c7 hiperbilirubinemia nn & insuficienta renala

8/14/2019 C7 Hiperbilirubinemia nn & Insuficienta Renala

1/70

NFUCZJFMFZSJFACKFNFUCZJFMFZSJFACKFLL

AC@ALTLMAC@ALTLM


2/70

BLS_CBLS_C

Nck`mfl lbstl d`jladft wftNck`mfl lbstl d`jladft wft!! H8 aftz`gszlat`faH8 aftz`gszlat`fa Rlaic c~tzlwlrbsmlz? + ncklt`lkcRlaic c~tzlwlrbsmlz? + ncklt`lkc

+ n bczcjzlm `bsmt- usmk`alz+ n bczcjzlm `bsmt- usmk`alz

U`mfbftckfc? + Tzlarg gct`kltcza rf gct`gctlmU`mfbftckfc? + Tzlarg gct`kltcza rf gct`gctlm+ Ucarlzc tlzdfw l+ Ucarlzc tlzdfw l B@B@


3/70

:!Bzcrtczcl bfzbsmltfcf catcz`ncultfbc:!Bzcrtczcl bfzbsmltfcf catcz`ncultfbc Rtca`l ufm`zfbRtca`l ufm`zfb

Ltzcfc fatcrtfalmLtzcfc fatcrtfalm Rtca`l ds`dcalmRtca`l ds`dcalm J`lml NfzrbnruzsaiJ`lml Nfzrbnruzsai

Fmcsr kcb`aflmFmcsr kcb`aflm Fmcsr ulzlmftfbFmcsr ulzlmftfb


4/70

2! Bàdftff kctlj`mfbc rf2! Bàdftff kctlj`mfbc rfcad`bzfac?cad`bzfac?

Ilmlbt`ckfcIlmlbt`ckfc Rfadz`k Bzfimcz+Aloolz .fbtcz glkfmflm acnck`mftfb&Rfadz`k Bzfimcz+Aloolz .fbtcz glkfmflm acnck`mftfb& J`lml IfmjcztJ`lml Ifmjczt

Nfu`tfz`fdfrkNfu`tfz`fdfrk Kcdfblkcatc rf n`zkàf Msbcv+Dzfrb`mmKcdfblkcatc rf n`zkàf Msbcv+Dzfrb`mm

++ a`w`jf`bfala`w`jf`bfal

Bùff dfa klkc dfljctfbcBùff dfa klkc dfljctfbc UzckltszftltcUzckltszftltc Nfuùftsftlzfrk rf lacabcglmfcNfuùftsftlzfrk rf lacabcglmfc


5/70

4!Blsc `jrtzsbtfwc4!Blsc `jrtzsbtfwc

Ltzcfc jfmflzLtzcfc jfmflz Rfadz`k Dsjfa+O`nar`aRfadz`k Dsjfa+O`nar`a

Rfadz`k Z`t`zRfadz`k Z`t`z Bnfrt b`mcd`bBnfrt b`mcd`b Gfjz`l bnfrtfbGfjz`l bnfrtfb

Dcgfbft dcDcgfbft dc


6/70

3! Kf~t3! Kf~t RcurfrRcurfr Fagcbtff tzlarkfrc wcztfblm? + T`~ùmlrk`Fagcbtff tzlarkfrc wcztfblm? + T`~ùmlrk`ll

+ Zsjc`ml+ Zsjc`ml

+ JFB+ JFB+ Nczucr rfkumc~+ Nczucr rfkumc~+ Ncultftl+ Ncultftl

+ Rfgfmfr bàicaftlm+ Rfgfmfr bàicaftlm

Rfadz`ksm dctzcrcf zcrufzlt`zffRfadz`ksm dctzcrcf zcrufzlt`zff Lrgf~fcLrgf~fc Bùff dfa klkc dfljctfbcBùff dfa klkc dfljctfbc


7/70

NFUCZJFMFZSJFACKFLNFUCZJFMFZSJFACKFL

ACB@AOSILTACB@AOSILT


8/70

J@LML NCK@MFTFB L A@S+J@LML NCK@MFTFB L A@S+

ARBSTSMSFARBSTSMSF.CZFTZ@JMLRT@_L GCTLM.CZFTZ@JMLRT@_L GCTLM&&


9/70

J`lml nck`mftfb lulzc a bldzsm sacf rlzbfafJ`lml nck`mftfb lulzc a bldzsm sacf rlzbfafnctcz`rucbfgfbc- a blzcnctcz`rucbfgfbc- a blzc klkl Zn+aciltfwklkl Zn+aciltfw

uz`dsbc latfb`zuf ku`tzfwl uz`uzfsmsf gt Zn+uz`dsbc latfb`zuf ku`tzfwl uz`uzfsmsf gt Zn+

u`ftfwu`ftfw!! Rtfksmlzcl latficafb crtc uz`dsr dc nckltffmcRtfksmlzcl latficafb crtc uz`dsr dc nckltffmc

gctlmc- blzc losai a bfzbsmlfl kltcza uzfagctlmc- blzc losai a bfzbsmlfl kltcza uzfafatczkcdfsm umlbcatcf8fatczkcdfsm umlbcatcf8

Ulrlosm nckltffm`zUlrlosm nckltffm`zcrtc klfcrtc klf fatcarfatcara tfkusma tfkusmbnfszctlocm`z- altczff f klacwzcm`z `jrtctzfblmcbnfszctlocm`z- altczff f klacwzcm`z `jrtctzfblmc!!


10/70

Cwfdcafczcl f cwlmslzcl blatftltfw l nckltffm`zCwfdcafczcl f cwlmslzcl blatftltfw l nckltffm`zgctlmc a bfzbsmlfl kltcza rc glbc bs lost`zsmgctlmc a bfzbsmlfl kltcza rc glbc bs lost`zsmkct`dcf Hmcfnlkcz f Jcthckct`dcf Hmcfnlkcz f Jcthc blzc bàrt a?blzc bàrt a?

uzcmcwlzcl sasf gz`tfs dc raic dc ml klk8uzcmcwlzcl sasf gz`tfs dc raic dc ml klk8 tzltlzc bs ` r`msfc lbfd- lu`f b`m`zlzc8tzltlzc bs ` r`msfc lbfd- lu`f b`m`zlzc8

bftfzc ml kfbz`rbùsm ùtfb!bftfzc ml kfbz`rbùsm ùtfb!


11/70

Dctczkfalzcl rfrtcksmsf Zn lzc ml jlDctczkfalzcl rfrtcksmsf Zn lzc ml jluzccal Li ml rsuzlgll nckltffm`z f rc glb bsuzccal Li ml rsuzlgll nckltffm`z f rc glb bslost`zsm rcz`tcrtcm`z!lost`zsm rcz`tcrtcm`z!

a rfrtcksm Zn bl f a bcm LJ@ as c~frta rfrtcksm Zn bl f a bcm LJ@ as c~frt

latfb`zuf altszlmf .latf+D- latf+L- latf+J&!latfb`zuf altszlmf .latf+D- latf+L- latf+J&! Gca`kcacmc ult`m`ifbc lmc sacf rlzbfafGca`kcacmc ult`m`ifbc lmc sacf rlzbfaf

nctcz`rucbfgfbc lulz ` dlt bs lulzfflnctcz`rucbfgfbc lulz ` dlt bs lulzffllatfb`zufm`z latf+Zn .latf+D&- a szkl rtfksmzfflatfb`zufm`z latf+Zn .latf+D&- a szkl rtfksmzff

latficafbc!latficafbc! Latfb`zuff blzc fls altczc glb ulztc dfa bmlrcmcLatfb`zuff blzc fls altczc glb ulztc dfa bmlrcmcFiI f FiK!FiI f FiK!


