Acetone mu mkodzo: amachititsa akuluakulu, kusanthula kwa zolembedwa

M'zaka zaposachedwa, akatswiri opanga ma labotale akuwonjezeranso kupeza acetone mu mkodzo wa achikulire kapena ana. Kodi ayenera kupezekapo? Ndi chifukwa chiyani kusintha kwamkodzo? Owerenga apeza mayankho a mafunso amenewa ndi mafunso ena m'nkhani yomwe tafotokozayi.

Chidule cha Acetonuria

Chozizwitsa chomwe chimapangitsa kuti pakhale zambiri zamatumbo a ketone zimadziwika mu mkodzo, madokotala amatcha acetonuria kapena ketonuria. Matupi a Ketone ndi zinthu zomwe zimapangidwa panthawi yomwe makutidwe a oxidation omwe samakwanira (mapuloteni) ndi mafuta (lipids) m'thupi. Makamaka, ndi acetone yokha, acetoacetic ndi hydroxybutyric acid. Acetone ikhoza kukhalapo mu mkodzo wa munthu wamsinkhu uliwonse. Chachikulu ndikuti kusunthika kwake munthawiyo kuyenera kukhala kopanda tanthauzo (kuchokera pa mamilimita makumi awiri mpaka makumi asanu patsiku). Kuchokera mthupi, imapitilizidwa ndi impso. Koma ngati kuchuluka kwa acetone kupyola zikhalidwe zovomerezeka, ndiye kuti ndikofunikira kuti muchitepo kanthu pazizindikiro zomwe thupi limatumiza.

Amayimira kuti "chizindikirocho" choti acetone owonjezera amakhala mkodzo:

Fungo lamakhalidwe pakukodza
Fungo la acetone lochokera mkamwa
kukhumudwa, ulesi.

Mu ana, zizindikilo zimatha kukhala zosiyana:

kukana chakudya,
Fungo la acetone lochokera mkodzo, masanzi, mkamwa,
nseru
kupweteka msomali,
kusanza mutatha kudya kapena kumwa chilichonse,
lilime louma
kufooka
kukwiya, kusinthidwa mwachangu ndi kugona komanso ulesi.

Zomwe zimawonekera ngati "acetone" owonjezera "mumkodzo

Akuluakulu, izi zimapangitsa kuti izi zisamachitike.

• Ngati zakudya za tsiku ndi tsiku zimayendetsedwa ndi zakudya zamafuta ndi mapuloteni ambiri, thupi likalephera kuwaphwanya onse. Ngati chakudyacho sichakudya chamafuta ambiri.
• Vutoli likhoza kuwongoleredwa ngakhale popanda mankhwala, mwa kusinthanitsa chakudya, kuyambitsa chakudya chamagulu menyu tsiku ndi tsiku.
• Cholinga china ndi kuchita masewera olimbitsa thupi mopitirira malire. Kenako, kuti muwongolere zowunikirazo, ndikofunikira kusintha magawo omwe thupi lingakwanitse.
• Chachitatu - kusala kudya kwanthawi yayitali, "kukhala" pazakudya zosasinthika. Kuti mubwezeretse thanzi, muyenera kuthandizidwa ndi wathanzi, kukanidwa ndi njala.
• Chachinayi - kuwonongeka kwa kapamba, mtundu 1 wa shuga, kapena mtundu 2 shuga. Zikuwonekeratu kuti anthu otere alibe chakudya chokwanira cha oxidation wathunthu wa lipid ndi mapuloteni. Izi zayamba kale, ndizowopsa chifukwa pamakhala mwayi wokhala ndi matenda ashuga.

Acetone ochulukirapo mu mkodzo amatha kuchuluka ndi:

• hypoglycemia, yomwe imakwiya chifukwa cha kuchuluka kwa insulin m'magazi,
• kutentha kwambiri
• matenda opatsirana (matenda ofiira, chimfine, meningitis),
• Pambuyo pa mitundu ina ya opaleshoni,
• thyrotoxicosis,
• kuledzera
• matenda osokoneza bongo
• mawonekedwe oyipa
• kuchepa thupi kwambiri,
• kuchepa magazi kwambiri
• stenosis (kupatulira) kwam'mero, khansa yam'mimba,
• kusanza kosakwanira kwa amayi apakati,
• toxosis yayikulu, yomwe imayamba mwa azimayi ena kumapeto kwa mayeso,
• pambuyo kuvulala kumabweretsa kuwonongeka kwa chapakati mantha dongosolo.

