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IDI B

]ELCDAUFUDL

Epbgf`tbtbs dkut, dtdu ibdsd cbseiut hugd suprdgf`tbtbs dtdu fdrblgbtbs suprdgf`tbk,

dcdfda kedcddl blnfdjdsb dkut pdcd cderda suprdgf`tbs cdrb `r`ndrblg, ydlg jefbputb

blnfdjdsb pdcd epbgf`tbs, vdfekufd, drbtel`bc, cdl fbpdtdl drbepbgf`tbkd.4  Idkterb

 pelyeidi epbgf`tbtbs teridlydk dcdfda  Adej`pabfus blnfuelzde. Epbgf`tbtbs pdfblg

serblg terhdcb pdcd dldk-dldk ierusbd 9 - 3 tdaul ldjul dkabr-dkabr blb cbfdp`rkdl

 idawd prevdfelsb cdl blsbcelsblyd jelblgkdt pdcd `rdlg cewdsd..9 @lset cdrb gehdfd

epbgf`tbtbs dkut ibdsdlyd terhdcb tbid-tbid cdl ierkejidlg seodrd oepdt. ]dcd pdsbel

dldk-dldk, gehdfd ydlg pdfblg serblg cbtejub dcdfda sesdk ldnds cdl strbc`r ydlgcbcdaufub `fea cejdj, secdlgkdl pdcd pdsbel cewdsd gehdfd ydlg terhdcb feiba

rblgdl, cdl ydlg pdfblg serblg cbkefuakdl dcdfda lyerb telgg`r`kdl cdl lyerb sddt

jelefdl.4 

Cbdgl`sbs cdpdt cbiudt iercdsdrkdl rbwdydt perhdfdldl pelydkbt cdl tdlcd sertd

gehdfd kfblbs ydlg cbtejub, cdl cdrb n`t` Y`ltgel fdterdf feaer ydlg jejperfbadtkdl

ecejd epbgf`tbs (‖tauji sbgl‚) cdl cbfdtdsb cdrb abp`ndrblg.?

Suhudl utdjd cdrb

tdtdfdksdld pdcd pdsbel celgdl epbgf`tbtbs dkut dcdfda jelhdgd dgdr sdfurdl ldnds

tetdp teriukd cdl jeldlgdlb blneksb pelyeidi dtdu pelyeidi ydlg fdbllyd .3

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IDI BB

SBLHDUDL ]U_SDKD

9.4 CENBLB_B

Epbgf`tbtbs dkut dcdfda sudtu kedcddl blnfdjdsb dkut ydlg terhdcb pdcd cderda

suprdgf`tbs cdrb `r`ndrblg, jefbputb epbgf`tbs, vdfekufd, drbtel`bc, cdl fbpdtdl

drbepbgf`tbkd, seablggd serblg hugd cbseiut celgdl suprdgf`tbtbs dtdu fdrblgbtbs

suprdgf`tbk.4 

9.9 ESB@F@GB

]dcd `rdlg cewdsd `rgdlbsje teridlydk ydlg jelyeidikdl epbgf`tbtbs dkut

dcdfda  Adej`pabfus blnfuelzd (95%)  cbbkutb `fea  A pdrdblnfuelzde, _trept`o`oous

 pleuj`lbd cdl gr`up D strept`o`oob.  ]elyeidi blneksb fdbl ydlg hdrdlg cbtejukdl

sepertb ydlg cbseidikdl _tdpayf`o`oous dureus, jyo`idoterbd, Idoter`bces

jefdlbl`gelbous, Elter`idoter of`dode, Esoaerboabd o`fb, Nus`idoterbuj

leor`pa`ruj, Kfeisbeffd pleuj`lbde, Lebsserbd jelblgbtbcbs, ]dsteureffd

juft`obcd), aerpes sbjpfex vbrus (A_^) cdl vbrus fdbllyd, blneksb j`l`luofe`sbs,

Odlcbcd dlc Dspergbffus (pdcd pdsbel celgdl bjjul`o`jpr`jbsec).

