මම මහතයිද? මම කෙට්ටුයිද? - ශරීර ස්කන්ධ දර්ශකය මනිමු | Know your Body Mass Index |

ඔබ නිතරම ඔබේ සෞඛ්‍ය තත්ත්වය ගැන සැලකිලිමත් වෙනවා නේද? එසේනම් ඔබ අසනීප වූ විට දැනගන්නේ කෙසේද? ශ්වසන මාර්ගයේ අසනීපයක් ඇතිවිත උණ ගන්නවා, සොටු දියර ගලනවා, කැස්ස එනවා. ආහාර මාර්ගයේ නම් බඩ රිදීම, වමනය, පාචනය ආදිය සිදු වෙනවා. මෙවැනි අමාරුකම් නැති විට අපි "හොඳ " සෞඛ්‍ය තත්ත්වයෙන් ඉන්නවා යැයි සිතනවා.

නමුත්, අපට නොපෙනෙන රෝග තත්ත්වයක් අප සතුව තිබිය හැකියි. "දුෂ්පෝෂණය" එවැනි රෝග තත්ත්වයක්. දුෂ්පෝෂණය යන්නට මන්ද පෝෂණය මෙන්ම අධි පෝෂණයද ඇතුලත්.

දුප්පත් පොහොසත් භේදයකින් තොරව ,අපේ වැරදි ආහාර පුරුදු නිසා අප සියල්ලෝම ඉහත සඳහන් කල ආකාර දෙකටම ලක්වීමට පුළුවන්.

මමත් මන්ද පෝෂණයෙන්/ අධි පෝෂණයෙන් පෙලෙනවාද?

මෙය දැන් ඔබට අනිවාර්යයෙන්ම ඇතිවන ප්‍රශ්නයක්. පිලිතුර හරිම සරලයි.ඔබේ ශරීර ස්කන්ධ දර්ශකය(BMI) ගණනය කරන්න.

BMI අගය යනු කුමක්ද?

මෙය ශරීරයේ උසට සරිලන බරක් තිබීම පිලිබඳ මිනුමකි.මෙය බර(kg)/උස(m)^2 යන සමීකරණයෙන් ලබාගත හැක. ලාංකීය වැඩිහිටියකුගේ මෙය 18 kg/m2 හා 23.5 kg/m2 අතර තිබීම අපේක්ෂා කෙරේ.මෙම අගයට වැඩි හෝ අඩු වීම දුශ්පෝෂණ තත්ත්වයකි.

ඔබේ වයසට අනුව නිවැරදි අංකය(A,B,C) වෙත ගමන් කරන්න.

A.ඔබ පාසැල් ශිෂ්‍යයෙකු(වයස අවු.5-18)නම්,

වයස අවුරුදු 5ට වැඩි ඕනෑම වයසක අයෙකුට ,මෙම වගුව ඇසුරෙන් තම BMI අගයත් ,තිබිය යුතු අවම හා උපරිම බරත් දැකගත හැකියි.මෙහිදී ඔබ +2 හා -2 අතර කලාපයේ සිටීනම් එය නිවැරදි BMI අගයක් වෙනවා.

BMI අගය මෙමගින් දැන ගන්න



පිරිමි ළමුන් සඳහා නම්, දැන් එයමෙතැන click කර ලැබෙන ප්‍රස්ථාරයට ඇතුලත් කර ඔබ සිටිනා ශරීර ස්කන්ධ දර්ශක කලාපය හඳුනා ගන්න.

ගැහැනු ළමුන් සඳහා නම්, දැන් එය දැන් එයමෙතැන click කර ලැබෙන ප්‍රස්ථාරයට ඇතුලත් කර ඔබ සිටිනා ශරීර ස්කන්ධ දර්ශක කලාපය හඳුනා ගන්න.


B.ඔබ වැඩිහිටියකු(අවු.18ට වැඩි ) නම්,

වයස අවුරුදු 18ට වැඩි ඕනෑම අයෙකුට පහත මෘදුකාංගයට උස හා බර ලබාදීමෙන් BMI අගය ලබාගෙන එය ප්‍රස්තාර ගත කරගත හැකියි.මෙහිදී ඔබ කහපාට කලාපයේ සිටීනම් එය නිවැරදි BMI අගයක් වෙනවා.



