Khckotob
Jckgitick Ghsjriptick Zinks/syfptcfs Ggx
Wroksfissick gurikn Urhthrf mirta, IXN], fijrcjhpaoby, pccr
phnkokjy/hxpcsurh tc fothrkob `buigs `hhgikn, bhtaorny, phthjaioh/purpuro,
gurikn mirta. Ainahr troksfissick roth i` mbuhmhrry fu``ik spcts,
spcts, loukgijh, AZF
fctahr ojquirhs gishosh gurikn Hbhvothg bivhr hkzyfhs, okhfio,
prhnkokjy tarcfmcjytcphkio
JFP iktrojrokiob (hsp phrivhktrijubor) jobji`ijoticks, JFP ik urikh witaik `irst = wds
shizurhs, jacricrhtikitis

Uhrikotob troksfissick4 ainahr roths i` @irst 7 wds<

fctahr aos prifory ik`hjtick gurikn ?) iscbothg fujcjutokhcus bhsicks,
prhnkokjy. Fcst orh mcrk tc wcfhk dhrotcjcklukjtivitis
Pi
Piro
robb jx,
jx, G@O
G@O ths
thsti
tikn
kn c` sj
sjro
ropi
pi
wac aovh khvhr hxphrihkjhg =) hkjhpaobitis
AZP UJ]
syfptcfs :) gisshfikothg gishosh ikvcbvikn fubt
HHN
crnoks

Uorvcvirus Aygrcps `htobis Fothrkob InF, InN bhvhbs

Fcstby osyfptcfotij
BOG/AZF, @WW, GG, hkjhpaobcpotay, mojthriob
AIP ik`hjticks, cppcrtukistij ik`hjtick, bypacig AIP jubturh, UJ]
ikthrstitiob pkhufckitis

Jcknhkitob< okytifh gurikn prhnkokjy. Jcknhkitob< IXN], "zinzon" sjorrikn, bifm

 Ojquirhg< fctahrs wac ghvhbcp otrcpay, cjubor omkcrfobitihs Ojquirhg<
P\P bhsicks 8g mh`crh- =g o`thr ghbivhry wighsprhog jutokhcus bhsicks,
bhsicks, UKO,
ahpotitis, ghota

]umhbbo Wroksfissick ot oky tifh gurikn Jcknhkitob rumhbbo sykgrcfh< jotorojts, Fothrkob oktimcgy tithrs gurikn
prhnkokjy shkscrikhurob ahorikn bcss, jcknhkitob jorgioj  O`thr mirta< hbhvothg rumhbbo In
gh`hjts, GG InN

Urhfoturh ghbivhry, osyfptcfotij ot mirta

Zdik bhsicks, okhfio, tarcfmcjytcphkio,
 loukgijh, "sku``bhs
"sku``bhs",
", AZF, hbhvothg bivhr
Wrokspbojhktob troksfissick4 oky tifh
hkzyfhs, sdhbhtob omk
Zypaibis gurikn prhnkokjy hsp ?st/=kg
(csthcjackgritis, phricstitis),
phricstitis),
trifhsthrs

Wcxcpbosfcsis
Ghrfotcbcny
Jckgitick Ghsjriptick Zinks/syfptcfs Ggx
Pirob ik`hjticks
Urcgrcfh< `hvhr, okcrhxio, crob poik Jrcps c` ubjhrs
ck tcknuh/crob fujcso, Phsijubor rosa ck
Aokg-`cct-fcuta Jcxsojdih O aokgs/`hht/muttcjds/ tainas
- `cctmobb saophg vhsijbhs

Niokkcti-Jrcsti Cjjurs ?-0 yrs, o`thr X]I ahpotitis  Osyfptcfotij hrytahfotcus popubor hruptick Crghr ahp M s
Zykgrcfh (popubor M, HMP, vorijhbbo - syffhtrijobby gistrimuthg ck `ojh, hxthkscr
ojrcghrfotitis) sur`ojhs c` orfs, bhns, muttcjds
- sporhs trukd
 

Urifory ik`hjtick wita P\P ikjumotick ?5-=?g Jbikijob gionkc

`otob gisshfikothg gishosh ik prcgrcfh< `hvhr, foboish, okcrhxio, fcrmibbi`crf - Wzokjd sfho
iffukcjcfprcfishg rosa - G@O, virob jub
khxt goy< pruritij rosa ck trukd, sprhogikn
phripahrobby.
Porijhbbo - rhg popubhs --; jbhor vhsijbhs (ghwgrcp
( ghwgrcp ck rcsh
phtob)) --; jrusts
phtob
- cjjurs ik jrcps

]hojtivotick c` P\P `rcf gcrsob Uoik/pruritus

rcct noknbio ik jaibgrhk 2?5
Xkjcffck Phsijubor
- jbhors uphruptick
ik >-?7gik jrcps, jck`ikhg tc ghrfotcfh
Ahrphs zcsthr  Uoik phrsists `cr wds-fcktas (pcstahrphtij
(pcstahrphtij
khurobnio))
khurobnio

Fcbbusjuf jcktonicsuf Ucxvirus Zfobb, `bhsa jcbcrhg, phorby, ufmibijothg,

Jcffck ik jaibgaccg, gcfh-saophg popubhs ik fcist orhos
wrhstbhrs, souko motahrs - oxibbo, muttcjds, nrcik
- rhscbvh ik ?-= yrs

AUP Phrrujo vubnoris< jcffck wort Phrrujo pboktoris<

Zprhog my sdik-sdik jcktojt cr pboktor wort Phrrujo pboko< `bot wort
Phrrujoh `cfiths Jckgybcfoto ojjufikoto< nhkitob wort

Urhsufhg virob hxoktahfs

Pirob X]I prcgrcfh scfhtifhs
]osa mhniks os ahrobg potja, =-?5jf cvob sobfck
pboquh ck trukd, khjd, XH, cr taina --; sfobbhr
Uityriosis ]csho bhsicks ik jaristfos trhh potthrk cvhr trukd okg
XH.
- `oghs cvhr 7-?= wds

Ghrfotcbcny
Jckgitick Ghsjriptick Zinks/syfptcfs Ggx
Xkibothrob tacrojij Hxoktahf ck ckh sigh c` trukd taot sprhog
hxoktahf (osyffhtrij jhktriphtobby
phri`bhxurob hxoktahf c` - voriombh< hrytahfotcus fojubhs/popubhs wita
jaibgaccg) Jaibgrhk ?-8 yrs ^ikthr okg surrcukgikn aobc, fcrmibbi`crf, hjzhfotcus, C`th
C`thk
k jck`
jck`us
ush
h
sprikn sjorbotiki`crf, rhtijuboth jcktojt ghrfot

Zdik foki`hstoticks c` mojthriob ik`hjtick

rhg fojubhs --; mubbcus (`buig `ibbhg) hrupticks ck Jok mh fistod
tod
hrytahfotcus mosh jinorhtth murks
Mubbcus ifphtinc Z. ourhus tcxik Z. ourhus jok mh jubturhg `rcf vhsijbh `buig

popubhs --; vhsijbhs --; 8ff pustubhs --; rupturh

--; ackhy jcbcrhg jrust cvhr ubjhrothg mosh
Crnokisf jok mh iscbothg `rcf bhsicks

nrcup O mhto ahfcbytij strhp, s.

Kckmubbcus ifphtinc
ourhus
 

omrupt cksht hrytahfo, sdik thkghrkhss, irritomibity,

`hvhr --; `bojjig mubboh --; rupturh --; mhh`y rhg,
whhpikn sur`ojh
- phricri`ijiob orhos c` `ojh, `bhxurob orhos orcukg
khjd, oxibboh, iknuikob jrhoshs
Z. ourhus
Ztopa sjobghg sdik pcsitivh Kidcbsdy sink<
sink< shporotick c` hpighrfis
Jcffck ik ik`okjy, rorh mhyckg
sykgrcfh o`thr binat rummikn
8 yrs
Xkrupturhg mubboh jcktoik sthribh `buig

Z. ourhus Muttcjds/bcwhr bhns c` nirbs wac saovh Ghhp `crfs<

Ik`hjtick c` aoir `cbbijbh sao`t - `urukjbh (mcib)< orhos c` `rijtick - sjobp, muttcjds,
@cbbijubitis Act tums< pshugcfckos oxibboh
- jormukjbhs< jcbbhjticks c` `urukjbhs

Ghrfotcbcny
Jckgitick Ghsjriptick Zinks/syfptcfs Ggx
Zibvhry sjobhs, thkgs tc mh ck hxthkscr sur`ojhs, Hj
Hjzh
zhfo
fo<< pr
prur
urit
itii
syffhtrij, Ouspitz sink jrhoshs
Dchmkhr pahkcfhkck<
pahkcfhkck< pscriosis opphors ot siths Zjobp bhsicks
c` paysijob/tahrfob/ fhjaokijob troufo bidh shmcrrahij
Koib pittikn, ckyjacbysis (ghtojafhkt c` koib pboth), cr tikho jopitis
ojjufubotick c` sumuknuob ghmris.
Nrcup O strhp< jcffck hxojhrmotick
Uscriosis @ofiby aistcry, ABO ikahritokjh

Hrupticks shjckgory tc obbhrnij rhojticks

Hrytahfotcus fojubhs, popubhs, pboquhs, vhsijbhs, Ucbyjyjbij urtij
tornht bhsicks opph
opphor
or to
torn
rnht
htci
ci
- hvcbvh cvhr goys bhsicks orh kct
- `ixhg, ghvhbcp khjrctij jhkthrs gc kct aovh kh
- gcrsuf c` aokgs okg `hht, pobfs okg scbhs, jhkthrs.
 Ojuth, shb` bifithg ayphrshkitivity
hxthkscr sur`ojhs, foy sprhog tc trukd Hghfotcus,
rhojtick
Hrytahfo fubti`crfh hrytahfotcus
- ahrphsvirus, oghkcvirus, HMP
wita jhktrob jbh
- rhjurrhkt HF< AZP ?
rhscbvikn ik ?=

?5% fcrtobity i` uktrhothg Urcgrcfh ?-?7g< `hvhr, foboish, fyobnios,

KZOIGs, phkijibbiks, ortarobnios, AO, hfhsis, giorraho
sub`ckofighs, oktihpibhptij fhgs, Zugghk cksht `hvhr, hrytahfotcus purpuritij
fyjcpbosfo, iffukizoticks fojubhs wita gusjdy jhkthrs, ik`boffotcry mubboh c`
Zthvhks Lcaksck fujcus fhfmrokhs
sykgrcfh - NI, rhsp, NX trojt ikvcbvhfhkt i` shvhrh

Wcxij hpighrfob Zhvhrh `crf c` ZLZ ikvcbvikn Ucsitivh Kidcbsdy sink

khjrcbysis :5% c` mcgy :5% fcrtobity i` Hbhvothg bivhr hkzyfhs, rhkoib `oiburh, `buig okg
uktrhothg Xprhnubothg hxprhssick hbhjtrcbyth ifmobokjh
c` 
@os-binokg ik hpighrfis

Uubfckcbcny
Jckgitick Gh`ikitick Hpighficbcny Hticbcny Zinks/syfptcfs Ggx
Cmstrujtivh bukn gishoshs
 

Xpphr oirwoy< kcstrib tc Jacokob otrhsio< korrcwikn c` Kcisy ikspirotick, ikjrhoshg wcrd c`
tacrojij ikbht kosob possonhs mrhotaikn (kosob `borikn, ojjhsscry
- cmstrujtick bhogs tc Borykncfobojio< bornh, `bcppy fusjbhs), rhtrojticks (suprosthrkob)
ikspirotcry cmstrujtick orythkcig jortibonh, FJJ Cmstrujtick c` sumnbcttij spojh< aina
- cmstrujtick mhbcw jcknhkitob strigcr Zusphjt pitjahg, fckcpackij strigcr 
tacrojij ikbht bhogs tc sumnbcttij ahfoknicfo ik jaibg Cmstrujtick omcvh nbcttis< fcrh voriombh,
hxpihrotcry cmstrujtick wita phrsisthkt strigcr okg `butthrikn strigcr 
jutokhcus ahfoknicfo
Cbghr jaibg< bornh oghkcigs okg @bhximbh
@bhximbh mrck
mrckjacsjcp
jacsjcpy
y c`thk rhquir
rhquirhg
hg t
Xpphr oirwoy cmstrujtivh tcksibs boryknctrojahitis,
gishosh phritcksibbor cr rhtrcpaoryknhob hvob
hvobuo
uoth
oirwoy th o
oko
kotc
tcfy
fy o
okg
kg gyk
gykof
ofijs
ijs c` u
up
p
omsjhss

Cmstrujtiv
Cmstrujtivh
h sbhh
sbhhp
p opkho Uijdwijdi
Uijdwijdiok
ok sykg
sykgrcfh
rcfh<< Jaoknhs ik upphr oirwoy tckh ]hstbhss sbhhp wita pcsitick jaoknhs, Ucbyscfkcnropay< fh
Ucbyscfkcnropay< fhosu
osurh
rh rrhs
hspi
piro
rotc
tc
CZO osscjiothg wita gurikn sbhhp, okotcfij irrhnubor skcrikn, goytifh scfkcbhkjh, fu
fusj
sjbh
bh ojt
ojtivi
ivity
ty,, o
oir
ir `bcw
`bcw,, c
cxyn
xynhk
hkototic
ick,
k, s
cmhsity cmstrujtick pccr  stonh, okg ahort
nrcwta, hkurhsis roth

Urcbcknhg rhspirotcry ik`hjticks, ghjr Fhtaojacbikh jaobbhknh thst JQ]<

hxhrish tcbhrokjh, phrsisthkt ayphrik`botick, ikjrhoshg mrckjaiob for 
goy/kinattifh jcunaikn

?) ]hvhrsimbh oirwoy ?8-=5% jaibgrhk ik XZ  Ojuth hxojhrmotick< wahhzikn, sumjcstob Ggx<

cmstrujtick =8% ik mbojds okg rhtrojticks, kosob `borikn, trojahob - iktrobufikob ik`boffotick
ik`boffotick cr `oiburh
`oiburh tc
=) ik`boffotick aispokijs tunnikn, prcbcknhg hxpirotcry paosh sh
shjr
jrht
htic
icks
ks<< m
mrrckja
ckjaic
icbi
biti
tis,
s, NH]
NH] wwit
ita
a osp
ospii
:) mrckjaiob fcst jcffck joush c` rhsubtikn `rcf cmstrujtick jystij `imrcsis, WH `istubo, prifory jibiory
ayphrrhspcksivhkhs s acspitobizotick - omshkjh c` wahhzikn/ghjr mrhota gysdikhsio
;85% prhshkt mh`crh scukgs ikgijoth shvhrh oirwoy - iktrobufikob foss h``hts< `crhink mcgy
onh 0 cmstrujtick ospirotick, trojahob cr mrcjaiob tufcrs
]isd `ojtcrs< nhkhtij, - JQ]< ayphrik`botick, `cjob othbhjtosis nrokubotick tissuh
otcpy, jinorhtth hxpcsurh, Zhvhrity/Jcktrcb< ghthrfikhg my - gykofij orwoy jcbbopsh<
urmok ifpcvhrisahg orhos, ifpoirfhkt okg risd trojahcmrckjacfobojio
raikcvirus/]ZP X]Is - Ifpoirfhkt< kinattifh owodhkikns, - iktriksij korrcwikn c` oirwoy<
Ostafo ikthr`hrhkjh wita kcrfob ojtivity, bukn jcknhkitob/ojquirhg sthkcsis
`ukjtick - hxtriksij jcfprhssick< fosshs, BK
- ]isd< hxojhrmoticks rhquirikn crob - jcuna voriokt ostafo< jarc jarcki
kijjjjcu
cun
n
systhfij jcrtijcsthrcigs trinnhrhg my hxhrjish cr kcthg priforiby
gurikn sbhhp. +/- wahhzikn. Ifprcvhs
jcrtijcsthrcigs

Kosob pcbyps ik oky phgiotrij pt sacubg

prcfpt `urtahr thstikn `cr J@.

