Ðe wò ŋutilã ƒe ŋutinu geɖe le dɔ wɔm zi ɖekaa? Mina míaƒo nu tso nɔnɔme sia si woyɔna be Multiple Organ Dysfunction Syndrome (MODS) ŋu!

Ðewohĩ èse be ne ame aɖe dze dɔ vevie kasia eye wòle kɔdzi ƒe dɔnɔdzikpɔƒe si wokpɔa dɔnɔwo gbɔ vevie (ICU) la, wogblɔna be, "Ðɔktawo gblɔ be yewoƒe ŋutilã ƒe akpa aɖewo mele dɔ wɔm nyuie o." Alo, "Mɔ̃woe le wo lém ɖe agbe." Le nyateƒe me la, ɣemaɣi la, nɔnɔme sesẽ aɖe ate ŋu anɔ ame ma ŋu. Le atikewɔwɔ me la, míeyɔa esia be Multiple Organ Dysfunction Syndrome, alo le Eŋlisigbe me la, ``Multiple Organ Dysfunction Syndrome - MODS.'' Ŋkɔa ɖi vɔvɔ̃ vie, gake mina míaƒo nu tso nusi wònye, nusita wòdzɔna, kple alesi nàwɔ anɔ agbe le mɔ bɔbɔe si gɔme nàte ŋu ase nu.

Nuka tututue nye MODS?

Kpuie ko la, MODS nye atikewɔwɔ me dɔléle sesẽ aɖe si dona kpata ŋutɔ (si nu sẽ ŋutɔ) . Nusi dzɔna le esia mee nye be ŋutinu eve alo esi wu nenema le míaƒe ŋutilã me siwo wɔa dɔ ɖekae la mewɔa dɔ nyuie zi ɖeka o. Bu eŋu kpɔ, míaƒe ŋutilã ƒe ɖoɖo geɖewo le abe gbɔgbɔtsixe, nuɖuɖumeŋusẽ, aɖuɖɔtoe ene. Amesiawo wɔa dɔ ɖekae be míanɔ lãmesẽ me. Ne MODS dzɔ la, ŋutinu siawo mate ŋu awɔ dɔ le wo ɖokui si o. Emegbe agbemenuhiahiãwo (`agbekpekpeɖeŋu`) hiã be woatsɔ awɔ ŋutinu mawo ƒe dɔ.

MODS ate ŋu akpɔ ŋusẽ ɖe ŋutilã ƒe ŋutinu ɖesiaɖe dzi, gake esiwo bɔ wue nye:

• Dzitodzito
• Dzi
• Hɔhɔ̃
• Ayikuwo
• Aklã
• Ʋu (ʋu) .

MODS ate ŋu atso nu geɖe gbɔ. Nusi gbɔ wòtsona wue nye dɔlékui sesẽ aɖe (sepsis) . Ne ɖɔktawo le MODS dam la, wodzea agbagba gbã be yewoaɖu nɔnɔme si gbɔ dɔlélea tso la dzi. Woɖea afɔ aɖewo hã tsɔ xea mɔ na ŋutinu bubuwo ƒe dɔwɔwɔ.

MODS nye atikewɔwɔ me dɔléle si me afɔku le ŋutɔ . Ate ŋu awu ame ne womewɔ atike nɛ kaba o. Woxɔa ame geɖe siwo ŋu MODS le ɖe dɔnɔdzikpɔƒe si wokpɔa dɔnɔwo gbɔ vevie (ICU) eye wohiã be woalé ŋku ɖe wo ŋu ɣesiaɣi ahakpe ɖe wo ŋu le agbe me.

Wotsɔ ŋkɔ bubu geɖe yɔa nɔnɔme sia, siwo dometɔ aɖewoe nye:

• Ŋutinu geɖe ƒe dɔmawɔmawɔ nyuie
• Ŋutinu geɖe ƒe dɔwɔwɔ ƒe kpododonu

Lãmenugbagbevi kawoe MODS ate ŋu akpɔ ŋusẽ ɖo?

