CHUL RIT THAR LEH ILA...

Kum 2 chuang a vei hnuah hei ka blog ka lut leh chiah!! Awm hmun insawn leh chhungkaw lam insingsak avang te, hna thawhna hmun sawn te pawh chhuanlam tling lo te te chu ni mah se chhuanlamah han hmang tho ta ila. Kawng leh lamah chuan Facebook lamah kan lo tuan ve thin bawk nen, hun hian min daih lo a ni deuh ber e. Chung zawng zawng bakah chuan khawvel ram changkang lo pawla chengte tan chuan Internet man phak lohna hmun te, manna tur pawisain a daih loh hun te pawh hi a lo awm ve leh fo thin a nih hi!

Engpawhnise, he blog hi lo chhiar ve palh te in awm chuan  Kum thar 2015 chibai ka han buk phawt mai ang che u. Medical lam topic lian tham chu rawn ziah leh zeuh zeuh hun te pawh a awm mai thei e. Amaherawhchu, hun neihin a daih loh chuan a tawi thei zawngin Medical lam thu thar leh in zawhna chhanna lam rawn thlur deuh tawh mai ila a that ka ring.

Chuvangin, tun tum atan chuan tun laia hriselna lam thu thar tlemte hian hmawr ka han bawk tawh ang e:

1. Tun thlasik chawlh chhung hian America ramah hritlang awmna hri a leng nasa hle a, naupang 15 velin an thih pui tawh a ni.

2. Ebola: Tun tum Ebola natna lo taidarh chiam kha a tidarh tantu chu Guinea ram mipa naupang Emile Ouamounoa ni thei mai awm mang e an ti. He mipa naupang hi an infiam laiin bak awmna thing kawrawng chhungah a lut a, chuta tang chuan Ebola a vei ta a, chu chu a taidarh ta a ni an ti.
Tunah hian Ebola vei mi 20,000 chuang awmin mi 8,000 velin an thih pui tawh a ni. Khawvel ram dangah chuan a la darh nasa lo nain, Africa rama Guinea, Sierra Leone leh Liberia ramah te chuan ziaawm lam a la pan hlei thei lo.

Post 15: Chhùl Cancer

(Post khât manah tun ṭum chu nû ho pual deuh bîk hi post daih teh ang!)

Chhùl Cancer chu engnge? 
Mizovin chhùl cancer kan tih mai hi chhùl pumpui cancer ni lovin chhùl hnuai lam hmâwr (cervix) cancer a ni tlângpui.  Chhûl han tih ngawt pawh hi a fiah tâwk lo hle a,  Sâpṭawnga 'uterus'  an han tih mai hi Mizo hian 'chhùl in  nghâk' kan tih nèn hian thuhmun a ni em? A lem hi lo en chhin ila:  

He milema 'cervix'  hi chhùl hmâwr kan han tih mai chu a ni a, he lai hi cancer awm tamna lai ber chu a ni.  Nau paina hmun tak tak chu chhùl pui (uterus) chhûngah hian a ni thung.  Helai pawh hi a cancer thei tho va, mahse chhùl hmâwr lai ai hi chuan cancer a awm khât fê zàwk.

(Fallopian tube = chi kawng)

(Ovary = chi bâwm)

Chhùl Cancer hi eng ang taka tam nge?  

Chhùl cancer hi hnute cancer dawta hmeichhe cancer vei tam ber a ni.  Khawvèl pumpuiah kum tin hmeichhia 2,50,000 aia tamin an thihpui mêk.  Chhùl cancer zà zêla sawmriat (80%) hi ram hnufual (developing countries) hmeichhiaten an vei a ni.  

Chhùl Cancer hi eng vanga lo awm nge? 

Chhùl Cancer awmtîrtu nia an hriat zinga langsàr zualte  chu:

• Human Papilloma Virus (HPV):   He virus hi chhùl cancer tam berah hian a inhnamhnawih tih hmuhchhuah a ni a, chhùl cancer za zêla sawm sarih (70%) vêl lai hi HPV vànga awm niin an chhût.
• Vaihlo zial zûk:  Mei zûk hrim hrim hian chhùl cancer a awmtîr thei an ti bawk.
• HIV: HIV positive-te hian chhùl cancer an vei awl bîk bawk.
• Kawppui ngah: Sex lama inhmang hmâ leh kawppui nei ngahte hian chhùl cancer hi an vei hma bîk bawk.
• Hriat loh: chhùl cancer ṭhenkhat chuan a chhan puh tùr an nei lo.

Chhùl Cancer chu engtinnge a lo lan chhuah ṭhin? 
A ṭan tìr lamah chuan engmah taksaah danglamna sawi tùr a awm lo fo ṭhin. Amaherawhchu tlêma a lo nasat ṭan deuh hnuah erawh chuan hêngte hi a lan chhuah dan tlângpui a ni:

• A hun pangngai ni lova thi chhuak (a bîk takin nupa inpàwl hnûah te)
• Serha bawlhhlawh chhuak tam
• Nupa inpàwl laia nâ

A natna a lo nasat tak tak hnuah phei chuan:

• Thi pùt nasa
• Serha bawlhhlawh chhuak rim chhia
• Tai chhûngril nâ
• Chaw ei tui lo
• Chêr tawlh tawlh
• Ke vûng / ke nâ
• Zun emaw êk emaw serh kua aṭanga pût

Chhùl Cancer leh Cancer loh engtinnge kan hriat ang?
Chhùl hmâwr pân aṭang khân 'sample' an la a, chu chu 'biopsy' an tih hi a ni. Chu chu  enlennain an lo en a, cancer a nih leh nih loh an finfiah thei ṭhin a ni.

