Yini i-Verapamil (Indlela Yokungenisa Ngemithambo): Ukusetshenziswa, Umthamo, Imiphumela Eceleni Nokunye

I-Verapamil enikezwa ngomthambo womjovo ngumuthi wenhliziyo osetshenziswa ezimweni eziphuthumayo ukulawula ngokushesha ukushaya kwenhliziyo okuyingozi. Lo muthi onamandla usebenza ngokuvimba iziteshi ze-calcium enhliziyweni yakho, usiza ukwehlisa ukushaya kwenhliziyo okusheshayo futhi ubuyisele isigqi esijwayelekile lapho ezinye izindlela zokwelapha zingasebenzi ngokushesha okwanele.

Lapho odokotela benikeza i-verapamil ngemithambo yakho, bangakwazi ukulawula ngqo ukuthi ungakanani owutholayo futhi baqaphe impendulo yakho ngokucophelela. Lolu hlobo olungena ngemithambo lusebenza ngokushesha kakhulu kunezibhebhe, okwenza libaluleke ezimweni eziphuthumayo zenhliziyo lapho iminithi ngalinye libalulekile.

Yini i-Verapamil (Indlela Yokungenisa Ngemithambo)?

I-Verapamil engena ngemithambo ngumuthi ovimba iziteshi ze-calcium olethwa ngqo egazini lakho ngomthambo. Ingowodwa ohlwini lwemithi esebenza ngokuvimba i-calcium ukuthi ingangeni emangqamuzaneni enhliziyo yakho nemithambo yegazi.

Lolu hlobo lomjovo lwenzelwe ukusetshenziswa esibhedlela lapho kudingeka khona ukulawulwa okusheshayo kwesigqi senhliziyo. Ngokungafani namathebulethi omlomo ongawathatha ekhaya, inguqulo engena ngemithambo ivumela odokotela ukuthi bafinyelele amazinga okuphulukisa egazini lakho ngemizuzu kunamahora.

Umuthi uza njengesixazululo esicacile, esingenambala esilungiswa futhi sinikezwe ochwepheshe bezempilo besebenzisa izinqubo zokuphepha eziqinile. Uzothola kuphela lokhu kwelashwa endaweni yezokwelapha lapho isigqi senhliziyo yakho nomfutho wegazi kungaqashwa ngokuqhubekayo.

Isetshenziselwani i-Verapamil (Indlela Yokungenisa Ngemithambo)?

I-IV verapamil isetshenziswa ikakhulukazi ukwelapha i-supraventricular tachycardia (SVT), isimo lapho inhliziyo yakho ishaya ngokushesha okuyingozi ngenxa yezinkinga zikagesi emagumbini aphezulu. Lo muthi ungakwazi ukwehlisa ngokushesha izinga lokushaya kwenhliziyo yakho libuyele esigqini esiphephile, esijwayelekile.

Odokotela basebenzisa i-verapamil yomthambo ngaphakathi (i-intravenous) nasekuqineni kwe-atrial kanye ne-atrial flutter lapho amagumbi angaphezulu enhliziyo yakho eshaya ngokungajwayelekile futhi ngokushesha kakhulu. Kulezi zimo, umuthi usiza ukulawula izinga lokushaya kwenhliziyo yakho ngenkathi ezinye izindlela zokwelapha zibhekana nenkinga eyisisekelo yesigqi.

Ngezinye izikhathi, amaqembu ezokwelapha asebenzisa i-IV verapamil ngesikhathi sezinqubo ezithile zenhliziyo ukuze anciphise isikhashana izinga lokushaya kwenhliziyo yakho. Lokhu kwenza kube lula odokotela ukwenza izivivinyo ezithile noma ukwelashwa okudinga ukushaya kwenhliziyo okuhamba kancane, okulawulwayo.

Ezimweni eziphuthumayo ezingavamile, odokotela bangasebenzisa i-verapamil yomthambo ngaphakathi ngenxa yomfutho wegazi ophezulu ongathobeli ezinye izindlela zokwelapha. Kodwa-ke, lokhu kusetshenziswa kudinga ukuqapha okucophelelayo ngoba umuthi ungenza umfutho wegazi wehle ngokushesha kakhulu.

Isebenza Kanjani I-Verapamil (Indlela Yomthambo Ngaphakathi)?

