Anticoagulants 2011
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Transcript of Anticoagulants 2011
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Lm~ @HQINB@D]L@HQ^
IF^I @jeubi~m S`u
Bnqbeum 5300
E(Sbliqi~
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Lm~ @HQINB@D]L@HQ^
U`ssml~ ~}u lgjb~q`~m mq l`nb`d}l`qibh
Dhu`liq~ ~}u lm~ qu`iqmjmhq~`hqinb`d}l`hq~
Lm~ aiffumhq~ qu`iqmjmhq~
`hqinb`d}l`hq~
Lm~ `hqi`dud`hq~ sl`p}mqq`ium~
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Lm~ @HQINB@D]L@HQ^
U`ssml~ ~}u lgjb~q`~m mq l`nb`d}l`qibh Dhu`liq~ ~}u lm~ qu`iqmjmhq~ `hqinb`d}l`hq~
Lm~ aiffumhq~ qu`iqmjmhq~ `hqinb`d}l`hq~ Lm~ hqi`dud`hq~ sl`p}mqq`ium~
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1
U`ssml~ ~}u lgjb~q`~m mq l` nb`d}l`qibh
Sghbjhm sgy~iblbdip}m nbjslmwm, mh n`~n`am, f`i~`hq ihqmuvmhiu amhbjeum}~m~ subqihm~ sl`~j`qip}m~ 'f`nqm}u~ am l` nb`d}l`qibh) mq`eb}qi~~`hq l` fbuj`qibh a}h n`illbq `fih a`uuqmu lgjbuu`dim(
Ihquq~ am l` nb`d}l`qibh ? Suvmhiu lm~ ~`idhmjmhq~ ~sbhq`h~,
@uuqmu lm~ gjbuu`dim~ mh n`~ am l~ibh~ v`~n}l`ium~(
Sghbjhm~ ihqmuvmh`hq a`h~ lgjb~q`~m mq l` nb`d}l`qibh ? l` v`~bnbh~quinqibh v` aijih}mu lm n`lieum a} v`i~~m`} l~,
l$ gjb~q`~m suij`ium : `ag~ibh am~ sl p}mqqm~ `} v`i~~m`} l~ mq mhqummllm~ '`dud`qibh sl`p}mqq`ium),
l$ gjb~q`~m ~mnbha`ium : nbuum~sbha l` nb`d}l`qibh, lm n`illbq `qqium mq ~qij}lm l` nubi~~`hnm am fieubel`~qm~ mq am nmll}lm~ am
j}~nlm li~~m `} ~mih am l` s`ubi v`~n}l`ium mq mhq`jm lm subnm~~}~ amus`u`qibh p}i u~}lqmu` fih`lmjmhq mh l` ai~~bl}qibh a} n`illbq 'fieuihbly~m)(
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=
U`ssml~ ~}u lgjb~q`~m mq l` nb`d}l`qibh
Gjb~q`~m suij`ium
Gjb~q`~m ~mnbha`ium
b} nb`d}l`qibh
A~`dud`qibh a} n`illbq s`u fieuihbly~m
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U`ssml~ ~}u lgjb~q`~m mq l` nb`d}l`qibh
Gjb~q`~m ~mnbha`ium 'b} nb`d}l`qibh) : fbuj`qibh a}h u~m`} fieuill`ium a`h~lmp}ml ~bhq mjsui~bhh~ lm~ SP, lm~ DU mq lm~ DE(
*8 Fbuj`qibh a}h qgubje}~ 'b} n`illbq ~`hd}ih)(
Lmh~mjelm m~q j`ihqmh} dunm am~ fil`jmhq~ am fieuihm( L` fbuj`qibh am l` fieuihm u~}lqm a}hm n`~n`am am u`nqibh~ mhzyj`qip}m~
f`i~`hq ihqmuvmhiu am~ f`nqm}u~ am l` nb`d}l`qibh sl`~j`qip}m~ abuidihmgs`qip}m mq sl`p}mqq`ium( Lq`sm fih`lm m~q l` qu`h~fbuj`qibh a} fieuihbdhm
~bl}elm mh fieuihm ih~bl}elm, ~b}~ l`nqibh am l` qgubjeihm(
Fieuihbdhm Fieuihm
Subqgubjeihm Qubjeihm
F`nqm}u~sl`p}mqq`ium~ + N`
5+
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U`ssml~ ~}u lgjb~q`~m mq l` nb`d}l`qibh
@nqiv`qibh mhabdhm
'nbhq`nq `vmn lm nbll`dhm)
@nqiv`qibh mwbdhm
'elm~~}um)
Vbimnbjj}hm
Lm~ aiffumhq~ f`nqm}u~ am l`
nb`d}l`qibh ?