Chhùl Cancer hi a tihdam theih em?
Theih e...a nasat hmâa hmuhchhuah chuan!  Hei tak hi hriat atâna pawimawh êm êm chu a ni. Chuvângin chhùl cancer hi a hmâ thei ang bera hmuchhuak tùrin hmeichhe tân inentirna pawimawh êm êm mai a awm a, chu chu 'Pap Smear' an tih hi a ni.

Pap Smear chu engnge?

A hmuchhuaktu Papanicolaou-a hming chawiin 'Pap Smear' an ti a. Chhùl hmâwr lai aṭang khân
heta milem ang hian 'cell' la chhuak tùrin a bîka siam hmawlhtê ang tak hmanrua hmangin an han hru zeuh a, chu chu 'slide'-ah an dah a, enlenna hmang bawkin an en a, cancer a insiam ṭan mêk emaw insiam hlauhthâwnawma a awm emaw kha an hmu chhuak thei ṭhin a ni.   Pap smear lan dàna zirin CIN-I, CIN-II leh CIN-III tein an thliar hrang leh a. (CIN = Cervical Intraepithelial Neoplasia)
CIN I: Hei hi chu engmah hlauhthâwnawm lova ngaih a ni.
CIN II: Cancer la siam thei mai dinhmuna ding a ni.
CIN III: Cancer a siam hlauhthâwnawm taka ngaih a ni.

Engtinnge ni zêl ang le? CIN chin hi chu chhùlah a langa hmuh tùr pân emaw engmah a awm lo va, cancer tak tak vei lova enkawl dam theih vek anga ngaih an ni. Chuvangin, Pap Smear tih tîr hi a pawimawh êm êm a, hmeichhia kum 30 kai chin chuan mahni inrinhlelh kher loh pawhin vawi khat tal pap smear tih a ṭha. A hnu zêlah chuan a ṭùl dàn angin doctor thuràwn zawm tawh mai tùr a ni.

CIN enkawl zui dàn tlângpui: CIN I chu engmah tih a ngai lêm lo. Amaherawhchu, a lan dàna zirin thla 3 emaw 6 hnuah Pap Smear tih nawn leh pawh a ṭha mai thei.

CIN II emaw III a lo nih chuan enkawl dan hrang hrang a awm thei ang a, a lâr zual deuhte chu:

• "Cell" tihchhiat: (Ablation/Tissue Destruction)
• Cryocautery: Khâwl hmangin hmanrua kha vawt êm êmin an siam a, chu thil vâwt (cold) hmang chuan chhùl hmâwr dik lo lai nia langa 'cell' te kha an tichhe ta ṭhin a ni. Chûng 'cell' chhia chu a thar leh ṭha zâwkin an rawn thlâk leh ṭhin a ni.
• Electrocautery:Hetah hi chuan sâ (heat) hmangin 'cell' kha an tichhe thung.
• Laser:  Laser hmang pawhin 'cell'  kha an tichhe bawk ṭhin.
• Hleh thlâk:
• LEEP (Loop Electrical Excision Procedure) - Electric chakna hmangin chhùl hmâwr ṭha lo lai kha an hlep thla ṭhin.
• Cone Biopsy: Chhùl hmâwr kha "cone" angin an zai thla ṭhin.
• Chemte hmangin (Cold knife conization)
• Laser hmangin (Laser conization)
• Biopsy:  Colposcopy-Directed Biopsy:  Chhùl hmâwr enlenna khâwl, Colposcope an tih hmangin chhùl hmâwr an en a, a rinhlelhawm lai ber nia lang lai aṭang khân 'Biopsy' an la ṭhin a ni.

Chhùl Cancer ṭai darh dàn:
Chhùl cancer hi  chhùl kiang  vêl hnai bâkah taksa hmun hrang hrangah a ṭai darh duh hle a. A darh nasat dâna zirin an ṭhen hrang leh thliah thliah a, chûng chu "stages" an ti a. Stage 1 aṭangin 4 thleng a awm a, Stage tin kha A leh B-ah an ṭhen hrang leh bawk.  Stage 1-ah hi chuan cancer pân kha chhùl hmâwrah a la awm a, Stage 4-ah hi chuan taksa peng hrang hrangah a darh tawh tihna a ni. Heng stage dinhmuna zirin enkawlna pawh a dang ṭhin.

