Laporan Kasus Tonsilitis
July 4, 2022 | Author: Anonymous | Category: N/A
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JBSD[BL S@LEBGPJPBL
BQPGBL I@S@LBUBBL BL@QU@QM SBEB Ll. [ E@LHBL UMLEBIBL UDLQMJ@IUDOM U@ILMI H@L@[BJ BL@QU@QM EM [POBG QBIMU MQJBO I@LEBJ
Emsusul Dj`g6 Lbob6 Jusm Mlebg Qmjvmb LMO6 ;327353303 ;327353303
MLQUMUPU U@ILDJDHM QBMLQ ebl I@Q@GBUBL SIP OPGBOOBEM]BG QP[BIB[UB UBGPL BFB[BL ;3;3/;3;2
KBK M S@LEBGPJPBL
M.
Jbtbr K`jbiblh
Udlsmjmtms o`rupbibl p`rbeblhbl yblh t`rfbem pbeb tdlsmj yblh ems`kbkibl dj`g vmrus btbu kbit`rm s`gmlhhb tdlsmj o`lfbem k`lhibi, o`rbg, o`julbi, ebl o`omjmim kmltmi-kmltmi putmg em p`rouibbllyb (H. V. Srbs`tyb, Iusuobstutm, & Iurlmbwbtm, ;327). Udlsmjmtms emkbhm o`lfbem ; tmp` ybmtu tdlsmjmtms biut ebl tdlsmjmtms irdlms (Sbjble`lh, Uuok`j, & E`gddp, ;325). Udlsmj`itdom o`rupbibl prds`eur dp`rbsm yblh prbitms ebl bobl ultui p`lhdkbtbl tdlsmjmtms irdlms (Qbvmtrm & ^mvmt, ;321). S`lblhblbl ly`rm biut pbsab dp`rbsm yblh tmebi kbmi bibl o`ly`kbkibl idopjmibsm i`s`gbtbl s`p`rtm pl`uodlmb, e``p v`ml tgrdokdsms, mln`ism, ly`rm irdlmi, ebl e`pr`sm (Srbkblebrm, Mlermbsbrm, & Obsid`l, ;327). Ly`rm bebjbg p`lhbjbobl s`lsdrmi ebl `odsmdlbj yblh tmebi o`ly`lblhibl bimkbt i`rusbibl fbrmlhbl, kbmi bitubj obupul pdt`lsmbj btbu yblh emhbokbribl ebjbo k`ltui i`rusbibl t`rs`kut (Kbgrueml, ;327). Q`abrb l`urdnmsmdjdhms, ly`rm ebpbt emijbsmnmibsmibl o`lfbem ; f`lms utbob ybilm ly`rm ldsms`ptmn ebl ly`rm l`urdpbtmi (Nbjjms, ;327). Udlsmj o`rupbibl sbjbg sbtu p`rtbgblbl tukug t`re`pbl. Bltmh`l yblh k`rbsbj ebrm mlgbjbl obupul mlh`stbl e`lhbl ouebg obsui i` ebjbo tdlsmj gmlhhb t`rfbem p`rjbwblbl p`rjb wblbl tukug ebl kmsb o`ly`kbkibl p`rbeblhbl dj`g vmrus yblh tuokug em o`okrbl ouidsb i`ouembl t`rk`ltui ndius mln`ism. I`bebbl mlm bibl s`obiml k`rbt fmib ebyb tbgbl tukug p`le`rmtb o`lurul bimkbt p`rbeblhbl vmrus s`k`juolyb. Udlsmjmtms biut yblh ems`kbkibl dj`g kbit`rm ems`kut p`rbeblhbl jdibj prmo`r. Q`t`jbg t`rfbem s`rblhbl tdlsmjmtms biut, tdlsmj bibl s`okug btbu kbgibl tmebi ebpbt i`okbjm s`gbt s`p`rtm s`oujb. S`ly`okugbl yblh tmebi s`opurlb bibl o`ly`kbkibl
p`rbeblhbl
rmlhbl
pbeb
tdlsmj.
S`rbeblhbl
ebpbt
o`ly`kbkibl i`jugbl tmebi lybobl i`pbeb p`le`rmtb k`rupb rbsb ly`rm sbbt o`l`jbl ibr`lb s`subtu yblh emt`jbl o`ly`ltug eb`rbg yblh o`lhbjbom p`rbeblhbl (Obujblb Nbig Nbig,, Ldvmbjem, & @jobtrms, ;32>).
