SINDROMA HEPATORENAL

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    Onphrnm Fnsus

    ULMJRHDN @I[NZHRIMNO

    Hoi`

    Lmsnm Gn`nyu

    MLD. ;9;0>>>72

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    BNB L

    [IMJN@YOYNM

    Ulmjrhdn `ipnthrimno (U@R) dirupnfnm fhdpolfnsl tirdlmno pnjn pnslim

    slrhsls `ipntls jimgnm nseltis, ynmg jljialmlslfnm sibngnl finjnnm gngno glmcno

    nfut jltnmjnl jimgnm holghurln prhgrisla ynmg tircnjl pnjn pimjirltn pimynflt `ntl

    birnt tnmpn pimyibnb onlm ynmg sienrn folmls, onbhrnthrls, jnm nmnthdls jnpnt

    dimyibnbfnm gngno glmcno.>

    [njn U@R fionlmnm ynmg jlcudpnl pnjn glmcno `nmyn birupn figngnonm

    aumgsl tnmpn jltnmjnl jimgnm fionlmnm nmnthdl. @no lml jnpnt jlbuftlfnm blon

    glmcno tirsibut jltnmsponmtnslfnm pnjn pimjirltn onlm ynmg tljnf jljnpntl fionlmnm

    `ntl, dnfn aumgsl glmcno tirsibut nfnm fidbnol mhrdno ntnu pimjirltn ynmg

    dimgnondl U@R jlonfufnm trnmspnonmtnsl `ntl dnfn aumgsl glmcnomyn nfnm

    fidbnol mhrdno. Uionlm pirubn`nm aumgsl glmcno, pimjirltn U@R cugn jltnmjnl

    jimgnm pirubn`nm slrfuonsl nrtirl slstidlf jnm nftlaltns slstid vnshnetlvi imjhgim

    ynmg birpirnm jnond tircnjlmyn `lphpirausl fi glmcno.>

    Ulmjrhdn `ipnthrimno tircnjl pnjn flrn-flrn : jnrl >;,;;; pimjirltn

    pimynflt `ntl, sipirtl gngno `ntl nfut, slrhsls `ntl, ntnu `ipntltls nofh`ho.

    Jlonphrfnm nmgfn dhrtnoltnsmyn njnon` oibl` bisnr jnrl ;% pimjirltn

    slrhsls jimgnm nseltis ynmg jlrnwnt lmnp. [njn slrhsls jifhdpimsntn jimgnm

    nseltis, prhbnbloltns umtuf tircnjlmyn U@R njnon` nmtnrn 0-2; % tlnp tn`um jnm

    dimlmgfnt sndpnl :;% jnond oldn tn`um.>,2

    [imynflt `ntl dnsl` dirupnfnm dnsnon` fisi`ntnm ynmg pimtlmg jl

    Lmjhmisln jnm dhrtnoltns dimlmgfnt jimgnm dumeuomyn fhdpolfnsl slmjrhdn`ipnthrimno dnfn pimtlmg bngl jhftir udud umtuf dimgitn`ul timtnmg slmjrhdn

    `ipnthrimno si`lmggn jnpnt dionfsnmnfnm jlngmhsls jnm pimntnonfsnmnnm jimgnm

    eipnt jnm tipnt. [njn onphrnm fnsus lml, nfnm jlbn`ns timtnmg slmjrhdn

    `ipnthrimno ynmg jltidufnm pnjn onfl-onfl birusln :9 tn`um, ynmg jlrnwnt jl

    Bnmgsno [imynflt Jnond [rln RUYJ Nrlalm Ne`dnj pnjn 20 Cuol 2;>2.

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    BNB LL

    ZLMCNYNM [YUZNFN

    2.> Jiaimlsl

    Jiaimlsl Ulmjrhdn @ipnth Rimno dimurut hoi` Lmtirmntlhmno Nseltis Eoub

    njnon` slmjrhdn folmls ynmg tircnjl pnjn pnslim pimynflt `ntl frhmlf jnm

    figngnonm `ntl onmcut sirtn `lpirtimsl phrtno ynmg jltnmjnl hoi` pimurumnm aumgsl

    glmcno jnm nbmhrdnoltns ynmg myntn jnrl slrfuonsl nrtirl jnm nftlaltns systid

    vnshnetlvi imjhgim.>

    [njn glmcno tirjnpnt vnshfhmstrlfsl ynmg dimyibnbfnm oncu alotrnsl

    gohdiruous rimjn`, jldnmn slrfuonsl jlounr glmcno tirjnpnt vnshjlonsl nrtirlho ynmg

    ouns dimyibnbfnm pimurumnm rislstimsl vnsfuoir slstidlf thtno jnm `lphtimsl.

    Disflpum slmjrhdn `ipnthrimno oibl` udud tirjnpnt pnjn pimjirltn jimgnm

    slrhsls onmcut, `no lml jnpnt cugn tldbuo pnjn pimjirltn pimynflt `ntl frhmlf ntnu

    pimynflt `ntl nfut onlm sipirtl `ipntltls nofh`holf ntnu figngnonm `ntl nfut.

    2.2 Lmsljim

    Bioud njn jntn ipljidlhohgls timtnmg slmjrhdn `ipnthrimno dnupum jl

    Lmjhmisln. Jl Ndirlfn Uirlfnt Ulmjrhd @ipnthrimno dirupnfnm fhdpolfnsl ynmg

    sirlmg jltidufnm. Lmsljimsl ynmg jlonphrfnm njnon` >;% pnjn pnslim rnwnt lmnp

    jimgnm slrhsls jnm nseltis. [njn slrhsls jifhdpimsntn jimgnm nseltis

    fidumgflmnm umtuf tircnjl Ulmjrhd @ipnthrimno njnon` nmtnrn 0-2;% pir tn`um

    jnm dimlmgfnt dimcnjl :;% jnond 9 tn`um.>,2

    2.5 [nthgimisls

    2

    [nthgimisls U@R sndpnl sifnrnmg bioud sienrn oimgfnp jlfitn`ul.

    @lphtisls pnthgimisls U@R njnon` sibngnl birlfut3 nflbnt slrhsls `ntl (U@) ntnu

    pimynflt `ntl tlmgfnt birnt jnm birsndn-sndn jimgnm `lpirtimsl phrtno nfnm

    dimgnflbntfnm tircnjlmyn vnshjlontnsl nrtirl sponmfmlf. Qnshjlontnsl lml nfnm

    dimgnflbntfnm tircnjlmyn `lphvhoidln nrtirlno simtrno, si`lmggn dirnmgsnmg

    nftlvnsl slstid snrna sldpntls, rimlm-nmglhtimslm-nojhstirhm, jnm `hrdhm

    nmtljluritlf ynmg sienrn fisiouru`nm nfnm dimyibnbfnm vnshfhmtrlfsl pidbuou`

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    jnrn` glmcno. Jl glmcno si`nrusmyn nfnm tircnjl difnmlsdi fhdpimsnsl, mndum

    jimgnm nonsnm ynmg bioud cions custru tircnjl fitljnfsildbnmgnm difnmlsdi

    fhdpimsnsl lml, ynltu dimlmgfntmyn vnshfhmstrlfthr jlsirtnl pimurumnm

    vnshjlonthr.

