Historia Clinica en Pediatria

 

E@^SHW@B ND@A@NB KA YKC@BSW@B

Db e`sthr`b ndïa`nb pkc`âtr`nb, ks ua `astruokath oàc`nh dkjbd ka kd quk sk rkj`strba dhs batknkckatks g`hdþj`nhs, pbthdþj`nhs y kvhdut`vhs ckd a`òh. Ks kd puath ck pbrt`cb ckd rbzh rbzhab abo` o`ka kath th oà oàc` c`nh nh pbrb pbrb ckf` ckf`a` a`rr kd c` c`bj bjaþ aþst st`n `nhh y tr trbt btbo bo`k `kat athh ck ckdd pb pbn` n`ka katk tk.. Ks `oprksn`ac`gdk pbrb kd nhatrhd ck db sbduc y skju`o`kath ck db kafkrokcbc (ka nbsh ck kx`st`r). Db kstrunturb jkakrbd quk thcb e`sthr`b ndïa`nb pkc`âtr`nb ckgk tkakr= h h h h h h

F`neb ck @ckat`f`nbn`þa Batknkckatks ekrkchfbo`d`brks Batknkckatks pkrshabdks ah pbthdþj`nhs Batknkckatks pkrshabdks pbthdþj`nhs Ybckn`o`kath bntubd @atkrrhjbthr`h phr bpbrbths y s`stkobs

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Kxpdhrbn`þa Dbghrbthr`hsfïs`nb rkbd`zbchs C`bjaþst`nh= nbrbntkrïst`nbs jkakrbdks

F@NEB CK @CKAS@F@NBN@ÞA  h h h h h h h h

 Ahogrk Kcbc ^kxh Fkneb ck abn`o`kath Dujbr ck rks`ckan`b Wkd`j`þa Ksnhdbr`cbc @afhrobatk = pbrkatksnh y ksnhdbr`cbc

 BASKNKCKASK^ EKWKCHFBO@D@BWK^  h h h h

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Ckd Ybcrk Ck db Obcrk Ck dhs ekrobahs Ck dhs bgukdhs, tïhs y pr`ohs E`sthr`b knhaþo`nb fbo`d`br  Ndbs`f`nbn`þa ck db fbo`d`b

 

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Ybcrk= ïcko. Ekrobahs= kcbc, skxh, kstbch ck sbduc. Bgukdhs= tïhs, pr`ohs quk prkskatka bdjuab kafkrokcbc ck `ophrtban`b. Obcrk= kcbc, kstbch n`v`d, ksnhdbr`cbc, trbgbmh, `ajrksh/oks, ehrbs ck trbgbmh, kstbch ck sbduc, thx`nhobaïbs. Batknkckatks ck btþp`bs fbo`d`brks

 C@BJAH^S@NH CK FBO@D@B h h h

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S`ph ck Fbo`d`b=  Aundkbr, kxtkasb, rknhast`tu`cb h ck ua shdh pbcrk. Fuan`habd`cbc= fuan`habd h c`sfuan`habd, ckpkac`kach s` nbcb o`kogrh ck db fbo`d`br mukjb kd rhd quk dk nhrrksphack. C`aâo`nb fbo`d`br< qu`àa ks kd prhvkkchr, qu`àa nu`cb bd a`òh.

 BASKNKCKASK^ YKW^HABDK^ AH YBSHDÞJ@NH^  h h h h h h h h h

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Batknkckatks prkabtbdks Batknkckatks pkr`abtbdks Batknkckatks akhabtbdks `aokc`bths Cksbrrhddh ps`nhohthr  Ckat`n`þa Bd`okatbn`þa @aoua`zbn`haks Ebg`tbt k e`j`kak pkrshabd Yrkabtbdks= Obcrk jkstb, pbrb, nksârkbs, bghrths, kcbc b db quk sk kogbrbzh ckd  pbn`katk, skobabs ck jkstbn`þa, nhatrhd prkabtbd, phr ph r qu`àa, pkr`hc`n`cbc, nhopd`nbn`haks curbatk kd kogbrbzh, bd`okatbn`þa curbatk kd kogbrbzh, trbuobt`sohs curbatk kd o`soh. Ykr`abtbdks = nbrbntkrïst`nbs ckd trbgbmh ck pbrth, curbn`þa ckd trbgbmh ck pbrth, skobabs ck jkstbn`þa, chack fuk btkac`cb, nhoh fuk hgtka`ch kd prhcunth, ka cþack sk btkac`þ, eugh nhopd`nbn`haks curbatk db kxtrbnn`þa, sk ut`d`zþ fþrnkps, nbrbntkrïst`nbs ckd dïqu`ch boa`þt`nh y ck db pdbnkatb. Wksp`rþ y ddhrþ kd prhcunth bd abnkr  Nubd fuk db nbd`f`nbn`þa ck Bpjbr  Nubd fuk db nbd`f`nbn`þa ck ^`dvkroba Bokr`tþ oba`hgrbs ck rkba`obn`þa kspkn`bdks tbdks nhoh= -  ghdsb ck hxïjkah - vkat`dbn`þa bs`st`cb nha bogý

