Waliwo obuzibu mu kutambula kw’omusaayi mu maaso? Ka tuyige ku (Ischemic Optic Neuropathy) mu ngeri ennyangu!

Wali owuliddeko mu bwangu ng’okulaba kwo kwali kwa bbugumu oba nga kuzibye? Mpozzi wazuukuse ku makya nga tolaba bulungi mu liiso erimu? Oba wawulira mangu nga waliwo ekiddugavu mu maaso go? Bwoba ofunye ekintu nga kino, tokigoba mangu bwekityo, okay? Leero tugenda kwogera ku mbeera eyinza okuleeta obubonero nga buno, era olina okwegendereza katono, naye bw’oba ​​ogimanyi nga bukyali, esobola okukuyamba okugiddukanya. Ekyo kiyitibwa `(Ischemic Optic Neuropathy)` , era ekimanyiddwa nga `(ION)` mu bufunze.

Omanyi `(Ischemic Optic Neuropathy - ION)` kye ki?

Mu ngeri ennyangu, `(Ischemic Optic Neuropathy)` mbeera nga obusimu obukulu obuleeta okulaba ku liiso lyo, `(Optic Nerve),` tebufuna musaayi gumala, ekivaamu okufiirwa okulaba. Teebereza, kiki ekibaawo singa ekimera ky’ebimuli mu lusuku lwaffe tekifuna mazzi gamala? Kifa mpolampola, nedda? Bwe kityo bwe kiri ne kino. Omusaayi bwe gutaataaganyizibwa mu bitundu ebimu ebya `(Optic Nerve)` yo, ebitundu ebyo bikoma okukola obulungi, era okukkakkana nga bitandika okufa. Singa okutaataaganyizibwa kuno okw’okutambula kw’omusaayi kufuuka kwa maanyi oba okumala ebbanga eddene, `(Optic Nerve)` esobola okwonooneka enkalakkalira.

Embeera eno etera okubaawo mu kitundu ekyekulungirivu emabega w'eriiso lyo ekiyitibwa ``Optic Disk.`` ``Optic Disk`` we wakwatagana emisuwa n'eriiso. Embeera eno eyitibwa ``ION``, si ya bulijjo nnyo era esinga kukwata bantu abasukka emyaka 50.

Waliwo ebika ebikulu ebya `(ION)`?

Yee, waliwo ebika bibiri ebikulu ebya `(Ischemic Optic Neuropathy)`. Ka tulabe kye bali:

1. Anterior Ischemic Optic Neuropathy (AION) : Kino kye kika kya ION ekisinga okubeerawo. Kikosa oba obusimu bw’amaaso wansi w’ekisenge ky’amaaso oba ekitundu ky’amaaso kyennyini.

2. `(Posterior Ischemic Optic Neuropathy - PION)` : Mu kika kino, ekikolwa kibaawo ku kitundu kya `(Optic Nerve)` ekisangibwa emabega katono.

Kati ka twogere ku buli kimu ku bika bino mu bujjuvu katono.

Enkyukakyuka mu `(AION)`

`(AION)` nate erina ebika bibiri ebitonotono:

• Arteritic Anterior Ischemic Neuropathy (AAION) : Kino kizimba emisuwa (Arteritis) . Embeera eno etera okubaawo n’embeera nga Vasculitis, nga zino zibeera kuzimba misuwa.
• `(Nonarteritic Anterior Ischemic Neuropathy - NAION)` : Mu kino, tewali kuzimba misuwa nga bwe kyayogeddwako emabegako. Kino kitera okubaawo kubanga okutambula kw’omusaayi mu `(Optic Nerve)` kuziyiziddwa.

Ka tuyige katono ku `(PION)`

Okufaananako ne AION, PION erina ebika bibiri, Arteritic ne Nonarteritic. Kwe kugamba nti PION eva ku bulwadde bw’emisuwa, ate PION eva ku kutaataaganyizibwa mu kutambula kw’omusaayi nga tewali bulwadde bwa misuwa.

Bubonero ki obulaga kino? Naawe bino olina?

Akabonero akakulu aka `(ION)` kwe kubulwa okulaba. Naye engeri gye kibeerawo eyinza okwawukana okusinziira ku kika kya `(ION)`. Mu ngeri y’emu, obubonero obulala nabwo bwawukana okusinziira ku kika.

