COVID-19 LEH BENGRI HRIATNA

Tunlai khawvela manganna, thlabarna, thihna, inrem lohna, harsatna, retheihna, ralṭitna leh innghirhona hial thlentu ‘Covid-19’ tia vuah hi hre lo kan awm lo hial awm e. News channel tinreng leh Chanchinbu tinrengte pawn chanchin hmathehah an dah ni tin a, buaipui lo réng an awm lo. Khawvel rampum chuan an mithiamte hmangin he natna hi an enkawl a, a damdawi leh vaccine siam tumin beihpui an chhuah reng bawk a ni. Kan pu Rosangliana (Zorock) ngei pawhin “He natna khirhkhan hian Zoram mit tidelin, WHO hialte pawhin an arkhawthim dai e,” a ti hial a nih kha. Heng buaina tam tak karah hian medical lam leh research lama tui mite chuan an theih leh thiamna chhuahin he Covid-19 natna hi zirchian an tum reng a, an thil hmuhchhuahte chu mipui vantlangte tan hamṭhatna leh enkawlna a nih theih beiseiin media leh thuziak hmangte'n an tarlang zel bawk a. Chung thil zirchianna neih tam tak zingah chuan Covid-19 hian kan bengri hriatna hial pawh a tichak lo thei dawn a ni tih hmuhchhuah leh rin a ni ve ta tlat mai a ni.

Mithiamte'n zirzauna an neih, April ni 2, 2020, American Journal of Otolaryngology-a an tarlanah chuan, Covid-19 vei mi 82 zingah, Thailand mi nu upa lam chuan bengṭha lo a nei tia sawi a ni a. Hei hi Covid-19 avanga bengngawng ta tarlan hmasa ber a ni thei hial awm e. He pitar hi, Covid-19 laka a dam hnuah pawh, a ri hriatna chu a chak lo zual zel nia sawi a ni. He thu hi, Turkey lama thil chik mite chuan he beng chak lohna hi thluak lam kaihhnawih a nih an ring ve thung. Covid-19 avanga bengri hriatna hloh ta sawi an la hriat loh thu an sawi tel bawk a ni. June thla maia Iran lama zirna mithiamte'n an neih ve thungah chuan, mi paruk kum 22-40 inkar, beng ṭhat lohna nei ngai lo; Covid-19 natna kaite enthlak a ni a. Heng mite hian Covid-19 an kai hnuah chuan beng chak lo leh ṭhat lohna neiin, an zinga mi 4 te chuan bengchheri (beng kiu, beng ri hum hum) neiin, mi dang pahnih chuan beng kaihhnawih si luhai an sawi bawk a ni. Tin, an vai chuan an beng rihriatna tlem aṭanga a laihawl (mild to moderate) thlenga chak lohna nei an ni tih finfiah a ni bawk. Iran lama beng doctor te chuan beng ṭhat lohna nei miah lo, covid-19 an kai hnua beng chak lo taa insawi leh inhriattir an awm nual mai a ni an ti. Chu mai ni lovin, July 24, 2020 a, JAMA Otoloryngology -Head & Neck surgery-a tarlanah chuan, Covid-19 avanga mitthi ruang pathum zet mai chu zirchian a ni a.  He thil zirnaah hian ruang pahnihte beng laihawl (middle ear) leh a chhehvel bekruh chhunglam beng lai leh chhungril tuamtu (mastoid) velah chuan SARS-CoV-2 natna hrik chambang (genetic material an tih) an hmuh thu an tarlang leh tlat mai a ni. He thil zirchiangtute, Johns Hopkins School of Medicine-a mite chuan Covid-19 virus hrik hian beng laihawl leh a chhehvelah hian natna a thlen thei ngei ang tih an sawi a ni.

