Kenako Malysheva amalankhula za Metformin, palibe amene anayesedwa

Metformin (dimethylbiguanide) ndi othandizira odwala matenda amkati, omwe ndi a gulu la Biguanides. Mphamvu ya Metformin imalumikizidwa ndi kuthekera kwa chinthu chogwira ntchito poletsa gluconeogenesis mthupi. The yogwira thunthu linalake ndipo tikulephera mayendedwe a ma elekitironi a kupuma maukonde a mitochondria. Izi zimabweretsa kuchepa kwa kuchuluka kwa ATP mkati mwa maselo ndi kukondoweza kwa glycolysis, kochitidwa mwa njira yopanda mpweya. Zotsatira zake, glucose amatenga maselo kuchokera kumalo akunja kumawonjezereka, ndipo kupanga kwa lactate ndi pyruvate mu chiwindi, matumbo, adipose ndi minofu minofu kumakulanso. Malo ogulitsa a glycogen m'maselo a chiwindi amachepa. Sizimayambitsa zotsatira za hypoglycemic, chifukwa siziyambitsa kupanga insulin. Imachepetsa njira zamafuta oxidation ndikuletsa zoletsa zamafuta a mafuta. Poyerekeza ndi momwe mankhwalawo amagwiritsidwira ntchito, mankhwalawo amasintha chifukwa cha kuchepa kwa insulin. Kuwonjezeka kwa kuchuluka kwa insulin / proinsulin kumadziwikanso. Chifukwa cha mapangidwe a momwe mankhwalawo amathandizira, pali kuchepa kwa shuga mu seramu yamagazi atadya chakudya, chizindikiro chachikulu cha shuga chimachepetsedwa. Chifukwa chakuti mankhwalawa samalimbikitsa kupangika kwa insulin ndi maselo a kapamba, zimayimitsa hyperinsulinemia, yomwe imawerengedwa kuti ndi imodzi mwazofunikira kwambiri pakuwonjezera kulemera kwa thupi mu shuga komanso kukula kwa zovuta zam'mimba. Kutsika kwa shuga m'magazi kumachitika chifukwa cha kuyamwa kwa glucose ndi maselo amisempha komanso kuwonjezeka kwa zotumphukira za insulin receptors. Mwa anthu athanzi (opanda matenda ashuga) mukamamwa metformin, kuchepa kwa shuga sikumawonedwa. Metformin imathandizira kuchepetsa thupi kunenepa kwambiri komanso matenda a shuga mwa kupondereza chilakolako cha chakudya, kuchepetsa kuyamwa kwa shuga m'zakudya ndi m'mimba thirakiti komanso kumalimbikitsa anaerobic glycolysis. Metformin imakhalanso ndi vuto la fibrinolytic chifukwa cha kuletsa kwa PAI-1 (minofu mtundu wa plasminogen activator inhibitor) ndi t-PA (minitsi plasminogen activator). Mankhwala amathandizira njira ya biotransfform ya glucose mu glycogen, imayendetsa magazi m'magazi a chiwindi. Katundu wa Hypolipidemic: amachepetsa mulingo wa LDL (otsika kachulukidwe lipoproteins), triglycerides (ndi 10-20% ngakhale ndikuwonjezeka koyambirira kwa 50%) ndi VLDL (otsika kwambiri a lipoproteins). Chifukwa cha zotsatira za metabolic, metformin imayambitsa kuwonjezeka kwa HDL (high density lipoproteins) ndi 20-30%. Mankhwala tikulephera kukula kwa yosalala minofu zinthu za chotengera khoma. Imakhala ndi phindu pa mtima komanso kupewa matenda a matenda ashuga. Pambuyo pakukonzekera pakamwa, pazomwe zimakhala pazomwe zimagwira ntchito zimafikira m'magazi pambuyo pa maola a 2,5. Odwala omwe adalandira mankhwalawa pazinthu zovomerezeka, zomwe zili kwambiri m'magazi a plasma sizinadutse 4 μg / ml. Patatha maola 6 mutamwa mapiritsi, kuyamwa kwa zinthu zomwe zimagwirizana ndi mankhwalawo kumatha, komwe kumayendetsedwa ndi kuchepa kwa plasma ndende ya metformin. Mukamamwa mankhwalawa pambuyo pa masiku awiri ndi awiri, kutsata kwa metformin kumapezeka m'magazi mkati mwa 1 μg / ml kapena kuchepera. Ngati mumwa mankhwalawa mukudya chakudya, ndiye kuti pali kuchepa kwa mayamwidwe a metformin kuchokera ku mankhwalawa. Metformin imapangidwa makamaka m'makoma a chimba cham'mimba: yaying'ono ndi duodenum, m'mimba, komanso tiziwalo tating'ono ndi chiwindi. Hafu ya moyo ili pafupifupi maola 6.5. Ndi kugwiritsa ntchito kwamkati kwa metformin, kutsimikizira kwathunthu mwa anthu athanzi kuli pafupifupi 50-60%. Pang'onopang'ono mapuloteni a plasma. Kugwiritsa ntchito secretion ya tubular ndi kusefera kwa glomerular, imakumba impso kuyambira 20 mpaka 30% ya mlingo womwe umayendetsedwa (osasinthika, chifukwa, mosiyana ndi formin, sunapangidwe). Mu vuto la impso, kutsekeka kwa impso kumachepa mogwirizana ndi kupezeka kwa syntinine, motero, ndende ya plasma ndi theka la moyo wa metformin ukuwonjezeka kuchokera mthupi, zomwe zingayambitse kudzikundika kwa chinthu chogwira ntchito mthupi.