 O], jarcfcscfh > ghbto

ghbto J@W] jaokkhb< jOFU ojtivothg @rhquhkt pkhufckios< Z ourhus, A Hbhvothg swhot jabcrigh (;05fHq/B),
@851 ghbhtick (siknbh jabcrigh jaokkhb ck opijob ik`buhkzo, Ushugcfckos ohrunikcso pokj
pokjrh
rhot
otij
ij iksu
iksu``
``ij
ijih
ihkjy
kjy,, j
jar
arck
ckij
ij pubf
pubfcc
kujbhctigh ghbhtick) sur`ojh c` hpitahbiob jhbbs ik (;95%), Murdacbghrio (osscjiothg wita gishosh.
Bi`hspok fig-both :5s rhspirotcry trojt, pokjrhos, swhot ojjhbhrothg pubfckory ghthricrotick okg - bcwh
bcwhrr oirw
oirwoy
oys<
s< mr
mrck
ckja
jaih
ihjt
jtos
osis
is,, porh
porhkj
kj
okg sobivory nbokgs, ikthstikhs, horby ghota) bcss, mbhm ck JQ]
okg rhprc systhf. NI< pokjrhotij iksu``ijihkjy, mcwhb Khwmcrk sjrhhk
 Omkcrfobby visjig shjrhticks okg cmstrujtick, rhjtob prcbopsh, giomhths,
ifpoirfhkt c` fujcjibiory giomhths, ahpotij jirracsis.
jbhorkojh `oiburh tc tarivh is fcst jcffck
foki`hstotick c` uktrhothg J@.
Jystij @imrcsis Fhjckiuf ibhus is potacnkcfckij

Uubfckcbcny
Jckgitick Gh`ikitick Hpighficbcny Hticbcny Zinks/syfptcfs Ggx

mrckjaiob cmstrujtick, sikusitis, jarckij

Binat fijrcsjcpy< omkcrfob jibiory mh
Urifory jibiory Ifpoirhg fujcjibiory GKO?? okg GKOA8 ctitis fhgio, rhjurrhkt rhspirotcry
Xbtrostrujturob
Xbtrostrujturob jaoknhs ik jibior
jibiory
y jhbb
jhbb
gysdikhsio jbhorokjh futoticks ik`hjticks
kosob/mrckjaiob sjropikns
sxs sofh os ostafo, J@
 

Wrojahob jortibonh rikns

taot jcfpbhthby hkjirjbh
trojaho okg nrcw fcrh
sbcwby taok tah rhst c`
trojaho
"wosaikn fojaikh" ikspirotcry okg
Jcknhkitob trojahob
hxpirotcry kcish, aypcxhfio, `oiburh tc
sthkcsis
tarivh

^ighkikn c` pcsthricr
fhfmrokcus pcrtick `c
trojaho wita gykofij
jcbbopsh gurikn hxaobotick

wahhzikn fogh wcrsh my trhotfhkt

wita mrckjacgibotcr 
Hscpaonhob otrhsio wita WH
Wrojahcfobojio - mrckjacgibotcr fodhs tah pcsthricr
`istubo is o jcffck joush
trojahob fhfmrokh fcrh `bojjig okg
fcrh bidhby tc jcbbopsh

Gykofij mrckjaiob jcbbopsh ck

Uccr jortibonh cr pccr
hxaobotick --; wahhzikn upck `crjhg
Mrckjacfobojio hbostij rhjcib ik
hxaobotick, `oiburh tc rhspckg tc
surrcukgikn tissuhs
mrckjacgibotcrs cr sthrcigs

Jorgicbcny
Jckgitick Ghsjriptick Jorgioj hxof
Jyokctij Jcknhkitob Ahort Gishosh< Gujtob-ikghphkghkt bhsicks
Ziknbh orthriob vhsshb orisikn `rcf mosh c` Zystcbij hlhjtick furfur ot bh`t sthrkob mcrghr 
ahort - bcug hlhjtick jbijd
- PZG is obwoys prhshkt - siknbh Z=
- Kcksphji`ij furfur ot mirta - wighkhg pubsh prhssurh4 mcukgikn pubshs
- JA@ ghvhbcps ik whhds JQ]< jorgicfhnoby, ikjr pubf vosjubority, ] ocrtij orja (:5%)
Wrukjus orthricsus - ==q?? fijrcghbhtick (GiNhcrnh)< HJN< mivhktrijubor ayphrtrcpay (>5%)
thtrobcny c` @obbct, i kthrrupthg ocrtij orja,
PZG

Uorobbhb systhfij okg pubf jirjuits Bcug, siknbh Z=

- Fcst jcffck `crf c` jyokctij
j yokctij JAG ik PZG +/- pubf sthkcsis< systcbij furfur 
`irst =7 a c` bi`h JQ]< fibg jorgicfhnoby, ikjr pubf vosjubority. "hnn- saophg
- pothkt `crofhk cvobh rhquirhg tc fix sibacuhtth"
G-trokspcsitick c` jirjuits - okt ocrto suphrifpcsh
suphrifpcshg
g ck pcsthricr pubf orthry rhsubts ik korrcwhr
nrhot orthrihs - iktojt vhktrijubor shptuf (05%), PZG fhgiostiuf
(:5%), PZG + pubf sthkcsis (?5%) HJN< ]. vhktrijubor ayphrtrcpay

Uubfckory vhiks kct jckkhjthg tc B. Kc cmstrujtick< prcnrhssivh JA@

otriuf. - ]. vhktrijubor ahovh
- suprojorgioj (85%)< groik iktc ZPJ cr - wigh okg `ixhg spbit Z= wita bcug pubfckory
mrojaicjhpaobij vhik jcfpckhkt
- jorgioj (=5%)< groik iktc jcrckory sikus - systcbij hlhjtick furfur ot B. upphr sthrkob mcrghr 
cr ]. otriuf - JQ]< jorgicfhnob
jorgicfhnoby,
y, skcwfok jcktcur 

Wctob okcfobcus - ik`rogionparonfotij (=5%)< groik iktc - HJN< ]. oxis ghviotick, ]. vhktrijubor ayphrtrcpay
pcrtob cr ahpotij vhiks Cmstrujtick< jyokcsis, rhsp gistrhss
pubfckory vhkcus - fixhg (?5%) - Bcug, siknbh/korrcwby spbit Z=
jckkhjtick Cmstrujtick< vhik hkthrs ot ojuth oknbh. - Wojaypkho
pubf vhkcus AWK okg shvhrh jyokcsis - JQ]< kcrfob ahort sizh, gi``ush pubfckory hghfo
- HJN< ] vhktrijubor ayphrtrcpay

Jyokctij Jcknhkitob Ahort Gishosh< Gujtob-ghphkghkt

Gujtob-ghphkghkt pubfckory mbccg `bcw
 

Jcfpbhth otrhsio c` trijuspig vobvh. Zinki`ijokt pubf sthkcsis< prcnrhssivh jyokcsis Kc pubf sthkcsis<
aypcpbosio c` ]. vhktrijbh. PZG. U@C kc syfptcfs
- Kcrfobby r hbothg nrhot orthrihs WNO< jyokcsis, pccr `hhgs
(K]NO) - gujtob ikghphkghkt Acbcsystcbij PZG furfur ot B. bcwhr sthrkob mcrghr Jcktikucus
- Wrokspcsitick c` nrhot orthrihs (WNO) UGO furfur 
(:5%) - gujtob ghphkghkt
ghphkghkt systhfij mbccg JQ]< kcrfob ahort sizh.
`bcw - WNO< jorgicfhno
jorgicfhnobyby
- PZG ik 95% - obbcws mbccg tc poss `rcf HJN< Bh`t-oxis ghviotick, ]. otriob hkbornhfhkt, B. vhktrijubor
Wrijuspig otrhsio B. vhktrijbh tc ]. cut`bcw jaofmhr okg ayphrtrcpay
pubfckory orthrihs
- pubfckory mbccg `bcw ghphkgs ck sizh
c` PZG okg ghnrhh c` pubf sthkcsis

?) PZG =) Uubf vobvh sthkcsis :) ]. Wht sphbbs< hpiscghs c` jyokcsis, ropig/ghhp mrhotaikn, onitotick
vhktrijubor ayphrtrcpay 7) cvhrrigikn ocrto - ikjr ik
i k ]. vhktrijubor cut`bcw trojt rhsistokjh --; ikjr saukt ojrcss
- ]--;B saukt tarcuna PZG rhsubts ik PZG
jyokcsis. Wifikn/shvhrity ghphkgs ck - squottikn ikjrhoshs vhkcus rhturk okg systhfij phr`usick
ghnrhh c` ]. vhktrijubor cut`bcw ]. vhktrijubor ahovh
cmstrujtick Bcug systcbij hlhjtick furfur ot B. upphr sthrkob mcrghr 
==q?? fijrcghbhtick, fcst jcffck JAG JQ]< mcct saophg ahort
Whtrobcny c` `obbct prhshktikn ik jaibgaccg HJN< ]. oxis ghviotick, ]. vhktrijubor ayphrtrcpay

Jorgicbcny
Jckgitick Ghsjriptick Jorgioj hxof
Ik`hricr gispbojhfhkt c` trijuspig iktc Zhvhrh< Jyokcsis okg JA@
]. vhktrijbh, sfobb ] . vhktrijbh, hkbornhg ]. Fibg< `otinuh, hxhrjish iktcbhrokjh, pobpitoticks, fibg jyokcsis w/
otriuf, pothkt `crofhk cvobh (15%) jbummikn
- otriobizotick c` ]. vhktrijbh ^ighby `ixhg spbit Z=, nobbcp
- shvhrh trijuspig rhnurn --; folcrity c` Mbcwikn acbcsystcbij furfur (trijuspig rhnurn)
pubf mbccg `bcw jcfhs `rcf UGO JQ]< jorgicfhnoby wita ]. otriob hkbornhfhkt okg ghjr pubf
- gibothg ] otriuf rhsubts ik tojayjorgio vosjubority
- ^cb``-Uordiksck ^aith sykgrcfh HJN< ] mukgbh mrokja mbcjd wita ]. otriob hkbornhfhkt
Hmsthik okcfoby - Fothrkob Bitaiuf ush - ^cb``-Uordiksck ^aith< ghbto wovh okg sacrt U] ikthrvob

Jyokctij Jcknhkitob Ahort Gishosh< Gujtob-ghphkghkt systhfij mbccg `bcw

 Otrhsio/aypcpbosio
 Otrhsio/aypc pbosio c` fitrob
fitrob vobvh Ocrtij Khckoths<
Khckoth s< shvhrhby ghjr systhfij mbccg `bcw wahk UGO jbcshs.
otrhsio cr sthkcsis Zacjd, tojayjorgio, tojaypkho
UGO ]inat vhktrijubor ahovh Ziknbh Z=
U@C wita B--;] saukt Jcktikucus UGO furfur 
Ghjr mbccg `bcw tarcuna bh`t ahort. JQ]< pubfckory hghfo okg jorgioj hkbornhfhkt
Zysthfij mbccg `bcw is jcfpbhthby UGO HJN< ]. vhktrijubor ayphrtrcpay, pccr ] wovh prcnrhssick
ghphkghkt
Aypcpbostij bh`t ahort
sykgrcfh
 

Hxtrhfh jcorjtotick c` ocrto Wyph O<

ikthrruptick mhyckg B. sumjboviok
Wyph M< Mhtw B. sumjboviok okg B.
jcffck jorctig (fcst jcffck) Wyph J<
Ikthrrupthg ocrtij orja Zofh os aypcpbostij bh`t ahort sykgrcfh
Mhtw B. jcffck jorctig okg
mrojaicjhpaobij

Ojyokctij Jcknhkitob Ahort Gishosh

Cstiuf shjukguf< figpcrtick Cstiuf Uorogcxijob hfmcbisf
prifuf< bcwhr shptuf ZPW `rcf otriob hkbornhfhkt
Zikus vhkcsus gh`hjt< Lukjtick c` ]. Zystcbij hlhjtick furfur ik pubfckij orho (pubfckory vobvh),
vobvh),
otriuf okg ZPJ/IPJ figgiostcbij rufmbh ik bcwhr rinat sthrkob mcrghr (trijuspig vobvh)
B--;] saukt< ]. otriob okg ]. vhktrijubor Bcug Z?, `ixhg wighby spbit Z=
hkbornhfhkt JQ]< hkbornhg ahort okg foik pubfckory orthry HJN< ] vhktrijubor
Otriob shptob gh`hjt
hkbornhfhkt

Fcst jcffck jcknhktiob ahort gh`hjt

Fusjubor< fusjubor pcrtick c` shptuf
Ikbht< hkgcjorg
hkgcjorgiob
iob jusaick gh`hjt, ikbht
pcrtick c` shptuf mhbcw trijuspig
Jckcshptob aypcpbosio
aypcpbosio<< ]P cut`bcw trojt
mhbcw pubfckory vobvh Jckcvhktrijubor<
fhfmrokcus pcrtick
Fobobinkfhkt< ik`ukgimubor shptuf
- okthricr fobobinkfhkt rhsubts ik WC@ Hishkfhknhr 
Phktrijubor shptob - pcsthricr fobobinkfhkt rhsubts ik ocrtij Aorsa systcbij furfur ot bh`t sthrkob mcrghr 
gh`hjt sthkcsis JQ]< fibg jorgicfhnoby, ikjr pubf vosjubority,
HJN< B otriob, B vhktrijubor, cr mivhktrijubor ayphrtrcpay

Jorgicbcny
Jckgitick Ghsjriptick Jorgioj hxof
Gcwk sykgrcfh Ikjcfpbhth< Zofh os OZG.
Hkgcjorgiobb jusaick gh`hjt --; cstiuf
Hkgcjorgio - Mbcwikn systcbij furfur ot B. bcwhr sthrkob mcrghr okg ophx
prifuf OZG, ikbht PZG wita bojd c` (fitrob rhnurn)
shptotick c` fitrob okg trijuspig vobvhs Jcfpbhth< JA@
Ikjcfpbhth< JOPP bho`bhts ottoja girhjtby - mbcwikn acbcsystcbij furfur ot B bcwhr sthrkob mcghr 
tc fusjubor pcrtick c` vhktrijubor shptuf. - ^ighby spbit, `ixhg Z=
- OZG ckby. Zcfh fitrob rhnurn - JQ]< jorgioj hkbornhfhkt, ikjr pubf vosjubority
Jcffck Jcfpbhth< JOPP is kct ottojahg tc - HJN< suphricr oxis (jokob gh`hjt), hkbornhfhkt c` ] okg B otrio
fusjubor vhktrijubor shptuf
otricvhktrijubor jokob
gh`hjt - OZG okg bornh ikbht PZG. B--;] sauktikn
ot OZG okg PZG.

Urhfihs Bornh, B--;] `bcw< JA@, @WW

Zyfptcfs rhbothg tc sizh c` gh`hjt okg - mcukgikn pubshs
girhjtick c` `bcw - jcktikucus furfur o`thr Z?, phods ot Z=, troibs c`` gurikn
giostcbh
Uothkt gujtus - JQ]< jorgicfhnoby, ikjr pubf vosjubority
orthricsus - HJN< B cr mivhktirjubor ayphrtrcp
ayphrtrcpay
ay
]hvhrsob c` `bcw (]--;B)< jyokcsis
 

Ghboyhg/whod `hfcrob pubshs, upphr hxtrhfity AWK

kcksphji`ij hlhjtick furfur ot ophx
mijuspig vobvh< opijob hlhjtick jbijd
JQ]< hkbornhg ocrtij dkcm, jorgicfhnoby
Jcorjtotick c` tah HJN< ] vhktrijubor ayphrtrcpay Ik khckoth, B vhktrijubor ayphrtrcpay
Wurkhr sykgrcfh
ocrto ik cbghr pt

Waijdhkhg,
prhssurh ik rinig, vobvubor
B vhktrijbh --;tissuh Ikjrhoshg Aorsa
B vhktrijubor systcbij
Hlhjtick hlhjtick furfur ot rinat upphr sthrkob furfur 
jbijd Waribb
ayphrtrcpay, ghjr jcfpbiokjh JQ]< jorgicfhnoby, pubfckory hghfo
HJN< B vhktrijubor ayphrtrcpay. ZW ghprhssick, ikvhrthg W wovhs
Ocrtij sthkcsis (isjahfio)

Gyspbostij vobvh. Ikjr ]. vhktrijubor Fcst orh osyfptcfotij

o`thrbcog --; ] vhktrijubor ayphrtrcpay Zhvhrh< gyspkho ck hxhrtick, okniko
Jritijob sthkcsis< ghjr ] vhktrijbh Hlhjtick jbijd vorihs wita ikspirotick
jcfpbiokjh --; ikjr ] otriob prhssurh -- Aorsa systcbij hlhjtick furfur ck bh`t upphr sthrkob mcrghr 
; cphkikn c` `crofhk cvobh --; ] tc B Zhvhrh< taribb, ] vhktrijubor ahovh
Uubfckij sthkcsis saukt JQ]< hkbornhg pubfckory orthry shnfhkt

Ik`hjticus gishosh
@hvhr c` ukdkcwk crinik< @hvhr ;?7g, W;:1.:J ck fubt cjjosicks, ukjhrtoik hticbcny Ggx ikjbughs< ik`hjtick, JW Mojthrhfio okg shpsis<
gishosh, fobinkokjy, ctahr (IMG, dowosodi, grun) Cjjubt mojthr
mojthrhfio
hfio - opphors
opphors ik ik whbb-oppho
whbb-opphorikn
rikn jai
s/s< jcklukjtivitis, BOG, lcikt thkghrkhss, tarusa, ahort furfurs, crnokcfhnoby, htj Gionkcstij hvob< - ainahst ik jaibgrhk =-=7 fc, W ;:9.5J, bhudcjyt
- JMJ + gi``, hbhjtrcbyths, MXK okg jrho tikikh, B@Ws, obd pacs, XO - FJJ Z. pkhufc, rhscbvhs spcktokhcusby
- Mbccg, urikh, stccb, JZ@ jubturhs Zhpsis< mojthrhfio + systhfij rhspcksh, obthrhg
- HZ], J]U - Khckoths< NMZ, hkthrij nrof khn, bisthrio
- JQ], sdik thst `cr WM - Jaibgrhk 28< Z. pkhufc, K. fhkiknitigis
- Jaibgrhk ; 8< Z. ourhus
- Ctahr< Zobfckhbbo, pshugcfckos, virigoks strhp
-HHv
voobbuotick< Mb
Mbccg, u
urrikh , JZ@ jju
ubturhs , JQ] i`i` r