12/70

Ucatzs j`lml nck`mftfb l a`s+arbstsmsf-Ucatzs j`lml nck`mftfb l a`s+arbstsmsf-ls fku`ztla d`lz latfb`zuff dfa bmlrlls fku`ztla d`lz latfb`zuff dfa bmlrlFiI- rfaiszff blzc tzcb jlzfczl umlbcatlz8FiI- rfaiszff blzc tzcb jlzfczl umlbcatlz8

a bfzbsmlfl gctlm lbctfl u`t ltfaica bfzbsmlfl gctlm lbctfl u`t ltfaicafwcmsm dc ml klk asklf ml 23 dcafwcmsm dc ml klk asklf ml 23 dcrutkaf dc icrtlfc!rutkaf dc icrtlfc!


13/70

Dflia`rtfbsm uzcaltlmDflia`rtfbsm uzcaltlm Lalkacl izlwfdcf + latcbcdcatc `jrtctzfblmc ult`mìfbcLalkacl izlwfdcf + latcbcdcatc `jrtctzfblmc ult`mìfbc

.tzlargsff dc raic Zn+u`ftfwlw`ztszf- arbsf k`zf.tzlargsff dc raic Zn+u`ftfwlw`ztszf- arbsf k`zfrls wff bs lalrlzb gct`+umlbcatlz- fbtczc izlwc rlsrls wff bs lalrlzb gct`+umlbcatlz- fbtczc izlwc rlslackfc nck`mftfb&8lackfc nck`mftfb&8

Zn+sm klkcf f r`smsf8Zn+sm klkcf f r`smsf8 Tftzsm dc latfb`zuf a dfalkfb8Tftzsm dc latfb`zuf a dfalkfb8 Rucbtz`g`t`kctzfl ML c~tzlr uzfa lkaf`bcatc8Rucbtz`g`t`kctzfl ML c~tzlr uzfa lkaf`bcatc8

+ rc luzcbfl izldsm dc lgcbtlzc l gtsmsf uzfa+ rc luzcbfl izldsm dc lgcbtlzc l gtsmsf uzfadctczkfalzcl jfmfzsjfacf a ML8dctczkfalzcl jfmfzsjfacf a ML8

+ b`zcmlzcl fadfbcmsf ùtfb l rucbtz`g`t`kctzfcf+ b`zcmlzcl fadfbcmsf ùtfb l rucbtz`g`t`kctzfcfML bs rsgczfal gctlm rc glbc bcm klf jfacML bs rsgczfal gctlm rc glbc bcm klf jfac atzc 25+atzc 25+24 rutkaf dc icrtlfc bs lost`zsm24 rutkaf dc icrtlfc bs lost`zsm dflizlkcfdflizlkcfMfmcvMfmcv!!


14/70

Lkaf`rb`ufl- dsu rutkal l 25+bclLkaf`rb`ufl- dsu rutkal l 25+bcldc icrtlfc8dc icrtlfc8

ML tzlarulzcat;gt fadcka8ML tzlarulzcat;gt fadcka8

ML wczsf rls ilmjca;rsg! gctlmML wczsf rls ilmjca;rsg! gctlmbczt8bczt8 ML z`; gt kszfjsad!ML z`; gt kszfjsad!


15/70


16/70

22 Fbtczsm izlw acàltlmFbtczsm izlw acàltlm!!

Dcjst + a uzfkcmc `zc dsu altczc .Dcjst + a uzfkcmc `zc dsu altczc .zlz uzccatzlz uzccatdc ml altczcdc ml altczc&-&- rc fatcarfgfb uzìzcrfw ucatzs bl dsu 2+4rc fatcarfgfb uzìzcrfw ucatzs bl dsu 2+4

fmc r rc u`lt fartlml fbtczsm asbmclzfmc r rc u`lt fartlml fbtczsm asbmclz

.cabcglmùltfl nfuczjfmfzsjfackfb&!

.cabcglmùltfl nfuczjfmfzsjfackfb&!

Fbtczsm asbmclz + rckacmc acsz`mìfbc?Fbtczsm asbmclz + rckacmc acsz`mìfbc?r`ka`mcal rls nfuczcrtcfc- kf`bmàff lmcr`ka`mcal rls nfuczcrtcfc- kf`bmàff lmc

gccf- afrtliksr- zcd`lzcl bcgcf- bàwsmrff-gccf- afrtliksr- zcd`lzcl bcgcf- bàwsmrff-uzfwfzc a *lusr dc r`lzc*- tcadfa dcuzfwfzc a *lusr dc r`lzc*- tcadfa dcdcgmcbtlzc l blusmsf!dcgmcbtlzc l blusmsf!


17/70

Lmtc rckac blzc ar`crb fbtczsm izlw ?Lmtc rckac blzc ar`crb fbtczsm izlw ? ulm`lzcl tciskcatcm`z8ulm`lzcl tciskcatcm`z8

ncult`rumca`kcilmfl8ncult`rumca`kcilmfl8 cdckcmc m`b! ml KF rls icaczlmfltccdckcmc m`b! ml KF rls icaczlmfltc czsufc uszuszfb f farsgfbfcaczsufc uszuszfb f farsgfbfca

blzdf`+zcrufzlt`zfc!blzdf`+zcrufzlt`zfc!


18/70

4!Lalrlzbl gct`+umlbcatlz4!Lalrlzbl gct`+umlbcatlz rtlzc icaczlm c~tzck dc izlw8rtlzc icaczlm c~tzck dc izlw8

cdckc icaczlmfltc8cdckc icaczlmfltc8 ulm`lzc c~tzck8ulm`lzc c~tzck8 ljd`kca kzft a w`msk8ljd`kca kzft a w`msk8

farsgfbfca blzdflb lbbcatslt!farsgfbfca blzdflb lbbcatslt!


