1.1.8 Guía de Taller N°3 " Oxigenoterapia y Nebulización"

 

N[ÈM IK YMJJK_ A³ 0 ‚FWBNKAFYK_MSBM R AKO[JBUM@BÐA‘

MPBNAMY[_M5 @ubimifs ik kadkrhkrèm hkib`f-qubrõrnb`f

IB_BNBIF M5 Kstuibmatks ik jm `mrrkrm tâ`ab`f ik kadkrhkrèm

_K][BPBYFP5 Pba rkqubsbtfs

 

BAY_FI[@@BÐA Jms kadkrhkimiks rkspbrmtfrbms sfa huy drk`ukatks ka jm pfojm`bða badmatbj y miujtfs hmyfrks pfr jf quk `faf`kr jms tkrmpbms quk rkqubkrka iurmatk kstfs prf`ksfs ks ik suhm bhpfrtma`bm ikobif m quk kstms kadkrhkimiks rkspbrmtfrbms pukika `musmr uam mjtkrm`bða ka jm `mptm`bða ik fxbnkaf y ka jm fxbnkam`bða ik jfs ibstbatfs tkebifs ikj frnmabshf. Kj fxbnkaf ks uam nms ba`fjfrf, bafifrf, basèpbif y pf`f sfjuojk ka mnum. @fastbtuyk kj ?=% ikj mbrk quk baspbrmhfs ka jm mthðsdkrm. Jm fxbnkaftkrmpbm ks jm mihbabstrm`bða ik fxbnkaf `fa dbaks tkrmpâutb`fs, ka `fa`katrm`bfaks hms kjkvmims quk jm kxbstkatk ka jm hkz`jm ik nmsks ikj mhobkatk. Kj fxbnkaf ikok `fasbikrmrsk ua dírhm`f pfrquk5 Sfskk baib`m`bfaks prk`bsms Ikok skr utbjbzmif ka ifsbs y tbkhpf mik`umifs Sfskk kdk`tfs mivkrsfs _kqubkrk `rbtkrbfs `jèab`fs y ik jmofrmtfrbf pmrm su kvmjum`bða.    

Iurmatk kstm nuèm vkrkhfs jfs ibstbatfs sbstkhms pmrm jm mihbabstrm`bða mihbabstrm`bða ik fxbnkaftkrmpbm fxbnkaftkrmpbm y jm mihbabstrm`bða ik akoujbzm`bfaks.

@fhpktka`bms Msf`bmims m jm Msbnamturm Srfpfr`bfamr `ubimifs ik kadkrhkrèm kspk`èdb`fs, ka pm`bkatks `fa pmtfjfnèms `fhpjkems, ik m`ukrif m jms ibvkrsms kspk`bmjbimiks hâib`ms, sknõa afrhmtbvms bastbtu`bfamjks 

[abimiks ik @fhpktka`bms Msf`bmims m jm Msbnamturm - Kek`utmr `ubimifs ik kadkrhkrèm kspk`èdb`fs msf`bmifs m pmtfjfnèms hkib`f qubrõrnb`ms ik m`ukrif m -

baib`m`bfaks ikj prfdksbfamj. Kek`utmr `ubimifs ik kadkrhkrèm msf`bmifs m pmtfjfnèms. _k`faf`kr _k`faf` kr jms m`tbvbim m`tbvbimiks iks rkjm`bfa rkjm`bfamim mims s `fa jfs `ubimif `ubimifs s ik kadkrhk kadkrhkrèm rèm msf`bmif msf`bmifs s m pmtfjfn pmtfjfnèms èms hâib`f qubrõrnb`ms, sknõa ak`ksbimiks ikj pm`bkatk.

 

HM_@F IK _KDK_KA@BM YKÐ_B@F =. FWBNKAFYK_MSBM Pk khpjkm kj târhbaf fxbnkaftkrmpbm rkdbrbâaifsk m jm utbjbzm`bða tkrmpâutb`m ikj fxènkaf, duaimhkatmjhkatk ka pmtfjfnèm rkspbrmtfrbm (kadkrhkimi kadbskhm, kt`.) yprf`ksfs tmhobâa `fhf trmtmhbkatf `fmiyuvmatk ka ftrfspujhfamr prf`ksfsfostru`tbvm pmtfjðnb`fs`rðab`m (sgf`l,-KSF@-, makhbm,mshm, basudb`bka`bm `mribm`m, akurfiknkakrmtbvfs, kt`.), pkrf af sk ikok fjvbimr su usf af hâib`f, pfr kekhpjf, ka m`tbvbimiks ikpfrtbvms ik mjturm f suom`uítb`ms.  Kj fxènkaf pmrm usf hkib`bamj ikok prks`rbobrsk duaimhk duaimhkatmif atmif ka uam rmzða víjbim y mihbabstrmrsk mihbabstrmrsk ka dfrhm `frrk`tm y sknurm. Jm gbpfxkhbm (gbpfxbm-gbpðxb`m) sk ikdbak `fhf jm ibshbau`bða ik jm prksbða mrtkrbmj ik fxènkaf (SmF?: 43 hhGn) y ik jm smturm`bða ik jm Gkhfnjfobam ka smanrk mrtkrbmj (: 20%). Jm gbpfxbm sk ikdbak `fhf jm ibshbau`bða ik jm ibspfabobjbimi ik fxènkaf ka jfs tkebifs. Sukik kxbstbr gbpfxbm sba quk ak`ksmrbmhkatk kxbstm gbpfxkhbm. Kj prba`bpmj foektbvf ks `frrknbr jm gbpfxkhbm (Tkr Ymojm =), ks ik`br, muhkatmr jm prksbða pmr`bmj ikj F? (SmF?) m hís ik 43 hhGn, hkibmatk kj mpfrtk ik uam `fa`katrm`bða supjkhkatmrbm ka jm drm``bða baspbrmim, y ik kstm dfrhm smturmr sudb`bkatkhkatk jm gkhfnjfobam. Ks prk`bsf rk`frimr quk kj fxènkaf ks ua dírhm`f y, `fhf tmj, ikok skry`fasbikrmif ka su baib`m`bða, ifsbdb`m`bða y mpjb`m`bða, skm `umj skm kj ibspfsbtbvf, sus kdk`tfs sk`uaimrbfs sus `ubimifs.