MODS ate ŋu akpɔ ŋusẽ ɖe ŋutinu siwo gbɔna la dometɔ eve alo esi wu nenema dzi:

1. Yagbɔgbɔ ƒe dɔwɔwɔ (aklãwo) .

Ne míaƒe lãkusiwo mete ŋu naa oxygen agbɔsɔsɔme si ŋutilãa hiã o, si fia be ŋutilãa ƒe lãkusiwo mele oxygen si sɔ xɔm o (hypoxia) alo ŋutilãa mele carbon dioxide (CO2) si sɔ gbɔ kpɔm o (hypercapnia) la, míeyɔnae be gbɔgbɔtsixetsixe. Le MODS me la, gbɔgbɔ sesẽna na wò eye ate ŋu ahiã be mɔ̃ aɖe gɔ̃ hã nagbɔ ya be wòakpe ɖe ŋuwò nàgbɔ ya. Nusi gblẽa nu le lãkusi ŋu vevie wu le MODS mee nye Acute Respiratory Distress Syndrome (ARDS).Le ARDS nɔnɔme sia me la, lãkusiwo sesẽna, si wɔnɛ be esesẽna ŋutɔ be woalé oxygen ƒe agbɔsɔsɔ si sɔ le ʋua me ɖe te.

2. Dzi kple ʋukawo ƒe dɔwɔwɔ (dzi) .

Míaƒe dzitodzitowoe nye nusi tsɔa ʋu yia ŋutilã bliboa me. Dzi ƒe dɔmawɔmawɔ nyuie kple ʋu ƒe sisi nye nɔnɔme siwo me dzitodzito me lãmekaa gbɔdzɔna alo sẽna, si wɔnɛ be mete ŋu tsɔa ʋu si sɔ ɖe ŋutilã bliboa me o. Dzoxɔxɔ si gbɔ eme si dzɔna le MODS ŋu ate ŋu ana ʋukawo nakeke, si ana ʋu si ɖoa lãmenugbagbeviwo kple ŋutinuwo gbɔ dzi naɖe akpɔtɔ. Esia ate ŋu ana ʋu ƒe sisi naɖiɖi (ʋu ƒe sisi alo dzidziƒoame) le MODS me. Tsi ate ŋu ado le ʋuka siawo me hã, si ana wòavuvu (edema).

3. Ʋu ƒe dɔwɔwɔ (ʋu) .

MODS ate ŋu ana protein aɖewo siwo le ʋua me nada asɔ o. Esia ate ŋu ahe ʋu ƒe dodo kple ʋu ƒe sisi ƒe kuxiwo vɛ. Àte ŋu ade dzesii be ŋutigbalẽa le ƒoƒom alo ʋu le dodom le wò dɔgbo me. Kuxi sesẽtɔ kekeake si ate ŋu agblẽ nu le wò ʋukawo ŋue nye Disseminated Intravascular Coagulation (DIC) . Le nɔnɔme sia me la, ʋu ate ŋu adze dodo gɔme tso ka alo mɔ̃ siwo le wò ŋutigbalẽ me la me.

4. Lãmetsiŋusẽ ƒe dɔwɔwɔ (ahɔhɔ̃) .

Míaƒe ahɔhɔ̃ nye ŋutinu vevi aɖe si kpɔa nuɖoanyi ɖesiaɖe si le ŋutilãa me dzi. Ne ahɔhɔ̃a ƒe akpa aɖe alo wo katã dzudzɔ dɔwɔwɔ le ahɔhɔ̃a alo titina lãmekawo ƒe akpa bubuwo (siwo dome aklã kple eƒe lãmeka siwo do ƒome kplii hã le) ƒe gbegblẽ ta la, míeyɔnae be `ahɔhɔ̃mekawo ƒe dɔmawɔmawɔ nyuie`. Le MODS me la, dɔdzẽ, ʋu ƒe sisi le ʋu ƒe dɔwɔwɔ ƒe kuxiwo ta, kple ʋu ƒe sisi ate ŋu aɖe ʋu si sina yia ahɔhɔ̃a me dzi akpɔtɔ. Esia ateŋu agblẽ nu le ahɔhɔ̃a ŋu eye wòana ame natɔtɔ (`delirium`) .