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U`ssml~ ~}u lgjb~q`~m mq l` nb`d}l`qibh
Lbu~p}m l` nin`qui~`qibh m~q qmujihm, lm n`illbq ~m a~`dudm s`ufieuihbly~m 'adu`a`qibh am l` fieuihm)( Lm~ nmll}lm~ mhabqgli`lm~ ihq`nqm~lieumhq lm qS@ '`nqiv`qm}u qi~~}l`ium a} sl`~jihbdhm) p}i v` `nqivmu l`
vbim am l` fieuihbly~m(
qS@
Sl`~jihbdhm Sl`~jihm
FieuihmU~ia}~ am
fieuihm
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U`ssml~ ~}u lgjb~q`~m mq l` nb`d}l`qibh
Mwslbu`qibh am lgjb~q`~m suij`ium Qmjs~ am ~`idhmjmhq H}ju`qibh am~ sl`p}mqqm~ Ab~`dm a} f`nqm}u am vbh Tillmeu`ha
Mwslbu`qibh am lgjb~q`~m ~mnbha`ium Qmjs~ am nsg`lihm `nqiv '@SQQ, Qmjs~ am nsg`lihm k`blih) Q`}w am subqgubjeihm 'QS, Qmjs~ am P}ink, IHU)
Qmjs~ am qgubjeihm qmjs~ am umsqil`~m Ab~`dm am~ f`nqm}u~ am nb`d}l`qibh
S`qgblbdim~ am lgjb~q`~m suij`ium qgubjebnyqbshim
Qgubjebs`qgim
J`l`aim am vbh Tillmeu`ha
S`qgblbdim~ am lgjb~q`~m ~mnbha`ium Gjbsgilim~
Afiniq mh viq`jihm K
Ih~}ffi~`hnm gs`qb*nmll}l`ium
@hqinbus~ `hqi*f`nqm}u~
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Lm~ @HQINB@D]L@HQ^
U`ssml~ ~}u lgjb~q`~m mq l` nb`d}l`qibh
Dhu`liq~ ~}u lm~ qu`iqmjmhq~`hqinb`d}l`hq~ Lm~ aiffumhq~ qu`iqmjmhq~ `hqinb`d}l`hq~
Lm~ hqi`dud`hq~ sl`p}mqq`ium~
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00
Dhu`liq~ ~}u lm~ qu`iqmjmhq~ `hqinb`d}l`hq~
Ihain`qibh~ ?
Qu`iqmjmhq am l` sg`~m `id} ? lbu~ a}hm qgubjeb~m vmihm}~m b} `uquimllms`qgblbdip}m
Sgleiqm, mjeblim s}ljbh`ium Mjeblim `uquimllm 'fieuill`qibh `}uin}l`ium)
Qgubjebsgleiqm nueu`lm
Mh subsgyl`wim suij`ium ?
Subsgyl`wim sui*bsu`qbium am l` ngiu}udim buqgbsaip}m @liqmjmhq sublbhd `vmn @QNA qgubjeb*mjeblip}m~
V`lvm n`uai`p}m jn`hip}m
Mh subsgyl`wim ~mnbha`ium ?
@hbj`lim~ nbh~qiq}qibhhmllm~ am l` nb`d}l`qibh @QNA qgubjeb*mjeblip}m~
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05
Dhu`liq~ ~}u lm~ qu`iqmjmhq~ `hqinb`d}l`hq~
Nbhqum*ihain`qibh~ ?
^`idhmjmhq~ mh nb}u~
]lnum d`~qub*a}bah`l hbh nin`qui~
@hbj`lim~ am l` nb`d}l`qibh ui~p}m gjbuu`dip}m 'gjbsgilim, mqn() Ih~}ffi~`hnm gs`qip}m mq uh`lm ~vum~
Sb~q*ngiu}udim ui~p}m 'mw? hm}ubngiu}udim)
S`qimhq ihn`s`elm am dumu nbuumnqmjmhq lm qu`iqmjmhq 'ajmhnm, qub}elm~
s~yngi`quip}m~) Ui~p}m am ng}qm 'smu~bhhm~ dm~, j`lvby`hq~, jbeiliq ua}iqm +++)
Ihqmu`nqibh~ jain`jmhqm}~m~ '@VK +++)
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0=
Lm~ gs`uihm~
5 qysm~ ags`uihm ?
Lm~ gs`uihm~ hbh fu`nqibhhm~ ?
