Post 10: ZUN-THLUM (Diabetes mellitus)

Zun thlum vei hi Mizote zingah kan tam ve ta hle mai.  Kan khawsak phung leh kan ei leh in lo danglam chho zel hian tûn hma kan pi leh pute huna a hming pawh kan hriat ngai loh Zun-thlum te pawh min rawn hmêlhriattîrin, tunah chuan kan tâ ber emaw tih mai tur khawpin kan lo hre chiang chho ve ta niin a lang. Khawvel pumpuiah mi maktaduai 120 vêlin zun-thlum hi an vei mêk a, kum 2020-ah chuan maktaduai 220 vel laiin an vei an ring.

Zun-thlum hi engnge a awmzia?  Kan taksa chhûngah hian ‘hormone’  pawimawh deuh mai pakhat  Insulin  an tih hi a awm a, chu chu kawchhunga  taksa peng pakhat ‘pancreas’ an tih hian a siam chhuah a ni. Chu Insulin chuan kan taksaa thil thlum (glucose) hi taksa tana ṭangkai tûrin a lo sâwngbâwl ṭhin a ni. Engemaw avângin kan taksain Insulin chu a lo nei tlêm emaw, Insulin chu hna thawk thei lovin a lo siam emaw a nih chuan kan taksaah (thisenah) glucose level a lo sâng êm êm a, kan thisenah mai ni lovin kan zunah te hial glucose chu kan lo zung chhuak ta ṭhin a ni.   Chutiang dinhmuna dingte chu zun-thlum vei an lo ni ta  a ni.

Zun thlum hi engtinnge taksaah a lo lanchhuah ṭhin? Zun-thlum (diabetes) natna hi a tîrah chuan engmah taksaah nâ leh insawisêlna an nei ngai lêm lo. Insawisêlna engemaw an neih pawhin natna dang emaw tiin doctor-te pawhin an hai palh fo ṭhin.  Zun-thlum vei insawisêlna tlângpui chu chauh ngawih ngawih te, tuihâl leh dang ro te, zun chhuak sek mai te, chaw ei tui fû sia chêr telh telh te leh  serh thak te hi an ni.  

Zun-thlum hmuh chhuah lohva rei tak lo vei tawhte chu an zun-thlumin an taksa pêng khawi lai emaw a tihchhiat tawh avânga natna khirh zâwk nêna damdawiin lo lût an awm châwk bawk. Mit khawhmuh ṭha lo te, ke pân hnai la ṭawih dur dur te, nikhaw hre lo hial emaw te pawhin an lo lût thei bawk.

Engtinnge zun-thlum vei tih kan inhriat theih ang?   Zuna glucose lang ringawt hi zun-thlum vei an ni ngawt lo va, thisen test ngei ngei tur a ni.  WHO (World Health Organization) chuan zun-thlum neia pawm tûr chin fel takin hetiang hian a lo rêl thlap mai:

1.    Zun-thlum rinhlelh theiha an taksaa lang chhuak (tuihâl, zung tam leh rihna hloh) bâkah thisen fîm(plasma) glucose level eng hunah pawh tehin  > 11.1 mmol/L (200mg/dl)   a nih chuan.

2.    Chawnghei (fasting) plasma glucose > 7.0 mmol/L (126mg/dl)  a nih chuan. (Chawnghei tih hian darkar 8 tal engmah ei lo tihna a ni)

3.    Glucose 75g ei hnu darkar 2-a plasma glucose chu > 11.1 mmol/L a tlin chuan.

(India ramah hian mmol/L aiah mg/dl kan hmang uar zâwk niin a lang)

Zun-thlum natna (Diabetes) chi hrang hrangte:

Type 1 Diabetes: Tûnhma chuan ‘Insulin dependent diabetes mellitus(IDDM)’ an ti ṭhin. An taksain Insulin a tih chhuah loh hrim hrim avangin a bul aṭangin Insulin injection an lâk nghâl char char a ngai.

Type 2 Diabetes:  Tûn hma chuan ‘non-insulin dependent diabetes mellitus (NIDDM) an ti ṭhin. An taksain Insulin a tichhuak tlêm emaw, Insulin-in a thawh tûr ang a thawk thei lo emaw a ni ṭhin.

