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Indwara ya Stevens-Johnson, uduheri tw’uruhu duterwa n’allergie y’ibiyobyabwenge

Indwara ya Stevens-Johnson, uduheri tw’uruhu duterwa n’allergie y’ibiyobyabwenge

Tekereza ufite umuriro, ububabare bw'umubiri, maze ugatangira gufata umuti wanditswe na muganga. Bite ho mu gihe, mu minsi mike, wenda icyumweru kimwe cyangwa bibiri, ugize ibisebe bitukura ku mubiri wawe, udusebe mu kanwa, mu maso no mu myanya ndangagitsina yawe, maze uruhu rwawe rugatangira gushwanyagurika no gushwanyagurika nk'aho rwahiye? Iyi ni indwara iteye ubwoba, iteje akaga cyane, kandi idakunze kugaragara. Uyu munsi tugiye kuvuga kuri iyi ndwara yitwa Stevens-Johnson Syndrome (SJS). Ni ngombwa cyane ko buri wese abimenya.

SJS na TEN ni iki? Itandukaniro riri hagati y'ibyo byombi ni irihe?

Indwara ya Stevens-Johnson Syndrome (SJS) ni ikibazo gikomeye cyo kwangirika k'uruhu rwacu n'imikaya, bigatuma uturemangingo dupfa ndetse n'uruhu rugashibuka. Imikaya ni imikaya yoroshye kandi itose igaragara mu kanwa kacu, mu mazuru, mu maso, mu myanya ndangagitsina no mu kibuno.

Hari ubundi bwoko bukomeye bw'iyi ndwara, twita Toxic Epidermal Necrolysis (TEN) . Mu magambo make, SJS na TEN ni nk'impande ebyiri z'indwara imwe.

  • SJS (Stevens-Johnson Syndrome): Muri iki gihe , munsi ya 10% by'uruhu rw'umubiri rukurwaho.
  • TEN (Toxic Epidermal Necrolysis): Iyi ni indwara ikomeye cyane kandi ishobora gushyira ubuzima mu kaga aho uruhu rw'umubiri rurenga 30% .

Izi ndwara zombi zirakomeye cyane, bityo umurwayi agomba kujya mu bitaro , rimwe na rimwe mu cyumba cy’indembe (ICU) cyangwa mu cyumba cy’ubushye.

Ni nde ufite amahirwe menshi yo kurwara iyi ndwara?

Nubwo SJS ishobora kugaragara mu myaka iyo ari yo yose, ikunze kugaragara cyane mu bana n'urubyiruko ruri munsi y'imyaka 30. Ishobora no kugaragara mu bantu bakuze. SJS igaragara cyane mu bagore kurusha abagabo.

Hari itandukaniro rito iyo urebye impamvu:

  • Impamvu nyamukuru itera SJS mu bana ni indwara zandura nka pneumonia .
  • Impamvu nyamukuru itera SJS/TEN ku bantu bakuru ni allergie iyo banyoye umuti .

Ni ibihe bimenyetso by'indwara ya SJS mu by'ukuri?

Ni ingenzi cyane kumenya ibi bimenyetso, kuko uko ubimenye vuba, ni ko ushobora gushaka ubuvuzi vuba. Ibimenyetso bikunze kugaragara mu cyumweru kimwe cyangwa bitatu uhereye igihe utangiye gufata umuti.

Ibimenyetso bya mbere ni ibimenyetso bisanzwe by'ibicurane nk'umuriro, kubabara umubiri, kuribwa umutwe, n'inkorora. Ibi bituma bigorana kumenya SJS mu minsi ya mbere. Icyo gihe ni bwo ibimenyetso bikomeye by'uruhu bigaragara.

Dore ibimenyetso by'ingenzi bya SJS.

