Types/ovarian/patient/ovarian-low-malignant-treatment-pdq
Abubuwan da ke ciki
Vananan Malananan Tumor na Ovarian
Janar Bayani Game da umanƙara mai umarfin Cutar vasa
MAGANAN MAGANA
- Vananan ƙwayar ƙwayar ovary wata cuta ce wacce ƙwayoyin cuta marasa kyau ke samuwa a cikin ƙwayar jikin da ke rufe ƙwan mahaifa.
- Alamomi da alamomin cututtukan ƙwayayen mara mai haɗari sun haɗa da ciwo ko kumburi a cikin ciki.
- Ana amfani da gwaje-gwajen da ke binciken kwayayen don gano (gano), gano asali, da kuma saurin kwai mara kyau mai saurin yuwuwa.
- Wasu dalilai suna tasiri hangen nesa (damar dawowa) da zaɓuɓɓukan magani.
Vananan ƙwayar ƙwayar ovary wata cuta ce wacce ƙwayoyin cuta marasa kyau ke samuwa a cikin ƙwayar jikin da ke rufe ƙwan mahaifa.
Vananan cututtukan ƙwayoyin Ovarian suna da ƙwayoyin cuta wanda ba zai iya zama kansa ba, amma galibi ba haka ba. Wannan cuta galibi tana nan a cikin ƙwarjin ƙwai. Lokacin da aka samu cuta a cikin kwayaye daya, sauran kwayayen ma ya kamata a duba su da kyau don alamun cutar.
Ovaries wasu gabobi ne guda biyu a cikin tsarin haihuwar mace. Suna cikin ƙashin ƙugu, ɗaya a kowane gefen mahaifa (rami, ɓangaren jikin pear inda ɗan tayi ya girma). Kowane kwayayen kwatankwacin girman almond. Ovaries suna yin ƙwai da homonan mata.
Alamomi da alamomin cututtukan ƙwayayen mara mai haɗari sun haɗa da ciwo ko kumburi a cikin ciki.
Varancin ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar tsofaffin ƙwayoyin cuta ba zai iya haifar da alamun farko ba. Idan kuna da alamu ko alamomi, zasu iya haɗa da masu zuwa:
- Jin zafi ko kumburi a ciki.
- Jin zafi a ƙashin ƙugu.
- Matsalolin ciki, kamar gas, kumburin ciki, ko maƙarƙashiya.
Waɗannan alamu da alamomin na iya haifar da wasu yanayi. Idan suka kara tsanantawa ko kuma basu tafi da kansu ba, sai a duba likitanka.
Ana amfani da gwaje-gwajen da ke binciken kwayayen don ganowa (gano), gano asali, da kuma saurin kwai mara kyau mai yuwuwa. Za a iya amfani da waɗannan gwaje-gwajen da hanyoyin:
- Jarabawa ta jiki da tarihi: Jarabawa ce ta jiki don bincika alamomin lafiya gaba ɗaya, gami da bincika alamun cuta, kamar kumburi ko wani abu da kamar baƙon abu. Za a kuma ɗauki tarihin al'adun lafiyar marasa lafiya da cututtukan da suka gabata da magunguna.
- Jarrabawar Pelvic: Nazarin farji, mahaifar mahaifa, mahaifa, tublop fallopian, ovaries, da dubura. Ana saka takamaiman tsari a cikin farjin kuma likita ko nas sun kalli farji da bakin mahaifa don alamun cuta. Yawancin lokaci ana yin gwajin Pap ne na mahaifar mahaifa. Likita ko nas din ma suna sanya yatsun hannu guda daya zuwa biyu masu hannu, cikin safofin hannu a cikin farjin ta kuma sanya dayan hannun a kan ƙananan ciki don jin girman, sura, da matsayin mahaifa da ƙwai. Likita ko nas ma suna saka mai yatsa, mai yatsan hannu a cikin duburar don jin kumburi ko wuraren da ba na al'ada ba.
