydr cS¾Kfha mj;akd úIu;d u.yerùu uf.a m%;sldr l%ufha iqúfYaIS ,laIKhla' l=i.skak j¾Okh ùu" wdydr fyd|ska cS¾Kh ùug fuh fya;= fjkjd' u<noaOh" úáka úg u< msgùu jeks nys>%dùh ÿn,;d;a fï ksid u.yefrkjd' YÍrfha tla/ia ù we;s úI fldgia neyer,Su;a fï T!IO j,ska flfrkjd'

DOCTOR MAGAZINE

Tfí fnfy;a mdúÉÑh myiqhs @ uu fnfy;a ksIamdokfhaoS kjH ;dlaIKh;a Bg tl;= lr.kakjd' fnfy;a jÜfgdare ,shdoSfuka neyerj" ;ïnd ms<f s h, l< lIdh fnda;,a f,iu ,nd fokjd' we;eï lIdh j¾. fm;s f,i ilia lr ;sfnkjd' óg wu;rj .=,s j¾." pQ¾K j¾."l,al" lajd: wdosh;a myiqfjka m%fhdackhg .; yels fia ksIm a dokh lr ;sfnkjd' fï ksid .=Kd;aul w.fhka by< fï fnfy;a wfma frda.k S g a myiqfjkau mdúÉÑ lrkak;a mq¿jks' DM

doctormagazine.lk

fnda fkdjk frda. ksÜgdjgu iqjlr.kak ldhsl frda. < .eiag%hsàia <Èhjeähdj < fm%I¾ < fldf,iagfrda,a < ysiroh < u<noaOh < w¾Yia" < kskao fkdhdu < wêl ksÈu; < mSkia frda. <w;a md ysßh < m¨oeóï leiSï wdY%s; úúO ifï frda. < jd;rla;" uq;%d frda. we;=¿ ish¨ ksoka.; frda.' ,sx.sl frda. < Èhjeähdj iy fjk;a ldhsl ;Fjhka ^WIaKdêl nj jeks& ksid yg.;a ,sx.sl fn,ySk;djh < mqreI Yla;sh ÿj_, ùu < ,sx.dY%s; isks÷ iu u;=msg me,Su jeks ;Fjhka' ldka;d frda. < oreM, mudùï < Tima fodaI < .¾NdI.; frda. < rla; m%or < Yafõ; m%or ^iqo hdu& Leucorshoea.

ish¿ frda. ;;a;ajhka wdhq¾fõo m%;sldr uÕska ksÜgdjgu iqjlr.ekSu i|yd yuqjkak' ^/lshdjka lrk w;r;=r myiqfjka Ndú;hg .; yels mßÈ T!IO ilia lr we;'&

wdhq¾fõo ffjoH rkam; rejka r;akdhl

rkam; fjo ueÿr 663" kqjr mdr" mE,shf.dv

wdhq',s'm' wxlh 13869 doctormagazine.lk

071 300 90 88 011 4 344 599

mÜáh ykaÈh fchrdÊ m%kdkaÿmq,af,a .=jka md,u wi, November 2016

DOCTOR MAGAZINE

131

132

November 2016

DOCTOR MAGAZINE

doctormagazine.lk

D•Magazine /

Fertility Capsule Baby Technology

orejka ke;s wUqieñhkg msysgg tk kj;u Capsule Baby ;dlaIKh orejka ke;s wUq ieñhkag ,; fkdù" ;ejq,a ixld fkdue;sj ;u n,dfmdfrd;a;= bgq lr.kakg k< ore ;dlaIKfhka ,enqfKA wkqmfïh iïudouls' tys ;j;a úma,ùh ikaêia:dkhla we;s ù ;ju;a jeä l,la .;ù fkdue;' ta Capsule Baby ;dlaIKh jYfhka m%p,s; kj;u ore iïm;a <`.d lroSfï ;dlaIKhhs' fuf;la Ndú; k<ore ;dlaIK jHjydrhkaf.a fmdÿ iudk;d /ila ;sìK' wê;dlaIKh weiqre lr.;a ridhkd.dr ixfiapk l%shdj,sh" fï W;aidyhka .ekSug jehjQ wêl msßjeh ta w;r m%Odk úh'