Obubonero bwa `(NAION)`

Okubulwa okulaba olw’obulwadde bwa NAION kitera kuba kya mangu era nga tekiruma. Kitera okuwulirwa ng’okuzibuwalirwa kw’okulaba oba okubulwa okulaba mu kitundu ky’ekifo ky’okulaba naddala ekitundu ekya wansi . Oluusi , okubulwa okulaba langi (dyschromatopsia) nakyo kiyinza okubaawo.

Abantu bangi basooka kulaba kubulwa amaaso kuno nga bazuukuse ku makya. Kiyinza okuba oluvannyuma lw’okwebaka ekiseera ekiwanvu oba okutuula akaseera katono.

Tekitera kubaawo, okulaba kuyinza okukendeera mpolampola mu bbanga lya wiiki nga bbiri. NAION kye kika kya ION ekisinga okubeerawo, era kitera okukwata eriiso erimu omulundi gumu. Wabula abantu nga 15% abalina NAION mu liiso erimu bayinza okufuna embeera eno mu liiso eddala oluvannyuma.

Obubonero bwa `(AAION)`

Mu `(AAION)` , okulaba kutera okubula mu bwangu. Kwe kugamba, okulaba kuyinza okuzibuwalirwa, okuzirika, okukendeera oba okubula ddala. Mu `(AAION)`, kiyinza okuwerekerwako obubonero obukwatagana ne `(Arteritis)` obwogeddwako emabegako. Bbo bali:

• Omutwe: Naddala ku njuyi zombi ez’ekyenyi.
• Okuzimba kw’emisuwa ku njuyi zombi ez’ekyenyi: Tewali kuwuuma kuyinza kuwulira nga zino zikwatiddwa.
• Obulumi mu binywa by’akawanga ng’okamula emmere.
• Malaise ne/oba okugejja mu ngeri etategeerekeka.

Mu bantu abatono, engeri "ey'obusamize" eya Arteritic ION eyinza okubaawo. Kino kitegeeza nti okulaba kubula, naye tewali bubonero bulala bwa Arteritis buliwo.

Obubonero bwa `(PION)`

Arteritic PION ne Nonarteritic PION zombi zireeta okufiirwa okulaba okw’amangu, okutaliimu bulumi. Wabula PION esobola okuba ng’egenda mu maaso mu biseera ebisooka. Kino kitegeeza nti obubonero bweyongera mpolampola okumala ekiseera.

Lwaki kino `(Ischemic Optic Neuropathy)` kibaawo? Biki ebivaako?

Ebivaako `(ION)` bisobola okwawukana okusinziira ku kika. Ka tulabe engeri gye kikola.

Ebivaako `(NAION)`

Abakugu n’okutuusa kati tebakakasa ddala lwaki NAION ekulaakulana. Naye balowooza nti ebiseera ebisinga kiba ensonga ezigatta.Kino kirowoozebwa nti kiva ku kuzibikira mu musaayi ogugenda mu busimu bw’amaaso. Embeera zino zitera okukosa engeri enkola yo ey’okutambula kw’omusaayi gy’efuga okutambula kw’omusaayi okuyita mu busimu bw’amaaso. Kasita okwefuga okwo kuba kukola bulungi, tojja kukulaakulanya NAION. Kyokka, ebintu ebimu oba ebizibu ebimu bisobola okutaataaganya okwefuga okwo. Mu bino mulimu:

• Enkyukakyuka mu nsengeka mu `(Optic Disk)` munda mu liiso: Kino kitegeeza nti `(Optic Disk)` efuuka ntono oba nnene. Kino era kiyitibwa "disk at risk".
• Puleesa (Peesa).
• `(Ssukaali ow'ekika eky'okubiri)` (Ssukaali ow'ekika eky'okubiri).
• Atherosclerosis (amasavu agateekebwa mu misuwa).
• Sleep Apnea (Obulwadde bw’okusannyalala mu tulo).
• Puleesa okukendeera nga yeebase (`Nocturnal Hypotension`).
• Anemia (okukendeera kw’obutoffaali obumyufu oba hemoglobin mu musaayi).
• Okunywa sigala (nga mw’otwalidde n’okunywa sigala).
• Obulwadde bw’omutwe omuzito.
• Eddagala erimu: Eddagala eriziyiza phosphodiesterase (okugeza, eddagala erikozesebwa okujjanjaba obuzibu bw’okusituka) liyinza okuyamba ku ION. Wabula abakugu tebakkiriza nti eddagala lino lyokka lireeta ION.

