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    Jflus

    XYOYKF^@XAI Xuoukfp`tbaisCa`gkul` Zircagi, Jr`glisl` Migl`rikka, Jr`glislf Imm`

    XYOYKF ^_F\\AM@KI

    Ckalfsura` rig`ki ug` lfghazafgi oigacg`, sagtfm`tal`, hfvut` rahuzafgi hikk` sfcka`ha ra`ssfroamigtf ha ckulfsaf kavikkf hik tuoukf prfssam`ki, silfgh`ra`` mut`zafga hia lftr`spfrt`tfra ha sfhaf-ckulfsaf. Ag lfghazafga ha gfr-mfckalima`, k` ckalfsura` gfrm`kmigti ssigti, s`kvf gia gifg`ta pri-m`tura. Ak ra`ssfroamigtf ha ckulfsaf vvaigi miha`gti hui tr`spfrt`tfra G`+ hapighigta4 \CKX0 ` o`ss` j gat i `kt` l`p`lat i \CKX? `h `kt`

    `j gat i o`ss` l`p`lat. \CKX0 ra`ssfroi k` m`ccafr p`rti hik ckulfsafktr`tf migtri \CKX? ra`ssfroi ki uktami tr`lli ha ckulfsaf gikki uragi.Mut`zafga ag`ttav`gta ha \CKX0 l`us`gf pirt`gtf ckalfsura` ampfrt`gti,`glbi ha havirsa cr`mma/hai, migtri ag l`sf ha mut`zafga hik cigi \CKX?,k` ckalfsura` pa mfhir`t`, cigir`kmigti agjirafri `k cr`mmf/hai. K`tr`smassafgi pu issiri `utfsfmal` rilissav` f `utfsfmal` hfmag`gti` pigitr`gz` v`ra`oaki.

    K` ha`cgfsa sa o`s` suk raslfgtrf ha ckalfsura` asfk`t`, ag prisigz` hackalima` gfrm`ki ih ag `ssigz` ha `ktra sagtfma i sicga ha tuoukfp`ta`. giliss`raf islkuhiri ug ha`oiti mikkatf miha`gti ckalima` ` hacaugf ihivigtu`kmigti lfg lurv` h` l`ralf ha ckulfsaf.

    \aghrfmi ha J`glfga hfvut` hasjugzafgi hikk` likkuk` tuouk`ri prfssam`ki lfg pirhat` ura-g`ra` ha sfst`gzi lbi vigcfgf gfrm`kmigti ra`ssfroati ` quistf kavikkf(sfhaf, pft`ssaf, lkfrf, l`klaf, magf`laha, ckulfsaf, jfsj`ta, oal`rofg`taih ktra sfkuta). Isastfgf jfrmi ahafp`talbi i silfgh`rai (irihat`rai f l-quasati) (X`oikk` 0). H`k pugtf ha vast` safp`tfkfcalf vaigi hislratt` aghavirsa mfhikka spiramigt`ka ug` rahftt` haspfgaoakat ha @X^ pir kigz G`-E-@X^`sa lfg lfgsicuigti rahuzafgi hikkistrusafgi o`sfk`tir`ki hasfhaf i rahuzafgi hik cr`haigti ikittrflbamalf giliss`raf `k tr`spfrtf`pal`ki ha sfkuta `llfppa`ta `k sfhaf.LKAGAL@4 ag cigir`ki a p`zaigta lfg jfrm` lfmpkit` ha J`glfga prisigt`-gf rat`rhf ha lrislat` st`turf-pfghir`ki, jriquigta ipasfha ha hasahr`t`zafgi,r`lbatasmf (h` pirhat` ha jfsj`ta), pfkaura` i pfkahapsa`. K` pirhat` urag`raha E+ i oal`rofg`ta pfrt` ag cigiri ` apfe`kaima` ih `lahfsa tuouk`ri.

