Methylene blue n'ibitotsi: ibyo amagerageza yanditse, n'ibyo nta muntu yapimye

Umurongo umwe mu mbonerahamwe y'ibibazo bitifuzwa ni wo kimenyetso gikomeye kurusha ibindi byose bihari ku bitotsi kuri uyu muryango w'imiti. Mu igerageza ryamaze ibyumweru 52, ryagabanyije abitabiriye hakoreshejwe tombola kandi rikorerwa ku bantu bafite ubwoko bw'indwara yo gutakaza ubushobozi bwo gutekereza ifata ibice by'ubwonko by'imbere n'iby'iruhande ikigaragaza mu myitwarire, kubura ibitotsi byatangajwe n'abarwayi 3 muri 110 bafataga 8 mg ku munsi, na 7 muri 108 bafataga 200 mg ku munsi. Abanditsi bashyira kubura ibitotsi mu bibazo bitifuzwa byiyongeraga uko ingano y'umuti yiyongeraga, hamwe no kubura amaraso, impiswi, isesemi, kubabara mu gihe cyo kwihagarika, kwihagarika kenshi no kuruka.

Ingano y'umuti ikubye inshuro makumyabiri n'eshanu yajyanye n'ubwinshi bwo kubura ibitotsi bukubye hafi inshuro ebyiri n'igice. Ni ikimenyetso gito kiri mu mbonerahamwe nto, kandi kigana mu cyerekezo gitandukanye n'impamvu abantu benshi bashakisha iyi ngingo.

Nta gerageza rya methylene blue, cyangwa ry'imiterere yayo yakiriye electron yitwa hydromethylthionine mesylate, ryagabanyije abitabiriye hakoreshejwe tombola ryapimye ibitotsi nk'umusaruro. Ishakisha ryakozwe kuri iyi nyandiko ntiryabonye ubushakashatsi bwakoresheje urutonde rw'ibibazo ku bitotsi, igipimo cy'ibikorwa by'umubiri hakoreshejwe igikoresho cyambarwa, cyangwa ijoro muri laboratwari y'ibitotsi. Igihari ni ibyo umurwayi yavuze n'ibyo umuganga yanditse akoresheje kode, ibyo bikaba uburyo bwo gupima bufite intege nke kurusha uko byumvikana.

Ibyo gahunda z'amagerageza yakoresheje tombola zanditse

Amatsinda atatu y'amakuru arimo ibyanditswe byose bifitanye isano n'ibitotsi byabonetse. Abiri ava mu magerageza yakoresheje tombola kuri hydromethylthionine, imiterere yakiriye electron y'urufatiro rumwe rwa phenothiazine, yahawe ituze mu buryo bw'umunyu. Irya gatatu ni amakuru yo muri Amerika agenewe abandika imiti ku gicuruzwa gitangwa mu mutsi.

Ibintu bibiri byo mu murongo wa kabiri biruta imibare mu kamaro. Icya mbere, icyiciro cy'igereranya cyahawe methylthioninium chloride, ari yo miti imwe igurishwa nka methylene blue, kuri 4 mg kabiri mu cyumweru. Yatanzwe nk'ibara ridakora mu buvuzi rihindura ibara ry'inkari, kugira ngo abitabiriye batamenya itandukaniro ry'ibyiciro byombi barebye mu musarani. Icya kabiri, nta na kimwe mu bibazo umunani byo kubura ibitotsi mu byiciro byafashe umuti ukora umushakashatsi yasanze gifitanye isano n'umuti. Ibibazo bitatu byo gusinzira bikabije muri 332 byo byafashwe gutyo.