Kodi metformin ndi chiyani?

Metformin ndi piritsi lomwe limagwiritsidwa ntchito pa matenda a shuga a 2. Ndilo gulu la Biguanides. Ndi imodzi mwakale kwambiri komanso imodzi mwa mankhwala othandiza kwambiri omwe agwiritsidwa ntchito pochiza matendawa. Kuchokera ku kalasi ya biguanides, awa ndi mankhwala okhawo omwe samakhudza odwala omwe ali ndi vuto la mtima. WHO adaziyika pamndandanda wazofunikira zamankhwala.

Metformin ndi dzina la generic genant mankhwala. Mayina amalonda awa akuwonetsedwa pamsika wa pharmacological: Glucofage, Glycomet, Bagomet, Diaformin, Insufor, Langerin, Meglifort, Metamine, Metfogamma, Metformin Sandoz, Metformin-Teva, Panfor Sr, Siofor, Zukronorm.

Kwa nthawi yayitali, mankhwalawa anali kugwiritsidwa ntchito kokha pochiza matenda ashuga. Pambuyo pazakafukufuku wazaka zambiri, zidapezeka kuti zimachepetsa mafuta. Pamaso pa prediabetes, itha kugwiritsidwa ntchito kuchepetsa mwayi wokhala ndi matendawa. Amagwiritsidwanso ntchito ngati polycystic ovary ndi ma pathologies ena angapo omwe kukana insulini ndikofunikira.

Ubwino wa metformin umawonedwa:

ndi matenda ashuga
ndi metabolic syndrome
popewa matenda amtima,
popewa khansa.

Mphamvu yovuta ya mankhwalawa polimbana ndi ukalamba imatsimikiziridwa. Mtengo wofunikira ndikuchepetsa gawo laimfa kuchokera ku zovuta zamtima. Zimatsimikizidwanso kuti zimachepetsa zoopsa zakukula kwa oncology kwa odwala omwe ali ndi matenda ashuga komanso metabolic. Kukana kwa mahormoni ndi imodzi mwamaopsezo opanga zotupa. Insulin imathandizira kukula kwa minofu, kuphatikiza osati yabwino kwambiri.

Kodi mankhwalawa amagwira ntchito bwanji?

Mankhwalawa amachepetsa kuchuluka kwa shuga m'magazi ndi kaphatikizidwe ka shuga m'chiwindi. Kuphatikiza pa hypoglycemic zotsatira, zimakhudza zovuta za lipid. Lowers triglycerides ndi cholesterol yoyipa (LDL). Ndiwokhawo mankhwala, malinga ndi maphunziro, omwe amachepetsa kuchuluka kwa matenda a mtima ndi stroko.

Chimodzi mwazabwino za mankhwalawa ndikuti samachulukitsa thupi poyerekeza ndi mankhwala ena a hypoglycemic. Kwa munthu wodwala matenda ashuga, amathandiza kutalikitsa komanso kukhala ndi moyo wabwino komanso wapamwamba. Zochita zake zimapangidwa kuti muchepetse kunenepa. Amawonetsera kunenepa, ngati chithandizo cha zakudya sichinabweretse zotsatira zoyenera.

