Concerta vs.Ritalin: Kusiyana, kufanana, ndi zomwe zili zabwino kwa inu
Mankhwala osokoneza bongo Vs. MnzanuKuwunika kwa mankhwala osokoneza bongo & kusiyana kwakukulu | Zinthu zothandizira | Mphamvu | Kuphunzira inshuwaransi ndi kufananiza mtengo | Zotsatira zoyipa | Kuyanjana kwa mankhwala | Machenjezo | FAQ
Ngati inu kapena mwana wanu mwapezeka kuti muli ndi ADHD, omwe amakuthandizani pa zaumoyo mwina adanenapo za kuyesera mankhwala a ADHD ngati gawo limodzi lamaphunziro azachipatala, kuphatikizapo chikhalidwe, machitidwe, ndi maphunziro. ADHD ndizofala : Ana 6.4 miliyoni azaka zapakati pa 4 mpaka 17 ku US apezeka ndi ADHD, ndipo 4% ya akulu ali ndi ADHD.
Concerta ndi Ritalin ndi mankhwala awiri olimbikitsa a ADHD omwe amavomerezedwa ndi United States Food and Drug Administration (FDA). Mankhwala onsewa amawonetsedwa ngati chithandizo cha ADHD (chidwi deficit hyperactivity disorder). Mankhwala onsewa ali ndi chinthu chimodzi, methylphenidate. Concerta imakhala ndi methylphenidate, pomwe Ritalin amakhala ndi methylphenidate. Concerta ndi Ritalin amagwira ntchito pogwiritsa ntchito CNS (chapakati dongosolo lamanjenje) kuti achulukitse kuchuluka kwa dopamine ndi norepinephrine muubongo, zomwe zimathandizira kukonza zizindikiritso za ADHD monga kusinkhasinkha komanso kukhala tcheru.
Mankhwala onsewa amadziwika kuti Ndandanda II mankhwala ndi Drug Enforcement Administration (DEA), kutanthauza kuti pali kuthekera kwakukulu kogwiritsa ntchito mankhwala osokoneza bongo komanso kudalira.
Ngakhale Concerta ndi Ritalin zonse ndizolimbikitsa zomwe zili ndi methylphenidate, zimasiyana. Pitilizani kuwerenga pansipa kuti mudziwe zambiri za Concerta ndi Ritalin.
Kodi pali kusiyana kotani pakati pa Concerta ndi Ritalin?
Concerta ndi Ritalin onse amadziwika kuti ndi mankhwala opatsa mphamvu ndipo onse amapezeka m'maina odziwika ndi generic. Dzina lodziwika bwino la Concerta ndi methylphenidate (kutulutsidwa kwina). Concerta idapangidwa kuti izikhala pafupifupi maola 12, ndipo imayikidwa kamodzi patsiku.
Dzinalo la Ritalin ndi methylphenidate ndipo ndi piritsi lotulutsira mwachangu. Mlingo umodzi wa Ritalin umatha pafupifupi maola anayi, chifukwa chake amadzipiritsa pafupipafupi, nthawi zambiri kawiri kapena katatu patsiku.
Mitundu ina ya Ritalin imatenga nthawi yayitali. Ritalin-LA ndi kapisozi wa nthawi yayitali (wopezeka mu brand and generic) ndipo Ritalin-SR (yopezeka mu generic) ndi piritsi logwira ntchito kwanthawi yayitali. Ritalin LA ali ndi njira zosinthira. Theka la methylphenidate limatulutsidwa nthawi yomweyo, ndipo theka lachiwiri limatulutsidwa pambuyo pake. Mlingo wa Ritalin LA umatha pafupifupi maola eyiti mpaka 10. Mlingo wa Ritalin-SR kumatenga pafupifupi maola eyiti.
