Anaphylaxis

August 25, 2022 | Author: Anonymous | Category: N/A
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Hehpjydhxks Gcgrlgeny Agphrtcget Qrghtcget @gddy CnJulj,   CA, _hnjhry ]gphesjg`,   CA* @G[\I]A^  Hehpjydhxks     Gpkegpjrkeg     Hehpjydhntkn sjin`     Hkrwhy chehlgcget   Hwh`g ketumhtkie



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  Hehpjydhxks ks h dkfg-tjrghtgekel hddgrlkn rghntkie tjht rgqukrgs tjg chehlgcget if hkrwhy, mrghtjkel, hea nkrnudhtkie.   Ketrhc Ketrhcusn usnudh udhrr gpkegp gpkegpjr jrkeg keg ks tjg chkest chkesthy hy if hehpjy hehpjydhx dhxks ks trghtc trghtcget get.. Qjg Qjgrg rg hrg ei hms hmsidu idutg tg nietrhkeaknhtkies ti hackekstrhtkie if gpkegpjrkeg.   Ketrhvgeius gpkegpjrkeg ks tjg trghtcget trghtcget if hehpjydhntkn sjin` sjin` hea sjiuda mg lkvge hs he kefuskie hdiel wktj ketrhvgeius nrysthddikas.  \jge uppgr hkrwhy imstruntkie tjhe rhpka sgqugeng ketumhtkie. egngsskthtgs ketumhtkie, hwh`g ketumhtkie chy mg shfgr  Qjgrg ks ei mgst prhntkng fir tjg hciuet if imsgrvhtkie rgqukrga hftgr trghtcget, hea tjks sjiuda sji uda mg thkdir thkdirga ga ti tjg keakvk keakvkauh auhdd phtkge phtkget, t, mgnhus mgnhusg g mkpjhs mkpjhskn kn rghntk rghntkies ies iftge iftge inn innur ur iutskag if trhaktkiehd imsgrvhtkie pgrkias.

KEQ]IAWNQKIE  Hehpjydhxks ks h sgrkius systgc systgckn kn hddgrlkn  hddgrlkn rghntkie wjknj, kf eit trghtga qukn`dy, nhe 8 dgha ti nhrakivhsnudhr niddhpsg. Gcgrlgeny agphrtcget (GA) nhrg kevidvgs hppriprkhtg trkhlg, hackekstrhtkie if gpkegpjrkeg, hea lgegrhd chehlgcget if tjg hkrwhy, mrghtjkel, hea nkrnudhtkie. Ketrhcusnudhr (KC) gpkegpjrkeg ks tjg chkesthy if hehpjydhxks dhx ks trg trghtc htcget get.. Fir pht phtkge kgets ts kemrienjiakdhtirs, sji sjin`, n`, ket ketrhv rhvgei geius us (KV) gpke gpkegpj gpjrke rkeg ghetkjksthckegs. ks egn egngss gsshry hry..  Haouentkvg cgaknhtkies kenduag nirtknistgrikas, hea Ldunhlie hea haaktkiehd vhsiprgssirs sjiuda mg usga wjge hehpjydhxks ks rgfrhntiry ti gpkegpjrkeg. Hkrwhy chehlgcget ks `gy kf tjgrg hrg skles if hkrwhy imstruntkie. KEKQKHD GVHDWHQKIE HEA CHEHLGCGEQ Qjg phtkget wktj sgvgrg hddgrlkn sycptics sjiuda mg trkhlga ti h ciektirga mga hea gvhduhtga my h pjysknkhe kccgakhtgdy, mgnhusg tjg kektkhd sycptics if hehpjydhxks

Agphrtcget if Gcgrlgeny Cgaknkeg, Dgwks @htz ^njiid if Cgaknkeg, Qgcpdg Wekvgrskty, >128 Eirtj Mriha ^trggt, Rjkdhagdpjkh, RH 8;812, W^H * Nirrgspieakel hutjir. G-chkdd haargss? G-chk haargss?   zhnjhry zhnjhry.rgphesjg`=Btujs.tgcpdg.gau .rgphesjg`=Btujs.tgcpdg.gau

Gcgrl Cga Ndke E Hc 12 (=2==) 8;„>= jttps?//aik.irl/82.8286/o.gcn.=2=8.2:.221 2>-:6=2 ckeutgs fir fiia, 87 ckeutgs fir vgeic, hea 7 ckeutgs fir cgaknhtkie.= KC gpkegpjrkeg sjiuda mg hackekstgrga hs siie hs hehpjydhxks ks kagetkfkga, wjknj chy mg aieg nienurrgetdy wktj tjg prkchry hssgsscget. ]ks` fhntirs fir fhthd hehpjydhxks sjiuda mg hssgssga kf pisskmdg. Qjgsg kenduag h jkstiry if nhrakipudciehry aksghsg, jkstiry if hstjch, pg p gheut ir trgg eut hddgrly, havhenga hlg, agdhyga prgsgethtkie, hea chst ngdd aksghsg.> ]gspkrhtiry akstrgss chy mg sgnieahry ti mrienjisphsc ir uppgr hkrwhy imstruntkie. ^trkair, ariidkel, hea tielug ir fhnkhd gagch hrg ickeius skles, sullgstkvg if  kcpgeakel hkrwhy imstruntkie, hea tjgrg sjiuda mg h diw tjrgsjida ti sgnurg tjg hkrwhy. Qjg pjysknkhe sjiuda gxpgnt hea prgphrg fir h akffknudt ketumhtkie. Jypitgeskie sjiuda hdgrt tjg privkagr if tjg pitgetkhd fir nkrnudhtiry niddhpsg. Qjg phtkgett sjiuda mg pdhnga ke tjg supke phtkge supkeg g pisktki pisktkie e ti kenrgh kenrghsg sg ngrgm ngrgmrhd rhd hea nhrakh nhrakhn n pgrfuskie. ^theakel jhs mgge hssinkhtga wktj nhrakivhsnudhr hrrgst, dk`gdy sgnieahry ti tjg prifiuea vhsiakdhtkie tjht innurs ke hehpjydhxks.1 Ke phtkgets wji hrg jypitgeskvg, KV nrysth nry sthddi ddikas kas sji sjiuda uda mg kekt kektkht khtga ga kccg kccgakht akhtgdy gdy00 8 D ti = D ir =2 cD/` cD/`l l if ksiti ksitiekn ekn fdu fdukas kas fir haudt hea pgakhtr pgakhtrkn kn phtkgets, rgspgntkv rgspgntkvgdy, gdy, sjiuda mg midusg midusga, a, uedgss tjgrg ks h jksti jkstiry ry

Niengre fir hehpjydhxks9

Hkrwhy, Mrghtjkel, Nkrnudhie = dhrlg-mirg dhrlg-mirg KVs, nieeuius nieeuius nhrakhn & I= ciektirkel ciektirkel Jypixkn? Jypi xkn? su suppdg ppdgcget cgethd hd I= Jypitgeskvg? Jypitgeskv g? pdhng supkeg, sthrt KVF + KC gpkegpjrkeg ]gsiduie if sycptics9

Ei

[gs 

Kenicpdgtg

]gpght KC gpkegpjrkeg gpkegpjrkeg x > q7 cke Jypitgeskie

^kles if uppgr hkrwhy imstrunie

Haouenvg cgaknhies (hs eggaga) Nirnistgrikas J 8/J= hethliek hethliekst st ν-hlieksts

JA sthmdg, ielikel nuthegius, LK, ir rgspkrhtiry niengres m

 • •

8 Y= dktgr dktgr, ir >2 cD/ cD/`l `l KVF midus Hehpjydhnn sjin`9

Rrgphrg fir nrknhd hkrwhy, Nieskagr hwh`g ketumhie

Qrght w/ haouenvg cgaknhies

Keaknhie fir haakiehd ciektirkel9 ^gvgrg prgsgethie ]ks` fhntirs fhntirs fir mkpjhskn rghnieh Nhrakipudciehry nicirmkakgs Jx if mkpjhskn rghnie Dkcktga hnngss ti nhrg • •



KV gpkegpjrkeg midus & kefuskie ]gfrhntiry sjin`9

Ie MM9 -5 ldunhlie ldunhlie Haakiehd vhsiprgssirs? Eirgpkegpjrkeg Rjgeydgpjrkeg Vhsiprgsske • • •



Hackt ti KNW

Hackt fir imsgrvhie



[gs

^ycptic rgnurrgeng rgnurrge ng

Nieskagr GA imsgrvhie

Ei

Ei rgnurrgeng

Aksnjhrlg wktj GpkRge

Fkl. 8.  Ivgrvkgw if hehpjydhxks chehlgcget ke tjg GA.   h]ks` fhntirs fir mkpjhskn rghntkie kenduag, kektkhd prgsgethtkie wktj sgvgrg fghturgs ir jypitgeskie, cudtkpdg aisgs if gpkegpjrkeg rgqukrga, agdhyga hackekstrhtkie if gpkegpjrkeg 62 ckeutgs ti 8;2 ckeutgs hftgr sycptic iesgt, iesgt if sycptics lrghtgr tjhe >2 ckeutgs hftgr tjg kektkhd gxpisurg, ir he ue`eiwe ue`eiw e trkllgr‑ei trkllgr‑eitg tg tjht tjgsg hrg eit nieskstget nieskstget hnriss stuakgs stuakgs   mFir ckeir lhstriketgstkehd sycptics, sycptics, sunj hs ielikel ielikel ehusgh ir akhrrjgh, akhrrjgh, ir ckeir nuthegius nuthegius sycptics, sunj hs rgskauhd urtknhrkh ir prurktks, phtkgets nhe mg aksnjhrlga jicg wktj liia fiddiw-up. MM, m-mdin`gr0 LK, lhstriketgstkehd0 JA, jgciayehcknhddy0 J 8, jksthckeg 80 J=, jksthckeg =0 Jx, jkstiry0 KNW, ketgeskvg nhrg uekt0 KVF, KV fdukas0 w/, wktj. Aiwedihaga fir Heieycius Wsgr (e/h) ht Qjg Wekvgrskty if Hrkzieh fric [email protected] my Gdsgvkgr ie Oheuhry 21, =2==. Fir pgrsiehd usg iedy. Ei itjgr usgs wktjiut pgrcksskie. Nipyrkljt ©=2==. Gdsgvkgr Ken. Hdd rkljts rgsgrvga.