Chhùl Cancer enkawlna:

• Zai (Surgery):  He cancer hi a ṭai darh hma êm avangin Stage 1A aia nasa hi chu an zai meuh lo. Avàng chu chhùl kha paih kim vek mahse cancer kha taksa hmun danga a lo ṭai darh hman tawh si chuan zaiin  awmzia a nei tawh lo a ni. 
• Hem (Radiotherapy): A tlangpui thuin Stage 1B chung lam hi an hem ṭhin. 
• Chemotherapy: Hei hi chu chhùl cancer nasa lutuk tawh tlêma tawrh ziaawm nan an hmang deuh ber a, amah maia hmang lo vin hem (radiotherapy) nen an hmang kawp tlângpui.
• Combination:  Zai leh hem te, chemo leh hem te, zai leh chemo te pawh a ṭùl dàna zirin an hmang kawp bawk ṭhin.

INVÈNNA: Hei hi a pawimawh lai tak chu a ni! 
Chhùl cancer hi hmuh chhuah hmà chuan tihdam theih a ni kan tih tawh kha! Hêng a hnuaia mite hi invènna kawng  pawimawhte chu an ni:

1. Pap Smear: Pap smear lâktîr hi a pawimawh êm êm a, duhthusàm chuan hmeichhia kum 21 a tlin aṭangin pap smear ti ṭan se a ṭha.  Engtia zinga tih tùr nge tihah ngaihdàn hrang hrang a awm a, pap smear ṭha pangngai tân chuan kum 3 dan vêla tih nawn a tâwk mai thei. Uluk taka kum 3 - 5 vêl dana pap smear entir zat zat chuan chhùl cancer zaa sawmriat laiin a titlêm thei niin an sawi. Engmah ṭhat lohna nei lo chuan kum 60 vêl an nih chuan Pap smear entir an titàwp theia ngaih a ni bawk.
2. HPV Vaccine: HPV (virus) laka invènna HPV Vaccine lâk hian chhùl cancer zaa 90 (90%) vêl zetin a vêng thei an ti. He vaccine hi HPV kai hmâa inchiu tùr a nih avàngin hmeichhia kum 9 leh kum 26 inkarte hnenah an pe deuh ber ṭhin.  Amaherawhchu he vaccine hi a man a to êm avàngin leh engtia rei chiah nge a vèn theih tih hi an la chian loh avàngin duh angin khawvêl pumah an la hmang kim hlei thei lo  a ni.
3. Condom: Condom hman hian chhùl cancer veina 'chance' a titlêm deuh thei.  Hei hian HPV kai engemaw chenah a vêng bâkah mipa chi aṭanga cancer tizual theia an ngaih prostaglandin chu a dang thei bawk niin an sawi.
4. Mei zûk loh: Mei zûk hian chhùl cancer a awmtîr thei a, zu lo chuan chumi chu an pumpelh dâwn tihna a ni. 

                                      .....................

Post 14: Damdawi Hman Dan

(Tunlai chu mahni rau rauah buai a zual a, Post thar dah a har hle mai. Hun awl tlemte neih laiin hei hi ka han zep zawk a ni e)

Damdawi  reng reng hi a ei dana zirin TUR an ni vek tih hre hmasa phawt ila. Chuvangin damdawi hi mahni rin thu thua ei mai mai loh tur a ni.  Tul lo leh dik lo taka damdawi ei khawvel hmun tam takah a hluar hle a, India ram hi hetiang lama a ti nasa pawl kan ni awm e.  Mi thiamten an chhut dan chuan khawvela damdawi hmang zawng zawng zinga a chanve vel hi a chawhtu emaw a hralhtuin tul lova an pek chhuah a ni a, damdawi ei zawng zawng zinga a chanve vel hian a ei dan tur ang takin an ei lo bawk an ti.

WHO chuan damdawi hman dan dik chu  "damlovin a natna atana ngeih tur tak, ei tur zat dik taka a ei, ei tur hun chhung dik taka a ei leh a man tlawm thei ang bera a lei hi a ni", a ti.

Damdawi  hman dik loh pawinate:  Damdawi a nih dan tur taka hman loh hi a pawi thui thei hle a, chung zinga a pawimawh zualte chu:

1. Natna hrik damdawia tihhlum theih loh a siam thei: A bik takin Antibiotics ho hman dik loh avangin tunah hian khawvel hmun hrang hrangah damdawi engmah ngeih lo (damdawi engmahin an tihhlum theih loh) natna hrik an pung sawt hle. India ram pawh hi hemi kawnga ram hlauhawm ber zingah a tel. Damdawi, a bik takin antibiotics lam hman danah dan mumal kan nei lo va, Drugs siamtu company kan ngah si a, heng company te pawh hian an sumdawnna atana hlawk tur melhin tul lo tak tak damdawi siam chhuah leh hralh pawh an ching fo niin a lang. Damdawi hi dik tak pawhin chawh ila, a eituin a ei tur zat leh a ei hun chhung dik taka a ei loh chuan chu chuan natna hrik kha a tihlum zo lo va, a hnu lamah natna hrik damdawia tihhlum theih loh a siam thei thin a ni. Tunlai hian khawvel hmun hrang hrangah TB,  TB damdawi pangngai hmanga tihdam theih tawh loh tam tak an lo lang mek bawk.
2. Tul lova sum khawhralna:  Damdawi hi a tlangpuiin a to hle a, nei leh nei lova damdawi kan lei, kan ei dik leh si loh emaw, damdawi fuh chiah lo kan lei emaw chuan, tul lova  sum leh pai khawhralna mai a ni tih a chiang.  Vitamin ang chite lei vak vak te hi a tul lo va, taksa hian kan ni tin ei leh ina tel bak Vitamin dang a mamawh tam lo hle.

