Ka pāngia koe e te mamae rerekē i ētahi wā e tīmata ana i roto i tō puku, ka horapa ki tō tuara? Kāore rānei, ka rongo koe i te kī tonu, i te kore whakamarie rānei i muri i te kai? Tērā pea he tohu ēnei mō tētahi raruraru hauora i roto i tētahi okana e warewarehia ana, engari he mea nui. I tēnei rā, me kōrero tātou mō te repe taiaki me tētahi mate e mōhiotia ana ko te Pancreatitis .
He aha te pancreas, ā, he aha tāna mahi?
He whakarāpopototanga noa iho, he okana iti engari he tino hira tō repe taiaki kei roto i tō puku. Whakaarohia te whakatakoto i tō ringa ki waenganui o tō puku; koinei te wāhi e noho ana - kei muri i tō puku, kei mua paku i tō tuaiwi.
E rua ngā mahi nui a tēnei ōkana kaha:
1. Te Nakunaku: Ka whakaputahia e ia ngā whākōkī motuhake (pēnei i te Amylase ) e wawahi ana i te kai e kainga ana e koe, e āhei ai tō tinana ki te mimiti pai i ngā matūkai. Ka haere ēnei whākōkī mā roto i tētahi ngongo e kiia nei ko te awa pancreatic ka ringihia ki roto i tō whekau iti.
2. Te Whakahaere Huka Toto: Kua rongo pea koe i te kōrero mō te Insulin . Mā te repeure tēnei me ētahi atu homoni e whakaputa hei pupuri i ngā taumata huka toto ki te awhe hauora, taurite hoki.
Na, he aha tonu te Pancreatitis?
Ko te mate pāwera te mumura o tō repe taiaki. Whakaarohia he whara ā-rohe e pupuhi ai, e mamae ai hoki ngā kiko. Ko tēnei mumura tonu te mea e puta ai te mamae o te puku ka pā ki a koe.
Ko te tikanga, ko te mumura ko te tere o te pūnaha ārai mate o tō tinana ki te whakatika i ngā kino o te kiko. Ina pāngia te repe taiaki e tētahi whara pēnei, ka puta tēnei urupare mumura. Ko te nuinga o te wā ka puta mai i ngā kōhatu o te puku e ārai ana i te awa taiaki taiaki, i te nui rawa rānei o te inu waipiro.
He rerekē ngā momo o te Pancreatitis?
Āe, e rua ngā āhua matua:
1. Te Pancreatitis Whakapeka
He āhuatanga rangitahi, ohorere tēnei. Ka puta mai ina pāngia te repe taiaki e te pakaru poto, ā, ka ngana te tinana ki te whakatika. Mō te tini, ka ora i roto i ngā rā torutoru me te tiaki hauora tika, tae atu ki te okiokinga, te whakainu nui, me te whakahaere mamae . Heoi, i ētahi wā ka kino te repe taiaki , ā, ka arahi ki ngā raruraru morearea .
2. Te mate pāwera mau tonu
He mate roa tēnei, e ahu whakamua ana . Kāore e memeha noa iho, ā, ka kino haere tonu i roto i te wā. Ina pāngia tonutia te repe taiaki e te kino, ka puta he kiriuhi (he whara). Nō reira, ka ngaro te kaha o te repe taiaki ki te whakaputa i ngā whākōkī me ngā homoni e tika ana. Ka taea e tēnei hekenga te puta i roto i ētahi tau.
He pēhea te noa o tēnei āhuatanga?
I roto i te maha o ngā whenua whakawhanake, neke atu i te 200,000 ngā tāngata e hōhiperatia ana i ia tau nā te mate pancreatitis whakapeka, ā, tata ki te 20% e kiia ana he kino. Ahakoa he iti ake te auau o ngā kēhi o te pancreatitis mau tonu, e 86,000 tonu ngā hōhiperatia i ia tau. Kei te piki haere te horapa o tēnei mate puta noa i te ao.
He aha ngā tohu, ā, he pēhea te āhua?
Ko te tohu matua o te pancreatitis ko te mamae o te puku . Heoi anō, tera pea ka haere tahi mai ētahi atu tohu whakatūpato.
Ngā tohu o te mate pāwera nui:
- Whakapairuaki me te ruaki .
- Te tere o te manawa.
- Te manawa tere, te manawa pāpaku.
- Kirika .