Secondary Diabetes:  Natna dangin ‘pancreas’ a tihchhiat vâng leh thil dang avânga zun-thlum lo awm hi zun-thlum vei zawng zawng za zêla 1-2 (1-2%) vêl an ni.

Zun-thlum hi engvanga lo awm nge?   Zun-thlum awm chhan hi hetiang hian lo sawi ila:

Type 1: 

·         Damlo taksa chhûng lam khâwl engemaw dik loh avangin mahni taksaa Insulin tichhuaktu ber kha taksa vêkin a tichhia.

·         Inthlah chhâwn – Zun-thlum vei phîrpui (identical twin) hian zun-thlum veina ‘chance’  30 – 50% a nei. Nu leh pa zun-thlum vei chu an faten zun-thlum  veina ‘chance’ 2-7% vêl an nei.

·         Khawsak dân leh tuamtu boruak hian zun-thlum veina kawngah hian awmzia a nei bawkin an sawi. Naupan laia hmun leh boruak thianghlim taka chêngte hian a hnu lamah Type 1 natna hi an vei awl bikin an sawi bawk.

Type 2:

·         Inthlah chhâwn – zun-thlum vei phîrpui hian 50% vêl zun-thlum veina ‘chance’ a nei.

·         Khawsak dân leh tuamtu boruak – pian tirha sawngnawi tak, puitlin hnua thau leh viau si  te hian zun-thlum an vei duh bîkin an sawi.   Hêng bâkah hian a hnuaia mite hi Type 2 natna bik vei awlsam bîka ngaihte an ni:

o   Kum 40 chung lam

o   Asian emaw African-Caribbean mite

o   Thau lutuk (obesity)

o   Chhungkaw zinga zun-thlum vei nei

o   Naupai laia zun thlum/ nau kg 4 chuang hring ṭhinte.

Zun-thlumin a khawih pawi theihte(Complications):  Zun-thlum natnain kan taksaa pawi a khawih theih hi a tam lutuk a, sawi vek sên pawh a ni lo. A tawi zâwngin sawi ila: Taksa khawi lai pawh hi a khawih chhe thei ti mai ang!  Zun-thlum  hian nun a titawi   a, zun-thlum veiin an thihpui tam ber chu lung lam ṭha lo (70%), kal ṭha lo (10%) leh pân leh ‘septic’ chi hrang hrang (6%) an ni.

Zun-thlum hian thisen zâm leh hriatna thazâm (nerves) a tichhia a, taksa râldo khâwl a tiṭhuanawp a, chûng thilten taksa an khawih pawi dân ṭhenkhat chauh lo târchhuak ila:

·         Stroke – mi pangngai  lêt hnihin an nei tam

·         Lungphu châwl – mi pangngai lêt ngain an nei tam

·         Ke pan nasa avanga ke tan bun ngai – a lêt 50 in an tam!

·         Mit delna

·         Kal chhia

·         Zun-in

·         Serh lâwng leh thak

·         Mipa pà thei lo

·         Pân hnai la chi hrang hrang

·         Kut leh ke mu chuah chuah – engmah hre lova chawmawlh

·         Adt.

·         Taksa râldo khâwl a tihchhiat avangin eng natna pawh an kai awlsamin an natna pawh a na zual bîk fo ṭhin.

Zun-thlum enkawl dân:  Zun-thlum natna hi vawikhat vei tawh chuan dam chhûng natna a ni tih hriat phawt a pawimawh hle. Thisen sâng natna ang deuh bawkin ‘dam hlen’ tih hi a awm ve lo va, ‘control’  tih lam a ni zâwk. Ngun taka inenkawla zun thlum (thisen thlum) ‘control’ erawh chuan mi pangngai nunin an nung thei thung a ni.  Zun-thlum enkawlnaah hian a veitu inpêkna leh tumruhna a pawimawh ber a, tun hmaa a nunphung pangngai ṭhin thlâkthleng dawrh pawh a ngai fo ṭhin.  Chuvangin, zun-thlum enkawl hlawhtling tûr chuan mimal (damlo) kha amah leh amah inenkawl tûra a inpekna leh tumruhna a pawimawh ber zêl dâwn a ni.  Zun-thlum enkawlnain a tum ber chu nunphung hrisêl leh pangngai thei ang bera nung tûra ṭanpui  hi a ni.