Ebivaako `(Arteritic ION)` (AAION ne APION) .

Bombi `(AAION)` ne `(APION)` balina ekivaako kye kimu: `(Arteritis)` (arteritis). Embeera eno ebaawo nga waliwo okuzimba mu nkola yonna ey’okutambula kw’omusaayi. Ebisinga okuvaako kino bye bino:

• `(Obulwadde bw'emisuwa gy'obutoffaali obunene - GCA)`
• Ebika ebirala ebya `(Vasculitis)` (embeera z’okuzimba emisuwa).

Ebivaako `(PION - NPION)`

Waliwo ensonga eziwerako entongole ezikwata ku `(NPION)`. Bbo bali:

• Embeera ezikosa entambula y’omusaayi mu liiso: Bangi ku bano bafaananako n’ezo ezireeta NAION. Okugeza Ssukaali ow’ekika eky’okubiri, Puleesa, Okuzimba emisuwa.
• Okuvaamu omusaayi: Puleesa bw’egwa amangu kiyinza okulemesa omusaayi okutambula emabega w’eriiso, ekivaako NPION.
• Okulongoosa: Puleesa esobola okukka olw’ensonga ezitali zimu ng’olongooseddwa. Kino kiyinza okuvaako PION.

Ani ali mu bulabe obw’amaanyi obw’okufuna kino?

Abantu abamu batera okufuna embeera eno (Ischemic Optic Neuropathy). Ka tulabe ani gwe bali:

• Abantu abalina obulabe bw’emisuwa: Kino kitegeeza nti abo abalina embeera ezoogeddwako emabegako, gamba nga puleesa, ssukaali, kolesterol omungi, okunywa sigala, n’okusannyalala mu tulo, bali mu bulabe bwa maanyi.
• Abantu abalina endwadde ezizimba: Okugeza, abantu abalina endwadde nga `(Giant Cell Arteritis - GCA)` nabo bali mu bulabe obw'okufuna `(ION)`.
• Abantu abasukka mu myaka 50.
• Ku basajjaZisobola okukula katono okusinga abakyala.

Omusawo kino akitegeera atya?

Omukugu wo mu kulabirira amaaso asobola okuzuula ION ng’akozesa enkola eziwerako ezigatta. Enkola y’okuzuula obulwadde butera okutandika n’okukubuuza ebibuuzo ebikwata ku bubonero bwo, ebibaddewo mu bulamu gye buvuddeko, n’ebyafaayo by’obujjanjabi bwo. Eby’okuddamu byo bijja kubayamba okukendeeza ku lukalala lw’ebiyinza okuvaako nga baggyawo embeera endala eziyinza okufaananako ne ION. Olwo bajja kukola okukebera amaaso , nga bafaayo nnyo ku bitundu by’eriiso ebitunuulira disiki y’amaaso, esangibwa emabega w’eriiso.

• Anterior ION (AION): AION zombi eziyitibwa Arteritic ne Nonarteritic AION zireeta enkyukakyuka ezirabika mu optic disc yo nga bukyali. Enkyukakyuka zino ziyamba omusawo w’amaaso okuzuula embeera eno. Nga bazudde AAION, era bajja kukebera okulaba oba olina obubonero bwonna obukwatagana n’obulwadde bwa Arteritis.
• `(Posterior ION - PION)`: Ebika bino bizibu katono okuzuula. Kubanga mu mitendera egyasooka, tewali nkyukakyuka zirabika mu `(Optic Disk)`.

Kino kigezo ki ekikolebwa?

Waliwo okukebera okuwerako okuyinza okuyamba okuzuula embeera eno (ION) n’embeera yonna eyinza okuba ng’egireeta. Ebimu ku bino byangu era tebyetaagisa kufuba nnyo mu mubiri. Okugeza nga:

• Okugezesa okulaba: Kebera oba waliwo obuzibu bwonna mu kifo ekirabika (ebifo ebizibe).
• Okupima puleesa.
• Okukebera omusaayi: Kebera embeera nga Ssukaali ow’ekika eky’okubiri, kolesterol omungi, n’obutaba na vitamiini.
• Okupima puleesa mu maaso.
• Fluorescein Angiography: Eno ekozesa langi ey’enjawulo okukuba ebifaananyi by’emisuwa egiri munda mu liiso.
• Optical Coherence Tomography (OCT): Kino kisobola okufulumya ebifaananyi ebikwata ku busimu bw’amaaso n’amaaso.