 

Hehpjydhxks

if jghrt fhkdurg ir gea-sthlg rgehd aksghsg. Dkfg-susthkekel gqukpcget, sunj hs h niag nhrt hea agfkmrkddhtir, sjiuda mg rghakdy hvhkdhmdg, hea privkagrs sjiuda mg rghay ti pringga ti havhenga nhrakhn dkfg suppirt ke tjg gvget if nhrakhn hrrgst. Qjg nhusg if hehpjydhxks chy eit hdwhys mg `eiwe. Kt ks kcpirthet, jiwgvgr, ti nieskagr ielikel gxpisurgs ti tjg trkllgr. Kf hehpjydhxks agvgdips wjkdg tjg phtkget ks hdrghay ke tjg GA, stip hdd pitgetkhd iffgeakel cgaknhtkies kccgakhtgdy. Fir tjisg wji jhvg mgge gevge gevgeichtg ichtga, a, httgcpt httgcpt ti rgcivg hey stkel stkelgrs grs tjht stkd stkddd  hrg kcmgaaga ke tjg s`ke. Ke nhsgs if fiia hddgrly, tjgrg ks ei ridg fir lhstrkn dhvhlg. 7 FK]^Q-DKEG QJG]HR[? GRKEGR]JKEG Gpkegpjrkeg ks tjg chkesthy if hehpjy hehpjydhxks hxks chehlgcget  chehlgcget hea ks wkagdy hnngptga my choir lukagdkegs hs fkrst-dkeg tjgrhpy. 8,>,6„82 Mgnhusg hehpjydhxks ks rhpka ke iesgt hea pitgetkhddy fhthd, hea gpkegpjrkeg jhs sunj h diel jkstiry if gffgntkvgegss, h rheaickzga nietriddga trkhd (]NQ) nicphrkel heitjgr ketgrvgetkie ks gtjknhddy qugstkiehmdg. hmd g. Qju Qjus, s,   tj tjgr grg g ks h dhn` dhn` if pri prisp spgn gntkv tkvg g ah ahth th tj tjht ht ag agci cies estr trht htg g tj tjg g mg mgeg egfkt fkts s if  nhsgs if  gpkegpjrkeg.88 Gxpgrkgeng jhs sjiwe kt ti mg gffgntkvg, jiwgvgr, hea cist nhsgs fhthd hehpjydhxks hrg hssinkhtga wktj agdhyga ir fhkdurg ti privkag gpkegpjrkeg. =,88 Gpkegpj Gpke gpjrke rkeg g hnt hnts s ie   h8-hargegrlkn,   m8-harge -hargegrlkn grlkn,, hea   m=-harge -hargegrlkn grlkn rgngp rgngptirs tirs ti -hargegrlkn grlkn rgngp rgngptir tir dghas niuetgrhnt hehpjydhntkn pjyskidily. ^tkcudhtkie if tjg   h8-harge ti agnrghsga cunishd gagch hea kenrghsga systgckn vhsnudhr rgskstheng, tjgrgmy agnrghskel hkrwhy imstruntkie hea kcprivkel jypitgeskie. ^tkcudhtkie if tjg   m8-rgngptir ngp tir dgh dghas as ti ken kenrgh rghsga sga kei keitri tripy py hea njr njriei ieitri tripy, py, hds hdsi i kcpr kcprivk ivkel el jyp jypitg itgesk eskie. ie. ^tkcudhtkie if tjg   m=-rgngptir nhusgs mrienjiakdhtkie hea agnrghsga priauntkie if  kefdhc kef dhccht chtiry iry cga cgakht khtirs irs tjh tjhtt itj itjgrw grwksg ksg wiu wiuda da ken kenrgh rghsg sg vhs vhsnud nudhr hr pgr pgrcgh cghmkdk mkdkty ty hea sciitj cusndg nietrhntkie hs wgdd hs httrhnt haaktkiehd kefdhcchtiry ngdds. 8= Agspktg tjg chey mgegfkts if gpkegpjrkeg, stuakgs sjiw tjht kt ks ueagrutkdkzga ke tjg gcgrlgeny sgttkel. Ieg rgtrispgntkvg stuay fiuea tjht iedy 86% if phtkgets prgsgetkel wktj hehpjydhxks rgngkvga gpkegpjrkeg. 8> Gpkegpjrkeg ks iftge wktjjgda ke tjg idagr pipudhtkie, gspgnkhddy ke tjisg wktj niriehry aksghsg, aug ti niengre fir prgnkpkthtkel ksnjgc ksn jgckh kh ir hrr hrrytj ytjckh ckh.. Qjg Qjgrg rg hrg ei hms hmsidu idutg tg nie nietrh trhkeak keaknht nhtkie kies s ti gpke gpkegpj gpjrkeg rkeg,, jiw jiwgvgv>,:,88 Cist Ci st ha havg vgrs rsg g gv gvge gets ts jh jhvg vg gr, gr, wj wjkn knj, j, wj wjge ge lkvg lkvge e KC KC,, gx gxjk jkmk mkts ts h wk wkag ag sh shfg fgty ty pr prif ifkd kdg. g. = innurrga hftgr usg if KV gpkegpjrkeg, gspgnkhddy wjge hackekstgrga kenirrgntdy. Kt ks eiw rgn rgnile ilekzg kzga a tjh tjhtt tjg tjgrg rg chy mg akrg akrgnt nt nhr nhraki akitix tixkn kn gff gffgnt gnts s fri fric c heh hehpjy pjydhx dhxks ks hs wgdd hs tjg pitgetkhd fir ksnjgckh fric jypitgeskie. 81 Qjus, gpkegpjrkeg sjiuda eit mg wktjjgda fric heyieg prgsgetkel wktj sgvgrg hddgrlkn sycptics. Ke phtkgets prgsgetkel wktj hehpjydhxks wji hrg eit ke nhrakhn hrrgst, tjg iptkchd hack ha ckek ekst strh rhtki tkie e riut riutg g if KC gp gpke kegp gpjr jrke keg g ks ke tj tjg g he hetg tgri ridh dhtg tgrh rhdd tj tjkl klj, j, ht h ai aisg sg   if  2.28 cl/`l, wktj h chxkcuc if 2.7 cl ke haudts hea 2.> cl ke njkdarge ( Qhmdg Qhmdg 8 ).8= Aisgs nhe mg rgpghtga ht 7-ckeutg ketgrvhds hs eggaga fir sycptic nietrid. Rhtkgets hdrghay chy jhvg rgngkvga gpkegpjrkeg vkh hutikeogntir prkir ti hrrkvhd ke h aisg if  2.8 cl, 2.87 cl, ir 2.> cl. Rhtkgets wji rgngkvga gpkegpjrkeg ge riutg wktjiut rgsidutkie if sycptics sjiuda mg trghtga kccgakhtgdy wktj he haaktkiehd aisg if KC gpkegpjrkeg. Qjgrg hrg dkcktga pjhrchni`kegtkn ahth ie gpkegpjrkeg ke hehpjydhxks, hea he a tjis tjisg g st stua uakg kgs s tj tjht ht jh jhvg vg mg mgge ge ni niea eaun untg tga a jh jhvg vg mg mgge ge ie jg jghd hdtj tjy y ph phtk tkge gets ts.. Ie Ieg g stua stuay y ke njkdarge wktj h jkstiry if hehpjydhxks fiuea tjht pgh` dgvgds if gpkegpjrkeg wgrg jkljgr hea hnjkgvga fhstgr wjge kt whs lkvge KC nicphrga wktj sumnuthegiusdy. 87  Heitjgr stuay ke haudts fiuea skckdhr86rgsudts wjge gpkegpjrkeg whs hackekstgrga ke tjg tjklj hs ippisga ti tjg agdtika. Fir phtkgets rgqukrkel cirg tjhe = aisgs if  KC gpkegpjrkeg mgnhusg if gktjgr ielikel rgspkrhtiry sycptics ir jypitgeskie, KV gpkegpjrkeg hs h midus ir kefuskie sjiuda mg nieskagrga. Aiwedihaga fir Heieycius Wsgr (e/h) ht Qjg Wekvgrskty if Hrkzieh fric [email protected] my Gdsgvkgr ie Oheuhry 21, =2==. Fir pgrsiehd usg iedy. Ei itjgr usgs wktjiut pgrcksskie. Nipyrkljt ©=2==. Gdsgvkgr Ken. Hdd rkljts rgsgrvga.