Gs`uihm ~baip}m *8 gs`uihm ~q`ha`ua s`u vbim IV
Gs`uihm n`lnip}m : N@LNIS@UIHM
*8 gs`uihm ~q`ha`ua s`u vbim ^N
Lm~ gs`uihm~ am e`~ sbia~ jbln}l`ium~ 'GESJ) ? vbim ^N
Mhbw`s`uihm ~baip}m : LBVMHBW
A`lqs`uihm ~baip}m : FU@DJIHM
Qihz`s`uihm ~baip}m : IHHBGMS H`aubs`uihm n`lnip}m : FU@WIS@UIHM, FU@WBAI
A`h`s`ubam : BUD@U@H
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06
Lm~ gs`uihm~
Jn`hi~jm a`nqibh ?
Fiw`qibh am lgs`uihm ~}u l`hqiqgubjeihm nm p}i `}djmhqm ~bh `nqibh ihgieiquinm ~}ul` qgubjeihm mq lm f`nqm}u W`( Il mh u~}lqm }hm `nqiviq `hqinb`d}l`hqm s}i~~`hqm(
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09
Lm~ gs`uihm~
Sb~blbdim~ mq ~}uvmill`hnm ?
Lm~ gs`uihm~ hbh fu`nqibhhm~ ?
Gs`uihm ~baip}m
Al`i mq a}um a`nqibh ? al`i *8 pp}m~ jih}qm~, a}um *8 > gm}um~
Sb~blbdim~ ? ebl}~ am =3 73]I"kd mh IVA s}i~ smuf}~ibh IV mh ~muihd}m lmnquip}m am 05 07]I"kd"g mh fbhnqibh am~ ihain`qibh~ mh n}u`qif( Sm} }qili~m mh suvmhqif(
^}uvmill`hnm ? 0mu sulvmjmhq 6g `su~ lih~q`}u`qibh a} qu`iqmjmhq s}i~ qb}qm~ lm~ 1*6g `su~ng`p}m jbaifin`qibh am sb~blbdim + ~}uvmill`hnm a} q`}w am SP(
Beomnqif a} qu`iqmjmhq ? QN@ mhqum =3 mq 43~mn b} 0,= 5,= fbi~ lm qjbih mq gs`uihjim 3,>
3,4]I"jL(
N@LNIS@UIHM
Al`i mq a}um a`nqibh ? al`i *8 0 5 gm}um~, a}um *8 7 05 gm}um~
Sb~blbdim~ ?
Mh n}u`qif *8 5 > iho ^N"o, =33]I"kd"o '> iho ~i vbl80,5jL)Mh suvmhqif *8 5 > iho ^N"o, 0=3]I"kd"o
^}uvmill`hnm ? 0mu sulvmjmhq 1 b} 6g `su~ lih~q`}u`qibh a} qu`iqmjmhq ~i > b} 5 iho"o,~m}lmjmhq mh n}u`qif+ ~}uvmill`hnm a} q`}w am SP(
Beomnqif a} qu`iqmjmhq ? QN@ mhqum =3 mq 43~mn b} 0,= 5,= fbi~ lm qjbih(
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Lm~ gs`uihm~
Ihain`qibh~ ?
Lm~ GESJ ?
Qu`iqmjmhq n}u`qif
* QVS nbh~qiq}m~ l` sg`~m `id}
* MS nbh~qiq}m~ l` sg`~m `id}* IAJ ~`h~ bham P mq `hdbu ih~q`elm l` sg`~m `id}
* IAJ `id} `vmn an`l`dm a} ~mdjmhq ^Q mq qu`iqmjmhq qgubjeblyqip}m
Qu`iqmjmhq suvmhqif
* Suvmhqibh am l` j`l`aim qgubjeb*mjeblip}m vmihm}~m ?* mh ngiu}udim
* mh jamnihm 's`qimhq `liq)
* ngmz lm~ s`qimhq~ `qqmihq~ am n`hnmu~
* Suvmhqibh am l` nb`d}l`qibh a`h~ lm~ niun}iq~ am NMN mq as}u`qibh mwqu`*uh`lm(
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50
Lm~ gs`uihm~
Sb~blbdim~ am~ GESJ mh qu`iqmjmhq n}u`qif ?
@@^ : `niam `nqyl~`linylip}m
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55
Lm~ gs`uihm~
Sb~blbdim~ am~ GESJ mh qu`iqmjmhq suvmhqif ?
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5>
Lm~ gs`uihm~
Suihnism a} qu`iqmjmhq mq ~}uvmill`hnm am~ GESJ mh qu`iqmjmhq
n}u`qif ?