Ebigezo ebimu bikolebwa mu ngeri ey'enjawulo okuzuula oba okugoba embeera nga ``Arteritis'' (ezeetaaga obujjanjabi obw'enjawulo amangu ddala). Ebigezo bino biyinza okuli:

• Okukebera ebifaananyi: Okukebera emisuwa wansi w’olususu ku njuyi zombi ez’ekyenyi mu ngeri ya ultrasound oba magnetic resonance imaging (MRI).
• Temporal Artery Biopsy: Akatundu akatono akaggibwa mu musuwa oguli ku njuyi zombi ez’ekyenyi ne kakeberebwa embeera nga GCA.
• Okukebera omusaayi okuzuula enkyukakyuka ezikwata ku kuzimba: gamba nga `(Erythrocyte Sedimentation Rate - ESR)` ne `(C-reactive Protein - CRP)` okukebera.

Omusawo ayinza okukuwa amagezi okwongera okukeberebwa okusinziira ku bubonero bwo n’ebyafaayo by’obulamu bwo. Basobola okukubuulira ebisingawo ku bigezo n’ensonga lwaki weetaaga.

Bujjanjabi ki obukolebwa ku kino? Kisobola okuwona?

Obujjanjabi bwa ION bwawukana okusinziira ku kivaako. Oluusi, omusawo asobola okujjanjaba ION butereevu. Oluusi, kye kyetaagisa kwe kufuga ensonga eziyinza okuvaako emisuwa n’okujjanjaba obubonero.

Obujjanjabi bwa `(Arteritic Ischemic Optic Neuropathy)`

Bombi `(Anterior)` ne `(Posterior Arteritic ION)` balina okujjanjabibwa mu bwangu n'eddagala eriziyiza okuzimba `(Corticosteroid)` (e.g. `(Prednisone)`) oba eddagala eriziyiza obusimu obuziyiza endwadde nga `(Tocilizumab - Actemra®)`. `(Corticosteroid)` etera okuweebwa ng’empeke, naye oluusi era eweebwa mu misuwa (IV). Dozi ya `(Corticosteroid)` eno esooka kuweebwa mu ddoozi nnyingi ate oluvannyuma n’ekendeezebwa mpolampola okumala ennaku oba wiiki eziwera. Abantu abamu bayinza okwetaaga okumira eddagala lino ku ddoozi entono okumala ebbanga eddene okutangira obuzibu bw’okulaba obw’olubeerera okuva mu `(ION)`.

Obujjanjabi bw'obulwadde bwa `(Nonarteritic Ischemic Optic Neuropathy)`

Ebyembi, tewali bujjanjabi bukakasibwa nti bukola bulungi ku `(Nonarteritic ION)`. Okujjako ng’olina embeera esirifu nga eddagala lya `(Arteritis)`, `(Corticosteroid)` teritera kusembebwa.

Mu kiseera kino, obujjanjabi obukulu obwa `(Nonarteritic ION)` kwe kufuga obubonero n'okujjanjaba oba okukendeeza ku bivaako n'ensonga eziyamba. Kino kikulu kubanga `(Nonarteritic ION)` etera okukosa eriiso erimu omulundi gumu. Kale enkola eno esobola okukendeeza ku bulabe bw'okufiirwa okulaba mu maaso gombi olw' `(ION)`.

Bw’oba ​​olina okubulwa okulaba olw’obulwadde bwa ION, omusawo wo ayinza okukuwa amagezi okukozesa ebyuma ebiyamba nga magnifiers, oba okukozesa ensengeka z’okukuza oba ebiragiro by’eddoboozi/okuddamu ku byuma byo. Bino bisobola okukuyamba okuliyirira oba okukola ku bizibu by’okulaba.

Kiki kye tusaanidde okusuubira singa embeera eno ebaawo?

