Chii chinonzi Diabetic Coma? Zviratidzo, Zvinokonzera, & Kurapa

Diabetic coma chirwere chinotyisa chinoda rubatsiro nekukurumidza apo shuga yeropa yakakwira kwazvo kana yakaderera kwazvo inokonzera kuti urege kuziva. Iri ndiro dambudziko remumuviri wako rekudzima kana shuga yeropa ikava yakashata kwazvo, ichigadzira mamiriro ausingakwanisi kumuka kana kupindura zvakajairwa.

Kunyangwe izwi rokuti "diabetic coma" richinzwa richitya, kunzwisisa kuti chii uye kuti ungachidzivisa sei kunogona kukubatsira kunzwa uchivimbika zvakanyanya mukugadzirisa chirwere cheshuga. Ichi chirwere chakakomba chinoda rubatsiro rwekurapa nekukurumidza, asi nekutarisira kwakanaka kwechirwere cheshuga uye kuziva zviratidzo zvekutanga, zvinogona kudzivirirwa zvakanyanya.

Chii chinonzi diabetic coma?

Diabetic coma inoitika kana shuga yeropa yako ikava yakashata kwazvo zvekuti uropi hwako harukwanisi kushanda zvakanaka, zvichikonzera kusaziva. Uropi hwako hunoda huwandu hwakakwana hweshugaru kuti huve nesimba, uye kana mazinga akakwira kana akaderera kwazvo, anokanganisa kugona kwako kuramba wakamuka uye wakangwara.

Ichi chirwere chinogona kuitika kune ani naani ane chirwere cheshuga, kungava chemhando 1 kana 2. Mashoko akanaka ndeakuti diabetic comas inogona kudzivirirwa nekutarisa shuga yeropa nguva dzose uye kutevera chirongwa chako chekugadzirisa chirwere cheshuga sezvakarayirwa nechikwata chako chehutano.

Ndeapi zviratidzo zve diabetic coma?

Musati maitika diabetic coma, muviri wako kazhinji unotumira zviratidzo zvekutanga zvinoti shuga yeropa iri kuita yakashata. Kuziva aya maratidzo ekutanga kunogona kukubatsira kutora matanho usati mamiriro acho ava akaoma.

Zviratidzo zvinoenderana nekuti shuga yako yeropa yakakwira kana yakaderera, uye kazhinji zvinoitika zvishoma nezvishoma kwemaawa kana mazuva:

Zviratidzo zve shuga yeropa yakakwira (hyperglycemia):

• Nyota yakanyanya uye kuenda kunyorovera kazhinji
• Kusvotwa uye kurutsa
• Mweya unonhuwira semichero
• Kufema kwakadzika, kukurumidza
• Kushaya simba uye kuneta
• Kusanzwisisa kana kuoma kuisa pfungwa
• Kurwadziwa mudumbu

Zviratidzo zve shuga yeropa yakaderera (hypoglycemia):

• Kuchema uye kudedera
• Kupururudza kwemoyo
• Kuita zvimwe zvinhu
• Nzara
• Kushatirwa kana kuchinja kwemanzwiro
• Kuora musoro kana kunzwa uchizorora
• Kusanzwisisa kana kuoma kutaura

Sezvo aya maratidzo achiwedzera, unogona kuva unodzoka zvakanyanya uye pakupedzisira urege kuziva. Kana ukaona chero chimwe chezviratidzo izvi, zvakakosha kuongorora shuga yako yeropa nekukurumidza uye kutsvaka rubatsiro rwekurapa kana mazinga ari akakwira kana akaderera kwazvo.

Ndeapi marudzi e diabetic coma?

Kune marudzi matatu makuru e diabetic coma, imwe neimwe inokonzerwa nekusawirirana kweshuga yeropa. Kunzwisisa aya marudzi kunogona kukubatsira kuziva kuti ndeipi mamiriro aunogona kunge uri mukati mawo uye kupindura zvakakodzera.

Diabetic ketoacidosis (DKA)

DKA inoitika kana shuga yako yeropa ikava yakakwira kwazvo uye muviri wako uchitanga kuputsa mafuta kuti uve nesimba panzvimbo yeshuga. Iyi nzira inogadzira zvinhu zvinokuvadza zvinonzi ketones izvo zvinoita kuti ropa rako rive rakashata, zvichikonzera matambudziko akakomba.