Q`eblhibl Udlsmjmtms irdlms o`rupbibl p`lybimt yblh pbjmlh s`rmlh t`rfbem pbeb t`lhhdrdibl t`rutbob pbeb usmb oueb. oueb. S`lybimt mlm t`rfbem ems`kbki ems`kbkibl bl p`rbeblhbl pbeb tdlsmj dj`g ibr`lb i`hbhbjbl btbu i`tmebi`submbl p`ok`rmbl bltmkmdtmi pbeb pbeb p`le`rmtb p`le`rmtb tdlsmjmtms tdlsmjmtms biut (Sbjble`lh `t bj., ;325). Udlsmjmtms irdlms obsmg o`lfbem obsbjbg i`s`gbtbl utbob ebjbo kmeblh UGU s`gmlhhb ebjbo p`lbtbjbisblbbllyb tdlsmj`itdom o`lfbem pmjmgbl yblh yblh t`rkbmi ebl gbrus gbrus s`subm e`lhbl mlemibsm, kbmi kbmi mlemibsm bksdjut obupul mlemibsm r`jbtmn pbeb s`tmbp pbsm`l k`rk`eb-k`eb (Qbvmtrm & ^mvmt, ;321). Udlsmjmtms ebpbt o`ly`kbkibl ly`rm fmib o`lhbjbom p`rbeblhbl bimkbt p`ly`okugbl yblh tmebi s`opurlb. Fmib tdlsmjmtms tmebi t`rbtbsm, ly`rm bibl k`rtbokbg ebl o`ly`kbkibl i`jugbl yblh tmebi lybobl pbeb p`le`rmtb (Obujblb Nbig `t bj., ;32>). E`lhbl e`omimbl prbit`i p`jbyblbl bl`st`sm o`lhgbrusibl s`tmbp p`lbtb bl`st`sm o`lmlhibtibl p`lh`tbgubl ebl i`t`rbopmjbllyb ebjbo prds`s
p`jbyblbl
i`s`gbtbl
ebl
o`obgbom
p`lybimt
e`lhbl
o`op`rgbtmibl p`ok`rmbl bsugbl i`p`rbwbtbl bl`st`sm idlemsm pbsm`l s`abrb mlemvmeubj ([dv`rs `t bj., ;321 ). K`rebsbribl p`okbgbsbl jbtbr k`jbiblh embtbs, obib p`ltmlh emjbiuibl tmlebibl h`l`rbj bl`st`sm pbeb pbsm`l e`lhbl tmlebibl tdlsmj`itdom . Emjmgbt ebrm urbmbl embtbs ebl jmt`rbtur yblh beb obib o`ledrdlh p`lujms ultui o`jbiuibl bsugbl i`p`rbwbtbl pbeb pbsm`l e`lhbl embhlds` tdlsmjmtms irdlms.
MM.
[uousbl Obsbjbg
K`rebsbribl urbmbl ebjbo jbtbr k`jbiblh embtbs, obib emruousibl obsbjbg ‚Bsugbl ‚Bsugbl I`p`lbtbbl Bl`st`sm pbeb Ll. [ e`lhbl Udlsmjmtms Irdlms e`lhbl U`glmi H`l`rbj Bl`st`sm em [uobg Qbimt Msjbo I`lebj. MMM.
Uufubl B. Uufubl Pouo
O`ok`rmibl bsugbl i`p`lbtbbl bl`st`sm pbeb pbsm`l Udlsmjmtms Irdlms Irdl ms e`lhbl t`ilmi H`l`rbj Bl`st`sm. K. Uufubl Igusus
2. Obgbsmswb emgbrbpibl obopu o`ok`rmibl bsugbl i`p`lbtbbl bl`st`sm pbeb pbsm`l pr`, mltrb ebl pdst dp`rbsm yblh bibl emjbiuibl p`ok`rmbl h`l`rbj bl`st`sm. ;. Obgbsmswb emgbrbpbibl obopu o`jbiuibl p`rgmtulhbl ebl p`ok`rmbl t`rbpm abmrbl pbeb sbbt pr`, mltrb ebl pdst dp`rbsm. 1. Obgbsmswb emgbrbpibl obopu o`jbiuibl p`rgmtulhbl edsms p`ok`rmbl dkbt-dkbt bl`st`sm s`subm e`lhbl idlemsm pbsm`l. 5. Obgbsmswb emgbrbpibl obopu o`jbiuibl tmlebibl mltukbsm ebl o`ok`rmibl p`o`jmgbrbbl tmlebibl bl`st`sm. 0. Obgbsmswb
emgbrbpbibl
obopu
o`ok`rmibl
bsugbl
i`p`lbtbbl bl`st`sm s`t`jbg s`j`sbm dp`rbsm ebl bigmr ebrm bl`st`sm.
KBK MM UMLFBPBL U@D[M M.
S`lh`rtmbl
Udlsmjjmtms o`rupbibl mlnjbobsm btbu p`ok`lhibibl biut pbeb tdlsmj btbu boble`j ([``v`s, ;332). Udlsmjmtms bebjbg p`rbeblhbl pbeb tdlsmj yblh t`rfbem ibr`lb vmrus, kbit`rm, btbu fbour (Kjbai, ;33>). Udlsmjmtms bebjbg t`rebpbtlyb t` rebpbtlyb p`rbeblhbl uouo ebl p`ok`lhibibl ebrm fbrmlhbl tdlsmj e`lhbl p`lhuopujbl j`uidsmt, s`j-s`j `pmt`j obtm ebl kbit`rm pbtdh`l ebjbo irmptb (E`rrmasdl, ;33=) MM.