Kutalika kwa chithandizo ndi Concerta kapena Ritalin kumasiyana. Odwala ena amatenga tchuthi cha mankhwala osokoneza bongo , komwe mankhwala amayimitsidwa kwakanthawi, mwachitsanzo, patchuthi cha chilimwe pomwe sukulu sinayende. Wothandizira zaumoyo wanu akhoza kukuthandizani kusankha ngati inu kapena mwana wanu muyenera kutenga tchuthi cha mankhwala osokoneza bongo.
| Kusiyana kwakukulu pakati pa Concerta ndi Ritalin | ||
|---|---|---|
| Konsati | Ritalin | |
| Gulu la mankhwala osokoneza bongo | Zolimbikitsa | Zolimbikitsa |
| Chizindikiro cha Brand / generic | Brand ndi generic | Brand ndi generic |
| Kodi dzina lachibadwa ndi liti? | Methylphenidate hydrochloride yotulutsidwa | Methylphenidate hydrochloride |
| Kodi mankhwalawa amabwera mwa mawonekedwe ati? | Pulogalamu yotulutsidwa | Piritsi, kapisozi wotulutsa nthawi yayitali (Ritalin LA), piritsi lotulutsa (Ritalin-SR) |
| Kodi mulingo woyenera ndi uti? | 18, 36, 54, kapena 72 mg kamodzi tsiku lililonse m'mawa (mlingo umadalira zaka, kulemera, ndi kuyankha mankhwala) | Ana: 5 mg kawiri tsiku lililonse kuyamba, kuchuluka kwake kumatha kuwonjezeka pang'onopang'ono Avereji ya tsiku ndi tsiku ndi 20 mpaka 30 mg pamlingo wogawa kawiri mpaka katatu patsiku (mwachitsanzo: 10 mg yopatsidwa katatu tsiku lililonse ikufanana ndi 30 mg) |
| Kodi mankhwalawa amatenga nthawi yayitali bwanji? | Zosintha: zitha kukhala zofunikira kwa nthawi yayitali koma sizinaphunzire kwa milungu yopitilira 7; funsani wothandizira zaumoyo | Zimasiyanasiyana: zitha kukhala zofunikira kwa nthawi yayitali; funsani wothandizira zaumoyo |
| Ndani amagwiritsa ntchito mankhwalawa? | Mibadwo 6 mpaka 65 | Zaka 6 mpaka wamkulu |
Mukufuna mtengo wabwino kwambiri pa Ritalin?
Lowani zidziwitso zamitengo ya Ritalin kuti mudziwe kuti mitengo isintha liti!
Pezani zidziwitso zamitengo
Zinthu zomwe Concerta ndi Ritalin adachita
Concerta ndi Ritalin onse akuwonetsedwa ngati chithandizo cha ADHD mwa ana azaka 6 kapena kupitilira apo, achinyamata , ndi akuluakulu . Ritalin amawonetsedwanso chifukwa cha matenda osokoneza bongo. Concerta kapena Ritalin iyenera kugwiritsidwa ntchito ngati gawo limodzi lamankhwala omwe atha kuphatikizira chithandizo chamankhwala.
| Mkhalidwe | Konsati | Ritalin |
| Attention Deficit Hyperactivity Disorder (ADHD) mwa ana azaka 6 kapena kupitilira apo, achinyamata, komanso achikulire mpaka zaka 65 | Inde | Inde (Ritalin wopanga zambiri sizikutanthauza msinkhu wazaka) |
| Kugonana | Kutumiza | Inde |
Kodi Concerta kapena Ritalin ndiwothandiza kwambiri?
Palibe maphunziro omwe amafananitsa Concerta ndi Ritalin womasulidwa mwachangu. Mayeso azachipatala a Concerta anaphunzira odwala omwe anatenga Concerta, Ritalin, kapena placebo; komabe, zotsatira zake zimangofanizira Concerta ndi placebo ndipo sizinaphatikizepo Ritalin. Zotsatira zake zidawonetsa kuti Concerta anali wapamwamba kuposa placebo, koma sanawonetse zotsatira poyerekeza ndi Ritalin.
Poyerekeza Concerta motsutsana ndi Ritalin, kumbukirani kuti mankhwala onsewa ali ndi methylphenidate, chifukwa chake tikuyang'ana mankhwala omwewo. Kusiyanitsa kumadalira momwe mankhwalawo amathandizira ndi kutalika kwake. Concerta imakhala pafupifupi maola 12 ndipo imayikidwa kamodzi tsiku lililonse m'mawa, chifukwa chake mwina ndi chisankho chabwino kwa munthu amene ayenera kuganizira maola ambiri ndipo safuna kumwa mankhwala owonjezera. Ritalin, yemwe amagwira ntchito pafupifupi maola anayi, atha kukhala njira yabwinoko kwa munthu amene angofunika maola ochepa a chithandizo chamankhwala kapena munthu amene safuna kumwa mankhwala owonjezera pakufunika.