- Gwajin duban dan tayi: Hanya ce wacce ake fitar da igiyar sauti mai karfi (duban dan tayi) daga kyallen ciki ko gabobin ciki kuma suna yin kuwwa. Eararrawa ta haifar da hoton kayan jikin da ake kira sonogram. Ana iya buga hoton don a kalleshi daga baya.
Sauran marasa lafiya na iya samun duban dan tayi.
- CT scan (CAT scan): Hanya ce da ke yin jerin hotuna dalla-dalla na wurare a cikin jiki, waɗanda aka ɗauka daga kusurwa daban-daban. Ana yin hotunan ne ta wata kwamfuta da aka haɗa ta da na'urar da ke ɗauke da x-ray. Ana iya yin allurar fenti a cikin jijiya ko haɗiye don taimakawa gabobin ko kyallen takarda su fito fili karara. Wannan hanya ana kiranta yanayin ƙididdigar lissafi, ƙirar kwamfuta, ko ƙirar ƙwaƙwalwar ajiyar kwamfuta.
- CA 125 gwaji: Gwajin da ke auna matakin CA 125 a cikin jini. CA 125 wani abu ne da ƙwayoyin halitta suka saki zuwa cikin jini. CAara matakin CA 125 wani lokaci alama ce ta kansar ko wani yanayin.
- Kirjin x-ray: X-ray na gabobin da kasusuwa a cikin kirji. X-ray wani irin katako ne na katako wanda zai iya ratsa jiki zuwa fim, yana yin hoton wurare a cikin jiki.
- Biopsy: Cirewar ƙwayoyin halitta ko kyallen takarda don a iya kallon su ta hanyar microscope ta hanyar masanin ilimin ɗan adam don bincika alamun kansar. Naman yawanci ana cire shi yayin aikin tiyata don cire kumburin.
Wasu dalilai suna tasiri hangen nesa (damar dawowa) da zaɓuɓɓukan magani.
Halin hangen nesa (damar dawowa) da zaɓuɓɓukan magani sun dogara da masu zuwa:
- Matakin cutar (ko ya shafi wani ɓangaren ƙwai, ko ya shafi ƙwayayen gaba ɗaya, ko kuma ya bazu zuwa wasu wurare a cikin jiki).
- Wane irin ƙwayoyin halitta ke yin ƙari.
- Girman kumburin.
- Babban lafiyar mai haƙuri.
Marasa lafiya da ke fama da ƙananan ƙwayoyin cuta masu cutar ƙwayoyin cuta suna da kyakkyawan hangen nesa, musamman ma lokacin da aka gano kumburin da wuri.
Matakai na vananan umananan Tumor
MAGANAN MAGANA
- Bayan an binciko ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar cuta, ana yin gwaje-gwaje don gano idan ƙwayoyin ƙwayoyin cuta suka yada cikin ƙwan ko kuma zuwa wasu sassan jiki.
- Ana amfani da matakai masu zuwa don ƙananan ƙwayar cuta mai haɗari:
- Mataki Na
- Mataki na II
- Mataki na III
- Mataki na IV
Bayan an binciko ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar cuta, ana yin gwaje-gwaje don gano idan ƙwayoyin ƙwayoyin cuta suka yada cikin ƙwan ko kuma zuwa wasu sassan jiki.
Hanyar da ake amfani da ita don gano ko ƙwayoyin halitta marasa kyau sun yaɗu a cikin ƙwai ko kuma zuwa wasu sassan jiki ana kiranta staging Bayanin da aka tattara daga tsarin daukar matakan tantance matakin cutar. Yana da mahimmanci a san matakin don shirya magani. Ana amfani da wasu gwaje-gwaje ko hanyoyin aiwatarwa. Ana iya amfani da laparotomy (aikin tiyata da aka yi a bangon ciki don cire kayan ƙwan ciki) Yawancin marasa lafiya ana bincikar su da cutar mataki na farko.
