Case Presentation - Acute Gastroentiritis

7/21/2019 Case Presentation - Acute Gastroentiritis

1/104

HKP\A@ZNPHAK

Tj, draup 7 am Cjvjc HHH sjnthak 7, fgvj nfasjk tfhs ngsj ta dghk ekawcj`dj gk`

ta mgohchgrhzj hk `hsjgsj pranjss, jthacady, ogkhmjstgthaks gk` ogkgdjojkts glaut

ojtglachn gctjrgthak tfgt ngusj sjhzurjs. Tj gcsa wgkt ta hopravj aur ekawcj`dj gk`

sehccs hk `jgchkd whtf hk`hvh`ugcs whtf tfhs ehk` am `hsjgsj, jspjnhgccy hk prjvjkthkd tfj

annurrjknj am jphsa`js am sjhzurjs gk` hts naopchngthak. Aur pgthjkt .!. hs g " yjgrs

ac` ogcj wfa hs `hgdkasj` am gnutj dgstrajktjrhths whtf sjhzurjs.

#h`y, $. %&'7&( )gstrajktjrhths hs gk hkmjnthak am tfj dut. Ht ngusjs `hgrrfjg, gk`

ogy gcsa ngusj vaohthkd, tuooy pghk gk` atfjr syoptaos. Hk oast ngsjs tfj hkmjnthak

ncjgrs whtfhk g mjw `gys, lut saojthojs tgejs cakdjr. #fj oghk rhse hs `jfy`rgthak. #fj

oghk trjgtojkt hs rjfy`rgthak, jknaurgdj tfj nfhc` ta jgt gs karogccy gs passhlcj.

!gky nfhc`rjk fgvj oarj tfgk akj jphsa`j hk g yjgr. #fj sjvjrhty ngk rgkdj

mrao g ohc` tuooy upsjt mar g `gy ar twa whtf saoj ohc` `hgrrfjg, ta sjvjrj `hgrrfjg

gk` vaohthkd mar sjvjrgc `gys ar cakdjr. !gky vhrusjs, lgntjrhg gk` atfjr ohnraljs

%djros( ngk ngusj dgstrajktjrhths.

*ctfaudf amtjk naksh`jrj` g ljkhdk `hsjgsj, gnutj dgstrajktjrhths rjoghks g

og+ar ngusj am oarlh`hty gk` oartgchty hk nfhc`rjk grauk` tfj warc` gnnaukthkd mar 7."

ohcchak `jgtfs gkkugccy hk nfhc`rjk yaukdjr tfgk - yjgrs, ar raudfcy 7- am gcc nfhc`

`jgtfs. *s tfj `hsjgsj sjvjrhty `jpjk`s ak tfj `jdrjj am mcuh` cass, gnnurgtjcy

gssjsshkd `jfy`rgthak stgtus rjoghks g nrunhgc stjp hk prjvjkthkd oartgchty.

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Hk oast nfhc`rjk, tfj syoptaos grj ohc` gk` tfjy tjk` ta djt ljttjr whtfhk g mjw

`gys. Hm vaohthkd annurs, ht amtjk cgsts akcy g `gy ar sa, lut saojthojs cakdjr. hgrrfjg

amtjk nakthkujs gmtjr tfj vaohthkd staps gk` naooakcy cgsts mar ljtwjjk - ta < `gys.

>chdftcy caasj staacs ogy pjrshst mar g wjje ar sa murtfjr ljmarj g karogc pgttjrk

rjturks. >aojthojs tfj syoptaos cgst cakdjr.

*rohk, jt.gc %&''aojthojs gmjlrhcj sjhzurjs

fgvj ljjk ekawk ta annur hk gssanhgthak whtf `jfy rgthak, jcjntracytj holgcgknj,

fypadcynjohg ar fypangcngjohg gk` naopchngtj` gnutj dgstrajktjrhths0 fawjvjr tfj

annurrjknj am gmjlrhcj sjhzurjs `urhkd vhrgc dgstrajktjrhths whtfaut `jfy rgthak ar

jcjntracytj holgcgknj fgs gcsa ljjk rjpartj`.

>jhzurj hs ljchjvj` ta gmmjnt 7 ta & am tfj papucgthak0 gppra:hogtjcy & ohcchak

pjapcj fgvj ljjk `hgdkasj` whtf tfhs `hsar`jr %Chpphknatt Thcchgos = Thcehks &''


3/104

H. @JOAD\GRFHN @GPGG. Hkhthgcs am Nchjkts Kgoj4 .!. @gtj am G`ohsshak9 gkugry


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3j akcy dat 7 àsj am L$), 7 àsj 3jpg L, & àsjs am 2#, akj àsj am

A2N gk` !jgscjs vgnnhkj. #fj pgthjkt `h`k8t jknauktjr gky gnnh`jkts ar mgcc tfus

fj `h`k8t fgvj gky mrgnturj hk tfj pgst, àjsk8t fgvj gky gccjrdy gk` mhrst thoj ta

sjje oj`hngc ngrj. *nnar`hkd ta 2ulchn 3jgctf 6urshkd, g nfhc` hs sgh` ta lj @5uccy

Hooukhzj` $fhc J wfjk g nfhc` rjnjhvjs akj àsj am L$), " àsjs am A2N whtf gk

hktjrvgc ljtwjjk àsjs am wjjes, " àsjs am 2# whtf gk hktjrvgc ljtwjjk àsjs

am wjjes, " àsjs am 3G2* L whtf M wjjes hktjrvgc mrao 7stàsj ta &k`àsj gk` ;

wjjes hktjrvgc mrao &k`àsj ta "r`àsj.

2gthjkt !8s oatfjr ncghoj` tfgt fj `h` j:pjrhjknj naooak hcckjssjs chej

mjvjr, naudf gk` nac`s. #fj pgthjkt fg` g nfhnejkpa: wfjk fj wgs 7 yjgr ac` gk`

ojgscjs wfjk fj wgs ; oaktfs. >fj ncghoj` tfgt pgthjkt ! fgs ka ekawk

gccjrdhjs hk maa`s gk` hk oj`hngthaks. #fjy `h`k8t rjcy tfgt ounf hk avjr tfj nauktjr

`ruds ljngusj mar fjr ht whcc +ust ogej oarj `jpjk`jkt hk syktfjthn rjoj`hjs gk`

sfj ncghoj` tfgt sfj usugccy usjs cgduk`h gk` arjdgka gs fjrlgc oj`hnhkj. *csa,

fj hs kat tgehkd gky vhtgohks. #wa `gys prhar ta gòhsshak tfj pgthjkt j:pjrhjknj`

`hgrrfjg, fj `jmjngtjs tfrhnj g `gy whtf yjccawhsf wgtjry staac, ka sach phjnjs,

jkthrjcy ch?uh` whtf sjjk wfhtj pgrgshthn waros gk` gnnaopgkhj` ly glàohkgc pghk.

2gthjkt .! gcsa vaohts nfgrgntjrhzj` ly yjccawhsf ch?uh` `hsnfgrdj jvjry thoj fj

wgs mj` ly fhs oatfjr. 3hs oatfjr gcsa ncghoj` tfgt hk tfjhr mgohcy, tfjrj grj ka

fhstary am fjrj`htgry `hsjgsjs sunf gs `hgljtjs gk` fypjrtjkshak. #fj pgthjkt `h`k8t

jknauktjr gky gnnh`jkts ar mgcc tfus fj `h`k8t fgvj gky mrgnturj hk tfj pgst. 2gthjkt

!8s oatfjr ncghoj` tfgt ht hs fhs mhrst thoj ta lj fasphtgchzj`.

]. FJ\J@A- MGOHCHGC FH^PA\X

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5/104

Hktjrprjtgthak9

#fj djkadrgo hs g phntarhgc `hspcgy am pgthjkt8s .!8s mgohcy rjcgthaksfhp gk`

oj hngc fhstary. Ht sfaws tfj tfrjjDdjkjrgthak mgohcy am tfj pgthjkt. #fj `hgdrgo

hkncu`js tfj nurrjkt gdjs gk` nurrjkt fjgctf stgtus am jgnf mgohcy ojoljr mrao tfj

tfrjj djkjrgthak mrao tfj pgthjkt.

#fj pgtjrkgc gk` ogtjrkgc sh`j am tfj pgthjkt hk latf am fjr drgk`pgrjkts wjrj

`jg` lut tfj oatfjr wgs kat surj mar tfj j:gnt ngusj am fjr `jgtf.

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6/104

Hk >jnak` )jkjrgthak, oast am tfj mgohcy ojoljrs wjrj gchvj gk` wjcc. #fjy

àk8t fgvj gky `hsjgsjs tfgt wjrj fjrj`htgry.

5ar tfj tfhr` djkjrgthak, fhs ac`jr shstjr `hj` hk tfj &''1 ljngusj am sjpshs.

+H. @J+J,AROJKPG, FH'PA\-

Jrh Jrhsaks Rs%$!asa$hgc @j"jca)ojkt P!jar%

'tgj ')j$hmh$ Pgs/s2J"h`jk$js am Ohcjstakj

G$!hj"jojkt

Gutakaoy vs.

^fgoj gk

@au!t

"Pa#j$%

jvjcapojktgc tgse hs ta maro g

sjksj pjrsakgc naktrac avjr

pfyshngc sehccs gk` g sjksj am

hk`jpjk`jknj. >unnjss cjg`s

ta mjjchkds am gutakaoy, mghcurj

rjsucts hk mjjchkds am sfgoj gk`

àult.