    Bibirnpn stujl dionphrfnm pirubn`nm blhfhdlnwl pnjn pnslim slrhsls

    `ipntls jimgnm U@R sibngnl birlfut3

    n. @ntl [imurumnm slmtisls nmglhtimslm jnm flmlmhgim [imurumnm pidien`nm rimlm, nmglhtimslm LL, nojhstirhm, imjhthfslm, jnm

    vnshprislm

    b. [onsdn [imlmgfntnm fnjnr rimlm, nmglhtimslm LL, nojhstirhm, imjhthfslm

    mhrnjrimnolm, vnshprislm, imjhtiolm 2 jnm 5, oiufhtrlim E: jnm J:,

    fnoslthmlm piptljn jnm `hrdhm nmtljluritlf

    [imurumnm fnjnr fnolfrilm, brnjlflmlm jnm mntrluitlf nrtirlnoe. Yrlm ntnu glmcno

    [imlmgfntnm rimlm, nmglhtimslm LL, nojhstirhm, imjhtiolm, trhdbhfsnmN2, oiufhtrlim i:, prhstngonmjlm I2, prhstnslfolm, brnjlflmlm.

    Anftn stujl jlntns flrnmyn dimumcuffnm bitnpn pnjn pnslim U@R tircnjl

    vnshfhmtrlfsl glmcno jimgnm signon nflbntmyn jimgnm difnmlsdi ntnu pnthgimisls

    ynmg snmgnt fhdpoifs. Utujl onlm dimyntnfnm bn`wn tircnjl pimurumnm slmtisls

    mltrlt hfsljn ynmg dirupnfnm vnshjlonthr funt, pnjn pnslim U@ jnm UR

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    Gndbnr 2.>. [nthgimisls tircnjlmyn slmjrhd `ipnthrimno pnjn pnslim jimgnm

    pimynflt `ntl birnt ntnu slrhsls `ntl

    2.: Gndbnrnm Folmls>,5

    Difnmlsdi folmls pimjirltn U@R jltnmjnl jimgnm fhdblmnsl nmtnrn gngno

    glmcno, gnmggunm slrfuonsl jnm gngno `ntl. Gngno glmcno jnpnt tldbuo sienrn

    piron`nm ntnu prhgrisla jnm blnsnmyn jllfutl jimgnm ritimsl mntrlud jnm nlr ynmg

    dimldbuofnm nsltis, ijidn jnm jloutlhmno `yphmntridln, ynmg jltnmjnl hoi`

    ifrisl mntrlud urlm ynmg rimjn` jnm pimgurnmgnm fidndpunm bunmg nlr (holgurl-

    nmurln).

    [imynflt `ntl birnt ntnu slrhsls `ntl

    +

    @lpirtimsl phrtno

    Qnshjlontnsl nrtirlno sponmlf birtndbn`

    @lphvhoidl nrtirlno simtrno

    Ulmjrhd ipnthrimno

    Nftlvnsl3

    - Uldpntls- Rimlm/nmglhtimslm/nojhstirhm- @hrdhm nmtljluritlf

    Qnshfhmtrlfsl rimno dimlmgfnt

    Lmtrnrimno3

    vnshfhmstrlfthr dimlmgfnt

    Qnshjlonthr dimurum

    Qnshfhmtrlfsl rimno oibl` dimlmgfnt

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    Gnmggunm slrfuonsl slstidlf ynmg birnt jltnmjnl jimgnm tifnmnm nrtirl

    ynmg rimjn`, pimlmgfntnm enrjlne hutput, jnm pimurumnm thtno tn`nmnm pidbuou`

    jnrn` slstidlf (Znbio 2)

    Znbio 2. Gnmggunm `idhjlmndlf ynmg sirlmg jltidufnm pnjn slmjrhdn

    `ipnthrimno

    Enrjlne hutput dimlmggl

    Zifnmnm nrtirlno dimurum

    Zhtno tn`nmnm pidbuou` jnrn` slstidlf dimurum

    Zhtno vhoudi jnrn` dimlmggl

    Nftlansl systid vnshfhmstrlfthr dimlmggl

    Zifnmnm phrtno dimlmggl[hrthsystidle

    Zifnmnm pidbuou` jnrn` sponmlf dimurum

    Zifnmnm pidbuou` jnrn` glmcno dimlmggl

    Zifnmnm nrtirl brne`lno jnm aidhrno dimlmggl

    Zn`nmnm pidbuou` jnrn` htnf dimlmggl

    Gndbnrnm folmls jnrl uridln cnrnmg jlcudpnl, bigltu cugn jimgnm nmnolsn urlm

    jnond finjnnm mhrdno.

    Uienrn folmls U@R jnpnt jlbijnfnm ntns 2 tlpi ynltu3

    >) Ulmjrhdn @ipnthrimno tlpi L (nfut)Zlpi L jltnmjnl hoi` pimlmgfntnm ynmg eipnt jnm prhgrisla jnrl BYM

    (Bohhj urin mltrhgim) jnm frintlmlm sirud ynltu mlonl frintlmlm =2,9 dg/jo ntnu

    pimurumnm frintlmlm folrims jnond 2: cnd sndpnl 9;%, finjnnm lml tldbuo jnond

    bibirnpn `nrl `lmggn 2 dlmggu.

    Gngno glmcno sirlmg jl`ubumgfnm jimgnm pimurumnm ynmg prhgrisla cudon`

    urlm, ritimsl mntrlud jnm `lphmntridl. [imjirltn jimgnm tlpi lml blnsnmyn jnond

    fhmjlsl folmlf ynmg snmgnt birnt jlsirtnl jimgnm nmurln, holgurln, `lphmntridln jnm

    tnmjn gngno `ntl onmcut sipirtl lftirus, imsianohpntl ntnu fhnguohpntl.