Mankhwala othandiza kwambiri kwa inu akuyenera kutsimikiziridwa ndi omwe amakuthandizani azaumoyo wanu omwe angaganizire zaumoyo wanu komanso mbiri yanu yazachipatala ndi mankhwala ena omwe mumamwa omwe amatha kulumikizana ndi Concerta kapena Ritalin. Funsani wolemba wanu kuti akuthandizeni.
Mukufuna mtengo wabwino pa Concerta?
Lowani zidziwitso zamitengo ya Concerta kuti mudziwe kuti mitengo isintha liti!
Pezani zidziwitso zamitengo
Kuphunzira ndi kuyerekezera mtengo wa Concerta vs.Ritalin
Concerta sikuti imapangidwa ndi Medicare Part D. Itha kukhala yokutidwa ndi inshuwaransi, makamaka momwe imapangidwira. Mtengo wotuluka m'thumba wa mapiritsi a generic a Concerta 36 mg atha kukhala opitilira $ 300. Coupon ya SingleCare ikhoza kuchepetsa mtengo uwu mpaka pansi pa $ 150.
Ritalin nthawi zambiri amakhala ndi Medicare Part D ndipo amatha kukhala ndi inshuwaransi, nthawi zambiri mumtundu wa generic. Mtengo wapa thumba wa mapiritsi 60 a Ritalin 10 mg ndi pafupifupi $ 85. Mtengo uwu ukhoza kutsitsidwa mpaka ochepera $ 25 ndi coupon ya SingleCare kuma pharmacies omwe akutenga nawo mbali.
Pezani khadi yotsitsa ya SingleCare
| Konsati | Ritalin | |
| Nthawi zambiri amakhala ndi inshuwaransi? | Zimasintha | Zimasintha |
| Nthawi zambiri amadzazidwa ndi Medicare? | Ayi | Inde |
| Mlingo woyenera | 30, 36 mg mapiritsi | 60, 10 mg mapiritsi |
| Wopanga Medicare wamba | $ 230 | $ 3- $ 48 |
| Mtengo wosakwatiwa | $ 130- $ 180 | $ 23- $ 53 |
Zotsatira zoyipa za Concerta vs.Ritalin
Zotsatira zoyipa kwambiri za Concerta ndi kupweteka m'mimba, kuchepa kwa njala, kuchepa thupi, kupweteka mutu, mkamwa wouma, nseru, kusowa tulo / kugona, nkhawa, chizungulire, kukwiya, ndi hyperhidrosis (thukuta lowonjezeka). Ritalin ali ndi zovuta zofananira, koma kuchuluka kwamafupipafupi sikunatchulidwe. Ili si mndandanda wathunthu wazotsatira. Zotsatira zoyipa zimatha kuchitika. Funsani wothandizira zaumoyo wanu kuti mupeze mndandanda wa zovuta zomwe zingachitike ndi Concerta kapena Ritalin.
| Konsati | Ritalin | |||
| Zotsatira zoyipa | Zoyenera? | Pafupipafupi | Zoyenera? | Pafupipafupi |
| Kumva kupweteka m'mimba | Inde | 6.2% | Inde | Osanenedwa * |
| Kuchepetsa njala / kuonda | Inde | ≥5% | Inde | Osati lipoti |
| Mutu | Inde | ≥5% | Inde | Osati lipoti |
| Pakamwa pouma | Inde | ≥5% | Inde | Osati lipoti |
| Nseru | Inde | ≥5% | Inde | Osati lipoti |
| Kukwiya | Inde | ≥5% | Inde | Osati lipoti |
| Nkhawa | Inde | ≥5% | Inde | Osati lipoti |
| Kutuluka thukuta kwambiri | Inde | ≥5% | Inde | Osati lipoti |
| Kusanza | Inde | 2.8% | Inde | Osati lipoti |
| Malungo | Inde | 2.2% | Inde | Osati lipoti |
| Matenda apamwamba opuma | Inde | 2.8% | Inde | Osati lipoti |
| Chizungulire | Inde | 1.9% | Inde | Osati lipoti |
| Kusowa tulo | Inde | 2.8% | Inde | Osati lipoti |
| Tsokomola | Inde | 1.9% | Inde | Osati lipoti |
* Peresenti yomwe sananene ndi Ritalin
Gwero: DailyMed ( Konsati ), Tsiku Lililonse ( Ritalin )
Kuyanjana kwa mankhwala a Concerta vs.Ritalin