@tmdjdhm
S`ly`kbk t`rfbemlyb tdlsmjjmtms ybmtu dj`g beblyb mln`ism kbit`rm ebl vmrus, (Oblsfd`r, ;331)6 2. Qtr`ptdidius K`tb G`odjmtmius Qtr`ptdidius k`tb g`odjmtmius bebjbg kbit`rm hrbo pdsmtmn yblh ebpbt k`ri`okblh kmbi emt`lhhdrdibl yblh s`gbt ebl kmsb o`ly`kbkibl mln`ism sbjurbl lbnbs biut. ;. Qtr`ptdidius Sydh`l`sms Qtr`ptdidius pydh`l`sms bebjbg kbit`rm hrbo pdsmtmn k`ltui kulebr yblh tuokug ebjbo rbltbm pblfblh ebl o`ly`kbkibl mln`ism str`ptdidius hrdup B. Qtr`ptdidius Sydh`l`sms bebjbg p`ly`kbk kblybi p`lybimt p`ltmlh pbeb oblusmb k`rimsbr ebrm mln`ism igbslyb k`roujb emt`lhhdrbibl ebl iujmt. 1. Qtr`ptdidius ^mrmebls Qtr`ptdidius vmrmebls bebjbg i`jdopdi k`sbr kbit`rm str`ptdidius ido`lsbj yblh kbmi b-g`odjmtmi, o`lhgbsmjibl wbrlb gmfbu p`ibt bhbr ebrbg. ^mrmebls o`omjmim i`obopubl yblh ulmi smlt`sms e`istrbl ebrm hjuidsb yblh o`oulhimlibl o`r`ib o`obtugm bhr`hbt nmkrml-pjbt`j`t emibtup fbltulh yblh rusbi. 5. ^mrus Mlnju`lzb ^mrus mlnju`lzb bebjbg vmrus [LB ebrm nbomjm Drtgdoyxd vmrmeb` (vmrus mlnju`lzb). ^mrus mlm emtujbribl e`lhbl o`emuo uebrb o`jbjum k`rsml
pbeb oblusmb h`fbjb uouo yblh t`rfbem ybmtu e`obo, sbimt t`lhhdrdibl, sbimt i`pbjb, gmeulh t`rsuokbt. Ebjbo ibsus yblh kurui mlnju`lzb fuhb ebpbt o`ly`kbkibl t`rfbemlyb pl`uodlmb. MMM.
Blbtdom ebl Nmsmdjdhm
Udlsmj o`rupbibl kbhmbl ebrm fbrmlhbl jmondme yblh o`jmlhibrm nbrmlh ebl s`abrb idj`itmn emi`lbj s`kbhbm amlaml wbje`y`r. Amlaml mlm t`remrm ebrm fbrmlhbl jmondme ebrm ebsbr jmebg (tdlsmj jmebg), eub tdlsmj t`ibi, be`ldme, ebl fbrmlhbl jmondme pbeb emlemlh pdst`rmdr. Fbrmlhbl mlm k`rp`rbl s`kbhbm p`rtbgblbl t`rgbebp mln`ism, t`tbpm ebpbt o`lfbem t`opbt mln`ism biut btbu irdlms (K`grobl, ;333)
Hbokbr ;.2 Udlsmjmtms
Udlsmj t`remrm btbs6 b. Udlsmj nbrmlh`bjms btbu be`ldme, bhbi o`ldlfdj i`jubr ebrm btbs nbrmlh ebl t`rj`tbi em k`jbiblh idblb. k. Udlsmj pbjbtmlb btbu nbuambj, emjbpmsm dj`g `pmt`j k`rjbpms h`p`lh tblpb jbpmsbl tbleui. a. Udlsmj jmlhubj btbu tdlsmj pblhibj jmebg, `pmt`j k`rjbpms h`p`lh tblpb jbpmsbl tbleui. Udlsmj k`rnulhsm o`la`hbg bhbr mln`ism tmebi o`ly`kbr i` s`jurug tukug e`lhbl abrb o`lbgbl iuobl o`obsuim tukug o`jbjum oujut, gmeulh, ebl i`rdlhidlhbl, dj`g ibr`lb mtu tmebi fbrblh tdlsmj o`lhbjbom p`rbeblhbl. S`rbeblhbl pbeb tdlsmj ems`kut e`lhbl tdlsmjmtms, p`lybimt mlm o`rupbibl sbjbg sbtu hblhhubl U`jmlhb, Gmeulh ebl U`lhhdrdibl ( UGU ).Qmst`o moulmtbs beb ; obabo
ybmtu moulmtbs s`juj`r ebl guodrbj. Moulmtbs s`juj`r k`i`rfb e`lhbl o`okubt s`j (jmondme U) yblh ebpbt ‚o`obibl‚ iuobl ebl vmrus s`rtb o`okuluglyb. Q`eblhibl moulmtbs guodrbj k`i`rfb ibr`lb beblyb
s`j
(jmondme
K)
yblh
ebpbt
o`lhgbsmjibl
zbt
moouldhjdkujml yblh ebpbt o`okulug iuobl ebl vmrus. Iuobl yblh emobibl dj`g moulmtbs s`juj`r tdlsmj ebl be`ldme t`ribeblh tmebi obtm ebl t`tbp k`rsbrblh emsblb s`rtb o`ly`kbkibl mln`ism boble`j yblh irdlms ebl k`rujblh (Udlsmjmtms irdlms). Mln`ism yblh k`rujblh mlm bibl o`ly`kbkibl tdlsmj ebl be`ldme k`i`rfb t`rus e`lhbl o`oprdeuism s`j-s`j moul yblh kblybi s`gmlhhb uiurbl tdlsmj ebl be`ldme bibl o`ok`sbr e`lhbl a`pbt o`j`kmgm uiurbl yblh ldrobj. M^.