Mihring beng hi hmun thumah a ṭhen theih a, chungte chu Mizo ṭawng chuan beng pawnlang (outer ear), beng laihawl (middle ear) leh beng chhungril (inner ear) kan ti thei ang chu. Covid-19 hi natna inkai awlsam tak mai, natna hrik RNA virus avanga lo awm niin mithiamte chuan an sawi a. RNA virus (natna hrik) an tih hian bengri hriatna a tichak lo thei a ni tih chu tun hma lamah an lo hmuhchhuak tawh a. A bik takin, he virus hian beng chhungrila hriatna thazam (nerve) a tih khaw loh ṭhin avangin, he virus avanga beng a lo chak lo emaw a lo chhia a nih chuan, a dam thei tawh lo a ni. RNA virus hi chi tam tak mai niin, a tlangpuiin CoV (Coronovirus) ang deuh hian thawkna dawt, ka leh hrawk bawrah natna a thlen tlangpui a, chungte chuan bengah chak lohna an thlen chhawng leh ṭhin a ni. He natna hrik hian a tam zawkah chuan beng chhungril thazam (hair cells) te chua tichimit emawin a tichak lo a, mi tam tak bengngawng an lo awm phah ṭhin a ni. A chang chuan beng pawnlamah bengtui, bengkherh emaw bengnatna dang thlen ve ṭhin mah se, heng natna hi chu damdawi nena enkawl theih mai a nih avangin, bengri hriatna pawh a pangngai deuhthawin a ṭha leh thei ṭhin. RNA virus avanga beng chhungrila hriatna thazam leh thil ri thluakin a lo hritthiam theih nan a lo thlifim ṭhintu timur (hair cells) a lo chhiat tawh chuan siamṭhat theih a ni tawh lova, mi tam tak bengngawn phah an lo awm ṭhin a ni. Tin, beng a lo ngawn nasat deuh phei chuan bengdar vuah hial a lo ṭul ta ṭhin.

 

RNA virus hi eng nge? Virus (natna hrik) chi leh kuang, an ziaranga RNA (Ribonucleic acid) neiho hrim hrim hi RNA virus an tih chu a ni mai a. RNA virus hi chi hnih a awm thei a, a ziarang lairil a mala invial, line khat anga kal (single stranded / ss RNA)) leh a thuah hniha invial, line hnih ang a kal te (double stranded / ds RNA) a awm ṭhin. Medical lam chuan virus te hi an ziarang azirin pawl hrang hrang paruk (Class I - VI), DNA virus pawl leh RNA virus pawl angte'n an ṭhen a.  DNA virus hi Class I leh Class II ah ṭhen a ni a. A bak zawng chu RNA virus niin, Class III, Class IV, Class V leh Class VI ah te ṭhen hran a ni. A chipchiara sawi sen chu a ni lova, amaherawhchu mihringteah hian DNA leh RNA virus hian natna hrang hrang an thlen ve a ni. DNA virus zinga bengri hriatna tichak lo thei langsar zual ṭhenkhat chu Cytomegalovirus (tangseh), Herpes simplex virus (vun, ka, hmui, mit leh serh bawr a natna, thluak a khawsik lut, encephalitis, etc), Herpes zoster (tangseh ang deuh tho), leh Hepatitis B te an ni. RNA virus zinga bengri hriatna tichhe thei leh ti chak lo thei ṭhenkhatte chu, Maternal Rubella (Sentut ang deuh), Mumps orthorubulavirus (MuV - Biangboh), Orthomyxoviruses (hritlang, Khuhhip), Hepatitis C Virus (HCV), SARS (Severe acute respiratory syndrome), measles (sentut), leh Human Immunodeficiency Virus (HIV) te an ni thei ang.

RNA virus hian mi tam tak bengngawngin leh beng chak loin a lo siam tawh ṭhin a. He virus avang hian, a ṭhen piantirh aṭanga bengngawng, a ṭhen upat hnua bengngawng, beng pakhat chauh emaw, beng pahnih a ngawngte pawh a thlen ṭhin. Heng virus avanga bengngawng hi a nasain a nasa lo ve thei thung a. Tlema bengchhet aṭanga nasa taka bengchhette pawh a awm thei. A bikin Virus avanga piantirh aṭanga bengngawngte hi a tlangpuiin a nasa duh hle ṭhin. Tin, beng lehlam chauh ngawng pawh a awm thei bawk. Virus in taksaah natna a thlen hian, kan taksa a natna dotu tichak lovin, natna dang tam tak kaihhnawih a thlen thei bawk a. HIV kan tih angte pawh hian, natna dang kaihhnawih bengkherh, bengtui, leh a dangte thlenin beng ri hriatna a tichak lo thei bawk. Virus natna Sentut kan tihte pawh hian beng chhungril a timur (hair cells) tichhiain bengngawng a siam thei bawk.RNA virus (DNA virus tepawh) avanga beng chak lo emaw bengngawngte hia lanchhuah ṭhin mai loh avang leh na ngawih ngawih awm lote a nih avang hian hmuhchhuah leh enkawl tlai a ni fo ṭhin a. Heng natna neite pawh hian ENT emaw, Audiolgogistte hi a tlai lampangah an pan tlangpui ṭhin a. Hei hian enkawl a tiṭhuanawp thei nia sawi a ni.