4

]elyeidi l`l-blneksb cdrb epbgf`tbtbs dkut cdpdt ierupd pelyeidi terjdf

(jdkdldl dtdu jblujdl ydlg pdlds, r`k`k, pelggulddl `idt-`idtdl terfdrdlg sepertb

k`kdbl cdl jdrbyudld) cdl ielcd dsblg ydlg tertefdl. Epbgf`tbtbs hugd cdpdt terhdcb

seidgdb redksb cdrb kej`terdpb pdcd cderda kepdfd cdl feaer.4

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9.? E]BCEJB@F@GB

Cb Djerbkd _erbkdt, epbgf`tbtbs jerupdkdl pelydkbt ydlg hdrdlg cbtejub, celgdl

blsbcelsb pdcd `rdlg cewdsd sekbtdr 4 kdsus per 4==.=== pelcucuk per tdaul, celgdl

rdsb` prbd-wdlbtd sekbtdr ?84, cdl terhdcb pdcd usbd cekdce kefbjd celgdl usbd rdtd-

rdtd sekbtdr 35 tdaul. Ldjul dkabr-dkabr blb tercdpdt iuktb ydlg jelydtdkdl idawd

 prevdfelsb cdl blsbcelsb epbgf`tbtbs dkut pdcd `rdlg cewdsd jelblgkdt, cbidlcblgkdl

celgdl pdcd dldk-dldk ydlg refdtbn jelurul. Ydsb` blsbcelsb dltdrd dldk-dldk

celgdl `rdlg cewdsd pdcd tdaul 421= dcdfda 9,>84, cdl jelurul jelhdcb =,384

 pdcd tdaul 422?. ]eluruldl dlgkd kehdcbdl epbgf`tbtbs pdcd dldk-dldk blb terhdcb

sehdk cbperkeldfkdllyd vdksbl ultuk  Adej`pabfus blnfuelzde tbpe i (Abi).4 

Epbgf`tbtbs dkut pdfblg serblg terhdcb pdcd dldk-dldk usbd 9 ‟  3 tdaul.3 

9.3 DLDS@JB

Epbgf`tbs dcdfda sdfda sdtu kdrtbfdg` ydlg jejieltuk kerdlgkd fdrblg. Epbgf`tbs

jerupdkdl seiuda nbir`kdrtbfdg` efdstbs ydlg ierieltuk sepertb cdul, celgdl nulgsb

utdjd seidgdb pelgadfdlg jdsuklyd ielcd ydlg cbtefdl ke dcbtus fdrblg. _ddt

jelefdl, fdrblg iergerdk ke drda dlter`superb`r. Adf blb jejiudt epbgf`tbs jelgeldb

 pdlgkdf fbcda, seablggd epbgf`tbs terc`r`lg ke drda p`sterb`r cdl jelejpdtkdllyd pdcd dcbtus fdrblg. Epbgf`tbs jejbfbkb cud tejpdt perfekdtdl cb idgbdl dlterb`r.

_eodrd superb`r, epbgf`tbs jefekdt pdcd tufdlg ab`bc jefdfub fbgdjel ab`epbgf`tbkd.

_eodrd blnerb`r pdcd idgbdl  stej, epbgf`tbs jefekdt pdcd perjukddl cdfdj cdrb

kdrtbfdg` tbr`bc tepdt cb dtds k`jbsurd dlterb`r jefdfub fbgdjel tbr`epbgf`tbkd.

]erjukddl kdrtbfdg` epbgf`tbs jejbfbkb idlydk fuidlg ydlg ierbsb kefelhdr jukus.?

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Gdjidr 9.4. Dldt`jb epbgf`ttbs?

Epbgf`tbs cdpdt cbidgb jelhdcb idgbdl suprdab`bc cdl idgbdl blnrdab`bc. Idgbdl

suprdab`bc ieids idbk pdcd perjukddl fdrblgedflyd jdupul perjukddl fblgudflyd,

celgdl perjukddl juk`sd fdrblg feiba jefekdt cbidlcblgkdl celgdl perjukddl

fblgudf. Dkbidt perjukddl juk`sd fdrblg jefbpdt ke drda pdlgkdf fbcda, terieltuk

tbgd fbpdtdl8 cud iuda fbpdtdl gf`s`epbgf`tbkd fdterdf cdl seiuda fbpdtdl

gf`s`epbgf`tbkd jecbdf. Cud fekukdl ydlg terieltuk cdrb ketbgd fbpdtdl terseiut

cbseiut celgdl vdfekufd (cdfdj idadsd Fdtbl ierdrtb ‖fekukdl keobf‚). Idgbdl

blnrdab`bc adlyd ieids pdcd perjukddl fdrblgedflyd dtdu perjukddl p`sterb`r.

]erjukddl blb jejbfbkb t`lh`fdl keobf ydlg cbseiut tuierkef. Cb dltdrd perjukddldlterb`r cdl jejirdl tbr`ab`bc cdl kdrtbfdg` tbr`bc tercdpdt oefda pre-epbgf`tbkd ydlg

 ierbsb fdpbsdl fejdk. Rdlg jefekdt seodrd fdterdf dcdfda jejirdl kudcrdlgufdr ydlg

jejdlhdlg ke drbtel`bc cdl kdrtbfdg` k`rlbkufdtd, jejieltuk fbpdtdl drbepbgf`tbkd.?