Ana amfani da matakai masu zuwa don ƙananan ƙwayar cuta mai haɗari:
Mataki Na
A mataki na I, ana samun ƙwayar a cikin ɗayan ko duka biyu. Stage I ya kasu kashi-kashi IA, stage IB, and stage IC.
- Mataki na IA: Ana samun ƙari a cikin ƙwaya ɗaya.
- Mataki na IB: Ana samun ciwon ciki a cikin duka ƙwai.
- Mataki na IC: Ana samun ƙari a cikin ɗayan biyu ko duka biyu kuma ɗayan masu zuwa gaskiya ne:
- ana samun kwayoyin tumo a saman farfajiyar kwaya daya ko duka; ko
- kwantena (murfin waje) na kwai ya fashe (karaya bude); ko
- Kwayoyin tumo ana samun su a cikin ruwa na kogon jikin mutum (ramin jiki wanda ya kunshi mafi yawan gabobin cikin ciki) ko kuma a cikin wankan mamacin (kayan da ke rufin bututun.
rami).
Mataki na II
A mataki na II, ana samun kumburin a ɗayan biyu ko duka biyu kuma ya bazu zuwa wasu yankuna na ƙashin ƙugu. Mataki na II ya kasu kashi biyu zuwa mataki na IIA, mataki na IIB, da kuma matakin IIC.
- Mataki na IIA: Ciwan ya yadu zuwa mahaifa da / ko tublopian (doguwar siraran siraran da ƙwai ke bi daga ovaries zuwa mahaifa).
- Mataki IIB: Ciwan ya yadu zuwa sauran kayan cikin ƙashin ƙugu.
- Mataki IIC: Ana samun kumburin a cikin ɗakunan biyu ko kuma duka biyu kuma ya bazu zuwa mahaifa da / ko fallopian tubes, ko kuma zuwa sauran kayan cikin ƙashin ƙugu. Hakanan, ɗayan masu zuwa gaskiya ne:
- ana samun kwayoyin tumo a saman farfajiyar kwaya daya ko duka; ko
- kwantena (murfin waje) na kwai ya fashe (karaya bude); ko
- ana samun kwayoyin tumo a cikin ruwa na ramin kogin (rami na jiki wanda ya ƙunshi mafi yawan gabobin cikin ciki) ko kuma a cikin wankan ɓoyayyun ɓangaren jikin (ƙyallen da ke rufe kogon gefen ƙofa).
Mataki na III

A mataki na III, ana samun kumburin a ɗayan biyu ko duka biyu kuma ya bazu a ƙashin ƙashin ƙugu zuwa wasu sassan ciki da / ko ƙwayoyin lymph da ke kusa. Mataki na III ya kasu kashi biyu zuwa mataki na IIIA, mataki na IIIB, da kuma mataki na IIIC.
- Mataki na IIIA: Ana samun ƙari a ƙashin ƙugu kawai, amma ƙwayoyin tumo waɗanda kawai ake iya ganinsu ta microscope sun bazu zuwa saman peritoneum (nama da ke layin bangon ciki kuma ya rufe yawancin gabobin cikin ciki), da ƙananan hanji, ko kuma nama wanda ya haɗa ƙananan hanjin zuwa bangon ciki.
- Mataki na IIIB: Ciwon ya yadu zuwa cikin ramin kuma ƙwanjin da ke cikin ramin ya wuce santimita 2 ko ƙarami.
- Mataki na IIIC: Ciwon ya yadu zuwa cikin ramin kuma kumburin da ke cikin ramin ya fi santimita 2 girma da / ko kuma ya bazu zuwa ƙwayoyin lymph a cikin ciki.
Hakanan yaduwar ƙwayoyin tumo zuwa saman hanta shima ana ɗaukarsa matsayin mataki na III.
Mataki na IV
A mataki na huɗu, ƙwayoyin ƙari sun bazu zuwa cikin ciki zuwa wasu sassan jiki, kamar huhu ko nama a cikin hanta.
