Ðe wò hã èle sesem le ɖokuiwò me be yegbɔdzɔa? Ðewohĩ esia nye nɔnɔme aɖe si woyɔna be myopathy!

Ðe nèsena le ɖokuiwò me ɣeaɖewoɣi be yeƒe abɔwo kple afɔwo gbɔdzɔ eye ɖeɖi te ye ŋua? Ðe wòsesẽna na wò be nàwɔ nu tsɛwo gɔ̃ hã abe fɔfɔ tso zikpui dzi, kɔ nu kpekpe aɖe, alo wò ɖa ƒoƒo enea? Ne èse le ɖokuiwò me be yeƒe lãmekawo le gbɔdzɔgbɔdzɔm le susu aɖeke ta la, mègabu eŋu ko be enye nusi sɔ o. Ðewohĩ nusi gbɔ dzesi siawo tsonae nye nɔnɔme aɖe si woyɔna be ‘myopathy’, si ŋu míele nu ƒom tsoe egbea. Mègatsi dzi o, míaƒo nu tso esia ŋu le mɔ bɔbɔe aɖe si gɔme nàte ŋu ase nu.

Nukae nye myopathy? Kpuie ko la,...

Myopathy, ne míagblɔe kpuie la, enye dɔlélewo ƒe ƒuƒoƒo aɖe si gblẽa nu le lãmeka siwo lé ɖe míaƒe ƒuwo ŋu. Dɔléle siawo gblẽa nu le míaƒe lãmekawo ŋu eye wogbɔdzɔna. Abe alesi ʋu ƒe mɔ̃ va gbɔdzɔna ene la, ʋukuku va sesẽna, ne lãmekawo gbɔdzɔ la, eva sesẽna na míaƒe ŋutilã be wòawɔ gbesiagbedɔwo.

Ðe lãmekawo ƒe dɔléle ƒomevi vovovowo lia?

Ẽ, woate ŋu ade lãmekawo ƒe dɔlélewo hatsotso vovovowo me. Woma wo ɖe hatsotso eve me koŋ: lãmekawo ƒe dɔléle siwo ƒe dome wonyi kple esiwo woxɔ . Mina míalé ŋku ɖe ƒomevi siawo dometɔ ɖesiaɖe ŋu.

Nukae Nye Domenyinyi ƒe Myopathies?

Esiawo nye lãmekawo ƒe dɔléle ƒomevi siwo tsoa domenyiŋusẽfianu ƒe tɔtrɔ si mesɔ o si nɔa míaƒe ŋutilã me le mía dziɣi, si zi geɖe tso mía dada alo mía fofo gbɔ, ƒe domenyinyi gbɔ.

• Lãmetsiŋusẽ ƒe dɔléle siwo wodzina:

Zi geɖe la, dzesiawo dzea egɔme tso vidzidzi alo ɖevime. Ke hã, woate ŋu adze ɣeaɖewoɣi le sɔhɛmenɔɣi alo emegbe gɔ̃ hã. Nusi ɖe dzesi le esia ƒomevi ŋue nye be menye lãmeka siwo te ɖe ŋutilã ƒe titina ŋu koe gbɔdzɔgbɔdzɔa tsona o, ke boŋ ate ŋu agblẽ nu le ŋutilã bliboa ƒe lãmekawo ŋu, eye zi geɖe la, dɔlélea menɔa ŋgɔ yim o.

• Mitochondrial ƒe lãmekawo ƒe dɔléle:

Dɔwɔƒe sue siwo woyɔna be mitochondria siwo wɔa ŋusẽ le míaƒe lãmenugbagbeviwo si. Mitochondria siawo ƒe gbegblẽ gbɔe lãmekawo ƒe dɔléle sia ƒomevi tsona. Tsɔ kpe ɖe lãmekawo ƒe gbɔdzɔgbɔdzɔ ŋu la, nɔnɔme siawo ate ŋu akpɔ ŋusẽ ɖe ŋutinu bubuwo hã dzi, abe dzi, ahɔhɔ̃, kple dɔgbo ƒe dɔwɔwɔ ene. Woate ŋu adze egɔme le domenyiŋusẽfianu ƒe tɔtrɔ ta, eɖanye ƒome ŋutinya aɖe li alo meli o.