l<,fõo úfYaI{ ffjoH fy<rejka mikal=udr iu. l< idlÉPdjla weiqßKs

doctormagazine.lk

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

November 2016

DOCTOR MAGAZINE

133

D•Magazine /

CAPSULE BABY TECHNOLOGY

Fertility

Capsule Baby ;dlaIKh fï wNsfhda. folu ch.kakg fndfyda hqj,j,g wkQmfïh wjia:djla Wod lr ÿkafkah' fuysoS orejd cSjh wrUkafka ;u ujf.a .¾NdIfhaoSuh' wef.a WKqiqu ,nñka wjYH iajdNdúl YÍr mßir ;;a;aj hgf;au orejdg jefvkakg ,eîu fl;rï jdikdjlao @ Capsule Baby ;dlaIKh fuys oS isÿ flfrkafka fhdaks ud¾.fha ;ekam;a l< yels úfYaIs; l=vd ma,diaála r|jkhl cSjhla wdrïN ùug wjYH idOl ,ndoSuhs' cSjhla wdrïN lsÍug äïn yd Y=l%dKq ;sìh hq;=h' .¾NdIfhaoS kï fï äïn yd Y=l%dKq j,g jefvkakg m%Yia; mßirhla ;sfí' ta;a ma,diaála r|jkhl ta udOH fldhskao @ fï ksid INVOcell r|jkhg uq,skau oukafka fï frdamk udOHhhs' ;j;a f,ilska lsõfjd;a ckldKq j,g jefvkakg wjYH wdydrhs' bka miqj äïn lsysmhlao Y=l%dKQ lsishï mßudjlao thg oukq ,efí'

;sfí' wjg mßirh iu. ldnka vfhdlaihsâ yd Tlaiscka jdhq ixirkhg yelshdj ,efnk fia fï úYañ; WmlrKh ks¾udKh lr ;sfí' fï wdldrfhka ckldKq yd tajd ixfiapkhg wjYH frdamk udOH wka;¾.; l< iSrejg INVOcell r|jkh bkamiq .¾NdIfha ;ekam;a flfrhs' th .¾NdIfha uekúka ia:dk.; jkq msKsi ;ekam;a lrkafk ldka;d fldkavuhla fhdodf.khs' Women having IVF can now incubate embryos in their own bodies before they are implanted in the womb. Incubation device could work as well as conventional IVF and be far cheaper. ó<`.g ;sfnkafka wisßu;a ixfiapkh''' th .¾NdIfhaoSu isoaO fjk ksid th w;sYh iajdNdúl ;;a;aj Wreu lr.;a ixfiapkhla' WIaK;ajh md,kh lrk bkalshqfíg¾ fuhg wjYH jkafka;a kE''' B<`. mshjf¾os isoaO fjk foa .ek jo fjkak ´ks;a kE' fndfydu iajdNdúl úosyg ixfiapkh isoaO fjkj' bkamiqj isÿúh hq;= cSj úoHd;aul ixisoaêka md,s; mßirhla hgf;a fkdfjhs" ujf. isrefr WKqyqu

fï ish,a, ord.;a INVOcell r|jkh .ek úfYaIfhka lsj hq;a;la 134

November 2016

DOCTOR MAGAZINE

WHAT IS INVOCELL? INVOcell is a medical device that turns your vagina into an incubator.

Your doctor performs an egg retrieval, then combines eggs and sperm in a small plastic device which then is placed in your vagina for three days. The device is held in place by a diaphragm.

doctormagazine.lk

ú|sñkau isoaO fjkjd' fï úosyg cSjhla ìys fjkak wjYH idOl iïmQ¾K lrñka isref¾ ;ekam;a l< INVOcell r|jkh ojia mylg miafi bj;a lr mÍlaId lrkjd' fuysoS ridhkd.drfhaoS ixfiaÑ; l<, w;ßka jvd;au ksfrda.S l<,h y÷kd.kakjd' th ;uhs l=fia ;ekam;a lrkafk' fï ksid IVF ;dlaIKfhaos jf.a nyq ore Wm;la isoaO fjkak wjia:djl=;a fuysos ,efnkafk kE' ukd úoHd;aul f;aÍula isÿfjk ksid fyd|u l<,h ;uhs úlikh ù ore iïm;la úosyg uõmshka foda;g imeñfKkafka'