Ibimenyetso Bisobanuwe mu buryo bworoshye
Ububabare bukomeye bw'uruhu Kumva ububabare bukabije ku buryo udashobora gukora ku ruhu rwawe.
Umuriro n'ububabare bw'umubiri Ibimenyetso birimo umuriro mwinshi, kubabara umubiri, no kuribwa umutwe.
Uduce dutukura n'uduce duto Uduheri cyangwa ibisebe bitukura bitangirira mu maso no mu gituza bigakwirakwira mu mubiri wose.
Ibisebe n'ibikomere Ibisebe n'ibisebe bibabaza ku ruhu, imbere mu kanwa, mu muhogo, mu maso, mu myanya ndangagitsina no mu maraso.
Gukura uruhu Udusebe twaturitse maze uruhu rwo hejuru rugashibukamo uduce duto.
Gusohora amacandwe mu kanwa Kunyara bitewe n'ibisebe byo mu kanwa, kudashobora gufunga umunwa.
Guhuza amaso Kubyimba kw'amaso no kubyimba, bigatuma bigorana gufungura amaso.
Ububabare mu gihe cyo kwihagarika Ububabare bukomeye mu gihe cyo kwihagarika bitewe no kubyimba kw'uturemangingo tw'amaraso.

Impamvu z'ingenzi n'ubwoko bw'imiti ishobora gutera SJS

Impamvu nyamukuru itera SJS ni allergie iterwa n'umuti runaka. Ariko, ibi ntibibaho ku miti yose. Hari ubwoko bwinshi bw'imiti bushobora gutera SJS.

Impamvu Ibisobanuro
Allergie ku miti Iyi ni yo mpamvu y’inyinshi mu manza za SJS na TEN.
Indwara zandurira mu mubiri Cyane cyane ku bana, ishobora guterwa n'indwara nka Mycoplasma pneumonia, Herpes, na Hepatite A.
Izindi mpamvu Indwara ya graft-versus-host, ikibazo kivuka nyuma yo guterwa umwongo w'amagufwa, inkingo (gake cyane), kandi rimwe na rimwe nta mpamvu iboneka.

Ibiyobyabwenge bifite ibyago byinshi byo gutera SJS

  • Imiti ya sulfa irwanya bagiteri: Ubwoko bumwe na bumwe bwa antibiyotike.
  • Imiti igabanya igicuri: Urugero, imiti nka `Phenytoin (Dilantin®)`, `Carbamazepine (Tegretol®)`, `Lamotrigine (Lamictal®)`, `Phenobarbital (Luminal®)`.
  • Allopurinol: Umuti ukoreshwa mu kuvura indwara ya goutte n'ubwoko bumwe na bumwe bw'amabuye mu mpyiko (`Aloprim®`, `Zyloprim®`).
  • Imiti igabanya ububabare (NSAIDs): Imiti igabanya ububabare itari iya steroid nka `Piroxicam (Feldene®)`, `Diclofenac (Cambia®, Flector®)`. Indi miti nka `Nevirapine (Viramune®)`.
  • Izindi Antibiyotike: Hari ubundi bwoko bwa antibiyotike nabwo bushobora gutera ibi.

Icy'ingenzi: Si buri wese uzarwara SJS binyuze mu miti yavuzwe hano. Abantu babarirwa muri za miriyoni barayikoresha. Ariko, iyi miti byagaragaye ko ifite ibyago byinshi byo kurwara SJS. Ntugahagarike gufata imiti yandikiwe na muganga hashingiwe kuri iyi ngingo.

Gusuzuma no kuvura indwara

Niba wowe cyangwa undi muntu uzi agize ibimenyetso byavuzwe haruguru, cyane cyane niba utangiye imiti mishya, ni ngombwa guhita ujya mu bitaro bikuru byihutirwa (ETU) by’ibitaro biri hafi yawe .

Abaganga bapima iyi ndwara bakoresheje:

  • Ukoresheje gusuzuma uruhu rwawe n'uturemangingo tw'imitsi (nk'umunwa, amaso).
  • Mu kubaza urwego rw'ububabare wumva.
  • Urebye umuvuduko ibimenyetso by'uruhu byakwirakwiriye n'uburyo byakwirakwiriye.
  • Iyo bibaye ngombwa, agace gato k'uruhu gashobora gufatwa kagasuzumwa (isuzuma ry'uruhu).

Uburyo bwo kuvura SJS

Intego nyamukuru zo kuvura SJS ni uguhagarika umuti wateye iyi ndwara, kugenzura ibimenyetso, gukumira ingorane, no gufasha uruhu gukira. Kujya mu bitaro ni ngombwa kuri ibi.