Uyu rudzi rwakajairika kune vanhu vane chirwere cheshuga chemhando 1 asi chinogonawo kuitika kune avo vane chirwere cheshuga chemhando 2 panguva yerwere rakakomba kana kushushikana. Kunhuwa kwemweya kwemichero chiratidzo cheDKA.

Hyperosmolar hyperglycemic state (HHS)

HHS inosanganisira mazinga akakwira kwazvo eshuga yeropa, kazhinji pamusoro pe 600 mg / dL, asi pasina kuunganidzwa kweketone kunoonekwa muDKA. Ropa rako rinoita rakapfava uye rakaoma, zvichiita kuti muviri wako ushande zvakajairwa.

Ichi chirwere chakajairika kune vanhu vane chirwere cheshuga chemhando 2 uye kazhinji chinoitika zvishoma nezvishoma kwemazuva kana mavhiki. Kushaya mvura kwakanyanya chiratidzo chikuru cheHHS.

Hypoglycemia yakakomba

Izvi zvinoitika kana shuga yeropa ikaderera kwazvo, kazhinji pasi pe 50 mg / dL. Uropi hwako hauhwirirani neshuga yakakwana kuti ushande, zvichikonzera kusanzwisisa, kuita zvimwe zvinhu, uye pakupedzisira kusaziva.

Hypoglycemia yakakomba inogona kuitika nekukurumidza, dzimwe nguva mukati memaminitsi, kunyanya kana wakatora insulin yakawanda kana mushonga wechirwere cheshuga usati wadya zvokudya zvakakwana.

Chii chinokonzera diabetic coma?

Diabetic coma inoitika kana zvinhu zvakati wandei zvichisanganiswa kuti zviise shuga yako yeropa kumazinga anotyisa. Kunzwisisa izvi zvinokonzera kunogona kukubatsira kutora matanho ekudzivirira ichi chirwere chakakomba.

Dambudziko riripo nguva dzose rine chekuita ne insulin - kana kuva ne shoma, yakawanda, kana muviri wako usingakwanisi kuishandisa zvakanaka:

Zvinokonzera coma yeshuga yeropa yakakwira:

• Kusapotsa mazai e insulin kana mishonga yechirwere cheshuga
• Kurwara kana hutachiona hunokwidza shuga yeropa
• Kudya kabhohydrate yakawanda kupfuura zvakajairwa pasina kugadzirisa mushonga
• Kuneta kubva pakuvhiya, kukuvara, kana kuzvidya mwoyo
• Mishonga yakati wandei senge steroids
• Chirwere cheshuga chisingazivikanwe
• Kushaikwa kwe insulin pump

Zvinokonzera coma yeshuga yeropa yakaderera:

• Kutora insulin yakawanda kana mushonga wechirwere cheshuga
• Kusiya kudya kana kudya zvishoma kupfuura zvakarongwa
• Kunwa doro pasina kudya zvokudya zvakakwana
• Kuita zvemitambo kupfuura zvakajairwa pasina kugadzirisa mushonga kana kudya
• Kurutsa kana kusakwanisa kuchengeta chikafu
• Kutora mishonga yakati wandei inosangana nemishonga yechirwere cheshuga

Dzimwe nguva, zvinhu zvisingawanzoitika zvinogonawo kuita kuti pave ne diabetic coma. Izvi zvinogona kusanganisira chirwere chakakomba cheitsvo kana chiropa, matambudziko emwoyo, kana kushomeka kwehomoni kunokanganisa kutonga kweshugaru.

Rini unofanira kuona chiremba nekuda kwe diabetic coma?

Fonera 911 nekukurumidza kana mumwe munhu asingazivi kana asingakwanisi kumuka, kunyanya kana vane chirwere cheshuga. Diabetic coma nguva dzose inenge iri chirwere chinoda kurapwa muchipatara - hapana nzira yakachengeteka yekurapa kumba.

Unofanirawo kutsvaka rubatsiro rwekurapa nekukurumidza kana ukaona aya maratidzo ekutanga, kunyange usati wava kusaziva:

• Shuga yeropa iri pamusoro pe 400 mg / dL kana pasi pe 50 mg / dL
• Kurutsa uye kusakwanisa kuchengeta mvura
• Zviratidzo zvekushushikana kwemvura
• Kunetseka kufema kana kufema kukurumidza
• Kunhuwa kwemweya kwemichero
• Kusanzwisisa kwakanyanya kana kuoma kuramba wakangwara
• Kurwadziwa pachipfuva kana kupururudza kwemoyo

Usamirira kuona kana maratidzo achivandudza oga. Nekukurumidza kwauri kugamuchira kurapwa, mukana wako wekudzivirira matambudziko akakomba uye kuporeswa zvizere uri nani.