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    X`o. 0 - Izafkfca` hikk` \aghrfmi ha J`glfga

    Jfrmi irihat`rai Jfrmi lquasati

    Lastagfsa @z`tafprag` C`k`ttfsima` Mihalag` lagisi Ckalfcigfsa Cigt`malag` Agtfkkir`gz` irihat`ra` k jruttfsaf Laspk`tagf, ajfsj`mahi Matflfghrafp`tai Agtfssal`zafgi h` mit`kka pis`gta \aghrfmi ha Kfwi Xumfra misiglbam`ka Xarfsagima` Maikfm` muktapkf M`k`tta` ha Saksfg \aghrfmi gijrfsal` M`k`tta` ha Higt Xr`pa`gtf rig`ki

    Ahafp`tal` \aghrfmi ha \dfcrig

    HA@CGF\A4 sa o`s` suk raslfgtrf ha `lahfsa mit`ofkal` lfg pirhat`urag`ra` ha `kl`kaga (pB urag`raf ikiv`tf), ckalfsura`, apirjfsj`tura`,apirl`klaura`, apfg`traima`, apfpft`ssima` ih `magf`lahura`. X`ka sicga pfssfgf issiri prisigta ag masur` pa f migf m`rl`t . Agfktri sa raslfgtr`gikki jfrmi pa cr`va prftiagura` ha o`ssf pisf mfkilfk`ri.XI_@^A@4 sagtfm`tal` gikk` saghrfmi ha J`glfga ahafp`tal`. K`lahfsamit`ofkal` gilissat` ha oal`rofg`tf ha sfhaf (h` ? ` 0> mIq/ec/hai).Kapfjfsjfrima` i ak r`lbatasmf vigcfgf tr`tt`ta lfg sfkuzafgi fr`ki hajfsj`ta (0-< cr/hai) i vat`mag` H. Kapfg`traima` i kapfe`kaima` ralbaihfgfsuppkimigta ha sfhaf lkfrurf i pft`ssaf (ELk, Elatr`tf, Ek`tt`tf). gilis-s`raf ssalur`ri ug hicu`tf ppfrtf ha kaquaha, lfg p`rtalfk`ri ttigzafgi`kki lfghazafga lbi pfssfgf j`vfrari ug` hasahr`t`zafgi (c`strfigtirata,hacaugf prfkugc`tf), i gia p`zaigta lbi gfg b`ggf kaoirf llissf a kaquaha. Gikki jfrmi silfgh`rai k` tir`pa` lfmprighi tir`pa` hikk` p`tfkfca` ha o`si fvi pfssaoaki.

    Lastagfsa k` praglap`ki l`us` ha saghrfmi ha J`glfga pramatav` gik o`moagf. ug`m`k`tta` `utfsfmal` rilissav`, silfgh`ra` ` mut`zafgi hik cigi LXG\

    lbi l`us` k`ssigz` ha ug` prftiag` ha mimor`g` kasfsfma`ki hiput`t``k tr`spfrtf ha lastag` h`k kasfsfm` virsf ak latfpk`sm`, lfg lfgsicuigti`llumukf agtr`kasfsfma`ki ha lastag`.LKAGAL@4 cigir`kmigti k` m`k`tta` isfrhasli r`pah`migti hfpf k` g`sla-t` lfg pfkaura`, hasahr`t`zafgi i cr`vi rat`rhf ha lrislat`. l`r`ttirazz`t`h` hipfsazafgi ha lrast`kka ha lastag` ag v`ra frc`ga, ag p`rtalfk`ri rigi,fllbaf, p`glri`s. @ kavikkf hik tuoukf prfssam`ki sa b` ug` saghrfmi ha

    J`glfga cigir`kmigti sivir` lfg prfcrissafgi virsf kagsuj laigz` rig` -ki tirmag`ki gikk` pram` f silfgh` hil`hi ha vat`. K` m`k`tta` lfagvfkci`glbi `ktra frc`ga l`us`ghf jftfjfoa`, l`kf hik vasus, ha`oiti mikkatf,apftarfahasmf, apfcfg`hasmf, mafp`ta` ih ag `kluga l`sa iglij`kfp`ta` prfcrissav` gikkit `hukt`.

