Ubururu bwa metilene ku bwandu bwa Candida mu kanwa: icyo ubushakashatsi ku buvuzi bukoresha urumuri bugaragaza

Umurwayi yireba mu ndorerwamo, akabona ibizinga byera byashize, maze agafata umwanzuro ko uduhumyo twashize. Uwo mwanzuro urumvikana. Mu bushakashatsi ku bururu bwa metilene bukangurwa n'urumuri mu kuvura ubwandu bwa Candida mu kanwa, ni na wo uteza urujijo rwinshi.

Ubu buvuzi bugizwe n'ibice bitatu, kandi buri kimwe gifite umurimo wacyo. Ubururu bwa metilene butwikira igikomere, urumuri rutukura rugakangura irangi, maze irangi ryakanguriwe rigaha ogisijeni ingufu kugira ngo habeho ibinyabutabire bimara igihe gito kandi byangiza uturemangingo tw'udukoko turi hafi. Uko ubururu bwa metilene bukora nk'ikinyabutabire gikangurwa n'urumuri ni ingenzi, kuko irangi rimwe ridafite urumuri rigira ubushobozi buke cyane bwo kurwanya udukoko. Ikibazo cy'ubuvuzi ni iki: iyo uru ruhererekane rukoreshejwe ku bwandu bwa Candida mu kanwa, ni iki gitera imbere, uko mu kanwa hagaragara cyangwa ibipimo byo gukurisha uduhumyo, kandi bimara igihe kingana iki?

Iryo tandukaniro ni ryo rigenga ibikurikira byose. Igisubizo ku bimenyetso by'indwara bivuga ibikomere bigaragara bike, gutukura cyangwa ibibambasi bisa n'ururenda bike, n'ububabare cyangwa kokera bike. Igisubizo ku duh umyo bivuga kugabanuka kw'utugize utukoroni mu bipimo byo kudukurisha cyangwa gushira burundu. Mu kanwa hashobora kuzuza ibisabwa n'igisobanuro cya mbere ariko ntihuzuze ibya kabiri.

Icyo ubushakashatsi bubiri bw'ingenzi bwagerageje

Ubushakashatsi bufitanye isano itaziguye n'iki kibazo kurusha ubundi, bwakorewe ku bantu bakuru bafite ubwandu bwa Candida butera gutukura mu kanwa, bwashyize abitabiriye 41 mu matsinda ku buryo bwa tombola: rimwe ryahawe ubuvuzi bukoresha ubururu bwa metilene bukangurwa n'urumuri, irindi rihabwa nystatin ivanze mu mazi. Itsinda ryahawe urumuri ryakorerwaga ubuvuzi buri cyumweru mu gihe cyageze ku byumweru bine. Igipimo cy'irangi cyari 0.1 ku ijana, rikarekwa ahavurwa iminota 15, hagakurikiraho urumuri rwa lazeri rwa 660 nm rutanga joules 4 kuri buri hantu mu masegonda 40, umubare w'ahavurwa ukagenwa n'uko ibikomere bingana. Ubuvuzi bwagereranyijwe na bwo bwari nystatin yo mu kanwa ivanze mu mazi, kuri 100,000 IU, yakoreshwaga buri munsi mu kunyuguza mu kanwa hafi iminsi 21. Abitabiriye bakurikiranwaga buri cyumweru mu gihe cy'ubuvuzi, ariko nta cyiciro kirekire cyo gukurikirana kugaruka kw'indwara cyatangajwe. Incamake yasohotse ivuga ko ibikomere byashize burundu kuri 16 mu barwayi 17 bahawe nystatin basuzumwe, no kuri 16 mu barwayi 19 bahawe ubuvuzi bukoresha urumuri basuzumwe. Ni ingenzi kwitondera iyo mibare y'abasuzumwe, kuko itandukanye na 18 na 23 bari bashyizwe mu matsinda ku buryo bwa tombola. Ubushakashatsi ntibwagaragaje ko itsinda ryahawe urumuri ryagize ibyavuye mu buvuzi byiza kurushaho. Ibikomere bikomeye byari bifite amahirwe make yo gushira muri buri tsinda. Umubare w'uduhumyo waragabanutse nyuma y'ubuvuzi bwa mbere bukoresha urumuri, ariko raporo ishyigikira kugabanuka kwihuse aho kwemeza kurandurwa burundu. Raporo yose iboneka mu bushakashatsi bwakoresheje tombola ku buvuzi bukoresha irangi rikangurwa n'urumuri ku bwandu bwa Candida butera gutukura.