Mankhwalawa amachepetsa kudya komanso kuyamwa kwa shuga m'mimba. Kutsegula kwa insulin sikumachitika, zotsatira za hypoglycemic zimachitika mwa kusintha kukhudzidwa kwa mahomoni ndi kuphatikizira kwakukulu kwa shuga. Chifukwa chomwa mankhwalawa, njira zamatenda zomwe zimayamba motsutsana ndi maziko a matendawa zimayamba kuchepa. Itha kugwiritsidwa ntchito ma pathologies omwe amawonetsa insulin kukana. Kuchita bwino kwa mankhwalawa kumawonetsedwa m'mimba lama polycystic, prediabetes, matenda ena a chiwindi, komanso kunenepa kwambiri.

Metformin imachepetsa kaphatikizidwe ka glucose m'chiwindi ndipo imawonjezera kaphatikizidwe ka glycogen. Mothandizidwa ndi mankhwalawa, magazi mu chiwindi amachitidwa, mulingo wa triglycerides ndi cholesterol amachepetsa. Kutenga kwa glucose ndi minofu, wogwiritsa ntchito mphamvu zazikulu, amathandizidwa. Kuchulukitsidwa kwa shuga wokonzedwa kumafotokozedwa ndikuti ndikosavuta kulowa minofu.

Zotsatira za kumwa mankhwalawa:

kuchepetsa shuga
Kuchepetsa kufunikira kwa insulin
choletsa kukana insulini,
Kuchepetsa kapena kupitilira kwa atherosulinosis,
kuchepa kwa triglycerides ndi LDL
kuchepetsa kupsinjika, kuchepa kwa shuga
Kuletsa michere yomwe imawononga ma cell,
kuteteza mtima.

Contraindication

Mwa contraindication ntchito:

kukanika kwa impso
Hypersensitivity mankhwala
matenda opatsirana pachimake,
ketoacidosis
kukanika kwa chiwindi
vuto la mtima
kusanachitike komanso mutatha kuyang'ana pa radiographic ndikumayambitsa kusiyana,
asanachitike kapena atachitidwa opaleshoni,
ukalamba
malabsorption B12.

Chithandizo cha matenda ashuga

M'mbuyomu, Metformin idagwiritsidwa ntchito kokha pochiza matenda ashuga. Kafukufukuyu adawonetsa kuti mankhwalawa akuwonetsa katundu wina. Amagwiritsidwa ntchito ngati thumba losunga mazira la polycystic, kunenepa kwambiri, komanso kupewa matenda ashuga.

Komabe, cholinga chachikulu cha metformin ndicho chithandizo cha matenda a shuga amitundu iwiri. Amachepetsa shuga komanso gluconeogenesis, amachepetsa triglycerides ndi LDL, ndipo amachepetsa chilakolako chochepa. Kuchepa kwa glucose kumachitika pamimba yopanda kanthu ndikatha kudya. Minofu minofu imalandira shuga wambiri chifukwa cha kuwonjezeka kwa kumwa kwake. Kuyamwa kwa shuga m'matumbo amachepetsa.

Mankhwalawa samalimbikitsa kupanga mahomoni. Kuchepetsa mphamvu ya shuga kumachitika mwa kukonza mayamwidwe a shuga ndi minofu. Panthawi ya chithandizo ndi Metformin, kufunika kwa insulin kumachepetsedwa. Chidachi chimachepetsa kuopsa kwa zovuta ndi kufa ndi pafupifupi 35% poyerekeza ndi mankhwala ena a hypoglycemic ndi insulin.

Mulingo wokwezeka wamafuta nthawi zonse umakhala wowopsa pamtima. Mtundu wa mawonekedwe pamakoma a zotengera, ma microcirculation amasokonekera. Kuchokera apa pali zotupa za m'maso, mitsempha yamagazi ya muubongo ndi mtima, ziwiya zamiyendo ndi zina zotero.

Mukamamwa mankhwalawo, mphamvu ya hypoglycemic imawonedwa. Kutengera ndi kuchuluka kwa shuga ndikuletsa glycemia, wodwalayo angafunenso kumwa chinthu china. Koma atalemba mankhwalawo, ndizotheka kuchepetsa kuopsa kwa matenda amtima ndi gawo limodzi.

