Uburibwa bwa Pituitary? Ibimenyetso, Impamvu, n'Ubuvuzi

Uburibwa bwa pituitary ni udukoko dukura mu gice cy'ubwonko kitwa pituitary gland, gito ariko gifite akamaro kanini mu mubiri. Ibyinshi muri ubwo buribwa ntabwo ari kanseri, bisobanura ko atari mbi kandi ko bidakwirakwira mu bindi bice by'umubiri.

Pituitary gland ikora nk'ikigo gikurikirana imisemburo y'umubiri, ikora imiti igengura byose kuva ku gukura kugeza ku kubyara. Iyo habaye uburibwa muri iki gice, bushobora gukanda ku tundi duce tw'ubwonko cyangwa bugatuma imisemburo idakora neza, bigatuma haboneka ibimenyetso bitandukanye bishobora kugaragara nk'ibidafite aho bihuriye.

Ni ibihe bimenyetso by'uburibwa bwa pituitary?

Ibimenyetso by'uburibwa bwa pituitary biterwa n'ingano y'ubwo buribwa niba bugira ingaruka ku misemburo. Abantu benshi babana n'ubwo buribwa buto batabizi, abandi bagaragaza impinduka ziboneka mu buzima bwabo bwa buri munsi.

Iyo uburibwa bukuruye buhagije kugira ngo bukomeze ku bindi bice by'ubwonko, ushobora kumva ibimenyetso byo gukanda. Ibi bibaho kuko uburibwa bukomeza gukanda ku duce tw'ingenzi duherereye hafi ya pituitary gland.

• Kubabara umutwe buhoraho bumva bitandukanye n'ububabara busanzwe bw'umutwe
• Ibibazo by'ububone, cyane cyane kubura ubushobozi bwo kubona ibiri ku mpande cyangwa kubona ibintu bibiri
• Isesemi no kuruka bisa nk'ibiturutse aho nta hantu
• Kuzenguruka cyangwa ibibazo byo kubura umutekano
• Uburwayi budakira nubwo waruhuka

Ibimenyetso bifitanye isano n'imisemburo bibaho iyo uburibwa bukoze imisemburo myinshi cyangwa bugabuza pituitary gukora ihagije. Ibi bimenyetso bishobora kuba bito kandi bikagenda buhoro buhoro mu mezi cyangwa imyaka.

Niba uburibwa bwawe bukoze imisemburo y'ubukure myinshi, ushobora kubona amaboko yawe, amaguru yawe, cyangwa imiterere y'isura yawe ikura buhoro buhoro. Iyi ndwara, yitwa acromegaly, ishobora kandi guteza ububabare bw'ingingo, guhagarika guhumeka nijoro, no guhinduka kw'ijwi ryawe.

Uburibwa bukoresha prolactin myinshi bushobora guteza imihango idahwitse mu bagore, gukora amata adasanzwe, no kugabanuka kw'irari ryo gutera akabariro mu bagabo n'abagore. Abagabo bashobora kandi kugira ibibazo byo kudatera inda cyangwa amabere akura.

Iyo uburibwa bukoze imisemburo nyinshi ishyushya cortisol, ushobora kugira indwara yitwa Cushing's disease. Ibi bishobora guteza ubwuzu bw'umubiri mu gice cy'inda, imirongo itukura, umuvuduko w'amaraso, n'impinduka z'imitekerereze nko kwiheba cyangwa guhangayika.

Gake, uburibwa bumwe na bumwe bukoresha imisemburo nyinshi ishyushya thyroid, bigatera ibimenyetso bisa n'iby'hyperthyroidism nko gutera umutima, kugabanya ibiro, guhangayika, no kugira ibibazo byo gusinzira.

Ni iyihe mitype y'uburibwa bwa pituitary?

Uburibwa bwa pituitary bugabanywamo ubwoko bubiri: ubwinshi bwabwo niba bukoresha imisemburo. Gusobanukirwa ibi bice bifasha muganga wawe kumenya uburyo bwiza bwo kuvura ukurikije uko uhagaze.

Ukurikije ubwinshi, abaganga bagabanya ubwo buribwa mu bwoko bubiri: microadenomas na macroadenomas. Microadenomas ni buto cyane kurusha mm 10 kandi akenshi ntibitera ibimenyetso biboneka. Macroadenomas ni binini kurusha mm 10 kandi bishobora guteza ibibazo by'imisemburo n'ibimenyetso byo gukanda.