Ngā Tohu o te Pancreatitis Mau tonu:
- Te mamae me te koretake o te kai i muri i te kai.
- Te ngaronga o te hiahia kai me te taumaha .
- Ngā tūtae hinuhinu, momona rānei(tērā pea ka kite koe i tētahi kiri kanapa, i tētahi kiri hinu rānei i roto i te peihana wharepaku).
- Pōuriuri, he maha ngā wā nā te toto toto iti.
He maha ngā tohu e tohu ana kei te memeha haere te mahi a tō repe taiaki.
Me pēhea te whakaatu o te mamae?
Ko te mamae o te mate pāwera i waenga i te ngawari ki te kino . He maha ngā wā ka horapa mai i te puku ki te tuara . Ko te mamae i roto i te mate pāwera nui he tino kaha, he koi hoki , ka ngawari te puku ki te pā atu. Ka rerekē te mamae o te mate pāwera mau tonu —tērā pea ka haere mai, ka haere atu, engari he maha ngā wā kāore e tino memeha, ka kaha haere i muri i te kai.
Ngā āhuatanga ka kaha ake te mamae:
- Te takoto papatahi ki runga i tō tuara.
- Te maremare.
- Te whakapau kaha tinana.
- Te kai i tētahi kai nui.
Ngā āhuatanga ka taea te whakamamae i te mamae:
- Te noho tika.
- E piko whakamua ana.
- Te piko ki te tūranga fetal.
- Te kai i ngā kai iti, māmā ake.
Me pēhea te tautuhi i te ngoikore o te pancreas?
Ina pāngia te mahi a te repe taiaki e te pancreatitis mau tonu, ka kite tuatahi koe i ngā panonitanga o tō nakunaku. Nā te mea kāore e taea e te repe taiaki te tuku i ngā whākōkī nakunaku ki te whekau, kāore e taea e tō tinana te mimiti tika i ngā matūkai, inā koa ngā ngako. Ka hua ake tēnei i te mamae i muri i te kai me te putanga atu o te ngako kāore anō kia nakunaku, ā, ka mutu ka heke te taumaha.
He aha ngā tino take?
E rua ngā tino take o te pancreatitis:
1. Ngā kōhatu o te pūhā
2. Te nui rawa o te inu waipiro
Ina huihuia, tata ki te 80% o ngā mate pancreatitis te take o ēnei.
1. Te mate pāwera o te kōhatu o te kapia
Ka uru te au mai i tō pūkahukahu ki te whekau mā te awaawa au noa . Ka hono tēnei awaawa ki te awaawa repeure i mua i te urunga ki te whekau. Mēnā ka haere te kōhatu repeure, ā, ka mau ki tēnei hononga, kāore e taea e ngā wai repeure te puta. Ka puta te pēhanga i ngā wai kua mau, ka whakahohehia ngā whākōkī i roto i te repeure, ka meinga te okana kia nakunaku i a ia anō. Ka puta te mumura.
2. Te Whakamahinga Waipiro
Ko te inu nui i te waipiro te tino pūtake o te mate pāwera. Ahakoa kei te rangahauhia tonutia te tikanga tika, e whakapono ana ngā tohunga ko ngā hua paitini o te waipiro ka puta te mumura, ka whakaoho rānei i te whakahohenga wawe o ngā whākōkī nakunaku. Ko te waipiro te take o te tata ki te haurua o ngā mate pāwera whakapeka me te mau tonu.
Ētahi atu Take
Haunga ēnei āhuatanga nui e rua, kei reira anō ētahi atu āhuatanga kāore i te tino kitea, hei whakaoho i te mamae.
- Ngā mate urutā maha, pērā i ngā mate huaketo.
- Ko tō ake pūnaha ārai mate e whakaeke ana i tō repe taiaki (pancreatitis autoimmune).
- Ngā whakarerekētanga ira tuku iho (Te mate pāwera tuku iho).
- Ngā raruraru hauora mai i ētahi atu mate pēnei i te Cystic fibrosis.
- Te nui o ngā ngako (triglycerides) i roto i tō toto (Hypertriglyceridemia).
- Te nui o te konupūmā i roto i tō toto (Hypercalcemia).
- Te whakahekenga o te rere o te toto ki te pancreas (Ischemia).
- Ngā āhuatanga matepukupuku.
- Ngā whara tinana, ngā whara rānei ki te repe taiaki.