I-Verapamil isebenza ngokuvimba iziteshi ze-calcium emsipheni wenhliziyo yakho nasezindongeni zemithambo yegazi. Cabanga nge-calcium njengokhiye ovula iminyango ngokuqhubekayo emangqamuzaneni enhliziyo yakho, okubavumela ukuthi baqine futhi bashaye.

Lapho i-verapamil ivimba lezi ziteshi ze-calcium, yehlisa amasignali kagesi enza inhliziyo yakho ishayele. Lokhu kusiza ukubuyisela isigqi esijwayelekile lapho inhliziyo yakho ishaya ngokushesha kakhulu noma ngokungajwayelekile ngenxa yezinkinga emagumbini angaphezulu.

Umuthi futhi uphumuza imisipha ebushelelezi emithanjeni yakho yegazi, engasiza ukwehlisa umfutho wegazi. Kodwa-ke, uma inikezwa ngomthambo ngaphakathi, umgomo oyinhloko uvame ukulawulwa kwesigqi senhliziyo kunokulawulwa komfutho wegazi.

Njengomuthi onamandla ngokulinganisela, i-IV verapamil ikhiqiza imiphumela kungakapheli imizuzu engu-1-5 yokunikezwa. Imiphumela ephezulu ivame ukwenzeka kungakapheli imizuzu engu-10-15, yingakho odokotela bengabona imiphumela ngokushesha futhi balungise ukwelashwa njengoba kudingeka.

Kufanele Ngiyithathe Kanjani I-Verapamil (Indlela Yomthambo Ngaphakathi)?

Ngeke empeleni "uzithathele" wena uqobo i-verapamil engena ngemithambo ngoba ochwepheshe bezempilo abaqeqeshiwe bazoyinika ngqo emthanjeni wakho. Umuthi unikezwa kancane kancane ngemizuzu embalwa ngenkathi abasebenzi bezokwelapha beqapha eduze isigqi senhliziyo yakho nomfutho wegazi.

Ngaphambi kokuthola umjovo, abasebenzi bezokwelapha bazosungula umugqa we-IV engalweni yakho noma esandleni sakho. Bazoxhuma imishini yokuqapha ukuze balandelele isigqi senhliziyo yakho, umfutho wegazi, kanye namazinga omoya-mpilo ngesikhathi sokwelashwa.

Umthamo wokuqala uvame ukunikezwa njengokucindezela okuhamba kancane ngemizuzu engu-2-3, kulandelwe ukuhlanjululwa ngamanzi anosawoti ukuze kuqinisekiswe ukuthi yonke imithi ingena egazini lakho. Uma isigqi senhliziyo yakho singathuthuki ngemva kwemizuzu engu-15-30, odokotela bangakunika umthamo wesibili.

Ngesikhathi sokunikezwa, kuzodingeka ulale phansi noma uhlale endaweni enethezekile. Ithimba lezokwelapha lizokucela ukuthi ubike noma yiziphi izimpawu ezinjengokugajezela, ubuhlungu besifuba, noma ukuphefumula kanzima ngokushesha.

Njengoba lokhu kuyimithi esezingeni eliphuthumayo, akukho okudingekayo okukhethekile kokudla ngaphambi kwesikhathi. Kodwa-ke, uma uqaphela futhi ukwazi ukuxhumana, tshela ithimba lakho lezempilo nganoma yimiphi imithi oyithathayo noma izimo zezokwelapha onazo.

Kufanele Ngiyithathe Isikhathi Esingakanani I-Verapamil (Indlela Engena Ngemithambo) ?

I-verapamil engena ngemithambo ngokuvamile iyindlela yokwelapha yesikhathi esisodwa noma inikezwa njengemithamo embalwa emahoreni ambalwa ngesikhathi esiphuthumayo sezokwelapha. Ngokungafani nemithi yomlomo ongase uyithathe nsuku zonke, i-IV verapamil isetshenziselwa ukulawula isigqi senhliziyo ngokushesha, ngesikhathi esifushane.

Iziguli eziningi zithola imithamo engu-1-3 ye-verapamil engena ngemithambo ngesikhathi sokuhlala kwazo esibhedlela, kuye ngokuthi inhliziyo yazo isabela kanjani ekwelashweni. Imiphumela yomthamo ngamunye ingahlala amahora angu-2-6, inikeze odokotela isikhathi sokusebenzisa ezinye izindlela zokwelapha noma banqume ukuthi ngabe imithamo eyengeziwe iyadingeka yini.