Ikibazo kitifuzwa si igipimo. Ni ibyo umuntu yavuze, byanditswe mu magambo atandukanye n'ayo umusomyi akoresha, mu itsinda ry'abantu bafite indwara yangiza buhoro buhoro uturemangingo tw'imyakura, benshi muri bo bakaba banifashisha imiti ituza n'imiti irwanya agahinda gakabije. Gusoma “ntibyashyizwe ku rutonde” mu murongo wa gatatu ukabyumva nk'aho bivuga “ntibibaho” na byo byaba ikosa ku mpamvu itandukanye: abarwayi 31 ni umubare muto bihagije ku buryo hafi ikintu cyose gishobora kutagaragaramo, kandi amakuru agenewe abandika umuti avuga yeruye ko isano hagati y'ingano umubiri ugerwaho n'umuti n'uko umubiri uwitabira, ndetse n'umutekano wawo, itazwi.

Aho ibivugwa ku bitotsi bikomoka

Hafi buri nyandiko, videwo n'urupapuro rw'igicuruzwa bihuza iyi miti n'ibitotsi amaherezo byerekeza ku musaruro umwe. Mu 2007, Oxenkrug na bagenzi be bapimye imikorere ya monoamine oxidase na indoles zo mu mvubura ya pineal y'imbeba nyuma y'ingano imwe y'umuti yatewe munsi y'uruhu.

Methylene blue yabuzaga monoamine oxidase y'ubwoko bwa A gukora mu buryo bwo kuyihataniriza ahafatirwa ibiyikorerwaho, kandi uko kuyibuza gukora kwashoboraga gusubira inyuma; Ki yayo yari hafi nanomoles 180. Ku bwoko bwa B, Ki yari hafi nanomoles 1,400, bivuze ko yahitagamo ubwoko bwa A hafi inshuro umunani kurusha B. Buri tsinda ryari rifite imbeba eshanu, zahawe 10 mg/kg munsi y'uruhu, maze imvubura za pineal zikurwamo nyuma y'iminota 90. Melatonin yazamutse iva kuri nanograms 0.17 igera kuri 0.71 kuri buri mvubura. N-acetylserotonin, ibanziriza melatonin ako kanya mu iyubakwa ryayo, yavuye ku rugero ruri munsi y'urwashoboraga gutahurwa igera kuri 0.86. Serotonin yo muri pineal yazamutse iva kuri 79 igera kuri 118, naho 5-HIAA, ikomoka ku isenywa ryayo, igabanuka iva kuri 10.9 igera kuri 4.1.

Ibisobanuro bikurikiraho birumvikana mu bya shimi. Serotonin ni ibikoresho fatizo byo gukora melatonin, kandi noradrenaline ituma haba intambwe yo kongeraho itsinda rya acetyl ihindura serotonin ikayigira N-acetylserotonin. Iyo ubuze enzyme isenya byombi gukora, pineal iba ifite ibikoresho fatizo byinshi mu gihe cy'urumuri, n'ibibanziriza melatonin byinshi biboneka igihe umwijima ugeze.

Ariko ibyo biracyari kure yo kwerekana ko umuntu asinzira neza kurushaho. Igipimo ni ibiri mu mvubura y'inyamaswa yatewe ikinya, mu mwanya umwe gusa, kandi nta na kimwe muri ubwo buryo bw'igerageza cyandika igihe imbeba yamaze isinziriye, uko yahise ibona ibitotsi, cyangwa uko yumvise imeze mu gitondo cyakurikiyeho. Inyandiko yanditswe ku mikorere y'imiti irwanya agahinda gakabije, kandi mu gice cyayo cy'isesengura itanga igitekerezo cy'uko kuzamura melatonin ku manywa bishobora gukosora injyana y'umubiri y'amasaha 24 yahindutse ku barwayi bafite agahinda gakabije. Icyo ni igitekerezo gikeneye kugeragezwa kiri mu gice cy'isesengura, kandi ni cyo nkomoko y'ibivugwa ku bitotsi.

