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Dengue In Children

Dengue in Children

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Written by Dr. B.J.C. Perera

dengue in children

There have been reports of high rise in cases of Dengue in Colombo and other parts of the country over the last several years. Dengue is a disease that could affect children and adults, and affects people irrespective of caste, creed, religion, or social status. The word Dengue is derived from the word “Ka – Dinga pepo” in the Swahili language and is pronounced as Dengi. The word in Swahili refers to an illness with cramps. One of the cardinal features of the disease is severe muscle pain, and perhaps the word was derived from Swahili to denote this important clinical feature. At other times, the condition has been called “break-bone fever” as well, referring to the intense limb pains associated with it.

The virus that causes Dengue was isolated in the 1940s, and there are four types of the virus that causes the disease in humans. Outbreaks of the disease are due to one or more of these four serotypes. The disease is transmitted by one of two species of mosquitoes known as Aedes aegypti and Aedes albopictus. The disease has a vast range of severity and presentation. In some children, it could present as the ordinary flu or viral fever, while in others, it could be a severe life-threatening illness. It depends on several factors such as the virulence of the infecting virus, the immunity of the individual, and whether it is the first attack or not. Attack by one type of virus does not confer immunity to the other three types. When there are second, third, and fourth attacks of Dengue in an individual, the incidence of the complications increases. This is due to the production of a type of antibody by one strain of the virus that enhances the effects caused by another strain. Some of these antibodies are not protective but augment the complications and deleterious effects of the other strains of the virus.

dengue symptoms

Symptoms and Signs of Dengue

Dengue fever starts just like any other viral fever. It commences with a high swinging fever, often associated with intense muscle and joint pains. The fever usually responds poorly to simple fever-lowering medications like paracetamol. The child may feel ill at times of fever, but in milder cases, especially when it is the first attack, the child may not feel too bad. After a couple of days, the fever appears to get better, only to flare up again within a day or so. This is generally known as a saddle-back type of fever. This second phase is the one that is associated with the dreaded complications of the disease. 

Complications arising through Dengue

The dengue virus induces a peculiar increase in permeability characteristics of the blood vessels leading to uncontrolled fluid movement from the bloodstream to the surrounding tissues. It is also known as the “leaking” of fluid from the bloodstream into the adjacent areas and is commonly referred to as the “leaking phase.” This situation leads to reduced fluid within the circulating compartment and is associated with a fall in blood pressure and cardiovascular malfunctioning. The patient presents in a state of collapse or shock. This is known as the “Dengue Shock Syndrome.”

In addition, the virus causes a certain amount of direct damage to the blood vessels, which leads to a bleeding tendency. The disease also causes a fall in the platelets of the blood, enhancing the bleeding as platelets are intimately involved in the clotting processes of normal blood. This is known as “Dengue Haemorrhagic Fever.” The bleeding manifests as spots on the skin or internal haemorrhage, particularly in the stomach and intestines, and this presents as brownish or blackish “coffee grounds” material in the vomitus or black faeces. 

In some rare cases, the heart is affected, leading to a complication known as myocarditis which leads to heart failure. This particular complication can be troublesome and needs to be managed very carefully. All these complications are associated with an increased rate of fatalities. However, with competent management, these fatalities could be reduced drastically.  

It is essential to point out that the child remains conscious and alert throughout the illness, even when they are quite ill with the dreaded complications. These complications cause death and are much more common during second and subsequent attacks of the disease. The standard, uncomplicated form starts with a high fever and vomiting, and the patient generally feels unwell. The period around the 4th to the 7th day is crucial for the development of the complications. However, many affected individuals go through the illness just like any other form of flu and recover without any problems. However, the more severely affected children feel quite ill, especially during the late phase of the disease that comes on after 3 to 4 days.