- Ngā rongoā motuhake ka pā kino pea ki tō repe taiaki.
Ahakoa e 20% pea o ngā take e pā ana ki ēnei take, i ētahi wā kāore e taea te whakatau i te pūtake o te mate.
He rite tonu ngā take o te mumura ohorere me te mumura roa?
I te nuinga o te wā, ka puta ohorere te pancreatitis hei mate rangitahi (Acute). Heoi, ko ngā āhuatanga pumau pēnei i ngā mate tuku iho ka arahi pea ki te pancreatitis roa, ki te pancreatitis mau tonu rānei. Hei tāpiri, ki te pāngia koe e ngā whakaekenga o te pancreatitis mau tonu, ka taea e ia te huri hei mate mau tonu.Whakaarohia pēnei: ina pāngia tō repe taiaki e te ahotea, e te whara rānei tonu, ka urutau pea tō tinana ki tētahi huarahi e mau tonu ai te mumura ahakoa kua memeha te whara tuatahi.
He mate mōrearea tēnei āhuatanga?
Ae, ki te kaha rawa te mate pāwera nui, ka taea e ngā raruraru te whakararu i te ora. Mō te hunga tokoiti, ka taea e te mate pāwera nui te whakaoho i tētahi tauhohenga pūnaha puta noa i te tinana. Ka taea e tēnei te arahi ki te ohorere me te ngoikore o ngā okana maha. Ki te kore he awhina hauora tere, ka mate pea tēnei. Nā te mea he uaua ki a koe te whakatau i te kaha o ō tohumate i a koe anō, ko te rapu awhina ohorere i te hōhipera te huarahi mahi pai me te haumaru.
He aha ngā raruraru ka pā mai?
Ko te nuinga o ngā mate pāwera nui kāore e puta he raruraru. Heoi, tata ki te 1 i roto i te 5 ngā mate ka kino rawa atu. Kāore anō kia tino mārama he aha i pāngia ai ētahi tāngata e te mate pāwera nui. Ahakoa he raruraru anō hoki e pāngia ai ētahi e te mate pāwera nui, ka āta whanake haere, ā, he iti ake te tūponotanga ka noho hei mōrearea tonu ki te ora. He maha o ēnei raruraru ka taea te whakahaere mā te maimoatanga hauora tika.
Ngā Pōrearea o te Pancreatitis Whakapeka:
- Te Matenga o ngā Kiko (Necrosis) me te Mate Pāwera: Mō te 1 i roto i te 3 o ngā mate kino nui, ka pupuhi nui te repe taiaki, ā, ka motuhia te rere o te toto. Ka mate te kiko repe taiaki, ka noho hei wāhi whakatupu huakita. Mena ka puta he mate, ka horapa tere ki roto i te toto (Septicemia), he āhuatanga ohorere hauora tēnei. Ka pā mai pea te mate urutā mumura pūnaha (SIRS). Ka whānui ake pea ngā oko toto i tēnei, ka heke te toto (Septic shock) ā, ka ngoikore ngā okana maha.
- Ngā pūkahukahu rūpahu: Ka ārai pea te mumura i te awaawa rūpahu, ka ārai i ngā whākōkī nakunaku kia tae atu ki ngā whekau. Ka turuturu pea ēnei whākōkī, ka puta te mumura ki ngā kiko e karapoti ana. I roto i te wā, ka ārai pea te tinana i tēnei wai, ka hanga he hanganga e kiia nei ko te pūkahukahu rūpahu. He maha ngā wā kāore ēnei e puta he tohu, ā, kāore e hiahiatia he maimoatanga, engari i ētahi wā ka pangia, ka nui rānei kia puta ai te mamae. He onge noa iho, ka pakaru pea tētahi oko toto ki roto i te pūkahukahu, ka hiahiatia he wawaotanga hauora ngaio hei tango i te wai, hei whakamutu rānei i te toto.
- Te mate pāwera pūmau: Ka taea e ngā whakaekenga maha o te mate pāwera pūmau te whanake hei mate pūmau. Ka hua ake te mumura tonu i te kiri kua pakaru (fibrosis), ka aukati i te kaha o te repe taiaki ki te mahi hei repe. I roto i te wā, ka heke te hanga o ngā whākōkī me ngā homoni nui, ka hua ake ngā raruraru hauora.