Stages in Blastocyst ivfgenesis.wordpress.com

ó<`. mshjr ;uhs iSrefjka f;dard.;a fyd|u l<,h ujf.a .¾NdIfha ;ekam;a lsÍu' f;dard.;a l<,h ;ekam;a l<dg miafi wef.a .¾NsKSNdjh fndfydau idudkH tlla' th idudkH .¾NsKshla .; lrk úosygu .; ld¾hh jvd;a ir< lrKQ msKsi ìysjQ ;dlaIKhla' ta ksidu fï ;dlaIKh Effortless IVF hkqfjkao ye|skafjkjd' iajdNdúl l%u j,g lsÜgqfjka hk ksid id¾:l;ajh ,eîfï by< bvlvla ;sfnkjd' úhou wvqùu" ksYaÑ;j y÷kd.;a l<,h ;ekam;a lsÍug ,eîu jeks lreKq;a fï ;dlaIKfhaos jdishg ysákjd' mqreIhdf.a Y=l%dKq mßudj wvqùu ksid .eí .; fkdyels jk ldka;djka rdYshla isákjd' fï INVOcell ;dlaIKfhka Tjqkaf. .eg¿jg b;d id¾:l ms<s;=rla ,efnkjd'

doctormagazine.lk

id¾:l .eí .ekSula i|yd idudkHfhka mqreIfhl=f.a Y=l%dKQ m%udKh ñ,shk 40-300 w;r m%udKhla wjYH fjkjd' Tn uú;hg m;a fõú''' ñ,shk 0'3l Y=l%dKq wvq m%udKhlg;a fï l%uhg ore iïm;a ,nd.kak mq¿jks' id¾:l;ajh flfryS n,mdk wjfYaI ldrKd ore iïm;la ,nd.kak idudkHfhka WmldÍ jk ldrKd ish,a,u mdfya fuysoSo id¾:l;ajhg n,mdkjd' wvq jhiska fuhg fhduq fjk úg wjia:dj jeähs' fyd| wdydr isß;la ;sîu" fi!LHiïmkak cSjk rgdj" u;ameka yd ÿïmdkh jeks ÿisß;a j,ska je<lSu id¾:l;ajfha wjia:dj jeä lrkjd' .¾NdIfhka ridhkd.drhg .sh wisßu;a ñksia ixfiapkh kej;;a ridhkd.drfhka .¾NdIhg le|jdf.k wd ;dlaIKh Capsule Baby ;dlaIKh wo k<ore ;dlaIKfha ;dlaIKsl l%shdj,sh ie<lsh hq;= uÜgulska udkqISlrKh lr ;sfnkjd' k<ore ;dlaIKfha l+gm%dma;sh iksgqyka jk fï hq.fhau ;dlaIKhg tfrysj lsishï úfrdaOdl,amhlao iudcfha f.dvke.S ;sfnkjd' th lsishï

November 2016

DOCTOR MAGAZINE

135

D•Magazine /

CAPSULE BABY TECHNOLOGY

Fertility

yeu flfklau jev wdrïN lrk ;ek''' wm yeu flfklaf.u cSú;h wdrïN jkafk ixfiapkh jqKQ tla ffi,hlska' th äïnhl yd Y=l%dKqjl iqixfhda. fhka yefok ffi,hla' wïuf. äïnh;a ;d;a;f. Y=l%dKqj;a fï tal ffi,sl wdrïNh iksgqyka lrkak WmldÍ fjkjd jf.auhs t;eka mgka úlikh jk YÍrhg fï fofokdf.au .;s ,laIK" cdk Wreu fjkjd' ixfiapkfhka ojilg miafi ffi,h ffi, folla fjkjd' ojia follska ffi, y;rla fjkjd' ;=kafjks ojfia th wgla fjkjd''' Th úosyg ;uhs wfma cSúf;a ks¾udKh jkafk''' iudc l;sldj;lao fï jk úg we;s lr ;sfnkjd' fï wNsfhda.hg ms<shula f,i Capsule Baby ;dlaIKh wmQ¾j ms<s;=rla úoHdfjkau

136

November 2016

Capsule Baby ;dlaIKh weiqf¾ ore iïm;la ,nd.kak wdldrh fï ùäfhdafj wmQrejg úia;r fjkjd' n,kak''' https://youtu.be/fEmItDr4Zw8