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    HA@CGF\A4 sa o`s` suk hfs`ccaf hikk` lastag` agtr`kiulflat`ra` i sukk`ralirl` hikk` mut`zafgi hik cigi LXG\. Kis`mi fjt`kmfkfcalf lfgk`mp`h` ` jissur` ivahigza` k` hipfsazafgi ha lrast`kka ha lastag` gikk

    lfgcaugtav` i gikk` pfrzafgi sfttfipatika`ki hikk` lfrgi`.XI_@^A@4 lfmprighi k` lfrrizafgi hicka squakaora ahrfikittrfkatala,hikk`lahfsa i hik r`lbatasmf, tapala hikk` saghrfmi ha J`glfga i tir`pa`lfg lasti`mag` pir lfgsigtari kistrusafgi h`k kasfsfm` ha lastag`.K` tir`pa` r`kkigt` k` prfcrissafgi hikkagsuj laigz` rig`ki, sfpr`ttuttfsi agaza`t` pram` hia ? `gga ha it i rahuli kagsfrcigz` ha `ktri lfmpka-l`gzi hikk` m`k`tta`. K` jfrmuk`zafgi utakazz`t` k` lasti`mag` oat`rtr`tf(Lyst`cfg). Ak hfs`ccaf ha larl` 0,< cr/m?/hai h` sfmmagastr`ri fcga :fri lfg hfs`ccaf m`ssamf ha 0,19 cr/m?/hai. A kavikka ha lastag` agtr`kiulflat`ra` hivfgf issiri mfgatfr`ta fcga ?-< misa pir h`tt`ri k` tir`pa`.Ak lfkkaraf ha lasti`mag` lfgsigti ha hassfkviri a lrast`kka lfrgi`ka.

    _`lbatasmf apfjfsj`timalf ug` m`k`tta` l`r`ttirazz`t` h` rahfttf ra`ssfroamigtf ha jfsjfrf ` ka-vikkf hik tuoukf rig`ki prfssam`ki, lfg apirjfsj`tura` ih apfjfsjfrima`silfgh`ra`. K` mut`zafgi hik cigi ^BIR `kk` o`si hikk` jfrm` pajriquigti, tr`smiss` silfghf mfh`kat R-kageih. Ki jimmagi pfrt`trala pfssfgf prisigt`ri sicga ha r`lbatasmf ivahigta ih apfjfsjfrima`, pirhfmag`gz` v`ra`oaki hikk` mut`zafgi gikki jimmagi pfrt`trala. Isasti`glbi ug` jfrm` utfsfmal` hfmag`gti, silfgh`ra` mut`zafgi hik cigiJCJ?< (Jaorfok`st Crfwtb J`ltfr), lfg pigitr`gz` spissf aglfmpkit`,it ha isfrhaf hia sagtfma v`ra`oaki i jriquigti rahuzafgi sacga l`tav`hikk` pirhat` ha jfsj`ta lfg k` lrislat`.LKAGAL@4 hfmag`t` h`a tapala sicga hik r`lbatasmf qu`ka rat`rhf halrislat`, lfx` v`r`, cagfllbaf v`kcf f v`rf, kfrhfsa, lajfslfkafsa.HA@CGF\A4 apirjfsj`tura`, apfjfsjfrima`, gfrmfl`klima , XB v`ra`- oaki, spissf gfrm`ki. \icga lkagala i r`hafkfcala ha r`lbatasmf.XI_@^A@4 sfkuzafgi ha jfsj`ta (0-< cr/hai) i l`klatrafkf -3> gc/ec/ha giliss`raf isicuari mfgatfr`ccaf ilfcr` lf rig`ki i hfs`ccaf hikk`

    l`klaura` pir pfssaoaki apirl`klaura` i gijrfl`klagfsa ag lfrsf ha tir`pa`lfg vat`mag` H ih `h`tt`ri k` tir`pa` pir m`gtigiri ak ^XB igtrf v`kfragfrm`ka.