Uburyo bumwe bwo kuvura buri hano hepfo:

Uburyo bwo kuvura Ibisobanuro
Guhagarika umuti utera indwara Iyi ni intambwe ya mbere kandi y'ingenzi cyane. Umuti ukekwaho gutera SJS uhita uhagarikwa.
Gutanga ibinyobwa n'imyunyu ku mubiri Gukura k'uruhu bituma amazi menshi asohoka mu mubiri, bityo amazi yo mu miyoboro ya IV akoreshwa mu gutanga amazi n'amashanyarazi akenewe.
Kuvura uruhu Uruhu rwakomeretse rutwikiriwe n'udupira twihariye tudafata neza, kimwe no kuvura ubushye.
Gutanga imirireKurya biragoye kubera ibisebe byo mu kanwa. Kubera ko bisaba imbaraga nyinshi kugira ngo bikire, ibiryo bifite karori nyinshi bitangwa binyuze mu muyoboro unyura mu mazuru ujya mu gifu (konsa imiyoboro).
Kurwanya ububabare Iyi ni indwara ibabaza cyane, bityo hatangwa imiti ikomeye igabanya ububabare.
Serivisi z'ubuvuzi zihariye Shaka ubufasha bw'umuganga w'uruhu, kandi niba amaso agize ikibazo, hamagara umuganga w'amaso.

Ingorane za SJS n'ingaruka nyuma yo gukira

SJS ni indwara ikomeye cyane ishobora no gutera urupfu. Hafi 10% by'abarwayi ba SJS na 50% by'abarwayi bafite ubwoko bukomeye bwa TEN, barapfa. Impamvu nyamukuru z'urupfu ni ingorane zikomeye nka sepsis, umusonga, no kunanirwa kw'ingingo nyinshi.

Nubwo iyo ndwara yakira, hari abantu bashobora kugira ingaruka z'igihe kirekire.

  • Impinduka z'uruhu: Uruhu rwumye, uburyaryate, ibara ry'uruhu rihinduka.
  • Ibibazo by'amaso: amaso yumye, kutabona neza kenshi, kutabona neza, kugorwa no kureba urumuri (photophobia).
  • Ibindi: Kubira ibyuya byinshi, kwangirika kw'ibihaha, gutakaza inzara cyangwa ubusembwa, gutakaza umusatsi, kubura uburyohe.

Icy'ingenzi cyane: Iyo wongeye guhura n'umuti wateye SJS, ku nshuro ya kabiri iyo ndwara ishobora kuba ikomeye cyane kurusha iya mbere. Kubwibyo, ni ngombwa kwibuka izina ry'umuti wateye SJS n'indi miti isa nayo ubuzima bwawe bwose no kubimenyesha buri muganga wese ugiye kubonana na we.

Ubutumwa bwo kujyana mu rugo

  • Indwara ya Stevens-Johnson Syndrome (SJS) ni indwara ikomeye y’uruhu ishyira ubuzima mu kaga, akenshi iterwa n’umuti.
  • Ibimenyetso bya mbere birimo umuriro n'ububabare bw'umubiri, ariko nyuma bikagenda bikuramo uduce dutukura tubabaza ku ruhu, uduheri, ndetse n'uruhu rugashibuka.
  • Niba ubonye ibi bimenyetso nyuma yo gutangira imiti mishya, jya ku bitaro byita ku barwayi ba ETU vuba vuba.
  • Uburyo bw'ingenzi bwo kuvura ni ukumenya no guhagarika umuti wateye iyi ndwara, no gutanga ubuvuzi bufasha mu bitaro.
  • Wibuke izina ry'umuti waguteye indwara ya SJS ubuzima bwawe bwose kandi ubibwire muganga wawe igihe cyose ugiye kwivuza. Ibi bishobora kugufasha kurokora ubuzima bwawe.

Indwara ya Stevens-Johnson, SJS, TEN, ubwivumbure bw'ibiyobyabwenge, indwara z'uruhu, indwara z'uruhu, uduheri, ubwivumbure bw'ibiyobyabwenge, uduheri tw'uruhu
⚠️ Important: The medical articles and information on Nirogi Lanka are for general awareness only, and are by no means a substitute for professional medical advice, diagnosis, or treatment. For any medical problem you have, consult a qualified physician immediately.

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Kwipimisha kanseri y'ibere, kwisuzuma no kwirinda byakozwe byoroshye. Kanseri y'ibihaha

Ishyirireho intego ya calorie hanyuma ubare itariki yo kugabanya ibiro.

