Diabetic Nephropathy Case Study

7/23/2019 Diabetic Nephropathy Case Study

1/61

AVX DG@Y AN KFXEY EADDFJFHaraljgl Eity$ Fgstfrl Ugkgr

@IGHFPIE LFRMXARGPMY

G Egsf Utu`y

Rrfsfltf` ta tmf Ngeudty anRgrgkfìegd @fpgrtkflt anAur Dg`y an Kfrey Eaddfjf

Il pgrtigd nudniddkflt an tmf rfquirfkfltsnar tmf @fjrff Hgemfdar an Ueiflef il Lursilj

Uuhkittf` hy?

Hgogra$ Lgrkif JgyHgdhg`g$ Kgrihftm

Hgdais$ Og`f Erfsid`gHgsg`g$ Cgrdg Kgf

Hgtudg$ Kgf MgzfdylEglìà$ Gdgil Oal

Dga$ Kgry OayDik$ Ogl Kiemgfd îleflt

Acghgygsmi$ GiArgdf$ Kfdizg

Kgrem 8=$ 8229


2/61

ILPXA@VEPIAL

Mistary

@ighftie lfpmrapgtmy -lfpmrapgtig ìghftieg)$ gdsa clawl gs Cikkfdstifd+

Zidsal syl`rakf gl` iltfregpiddgry jdakfrudalfpmritis$ is g prajrfssivf ci`lfy

ìsfgsf egusf` hy gljiapgtmy an egpiddgrifs il tmf ci`lfy jdakfrudi, It is

emgrgetfrizf` hy lfpmratie syl`rakf gl` laùdgr jdakfrudasedfrasis, It is ùf ta

daljstglìlj ìghftfs kfdditus$ gl` is g prikf egusf nar ìgdysis il kgly Zfstfrl

eaultrifs,

@iseavfrf` hy Hritism pmysieigl Edinnar` Zidsal -792>+799:) gl` Jfrkgl+

harl Gkfriegl pmysieigl Rgud Cikkfdstifd -7922+79:2) gl` wgs puhdismf` nar

tmf nirst tikf il 795>,

Egusfs

Pmf fxget egusf an ìghftie lfpmrapgtmy is ulclawl$ hut it is hfdifvf` tmgt

ulealtraddf` mijm hdaa` sujgr dfg`s ta tmf `fvfdapkflt an ci`lfy `gkgjf, Il

sakf egsfs$ yaur jflfs ar ngkidy mistary kgy gdsa pdgy g radf, Lat gdd pfrsals

witm ìghftfs `fvfdap tmis ealìtial,

Fgem ci`lfy is kg`f an mul`rf`s an tmausgl`s an nidtfrilj ulits egddf`

lfpmrals, Fgem lfpmral mgs g edustfr an tily hdaa` vfssfds egddf` g jdakfrudus,

Pajftmfr tmfsf strueturfs mfdp rfkavf wgstf nrak tmf ha`y, Paa kuem hdaa`

sujgr egl `gkgjf tmfsf strueturfs$ egusilj tmfk ta tmiecfl gl` hfeakf

segrrf`, Udawdy$ avfr tikf$ karf gl` karf hdaa` vfssfds grf `fstrayf`, Pmf

ci`lfy strueturfs hfjil ta dfgc gl` pratfil -gdhukil) hfjils ta pgss ilta tmf

urilf,

Rfrsals witm ìghftfs wma mgvf tmf naddawilj risc ngetars grf karf dicfdy

ta fvfdap tmis ealìtial?

Gnriegl Gkfriegl$ Mispglie$ ar Gkfriegl Ilìgl arijil

Ngkidy mistary an ci`lfy ìsfgsf ar mijm hdaa` prfssurf

Raar ealtrad an hdaa` prfssurf

Raar ealtrad an hdaa` sujgrs

Pypf 7 ìghftfs hfnarf gjf 82Ukacilj

@ighftie lfpmrapgtmy jflfrgddy jafs gdalj witm atmfr ìghftfs

eakpdiegtials ileduìlj mijm hdaa` prfssurf$ rftilapgtmy$ gl` hdaa` vfssfd

emgljfs,


3/61

Rrfvgdflef gl` Ilei`flef Xgtf

@ighftfs mgs hfeakf tmf prikgry egusf an fl`+stgjf rflgd ìsfgsf

-FUX@)$ gl` tmf ilei`flef an typf 8 ìghftfs kfdditus ealtilufs ta jraw il tmf

Vlitf` Utgtfs gl` ward`wi`f, Gppraxikgtfdy 00& an lfw pgtiflts fltfrilj

ìgdysis il tmf Vlitf` Utgtfs grf ìghfties, Fgrdy ìgjlasis an ìghftfs gl` fgrdy

iltfrvfltial grf eritiegd il prfvfltilj tmf larkgd prajrfssial ta rflgd ngidurf sffl

il kgly typf 7 gl` g sijlinieglt pfrefltgjf an typf 8 ìghfties,

Il tmf Vlitf` Utgtfs$ gppraxikgtfdy 82,= kiddial pfapdf$ ar :,2& an tmf

papudgtial$ grf fstikgtf` ta mgvf ìghftfs$ witm g jrawilj ilei`flef, Xaujmdy

alf tmir` an tmis papudgtial$ >,8 kiddial$ is fstikgtf` ta hf ulìgjlasf` witm typf8 ìghftfs, Pmf prfvgdflef an ìghftfs is mijmfr il efrtgil rgeigd gl` ftmlie

jraups$ gnnfetilj gppraxikgtfdy 75& an Gnriegl Gkfriegls$ 9,6& an Mispglies$

gl` 76& an Lgtivf Gkfriegls$ prikgridy witm typf 8 ìghftfs,Gppraxikgtfdy 82&

ta 52& an gdd ìghfties widd `fvfdap fvi`flef an lfpmrapgtmy$ gdtmaujm g mijmfr

pfrefltgjf an typf 7 pgtiflts prajrfss ta FUX@,

Fpi`fkiadajy

Pmf syl`rakf egl hf sffl il pgtiflts witm emralie ìghftfs -76 yfgrs ar

karf gntfr alsft)$ sa pgtiflts grf usugddy an ad`fr gjf -hftwffl 62 gl` :2 yfgrs

ad`), Pmf ìsfgsf is prajrfssivf gl` kgy egusf `fgtm twa ar tmrff yfgrs gntfr

tmf ilitigd dfsials$ gl` is karf nrfquflt il kfl, @ighftie lfpmrapgtmy is tmf kast

eakkal egusf an emralie ci`lfy ngidurf gl` fl`+stgjf ci`lfy ìsfgsf il tmf

Vlitf` Utgtfs, Rfapdf witm hatm typf 7 gl` typf 8 ìghftfs grf gt risc, Pmf risc is

mijmfr in hdaa`+jdueasf dfvfds grf paardy ealtraddf`, Nurtmfr$ alef lfpmrapgtmy

`fvfdaps$ tmf jrfgtfst rgtf an prajrfssial is sffl il pgtiflts witm paar ealtrad antmfir hdaa` prfssurf, Gdsa pfapdf witm mijm emadfstfrad dfvfd il tmfir hdaa` mgvf

kuem karf risc tmgl atmfrs,

Uijls . Uykptaks

Fgrdy sijls gl` sykptaks an ci`lfy ìsfgsf il pgtiflts witm ìghftfs grf

typiegddy ulusugd, Mawfvfr$ g vgst grrgy an sijls gl` sykptaks distf` hfdaw kgy

kglinfst wmfl ci`lfy ìsfgsf mgs prajrfssf`?

Uwfddilj$ usugddy graul` tmf fyfs il tmf karliljs3 dgtfr$ jflfrgd ha`y

swfddilj kgy rfsudt$ suem gs swfddilj an tmf dfjs

Nagky gppfgrglef ar fxefssivf nratmilj an tmf urilf

Vliltfltialgd wfijmt jgil -nrak ndui` geeukudgtial)

Ngtijuf


4/61

Nrfquflt mieeups

Jflfrgd idd nffdilj

Jflfrgdizf` itemilj

Mfg`gemf

Lgusfg gl` vakitilj

Raar gppftitf

Zfgclfss$ pgdflfss$ gl` glfkig

Glcdf gl` dfj swfddilj$ dfj ergkps

Jailj ta tmf hgtmraak karf antfl gt lijmt

Mijm hdaa` prfssurf

Pfsts gl` ìgjlasis

Dghargtary tfsts tmgt kgy hf àlf iledu`f?

HVL -Hdaa` Vrfg Litrajfl)

Ufruk erfgtililf

Pmf dfvfds an tmfsf tfsts widd ilerfgsf gs ci`lfy `gkgjf

jfts warsf, Atmfr dghargtary tfsts tmgt kgy hf àlf iledu`f?

80+maur urilf pratfil

Hdaa` dfvfds an pmaspmarus$ egdeiuk$ hiegrhalgtf$ gl` patgssiuk

Mfkajdahil

Mfkgtaerit

Rratfil fdfetrapmarfsis + urilf

Xf` hdaa` efdd -XHE) eault

Eakpdiegtials

Rassihdf eakpdiegtials iledu`f?

mypajdyefkig -nrak `ferfgsf` fxerftial an ilsudil)

rgpi`dy prajrfssilj emralie ci`lfy ngidurf

fl`+stgjf ci`lfy ìsfgsf

mypfrcgdfkig

sfvfrf mypfrtflsial

eakpdiegtials an mfkaìgdysis

eakpdiegtials an ci`lfy trglspdglt

eafxistflef an atmfr ìghftfs eakpdiegtials

pfritalitis -in pfritalfgd igdysis usf`)

ilerfgsf` ilnfetials


5/61

Prfgtkflts gl` `rujs

Pmf jagds an trfgtkflt grf ta cffp tmf ci`lfy ìsfgsf nrak jfttilj warsf

gl` prfvflt eakpdiegtials, Pmis ilvadvfs cffpilj tmf hdaa` prfssurf ul`fr

ealtrad -ul`fr 752!=2), Ealtraddilj mijm hdaa` prfssurf is tmf kast fnnfetivf wgy

an sdawilj ci`lfy `gkgjf nrak ìghftie lfpmrapgtmy,

Pmf àetar kgy prfserihf tmf naddawilj kfìeilfs ta dawfr tmf hdaa`

prfssurf?

Gljiatflsil+ealvfrtilj flzykf -GEF) ilmihitars

Gljiatflsil rfefptar hdaecfrs -GXHs)

Pmfsf `rujs mfdp rfùef tmf gkault an pratfil il tmf urilf, Kgly stuìfsmgvf sujjfstf` tmgt g eakhilgtial an tmfsf twa typfs an `rujs kgy hf hfst,

It is gdsa vfry ikpartglt ta ealtrad dipi` dfvfds$ kgiltgil g mfgdtmy wfijmt$

gl` fljgjf il rfjudgr pmysiegd getivity,

Edasfdy kalitar tmf hdaa` sujgr dfvfds, @ailj sa kgy mfdp sdaw àwl

ci`lfy `gkgjf$ fspfeigddy il tmf vfry fgrdy stgjfs an tmf ìsfgsf, Emgljf

ìft ta mfdp ealtrad hdaa` sujgr,

Pmf àetar kgy gdsa prfserihf kfìegtials ta mfdp ealtrad tmf hdaa`

sujgr, @asgjf an kfìeilf kgy lff` ta hf gòustf` nrak tikf ta tikf, Gs

ci`lfy ngidurf jfts warsf$ aur ha`y rfkavfs dfss ilsudil$ sa skgddfr àsfs

kgy hf lff`f` ta ealtrad jdueasf dfvfds,

Vrilgry trget gl` atmfr ilnfetials grf eakkal gl` egl hf trfgtf` witm

gppraprigtf gltihiaties,

@igdysis kgy hf lfefssgry alef fl`+stgjf rflgd ìsfgsf `fvfdaps, Gt tmis

stgjf$ g ci`lfy trglspdglt kust hf ealsi`frf`, Glatmfr aptial nar pgtiflts

witm typf 7 ìghftfs is g eakhilf` ci`lfy+pglerfgs trglspdglt,


6/61

RGPIFLPU RXANIDF

I, ÎPGD ILNAXKGPIAL

LGKF? Krs, G,

G@@XFUU? Juiugl$ Fgstfrl Ugkgr

GJF? >9 yfgrs ad`

UF]? Nfkgdf

MFIJMP? 6 Nt,

ZFIJMP? 6= Cj

LGPIALGDIPY? Nidipila

XFDIJIAL? Xakgl Egtmadie

HIXPM@GY? Oulf 88$ 7959

UPGPVU? Kgrrif`

AEEVRGPIAL? Mausfwinf

G@KIUUIAL @GPF? Kgrem 28$ 8229

XAAK LA? Nfkgdf Kfìegd Zgr`

HF@ LA? 6GPPFL@ILJ RMYUIEIGL? @rg, Kyrlg @igz

EMIFN EAKRDGILP? Fgsy ngtijghidity$ Emfst gl` hgec pgil

ILNAXKGLP? Rgtiflt itsfdn

II, EDILIEGD GUUFUUKFLP

Mistary a n Rrfsflt Iddlfss

Al tmf 8l` `gy an Kgrem 8229 gt graul` 5 il tmf gntfrlaal$ tmf

pgtiflt wgs ealnilf` gt Fgstfrl Ugkgr Rravileigd Maspitgd witm g emifn

eakpdgilt an fgsy ngtijghidity$ hgec pgil gl` swfddilj an hatm dfjs gl`

ngef gl` gl g`kittilj ìgjlasis an ìghftie lfpmrapgtmy witm sfvfrf

glfkig,

G wffc RPE tmf pgtiflt sunnfrf` emfst pgil$ ìzzilfss gl`

eaujm wmidf smf wgs àilj mausfmad` emarfs -Uwffpilj$ wgsmilj

edatmfs$ fte,), Pmfrfgntfr$ smf taac g pgil rfdifvfr kfìegtial ta fgsf

tmf pgil gl` g hglyas gppdyilj it ulta mfr emfst, Mfr sdffpilj pgttfrl

wgs gdsa gnnfetf` gs smf eaud` lat sdffp wfdd,

Mawfvfr$ fgsy ngtijghidity$ hgec pgil gl` swfddilj an mfr hatm

dfjs . ngef warsfl mfr ealìtial, Pmus$ prakptf` mfr ngkidy ta ealnilf


7/61

mfr gt Nfdipf Ghrija Kfkarigd Maspitgd$ Juiugl$ Fgstfrl Ugkgr al tmf

8=tm `gy an Nfhrugry 8229,

Ufvfrgd tfst -hdaa` emfkistry . urilgdysis) mg` hffl kg`f gl`

smf wgs ìgjlasf` witm @ighftie Lfpmrapgtmy witm sfvfrf glfkig,

Egptrapid 86 kj UD 7tgh hi` . nurasfki`f wgs jivfl gs mfr ilitigd

trfgtkflt, Mawfvfr$ mfr ealìtial pfrsistf` gl` smf ì` lat rfspal` ta

kfìegtial gl` trfgtkflt jivfl ta mfr wmidf smf wgs ealnilf` al tmf

sgi` maspitgd, Pmus$ smf wgs rfnfrrf` hy mfr àetar ta Fgstfrl Ugkgr

Rravileigd Maspitgd nar nurtmfr fxgkilgtial gl` trfgtkflt,

Rgst Kfìegd Mistary

Uakftikf il 7990$ gs rfegddf` hy tmf pgtiflt$ smf wgs

ìgjlasf` witm @ighftfs Kfdditus Pypf 8 hy g privgtf Kfìegd @aetar,

@igkieral wgs jivfl gs mfr kfìegtial nar mfr fvfry`gy kgiltflglef

hut smf ngidf` ta naddaw tmf @aetars ar`fr, Dgst yfgr al tmf kaltm an

Aetahfr smf wgs ealnilf` gt F^XKE ùf ta swfddilj an mfr hatm dfjs

gl` wgs ìgjlasf` witm @ighftie Lfpmrapgtmy, Mfr ealìtial wgs

tfkpargridy rfdifvf, Pmus$ mfr pmysieigl pfrkittf` mfr ta ja makf, La

gly surjfry mgs hffl àlf ùrilj mfr yauljfr yfgrs,

Rsyemasaeigd Mistary

Krs, G is gl fdfkfltgry jrgùgtf nrak Juiugl Lgtialgd Mijm

Uemaad$ ulnartulgtfdy$ smf mgvflt nilismf` mfr sfeal`gry dfvfd, Mfr

ngtmfr ìf` witm la clawl egusf gt mfr gjf an 50$ wmidf mfr katmfr

sueeukhf` ta @K gt mfr gjf an 08, Umf kgrrif` gt tmf gjf an 88$ gl`hdfssf` witm > emid`rfl$ 5 an wmak grf hays gl` 5 wfrf jirds, Hut 5 an