,nd fokjd' .¾NdIfhka ridhkd.drhg .sh wisßu;a ñksia ixfiapkh kej;;a ridhkd.drfhka .¾NdIhg le|jdf.k hñka k<ore ;dlaIKfha fojk ú,ma,jh iksgqyka lrkafka fï Capsule Baby ;dlaIKhhs' Capsule Baby ;dlaIKh ms<sn|j Tng we;s .eg¿ j,g oeka m%ùK l<,fõosfhl=f.ka ms<s;=re ,nd.; yelshs' fï iïnkaOfhka Tng wjYH ´kEu f;dr;=rla ,nd.ekSug wu;kak 0779728799 ke;fyd;a msh k.kak" kqf.af.dv" Wvyuq,af,a" mrK fldÜgdj mdr" li.yj;a; mdf¾ WISH Fertility & IVF Clinic fj;' DM

DOCTOR MAGAZINE

doctormagazine.lk

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

ì%;dkHfha iqÿiqlï ,enQ idhksl úfYaI{ ffjoHjrfhl=f.a fiajh ,nd .ekSug 011 2836 788 ÿrl:k wxlhg wu;kak'

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

WISH Fertility & IVF Clinic No.393/6, Kasagahawaththa Road, Old Kottawa Road , Udahamulla, Nugegoda , Sri Lanka.

Tel: 077 9728 799, 077 3273 866 E mail: wishiuiivf@gmail.com 83 2016 iema;eïn¾ l<dmhWeb: wishiuiivf.com doctormagazine.lk

November 2016

DOCTOR MAGAZINE

137

AD-MIRE Creative

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

ive s clu Ex

D•Magazine /

Health & Fitness

iqj;djh yd ksfrda.S;djh Wfoid i;=áka cSú;h fjkia lr .ksuq

Health

& fitness

tlai;a rdcOdksfha ffjoH iNdfõ úfYaI{ ffjoH wix. úchr;ak úisks

iqj;djh yd ksfrda.S;djh Wfoid i;=áka cSú;h fjkia lr .ksuq

ks

frda.SNdjh;a /lf.k" YÍrh w,xldrj ;ndf.k cSj;a fjkak wlue;s ljqo @ ksfrda.S;djh lshkafk iqj;djh /lf.k cSj;a ùuhs' YrRh w,xldrj;aj ;nd.kak fhda.H;djh wjYH fjkjd' Wellness and Fitness''' fuh cSú;hl .=Kd;aulNdjhg wjYHfhkau ;sìh hq;= ldrKd folla'

jeros oeKqu Nhdklhs fï iïm;a;Ska yiqrejd.kak tl fldhs ld,fh;a ck;djf.a me;=u jqKd' tl,g jvd wo fï wjYH;d imqrd.kakg wfma mrïmrdfõ Woúh lghq;= lrk wdldrh ;rula fjkia''' lg jpkfhka" fmd; mf;ka jf.au wka;¾cd,fhka" uqyqKqfmdf;ka oeKQj;a jkak W;aidy .kakd wh;a wo ojfia tugj;a' oeKqu ,nd .ekSfï wfma W;aidyfhaoS ta uQ,dY% ksjeros yd úYajdikSho lshk ldrKh .ek wm fndfydau ie<ls<su;a úh hq;=hs' j.lSï úrys; whf.a Wmfoia wrf.k ;snqKQ fi!LH iïmkakNdjh;a ke;s lr.;a Woúh wfma iudcfha ´kE ;rï isákjd' fï ksid j.lSulska hqla;j Tfí fi!LHh yd fhda.H;djh /l.kak lshk WmfoaYh wmg m<uqfjkau fokak isoaO fjkjd'

138

November 2016

DOCTOR MAGAZINE

doctormagazine.lk

f,dalh mqrd ck;djf.a ieye,a¨ cSjk fmj; Wfoid jákd .=reyrelï fok wdh;khla ;sfnkjd' American College of Sports Medicine (ACSM) Tjqkaf.a Wmfoia w;sYhskau úoHd;aulhs' ta Wmfoia ms<smoskak l%Svlfhla fjkaku ´fk;a kE' fldhs ljqre;a ta Wmfoia ms<smeoafod;a jdish ta whguhs' lS¾;su;a Doctor Magazine iu.ska wm fï l,dmfha isg Tfí cSjk p¾hdjka jvd;a hym;a lr.kakg bjy,a jk .=reyrelï /ila Tn yuqfõ ;nkakg wm doctormagazine.lk

woyia lrkjd' fï tys m%drïNhhs' uq,a mshjrhs'