    Zlpi lml udud pnjn slrhsls nofh`holf bir`ubumgnm jimgnm `ipntltls

    nofh`holf, titnpl jnpnt cugn tldbuo pnjn slrhsls mhm nofh`holf. Flrn-flrn 9;%

    fnsus U@R tlpi lml tldbuo sphmtnm tnmpn njn anfthr prislpltnsl ynmg jlfitn`ul,

    fnjnmg-fnjnmg pnjn sibnglnm pimjirltn tircnjl `ubumgnm sibnb nflbnt ynmg irnt

    jimgnm bibirnpn fhdpolfnsl ntnu lmtirvimsl tirnpl (sipirtl lmaifsl bnftirl,

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    pirjnrn`nm gnstrhlmtistlmno, pnrnslmtisls tnmpn pidbirlnm ponsdn ixpnmjir,

    pidbirlnm jluritlf, pirburufnm aumgsl `ntl, jnm hpirnsl bisnr). Uphmtnmius

    bnetirlno pirlthmlrtls (UB[) njnon` pimyibnb udud jnrl pimurumnm aumgsl glmcno

    pnjn slrhsls. Flrn-flrn 59% pimjirltn slrhsls jimgnm UB[ tldbuo U@R tlpi L.

    U@R Zlpi L njnon` fhdpolfnsl jimgnm prhgmhstlf ynmg snmgnt buruf pnjn

    pimjirltn slrhsls, jimgnm dhrtnoltns dimenpnl

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    Znbio 5. Frltirln Dnyhr jlngmhstlf U@R birjnsnrfnmLmtirmntlhmno Nseltis Eoub

    >. [imynflt `ntl nfut ntnu frhmlf jimgnm gngno `ntl onmcut jnm `lpirtimsl phrtno.2. GAR rimjn`, firntlm sirud =>,9 dg/jo ntnu frintlmlm folrims 2: cnd ? :;

    do/dmt.

    5. Zljnf njn syhf, lmaifsl bnftirl sijnmg bironmgsumg, fi`lonmgnm enlrnm jnmdimjnpnt hbnt miarhthfslf.

    :. Zljnf njn pirbnlfnm aumgsl glmcno jimgnm pidbirlnm ponsdn ifspnmjir >,9 otrjnm jluritle (pimurumnm frintlmlm sirud dimcnjl ? >,9 dg/jo ntnu

    pimlmgfntnm frintlmlm folrims dimcnjl = :; do/dmt)

    9. [rhtilmurln ? ;,9 g/`nrl jnm tljnf jlcudpnl hbstruftla urhpntl ntnu pimynfltpnrimfld glmcno sienrn uotrnshmhgrnal.

    Frltirln tndbn`nm 3

    >. Qhoudi urlm ? 9;; do / `nrl

    2. Mntrlud urlm ? >; dig/oltir

    5. Hsdhonoltns urlm = hsdhonoltns ponsdn

    :. Irltrhslt urlm ? 9; /opb

    9. Mntrlud sirud ?>5; dig / oltir

    Uidun frltirun dnyhr `nrus jlcudpnl jnond dimignffnm jlngmhsn U@R,

    sijnmgfnm frltirln tndbn`nm dirupnfnm pimjufumg umtuf jlngmhsn U@R.

    Bibirnpn pnfthr prijlfthr umtuf tldbuomyn U@R pnjn pimjirltn slrhsls jimgnm

    nseltis jnpnt jlol`nt pnjn tnbio.

    Znbio :. Anfthr prijlfthr tldbuomyn U@R pnjn slrhsls jimgnm nseltis

    [imlmgfntnm rlmgnm BYM jnm ntnu frintlmlm sirudDimurummyn ifsfrisl nlr sition` pidbirlnm enlrnm

    Ifsfrisl mntrlud urlm ynmg rimjn`

    @lphtimsl nrtirlno

    Nftlaltns ponsdn rimmlm dimlmggl

    Fnjnr mhriplmiarlm ponsdn tlmggl

    Riarnftir nseltis

    Zljnf njn `ipnthdignol

    [imlmgfntnm vnseuonr rislstlvi lmjix glmcno

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    Jlngmhsls U@R `nrus jlpirtldbnmgfnm pnjn sitlnp pnslim slrhsls `ipntls

    ynmg jlsirtnl gngno glmcno holgurlf ntnu mhm holgurlf, titnpl pirou jllmgnt bn`wn

    gngno glmcno nfut jnpnt tircnjl pnjn pimynflt `ntl frhmlf nflbnt Mifrhsls tubuonr

    nfut (MZN) nzhtidln pririmno, jnm U@R.

    2.1 [imntnonfsnmnnm>,2

    Undpnl snnt lml bioud njn pimghbntnm iaiftla umtuf U@R, hoi` fnrimn ltu

    pimeign`nm tircnjlmyn U@R `nrus dimjnpnt pir`ntlnm ynmg utndn. Jimgnm

    dimgitn`ul bibirnpn anfthr pimeitus umtuf tldbuomyn U@R pnjn pimjirltn slrhsls

    jimgnm nseltis dnfn fltn jnpnt dimeign` tldbuomyn gngno glmcno pnjn pimjirltn

    lml. [idbirlnm ponsdn ifspnmjir sition` pnrnslmtisls jnond cudon` bisnr,

    tirutndn nobudlm, dimgurnmgl lmsljim U@R. Bigltu puon pidbirlnm nmtlblhtlf

    umtuf dimeign` UB[ pnjn pimjirltn slrhsls `ntl jimgnm rislfh tlmggl umtuf

    tldbuomyn fhdpolfnsl lml nfnm dimgurnmgl lmsljim U@R. Njn bibirnpn dhjnoltns

    tirnpl jlgumnfnm pnjn pimjirltn jimgnm U@R jimgnm iaif ynmg `nmyn sijlflt ntnu

    tljnf njn sndn sifnol.

    2.1.> [imntnonfsnmnnm Ydud

    U@R sibnglnm bisnr jlpleu hoi` fitljnfsildbnmgnm enlrnm jnm ioiftrholt

    pnjn pnslim U@. Hoi` fnrimn pnslim U@ snmgnt simsltla jimgnm pirubn`nm

    fisildbnmgnm enlrnm jnm ioiftrholt, dnfn `lmjnrl pidnfnlnm jluritlf ngrisla,

    pnrnslmtisls nsltis, jnm ritrlfsl enlrnm ynmg biroibl`nm.

    - Zirnpl suphrtla birupn jlit tlmggl fnohrl, jnm rimjn` prhtilm- Fhrifsl fisildbnmgnm nsnd bnsn- @lmjnrl pidnfnlnm HNLMU-

    [irlthmltls bnftirlno sphmtnm pnjn U@ `nrus sigirn jlhbntl sijlml jnmsinjifunt dumgflm.

    - [imeign`nm imsiohpntl `ipntlf cugn `nrus jlonfufnm jnond rnmgfndimeign` tircnjlmyn U@R.

    - @idhjlnolsls bioud pirmn` sienrn ahrdno jltioltl hoi` pnslim U@R, mndumtndpnfmyn tljnf eufup iaiftla jnm iaif sndplmg tlmjnfnm eufup birnt,

    dlsnomyn `lphtimsl, fhnguohpntl, sipsls, jnm pirjnrn`nm snournm eirmn.