 

=8

 

==

CnJulj & ]gphesjg`

Qhmdg 8 Gpkegpjrkeg aiskel fir hehpjydhxks Gpkegpjrkeg aisg

Haudts

Rgakhtrkns

2.>„2.7 cl KC 8?8222 (chx 2.7 cl) q7 cke

2.28 cl/`l KC 8?8222 (chx 2.> cl) q7 cke

Kektkhd aiskel

^gvgrg jypitgeskie/sjin` KV midus 82„=2  c l KV pusj q =„7 cke Haa 8 cD if 8?82,222 gpk ti ; cD syrkelg if E^ Kefuskieh

7

82-cl/cD sidutkie

2.8„8  c l/`l/cke

Haa 8 cl gpk (8 cD if 8?8222 ir 82 cD if 8?82,222) ti 8D E^

2.28„8  c l/`l/cke KV 7

8  c l/cD sidutkie

 Hmmrgvkhtkies?  gpk,

gpkegpjrkeg0 chx, chxkcuc0 E^, eirchd shdkeg0 pgas, pgakhtrkns. Gpkegpjrkeg kefuskie sjiuda mg tktrhtga ti hnjkgvg CHR lrghtgr tjhe 670 kenrghsg my jhdf tjg sthrtkel aisg gvgry = cke ti > cke. h

HEHRJ[DHNQKN ^JIN@ Agfkektkie hea Cgnjhekscs ^jin` innurs wjge nkrnudhtkie ks kehagquhtg ti cggt tjg ixylge rgqukrgcget if tkssugs, dghakel ti ngddudhr hea gea irlhe aysfuentkie.8< Qjgrg hrg cudtkpdg cgnjhekscs my wjknj akstrkmutkvg sjin` agvgdips ke hehpjydhxks. KlG-cgakhtga rgdghsg if vhsihntkvg cgakhtirs fric chst ngdds hea mhsipjkds dghas ti agnrghsga systgckn vhsnudhr rgskstheng wktj rgsudthet jypitgeskie.8: Qjgrg hdsi ks sklekfknhet nhpkddhry dgh`, dghakel ti ketrhvhsnudhr viducg agpdgtkie. Agnrghsga niriehry pgrfuskie chy nhusg cyinhrakhdd ag akh agpr prgs gssk skie ie,, furt furtjg jgrr gx gxhn hngr grmht mhtke kel l jy jypi pitg tges eski kie. e. Qj Qjgr grg g hd hdsi si ks lr lriw iwke kel l gv gvka kage geng ng tj tjht ht kefdhcchtiry cgakhtirs chy dgha ti niriehry vhsiniestrkntkie hea akrgnt cyinhrakhd keoury.81 Ketrhvgeius Gpkegpjrkeg Firr ph Fi phtk tkge gets ts prgs prgsge getk tkel el ke sj sjin in`, `, KC gp gpke kegp gpjr jrke keg g ch chy y mg lk lkvg vge e wj wjkd kdg g KV hn hnng ngss ss ks mg mgke kel l imthkega. KC gpkegpjrkeg hdieg, jiwgvgr, ks uedk`gdy ti mg hagquhtg, hea KV gpkegpjrkeg sjiuda mg usga. Ke 8 nhekeg stuay if hehpjydhntkn sjin`, KC gpkegpjrkeg jha ei gffgnt i gffgnt  ie e cghe hrtgrkh hrtgrkhdd prgssu prgssurg rg (CHR), mut KV gpkegpj gpkegpjrkeg rkeg whs gffgnt gffgntkvg kvg ht kenrg kenrghskel hskel CHR.8; Nicphrga wktj KC, KV gpkegpjrkeg ks fhstgr ke iesgt, jhs h cirg prgaknthmdg gffgnt,, hea ks cirg ghskdy tktrhthmdg gffgnt tktrhthmdg,, hdd if wjknj hrg fhvirhmdg ke tjg nrktknhddy kdd phtkget.  He kefuskie if gpkegpjrkeg sjiud sjiuda a mg st sthr hrtg tga a ht 8 cl/ l/ck cke e ti 82 cl/ck l/cke e he hea a tk tktr trht htga ga up > hs eggaga ti hnjkgvg h CHR if 67. Kf he gpkegpjrkeg kefuskie ks eit kccgakhtgdy hvhkdhmdg, tjks nhe mg chag my haakel 8 cl if gpkegpjrkeg, gktjgr 8 cD if tjg 8?8222 sidutk dutkie ie,, ir 82 cD if 8?8 ?82, 2,22 222 2 sidut idutki kie, e, ti h 8-D mh mhl l if ei eirc rchd hd sh shdk dkeg eg.. Qj Qjks ks nrg nrghtgs htgs h 8-cl/  cD sidutkie if gpkegpjrkeg. ^thrtkel tjg kefuskie ht h rhtg if 62 cD pgr jiur lkvgs h aisg if 8  cl/cke. Qjg kefuskie sjiuda mg tktrhtga ti hnjkgvg h CHR if 67 my kenrghskel my ie iegg-jh jhdf df if tj tjg g st sthr hrtk tkel el ai aisg sg gvgr gvgry y = ck ckeu eutg tgs s ti > ck ckeu eutg tgs. s. Qj Qjks ks typk typknh nhdd ddy y ks hn hnjk jkgv gvga ga ke h rhelg rhelg fri fric c 82 cl/cke ti =2 cl/cke, mut h jkljgr jkljgr aisg chy mg utkdkzg utkdkzga a kf tjgrg ks eit hagquhtg rgspiesg. H midus if gpkegpjrkeg nhe hdsi mg lkvge wjkdg tjg kefuskie ks mghagquhtg kel kel prg prgph phrg rga. a. Mi Midu duss-ai aisg sg gp gpke kegp gpjr jrke keg g nh nhe e mg nr nrgh ghtg tga a my ha haake akel l 2. 2.8 8 cl if gp gpke kegp gpjr jrke keg g (8 cD if ni niag ag ai aisg sg P8 P8?8 ?82, 2,22 222S 2S gp gpke kegp gpjr jrke keg) g) ti h ;;-cD cD sy syrk rkel elg g if ei eirc rchd hd sh shdk dkeg eg ti nrgh nrghtg tg =2,,=8 =2 ^chdd hdkquits if 82   cl ti =2   cl nhe mg lkvge gvgry fgw h 82   cl/cD sidutkie. Aiwedihaga fir Heieycius Wsgr (e/h) ht Qjg Wekvgrskty if Hrkzieh fric [email protected] my Gdsgvkgr ie Oheuhry 21, =2==. Fir pgrsiehd usg iedy. Ei itjgr usgs wktjiut pgrcksskie. Nipyrkljt ©=2==. Gdsgvkgr Ken. Hdd rkljts rgsgrvga.

 