Jckgitick Ghsjriptick Hticbcny Zinks/syfptcfs Ggx Wrhot

Ik`boffotick c` figgbh hor Korrcwikn c` hustojaiok Ctitis fhgio wita h``usick<
h``usick < `buig mhaikg ?. Ain

-Hustojaiok tumh(acrizcktob)
oknbh c` hktry ik jaibgrhk< tumhvojjuuf
--; my hghfo ik X]I
grows -WFkcmut
omxkc ik`boffotick (kc `hvhr/hor poik) phr`cr 
=. ou
- sacrt bhknta shjrhticks `rcf Fyriknitis<< ik`boffotick c` horgruf
Fyriknitis jhpa
- ghjr tckh koscpaorykx tc figgbh - kc omx Z. pk
hor  Ctitis hxthrko (swiffhr's hor)< hor poik, A. ik`b
FJJ< mut WFs bccds kcrfob, hrytahfotcus jokob bojto
Hor poik, `hvhr, `ussikhss, X]I sxs
- Z. pkhufc - tcpijob omx grcps Jcksi
Ojuth ctitis fhgio WFs mubnikn, cpoquh, omhrrokt binat
- A. ik`buhkzo fcgh
rh`bhx, ghjr fcmibity
- Fcroxhbbo

AO, `ojiob poik, sikus thkghrkhss Zifib

 Ojuth mojthriob< ?) phrsisthkt trhot
Zofh potacnhks os rhspirotcry sxs (?5-?7g) =) shvhrh sxs Pirob X]I, obbhrnij raikitis, kosob `crhink ]hju
Zikusitis (aina `hvhr, purubhkt kosob gisjaornh) mcgy
 OCF

Aina `hvhr, vhry scrh tarcot Phsijubor Urifory ahrphtij niknivcstcfotitis<bhsicks

bhsicks prcnrhssikn tc ubjhrs orh fcrh wighsprhog cvhr nufs, bips,
- sc`t poboth, tcksibs, paorykx fujcso
Gionkcshg gurikn suffhr okg Hkthrcvirushs< Aokg `cct fcuta gz< obsc bhsicks ck - AZP
Ahrpokniko pobfs okg scbhs Zhb` bi
`obb ik ycukn jaibgrhk jcxsojdihvirus, htj
 

scrh tarcot, `/AO/k/omg poik UH< Pirob paoryknitis, ik`hjticus fckckujbhc

fckckujbhcsis
sis
hkbornhg hrytahfotcus, hxugotivh Gh`ikitivh gionkcsis rhquirhs tarcot jubturh
tcksibs, phthjaioh ck sc`t poboth cr oktinhk ghthjtick thst `cr NOZ
Kc raikcrraho, acorshkhss cr ]opig oktinhk ghthjtick< aina sphji`ijity,
jcunaikn voriombh shksitivity (ghphkgs ck quobity c`
Zjorbht `hvhr< sokgpophr rosa wita swom). jck`irf khnotivh thst wita tarcot
`hvhr okg paoryknitis jubturh
Zjaccb onhg jaibgrhk okg
Ztrhptcjcjjob - mhniks ot khjd/oxibboh/nrcik
khjd/oxibboh/nrcik,, sprhogs
ogcbhsjhkts, sprhog vio crob Nrcup O strhp UC p
paoryknitis tc hxtrhfitihs, foy ghsquofoth
shjrhticks

Urifory HMP ik`hjtick ik cbghr JFP, tcxcpbosfo nckgii, AAP0,

jaibgrhk okg ogcbhsjhkts oghkcvirus, AIP
Folcrity c` phcpbh orh ik`hjthg Uokjytcphkio ikgijoths fobinkok
fobinkokjyjy
wita HMP okg shrcjckvhrt ik Bhudcjytcsis cr bhudcphkio, 85%
horby jaibgaccg (usu byfpacjyth, ot bhost ?5% otypijob
osyfptcfotij) byfpacjyths Zhb` bi
Zhvhrh hxugotivh paoryknitis, `hvhr,
Ik`hjticus fckc HMP Ahthrcpaibh oktimcgy<
oktimcgy< bifithg shksitivity ik rhstri
prc`cukg `otinuh
pts 27 Warcfmcjytcph
Warcfmcjytcphkio,kio, hbhvothg ruptu
ahpotij troksofikosh bhvhbs

Jckgitick Ghsjriptick Hticbcny Zinks/syfptcfs Ggx Wrhot

Pirus ikgujhg ik`boffotick c` Acorsh vcijh, mordy/sho
mordy/shobb bidh jcuna,
jcuna,  OU khjd okg jahst rogicnropas Jccb
boryknctrojahob tissuhs, ikspirotcry strigcr waija foy prcnrhss sacw sthhpbh sink (285%) strigc
rhsubtikn ik upphr oirwoy tc rhspirotcry gistrhss Ggx< hpinbcttitis, mojthriob trojahitis, ]hscb
cmstrujtick Urcgrcfh< bcw nrogh `hvhr okg `crhink mcgy ospirotick, okopayboxis, H]< n
Fcst prckcukjhg ik ycukn raikcrraho ?=-=7a pricr tc cksht c` oknickhurctij hghfo hpik
jaibgrhk guh tc korrcw jobimhr c` strigcr  - Hpinbcttitis< bi`h-tarhothkikn hfhrnhkjy, jcrti
Uorofyxcvirus
Jrcup Ojuth sumnbcttij rhnick. Uhods ik both taufmprikt sink. Jaibg grccbs okg bhoks
(poroik`buhkzo3),
(poroik`buhk zo3), jok
boryknctrojahc `obb/wikthr  `crworg wita jaik hxthkghg. Hfhrnhkt
obsc rhsubt `rcf
mrckjaitis iktumotick cr jrijctayrcigctcfy. IP
ik`buhkzo cr ]ZP
ofpijibbik- submojtof. Minnhst risd `ojtcr is
`oiburh tc foiktoik Aim vojjikotick
stotus

 Ojuth virob bcwhr rhspirotcry

rhspirotcry ]opig ossoys `rcf kosob shjrhticks `cr Zupp
trojt ik`hjtick rhsubtikn ik ]ZP, ik`buhkzo O okg M, htj JQ] `cr ibb cr Uovob
ik`boffotcry
ik`boffot cry cmstrujtick c` tah aypcxij pts cr rhjurrhkt wahhzikn om)< p
phripahrob
 Ot bhost 85%oirwoys
c` jaibgrhk orh -taijdhkikn
bukn ayphrik`botick, phrimrckjaiob
phrimrckjaio
(ju``ikn), ikjr b
ikthrstitiob wi
wikt
jakth
rchk
ik`hjthg mh`crh ? yr c` onh, Ik`hjthg khckoths foy ghvhbcp bi`h fordikns prhfi
]ZP, obsc
rhjurrhkt ik`hjticks orh tarhothkikn opkho
poroik`buhkzo,
poroik`buhkzo, ik`buhkzo,
jcffck. :% c` ik`okts ik `irst ?= Ikitiob `hvhr, jcuna, raikcrraho `cbbcwhg
Mrckjaicbitis aufok
fc c` bi`h orh acspitobizhg `cr my rhspirotcry gistrhss UH< wahhzikn,
fhtopkhufcvirus,
mrckjaicbitis Jacrkij bukn rackjai, jrojdbhs, ojjhsscry fusjbh
oghkcvirus
gishosh, jcknhkitob ahort ush
gishosh, iffukcgh`ijihkjihs orh
risd
`ojtcrs

 Obfcst obb orh o`hmribh Jotorraob Bhudcjytcsis wita byfpacjyth Acspi

paosh<< >-?5g ikjumotick, ?-= wds bcw-
paosh prhgcfikokjh jyok
nrogh `hvhr, jcuna, jcryzo UJ] cr jubturh c` crnokisfs ik gi``iju
Uorcxysfob paosh<
paosh< sposfs c` koscpaoryknhobb shjrhticks
koscpaoryknho Hryta
X]I okg phrsisthkt jcuna ik jcunaikn `cbbcwhg my sugghk JQ] usuobby kcrfob, ik`ibtroths foy mh jotor
Uhrtussis ogubts, bi`h tarhothkikn gishosh Mcrghthbbo phrtussis ikaobotick ("waccp") shhk prcpa
ik khckoths/ik`okts Jckvobhsjhkt paosh
Jckvobhsjhkt paosh<< fcst sxs
rhscbvh my jcuna phrsists =-1wds

J. trojacfotis< o`hmribh, jcklukjtivitis, I` pbhurob h``usick< groik, jhbb jcukt, nrof Aina
stojjotc jcuna F pkhufc okg J. stoik, jubturh fcst
pkhufc< `/AO/fyobnio I` aina `hvhr ik jaibg< mbccg jubturh Hryta
F pkhufc< fojubor/hrytahfotcus
fojubor/hrytahfotcus ropig ik`buhkzo thst, G@O/UJ]/tissuh jborit
rosa, hrytahfo fubti`crfh jubturh `cr J. trojacfotis pkhu
Pirob< gi``ush wahhzikn okg jrojdbhs F pkhufc< UJ] cr jcbg onnbutikiks  Ozita
Mojthriob< `cjob jrojdbhs/ghjr troja
Ycukn jaibgrhk< virushs phrjussick/hncp
phrjussick/hncpacky/mrckjac
acky/mrckjacpa
pa cky Khck
ojuth ik`boffotcry prcjhss FJJ Ycukn jaibg< tojaypkho cut c` (cr n
Ukhufckio
cjjurikn ik bukns J. trojacfotis ot =-: fc prcpcrtick tc `hvhr 
Z. pkhufc, htj
 

Jckgitick Ghsjriptick Hticbcny Zinks/syfptcfs Ggx Wrhot

Ik`hjtick c` bhptcfhkiknhs okg k/v, pactcpacmio, irritomibity, bhtaorny, Hkjhpaobitis, grun iktcxiotick cr s/h, Khck
JZ@ AO, sti`` khjd okcxio/aypcxio, prifory cr fhtostotij JKZ Bisthr
Khckoths< bcw mirta whinat, Pirob prcgrcfh< `/foboish, scrh tarcot, fobinkokjy, mojthriob hkgcjorgitis wita vokj
prcbcknhg rupturh c` fyobnios. Xsuobby rhscbvhs ik =-7g shptij hfmcbisf, iktrojroikiob jhpa
fhfmrokhs,
fhfmrokh s, jacricofkickitis
jacricofkickitis Mojthriob< kc prcgrcfh. Aina `hvhr  ahfcrraonh/ahfotcfo, fobinkokt AWK,  Omx u
prhgispcsh tc shptijhfio okg - AWK, mrogyjorgio, opkhij, ikjr IJU ghfyhbikotick giscrghrs ri`of
fhkiknitis Byfh< bcw nrogh `hvhr, AO, sti`` khjd, JZ@ okobysis gionkcstij< jhbb jcukts
FJJ hkthrcvirus pactcpacmio
pactcpac mio cvhr ?-= wds + gi``, nrof stoik, nbujcsh okg prcthik
Mojthriob< Z. pkhufc Dhrkin< dkhh hxthksick --; `bhxick c` bhvhbs, jubturh
aip wita poik Mrugziksdi< possivh UJ] `cr AZP okg hkthrcvirushs
Fhkiknitis okg K. fhkiknitig
fhkiknitigis
(khckoths is
okg jaibgrhk khjd `bhxick
2: orh ainahst risd) --; ikvcbuktory bhn `bhxick

Zobfckhbbo, Zainhbbo, Hxjhssivh stccbikn --; ghaygrotick,  Omx p

H. Jcbi, Yhrsikio ikoghquoth
ikoghquo th kutritick, hbhjtrcbyth ikjrh
hkthrcjcbitijo, omkcrfobitihs sykgr 
Jofpybcmojthrr lhluki,
Jofpybcmojth Mojthriob giorraho< `hvhr, omgcfiko
omgcfikobb WFU
Pimric jacbhro jrofpikn, foboish, thkhsfus, hryta
]ctovirus< folcr joush vcfitikn is bhss jcffck. Ztccbs w/  lhluki
c` kckmojthriob
kckmojthriob fujus, nuioij pcsitivh
nostrchkthritis ik ik`okts Zainhbbo< khurcbcnij sxs Zobfckhbbo<
okg tcggbhrs hxtroikthstikob gishosh (fhkiknitis okg
Niorgiosis< FJ ikthstikob csthcfyhbitis)
gishosh ik XZ Zainhbbo okg H. Jcbi< ahfcbytij Hbhjtrcbyth okg rhkob `ukjtick stugihs
Nostrchkthritis
urhfij sykgrcfh Mbccg jubturh ot tifh c` ikitiob hvobuotick
Yhrsikio< hrytahfo kcgcsuf,
pshugcopphkgijitis

Hkthrcmius vhrfijuboris  Ogahsivh toph fhmh

Uikwcrf Uhriokob, vubvor itjaikn stccb C&U kct rhjcffhkghg - `hw cvo ik obmhk
stccb
Uhrikotobby ik`hjthg< osyfptcfotij Ggx< HMP, JFP, hkthrcvirus, ctahr virob
AOP okg AHP< giorraho ik`hjticks. Outciffukh ahptotitis,
Zjbhrob ijthrus cr
ahpotcfhnoby, loukgijh,
]X_ thkghrkhss, fhtomcbij
giscrghrs, bivhr
grungishosh, mibiory trojt
iknhsticks
mhkink-opphorikn
mhkink-opp horikn rosa ik horby AMP AOP< okti-AOM InF oktimcgy 6 ik`hjtick
AJP oktimcgy< prhshkt ik ojuth okg
jarckij, ?= wd wikgcw phricg
Jorrihr stoth osscjiothg wita AJP ]KO< pcsitivh wtiaik ? wd AOP<
Ahpotitis
ahpotcjhbbubor
ahpotcjhbbu bor jorjikcfo - AJP ]KO wita khnotivh oktimcgy 6 ojuth witaik
ik`hjtick (wikgcw phricg)
- khnotivh AJP ]KO 6 rhjcvhry

Jcknhkitob< ahpotcfhnoby, PG]B okg ]U]< thsts `cr oktimcgihs tc

spbhkcfhnoby,
spbhkcfhn oby, fujcjutokhc
fujcjutokhcus
us bipcigob fcbhjubh rotahr taok crnokisf
bhsicks, loukgijh, BOG, sku``bhs itshb`.
(mbccgy, fujcpurubhkt kosob - @obsh pcsitivhs ik ik`hjticus fckc,
gisjaornh) jckkhjtivh tissuh gishosh, hkgcjorgitis,
Jcknhkitob cr shxuobby ojquirhg.
Jcknhkitob Zhxuobby ojquirhg< prifory jaokjrh okg WM
Zypaibis Jcffckby jcik`hjtick wita ctahr Wrhpckhfo pobbiguf taot ahobs ik :-0 wds, shjckgory @WO-OMZ okg portijbh onnbutikot
onnbutikotick<
ick< `hwhr IF cr
ZWG. ghrfotcbcnij ikvcbvhfhkt (pobf okg `obsh pcsitivhs
scbh rosa), thrtiory nuffos ik sdik, Khwmcrks< bufmor pukjturh tc
mckh ahort, JKZ ighkti`y khurcsypaibis - pbhcjytcsis okg
hbhvothg prcthik
?=

Jckgitick Ghsjriptick Hticbcny Zinks/syfptcfs Ggx Wrhot

Nhkitob AZP AZP = cr ?
ik`hjtick
 

Hitahr jhrvijob fctick thkghrkhss cr KOOW thsts `cr nckcrraho okg jabofygio ]x ``c c
uthrikh/ogkhxob thkghrkhss - fust obsc c``hr thstikn `cr sypaibis, AIP, okoh
 Oggitickob jrithrio<
jrithrio< crob W;?5?,
W;?5?, okg ctahr ZWI J tro
hbhvothg HZ] cr J]U, ^MJs ik - prhnkokjy thst Ziknb
vonikob shjrhticks, fujcpurubhkt Nyk ggx< fujupurubhkt jhrvijitis, hjtcpij gcxy
J. trojacfotis, K. gisjaornh, bom hvighkjh prhnkokjy, rupturhg cvoriok jyst, shptij  Okoh
Uhbvij
nckcrrahoh omcrtick, hkgcfhtricsis Kcknyk ggx<
ik`boffotcry Xsuobby pcbyfijrcmiob
- obsc okohrcmhs okg opphkgijitis, pyhbckhparitis, IMG
Gishosh
hkthrij nrof khns

Wrijacfckos< fcst osyfptcfotij, Wrijacfckos< UFKs okg trijacfckogs ck

fobcgcrcus, `rctay nroy gisjaornh okg wht prhp
vonikob gisjcf`crt. Uhkibh gisjaornh Mojthriob< vonikob pA ; 7.8, jbuh jhbbs
Mojthriob< taik, waith, `cub- sfhbbikn Jokgigo< yhost okg pshugcaypaoh ck wht
gisjaornh wita `isay cgcr wahk fixhg prhp wita DCA
wita DCA Wrija
Jokgigo cjjurs ik wcfhk wita
Jokgigo, Wrijacfckos, Jokgigo< taijd waith vonikob gisjaornh Mojth
Pubvcvonikcsis omx ush, prhnkokjy, giomhths,
mojthriob wita vonikob itjaikn okg murkikn okti`u
iffukcsupprhssick,
iffukcsupprhssi ck, CJU ush
UC `b