19/70

Lbclrt g`zk bmfafb klf u`ltc lulzc a?Lbclrt g`zk bmfafb klf u`ltc lulzc a?

fagcbff bàicaftlmc .mscr- t`~ùmlrk`-fagcbff bàicaftlmc .mscr- t`~ùmlrk`-bft`kcilmfc- ncultft bàicaftlm&8bft`kcilmfc- ncultft bàicaftlm&8

rfadz`lkc lackfbc .tlmlrckfc g`zklrfadz`lkc lackfbc .tlmlrckfc g`zklnck`fi`t- dcgfbfd dc I+7UD bs faicrtfc dcnck`fi`t- dcgfbfd dc I+7UD bs faicrtfc dckcdfblkcatc dc btzc klk&8kcdfblkcatc dc btzc klk&8

blzdfùltff bàicaftlmc izlwc8blzdfùltff bàicaftlmc izlwc8 j`mf zcalmc izlwc- dfljct kltcza-j`mf zcalmc izlwc- dfljct kltcza-


20/70

Nfdz`ur gctlmNfdz`ur gctlm


21/70

Dltcmc dc mlj`zlt`zDltcmc dc mlj`zlt`z az! dc nckltff f l Nj uc ` uczf`ld dc : msaf8az! dc nckltff f l Nj uc ` uczf`ld dc : msaf8 czftz`jmltfm`z + lu`f rb ua ml dfrulzfflczftz`jmltfm`z + lu`f rb ua ml dfrulzffl zctfbsm`bft`l8zctfbsm`bft`l8 tz`kj`bftùcafc8tz`kj`bftùcafc8 rbdczcl lbtfwftff glbt`zfm`z bàrskljfmf lf b`lismzff8rbdczcl lbtfwftff glbt`zfm`z bàrskljfmf lf b`lismzff8 JF dfa b`zdàJF dfa b`zdà 11 2ki2ki## uzccal sz`jfmfaìcasmsf a szfauzccal sz`jfmfaìcasmsf a szfa nfuìmfbckfc dlt! nfuczumlfcf bcmsmcm`z jctl+farsmlzc8nfuìmfbckfc dlt! nfuczumlfcf bcmsmcm`z jctl+farsmlzc8 tcrt B``kjr u`ftfw f tftzsm Lb bzcrbst ml klk8tcrt B``kjr u`ftfw f tftzsm Lb bzcrbst ml klk8 tcrt B``kjr dfzcbt f fad! f Zn+u`ftfw ml bùfm!tcrt B``kjr dfzcbt f fad! f Zn+u`ftfw ml bùfm!


22/70

Tzltlkcat uz`gfmlbtfbTzltlkcat uz`gfmlbtfb

Uz`gfml~fl f`fksafzff ?Uz`gfml~fl f`fksafzff ? Cwftlzcl ldkfafrtzzff dc raic Zn+u`ftfw- tstsz`zCwftlzcl ldkfafrtzzff dc raic Zn+u`ftfw- tstsz`z

gckcfm`z Zn+aciltfwc dfa uczf`ldl bcl klf uzcb`bc lgckcfm`z Zn+aciltfwc dfa uczf`ldl bcl klf uzcb`bc lwfcff8wfcff8

Gckcfmc Zn+aciltfwc w`z uzfkf ` d` dc fksaìm`jsmfaGckcfmc Zn+aciltfwc w`z uzfkf ` d` dc fksaìm`jsmfaI latf+D- dc :55+255I latf+D- dc :55+255 i- atzc uzfkl f l tzcfl f dsu sai- atzc uzfkl f l tzcfl f dsu salw`zt rls altczcl sasf uz`dsr dc bàbcufc Zn+u`ftfwlw`zt rls altczcl sasf uz`dsr dc bàbcufc Zn+u`ftfw

Bad mcnsl lzc latfb`zuf latf+D- +Bad mcnsl lzc latfb`zuf latf+D- + AS ldkfafrtzlzcl FiAS ldkfafrtzlzcl Fi

Bad ml fab`kultfjfmftltcl Zn rc lr`bfl f sal dc izsuBad ml fab`kultfjfmftltcl Zn rc lr`bfl f sal dc izsuLJ@- ldkfafrtzlzcl dc Fi as klf crtc acbcrlz!LJ@- ldkfafrtzlzcl dc Fi as klf crtc acbcrlz!


23/70

Tzltlkcat uz`gfmlbtfbTzltlkcat uz`gfmlbtfb

Fadsbczcl altczff altszlmc rls uzfa bclzflaFadsbczcl altczff altszlmc rls uzfa bclzfla- a tfku- a tfkuùtfk- a gsabfc dc izldsm dc kltszftltc- dlz f dc izldsm dcùtfk- a gsabfc dc izldsm dc kltszftltc- dlz f dc izldsm dclgcbtlzc l gtsmsf- a b`mlj`zlzc bs latcbcdcatcmclgcbtlzc l gtsmsf- a b`mlj`zlzc bs latcbcdcatcmc

`jrtctzfblmc lmc klkcf8`jrtctzfblmc lmc klkcf8

Fkltszftltcl gtsmsf + lbbcatslt f fadfbcmc ùtfb lm MLFkltszftltcl gtsmsf + lbbcatslt f fadfbcmc ùtfb lm ML 11 5-:5-:+ tzlargsfl fs dc rai+ tzlargsfl fs dc raic- bs bcmc klf jsac zcsmtltc atzc :>+c- bs bcmc klf jsac zcsmtltc atzc :>+2: rutkaf dc icrtlfc82: rutkaf dc icrtlfc8

; 35+>5km dc raic izsu @ .F&- Zn+aciltfw a blwftltcl; 35+>5km dc raic izsu @ .F&- Zn+aciltfw a blwftltcluczftàclm l gtsmsf8 rc u`ltc zcuctl dsu d`s rutkaf8uczftàclm l gtsmsf8 rc u`ltc zcuctl dsu d`s rutkaf8


24/70

TzltlkcatTzltlkcat

Ltftsdfacl a rlml dc altczfLtftsdfacl a rlml dc altczf Fartlmlzcl zcrufzlfcf f rtljfmflzclFartlmlzcl zcrufzlfcf f rtljfmflzcl

tckuczltszff8tckuczltszff8 Zcrsrbftlzcl bùfmsmsf bs nfdzùr- mlZcrsrbftlzcl bùfmsmsf bs nfdzùr- ml

acw`fc wcatfmlfc lrfrtlt ( C!R!T ulzflmacw`fc wcatfmlfc lrfrtlt ( C!R!T ulzflmbs :5+45 km klr czftz`bftlz Zn aciltfw!bs :5+45 km klr czftz`bftlz Zn aciltfw!

Kàft`zflzcl dc mlj`zlt`z?Kàft`zflzcl dc mlj`zlt`z? Nt8 Jfmfzsjfal rczfb t`tlm ? ml 4+7 `zcNt8 Jfmfzsjfal rczfb t`tlm ? ml 4+7 `zc

ua wl gf a dcbmfaua wl gf a dcbmfa


25/70

CRTCRT bad a`s+arbstsm uzcfat? ulm`lzc lbbcatsltbad a`s+arbstsm uzcfat? ulm`lzc lbbcatslt

rls fbtcz tciskcatlz- cdckc-rls fbtcz tciskcatlz- cdckc-ncult`rumca`kcilmfc- rtlzc icaczlm lmtczlt8ncult`rumca`kcilmfc- rtlzc icaczlm lmtczlt8

Nj ml aa ml tczkca crtc rsj


26/70

G`t`tczlufl?G`t`tczlufl?

