Ubururu bwa metilene ku ndwara z'imyakura n'ububabare: indwara zakozweho ubushakashatsi

Ese ubururu bwa metilene bugabanya indwara z'imyakura n'ububabare? Bisa n'aho ari ikibazo kimwe, ariko inyandiko z'ubushakashatsi zisubiza ibibazo byinshi bitandukanye. Irangi riterwa muri disiki iri hagati y'amagufwa y'uruti rw'umugongo, irangi riterwa munsi y'uruhu ruzengurutse umwoyo, irangi rishyirwa mu mutsi w'amaraso, n'irangi rinyuguzwa mu kanwa bihuje izina, ariko bikoreshwa mu kugerageza ibitekerezo bitandukanye, bikora mu buryo butandukanye. Igisubizo kiboneka kuri kimwe ntigishobora kwimurirwa ku bindi.

Bitekereze nk'ibitekerezo bine bifite izina rimwe. Icya mbere cyangiza cyangwa kigabanya ubushobozi bwo kumva bw'udusozo duto tw'imyakura dukura twinjira muri disiki yangiritse. Icya kabiri gitera ikinya cyangwa kigabanya ibikorwa by'imyakura yo mu ruhu aho irangi ryatewe. Icya gatatu kigera ku rwungano rw'imyakura binyuze mu maraso azenguruka umubiri. Icya kane gisiga ahantu hakomeretse kugira ngo kigabanye ububabare bwaho. Iyo umaze gutandukanya ibyo, ibimenyetso biroroha kubishyira mu byiciro, kandi icyuho kigaragara: igitekerezo gikunze kuvugwa kireba icya gatatu ariko hakoreshejwe amazi anyobwa, ari na ho ibimenyetso byo mu bushakashatsi ku bantu ari bike cyane.

Imbonerahamwe y'ibimenyetso hakurikijwe indwara n'uburyo bwo gukoresha

Iyi mbonerahamwe ni incamake y'iyi nyandiko. Buri murongo uhuza indwara, uburyo bwo gukoresha n'igikorwa cy'ubuvuzi, kuko kubitandukanya ari byo bituma ibyo bavuga ku kugabanya ububabare birengerwa.