Uburibwa bukora imisemburo buhora bukoresha imisemburo, mu gihe uburibwa budakora imisemburo budakora imisemburo myinshi ariko bushobora guteza ibibazo bwo gukura bikabije bigakanda ku bindi bice.

Prolactinomas ni bwo bwoko bugaragara cyane bw'uburibwa bwa pituitary bukora imisemburo, bugera kuri 40% by'ubwo buribwa bwose bwa pituitary. Ubwo buribwa bukoresha prolactin myinshi, imisemburo ishinzwe gukora amata.

Uburibwa bukoresha imisemburo y'ubukure butera gigantism mu bana na acromegaly mu bakuru. Ubwo buribwa si bwinshi ariko bushobora guteza impinduka zikomeye mu mubiri niba budavuwe.

Uburibwa bukoresha ACTH bukoresha imisemburo nyinshi ya adrenocorticotropic, bigatera Cushing's disease. Ubwo buribwa busanzwe ari buto ariko bushobora kugira ingaruka zikomeye ku mikorere y'umubiri.

Gake, ushobora kubona uburibwa bukoresha TSH butera hyperthyroidism, cyangwa uburibwa bukoresha gonadotropin bugira ingaruka ku misemburo y'imyororokere. Ubwo bwoko bugera kuri munsi ya 5% by'ubwo buribwa bwose bwa pituitary.

Ni iki giteza uburibwa bwa pituitary?

Impamvu nyamukuru y'ubwo buribwa bwinshi bwa pituitary ntirazwi, ibyo bishobora gutera agahinda iyo ushaka ibisubizo. Ariko rero, abashakashatsi bamenye ibintu bimwe na bimwe bishobora gutera iterambere ryabwo.

Uburibwa bwinshi bwa pituitary busa n'ubutera kubera impinduka z'imiterere y'uturemangingo twa pituitary. Izi mpinduka zituma uturemangingo tukura kandi tugakwirakwira vuba kurusha uko bisanzwe, amaherezo bikaba uburibwa.

Mu bihe bidafite akenshi, uburibwa bwa pituitary bushobora kuba igice cy'indwara z'imiterere y'umuntu. Multiple Endocrine Neoplasia type 1 (MEN1) ni bwo bwoko bugaragara cyane bw'izo ndwara, bugera kuri 1 kuri 30.000.

McCune-Albright syndrome ni indi ndwara idasanzwe y'imiterere y'umuntu ishobora kuba irimo uburibwa bwa pituitary, hamwe n'ibibazo by'amagufwa n'impinduka z'uruhu. Iyi ndwara igera kuri munsi ya 1 kuri 100.000.

Carney complex ni indwara idasanzwe cyane y'imiterere y'umuntu ishobora guteza ubwoko butandukanye bw'uburibwa, harimo na pituitary adenomas. Hari ibihumbi bike by'abantu babonye iyi ndwara ku isi hose.

Ubushakashatsi bumwe bugaragaza ko imvune z'umutwe zishobora kongera amahirwe yo kurwara uburibwa bwa pituitary, ariko ubu buhunganirane ntibumeze neza. Ibintu by'ibidukikije n'imibereho ntibigira uruhare rukomeye mu iterambere ry'ubwo buribwa.

Ni ryari ukwiye kujya kwa muganga kubera uburibwa bwa pituitary?

Ukwiye kuvugana na muganga wawe niba ufite ibimenyetso biramba bishobora kugaragaza uburibwa bwa pituitary. Kumenya hakiri kare akenshi bigira ingaruka nziza ku buvuzi kandi bishobora gukumira ingaruka mbi.

Shaka ubufasha bw'abaganga niba ufite ububabare bukomeye kandi buhoraho bw'umutwe bumva bitandukanye n'ububabare bw'umutwe wari usanzwe ufite. Ibi ni ingenzi cyane niba ububabare bw'umutwe buherekejwe n'impinduka z'ububone cyangwa isesemi.

Ibibazo by'ububone bikwiye gusuzuma vuba, cyane cyane niba ubona ko ugonga ibintu biri ku mpande zawe cyangwa ugira ibibazo byo kubona ibiri ku mpande. Izi mpinduka zishobora kugaragaza ko uburibwa bukanda ku mitsi y'amaso.