0 'ihhbgms mq fu`wbai) b} 5 'lbvmhbw, fu`wis`uihm, fu`djihm) ihomnqibh~ ^N"o
Jm~}um am l`nqiviq `hqi*W` >*1g `su~ l` >jm ihomnqibh 'beomnqif ? 3,=*0]I"jL)
A}um a} qu`iqmjmhq ? 03 ob}u~ j`wij}j s}i~ ~i sb~~ielm, uml`i~ s`u lm~ @VK
Suihnism a} qu`iqmjmhq mq ~}uvmill`hnm am~ GESJ mh qu`iqmjmhq
suvmhqif ?
0 ihomnqibh ^N"o
Ab~m~ `a`sqmu `} ui~p}m
S`~ am ~}uvmill`hnm a} QN@ mq am l`nqiviq `hqi*W`
S`~ a`a`sq`qibh sb~blbdip}m
^}uvmill`hnm am~ SP 5 fbi~"~mj`ihm
A}um a} qu`iqmjmhq ~mlbh lm ui~p}m
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Lm~ gs`uihm~
Lm a`h`s`ubam : BUD@U@H
^m}lm GESJ ihaip}m mh n`~ a@QNA am QIG
Qu`iqmjmhq suvmhqifam~ j`hifm~q`qibh~ qgubjebmjeblip}m~ ? mh ^N
< 93kd ? 4=3]I 5 b} > fbi~"o '> fbi~ ~i QIG ~`h~ qgubjeb~m) 8 93kd ? 05=3]I 5 b} > fbi~"o '> fbi~ ~i QIG ~`h~ qgubjeb~m)
Mh subsu`qbium, l` amuhium ihomnqibh abiq qum mffmnq}m 0 1g `v`hq lihqmuvmhqibh
Lm qu`iqmjmhq suvmhqif ~mu sb}u~}ivi `su~ lihqmuvmhqibh smha`hq 4 03o b} o}~p} nm p}mlm ui~p}m qgubjebmjeblip}m `iq aijih}
Qu`iqmjmhq n}u`qifam~ j`hifm~q`qibh~ qgubjebmjeblip}m~ ? 5=33]I mh ebl}~ IV s}i~ 5333]I 5 fbi~"o mh ^N
@a`sqmu l` sb~blbdim mh fbhnqibh a} ab~`dm am l`nqiviq `hqi*W` 'beomnqif ? 3,1 3,7 ]I `hqi*W`"jL) ~i IU b} ~}usbia~ b} n`ngmwim
Qu`iqmjmhq am = 4 ob}u~
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Lm~ @HQINB@D]L@HQ^ U`ssml~ ~}u lgjb~q`~m mq l` nb`d}l`qibh
Dhu`liq~ ~}u lm~ qu`iqmjmhq~ `hqinb`d}l`hq~
Lm~ aiffumhq~ qu`iqmjmhq~ `hqinb`d}l`hq~ Lm~ gs`uihm~
Lm~ ihgieiqm}u~ ~lmnqif~ a} f`nqm}u W`
Lm~ giu}aihm~ umnbjeih`hqm~
Lm~ ihgieiqm}u~ aiumnq~ am l` qgubjeihm
Lm~ @VKLm~ hqi`dud`hq~ sl`p}mqq`ium~
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Lm~ ihgieiqm}u~ ~lmnqif~ a} f`nqm}u W`
Lm fbha`s`uih}w : @UIWQU@
Jbln}lm am ~yhqg~m umsu~mhq`hq l` sl}~ smqiqm ~p}mhnm sbly~`nng`uiaip}m amlgs`uihm n`s`elm aihgiemu ~lmnqivmjmhq lm f`nqm}u W` mh ~m li`hq }hip}mjmhq l`hqiqgubjeihm hihgie`hq s`~ l` qgubjeihm( Jbln}lm ihaip}m mh n`~ a@QNA am
QIG(
Ihain`qibh~ mh qu`iqmjmhq suvmhqif? Mvhmjmhq~ qgubjebmjeblip}m~ vmihm}w ?
mh ngiu}udim buqgbsaip}m j`om}um a} jmjeum ihfuim}u,
mh ngiu}udim `eabjih`lm ngmz am~ s`qimhq~ g`}q ui~p}m 'n`hnmu~),
Ngmz lm~ s`qimhq~ `liq~ sb}u }hm `ffmnqibh jain`lm `id} mq o}d~ g`}q ui~p}m
Qu`iqmjmhq n}u`qifam~ QVS `id}~ mq am~ MS `id}~
^yhaubjm nbubh`uimh `id} hbh ^Q ~}~ ui~p}m ihqmujai`ium b} f`ielm
Sb~blbdim~ ?
