Darthlalang i en emaw, mi pakhatin i mit var chu a sen vek tih a hrilh che chuan a hlauhawm deuh a ni lawm ni? Dik tak chuan hei hi kan taksa, a bik takin thin (liver)-ah thil dik lo a awm tih hriattirna hmasa ber a ni thei fo. Chuvangin he mit sen, damdawi lama `(Scleral Icterus)` tia koh hi thu awlsam takin han sawi ila.
Scleral Icterus chu eng nge ni tak tak?
A awlsam zawngin, `Scleral Icterus` tih hi kan mit peng var, chu chu `(Sclera)` kan tih hi a sen a nih chuan a ni. Mahse hetah hian thil dang a awm. Sclera ngei pawh hi a takah chuan yellow a ni lo. A chung lam a ni a, chu chu `(Conjunctiva) an tih, membrane te tak te, langtlang tak a ni.` He membrane hi a sen a nih chuan a hnuaia sclera hmun dum avang hian a sen rawng chu chiang takin a lang thei a ni.
Mi tam takin `(Jaundice)` an ti bawk. Chuti chung chuan `Jaundice` tih thumal hi a zau deuh a ni. Mit sen (yellowing) bakah vun sen (yellowing) tihna a ni. Mahse, `Scleral Icterus` hi mit a bik takin a nghawng a ni .
Engvangin nge kan mit hi a sen vek? Bilirubin chanchin
He rawng sen kan neih chhan ber chu kan thisena chemical compound sen bilirubin an tih a pun vang a ni. Hetiang dinhmun hi ``Hyperbilirubinemia`` kan ti a.
Ngaihtuah teh, kan taksaa thisen sen (red blood cells) te hian dam chhung hun an nei bawk. Heng thisen sen hlui te hi an chhiat chuan bilirubin hi a lo piang chhuak thin. A tlangpuiin thil thleng tur chu kan liver hian filter ang maiin hna a thawk a, thisen atanga he bilirubin tul lo tak hi a filter a, bile nen a inzawm khawm a, chaw ei kawngah a hruai lut thin. A tawp berah chuan chu bilirubin chu taksa atangin bawlhhlawh hmangin a chhuak ta a ni.
Amaherawhchu, he bilirubin hi thisen atanga tha taka lakchhuah theih a nih loh chuan, thin lama harsatna vang emaw, thil dang vang emaw a nih chuan thisenah a pungkhawm tan thin. Hetianga bilirubin pungkhawm hian mit leh vun a ti sen a ni.
Mit a rawng inthlak danglamna hi kan hriat hmasak chhan chu bilirubin hi awlsam takin mit tissue ``Conjunctiva`` an tih ah a insiam lut a, a hnuaia background dum a awm avangin bilirubin level tlemte pawh awlsam takin kan hmu thei a ni.
Bilirubin level sang chhan ber berte chu engte nge ni?
Bilirubin level sang a, mit a sen theih chhan hrang hrang a awm thei. Ṭhenkhat chu a awlsam a, ṭhenkhat erawh chu a serious deuh thei. Chuvangin hei hi hriat chian a pawimawh.
| Chhan | A sawifiahna awlsam tak |
|---|---|
| Liver kaihhnawih natna | Zu avanga thin ( cirrhosis ), virus infection (Hepatitis A, B, C), leh autoimmune hepatitis te ang chi dinhmun te. |
| Gallbladder leh pancreas natna te | Gallstones , bile duct strictures , pancreatitis ang chi natna te . |
| Infection awm thei te | Leptospirosis , virus fever dengue ang chi, natna khirh tak tak, taksa pum puia darh ( sepsis ), leh parasitic infection (e.g. Schistosomiasis ) te. |
| Ruihhlo leh toxins te | Damdawi thenkhat (e.g. steroid, antibiotics thenkhat) leh natna tidamtu Acetaminophen (Panadol) te hman tam lutuk. Traditional herbs leh toxins thenkhat agrochemicals te pawh hi a chhan a ni thei bawk. |
| Genetic natna te | Natna rochun Sickle Cell Disease leh Gilbert’s Syndrome te, bilirubin metabolism tichhe thei te. |
| Lumps leh tumor te a awm | Liver, gallbladder emaw a kaihhnawih hmuna tumor pangngai emaw cancer emaw avanga bile flow tihkhawtlai. |
| Nausen piang thar (Neonatal Jaundice) a awm | Nausen piang thar thin (liver) a lo thang kim loh avangin kar hmasa pahnihah mit a sen vek hi thil pangngai a ni. Mahse, a \henah chuan hei hi a pawi thei hle. |
Engtin nge enkawl a nih?
Hetah hian hriatthiam tur pawimawh ber chu `Scleral Icterus` hi natna a ni lo va, symptom a ni zawk . Chuvangin, a enkawl dan chu mit sen tur a ni lo; a thlentu dinhmun hnuaia awm (underlying condition) tan a ni.
Entirnan, gallstone vangin i mit a sen a nih chuan lung chu paih chhuak turin enkawl i ni ang. Liver infection a nih chuan chu chu enkawl i ni ang. A chhan zawng turin i doctor chuan thisen test, scan, etc. So , mahni inenkawl ai chuan damdawi lam thurawn lak a tha ber.
Mit sen i ngaihthah chuan eng nge thleng ang?
Mit sen (yellowing) hi a takin a hlauhawm lo. Mahse vaukhânna chhinchhiahna a ni . Enkawl loh chuan thisenah bilirubin level a sang zual thei a, thluak pawh a nghawng thei bawk. Hei hi dinhmun hlauhawm tak a ni.