Diagnosis could be quite tricky in the early stages

It is noteworthy that a definitive diagnosis could be quite tricky in the early stages of the disease. Although some sophisticated tests such as NS1 Antigen Test could detect the virus even in the first couple of days of the illness, these are not fool-proof and is expensive. These tests detect the virus’s genetic structure using a technique known as the Polymerase Chain Reaction or PCR. The standard blood counts show typical features of any viral infection in the first couple of days. Subsequently, these counts show thickening of the blood caused by an uncontrolled shifting of fluids out of the bloodstream and a fall in the platelet count. The tests to detect antibodies become positive from about the 3rd or 4th day but once again, they are not fool-proof. Negative antibody test does not exclude dengue fever. A characteristic feature in the leaking phase is developing a collection of fluid in the chest around the lung, particularly on the right side. This feature, seen quite well in a chest x-ray, is a significant diagnostic value. Fluid also accumulates in the tummy and is detected by ultrasound scans.

doctor treating child patient with dengue

Immediate medical supervision is essential

A child with Dengue must come under medical supervision as soon as possible. Many of them who do not develop any complications will only need simple measures to control the temperature and would only need further observation. However, if a complication develops, the recovery is determined by how quickly a medical team intervenes with aggressive active management. Many of them would need intravenous fluids to control the shifting of fluids within the different compartments of the body. A lot has been learned during the last decade in managing these patients, and constant vigilance is required practically from hour to hour when there are significant complications. Much can be done in the acute phase, especially if complications develop. All medical facilities in the government sector are quite well equipped to handle these cases, and people in these institutions are the most experienced in dealing with these cases. Although fatalities are highlighted in the media the mortality rate in children is extremely low and is now well under one percent. Unfortunately, up to now, there is no vaccine to prevent Dengue. Quite a few vaccines are still in the trial stage. Thus, preventive measures are directed toward controlling the mosquito population.

Lack of concern for health, rains and abundance of mosquitoes create the ideal breeding ground

There are reports of a resurgence of Dengue Fever in this country from time to time. Some families, unfortunately, have lost beautiful normal children to the disease. The rains do come from time to time, and mosquitoes are everywhere. The usual nonchalance and lack of health consciousness of the people are also abundant. This means the three cardinal ingredients for the perpetuation of Dengue Fever are in place right around the country. It is a disease that conjures up visions of unsavory consequences and death in most people’s minds. Sporadic cases are seen regularly in our medical facilities, and from time-to-time increased incidence of the epidemic, nature occurs practically throughout the country. It is not a new disease, but it is perhaps quite apparent that it has now come to stay. It is most unlikely that any form of control measures undertaken will ever be able to completely eradicate the disease from this country. 

The public in the community must cooperate with the authorities to eliminate the breeding places and habitats of the mosquitoes that transmit this disease. This is certainly not an enterprise that the state could undertake successfully. Civic consciousness, collaboration, and support on the part of the general populace are of paramount importance in any control measures undertaken by the authorities. Most unfortunately and quite sadly, it is almost a national trait of many people to remain apathetic and indifferent in such endeavors as long as the fundamental problem does not affect them directly. It is of the essence to reiterate that Dengue can strike anybody and at any time. A unified and concentrated effort to prevent it is the need of the hour.

This is an excerpt from the book MODERN CHILD HEALTHCARE: A GUIDE TO PARENTS written by Dr B. J. C. Perera. Titles added by the oDoc team.

Dr B. J. C. Perera

Paediatrician

SLMC number 4979

Asiri Medical Hospital in Kirula Road and King’s Hospital (former Oasis Hospital).

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“Good” and “Bad” Cholesterol – What you need to know

“Good” and “Bad” Cholesterol - What you need to know

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Cholesterol is the misunderstood, problem child of wellness and good health. It gets a bad rap, but no one really tells you why it’s there, what it does, or why it isn’t just all bad. In this week’s blog, we break down the what’s what of cholesterol so you will have a greater appreciation of its benefits and why it’s important to keep tabs on its status. 

What is cholesterol? 