 

Hmtkrbmj m [tbjbzmr5   

Dukatk ik fxènkaf5 ik pmrki, omjm, Ymaquk jèqubif f `fa`katrmifr (dbnurm =). Hkibifr ik djuef ik fxènkaf (dbnurm ?).

 

Guhbibdb`mifr Guhbibdb`mi fr (dbnurm 0) Hmafrrkiu`tfr. Yuoujmiurms f sbstkhms ik `fakxbða. Pbstkhm ik mpjb`m`bða baib`mif5 hms`mrbjjm, `íaujm amsmj f akoujbzmifr (dbnurm 9).

Pbstkhms ik fxbnkaftkrmpbm Ibspfsbtbvfs ik omef djuef5 Pfa ibspfsbtbvfs ka jfs `umjks kj pm`bkatk rkspbrm mbrk mhobkatmj y m trmvâs ik jfs quk rk`bok fxènkaf supjkhkatmrbf< af ks pfsbojk iktkrhbamr `fa rbnfr jm DbF? quk miqubkrk kj pm`bkatk, mj ikpkaikr âstm ik vmrbfs dm`tfrks `fhf sfa5  Kj vfjuhka `frrbkatk (T@) ikj pm`bkatk.  Jm drk`uka`bm rkspbrmtfrbm. Kj djuef ik fxènkaf.

Ybpfs5 Jfs ibspfsbtbvfs pmrm jm mihbabstrm`bða ik fxènkaf ik omef djuef hís utbjbzmifs sfa5  @íaujm f nmdm amsmj.  Hms`mrbjjm sbhpjk. Hms`mrbjjm `fa rkskrvfrbf.

@íaujm @íau jm f nmdm amsmj amsmj55 @fasbstk ka uam Yuoujmiurms ik pjístb`f djkxbojk, `fa `mpm`bimi ik mimptm`bða m jms dfsms amsmjks ikj pm`bkatk ka su pmrtk prfxbhmj< sk suektm m jfs pmokjjfaks muibtbvfs ka su pmrtk hkibmj y sk uak m jm dukatk ik fxènkaf ka su pmrtk ibstmj (Tkr Bhmnka =). Pk ikok jbhbtmr kj djuef m trmvâs ikj sbstkhm m

 

hkafs ik ; J/hba, ym quk djuefs hmyfrks rksk`ma jm hu`fsm amsmj, prfvf`ma brrbtm`bfaks y af `fasbnuka muhkatmr jm dbF?.

@mrm`tkrèstb`ms5   

Skrhbtk djuefs ik = m 4 jbtrfs pfr hbautf (jph). Skrhbtk mihbabstrmr uam DbF? iksik kj ??% gmstm kj 93%. Jms `fa`katrm`bfaks ik fxènkaf mihbabstrmif pfr `íaujm sk hukstrma ka jm Ymojm =.

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Tkatmems y jbhbtm`bfaks ikj usf ik `íaujm amsmj5

Hms`mrbjjm sbhpjk5 Jm hms`mrbjjm sbhpjk ks ua ibspfsbtbvf trmaspmrkatk y djkxbojk, quk `uork tfim jm of`m y jm amrbz ikj pm`bkatk, `fa ifs frbdb`bfs jmtkrmjks pmrm jm kxgmjm`bða ikj @F? y jm katrmim ik mbrk mhobkatmj.

 

@mrm`tkrèstb`ms  Skrhbtk fotkakr `fa`katrm`bfaks hmyfrks (gmstm ik ua ;3%-43%) hmatkabkaif ua djuef omef (4-=3 jph) (Tkr Ymojm 0).

 

Srkskatm sbstkhms Srkskatm sbstkhms ik meustk meustk (nfhm (nfhm pfstkrb pfstkrbfr fr y hktmj hktmj hmjkmoj hmjkmojk k amsmj) amsmj) pmrm nmrmatbzm nmrmatbzmrr uam hmyfr  kdk`tbvbimi ka jm mihbabstrm`bða ik F?.

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Tkatmems y jbhbtm`bfaks ik jm hms`mrbjjm sbhpjk (Tkr tmojm 9)

 

Hms`mrbjjm `fa rkskrvfrbf5 @fasbstk ka uam hms`mrbjjm ik bnumjks `mrm`tkrèstb`ms `mrm`tkrèstb`ms quk jm hms`mrbjjm sbhpjk m jm quk sk jk mýmik uam ofjsm rkskrvfrbf `fa `mpm`bimi híxbhm ik >;3 hj, msè `fhf uam `fakxbða m jm dukatk ik fxènkaf y uam víjvujm uabibrk``bfamj ka kj skatbif ik jm baspbrm`bða ikj pm`bkatk.

@mrm`tkrèstb`ms5  Skrhbtk prfpfr`bfamr uam `fa`katrm`bða ik fxènkaf hmyfr quk jm ik jfs ifs ibspfsbtbvfs matkrbfrks (`íaujm amsmj y hms`mrbjjm sbhpjk), pkrf hmatkabkaif jm vkatmem ik omefs djuefs.  Kxbstka ifs tbpfs ik hms`mrbjjms `fa sus rkspk`tbvms tmsms ik djuef y `fa`katrm`bða (Tkr tmojm ;)5

HÍP@M_M @FA BAGMJM@BÐA SM_@BMJ5  Ks uam hís`mrm sbhpjk `fa uam ofjsm f rkskrvfrbf ka su kxtrkhf badkrbfr< kj djuef ik fxènkaf ikok skr sbkhprk sudb`bkatk pmrm hmatkakr jm ofjsm badjmim. M ua djuef ik 7 m =? jbtrfs pfr hbautf pukik mpfrtmr uam DbF? ik 3,9-3,> (93%->3%).

 

HÍP@M HÍP @M_M _M IK PBA BAG BAGMJ MJM@B M@BÐA ÐA SM_ SM_@BM @BMJ J5 Kstms Kstms hís`m hís`mrms rms ik fxènk fxènkaf af sf sfa a sbhbjm sbhbjmrks rks m jms hís`mrms `fa bagmjm`bða pmr`bmj, kx`kptf, kx`kptf, pfr jm prkska`bm ik uam víjvujm uabibrk``bfamj katrk jm ofjsm y jm hís`mrm quk kvbtm quk kj mbrk kspbrmif rktfrak m jm ofjsm. Jms hís`mrms sba bagmjm`bða ikoka tkakr  ua djuef hèabhf ik =3 jbtrfs pfr hbautf (J) y mpfrtma uam DbF? ik 3,4-3,7 (43%-73%).