Metformin sikumatsogolera pakukula kwa hypoglycemia ikatengedwa molondola. Amawonedwa kawirikawiri ndi zolimbitsa thupi kapena kugwiritsa ntchito mankhwalawo ndi ena othandizira a hypoglycemic. Mwa odwala athanzi, samachepetsa shuga.

Kukalamba

Monga tafotokozera pamwambapa, a Elena Malysheva adati mu pulogalamu yake yomwe Metformin imalepheretsa ukalamba. Adanenanso za kuthekera kokulitsa moyo wathunthu komanso wapamwamba. Tsopano mwatsatanetsatane wazambiri.

“Ukalamba wa chamoyo” ndi lingaliro lophiphiritsa. Zikutanthauza kukalamba msanga chifukwa cha matenda. Mwanjira ina, uwu ndi m'badwo wabadwidwe wa thupi, womwe sugwirizana ndi chizindikirochi.

Pa pulogalamu ya "Live Healthy" machitidwe adayikidwa ngati masikelo amagetsi, omwe amayeza zaka zakubadwa.

Chinsinsi cha kukalamba kotereku ndi kuchuluka kwa glucose m'magazi. Zotsatira zake, mapuloteniwa amawawa (izi zimaphatikizapo mapuloteni amkhungu), zomwe zimatsogolera pakupanga makwinya. Ming'alu mawonekedwe mu ziwiya mothandizidwa ndi kuchuluka shuga.

Kuchokera pa molekyulu yoyamba ya shuga, ma molekyulu awiri a triglyceride amapezeka, i.e. mafuta. Mafuta amadziunjikira muming'alu, ndikupanga malo otchedwa atherosranceotic malo. Mankhwala amapangidwa kuti aletse njirazi zomwe zimachitika m'matumbo.

M'zaka zonse zapitazi, maphunziro osiyanasiyana azachipatala apangidwa. Kumapeto kwa chaka cha 2015, kafukufuku wasayansi (wazaka 25) wa Metformin ku University of England adamalizidwa.

Ophunzirawo anali anthu omwe anali ndi matenda ashuga amitundu iwiri. Malinga ndi zoneneratu, anali ndi zaka 8 zokha kuti akhale ndi moyo. Koma palibe amene anamwalira pa kuyesaku. Anazindikira kuti mankhwalawo amakankhira mwachindunji kuyamba kwa kufa ndi ukalamba.

Kanema wokhala ndi ndemanga ya Dr. Malysheva wokhudza Metformin:

Zokhudza thupi

Metformin sichimakhudza kulemera kwakukulu poyerekeza ndi sulfonylureas. M'malo mwake, amagwiritsidwa ntchito mu zovuta kuchitira kunenepa. Zinapezeka kuti mankhwalawa amachepetsa mafuta.

Anthu athanzi omwe ali ndi shuga athanzi omwe akufuna kuchepetsa thupi amatha kumwa mankhwala. Kudya pafupipafupi kumatha pafupifupi 2.5,5 kg ndikuchepetsa kuchuluka kwa chakudya chomwe mumadya. Mwa munthu wathanzi, mankhwalawa samachepetsa shuga, motero angagwiritsidwe ntchito Mlingo wambiri.

Pulogalamu Malysheva akuti Metformin yochepetsa thupi imagwira ntchito.

Kufunsira kwa ovary ya polycystic

Metformin ndi mankhwala othandizira omwe amagwiritsidwa ntchito pakuchiritsa kovuta kwa kubereka. Akatswiri ena amati kugwiritsa ntchito mankhwalawa kukhala mankhwala oyambira, ena ngati mzere wachiwiri.

Zimathandizira ovulation ndikuthandizira mkazi kutenga pakati. Ndipo monga mukudziwa, ovary ya polycystic ndi endocrinological matenda omwe amatsogolera ku kubereka. Mkaziyo ali ndi insulin kukana.

Chifukwa chake, Metformin ndiyofunikira kwambiri pochiza matenda. Amawerengera mu regimen yokhala ndi mahomoni ndi mankhwala ena.

Zotsatira zoyipa

Ndi zabwino zonse za mankhwala, simuyenera kupita kuchipatala. Amatengedwa pazifukwa zamankhwala komanso monga adanenera dokotala. Choyamba, ndikofunikira kumvetsetsa kuti Metformin ndi mankhwala. Ndipo mankhwala aliwonse, monga mukudziwa, amayambitsa mavuto.