Ngā Pōrearea o te Pancreatitis Mau tonu:
Ko te tikanga ka puta ake ēnei raruraru i roto i te wā:
- Te ngoikore o te repe taiaki (EPI), te mimiti koretake, me te kore kai pai: I te nui haere o te kiriuhi, ka iti ake ngā whākōkī nakunaku e whakaputaina ana e te repe taiaki. Nā tēnei ka uaua ki te mimiti i ngā ngako me ngā huaora wairewa-ngako mā tō tinana. Ka hua ake pea tēnei i ngā tūtae ngako me te korere. I te mea ka iti ake te kai e whiwhi ana tō tinana mai i te kai, ka nui pea te hekenga o tō taumaha me te korenga o ngā kai.
- Te piki me te heke o te huka toto (Te huka toto iti, te huka toto nui, me te mate huka momo 1): Ka pā te mumura mau tonu ki ngā homoni e whakahaere ana i tō huka toto. I runga i ngā homoni ka pāngia tuatahi, ka pāngia pea koe e te huka toto iti (nā te korenga o te glucagon) te huka toto tiketike rānei (nā te korenga o te insulin). I te mutunga, ko te korenga o ngā mea e rua ka arahi ki te mate huka.
- Mamae mau tonu: Ahakoa ka kitea he whakamarie i ētahi tūroro, ka pāngia pea ētahi e te mamae kino, e te mamae pumau rānei. He uaua pea tēnei ki te whakahaere ahakoa he rongoā, ā, ka pā kino pea ki tō oranga hinengaro.
- Te pikinga ake o te mōrearea o te mate pukupuku repeure:Ka piki ake te mōrearea o te mate pukupuku i te mumura tonu i ngā wāhi katoa o te tinana. Ko te hunga e pāngia ana e te pancreatitis mau tonu ka piki ake te mōrearea ki te whakawhanake i te adenocarcinoma pancreatic mā te 1% – 2%. Nā te mea ka taea e ngā tohu te rite ki te mumura mau tonu, ka kore pea e kitea te mate pukupuku. E tino taunaki ana ngā tākuta o Nirogi Lanka kia tirotirohia auautia ngā tūroro e pāngia ana e ngā mate mau tonu.
Me pēhea te tautuhi i tōna mate?
Mena kei te pāngia koe e ngā tohu, ka arotakehia e te tākuta tō repe taiaki mā te whakamahi i ngā whakamātautau toto me ngā whakamātautau whakaahua. Ka tirohia e ngā whakamātautau toto ngā taumata whākōkī repe taiaki kua teitei ake—mēnā he toru ngā wā neke atu i te taumata noa, e whakapaetia ana he mate pāwera. Kātahi ka whakamahia he matawai CT, he MRI rānei hei whakaū i te mate mā te whakaatu i te pupuhi, i te kohi wai rānei. Mena kei te whakapaetia he mate pāwera mau tonu, ka mahia pea ētahi atu whakamātautau:
- Whakamātautau huka toto (hei aroturuki mēnā kei te nui te insulin e hangaia ana e tō repe taiaki).
- Whakamātautau elastase tūtae (hei tirotiro mēnā kei te whakaputa tō repe taiaki i ngā whākōkī nakunaku e rawaka ana).
- Te tātaritanga ngako paru (hei tirotiro i ngā tohu o te mimiti ngoikore o te ngako).
- Ngā whakamātautau toto (hei aromatawai i tō āhua kai me ngā taumata o ngā huaora wairewa-ngako).
Me pēhea te rongoā?
Ko te maimoatanga e whakawhirinaki ana ki te take, ahakoa he mate pāwera, he mate mau tonu rānei, me tōna kaha. Me rapu tonu i te awhina hauora mēnā kei a koe ngā tohu o te pancreatitis. Ahakoa ka memeha noa iho ētahi mate pāwera ngawari, ko tō matapae e whakawhirinaki ana ki te take me te kaha. I tēnei wā, he maha ngā tāngata e hiahia ana ki ngā rongoā whakamamae mamae. Ko ētahi e hiahia ana ki te awhina hauora tere, ko ētahi e hiahia ana ki te whakauru ki te wāhanga tiaki nui mēnā ka puta he raruraru.