ION etera okuvaako okubulwa okulaba okw’amangu. Bwemba ngamba nti "sudden," kiyinza okubaawo mu ddakiika oba essaawa, naye oluusi kiyinza okutwala ennaku. Ebika bya ION ebisinga okubeerawo bireeta okulaba okuzibu oba okunafu. Ebika ebimu bisobola okuvaako okubulwa okulaba ddala. Oluusi, wayinza okubaawo ebiseera ebimpi eby’okulaba okuzibu nga ION tennaleeta kufiirwa kulaba kwonna.

Kino kinaddamu okunfuula okwolesebwa kwange okulungi?

`(ION)` si kya bulabe eri obulamu bwo, naye kiyinza okuvaako okufiirwa okulaba okw'amaanyi ekiyinza okutaataaganya obulamu bwo.

Mu mbeera ezimu, ION ekyukakyuka, naye emirundi egisinga ereeta waakiri okufiirwa okulaba okw’olubeerera.Wabula abantu ababulwa amaaso nabo bayiga `okumanyiira` embeera eno. Olwo ne batandika okukozesa ebitundu ebirala eby’okwolesebwa kwabwe okukola emirimu egy’enjawulo, gamba ng’okusoma. Kino bwe kibaawo, kiyinza okulabika ng’okulaba kwabwe kulongooseddwa, naye ekituufu ekigenda mu maaso kwe kuba nti bafuuka balungi mu kukola okwetoloola okubulwa okulaba kwabwe.

Obulwadde bw’obusimu obuyitibwa Ischemic Optic Neuropathy busobola okuziyizibwa?

Tosobola kuziyiza ddala (ION). Naye osobola okukendeeza ku bulabe bw’okubufuna. Engeri enkulu ey’okukola kino kwe kwewala oba okufuga embeera eziyinza okuleeta oba okuyamba ku (ION). Omusawo ayinza okukuwa amagezi okukyusa eddagala lyo erya puleesa okuziyiza puleesa okukka nga weebase, okutandika eddagala erikendeeza ku kolesterol, okutereeza eddagala lyo erya sukaali, okukomya okukozesa taaba (nga mw’otwalidde n’okunywa taaba), n’ebirala ebiziyiza okukendeeza ku mikisa gyo egy’okulwala (ION).

Ate era, bw’oba ​​weetaaga okulongoosebwa, abakugu mu by’obujjanjabi bajja kukola emitendera okuziyiza `(ION)`. Bw’oba ​​obaddeko ne `(ION)` emabegako, oba bw’oba ​​okimanyi nti olina embeera eyinza okugireeta (nga `GCA` oba `vasculitis`), tegeeza omusawo wo alongoosa ne/oba omusawo asumulula nga tonnalongoosebwa. Olwo basobola okuteekateeka okusinziira ku ekyo ne bakola enkyukakyuka zonna ezeetaagisa.

Weerabirira otya singa oba olina embeera eno?

Bwoba nga emabegako walina ``Nonarteritic ION'' mu liiso erimu, olina okwegendereza ennyo enkyukakyuka yonna oba okufiirwa okulaba mu liiso lyo eddala. Kubanga bwe kimala okubeera mu liiso erimu, emikisa mingi nti kijja kubeera mu liiso eddala oluvannyuma.

Bw’oba ​​olina Arteritic ION, omusawo w’amaaso ajja kukusindika ew’omusawo omukugu, gamba ng’omusawo w’enkizi. Omusawo w’endwadde z’enkizi asobola okuyamba okuzuula n’okujjanjaba embeera zonna ezisirikitu ez’abaserikale b’omubiri oba okuzimba eziyinza okuba nga ze zikuleetera Obulwadde bw’Emisuwa. Kikulu okugoberera ebiragiro by’omusawo w’amaaso n’abasawo abalala okusobola okuddukanya embeera yo. Kino kijja kukuyamba okwewala okubumbulukuka n’okwongera okubulwa amaaso oba obuzibu mu biseera eby’omu maaso.

Ddi lw’osaanidde okulaba omusawo wo ow’amaaso?

Omusawo w’amaaso ajja kutegeka okugenda okugoberera buli kiseera okulondoola okulaba kwo oba amaaso go oba waliwo enkyukakyuka yonna. Olina okukuuma appointments zino nga bwebakugamba. Ate era bw’olaba enkyukakyuka yonna mu kulaba kwo, olina okubatuukirira amangu ddala nga bwe kisoboka. Bayinza okukubuulira oba weetaaga okwogera nabo, okugenda mu ddwaaliro ery’amangu, oba enkyukakyuka endala yonna entongole.