G`t`tczlufl? + dfa F+l f dc wflG`t`tczlufl? + dfa F+l f dc wfl g`t`f`kczflzcl ic`kctzfb l JF- uzcmslt dc gfbltg`t`f`kczflzcl ic`kctzfb l JF- uzcmslt dc gfblt

jfmjfm g`zklzcl dc mskfzsjfag`zklzcl dc mskfzsjfa jfmjfm

zclbff dc `~fdlzc l J!Zzclbff dc `~fdlzc l J!ZKrszf rsumfkcatlzc?Krszf rsumfkcatlzc? Uz`tcolzcl `bnfm`z .faoszff `bsmlzc&Uz`tcolzcl `bnfm`z .faoszff `bsmlzc& Lbuczfzcl ufczdczfm`z dc lu farcarfjfm f dficrtfwLbuczfzcl ufczdczfm`z dc lu farcarfjfm f dficrtfw Cwftlzcl rsuzlabmfzff a!a!Cwftlzcl rsuzlabmfzff a!a! Cgcbtc rcbsadlzc? rfadz!* bùfmsmsf jzàlt* uzfaCgcbtc rcbsadlzc? rfadz!* bùfmsmsf jzàlt* uzfa

zctcafc dc lb! jfmflzfzctcafc dc lb! jfmflzf Bàtzlfadfblff? u`zgfzfl bàicaft!Bàtzlfadfblff? u`zgfzfl bàicaft!


27/70

Tzltlkcat kcdfblkcat`rTzltlkcat kcdfblkcat`r

Gca`jlzjftlmsmGca`jlzjftlmsm?? Bzctc afw! lbtfw! Im! tzlargczlcf ml afwcm ncultfbBzctc afw! lbtfw! Im! tzlargczlcf ml afwcm ncultfb Bzctc gms~sm jfmflz acdcucadcat dc rzszf jfmflzcBzctc gms~sm jfmflz acdcucadcat dc rzszf jfmflzc Bzctc bàbcatz! ncult`bftlz l uz`tcfacf V blzcBzctc bàbcatz! ncult`bftlz l uz`tcfacf V blzc

u`tcacl tzlaru`ztsm jfmfzsjfacf ml zctfbsmsmu`tcacl tzlaru`ztsm jfmfzsjfacf ml zctfbsmsmcadùmlrklfb- sadc rc lgm jfmfzsjfa+cadùmlrklfb- sadc rc lgm jfmfzsjfa+imsbszàfmtzlargczlimsbszàfmtzlargczl

D`l kcdfc ? 3 ki/Hi/fD`l kcdfc ? 3 ki/Hi/fLmjskfal sklaLmjskfal skla? +mcli JF? +mcli JF D`l?


28/70

B`kumfbltffB`kumfbltff

J!K! nflmfacJ!K! nflmfac NfuìmfbckfcNfuìmfbckfc

Tz`kj`bftùcafl8Tz`kj`bftùcafl8 Fbtcz `jrtzsbtfw .rfadz! jfm iz`lr&8Fbtcz `jrtzsbtfw .rfadz! jfm iz`lr&8 Lackfl rcwcz ml a!a! nfdzùfbLackfl rcwcz ml a!a! nfdzùfb


29/70

Fbtczsm b`mcrtltfb a!a!Fbtczsm b`mcrtltfb a!a!


30/70

Lulzc uzfa tsmjszlzcl dzcalosmsf jfmcf bsLulzc uzfa tsmjszlzcl dzcalosmsf jfmcf bsbzctczcl J!D! ucrtc


31/70

BlscmcBlscmc

Rfadz! T@ZBN-Rfadz! T@ZBN- ncultftcmc L f J-ncultftcmc L f J- Cbn`wfzsr-Cbn`wfzsr- W! B`~rlhfc-W! B`~rlhfc- fagcbff jlbtczfcac!fagcbff jlbtczfcac!


32/70

:!:!Icactfbc f kctlj`mfbc?Icactfbc f kctlj`mfbc?

ilmlbt`ckflilmlbt`ckfl Fat`mczlal ml gzsbt`Fat`mczlal ml gzsbt` Ksb`wfrbfd`l- tfz`rfackflKsb`wfrbfd`l- tfz`rfackfl Dcgfbfcal lmgl+


33/70

2! LMTC BLS_C2! LMTC BLS_C J! nck`mftfb-J! nck`mftfb- lmfk! ulzcatczlm T!-lmfk! ulzcatczlm T!- farsg! blzdflb-farsg! blzdflb- ltzcfl/nfuùmlfl jfmflz-ltzcfl/nfuùmlfl jfmflz-

rtzf u`rtùczlt`zff-rtzf u`rtùczlt`zff- dzìszf!dzìszf!


34/70

Lrucbtc bmfafbcLrucbtc bmfafbc

a gsabfc dc fatcarftltcl j`mff?a gsabfc dc fatcarftltcl j`mff? tciskcatc fbtczfbc-tciskcatc fbtczfbc- ncult`rumca`kcilmfc-ncult`rumca`kcilmfc- szfaf nfuczbz`kc-szfaf nfuczbz`kc- rblsac lb`mfbcrblsac lb`mfbc

rfkut`klt`m`ifl j`mff dc jlrfkut`klt`m`ifl j`mff dc jl ?? `b- rtzf`b- rtzfrcutfbc . jlbtczfcac- wfzlmc- gsaifbc& rlsrcutfbc . jlbtczfcac- wfzlmc- gsaifbc& rlsdcr`zdfaf kctlj`mfbc!dcr`zdfaf kctlj`mfbc!


35/70

DDflia`rtfbflia`rtfbFwcrtfilff dc zstfaFwcrtfilff dc zstfa?? Jfmfzsj! .D!T&-Jfmfzsj! .D!T&- Tzlarlk!Tzlarlk! g`rgltlc lmblmfac-g`rgltlc lmblmfac- nck`bsmtsz-nck`bsmtsz-

tftzsm T@ZBN- bft`kcilmwfzsr a bsmtsz szfalz-tftzsm T@ZBN- bft`kcilmwfzsr a bsmtsz szfalz- LiNjr- Lb! FiK ut! N!W!-LiNjr- Lb! FiK ut! N!W!- afwcmsm lmgl+


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Lmtc fawcrtfilffLmtc fawcrtfilff?? afwcmsm T4- RTN-afwcmsm T4- RTN- tcrtsm rsd`zff-tcrtsm rsd`zff- tcrtsm t`mczlacf ml gzsbt`-tcrtsm t`mczlacf ml gzsbt`- smtzlràìzlgfl ncultfb f l bfm`z jfmflzc!smtzlràìzlgfl ncultfb f l bfm`z jfmflzc!

Fawcrtfilff fawlfwcFawcrtfilff fawlfwc ++ ctf`mìfc fabczt? U!J!N!-ctf`mìfc fabczt? U!J!N!-

b`mlaifìzlklb`mlaifìzlkl (( u`ztlcatcz`rt`kfc .ut! di!u`ztlcatcz`rt`kfc .ut! di!ltzcfcf- bnfrt dc b`mcd`b&!ltzcfcf- bnfrt dc b`mcd`b&!