Engtinnge damdawi kan hman dik theih ang?  Hetiang zawng hian rawtna han siam ila:

• Mimal mawhphurhna: Mahni thu thuin damdawi inchawh mai mai suh. Mizo chu natna engemaw han nei ila, thiante nen kan han sawi ho liam liam a, "Kei pawh chutiang chiah chuan ka awm. I damdawi ei ang chu lo ei ve ila ka tha mai ang", kan han ti ve ngawt a. Hei hi thil hlauhawm tak a ni thei. Natna inang emaw kan tih hi natna dang daih a ni thei. Entir nan lu na lo nei ta la, lu nat chhan tam tak a awm. Mi pakhat lu na kha BP sang vang te lo ni se, nangma lu na kha Malaria vang te lo ni se, BP sang damdawi khan Malaria a tidam awzawng lo vang. Chuvangin, doctor rawn lova damdawi ei mai mai hi tih loh tawp tur a ni.
• Doctor mawhphurhna: Damlo natna dik tak hriat leh a ngeih tur tak damdawi chawh hi doctor mawhphurhna a ni.  Doctor thenkhat chu kan han senior deuh hnu phei hi chuan kan thatchhia a, mahni tih dan phung te hi kan beng bel a, natna enkawlna kawnga thil thar leh hriselna kawnga khawvel hmasawnna tharte kan ngaihven peih lo va,  lehkhabu leh journal te kan keu peih tawh lo va, Internet lamah kan bih peih bawk si lo va, tun hma kum 10 chuang liam taa kan tih dan ngai te kha khawvelin kalsan tawh mahse kan la chhunzawm bek bek zel a nih chuan inen chian a tul tihna a ni.  Thil dang leh chu Pharmaceutical Company ten drug sample leh therhlo engemaw min pek avanga an damdawi a that leh that loh pawh ngaihtuah lo va chawhsak mai mai te, damdawi chhuak thar apiang chawh tawp tawp ang chite hi tih loh a tha.  Mizorama kan chin lar tak pakhat chu damlo pakhat hnena damdawi tam tak chawh teuh teuh thin hi a ni. A natna atana a bik taka damdawi bakah Vitamin leh thil dang tul lem lo kan chawh tel teuh thin a, hei hi a tul lo viau na a damlo lam zawk zawk hian damdawi tlemte chawh chu an ngaih a tha tawh lo va, damdawi pahnih khat lek chawh ching doctor chu doctor thiam loah kan puh lek lek zawk fo nia! Heimi kawngah hian inzirtir kan la mamawh khawp mai.  Tunlai khawvela doctor tana thil pawimawh tak pakhat leh chu  kan thiamna in 'update' fo hi a ni a. Mi tin hian Internet te an lut thei vek tawh a, an natna chungchang kha nasa takin an chhiar lawk fo tih hriat tur a ni. Doctor ai mah mahin anmahni natna na na na kha chu an hre chipchiar zawk fo a nia!  Court-a inkhin rup rup te hi thil awm thei a ni tih hriat a hun ta.
• Sawrkar Mawhphurhna:  Sawrkar leh Health Department hian mawhphurhna sang ber an nei ti ila a sual tam pui awm lo ve. Heng a hnuaia rawtna  thenkhat te hi bawhzui theih ni ta se:
• Damdawi hman leh zawrh chungchanga sawrkar dan ding laite khauh lehzuala hman
•  Health Department hian Drug & Therapeutic Committee din ni se, chu chuan damdawi hman dan tur leh ram/state chhunga damdawi (a bik takin antibiotics) hman phal tur chite fel takin rel se.  Essential Medicine List fel taka siamin, chung damdawite chauh chu ram chhungah hman phal ni se.
• Drug Inspector ho hi thuneihna sang zawk pein hmang tangkai leh zual ila.
• Mipuite hnenah damdawi hman dan dik zirtir thin ni se.

Tlangkawmna:  Damdawi hman hi fimkhur ila, damdawi dik tak, a hun takah leh a hun chhung dik tak ei thei ila, mahni rin thuthua damdawi inchawh hi i sim ang u. Kan fimkhur loh chuan damdawi hian damna aiin dam lohna a thlen thei tih i hre nawn leh ang u.

Post 13: HEPATITIS

Hepatitis  chu thin vûng tihna a ni mai âwm e.  Tum ṭum chu Hepatitis natna chi hrang hrangte hi a tawi zawngin ṭum khatah i han tlar vek mai teh  ang.  Hepatitis thlen thei thil dang awm bawk mahse Viral Hepatitis chungchâng bîk chauh kan sawi dawn a ni.

