Inkingi ya BCG ya Vakiseni ya Live Intravesical Route: Ibikoresho, Urutonde rw'Imiti, Ingaruka z'Imiti n'ibindi

Inkingi ya BCG (Bacillus of Calmette and Guerin) ya vakiseni ya live intravesical route ni uburyo bwihariye bwo kuvura kanseri y'inkari bukoresha uburyo bworoshye bwa bagiteri kugira ngo bufashe urugero rwawe rw'umubiri kurwanya selile za kanseri. Iyi siyo vakiseni ya BCG ikoreshwa mu gukumira igituntu - yagenewe by'umwihariko gushyirwa mu nkari zawe hakoreshejwe kateteri. Ubu buvuzi bumaze imyaka myinshi bufasha abantu bafite ubwoko runaka bwa kanseri y'inkari, kandi bukora butoza uburyo umubiri wawe wihanganira ibintu bisanzwe kumenya no kurwanya selile za kanseri neza.

Vakiseni ya BCG ya Live Intravesical Route ni iki?

Vakiseni ya BCG ya live intravesical route ni urukingo ruzima, rworoshye rwa bagiteri abaganga bashyira mu nkari zawe kugira ngo bavure kanseri y'inkari. Ijambo "intravesical" risobanura gusa "imbere mu nkari," kandi ubu buvuzi butanga umuti neza aho ukenewe cyane. Tekereza nk'umubiri w'imbaraga z'umubiri wibanda ku buryo bukora by'umwihariko mu nkari zawe.

Ubu buvuzi burimo bagiteri ya Mycobacterium bovis nzima ariko yoroshye, ifitanye isano rya hafi na mikorobe itera igituntu. Ntukigire impungenge - izi bagiteri zihinduriwe by'umwihariko ku buryo zitashobora gutera igituntu, ariko ziracyakomeye bihagije kugira ngo zikangure urugero rwawe rw'umubiri kandi zifashe kurwanya selile za kanseri.

Urukingo ruza mu ifu abaganga bawe bavanga n'umuti utagira mikorobe mbere gato yo kuvurwa. Uyu muvange mushya utuma bagiteri ziguma zizima kandi zikora neza iyo zigera mu nkari zawe.

Vakiseni ya BCG ya Live Intravesical Route ikoreshwa mu iki?

Urukingo rwa BCG rukoreshwa cyane mu kuvura kanseri y'urugingo rw'inkari itagera ku misitsi, cyane cyane nyuma yo kubagwa kugira ngo bakuremo ibibyimba bigaragara. Ubu buvuzi bufasha kwirinda ko kanseri yagaruka kandi rimwe na rimwe ishobora kuvura kanseri itashoboye gukurwaho burundu mu gihe cyo kubagwa.

Muganga wawe ashobora kugusaba ubu buvuzi niba ufite kanseri y'urugingo rw'inkari yo ku rwego rwo hejuru cyangwa carcinoma in situ (CIS), ni ukuvuga ubwoko bwa kanseri y'urugingo rw'inkari yo mu ntangiriro iguma ku gasozi ariko ishobora kugira urugomo. Ubuvuzi bwa BCG bufasha cyane abantu kanseri yabo ifite amahirwe menshi yo kugaruka cyangwa gukwirakwira mu rukuta rw'urugingo rw'inkari.

Rimwe na rimwe, abaganga bakoresha kandi ubuvuzi bwa BCG ku bantu bagize ibibyimba byinshi byo mu rurimi rw'inkari cyangwa kanseri yabo yagarutse nyuma yo kuvurwa bwa mbere. Ubu buvuzi bushobora kugabanya cyane ibyago byo kugaruka kwa kanseri iyo bikoreshejwe nk'igice cy'umugambi wuzuye wo kuvura.

Urukingo rwa BCG rukora gute?

Urukingo rwa BCG rukora mu kurema uburyo bwo kwirinda buri hagati mu rurimi rw'inkari, mu by'ukuri wigisha umubiri wawe kumenya no kurimbura selile za kanseri. Iyo bagiteri zoroheje zihuye n'urukuta rw'ururimi rw'inkari, zituma umubiri wawe wo kwirinda wohereza selile zirwanya indwara muri ako gace.

Ubu buryo bwo kwirinda burakomeye kandi bugamije. Bagiteri ntizirwanya kanseri ubwazo - ahubwo, zikora nk'umushinga wo kwigisha umubiri wawe wo kwirinda. Uburyo umubiri wawe wihanganira bwigira kumenya selile za kanseri nk'abashyitsi b'abanyamahanga kandi bagakora kugira ngo bazikureho.

