Yini i-Tagraxofusp-erzs: Ukusetshenziswa, Umthamo, Imiphumela Eceleni nokuningi

I-Tagraxofusp-erzs iyikhambi lomdlavuza eliqondiswe ngqo elisiza ukulwa nomdlavuza wegazi ongavamile obizwa ngokuthi i-blastic plasmacytoid dendritic cell neoplasm (BPDCN). Lokhu kwelashwa okukhethekile kusebenza ngokunamathela kumaprotheni athile kumaseli omdlavuza futhi kuletha ubuthi obuwachithayo ngaphakathi. Yenzelwe abantu abadala nezingane ezinalo hlobo oluthile lomdlavuza wegazi, inikeza ithemba lapho okunye ukwelashwa kungase kungafaneleki.

Yini i-Tagraxofusp-erzs?

I-Tagraxofusp-erzs iyikhambi lomdlavuza elinikezwa ngudokotela elihlanganisa izingxenye ezimbili ezinamandla ukulwa namaseli omdlavuza. Ingxenye yokuqala isebenza njenge-missile eqondisiwe, ithola futhi inamathele kumaprotheni athile abizwa ngokuthi ama-CD123 receptors kumaseli omdlavuza. Ingxenye yesibili iletha ubuthi obuchitha lawa maseli aqondiwe kuyilapho ishiya amaseli anempilo engalimalanga kakhulu.

Lo muthi ungowesigaba semithi ebizwa ngokuthi ama-CD123-directed cytotoxins. Cabanga ngayo njengebhoma elihlakaniphile elingahlukanisa phakathi kwamaseli anempilo namaseli omdlavuza. Umuthi unikezwa ngomjovo we-IV, okuvumela ukuthi uhambe ngaphakathi kwegazi lakho ukuze ufinyelele kumaseli omdlavuza noma ngabe acashe kuphi.

Ithimba lakho lezempilo lizolungisa futhi linikeze lo muthi esikhungweni sezokwelapha lapho ungaqashwa khona eduze. Le ndlela eqaphelayo isiza ukuqinisekisa ukuphepha kwakho futhi ivumela ukusabela ngokushesha uma kwenzeka imiphumela emibi ngesikhathi sokwelashwa.

Yini i-Tagraxofusp-erzs Esetshenziselwa Yona?

I-Tagraxofusp-erzs igunyazwe ngokuqondile ukwelapha i-blastic plasmacytoid dendritic cell neoplasm (BPDCN) kubantu abadala nezingane ezineminyaka engu-2 ubudala nangaphezulu. I-BPDCN ngumdlavuza wegazi ongavamile futhi onolaka othinta amaseli akhethekile omzimba okuthiwa ama-plasmacytoid dendritic cells.

Lo mdlavuza ngokuvamile uvela njengamanxeba esikhumba, ama-lymph nodes avuvukile, noma uthinta umnkantsha wamathambo negazi. Ngenxa yokuthi i-BPDCN iyivelakancane, ithinta abantu abangaphansi koyedwa kwabayi-100,000, kwakukhona izinketho ezilinganiselwe zokwelashwa ngaphambi kokuba le mithi ithuthukiswe.

Udokotela wakho angase ancome lokhu kwelashwa uma utholakale ukuthi une-BPDCN futhi ezinye izindlela zokwelapha azisebenzanga noma azilungele isimo sakho. Le mithi ibonise isithembiso ezivivinyweni zomtholampilo, neziguli eziningi ezibona ukuthuthuka okukhulu ezimpawini zazo zomdlavuza.

Isebenza Kanjani I-Tagraxofusp-erzs?

I-Tagraxofusp-erzs isebenza ngenqubo eyinkimbinkimbi yezinyathelo ezimbili eziqondise amaseli omdlavuza ngokunemba okukhulu. Le mithi yakhelwe ukuthi ifune futhi ibophe kuma-CD123 receptors, atholakala ngenani eliphezulu kumaseli omdlavuza we-BPDCN kodwa avamile kakhulu kumaseli anempilo.

Lapho imithi inamathisela kula ma-receptors, iseli lomdlavuza empeleni lisiza inqubo ngokudonsa imithi ngaphakathi ngenqubo yemvelo ebizwa ngokuthi i-endocytosis. Cabanga ngayo njengeseli lomdlavuza lingazi livula umnyango walo ukuze lingene imithi.