• Lãmetsiŋusẽ ƒe lãmekawo ƒe dɔléle:

Domenyiŋusẽfianu siwo wɔa enzyme siwo kpena ɖe lãmekawo ŋu wòwɔa dɔ heʋãna nyuie ƒe gbɔdzɔgbɔdzɔwo gbɔe lãmekawo ƒe dɔléle sia tsona. Ate ŋu ana ɖeɖi nate ame ŋu le kamedede me, abɔta kple ata nase veve ne ele kame dem, alo nɔnɔme aɖe si woyɔna be rhabdomyolysis, si me lãmekawo gbãna abi aɖeke manɔmee. Ɣeaɖewoɣi la, dzesiawo ate ŋu ava eye woadzo, eye lãmekawo nagbɔdzɔ eye emegbe woagatrɔ ava nɔ nɔnɔme si sɔ me.

• Lãmetsiwo ƒe dɔmawɔmawɔ nyuie:

Le nɔnɔme siawo me la, lãmekaawo gbɔdzɔna vivivi eye woƒe lãme vuvu le esi lãmekawo ƒe lãmenugbagbeviwo hiã na xɔtuɖoɖo ƒe kpeɖeŋutɔ protein siwo mesɔ o alo woƒe anyimanɔmanɔ ta. Le go ɖesiaɖe me la, egblẽa nu le abɔwo kple/alo afɔwo ŋu le agbɔsɔsɔ vovovowo me. Ɣeaɖewoɣi la, ate ŋu agblẽ nu le ŋku alo mo ƒe lãmekawo hã ŋu.

Nukae nye lãmekawo ƒe dɔléle siwo woxɔ?

Esiawo nye lãmekawo ƒe dɔléle ƒomevi siwo doa mo ɖa le eƒe tsitsime. Nu vovovowo ate ŋu atso wo gbɔ, siwo dometɔ aɖewoe nye dɔléle bubuwo, dɔlékuiwo, atike aɖewo zazã, kple elektrikŋusẽ ƒe masɔmasɔ le ŋutilãa me.

• Dɔlélenutsiŋutete/dɔlékui ƒe lãmekawo ƒe dɔléle:

Nusi dzɔna le esia mee nye be míaƒe ŋutilã ŋutɔ ƒe dɔlélenutsiŋutete dzea mía ŋutɔwo ƒe lãmekawo dzi. Esia wɔnɛ be lãmekawo megawɔa dɔ nyuie o. Ele abe mía ŋutɔwo ƒe ametakpɔnuwo le wo ɖokui dzi dzem ene.

• Aɖi ƒe lãmekawo ƒe dɔléle:

Nɔnɔme sia dzɔna ne aɖi alo atike aɖe gblẽ nu le lãmekawo ƒe wɔwɔme alo dɔwɔwɔ ŋu.

• Aɖinuwo: Aha sesẽ, toluene (nusi me dzoxɔxɔ le si le nuwo abe amadede ene me si ame aɖewo gbɔa be woƒe lãme nasẽ).
• Atikewo: Dzesi siwo xea mɔ na dɔlélenutsiŋutete (e.g., pembrolizumab, nivolumab), corticosteroids (e.g., prednisone), atike siwo ɖea ʋumemi dzi kpɔtɔna (statins), amiodarone, colchicine, chloroquine, dɔlékuiwutikewo kple protease mɔxenu siwo xea mɔ na HIV dɔlékui, omeprazole.

• Dɔlékuiwutikewo ƒe lãmekawo ƒe dɔléle:

Nɔnɔme sia dzɔna ne lãmetsi siwo le míaƒe ŋutilã me ƒe dɔwɔwɔ gblẽ nu le lãmekawo ŋu.

• Thyroid gland: Togbɔ be thyroid hormone ƒe agbɔsɔsɔ si bɔbɔ (hypothyroidism) bɔ wu hã la, kuxiwo ate ŋu ado mo ɖa hã le thyroid hormone ƒe agbɔsɔsɔ si sɔ gbɔ (hyperthyroidism) ta.
• Parathyroid gland: Hyperparathyroidism nana calcium ƒe agbɔsɔsɔ dzina ɖe ʋua me.
• Adrenal gland: `Addison ƒe dɔléle` kple `Cushing ƒe dɔléle`.