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    tirutndn blon jlfhdblmnsl jimgnm pidbirlnm lmaus nobudlm ntnu fhrifsl nobudlm

    sirud. Fhdblmnsl hrmlprisslm jimgnm pimndbn`nm vhoudi ponsdn jimgnm

    nobudlm didpirbnlfl aumgsl glmcno jnm dimhrdnofnm pirubn`nm `idhjlmndlf

    pnjn pnslim slrhsls jimgnm U@R. Zirnpl lml jnpnt jlgumnfnm jimgnm fiwnspnjnnm

    ynmg tlmggl, pnjn bibirnpn pnslim `no lml tljnf jlonmcutfnm fnrimn fhdpolfnsl

    lsfidlf.

    2.1.5 Zlmjnfnm Lmvnsla

    [irlthmihvimhus s`umt

    [irlthmihvimhus s`umt tion` jlgumnfnm sienrn sphrnjls pnjn dnsn ynmg

    onou jl jnond pionfsnmnnm pnslim-pnslim U@R jimgnm slrhsls. [idnsnmgnm s`umt

    dimyibnbfnm nolrnm ynmg tirus dimirus enlrnm nseltis jnrl rhmggn pirlthmiud fi

    slrfuonsl slstidlf ynmg birpirnm jnond dimlmgfntfnm eurn` cnmtumg (enrjlne

    hutput) jnm pimndbn`nm vhoudi lmtrnvnsfuoir. Iaif `idhjlmndlf jnrl

    pirlthmihvimhus s`umt jl`ubumgfnm jimgnm pimifnmnm ynmg myntn jnrl nftlaltns

    slstid vnshfhmstrlfthr, pimlmgfntnm ifsfrisl mntrlud jnm bibirnpn fnsus

    didpirbnlfl nolrnm jnrn` glmcno jnm oncu alotrnsl gohdiruous, `no mlon` ynmg

    dimyibnbfnm rnslhmnolsnsl tlmjnfnm pnjn pimjirltn U@R.

    [hrthsystidle s`umt

    Nf`lr-nf`lr lml tion` jlpirfimnofnm suntu dithji mhmbijn` jnrl fhdprisl

    phrtno ynltu Zrnmscuguonr lmtrn`ipntle phrthsystidle s`umt (ZL[U). Fiumtumgnm

    dithji lml jlbnmjlmg jimgnm hpirnsl phrthenvno s`umt njnon` pimurumnm

    dhrtnoltns nflbnt hpirnsl.

    Fhdpolfnsl ynmg pnolmg sirlmg pnjn pnslim ynmg dimjnpnt pimghbntnm

    jimgnm ZL[U njnon` `ipntle imeip`nohp`nty jnm hbstrufsl jnrl stimt. Bibirnpnonphrnm ynmg diolbntfnm sicudon` pnslim eimjrumg didpirol`ntfnm bn`wn

    prhsijur lml dimlmgfntfnm aumgsl glmcno pnjn pnslim slrhsls `ntl jimgnm U@R ynmg

    tljnf jnpnt ongl umtuf jlonfufnm trnmsponmtnsl `ntl. [imioltlnm jlntns dimumcuffnm

    bn`wn ZL[U didbirlfnm bnmynf fiumtumgnm pnjn pimntnonfsnmnnm U@R.

    Wnonupum jidlflnm, pimggumnnm ZL[U dnsl` didiroufnm pimioltlnm fhmtrho

    umtuf jnpnt dirhfhdimjnslfnm.

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    Zrnmsponmtnsl @ntl

    Zrnmsponmtnsl `ntl lml sienrn tihrl njnon` tirnpl ynmg tipnt umtuf pimjirltn

    U@R, ynmg jnpnt dimyidbu`fnm bnlf pimynflt `ntl dnupum jlsaumgsl glmcnomyn.

    Zlmjnfnm trnmspnomtnsl lml dirupnfnm dnsnon` utndn dimglmgnt prhgmhsls buruf

    jnrl U@R jnm jnatnr tumggu ynmg ondn umtuf tlmjnfnm tirsibut jl pusnt

    trnmsponmtnsl. Uigirn sition` trnmsponmtnsl `ntl, figngnonm aumgsl glmcno jnpnt

    jlndntl siondn :0 cnd sndpnl 72 cnd. Uition` ltu oncu alotrnsl gohdiruous duonl

    dimgnondl pirbnlfnm.

    2.7. [imeign`nm:,9

    Rislfh U@R jnpnt jlfurnmgl jimgnm pidnfnlnm tirnpl jluritlf sienrn

    bir`ntl-`ntl jnm pidnmtnunm fitnt, pimidunm jlml sitlnp fhdpolfnsl sipirtl

    fitljnfsildbnmgnm ioiftrholt, pirjnrn`nm ntnu lmaifsl. Hbnt miarhthfslf jl`lmjnrl.

    Rislfh pirburufnm glmcno sition` pnrnslmtisls vhoudi bisnr jlfurnmgl jimgnm

    pidbirlnm nobudlm rimjn` gnrnd.

    - [imeign`nm lmaifslRislfh sirnmgnm uonmgnm pirlthmltls bnftirlno sphmtnm jlfurnmgl jimgnm

    pidbirlnm nmtlblhtlf prhalonfsls. Blon pnslim UB[ dimjnpnt tirnpl nmtlblhtlfn,

    pidbirlnm nobudlm nfnm dimgurnmgl arifuimsl jlsaumgsl glmcno. Lmaifsl

    bnftirl tircnjl pnjn `ndplr 9;% pnslim jimgnm pirjnrn`nm vnrlsis jnm

    pimeign`nm lmaifsl bnftirl jimgnm nmtlblhtlfn prhalonfsls didpirbnlfl

    survlvno sifltnr >;%.

    - Ifspnmsl vhoudiIfspnmsl vhoudi dimeign` tircnjlmyn gngno glmcno pnjn pnslim UB[,

    jlrifhdimjnslfnm pidbirlnm ifspnmsl vhoudi ponsdn jimgnm nobudlm 2;%(>->,9 grnd/fgBB siondn >-5 `nrl) pnjn snnt jlngmhsls umtuf dimeign`

    jlsaumgsl slrfuonsl, gnmggunm glmcno, jnm dhrtnoltns.

    - [idnfnlnm jluritlf jimgnm blcnfsnmnDimgljimtlalfnsl jhsls iaiftla tirimjn` jluritlf umtuf sitlnp lmjlvlju pnslim

    njnon` snmgnt pimtlmg fnrimn gnmggunm aumgsl glmcno nflbnt jluritlf tircnjl

    pnjn sifltnr 2;% pnslim nsltis si`lmggn tircnjl pimurumnm vhoudi

    lmtrnvnsfuonr.