Viral hepatitis hian thin ro (cirrhosis)  a siam theih bâkan  thin cancer thlentu bulpui ber a ni bawk.   Hepatitis virus chi hrang hrang an awm a, chûng zinga pawimawh  leh lâr zualte chu Hepatitis A, B leh C te hi an ni.

Hepatitis Hrang Hrangte:

Hepatitis A (HAV)	Hepatitis B (HBV)	Hepatitis C (HCV)	Hepatitis D (HDV)	Hepatitis E (HEV)
Engnge a nih?
HAV hian thin a tivûng a, mahse a châm rei (chronic) ngai lo.	HBV hian thin a tivûng a, thin ro(cirrhosis) leh thin cancer a thlen thei.	HCV hian thin vûng, thin ro leh cancer a thlen thei.	HDV hian thin a tivûng a, mahse HBV veite chauh a khawih ṭhin.	HEV hian thin a tivûng a, mahse a châm hlen lo.
A hrik kai aṭanga taksaa a lo lanchhuah hun:
Ni 15 – 50. A tlangpuiin ni 30 vêl.	Ni 45 – 160. A tlangpuiin ni 120	Chawlhkâr 2–25. A tlangpuiin chawlhkâr 7 – 9.	Chawlhkâr 2 - 8	Chawlhkâr 2-9 A tlangpuiin ni 40
Engtia inkai darh nge?
HAV vei êk aṭang te, inhnaih chilh taka khawsak ho te leh tui emaw ei tûr thianghlim lo ei aṭangin.	HBV vei thisen, serh tui / chi tui (semen), hriau thianghlim lo hman, mipat hmeichhiat hman aṭangin leh nuin a fapai laiah. (HIV nen a inang)	HBV nen a inang tlangpui a, mahse mipat hmeichhiatna aṭanga kai erawh chu a tam lutuk lo.	HBV kai dan nen a inang..	HAV kai darh dan nen a inang tlangpui.
A lanchhuah dan:
Engtin mah an awm lo mai thei. A châng chuan êk vâr deuh hluak, zun eng uk lam rawngin an zung thei a, chauh hluah hluah, khawsik leh jaundice an nei thei bawk.	Engtin mah an awm lo mai thei.Ṭhenkhat chuan hritlâng na vak lo neiin, êk vâr, zun eng/uk , chau, khawsik leh jaundice an nei thei bawk.	Hepatitis dang zawng aiin taksaa lang chhuak a tlêm. Thil dangah chuan HBV nen an inang.	HBV ang tho.	HBV ang tho.
A enkawl dan:
Enkawlna bîk a awm lo.  Damdawi ina admit a ṭul lem lo mai thei.	Enkawlna bîk a awm lo. A ṭul ang zela a na tinep thei tura ṭanpui Supportive) a ni ber mai.	Interferon  chauh emaw,   virus damdawi ribavirin nena kawpin emaw  an hmang ṭhin.	Enkawlna bîk a awm lo..	Enkawlna bîk a awm lo.
Vaccine :
Vawi hnih , thla 12 tlinin leh a hnu thla 6 ah.	Vawi 3: pian veleh vawi khatna, thla 1 -2ah vawi hnihna, thla 6 -18 ah vawi 3-na.	Vaccine a nei rih lo. HBV vaccine hian engemaw chen a veng ve thoin an sawi	HBV vaccine hian HDV pawh a vêng.	Vaccine a nei lo..
Tute tan nge kai hlauhawm?
HAV vei nena cheng ho emaw, HAV vei nena sex hmang te, HAV hri lênna hmuna chêng te, mipa leh mipa sex hmang ho zingah te, drug tih chingte.	HBV veiin a naupaiah, HBV vei nena sex hman, Drug ngawl vei, Damdawi ina hnathawk, mipa leh mipa sex hmang, HBV vei nena in pakhata khawsa ho.	1992 hma lama thisen pek (blood transfusion), damdawi ina thawk, drug ngawl vei,  dialysis hmang ṭhin, HCV paiin a naupai ah, mi tam tak kawp lâwr.	HBV kai dan nen a inang.	Ram hnufual tlawha zin ṭhin te, a bîk takin naupai lai ten an kai hma bîk.
Invênna:
Hepatitis A vaccine-in inchiu tûr. Nausen laia inchiu dan a chunga sawi bakah HAV vei hlauhawma awmte tan vaccine lak a ṭha. HAV virus kai aṭanga chawlhkâr 2 chhungin Immunoglobulin damdawiin an inchiu ṭhin bawk.. Inthiar (êk) zawhah sahbawn leh tuiin kut sil ziah tùr. Hmanrua/bungrua damlo zun leh ekin a khawih palh theih zawng zawng chu Bleach hmanga sil fai fo tur. Sex hman fimkhur.	Hepatitis B vaccine lâk HBV kai aṭanga kâr 2 chhungin Immunoglobulin lâk tur. Sex hman fimkhur. Thisen kai rêng rêng Bleach hmanga tihfai tur. Kut kawr (Glove) hman tur. Hmul mehna te, toothbrush te, inchiuna hriau te midang ta ṭawmpui suh. Drugs-a inchiu loh tur. Tatoo te, taksa engemaw lai verh te tih loh tur.	Sex hman fimkhur. Thisen kai Bleach hmanga tihfai, glove bun tur. Hmul mehna, toothbrush te inṭawm loh tur. Drugs-a inchiu te, tattoo leh taksa verh pawhte tih loh tur.	HBV vaccine la rawh. Sex hman fimkhur.	Ei leh inah fimkhur. Ek zawh apiangin sahbawn leh tuiin kut sil ziah rawh