• Lãmetsiŋusẽ ƒe dɔléle siwo xɔa ame:

Dɔlékui vovovowo ate ŋu agblẽ nu le lãmekawo ƒe dɔwɔwɔ ŋu.

• Dɔlékuiwo ƒe dɔlélewo: `HIV`, `dzamezã`, `Epstein-Barr`.
• Dɔlékui ƒe dɔlélewo: `dɔlékui ƒe pyomyositis`.
• `Lyme dɔléle`.
• Dɔlékui siwo tsoa dɔlékuiwo gbɔ: `trichinosis`, `toxoplasmosis`, `cysticercosis`.
• Fungi ƒe dɔlékuiwo: Candida, Coccidiomycosis.

• Elektrikŋusẽ ƒe masɔmasɔ:

Elektrikŋusẽ vevi aɖewo ƒe agbɔsɔsɔ si le míaƒe ŋutilã me ƒe dzidziɖedzi alo ɖiɖi ate ŋu akpɔ ŋusẽ ɖe lãmekawo ƒe dɔwɔwɔ dzi.

• Potassium: dzi ɖe kpɔtɔ (`hypokalemia`), dzi ɖe edzi (`hyperkalemia`).
• Magnesium: Dzidzi ɖe edzi (`Hypermagnesemia`).

• Dɔléle sesẽwo ƒe myopathy le dɔnɔdzikpɔƒe si wokpɔa dɔnɔwo gbɔ vevie:

Esia nye nɔnɔme si gblẽa nu le ame siwo le dɔ lém vevie eye wole atike wɔm na le dɔnɔdzikpɔƒe si wokpɔa dɔnɔwo gbɔ le vevie (ICU) ƒe abɔwo kple gbɔgbɔtsixe ƒe lãmekawo ŋu . Ate ŋu atso lãmekawo ƒe ɖiɖiɖeme, corticosteroids, kple alɔ̃dɔdɔtike siwo wozãna le atikewɔwɔ me zazã gbɔ ɣeyiɣi didi aɖe.

Amekae ate ŋu axɔ lãmekawo ƒe dɔléle wu? Aleke gbegbee nɔnɔme sia bɔe?

Myopathy ate ŋu adze ame sia ame dzi ŋutɔŋutɔ, gake ame aɖewo ya le afɔku me vie.

Nusiwo ate ŋu ana afɔkua nadzi ɖe edzi:

• Ne lãmekawo ƒe dɔléle le ƒomea me la, ekema mɔnukpɔkpɔ gã aɖe li be wòanyi dɔléle sia ƒe dome le domenyiŋusẽfianu me.
• Ŋutsu nyenye. Mɔ̃memi ƒe dɔléle ƒomevi aɖewo toa X domenyiŋusẽfianu dzi, eyata ate ŋu adze ŋutsuwo dzi wu nyɔnuwo. Gake lãmekawo ƒe dɔléle ƒomevi siwo wodzina siwo toa domenyiŋusẽfianu bubuwo dzi la kpɔa ŋusẽ ɖe amesiame dzi sɔsɔe.
• Dɔléle si tsoa dɔlélenutsiŋutete, lãmenugbagbeviwo ƒe dɔwɔwɔ, alo lãmenugbagbeviwo ƒe dɔwɔwɔ gbɔ ƒe amesinɔnɔ.
• Atike alo aɖi aɖewo zazã (kpɔ akpa si ku ɖe aɖi ƒe lãkusidɔ si ŋu míeƒo nu tsoe va yi ŋu).