Cholesterol is a waxy, fat-like substance found in all the cells of your body. It’s not inherently bad; it has an important function: your body needs it to build cells and make vitamins and hormones. Your liver produces about three-quarters of the cholesterol in your body, and the rest comes from animal foods such as egg yolks, meat, and cheese. However, too much cholesterol can cause problems. 

Cholesterol travels through your bloodstream on proteins called “lipoproteins.” There are 2 types of lipoproteins:

LDL (low-density lipoprotein), or “bad” cholesterol

LDL makes up most of your body’s cholesterol. It’s a larger molecule, so high levels of LDL mean there can eventually be a build-up within the walls of your blood vessels, causing narrowing of the passageways and inhibiting the free flow of oxygen-rich blood. Further, there are possibilities for clots to form and get stuck in a narrowed space, which could lead to a heart attack or stroke.

HDL (high-density lipoprotein), or “good” cholesterol

HDL is the good guy: helping clean up the mess! It travels through your blood, picks up excess cholesterol, and takes it back to your liver, where it is broken down and removed from your body. HDL helps you lower your risk of heart disease and stroke.

Triglyceride

The HDL cholesterol is closely related to triglycerides, a type of fat found in your blood that is stored in your fat cells and later released by your hormones for energy between meals. However, suppose you regularly consume more calories than you burn, especially from high-carbohydrate foods, it may result in high levels of triglycerides​​, which increases the risk of strokes, heart attacks and heart disease.

Usually, those with high triglycerides have a propensity to have low HDL cholesterol levels. The triglyceride/HDL ratio should be below 2 (divide your triglyceride levels by your HDL). If the triglyceride/HDL level is above 4, it is considered a risk, and therefore it is advisable to have a lower ratio by changing diet and taking up exercise. 

Increased triglycerides can be a reliable sign of biliary function, fat metabolism, liver function, and genetic factors. Problems with sugar typically accompany elevated triglycerides (sweet tooth) or adult-onset diabetes. Therefore, maintaining a triglyceride level between 70 and 100 mg/dl is advisable. 

Reduced triglycerides indicate inadequate fatty acid release, hormonal hyperactivity, and perhaps immunological issues.As opposed to simply high cholesterol and LDL/HDL ratios, keep in mind that the triglyceride to HDL ratio is a significantly better predictor of heart disease. It’s crucial to realise that additional factors besides high cholesterol also point to possible issues.

Risk factors that can impact your cholesterol levels

  • Obesity
  • Type 2 diabetes
  • Diet high in saturated and trans fats
  • Lack of exercise
  • Smoking
  • Genes
  • Old age

What are optimal levels of HDL cholesterol?

 

Risk levels

Desirable level

Men

Less than 40 mg/dL (1.0 mmol/L)

60 mg/dL (1.6 mmol/L) or above

Women

Less than 50 mg/dL (1.3 mmol/L)

60 mg/dL (1.6 mmol/L) or above

Cholesterol levels are measured in milligrams (mg) of cholesterol per deciliter (dL) of blood or millimoles (mmol) per liter (L).

How could you keep these numbers in check?

Things outside of your control can also affect cholesterol levels.

Age and Sex – The older you get, your cholesterol levels rise. Before menopause, women have lower total cholesterol levels than men of the same age. After the age of menopause, women’s LDL levels begin to rise.

Heredity – Your genes partly determine how much cholesterol your body makes. High blood cholesterol can be genetic.

Race – Certain races may have an increased risk of high blood cholesterol. For instance, African Americans typically have higher HDL and LDL cholesterol levels than whites.

Many things influence your cholesterol levels, which you have control over.

Physical activity – Though genes and weight may play an important role, your lifestyle choices around diet and exercise also influences your overall numbers.

Eat healthily – Add more fibre (whole grains) to your diet and include healthy fats like olive oil, Avacado and certain nuts. 

Limit your alcohol intake –  Drinking too much alcohol can raise levels of triglyceride fats in the bloodstream and lead to conditions such as high blood pressure and atrial fibrillation.