Ibivugwa ku nzozi zigaragara cyane nta nkomoko yatangajwe bifite

Ishakisha ryakozwe kuri iyi nyandiko ntiryabonye raporo y'umurwayi umwe, raporo y'abarwayi benshi, ibyanditswe mu igerageza, cyangwa ubushakashatsi bwahuje methylene blue n'inzozi zigaragara cyane, inzozi mbi, cyangwa ihinduka mu kwibuka inzozi. Ibyo bivugwa biri mu biganiro byo kuri interineti, si mu nyandiko z'ubushakashatsi.

Ibimenyetso kuri uyu muryango w'imiti byerekeza mu cyerekezo gitandukanye mu gihe cyo kuyifata. Igihe clorgyline na pargyline, imiti ibuza mu buryo bwihariye monoamine oxidase y'ubwoko bwa A na B gukora, byatanzwe mu gihe cy'ibyumweru bine ku barwayi bafite indwara z'imimerere y'amarangamutima, ibitotsi bya REM byahagaritswe hafi burundu kandi igihe cyose cyo gusinzira kiragabanuka. Isesengura ry'ubushakashatsi ryakozwe mu buryo buteguye ku miti irwanya agahinda gakabije n'inzozi, ryarebye ubushakashatsi 21 ku bantu na raporo 25 z'abarwayi, ryasanze inshuro zo kwibuka inzozi zigabanuka ku bafata phenelzine, umuti uzwi cyane ubuza monoamine oxidase gukora. Inzozi mbi zivugwa muri izo nyandiko zigaragara mu gihe cyo kureka umuti, igihe ibitotsi bya REM bigarukana imbaraga, si mu gihe umuti ugifatwa.

Bityo, imikorere ikunze gutangwa nk'impamvu y'inzozi zigaragara cyane ahubwo iteganya ibitotsi bya REM bike no kwibuka inzozi gake mu bihe bisanzwe, bigakurikirwa no kugaruka kw'ibyo bitotsi mu buryo butameze neza igihe umuti uhagaritswe. Niba methylene blue ikora kimwe muri ibyo ku muntu ntibirageragezwa. Uburyo bwayo bwo kubuza enzyme gukora bushobora gusubira inyuma, ifite imbaraga nke cyane kurusha phenelzine, kandi ubushakashatsi ku bantu bwasubiza icyo kibazo ntibwigeze bukorwa.

Ibivugwa ku ihungabana ryo guhindura amasaha mu ngendo bifite inkomoko nyayo

Inyandiko imwe ni yo ibiri inyuma. Oxenkrug na Requintina bakoze icyitegererezo cy'ihungabana ryo guhindura amasaha mu ngendo ku mbeba bahindura uruhererekane rw'urumuri, hanyuma bapima serotonin, N-acetylserotonin na melatonin zo muri pineal bakoresheje uburyo bwo gutandukanya ibinyabutabire mu mazi bukora ku rwego rwo hejuru, hamwe no kubitahura hakoreshejwe urumuri rwa fluorescence.

Hatangajwe ibintu bibiri byabonetse. Gutera melatonin mu ntangiriro y'igihe gishya cy'umwijima byihutishije gusubirana kw'injyana za N-acetylserotonin na melatonin. Kandi N-acetylserotonin na methylene blue, yasobanuwe muri iyo nyandiko nk'ibuza monoamine oxidase A gukora, byagabanyije ihungabana rya N-acetylserotonin ryatewe n'urumuri, ariko ntibyagabanyije irya melatonin.

Soma ibyo witonze. Mu cyitegererezo cy'inyamaswa cyageragezaga neza uko ibintu bivugwa bimeze, methylene blue yahinduye igipimo kimwe cy'ikibanziriza melatonin ariko ntiyahinduye injyana ya melatonin. Imyanzuro y'iyo nyandiko ubwayo ivuga igihe cyo kugera iyo ujya cyaba cyiza ku rugendo rw'indege rugana iburasirazuba, n'uko igihe cyo gufata melatonin cyakagenwa. Ntitanga methylene blue nk'umuti w'ihungabana ryo guhindura amasaha mu ngendo, kandi nta bushakashatsi ku bantu bwayigerageje muri ubwo buryo.