Nunphung hrisêl (healthy lifestyle):  A tâwk chauhva Exercise lâk ṭhin te,  ei hrisêl te, thau lutuk lo tûra insûm te, mei zûk loh te hian nasa takin zun-thlum vei enkawlnaah an pui thei.

Ei leh in chungchâng: Zun-thlum enkawlnaa ei leh in chungchâng pawimawhzia hi sawi uar a pawimawh khawp mai. Eng damdawi pawh ei ila kan ei leh in lama kan insûm  si loh chuan kawngro a su tak tak thei lo. Amaherawhchu, ni danga a ei phung pangngai kha loh theih lohvah chauh, chu pawh a tlêm thei ang ber chauh  tihdanglam tum ni se, ei leh in phung thlâkthleng chiam chiam hi a ṭûl lo bâkah tuman an zâwm thei tak tak lo. Mi zawng zawng tâna ei tur hrisêl hi zun-thlum tân pawh a danglam chuang lo.  Chuvangin hetiang hian thurâwn mâwl tê lo târlang ila:

ü  Thlum lampang rêng rêng ei tlêm rawh

ü  Thau lam ei tlêm rawh

ü  Thlai hring leh thei ei tam rawh

ü  Sangha leh sa tihrâwl ṭha pangngaiah insûm a ngai lo.

ü  I taksa rihna kha a pangngai thei ang berin ‘control’ tum ang che.

Damdawia inenkawlna:  Zun-thlum damdawi hi chi hnihin a ṭhen theih a, chûngte chu:

ü  Injection chi(Insulin) – Type 1 tân lâk ngei ngei a ngai

ü  A mûm ei chi – Type 2 ho tân. Hêng ho pawh hian a tâwpah chuan Insulin injection hi an mamawh ve leh châwk ṭhin.

I natna type-a zirin leh I thisena thlum ‘level’ enin doctor-in i damdawi tûr a chawh ang che.  Damdawi chawh mai bâkah ei leh in lam thlengin doctor chuan thurâwn a pe ang che. Chûng chu ngun taka zawm tûr a ni.

In lama mahni inenkawl: Zun-thlum natna hi mahnia inenkawl awlsam tak a ni a, chumi tihlawhtling tûr erawh chuan rilrua tih tak takna leh mahni inthunun theihna a pawimawh êm êm a ni. Injection lâk ngai pawh ni se mahnia injection tih theih mai a ni a, a injection-na syringe  leh hriau te hi te tak te an nih avangin chelek pawh an awlsam phian.  Insulin erawh hi chu uluk deuhva dah a ngai ṭhin a, Fridge chhunga dah vawh (Freezer-ah ni lo) tûr a ni.

Mahni thisen pawh awlsam têa in-test mai theih a ni bawk a, hmanrua  pawh (hetiang hi) a man a sâng lutuk lêm lo.  Thil  pawimawh leh êm êm chu he natna enkawl tûr hian chhungkuaa ṭan tlân a ngai tih hi. Ei leh in thuah te, damdawi ei hun inhriatpui te,  infuih tawn fo te hi a pawimawh êm êm a ni.  Zun-thlum natna hi dam chhûng daih a ni tih hi hriat nawn fo a pawimawh bawk.

A khât tâwka doctor inentîr:  Insawisêlna êm êm neih loh pawhin a khât tâwkin inentîr fo tûr a ni.  Mahnia i lo in ‘test’ ṭhin a nih pawhin doctor-in a endik sak che a pawimawh a, hmabâka inenkawl zêl dân tûr leh ṭul dangte in sawi ho bawk ang.

Zun-thlum vei chu an taksa pem hlek leh pân hlek pawh hi a pûn hluai duh a, engemaw intih pem palh hlek pawh na lêm lo mahse rang taka inenkawl vat zêl tûr a ni.  A bîk takin kephah vêl hi enkawl ngun a ngai zual a, ke lâwnga kal lovin pheikhawk bun hrâm hrâm tûr a ni a, amaherawhchu pheikhawk  tâwt lutuk leh min nâwt pilh thei tûr ang chu bun hauh loh tûr a ni.

