Phepo e nepahetseng bakeng sa Mokhathala o amanang le Kankere kapa Cachexia

Lintlha-khōlō Tsa

Mokhathala o amanang le mofets'e kapa cachexia ke boemo bo phehellang, bo sithabetsang bo bonoang ho bakuli ba bangata ba mofets'e le baphonyohi le lilemo tse ngata kamora kalafo. Liphuputso tse fapaneng li bonts'a mekhoa e nepahetseng ea phepo e nepahetseng e kenyeletsang ts'ebeliso ea li-supplement tsa zinc, Vitamin C, omega-3 fatty acids, likarolo tsa guarana, mahe a linotši a tualang kapa mahe a linotši a entsoeng le jelly ea borena a ka kenya letsoho haholo ho fokotsa matšoao a amanang le mokhathala kapa cachexia mefuteng e itseng ea mofetše le kalafo. Ho haella ha vithamine D ho bakuli ba mofets'e ba tlalehang mokhathala ho boetse ho fana ka maikutlo a hore tlatsetso ea Vitamin D e ka thusa ho fokotsa matšoao a cachexia.

Mokhathala o amanang le mofets'e kapa Cachexia

Mokhathala o sa feleng kapa bofokoli bo fetelletseng bo atisang ho bonoa ho bakuli ba mofets'e bo bitsoa 'Mokhathala o Amanang le Kankere' kapa 'Cachexia'. E fapane le bofokoli bo tloaelehileng bo atisang ho tima kamora ho ja lijo tse nepahetseng le ho phomola. Cachexia kapa mokhathala li ka bakoa ke lefu la mofets'e kapa litla-morao tsa liphekolo tse sebelisetsoang kalafo ea mofets'e. Bofokoli ba 'mele, maikutlo le kelello bo bonoang ho bakuli ka lebaka la mofets'e kapa kalafo ea mofets'e kapa ka bobeli li bohloko ebile hangata li sitisa tšebetso e tloaelehileng ea bakuli.

Matšoao a cachexia e amanang le mofetše:

• boima ba 'mele bo boima
• ho lahleheloa ke takatso ea lijo
• khaello ea mali
• bofokodi / mokgathala.

Mokhathala o amanang le mofets'e kapa cachexia esale e le bothata bo bonoang ho boholo ba bakuli ba mofets'e nakong ea kalafo ea mofets'e le kamora moo e qetellang e theola boima ba 'mele haholo. Mokhathala le matšoao a amanang le mokhathala a amanang le mofetše a ka fapana ho latela lintlha tse fapaneng ho kenyelletsa:

• mofuta oa kankere
• kankere ea kankere
• phepo e nepahetseng le phepo
• bophelo bo botle ba mokuli pele ho kalafo 

Ho ja lijo tse nepahetseng le litlatsetso e le karolo ea phepo ea mofets'e ho bohlokoa ho sebetsana le matšoao a cachexia. Ka blog ena, re tla fana ka mehlala ea lithuto tse fapaneng tse entsoeng ke bafuputsi lefats'eng lohle ho lekola litlamorao tsa phepelo ea phepo e nepahetseng ho kenyelletsa le li-supplements / lijo tse fapaneng bakeng sa ho fokotsa mokhathala kapa cachexia ho bakuli ba mofets'e.

Lisebelisoa tsa Zinc bakeng sa Mokhathala o Amanang le Kankere ho Bakuli ba Colorectal Cancer 

Phuputso ea bongaka e entsoeng ke bafuputsi ba Brazil e hlahlobile boitsebiso bo tsoang ho bakuli ba 24 ka chemotherapy bakeng sa colorectal adenocarcinoma sepetleleng sa sechaba sa tlhokomelo e phahameng, ho lekola litlamorao tsa tlatsetso ea zinc ea molomo ka mokhathala o amanang le mofetše kapa cachexia. Bakuli ba ile ba fuoa li-capsule tsa zinc tsa molomo 35mg habeli ka letsatsi bakeng sa libeke tse 16 hang hang ka mor'a ho buuoa ho fihlela potoloho ea bone ea chemotherapy. (Sofia Miranda de Figueiredo Ribeiro le al, Einstein (Sao Paulo)., Pherekhong-Mar 2017)

Phuputso e fumane hore bakuli ba sa fumaneng li-capsules tsa zinc ba tlalehile ho mpefala ha boleng ba bophelo le mokhathala o eketsehileng lipakeng tsa chemotherapy ea pele le ea bone. Leha ho le joalo, bakuli bao ba mofets'e ba neng ba fuoa li-capsules tsa Zinc ha baa ka ba tlaleha boleng ba bophelo kapa mokhathala. Ho ipapisitsoe le phuputso, bafuputsi ba fihletse qeto ea hore tlatsetso ea zinki e ka ba molemo ho thibela mokhathala kapa cachexia le ho boloka boleng ba bophelo ba bakuli ba nang le mofetše o moholo ho chemotherapy.