Kubuza imbeba ibitotsi si ugupima ibitotsi

Igerageza rikunze kuvugwa cyane nk'ikimenyetso cy'uko methylene blue ifasha mu gihe cyo kubura ibitotsi ntiryapimye ibitotsi. Marzabadi na bagenzi be bashyize imbeba z'ingabo 60 za BALB/c mu buryo bwahinduwe bukoresha utubuga twinshi, aho inyamaswa ishyizwe ku kabuga gafunganye ihatirwa gukomeza kuba maso. Bagereranyije itsinda ry'igereranya ryari ku kabuga kagari n'inyamaswa zabujijwe ibitotsi, izahawe methylene blue yonyine, izahawe lazeri itanga urumuri mu ntambwe zicagaguye rw'uburebure bw'umuraba bwa nanometres 810 yonyine, n'izahawe byombi.

Methylene blue yatewe kuri 0.5 mg/kg mu minsi icumi ikurikirana mbere y'uko kubuzwa ibitotsi bitangira, naho lazeri ikoreshwa buri nyuma y'umunsi umwe. Kwiga no kwibuka byapimwe hakoreshejwe inzira ifite ishusho ya T, ikizamini cy'imibanire n'agasanduku ko kwimuka hagati y'ibice bibiri, hanyuma hapimwa urugero rwa PSD-95, GAP-43 na synaptophysin muri hippocampus.

Kubuzwa ibitotsi byagabanyije inshuro zo guhinduranya inzira, imibanire, kwitabira mugenzi mushya n'igipimo cyo kwibuka. Nta na bumwe mu buryo bwakoreshejwe ukwabwo bwagaruye ibipimo byinshi muri ibyo. Kubuhuza byarabigaruriye, kandi byazamuye ibimenyetso uko ari bitatu by'amasangano y'uturemangingo tw'imyakura. Icyabonetse ni uko guhuza uburyo bubiri mbere y'igerageza byarinze ubushobozi bwo kwibuka mu nyamaswa zari zahungabanyijwe ibitotsi. Muri ubwo buryo bw'igerageza, kubuzwa ibitotsi ni cyo cyangiza, si cyo musaruro upimwa. Nta gihe cyo gutegereza mbere yo gusinzira, igihe cyo gusinzira cyangwa imiterere y'ibyiciro by'ibitotsi byanditswe, kandi gufata iyo nyandiko nk'ikimenyetso cy'uko umuntu asinzira neza bihindura icyo yapimye.

Mu gitondo cyangwa nijoro: imibare ntitanga igisubizo

Inama z'igihe cyo gufata uyu muti zisubirwamo abantu bazizeye, nyamara ntizigeze zigeragezwa. Nta gerageza ryagereranyije gufata umuti mu gitondo no ku mugoroba, mu itsinda iryo ari ryo ryose, ku musaruro uwo ari wo wose werekeye ibitotsi.

Icyapimwe ni uko uyu muti ugenda buhoro mu mubiri. Mu bushakashatsi ku ngano imwe y'umuti bwakorewe ku bakorerabushake bafite ubuzima bwiza, 200 mg zafashwe mu kanwa nyuma yo gutegura amara zatumye urugero rw'umuti mu maraso rukomeza kuzamuka mu masaha cumi n'abiri, maze igihe cyo kugera ku rugero rwo hejuru kigira agaciro ko hagati k'amasaha 16. Igihe bifata ngo urugero rw'umuti rugabanukeho kimwe cya kabiri cyari hagati y'amasaha 14 na 27 kuri iyo ngano, no hagati y'amasaha 6 na 26 kuri 400 mg. Igicuruzwa gitangwa mu mutsi kivugwa mu makuru agenewe abandika umuti gifite igihe cyo kugabanukaho kimwe cya kabiri kingana n'amasaha hafi 24, kandi hafi 40% isohoka mu nkari idahindutse, mu gihe ingano umubiri ugerwaho n'umuti yiyongera cyane iyo impyiko zidakora neza.