Muubwana, acetone mu mkodzo amawonekera chifukwa cha kusachita bwino kwa kapamba. Ngati kapamba satha kugwira ntchito yake, ndiye kuti amapanga michere yokwanira.

Zifukwa zakukula kwa ketonuria mwana (acetonuria):

• kudya kwambiri, zolakwika mu zakudya, kupezeka kwa mankhwala osokoneza bongo, utoto, zonunkhira za kupanga,
• nkhawa, kuchuluka kwa mwana,
• kutopa, kugwira ntchito molimbika,
• kumwa mankhwala osalamulirika kuchokera ku gulu la antibayotiki,
• hypothermia
• kutentha kwambiri
• kamwazi, kupezeka kwa helminthic infestations, diathesis.

Malangizo azithandizo

• Chithandizo cha ketonuria mwachindunji zimatengera zomwe zimayambitsa mkodzo mumkodzo komanso kuopsa kwa njirayo.
• Nthawi zina zimakhala zokwanira kungosintha zakudya zokha, kusintha zakudya zanu tsiku ndi tsiku.
• Ngati acetone ndi yokwera kwambiri, ndiye kuti wodwala amatumizidwa kuchipatala.
• Malingaliro azithandizo zimatengera zomwe zimayambitsa kuwoneka kwa acetone mkodzo. Ngati zoyambitsa zichotsedwa, ndiye kuti kusanthula kukhale bwino.

Chifukwa chake, zonse zimayamba ndi kudya mosamalitsa ndikumwa madzi ambiri. Amatenga pang'ono, koma nthawi zambiri. Ana amapatsidwa mphindi zisanu zilizonse supuni (yomwe ndi 5 ml). Mayankho omwe adapangidwa kale omwe adagulidwa mu pharmacy, mwachitsanzo, Regidron, Orsol, ndi othandiza. Amaloledwa kumwa mchere wam'madzi (wopanda mpweya), chosakanizira cha zoumba kapena zipatso zina zouma, kulowetsedwa kwa chamomile.

Wodwala akayamba kusanza kwambiri, ndiye kuti dokotala amakupatsani mayankho ake kudzera mu kulowererapo kwa mkodzo. Metoclopramide (Cerucal) amagwiritsidwa ntchito pothandiza kutsuka.

Nthawi zina, kukonza chiwindi, Essentiale, Methionine, mkaka nthula chakudya ndi mankhwala.

Kupititsa patsogolo kuthana ndi poizoni, malasha "oyera", Sorbex, Anatulutsa kaboni, Polyphepan, Polysorb, Enterosgel amagwiritsidwa ntchito.

Zokhudza zakudya

Monga PoMedicine walemba kale, ndi mawonekedwe a acetone mkodzo Ndikofunika kutsatira zakudya zina. Ndikofunika kudya supu zamasamba osiyanasiyana, chimanga, mbale zam'madzi (mafuta ochepa). Amaloledwa kudya nyama yaying'ono ya nkaka, kalulu, ng'ombe, ng'ombe. Ndikofunika kuphika nyama, mphodza kapena kuphika mu uvuni.

Bwezeretsani mulingo wamadzi, dzazani thupi ndi mavitamini othandizira zipatso, ndiwo zamasamba, timadziti (tofinya kumene), zakumwa za zipatso, zakumwa za zipatso.

Ndikofunika kupewa nyama yamafuta, zakudya zam'chitini, zakudya zokazinga, nyama zosuta, cocoa, khofi, zonunkhira, bowa, mitundu yonse ya maswiti, komanso nthochi, zipatso zamalanje.

Ngati pokodza akumverera fungo la acetone, ndiye izi zikuwonetsa kuti zovuta zina zachitika mthupi. Ngati dokotalayo adazindikira molondola chomwe chayambitsa kuchuluka kwa ketone mu mkodzo, amupereka chithandizo chokwanira ndikuwonetsa kusintha komwe kumayenera kuchitika pakudya.

Amayambitsa chinthu mkodzo

Nkhani yofunikira pamabwalo ambiri odwala pakati pa odwala imakhalabe ndizomwe amatanthauza ngati acetone wapezeka mkodzo.