    \aghrfmi ha Higt hfvut` mut`zafga ag`ttav`gta hik l`g`ki k lkfrf LkLG9, ak lua cigi kfl`kazz`tf suk lrfmfsfm` R. Puisti mut`zafga hitirmag`gf ug`ktir`-

    zafgi hik prflissf ha ighflatfsa rispfgs`oaki hik prflissf ha ra`ssfroa-migtf i hicr`h`zafgi hikki prftiagi ha o`ssf pisf mfkilfk`ri ` kavikkfhikk` likkuk` tuouk`ri prfssam`ki. Gi lfgsicui prftiagura` ha o`ssf pisfmfkilfk`ri i va sa ssfla` apirl`klaura`, k` lua spaic`zafgi safp`tfkfcal`

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    `glfr` hasluss`. ^fssfgf issiri prisigta `glbi gijrfl`klagfsa, kata`saurag`ra` ih `ktra sicga ha hasjugzafgi tuouk`ri prfssam`ki lfg saghrfmiha J`glfga pa f migf lfmpkit`.

    Ak jigftapf lkagalf v`ra`oaki. A m`slba jjitta pfssfgf svakupp`ri agsuj-laigz` rig`ki lrfgal` gikkit `hukt`.

    Lastagura` ug` m`k`tta` `utfsfmal` rilissav`, hfvut` ` hajittf ha tr`spfrtf hicka`magf`laha hao`sala (frgatag`, rcagag`, kasag`) i hikk` lastag` ttr`virsf k`mimor`g` pal`ki hikki likkuki tuouk`ra, lfg lfgsicuigti l`klfkfsa rig`kilastagal`. l`us`t` h` mut`zafgi hik cigi \KL% hia l`sa). K` lastag` ag illissfgikki uragi prilapat` i prfvfl` k` jfrm`zafgi ha l`klfka. J`ttfra j`vfrigtasfgf k` rahuzafgi ha pB urag`raf i k`umigtf ha fsmfk`rat urag`ra`.HA@CGF\A4 kis`mi malrfslfpalf hik sihamigtf urag`raf mfstr`spissf lrast`kka is`cfg`ka ha lastag`.Xist ha Or`gh (qu`kat`tavf)4 lfgsastigik tist`ri 0> ll ha uragi lfg la`gurf ha pft`ssaf5 ag l`sf ha pfsatavat kiuragi `ssumfgf lfkfri rfss`strf. \i ak tist ha Or`gh pfsatavf sa isicuihfs`ccaf qu`gtat`tavf hikk` lastag` i hicka `magf`laha hao`sala urag`ra.@g`kasa lbamal` hia l`klfka.XI_@^A@4 giliss`raf `umigt`ri k`ppfrtf ahralf pir rahurri kf-smfk`rat urag`ra`, `kl`kagazz`ri ki uragi lfg oal`rofg`tf ha sfhaf (0-?mIq/ec/hai) f latr`tf ha pft`ssaf. Ak pB urag`raf v` m`gtigutf tr` 3 i 2,`ssalur`ghfsa lbi gfg lfisast` apirl`klaura`, pir`ktrf agjriquigti, pir k` pfssaoaki prilapat`zafgi ha s`ka ha l`klaf. @k gi ha mfhuk`ri k` tir`pa``kl`kagazz`gti, giliss`raf ak mfgatfr`ccaf pirafhalf hfmalaka`ri hik pBurag`raf lfg strasli ri`ttavi.K` tir`pa` spila l` lfgsasti gikkampaicf ha lbik`gta hikk` lastag`, lfmik -mirl`ptf-prfpafgakckalag` i k` pigalakk`mag` ( mc/ec/hai, gf hug m`x ha 0-? cr/hai). A kavikka urag`ra ha lastag` kaoir` ghriooirf m`gti-

