Yala ɔrimɔni gɛlɛya bɛ aw denmisɛnnin na wa? An ka kuma denmisɛnw ka kɔnɔboli dɔgɔtɔrɔ dɔ kan!

Tuma dɔw la, n’an bɛ miiri banaw la minnu bɛ an denmisɛnninw sɔrɔ, kɛrɛnkɛrɛnnenya la, n’a bɛ iko u ka gɛlɛn dɔɔnin, an bɛ doni belebele dɔ ye an dusukunw kan, tiɲɛ tɛ? Gɛlɛya minnu bɛ sɔrɔ ɔrimɔni fɛ, olu ye kelen ye. Nka, kun t’a la ka hami. Sabula dɔgɔtɔrɔ kɛrɛnkɛrɛnnen dɔw bɛ yen minnu bɛ se ka aw ni aw den dɛmɛ nin waati suguw la. O ye mɔgɔ sugu ye min ye denmisɛnw ka kɔnɔboli dɔgɔtɔrɔ ye , walima i n’a fɔ an b’a fɔ cogo min na tubabukan na, ``Denmisɛnw ka kɔnɔboli dɔgɔtɔrɔ''. O la bi, an ka kuma dɔɔni dɔɔni nin dɔgɔtɔrɔ kɛrɛnkɛrɛnnen in kan.

Jɔn ye Denmisɛnw ka Endocrinologist ye?

N’an y’a fɔ cogo nɔgɔman na, denmisɛnw ka ɔrimɔni kɛrɛnkɛrɛnnen ye dɔgɔtɔrɔ ye min bɛ banaw sɛgɛsɛgɛ ani k’u furakɛ minnu bɛ sɔrɔ ɔrimɔni fɛ denmisɛnw ni funankɛninw na , o kɔrɔ ye ko gɛlɛya minnu bɛ sɔrɔ kɔnɔbara basigilen na. Ni gɛlɛya bɛ den cɛya la , a bonya gɛlɛyaw, bana dɔw i n’a fɔ sukarodunbana , walima bana wɛrɛ minnu bɛ tali kɛ ɔrimɔni ni u bɔyɔrɔ la, nin dɔgɔtɔrɔ kɛrɛnkɛrɛnnen bɛ se ka dɛmɛ don.

O la, nin endocrinologie ye mun ye?

Endocrinologie ye furakɛli bolofara ye min bɛ endocrine system sɛgɛsɛgɛ an farikolo la. O cogoya in bɛ kɛ ni kɔnɔnatumuw, farikolo yɔrɔw ani ɔrimɔni ye. Miiri k’a filɛ i n’a fɔ fɛɛrɛ kɛrɛnkɛrɛnnen dɔ an farikolo bɛ se ka cikanw lase mɔgɔw ma.

Glande endocrine (Glande endocrine (Glande endocrine).

Olu ye farikolo yɔrɔ kɛrɛnkɛrɛnnenw ye an farikolo la minnu bɛ ɔrimɔni bɔ ka u bila joli la. Glande suguya caman bɛ yen:

• Sugunɛbilenni : Nin ye gland misɛnnin fila ye minnu bɛ sɔrɔ an ka sugunɛ sanfɛ. U bɛ ɔrimɔni dɔw dilan minnu bɛ degun jaabi, ani ɔrimɔni minnu bɛ kɔgɔ hakɛ kɔlɔsi.
• Glande pituitaire : Nin glande fitini min bɛ i n’a fɔ kolo, min bɛ sɔrɔ kunsɛmɛ jukɔrɔ dɔrɔn, o bɛ glande caman wɛrɛw mara, o la a bɛ wele tuma dɔw la ko "gland master".
• Thyroïde : Nin gland in min bɛ i n’a fɔ wuluwulu, n’a bɛ sɔrɔ kɔ ɲɛfɛ, o bɛ ɔrimɔni dɔw dilan minnu bɛ farikolo fanga baara hakɛ kɔlɔsi.
• Parathyroïde glandes : Nin gland misɛnnin naani minnu bɛ thyroïde gland kɔfɛ, olu bɛ kalisiyɔmu hakɛ kɔlɔsi farikolo la.