Qu`iqmjmhq suvmhqif ? mh ^N, 5,=jd"o
Qu`iqmjmhq n}u`qif ? mh ^N
< =3kd ? =jd"o
8 =3kd ? 4,=jd"o
8 033kd ? 03jd"o
^yhaubjm nbubh`uimh `id} ? mh ^N, 5,=jd"o
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Lm~ ihgieiqm}u~ ~lmnqif~ a} f`nqm}u W`
Lm uiv`ubw`e`h : W@UMLQB
Ihgieiqm}u aiumnq, nbjsqiqif, uvmu~ielm mq ~snifip}m a} f`nqm}u W` ~`h~ mffmqihgieiqm}u aiumnq ~}u l` qgubjeihm( Il subvbp}m }h `llbhdmjmhq a} QP mq a} QN@(
Ihain`qibh~ ?Suvmhqibh suij`ium am~ vhmjmhq~ qgubjebmjeblip}m~ vmihm}w ngmz lm~ s`qimhq~ehfini`hq a}hm ihqmuvmhqibh ngiu}udin`lm subdu`jjm sb}u SQG b} SQD(
Nbhqum*ihain`qibh~ ?
gysmu~mh~ieiliq, ~`idhmjmhq vbl}qif nlihip}mjmhq ~idhifin`qif b} ui~p}m am~`idhmjmhq du`vm 'Gim nueu`lm < 6 jbi~), `qqmihqm gs`qip}m `~~bnim }hmnb`d}lbs`qgim mq }h ui~p}m am ~`idhmjmhq nlihip}m ~idhifin`qif
Sb~blbdim ? NS *8 VBIM BU@LM
03jd"o ae}qmu 6 03g `su~ lihqmuvmhqibh nbhaiqibh p}}hm gjb~q`~m `iq s} qum
beqmh}m(a}um a} qu`iqmjmhq ? 5 ~mj`ihm~ sb}u l` SQD mq = ~mj`ihm~ sb}u l` SQG(
s`~ am ~}uvmill`hnm am~ s`u`jqum~ am l` nb`d}l`qibh mh ub}qihm
s`~ a`o}~qmjmhq am l` sb~blbdim mh fbhnqibh a} sbia~, a} ~mwm, am ldm, ~i
Nl nu`q8>3jL"jih(
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Lm~ @HQINB@D]L@HQ^ U`ssml~ ~}u lgjb~q`~m mq l` nb`d}l`qibh
Dhu`liq~ ~}u lm~ qu`iqmjmhq~ `hqinb`d}l`hq~
Lm~ aiffumhq~ qu`iqmjmhq~ `hqinb`d}l`hq~ Lm~ gs`uihm~
Lm~ ihgieiqm}u~ ~lmnqif~ a} f`nqm}u W`
Lm~ giu}aihm~ umnbjeih`hqm~
Lm~ ihgieiqm}u~ aiumnq~ am l` qgubjeihm
Lm~ @VKLm~ hqi`dud`hq~ sl`p}mqq`ium~
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>3
Lm~ giu}aihm~ umnbjeih`hqm~
L` a~iu}aihm : UMV@^N
@hqiqgubjebqip}m `di~~`hq nbjjm }h ihgieiqm}u ~snifip}m am l` qgubjeihm mhj`~p}`hq l`nn~ ~bh ~iqm `nqif(
Ihain`qibh~ ?
suvmhqibh am~ QVS `su~ ngiu}udim buqgbsaip}m(
Nbhqum*ihain`qibh~
Mffmq~ iha~iu`elm~ fup}mhq~
Sun`}qibh~ amjslbi ?
qu`iqmjmhq `hquim}u s`u giu}aihm~ *8 s`qimhq ui~p}m +++ am ngbn h`sgyl`nqip}m
Sb~blbdim ? vbim ^N `eabjih`lm
0=jd 5 fbi~"o smha`hq 9*05 ob}u~(
beomnqif ? QN@ < 5(
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>0
Lm~ giu}aihm~ umnbjeih`hqm~
L` eiv`liu}aihm : @HDIBW
@hqiqgubjebqip}m `di~~`hq nbjjm }h ihgieiqm}u ~snifip}m am l` qgubjeihm mhj`~p}`hq l`nn~ ~bh ~iqm `nqif(
Ihain`qibh~ ?
ihaip}m ngmz lm~ s`qimhq~ ~}ei~~`hq 0 ihqmuvmhqibh nbubh`ium smun}q`hm(
Nbhqum*ihain`qibh~
Sb~blbdim ?