K nckcrraho okg J Xrhtarob gisjaornh, itjaikn, gysurio, Gionkcsis< fujcig cr purubhkt urhtarob Nckc
trojacfotis `rhquhkjy. gisjaornh, pcs bhud hsthrosh, ^MJs ck  OKG
- obsc fyjcpbosfo `irst-vcig urikh, nrof khn iktrojhbbubor C] >
nhkitobiuf okg gipbcjcjji ck nrof stoik - ozit
Xrhtaritis
trijacfckos vonikobis - thst pts `cr ctahr ZWGs jcvhr
nhkit

 OIGZ< OIGZ-gh`ikikn
OIGZ-gh`ikikn ibbkhss
ibbkhss Nhkhrobizhg BOG, ahpotcfhnoby, Urhn
cjjurs cr wahk JG7+ spbhkcfhnoby, `oiburh tc tarivh, `cbbc
byfpacjyth jcukt is bhss taok o giorraho, jogigiosis, porctitis, okg 0 wd
gh`ikhg kufmhr `cr onh ghvhbcpfhktob ghboy troks
;95% ik uthrc cr phrikotob ]isd ]hsp< byfpacig ikthrstitiob UKO, UJU HBIZO okg ^hsthrk mbct kct ush`ub ik K]WI,
AIP okg OIGZ c` troksfissick is =8% i` UKO WFU-
jaibgrhk 2?1 fcktas
uktrhothg

]cjdy Fcuktoik Wijd mith (wccg tijd, gcn tijd, @hvhr, AO, rosa >g o`thr tijd mith Kc rhbiombh gionkcstij thst. Oms jck`irf Hfpi
Zpctthg @hvhr  bckh stor tijd) - `/j/AO/k/v/fyobnios
`/j/AO/k/v/fyobnios gionkcsis ?5g o`thr sxs okg
 Oprib-Zhpt - rosa ck =kg-8ta goy, mbokjaikn Warcfmcjytcphkio
Warcfmcjytcphki o okg aypckotrhfio gcxy
hrytahfotcuj fojubor bhsicks taot Ggx< hrbijaicsis, fhkikncjcjjhfio,
fhkikncjcjjhfio, ogg j
]ijdhttsio rijdhttsii prnrhss tc phthjaioh cr purpuro otypijob fhosbhs susp
- storts ck wrists/okdbhs okg
sprhogs ikworg

Hrytahfo finroks (horby bcjobizhg  Otypijob rosa foy

foy mh jck`ushg wita
wita Wrhot
gishosh, :-:5g o`thr mith), `, AO, hrytahfo fubti`crfh cr hrytahfo gissh
fyobnios fornikotuf Ycuk
Horby (goys--; wds)< fubtipbh hrytahfo Ggx ortaritis< luvhkih igicpotaij ortaritis, jh`ur 
Wijd mith (ghhr tijds, mbojd finroks bhsicks, jrokiob khrvh pobsy rhojtivh ortaritis, ]hithr sykgrcfh. Jaibg
bhnnhg tijds) fhkiknitis Ggx fhkiknitis< oshptij fhkiknitis
Byfh gishosh Mcrrhbio murngcr`hri Both (;0wds)< ortaritis, usuobby Jbikijob gionkcsis,
gionkcsis, hbhvothg InF tithr wds
- ik`hjthg tijd fust `hhg `cr 
;71a ikvcbvikn dkhh o`thr tijd mith

?:
Ahfh
Jckgitick Ghsjriptick Zinks/syfptcfs Ggx
Fijrcjytij okhfios
]isd `ojtcrs< hxthkghg hxjbusivh mrhost`hhgikn Cjjurs os horby os : fc ik prhfih.
(;0 fc), bcw-irck `crfubo, bcw-irck scbigs, Fibg (0-1 n/gB)< ghjr opphtith, irritomibity, `otinuh, ghjr hxhrjish
hxjhssivh jcw fibd. tcbhrokjh. Zdik/fujcus fhfmrokh pobbcr, tojayjorgio, systcbij
Cjjubt mbccg bcss< NI okcfobihs (fhjdhb, hlhjtick furfur obckn bh`t sthrkob mcrghr 
 luvhkibh pcbyps) Zhvhrh (2: n/gB)< JA@, tojayjorgio, Z: nobbcp, jorgicfhnoby,
Cvhrt bcss< mbccgy stccbs cr troufotij ahpotcfhnoby, gisthkghg khjd vhiks, robhs
ahfcrraonh Nbcssitis, oknubor stcfotitis, dcibckyjaio ik j aibgrhk wita iscbothg ]h
]hsp
spck
cksh
sh tc op
oppr
prcp
cpri
riot
oth
h iirc
rck
k su
supp
ppbh
bhfh
fhk
k
Irck gh`ijihkjy okhfio irck gh` okhfio ik ghvhbcphg koticks mhst gionkcstij thst
 

Am Morts<
Morts< Noffo-nbcmik thtrofhrs. Aina o``ikity `cr cxynhk --;  Obpao taob
taob folcr< AmMorts
AmMorts
aypcxio, ahort `oiburh, AZF, hghfo, aygrcps `htobis AmA gishosh<
gishosh< ?5-75% AmA, 05-95% Am
AmA< mhto nbcmik thtrofhr. AmA gishosh< ghbhtick c` : cut c` 7 taob troit< kcrfob hbhjtrcpacrhsis, sifibor
obpao nhkhs. gh`ijihkjy
- ot mirta< AmMorts prhgcfikoths Mhto taob folcr< kcrfob mbccg jcukts ot
- `irst `hw fcktas< AmA prhgcfikoths - aypcjarcf
aypcjarcfio, io, fijrc
fijrcjytcs
jytcsis,
is, okiscjytcs
okiscjytcsii
- okhfio, AZF, rhquirh ikthrfitthkt troks`usicks pcidibcjytcsis
Obpao taob< ghbhticks Obpao taob troit< ghbhtick c` = nhkhs. Mbojds okg Fhgithrrokhok. - hbhvothg Am@
Mhto taob< pcikt futoticks C`thk jck`ushg wtia @h-gh` okhfio Mhto taob
taob fikc
fikcr<
r< hbh
hbhvotic
voticks
ks c` AAmO=
mO= o
okg/
kg/
Obpao okg Mhto Mhto taob< kcrfob mbccg jcukts ot mirta (fcstby `htob Am), shvhrh
Ifmobokjh mhtwhhk obpao okg mhto jaoiks --;
taobosshfio
hxjhss c` ckh typh --; ukstombh fckcfhrs taot okhfio, crnokcfhnoby,
Hxtrofhgubbory nrcwta--;
ahfotcpcihsis `oiburh gurikn
`rcktob `irst yhor.
mcssikn, foxibbory
prhjipitoth okg gofonhs fhfmrokh
ayphrtrcpay, cvhrmith

Ik`boffotick --; ikjr ahpotij prcgujtick c` WIMJ bcw, `hrritik kcrfob cr ikjr 
ahpjigik --; ikthrkobizotick/ghnrogotick c` MF hxo
hxof<
f< IIkjr
kjr ik s
stcr
tcronh
onh irc
irck,
k, ghj
ghjrr ik iirr
Okhfio c` `hrrcpcrtik --; ifpoirhg rhbhosh c` irck `rcf jcktoikikn hrytarcmbosts
fojrcpaonhs okg omscrptick c`  Fibg okhfio (1-?5 n/gB) Xsuobby kcrfcjytij ikitiobby
ik`boffotick
irck `rcf nut

Kckfhnobcmbostij fojrcjytij okhfios

Giofckg-Mbojd`ok Jcknhkitob purh rhg jhbb opbosio futotick ik Urhshkts ik `irst yhor c` bi`h. Fojrcjytcsis, rhtijubcjytcphkio hbhvothg
Okhfio rimcscfob prcthik Z?9 (]UZ?9) =8% aovh osscjiothg okcfobihs< sacrt stoturh, whm khjd, jbh`t bip, Hbhvothg ]MJ oghkcsikh ghofikosh
saihbg jahst, tripaoboknhob taufm

Fojrcjytcsis Hbhvothg Am@

?5% ghvhbcp bhudhfio
Ayphrpinfhktotick, jo`é ou boit spcts, fijrcjhpaoby, Jc
Jck`
k`ir
irf
f gi
gion
onkc
kcsi
sis
s my
my ghf
ghfck
ckst
stro
roti
tik
kn ikj
ikjrr
 O] cr Q bikdhg,
bikdhg, pokjytc
pokjytcphkio
phkio Gh`hjt
Gh`hjt ik GKO jarcfcscfob mrhodonh wita
@okjcki okhfio fijrcpataobfio, sacrt stoturh, acrshsach/omshkt digkhy, omshkt
rhpoir  hxpcsurh tc gihpcxymutokh (GHM)
taufms

@oiburh c` ahfotcihtij sthf jhbbs --; JMJ< jytcphkio, fijrcjytcsis

pokjytcphkio Gionkcsis< phripahrob pokjytcphkio +
Zhvhrh Opbostij - guh tc jahfijobs (mhkzhkh), gruns aypcjhbbubor mckh forrcw
(jabcrofpahkijcb, sub`ckofighs), ik`hjticus  Okhfio, tarcfmcjytc
tarcfmcjytcphkio,
phkio, khutrcph
khutrcphkio
kio
Okhfio
onhkts (ahpotitis), ickizikn
rogiotick. Xsuobby igicpotaij.

Giscrghrs c` ahfcstosis
 Oktipbothbht outcoktimcgihs
 Oktipbothbht outcoktimcgihs --; ghstrujtick my JMJ< kcrfob, hxjhpt tarcfmcjytcphkio
]HZ - bornh, ycukn pbothbhts
Iffukh - prifory, cr shjckgory tc ZBH cr AIP Gionk
Gionkcscsis
is mos
moshg
hg ck aiaistc
stcry,
ry, pa
paysi
ysijob
job,, mb
Omrupt cksht phthjaioh/mruisikn ?-7wds o`thr `hmribh/virob ibbkhss jc
jcuk
ukt.
t. Gc
Gchs
hs kc
kctt rh
rhq
qui
uirh
rh MF hxof
hxof,, bo
bom
m tth
h
tarcfmcjytcphkio
oktimcgy ghthjtick

Xkhxpboikhg pcst-cp mbhhgikn

Khwmcrks< iktrojrokiob mbhhgikn `rcf ghbivhry, mbhhgikn o`thr
jirjufjisick (ovcig jirjufjisick
jirjufjisick))

Ahfcpaibio O okg M Ahfcpaibio O< `ojtcr PIII Ahfcpaibio M< `ojtcr IQ

?7
Ckj
Jckgitick Ghsjriptick Zinks/syfptcfs Ggx Wr  
Bhudhfio
 

Fcst jcffck phgiotrij jokjhr (>8%) Kcrfcjarcfij kcrfcjytij okhfio, bcw rhtij Ikg
Fcst jcffck is prhjurscr M jhbb jcukt, bcw ^MJ jcukt voriombh sth
(15%) nccg prcnkcsis4 W jhbb OBB AZF okg jhrvijob BOG ot gionkcsis.  Og
(?9%), Foturh M jhbb (Murditt) (?%) Hxtrofhgubbory ikvcbvhfhkt ik JKZ, sdik, Jc
Uccr prcnkcsis< onh ;?5 yrs cr  thstijbhs (8%). dibb
2? yr, ^MJ ;85,555 ot - AO hfhsis, popibbhghfo, JK0 pobsy `oib
gionkcsis,, `oiburh tc rhspckg tc
gionkcsis @hvhr, fhgiostikob foss (fcstby W jhbb), Ikt
ikgujtick tahropy, Uaiboghbpaio FW
jarcfcscfh ]o
gis

OBB

=5% jaibgaccg bhudhfios Ja

Mhst prcnkcsis< F: OFB (OUFB) okg Ikg
triscfy =? pts wita F> OFB Bc
^crsh prcnkcsis< ^MJ tro
;?55,555/ff: Jabcrcfo< sc`t tissuh tufcr ik spikob jcrg,
Jabcrcfo<
Bcw risd< ikv ?0, t?04?0, t14=? Aina mroik, sdik
OFB risd< fckcscfh 8 cr >, cr kc Bhudhfio jutis
jutis<< Khckoths, Mbuhmhrry

rhfissick fu``ik spcts

Niknivob ayphrtrcpay

Byfpcmbostij (85%)< prh-W cr prh- M W jhbb byfpacmbostij byfpacfo<

by fpacfo< fhg
fhgiostikob
iostikob JMJ< bhudcjytcsis, Jc
Murditt (:8%) cr bornh M jhbb foss tarcfmcjytcphkio, okhfio rhs
 Okopbostij bornh jhbb (?8%) M jhbb byfpacmbostij byfpacfo<
b yfpacfo< mckh JFU `cr tufcr bysis - tu
:rg fcst jcffck fobinkokjy ik ikvcbvhfhkt, iscbothg byfpa kcghs, sdik JQ] `cr fhgiostikob foss MF `bu
jaibgaccg, ?5% c` jaibgaccg jokjhrs. Murditt< omgcfikob tufcr w/ k/v, ospirotick okg micpsy wita `bcw hbh
Mcys :x os foky os nirbs iktussusjhptick, tcksibs, mckh forrcw, JKZ jytcfhtry - ai
]isd `ojtcrs< jcknhkitob  Okopbostij bornh< sbcwby prcnrhssivh BU `cr JKZ
JKZ ikvcbvhfhkt JW rhq
iffukcgh`ijihkjy (^isdctt Obgrija, gishosh wita `hvhr  sjok tc osshss hxthkt ct
Kck-Acgndik byfpacfo ZJIG), ojquirhg iffukcgh`ijihkjy, gishosh
Mbccf sykgrcfh, otoxio
thboknihjtosio

Ckj
Jckgitick Ghsjriptick Zinks/syfptcfs Ggx Wr  
Ikjrhosh ikjighkjh c` iffukh Ggx rhojtivh/ik`boffotcry
gysrhnubotick kcghs< mojthriob byfpaoghkitis,
 Osscjiotick wita HMP ik`hjticus fckc, WM, otypijob
Ikjr risd ik otoxio thbhoknihjtosio, fyjcmojthriob ik`hjtick, jot
^isdctt-Obgrija, Mbccf sjrotja, AIP, aistc, tcxc
Mifcgob gistrimutick ?. JQ] `cr
`cr fhgiostikob
Zumtyphs< ikvcbvhfhkt, oirwoy
- Kcgubor sjbhrcsikn (75-88%) jcfprcfish
- Byfpacjyth prhgcfikokt (?5- ?8%) Uoikbhss, rummhry, jhrvijob BOG =. Uubfckory `ukjtick thst,
- Fixhg (:5%) (15%) HJAC mh`crh okhstahsio ik pts
- Byfpacjyth ghpbhthg (8%) wita fhgiostikob foss Fu
M syfptcfs< `hvhr, kinat swhots, whinat
Acgndik byfpacfo :. Hxjisickob byfpa kcgh By
bcss
micpsy rhquirhg `cr gionkcsis< prc
Hkbornhfhkt c` bivhr/spbhhk ik ogvokjhg
gishosh ]hhg sthrkmhrn
Hcsikcpaibio jhbbs
(?8-:5%)

JKZ tufcrs
 

Jaibgaccg hfmryckob fobinkokjy c`  Omgcfikob tufcrs< aorg sfccta, kck kckthkghr

thkghr Ggx< ogrhkob ahfcrraonh, Ur
pcstnoknbickij syfpotahtij khrvcus omgcfikob fosshs pobpothg ik `bokd, aygrckhparcsis, pcbyjystij tu
systhf. 1% c` obb jaibgaccg jokjhrs gispbojh digkhy. digkhy gishosh, spbhkcfhnoby, -Z
2?8yrs, fcst jcffck scbig tufcr Khjd< Acrkhr sykgrcfh, ahthrcjarcfio c` rhkob jhbb jo, wibfs tufcr, Zt
cutsigh JKZ. iris ck o``hjthg sigh ahpotcmbostcfo, bhudhfio, Zu
- omgcfikob tufcrs (>5%) `rcf Hpigurob ikvosick --; mojd poik okg jcrg byfpacfo, rhtrcphritckhob vik
syfpotahtij noknbio/ogrhkob fhgubbo, jcfprhssick sxs raomgcfycsorjcfo gc
tacrojij fosshs (=5%) `rcf Fhtostotij shquhboh< Jck`irf foss my JW c`
porospikob noknbio, khjd (8%) - Autjaiksck sykgrcfh< jcrtijob mckh poik jahst/omg/phbvis
ikvcbvhs jhrvijob noknbick jousikn bifp tufcr jhbbs ck MF ospiroth
- Uhpphr sykgrcfh< bivhr ik`ibtroth jousikn + hbhvothg urikory
Khurcmbostcfo ahpotcfhnoby jothjacbofikhs
 ‚ ]ojjcck hyhs< phricrmitob ik`ibtrothx Wissuh micpsy `cr aistcbcny,
Uorokhcpbostij h``hjts< wothry giorraho ik GKO pbcigy, okg FYJ- rhbothg
tufcrs shjrhtikn PIU, cpscjbckus ckjcnhkh
fycjbckus (jaoctij hyh fcvhfhkts,
fycjbckij lhrdikn, trukjob otoxio)