 

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@atugbn`þa Okc`nbokaths Yhsabtbdks= Bokr`tþ kstbr ka `anugbchrb, nubath t`koph y phrquà.

 BASKNKCKASK^ J@AKNHDÞJ@NH^  h

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Ka a`òbs= Ka ktbpb Ksnhdbr y Bchdksnkatk, `andu`r  Kcbc ck `a`n`h ck Skdbrnb. Kcbc ck `a`n`h ck Yugbrnb. Kcbc ck `a@n`h ck Bcrkabrnb. Kcbc ck Okabrnb Kcbc J`aknhdþj`nb (S`koph trbasnurr`ch katrk db okabrnb y kd ohokath ck kvbdubn`þa) N`ndhs Okastrubdks= Frknukan`b Curbn`þa Nbat`cbc ( auo. thbddbs prhokc`h/ cïb) C`sokahrrkb ^`/ Ah Ka a`òhs= Ka vbrhaks skrïb nhavka`katk `andu`r= @a`n`h ck Yugbrnb @a`n`h ck Bcrkabrnb Kcbc ck kspkrobqu`b

 CK^BWWHDDH Y^@NHOHSHW h

Cksbrrhddh Ys`nhohthr=

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Ohthr Ohthr f`ah jruksh Dkajubmk shn`bd bcbptbt`vh

 CK^BWWHDDH OHSHW F@AH, kmkopdhs= h

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Y`azb f`ab ebnkr rbybs ebnkr uab nruz ebnkr ua tr`âajudh ebnkr ua nubcrbch ebnkr ua rkntâajudh

 

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ebnkr ua rhogh Ksnr`gk pbdbgrbs

 CK^BWWHDDH OHSHW JW[K^H h

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^hstàa nkfâd`nh > oksks Whcbo`kath ; oksks ^kckstbn`þa nha byucb ; oksks ^kckstbn`þa shdh 6 oksks Jbtkh 5-29 oksks G`pkckstbn`þa 27-2; oksks ^ug`r y gbmbr ksnbdkrbs s`a bdtkrabr dhs p`ks 7 bòhs Gr`anbr ka chs p`ks 7 bòhs ^ug`r y gbmbr bdtkrabach dhs p`ks 3 bòhs Gr`anbr ka ua p`k 3-; bòhs

 DKAJ[BMK  h

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^ha`chs juturbdks Ohahsïdbghs G`sïdbghs Frbsks ck > pbdbgrbs Dkajubmk fdu`ch ck oâs ck > pbdbgrbs Nhoprkas`þa ck nhsbs bgstrbntbs Yrhauan`bn`þa ck db W y ^

 ^HN@BD-BCBYSBS@VH h

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2rb. Bjust`b ck skpbrbn`þa 7cb bajust`b ck skpbrbn`þa Mukjh ka pbrbdkdh Mukjh ka jruph Wkdbn`þa nha sus nhopbòkrhs y fbo`dbrks

 BD@OKASBN@ÞA  h

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^kah obtkrah= nubath t`koph Bjdbntbn`þa= nhoh sk `a`n`þ @atkjrbn`þa c`ktb fbo`d`br 

 

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Jruphs ck bd`okaths ka nbat`cbc y nbd`cbc phr skobab ( nbrak, dknek, eukvh, frutbs, vkrcurbs, nkrkbdks y dkjuo`ahsbs)

 CKAS@N@ÞA  h

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@a`n`h ck db ckat`n`þa Nuâach `a`n`b db bahchan`b pbrn`bd, db pr`okrb h skjuacb8 Nuâatbs p`kzbs ckatbr`bs t`kak8 Eb tka`ch nbr`ks prkv`bokatk8 Eb usbch bdjýa bpbrbth ck hrthchan`b8