Te rongoā i te mate pāwera nui:
Manaaki Tautoko
Mena kua arohia te take, ā, kāore i te kino te āhua, ko te arotahi ko te tautoko i te tukanga whakaora ā-taiao o tō tinana. Ko te tikanga, kei roto i tēnei:
- Wai IV: Ka nui te matewai ka puta mai i te mate pāwera, nō reira ko te whakamakuku anō i te wai he taahiraa tuatahi nui ki tō whakaoranga.
- Whāngai Ngongo: Mena ka ārai tō mate i a koe ki te kai noa, ka whakaratohia pea e tō tīma hauora he kai mā te ngongo e whakatakotoria ana ki roto i tō puku, i tō whekau rānei.
- Kai Whakaranua: I ngā wā tino kino, me whai kai ā-uaua kia whiwhi ai tō tinana i ngā matūkai nui.
- Whakaora Mamae: Ka tukuna atu ki a koe ngā rongoā whakaora mamae, ka hoatu mā te uaua, mā te waha rānei, kia pai ai tō noho.
Te Tango i te Kōhatu Auaha
Mena ko ngā kōhatu o te pūkahukahu te take o tō pancreatitis, me tango pea e ō tākuta ngā kōhatu e ārai ana i ō awa wai. Hei tāpiri, ka tūtohu pea rātou i tētahi pokanga tango pūkahukahu (cholecystectomy) hei ārai i ngā wā e pā mai ana. Ko ngā tikanga noa ko:
- Te Kōparapara Retrograde Endoscopic (ERCP): Ko tēnei tikanga he whakamahi i tētahi endoscope—he ngongo angiangi, ngāwari hoki, he kāmera tōna—hei tiro i ō awaawa wai. He maha ngā kōhatu ka taea te tango i tēnei tukanga. Ka tukuna te ngongo mā roto i tō korokoro ki roto i tō puku, kātahi ki roto i ngā awaawa wai.
- Pokanga Tango i te Pūngāwerewere: Mena kua mau koe ki te hōhipera mō ngā kōhatu pūngāwerewere, he nui te tūponotanga o te hokinga mai anō, koia te take e tūtohutia ana kia tangohia i te pokanga. Ko te tikanga ka mahia tēnei mā te whakamahi i te laparoscopic cholecystectomy , he tikanga iti rawa te whakaekenga e uru ana ki ētahi tapahi iti noa iho.
Tautoko Tāpiri
I runga anō i ngā raruraru pea, ka hiahia pea koe ki:
- Ngā rongoā paturopi: Hei rongoā, hei ārai rānei i ngā mate pāwera.
- Te Pokanga: Hei tango i ngā wai e kohia ana, hei tango rānei i ngā kiko kua pakaru/necrotic.
- Manaaki Kaha: Hei aroturuki tata mēnā ka kino haere tō āhua.
Te rongoā i te Pancreatitis Mau tonu
Mena ka kitea tēnei mate kei a koe, ka tukuna koe e tō tākuta tiaki tuatahi ki tētahi tohunga puku . Ka tīmata te maimoatanga mā te whakahaere i tō mamae me te whakatinana i ngā huringa āhua noho hei whakaroa i te haere whakamua o te mate. I roto i te wā, ka hiahia pea koe ki ētahi atu whākōkī nakunaku me te insulin mena kāore e taea e tō repe taiaki te whakaputa pai i aua whākōkī.
Ngā Huringa Āhua Noho
He mea nui ēnei. Me mutu rawa te inu waipiro me te momi hikareti. Ka kino rawa atu te pancreatitis i ngā mea e rua, ā, ka tere ake te haere o te mate. Ma tō tākuta koe e hono atu ki ngā rauemi tautoko hei āwhina i a koe ki te whakamutu. Hei tāpiri, he mea nui te kai iti-ngako, he nui ngā matūkai i roto i ngā huawhenua me ngā hua, me te nui hoki o te wai i ia rā, mō tō hauora mō te wā roa.
Te Whakahaere Mamae
He uaua pea te whakahaere i te mamae mau tonu, ā, me whai huarahi whaiaro koe. Me whakamātau pea koe i ngā rongoā me ngā maimoatanga rerekē kia kitea ai te mea e pai ana mōu. Kōrerohia tonutia ō taumata mamae me ō pānga taha ki tō tākuta; ka tukuna pea koe e rātou ki tētahi tohunga mamae mau tonu . I ētahi wā, ka taea e ngā tikanga endoscopic hei tango i te kiko whara, i ngā kōhatu pancreatic rānei te whakaora. Ko te aukati i te celiac plexus — he werohanga hei aukati i ngā io motuhake — tētahi atu kōwhiringa pai mō ētahi tūroro.