Indwara	Uburyo bwo gukoresha bwakorewe ubushakashatsi	Ubushakashatsi bw'ingenzi n'ibyo bwabonye	Imbogamizi nyamukuru
Ububabare budakira bwo mu mugongo wo hasi buturuka kuri disiki	Gutera muri disiki	Igerageza ryo mu 2010 ryagabanyije abarwayi mu matsinda ku buryo bwa tombola: abarwayi 72, 10 mg z'ubururu bwa metilene hamwe na lidocaine bigereranywa n'amazi arimo umunyu hamwe na lidocaine; igabanuka rikomeye ry'ububabare n'imbogamizi mu gukora ibikorwa nyuma y'amezi 24	Igisubizo cyo ku kigo kimwe kitongeye kuboneka mu igerageza rya IMBI ryakurikiyeho ryakorewe ku bigo byinshi
Ububabare budakira bwo mu mugongo wo hasi buturuka kuri disiki	Gutera muri disiki	Igerageza rya IMBI ryakorewe ku bigo byinshi: igereranya ry'amatsinda yagabanyijwe ku buryo bwa tombola ku bigo bitandukanye	Ntiryo ryemeje igisubizo gikomeye cya Peng; ibimenyetso ku bushobozi bwo kuvura biracyavuguruzanya
Kwishimagura ku mwoyo n'ibimenyetso byo hafi yawo	Gutera mu ruhu ruzengurutse umwoyo	Urukurikirane rw'abarwayi rutagira itsinda ryo kugereranya (urugero, abarwayi 30 bahawe 15 mL z'umuti ufite 1%): benshi nta bimenyetso bari bafite nyuma y'ukwezi kumwe, kandi kuri benshi byakomeje kugeza ku mwaka umwe	Nta tsinda ryahawe igikorwa cyo kwigana iryo vura; isesengura rihuriza hamwe ubushakashatsi bw'itsinda rimwe ryo mu 2023 ry'ubushakashatsi 7 n'abarwayi 225 ntirishobora gukuraho icyo cyuho
Ububabare nyuma yo kubagwa hakurwaho imitsi yabyimbye ku mwoyo	Gutera mu ruhu ruzengurutse umwoyo	Igerageza ryo mu 2014 ryagabanyije abarwayi mu matsinda ku buryo bwa tombola: abarwayi 67; ububabare buke no gukoresha paracetamol nke mu minsi 3 ya mbere nyuma yo kubagwa	Kugabanya ububabare by'igihe gito bijyanye n'igikorwa cy'ubuvuzi, si ukuvura ububabare budakira
Ububabare nyuma yo kubagwa hakurwaho imitsi yabyimbye ku mwoyo	Gutera mu ruhu nyuma yo kubagwa	Igerageza ryo mu 2024 aho abarwayi n'abashakashatsi batari bazi itsinda bahawe: abarwayi 97; ububabare buke kuva ku munsi wa 1 kugeza ku wa 7	Inyungu yagarukiye mu cyumweru cya mbere
Ububabare buturuka ku kwangirika kw'imyakura butitabira ubuvuzi, butewe n'impamvu zitandukanye	Gushyira umuti mu mutsi w'amaraso	Igerageza rito ry'ibanze ryo mu 2015 aho abarwayi n'abashakashatsi batari bazi itsinda bahawe: abarwayi 10, 2 mg/kg bigereranywa n'itsinda ryahawe ingano nto cyane; amanota y'ububabare yagabanutse mu gihe kingana n'umunsi 1 kugeza ku minsi 2	Itsinda rito cyane ry'abarwayi bafite imiterere itandukanye, hamwe n'ikimenyetso cy'inyungu y'igihe gito
Ububabare bw'imyakura busigara nyuma y'indwara ya zona	Guhagarika ibimenyetso by'imyakura iruhande rw'uruti rw'umugongo cyangwa gushyirayo umuti hamwe n'umuti utera ikinya ahantu hamwe	Igereranya ryo mu 2021 ryagabanyije abarwayi mu matsinda ku buryo bwa tombola: abarwayi 104; ububabare buke no gukoresha imiti y'inyongera yo kubugabanya mike kugeza ku mezi 6 mu itsinda ryahawe ubururu bwa metilene	Gukoresha ahantu hamwe hamwe n'umuti utera ikinya, si ubuvuzi bunyura mu maraso bugera mu mubiri wose cyangwa umuti unyobwa
Ububabare bwo mu mugongo wo hasi nyuma yo kubagwa hakurwaho disiki	Gushyira umuti mu nyama z'igikomere	Igerageza ryo mu 2016 aho ibyiciro bitatu by'abagize uruhare bitari bizi itsinda ryahawe: abarwayi 115; amanota y'ububabare bwo mu mugongo yari hasi nyuma y'amasaha 24 n'amezi 3	Igisubizo cy'ubuvuzi bw'inyongera mu kubaga; itandukaniro mu bubabare buturuka ku mizi y'imyakura ntiryari rifite agaciro mu mibare nyuma y'amezi 3
Ububabare bwo kubyimba kw'agahu gatwikiriye imbere mu kanwa butewe no kuvura kanseri	Kunyuguza mu kanwa, ntibunyobwe	Igerageza ryo mu cyiciro cya 2 ryo mu 2022 ryagabanyije abarwayi mu matsinda ku buryo bwa tombola: abarwayi 60; igabanuka ry'ububabare ryari rinini ku munsi wa 2 ku miti itatu yo kunyuguza yari ifite ingano zitandukanye z'ubururu bwa metilene	Umuti wo kunyuguza usiga imbere mu kanwa si ikimenyetso cy'uko ingano inyobwa igera mu mubiri wose ikora
Indwara y'imyakura iterwa na diyabete, ububabare bw'umwakura wa trigeminal, CRPS	Kunywa cyangwa gushyira mu mutsi w'amaraso	Nta gerageza ry'ubuvuzi ku bantu ryujuje ibisabwa ryabonetse	Ubushakashatsi ku nyamaswa ku buryo bikora burahari, ariko ntibushobora gusimbura amagerageza ku barwayi

Banza usome inkingi y'uburyo bwo gukoresha kuva hejuru kugeza hasi mbere yo gusoma umutwe uwo ari wo wose. Buri kimenyetso cy'inyungu cyabonetse ku bantu kiri mu murongo wo gukoresha ahantu hamwe cyangwa mu gikorwa cy'ubuvuzi. Imirongo yerekeye gukoresha umuti ugera mu mubiri wose irimo igerageza rimwe rito cyane n'utuzu twinshi tutarimo ibimenyetso.