C.වයස අවු. 5ට අඩු දරුවෙක් නම්,

අවුරුදු 5ට අඩු දරුවන් සඳහා පහත දැක්වෙන වගු භාවිතා කර ඔවුන්ගේ දිග(අවුරුදු 2ට අඩු දරුවන් සඳහා දිග භාවිතා වේ) උසට අනුව බර වැටෙන්නේ කුමන වර්ණ තීරුවටදැයි බලා ගන්න. දරුවා මෙහි කොළ හෝ ළා කොළ පාට කලාපයේ සිටිය යුතුයි.



ඔබට ඔබේ පෝෂණ තත්ත්වය පිළිබඳ ගැටළු ඇත්නම්,
පෝෂණ තොරතුරු ඒකකය, වෛද්‍ය පර්යේෂණ ආයතනය, බොරැල්ල වෙත ඒවා යොමු කරන්න.ඒවාට පිළිතුරු ලබා දීමට අප සැම විටම සැදී පැහැදී සිටිනවා.

written by Dr.Wedisha Gankanda

For the English version of this article Click Here | ๧මම ල๢ප๢๧ය๞ ඉංග්‍රීසි ප໱ව໮තනය සඳහ๟ ๧මත๠නට යන๞න. 

Do I have to avoid all oils? | කෑම රස කරන තෙල් නිසි පරිදි පාවිච්චි කරමු.

No oil !!!!

Now people are scared of using oil. In Sri Lanka, we have been using coconut oil for years in cooking. I think Sri Lankan women always try to make food taste better by adding coconut oil. But, it is proven that oil has a major role in increasing risk of heart attacks and strokes. When we eat oil, they get absorbed in our gut, and then it increases fat levels in our blood. When there is an increase in fat in the blood it tends to deposit in our blood vessels as cholesterol plaques.

We need 20-30% of daily energy intake from fat. This means around three to five table spoons of oil can be consumed by a person daily. So I am sure you are looking for a safe oil to add to your food while keeping your heart healthy. Out of the types of oil available in Sri Lankan market Canola oil, Sun flower oil, Corn oil, Sesame oil and olive oil are safe to use. Next safer thing is our coconut oil. Coconut oil is better than palm oil or Margarine for cooking.

The way we use the oil is important as well as the type. Deep frying is the worst thing. In that case when oil gets over-heated its composition changes into bad fatty acids (Trans fatty acids) which make more cholesterol plaque inside our blood vessels. When adding oil to food, don’t let it heat till the dark smoke comes out. You can do it by adding little amount of water in to the pan before adding oil, so oil will get heated without overheating. None of the above oil is good for deep frying.

facts by - Dr.Renuka Jayatissa

written by Dr.Malsha Gunathilake

For the Sinhalese version of this article Click Here | ๧මම ල๢ප๢๧ය๞ ස๢๜හල ප໱ව໮තනය සඳහ๟ ๧මත๠නට යන๞න. 

Know your Body Mass Index | මම මහතයිද? මම කෙට්ටුයිද? - ශරීර ස්කන්ධ දර්ශකය මනිමු

Body Mass Index(BMI) is the single best predictor of your malnutrition state.

Remember , both "Over" nutrition and "Under" nutrition is considered "Malnutrition" and both cause trouble.

Since the height of the adults wont change, you can easily keep an eye on your BMI value by regularly measuring your weight using a correct scale.



use this software to calculate your BMI, and plot it so that you can easily see to which category you fall in to. The formula for BMI is Weight(Kg)/Height(m)^2.

Try to be in the "Normal" (Yellow) Zone, if you are deviated try to adjust your exercise + diet to achieve that zone; more regular weight measurement is also essential. Consult your family doctor if you need any help, he'll direct you to a Nutritionist for counseling.

For any nutritional/dietary information feel free to contact us on -

Nutrition information center,
Medical research institute ,
Borella , Colombo 08
0112693532-4 ext 825
0112695999

PS- Please consider that in these calculations desirable BMI levels has been taken as 18.5 to 25 kg/m2 ; for the asian populations it's recommended to take the upper limit as 23.5 kg/m2

written by Dr.Wedisha Gankanda

For the Sinhalese version of this article Click Here | ๧මම ල๢ප๢๧ය๞ ස๢๜හල ප໱ව໮තනය සඳහ๟ ๧මත๠නට යන๞න. 