Novel Corona Virus-in bengri hriatna peng hrang hrangah eng angin nge hna a thawh tih zir mek a ni a. Mustafa, Associate professor thiam tak mai, Egypt ram mi chuan mi 20 Covid-19 PCR- positive case chu an beng ṭhat leh ṭhat loh a finfiah vek a. Tin, mi 20 tho kum 20 – 50a upa hrisel leh natna nei lo nen a tehkhin bawk a. Covid-19 hian bengah hna a thawh dan finfiah nan hian, khawl hmangin beng rihriatna chak leh chak lo zawng enna (Pure tone audiometry) leh bengchhungril (inner ear) a timur (hair cells) ṭhat leh ṭhat loh enna (Oto acoustic emission) hmanga enfiah a ni a. He finfiahna pahnihah hian covid-19 veiho hian ri sin (high frequency sound) hriatna an hloh a ni tih hmuhchhuah a ni. Hemi avang hian Covid-19 hian bengchhungrila timur rihriatna atana pawimawhte chu a tichhe thei hulhual a ni tih rinna a siam a. Amaherawhchu zirzauna neih a la pawimawhzia pawh tarlan a ni.

Engti ang kawngin nge covid-19 hian bengah natna a thlen theih dan? Kan sawi tawh leh hriat ṭheuh angin, he virus natna hrik hian hnar leh dang/hrawk velah natna a thlen hmasa a. Dang/hrawk chung lama kua (dangkua) leh hnarkua leh beng laihawl (middle ear) hi dawt (eustachian tube) hmanga inzawm vek a ni a, an inhnaih hle a ni. Virus natna hrik hrawk vela awm chu heng dawt aṭang hian beng laihawlah lutin, heta ṭang hian beng chhungril bang tuamna a tukverh bial an tih (round window) kal tlangin bengchhungril lama timur (hair cells) chu harsa lovin a thleng phei thei a ni. Chumai ni lovin, virus (natna hrik) hi thisen kal tlangin taksa peng tinrengah natna a thlen thei a ni.

Hri veite hi engtia enkawl chi nge ni ta ang? Kum 2014 khan Virus natna hrileng SARS -CoV (RNA virus chhungkua tho)an tih chu a lo hluar tawh a. Khami ṭum khan Nitric Oxide (NO) chu enkawl nan leh a ṭangkainate hmuh a lo ni tawh a.  He NO hian chuap a natna tiziaawmin, oxygen tlakchham tiziaawmin, leh oxygen pek ngai leh enkawl ngai zualte pawh a tiziaawm thei a ni.  Virus natna laka damchhuak pawh an tam phah a ni. CoV (SARA-CoV) ziarang pawh hi Covid-19 nen hian a inang ve riau mai a ni. Zirchianna lo awm tawhah chuan NO hian RNA virus insiam leh hnathawh hi 82% laiin a tihniam thei tih a ni a. NO hian virus emaw natna punlun tur a do thei tih hriat a ni a, hei hi kan taksain a neih that chuan beng chhungrila natna thleng lo tur pawn a pui thei ang tih beisei a ni. Hemi avang hian Covid-19 vei te damdawi leh khawl hmanga enkawlna kawngah hian Nitric Oxide hi telh ve a ṭha ngei ang tih rin leh beisei a ni.

Nitric oxide hi thil inchawhpawlh taksain a mamawh em em mai a ni ve a. Thisen zama thisen kal theih tawk tura lo tikau a, taksa hrisel nana pangti pengthununtu ṭhalbe tuihnang (hormones an tih) pek chhuahtirtu, taksa ṭhan lenna leh chakna pe thei thil pawimawh tak mai a ni. He nitric oxide pawimawh tak mai hi taksain mamawh tawka a siamchhuah emaw a pekchhuah theih lova, taksain a tlakchham chuan natna hrang hrang mihringte hian kan vei thei a. Chung natna langsar zualte chu thisenzam natna, thisen sang, leh lung natnate a ni. Taksa hrisel nei tura ni tin taksa sawizawi hian kan taksa a thisen zam te a lo ti hrisel a, chung chuan he nitric oxide hi taksaah a tipung thei a ni. Taksa in nitric oxide a lo tlakhniam chuan hah ngawih ngawihna, mipat theih lohna, rilru hah, asthma, mut theihloh, lungphu chianglo, haihawt leh a dang dang pawh a thleng thei a ni. 

Taksaah Nitric oxide hi mamawh tawk engtin nge kan neih theih ang? Nitric oxide mihringin a mamawh tawk tura taksaa nei tur chuan chawṭha ei a ngai a. Tin, taksa hrisel ṭha tak neih a ngai bawk a ni. Chawtha kan han tih bik theih tur te chu khawizu, theirah, lakhuihthei tui, thlai thar leh tlaihnah hel te a ni a. Heng hian kan taksaa natna dotu a tichak thei em em a ni. Eitur dang pawimawh, NO taksa a titam thei turte chu beetroot, purun var, sa thianghlim, chocolate dum, thlaihnah hring dap mai, thei thur, theibuhfai, be mu, dawnfawh leh grape um te kan ti thei ang. Sawhthing pawh hi taksa a natna do thei a tichak thei (antioxidant) tha tak a sawi ve a ni bawk. Tin taksa hrisel nei turin ni tin minute 30 tal taksa insawizawi, emaw a ṭul anga mithiamte rawnin damdawi mum anga siam L-arginine leh L-citrulline te ei thin tur ani.