Bityo, ingano y'umuti ifashwe mu kanwa mu gihe cyo gufata ifunguro rya mu gitondo igera ku rugero rwayo rwo hejuru rwapimwe hafi ya saa sita z'ijoro. Ibyo bikwiye gutekerezwaho, kuko inama ebyiri zikunze guhererekanywa zishingira ku kuba ibyo atari ukuri. “Yifate mu gitondo kugira ngo idahungabanya ibitotsi” bifata ko ingaruka zayo ziba zarashize igihe cyo kuryama kigeze. “Yifate nijoro kuko ishira vuba” byo bifata ibinyuranye n'ibyo. Ubushakashatsi bumwe ku bantu buhari ku ngendo z'umuti mu mubiri ntibushyigikira ingaruka zimara igihe gito ku mugoroba, kandi igerageza ku mbeba rishingirwaho mu nkuru ya melatonin ritanga impamvu yo gufata umuti mu ntangiriro y'igihe cy'urumuri kubera indi mpamvu rwose: kuzamura ikibanziriza melatonin ku manywa. Hari inyandiko yihariye ku gihe uyu muti umara mu mubiri niba imibare y'uko usohoka mu mubiri ari yo wari ushaka.

Igisubizo cy'ukuri ku kibazo cy'igihe cyo kuwufata ni uko nta muntu ubizi, kandi ingano zapimwe mu maraso zitanga impamvu zo kutigira nk'aho hari ubizi.

Raporo imwe ku muntu ifite ikibazo cy'ibitotsi cyahindutse

Habonetse inyandiko imwe gusa ku bantu aho methylene blue yahawe umuntu ufite indwara y'ibitotsi, kandi ni raporo y'umurwayi umwe.

Raporo y'umurwayi yatangajwe muri Cureus mu 2021 isobanura umusore w'imyaka 15 wari ufite sindorome ya Kleine-Levin, indwara idakunze kuboneka irangwa n'ibihe bigaruka byo gusinzira bikabije bimara iminsi kugeza ku byumweru, bijyana no kujijwa, kumva ko ibimukikije atari iby'ukuri no guhinduka kw'imyitwarire. Yari amaze imyaka itatu avurwa na lithium, kandi modafinil, methylprednisolone, imiti idasanzwe irwanya indwara zo mu mutwe na amantadine nta terambere byari byazanye. Ageze ku myaka 18, yagize igihe cy'uburwayi cyamaze hafi amezi atandatu. Ababyeyi babyemeye, yahawe 10 mg za methylene blue mu kanwa isaha imwe mbere yo guhabwa urumuri rutukura mu mazuru buri joro mu gihe cy'iminota 25, rufite uburebure bw'umuraba bwa nanometres 633, joules 11.4 kuri santimetero kare. Mu cyumweru kimwe, gusinzira bikabije n'ibimenyetso byo mu myitwarire byarashize. Nyuma y'imyaka ibiri, ntibyari byarongeye kugaruka kandi nta yindi miti yafataga.

Abanditsi ubwabo bavuga imbogamizi: umuntu umwe, nta gukurikirana mu bushakashatsi bw'igihe kirekire, kandi bizwi ko ibihe bya Kleine-Levin bigenda biba bike uko imyaka ishira, bigatuma bidashoboka kwemeza ko ubuvuzi ari bwo bwatumye ibimenyetso bishira. Hari n'imbogamizi ya kabiri batibandaho. Umurwayi yahawe uburyo bubiri icyarimwe, kandi bumwe bwari urumuri rutukura rwinjijwe mu mwanya w'izuru hamwe n'umuti ukoreshwa mu buvuzi bukoresha urumuri kubera ko urumuri ari rwo rutuma ukora. Umusomyi ntashobora gutandukanya uruhare rw'irangi, urumuri n'igihe cyashize, kandi iyo raporo si impamvu yo kugerageza methylene blue ku kibazo cy'ibitotsi.