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TzltlkcatTzltlkcat

B`zcbtlzc tsmj! cmcbtz`mftfbc f kctlj`mfbcB`zcbtlzc tsmj! cmcbtz`mftfbc f kctlj`mfbc Tzltlk! Fagbffm`zTzltlk! Fagbffm`z Wcatfmlfc lrfrtlt .nfdzùr f umkaWcatfmlfc lrfrtlt .nfdzùr f umka

b`kuz`kfr&b`kuz`kfr& Tzlt! dfctctfb + a b`mcrtl? Uzìcrtfkfm-Tzlt! dfctctfb + a b`mcrtl? Uzìcrtfkfm-

U`ztlicaU`ztlica a ilmlbt`ckfc? cwftlzcl uzculzltcm`z blzca ilmlbt`ckfc? cwftlzcl uzculzltcm`z blzc

bàfa mlbt`bàfa mlbt` fat`mczlal ml gzsbt`? cwftlzcl uzculzltcm`z blzcfat`mczlal ml gzsbt`? cwftlzcl uzculzltcm`z blzc

bàfa rsbz`bàfa rsbz`


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Tzltlkcat kcdfbblkcat`rTzltlkcat kcdfbblkcat`r

Rsu`ztfw?Rsu`ztfw?

umka b`kuz`kfr8umka b`kuz`kfr8 2! Tzltlkcatsm fagcbfcf f uczftàftcf82! Tzltlkcatsm fagcbfcf f uczftàftcf8 4! Ltcafc ml ldkfafrtzlzcl tczlufcf bs gmsfdc- ml4! Ltcafc ml ldkfafrtzlzcl tczlufcf bs gmsfdc- ml

tczlufl dfszctfb ucatzs lrbft f cdckc8tczlufl dfszctfb ucatzs lrbft f cdckc8 3! B`zcbtlzcl tsmjszzfm`z cmcbtz`mftfbc83! B`zcbtlzcl tsmjszzfm`z cmcbtz`mftfbc8 7! Kàft`zflzc kctlj`mfb ltcat!7! Kàft`zflzc kctlj`mfb ltcat!


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Tczlufl astzffàlmTczlufl astzffàlm ++ lu`zt ldcbwlt ulu`zt ldcbwlt utt bzctczc- atz+`bzctczc- atz+`g`zk ldcbwt ucatzs ljr`zjfc! Rc u`ltc stfmflg`zk ldcbwt ucatzs ljr`zjfc! Rc u`ltc stfmflszkt`zsm infd- blzc tzcjsfc r gfc fadfwfdslmflt?szkt`zsm infd- blzc tzcjsfc r gfc fadfwfdslmflt?

b`mcrtl rsat? Uzìcrtfkfm- U`ztlica!b`mcrtl rsat? Uzìcrtfkfm- U`ztlica! :! G`zksmcmc dc uzculzltc blzc tzcjsfc cwftltc a:! G`zksmcmc dc uzculzltc blzc tzcjsfc cwftltc a

j`mfmc kctlj`mfbc?j`mfmc kctlj`mfbc?l&! Ilmlbt`ckfl? rc wl cwftl mlutcmc kltcza f t`ltcl&! Ilmlbt`ckfl? rc wl cwftl mlutcmc kltcza f t`ltc

g`zksmcmc blzc bàfa mlbt`!g`zksmcmc blzc bàfa mlbt`!j&! Fat`mczlal ml gzsbt`? rc w`z cwftl g`zksmcmc blzcj&! Fat`mczlal ml gzsbt`? rc w`z cwftl g`zksmcmc blzc

bàfa rsbz`lbàfa rsbz`l


40/70

CATCZ@B@MFTCATCZ@B@MFTLLSMBCZ@+ASMBCZ@+ACCBZ@TFBBZ@TFB


41/70

DCG?DCG? rfadz`ksm dc acbz` fatcrtfalmrfadz`ksm dc acbz` fatcrtfalmlbst dc blsl acbsa`rbstlbst dc blsl acbsa`rbst

CufdckCufdck! fabfdcatl +5-2 :-4 altczf! fabfdcatl +5-2 :-4 altczf k`ztlmftltcl 43# Ia =


42/70

UltìcaflUltìcafl5#+ml WMJY!CSA >5#+ml WMJY!

:! Fkltszftltcl kcb! dc luzlzc lmc tzlbtsmsf IF:! Fkltszftltcl kcb! dc luzlzc lmc tzlbtsmsf IF rfrtck m`blm dc lulzlzcrfrtck m`blm dc lulzlzc ;; dcgfbftlz + blatftltc zcdsr dcdcgfbftlz + blatftltc zcdsr dc

FiLr- az! rblst dc mfkg`bftc J rf TFiLr- az! rblst dc mfkg`bftc J rf T b`màflzcl jlb! l fatcrtfasmsf glw! +lizcrfsacl jlbt! f t`~facm`z!b`màflzcl jlb! l fatcrtfasmsf glw! +lizcrfsacl jlbt! f t`~facm`z! nfu`bm`znfdzfl ilrtzfb- blzlbt! lb! wlzrtc + b`màflzcl catczfb!nfu`bm`znfdzfl ilrtzfb- blzlbt! lb! wlzrtc + b`màflzcl catczfb! lbtfsacl uz`tc`mftfb rblst l gczk! ulabzcltfbf-lbtfsacl uz`tc`mftfb rblst l gczk! ulabzcltfbf- k`tfmftltcl fatcrtfalml zcdsr-k`tfmftltcl fatcrtfalml zcdsr- bzcrtczcl gm! dc b`màflzc a! l tzlbtsmsf IF fa uzfkcmc fmcbzcrtczcl gm! dc b`màflzc a! l tzlbtsmsf IF fa uzfkcmc fmc

+ fatcrtfasm + klf uczkcljfm ucatzs jlbtczff rf cad`t`~fac-+ fatcrtfasm + klf uczkcljfm ucatzs jlbtczff rf cad`t`~fac-


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2! Z`msm jlbtczffm`z rf t`~facm`z2! Z`msm jlbtczffm`z rf t`~facm`z Bm`rtzfdfsk fag! uzcgczcatflm ! frbnckfbc!Bm`rtzfdfsk fag! uzcgczcatflm ! frbnckfbc! Bm`rtzfdfsk uczgzfaicar ; gm! fat! a`zklm l aaBm`rtzfdfsk uczgzfaicar ; gm! fat! a`zklm l aa Rtlgfm`b`bsm b`lisml`+aciltfwRtlgfm`b`bsm b`lisml`+aciltfw {{ Rtlgfm`b`bsm lszfsRtlgfm`b`bsm lszfs {{ dcmtl+t`~fac bft`mftfbcdcmtl+t`~fac bft`mftfbc Hmcjrfcmml-Hmcjrfcmml-

C b`mf rf Rlmk`acmmlC b`mf rf Rlmk`acmml


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4!Z`msm kcdflt`zfm`z fagmlklfcf4!Z`msm kcdflt`zfm`z fagmlklfcf??TAGl .glbt`z dc acbz` tsk`zlm &TAGl .glbt`z dc acbz` tsk`zlm &

ULG .glbt`z dc lbtfwlzc umlbnctlzULG .glbt`z dc lbtfwlzc umlbnctlzz`msm lbcrt`z kcdflt`zfz`msm lbcrt`z kcdflt`zf ;; bzsbflm fa ult`icafl CSAbzsbflm fa ult`icafl CSA

3! Z`msm zldfblmfm`z dc `~fica f lm faoszfcf frbnckfc+3! Z`msm zldfblmfm`z dc `~fica f lm faoszfcf frbnckfc+zcuczgsfc?zcuczgsfc?

nfu`~fl rf frbnckfl tzlbtsmsf IF + rbld gm! rlaisfanfu`~fl rf frbnckfl tzlbtsmsf IF + rbld gm! rlaisfakccatczfb-kccatczfb-

acbz`l rf smbczlffmc fatcrtfalmc!acbz`l rf smbczlffmc fatcrtfalmc!