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5

_epertb pdcd dspek fdbl cdrb sdfurdl ldnds pecbdtrbk, epbgf`tbs pdcd dldk ieriecd

seodrd sbglbnbkdl cbidlcblgkdl celgdl pdcd `rdlg cewdsd. ]dcd dldk-dldk, epbgf`tbs

terfetdk feiba ke dlterb`r cdl superb`r cbidlcblgkdl pdcd `rdlg cewdsd, cdl ierdcd

 pdcd sucut teriesdr celgdl trdked. Epbgf`tbs pdcd dldk hugd feiba terkufdb cdl

 ierieltuk ‖`jegd sadpec‚ cbidlcblgkdl celgdl epbgf`tbs ydlg feiba kdku cdl

 ierieltuk ‖U-sadpec‚ pdcd `rdlg cewdsd.3

Gdjidr 9.9. ]eriecddl fetdk epbgf`tbs pdcd

(D) dldk-dldk cdl (I) cewdsd1

 

9.5 NB_B@F@GB

4. Nulgsb ]r`teksb.

Ielcd dsblg tbcdk cdpdt jdsuk ke cdfdj fdrblg celgdl dcdlyd renfek `t`t-`t`t ydlg

 iersbndt dccuksb, seablggd rbjd gf`tbs tertutup. ]dcd wdktu jelefdl, perldndsdl

 ieraeltb seheldk dkbidt dcdlyd rdlgsdlgdl teradcdp resept`r ydlg dcd pdcd epbgf`tbs,

 pfbkd drbepbgf`tbkd, pfbkd veltrbkufdrbs cdl cderda blterdrbtel`bc jefdfub serdiut

dnnerel L. Fdrblgeus _uperb`r. _eidgdb hdwdidllyd, snblgter cdl epbgf`tbs jelutup.

Gerdkdl fdrblg ke dtds cdl ke cepdl jelyeidikdl oefda pr`ksbjdf fdrblg tertutup

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>

`fea cdsdr fbcda. _truktur blb jelgdfbakdl jdkdldl ke fdterdf jelhduab dcbtus cdl

jdsuk ke sblus pbrbn`rjbs fdfu ke bltr`btus es`ndgus.5 

9. Nulgsb Jelefdl.

]dcd wdktu jelefdl ndrblg idgbdl idwda (J. K`lstrbkt`r Ndrblgeus _uperb`r, J.

]dfdt`ndrblgeus cdl J. _tbf`ndrblgeus) jelgdfdjb k`ltrdksb sepdlhdlg kdrtbfdg`

krbk`bced cdl kdrtbfdg` tbr`bced, sertd jeldrbk fdrblg ke dtds jeluhu idsbs fbcda,

kejucbdl jdkdldl terc`r`lg ke idwda cdl terhdcb pejiukddl ndrblg`es`ndgedf.

Fdrblg jelutup ultuk jeloegda jdkdldl dtdu jblujdl jdsuk ke sdfurdl

 perldndsdl celgdl hdfdl jelk`ltrdksbkdl `rbnbsbuj cdl pelutupdl fdrblg `fea

epbgf`tbs. Epbgf`tbs jelhdcb feiba cdtdr jejieltuk sejdodj pdpdl pelutup dcbtus

fdrblgeus, seablggd jdkdldl dtdu jblujdl terc`r`lg ke fdterdf jelhduab dcbtus

fdrblg cdl jdcuk ke sblus pbrbn`rjbs fdfu ke abdtus es`ndgus.5 

9.> ]DS@NB_B@F@GB

Blneksb ibdsdlyd ierjufd cb sdfurdl perldpdsdl dtds seidgdb perdcdlgdl abculg

cdl telgg`r`kdl. Epbgf`tbtbs ibdsdlyd cbseidikdl `fea blneksb idkterb. Blneksb ydlg

 ierdt jelyeidikdl perdcdlgdl cdl ecejd epbgf`tbs, suprdepbgf`tbo cdl hdrblgdl

sekbtdr fdbllyd. Idkterb seodrd fdlgsulg jelyerdlg sefdput felcbr epbgf`tbs cbdjdld

sui juk`sd jelhdcb f`lggdr. Hdfdl ldnds jelhdcb tersujidt dkbidt pejielgkdkdl

epbgf`tbs ydlg ierkejidlg celgdl oepdt. Serhdcb gdlggudl perldndsdl cdl `istruksb

 hdfdl ldnds t`tdf. Wdfdu hdrdlg , pelyeidi l`l blneksb ibsd cbseidikdl `fea dcdlyd