Ububabare bwo mu mugongo buturuka kuri disiki: igerageza rimwe ryatanze ibisubizo bikomeye, n'irindi ryananiwe kubisubiramo

Amateka yo gutera muri disiki atangirana n'igerageza rito ry'ibanze ryo mu 2007 ritagira itsinda ryo kugereranya ku barwayi 24 bari bafite ububabare bwemejwe n'isuzuma rya disiki hakoreshejwe amashusho, butitabiraga ubuvuzi budakoresha kubaga. Nyuma yo guterwa rimwe muri disiki 10 mg z'ubururu bwa metilene, 21 muri 24 bavuze ko ububabare bwashize cyangwa bwagabanutse cyane mu gihe cy'ikurikiranwa kingana n'amezi 18. Hatabayeho itsinda ryo kugereranya, icyo gisubizo gishobora kuba cyaratewe n'uburyo abarwayi batoranyijwe, uko indwara yari isanzwe igenda, cyangwa lidocaine yatanzwe hamwe n'ubururu bwa metilene. Bityo, cyatumye havuka ubushake bwo gukora ubushakashatsi aho gusubiza ikibazo cy'ubushobozi bwo kuvura.

Hakurikiyeho igerageza ryo mu 2010 ryakoresheje umuti udafite igikorwa cyo kuvura, aho abarwayi n'abashakashatsi batari bazi itsinda bahawe, ku barwayi 72, rigereranya ubururu bwa metilene hamwe na lidocaine n'amazi arimo umunyu hamwe na lidocaine. Nyuma y'amezi 24, itandukaniro ryatangajwe ryari rinini cyane: impuzandengo y'igabanuka ry'amanota y'ububabare yari amanota 52.5 ugereranyije na 0.7, naho kunyurwa byari 91.6% ugereranyije na 14.3%. Inyandiko y'ubwanditsi yabuherekeje yabajije mu buryo bweruye niba ubu bwari ubuvuzi bukiza ububabare bwo mu mugongo, bigaragaza ukuntu icyo cyifuzo cyasaga n'ikidasanzwe ku nzobere icyo gihe.

Ibyavuzwe bidasanzwe bisaba kongera kugeragezwa, kandi iryo gerageza ntiryasubiyemo ibyo bisubizo. Igerageza rya IMBI ryakorewe ku bigo byinshi nyuma yaho ryagerageje ubururu bwa metilene buterwa muri disiki ku bigo bitandukanye, ariko ntiryemeje igisubizo cya Peng. Amatsinda mato yigenga y'abarwayi yakurikiranwe nta matsinda yo kugereranya, muri rusange, yagaragaje igipimo cyo kwitabira ubuvuzi kiri hasi cyangwa kigenda kigabanuka. Incamake ivugisha ukuri ni uko ibimenyetso bivuguruzanya: intsinzi imwe ikomeye yo ku kigo kimwe, ugereranyije no kunanirwa kuyisubiramo ku bigo byinshi. Iyo shusho ntihamya ko ari ubuvuzi bwemejwe, kandi nta cyo ivuga ku kunywa ubururu bwa metilene, kuko butagera muri disiki ku rugero rugereranywa n'urwatewe muri yo. Incamake yacu y'ibimenyetso ku bubabare budakira ishyira iri vuguruzanya hamwe n'ibindi bikorwa by'ubuvuzi.

Gutera hafi y'umwoyo: ibimenyetso by'inyungu birahari, ariko aho bireba ni hato

Ubururu bwa metilene buterwa mu ruhu ku kwishimagura ku mwoyo kutitabira ubuvuzi bufite amateka maremare kurusha ubundi y'inkurikirane z'abarwayi, guhera mu 1990 no gukomeza mu matsinda y'abarwayi 25, 30, 49 na 103. Ibipimo byo kwitabira ubuvuzi bisa n'ibiri hejuru; akenshi benshi nta bimenyetso baba bagifite nyuma yo guterwa rimwe cyangwa kabiri, ariko buri rukurikirane nta tsinda ryo kugereranya rufite. Kwishimagura gutuma umurwayi yitabaza igikorwa cy'ubuvuzi cyinjira mu mubiri bishobora guhindagurika, kandi gutera umuti ubwabyo bishobora kugira ingaruka zituruka ku byo umurwayi yiteze. Bityo, ibipimo byo kugabanuka kw'ibimenyetso bitagira itsinda ryo kugereranya ntibishobora kwemeza ubushobozi bwo kuvura.