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Tkatmems y jbhbtm`bfaks (Tkr tmojm 4)5

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@ubimifs kspk`èdb`fs5  Matks ik bastmjmrsk sk ikok `fak`tmr mj mj F? Pk utbjbzm sba guhbibdb`mifr (kj mnum rktbkak @F?) Af sk rk`fhbkaim usmr pfr hís ik ?9 grs Af sk rk`fhbkaim ka pm`bkatks rktkakifrks ik @F?(KSF@) 

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@ubimifs ik kadkrhkrèm5 - Kxpjb`mr kj prf`kibhbkatf mj pm`bkatk y su dmhbjbm - Tm Tmjf jfrmr rmr jm ba baib` ib`m` m`bða bða ik kst kstk k ibspf ibspfsbt sbtbvf bvf55 pmtrð pmtrða a rkspbr rkspbrmtf mtfrbf rbf,, vf vfjuh juhka ka `f `frrb rrbka katk tk y drk`uk drk`uka` a`bm bm rkspbrmtfrbm.

 

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Srkpmrmr tfif kj hmtkrbmj5 @íaujm ik tmhmýf mik`umif, Dukatk ik fxènkaf, Guhbibdb`mifr `fa mnum kstârbj, Lbt ik mskf amsmj. _kvbsmr jm mamtfhèm amsmj ikj pm`bkatk5 iksvbm`bða ikj tmobquk, fostru``bða amsmj f pðjbpfs. _kmjbzmr mskf amsmj prkvbf mj prf`kibhbkatf [ob`mr mj pm`bkatk ka pfsb`bða dfwjkr f skhbdfwjkr   Morbr kj fxènkaf mj djuef prks`rbtf y msknurmrsk msknurmrsk ikj `frrk`tf dua`bfamhbkatf dua`bfamhbkatf ikj sbstkhm5 af gmy dunms ka jms `fakxbfaks, af gmy sfabifs (pbtbifs) kxtrmýfs, kj mnum ikj guhbibdb`mifr ourouekm y ka kj kxtrkhf prfxbhmj gmy djuef Ka kj `msf ik jm hms`mrbjjm `fa rkskrvfrbf ikok msknurmrsk quk5   Momr`m `frrk`tmhka `frrk`tmhkatk tk jm of`m y jm amrbz ikj pm`bkatk. pm`bkatk.  Pk gm meustmif jm nfhm ik suek`bða pfstkrbfr, pkrf sba `fhprbhbr kx`ksbvmhkatk.  Pk gm mprktmif kj hktmj supkrbfr m jm amrbz, pmrm kvbtmr kj ks`mpk ik fxènkaf gm`bm jfs fefs.  Jm ofjsm rkskrvfrbf sk ka`ukatrm tftmjhkatk basudjmim  @fak`tmr kj ibstmj m jm dukatk ik fxènkaf   Srftknkr jms zfams ik jm hms`mrbjjm quk hfjkstma mj pm`bkatk `fa nmsms [am vkz bab`bmim jm fxbnkaftkrmpbm, kxpjb`mr mj pm`bkatk jfs kdk`tfs quk pukik aftmr (skqukimi amsmj y fprksbða ikj ibspfsbtbvf) y jfs sèatfhms sfork jfs quk ikok badfrhmr mj pkrsfamj smabtmrbf (hmrkf, sfhafjka`bm f baqubktui). @fadbrhmr jm mik`umim vkatbjm`bða ikj pm`bkatk. @fadbrhmr jm mik`umim fxbnkam`bða5 smturm`bða ik fxènkaf (PmtF?) y nmsfhktrèm sb prf`kik.   Tbnbjmr Tbnbjmr jm mpmrb`bð mpmrb`bða a ik sbnafs sbnafs y sèatfhms sèatfhms rkjm`bfam rkjm`bfamifs ifs `fa mjtkrm`bða mjtkrm`bða ka jm fxbnkam fxbnkam`bða `bða55 ibsakm, ibsakm, tmqubpakm, tmqub`mribm, `kdmjkm, `bmafsbs, usf ik hõs`ujfs m``ksfrbfs ka jm rkspbrm`bða, mnbtm`bða y `fadusbða Tbnbjmr jm mpmrb`bða ik mjtkrm`bfaks ka hu`fsms y pbkj. _kvbsmr pkrbðib`mhkatk jm `frrk`tm `fjf`m`bða ik jm `íaujm y ikj rkstf ik jms Yuoujmiurms (af gmy m`fimhbkatfs, af sk gm hfibdb`mif kj djuef pmutmif, kt`.).  @mhobmr pkrbðib`mhkatk kj ibspfsbtbvf pfr uaf aukvf. (Pknõa afrhmtbvm ikj skrvb`bf) _knbstrmr puatumjhkatk tfifs jfs `ubimifs y prf`kibhbkatfs, kspk`bmjhkatk jfs rkjm`bfamifs `fa jfs `mhobfs ik djuef ik fxènkaf, jms mjtkrm`bfaks nmsfhâtrb`ms f jfs sbnafs y sèatfhms kxpkrbhkatmifs pfr kj pm`bkatk.

Ibspfsbtbvfs ik mjtf djuef5 Pfa mqukjjfs sbstkhms quk pkrhbtka mihbabstrmr ua djuef ik nms ak`ksmrbf, ks ik`br, mpfrtma fxènkaf `fa èaib`ks supkrbfrks supkrbfrks m jm drm``bða ik djuef kspbrmtfrbf afrhmj afrhmj y ka jfs quk jms vmrbm`bfaks ik jm DbF? af `mhobma `fa kj pmtrða rkspbrmtfrbf ikj pm`bkatk. Pfa mqukjjfs sbstkhms quk pkrhbtka mihbabstrmr ua djuef ik nms ak`ksmrbf, ks ik`br, mpfrtma fxènkaf `fa èaib`ks supkrbfrks supkrbfrks m jm drm``bða ik djuef kspbrmtfrbf afrhmj afrhmj y ka jfs quk jms vmrbm`bfaks ik jm DbF? af `mhobma `fa kj pmtrða rkspbrmtfrbf ikj pm`bkatk.