Ngaphakathi kweseli lomdlavuza, imithi ikhipha umthwalo wayo onobuthi, okuphazamisa ikhono leseli lokwenza amaprotheni abalulekile ekuphileni. Lokhu kuholela ekufeni kweseli lomdlavuza ngenkathi kunciphisa umonakalo kumaseli anempilo angenawo ama-CD123 receptors amaningi.

Le ndlela eqondiwe ithathwa njengeqinile futhi isebenza kahle nge-BPDCN, nakuba ingabangela imiphumela emibi ebalulekile ngoba amanye amaseli anempilo nawo anama-CD123 receptors, ikakhulukazi esibindini nasemithanjeni yegazi.

Kufanele Ngiyithathe Kanjani I-Tagraxofusp-erzs?

I-Tagraxofusp-erzs inikezwa njenge-intravenous (IV) infusion ngokuqondile egazini lakho esikhungweni sezokwelapha. Awukwazi ukuthatha le mithi ekhaya, futhi kufanele ilungiswe futhi inikezwe ochwepheshe bezempilo abaqeqeshiwe abangochwepheshe ekwelashweni komdlavuza.

Uhlelo olujwayelekile lokwelapha luhlanganisa ukuthola umuthi kanye ngosuku izinsuku ezinhlanu zokuqala zomjikelezo wezinsuku ezingama-21. Ithimba lakho lokunakekelwa kwezempilo lizofaka umugqa we-IV emthanjeni wakho engalweni yakho noma ngomugqa omkhulu uma unawo. Ukumnika ngokuvamile kuthatha imizuzu engaba ngu-15 ukuqedela.

Ngaphambi kokumnika ngakunye, uzothola imithi yangaphambi kokwelashwa ukusiza ukuvimbela ukusabela komzimba nokunye okungemihle. Lokhu kungabandakanya ama-antihistamines, ama-corticosteroids, kanye nezinto ezinciphisa umkhuhlane. Ithimba lakho lezokwelapha lizobheka izimpawu zakho ezibalulekile ngesikhathi nangemva kokumnika.

Akudingeki ukhathazeke ngemikhawulo yokudla ngaphambi kokwelashwa kwakho, kodwa ukuhlala unamanzi kahle kubalulekile. Ithimba lakho lokunakekelwa kwezempilo lingancoma ukuphuza amanzi amaningi ezinsukwini eziholela ekwelashweni kwakho ukusiza izinso zakho ukuthi zisebenze ngempumelelo umuthi.

Kufanele Ngithathe Isikhathi Esingakanani I-Tagraxofusp-erzs?

Ubude bokwelashwa kwakho kwe-tagraxofusp-erzs buxhomeke ekutheni umdlavuza wakho usabela kahle kangakanani nokuthi ukubekezelela kahle kangakanani umuthi. Iziguli eziningi zithola imijikelezo eminingi yokwelashwa, lapho umjikelezo ngamunye uhlala izinsuku ezingama-21 futhi uhlanganisa izinsuku ezinhlanu zokuphathwa komuthi wangempela.

Udokotela wakho uzobheka njalo umdlavuza wakho ngokuhlolwa kwegazi, izifundo zokuthwebula izithombe, kanye nokuhlolwa komzimba ukuze anqume ukuthi ukwelashwa kuyasebenza yini. Uma umdlavuza wakho usabela kahle futhi ubekezelela umuthi ngaphandle kwemiphumela emibi, ungaqhubeka nokwelashwa imijikelezo eminingana.

Ezinye iziguli zingafinyelela ekutheni zithuthuke ngemva kwemijikelezo embalwa, kanti ezinye zingase zidinge ukwelashwa isikhathi eside. Ithimba lakho lokunakekelwa kwezempilo lizosebenza nawe ukuthola ibhalansi efanele phakathi kokulwa nomdlavuza wakho ngempumelelo nokugcina izinga lempilo yakho.

Izinqumo zokwelashwa zenzelwe umuntu ngamunye kakhulu, futhi udokotela wakho uzocabangela izinto ezinjengempilo yakho yonke, ukusabela komdlavuza, kanye nanoma yimiphumela emibi oyitholayo lapho enquma ukuthi uzokwelashwa isikhathi esingakanani.

Ziyini Imiphumela Eceleni ye-Tagraxofusp-erzs?