    guta sfttf 0>> mlmfk/mmfk ha lri`tagag` (p`ra h ug aglrimigtf ha larl`< vfkti raspittf `k v`kfri gfrm`ki). Kusf hia lbik`gta lfmpfrt` ak raslbafha ijjitta lfkk`tir`ka, ha lua ak pa ampfrt`gti k` lfmp`rs` ha prftiagura`

    gf `h ug` vir` i prfpra` saghrfmi gijrfsal` (CG mimor`gfs`) lbiampfgi k` sfspigsafgi hik tr`tt`migtf. irt`gtf glbi k` prftiagura` v`mfgatfr`t` ` hfmalakaf lfg k`usakaf ha strasli ri`ttavi.

    @lahfsa tuouk`ri prfssam`ki (tapf ?) l`r`ttirazz`t` h` ug` rahftt` sfcka` ha ra`ssfroamigtf hia oal`rofg`ta. Gfrm`kmigti ak tuoukf prfssam`ki ra`ssfroi k29% hia oal`rofg`ta ktr`ta.Ag quist` p`tfkfca` k` quft` ra`ssfroat` slighi gf `k :>%5 pfalb ak tu-

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    oukf hast`ki gfg ag cr`hf ha ra`ssfroari killissf ha oal`rofg`ta, quistalfmp`afgf gikki uragi. Isastfgf jfrmi pramatavi i jfrmi silfgh`rai lbisa prisigt`gf gikk`moatf ha ug` saghrfmi ha J`glfga. Ki jfrmi pramatavi

    pfssfgf issiri tr`gsatfrai hikkagj`gza` f hitirmag`ti cigital`migti.LKAGAL@4 gikki lahfsa tuouk`ra rig`ka ak sagtfmf praglap`ki ak hajiha lrislat` lbi lfmp`ri spissf lfg ak p`ss`ccaf h`k k`tti m`tirgf k k`tti`rta la`ki f lfg ak havizz`migtf. K`umigt`tf l`ralf prftialf agj`tta`ccr`v` k`lahfsa lbi ak tuoukf gfg raisli ` lfgtr`st`ri. @ktrf sagtfmfjriquigti ak vfmatf ralfrrigti.HA@CGF\A4sa o`s` suk raslfgtrf ha lahfsa mit`ofkal` lfg pB urag`raf7 9.9-:, suppfrt`tf ivigtu`kmigti h`kk` v`kut`zafgi hikk` sfcka` rig`ki`k oal`rofg`tf.XI_@^A@4 lfgsasti gikk` sfmmagastr`zafgi ha oal`rofg`tf ha sfhaf agqu`gtat spissf ikiv`ti ( gf ` 0> mIq/ec/hai) f ha latr`tf ha pft`ssaf.

    @G\@ HA BIGKI

    \aghrfmi ha O`rttirM`k`tta` l`r`ttirazz`t` h` apfpft`ssima`, kl`kfsa mit`ofkal` ih apirriga-gima` ssfla`t` gfrmftigsafgi. hfvut` havirsi gfm`kai cigitalbiagtiriss`gta v`ra tr`spfrt`tfra prftiala ` kavikkf hik tr`ttf `slighigtihikk`gs` ha Bigki. Ag o`si `k tr`spfrt`tfri lfagvfktf sa hastagcufgf 8tapa ha saghrfmi ha O`rttir4 Xapf 04 mut`zafgi cigi \KL0?@0 lfha l`gti lftr`spfrt`tfri G`-E-Lk,

    jurfsimahi sigsaoaki. Xapf ?4 mut`zafgi cigi ELGD0 lfha l`gti ak l`g`ki pft`ssaf pal`ki _FME. Xapf

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    lfg rahftt` islrizafgi urag`ra` ha sfhaf, k` pirhat` ikittrfkatal` ixtr`-rig`ki ih giliss`raf islkuhiri k` orfsa lastal`, `ktr` l`us` ha pirhat`ixtr`rig`ki ha sfhaf.