Ɲɛgɛnɛsiraw (organes endocrinies).

O farikolo yɔrɔw fana bɛ ɔrimɔni dilan ani ka baara kɛrɛnkɛrɛnnen wɛrɛw kɛ.

• Pankreyasi : Nin yɔrɔ in min bɛ kɔnɔbara sanfɛla la, o ni sukarodunbana bɛ tali kɛ ɲɔgɔn na.a bɛ insuline hormone dilan .
• Hypothalamus (Hypothalamus): Nin kunsɛmɛ yɔrɔ in bɛ ɲɛgɛnɛsiralabanaw kɔlɔsi.
• Ovaries : Muso ka bangekɔlɔsi fɛɛrɛ dɔ don min bɛ cɛnimusoya hormones dilan.
• Testes : Cɛ ka bangekɔlɔsi fɛɛrɛ dɔ don min bɛ cɛya ni musoya hormones dilan.

Ɔrimɔniw (hormones).

Ɔrimɔniw bɛ i n’a fɔ kemikɛli cidenw an farikolo la. U bɛ bɔ glande kelen na ka taa gland wɛrɛ la joli sira fɛ ka nɔ bila farikolo yɔrɔ walima farikolo yɔrɔ wɛrɛ laɲinilen wɛrɛ la. Ɔrimɔni bɛ nɔ bila wale nafama caman na an farikolo la. Misali damadɔw filɛ nin ye:

• Farikoloɲɛnajɛ : Farikolo bɛ dumuni caman tigɛli kɛ fanga ye ani ka baara kɛ n’o fanga ye.
• Bonya: An bɛ janya cogo min na ani an farikolo bɛ bonya cogo min na.
• Cɛnimusoko : Fɛn minnu bɛ i n’a fɔ cɛya ni musoya se.
• Sunɔgɔ: Ka an ka sunɔgɔ ni an ka kununcogo kɔlɔsi.

Danfara jumɛn bɛ denmisɛnw ka ɔrimɔni kɛrɛnkɛrɛnnen ni ɔrimɔni kɛrɛnkɛrɛnnen dɔ cɛ?

Nin ye ko ye min nafa ka bon kosɛbɛ. Denmisɛnw tɛ mɔgɔ fitininw ye. U farikolo bɛ bonya cogo min na ani u ka ɔrimɔni bɛ baara kɛ cogo min na, o ni balikuw tɛ kelen ye kosɛbɛ. Denmisɛnw bɛ gɛlɛya minnu sɔrɔ ɔrimɔni na, olu fana bɛ se ka kɛ danfara ye ni balikuw bɛ gɛlɛya minnu sɔrɔ. Denmisɛnw ka ɔrimɔni kɛrɛnkɛrɛnnenw ye dɔgɔtɔrɔw ye minnu ye kalan kɛrɛnkɛrɛnnen sɔrɔ o ɔrimɔni gɛlɛyaw bɛ tali kɛ cogo min na denmisɛnw ka bonya ni u ka yiriwali la. O la, u bɛ se ka furakɛli kɛrɛnkɛrɛnnenw kɛ denmisɛnw ye.

Denmisɛnw ka ɔrimɔni kɛrɛnkɛrɛnnen bɛ mun kɛ? U bɛ bana jumɛnw furakɛ?

Denmisɛnw ka farikolojidɛsɛ furakɛla dɔ bɛ bana suguya caman sɛgɛsɛgɛ, k’u furakɛ ani k’u ɲɛnabɔ, bana minnu bɛ nɔ bila den ka kɔnɔbara la. An ka o cogoya dɔw lajɛ.

