So wote nka sɛ wo mogya mu nkwammoaa kɔkɔɔ pii dodo? Momma yɛnka erythrocytosis ho asɛm!

Ɛtɔ mmere bi a, wote nka sɛ woabrɛ kɛkɛ, wo ti yɛ wo yaw, anaa wote nka sɛ woayɛ mmerɛw? Mpɛn pii no yɛmfa yɛn adwene nsi nneɛma nketenkete yi so kɛse, ɛnte saa? Nanso, sɛ mogya mu nkwammoaa kɔkɔɔ dodow a ɛwɔ wo nipadua mu no kɔ soro sen dodow a wɔkamfo kyerɛ, a ɛno ne nea nnuruyɛfo frɛ no erythrocytosis anaa polycythemia , a, saa sɛnkyerɛnne ahorow yi betumi ada adi. Eyi yɛ biribi a ɛtɔ mmere bi a ɛsɛ sɛ wohaw wo ho kakra. Enti, ɛnnɛ yɛbɛka nea erythrocytosis yɛ, nea enti a ɛba, ne nea wobetumi ayɛ ho asɛm akɔ akyiri.

Dɛn ankasa ne erythrocytosis?

Sɛ yɛbɛka no tiawa a, Erythrocytosis yɛ bere a wo mogya mu Nkwammoaa Kɔkɔɔ (Erythrocytes) dodow dɔɔso sen sɛnea ɛsɛ. Sɛnea wunim no, yɛn mogya yɛ afã abien. Biako ne ɔfã a ɛyɛ den no, a ɛne mogya mu nkwammoaa kɔkɔɔ, mogya mu nkwammoaa fitaa, ne mogya mu nkwammoaa kɔkɔɔ. Ɔfã foforo no ne ɔfã a ɛyɛ nsu, a yɛfrɛ no plasma no. Wɔ erythrocytosis mu no, mogya mu nkwammoaa kɔkɔɔ dodow kɔ soro bere a wɔde toto ɔfã a ɛyɛ nsu a ɛyɛ plasma no ho no.

Sɛ woyɛ mogya mu nhwehwɛmu a, wubehu gyinapɛn abien wɔ amanneɛbɔ no so: Hematocrit ne Hemoglobin .

• Hematocrit (HCT): Eyi ma wuhu wo mogya mu ɔha biara mu nkyem ahe na ɛyɛ mogya mu nkwammoaa kɔkɔɔ.
• Hemoglobin (HB): Eyi yɛ protein a ɛho hia paa a ɛwɔ mogya mu nkwammoaa kɔkɔɔ mu a ɛde mframa pa kɔ yɛn nipadua mu nyinaa.

Wɔ erythrocytosis mu no, ebia saa hematocrit ne hemoglobin dodow yi mu biako anaa abien no nyinaa bɛkɔ soro asen sɛnea ɛte daa.

Ɔkwan bɛn so na mogya mu nkwammoaa kɔkɔɔ a ɛkɔ soro yi ka nipadua no?

Mogya mu nkwammoaa kɔkɔɔ ho hia ma yɛn nipadua. Wɔde mframa pa fi ahurututu mu kɔ nkwammoaa ne ntini biara a ɛwɔ nipadua no mu. Eyi nti na yɛn ntini ahorow no nya aduannuru na ɛma apɔwmuden no.

Nanso, sɛ mogya mu nkwammoaa kɔkɔɔ yi dɔɔso dodo a, ɔhaw ahorow betumi aba. Egyina nea enti a mogya mu nkwammoaa kɔkɔɔ no dɔɔso no so. Nneɛma bi a efi mu ba no sua koraa. Ebia nneɛma te sɛ tiyɛ ne ɔbrɛ nkutoo na wobɛte nka. Nanso, sɛ mogya mu nkwammoaa kɔkɔɔ no dɔɔso esiane nneɛma bi a anibere wom nti a, mogya no fi ase yɛ den. Afei asiane wɔ hɔ sɛ tebea horow a ɛyɛ hu te sɛ mogya a ɛtɔ, komayare anaa ɔyare a ɛma obi hwe ase .

Ɛno nti, sɛ wowɔ sɛnkyerɛnne a ɛte saa a, ɛho hia yiye sɛ wobɛkɔ oduruyɛfo nkyɛn akɔhwehwɛ nea ɛde ba ankasa. Ɛno ansa na wubetumi anya ayaresa a ɛfata, atew yare no ho sɛnkyerɛnne so, anaa asiw tebea horow a asiane wom ano.