Nthawi zambiri, zomwe zimakhala pazinthuzi siziyenera kupitirira 0,5 mmol / L.

Kuchulukitsa mtengo wabwinobwino kumatha kukhala chifukwa cha matenda kapena mikhalidwe yambiri. Acetonuria imachitika akadzakula komanso ubwana.

Kuwonjezeka kwa acetone mu mkodzo mwa akulu, amuna ndi akazi, kumatha kuyambitsidwa ndi zifukwa zingapo:

1. Zizolowezi zoyipa kudya. Kuperewera kwa zakudya zamankhwala am'mimba, kuchuluka kwa mapuloteni ndi lipids kumayambitsa kuphwanya njira za metabolic. Ndikofunikanso kuti musamadye zakudya zomwe zimayambitsa ziwengo. Pachifukwa ichi, kuyezetsa magazi kumachitika, komwe kumapangitsa kuti pakhale tsankho.
2. Zochita zolimbitsa thupi. Nthawi zina kuchita masewera olimbitsa thupi kwambiri kungapangitse acetonuria. Kenako kusintha zochita zolimbitsa thupi kumafunika.
3. Kusala kudya kwanthawi yayitali. Zikatero, muyenera kupita kwa wathanzi kuti akuthandizeni ndikukhala ndi chakudya choyenera.
4. Matenda a shuga. Acetonuria ikhoza kukhala chifukwa cha kufooka kwa pancreatic mu shuga kapena odwala matenda a insulin.
5. Thirotooticosis. Ndi kuchuluka kwa mahomoni a chithokomiro, kuwonjezeka kwa matupi a ketone kumatha kuchitika.
6. Hyperinsulinism. Kuwonjezeka kwa ndende ya insulin kumayambitsa kuchepa kwambiri kwa glucose (hypoglycemia), komwe kumayambitsa acetonuria.
7. Matumbo dongosolo. Izi zimaphatikizapo stenosis ya pylorous ya esophagus kapena m'mimba, kukhalapo kwa zotupa za khansa.
8. Zifukwa zina - kuledzera, kuledzera kwa m'matumbo, matenda oopsa a m'mimba, kuthana ndi vuto la pakati, kupweteka kwa magazi, kuvulala kwamitsempha yam'mimba, matenda opatsirana, kuchepa magazi, cachexia, poyizoni wokhala ndi zitsulo zambiri komanso mankhwala.

Kusukulu komanso kuubwana, matendawa amakula mothandizidwa ndi zinthu izi:

• zolakwika mu zakudya,
• kugwira ntchito mopitirira muyeso,
• zolimbitsa thupi,
• hypothermia,
• mavuto,
• kusakhazikika,
• hyperthermia,
• helminthic infestations,
• kamwazi ndi diathesis,
• kumwa maantibayotiki.

Nthawi yapakati, kukhalapo kwa acetone mu mkodzo kumatha kumalumikizana ndi chikhalidwe cham'maganizo, zotsatira zoyipa za zinthu zakunja, toxicosis, kuchepa chitetezo chokwanira, kapena kugwiritsidwa ntchito kwa mankhwala okhala ndi utoto, mankhwala, mankhwala osungira.

Kanema: Acetone mu mkodzo: zimayambitsa, Zizindikiro, mankhwala, zakudya

Zambiri za acetonuria

Gawo loyamba ndikuwona mawonekedwe ndi mawonekedwe a matupi a ketone - izi zikuthandizira kumvetsetsa kwathunthu kwazowopsa za acetonuria. Ikufotokozanso chifukwa chake kupendekera kwakukulu kumafunikira kuchipatala msanga. Mawu ofanana kwambiri ndi ma ketones, makamaka pakati pa madokotala (ngakhale amafanana ndi akatswiri a jargon (slang)), ndi acetone. Liwuli limatenga mizu yake kuchokera ku Latin "acetum", yomwe imamasulira kuti acid.

Zowona zakale! Leopold Gmelin (Leopold Gmelin) - pulofesa wa sayansi yamatenda ndi zamankhwala ku Germany kuyambira 1848 adayambitsa mawuwa pakugwiritsidwa ntchito, pogwiritsa ntchito liwu lakale lachijeremani "aketon", lomwe limachokera ku Latin "acetum". Mawuwa pambuyo pake adadzakhala dzina limodzi lalikulu la ma ketones kapena acetone mu mankhwala.