Zotsatira zoyipa zomwe zimadziwika zimawonetsedwa ndi m'mimba. Nusea iyamba, kukoma kwachitsulo kumawonekera mkamwa, tulo tosokosera. Mankhwalawa amatha kusokoneza kuyamwa kwa B12, zomwe zimapangitsa kuti azigwirizana komanso azikumbukira.

Zotsatira zachilendo koma zowopsa za kugwiritsidwa ntchito kosalamulirika kwa Metformin ndi lactic acidosis, vuto limodzi limachitika pa 10,000.

Komabe, kusamala kuyenera kuchitidwa:

kuvomerezedwa kumaloledwa ndi impso wathanzi komanso kugwira ntchito koyenera kwa kusefera kwa glomerular,
osatumizidwa kwa anthu okalamba kwambiri
Magulu a creatinine ayenera kukhala opanda malire,
pachipatala chilichonse, kulandila kumayimitsidwa, makamaka ndi maphunziro a x-ray.

Metformin ili ndi zabwino zambiri pakuchiritsa kwake, koma sikuti ndi vuto lenileni. Amatengedwa monga momwe dokotala amafotokozera komanso chifukwa cha zamankhwala. Koma ngati munthu wapezeka ndi matenda a shuga, kumwa mankhwalawa ndikofunikira komanso kothandiza.

Metformin: mfundo zoyenera kuchita

Chizindikiro chachikulu pakugwiritsa ntchito mankhwalawa, monga tafotokozera pamwambapa, ndi matenda ashuga. Pogwiritsa ntchito mankhwalawa, sizimangokhala zochepetsa shuga, komanso kuthana ndi mawonekedwe a kunenepa kwambiri. Chifukwa cha izi, metformin imakonda kulimbikitsidwa kuti muchepetse kunenepa. Kuyenda pang'ono kumachitika chifukwa chakuti metformin imachita motere:

Imachepetsa kukonza mafuta, makamaka osavuta,
kumapangitsa shuga kumaso,
amachepetsa chilakolako chotseka mapangidwe a insulin.

Metformin ilibe mafuta owotcha. Koma kugwiritsidwa ntchito kwake kumatilola kuti tizipereka zinthu zomwe zingakhale zovuta kuti tichotse mafuta omwe alipo. Ndipo izi ndizachilengedwe, popeza mankhwalawa ndi analogue a metformin yosavuta.

Komabe, ndikofunikira kudziwa malingaliro a akatswiri pakugwiritsa ntchito mankhwalawa, ndipo nthawi yomweyo muyang'ane momwe amagwirira ntchito. Mwa akatswiri onse odziwika bwino, mwina otchuka kwambiri pakati pa anthu wamba ndi a Elena Malysheva.Chifukwa chake, lingaliro lake ndiloyenera koyamba poyang'ana malingaliro a chida chotere.

Malingaliro a Malysheva okhudza metformin

Pulogalamu yodziwika komanso yotchuka kwambiri "Live wathanzi!" Angapo rez adalankhula za metformin. Kuphatikiza apo, kwakukulu, sizinawonedwe ngati njira yochepetsera thupi. Kupatula apo, cholinga choyambirira cha mankhwalawa ndikupangitsa moyo kukhala wosavuta kwa odwala matenda ashuga. Chifukwa chake, ndemanga za Malysheva zimakhudzana makamaka ndi machitidwe ake achire. Apa mutha kuzindikira mfundo zazikuluzikulu zomwe zimagwirizanitsidwa ndi mankhwalawa.

Monga momwe dokotala akutsimikizira, metformin ndi njira yotithandizira kugaya chakudya. Izi zikutanthauza kuti, choyambirira, ziyenera kutengedwa ndi anthu omwe ali ndi vuto loyenerera. Nthawi yomweyo, Malysheva amalimbikitsa kugwiritsa ntchito metformin moyenera kwa aliyense amene akufuna kutalikitsa unyamata, chifukwa kuyamwa koyenera kwa michere kumathandizira kukhala wathanzi kwakanthawi.
Malysheva samapatula mwayi wogwiritsa ntchito metformin pakuchepetsa thupi. Koma payenera kukhala zofunikira zoyambirira izi. Ngati pali kuphwanya kwa insulin, ndiye kuti kumwa mankhwalawo kuli koyenera. Zowona, dokotala amayenera kuwunika mankhwalawo. Chifukwa chake, katswiriyo samatcha metformin ngati njira yochotsera mapaundi owonjezera, ngakhale kufunikira kwake sikukana.