Ubu buvuzi butera umubiri kubyimba mu rurimi rw'inkari, ibyo bishobora gutera impungenge, ariko uku kubyimba ni ko gashaka. Bizana selile zo kwirinda ku rukuta rw'ururimi rw'inkari aho zishobora kubona no kurimbura selile zose za kanseri zishobora kuba nto cyane zo kubona cyangwa gukurwaho mu gihe cyo kubagwa.

Ubuvuzi bwa BCG bufatwa nk'ubuvuzi bukomeye bukorwa neza, ariko bisaba ko umubiri wawe ukora neza. Imbaraga z'ubu buvuzi ziri mu bushobozi bwa bwo bwo kurema urwibutso rurambye rwo kurwanya selile za kanseri y'inkari.

Nkwiriye Gufata Urukingo rwa BCG Live Intravesical Route Nte?

Urukingo rwa BCG live intravesical route rutangwa mu nkari zawe hakoreshejwe urushinge ruto rworoshye rwitwa catheter. Ntabwo ufata uyu muti unywa cyangwa utera - ushyirwa neza aho ukeneye gukora. Ubuvuzi bukorwa buri gihe n'abantu babihuguriwe mu rwego rw'ubuzima.

Mbere yo kuvurwa, uzakenera kugabanya amazi unywa mu isaha nka 4 kugira ngo inkari zawe zituzure cyane. Itsinda ryawe ry'ubuzima rizashyira catheter mu muyoboro w'inkari (umuyoboro usanzwe unyuramo inkari) no mu nkari zawe. Igisubizo cya BCG noneho gishyirwa buhoro buhoro mu nkari zawe hakoreshejwe iyi catheter.

Nyuma yo guhabwa ubuvuzi, uzakenera gufata umuti mu nkari zawe mu isaha nka 2 niba bishoboka. Muri iki gihe, ushobora gusabwa guhindura imyanya buri minota 15-30 kugira ngo bifashe umuti gusakara ahantu hose mu rukuta rw'inkari zawe. Abantu benshi babona ko bifasha gushyiraho ibyibutso byoroheje cyangwa kuzana ikintu cyo kwishimisha muri iki gihe cyo gutegereza.

Igihe kigeze cyo kunyara, uzakenera kwicara (tutitaye ku myifatire yawe isanzwe) hanyuma unyare mu musarani. Mu masaha 6 ya mbere nyuma yo kuvurwa, uzongeramo igikombe cya javel mu musarani mbere yo gukaraba kugira ngo uhagarike bagiteri zisigaye.

Nkwiriye Gufata Urukingo rwa BCG Live Intravesical Route Mugihe Kingana Gite?

Ubuvuzi bwa BCG busanzwe bukurikiza gahunda yihariye muganga wawe azahindura bitewe n'uko ubuzima bwawe bumeze. Abantu benshi batangira n'ubuvuzi bwa mbere bw'ibyumweru 6, bifasha gushyiraho uburyo umubiri urwanya indwara mu nkari zawe.

Nyuma yo kurangiza amasomo y'ibyumweru 6 byambere, abantu benshi bakomeza gukoresha imiti yo kubungabunga. Ibi mubisanzwe bikubiyemo guhabwa imiti ya BCG mu gihe cy'amezi 3 mu gihe kingana n'imyaka 3, nubwo gahunda nyayo iterwa n'uburyo wemera imiti n'ubuzima bwawe muri rusange.

Muganga wawe azakurikiza uko urimo utera imbere akoresheje ibizamini bya cystoscopy (aho bareba imbere mu rwagashya rwawe bakoresheje kamera ntoya) kandi ashobora guhindura gahunda yawe yo kuvurwa bitewe n'ibyo basanze. Abantu bamwe bakeneye amasomo magufi, mu gihe abandi bungukirwa n'igihe kirekire cyo kuvurwa.

Igihe cyose cyo kuvurwa kigereranya imikorere n'ubushobozi bwo kwihanganira. Amasomo maremare yo kuvurwa ashobora gutanga uburinzi bwiza kurwanya kanseri yongera kugaruka, ariko kandi yongera amahirwe yo kugira ingaruka. Itsinda ryawe ry'ubuzima rizakorana nawe kugirango ubone uburyo bukwiye bw'imibereho yawe.

Ni izihe ngaruka ziterwa n'urukingo rwa BCG Live Intravesical Route?