Alesi lãmekawo ƒe dɔléle bɔe la toa vovo le eƒe ƒomevi nu. Le kpɔɖeŋu me, lãmekawo ƒe dɔléle si doa mo ɖa le eƒe tsitsime:

• Dɔdzẽ kple lãmenugbagbeviwo ƒe dɔlélewo bɔ wu ƒomevi bubuwo, eye wobɔ ɖe nyɔnuwo me wu ŋutsuwo.
• Ame 9 va ɖo 32 le ame 100,000 ɖesiaɖe dome la, lãmekawo ƒe dɔléle si nana ame ƒe lãme gblẽna.
• Ame tsitsi siwo ŋu ʋumenugbagbeviɣidɔ le ƒe 25% va ɖo 79% ate ŋu axɔ dzesi siwo do ƒome kple lãmekawo, gake lãmekawo ƒe dɔléle si dzena gaglãa ƒe dzɔdzɔ ate ŋu anɔ ʋɛ abe 10% ene.

Lãmetsiŋusẽ ƒe dɔléle siwo wodzina wue nye lãmekawo ƒe dɔmawɔmawɔ nyuie, si zi geɖe bɔ ɖe ŋutsuwo me wu.

• Duchenne kple Becker ƒe lãmekawo ƒe dɔmawɔmawɔ nyuie ye nye esiwo bɔ wu, eye wòdzea ame abe 7 le ame 100,000 ɖesiaɖe me le xexeame katã.
• Mitochondrial dɔlélewo dzea ame ɖeka le ame 5,000 ɖesiaɖe me dzi, eye esiawo dometɔ akpa gãtɔ gblẽa nu le ƒunukpeƒeŋusẽ ŋu.
• Lãmetsiŋusẽ ƒe dɔléle ƒomevi bubuwo mebɔ kura o.

Eyata nukawoe nye lãmekawo ƒe dɔléle ƒe dzesiwo?

Dzesi geɖe siwo bɔ ɖe lãmekawo ƒe dɔléle ƒomevi geɖe ŋu. Esiawoe nye:

• Lãmetsiwo ƒe gbɔdzɔgbɔdzɔ.Vevietɔ abɔta, abɔta, kple ata ƒe lãmekawo (esiawoe nye esiwo ŋu wògblẽa nu le wu eye wòsẽna wu).
• Lãmetsiwo ƒe ʋuʋu, woƒe sesẽ, kple woƒe ʋuʋu.
• Ðeɖiteameŋu ƒe seselelãme kabakaba ne èle kame dem alo le dɔ sue aɖe gɔ̃ hã wɔm.
• Sese le eɖokui me be agbe mele ye si o eye ŋusẽ mele ye ŋu o.

Aleke lãmekawo ƒe dɔléle sena le eɖokui me ŋutɔŋutɔ?

Le lãmeka siwo me ʋu sina tona ƒe dɔléle geɖe me la, lãmeka siwo le ŋutilã ƒe akpa eveawo (si sɔ kple wo nɔewo) gbɔdzɔna sɔsɔe. Lãmetsi siwo te ɖe ŋutilãa titina (lãmeka siwo te ɖe ame ŋu), abe abɔta, abɔta, akɔta, kple ata ene koŋue wògblẽa nu le. Esia awɔe be àte ŋu akpɔ dzesiwo abe:

• Gbesiagbedɔwo wɔwɔ sesẽ, abe tsilele, awudodo, kple ɖaƒoƒo ene.
• Esesẽna be nàfɔ tso zikpui dzi, atrakpuiwo lialia, alo awɔ dɔ siwo abia be nàdo asi ɖe wò ta dzi (e.g., akaɖi si le dzisasrãa dzi tɔtrɔ).
• Sese le eɖokui me abe lãmekawo le ʋuʋum hele ʋuʋum ene.
• Ðeɖi tea lãmekawo ŋu kabakaba ne wole dɔ aɖe wɔm.
• Yagbɔgbɔ sesẽ le kamedede me.

Zi geɖe la, mekpɔa ŋusẽ ɖe asibidɛwo kple afɔkpodzi ƒe lãmekawo dzi o.

Dzesi bubuwo toa vovo le lãmekawo ƒe dɔléle ƒomevi nu.