Invênna:  Pianpui rêng leh taksa chhûng lama dik lo sâ chu tihngaihna vak a awm lo mai thei. Amaherawhchu, zun-thlum vei tihlauhawmtu thil ṭhenkhat hi chu pumpelh theih a ni a, mahni inthununa nun dân fimkhur chuan zun-thlum leh natna dang tam tak kan pumpelh thei a ni. Heng thilte hi lo hre nawn leh ila:

F  Ei leh inah fimkhur rawh

F  Thau leh thlum lam ei tlêm la, thlai hring leh thei ei tam rawh.

F  Mei zu suh.

F  A tâwk chauhvin exercise la ṭhin ang che.

F  Thau lutuk leh taksa rit lutuk pumpelh rawh.

…………………………

Post 9 : Thisen-Sâng/BP Sâng (Hypertension)

Thisen sâng chu engnge? 

Thisen sâng hi Mizo ṭawnga hrilhfiah han tum chhin ila:  Lungin thisen a ‘pump’ chhuah hian taksa bung hrang hrangah thisen zâm kal tlangin thisen a pe a. Chung thisen zâm chhunga “pressure”  chu a nih tûr aia a lo sân hian thisen-sâng  an ti ṭhin a ni.  Thisen sân leh sân loh (blood pressure=BP)  tehna hi “BP Apparatus” (Sphignomanometer) an ti a. BP chhinchhiahnaa a sâng lam hi “Systolic pressure” an ti a, a hniam lam hi “Diastolic pressure” an ti  thung.  Khawvêl ram hrang hrangah thisen-sâng  sawifiah dân a dang hret hret thei a,  British Hypertension Society hovin an hrilhfiah dân chu hetiang hi a ni:

A pangngaia ngaih chin	Systolic (mmHg)	Diastolic(mmHg)
*duhthusâm	<120	<80
*Ṭha pangngai	<130	<85
*Ṭha thawkhat	130-139	85-89
Thisen-sâng
*Grade 1 (mild)	140-149	90-99
*Grade 2 (moderate)	160-179	100-109
*Grade 3 (severe)	> 180	> 110
Systolic chauh sâng (Isolated systolic hypertension)
*Grade 1	140-149	<90
*Grade 2	> 160	<90

Thisen-sâng chu engtia lo awm nge?  

BP sâng zinga 90% emaw lai hi a chhan hriat mai  loh an ni a, hetiang BP sâng hi  ‘Essential Hypertension’  an ti.  A chhan puh tûr awm ho hi “Secondary Hypertension” an ti thung.

Essential Hypertension hi a chhan chiah hriat loh ni mahse hêng a hnuaia mite hi a kaihhnawih tih chu hriat a ni:

·         Genetic (pianpui):  BP sâng hi chhungkuaah leh thlah chhâwng hovah a awm duh bîk an ti.

·         Pian tirha rihna hniam (low birth weight): Heng ho hian puitlin hnuah BP sâng an nei duh bîk nia chhût a ni.

·         Thau lutuk: An zingah BP sâng nei an tam bîk.

·         Zu in tam : zu in tam ho zingah BP sâng an tam. Amaherawhchu, tlêm tlêma in ṭhin ho chu mi pangngai aiin an BP a hniam thei thung.

·         Chi al ei tam: BP sâng leh chi al ei tam hi an inlaichîn bawk.

·         Zun thlum (diabetes) kaihhnawih: BP sâng leh zun thlum hi a inkawp duh viau bawk.

Secondary Hypertension  awmtirtu pawimawh zualte chu:

·         Kal (kidneys) ṭha lo:  BP sâng chhan hriat zinga 80% chuang hi kal lam ṭhat loh vâng a ni.

·         Kawchhûng lam ‘gland’ (Endocrine glands) dik lohna:

o   Conn’s syndrome

o   Cushing’s syndrome

o   Adrenal hyperplasia

o   Pheochromocytoma, adt.

·         Damdawi ṭhenkhat – na chhâwkna chi khat NSAIDs an tih ho te, chhang khâtna (oral pills) te, steroids leh adt.

·         Naupai laiin BP a sâng  thei bawk.

·         Pianpui lung/thisen zâm  ṭha lo – Coarctation of aorta.

