Rashin mai

Rashin mai
Description (en)
Iri	poisoning (en)
Specialty (en)	endocrinology (en)
Effect (en)	hyponatremia (en)
Identifier (en)
ICD-10	E87.7
ICD-9	276.69
MeSH	D014869

Gurbataccen ruwa, wanda kuma aka sani da guba na ruwa, hyperhydration, overhydration ko toxemia na ruwa shine mai yuwuwar tashin hankali a cikin ayyukan kwakwalwa wanda zai iya haifar da lokacin da aka tura ma'auni na al'ada na electrolytes a cikin jiki a waje da iyakokin aminci ta hanyar shan ruwa mai yawa.

A cikin yanayi na al'ada, cin ruwa da yawa bisa kuskure ba kasafai ba ne. Galibin mace-macen da ke da alaka da buguwar ruwa a cikin mutane masu lafiya ko dai ta samo asali ne daga gasar shan ruwa, inda daidaikun mutane ke kokarin cinye ruwa mai yawa, ko kuma ta tsawon lokacin motsa jiki inda aka sha ruwa mai yawa. Bugu da ƙari, maganin ruwa, hanyar azabtarwa wanda ake tilasta wa wanda aka azabtar ya sha ruwa mai yawa, yana iya haifar da maye gurbin ruwa.

Ruwa, kamar kowane abu, ana iya la'akari da shi guba ne idan an sha da yawa a cikin ɗan gajeren lokaci. Barasa ruwa yakan faru ne lokacin da ake shan ruwa da yawa yana haifar da hargitsi a ma'aunin electrolyte.

Yawan ruwa na jiki kuma na iya zama sakamakon rashin lafiya ko rashin magani; duba "hyponatremia" don wasu misalai. Ana ɗaukar ruwa ɗaya daga cikin mafi ƙarancin mahadi masu guba, tare da LD50 wanda ya wuce 90,000 mg/kg (90 g/kg) nauyin jiki a cikin beraye; shan lita shida a cikin sa'o'i uku ya yi sanadiyar mutuwar wani mutum.

Abubuwan haɗari

Ƙananan nauyin jiki (yara)

Zai iya zama da sauƙi ga yara masu ƙasa da shekara ɗaya (musamman waɗanda ba su kai watanni tara ba) su sha ruwa mai yawa. Saboda ƙananan ƙwayar jikinsu, yana da sauƙi a gare su su sha a cikin ruwa mai yawa dangane da yawan jiki da jimillar sodium na jiki.

Wasanni na jimiri

Masu tseren gudun fanfalaki suna iya kamuwa da buguwar ruwa idan sun sha da yawa yayin gudu. Wannan yana faruwa lokacin da matakan sodium ya ragu ƙasa da 135 mmol/L, wanda zai iya faruwa lokacin da 'yan wasa suka cinye ruwa mai yawa. An lura da wannan sakamakon ƙarfafawa na maye gurbin ruwa mai yawa ta hanyar jagororin daban-daban. An gano wannan galibi a cikin masu tseren marathon azaman dilutional hyponatremia. Wani bincike da aka gudanar kan ‘yan gudun hijira da suka kammala tseren gudun hijira na Boston a shekara ta 2002 ya nuna cewa kashi goma sha uku cikin dari sun kammala tseren tare da hyponatremia. Binciken ya ƙaddamar da cewa mafi ƙarfin tsinkaya na hyponatremia shine karuwar nauyi yayin tsere (over-hydration), kuma hyponatremia yana iya faruwa a cikin masu gudu da suka zaɓi abubuwan sha na wasanni kamar waɗanda suka zaɓi ruwa.

Hyponatremia da sauran yanayin jiki da ke da alaƙa da maye na ruwa an fi gani a cikin waɗanda ke shiga horon soja. Wani binciken sojojin Amurka ya gano an kwantar da masu horo 17 a asibiti tsawon shekara guda saboda shaye-shayen ruwa yayin da wani ya gano cewa sojoji uku sun mutu, lamarin da ya sa aka ba da shawarar cewa kada a sha fiye da lita 1-1.5 na ruwa a cikin sa'a guda na gumi. 

Yawan damuwa da damuwa

Duk wani aiki ko yanayi da ke haɓaka gumi mai nauyi zai iya haifar da maye na ruwa lokacin da aka sha ruwa don maye gurbin abubuwan da suka ɓace. Mutanen da ke aiki cikin matsanancin zafi da/ko zafi na dogon lokaci dole ne su kula da sha da ci ta hanyoyin da ke taimakawa wajen kiyaye ma'aunin electrolyte. Mutanen da ke amfani da kwayoyi irin su MDMA (wanda aka fi sani da "Ecstasy") na iya wuce gona da iri, suna yin gumi sosai, su ji ƙishirwa mai yawa, sannan su sha ruwa mai yawa don sake dawo da ruwa, wanda zai haifar da rashin daidaituwa na electrolyte da maye gurbin ruwa - wannan yana haɗuwa da MDMA. Yi amfani da haɓaka matakan hormone antidiuretic (ADH), rage yawan ruwan da aka rasa ta hanyar fitsari. Hatta mutanen da suke hutawa cikin nutsuwa cikin matsanancin zafi ko zafi suna iya fuskantar haɗarin buguwar ruwa idan sun sha ruwa mai yawa cikin ɗan gajeren lokaci don samun ruwa.