Hms`mrbjjm Tkaturb5 Ybkak jms hbshms `mrm`tkrèstb`ms quk jm hms`mrbjjm sbhpjk, pkrf `fa jm ibdkrka`bm ik quk ka su pmrtk badkrbfr  pfskk ua ibspfsbtbvf quk pkrhbtk rknujmr jm `fa`katrm`bða ik fxènkaf quk sk kstí mihbabstrmaif, ik tmj hmakrm hma krm quk pkrhbtk pkrhbtk suhbabst suhbabstrmr rmr uam `fa `fa`kat `katrm`b rm`bða ða kxm kxm`tm `tm ik fxènkaf fxènkaf baikpka baikpkaibka ibkatkhk tkhkatk atk ikj pmtrða pmtrða

 

rkspbrmtfrbf ikj pm`bkatk. Imif quk mpfrtma uam `fa`katrm`bða ik fxènkaf `fastmatk ka kj mbrk baspbrmif, jms hms`mrbjj hms` mrbjjms ms Tkaturb Tkaturb sfa mik`umims mik`umims ka jfs pm`bkatk pm`bkatks s `fa gbpkr`mpabm gbpkr`mpabm `rðab`m y `fa gbpfxkhbm gbpfxkhbm ik nrmif nrmif hfikrmif m batkasf, tmj `fhf f`urrk `fa jfs quk prkskatma kadkrhkimi pujhfamr fostru`tbvm `rðab`m.

Ftrfs sbstkhms5 Srksbða `fatbaum ka jm vèm mârkm (OSMS f @SMS)5 Ka sbtum`bfaks ik gbpfxkhbm ks utbjbzmif ka pm`bkatks `fas`bkatks y `fjmofrmifrks, sk utbjbzm ka skrvb`bfs ik `ubimifs batkrhkibfs f batkasbvfs. Pk mpjb`m uam hms`mrbjjm meustmim gkrhâtb`mhkatk y kqubpmim `fa víjvujms rknujmifrms ik prksbða.

S_K@M[@BFAKP R SFPBOJKP @FHSJB@M@BF @FHSJB@M@BFAKP AKP Kj fxènkaf, `fhf `umjqubkr hkib`mhkatf, ikok skr mihbabstrmif ka jm ifsbs y pfr kj tbkhpf rkqukrbif, `fa omsk ka jm `faib`bða `jèab`m ikj pm`bkatk y, ka jf pfsbojk, duaimhkatmif ka jm hkib`bða ik jfs nmsks mrtkrbmjks. Jm tfxb`bimi pfr fxènkaf sk foskrvm ka baibvbiufs quk rk`boka fxènkaf ka mjtms `fa`katrm`bfaks (hmyfrks ikj 43% pfr hís ik ?9 gfrms. Pk ikoka tkakr ka `ukatm jms sbnubkatks prk`mu`bfaks5

 

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Yfxb`bimi pfr fxbnkaf5  @fhf rksujtmif rksujtmif ikj prf`ksf prf`ksf ik hktmof hktmofjbshf jbshf ikj fxbnkaf fxbnkaf sk prfiu`k prfiu`ka a

rmib`mjk rmib `mjks s jborks jborks `fa nrma `mpm`bimi `mpm`bimi ik rkm``bfa rkm``bfamr mr quèhb`m quèhb`mhka hkatk tk `fa kj tkebif tkebif pujhfam pujhfamr. r. Kstfs Kstfs rmib`mjks jborks sfa tðxb`fs pmrm jms `âjujms ikj írofj trfqukmorfaqubmj, msè `fhf tmhobâa kj mjvkfjf pujhfamr.  _k _ktk tka` a`bð bða a ik @F? @F?55 Ka pm`bk pm`bkatk atks s `f `fa a pmtfj pmtfjfn fnèms èms `rðab` `rðab`ms ms `f `fhf hf kj KSF@ KSF@ kxbstk kxbstk jk rbk rbksn snf f ik gbpkr`mpabm gbpkr`mp abm (rktka`bða ik @F?) sb sk mihbabstrm fxbnkaf fxbnkaf ka ifsbs mjtms puibkaif iksmrrfjjmr ikprksbða rkspbrmtfrbm.  Pkqu Pkqukimi kimi ik hu`fsms k brrb brrbtm`bð tm`bða5 a5 Pk kvbtm hkibmatk jm guhbibdb`m`bða ikj fxbnkaf matks ik su jjknmim m jms vèms rkspbrmtfrbms.

?. AKO[JBUM@BÐA @fasbstk ka Yrmasdfrhm`bða ik uam sfju`bða jèqubim ka ua mkrfsfj ik dbams pmrtè`ujms (; y 3,; hb`rms) quk skría bagmjmims y ikpfsbtmims sfork kj trm`tf rkspbrmtfrbf. Pk utbjbzm pmrm mihbabstrmr dírhm`fs `fhf orfa`fibjmtmifrks f hu`fjètb`fs, tmhobâa sk pukik usmr sfjf `fa sukrf dbsbfjðnb`f pmrm myuimr m djubibdb`mr sk`rk`bfaks.

Baib`m`bfaks5      

Ka kj trmtmhbkatf ik prf`ksfs rkspbrmtfrbfs, kspk`bmjhkatk ka jms mnuibzm`bfaks5 KSF@.  Mshm. Orfaqubfjbtbs. Kadbskhm. @rup jmrèankf. Orfa`fkspmshfs ik ibvkrsm ktbfjfnèm

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Pbtum`bfaks ka jms quk sk prk`bsk uam hmyfr guhbibdb`m`bða ik jm vèm rkspbrmtfrbm.

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Srf`ksfs ka jfs quk sk ak`ksbtk ua muhkatf ik jm kxpk`tfrm`bða

Hmtkrbmjks ak`ksmrbfs5     

_ki ik mbrk u fxbnkaf Djueðhktrf  Mimptmifr  Mimptm ifr pmrm suhbabstrf suhbabstrf (Abpjk) (Abpjk) Fxèhktrf ik pujsf f smturðhktrf Pkt pmrm akoujbzm`bða5 hms`mrm dm`bmj pmrm akoujbzm`bða, `íhmrm ik akoujbzmifr y `fak`tfr.