Ngemuva kokuthi isigqi senhliziyo yakho sizinzile, udokotela wakho cishe uzokushintshela emithini yenhliziyo yomlomo noma ezinye izindlela zokwelapha ukuze kulawulwe isikhathi eside. Ukushintsha kusuka ku-IV kuya emithini yomlomo kuvame ukwenzeka phakathi kwamahora angama-24-48 uma isimo sakho sizinzile.

Kwezinye izimo, odokotela bangase basebenzise ukumnika okuqhubekayo kwe-IV ye-verapamil amahora amaningana uma udinga ukulawulwa okuqhubekayo kwesilinganiso senhliziyo. Le ndlela ivumela ukulethwa kwemithi okunembile kakhulu kanye nokulungiswa okulula kwemithamo njengoba isimo sakho sishintsha.

Yiziphi Imiphumela Eceleni Ye-Verapamil (Indlela Ye-Intravenous)?

Imiphumela emibi evame kakhulu ye-IV verapamil ihlobene nemiphumela yayo enhliziyweni yakho nasemithanjeni yegazi. Lezi zimpendulo zenzeka ngoba imithi isebenza ukwehlisa isilinganiso senhliziyo yakho futhi iphumulele imithambo yakho yegazi.

Nansi imiphumela emibi ongase uyithole, ukhumbula ukuthi abasebenzi bezokwelapha bazokuqapha eduze ukuze babambe futhi babhekane nanoma iyiphi inkinga ngokushesha:

• Ukwehla kwegazi (hypotension) okubangela isiyezi noma ukukhathala
• Isilinganiso senhliziyo esinensayo (bradycardia) esingakwenza uzizwe ubuthakathaka noma ukhathele
• Isicanucanu noma isisu esincane
• Ikhanda elibuhlungu noma isiyezi esincane
• Ukubomvu noma ukufudumala ebusweni bakho nasentanyeni yakho
• Ukuqunjelwa kwesikhashana

Le miphumela emibi evamile ivame ukuba mnene futhi yesikhashana, ngokuvamile ithuthuka njengoba imiphumela yemithi iphela emahoreni ambalwa alandelayo.

Imiphumela emibi engathi sína ingenzeka kodwa ayivamile uma imithi inikezwa ngendlela efanele esibhedlela. Ithimba lakho lezokwelapha liqeqeshwe ukubona nokwelapha lezi zimpendulo ngokushesha:

• Ukwehla okukhulu kwegazi okubangela ukuquleka noma ukushaqeka
• Ukuvinjelwa kwenhliziyo (lapho amasignali kagesi engakwazi ukuhamba ngendlela ejwayelekile ngenhliziyo yakho)
• Ukwanda kokuhluleka kwenhliziyo ezigulini ezinamaphutha enhliziyo akhona
• Ukuphendula okukhulu komzimba okubangela ubunzima bokuphefumula noma ukuvuvukala
• Ubuhlungu besifuba noma ukuphefumula kanzima

Ngenxa yokuthi uthola lo muthi esibhedlela, abasebenzi bezokwelapha bangakwazi ukuthola ngokushesha futhi belaphe noma yiziphi izimo ezingathi sína ezingase zenzeke.

Ezimweni ezingavamile, ezinye iziguli zingase zibe nomfutho wegazi ophansi noma izinga lokushaya kwenhliziyo elide elidinga eminye imithi noma ukusekelwa. Ngokungavamile kakhulu, iziguli zingase zibe nezinkinga zesibindi noma ukusabela okukhulu komzimba, kodwa lezi zinkinga azivamile kakhulu futhi zilawuleka endaweni yesibhedlela.

Ubani Ongafanele Athole i-Verapamil (Indlela Yokujova)?

Abantu abathile akufanele bathole i-verapamil ejovwayo ngoba ingase yenze izimo zabo zezokwelapha zibe zimbi noma ihlangane ngendlela eyingozi nemithi yabo yamanje. Ithimba lakho lezokwelapha lizobuyekeza umlando wakho wezempilo ngaphambi kokukunika lo muthi.