Yanayin ƙwaƙwalwa

Psychogenic polydipsia shine yanayin tabin hankali wanda marasa lafiya ke jin an tilasta musu shan ruwa mai yawa, don haka yana jefa su cikin haɗarin buguwar ruwa. Wannan yanayin na iya zama haɗari musamman idan majiyyaci kuma ya nuna wasu alamomin tabin hankali (kamar yadda yake sau da yawa), kamar yadda masu kulawa zasu iya yin kuskuren fahimtar alamun hyponatremic.

Iatrogenic

Lokacin da ake ciyar da wanda bai sani ba ta hanyar jijiya (misali, jimlar abinci mai gina jiki na mahaifa) ko ta bututun nasogastric, ruwan da aka bayar dole ne a daidaita shi a hankali a cikin abun da ke ciki don dacewa da ruwa da electrolytes da suka ɓace. Wadannan ruwaye yawanci hypertonic ne, don haka ruwa sau da yawa ana gudanar da shi tare. Idan ba a kula da electrolytes ba (ko da a cikin asibiti na asibiti), ko dai hypernatremia ko hyponatremia na iya haifar da.

Wasu magungunan ƙwayoyin cuta / masu tabin hankali (oxcarbazepine, da sauransu) an samo su don haifar da hyponatremia a wasu marasa lafiya. Marasa lafiya masu ciwon sukari insipidus suna da rauni musamman saboda saurin sarrafa ruwa.

Ilimin jiki

A farkon wannan yanayin, ruwa a waje da sel yana da ƙarancin adadin abubuwan solutes, irin su sodium da sauran electrolytes, idan aka kwatanta da ruwa a cikin sel, yana sa ruwan ya shiga cikin sel don daidaita ma'aunin osmotic. Wannan yana sa sel su kumbura. Kumburi yana ƙara matsa lamba na intracranial a cikin kwakwalwa, wanda ke haifar da alamun farko da ake iya gani na buguwa na ruwa: ciwon kai, canje-canjen hali, canje-canje a cikin hali, rudani, fushi, da barci. Wadannan wasu lokuta ana biye da su da wahalar numfashi yayin aiki, raunin tsoka da raɗaɗi, ƙwanƙwasa, ko ƙumburi, tashin zuciya, amai, ƙishirwa, da ƙarancin iya fahimta da fassara bayanan azanci. Yayin da yanayin ya ci gaba, alamun papillary da alamun mahimmanci na iya haifar da su ciki har da bradycardia da fadada bugun bugun jini. Kwakwalwa na iya kumbura har zuwa inda jini ya katse wanda ke haifar da edema na kwakwalwa. Kwayoyin kwakwalwa masu kumbura kuma na iya amfani da matsa lamba ga tushe na kwakwalwa wanda ke haifar da rashin aiki na tsarin juyayi na tsakiya. Dukansu edema na cerebral da tsangwama tare da tsarin juyayi na tsakiya suna da haɗari kuma suna iya haifar da kamawa, lalacewar kwakwalwa, coma ko mutuwa.

Rigakafi

Za a iya hana maye gurbin ruwa idan ruwan da mutum ya sha bai wuce asararsa ba. Kodan lafiya suna iya fitar da kusan milliliters 800 zuwa lita daya na ruwa mai ruwa (0.84-1.04 quarts) a kowace awa. Duk da haka, damuwa (daga tsayin daka na jiki), da kuma jihohin cututtuka, na iya rage yawan wannan adadin.

Magani

Ƙananan maye na iya zama asymptomatic kuma yana buƙatar ƙuntata ruwa kawai. A lokuta masu tsanani, magani ya ƙunshi:

• Diuretic don kara fitsari, wanda ya fi tasiri ga yawan jini.
• Masu karɓar Vasopressin

Shahararrun lokuta

• 325 BC: Alexander the Great loses many companion travelers to excessive water intake during a march through the Gedrosian Desert
• 1097: During the First Crusade, according to at least one chronicle, many crusaders died after drinking too much from a river while marching to Antioch.
• 1991, Andy Warhol: Five years after his death, Warhol's family publicly accused the hospital where he had his gallbladder removed of causing his death by water intoxication administered post-operatively. A claimed autopsy weight of 150 pounds (68 kg), with his weight being 128 pounds (58 kg) when admitted, was cited as evidence that too much fluid had been given.
• November 16, 1995: Leah Betts, a British schoolgirl, died as the result of drinking too much water, though in the media her death was mistakenly attributed to taking an ecstasy tablet at her 18th birthday party.
• 2003: British actor Anthony Andrews survived a case of water intoxication. He was performing as Henry Higgins in a revival of the musical My Fair Lady at the time, and consumed up to eight litres of water a day. He was unconscious and in intensive care for three days.
• February 2, 2005: Matthew Carrington, a student at Chico State University in Chico, California, died as a direct result of a fraternity hazing ritual involving forced water intoxication.
• January 12, 2007: Jennifer Strange died after drinking nearly 2 US gallons (7.6 L) of water in an attempt to win a Nintendo Wii. The KDND radio station's morning show, the Morning Rave, held an on-air contest entitled "Hold Your Wee for a Wii," in which contestants were asked to drink as much water as they could without urinating. The DJs were made aware of the dangers but did not inform the contestants. KDND's parent company, Entercom Sacramento LLC, was subsequently ordered to pay $16,577,118 in damages to Strange's family.
• March 11, 2020: Zachary Sabin, an 11-year-old child, died after being forced to drink almost three liters of water in just four hours by his parents. They thought his urine was too dark, so they made him drink water until he threw up.
• A 2022 study proposed that martial-arts actor Bruce Lee's death in 1973 was due to water poisoning.
• July 4, 2023: A 35-year-old Indiana woman died after consuming too much water while on vacation with her family.