 

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Pukrf dbsbfjðnb`f mj 3.2% Ekrbanm ;`` Dírhm`f m mihbabstrmr pmrm jm akoujbzm`bða (Pknõa baib`m`bða hâib`m) Kjkhkatfs ik prftk``bða pkrsfamj

@fasbikrm`bfaks5 

Kj djuef ik mbrk u fxènkaf gm ik pfikr mj`mazmr ik 4 m =3 jbtrfs pfr hbautf.  Jm drm``bða rkspbrmojk skrí hmyfr quk kj ;3% ik jm drm``bða tftmj prfiu`bim.  Kj tbkhpf ik akoujbzm`bða af tbkak quk supkrmr jfs =3 hbautfs.  Kj rksbiuf jèqubif ka kj rkskrvfrbf, mj dbamjbzmr jm akoujbzm`bða, af tbkak quk supkrmr = hj.

Iks`rbp`bða ikj prf`kibhbkatf prf`kibhbkatf55 =. @frrfofrmr baib`m`bða hkib`m ?. Tmjfrmr pmtrða rkspbrmtfrbf ikj pm`bkatk, drk`uka`bm rkspbrmtfrbm y smturm`bða ik fxbnkaf. 0. Srkpmrmr tfif kj hmtkrbmj5  Hms`mrbjjm ik tmhmýf mik`umif.  Dukatk ik fxènkaf f mbrk m prksbða.  @íhmrm rkskrvfrbf  Pukrf dbsbfjðnb`f 3.2%  Ekrbanm ik ; hj.  Hkib`m`bða sknõa prks`rbp`bða. 9. Pb kj pm`bkatk kstí `fas`bkatk, kxpjb`mrjk kj prf`kibhbkatf, rkspfaikr m tfims sus iuims y sfjb`btmr su `fjmofrm `fjm ofrm`bða `bða kspk`bmjhka kspk`bmjhkatk tk ka jm af hmabpuj hmabpujm`bð m`bða a ikj ibspfsbtbvf ibspfsbtbvf,, ka jm sknurbim sknurbimi i ikj katfraf y ka jm bhpfrtma`bm ik jm pmutm prks`rbtm ;. Ka `msf ik mjtkrm`bða ikj abvkj ik `fas`bka`bm, `fhkatmrjk kj prf`kibhbkatf y jms hkibims ik sknurbimi mj m`fhpmýmatk. 4. @fjf`mr mj pm`bkatk skatmif f ka pfsb`bða ik Dfwjkr 9;³. >. Jmvmrsk jms hmafs. 7. _kvbsmr jm mamtfhèm ou`mj y amsmj ikj pm`bkatk5 fostru``bfaks pfr m`õhujf ik sk`rk`bfaks, iksvbm`bða ikj tmobquk, fostru``bða amsmj, pðjbpfs, kt`. 2. Mpjb`mr jm `matbimi ik dírhm`f pmrm bagmjm`bða hís jm `matbimi ik sukrf dbsbfjðnb`f pmutmim ka jm `íhmrm rkskrvfrbf (vfjuhka tftmj 9 hj).

 

=3. @fjf`mr jm hms`mrbjjm dm`bmj mj pm`bkatk `fa prk`mu`bða ik af ikrrmhmr kj jèqubif ikj rkskrvfrbf, tkabkaif ka `ukatm5   Momr`mr `frrk`tmhka `frrk`tmhkatk tk jm of`m y jm amrbz ikj pm`bkatk. pm`bkatk.   Meustmr jm nfhm ik suek`bða pfstkrbfr, pfstkrbfr, pkrf pkrf sba `fhprbhbr `fhprbhbr kx`ksbvmhkatk. kx`ksbvmhkatk.   Mprktmr kj kj hktmj supkrbfr supkrbfr m jm amrbz amrbz pmrm kvbtmr kvbtmr kj ks`mpk ks`mpk ik dírhm`f gm`bm gm`bm jfs fefs. fefs. ==. @fak`tmr jm Yuoujmiurms m jm dukatk ik fxènkaf f rki ik mbrk y morbr kj djuef m =3 jph. =?. @fhprfomr jm smjbim ik vmpfr pfr jfs frbdb`bfs jmtkrmjks ik jm hms`mrbjjm dm`bmj. (Auok ik mbrk) =0. Pb gmy smjbim ik vmpfr, omemr kj djuef ik fxènkaf 4 m 7 jph y `fadbrhmr jm smjbim ik vmpfr. =9. Iurmatk jm mihbabstrm`bða ik dírhm`fs akoujbzmifs5  Foskrvmr jm mpmrb`bða ik mjkrnbms dmrhm`fjðnb`ms.  Kstmr mtkatf m jm mpmrb`bða ik kdk`tfs sk`uaimrbfs y m jm tfjkrma`bm ikj pm`bkatk.  Srkstmr mtka`bða m jm mpmrb`bða ik brrbtm`bfaks f`ujmrks, `utíakms, kt`. =;. Tbnbjmr jm mpmrb`bða ik mjtkrm`bfaks ka hu`fsms y pbkj. =4. _kvbsmr pkrbðib`mhkatk jm `frrk`tm pfsb`bða ikj pm`bkatk y kj `frrk`tf dua`bfamhbkatf ikj ibspfsbtbvf (af gmy m`fimhbkatfs, af sk gm hfibdb`mif kj djuef pmutmif y af sk gma fostrubif jms vkatmams jmtkrmjks ikj `faf rknujmifr ik DbF?, kt`.). =>. [am vkz tkrhbamim jm akoujbzm`bða, jmvmr y sk`mr kj ibspfsbtbvf pmrm jm prðxbhm sksbða. =7. Kstbhujmr mj pm`bkatk m jm rkmjbzm`bða ik rkspbrm`bfaks prfduaims y tfs prfiu`tbvm. =2. _knbstrmr puatumjhkatk tfifs jfs `ubimifs y prf`kibhbkatfs, kspk`bmjhkatk jfs rkjm`bfamifs `fa jfs `mhobfs ik djuef ik fxènkaf, jms mjtkrm`bfaks nmsfhâtrb`ms f jfs sbnafs y sèatfhms kxpkrbhkatmifs pfr kj pm`bkatk, ifsbs, gfrm, kt`.