*s stgtj` ly fhs oatfjr, tfj pgthjkt

ljdhks ta hohtgtj pgrjkts àhkd

fausjfac` nfarjs. @!gfhchd shygkd

ogdcgra gt egpgd kgdcgcglg gea

kgohohcht shygkd ogdcglg `hk.J 3j

ekaws fhs awk kgoj gk` gcrjg`y

ekaws ta nfaasj wfgt ehk` am

ncatfjs sfauc` fj wjgr ar wfgt ehk`

am tays sfauc` fj pcgy. 3j mrj?ujktcy

usjs @kaJ jspjnhgccy wfjk fj

àjsk8t wgkt ht.

'ho(k` &rj(`s Rs%$!agkgc%th$ @j"jca)ojkt P!jar%


G$!hj"jojkt

Gkg# ^tg&j"'( oaktfs-)

yjg$s a#%

#fj nfhc` fgs ta cjgrk ta

naktrac fhs ar fjr la`hcy kjj`s.

*nnar`hkd ta tfj pgthjkt8s oatfjr,

@Fgpgd kgtgtgj a kghhfh shyg

kgdgsgsglh shyg sg gehk gt

shkgsgogfgk eaJ. 3hs pgrjkts

uthchzj prghsj gk` rjwgr`s mar

ushkd tfj tahcjt.

*jgk Rhgjts Nakhth"j @j"jca)ojkt P!jar%

M / 2 g d j


7/104


G$!hj"jojkt

R$j-a*j$gt+akg#

Pfau&ft

#a `cjrs cjgrk tfraudf

prjtjk` pcgy lut sthcc struddcj

whtf cadhn gk` tgehkd tfj pahkt

am vhjw am atfjr pjapcj.

*nnar hkd ta fhs oatfjr, @!gfhchd

shyg ogehpgdcgra ohksgk

ogcgwge yukd hogdhkgthak khyg.

)hkgdgyg khyg yukd tgtgy khyg

pgcgdh egpgd kgehehpgdeuchtgk.J

*nnar hkd ta fhs oatfjr, tfj

pgthjkt fgs g wh`j hogdhkgthak,

chejs ta `hsnavjr kjw tfhkds. 3j

hs stgrthkd ta ljnaoj nurhaus hk

saojtfhkd fj sjjs, chejs ta

?ujsthak gk` hkvjsthdgtj kjw

tfhkds. 3hs tfaudfts ljnaoj

oarj syolachn. 3j usjs gk

al+jnt ta rjprjsjkt saojtfhkd

jcsj, sunf gs prjtjk`hkd g lraao

hs g farsj, g la: hs g tglcj gk` g

phjnj am pgpjr hs ljhkd pcgtj. 3j

pcgys whtf tfj atfjrs gk` nrjgtjs

jcglargtj pcats gk` nfgrgntjrs

nucohkgtj hk tfj uk`jrstgk`hkd am

rjprjsjktgthakgc tfaudfts gk`

gnthvhthjs.

,g#rjk$j 7a!c


8/104

gmmjnthak gk` gppravgc0 mar

atfjr gnthaks, pgrjkts snac`

gk` cgljc tfj ljfgvhar

@lg`J. Ht hs hopartgkt hk tfhs

stgdj ta prghsj g ta``cjr mar

`ahkd wfgt fj ar sfj fgs

ljjk gsej` ta `a.

gnthaks. >fj vjrlgchzj`, @Fgpgd

kgohohcht shygkd ogdcglg rhk

egpgd kgdcgcglg gea,

shkgsglhfgk ea cgkd shygkd

ogdljfgvj. Fgpgd kgdljfgvj

shyg lhlhdygk ea shyg kd

prjoya. !hksgk tgtgfhohe cgkd

shyg. 2jra ogy odg grgw rhkd

kgdpupuohcht shyg gt kgdDhhyge.

+HH. DA\@AK' >> &ZKNPHAKG, FJG,PF RGPPJ\K'

G. Fjg#tf Rj$,j*t+ak- Fjg#tf Ogkg&jojkt

>fj ncghoj` tfgt tfj pgthjkt `h` j:pjrhjknj naooak hcckjssjs chej mjvjr,

naudf gk` nac`s. *t tfj gdj am 7 tfj pgthjkt staps `rhkehkd ohce lut hkstjg` fj hs

`rhkehkd nammjj. 3hs oatfjr ncghoj` tfgt wfjkjvjr fj dat shne, tfjy `h`k8t gcrjg`y

tgej fho ta tfj fasphtgc ljngusj am cgne am oakjy. #fjy grj ushkd fjrlgc

oj`hnhkjs mar oj`hngthaks chej arjdgka gk` cgduk`h. #fjy rgtfjr prjmjr fjrlgc

oj hnhkjs gs g rjoj`y wfjkjvjr fj dat shne. #fj pgthjkt hs kat tgehkd gky

vhtgohks.

*t prjsjkt, tfj oatfjr pjrnjhvjs tfgt tfj djkjrgc fjgctf am fhs sak wgs

naopraohsj`. #fj oatfjr ncghoj` tfgt ht hs tfj mhrst thoj tfgt tfj pgthjkt fg` g

sjrhaus nak`hthak gk` fasphtgchzj` mar gcoast " wjjes.

. Kut$+t+akg#-Ojtg!a#+, Rgttj$k

; / 2 g d j


9/104

*nnar`hkd ta fhs oatfjr, tfj pgthjkt usj` ta lrjgstmjj` tfjk fj stgrtj`

`rhkehkd maroucgtj` ohce gt 7 yjgr ac`. *nnar`hkd ta fhs oatfjr, fj chejs ta rhke

nammjj0 fj stgrtj` `rhkehkd wfjk fj wgs 7 yjgr ac` ljngusj saojthojs tfjy

wjrj kat glcj ta purnfgsj ohce. 3j usj` ta jgt mruhts, vjdjtglcjs, ojgt, gk` rhnj

`ghcy. 3j gtj tfrjj thojs g `gy gk` tfgt hkncu`js lrjgemgst, cuknf, gk` `hkkjr. 3hs

typhngc `ghcy mcuh` hktgej hs "D dcgssjs am wgtjr. #fj saurnj am tfjhr wgtjr ngoj

mrao tfj mgunjt gk` `h`k8t lahc ht. #fj pgthjkt gcsa jgts whtf lgrj fgk` whtfaut

wgsfhkd ht gmtjr pcgyhkd hk tfj mgro.

Tfjk fj wgs fasphtgchzj`, tfj pgthjkt fg` cass gppjthtj gk` cgne am

hktjrjst ak jgthkd, gk` saojthojs fj +ust usugccy gtj lrjg` gk` nammjj mar tfj

wfacj `gy. 3hs oatfjr gcsa ncghoj` tfgt wfjkjvjr fj jgts fj su``jkcy vaohts

whtf yjccawhsf `hsnfgrdj. pak pfyshngc j:gohkgthak, tfjrj grj " `jktgc ngrhjs4 7

gt tfj cjmt cawjr oacgr, 7 hk rhdft cawjr oacgr gk` 7 hk prjoacgr. #fj pgthjkt `h`k8t

tgej gky vhtgohks ar suppcjojkts.

#fj pgthjkt `ajsk8t fgvj gky pralcjo ak nfjwhkd gk` swgccawhkd. 3j

gcsa fg` `ry sehk gk` paar sehk turdar wfhnf hk`hngtjs `jfy`rgthak. *nnar hkd ta

tfj `antar8s ar`jr fj hs oghktghkj` ak mjj` whtf >*2. 3j gcsa `jnrjgsjs la`y

wjhdft mrao 77ed ta 7'ed gs tgejk upak pfyshngc j:gohkgthak. #fj pgthjkt fgs

gk HN hkmushak am -H!L sacuthak hk -''oc, rjducgtj` gt ;D1 uddts ak fhs cjmt

ojtgngrpgc vjhk. Ht hk hngtj` mar tfj oghktjkgknj am mcuh` gk` jcjntracytjs

jspjnhgccy ta pgthjkts wfa kjj` ngcarhjs gk` fy`rgthak. #fj HN chkj wgs hkmushkd

wjcc gk` ka ghr gk` lgne mcaw sjjk.

N. J#+o+kgt+ak

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Ljmarj fasphtgchzgthak, gnnar`hkd ta pgthjkt8s oatfjr fj usj` ta `jmjngtj

rjducgrcy mar glaut " thojs g wjje. #fj mjngc nfgrgntjrhsthn wgs lrawk hk nacar,

schdftcy samt whtf sjpgrgtj` cuops whtf sjohsach` tj:turj. 3j `ajs kat fgvj gky

`hmmhnucty ar pralcjos hk naktracchkd gk` hkmaros fjr oatfjr wfjk ta urhkgtj gk`

`jmjngtj. 3j urhkgtjs " ta thojs `ghcy whtf chdft yjccaw hk nacar. *nnar`hkd ta

5uk`gojktgcs am 6urshkd


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fhs mrhjk` gk` shlchkd jvjry `gy. Tfjk fj hs gt faoj, fj usugccy wgtnfjs

tjcjvhshak ljmarj dahkd ta scjjp. Ljngusj fj hs sthcc yaukd fj àjsk8t fgvj gky

maro am j:jrnhsjs.

Tfjk fj wgs fasphtgchzj`, fj mjct vjry wjge gk` thrj` ùj ta j:njss

vaohts gk` `jmjngthkd. 3j caaes pgcj gk` cjtfgrdhn. 3hs pfyshngc gnthvhty cjssjks

gk` fj gcwgys tjk`s ta scjjp mar naksjrvgthak am fhs jkjrdy. *csa, fj kjj`s

gsshstgknj wfjkjvjr dahkd ta tfj lgtfraao ar jvjk stgk`hkd up hk prjvjkthkd

gnnh`jkts jspjnhgccy mgcc.