Ckj
Jckgitick Ghsjriptick Zinks/syfptcfs Ggx Wr  
 Osscjiothg okcfobihs< spcrogij okirigio,
ahfiayphrtrcpay, jryptccrjaigisf,
aypcspogios, ctahr NX okcfobihs
Mhjdwita-^ihghfokk< ahfiayphrtrcpay,
fojrcnbcssio, cfpaobcjhbh, NX omk
^ON]< ^ibfs, okirigio, NX omk, fhktob
rhtorgotick
Fcst jcffck rhkob tufcr ik jaibgrhk, Uhrbfok sykgrcfh< ukusuob `ojihs, isbht Ggx< aygrckhparcsis, UDG, Zu
jarcfcscfob bcji ??p?: okg ??p?8 jhbb ayphrtrcpay, fojrcsjcfio, spbhkcfhnoby tah
^ibfs tufcr  - fcst orh ukibothrob aofortcfos  Omg XZ, JW, cr F]I
F]I Nc
- fcst jcffck rhkob tufcr  Ctahr `ikgikns< ahfoturio, AWK, vorijcjhbh Ztonikn gckh o`thr kc
- usuobby gionkcshg ik `irst 8 yrs Pck wibbhmrokg's gishosh ik 1% hxpbcrotcry boporctcfy ikv

Mckh tufcrs
Xkgi``hrhktiothg sorjcfo taot orishs Ggx< csthcfyhbitis, hcsikcpaibij
priforiby ik mckh nrokubcfo (boknhraoks jhbb
- t(??4==) ik 18% c` pts aisticjytcsis), csthcsorjcfo,
 ‚ ogcbhsjhkts khurcmbostcfo cr

- `bot okg
phbvis bckn`imubo
(=5%), mckhs< `hfur
(?=%), (=5%),
aufurs raomgcfycsorjcfo
tc mckh fhtostosis
okg timio (?=%) ]ogicnropas< bytij mckh
Ja
- mhniks figsao`t ik bbck
cknnm
mck
ckhs
hs Uoik
Uoik okg
okg bcjo
bcjobi
bizh
zhg
g swh
swhbb
bbik
ikn
n Zyst
Zysthf
hfij
ij<< `hvhr,, bhsick wita jobji`ihg
`hvhr
Hwikn sorjcfo -j
whinat bcss, `otinuh phricsthob hbhvotick (ckick
(ob
sdik) okg/cr sc`t tissuh foss

Wufcr c` mckh-prcgujikn Uoik okg bcjobizhg swhbbikn Zysthfij Ggx< hwikn sorjcfo, mhkink
fhshkjayfob sthf jhbbs foki`hstoticks rorh (vs Hwikn) mckh tufcrs, jarckij
- orishs ik fhgubbory jovity cr =5% aovh fhts< bukn fcst jcffck Noit csthcfyhbitis
phricsthuf gisturmokjh, potacbcnij `rojturhs bytij mckh bhsick wita
- usuobby ot fhtopaysis c` mckhs wita phricsthob rhojtick (sukmurst
foxifuf nrcwta vhbcjity< gistob opphorokjh) Zu
Csthcsorjcfo `hfur, prcxifob timio, prcxifob F]I tc osshss hxthkt, JW tc ]h
aufhrus ghthjt pubf
kcgubhs), fhts
mckh (jobji`ihg
sjok `cr fhts Ja
 

GGx< jcknhkitob jotorojt, Hk

fhgubbchpitahbicfo,
fhgubbchpita hbicfo, Wcxcjoro tah
jokis hkgcpataobfitis,
hkgcpataobfitis, rog
phrsisthkt ayphrpbostij prifory - tr
vitrhcus, Jcots gishosh jbo
Wufcr c` hfmryckij khurob rhtiko Bhudcjcrio (omshkt rhg rh`bhx) Cpataobfcbcnij hxof,
hxof, F]I Jai
]htikcmbostcfo Jarcfcscfh
Jarcfcscf h ?:q?7, M]?
M ]? bcjus Wribothrob rm< ikvcbvhfhkt c` pikhob cr cr
- 05% ukibothrob poroshbbor siths sa
rhn

Zc`t tissuh sorjcfos

?>
Ckj
Jckgitick Ghsjriptick Zinks/syfptcfs Ggx Wr  
Fcst jcffck ZWZ ik jaibgrhk 2?5 Ahog okg khjd (:8%),
(:8%) , NX (==%), JW cr F]I c` sith, jahst JW
- Osscjiothg `ofibiob sykgrcfhs< hxtrhfhtihs (=5%) okg mckh sjok `cr fhts mckh
khurc`imrcfotcsis, Bi @roufhki =8% aovh gistokt fhts, bukn fcst jcffck forrcw micpsy rhquirhg
- = sumtyphs< hfmryckob (8:%), sith Zu
]aomgcfycsorjcfo
obvhcbor (=?%) -j
- t(=4?:) okg t(?4?:)

Kck raomgcfycsorj
raomgcfycsorjcfo
cfo Ahthrcnhkcus JW cr F]I c` sith, jahst JW
Fobinkokt phripahrob khrvh sahota okg mckh sjok `cr fhts
tufcrs< osscjiothg wita K@ typh I Zu
- Fobinkokt `imrcus aisticjytcfo cr 
bhicfycsorjcfo
Iffukcbcny, Obbhrny, ]ahuf
Jckgitick Ghsjriptick Zinks/syfptcfs Ggx
Iffukcbcny
Pirushs, fyjcmojthrio ik`hjticks, `ukni, UJU Q bikdhg ZJIG< Ghjrhoshg omscbuth
Ghjrhoshg omscbuth byfpac
byfpacjyth
jyth jcuk
prhshkts ik `irst 0 fc wita W jhbbs.
virob/mojthriob ik`hjticks, giorraho, `oiburh tc tarivh.  Omshkt W jhbb `ukjtick< ik vitrc
vitrc fitcnh
Byfpacphkio, omshkt JG7 jhbbs stifubotick, iktroghrfob ghboyhg
?. Q-bikdhg< IB=]N nhkh - noffo jaoik Ginhcrnh< jcknhkitob ahort gishosh, aypcjobjhfij thtoky, ayphrsh
ayphrshksi
ksiti
tivit
vity
y thstikn
thstikn Omshkt
Omshkt okt
oktimc
imc
W jhbb iffukity< ZJIG c` IB-= rhjhptcrs fob`crfhg hors/`ojh `ukjtick (fhosurh o`thr 0 fc)
=. GiNhcrnh GiNhcrnh< omshkt tayfij saogcw ck
@IZA

Q bikdhg onoffonbcmubikhfio Gionkcstij hvobuotick<

(Mrutck)< kc foturh M jhbbs. Bi`h - InN, InO, InF bhvhbs
tarhothkikn hkthrcvirus ik`hjticks - shruf prcthik sjrhhk - obmufik cr
JPIG< aypcnoffonbcmubikhfio, hsp troks`hrrik tc r/c ctahr hticbcnihs
InN okg InO. Ghjr oktimcgy `crfotick tc - okt
oktiimcgy
mcgy ti thr
thrs
soo``t hr
hr iiff
ffukukii z
zot
otiick (t
vojjikhs. Ikjr byfpacfo okg okg giptahrio 6 prcthik oktinhks4
outciffukh gz pkhufcjcjji okg A ik`buhkzo 6 jorm
Zhbhjtivh InO gh`ijihkjy< InO 28 oktinhks)
Aufcrob iffukity< fn/gb, mojthriob ik`hjticks c` rhspirotcry, Wroksihkt
Wroksi hkt aypcnoffonbcmubikhf
aypcnoffonbcmubikhfii
]hjurrhkt ik`hjticks wita hkjopsubothg crnokisfs
Oktimcgy gh`ijihkjy NI, okg urikory trojts ik`okjy<< ghboyhg
ik`okjy ghboyhg o ojqui
jquisit
sitick
ick c` kcrf
kcrf
o`thr 0 fcs- ctitis fhgio, sikusitis, pkhufckio
sykgrcfhs iffukcnbcmubik bhvhbs
- fcst
fcst g ghvh
hvhbcp
bcp kcrf
kcrfob ob bbhvh
hvhbs
bs mmy
y =-8 y
aovh iktojt rhspckshs tc vojjikotick

^isdctt-Obgrija< Q bikdhg, M okg W jhbb

^isdctt-Obgrija< Ikjr susjhptimibity tc virubhkt okg cppcrtukistij ik`hjticks,
giscrghr. Acst's oms gc kct rhspckg tc outciffukity
jormcaygroth oktinhks ^isdctt Obgrija< otcpij ghrfotitis, tarcfmcjytcphkio.
Jcfmikhg Ayphr InF< JG75B futotick. @oiburh c` Ayphr InF< rhjurrhkt sikcpubf ik`hjticks, UJU
iffukcgh`ijihkjy jboss switjaikn.
 

Iksu``ijihkt kufmhr c` UFKs Niknivitis, sdik ik`hjticks, r hjtob ik`boffotick

ik`boffotick,, ctitis fhgio, Khutrcphkio ggx< ik`hjtick (hsp v iirru
(khutrcphkio),
(khutrcphkio ), jhbb gys`ukjtick, cr pkhufckio, shpsis. Z. ourhus okg nrof khn ik`hjticks.
pkhufckio, fhgijotick ogfikistrotick (phkijibbik,
finrotick gh`hjt - omshksh c` ik`boffot
ik`boffotcry
cry rhspcksh --; kc hrytahfo, worfta, su
sub`
b`ck
ckof
ofig
ighs
hs,, okti
oktijc
jckv
kvub
ubso
sokt
kts)
s),, fobin
obin
Jarckij nrokubcfotcus gishosh< fcst cr swhbbikn ik MF, opbostij okhfio
jcffck. @oiburh tc nhkhroth suphrcxigh JNG<< jarckij/rhjurrhkt pycnhkij ik`hjticks my jotobosh pcs
JNG - shvhrh< OKJ 25.8x?5[:
Bhudcjyth ogahsick gh`ijihkjy< crnokisfs, omsjhsshs. @oiburh tc tarivh, giorraho, phrsisthkt - jarckij< ;=-: fcktas
gh`hjt ik ogahsick tc hkgctahbi
hkgctahbiob
ob jhbbs, jokgigiosis c` fctua JNG< ^MJ mhtw ?5,555-=5,555,
fcst jcffckby JG?1 BOG<< ^MJ jcukts 8-?5x kcrfob, ukombh tc `crf nrokubcfos.
BOG bhudchrytarcmbostij
bhudchrytarcmbo stij rhspcksh
Uaoncjytij iffukity Zhvhrh niknivitis, ikthstikob `istuobs, pccr wcukg ahobikn, - kitrcmbuh thtrozcbiuf thst,
ghboyhg shporotick `c ufmibijo jcrg giaygrcracgofikh
giaygrcracgof ikh rhgujtick (GA])
BOG< `bcw jytcfhtry okobysis c` JG

Jcfpbhfhkt iffukity Mojthriob ik`hjticks, rahufotcbcnij gishosh J8-J9 gh` <

Ifpoirhg cpsckizotick Khisshrio fhkiknitigis ik`hjticks J?-J7 gh`< ZBH

Obbhrny
Jarckij rhbopsikn/rhfittikn rhojtick tc Ururitij, hrytahfotcus, whhpikn popubcvhsijubor rhojtick --;
obbhrnhks (`ccg/hkv) ?5% c` phgiotrij sjobikn, ayphrtrcpay, bijahki`ijotick
pcpubotick nhkhtij prhgibhjtick 2= yrs< hxthkscr sur`ojhs
Otcpij ghrfotitis 85% ghvhbcp obbhrnij raikitis ;= yrs< `bhxcr sur`ojhs,
sur`ojhs, khjd, wrists, okdbhs GGx< jcktojt ghrfotitis, pscriosis
okg/cr ostafo

Iffukcbcny, Obbhrny, ]ahuf

Jckgitick Ghsjriptick Zinks/syfptcfs Ggx
W? ayphrshksitivty, InH shosckob (aoy Kosob jcknhstick, raikcrraho, pcstkosob groikonh, skhhzikn, Ggx<
`hvhr)<< bifithg tc pcbbikotick fcktas,
`hvhr) itjaikn - Ik`hjticus raikitis< fcrh jcffck ik
ukjcffck mht`crh 7-8 yrs Kosob fujcso opphors mcnny okg mbuisa ik`okts/tcggbhrs,
ik`okts/tcggb hrs, fujcpurubhk
fujcpurubhktt
]isd `ojtcrs< otcpy, nhkhtij, sfcdikn ?. obbhrnij saikhrs< gord jirjbhs ukghr hyhs shjckgory tc - Zikusit
Zikusitis<
is< j
jarc
arckij
kij raik
raikcr
crrah
raho,
o, pcs
pcstko
tko
- ahovy hxpcsurh tc okifob gokghr horby vhkcus jcknhsticks w/ `ojiob thkghrkhss, jcuna, okg/cr A
ik bi`h rhgujhs risd =. obbhrnij sobuth< acrizcktob jrhosh ojrcss figgbh c` kcsh - Kosob `crhink mcgy< ukibothrob, taijd,
guh tc upworg wipikn fctick wita aokg gisjaornh
- Posc
Poscfc
fctc tcrr raik
raikit
itis
is (i
(igi
gicp
cpot
otai
aij
j kcko
kckobb
bb
hxonnhrothg vosjubor rhspcks tc irrit
- ]aikitis fhgijofhktcso< cvhrush c`
Obbhrnij raikitis ghjcknhstokts
Hbhvothg koscpaoryknhob
koscpaoryknhob hc hcsikcpaibs
sikcpaibs
shr
shruf
uf rogico
rogicobbhbbhrnc
rncsrc
srcmomokt
kt (]O
(]OZW)
ZW) th
girhjt sdik thstikn

Xrtijorio< roishg hghfotcus aivhs ck sdik/fujcus

sd ik/fujcus
fhfmrokhs
fhfmrokh s rhsubtikn `rcf vosjubor gibotick okg ikjrhoshg
phrfhomibity
- itja, mbokja, rhscbvh
Xrtijorio okg Ahrhgitory oknichghfo< J? hsthrosh Oknichghfo<< bcwhr ghrfis okg sumjutokhcus orhos, whbb
Oknichghfo
oknichghfo gh`ijihkjy ghforjothg orho, kc pruritis/hrytahfo/
pruritis/hrytahfo/worfta
worfta

Ggx<
- @ccg iktcbhrokjh< kckiffukcbcnij
(jo``hikh
(jo``hikh-ikgu
-ikgujhg
jhg tojayjor
tojayjorgio,
gio, bojtcs
bojtcs
15% prhshkt ik ?st yhor 
Iscbothg jutokhcus
jutokhcus rxks, NI sxs
sxs,, rhspirotcry sxs, bi`h- iktcbhrokjh)
@ccg obbhrnihs - phokuts, hnns, fibd, scy, wahot, trhh
tarhothkikn okopayboxis. Gc
Gcumumbh
bh-m
-mbi
bikg
kg pb
pboj
ojhm
hmcc ja
jaob
obbh
bhkn
knhh- `
kuts, `isa jaobbhknh< ncbg stokgorg.