Sbtdnmsmdjdhm
Kbit`rm ebl vmrus obsui obsui ebjbo tukug o`jbjum sbjurbl lbnbs kbhmbl btbs, bibl o`ly`kbkibl o`ly` kbkibl mln`ism pbeb gmeulh gmeu lh btbu nbrmlh i`ouembl o`ly`kbr o`jbjum smst`o jmonb i` tdlsmj. Beblyb kbit`rm ebl vmrus pbtdh`l pbeb tdlsmj o`ly`kbkibl t`rfbemlyb prds`s mlnjb mlnjbobsm obsm ebl mln`ism s`gmlhhb tdlsmj o`ok`sbr ebl ebpbt o`lhgbokbt i`jubr obsuilyb uebrb. Mln`ism fuhb ebpbt o`lhbimkbtibl i`o`rbgbl ebl `e`ob pbeb nbrmlh s`rtb emt`ouibllyb `isuebt k`rwbrlb putmg i`bkubl pbeb tdlsmj s`gmlhhb o`ly`kbkibl tmokujlyb sbimt t`lhhdrdibl, ly`rm t`jbl, e`obo tmlhhm kbu oujut s`rtb dtbjhmb ybmtu ly`rm yblh o`lfbjbr i` t`jmlhb. (Lurkbmtm ;332). Sbeb Udlsmjmtms Biut, S`lujbrbl t`rfbem o`jbjum erdpj`t emoblb iuobl o`lhmlnmjtrbsm jbpmsbl @pmt`j i`ouembl kmjb @pmt`j mlm t`rimims obib fbrmlhbl Pondje sup`rimstbj k`r`bism emoblb t`rfbem p`ok`leulhbl rbeblh e`lhbl mlnmjtrbsm j`uidsmt pdjmodrnd luaj`br, s`eblhibl tdlsmjjmtms irdlmi t`rfbem ibr`lb prds`s rbeblh k`rujblh ,obib `pmt`j ouidsb ebl fbrmlhbl jmopdme t`rimims, s`gmlhhb pbeb prds`s p`ly`okugbl fbrmlhbl jmopdme emhbltm dj`g fbrmlhbl pbrut. Fbrmlhbl mlm bibl o`lh`rut s`gmlhhb s `gmlhhb rublh bltbrb `jdopdi o`j`kbr (irmptus) yblh bibl emmsm dj`g e`trmtus. Srds`s mlm o`jubs gmlhhb o`l`okus ibpsuj ebl bigmrlyb tmokuj purj`lhtbl e`lhbl fbrmlhbl s`imtbr ndsb tdlsmjbrms.
^.
Ijbsmnmibsm Udlsmjmtms
Obabo-obabo tdlsmjjmtms o`lurut Mobo O`hbltbrb (;33>), ybmtu s`kbhbm k`rmiut6 2. Udlsmjjmtms biut Udlsmj biut o`rupbibl rbeblh biut pbeb tdlsmj. Ems`kbkibl dj`g str`ptdadaaus pbeb g`odjmtmaus, str`ptdadaaus vmrmembls, ebl str`ptdadaaus pmdhyl`s, ebpbt fuhb ems`kbkibl dj`g vmrus. ;. Udlsmjmtms nbjmiujbrms Udlsmj o`ok`lhibi ebl gmp`r`oms, p`rouibbllyb emjmputm `isuebt emjmputm k`rabi putmg yblh o`lhmsm imptm tdlsmj yblh ems`kut e`trmtus. E`trmtus mlm t`rebpbt j`uidsmt, `pmt`j yblh t`rj`pbs bimkbt p`rbeblhbl ebl smsb-smsb obiblbl yblh t`rsblhiut. 1. Udlsmjmtms Jbiulbrms Kmjb k`rabi yblh k`re`ibtbl k`rsbtu ebl o`lhmsm jbaulb (j`iui-j`iui) p`rouibbl tdlsmj. 5. Udlsmjmtms O`okrbldsb (Q`ptms sdr` Ugrdbt) Kmjb `isuebt yblh o`lutupm p`rouibbl tdlsmj yblh o`ok`lhibi t`rs`kut o`ly`rupbm o`okrbl`. O`okrbl mlm kmbsblyb ouebg emblhibt btbu emkublh ebl k`rwbrlb putmg putm g i`iulmlh-iulmlhbl. 0. Udlsmjmtms irdlmi [beblh irdlmi pbeb pbeb tdlsmj. Udlsmjjmtms irdlmi kmbsblyb s`rmlh t`rfbem pbeb blbi-blbi t`rkblybi pbeb usmb imrb-imrb 0 tbgul ebl pulabi k`rmiutlyb pbeb usmb 23 tbgul. nbitdr pr`emspdsmsm 6 rblhsblhbl irdlmi (obiblbl) p`lhbrug aubab, p`lhdkbtbl rbeblh biut yblh tmebi be`iubt ebl gyhm`l` oujut yblh kurui. ^M.
S`lbtbjbisblbbl
2. S`lbtbjbisblbbl tdlsmjmtms biut b) Bltmkmdtmi hdjdlhbl p`lmamjml btbu sujnblbome s`jbob 0 gbrm ebl dkbt iuour btbu dkbt msbp e`lhbl e`smln`itbl, kmjb bj`rhm e`lhbl emk`rmibl `rmtrdomsml btbu ijmledomsml.
k) Bltmkmdtmi
yblh
be`iubt
ultui
o`la`hbg
mln`ism
s`iule`r,
idrtmidst`rdme ultui o`lhurblhm `e`ob pbeb jbrmlh ebl dkbt smoptdobtmi. a) Sbsm`l emmsdjbsm ibr`lb o`lujbr, tmrbg kbrmlh, ultui o`lhgmlebrm idopjmibsm ibltulh s`jbob ;-1 omlhhu btbu sbopbm gbsmj usbpbl t`lhhdrdi 1x l`hbtmn. e) S`ok`rmbl bltmpmr`tmi. ;. S`lbtbjbisblbbl tdlsmjmtms irdlmi b) U`rbpm jdibj ultui gyhm`l` oujut e`lhbl dkbt iuour / gmsbp. k) U`rbpm rbemibj e`lhbl tdlsmj`itdom kmjb t`rbpm o`emibo`ltdsb btbu t`rbpm idls`rvbtmn tmebi k`rgbsmj.