Ndeapi njodzi dze diabetic coma?

Kunyangwe ani naani ane chirwere cheshuga anogona kuwana diabetic coma, zvinhu zvakati wandei zvinoita kuti njodzi yako iwedzere. Kuziva aya njodzi kunogona kukubatsira iwe nechikwata chako chehutano kutora matanho ekudzivirira ichi chirwere chakakomba.

Mamwe njodzi aunogona kudzora, nepo mamwe ane chekuita ne nhoroondo yako yekurapa kana mamiriro ako ezvehutano aripo iye zvino:

Njodzi dzinodzorwa:

• Kutonga kwakaipa kweshugaru yeropa kana kusatarisa nguva dzose
• Kusiya mazai e insulin kana mishonga
• Kusatevedzera chirongwa chako chekudya chechirwere cheshuga
• Kushaiwa kuongororwa kwehutano nguva dzose
• Kunwa doro kwakanyanya
• Kusava nechirongwa chekugadzirisa chirwere cheshuga

Njodzi dzehutano:

• Chirwere cheshuga chemhando 1 (njodzi yakakura yeDKA)
• Nhoroondo yematambudziko ekutanga echirwere cheshuga
• Zvimwe zvirwere zvinoramba zvichiitika senge chirwere chemwoyo kana matambudziko etsvo
• Kutapukirwa kazhinji kana maronda anorapa zvishoma
• Mamiriro ezvepfungwa anokanganisa kutarisira kwechirwere cheshuga
• Zera pamusoro pe 65 (njodzi yakakura yeHHS)

Uyezve, mamiriro ezvinhu ehupenyu anogona kuwedzera njodzi yako nekukurumidza, senge kurwara kukuru, kuvhiya, pamuviri, kana kushushikana kwakanyanya kwepfungwa. Panguva idzi, kushanda pedyo nechikwata chako chehutano kunova kukosha zvakanyanya.

Ndeapi matambudziko anogona kuitika e diabetic coma?

Diabetic coma inogona kukonzera matambudziko akakomba anokanganisa masisitimu akawanda emuviri wako. Zvisinei, nekurapwa nekukurumidza, akawanda ematambudziko aya anogona kudzivirirwa kana kuderedzwa.

Nguva yakareba munhu anoramba ari mu diabetic coma pasina kurapwa, njodzi yekukuvara kwenguva refu inowedzera:

Matambudziko ekukurumidza:

• Kuwedzera kweuropi (cerebral edema)
• Kushaya mvura kwakanyanya uye kushaikwa kweropa
• Kushaikwa kwekurima kwemoyo
• Mamazinga e potassium akaderera kwazvo
• Matambudziko ekugwamba kweropa
• Kukundikana kweitsvo
• Kunetseka kufema

Matambudziko ekure refu:

• Kukuvara kwenguva refu kweuropi
• Matambudziko ekurangarira kana kuchinja kwepfungwa
• Kuwedzera njodzi yematambudziko ekutanga echirwere cheshuga
• Kuwedzera kukurumidza kwechirwere cheshuga senge kukuvara kwetatu
• Mhedzisiro yepfungwa kusanganisira kunetseka nezve kutonga kweshugaru yeropa

Mashoko akanaka ndeakuti vanhu vakawanda vanowana kurapwa nekukurumidza kwe diabetic coma vanoporesa zvizere pasina mhedzisiro inogara. Ndosaka kuziva zviratidzo zvekutanga uye kutsvaka rubatsiro rwekurapa nekukurumidza zvakakosha kwazvo kune hutano hwako hwekure refu uye hutano.

Diabetic coma inogona kudzivirirwa sei?

Kudzivirira diabetic coma kunogoneka zvachose nekutarisira kwenguva dzose kwechirwere cheshuga uye kuziva zviratidzo zvekutanga zvemumuviri wako. Chinhu chikuru kuchengetedza mazinga eshuga yeropa akatsiga uye kuziva kuti ungapindura sei kana atanga kubuda panzira.