    XI_@^A@4 Jfrmi gifg`t`ka4 lfrricciri hasahr`t`zafgi i squakaoraf ikittrfkatalf pirlfmpigs`ri ki pirhati urag`rai, spissf mfktf `oofgh`gta gik pirafhfgifg`t`ki.

    Lfrrizafgi hikkapfe`kaima`4 lkfrurf ha pft`ssaf. Agaoatfra hikk` sagtisa ha prfst`ck`ghagi4 aghfmit`lag` (?-9 mc/ec/hai)

    f aouprfjigi ( gf ` mc/ec/hai). Ijjitta lfkk`tir`ka (r`ra)4 g`usi`,vfmatf, hfkfri `hhfmag`ki, uklir` piptal`, tfssalat im`tfpfaital`,h`ggf ip`talf.

    K` jfrm` `ssfla`t` ` apf`lusa` giurfsigsfra`ki (O`rttir tapf AZ) ra-spfghi sl`rs`migti `kk` tir`pa` lfg aghfmit`lag`. giliss`ra` ug` pris` ag l`ralf `uhafkfcal` prilfli.

    XYOYKF HA\X@KI I LFKKIXXF_I

    \aghrfmi ha Catikm`gM`k`tta` hfvut` ` mut`zafga hik cigi lfha l`gti ak lftr`spfrt`tfri G`-Lk (\KL0?@

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    HA@CGF\A4 apire`kaima`, apirrigagima`, hajittf silrizafgi rig`ki ha pft`ssaf, apirl`klaura`.XI_@^A@4 ahrflkfrfta`zahi 0-? mc/ec/hai.

    Ha`oiti agsapahf gijrfcigalf ug` m`k`tta` l`r`ttirazz`t` h` agl`p`lat hik rigi lfgligtr`ri ki uragi, pir risastigz` `kk`zafgi hikkfrmfgi `gtahauritalf (@HB) ` kavikkf hiahftta lfkkittfra hia gijrfga. Gik 1>% k` tr`smassafgi R-kageih, hfvut` mut`zafgi hik cigi lfha l`gti ak rilittfri hikk` v`sfprissag` (@Z^_?).Isasti ug` jfrm` rilissav` hfvut` mut`zafgi hik cigi @P^? (`lqu`pf -rag` ?), lfha l`gti a l`g`ka `pal`ka hikk`lqu` gia hftta lfkkittfra rig`ka.LKAGAL@4 si ak p`zaigti b` kaoirf `llissf `kk`lqu`, sfgf prisigta pfkaura` i pfkahapsa`. \i ak p`zaigti gfg oivi, lfmp`afgf hasahr`t`zafgii apirg`traima`. Gfg rakaivf `g`mgistalf ha pfkahr`mgafs. Gikk` pram` agj`gza` gf ` qu`ghf ak p`zaigti `kamigt`tf lfg k`ttim`tirgf (o`ssf lfgtigutf ha s`ki i prftiagi) k` lrislat` spissf ricfk`rii a sagtfma sfgf spissf ssigta. Pu`ghf vaigi agtrfhfttf k`tti ag jfrmukif k`tti v`llagf (`kt` l`ral` fsmftal` rig`ki) a sagtfma havigcfgf m`rl`ta,lfg `vahat hikk` suzafgi, pfpp`ti spissf agsuj laigta, vfmatf. Ag l`sfha cr`vi hasahr`t`zafgi pu lfmp`rari kit`rca`. Gik o`moagf pa cr`ghi cigir`kmigti pfkaura`, galtura`, pfkahapsa`K` lkagal` pu issiri l`r`ttirazz`t` `glbi h` vfmatf, `gfrissa`, sl`rs`lrislat` st`turf-pfghir`ki.K` pfkaura` pu glbi l`us`ri ahrfgijrfsa, hak`t`zafgi paikal`, ratigzafgiurag`ra`, igurisa, mic`vislal`. spissf prisigti ug` saghrfmi apirlagital`, sfggfkigz` i sl`rs` l`p`latha lfgligtr`zafgi hfvuta ` galtura` jriquigti i sfggf arricfk`ri.HA@CGF\A4 r`r`migti hfpf k`ggf. G`traima` 7 08< mIq/k lfg pisf spila lf urag`raf o`ssf, ag `ssigz`