wmiem grf `fg`$ 7 hay gl` 8 jirds, Vpal rfegdd an Krs, G$ gt 7 y,a mis

sal ìf` hfegusf an kfgsdfs$ gdsa mfr `gujmtfr gt tmf sgkf gjf ìf`

hfegusf an tmf sgkf ìsfgsf, Mfr atmfr `gujmtfr ìf` ùf ta dfucfkig

gt tmf gjf an 80$ hut mgvf kgrrif` gt tmf gjf an 82 gl` hdfssf` witm 8

emid`rfl, Mfr 0tm gl` aldy ulkgrrif` sal rfkgils il tmfir mausf gt tmf

prapfr an Juiugl$ gl` tmf atmfr 8 gdrfg`y mgvf tmfir awl ngkidy,

Krs, G mgs g skgdd sgri+sgri starf wmfrf smf spfl`s kast an mfr

tikf, Pmis starf is tmfrf prikgry sauref an ileakf, Umfs nal` an fgtilj

swfft naa`s,

Umf is g skacfr$ smf hfjil skacilj il mfr yauljfr yfgrs, Umf

egl ealsukf 5 stiecs il g `gy oust gntfr fgtilj mfr kfgds, Umf gdsa


8/61

`rilcs tuhg gl` hffr aeegsialgddy, Mawfvfr smf quittf` skacilj `uf

ta ighftfs kfdditus,

Flviralkfltgd Mistary

Krs, G gl` mfr mushgl` divfs il Hrjy, Hgrha$ Juiugl Fgstfrl

Ugkgr, Pmfy prfnfr ta stgy tmfrf$ wmfrf il nget tmfy mgvf tmfir mausf

il tmf prapfr an Juiugl, G sgri+sgri starf is il tmfir nralt ygr`$ tmis

cffps mfr husy fvfry `gy,

Nruit trffs grf visihdf il tmfir vieility, Zgtfr suppdifs nar

`rilcilj$ eaacilj$ wgsmilj grf tgcfl nrak g eakkulgd ngueft lfgr tmf

rivfr$ 82 kftfrs gwgy nrak tmf eaknart raak,

Naa` prfpgrgtial is usugddy `alf hy mfr, Pmfy usugddy starf tmfir

naa` il tmf rfnrijfrgtar, Pmfy mgvf g pgid ndusm typf taidft daegtf` gt tmf

hgec an tmfir mausf, Pmfy tmraw tmfir jgrhgjf il tmfir eakpast pit

daegtf` gt tmfir hgecygr`,


9/61

NGKIDY MFGDPM MIUPAXY

DFJFL@?

@K + @ighftfs KfdditusMpl + MypfrtflsialGss + Gstmkg

Ksd + KfgsdfsD + DfucfkigK!N + Kgdf!Nfkgdf

Katmfr

-#) @K

@fefgsf`

Ngtmfr

Vlclawl @isfgsf

@fefgsf`

7st

Emid`

-N)

6tm

Emid`

-N)

0tm

Emid`

-K)

8l`

Emid`

-K)

5r`

Emid`

-N)

@K

Mpl

7st

Emid`

-N)

6tm

Emid`

-K)

@fefgsf`

Ksd

8l`

Emid`

-K)

0tm

Emid`

-K)

5r`

Emid`

-N)

@fefgsf`

D

>tm

Emid`

-N)

@fefgsf`

Ksd


10/61

Rgttfrls an Nuletialilj

Rgttfrl HfnarfIddlfss

@uriljIddlfss

@uriljMaspitgdizgtial

Glgdysis

FgtiljRgttfrl

+ Rrfnfrsvfjftghdfs$nism gl`sakftikfskfgt,

+ Pypiegdnaa` iltgcfealsists anrief gl`

vigl`,+ rfstrietial

wgs kg`fgs ar`frf`hy tmfàetar wgyhgec 7990wmfl smfwgsìgjlasf`w! @K 8

+ 5!0 eup anrief gl`viglèalsukf`

+ Xfstrietialwgs kg`fhut ngidf` tanaddaw

+ +rfstrietial almijm il saìuk$mijm il hatmsgturgtf` ngtgl` tatgd ngt$mijm ilegrhamy`rgtfs,

+ +ìft mijm ilegdeiuk$

patgssiuk gl`kgjlfsiukwgs ar`frf`,

+

+ Fgtiljpgttfrl mgshfflkaìnif`ùf taiddlfss,

@rilciljRgttfrl

+Mfr typiegdwgtfr!nduiìltgcf isusugddy 6 > jdgssfspfr `gy,

+smf `rilcs 0ta > jdgssfsan wgtfr pfr`gy,

+smf `rilcs 7jdgss an wgtfrg `gy

+@rilcilj anwgtfr mgshffl`ferfgsf`ùf ta mfrealìtial

FdikilgtialRgttfrl

+ Fdikilgtfsalef g `gy$usugddy iltmf karlilj

+ @fnfegtfstwief gwffc,

+ Nrfquflturilgtial

+ @fnfegtfs alefg `gy,

+ Vrilgtfs 6tikfs g `gy

+ Fdikilgtialpgttfrl mgshfflgdtfrf` ùfta mfr

ealìtial

UdffpiljRgttfrl

+ Vsugddysdffpsgraul` 9 ar72 il tmffvfliljgl` wgcfsup graul`6 gk al gtypiegd `gy,

+ Udffp gtgraul` 6 : pk gl`wgcfs upgraul` 0 > gk

+ Vsugddy gwgcf + Udffpiljpgttfrl mgshffliltfrruptf`ùf ta tmfrfefltealìtial

UaeigdRgttfrl

+ Umf is g

nrifl`dypfrsal,

+ @rilcstuhg glìs g skacfr

+ Vsugddy

stgys gtmakf

+ Xfnrgilnrak`rilciljtuhg glÙkacilj,

+ Eakkuliegtial

ta mis rfdgtivfgl` atmfrpfapdf mgshffl dikitf`,

+ Uaeigd

pgttfrl mgshfflgdtfrf` ùfta mfrealìtial,


11/61

XF^IFZ AN UYUPFKU

Jflfrgd Uurvfy? upal gssfsskflt$ tmf pgtiflt wgs sffl al hf` ealseiaus,

^!U? P ; 5:,:E3 R ;9= hpk3 XX ;80 epk3 HR ;7=2!92 kkMj,

Rmysiegd Gssfsskflt

Uystfk Utrue turfs Larkgd Nil`iljs Xfkgrcs

Iltfjukfltgry

Uizf$ smgpf .

sykkftry

Mfg

Rrfsflef an la udfs .kgssfs

UegdpMgir

Pmieclfss!tmillfssPfxturf

Gkault

FyfhrawsFyfs

Fyfdi sFyfdgsmfs

Ealouletivg

Fxtfrlgd LasfLasf

Guriedf eadarFgrs

UizfRasitial

EadarUcil

Eurvgturf . gljdf

Lgids

EadarPfxturf

Egpiddgry rfnidd

Xaul f $ skaatm scudd

ealtaurUkaatm$ ulinarkealsistfley$ghsflef an la udfsar kgssfs

Fvfldy istrihutf mgirPmiec mgirUidcy$ rfsidiflt mgir^grighdf

Mgir fvfldy istrihutf`

Ucil iltget sagrFqugddy istrihutf`

Prglspgrflt . smily

Uykkftrie . strgijmt

Eadar sgkf gs ngeigd scil

NirkUykkftrie pasitial

La segr

La dfsials

Vlinark il grfgsfxpasf ta tmf sul

Ealvfx eurvgturf .gljdf 7>2

Mijmdy vgseudgr . pilcUkaatm tfxturf

Larkgd il sizf$

raul f $Ghsflef anla udf arkgssfs$skaatm scudd,

Fvfldyistrihutf mgir

Pmiec mgirUidcy$ rfsidifltmgir

^grighdf

Uykkftriegddygdijlf`

Ucil iltgetFqugddy

istrihutf`Prglspgrflt .smily

Uykkftriegd glstrgijmt$ largilgjf,

Eadar sgkf gsngeigd scil

NirkUykkftriegd

Uegr latf alhatm dfjs

Dfsials latf alhatm dfjs

Vlinarkf ilgrfgs fxpasfta tmf sul

Ealvfx ileurvgturf

RgdfUkaatm

Ahtgilf uriljal mfremid maa yfgrs

@uf ta glfkig


12/61

Lfec kusedfsLfec

UcilDawfr Fxtrfkitifs

Rrakpt rfturl an pilc arusugd eadar -5 sfe,)

Fqugd il sizf$ mfgèfltfrf`

La f fkg

Rrakpt rfturl tausugd eadar -5

sfe,)Fqugd il sizf$mfg efltfrf

F fkg al hatmdfjs-Rittilj f fkg an86,0 kk)

@uf ta ci lfyngidurf

Xfspirgtary

XXEmfst

Hrfgtmilj Rgttfrl

Uferftials

76+82 epkWuit$ rmytmkie .

fnnartdfss

rfspirgtialLalf

80 epk@ysplie

Lalf

Hfe, anferfgsf A8

egrryilj XHE il

vitgd arjgls suemgs tmf duljs

Egrìavgseudgr

Rfripmfrgd RudsfRgdpgtials

UcilRfripmfrgd Rfrnusial

Nudd pgdpgtials

Ucil eadar pilcUcil tfkpfrgturf lat

fxefssivfdy wgrk aread

Nudd pgdpgtials

RgdfUcil tfkpfrgturflarkgd

@uf ta glfkig

Jgstrailtfstilgd

Dips

Kautm

Juks

Pfftm

Paljuf

UcilGh akfl

RgdpgtialDijmt pgdpgtial

@ffp Rgdpgtial

Rilc . kaist

Ukaatm . smily

58 gùdt tfftm

Efltrgd pasitial .skaatm

Vlhdfkismf scil .

ulinark il eadar

La tfl frlfss3 rfdgxfgh akfl witmskaatm$ ealsistflttflsial

La tfl frlfss

@ry dips$ sdijmtdypgdf

Udijmtdy `grc ileadar

Ileakpdftfflturfs

Efltrgd pasitial

Vlhdfkismf

scil glulinarkf ileadarLatftfl frlfss glmypfrsfltivityal DDWDaegdizf`tfl frlfss alDDW

@uf ta rylfssan kueasgddililj hfe , smfwgs ysplie@uf ta skacilj

@uf ta ci lfyikpgirkflt

@uf ta ci lfyikpgirkflt

JVP

RgdpgtialHdg fr

Rfreussial

Lat Rgdpghdf

@uddlfss witm nudd hdg``fr

@istfl f gl

pgdpghdf gsskaatm$ raul $tflsf kgssDgrjf udd grfgs

@uf ta urilgry

rftfltial


13/61

GLGPAKY GL@ RMYUIADAJY

PMF FL@AEXILF UYUPFK

Pmf lfrvaus systfk sfl`s fdfetriegd kfssgjfs ta ealtrad gl` eaarìlgtf

tmf ha`y, Pmf flàerilf systfk mgs g sikidgr oah$ hut usfs emfkiegds ta

eakkuliegtf, Pmfsf emfkiegds grf clawl gs markalfs, G markalf is g

spfeinie kfssfljfr kadfeudf syltmfsizf` gl` sferftf` hy g jraup an spfeigdizf`

efdds egddf` gl flàerilf jdgl`, Pmfsf jdgl`s grf ùetdfss$ wmiem kfgls tmgt

tmfir sferftials -markalfs) grf rfdfgsf` ìrfetdy ilta tmf hdaa`strfgk gl` trgvfd

ta fdsfwmfrf il tmf ha`y ta tgrjft arjgls$ upal wmiem tmfy get,

Nuletial

Pmf Flàerilf systfk is gl ilnarkgtial sijlgd systfk kuem dicf tmf

lfrvaus systfk, Mawfvfr$ tmf lfrvaus systfk usfs lfrvfs ta ealùet

ilnarkgtial$ wmfrfgs tmf flàerilf systfk kgildy usfs hdaa` vfssfds gs

ilnarkgtial emgllfds, Jdgl`s daegtf` il kgly rfjials an tmf ha`y rfdfgsf ilta

tmf hdaa`strfgk spfeinie emfkiegd kfssfljfrs egddf` markalfs, Markalfsrfjudgtf tmf kgly gl` vgrif` nuletials an gl arjglisk$ f,j,$ kaa`$ jrawtm gl`

`fvfdapkflt$ tissuf nuletial$ gl` kftghadisk$ gs wfdd gs sflìlj kfssgjfs gl`

getilj al tmfk,

Xadf il ìsfgsf

@isfgsfs an tmf flàerilf systfk grf eakkal$ ileduìlj ìsfgsfs suem

gs ìghftfs kfdditus$ tmyrai` ìsfgsf$ gl` ahfsity, Flàerilf ìsfgsf is

emgrgetfrisf` hy `ysrfjudgtf` markalf rfdfgsf -g praùetivf Rituitgry

g`flakg)$ ilgppraprigtf rfspalsf ta sijlgddilj -Mypatmyraiìsk)$ dgec ar

`fstruetial an g jdgl` -@ighftfs kfdditus typf 7$ ìkilismf` frytmrapaifsis il

Emralie rflgd ngidurf)$ ar strueturgd fldgrjfkflt il g eritiegd sitf suem gs tmf lfec

-Paxie kudtilaùdgr jaitrf), Mypanuletial an flàerilf jdgl`s egl aeeur gs rfsudt

an dass an rfsfrvf$ mypasferftial$ gjflfsis$ gtrapmy$ ar getivf `fstruetial,

Mypfrnuletial egl aeeur gs rfsudt an mypfrsferftial$ dass an supprfssial$

mypfrpdgstie$ ar lfapdgstie emgljf$ ar mypfrstikudgtial,

Flàerilapgtmifs grf edgssinif` gs prikgry$ sfeal`gry$ ar tfrtigry, Rrikgry

flàerilf ìsfgsf ilmihits tmf getial an àwlstrfgk jdgl`s, Pfrtigry flàerilf

ìsfgsf is gssaeigtf` witm `ysnuletial an tmf mypatmgdgkus gl` its rfdfgsilj

markalfs,


14/61

Eglefr egl aeeur il flàerilf jdgl`s$ suem gs tmf tmyrai`$ gl` markalfs

mgvf hffl ikpdiegtf` il sijlgddilj ìstglt tissufs ta pradinfrgtf$ nar fxgkpdf tmf

Fstrajfl rfefptar mgs hffl smawl ta hf ilvadvf` il efrtgil hrfgst eglefrs,

Flàerilf$ Rgrgerilf$ gl` gutaerilf sijlgddilj mgvf gdd hffl ikpdiegtf` il

pradinfrgtial$ alf an tmf rfquirf` stfps an aleajflfsis,

Jdgl`s an tmf Mukgl Flàerilf Uystfk

Markalfs sferftf` hy tmf kgil Flàerilf Jdgl`s

Jdgl` Markalf-s) Uferftf` Nuletial-s) an Markalfs

Rituitgry Pmf pituitgry jdgl` is g skgdd avgd flàerilf jdgl` tmgt difs gt tmf

hgsf an tmf hrgil, It is sakftikfs egddf` tmf kgstfr jdgl` an tmf

ha`y, Pmis pgrt an tmf hrgil ealsists an tmrff dahfs egddf`

(gltfriar($ (iltfriar( gl` (pastfriar(,

Rastfriar Axytaeil Utikudgtfs utfrilf ealtrgetialgl` hrfgst ealtrgetial narkidc rfdfgsf,

Glti +@iurft ie Utikudgtfs rf+ghsarptial an


15/61

Markalf -G@M)$gdsa clawl gs

*vgsaprfssil*

wgtfr nrak ci`lfy tuhudfs,

Mypa+

egusfs @ighftfsIlsipiùs -dgrjf gkaults anurilf praùef`),

Gltfr iar Rradgetil -RXD) Rraùetial an hrfgst kidc-warcs il kfl taa),

Mukgl JrawtmMarkalf -MJM) +

Jrawtm

Mypa

+ @wgrnisk

Mypfr

+Jijgltisk

Pmyrai` UtikudgtiljMarkalf -PMU)

Utikudgtfs tmf tmyrai` tarfdfgsf tmyraxil,

G`rflaeartieatrapmie Markalf -GEPM) +

Utikudgtfs tmf g`rflgd eartfxta praùef?