5. Ayikuwo ƒe dɔwɔwɔ (ayikuwo) .

Ayiku ƒe dɔmawɔmawɔ nyuie nye ne ayikuawo mete ŋu wɔa woƒe dɔ aɖewo alo wo katã o, siwo dometɔ aɖewoe nye gbeɖuɖɔwo ɖeɖe le ʋua me. Ayikuwo ɖea míaƒe ʋu, wɔa aɖuɖɔ, eye wòɖea tsi siwo mehiã o ɖa le ŋutilãa me. Le MODS me la, woate ŋu agblẽ nu le ɖoɖo sia ŋu.

6. Aklã ƒe dɔwɔwɔ (aklã) .

Aklã ƒe dɔmawɔmawɔ nyuie nye ne aklã mete ŋu wɔa eƒe dɔ gbogboawo dometɔ aɖewo alo wo katã o, abe aɖiwo ɖeɖeɖa le ʋua me, ʋumenugbagbevi dzĩ xoxowo ɖeɖeɖa, kple ʋumenugbagbevi dzĩ (si nye acid ɣi/amagbe si kpena ɖe nuɖuɖu ŋu wòɖua) wɔwɔ ene. Dzoxɔxɔ kple ʋu ƒe sisi yi aklãa me dzi ɖeɖe kpɔtɔ ate ŋu ana aklãa nawɔ dɔ nyuie. Esia ate ŋu ana ŋutigbalẽa kple/alo ŋkuwo nazu ɣie (jaundice). Aklã ƒe dɔmawɔmawɔ nyuie ate ŋu ana ŋutinu bubuwo hã nawɔ dɔ.

Aleke gbegbee MODS bɔe?

MODS nye nɔnɔme si bɔ si wokpɔna le dɔléle sesẽ siwo nu sẽ me. Numekukuwo ɖee fia be dɔnɔ siwo le dɔnɔdzikpɔƒewo ƒe 28% va ɖo 88% ate ŋu axɔ MODS. Enye nusi koŋ gbɔ ku tsona le amekoko ƒe dɔnɔdzikpɔƒewo (ICU) hã.

Nukae nye MODS ƒe dzesi gbãtɔwo?

Esi wònye be MODS ate ŋu akpɔ ŋusẽ ɖe ŋutilã ƒe ŋutinu ɖesiaɖe dzi ta la, dzesiawo nɔ te ɖe ŋutinu si ŋu wògblẽ nu le dzi. Dzesi siawo ate ŋu anɔ bɔbɔe le dɔléle si hea MODS vɛ ƒe gɔmedzedze, alo woate ŋu asẽ . Ne MODS le ŋgɔ yim tso dɔléle sesẽ aɖe me la, àte ŋu akpɔ:

• Aɖuɖɔtoe kple ʋuʋudedi
• Nudzroame
• Sese le eɖokui me be yegbɔdzɔ alo ɖeɖi te ye ŋu vevie
• Asrã
• Fafa na wò
• Tɔtɔ alo susu ƒe dɔwɔwɔ sesẽ
• Gbɔgbɔ kabakaba, si me goglo o
• Dzi ƒe tsotso kabakaba alo esi mewɔ ɖeka o
• Akɔta kple/alo dɔgbo ƒe vevesese ɣeyiɣi didi
• Ƒodo ƒe ʋuʋu
• Abɔ kple afɔwo ƒe vuvu
• Ŋutilã alo ŋku ƒe ɣie (jaundice) .
• Ŋutilã, nuyi, aɖe, aɖu, asibidɛ, alo ŋku ƒe amadede ƒe tɔtrɔ blɔ alo ɣi/ɣi (cyanosis) .
• Ame ƒe susu ƒe dɔwɔwɔ

Nukae hea MODS vɛ?