Sun`}qibh~ amjslbi ?qu`iqmjmhq `hquim}u s`u giu}aihm~ *8 s`qimhq ui~p}m +++ am ngbn h`sgyl`nqip}m~}uvmillmu lm QN@ = jih}qm~ `su~ lm ebl}~, ihomnqmu }h hb}vm`} ebl}~ am 3,>jd"kd ~iQN@ < 55= ~mn(IU jbaum 'Nl nu`q mhqum >3 mq 63jL"jih) *8 ua}ium l` viqm~~m am smuf}~ibh
0,1jd"kd"g(
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>5
Lm~ giu}aihm~ umnbjeih`hqm~
L` lsiu}aihm : UMFL]A@H
@hqiqgubjebqip}m `di~~`hq nbjjm }h ihgieiqm}u ~snifip}m am l` qgubjeihm mhj`~p}`hq l`nn~ ~bh ~iqm `nqif(
Ihain`qibh~ ?
ihgieiqibh am l` nb`d}l`qibh ngmz lm~ s`qimhq~ `a}lqm~ `qqmihq~ a}hm QIG mq a}hmj`l`aim qgubjebmjeblip}m hnm~~iq`hq }h qu`iqmjmhq `hqiqgubjebqip}m s`u vbims`umhqu`lm 'lm ai`dhb~qin am QIG abiq qum nbhfiuj s`u }h qm~q a`nqiv`qibhsl`p}mqq`ium iha}iqm s`u lgs`uihm)(
Nbhqum*ihain`qibh~
Mffmq~ iha~iu`elm~ ?
* gjbuu`dim~ '>9- abhq 00- agjbuu`dim~ ~vum~)
* `hjim b} e`i~~m a} qw agjbdlbeihm ~`h~ n`}~m gjbuu`dip}m viamhqm '05-)
* fivum '4-), u`nqibh~ `llmudip}m~ am qb}q qysm 'u`nqibh~ `h`sgyl`nqip}m~ 1-)
* IU '5-)* u`nqibh `} sbihq aihomnqibh
Sb~blbdim
Sun`}qibh~ amjslbi ?
qu`iqmjmhq `hquim}u s`u giu}aihm~ *8 s`qimhq ui~p}m +++ am ngbn h`sgyl`nqip}m
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>>
Lm~ giu}aihm~ umnbjeih`hqm~
Sl`nm am~ giu}aihm~ s`uji lm~ qu`iqmjmhq~ `hqinb`d}l`hq~
Nbhnmuh`hq l` a~iu}aihm : UMV@^N ?
nbq ijsbuq`hq am nm hb}vm`} jain`jmhq 'mhviubh ~iw fbi~ lm nbq ob}uh`limua$}h qu`iqmjmhq s`u GESJ),
`e~mhnm a$}hm ~}suibuiq ajbhqum ~}u am~ nuiqum~ nlihip}m~(*8 @ u~muvmu sb}u lm~ j`l`am~ g`}q ui~p}m qgubjebmjeblip}m mq"b}`vmn am~ `hqnamhq~ am QIG(
Nbhnmuh`hq l` lsiu}aihm : UMFL]A@H ?