Sugunɛbilenni banaw

An ka sugunɛbaralabana bɛ ɔrimɔni nafama caman dilan. Gɛlɛya minnu bɛ se ka sɔrɔ o glandew la, olu dɔw ye:

• Addison ka bana : O bɛ kɛ ni den farikolo ma ɔrimɔni fila bɔ ka ɲɛ, kɔritizɔli (ɔrimɔni min bɛ degun jaabi) ani aldosterone (ɔrimɔni min bɛ kɔgɔ hakɛ kɔlɔsi).
• Sugunɛbilenni bangenen : O ye bana ye min bɛ sɔrɔ jamu fɛ, min bɛ nɔ bila den ka ɔrimɔni (cortisol), aldosterone ani androgène (cɛ ka ɔrimɔni suguya dɔ) bɔli la.
• Cushing ka bana:O fana bɛ Weele ko `(Hypercortisolisme)`. Min bɛ kɛ yan, o ye ko den fari bɛ `(Cortisol)` ɔrimɔni caman bɔ.

Kolow ni kalisiyɔmu cogoyaw

Ɔrimɔni caman jɔyɔrɔ ka bon an kolo barika la ani ka kalisiyɔmu hakɛ bɛnnen mara.

• Kalisiyɔmu (hypercalcémie) : O ye bana ye min na kalisiyɔmu hakɛ bɛ den joli la ka tɛmɛ a cogo kɔrɔ kan.
• Kalisiyɔmu dɔgɔyali (hypocalcémie): O ye bana ye min na kalisiyɔmu hakɛ bɛ den joli la ka dɔgɔn ka tɛmɛ a cogo kɔrɔ kan.
• Ɲɛgɛnɛsiraw : Nin ye bana ye min bɛ sɔrɔ witamini D dɛsɛ fɛ.O bɛ se ka kɛ sababu ye ka denmisɛnw kolo fanga dɔgɔya ani ka u kunbiri gwan.

Sukarodunbana ni farikoloɲɛnajɛ cogoyaw

Denmisɛnw ka ɔrimɔni kɛrɛnkɛrɛnnenw fana bɛ gɛlɛyaw furakɛ minnu bɛ tali kɛ farikoloɲɛnajɛ la, o ye farikolo fanga dilancogo ye. Sukarodunbana ye bana ye min ka ca kosɛbɛ.

• Sukarodunbana suguya fɔlɔ : O ye waati ye den yɛrɛ ka farikolo tangacogo (autoimmune attack) bɛ kɔnɔbara basigilen farikolokisɛw tiɲɛ minnu bɛ inisɔndiya dilan. O de kosɔn, pankreyasi tɛ se ka inisɔndiya dilan.
• Sukarodunbana suguya 2 : Nin bana in na, pankreyasi bɛ inisɔndiya dilan, nka farikolo tɛ se ka baara kɛ n’a ye ka ɲɛ. A ka ca a la, o bɛ tali kɛ fasa la.
• Fasa: Bana gɛlɛn don, min bɛ mɛn sen na, farikolo tulu caman bɛ ɲɔgɔn sɔrɔ min na, wa a bɛ tiɲɛni kɛ kɛnɛya la. O fana bɛ se ka kɛ ni ɔrimɔni balanbaliya ye.

Cɛnimusoko yiriwali gɛlɛyaw

Tuma dɔw la, denmisɛnw bɛ se ka fɛn dɔw sɔrɔ u ka cɛnimusoya yiriwali la. Misali la, bana dɔ bɛ wele ko atypical genitalia . Nin ye bana ye min man teli ka sɔrɔ jamu fɛ. O cogo la, a bɛ se ka kɛ den kɛnɛma yɔrɔw tɛ cɛ walima muso cogoya ye, nka a bɛ se ka bɔ yɔrɔ dɔ la u ni ɲɔgɔn cɛ. Denmisɛnw ka ɔrimɔni kɛrɛnkɛrɛnnen dɔ bɛ se ka o bana suguw sɛgɛsɛgɛ ani ka laadilikanw ni furakɛli wajibiyalenw di.

Ɲɛgɛnɛsiraw ka bana minnu bɛ sɔrɔ jamu fɛ

Ɔrimɔni gɛlɛya dɔw bɛ se ka sɔrɔ jamu fɛ.