MODS ate ŋu atso dɔléle gã ɖesiaɖe, abixɔxɔ, alo dɔlékuiwo gbɔ. Ðɔktawo kple numekulawo menya nusi tututu gbɔ MODS tsona haɖe o. Gake numekuku siwo wowɔ fifia ɖee fia be zi geɖe la, dɔdzẽ kple ʋu ƒe agbɔsɔsɔ si dzi ɖe kpɔtɔ gbɔe MODS tsona. Menye atikewɔwɔ me nɔnɔme ɖeka aɖe si gbɔ wòtso gbɔe MODS tsona o. Edzɔna tso nudzɔdzɔ siwo kplɔ wo nɔewo ɖo siwo gblẽa nu le ŋutilãa ƒe ŋutinu geɖe alo wo katã ŋu me. Ʋu kple oxygen ƒe agbɔsɔsɔ si dzi ɖe kpɔtɔ ate ŋu agblẽ nu le ame ŋu.

Bu eŋu kpɔ, le dɔléle sesẽ aɖe me la, nudzɔdzɔ geɖe ate ŋu adzɔ siwo ana woaxɔ MODS.

1. Nudzɔdzɔ vevitɔ: Esiae nye nusi gbɔ wòtso gbã. Le kpɔɖeŋu me, dɔlékui sesẽ aɖe (sepsis), afɔku gã aɖe (abe ʋufɔku ene), alo dzidɔ sesẽ aɖe.

2. Nudzɔdzɔ evelia: Esiae nye ne wò dɔlélenutsiŋutete wɔa nu wògbɔa eme, si nana ame ƒe ŋutilã katã xɔa abi vevie.

3. Nudzɔdzɔ etɔ̃lia: Ne dɔlékui yeye aɖe dze dziwò, alo wòhiã be woawɔ dɔ na wò atsɔ ada dɔléle aɖe si nɔ ŋuwò gbã la, ema ate ŋu anye nudzɔdzɔ etɔ̃lia.

Nusiwo gbɔ MODS tsona zi geɖe dometɔ aɖewoe nye:

• Sepsis alo septic shock: Esia ate ŋu anye dɔdzẽ sesẽ si tso dɔlékui alo dɔlékui ƒe dɔléle sesẽ aɖe gbɔ.
• Nuveviwɔame si gblẽa nu le ame ŋu: Nuwo abe ʋufɔku, dzobibi vevie, akplɔdada, alo tudada ene.
• Dɔdzẽ: Dɔdzẽ si le dɔgboa me. Esia ate ŋu atso aɖuɖɔtoemekpewo, ahanono fũu akpa, atike aɖewo, kple nu bubuwo gbɔ.
• Dzidɔ gã: Ʋuka si naa ʋu yia dzia me ƒe xexe gbɔe wòtsona.
• Aklã ƒe dɔmawɔmawɔ nyuie: Esia ate ŋu atso Aklãdɔléle B, Aklãdɔléle C, aklãdɔ si me ami le, ahanono fũu akpa, kple aklãdɔléle gbɔ.
• Aɖi ƒe abixɔxɔ kple aɖi:Aɖinuwo ƒe amedzidzedze gbɔe wòtsona. Le kpɔɖeŋu me, atike vɔ̃ɖi alo aha sesẽ zazã kpata alo atraɖii, atike siwo me aɖi le abe nudzodzoeviwutikewo kple nu xoxo siwo wotsɔ xea mɔ na dzoxɔxɔ (asbestos), kple dɔlékuiwo ƒe dɔlékuiwo.

Nɔnɔme siawo hea tɔtrɔ gãwo vaa wò dɔlélenutsiŋutete kple ʋu ƒe dɔwɔwɔ me, si gblẽa nu le ŋutinu bubuwo hã ŋu.

Ŋutinu kae do kpo nu gbãtɔ le MODS me?

Almost everyone with MODS experiences lung problems first , gake ɖɔktawo kple numekulawo mese nusita lãkusi ƒe dɔmawɔmawɔ nyuie dzɔna zi geɖe do ŋgɔ na MODS gɔme nyuie haɖe o.

