HEPATITIS/THIN VUNG
Dr. Zoramthanga, MD
Thin hi taksa peng zinga a pawimawh ber pakhat a ni. Hna chi hrang hrang a thawh tlangpuite chu : Kan chaw ei zawng zawng te hi thinah a lut chho vek a, taksa tana hman tlak turin a lo sawng bawl a ni. Glucose te, thau-cholesterol, triglyceride te, sa (protein) te leh vitamin te a chhekin a sem kual vel a ni. Taksaa bawlhhlawh tam tak mit(bile)-ah a paih chhuak a, damdawi tam tak te hi thawk thei turin a lo siam danglam a, tin, an thawh tur an thawh zawhah a paih chhuak leh a ni. Thisen ti khal tu hi thin siam a ni a, thin chak lo te hi an thisen a pan a, an thi duh bik a ni. Albumin te siamin a siam tlem chuan vung te a thlen thei a ni. Tin, taksa in hrik a do naah thui tak a thawk bawk a ni.
Hepatitis hi thin vung tihna a ni. Chhan tam tak a nei a .Natna hrik-virus,bacteria,protozoa te,damdawi chi hrang hrang- antibiotic, na chhawkna, hnimhlum, cancer damdawi etc ten thin vung an thlen thei.A tlangpui te chu: - Hepatitis A,B,C,D,E,G, cmv, eb virus,TB hrik, Amoeba/Santen hrik/Malaria ,Drugs -na chhawkna - Acetaminophen,Brufen-Antibiotics - Tetracycline,Rifampicin, Hnimhlum leh a dang - Pa(mushroom) thenkhat te a ni.
Hepatitis hi acute leh chronic in an then leh a. Acute awmzia chu, rawn awm thut - rei vak lova dam leh mai. Chronic chu benvawn tihna a ni a.
ACUTE HEPATITIS: kan sawi tawh angin acute hepatitis chu rawn awm thut kan tih kha.
-Khua a sik ser sera,
-an chau ngawih ngawih a,
-thin zawn a na a,
-luak a chhuak a,
-chaw eia tui lova,
-mit a liam a(jaundice) .
A tlang puiin kar 2 velah an dam leh mai thin.
CHRONIC HEPATITIS: Acute hepatitis dam zo ve ta lo ho hi an benvawn ta thin a ni.
Thin vung an lo neih benvawn hian ,zawi zawi in a cell (timur) te kha a ti chhia a, insiam tha leh teh mahse a ngai a awh tawh lo thin a ni. Thin vung hian ser a siam a, a rei tawlh tawlh a,ser a tam tawlh tawlh a, heng ser te hian thin lo pawt sawngin cirrhosis (thin sawng) a lo thlen ta thin a ni. Hetih hunah hi chuan thin a lo chak lo hle tawh a, a veite chu hetiangin an awm tlangpui.
-An zawiin an chak lo hle
-An vung/pum puar
-Thi a put awl- hnar thi, thi a luak, ek dum etc.
-Mit liam, eng pip pep/ thisen tlem
-Rilru te khawih buaiin nikhaw hre lo (coma) te pawhin an awm thei.
-Piles leh Oesophageal varix (pumpui hnuna thisen dawt puar) te an nei thin
eg. Mitliam kan tih mai Viral Hepatitis ‘A’ hi , thil thianghlim lo ei vanga thleng a ni a,Mit a lo eng a, an zawi hle a, mahse a tlangpuiin kar hnih velah an dam leh mai. Zu in nghek te pawh hian Acute Hepatitis a thlen thin. Miin zu a in reng chuan Chronic Hepatitis a thlen thin a ni. Mizoramah hian heng hepatittis kan sawi tak zingah hian hepatitis benvawn pathum kan buaipui zual a; chung te chu Alcoholic Hepatitis (zu), Chronic Hepatitis B leh Chronic Hepatitis C te an ni, Heng veite hian thin cancer an nei duh bik a ni.
Tun tumah hi chuanHepatitis B leh C te hi han chhui zau deuh ila. Hepatitis B leh C te hi virus an ni a, natna an thlen dan a inantlangpui avangin kan han sawi kawp mai ang a, an in an lohna te a tul angin kan han tarlang ang.
Inkai dan : Virus ve tho, HIV (AIDS natna hrik) te nen hian inkai dan a inang tlang pui ie. inchiu, sex, thisen inpeh, nuin nau paiah etc. Amaherawhchu kai awlsam dan a inang lo. Hriau in vih palh tein inkai a awl em em a, Hepatitis C te hi chu sex lam atangin kai a awl lutuk lo.
Natna thlen dan : Hepatitis B or C miin a veiin Acute Hepatitis (mitliam kan tihna) an vei phawt a,hei hi Hepatitis A te angin a na lutuk lova. Hepatitis C leh B vei tam tak chuan an vei lai pawh hre lovin an benvawn, thin sawn (cirrhosis) hnuah chauh te an in hre thin. Heng ho ah hi chuan acute hepatitis kha a na lo lutuka an in hre lo a ni.Acute Hepatitis hi chu kar hnih velah a dam leh mai a, mahse dam zo ve ta lo,a hrik pai benvawn an lo awm thei ta a.