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    - Dimg`lmjnrl pidnfnlnm hbnt miarhthfslf 3 pnslim jimgnm slrhsls jnm nsltisdirupnfnm prijlsphslsl dimjnpnt ndlmhgolfhsljn jimgnm gngno glmcno tircnjl

    sifltnr 55%. [imyibnb pimtlmg onlm figngnonm glmcno njnon` pidnfnlnm

    MUNLJs. Hbnt lml dimg`ndbnt pidbimtufnm prhstngonmjlm lmtrn rimno ynmg

    dimgnflbntfnm pimurumnm myntn aumgsl glmcno jnm ifsrisl Mn+/@2H2 pnjn

    pnslim slrhsls jimgnm nsltis.

    2.0 [rhgmhsls:,9

    [rhgmhsls U@R buruf jnm ududmyn antno jimgnm dhrtnoltns nmtnrn 0;-

    : `nrl. Fionmgsumgnm `ljup pnjn U@R tlpi LL blnsnmyn oibl` ondn jnm sifltnr

    :->;% pnslim jnpnt dimgnondl piduol`nm aumgsl glmcno. Fionlmnm pnjn U@R

    jnpnt rivirslbio sition` trnmsponmtnsl `ntl hrththplf ntnu clfn pimynflt `ntl prldir

    jnpnt jlhbntl. Clfn sidbu , blnsnmyn tircnjl fnrimn pirbnlfnm pimynflt `ntl jnm

    bufnm fnrimn pimyidbu`nm prldir U@R. Anfthr onlm ynmg cugn birpirnm jnond

    fidntlnm njnon` pirjnrn`nm snournm eirmn, lmaifsl bnftirl, jnm fnrslmhdn

    `ipnthsiouonr.

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    >5

    BNB LLL

    ON[HRNM FNUYU

    LJIMZLZNU3

    Mndn 3 Zm. UU

    Cimls fiondlm 3 Onfl-onfl

    Ydur 3 :9 tn`um

    [ifircnnm 3 Uwnstn

    Ngndn 3 [rhtistnm

    Nondnt 3 [ifnmbnru

    Mh. DR 3 71 ;1 75

    Dnsuf RU 3 20 Cuol 2;>2

    NMNDMIULU

    Fiou`nm Ytndn3

    Bnjnm tirnsn oidn` sicnf > `nrl UDRU

    Rlwnynt [imynflt Uifnrnmg

    Uicnf > `nrl UDRU pnslim dimgiou`fnm bnjnm tirnsn oidn`, tljnf dnudnfnm jnm dlmud. [nslim cugn dirnsnfnm duno, mndum tljnf njn dumtn`.

    Bntuf birjn`nf, jn`nf birwnrmn putl` jnm sisnf mnans ynmg sidnflm

    birtndbn` clfn pnslim tljur tioimtnmg. BNF pnslim cudon`myn sijlflt

    jlbnmjlmgfnm blnsnmyn, BNF birwnrmn fumlmg firu`.

    2 buonm ynmg onou pnslim dimgiou`fnm pirut sidnflm didbisnr. [irutdidbisnr jlsirtnl jimgnm rnsn sisnf. Uisnf sidnflm birtndbn` clfn pnslim

    tljur tioimtnmg, jnm birfurnmg blon pnslim jujuf. [nslim cugn dimgiou`fnmbimgfnf pnjn fijun fnfl. Fijun dntn fumlmg, BNB birwnrmn `ltnd. BNF

    fumlmg pifnt, tljnf myirl jnm onmenr. Birnt bnjnm cugn dimurum jrnstls.

    9 buonm ynmg onou pnslim dimgiou`fnm myirl pnjn uou `ntl, `lonmg tldbuo,tljnf dimcnonr. Myirl uou`ntl jlsirtnl duno jnm dumtn`. BNB pnslim

    mhrdno, tljnf njn BNB birwnrmn `ltnd. Dntn fumlmg jnm [irut jlrnsnfnm

    duonl didbisnr. [nslim birhbnt fi RUYJ jnm jlngmhsls dimgnondl

    pimynflt `ntl.

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    >:

    Rlwnynt [imynflt Jn`uou

    Zljnf njn rlwnynt tifnmnm jnrn` tlmggl Rlwnynt pimynflt JD jlsnmgfno hoi` pnslim

    Rlwnynt [imynflt Fiounrgn

    Zljnf njn nmgghtn fiounrgn ynmg dimjirltn pimynflt sipirtl lml

    Rlwnynt fiblnsnnm

    Dlmud nofh`ho (+) Dirhfhf (+)

    [IDIRLFUNNM ALULF (20 Cuol 2;>2)

    Utntus gimirnols

    Finjnnm udud 3 Zndpnf snflt birnt

    Fisnjnrnm 3 ehdphsdimtls

    Znmjn vltno

    Zifnmnm jnrn` 3 ;; x/dimlt riguoir, iquno, lsl eufup [irmnansnm 3 52 x/dimlt Zidpirntur 3 51,9;E

    Fipnon/Oi`ir3

    Fhmcumgtlvn nmidls (-/-), sfoirn lftirlf (+/+), ijidn pirlhrbltn (-/-), slnmhsls (-),

    aithr `ipntlfud (-), aithr uridlfud (-),pidbisnrnm FGB (-), jivlnsl trnfin (-),

    pimlmgfntnm CQ[ (-).

    Z`hrnfs3

    [uodh3

    Lmspifsl 3 bimtuf jnm girnfnm slditrls, ritrnfsl lmtirfhstn (-), spljirmivl (-), vimiftnsl (-)

    [nopnsl 3 aridltus rnbn jifstrn 4 slmlstrn [irfusl 3 shmhr jl siouru` onpnmgnm pnru Nusfuotnsl 3 sunrn mnans vislfuoir, rhmf`l (-/-), w`iizlmg (-/-)

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    >9

    Ehr3

    Lmspifsl 3 letus ehrjls tljnf tndpnf [nopnsl 3 letus ehrjls tljnf tirnbn [irfusl 3 bntns cnmtumg jnond bntns mhrdno Nusfuotnsl 3 U>, U2 riguonr, sunrn tndbn`nm (-)

    Nbjhdim3

    Lmspifsl 3 eidbumg, enput dijusni (+) Nusfuotnsl 3 blslmg usus (+) dimurum [nopnsl 3 jlstimsl (+), myirl tifnm (-) pnjn sidun funjrnm,

    `ipnr/olim/glmcno suolt umtuf jlmlonl, jianms duseuonr (-), O[ 4 2)

    @b3 >5,0 g/jo

    @t3 55.0;; /o

    Zrhdbhslt3 7:.;;; /o

    Fldln jnrn` (20 Cuol 2;>2)