Abagore bagomba kujya kwa muganga kubera imihango idahwitse idasobanurwa n'ibindi bintu, cyane cyane niba biherekejwe no gukora amata adasanzwe cyangwa kugabanuka kw'irari ryo gutera akabariro.

Abagabo bagomba gusuzumwa kubera ibibazo byo kudatera inda bitasobanuwe, kugabanuka kw'irari ryo gutera akabariro, cyangwa amabere akura, cyane cyane niba ibi bimenyetso bigenda buhoro buhoro mu gihe.

Vugana na muganga wawe niba ubona impinduka buhoro buhoro mu isura yawe, nko kuba amaboko yawe, amaguru yawe, cyangwa imiterere y'isura yawe ikura, cyangwa niba ufite ubwuzu budasobanuwe mu gice cy'inda.

Ni ibihe bintu byongera ibyago by'uburibwa bwa pituitary?

Uburibwa bwinshi bwa pituitary butera nta bintu byongera ibyago byabwo, bigatuma bigoye kubiteganya cyangwa kubikumira. Ariko rero, gusobanukirwa ibyongera ibyago bishobora kugufasha kumenya ubuzima bwawe.

Imyaka igira uruhare mu iterambere ry'uburibwa bwa pituitary, uburibwa bwinshi buhabwa abantu bari hagati y'imyaka 30 na 50. Ariko rero, ubwo buribwa bushobora kuba mu myaka yose, harimo n'abana n'abakuze.

Igitsina kigira uruhare mu kuba hari ubwoko bumwe bw'uburibwa. Abagore bafite amahirwe menshi yo kurwara prolactinomas, cyane cyane mu myaka yabo yo kubyara, mu gihe uburibwa bukoresha imisemburo y'ubukure bugira ingaruka ku bagabo n'abagore kimwe.

Kugira amateka y'umuryango w'indwara zimwe na zimwe z'imiterere y'umuntu byongera cyane ibyago byawe. Niba abantu benshi bo mu muryango wawe baragize uburibwa bw'imisemburo, inama y'abaganga ishobora kugufasha gusuzuma ibyago byawe.

Kuba warahumuriwe mu mutwe no mu ijosi, cyane cyane mu bwana, bishobora kongera amahirwe yo kurwara uburibwa bwa pituitary mu myaka y'ubukure. Ibi birimo kuvurwa kwa kanseri cyangwa gusuzuma kenshi.

Abantu benshi barwara uburibwa bwa pituitary nta bintu byongera ibyago byabwo, bisobanura ko ubwo buribwa buhora buza gatagatifu. Ibi bishobora gutera agahinda, ariko bisobanura kandi ko nta kintu wakora kugira ngo ukumire iterambere ry'ubwo buribwa.

Ni iyihe ngaruka mbi zishoboka z'uburibwa bwa pituitary?

Nubwo uburibwa bwinshi bwa pituitary butera ibimenyetso byoroshye, bumwe bushobora guteza ingaruka mbi zikomeye niba budavuwe. Gusobanukirwa ibyo bibazo bishobora kugaragaza impamvu kumenya hakiri kare no kuvura ari ingenzi.

Uburibwa bunini bushobora gukanda ku mitsi y'amaso, bigatera kubura ubushobozi bwo kubona burundu niba budavuwe vuba. Ibi bisanzwe bitangira nk'ikibazo cyo kubona ibiri ku mpande ariko bishobora kugera ku buhumyi bwuzuye mu bihe bikomeye.

Kudahaza kw'imisemburo bituruka ku buribwa bukora imisemburo bishobora guteza ibibazo by'ubuzima mu gihe kirekire bigira ingaruka ku bice byinshi by'umubiri. Izo ngaruka mbi akenshi zigenda buhoro buhoro kandi zishobora kudasobanuka ako kanya.

• Ibibazo by'umutima bituruka ku misemburo y'ubukure cyangwa cortisol myinshi
• Diabete bituruka ku kudahaza kw'imisemburo bigira ingaruka ku gukora isukari mu maraso
• Osteoporosis bituruka ku kuba hari cortisol myinshi cyangwa kubura imisemburo y'ubukure
• Guhagarika guhumeka nijoro bituruka ku isura cyangwa ururimi runini
• Umuvuduko w'amaraso mwinshi bituruka ku kudahaza kw'imisemburo

Pituitary apoplexy ni ingaruka mbi idasanzwe ariko ikomeye aho amaraso cyangwa kubyimbagira bibaho mu buribwa. Iyi mpanuka ikomeye itera ububabare bukomeye bw'umutwe, ibibazo by'ububone, no kubura imisemburo bishobora kuba bibi.

