Dermatitis chithandizo cha matenda ashuga
Matenda a shuga ndi matenda omwe amadziwonetsa mu zovuta zazikulu za metabolic mwa anthu. Izi zimapangitsa kuti ziwalo zonse zamkati ndi kachitidwe ka wodwalayo zitheke, zimapangitsa kuti pakhale zovuta zowopsa.
Makamaka omwe adakhudzidwa ndi matendawa ndi thanzi la khungu, lomwe limatsogolera pakukula kwa matenda oopsa ngati dermatitis. Amayamba chifukwa chophwanya kagayidwe kazakudya komanso kuwonjezeka kwa shuga m'magazi, zomwe zimapangitsa kuti zinthu zambiri zowonongekeka zizipezeka m'thupi lonse, kuphatikiza khungu.
Zinthu izi zimasokoneza kapangidwe kake ka khungu, kumapangitsa kusintha kwakukulu kwa khungu ndi khungu, komanso kusokoneza tsitsi komanso thukuta la thukuta. Kuphatikiza ndi polyneuropathy (kuwonongeka kwa ma nerve malekezero), ma micro- ndi macroangiopathies (necrosis ya mitsempha yamitsempha yamtima) komanso kuwonongeka pakugwira ntchito kwa chitetezo chamthupi, amakhala chifukwa chachikulu cha matenda akhungu.
Pofuna kupewa izi, muyenera kudziwa chilichonse chokhudza matenda a chifuwa cha matenda a shuga ndi matenda ake.
Mitundu ya Dermatitis
Zadziwika kuti dermatitis ndi matenda a shuga zimayenderana kwambiri. Nthawi zambiri, mawonekedwe a dermatitis ndiye chizindikiro choyamba cha matenda a shuga. M'magawo oyamba a shuga, imatha kuwoneka ngati khungu lowuma komanso kuyimitsidwa nthawi zonse, komanso kubwerezabwereza kwamatenda a khungu monga candidiasis ndi pyoderma.
Kuwoneka kwa dermatitis mwa anthu omwe ali ndi matenda ashuga kale kungawonetse kukulira kwa matendawa kapena chithandizo chosankhidwa bwino. Pakadali pano, khungu la wodwalayo limakhala loyipa kwambiri komanso lothina, limasuluka kwambiri, ndipo ming'alu ndi chimanga chambiri zimatha kupezeka m'dera la manja ndi manja.
Dermatitis nthawi zambiri imakhudza khungu, ndikupangitsa kuti tsitsi lipere. Kuphatikiza apo, zimakhudza mkhalidwe wa misomali, zimapangitsa kusokonezeka kwawo ndikukula.
Dermatitis yokhala ndi shuga imagawika m'magulu atatu:
- Poyamba. Amapangidwa mogwirizana ndi kuphwanya kagayidwe kazakudya zam'mimba komanso kuphwanya kwa zotumphukira zamagetsi ndi kuzungulira kwa machitidwe. Izi zimaphatikizapo matenda a shuga, matenda ashuga xanthomatosis, lipoid necrobiosis ndi matuza a matenda ashuga.
- Sekondale Mitundu iyi ya dermatitis imayamba chifukwa chotenga kachilombo ka fungus kapena bacteria. Pakati pawo, candidiasis, pyoderma, zithupsa, carbuncle ndi phlegmon ndizodziwika bwino,
- Thupi lawo siligwirizana komanso mbali. Izi dermatitis amawonekera mwa wodwala mu mawonekedwe a zoyipa kapena matupi awo sagwirizana ndi mankhwala omwe amagwiritsidwa ntchito pochiza matenda ashuga. kotero zitha kukhala zosakanikirana ndi matenda ashuga.
Awa ndimomwe zimachitika modabwitsa, urticaria, toxidermia, post-jakisoni lipodystrophy.
Neurodermatitis. Vuto lotupa la khungu limatha kuwonedwa mwa odwala omwe ali ndi matenda ashuga ngakhale koyambirira kwamatenda. Neurodermatitis kapena, monga amatchedwanso, dermatitis ya atopic, nthawi zambiri imakhala imodzi mwazizindikiro zoyambirira zomwe zikuwonetsa kuchuluka kwa shuga m'magazi, omwe nthawi zambiri amathandizira kudziwa matenda a shuga, omwe amapezeka mwanjira yatsopano.
Ndi neurodermatitis, munthu amakhala ndi kuyabwa kwambiri, komwe nthawi zambiri kumachitika m'mimba, m'matumbo, m'matako, matako ndi m'miyendo. Pankhaniyi, munthu amakumana ndi kuyabwa kwambiri kumayambiriro kwa matenda. Ndi chitukuko cha matenda ashuga, amayamba kutha.
Matenda a diabetes. Matendawa amawonekera mu mawonekedwe a mawanga owala a pinki, omwe amapangidwira m'malo otseguka khungu, monga nkhope, khosi ndi manja. Erythema nthawi zambiri amakhudza amuna azaka zapakati (azaka 40 ndi akulu) omwe amadwala matenda ashuga kwakanthawi kochepa.
Malo a erythematous, monga lamulo, ali ndi kukula kwakukulu, mawonekedwe ozungulira komanso malire omveka. Ndi matenda awa, wodwalayo samva ululu kapena kuwawa. Nthawi zina, odwala amatha kudandaula kuti kumangogunda khungu.
Matenda a pakhungu awa amadziwika ndi njira yayifupi, osapitilira masiku 2-3. Pambuyo pake imadutsa yokha popanda chithandizo chapadera.
matenda bakiteriya. Nthawi zambiri, odwala matenda ashuga amatulutsa pyoderma - purulent kutupa kwa khungu chifukwa cha pyococci, staphylococci ndi streptococci. Poyamba, imadziwoneka ngati totupa, yopangidwa ndi zotupa zochepa.
Ndi chitukuko cha matendawa, wodwalayo amatha kupeza zilonda zamkati kwambiri, monga folliculitis, hydradenitis, furunculosis ndi carbunculosis. Zinthu ngati izi ndizowopsa kwa odwala matenda a shuga komanso zitha kukhala zowopsa m'moyo wa wodwala.
Chifukwa cha kuchuluka kwa shuga m'magazi, zotupa za m'mimba mwa anthu odwala matenda ashuga zimachiritsa kwa nthawi yayitali ndipo zimachitika ndi kuledzera kwamthupi. Zilonda zam'miyendo zamiyendo ndizowopsa kwambiri, chifukwa zimatha kutsitsa miyendo.