Thisen sâng chu engtinnge a lo lanchhuah ṭhin?  Thisen a sâng hle a nih loh chuan taksaah insawisêlna êm êm a awm lo fo ṭhin. Chuvangin, kum 40 vêl kai tawh tân chuan a khât tâwka BP check fo a ṭha.  Mi ṭhenkhat chu an BP sâng mahse anmahni hriat dânah engmah harsatna an neih loh chuan inenkawl vak pawh ṭûl lovin an hria a, hei hi thil âtthlak leh hlauhawm tak a ni.  Vawilehkhatah Stroke emaw lungphu châwl (heart attack) emaw an nei thut thei a ni.  

Thisen sâng a nasat viau erawh chuan lu nâ, lu hai, mit vai ruai angtein a langchhuak thei.

Thisen sâng pawikhawih theih lâr zualte (Complications):

·         Stroke: Thisen sâng nei zingah Stroke hi a lêt rukin a tam.

·         Lungphu châwl: Thisen sâng ho zingah hian mi pangngai aiin a lêt thumin lungphu châwla thi an tam.

·         Kal nâ: Kal lam ṭha lo hian BP sâng a siam thei ang bawkin BP sâng hrim hrim hian kal ṭha lo a siam thei bawk.

·         Kut leh ke hmâwr lam thisen kal ṭha lo a thlen thei bawk.

‘Malignant Hypertension’ :  Thisen sâng nasa tak, ‘Diastolic BP’ pawh 120 leh a aia sâng sawina a ni.  Mit a khawih chhe tel a, lu nâ, lu hai leh mit khaw hmuh fiah lo tein a lang chhuak fo ṭhin. Rang taka enkawl nghâl loh chuan za zêla 90 vêl laiin kum 1 chhûngin an thihpui ṭhin.

Test tih ngaite:  Thisen sâng awmtîrtu chhui chhuah nan Test chi hrang hrang doctor-in an râwn ṭhin. A tlangpuiin hengte hi i test a ngai ang:

·         Thisen:   urea, electrolytes, creatinine, glucose, cholesterol.

·         Zun:  sugar, protein, RBCs, adt.

·         ECG/ECHO – lung lam enna

·         Ultrasound – a bîk takin kal (kidneys) en nân

·         Fundoscopy – mit chhûng lam enna

A enkawl dan:  Thisen sâng a nasa hle a nih loh chuan a tîrah damdawi ei nghâl mai tûr a ni lo.  BP chu eng ang chiaha sâng nge tih enfiah hmasak zet a ṭûl a, ni khat chhûngin a danglam em tih te an enfiah bawk ṭhin. Ram changkângah chuan nilênga (24 hours) BP endikna hmanrua te an nei.

BP tisângtu taksaah natna dang a awm leh awm loh enfiah pahin, damdawi tel lova inenkawl  hmasak phawt a ṭha a, a hnuaia mi ang hian tih a ṭangkai:

·         Rihna tihhniam

·         Thau lam ei tlêm

·         Chi al ei tlêm

·         Zu in tlêm

·         Mei zûk bânsan

·         Exercise – ni tin minit 30 chhûng tal kêa kal tûr

·         Thei leh thlai hring ei tam

Damdawi hmanga enkawlna:  BP sân dâna zirin damdawi pêk tûr doctor-in a ruahman ang. A tlangpuiin:

Ø  BP 160/100 vêl a nih reng chuan damdawi ei ṭan tur a ni.

Ø  BP  a sâng lam (systolic) 140 aṭanga 159 inkâr leh a hniam lam (diastolic) 90 aṭanga  99 inkâr ho hi chu zun thlum emaw natna dang an neih chuan damdawi ei ṭan tho tur a ni. Natna dang an neih lêm loh chuan la enthlâk rih deuh a pawi lo.

Ø  Damdawia enkawlnain a tum chu:  BP 140/85 aia hniama dah a ni a, zun thlum vei erawh chu BP 130/80 aia hniama dah a ṭha.

Ø  Thisen sâng nei tam ber chuan damdawi chi hnih emaw a aia tam emaw an mamawh thei bawk.

