So mogya mu nkwammoaa a ɛdɔɔso dodo wɔ wo mogya mu? Momma yɛnka Essential Thrombocythemia ho asɛm!

So woahwɛ mogya ho amanneɛbɔ bi pɛn na woahu sɛ mogya mu nkwammoaa a ɛwɔ wo mogya mu no dɔɔso yiye? Anaasɛ woanya nneɛma te sɛ mogya a ɛtɔ gu wo nipadua mu mmeae ahorow a ntease biara nnim, anaasɛ mogya a ɛretu kɛkɛ? Ebia na woamfa w’adwene ansi saa nneɛma yi so kɛse. Nanso, ɛho hia yiye sɛ yehu tebea a ɛntaa nsi a ebetumi aba saa nneɛma yi akyi, a yɛrebɛka ho asɛm nnɛ, a wɔfrɛ no Essential Thrombocythemia no.

Dɛn ne Thrombocythemia a Ɛho Hia? Momma yɛnte ase tiawa.

Sɛ yɛbɛka no tiawa a, thrombocythemia a ɛho hia yɛ tebea a yɛn nnompe mu ntini, adwumayɛbea titiriw a ɛma mogya no yɛ mogya mu nkwammoaa bi a wɔfrɛ no mogya mu nkwammoaa a ɛboro nea ehia so. Now you may be asking, "What are these platelets ?" Nkwammoaa a wɔfrɛ no platelets ne nkwammoaa nketenkete a ɛwɔ yɛn mogya mu. Wɔte sɛ asraafo nkumaa. Sɛ kuru bi wɔ baabi na mogya fi ase retu a, saa mogya nkwammoaa yi na edi kan de ahopere kɔ hɔ, ka bom, na ɛyɛ mogya a ɛtɔ ma mogya no gyae. Wo de susuw ho hwɛ, sɛ biribi asɛe wɔ nnompe mu ntini, adwumayɛbea a wɔyɛ mogya mu nkwammoaa kɔkɔɔ no ho, na wɔyɛ mogya nkwammoaa yi boro so a, dɛn na ɛba? Ɛno na ɔhaw no fi ase. Saa tebea yi ba esiane nsakrae a ɛba yɛn nipadua mu awosu mu nkwaadɔm bi mu, kyerɛ sɛ, nkwaadɔm mu nsakrae nti . Eyi nyɛ biribi a wɔde wo awo, na mmom ɛyɛ biribi a ɛkɔ so wɔ nkwa mu. Ɛno nti na wɔfrɛ no ``acquired genetic condition.'' Mpɛn pii no, wohu tebea no wɔ akwanhyia mu wɔ mogya mu nhwehwɛmu a wɔyɛ esiane biribi foforo nti. Ebia nnipa binom rennya yare no ho sɛnkyerɛnne biara koraa. Afei nso, ɛnyɛ obiara na obehia ayaresa ntɛm ara. Ɛwom sɛ wontumi nsa no koraa de, nanso ayaresa a ɛfata betumi atew asiane a ɛwɔ hɔ sɛ ɔhaw ahorow a emu yɛ den benya no so kɛse.

Eyi ka me nipadua dɛn?

Seesei wote nea ɛba bere a nnompe mu ntini no ma mogya nkwammoaa dɔɔso dodo no ase. Saa mogya nkwammoaa a ɛboro so yi nte sɛ mogya nkwammoaa a ɛteɛ, ebi sõ sen sɛnea ɛte daa na ɛsono ne nsusuwii kakra. Ɛte sɛ adwumayɛbea bi a ɛreyɛ nneɛma a ɛba fam akuw bi. Saa mogya nkwammoaa a ɛnyɛ ne kwan so a ɛboro so yi ma mogya tu wɔ mogya ntini no mu. Saa mogya a ɛretu yi siw mogya no kwan, te sɛ kar a akyeakyea wɔ kwan so. Saa mogya a ɛtwetwe yi tumi ba nipadua no mu baabiara. Nanso wɔtaa hu wɔn wɔ amemene, nsa, ne anan mu.

Saa tebea yi, titiriw wɔ ɛnanom a wɔyem fam no, ma asiane a ɛwɔ hɔ sɛ mogya bɛtɔ no yɛ kɛse .