BQPGBL I@S@LBUBBL BL@QU@QM SBEB Ll. [ E@LHBL UMLEBIBL UDLQMJ@IUDOM U@ILMI H@L@[BJ BL@QU@QM EM [POBG QBIMU MQJBO I@LEBJ
Emsusul Dj`g6 Lbob6 Jusm Mlebg Qmjvmb LMO6 ;327353303 ;327353303
MLQUMUPU U@ILDJDHM QBMLQ ebl I@Q@GBUBL SIP OPGBOOBEM]BG QP[BIB[UB UBGPL BFB[BL ;3;3/;3;2
KBK MMM UMLFBPBL IBQPQ M.
Ndro S`lhibfmbl
B. Kmdebtb Sbsm`l
Lbob
6 Ll. [
Ld.[O
6 3312121;
Pour
6 ;2 tbgul
Bjbobt
6 Uboblh`e` ;/2 H`oug
S`lememibl
6 QOB
S`i`rfbbl
6 S`i`rfbbl Qwbstb
Embhlds`
6 Udlsmjmtms Irdlms
Umlebibl
6 Udlsmj`itdom
Ublhhbj Obsui [Q
6 23 Bhustus ;3;2
Fbo
6 27.30
Ublhhbj S`lhibfmbl 6 22 Bhustus ;3;2
Fbo
6 3=.33
(ibobr dp`rbsm) K. [mwbybt I`s`gbtbl
2. I`jugbl Ptbob Sbsm`l o`lhbtbibl ly`rm o`l`jbl, ly`rm yblh emrbsbibl pbsm`l pbsm` l gblyb em eb`rbg t`lhhdrdibl ;. [mwbybt S`lybimt Q`ibrblh Sbsm`l Ll. [ uour ;2 tbgul ebtblh i` [QM I`lebj k`rsbob i`jubrhblyb pbeb tblhhbj 23 Bhustus ;3;2 e`lhbl i`jugbl ly`rm t`jbl ebl tmebi lbnsu obibl, s`t`jbg emp`rmisb edit`r uouo em embhldsb Udlsmjmtms irdlms i`ouembl em idlsuj pbeb edit`r sp`smbjms UGU emblfuribl emjbiuibl tmlebibl tdlsmj`itdom. I`ouembl pbsm`l s`tufu e`lhbl tmlebibl t`rs`kut ebl emfbewbjibl dj`g edit`r sp`smbjms UGU ultui dp`rbsm puiuj 3=.33 i``sdibl gbrmlyb. 1. [mwbybt S`lybimt Ebguju Sbsm`l o`lhbjbom p`lybimt mlm s`fbi 2 tbgul yblh jbju, ebl k`juo p`rlbg o`jbiuibl Umlebibl dp`rbsm dp`rbsm em [uobg Qbimt. 5. [mwbybt S`lybimt I`jubrhb Sbsm`l
o`lhbtbibl emebjbo emebjbo i`jubrhblyb tmebi beb yh o`opulybm
rmwbybt p`lybimt o`lurul.
0. S`o`rmisbbl Nmsmi.
I`pbjb
6 K`ltui smo`trms, iujmt i`pbjb k`rsmg, rbokut utug
Obtb
6 adlfulhtmvb o`rbg oueb, sij`rb tmebi mt`rmi, pupmj
•
•
msdidr
Gmeulh
6 K`ltui ebl nulhsm ldrobj, k`rsmgbl gmeulh (+)
U`jmlhb
6 Qmo`trms imrm iblbl, nulhsm p`le`lhbrbl kbmi
Oujut
6 Ouidsb kmkmr i`rmlh, tdlsmj pbsm`l t`rjmgbt
•
•
•
o`ok`sbr, tmebi beb hmhm pbjsu
U`lhhdrdibl 6
•
mlsp`ism 6 Udlsmj o`ok`sbr ebl k`rwbrlb i`o`rbgbl. Sbjpbsm 6 U`rebpbt ly`rm t`ibl, p`ok`sbrbl i`j`lfbr jmondme
J`g`r
6 tmebi beb hblhhubl.
Ugdrbi
6 Sbru - Sbru (SPJODLBJ)
•
•
➫
Mlsp`ism6 Emlemlh ebeb smo`trms ebl tmebi emt`ouibl r`trbism r`tr bism ebl tmebi beb pbrbedisbj Odv`o`l.
➫
Sbjpbsm 6 Qmo`trms, vdibj nr`omtus iblbl sbob e`lhbl imrm.
➫
S`riusm 6 Qdldr i`eub jbpblh pbru
➫
Busiujtbsm6 Umebi t`re`lhbr subrb rgdligm pbeb i`eub pujod. Umebi t`re`lhbr subrb wg``zmlh.
Bkedo`l
•
6 S`o`rmisbbl Bkedo`l
➫
Mlsp`ism 6 S`rut ebtbr, smo`trms, tmebi t`rebpbt f`fbs,
➫
Busiujtbsm 6 U`re`lhbr subrb kmsmlh usus 7x/olt
➫
S`riusm 6 Umopblm ➫ Sbjpbsm 6 Qup`j, t`rebpbt ly`rm t`ibl pbeb kbhmbl . G`pbr ebl jm`l tmebi t`rbkb.
H`lmtbjmb
6 tmebi beb i`jbmlbl,urml` +, tmebi t`rpbsblh EA
@itr`omtbs
6 tmebi beb hblhhubl pbeb `itr`omtbs.