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Indwara ya Stevens-Johnson, uduheri tw’uruhu duterwa n’allergie y’ibiyobyabwenge
Indwara z'uruhu2026 Nyakanga 15

Indwara ya Stevens-Johnson, uduheri tw’uruhu duterwa n’allergie y’ibiyobyabwenge

Tekereza ufite umuriro, ububabare bw'umubiri, maze ugatangira gufata umuti wanditswe na muganga. Bite ho mu gihe, mu minsi mike, wenda icyumweru kimwe cyangwa bibiri, ugize ibisebe bitukura ku mubiri wawe, udusebe mu kanwa, mu maso no mu myanya ndangagitsina yawe, maze uruhu rwawe rugatangira gushwanyagurika no gushwanyagurika nk'aho rwahiye? Iyi ni indwara iteye ubwoba, iteje akaga cyane, kandi idakunze kugaragara. Uyu munsi tugiye kuvuga kuri iyi ndwara yitwa Stevens-Johnson Syndrome (SJS). Ni ngombwa cyane ko buri wese abimenya.

SJS na TEN ni iki? Itandukaniro riri hagati y'ibyo byombi ni irihe?

Indwara ya Stevens-Johnson Syndrome (SJS) ni ikibazo gikomeye cyo kwangirika k'uruhu rwacu n'imikaya, bigatuma uturemangingo dupfa ndetse n'uruhu rugashibuka. Imikaya ni imikaya yoroshye kandi itose igaragara mu kanwa kacu, mu mazuru, mu maso, mu myanya ndangagitsina no mu kibuno.

Hari ubundi bwoko bukomeye bw'iyi ndwara, twita Toxic Epidermal Necrolysis (TEN) . Mu magambo make, SJS na TEN ni nk'impande ebyiri z'indwara imwe.

  • SJS (Stevens-Johnson Syndrome): Muri iki gihe , munsi ya 10% by'uruhu rw'umubiri rukurwaho.
  • TEN (Toxic Epidermal Necrolysis): Iyi ni indwara ikomeye cyane kandi ishobora gushyira ubuzima mu kaga aho uruhu rw'umubiri rurenga 30% .

Izi ndwara zombi zirakomeye cyane, bityo umurwayi agomba kujya mu bitaro , rimwe na rimwe mu cyumba cy’indembe (ICU) cyangwa mu cyumba cy’ubushye.

Ni nde ufite amahirwe menshi yo kurwara iyi ndwara?

Nubwo SJS ishobora kugaragara mu myaka iyo ari yo yose, ikunze kugaragara cyane mu bana n'urubyiruko ruri munsi y'imyaka 30. Ishobora no kugaragara mu bantu bakuze. SJS igaragara cyane mu bagore kurusha abagabo.

Hari itandukaniro rito iyo urebye impamvu:

  • Impamvu nyamukuru itera SJS mu bana ni indwara zandura nka pneumonia .
  • Impamvu nyamukuru itera SJS/TEN ku bantu bakuru ni allergie iyo banyoye umuti .

Ni ibihe bimenyetso by'indwara ya SJS mu by'ukuri?

Ni ingenzi cyane kumenya ibi bimenyetso, kuko uko ubimenye vuba, ni ko ushobora gushaka ubuvuzi vuba. Ibimenyetso bikunze kugaragara mu cyumweru kimwe cyangwa bitatu uhereye igihe utangiye gufata umuti.

Ibimenyetso bya mbere ni ibimenyetso bisanzwe by'ibicurane nk'umuriro, kubabara umubiri, kuribwa umutwe, n'inkorora. Ibi bituma bigorana kumenya SJS mu minsi ya mbere. Icyo gihe ni bwo ibimenyetso bikomeye by'uruhu bigaragara.

Dore ibimenyetso by'ingenzi bya SJS.

Ibimenyetso Bisobanuwe mu buryo bworoshye
Ububabare bukomeye bw'uruhu Kumva ububabare bukabije ku buryo udashobora gukora ku ruhu rwawe.
Umuriro n'ububabare bw'umubiri Ibimenyetso birimo umuriro mwinshi, kubabara umubiri, no kuribwa umutwe.
Uduce dutukura n'uduce duto Uduheri cyangwa ibisebe bitukura bitangirira mu maso no mu gituza bigakwirakwira mu mubiri wose.
Ibisebe n'ibikomere Ibisebe n'ibisebe bibabaza ku ruhu, imbere mu kanwa, mu muhogo, mu maso, mu myanya ndangagitsina no mu maraso.
Gukura uruhu Udusebe twaturitse maze uruhu rwo hejuru rugashibukamo uduce duto.
Gusohora amacandwe mu kanwa Kunyara bitewe n'ibisebe byo mu kanwa, kudashobora gufunga umunwa.
Guhuza amaso Kubyimba kw'amaso no kubyimba, bigatuma bigorana gufungura amaso.
Ububabare mu gihe cyo kwihagarika Ububabare bukomeye mu gihe cyo kwihagarika bitewe no kubyimba kw'uturemangingo tw'amaraso.