    Gou3 7: dg/jo

    BYM3 05 dg/jo

    ER-U3 :,;1 dg/jo

    NUZ3 2;< LY/O

    NOZ3 9; LY/O

    NOB3 >,7 dg/jo

    Z.Blo3 52,7 dg/jo

    J.Blo3 >:,9 dg/jo

    Yriud3 >77,1 dg/jo

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    RIUYDI

    Zm Us, :9 tn`um jntnmg fi RUYJ NN jimgnm fiou`nm fiou`nm bnjnm

    tirnsn oidn` sicnf > `nrl UDRU. Jnrl nmndmisls jljnpntfnm bnjnm tirnsn oidn`,

    duno (+), tljnf dnu dnfnm jnm dlmud, fijun dntn fumlmg. [irut didbisnr,

    bntuf birjn`nf (+), sisnf mnans snnt birbnrlmg. Qhoudi BNF sijlflt, BNF

    fumlmg pifnt, BNB birwnrmn `ltnd. Birnt bnjnm dimurum jrnstls, myirl jl uou

    `ntl jnm jljlngmhsls dimgnondl pimynflt `ntl 9 buonm ynmg onou. Rlwnynt

    fiblnsnnm Dlmud nofh`ho (+) Dirhfhf (+). Jnrl pidirlfsnnm alslf jljnpntfnm

    sfoirn lftirlf, pirut jlstimsl, enput dijusni (+), nsltis, s`latlmg juoomiss (+), ujid

    tumgfnl (+). Jnrl pidirlfsnnm pimumcnmg jljnpntfnm oiufhslt >5.0;; /o

    trhdbhslthpimln (Zrhdbhslt3 7:.;;; /o), `lphnobudlmidln (>,7 dg/jo), BYM

    dimlmgfnt (05 dg/jo), frintlmlm dimlmgfnt :,;1 dg/jo).

    JNAZNR DNUNON@

    >. Bnjnm oidn`2. Lftirus5. Nsltis:. Oiufhslthsls9. Zrhdbhslthpimln1. @lphnobudlmidln7. [imlmgfntnm BYM jnm frintlmlm sirud0. Holghurln

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    >7

    RIMENMN [IDIRLFUNNM

    Eif ioiftrholt

    YUG glmcno

    [IMNZNONFUNMNNM

    LQAJ J9 % >; tpd Lmcifsl aurhsidlj 5 x > ndpuo Lmcifsl Rnmltljlm 2 x > ndpuo Lmcifsl Eiatrlnxhm 2 x > gr Uubstltusl Nobudlm Rimenmn @idhjlnolsn elth

    [RHGMHULU

    Qltnd 3 dnond

    Aumetlhmnd 3 dnond

    AHOOHW Y[

    Znmggno 22

    Uubciftla 3 oidn`, giolsn`, sisnf (+), bntuf(+), tljnf blsn tljur

    Hbciftla

    Fisnjnrnm 3 shdmhoim

    ZJ3 ;; x/l RR 320 x/l Z351 ;E

    Qhoud urlm/2:cnd3 ?>;;do

    Nssisdimt 3 slmjrhdn `ipnthrimno+imsianohpntl

    [onmlmg

    Zirnpl onmcut

    [nsnmg MGZ

    EZD 2x >

    Ndbrhxho 5x>

    Znmggno 5;-;7-2;>2 (pngl)

    Uubciftla 3 sidnflm oidn`, giolsn`, sisnf, bntuf(+), tljnf blsn tljur

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    >0

    Hbcietla

    Fisnjnrnm 3 Uhdmhoim

    ZJ3 >;x/l RR 320 x/l Z351 ;E

    Qhoud urlm/2:cnd3 ?>;;do

    Nssisdimt3 slmjrhd `ipnthrimno +imsianohpntl

    [onmlmg

    Zirnpl onmcut

    Znmggno 5;-;7-2;>2 (shri)

    Uubciftla 3 sidnflm oidn`, sidnflm sisnf,

    Hbcietla

    Fisnjnrnm 3 Uhdmhoim

    ZJ3 0;/1; M 3 >>9x/l RR 352 x/l Z351 ;E

    Nssisdimt3 slmjrhd `ipnthrimno +imsianohpntl

    [onmlmg

    Jrlp jhpndlm >2 tpd

    BNB LQ

    [IDBN@NUNM

    Jlonphrfnm pnslim onfl-onfl birudur :9 tn`um ynmg jlrnwnt jl runmg

    [imynflt jnond prln RUYJ Nrlalm Ne`dnj jnrl tnmggno 20 Cuol 2;>2 jimgnm

    jlngmhsls U@R. Jlngmhsls U@R jljnsnrfnm ntns nmndmisls, pidirlfsnnm alslf

    sirtn pidirlfsnnm pimumcnmg.

    NMNDMIULU

    Jnrl nmndmisls jljnpntfnm bnjnm tirnsn oidn`, duno (+), tljnf dnu

    dnfnm jnm dlmud, fijun dntn fumlmg. [irut didbisnr, bntuf birjn`nf (+),

    sisnf mnans snnt birbnrlmg. Qhoudi BNF sijlflt, BNF fumlmg pifnt, BNB

    birwnrmn `ltnd. Birnt bnjnm dimurum jrnstls, myirl jl uou `ntl jnm jljlngmhsls

    dimgnondl pimynflt `ntl 9 buonm ynmg onou. Rlwnynt fiblnsnnmDlmud nofh`ho (+)

    Dirhfhf (+).

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    >5.0;;/o jnm trhdbhslthpimln jimgnm mlonl 7:.;;; /o. Zrhdbhslthpimlnpnjn

    pnslim slrhsls `ntl njnon` tircnjl fnrimn pimlmgfntnm phholmg trhdbhslt pnjn

    spoimhdignol, sibngnl nflbnt pirubn`nm `idhjlmndlf ynmg jlsibnbfnm hoi`

    `lpirtimsl phrtno.

    Fnjnr uriud jnm frintlmlm pnslim lml tlmggl pnjn snnt dnsuf rudn` snflt

    dimnmjnfnm tircnjlmyn lmsualsimsl rimno. Fnjnr nobudlm ynmg rimjn`

    (`lphnobudlmidln) dimnmjnfnm aumgsl slmtisls `ntl ynmg tirgnmggu jnm fhmslstim

    jimgnm finjnnm gngno `ntl.

    [idirlfsnnm ioiftrholt si`nrusmyn jlonfufnm. Ymtuf diol`nt fnjnr Mn+

    sirud ynmg blnsnmyn dimgnondl pimurumnm jnm fnjnr F+ ynmg dimlmgfnt

    (`lpirfnoidln) ynmg sirlmg jltidufnm pnjn gngno glmcno.