Beng chak lo leh bengngawng (Sensorineural hearing loss) neite hian rilru leh ngaihtuahna lamah tlakhniamna an nei fo ṭhin a. Khawvel ram a Covid-19 kai ṭhahnem tak hi, bengri hriatna chak lo leh kum upa lam an ni ve hlawm a. Tun hnai mai khan Eleonora Trecca leh a thiante chuan Italy ram Emergency hospital-ah bengri hriatna chak lo Covid-19 vei mi 59 enkawl ngaite chu an zirchiang a. Heng zinga ṭhahnem tak mai (44.1%, n = 26) te chuan anmahni enkawltuten hmaikawr vuah (PPE inthuamna nen) a an biak hian an thusawi an hrethiam lo a, tin, 55.9% (n = 33) lai chuan a enkawltute hmui zaizir an hmuh theih loh avangin an buai tih hriatchhuah ani.  Heng avangte hian bengchak lohna nei hrileng kaite hian rilrutlakhniamna an nei belh thei khawp mai.  Chumai nilovin, he natna avang hian fianriala dah leh enkawl bik ngai an nihna hian rilru a tibuai zual a ni. Chuvangin beng chak lo Covid-19 kaite an awm a nih chuan hriatthiamna, abika ngaihtuah ngai, thlamuan ngaizual bik an ni tih hriat a pawimawh hle.  Tin, ṭawng an hriatthiam theih tur zawng a biak, zaizira biak, hmaikhuh lova hmui leh ka ṭawngzia an hmuh theih tura biak, ṭawng rin deuh hlek, fiah leh muang deuh a thu sawi, chawṭha pek leh a ṭul anga nun dan thlak thiam pawh a ngai hial thei a ni.

A tawp lam atan han tarlang leh zuai ila. Covid-19 vanga a bengri hriatna chak lo ta hi, amah (Covid-19) hri vang liau liau ni lo pawn, a enkawlna damdawi hnathawh (side effect) vangte pawh a ni ve thei tho bawk. Tunlai damdawi tam tak, natna enkawl nana hman hian beng chhungrila hriatna thazam leh timur te tak te tete chu an tichhe ve thei tlat a, heng damdawite hi Ototoxic drugs an tih chu a ni. Tun thla July, 2020 mai khan, Audiolgist rual, University Hospital, Ferrara ami te chuan chhuiin, Covid-19 enkawl nana hman damdawi pawimawh tak takte hi beng tichak lo thei an ni ve tih an tarlang a ni. Chung damdawi langsar zualte chu azithromycin, remdesivir, favipiravir, leh lopinavir an ni a. Heng damdawi te hian beng tichak lovin leh bengchheri (tinnitus) te an thlen thei a ni an ti. Heng damdawi hman dan azir hian beng chhungrila hriatna thazam (nerve) te chu a chhe thei a, hman rei dan azir leh hman tam dan azirin bengin a tuar nasa thei hle a ni. Tin, hemi bakah hian, virus hnathawh hian oxygen tlakchhamna a siam thei a, taksa leh thisenah oxygen a tam tawk loh chuan a ngial a nganin beng chhungrila hriatna thazam leh timurte a chhe nghal thei bawk a ni. Beng chhungrila timur (hair cells) hi hnathawk reng an nih avang hian oxygen tlakchham hi an tuar em em a, oxygen an tlachham a nih chuan an hnathawh a buaiin an chak lo nghal rawk rawk thei bawk a ni. 

A tawp berah chuan, tupawh covid-19 hneh thei tur chuan hrisel ṭhat a ngai tih kan sawi nain, natna hri hian taksaah eng anga nasain nge a thawh dawn hriat a ni lova. Hemi avang hian mimal ṭheuh natna lakah kan inven thiam hi thil pawimawh ber pakhat chu a ni. Covid-19 hian kan beng mai ni lovin, hriselna kawng tinrengah pawi a khawih thui thei hle tih kan hre ṭheuh a, chuvangin mithiamte enkawlna thlawp chunga mahni hriselna ngai pawimawhin he natna lakah theihtawpin kan inveng tur a ni. Covid-19 vei reng rengte pawh a ṭul anga, a beng ri hriatna te an hloh nge hloh lo enfiahsakte pawh thil pawimawh tak a ni.