Impamvu z'ingenzi n'ubwoko bw'imiti ishobora gutera SJS

Impamvu nyamukuru itera SJS ni allergie iterwa n'umuti runaka. Ariko, ibi ntibibaho ku miti yose. Hari ubwoko bwinshi bw'imiti bushobora gutera SJS.

Impamvu Ibisobanuro
Allergie ku miti Iyi ni yo mpamvu y’inyinshi mu manza za SJS na TEN.
Indwara zandurira mu mubiri Cyane cyane ku bana, ishobora guterwa n'indwara nka Mycoplasma pneumonia, Herpes, na Hepatite A.
Izindi mpamvu Indwara ya graft-versus-host, ikibazo kivuka nyuma yo guterwa umwongo w'amagufwa, inkingo (gake cyane), kandi rimwe na rimwe nta mpamvu iboneka.

Ibiyobyabwenge bifite ibyago byinshi byo gutera SJS

  • Imiti ya sulfa irwanya bagiteri: Ubwoko bumwe na bumwe bwa antibiyotike.
  • Imiti igabanya igicuri: Urugero, imiti nka `Phenytoin (Dilantin®)`, `Carbamazepine (Tegretol®)`, `Lamotrigine (Lamictal®)`, `Phenobarbital (Luminal®)`.
  • Allopurinol: Umuti ukoreshwa mu kuvura indwara ya goutte n'ubwoko bumwe na bumwe bw'amabuye mu mpyiko (`Aloprim®`, `Zyloprim®`).
  • Imiti igabanya ububabare (NSAIDs): Imiti igabanya ububabare itari iya steroid nka `Piroxicam (Feldene®)`, `Diclofenac (Cambia®, Flector®)`. Indi miti nka `Nevirapine (Viramune®)`.
  • Izindi Antibiyotike: Hari ubundi bwoko bwa antibiyotike nabwo bushobora gutera ibi.

Icy'ingenzi: Si buri wese uzarwara SJS binyuze mu miti yavuzwe hano. Abantu babarirwa muri za miriyoni barayikoresha. Ariko, iyi miti byagaragaye ko ifite ibyago byinshi byo kurwara SJS. Ntugahagarike gufata imiti yandikiwe na muganga hashingiwe kuri iyi ngingo.

Gusuzuma no kuvura indwara

Niba wowe cyangwa undi muntu uzi agize ibimenyetso byavuzwe haruguru, cyane cyane niba utangiye imiti mishya, ni ngombwa guhita ujya mu bitaro bikuru byihutirwa (ETU) by’ibitaro biri hafi yawe .

Abaganga bapima iyi ndwara bakoresheje:

  • Ukoresheje gusuzuma uruhu rwawe n'uturemangingo tw'imitsi (nk'umunwa, amaso).
  • Mu kubaza urwego rw'ububabare wumva.
  • Urebye umuvuduko ibimenyetso by'uruhu byakwirakwiriye n'uburyo byakwirakwiriye.
  • Iyo bibaye ngombwa, agace gato k'uruhu gashobora gufatwa kagasuzumwa (isuzuma ry'uruhu).

Uburyo bwo kuvura SJS

Intego nyamukuru zo kuvura SJS ni uguhagarika umuti wateye iyi ndwara, kugenzura ibimenyetso, gukumira ingorane, no gufasha uruhu gukira. Kujya mu bitaro ni ngombwa kuri ibi.