]ahufotcbcny
 

Cbincortijubor LIO<
LIO< fcst jcffck. Ggx< pcsiksik`hjt
`hjtic
icuus orortari
tarittis (o
(oju
jutth ra
rah
- nirbs =-7yrs `hvhr)
`hvhr),, systhf
systhfij ij ik`
ik`bof
boffot
fotcrycry jckg
jckgiti
iti
- bornh lcikts (dkhh, okdbh) (IMG,
(IMG, jck
jckkhkhjti
jtivh
vh tissu
tissuhh gish
gishosh
oshs,s, AZ
AZ
- lcikt jcktrojturhs, fusjbh otrcpay, ikjrhoshg hxtrhfity ik`hjtic
ik`hjticks
ks (shp
(shptij
tij orta
ortaritis
ritis,, virob or
ortarit
taritii
nrcwta ik o``hjthg bifm Byfh gishosh),
gishosh), fobinkok
fobinkokjy jy (bh
(bhudh
udhfifi
- >8% aovh pcsitivh OKO thst -- osscjiothg wita jarckij khurcmbostcfo, mckh tufcrs)
kcknrokubcfotcus okthricr uvhitis - osyfptcfosyfptcfotij,
otij, ghthjt Gionkcsis<
ck sbit bofp - ojuth paosh rxk
Ucbyortijubor LIO - - OKO osscjiothg wita okthricr uvhiti
- ]@ pcsitivh< rhshfmbhs ogubt rahufotcig oratritis - ]@ ckby ik 8%
- ]@ khn< ogcbhsjhkts, bornh okg sfobb lcikts, mhtthr prcnkcsis - Zykcviob
Zykcviob `buig<
`buig< ^^MJMJ ; = =555
555/ff
/ff: : wi
Zysthfij LIO< outcik`boffotcry giscrghr  fckckujbhor
fckcku jbhor jhbbs
- hxtroortijubor, ikthrfitthkt aina `hvhr, sobfck
s obfck jcbcrhg rosa,
AZF, BOG, phrijorgitis.
Jarckij ortaritis ; 0 whhds ik ikgiviguobs - bornh okg sfobb lcikts
Luvhkibh Igicpotaij 2?0 yrs sykcvitis< ik`boffotick okg - ojuth paosh rxk< bhudcjytcsis, tarcfmcjytcsis,
tarcfmcjytcsis, okhfio, ikjr
Ortaritis ayphrtrcpay c` sykcviuf HZ] okg J]U, ikjr `hrritik.
- WK@ obpao fhgiothg Hktahsitis-rhbothg
Hktahsitis-rh bothg ortaritis< sojrcibioj lcikts, cjjurs ot
thkgck ikshrticks (ojaibbhs, pboktor `osjio, OZIZ)
Uscriotij ortaritis<
ortaritis< koib pittikn, ckyjacbysis,
gojtybitis guh tc `bhxcr thkgck thkcsykcvitis

Iffukcbcny, Obbhrny, ]ahuf

Jckgitick Ghsjriptick Zinks/syfptcfs Ggx
 Okhfio, bhudcphk
bhudcphkio,
io, tarcfm
tarcfmcjytcphk
cjytcphk
hbhvothg HZ], J]U kcrfob
Ucsitivh jccfms --; ahfcbytij okhfi
Ghjr jcfpbhfht bhvhbs
Uoikbhss crob ubjhrs, fobor rosa, gisjcirg bupus,  OKO, oktipacspacbip
oktipacspacbipig
ig oms, okti
okti sfita
Zysthfij bupus  Omkcrfob jhbb ghota --; ikjr hxpcsurh tc
pactcshksitivity. gsGKO, okti-]KU, okti- ]c, okti-Bo
hrytahfotcsus shb` kujbhor jcfpckhkts
jcfpckhkts
]hkob `oiburh ik Wyph IP BK (gi``ush prcbi`hrotivh)

Ggx< pcbyfycsitis (kc sdik `ikgikns,

byfpacjyt
byfp acjyths
hs ik`ibtr
ik`ibtroth
oth fusjbh `osji
`osjijbh
jbh
ottoj
ttojd
d fu
fusj
sjbh
bh `im
`imhrs gi
girhjt
rhjtbby),
y), bh
bhss jc
ik jaibgrhk
hbh
bhv
vothg
thg sh
shruf jr jrh
hotikh
tikh pacs cspapacd
cd
(rhbhoshg gurikn fusjbh mrhodgcwk),
Picbojhcus ghrfotitis c` hyhbigs (ahbictrcph), aokgs, hbmcws, fusjbh hkzyfhs. Hbhvothg P^@.
outciffukh gishosh ikvcbvikn dkhhs, okdbhs. Gh`ikitivh gionkcsis<
gionkcsis< fusjbh micpsy -
Ghrfotcfycsitis
sdik/sdhbhtob fusjbhs Ncttrck popubhs<
popubhs< sjoby hrytahfotcus popubhs ck hxthkscr phrivosjubor ik`boffotcry ik`ibtroth,
sur`ojhs c` `iknhrs, hbmcws, dkhhs phri`osjijubor otrcpay

Ahkcja Zjackbhik InO iffukh

iffukh jcfpbhxhs ik vhssh
vhsshbb wobbs
wobbs Zdik, lcikt,
lcikt, NI, digkhy
digkhy gish
gishosh.
osh. K
Kcktarcfmcjytcphkij purpuro Zuppcrtivh, Zpcktokhcus rhscbutick
cktarcfmcjytcphkij
purpuro ck bcwhr hxtrhfitihs, muttcjds. Zjrcob hghfo, hxtrhfity wds, sxs foy phrsist `cr ?= wds
swhbbikn
@hvhr wita omrupt cksht okg thrfikotick
@ofibiob Fhgithrrokhok @hvhr < FH@P nhkh, fcst jcffck.
Uhritckitis, hrysiphbos-bidh rosa, cbincortaritis
WK@ rhjhptcr-osscjiothg Uhricg @hvhr Zykgrcfh
(W]OUZ)< OG,
(W]OUZ)<  OG, `hvhrs >-=?g,
>-=?g, =-:x/yr. O
Omg
mg poik, shvhrh fusjbh
ojahs wita cvhrbytikn hrytahfo, jcklukjtivitis, phricrmitob
hghfo, bornh lcikt ortaritis
Uhricgij @hvhr, Optacus stcfotitis, paoryknitis, oghkitis
sykgrcfh (U@OUO)<
(U@OUO) < : cr fcrh hpiscghs c` `hvhr, thkghr
Uhricgij @hvhr jhrvijob BOG, paoryknitis/optacus ubjhrs, kcrfob ^MJ, J]U, ^MJ, J]U, HZ] hbhvothg
hbhvothg gurikn
gurikn `hv
`hv
Zykgrcfhs HZ] ottojds

Hkgcjrikh
Jckgitick Ghsjriptick Zinks/syfptcfs Ggx
 

Khparcbcny okg Xrcbcny

Jckgitick Ghsjriptick Zinks/syfptcfs Ggx Wrhotfhkt

]hkob gyspbostij okg jystij gishoshs
]hkob Gyspbosio< ]hkob porhkjayfob tissuh gchs kct `crf jcrrhjtby tarcunacut, usuobby mibothrob. ikjr risd c` omkcrfob ghvhbcpfhkt hbshwahrh
- ikomibity c` digkhy tc jckjhktroth urikh
- ifpoirhg omibity tc rhscrm `buigs --; `rhquhkjy, ikjcktikhkjh,
ikjcktikhkjh, susjhptimibity tc ghaygrotick
- c`thk gchs kct prhshkt wita AWK
- ]hkob XZ< digkhys opphor ayphrhjacij

@oiburh c` ckh cr mcta digkhys tc `crf

- Mibothrob --; cbincaygrofkics
cbincaygrofkics --;
Uctthr shquhkjh (jbummhg `hht, jrokiob
]hkob onhkhsis
omkcrfobitihs)

Digkhy jcksists c` kufhrcus Ucstkotob XZ< kckjcffukijotikn jysts Fcst joshs ukghrnc spc
kckjcffukijotikn
kckjcff ukijotikn `buig `ibbhg jysts. ]hkcnrof< bojd c` `ukjtick Khparhjtcfy i` digkhy ja
- Obfcst obwoys ukibothrob opphorokjh, phrsisthkt A
Fcst jcffck rhkob jystij gz c` 
Fubtijystij
digkhy gyspbostij jaibgaccg, fcst jcffck omgcfikob foss
ik khwmcrk

Ucbyjystij digkhy  O]UDG< gibothg

gibothg rhkob jcbbh
jcbbhjtikn
jtikn tumubhs
tumubhs Uobpombh rhkob foss ik ik`okt O]UDG<
gishosh --; sfobb jysts AWK, ghjbikh ik rhkob `ukjtick
- gibothg ahpotij mibh gujts  OGUDG< AWK, ahfoturio
ahfoturio Ikjrhoshg hjacnhkijity ck XZ O]UDG< giobysis
 OGUDG< usuobby
usuobby kct ghthjthg
ghthjthg uktib
ogubtaccg

FJJ c` aygrckhparcsis ik jaibgaccg Khwmcrks< pobpombh omgcfikob foss

- Urifory< iktriksij korrcwikn ot lukjtick c` Cbghr jaibgrhk< omg cr `bokd poik, jyjbij
rhkob phbvis okg urhthr cr oknubotick c` vcfitikn, ahfoturio + foss
urhthr `rcf o jrcssikn rhkob vhssb
Xrhthrcphbvij lukjtick
Xrhthrcphbvij - Zhjckgory< sjorrikn, oknubotick Zurnijob j
jc
crrhjtick< f
fiiki
shjckgory tc urhthrob gibotick ]hkob XZ
cmstrujtick surnhry cr cphk pyhbcpbo
(stckhs)

Bhknta c` tukkhb c` urhthr tarcuna PJXN< vcigikn jystcurhtarcnrof ghthjts Oktimictij prcpayboxis `
mbogghr sumfujcso is iksu``ijihkt tc omkcrfobitihs ot hrthrob ikshrtick siths okg - 2 :yrs< ofcxijibbik
prhvhkt rhtrcnrogh `bcw c` urikh obbcws jbossi`ijotick c` nrogh c` r h`bux - cbghr< mojtrif cr kitrc` 
- ukibothrob cr mibothrob @rhquhkt XWIs - aina nrogh< bornh tcrtucus urhthrs, gistcrtick Zurnhry< bhkntahk iktrovh
Phsijcurhthrob rh`bux ]htrcnrogh `bcw c` ik`hjthg urikh - c` rhkob phbvis okg jobyjhs tukkhb (urhthrob rhifpbokt
-; pyhbckhp
pyhbckhparitis
aritis

Cmstrujtikn bho`bhts witaik pcsthricr Urhkotob XZ< aygrckhparcsis okg mbogghr  Ombotick c`c` cmstrujtikn vo
urhtaro --; portiob-tc- jcfpbhth mbogghr gisthktick prcpayboxis i` PX] is prh
cutbht cmstrujtick ]hkob XZ< gisthkghg mbogghr wita taijdhkhg Horby surnijob jcrrhjtick
- urhtarob gibotick, mbogghr khjd wobbs okg tromhjubotick. Mibothrob gisjcuronhg< mbogghr pot
ayphrtrcpay, mbogghr tromhjubotick aygrckhparcsis. cvh
cvhrr ttifh
ifh,, h
horb
orby
y surn
surnhry
hry a
- fobhs ckby PJXN< visuobizotick c` pcsthricr urhtarob roth
Ckh c` tah fcst jcffck joushs c` hkg- Gisthkghg mbogghr cr rhkob foss vobvhsx
Ucsthricr urhtarob vobvhs stonh rhkob gishosh ik fobh jaibg Cbghr ik`okts< whod/grimmbikn
whod/grimmbikn urikory - gibothg mbogghr, ayphrtrcpaihg khjd, gibothg
strhof cr ukhxpboikhg goytifh whttikn pcsthricr urhtaro wita saihbg-saoph
(spikkodhr-soib )

Ikjcfpbhth ghvhbcpfhkt c` gistob urhtaro Aypcspogios + jryptcrjaigisf prcfpts Jirjufjisick is jcktroi  

--; fobpcsitick c` urhtarob fhotus obckn ofminucus nhkitobio wcrdup (nhkhtij rh
rhpo
poir
ir foy
foy rrhq
hquir
uirh
hpprhp
rhput
ut
vhktrob sigh c` phkis tcworg phrikhuf doryctypikn)
Aypcspogios - jacrghh< osscjiothg jurvoturh
c` phkis

Khparcbcny okg Xrcbcny

Jckgitick Ghsjriptick Zinks/syfptcfs Ggx Wrhotfhkt

Bojd c` pcsthricr ottojafhkt tc tukijo  Ojuth cksht ukibothrob

ukibothrob sjrctob poik, k/v Ggx<
sjrctob Zurnijob hfhrnhkjy
vonikobis --; fcmibh thstis -- Zwcbbhk, hrytahfotcus sjrctuf Omshkt - hpigigyfitis (ik`hjticus cr shjckgory tc - surnhry witaik 0 ars
; mhbb-jbopphr gh`crfity jrhfosthrij rh`bhx hpigigyfob opphkgix) - rhfcvh khjrctij thsths,
- opphkgix thsths< "mbuh gct" sink + kcrfob sjrctob hkvhbcph
Whstijubor tcrsick jrhfosthrij rh`bhx Whstijubor cr hpigigyfob
jbikijob gionkcsis rhscbvhs spcktokhcusby
 

Aygrcjhbhs< `buig-`ibbhg sojs ik sjrctob Aygrcjhbhs< rhpoir jcff

jovity jcksistikn c` rhfkokts c` aygrcjhbhs
aygrcj hbhs okg ahrkio
ahrkiosst
prcjhssus vonikobis ikjorjhrothg ahrkio
- jcffukijoth wita phritckhob jovity Porijcjhbhs< surnijob rhp
tarcuna pothkt prcjhssus, risd `cr -uukr
krhp
hpoi oirh
rhg
g vor
vorij
ijcj
cjhb
hbhs
hs i
ikjorjhrotick Porijcjhbhs< ghthjtombh ik mcys gurikn ik`hrtibity
Porijcjhbh< gibotick c` thstijubor vhiks + ogbhsjhkjh, fcrh jcffck ck bh`t,
Aygrcjhbhs okg
hkbornhfhkt c` pofpiki`crf pbhxus kckthkghr 
vorijcjhbhs
- hvighkt wahk pt is stokgikn< vhiks
gisthkg, "mon c` wcrfs"

XWI
GGx< Uts wita
wita pcsiti
pcsitivh
vh bhudcjyt
bhudcjyt
- Oghkcvirus< shb`-bifithg ahfcrraonij jystitis mh trhothg `cr prhsufhg
taot gchs kct rhspckg tc omx rhsubts orh ovoibombh
- Ucsthricr urhtarobnio< mhkink, shb`- bifitikn Jys
Jyst itit is<
is< of
ofcx
cxiiji
jibbbi k,
k, ofp
ofpii
ik`boffotick c` pcsthricr urhtaro ik mcys kitrc`uroktcik, cr WFU-Z
- Bcwhr bcmh UKO ik `hmribh j aibg< `/jaibbs/`bokd Uyhbckhparitis< UC jhpao
poik ofpijibbik + nhktofijik
- Xrcbitaiosis< gysurio, ahfoturio, `bokd poik
 Obb jaibgrhk 2=7 fcktas fust ukghrnc rhkob
Ik`okts< `hvhr foy mh ckby sink
XZ tc r/c aygrckhparcsis cr strujturob bhsicks.
- ahfotcnhkcus shhgikn c` digkhy
@irst yhor c` bi`h< nirbs 6 mcys O`thr `irst PJXN i` aygrckhparcsis cr kckrhspckghrs tc
XWI Cbghr jaibgrhk< sofh os ik ogubts
yhor< nirbs aovh ?5x ikjighkjh omx. GFZO i` susphjthg pyhbckhparcsis
- upphr trojt ikvcbvhfhkt< ikjr ^MJ,
HZ], J]U

Kcksphji`ij ibbkhss o `hw whhds pricr  prcthikurio< ; ?555 fn/f=/goy, spct

Fordhg prcthikurio< Gihtor
Gihtory y sobt rh
rhstr
strijt
ijtick
ick,, cr
Uhricrmitob hghfo< `irst omkcrfobity urikory prcthik<jrhotikikh rotic ; =.5 -ssttrcknhr if
iffukcsupprh
kcthg - rhsubts ik aypcobmufikhfio (2=.8 n/gB) kckrhspckghrs ((j jyjbcpac
Ghphkghkt hghfo, whinat noik Ayphrbipighfio (biposhs orh bcst ik urikh) jobjikhurik ikaimitcrs)
@ZNZ, shjckgory hticbcnihs, Fijrcsjcpij ahfoturio, fibg aypckotrhfio IP obmufik< ik ikgujhs ththfp
nbcfhrubckhparitis< nrcss ahfoturio, (`buig cvhrbcog), aypcjobjhfio (obmufik bcss),
AWK ikjr jrhotikikh (rhkob aypcphr`usick)
FJG< h``ojhfhkt c` `cct prcjhsshs @ZNZ<
fhsokniob ayphrtrcpay, tumubor otrcpay
Urcthikurio, aypcobmufikhfio, Gi``ush FUNK< ikjr fhsonkiob jhbbubority,
ayphrbipighfio, hghfo nbcfhrubor MF taijdhkikn FK< gi``ush
- Urifory< FJG (fcst jcffck), taijdhkikn c` jopibbory wobbs
Khparctij sykgrcfh @ZNZ, FUNK, FK
-(ZBH,
Zhjckgory< Ik`hjticks,
AZU, InO), systhfij gz
gruns (KZOIGs, ahrcik),
fobinkokjihs, nhkhtij

Cpataobfcbcny
Jckgitick Ghsjriptick Zinks/syfptcfs Ggx

7% c` jaibgrhk Hsctrcpio< ikworg

Hxctrcpio< cutworg
 Osscjiothg wita jhrhmrob
jhrhmrob pobsy, gcwk
Ztromisfus sykgrcfh, aygrcjhpaobus,  Ofmbycpio `cukg
`cukg ik fcs
fcstt pts wita h
hsctrcpio
sctrcpio Jcrkhob binat
binat rh`bhx, jcv
jcvhr
hr t
mroik tufcrs

]hgujhg visick ik ctahrwish kcrfob

hyh
- stromisfij ofmbycpio< supprhssick c`
rhtikob ifonhs ik fisobinkhg hyh
Ofmbycpio - okiscfhtrcpij ofmbycpio< ukhquob Zumkcrfob visick
rh`rojtivh hrrcrs ik twc hyhs

]htikcmbostcfo, jotorojts (
jcffck), rhtikcpotay c` pr
Bhudcjcrio ^aith pupib/omshkjh
pupib/omshkjh c` rhg rh`bhx jcknhkit
jcknhkitob
ob nboujc
nboujcfo,
fo, cjubo
 

Jcknhkitob @oiburh c` gistob fhfmrokcus hkg c` Jarckij thorikn ik omshkjh c`

koscbojrifob gujt koscbojrifob gujt tc cphk jcklukjtivobb iklhjtick
jcklukjtivo
cmstrujtick - Jcffck joush c` cvhr`bcw thorikn
(gojrycsthkcsis) - =8% c` khckoths

Jcrkhob omrosick<
omrosick< Uoik`ub,
Ik`hjticus Ik`boffotick
Ik`boffotick ik jcklukjtivo Pirob< pa
pactc
ctcshk
shksit
sitivit
ivity.
y. Hxo
Hxofik
fikot
otii
A. ik`buhkzo<
ik`buhkzo< sofh-sighg ctitis fhgio
jcklukjtivitis oghkcvirus binat
Wr hottwita
Wrho wita`bucrhsjhik
wita hy
hyh
h po
potj
tjai rh. vAh
aikn
kn.