Ade foforo a ɛyɛ nwonwa ne sɛ ɛtɔ mmere bi a saa tebea yi tumi ma mogya tu dodo.Ebia wobɛdwene sɛ, "Mogya a ɛtwetwe ne nea ɛba, enti ɔkwan bɛn so na mogya no sen?" Nea enti a ɛte saa ne sɛ, sɛ mogya tu no dɔɔso dodo a, mogya nkwammoaa a ɛwɔ nipadua no mu nyinaa sa. Afei, mogya nkwammoaa a ɛdɔɔso nni hɔ a ɛbɛma mogya no agyae ankasa sɛ obi pira a. Hwɛ? Esiane eyi nti, nnipa a wɔwɔ thrombocythemia a ɛho hia no wɔ asiane kɛse mu sɛ wobenya tebea horow a emu yɛ den te sɛ komayare anaa akisikuru.

So eyi yɛ kokoram? So ɛne mogya mu kokoram wɔ abusuabɔ?

Yiw, thrombocythemia a ɛho hia yɛ mogya mu kokoram bi. Nnuruyɛfo frɛ no myeloproliferative neoplasm. Sɛ yɛbɛka no tiawa a, ɛyɛ tebea a ɛma mogya mu nkwammoaa bi (wɔ eyi mu no, mogya mu nkwammoaa kɔkɔɔ) yɛ dodo. Nanso, ɛnyɛ mogya mu kokoram bi a wɔfrɛ no mogya mu kokoram ankasa. Nanso, wɔ nsɛm a ɛntaa nsi koraa mu no, saa tebea yi betumi abɛyɛ mogya mu kokoram wɔ nnipa binom mu. Ɛno nti na nnuruyɛfo hwɛ so bere nyinaa no.

So thrombocythemia a ɛho hia ne thrombocytosis yɛ ade koro?

Saa edin abien yi di nsɛ kakra, enti wobetumi afrafra. Nanso nsonsonoe wɔ abien no ntam.

• Thrombocythemia a Ɛho Hia: Ɛha yi, mogya nkwammoaa dodow kɔ soro esiane ɔhaw bi a ɛwɔ nnompe mu ntini no ankasa mu nti, na ɛnyɛ yare foforo biara nti.
• Reactive Thrombocytosis: Ɛha yi, mogya nkwammoaa dodow kɔ soro sɛ nea wɔyɛ wɔ aduruyɛ mu tebea foforo ho (e.g., ɔyare mmoawa, dade a enni nipadua mu , wɔ oprehyɛn akyi).

Wɔ abien no mu no, tebea bi a wɔfrɛ no thrombocytosis abu so sen thrombocythemia a ɛho hia.

Hena na ɛda adi sɛ obenya saa tebea yi?

Thrombocythemia a ɛho hia yɛ tebea a ɛntaa nsi koraa. Sɛnea akontaabu a ɛwɔ United States kyerɛ no, ɛka nnipa bɛyɛ baanu wɔ nnipa 100,000 biara mu. Mmea taa nya bi sen mmarima mmɔho abien. Tebea no taa ka nnipa a wɔadi fi mfe 60 kosi 80. Nanso, wɔn a wonya bi no mu bɛyɛ 20% nni mfe 40. Ɛntaa mma koraa sɛ mmofra benya bi. Sɛ wɔyɛ saa a, ɛda adi kɛse sɛ wonya fi awosu mu fi wɔn awofo hɔ.

Dɛn ne eyi ho sɛnkyerɛnne? Woyɛ dɛn hu no?

Ɛnyɛ obiara na ɔwɔ yare no ho sɛnkyerɛnne koro. Nnipa binom tumi kɔ mfe pii a wonni sɛnkyerɛnne biara. Bere a mogya nkwammoaa dodow kɔ soro nkakrankakra nkutoo na sɛnkyerɛnne ahorow no fi ase da adi. Nsɛnkyerɛnne titiriw ne nea mogya a ɛtwetwe na ɛde ba. Eyinom betumi aba wɔ mmeae te sɛ amemene, nsa, ne nan. Nsɛnkyerɛnne a ebetumi aba esiane mogya a ɛtwetwe nti no bi ne:

• Tiyɛ a enni sabea .
• Adwene a ɛyɛ basaa .
• Ɔhyew anaasɛ ɛbɔ nkate wɔ nsateaa ne nan ase.
• Nsa ne anan a ɛyɛ mmerɛw anaasɛ ɛyɛ kɔkɔɔ .
• Nsakrae a ɛba wɔ kasa nhyehyɛe mu.
• Atiridiinini .
• Ntini a ɛma obi ho kyere no .
• Ɛyaw anaa ɔhaw a ɛba wo koko, nsa, akyi, kɔn, anom, anaa yafunu mu.
• Abofono .
• Ɔhome a ɛyɛ den (dyspnea).
• Koko mu yaw .
• Mrɛyɛ .
• Enlarged spleen - akwaa a ewo yafunu no benkum so atifi.
• Mogya a ɛba hwene mu (epistaxis).
• Mogya a ɛretu wɔ anom.
• Mogya a ɛwɔ nsu mu.
• Mogya a ɛwɔ nsu mu (hematuria).
• Bruising a ɛnyɛ den.
• Mmea kɔ brayɛ mu denneennen .

Ɔkwan bɛn so na eyi ka nyinsɛn?

Asiane wɔ hɔ bere nyinaa sɛ mogya a ɛbɛtɔ ɔbea nipadua mu bere a wanyinsɛn no. Asiane yi yɛ kɛse mpo ma ɛna a onyinsɛn a ɔwɔ thrombocythemia a ɛho hia no. Afei nso, ayaresa ahorow bi a wɔde sa yare yi mfata mma mmea a wɔyem anaa wɔn a wɔreyɛ nhyehyɛe anyinsɛn no. Enti, sɛ wowɔ saa tebea yi a, ɛho hia sɛ wo ne wo duruyɛfo susuw eyi ho ansa na woasusuw ho sɛ wobɛwo.

Mma wo werɛ mmfi sɛ, saa tebea yi betumi ama obi anya komayare ne akisikuru. Sɛ wowɔ saa tebea yi a, ɛsɛ sɛ wofrɛ 1990 ntɛm ara sɛ wuhu komayare anaa akisikuru ho sɛnkyerɛnne a.

Dɛn nti na tebea yi ba? Dɛn ne nea enti a ɛte saa?

Sɛnea yɛadi kan aka no, nsakrae (nsakrae) a ɛba awosu mu nkwaadɔm mu na ɛde eyi ba. Eyinom nyɛ awosu mu nkwaadɔm a ɛwɔ hɔ wɔ awo mu, na mmom awosu mu nkwaadɔm a ɛsakra wɔ nkwa mu. Ne titiriw no, nkwaadɔm mu nsakrae a ɛba awosu mu nkwaadɔm abiɛsa mu a ɛka ntini mu nkwammoaa a ɛwɔ yɛn nnompe mu nkwammoaa a ɛma mogya mu nkwammoaa no mu no ne ade titiriw a ɛde ba. Saa awosu mu nkwaadɔm yi ne:

• (JAK2) gene: Saa gene yi na ɛkyerɛ protein bi a wɔfrɛ no ``(JAK2)``. Saa protein yi boa ma wodi mogya mu nkwammoaa a wɔyɛ no so.
• (CALR) gene: Saa gene yi na ɛkyerɛ protein bi a wɔfrɛ no ``calreticulin''. Nhwehwɛmufo gye di sɛ eyi di dwuma wɔ nkwammoaa nyin, mpaapaemu, ne owu a wodi so.
• (MPL) gene: Wɔsan frɛ saa gene yi ``oncogene'', gene a ɛne kokoram a ɛde ba no wɔ abusuabɔ.

Sɛ saa awosu mu nkwaadɔm yi sesa a, ɔkwan a wɔfa so yɛ mogya nkwammoaa a ɛwɔ nnompe mu no yɛ nea wontumi nni so na ɛyɛ ntɛmntɛm dodo. Ɛte sɛ nea afiri a ɛma ahoɔhare bɔ wo! Ɛno ne bere a nipadua no yɛ mogya nkwammoaa pii sen sɛnea ebetumi adi ho dwuma.

Ɔkwan bɛn so na nnuruyɛfo hu eyi? (Nyare a Wɔahu) .