 EÂG@SBS  h

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Nhac`n`haks ck db ebg`tbn`þa, S`ph ck nhastrunn`þa, ck nuâaths nubrths nhastb. Nukatb nha skrv`n`hs8 , ka cþack kstb dhnbd`zbcb. Nuâatbs pkrshabs v`vka beï8 Nhav`vkan`b nha ba`obdks

 E@J@KAK  h

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Nbcb nuâach sk gbòb8 Nbcb nubach sk nbog`b ck rhpb Dbvbch ck c`katks

 BASKNKCKASK^ YKW^HABDK^ YBSHDÞJ@NH^  h

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Kcbc ckd pbckn`o`kath S`ph ck pbckn`o`kath Kvhdun`þa Nhopd`nbn`haks Srbuoât`nhs, bdàrj`nhs y trbasfus`habdks

 YBCKN@O@KASH BNS[BD   Cksjdhsbr s`jahs y sïathobs ck obakrb nrhahdþj`nb. Kmo= @a`n`b ebnk 7 oksks nha= h

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Kckob...........7oksks C`sakb...........2 skobab

 

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Shs------------7 cïbs Yhstkr`hrokatk ebnkr db sko`hdhjïb cktbddbcb ck nbcb uah ck dhs s`jahs y sïathobs, `anduykach dhs okc`nbokaths quk rkn`g`þ y db rkspukstb quk tuvh nha kddhs.

 KUYDHWBN@ÞA FÏ^@NB h

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Okc`cbs batrhphoàtr`nb= pksh, tbddb, YN, YS, ^@, NG, NY, pd`nhoktrïb, okc`n`þa ck fhatbakdb batkr`hr. Nâdnudh ckd ârkb ck jrbsb y ârkb ousnudbr, @ON. s`jahs v`tbdks= SB, FN, FW y tkopkrbturb

 

 @A^YKNN@ÞA JKAKWBD ^kxh, kcbc bpbrkat bpbrkatk, k, nhafhro` nhafhro`cbc, cbc, kstbch autr` autr`n`habd n`habd bpbrkatk bpbrkatk,, kstbch ck bdkrtb, bdkrtb, kxprks`þa kxprks`þa fbn`bd, obrneb, ohv`o`kaths ksphatâakhs, nbrbntkrïst`nbs ckd ddbath, t`ph ck rksp`rbn`þa, nhhpkrbn`þa, nbrbntkrïst`nbs ckd dkajubmk, y s` kd pbn`katk kstâ bnhopbòbch.

 Y@KD P FBAKWB^  h

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Nhdhrbn`þa, euokcbc, skas`g`d`cbc tkopkrbturb dhnbd y jkakrbd`zbcb krupn`haks, cksnbobn`haks, udnkrbn`haks n`nbtr`nks, kckob, aþcudhs, kqu`ohs`s ekobaj`hobs, pktkqu`bs, eukddbs ck rbsnbch, obanebs ohajþd`nbs e`pkrnrþo`nbs k e`phnrþo`nbs Nbrbntkrïst`nbs ckd pkdh ck nbgkzb, bx`dbr, pug`bah. Nhdhrbn`þa ck db uòbs, fhrob, frbj`d`cbc ck dbs uòbs. C`str`gun`þa bahrobd ckd tkm`ch d`afât`nh= tbobòh, nhafdukan`b, nhdhrbn`þa, ohv`d`cbc y buokath ck db tkopkrbturb dhnbd, chdhr b db pbdpbn`þa.

NBGK]B h

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Fhrobb ck Fhro ckdd nr nrâa âakh kh,, `opd pdba batb tbn` n`þa þa ckd ckd pk pkddh, fr frbj bj`d `d``cb cbc, c, hp hpbn bn``cb cbc, c, t`ò `òb, b, `opàt`jh,fhrýanudhs, pbrâs`ths. Sbobòh y tkas`þa ck dbs fhatbakdbs. ^uturbs bg`krtbs, nkrrbcbs, puat`fhroks, nbgbdjbcbs. Nrbakhtbgks, bahobdïbs þskbs htrbs. Bs`oktrïb fbn`bd, ckg`d`cbc ousnudbr Nkfbdhekobthob

 

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Ekobthob ^ugjbdkbd Frbnturb pbr`ktbd nha euac`o`kath

HMH^  h

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Bjuckzb v`subd, a`stâjous, pbrâd`s`s. Yârpbchs (dbjr`okh, gdkfhrhkspâsoh, pths`s, nkdud`t`s, nebd`bz`þa). Nhamuat`vb y nþrakb (qukrbt`t`s, nhamuat`v`t`s, `ntkr`n`b ktn). Yup`dbs(s`oktrïb, rkbnn`þa b db duz, bnhohcbo`kath, fhthfhg`b). Fhach ck hmh (pbp`dkckob, btrhf`b ck pbp`db, vbshs.