Icyerekezo gifite amakuru ku bantu ni ugutuza no gusinzira bitewe n'umuti

Aho hari ibipimo ku bantu byerekeye urwungano rw'imyakura rwo hagati, ahanini byerekeza ku gutuza no gusinzira bitewe n'umuti aho kwerekeza ku kuba maso.

Ubushakashatsi bwo mu 2008 muri Anaesthesia bwagereranyije abarwayi 11 bahawe methylene blue mbere n'abarwayi 11 b'igereranya bafite ibibaranga bisa, mu gihe cyo gutangira ikinya no kubagwa, hakoreshejwe igipimo cya Bispectral n'itangwa rya propofol mu mutsi rigenzurwa kugira ngo rigere ku rugero rwateganyijwe. Ku rugero rwa propofol rwari ruteganyijwe aho ikorera rwa micrograms 2 kuri millilitre, amanota yo gutuza no gusinzira n'indangagaciro z'igipimo byari hasi ku buryo bugaragara mu itsinda ryahawe umuti. Mu gihe cyose cyo kubagwa, abarwayi bari bahawe umuti mbere bakeneraga impuzandengo ya propofol iri munsiho 50% kugira ngo bagere ku rwego rumwe rw'ikinya. Iyo nyandiko itangira ivuga ko gutinda kuva mu kinya n'ihungabana ry'imikorere y'imyakura byari byaratangajwe ku barwayi babagwaga imvubura za parathyroid bari bahawe methylene blue mbere, kandi isoza igira inama yo kongera umuti buhoro buhoro witonze igihe cyose utangwa mu mutsi mu gihe gikikije kubagwa.

Amakuru agenewe abandika umuti avuga kimwe mu yandi magambo. Ubuvuzi bushobora gutera kujijwa, kuzungera n'ihungabana ryo kubona, kandi abarwayi bagirwa inama yo kwirinda gutwara ibinyabiziga cyangwa gukoresha imashini ziteje ibyago kugeza ibyo bishize; amabwiriza adafitanye isano igaragara n'umuti ugurishwa nk'ufasha gusinzira.

Hari kandi uburyo ukoreshwa koko mu kuvura imimerere isa no gusinzira. Ifosfamide, umuti ukoreshwa mu buvuzi bwa kanseri, ishobora gutera ihungabana ry'ubwonko rirangwa cyane no gusinzira bikabije, kudatuza no kujijwa, bikagera no kuri koma. Methylene blue ni umwe mu miti itangwa mu kubuvura. Mu isesengura ry'abarwayi 24 muri MD Anderson Cancer Center, abarwayi 20 bahawe methylene blue kandi ibimenyetso bishira kuri 19; byongeye kugaruka kuri batatu muri batanu nyuma bongeye guhabwa ifosfamide mu gihe bafataga methylene blue mu rwego rwo kubikumira.

Umuti wongera ubujyakuzimu bw'ikinya, utera kuzungera no kujijwa, kandi ukoreshwa mu gusubiza inyuma imimerere yo gusinzira bikabije yatewe n'ubuvuzi bwa kanseri, ntabwo bigaragara ko ari umuti ufasha gusinzira. Ni umuti ufite ingaruka nyazo ku rwungano rw'imyakura rwo hagati, icyerekezo cyazo kigaterwa n'ibindi biri mu mubiri icyarimwe na wo.

Imiti ifatwa nijoro, no guhumeka nijoro

Ibintu bibiri biri mu makuru agenewe abandika umuti bikwiye kwitabwaho n'umuntu wese ufata methylene blue ku mugoroba hamwe n'ikindi kintu.