Heano mazano ekudzivirira anoshanda zvikuru aunogona kushandisa zuva nezuva:

Maitiro ekudzivirira zuva nezuva:

• Tarisa shuga yako yeropa nguva dzose sezvakarayirwa nachiremba wako
• Tora mishonga ne insulin chaizvo sezvakarayirwa
• Tevera chirongwa chako chekudya uye verenga kabhohydrate nguva dzose
• Ramba wakanyorova nekudya mvura yakawanda
• Ita zvemitambo nguva dzose asi gadzirisa chikafu nemishonga sezvinodiwa
• Chengetedza glucose inokurumidza kushanda iripo kune zviitiko zveshuga yeropa yakaderera
• Pfeka zvishongo zvinoratidza zvirwere

Kuronga mamiriro chaiwo:

• Gadzira chirongwa chekugadzirisa chirwere cheshuga nechikwata chako chehutano
• Dzidza kuti ungayedza sei ketones kana shuga yeropa yakakwira
• Ziwa kuti rini unofanira kufona chiremba wako kana kuenda kuchipatara chekukurumidza
• Iva nevanhu vanobatsira vanowanikwa nyore nyore
• Chengetedza zvinhu zvakawanda zvechirwere cheshuga zviripo
• Dzidzisa nhengo dzemhuri nezviratidzo zvechirwere cheshuga

Yeuka, kudzivirira kuri nyore kupfuura kurapa. Nekuramba uine tsika yekutarisira chirwere cheshuga uye kutaurirana nguva dzose nechikwata chako chehutano, unogona kuderedza njodzi yako yekuwana chirwere cheshuga.

Diabetic coma inoziviswa sei?

Kuziva diabetic coma kunosanganisira bvunzo yeropa nekukurumidza uye kuongororwa kwemuviri kuti uone chiri kukonzera kusaziva uye kuti ungaraira sei zvakanyanya. Mapoka ekurapa ekukurumidza akarovedzwa kuziva uye kupindura kumatambudziko echirwere cheshuga nekukurumidza.

Maitiro ekurapa kazhinji anoitika nekukurumidza mukamuri yekukurumidza:

Bvunzo dzekukurumidza:

• Kuyerwa kweshuga yeropa
• Kuongororwa kweketone (ropa kana weti)
• Kuongororwa kwemhepo yeropa kuti uone mazinga asina kunaka
• Metabolic panel ye electrolytes
• Kuongororwa kweropa uye kuyerwa kwemoyo

Bvunzo dzimwe dzinosanganisira:

• Kuverenga kweropa kwakakwana kuti uone hutachiona
• Kuongororwa kweitsvo
• Kuongororwa kwemoyo (EKG)
• X-ray yechipfuva kana paine matambudziko ekufufa
• Kuongororwa kwepfungwa kana wakamuka

Nhoroondo yako yekurapa uye chero ruzivo kubva kune nhengo dzemhuri nezviratidzo zvekutambudzika, kuchinja kwemishonga, kana kurwara kunobatsira madokota kunzwisisa chakakonzera coma. Iyi ruzivo inotungamira sarudzo dzekurapa uye inobatsira kudzivirira zviitiko zvemangwana.

Kurapa kwe diabetic coma chii?

Kurapa kwe diabetic coma kunotarisa pakudzoka zvishoma nezvishoma mazinga eshuga yeropa kune akajairika nepo uchitsigira mabasa akakosha emuviri wako. Kurapa kwakakosha kunoenderana nekuti shuga yako yeropa yakakwira kana yakaderera, asi zviitiko zvose zvinoda rubatsiro rwekurapa nekukurumidza.

Kurapa kwekukurumidza kazhinji kunotanga usati wapinda muchipatara uye kunoramba kuripo mune intensive care unit:

Kune coma yeshuga yeropa yakakwira (DKA / HHS):

• Mvura yeIV kudzora kushaya mvura
• Kurapa kwe insulin kuderedza shuga yeropa zvishoma nezvishoma
• Kutsiva kwe electrolytes senge potassium uye sodium
• Kurapa zvinokonzera senge hutachiona
• Kuongororwa kwakanyanya kwemoyo neitsvo

Kune coma yeshuga yeropa yakaderera:

• Mhinduro yeIV glucose (shuga)
• Jekiseni reGlucagon kana kuwana IV kuri kuoma
• Kuongororwa kwenguva dzose kweshugaru yeropa
• Kudya zvishoma nezvishoma kana wakamuka uye uchikwanisa kumira
• Kugadzirisa mushonga kudzivirira kudzokera

Kurapa kazhinji kunotora maawa mashoma kusvika kumazuva, zvichienderana nekuti coma yakakomba sei uye nekukurumidza kwawakawana rubatsiro rwekurapa. Panguva ino, mapoka ekurapa anotarisa kufambira mberi kwako zvakanyanya uye anogadzirisa kurapa sezvo mamiriro ako achiwedzera.

Kana wava wakagadzikana, madokota acashanda newe kuti unzwisise chakakonzera coma uye kuti ungadzivirira sei kuti isazodzokera zvakare kuburikidza nekutarisira kwakanaka kwechirwere cheshuga.

Maitiro ekugadzirisa chirwere cheshuga kumba mushure me diabetic coma?

Kuporesa kubva ku diabetic coma kunoda kutarisirwa kwakanyanya pakutarisira kwechirwere cheshuga uye kazhinji kunosanganisira kugadzirisa tsika yako yezuva nezuva. Chikwata chako chehutano chichapa mirairo chaiyo zvichienderana nezvakakonzera coma yako uye kuti muviri wako wakapindura sei kurapwa.

Mukati memavhiki mashomanana mushure mekubudiswa, iwe uchada kutarisa shuga yako yeropa kazhinji kupfuura zvakajairwa:

Chirongwa chekuongorora chakanyanya:

• Tarisa shuga yeropa kanenge ka4 pazuva, kana sezvakarayirwa
• Yedza ketones kana shuga yeropa ikakwira pamusoro pe 250 mg / dL
• Chengetedza marekodhi akakwana eshuga yeropa, chikafu, nezviratidzo
• Zviyereke zuva nezuva kuti uone kuchinja kwemvura
• Tora mishonga chaizvo sezvakarayirwa, kunyangwe uchizvinzwa zvakanaka

Kugadzirisa mararamiro:

• Tevera chirongwa chekudya chakatsiga nechikamu chakayerwa
• Ramba wakanyorova asi dzivisa kunwa mvura yakawanda
• Dzoka kuita zvemitambo zvishoma nezvishoma nebvunzo yechiremba
• Wana hope dzakakwana uye gadzira mazinga ekushushikana
• Dzivisa doro kusvika chiremba wako ataura kuti zvakanaka

Mishonga yako yechirwere cheshuga kana mazai e insulin anogona kudiwa kugadziriswa mushure me diabetic coma. Usambochinja mazai oga - shanda nguva dzose nechikwata chako chehutano kuti uite chero shanduko pachirongwa chako chekurapa.

Ungagadzirira sei kuenda kuchiremba mushure me diabetic coma?

Kugadzirira misangano yekutevera mushure me diabetic coma kunobatsira kuve nechokwadi chekuti unowana zvakanakira nguva yako nevanopa hutano. Aya misangano inokosha pakudzivirira zviitiko zvemangwana uye kuvandudza kutarisira kwechirwere cheshuga.

Usati waenda kumisangano,unganidza ruzivo rwakakosha ruchabatsira chiremba wako kunzwisisa mamiriro ako aripo iye zvino:

Ruzivo rwekutora:

• Marekodhi eshuga yeropa kubva pakabudiswa
• Rondedzero yemishonga yese iripo nemazai
• Rekodhi yezviratidzo kana zvinetso
• Mibvunzo nezve kutarisira kwechirwere cheshuga
• Mirayiridzo yekubudiswa kwepamberi
• Makadhi einishuwarenzi nezvinhu zvinoratidza zvirwere

Mibvunzo yekubvunza chiremba wako:

• Chii chakakonzera diabetic coma yangu?
• Ndingadzivirira sei izvi kuti zvisazodzokera zvakare?
• Mishonga yangu inoda kugadziriswa here?
• Kazhinji kangani ndinofanira kutarisa shuga yangu yeropa iye zvino?
• Ndeapi maratidzo andinofanira kutarisa?
• Rini ndinofanira kukufonera pane kuenda kuchipatara chekukurumidza?