I-Tagraxofusp-erzs ingabangela imiphumela eceleni ehlukahlukene, kusukela kokulula kuya kokukhulu, ngoba imithi ithinta hhayi kuphela amaseli omdlavuza kodwa namanye amaseli anempilo anama-CD123 receptors. Ukuqonda le miphumela engaba khona kungakusiza wena nethimba lakho lezempilo ukuyiphatha ngempumelelo.

Imiphumela eceleni evame kakhulu ongase uyithole ihlanganisa ukukhathala, isicanucanu, umkhuhlane, nokuvuvukala ezingalweni zakho, emilenzeni, noma ebusweni. Iziguli eziningi zithuthukisa nokusabela kwesikhumba, izinguquko ekuhlolweni komsebenzi wesibindi, kanye nokubalwa kwegazi okuphansi okungandisa ingozi yakho yokutheleleka noma ukopha.

Imiphumela Eceleni Evamile

Nansi imiphumela eceleni eyenzeka ezigulini eziningi ezithola lo muthi, nakuba kungewona wonke umuntu ozoyithola yonke:

• Ukukhathala nobuthakathaka obungaphazamisa imisebenzi yansuku zonke
• Isicanucanu nokuhlanza, okuvame ukuphathwa ngemithi elwa nesicanucanu
• Umkhuhlane namakhaza, ikakhulukazi ngemva kwemithamo embalwa yokuqala
• Ukuvuvukala (i-edema) ezandleni, ezinyaweni, emilenzeni, noma ebusweni ngenxa yokugcinwa kwamanzi
• Ukusabela kwesikhumba okuhlanganisa ukuqubuka, ukuluma, noma isikhumba esomile
• Ushintsho ekuhlolweni komsebenzi wesibindi, okuzoqashwa udokotela wakho eduze
• Ukubalwa kwamangqamuzana egazi okuphansi okuthinta amaseli amhlophe egazi, amaseli abomvu egazi, noma ama-platelet
• Ikhanda elibuhlungu nesiyezi
• Ukulahlekelwa isifiso sokudla kanye nezinguquko zesisindo

Le miphumela eceleni evamile ivame ukuphathwa ngokunakekelwa okusekelayo nemithi. Ithimba lakho lezempilo lizosebenza nawe ukunciphisa umthelela wazo empilweni yakho yansuku zonke.

Imiphumela Eceleni Engathi Sína

Nakuba kungavamile, ezinye iziguli zingase zithole imiphumela eceleni engathi sína edinga ukunakekelwa kwezempilo ngokushesha nokuqashwa ngokucophelela:

• I-capillary leak syndrome, ebangela ukuthi uketshezi luvele emithanjeni yegazi lungene ezicutshini eziqashile
• Izinkinga zesibindi ezinzima ezingaba yingozi ekuphileni uma zingelashwa ngokushesha
• Izifo ezinzima ngenxa yokwehla kwenani lamangqamuzana amhlophe egazi
• Ukungezwani komzimba okukhulu ngesikhathi noma ngemva nje kokufakwa
• I-Tumor lysis syndrome, lapho amangqamuzana omdlavuza ewohloka ngokushesha kakhulu
• Ukugcinwa okukhulu koketshezi okuthinta ukusebenza kwenhliziyo noma yamaphaphu
• I-Hemophagocytic lymphohistiocytosis, ukusabela okungavamile kodwa okunzima komzimba

Ithimba lakho lezokwelapha lizokugada ngokucophelela ukuze libone le miphumela emibi futhi lizoyeka ukwelapha uma kunesidingo sokuvikela impilo yakho. Eminingi yale miphumela iyabuyiseka ngokunakekelwa okufanele kwezokwelapha.

Imiphumela engavamile kodwa ebalulekile

Ezinye iziguli zingase zibe nemiphumela engavamile, nakuba ingavamile, kubalulekile ukuyiqaphela:

• Imiphumela emibi yezinzwa ezinzima ehlanganisa ukudideka, ukuquleka, noma izinguquko esimweni sengqondo
• Izinkinga zenhliziyo ezihlanganisa ukushaya kwenhliziyo okungajwayelekile noma uketshezi oluzungeze inhliziyo
• Izinkinga ezinzima zezinso ezidinga i-dialysis
• Ukuphazamiseka kokujiya kwegazi okungabangela amahlule ayingozi noma ukuphuma kwegazi
• Ukungalingani okukhulu kwama-electrolyte okuthinta imisipha nokusebenza kwemizwa
• Ukuvuvukala kwamanyikwe (pancreatitis) okubangela ubuhlungu obukhulu besisu

Le miphumela engavamile idinga ukunakekelwa kwezokwelapha ngokushesha futhi ingase ibangele ukulaliswa esibhedlela ukuze kuqashwe futhi kulashwe ngokuqinile.