Akufanele uthole i-IV verapamil uma unesifo senhliziyo esibi, njengoba umuthi ungenza inhliziyo yakho ibe buthakathaka ekwazi ukumpompa igazi ngempumelelo. Abantu abanezinhlobo ezithile zokuvinjwa kwenhliziyo nabo abakwazi ukuthola lo muthi ngokuphepha.

Nawa amakhona amakhulu angakuvimbela ukuthi ungatholi i-verapamil ejovwayo:

• Ukwehluleka kwenhliziyo okukhulu noma ukushaqeka kwe-cardiogenic
• Ukuvinjwa kwenhliziyo kwesibili noma kwezinga lesithathu ngaphandle kwe-pacemaker
• Umfutho wegazi ophansi kakhulu (hypotension)
• Ukungezwani okwaziwayo ne-verapamil noma imithi efanayo
• I-Wolff-Parkinson-White syndrome ene-atrial fibrillation
• Isifo sesibindi esibi

Udokotela wakho uzophinda aqaphele ngokukunika i-IV verapamil uma une-mild heart failure, izinkinga zezinso, noma uthatha eminye imithi ethile engase ihlangane ngendlela eyingozi.

Abantu abathatha ama-beta-blockers (njenge-metoprolol noma i-atenolol) badinga ukucatshangelwa okukhethekile ngoba ukuhlanganisa le mithi ne-IV verapamil kungabangela amazinga enhliziyo noma umfutho wegazi ophansi ngendlela eyingozi. Ngokufanayo, labo abase-digoxin badinga ukuqapha ngokucophelela ngoba i-verapamil ingakhuphula amazinga e-digoxin egazini lakho.

Abesifazane abakhulelwe ngokuvamile akufanele bathole i-IV verapamil ngaphandle uma izinzuzo ezingaba khona ziqeda ubungozi, njengoba umuthi ungangena esiswini futhi uthinte ingane esakhula.

Amagama Omkhiqizo we-Verapamil

I-Verapamil ye-Intravenous itholakala ngaphansi kwamagama amaningi omkhiqizo, nakuba izibhedlela eziningi zisebenzisa izinguqulo ezivamile zomuthi. Igama lomkhiqizo elivamile ongahlangana nalo yi-Isoptin, esetshenziswe amashumi eminyaka emithini ephuthumayo.

Amanye amagama omkhiqizo afaka i-Calan ne-Verelan, nakuba lokhu kuvame ukubonakala ngezindlela zomlomo kunokulungiswa kwe-IV. Izibhedlela eziningi zigcina i-verapamil injection ejwayelekile, equkethe isithako esisebenzayo esifanayo futhi esebenza ngokufanayo nezinguqulo zegama lomkhiqizo.

Umkhiqizo othile noma inguqulo ejwayelekile oyitholayo ngeke ithinte ukusebenza kahle noma ukuphepha komuthi. Ithimba lakho lezempilo lizosebenzisa noma iyiphi ifomu elitholakala endaweni yabo, konke okuhlangabezana namazinga afanayo aqinile ekhwalithi nokuphepha.

Ezinye izindlela ze-Verapamil

Imithi eminingi ehlukile ingelapha izinkinga ezifanayo zesigqi senhliziyo njenge-verapamil ye-intravenous, nakuba ukukhetha okungcono kuncike esimweni sakho esithile nomlando wezokwelapha. Udokotela wakho uzokhetha inketho efanele kakhulu ngokuya ngesimo sakho.

I-Adenosine ivame ukuba yinto yokuqala yokukhetha ezinhlotsheni ezithile zesigqi senhliziyo esheshayo (SVT) ngoba isebenza ngokushesha kakhulu futhi inesikhathi esifushane sokusebenza. Lo muthi ungamisa isigqi senhliziyo esingajwayelekile ngemizuzwana kodwa ungase ubangele ukungakhululeki esifubeni okufushane noma ukuphefumula kanzima.

Ezinye izithiyo zomgudu we-calcium njenge-diltiazem (Cardizem) zisebenza ngendlela efanayo ne-verapamil futhi zingasetshenziswa uma ungenakuthola i-verapamil ngasizathu simbe. Ama-beta-blockers afana ne-metoprolol noma i-esmolol anganciphisa izinga lenhliziyo, nakuba esebenza ngezindlela ezihlukene.