Matupi a Ketone (awa akuphatikizapo acetone, acetoacetic acid, hydroxybutyric acid) ndi mankhwala omwe amawonongeka ndi ma enzymes a chiwindi kuchokera ku zakudya zomwe zimalowa m'thupi. Pafupifupi ma lipids onse (mafuta), komanso mapuloteni ena, amatenga nawo gawo pazomwe amapereka.

Mpaka posachedwa, ketonuria inali yosowa kwambiri ndipo nthawi zambiri inkapezeka mu mkodzo wa ana kapena amayi oyembekezera. Izi ndichifukwa cha magawo a mapangidwe a ziwalo zina (mwachitsanzo, kapamba) mwa ana ndi amayi apakati omwe ali ndi kuchuluka kwa katundu mthupi la mayi. Koma tsopano kupatuka kofananako ku chizolowezi nthawi zambiri kumapezeka mwa abambo akuluakulu ndi amayi omwe si amayi oyembekezera.

Mwa anthu ambiri, matupi a ketone amapezeka mthupi laling'ono - ndi mtundu wina wamagetsi. Kuphatikiza apo, kuchuluka kwa chidwi chawo kumayambitsa kusokonezeka kwa ziwalo za anthu ndi machitidwe awo, ndikuwadzetsa kuwawa. Kwenikweni, ndi chapakati acetonuria, dongosolo lamanjenje lamkati limavutika, ngakhale monga chimbudzi, kupuma kapena kwamikodzo sizimacheperako, ndipo chotulukapo chake, mkhalidwe wa munthu ukuipiraipira.

Nthawi zina, njirayi imatha kuchitika mwachangu komanso imayambitsa imfa. Izi zimachitika motsutsana ndi maziko a zamadzimadzi kagayidwe kachakudya matenda. Chofunikira kwambiri chakumapeto kwake ndi shuga (shuga), mosasamala kanthu komwe amalowa m'thupi - kuchokera kuzakudya, zowonjezera zakudya, mankhwala kapena njira yamapangidwe a ma cell.

Kuzindikira kwathunthu kumachitika chifukwa cha kapangidwe kokwanira ka insulin ya kapamba, komwe ndikofunikira pakuchita kwa shuga. Ndi kuchepa kwa ntchito ya pancreatic, zomwe zikutanthauza kuchepa kwa kupanga kwa insulini, shuga amalowa m'maselo osakwana kofunikira, zomwe zimayambitsa kufa kwawo ndi njala.

Kubwezeretsanso kuperekera kwa chakudya m'maselo, mapuloteni ndi lipids zimawonongeka, chifukwa cha chomwe matupi a ketone amasulidwa. Ngati zomwe akambirana zipitilira muyeso wovomerezeka (20-50 mg / tsiku), ndiye kuti izi zimafanana ndi zoopsa pakugwirira ntchito kwa thupi ndipo akufunika chithandizo choyenera.

Chifukwa chiyani acetonuria imayamba?

Zomwe zimayambitsa maonekedwe a acetone mu mkodzo zimakhala ndi mitundu yambiri, koma kufanana kwawo kumagona m'zakudya zosayenera (zopanda malire), zomwe zimapangitsa chidwi. Izi zimaphatikizapo zakudya zomwe zimakhala ndi mapuloteni ambiri amtundu wa nyama, komanso kunyalanyaza mankhwalawa.

Kuphatikiza apo, zovuta zoyipa za kutentha kwambiri kwa mpweya (nyengo yotentha) komanso kugwira ntchito molimbika pakuchita masewera olimbitsa thupi kapena kuchita masewera olimbitsa thupi zitha kudziwika. Kuchulukitsa kwa acetone mu mkodzo mwa anthu akuluakulu kumawonedwa nthawi zambiri chifukwa cha chakudya chopanda chakudya chopatsa mphamvu chomanga thupi chomwe chimagwiritsa ntchito mafuta ndi mapuloteni ena.

Ketonuria pamwambapa imakula msanga, koma nthawi zambiri patatha masiku 2-3, ndipo kupangika kwa mkodzo kumabwereranso ku mawonekedwe. Ngati matupi a acetone akatsimikiza mkati mwa masiku 5 kapena kuposerapo, muyenera kupita kwa dokotala kuti akuuzeni malangizo ndi kuwunikira kwathupi lonse.