Dɛn ne erythrocytosis ahorow atitiriw?

Wobetumi akyekyɛ erythrocytosis mu abien a egyina ɔkwan a nkwammoaa kɔkɔɔ yi fa so dɔɔso so:

1. Absolute Erythrocytosis: Eyi ne bere a mogya mu nkwammoaa kɔkɔɔ dodow a ɛba wo nipadua mu no dɔɔso sen sɛnea ɛte daa ankasa.

2. Relative Erythrocytosis: Eyi ne bere a ebia mogya mu nkwammoaa kɔkɔɔ dodow yɛ nea ɛfata, nanso plasma dodow a ɛwɔ mogya no mu no so tew, enti ɛte sɛ nea mogya mu nkwammoaa kɔkɔɔ dodow no kɔ soro. Sɛ nhwɛso no, sɛ wofe pii na wo dwensɔtwaa na wohwere nsu pii fi wo nipadua mu a, wo mogya mu nsu no so tew. Saa tebea yi betumi aba wɔ mmere te sɛ eyinom mu.

Wɔakyekyɛ Absolute Erythrocytosis mu bio ayɛ no ahorow abien, a egyina nea ɛde ba no so:

Erythrocytosis a Ɛho Hia

Ɔhaw no da yɛn nnompe mu ntini mu. Sɛnea wunim no, nnompe mu ntini ne adwumayɛbea titiriw a ɛwɔ yɛn nipadua mu a ɛyɛ mogya mu nkwammoaa kɔkɔɔ. Enti, wɔ erythrocytosis titiriw yi mu no, esiane awosu mu sintɔ bi a ɛwɔ ntini mu nkwammoaa (agyanom nkwammoaa) a ɛwɔ nnompe mu ntini mu nti, mogya mu nkwammoaa kɔkɔɔ a wɔyɛ no kɔ soro a wontumi nni so. Saa awosu mu dɛmdi yi betumi afi awo mu (sɛ awo mu dɛmdi), anaasɛ ebetumi aba nso wɔ nkwa nna mu.

• Acquired Primary Erythrocytosis: Eyi ho nhwɛso pa ne tebea bi a wɔfrɛ no Polycythemia Vera . Nnipa pii frafra Erythrocytosis ne Polycythemia Vera sɛ yare koro no ara. Nanso, wɔnyɛ pɛ. Polycythemia Vera yɛ tebea pɔtee bi a emu yɛ den yiye a ɛde Erythrocytosis ba.
• Erythrocytosis Mfitiase a Wonya fi Awo Mu: Ɛtɔ mmere bi a, sintɔ ahorow a ɛwɔ awosu mu nkwaadɔm a wonya fi awofo hɔ no betumi ama nnompe mu ntini no ayɛ nkwammoaa kɔkɔɔ pii dodo.

Erythrocytosis a Ɛto so Abien

Ɔhaw a ɛwɔ ha no nni nnompe mu ntini mu, na mmom biribi foforo a ɛnyɛ nnompe mu ntini no mu. Mpɛn pii no, nea ɛde erythrocytosis a ɛto so abien ba ne sɛ yɛn nipadua no yɛ hormone bi a wɔfrɛ no erythropoietin , anaa EPO , pii dodo. `EPO` yɛ nnuru sobɔfo. Ɛyɛ nea ɛka kyerɛ nnompe mu ntini no sɛ "ɛnyɛ nkwammoaa kɔkɔɔ pii."

Fa no sɛ wowɔ ahurututu mu yare anaa komayare. Afei mframa pa dodow a nipadua no nya no sua. Saa bere no, nipadua no bɔ mmɔden sɛ ɛbɛyɛ hormone `EPO` no pii, na ɛnam so, ɛkanyan nnompe mu ntini no ma ɛyɛ nkwammoaa kɔkɔɔ pii. Efisɛ nkwammoaa kɔkɔɔ no de mframa pa kɔ. Nanso, sɛ nkwammoaa kɔkɔɔ a wɔyɛ wɔ saa kwan yi so no kɔ soro dodo a, ɛde erythrocytosis a ɛto so abien ba. Saa erythrocytosis a ɛto so abien yi nso betumi afi awosu mu tebea horow bi mu aba, nanso saa awosu mu sintɔ ahorow no nyɛ nea ɛwɔ nnompe mu ntini mu no.