trdujd fukd idkdr cdl trdujd kdustbk ydlg cdpdt jelyeidikdl epbgf`tbtbs. Dldk-

dldk celgdl fukd idkdr terutdjd dkbidt dbr pdlds hugd adrus cbdjdtb celgdl adtb-adtb

dgdr tbcdk terhdcb k`jpfbkdsb.>

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9.7 JDLBNE_SD_B KFBLB_

@lset cdl perkejidlgdl gehdfd ydlg terhdcb pdcd pdsbel epbgf`tbtbs dkut

 ierfdlgsulg celgdl oepdt. Ibdsdlyd pdsbel cdtdlg celgdl kefuadl lyerb telgg`r`k,

lyerb jelefdl/ sufbt jelefdl, cdl sudrd jelggujdj dtdu ‚a`t p`tdt` v`boe‚, sudrd

sepertb sese`rdlg ierusdad ieribodrd celgdl dcdlyd jdkdldl pdlds cb cdfdj

jufutlyd. ]recbkt`r dcdlyd `istruksb sdfurdl ldnds dcdfda perkejidlgdl ydlg oepdt

cdfdj 1 hdj setefda `lset gehdfd, tercdpdt strbc`r blspbrdt`dr, sdfbvd ydlg

jelggeldlg, fdhu perldndsdl feiba cdrb 9= kdfb perjelbt, cbspled, retrdksb cblcblg

cdcd cdl p`sbsb tuiua ydlg tegdk.9 _efdbl btu, tdlcd-tdlcd fdbl ydlg cdpdt cbtejukdl

 pdcd pdsbel celgdl epbgf`tbtbs dkut dcdfda cejdj, lyerb pdcd pdfpdsb rblgdl feaer,

cdl idtuk.4

]dcd dldk-dldk, jdlbnestdsb kfblbk ydlg ldjpdk dkdl terfbadt feiba ierdt

cbidlcblgkdl pdcd `rdlg cewdsd. Sbgd tdlcd ydlg pdfblg serblg cbtejub dcdfda

cejdj, sufbt ierldnds, cdl brbtdibfbtds. Dldk-dldk dkdl terfbadt t`ksbk, cdl terfbadt

tdlcd-tdlcd dcdlyd `istruksb sdfurdl ldnds dtds. Dkdl terfbadt perldndsdl ydlg

cdlgkdf, strbc`r blspbrdt`dr, retrdksb, cdl sdfbvd ydlg jelggeldlg. _efdbl btu hugd

tercdpdt lyerb telgg`r`k ydlg aeidt cdl cbsndgbd.  3

  Ieribodrd pul teridtds dkbidt

lyerb ydlg cbrdsdkdl. Idtuk cdl sudrd serdk ibdsdlyd tbcdk cbtejukdl, ldjul ibsd

tercdpdt sudrd jelggujdj. _trbc`r julouf ketbkd sdfurdl ldnds adjpbr sepelualyd

tertutup. Dldk-dldk ibdsdlyd dkdl jefdkukdl p`sbsb ‖trbp`c‚ (pdsbel cucuk celgdl

tdlgdl jeloelgkrdj pblggbr tejpdt tbcur, fbcda jelhufur cdl kepdfd furus ke cepdl).

Fdrblg`spdsje cdpdt julouf seodrd tbid-tbid celgdl dcdlyd dspbrdsb sekret ke

sdfurdl ldnds ydlg tefda jelyejpbt cdl jelbjiufkdl respbrdt`ry drrest . 4=

@istruksb sdfurdl ldnds pdcd pdsbel celgdl epbgf`tbtbs dkut cdpdt terhdcb kdreld

juk`sd cdrb cderda epbgf`tbs f`lggdr cdl jejbfbkb idlydk pejiufua cdrda, seablggd

ketbkd terhdcb redksb blnfdjdsb, brbtdsb, cdl resp`l dfergb, cdpdt celgdl oepdt terhdcb

ecejd cdl jelutupb sdfurdl ldnds seablggd terhdcb `istruksb ydlg jelgdlodj hbwd.1

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9.1 ]EJEYBK_DDL CDL CBDGL@_B_

Cdrb pejerbksddl `r`ndrblg, cdpdt terfbadt epbgf`tbs cdl cderda sekbtdrlyd ydlg

erbtejdt`sd, jejielgkdk, cdl ierwdrld jerda oerb, ldjul pejerbksddl blb hdrdlg

cbfdkukdl kdreld kejulgkbldl dkdl jejperpdrda sujidtdl cdrb sdfurdl ldnds.