#fj pgthjkt gcsa ljnaoj hrrhtglcj gk` nrhjs mrj?ujktcy jspjnhgccy wfjk fj

sjjs g pjrsak `rjssj` hk wfhtj ukhmaro gk` àhkd tfj rauk`s wfhnf hs us,

stu`jkt kursjs gk` tfj rjdhstjrj` kursjs ht wgs ngccj` Tfhtj $agt *k:hjty. >trjss

gk` gk:hjty pcgy g fudj racj hk tfj `jvjcapojkt am wfhtj nagt syk`raoj. Hm yau

fg` g lg` j:pjrhjknj whtf oj`hngc `hgdkashs gk` trjgtojkt hk yaur nfhc`faa`, ht8s

vjry passhlcj tfgt kaw yau grj sulnaksnhauscy gmrgh` am gcc àntars ljngusj tfjy

rjohk` yau am yaur pgst trguog. Hk tfj kj:t mjw `gys tfj pgthjkt sfaws ka

hktjrjst hk pcgyhkd, fj ljnaoj oarj hrrhtglcj gk` wjge.

7gt0 Hk`j: am Hk`j)jk`jk$j hk G$th"hthjs am @ghc% ,h"hk

*nthvhthjs Hk`jpjk`jknj %7(jpjk`jknj %'(

Lgtfhkd '@rjsshkd '

Pahcjthkd 'Prgksmjrrhkd 'bbNakthkjknj '

77 / 2 g d j


12/104

Mjj`hkd 'PAPGC

RAHKP^9'

Hktjrprjtgthak9

#fj pgthjkt wgs muccy `jpjk`jkt ta fhs oatfjr. 3j sjjes duh`gknj

gk` gsshstgknj whtf fhs oatfjr.

J. ^#jj*-\jst

*nnar`hkd ta tfj pgthjkt8s oatfjr, ! gcoast spjk`s fhs wfacj `gy

scjjphkd. 3j usugccy wgejs up M go gk` scjjps 7' po. #fj ùrgthak am fhs scjjp

hs +ust jkaudf mar fhs `jvjcapojkt. urhkd spgrj thoj, sfj spjk`s ht ly pcgyhkd

whtf fhs mrhjk`s gk` naushks gk` fj gcwgys tgej gk gmtjrkaak kgp mrao 7& po ta

po.

urhkd fasphtgchzgthak, tfj oatfjr ncghoj` tfgt fj àjsk8t fgvj gky

jkaudf scjjp jspjnhgccy wfjk tfj kursjs wjrj àhkd tfjhr rauk`s gk` tgehkd vhtgc

shdks. #fj pgthjkt usugccy scjjps - faurs mar jvjkhkd tfjk fgs g kgp mar & faurs

hk tfj gmtjrkaak. 3hs scjjphkd `hsturlgknjs wjrj fhs glàohkgc pghk gk` fat

raao tjopjrgturj. Ljmarj dahkd ta scjjp fj gcwgys prgyj` gs fhs oatfjr

tjgnfjs fho.

3hs oatfjr stgtj` tfgt fj gcwgys sohcjs gmtjr wgehkd ukchej kaw tfgt fj

usugccy nrhjs wfjk fj wgejs up gk` wfjk fjr oatfjr cjgvjs fho wfhcj fj wgs

sthcc scjjphkd. #fj oast naomartglcj scjjphkd pashthak am 2gthjkt .! wgs sh`j

cyhkd pashthak whtf 7 phccaw ak tfj fjg` gk` àjsk8t wgkt g lcgkejt.

M. Na&k+t+vj / Rj$,j*tug#

7& / 2 g d j


13/104

Ljmarj fasphtgchzgthak, pgthjkt ! fgs ka pralcjo hk sojcc, vhshak gk`

fjgrhkd jvjk tfaudf fj wgs j:pasj` ak cau` kahsj gt tfjhr faojs. 3j hs g vjry

pcgymuc pjrsak gk` vjry mrhjk`cy whtf atfjrs.

2gthjkt .! jgshcy manusjs gttjkthak jspjnhgccy wfjk fj wgtnfjs

tjcjvhshak. 3j ngk gcsa jgshcy rjojoljr kgojs, pcgnjs gk` kuoljrs. 3j ngk

gcsa maccaw gk` uk`jrstgk` `hrjnthaks.

urhkd fasphtgchzgthak gk` upak tfaraudf pfyshngc j:gohkgthak, 2gthjkt

! fgs ka pralcjo whtf fhs fjgrhkd, sojcc gk` whtf fhs vhshak lut fg` nfgkdjs hk

tgstj am maa`s gs jvh`jknj` ly cass am gppjthtj gk` nfaashkd g vhgk`. #fj pgthjkt

fg` j:pjrhjknj` pghk hk tfj glàojk gk` sfaws dugr hkd ljfgvhar gk`

hrrhtglhchty.

D. ^j#2-Rj$,j*t+ak - ^j#2-,ak,j*t Rgttj$k

#fj pgthjkt hs " yjgrs ac`, nurrjktcy j:pjrhjknhkd pghk gk` wgs kat glcj ta

sgy gkytfhkd glaut fhosjcm. *s stgtj` ly tfj oatfjr, pgthjkt .! gs g nfjjrmuc,

kgudfty, g cavhkd sak gk` lratfjr. Ljmarj fasphtgchzgthak, fj wgs glcj ta dghk

trust ta gkyakj lut wfjk fj wgs stgrtj` ta gòhttj`, fj jgshcy djts hrrhtgtj`

ljngusj am tfj golhgknj hk tfj fasphtgc gs wjcc gs wfjk tfj kursj àhkd tfjhr

rauk`s ljngusj fj ngkkat rjst wjcc. #fj oatfjr gcsa ncghoj` tfgt sfj ekjw tfgt

tfj pgthjkt8s fjgctf wgs tfjk naopraohsj` gk` wgs kat glcj ta pcgy chej ljmarj.

7" / 2 g d j


14/104

F. \a#j \j#gt+aksf+*

2gthjkt ! hs tfj yaukdjst goakd tfj nfhc`rjk am fhs pgrjkts. 3j chvjs

whtf fhs cavhkd pgrjkt gk` shlchkd. *nnar hkd ta fhs oatfjr, fj gcwgys ogejs

tfjo fgppy wfjkjvjr fj sohcjs gk` gcwgys pcgyhkd whtf fhs ac`jr lratfjrs. 3hs

pgrjkts usugccy vhsht gk` tgej daa` ngrj am fho ljngusj tfjy sgh` tfgt tfjhr nfhc`

wgs vjry hopartgkt ta tfjo. #fj pjrsak wfa spjk`s cakd pjrha` am thoj whtf tfj

pgthjkt hs fhs oatfjr gk` ht hs jvh`jknj` tfgt tfj pgthjkt hs rjnjhvhkd jkaudf ngrj

gk` cavj.

urhkd tfj hktjrvhjw fhs pgrjkts wgs tatgccy warryhkd glaut tfj pgthjkt8s

nak`hthak. Ht sjjos tfgt tfjy rjgccy ngrj hk tfjhr yaukdjst nfhc`. #fjy ogkgdj tfj

pgthjkt ly dhvhkd gk j:trg ngrj ta fjcp fho rjnavjr ly fhs hcckjss. *s am kaw, tfjhr

hknaoj wgs kat jkaudf mar tfj fasphtgc j:pjksjs, ljngusj fhs mgtfjr8s +al wgs

hksummhnhjkt mar tfjhr `ghcy chmj. #fjy trust )a` tfgt tfjhr sak whcc lj fjgcj`.

H. ]g#uj / j#+j2 Rgttj$k

*nnar hkd ta fhs oatfjr, 2gthjkt ! wgs lgpthzj` gs 9aogk $gtfachn gk`

jvjry >uk`gy tfjy wjkt ta nfurnf whtf fhs mgohcy. 3j prgnthnjs prgyhkd ljmarj

scjjphkd gt khdft. 3hs oatfjr sgh` tfgt )a` fjcps tfjo ta djt tfraudf whtf tfjhr

pralcjos hk chmj. 9jchdhak mar tfjo wgs vjry hopartgkt. #fjy trust gk` dghk strjkdtf

ly )a`. #fjy ljchjvj` tfgt tfjhr sak whcc lj fjgcj` saoj`gy.

urhkd fasphtgchzgthak, 2gthjkt ! hs kat gnthvj hk dahkd ta nfurnf ljngusj fj

hs sthcc hk fasphtgc gk` tfj pgthjkt kjj`s dugr`hgk. jsphtj am ht, fhs oatfjr gk`

7 / 2 g d j


15/104

pgthjkt .! wjrj sthcc prgyhkd mar fhs mgst rjnavjry. Hk tjros am oj`hngc gppragnfjs,

fhs oatfjr rjchjs hkta tfj fjrlgc oj`hnhkjs gk` ncghoj` tfgt sfj `ajsk8t rjcy taa

ounf ak tfj avjr tfj nauktjr `ruds. #fjy gcsa ljchjvj hk ?ugne `antars gk`

ljchjvj` hk supjrsththaus gs jvh`jknj` ly djtthkd tfj fjhdft am tfj pgthjkt wfhcj fj

wgs scjjphkd lut tfj oatfjr rj+jntj` ljngusj sfj ljchjvjs tfgt ht hs chej djtthkd tfj

shzj am tfj nammhk. *s g stu`jkt kursj, wj uk`jrstgk` gk` rjspjntj` tfjhr nucturj gk`

ljchjms.