Sɛ oduruyɛfo bi susuw sɛ wowɔ saa tebea yi a, wobedi kan ayɛ wo nipadua mu nhwehwɛmu . Wobebisa wo yare no ho sɛnkyerɛnne nso ne sɛ ebia obi a ɔwɔ w’abusua mu anya ɔhaw a ɛte saa ara anaa. Afei, ebia wɔbɛyɛ sɔhwɛ ahorow bi te sɛ:

• Mogya Dodow a Edi Mu (CBC): Eyi hwɛ sɛnea nkwammoaa ahorow a ɛwɔ wo mogya mu nyinaa te, titiriw mogya mu nkwammoaa dodow.
• Peripheral Blood Smear: Eyi hwehwɛ sɛ wɔfa mogya na wɔde afiri a wɔde hwɛ mogya mu nkwammoaa nketenkete no hwɛ sɛ ebia ɛte sɛ nea ɛteɛ anaasɛ ɛnyɛ nea ɛfata wɔ ne nsusuwii ne ne kɛse mu. Ebia mogya nkwammoaa a ɛnteɛ no bɛyɛ akɛse na ɛsono ne nsusuwii.
• Nnompe mu ntini mu nhwehwɛmu: Ɛtɔ mmere bi a wobetumi afa nnompe mu ntini ketewaa bi de ayɛ nhwehwɛmu (Bone Marrow Aspiration anaa Bone Marrow Biopsy). Eyi betumi aboa ma wɔahu sɛnea nnompe mu ntini no te no pɛpɛɛpɛ.
• `(Genetic testing)`: `(JAK2)`, `(CALR)`, `(MPL)` .

Nea ebefi nhwehwɛmu ahorow yi mu aba no bɛboa wo duruyɛfo ma wasusuw asiane a ɛwɔ mu no ho na wayɛ ayaresa ho nhyehyɛe. Mpɛn pii no, asiane ahorow a ɛde tebea yi ba no bi ne:

• Sɛ́ wadi boro mfe 60.
• Ɔbea a obi yɛ.
• Esiane sɛ na wadi kan anya mogya a ɛtɔe nti.
• Awosu mu nsakrae a yɛadi kan aka ho asɛm no a ɛwɔ nipadua no mu.

So obiara hia nnuru ma eyi? Dɛn ne ayaresa ahorow no?

Eyi nyɛ ade koro wɔ obiara fam. Wɔ nnipa binom fam no, sɛ wonni sɛnkyerɛnne biara a, nnuruyɛfo betumi akamfo ɔkwan bi a wɔfrɛ no “ɔwɛn a wɔbɛtwɛn.” Eyi kyerɛ sɛ wɔbɛhwɛ sɛnea nsɛnkyerɛnne ne sɛnkyerɛnne ahorow bɛba. Nnipa a wɔwɔ yare no ho sɛnkyerɛnne anaasɛ asiane kɛse wom sɛ mogya bɛtɔ wɔn no behia ayaresa. Wɔde ayaresa no atirimpɔw titiriw ne sɛ wobesiw mogya a ɛbɛtɔ ne/anaasɛ wɔbɛtew mogya nkwammoaa dodow so. Nnuru ahorow pii wɔ hɔ a wɔde yɛ eyi:

• Aspirin: Eyi mma mogya a ɛtwetwe no ntumi nkɔ. Nanso, nnuruyɛfo yɛ ahwɛyiye wɔ aspirin a wɔde bɛma nnipa a mogya mu nkwammoaa a ɛdɔɔso yiye no ho, efisɛ ebetumi ama mogya atɔ nnipa a wɔwɔ tebea bi a wɔfrɛ no acquired Von Willebrand syndrome mu no ayɛ kɛse.
• Hydroxyurea: Eyi yɛ nnuru a wɔde sa yare. Ɛma mogya nkwammoaa a ɛwɔ mogya mu no dodow so tew. Wobetumi de aka aspirin ho ama nnipa a asiane kɛse wom sɛ mogya bɛtɔ wɔn.
• Anagrelide: Te sɛ hydroxyurea no, eyi nso boa ma mogya nkwammoaa dodow ne asiane a ɛwɔ hɔ sɛ obi benya komayare ne ɔyare a ɛma obi hwe ase no so tew.
• Interferon a wɔfrɛ no alfa:Eyi yɛ aduru a wɔde sa yare a ɛma nipadua no tumi ko tia nyarewa. Ɛma mogya nkwammoaa a ɛnyɛ ne kwan so no gyae sɛ ɛbɛpaapae na anyin.
• Busulfan: Eyi nso yɛ aduru a wɔde ko tia kokoram. Wɔde ma nnipa a wɔnyɛ hydroxyurea ho biribi anaasɛ wontumi mfa nni dwuma.
• `(Ruxolitinib)`: , , , .