Thupi lawo siligwirizana. Nthawi zambiri mwa odwala matenda ashuga, mitundu yambiri ya khungu imayang'aniridwa, zomwe zimachitika mthupi kumankhwala osiyanasiyana, kuphatikizapo mayankho a insulin. Anthu odwala matenda ashuga amatha kukhala ndi matenda osiyanasiyana omwe samakhala nawo, koma kuphatikiza kwa matenda monga uritisaria ndi matenda a shuga kumakhala kofala kwambiri.
Urticaria imawoneka ngati zotupa, zomwe zimatha kukhala ndi kukula kuchokera mamilimita angapo mpaka masentimita angapo. Urticaria imadziwika ndi kufiira kwambiri kwa khungu komanso kuyabwa kwambiri.
Urticaria yokhala ndi matenda ashuga, chithunzi chake chomwe chatchulidwa m'nkhaniyi, chimatha kutenga nthawi yayitali ndikubwera kwa milungu ingapo ngakhale miyezi ingapo.
Maziko a chithandizo cha dermatitis iliyonse mu shuga amachepetsa shuga m'magazi ndikuwasunga mkati mwazotheka. Pachifukwa ichi, ndikofunikira kuti wodwala yemwe ali ndi matenda ashuga azitsatira zakudya zapadera zochizira, zomwe zimaphatikizapo kusiyanitsidwa kwathunthu ndi zakudya zonse zamafuta ndi mafuta ambiri.
Pakatha masiku ochepa chotsatira chakudyacho, wodwalayo amamva kuwongolera kwakukulu: kuyimitsidwa kwa kuyamwa kudzachepa, malo a totupa amachepera, khungu limaleka kusuzumira komanso kukhalanso wathanzi komanso zotanuka. Kuyabwa nthawi zina kumachitika mwa azimayi omwe ali ndi matenda ashuga pamalo oyandikira, koma ichi ndi chiwonetsero china.
Chithandizo cha neurodermatitis - chifukwa chake tikulimbikitsidwa kugwiritsa ntchito mafuta a corticosteroid, omwe amathandizanso kuyimitsa komanso kuthandiza kuthana ndi matendawa mwachangu. Mu matenda ashuga, mafuta awa otsatirawa amagwiritsidwa ntchito bwino:
Pofuna kuthana ndi urticaria, wodwalayo ayenera kugwiritsa ntchito antihistamines, yomwe imapezeka onse ngati mafuta ndi mapiritsi. Othandizira anti-allergen onse ndi:
Ndikofunikira kuchiza matenda a pyoderma ndi shuga. Matendawa, musatero muyenera kunyowetsa khungu komwe lakhudzidwa, chifukwa izi zimapangitsa kutupa.
Ndikofunika kusamala ndikukhala ndiukhondo ndikusamba m'manja ndi sopo nthawi zambiri. Thupi liyeneranso kukhala loyera ndikupukutidwa tsiku ndi tsiku ndi chinkhupule chonyowa choviikidwa m'madzi ofunda. Makanda athanzi okhala pafupi ndi chotupa ayenera kuthandizidwa pafupipafupi ndi njira zotsatirazi:
- 0,1% yankho lamadzimadzi a potaziyamu,
- 1 - 2% mowa yankho la salicylic acid,
- 1 - 2% mowa yankho la boric acid.
Kuthana ndi zotupa za purulent nokha, mutha kugwiritsa ntchito bactericidal othandizira monga:
- Fucortsin,
- Methylene buluu yankho,
- Yabwino kubiriwira yankho
- Mowa yankho la chlorophyllipt.
Kuphatikiza apo, kuwonekera kwa dera lomwe lakhudzidwa ndi khungu, tikulimbikitsidwa kugwiritsa ntchito mafuta a antibacterial:
- Gioxizonova,
- Lincomycin
- Erythromycin
- Ichthyol,
- Mafuta a Vishnevsky.
Pachifukwa ichi, mutha kugwiritsa ntchito ma pastes okhala ndi antibacterial, omwe ndi lincomycin kapena erythromycin.
Ngati chithandizo cham'deralo cha pyoderma sichinapereke zotsatira zomwe zikufuna ndipo vuto la wodwalayo liyayamba kuwonongeka, ndikofunikira kulimbikitsa antibacterial. Pachifukwa ichi, kukonzekera kwa maantibayotiki kuyenera kugwiritsidwa ntchito, komwe kumatha kumwa onse pakamwa komanso ngati jakisoni wa intramuscular.
Zotsatira zabwino kwambiri pochizira zotupa za pak purifya zimaperekedwa ndi mankhwala a gulu lawo la macrolide, omwe ndi:
Kuonjezera kukana kwa thupi kwa wodwala, tikulimbikitsidwa kuti muyambe kumwa ma immunomodulators omwe cholinga chake ndi kuthana ndi pyococci, staphylococci ndi streptococci:
- y-globulin
- Staphylococcal toxoid,
- Antifagin.
Pakulimbitsa thupi kwathunthu, makonzedwe amakono a multivitamin angagwiritsidwe ntchito.
Njira zingapo zodziwika bwino za matenda a dermatitis zimawonetsedwa mu kanema munkhaniyi.
Zomwe zimachitika
Dermatitis ya seborrheic pakhungu nthawi zambiri imakhudza achinyamata ndi achinyamata osakwana zaka 25-27. Matendawa akufotokozedwa mu activation ya sebaceous tiziwalo tating thunzi tating'ono totsegulira nkhope, ndi kusintha kwa kapangidwe kake ka sebum.
Chizindikiro cha seborrheic dermatitis pankhope imatha kuzindikirika ndi mawanga ofiira komanso opanda kanthu. Pogwirizana ndi izi, tanthauzo longa seborrheic eczema limagwiritsidwa ntchito nthawi zambiri.
Zonsezi ndi izi zinaonetsa njira yotupa yopepuka, pamenepa ikukhudza dera la nkhope. "Ma Scenarios" samachotsedwera pomwe amafalikira kumaso.
Matenda a shuga amayambitsa kusokonezeka kwa kagayidwe kazakudya m'thupi la munthu. Kuphwanya kotereku kumapangitsa kuchuluka kwa shuga ndi mkodzo. Njira ya pathological imapangitsa kusintha kwa ziwalo, ma dermis ndi khungu la khungu. Zomwe zimayambitsa mawonekedwe a neurodermatitis mu shuga ndi monga:
- Kugwiritsa ntchito bwino chitetezo chathupi,
- kudzikundikira kwa zinthu zovulaza ziwalo ndi minofu.