- Nau piang tharte zingah hian he natna hi ``Kernicterus'' an ti a, thluak tichhe reng thei a ni.
- Puitlingah chuan he natna hi ``Hepatic Encephalopathy'' an ti a, hriatrengna hloh, buaina, coma thlengin a awm thei.
Heng dinhmun pahnihah hian emergency medical treatment a ngai a ni .
Doctor hmuh hun tur emaw, ETU pan nghal tur emaw
I mit a sen vek tih i hriat chuan a rang thei ang bera doctor pan turin appointment siam rawh. Mahse, i mit sen ruala a hnuaia symptoms te hi i neih chuan damdawi in Emergency Department (ETU) ah kal nghal rawh.
| Ngaihtuah vat ngai symptoms te | |
|---|---|
| ⚫ Pum natna nasa tak emaw, natna awm reng emaw | ⚫ Khawsik |
| ⚫ Luak chhuak chhunzawm zel | ⚫ Luak chhuak emaw, hriatna hloh emaw |
| ⚫ Pum hring emaw tui tlakchhamna emaw | ⚫ Buaina, mutthilh, emaw hriatrengna hloh |
Thurawn tlem tal
A châng chuan kan chhehvêla eng rawng (e.g. yellow bulb) rawng hian kan mit a ti sen thei bawk. Chuvangin rinhlelhna i neih chuan eng tha tak, natural lighted area-ah kal la, mirror-ah en rawh. Chutiang chuan a rawng danglamna dik tak chu i chiang thei ang.
Hetiang dinhmun hi ven theih a ni em?
A pumpelh kim thei lo nain, a hlauhawmna tihziaawmna tur thil engemaw zat kan tih theih a awm.
- Zu control: Zu in tlem hian thin (liver) chhiatna nasa takin a ti tlem thei a ni.
- Vaccine lak: Liver tichhe thei natna, Hepatitis A leh B te lakah vaccine lak hmangin inveng rawh.
- Damdawi lakah fimkhur rawh: Damdawi tul lo, thing leh mau, supplement te chu Doctor rawn hmasa lovin ei suh. Damdawi, a bik takin Acetaminophen (Panadol) aia tam ei hian thin a tichhe thei a ni.
- Kum tin medical checkup neih thin ang che: Thisen test pangngai pawhin a lan chhuah hmain liver function a inthlak danglam tih a hmuchhuak thei.
Take-Home Thuchah a ni
- Scleral icterus (mit dum hring hring) hi natna a ni lo va, a hnuaia awm dinhmun chhinchhiahna a ni.
- Hei hi a chhan ber chu thisenah bilirubin level a san vang a ni. Hei hi thin (liver problem) vang a ni fo thin.
- Mit sen i hriat chuan hlauthawng suh, mahse ngaihthah bawk suh . Doctor pan vat rawh.
- I natna lan chhuah dan dang, pum na tak, khawsik, emaw, buaina emaw i neih chuan damdawi in Emergency Department (ETU) -ah kal nghal rawh.
- Enkawlna chu mit sen chhan bulpui (underlying condition)-ah a innghat a ni. Chuvangin, uluk taka enfiah leh enkawl dan tur chuan damdawi lam thurawn lak a pawimawh hle .
👩🏽 ⚕️ Zawhna dang (FAQ)
💬 Spleen lian (Enlarged Spleen / Splenomegaly) hi eng dinhmun hlauhawm nge ni?
Spleen hi taksa peng te tak te, kan rilru veilam, rib cage hnuai/ril hnung lama awm tlangpui a ni a, thisen a filter/thisen sen hlui a tichhia (a tlangpuiin i kutpui aiin a te zawk). Mahse ‘Enlarged Spleen’ hi he taksa peng hi a pangngai lo taka a hring a, left rib cage (LUQ) hnuai lama hriat theih a ni! Hei hi taksaa thisen kaihhnawih natna khirh tak a awm tih hriattirna lian ber a ni.
💬 Veilam sir lama spleen lian lo tak awm chhan berte chu engte nge ni?
Hei hi a chhan lian ber 3 a awm a, chungte chu: 1) ‘Leukemia / Lymphoma’ - Hetiang a nih chuan cancer cell-in a luah khat avangin spleen hi a lian a ni. 2) ‘Liver Cirrhosis’ - Liver kal tlanga thisen kal chu a block chuan chu thisen chuan spleen veins (Portal hypertension) chu a luah khat a, a lo hring chhuak thin. 3) Malaria / Dengue emaw jaundice (Malaria / EBV Infections) leh thisen zam (red blood cells) a awm dan pangngai lo (Hemolytic anemia) natna te pawhin hetiang hi a thlen ngei ngei tur a ni.
💬 Left rib cage hnuaia lump/enlarged spleen a awm chuan damdawi ina admission nghal ngai ‘nunna atana hlauhawm/emergency situations’ te chu engte nge ni?
Hei hi Doctor hmuh ngai (CT Scan neih a ngai) natna a ni. Mahse, hlauhawm ber leh pawi ber chu! 1) Veilam rib cage hnuai lama 'severe pain like an unbearable knife stab (Severe LUQ pain - Splenic Rupture)' i tawk nghal a, chu natna chu veilam shoulder (Kehr's sign)-ah a darh a, i lu a buai a, i hriatna i hloh a nih chuan 'spleen rupture' a ni ngei ang! Hei hian minute tlemte chhungin thisen a chhuah a, thihna a thlen thei a, chuvangin tihkhawtlai lova damdawi inah dah a ngai!
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