Eartieastfrai`s

+kilfrgdeartieai`s

+jdueaeartieai`s

+eartisad-lgturgd glti+ilndgkkgtary)

+gl`rajfls$f,j,geàstfralf,

DutfiliziljMarkalf -DM)

Hriljs ghaut avudgtial gl`kgiltgils tmf earpus dutfuk,

Naddiedf UtikudgtiljMarkalf -NUM)

Utikudgtfsjrawtm!`fvfdapkflt anJrggnil naddiedfs -; g kgturfnaddiedf il tmf avgry priar taavudgtial$ ealtgililj g dgrjf

ndui`+niddf` egvity tmgt ìstfl`stmf surngef an tmf avgry) algpprax, 8= `gy eyedf,

Kfdglil UtikudgtiljMarkalf -KUM)


16/61

Jalgàtrapmils + Ufeal`gry sfxugdemgrgetfristies,

Iltfrstitigd EfddUtikudgtiljMarkalf -IEUM)

Zarcs al tmf sfkilinfraustuhudfs il tmf tfstfs tapraùef spfrk wmiem tgcf87 `gys ta kgturf,-In lat fogeudgtf` witmil 87`gys$ tmf spfrk grf rf+ghsarhf` hgec ilta tmf ha`y,)

Rilfgd G pfg+sizf` kgss an lfrvf tissuf gttgemf` hy g stgdc ta tmfpastfriar wgdd an tmf tmir` vfltriedf an tmf hrgil$ `ffp hftwffl tmfefrfhrgd mfkispmfrfs gt tmf hgec an tmf scudd,

Kfdgtalil G markalf praùef` hy tmfpilfgd jdgl` il `grclfss hut latil hrijmt dijmt,

Kfdgtalil rfefptars il tmf hrgilrfget ta tmis markalf gl`sylemralizf tmf ha`y ta tmf 80maur `gy!lijmt rmytmk$ tmusilnarkilj tmf hrgil wmfl it is `gygl` wmfl it is lijmt,

Kfdgtalil is `frivf` nraksfrgtalil$ witm wmiem it warcs tarfjudgtf tmf sdffp eyedf,

Pmyrai`Jdgl`

Daegtf` il tmf gltfriar pgrt an tmf lfec il tmf ki`dilf, It ealsistsan twa dgtfrgd dahfs dyilj al fgem si`f an tmf tmyrai` egrtidgjf-G`gk*s gppdf) gl` eallfetf` hy g hgl` an tissuf egddf` tmfistmkus,

Pmyraxil Ealefrlf` witm tmf HgsgdKftghadie Xgtf -HKX)$ wmiem istmf gkault an flfrjy tmf ha`yusfs$ oust ta tiec avfr,

Mypfr+Pmyraiìsk ; avfr+getivftmyrai` ; PmyrataxieasisUykptaks? ilerfgsf il HKX3ilerfgsf il mfgrt+rgtf3 dass anwfijmt3 mypfr+getivity3 ilsaklige3

`fvfdaps hudjilj fyfs ùf tageeukudgtial an ndui` hfmil` tmffyf3 kgy `fvfdap Jaitrf3 passihdfdilc witm Gttfltial @fnieit @isar`fr,

Mypa+Pmyraiìsk


17/61

Uykptaks3 `ferfgsf il HKX3wfijmt jgil3 dftmgrjy3 scil hfeakfs

`ry gl` punny3 mgir hfeakfs tmilgl` hrittdf,Egusfs? @frhysmirf Lfec-arijilgddy ùf ta ilsunnieiflt iaìlfil tmf said il @frhysmirf)$ Jrgvfs@isfgsf$ gl` Erftilisk -; kftgdgl` sfxugd `fvfdapkflt ikgpgirf`$in aeeurs il emid`rfl),

Egdeitalil Vptgcf an egdeiuk ta half,

Rgrgtmyrai` Jdgl`

Ukgdd jdgl`s an tmf flàerilf systfk wmiem grf daegtf` hfmil`tmf tmyrai`, Pmfrf grf naur pgrgtmyrai` jdgl`s wmiem grf larkgddyghaut tmf sizf an g pfg,

Rgrgtmarkalf Gssaeigtf` witm tmf jrawtm ankusedf gl` half,

@istrihutial an egdeiuk gl`pmaspmgtf il tmf ha`y,

Mypfr+ Egusfs trglsnfr an egdeiuk

nrak tmf halfs ta tmf hdaa`3 halfshfeakf nrgjidf . fgsidy hracfl3astfaparasis,-Rgrgtmarkalf getivity is ilmihitf`hy afstrajfl,)

Mypa+

Dawfrs hdaa` egdeiuk dfvfds$egusilj tftgly -wmiem kgy hftrfgtf` hy ilofetials an tmfmarkalf)3 daw egdeiuk dfvfds ilscfdftgd kusedf -wmiem kgy egusf

ergkps),

Pmykus Pmf tmykus jdgl` is daegtf` strg``df` gerass tmf trgemfg .hralemi il tmf uppfr tmargx -g hi+dahf` arjgl il tmf raat an tmflfec$ ghavf gl` il nralt an tmf mfgrt),Pmf tmykus -g jdgl` gssaeigtf` witm tmf ikkulf systfk)$ isfledasf` il g egpsudf gl` ìvi`f` iltfrlgddy hy erass+wgdds iltakgly dahudfs -nudd an P+dykpmaeytfs),

Pmykasil Getivgtfs tmf ikkulf systfk hygetivgtilj tmf P+Efdds -P+Ciddfr

Efdds3 P+Mfdpfr Efdds3 P+KfkaryEfdds),

P+Dykpmaeytfs Pmf tmykus ealsists an dahudfsnudd an P+dykpmaeytfs -wmitfhdaa` efdds gssaeigtf` witm


18/61

gltiha`y praùetial),

P+dykpmaeytfs kijrgtf nrak tmfhalf kgrraw ta tmf tmykus$wmfrf tmfy kgturf gl`ìnnfrfltigtf ultid getivgtf` hygltijfls,

Rglerfgs Pmf mukgl pglerfgs wfijms gppraxikgtfdy =2 jrgks$ mgsraujmdy ealnijurgtial an gl ilvfrtf` skacfr*s pipf$ gl` issitugtf` il tmf uppfr ghàkfl, Pmf mfg` an tmf pglerfgs-fquivgdflt ta tmf hawd an tmf pipf) is ikkfìgtfdy gògeflt ta tmfùa`fluk$ wmidf its ha`y gl` tgid fxtfl` gerass tmf ki`dilf

lfgrdy ta tmf spdffl,

Isdfts anDgljfrmgl

Daegtf` witmil tmf pglerfgs, Ealtgils jraups an hatm Gdpmg+ gl`Hftg+ efdds,

Hftg Efdds Ilsudil Ealvfrsial an jdueasf tajdyeajfl,

Efddudgr up+tgcf an Jdueasf,

Ealvfrsial an fxefss jdueasf tangt,

Mypa+

Uykptaks? Hdaa` jdueasf dfvfdsrisf -mypfrjdyegfkig), Jdueasf isfxerftf` ilta tmf urilf -jdyeasurig)+ wmiem ilerfgsfs dfvfds anurilgtial$ egusilj `fmy`rgtial,

Gs jdueasf dfvfds il tmf hdaaìlerfgsf$ ngt gl` pratfil grfhracfl+àwl nar flfrjy, Eakg gl``fgtm kgy naddaw in tmf sykptaksgrf lat trfgtf`,

egusfs @ighftfs Kfdditus?

GdpmgEfdds

Jduegjal Ealvfrsial an jdyeajfl tajdueasf,

G`rflgdJdgl`s

Pmf g`rflgd jdgl`s grf argljf+eadarf` flàerilf w!e grfdaegtf` al tmf tap an hatm ci`lfys ,

G`rflgdil-Fpilfpmrilf)

Rrfpgrfs tmf ha`y nar (nrijmt$ nijmtar ndijmt( gl` mgs kgly fnnfets?

Getial an mfgrt ilerfgsf`,

Xgtf gl` `fptm an hrfgtmilj


19/61

ilerfgsf`,

Kftghadie rgtf ilerfgsf`,

Naref an kuseudgr ealtrgetialikpravfs,

Alsft an kuseudgr ngtijuf`fdgyf`,

Hdaa` suppdy ta tmf hdg``fr glìltfstilfs rfùef`$ tmfirkuseudgr wgdds rfdgx$ tmfspmiletfrs ealtrget,

Larg`rflgdil -Larfpilfpmrilf)

Uikidgr fnnfets ta g`rflgdil?

Ealstrietial an skgdd hdaa`vfssfds dfgìlj ta ilerfgsf ilhdaa` prfssurf,

Ilerfgsf` hdaa` ndaw tmraujm tmfearalgry grtfrifs gl` sdawilj anmfgrt rgtf,

Ilerfgsf il rgtf gl` `fptm anhrfgtmilj,

Xfdgxgtial an tmf skaatm kusedfil tmf iltfstilgd wgdds,

Avgrifs Pmf avgrifs grf pgir an nfkgdf rfpraùetivf arjgls, Pmfy grfdaegtf` il tmf pfdvis$ alf al fgem si`f an tmf utfrus,

fstrajfl Hrfgc+àwl an tmf utfrilf wgdd,

Rrajfstfralf Huid`s up gl` kgiltgils tmfutfrus wgdd nar fkhf`ìlj annfrtidizf` fjj,

Gssaeigtf` witm sfeal`grysfxugd emgrgetfristies$ f,j, ha`ymgir$ hrfgst fldgrjfkflt$emgljfs il pmysiegd ha`y,

Pfstfs Pwa jdgl`s suspfl`f` witmil g sge an scil egddf` seratuk, Pmfy

grf eakpasf` an g dgrjf lukhfr an sfkilinfraus tuhudfs

Pfstastfralf @fvfdapkflt gl` nuletial ankgdf sfx arjgls,

Ufeal`gry sfxugdemgrgetfristies, f,j, ha`y mgir$


20/61

kusedf `fvfdapkflt$ vaiefemgljf,

Pmf Flàerilf Rglerfgs

Pmf pglerfgs mausfs twa ìstiletdy ìnnfrflt tissufs, Pmf hudc an its kgss

is fxaerilf tissuf gl` gssaeigtf` ùets$ wmiem praùef gl gdcgdilf ndui` dag`f`

witm ìjfstivf flzykfs wmiem is `fdivfrf` ta tmf skgdd iltfstilf ta ngeiditgtf

ìjfstial an naa`stunns, Uegttfrf` tmraujmaut tmf fxaerilf tissuf grf sfvfrgd

mul`rf` tmausgl` edustfrs an flàerilf efdds wmiem praùef tmf markalfs

ilsudil gl` jduegjal$ pdus g nfw atmfr markalfs,Ilsudil gl` jduegjal grf eritiegd pgrtieipglts il jdueasf makfastgsis gl`

sfrvf gs geutf rfjudgtars an hdaa` jdueasf ealefltrgtial, Nrak g kfìegd

pfrspfetivf$ ilsudil il pgrtieudgr is flarkausdy ikpartglt + g `fnieifley il ilsudil

ar `fnieits il ilsudil rfspalsivflfss dfg` ta tmf ìsfgsf ìghftfs kfdditus,

Pmf pglerfgs is gl fdaljgtf` arjgl lfstdf` lfxt ta tmf nirst pgrt an tmf

skgdd iltfstilf, Pmf flàerilf pglerfgs rfnfrs ta tmasf efdds witmil tmf pglerfgs

tmgt syltmfsizf gl` sferftf markalfs,

Pmf flàerilf partial an tmf pglerfgs tgcfs tmf nark an kgly skgdd

edustfrs an efdds egddf` isdfts an Dgljfrmgls ar$ karf sikpdy$ isdfts, Mukgls mgvf

raujmdy alf kiddial isdfts, Il stgl`gr` mistadajiegd sfetials an tmf pglerfgs$ isdfts

grf sffl gs rfdgtivfdy pgdf+stgililj jraups an efdds fkhf``f` il g sfg an `grcfr+

stgililj fxaerilf tissuf,

Rglerfgtie isdfts mausf tmrff kgoar efdd typfs$ fgem an wmiem praùefs g

ìnnfrflt flàerilf praùet?

Gdpmg efdds -G efdds) sferftf tmf markalf jduegjal,

Hftg efdds -H efdds) praùef ilsudil gl` grf tmf kast ghul`glt an tmf isdft

efdds,

@fdtg efdds -@ efdds) sferftf tmf markalf sakgtastgtil$ wmiem is gdsa

praùef` hy g lukhfr an atmfr flàerilf efdds il tmf ha`y,

Iltfrfstiljdy$ tmf ìnnfrflt efdd typfs witmil gl isdft grf lat rglàkdy

ìstrihutf` + hftg efdds aeeupy tmf efltrgd partial an tmf isdft gl` grf surraul`f`

hy g (ril`( an gdpmg gl` `fdtg efdds, Gsi`f nrak tmf ilsudil$ jduegjal gl`

sakgtastgtil$ g lukhfr an atmfr (kilar( markalfs mgvf hffl i`fltinif` gs

praùets an pglerfgtie isdfts efdds,


21/61

Isdfts grf riemdy vgseudgrizf`$ gddawilj tmfir sferftf` markalfs rfg`y

geefss ta tmf eireudgtial, Gdtmaujm isdfts eakprisf aldy 7+8& an tmf kgss an tmf

pglerfgs$ tmfy rfefivf ghaut 72 ta 76& an tmf pglerfgtie hdaa` ndaw,

G`ìtialgddy$ tmfy grf illfrvgtf` hy pgrgsykpgtmftie gl` sykpgtmftie lfurals$

gl` lfrvaus sijlgds edfgrdy kaùdgtf sferftial an ilsudil gl` jduegjal,

PMF VXILGXY UYUPFK

Pmf urilgry systfk ealsists an twa ci`lfys$ twa urftfrs$ tmf urilgry

hdg``fr$ gl` tmf urftmrg, Pmf narkgtial an urilf is tmf nuletial an tmf ci`lfys$

gl` tmf rfst an tmf systfk is rfspalsihdf nar fdikilgtilj tmf urilf,Ha`y efdds praùef wgstf praùets suem gs urfg$ erfgtililf$ gl`

gkkalig$ wmiem kust hf rfkavf` nrak tmf hdaa` hfnarf tmfy geeukudgtf ta

taxie dfvfds, Gs tmf ci`lfys nark urilf ta fxerftf tmfsf wgstf praùets$ tmfy gdsa

geeakpdism sfvfrgd atmfr ikpartglt nuletials?