The complentary feeding day was succesfully completed

Here are some of the footage.............

click here to see all...........

Complementary Feeding Day at MRI | ඔබේ දරුවාට කෑම දෙන නිවැරදි ආකාරය දැන ගන්න ජුනි 24 වැනදා වෛද්‍ය පර්යේෂණ ආයතනයට එන්න

"We are willing to give something important to the society which will bring long-term benefits. One thing we have specifi­cally noticed is most of the babies who are born perfectly healthy start reducing their good health condition after six months, no sooner the complementary feeding is started. Complementary feeding practices are not strong enough in Sri Lanka since there are a tot of useless beliefs and myths. It is a huge obsta­cle which we have to get rid of."

"The critical peri­od of growth of a baby is during the first two years where their brain growth occurs. Brain growth could be badly affected by wrong feeding practices which could result in many negative outcomes. This directly affects the longer term growth and it could result in malnutri­tion which is really diffi­cult to reverse. To do so, there are a number of food items and combination of food which should be given in a very particular and perfect manner."

"We hope to conduct a very important pro­gramme, totally focusing on complementary feeding practices. We have done an island wide research on this and are willing to give its benefits to the people. We will hold complemen­tary feeding day on June 24 targeting to give a proper training to our medical officers, especially to the midwives who are very close to mothers as these  problems can be identified and to advo­cate and counsel them. And the other important thing is to make people aware of it via media.

Media has to play a vital rote, on the other hand we try to make people understand that the  wrong beliefs and myths of different communities are unneces­sary and unrealistic. We hope to educate them on what should and should not be done" 

Based on an interview wiith Dr.Renuka Jayatissa done by Nipuni Wimalapala

Nutrition For All-Play Your Role (National Nutrition Month 2011) -I | දරුවාට නිවැරදිව අමතර ආහාර දීමෙන් ඔබේ වගකීම ඉටු කරන්න.

 

Health and Nutri­tion Ministry has declared June as the Month of Nutrition and countrywide awareness campaigns have been organized to mark its signifi­cance under the theme Nutrition for all – “Play your role”.

Daily News interviewed Medical Research Institute Department of Nutrition Head Dr. Renuka Jayatissa who emphasized the importance of a nutri­tious diet in order to lead a healthy life. "There are five main food categories which are essential for a healthy diet • cereal food, vegetables, fruits, milk and milk prod­ucts, and protein rich foods. The main thing that ire should concern about is, how to spread these food groups in our three meals Dr. Jayatissa stat­ed.

Food groups

As she mentioned, at least three of these food groups should be included in a meal and throughout the day we should take all five food groups which is the only way we can have sufficient quantity of pro­teins, fibres, vitamins and minerals which are the components of a balanced diet. "So everybody must remember that food plays a major role in our life and we should eat what we really need," Dr. Jayatissa noted. 

Number of meals

Dr. Jayatissa added that a normal healthy person requires only three meals per day and there is no need of taking extra meals unless a person is having some special health condi­tions. In today's context people are very interested in taking multi vitamin capsules than eating healthy food ,but it is obvious that having neces­sary food is the best way as it has many benefits. For example, if we eat fruits and vegetables we get fiber which helps absorb sugar, cholesterol and do bowel habits prop­erty - so eating healthy food is more helpful than taking multivitamin capsules. But if a person is asked to get multivitamin capsules for any deficiency by a doctor, then that 'par­ticular' person must get them.

Variety

"Variety of food does help one carry on a healthy life. In Sri Lanka there is no doubt that it is possible to get different types of vegetables, fruits and cereals without being framed into monotonous food patterns. No need to put a big effort to make the variety but it could be done automatically while doing shopping. If you can buy small amounts of dif­ferent foods without buying a large amount of one food," Dr. Jayatissa men­tioned.

Children

"When it comes to chil­dren, it is very important that they should be given proper meals. Supplemen­tary feeding can be started after six months and the best thing to give first is rice and can add other food one by one gradually. when we introduce a new food group to a child we must remember to give small amounts first, to see whether there are any allergies.

"Children are 'small eaters', so they need very small amounts of food. Never force children to eat a large amount of food. Another significant factor is not to give food to chil­dren all the time because an interval is needed digest what they eat - leading to them skipping their main meal.So wait till they are hun­gry and give food, then ' food will become an inter­esting experience for them. Always try to prepare food in an attractive manner with different colors.