Ubani Ongafanele Athole i-Tagraxofusp-erzs?

I-Tagraxofusp-erzs ayifanele wonke umuntu, futhi udokotela wakho uzohlola ngokucophelela ukuthi lokhu kwelashwa kuphephile yini kuwe. Abantu abanezimo ezithile zezokwelapha noma izimo kungenzeka bangabi ngabakhethi bale mithi.

Akufanele uthole lo muthi uma wazi ukuthi unokungezwani komzimba ne-tagraxofusp-erzs noma yiziphi izingxenye zawo. Udokotela wakho uzobuye acabangele isimo sakho sempilo esiphelele, okuhlanganisa umsebenzi wenhliziyo, isibindi, kanye nezinso, ngaphambi kokuncoma lokhu kwelashwa.

Iziguli ezinokugula kwesibindi okukhulu kungenzeka zingakwazi ukuthola lo muthi ngokuphepha ngoba kungase kubhebhethekise izinkinga zesibindi. Ngokufanayo, abantu abanezifo zenhliziyo ezinzima bangase babe sengozini enkulu yezinkinga ezivela ekugcinweni kwamanzi kanye neminye imiphumela yenhliziyo nemithambo yegazi.

Abesifazane abakhulelwe akufanele bathole i-tagraxofusp-erzs ngoba ingalimaza ingane esakhula. Uma useminyakeni yokuzala, udokotela wakho uzoxoxa ngezindlela zokulawula ukuzala ezisebenzayo okufanele zisetshenziswe ngesikhathi sokwelashwa kanye nangezinyanga eziningana ngemuva kwalokho.

Igama Lomkhiqizo le-Tagraxofusp-erzs

I-Tagraxofusp-erzs ithengiswa ngaphansi kwegama lomkhiqizo elithi Elzonris. Leli gama lomkhiqizo lisetshenziswa e-United States nakwamanye amazwe lapho umuthi uvunyelwe ukwelapha i-BPDCN.

Uma uthola ukwelashwa kwakho, ungase ubone elinye igama kumarekhodi akho ezokwelapha noma emadokhumenti omshwalense. Womabili la magama abhekisela emuthini ofanayo, ngakho-ke ungadideki uma ubona amagama ahlukene esetshenziswa ezindaweni ezihlukene.

I-Elzonris yenziwa yi-Stemline Therapeutics futhi itholakala kuphela ngezikhungo zokwelapha umdlavuza ezikhethekile nezibhedlela ezinolwazi ngalolu hlobo lokwelashwa oluqondiwe.

Ezinye Izindlela Zokwelapha ze-Tagraxofusp-erzs

Ngenxa yokuthi i-BPDCN ingumdlavuza ongavamile, kukhona ukwelashwa okuncane okutholakalayo. Ngaphambi kokuthi i-tagraxofusp-erzs ivunywe, odokotela ngokuvamile babevame ukusebenzisa inhlanganisela yemithi ye-chemotherapy efana nalezo ezisetshenziselwa eminye imidlavuza yegazi.

Izindlela zokwelashwa ze-chemotherapy zendabuko zingase zihlanganise inhlanganisela yemithi efana ne-cyclophosphamide, doxorubicin, vincristine, kanye ne-prednisone. Kodwa-ke, lokhu kwelashwa kuvame ukuba nokusebenza okulinganiselwe ngokumelene ne-BPDCN futhi kungabangela imiphumela emibi ebalulekile.

Kwabanye iziguli, ukufakelwa kwamaseli esiqu kungase kucatshangelwe, ikakhulukazi uma befinyelela ekutheni isifo sihlehle ngemithi yokuqala. Le nqubo eqinile ihlanganisa ukufaka esikhundleni somnkantsha wamathambo ogulayo ngamaseli anempilo avela kumnikeli.