Tšebeliso ea Vitamin C bakeng sa Mokhathala o Amanang le Kankere kapa Cachexia

Tšebeliso ea Vitamin C bakeng sa Kalafo ea Kankere ea Boko e Amanang le Mokhathala

Phuputsong ea bongaka e phatlalalitsoeng ka 2019, bafuputsi ba ile ba lekola polokeho le phello ea ho sebelisa infusion ea ascorbate (Vitamin C) hammoho le kalafo e tloaelehileng ea tlhokomelo ho bakuli ba mofetše oa boko / glioblastoma. Boithuto bo hlahlobile lintlha tse tsoang bokong ba 11 tsoaroa ke kankere bakuli le ho hlahloba litla-morao tsa kalafo tsa mokhathala, ho nyekeloa ke pelo le liketsahalo tse mpe tsa hematological tse amanang le kalafo e tloaelehileng ea tlhokomelo. (Allen BG le al, Kankere ea Kankere ea Kliniki., 2019) 

Bafuputsi ba fumane hore li-infusions tse nang le methapo e mengata ea Vitamin C / ascorbate li ntlafalitse bophelo bohle ba bakuli ba glioblastoma ho tloha likhoeling tse 12.7 ho isa likhoeling tse 23 hape ba fokotsa litlamorao tse mpe tsa mokhathala, ho nyekeloa ke pelo le liketsahalo tse mpe tsa hematological tse amanang le kalafo ea mofetše oa boko. Litholoana feela tse mpe tse amanang le ho tšeloa ha Vitamin C tseo bakuli ba nang le tsona e ne e le molomo o ommeng le ho bata.

Kameho ea Vitamin C ho boleng ba bophelo ba bakuli ba mofets'e

Phuputsong ea litsi tse ngata tse fapaneng, bafuputsi ba ile ba lekola litlamorao tsa tšelo e phahameng ea methapo ea vithamine C boleng ba bophelo ba bakuli ba mofets'e. Bakeng sa boithuto bona, bafuputsi ba ile ba lekola lintlha tsa bakuli ba mofets'e ba sa tsoa fumanoa ba fumaneng vithamine C e kenang methapong e le kalafo e thusang. Lintlha tse tsoang ho bakuli ba mofets'e ba 60 li fumanoe ho tsoa litsing tse nkang karolo Japane lipakeng tsa Phuptjane le Tšitoe 2010. Tekolo ea boleng ba bophelo e entsoe ho sebelisoa lintlha tse thehiloeng lipotsong tse fumanoeng pele, le libekeng tse 2 le tse 4 kalafo e phahameng ea methapo ea vithamine C.

Phuputso e bontšitse hore tekanyetso e phahameng ea methapo ea vithamine C e ka ntlafatsa bophelo bo botle ba lefats'e le boleng ba bophelo ba bakuli ba mofets'e. Phuputso e boetse e fumane ntlafatso ea ts'ebetso ea 'mele, maikutlo, kelello le boits'oaro nakong ea libeke tse 4 tsa tsamaiso ea Vitamin C. Liphetho li bontšitse phokotso e kholo ea matšoao ho kenyelletsa mokhathala, bohloko, ho hlobaela le ho sokela. (Hidenori Takahashi et al., Botho ba Meriana e Ikhethileng, 2012).