Ameka dzie MODS gblẽa nu le wu?

Amesiame ate ŋu axɔ MODS, gake anɔ eme be àxɔ MODS ne dɔléle aɖe si le ŋuwò, abe dɔléle si nɔa anyi didi alo dɔlélenutsiŋutete ƒe gbɔdzɔgbɔdzɔ ene, le ŋuwò.

Aleke woawɔ ade dzesi MODS?

Ðɔktawo zãa dodokpɔ vovovowo tsɔ dea dzesi ŋutinuwo ƒe dɔmawɔmawɔ nyuie le wò ŋutilã katã me. Esiawo ate ŋu anye:

• Ʋudodokpɔwo
• Ʋukawo me ʋu ƒe gas dodokpɔ
• Aklã ƒe dɔwɔwɔ dodokpɔwo
• Ayikuwo ƒe dɔwɔwɔ dodokpɔwo
• Ʋu kple lãmenugbagbeviwo ƒe dekɔnuwo
• Echocardiogram (dzi ƒe ultrasound) .
• Nɔnɔmetatawo dodokpɔ abe ultrasound alo CT scan ene

Aleke wowɔa atike na MODS?

MODS dada nɔ te ɖe nusi gbɔ wòtso kple ŋutinu siwo ŋu wògblẽ nu le dzi. Atikewɔwɔ ƒe tiatia aɖewoe nye:

• Da ʋu ƒe agbɔsɔsɔ si mede ame dzi o to tsi siwo wodona ɖe ʋuka me (IV) nana me .
• Vasopressor atikewo nana be ʋu ƒe sisi to ʋukawo kple lãmenugbagbeviwo me nadzi ɖe edzi (tissue perfusion).
• Na dɔlékuiwutikewo nàtsɔ ada dɔlékuiwo kple/alo dɔlékuiwutikewo.
• Ʋudodo be woatsɔ aɖɔli ʋu si bu le abi alo amekoko ta.
• Oxygen zazã be woana oxygen geɖe ŋutilãa.
• Ne màte ŋu agbɔ ya le ɖokuiwò si o la, ɖewohĩ ahiã be nàzã mɔ̃ si ana nàgbɔ ya.
• Dialysis be wòakpe ɖe ŋuwò nàɖe gbeɖuɖɔwo kple tsi si sɔ gbɔ ɖe wò ŋutilã me ɖa.
• Extracorporeal membrane oxygenation (ECMO) si wotsɔ dea oxygen ʋua me eye wòɖea ya si woyɔna be carbon dioxide ɖa.
• Molecular absorbent recirculating system (MARS) si wotsɔ doa alɔ aklãa.
• Amekoko na dɔnɔ siwo xɔ abi vevie.
• Amekoko si wowɔna tsɔ doa ŋutinuwo na ame nye ŋutinu si le dɔ lém alo esi mewɔa dɔ nyuie o la ɖɔliɖɔli kple ŋutinu si le lãmesẽ me tso ame si tsɔe na ame gbɔ.
• Ne ʋu le dodom le dɔgboa me (GI) alo dɔgbo ƒe nɔnɔme aɖe si xea mɔ na wò be màɖu nu o, alo ne mète ŋu ɖua nu le ŋutilã me o la, ahiã be nàxɔ nunyiamewo to IV (to ʋuka me) alo dɔgbo me nunyiame (nunyiame si wodona le dɔgboa me) dzi.

Aleke gbegbee nye lãme asẽ kaba le atikewɔwɔ vɔ megbe?

Wò hayahaya anɔ te ɖe nusi gbɔ wòtso kple atikewɔwɔ dzi. Ðɔkta ate ŋu ana nàkpɔ ɣeyiɣi si me nàte ŋu akpɔ mɔ be yeakpɔ ŋgɔyiyi le atikewɔwɔ vɔ megbe la nyuie wu.

Nukae nye MODS ƒe etsɔme?