In lama inenkawl dân:  Thisen sâng enkawlnaah hian a veitu inpêkna leh tumruhna a pawimawh hle. Thisen sâng tam ber hi natna dang angin  ‘dam hlen’ chi a ni ve lo va, damdawi leh thil danga dam chhûng inenkawl ngai a ni tih hi hriat hmasak phawt a ṭûl. Inenkawl nguna BP a pangngaia dah reng theih erawh chuan mi dam ṭha pangngai ang tho kan ni thei tih hre bawk ila.

Doctor-in damdawi a chawh rêng rêng kha dik taka ei tur a ni a, damdawi ei veleh thisen kha a hniam nghâl sawt sawt dawn lo va, damdawi hnathawh lan nan hun engemaw chen a duh ṭhin tih hriat a pawimawh bawk. Chuvangin, ni hnih khat hnuah kan BP a hniam nghâl mai lo a nih pawhin damdawi kha ei zawm zêl tho tur a ni.

BP hi mahni pawhin inen harsa lo tak a ni a, a hmanrua mahniin neih theih phei chuan a ṭha leh zual.  Damdawi rêng rêng hian side-effect an nei vek a, chuvangin, damdawi ei hnuah emaw ei laiin emaw insawisêlna neih chuan  doctor râwn thuai tur a ni. 

Inenkawlna chungchângah engemaw hriat thiam loh neih chuan doctor zawh fiah hreh loh tur a ni a, damloin a inenkawlna chungchâng engkim a hriat thiam ve chuan amahah ṭan nasa takin a la ve thei a, a damna turin phûr takin a thawk ve thei dâwn a ni.  A tawp berah chuan BP sâng enkawlnaah hian chhungkuaa ṭan tlân a pawimawh êm êm tih i hria ang u.

Post 8: STROKE

Stroke hi Mizote pawhin kan hmêlhriat ve ta hle mai. Ram changkângah chuan thihna chhan tam ber pathumna a tling hial a ni. Stroke hi hmeichhia aiin  mipaah a tam zawk a, kum 40  chunglamah a awm deuh ber. A awmtîrtu tam ber chu Thisen sâng (hypertension) hi a ni.

Stroke chu engnge?  Stroke chu thluaka thisen zâm kal dik loh avanga vawilehkhata taksa lo chau thut emaw, pangkhing zeng thut emaw, ṭawng thei lo hiala lo awm thut, darkar 24 aia rei awh  hi a ni kan ti thei awm e.

Stroke hi a nasat leh nasat  loha zirin chi hrang hrangin an sawi leh a:

·    Complete  stroke:  rei lo teah (darkar 6 chhûngin) taksa a khawih tur a khawih vek hman

·    Stroke-in-evolution: Stroke a thlen aṭanga darkar 24 chhûnga a natna hmasâwn dân sawina a ni.

·    Minor stroke: damlo chu taksaah chhiat hlenna thleng lovin a ṭha chhuak leh (chawlhkar khat chhungin an ṭha chhuak tlangpui).

·    Transient Ischemic Attack(TIA): rei lo te chhûng taksa bung khawilai emaw ber lo chau thut emaw, ṭawng thei lo thut emaw, mit del thut emaw an nei a, darkar 24 chhungin a dam fel leh vek ṭhin.

Stroke chu engtia lo awm nge?  Stroke awm chhan tlanglâwn ber ber  kawng 3-in a sawi theih âwm e:

·    Taksa peng dang khawimaw lai aṭanga thisen khal emaw bawlhhlawh dang lo lûtin thisen zâm rawn zuiin thluak thisen zâm khawimaw laiah a tâng ta a,  a bul hnai thluak area chuan thisen a hmuh loh avangin a hliam(infarct) ta a, chu chuan taksa zeng leh thil dangte a rawn thlen ta ṭhin a ni.

·    Thluak leh a bul hnaia thisen zâm hrim hrim  ṭhat loh avangin thluaka thisen kal lai a dang ping  thei bawk.

·    Thluak chhungah thi pût a awm vangin.