Tsamaiso ea Vitamin C ho bakuli ba mofets'e oa matsoele

Phuputsong ea sehlopha sa batho ba bangata Jeremane, lintlha tse tsoang ho bakuli ba mofetše oa matsoele oa 125 Stage IIa le IIIb li ile tsa hlahlojoa ho ithuta phello ea tsamaiso ea Vitamin C boleng ba bophelo ba bakuli ba mofetše oa matsoele. Har'a bona, bakuli ba 53 ba ile ba fuoa vithamine C e kenang methapong hammoho le kalafo ea bona e tloaelehileng ea mofets'e bonyane libeke tse 4 mme bakuli ba 72 ha baa ka ba fuoa Vithamine C. tsoaroa ke kankere phekolo. (Claudia Vollbracht et al, In Vivo., Nov-Dec 2011)

Phuputso e fumane hore ha ho bapisoa le bakuli ba sa fumaneng vithamine C, ho bile le phokotso e kholo ea litletlebo tse bakoang ke lefu lena le chemotherapy / radiotherapy ho kenyelletsa mokhathala / cachexia, ho nyekeloa ke pelo, khatello ea maikutlo, mathata a ho robala, ho tsekela le ho haemorrhagic diathesis ho bakuli ba fumaneng vithamine C. ea methapo

Liphuputso ho bakuli ba mofets'e tse ipapisitseng le morero oa European Palliative Care Research Cachexia Project 

Tlhahlobo e hlophisitsoeng e entsoe ke bafuputsi ba Sepetlele sa Univesithi ea Bonn Jeremane, Sepetlele sa Univesithi ea Diponegoro / Kariadi Indonesia le Univesithi ea Saense le Theknoloji ea Norway ho Norway, ho lekola litlamorao tsa livithamini, liminerale, liprotheine le litlatsetso tse ling ho cachexia kankere. Phuputso e hlophisitsoeng ea lingoliloeng ho CENTRAL, MEDLINE, PsycINFO, ClinicalTrials.gov le likhetho tsa likoranta tsa mofets'e ho fihlela ka la 15 Mmesa 2016 li hlahisitse lingoliloeng tse 4214, tseo ho tsona tse 21 li kentsoeng thutong. (Mochamat et al, J Cachexia Sarcopenia Muscle., 2017)

Phuputso e fumane hore tlatsetso ea vithamine C e lebisitse ho ntlafatsong ea likarolo tse fapaneng tsa bophelo ka sampole e nang le tšoaetso ea mofets'e e fapaneng.

Kameho ea β-hydroxy-β-methylbutyrate (HMB), Arginine le Glutamine e kopaneng ho 'Mele oa' Mele o Tšepahalang ho bakuli ba Advanced Solid Tumor

Phuputsong e tšoanang e boletsoeng kaholimo e neng e le tlasa Morero oa Cachexia oa Palliative Care Center ea Europe, bafuputsi ba boetse ba fumane hore kalafo e kopaneng ea β-hydroxy-β-methylbutyrate (HMB), arginine le glutamine e bontšitse keketseho ea boima ba 'mele kamora nako. Libeke tse 4 thutong ea bakuli ba tsoetseng pele ba hlahala e tiileng. Leha ho le joalo, ba fumane hape hore motswako ona ona ha o na molemo ho 'mele o omeletseng ka sampole e kholo ea bakuli ba matšoafo le bakuli ba bang ba mofets'e kamora libeke tse 8. (Mochamat et al, J Cachexia Sarcopenia Muscle., 2017)

Tlatsetso ea Vitamin D bakeng sa Cachexia kapa Mokhathala o Amanang le Kankere

Morero oa Cachexia oa Setsi sa Palliative Care

European Palliative Care Research Center Cachexia Project le eona e fumane hore vithamine D tlatsetso e na le monyetla oa ho ntlafatsa bofokoli ba mesifa ho bakuli ba nang le mofetše oa prostate. (Mochamat et al, J Cachexia Sarcopenia Muscle., 2017)

Ntle le moo, thuto e tšoanang e boetse e fumane hore L-carnitine e ka lebisa keketsehong ea boima ba 'mele le keketseho ea pholoho ka kakaretso ho bakuli ba mofets'e ba tsoetseng pele ba mofets'e.

Khokahano lipakeng tsa khaello ea Vitamin D le Mokhathala o Amanang le Kankere / Cachexia

Ho entsoe lithuto tse fapaneng ho utloisisa likamano lipakeng tsa khaello ea Vitamin D le mokhathala kapa cachexia ho bakuli ba mofets'e. 