HÏCH^  h

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Bjuckzb buc`t`vb Nhacunth buc`t`vh kxtkrah y okogrbab t`opâa`nb(`atkjr`cbc, nhdhrbn`þa, nhajkst`þa, bghogbo`kath h rktrbnn`þa, prkskan`b ck sknrkn`þa h nukrph kxtrbòh).

 ABW@]  h

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 Abr`z= Ounhsb ( nhdhrbn`þa, udnkrbn`÷a, nhstrbs ekoét`nbs. ^knrkn`þa (nbrbntkr`st`nbs). Hgstrunn`þa= cksv`bn`þa ckd tbg`quk, pþd`phs, pskuchokokgrbabs, nukrph kxtrbòh k e`pkrtrhf`b ck nhraktks. Ghnb y Fbr`ajk= Dbg`hs (obdfhrobn`haks, dks`haks udnkrhsbs, f`surbs, quk`dhs`s ktn). Ybdbcbr= `atkjr`cbc y bspknth. C`katks= e`j`kak y aýokrh ck p`kzbs, nbr`ks, obanebs y obdb hndus`þa.

 GHNB h

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Ounhsb gunbd nhdhr  euokcbc dks`haks udnkrhsbs  pktkqu`bs Dkajub tbobòh `afdbobn`þa

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tuohrbn`haks Boïjcbdbs e`pkrko`b e`pkrtrþf`nbs kckob ýdnkrbs kxucbch  pskuchokokgrbabs

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sbgurrbd frka`ddh

bgsnkshs

 

N[KDDH h

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Fhrob y tbobòh kckob chdhr b db pbdpbn`þa fdkx`g`d`cbc  phs`n`þa ck db trâqukb t`rh`cks( tbobòh, nhas`stkan`b y ckspdbzbo`kath)

SÞWBU  h

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Sbobòh fhrob s`oktrïb ohv`o`kaths t`ph ck rksp`rbn`þa FW   pkrnus`þa y VV

NHWB]ÞA  h

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FN dhnbd`zbn`þa ck dbt`ch Wu`chs nbrc`bnhs shpdhs nbrc`hokjbd`b brr`to`b ktn  pbrâd`s`s ckd c`bfrbjob

 BGCHOKA 

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rkfdkmhs nutâakhs ekra`bs n`nbtr`z uog`d`nbd.

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Ykr`stbds`s dhnbd`zbn`þa c`rknn`þa ckd ohv`kach E`pkrkstks`b thah ousnudbr 

vhduoka Fhrob

chdhr supkrf`n`bd h prhfuach b db  prks`þa

 

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Eïjbch tbobòh nhas`stkan`b chdhr  Gbzh

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r`òþa vkm`jb tuohrbn`haks = dhnbd`zbn`þa, tbobòh, fhrob, nhas`stkan`b, ohv`d`cbc y chdhr 

 KUSWKO@CBCK^  h

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Ckfhro`cbcks nhajàa`tb= (duxbn`þa ck nbckrb, bahobdïbs ck dbs fbdbajks, p`à ghtt, kqu`ah vbrh, bnhacrhpdbs`b ktn.) Bcqu`r`cbs= rbqu`t`soh, sïf`d`s, tugkrnudhs`s. Brtr`t`s rkuobth`ck. Brt`nudbn`haks= buokath ck tbobòh, skas`g`d`cbc, tkopkrbturb, nhdhr y ohv`d`cbc

JKA@SBDK^  h

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Ckfhro`cbcks ekra`bs Ykak= f`ohs`s, bcekrkan`bs prkpun`bdks e`phspbc`bs). Skstïnudhs= tbobòh, e`crhnkdk, nr`pthrquïckb, trbas`duo`abn`þa , tuohrks, nhrcþa kspkroât`nh, vbr`nhnkdk. Vudvb= e`oka, bcekrkan`bs, sknrkn`þa, nd`tþr`s, `atkjr`cbc. Kvbdubr Sbaakr 

 BAH WKNSBD h

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Btrks`b Fïsurbs nhac`dhobs  prhdbpsh rkntbd kr`tkob pkr`babd bgsnksh pkr`babd bspknth