Acrghcbuf< ojuth ik`hjtick c` nbokgs Acrghcbuf<< bcjobizhg

Acrghcbuf b cjobizhg thkghr swhbbikn, tahk
orcukg hyhbos `cbbijbh rupturh
- Z. ourhus Jaobozick< `irf, kckthkghr orho
Jaobozick< sthribh bipcnrokubcfotcus
bipcnrokubcfotcus
Ztyhs
rhojtick witaik nbokgs ik torsob pboth

Mojthriob ik`hjtick c` hyhbigs/sdik Crmitob jhbbubitis<

jhbbubitis< shvhrh p
okthricr tc crmitob shptuf fcvhfhkt,
fcvhfhk t, prcptcs
prcptcsis,
is, visic
- mrhods ik sdik< s. ourhus, nrcup O cjubor fcmibity.
strhp Jck`irf wita JW.
Uhricrmitob jhbbubitis - ahfotcnhkcus< s. pkhufc, a. Zdik orcukg hyh is ikgurothg, worf, thkghr  Wroufo, hghfo, obbhrnihs,
ik`buhkzo
- sikushs/rhsp< s. pkhufc, a. ik`buhkzo,
fcroxhbbo
 

Wrhotfhkt Jcfpbijoticks

FJJ c` ik`hjticus shkscrikhurob

ahorikn bcss
  c` b i`i`h Zuppcrtivh4 nokji j
jbbcvir  
Ghvhbcpfhktob ghboy, F], JU, ghktob
gh`hjts

Bcjob gishosh< rhjurrhkt fujcjutokhcus

bhsicks Hkjhpaobitis< jotorojts/mikgkhss,
fijrcjhpaoby, GG/bhorkikn gisomibitihs
  ns. JZ@<
Gisshfikothg< shvhrh khurc
IP ojyjbcvir.
ifpoirfhkt, ghota

  Iktrouthrik
Iktrouthrikh
h mbccg troks
troks`usick
`usicks,
s, suppcr
suppcrtivh
tivh Kckh

Urhvhktick< zigcvugikh tc fctahr gurikn

prhnkokjy, zigcvugikh tc ik`okt `cr `irst 0
wds c` bi`h.

  prhnkokjy
  cr 

Uhkijibbik N Khurcsypaibis, gho`khss

Wrhotfhkt Jcfpbijoticks

Zuppcrtivh

  rcbcn
rcbcnih
ihs
s Zu
Zuppppcr
crti
tivh
vh
- todhs up tc 1 wds
 

  sis Zuppcrtivh Urcnrhssivh vorijhbbo<

  r  - Oktipyrhtijs, goiby motaikn fhkiknchkjhpaobitis,
  turh, UJ]  Ogfikisthr P\P vojjikh witaik >=a c` ahpotitis, pkhufckitis ik
hxpcsurh iffukcjcfprcfishg
 Ojyjbcvir/vobojyjbcvir/`ofjijbcvir
 Ojyjbcvir/vobojyjbcvir/` ofjijbcvir kct ]hyh sykgrcfh i` todikn
ikgijothg `cr jaibgrhk wita ukjcfpbijothg ospirik
prifory vorijhbbo

 Oktivirobs `cr iffukcjcfprcfishg, pts ;?=

yrs, jaibgrhk wita jarckij gishosh, okg tacsh
wac aovh rhjhivhg systhfij sthrcigs

Jurrhtonh, jryctahropy, joktaorigik, UC

jifhtigikh, ifiquifcg jrhof

Wcpijob sobijybij ojig, biquig kitrcnhk,

ifiquifcg jrhof, UC jifhtigikh, UC zikj
sub`oth, iklhjthg iffukctahropihs (jokgigo
oktinhk),
squorij ojig gimutybhsthr 

Zhb` bifithg
 Oktiaistofikhs, tcpijob sthrcigs `cr pruritis
sukbinat

Wrhotfhkt Jcfpbijoticks
Zhb` bifithg - 0-1 wds Oktiaistofikhs, tcpijob
sthrcigs `cr pruritis

  wita
itis

 
k `cr

Bifithg< Fujiprcjik ciktfhkt Kufhrcus<

jhpaobhxik (?st nhk)
- jcvhrs stopa okg strhp
Zusphjt F]ZO< jbikgofyjik cr WFU- ZFQ
]hfcvh ackhy jcbcrhg jrusts wita worf
jcfprhss
 

Fibg-fcghroth< UC oktistopaybcjcjjob
fhgijotick Zhvhrh< trhot bidh =kg ghnrhh
murk

oktishptij jbhokshrs, tcpijob fujiprcjik

Wrhotfhkt Jcfpbijoticks
  ij, `bhxurob

oy bccd
ghrfotitis

Dhhp sdik whbb aygrothg Wcpijob sthrcigs

Pit G, XPM binat Uscriotij ortaritis
Zhvhrh< FWQ, iffukcsupprhssokts

 
orio< jok
ig, mut
`ixhg okg
jrctij

UC oktiaistofikhs, fcist jcfprhsshs,

crghrs
cotfhob motas
orikn,
=7 ars

Acspitobizotick, `buig okg hbhjtrcbyth suppcrt,

fcist jcfprhsshs, cotfhob motas
Crob fujcsob< fcutawosahs wita bigcjoik,
gipahkaygrofikh, Foobcx
Cpataobfcbcny jcksubt

@buig tahropy, trhot bidh o murk

IPIN<< foy o``hjt mikgikn/h``hjt c` @os binokg
IPIN

Wrhotfhkt Jcfpbijoticks Aina Yihbg `ojts

 

MB jacokob otrhsio< prhshkts

  wita bi`h tarhothkikn rhspirotcry
hr Wrojahcstcfy gistrhss ik ghbivhry rccf.
Cxynhkotick ifprcvhs wahk
ik`okt is jryikn.

  ry shvhrh CZO --; JA@, ghota Uijdwijdiok

bhhp sykgrcfh<< jarckij aypcvhktibotick rhsubts ik
sykgrcfh
]hfcvh tcksibs/oghkcigs, JUOU pubfckory
ayphrthksick okg JA@

  ]hfcvh ikjitikn onhkts `rcf potihkt's

dikns hkvirckfhkt, foikthkjh okti- ik`boffotcry
fhgijotick

 Ojuth hxojhrmotick< ikaobhg mrckjacgibotcr  Jcktrcb vs shvhrity< shvhrity 6

  jbhor Uhrsisthkt ostafo< Ikaobhg jcrtijcsthrcigs ghnrhh c` ifpoirfhkt pricr tc
rotick, - syfptcf jcktrcb, ovcigokjh c` trhotfhkt, jcktrcb 6 fckitcrikn
hxojhrmoticks ifpoirfhkt okg risd c` `uturh
 Obsc m= onckists, bhudctrihkh rhjhptcr
rhjhptcr hxojhrmoticks
oktonckists - osshssikn/foiktoikikn jcktrcb
r Wahcpaybbikh< ogg ck tahropy ik pts wac gc is fcrh ifpcrtokt taok
kct rhspckg tc jckvhktickob tahropy, shvhrh osshssikn shvhrity
hxojhrmotick.
Cfobizufom< fckcjbckob om vs InH, ush ik
pts ;?= yrs wita shvhrh obbhrnij ostafo
Jcrtijcsthrcigs UC cr IP

a
ot kinat
ita

  Foiktoik h``hjtivh oirwoy jbhorokjh, ahfcptysis cjjurs ik pts wita shvhrh

kory mrckjacgibotcrs, omx, rhnubor ikaobhg mrckjaihjtosis. @rhquhkt jcunaik okg
tcmrofyjik `cr pts wita Ushugcfckos, ikb`offotick --; hrcsick c` wobbs c` mrckjaiob
ayfob ozitarcfyjik, ikaobhg ayphrtckij sobikh orthrihs --; sputuf strhodhg wita mbccg.
Uokjrhotij hkzyfh rhpbojhfhkt, aina jobcrih Mbccg bcss ;855fB ik =7a rhquirhs orthriob
aina prcthik gihts. Foiktoik ahinat/whinat hfmcbizotick
;=8ta phrjhktibh. spcktokhcus pkhufctacrox<
pkhufctacrox < pbojh jahst
tumh. 85% rhjurrhkjh ukbhss pbhurcghsis is
phr`crfhg
jarckij pubfckory
prcnrhssivh AWK < rhsubts `rcf ik
AWK<
oirwoy cmstrujtick/aypcxio
ogvokjhg gishosh.

Wrhotfhkt Jcfpbijoticks Aina Yihbg `ojts

  t
Zofh os pubfckory J@ trhotfhkt, hxjhpt gc Uts gc kct aovh prcphksity tc
  `rcf Mrckjaihjtosis ik =kg cr :rg ghjogh
kct khhg pshugcfckos trhotfhkt. Ushugcfckos ik`hjtick
 

Wrhotfhkt

Zurnhry<
- jbcsh PZG
- shporoth pubfckory orthrihs `rcf trukjob
vhsshb
- pbojh jckguit mhtwhhk ]. vhktrijbh okg
pubfckory orthrihs

UNH?
Mobbcck otriob shptcstcfy (]osadikg
prcjhgurh)
- hkbornh U@C, ikjr otriob bhvhb
b hvhb fixikn
 Orthriob switja prcjhgurh
prcjhgurh

Zurnhry

 
 

K]NO, pubf sthkcsis<

- UNH?
- Mbobcjd-Woussin saukt (khckoth)<
(khckoth)<
jckkhjt sumjboviok okg pubfckory orthry
- Jovcpubfckory
Jovcpubfckory okostcfcsis (ik`okjy)<
jckkhjt ZPJ tc pubfckory orthry
- @cktok (=-8 yrs)< jckkhjt IPJ okg
ahpotij vhik tc pubfckory jirjubotick
WNO<
- UNH?
- shvhrh orja cmstrujtick< rhjckstrujt
ocrtij orja

Wht sphbbs< squottikn

squottikn,, vonob fokhuvh
fokhuvhrs
rs
(dkhh-jahst pcsitick), C=, fcrpaikh
sub`oth
- vcbufh hxpoksick, voscjckstrijtcrs
voscjckstrijtcrs tc
ikjrhosh systhfij vosjubor rhsistokjh
- mhto mbcjdhrs tc ghjr ik`ukgimubor sposf
- scgiuf mijorm tc rhgujh ojigcsis okg
ghjr pubfckory vosjubor rhsistokjh

Wrhotfhkt

UNH?
Ovcig surnhry
Ahort trokspbokt i` shvhrh

 
UNH?
Kc jcrrhjtivh surnhry ovoibombh - ckby
pobbiotivh
@irst whhd<
- jckkhjt pubf orthry okg ocrto
- otriob shpthjtcfy
shpthjtcfy
- jckkhjt ]. vhktrijbh tc pubf orthry
(fcgi`ihg mbobcjd-toussin)
:-0 fcktas<
- jovcpubfckory
jovcpubfckory okostofcsis (ahfi
@cktok)
=-8 yhors<
- fcgi`ihg @cktok
 

UNH?
Jckkhjt ikthrrupthg ocrtij shnfhkts

Zurnhry
-- potja
foy kct mh khjhssory
jbcsurh

Wrhotfhkt

JA@< ojh ikaimis okg giurhtijs

]hpoir bornh PZGs witaik 0 fcktas tc
ghjrhosh risd c` pubfckory orthry AWK
okg pubfckory vosjubor cmstrujtivh
gishosh

Ikgcfhtaojik
- risd c` rhkob iksu``ijihkjy
Xsuobby jbcshs my itshb` ik `irst fckta c` bi`h
ik @W ik`okt
 

UNH?
Zurnhry< okostcfcsis cr potja ocrtcpbostij
Ikthrvhktickob< mobbcck oknicpbostij
]hsthkcsis jcffck

UNH?
mobbcck vobvubcpbosty

  ibg wita kc cmvicus scurjh c` ik`hjtick

  sis

  crnok phr`usick
 

spirotcry sinks prhshkt

fhkt Jcfpbijoticks Aina Yihbg `ojts

  a gcsh ofcxijibbi k, tcpijob omx i` Ahorikn bcss, ctitis fhgio hxthrko
ofcxijibbik,
othg Fhkiknitis (FJ iktrojrokiob)
  fhktik, UC shjckg cr :rg nhk  Otcpij jckstitutick
jckstitutick ikjrhoshs
ikjrhoshs risd `c
`crr
bcspcrik, cr IF jh`trioxckh rhjurrhkt CF
  hufc< 85% phkijibbik
phkijibbi k rhsistokt. Fostcigitis<< shvhrh, mut ukjcffck
Fostcigitis
  buhkzo okg F. jotorraobis< mhto- - aina `hvhr, thkghrkhss c` fostcig
osh ojtivity mckh
ighr tyfpokcstcfy tumh i` Ghjr fcmibity c` WF is
roth ahorikn bcss, rhjurrhkt OCF fcst sphji`ij sink

r omx os OCF mut bcknhr Jcfpbijoticks ukjcffck

hkt jcursh (?7-=?g) - mcky hrcsick, crmitob jhbbubitis,
rrhkt gishosh< sikus ospirotick iktrojrokiob hxthksick

  fithg (8->g)
 

Zuppurotivh< phritcksibbor  Gc kct trhot paoryknitis

omsjhss, rhtrcpaoryknhob omsjhss wita omx hfpirijobby mj
Kcksuppurotivh<
Kcksuppuro tivh< rahufotij `hvhr, fcst joushs orh virob -
pcststrhptcjcjjob nbcfhrubck
nbcfhrubckhparitis
hparitis fodh tahrophutij
]ahufotij
]ahufot ij `hvhr< :wd `cbbcwikn ghjisicks moshg ck
paoryknitis. Uhkijibbik prcpayboxis tc tarcot jubturh cr ropig
prhvhkt rhjurrhkt O]@ oktinhk ghthjtick rhsubts
Ucststrhp nbcfhrubckhparitis< cjjurs
  kijibbik (?5g)
`cbbcwikn hitahr paoryknitis cr sdik
ik`hjtick
- phkijibbik tahropy okg

]orh mut shricus< upphr oirwoy Uts ik`hjthg wita HMP

cmstrujtick (rx< jcrtijcsthrcigs), wac rhjhivh ofcxijibbik
spbhkij rupturh, fhkiknchkjhpaobitis
fhkiknchkjhpaobitis (`cr fisgionkcshg
Iffukcjcfprcfishg
Iffukcjc fprcfishg ot risd `cr mojthriob ik`hjtick) foy
gisshfikothg gishosh okg aovh fojubcpopu
fojubcpopuborbor
  fithg, suppcrtivh jorh Ojtivity byfpacprcbi`hrotivh
byfpacprcbi`h rotivh giscrghrs rosa
ticks guh tc risd c` spbhkij
h

fhkt Jcfpbijoticks Aina Yihbg `ojts

 kinat oir/aufigity `cr jcuna okg
r 
bvhs ik 7->g
  ivh jccb fist, rojhfij
parikh, UC/IP/IF
csthrcigs

crtivh, shb` bifithg

izufom (IF ]ZP fckcjbckob
fckcjbckob
ossivh prcpayboxis. Nivh ik
r tc ot risd pts 2= yrs (ahort gz,
ij bukn gishosh c` prhfoturity,
hs 2:8 wds)

Fcrh oirwoy ayphrrhspcksivhkhss

bothr ik bi`h

itobizhg tc fokonh opkho,

sis, aypcxio, okg `hhgikn
btihs
rcfyjik cr ozitarcfyjik ckby ik
aob paosh, ghjrhoshs ik`hjtivity,
yboxis ik jbcsh jcktojts

 gcsh ofcxijibbik cr ofcx/jbov `cr Ubhurob h``usick --; jcfprcfish

mojthriob pko. rhspirotcry h``crt. Jahst tumh
rcfyjik/ozitarcfyjik/ - fcst bornh pbhurob h``usicks orh
rcfyjik `cr F pkhufc cr J joushg my s. ourhus pkhufckio
c. Bukn omsjhsshs guh tc okohrcmij
cfyjik/Hrytarcfyjik `cr J. ik`hjticks
fotis
oths< ofpijibbik okg jh`ctoxifh Jcbg onnbutikik tithrs orh
ktofijik) hbhvothg ik F. pkhufc,
foky virob okg scfh
mojthriob pkhufck
pkhufckiosios
 

fhkt Jcfpbijoticks Aina Yihbg `ojts

oths< ofpijibbik `cr NMZ okg Gp kct otthfpt BU ik o
io + jh`ctoxifh Jaibg< jaibg wita `cjob
fyjik + :rg nhk khurcbcnij gh`ijits
bcspcrik okg/cr ikjrhoshg IJU
  suobby ?5-?7g uktib ok hxpokgikn foss
pik prcpayboxis ik jbcsh jcktojts bhsick is hxjbughg my JW
cr F]I
?5-=5% ghvhbcp phrsisthkt
khurcbcnij gh`ijit< ahorikn bcss,
ghvhbcpfhktob ghboy, fctcr
ikjccrgikotick,
ikjccrgikotick, shizurhs,
aygrcjhpaobus

  rcbckns Zobfckhbbo sahggikn,

shs risd c` ahfcbytij urhfij
cfh.
 ZFQ cr ozitarcfyjik `cr sainhbbo,
cfyjik cr ozitarcfyjik `cr J.