7, Xfjudgtial an tmf vadukf an hdaa` hy fxerftial ar ealsfrvgtial an wgtfr

8, Xfjudgtial an tmf fdfetradytf ealtflt an tmf hdaa` hy tmf fxerftial ar

ealsfrvgtial an kilfrgds

5, Xfjudgtial an tmf gei`hgsf hgdglef an tmf hdaa` hy fxerftial ar

ealsfrvgtial an ials suem gs MQ ials ar MEA5Q ials

0, Xfjudgtial an gdd an tmf ghavf il tissuf ndui`


22/61

Ci`lfys

Mgs g miduk nar pgssgjf an

+ 8 -pgirf`), Pmf dfnt is mijmfr tmgl tmf rijmt ùf ta tmf prfsflef an tmf

divfr,

7, rflgd grtfry

8, rflgd vfil

5, urftfr

0, lfrvfs

is daegtf` rftrapfritalfgd, It is fkhf``f` il ngt, Pmis ngtty pauem ealsists

an 5 dgyfrs?

7, Xflgd egpsudf + illfrkast dgyfr, Is stralj gl` nihraus, It isgttgemf` ta tmf ci`lfy, It nuletials ta prfvflt ilnfetial,

8, Gìpasf egpsudf + sfeal` dgyfr, Is g pratfetivf dgyfr,

5, Xflgd ngseig + tmir` dgyfr, Is g suppartivf dgyfr, It glemars tmf

ci`lfy ta tmf pfritalfuk gl` tmf ghàkilgd wgdd,

Ci`lfy strueturf

7, Autfr eartfx + kgly egpiddgrifs

Mgs twa dgyfrs

8, illfr kfùddg + kgly hdaa` vfssfds gl` tuhudfs

g, rflgd pyrgki`s + tuhudfs -tips ; rflgd pgpiddg)

h, rflgd eadukls + sfpgrgtf pyrgki`s, Prglskit hdaa` vfssfds

Lfpmral

+ tmf nuletialgd ulit an tmf ci`lfy, It nuletials ta praùef urilf, It is

kg`f up an kgly tuhudfs gl` tmfir gssaeigtf` hdaa` vfssfds, Pmfrf grf avfr 7

kiddial lfpmrals

Jdakfrudus

+ G tunt an egpiddgrifs witm nflfstrgtials

Jdakfrudgr -Hawkgl*s) egpsudf + surraul`s tmf jdakfrudus, Pajftmfr tmfy nark

tmf rflgd earpusedf, Pmf fpitmfdiuk an tmf jdakfrudgr egpiddgrifs ealtgils parfs

egddf` nflfstrgf, Pmfsf gddaw nidtrgtf hut LAP pratfils ta pgss nrak tmf hdaa` ilta

tmf jdakfrudgr egpsudf, Pmf jdakfrudgr egpsudf mgs g pgriftgd gl` g visefrgd

dgyfr, Pmf pgriftgd dgyfr

Pmf visefrgd dgyfr is kg`f up an mijmdy spfeigdizf` efdds egddf` paàeytfs, Pmfsf

efdds mgvf naat praefssfs -pfìefds) wmiem dilf tmf hgsfkflt kfkhrglf an tmf

jdakfrudus, Hftwffl tmf naat praefssfs wf sff nidtrgtial sdits wmiem gddaw tmf

nidtrgtf ta pgss ilta tmf egpsudgr spgef,

is nar strueturf aldy gl` àfs lat pdgy g radf il nidtrgtial,


23/61

Rraxikgd ealvadutf` tuhudf

+ Mfrf wf sff euhai`gd efdds witm g hrusm har`fr

-kieraviddi) Pmfsf efdds rfsarh suhstglefs nrak tmf nidtrgtf gs wfdd gs sferftf

suhstglefs ilta tmf nidtrgtf, Pmf kieraviddi jrfgtdy ilerfgsf tmf ghidity ta rfsarh

wgtfr,

Daap an Mfldf

+ mgs hatm gseflìlj gl` `fseflìlj dikhs

@fseflìlj dikh

+ -tmil sfjkflt) is sikpdf squgkaus fpitmfdiuk gl` is mijmdy

pfrkfghdf ta wgtfr,

Gseflìlj dikh

+ -tmiec sfjkflt) tmf fpitmfdiuk is euhai`gd ar fvfl daw

eaduklgr,

@istgd ealvadutf` tuhudf

7, iltfregdgtf` efdds -euhai`gd witm kieraviddi) + tmfsf nuletial il gei`!hgsf

hgdglef an tmf hdaa`,

+ mfrf tmf efdds grf euhai`gd gl` tmillfr tmgl tmasf sffl

il tmf praxikgd ealvadutf` tuhudf, Pmis smaws tmgt tmfsf efdds pdgy g radf il

sferftilj suhstglefs ilta tmf nidtrgtf rgtmfr tmgl rfkavilj suhstglefs nrak it,

Mfrf wf gdsa sff twa efdd typfs?

8, prileipgd efdds - la kieraviddi) + tmfsf nuletial il ha`y Lg# gl` wgtfr

hgdglef,

Eaddfetilj ùet

+ Lat g pgrt an tmf Lfpmral, Pmf ìstgd ealvadutf` tuhudfs

eallfet ta eaddfetilj ùets, Rgssfs tmraujm tmf rflgd pyrgki`s gl` fl`s gt tmf

rflgd pgpiddgf wmfrf it fkptifs ilta g kilar egdyx,

Pwa typfs an Lfpmrals?

7, Eartiegd lfpmrals? tmfsf kgcf up =6& an aur lfpmrals, Zitm tmf

fxefptial an tmf tip an tmf daap an Mfldf tmfsf lfpmrals grf daegtf` il

tmf rflgd eartfx,

8, Ouxtgkfùddgry lfpmrals? mfrf tmf rflgd earpusedfs grf daegtf` il tmf

eartfx$ yft vfry lfgr tmf eartfx+kfùddg ouletial,

Hdaa` suppdy + rflgd grtfrifs nff` ilta sfjkfltgd grtfrifs$ wmiem turl iltailtfrdahgr grtfrifs -il rflgd eadukls) wmiem nff` ilta greugtf grtfrifs -hrglemf`

aut gt tmf dfvfd hftwffl tmf eartfx gl` kfùddg), Iltfrdahudgr grtfrifs hrglem ann

an tmf greugtf grtfrifs gl` rul aut ilta tmf eartfx, Nrak tmfsf hrglem tmf gnnfrflt

grtfriadfs wmiem hrilj hdaa` ta tmf jdakfrudi -hdaa` nidtrgtf fltfrs tmf urilgry


24/61

tuhudfs), Hdaa` dfgvilj tmf jdakfrudus fltfrs gl fnnfrflt grtfriadf wmiem tgcfs

tmf hdaa` ta pfrituhudgr egpiddgrifs graul` tmf ealvadutf` tuhudfs AX vgsg rfetg

surraulìlj tmf gseflìlj gl` `fseflìlj dikhs an Mfldf, Gt tmis pailt tmf hdaa`

fltfrs vfils tmgt pgrgddfd tmf grtfrifs, Pmgt is$ iltfrdahudgr vfils ta greugtf vfils

ta iltfrdahgr vfils ta rflgd vfils ta tmf IÊ,

Vrftfrs

+ grf rftrapfritalfgd gl` pgirf`, + fltfr tmf urilgry hdg``fr

Pmf wgdd an tmf urftfr mgs 5 dgyfrs -tulies)

7, illfr kueasg

8,

+ ealtiluaus witm tmf dililj an tmf urilgry hdg``fr, It mgs

trglsitialgd fpitmfdiuk tmgt sferftfs g pratfetivf kueaus -duhriegtial)

ki``df dgyfr

5,

+ Kuseudgris, It mgs gl illfr daljituìlgd gl` autfr eireudgr

dgyfr an skaatm kusedf,

Autfr dgyfr

+ nihraus eagt kg`f an daasf EP, Pmis eagt eavfrs tmf

urftfr gl` glemars it il pdgef,

Vrilgry hdg``fr

+ stargjf hgj nar urilf, It is daegtf` hfmil` tmf puhie sykpmysis

yft il nralt an tmf rfetuk il kgdfs gl` il nralt an tmf utfrus il nfkgdfs,

Pmf wgdd mgs 0 dgyfrs?

7, Kuseag

8,

+ illfrkast dgyfr, Mgs trglsitialgd fpitmfdiuk, Zidd nil` kgly

nad`s -rujfg) fxefpt il tmf grfg clawl gs tmf trijalf, Pmis is g

trigljudgr grfg `fkgregtf` hy tmrff pailts$ tmf twa apfliljs an tmf

urftfrs gl` tmf fxit pailt nar tmf urftmrg,

Uuhkueasg

5,

+ supparts tmf kueasg

Kuseudgris + mgs tmrff dgyfrs egddf` `ftrusar

0,

kusedf, Pmis kusedf

mfdps ta nark tmf iltfrlgd urftmrgd spmiletfr,

Ufrasg

+ autfrkast dgyfr, It is naul` aldy al tmf supfriar surngef an tmf

hdg``fr, It is getugddy g ealtilugtial an tmf pfritalfuk,

Vrftmrg

kgdf + daljfr, Ealsists an tmrff rfjials

+ nfkgdf + smart, Gpprax, 0 ek dalj

7, prastgtie urftmrg

8,

+ pgssfs tmraujm tmf prastgtf jdgl`

kfkhrglaus urftmrg5,

+ pgssfs tmraujm tmf VJ ìgpmrgjkRflidf -spaljy) urftmrg

+ pgssfs tmf dfljtm an tmf pflis,

Vrftmrgd wgdd +Pmf ilsi`f an tmf wgdd is dilf` hy kueaus kfkhrglf surraul`f` hy

g tmiec dgyfr an skaatm kusedf, Zf gdsa sff urftmrgd jdgl`s wmiem sferftf


25/61

kueaus ilta tmf urftmrgd eglgd, Pmfrf is gl fxtfrlgd urftmrgd spmiletfr wmiem is

eakpasf` an vadultgry scfdftgd kusedf,

Kieturitial

+ urilgtial$ wmiem is g rfndfx getial, Utrftem rfefptars getivgtf tmf

`ftrusar kusedf gl` rfdgx tmf iltfrlgd urftmrgd spmiletfr, Pmf fxtfrlgd urftmrgd

spmiletfr is ul`fr vadultgry ealtrad gntfr gpprax, 8 yfgrs an gjf, Pmis mgs ta `a

witm jrawtm an tmf spilgd ear` gl` gppraprigtf lfrvfs,


26/61

@K PYRF 8Dfss sflsitivity an tissuf ta ilsudil

Ikpgirf` utidizgtial an ilsudil .

jdueasf

Ilghidity an jdueasf ta pflftrgtf tmf

efdd

Efdd stgrvgtia l Mypfrjdy efkig

Ilerfgsf` pdgskg askadgdity a n

jdueasf

Jdueasf spidd ta rflgd tuhudfs

-Jdueasurig)

Jdueasf gttrgets wgtfr

Fxefssivf Vrilgtial -Radyurig)

Pmf efdd widd smrilc!`fmy`rgtf`

Fxefssivf tmirst -Radyìpsig)

Ilerfgsf` hgsgd mfpgtie jdu easf

praùetial

Utikudgtf hrgil

-Mypatmgdgkus) t a fgt

Fxefssivf mu ljfr

-Radypmgjig)

Emralie fdfvgtial an

hdaa` jdueasf

Hrfgcàwl an ngts

-Dypadysis)

Mypfrdipi`fkig

Nrff ngtty gei`s

Gtm fras edfra sis

Mypfrtflsial

`ferfgsf hdaa` p frnusialan suppdy ta vitgd arjgls

@ighftie Xftilapgtmy

Ikpgirf` ikkulf nuletial

@ighftie Lfurapgtmy

Ilnfetial

Uu``fl visial emgljfs Lukhlfss . tiljdilj il tmf

dawfr fxtrfkitifs

Zfijmt dass

Rrfìspasilj

Ngetar

Mfrf itgry

Dinf Utydf

Ad gjf

Rrfeipitgtilj

Ngetar

Jflfs

Ahfsity

>9 yrs ad

@ighftie Lfpmrapgtmy


27/61

LFRMXARGPMY

Fgrdy jdakfrudgr mfka`ylgkie

emgljfs

Mypfrnidtrgtial . Mypfrpfrnusial

@ysnuletial an gutarfjudgtary

rfspalsf

Kieragdhukilurig

Ilerfgsf grtfrigd idgtial

Ilerfgsf` kfssgljigd efdd

kgtrix praùetial

Ilerfgsf` iltrgjdakfrudgr

prfssurf

Ilerfgsf` fxtrgefddudgr

kgtrix `fpasitial .

kfssgljigd mypfrtrapm y

Fxpglsial an kfssgljigd

grfg

Rrfìspasilj

Ngetar

Dalj Utgl ilj @KAd Gjf

Rrfeipitgtilj

Ngetar

76yrs>9 yrs adMypfrtflsialMypfrjdyefkig

@ferfgsf` jdakfrudgr

nidtrgtial rgtf

Xfùetial an tmf surngef

grfg nar n idtrgtial

Kgrcs tmf hfjill ilj an

rflgd ngidurf

@ferfgsf` jdakfrudgr

nidtrgtial

Ilerfgsf` saìuk

erfgtililfIlerfgsf HVL

Mypftrapmy an rfkgililj

lfpmrals

Ilghidity ta ealefltrgtf

urilf


28/61

Nurtmfr dass an lfpmral nuletial

Dass an lalfxerftary rflgd

nuletial

Ngidurf ta pra`uef

frytmrapaiftil

Dass an fxerftary rflgd

nuletial

Glfki g$ pgdd ar$

wfgclfss$ ngtiju f

Ikkulf isturhglefs

Ilnfetial

@ferfgsf` sa` iuk

rfghsarptial il tuhudf

Zgtfr rftfltial

F`fkg


29/61

DGHAXGPAXY PFUPU . XFUVDPU

Eakpdftf Hdaa` Eault

G eakpdftf h daa` eault -EHE)$ gdsa clawl gs nudd hdaa` eault -NHE) ar

nudd hdaa` fxgk -NHF) ar hdaa` pglfd$ is g tfst rfqufstf` hy g àetar ar atmfr

kfìegd pranfssialgd tmgt jivfs ilnarkgtial ghaut tmf efdds il g pgtiflt*s hdaa`, G

dgh tfemlieigl -ìpdakg mad`fr) ar tfemladajist -hgemfdar mad`fr) pfrnarks tmf

rfqufstf` tfstilj gl` pravi`fs tmf rfqufstilj Kfìegd Rranfssialgd witm tmf

rfsudts an tmf EHE, G EHE is gdsa clawl gs g (mfkajrgk(,

G eakpdftf hdaa` eault widd larkgddy iledu`f?