    ha illissa ha `ppfrtf ha sfhaf. Xist lfg hismfprissag`4 fsmfk`rat urag`ra` ;?>> mFsm. Gik ha`oiti

    agsapahf ligtr`ki agvili sa b` raspfst` `kk` hismfprissag`.

    Xist ha `ssit`migtf4 pir islkuhiri pfkahapsa` psalfcig`. Gfg gilis-s`raf si ak tist kk` hismfprissag` pfsatavf. Gfg aghal`tf gia k`tt`gta.XI_@^A@4 mfktf ampfrt`gti4 `ssalur`ri `llissf kaoirf `a kaquaha. Gik pramf `ggf ha vat` spissf

    giliss`raf utakazz`ri ug sfghagf g`sf-c`stralf pir ssalur`ri ug lfrrittf`ppfrtf ha kaquaha `glbi hur`gti ki fri gftturgi5

    j`lakat`ri kf svuft`migtf vislal`ki haurgf i gftturgf5

    rahurri ak l`ralf fsmftalf rig`ki lfg ug` hait` apfsfhal` (; 0 mIq/ec/hai) m` gfrmfprftial`5 `ssalur`ri ricami l`kfralf `hicu`tf, sigz` umigt`ri ak l`ralf fsmftalf

    rig`ki (`umigt`ri quft` ckulahal` i kapahal`).

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    J@_M@LA4 aghfmit`lag` (? mc/ec/hai) gia prama `gga ha vat`, lfgsacka`t` h` kluga

    `utfra5

    ahrflkfrfta`zahi (?-8 mc/ec/hai) rahuli k` haurisa pir `umigtf hikra`ssfroamigtf tuouk`ri ha sfhaf i lqu`. \a pu ssfla`ri tir`pa` lfg`makfrahi (>.< mc/ec/hai) pir privigari kapfe`kaima` h` ahrflkfrfta`-zahi.

    \aghrfmi ha Kahhki ug` m`k`tta` utfsfmal` hfmag`gti hfvut` mut`zafgi hikk` suougathik l`g`ki ipatika`ki hik sfhaf hia tuouka lfkkittfra hiput`tf `k ra`ssfr- oamigtf ha sfhaf ag raspfst` `kk`khfstirfgi. La hitirmag` ug oak`glafsfhalf pfsatavf lfg apirtigsafgi.LKAGAL@4 a sagtfma pfssfgf lfmp`rari gikk` pram` agj`gza` i aglkuhf-gf apirtigsafgi `rtirafs`, `kl`kfsa mit`ofkal` apfe`kaimal`, silrizafgi`ssigti ha rigag` i `khfstirfgi.HA@CGF\A4 ampfrt`gti k`g`mgisa j`maka`ri, spissf pfsatav` pirapirtigsafgi `rtirafs` ag cigir`zafga sullissavi. Za m`gl`t` raspfst`apftigsav` `kk` sfmmagastr`zafgi ha sparfgfk`ttfgi.XI_@^A@4 suppkimigt`zafgi ha pft`ssaf (ELk) i tra`mtirigi (0> mc/ec/hai) f `makfrahi.