Hehpjydhxks

ckeutgs ti hnjkgvg CHRs hmivg 67. Qjks aisg hdsi niuda mg lkvge ke tjg sgttkel if  gxtrgcg jgciayehckn kesthmkdkty ke he httgcpt ti hvika nhrakhn hrrgst. Nhutkie sjiuda mg th`ge wjge hackekstgrkel KV gpkegpjrkeg hs h midus ir kefuskie. Hdtjiulj KC gpkegpjrkeg ks rgdhtkvgdy shfg, havgrsg nhrakhn gvgets, kenduakel ksnjgckh hea hrrytjckhs, jhvg mgge imsgrvga wktj KV gpkegpjrkeg, usuhddy wjge kt ks lkvge ht tjg kenirrgnt aisg. =  Haak  Haaktkiehdd tkiehddy, y, imsgrvh imsgrvhtkiehd tkiehd stuakg stuakgs s jhvg sjiwe tjht havgrs havgrsg gvget gvgets s hrg eit uenic ueniccie cie wjge midusmidus-aisg aisg vhsiprgs vhsiprgssirs sirs hrg utkdkzg utkdkzga a == ke tjg GA. Qjgrg ks pitgetkhd fir grrir mitj mgnhusg if niefuskie ivgr aiskel hea fric cksth`gs wjge ckxkel tjg cgaknhtkies. Kcpirthetdy, niag aisg gpkegpjrkeg (8 cl) egvgr sjiuda mg lkvge ti h phtkget wktj h pudsg, mgnhusg tjks nhe dgha ti fhthd hrrytjckhs. Fdukas Fduka rgsusnkthtkie ks he kcpirthet phrt if hehpjydhxks chehlgcget, mgnhusg sklekfknhet ketrhvhsnudhr viducg nhe mg dist aug ti kenrghsga nhpkddhry pgrcghmkdkty. Ieg stua stuay y ke ph phtk tkge gets ts ke tj tjg g ip ipgr grht htke kel l ri riic ic wk wktj tj he hehp hpjy jydh dhxk xks s gs gstk tkch chtg tga a tj tjht ht >7 >7% % if pdhs pdhsch ch => viducg nhe mg dist fric nhpkddhry dgh` wktjke ckeutgs. Rhtkgets hdsi chy disg viducg tjriulj vicktkel hea akhrrjgh fric hehpjydhxks. Rhtkgets prgsgetkel ke sjin` chy rgqu rgqukr krg g dhrl dhrlg g vi vidu ducg cgs s if fduka fduka ti rg rgst stir irg g ketr ketrhv hvhs hsnu nudhr dhr vi vidu ducg cg,, ke ha haakt aktki kie e ti KV gp gpke kegpj gpj-rkeg. Midusgs if ksitiekn nrysthddika, >2 cD/`l fir haudts ir =2 cD/`l fir pgakhtrkn phtkgets, nhe mg lkvge ti tjisg prgsgetkel wktj jypitgeskie ir jypividgckh hea wktjiut h ndghr nietrhkeaknhtkie ti viducg. Midusgs nhe mg rgpghtga hs egngsshry ti chkethke pgrfuskie.8,>,6,;,=1 My nietrhst, tjisg wji hrg eircitgeskvg, wktj prkchrkdy rgspkrhtiry sycptics, chy eit egga hllrgsskvg fduka rgsusnkthtkie. Kt ks kcpirthet ti ciektir hdd phtkgets rgngkvkel dhrlg viducgs if fdukas fir skles if viducg ivgrdiha. Duel hea kefgrkir vgeh nhvh udtrhsiuea nhe mg usgfud haouents ti tjg pjysknhd gxhckehtkie wjge hssgsskel viducg sthtus. ^GNIEA-DKEG QJG]HR[ Kejhdga Mrienjiakdhtirs ^jirt-hntkel  kejhdga ^jirt-hntkel kejhd ga   m-hlieksts nhe mg usga ti trght mrienjisphsc hssinkhtga wktj 8,>,6,;  Hdtjiulj tjgrg hrg ei jklj-quhdkty ahth sullgstkel tjht kejhdga hehpjydhxks. -hliek ieksts sts hrg gff gffgnt gntkvg kvg ke tjk tjks s sgt sgttke tkel, l, tjg tjgy y chy mge mgegfkt gfkt pht phtkge kgets ts wktj sklekf sklekfknh knhet et m-hl wjggzkel tjht pgrsksts hftgr gpkegpjrkeg ks lkvge. Hdmutgrid nhe mg lkvge vkh egmudkzgr ir cgtgrga aisg kejhdgr, skckdhrdy ti kts usg ke hstjch. Kejhdga hetknjidkegrlkns, sunj hs kpr kprht htri ripku pkuc, c, hdtj hdtjiu iulj lj ei eitt ni nies eskst kstge getdy tdy rg rgni nicc ccge geag aga, a, hd hdsi si nh nhe e mg lk lkvg vge e kf  wjggzkel ks sklekfknhet ( Q Qhmdg hmdg = ). Kcpirthetdy, kejhdga  m -hlieksts hea hetknjidkegrlkns jhvg ei ridg ke tjg trghtcget if uppgr hkrwhy gagch, wjknj typknhddy prgsgets hs strkair hea ks h cirg niengrekel skle if kcpgeakel hkrwhy nicpricksg. Fir hey phtkget wktj hehpjydhxks prgsgetkel wktj rgspkrhtiry sycptics, hkrwhy imstruntkie sjiuda mg fkrst rudga iut hs tjg pitgetkhd nhusg mgfirg trghtkel pudciehry aksghsg. Nirtknistgrikas Nirtknistgrikas frgqugetdy hrg lkvge ke tjg GA fir tjg trghtcget if hehpjydhxks. Qjg mgegfk mge gfkts ts hrg tjg tjgirg irgtkn, tkn, jiw jiwgvg gvgr, r, hea tjg tjgrg rg hrg ei jkl jklj-q j-quhd uhdkty kty ahth sji sjiwkel wkel tjh tjhtt =7 tjgy hrg gffgntkvg fir tjg hnutg chehlgcget if hehpjydhxks. Agspktg tjks, sicg stuakgs sjiw tjht nirtknistgrikas nirtknistgrikas stkdd hrg usga hs fkrst-dkeg tjgrhpy tjgrhpy ivgr gpkegpjrkeg.=7 Nirtkn Nir tknist istgri grikas kas hnt my ciaud ciaudhtki htkie e if trh trhesn esnrkpt rkptkie kie,, dgh dghake akel l ti agnrg agnrghsg hsga a pri priaun auntki tkie e if  kefdhcchtiry nyti`kegs, wktj he iesgt if hntkie if hpprixkchtgdy 1 jiurs ti 6 jiurs. =6 Qjgy hrg kegffg kegffgntkvg ntkvg,, tjgrg tjgrgfirg, firg, fir tjg kccgakhtg trghtcget if hehpj hehpjydhxks ydhxks.. Ke tjgiry, Aiwedihaga fir Heieycius Wsgr (e/h) ht Qjg Wekvgrskty if Hrkzieh fric [email protected] my Gdsgvkgr ie Oheuhry 21, =2==. Fir pgrsiehd usg iedy. Ei itjgr usgs wktjiut pgrcksskie. Nipyrkljt ©=2==. Gdsgvkgr Ken. Hdd rkljts rgsgrvga.

 

=>

 

=1

CnJulj & ]gphesjg`

Qhmdg = ^gniea-dkeg ^gniea -dkeg tjgrhpkgs fir hehpjy hehpjydhxks dhxks wktj haudt hea pgakhtrkn pgakhtrkn aiskel ^gniea Dkeg Hlgets

Haudt Aiskel

Rgakhtrkn Aiskel

Agxhcgtjhsieg

:„86 cl KV/KC/RI

2.> cl/`l RI/KV/KC (chx : cl)

Rrgaeksieg

8cl/`l (chx 72 cl) RI

8-= cl/`l (chx 72 cl) RI

Nirtknistgrikash

Cgtj Cg tjyd ydpr prga gaek eksid sidie ieg g 8„= 8„= cl cl/` /`l l (c (chx hx 8=7 8=7 cl cl)) KV

88-= = cl/` cl/`l l (c (chx hx 62 cl) cl) KV

Jyarinirtksieg

=22„722 cl KC ir KV

7„82 cl/`l (chx 722 cl) KC, KV

Ak Akpj pjge gejy jyar arhc hckeg keg

=7„7 =7„72 2 cl KV/K KV/KC/ C/RI RI iv ivgr gr 7 cke cke

8 cl/` cl/`l l KC/K KC/KV/R V/RI I iv ivgr gr 7 cke cke

Ngtkrkzkeg

82 cl RI/KV ivgr 8„= cke

46 yi =.7 cl KV/RI 6„88 yi 7„82 cl KV/RI

]hektkakeg

72 cl KV/RI

8 cl/`l (chx 72 cl) KV/RI

Fhcitkakeg

=2 cl KV/RI

2.=7 cl/`l (chx =2 cl) KV/RI

J8  hethliekstsm

J=  hethliekstsm

Mrienjiakdhtirs Hdmutgrid

=.7„7 cl egmudkzga q=2 cke     > 8.=7„7.2 cl egmudkzga q=2 cke   > 1„: puffs CAK q=2 cke   > =„: puffs CAK q=2 cke     > 87 cl nietkeuius egmudkzga 7„87 cl nietkeuius egmudkzga

Kprhtripkuc

722  c l egmudkzga

=72„722  c l egmudkzga

 Hmmrgvkhtkies ?

chx, chxkcuc0 chxkcuc0 CAK, cgtgrga aisg kejhdgr0. kejhdgr0. Lkvge dhn` if gvkageng tjht pridielga stgrika niursg ks gffgntkvg ke prgvgetkel rgnurrgeng, h 8tkcg aisg if agxhcgtjhsieg ks rgniccgeaga fir phtkgets wktj uenicpdknhtga prgsgethtkie. m Ei privga mgegfkt if KV ivgr RI hetkjksthckegs0 nieskagr RI uedgss sgvgrg ehusgh/vicktkel, hkrwhy/rgspkrhtiry nicpricksg. h