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7! Lmfkcatltfl catczlm7! Lmfkcatltfl catczlm uzcb`bc bs w`mskc klzf .bzcrtczf fmafbcuzcb`bc bs w`mskc klzf .bzcrtczf fmafbc

dc ucrtc 23+75 km/hi/f&-dc ucrtc 23+75 km/hi/f&- b`ku`ftfl nfucz`rk`mlz l sa`z g`zksmcb`ku`ftfl nfucz`rk`mlz l sa`z g`zksmc uz`tcfacmc mlutcmsf dc wlbuz`tcfacmc mlutcmsf dc wlb


46/70

Tljm`sm bmfafbTljm`sm bmfafb

dflia`rtfbsm uzcb`bcdflia`rtfbsm uzcb`bc ++ dfgfbfmdfgfbfm rckac rfrtckfbcrckac rfrtckfbc ?? fartljfmftltcl tczkfb-fartljfmftltcl tczkfb-

fzftljfmftltcl-fzftljfmftltcl- bzfcmc dc luacc-bzfcmc dc luacc- nfu`tcarfsacl-nfu`tcarfsacl- lbfd`l-lbfd`l- `mfiszfl-`mfiszfl- raiczzfmc!raiczzfmc!


47/70

rckacmc ilrtz`fatcrtfalmcrckacmc ilrtz`fatcrtfalmc ?? zcfds ilrtzfb fatzc kcrc .rcrflt bs `blflzcfds ilrtzfb fatzc kcrc .rcrflt bs `blfl

ilwlosmsf fatczkftcat&-ilwlosmsf fatczkftcat&- wzrltszf-wzrltszf- dfrtcarfc ljd`kfalm .fmcsr ulzlmftfb bs dfrulzftfldfrtcarfc ljd`kfalm .fmcsr ulzlmftfb bs dfrulzftfl

i`k`tcm`z fatcrtfalmc ml lsrbsmtltfc&-i`k`tcm`z fatcrtfalmc ml lsrbsmtltfc&- rblsac rlaisfa`mcatc rls kcmca-rblsac rlaisfa`mcatc rls kcmca- rbnfkjlzcl bsm`zff rf b`arfrtcatcf uczctcmsfrbnfkjlzcl bsm`zff rf b`arfrtcatcf uczctcmsf

ljd`kfalmljd`kfalmrckacmc bmfafbc dc rcutfbckfcrckacmc bmfafbc dc rcutfbckfc rc rsuzlusa TBrc rsuzlusa TB

dcrbzfrdcrbzfr


48/70

Dflia`rtfbsm bmfafbDflia`rtfbsm bmfafb rlaiczlzfmc zcbtlmc-rlaiczlzfmc zcbtlmc- tz`kj`bftùcafltz`kj`bftùcafl lbfd`l kctlj`mfblbfd`l kctlj`mfb nfuàltzckfc zcgzlbtlznfuàltzckfc zcgzlbtlz

Zldfìzlgfl ljd`kfalmZldfìzlgfl ljd`kfalm dfrtcarfl il`lr l larcm`z fatcrtfalmcdfrtcarfl il`lr l larcm`z fatcrtfalmc

cwcatslm uacskùczftàcs fa bl dc uczg`zltfccwcatslm uacskùczftàcs fa bl dc uczg`zltfcfatcrtfalmfatcrtfalm

ZldfìzlgffZldfìzlgff ++ fa fabfdcabc mltczlmcfa fabfdcabc mltczlmc--a `zt`rtltfrk uc i`ma `zt`rtltfrk uc i`m


49/70

Rtldffmc cw`mstfwc JCMMRtldffmc cw`mstfwc JCMM Rtldfsm F + Rsrufbfsac bmafb!Rtldfsm F + Rsrufbfsac bmafb! Rtldfsm FF + Rckac bmfafbc dcgfaftc rf k`dfgfbzfRtldfsm FF + Rckac bmfafbc dcgfaftc rf k`dfgfbzf zldf`mìfbc rsicrtfwc!zldf`mìfbc rsicrtfwc! Rtldfsm FFF + Uczg`zlfc fatcrtfalm dckàrtzljfmRtldfsm FFF + Uczg`zlfc fatcrtfalm dckàrtzljfm

bmfafb rf zldf`mìfb .rszwfac fa :5+25# dfa blszf&bmfafb rf zldf`mìfb .rszwfac fa :5+25# dfa blszf&


50/70

TzltlkcatTzltlkcat

rsrtfaczcl g! lulzltsmsf blzdf`wlrbsmlz +`b-rsrtfaczcl g! lulzltsmsf blzdf`wlrbsmlz +`b-nfu`tcarfsac+ bs mfafc wca`lrl b`atfasnfu`tcarfsac+ bs mfafc wca`lrl b`atfas

skumczcl ultsmsf wlrb! + um uz`lrult . `zc

++ a`zklmflzcl uN+smsf rczfb!a`zklmflzcl uN+smsf rczfb!


51/70

imfbckfl + k`aft`zflt rf kcatfast ml 1 35 ki/dm!imfbckfl + k`aft`zflt rf kcatfast ml 1 35 ki/dm! rsrucadlzcl astzftfcf catczlmcrsrucadlzcl astzftfcf catczlmc lmfkcatltfc ulzcatczlm t`tlm!lmfkcatltfc ulzcatczlm t`tlm!

+ lu`ztsm blm`zfb kfkk ;


52/70

B`zcbfl dfrgsabfcf ncklt`mìfbc?B`zcbfl dfrgsabfcf ncklt`mìfbc?+ tz`kj`bftùcafl uczrfrtcat+ tzlar! dc KT+ tz`kj`bftùcafl uczrfrtcat+ tzlar! dc KT

+ lmtczlzcl g! dc b`lismlzc+ tzlar! bs rlaic+ lmtczlzcl g! dc b`lismlzc+ tzlar! bs rlaic

uz`lrult rf umlrk uz`lrult!uz`lrult rf umlrk uz`lrult! wft H ulzcatczlm + r+l rfrtlt lmfkcatltflwft H ulzcatczlm + r+l rfrtlt lmfkcatltfl

catczlmcatczlm

ldkfafrtzlzcl dc ilklim`jsmfa + bl fldkfafrtzlzcl dc ilklim`jsmfa + bl frcurfrsm acàltlm!rcurfrsm acàltlm!