- vuto la autoimmune
- chibadwa
- Matendawa ndimomwe ndimankhwala omwe amagwiritsidwa ntchito pochiza matenda oyambitsidwa ndi matendawa.
- kuchuluka kwa shuga m'magazi ndi shuga yakhazikitsidwa.
Neurodermatitis kapena atopic dermatitis imayamba magawo a shuga. Psychology yotere ndi chizindikiro choyamba cha kuchuluka kwa shuga m'magazi. Kukhalapo kwake kumathandiza kuzindikira matendawo.
Zizindikiro ndi zizindikiro za matenda apakhungu
Matenda a shuga amakhala ndi vuto lililonse pamitsempha yamagazi, yomwe imapangitsa kuti magazi aziyenda pansi pa khungu komanso mucous nembanemba.
Mwa akazi, mawonetsedwe akhungu la matenda atha kukhala motere:
- pindani ndi nkhope,
- kulimbikira
- khungu lowuma
- ziphuphu,
- matenda oyamba ndi bakiteriya,
- ma microcracks pa mucous nembanemba,
- kuphwanya microflora ya nyini.
Mwa amuna, mawonekedwe a khungu la matenda ashuga amatha kukhala motere:
- khungu pakhungu,
- furunculosis,
- matenda a fungal pakhungu la miyendo ndi pakamwa
- khungu lowuma,
- kupoleka pang'onopang'ono
- ziphuphu.
Nthawi zambiri, ana odwala matenda ashuga amakhala ndi matenda akhungu lotere:
- thonje,
- kulimbikira kwamanyazi,
- ichthyosis,
- neurodermatitis
- kuyabwa ndi khungu.
- mapangidwe osangalatsa
- khungu lowuma.
Za matenda ndi zizindikiro zake
Kuphwanya kwakukulu kwa zochita zonse za metabolic zomwe zimadziwika ndi matenda osokoneza bongo zimapangitsa kuti masinthidwe amthupi azikhala zambiri komanso ziwalo zambiri zamthupi. Kuphatikizira, zikafika pakhungu.
Pakadali pano, mitundu yopitilira 30 ya zilonda zapakhosi imadziwika kuti ngakhale katswiri wothamanga samatha kupirira. Amagawika m'magulu omwe amayambitsa matenda ashuga ndi omwe amapanga motsutsana ndi maziko ake.
Chimodzi mwazomwe tikuwonetsa ndi dermatitis, zokhudza zonse zomwe zingafotokozedwe pansipa.
Dermatitis mu diabetes iliyonse imapangidwa, kukhala chifukwa chophwanya njira zonse za metabolic m'thupi. Kuphatikiza apo, ili ndi vuto lalikulu:
- kuphwanya ma microcirculation, omwe amatha kusintha ndi xylitol,
- adachepetsa chitetezo pakhungu, lomwe limayamba kusokonezeka.
Kuphwanya kwakukulu kwa zochita zonse za metabolic zomwe zimadziwika ndi matenda osokoneza bongo zimapangitsa kuti masinthidwe amthupi azikhala zambiri komanso ziwalo zambiri zamthupi. Kuphatikizira, zikafika pakhungu.
Pakadali pano, mitundu yopitilira 30 ya zilonda zapakhosi imadziwika kuti ngakhale katswiri wothamanga samatha kupirira. Amagawika m'magulu omwe amayambitsa matenda ashuga ndi omwe amapanga motsutsana ndi maziko ake.
Chimodzi mwazomwe tikuwonetsa ndi dermatitis, zokhudza zonse zomwe zingafotokozedwe pansipa.
- kuphwanya ma microcirculation, omwe amatha kusintha ndi xylitol,
- adachepetsa chitetezo pakhungu, lomwe limayamba kusokonezeka.
Ma pathologies onse a pakhungu amasiyanitsidwa m'magulu awiri akuluakulu.
Zilonda zamkhungu zomwe zimayambitsidwa ndi matenda a shuga, monga lamulo, zimatenga nthawi yayitali, zimadziwika ndi kufalikira pafupipafupi. Kuchiza ndi kuzindikira matenda a dermatoses ndi ntchito ya dermatologist ndi endocrinologist.
Zizindikiro za neurodermatitis mu shuga zimadziwika ndi kukula pang'onopang'ono. Ndi kukula kwa matenda oterowo, munthu amakhala akumva kuyabwa kwambiri, komwe kumakhala kwina m'dera la kutsogolo, maliseche, ntchafu ndi pamimba. Njira ya pathological imadutsa zotsatirazi:
- Kudula ziwiya zazing'onoting'ono ndimakristali a shuga kumachitika.
- Khungu limakhala loonda, loyipa, nthawi zina limapunduka.
- Chinyezi ndi masoka achilengedwe pakhungu amachepa.
- Ndi shuga wambiri, mawonekedwe a thovu pamtunda wa khungu.
- Kuyamwa kwambiri kumawonekera.
- m'malo mwa thovu, zisa ndi mawonekedwe a mabala.
- CNS yasokonekera.
- Pali kusintha pamlingo wamalingaliro am'madera omwe akhudzidwa.
- Matenda a munthu amakhala akuipiraipira:
- pali kusokonekera,
- kutentha kwa thupi kumawonjezeka
- minofu, kuphatikizika ndi mutu kumamveka.
Kuwonjezeka kwa shuga m'magazi ndi kusokonezeka kwa magazi m'malo ena kumayambitsa kuonekera kwa matenda:
- redness ndi kutupa,
- tinthu tating'ono tating'ono,
- kuyaka ndi kuwawa pakukhudzidwa,
- kuyamwa kwadzaoneni.
Nthawi yomwe wodwalayo sakudziwa za matenda ake a shuga, chikanga sichingadziwike ngati umboni wake. Pankhaniyi, dermatosis imakhala kuti si chizindikiro chodwaladwala, koma chisonyezo chakufunika koyesedwa kwathunthu chifukwa chomuikira.
Kodi ndimatenda bwanji khungu limakhala ndi shuga wambiri?
Ndizofunikira kudziwa kuti kuchuluka kwa zowonongeka pa khungu ndi kuchuluka kwa mawonetsedwe nthawi zambiri zimangodalira gawo la matenda ashuga. Ndi mawonekedwe a eczema motsutsana ndi matendawa a matendawa, sizovuta kudziwa zovuta za zotupa za pakhungu.