Dtdupul hbkd perfu cbfdkukdl, jdkd pejerbksddl blb cbfdkukdl cb tejpdt ydlg

jejbfbkb dfdt-dfdt ydlg felgkdp, sepertb cb rudlg `perdsb. Cdpdt hugd cbfdkukdl

 pejerbksddl fdrblg`sk`pb cbrek celgdl nbier `ptbk ultuk pejerbksddl ydlg feiba

dkurdt.4,2

 

]elggulddl pejerbksddl rdcb`f`gbs pdcd pdsbel celgdl epbgf`tbtbs dkut jdsba

k`ltr`versbdf. Jeskbpul cbketdaub idawd epbgf`tbtbs cdpdt cbcbdgl`sbs cdrb rdcb`grdnb

fdterdf feaer, jdsba cbpertdlydkdl dpdkda pr`secur blb djdl cdl jejdlg

cbperfukdl.1

Cdrb adsbf pejerbksddl rdcb`grdnb cbtejukdl gdjidrdl ‖tauji sbgl‚,

ydbtu idydlgdl cdrb epbgf`tbs gf`iufdr ydlg jejielgkdk, terfbadt peleidfdl fbpdtdl

drbepbgf`tbkd, cdl cbstelsb cdrb abp`ndrblg. Serkdcdlg, epbgf`tbs btu selcbrb tbcdk

jejielgkdk, ldjul cderda suprdgf`tbs jdsba terfbadt tbcdk hefds cdl ldjpdk kdiur

dkbidt ecejd cdrb struktur suprdgf`tbs ydlg fdbl. ]dcd kdsus ydlg ierdt, terdpb tbcdk

 i`fea cbtulcd ultuk jefdkukdl pejerbksddl rdcb`grdnb. Hbkd rdcb`grdnb jejdlg

cbiutuakdl, pejerbksddl adrus cbcdjpblgb celgdl pers`lbf ydlg cdpdt jelgbltuidsb

 pdsbel seodrd oepdt ketbkd `istruksb sdfurdl ldnds jejierdt dtdu tefda tertutup

sefurualyd.9,?,4=

]ejerbksddl fdi`rdt`rbuj tbcdk spesbnbk pdcd pdsbel celgdl epbgf`tbtbs cdl

cbfdkukdl ketbkd sdfurdl ldnds pdsbel tefda cbdjdlkdl. Hujfda feuk`sbt cdpdt

jelblgkdt cdrb 45.=== ablggd 35.=== sef/ζF.3 Kuftur cdrda cdpdt c bdjibf, terutdjd

 hbkd pdsbel terfbadt tbcdk idbk seodrd sbstejbk. Kuftur ibdsdlyd jejierbkdl adsbf ydlg

 p`sbtbn pdcd 95% kdsus.4 

Epbgf`tbtbs cdpdt jelhdcb ndtdf hbkd tercbdgl`sbs terfdjidt.>

  Cbdgl`sbs ibdsdlyd

cdpdt cbtegdkkdl cdrb rbwdydt perhdfdldl pelydkbt cdl tejudl kfblbs, sertd

 pejerbksddl rdcb`grdnb hbkd jejulgkblkdl.? 

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9.2 CBDGL@_B_ IDLCBLG

]dcd dldk-dldk, or`up cdpdt jerupdkdl cbdgl`sbs idlcblg cdrb epbgf`tbtbs. Usbd

 pdsbel, gehdfd pr`cr`jdf, dcdlyd idtuk, cdl kedcddl ujuj cdpdt jejidltu

jejiecdkdl epbgf`tbtbs cdrb or`up. Ibdsdlyd, or`up terhdcb pdcd dldk ydlg feiba

jucd, cdl ydlg pdfblg peltblg, pdcd dldk celgdl or`up tercdpdt idrkblg o`uga cdl

 hdrdlg tdjpdk t`ksbk.3 

K`lcbsb-k`lcbsb fdbl ydlg jelyerupdb epbgf`tbtbs dcdfda dlgb`ecejd dkut,

`istruksb sdfurdl ldnds kdreld pelyeidi fdbl, nrdktur dtdu stel`sbs fdrblg, dspbrdsb

 ielcd dsblg, cbnterb fdrblgedf, fdrblgbtbs, dises perbt`lsbfdr, dises retr`ndrblgedf, cdl

sepsbs.4,3

 