my agn agnrgh rghske skel l kef kefdhc dhccht chtiry iry cga cgakht khtirs irs,, nir nirtkni tknistg stgrik rikas as chy dgs dgssge sge tjg njh njheng eng if  sycptic rgture hftgr kektkhd rgsidutkie, rgfgrrga ti hs h mkpjhskn rghntkie. Qjgrg hrg ei nicpgddkel ahth, jiwgvgr, sjiwkel tjks ti mg trug. Choir luk lu kagdkeg gdkegs s   rgn gniccgea iccgea 8,6,;,82, 82,=1 =1,,=6 nirtkn nir tknist istgri grikas kas mg lkv lkvge ge hs sgn sgniea iea-dke -dkeg g tjg tjgrhpy rhpy ir eit ht hdd.  H skeldg aisg if nirtknistgrikas ks uedk`gdy ti jhvg sklekfknhet havgrsg gffgnts0 tjgrgfirg, kf stgrikas hrg ti mg usga ht hdd, h 8-tkcg aisg if agxhcgtjhsieg ke tjg GA chy mg lkvge iedy hftgr gpkegpjrkeg ks hackekstgrga. Fir phtkgets wjisg sycptics jhvg rgsidvga, tjgr tjgrg g ks ei eg egga ga fir fir ha haakt aktki kieh ehdd st stgr grik ikas as ht aks aksnj njhr hrlg lg.. Fi Firr tj tjis isg g wk wktj tj rg rgsk skau auhd hd s syc ycpt ptic ics s ir wji hrg hackttga ti tjg jispkthd, h >-ahy ti 7-ahy niursg if irhd stgrikas chy mg nieskagrga.  Qhmdg =  dksts tjg rgniccgeaga hlgets hea aisgs.  Hetkjksthckegs ^kckdhr ti nirtknistgrikas, hetkjksthckegs jhvg ei ridg ke tjg prkchry chehlgcget if  dkfg-tjrghtgekel skles hea sycptics if hehpjydhxks, kenduakel uppgr hkrwhy gagch hea sjin`. Qjg rhtkiehdg fir tjgkr usg stgcs fric tjg gffgntkvgegss if hetkjksthckegs ke itj itjgr gr hdd hddgrl grlkn kn aksi aksiragr ragrs, s, mut tjgrg hrg ei aht ahth h tjh tjhtt sul sullgs lgstt mge mgegfk gfktt ke heh hehpjy pjy-=< =2 Cist choir lukagdkegs rgniccgea tjht mitj J 8 mdin`grs hea J=  mdin`grs mg lkvge hs haouentkvg tjgrhpy hftgr tjg hackekstrhtkie if  gpkegpjrkeg. J8   mdin`grs hea J=  mdin`grs hrg rgniccgeaga kf tjgrg hrg sklekfknhet nuthegius nuthe gius ir lhstr lhstriketgs iketgstkehd tkehd sycptics, mut tjks sjiuda eit agdhy tjg hackek hackekstrhtki strhtkie e if gpkegpjrkeg.  Qhmdg =  dksts rgniccgeaga hlgets hea aiskel. Aiwedihaga fir Heieycius Wsgr (e/h) ht Qjg Wekvgrskty if Hrkzieh fric [email protected] my Gdsgvkgr ie Oheuhry 21, =2==. Fir pgrsiehd usg iedy. Ei itjgr usgs wktjiut pgrcksskie. Nipyrkljt ©=2==. Gdsgvkgr Ken. Hdd rkljts rgsgrvga.

 

Hehpjydhxks

]GF]HNQI][ ]GF]HNQI] [ HEHRJ[DHZK^  H choirkty if hehpjydhntkn rghntkies rgspiea ti gpkegpjrkeg. Ie innhskie, jiwgvgr, phtkgets chy jhvg sjin` ir hkrwhy nicpricksg tjht ks rgfrhntiry ti kektkhd trghtcget. Ld Ldun unhl hlie ie ch chy y mg gffg gffgnt ntkv kvg g ke tj tjgs gsg g kest kesthe heng ngs, s, gs gspg pgnk nkhd hddy dy kf tj tjg g ph phtk tkge gett ks ie h m-mdin`gr. Haaktkiehd vhsiprgssirs hdsi chy mg rgqukrga fir rgfrhntiry sjin`. Fir sgvgrg hkrwhy imstru imstruntkie, ntkie, ketumhtkie ks egngs egngsshry. shry. Ldunhlie m-Mdin`gr usg usg jh jhs s mgge hssinkhtga wktj kenrghsga kenkageng if sgvgrg, pritrhntga >8„>> hehpjydhxks. Ketrkeskn   m-hargegrlkn gffgnts mduet priaunt priauntkie kie if kefdhcchtiry cgakhtirs, wjgrghs  h -hargegrlkn gffgnts kenrghsg priauntkie. >8 Qjus  m -mdin`hag wiuda mg gxpgntga ti sjkft tjg mhdheng ke fhvir if hehpjydhntkn cgakhtirs. Qjg gffgnts if  gpkegpjrkeg hdsi hrg dk`gdy ti mg mduetga ke tjisg th`kel   m-mdin` -mdin`grs, grs, hea ueippi ueippisga sga hdpjh stkcudhtkie chy rgsudt ke h rgfdgx kenrghsg ke vhlhd tieg, nhuskel mrhaynhrakh hea kenrg kenrghsga hsga kefdhc kefdhcchtiry chtiry cgakhtir rgdghsg. rgdghsg.>8 ^gvgrhd nhsg rgpirts jhvg sjiwe >=,>1, >1,>7 ldunhlie ti mg gffgntkvg ke phtkgets ie   m-mdin`grs wktj rgfrhntiry hehpjydhxks.>=, ^kckdhr ti usg ke  m-mdin`gr ivgraisg, ldunhlie myphssgs tjg  m -rgngptir hea hntkvhtgs hageyd nyndhsg, tjgrgmy kenrghskel keitripy hea njrieitripy. Ldunhlie hdsi chy mg gffgntkvg ke tjisg wji hrg eit th`kel  m -mdin`grs hea sjiuda mg lkvge ti phtkgets wji hrg eit rgspieakel ti gpkegpjrkeg, rglhradgss if cgaknhtkie jkstiry.> Qjg rgniccgeaga aisg if ldunhlie ke haudts ks 8 cl ti 7 cl ivgr 7 ckeutgs, fiddiwga my he kefuskie if 7   cl/cke ti 87   cl/cke, tktrhtga ti ndkeknhd rgspiesg.> Fir pgakhtrkns, =2   cl/`l ti >2   cl/`l nhe mg lkvge ivgr 7 ckeutgs fiddiwga my kefuskie if 7   cl/cke ti 87   cl/  cke. Vicktkel ks h frgquget havgrsg rghntkie ti ldunhlie, si phtkgets sjiuda jhvg h sgnurg hkrwhy hea hetkgcgtkns sjiuda mg nieskagrga prkir ti hackekstrhtkie. Vhsiprgssirs Kf jypitg jypitgeskie eskie pgrsksts agspktg gsnh gsnhdhtkel dhtkel aisgs if gpkeg gpkegpjrkeg, pjrkeg, haaktkiehd vhsiprgssirs sjiuda mg haaga. Qhnjynhrakh hea hrrytjckhs chy dkckt tjg aisgs if gpkegpjrkeg tjht tjht nh nhe e mg us usga ga ti ch chke keth thke ke hn hnng ngpth pthmdg mdg md mdii iia a prgs prgssu surg rg.. Hdt Hdtji jiul ulj j tj tjgr grg g hrg ei ah ahth th ti ke keak aknh nhtg tg wj wjge ge ti ha haa a h sg sgni niea ea vh vhsi sipr prgs gssi sir, r, kf 87 cl/ l/ck cke e ti =2 cl/ l/ck cke e if gp gpke kegp gpjr jrke keg g ks eit hagquhtg, dk`gdy heitjgr hlget ks eggaga. Qjks chy kenduag eirgpkegpjrkeg, pjgeydgp ydgpjr jrke keg, g, ir vh vhsi siprg prgss sske ke.. Ei Eirg rgpke pkegpj gpjrke rkeg g ks tj tjg g vh vhsi siprg prgss ssir ir if nj njik ikng ng ke sg sgpt ptkn kn sj sjin in`, `, wjknj, dk`g hehpjydhxks, ks h akstrkmutkvg firc if sjin`. Eirgpkegpjrkeg jhs mitj   h8hargegrlkn hea   m8-hargegrlkn gffgnts. Kt ks h cirg pitget vhsiniestrkntir nicphrga wktj gpkegpjrkeg mut ks dgss dk`gdy ti nhusg thnjyhrrjytjckhs, ch`kel kt h rghsiehmdg hlgett ti haa. Rjgey hlge Rjgeydgpjrke dgpjrkeg, g, he  h 8-hliekst, hdsi chy mg usga. Qjg sunngssfud usg if  ri ic jhs mgge h-hlieksts ti trght rgfrhntiry hehpjydhntkn sjin` ke tjg ipgrhtkel rii agsnrkmga hea chy niuetgrhnt tjg thnjynhrakh keaunga my gpkegpjrkeg. >6 Qjgrg Qjg rg ks dkck dkcktga tga gvk gvkage ageng ng tjh tjhtt vhs vhsipr iprgss gsske ke chy mg gff gffgnt gntkvg kvg ke nht nhtgnj gnjidh idhcke ckeggrgsksthet hehpjydhntkn sjin`. Ke sgvgrhd nhsg rgpirts, vhsiprgsske kcprivga jypitgeskie ski e rgf rgfrhn rhntir tiry y ti cud cudtkpd tkpdg g vhs vhsipr iprgss gssirs irs,, ken kenduak duakel el gpke gpkegpj gpjrkeg rkeg..>  dksts tjg vhrkius cgtjias hea aiskel fir tipknhd hegstjgskh. Kf ehshd ketumhtkie ks ti mg pgrfircga, h tipknhd vhsiniestrkntir, sunj hs pjgeydgpjrkeg, nhe mg hppdkga hdiel wktj he hegstjgtkn ti prgvget mdggakel. Kf sthmkdkty hddiws, dkljt sgahtkie chy mg hackekstgrga si tjht tjg phtkget ks nicfirthmdg, mut spiethegiusdy mrghtjkel, ti jgdp fhnkdkthtg tjg pringaurg.  Qhmdg 1  agthkds tjg rgnic rgniccgeaga cgeaga hlgets hea aiskel aiskel.. Ketumh Ketumhtkie tkie tjge nhe mg pgrfircga uskel tjg fkmgriptkn mrienjisnipg, akrgnt dhryelisnipg, ir vkagi dhryelisnipg. H schddgr-skzga geaitrhnjghd tumg chy mg egngsshry, agpgeakel ie tjg aglrgg if hkrwhy gagch. Ieng tjg phtkget ks ketumhtga, hagquhtg pdhngcget if  tjg tjg tu tumg mg sj sjiu iuda da mg ni nief efkrc krcga ga,, he hea a st sthe heah ahra ra sg sgah ahtki tkie e he hea a he hehd hdlg lgsk skh h sj sjiu iuda da mg privkaga. IM^G]VH IM^G]V HQKIE HEA AK^RI^KQKIE Qjg akspisktkie if phtkgets wktj hehpjydhxks agpgeas ie tjg sgvgrkty if tjg rghntkie, tjg rgsidutkie if sycptics, phtkget jkstiry, hea hnngss ti nhrg. Rhtkgets wktj ielikel sycptics rgqukrkel gpkegpjrkeg kefuskie ir ketumhtkie sjiuda mg hackttga ti he ketgeskvg nhrg uekt. Rhtkgets wktj sycptics tjht jhvg eit nicpdgtgdy rgsidvga, itjgr tjhe ckda nuthegius ir lhstriketgstkehd sycptics, chy rgqukrg hacksskie fir imsgrvhtkie. Aiwedihaga fir Heieycius Wsgr (e/h) ht Qjg Wekvgrskty if Hrkzieh fric [email protected] my Gdsgvkgr ie Oheuhry 21, =2==. Fir pgrsiehd usg iedy. Ei itjgr usgs wktjiut pgrcksskie. Nipyrkljt ©=2==. Gdsgvkgr Ken. Hdd rkljts rgsgrvga.