Hk tfj kjgr muturj, tfjy wgkt tfjhr nfhc` ta ljnaoj sunnjssmuc gk` mhkhsfj` fhs

stu`hjs saoj`gy. #fj oast hopartgkt tfhkds hk tfjhr chmj wjrj 2gthjkt .! gk` tfjhr

mgohcy.

+HHH. NAOR\JFJK'H+J RF-'HNG, J=GOHKGPHAK

G. +htgc 'hks

*gk(gr% 468 46>

PHOJ

Pjo)jrgt(rj \gtj

/5N2

R(csj \gtj

/


16/104

` Fjh!t9 1; noj 3jh!t977 ed

La`% Ogss Hk`j:9

&aro(cg9 /Lgsj ak ONK ?t!

j`. 1BB&ar %jgrs ac`9 La%2LOHTjhdft %ed( E >tgturj %no( E >tgturj %no( : 7',''' Ar Tjhdft %cl( E >tgturj %hk( E >tgturj %hk( : tgturj %no( E >tgturj %no( : 7',''' 77 ed E 1; no E 1; no E : 7','''LOH >>.? ar (k`jr ka(rhs!

N. DJKJ\G, GRRJG\GKNJ9

2gthjkt ! djkjrgccy caaes pgcj gk` cjtfgrdhn. #fj la`y wgs chdft luhct whtf sogcc

+ahkt gk` fhs ousncj wgs cjgk. 5cgnnh`hty wgs jvh`jkt whtf tfj pgthjkt gk` wgs kat

rjcg:j`. #fj sehk wgs ncjgk, kghcs wjrj kjgt. 3j fgs ka ukusugc la`y gk` lrjgtf a`ar.

2gthjkt ! fgs naoprjfjkshlcj tfaudfts gk` fhs vahnj ngk lj fjgr` hk oa`jrgtj

pgnj.

7M / 2 g d j


17/104

Nj)!gca$g(`gc Gssjssojkt

/Lgsj` ak t!j N!hc`rjk +grhgthaks2

7< / 2 g d j


18/104

@. Nj)!gca$g(`gc Gssjssojkt9

/Lgsj` ak t!j N!hc`rjk +grhgthaks2

La`% Rgrt

J:gohkj`

Karogc &hk`hk G$t(gc &hk`hk Nchkh$gc 'hkhmh$gk$j

HKPJDZOJKPG\- '-'PJO

^7+kehk nacar rgkdjs

mrao pgcj wfhtj

whtf phke, yjccaw,

ar achvj takjs ta

`gre lrawk ar

lcgne.

H4 Ksehk nacar hs

lrawk

Kmcusfj` sehk

Hkspjnthak rjvjgcs jvjkcy

nacarj` sehk takjs, whtfaut

ukusugc `hsnacargthaks.

*nnar`hkd ta Tjlljr =

Fjccjy 3jgctf *ssjssojkt hk

6urshkd "r`j`hthak tfgt

>ogcc goaukt am ojcgkhk

grj naooak hk wfhtjr sehks,

wfhcj cgrdj goaukts am

ojcgkhk grj naooak hk

achvj gk` `grejr sehks.

$gratjkj gnnaukts mar g

yjccaw ngst.

*lkarogc mhk`hkd4 5cusfj`

sehk `uj ta hknrjgsj la`y

tjopjrgturj.

7; / 2 g d j


19/104

aàr, O6a strakd aàr

sfauc` lj jvh`jkt.

H4 Kka strakd

aàr

Kpramusj

swjgthkd

*nnar`hkd ta 3jgctf =

2fyshngc *ssjssojkt hk

6urshkd ly 8*ohna gk`

Lgrlgrhta tfgt Ohgpfarjshs

%pramusj swjgthkd( annurs

ùrhkd j:jrthak, pghk, gk`

joathakgc strjss.

OC*L4 Hknrjgsj cjvjc am

$rjgthkhkj hk 77M.-1uoacEC

ngusj `jfy`rgthak ar

hkg`j?ugtj wgtjr hktgej

sunf gs swjgthkd ngk ngusj

lcaa` naknjktrgthak gk`

rjùnj` lcaa` mcaw hk tfj

eh`kjys. nrjgthkhkj whcchknrjgsj.

gk` cjshaks. Osehk sfauc` lj

cjshak mrjj.

H4 Kwhtf cjshaks hk

tfj latf cawjr

j:trjohthjs

Kwhtf htnfhkjss




fgvhkd cjshaks hk tfj sehk

wgs ùj ta hksjnt lhtjs.

2gcpgtj mar

tjopjrgturj,

O>ehk hs karogccy

wgro tjopjrgturj.

2g4 K wgro ta

taunf

K"ehk phknfjs

jgshcy gk`

hooj`hgtjcy

rjturks ta htsarhdhkgc pashthak.

2g4 Kpaar sehk

turdar



6urshkd "r`j`hthak tfgt sehk

hs kat ?uhnecy g rjturk taarhdhkgc sfgpj gmtjr ljhkd

phknfj`. 2aar sehk turdar

hk`hngtjs `jfy`rgthak.

OC*L>4 * cawjrDtfgkDkarogc

cjvjc am nfcarh`j %;;.-

ooacEC( hs ngccj`

71 / 2 g d j


20/104

fypanfcarjohg. Ht ogy lj

ùj ta jfy`rgthak.

Djfy`rgthakar g`hjtfhdf

hk pratjhk ngk ogej yaur

L6 cjvjc fhdfjr %&".&'EC(.

D * cawjrDtfgkDkarogc cjvjc

am nfcarh`j %;;.- ooacEC( hs

ngccj` fypanfcarjohg. Ht

ogy lj ùj ta jfy`rgthak.

gk` j`jog. O>ehk rjlauk`s

gk` àjs kat

rjoghk hk`jktj`

wfjk prjssurj hs

rjcjgsj`.

2g4 Kka j`jog *nnar hkd ta Tjlljr =


6urshkd "r`j`hthak hs

*lsjknj am j`jog ogy

hk`hngtj g `jsnjkt sehk

nak`hthak.Fg+$ncjrg hs

wfhtj.H4 hrhs gk` tfj

puphcs.

O2uphcs grj j?ugc,

rauk`, gk`

rjgnthvj ta chdft

gk`

gnnaooa`gthak

%2G99C*(.

H4 Kj?ugc

K rjgnthvj ta

chdft gk`

gnnaooa`gthak

Kkarogc gk`

j?ugc hk shzj

KhrhsDrauk`, mcgt,

gk` jvjkcy

nacarj`

KpuphcD rauk`whtf rjducgr

lar`jr, hs

njktrj` hk hrhs.



6urshkd "r`j`hthak tfgt tfj

hrhs hs typhngccy rauk`, mcgt,

gk` jvjkcy nacarj`. #fj

puphc, rauk` whtf g rjducgr

lar`jr, hs njktrj` ak tfj hrhs.

5hkgccy hkspjnt

tfj jyjlraw gk`

jyjcgsfjs.

OGyjlraws

sfauc` lj

syoojtrhn hk

H4 Kjvjkcy

`hstrhlutj`

Kjyjlraws




&" / 2 g d j


24/104

sfgpj gk`

oavjojkt. #fjy

sfauc` kat ojjt

hk oh`chkj.

OGyjcgsfjs

sfauc` lj jvjkcy

`hstrhlutj` gk`

nurcj` autwgr`.

àjs kat ojjt hk

tfj oh`chkj

Ksyoojtrhn hk

sfgpj gk`

oavjojkt.

jyjlraws sfauc` lj

syoojtrhn hk sfgpj gk`

oavjojkt.

Jg$s gk Fjg$+k&

H4 gu$+,#jsmar

nacar, syoojtry

gk` pashthak

O#fj jgrs grj

jvjkcy nacarj`. Ht

hs j?ugc hk shzj

lhcgtjrgccy.

H4 Kgurhncj gchdks

whtf tfj narkjr am

jgnf jyj

K lhcgtjrgccy

j?ugc hk shzj

Knacar hsnakshstjkt whtf

mgnhgc nacar




nacar, pashthak gk` tfj

syoojtry am tfj jgrs sfauc`

lj h`jkthngc gk` ukhmarocynacarj`. #fj gchdkojkt am

tfj gurhncj ogej strghdft ta

tfj narkjr am tfj jyj.

4 jtj$kg# ,gkg#

mar njruojk

O* sogcc goaukt

am aàrcjss

njruojk hs tfj

akcy `hsnfgrdj

karogccy prjsjkt.

H4 K6arogc

goaukt am

yjccawhsf

njruojk upak

gssjssojkt hk

fjr jgr.



6urshkd "r`j`hthak tfgt tfjrj

sfauc` lj ka j:njsshvj

njruojk.

5aucDsojcchkd, sthney, yjccaw

`hsnfgrdjRathths j:tjrkg arhopgntj` marjhdk la`y.

cjshaks, pus ar

lcaa`

O#fj ngkgc wgccs

sfauc` lj phke

gk` soaatf gk`

whtfaut kaùcjs.

H4 Kka cjshaks,

pus ar lcaa`

prjsjkt gs sjjk

whtf tfj usj am

pjkchdft.

Kka `hsnfgrdj

prjsjkt



6urshkd "r`j`hthak tfgt kakD

gppjgrgknj am cjshaks gk`

lcaa` hs karogc. Lcaa`y,

purucjkt `hsnfgrdjRathths

oj`hg whtf rupturj`

tyopgkhn ojolrgkj.

24 gu$+,#jsmartj:turj, jcgsthnhty

gk` grjgs am

tjk`jrkjss

O#fj sehk hssoaatf whtf ka

cjshaks, cuops, ar

kaùcjs. 6arogccy

tfj gurhncj hs kat

tjk`jr.