Wobɛyɛ dɛn ahwɛ mogya dodow mu ahwɛ sɛ wowɔ erythrocytosis anaa?

Nokwarem no, mogya mu nkwammoaa kɔkɔɔ dodow a wobu no sɛ ɛyɛ nea ɛfata no betumi ayɛ soronko wɔ onipa biara ho. Nneɛma pii ka eyi, a nea ɛka ho ne mfe a woadi, sɛ́ woyɛ ɔbarima anaa ɔbea, ne beae a wote no sorokɔ (sɛ́ ebia wowɔ po so anaasɛ wowɔ beae a mmepɔw wɔ).

Mpɛn pii no, wɔde hematocrit (HCT) ne/anaasɛ hemoglobin (HB) a ɛkɔ soro na ɛkyerɛ sɛ mogya mu nkwammoaa a ɛma mogya tu no nya mpanyimfo. Wobetumi de mogya mu nhwehwɛmu a wɔfrɛ no ``Complete Blood Count (CBC)`` asusuw saa gyinapɛn ahorow yi.

Wɔ mmarima fam no:

• Hematocrit (HCT): Sɛ ɛboro 50% a .
• Hemoglobin (HB): Sɛ ɛboro 17.5 g/dL a

Wɔ mmea a wɔnyɛ nyinsɛn fam no:

• Hematocrit (HCT): Sɛ ɛboro 45% a .
• Hemoglobin (HB): Sɛ ɛboro 15.3 g/dL a

Nea ɛho hia: Saa gyinapɛn ahorow yi yɛ akwankyerɛ a ɛfa nneɛma nyinaa ho ara kwa. Wo duruyɛfo no behu sɛ ebia wowɔ erythrocytosis ankasa bere a wasusuw w’akwahosan nyinaa ho awie no.

Dɛn ne nneɛma a ɛde Relative Erythrocytosis ba?

Eyi fi nsu dodow a ɛwɔ nipadua no mu a ɛso tew, na ɛma mogya no mu nsu (plasma) so tew na mogya mu nkwammoaa kɔkɔɔ dodow kɔ soro. Enti, ade titiriw nti a ɛte saa ne nsu a ɛho ayɛ fĩ .

• Ɔfe a emu yɛ den
• Ayamtuo
• Nnuru bi, sɛ nhwɛso no, diuretics (nnuru a ɛyi nsu fi nipadua no mu) (Wɔde eyinom ma mogya mmoroso anaa nsu a ɛkɔ nipadua no mu).

Esiane nneɛma a ɛtete saa nti, nsu dodow a ɛwɔ nipadua no mu no betumi so atew na ama mogya mu nkwammoaa a ɛyɛ mmerɛw kakra.

Dɛn ne nneɛma a ɛde Absolute Erythrocytosis ba?

Nneɛma abien na ɛde eyi ba: nea edi kan ne nea ɛto so abien.

Nneɛma a ɛde erythrocytosis titiriw ba:

Mpɛn pii no, awosu mu sintɔ bi a ɛka nnompe mu ntini no na ɛde eyi ba.

• Polycythemia Vera ne Myeloproliferative Neoplasms Afoforo: Eyinom yɛ tebea horow a nnompe mu ntini no ma mogya mu nkwammoaa kɔkɔɔ ne mogya mu nkwammoaa afoforo boro so. Polycythemia Vera na ɛtaa ba eyinom mu.
• : .

Nneɛma a ɛde erythrocytosis a ɛto so abien ba:

Eyi taa fi hormone `EPO` a ɛkɔ soro.