 

Hehpjydhxks Qhmdg > Qipknhd hegstjgskh fir hwh`g ketumhtkie Hppdknhtkie

Aisgh

Qgnjekqug

Htickzga

82 cD if 1% dkainhkeg sidutkie

Niccgrnkhd agvkngs? G_ Htickzgr (Hdnivg (Hdni vg Cgaknhd Cgaknhd Ken. ), cunishd htickzga agvkng ^prhy keti tjg mhn` if tjg iripjhryex prkir ti pringaurg, hea sprhy aiwe ti vinhd niras

Egmudkzga

1 cD if 1% dkainhkeg sidutkie ht 1 D/cke

aurkel tjg pringaurg pringaurg Egmudkzgr wktj chs`

Akrgnt hppdknhtkie Irip Iripjh jhrye ryelg lghd hd

=% vksn vksniu iuss dkai dkainh nhke keg, g, 7% dkainhkeg iketcget

Dkainhkeg diddkpip‑hppdy h mdim if vksnius ir dkainhkeg iketcget ti h tielug agprgssir, kesgrt tjg tielug agprgssir hs pistgrkir keti tjg iripjhryex iripjhryex hs pisskmdg0 pisskmdg0 kestrunt phtkget ti jida kt mut eit ti swhddiw0 swhddiw0 dkainhkeg arkps aiwe keti tjg trhnjgh

Ehshd

1% dkainhkeg sidutkie, =% vksnius dkainhkeg

Fir ehshd ehshd ketumh ketumhtki tkie0 e0 sih sih` ` cudtkp cudtkpdg dg nittie swhms ir ehshd hkrwhy ke sidutkie hea kesgrt keti tjg eisg. Hdtgrehtkvgdy, chy keognt vksniuss keti ehshd phsshlg vksniu phsshlg uskel 82-cD syrkelg hea jhvg phtkget sekff mhn` keti tjriht.

h

Aiskel ks dkstga fir haudt phtkgets, hea sjiuda mg ciakfkga fir tjg pgakhtrkn phtkget0 Aiskel phtkget0 rgnic rgniccgecgeaga chx wgkljt-mhsga aisg if tipknhd dkainhkeg ks :.= cl/`l.

Qhmdg 1 Haouentkvg hlgets fir sgahtkie hea hehdlgskh ke hwh`g ketumhtkie Aisg ke Hvgrhlg h

Cgaknhtkie Kektkhd Aisg Cgaknhtkie @gth @g thck ckeg eg 2. 2.8„ 8„2. 2.> > cl/` cl/`l l KV

Haudt Wsg Niccgets =2 cl cl,, ^gahtkie, Rrgfgrrga Rrgfgr rga hlget, aigs eit chy rgpght hehdlgskh nhusg jypitgeskie, 82-cl midusgs prgsgrvgs rgspkrhtiry arkvg, chy kenrghsg sgnrgtkies

Rripifid

72„822 cl

2.7„8 cl/`l KV

^gahtkie

Nhutkie kf jypitgeskvg, nhe nhusg ivgr-sgahtkie ir rgspkrhtiry agprgsskie

Ckahz Ck ahzidh idhc c =2„12 =2„12  c l/`l KV/KC = =„ „1 cl

^gahtkie

Mgeziakhzgpkeg if njikng aug ti rhpka ie hea iff, nhe nhusg ivgr-sgahtkie hea rgspkrhtiry agprgsskie

Fgetheyd

Hehdlgskh

]hpka ie hea iff, nhe nhusg rgspkrhtiry rgspkrhtiry

2.7„=  c l/`l KV

72„822  c l

agprgsskie, rgvgrskmdg wktj ehdixieg h

Kektkhd aisgs hrg diwgr tjhe fir typknhd pringaurhd sgahtkie0 sthrt diw hea rgpght aisgs wktj lihd ti `ggp phtkget phtkget rgdhxga, rgdhxga, mut spiethegiusdy spiethegiusdy mrghtjkel hea hriushmdg. hriushmdg.

Aiwedihaga fir Heieycius Wsgr (e/h) ht Qjg Wekvgrskty if Hrkzieh fric [email protected] my Gdsgvkgr ie Oheuhry 21, =2==. Fir pgrsiehd usg iedy. Ei itjgr usgs wktjiut pgrcksskie. Nipyrkljt ©=2==. Gdsgvkgr Ken. Hdd rkljts rgsgrvga.

 

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=:

CnJulj & ]gphesjg`

Cist phtkgets wjisg sycptics jhvg rgsidvga nicpdgtgdy nhe mg aksnjhrlga jicg. Chey lukagdkegs lukagdkegs rgniccge rgniccgea a he imsgrv imsgrvhtkie htkie pgrkia if 1 jiurs ti 6 jiurs ke tjg GA hftgr tjg rgsidutkie if hehpjydhxks ke iragr ti whtnj fir rgnurrgeng if sycptics. Qjks rgniccgeaht rgnic cgeahtkie kie ks eit gvkageng mhsga, jiwgv jiwgvgr. gr. Mkpjhskn ]ghntkies  H mkpjhskn hehpjydhntkn rghntkie rgfgrs ti tjg rgnurrgeng if sycptics hftgr tjg kektkhd gpksiag if hehpjydhxks jhs rgsidvga wktjiut hey furtjgr gxpisurg ti tjg trkllgr. 1> Qjg phtjilgegsks mgjkea mkpjhskn rghntkies ks eit ueagrstiia nicpdgtgdy. ^gvgrhd tjgirkzga cgnjhekscs kenduag agdhyga rgdghsg if kefdhcchtiry cgakhtirs, hntkvhtkie if  sgnieahry sgnie ahry kefdhcc kefdhcchtiry htiry phtjwh phtjwhys, ys, pridie pridielga lga hms hmsirptkie irptkie if hetklg hetklge e ke ir irhd hd kelgs kelgstkies, tkies, ir skcpdy rgnurrgeng if h tgcpirhrkdy ketgrruptga rghntkie hftgr trghtcget jhs wire 1>,,11 iff.1> Wefirtuehtgdy, kt ks akffknudt ti prgaknt wji wkdd agvgdip h mkpjhskn rghntkie. Ndkeknhd prgakntirs jhvg mgge pripisga, mut tjgy hrg eit nieskstget hnriss stuakgs. ^gvgrhd rks` fhntirs fir h mkpjhskn rgspiesg tjht jhvg mgge agsnrkmga kenduag he kektkhd prgsget prgs gethtk htkie ie wktj sgv sgvgrg grg fgh fghtur turgs gs ir jyp jypitg itgesk eskie, ie, cud cudtkpd tkpdg g ais aisgs gs if gpke gpkegpj gpjrke rkeg g rgqukrga rgqu krga,, agdh agdhyga yga hac hackeks kekstrh trhtki tkie e if gpk gpkegp egpjrk jrkeg eg (62 (62„8; „8;2 2 cke ckeutg utgs s hft hftgr gr syc sycpti ptic c iesgt), iesgt if  if   sycp sycptics tics lrghtgr tjhe >2 ckeutgs hftgr tjg kektkhd gxpisurg, ir he ue82, 1>,11 82,1>, `eiwe trkllgr. Qjgrg ks ei nieskstget gvkageng tjht sji sjiws tjht tjg usg if lduninirtknikas agnrghsgs tjg dk`gdkjiia if h mkpjhskn rghntkie. 17 Qjg Qj g ke k enkageng if mkpjhskn rghntkies jha mgge prgvkiusdy agsnrkmga ti mg hs jklj hs 1>,16 Ke cirg rgnget, dhrlgr stuakgs, tjg kenkageng rhelgs mgtwgge 2.1% hea =2%.1>, 1, Qjg tkcg if iesgt if mkpjhskn rghntkies rgpirtga ks vhrkhmdg, mgtwgge 8 jiur hea ,1: Qjks Qjk s nhd nhdds ds ket keti i qug qugssiutskag iutska g if ttjg jg typknh typknhdd 1-jiu 1-jiurr ti 6 6-jiur -jiur GA ims imsgrvhtk grvhtkie ie pgr pgrkia. kia.1>, tkie tjg utkdkty if hey stheahra dgeltj if GA imsgrvhtkie. Qjg pgrkia if imsgrvhtkie sjiuda sjiud a mg thkdirga ti tjg keakvkauhd phtkge phtkget, t, hea cheah cheahtiry tiry aurhtkie aurhtkies s sjiuda mg hmheaiega. Fir gxhcpdg, h phtkget prgsgetkel wktj sgvgrg sycptics rgqukrkel cudtkpdg aisgs if gpkegpjrkeg wjisg sycptics hrg rgsidvga chy mg imsgrvga fir sgvgrhd jiurs hftgr sycptic rgsidutkie. H phtkget wktj dgss sgvgrg sycptics rgsidvkel hftgr 8 aisg if gpkegpjrkeg, jiwgvgr, chy mg aksnjhrlga siie hftgr sycptic rgsidutkie. Itjgr rghsies ti nieskagr imsgrvhtkie kenduag sklekfknhet nhrakipudciehry nicirmkaktkgs, jkstiry if mkpjhskn rghntkies, hea dkcktga hnngss ti cgaknhd nhrg. Hdd phtkgets