Fitness fhda.H;djh hkqfjka ye|skafjkafka ljrlao @ YdÍßl" udkisl jf.au idudcSh jYfhkq;a ;ukaf. ksfrda.S;djh mj;ajd .ekSu fhda.H;djhhs'

Wellness iqj;djh hkqfjka ye|skafjkafka ljrlao @ YdÍßl" udkisl yd idudcSh ksfrda.S;djh i;=áka" ndOdjlska f;drj l%shd;aul ùu iqj;djhhs'

Dr. Asanga Wijeratne is a Human kinetic specialist and the only sports scientist in South Asia for this specific purpose.His expertise focuses mainly in Fitness & Wellness,Sports Nutrition,Exercise Counseling & Therapy ,Sports Physiology/ Psychology, Human Kinetics & Sports Medical Science,Physical Education & Scientific Sports Coaching , Surgery Recovery, Injury Prevention & Special Needs Training.

November 2016

DOCTOR MAGAZINE

139

D•Magazine /

iqj;djh yd ksfrda.S;djh Wfoid i;=áka cSú;h fjkia lr .ksuq

Health & Fitness

ysf;a ÿlla ;shdf.k Fitness fidhkak tmd''' mjqf,a ffjoHjrhd wk;=re y`.jk ksidu jHdhdu lrk wh wm w;r bkakjd' YÍrfha nr oel, nh jqKdu jHdhduh u;la fjk wh;a bkakjd' wfma we;efula csï tlg hkafk'' ux;Sre j, weúoskafk''' iqïnd mx;s hkafk''' uyd wd;;shl=;a ysf;a ordf.k''' wdydr md,khla we;s lr.kak W;aiql jkafk ;ukau th fyd|hs lsh, ys;k ksid fkdfjhs''' mk fír .kak ´ks yskao''' b;ska wdydr ál wvq fjkfldg uyd ÿlla ysf;a we;s fjkjd' fï úosyg wdhdifhka wfma mqreÿ fjkia lrkak .kak W;aidyhka wid¾:lhs' fï yeu fohlau lrkjd kï lrkak ´ks i;=áka' jHdhduh i;=áka lrkak ´ks''' vhÜ lrk tl;a i;=áka lrkak ´ks''' fuhska ,efnk hym;a m%;sM< j,g uq,skau Tn wdi fjkak ´ks' ta i|yd wkq.ukh lrk ud¾. fha fid÷re u`.igyka w;Efrkafk th nrla lr.;a;uhs' ta ksid ta

140

November 2016

fid÷re u`. i<l=KQ iam¾Y lrñka iqj;djfha" fhda.H;djfha .uk hkak Tn bgdkak ´ks' fu;eka mgka Tfí cSú;fha Okd;aul fjkila fjkqfjka wm b`.s ,nd oSu wdrïN lrkjd'

Tfí ys;lr YÍr nr m%udKh y÷k.kak myiq l%uhla''' uq,skau Tfí Wi fikaáóg¾ j,ska uek. kak' tu ,enqKQ w.fhka 100la wvq lr.kak' WodyrKhla fokakï' Tfí Wi fi'ó 165 kï bka 100la wvq lr 65 hhs igyka lr.kak' fï wdmq W;a;rhg fi'ó' fjkqjg lsf,da .a?ï hkqfjka wdfoaY lr.kak' fuh ;uhs Tng ;sìh hq;= Wmßu nr m%udKh' by; WmyerKh wkQj Tfí YÍr nr lsf,da .a?ï 65g jvd wvq úh hq;=hs' BMI w.h tlal yemafmkak .syska uki wjq,a jqKq whg fï kj l%uh fyd| wdrïNhla' fï úosyg b,lal ;nd. kak tl yßu myiqhs' úoHd;aulhs'

DOCTOR MAGAZINE

ojilg Tng wjYH jk j;=r m%udKh oeka wms ;j;a mshjrla bosßhg huq' ojilg j;=r fldamam wÉpr fndkak ´ks''' fuÉpr fndkak ´ks''' tl tl l;d''' yß tl`.;djhla kE''' oeka Tfí nr lsf,da .a?ï j,ska uek.kak' th yf;ka fnokak' Wodyrkhla f,i lsf,da .a?ï 70la nr flfkla nr 7ka fnÿju ,efnk W;a;rh 10hs' fïl ;uhs Tyq ta ojig mdkh l< hq;= j;=r mßudj''' m<;=re úosyg yß lEu úosyg yß fudkhïu úosyg yß fï j;=r m%udKh Tyq YÍrhg wjfYdaIKh lr.; hq;= jkjd' wfma YÍr fi!LH uekúka mj;ajd .kakg m%udKj;a ic,khla mej;sh hq;=uhs' tfia fkdùfuka Tfí cSú;h lsysmdldrhlska wjodkulg ,la fjkjd' fï ksid Tfí orejd l=vd ld,fha isgu m%udKj;a ic,khla mj;ajd .kakg Wmfoia fokak'