Izivivinyo zomtholampilo nazo zingase zinikeze ukufinyelela ekwelashweni okungokwesipiliyoni okucwaningwayo nge-BPDCN. Udokotela wakho we-oncologist angakusiza ukuthi uhlole zonke izinketho ezitholakalayo futhi unqume indlela engcono kakhulu yesimo sakho esithile.

Ingabe i-Tagraxofusp-erzs Ingcono Kunezinye Izindlela Zokwelapha?

I-Tagraxofusp-erzs imelela intuthuko enkulu ekwelapheni i-BPDCN uma iqhathaniswa nezindlela zokwelapha ngamakhemikhali zendabuko. Izivivinyo zomtholampilo zikhombisile ukuthi le ndlela yokwelapha eqondiwe ingasebenza kangcono kunezindlela zokwelapha ezivamile ezigulini eziningi ezinomdlavuza ongavamile.

Indlela yokwelapha eqondiwe yomuthi isho ukuthi ingahlasela amaseli omdlavuza ngokunembile kakhulu ngenkathi kungenzeka ukuthi ibangele imiphumela emibi embalwa ehambisana nokwelashwa ngamakhemikhali okuhlukahlukene. Lokhu kungaholela emiphumeleni engcono kanye nokuthuthukiswa kwekhwalithi yempilo ezigulini eziningi.

Nokho,

Udktela wakho uzohlola ukusebenza kwesibindi sakho ngaphambi kokuqala ukwelashwa futhi aqhubeke nokubheka ngaso sonke isikhathi sokwelashwa kwakho. Uma unezinkinga zesibindi ezincane, ungase ukwazi ukuthola imithi ngokubheka ngokucophelela futhi mhlawumbe ulungise umthamo.

Abantu abanezifo zesibindi ezinzima ngokuvamile ababona abazongenela lokhu kwelashwa ngoba izingozi zingase zidlule ezinzuzweni. Ithimba lakho lokunakekelwa kwezempilo lizosebenza nawe ukuthola indlela yokwelashwa ephephe kunazo zonke futhi esebenza kahle kakhulu esimweni sakho.

Q2. Kufanele Ngenzeni Uma Ngithola Imiphumela Emibi Esinzima?

Uma uthola imiphumela emibi esinzima njengobunzima bokuphefumula, ukuvuvukala okukhulu, ubuhlungu obukhulu besisu, noma izinguquko esimweni sengqondo, kufanele ufune ukunakekelwa kwezempilo ngokushesha. Ungalindi ukubona ukuthi izimpawu ziyathuthuka zodwa.

Xhumana nethimba lakho lokunakekelwa kwezempilo ngokushesha uma uthola umkhuhlane, izimpawu zokutheleleka, ukuphuma kwegazi okungavamile noma ukulimala, noma ukukhathala okukhulu okukuvimbela ekwenzeni imisebenzi yansuku zonke. Lokhu kungaba yizimpawu zezinkinga ezinzima ezidinga ukwelashwa okusheshayo.

Ithimba lakho lezokwelapha linolwazi lokuphatha imiphumela emibi yalo muthi futhi linganikeza ukwelashwa ukukusiza ukuba uzizwe ungcono. Bangase balungise isimiso sakho semithi, banikeze ukunakekelwa okusekelayo, noma bamise ukwelashwa okwesikhashana uma kudingekile.

Gcina uhlu lwezinombolo zokuxhumana eziphuthumayo ezivela eqenjini lakho lokunakekelwa kwezempilo futhi wazi ukuthi yisiphi isibhedlela noma isikhungo sokwelashwa okufanele uye kuso uma udinga ukunakekelwa ngokushesha ngaphandle kwamahora ajwayelekile ehhovisi.

Q3. Ngizokwazi Kanjani Uma Ukwelashwa Kusebenza?

Udktela wakho uzoqapha impendulo yakho ku-tagraxofusp-erzs ngokuhlolwa kwegazi okuvamile, ukuhlolwa komzimba, kanye nezifundo zokucabanga. Ungase uqale ukuqaphela ukuthuthuka ezimpawini ezinjengokukhathala, izilonda zesikhumba, noma ama-lymph nodes avuvukele ngaphakathi kwemijikelezo embalwa yokuqala yokwelashwa.