Mikhalidwe ya thupi ndi kuchuluka kwa kupitirira kwa matenda a zamatsenga nthawi zambiri zimagwira ngati zomwe zimapangitsa kuti kuphwanya kwa kagayidwe kachakudya ka minyewa ya epithelial.
Momwe tiyenera kuchitira
Kodi mungapewe bwanji kuyimitsidwa mu shuga?
Lamulo loyamba ndi kukula kwa shuga m'magazi, ndiye kuti, chithandizo chokwanira cha matenda oyambitsidwa.
Mukamayang'ana popanda zizindikilo zakunja, malangizo otsatirawa angathandize:
- osasamba madzi osamba owuma khungu,
- ikani mafuta odzola pathupi lonse mutangotha kuyanika pakhungu, kupatula malo okhwima,
- Pewani moisturizer yokhala ndi utoto ndi kununkhira, ndibwino kugwiritsa ntchito mankhwala opangira hypoallergenic kapena mankhwala apadera pokonzekera khungu kusamalira matenda ashuga,
- samalani zakudya zofunika, pewani kugwiritsa ntchito mafuta osavuta.
Kusamalira khungu matenda a shuga kumaphatikizanso malamulo awa:
- gwiritsani sopo wofatsa, muzimutsuka bwino ndikuwuma pang'ono khungu lanu osalipaka,
- pukutani malo a madalo awiri, pewani thukuta kwambiri mapazi,
- pewani kuvulala pakhungu, periungual roller, cuticle mukasamalira misomali,
- gwiritsani zovala zamkati ndi masokosi okha,
- ngati kuli kotheka, valani nsapato zotseguka zomwe zimathandiza kuti mapazi azikhala ndi mpweya wabwino,
- ngati banga lililonse kapena kuwonongeka kuwoneka, funsani endocrinologist.
Khungu lowuma limasweka nthawi zambiri ndipo limatha kutenga kachilomboka. M'tsogolo, izi zitha kuyambitsa zovuta zambiri. Chifukwa chake, pakaonongeka, kuonana ndi dokotala ndikofunikira. Kuphatikiza pa mankhwala omwe amasintha kayendedwe ka magazi ndi ma peripheral nerve function (mwachitsanzo, Berlition), endocrinologist amatha kukupatsani mankhwala othandizira. Nayi othandiza kwambiri pa matenda ashuga:
- Bepanten, Pantoderm, D-Panthenol: ndiuma, ming'alu, abrasions,
- Methyluracil, Stisamet: ndi mabala ochiritsa olakwika, zilonda zam'mimba,
- Kubwezera: Zilonda zam'mimba, zilonda zam'mimba,
- Solcoseryl: gel - kwa zilonda zatsopano, zonyowetsa, mafuta - a mabala owuma, ochiritsa,
- Ebermin: yankho lothandiza kwambiri la zilonda zam'mimba.
Kuchiza kuyenera kuchitika kokha moyang'aniridwa ndi dokotala. Matenda a shuga amfalikira mwachangu ndipo amakhudza zigawo za khungu lakuya. Kusokonezeka kwa magazi ndi kusungidwa kwa malo osungirako zinthu zakale kumapangitsa kuti minofu necrosis ipangidwe. Chithandizo cha matenda oterewa nthawi zambiri chimachitidwa opareshoni.
Khungu limakhudza insulin
Matenda a shuga ndi matenda omwe amadziwonetsa mu zovuta zazikulu za metabolic mwa anthu. Izi zimapangitsa kuti ziwalo zonse zamkati ndi kachitidwe ka wodwalayo zitheke, zimapangitsa kuti pakhale zovuta zowopsa.
Makamaka omwe adakhudzidwa ndi matendawa ndi thanzi la khungu, lomwe limatsogolera pakukula kwa matenda oopsa ngati dermatitis. Amayamba chifukwa chophwanya kagayidwe kazakudya komanso kuwonjezeka kwa shuga m'magazi, zomwe zimapangitsa kuti zinthu zambiri zowonongekeka zizipezeka m'thupi lonse, kuphatikiza khungu.
Zinthu izi zimasokoneza kapangidwe kake ka khungu, kumapangitsa kusintha kwakukulu kwa khungu ndi khungu, komanso kusokoneza tsitsi komanso thukuta la thukuta. Kuphatikiza ndi polyneuropathy (kuwonongeka kwa ma nerve malekezero), ma micro- ndi macroangiopathies (necrosis ya mitsempha yamitsempha yamtima) komanso kuwonongeka pakugwira ntchito kwa chitetezo chamthupi, amakhala chifukwa chachikulu cha matenda akhungu.
Pofuna kupewa izi, muyenera kudziwa chilichonse chokhudza matenda a chifuwa cha matenda a shuga ndi matenda ake.
Dermatitis yokhala ndi matenda a shuga imatha kukhala mitundu yambiri. Izi zimaphatikizira monga atopic dermatitis kapena mawonekedwe a atopic a matendawa. Cholinga chachikulu cha mawonekedwe oyamba a mitundu yomwe yaperekedwa iyenera kuonedwa ngati vuto lomwe likupita patsogolo m'thupi. Ndikofunikira kudziwa kuti ndizobadwa nazo, komanso chizolowezi chopanga matenda a shuga.
Dermatitis ya seborrheic kumaso ndi matenda osakhazikika a pakhungu amadziwika ndi zotupa komanso kutupa pakhungu pankhope. Malinga ndi ziwerengero, amuna amadwala nthawi zambiri kuposa azimayi, ndipo matendawa amathanso kuchitika mwa makanda ndi achinyamata.
Chithandizo Chachikhalidwe
Dermatitis ndi kutupa kwa khungu komwe kumachitika chifukwa cha kukwiya mwachindunji kapena kuchititsa chidwi pazinthu zina zakunja. Kukwiya kumakhumudwanso patatha masiku ochepa kuchotsedwa kwa zinthu zoyipa. Yogwirizana ndi kufunda kwamilomo, dermatitis amatchedwa cheilitis, komanso wachibale wa chigoba cha mkamwa - stomatitis.
Dermatitis ya pachimake imawonetsedwa ndi erythema, edema, mawonekedwe a zotupa, matuza kapena minofu necrosis popanga zilonda ndi zipsera.
Pakadali pano, mankhwala ovomerezeka alibe njira zochizira matenda ashuga. Madokotala azindikira kuti zosokoneza zimapangidwa pakukhazikika kwa matenda ashuga.