Kwabanye iziguli, i-electrical cardioversion (ukushaqeka kagesi okulawulwayo enhliziyweni) ingase ithandwe ngaphezu kwemithi, ikakhulukazi uma imithi ingasebenzi noma uma isimo sisongela impilo ngokushesha.

I-Digoxin ngezinye izikhathi isetshenziselwa ukulawula izinga lokushaya kwenhliziyo isikhathi eside, ikakhulukazi ezigulini ezinokushaya kwenhliziyo okungajwayelekile, nakuba ngokuvamile ingasetshenziselwa izimo eziphuthumayo njenge-IV verapamil.

Ingabe i-Verapamil Ingcono Kune-Diltiazem?

Kokubili i-verapamil ne-diltiazem ziyizithiyo zesiteshi se-calcium ezisebenza ngendlela efanayo ekulawuleni isigqi senhliziyo, kodwa zinezinye izinto ezizenza zifaneleke kakhulu kunenye kwezinye izimo. Akukho noyedwa othi “ungcono” kunomunye.

I-Verapamil ivame ukuba nemiphumela eqinile esigqini senhliziyo futhi ingasebenza kahle ezinhlotsheni ezithile ze-supraventricular tachycardia. Kodwa-ke, futhi inemiphumela eqinile ekusebenzeni kwemisipha yenhliziyo, okusho ukuthi ingase ingafaneleki kubantu abanenhliziyo ehlulekayo.

I-Diltiazem ivame ukukhethwa ezigulini ezinokuhluleka kwenhliziyo okuncane ngoba inethonya elincane ekukwazini kwenhliziyo ukumpompa ngenkathi isahlinzeka ngokulawula okuhle kwesigqi senhliziyo. Ivame futhi ukukhethwa ezigulini ezidinga kokubili ukulawulwa kwesigqi senhliziyo nokuphathwa kwengcindezi yegazi.

Ukukhetha phakathi kwale mithi kuncike esimweni sakho sezokwelapha, okuhlanganisa ukusebenza kwenhliziyo yakho, ingcindezi yegazi, eminye imithi oyithathayo, kanye nohlobo oluthile lwenkinga yesigqi senhliziyo oyitholayo.

Udokotela wakho uzocabangela zonke lezi zinto lapho enquma ukuthi iyiphi imithi efaneleka kakhulu esimweni sakho. Zombili le mithi isebenza kahle kakhulu uma isetshenziswa ezimweni ezifanele.

Imibuzo Evame Ukubuzwa Nge-Verapamil (Indlela ye-Intravenous)

Q1. Ingabe i-Verapamil (Indlela ye-Intravenous) iphephile Kubantu Abanezifo Zenhliziyo?

I-verapamil engena ngemithambo ingaba ephephile kubantu abanezinhlobo ezithile zesifo senhliziyo, kodwa idinga ukuhlolwa nokuqashwa ngokucophelela yithimba lakho lezokwelapha. Ukuphepha kuncike ohlotsheni oluthile nobukhulu besimo senhliziyo yakho.

Kubantu abanesifo semithambo yenhliziyo (imithambo yenhliziyo evaliwe) kodwa umsebenzi wenhliziyo ojwayelekile, i-IV verapamil ngokuvamile iphephile futhi ingasebenza kahle kakhulu ekwelapheni izinkinga zesigqi. Kodwa-ke, abantu abanenhliziyo ehlulekayo noma imisipha yenhliziyo ebuthakathaka (i-cardiomyopathy) kungenzeka bangabi ngabantu abafanelekayo ngoba umuthi ungaqhubeka nokunciphisa ikhono lenhliziyo lokumpompa.

Udokotela wakho uzobuyekeza izivivinyo zakho zenhliziyo zakamuva, okuhlanganisa ama-echocardiograms noma imiphumela ye-cardiac catheterization, ngaphambi kokunquma ukuthi i-IV verapamil ilungele yini wena. Bazobuye bacabange ngemithi yakho yamanje kanye nesimo sempilo yakho esiphelele.

Q2. Kufanele ngenzeni uma ngithola i-Verapamil eningi ngengozi?

Njengoba i-verapamil engena ngemithambo inikezwa kuphela ochwepheshe bezempilo ezindaweni zezokwelapha, ukweqisa ngengozi akuvamile kakhulu. Kodwa-ke, uma kunikezwa umuthi omningi kakhulu, abasebenzi bezokwelapha baqeqeshwe ukuthi baqaphele futhi belaphe lesi simo ngokushesha.