Urukingo rwa BCG Live Intravesical Route rushobora gutera ingaruka kuko rugamije gukora uburyo bwo kwirinda indwara mu rwagashya rwawe. Ingaruka nyinshi zifitanye isano no kurakara kw'urwagashya kandi mubisanzwe birashoboka kubicunga, nubwo abantu bamwe bashobora guhura n'ibibazo bikomeye.

Kumenya icyo witegura bishobora kugufasha kumva witeguye kandi umenye igihe wahamagara itsinda ryawe ry'ubuzima. Hano hari ingaruka zisanzwe ushobora guhura nazo:

• Ibimenyetso byo kurakara kw'urwagashya - gutwika mugihe cyo kunyara, kunyara kenshi, no guhura n'urwagashya rwo kunyara
• Amaraso mu nkari - ibi bishobora kuva ku bidashoboka kugaragara kugeza ku nkari zisa n'umutuku cyangwa umutuku
• Ibimenyetso bisa na grip - umuriro, ibikonjo, umunaniro, no kumva muri rusange utameze neza
• Kutamererwa neza mu gatuza cyangwa mu nda yo hasi - kuribwa cyangwa kubabara mu gice cy'urwagashya
• Isesemi - rimwe na rimwe riherekejwe no kugabanya ubushake bwo kurya

Ibi bimenyetso bigaragara kenshi, akenshi bitangira nyuma y'amasaha make yo kuvurwa kandi bishobora kumara iminsi 2-3. Abantu benshi basanga ibimenyetso bigenda bigabanuka uko umubiri wabo wimenyereza imiti mu byumweru byinshi.

Ibyago bidasanzwe ariko bikomeye bisaba ubufasha bwihuse bw'abaganga. Nubwo ibi bitaba ku bantu benshi, ni ngombwa kubimenya:

• Urubavu rwinshi (kurenza 103°F cyangwa 39.4°C) rutitabira imiti igabanya umuriro
• Ibyiyumvo bikomeye by'ibicurane bimara iminsi irenga 2-3
• Urubavu rukabije rw'inkari rubuza umuntu gukora imirimo ya buri munsi
• Ibimenyetso by'ubwandu bwagutse - kubabara mu ngingo, amabara ku ruhu, cyangwa imitsi yabyimbye
• Kugorana kwihagarika cyangwa kutabasha kwihagarika na gato

Ingorane zitabaho ariko zikomeye zirimo kwandura kwa BCG bikwirakwira hanze y'inkari, ibyo bisaba kuvurwa ako kanya n'imiti irwanya igituntu. Ibi ntibisanzwe ariko bishobora kuba bikomeye iyo bitamenyekanye ngo bivurwe vuba.

Itsinda ry'abaganga bazagukurikiranira hafi ibimenyetso byose by'ingorane kandi bazaguha amabwiriza asobanutse y'igihe cyo guhamagara ubufasha. Abantu benshi bafata neza imiti ya BCG, kandi ingaruka zikunze kugabanuka uko imiti ikomeza.

Ninde utagomba gufata urukingo rwa BCG Live Intravesical Route?

Urukingo rwa BCG live intravesical route ntirukwiriye kuri buri wese, cyane cyane abantu bafite ubudahangarwa budakora neza cyangwa indwara zimwe na zimwe. Kubera ko iyi miti yishingikiriza ku mikorere y'ubudahangarwa bwawe, ni ngombwa ko umubiri wawe ushobora guhangana n'iki kibazo cy'agakoko mu buryo bwizewe.

Ntugomba guhabwa imiti ya BCG niba ufite ubwandu ubwo aribwo bwose bukora cyangwa ibimenyetso by'indwara. Itsinda ry'abaganga bazashaka kumenya neza ko wumva umeze neza mbere ya buri miti kugirango bagabanye ibyago by'ingorane.

Indwara nyinshi z’ubuvuzi zituma imiti ya BCG idatekanye cyangwa idatanga umusaruro. Ibi bikubiyemo ibihe aho umubiri wawe utashobora gusubiza neza:

• Umutekano muke w’umubiri - uvuye kuri SIDA, imiti ivura kanseri, cyangwa imiti igabanya ubudahangarwa bw’umubiri
• Ubukana bwa tuberculosis cyangwa amateka ya tuberculosis itavuwe neza
• Urubanza cyangwa indwara ikora mu rwagashya - kuvurwa bigomba gutegereza kugeza igihe ibi bikemukiye
• Amara mu nkari avuye mu mvune - nko gushyirwaho catheter vuba cyangwa kubagwa mu rwagashya
• Gusama cyangwa konka - ingaruka ku bana bakiri bato ntizizwi neza

Imiti imwe irashobora kandi gutuma imiti ya BCG idakwiriye. Muganga wawe azasuzuma imiti yawe yose, harimo imiti yandikwa na muganga, imiti igurishwa ku isoko, n’ibyongerera imiti, kugirango yemeze ko itazabangamira kuvurwa.