Xf` efdds

Patgd rf` hdaa` efdds

+ Pmf lukhfr an rf` efdds is jivfl gs gl ghsadutf

lukhfr pfr ditrf,

Mfkajdahil

+ Pmf gkault an mfkajdahil il tmf hdaa`$ fxprfssf` il jrgks

pfr feiditrf, -Daw mfkajdahil is egddf` glfkig,)

Mfkgtaerit ar pgecf` efdd vadukf -RE^)

Xf` hdaa` efdd ilìefs

+ Pmis is tmf nrgetial an wmadfhdaa` vadukf tmgt ealsists an rf` hdaa` efdds,

Kfgl earpuseudgr vadukf -KE^)

nfktaditrfs

+ tmf gvfrgjf vadukf an

tmf rf` efdds$ kfgsurf` il ,Glfkig is edgssinif`

gs kieraeytie arkgeraeytie hgsf` al wmftmfr tmis vgduf is

ghavf ar hfdaw tmf fxpfetf` larkgd rgljf, Atmfr ealìtials

tmgt egl gnnfet KE^ iledu`f tmgdgssfkig gl` rftieudaeytasis,

Kfgl earpuseudgr mfkajdahil -KEM)

+ tmf gvfrgjf gkault

an mfkajdahil pfr rf` hdaa` efdd$ il pieajrgks,

Kfgl earpuseudgr mfkajdahil ealefltrgtial -KEME)

+ tmf

gvfrgjf ealefltrgtial an mfkajdahil il tmf efdds,

Xf` hdaa` efdd ìstrihutial wi`tm -X@Z)

+ g kfgsurf an tmf vgrigtial an tmf

XHE papudgtial

Zmitf efdds

Patgd wmitf hdaa` efdds + Gdd tmf wmitf efdd typfs grf jivfl gs g pfrefltgjf

gl` gs gl ghsadutf lukhfr pfr ditrf,

G eakpdftf hdaa` eault witm ìnnfrfltigd widd gdsa iledu`f?
http://en.wikipedia.org/wiki/Femtolitrehttp://en.wikipedia.org/wiki/Femtolitrehttp://en.wikipedia.org/wiki/Anemiahttp://en.wikipedia.org/wiki/Microcytic_anemiahttp://en.wikipedia.org/wiki/Macrocytic_anemiahttp://en.wikipedia.org/wiki/Thalassemiahttp://en.wikipedia.org/wiki/Reticulocytehttp://en.wikipedia.org/wiki/Mean_corpuscular_hemoglobinhttp://en.wikipedia.org/wiki/Mean_corpuscular_hemoglobinhttp://en.wikipedia.org/wiki/Mean_corpuscular_hemoglobinhttp://en.wikipedia.org/wiki/Mean_corpuscular_hemoglobin_concentrationhttp://en.wikipedia.org/wiki/Mean_corpuscular_hemoglobin_concentrationhttp://en.wikipedia.org/wiki/Picogramhttp://en.wikipedia.org/wiki/Mean_corpuscular_hemoglobin_concentrationhttp://en.wikipedia.org/wiki/Red_blood_cell_distribution_widthhttp://en.wikipedia.org/wiki/Red_blood_cell_distribution_widthhttp://en.wikipedia.org/wiki/Red_blood_cell_distribution_widthhttp://en.wikipedia.org/wiki/White_blood_cellshttp://en.wikipedia.org/wiki/White_blood_cellshttp://en.wikipedia.org/wiki/Red_blood_cell_distribution_widthhttp://en.wikipedia.org/wiki/Mean_corpuscular_hemoglobin_concentrationhttp://en.wikipedia.org/wiki/Picogramhttp://en.wikipedia.org/wiki/Mean_corpuscular_hemoglobinhttp://en.wikipedia.org/wiki/Reticulocytehttp://en.wikipedia.org/wiki/Thalassemiahttp://en.wikipedia.org/wiki/Macrocytic_anemiahttp://en.wikipedia.org/wiki/Microcytic_anemiahttp://en.wikipedia.org/wiki/Anemiahttp://en.wikipedia.org/wiki/Femtolitre


30/61

Lfutrapmid jrgludaeytfs + Kgy ilìegtf hgetfrigd ilnfetial, Kgy gdsa hf

rgisf` il geutf virgd ilnfetials,Hfegusf an tmf sfjkfltf` gppfgrglef an

tmf luedfus$ lfutrapmids grf sakftikfs rfnfrrf` ta gs (sfjs,( Pmf luedfus

an dfss kgturf lfutrapmids is lat sfjkfltf`$ hut mgs g hgl` ar ra`+dicf

smgpf, Dfss kgturf lfutrapmids + tmasf tmgt mgvf rfefltdy hffl rfdfgsf`

nrak tmf half kgrraw ilta tmf hdaa`strfgk + grf clawl gs (hgl`s( ar

(stghs(, Utgh is g Jfrkgl tfrk nar ra`,

Dykpmaeytfs + Mijmfr witm sakf virgd ilnfetials suem gs jdglùdgr nfvfr

gl`, Gdsa rgisf` il dykpmaeytie dfucgfkig EDD, Egl hf `ferfgsf` hy MI^

ilnfetial, Il gùdts$ dykpmaeytfs grf tmf sfeal` kast eakkal ZHE typfgntfr lfutrapmids, Il yaulj emid`rfl ul`fr gjf =$ dykpmaeytfs grf karf

eakkal tmgl lfutrapmids,

Kalaeytfs + Kgy hf rgisf` il hgetfrigd ilnfetial$ tuhfreudasis$ kgdgrig$

Xaecy Kaultgil spattf` nfvfr$ kalaeytie dfucfkig$ emralie udefrgtivf

eaditis gl` rfjialgd fltfritis

Fasilapmid jrgludaeytfs + Ilerfgsf` il pgrgsitie ilnfetials$ gstmkg$ ar

gddfrjie rfgetial,

Hgsapmid jrgludaeytfs + Kgy hf ilerfgsf` il half kgrraw rfdgtf`

ealìtials suem gs dfucfkig an dykpmakg,

Rdgtfdfts

Rdgtfdft lukhfrs grf jivfl$ gs wfdd gs ilnarkgtial ghaut tmfir sizf gl` tmf

rgljf an sizfs il tmf hdaa`,
http://en.wikipedia.org/wiki/Neutrophil_granulocytehttp://en.wikipedia.org/wiki/Bacteriahttp://en.wikipedia.org/wiki/Lymphocytehttp://en.wikipedia.org/wiki/Virushttp://en.wikipedia.org/wiki/Glandular_feverhttp://en.wikipedia.org/wiki/CLLhttp://en.wikipedia.org/wiki/Monocytehttp://en.wikipedia.org/wiki/Eosinophil_granulocytehttp://en.wikipedia.org/wiki/Parasitehttp://en.wikipedia.org/wiki/Basophil_granulocytehttp://en.wikipedia.org/wiki/Platelethttp://en.wikipedia.org/wiki/Platelethttp://en.wikipedia.org/wiki/Basophil_granulocytehttp://en.wikipedia.org/wiki/Parasitehttp://en.wikipedia.org/wiki/Eosinophil_granulocytehttp://en.wikipedia.org/wiki/Monocytehttp://en.wikipedia.org/wiki/CLLhttp://en.wikipedia.org/wiki/Glandular_feverhttp://en.wikipedia.org/wiki/Virushttp://en.wikipedia.org/wiki/Lymphocytehttp://en.wikipedia.org/wiki/Bacteriahttp://en.wikipedia.org/wiki/Neutrophil_granulocyte


31/61

@gy Larkgd ^gdufs Xfsudt Xfkgrcs ilìegtialsEdiliegd

Uijlinieglef

Nfh,8=$8229

Dfueaeytfs La,EalfGùdt?6+72 x729!D

:,7 x729!D

Larkgd Pa i`fltinylarkgd hdaaèfdds taìgjlasf`hdaa`ìsfgsf

@inn, Efdd Eault

Ufjkfltfrs?

2,>6+2,=6

Dykpmaeytfs?2,76+2,56

MfkajdahilKgss Ealf?

78,2+70,2 j!D

Mfkgtaerit2,5:+2,0:

2,92

2,72

>,2 j!D

2,7=

Ilerfgsf`

@ferfgsf`

@ferfgsf`

@ferfgsf`

îtgd ilìgjlasiljgl`

trfgtkflt anmfkarrmgjieìsfgsf

Kfgsurfstmf gkaultanmfkajdahil

il tmf hdaa`

Kfgsurf anXHE naulìl tmf hdaa`$stgtf` gs gpfrefltgjfan tmf tatgdhdaa`vadukf

+prfsflef anilnfetial

+glfkig

+glfkig gl` mfgrtìsfgsf

+glfkig


32/61

Ediliegd Emfkistry


Uijlinieglef

Kgrem,8$8229

Mjt=2+782 kj!`D

Hdaa` Vrie Gei`8,>+>,2 kj!`D

Hdaa` VrfgLitrajfl7,:+=,5 kkad!D

UfrukErfgtililf2,6+7,8 kj!`d

822kj!`D

9,2

kj!`D

7>,5kkad!D

9,=kj!`D

Ilerfgsf`

Ilerfgsf`

Ilerfgsf`

Ilerfgsf`

Pa`ftfrkilftmf dfvfd anhdaa` sujgril tmf hdaa`

Rra`uet an

kftghadiskan pratfilprfsflt iltmf hdaa` .fxerftf` iltmf urilf

Pmf gkaultan litrajflil tmf hdaa`

il tmf narkan urfg

Kfgsurfstmf gkaultan erfgtililfil tmf hdaa`

-#) @K

Jaut

@ighftielfpmrapgtmy

@ighftielfpmrapgtmy


33/61

Vrilgdysis

G urilgdysis is g jraup an kglugd gl`!ar gutakgtf` qugditgtivf gl` sfki+

qugltitgtivf tfsts pfrnarkf` al g urilf sgkpdf, G rautilf urilgdysis usugddy

iledu`fs tmf naddawilj tfsts? eadar$ trglspgrfley$ spfeinie jrgvity$ pM$ pratfil$

jdueasf$ cftalfs$ hdaa`$ hidiruhil$ litritf$ urahidilajfl$ gl` dfucaeytf fstfrgsf,

Uakf dghargtarifs iledu`f g kieraseapie fxgkilgtial an urilgry sfìkflt witm gdd

rautilf urilgdysis tfsts, In lat$ it is eustakgry ta pfrnark tmf kieraseapie fxgk$ in

trglspgrfley$ jdueasf$ pratfil$ hdaa`$ litritf$ ar dfucaeytf fstfrgsf is ghlarkgd,

Rurpasf

Xautilf urilgdysfs grf pfrnarkf` nar sfvfrgd rfgsals?

jflfrgd mfgdtm serfflilj ta ftfet rflgd gl` kftghadie isfgsfs

ìgjlasis an isfgsfs ar isar`frs an tmf ci`lfys ar urilgry trget

kalitarilj an pgtiflts witm ìghftfs

Il g`ìtial$ qugltitgtivf urilgdysis tfsts kgy hf pfrnarkf` ta mfdp

ìgjlasf kgly spfeinie ìsar`frs$ suem gs flàerilf ìsfgsfs$ hdg``fr eglefr$

astfaparasis$ gl` parpmyrigs -g jraup an ìsar`frs egusf` hy emfkiegdikhgdglef), Wugltitgtivf glgdysis antfl rfquirfs tmf usf an g tikf` urilf sgkpdf,

Pmf urilgry kieragdhukil tfst kfgsurfs tmf rgtf an gdhukil fxerftial il tmf urilf

usilj dghargtary tfsts, Pmis tfst is usf` ta kalitar tmf ci`lfy nuletial an pfrsals

witm ìghftfs kfdditus, Il ìghfties$ tmf fxerftial an jrfgtfr tmgl 822 j!kD

gdhukil is prfìetivf an ikpflìlj ci`lfy isfgsf,


34/61


Uijlinieglef

Nfh, 8=$8229

EadarGkhfr yfddaw

PrglspgrfleyEdfgr

Jrgvity7,226+7,252

pM:,56+:,06Gvf? >,2

Gdhukil

Jdueasf 2 arlat prfsflt

Hdaa` latprfsflt

yfddaw

turhi`

7,276

6,2

-#)

trgef

-#)

Larkgd

Larkgd

@ferfgsf`

Rrfsflt

Rrfsflt

Rrfsflt

Rrfsflef anhdaa` efdds

Ilìegtial anurilfealefltrgtial

ar gkault ansadutfsprfsflt iltmf urilf,

Pa `ftfrkilftmf rfdgtivfgeiìty gl`gdcgdility anurilf gl`gssfss tmf

ediflts gei`+hgsf` stgtus,

Pa `ftfrkilftmf gkaultan pratfilhfilj dast iltmf urilf

Ikpartglttfst an

ìghftie glàtmfrìsar`fr

Pa `ftfrkilftmf prfsflefan hdaa` iltmf urilf

@fhris$ hgetfrigsfìkflt

Ilerfgsf geiìtywitm rflgd tuhudgrgeiàsis trget

ilnfetial

Gei ity$ VPI

Gdhukilurig

Mijm hdaa`jdueasf dfvfd

VPI gl` @ighftielfpmrapgtmy


35/61


Uijlinieglef

Kgr, 5$8229

EadarGkhfr yfddaw

PrglspgrfleyEdfgr

Jrgvity7,226+7,252

pM:,56+:,06Gvf? >,2

Gdhukil

Jdueasf 2 arlat prfsflt

Russ efdd

XHE0,8+6,0 x72>!kD5

yfddaw

turhi`

7,282

6,2

-#0)

-#7)

72+76

6+72

Larkgd

Larkgd

@ferfgsf`

Rrfsflt

Rrfsflt

Ilerfgsf`

Ilerfgsf`

Rrfsflef anhdaa` efdds

Ilìegtial anurilfealefltrgtial

ar gkault ansadutfsprfsflt iltmf urilf,

Pa `ftfrkilftmf rfdgtivfgeiìty gl`gdcgdility anurilf gl`gssfss tmf

ediflts gei`+hgsf` stgtus,

Pa `ftfrkilftmf gkaultan pratfilhfilj dast iltmf urilf

Ikpartglttfst an

ìghftie glàtmfrìsar`fr

Ilìegtf tmfegusf anilnfetial

Pa `ftfrkilfpratfilurig .mijm pratifl

@fhris$ hgetfrigsfìkflt

Ilerfgsf geiìtywitm rflgd tuhudgrgeiàsis trget

ilnfetial

Gei ity$ VPI

Gdhukilurig

Mijm hdaa`jdueasf dfvfd

Rrfsflef anilnfetial

Rratflurig


36/61

Jflfrie Lgkf-Hrgl` Lgkf)

Egtfjary Getial Lursilj Ealsi`frgtial Rgtiflt Pfgemilj Ealtrgilìegtial

Jdiedgzi`f

-@igkieral)RrfjlgleyEgtfjary E

Mfdps ta dawfr hdaa`jdueasf hystikudgtilj tmfrfdfgsf an ilsudilnrak tmf pglerfgs,

G`kilistfr witm naa`ta `ferfgsf JIPirritgtial gl` prfvfltmypajdyefkig,

Ilstruet tmf pgtiflt latta tgcf gdeamadiehfvfrgjfs hfegusf it

egl dfg` ta sfvfrfmypajdyefkierfgetial,

Gssfss pgtiflt narsijls an `fprfssialtmraujmaut tmftmfrgpy,

Umaud` hf ilnarkf`tmgt pradaljf` usfkgy dfg` ta`fpfl`flef,

Umaud` lat hf usf` il@K eakpdiegtf` hygeiàsis$ cftageiàsisar eakg$ ar il pgtifltwitm g mistary anrfpfgtf` fpisa`fs ancftagei asis ar eakg,

Jdipizi`f

-Jdueatrad)RrfjlgleyEgtfjary E

Hdaa` jdueasfdawfrilj `ruj ansudnalydurfg edgss,

Ghlarkgd hdaa`jdueasf dfvfds ùriljprfjlgley grfgssaeigtf` witm gmijmfr ilei`flef anealjflitgdghlarkgditifs,

Gvai` atmfrkfìegtialsfspfeigddy gspiril gl`gdeamad,

Umaud` hf ilnark anpatfltigd risc gl`g`vgltgjfs anJdueatrad gl` angdtfrlgtivf ka`f antmfrgpy, Pmfy smaud`gdsa hf ilnarkf`ghaut tmf ìftgryilstruetials an grfjudgr fxfreisfprajrgk gl` anrfjudgr tfstilj an urilf

gl` ar hdaa` sujgr, In mypajdyefkig

aeeurs tgcf g jdgss anargljf ouief$ 8+5 tspan sujgr$ malfy ar

Umaud` lat hf jivfl tapgtiflt witm clawlmypfrsflsitivity ta tmf`ruj,

Umaud` lat hf jivfl tapgtiflt witm @K typf 7$ìghftie cftageiàsiswitm ar witmaut eakg,