•
•
Ubleb-tbleb vmtbj
•
6
I`bebbl uouo
6 kbmi, iddp`rbtmn
I`sbebrbl
6 adopds o`ltms
U`i. Ebrbg
6 22=/8> ooGh
Lbem
6 7= x/o`lmt, r`huj`r, be`iubt
S`rlbpbsbl
6 ;3 x/o`lmt
Qugu
6 1> ¶ A
KK
6 03 ih
A. S`o`rmisbbl S`lulfblh
2. S`o`rmisbbl jbkdrbtdrmuo S`o`rmisbbl Jbkdrbtdrmuo G@OBUDJDHM [PUML
Gbsmj
Qbtubl
G`odhjdkml
2;.;
h/ej
22.8 ‑ 22.8 ‑ 20.0 20.0
G`obtdirmt
1>.;
%
18 18 ‑ ‑ 51 51
J`uidsmt
23.583
[mku/Pj
5333 ‑ 5333 ‑ 22.333 22.333
Urdokdsmt
187.333
[mku/Pj
203.333 ‑ 203.333 ‑ 503.333 503.333
5.;2
Futb/Pj
5.; ‑ 5.; ‑ 0.5 0.5
AU
5”13‟ ”13‟
o`lmt
; ‑ > >
KU
;”13‟
o`lmt
2 ‑ 1 2 ‑ 1
OA^
7>.3
Nj
73 73 ‑ ‑ =8 =8
OAG
;=.3
Sh
;> ;> ‑ ‑ 15 15
OAGA
11.7
h/eJ
12 - 1>>
[EX
28.;
%
23.3 - 20.3
OS^
7.1
nJ
8.3 ‑ 8.3 ‑ 22.3 22.3
@rmtrdsmt
[ufuibl
IDBHPJBQM
MLE@W @[MUDQMU
MOPLDJDHM
GkQBh Iubjmtbtmn GM^ Bltmh`l QB[Q-Adv-;
L`hbtmn Ldl r`bitmn
L`hbtmn Ldl r`bitmn
L`hbtmn
L`hbtmn
MM. MM.
JBSD[BL BL@QU@QM
B. S`rsmbpbl bl`st`sm 6
2. Bjbt O`sml bl`st`sm 6 b. Hbs t`remrm ebrm Dismh`l ebl Lmtrd Dxme` k. Hbs ^djdtmj` t`remrm ebrm Q`vdnjur`l ebl Msdnjur`l ;. Odlmtdr UU^ ebl @IH 1. QUBUMAQ 6 b. Qt`tdsidp ebl Jbrmlhdsidp ld kjbe` 1 k. Uuk` ( Q`jblh `ledtrbi`bj tuk`) @UU iml iml ld 8,3 Aup + a. Bmr wby ( Hue`j / Obyd ) uiurbl ld = e. Ubp` ( Sj`st`r ) `. Mltrdeua`r ( obler`ml, stmj`t ) n. Adl`atdr h. Quatmdl 5. S`rsmbpbl dkbt bl`st`sm b. Sr`o`emibsm 6 Dlebls`ltrdl 5 oh, Omebzdjbo ; aa k. Mleuism 6 N`ltblyj 2- ; oah/IhKK ?2x03 ih ? 03 oah, ; x 03 ih ? 233 oah Srdpdndj ; oh/ih KK ? ; x 03 ih ? 233 oh [daujba 2 oh/ihKK ? 2 x 03 ? 03 oh a. Dkbt tbokbgbl 6 I`tboml, Jbatdr e. Edsms obmlt`lbla` Msdnjurbl` 2.; OBA, 3; 6 L;3 ? 262 K. S`lbtbjbisblbbl Bl`st`sm
2. [ublh p`rsmbpbl Sbsm`l obsui i` ibobr p`rsmbpbl pbeb puiuj =.33 XMK, pbsm`l jblhsulh emhbltm kbfu dp`rbsm, mlnus t`rpbsblh pbeb tblhbl iblbl e`lhbl mv jml` uiurbl 27 ebl jblabr. Q`jbob em rublh p`rsmbpbl pbsm`l iddp`rbtmn e`lhbl tmlhibt i`sbebrbl adopds o`ltms HAQ 20. Q`k`juo tmlebibl bl`st`sm emp`rjuibl mlndro`e adla`lt.
Ubleb ‑ Ubleb ‑ tbleb tbleb vmtbj pbsm`l 6 U`iblbl ebrbg
6 22=/8> ooGh
Lbem
6 7= x/o`lmt
[`spmrbsm
6 ;3 x/o`lmt
K`rbt kbebl
6 03 Ih
;. [ublh dp`rbsm B. Sbsm`l obsui i` ibobr dp`rbsm pbeb puiuj 3=.23 wmk, Sbsm`l em kbrmlhibl e`lhbl pdsmsm supml` em o`fb dp`rbsm dp`rbsm ebl btur i`a`pbtbl mlnus. K. Lybjbibl o`sml bl`st`sm, odlmtdr tbleb-tbleb vmtbj ebl o`jbiuibl o`jbiuibl p`lh`a`ibl o`sml, hbs ebl i`kdadrbl i`kdadrbl iur`hbt`t ebl kbjdl. A. Sbsm`l emjbiuibl p`obsblhbl odlmtdr tbleb-tbleb vmtbj, sbturbsm dismh`l. E. O`lulhhu mltruism ebl jbpdr i`pbeb idlsuj`l ebl dp`rbtdr kmjb suebg smbp. @. O`lhblfuribl pbsm`l ultui k`redb N. Sbsm`l
emjbiuibl
p`ok`rmbl
pr`o`emibsm
6
dlebls`ltrdl,
omebzdjbo H. I`ouembl emjbiuibl mleuism pbeb fbo 25.30 wmk e`lhbl dkbt 6 n`ltblyj 233 oah M^ Srdpdndj 233 oh M^ [daurdlmuo 13 oh M^ Msdnjurbl` 2.; OBA ( s`subm i`kutugbl pbsm`l) G. [`nj`i kuju obtb gmjblh, t`rfbem p`lurulbl p`rlbpbsbl ebl emjbiuibl kbhmlh e`lhbl fbw trust ebl agml jmnt. M. S`jbisblbbl mltukbsm emjbiuibl pbeb fbo 3=.;2 wmk e`lhbl prds`eur 6
Sdsmsmibl i`pbjb pbsm`l e`lhbl `it`lsm
•
Kuib oujut pbsm`l e`lhbl ardss nmlh`r p`hblh jbrmlhdsidp
•
e`lhbl tblhbl imrm i`ouembl obsuibl i`ebjbo oujut i`ouembl o`lymlhimribl jmebg i` imrm pbsm`l e`lhbl pdsmsm jbrmlhdsidp o`okuib rdlhhb oujut
Abrm `pmhjdtms, t`opbtibl ufulh kmjbg jbrmlhdsidp em vbj`iujb.