Ibimenyetso bikomeye kurushaho byo kugereranya biboneka mu bubabare nyuma yo kubagwa. Amagerageza abiri yagabanyije abarwayi mu matsinda ku buryo bwa tombola ku bururu bwa metilene buterwa mu ruhu ruzengurutse umwoyo hafi y'igihe cyo kubagwa hakurwaho imitsi yabyimbye ku mwoyo yasanze amanota y'ububabare ari hasi no gukoresha imiti y'inyongera yo kubugabanya ari bike kuva ku munsi wa 1 kugeza ku wa 3 mu igerageza ry'abarwayi 67, no kuva ku munsi wa 1 kugeza ku wa 7 mu igerageza ry'abarwayi 97. Ibyo ni ibimenyetso nyakuri byo kugabanya ububabare ku gikorwa cy'ubuvuzi, ingano y'umuti n'icyumweru byagenwe. Si ibimenyetso ku ndwara z'imyakura zidakira, kandi uburyo bivugwa ko bukora ni ukugabanya ubushobozi bwo kumva bw'imyakura ku gikomere, ibyo igitonyanga kinyobwa kidashobora gukora muri ubwo buryo. Ibisobanuro ku buryo ubururu bwa metilene bukora ku myakura na mitokondiriya bisobanura impamvu imikorere y'ibinyabutabire ikoreshwa ahantu hamwe iguma aho hantu.

Gukoresha umuti ugera mu mubiri wose ku bubabare buturuka ku kwangirika kw'imyakura: igerageza rimwe rito cyane

Ku gitekerezo abaguzi benshi bitaho, cy'uko ubururu bwa metilene bugera mu mubiri wose bugabanya ububabare buturuka ku kwangirika kw'imyakura, inyandiko zose z'ubushakashatsi ku bantu zifite itsinda ryo kugereranya zisa n'izigarukira ku igerageza rito ry'ibanze ryo mu 2015 ku barwayi 10 bari bafite ububabare budakira buturuka ku kwangirika kw'imyakura, butitabira ubuvuzi kandi butewe n'impamvu zitandukanye. Ubururu bwa metilene bwashyizwe mu mutsi w'amaraso ku rugero rwa 2 mg/kg bwatanze amanota y'ububabare ari hasi kurusha itsinda ryahawe ingano nto cyane ku munsi wo kuvurwa no ku munsi wakurikiyeho, ariko inyungu yari hafi gushira nyuma y'iminsi mike. Abarwayi batatu bagaragaje igabanuka ry'ububabare buterwa no gukorwaho ubusanzwe kutababaza.

Abarwayi icumi bafite imiterere itandukanye n'iminsi ibiri yo kugabanuka kw'ububabare ni impamvu yo gukomeza ubushakashatsi, si ishingiro ryo kuvura. Umuntu umwe gusa mu bitabiriye yari afite ububabare bw'imyakura busigara nyuma ya zona, bityo iri na ryo si igerageza kuri ubwo bubabare. Nta gerageza ku bantu ryujuje ibisabwa ryabonetse ku bururu bwa metilene bugera mu mubiri wose ku ndwara y'imyakura yo mu bice by'umubiri bya kure iterwa na diyabete, ububabare bw'umwakura wa trigeminal, cyangwa syndrome y'ububabare bukomeye bwo mu gice cy'umubiri. Ubushakashatsi ku bubabare bw'imyakura busigara nyuma ya zona, bukoresha umuti iruhande rw'uruti rw'umugongo, rimwe na rimwe bugaragazwa na moteri z'ishakisha, bwahuzaga ubururu bwa metilene n'umuti utera ikinya ahantu hamwe ku ruti rw'umugongo. Ibyo biri mu gitekerezo cy'igikorwa cy'ubuvuzi, si icy'umuti ugera mu mubiri wose.