meyeir iqj b`.s (Health Tips) lsysmhla iu.ska foieïn¾ l,dmfhkq;a yuq fjuq' DM

doctormagazine.lk

doctormagazine.lk

November 2016

DOCTOR MAGAZINE

141

142

November 2016

DOCTOR MAGAZINE

doctormagazine.lk

D•Magazine /

Advertorial Wor uÜgq .%Ska y¾n,a fïo yrK pQ¾Kh

Tfí YÍrfha fïoh oshlr isyska isrerla ,nd fok cd;Hka;rh oskQ fy< wdhq¾fõo Tiqj

Wor uÜgq .%Ska y¾n,a fïo yrK pQ¾Kh

f.drld" iqÿ¿Kq lrmsxpd yd ;j;a wuqøjH oy wgla weiqf¾ ksIamdokh lrk n,.;= T!IOhls' ia;%S" mqreI" f,dl=" l=vd ldg;a iqÿiqh' iïmQ¾K Ydlidr pQ¾Khls' úfoaYhka i|ydo wdkhkh lrk w;r úYd, b,a¨ula úfoaYhkaf.kao fõ' Wor uÜgq ,nd .ekSfuka we;sjk m%;sM< oskm;d udihla mdkh lsÍfïoS YÍrfha nr lsf,da .a?ï 3 lska wvq lr.; yel' fmKqfuyso ie<lsh hq;= fjkila we;s jkafkah'

ia:q,;djh frda. /ilg fya;=jls' wêreêr mSvkh" oshjeähdj" wd;rhsáia" wï, ms;a; frda.h wdosh we;sùug YÍrfha wêl fïoho fya;=jla fjhs' ishhg ishhla Ydlidr muKlau Wmfhda.S lrf.k ksIamdokh lrk ,o fuu zz.%Ska y¾n,a Wor uÜgqZZ Ydlidr pQ¾Kh Tfí isref¾ ia:q,;djh ke;s lrhs' fïoh uekúka oykh lrhs' rildrl" fjk;a wdl,k" fydafudak lsisjla wvx.= ke;' .eg¿ /ila tljr úi|k fnfy;la ia:q,;djh" wêl fldf,iagfrda,a" Worh úYd, ùu" wêreêr mSvkh fukau wdudY.; wcS¾K ;;a;aj mjd ke;s lrhs'

uekúka m%;HlaI l< T!Iëh wdkqmdk j, .=Kh ksid lsisÿ ixl+,;djhla we;s fkdfõ' osjhsfka jeä fofkla úYajdifhka mdúÉÑ lr Worh isyska lr .kshs' ta;a iu.u f,v frda. /ila iqj lr .kshs' .%Ska y¾n,a fjo ueÿr Ñrd.; T!Iëh iïm%odfha ;j;a m%d;sy¾hd;aul Tiqjls' Ndú;h i|yd úuiSï ffjoH lreKd .uf.a 0775507381" 0776165705 wdhq' ksIamdok wxlh 6$2$1$04$15