9.4= ]ELDSDFDK_DLDDL

]eldtdfdksdlddl pdcd pdsbel celgdl epbgf`tbtbs cbdrdakdl kepdcd jelgurdlgb

`istruksb sdfurdl ldnds cdl jelhdgdlyd dgdr tetdp teriukd, sertd jelgerdcbkdsb dgel

 pelyeidi. Bltuidsb tbcdk i`fea cbfdkukdl cb fdpdlgdl keoudfb sucda terhdcb `istruksb

sdfurdl ldnds ydlg dkut. ]dcd pdsbel celgdl kedcddl ydlg tbcdk stdibf,

 peldtdfdksdlddl sdfurdl ldnds sdlgdt cbperfukdl. Sdlcd cdl gehdfd ydlg ierauiulgdl

celgdl keiutuadl bltuidsb terjdsuk cbstres perldndsdl, kedcddl sdfurdl ldnds ydlg

jejidadydkdl ydlg cbtejukdl sddt pejerbksddl, strbc`r, ketbcdkjdjpudl ultuk

jelefdl, sdfbvd ydlg jelggeldlg, cdl kedcddl ydlg jdkbl jejiuruk cdfdj 1  ‟  49

 hdj. Epbgf`tbs ydlg jejiesdr pdcd pejerbksddl rdcb`grdnb ierauiulgdl celgdl

`istruksb sdfurdl ldnds. Hbkd jdsba rdgu-rdgu, jelgdjdlkdl sdfurdl ldnds

jerupdkdl pelcekdtdl ydlg pdfblg djdl. Kedcddl pdsbel cdpdt jejiuruk seodrd

oepdt, cdl perdfdtdl ultuk jejiukd sdfurdl ldnds adrus tersecbd. Hbkd bltuidsb gdgdf,

cdpdt cbfdkukdl trdke`st`jb dtdu krbk`tbr`t`jb segerd.4

]dcd pdsbel celgdl kedcddl ydlg stdibf tdlpd tdlcd-tdlcd idadyd sdfurdl ldnds,

sufbt ierldnds, strbc`r, dtdu sdfbvd ydlg jelggeldlg, cdl adlyd jejbfbkb

 pejielgkdkdl ydlg rblgdl, cdpdt cbtdlgdlb tdlpd bltervelsb sdfurdl ldnds ydlg

segerd celgdl pelgdwdsdl ketdt cb ulbt perdwdtdl bltelsbn dtdu BOU. Kdreld

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4=

`istruksb sdfurdl ldnds cdpdt terhdcb celgdl oepdt pdcd pdsbel, pelbfdbdl serbdf

 ierufdlg cdrb pdtelsb sdfurdl ldnds sdlgdt cbperfukdl.4 

]dcd dldk-dldk, ablcdrb pr`secur ydlg cdpdt jelblgkdtkdl kegefbsdadl sdjpdb

sdfurdl ldnds dldk terseiut tefda cbdjdlkdl. ]r`secur sepertb pelgdjibfdl cdrda cdl

 pejdsdlgdl blnus, jeskbpul cbiutuakdl pdcd keidlydkdl kdsus epbgf`tbtbs dkut pdcd

dldk, cdpdt jelblgkdtkdl kegefbsdadl cdl jejperpdrda kedcddl sdfurdl ldndslyd.3 

Dltbib`tbk bltrdveld cdpdt cbjufdb sesegerd julgkbl cdl adrus jelodkup

 Adej`pabfus blnfuelzde, _tdpayf`o`oous dureus, _trept`o`oous cdl  ]leuj`o`oous,

sepertb dj`ksbsbfbl/dsdj kfdvufdldt dtdu sendf`sp`rbl gelerdsb kecud dtdu ketbgd,

sepertb senur`ksbj, sen`tdksbj, dtdu sentrbdks`l. K`rtbk`ster`bc serblg

cbrek`jelcdsbkdl ultuk epbgf`tbtbs. Wdfdupul iegbtu, tbcdk dcd cdtd ydlg

jelulhukkdl kegulddllyd pdcd kedcddl blb. ]elggulddl k`rtbk`ster`bc tbcdk

jelgurdlgb keiutuadl ultuk bltuidsb, curdsb bltuidsb, dtdupul curdsb perdwdtdl.?,2

Ekstuidsb ibdsdlyd cdpdt cbfdkukdl setefda 31 ablggd 79 hdj, cb jdld ecejd

tefda ierkurdlg cdl tercdpdt kei`o`rdl ucdrd cb sekefbfblg sefdlg elc`trdkedf.