Stroke awmtîrtu ṭhenkhat leh a invên dante:

·     BP sâng(Hypertension):  Stroke tam ber chu BP sâng vâng a ni.  BP sâng neite tan BP sâng lo tûra inenkawl hi Stroke pumpelh tura invênna  pawimawh ber chu a ni.  BP sâng nei ṭhenkhatin, “Engmah harsatna ka nei chuang lo. BP sâng hian min ‘effect’ lo ve. Hetiang BP sâng hi chu ka ‘normal’ ve rêng a ni e” tiin  damdawi ei loh an chîng ṭhin a, heihi a hlauhawm êm êm a ni. Pâwn lamah an taksain tuar lovin lang mah se an thluaka thisen zâm te tak tê tê (capillaries) tân khân a hlauhawm êm êm a, BP sâng “pressure” khan a tipuakkeh thei a, an rin loh hlânin  Stroke-in a man thut fo ṭhin a nih hi.

·    Mei zûk:  Vaihlo zial zu miten mi pangngai aiin stroke an nei awl bîk a, mei zûk loh hi invênna pawimawh tak a ni bawk. Mei nghei aṭanga kum khat hnuah Stroke neihna ‘chance’  zaa sawmnga (50%)-in a tlahniam a, kum 5 nghei hnuah chuan mi pangngai ang an lo ni ṭhin.

·   Ṭhu chunga hnathawh:  Taksa hah lo leh che chhuak lova awmhmuna awm reng hian Stroke neih a hlauhawm bîk bawk. Computer hmaa nilêng lênga ṭhut te hi a hlauhawm hle a, rei tak tak ṭhut reng ngai ang chi hna kan nei a nih pawhin a khât tâwka dina office chhûngah pawh kea vei kual vêl fo ṭhin  tûr a ni.

·    Zû:  Zu tlêm in ṭhin hian engemaw chenah Stroke a vêng  an ti!

·    Thau lutuk:  Taksa rihna a tawk chauha vawn hi a pawi mawh hle bawk.

·    Lung natna: A bik takin lungphu rang lutuk leh mumal lo (Atrial fibrillation) te, lung ‘valve’ ṭha lo te  hian Stroke an siam awl hle a, hêng hi enkawl vat vat tûr a ni.

·    Zun Thlum (Diabetes): Zun thlum veite tân ngun taka inenkawl loh chuan Stroke vei a hlauhawm bîk bawk.

·    Polycythaemia: Thisenah nasa takin  red blood cells (RBC) an lo pung hluai a, chu chuan thisen a tikhal a, Stroke a siam thei. Hetiang natna neite tan inenkawl ṭhat a pawimawh hle bawk.

·    Thluaka thisen zâm kaw zîm:  Thluak thisen petu thisen zâm zinga pakhat Carotid artery  an tih hi a nih tûr aia zîmin a awm thei a, chu chuan stroke a siam thei a, hetiang hi hriatchhuah chuan zai dam theih a ni bawk.

·    Thisena cholesterol sâng:  Damdawi pakhat Statin  an tih ho hmanga cholesterol tihhniam hian Stroke engemaw chen  a vêng thei bawk.

·    Syphillis:  He natna hian stroke leh thluak natna dang a thlen ve thei a, enkawla tihdam a pawimawh.

Stroke chu engtiangin nge a lo lanchhuah?  Thluak a khawihna lai leh a khawih chhiat zau leh zau loha zirin a lanchhuah dân a dang thei. A tlanglâwn berah chuan second rei lo te aṭanga darkâr engemaw zât chhûngin thluak a khawih chhiat lohna lam taksa pangkhing kha a lo zawiin a lo zeng ṭan a, hmai pangkhing pawh a khawih tel châwk ṭhin. A châng chuan ṭawng thei lovin an lo awm bawk ṭhin.  Lu nâ emaw nikhaw hre lova awm hi an awm khât hle a, phûngzâwl tlu anga han tlûk erawh chu nei an awm ve zeuh mai thei.

Thluak hnûn (Brain stem) lam a khawih tel chuan mit khawhmuh fiah lo te, thil lem theih lohna te, kut leh ke zawng zawng zeng te,  luhai te, luak te,  zun leh êk ‘control’  theih lohna te, nikhaw hriat lohna te a thleng thei bawk.

Test tih tûrte:

·    CT Scan/MRI:  Hei hi a remchâng hmasa bera  tih a ṭha.  Stroke awm chhan kha engemaw chen a hriat theih ṭhin a ni.