Ngati pali thovu, amatsegula ndikusintha.
Dermatitis yayitali, malo osambira ofunda ndi mafuta okometsera, corticosteroid, kenako mafuta opangira keratoplastic amagwiritsidwa ntchito. Chithandizo cha zowotcha zambiri ndi frostbite zimachitika m'madipatimenti apadera.
Chithandizo cha dermatitis mwa amayi apakati iyenera kuchitika moyang'aniridwa ndi dokotala mogwirizana ndi malangizo ndi malangizo ake. Kutengera mtundu wa dermatitis komanso momwe mayi wapakati amakhalira, mankhwala a antihistamines ndi mankhwala osokoneza bongo nthawi zambiri amapatsidwa mankhwala.
Zokonda zimaperekedwa pakukonzekera kwapamwamba - zokambirana za antipruritic, mafuta a calamine ndi mafuta a corticosteroid.
Dotolo amalimbikitsa mayi woyembekezera kuti azitsatira zakudya mosamalitsa - kukana mafuta, mchere, zonunkhira, zotsekemera, utoto, mankhwala osungira, zakudya zakunja. Chithandizo chithandizika poyerekeza ndi maziko azakudya zomwe zimapangitsa dermatitis, ndipo izi kwa azimayi oyembekezera nthawi zambiri zimakhala ziweto, fumbi, mabuku akale, nsalu zokutira, mankhwala amnyumba kapena zodzola.
Kuzindikira kwa dermatitis yosavuta ndikuzindikira kutulutsa kwina.
Kuti adziwitse matenda a khungu la khungu, anamnesis amagwira ntchito yofunika, komanso kuyang'ana zitsanzo za khungu, zomwe ndizofunikira kwambiri pofufuza ziwopsezo za ntchito.
Maphunziro a Laborator angagwiritsidwe ntchito: zochita za immunological ndi ma antigen apadera.
Dermatitis ya mziwindi imasiyanitsidwa ndi eczema.
Chithandizo cha Conservative
Njira yochizira zotupa pakhungu la odwala matenda ashuga ndi kubwezeretsa kwa zovuta za kagayidwe kazakudya.
Matenda a pakhungu amateteza kutulutsa kwake, ngati alipo, chithandizo cha hypoglycemic iyenera kulimbikitsidwa kapena kusintha. Komanso, wodwalayo ayenera kuyang'anitsitsa glycemia.
Kwenikweni, matenda a pakhungu alibe njira yeniyeni, maultivitamini, mavitamini, jakisoni wokhazikika wa insulin, Heparin ndi corticosteroids akhoza kukhazikitsidwa.
Anthu odwala matenda ashuga ayenera kuyang'anitsitsa khungu lawo ndi momwe angapewere kutaya khungu. Alimbikitsidwa:
- Chitani pafupipafupi magazi a shuga
- kumwa pafupifupi malita 1.5 amadzi oyera tsiku lililonse,
- gwiritsani ntchito madzi ofunda pogwiritsa ntchito moisturizer,
- Tetezani khungu ku kutentha kwambiri kapena kutentha kwambiri, komanso kuzizira kwambiri,
- Chitani kafukufuku wa khungu tsiku ndi tsiku
- yang'anirani zakudya zanu,
- ngati mabala, kuwotcha, kukanda, mafoni, mwachangu gwiritsirani ntchito madera omwe akhudzidwa ndi bactericidal othandizira,
- sinthani kagayidwe kachakudya mu thupi,
- pa zaukhondo gwiritsani ntchito zinthu zopanda mafuta onunkhira zomwe sizimayambitsa chifuwa, mkwiyo ndi khungu louma.
- yang'anirani khungu la miyendo ndi kukonza ukhondo wawo, makamaka pakati zala,
- Zovala siziyenera kutikita khungu kapena kufinya khungu, zopangidwa ndi nsalu zachilengedwe,
Kuthetsa vutoli pogwiritsa ntchito wowerengeka azitsamba
Kuti mukhale ndi khungu labwinobwino, odwala matenda ashuga amatha kuyambiranso wowerengeka azitsamba.
Malo osambira otentha amalimbikitsidwa ndi kuwonjezeredwa kwa chingwe kapena khungwa la oak, chithandizo cha malo omwe adatsitsidwa ndi decoction ya masamba a birch, kutikita khungu ndi madzi atsopano.
Poyamwa, kuyamwa masamba owoneka ndi masamba a St John akhoza kuthandizidwanso kunja. Iyenera kugwiritsidwa ntchito mwapadera mawonekedwe ofunda, kupukuta malo omwe ali ndi khungu.
Czema ndi matenda a shuga zimawopseza osati kuwonongeka kwa chikhalidwe chamunthu, komanso moyo wa wodwalayo. Chithandizo cha matenda a pakhungu chimafunikira njira yoyenera.
Kumuwonetsa kwakunja madera omwe akhudzidwa ndi mankhwalawa kungadzetse kwakanthawi kochepa, chovuta chake sichikhala chopanda tanthauzo konse. Chifukwa chake, kutenga chithandizo cha dermatosis, kutsimikizika kwakukulu kuyenera kukhala kuchepetsa shuga.
Nthawi zambiri, ma dermatoses oyamba a shuga safuna chithandizo chapadera. Matenda a wodwalayo akadzikhazikika, zizindikilo zake zimachepa.
Kuchiza matenda opatsirana a dermatoses kumafuna kuikidwa kwa mankhwala enieni pogwiritsa ntchito mankhwala antifungal ndi antibacterial.
Kupewa matenda
Ngati zotupa kapena zilonda zimoneka pakhungu, muyenera kuyendera dokotala kuti akuthandizeni.
Kukula kwa madokotala mwachindunji kumatengera momwe kukonza kwa kagayidwe kachakudya komanso momwe wodwalayo angakhalire ndi matenda ashuga.
Kukula kwa matenda a shuga a matendawa kumatengera kuchuluka kwa wodwala amene ali wokonzeka kulimbana ndi matendawa ndikubwezeretsa kagayidwe.
Yakhazikika pakhungu ndi kuyabwa: momwe angachitire?
Januware 23. Alexandra Bondareva
Zimayambitsa kuyabwa
Chotupa chotsamira ndi kuyabwa chimachitika kamodzi pachilichonse.