• Lãmetsiwo ƒe gbɔdzɔgbɔdzɔ ate ŋu anɔ anyi ɖaa (mawɔ ŋgɔyiyi o) alo anɔ ŋgɔ yim vivivi. Le dɔléle aɖewo me la, lãmekawo ƒe gbɔdzɔgbɔdzɔ ate ŋu ava hedzona, evɔ le ɣeyiɣi bubuwo me la, ŋusẽ si sɔ ate ŋu anɔ anyi.
• Lãmetsiwo ƒe dɔwɔwɔ ƒe ŋutetewo ƒe tsitsi megbetsitsi (e.g. azɔlizɔzɔ, titri, atrakpuiwo lialia, gaku alo pɛnsil léle ɖe asi) le ɖevi suewo me.
• Ŋutete manɔanyi be woawɔ ɖeka kple ɖevi bubuwo ne wole kamedefefe wɔm alo le fefem le gota (e.g., wole catch ƒom).
• Kuxi siwo le lãmeka siwo kpena ɖe ame ŋu le nu mimi kple nuƒoƒo me ŋu. Esia ate ŋu ana nuɖuɖu natsi eye nuƒoƒo naƒo ɖi.

Nukae wòle be mawɔ ne mesusu be ŋkudɔ le ŋunye?

Ne dzesi siawo le ŋuwò la, ele be nàƒo nu kple wò ɖɔkta si kpɔa dɔnɔwo gbɔ gbã. Le wò dzesiwo nu la, ate ŋu aɖo wò ɖe dɔdala bibi aɖe, abe ahɔhɔ̃ŋutinunyala alo lãmekaŋutinunyala ene.

Aleke wokpɔa lãmekawo ƒe dɔléle?

Wò ɖɔkta abia nya wò tso wò atikewɔwɔ ŋutinya ŋu, nenye be dɔléle sia tɔgbe nɔ wò ƒomea me tɔ aɖe ŋu, atike siwo nènona, kple wò dzesiwo hã. Emegbe woawɔ ŋutilãmedɔdada. Woalé ŋku ɖe wò ŋutigbalẽ, wò ŋutigbalẽ ƒe dɔwɔwɔ, lãmekawo ƒe ŋusẽ, dadasɔ, kple seselelãme ŋu.

Dodokpɔ ƒomevi siwo ɖɔkta ate ŋu adɔ:

• Ʋudodokpɔ:
• Le lãmekawo ƒe dɔléle aɖewo me la, lãmekawo me enzymewo abe creatine kinase (CK) alo aldolase ƒe agbɔsɔsɔ ate ŋu adzi ɖe edzi le lãmekawo ƒe gbagbã ta.
• Elektrikŋusẽ ƒe agbɔsɔsɔ abe sodium, magnesium, potassium, calcium, kple phosphorus ene.
• Dodokpɔwo hena dɔléle siwo dɔlélenutsiŋutete wɔa dɔ le: Le kpɔɖeŋu me, `Antinuclear Antibodies (ANA), `Rheumatoid Factor', `Sedimentation Rate' kple `C-reactive protein'.
• Endocrine gland dodokpɔwo: le kpɔɖeŋu me, thyroid hormone ƒe agbɔsɔsɔ.
• Electromyography (EMG) kple lãmekawo ƒe ʋuʋu ŋuti numekukuwo: Dodokpɔ siawo dzidzea lãmekawo ƒe gbegblẽ ƒomevi kple afisi wòkeke ɖo to alesi elektrikŋusẽ toa lãmekawo me dzidzedze kple aŋe suewo dede lãmekawo me me.
• Magnetic resonance imaging (MRI) dodokpɔ si wowɔna le lãmekawo ŋu .
• Domenyiŋusẽfianu dodokpɔwo.
• Lãmetsiwo ɖeɖe ɖa: Esia bia be woawɔ dɔ na amekoko be woaɖe lãmeka sue aɖe ɖa be woadoe kpɔ.

Aleke wodaa lãmekawo ƒe dɔléle?

Ne wonya de dzesi lãmekawo ƒe dɔléle ƒomevi si tututu le ŋuwò ko la, wò ɖɔkta awɔ atikewɔwɔ ƒe ɖoɖo si sɔ ɖe wò dzesiwo nu.