Kwayoyin tumor a cikin ruwan dake zagaye da huhun kuma ana ɗaukar cutar ta mataki na huɗu.
Vananan ƙwayar ƙwayar ƙwayar ovarian kusan ba ta kai ga mataki na huɗu ba.
Maimaita Oananan vananan umananan Owayoyi
Vananan cututtukan ƙwayoyin Ovarian na iya sake dawowa (dawowa) bayan an kula da su. Ciwan ciwan na iya dawowa a wani bangaren kwayayen ko a wasu sassan jiki.
Bayanin Zaɓin Jiyya
MAGANAN MAGANA
- Akwai nau'ikan magani daban-daban ga marasa lafiya da ke fama da ƙananan ƙwayar cuta.
- Ana amfani da nau'ikan magani iri biyu:
- Tiyata
- Chemotherapy
- Ana gwada sababbin nau'ikan magani a gwajin asibiti.
- Jiyya don ƙananan ƙwayoyin cuta na ƙwayar cuta na iya haifar da sakamako masu illa.
- Marasa lafiya na iya son yin tunani game da shiga cikin gwaji na asibiti.
- Marasa lafiya na iya shiga gwajin asibiti kafin, yayin, ko bayan fara jiyyarsu.
- Ana iya buƙatar gwaje-gwaje na gaba.
Akwai nau'ikan magani daban-daban ga marasa lafiya da ke fama da ƙananan ƙwayar cuta.
Akwai nau'ikan magani daban-daban ga marasa lafiya da ke fama da ƙananan ƙwayar cuta. Wasu jiyya suna daidaito (magani da ake amfani dashi yanzu), kuma wasu ana gwada su a gwajin asibiti. Gwajin gwajin magani shine binciken bincike wanda ake nufi don taimakawa inganta ingantattun jiyya na yanzu ko samun bayanai game da sababbin jiyya ga marasa lafiya da ciwon daji, ciwace-ciwacen daji, da yanayin da suka dace. Lokacin da gwaji na asibiti ya nuna cewa sabon magani ya fi magani na yau da kullun, sabon magani na iya zama daidaitaccen magani. Marasa lafiya na iya son yin tunani game da shiga cikin gwaji na asibiti. Wasu gwaji na asibiti ana buɗe su ne kawai ga marasa lafiyar da basu fara magani ba.
Ana amfani da nau'ikan magani iri biyu:
Tiyata
Nau'in aikin tiyatar (cire kumburin a yayin wani aiki) ya dogara da girma da yaduwar kumburin da kuma shirin mace na samun yara. Yin tiyata na iya haɗawa da masu zuwa:
- Yin aikin salpingo-oophorectomy na musamman: Yin tiyata don cire ƙwarjin ƙwai ɗaya da mahaifa ɗaya.
- Hanyar salpingo-oophorectomy: Yin tiyata don cire duka ƙwarjiyoyin biyu da na bututun mahaifa.
- Jimlar hysterectomy da salpingo-oophorectomy na biyu: Yin tiyata don cire mahaifa, wuyan mahaifa, da kuma duka kwayayen da ke cikin mahaifa. Idan an fitar da mahaifa da mahaifar mahaifa ta cikin farji, ana kiran aikin tiyatar farji. Idan an fitar da mahaifa da mahaifar mahaifa ta hanyar babban yanki (yankewa) a cikin ciki, ana kiran aikin da aikin duka hysterectomy na ciki. Idan an fitar da mahaifa da mahaifar mahaifa ta wani karamin yanki (yankewa) a cikin ciki ta amfani da laparoscope, ana kiran aikin da ake kira duka laparoscopic hysterectomy.

- Oophorectomy na Musamman: Tiyata don cire ɓangaren ƙwai ɗaya ko ɓangare na ƙwai biyu.
- Omentectomy: Tiyata don cire omentum (wani ɓangaren nama da ke rufe bangon ciki).