Phuputsong e phatlalalitsoeng ka 2015, bafuputsi ba Spain ba ile ba lekola botsoalle ba khaello ea Vitamin D le boleng ba litaba tsa bophelo, mokhathala / cachexia le ts'ebetso ea 'mele ho bakuli ba mofets'e ba tsoetseng pele kapa ba metastatic kapa ba sa sebetseng ba tlhokomelong ea palliative. Har'a bakuli ba 30 ba nang le mofetše o tiileng o tsoetseng pele ba neng ba le tlasa tlhokomelo ea kalafo, 90% ba ne ba na le khaello ea Vitamin D. Tlhatlhobo ea liphetho tsa phuputso ena e fumane hore khaello ea Vitamin D e kanna ea amahanngoa le mokhathala / cachexia e amanang le mofetše, e fanang ka maikutlo a hore tlatsetso ea vithamine D e ka fokotsa sekhahla sa mokhathala le ho ntlafatsa boiketlo ba mmele le bo sebetsang ba bakuli ba mofets'e ba tsoetseng pele ba mofets'e. (Montserrat Martínez-Alonso et al, Palliat Med., 2016)

Leha ho le joalo, joalo ka ha ho hlahisoa feela ka khokahano lipakeng tsa khaello ea Vitamin D le mokhathala / cachexia e amanang le mofetše, netefatso ea tlhaloso ena thutong e laoloang ea hlokahala.

Omega-3 acid e mafura bakeng sa Mokhathala o Amanang le Kankere kapa Cachexia

Omega-3 Fatty Acid Supplementation ho bakuli ba nang le Bile Duct kapa Kankere ea Pancreatic ea Chemotherapy

Phuputsong e entsoeng ke bafuputsi ba Jikei University School of Medicine, Tokyo Japane, phepo ea lijo (phepelo ea lijo ka pampitšana ea masapo (GI)) limatlafatsi tse entsoeng ka omega-3 fatty acids, e fuoe 27 pancreatic le bile duct bakuli ba mofets'e. Tlhahisoleseling mabapi le masapo a mesifa le tlhahlobo ea mali e fumanoe pele e fa omega-3-fatty acid e tlatsetsang ho bakuli le libekeng tsa 4 le 8 kamora hore ba qale ho noa li-supplements. (Kyohei Abe et al, Anticancer Res., 2018)

Phuputso e fumane hore ho bakuli bohle ba 27, masapo a mesifa a eketsehile haholo libekeng tse 4 le tse 8 kamora ho qala ha omega-3-fatty acids ha e bapisoa le masapo a mesifa pele ho tsamaiso ea omega-3-fatty acids. Liphuputso tsa boithuto li khothalelitse hore omega-3 fatty acid supplementation ho bakuli ba nang le mofetše oa pancreatic le bile e sa bonahaleng e ka ba molemo ho ntlafatseng matšoao a mofets'e a kankere.

n-3-mafura a sebelisoa ho bakuli ba Pancreatic Cancer bakeng sa Cachexia

Teko e 'ngoe ea bongaka e entsoe ke bafuputsi ba Jeremane ho bapisa phospholipids ea leoatleng le li-formulations tsa oli ea tlhapi, tse neng li na le palo e lekanang le sebopeho sa n-3 fatty acid, ka boima ba' mele le takatso ea takatso ea lijo, boleng ba bophelo le lifaele tsa mafura a mali a lero la mali. ho bakuli ba tšoeroeng ke mofetše oa pancreatic. Phuputso e ne e kenyelletsa bakuli ba mofets'e ba nang le mofets'e ba 60 ba neng ba fuoa oli ea tlhapi kapa phospholipids ea metsing. (Kristin Werner et al, Lipids Health Dis. 2017)

Phuputso e fumane hore ho kenella ka lethal dose n-3-fatty acids, ekaba oli ea tlhapi kapa tlatsetso ea MPL, ho felletse ka ho ts'episa boima le takatso ea takatso ho bakuli ba mofets'e oa pancreatic. Phuputso e boetse e fumane hore li-capsule tsa leoatle tsa phospholipids li ne li mamelloa hanyane hanyane ka litla-morao tse fokolang, ha li bapisoa le tlatsetso ea oli ea tlhapi.