Ɛtɔ mmere bi a, sɛ wo mogya mu mogya mu nkwammoaa dodow kɔ soro mpofirim dodo a, wɔde ɔkwan bi a wɔfrɛ no plateletpheresis di dwuma. Wɔ eyi mu no, wɔde wo mogya no bata afiri titiriw bi ho, na eyi mogya nkwammoaa a ɛboro so no bi fi hɔ.

So ɔkwan bi wɔ hɔ a wɔbɛfa so asiw eyi ano?

Nokwarem no, dabi. Eyi fi nsakrae a ɛba awosu mu nkwaadɔm mu, na biribiara nni hɔ a yebetumi ayɛ de asiw saa nsakrae no ano. Nhwehwɛmufo nnya nhuu nea enti a saa awosu mu nkwaadɔm yi sesa.

So ebetumi aba sɛ wobɛtra ase sɛnea ɛte biara a tebea yi wɔ hɔ? Nkwa nna yɛ dɛn?

Akyinnye biara nni ho sɛ wubetumi! Sɛ wowɔ sɛnkyerɛnne ahorow mpo a, nnuruyɛfo betumi asa wo yare de asiw ɔhaw ahorow a emu yɛ den te sɛ komayare ne akisikuru ano. Enti, ɛho hia sɛ woremmɔ hu na wudi wo duruyɛfo akwankyerɛ akyi yiye. Sɛ ɛba nkwa nna ho a, wɔka sɛ ebia nnipa a wɔwɔ saa tebea yi nkwa nna yɛ tiaa kakra sen wɔn a wonni bi no. Nanso, eyi gu ahorow wɔ onipa biara mu. Nneɛma pii te sɛ wo tebea no ne w’akwahosan ho su horow ka eyi. Enti, ɔkwan pa a wobɛfa so ahu eyi ne sɛ wubebisa wo duruyɛfo.

Mɛyɛ dɛn ahwɛ me ho? (Ne ho a wɔhwɛ) .

Nnipa a wɔwɔ thrombocythemia a ɛho hia no wɔ asiane kɛse mu sɛ mogya bɛtɔ wɔn na/anaasɛ mogya atɔ wɔn wɔ ɔkwan a ɛnteɛ so. Nneɛma pii wɔ hɔ a wubetumi ayɛ de atew asiane yi so:

• Kwati sigaretnom koraa: Nnipa a wɔnom sigaret no wɔ asiane kɛse mu sɛ mogya betu. Sɛ woyɛ obi a ɔnom sigaret a, hwehwɛ mmoa na ama woagyae.
• Kura mu duru a ɛfata mu: Nnipa a wɔayɛ kɛse mmoroso no wɔ asiane kɛse mu sɛ wobenya mogya a ɛbɛtɔ. Hwehwɛ afotu fi aduannuru ho ɔbenfo hɔ na fa adidi pa tom.
• Apɔw-mu-teɛteɛ daa: Apɔw-mu-teɛteɛ ma asiane a ɛwɔ hɔ sɛ mogya bɛtɔ no so tew.
• Di nyarewa afoforo a ɛma asiane a ɛwɔ hɔ sɛ mogya tu no yɛ kɛse no so: Sɛ wowɔ tebea horow te sɛ asikreyare anaa mogya mmoroso a, di so yiye.
• Hu w’akwahosan nyinaa: Ɛtɔ mmere bi a, tebea yi betumi aba a enni sɛnkyerɛnne biara, enti bisa wo duruyɛfo sɛnkyerɛnne ahorow a ɛsɛ sɛ wohwɛ yiye.

Bere bɛn na ɛsɛ sɛ mekɔ oduruyɛfo nkyɛn? Bere bɛn na ɛsɛ sɛ mekɔ baabi a wɔhwɛ wɔn a egye ntɛmpɛ?