Ddi lw’osaanidde okugenda mu kitongole ekijjanjaba abalwadde ab’amangu (ETU) ?

Okubulwa okulaba kwonna okw’amangu kabonero ka mangu era nga kyetaagisa okujjanjabibwa amangu.Kubanga, oluusi kiyinza okuba akabonero k’embeera eyinza okutta obulamu nga `(Stroke)` (embeera nga okusannyalala), oba kiyinza okuba eky’amangu eky’amaaso nga `(Retinal Detachment)` (okukutuka kw’amaaso - ekiyinza okuwona singa kijjanjabwa mangu).

Omukugu mu by’obujjanjabi omutendeke n’okukeberebwa okw’enjawulo yekka y’asobola okumanya oba ddala okubulwa okulaba okw’amangu kiba kya mangu. Mu mbeera ng’eyo , eddakiika zisobola okuleeta enjawulo nnene. Eno y’ensonga lwaki kirungi obutakibuusa maaso bw’oba ​​tofunangako kufiirwa kulaba kwa mangu. Bw’oba ​​olina embeera ekuteeka mu bulabe bw’okubulwa amaaso mu bwangu, oba bw’oba ​​obadde nayo emabegako, yogerako n’omusawo wo. Bayinza okunnyonnyola ddi akabonero kano lwe keetaaga obujjanjabi obw’amangu ne ddi lwe kiba kintu ky’osuubira okusinziira ku mbeera gy’olimu.

Ebibuuzo by’olina okubuuza omusawo wo

Bino bye bimu ku bibuuzo by’oyinza okwagala okubuuza:

• Nnina obulwadde bwa Ischemic Optic Neuropathy bwa kika ki?
• Kiki ekiyinza okuba nga kye kivaako oba ekiviiriddeko kino?
• Bujjanjabi ki bw’okuwa amagezi?
• Okubulwa okulaba kwange kunaaba kwa lubeerera oba waliwo omukisa okutereera?

`(Obulwadde bw'obusimu obuyitibwa Ischemic Optic Neuropathy)` `(Okusannyalala)`?

Nedda, naye waliwo ebifaanagana.

`(Ischemia)` bwe butoffaali obutafuna musaayi gumala ne butandika okufa. `(Ischemic Stroke)` bwe bubaawo mu bwongo bwo. `(ION)` ebaawo mu `(Optic Nerve)` yo. Y’ensonga lwaki bafaanagana naye nga si kye kimu.

Ensonga endala lwaki zifaanagana eri nti abantu abalina `(ION)` oluusi baba n'obubonero obutasalako. Kino bwe kibaawo, kitegeeza nti oli mu bulabe bwa maanyi obw’okulwala `(Optic Nerve Ischemia)` n’okubulwa okulaba mu nnaku ezijja. Kale, tolina kubuusa maaso kufiirwa kulaba kwa mangu. Kino bwe kibaawo, olina okugenda mu ddwaaliro ery’amangu mu bwangu.

N’ekisembayo, ebintu by’olina okujjukira

Okubulwa okulaba okw’amangu ng’olina obulwadde bwa Ischemic Optic Neuropathy kitegeeza nti Optic Nerve yo tefuna musaayi gumala. Ekiseera bwe kigenda kiyitawo, kino kiyinza okuvaako okwonooneka okw’olubeerera n’okubulwa okulaba. N’olwekyo, okufiirwa okulaba okw’amangu si kintu kya kubuusa maaso oba okulinda.

Bwoba olina embeera eyinza okukuviirako okubulwa okulaba okw'amangu oba ``ION'', kirungi okwogera n'omusawo wo omukugu mu maaso. Basobola okukubuulira by’olina okutunuulira n’eky’okukola singa olaba enkyukakyuka mu kulaba kwo. Okukola amangu kiyinza okuleeta enjawulo nnene n’okuyamba okukukuuma okuva ku buzibu obw’amaanyi obw’okulaba n’obutabeera bulungi. Kale, faayo ku maaso go!

` Ischemic Optic Neuropathy, ION, AION, PION, Okubulwa okulaba, Obulwadde bw’amaaso, Obusimu bw’amaaso, Okufiirwa okulaba okw’amangu