• Turner syndrome: Nin bana in bɛ npogotigininw dɔrɔn de minɛ. U ka X kolosinsinnan kelen walima u bɛɛ tɛ yen. O bɛ nɔ bila fɛnw na i n’a fɔ bonya ni kɔnɔbara baara.
• Prader-Willi ka bana : Nin fana ye bana ye min bɛ sɔrɔ jamu fɛ. A bɛ nɔ bila den ka farikoloɲɛnajɛ la, ka farikolo ni kɛwale caman wuli (misali la, kɔngɔ kojugu, bonya gɛlɛyaw).

Gɛlɛya minnu bɛ sɔrɔ bonya ni cɛya ni musoya la

Ɔrimɔni nafa ka bon kosɛbɛ den ka bonya ni a ka yiriwali la ani walasa u ka se cɛya la waati bɛnnen na. Gɛlɛya minnu bɛ se ka sɔrɔ o siratigɛ la, olu dɔw ye:

• A janya ka surun:Den ka surun den tɔw 95% la minnu si hakɛ ni u cɛya ye kelen ye. O kun caman bɛ se ka sɔrɔ, o dɔ ye ɔrimɔni dɛsɛ ye.
• Furuɲɔgɔnmaya joona : Ni npogotiginin ye cɛya daminɛ taamasiɲɛw jira (misali la, sinji bɔli npogotigininw na, cɛdenw ka cɛya bonya) sani a ka se san 8 ma, walima cɛden ka kɔn san 9 ɲɛ, o bɛ jate cɛya daminɛ joona ye.
• Furuɲɔgɔnmaya kɔtigɛlen : Ni cɛya ni musoya ma daminɛ fo ka tɛmɛ a cogo kɔrɔ kan kosɛbɛ, o kɔrɔ ye ko npogotiginin ma cɛya taamasiɲɛw jira fɔlɔ a si san 13 la walima cɛdennin ma a si san 14 la, o bɛ se ka kɛ cɛya ni musoya latɛmɛni ye.

Ɲɛgɛnɛsiraw ka banaw

I n’a fɔ an y’a ɲɛfɔ cogo min na ka tɛmɛ, pituitaire gland bɛ ɔrimɔni nafama caman dilan. Ni gɛlɛya dɔ bɛ nin gland in baarakɛcogo la, taamasiɲɛ suguya caman bɛ se ka bɔ a la.

• Sukarodunbana : O ni sukarodunbana tɛ kelen ye. Min bɛ kɛ yan, o ye ko farikolo bɛ sugunɛ caman bɔ a la, wa a tɛ se ka ji mara ka ɲɛ. Minnɔgɔ kojugu fana ye o taamasiɲɛ ye.
• Ɲɛgɛnɛsiraw dɔgɔyali : Ni ɔrimɔni kelen walima caman tɛ sɔrɔ ɲɛgɛnɛsira fɛ, o bɛ se ka nɔ bila bonya la, sɔgɔsɔgɔninjɛ baara la, sugunɛbaralabana baara la, cɛya ni musoya la ani minnɔgɔ kunbɛnni.

Thyroïde (banakisɛfagalanw) cogoyaw

Gɛlɛyaw bɛ sɔrɔ ni ɔrimɔni hakɛ min bɛ bɔ sɔgɔsɔgɔninjɛ la, o ka dɔgɔn walima ni a ka ca.

• Goiter: O ye sɔgɔsɔgɔninjɛ ye min bɛ bonya. O bɛ se ka kɛ hali ni ɔrimɔni hakɛ tɛ a cogo la, a dɔgɔyara walima a ka ca.
• Sugunɛbilenni (hypothyroïdie): Ɲɛgɛnɛsiraw tɛ sɔgɔsɔgɔninjɛ ɔrimɔni caman bɔ joli la. O bɛ se ka kɛ sababu ye ka farikolo sumaya, ka kɛ sababu ye ka mɔgɔ girinya, ka kɔnɔboli bila mɔgɔ la.
• Hyperthyroïdie : Bana min na thyroïde glande bɛ thyroïde hormone caman bɔ ka a bila joli la. O bɛ se ka kɛ sababu ye ka dusukun tantanni teliya, ka farikolo girinya dɔgɔya, ka sumaya caya.