Bayan likita ya cire duk wata cuta da za a iya gani a lokacin tiyatar, ana iya ba majiyyacin magani bayan an yi masa tiyata don kashe duk ƙwayoyin tumor da suka rage. Maganin da aka bayar bayan tiyata, don rage haɗarin cewa ƙari zai dawo, ana kiran sa adjuvant therapy.
Chemotherapy
Chemotherapy magani ne na cutar kansa wanda ke amfani da magunguna don dakatar da haɓakar ƙwayoyin kansa, ko dai ta hanyar kashe ƙwayoyin ko ta hana su rarraba. Lokacin da ake shan chemotherapy ta baki ko allura a cikin jijiya ko tsoka, magungunan suna shiga cikin jini kuma zasu iya kaiwa ga kwayoyin cutar kansa a cikin jiki duka (systemotherapy chemotherapy). Lokacin da aka sanya chemotherapy kai tsaye zuwa cikin ruwa mai ruɓaɓɓen ciki, gaɓoɓi, ko rami na jiki kamar ciki, magungunan yawanci suna shafar ƙwayoyin kansa ne a waɗancan yankuna. Hanyar da ake ba da cutar sankara ta dogara da nau'in da matakin cutar kansa.
Ana gwada sababbin nau'ikan magani a gwajin asibiti.
Ana samun bayani game da gwaji na asibiti daga gidan yanar gizon NCI.
Jiyya don ƙananan ƙwayoyin cuta na ƙwayar cuta na iya haifar da sakamako masu illa.
Don bayani game da illolin da cutar ta kansar ta haifar, duba shafin mu na Side Side.
Marasa lafiya na iya son yin tunani game da shiga cikin gwaji na asibiti.
Ga wasu marasa lafiya, shiga cikin gwaji na asibiti na iya zama mafi kyawun zaɓin magani. Gwajin gwaji wani bangare ne na aikin binciken likita. Ana yin gwaje-gwajen asibiti don gano idan sababbin jiyya suna da lafiya da tasiri ko sun fi magani mai kyau.
Yawancin hanyoyin yau da kullun don cutar sun dogara ne akan gwajin asibiti na farko. Marasa lafiya da ke cikin gwaji na asibiti na iya karɓar daidaitaccen magani ko kuma su kasance cikin farkon waɗanda za su karɓi sabon magani.
Marasa lafiya da ke shiga cikin gwaji na asibiti suma suna taimakawa inganta yadda za a magance cututtuka a nan gaba. Koda lokacin gwajin asibiti bai haifar da sababbin magunguna ba, sau da yawa sukan amsa mahimman tambayoyi kuma suna taimakawa ci gaba da bincike gaba.
Marasa lafiya na iya shiga gwajin asibiti kafin, yayin, ko bayan fara jiyyarsu.
Wasu gwaji na asibiti kawai sun haɗa da marasa lafiya waɗanda ba su sami magani ba tukuna. Sauran gwaje-gwajen suna gwada jiyya ga marasa lafiya waɗanda cutar ba ta samu sauki ba. Akwai kuma gwaji na asibiti da ke gwada sabbin hanyoyin dakatar da wata cuta daga sake dawowa (dawowa) ko rage illar magani.
Gwajin gwaji na gudana a sassa da yawa na ƙasar. Bayani game da gwajin asibiti wanda NCI ke tallafawa ana iya samun shi akan shafin binciken gwaji na NCI. Ana iya samun gwajin gwaji na asibiti wanda wasu kungiyoyi ke tallafawa akan gidan yanar gizon ClinicalTrials.gov.
Ana iya buƙatar gwaje-gwaje na gaba.
Za a iya maimaita wasu gwaje-gwajen da aka yi don gano cutar. Za a maimaita wasu gwaje-gwaje don ganin yadda magani ke aiki. Shawarwari game da ci gaba, canji, ko dakatar da magani na iya dogara ne da sakamakon waɗannan gwaje-gwajen. Wannan wani lokaci ana kiransa sake staging.