VB^N[DBW YKW@FÀW@NH h

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Nbrbntkrïst`nbs ckd pudsh Vbr`bn`þa ck uab kxtrko`cbc b htrb Nbog`hs ck nhdhrbn`þa ck db p`kd Yudsh Skas`þa brtkr`bd (grbzbdktk bprhp`bch

 

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Ddkabch nbp`dbr 

 AK[WHDÞJ@NH h

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Kstbch okatbd  A`vkd ck nhan`kan`b nhhpkrbn`þa hr`katbn`þa (t`koph, dujbr y  pkrshab) Bnt`tucks h ohv`o`kaths bahrobdks Okohr`b rkfdkmh ck ohrh `rr`tbg`d`cbc jr`th nkfâd`nh

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rkfdkmhs ck gýsqukcb, prkas`þa , sunn`þa y ckjdun`þa Dkajubmk Ykrïoktrh nkfâd`nh Okohr`b rkfdkmh ck ohrh `rr`tbg`d`cbc jr`th nkfâd`nh rkfdkmhs ck gýsqukcb, prkas`þa , sunn`þa y ckjdun`þa Dkajubmk Ykrïoktrh nkfâd`nh

 YBWK^ NWBAKBDK^  h

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@ Hdfbthr`h= sk kxpdhrb ka nbshs kspkn`bdks @@ Hpt`nh= nbophs v`subdks, fhach ck hmh. @@@, @V, V. Yup`dbs= tbobòh, s`oktrïb, rkspukstb ck db duz, bnhohcbn`þa, rkfdkmh nhaskasubd. Ohv`o`kaths hnudbrks, a`stbjous, kstrbg`soh, pths`s y pbrâd`s`s V@ Ohthr, kstrbg`soh nhavkrjkatk V@@ Bs`oktrïb fbn`bd, pkrnkpn`þa justbt`vb7/> batkr`hrks dkajub V@@@ Bjuckzb buc`t`vb, nhacunn`þa bàrkb, btbx`b @U, U Cksv`bn`þa ck db ývudb. Wkfdkmh abuskhsh, bnuoudh ck sknrkn`haks. U@ Kxpdhrbn`þa ck kstkrahndk`chobsth`ckh y trbpkn`h U@@ Yrhtrus`þa ck db dkajub, btrhf`b, tkogdhr y f`gr`dbn`þa.

 WKFDKMH^  h

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Hstkhtkac`ahshs= g`n`p`tbd, tr`n`p`tbd, rbc`bd, pbtkdbr, bqu`d`bah, ndhaus pbtkdbr, ndhaus bqu`d`bah. ^upkrf`n`bdks= bgcho`abdks, nrkobstkr`bah pbtkdbr, ehffoba, hppkaek`o, nebchnl.

NHHWC@ABN@ÞA  h

Yrukgb ckch abr`z

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Ohv`o`kaths bdtkrahs râp`chs Yrukgb tbdþa rhc`ddb t`g`b

 

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Y`k ckd pbn`katk b ïac`nk ckd kxbo`abchr  tkogdhrks y c`s`oktrïb.

FKAÞOKAH^ B[SHAÞO@NH^  h

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Ârkbs ck rkskqukcbc e`pkrsuchrbn`þa [a`fhro`cbc ck tkopkrbturb Wkfdkmh n`d`hksp`abd

 ^@^SKOB OHSHW ^KA^HW@BD h

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Cksbrrhddh ousnudbr= d`o`tbn`þa bd ohv`o`kath pbs`vh. Ohv`o`kaths vhduatbr`hs ckg`d`cbc r`j`ckz thah ousnudbr  fukrzh ousnudbr 

 O[^N[DBW h

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Kspbst`n`cbc ohv`o`kaths `avhduatbr`hs o`hndha`bs, ohv`o`kaths btktþs`nhs fbsn`nudbn`haks

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nhrk`nhs t`ns, nhavuds`haks chdhr , tkopkrbturb y tbnth

NHD[OAB VKWSKGWBD h

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^`jahs okaïajkhs r`j`càz ck aunb lkra`j  grucz`asl` nkfâd`nh y nhatrbdbtkrbd nurvbs ahrobdks kspbsohs ousnudbrks

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Fdkx`haks hp`stþthahs o`kdhoka`ajhnkdk ksnhd`hs`s x`fhs`s qu`stk p`dha`cbd