ui~p}m a$gjbuu`dim du`vm em`}nb}s sl}~ ijsbuq`hq p}$`vmn l$Bud`u`h, aiffin}lq a} ~}ivi eiblbdip}m `vmn lm QN@(
*8 ]qili~`qibh mh 5jm ihqmhqibh , }hip}mjmhq mh n`~ am u`nqiviqnubi~m Bud`u`h "gs`uihm~(
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>=
Lm~ ihgieiqm}u~ aiumnq~ am l` qgubjeihm
Lm A`eid`qu`h : SU@A@W@
Ihgieiqm}u aiumnq, nbjsqiqif, s}i~~`hq mq uvmu~ielm am l` qgubjeihm mq d`lmjmhq aml`dud`qibh sl`p}mqq`ium iha}iqm s`u l` qgubjeihm(
Ihain`qibh~ ?Suvmhqibh suij`ium am~ vhmjmhq~ qgubjebmjeblip}m~ vmihm}w ngmz lm~ s`qimhq~ehfini`hq a}hm ihqmuvmhqibh ngiu}udin`lm subdu`jjm sb}u SQG b} SQD(
Nbhqum*ihain`qibh~
Sb~blbdim ? NS *8 VBIM BU@LM< 4= `h~ ? 553jd"o mh 0 sui~m '0"5 ab~m ~i ih~q`}u`qibh < 51g sb~q ihqmuvmhqibh)
8 4= `h~ ? 0=3jd"o mh 0 sui~m '0"5 ab~m ~i ih~q`}u`qibh < 51g sb~q ihqmuvmhqibh)
a}um a} qu`iqmjmhq ? 03 ob}u~ sb}u l` SQD mq 57 >= ob}u~ sb}u l` SQG(
s`~ am ~}uvmill`hnm am~ s`u`jqum~ am l` nb`d}l`qibh mh ub}qihm
s`~ a`o}~qmjmhq am l` sb~blbdim mh fbhnqibh a} sbia~, a} ~mwm, am ldm, mh n`~aih~}ffi~`hnm gs`qip}m jbaum(
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Lm~ @HQINB@D]L@HQ^ U`ssml~ ~}u lgjb~q`~m mq l` nb`d}l`qibh
Dhu`liq~ ~}u lm~ qu`iqmjmhq~ `hqinb`d}l`hq~
Lm~ aiffumhq~ qu`iqmjmhq~ `hqinb`d}l`hq~ Lm~ gs`uihm~
Lm~ ihgieiqm}u~ ~lmnqif~ a} f`nqm}u W`
Lm~ giu}aihm~ umnbjeih`hqm~
Lm~ ihgieiqm}u~ aiumnq~ am l` qgubjeihm
Lm~ @VKLm~ hqi`dud`hq~ sl`p}mqq`ium~
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>7
Lm~ `hqi*viq`jihm~ K '@VK)
Subsuiq~
*8 Ihgieiqibh am l` ~yhqg~m gs`qip}m am~ f`nqm}u~ am l` nb`d}l`qibh viq`jihm K asmha`hq~ ?f`nqm}u~ II, VII, IW mq W mq lm~ subqihm~ N mq ^ 'f`nqm}u~ `hqinb`d}l`hq~)(
*8 S`~ amffmq `hqinb`d}l`hq ijjai`q(
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>9
Lm~ `hqi*viq`jihm~ K '@VK)
Suihnism a} qu`iqmjmhqlm qu`iqmjmhq s`u @VK abiq qum ~}ivi vmn }hm du`ham vidil`hnm n`u il mwsb~m 5 ui~p}m~ suihnis`}w ?
* lm ui~p}m agjbuu`dim li }h ~}uab~`dm,
* lm ui~p}m am qgubjeb~m li }h ~b}~*ab~`dm(
Ihain`qibh~ mq nielm qgu`sm}qip}m am lIHUlIHU jm~}um lm qmjs~ am nb`d}l`qibh a}h s`qimhq mq lm nbjs`um }h ~}omq p}i hm umbiq s`~ a@VK( Ngmz}h ~}omq hbh qu`iq, lIHU : 0( Ngmz }h s`qimhq qu`iq s`u }h @VK, sl}~ lm qmjs~ am nb`d}l`qibh ~`llbhdm,sl}~ lIHU `}djmhqm( L` nielm am lIHU asmha am l` s`qgblbdim hnm~~iq`hq lIHU
Jba`liq~ a} uml`i~ gs`uihm @VK ?