Khungu loyenda limasokoneza kwambiri moyo, limabweretsa nkhawa, kugona tulo komanso kusokonezeka kwa ntchito. Khungu loyenda limakupangitsani kuti mufuna kulikanda, ndipo izi zimapangitsa kuti zikande, kuthandizira, pomwe matenda amatha kulowa m'magazi.
Kulowa pakokha si matenda, ndi chimodzi mwazizindikiro za matenda a pakhungu kapena kusagwira bwino ntchito kwamkati.
Kodi zotupa zimawoneka bwanji?
Mitundu ya zotupa pa thupi la munthu nthawi zambiri imakhala ili:
Zimayambitsa kuyabwa
Zomwe zimayambitsa zotupa pakayendedwe ndi izi:
Tiyeni tikambirane chilichonse mwatsatanetsatane.
Kuyabwa pakhungu ndi zotupa kungayambike chifukwa cha tsankho kwa gulu lina la mankhwala kapena mankhwala, kulumikizana ndi zinthu zomwe zimakhumudwitsa khungu (zonona, mafuta onunkhira, ochapira zovala ndi zina).
Tizilombo tating'onoting'ono kapena mawanga, kutupa pakhungu, kuyabwa kwambiri.
- Yesetsani kuti musapikisane malo osangalatsa
- Tengani mankhwala okalamba omwe adokotala amuuzani.
- Mutha kuthira compress ndi madzi owiritsa osenda m'madzi.
- Ndi dera lalikulu la totupa - kusamba ndi yankho la soda.
Patulani mafutawo ndi mafuta apadera (mwachitsanzo, Fenistil - gelisi).
Kukambirana ndi dermatologist ndikofunikira. Makamaka ngati:
Mtundu umodzi wa ziwengo. Amatchulidwanso kuti urticaria chifukwa chofanana ndi zotupa kuchokera pakuwotcha. Ndi pachimake (mpaka masiku 30) komanso nthawi zonse (masiku opitilira 30).
Matenda opatsirana
Kuyamba ndi zotupa nthawi zambiri kumakhala chizindikiro cha matenda opatsirana.
Nthawi zambiri, zotupa zimachitika mthupi lonse, kuphatikiza mutu ndi miyendo. Ndi ziphuphu zakumaso pamiyendo ya munthu wamkulu yemwe amakhala chimodzi mwazizindikiro zazikulu zamatenda ambiri. Chifukwa chake, ngati zotupa zikuonekera pamenepo, muyenera kufunsa dokotala.
Ndipo pakuwoneka zotupa, adzazindikira ndi kuperekera chithandizo.
Kodi ndingapewe bwanji kuyimitsidwa?
Mulimonsemo, ngati kuyabwa ndi zotupa sizikutha mkati mwa sabata, musadzimvere, kukaonana ndi dermatologist.
Zoopsa mwa ana.
Momwe mungathanirane ndi nkhanza m'mwana ndipo ndi chithandizo chiti chothandiza kwambiri - tikambirana njira zodziwika bwino zamakono komanso njira zina zomwe zingagwiritsidwe ntchito pochiza ziphuphu mwachangu, popanda zotsatirapo zaumoyo. popanda chifukwa, ndipo nthawi yomweyo chimayima mphindi iliyonse, zomwe zikutanthauza kuti ali ndi mphere. Musachite mantha, sizinachokerane ndi nyama. Nthawi zambiri mwana amamutenga akamalankhulana ndi ana ena pabwalo lamasewera kapena pasukulu ya ana.
Kodi nkhanambo zimachitika bwanji mwa ana ndipo ndi zomwe zimawonedwa? Tsikuli limalowa mu epithelium ndikuyamba kupanga magawo ang'onoang'ono mthupi lonse mmenemo (onani chithunzi cha Scabies pansipa). Pakatha milungu iwiri, macheza onse am'maso akuwoneka kale, chachikulu ndikukhazikika kwa khungu, komwe kumakulirakulira usiku. Mwana amadwala nthawi zonse ndipo mabala amapezeka pomwe mitundu yosiyanasiyana ya matenda imagwera mosavuta. Mu ana, okhala ndi nkhanambo, nthawi zina pamakhala timiyala ta pinki kapena matupi amanyama. Amapezeka pakati pa zala, pazitseko za manja, kumbuyo ndi m'mimba, komanso pazikondwerero. Mu makanda, amatha kupezekanso pankhope. Makanda amakhudzidwa ndi kuwonongeka kwa msomali.
Kodi ma scaba amawonekera bwanji ndipo ndi zizindikiro ziti za matendawa zomwe muyenera kulabadira choyamba? Mwana amagona pang'ono usiku, motero masinthidwe amadzuka, amalira kawirikawiri ndipo watopa kwambiri, pamakhala mavuto ndi kusowa kwa chakudya. Zovuta sizikhala zokha, muyenera kupitilira chithandizo chake. Koma muyenera kuchotsa nkhupakupa mosamala kuti matenda asagwere enawo. Palibe chochita mantha, mankhwalawa akhungu ndi akomweko. Mafuta, zothetsera, ma erosos amaperekedwa kwa mwana. Madokotala nthawi zambiri amalimbikitsa kugwiritsa ntchito "Benzyl benzoate" kapena "Spregal", pomwe ma antihistamines amafunikiranso. Mulimonsemo, musasankhe chithandizo nokha, simungathe kuchita popanda kufunsa adokotala. Posachedwa, nkhanambo mu ana zakhala matenda ofala kwambiri ndipo chithandizo chitha kuchitika pogwiritsa ntchito njira zina ngati sizingatheke kugula mankhwala amakono. Ganizirani maphikidwe otchuka kwambiri.
Phatikizani malo okhudzidwawo ndi mafuta anyama (2 lobes) ndi sulufule (1 lobe). Mutadzuka m'mawa ndi madzulo musanagone, muyenera kupaka mafuta pakhungu. Zosakaniza ndi: mafuta anyama, sopo wobiriwira, sulufule mu ufa (chilichonse chopanga theka la supuni), kuphatikiza supuni 1 ya phula (peeled yokha). Sakanizani zonse mpaka yosalala.