Concerta kapena Ritalin sayenera kutengedwa ndi MAOIs (monoamine oxidase inhibitors) chifukwa kuphatikiza kwake kumatha kubweretsa vuto la kuthamanga kwa magazi. Concerta kapena Ritalin ayenera kupatulidwa ndi MAOI masiku osachepera 14. Concerta kapena Ritalin iyenera kugwiritsidwa ntchito mosamala ndi ma vasopressor agents (mankhwala omwe amagwiritsidwa ntchito kuonjezera kuthamanga kwa magazi) chifukwa chakuchuluka kwa kuthamanga kwa magazi. Concerta kapena Ritalin imatha kukulitsa kuchuluka kwa warfarin, ma anticonvulsants, ndi tricyclic kapena SSRI antidepressants. Kusintha kwamiyeso kungafune ngati kutengedwa ndi Concerta kapena Ritalin. Concerta kapena Ritalin imatha kuchepetsa mphamvu ya mankhwala okodzetsa kapena kuthamanga kwa magazi. Ili si mndandanda wathunthu wazomwe zimachitika ndi mankhwala. Funsani wothandizira zaumoyo wanu kuti mupeze mndandanda wathunthu wamagwiridwe antchito.
| Mankhwala osokoneza bongo | Gulu la Mankhwala | Konsati | Ritalin |
| Phenelzine Rasagiline Selegiline Zamgululi | MAOI | Inde | Inde |
| Dobutamine Epinephrine Norepinephrine Phenylephrine | Othandizira a Vasopressor | Inde | Inde |
| Warfarin | Wotsutsa | Inde | Inde |
| Citalopram Kuyanjana Fluoxetine Fluvoxamine Paroxetine Sertraline | Mankhwala opatsirana pogonana a SSRI | Inde | Inde |
| Amitriptyline Desipramine Imipramine Mzere wa Nortriptyline | Tricyclic antidepressants | Inde | Inde |
| Phenobarbital Phenytoin Primidone | Ma anticonvulsants | Inde | Inde |
| Furosemide Hydrochlorothiazide | Okodzetsa | Inde | Inde |
| Amlodipine Atenolol Diltiazem Enalapril Irbesartan Lisinopril Losartan Zamgululi Olmesartan | Zotsutsana | Inde | Inde |
Machenjezo a Concerta ndi Ritalin
Mukalandira chitsogozo cha mankhwala nthawi iliyonse mukamalemba mankhwala a Concerta kapena Ritalin, omwe amakhala ndi machenjezo komanso zambiri zamankhwala oyipa. Concerta ndi Ritalin onse ali ndi chenjezo la bokosi , ndilo chenjezo lamphamvu kwambiri lofunidwa ndi FDA. Chifukwa cha chiopsezo chozunzidwa kapena kudalira, odwala ayenera kuwunika ngati ali ndi vuto lakuzunzidwa asanalembedwe Concerta kapena Ritalin. Odwala omwe amatenga Concerta kapena Ritalin ayenera kuyang'aniridwa ngati ali ndi zizunzo panthawi yachipatala.
Machenjezo ena:
- Imfa mwadzidzidzi imanenedwa ndi mankhwala opatsa mphamvu, ngakhale pamlingo woyenera. Izi zachitika mwa ana / achinyamata omwe ali ndi zovuta zina pamtima kapena zovuta. Imfa mwadzidzidzi, sitiroko, komanso matenda amtima adanenedwa mwa akulu. Zochitika izi zimatha kuchitika kwa achikulire omwe ali ndi vuto la mtima kapena mavuto ena amtima. Chifukwa chake, zotonthoza monga Concerta kapena Ritalin siziyenera kugwiritsidwa ntchito kwa ana, achinyamata, kapena achikulire omwe ali ndi mavuto amtima kapena zodetsa nkhawa.
- Kuthamanga kwa magazi ndi / kapena kugunda kwa mtima kumatha kuwonjezeka; odwala ayenera kuyang'aniridwa. Odwala omwe ali ndi vuto la magazi kapena mavuto amtima ayenera kuthandizidwa mosamala.