Abantu bafata imiti yica mikorobe irwanya bagiteri ya tuberculosis ntibagomba guhabwa imiti ya BCG, kuko iyi miti ishobora kwica bagiteri ya urukingo mbere yuko zikora. Mu buryo nk'ubwo, imiti imwe igabanya ubudahangarwa bw’umubiri irashobora kubuza BCG gukora neza.

Itsinda ryawe ry’ubuzima rizasuzuma neza amateka yawe y’ubuzima n’ubuzima bwawe bwa none mbere yo kugusaba imiti ya BCG. Bazanaganira ku zindi miti niba BCG itagukwiriye.

Amazina y’ubwoko bwa BCG Vaccine Live Intravesical Route

Urukingo rwa BCG live intravesical route ruboneka munsi y’amazina menshi y’ubwoko, aho izwi cyane ari TICE BCG na PACIS. Ubu bwoko butandukanye burimo ubwoko bumwe bwa bagiteri yoroshye ariko bushobora kuba butandukanye gato mu buryo butegurwamo cyangwa bubikwamo.

TICE BCG ni imwe mu miterere ikoreshwa cyane muri Leta Zunze Ubumwe z'Amerika kandi imaze imyaka myinshi ifasha abantu barwaye kanseri y'urwagashya. PACIS ni irindi zina ryashinzwe rikora kimwe na TICE BCG.

Itsinda ryawe ry'ubuvuzi rizagena ubwoko bwihariye bushingiye ku kuboneka, ubunararibonye bwabo ku bicuruzwa, n'ibyo ukeneye. Inkingo zose za BCG zemewe gukoreshwa mu buryo bwo mu rwungano rw'inkari zujuje ibisabwa by'umutekano n'ubushobozi, bityo ushobora kumva ufite icyizere mu bwoko ubwo aribwo bwose muganga wawe yakugira inama.

Uburyo bwo kuvura bwa BCG Vaccine Live Intravesical Route

Niba ubuvuzi bwa BCG butagukwiriye cyangwa butagira akamaro, hari uburyo bwinshi bwo kuvura bushobora gufasha mu kuvura kanseri y'urwungano rw'inkari. Muganga wawe azatekereza ku miterere yawe yihariye, harimo ubwoko n'icyiciro cya kanseri yawe, ubuzima bwawe muri rusange, n'intego zawe zo kuvurwa.

Ubuvuzi bundi bwo mu rwungano rw'inkari bushobora gushyirwa mu buryo butaziguye mu rwungano rw'inkari kimwe na BCG. Ibi birimo imiti ya chemotherapy nka mitomycin C cyangwa gemcitabine, ikora mu buryo butandukanye na BCG mu kugaba ibitero ku ngirangingo za kanseri aho gushishikariza urwego rwawe rw'ubudahangarwa.

Ku bantu batabasha kwihanganira ubuvuzi bwo mu rwungano rw'inkari, ubuvuzi bwa sisitemu bushobora kuba uburyo bwiza. Ibi birimo imiti mishya ya immunotherapy ikora mu mubiri wawe wose, nubwo akenshi bigenewe ibibazo byateye imbere.

Rimwe na rimwe, uburyo bwo kubaga burakenewe, cyane cyane niba ubundi buvuzi butagize akamaro. Ibi bishobora guhera ku kubaga urwungano rw'inkari cyane kugeza ku gukuraho urwungano rw'inkari rwose hamwe no kubaka bundi bushya, bitewe n'imimerere yawe yihariye.

Itsinda ryawe ry'ubuvuzi rizaganira nawe ku buryo bwose buhari, ritegerezanya ubushobozi bwo kuvura butandukanye n'ingaruka zishobora kugira ku mibereho yawe. Intego ni ukubona uburyo buguha amahirwe meza yo kugenzura kanseri yawe mugihe ukomeza guhumurizwa no kugira ubuzima bwiza.

Ese BCG Vaccine Live Intravesical Route iruta Mitomycin C?