Uburyo bumwe bwo kuvura buri hano hepfo:

Uburyo bwo kuvura Ibisobanuro
Guhagarika umuti utera indwara Iyi ni intambwe ya mbere kandi y'ingenzi cyane. Umuti ukekwaho gutera SJS uhita uhagarikwa.
Gutanga ibinyobwa n'imyunyu ku mubiri Gukura k'uruhu bituma amazi menshi asohoka mu mubiri, bityo amazi yo mu miyoboro ya IV akoreshwa mu gutanga amazi n'amashanyarazi akenewe.
Kuvura uruhu Uruhu rwakomeretse rutwikiriwe n'udupira twihariye tudafata neza, kimwe no kuvura ubushye.
Gutanga imirireKurya biragoye kubera ibisebe byo mu kanwa. Kubera ko bisaba imbaraga nyinshi kugira ngo bikire, ibiryo bifite karori nyinshi bitangwa binyuze mu muyoboro unyura mu mazuru ujya mu gifu (konsa imiyoboro).
Kurwanya ububabare Iyi ni indwara ibabaza cyane, bityo hatangwa imiti ikomeye igabanya ububabare.
Serivisi z'ubuvuzi zihariye Shaka ubufasha bw'umuganga w'uruhu, kandi niba amaso agize ikibazo, hamagara umuganga w'amaso.

Ingorane za SJS n'ingaruka nyuma yo gukira

SJS ni indwara ikomeye cyane ishobora no gutera urupfu. Hafi 10% by'abarwayi ba SJS na 50% by'abarwayi bafite ubwoko bukomeye bwa TEN, barapfa. Impamvu nyamukuru z'urupfu ni ingorane zikomeye nka sepsis, umusonga, no kunanirwa kw'ingingo nyinshi.

Nubwo iyo ndwara yakira, hari abantu bashobora kugira ingaruka z'igihe kirekire.

  • Impinduka z'uruhu: Uruhu rwumye, uburyaryate, ibara ry'uruhu rihinduka.
  • Ibibazo by'amaso: amaso yumye, kutabona neza kenshi, kutabona neza, kugorwa no kureba urumuri (photophobia).
  • Ibindi: Kubira ibyuya byinshi, kwangirika kw'ibihaha, gutakaza inzara cyangwa ubusembwa, gutakaza umusatsi, kubura uburyohe.

Icy'ingenzi cyane: Iyo wongeye guhura n'umuti wateye SJS, ku nshuro ya kabiri iyo ndwara ishobora kuba ikomeye cyane kurusha iya mbere. Kubwibyo, ni ngombwa kwibuka izina ry'umuti wateye SJS n'indi miti isa nayo ubuzima bwawe bwose no kubimenyesha buri muganga wese ugiye kubonana na we.

Ubutumwa bwo kujyana mu rugo

  • Indwara ya Stevens-Johnson Syndrome (SJS) ni indwara ikomeye y’uruhu ishyira ubuzima mu kaga, akenshi iterwa n’umuti.
  • Ibimenyetso bya mbere birimo umuriro n'ububabare bw'umubiri, ariko nyuma bikagenda bikuramo uduce dutukura tubabaza ku ruhu, uduheri, ndetse n'uruhu rugashibuka.
  • Niba ubonye ibi bimenyetso nyuma yo gutangira imiti mishya, jya ku bitaro byita ku barwayi ba ETU vuba vuba.
  • Uburyo bw'ingenzi bwo kuvura ni ukumenya no guhagarika umuti wateye iyi ndwara, no gutanga ubuvuzi bufasha mu bitaro.
  • Wibuke izina ry'umuti waguteye indwara ya SJS ubuzima bwawe bwose kandi ubibwire muganga wawe igihe cyose ugiye kwivuza. Ibi bishobora kugufasha kurokora ubuzima bwawe.

Indwara ya Stevens-Johnson, SJS, TEN, ubwivumbure bw'ibiyobyabwenge, indwara z'uruhu, indwara z'uruhu, uduheri, ubwivumbure bw'ibiyobyabwenge, uduheri tw'uruhu
⚠️ Important: The medical articles and information on Nirogi Lanka are for general awareness only, and are by no means a substitute for professional medical advice, diagnosis, or treatment. For any medical problem you have, consult a qualified physician immediately.

💬 Comments (0)

Kwipimisha kanseri y'ibere, kwisuzuma no kwirinda byakozwe byoroshye. Kanseri y'ibihaha

Ishyirireho intego ya calorie hanyuma ubare itariki yo kugabanya ibiro.

Kwipimisha kanseri y'ibere, kwisuzuma no kwirinda byakozwe byoroshye. Kanseri y'ibihaha 9 + 9 =