    [idirlfsnnm YUG glmcno cugn pirou jlonfufnm umtuf didnstlfnm tljnf

    njnmyn fionlmnm nmnthdl pnjn glmcno. [njn U@R fionlmnm ynmg jlcudpnl pnjn

    glmcno `nmyn birupn figngnonm aumgsl tnmpn jltnmjnl jimgnm fionlmnm nmnthdl.

    JLNGMHULU

    Jnrl nmndmisls, pidirlfsnnm alslf, jnm pidirlfsnnm pimumcnmg jnpnt

    jlsldpuofnm bn`wn pnslim didimu`l gndbnrnm slrhsls fnrimn didimu`l frltirlnlftirlf, nsltis. [nslim cugn didimu`l `ndplr sidun frltirln dnyhr umtuf

    jlngmhsls slmjrhdn `ipnthrimno. Gndbnrnm `nslo pidirlfsnnm onbhrnthrlud pnslim

    dimgnrn` fi slmjrhdn `ipnthrimno tlpi >, jldnmn tircnjl pimlmgfntnm uriud

    (bohhj urin mltrhgim) jnm frintlmlm ynmg prhgrisla jnond wnftu riontla slmgfnt.

    [imjirltn jimgnm tlpi lml blnsnmyn jnond fhmjlsl folmlf ynmg snmgnt birnt jimgnm

    tnmjn gngno `ntl onmcut sipirtl lftirus jnm imsianohpntl.

    Jlngmhsls bnmjlmg pnjn pnslim lml njnon` Mifrhsls tubuonr nfut (MZN).

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    2>

    MZN riontla sirlmg tircnjl pnjn slrhsls `ipntls jimgnm nsltis, `lphtimsl, sipsls, jnm

    miarhthfslf fnrimn hbnt sipirtl ndlmhgolfhsljn tirutndn clfn hbnt lml jlfhdblmnsl

    jimgnm siahtnfsld. [njn MZN blnsnmyn sijldim urlm didpirol`ntfnm slolmjir

    grnmuonr jnm ifsfrisl mntrlud urlm = >; dIq/o. Imzld urlm sipirtl gnddn

    goutndlotrnms piptljnsi, oiuslm ndlmhpiptljnsi, jnm -2 dlfrhgohbuolm jnpnt

    jlgumnfnm umtuf didbijnfnm MZN jimgnm U@R.

    Jlngmhsls bnmjlmg onlmmyn njnon` nzhtidln pririmno. [njn U@R tirjnpnt

    pimurumnm vhoudi vnsfuonr jnm vnshfhmstrlfsl glmcno ynmg jltnmjnl jimgnm

    mntrlud sirud ynmg rimjn`, hsdhonoltns urlm ynmg dimlmgfnt, rnslh hsdhonoltns

    urlm/ponsdn ynmg dimlmgfnt, jnm rnslh frintlmlm urlm/ponsdn ynmg tlmggl.

    Gndbnrnm onbhrnthrlud jnond jnrn` jnm urlm sndn jimgnm nzhtidln pririmno.

    Finjnnm lml birbijn jimgnm MZN ynmg jltnmjnl jimgnm dimlmgfntmyn mntrlud

    jnond urlm (=5; dIq/O), hsdhonoltns urlm sndn jimgnm ponsdn, rnslh hsdhonoltns

    urlm ponsdn ynmg rimjn`, jnm rnslh frintlmlm urlm ponsdn ynmg rimjn` (? 2; 3 >).

    [IMNZNONFUNMNNM

    [imntnonfsnmnnm slmjrhdn `ipnthrimno ynmg jlonfufnm njnon` birslant

    suphrtla ynltu dhmlthrlmg fnjnr urlmi jnm ristrlfsl enlrnm. Zirnpl jialmltla

    slmjrhdn `ipnthrimno njnon` trnmsponmtnsl `ntl titnpl tljnf jnpnt jlonfufnm.

    >. [imntnonfsnmnnm nsltis pnjn pnslim lml njnon` jimgnm didbirlfnm tirnpljluritlf. Hbnt jluritlf ynmg jlgumnfnm njnon` lmcifsl aurisidlj.

    [imntnonfsnmnnm nsltis jnpnt jlonfufnm jimgnm enrn tlrn` bnrlmg jnm jlnwnol

    jlit rimjn` gnrnd, fhmsudsl gnrnd sibnmynf 9,2 grnd ntnu ;;-2;; dg sifnol si`nrl. Risphmjluritlf blsn jldhmlthr jimgnm pimurumnm birnt bnjnm ;,9 fg/`nrl. Blon

    pidbirlnm splrhmhonfthm tljnf njifunt blsn jlfhdblmnsl jimgnm aurhsidlj

    jimgnm jhsls 2;-:; dg/`nrl. [idbirlnm aurhsidlj blsn jltndbn` jhslsmyn

    blon tljnf njn risphm jimgnm jhsls dnfsldno >1; dg/`nrl. [nrnslmtisls

    jlonfufnm npnblon nsltis snmgnt bisnr. [imgiounrnm nsltis blsn `lmggn :-1 oltir

    jnm jlolmjumgl jimgnm pidbirlnm nobudlm.

    Hoi` fnrimn pnslim U@ snmgnt simsltla jimgnm pirubn`nm fisildbnmgnm

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    22

    enlrnm jnm ioiftrholt, dnfn pidnfnlnm jluritlf ngrisla, pnrnslmtisls nsltis, jnm

    ritrlfsl enlrnm ynmg biroibl`nm `nrus jl`lmjnrl.

    2. [idbirlnm nmtlblhtlf Eiatrlnxhm >g/>2 cnd pnjn pnslim lml birtucunm umtufdimeign` sphmtnm bnetirlno pirlthmltls (UB[). Rislfh sirnmgnm uonmgnm UB[

    jlfurnmgl jimgnm pidbirlnm nmtlblhtlf prhalonfsls. Blon pnslim UB[ dimjnpnt

    tirnpl nmtlblhtlfn, pidbirlnm nobudlm nfnm dimgurnmgl arifuimsl jlsaumgsl

    glmcno.

    5. [njn pnslim lml jlrimenmnfnm umtuf dimjnpnt substltusl nobudlm. [idbirlnmnobudlm jnpnt dimeign` jlsaumgsl slrfuonsl jnm tldbuomyn U@R. Nobudlm

    dimeign` umjiraloolmg nrtirl jnm nftlvnsl slstid vnshfhmstrlfthr nflbnt

    lmaifsl.

    :. [nslim lml tljnf jlbirlfnm hbnt vnshjlonthr ntnu vnshfhmstrlfthr.Hbnt-hbntnmvnshjlonthr jlpnfnl pnjn pimjirltn U@R umtuf dimurumfnm rislstimsl

    vnsfuoir glmcno. Uijnmgfnm vnshfhmtrlfthr umtuf dimgntnsl vnshjlontnsl

    sponmfmlf.