Consider quitting smoking – Smoking decreases HDL cholesterol.

Check your cholesterol levels – Knowing your cholesterol status can help you control your health.

  • If you are an adult under 45, it is advisable to get your cholesterol checked every 4 to 6 years.
  • If you have heart disease, diabetes or a family history of high cholesterol, it is advisable to check your cholesterol more often.
  • Children and adolescents should check their cholesterol at least once between ages 9 and 11 and again between ages 17 and 21.

Men between 45 to 65 and women between 55 to 65 should check for cholesterol every 1 to 2 years.

Are you unable to go to the hospital to get a test done?

oLabs provides a hassle-free process for checking your calendar and booking mobile lab tests via the oDoc app according to your flexibility. 

  • Convenience – You can simply stay at home and wait for your scheduled appointment time without worrying about traffic or parking. 
  • Safety – You can avoid crowded and potentially germ-filled waiting rooms. Instead of feeling awkward while your test samples are being collected, you can just relax in the comfort and safety of your own home. 
  • Efficiency – If more than one person in your household needs a test sample, we can gather both samples simultaneously. This omits the need for multiple appointments or trips to the collection clinic. 

However, if you wish to discuss more or gain advice on maintaining your cholesterol levels, speak to a general practitioner via the oDoc app from the comfort of your home.

Reference

  1. The Recommended Cholesterol Levels by Age, Healthline (2021).
  2. Nutrition and healthy eating, Mayo Clinic (2021)
  3. Cholesterol, Healthdirect (2020).
  4. Cholesterol ,Mediline plus (2020).
  5. What is Cholesterol? Heart attack and strong symptoms (2020).
  6. HDL cholesterol: How to boost your ‘good’ cholesterol, Mayo Clinic (2020).
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ඔබටත් තුනටියෙන් පහළ ඉවසීමට නොහැකි වේදනාවක් තිබේද?

ඔබටත් තුනටියෙන් පහළ ඉවසීමට නොහැකි වේදනාවක් තිබේද?

තුනටිය ප්රදේශයෙන් පටන් ගෙන කකුල් වල පිටුපස ප්රදේශය දිගේ පහලට මහපටැඟිල්ල දක්වා පවතින වේදනාවකින් ඔබත් පීඩා විඳ ඇත්නම් හෝ එම රෝගයෙන් දැනටමත් ඔබ පීඩා විඳිනවානම් මෙම ලිපිය ඔබට ඉතාමත් වැදගත් වන බව නොඅනුමානයි.
කොඳු ඇටපෙළ ආශ්රිතව ඇතිවන රෝග අතරින් ප්රධානතම රෝගයක් ලෙස මෙම රෝග තත්වය හැඳින්විය හැකිය. මෙහිදී රෝගියාගේ කොඳු ඇට පෙළෙහි පහල ප්රදේශයෙන් ආරම්භවන වේදනාව පාද වල වළලුකර හෝ ඇඟිලි දක්වාම ගමන් කිරීම සිදුවේ. ඇතැම් විට මෙම වේදනාව ඉතා තීව්ර වන අතර රෝගියා ඉමහත් අපහසුතාවයකට පත්වේ.
මෙම රෝග තත්වය ආයුර්වේදයේ ගෘධ්රසිලෙස හඳුන්වයි. එලෙස හැදින්වීමට හේතුව වනුයේ මෙම රෝග තත්වයෙන් පෙලෙන රෝගියාගේ ගමන ගිජුලිහිණියෙකුගේ ගමන් විලාශයට සමාන වන හෙයිනි.
මෙහෙදී සිදුවන්නේ කොඳු ඇට පෙළෙහි පහල ප්රදේශයෙන් ආරම්භ වන පාද වලට ස්නායු සැපයුම සිදු කරන සයටික් ස්නායුව (Sciatic Nerve) තෙරපීමකට ලක් වීමයි. මෙම රෝගයට නිවැරදිව ප්රතිකාර නොකිරීම නිසා පසුකාලීනව පාද ආශ්රිත හිරිය වැනි තත්ව ද ඇතිවීමට හැකිය.
ගෘධ්රසි රෝගී තත්වය බටහිර Sciatica යන රෝගී තත්වයට බොහෝ සෙයින් සමාන ලක්ෂණ පෙන්නුම් කරයි.