    ^siuhfapf`khfstirfgasmf tapf 0 ug` m`k`tta` l`r`ttirazz`t` h` m`gl`t` f rahftt` raspfst` hik tuoukfrig`ki kk`zafgi hikk`khfstirfgi, lfg lfgsicuigti lahfsa apire`kaimal`i pirhat` urag`ra` ha sfhaf. gft` ug` jfrm` `utfsfmal` hfmag`gti ihug` jfrm` `utfsfmal` rilissav`. K` jfrm` `utfsfmal` rilissav` b` ci-gir`kmigti ug jigftapf sivirf, m`gajist`ghfsa lfg cr`vi hasahr`t`zafgi,vfmatf, apfg`trima`, apirpft`ssaima`, apir`khfstirfgasmf. Gikk` jfrm`hfmag`gti spissf sa b` gfrm`kazz`zafgi hikk` e`kaima` lfg kit.K` tir`pa` lfmprighi kl`kagazz`zafgi, hait` apfpft`ssal` i si giliss`rafkusf ha lbik`gta hik pft`ssaf (e`yix`k`ti).

    @lahfsa tuouk`ri hast`ki (f tapf 0) l`r`ttirazz`t` h` agsuj laigti `laha l`zafgi urag`ra` h` p`rti hikkilikkuki `kj`-agtirl`k`ti hik tuoukf hast`ki. \fgf ralfgfslauti havirsijfrmi cigitalbi4 ug` jfrm` utfsfmal` hfmag`gti l`us`t` h` mut`zafgagik cigi lfha l`gti pir kf sl`moa`tfri `gafgalf lkfrf-oal`rofg`tf ihug` jfrm` `utfsfmal` rilissav` lfg mut`zafga gik cigi lfha l`gti k`

    suougato0 hikk` pfmp` B+-@X^`sa, ssfla`t` sfrhat giurfsigsfra`ki.LKAGAL@4 a sagtfma sfgf samaka ` quikka hikk`lahfsa tuouk`ri prf-m`ki. Ak pB urag`raf simpri 7 :. Ak sicgf lkagalf praglap`ki ak hajittfha lrislat`.

  • 7/25/2019 44 Tubulopatie Optimized

    9/9

    HA@CGF\A4 k` lfglfmat`gz` ha lahfsa mit`ofkal` (oal`rofg`ta pk`sm`-tala ; 02 mIq/k) i ha pB urag`raf ikiv`tf succistav` ha lahfsa tuouk`ri.\a pfssfgf `ssfla`ri apfe`kaima`, apirl`klaura` lfg lfgsicuigti gijrf-

    l`klagfsa i apflatr`tura`. Ak pB urag`raf ikiv`tf `ssfla`tf ` apirl`klaura`i apflatr`tura` j`vfrasli k` jfrm`zafgi ha l`klfka rig`ka.XI_@^A@4`hicu`tf tr`tt`migtf `kl`kagazz`gti lfg oal`rofg`tf ha sf-haf i/f latr`tf ha pft`ssaf (cigir`kmigti ?-< mIq/ec/hai). X`ki tir`pa` pfrt` ag cigiri `h ug prfgtf rilupirf hikk` lrislat` st`tur`ki i ` r`pah`ricrissafgi hia sagtfma. Gikk`lahfsa tuouk`ri hast`ki ha tapf AZ, cigir`kmigti ssfla`t` m`kjfr -m`zafga urag`rai, va apire`kaima` silfgh`ra` ` agsigsaoakat hik tuoulfkkittfri i hast`ki `kk`khfstirfgi.

    Oaokafcr`j` issigza`ki

    - Mibuk \b`b.@pprf`lb Xf _ig`k Xuouk`r Hasfrhirs. Agha`g Dfurg`k Fj r`ltal`k^iha`trals. ?>0?5084 030.

    - Kiugc DL. Agbiratih rig`k hasi`sis. Lurr ^iha`tr _iv. ?>0850>419-0>>.- Lbiv`kair _K, Jfrois M\, it `k. _ispfgsis fj prfxam`k tuouk`r likks tf agdury

    ag lfgcigat`k rig`k hasi`si4 cbt fr acbt. iha`tr Gipbrfk. ?>085?1490