Children will love to eat them and children should be give what they like also. Then only they will be good eaters." Dr. Jayatissa said. 

Dr.Renuka Jayatissa,Head Dept of Nutrition ,MRI

-Original article by Nipuni Wimalapala

BLOG DIRECTORY, Submit blog free, Promote Blog, Best directory

ආහාර සුරක්ෂිතභාවය| Food safety

ආහාර සුරක්ෂිතභාවය යනු කුමක්ද?

පලමුවෙන්ම මෙය ආහාර සුරක්ෂිතතාව(food security) යන්නෙන් වෙන්කර හඳුනා ගත යුතුය.(ආහාර සුරක්ෂිතතාවය යනු සැමට අහාර ලැබීම පිළිබඳ මිම්මකි).

මෙහි සරල අදහස නම් අහාර වගාකිරීමෙ,නිපදවීමේ,සකස් කිරීමේ සිට බෙදා හැරීම හා පරිභෝජනය දක්වා සෞඛ්‍යාරක්ෂිතව ලබා දීම තහවුරු කිරීමයි. එය මූලික මිනිස් අයිතිවාසිකමක්ද වේ.

ආහාර සුරක්ෂිතභාවයේ ඇති කාලීන වැදගත්කම කුමක්ද?

අන් කවරදාවකටත් වඩා ආහාර සුරක්ෂිතභාවය ගැන ලෝකයෙම අවධානය යොමුව ඇති කාලයකි මේ. සිය ගනනක් වූ තර්ජනාත්මක ලෝක වසංගත අතර වලක්වාගත හැකි ව්‍යසනයක් ලෙස ආහාර සුරක්ෂිතභාවය අවධානයට පාත්‍ර වී තිබේ.එසේම මෙය ලෝක ආහාර වෙලෙඳාමට දරුණු බලපෑමක් ඇතිකරන දේශපාලනික කරුණකි.
මෑත ඉතිහාසය ගත් කල පහත අවස්ථා සැළකීමෙන් සාමාන්‍ය ජනයාගේ සිට  දියුණු/නොදියුණු රාජ්‍යයන්ගේ නොමඳ අවධානයට, ආහාර සුරක්ෂිතභාවය ලක්වී ඇති සැටි දැක බලා ගත හැකිය.  

•  කුරුළු උණ- පසුගිය දශකය පුරා වරින් වර  වසන්ගතයක් ලෙසින් පැතිර ගිය කුරුළු උණ ලෝක කුකුළු මස් වෙළෙඳාමට හා ජනතාවගේ මාංශ පරිභෝජනයට කල බලපෑම අති මහත් විය..

• න්‍යෂ්ටික කාන්දුවීම්- ජපානයේ න්‍යෂ්ටික කාන්දුවීම් නිසා ජපන් අහාර අපනයන ජාත්‍යන්තරයේ ප්‍රතික්ෂේප වීම.

• ආසනික් අඩංගු වල් නාශක හා රජරට වකුගඩු රෝගය- පසුගිය දින මේ මාතෘකාව ආශ්‍රිතව ඇතිවූ මහත් වූ ආන්දෝලනය, දේශීය සහල් ගොවියා රැකගැනීම, පාන් පරිභෝජනය වැඩිවීම පමනක් නොව පර්යේෂකයන්ට තර්ජනය කිරීම දක්වා ඇදී ගිය බව දැක්වුනි.  

• මෙලමයින් හා කිරිපිටි- කිරි පිටි වල ප්‍රෝටීන වැඩි කිරීමට යැයි කියා මෙලමයින් නම් ද්‍රව්‍යය එකතු කිරීමත් ඒ හරහා ඇතිවූ චීන කිරිපිටි කර්මාන්තයේ කඩාවැටීම. 

• E-Coli -‍යුරෝපයේ මේ දිනවල පැතිර යන   වසන්ගතය හා ඉන් යුරෝපීය ආහාර වෙළෙඳාමට වන අහිතකර බලපෑම.  

• ජාන තාක්ෂණය්-ලෝක ආහාර අර්බුදයට පිලියමක් ලෙස වැඩි අස්වැන්නක් දෙන පරිදි ජාන තාක්ෂණයෙන් නිපදවූ ආහාර භාවිත කිරීමට දැරූ ප්‍රයත්නය, මෙම ආහාර කෙරෙහි පැන නැගූ විරෝධය නිසා යටපත් වෙමින් පවතී.

