Casharka 55aad

 Habdhiska dheefshiidka (digestive system).

Casharka 55aad

Fashillanka dagdag ee beerka(Acute liver failure).

Waa isbeddel degdeg ah oo ku dhaca shaqada beerka, kaasoo ka dhasha hoos u dhaca waxyaabaha ka qeyb qaata xinjirowga dhiigga, iyo in aamoniya (ammonia) ay ku badato jirka. Xaaladdan waxa ay ku dhacdaa qof aan hore u lahayn xanuunnada beerka, waxaana ay dhacdaa maalmo ama isbuucyo gudahood. Waxay keeni kartaa xaalad qatarta ah oo daran. Waxa jira waxyaabo keena shaqo gabka degdegga ah ee beerka.

Dhaawaca toos ee beerka(Direct Hepatocyte Injury): Shaqo gabka beerka wuxuu ka imaan karaa dhaawac toos ah oo soo gaadha unugyada beerka, taasoo ay sababi karaan dawada acetaminophen (paracetamol) marka xaddi badan la qaato. Tani si toos ah ayay u dhaawacdaa unugyada beerka, waxaana sababi karta in unugyadaasi ay dhintaan. Sunta dawadan waxaa lagaga saaraa beerka, xaddiga badan ee laga qaato ayaana keeni kara inuu beerka ku sumoobo, taasoo dhaawac weyn gaarsiineysa unugyada beerka. Acetaminophen waa sababta ugu badan ee keenta shaqo gabka beerka.

Carqalad ku timaada shaqada guriga tamarta(Disrupted Mitochondrial Function): Mitokondriyaha waa xarunta tamarta ee unugyada beerka ka helaan tamarta. Waxay kaalin muhiim ah ka ciyaaraan in beerka uu shaqeeyo si wanaagsan. Haddii mitokondriyaha uu dhaawac soo gaadho, waxa hoos u dhacaya tamartii unugyada beerka, taasina waxay carqaladeyneysaa shaqooyinka muhiimka ah ee beerka, sida sifeynta, gaadiideynta, iyo soo saaridda borotiinnada. Tamarta oo hoos u dhacda waxay keentaa dhimashada unugyada beerka.

Hannaan difaaca(Immunological): Xanuunnada hafeefka beerka sida Hepatitis A, B, C, ama E ayaa sababi kara shaqo gabka beerka. Habka difaaca jirka ayaa weerar ku qaada fayrusyada, taasoo keenta saameyn ku timaadda unugyada beerka, ugu dambeynna sababta in unugyada beerka ay dhintaan.

Shaqa gabka xiddidada yaryar(Microvascular Dysfunction): Shaqo gabka degdegga ah ee beerka waxa keeni kara dhiig yarida gaarta beerka. Qulqulka dhiigga ayaa hoos u dhacaya, taasoo keentay in nafaqadii iyo ogsijiintii loo baahnaa aanay gaadhin unugyada beerka, si degdeg ah ayayna u dhintaan unugyadaasi.

Qoraal daweed(Prescription Medications): Dawooyin badan sida kuwa aan istooroydka ahayn (anti-inflammatory) iyo kuwa qalalka ka hortaga ayaa sababi kara shaqo gabka beerka.

Shaqo gabka dagdag beerk(Acute Liver Failure): Shaqo gabka degdegga ah ee beerka waxa kale oo sababi kara hoos u dhaca dhiigga jirka, taasoo keentay in cadaadiska dhiigga uu hoos u dhaco. Unugyada beerka waxay u baahan yihiin ogsijiin iyo nafaqo si ay shaqadooda u gutaan. Haddii mugga dhiigga uu yaraado (hypovolemia), unugyada beerka ma helayaan quudinta ku filan, taasina waxay keentaa in shaqada beerka hoos u dhacdo.

Kansarka Beerka (Hepatocellular Carcinoma): Kansarka beerka wuxuu sababi karaa shaqo gab degdeg ah. Marka kansarka uu faafo, waxa uu sababi karaa in qulqulka dhiigga uu xirmo, cadaadiskuna uu kordho, taasoo keeneysa in beerka uusan sifeyn iyo soo saarid borotiin sameyn karin, sidaasina beerku uu shaqo gab ku yimaado.

Calaamadaha

1. Jaundice: Maqaarka iyo indhaha oo jaallo noqda.

2. Hepatic Encephalopathy: Maskaxda oo aamoniya gaadho taasoo keenta wareer, isku dhex yaac, ama kooma.

3. Coagulopathy: Dhiig bax oo ku yimaada qofka sababtoo ah xinjirowga dhiigga oo aan si fiican u shaqeyn.

4. Nausea and Vomiting: Lallabo iyo matag.

5. Right Upper Quadrant Pain: Xanuun ka jira qeybta midig ee sare ee caloosha, taasoo keenta beerka oo weynaanaya.

6. Ascites: Hoore ku urura caloosha, inkastoo ay adag tahay in si wanaagsan loo arko.

Baaritaanka

1. Liver Function Tests (LFTs): Waxaa la hubinayaa heerka shaqada beerka iyadoo la eegayo ALT, AST, iyo heerka cagaarisada (bilirubin), borotiinka albuminka, si loo caddeeyo in shaqada beerka ay cillad ku jirto.

2. Coagulation Studies: Heerka xinjirowga dhiigga (prothrombin time, INR) ayaa la cabirayaa si loo ogaado cilladaha xinjirowga dhiigga.

3. Ammonia Levels: Waxa la cabirayaa heerka aamoniya si loo ogaado haddii uu beerka keeno sumowga maskaxda (hepatic encephalopathy).

4. Imaging: Raajooyinka sida CT-scan ama ultrasound ayaa loo adeegsan karaa in lagu ogaado xaaladda xididdada dhiigga ee beerka.

5. Viral Serologies: Baadhitaannada fayrusyada hafeefka beerka (Hepatitis) ayaa la sameeyaa.

6. Acetaminophen Levels: Heerka dawada acetaminophen ayaa la cabirayaa haddii looga shakiyo iney sababi karto shaqo gabka beerka.

Daaweynta

1. Supportive Care: Bukaanka waxaa si degdeg ah loogu sameynayaa taageero guud si xaaladda aysan uga sii darin.

Intravenous Fluids iyo Glucose: Hoore iyo sokor ayaa la siinayaa si loo ilaaliyo  sokorta iyo quudinta xubnaha jirka.

Correction of Coagulopathy: Haddii dhiig bax jiro, qofka waxaa la siinayaa dhiigga xinjirowga (fresh frozen plasma) iyo faytamiin K.

2. Specific Therapies:

Acetylcysteine: Haddii bukaanka uu qaatay xaddi badan oo acetaminophen ah, dawadan ayaa loo isticmaalaa si loo badbaadiyo beerka, looga dhaqo sumowga daawada.

Antiviral Therapy: Fayrusyada hafeefka beerka waxaa lagula dagaallami karaa dawooyinka lidiga fayruska.

3:Liver Transplant: Xaaladaha daran, beddelidda beerka ayaa ah daaweynta ugu dambeysa haddii uu beerka dhaawac soo gaaray oo aan lahayn xaalad ka soo noqosho.

4: Reduction of Ammonia Levels: Heerka aamoniya dhiigga ayaa la yareynayaa iyadoo la siinayo lactulose si looga hortago sumowga maskaxda.

References:

Books:

Harrison's Principles of Internal Medicine (21st Edition)

Liver Disease: Diagnosis and Management by Schiff

Current Medical Diagnosis and Treatment (Lange)

Websites:

Mayo Clinic: Acute Liver Failure

Amboss

Medscape

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