37/61

earl syrup ìssadvf ilwgtfr,

Dgetudasf

-Rartgdge)RrfjlgleyEgtfjary H

Ilerfgsf M8A ealtfltgl` santfls mf staad,

Dawfrs tmf pM an tmfeadal,

Gssfss pgtiflt narghàkilgd ìstfltial$prfsflef an hawfdsaul`s$ gl` larkgdpgttfrl an hawfdnuletial,

Fnnfets grf sffl il

80+0= maurs @a lat sfdn kfìegtf

witm glatmfr dgxgtivfhfegusf an sdawalsft,

Latiny @aetar inìgrrmfg pfrsists narkarf tmgl 80 mrs,$eaud` hf g sijl anavfràsf gl` kg`fnar kf` gòustkflt,

Fùegtf pgtiflt tmgttmis `ruj is usfègutiausdy il @K$prfjlgley$ dgetgtial$ar emid`rfl,

Fxefssivf arpradaljf` usf kgy

dfg` ta `fpfl`flef,

smaud` lat hf jivfl tapgtiflt al daw jgdgetasf pgtiflt,

Akfprgzadf

-Dgsfe)RrfjlgleyEgtfjary H

Hil`s ta gl flzykfal jgstrie pgriftgdefdds il tmf prfsflefan geiìe pM$prfvfltilj tmf nilgdtrglspart an my`rajflials ilta tmf jgstriedukfl,

G`kilistfr hfnarfkfgds, Egutial pgtifltta swgddaw egpsudfswmadf+lat ta apfl$emfw$ ar erusm tmfk,

Grrgljf nar nurtmfrfvgdugtial an pgtifltgntfr = wc an tmfrgpy

nar jgstrarfnduxìsar`frs3 latiltfl`f` narkgiltflglef tmfrgpy,

G`kilistfr gltgei`s

Ilstruet pgtiflt ta tgcfkfìegtial gs irfetf`nar tmf nudd eaursf antmfrgpy$ fvfl innffdilj hfttfr,

Kgy egusf aeegsialgd`rawsilfss anìzzilfss,

G`visf pgtiflt tagvai` gdeamad praùetsealtgililj gspiril$ tmiskgy egusf JIirritgtial,

Umaud` lat hf jivfl tapgtiflt witm clawlmypfrsflsitivity,


38/61

witm akfprgzadf$ inlff`f`,

G`visf pgtiflt tarfpart alsft an hdgectgrry staad$ ìgrrmfggl` pfrsistfltmfg`gemf,

Kftaedapraki`f

-rfjdgl)RrfjlgleyEgtfjary H

Hdaec àpgkilfrfefptars ilemfkarfefptartrijjfr zalf il ELU

Utikudglts katidity antmf uppfr JI trget$gl` geefdfrgtfsjgstrie fkpty,

Gssfss pgtiflt narlgusfg gl` vakitilj$ghàkilgd ìstfltial$gl` hawfd saul`s

priar ta gl` naddawiljg`kilistrgtial, Gssfss pgtiflt nar

sijls an `fprfssialtmraujmaut tmftmfrgpy,

Ilstruet pgtiflt ta tgcfkftaedapraki`ffxgetdy gs irfetf`,

G`visf pgtiflt ta

gvai` ealeurrflt usfan gdeamad gl` atmfrELU `fprfssglts$wmidf tgcilj tmiskfìegtial

Pmis kfìegtial kgyegusf `rawsilfss$egutial pgtiflt ta

gvai` `rivilj ar atmfrgetivitifs rfquiriljgdfrtlfss ultidrfspalsf takfìegtial is clawl,

Mypfrsflsitivity$mfkkarrmgjf$ mistaryan sfizurfs ìsar`frs$pgrcilsals ìsfgsf,

Xglitiìlf

-_gltge)RrfjlgleyEgtfjary H

Ilmihits tmf getial anmistgkilf gt tmf M8rfefptar sitf daegtf`prikgridy il jgstriepgriftgd efdds,

Gssfss pgtifltrautilfdy nar fpijgstriear ghàkilgd pgil gl`rglc ar aeeudt hdaa` iltmf staad$ fkfsis arjgstrie gspirgtf,

Fleaurgjf pgtiflt taquit skacilj$ ar gtdfgst lat ta skacfgntfr dgst àsf an tmf`gy,

Ilnark pgtiflt tmgt

ilerfgsf ndui` gl`nihfr iltgcf gl`fxfreisf kgykilikizf ealstipgtial,

Mypfrsflsitivity$ sakfargd diqui`s ealtgilgdeamad gl` smaud` hfgvai`f` il pgtifltswitm clawl tadfrglef,


39/61

Upiraladgetalf

-Gd`getalf@iurfties -patgssiuk Upgrilj)

Egusf dass an saìukhiegrhalgtf glègdeiuk wmidf sgviljpatgssiuk gl`my`rajfl ials,

Gltgjalizfsgdàstfralf il tmfìstgd tuhudfs$ilerfgsilj saìuk

gl` wgtfr fxerftial,

Kalitar I.A rgtiasgl` `gidy wfijmtùrilj tmfrgpy,

In kfìegtials is jivflgs gl gòulet tagltimypfrtflsivftmfrgpy$ kalitar HRhfnarf g`kilistfrilj,

Kalitar rfspalsf an

U!Ux an mypacgdfkig-wfgclfss$ ngtijuf$grrmytmkigs$ padyurig$gl` padyìpsig),

Pa flmglefghsarptial$ jivf `rujwitm kfgds,

Rratfet `ruj nrakdijmt,

Kalitar fd`frdypgtiflts edasfdy$ wmagrf susefptihdf tafxefssivf iurfsis,

Ilstruet pgtiflt ta tgcf`ruj il tmf karlilj taprfvflt lff` taurilgtf gt lijmt,

Pa prfvflt sfriausmypfrcgdfkig$ wgrlpgtiflt ta gvai`fxefssivf iljfstial anpatgssiuk+riem naa`s$

sgdts suhstitutfs gl`patgssiuksuppdfkflts,

Egutial pgtiflt lat tapfrnark mgzgràusgetivitifs in g`vfrsfrfgetials aeeurs,

Ealtrgilìegtf` ilpgtiflt mypfrsflsitivfta `ruj gl` il tmasfwitm glurig$ geutf arprajrfssivf rflgdilsunnifley$ armypfrcgdfkig,

Efnuraxikf

-_ilgefn)Ufeal`+jflfrgtialefpmgdasparilsGlti+ilnfetivfs

Ilmihits efdd+wgddsyltmfsis$ prakatiljaskatie ilstghidity$usugddy hgetfriei`gd,

Hfnarf jivilj `ruj$gsc pgtiflt in mf arsmf is gddfrjie tapflieiddils arefpmgdasparils,

Nar IK usf$ ilofet ilta

g dgrjf kusedf$ suemgs tmf jdutfuskgxikus ar tmf si`fan tmf tmijm,

Ghsarptial ar argd`ruj is flmglef` hy

Pfdd pgtiflt ta tgcf`ruj gs prfserihf`$fvfl gntfr mf!smfnffds hfttfr,

Ilstruet pgtiflt ta tgcfargd nark witm naa`,

In pgtiflt mgs ìnnieudtyswgddawilj tghdfts,Umaw mfr!mik maw taìssadvf ar erusmtghdfts, Hut wgrkmik!mfr tmf hittfr tgstf

Ealtrgilìegtial ilpgtiflts mypfrsflsitivfta `ruj ar atmfrefpmgdasparils,


40/61

naa`, Pghdfts kgy hf

erusmf`$ in ghsadutfdylfefssgry$ narpgtiflts wma egltswgddaw tghdfts,

is mgr` ta kgsc fvflwitm naa`,

Pfdd pgtiflt ta smgcfsuspflsial wfddhfnarf kfgsuriljàsf,

G`visf pgtifltrfefivilj `ruj I,^, tarfpart ìseaknart gt

I,^, ilsfrtial sitf,

Nurasfki`f-Dgsix)

Daap ìurftie Ilmihits saìuk glèmari`f rfghsarptialgt tmf praxikgd gl`ìstgd tuhudfs gl` tmfgseflìlj daap anmfldf,

Pa prfvflt laeturig$jivf R,A, gl` IKprfpgrgtials il tmfkarlilj, Jivf sfeal`àsf il fgrdygntfrlaal,

Kalitar wfijmt $ HR$gl` pudsf rgtfrautilfdy witm dalj+tfrk usf gl` ùriljrgpi` ifrfsis,

Kalitar ndui` iltgcfgl` autput gl`fdfetradytf$ HVL glègrhal ìaxi`f dfvfds

nrfqufltdy, Zgtem nar sijls an

mypacgdfkig$ suem gskusedf wfgclfss glèrgkps,

G`visf pgtiflt ta tgcf`ruj witm naa` taprfvflt JI upsft$ gl`ta tgcf `ruj ilkarlilj ta prfvfltlff` ta urilgtf gtlijmt,

Ilnark pgtiflt anpassihdf lff` narpatgssiuk arkgjlfsiuksuppdfkflts,

Ilstruet pgtiflt taealsudt mfgdtm egrfpranfssialgd rfjgrìlj

g ìft mijm ilpatgssiuk,

Ealtrgilìegtf` ilpgtiflts mypfrsflsitivfta `ruj gl` il tmasfwitm glurig,


41/61

Kftapradad

-Daprfsar)Hftg hdaecfrsGltigljilgds$gltimypfrtflsivfs

G sfdfetivf hftghdaecfr tmgtsfdfetivfdy hdaecshftg rfefptars3`ferfgsfs egrìgeautput$ pfripmfrgdrfsistglef$ glègrìge axyjflealsukptial3 gl`

`fprfssfs rfllilsferftial,

Gdwgys emfecpgtiflts gpiegd pudsfrgtf hfnarf jivilj`ruj,

Kalitar jdueasf dfvfdedasfdy hfegusf `rujkgscs eakkal U!Uxan mypajdyefkig,

Kalitar HR nrfqufltdy3

`ruj kgscs eakkalU!Ux an smaec, Kalitar I.A autput

rgtias gl` `gidywfijmt,

Ilstruet pgtiflt ta tgcf`ruj gs fxgetdy gsprfserihf` gl` witmkfgds,

Pfdd pgtiflt ta gdfrtprfserihfr in smartlfssan hrfgtm aeeurs,

Ilstruet pgtiflt lat tastap `ruj su``fldy

hut hatiny prfserihfrghaut ulpdfgsgltg`vfrsf rfgetials,

Ealtrgilìegtf` ilpgtiflts mypfrsflsitivfta `ruj ar atmfr hftghdaecfrs,


42/61

LVXUILJ EGXF RDGL

GUUFUUKFLP LUJ, @IGJLAUFU XGPIALGDF F]RFEPF@ AVPEAKF LUJ, ILPFX FLPIAL XGPIALGDF F GD VGPIAL

Uuhofetivf?

+ gla gwdgcgmilujg mfl ljggc dgwgs gsvfrhgdizf hy tmfpgtiflt

Ahofetivf?!U?

+ P ? 5:,:E+ RX ? 9= HRK+ XX ? 80 ERK+ HR ? 7=2!92 kkMj

Zfijmt ? 68 cj -prf+iddlfss)6= cj - urilj

maspitgdizgtial)

Ilgeeurgtf naddaw tmraujm anilstruetial

Nrfquflt gscilj ghaut mfreal itial

frhgdizilj ilgeeurgtfilnarkgtial

Clawdf`jf `fnieitrfjgrìlj ealìtial$prajlasis$ trfgtkflt$ sfdnegrf gl` ìsemgrjf lff`srfdgtf` ta ulngkidigritywitm ilnarkgtialrfsaurefs gs kglinfstf`hy nrfquflt gscilj anqufstials rfjgrìlj@ighftfs Lfpmrapgtmy,

+Ghsflef ar fnieifley aneajlitivf ilnarkgtial rfdgtf`ta spfeinie tapie, -Judgliec$ft, Gd)+Ilnarkgtial kust hf tgujmtta pt, witm @L il ar fr tagddgy glxifty$ prfvflteakpdiegtials gl it kgysfrvf gs gl appartulity nardfgrlilj sfdn kglgjfkfltscidds, -@afljfs$ ft,gd)

Gntfr gl maur an mfgdtm

tfgemilj al fssfltigd

fdfkflts rfjgr ilj

eal itial$ prajlasis$

trfgtkflt$ sfdn egrf gl

isemgrjf lff s$ tmf pgtifltwidd hf ghdf ta vfrhgdizf

ul frstgl ilj an eal itial !

isfgsf praefss$ prajlasis

. trfgtkflt3 i fltiny

rfdgtialsmip an sijl !

sykptaks ta tmf isfgsf

praefss gl earrfdgtf

sykptaks witm egusgtivf

ngetars3 gl ilitigtf

lfefssgry dinfstydf emgljfs

gl pgrtieipgtf il trfgtkflt

rfjikfl,

Il fpfl flt7),Erfgtf gl flviralkflt antrust hy distflilj taealefrls$ hfilj gvgidghdf

8),@iseuss isfgsf praefss$prajlasis$ gl prfeipitgtiljngetars,

5),@iseuss iftgry pdgldikitilj iltgcf an sujgr$ ngt$sgdt$ gdeamad gl fgtiljeakpdfx egrhamy rgtfsspfeigddy tmasf mijm il nihfrgl wgys ta fgd witm kfgdsautsi f tmf makf,0),Fleaurgjf pgtiflt taahsfrvf emgrgetfristies anurilf gl gkault!nrfqufleyan autput,6),@iseuss getivity rfstrietialgl jrg ugd rfsukptial anfsirf getivity, Fleaurgjf

usf an flfrjy+sgvilj$rfdgxgtial$ gl ivfrsialgdtfemliqufs,

>),Xfeakkfl semf udiljgetivitifs witm g fqugtf rfstpfria s,

7),Xgppart an rfspfet lffta hf fstghdismf hfnarf tmfpgtiflt widd hf widdilj ta tgcfpgrt il tmf dfgrlilj praefss,-@afljfs$ ft,gd)8),Rravi f clawdf jf hgsfal wmiem tmf pt, egl kgcfilnarkf emaiefs,-@afljfs$ ft,gd)5),G`fqugtf lutritial islfefssgry ta prakatfmfgdilj!tissuf rfjflfrgtialwmidf g mfrflef tarfstrietials kgy prfvflteakpdiegtials0),Emgljfs kgy rfndfetgdtfrgtials il rflgdnuletial!lff nar igdysis,-@afljfs$ ft,gd)6),Rgtiflt witm GXN kgylff ta rfstriet getivitygl !ar kgy nffd wfgc nar glfxtfl f pfria urilj

dfljtmy rfeavfry pmgsf$rfquirilj kfgsurfs taealsfrvf flfrjy glrf uef harf ak !fprfssial, -@afljfs$ ft,gd)

>),Rrfvflts fxefssivfngtijuf gl ealsfrvfsflfrjy nar mfgdilj$ tissufrfjflfrgtial, -@afljfs)

Gntfr gl maur an mfgdtm

tfgemilj al fssfltigd

fdfkflts rfjgr ilj tmf

isfgsf$ tmf pgtiflt

vfrhgdizf ul frstgl ilj an

eal itial ! isfgsf praefss$prajlasis . trfgtkflt3

i fltinif rfdgtialsmip an sijl

! sykptaks ta tmf isfgsf

praefss gl earrfdgtf

sykptaks witm egusgtivf

ngetars3 gl ilitigtf`

lfefssgry dinfstydf emgljfs

gl pgrtieipgtfs il trfgtkflt

rfjikfl,


43/61

LVXUILJ EGXF RDGL


Uuhofetivf?