MODS ƒe etsɔme nɔ te ɖe nusi gbɔ wòtso dzi. Ɣeaɖewoɣi la, wò sidzenuwo dometɔ aɖewo alo wo katã ate ŋu atrɔ ava nɔ abe alesi wònɔ tsã ene, gake àte ŋu ahiã ɣeyiɣi kpui aɖe ƒe agbetsitsi vaseɖe esime nàhaya.

MODS kple nusi gbɔ wòtso ƒe dzesidede kaba kple edada le vevie ŋutɔ be woakpɔ nɔnɔme sia gbɔ dzidzedzetɔe.

MODS ƒe ŋgɔdonya toa vovo le dɔnɔdzikpɔƒe siwo wokpɔa dɔnɔwo gbɔ vevie (ICU) me. Ðɔktawo bua nɔnɔme sia be enye nusi hea ku vɛ enuenu le dɔnɔ siwo woxɔ ɖe amekoko ƒe dɔnɔdzikpɔƒewo.

Ne dɔlélea yi edzi va ɖo afisi wòsẽ ŋutɔ la, ŋutinuwo ate ŋu agblẽ tegbee. Ðewohĩ ahiã be woado wò agbe ɣeyiɣi didi alo woado ŋutinuwo na wò. Ate ŋu awu ame hã.

Numekuku geɖe hiã be woatsɔ ade dzesi nusiwo ate ŋu ana dɔnɔwo nate ŋu akpɔ ŋusẽ ɖe MODS dzi, si ate ŋu ana dɔnɔwo nakpɔ etsɔme nyui aɖe.

Nukae nye agbetsitsi ƒe agbɔsɔsɔme tso MODS me?

Ðɔktawo kple numekulawo bu akɔnta be amesiwo tsi agbe le MODS ta le 50% va ɖo 60% dome .

Ðe woate ŋu axe mɔ ɖe MODS nua?

Womate ŋu axe mɔ ɖe nusiwo hea MODS vɛ dometɔ aɖewo nu o. Eye fifia la, atike aɖeke meli koŋ si ate ŋu akpe ɖe ame ŋu wòaxe mɔ ɖe MODS nu o. Numekulawo le mɔ siwo dzi woato ada MODS le eƒe gɔmedzedze be woaxe mɔ ɖe dɔlélea nu be wòagagblẽ ɖe edzi o la dim. Wole numekuku geɖe wɔm fifia le go sia me.

Àte ŋu akpe asi ɖe wò ŋutinuwo takpɔkpɔ ŋu to nuwo abe:

• Takpɔ wò ŋutinuwo ta tso ʋuʋudedi me to zikpuimeka dodo ne èle ʋu me kple ametakpɔnu ne èle kamedefefe siwo gblẽa nu le ame ŋu vevie wɔm.
• Do atike na wò be nàxe mɔ ɖe dɔlékui sesẽwo xɔxɔ nu ne ɖɔktawo kafui.
• Ðe atike siwo womeŋlɔ na wò o, abe nonsteroidal anti-inflammatory drugs (NSAIDs) ene, siwo ate ŋu agblẽ nu le ayiku ŋu dzi kpɔtɔ alo nàdzudzɔ nono.
• Ðe atikewo alo nu bubu siwo ate ŋu ana dɔgboa naxɔ abi, abe NSAID, atamanono, kple aha sesẽ ene dzi kpɔtɔ alo nàdzudzɔ nono .
• Di atike na ʋusɔgbɔdɔ (ʋusɔgbɔdɔ) .

Ne èle kɔdzi kple dɔléle sesẽ aɖe la, wò ɖɔktawo ate ŋu awɔ nu siawo tɔgbe be MODS nagagblẽ o:

• Mɔ̃ɖaŋununya ƒe yaƒoƒo ƒe nugbegblẽ le wò lãkusiwo ŋu dzi ɖeɖe kpɔtɔ.
• Ðe seɖoƒe na ʋudodo vaseɖe esime wòahiã vevie.
• Ʋumenugbagbeviɣitikewo zazã ne ehiã be woaxe mɔ ɖe ʋu ƒe sisi nu.