Hypopituitarism ishobora kubaho iyo uburibwa bwangije imisemburo isanzwe ya pituitary, bigatera kubura imisemburo myinshi. Iyi ndwara isaba kuvurwa kw'imisemburo ubuzima bwose no gukurikiranwa n'abaganga.

Gake, uburibwa bunini cyane bushobora guteza umuvuduko mwinshi mu mutwe, bigatera ububabare bukomeye bw'umutwe, guhuzagurika, no gukanda ubwonko bishobora kuba bibi. Iyi mpanuka isaba ubufasha bw'abaganga ako kanya.

Uburibwa bwa pituitary bumenyekana gute?

Kumenya uburibwa bwa pituitary bikubiyemo intambwe nyinshi, bitangirira ku mateka yawe y'ubuzima n'ibimenyetso. Muganga wawe azakubaza ibibazo birambuye ku bimenyetso byawe, igihe byatangiye, n'uko byahindutse mu gihe.

Ibizamini by'amaraso ni ingenzi mu kupima urwego rw'imisemburo no kumenya niba uburibwa bwawe bukoresha imisemburo myinshi. Ibi bizamini bishobora kuba bikenewe gusubirwamo mu bihe bitandukanye by'umunsi kuko imisemburo imwe na imwe ihinduka uko umunsi ugenda.

Muganga wawe ashobora gutegeka ibizamini byihariye byo gukangurira cyangwa guhagarika imisemburo kugira ngo abone ishusho isobanutse y'uko pituitary gland yawe ikora. Ibi bizamini bikubiyemo gufata imiti hanyuma ukareba uko imisemburo yawe isubiza.

Ibizamini bya MRI bitanga amashusho arambuye ya pituitary gland kandi bishobora kubona uburibwa buto cyane nk'mm nke. Iki kizamini gikoresha uburyo bwa magnétique aho gukoresha imirasire, bigatuma gikora ku bantu benshi.

Gusuzuma ubushobozi bwo kubona bifasha kumenya niba uburibwa bugira ingaruka ku mitsi y'amaso. Ibi bikubiyemo gusuzuma ubushobozi bwo kubona ibiri ku mpande n'ubushobozi bwo kubona neza, ibyo bishobora kugaragaza ibibazo mbere y'uko ubimenya.

Mu bihe bimwe na bimwe, muganga wawe ashobora kugutegeka gusuzuma imiterere yawe, cyane cyane niba ufite amateka y'umuryango w'uburibwa bw'imisemburo cyangwa niba uburibwa bwawe bugaragaye mu myaka mike.

Ni iki kivura uburibwa bwa pituitary?

Ubuvuzi bw'uburibwa bwa pituitary biterwa n'ibintu byinshi birimo ingano y'ubwo buribwa, ubwoko bwabwo, niba butera ibimenyetso. Uburibwa buto, budakora imisemburo, bukeneye gukurikiranwa gusa aho kuvurwa ako kanya.

Imiti ni bwo buryo bwa mbere bwo kuvura prolactinomas n'ubundi buribwa bumwe na bumwe bukora imisemburo. Iyo miti ishobora kugabanya uburibwa kandi igahaza imisemburo, ikenshi itanga impumuro ikomeye ku bimenyetso.

Dopamine agonists nka cabergoline cyangwa bromocriptine ni nziza cyane kuri prolactinomas, abantu benshi babona impinduka mu byumweru bike. Iyo miti ikora nk'ikigereranyo cya dopamine, ikagabanya prolactin.

Somatostatin analogs ishobora gufasha kugenzura uburibwa bukoresha imisemburo y'ubukure binyuze mu kuburizamo imisemburo. Iyo miti isanzwe itangwa nk'injeksiyon buri kwezi kandi ishobora kugabanya cyane uburibwa n'imisemburo.

Kubaga biba ngombwa iyo imiti idakora cyangwa iyo uburibwa bunini buhagije kugira ngo butere ibibazo by'ububone cyangwa ibindi bimenyetso bikomeye. Ibyinshi mu mibaga ya pituitary bikorwa mu mazuru, bikarinda gufungura umutwe.