Izimpawu zokweqisa i-verapamil zihlanganisa ukwehla okukhulu kwengcindezi yegazi, isilinganiso senhliziyo esinensayo, ubunzima bokuphefumula, nokulahlekelwa ukwazi. Uma lezi zimpawu zenzeka, ithimba lakho lezokwelapha lizohlinzeka ngokunakekelwa okusekelayo ngokushesha, okungase kuhlanganise uketshezi lwe-IV, imithi yokukhuphula ingcindezi yegazi, futhi mhlawumbe ukuhamba kwenhliziyo okwesikhashana.

Isibhedlela sinemithi ephikisana nemithi kanye nezinqubo eziphuthumayo ezikhethekile zokweqisa i-calcium channel blocker, okuhlanganisa ukuphathwa kwe-calcium nezinye izinyathelo zokusekela. Ngenxa yokuthi usuvele uqashwe eduze, noma yiziphi izinkinga zingatholwa futhi zelashwe ngokushesha.

Q3. Kufanele ngenzeni uma ngiphuthelwa umthamo we-Verapamil?

Lo mbuzo awusebenzi ku-verapamil engena emithanjeni yegazi njengoba inikezwa njengokwelashwa kwesikhathi esisodwa noma uchungechunge olufushane lwemithamo esesibhedlela. Ngeke ube nesibopho sokuthatha noma ukweqa imithamo yalo muthi.

Uma ushintshelwa ku-verapamil yomlomo ngemva kokuhlala kwakho esibhedlela, udokotela wakho uzokunikeza imiyalelo ethile mayelana namashejuli okulinganisa nokuthi yini okufanele uyenze uma weqa umthamo womuthi womlomo.

Ifomu le-IV linikezwa ngokuphelele ochwepheshe bezokwelapha njengengxenye yokwelashwa kwakho okuphuthumayo, ngakho-ke akukho ukukhathazeka mayelana nokweqa imithamo ngomqondo wendabuko.

Q4. Ngingayeka nini Ukuthatha i-Verapamil?

I-verapamil engena emithanjeni yegazi iyeka ukusebenza yodwa kungakapheli amahora ambalwa ngemva kokunikezwa, ngakho-ke asikho isidingo 'sokuyeka' lo muthi. Imiphumela iyaphela ngokwemvelo njengoba umzimba wakho usebenza futhi uqeda umuthi.

Udokotela wakho uzonquma ukuthi ngabe udinga imithamo eyengeziwe ngokuya ngokuthi isigqi senhliziyo yakho siphendula kanjani ekwelashweni. Uma isigqi senhliziyo yakho sizinzile, cishe bazokushintshela emithini yomlomo noma kwezinye izindlela zokwelapha ukuze kuqhubeke ukuphathwa.

Uma unikezwe i-verapamil yomlomo ngemva kokuhlala kwakho esibhedlela, ungalokothi uyeke ukuyithatha kungazelelwe ngaphandle kokukhuluma nodokotela wakho kuqala, njengoba lokhu kungabangela ukuthi izinkinga zakho zesigqi senhliziyo zibuye.

Q5. Ngingashayela Ngemva Kokuthola I-Verapamil Engena Emithanjeni Yegazi?

Akufanele ushayele okungenani amahora angama-24 ngemva kokuthola i-verapamil engena emithanjeni yegazi, njengoba umuthi ungadala isiyezi, umfutho wegazi ophansi, neminye imiphumela engaphazamisa ikhono lakho lokushayela ngokuphepha.

Njengoba cishe uzobe usesibhedlela lapho uthola i-verapamil ye-IV, ukushayela ngeke kube yinto ekhathazayo ngokushesha. Kodwa-ke, lapho ukhishwa, lungiselela omunye umuntu ukuthi akuqhubele ekhaya futhi gwema ukushayela uze uzizwe ujwayelekile ngokuphelele futhi udokotela wakho akukhiphe ukuze wenze imisebenzi ejwayelekile.

Imiphumela yomuthi emithanjeni yegazi nesivinini senhliziyo ingahlala amahora amaningi, okungenzeka ukuthi kubangele isiyezi esilibazisekile noma ubuthakathaka obungaba yingozi ngenkathi ushayela.