Ɣekaɣie wòle be makpɔ ɖɔkta?

Ne dɔléle aɖe si nɔa anyi didi le ŋuwò eye nèle MODS ƒe dzesiwo kpɔm, si ate ŋu ana nàdze dɔ sesẽ eye ŋutinuwo nawɔ dɔ nyuie la, anyo ɣesiaɣi be nàyi ɖɔkta gbɔ. Woate ŋu agblɔ dzesi alo dzesi tɔxɛ siwo ŋu nàlé ŋku ɖo kple alesi nàwɔ akpɔ nɔnɔme ɖesiaɖe gbɔe na wò.

Ɣekaɣie wòle be mayi Dɔwɔƒe si Kpɔa Nudzɔdzɔ Kpatawo Gbɔ (ETU) ?

Ne MODS ƒe dzesiwo le ŋuwò la, yi xɔ si te ɖe ŋuwò si kpɔa nudzɔdzɔ kpatawo gbɔ alo ƒo ka na 911. Esia ate ŋu awu ame ne mèwɔ atike nɛ kaba o.

Nya kawoe wòle be mabia ɖɔkta?

Nya aɖewo siwo nàte ŋu abia wò ɖɔktae nye esi:

• Nukae hea MODS vɛ?
• Atikewɔwɔmɔnu kawoe le asinye?
• Atike kawoe nèkafu?
• Taɖodzinu kawoe le nye belélename ŋu?
• Zi nenie wòhiã be woawɔ atike nam?

Kpuie kple gbedasi mamlɛtɔ

Enyo, eyata fifia ènya be ŋutinu geɖe ƒe dɔmawɔmawɔ nyuie ƒe dɔléle (MODS) nye dɔléle sesẽ aɖe si gblẽa nu le ŋutinu eve alo esi wu nenema ƒe ɖoɖo siwo le wò ŋutilã me ŋu. Togbɔ be MODS ate ŋu akpɔ ŋusẽ ɖe ŋutinu ɖesiaɖe dzi hã la, zi geɖe la, egblẽa nu le lãkusi, dzi, ayiku, aklã, ahɔhɔ̃, kple ʋu ŋu. Nu geɖe li siwo ate ŋu ahe esia vɛ. Wo dometɔ siwo bɔ wue nye nuveviwɔame sesẽwo, dɔléle sesẽwo, kple dɔlékui siwo kaka ɖe teƒe geɖe. Dɔdamɔnua ku ɖe dɔléle si gbɔ wòtso la dada ŋu esime wole mɔ xem ɖe ŋutinu bubuwo ƒe dɔwɔwɔ ƒe gbegblẽ geɖe wu nu.

Enye nusi sɔ be vɔvɔ̃ naɖo wò ne èse be wò alo wò lɔlɔ̃tɔ aɖe ƒe ŋutinuwo mele dɔ wɔm o. Gake wona hehe ɖɔktawo kple dɔwɔla siwo le Atikewɔwɔ Kpata ƒe Dɔwɔƒe (ETU) kple Dɔnɔdzikpɔƒe si Kpɔa Dɔléle Sesẽwo Gbɔ (ICU) be woado alɔ wò ŋutinuwo katã, axe mɔ ɖe nu bubu siwo agblẽ nu, eye woakpe ɖe wò ŋutilã ŋu wòahaya. Eyata mègana mɔkpɔkpɔ o. Ne wowɔ atike na wò kaba eye nèɖo aɖaŋu na wò nyuie le atikewɔlawo me la, àte ŋu adze agbagba ado le nɔnɔme sia me.

` Ŋutinu geɖe ƒe dɔmawɔmawɔ nyuie, MODS, ŋutinuwo ƒe dɔmawɔmawɔ nyuie, dɔlékuiwutikewo ƒe dɔmawɔmawɔ nyuie, beléle na dɔnɔwo vevie, ŋutinuwo ƒe dɔmawɔmawɔ nyuie, agbetsitsi