Sɛ wowɔ saa tebea yi a, ɛho hia yiye sɛ wobɛkɔ akɔhwɛ wo daa. Eyi bɛma wo duruyɛfo atumi ahwɛ wo tebea no, ahwɛ sɛnea mogya nkwammoaa a ɛwɔ wo mogya mu no te, na wayɛ nsakrae biara a ɛho hia wɔ ayaresa mu. Wɔ tebea a egye ntɛmpɛ mu no, ɛno kyerɛSɛ wuhu komayare anaa akisikuru ho sɛnkyerɛnne a, ɛsɛ sɛ wofrɛ 911 ntɛm ara na wokɔ ayaresabea. Ebia komayare ho sɛnkyerɛnne ahorow bi ne:

• Koko mu yaw anaasɛ ɛyɛ den (angina).
• Ɔhome a ɛyɛ den.
• Sɛ wote nka sɛ wo ho ayɛ wo yaw anaasɛ wo yafunu ayɛ wo yaw.
• Koma a ɛbɔ ntɛmntɛm (a ne koma bɔ denneennen).
• Nkate a ɛma obi ho nyɛ no dɛ anaasɛ te sɛ nea biribi bɔne bi reba.
• Fifiri a ɛrefifi.
• Adwene a ɛyɛ basaa (vertigo), aniwa a ɛyɛ kusuu, anaasɛ adwenem naayɛ.

Mmea betumi anya yare no ho sɛnkyerɛnne ahorow:

• Ɔbrɛ a ɛboro so ne nna a wontumi nna.
• Ɔhome a ɛyɛ den (dyspnea).
• Ɛyaw wɔ akyi, mmati, kɔn, abasa, anaa yafunu mu.
• Ɔfe a wɔfe.

Nsɛnkyerɛnne a ɛkyerɛ sɛ obi anya ɔyare a ɛma obi hwe ase no betumi ayɛ:

• Nipadua no fã biako (anim, abasa) a ɛyɛ mmerɛw anaa mmerɛwyɛ mpofirim.
• Ɔkasa a ɛyɛ den mpofirim.
• Ɛyɛ den mpofirim sɛ wubehu ade wɔ aniwa biako anaa abien no nyinaa mu.
• Adwene a ɛyɛ den, ɛyɛ den sɛ ɔbɛnantew, sɛ obi ntumi nkari pɛ.
• Tiyɛ a emu yɛ den a ɛba mpofirim a ntease biara nnim.

Nsɛm bɛn na ɛsɛ sɛ wubisa oduruyɛfo no?

Esiane sɛ thrombocythemia a ɛho hia yɛ yare a ɛntaa nsi nti, ebia wubenya nsɛmmisa pii wɔ ho. Sɛ wokɔ wo duruyɛfo nkyɛn a, ntwentwɛn wo nan ase sɛ wubebisa nsɛm te sɛ eyinom:

• Adɛn nti na eyi too me?
• Minni sɛnkyerɛnne biara mprempren. Bere bɛn na sɛnkyerɛnne ahorow bɛda adi?
• Dɛn na "ɔwɛn a wɔtwɛn" kyerɛ?
• Aduru bɛn na wokamfo kyerɛ me?
• So ɛsɛ sɛ menom nnuru wɔ me nkwa nna nyinaa mu?

Nkrasɛm a Wɔde Kɔ Fie

Okay, enti ma menka eyi nkyerɛ wo na aboa wo ma woakae nsɛntitiriw a ɛho hia sen biara no bi afi nea yɛaka ho asɛm no mu.

Essential Thrombocythemia yɛ mogya mu yare a ɛntaa nsi, a efi awosu mu a nnompe mu ntini no ma mogya mu nkwammoaa pii a wɔfrɛ no mogya mu nkwammoaa kɔkɔɔ. Eyi ma asiane a ɛwɔ hɔ sɛ mogya bɛtɔ, komayare, ne akisikuru no yɛ kɛse.

Ɛwom sɛ wontumi nsa no koraa de, nanso sɛ wonya ayaresa a ɛfata na woboa a, wubetumi adi tebea yi so yiye, atew nsɛnnennen so, na woabɔ bra sɛnea ɛsɛ. Enti, sɛ w’adwene mu yɛ wo naa wɔ eyi ho, anaasɛ wowɔ sɛnkyerɛnne ahorow a ɛyɛ soronko a, hwehwɛ aduruyɛfo afotu ntɛm ara. Ɛnyɛ wo nko ara, na nnuruyɛfo wɔ hɔ a wɔbɛboa wo wɔ akwantu yi mu. Thrombocythemia a Ɛho Hia, Ntini Mu Ntini, Mogya a Ɛtwetwe, Nnompe mu Ntini, Mogya mu Nyarewa, Awosu mu Nsakrae, Kokoram