Obojbfnrmdèm - 

- 

Dkraíaikz, Dkraíai kz, _., Dkra Dkraíai íaikz, kz, I. (?33>). (?33>). M`tumjbz M`tumjbzm`bð m`bða a ka fxbnkaf fxbnkaftkrm tkrmpbm pbm pmrm kadkrhkr kadkrhkrèm. èm. Hmirbi, Hmirbi, Kspmým. Kibtfrbmj Ibdusbða mvma`ks ik kadkrhkrèm Sârkz, K., Dkraíaikz, M., (?3=0). Muxbjbmr ik kadkrhkrèm. Hmirbi, Kspmým. H`Nrmw-Gbjj 

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Fxbnkaf Fxbnk aftkr tkrmp mpbm( bm(s.d s.d.). .)._k _k`up `upkrm krmif if ik gttps5//if`pjmykr.ks/0?7=?39-Sfatbdb`bm-uabvkrsbimi-`mtfjb`m-ik`gbjk-ks`ukjm-ik-kadkrhkrbm-fxbnkaftkrmpbm.gthj 

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Kadkrhkrèm `jèab`m B5 Fxbnkaftkrmpbm (s.d.) gttps5//f`w.uab`ma.ks/pjunbadbjk.pgp/70>/`fursk/sk`tbfa/23?/Mpuatks%?;?3ik %?;?3Fxbnkaftkrmpbm.pid 

- 

_k`upkrmif

ik

Ptb`g, E. @msbjjm, I. (?3=3). Ibspfsbtbvfs pmrm jm mihbabstrm`bða mihbabstrm`bða ik fxènkaf. fxènkaf. \mr`gbvf SIDX. _k`upkrmif _k`upkrmif ik gttps5//www.kjskvbkr.ks/ 

Ymjjkr A³ 0

 

Afhork ikj Ymjjkr  _kqubsbtfs pmrm Ymjjkr  Ybkhpf A³ kstuibmatks Kstm`bða Ks`kamrbff Ks`kamrbf =5 @faf`kr fxbnkaftkrmpbm

Fxbnkaftkrmpbm y akoujbzm`bða Ikoka trmkr jm nuèm ik tmjjkr kstuibmim Srkskatm`bða pkrsfamj ik m`ukrif m afrhmtbvm ik @P@ ? hðiujfs =3-=?

ibspfsbtbvfs

Ks`kamrbf =5 ik M`tbvbimi

Ka kstk ks`kamrbf ikoka kstmr ibspukstfs tfifs jfs sbstkhms ik fxbnkaftkrmpbm fxbnkaftkrmpbm ik mjtf y omef djuef, y jfs kjkhkatfs ak`ksmrbfs pmrm su bastmjm`bða.

Ka kstk ks`kamrbf jfs kstuibmatks ikoka `faf`kr y dmhb dmhbjb jbmr mrbz bzmr mrsk sk `f `fa a jf jfs s ibst ibstba batf tfs s sbst sbstkh khms ms ik fxbnkaf fxbn kaftkrm tkrmpbm pbm,, `fhf `fhf sk mrhma mrhma y jfs kjkhkat kjkhkatfs fs quk sk rkqubkrka pmrm su bastmjm`bða.

Ks`kam Ks`k amrb rbf f ?5 _k _kmj mjbz bzmr mr jm mi mihb hbab abst strm rm`b `bða ða ik Ks`kamrbf ?5 Pk ibvbibrí kj tmjjkr ka ? nrupfs y m `mim uaf sk jk fxbnkaftkrmpbm. Ka kstk kstk ks`ka ks`kamrb mrbf f sk ikok ikok tkak tkakrr ? pm`bk pm`bkat atks ks ka uabi uabimi mi ik gfsp gfspbtm btmjbz jbzm`b m`bða ða,, puki pukika ka sk skrr miuj miujtfs tfs f pk pkib ibít ítrb rb`f `fs s m jf jfs s qu quk k sk jks jks pu puki kim m rkmj rkmjbz bzmr mr jm bastmjm`bða ik fxbnkaftkrmpbm. Ikok `fatmr `fa gfem ik rknbstrf ik kadkrhkrèm.

Ks`kamrbf 05 _kmjbzmr jm prkpmrm`bða mihbabstrm`bða ik akoujbzm`bða.

Ks`kamrbf 05 Pk jk sfjb sfjb`b `btm tmrí rí m ua kstu kstuib ibma matk tk qu quk k rk rkmj mjb` b`k k jm

prkpmr mrm` m`bð bða a ik ua uam m ak akou oujb jbzm zm`b `bða ða y ju jukn knf f jm y prkp

Ka kstk ks`kamrbf ikok gmokr uam pm`bkatk ka uam uabi uabimi mi ik gfspb gfspbtm tmjbz jbzm`b m`bða ða mj quk quk sk jk rkmjb` rkmjb`k k jm mihbabs mih babstrm`b trm`bða ða ik akoujbz akoujbzm`bð m`bða. a. Ikok Ikok `fatmr `fatmr `fa gfem ik rknbstrf ik kadkrhkrèm.

_k`ursfs

katrknmrm ? `msfs `jèab`fs ifaik ikoka rkmjbzmr jm mihba mihbabst bstrm` rm`bð bða a ik fxbnk fxbnkaf aftk tkrmp rmpbm bm k baib`m baib`mrr jfs `ubimifs ik kadkrhkrèm mtbankatks ik m`ukrif mj `msf.

mihbabstrm`bða, rkvbsmaif mspk`tfs ik jm tâ`ab`m y `u `ubim bimif ifs, s, juknf juknf sk sfjb`b sfjb`btmr tmrm m m `mim `mim ua uaf f ik jfs kstuibmatks quk rkmjb`k jm tâ`ab`m.