මෙම රෝග තත්වය ඇතිවීමට හේතු

  • බොහෝ වේලාවක් සිටගෙන සිටීම
  • බොහෝ දුර පයින් ගමන් කිරීම
  • ගැස්සෙන වාහනවල නිතර ගමන් කිරීම
    උදා:- යතුරු පැදි, ත්රී රෝද රථ ආදී
  • අධික වෙහෙසකර ශාරීරික ව්යායාම වල නිරතවීම
  • අධික ලෙස බර වැඩ වල නිරත වීම 
  • වැරදි ඉරියව් (එකම ඉරියව්වකින් බොහෝ වේලාවක් සිටීමද හේතු වේ)
  • හදිසි අනතුරු.(වැටීම, කොන්ද ප්රදේශයට තද පහරක් වැදීම වැනි)
  • වයස්ගත වීමත් සමඟ ඇතිවන අස්ථි ගෙවීම් (Degenerative Diseases )
  • කොඳු ඇට පෙළ ආශ්රිත ශල්ය කර්මයකින් පසු
  • දරු ප්රසූතියකට පසු
  • සමහර පිළිකා තත්ත්ව (Malignant or Benign Tumor)
  • පෝෂ්යදායක ආහාර නොගැනීම
  • සවස් කාලයේ සිසිල් ජලය ස්නානය කිරීම
  • වෙනත් රෝග තත්ව ( osteoporosis)

මේ හේතු නිසා

  •  කශේරුකාවේ අන්තර් කශේරැකා මඬල (කශේරුකා දෙකක් අතර ඇති කොටස) පිටතට නෙරා යාම (intervertibral disc prolapse) හේතුවෙන් ස්නායු තෙරපීමක් ඇතිවිය හැක. මෙමඟින් ස්නායු ගමන් කරනා මාර්ගයේ යම් පීඩනයක් ඇතිවිය හැක.
  • ස්නායු ගමන් ගන්නා මාර්ගයේ ඇති මාංශපේශිවලට යම් හානියක් සිදුවීමෙන්ද මෙම ස්ථානය පටුවීමක් සිදුව මෙම රෝග තත්ත්වය ඇතිවිය හැක.
  • Sciatic nerve තෙරපීමෙන් (දනහිස නැවීමකින් තොරව කොන්ද නමා බර එසවීමෙන් කටී කශේරුකා වල ඇතිවන වෙනස්කම් නිසා sciatic nerve තෙරපීමෙන්), ස්නායුව ඇදීමෙන් මෙය ඇති විය හැක.
  • කශේරුකා අවහන්දි (dislocation) වීමෙන්.
  • Sciatic nerve හා එහි මූලයන් ආඝාත වීම වැනි හේතු නිසාත්.
  • ස්නායු දිරාපත් වීම වැනි හේතු නිසාද මෙම රෝගී තත්වය ඇති විය හැකියි.
තුනටිය වේදනාව

මෙහිදී ඇතිවන රෝග ලක්ෂණ

  • වේදනාව කටී ( තුනටිය ) ප්රදේශයෙන් ආරම්භ වී තට්ටම්, කලවා, බත් කෙණ්ඩා හරහා පාද ඇඟිලි දක්වා පැතිරේ.
  • පාද වල තද බවක් ඇති වේ.
  • වරින් වර පාද වල ගැස්මක් ඇති වේ.