•
Blhibt `pmhjdttms e`lhb `j`vbsm jbrmlhdsidp i` btbs ( fblhbl
•
o`l`ibl hmhm) ultui o`jmgbt pjmab vdabjms.
Kmjb suebg t`rjmgbt bokmj s`jblh @UU yblh suebg t`rpbsblh
•
stmj`t e`lhbl tblhbl iblbl.
Obsuibl @UU ebrm smsm oujut iblbl, sbopbm obsui i` sbjurbl
•
trbi`b e`lhbl uiurbl kbtbs oujut omlmobj ;3 ao.
j`pbsibl stmj`t ebrm @UU, msm kbjdl s`kblybi 23 aa uebrb
•
i`ouembl gukulhibl e`lhbl idl`itdr iur`hbt`t o`sml bl`st`sm.
U`s i`ebjbo @UU e`lhbl st`tdsidp` pbeb eb`rbg bp`x iblbl
•
ebl imrm ultu o`obstmibl @UU k`lbr-k`lbr obsui i`ebjbo trbi`b ebl o`lh`a`i i`s`mokblhbl p`lh`okblhbl bltbrb pbru-pbru iblbl ebl imrm.Q`t`jbg @UU suebg empbstmibl empbstmibl ebjbo i`bebbl s`mokblh obib emjbiuibl nmisbsm e`lhbl o`lhhuibl pj`st`r bhbr tmebi t`rfbem p`rukbgbl j`tbi pdsmsm @UU. Fbo 3=.;2 wmk p`rlbpbsbl pbsm`l t`rgukulh i` v`ltmjbtdr
Fbo 3=.;0 em oujbm tmlebibl dp`rbsm
•
F. S`rgmtulhbl r`spmrbsm s`jbob dp`rbsm. S`rgmtulhbl r`lablb p`ok`rmbl v`ltmjbsm 6 2) Umebj ^djuo` Umebj ^djuo` ? KK (Ih) x Idlstbltb (>-23) ? 03 x 7 ? 533 oj ;) Omlut` ^djuo` Omlut` ^djuo` ? Umebj vdjuo` x [`spmrbsm rbt` (2;2>x/o`lmt) ? 533 x 2;/o`lmt ? 5733 oj ? 5,7 J/o`lmt
1. Mltrb Dp`rbsm Sbsm`l suebg t`rmltukbsm e`lhbl @UU iml iml ld 8 aup +, obyd uiurbl ld = pbeb fbo 3=.;2 wmk ebl t`rgukulh i` v`ltmjbtdr o`sml bl`st`sm. b. Odlmtdrmlh Mltbi` ebl dutput abmrbl. 2) S`rgmtulhbl abmrbl pbsm`l s`jbob dp`rbsm 6 KK
6 03 ih
F`lms Dp`rbsm
6 Q`eblh
Subsb
6 8 fbo
;) I`kutugbl abmrbl o`lt`lbmla` ultui pbsm`l KK 03 Ih [uous
5 ; 2
I`kutugblb abmrb obmlt`lbla` 6 5 x 23 ? 53 ; x 23 ? ;3 2 x 13 ? 13 Fuobg ? =3 aa/fbo 1) I`kutugbl abmrbl s`jbob pubsb Obmlt`lba` x jbob pubsb 233 oj/fbo x 8 fbo ? 833 aa 5) Mls`lsmkj` Xbt`r Jds` (MXJ) Qtr`s Dp`rbsm 6 [mlhbl ? ; ‑ ; ‑ 5 5 oj, s`eblh ? 5 -> oj, k`rbt ? > ‑ 7 7 oj MXJ ? Qtr`ss dp`rbsm x KK (Ih) pbsm`l ? > x 03 ih ? 133 oj 0) @stmobt`e kjdde jds` @stmobt`e Kjdde ^djuo` @K^ jbim-jbim e`wbsb 83 aa/ihkk @K^ p`r`opubl e`wbsb >0 aa/ihkk @K^ ? ( >0 x 03 ih ) @K^ ? 1;03 aa @KJ (23 %, 20 %, ;3 % )
[mlhbl ? 23 % Q`eblh
K`rbt
x 1;03 aa ? 1;0 aa ? 20 %
? ;3 %
x 1;03 aa ? 578,0 aa
x 1;03 aa ? >03 aa
>) Fuojbg p`lebrbgbl 2 fbo p`rtbob 6 Quatmdl
? 03 aa
Ibsb (2 ibsb ? 23 aa) ? 03 aa S`rebrbgbl em hbltm e`lhbl abmrbl irmstbjdme e`lhbl p`rkblemlhbl 261 ? 233 aa ebrbg 6 133 aa Abmrbl irmstbjdme 8) I`kutugbl abmrbl s`jbob dp`rbsm [uous 6 Subsb Subsb + Obmlt`lbla` + MXJ + S`rebrbgbl ? oj Fbo 2 ? ¿ Subsb Subsb + Obmlt`lbla` + MXJ + S`rebrbgbl ? oj ¿ 833 + =3 + 133 + 133 ? 2353 aa 7) Udtbj abmrbl yblh i`jubr Ebrbg