·     Test dangte chu-

o   BP/Pulse check

o   Thisen test (FBC,ESR,Platelets, Syphillis serology, U&E,adt.)

o   Chest XRay

o   ECG

o   Carotod Doppler

o   adt.

·    Heng test chi hrang hrangten an tum ber chu-

o   A natna dik tak hriat chhuah

o  Stroke chu thluaka thisen pût vang nge thluak hliam (infarction) vang tih finfiah

o   A awmtîrtu natna dang hmuh chhuaha enkawl nghâl.

Stroke chu engtia enkawl tûr nge?  Damlo chu a tîrah chuan damdawiin panpui ngei tûr a ni a, a natna dinhmun tak hriat a nih hnuah chuan damlo dinhmun leh hospital dinhmuna zirin damdawiina enkawl zui chi nge in lama enkawl tûr tih thutlûkna siam theih a ni ang. Damlo na lutuk lo chu in lama enkawlin, a ṭûl ang zêla doctor râwn chhunzawm mai ṭhin a finthlâk mai thei. Damdawiin changkângah chuan Stroke Unit te an nei a, a ṭangkai hle.

Stroke-a damlo enkawl dân tlângpui hetiang hian lo entîr ila:

·     Damdawiinah ‘admit’ nghal

·     Doctor/nurse hovin hengte hi an han ngaihven zung zung ang:

o   Damlo chu a thaw ṭha em? Oxygen pek a ngai em?

o   A lungphu/BP a ṭha em? A BP a sâng em?

o   Tui/chaw a lem thei em?

o   A ‘blood sugar’a sâng/hniam em?

o   Thisen chaw pêk a ngai mai thei bawk.

·    CT Scan/MRI hmangin an endik ang a, chuta an hmuh chhuaha zirin enkawlna pawh ṭan nghal a ni ang.

·    Chest XRay, ECG, Thisen leh thil dang test ṭûl apiang  an test ang a, Stroke awmtîrtu nia rinhlelh hmuhchhuah a nih chuan chu chu enkawlna pêk nghal a ni bawk ang.

Engtinnge ni zêl ang le? Stroke hi natna namai lo tak a ni a, zaa 40 vêl chauhvin ngai an awh leh ṭhin.  Ṭhat chhuah leh hun chhûng hi a inang lo va, thla emaw kum emaw hial a duh ṭhin. Za zêla 25 chu Stroke an neih aṭanga kum 2 chhûngin an thi niin an chhût a, stroke nei tawh nei nawn leh hi engemaw zat an awm bawk.

In lama inenkawl:  Mahnia che thei lo enkawl hi a enkawltu tân dawhtheih leh zaidam a ṭûl khawp mai. Zun leh êk inthiar thei lote phei chu enkawl ngun an ṭul leh zual a, an zun siaksak hial ngai an nih chuan an zun siakna catheter kha a khât tâwkin (kar khatah vawi khat tal) thlâk ni se.  Mahnia inlet thei loten mawng/ngûm pân (Pressure sores) an neih loh nan darkar 2 emaw 3 emaw danah an mut dân sawn sak fo tûr a ni. A ṭûl angin doctor râwn fo hreh loh a ṭha.  A tîr aṭangin exercise /physiotherapy tih ṭan nghal a ṭha bawk.

Depression a nei em?  Tun hmaa mi  dangte ṭanpuitu ni ṭhin kha tûnah mahni pawh  inenkawl thei lo leh che hlei thei lova a awm hi  hrehawm a ti êm êm ang tih hriatpui tûr a ni a, Stroke ṭhenkhat ṭawng thei lote pawh hi rilru buaina nei miah lo leh kan thu sawi zawng zawng  hre thei vek an ni fo tih hriain an bula kan ṭawngkamte hi fimkhur tûr a ni. Midangte tana phurrit mai thlentu nia an inhriat chuan thih mai an duh zawk fo ṭhin. Chu chuan an natna aṭanga ṭhatchhuah lehna kawng nasa takin a dâl thei a ni.  Chuvangin, rilru zângkhai leh beiseina nei tûr zâwnga kan enkawl pawh a ṭûl  tih hriat tel a ṭha.

                                                  ……………….

References:

• Kumar & Clark's Clinical Medicine
• Oxford Handbook of Clinical Medicine
• Current Medical Diagnosis & Treatment
• Others.