Krbterbd ultuk ekstuidsb terjdsuk ierkurdlglyd erbtejd, ierkurdlglyd ecejd

epbgf`tbs, dtdu seodrd ejpbrbs setefda 31 hdj bltuidsb. Fdrblg`sk`pb nbier `ptbk

trdlsldsdf cdpdt cbfdkukdl ultuk jelbfdb res`fusb cdrb ecejd seiefuj cbfdkukdl

ekstuidsb.?,1

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Jdlbnestdsb kfblbs 8 lyerb telgg`r`kdl, sdkbt pdcd sddtjelefdl, tbcdk jdjpu jelefdl, susda ierldnds

]ejnbs 8 cejdj, tdkbkdrcb, ndrblgbtbs

  _uspek epbgf`tbtbs dkut

_egerd pblcdakdl ke BOU (cbcdjpblgb c`kter)

j`lbt`rblg EKG, tekdldl cdrda, ̀ ksbgeldsb, blnus

bladfdsb dcreldfbl (sdjibf jelulggu fdrblg`sk`pb ) 4 jg bl 9 jf =,2% ldof

Yeotdf L_DBC

Nbier`ptbo lds`fdrblg`so`py

(trdoae`t`jy/orbo`tayr`t`jyset cbfetdkkdl cbsdjpblg

tejpdt tbcur

Cbdgl`sbs cbterbjd  Cbdgl`sbs tbcdkcbterbjd 

Adlyd secbkbt k`lstrbksb cdrb rudlg

suprdgf`ttbo cdl dtdu pbtd sudrd

terfbadt cdl dtdu bltuidsb

elc`trdoaedf jejulgkblkdl

K`lstrbksb ierdt cdrb rudlg

suprdgf`ttbo cdl dtdu pbtd sudrd tbcdk

terfbadt cdl dtdu bltuidsb elc`trdoaedf

tbcdk jejulgkblkdl

]r`secur cbdgl`sbs fdbl

Sbcdk cb bltuidsbDldstesb f`kdf, lds`trdkedf

bltuidtb`l pdsbel sdcdr

_ecdsb celgdl jbcdz`fdj

dtdu pr`n`f

Dltbib`tbk ( dj`xbobfbl ofdvufdlbo dobc , gelerdsb ketbgd oendf`sp`rbl)

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9.44 K@J]FBKD_B CDL ]Y@GL@_B_

Jeskbpul epbgf`tbtbs dkut btu selcbrb jerupdkdl pelydkbt ydlg cdpdt jelgdlodj

 hbwd, blneksb fdbl cdpdt terhdcb seodrd iersdjddl. K`jpfbkdsb pdfblg serblg dcdfda

 pleuj`lbd. Blneksb k`lk`jbtdl celgdl  Adej`pabfus blnfuelzde ydlg fdbl terjdsuk

jelblgbtbs, dcelbtbs servbkdf, perbkdrcbtbs, cdl `tbtbs jecbd. _efdbl btu, cdpdt hugd

terhdcb dises epbgf`tbs cdl uvufbtbs.2,4=

K`jpfbkdsb l`l-blneksb hugd cdpdt terhdcb pdcd pdsbel celgdl epbgf`tbtbs. ]dsbel

celgdl `istruksb sdfurdl ldnds ydlg jelyefurua cdl respbrdt`ry drrest cdpdt

jelgdfdjb kerusdkdl abp`ksbk cdrb sbstej sdrdn pusdt cdl sbstej `rgdl ydlg fdbl.

Idakdl pdsbel ydlg tefda jelcdpdt tdtdfdksdld ydlg oukup cdpdt jelhdcb abp`ksbk.4=

 

J`rtdfbtds pdcd pdsbel dldk-dldk tefda jelurul cdrb 7,4% jelhdcb =,2% sehdk

cbguldkdllyd bltervelsb sdfurdl ldnds pr`nbfdksbs. J`rtdfbtds pdcd `rdlg cewdsd

sekbtdr 4 ‟  7%, ldjul hbkd terhdcb `istruksb, j`rtdfbtds jelhdcb 47,>%.

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IDI BBB

]ELUSU]

?.4 KE_BJ]UFDL

Epbgf`tbtbs dkut dcdfda sudtu kedcddl blnfdjdsb dkut ydlg terhdcb pdcd cderda

suprdgf`tbs cdrb `r`ndrblg, jefbputb epbgf`tbs, vdfekufd, drbtel`bc, cdl fbpdtdl

drbepbgf`tbkd, seablggd serblg hugd cbseiut celgdl suprdgf`tbtbs dtdu fdrblgbtbs

suprdgf`tbk. Kdsus epbgf`tbtbs dkut cbfdp`rkdl pertdjd kdfb `fea Saebsel pdcd tdaul

42== seidgdb ‖dlgbld-epbgf`ttbces‚. _ehdk btu, epbgf`tbtbs dkut tefda cbpuifbkdsbkdl

seodrd fuds cdfdj fbterdtur pecbdtrbk.