Imiti yo kunyuguza, ibikomere n'ingingo: ibimenyetso byo ahantu hamwe bidashobora kwimurirwa ahandi

Ibindi bimenyetso by'inyungu ku bantu byose byabonetse mu gukoresha ahantu hamwe. Igerageza ryo mu cyiciro cya 2 ryo mu 2022 ryagabanyije abarwayi mu matsinda ku buryo bwa tombola ryasanze umuti w'ubururu bwa metilene wo kunyuguza mu kanwa, ufite ingano eshatu zitandukanye z'ubwo bururu, wagabanyije ububabare bwo kubyimba kw'agahu gatwikiriye imbere mu kanwa butewe no kuvura kanseri kurusha ubuvuzi busanzwe ku munsi wa 2. Umuti wo kunyuguza usiga agahu kakomeretse hanyuma ugacirwa. Kuwifashisha mu gushyigikira ibitonyanga binyobwa ni ukuvangavanga gukoresha umuti hejuru y'ahantu hamwe n'ingano y'umuti igera mu mubiri wose.

Mu buryo busa n'ubwo, gusiga inyama zibagwa ubururu bwa metilene bwavanzwe kugira ngo ingano yabwo igabanuke, mu gihe cyo kubaga hakurwaho disiki yo mu mugongo wo hasi, byagabanyije amanota y'ububabare bwo mu mugongo mu igerageza ry'abarwayi 115 aho ibyiciro bitatu by'abagize uruhare bitari bizi itsinda ryahawe, naho igerageza ryo gutera umuti mu ngingo nto zihuza amagufwa y'uruti rw'umugongo ryatangaje amanota y'ububabare n'imbogamizi mu gukora ibikorwa ari hasi nyuma y'amezi 3 na 6. Buri gisubizo kijyanye n'aho umuti washyizwe. Nta na kimwe gishobora kwimurirwa ku gicuruzwa kinyobwa.

Ibyo inyamaswa zigaragaza, n'aho uburyo bwo gukora bushobora kugira ingaruka zinyuranye

Ubushakashatsi ku mbeba zatejwe ububabare buturuka ku kwangirika kw'imyakura butanga ibisobanuro by'uburyo bishobora gukora bikunze kuvugwa. Ubururu bwa metilene bwashyizwe mu mwanya urimo amatembabuzi akikije umusokoro wo mu ruti rw'umugongo bwahagaritse kumva ububabare bukabije buterwa n'ubushyuhe mu gihe cy'amasaha hafi 4, nyuma yo guhambira umwakura wa siyatika, mu igerageza rya mbere ryo mu 1992. Ibyo byari bihuye n'uruhare rw'inzira iva kuri nitric oxide ikagera kuri cGMP mu musokoro wo mu ruti rw'umugongo. Ubushakashatsi bwakurikiyeho ku gukomeretsa umwakura hakoreshejwe kuwukanda igihe kirekire bwasanze ubururu bwa metilene bugabanya kwitabira ibitera ububabare ubwabwo, kandi bushobora guhagarika kwiyongera ko kumva ububabare gukabije kwatewe na sildenafil, bwongera kugaragaza uruhare rw'ihererekanya ry'ibimenyetso rya nitric oxide. Ubushakashatsi bwo mu 2021 bwongeyeho uburyo bwa kabiri bwo gukora: kugabanya mu buryo butaziguye ihererekanya ry'ibimenyetso by'amashanyarazi mu myakura, bisa n'ingaruka ku miyoboro ya sodium, kandi uko kugabanya kwamaze igihe kirekire kurusha ukwa lidocaine mu buryo bwageragejwe.

Hari itandukaniro rito rikwiye kwibukwa kuko abacuruzi barireka. Inyandiko ku bushakashatsi bwa nitric oxide bukorwa mbere y'amagerageza ku bantu ntizose zigaragaza ko ubururu bwa metilene busobanura kugabanya ububabare. Mu buryo bumwe bw'igerageza, ihererekanya ry'ibimenyetso rya nitric oxide ubwaryo rifasha kugabanya ububabare, kandi ubururu bwa metilene bukabuza iryo gabanuka. Mu ndwara y'imyakura iterwa na diyabete yakozwe mu igerageza, ubururu bwa metilene bwahagaritse igabanuka ryo kwitabira ibitera ububabare ryajyanaga na sildenafil, kandi ubwabwo bwongereye kumva ububabare bukabije. Ingaruka z'uburyo bikora ziterwa n'imiterere y'igerageza n'inzira y'ibimenyetso ikoreshwa. Iyo ni indi mpamvu ituma ibyabonetse ku nyamaswa bidashobora gufatwa nk'inama ku ngano y'umuti yo gukoresha.