_fj ikj If`katk

 Mj bab`bf ikj tmjjkr kj if`katk ikok imr jm obkavkabim obkavkabim m jfs kstuibmatks kstuibmatks y -_ki ik mbrk y fxbnkaf. rkmjbzmr uam pkqukým rkvbsbða ik jfs `fatkabifs quk sk vkría iurmatk kj -Hmaðhktrf ik prksbða tmjjkr, kstm af sk ikok kxtkaikr hís ik =3 hbautfs. - Djuefhktrf (? ua) Juknf prf`kikrí m trmomemr jm pmrtk prm`tb`m ka `mim ks`kamrbf `fa jfs - Guhbibdb`mifr (9 ua) -Mnum obikstbjmim hmtrmz (4 kstuibmatks. ua) - @íaujm amsmj (9 ua) Ks`kamrbf =5 Kj if`k if`kat atk k iko ikok hfst hfstrm rmrr jfs jfs ibst ibstba batf tfs s sbst sbstkh khms ms pm pmrm rm mi mihb hbab abst strm rmr  r  - Hms`mrbjjm sbhpjk (? ua) - Hms` Hms`mrbj mrbjjm jm `fa rkskrvfrb rkskrvfrbf f fxbnkaftkrmpbm, `ðhf sk mrhma y jfs ibstbatfs kjkhkatfs quk sk rkqubkrka pmrm su mihbabstrm`bða, ikok hfstrmr mikhís ifaik sk ka`ukatrm jm rki ik (? ua) fxbnkaf ka jm uabimi ikj pm`bkatk. -Hms`mrbjjm Tkaturb (9 ua) Ks`kamrbf ?5 - Abpjk Hms`mrbjjm pmrm Kj ik`katk ikok katrknmr ? `msfs `jèab`fs m `mim nrupf pmrm quk prkpmrka y mihbabstrka jfs sbstkhms ik fxbnkaftkrmpbm, juknf ikoka prkskatmrjf mj akoujbzm`bða (9 ua) - Lbt ik mskf amsmj (tðrujms rkstf ikj nrupf baib`maif jfs `ubimifs ik kadkrhkrèm ka jm bastmjm`bða y ik mjnfiða y sukrf hmatka`bða ik jfs ibspfsbtbvfs. dbsbfjðnb`f). Ks`kamrbf 05 - Pmturðhktrf -Gfem ik rknbstrf ik Kj if`katk nubmrm m jfs kstuibmatks ka jm prkpmrm`bða y mihbabstrm`bða ik jm kadkrhkrèm Hkib`mhkatf pmrm akoujbzm`bða, imaif âadmsbs ka jm prkpmrm`bða ikj pm`bkatk, mspk`tfs ik jm dfrhm`bða ik jm auok ik mbrk, tbkhpf ik mihbabstrm`bða, katrk ftrfs akou akoujbz jbzm`b m`bða ða (smjo (smjoutm utmhfj hfj,, tâ`ab`m, dfrhm`bða mspk pk`t `tfs fs.. Mikh Mikhís ís,, ikok ikok vkrb vkrbdb db`m `mrr qu quk k `mim `mim kstu kstuib ibma matk tk rk rkmj mjb` b`k k kj okrfiumj, orfhurf ik ms prf`kibhbkatf y rknbstrk ka jm gfem ik kadkrhkrèm. bprmtrfpbf)

 

A³ Srf`kibhbkatf

Suatmek Jfnrmi f

Af jfnrmif

=

Pk gbn gbnbkabzm jms jms hma hmafs `fa `fa = mj`fgfj nkj sknõa HBAPMJ ? _kõak jfs hmtkrbmjks m = utbjbzmr tmjks `fhf5 guhb guhbib ibdb db`m `mif ifr, r, `f `fak akxb xbða ða,, - Ekrbanm ;`` (=9 ua) dukatk ik fxènkaf, - Pukrf dbsbfjðnb`f 3.2% ;hj Djueðhkt Djue ðhktrf, rf, mnum mnum ikstbjmi ikstbjmim, m, Hms`mrbjj Hms` mrbjjm m Tkaturb, Tkaturb, tkjm pmrm umhrmmtbvpmrf Kvmjum`bða  Kvmjum`bða dbe dbemr y  sp rftk tkn nkr S pbmkuj tm ik `ftkef ibspfsbtbvf vkrik f ojma`f ik m`ukrif mj `msf katrknmif.

0

9 ; 4 > 7

2

*Iko *Ikokk rku rkuabr tfif tfifss jf jfss hmtk hm tkrb rbmj mjks ks pm pmrm rm tkak tkakrr kj puatmek Pkjk Pk jk`` ``bf bfam am ibsp ibspfs fsbt btbv bvf f ? mik`umif5 Hms`mrbjjm Tkat Tk atur urbb `f `fa a ibsp ibspfs fsbt btbv bvf f ojma`f f vkrik sknõa `msf baib`mif. Tkrb Tkrbdb db`m `m jf jfs s ; `f `frr rrk` k`tf tfs s ka jm jms s baib`m`bfaks pfr kj hâib`f Badfrhm m pm` pm`bkatk y dmh dmhbjbm kj prf`kibhbkatf @fjf`m m pm`bkatk ka pfsb`bða Dfwjkr  Kvmj Kvmjõm õm pk pkrh rhkm kmob objb jbim imi i ik vè vèms ms mârkms @fhpjktm drms`f guhb hbi ibdb` db`mifr `fa `fa mnum obiks obi kstbj tbjmi mim, m, katrk katrk hèabhf hèabhf y híxbhf, sba `fatmhbamr. Bastmjm `fakxbfaks ikj ibspfsbt ibsp fsbtbvf bvf mj guhbibdb` guhbibdb`mif mifr  r  sba `fatmhbamr.

= = = = =

=

=3

Mork rknujmifr ik djuef y jf ? ikem ka jfs J/hba ik m`ukrif m DBF?  rkqukrbim (ikok hka`bfamrjf).

==

fbh Fk?,j = h@ ki maptrkukom ousrmojbuiem kf ik i guhbibdb`mifr (pukik hka`bfamrjf.. hka`bfamrjf @fjf`m hms`mrbjjm mj = pm`bkatk5  @uorbkaif of`m y dfsms amsmjks  Smsm jm `fakxbða, pfr  sfork kj pmokjjða murb`ujmr    Meustm jm `fakxbða Tkrbdb`m smturm`bða quk jm = smturm`bða ikj pm`bkatk kstk

=?