+ lgmuhgj it gc sicigs vfrhgdizf hytmf pgtiflt

Ahofetivf?!U?

+ P ? 5:,: E+ RX ? 9= HRK+ XX ? 80 ERK+ HR ? 7=2!92 kkMj


maspitgdizgtial)

flaus istflsialJflfrgdizf f fkgXfpart an ngtijuf$ wfgclfss

gl ha y kgdgisfRittilj F fkg -86,0 kk)Xfstdfsslfss

Ndui` vadukf fxefssrfdgtf` ta eakprakisfrfjudgtary kfemglisk-rflgd ngidurf) gsfvi`flef` hy vflaus`istflsial$ jflfrgdizf`f`fkg$ ngtijuf$ wfgclfss$ha`y kgdgisf$rfstdfsslfss gl` pittiljf`fkg -86,0 kk),

+Ci lfy ngidurf ferfgsfsci lfys ghidity ta fxerftfsgdt il tmf urilf, Pmus$ tmfgkault an sgdt il tmf ha yilerfgsfs$ w!e egusfs tmfha y ta rftgil wgtfr .ferfgsf urilf autput,

Gntfr = maurs an ndui`

rfstrietials$ g`kilistfrilj

kf iegtials- iurfties .

gltimypfrtflsivf) gs

il iegtf $ tmf pgtiflt widd

fxpfriflef larkgd nduihgdglef$ ispdgy gppraprigtf

urilgry autput witm spfeinie

jrgvity !dghargtary stu ifs

lfgr larkgd$ stghdf wfijmt

gl ghsflef an f fkg

Il fpfl flt7),Xfear geeurgtf iltgcfgl autput -I!A),

@fpfl flt8),G kilistfr!rfstriet ndui gsil iegtf ,

5),G`kilistfr kf iegtial gsil iegtf -@iurfties),

Gltimypfrtflsivf

Il fpfl flt

0),Zfijm gidy gt sgkf tikfan gy$ al sgkf segdf$ witmsgkf fquipkflt gledatmilj,6),Gssfss scil$ ngef$fpfl flt grfgs nar f fkg,

7),Geeurgtf I!A is lfefssgrynar ftfrkililj rflgdnuletial gl nduirfpdgefkflt lff s glrf`ueilj risc an nduiavfrdag ,

8),Ndui kglgjfkflt isusugddy egdeudgtf ta rfpdgefautput nrak gdd saurefs glfstikgtf ilsflsihdf dassfs,5),Jivfl fgrdy il adijuriepmgsf an rflgd ngidurf il glfnnart ta ealvfrt laladijuriepmgsf$ ndusm tmf tuhudgrdukfl an fhris glprakatf urilf vadukf,Kgyhf jivfl ta trfgtmypfrtflsial hyeaultfrgetilj fnnfets anrflgd hdaa` ndaw gl !areireudgtilj vadukf avfrdag

0),@gidy ha y wfijmt is hfstkalitar an ndui stgtus,

6),F fkg aeeurs ilfpfl flt tissufs an tmf

ha y, -f,j, mgl s$ nfft$dukhasgergd grfg), Rgtifltegl jgil up ta 72 dhs -0,6

Pmf jagd wgs kft3 pgtiflt

mgs ispdgyf !fxpfriflef

larkgd ndui hgdglef$

gppraprigtf urilgry autput

witm spfeinie jrgvity

!dghargtary stu ifs lfgrlarkgd$ stghdf wfijmt gl

ghsflef an f fkg gntfr =

maurs an ndui rfstrietials$

g kilistfrilj kf iegtial

- iurfties .

gltimypfrtflsivf) gs

il iegtf ,


44/61

>),Rdgl argd nduirfpdgefkflt witm pgtiflt$witmil kudtipdf rfstrietials,

cjs) an ndui hfnarf pittiljf fkg is ftfetf ,>),Mfdps kilikizfsharf ak an dikitf emaiefsgl rf uefs sflsf an`fprivgtial gl tmirst,

,


45/61


Uuhofetivf?

+ kgimg kgtgkhgdgl gc mghad i imgl gc tuma gsvfrhgdizf hy tmfpt,

Ahofetivf?!U?



iddlfss)

Mijm Jdueasf dfvfd XHU hymjt?25!28!29 ? 822 kj! dDfsials latf al hatm dfjs

Larkgd gduf?MJP ? =2 772 kj! d

Mijm risc nar ikpgirf` scil

iltfjrity rfdgtf` ta gdtfrf`

sflsgtial sfeal`gry ta

`isfgsf praefss gs

fvi`flef` hy mijm

jdueasf dfvfds an MJP?

822 kj!`d3 gl` dfsials

latf` al hatm dfjs

+Pmf risc an ilnfetialfdfvgtfs tmf mijmfr tmfJdueasf dfvfd an g pfrsalwitm ighftfs, Pmis is dgrjfdyhfegusf3 Mijm hdaa sujgregusfs tmf dass an sflsgtial-lfurapgtmy) gl ikpf fseireudgtial tmraujmaut tmfha y -spfeigddy tmf nfft),@ikilismf sflsgtial egliltfrnfrf witm tmf ha ysiloury wgrlilj systfk$ pgil,Pmus$ Ukgdd euts$ ghrgsialsgl atmfr scil gdtfrgtialskgy ja ullatief glhfeakf ilnfetf , -Zadnf$ D,),

Gntfr naddawilj g 5 gy

sfrifs an mfgdtm tfgemiljs

al tmf prfvfltivf kfgsurfs$

tmf pt, widd kgiltgil iltget

scil$ i fltiny risc ngetars gl

fkalstrgtf

hfmgviars!tfemliqufs tmgt

prfvflts scil hrfgc awl,

Il fpfl flt?7),Gltieipgtf gl usfprfvfltivf kfgsurfs il ptswma grf gt risc nar scilhrfgc awl$ suem gs glyalfwma is tmil$ ahfsf$ gjilj$ ar`fhiditgtf ,

8),Kgiltgil striet scilmyjiflf$ usilj kid $lal ftfrjflt sagp -in gly)$ryilj jfltdy gl

tmaraujmdy$ gl duhriegtiljwitm datial ar fkaddiflt,

5),Kgssgjf halyprakilflef jfltdy witmdatial ar erfgk,

0),Ilspfet scil surngef!nad sgl haly prakilflefs

7),@feuhitus udefrs grfinnieudt ta mfgd$ gl`

prfvfltial is tmf hfsttrfgtkflt, -@afljfs$ ft,gd)

8),G`gidy hgtm Is usugddy latlfefssgry il fr frdypgtiflts hfegusf tmfrf isgtrapy an sfhgefaus glswfgt jdgl s$ gl hgtmiljkgy erfgtf ry+scilprahdfks, Mawfvfr$ gsfpi frkis tmils witm gjf$edfglsilj gl usf anduhrieglts is lff f ta cffpscil sant!pdighdf gl pratfetsusefptihdf scil nrakhrfgc awl, -@afljfs$ ft,gd)

5),Flmglefs eireudgtial tatissufs$ ilerfgsfs vgseudgrtalf$ gl rf uefs tissuff fkg, -ealtrgil iegtf in

grfg pilc!rf $ gs efddudgrgkgjf kgy aeeur,) Jfltdf

kgssgjf graul grfg kgystikudgtf eireudgtial taikpgirf tissufs, -@afljfs$ft,gd)

0),Ucil hrfgc awl eglaeeur quiecdy witm patfltigd

Rgtiflts scil rfkgilsiltget$ gs fvi flef hy larf lfss avfr halyprakilflefs gl egpiddgryrfnidd dfss tmgl > sfeal savfr grfgs an rf lfss gntfrnaddawilj g 5 gy sfrifs anmfgdtm tfgemiljs al tmfprfvfltivf kfgsurfs,


46/61

rautilfdy, Ilerfgsfprfvfltivf kfgsurfs wmflrf flf grfgs grf latief ,

6),Eal uet mfgdtm tfgemiljal prfvfltivf egrf narighftfs+naat rfdgtf

eakpdiegtials suem gs3

+Zgsm rfsi ugd dikh witmkid sagp gl wgtfr$ tmflrilsf gl pgt ry, @a tmis gtdfgst alef g gy3 a it karfantfl in yau swfgt g dat argrf trfgtilj g rgsm arilnfetial,

+@a lat usf gdeamad+hgsfdatials al yaur scil

+@a lat usf taa kuemsantflilj datial3 usf oustflaujm ta prfvflt ry scil,

+Kgiltgil g jaa prastmftienit gt gdd tikfs

nar ilnfetial . lferasis$passihdy ilvadvilj kusedfgl half, Pmfrf isilerfgsf risc anrf`lfss!irritgtial graul`dfjs uf ta fdgstie hgl s ilg udt igpfrs!ilealtilflefpg s, -@afljfs$ ft,gd)

6),Pmf kast nrfquflt rfgsalnar maspitgdizgtial ilpfrsals witm ighftfs is ufta prahdfks witm tmfir nfft,Pmfsf eaud hf prfvfltftmraujm sikpdf prfvfltivfnaat egrf, -Zadnf$ D,)

+ta cffp scil sant!pdighdfgl pratfet susefptihdf scilnrak hrfgc awl, -@afljfs$ft,gd)

+it kgy egusf tmf scil ta rygl ergec$ ilerfgsilj tmfemglef an ilnfetial, -Zadnf$

D,)

+usilj taa kuem santfliljdatial kgy egusf scilirritgtial, -Zadnf$ D,)

+ta kgiltgil earrfetgdijlkflt gl saecft nit,


47/61

+Emfec nfft gidy glikkf igtfdy egrf nar skgddeuts ar hdistfr

+Fgt g hgdglef ift$ rilcg fqugtf wgtfr fgem gygl fxfreisf rfjudgrdy

@fpfl flt+Dikit rilcilj hfvfrgjfswmiem ealtgils egnnfilf

+ cffp hdaa prfssurf ul frealtrad

>),Kalitar gl kgiltgiljdueasf dfvfds gt larkgdrgljf -=2+722 kj! d),

:),G`kilistfr lutritialgdsuppdfkflts gl vitgkilsgs il iegtf`

Mgvilj tmf rijmt nit widd mfdprfdifvf prfssurf spats glsarflfss, -Zadnf$ D,)

+kast prahdfks nar ighftieshfjils witm skgdd sarfs altmf scil dicf ergpfs glhdistfrs, -Zadnf$ D,)

+stgyilj nit gl mfgdtmy widdealtrihutf ta avfrgddighftfs ealtrad, Fxfreisf

ilerfgsfs hdaa ndaw glilsudil sflsitivity, -Zadnf$ D,)

+ rilcilj egnnfilf hfvfrgjfsegl ealstriet hdaa vfssfdsgl kgy ealtrihutf taeireudgtial prahdfks, -Zadnf$D,)

+Mijm HR egl egusfeireudgtary prahdfks il tmfnfft, -Zadnf$ D,)

>),Cffpilj il rgljf gs antflgs passihdf widd rgkgtiegddyrf`uef risc an sfriaus

eakpdiegtials nrakighftfs, -Zadnf$ D,)

:, Gi s il mfgdilj ! efddudgrrfjflfrgtial, -@afljfs$ft,gd)


48/61

LVXUILJ EGXF RDGL


Uuhofetivf?

+ kgduyg pirkf it gcpgjghgt gsvfrhgdizf hy tmfpgtiflt

Ahofetivf?!U?



iddlfss)

Ufvfrf GlfkigZfgclfssRgddarXfstdfsslfss

Mijm Jdueasf dfvfd XHU hymjt?

25!28!29 ? 822 kj! d

Larkgd gduf?MJP ? :2 722 kj! d

Ngtijuf rfdgtf` ta`ferfgsf` kftghadieflfrjy pra`uetial gsfvi`flef` hy wfgclfss$rfstdfsslfss$ pgddar$sfvfrf glfkig . mijmjdueasf dfvfd XHU an mjt?822 kj!`d,

+Ngtijuf is g nffdilj antirf lfss$ fxmgustial$ ardgec an flfrjy, It nffds kid dyngtijuf hfegusf anavfrwarc$ paar sdffp$ warry$harf ak$ ar dgec anfxfreisf, Gly iddlfss$ suemgs g ead ar tmf ndu$ kgyegusf ngtijuf$ wmiem usugddyjafs gwgy gs tmf iddlfssedfgrs up, G strfssnudfkatialgd situgtial kgy gdsaegusf ngtijuf, Pmis typf anngtijuf usugddy edfgrs upwmfl tmf strfss is rfdifvf ,Kgly prfseriptial gllalprfseriptial kf ieilfsegl gdsa egusf ngtijuf, Itkgy hf egusf hy g karfsfriaus mfgdtm prahdfk$suem gs? Kftghadieisar frs$ suem gs ighftfs$

il wmiem sujgr -jdueasf)rfkgils il tmf hdaa rgtmfr

tmgl fltfrilj tmf ha ysefdds ta hf usf nar flfrjy,-ZfhK@)

Gntfr g `gy an pravi iljgdtfrlgtf getivitifs witmpfria s an rfst gluliltfrruptf sdffps$ tmfediflt widd ikpravf sunnieifltflfrjy ta eakpdftf fsirfdijmt getivitifs,

Il fpfl flt7),@iseuss witm pt, tmf lff`nar getivity, Rdgl semf udfwitm pt, gl i fltinygetivitifs tmgt dfg ta ngtijuf,

8),Gssfss pgtiflts ghidity tapfrnark larkgd tgscs!latilj rfparts an wfgclfss$ngtijuf$ gl innieudtygeeakpdismilj tgsc

5),Gdtfrlgtf getivity w!pfria s an rfst !uliltfrruptf sdffp,

0),Kalitar pudsf$ rfspirgtaryrgtf gl HR hfnarf!gntfrgetivity,

6),@iseuss wgys anealsfrvilj flfrjy wmidfhgtmilj$ trglsnfrrilj$ gl saal,

>),Ilerfgsf pt, pgrtieipgtialil G@Ds gs tadfrgtf ,

7),F uegtial kgy pravi fkativgtial ta ilerfgsfgetivity dfvfd fvfl tmaujm pt,kgy nffd taa wfgc ilitigddy,-Judgliec$ ft, Gd)8),Ilnduflefs emaief aniltfrvfltials! lff fgssistglef, -Judgliec$ ft,Gd)

5),Rrfvflts fxefssivfngtijuf, -Judgliec$ ft, Gd)

0),Il iegtfs pmysiadajiedfvfds tadfrglef, -Judgliec$ft, Gd)

6),Rt, widd hf ghdf tageeakpdism karf witm gferfgsf fxpfl iturf an

flfrjy,

>),Ilerfgsfs ealni flefdfvfd!sfdn+fstffk gs wfdd gstadfrglef dfvfd, -Judgliec$ft, Gd)

Rgtiflt vfrhgdizf mgviljsunnieiflt flfrjy taeakpdftf `fsirf getivitifsgntfr g `gy an pravi iljgdtfrlgtf getivitifs witmpfria s an rfst gluliltfrruptf sdffps,
http://www.webmd.com/hw-popup/stresshttp://www.webmd.com/hw-popup/medications-that-can-cause-weakness-or-fatiguehttp://www.webmd.com/hw-popup/diabeteshttp://www.webmd.com/hw-popup/diabeteshttp://www.webmd.com/hw-popup/medications-that-can-cause-weakness-or-fatiguehttp://www.webmd.com/hw-popup/stress


49/61

LVXUILJ EGXF RDGL


Uuhofetivf?