Ubushakashatsi bwa kabiri bw'ingenzi ni igerageza rito ry'ibanze rigaragaza neza itandukaniro hagati y'ibimenyetso by'indwara n'ibipimo by'uduhumyo. Abantu bakuru cumi n'umunani bari bafite ubwandu bwa Candida mu kanwa bwemejwe n'isuzuma ry'ibimenyetso n'ibipimo by'uduhumyo bashyizwe mu matsinda hakoreshejwe tombola mu byiciro, 9 muri buri tsinda, naho 16 barangiza ubushakashatsi. Abantu bafite diyabete, abakoresha amenyo asimbura ayabo, abakoresheje antibiyotike, cyangwa bafite isuku nke bashoboraga kwitabira, ariko abafite ubwandu bwa HIV bwemejwe ntibemererwaga. Itsinda ryahawe urumuri ryakoresheje irangi rifite igipimo cyo hasi cyane, 0.1 mg kuri mL, rikarekwa ahavurwa umunota 1, rigakurikirwa n'urumuri rwa diyode rwa 660 nm rutanga joules 1.2 kugeza kuri 3.3 kuri cm2 mu gihe cy'amasegonda hafi 60 kuri buri hantu. Ubuvuzi bwakorwaga inshuro esheshatu mu byumweru bibiri. Ubuvuzi bwagereranyijwe na bwo bwari ibinini bya nystatin bishongeshwa mu kanwa kuri 500,000 IU, inshuro eshatu buri munsi mu minsi 14. Gukurikirana byarangiye ku munsi wa 14, nta suzuma ryakurikiyeho ryo kureba niba indwara yagarutse. Kugabanuka kw'ibimenyetso byagaragaye kuri 6 muri 9 bahawe ubuvuzi bukoresha urumuri, ugereranyije na 8 muri 9 bahawe nystatin. Igisubizo ku bipimo by'uduhumyo cyari 5 muri 9 ugereranyije na 8 muri 9, naho gushira burundu kw'uduhumyo kwari 4 muri 9 ugereranyije na 8 muri 9. Nta tandukaniro na rimwe ryageze ku rwego rw'akamaro mu mibare y'ibarurishamibare, bikaba byitezwe ku bushakashatsi bungana butyo. Icy'ingenzi cyabonetse ni itandukaniro riri mu itsinda ryahawe urumuri ubwaryo: 66.7 ku ijana bagize kugabanuka kw'ibimenyetso, ugereranyije na 44.4 ku ijana uduhumyo twashize burundu. Ibikomere byagabanutse kenshi kurusha uko uduhumyo twashize mu bipimo byo kudukurisha. Nta ngaruka mbi zikomeye zabaye. Uko ubushakashatsi bwateguwe n'imibare yabwo bisobanurwa mu igerageza ry'ibanze ryo kureba niba ubuvuzi bwa Candida mu kanwa bushobora gukorerwa aho umurwayi avurirwa.

Abasomyi bashakisha ubururu bwa metilene ku bwandu bwa Candida mu kanwa bakwiye kuzirikana iryo tandukaniro mbere yo gusoma umubare uwo ari wo wose w'abakize uvugwa mu mutwe w'inkuru. Igipimo cyo gukira gihuza ibimenyetso n'ibipimo byo gukurisha uduhumyo gihisha amakuru nyirizina umurwayi ufite ibimenyetso bigaruka aba akeneye.