2g4 K#fj gurhncjsgrj soaatf. Ht hs

saojwfgt jcgsthn

Kka

tjk`jrkjss

*nnar`hkd ta Tjlljr =Fjccjy 3jgctf *ssjssojkt hk

6urshkd "r`j`hthak tfgt g

pghkmuc gurhncj hs gssanhgtj`

whtf athths j:tjrkg ar g past

gurhnucgr nyst.

Kasj gk ^+kusjs.

& / 2 g d j


25/104

H4 kasj `jvhgthak

hk sfgpj, shzj,

nacar, mcgrhkd,

`hsnfgrdj

O $acar hs tfj

sgoj gs tfj rjst

am tfj mgnj0 tfj

kgsgc strunturj hs

soaatf gk`

syoojtrhn.

H4 K#fj kasj hs

syoojtrhnE hs hk

oh`chkj am tfj

mgnj.

K $acar hs tfj

sgoj gs tfj

mgnj. K6a mcgrhkd

%rj`kjss( ar

`hsnfgrdj

prjsjkt




nacar hk j:tjrkgc kasj hs

sgoj gs tfj rjst am tfj mgnj0

tfj kgsgc strunturj hs

soaatf gk` syoojtrhn.

Ljngusj, 5cgrhkd ar

`hsnfgrdjs hs gk glkarogc

shdks.

4 kgsg# ou,asg

mar rj`kjss,

swjcchkd, drawtf

ar `hsnfgrdj

O #fj kgsgc

ounasg hs `gre

phke, oahst, gk`

mrjj am j:u`gtjs.

#fj kgsgc sjptuohs hktgnt gk` mrjj

am ucnjrs ar

pjrmargthaks.

H4 K6a rj`kjss,

swjcchkd, ar

`hsnfgrdjs am

kgsgc ounasg.

Kphke hk nacar




kgsgc ounasg hs `gre phke,

oahst, gk` mrjj am j:u`gtjs.#fj kgsgc sjptuo hs hktgnt

gk` mrjj am ucnjr ar

pjrmargthaks.

G:njsshvj gnnuoucgthak am

ounus sjnrjthak rjsucts ta

nac`s.

2gcpgtj tfj

shkusjs hk ac`jr

nfhc`rjk hm

shkushths hssuspjntj`.

O6a tjk`jrkjss

pgcpgtj` avjr

shkusjs.

2g4 Kka

tjk`jrkjss



6urshkd "r`j`hthak tfgt hm

tfjrj hs g tjk`jr shkusjssuddjst shkushths.

Oautf gk Pf$agt

H4 #+*sgk`

o($a(s

ojo


26/104

L6 cjvjc fhdfjr %&".&'EC(.

D * cawjrDtfgkDkarogc cjvjc

am nfcarh`j %;;.- ooacEC( hs

ngccj` fypanfcarjohg. Ht

ogy lj ùj ta jfy`rgthak.

4 tjjtfmar

gchdkojkt, cass,

`jktgc mhcchkds gk`

ngrhjs.

Ojnhàus tjjtf

ljdhk ta `jvjcap

ljtwjjk gk` M

oaktfs0 gcsa &'

jrupt ly "M

oaktfs0 tjjtf

ljdhk ta mgcc aut

grauk` M yjgrs,

wfjk pjrogkjkt

taatf jrupthak gk`pradrjssjs ukthc

gcc "& fgvj

jruptj`.

H4 K" jktgc

ngrhjs, 7 gt tfj

cjmt cawjr oacgr

gk` 7 hk rhdft

cawjr oacgr0 7 hk

prjoacgr



6urshkd "r` j`hthak tfgt

taatf `jngy %ngrhjs( ogy

gppjgr gs lrawk àts ar

navjr oarj j:tjkshvj grjgs

am nfjwhkd surmgnj. * nfgcey

wfhtj grjg hk tfj taatf

surmgnj hs g ngvhty tfgt whcc

turk `grejr whtf thoj.

4 &uosmar

lcjj`hkd, nacar,

rjtrgnthak,

cjshaks, swjcchkd

O )uos grj phke,

oahst, gk` mhro

whtf thdft ogrdhks

ta tfj taatf. O6a

cjshaks ar

ogssjs.

H4 K phkehsf duos,

whtfaut tfj

prjsjknj am

lcjj`hkd,

cjshaks, swjcchkd,

ar duo rjtrgnthak

gs alsjrvj`.



6urshkd "r`j`hthak tfgt 9j`,

swaccjk duos tfgt lcjj`

jgshcy grj sjjk hk dhkdhvhths,

snurvy %vhtgohk $

`jmhnhjkny(, gk` cjuejohg.9jnj`hkd rj` duos whtf

cass am tjjtf grj sjjk hk

pjrhaàkthths. Ht hs glkarogc

hk yaukdjr nchjkts.

4 tak&ujmar

pashthak, nacar =

tj:turj

O #akduj sfauc`

lj phke, oahst, g

oa`jrgtj shzj

whtf pgphccgj

prjsjkt, gk`

syoojtrhn hkpashthak.

H4 K takduj wgs

phke hk nacar whtf

wfhtj nacargthak,

oahst, gk`

syoojtrhn.

K#fjrj hs gprjsjknj am

pgphccgj ak ht.




goakd passhlcj

glkarogchthjs grj `jjp

cakdhtu`hkgc mhssurjs sjjk hk`jfy`rgthak0 g lcgne takduj

hk`hngthvj am lhsoutf

ta:hnhty4 lcgne, fghry takduj0

g soaatf, rj``hsf, sfhky

takduj whtfaut pgphccgj

hk`hngthvj am khgnhk ar L7&

&M / 2 g d j


27/104

`jmhnhjknhjs, njrtghk gkjohg,

gk` gkthkjapcgsthn tfjrgpy.

oavjojkt O #fj takduj

ammjr strakd

rjshstgknj.

H4 K takduj

oavjs wfjk

hkstrunthkd tfj

pgthjkt ta oavj

ht.




jnrjgsj` takduj strjkdtf

ogy annur whtf g `jmjnt am

tfj WHH nrgkhgc kjrvj

%fypadcassgc( ar whtf g sfart

mrjkucuo tfgt chohts oathak.

4 *g#gtjsmar

nacar, sfgpj,

tj:turj, prjsjknj

am laky

praohkjknjs

O #fj fgr` pgcgtj

hs pgcj ar wfhthsf

whtf mhro,

trgksvjrsj rudgj.

H4 K samt pgcgtj

DDphkehsf gk`

soaatf

Kfgr`

pgcgtjDDD mhro gk`

fgs tfj prjsjknj

am trgksvjrsj

rudgj.



6urshkd "r`j`hthak tfgt *

ngk`h`gc hkmjnthak ogy

gppjgr gs tfhne wfhtj

pcg?ujs ak tfj fgr` pgcgtj.

4 uvu#gmar

pashthak =

oalhchty

O #fj uvucg hs g

mcjsfcy, sach`

strunturj tfgt

fgkds mrjjcy hk

tfj oh`chkj.

O 6a rj`kjss am

ar j:u`gtjs mraouvucg gk`

syoojtrhn

jcjvgthak am tfj

samt pgcgtj.

H4 K #fj uvucg hs

syoojtrhn gk`

oavjs wfjk

sgyhkd @gggfJ.




pgcgtj mghcs ta rhsj gk` uvucg

`jvhgtjs ta karogc sh`j, ht

hk`hngtjs whtf nrgkhgc kjrvj

W %vgdus( pgrgcyshs.

6atj tfj

nak`hthak am tfj

tfragt gk` takshcs

O#akshcs grj

jgshcy sjjk ly

gdj M wfjk tfjy

hknrjgsj ta g`uct

`hojkshaks.

H4 K#akshcs grj

karogccy phke

gk` syoojtrhn.

K6a j:u`gtj ar

cjshaks.




latf takshcs grj mauk`

ljfhk` tfj phccgrs.

NG\@HA+G'NZ,G\ '-'PJO

Fjg$t

Rrj$ar`h(o.

6atj chmts,

fjgvjs, gk`

gphngc hopucsj.

O#fj gphngc

hopucsj hs gt tf

hktjrnastgc spgnj

%H$>( ukthc tfj gdj

am < yjgrs, wfjk

H4 K*phngc

hopucsjs ogy

kat lj vhshlcj

2g4 Kka pucsgthak



6urshkd "r`j`hthak tfgt g

systachn fjgvj hm ogy

hk`hngtjDrhdft vjktrhnucgr

&< / 2 g d j


28/104

ht `raps ta tfj -tf.

OHt hs ta tfj cjmt am

tfj oh`ncgvhnucgr

chkj %!$C( ukthc

gdj .

ar vhlrgthaks grj

pgcpgtj` hk grjgs

am gpj:

jkcgrdjojkt. *phngc pucsj

tfgt hs kat hk prapjr cangthak

mar gdj ogy hk`hngtj

ngr`haoyapgtfy,

pkjuoatfarg:, ar

`hgpfrgdogthn fjrkhg.

6atj rgtj rfytfo

am tfj gphngc

hopucsj.

O*wgej gk`

rjsthkd rgtjs vgry

whtf tfj gdj am

tfj nfhc`4

& yjgrs ta 7'

yjgrs4


29/104

&'7(

'&po4 &- npo

'po4 &; npo

'Mpo4 &- npo

';po4 "' npo

N!jst. urhkd

pjrnusshak am tfj

cukds, katj takj

jchnhtj`.