Ibitarakorewe ubushakashatsi, n'imipaka y'umutekano

Nta gerageza ryagabanyije abarwayi mu matsinda ku buryo bwa tombola cyangwa urukurikirane rwizewe rw'abarwayi mu buvuzi rwabonetse ku bururu bwa metilene bunyobwa ku bubabare budakira buturuka ku kwangirika kw'imyakura, indwara y'imyakura iterwa na diyabete, ububabare bw'umwakura wa trigeminal, syndrome y'ububabare bukomeye bwo mu gice cy'umubiri, cyangwa ububabare bw'imyakura busigara nyuma ya zona. Igerageza ryonyine rireba mu buryo butaziguye umuti ugera mu mubiri wose ku bubabare buturuka ku kwangirika kw'imyakura ni igerageza rito ry'ibanze ry'abarwayi 10 ryakoresheje umuti mu mutsi w'amaraso, ryagaragaje ikimenyetso cy'inyungu y'umunsi 1 kugeza ku minsi 2. Ibisubizo byo gutera muri disiki, mu ruhu, mu ngingo, iruhande rw'uruti rw'umugongo no kunyuguza ntibishobora kwimurirwa ku bitonyanga bigurishwa hashingiwe ku mikorere y'imiti. Ingano yabyo igera aho igamije gukorera itandukanye ku rwego rwikuba inshuro nyinshi cyane, kandi ntibishyirwa aho hantu hakoreshejwe igikorwa cy'ubuvuzi.

Kuvangavanga uburyo bwo gukoresha na byo bijyana n'umuburo w'umutekano. Imyanya itandukanye yo ku ruti rw'umugongo ntishobora gusimburana: gushyira umuti muri disiki, iruhande rw'uruti rw'umugongo, hanze y'agahu gakomeye gatwikiriye umusokoro, no mu matembabuzi akikije umusokoro biratandukanye mu mikorere y'umuti no mu ngaruka z'uburozi. Uburozi bukomeye ku myakura nyuma yo gushyira ubururu bwa metilene mu matembabuzi akikije umusokoro bwatumye hatangwa umuburo weruye w'akaga. Ikindi, ubururu bwa metilene bugirana imikoranire n'imiti igira ingaruka kuri serotonine, kandi ntibukwiye gukoreshwa ku bafite ibura rya G6PD. Bityo, umurwayi uwo ari we wese ufite ububabare utekereza kubukoresha akeneye kubanza gusoma incamake y'ingaruka mbi n'ibihe bituma butagomba gukoreshwa no kuganira n'umuganga, yifashishije ibi bibazo byo kubaza ku bururu bwa metilene.

Uko wakoresha ibi bimenyetso

Umuntu wese usuzuma ubururu bwa metilene ku bubabare akwiye kubaza ibibazo bitatu kuri buri nyandiko yifashishwa. Ni iyihe ndwara nyirizina, kuko gukira nyuma yo kubagwa hakurwaho imitsi yabyimbye ku mwoyo atari indwara y'imyakura iterwa na diyabete. Ni ubuhe buryo bwo gukoresha nyirizina, kuko gushyira umuti muri disiki cyangwa mu ruhu atari ingano y'umuti inyobwa. Kandi ni iki cyapimwe mu gihe kingana iki, kuko iminsi yo kugabanuka kw'ububabare nyuma y'igikorwa cy'ubuvuzi atari amezi yo kugenzura indwara y'imyakura.

Dushingiye ku bimenyetso biriho ubu, ibimenyetso by'uko ubururu bwa metilene bugabanya ububabare ku bantu bigarukira ku kubukoresha ahantu hamwe cyangwa mu bikorwa by'ubuvuzi, kandi ubushobozi bwo kuvura buravuguruzanya hakurikijwe indwara. Ibimenyetso ku kubukoresha bukagera mu mubiri wose bigarukira ku igerageza rimwe rito cyane ry'ibanze ryakoresheje umuti mu mutsi w'amaraso, kandi nta bimenyetso by'ubuvuzi bishyigikira ubururu bwa metilene bugurishwa bunyobwa ku bubabare buturuka ku kwangirika kw'imyakura cyangwa ububabare budakira.