kgozcbh, pyrokthb pofcoth, cr rhik`hjticks orh jcffck

gozcbh aokgwosaikn
aokgwosaik n is mhst prhvhktick

AOP< `ubfikokt ahpotitis rorh mut

fcrtobity up tc 85% AMP< jarckij
ik`hjtick
AGP< AGP okg AMP
sifubtokhcusby
sifubtokhcu sby ik`hjtick puts pt ot
nrhothr risd `cr fcrh shvhrh jarckij
ahpotitis M okg ainahr fcrtobity roth.
 iffukh nbcmubik, ogfikisthr AGP suphrik`hjtick ck tcp c`
?7g c` hxpcsurh hxisitikn AMP rhsubts ik ojuth
hxojhrmotick okg ojjbhrothg jcursh
rhsubt.
AJP< 85% ghvhbcT jarckij ahpotitis

Xktrhothg ik`okts foy ghvhbcp

okhfio, tarcfmcjytcphkio, okg
  IP phkijibbik N
rogicnropay omkcrfobitihs
omkcrfobitihs c` bckn
mckhs

fhkt Jcfpbijoticks Aina Yihbg `ojts

 

  r K. nckcrraho, J. trojacfotis, Ghjrhoshg `hrtibity, hjtcpij

cmhs prhnkokjy, gysporhukio, jarckij
  acfotis okg K. nckcrraho< phbvij poik, ogahsicks
gcsh IP jh`tioxckh + UC K. nckcrraho< ortaritis
yjbikh J. trojacfotis< ]hithr 
rcmhs< fhtrckigozcbh sykgrcfh
Mcta< @itz-Auna-Jurtis
sykgrcfh (phriahpotitis)
(phriahpotitis)

fckos< UC fhtrckigozcbh
riob< UC fhtrckigozcbh Jokgigo<
knob jrhofs cr siknbh gcsh c`
jckozcbh

jcjjob< =:5fn IF jh`trioxckh

hitahr ? gcsh UC ozitarcfyjik
g c` UC gcxyjyjbikh
  rcfyjik prh`hrrhg mhjoush it
s fyjcpbosfo
biuf

okt wcfhk< zigcvugikh (O\W),

hg my trhotfhkt c` ik`okt `cr `irst
c` bi`h rhgujhs vhrtijob
issick tc =%
, KK]WIs, UIs
ZFQ prcpayboxis onoikst UJU

ij rx - khhg tc jcvhr hrbijaicsis

.yjbikh
fhkiknitigis
fhkiknitigis
  h`ctoxifh cr jh`trioxckh i`
jtikn fhkikncjcjjhfio

fhkt prhvhkts horby

fikothg okg both gishosh
n jaibgrhk< ofcxijibbik cr
xifh
hk ;1yrs< UC gcxyjyjbikh

Wrhotfhkt Jcfpbijoticks

Irck suppbhfhkt< rhtijubcjyth jcukt ikjr witaik

:g, Am jckjhktrotick kcrfobizhs witaik o fckta.
Jcktikuh tahropy `cr =-: fc tc rhpbhkisa stcrhs
okg prhvhkt `uturh cjjurrhkjh.

  totick is
 

Waobosshfio folcr< ]MJ troks`usick tc

  Obpao hbifikoth okhfio, supprhss hxtrofhgubbory
tc @h hrytarcpcihsis, ghjr irck cvhrbcog
- ncob is tc foiktoik Am ;?5n/gb
mirta. - Zpbhkhjtcfy wita ikjr troks`usick
  is, rhquirhfhkt
Waobosshfio ikthrfhgio (obpao cr mhto)< `cbij
ojig suppbhfhkts `cr pts kct ck troks`usick Mhto taob folcr< Irck cvhrbcog guh tc
cr Am@ tahropy ayphromscrptick c` gihtory irck cr
troks`usickob irck bcogikn
- jorgicfycpotay, JA@
- jorgioj gishosh is foik joush c` ghota

 
k-

Wrhot ukghrbyikn ik`boffotick

  Am@ UC jcrtijcsthrcigs MF trokspbokt

 

  ]MJ troks`usick
troks`usicks
s
Ahfotcbcnij ifprcvhfhkt wita okgrcnhk
hoshg tahropy
ZJ trokspbokt
- ghjrhosh gcshs c` rogiotick/jahfc mj tahy
gofonh GKO

MF trokspbokt
  Iffukcsupprhssick i` kc gckcr jok mh `cukg

Xsuobby shb` bifithg Jcrtijcsthrcigs, IPIN, okti-G

iffukcnbcmubik jok thfpcroriby ikjrhosh
  cg pbothbht jcukt
stikn, cr

@ojtcr tahropy tc prhvhkt lcikt gofonh `rcf Cbghr pts< rhjhivhg mbccg prcgujts wita AIP
rhjurrhkt ahfortarcsis (ahfcpaibij
(ahfcpaibij --; OIGZ is FJJ ghota
ortarcpotay))
ortarcpotay @crfotick c` ikaimitcrs< khutrobizikn InN oms
GGOPU< rhbhoshs `ojtcr PIII `rcf hkgctahbiob vs `ojtcr PIII cr IQ
jhbbs
 Ofikcjoprcij
 Ofikcjoprc ij ojig< ikaimits
ikaimits `imrikcbysis

otfhkt Jcfpbijoticks
 

ujtick tahropy< =1g c` vikjristikh, Khutrcphkio (OKJ 2 855/ff:) prhgispcshs tc

rcigs, iktrotahjob FWQ, osporonikosh. shricus mojthriob okg `uknob ik`hjticks.
g goukcfyjik `cr aina risd pts. Aina risd c` tufcr bysis sykgrcfh<
sykgrcfh<
kscbigotick< ikthksi`ijotick c` tahropy tc ayphrurijhfio, a yphrpacspaothfio
yphrpacspaothfio,,
oggitickob bhudhfij jhbbs i` ikgujtick ayphrdobhfio
s - hsphjiobby ik W jhbb OBB cr Murditt byfpacfo
rif foikthkokjh< vikjristikh, 0- FU, - nrhothst risd ik `irst :g c` jahfc
Q - foiktoik Am 2?5fn/gB
iotick tahropy `cr JKZ okg thstijubor Ayphrbhudcjytcsis (^MJ;=55,555)< jok
hosh, JKZ prcpayboxis. joush vosjubor stosis --; fhktob stotus
jaoknhs, AO mburry visick, gizzikhss, sz,
gyspkho
Fhgiostikob foss --; ZPJ sykgrcfh<
gisthkghg khjd vhiks, swhbbikn c`
`ojh/khjd/upphr bifms, jyokcsis, jcklukjtivob
iklhjtick

hfctahropy fcrh ikthksh taok OBB Ayphrbhudcjytcsis (8-==%)< gyspkho,

Ayphrbhudcjytcsis
ujtick< oktarojyjbikh + oromikcsigh aypcxhfio, htj
 risd< jahfc ckby Aina risd< MF - trhot horbihr taok OBB mj OFB jhbbs orh bornhr
spbokt okg stijdihr taok byfpacjyths ik OBB.
- foiktoik Am 2 ?5 fn/gB

fmikotick jahfc Murditt< surnijob

hjtick
  fcr bysis< jorh
jorh`ub
`ub fokonhfh
fokonhfhkt kt wita ikjr
i iktodh, obdobikzotick c` urikh,
jtrcbyth cmshrvotick, obbcpurikcb
  na risd c` ghvhbcpikn digkhy `oiburh
uirikn giobysis `rcf tufcr bysis
Fhgiostikob foss< ZPJ sykgrcfh Murditt<
tufcr bysis sykgrcfh - hvhk mh`crh jahfc is
storthg.

otfhkt Jcfpbijoticks

Zhjckgory fobinkokt khcpbosfs (mrhost,

btionhkt jahfc
tayrcig, sorjcfos), jorgioj tcxijity
pacjyth-prhgcfikokjh aos mhst
(oktarojyjbikhs), pubf (mbhcfyjik),
nkcsis
aypctayrcigisf (Q]W)
 

nkcsis< IKZZ stonikn, GKO ikghx c`

cr, FYJK nhkh ofpbi`ijotick
  onh I, II, IPZ aovh nccg prcnkcsis.
nh III, IP aovh pccr prcnkcsis
rnhry, jahfc, rogiotick, htj. Jahfc<
jristikh, jyjbcpacspaofigh,
crumijik, jispbotik

otfhkt Jcfpbijoticks

rnijob rhfcvob c` digkhy ]ogiotick

Ikvosick c` rhkob jopsubh, hxthksick tarcuna
ropy jok mh ushg `cr fhtostotij siths
si ths
oglojhkt vhsshbs (IPJ), rhnickob kcghs, bukn,
cg prcnkcsis< sfobb sizh, ycuknhr
y cuknhr onh,
bivhr 
BK/fhtostoshs, kc jopsubor/vosjubor
Bukn fcst jcffck sith c` fhtostosis
osick

hfc + rogiotick
  hfc< rhgujh sizh okg trhot fhts
cst obb pts aovh fhts)

rnijob rhfcvob c` prifory tufcr

istokt tc rogiotick tahropy (vs hwikn)
hfc< jispbotik, gcxcrumijik, FWQ
 

jbhotick, jahfctahropy, bcjob

ropihs, rogicpboquhs, hxthrkob mhof
iotick
  otfhkt ghphkgs ck ]hhsh- Hbbswcrta
ssi`ijotick
ibg mcrk tc porhkt wita MB rhtikcmbostcfo
kibothrob rm wita dkcwk nhkhtij futotick
ubg mh sjrhhkhg `cr rm ot mirta okg ot
ubor ikthrvobs uktib 7 cr 8 yrs

otfhkt Jcfpbijoticks

nhry, rogiotick, jahfc

  hfc ahbps rhgujh tufcr sizh okg fhts

nhry, rogiotick, jahfc

Wrhotfhkt Jcfpbijoticks

  ts okg

gy Iffukcnbcmubik rhpbojhfhkt, onnrhssivh

Iffukcnbcmubik
Pojjikh osscjiothg giorraho wita
ighkti`ijotick okg trhotfhkt c` ik`hjticks
JQ], bivh/otthkuothg
bivh/otthkuothg rctovirus vojjikh
MF trokspbokt

tokus

c`
b ik`okt IPIN

rs,
 

  shs),  Ojuth khutrcphkio<

khutrcphkio< kc trhotfhkt
trhotfhkt
Jarckij khutrcphkio
khutrcphkio/ik`hjticks<
/ik`hjticks< rhjcfmikokt
kokjy aufok nofhtcjyth jcbcky stif `ojtcr (raN-
JZ@)
JNG< prcpaybojtij WFU-ZFQ.
WFU-ZFQ. MF
trokspbokt
BOG< MF trokspbokt.

?1

Whrfikotick c` itja-sjrotja-itja jyjbh<

bcticks, tcpijob jcrtijcsthrcigs,
jcrtijcsthrcigs,
pifhjrcbifus jrhof (ikaimits W jhbb
  ojtivotick), tcpijob tojrcbifus Mojthriob suphrik`hjtick

Wrhotfhkt Jcfpbijoticks
 Obbhrnhk ovcigokjh
ovcigokjh
  A? mbcjdhr< UC cr iktrokosob Iktrokosob
jrcfcbyk< prhvhktivh Kosob tcpijob sthricgs
sob grip UC bhudctrihkh rhjhptcr oktonckists
 O Wcpijob/ikaobhg
Wcpijob/ikaobhg syfpotacfifhtijs
syfpotacfifhtijs -
  `cub pshugchparikh

hrnij)<
kt
  tcpijob
]hjurrhkt sikusitis, ctitis fhgio wita h``usick
,
st,

Zumjutokhcus hpikhparikh< hfhrnhkjy

 Obsc IP gipahkaygrofikh
gipahkaygrofikh okg sthrcigs
UC oktiaistofikhs, syfpotacfifhtijs, UC
sthricgs J? hsthrosh rhpbojhfhkt `cr
ahrhgitory oknichghfo
oknichghfo

 Ovcig c``hkgikn
c``hkgikn `ccg
  - Jcw fibd, hnn, scy, okg wahot obbhrnihs
jok mh cutnrcwk
- phokut, kut, okg `isa obbhrnihs usuobby
cg phrsist
 

  ufotij
ks
U),
s,
,

ta

Ziknbh bornh lcikt< iktro-ortijubor

jcrtijcsthrcig iklhjtick Mcky hrcsicks, gh`crfitihs, nrcwta
Fubtipbh lcikts< fhtactrhxoth gisturmokjhs
- WK@-obpao, IB-B, IB-0, W-jhbb jcstifubotick

Wrhotfhkt Jcfpbijoticks
  io,

o
 Ocvig suk
  , okti- aygrcxyjabcrcquikh
aygrcxyjabcrcqu ikh `cr prhvhktikn gishosh
  `borhs
KZOIGs, jcrtijcsthrcigs

  G1 Jcrtijcsthrcig tahropy, IPIN, jyjbcspcrikh

s okg aygrcxyjabcrcquikh< trhots jutokhcus
ffck foki`hstoticks

ikosh
ctahr
Zpcktokhcus phr`crotick c` mcwhb is bhogikn
joush c` ghota

  itaik 7

hr

Wrhotfhkt Jcfpbijoticks
 

Jcfpbijoticks Aina Y
Yiihbg ``o
ojts

  tokhcus ikvcbuti
ikvcbutick
ck
  oknhs ik sizh cr
WK

obby ikvosivh
ty

  cr XWIs
 
uroktcik
  sijubor shnfhkt c`
otick)

  bvh bho`bhts Omx

hkt
  ` rh`bux is
cpays jaoknhs
os aina `oiburh

Jarckij digkhy
gishosh - rhquirhs
bckn thrf `cbbcw up

  kgijothg-- surnijob
kgijothg
iob tissuh

Jcfpbijoticks Aina Y
Yiihbg ``o
ojts
 

`ix JB thstis tc

pphkgix< tcrsick
pigigyfitis< omx
 

  kijotikn
prhvhkt

ir 
  kjr risd `cr

hsthrosh sacubg
WI uktib jubturh

ibbik,
Q
  bcspcrik cr IP

Uyhbckhparitis<
Monnhg sphjifhks orh
phrikhparij omsjhss,
ikoghquoth
ikoghqu oth `cr XWI
rhkob sjorrikn, rhkob
hvobuotick
`oiburh

  b sthrcig tahropy Zpcktokhcus

  ssokts ik mojthriob phritckitis -
spaofigh, ikjr risd c`
hkjopsubothg
crory giurhsis crnokisfs guh tc
bcss c` prcthiks
ikvcbvhg ik
paoncjytcsis c`
jopsubh
Warcfmchfmcbij
hvhkts, phrsisthkt
ayphrbipighfio,
ayphrbipig hfio, sthrcig
tcxijitihs

Wrhotfhkt Jcfpbijoticks

 Ofmbycpio, rhgujhg
 Ofmbycpio, rhgujhg
sthrhcpsis
Jcrrhjtivh bhkshs, cjjbusick, otrcpikh
st
phkobizotick, surnhry

Jcrrhjt rh`rojtivh hrrcrs Cjjbusick c` Uhrfokhkt visick

mhtthr hyh bcss, gifikisahg
Wrhotfhkt is uksujjhss`ub mhyckg 1 yrs sthrhcpsis

  fcst Hkujbhotick, jahfc, rogiotick, jryc  Ofmbycpio ]CU<

hfoturity, Jotorojt surnhry ]htikob ghtojafhkt,
r tcxcjoriosis ]CU< boshr ombotick c` rhtiko cr jryc sjorrikn
rhgujhs prcnrhssick tc rhtikob
ghtojafhkt/sjorrikn
 

90% rhscbvh spcktokhcusby ik ? yr

Urcmikn c` koscbojrifob gujt systhf ot
?=-?8 fc.

 Oktimictij grcps<
grcps< pcbyfyxik- momojitrojik,
jitrojik,
hrytarcfyjik
- omx bifit
b ifit ik`hjtivity okg ghjrhosh gurotick
my = goys
  thorikn, - Khisshrio< IP jh`trioxckh
k ukghr mbuh - A. ik`buhkzo< ofcxijibbik-jbovubokij ojig
bs omrosick. - AZP?<
AZP?< gc kct nivh sthrcig- jcktoikikn
obs ik =7a omx.. ]isd c` fcrh shvhrh gishosh okg
omx
visuob ifpoirfhkt

Acrghcbuf< worf jcfprhsshs, omx

Jaobozick< hxjisick foy mh rhquirhg

  oik wita hyh IP omx

jaoknhs, ghjr Mrhods ik sdik< phkijibbik cr ?st nhk
jhpaobcspcrik
Jh`urcxifh
ufcr  :rg nhk jhpa< prhvhkt hxthksick tc
fhkiknhs