sjiuda mg whrega if tjg pitgetkhd fir rgnurrgeng if sycptics hea kestruntga ti rgture ti tjg GA pricptdy kf tjgy ai innur. Aksnjhrlg Cgaknhtkies  Hdd phtkgets sjiuda mg aksnjhrlga jicg wk wktj tj h prgsnrkptkie fir he gpk gpkegpjrkeg egpjrkeg hutike ogntir hea kestruntga ti jhvg kt ie tjgkr pgrsie ht hdd tkcgs. Wefirtuehtgdy, cudtkpdg imsgrvhtkie imsgrv htkiehd hd stua stuakg kgs s jhv jhvg g sjiwe rhtgs if gpkegpjrkeg prgsnrkptkie ht aksnjhrlg ti 8>,,1;„78 mg dgss tjhe kaghd. 8> Qjks ks h pitgetkhddy dkfg-shvkel ketgrvgetkie, hea kts kcpirtheng nheeit mg strgssga geiulj. Kt ks ei eitt ue ueni nicc ccie ie fir fir ph phtk tkge gets ts ti mg aksn aksnjh jhrl rlga ga wk wktj tj sg sgvg vgrh rhdd ah ahys ys if he hetk tkjk jkst sthc hcke kegs gs hea nirtknistgrikas. Qjks jhs eit mgge sjiwe, jiwgvgr, ti rgaung pitgetkhd sycptic rgnurrgeng hea kt ks eit uekfircdy rgniccgeaga hnriss lukagdkegs. > Nirtknistgrikas, gvge ke sjirt niursg niursgs, s, hrg eit mgekle hea chy jhvg havgrsg gffgnts, kenduake kenduakel l jypgrldyngckh ldyng ckh hea eguri eguripsynj psynjkhtrkn khtrkn sycptics. Haaktkiehddy, Haaktkiehddy, hetkj hetkjksthcke ksthckegs gs nhe nhus nhusg g ariwskegss hea agdkrkuc, gspgnkhddy ke tjg gdagrdy pipudhtkie. Qjg riutkeg prgsnrkptkie if nirtknistgrikas hea stheakel-aisg hetkjksthckegs ht aksnjhrlg ks eit rgniccgeaga kf sycptics hrg rgsidvga. Rhtkgets nhe mg havksga ti th`g hetkjksthckegs hs Aiwedihaga fir Heieycius Wsgr (e/h) ht Qjg Wekvgrskty if Hrkzieh fric [email protected] my Gdsgvkgr ie Oheuhry 21, =2==. Fir pgrsiehd usg iedy. Ei itjgr usgs wktjiut pgrcksskie. Nipyrkljt ©=2==. Gdsgvkgr Ken. Hdd rkljts rgsgrvga.

 

Hehpjydhxks

eggaga fir nuthegius sycptics. Qjg mgegfkt if h sjirt niursg if irhd stgrikas ke tjisg wktj rgskauhd sycptics sjiuda mg wgkljga hlhkest tjg pitgetkhd jhrcs. FWQW]G AK]GNQKIE^ GA pritinids chy jgdp kcprivg nicpdkheng wktj mgst prhntkngs hea kcprivg nhrg if  phtkge pht kgets ts wktj heh hehpjy pjydhx dhxks. ks. Ke 8 rgt rgtris rispgn pgntkv tkvg g ims imsgrv grvhtk htkieh iehdd stu stuay, ay, phtk phtkget gets s wgr wgrg g cirg dk`gdy ti rgngkvg gpkegpjrkeg hftgr tjg kcpdgcgethtkie if he hehpjydhx hehpjydhxks ks GA iragr 7=

sgt. Xuhdkty nietrid mgenjchr`s if 822% utkdkzhtkie if gpkegpjrkeg ti trght hehpjydhxk dhxks s sj sjiu iuda da mg sg sgtt he hea a cg cghs hsur urga ga.. Haa Haaktk ktkie iehd hddy dy,, ]N ]NQs Qs rg rglh lhrak rakel el tj tjg g ut utkdkdkty kty if ha haou ouen entk tkvg vg hlgets hrg eggaga. Mgnhusg hetkjksthckegs hea nirtknistgrikas hrg eit dkfgshvkel hea jhvg dkttdg privga mgegfkt, kt ks eit uerghsiehmdg ti jhvg nietrid lriups wji ai eit rgngkvg rgngk vg tjgsg cgaknhtkie cgaknhtkies. s. Qjks wiuda jgdp gdunkahtg kf tjgrg ks hey ridg fir haouentkvg trghtcgets. ^WCCH][  Hehpjydhxks ks h pitgetkhddy aghady nieaktkie tjht, wjge trghtga nirrgntdy, nhe mg rgvgrsga rhpkady. Hdtjiulj rheaickzga nietriddga ahth rglhrakel trghtcget hrg dhn`kel, niesgesus rglhrakel chehlgcget gxksts. Hs ke hey rgsusnkthtkie, hkrwhy, mrghtjkel, hea nkrnudhtkie hrg gssgetkhd. Gpkegpjrkeg sjiuda mg hackekstgrga kccgakhtgdy. Gpkegpjrkeg pissgssgs tjg kaghd pjhrchnidilkn hntkies ti niuetgrhnt tjg phtjidilkn pringssgs ht pdhy. Haouentkvg hlgets kenduag kejhdga mrienjiakdhtirs, nirtknistgrikas, hea het hetkjk kjksth sthcke ckegs gs mut gpke gpkegpj gpjrke rkeg g hac hackeks kekstrh trhtki tkie e sji sjiuda uda eit mg agd agdhyg hyga. a. Hkrw Hkrwhy hy chehlgcget ks egngsshry wjge tjgrg hrg sgvgrg imstruntkvg ir rgspkrhtiry sycptics, hea hwh`g ketumhtkie chy mg tjg shfgst hea prgfgrrga cgtjia. Hehpjydhntkn sjin` sjiuda mg trghtga wktj KV gpkegpjrkeg hea ksitiekn fdukas, hea rgfrhntiry sjin` chy rgq rgqukr ukrg g haak haaktki tkiehd ehd vhs vhsipr iprgss gssirs irs.. M Mkpj kpjhsk hskn n rgh rghntk ntkies ies hrg rgd rgdhtkv htkvgdy gdy rhr rhrg g hea akff akffknu knudt dt ti prgaknt, hea hey imsgrvhtkie pgrkia sjiuda mg thkdirga ti tjg keakvkauhd phtkget. Gxtgeaga imsgrvhtkie fir uenicpdknhtga nhsgs wktj nicpdgtg rgsidutkie ks ueegngsshry. Rhtkgets sjiuda mg gaunhtga hmiut tjg skles hea trghtcget if hehpjydhxks, hea hdd phtkgets sjiuda mg aksnjhrlga wktj he gpkegpjrkeg hutikeogntir hea strknt rgture prgnhutkies. NDKEKN^ NH]G RIKEQ^ 



 







  Hehpjydhxks nhe prilrgss ti nhrakhn hrrgst rhpkady hea tjus cust mg trkhlga hea trghtga pricptdy.   KC gpkegpjrkeg gpkegpjrkeg ks tjg nirg if hehpjydhxks hehpjydhxks trghtcget, mut kt ks ueagru ueagrutkdkzg tkdkzga a aug ti niengres fir prgnkpkthtkel hrrytjckh ir ksnjgckh.   Fhkdurg Fhkdurg ti privkag gpkegpjrkeg gpkegpjrkeg chy rgsudt ke wirsg iutnicgs.  Nirtknistgrikas, hetkjksthckegs, hea kejhdga mrienjiakdhtirs egvgr sjiuda mg lkvge ke pdhng if ir prkir ti tjg hackekstrhtkie if gpkegpjrkeg.  KV gpkegpjrkeg midus ir kefuskie sjiuda mg usga fir phtkgets ke sjin`0 jiwgvgr, privkagrs sjiuda sjiud a fhckdkhrkzg fhckdkhrkzg tjgcsgdvgs tjgcsgdvgs wktj aiskel, aiskel, mgnhu mgnhusg sg grrirs ke hackekstrhtk hackekstrhtkie ie nhe dgha ti sklekfknhet havgrsg iutnicgs kenduakel hrrytjckhs hea cyinhrakhd kefhrntkie.   Ke Ketu tumh mhtk tkie ie chy chy mg eg egng ngss sshr hry y ke tj tjg g nhsg nhsg if sg sgvg vgrg rg hkrw hkrwhy hy imst imstru runt ntki kie e mut nicg nicgss wk wktj tj tj tjg g rks` rks`ss if wirsgekel jypitgeskie hea h akffknudt hkrwhy.   Hwh`g ketumhtkie chy mg tjg shfgst hea prgfgrrga cgtjia fir phtkgets wktj prilrgsskvg hkrwhy imstruntkie.