* Ihquba}nqibh am~ @VK lm sl}~ qqsb~~ielm '0*>o `su~ lm ae}q amlgs`uihbqgu`sim)
* @ajihi~qu`qibh ~ij}lq`hm o}~p}beqmhqibh am 5 IHU ~}nnm~~if~ 8 5
* A}um qbq`lm am lgs`uihbqgu`simo`j`i~ < = ob}u~(
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L i i i K '@VK)
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15
Lm~ `hqi*viq`jihm~ K '@VK)
@nniamhq~ gjbuu`dip}m~ am~ @VK
Msiajiblbdim ? Mhviubh 933 333 smu~bhhm~ qu`iqm~ s`u @VK 'abhhm @F^^@S^ 5339),
`nniamhq~ gjbuu`dip}m~ jbuqml~ *8 3,5= 3,7- s`u `h,
gjbuu dim~ du`vm~ *8 0,0 1,9- s`u `h(
^}uvmh}m am~ `nniamhq~ gjbuu`dip}m~ Qu`}j`qi~jm
^`idhmjmhq a}hm l~ibh jnbhh}m '}lnum, fieubjm, `hvui~jm)
^}uab~`dm 'ui~p}m gjbuu`dip}m +++ p}`ha IHU 8 =)
Nbhqum*ihain`qibh~ am~ @VK
L i i i K '@VK)
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1>
Lm~ `hqi*viq`jihm~ K '@VK)
^}uab~`dm mh @VK ? nbha}iqm qmhiu
IHU < = S`~ am ~`idhmjmhq, s`~ amngiu}udim suv}m
^}ssuijmu l` subng`ihm sui~m s}i~ ua}ium lm~ ab~m~}lquim}um~
IHU mhqum = mq 9 S`~ am ~`idhmjmhq
^`idhmjmhq jihm}u
Ngiu}udim ~mji*}udmhqm'al`i 8 05g)
^}ssuijmu lm~ 5 subng`ihm~ sui~m~ s}i~ ua}ium lm~
ab~m~ }lquim}um~( IHU p}bqiaimh(^}ssuijmu l` subng`ihm sui~m mq `ajihi~qumu am l`viq`jihm K0 '0 5jd smu b~)( IHU p}bqiaimh(
@uuq am~ @VK( @ajihi~qumu am l` viq`jihm K0 '5 1jd smu b~ b} 0 5jd IV lmhqm)( IHU 6g `su~(Umhb}vmlmu l` viq`jihm K0 ~i em~bih(
IHU 8 9 S`~ am ~`idhmjmhq b}~`idhmjmhq jihm}u
@uuq am~ @VK( @ajihi~qumu am l` viq`jihm K0 '> =jd smu b~ b} 5 1jd IV lmhqm)( IHU 6g `su~(Umhb}vmlmu l` viq`jihm K0 ~i em~bih( Umsumhauml@VK ab~m jbihaum p}`ha lIHU ~mu` umvmh}a`h~ l` zbhm qgu`sm}qip}m
P}mlp}m ~biqlIHU ^`idhmjmhq j`om}u b}ngiu}udim }udmhqm 'al`i sui~m~
Mffmq~ iha~iu`elm~ ? h`}~m~, vbji~~mjmhq~, ai`uugm~, nsg`lm~, vmuqidm~Sun`}qibh~ amjslbi ? lih~q`}u`qibh subdum~~ivm a} qu`iqmjmhq mq lm fu`nqibhhmjmhq am~
sui~m~ smujmqqmhq am aijih}mu lm~ mffmq~ iha~iu`elm~ '~}uqb}q lm~ nsg`lm~)
Lm~ `hqi`dud`hq~ sl`p}mqq`ium~
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=5
Lm~ `hqi`dud`hq~ sl`p}mqq`ium~
Qinlbsiaihm : QINLIA
Ihain`qibh~ ?* Suvmhqibh am~ `nniamhq~ i~ngjip}m~ j`om}u~, mh s`uqin}limu nbubh`uimh~, ngmz lm~
s`qimhq~ su~mhq`hq }hm `uquibs`qgim am~ jmjeum~ ihfuim}u~ `} ~q`am am nl`}ain`qibh(
* Suvmhqibh am~ nbjslin`qibh~ qgubjebqip}m~ `uquimllm~ '@VN, IAJ, jbuq am n`}~mv`~n}l`ium) `su~ }h 0mu @VN li l`qgub~nlub~m(
* Suvmhqibh am l` qgubjeb~m ~}e`id} ~}u ~qmhq 'mhabsubqg~m nbubh`ium), suvmhqibh mqnbuumnqibh am~ qub}elm~ sl`p}mqq`ium~ iha}iq~ s`u lgjbai`ly~m(
Sb~blbdim ? 5=3jd 5 fbi~"o `} nb}u~ am~ ums`~
Mffmq~ iha~iu`elm~ ? qbwiniq gj`qblbdip}m 'lm}nbshim, qgubjebshim, `hjim, `sl`~imja}ll`ium) *8 `uuq ijjai`q a} qu`iqmjmhq, qub}elm~ aidm~qif~ 'ai`uugm~, vbji~~mjmhq),gjbuu`dim
Sun`}qibh~ amjslbi ?
* ^}uvmill`hnm am lgjbdu`jjm qb}~ lm~ 0= ob}u~ smha`hq lm~ > sumjimu~ jbi~* ^i ~}uvmh}m a}hm gjbuu`dim *8 `uuqmu lm qu`iqmjmhq mq umngmungmu }hm
`du`h}lbnyqb~m
* Ihqmuvmhqibh ngiu}udin`lm *8 `uuqmu lm qu`iqmjmhq 03 ob}u~ `v`hq
* @ajihi~qu`qibh `} nb}u~ a} ums`~ sb}u aijih}mu lm~ qub}elm~ aidm~qif~
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