• Tebea horow a ɛma oxygen so tew kɔ ntini ahorow mu:
• Ahurututu mu Yare (e.g. ahurututu mu yare a enni sabea, ahurututu mu yare) .
• Koma Yare (e.g. komayare a wɔde awo obi) .
• Dae mu ahomegye a ɛyɛ den
• Hemoglobinopathy: Eyinom yɛ tebea horow a hemoglobin protein a ɛwɔ mogya mu nkwammoaa kɔkɔɔ mu no ntumi mfa mframa pa nkɔ yiye esiane sintɔ bi nti.
• Asaabo mu nyarewa ne asaabo a wɔde ma obi foforo:
• Renal Artery Stenosis (mogya ntini a ɛma asaabo no yɛ teateaa) .
• Hydronephrosis (asaabo a ɛho ahonhon esiane nsu a ɛboaboa ano nti) .
• Ɛtɔ mmere bi a, saa tebea yi betumi aba bere a wɔde asaabo foforo ama obi akyi mpo.
• Akisikuru: Akuru bi a kokoram wom ne nea enni kokoram betumi ama EPO hormone a ɛboro so afi mu.
• Kokoram akisikuru: Adwene mu Nkwammoaa mu Kokoram, Hemangioblastoma, Hepatocellular Carcinoma, Parathyroid Kokoram.
• Akuru a ɛnyɛ kokoram: Awotwaa mu Fibroids, Pheochromocytoma, Meningioma.
• Carbon monoxide awuduru ne sigaretnom: Sigaretnom a ano yɛ den betumi ama carbon monoxide awuduru aba, na ɛno betumi atew oxygen a ɛkɔ ntini ahorow no mu no so.
• Nnuru ne nnuru bi:
• Anabolic Steroids (a agumadifo nom na ama wɔn ahoɔden ayɛ kɛse) .
• Hormone a wɔfrɛ no testosterone a wɔnom.

Nsɛnkyerɛnne bɛn na obi a ɔwɔ erythrocytosis betumi anya?

Nsɛnkyerɛnne a wuhu (ne sɛnea emu yɛ den) gyina nea ɛde wo erythrocytosis ba no so. Sɛ nhwɛso no, obi a ɔwɔ erythrocytosis a ɛto so abien betumi anya yare no ho sɛnkyerɛnne te sɛ:

• Tipaeɛ
• Tebea a ɛyɛ basaa, tebea a ɛyɛ den sɛ wode w’adwene besi biribi so
• Ɛyɛ den sɛ wobɛda
• Ɔte nka sɛ wayɛ mmerɛw, ɔbrɛ

Obi a ɔwɔ erythrocytosis titiriw (titiriw polycythemia vera) betumi anya yare no ho sɛnkyerɛnne a emu yɛ den kɛse:

• Mogya Nhyɛso a Ɛkɔ Anim
• Fifiri a ɛboro so anadwo
• Mu duru a wɔtew so a ntease biara nnim
• Ɛyaw a emu yɛ den, ɛho hohoro, na ɛyɛ kɔkɔɔ wɔ nkwaa mu (a wɔsan frɛ no gout ) .
• Mogya a ɛtɔ ho haw (mogya a ɛtaa tu fi hwene mu, mogya a ɛtɔ anaa akisikuru a efi opira ketewaa bi mpo mu) .
• Wora a ɛyɛ wo yaw (ebetumi ayɛ wo yaw, titiriw bere a woaguare a ɛyɛ hyew awie no) .
• Akwaa a ɛyɛ mmerɛw, atenka a ɛte sɛ nwansena retu mmirika akɔ akyirikyiri
• Anim, nsa, ne nan a ɛyɛ kɔkɔɔ a ɛyɛ hyew.

Ɔkwan bɛn so na nnuruyɛfo hu sɛ obi anya erythrocytosis?

Wo duruyɛfo no bedi kan abɔ mmɔden sɛ obehu nea ɛde wo mogya mu nkwammoaa kɔkɔɔ dodow a ɛkɔ soro no, denam nhwehwɛmu ne akwan horow so.

Nea edi kan no, wobebisa nsɛm afa w’ayaresa ho abakɔsɛm, nnuru a wonom, w’asetra kwan (sɛ nhwɛso no, so wonom sigaret), ne wo sɛnkyerɛnne ahorow ho, na wɔahwɛ sɛ ebia erythrocytosis (a ɛnam mogya mu mogya a ɛso tew so na ɛde ba) anaa. Wɔbɛyɛ nipadua mu nhwehwɛmu nso.

Ade a edi hɔ a ɛsɛ sɛ wohwɛ ne sɛ ebia wowɔ primary anaa secondary . Wubetumi nso de nsɛm a yɛaka ho asɛm wɔ atifi hɔ no ayɛ sɔhwɛ kakraa bi bio.

Sɔhwɛ ahorow bɛn na wɔreyɛ?