- Hypersensitivity ndi ochepa koma amatha kuchitika. Ngati mukuvutika kupuma, kapena kutupa kwa nkhope, mmero, lilime, kapena khosi, siyani kumwa Concerta kapena Ritalin ndikupita kuchipatala mwadzidzidzi.
- Zolimbikitsa zitha kukulitsa zizindikilo zakusokonekera kwamakhalidwe ndi matenda amalingaliro kwa odwala omwe ali ndi vuto la psychotic, monga matenda ochititsa munthu kusinthasintha zochitika. Odwala ayenera kuwunikidwa asanayambe chilimbikitso.
- Odwala omwe akuyamba kulandira chithandizo cha ADHD ayenera kuyang'aniridwa chifukwa cha mawonekedwe kapena kuwonjezeka kwamakhalidwe ankhanza kapena chidani.
- Zolimbikitsa zimatha kuchepetsa kulanda kwa odwala omwe ali ndi mbiri yakale yakugwidwa. Ngati kugwidwa kumachitika, mankhwalawa ayenera kuthetsedwa.
- Kukonda (kupitirira, kuwawa kowawa) kwachitika. Izi zikachitika, pitani kuchipatala msanga.
- Odwala a Concerta kapena Ritalin ayenera kuwonedwa chifukwa cha zotumphukira za vasculopathy, kuphatikiza chodabwitsa cha Raynaud.
- Kukula kwa ana kuyenera kuyang'aniridwa panthawi yothandizira. Ana omwe amapatsidwa mankhwala masiku asanu ndi awiri pa sabata chaka chonse amatha kuchepa kwakanthawi.
- Masomphenya olakwika amatha kuchitika. Funsani wothandizira zaumoyo wanu ngati izi zichitika.
- CBC, kusiyanitsa, ndi kuwerengera kwa ma platelet ziyenera kuyang'aniridwa nthawi ndi nthawi.
- Chifukwa cha mawonekedwe a piritsi la Concerta, odwala omwe ali ndi mavuto ena a GI (m'mimba) sayenera kutenga Concerta. Izi ndichifukwa choti piritsi silimasintha mawonekedwe amtundu wa GI ndipo limatha kubisala.
- Piritsi la Concerta liyenera kumeza lonse ndipo siliyenera kutafuna, kugawikana, kapena kuphwanyidwa. Chigoba (chosagwira) cha piritsiyo chitha kuwoneka pansi.
- Mapiritsi a Ritalin-SR ayenera kumezedwa kwathunthu ndipo mwina sangaphwanye kapena kutafuna.
- Makapisozi a Ritalin LA ayenera kumezedwa kwathunthu, ndipo sayenera kuphwanyidwa, kutafunidwa, kapena kugawidwa. Kapena, mungatsegule kapisozi wa Ritalin LA ndikuwaza mikanda pa supuni imodzi ya maapulo ndi kudya nthawi yomweyo. Osasunga chisakanizocho kuti mugwiritse ntchito mtsogolo.
Mafunso omwe amafunsidwa pafupipafupi za Concerta vs.Ritalin
Concerta ndi chiyani?
Concerta ndichopatsa mphamvu chomwe chimagwiritsidwa ntchito pochiza ADHD. Lili ndi mawonekedwe okhalitsa a methylphenidate ndipo amatengedwa kamodzi patsiku.
Ritalin ndi chiyani?
Ritalin ndichopatsa mphamvu chomwe chili ndi methylphenidate ndipo chimagwiritsidwa ntchito pochizira ADHD kapena narcolepsy. Nthawi zambiri amatengedwa kawiri kapena katatu tsiku lililonse chifukwa sachedwa kuchita zinthu. Mitundu yanthawi yayitali ya Ritalin ikupezeka, nawonso.
Kodi Concerta ndi Ritalin ndi ofanana?
Concerta ndi Ritalin onse ali ndi chinthu chimodzimodzi chogwira ntchito, methylphenidate. Komabe, Concerta idapangidwa kuti izikhala pafupifupi maola 12, chifukwa chake imayikidwa kamodzi patsiku m'mawa. Ritalin, momwe amamutulutsira mwachangu, amamuyeza kawiri kapena katatu tsiku lililonse chifukwa ndiwofupikitsa.