Ibyavuye ku bimenyetso by'indwara ugereranyije n'ibyavuye ku duh umyo

Imbonerahamwe igaragaza uko ibyavuye mu bushakashatsi bikunze kugenda. Aho ubushakashatsi butandukanya ibyo bipimo bibiri, kugabanuka kw'ibikomere kurusha gushira k'uduhumyo mu bipimo byo kudukurisha. Aho bubihuza, umusomyi ntashobora kumenya icyagize uruhare rukomeye mu byabonetse. Icyo igipimo cy'urumuri rutukura kigenga gisobanura igice cy'iryo tandukaniro, kuko igipimo cy'irangi, igihe rirekwa ahavurwa, uburebure bw'umuraba, ingufu kuri buri buso, n'umubare w'inshuro z'ubuvuzi bitandukanye kuri buri murongo.

Impamvu gahunda z'ubuvuzi zitandukanye cyane

Igipimo cy'irangi kiri hagati ya 0.01 na 0.1 ku ijana mu bushakashatsi bw'ingenzi bwakorewe mu kanwa. Igihe irangi rirekwa ahavurwa kiri hagati y'umunota 1 n'iminota 15. Gahunda zimwe zikora ubuvuzi rimwe, izindi zikabukora inshuro esheshatu mu byumweru bibiri. Igipimo cy'urumuri, umubare w'ahavurwa, no kuba amenyo asimbura ay'umurwayi na yo ahabwa urumuri cyangwa ataruhabwa, byose bihindura ingufu zitangwa. Uku kudahuza bivuga ko nta gipimo kimwe cy'ubururu bwa metilene ku bwandu bwa Candida cyatangwa nk'incamake. Umubare uwo ari wo wose wakusanya ibyavuye muri ubwo bushakashatsi wavanga ubuvuzi butandukanye munsi y'izina rimwe.

Itandukaniro ry'abitabiriye ryongeraho urundi rwego. Ubwandu bwa Candida butera gutukura, ubwandu butera ibibambasi bisa n'ururenda, gutukura no kubyimba biterwa n'amenyo asimbura ay'umurwayi, n'ubwandu bwa Candida bufitanye isano na HIV, bigenda mu buryo butandukanye kandi bikagaruka kubera impamvu zitandukanye. Abakoresha amenyo asimbura ayabo bashobora kongera gukwirakwizwaho uduhumyo tuvuye ku buso bw'ayo menyo. Abantu bafite umunwa wumye, diyabete, abakoresha imiti ya steroyide ihumekwa, cyangwa baherutse gukoresha antibiyotike bafite impamvu zitandukanye zishobora gutuma indwara igaruka. Ibyabonetse mu itsinda rimwe ntibihita bikoreshwa mu rindi, kandi nta na bumwe muri ubu bushakashatsi bwo mu kanwa bugerageza ibivugwa kuri Candida yo mu mubiri hose cyangwa mu mara.

Uko wasoma ubushakashatsi ku bwandu bwa Candida mu kanwa mu minota ibiri

Mbere na mbere, reba interuro isobanura abitabiriye. Abantu bakuru bakoresha amenyo asimbura ayabo, abantu bafite HIV, n'amatsinda rusange y'abafite ubwandu bwa Candida mu kanwa basubiza ibibazo bitandukanye. Icya kabiri, andika ubuvuzi bwagereranyijwe n'umubare w'abitabiriye. Nystatin ivanze mu mazi, ibinini bya nystatin bishongeshwa mu kanwa, jeli ya miconazole, na fluconazole si ubuvuzi bw'igereranya bushobora gusimburana. Kandi ubushakashatsi bufite abitabiriye 7 kugeza kuri 23 muri buri tsinda bushobora gusa gushyigikira imyanzuro yerekeye niba ubuvuzi bushobora gukorwa. Icya gatatu, shaka itariki gukurikirana byarangiriyeho. Igipimo cya nyuma cyo ku munsi wa 14 cyangwa ku munsi wa 30 gipima igisubizo cy'igihe gito, ntabwo gipima gukumira kugaruka kw'indwara. Icya kane, saba imibare itandukanye ku bikomere no ku bipimo byo gukurisha uduhumyo. Niba inyandiko itanga gusa igipimo cyo gukira gihuza byombi, ifate nk'ibimenyetso bituzuye ku kibazo cy'uduhumyo.