+ gjsuh gc ukghgtljg kgtutukhg gcgs vfrhgdizf hytmf pgtiflt

Ahofetivf?!U?



iddlfss)RgddarEmfst pgilXfstdfsslfssNgtijufJflfrgdizf f fkg latfRittilj f fkg latfFdfvgtial il HVL -7>,5kkad!dEgpiddgry rfnidd < 5 sfes

Mijm Jdueasf dfvfd XHU hymjt?25!28!29 ? 822 kj! d

Larkgd gduf?MJP ? :2 722 kj! dHVL? 7,:+=,5 kkad!d

@ferfgsf` tissufpfrnusial rfdgtf` tapfripmfrgd vgsa+aeedusialan hdaa` vfssfdssfeal`gry ta ìsfgsfpraefss gs fvi`flef` hyemfst pgil$ rfstdfsslfss$

pgddar $ ngtijuf$ jflfrgdizff`fkg$ fdfvgtial il HVL-7>,5 kkad!d$ egpiddgryrfnidd < 5 sfes gl` HR an7=2!92 kkMj

Aeedusial an pfripmfrgdhdaa vfssfds widd gdtfr ndawan hdaa ta pfrnusf tmfinnfrflt efdds an tmf ha y,

-mttp?!!www,fdsfvifr,eak)

Gntfr 0 maurs anikpdfkfltilj kfgsurfs tarf uef vgseudgr rfsistglefgl ikpravf tissufpfrnusial?+jivilj gltimypfrtflsivfrujs

+kgiltgil ndui gl iftgrysa iuk rfstrietials+kgiltgil pmysiegd gl

fkatialgd rfsttmf pgtiflt hdaa prfssurfwidd ferfgsf nrak 7=2!92kkMj ta 752!=2,

Il fpfl flt7),Jivf gltimypfrtflsivfrujs$ iurfties gs

prfserihf ,

@fpfl flt8),Kalitar hdaa prfssurffvfry 0 maurs,

5),Ikpdfkflt kfgsurfs tarf uef vgseudgr rfsistglefgl ikpravf tissufpfrnusial?+Kgiltgil ndui gl iftgrysa iuk rfstrietials

+@iseaurgjf iltgcf aneannff$ tfg$ eadgs$ glèmaeadgtf$ wmiem grf mijm ilegnnfilf+ iseaurgjf skacilj

+kgiltgil pmysiegd glfkatialgd rfst,

0), Flsurf g fqugtf ndui

iltgcf uldfss ealtrgil iegtf

7),G wi f rgljf ankf iegtials is gvgidghdf nartrfgtkflt? vgsa idgtars$hftg+hdaecfrs$ glgljiatflsilajfl+ealvfrtiljflzykf -GEF) ilmihitar,

8),Pa claws tmf hgsf dilf anHR,

5),

+ta rfùef ndui rftfltial$wmiem ealtrihutfs tamypfrtflsial,+egnnfilf stikudgtfssykpgtmftie lfrvaus systfk

+egusfs vgsaealstrietialgl ealtrihutfs taferfgsfs tissuf

axyjflgtial hy rf ueilj A8gvgidghidity

+sf gtivfs egl hf usf tarf uef strfss glgssaeigtf vgsaealstrietial,0), adukf fpdftialflmglefs patfley anmypfrtflsivf rujs gl gdsarf uefs pfrnusial taci lfys,

Gntfr 0 maurs an trfgtkflt

tmf jagd wgs kft$ tmf

pgtiflt hdaa prfssurf wgs

ferfgsf nrak 7=2!92

kkMj ta 752!=2,


50/61

LVXUILJ EGXF RDGL


Uuhofetivf?

+ kgduyg pirkf it gcpgjghgt gsvfrhgdizf hy tmfpgtiflt

Ahofetivf?!U?



iddlfss)

NgtijufUfvfrf GlfkigZfgclfssRgddarXfstdfsslfssFxfrtialgdiseaknart! ysplfg


Larkgd gduf?MJP ? :2 722 kj! d

Ge tiv ity il tadfr glefrfdgtf` ta ikhgdglefhftwffl axyjfl suppdygl` `fkgl` gs fvi`flef`hy wfgclfss$rfstdfsslfss$ ngtijuf$pgddar$ sfvfrf glfkig .mijm j dueasf dfvfd XHU anmjt? 822 kj!`d,

+hfegusf an ikilismfaxyjfl+egrryilj egpgeity antmf rf hdaa efdds$ tmusrfsudtf ta ilsunnieifltpmysiadajiegd flfrjy tafl urf ar eakpdftf rfquirfar `fsirf `gidy getivitifs,-mttp?!!clad,jaajdf,eak!c!emgrdfs+paddgec!smartlfss+an+hrfgtm!zqx dNXk!so7DgG%)

Umart tfrk?Gntfr = maurs an eakpdftfhf rfst witm fdfvgtf MAHgl ikpdfkfltilj flfrjysgvilj tfemliquf$ tmfpgtiflt widd rfpart glilerfgsf il getivity tadfrglefiledu ilj getivitifs an `gidydivilj$ `fkalstrgtf gferfgsf il pmysiadajiegd

sijls an iltadfrglef glispdgy dghargtary vgdufs

witmil geefptghdf rgljf,

Dalj tfrk?Gntfr kaltms an lursiljiltfrvfltials tmf pgtiflt isnrff nrak wfgclfss gl riscan eakpdiegtials mgs hfflprfvfltf ,

Il fpfl flt7),Gssfss pgtiflts tapfrnark larkgd tgsc argetivitifs an gidy divilj,8),Fdfvgtf mfg an hf gstadfrgtf ,

5),I fltiny ar ikpdfkfltflfrjy sgvilj tfemliquf dicfsittilj wmidf ailj g tgsc,

0),Xfeakkfl quitfgtkaspmfrf$ hf rfst inil iegtf ,

6),Latf emgljfs ilhgdglef!jgit isturhglefsgl kusedf wfgclfss,

>),Rravi f ar rfeakkflgssistglef witm getivitifs argkhudgtial gs lfefssgry$gddawilj pgtiflt ta a gskuem gs passihdf,

:),Rdgl getivity prajrfssialwitm pgtiflt$ iledu iljgetivitifs tmgt tmf pgtifltvifws fssfltigd,

7),Ilnduflefs emaief aniltfrvfltials ar lff fgssistglef,8),Flmglefs dulj fxpglsialta kgxikizf axyjflgtial narefddudgr uptgcf,5),Fleaurgjf pgtiflt ta ags kuem gs passihdf$ wmidfealsfrvilj dikitf flfrjy .prfvfltilj ngtijuf,0),Xfeakkfl quitfgtkaspmfrf$ hf rfst inil iegtf ,

6),Kgy il iegtfslfuradajiegd emgljfsgnnfetilj pgtiflt sgnfty arrisc an iloury,>),Flmglefs rfst ta dawfrha ys axyjfl rfquirfkfltsgl rf uef strgil al tmfmfgrt gl duljs,

:),Gdtmaujm mfdp kgyhflfefssgry$ sfdn fstffk isflmglef wmfl pgtifltafs sakf tmiljs nar sfdn,

Rrakatfs jrg ugd rfturl talarkgd getivity dfvfd gl`ikpravf kusedf talf arstgkilg witmaut ul ufngtijuf,

Pmf pgtiflt rfvfgdf glilerfgsf il getivitytadfrglef$ fkalstrgtilj grf`uetial il pmysiadajiegdsijls an iltadfrglef gldghargtary vgdufs witmillarkgd rgljf gntfr = maursan eakpdftf hf rfst witmfdfvgtf MAH glikpdfkfltilj flfrjy sgviljtfemliquf,


51/61

Eaddghargtivf?=),Kalitar dgh stu ifs Mh$Met$ . XHE eault,

=),I fltinifs `fnieifleifs ilXHE eakpalflts gnnfetiljaxyjfl trglspart .trfgtkflt lff s arrfspalsf ta tmfrgpy,


52/61

LVXUILJ EGXF RDGL


Ahofetivf?!U?



iddlfss)

@ysplfg@ferfgsf an urilf autput

862 eeJflfrgdizf f fkgRittilj f fkg al dawfr

fxtrfkitifsXfstdfsslfss@rihhdilj an urilf


Larkgd gduf?MJP ? :2 722 kj! dVrilf Autput-g udt) ? 7822+7622 ee! gy

Gd tfrf` nd ui` .fdfetradytfs hgdglefrfdgtf` ta urilgryrftfltial gs fvi`flef` hy`ysplfg$ `ferfgsf anurilf autput 862 ee$jflfrgdizf` f`fkg$ pittilj

f`fkg al dawfrfxtrfkitifs$ rfstdfsslfss$`rihhdilj an urilf

Pmf pra uetial an gl

ghlarkgddy skgdd vadukf an

urilf is g rfsudt an ci lfy

ngidurf,

Xflgd ngidurf

@ferfgsf hdaa ndaw taci lfy

@ferfgsf pfrnusial ilci lfy

@ferfgsf urilgry autput

Vrilgry rftfltial

Umart tfrk?Gntfr = maurs an trfgtkflt?fleaurgjilj ediflt ta vaifvfry 8+0 maurs gl wmflurjf is latf $ tmf pgtifltwidd hf ghdf ta ilerfgsf urilfautput ta gt dfgst 7622 ee,

Dalj tfrk?Gt tmf fl` an maspitgdizgtialtmf pgtiflt widd hf ghdf tamgvf g larkgd urilf autputgl vai ilj pgttfrl,

Il fpfl flt7),Gssfss tmf egusf anferfgsf urilgry autput,

8),Fleaurgjf ediflt ta vaifvfry 8+0 maurs gl wmflurjf is latf ,

5),@ftfrkilf tmf ilitigd ndui s

gl fdfetradytfs dfvfd

0),Kalitar I!A maurdy,

@fpfl flt6),Rfreuss!pgdpgtfsuprgpuhie grfg

>),Ahsfrvf sijl glsykptaks an ndui glfdfetradytfs ikhgdglef suemgs ysplfg gl emgljfs ilFEJ,

7),Pa hf ghdf ta gppdy tmfprapfr tmfrgpfutie rfjikfl,

8),Kgy kilikizfs urilgryrftfltial!avfr istfltial antmf hdg` fr,

5),Ufrvfs gs hgsfdilf narprajrfss,

0),Pa ftfrkilf tmfprajrfss an tmf isfgsf,

6),G istfl`f hdg `fr eglhf nfdt il tmf suprgpuhiegrfg,>),Pa hf ghdf ta prfvfltnurtmfr eakpdiegtial glg kilistfr prapfrtmfrgpfutie rfjikfl,

Jagd pgrtigddy kft3 pgtifltpgssf aut urilf gt dfgst522 ee


53/61

LVXUILJ EGXF RDGL


Uuhofetivf?

+ sgl+a gwdg gcmil kgtgtgkhgdkgimg lgm il ljggc sgcit gsvfrhgdizf hy tmfpgtiflt

Ahofetivf?!U?



maspitgdizgtial)

Nrfquflt gscilj ghaut mfreal itial

ZfgclfssEalnusial@istrfssf

Ilerfgsf hdaa prfssurfNfgrnudXfstdfsslfssNffdiljs an mfdpdfsslfss .

iseaknartNarjftnudlfssUdffp prahdfks

Gl xift y rfd gtf` ta emgljfil mfgdtm stgtus-prajrfssivf!`fhiditgtiljìsfgsf) gs kglinfstf` hynrfquflt gscilj anqufstials rfjgrìlj mfrealìtial$ wfgclfss$ealnusial$ ìstrfssf`$ilerfgsf hdaa` p rfssurf$nfgrnud3 rfstdfsslfss$nffdiljs an mfdpdfsslfss .ìseaknart$ sdffpprahdfks3 gl`narjftnudlfss

+Glxifty is g larkgdfxpfriflef, Ka frgtf armijm dfvfd an glxifty eglilerfgsf gdfrtlfss glpfrnarkglef il pgrtieudgrsitugtial, Mawfvfr$ pfapdfwma fxpfriflef ealtilufsar rfeurrilj nfgrs arfpisa fs an iltflsf nfgr eglnffd pawfrdfss ta kglgjftmfir sykptaks gl tmfirdivfs hfeakf sfvfrfdyrfstrietf ,-mttp?!!www,pglieglxiftyìsar`fr,arjgu!il`fx,mtk)

Gntfr kgiltgililj g egdk

gl tadfrglt kgllfr wmidf

iltfrgetilj witm pt,$ gl`

gssistilj il `fvfdapilj

glxifty+rfùeilj scidds

-rfdgxgtial$ `ffp hrfgtmilj$pasitivf visugdizgtial$

rfgssurilj sfdn+stgtfkflts$

fte,) tmf ediflt widd gppfgr

rfdgxf gl rfpart glxifty

ta g kglgjfghdf dfvfd$

vfrhgdizf gwgrflfss an

nffdiljs an glxifty gl

i fltiny mfgdtmy wgys ta fgd

witm gl fxprfss glxifty,

Il fpfl flt7),Gssfss pgtiflts dfvfd anglxifty,

8),Geclawdf jf gwgrflfssan pgtiflts glxifty,

5),Kgiltgil g egdk gltadfrglt kgllfr wmidfiltfrgetilj witm pgtiflt,

0),Xf uef sflsary stikudihy kgiltgililj g quitfflviralkflt,6),Gssist il fvfdapiljglxifty+rfùeilj scidds-rfdgxgtial$ `ffp hrfgtmilj$pasitivf visugdizgtial$rfgssurilj sfdn+stgtfkflts$

fte,)>),Fleaurgjf pgtiflt talatiny stgnn wmfl glxiausnffdiljs aeeur,

@fpfl flt:),G`kilistfr gltiglxiftykf iegtials gs il iegtf

7),Mfdps ftfrkilf tmf cilan iltfrvfltials rfquirf ,-Judgliec$ ft gd)8),geclawdf jfkflt anpgtiflts nffdiljs vgdi gtfstmf nffdiljs gleakkuliegtfs geefptglefan tmasf nffdiljs, -Judgliec$ft gd)5),Utgnns glxifty kgy hffgsidy pfrefivf hy pgtiflt,Pmf pgtiflts nffdilj anstghidity ilerfgsfs il egdkgl laltmrfgtfliljgtkaspmfrf,-Judgliec$ ft gd)0),Glxifty kgy fsegdgtfwitm fxefssivf ealvfrsgtialgl laisf, -Judgliec$ ft gd)6),Vtidizilj glxifty+rfùetialstrgtfjifs flmglef pgtifltssflsf an pfrsalgd kgstfrygl ealni flef, -Judgliec$ft gd)

>),Utgnn gvgidghidityrfilnarefs g nffdilj ansfeurity nar pgtiflt,-Judgliec$ ft gd):),Pa kf iegtials kgyhfusf in pgtiflts glxiftyealtilufs ta fsegdgtf gltmf glxifty hfeakfsisghdilj, -Judgliec$ ft gd)

Pmf ediflt gppfgrf rfdgxf

gl rfpart glxifty ta g

kglgjfghdf dfvfd$

vfrhgdizf gwgrflfss an

nffdiljs an glxifty gl

i fltinif mfgdtmy wgys tafgd witm gl fxprfss

glxifty gntfr kgiltgililj g

egdk gl tadfrglt kgllfr

wmidf iltfrgetilj witm pt,$

gl gssistilj il fvfdapilj

glxifty+rfùeilj scidds

-rfdgxgtial$ `ffp hrfgtmilj$

pasitivf visugdizgtial$

rfgssurilj sfdn+stgtfkflts$

fte,)


54/61

LVXUILJ EGXF RDGL


Uuhofetivf?

+ cilgcgpas gc mitpgjmiljg gsvfrhgdizf hy tmfpgtiflt

Ahofetivf?!U?



maspitgdizgtial)

@ysplfgZfgclfssXfstdfsslfssFgsy ngtijufRgddar@izzilfssEalnusial

Irritghidity

Ikpgirf` jgs fxemgljfrfdgtf` ta `ferfgsf` A8+egrryilj egpgeity an hdaa`sfeal`gry ta glfkig gsf

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Diabetic Nephropathy Case Study