doctormagazine.lk

November 2016

DOCTOR MAGAZINE

143

ffjoH lreKd ^wdhq¾'& .d,a, 0776165705 ffjoH .d,a,f.a ^wdhq¾'& yslalvqj 0719657897 ffjoH iqcSjkS úl%uisxy ^wdhq¾'& háhkaf;dg 0362270437 ffjoH oSmsld iQßhwdrÉÑ noafo.u 0711539432 ffjoH l=udß lreKdr;ak ^wdhq¾'& .ïfmd, 0814485534 fca'ã' isßudk ^wdhq¾'& wúiaidfj,a, 0773678335 ffjoH pkaok Whl=udr je,sfõßh ^wdhq¾'& 0777063034 ffjoH ví'ta'tia'úodkwdrÉÑ ^wdhq¾'& fk¿j 0716272745 ffjoH bkaosl m%kdkaÿ ^wdhq¾'& j;a;, 0712019811 we,amsáh" l=re÷.yye;elau cSjl Tiqi, fnd/,a, isxy, wdhq¾fõo Tiqi, fjdaâ maf,aia mdr uykqjr fndaj;a; T!IOd,h" fld<U ùosh l=reKE., o ksõ *duis merl=ïnd ùosh" cSjka; Tiqi, .d,a, hqkhsgâ *dud" tlai;a Tiqy, ud;r hqkhsgâ *dud" fldgqf.dv Tiqy, l¿;r hqkhsgâ *dud" lgql=rekao" uqksr;ak" ÿïßhm< mdr nKavdrfj, iriú Tiqi, lelsrdj ßá., Tiqi, r;akmqr nqoaêl *duis nia kej;=ïm< wi, mdkÿr Woh T!IOd,h" uy ùosh ;,j;=f.dv Ydks *duish l<,af.dv yxosh uyr.u kkaok Tiqi," yhsf,j,a mdr kqf.af.dv úch Tiqi, kdj, mdr kkaok Tiqy," mrK leianEj mdr lsßn;af.dv isxy, fnfy;a nvq fj<|ie, kqjr mdr" udfld, mdr lvj; iq,,s; Tiqi," fffjoH .`.nv cdwe, iuka Tiqy,"iqcSj Tiqy, ó.uqj ,xld *duish" w,shußlald¾ wkqrdOmqrh t,a î fla T!IOd,h udlÜ fmfoi fmdf<dkakrej cSjl T!IOd,h" ,xld fuäl,a

lÿrefj, wïmdr iïm;a Tiqy, ys`.=rlaf.dv iïm;a Tiqy, uyshx.kh cSjdkkao Tiqy, uyjej Wcs;a iafgda¾ia y,dj; mdr nÿ,a, wókd wdhq¾fõo Tiqy, my< ùosh lsß|sje, iqks,a Tiqy, msgfldgqj" noafoa.u iagda¾ia" u,aj;a; mdr fldïm[a[ ùosh ksu,a fmf¾rd 0777955934 lvqfj, lvqfj, fuäl,aia ms<shkao, l=udrisxy Tiqi, iqm¾ udlÜ wxl 1 lE.,a, lE.,a, T!IOd,h uy ùosh" iriaj;S Tiqi, ud;f,a ridla wdhq¾fõoh fldáldj;a; ykaosh Wodr Tiqy, fydaud.u .=Kisß Tiqy, n,xf.dv Y%S fi;a isxy, fnfy;a lfâ ;dkdhu wi, rd.u ;s,l Tiqi, rdc.sßh ú,aika wdhq¾fõo Tiqy, fmd,a.yfj, fmd,a.yfj, Tiqy, lgqneoao ld¾ñl ixj¾Ok uKAv,h fj<|ie, u;=.u isxy, fnfy;a nvq lfâ nÿr,sh osuq;= *duish fydrK j,amsg Tiqy," fikag%,a *duish fldÜgdj iqfj,akd Tiqy, jdoaÿj iriaj;S Tiqy, w¿;a.u ,skafka wdhq¾fõo Tiqy, n;a;ruq,a, úmq, Tiqy, kqjrt<sh úydkd wdhq¾fõoh" HERO Tiqi, ;x.,a, YHdkq *duish je,s.u lfrda,sia mq;%fhda ÿïßhfmd< mdr .ïmy biqr *duish" Tref;dg mdr" .hdka tackaisia ñKQjkaf.dv Ydka;s Tiqi, wxf.dv isxy, fnfy;a nvq fj<|ie, fudKrd., ,laisß *duish" hibiqre uq,af,aßhdj Drug City Tiqi, n;a;ruq,a, fldiaj;a; TiqOr kd;a;kaäh kd.=¾wmamd

www.hairlanka.com ksIAmdokh .%Ska y¾n,a m%vlaÜia fm!oa.,sl iud.u" .=rej;a; j,õj" ñáhdf.dv fg,s ( 077-5507381 *elaia( 0914944082 ,s'm' wxlh PV 70430 144

November 2016

DOCTOR MAGAZINE

doctormagazine.lk

AD-MIRE Creative

flaYuQ, ;r,h iy .%Ska y¾n,a wfkl=;a ksIamdok ,nd.; yels osjhsk mqrd Tiqi,a iuyrla