Aw ka kan ka mun makɔnɔ ni aw taara denmisɛnw ka ɔrimɔni kɛrɛnkɛrɛnnen dɔ fɛ aw siɲɛ fɔlɔ la?

Ni aw ni aw den ye denmisɛnw ka ɔrimɔni kɛrɛnkɛrɛnnen dɔ kunbɛn fɔlɔ, dɔgɔtɔrɔ bɛna aw ɲininka caman na aw den ka bana taamasiɲɛw kan, a ka denbaya ka furakɛli tariku kan, ani aw den bɛ fura minnu ta sisan . a bɛna farikolo sɛgɛsɛgɛli fana kɛ . Tuma dɔw la, joli sɛgɛsɛgɛli ni sɛgɛsɛgɛli bɛ se ka kɛ. Aw kana aw hakili ɲagami, nin bɛɛ bɛ kɛ walasa ka hakilina ɲuman sɔrɔ aw den ka bana kan.

Min nafa ka bon kosɛbɛ, o ye ka i ka fɛn fitinin bɛɛ fɔ dɔgɔtɔrɔ ye , hali ni a ka dɔgɔ cogo o cogo. O bɛna u dɛmɛ ka bana sɛgɛsɛgɛli tigitigi kɛ.

I bɛ se ka kɛ denmisɛnw ka ɔrimɔni kɛrɛnkɛrɛnnen ye cogo di?

A ka ɲi fana k’o dɔn. Denmisɛnw ka kɔnɔmaya dɔgɔtɔrɔ ye mɔgɔ ye min bɛ fɔlɔ ka furakɛliba kɛ (san 4-5) ka sɔrɔ ka kalan kɛrɛnkɛrɛnnen kɛ denmisɛnw ka kɛnɛyako la (san 3 ɲɔgɔn). O kɔfɛ, u ka kan ka san 3 wɛrɛ kalan kɛrɛnkɛrɛnnen kɛ (fellowship) denmisɛnw ka kɔnɔboli la, o kɔrɔ ye ko denmisɛnw ka ɔrimɔni banaw. Nin kalan in ka kan ka sɔn fana furakɛli kalanjɛkulu dɔ fɛ min lakodɔnnen don (i n’a fɔ dɔgɔtɔrɔso kalanso min bɛ wele ko Accreditation Council of Graduate Medical Education - ACGME). Ka fara o kan, seereyaw minnu bɛ bɔ baarada lakodɔnnenw fɛ i n’a fɔ Ameriki denmisɛnw ka kɛnɛyako tɔnba (ABP) fana b’u ka dɔnniya sinsin. O kalan jan in de kosɔn, u bɛ dɔnniya jugu sɔrɔ o baara gɛlɛn in na.

Nka an ka jamana na, o kɔrɔ ye ko Sri Lanka, cogo min na ka kɛ Consultant Pediatric Endocrinologist ye, o tɛ kelen ye dɔɔnin. A bɛ kɛ PGIM (Post Graduate Institute of Medicine) fɛ min ni Kolonbɔ Iniwɛrisite bɛ ɲɔgɔn na.

Sri Lanka jamana na, nin taama in bɛ Taa nin cogo in na:

1. Basic Qualifications (MBBS & Internship): Fɔlɔ, i ka kan ka MBBS diplomu sɔrɔ dɔgɔtɔrɔso la, ka stage wajibiyalen dafa, ka i tɔgɔ sɛbɛn SLMC la.

2. Donda sɛgɛsɛgɛli (Selection Exam): O kɔfɛ, i ka kan ka tɛmɛ "MD (Paediatrics) Selection Exam" kan min bɛ kɛ PGIM fɛ. Nin ye ɲɔgɔndan sɛgɛsɛgɛli ye.

3. Denmisɛnw ka kɛnɛyako bɛɛ lajɛlen - Sɛbɛnnikɛla : Ni i tɛmɛna ɛkizamɛn na, i bɛna san 3 ɲɔgɔn kalan sɔrɔ (Sɛbɛnni waati). O la, aw bɛna denmisɛnw ka kɛnɛyako bɛɛ dɔn kosɛbɛ.