Urukingo rwa BCG rukoreshwa mu rwego rw'imbere mu rurenda rw'inkari na mitomycin C ni imiti yombi ikora neza mu kuvura kanseri y'ururenda rw'inkari, ariko ikora mu buryo butandukanye kandi bishobora kuba byiza ku bantu batandukanye. BCG ikunda gukora neza mu gukumira kanseri kongera kugaruka mu gihe cy'ibibazo bikomeye, mugihe mitomycin C ishobora gukundwa nabantu batabasha kwihanganira BCG cyangwa bafite indwara zimwe na zimwe.

Ubushakashatsi bwerekana ko BCG muri rusange ikora neza kurusha mitomycin C mu gukumira kanseri y'ururenda rw'inkari kongera kugaruka, cyane cyane kubantu bafite ibibyimba byo hejuru cyangwa carcinoma in situ. Ubuvuzi bwa BCG bushobora kugabanya ibyago byo kongera kugaruka kwa kanseriho hafi 30-40% ugereranije na mitomycin C muri ibi bihe byo hejuru.

Ariko, ubuvuzi bwa BCG busanzwe butera ingaruka nyinshi kurusha mitomycin C kuko itera imyumvire ikomeye y'ubudahangarwa. Abantu bahura n'ingaruka zikomeye za BCG bashobora gusanga mitomycin C yihanganirwa cyane, nubwo bishobora kutagira akamaro kanini mu gukumira kongera kugaruka.

Gu hitamo hagati yiyi miti biterwa nibintu bitandukanye harimo imiterere ya kanseri yawe, ubuzima bwawe muri rusange, ubushobozi bwawe bwo kwihanganira ingaruka, nibyo ukunda. Umuganga wawe w'inzobere mu by'indwara z'umwijima azagufasha gusobanukirwa uburyo bushobora gukora neza kubibazo byawe byihariye.

Ibikunze Kubazwa Kubijyanye n'Urukingo rwa BCG rukoreshwa mu rwego rw'imbere mu rurenda rw'inkari

Ese Urukingo rwa BCG rukoreshwa mu rwego rw'imbere mu rurenda rw'inkari rufite umutekano ku bantu barwaye diyabete?

Urukingo rwa BCG rukoreshwa mu rwego rw'imbere mu rurenda rw'inkari muri rusange rushobora gukoreshwa neza kubantu barwaye diyabete, ariko kugenzura isukari mu maraso yawe bigomba gucungwa neza mbere yo kuvurwa. Diyabete irashobora kugira ingaruka kubushobozi bwa sisitemu yawe y'ubudahangarwa bwo gusubiza mu gihe cy'indwara, bityo ikipe yawe y'ubuzima izashaka kumenya neza ko diyabete yawe ihagaze neza.

Niba diyabete yawe icungwa neza, ubuvuzi bwa BCG ntibwagombye kugira ingaruka zikomeye ku isukari yo mu maraso yawe. Ariko, umunaniro wo kuvurwa n'ingaruka zose nka umuriro cyangwa kugabanya ubushake bwo kurya bishobora guhagarika igihe gito imicungire ya diyabete yawe.

Muganga wawe ashobora gufatanya n’ikipe ishinzwe kwita ku ndwara ya diyabete kugira ngo bakurikirane isukari yo mu maraso yawe mu gihe uvurwa na BCG. Bashobora kandi kugusaba guhindura imiti ya diyabete niba bibaye ngombwa kugira ngo bishyire mu gaciro impinduka zose ziterwa n’imiti mu mirire yawe cyangwa mu bikorwa byawe.

Nkwiriye gukora iki niba nifashishije urukingo rwa BCG rwinshi ku buryo butunganye?

Niba wakoresheje urukingo rwa BCG rwinshi, vugana n’umuganga wawe ako kanya, kabone n’iyo wumva umeze neza. Nubwo kurenza urugero rwa BCG rukoreshwa mu rwungano rw’inkari bitajyenda kenshi kuko ubuvuzi butangwa mu buryo bugenzurwa na muganga, kwakira rwinshi bishobora kongera ibyago byo kugira ingaruka zikomeye.

Ibimenyetso byerekana ko ushobora kuba warakoresheje BCG nyinshi harimo ibimenyetso bikomeye by’indwara y’ibicurane, umuriro mwinshi cyane, cyangwa ibimenyetso byo mu rwungano rw’inkari birushijeho kuba bibi kuruta uko byari byitezwe. Ntukegere ngo urebe niba ibimenyetso bigaragara - ni byiza kuvugana n’ikipe yawe y’ubuvuzi ako kanya.