Kukonzekera mafuta otsatira, tengani phula la birch (loyeretsedwa, lamadzi) m'magawo pafupifupi 200 magalamu, ndikuthira misayo mumtsuko wamadzi, iyenera kukhala yayikulu. Kenako, yambani kusakaniza chilichonse mpaka madzi atayamba kukhala amtoto. Pakani madzi akuda ndikudzaza chotengera ndi madzi oyera. Njirayi imabwerezedwa kangapo kasanu ndi kawiri, mpaka pakakhala kulumikizana kwamkati ndi uchi. Madera okhala ndi matendawa.Scabies mu mwana Chithunzi
Pansipa tikufotokozerani mwatsatanetsatane za momwe muyenera kukhalira ndi nkhanambo moyenera kwa ana, ndi zofunikira ziti kuti muzitchera khutu komanso ndizizindikiro zazikulu ziti zowonetsera matendawa kwa mwana. Mupezanso kuti ndi mankhwala ati wowerengeka omwe amagwiritsidwa ntchito bwino pakhungu limapezeka mwa mwana, kuti matendawo athe kuchira msanga komanso popanda zovuta.
Tsopano mukudziwa momwe mungachiritsire nkhanambo komanso zizindikilo za matendawa zimasonyezeratu kupezeka kwa nkhanambo mu gawo lozungulira. Mumazindikira njira zamakono komanso zodziwika bwino za anthu wowerengeka zothandizira komanso kupewa ma scabies mwa ana.
Zovuta - zoyambitsa ndi njira za matenda
Scabies, zomwe zimayambitsa ndi tiziromboti, ndiko kuti, nkhono mite, ndimatenda opatsirana omwe aliyense angagwire. Choyambitsa matendawa chimayambitsidwa pakhungu m'malo osatetezeka kwambiri - m'malo ometera, m'mphepete, m'miyendo, m'mapewa, pakati pa zala. Koma kwa matenda, kulumikizana kwakanthawi ndi wodwala sikokwanira. Kuti nkhupizo ikwere, imatenga mphindi 20 mpaka 30. Mtengo wa itch, womwe umadziwikanso kuti kuyabwa, umatha kulowa m'thupi la ana motere:
- kulumikizana mwachindunji ndi wodwala wokhala ndi zipsera, makamaka usiku (makolo odwala akagona ndi ana),
- mogwirizana ndi zinthu za wodwala,
- m'malo a anthu onse
- m'masukulu ophunzirira komanso masukulu osamalira ana masukulu.
Scalies mu ana - Zizindikiro
Makolo ochita zinthu mwachangu amatha kuona mwachangu zipsinjo za ana, koma vuto ndiloti ena mwa iwo ndi mawonekedwe a khungu lina: zovuta zomwe zimayambitsa matenda osiyanasiyana. Ndikosavuta kuzindikira kuti pawokha kudayamba ana. Ndi chifukwa chake kuwunika kwa matenda kuchipatala kumafunikira. Zofunikira zake ndi:
- kuyabwa kumapeto kwausiku ndi nthawi yausiku, pamene nthawi yakuyambitsa tizilombo tosaoneka ukuyamba,
- Zizindikiro zoyambirira za nkhanza kwa ana mpaka miyezi isanu ndi umodzi zilira, kuda nkhawa usiku, matuza ngati urticaria, omwe ali ofanana ndikulira eczema,
- nkhanambo mu ana okalamba ndi chotupa cha malo ophatikizana ndi matuza osiyanasiyana osiyanasiyana mthupi lonse kupatula mutu,
- zotupa zofiirira zokhala ndi ma scaba mwa ana zimakhala ndi timadzi tating'ono tambiri mkati,
- ndi kuwonongeka kwakukuru, malo owuma akhungu pansi pa khungu amawonekera, pomwe zotupa pakati pa ana ndi malo omwe tiziromboti timakumana.
Kodi nkhanizi zimayamba bwanji mwa ana
Mwa ana azaka zitatu, matendawa amapezeka mosavuta ngati zizindikiro zoyambirira za nkhanza kwa ana zili pamphumi. Mwa ana ochepera zaka zino, kuwunikira ndikofunikira kuti muzindikire zomwe zimayambitsa zotupa. Choyamba, khungu pakati pa zala limakhudzidwa, ndiye kuti zotupa zimachitika kumbuyo kwanthawi, matako, kumaliseche. Ana omwe amasamalidwa bwino pankhani ya ukhondo sakonda kupsa, ndipo iwo omwe ali ndi regulen iyi amaphwanyidwa amakhala ndi mawanga. Pambuyo totupa yoyamba kuoneka, kuyabwa ndi kukanda pakhungu kumawonekera usiku, zomwe zimayambitsa matenda apakati.
Kodi nkhanizi zimawoneka bwanji mwa ana?
Chifukwa cha kuchuluka kwa matendawa, makolo ayenera kudziwa momwe nkhanambo zimawonekera mwa ana, momwe zimawonekera. Popeza nkhupakupa ikuyang'ana khungu losalala kwambiri, chinthu choyamba muyenera kulabadira ma bondo ndi maondo, malo pakati pa zala. Khungu pamenepo limakhala louma, limayamba kusweka ndi kuphulika. Tizilombo tokhala ndi thupi timakhala tosiyanasiyana ndi chinyemba, chomwe, chikasungunuka, timapanga kutumphuka.
Momwe mungadziwire nkhanambo mu mwana?
Kuwulula nkhonya mite mu mwana, kufunsana ndi nkhope ndi dermatologist ndikofunikira. Nthawi imeneyi, dotolo amayang'anitsitsa thupi la wodwalayo ali ndi chiyembekezo chowona nkhupakupa kusuntha, komwe nthawi zambiri kumawonekera ndi maliseche. Kuti muchite kudalirika kwambiri, malo omwe azindikira amawapaka ndi ayodini kapena utoto wina wa aniline kuti awonetse momwe zimasunthira. Pambuyo pake, amatenga bala kuchokera kudera lomwe lakhudzidwalo. Ana aang'ono atha kuphunzitsidwa kupaka papule ndi singano kuti atulutse majeremusi ndikuwunika kwake.
Kodi kuchitira nkhanambo mu ana?
Nthawi zambiri, chithandizo cha nkhanambo mu ana chimachitika kunyumba. Zimatenga osachepera sabata kuti muchiritse kwathunthu. Kupuma pogona sikofunikira ndipo pakatha masiku 7 mutha kuyamba kuyenda. Kuti nkhanambo mu ana ang'ono zichiritsidwe kwathunthu, mafuta osiyanasiyana, mafuta ndi ma emulsions amagwiritsidwa ntchito. Ndi mawonekedwe ake atypical, mwana amathandizidwa kuchipatala, koma milandu ngati imeneyi ndiyosowa kwambiri.