• Mogya Dodow a Edi Mu (CBC): Eyi betumi ahwɛ sɛnea wo mogya mu nkwammoaa kɔkɔɔ dodow, hemoglobin (HB), ne hematocrit (HCT) dodow te.
• Peripheral Blood Smear (PBS): Nea ɛka eyi ho ne sɛ wobɛfa mogya a ɛtɔ gu fam na wɔahwɛ nkwammoaa no wɔ afiri a wɔde hwɛ nneɛma nketenkete mu ahwɛ sɛ ebia wɔn nsusuwii anaa ne kɛse nyɛ nea ɛfata anaa. Sɛ wowɔ tebea bi te sɛ Polycythemia Vera a, ebia wubehu nkwammoaa a ɛnyɛ ne kwan so.
• Asaabo ne Mmɛn Dwumadi Ho Nhwehwɛmu: Eyi betumi ama woanya adwene sɛ ebia asaabo mu yare bi wɔ hɔ anaasɛ akisikuru bi a ɛreyɛ EPO dodo.
• Pulse Oximetry: Sensor ketewaa bi a wɔde si nsateaa no so susuw oxygen dodow a ɛwɔ mogya no mu. Eyi betumi aboa ma wɔahu sɛ ebia nneɛma te sɛ komayare anaa ahurututu mu yare na ɛde tebea no ba anaa.
• Erythropoietin (EPO) dodow a wɔhwɛ: Sɛ `EPO` dodow sua a, ebetumi ayɛ erythrocytosis titiriw, sɛ `EPO` dodow no dɔɔso a, ebetumi ayɛ erythrocytosis a ɛto so abien.
• Nsu mu nhwehwɛmu: Wɔfa nsu mu nsu de hwɛ sɛ ebia biribi a ɛnteɛ anaa. Sɛ nkwammoaa kɔkɔɔ wɔ nsu no mu a, ebia efi asaabo mu yare.

Sɛ oduruyɛfo no susuw sɛ tebea pɔtee bi te sɛ polycythemia vera a, obetumi ayɛ nhwehwɛmu afoforo nso te sɛ nnompe mu ntini mu nhwehwɛmu .

Ɔkwan bɛn so na wɔsa erythrocytosis?

Mpɛn pii no, wontumi nsa nea ɛde erythrocytosis ba no koraa. Nanso, ayaresa tumi di sɛnkyerɛnne ahorow no so na ɛtew so. Wɔ erythrocytosis a nneɛma a anibere wom de ba mu no, wɔde ayaresa nso di dwuma de siw tebea horow a asiane wom te sɛ mogya a ɛtɔ gu nipadua no mu ano.

• Phlebotomy anaa Venesection a Wɔyɛ:

Eyi ne aduru a wɔtaa de sa polycythemia vera. Ɛte sɛ mogya a wɔde ma, nanso nea ɛka ho ne sɛ wobegye mogya kakraa bi afi ntini bi mu na wɔtew mogya mu nkwammoaa kɔkɔɔ dodow ne mogya dodow a ɛdɔɔso dodo no so. Mpɛn pii no, erythrocytosis a ɛto so abien no nhia saa ayaresa yi.

• Nnuru a Wɔde Yɛ:
• Wɔ nnipa a asiane kɛse wom sɛ mogya bɛtɔ fam fam no, oduruyɛfo betumi akamfo akyerɛ sɛ wɔnnom aspirin a ano nyɛ den da biara.
• Nnuru bi nso wɔ hɔ a ɛtew mogya mu nkwammoaa kɔkɔɔ dodow so:
• Hydroxycarbamide `(Nsuo a wɔde yɛ adwuma)`
• Hydroxyurea `(Nsuo mu nsuo mu nsuo)`
• Busulfan na ɔkyerɛwee
• Interferon alfa `(Nneɛma a ɛwɔ nipadua mu)`
• Ruxolitinib a wɔde di dwuma

Wo duruyɛfo bɛkyerɛw nnuru a ɛfata wo tebea no. Wɔbɛkyerɛw ayaresa nso ama tebea a ɛwɔ ase no, a egyina nea ɛde wo erythrocytosis ba no so.

Sɛ mewɔ saa tebea yi a, dɛn na ɛsɛ sɛ mehwɛ kwan?