Matupi a Ketone mu mkodzo amatha kukhala mawonetseredwe oyambilira a kusokonezeka kwa metabolic, ndipo amatha kukhala zotsatira za kusintha kwa pathological. Acetonuria, monga lamulo, imawonedwa likufanana ndi acetonemia (acetone m'magazi), popeza ma ketoni ochokera m'magazi amayamba kuchotsedwa mwamphamvu chifukwa cha impso yomaliza, ndipo amatumizidwa kumkodzo.

Zomwe zimayambitsa matenda achilengedwe omwe amakulitsa acetone mu mkodzo ndi awa:

• magawo oyambirira a chitukuko cha zotupa za m'mimba ndi matumbo aang'ono,
• khansa, leukemia (matenda oopsa a hematopoietic system),
• chithokomiro (kuchuluka kwa mahomoni a chithokomiro),
• kuvulala, ntchito limodzi ndi kuchepa kwa shuga,
• kuwonongeka kwa chiwindi parenchyma chifukwa cha uchidakwa,
• stenosis (kupendekera kwa lumen) kwam'mero ​​kapena m'mimba,
• kuchepa magazi kwambiri (kuchepa hemoglobin),
• cachexia wamphamvu (wotopa kwambiri),
• kupsinjika, mantha, kulimbitsa thupi,
• shuga wowonjezera,
• neoplasms mu ubongo,
• toxicosis pa nthawi yapakati,
• matenda amtundu
• kukangana
• chifuwa chachikulu.

Komanso ketonuria imatha kuwoneka ndi poyizoni wokhala ndi mchere wazitsulo kapena kugwiritsa ntchito mankhwala kwa nthawi yayitali (maantibayotiki kapena atropine). Mutha kuwerenga zambiri za mawonekedwe a acetone mu mkodzo mwa ana m'nkhaniyi.

Mawonetsero akuluakulu a acetone okwera mumkodzo

Zizindikiro zoyambirira za ketonuria poyamba, nthawi zambiri, zimawoneka pang'onopang'ono, ndipo fungo lokhazikika la mkamwa kuchokera pakamwa lingatanthauze kuti panali zovuta zina mthupi. Monga lamulo, zizindikiro zowonjezera monga:

• kudya kwakachepa, komwe kumayambitsa kukanidwa kwa zakudya ndi zakumwa,
• zimachitika mseru pambuyo kudya kapena kusanza,
• Fungo la acetone lochokera mkodzo pokodza,
• kuphwanya ntchito yogaya chakudya (kudzimbidwa, kutsekula m'mimba),
• kupweteka kwamankhwala m'dera lachiwombolo,
• pallor ndi kuuma kwa khungu ndi mucous nembanemba.

Kwa mawonekedwe apamwamba a matendawa, zizindikiro zotsatirazi ndizodziwika, zomwe zimayamba pang'onopang'ono kapena kuwonjezeka mofulumira:

• chisokonezo tulo, kugona tulo,
• kukulitsa chiwindi
• kuledzera
• kusowa kwamadzi kwambiri
• chikomokere.

Kuwonetsedwa kotereku kumafunikira kuchipatala kuchipatala, komwe kuli kofunikira kupatsira mayeso amkodzo, komanso mayeso ena onse kuti mudziwe chifukwa chake matendawa adayamba komanso chithandizo chamankhwala chotani. Werengani zambiri za mawonekedwe a acetone mu mkodzo panthawi yapakati mutha kuwerengera m'nkhaniyi.

Zoyenera kuchita ndi ketonuria

Ngati vuto la munthu silili lovuta, ndiye kuti, kupha thupi kwa matupi a ketone sikunadziwonetse okha mwa zisonyezo zazikulu, ndiye kuti choyambirira kuchita ndikuchezera dokotala kuti mukawone. An anamnesis adzasonkhanitsidwa munjira, yomwe ikhoza kuwunikira pazomwe zimayambitsa kukula kwa ketonuria.Kenako, malingana ndi momwe wodwalayo alili ndi zotsatira za kusanthula kwake, njira yolandirira yoyenera imapangika - chithandizo pamaziko apadera kapena kuchipatala.