Hepatitis B: Puitlingah chuan 95 % aia tam an dam leh a, 5% aia tlem an benvawn thin.
Nausen ah chuan 5% a dam leha, 95% vel an benvawn
Naupang kum 4 velah 40% vel an benvawn
A awmzia chu, naupangah a benvawn duh bik.
Hepatitis C : ah chuan 20-30% vel an dam leh a, 70-80% vel an ben vawn ta thina ni.Benvawn kan tih hian, thla ruk chhunga dam hman ve ta lote kha an ni.
Hetia Chronic (benvawn) Hepatitis B or C an lo vei tak hian an hma lam hun chu a hrik leh mihring taksa inbeih danah a innghat ta a ni. Hrik ninhlei tak a nih chuan thin a khawih chhe chak a, hrik nin hlei lo a nih chuan muang changin. Tin, taksain a hrik alo beih danah te a innghat bawk. A tlangpuiinkum 20-30 ah 30% velah chuan an thin a lo sawng chhe hman thin a ni. Hei aia hma deuh a ni thei a. Tin, rei tak thin khawih chhe lovin an awm thin bawk.Zu nen an pawi khawih dan a inang a, chuvangin zu nen chuan cirrhosis hi a thleng hma hle a ni.
Kan sawi tawh angin kum 20-30 vel thin sawng turin a duh a, hemi chhung hian tam tak chuan an vei tih an inhre lo thin a ni.A tam zawk chu thin sawng in buaina a thlen hunah chauh an in hre chhuakthin a ni.Hetih hunah hi chuan a tlai tawh deuha ,enkawl an harsa thin a ni. A then, a bik takin Hepatitis B te chu Jaundice te an nei zeuh zeuh a, chung atang te chuan an lo hriat theih a ni. Mizorama kan hriat chhuah hmate pawh hi thil dang vanga test emaw, in test ve tawp te an ni hlawm.
Enkawl dan :
Hepatitis B : Hepatitis B hi a dam har a, damdawi a kan enkawl hian, kan tum ber pakhat chu, a hrik pawi sawi lova siam hi a ni. i.e currhosis emaw thin cancer a thlen loh nan. Enkawl nan hian a chiu chi, Interferon leh a mum chi hrang hrang a awm.Heng damdawi te hi thla ruk atanga kum 2 emaw, a aia rei te pek an ngai a ni.
Hepatitis C : Hepatitis C enkawl hi chu Hepatitis B lakah chuan enkawl a nuam hle a ni. Mi 70-80% vel an dam thin a ni. Mahse cirrhosis te a thlen tawh chuan a dam har a ni.
Hepatitis C enkawl nan hian Interferon chiu chi leh tablet ribavarin pek dun a ni a, 6-12 months pek thin an ni. A hrik Genotype 2 leh 3 hi thla ruk chhung enkawl an ni tlangpui a, tin, a dang Genotype 1,4,5,6 te hi kum khat enkawl thin an ni. Tin, genotype 2 leh 3 te pawh hi an nat dan a zirin thla 6 aia tam te pawh enkawl an ngai thei. (genotype= hepatitis C rau rau ah chi hrang paruk a awm a, an dam har dan leh pawi khawih dan te a in ang lo.)
Hepatitis C enkawl hian ‘relapse’ kan ti a, chu chu dam tawha ngaihah a awm nawn leh thei a ni. Heng awm nawn lehah hian a hma aia rei enkawlin tam tak chu an dam leh thei a ni.Amaherawhchuthen khat chu interferon/ribavarin in a tih dam theih loh an awm ve bawk.
Kan hriat tur pawimawh deuh chu Anti HCV - kan test hian, a hrik a en lova, a hrik dotu sipai (antibody)a en ani . Heng test hi Aizawl a awlsam taka kan test na hi a ni. Heng Anti HCV test positive ho hi, an thisenah Hepatitis C hrik awm leh awm loh phaiah kan thawn ta thina ni. Enkawl dam tawh hnuah pawh Anti HCV hi rei tak a positive theih avangin interferon la tawhah chuan he test hian awmzia a nei lo. Enkawl dam tawh then khat ten mahni thuin an lo test ve a, a lo positive leh a, an ngaih a tha lo ta thin a ni. A hrik test na a ni lova- a hrik dotu sipai test na a ni.
Enlawna : Hepatitis C Interferon a enkawl zawng zawng hian an dampui kher lo. A to chi Peg interferon hian 70-80% a ti dam a, a tlawm chi Plain interferon hian 50-60% a ti dam a ni. Na nei tawh leh thin sawng (Cirrhosis) leh a hrik pai hnenah te a dam har a ni.
Enkawl Man :
Plain Interferon -Rs 50,000/- vel thla ruk tan
Pegylated Interferon-Rs3,50,000/- vel thla ruk tan
Interferon hi hepatitis B leh C tan a hman theih a ni. Pegylated khi a chak tha zawk a ni.
Hepatitis B enkawlna mum chi hrang hrang te hi thla khat tan Rs 600 atanga Rs 6000 te an ni a, kum 2 emaw a aia tam te pek thin an ni.
Heng aia chipchiara hre duh tan a in zawh theih reng e.