Mafuta onenepa ana
Ndiosavuta kuchitira ana nkhanza. Ndikofunika kutsatira malamulo ena pochiza khungu. Chifukwa chakuti tiziromboti timene timalumikizidwa madzulo, zochitika zonse zoyenera kuchitidwa ziyeneranso kuikidwa mpaka madzulo. Choyamba, thupi la mwana liyenera kutsukidwa ndi bafa, madzi ndi sopo, kenako ndikugwiritsa ntchito mankhwalawa omwe adokotala adawauza. Mankhwala otsatirawa amagwiritsidwa ntchito pochiza matenda:
- Mafuta kapena emulsion Benzyl benzoate. Mankhwalawa amawaika pakhungu tsiku loyamba ndi lachinayi (kupatula nkhope ndi mutu). Munthawi yamankhwala, ndikofunikira kuti muthane ndi nthawi ya maola 12 popanda njira zamadzi. Mankhwalawa amadziwika kuti ndi amodzi othandiza komanso otsika mtengo. Itha kugwiritsidwa ntchito kwa ana kuyambira wazaka 2-3. Kuphatikiza apo, kusintha kwamabedi ndi zovala zamkati tsiku lililonse kumafunika.
- Permethrin ndi mankhwala a ana kuyambira 1 chaka chimodzi, omwe amapezeka mitundu yosiyanasiyana ya mlingo. Sizoyipa kwa mwana.
- Mafuta a salfa amagwiritsidwa ntchito paunyamata ndipo palibe chifukwa chilichonse chomuyenera kwa ana osakwana zaka 3.
Scabies - njira zachikhalidwe zamankhwala
Kwa iwo omwe amalekerera mankhwala osiyanasiyana, njira yothetsera matenda amphere ya ana ingathe kusinthidwa ndi mankhwala omwe amatsimikiziridwa. Ayenera kugwiritsidwa ntchito mpaka masiku 7 chisanachitike chiwembu.
Onaninso: Chithandizo chowuma cha seborrheic dermatitis
Kuthira mafuta omwe akukhudzidwa ndi malo osakanikirana:
- smoky wakuda ufa ndi kefir / wowawasa kirimu muyezo wa 1: 3,
- pa supuni ya tiyi yosungunuka, phula, sulufule,
- Sopo yochapira, anyezi ndi adyo, kuchokera ku msuzi wowotchera amapangira sopo wopanga ndikusambitsa.
Pomwepo pachedwa komanso kuchepetsedwa mphamvu ya hypersensitivity
Kwa zaka zambiri osavutika ndi ALLERGY?
Mkulu wa Sukulu: "Mudzadabwa momwe kumakhalira kosavuta kuchiritsa chifuwa tsiku lililonse ...
Kuti mupeze yankho la zomwe zimayambitsa matendawa, muyenera kulolera kudzidzimutsa ndikumvetsetsa mitundu ndi njira zomwe zimayambitsa matupi awo sagwirizana.
Mitundu ya hypersensitivity reaction (GST) yomwe imachitika nthawi yomweyo imayamba chifukwa cha zochita za antibodies amthupi zomwe zimalowa. Pambuyo pa kulumikizana kwa zinthu zomwe zimakwiyitsa ndi mamolekyulu a IgE, IgM, IgG mphindi zochepa pambuyo pake, kuwonongeka kwa zamomwe zimayambira, kumayambitsa vasodilation, kuwonjezeka kwa kuwala kwawo. Chifukwa cha izi, munthu amene amakonda kulimbana ndi ziwopsezo zimayambitsa kuyabwa, totupa, kutupa kwa khungu ndi mucous nembanemba, bronchospasm.
Mitundu ya zomwe zimachitika pa GNT
Zotsatira zamthupi zimagawika m'magulu osiyanasiyana, osati kutengera liwiro la chiwonetsero, komanso kupatsidwa njira za pathological process.
Type I hypersensitivity zimachitika pambuyo mobwerezabwereza kulumikizana ndi allergen. Msonkhano woyamba ndi wothandizira aliyense yemwe wakhumudwitsa, kupanga class E immunoglobulins kumachitika, komwe kumalumikizidwa ndi ma basophils ndi ma cell. Ngati munthu akumananso ndi chinthu chomwe chimam'lepheretsa, maselo amenewa amawonongeka ndikumasulidwa kwa mkhalapakati wambiri ngati histamine. Umu ndi momwe ming'oma, anaphylactic mantha, amayamba chifukwa cha kuyanjana ndi poizoni.
Pokhazikitsa mtundu wa II hypersensitivity zimachitika, gawo lofunikira limaseweredwa ndi ntchito ya cytotoxic ya dongosolo lothandizira, kutsogoza kuwonongeka kwa maselo a pathogenic. Umu ndi momwe matenda ambiri a autoimmune amayambira, mwachitsanzo, pemphigus, zilonda za myasthenia gravis, ndi mtundu II shuga mellitus. Mtundu wachitatu hypersensitivity zochita zimayambira ndi kutenga gawo la chitetezo cha mthupi chokhala ndi ma antibodies ndi ma antigen.
Njira yotereyi imabweretsa kutseguka kwa makina othandizira, kuyika kwa chitetezo cha mthupi pamatumbo, makoma a chotengera ndi chitukuko cha matenda monga systemic vasculitis, nephritis, nyamakazi.
Kuchedwa Hypersensitivity Reaction (HRT)
Zizindikiro zoyambirira za mtundu wosachedwa kupezeka zimawonekera patangopita maola 24 mutatha kulumikizana ndi allergen. Njira ya pathological iyi siyokhudzana ndi zochitika zama antibodies ndipo chifukwa cha T-lymphocyte. Kuchita mosaganizira kotero kumatha kuchitika chifukwa chokhala ndi mabakiteriya, protozoal, fungal, ma antijeni, helminths, mankhwala osokoneza bongo.
Chitsanzo chowoneka bwino cha zotsatira zoyipa chotere ndi kuyesa kwa tuberculin kapena kuyesedwa kwa Mantoux, pamene, poyankha pakubweretsa tuberculin, redness ndi kutupa zimawonedwa tsiku lachiwiri kapena lachitatu pambuyo pa kuyesedwa.
Maonekedwe a zizindikiro zoyipa zam'mimba zimayenera kukhala chifukwa chopita kwa dokotala, polandirira komwe muyenera kufotokozera mwatsatanetsatane za zovuta zomwe zakhala zikuchitika komanso kulumikizana ndi zomwe zingayambitse mankhwalawo.