Zitsanzo zina zamankhwala olimbikitsanso omwe mwina mudamvapo za awa Vyvanse , Quillivant XR, ndi Adderall (amphetamine salt), pakati pa ena.
Kodi Concerta kapena Ritalin ndibwino?
Palibe maphunziro omwe akuyerekezera Concerta ndi Ritalin. Chifukwa mankhwala onsewa ali ndi methylphenidate, kusankha mankhwala omwe mungagwiritse ntchito kumadalira pazinthu zingapo, monga mankhwala omwe ali oyenera ndandanda yanu, ndi mankhwala ati omwe angakhale oyenera pamoyo wanu, komanso momwe mungayankhire. Wothandizira zaumoyo wanu akhoza kukuthandizani kusankha ngati Concerta kapena Ritalin ndi mankhwala oyenera kwa inu.
Kodi ndingagwiritse ntchito Concerta kapena Ritalin ndili ndi pakati?
Concerta ndi Ritalin ali mgulu C pakubadwa, kutanthauza kuti palibe kafukufuku wamankhwala omwe ali ndi pakati, koma kafukufuku wazinyama awonetsa kuti pali ngozi kwa mwana wosabadwayo. Nthawi zambiri, Concerta kapena Ritalin samagwiritsidwa ntchito pathupi. Ngati mutenga Concerta kapena Ritalin ndikupeza kuti muli ndi pakati, lemberani kalata kwa alembi anu mwachangu.
Kodi ndingagwiritse ntchito Concerta kapena Ritalin ndi mowa?
Ngati mutenga cholimbikitsa monga Concerta kapena Ritalin, muyenera pewani mowa . Ngakhale zolimbikitsira zili pamwamba, mowa umakhala wotsika. Zimalimbana wina ndi mnzake, ndipo mwina mungamamwe mowa mopitirira muyeso, ndikupangitsani kumwa kwambiri, zomwe zingayambitse ngozi kapena poyizoni wa mowa (zomwe zingayambitse kugunda kwamtima mosalekeza, kupuma movutikira, nseru, kusanza, ndi / kapena kugwidwa).
Kodi Ritalin ndi liwiro?
Kuthamanga ndi methamphetamine. Adderall, mankhwala ena a ADHD, ali ndi amphetamine salt (amphetamine ndi dextroamphetamine), yomwe imagwirizana ndi methamphetamine. Liwiro, kapena methamphetamine, ndizovuta kuposa Adderall. Komanso ndiwowopsa ndipo amatha kuwononga ubongo, kuwonongeka kwa mtima, kuwola kwa mano, ndi mavuto ena. Osanenapo, methamphetamine nthawi zambiri imapezeka mumsewu, womwe ndiwowopsa.
Ritalin imakhala ndi methylphenidate. Monga Adderall, Ritalin ndiwopatsa mphamvu ndipo amafanana ndi amphetamines. Monga mankhwala a Pulogalamu yachiwiri, Ritalin ali ndi kuthekera kwakukulu kozunzidwa komanso kudalira. Ngati inu kapena mwana wanu mutenga Ritalin (kapena mankhwala aliwonse a ADHD), muyenera kuyang'aniridwa ndi omwe adakupatsani.
Kodi Concerta andipanga nayo bwanji?
Concerta iyenera kuthandiza kukonza zizindikilo za ADHD. Zitha kutenga kusintha kwamiyeso mpaka wothandizira zaumoyo wanu atapeza mulingo woyenera kwa inu. Zotsatira zoyipa za Concerta ndi kupweteka m'mimba, kuchepa kwa njala, kuchepa thupi, kupweteka mutu, mkamwa wouma, nseru, mavuto ogona, nkhawa, chizungulire, kukwiya, ndi thukuta. Ngati muli ndi zovuta zina zomwe zimakhala zovuta kapena zovuta (monga kuthamanga kapena kupuma movutikira), dziwitsani omwe akukuthandizani nthawi yomweyo.
Kodi Concerta amasintha umunthu wanu?
Mankhwala a ADHD sayenera kusintha umunthu wanu (kapena wa mwana wanu). Kusintha kwina kulikonse kwachilendo kumatha kukhala chifukwa chodya kwambiri. Mukawona kusintha kwa umunthu, funsani wolemba wanu za kuchepetsa mlingo kapena kusintha mankhwala.