Usanetseka kutora nhengo yemhuri kana shamwari kumusangano wako. Vanogona kukubatsira kuyeuka ruzivo rwakakosha uye kupa rutsigiro sezvaunoshingaira pakuvandudza chirongwa chako chekutarisira chirwere cheshuga.

Chii chinonyanya kukosha nezve diabetic coma?

Diabetic coma chirwere chakakomba asi chinogona kudzivirirwa chechirwere cheshuga chinoda rubatsiro rwekurapa nekukurumidza. Kunyangwe richinzwa richitya, kunzwisisa zviratidzo zvekutanga uye kuchengetedza kutonga kwakanaka kweshugaru yeropa kunogona kukubatsira kudzivirira ichi chirwere zvachose.

Chinhu chakakosha kukurangarira ndechekuti muviri wako kazhinji unokupa zviratidzo zvekutanga usati waitika diabetic coma. Nekutarisa shuga yako yeropa nguva dzose, kutora mishonga sezvakarayirwa, uye kuziva kuti rini unofanira kutsvaka rubatsiro, unogona kuramba wakachengeteka uye une hutano.

Kana uine zvinetso nezve mazinga eshuga yako yeropa kana kutarisira kwechirwere cheshuga, usanetseka kubata nechikwata chako chehutano. Varipo kukutsigira mukurarama zvakanaka nechirwere cheshuga uye kudzivirira matambudziko senge diabetic coma.

Mibvunzo inobvunzwa kazhinji nezve diabetic coma

Q1: Unogona kufa ne diabetic coma here?

Hungu, diabetic coma inogona kutyisa kana isina kurapwa nekukurumidza. Zvisinei, nerubatsiro rwekurapa nekukurumidza, vanhu vakawanda vanoporeka zvizere. Chinhu chikuru ndechekuziva zviratidzo zvekutanga uye kutsvaka kurapwa kwekukurumidza nekukurumidza. Kurapa kwazvino kwakavandudza zvakanyanya huwandu hwevanhu vanopona kubva kumatambudziko echirwere cheshuga.

Q2: Zvinotora nguva yakareba sei kuporesa kubva ku diabetic coma?

Nguva yekuporesa inosiyana zvichienderana nekuti coma yakakomba sei uye nekukurumidza kwakavamba kurapwa. Vanhu vakawanda vanodzoka kuziva mukati memaawa ekutanga kurapwa, asi kuporesa kwakazara kunogona kutora mazuva mashoma. Kugadzikana kwakazara kweshugaru yeropa nekudzoka kumabasa akajairika kazhinji kunoitika mukati mevhiki nerubatsiro rwekurapa rwakakodzera.

Q3: Diabetic coma inogona kuitika kunyangwe ndichitora mishonga yangu nguva dzose here?

Hungu, diabetic coma inogona kuitika kunyangwe uchishandisa mishonga nguva dzose. Kurwara, hutachiona, kushushikana, kana zvimwe zvirwere zvinogona dzimwe nguva kukunda tsika yako yakajairwa yekutarisira chirwere cheshuga. Ndosaka kuva nechirongwa chezuva rerwere uye kuziva kuti rini unofanira kutsvaka rubatsiro rwekurapa zvakakosha kwazvo kune munhu wese ane chirwere cheshuga.

Q4: Diabetic coma yakajairika here mu chirwere cheshuga chemhando 1 kana 2?

Marudzi akasiyana e diabetic coma akajairika mune marudzi akasiyana echirwere cheshuga. Diabetic ketoacidosis (DKA) inowanzoitika mu chirwere cheshuga chemhando 1, nepo hyperosmolar hyperglycemic state (HHS) ichijairika mu chirwere cheshuga chemhando 2. Zvisinei, marudzi ese echirwere cheshuga anogona kuwana chero rudzi rwechirwere cheshuga.

Q5: Ndichava nekukuvara kwenguva refu kweuropi mushure me diabetic coma here?

Vanhu vakawanda vanowana kurapwa nekukurumidza kwe diabetic coma vanoporeka zvizere pasina kukuvara kwenguva refu kweuropi. Njodzi yemhedzisiro inogara inowedzera nguva yakareba munhu anoramba asingazivi pasina kurapwa. Ndosaka rubatsiro rwekurapa nekukurumidza riri kukosha kwazvo - kurapwa kwekukurumidza kunodzivirira uropi hwako nemamwe matunhu emuviri kubva kukuvara.