    9. @idhjlnolsn tljnf sidpnt jlonfufnm pnjn pnslim lml. Ui`nrusmyn @idhjlnosnjlonfufnm sigirn pnjn pnslim lml fnrimn fnjnr uriud jnm frintlmlm ynmg

    tlmggl.

    Zirnpl suphrtla tir`njnp glmcno jlonfufnm clfn dumgflm tircnjl

    pimyidbu`nm `ntl ntnu fidumgflmnm trnmsponmtnsl `ntl, fnrimn clfn tljnf

    dnfn tirnpl suphrtla tir`njnp glmcno `nmynon` didpirondbnt fidntlnm.

    Birbngnl tirnpl jnpnt jlonfufnm sipirtl jlnolsls pirlthmino, `idhjlnolsls, ntnu

    `idhalotrnsl. @idhjlnolsls jnm jlnolsls pirlthmino jlonfufnm umtuf dimggnmtl

    aumgsl glmcno sndblo dimumggu pirbnlfnm pimynflt `ntl ntnu trnmsponmtnsl

    `ntl. @idhjlnolsls jnpnt dimgntnsl fitljnfsildbnmgnm nlr jnm ioiftrholt,mndum tljnf jnpnt dimyidbu`fnm U@R.

    [RHGMHULU

    [nslim lml sujn` tirdnsuf fi jnond fntighrl ynmg didbutu`fnm

    trnmsponmtnsl `ntl, titnpl fnrimn prhsijur tirsibut tljnf jnpnt jlonfufnm dnfn

    prhgmhsls pnslim dimcnjl buruf (dnond). Uionlm ltu slmjrhdn `ipnthrimno tlpi >

    didnmg birfnltnm jimgnm prhgmhsls ynmg buruf.

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    BNB Q

    FIULD[YONM

    Zion` jlonphrfnm sihrnmg prln usln :9 tn`um jntnmg jimgnm bnjnm tirnsn

    oidn`, duno (+), tljnf dnu dnfnm jnm dlmud, fijun dntn fumlmg. [irut

    didbisnr, bntuf birjn`nf (+), sisnf mnans snnt birbnrlmg. Qhoudi BNF sijlflt,

    BNF fumlmg pifnt, BNB birwnrmn `ltnd. Birnt bnjnm dimurum jrnstls, myirl jl

    uou `ntl jnm jljlngmhsls dimgnondl pimynflt `ntl 9 buonm ynmg onou. Rlwnynt

    fiblnsnnmDlmud nofh`ho (+)Dirhfhf (+).

    [njn pidirlfsnnm alslf jljnpntfnm njnmyn lftirlf, enput dijusni, nseltis

    jnm, ijidn pirlair. Zljnf jltidufnm njnmyn stlgdn slrhsls `ipntls. Ulmjrhd

    `ipnthrimno tljnf didlolfl tnmjn ynmg spislalf. Dimjitifsl njnmyn stlgdntn

    pimynflt `ntl frhmlf pimtlmg umtuf jlonfufnm fnrimn fibnmynfnm pnslim Ulmjrhd

    `ipnthrimno dimgnondl slrhsls.

    Jnrl nmndmisls, pidirlfsnnm alslf, jnm pidirlfsnnm pimumcnmg jnpnt

    jlsldpuofnm bn`wn pnslim didimu`l gndbnrnm slrhsls `ipntls. [nslim cugn

    didimu`l `ndplr sidun frltirln dnyhr umtuf jlngmhsls slmjrhdn `ipnthrimno.

    [imntnonfsnmnnm slmjrhdn `ipnthrimno ynmg jlonfufnm njnon` birslant suphrtla

    ynltu nmthblhtlf, dhmlthrlmg fnjnr urlmi jnm ristrlfsl enlrnm. Zirnpl jialmltla

    slmjrhdn `ipnthrimno njnon` trnmsponmtnsl `ntl titnpl tljnf jnpnt jlonfufnm.

    [rhgmhsls slmjrhd `ipnthrimno bnlf vltnd dnupum aumetlhmnd njnon` dnond.

    [nslim dimcnonml pirnwntnm siondn 2 `nrl, jnm fidujlnm dimlmggno.

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    Jnatnr [ustnfn

    >. Uutnjl UD. Ulmjrhdn @ipnthrimno Bnglnm Lodu [imynflt JnondAnfuotns Fijhftirnm Ymlvirsltns Uudntirn Ytnrn. Jlumju` jnrl

    `ttp3//olbrnry.usu.ne.lj/jhwmohnj/af/pimyjnond-srldnrynml1.pja

    VJlnfsis 5 Ngustus 2;>2T.

    2. Uujhyh, Nrl W jff. Bufu Ncnr Lodu [imynflt Jnond Clolj L Ijlsl LQ.[usnt [imirbltnm Jipnrtidim Lodu [imynflt Jnond Anfuotns

    Fijhftirnm Ymlvirsltns Lmjhmisln. Cnfnrtn. Cuml 2;;1. :92-:9:

    5. Uujumg H. [nrjiji. Ulmjrhd @ipnthrimno. Eirdlm Jumln FijhftirnmMh. >:;, 2;;5 Bnglnm Lodu Fisi`ntnm Nmnf Anfuotns Fijhftirnm

    Ymlvirsltns Lmjhmisln/ Rudn` Unflt Ydud [usnt Mnslhmno Jr. Elpth

    Dnmgumfusudh, Cnfnrtn

    :. @nrlshm. [rlmslp [rlmslp Lodu [imynflt Jnond Ijlsl >5 Qhoudi LQ.IGE [imirblt Bufu Fijhftirnm. Cnfnrtn. 2;;;. >155->150

    9. E`nrois FA Mg, Dle`nio @D E`nm, Dhrrls @O Znl, E`rlsthp`ir WFOnd. Dlml-rivliw3 @ipnthrimno Uymjrhdi. Jipnrtdimt ha E`idleno

    [nt`hohgy, Z`i E`lmisi Ymlvirslty ha @hmg Fhmg, [rlmei ha Wnois

    @hspltno, U`ntlm, @hmg Fhmg.

    `ttp3//www.pubdijeimtrno.ml`.ghv/aprimjir.aegl VJlnfsis 5 Ngustus

    2;>2T.

    http://library.usu.ac.id/download/fk/penydalam-srimaryani6.pdfhttp://www.pubmedcentral.nih.gov/fprender.fcgihttp://www.pubmedcentral.nih.gov/fprender.fcgihttp://library.usu.ac.id/download/fk/penydalam-srimaryani6.pdf