Muganga wawe ashobora kugusaba gukurikiranwa by’inyongera, imiti igabanya ingaruka ziterwa n’imiti, cyangwa mu bihe bidasanzwe, imiti yica mikorobe ikora ku bagaragaza umusonga. Ikintu cy’ingenzi ni ukubona ubufasha bw’ubuvuzi vuba kugira ngo ingorane zishoboka zishobore gukumirwa cyangwa zikavurwa hakiri kare.

Nkwiriye gukora iki niba ntasibye urukingo rwa BCG?

Niba usibye ubuvuzi bwa BCG bwatanzwe, vugana n’umuganga wawe vuba bishoboka kugira ngo utegereze. Ntugerageze gusimbura urukingo rwasibwe ukoresha kabiri ku buvuzi bwawe bukurikira - ibi bishobora guteza akaga kandi ntibizongera imikorere y’ubuvuzi bwawe.

Muganga wawe azagena uburyo bwiza bwo gusubiza ubuvuzi bwawe mu nzira. Rimwe na rimwe ibi bisobanura kongera gutegereza urukingo rwasibwe ku gihe cyo guhura gikurikira. Ibindi bihe, muganga wawe ashobora gukenera guhindura gahunda yawe yose y’ubuvuzi.

Kutabona urukingo rimwe na rimwe ntibigira ingaruka zikomeye ku mikorere y'umuti wawe, ariko ni ngombwa kurangiza umuti uko wategetswe. Itsinda ryawe ryo mu buvuzi risobanukirwa ko ubuzima bugenda kandi bazakorana nawe kugira ngo babone gahunda ikwiriye imeze neza mu mibereho yawe.

Nshobora Kureka Gukoresha Urukingo rwa BCG Ryari?

Ugomba kureka gukoresha umuti wa BCG gusa igihe muganga wawe akubwiye ko byemewe. Umwanzuro wo kureka umuti biterwa n'uko urimo witwara neza, ibyo ibizamini byawe byerekana, niba urimo guhura n'ingaruka zikomeye.

Abantu benshi barangiza umuti wa BCG wategetswe, akenshi harimo urukurikirane rwa mbere rw'ibyumweru 6 kandi akenshi imiti yo gukomeza mu myaka 1-3. Muganga wawe azakoresha ibizamini bisanzwe bya cystoscopy n'izindi ngero kugira ngo akurikirane iterambere ryawe kandi amenye igihe bikwiriye kureka umuti.

Niba urimo guhura n'ingaruka zikomeye zituma umuti ugorana kwihanganira, muganga wawe ashobora kugusaba kureka BCG hakiri kare hanyuma ugahindurirwa undi muti. Ariko, uyu mwanzuro ugomba gufatwa buri gihe hamwe n'itsinda ryawe ryo mu buvuzi, ukita ku byago n'inyungu byo gukomeza cyangwa kureka umuti.

Nshobora Kugira Imibonano Mpuzabitsina Mugihe Nkoresha Urukingo rwa BCG?

Muri rusange ushobora gusubukura imibonano mpuzabitsina nyuma yo gukoresha umuti wa BCG, ariko hari ibintu by'ingenzi by'umutekano byo kwibuka. Mu masaha 48 ya mbere nyuma ya buri muti, ugomba kwirinda imibonano mpuzabitsina kugira ngo wirinde icyo aricyo cyose gishobora kwandura na mikorobe y'urukingo kuwo mwashakanye.

Nyuma y'amasaha 48 ya mbere, imibonano mpuzabitsina akenshi iratekanye, nubwo ushobora gusanga ibimenyetso byo kurakara kw'umubiri bituma bitaryoha. Gukoresha amavuta yongera ububobere birashobora gufasha niba wumva umubiri wumye cyangwa urakaye, kandi kuvugana n'uwo mwashakanye ku byerekeye ibitagenda neza ni ingenzi.

Niba urimo guhura n'ibimenyetso bikomeye by'umubiri w'inkari nk'ububabare, gushya, cyangwa kunyara kenshi, ushobora gusanga byoroshye gutegereza kugeza igihe ibi bimenyetso bigabanuka mbere yo gusubukura imibonano mpuzabitsina. Itsinda ryawe rishinzwe ubuzima rishobora gutanga ubuyobozi bwihariye bushingiye ku miterere yawe bwite n'ibimenyetso.