Ngā Tāpiringa
I roto i te wā, he maha ngā tūroro e pāngia ana e te ngoikore o te repe taiaki (EPI). Tērā pea ka hiahiatia he tāpiringa whākōkī repe taiaki hei āwhina i te nakunaku. Hei tāpiritanga, tērā pea ka hiahiatia he tāpiringa kai hei whakarite kia tutuki i a koe ō hiahia karori, huaora, me ngā kohuke. Mēnā ka ngaro te kaha o tō tinana ki te whakahaere i te huka toto, ka pāngia pea koe e te mate huka, ā, ka hiahiatia he rongoā insulin.
Pokanga
Mena kei tētahi wāhanga motuhake o te repe taiaki te mumura mau tonu, ā, ka mamae, ka uaua rānei te whakahaere, ka tūtohu pea tō tākuta kia tangohia taua wāhanga mā te pokanga . I ngā wā kua tino kino te repe taiaki, ā, kāore e mutu te mamae, ka tūtohutia pea kia tangohia katoatia te repe taiaki .
He aha te tirohanga mō te wā roa?
Ka ora katoa te nuinga o te tangata i te pancreatitis whakapeka . Mena he ngawari te mate, ka ora pea koe i roto i ngā rā 5–10. Ko ngā mate kino, ko ngā mate pōrearea rānei, me noho pea koe ki te hōhipera mō ngā wiki. Mā te aro ki te pūtake o te mate, ka taea te ārai i te hokinga mai. I roto i te hunga tokoiti e pāngia ana e te ngoikore o ngā okana, tata ki te 20% te nui o te mate.
He mate ahu whakamua te mate pāwera mau tonu . He mea nui te tirotiro hauora auau hei aroturuki i tō āhua me te whakahaere wawe i ngā raruraru. He wero nui te whakahaere i te mamae ka pā ki tō hauora hinengaro me te kounga whānui o te oranga. Ka whakaarohia pea ngā kōwhiringa pokanga ina kore e ranea te whakahaere hauora. Ahakoa ka taea e koe te ora me te kore he repe taiaki, me whakahaere mō te wa katoa me te whakakapinga insulin me te whākōkī.
Ka taea te ārai?
Kāore e taea te ārai i ngā take katoa; heoi, ka taea e koe te whakaiti i tō mōrearea mā te whakawhāiti i te inu waipiro . Ka taea hoki e koe te whakaiti i te mōrearea o te pancreatitis e pā ana ki te kohatu pūkahukahu mā te whakahaere i ō taumata cholesterol . Mena kua pāngia koe e tētahi wā ohorere, ko te whakamutu i te waipiro me te momi hikareti te taahiraa nui rawa atu hei ārai i ngā whakaekenga a muri ake nei. Mena i puta mai tō mate i ngā kohatu pūkahukahu, mā te tango i tō pūkahukahu ka ārai i te hokinga mai.
Kāore pea koe e whakaaro nui ki tō repe taiaki tae noa ki te wā e mamae ai. He wheako whakamataku, he wheako hoha hoki, engari he whakaohooho kia aro nui ki tō hauora mō te wā roa.
Ngā Whakamaumahara Whakamutunga Hira
Mena ka puta mai ngā tohu o te pancreatitis, kaua e warewarehia.Rapua tonutia te awhina hauora. Ka memeha haere te mate pāwera nui i roto i ngā rā me te tiaki tika, ā, he mea nui te tautuhi i te pūtake hei ārai i te mamae ā muri ake nei.
Ka taea e te mate pāwera mau tonu te whanake haere, i ētahi wā ka noho tonu kāore i te kitea kia horapa noa te mate. Ahakoa e mōhiotia ana ko ngā āhuatanga o te noho pērā i te waipiro he take, ko ētahi atu he mea ohorere, he mea ira rānei. He haerenga te ako ki te noho me te mate mau tonu. Me whai tākuta pono koe hei tautoko i a koe puta noa i tō oranga. Ko tō hauora tō kawenga, nō reira kia tiakina pai me te āwhina a te tīma i Nirogi Lanka.
Pānihi, Pānihi, Mamae puku, Kōhatu au, Waipiro, Nakunaku