=0

ka rmanfs afrhmjks. =9 Ikem mj pm`bkatk `ðhfif = =; Pk jmvm jms hmafs = =4 _knb _knbst strm rm kj prf prf`k `kib ibhb hbka katf tf ka = db`gm ik kadkr kadkrhkr hkrèm( èm( mihba mihbabst bstrm` rm`bð bða a

MAKWFP SM[YM IK @FYKEF5 FWBNKAFYK_MSBM FWBNKAFYK_ MSBM SF_ HMP@M_BJJM TKAY[_B

F? pfr pfr hms`m hms`mrbj rbjjm jm Tkatu Tkaturb, rb, Jb Jbtr trfs fs ik ik fxè fxè ka kaf f tf tfjk jkrm rma` a`bm bm  

SM[YM IK @FYKEF5 FWBNKAFYK_MSBM SF_ AM_B@K_M

A ³

M`tbvbimiks

Suatme k

= ?

Pk gbnbkabzm jms hmafs `fa mj`fgfj nkj _kõak hmtkrbmj5  Guhbibdb`mifr    Mnum obikstbjmim obikstbjmim  Pbstkhm ik fxbnkaftkrmpbm  Pmturðhktrf

= =

( Ikok rkuabr tfifs jfs kjkhkatfs pmrm tkakr kj puatmek)

0 9 ; 4

Kxpjb`m kj prf`kibhbkatf mj pm`bkatk Sfsb`bfam mj pm`bkatk ka pfsb`bða skhbdfwjkr. Tkrbdb`m pkrhkmobjbimi ik `mvbimi amsmj y ou`mj (jf hka`bfam). Pkjk Pkjk`` ``bf bfam am ibs ibspf pfsb sbtb tbvf vf mik mik`u `umi mif5 f5  @íaujm amsmj > @fhp @fhpjk jktm tm drms`f drms`f guhbi guhbibd bdb` b`mi mifr fr `fa `fa mn mnum um obiks obikstb tbjm jmim im,, ka katr trk k hè hèab abhf hf y híxb híxbhf hf,, sba sba `fatmhbamr. 7 Bastmjm `fakxbfaks ikj ibspfsbtbvf mj guhbibdb`mifr sba `fatmhbamr. 2 Mork Mork rk rknu nujm jmif ifrr ik djue djuef f y jf ikem ikem ka ka jf jfs s J/h J/hba ba ik ik m` m`uk ukri rif f m DBF?  rkqukrbim (ikok hka`bfamrjf). =3 @fhp @fhpru ruko kom m smjb smjbim im ik F?, hkibmatk ourouekf ikj guhbibdb`mifr (pukik hka`bfamrjf). == Bastmjm Bastmjm `frrk`tm `frrk`tmhka hkatk tk ibspf ibspfsbtbv sbtbvf f mj pm` pm`bkat bkatk5 k5  @fjf`m jm Amrb`krm mj pm`bkatk, ka frbkatm`bða ik dfsms amsmjks  

=? =0

= = =

? ? =

? =

?

Smsm jm `fakxbða pfr sfork kj pmokjjða murb`ujmr   Meustm jm `fakxbða `fakxbða Ikem mj pm`bkatk `ðhfif = Tkrbdb`m Tkrbdb`m mik`umi mik`umim m fxbnkam`b fxbnkam`bða ða ikj pm`bkatk pm`bkatk `fa smturf smturfhktr hktrèm èm y vmjfrm`bða vmjfrm`bða ikj ikj pmtrða = rkspbrmtfrbf

P b

Af

 

=9 =;

Hk Hka`bfam jmvmif ik hmafs. _knbstrm prf`kibhbkatf (jf hka`bfam).

= = =2 pts.

YFYMJ SM[YM IK KTMJ[M@BFA MIHBABPY_M@ MIHBABPY_M@BFA BFA IK AKO[JBUM@B AKO[JBUM@BFA FA

A³ = ?

AKO[JBUM@BFA

SYEK Pk gbnbkabzm jms hmafs `fa mj`fgfj nkj = _kõ _kõak ak jfs jfs hmtk hmtkrbm rbmjk jks s m utbj utbjbzm bzmrr tmjk tmjks s `fhf5 `fhf5 akou akoujbz jbzmi mifr, fr, hkib`m hkib`mhka hkatf, tf, = sukrf dbsbfjðnb`f, ekrbanm, rbýf, f omaikem, lbt ik mskf amsmj.

( Ikok rkuabr tfifs jfs hmtkrbmjks pmrm tkakr kj puatmek) 0 9 ; > 7 2 =3 == =? =0

=9 =; =4 =>

Tkrbdb`m jfs ; `frrk`tfs ka jms baib`m`bfaks pfr kj hkib`f _k _kttbr brm m ikj drm rms` s`f f ik hk hki ib`mhk `mhka atf, tf, jm ifsbs baib` b`m mim, sba `fatm tmhb hba amr @fh @fhpjk pjktm tm kj drms`f drms`f akou akoujbz jbzmi mifr fr `f `fa a híxbhf híxbhf 9 `` `` ik ik suk sukrf rf dbs dbsbfj bfjðn ðnb`f b`f,, sba `fatmhbamr  Mrhm akoujbzmifr sba `fatmhbamr Ikpfsbtm kj hkib`mhkatf ka kj drms`f akoujbzmifr

@fak`tm akoujbzmifr mj dua`bfamhbkatf(auokk ik mbrk) dua`bfamhbkatf(auo

Djueðhktrf,

Bad Badfr frhm hm m pm`bk pm`bkatk atk y dmhbj dmhbjbm bmrr prf`ki prf`kibhb bhbka katf tf [ob`m mj pm`bkatk ka pfsb`bða dfwjkr f skatmif Tkrbdb`m pkrhkmobjbimi ik jm vèm mârkm

`fhprukom

= = = = =

su ? = = =

? @fjf`m jm hms`mrbjjm mj pm`bkatk `frrfofrmaif `frrfofrmaif55   @uork su amrbz y of`m, ikem dukrm jm zfam ik jfs fefs. Smsm kj kjístb`f sfork frkems y au`m ikj pm`bkatk Pbtõm kj Dju Djueðhk eðhktrf trf ka mbr mbrkk `fh `fhprbh prbhbif bif kka a 4 m 7 J y vkrom vkromjbzm jbzm ? quk kstf iurmrm ik ; m =3 hbautfs.( = puatf `/u) Ikem mj pm`bkatk `ðhfif Pk jmvm jms hmafs _knbst _knbstrm rm kj pr prf` f`ki kibhb bhbka katf tf ka db` db`gm gm ik kadkr kadkrhkr hkrèm èm

= = =

Yftmj

=2

J

AJ