Atikewɔwɔ akpa gãtɔ dometɔ aɖewoe nye kamedede, dɔwɔwɔ ƒe atikewɔwɔ, kple kamedede ƒomevi aɖe . Atikewɔwɔ bubuwo ku ɖe lãmekawo ƒe dɔléle ƒomevi ŋu koŋ. Le goawo katã me la, woate ŋu akpɔ lãmekawo ƒe dɔléle siwo woxɔ ƒe akpa gãtɔ gbɔ nyuie, si wɔnɛ be gbɔdzɔgbɔdzɔ kple dzesiwo dzi ɖena kpɔtɔna. Atike tɔxɛ aɖewo le lãmekawo ƒe dɔléle siwo wodzina dometɔ aɖewo ŋu siwo ate ŋu ana dɔlélea nayi edzi blewu. Fifia la, atike aɖeke meli koŋ na lãmekawo ƒe dɔléle akpa gãtɔ siwo wodzina o, gake kamedede kple kamedede ƒomevi aɖewo ate ŋu akpe ɖe ame ŋu.

Dzoxɔxɔ kple dɔlélenutsiŋutete ƒe dɔléle siwo do ƒome kple lãmekawo ƒe dɔléle

Taɖodzinu si le nusiawo dada ŋue nye be woaɖe abi kple ŋutilã ƒe dɔlélenutsiŋutete ƒe dɔwɔwɔ dzi akpɔtɔ. Atike siwo bɔ ɖe lãmekawo ƒe dɔléle siawo ŋu dometɔ aɖewoe nye:

• Dɔlélenutsiŋutete ƒe tɔtrɔ/dɔlélenutsiŋutete ƒe atikewo: Le kpɔɖeŋu me, methotrexate, cyclosporine, tacrolimus, azathioprine, mycophenolate, rituximab, kple dɔlélenutsiŋutete si wodona ɖe ʋuka me (IVIg) alo le ŋutigbalẽ te (SubQIg) me.
• `Corticosteroids`: Le kpɔɖeŋu me `prednisone` alo `methylprednisolone`.

Domenyinyi kple domenyiŋusẽfianu ƒe lãmekawo ƒe dɔléle

Atike aɖeke koŋ mele lãmekawo ƒe dɔléle siwo wodzina kple domenyiŋusẽfianu ƒe dɔléle geɖe ŋu alo woda wo keŋkeŋ o.Dzesiwo dzi ɖuɖu kple atikewɔwɔmɔnu vovovowo koŋue wozãna tsɔ kpɔa dɔlélea gbɔe. Wole dɔdamɔnu dodokpɔ geɖe wɔm le numekuku vovovowo me ku ɖe atikewɔwɔ kple domenyiŋusẽfianu ƒe atikewɔwɔ ŋu.

Woate ŋu atsɔ atike aɖewo koŋ ada nɔnɔme siwo woyɔna be Duchenne muscular dystrophy kple Pompe dɔlélea.

Lãmetsiŋusẽ bubu siwo woxɔ

Ðɔktawo daa lãmekawo ƒe dɔléle si tso lãmenugbagbeviwo ƒe dɔwɔwɔ, aɖi, kple dɔlékuiwo gbɔ to dɔléle si gbɔ lãmenugbagbeviwo ƒe dɔlélea tso la dada me. Wodaa aɖi ƒe lãmekawo ƒe dɔléle to atike si doa dziku na ame (e.g., aha, toluene) alo atike (e.g., statins) la nu tsotso me. Zi geɖe la, lãmekawo ƒe dzesi siwo dɔlékuiwo, dɔlékuiwo, alo dɔlékui bubuwo hena vɛ la nyona ɖe edzi ne wotsɔ dɔlékuiwutikewo da dɔa tẽ.

Aleke malé be na nye lãmesẽ?