මේ සඳහා අදාල ආයතනමොනවාද?

ජ්‍යාත්‍යන්තර මෙන්ම දේශීය ආයතන රැසක්ම ආහාර වල ගුණාත්මක භාවය රැකී ඇති බවට සහතික කිරීම සිදු කරනු ලැබේ.HACCP , ISO 22000, SLS ,Codex Alimentarius යනාදිය ,ඇතැම් විට ඔබ ආහාර අසුරන ලේබල මත දැක ඇතුවාට සැක නැත.මේවා සියල්ල WHO, FAO ,CDC වැනි ජ්‍යාත්‍යන්තර ආයතන හා වෙනත් එක් එක් රටවල ප්‍රමිති ආයතන විසින් නිකුත් කරනු ලබන සහතික වේ.මේවා ලබා ගැනීම නූතන ජ්‍යාත්‍යන්තර වෙළෙඳාමේ අනිවාර්ය අවශ්යතාවයක් බවට දැනටමත් පත්වී හමාරය. 
අප රටේ මේ බොහෝ කටයුතු ප්‍රමිති ආයතනය(SLSI), කාර්මික පර්යේෂණ ආයතනය(ITI), හා වෛද්‍ය පර්යේෂණ ආයතනය(MRI) මගින් සිදු වේ.


written by - Wedisha Gankanda

Amylase Rich Food (ARF)

Preparation of ARF at the MRI laboratory

During complementary feeding (after 6 months of age), traditionally; the first food introduced to a child is porridge. This is usually prepared from a cereal or cereal flour such as mung, cowpea or ulundu. These porridges tend to have a high viscosity and a low energy content, which may not meet the daily energy requirements of the child.

The addition of ARF lowers the dietary bulk and increased the energy content, thus making the porridge easier to consume as well as increasing the calorie content per unit volume of food consumed.

ARF can be easily produced inexpensively at home. The preparatory method can be seen below:

1. Select whole, unbroken grains (i.e. mung, cowpea, ulundu) 


2. Soak the grains in water until sprouting takes place (around 48 hours)

3. Dry in the sun / roast lightly on low flame

4. Powder by hand pounding or in an electric grinder

5. Store in a wide mouthed screw cap bottle

6. Add one teaspoonful powder to the cereal during the preparation of feeding

Homemade ARF is both easy and inexpensive to help prepare a low-bulk, high-energy dense meal for your child.

Teaching mothers the easy and inexpensive method of preparing ARF at the household level

Source: Gopaldas T, Deshpande S, Chinnamma J. Studies on a wheat-based amylase-rich food. The United Nations University. 

"Gout" what is it? | "ගවුට්" යනු කුමක්ද?

Image From-http://upload.wikimedia.org

Gout is another type of Arthritis, like Rheumatoid Arthritis which most people know about. It is not only an arthritis, but there are other manifestations of the disease as well as kidney disease.

This is a genetic disease which comes from your parents or ancestors, the problem lies in an enzyme which breaks down the by-products of the protein in our diet. It make excess uric acid in blood which inturn deposits in joints to cause arthritis or in kidney causing glomerular nephritis.

Some people are more prone to this disease such as those who are obese, diabetic, people taking some diuretic drugs and leakeamics. Even losing weight rapidly can aggravate this condition.

Image from- http://knol.google.com/k/gout

There is a long lasting state of the disease called "chronic gout" and an suddenly occurring state called "acute gout" which very painful and usually presents as arthritis around big toe.

This condition is more common in western world, however we see increasing number of cases appearing in Sri Lanka in the recent past.

Apart from the medical management using drugs like Allopurinol and pain killers, every patient must adhere to strict dietary guidelines; especially during an acute attack to control the disease. The limitations are very drastic specially at acute state; therefore the patient should be a highly motivated.

They should refrain from using all the meat, poultry and fish products; even pulses like dhal to reduce the protein consumption to at least to 60g per day. Instead, they can consume milk and milk products and nuts as alternative protein sources. In milder patients it is advisable to try no more than one item from this "banned" list per day if they wish, with caution.