Post 12: JAUNDICE (MÎT LIAM)

Jaundice:  Thisena thil awm pakhat ‘bilirubin’  an tih hi a nih tûr aia tam a awm chuan taksa (vun, mit ) leh zun te an lo eng a,  chu chu ‘Jaundice’ an tih, Mizovin ‘mît liam’  kan lo tih chu  a ni. Bilirubin hi mîta tel ve tlat a ni a, Jaundice natna  ‘mît liam’ tia han sawi  pawh hi a inhmeh khawp mai.  Bilirubin hi thisena Red Blood Cells (RBC) an tih keh chhia aṭangin a insiam a, chu chu thin (liver) hian lo la chhâwngin taksa tan a nih tûr dik tak ni tûrin a lo sâwngbàwl ta ṭhin a ni.

Jaundice chi hrang hrangte:  Jaundice awm chhan hi hetiang hian a awlsam zâwngin lo thliar hrang  ila:

1.    Pre-hepatic jaundice:  Bilirubin kalkawngah thin(liver) a thlen hmain dik lo  a awm. Hetah hian thisena RBC kha engemaw avangin a nih tur pangngai aia nasain a keh chhia a, chu chuan taksaa bilirubin kha a tipung ta hluai ṭhin a ni.  Malaria avanga jaundice awm ṭhin te pawh hi a chhan chu hetiang hi a ni.

2.    Hepatic jaundice: Thinah engemaw dik lo a awm.  Hepatitis te, cancer te, zu in tam luat te, damdawi hnathawh leh thil dangten  thin an khawih chhe thei a. Mît kha luang chhuak lovin a tling khâwm ta ṭhin a, chu chuan jaundice a siam ṭhin a ni.

3.    Post-Hepatic jaundice:  Bilirubin kalkawngah thin a pelh hnuin dik lo/ dâltu a awm.

Jaundice awmtîr thei thil langsâr zualte:

·         Hepatitis

·         Cancer

·         Alcohol

·         Thin hnai la

·         Damdawi

o   Paracetamol

o   Halothane (Hnimhlum)

o   TB damdawi

o   Steroids, adt.

Jaundice veiin eng ‘test’ te nge tih ngai?

·         Thisen test – hepatitis chi hrang hrang an awm leh awm loh hmuchhuak turin; thin ṭhat leh ṭhat loh en turin; thin cancer awm leh awm loh hriat nan, leh adt.

·         Zun test – bilirubin(urobilinogen)

·         Ultrasound – thin leh a vêlah bâwk a awm leh awm loh te, mît kawngah hnawhtu a awm em tih te Ultrasound hian a hmu thei dawn a ni.

A ṭûl dâna zirin hengte pawh hi tih a ngai mai thei bawk:

·         CT Scan  

·         Liver Biopsy

·         ERCP (Endoscopic Retrograde Cholangiopancreatography)

Jaundice enkawlna:  Amah Jaundice hrim hrim hi natna  a ni lo va, a awmtîrtu natna lo lanchhuah dân pakhat a ni chauh zâwk a ni. Chuvangin, a enkawl dân pawh jaundice awmtîrtu natna  kha hriat chhuaha enkawl a ni ber mai. Entîr nan mît luan chhuahna dâltu awm avânga jaundice lo awm chu a dâltu kha lâk bo theih chuan jaundice chu a reh nghâl mai dawn a ni. Malaria vânga jaundice pawh malaria tihdam kha a enkawl dân chu a ni leh mai. Jaundice awmtîrtu chi hrang hrang enkawl dân chu helaiah hi chuan kan sawi sêng lo tih a chiang nghâl a, ni danga sawiah khêk rih ila a ṭha mai âwm e.

Post 11: THAU LUTUK (Obesity)

A tâwk chauhva thau chu chêr ai chuan taksa a mâm nalh zâwk an ti ṭhin.  A dik pawh a dik mai thei. Amaherawhchu, taksaa thau a tam lutuk erawh chuan kan mawipui lo mai ni lovin kan hrisêl loh phah zâwk fo ṭhin. Mi thau ho hian midangte aiin thil an ei hnem a ni chuang kher lo va, amaherawhchu an mamawh aia tam an ei tih erawh a chiang thung.  Thau lutukna hian khawvêl pumpui mihring a khawih buai a, tunah phei chuan ram changkâng lo zâwkte thlengin an  lo buaipui ve ta.  Chu bâkah  kum a lo upat hnu hian mihring hi kan thau sawt bawk ṭhin a ni.