Uhlolo lwegazi luzokhombisa izinguquko emangqamuzaneni omdlavuza kanye nenani legazi eliphelele, kuyilapho izifundo zokuthwebula izithombe njenge-CT scans noma i-PET scans zingadalula ukuthi amasende ayancipha yini. Udokotela wakho uzochaza ukuthi lezi zivivinyo zikhombisani nokuthi zisho ukuthini ngohlelo lwakho lokwelashwa.

Ezinye iziguli zingase zizizwe zibi ekuqaleni njengoba amangqamuzana omdlavuza wabo ebhubhiswa, okungase kwandise okwesikhashana imiphumela emibi ethile. Lokhu akusho ngempela ukuthi ukwelashwa akusebenzi, kodwa ithimba lakho lezempilo lizokusiza ukuthi uqonde ukuthi yini ongayilindela.

Ukusabela ekwelashweni kungahluka kakhulu phakathi kweziguli, futhi kungase kuthathe imijikelezo eminingana ngaphambi kokuthi wena nodokotela wakho bakwazi ukuhlola ngokugcwele ukuthi imithi isebenza kahle kangakanani kuwe.

Q4. Ngingaqhubeka NemiSebenzi Yami Ejwayelekile Ngesikhathi Sokwelashwa?

Iziguli eziningi zingaqhubeka nemisebenzi ethile ejwayelekile ngesikhathi sokwelashwa, nakuba kungase kudingeke ukuthi wenze izinguquko ngokusekelwe endleleni ozizwa ngayo nemiphumela emibi yakho. Ukukhathala kuvamile, ngakho kungase kudingeke uphumule kakhulu kunokujwayelekile futhi uhlele imisebenzi yakho.

Kufanele ugweme izindawo ezigcwele abantu kanye nabantu abagulayo ngoba lo muthi ungenza ukuthi inani lakho lamangqamuzana egazi elimhlophe lehle, okukwenza uthambekele ezifweni. Ithimba lakho lezempilo lizohlinzeka ngemihlahlandlela ethile mayelana nokuthi kuphephile nini ukuba nabanye.

Ukuzivocavoca okulula njengokuhamba kungaba usizo uma uzizwa ukulungele, kodwa gwema imisebenzi eqinile engase ikhulise ingozi yakho yokulimala, ikakhulukazi uma inani lakho lama-platelet liphansi. Ukubhukuda emachibini omphakathi kufanele kugwenywe ngenxa yengozi yokutheleleka.

Xoxa nethimba lakho lezempilo ngomsebenzi wakho, izinhlelo zokuhamba, neminye imisebenzi. Bangakusiza ukuthi wenze izinqumo ezinolwazi mayelana nokuthi yini ephephile futhi efanelekayo ngesikhathi sakho sokwelashwa.

Q5. Ngizodinga Ukuhlala Esibhedlela Ngesikhathi Sokwelashwa?

Iningi labantu abagulayo lithola i-tagraxofusp-erzs njengokwelashwa ngaphandle, okusho ukuthi ungahamba ekhaya ngosuku olufanayo ngemuva kokufakwa ngakunye. Kodwa-ke, ukwelashwa kwakho kokuqala kuzodinga ukuqashwa ngokucophelela, futhi kungase kudingeke uhlale esikhungweni sokwelashwa amahora amaningana ngemuva kokufakwa ngakunye.

Abanye abantu abagulayo bangase badinge ukulaliswa esibhedlela, ikakhulukazi uma bethola imiphumela emibi engathi sína efana ne-capillary leak syndrome noma izinkinga ezinzima zesibindi. Ithimba lakho lezempilo lizinquma indawo ephephe kakhulu yokwelashwa kwakho ngokusekelwe ezingozini zakho ngazinye.

Uma uhlala kude nesikhungo sokwelashwa, udokotela wakho angase ancome ukuhlala eduze ngesikhathi sokwelashwa kwakho ukuze ukwazi ukuthola usizo ngokushesha uma kudingeka. Izikhungo eziningi zomdlavuza zingahlinzeka ngolwazi mayelana nezinketho zokuhlala kwabantu abagulayo nemindeni.

Ithimba lakho lokwelashwa lizoxoxa ngohlelo lokuqapha nawe futhi likusize uqonde okulindelekile ngesikhathi nangemva kweseshini ngayinye yokwelashwa. Bazophinde banikeze imiyalelo ecacile mayelana nokuthi kufanele ufune nini ukunakekelwa kwezempilo ngokushesha.