Transsphenoidal surgery ni uburyo bwiza, aho abaganga bagera kuri pituitary binyuze mu mazuru n'igice cy'umutwe kitwa sphenoid bone. Ubu buryo busanzwe butera igihe gito cyo gukira n'ingaruka nke kurusha ubundi buryo bwo kubaga ubwonko.

Radiotherapy ishobora kugirwa inama ku buribwa budashobora gukurwaho burundu hakoreshejwe ubuvuzi cyangwa budasubiza imiti. Uburyo bwa none bwo kuvura imirasire bushobora kugera ku turemangingo tw'uburibwa neza mu gihe kidakomeretsa utundi turemangingo.

Stereotactic radiosurgery itanga imirasire yibanze mu cyiciro kimwe, mu gihe radiotherapy isanzwe ikoresha inzego nto nyinshi mu byumweru byinshi. Muganga wawe azagufasha kumenya uburyo bukwiriye ukurikije uko uhagaze.

Uko wakwitwara mu rugo ufite uburibwa bwa pituitary

Kwitwara mu buzima ufite uburibwa bwa pituitary bikubiyemo gukorana na baganga bawe mu gihe ufata ingamba zo gushyigikira ubuzima bwawe rusange. Impinduka nto mu mibereho zishobora kugira uruhare rukomeye mu kuntu wumva buri munsi.

Guta imiti nk'uko yategetswe ni ingenzi mu kugenzura imisemburo no gukumira ingaruka mbi. Shyiraho uburyo bwo kugufasha kwibuka imiti yawe, cyane cyane niba ufashe imiti myinshi mu bihe bitandukanye.

Gukurikirana ibimenyetso byawe bigufasha wowe na muganga wawe gukurikirana uko ubuvuzi bwawe bukora. Komereza ku kwandika impinduka mu mbaraga, imitekerereze, ubushobozi bwo kubona, cyangwa ibindi bimenyetso wabonye.

Gusubira kwa muganga buri gihe ni ingenzi nubwo wumva umeze neza. Muganga wawe akeneye gukurikirana imisemburo no kureba impinduka mu bunini cyangwa imikorere y'uburibwa bwawe.

Kugira imibereho myiza ishyigikira ubuzima bwawe rusange kandi ishobora gufasha kugenzura ibimenyetso bimwe na bimwe. Fata umwanya uhagije wo kuryama, kurya ibiryo biringaniye, no kuguma ukora imyitozo ngororamubiri uko ubuzima bwawe bubikwemerera.

Kugengura umunaniro biba ingenzi cyane kuko umunaniro ushobora kongera ibimenyetso byinshi bifitanye isano n'imisemburo. Tekereza ku buryo bwo kuruhuka, imyitozo ngororamubiri yoroshye, cyangwa inama niba uhanganye n'ibibazo by'amarangamutima by'uburwayi bwawe.

Guhuza n'amatsinda y'abantu bafite uburibwa nk'ubwawe, haba mu bantu cyangwa kuri internet, bishobora gutanga inkunga ikomeye y'amarangamutima n'amabanga akorwa n'abandi basobanukiwe ibyo ucamo.

Uko wakwitegura gusura muganga

Kwitoza gusura muganga bigufasha kugira igihe cyiza cyo kuvugana na muganga wawe. Kwitegura neza bishobora gutuma hamenyekana neza uburwayi no gutegura neza ubuvuzi.

Andika ibimenyetso byawe byose, harimo igihe byatangiye n'uko byahindutse mu gihe. Fata ibimenyetso bisa nk'ibidafite aho bihuriye, kuko uburibwa bwa pituitary bushobora kugira ingaruka zitandukanye ku mubiri wawe.

Zana urutonde rwuzuye rw'imiti yose, ibinyobwa, na vitamine ufata. Fata umwanya wo kuvuga umunaniro, kuko hari imiti ishobora kugira ingaruka ku misemburo cyangwa ikagira ingaruka ku buvuzi.

Kora amateka yawe y'ubuzima, harimo imibaga yose yabanje, indwara zikomeye, cyangwa amateka y'umuryango w'uburibwa cyangwa ibibazo by'imisemburo. Aya makuru afasha muganga wawe gusuzuma ubuzima bwawe rusange.