Icya mbere ni urutonde rw'imikoranire n'indi miti. Amabwiriza avuga SSRIs, SNRIs, MAOIs, bupropion, buspirone, clomipramine, mirtazapine, linezolid, opioids na dextromethorphan, kandi agira inama yo kutagira umuti uwo ari wo wose ukora kuri serotonin ufatwa mu masaha 72 nyuma y'ingano ya nyuma. Ibiri muri ibyo bikunze kuba ku meza yo hafi y'uburiri. Mirtazapine ni umuti urwanya agahinda gakabije utuma umuntu asinzira, ukunze gufatwa nijoro. Dextromethorphan ni umuti uhagarika inkorora uri mu miti y'ibicurane ifatwa nijoro, kandi ugurishwa nta rupapuro rwa muganga. Nta na rimwe muri ayo mahuriro rishingiye ku bitekerezo gusa: amabwiriza yandika ibibazo bya sindorome ya serotonin byatewe n'ibicuruzwa byo mu muryango wa methylene blue, kandi bimwe muri byo byahitanye abantu. Raporo yatangajwe y'umurwayi mu gihe gikikije kubagwa isobanura umugabo w'imyaka 67 wagaragaje kudatuza, kwikanya kw'imikaya gusubiramo n'ubushyuhe bw'umubiri bukabije igihe yavaga mu kinya rusange, nyuma yo guhabwa methylene blue mu gihe cyo kubagwa.

Melatonin, benzodiazepines, imiti ya z nka zopiclone, na diphenhydramine ntibikora kuri serotonin, bityo ikibazo gihangayikishije aho si sindorome ya serotonin. Ni icyapimwe n'ubushakashatsi ku kinya: ingaruka zo gutuza no gusinzira ziteranyirizaho ku ngano nta muntu urasobanura neza.

Icya kabiri kireba guhumeka. Mu ngaruka zitifuzwa zatangajwe ku bicuruzwa byo mu muryango wa methylene blue, amakuru agenewe abandika umuti ashyiramo kuziba izuru, kubabara mu kanwa no mu muhogo, kugira ibimyira no kwitsamura. Izo ni raporo zatanzwe ku bushake, zidafite imibare y'inshuro ibyo bibaho cyangwa uburyo umuti watanzwemo, kandi ni ubwoko bw'impinduka zishobora kugaragara nko gukanguka umunwa wumye no kumva ko guhumeka unyuze mu mazuru byahindutse mu ijoro. Inkuru y'umusomyi umwe uvuga ko yatangiye guhumekera mu kanwa mu buryo butunguranye igihe asinziriye iri mu kiganiro cyo ku rubuga, nta suzuma, nta mateka y'imiti yafashe cyangwa igipimo na kimwe; ibyo byemeza gusa ko hari umuntu watanze iyo raporo, nta kindi.

Umuntu wese ufite ikibazo cy'ibitotsi kirangwa no kugona, guhagarika guhumeka kwabonywe n'abandi, cyangwa gusinzira ku manywa bikabije ku buryo asinzira atwaye imodoka, yagombye kureba ikibazo cyo guhagarika guhumeka mu gihe cyo gusinzira aho kureba inyunganiramirire. Guhagarika guhumeka mu bitotsi birashobora gusuzumwa, birashobora kuvurwa, kandi nta kimenyetso na kimwe mu byavuzwe haruguru kibireba.

Ubwoko bw'ibikoresho na bwo ni ikintu gihinduka hano

Ingano z'umuti mu bushakashatsi bwose bwavuzwe haruguru zari ingano zapimwe z'ikinyabutabire cyasobanuwe neza cyaturutse ku ruganda rukora imiti, gifite icyemezo cy'isesengura. Icupa rivuye ku mucuruzi utagenzuwe ntabwo ari ibyo, kandi itandukaniro si iryo ku isura gusa. Icyiciro cya USP ni cyo gipimo ngenderwaho umuguzi ashobora kugenzura, kandi ibikoresho bitacyubahiriza bishobora kuba ari ibyo ku rwego rwo gusiga amabara imyenda. Bishobora kuba birimo imyanda y'ibinyabutabire nka Azure B, ibisigazwa by'ibishongesha n'ibyuma biremereye ku ngano amabwiriza agenga imiti ashyiriraho imipaka.