ආයුර්වේද මතයට අනුව,
තට්ටම් පෙරදැරි කොට පවත්නා ගෘධ්රසී වාතය පිළිවෙලින් උකුල, උරස් ප්රදේශය , පාදයේ පිට පැත්ත, කලව ප්රදේශය , දනහිස , කෙණ්ඩා ප්රදේශය සහ පාදය දක්වා ගමන් කරමින් හිරවීම්, වේදනා, අනින්නාක් බදු වේදනා ඇති කිරීම ගෘධ්රසි ලෙස හදුන්වයි .

දෝෂ තත්වය අනුව මෙහි ප්රභේද 2ක් වේ,
1.කේවල වාතජ ගෘධ්රැසී
2.වාත කඵජ ගෘධ්රැසී

ඉහතින් දැක්වූ පොදු ලක්ෂණ වලට අමතරව

වාතජ ගෘධ්රසියේදී,
පාදයේ තද ගතිය, වේදනාව, හිරි ගතිය, දණහිස් සන්ධි වල ඉදිමීම, උලකින් අනින්නාක් බඳු වේදනාව සහ වරින් වර පාදයේ වෙව්ලීම වැනි රෝග ලක්ෂණ පෙන්නුම් කරන අතර

වාත කඵ අනුබද්ධ අවස්ථාවේදී,
පාදයේ බර ගතිය, අරුචිය, බඩගිනි මඳකම, නිදිමත ගතිය යන ලක්ෂණ පෙන්නුම් කරයි.

  • මෙහිදී ඇතිවන වේදනාව රාත්රියට වැඩිවන අතර, මෙම රෝගින් සවස් කාලයේ ස්නානය කිරීම නිසා සහ සීතල කෑම වර්ග (බණ්ඩක්කා, මෑ කරල්, වම්බටු, කොස් ආදී ආහාර) වැඩිපුර ආහාරයට ගැනිමත්, රාත්රී කාලයේදී ආහාරයට ගැනීමත් නිසා වේදනාව වැඩිවේ.

ප්‍රතිකාර

  •  මෙම රෝග තත්වය නිවැරදි අභ්යන්තර ප්රතිකාර පද්ධතියක් හා බාහිර ප්රතිකාර පද්ධතියක් මගින් සුව කළ හැකිය.
  • මෙහිදී අභ්යන්තර ප්රතිකාර ලෙස කෂාය, ගුලි, කල්ක, චූර්ණ ආදී ආයුර්වේද ඖෂධ වලින් සමන්විත ප්රතිකාර පද්ධතියක් භාවිතා කරයි. බාහිර ප්රතිකාර ලෙස තෛල අභ්යංග, තැවීම, පත්තු දැමීම, තෛල පිචු, කටී වස්ති ආදිය අවස්ථානුකූලව සළකා බලා සිදු කරයි.
  • මීට අමතරව පංච කර්ම ප්රතිකාරද මෙම රෝග තත්වය සුවපත් කිරීම සදහා අවස්ථානුකූලව භාවිතා කළ හැකිය.