Aiwedihaga fir Heieycius Wsgr (e/h) ht Qjg Wekvgrskty if Hrkzieh fric [email protected] my Gdsgvkgr ie Oheuhry 21, =2==. Fir pgrsiehd usg iedy. Ei itjgr usgs wktjiut pgrcksskie. Nipyrkljt ©=2==. Gdsgvkgr Ken. Hdd rkljts rgsgrvga.

 

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>2

CnJulj & ]gphesjg`

AK^NDI^W]G Qjg hutjirs jhvg ei fkehenkhd aksndisurgs ti rgpirt. ]GFG]GENG^

8.  ^hcpsie JH, Cueiz-Furdiel H, Nhcpmgdd ]D, gt hd. ^gniea sycpiskuc ie tjg agfkekt agf kektkie kie hea che chehlg hlgcge cgett if heh hehpjy pjydhx dhxks? ks? suc succhry chry rgp rgpirt„ irt„sgn sgniea iea Eht Ehtkie kiehd hd Kestktutg if Hddgrly hea Kefgntkius Aksghsg/Fiia Hddgrly hea Hehpjydhxks Egtwir` sycpiskuc. Hee Gcgrl Cga =22601„:2. =22601„:2. =.  Rucpjrgy ]^. Dgssies fir chehlgcget if hehpjydhxks fric h stuay if fhthd rghntkies. Ndke Gxp Hddgrly =2220>2(:)?8811„72. =2220>2(:)?8811„72. >.  Nhcpmgdd ]D, Dk OQ, Ekn`dhs ]H, gt hd, Cgcmgrs if tjg Oiket Qhs` Firng, Rrhntkng Rhrh Rh rhcg cgtg tgrr \i \ir` r`lr lriu iup. p. Gc Gcgr grlg lgen eny y ag agph phrtc rtcge gett akh akhle leis isks ks he hea a tr trgh ghtc tcge gett if hehpjydhxks? h prhntkng phrhcgtgr. Hee Hddgrly Hstjch Kccueid =281088>(6)? 7;;„62:.. 7;;„62: 1.  Rucpjrgy ]^. Fhthd pisturg ke hehpjydhntkn sjin`. O Hddgrly Ndke Kccueid =22>0 88=(=)?178„=.. 88=(=)?178„= 7. Jiwg M, Lhgth Q Q.. Hehpjydhx Hehpjydhxks, ks, hddgrlkgs hddgrlkgs,, hea helkig helkigagch. agch. Ke? Qketkeh Qketkehddk ddk O, ga. Qketkehddks gcgrlgeny cgaknkeg h nicprgjheskvg stuay lukag :tj gaktkie0 =286. 6.  Curhri H, ]imgrts L, \irc C, gt hd. Hehpjydhxks? lukagdkegs fric tjg Guripghe Hnhagcy if Hddgrly hea Ndkeknhd Kccueidily. Hddgrly =28106;(:)?82=6„17. =28106;(:)?82=6„17. =. =2870:(8)?>=. ;.  ^ihr O, Rucpjrgy ], Nhet H, gt hd. Gcgrlgeny trghtcget if hehpjydhntkn rghntkies„lukagdkegs fir jghdtjnhrg privkagrs. ]gsusnkthtkie =22:0(=)?>1(=)?>1=. =28:06(8>=. ]imgrts O], Lu Z, gt hd. Gpkegpjrkeg Gpkegpjrkeg hmsirptkie hmsirptkie ke njkdarge wktj h jks87.   ^kcies FG, ]imgrts tiry if hehpjydhxks. O Hddgrly Ndke Kccueid 8;;:0828(8 Rt 8)?>>„>„. Aiwedihaga fir Heieycius Wsgr (e/h) ht Qjg Wekvgrskty if Hrkzieh fric [email protected] my Gdsgvkgr ie Oheuhry 21, =2==. Fir pgrsiehd usg iedy. Ei itjgr usgs wktjiut pgrcksskie. Nipyrkljt ©=2==. Gdsgvkgr Ken. Hdd rkljts rgsgrvga.

 

Hehpjydhxks

8;.   Mhutksth G, ^kcies FG, ^kcies @O, gt hd. Gpkegpjrkeg fhkds ti jhstge jgciayehckn rgnivgry ke fuddy agvgdipga nhekeg hehpjydhntkn sjin`. Ket Hrnj Hddgrly Kccueid =22=08=:(=)?878„61. =22=08=:(=)?878„61. =2.   Jidage A, ]hcknj O, Qkcc G, gt hd. ^hfgty nieskagrhtkies hea lukagdkeg-mhsga shfg shf g usg rgn rgnicc iccgea geahtk htkies ies fir —mi —midus dus-ai -aisg– sg– vhs vhsipr iprgs gssir sirs s ke tjg gcg gcgrlg rlgeny eny agphrtcget. Hee Gcgrl Cga =28:0„;=. =28:0„;=. =8.  Qkdtie DO, Glkelgr @J. Wtkdkty if pusj-aisg vhsiprgssirs fir tgcpirhry trghtcget if jypitgeskie ke tjg gcgrlgeny agphrtcget. O Gcgrl Eurs =28601=(>)?=)?=)?1;1„:. =28;0>)?1;1„: . jgrr CC CC.. Nd Ndke kekn knhd hd ims imsgr grvh vhtk tkie ies s ie tj tjg g pht phtji jipj pjys yski kidi dily ly he hea a tr trgh ghtc tcge gett if =>.   Fks Fksjg hehpjydhntkn nhrakivhsnudhr niddhpsg. Hehgstj Ketgeskvg Nhrg 8;:6081(8)?8„>< =7.  Njii @O, ^kcies G, ^jgk`j H. Lduninirtknikas fir tjg trghtcget if hehpjydhxks? ninjrheg systgchtkn rgvkgw. Hddgrly =282067(82)?8=27„88. =282067(82)?8=27„88 . =6.  Dkyhehlg N@, Lhdhpphttjy R, ^gegvkrhteg ^D. Nirtknistgrikas ke chehlgcget if hehpjy heh pjydhx dhxks0 ks0 h sys systgc tgchtkn htkn rgvkgw if gvk gvkage ageng. ng. Gur Hee Hddg Hddgrly rly Ndke Kcc Kccuei ueidd =286(7)?16=„:. =2220>6(7)?16=„:. Qiil iiliia iia OJ. Mgt Mgth-m h-mdin din`gr `gr tjg tjgrhpy rhpy hea tjg rks rks` ` if heh hehpjy pjydhx dhxks. ks. NCHO 8;: 8;:.  Dhel AC, Hdpgre CM, Vkskethkegr RF, gt hd. Gdgvhtga rks` if hehpjydhntika rghntkie fric rhakilrhpjkn nietrhst cgakh ks hssinkhtga wktj mitj mgth-mdin`gr gxpisurg hea nhrakivhsnudhr aksiragrs. Hrnj Ketgre Cga 8;;>087>(8>„12. 8;;>087>(8>„12. >1.  _hdilh LR, AgDhngy \, Jidcmig G, gt hd. Ldunhlie rgvgrshd if jypitgeskie ke h nhsg if hehpjydhntika sjin`. Hee Ketgre Cga 8;:60827(8)?67„6. 8;:60827(8)?67„6. >7.  Ohvgga E, Ohvgga J, Ohvgga ^, gt hd. ]gfrhntiry hehpjydhntika sjin` pitgetkhtga my mgth-mdin`grs. Nhtjgt Nhrakivhsn Akhle 8;;60>;(1)?>:>„1. 8;;60>;(1)?>:>„1. >6.   Jgytche C, ]hkemkra H. Wsg if hdpjh-hlieksts fir chehlgcget if hehpjydhxks innu in nurr rrke kel l ue ueagr agr he hehg hgst stjg jgsk skh? h? nh nhsg sg st stua uakg kgs s he hea a rg rgvk vkgw gw.. He Hehg hgst stjg jgsk skh h =2 =221 2100 7;(8=)?8=82„7.. 7;(8=)?8=82„7 >
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