O3ypjr

rjsakgknj hs tfj

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30/104

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31/104

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32/104

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33/104

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34/104

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35/104

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38/104

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; / 2 g d j
http://www.webmd.com/hepatitis/liverhttp://www.webmd.com/hw-popup/heart-failure-8021http://www.webmd.com/hw-popup/heart-failure-8021http://www.webmd.com/hw-popup/dehydrationhttp://www.webmd.com/diet/old-diet-tochttp://www.webmd.com/hepatitis/liverhttp://www.webmd.com/hw-popup/heart-failure-8021http://www.webmd.com/hw-popup/dehydrationhttp://www.webmd.com/diet/old-diet-toc


49/104

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1 / 2 g d j
http://www.webmd.com/hw-popup/electrolytes-and-electrolyte-imbalanceshttp://www.webmd.com/heart/anatomy-picture-of-bloodhttp://www.webmd.com/hypertension-high-blood-pressure/guide/blood-pressure-causeshttp://www.webmd.com/hw-popup/phhttp://www.webmd.com/hw-popup/phhttp://www.nlm.nih.gov/medlineplus/ency/article/000378.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/000158.htmhttp://www.webmd.com/hw-popup/electrolytes-and-electrolyte-imbalanceshttp://www.webmd.com/heart/anatomy-picture-of-bloodhttp://www.webmd.com/hypertension-high-blood-pressure/guide/blood-pressure-causeshttp://www.webmd.com/hw-popup/phhttp://www.nlm.nih.gov/medlineplus/ency/article/000378.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/000158.htm


50/104

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-7 / 2 g d j


52/104

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-& / 2 g d j
http://www.healthcaremagic.com/articles/The-Urinary-Tract/8110http://www.healthcaremagic.com/topics/leukocyte-esterase/33867http://www.healthcaremagic.com/topics/leukocyte-esterase/33867http://www.healthcaremagic.com/articles/The-Urinary-Tract/8110http://www.healthcaremagic.com/topics/leukocyte-esterase/33867http://www.healthcaremagic.com/topics/leukocyte-esterase/33867


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gkdhaj`jog, lurkhkdgk` htnfhkdgt hk+jnthakshtj.

*`vjrsj

Gmmjnts4hgrrfjg,`hzzhkjss,thrj`kjss,fjg`gnfj =rgsf.

nfjst pghk

mjvjr

mjjchkd sfart am

lrjgtf

naudfhkd up

drjjk aryjccawounus

jgsy lruhshkd ar

lcjj`hkd

ukusugc

wjgekjss

mgst ar scaw

fjgrt rgtj

pralcjos whtf

yaur vhshak

sarj tfragt

fjg`gnfjwhtf g sjvjrjlchstjrhkd,pjjchkd

rj` sehk rgsf ar

staognf pghk

!akhtar vhtgc shdks

am tfj pgthjkt.

*òhkhstjr

oj`hngthak gs

prjsnrhlj` ly tfj

pfyshnhgk.

*sshst tfj pgthjkt

wfjk

gòhkhstjrhkd tfj

oj`hngthak.

*`vhsj pgthjkt ta

rjpart glàohkgc

pghk, lcaa` hk staac

ar jojshs, lcgne,

tgrry staacs, ar

nammjjDdrauk`

jojshs.

*ssjss pgthjkt mar

glàohkgc pghk.

6atj prjsjknj am

lcaa` hk jojshs,

M" / 2 g d j

+H'HAK* prjohjr ukhvjrshty hk fhstarhn $gvhtj

rjnadkhzj` mar j:njccjknj hk tfj`jvjcapojkt am oargccy uprhdft gk` dcalgccy

naopjththvj hk`hvhùgcs.



?ugchty hkstrunthak gk` rjcjvgkt rjsjgrnf gk``jvjcapojkt gnthvhthjs. Ht sfgcc praùnj

pramjsshakgc, sehccj` gk` oargccy uprhdfthk`hvhùgcs mar dcalgc naopjththvjkjss.

\j)(


64/104

9jvjrshlcjnakmushakgcstgtj. 5jvjr,grtfrgcdhg,oygcdhg,lcaa` = $N`hsar`jrs

caw mjvjr

cass am gppjthtj

`gre urhkj

ncgyDnacarj`

staacs

+guk`hnj

%yjccawhkd amtfj sehk arjyjs(

Cjss sjrhaussh`j jmmjntsogy hkncu`j4

fjg`gnfj %ogy

lj sjvjrj(

`rawshkjss

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scjjp pralcjos

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kgusjg

vaohthkd

staognf pghk

`hgrrfjg

naksthpgthak.

staac, ar dgstrhn

gsphrgtj.

M / 2 g d j


65/104

@r( 't(`%

@\ZD

&JGPZ\J'

OJNFGKH'O

A& GNPHAK


J&&JNP'

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Lrgk` Kgoj9

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Gkthjrhaushkmjnthak wfjkngusgthvjardgkhsos grjkat ekawk.#rjgtojkt amsupjrmhnhgcanucgrhkmjnthaks ujta strghks amohnraardgkhsosusnjpthlcj tadjktgohnhk.

sj nguthauscy whtf

rjkgc ar fjpgthn hsjgsj

sucmhtj sjkshthvhty0

prjj:hsthkd fjgrhkd

cass0 gnthvj hkmjnthak

whtf fjrpjs, vgnnhkhg,

gk` mukdgc hkmjnthak.

$6>4

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2gcphtgthak,3ypatjkshak

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)4

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glàohkgc ar

staognfpghkEnrgophkd

lcaaÈounus hk

yaur staac rgsf,

htnfhkdEswjcchkd%jspjnhgccy amtfjmgnjEtakdujEtfragt(

sjvjrj

`hzzhkjss

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lrjgtfhkd.

!akhtar sjruo

naknjktrgthak wfjkmjgshlcj ta gvah`patjkthgccy ta:hncjvjcs.

*ssjss pgthjkt mar

shdks gk` syoptaosam hkmjnthak ljmarjgk` urhkd tfjtrjgtojkt

$ucturj hkmjntj` grjg

ljmarj tfjrgpy

*ssjss mar gccjrdhn

rjgnthak. *vah` cakd trjk

tfjrgphjs ljngusj amhknrjgsj` rhse amta:hnhthjs.

M- / 2 g d j



?ugchty hkstrunthak gk` rjcjvgkt rjsjgrnf gk``jvjcapojkt gnthvhthjs. Ht sfgcc praùnjpramjsshakgc, sehccj` gk` oargccy uprhdfthk`hvhùgcs mar dcalgc naopjththvjkjss.

\j)(


66/104

@r( 't(`%

@\ZD

&JGPZ\J'

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A& GNPHAK


J&&JNP'

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pghk njktjr hk

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alstrunthkd

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nfjoarjnjptars

. #fj `rud

praùnjs

gkthpyrjshs ly

gk gnthak ak tfj

fypatfgcgous0

fjgt hsshpgthak

hs hknrjgsj` gs

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vgsa`hcgthak gk`

hknrjgsj`

#a rjchjvjohc` taoa`jrgtjpghk ùj tatfhkds sunfgs fjg`gnfj,ousncj gk`

+ahkt pghklgnegnfj gk`pjrha` pghks.

Ht hs gcsa usj`ta lrhkd awkg fhdftjopjrgturj.

5ar tfhsrjgsak,pgrgnjtgoacngk lj dhvjkta nfhc`rjkgmtjrvgnnhkgthaks

3ypjrsjkshthvhty ta

gnjtgohkapfjk ar

pfjkgnjthk0 usj whtf

gcnafac.

3jogtacadhn4

fjoacythn gkjohg,

cjueapjkhg,

kjutrapjkhg,

pgknytapjkhg,

tfraolanytapjkhg.

3jpgthn4

chvjr gogdj,

+guk`hnj

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fypadcynjohg

>ehk4 rgsf, urthnurhg

yspjpshg

sehk rgsf

htnfhkd

fhvjs

Gssjssojkt @r(Jmmj$tsD!akhtar mar >=> am4fjpgtata:hnhty, jvjk whtfoa`jrgtj gnjtgohkapfjkàsjs, jspjnhgccy hkhk`hvhùgcs whtf paarkutrhthak.Rgthjkt &gohc%J`($gthak

Da kat tgej atfjroj`hngthaks %j.d., nac`prjpgrgthaks( naktghkhkdgnjtgohkapfjk whtfautoj`hngc g`vhnj0avjràshkd gk` nfrakhnusj ngk ngusj chvjr`gogdj gk` atfjr ta:hnjmmjnts.

Da kat sjcmDoj`hngtjnfhc`rjk mar pghk oarj

MM / 2 g d j




\j)(


67/104

Ncjgr pjrhpfjrgc lcaa`

mcaw.

ta prjvjktpastDhooukhzgthakpyrj:hg %fhdftjopjrgturj(.

2grgnjtgoachs amtjkhkncu`j` hknaudf, nac`

gk` mcurjoj`hjs.

tfgk - ` whtfautnaksucthkd g pfyshnhgk.

Da kat usj mar mjvjrpjrshsthkd cakdjr tfgk "`, mjvjr avjr "1.- $ %7'"5(, ar rjnurrjkt mjvjr.

D a kat dhvj nfhc`rjk

oarj tfgk - `asjs hk &

f ukcjss prjsnrhlj` lypfyshnhgk.

M< / 2 g d j


68/104

L. @hjtgr% Rrjs$rh)thakI \jstrh$thak

*nnar`hkd ta tfj `antar8s ar`jr, 2gthjkt .! sfauc` lj oghktghkj` 5jj` whtf

>trhnt *sphrgthak.