    නමුත්,

  • මේ රෝගය සඳහා කරනු ලබන ප්රතිකාර රෝගියාගෙන් රෝගියාට වෙනස් වේ.
  • මේ සඳහා හිතුමතේට අත්බෙහෙත් කිරීම සුදුසු නැත. වෙනත් කෙනෙකු වෙනුවෙන් වෛද්යවරයකු ලබාදුන් ඖෂධ හෝ ප්රතිකාර හිතුමතේට වෛද්ය උපදෙස්වලින් තොරව භාවිතයද කිසිසේත්ම සුදුසු නොවේ.
  • රෝගියාගෙන් රෝගියාට රෝග ලක්ෂණ මෙන්ම රෝගය පැතිර යාමේ ක්රමවේදයද වෙනස් වේ. ඇතැම් රෝගීන්ට මෙම රෝගය සඳහා කිසිදු ප්රතිකාරයක් නොකොට දින දෙක තුනකින් සුව විය හැක. එය රෝගය ඇතිවමට බලපාන හේතුව අනුව තීරණය වේ. නමුත් බොහෝවිට මෙම රෝගය සඳහා ප්රතිකාර අවශ්යම වේ.
  • ප්රතිකාර මෙන්ම ව්යායාමද ඉතා යෝග්ය වේ. මේ සඳහා විශේෂිත වූ ව්යායාම් ඇති අතර ඇතැම් ව්යායාම් මෙම රෝගීන් සඳහා යෝග්ය නොවේ. එය පිළිගත් වෛද්යවරයකුගේ අනුදැනුම සහ උපදෙස් අනුව කළ යුතුවේ. මේ සඳහා යෝග ව්යායාමද ඉතා යෝග්ය ප්රතිකාර ක්රමයක් වේ. මේ සඳහාම විශේෂිත වූ යෝග ව්යායාම් ඇත.
  • ආයුර්වේදයෙහි මේ සඳහා ප්රතිකාර පද්ධතියන් ක්රියාත්මක කෙරේ. රෝගියාගේ දෝෂ අනුව ඒ ප්රතිකාර වෛද්යවරයා විසින් තීරණය කෙරේ. බාහිරව සහ අභ්යන්තර ප්රතිකාර ක්රම අනුව මේ සඳහා ප්රතිකාර කෙරේ.
  • හිතුමතේට මේ සඳහා ආයුර්වේද තෙල් ආලේප නොකළ යුතුය. ඇතැම් තෙල් වර්ග සෑම වේදනාවකටම ගුණදායක නොවේ. මේ නිසා හිතුමතේට තෙල් නොගෑ යුතුය. ඒ සඳහා ක්රමවේදයක් ඇත. එක් එක් රෝගය අනුව තෙල් වර්ගයද වෙනස් වේ. තෙල් වර්ගවල ගුණ එකිනෙකට වෙනස් වේ.
  • මේ නිසා මෙවැනි රෝග තත්ත්වයක් ඔබට ඇත්නම් වහාම සුදුසුකම් ලත් ආයුර්වේද වෛද්යවරයකු මුණගැසෙන්න.

සුදුසු ආහාර

කාබෝහයිඩ්රේට වැඩි ප්රමාණයක් අඩංගු ආහාර, පලා වර්ග, තන්තු සහිත ආහාර. විශේෂයෙන් ජීර්ණයට පහසු ආහාර ගැනීම වැදගත් වේ.

සුදුසු විහරණ

මෙම රෝග තත්වය සඳහා ආහාර වලට වඩා ඉතාමත් වැදගත් වනුයේ චර්යා පැවැත්ම හා නිවැරදි ඉරියව් භාවිතයයි.

  • මිනිත්තු 30 කට වරක්වත් ඉරියව් වෙනස් කළ යුතුය.
  • පුටුවක වාඩිවී සිටින විට කොඳු ඇට පෙළ සෘජුව සිටින සේ පවත්වා ගන්න.
  • බිම ඇති දෙයක් ගැනීමේ දී හෝ බරක් එසවීමේ දී දණහිස් නවා පහත් වී බර ඔසවන්න. කොන්ද නවා බර එසවීමෙන් වළකින්න.
  • ගැස්සෙන වාහන භාවිතය අඩුකරන්න ( යතුරු පැදි, ත්‍රී රෝද රථ, බස්‍ රථ වල රෝදය අසල).
  • නිදාගැනීමේදී උඩුබැලි අතට නිදාගෙන පාද ඔසවා දණහිස යටින් කොට්ටයක් තැබිය යුතුය.
  • නිදාගැනීමට තුනී මෙට්ටයක්, තුනී කොට්ටයක් භාවිතා කරන්න.
  • සවස් කාලයේ ස්නානය කිරීමෙන් වළකින්න.


සටහන –
අන්තර්ජාලය හා පොතපත ඇසුරිනි

Dr. Ruwan Bandara

Ayurvedic Medical Practitioner on oDoc

SLAMC 14990

Ayurveda Community Medical Officer – Central province