Amakuru ku mutekano muri ubu bushakashatsi ni make, ariko aratanga icyizere ku byo yarebye. Igerageza ry'ibanze ryatangaje umurwayi umwe wagize gutukura n'ububabare mu ishinya, bikaza gufatwa nk'ibidafitanye isano n'ubuvuzi nyuma yo kubona indwara y'amenyo. Ryatangaje kandi umuntu umwe wahagaritse kubera uburyohe no kuribwa bijyanye na nystatin, n'undi wahagaritse kubera ko yumvaga ubuvuzi bukoresha urumuri nta ngaruka bugira. Ibibazo byagutse ku bushobozi bw'agahu gatwikira imbere mu kanwa bwo kwihanganira ubuvuzi bikwiye kureberwa mu makuru y'umutekano y'ikoreshwa kuri ako gahu, aho kureberwa mu mbonerahamwe z'ubushobozi bw'ubuvuzi.

Icyo ibi bivuze ku barwayi n'abavuzi

Ku ndwara zifitanye isano n'amenyo asimbura ay'umurwayi, ayo menyo na yo agomba kwitabwaho hamwe n'agahu gatwikira imbere mu kanwa. Ni yo mpamvu uburyo bwo kwita ku bwandu bwa Candida bufitanye isano n'ayo menyo ari icyemezo gitandukanye no guhitamo umuti urwanya uduhumyo cyangwa gahunda y'ubuvuzi bukoresha urumuri. Ku bwandu bwa Candida mu kanwa bugaruka, gahunda igenzura ibyo umuntu abona mu ndorerwamo n'ibipimo byo gukurisha uduhumyo irumvikana kurusha gukoresha kimwe gusa. Ibimenyetso n'urwego rw'ibikomere bifasha kuyobora ibyemezo ku kugabanya kubangamirwa no ku mikorere y'akanwa. Gusubiramo ibipimo byo gukurisha uduhumyo cyangwa kubara utukoroni bifasha kumenya niba uduhumyo dukomeje kuba aho nyuma y'uko ibikomere bigabanutse.

Incamake itabogamye y'uko ibintu bihagaze ubu ni iyi. Ubuvuzi bukoresha ubururu bwa metilene bukangurwa n'urumuri bushobora kugabanya ibikomere n'umubare w'uduhumyo mu bwandu bwa Candida mu kanwa mu minsi kugeza ku byumweru. Gushira burundu kw'uduhumyo mu bipimo byo kudukurisha no kumara igihe kirekire twarashize ntibigaragazwa kimwe mu bushakashatsi bwose. Kandi ubushakashatsi bugereranya ubu buvuzi na nystatin cyangwa miconazole bufite abitabiriye bake cyane kandi bumara igihe gito cyane ku buryo butashyigikira ko ubwo buvuzi bungana mu mikorere. Isesengura ryagutse ryo mu 2025 ryarebye ubushakashatsi 16 ku buvuzi bukoresha ibinyabutabire bitandukanye bikangurwa n'urumuri, risanga nta tandukaniro rusange rifite akamaro mu ibarurishamibare ugereranyije n'imiti irwanya uduhumyo ku gisubizo rusange. Ryagaragaje kandi kudahuza gukomeye n'impungenge ku kubogama, bikaba bitanga amakuru y'inyongera aho gutanga igipimo cyihariye ku bururu bwa metilene.

Icyo ni ikimenyetso giciriritse ariko gifatika. Gishyigikira gukomeza ubushakashatsi bukoresha ibipimo bihamye by'irangi n'urumuri, ibipimo by'ibisubizo bitandukanye, no gukurikirana kugaruka kw'indwara. Ntigishyigikira imyanzuro yo kubukoresha mu rugo, kandi iri sesengura ntirireba amara cyangwa amaraso. Abasomyi bashaka kumenya mu buryo bwagutse ubushakashatsi ku marangi akangurwa n'urumuri bashobora kwifashisha incamake y'indwara zo mu kanwa zizwe hakoreshejwe amarangi akangurwa n'urumuri, hamwe n'ubushakashatsi bubiri bw'ingenzi bwahawe amahuza haruguru.