Wasu daga cikin gwaje-gwajen za a ci gaba da yi daga lokaci zuwa lokaci bayan an gama jiyya. Sakamakon wadannan gwaje-gwaje na iya nuna idan yanayin ka ya canza ko kuma idan cutar ta sake dawowa (dawo). Wadannan gwaje-gwajen wasu lokuta ana kiran su gwaje-gwaje na gaba ko dubawa.
Zaɓuɓɓukan Jiyya don Ciwan umananan umananan Tumurai
A Wannan Sashin
- Matakin Farkon Ovarian mara Potarancin Tumurai (Mataki I da II)
- Mataki na Oarshen Ovarian Lowananan umananan Tumor (Mataki na III da na IV)
- Maimaita Oananan vananan umananan Owayoyi
Don bayani game da jiyya da aka jera a ƙasa, duba sashin Kula da Zaɓin Jiyya.
Matakin Farkon Ovarian mara Potarancin Tumurai (Mataki I da II)
Yin aikin tiyata shine daidaitaccen magani don farkon ƙwayar mace mai ƙananan ƙwayar cuta. Nau'in tiyatar galibi ya dogara ne da mace na shirin haihuwa.
Ga matan da suke shirin haihuwar yara, aikin tiyata shine:
- salpingo-oophorectomy na gefe daya; ko
- sassaucin rashi.
Don hana sake kamuwa da cuta, yawancin likitoci sun ba da shawarar tiyata don cire ragowar ƙwayoyin halittar kwan mace lokacin da mace ba ta da shirin haihuwa.
Ga matan da ba su da shirin haihuwar yara, magani na iya zama tiyatar mahaifa da kuma salpingo-oophorectomy.
Yi amfani da binciken bincikenmu na asibiti don nemo NCI na goyan bayan gwajin asibiti wanda ke karɓar marasa lafiya. Kuna iya bincika gwaji dangane da nau'in ciwon daji, shekarun mai haƙuri, da kuma inda ake yin gwajin. Ana samun cikakken bayani game da gwaji na asibiti.
Mataki na Oarshen Ovarian Lowananan umananan Tumor (Mataki na III da na IV)
Jiyya don ƙarancin ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar cuta, haɓaka salpingo-oophorectomy, da omentectomy. Hakanan za'a iya yin rarrabawar lymph.
Yi amfani da binciken bincikenmu na asibiti don nemo NCI na goyan bayan gwajin asibiti wanda ke karɓar marasa lafiya. Kuna iya bincika gwaji dangane da nau'in ciwon daji, shekarun mai haƙuri, da kuma inda ake yin gwajin. Ana samun cikakken bayani game da gwaji na asibiti.
Maimaita Oananan vananan umananan Owayoyi
Jiyya don ƙananan ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar cuta na iya haɗawa da masu zuwa:
- Tiyata.
- Yin aikin tiyata ya biyo baya ta chemotherapy.
Yi amfani da binciken bincikenmu na asibiti don nemo NCI na goyan bayan gwajin asibiti wanda ke karɓar marasa lafiya. Kuna iya bincika gwaji dangane da nau'in ciwon daji, shekarun mai haƙuri, da kuma inda ake yin gwajin. Ana samun cikakken bayani game da gwaji na asibiti.
Don Moreara Koyo Game da umananan umananan Ciwan uman Tuwa
Don cikakkun bayanai game da cutar kansa da sauran albarkatu daga Cibiyar Cancer ta Kasa, duba mai zuwa:
- Game da Ciwon daji
- Tsayawa
- Chemotherapy da ku: Tallafi ga Mutanen da ke Ciwon daji
- Radiation Far da Kai: Taimako ga Mutane Tare da Ciwon daji
- Yin fama da Ciwon daji
- Tambayoyi don Tambayar Doctor game da Ciwon daji
- Don Tsira da Kulawa