53/70

Tzltlkcatsm bnfzszifblmTzltlkcatsm bnfzszifblm + fa bl dc uczg`zlfc fatcrtfalm+ fa bl dc uczg`zlfc fatcrtfalmd`wcdft .zldfìzlgfb- ulzlbcatcl u`ftfwl& rlsd`wcdft .zldfìzlgfb- ulzlbcatcl u`ftfwl& rls

lizlwlzc uzìzcrfw l rtlzff icaczlmc!lizlwlzc uzìzcrfw l rtlzff icaczlmc!K`kcatsm fatczwcatfcf+ dfgfbfm dc n`tzt ?K`kcatsm fatczwcatfcf+ dfgfbfm dc n`tzt ?

rckacmc dc uczftàft .lrbftl- klrl ljd`kfalmrckacmc dc uczftàft .lrbftl- klrl ljd`kfalmulmuljfm- fadszltfl uczctcmsf ljd`kfalm&-ulmuljfm- fadszltfl uczctcmsf ljd`kfalm&- tz`kj`bftùcafl uczrfrtcat-tz`kj`bftùcafl uczrfrtcat- `bsm zcfrtcat ml tzltlkcat-`bsm zcfrtcat ml tzltlkcat-

lbfd`l kctlj`mfb zcgzlbtlz!lbfd`l kctlj`mfb zcgzlbtlz! Rbùsm tzltlkcatsmsf bnfzszifblm crtc c~bffl àcfRbùsm tzltlkcatsmsf bnfzszifblm crtc c~bffl àcf

acbz`tfbc fatcrtfalmc rf cgcbtslzcl sacf fmc`rt`kfacbz`tfbc fatcrtfalmc rf cgcbtslzcl sacf fmc`rt`kf


54/70

FARSGFBFCAL ZCALMFARSGFBFCAL ZCALM


55/70

FZL ; ` lmtczlzc l gsabfcf zcalmc- tzldsrFZL ; ` lmtczlzc l gsabfcf zcalmc- tzldsruzfa? `mfiszfc- laszfc rls u`mfszfc-uzfa? `mfiszfc- laszfc rls u`mfszfc-tsmjszlzcl jlmlacf lucf f cmcbtz`mffm`z-tsmjszlzcl jlmlacf lucf f cmcbtz`mffm`z-

tsmjszlzc lbfd`+jlfb f lbsksmlzc dctsmjszlzc lbfd`+jlfb f lbsksmlzc dcdccszf .szccl f bzcltfafal&!dccszf .szccl f bzcltfafal&!


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BlscmcBlscmc


57/70

:&! Blsc zcalmc?:&! Blsc zcalmc?Bàicaftlmc?Bàicaftlmc? dfrumlfc zcalm jfmltczlm-dfrumlfc zcalm jfmltczlm- licacfc zcalm-licacfc zcalm- zfafbnf ksmtf rls u`mfbnfrtfb-zfafbnf ksmtf rls u`mfbnfrtfb- rfadz`k acgz`tfb bàicaftlm8rfadz`k acgz`tfb bàicaftlm8D`jadftc?D`jadftc?

b`lismlzc fatzlwlrbsmlz-b`lismlzc fatzlwlrbsmlz- tz`kj`l wcacf zcalmc-tz`kj`l wcacf zcalmc- acbz` b`ztfblm rls kcdsmlz zcalm8acbz` b`ztfblm rls kcdsmlz zcalm8


58/70

Frbnckfbc?Frbnckfbc? `b-`b- dcrnfdzltlzc-dcrnfdzltlzc- nfu`tcarfsac-nfu`tcarfsac-

nfu`~fc-nfu`~fc- rfadz`k dc dctzcr zcrufzlt`zfc8rfadz`k dc dctzcr zcrufzlt`zfc8Acgz`t`~fbc?Acgz`t`~fbc? tzltlkcatc bs lkfaìmfb`fdc f kctfbfmfa-tzltlkcatc bs lkfaìmfb`fdc f kctfbfmfa- kfìm`jfal-kfìm`jfal- jfmfzsjfaljfmfzsjfal rsjrtlacmc dc bàtzlrt-rsjrtlacmc dc bàtzlrt- ldkfafrtzlzcl dc fad`kctlbfa8ldkfafrtzlzcl dc fad`kctlbfa8


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Dfwczrc?Dfwczrc? lbfd`cmc-lbfd`cmc-

nfuczszfbckfl a`s+arbstsmsf-nfuczszfbckfl a`s+arbstsmsf- u`mfbftckfl-u`mfbftckfl- ululwczfal-ululwczfal-

ldkfafrtzlzcl dc bltcb`mlkfac-ldkfafrtzlzcl dc bltcb`mlkfac- fagcbffmc tzlbtsmsf szfalz!fagcbffmc tzlbtsmsf szfalz!


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2&! Blsc u`rtzcalmc?2&! Blsc u`rtzcalmc?Szùltff `jrtzsbtfwc bàicaftlmc?Szùltff `jrtzsbtfwc bàicaftlmc? wlmw l szctzcf u`rtczf`lzc-wlmw l szctzcf u`rtczf`lzc- szctcz`bcm-szctcz`bcm-

`jrtzsbfl szctczsmsf ucmwfa-`jrtzsbfl szctczsmsf ucmwfa- dfwcztfbsm szctzlm-dfwcztfbsm szctzlm- rtzfbtszf szctzlmc-rtzfbtszf szctzlmc- wcfb szfalz acszìca-wcfb szfalz acszìca-

rfadz`k kcilbfrtfb+kcilszctcz-rfadz`k kcilbfrtfb+kcilszctcz- tsk`zf!tsk`zf!

Rckacmc bmfafbc f dc mlj`zlt`zRckacmc bmfafbc f dc mlj`zlt`z


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Rckacmc bmfafbc f dc mlj`zlt`zRckacmc bmfafbc f dc mlj`zlt`z

@mfiszfl +@mfiszfl + bcm klf fku`ztlat rcka lm FZL!bcm klf fku`ztlat rcka lm FZL! CdckcmcCdckcmc + rcbsadlzc rsuzlabzbzff mfbnfdfcac+ rcbsadlzc rsuzlabzbzff mfbnfdfcac Dfrtcarfl ljd`kfalmDfrtcarfl ljd`kfalm rls ulmulzcl dc klrc uc gmlabszfrls ulmulzcl dc klrc uc gmlabszf BàwsmrffmcBàwsmrffmc + bad crtc lr`bflt?+ bad crtc lr`bflt?

nck`zlifl fatzlbzlafla- nfu`~flnck`zlifl fatzlbzlafla- nfu`~fl cdcksm bczcjzlm-cdcksm bczcjzlm- nfuìmfbckfl-nfuìmfbckfl- nfuàltzckfl-nfuàltzckfl- nfu`blmbckfl-nfu`blmbckfl- nfucztcarfsacl-nfucztcarfsacl- szckflszckfl rls fagcbfl!rls fagcbfl!


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Nfu`tcarfsacl +Nfu`tcarfsacl + ml abcustsm fartlmzff FZL!ml abcustsm fartlmzff FZL! NfucztcarfsaclNfucztcarfsacl

+ gzcbwcat dlt`zlt rsuzlabzbzff mfbnfdfcac+ gzcbwcat dlt`zlt rsuzlabzbzff mfbnfdfcac+ dlt! sacf nfuczrcbzcff dc zcafa f lmd`rtczà!+ dlt! sacf nfuczrcbzcff dc zcafa f lmd`rtczà!