The patient can consume a high carbohydrate diet. In contrary to the common norm of eating raw rice and whole grain, these people will benefit from using refined products.

There should be low fat intake; as for a normal healthy person.

Alcohol except for wine, some vegetables like spinach and cabbage will have to be opted from your menu, while your tea consumption can be maintained at nearly two cups per day.

We hope this guide would be a guide to people suffering from Gout, for more information contact our Deprtment's "Nutrition Information Center".

Based on an interview with Dr. Renuka Jayatissa (Consultant Medical Nutritionist)

Written by-
Dr. Wedisha Gankanda

A Way Towards The Prevention of Osteoporosis Through The Sri Lankan Diet -Part II| ඔස්ටියොපොරෝසිස් වලට තිත තියන දේශීය ආහාර වට්ටෝරුවක් මෙන්න II-කොටස

Osteoporosis

There are four steps, which can optimise bone health and help prevent osteoporosis:

1. Healthy diet rich in calcium:

Calcium, the main compound for strong and healthy bones, is needed in different quantities during the life cycle. The below table gives the daily recommended intake of calcium for Sri Lankans, of different age groups, by adopting recommendations of the World Health Organisation. However, maximum recommended intake of calcium is 2000mg /day.

Source from: Methods of Healing

Daily Recommended Calcium (mg) intake for Sri Lankans

Age group	mg
Infants	650
Child (1-3 years)	500
Child (4-6 years)	550
Child (7-9 years)	700
Adolescents (10-19 years)	1000
Male (>19 years)	750
Female (19-50 years – pre menopausal)	750
Female (>50 years – post menopausal)	800

Calcium is found in many foods. You can eat one or two servings of calcium rich foods daily as given in the table below. The recommended portion of each food item is also given in the table (the portions below have been recommended to fulfill all nutrients needed for a healthy life). 

Food	Average portion and weight	Calcium content (mg)	Additional benefits
Milk	½ tea cup	115	Protein, saturated fat
Curd	½ tea cup	149	Protein, saturated fat
Yogurt	1 cup(80 ml)	86	Protein, saturated fat
Dried sprat	10 medium	75	Protein, iron
Kunissa (shrimps)	1 table spoon	658	Protein, iron
ice cream	1 cup (80 ml)	80
Kathurumurunga	½ tea cup	1130	Vit. A, B,C, iron
Lotus stem	3 table spoons	182	Iron
Pumpkin leave	½ tea cup	392	Vit. A, B,C, iron
Kura Thampala	½ tea cup	800	Vit. A, B,C, iron
Carrot leave	½ tea cup	340	Vit. A, B,C, iron
Drumstick leave	½ tea cup	440	Vit. A, B,C, iron
Knol-khol leave	3 table spoons	300	Vit. A, B,C, iron
Gingelly seeds	1 table spoons	80	Protein, iron
Example of a meal Rice Kunissa Katurumurunga Malluma Knol-khol curry Woodapple as a desert	2 cups 1 table spoon 3 table spoon 3 table spoon 1 medium Total	20 658 508 111 130 1427	Energy, Protein, Vitamin and minerals

This shows that Sri Lankan diet can fulfil the calcium requirement if we take it appropriately in right quantities and include at least one calcium rich food item every day into our diet. When you are selecting food items go for a variety rather than depending on one or two items, which will promote the overall health.

Those with an inadequate calcium intake can take an inexpensive form of calcium tablets after consulting your doctor for a daily cost of 30cts. Don't forget even mineral water can fulfill up to 1/3 of daily calcium need!

2. Weight-bearing exercise:

Source from: Conversations for Women in their Twenties

Exercise simulates bones to be stronger.To build strong bones during childhood and adolescence, a minimum of ½ hour physical activity (playing, walking, running and swimming) is needed daily till the age of 18 years in addition to a calcium rich diet. After that it should be maintained at least three to five days per week throughout life.

3. A healthy lifestyle:

Source from: www.besthealthylifestyletips.com

The best way to keep your bones healthy is to establish a healthy lifestyle with no smoking or an excessive alcohol intake.

4. Bone density testing and medication when appropriate:

This may be done at your local hospital, after consulting with your doctor.

osteoporosis is highly preventable. LET’S START FROM CHILDHOOD and get used to healthy eating habits and regular physical activities.

Written By-

Dr. Renuka Jayatissa