4. MD sɛgɛsɛgɛli : Nin san 3 ninnu laban na, "MD (Denmisɛnw ka kɛnɛyako) sɛgɛsɛgɛli" bɛ kɛ. Nin tɛmɛni ye setigiya jɔnjɔn ye walasa ka kɛ "dɔgɔtɔrɔ kɛrɛnkɛrɛnnen" ye.

5. Sub-specialty Selection: MD tɛmɛnen kɔ, mɔgɔ ka kan k’a latigɛ a ka kan ka taa sira min fɛ. O yɔrɔ la, mɔgɔ ka kan ka kɛrɛnkɛrɛnnenya fitinin dɔ sugandi min bɛ wele ko "Paediatric Endocrinology" (denmisɛnw ka ɔrimɔni). (O bɛ sɔrɔ ka da Merit ni baarakɛyɔrɔ lakolonw kan).

6. MD kɔfɛ kalan - Sɛbɛnnikɛla kɔrɔ : O yɔrɔ de la kalan kɛrɛnkɛrɛnnen bɛ daminɛ ɔrimɔni ko la. A ka ca a la o bɛ san 2-3 ɲɔgɔn ta.

   • Sigida Kalan:Aw ka kan ka baara kɛ san kelen ɲɔgɔn kɔnɔ denmisɛnw ka ɔrimɔni yɔrɔ la dɔgɔtɔrɔsoba dɔ la Sri Lanka.

   • Jamana kɔkan kalan: I ka kan ka kalan sɔrɔ san kelen walima san fila kɔnɔ jamana kɔkan (a ka c’a la Angletɛri walima Ɔsitarali) santiri la min lakodɔnnen don.

7. Baarakɛjɛkulu ka seereyaw : Ni nin bɛɛ kɛra ka ban, i bɛna seereya sɔrɔ ko "Board Certified Consultant Pediatric Endocrinologist" PGIM fɛ.

O la, i n’a fɔ taabolo caman min fɔra ka tɛmɛ, Sri Lanka fana, nin ye taama ye min bɛ cɛsiriba de wajibiya san 6-7 wɛrɛ kɔnɔ MBBS kɔfɛ.

O la sa, an ye kuma min kan, an ka kan ka an hakili to fɛn jumɛn na? (Take-Home Message)

• Ni aw b’a miiri ko gɛlɛya dɔ bɛ aw den na min bɛ tali kɛ ɔrimɔni, bonya, cɛya ni musoya walima sukarodunbana na, aw bɛ fɔlɔ ka aw ka denbaya dɔgɔtɔrɔ walima denmisɛnw ka dɔgɔtɔrɔ ɲininka.
• Ni u y’a ye ko a ka kan, u bɛna aw bila denmisɛnw ka kɔnɔboli dɔgɔtɔrɔso la.
• O dɔgɔtɔrɔ kɛrɛnkɛrɛnnenw ye dɔgɔtɔrɔw ye minnu ka dɔnniya ni dege kɛrɛnkɛrɛnnenw bɛ denmisɛnw ka ɔrimɔni gɛlɛyaw la. U bɛ se ka den ka bana sɛgɛsɛgɛ ka ɲɛ ani ka furakɛli ni furakɛli fɛɛrɛ ɲumanw di.
• Aw ye aw hakili to a la ko denmisɛnw ka ɔrimɔni gɛlɛyaw ni balikuw ta tɛ kelen ye, o la a nafa ka bon aw ka dɛmɛ ɲini dɔnnikɛlaw fɛ.

O la, ni nin bana ninnu dɔ bɛ aw den na, aw kana siran, aw bɛ dɔgɔtɔrɔ ka laadilikan ɲumanw ɲini. Fɛn bɛɛ ɲɛnabɔcogo bɛ yen! Ɔrimɔni, Denmisɛnw ka kɛnɛya, Bonya, cɛya, sukarodunbana, Endocrine System, Denmisɛnw ka ɔrimɔni kɛrɛnkɛrɛnnen