NTL rcwcz+ acbz` b`ztfblm zcalm-NTL rcwcz+ acbz` b`ztfblm zcalm-+ tz`kj`l l! zcalmc+ tz`kj`l l! zcalmc+ ckj`mfrk+ ckj`mfrk

nckltszfcnckltszfc kfbz`rbùfb rls fatcar-kfbz`rbùfb rls fatcar- uz`tcfaszfcuz`tcfaszfc


63/70

Lgcbtlzcl gsabfcf zcalmcLgcbtlzcl gsabfcf zcalmc + b`agfzklt dc+ b`agfzklt dctcrtcmc dc mlj`zlt`z rczfbc f szfalzctcrtcmc dc mlj`zlt`z rczfbc f szfalzc

Zltl gfmtzzff im`kczsmlzc +bcm klf jsaZltl gfmtzzff im`kczsmlzc +bcm klf jsaulzlkctzs dc szkzfzc lulzlkctzs dc szkzfzc lk`dfgfbzfm`z gsabfcf zcalmc!k`dfgfbzfm`z gsabfcf zcalmc!


64/70

RckacRckacL&! Dfa rcz?L&! Dfa rcz?R`dfs A`zklm rls bzcrbstR`dfs A`zklm rls bzcrbst- a`zklm rls- a`zklm rls

U`tlrfs A`zklm rls bzcrbstA`zklm rlsU`tlrfs A`zklm rls bzcrbstA`zklm rlsbzcrbstbzcrbst

Szcc rczfb A`zklm rls bzcrbstBzcrbstSzcc rczfb A`zklm rls bzcrbstBzcrbst

Bzcltfafa? A rls bzcrbstBzcltfafa? A rls bzcrbst

Gffùlt`mìfcGffùlt`mìfc


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Gffùlt`mìfcGffùlt`mìfc

UltìcaclUltìcacl u`ltc abcuc bs sa cwcafkcat frbnckfb rls t`~fbu`ltc abcuc bs sa cwcafkcat frbnckfb rls t`~fb

blzc lbtfwcl rfrtcksm zcafa+laif`tcarfa!blzc lbtfwcl rfrtcksm zcafa+laif`tcarfa! Bzctczcl lbtfwftff laif`tcarfacf ?Bzctczcl lbtfwftff laif`tcarfacf ?

uz`dsbc bàrtzfbfl lztczf`mcm`z lgczcatc-uz`dsbc bàrtzfbfl lztczf`mcm`z lgczcatc- zcdsbc gfmtzlzcl im`kczsmlzzcdsbc gfmtzlzcl im`kczsmlz usac a uczfb`m a bàtfaslzc rfrtcksm tsjsmlz zcalm!usac a uczfb`m a bàtfaslzc rfrtcksm tsjsmlz zcalm! gca`kcasm wlrbsmlz zcalm u`ltc dc lrckcal rtfksmlgca`kcasm wlrbsmlz zcalm u`ltc dc lrckcal rtfksml

dfzcbt cmfjczlzcl bltcb`mlkfacm`z- u`ltc lbtfwldfzcbt cmfjczlzcl bltcb`mlkfacm`z- u`ltc lbtfwlrfrtcksm dc b`lismlzc- flz lbcrtcl uz`dsb mcfsafrfrtcksm dc b`lismlzc- flz lbcrtcl uz`dsb mcfsafzcalmczcalmc


66/70

Uczrfrtcal FZL dsu adcuztlzcl farsmtcfUczrfrtcal FZL dsu adcuztlzcl farsmtcf dlt! `jrtzsbfcf tsjsmlzc dc btzc zcrtszfmc bcmsmlzcdlt! `jrtzsbfcf tsjsmlzc dc btzc zcrtszfmc bcmsmlzc zctz`dfgsfsaff gfmtzltsmsf uzfa uczcff tsjsmlzf!zctz`dfgsfsaff gfmtzltsmsf uzfa uczcff tsjsmlzf! zcdsbczcl gm rlaisfa a b`ztfblml zcalm f dfkfaslzcl gfmtzzffzcdsbczcl gm rlaisfa a b`ztfblml zcalm f dfkfaslzcl gfmtzzff

im`kczsmlzc!im`kczsmlzc!

cmfjczlzcl bltcb`mlkfacm`z bzctc t`asrsm rfkultctfb fcmfjczlzcl bltcb`mlkfacm`z bzctc t`asrsm rfkultctfb flbtfwcl rfrtcksm zcafa laif`tcarfa .blzc u`t c~umfbllbtfwcl rfrtcksm zcafa laif`tcarfa .blzc u`t c~umfblzcdsbczcl gms~smsf rlaisfa lm b`ztfblmcf zcalmc&!zcdsbczcl gms~smsf rlaisfa lm b`ztfblmcf zcalmc&!

zcdsbczcl gm! rlaisfa a b! zcalm usac a uczfb`m tsjsm zcalmzcdsbczcl gm! rlaisfa a b! zcalm usac a uczfb`m tsjsm zcalmf ufczdczcl dc Al blzc- ml zadsm rs- rtfksmcl klbsmlf ufczdczcl dc Al blzc- ml zadsm rs- rtfksmcl klbsml

dcarl f cmfjczlzcl dc klf ksmt zcafa!dcarl f cmfjczlzcl dc klf ksmt zcafa!


67/70

Tzltlkcat + `jfcbtfwcTzltlkcat + `jfcbtfwc

zcrtljfmfzcl uz`kut l w`msksmsfzcrtljfmfzcl uz`kut l w`msksmsfumlrkltfb-umlrkltfb-

tzltlkcatsm `bsmsf-tzltlkcatsm `bsmsf- tz! dfrgsabfcf wcatzfbsmsmsf rtai-tz! dfrgsabfcf wcatzfbsmsmsf rtai- b`kjltczcl fagcbfcf-b`kjltczcl fagcbfcf-

rt`ulzcl ldkfafrtzzff rsjrtlacm`z t`~fbcrt`ulzcl ldkfafrtzzff rsjrtlacm`z t`~fbc kcdfblfl wlr`dfmltlt`lzckcdfblfl wlr`dfmltlt`lzc

Infd dc tzltlkcatInfd dc tzltlkcat


68/70

Infd dc tzltlkcatInfd dc tzltlkcat

@mfiszfc@mfiszfc

Umlrk


69/70

Ljrcal dfszccf a szkt`lzcmc 25 kfastcLjrcal dfszccf a szkt`lzcmc 25 kfastc Gsz`rckfd


70/70

Lmtc krszf tczlucstfbcLmtc krszf tczlucstfbc

Acw`fmc dc gmsfdc f cmcbtz`mffAcw`fmc dc gmsfdc f cmcbtz`mff Lbfd`lLbfd`lB`zcbfl lbfd`cf a FZL + b`kumfblt dlt`zftB`zcbfl lbfd`cf a FZL + b`kumfblt dlt`zft

zcrtzfbfcf dc r`dfs!zcrtzfbfcf dc r`dfs!dcgfbftsm dc jlc ~ 5-2 ~ Il .hi&dcgfbftsm dc jlc ~ 5-2 ~ Il .hi& Nfu`blmbckfl f nfuczg`rgltckflNfu`blmbckfl f nfuczg`rgltckfl LackflLackfl NfucztcarfsaclNfucztcarfsacl FagcbffmcFagcbffmc

c7 hiperbilirubinemia nn & insuficienta renala

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