Koma kodi zitheka kupeza chitsimikiziro cha chida ichi pochita? Kuti mumvetsetse momwe mankhwalawo alili othandizira, ndikofunikira kuyang'ana pa ndemanga za anthu omwe adamwa. Tsopano ndemanga zochepetsera thupi zitha kupezeka zochuluka. Tsoka ilo, kutali ndikungolankhula zochepera thupi. Nthawi zina pamakhala mawu onena za kuwopsa kwa malonda.

Metformin: ndemanga yochepetsa thupi komanso kuchepa thupi

"Amachepetsa shuga ndikuchotsa ma kilogalamu"

Chifukwa cha kuchuluka kwa shuga ndi chiwopsezo cha shuga, ndidalamulidwa kumwa metformin. Ndisanatenge chida ichi, ndidaganiza zowunikira zomwe zidatsalira kuti ndiziyimira molondola zomwe ndikanakumana nazo. Ndemanga zake zinkakambirana zakutha kwa mankhwalawo kuti achepetse ngakhale kunenepa. Mlingo womwe adandiuza pang'ono, kotero panthawi yolandila sindinazindikire zosangalatsa zilizonse. Koma shuga, ndithudi, adachepa. Ndipo mwezi umodzi ndi hafu, pamene ndimamwa mapiritsi, kulemera kwanga kunacheperanso ndi 3 kg. Koma sindikudziwa ngati mankhwalawa athandiza iwo omwe poyamba amakhala ndi chilichonse mwadongosolo ndi shuga.

“Molumikizana ndi ntchito yamadyedwe”

Sindinayesepo kuchepetsa thupi kokha mothandizidwa ndi mapiritsi kapena mtundu wina wa chakudya. Koma, nditabweranso pachakudya, ndidaganiza zowonjezerera. M'malo mwa chithandizo chotere, ndidangosankha metformin. Kungosangalatsidwa ndi mawunikidwe, momwe iye amadzitamandira mu mitundu yonse. Mwiniwakeyo adawona kuti sizonse ndizosavuta ndi mankhwalawa. Poyamba, sanali kumva bwino - anali kudwala komanso anali ndi chizungulire. Kenako zinayamba kukhala bwino. Kwa miyezi iwiri, pomwe amadzipatsa chakudya ndikudya metformin, adataya pafupifupi 7 kg. Ndikuganiza zotsatira zake ndi zabwino. Chifukwa chake, yesani ndipo mumachepetsa thupi chimodzimodzi. Zikuwoneka kuti zithandizadi.

"Kuchepetsa thupi pa metformin mutabadwa mwana"

Nkhani yanga ndiyabwino - mwana akangobadwa kumene, imakhala yodziwika bwino kuposa kale. Poyamba, sanafune chidwi ndi izi. Ndinkakhulupirira kuti zochulukirapo mwachangu zidzatha. Koma ayi - patapita nthawi, ndidawonjezeranso zina. Kuchuluka kwake kunali pafupifupi 10 kg. Ndidafunsa adotolo wanga ngati pali njira yabwino komanso yabwino yothandizira kuti athetse. Adalangiza metformin. Zowonadi, pafupifupi miyezi ingapo idabweranso. Zowona, ndinatsatiranso kadyedwe kakang'ono ka carb, chifukwa chake sizodabwitsa.

"Zothandiza, koma pali zovuta zina"

Nthawi zambiri ndimamwa metformin pakafunika kuchepetsa thupi popanda kuchita khama. Ndipo, makamaka, amandithandizira. Pali vuto limodzi lokha - munthawi ya makonzedwe ake, mavuto ndi matumbo amawonekera: nthawi zina kudzimbidwa, ndipo nthawi zina, pepani, kutsegula m'mimba. Zotsatira zoyipa izi ndizosasangalatsa, koma ndimazizolowera. Chachikulu ndichakuti mankhwalawo amagwira ntchito ndipo sayambitsa vuto lalikulu. Chifukwa chake, nthawi ina mukafunanso kuchepa thupi, kumbukirani za mapiritsi ngati amenewo. Ndizotheka kuti azikuyenererani komanso kukuthandizani kuti muchepetse thupi.