Eɖanye lãmekawo ƒe dɔléle nye dɔléle si wodzina, si woxɔ, alo dɔléle si nɔa anyi didi (si nɔa anyi didi) o, nanewo li nàte ŋu awɔ be nàlé wò lãmesẽ me ɖe asi ahakpɔ nɔnɔmea gbɔ. Esiawo dometɔ aɖewoe nye:

• Ƒo nuɖuɖu nyui si da sɔ. De atikutsetse kple amagbe vovovo gbogbo aɖewo wò nuɖuɖu me.
• Nɔ dɔ dzi to dzitodzito me kamedede fafɛ me. Le wò lãmekawo ƒe dɔléle ƒomevi nu la, woate ŋu aɖo aɖaŋu na wò be mègawɔ kpekpeme kɔkɔ ƒomevi aɖewo o. Eyata ƒo nu kple wò ɖɔkta hafi nàdze kamedede ƒe ɖoɖo ɖesiaɖe gɔme.
• Lé lolo si sɔ me ɖe asi.
• Ne ŋutigbalẽ ƒe ʋuʋu le ŋuwò si tso dermatomyositis gbɔ la, kpɔ wò ŋutigbalẽ ta tso ŋdɔkutsu dzatsɛ me. Esia ate ŋu ana ʋuʋudedia nagasẽ ɖe edzi. Do ametakpɔwu kple kposɔ ɣesiaɣi si wòanya wɔ. Mègaŋlɔ be be yeazã ɣe ƒe keklẽŋusẽtike si me SPF 30 ya teti le hafi ado go o.
• Ne nu mimi sesẽ na wò la, ɖu nuɖuɖu siwo fa alo esiwo mesẽ o. Àte ŋu awɔ wò nuɖuɖu hã. Ne ènye amesi mlɔ aba dzi la, ɖu nu esime nèbɔbɔ nɔ aba dzi.
• No atike siwo katã woŋlɔ na wò ɖe game dzi.
• Ne wokafu atikewɔwɔwo abe kamedede, dɔwɔɖui, alo nuƒoƒo ƒe atikewɔwɔ ene la, kpɔ gome le wo me.

Ðo ŋku edzi be esi wònye be lãmekawo ƒe dɔléle ƒomevi geɖe li ta la, ahiã be wò ɖɔkta nawɔ atikewɔwɔ ƒe ɖoɖo si asɔ na wò lãmekawo ƒe dɔléle ƒomevi kple wò dzesiwo koŋ. Eyata ele vevie be míawɔ ɖe eƒe mɔfiamewo dzi pɛpɛpɛ. Azɔ hã, lé ŋku ɖe wò ŋutilã ŋu. De dzesi tɔtrɔ ɖesiaɖe si ava wò nɔnɔmea me alo wò dzesiawo ƒe sesẽme. Kpɔ wò ɖɔkta le ɖoɖowɔɖi si nèwɔna edziedzi me (alo kaba ne ède dzesi tɔtrɔ aɖewo). To mɔ sia dzi la, àte ŋu awɔ tɔtrɔ le wò atikewɔwɔ ƒe ɖoɖoa ŋu ne dzesiawo dze ko.

Mlɔeba la, nu vevitɔ kekeake siwo dzi wòle be woaɖo ŋkui

Myopathy menye nusi wòle be woavɔ̃ na o, gake menye nɔnɔme si dzi woaŋe aɖaba aƒui hã o.

• Ne èkpɔ lãmekawo ƒe gbɔdzɔgbɔdzɔ atraɖii, vevesese, alo ɖeɖiteameŋu la, kpɔ egbɔ be yeyi ɖɔkta gbɔ.
• Lãmetsiŋusẽ ƒe dɔléle ƒomevi geɖe li, eyata dɔlélea didi nyuie le vevie ŋutɔ.
• Atikewɔwɔ kple edzikpɔkpɔ ƒe mɔnuwo li na lãmekawo ƒe dɔléle ƒomevi geɖe.
• Ne èwɔ ɖe wò ɖɔkta ƒe mɔfiamewo dzi, no atike siwo woŋlɔ na wò, eye nènɔ agbe le lãmesẽ me la, àte ŋu anɔ agbe nyui kple nɔnɔme sia.

Mele mɔ kpɔm be nyatakaka sia akpe ɖe ŋuwò. Ne nya bubu aɖewo gale asiwò la, mègavɔ̃ be yeaƒo nu kple ɖɔktaa ɣesiaɣi o.

` Myopathy, lãmekawo ƒe gbɔdzɔgbɔdzɔ, lãmekawo ƒe vevesese, domenyiŋusẽfianu ƒe dɔlélewo, autoimmune dɔlélewo, lãmeka ƒe dzesiwo, myopathy dɔdamɔnu