Tegura ibibazo mbere y'igihe kugira ngo wibuke ibibazo by'ingenzi mu gihe cy'isura. Andika ibibazo byawe kandi ushyire imbere iby'ingenzi mu gihe igihe cyabuze.

Tekereza kuzana inshuti cyangwa umuryango wawe wizewe mu isura. Bashobora kugufasha kwibuka amakuru yavuzwe no gutanga inkunga y'amarangamutima mu gihe cy'isura ishobora kuba ikomeye.

Niba warigeze gukora ibizamini by'amashusho cyangwa ibizamini by'amaraso ahandi, saba kopi uze kuyizana mu isura. Ibi bishobora kugabanya igihe no kwirinda gukora ibizamini bibiri.

Icyingenzi cyo kumenya ku buribwa bwa pituitary

Ikintu cy'ingenzi cyo kumenya ku buribwa bwa pituitary ni uko akenshi ari indwara ivurwa kandi ifite ibyiza iyo igenzurwa neza. Ibyinshi ntabwo ari mbi kandi ntibikwirakwira mu bindi bice by'umubiri.

Kumenya hakiri kare no kuvurwa neza bishobora gukumira ingaruka mbi kandi bigufasha kugira ubuzima bwiza. Abantu benshi barwaye uburibwa bwa pituitary bakomeza kubaho ubuzima busanzwe bafite ubufasha bw'abaganga.

Gukorana n'inzobere mu kuvura imisemburo cyangwa umuganga w'ubwonko biguha amahirwe meza yo kugira ibyiza. Izo nzobere zisoma isano iri hagati y'imikorere ya pituitary n'ubuzima rusange.

Wibuke ko ubuvuzi ari inzira y'igihe kirekire, kandi bishobora gutwara igihe kugira ngo ubone uburyo bukwiriye ukurikije uko uhagaze. Umujinya n'ibiganiro bihamye n'abaganga bawe ni ingenzi mu gucunga neza.

Ibibazo byakenshi bibazwa ku buribwa bwa pituitary

Uburibwa bwa pituitary bushobora gukumirwa?

Ikibabaje ni uko uburibwa bwinshi bwa pituitary budashobora gukumirwa kuko busanzwe butera kubera impinduka z'imiterere y'uturemangingo. Ariko rero, niba ufite amateka y'umuryango w'indwara zifitanye isano n'uburibwa bwa pituitary, inama y'abaganga ishobora kugufasha gusuzuma ibyago byawe no kuyobora uburyo bwo gukurikirana.

Uburibwa bwa pituitary ni kanseri?

Ibyinshi mu buribwa bwa pituitary ntabwo ari kanseri, bisobanura ko atari mbi kandi ko bidakwirakwira mu bindi bice by'umubiri. Uburibwa bwa pituitary bubi ni buke cyane, bugera kuri munsi ya 1% by'ubwo buribwa bwose bwa pituitary.

Nzakenera kubagwa kubera uburibwa bwa pituitary?

Si uburibwa bwose bwa pituitary bukeneye kubagwa. Uburibwa buto, budakora imisemburo, bukeneye gukurikiranwa gusa, mu gihe uburibwa bukora imisemburo bwinshi busubiza neza imiti. Kubaga bisanzwe bigirwa inama iyo uburibwa butera ibibazo by'ububone, budasubiza imiti, cyangwa bugakomeza gukura nubwo buvuwe.

Uburibwa bwa pituitary bugira ingaruka ku nda?

Uburibwa bwa pituitary bushobora kugira ingaruka ku kubyara no gutwita, cyane cyane prolactinomas ishobora kuburizamo ovulation. Ariko rero, abagore benshi barwaye uburibwa bwa pituitary bashobora gutwita neza bafite ubufasha bw'abaganga no gukurikiranwa mu gihe cyo gutwita.

Nzinga gusubira kwa muganga kenshi gute?

Gusubira kwa muganga kenshi biterwa n'ubwoko bw'uburibwa bwawe n'uburyo bwo kuvura. Mu ntangiriro, ushobora kuba ukeneye gusubira kwa muganga buri mezi 3-6, ariko iyo ubuzima bwawe buhagaze neza, gusubira buri mwaka bihagije. Muganga wawe azahindura gahunda ukurikije ibyo ukeneye n'uko usubiza ubuvuzi.