Omega-3-Fatty Acid Supplementation ho bakuli ba Kankere ea mala le mala

Phuputsong ea meta e entsoeng ke bafuputsi ba Portugal, ba ile ba lekola phello ea n-3 polyunsaturated fatty acids likarolong tsa phepo e nepahetseng le boleng ba bophelo ba cachexia ea mofetše. Ba fumane lithuto tsa liteko tsa bongaka tse phatlalalitsoeng lipakeng tsa 2000 le 2015 ka lipatlisiso tsa lingoliloeng ho database tsa PubMed le B-ho. Ho sebelisitsoe lithuto tsa 7 bakeng sa tlhahlobo. (Daryna Sergiyivna Lavriv le al, Lithethefatsi tsa Kliniki ea ESPEN., 2018)

Phuputso e fumane hore boima ba bakuli ba nang le mofetše oa mala bo eketsehile haholo ka ts'ebeliso ea n-3 polyunsaturated fatty acid, leha ho le joalo, bakuli ba nang le mofetše oa matšoafo ha ba bontše karabo ea bohlokoa.

Guarana (Paullinia cupana) Sebelisa bakuli ba nang le mofets'e o tsoetseng pele

Bafuputsi ba ABC Foundation Medical School e Brazil ba lekotse litlamorao tsa lihlahisoa tsa guarana phokotsong ea takatso ea lijo le ho theola boima ba 'mele ho bakuli ba mofets'e ba tsoetseng pele. Bakuli ba ile ba fuoa 50 mg ea guarana e sa ommeng habeli ka letsatsi libeke tse 4. (Cláudia G Latorre Palma et al, J Liet Suppl., 2016)

Ho tsoa ho bakuli ba 18 ba phethileng protocol, bakuli ba babeli ba ile ba ba le boima ba 'mele kaholimo ho 5% ho tloha molemong oa bona oa motheo mme bakuli ba tšeletseng ba bile le ntlafatso ea lintlha tse 3 ho sekhahla sa takatso ea pono ha ba fuoa lits'oants'o tsa guarana. Ba fumane hore ho na le phokotso e kholo ea khaello ea takatso ea lijo le boroko nako e telele ka mokhoa o sa tloaelehang.

Phuputso e hlokometse botsitso ba 'mele le takatso e matla ea lijo ha e tlatsetsoa ka lihlahisoa tsa guarana tse fanang ka melemo ea mokhathala / cachexia e amanang le mofetše. Bafuputsi ba khothalelitse lithuto tse ling tsa guarana ho bakuli ba nang le mofetše.

Ho Sebelisa Mahe a Linotsi Bakeng sa Mokhathala o Amanang le Kankere kapa Cachexia

Mahe a linotši a Tualang bakeng sa Mokhathala o Amanang le Kankere / Cachexia ho Bakuli ba Kankere ea Hlooho le ea Neck

Phuputsong ea bongaka e kenyeletsang barupeluoa ba 40, ba lilemo li pakeng tsa 18 le 65, ba nang le mofetše oa hlooho le molala ba phethileng chemotherapy le / kapa radiotherapy ho Sepetlele sa USM, Kelantan Malaysia kapa Hospital Taiping, bafuputsi ba ile ba lekola phello ea ho tlatselletsa mahe a linotši a Tualang kapa Vitamin C ho mokhathala le boleng ba bophelo. (Viji Ramasamy, Koung J Oncolog., 2019)

Phuputso e fumane hore kamora libeke tse 'ne le tse robeli tsa kalafo le mahe a linotši a Tualang kapa Vitamin C, mokhathala oa bakuli ba alafiloeng ka mahe a linotši a Tualang o ne o le betere haholo ho feta ba ileng ba phekoloa ka Vitamin C. Bafuputsi le bona ba fumane ntlafatso e kholo boleng ba bophelo ho bakuli ba alafshoang ka mahe a linotši a Tualang bekeng ea 8. Leha ho le joalo, moo ha baa ka ba fumana phapang / ntlafatso ea bohlokoa ho palo ea lisele tse tšoeu le boemo ba protheine bo sebetsang ba C lipakeng tsa lihlopha tse peli tsa bakuli.