N. Fas)htgc Rra$j`(rjs

Rra$j`(rjs Hk`h$gthak &hk`hks K(rshk

\js)aksh


69/104

wfhnf g ngkkucg hs

pcgnj` hksh`j g vjhk

ta pravh`j vjkaus

gnnjss.

Njkaus gnnjss

gccaws sgopchkd am

lcaa` gs wjcc gs

g`ohkhstrgthak am

mcuh`s, oj`hngthaks,

pgrjktjrgc kutrhthak,

nfjoatfjrgpy, gk`

lcaa` pra`unts.

ngtfjtjrhzj` whtf ka.

"" -H!L rjducgtj`

gt ;D1 udtts ak fjr

cjmt ojtgngrpgc vjhk.

gssjss tfj HN shtj ta

nfjne hm tfjrj hs

jolachso,

ohspcgnjojkt am HN

$gkkucg ar atfjr

pralcjos hk rjcgthak ta

HN #fjrgpy.

M1 / 2 g d j


70/104

Avjrvhjw*kgtaoy gk` 2fyshacady


71/104

GKGPAO- GK@ RF-'HA,AD-

DG'P\AHKPJ'PHKG, P\GNP

#fj fuogk gstrahktjsthkgc trg$t%)H trgnt(, rjmjrs ta tfj staognfgk` hktjsthkj,

gk` hs `hvh`j` hkta tfj uppjr gk` cawjr dgstrahktjsthkgc trgnts. Ht ngk gcsa hkncu`j gcc tfjstrunturjs mrao tfj oautfta tfj gkus.

#fj wfacj `hdjsthvj trgnt hs glaut khkj ojtrjs cakd. #fj trgnt ogy gcsa lj

`hvh`j` hkta marjdut, oh`dut, gk` fhk`dut, rjmcjnthkd tfj jolryacadhngcarhdhk am jgnf

sjdojkt am tfj trgnt.

#fj )H trgnt nakstgktcy rjcjgsjs faroakjsta fjcp rjducgtj tfj `hdjsthvj pranjss.

#fjsj faroakjs, hkncu`hkd dgstrhk, sjnrjthk, nfacjnystaehkhk, gk` dfrjchk, grj oj`hgtj`

tfraudf jhtfjr hktrgnrhkjar gutanrhkjojnfgkhsos, hk`hngthkd tfgt tfj njccs rjcjgshkd

tfjsj faroakjs grj naksjrvj` strunturjs tfraudfaut jvacuthak.

GKGPAO-

Z))jr gstrahktjsthkgc trg$t

#fj uppjr dgstrahktjsthkgc trgnt nakshsts am tfj jsapfgdus, staognf,

gk` ùa`jkuo. #fj j:gnt `jogrngthak ljtwjjk tfj uppjr gk` cawjr trgnts ngk vgry.

pak `hssjnthak, tfj ùa`jkuo ogy gppjgr ta lj g ukhmhj` ardgk, lut ht hs amtjk `hvh`j`

hkta twa pgrts lgsj` upak muknthak, grtjrhgc suppcy, ar jolryacady.

#fj suspjksary ousncj am ùa`jkuohs gk hopartgkt gkgtaohngc cgkògre wfhnfsfaws tfj marogc `hvhshak ljtwjjk tfj ùa`jkuo gk` tfj +j+ukuo, tfj mhrst gk` sjnak`

pgrts am tfj sogcc hktjsthkj, rjspjnthvjcy. #fhs hs g tfhk ousncj wfhnf hs `jrhvj` mrao

tfj jolryakhnojsa`jro.

,a#jr gstrahktjsthkgc trg$t


72/104

#fj cawjr dgstrahktjsthkgc trgnt hkncu`js oast am tfj sogcc hktjsthkjgk` gcc am

tfj cgrdj hktjsthkj.

La#jcar hktjsthkj

'ogcc Hktjsthkj4 3gs tfrjj pgrts4

@(a`jk(o93jrj tfj `hdjsthvj +uhnjs mrao tfj pgknrjgs%`hdjsthvj

jkzyojs( gk` faroakjs gk` tfj dgcc lcg``jr%lhcj( oh:. #fj `hdjsthvj

jkzyojs lrjge àwk pratjhks gk` lhcj gk` joucshmymgts hkta ohnjccjs.

#fj ùa`jkuonaktghks Lrukkjr^s dcgk`swfhnf praùnj g ounusDrhnf

gcegchkj sjnrjthak naktghkhkd lhngrlakgtj, wfhnf Hk naolhkgthak whtf

lhngrlakgtj mrao tfj pgknrjgs kjutrgchzjs 3$cam tfj staognf.

*jE(k(o9#fhs hs tfj oh`sjnthak am tfj hktjsthkj, nakkjnthkd tfj

ùa`jkuo ta tfj hcjuo. Ht naktghks tfj pchngj nhrnucgrjs, gk` vhcchtfgt

hknrjgsj tfj surmgnj grjg am tfhs pgrt am tfj )H #rgnt. 2raùnts am `hdjsthak

%sudgrs, gohka gnh`s, gk` mgtty gnh`s( grj glsarlj` hkta tfj lcaa`strjgofjrj.

Hcj(o93gs vhcchshohcgr ta tfj +j+ukuo, gk` glsarls oghkcy vhtgohk

L7&gk` lhcj gnh`s, gs wjcc gs gky atfjr rjoghkhkd kutrhjkts.

,grj Hktjsthkj93gs tfrjj pgrts4

Ngj$(o9#fj vjrohmaro gppjk`h:hs gttgnfj` ta tfj ngjnuo.

Nacak9Hkncu`js tfj gsnjk`hkd nacak,trgksvjrsj nacak,`jsnjk`hkd

nacakgk`

'hoah` &cj:(rj9#fj oghk muknthak am tfj $acak hs ta glsarl

wgtjr, lut ht gcsa naktghks lgntjrhgtfgt praùnj

ljkjmhnhgc vhtgohkschej vhtgohk F.

\j$t(o

Gkgc $gkgc9 #fj tjrohkgc pgrt am tfj cgrdj hktjsthkj.

RF-'HA,AD-

#fj thoj tgejk mar maa` ar atfjr hkdjstj` al+jnts ta trgksht tfraudf tfj

dgstrahktjsthkgc trgnt vgrhjs `jpjk`hkd ak ogky mgntars, lut raudfcy, ht tgejs cjss tfgk

gk faur gmtjr g ojgc mar -' am staognf naktjkts ta jopty hkta tfj hktjsthkjs gk` tatgcjoptyhkd am tfj staognf tgejs grauk` & faurs. >ulsj?ujktcy, -' joptyhkd am tfj

sogcc hktjsthkj tgejs 7 ta & faurs. 5hkgccy, trgksht tfraudf tfj nacak tgejs 7& ta -' faurs

whtf wh`j vgrhgthak ljtwjjk hk`hvhùgcs.


73/104

Hoo(kj m(k$thak

#fj dgstrahktjsthkgc trgnt hs gcsa g praohkjkt pgrt am tfj hooukj systjo. #fj

surmgnj grjg am tfj `hdjsthvj trgnt hs jsthogtj` ta lj tfj surmgnj grjg am g maatlgcc mhjc`.

Thtf sunf g cgrdj j:pasurj, tfj hooukj systjo oust ware fgr` ta prjvjkt pgtfadjks

mrao jktjrhkd hkta lcaa` gk` cyopf.#fj caw p3%rgkdhkd mrao 7 ta ( am tfj staognf hs mgtgc mar

ogky ohnraardgkhsostfgt jktjr ht. >hohcgrcy, ounus%naktghkhkd Hd*gkthla`hjs(

kjutrgchzjs ogky am tfjsj ohnraardgkhsos. Atfjr mgntars hk tfj )H trgnt fjcp whtf

hooukj muknthak gs wjcc, hkncu`hkd jkzyojshksgchvggk` lhcj. Gkzyojssunf gs

$yp"*, gcakd whtf tfj gkthpartjr gnthvhthjs, gcsa grj hkstruojktgc hk tfj hktjsthkj^s racj

am `jta:hmhngthak am gkthdjksgk` :jkalhathns, sunf gs `ruds, hkvacvj` hk mhrst pgss

ojtglachso.

3jgctfDjkfgknhkd hktjsthkgc lgntjrhgsjrvj ta prjvjkt tfj avjrdrawtf am

patjkthgccy fgromuc lgntjrhghk tfj dut. #fjsj twa typjs am lgntjrhg naopjtj mar spgnj

gk` Vmaa`,V gs tfjrj grj chohtj` rjsaurnjs whtfhk tfj hktjsthkgc trgnt. * rgtha am ;'D;-

ljkjmhnhgc ta 7-D&' patjkthgccy fgromuc lgntjrhg djkjrgccy hs naksh`jrj` karogc whtfhktfj hktjsthkjs. !hnraardgkhsos gcsa grj ejpt gt lgy ly gk j:tjkshvj hooukj systjo

naoprhshkd tfj dutDgssanhgtj` cyopfah` thssuj%)*C#(.

L\GHK

#fj lrghk hs akj am tfj oast naopcj: gk` ogdkhmhnjkt ardgks hk tfj fuogk la`y.

Aur lrghk dhvjs us gwgrjkjss am aursjcvjs gk` am aur jkvhrakojkt, pranjsshkd g

nakstgkt strjgo am sjksary `gtg. Ht naktracs aur ousncj oavjojkts, tfj sjnrjthaks am

aur dcgk`s, gk` jvjk aur lrjgtfhkd gk` hktjrkgc tjopjrgturj. Gvjry nrjgthvj tfaudft,mjjchkd, gk` pcgk hs `jvjcapj` ly aur lrghk. #fj lrghk8s kjuraks rjnar` tfj ojoary am

jvjry jvjkt hk aur chvjs.