Ma ketoni akapezeka mumkodzo, mankhwalawa adzachitika mbali zingapo. Pamaso pa matenda omwe amayambitsidwa ndi acetonuria, njira zimayenera kuchitidwa kuti zithetsedwe kapena kukhazikika pakati pa wodwalayo. Mwachitsanzo, ngati wodwala ali ndi matenda ashuga, ndiye kuti ayenera kumamwa mankhwala nthawi zonse, komanso kupereka magazi ndi mkodzo wa shuga. Kuphatikiza apo, muyenera kuyang'anira zakudya.

Fungo la acetone limawonetsa kukhalapo kwa poizoni woposa omwe amatchulidwa kuti ndi abwinobwino, chifukwa chake ayenera kuchotsedwa. Izi zitha kuchitika pogwiritsa ntchito adsorbents - Polysorb, Enterosgel kapena ochiritsira kukonzanso kaboni.

Komanso pazolinga izi, enemas yoyeretsa imagwiritsidwa ntchito. Ngati izi zimachitika mwa mayi wapakati motsutsana ndi poyizoni, ndiye kuti muchepetse poyizoni mwachangu, kulowetsedwa kwamankhwala kumachitika.

Kuphatikiza apo, ngati kulakalaka kusanza kumakupatsani mwayi kuti mumwe madzi pang'ono, ndiye kuti ndikulimbikitsidwa kumwa pang'ono pokha osati tiyi wotsekemera kapena shuga. Matupi a ketone akapezeka mkodzo, odwala amapatsidwa madzi amchere ndi zinthu zamchere, komanso njira zothetsera madzi amkamwa, monga Regidron, Chlorazole ndi ena. Ngati wodwala akudwala malungo, mankhwala othandizira antiretretic ndi mankhwala ena amtundu wa mankhwala amakhazikika.

Mfundo yofunikira kwambiri pochiritsa wodwalayo kapena kukhazikika pamatenda ake ndi ketonuria ndikutsatira njira zazikulu zopezera zakudya zoyenera. Msuzi wamafuta onenepa, zakudya yokazinga, zipatso za malalanje, zipatso ndi maswiti siziyenera kuphatikizidwa. Nthawi yomweyo, ndikofunikira kusankha zokonda zamasamba, chimanga, mitundu yamafuta ndi nsomba.

Ngati palibe zabwino pamanthawi othandizira odwala kwa masiku 4-5, ndiye kuti wodwalayo amagonekedwa kuchipatala ndipo odwala amakulimbikitsani kwambiri. Zimaphatikizanso kuyambitsidwa kwa mankhwala ndi Drip, komanso njira zovuta zomwe zimathandizira kuthandizira kwa mankhwalawa.

Kudzisankhira nokha mulingo wa matupi a ketone

Milingo ya ketone ya urin ndiyosavuta kudziwa kunyumba, ndipo uwu ndi mwayi wabwino, makamaka kwa odwala matenda a shuga. Pali zingwe zapadera zodziwira acetone, zomwe zitha kugulidwa mosavuta pafupi ndi mankhwala aliwonse. Ndikosavuta kuchita mayeso ngati awa, ndipo kwa amayi omwe asankha mobwerezabwereza kuti adziwe njira yotere, sizivuta konse.

Kuti muchite izi, muyenera kutenga gawo la mkodzo m'mawa, mutagwira chimbudzi cham'mimba ndikulowetsa khomo la kumaliseche ndi swab ya thonje. Kenako yambitsani chingwe ndi gawo lomalizidwa ndi mkodzo, kwa mphindi zochepa. Kenako gwedezani zotsalira za mkodzo, dikirani pang'ono ndikufanizira mthunziwo ndi mitundu yomwe ikuwoneka pamayeso oyeserera.

Ngati zotsatira zake zimakhala ndi pinki kulocha, ndiye kuti izi zikutanthauza kuti kupezeka kwa ma ketones ndikwapamwamba kuposa kwawonekera, koma pang'ono. Mtundu wa violet umawonetsa zinthu zambiri za acetone, zomwe zimafunikira kupita ku chipatala mwachangu.

Dokotala wodziwika bwino wa ana komanso otsogolera Komarovsky amalimbikitsa kwambiri kuti makolo omwe ali ndi ana omwe ali ndi matenda ashuga azikhala ndi mikwingwirima yoyesera kunyumba kuti adziwe ngati ali mumkodzo. Izi zikuthandizani kuti muzilamulira khansa ya mwana, zomwe zikutanthauza kuti mutha kupewa zovuta zina pakapita nthawi, monga kuchepa kwa magazi.