Wo suahu no begyina nea ɛde wo erythrocytosis ba ne sɛnea emu yɛ den no so. Sɛ nhwɛso no, awosu mu tebea horow bi a ɛma mogya mu nkwammoaa kɔkɔɔ titiriw no de sɛnkyerɛnne ahorow a emu nyɛ den nkutoo ba na ɛnyɛ nea ɛde nkwa to asiane mu. Nanso, tebea horow a emu yɛ den kɛse te sɛ polycythemia vera betumi ahwehwɛ sɛ wɔsa no nkwa nna nyinaa.

Mɛyɛ dɛn ahwɛ me ho?

Nea ɛho hia sen biara ne sɛ wubedi wo duruyɛfo akwankyerɛ akyi pɛpɛɛpɛ. Saa bere yi de, nsakrae kakraa bi wɔ w’asetra mu a ebetumi aboa wo:

• Sɛ wonom sigaret a, gyae.
• Kura wo nipadua mu duru a ɛfata mu.
• Sɛ wowɔ mogya mmoroso a, di so.
• Kwati sɛ wubefi po so akɔ mmeae a ɛkorɔn yiye (mmepɔw so mmeae) sɛnea wubetumi biara.

Bere bɛn na ɛsɛ sɛ mekɔ ayaresabea ntɛm ara (ETU) ?

Sɛ wowɔ tebea bi a ɛfa erythrocytosis ho a ɛde wo to asiane mu sɛ mogya bɛtɔ a, ɛho hia sɛ wuhu mogya a ɛbɛtɔ ho sɛnkyerɛnne. Sɛ wuhu sɛnkyerɛnne ahorow a edidi so yi mu biara a, kɔ oduruyɛfo ntɛm ara:

• Deep Vein Thrombosis (DVT): Nan biako ho ahonhon, ɛyaw, na ɛyɛ kɔkɔɔ.
• Mogya a ɛtwetwe wɔ ahurututu mu (Pulmonary Embolism - PE): Koko mu yaw, ɛyɛ den sɛ wobɛhome, ɛyɛ wo yaw.
• Akisikuru: Kari pɛ a ɛyera mpofirim, ɛnyɛ adwuma yiye, ntini a ɛyɛ mmerɛw anaasɛ ɛyɛ mmerɛw wɔ nipadua no fã biako.
• Koma Yare: Koko mu yaw, ahome a ɛyɛ tiaa, adwene a ɛyɛ basaa, fifiri.

Sɛ wowɔ saa sɛnkyerɛnne yi bi a, yɛsrɛ wo kɔ oduruyɛfo nkyɛn ntɛm ara a ɛnkyɛ.

Nea etwa to no, nneɛma a ɛsɛ sɛ wokae (Take-Home Message) .

Erythrocytosis yɛ mogya mu nkwammoaa kɔkɔɔ dodow a ɛkɔ soro wɔ wo mogya mu. Eyi betumi ayɛ tebea ketewaa bi, anaasɛ ɛtɔ mmere bi a ebetumi ayɛ tebea bi a emu yɛ den ho sɛnkyerɛnne.

• Sɛ wowɔ sɛnkyerɛnne bi a ɛyɛ soronko (titiriw ɔbrɛ a ɛkɔ so, tiyɛ, honam ani akisikuru, ɛyɛ den sɛ wobɛhome) a, kɔ oduruyɛfo nkyɛn.
• Oduruyɛfo no bɛkyerɛ nea ɛde wo mogya mu nkwammoaa kɔkɔɔ dodow a ɛkɔ soro ba ankasa.
• Ɛtɔ da bi a, asetra mu nsakrae a ɛnyɛ den (sɛ nhwɛso no, nnuru dodow a wobɛtew so, nsu a ɛho ayɛ fĩ a wobɛsa) betumi adi ɔhaw yi ho dwuma.
• Sɛ tebea bi a emu yɛ den kɛse na ɛde erythrocytosis ba a, wo duruyɛfo bɛhwɛ wo daa na wama wo ayaresa a ɛho hia.

W’akwahosan a wobɛhwɛ so no ho hia paa, enti sɛ wowɔ biribi a ɛhaw wo a, nsuro sɛ wo ne oduruyɛfo bɛkasa.

` Erythrocytosis, polycythemia, mogya mu nkwammoaa kɔkɔɔ, hemoglobin, hematocrit, mogya a ɛtwetwe, nnompe mu ntini