Mahe a linotši a sebetsitsoeng le Royal Jelly Bakeng sa Mokhathala o Amanang le Kankere kapa Cachexia

Phuputsong e phatlalalitsoeng ka 2016, bafuputsi ba tsoang liunivesithing tse fapaneng tsa Saense ea bongaka Iran ba ile ba lekola katleho ea mahe a linotši a sebelisitsoeng le jelly ea borena lipontšong tsa mokhathala kapa cachexia ho bakuli ba mofets'e ba alafshoang ke lihormone, chemotherapy, chemo-radiation kapa radiotherapy. Phuputso e kenyelelitse barupeluoa ba 52 ho tsoa ho bakuli ba etileng tleliniking ea oncology ea sepetlele sa Shohada-e-Tajrish se Tehran (Iran) lipakeng tsa Mots'eanong 2013 le Phato 2014. Lilemo tse bolelang tsa bakuli bana e ne e le lilemo tse ka bang 54. Har'a bona, bakuli ba 26 ba fumane mahe a linotši a ntlafalitsoeng le jelly ea borena, ha ba bang kaofela ba fumana mahe a linotši a hloekileng, habeli ka letsatsi bakeng sa libeke tse 4. (Mohammad Esmaeil Taghavi et al, Ngaka ea Electron., 2016)

Phuputso e fumane hore ts'ebeliso ea mahe a linotši a sebelisitsoeng le jelly ea borena e fokolitse mokhathala kapa matšoao a cachexia ho bakuli ba mofets'e ho bapisoa le ts'ebeliso ea mahe a linotsi a hloekileng.

fihlela qeto e

Boholo ba lithuto tse boletsoeng kaholimo li bontša bohlokoa ba ho nka lijo tse nepahetseng le litlatsetso bakeng sa mefuta e itseng ea mofets'e ho fokotsa mokhathala le cachexia ho bakuli ba mofets'e. Ho nka li-supplement tsa zinc, Vitamin C, omega-3 fatty acids, lihlahisoa tsa guarana, mahe a linotši a tualang, mahe a linotši a sebelisitsoeng le jelly ea borena li ka kenya letsoho haholo ho fokotsa mokhathala kapa cachexia mefuteng e itseng ea mofetše le kalafo. Ho haella ha vithamine D ho bakuli ba mofets'e ba tlalehang mokhathala ho ka supa hore tlatsetso ea Vitamin D e ka thusa ho fokotsa cachexia. 

Ho kenella ka phepo e nepahetseng ho bapala karolo ea bohlokoa ho fokotsa mokhathala kapa matšoao a cachexia ho bakuli ba mofets'e le baphonyohi. Bakuli ba mofets'e ba lokela ho ikopanya le ngaka ea bona ea li-oncologist le setsebi sa phepo e nepahetseng ho rala leano le nepahetseng la phepo e khethiloeng ke mofets'e le kalafo ho ntlafatsa bophelo ba bona. 

Lijo tseo u li jang le tse u tlatsetsang ke qeto eo u e etsang. Qeto ea hau e lokela ho kenyelletsa ho nahanisisa ka liphetoho tsa liphatsa tsa lefutso tsa mofetše, e leng mofetše, kalafo e tsoelang pele le litlatsetso, ho kula hohle, leseli la bophelo, boima, bolelele le litloaelo.

Morero oa phepo e nepahetseng bakeng sa mofets'e ho tsoa addon ha o ea ipapisa le lipatlisiso tsa inthanete. E iketsetsa liqeto bakeng sa hau e ipapisitse le mahlale a limolek'hule a kentsoeng tšebetsong ke bo-rasaense ba rona le lienjineri tsa software. Ho sa tsotelehe hore na o tsotella ho utloisisa metheo ea limolek'hule kapa che - bakeng sa moralo oa phepo ea mofets'e kutloisiso ea hlokahala.

Qala hona joale ka moralo oa hau oa phepo e nepahetseng ka ho araba lipotso lebitsong la mofetše, phetoho ea lefutso, kalafo e tsoelang pele le litlatsetso, ho kula hohle, litloaelo, mokhoa oa bophelo, sehlopha sa lilemo le bong.

Bakuli ba mofets'e hangata ba tlameha ho sebetsana le tse fapaneng litla-morao tsa chemotherapy tse amang boleng ba bona ba bophelo le ho batla mekhoa e meng ea kalafo ea mofets'e. Ho nka phepo e nepahetseng le litlatsetso ho latela maikutlo a mahlale (ho qoba ho inahanela le ho khetha ka mokhoa o sa reroang) ke pheko ea tlholeho bakeng sa mofets'e le litla-morao tse amanang le kalafo

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