Abacuruzi benshi bavuga ko igicuruzwa cyapimwe n'ikigo cyigenga bapima ibyuma biremereye gusa, maze bagatanga iryo tsinda rimwe ry'ibipimo nk'ikimenyetso cy'uko amabwiriza yose yubahirijwe. Blupreme ipima ibisabwa byose bya USP: umwirondoro w'ikinyabutabire, ubuziranenge, imyanda y'ibinyabutabire, ibisigazwa by'ibishongesha, imyanda y'ibinyabutabire by'ibanze, ibisigazwa nyuma yo gutwika, imipaka y'udukoko n'uburozi bwa endotoxins bukomoka kuri bagiteri. Buri cyiciro cy'umusaruro cyoherezwa gifite icyemezo cy'isesengura, kandi kugisoma neza bisaba kugenzura ko nimero y'icyiciro cy'umusaruro na laboratwari bihuye n'icupa ufite mu ntoki.

Nta na kimwe muri ibyo gitanga inyungu ku bitotsi, kandi si yo mpamvu yo gufata uyu muti. Niba uwufata uko byagenda kose, kumenya ibiri mu kapsule ni cyo kintu cy'ibanze, kandi inyandiko yifashishwa ku mutekano n'inyandiko ku mikoranire n'indi miti bisobanura ibibazo bibanza mbere y'ikiganiro icyo ari cyo cyose ku gihe cyo kuwufata.

Umwanzuro

Nta gerageza ryagabanyije abitabiriye hakoreshejwe tombola ryapimye ibitotsi mu gihe cyo kuvurwa na methylene blue. Ibyonyine byanditswe ku bitotsi mu makuru y'amagerageza yakoresheje tombola ni imirongo y'ibibazo bitifuzwa, kandi mu igereranya rinini kurusha ayandi rihari ry'ingano z'umuti, igipimo cyo kubura ibitotsi cyari 2.7% kuri 8 mg ku munsi ugereranyije na 6.5% kuri 200 mg ku munsi.

Ibivugwa ku nzozi zigaragara cyane nta nkomoko yatangajwe bifite, kandi inyandiko ku monoamine oxidase ziteganya ibinyuranye na byo mu gihe cyo kuvurwa. Ikibazo cyo gufata umuti mu gitondo cyangwa nijoro nticyigeze kigeragezwa, kandi ingano y'umuti ifashwe mu kanwa igera ku rugero rwo hejuru mu maraso ku gihe gifite agaciro ko hagati k'amasaha 16, bikaba byegereye saa sita z'ijoro kurusha igihe cy'ifunguro rya saa sita ku muntu uwufata mu gihe cy'ifunguro rya mu gitondo. Igerageza ryo kubuza ibitotsi rihererekanywa nk'ikimenyetso ni ubushakashatsi ku kwibuka butanditse ibitotsi na gato, kandi raporo imwe ku muntu wagize iterambere ku ndwara y'ibitotsi ivuga umurwayi umwe wari uzi ubuvuzi ahabwa, yahawe uburyo bubiri icyarimwe.

Incamake y'ibimenyetso ku bantu ikusanya ibyo aya magerageza yemeza koko, isesengura ku kwibuka no kwibanda risuzuma ibipimo by'ubushobozi bwo gutekereza byegereye cyane ibitotsi muri ubwo bushakashatsi, kandi ububiko bw'ubushakashatsi bushyira ku rutonde inyandiko zishingirwaho kuri buri kintu kivugwa kuri uru rupapuro.