Thau lutuk hi engvanga lo awm nge?  A tawi zâwngin hetiang hian lo sawi ila:

• Pianpui (genetic) leh chênna boruak:   Mi thau ho thauna chhan zà zêla sawmriat (80%) vêl lai hi pianpui (genetic) vâng niin an sawi.   Taksa vun hnuaia thau hian 'hormone' pakhat Leptin an tih hi a tichhuak a, hei hian thluak lamah hna thawkin mihring thau lutuk tûr a vêng thei an ti bawk.  Naupan lai aṭanga thau lutuk ho hian Leptin an nei tlêm tlangpui niin an sawi.  Hêng bakah hian  taksa pianpui thil dang tam tak inhnamhnawih an la awm bawk a, zir miten an la zir mêk zêl a ni.
• Ei leh in: Ei leh in uar, a phû tâwka taksa che chhuak leh si lote chu an thau lo thei lo a ni. Ei leh ina thauna (calories) kan lâkluh zât tal kan paih chhuah leh si loh chuan kan taksaah thau a inchhêk khâwl a, kan thau ta ṭhin a ni.
• Taksa che chhuak tlêm:  Ṭhu chunga hna thawk chi leh taksa che chhuaka thlan tla khawpa hna thawk ngai lote hi an thau duh bik niin a lang bawk. A chhan pawh a chunga kan sawi 'calories' lâk luh leh pêk chhuah a inbûk tâwk lo tihna a ni ber.
• Taksa lumna pêk chhuah (Thermogenesis):  Kan thil eia thauna kan lâk luh 10% vêl hi kan taksa hian lum (heat) siam nan hmangin taksa aṭangin a paih chhuak leh ṭhin a, hei hi mi thau ho zingah chuan a tlêm deuh bik niin an sawi bawk.

Thau lutuk avânga natna awm theite: Thau lutuk ho hi an thih hun tûr pangngai hmâin an thi  duh hle a, an thihna chhan tam ber chu:  zun-thlum, lungphu châwl leh thluaka thisen zâm kal buai (stroke, etc) te an ni. Mipa zingah an rihna tûr aia  10% -a ritte chuan a hun hmaa thihna 'chance'  13%  vêl an nei a,  an rihna 20% -a  chuang liamte  chuan 25% laiin a hun hmaa thih an hnaih thung.  Hmeichhe ho zingah chuan hei ai hian a hniam deuh.  Rihna chuang liam tih hniam hian hêng thihna 'chance' te hi a tihniam ve zêl a, chuvangin theih tâwpa taksa rihna 'control' tûra ṭanlâk hi a sâwt êm êm a ni.  Natna dang a thlen theihte chu:

·         Rilru lam harsatna

·         Thisen sâng

·         Kâwng leh khûp ruh nâ

·         Thaw hah

·         Lung nâ

·         Varicose veins (Vein tawm)

·         Mîta lungte awm

·         Hnungzâng nâ

·         Muthilha hnâr bur bur leh thâwk ṭhat theih loh

·         Hmeichhe thi neih mumal lo

·         Cancer

Engtinnge thau lutuk tih kan inhriat ang? 

A hnuaia chart hi taksa sân zâwng leh rih zâwng inphû tâwk nia an ngaihte chu a ni. Heta ṭang  pawh hian kan dinhmun chu kan hre thei ang:

MIPA
Sân zâwng(centimeters)	Ruhrêl tê(Rihna - kgs)	Ruhrêl vantlâng(Rihna- kgs)	Ruhrêl lian(Rihna-kgs)
158	58 - 61	59 - 64	63 - 68
160	59 - 62	60 - 65	64 - 69
163	60 - 63	61 - 66	64 - 71
165	61 - 64	62 - 67	65 - 73
168	62 - 64	63 - 69	66 - 74
170	63 - 66	64 - 70	68 - 76
173	64 - 67	66 - 71	69 - 78
175	64 - 69	67 - 73	70 - 80
178	65 - 70	69 - 74	72 - 82
180	66 - 71	70 - 75	73 - 84
183	68 - 73	71 - 77	74 - 85
185	69 - 74	73 - 79	76 - 87
188	70 - 76	74 - 81	78 - 89
191	72 - 78	76 - 83	80 - 92
193	74 - 80	78 - 85	82 - 94
HMEICHHIA
Sân zâwng(centimeters)	Ruhrêl tê(Rihna-kgs)	Ruhrêl vantlâng(Rihna-kgs)	Ruhrêl lian(Rihna-kgs)
147	46 - 50	49 - 54	53 - 59
150	46 - 51	50 - 55	54 - 60
152	47 - 52	51 - 57	55 - 62
155	48 - 53	52 - 58	56 - 63
158	49 - 54	53 - 59	58 - 64
160	50 - 56	54 - 61	59 - 66
163	51 - 57	56 - 62	66 - 68
165	53 - 59	57 - 63	62 - 70
168	54 - 60	59 - 65	63 - 72
170	55 - 61	59 - 66	64 - 73
173	57 - 63	61 - 68	66 - 75
175	59 - 64	63 - 69	68 - 77
178	59 - 65	64 - 70	68 - 78
180	61 - 67	65 - 72	70 - 79
183	62 - 68	67 - 73	71 - 81