Epbgf`tbtbs dkut ibdsdlyd cbseidikdl `fea blneksb idkterb, ydlg pdfblg serblg

cbtejukdl dcdfda Adej`pabfus blnfuelzde tbpe i, ldjul cdpdt hugd cbseidikdl `fea

 idkterb fdbl, vbrus cdl hdjur. _efdbl btu hugd tercdpdt pelyeidi l`l-blneksb, sepertb

 pelyeidi terjdf, pelyeidi kdustbk, cdl ielcd dsblg ydlg tertefdl. Epbgf`tbtbs hugd

cdpdt terhdcb seidgdb redksb cdrb kej`terdpb pdcd cderda kepdfd cdl feaer.

Ibdsdlyd pdsbel cdtdlg celgdl kefuadl lyerb telgg`r`k, lyerb jelefdl cdl/ dtdu

sufbt jelefdl, cdl sufbt ierldnds. ]dcd dldk-dldk, gehdfd ydlg ldjpdk dkdl terfbadt

feiba ierdt.

Epbgf`tbtbs cdpdt jelhdcb ndtdf hbkd tercbdgl`sbs terfdjidt, kdreld cdpdt

jelyeidikdl `istruksb sdfurdl ldnds. Cbdgl`sbs ibdsdlyd cdpdt cbtegdkkdl cdrb

rbwdydt perhdfdldl pelydkbt cdl tejudl kfblbs, sertd pejerbksddl rdcb`grdnb hbkd

jejulgkblkdl.

]eldtdfdksdlddl pdcd pdsbel celgdl epbgf`tbtbs cbdrdakdl kepdcd jelgurdlgb

`istruksb sdfurdl ldnds cdl jelhdgdlyd dgdr tetdp teriukd, sertd jelgerdcbkdsb dgel

 pelyeidi. Cdpdt cbfdkukdl bltuidsb hbkd tefda terhdcb `istruksb, celgdl ekstuidsb

setefda 31 ‟  79 hdj, sertd pejierbdl dltbib`tbk ydlg dcekudt.

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CDNSDY ]U_SDKD

4.  G`jpn, _.G. Epbgf`tbtbs 9=44. Sersecbd cb8

attp//ejecboble.jecsodpe.o`j.drtbofe/7>?>49 (cbdkses 9 dgustus 9=49)

9.  Oaulg, O.A. Odse dlc Fbterdture Yevbew8 Dcuft Doute Epbgf`ttbtbs ‟  Ybsblg

Blobceloe `r Bloredsblg Dwdreless. A`lg K`lg H Ejerg Jec .. Sersecbd cb 8

attp8//www.akoej.o`j/atjf/puifbodtb`ls/H`urldf/9==4-?/997-9?4.pcn

[cbdkses 9 dgustus 9=49Z.

?.  _l`w, H.I., Idffelger, H.H.  Idffelger‒s @t`rabl`fdrylg`f`gy Aedc dlc Leok

_urgery. 4>ta Ec. U_D8 IO Ceoker; 9==?.

3.  S`fdl, Y.W. ]ecbdtrbo Epbgf`ttbtbs. 9=44.

Sersecbd cb8 attp8// attp8//ejecboble.jecsodpe.o`j/drtbofe/2>?77? [cbdkses ?dgustus 9=49Z.

5.  Fee, K.H. Odloer `n tae Fdrylx. Bl;  Esseltbdf @t`fdrylg`f`gy Aedc dlc Leok_urgery . Ebgat ecbtb`l. O`lleotbout. JoGrdw-Abff, 9==?

>.  Fee K.H,JC,NDO_ , Esseltbdf @t`fdrylg`f`gy ,Ecbsb 41, JoGrdw ‟ Abff 9==?

7.  Cablgrd, ].F. Doute dlc Oar`lbo Blnfdjjdtb`l `n Fdrylx. Bl8 Cablgrd, ].F.

 Cbsedses `n Edr, L`se dlc Sar`dt. 3ta Ec. U_D8 Efsevber; 9==7

1.  Oaulg, O.A. Doute Epbgf`ttbtbs ]reseltblg ds tae _elsdtb`l `n d N`rebgl I`cy

bl tae Sar`dt.  A`lg K`lg Jec H. _eptejier 9===.

Sersecbd cb8 attp8//www.akjh.`rg/drtbofePpcns/akj===2p?99.pcn [cbdkses 3dgustus 9=49Z.

2.  Wbok, N., Idffjer, ].E., Adffer, D. Doute Epbgf`ttbtbs bl Dcufts. _wbss Jec

Wkfy. 9==9; 4?98 534-53>.Sersecbd cb8 attp8//www.sjw.oa/c`os/pcn9==x/9==9/?7/sjw-4==5=.]CN

[cbdkses 3 dgustus 9=49Z.

4=. Oujjblgs, O.W. et df. Oujjblgs @t`fdrylg`f`gy - Aedc & Leok _urgery.5ta Ec. U_D8 Efsevber; 9=4=8 91=>-2.