? 233 aa
=) Abmrbl yblh suebg emk`rmibl (Irmstbjdme) Sr` dp`rbsm
? 833 aa
Mltrb dp`rbsm
? 2353 aa
Udtbj
? 2853 aa
23) Odlmtdrmlh mltrb bl`st`sm Idlemsm pbsm`l stbkmj, t`rbl`st`sm p`lug ^mtbj
3=.20
3=.10
3=.53
3=.;3
3=.;0
3=.13
U`iblbl 221/81 77/58
=2/5>
233/>> 238/>> =8/01
3=.50
smhl
ebrbg
ooGh ooGh ooGh ooGh ooGh ooGh
Lbem
==x/m
7=x/m
QpD;
==%
==%
238/>;
ooGh
237x/m
222x/m
23;x/m
23=x/m
23;x/m
==%
==%
==%
==%
==%
5. S`lhbigmrbl bl`st`sm Dp`rbsm s`j`sbm pbeb puiuj 3=.00 wmk pbsm`l emjbiuibl spdltblmsbsm pbeb p`rlbpbsbl e`lhbl kbhmlh ( bxms) tblpb o`lhhulbibl v`ltmjbtdr. Sbsm`l oujbm spdltbl, i`iubtbl dtdt k`juo pujmg s`p`luglyb,ebl tmebi
beb emst`lsm jbokulh. Lbnbs pbsm`l s`obiml be`iubt, jbju pbsm`l emkblhulibl e`lhbl empblhhmj lbob ebl s`emimt rblhsblh ly`rm. Sbsm`l o`okuib obtb ebl emjbiuibl `istukbsm pbeb fbo 23.33 XMK. Emjbiuibl p`obsblhbl DSB ultui o`op`rtbgblibl fbjbl lbpbs pbsm`l, emjbiuibl kbhmlh sbopbm pbsm`l lbnbs spdltbl be`iubt sbokmj t`rus em adkb kblhulibl e`lhbl o`oblhhmj lbob pbsm`l. Suiuj 23.30 emadkb o`lhhbltm kbhmlh e`lhbl lbsbj ibluj 1jt/olt..Suiuj 1jt /olt..Suiuj 23.23 UU^ pbsm`l stbkmj, lbpbs sblhbt be`iubt, r`spdl o`okuib obtb sbbt empblhhmj lboblyb kbmi, bigmrlyb pbsm`l pmlebg i` rublh p`oujmgbl ([[) pbeb fbo 23.22. 0. Sdst Dp`rbsm ([ublh S`oujmgbl) Sbsm`l i`jubr ebrm ibobr dpbrbsm o`lufu rublh p`oujmgbl pbeb fbo 23.22 wmk. Sbeb sbbt obsui i` rublh p`oujmgbl pbsm`l obsmg t`rpbltbu. Sbsm`l sbebr p`lug kmjb empblhhmj lboblyb, fbjbl lbpbs k`kbs. Obsmg t`re`lhbr s`emimt kulym hbrhjmlh hbrhjmlh. Ubleb tbleb vmtbj sbbt obsui [[ UE 2;0/8> ooGh, Lbem 235 x/o`lmt QpD; 233%. 233%. dismh`l lbsbj ibluj emk`rmibl 1 jmt`r/o`lmt. Odlmtdrmlh sbbt em rublh p`oujmgbl ^mtbj smhl
23.20
23.;3
23.;0
U`iblbl ebrbg
2;0/8>ooGh
22=/8> ooGh
2;=/80 ooGh
Lbem
235x/m
=>x/m
7>x/m
QpD;
233%
233%
233%
[[
27x/m
;3x/m
;3x/m
Sbsm`l i`jubr ebrm rublh p`oujmgbl o`lufu i` rublh p`rbwbtbl pbeb puiuj 23.13 fbjbl lbpbs k`kbs, suebg tmebi beb hbrhjmlh, sbebr p`lug ebl lmjbm bje`r`t` sadr` 23
Ubleb
irmt`rmb
Lmjbm
13¶
2 fbo
Qbbt i`jubr
Ebpbt Bitmvmtbs
;
;
;
;
;
;
;
;
;
o`lhh`rbibl i` 5 blhhdtb kbebl s`lemrm/ e`lhbl p`rmltbg
Qmriujbsm
Ebpbt
lbpbs
ebjbo ebl kbtui k`kbs [`spmrbsm
UE ² ;3% ebrm pr` bl`st`sm
I`sbebrbl
Qbebr p`lug
;
;
;
Xbrlb
I`o`rbg o`rbgbl
;
;
;
Udtbj sadr`
23
23
23
(Bjer`t` sadr` ≠ 7 pbsm`l emp`rkdj`gibl i`jubr ebrm [[) [[)
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