He mi chart ai mah hian Body Mass Index (BMI) hi taksa thau/rih dan teh nân rintlâk zâwkah an ngai. BMI chawh chhuah dân chu: I rih zawng kg zât kha i sân zawng metre-a tehin chumi square chuan sem rawh.  Entir nan: I rih zâwng kha kg 60 niin,  i sân zâwng kha  centimeter 150 (chu chu metre 1.5) lo ni se, 60 hi (1.5)² in i sem dâwn a nih chu.  Chuta lo chhuak chu i BMI chu a lo ni ta a ni.   Hetiang hian: 60÷(1.5×1.5) =26.6 

National Institute of Health (NIH) chuan hetiang hian rih/thau zâwng an teh:

BMI zât	Nihna
18.5 – 24.9	Mi pangngai
25.0 – 29.9	Overweight (Rit lu hret)
30.0 – 34.9	Class I obesity ( Thau tak)
35.0 – 39.9	Class II obesity( Thau êm êm)
>40.0	Class III (extreme)obesity(Thau lutuk)

A enkawl dân:

·    Ei leh in insûm:  Rihna/thauna tihniam tûr chuan ei leh in insûm hi a pawimawh hle. Amaherawhchu rihna tihniam tak tak tûr chuan ei leh in insûm hi hun rei lo te atan mai ni lovin kum tam tak chhûng atan a ni tih hriat hmasak tûr a ni a, chaw ei dân leh ei duhzâwng te pawh thlâkthleng a ṭûl fo ṭhin.   Rihna tlêmazâwng han hloh mai hi chu a har lo va, mahse hloh hlen tûra ṭanlâk hi a har lai tak chu a ni zâwk.  

Mi thiamten an thurâwn tlângpuiah chuan ni tin kan ei leh in hi  ‘calories’  1000 vêl ni se, chutah chuan protein (sa, artui, sangha, be lam chi, etc) gram 60, thau lam chi gram 40 leh ‘carbohydrate’  (buh, bahra, chhang, adt) gram 100 vêl awm thei se a ṭha an ti. Hetiang si sê hi chu mi nazawng chuan kan hre thiam tak tak phâk lo va, sawi thui lo mai ila. A pawimawh ber erawh chu ei leh in insûm pawhin  kan ei ang angah khan kan taksa tana ṭha tûr thil  (balanced diet) ei tel ngei ngei tûr a ni. 

·    Nunphung (lifestyle) thlâkthleng: Ei leh in mai ni lovin ni tin kan khawsak phung  thlenga thlâk ngai a awm thei. Ni danga kea kal ngai lo kha kea kal tam te, ṭhian kawm fimkhur te, zu lam in tam loh te, infiamna  leh sports lam inhman te, ei tur awmna hnaivaia awm tam loh te  thlengin a huam thei âwm e.

·    Exercise:  Exercise hi rihna tihhniamna bâkah hniam reng tûra puitu pawimawh tak a ni. Rihna tihniam tawhte tan ni tin darkar khat vêl hah lutuk lova exercise lâk hian taksa thau lêt leh tûr kha a vêng thei an ti. Aerobic exercise an tih hote hi hetiang atan hian a remchâng hle bawk.

·    Thurualpui neih:  Thurualpui neih hian nasa takin rihna tihhniam lama hlawhtling tûrin min pui thei bawk.  A khât tâwka doctor râwn chungin, chhûngkhat laina leh ṭhiante thurualpui tûr leh min phûrpuitu tûr neih hi a ṭangkai êm êm a ni.

·    Damdawi:  Intih chêrna damdawi hi hmang an awm bawk a. Heng damdawite hi amah maia hmang lovin ei leh in insum leh exercise tihte nen a kal kawp tûr a ni.  Damdawi rêng rêng hian side effect an nei vek tih hre bawk ila. Tunlaia damdawi an hman ber chu Sibutramine leh Orlistat te hi an ni. Heng damdawite hi mahni thua ei ngawt tûr a ni lo va, doctor râwn hmasak ngei ngei tûr a ni.

·    Inzai (surgery):  Hei hi chu a tâwpkhâwkah chauh an ti ṭhin.  A tlângpui thuin hêng inzai (bariatric operation an ti) te hi taksain chaw a ei tam theih loh nan emaw, chaw ei ang ang pawh tisa leh thisena  a luh tam loh nana pumpui leh ril vêl zai danglam a ni deuh ber.  Thau hip chhuah (Liposuction) hi chuan thau awmsa a paih ṭhen ringawt a, thauna chhan engmah a tidanglam chuang lo va, thau avanga natna thleng theite a titlêm chuang êm êm lo bawk.

Invenna lam: Thau tawh sa intihchêr tum ai chuan thau lo tûra inven hi a awlsam zâwk tih hriatreng a pawimawh.  Chuvangin, naupan lai aṭang pawhin thau lutuk lo tûra infuih hi a pawimawh a, sawrkar leh khawtlâng hruaitute pawhin mipui mimirte tana infiamna leh lên vahna hmun ṭha te hi  an siam thliah thluah a pawimawh khawp mai.