GKGPAO-


74/104

#fjrj grj `hmmjrjkt wgys am `hvh`hkd tfj lrghk gkgtaohngccy hkta rjdhaks. Cjt8s usjg naooak ojtfa` gk` `hvh`j tfj lrghk hkta tfrjj oghk rjdhaks lgsj` ak jolryakhn`jvjcapojkt4 tfj marjlrghk, oh`lrghk gk` fhk`lrghk. k`jr tfjsj `hvhshaks4

#fj marj


75/104

mar hktjdrgthkd gk` pranjsshkd hkmarogthak `jchvjrj` ta tfj lrghk ly sjksary kjuraks.Hktjrkjuraks sjk` shdkgcs ta oatar kjuraks, wfhnf ngrry shdkgcs ta ousncjs gk` dcgk`s.

Kju$a+g8ar dchgc njccs, gnt gs tfj fjcpjr njccs am tfj lrghk0 tfjy suppart gk`pratjnt tfj kjuraks. Hk tfj lrghk tfjrj grj maur typjs am dchgc njccs4 gstranytjs,

achda`jk`ranytjs, ohnradchg, gk` jpjk`yogc njccs.

Gst$a,ytjspratjnt kjuraks ly mhctjrhkd kutrhjkts aut am tfj lcaa` gk` prjvjkthkd

nfjohngcs gk` pgtfadjks mrao cjgvhkd tfj ngphccgrhjs am tfj lrghk.

A#+&ajk$a,ytjswrgp tfj g:aks am kjuraks hk tfj lrghk ta praùnj tfj

hksucgthak ekawk gs oyjchk. !yjchkgtj` g:aks trgksoht kjrvj shdkgcs ounf mgstjr tfgkukoyjchkgtj` g:aks, sa achda`jk`ranytjs gnnjcjrgtj tfj naooukhngthak spjj` am tfjlrghk.

O+,$a+ggnt ounf chej wfhtj lcaa` njccs ly gttgnehkd gk` `jstrayhkd pgtfadjks

tfgt hkvg`j tfj lrghk.

J*jkyog# ,j##s chkj tfj ngphccgrhjs am tfj nfarah` pcj:usjs gk` mhctjr lcaa`

pcgsog ta praùnj njrjlrasphkgc mcuh`.#fj thssuj am tfj lrghk ngk lj lraejk àwk hkta twa og+ar ncgssjs4 drgy ogttjr gk`wfhtj ogttjr.

0$gy ogttj$hs og`j am oastcy ukoyjchkgtj` kjuraks, oast am wfhnf grj

hktjrkjuraks. #fj drgy ogttjr rjdhaks grj tfj grjgs am kjrvj nakkjnthaks gk`pranjsshkd.

:f+tj ogttj$hs og`j am oastcy oyjchkgtj` kjuraks tfgt nakkjnt tfj rjdhaks am

drgy ogttjr ta jgnf atfjr gk` ta tfj rjst am tfj la`y. !yjchkgtj` kjuraks trgksoht kjrvjshdkgcs ounf mgstjr tfgk ukoyjchkgtj` g:aks à. #fj wfhtj ogttjr gnts gs tfjhkmarogthak fhdfwgy am tfj lrghk ta spjj` tfj nakkjnthaks ljtwjjk `hstgkt pgrts am tfjlrghk gk` la`y.

FHK@L\GHK /\FAOLJKNJRFG,AK2

Lrghkstjo $akkjnthkd tfj lrghk ta tfj sphkgc nar`, tfj lrghkstjo hs tfj oast hkmjrhar parthakam aur lrghk. !gky am tfj oast lgshn survhvgc muknthaks am tfj lrghk grj naktraccj` ly tfjlrghkstjo.

#fj lrghkstjo hs og`j am tfrjj rjdhaks4 tfj ojùccg alcakdgtg, tfj paks, gk`tfj oh`lrghk. * kjtDchej strunturj am oh:j` drgy gk` wfhtj ogttjr ekawk gs tfj rjthnucgr

marogthak hs mauk` hk gcc tfrjj rjdhaks am tfj lrghkstjo. #fj rjthnucgr marogthak naktracsousncj takj hk tfj la`y gk` gnts gs tfj swhtnf ljtwjjk naksnhauskjss gk` scjjp hk tfjlrghk.

#fj oju##g a!#ak&gtghs g raudfcy nychk`rhngc ogss am kjrvaus thssuj tfgtnakkjnts ta tfj sphkgc nar` ak hts hkmjrhar lar`jr gk` ta tfj paks ak hts supjrhar lar`jr.#fj ojùccg naktghks oastcy wfhtj ogttjr tfgt ngrrhjs kjrvj shdkgcs gsnjk`hkd hkta tfjlrghk gk` `jsnjk`hkd hkta tfj sphkgc nar`. Thtfhk tfj ojùccg grj sjvjrgc rjdhaks amdrgy ogttjr tfgt pranjss hkvacuktgry la`y muknthaks rjcgtj` ta faojastgshs. #fj


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ngr`havgsnucgr njktjr am tfj ojùccg oakhtars lcaa` prjssurj gk` a:ydjk cjvjcs gk`rjducgtjs fjgrt rgtj ta pravh`j summhnhjkt a:ydjk suppchjs ta tfj la`y8s thssujs. #fjojùccgry rfytfohnhty njktjr naktracs tfj rgtj am lrjgtfhkd ta pravh`j a:ydjk ta tfjla`y. Naohthkd, skjjzhkd, naudfhkd, gk` swgccawhkd rjmcj:js grj naar`hkgtj` hk tfhsrjdhak am tfj lrghk gs wjcc.

#fj*akshs tfj rjdhak am tfj lrghkstjo mauk` supjrhar ta tfj ojùccg alcakdgtg,hkmjrhar ta tfj oh`lrghk, gk` gktjrhar ta tfj njrjljccuo. #adjtfjr whtf tfj njrjljccuo, htmaros wfgt hs ngccj` tfj !jtjknjpfgcak. *laut gk hknf cakd gk` saojwfgt cgrdjr gk`wh`jr tfgk tfj ojùccg, tfj paks gnts gs tfj lrh`dj mar kjrvj shdkgcs trgvjchkd ta gk`mrao tfj njrjljccuo gk` ngrrhjs shdkgcs ljtwjjk tfj supjrhar rjdhaks am tfj lrghk gk`tfj ojùccg gk` sphkgc nar`.

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@hjk$j)!gcak >upjrhar gk` gktjrhar ta tfj oh`lrghk hs tfj rjdhak ekawk gs tfj hktjrlrghk, ar`hjknjpfgcak. #fj tfgcgous, fypatfgcgous, gk` phkjgc dcgk`s ogej up tfj og+ar

rjdhaks am tfj `hjknjpfgcak.

#fj tfg#gousnakshsts am g pghr am avgc ogssjs am drgy ogttjr hkmjrhar ta tfj

cgtjrgc vjktrhncjs gk` surrauk`hkd tfj tfhr` vjktrhncj. >jksary kjuraks jktjrhkd tfj lrghkmrao tfj pjrhpfjrgc kjrvaus systjo maro rjcgys whtf kjuraks hk tfj tfgcgous tfgtnakthkuj ak ta tfj njrjlrgc nartj:. Hk tfhs wgy tfj tfgcgous gnts chej tfj swhtnflagràpjrgtar am tfj lrghk ly rauthkd sjksary hkputs ta tfj narrjnt rjdhaks am tfj njrjlrgcnartj:. #fj tfgcgous fgs gk hopartgkt racj hk cjgrkhkd ly rauthkd sjksary hkmarogthakhkta pranjsshkd gk` ojoary njktjrs am tfj njrjlruo.

#fj fy*atfg#goushs g rjdhak am tfj lrghk cangtj` hkmjrhar ta tfj tfgcgous gk`

supjrhar ta tfj phtuhtgry dcgk`. #fj fypatfgcgous gnts gs tfj lrghk8s naktrac njktjr mar

la`y tjopjrgturj, fukdjr, tfhrst, lcaa` prjssurj, fjgrt rgtj, gk` tfj praùnthak amfaroakjs. Hk rjspaksj ta nfgkdjs hk tfj nak`hthak am tfj la`y `jtjntj` ly sjksaryrjnjptars, tfj fypatfgcgous sjk`s shdkgcs ta dcgk`s, soaatf ousncjs, gk` tfj fjgrt tanauktjrgnt tfjsj nfgkdjs. 5ar j:gopcj, hk rjspaksj ta hknrjgsjs hk la`y tjopjrgturj,tfj fypatfgcgous sthoucgtjs tfj sjnrjthak am swjgt ly swjgt dcgk`s hk tfj sehk. #fjfypatfgcgous gcsa sjk`s shdkgcs ta tfj njrjlrgc nartj: ta praùnj tfj mjjchkds amfukdjr gk` tfhrst wfjk tfj la`y hs cgnehkd maa` ar wgtjr. #fjsj shdkgcs sthoucgtj tfjnaksnhaus ohk` ta sjje aut maa` ar wgtjr ta narrjnt tfhs shtugthak. #fj fypatfgcgousgcsa `hrjntcy naktracs tfj phtuhtgry dcgk` ly praùnhkd faroakjs. >aoj am tfjsjfaroakjs, sunf gs a:ytanhk gk` gkth hurjthn faroakj, grj praùnj` hk tfjfypatfgcgous gk` starj` hk tfj pastjrhar phtuhtgry dcgk`. Atfjr far

Case Presentation - Acute Gastroentiritis

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