M\\H^ZHBNM

W\FSFKZF\- J\ W\MYFFK OVBM\

B@JF\MZ@\- J\ SMKJH^M CHMVHMK
 

M\\H^ZHBNM5-

•
Zhf tfrb mrrhythbnm rfifrs t` m jnsturlmkcf nk hfmrt rmtf `r rhythb.
•
Such jnsturlmkcfs cmk afmj t` hfmrt rmtfs thmt mrf mlk`rbmaay imst,
sa`w, `r nrrfduamr.
•
Zhfy bmy lf trmksnfkt `r nkcfssmkt, c`kdfkntma `r mcqunrfj, `r
cmusfj ly m t`xnk `r ly jruds.
•
Zhfy bmy lf mss`cnmtfj wnth pmrtncuamr i`rbs `i c`kdfkntma hfmrt
jnsfmsf (CHJ), bmy lf m c`bpancmtn`k `i surdncma rfpmnr `i CHJ,
bmy lf m rfsuat `i cfrtmnk dfkftnc cmusfs, `r bmy lf cmusfj ly iftma
nkiambbmtn`k, ms nk bmtfrkma c`kkfctnvf tnssuf jnsfmsf.
KFAS@K ZFXZL@@O @I WFJNMZ\NCS <=st
 
FJNZN@K

 Mrrhythbnms, fnthfr sa`w `r imst, bmy afmj t` mcutfay jfcrfmsfj

cmrjnmc
such ms `utput, jfdfkfrmtn`k
vfktrncuamr nkt` `r
inlrnaamtn`k, m b`rf jmkdfr`us
ni nkcfssmkt mrrhythbnm
bmy afmj t`
cmrjn`by`pmthy.
 Mrrhythbnms bmy afmj t` sykc`pf `r t` sujjfk jfmth. Thfk m
 pmtnfkt hms mk mrrhythbnm, nt ns nbp`rtmkt t` jftfrbnkf whfthfr thf
 pmrtncuamr rhythb ns anofay t` afmj t` sfvfrf sybpt`bs `r t`
jftfrn`rmtf nkt` m anif-thrfmtfknkd c`kjntn`k.

KFAS@K ZFXZL@@O @I WFJNMZ\NCS <=st FJNZN@K

 

 
Zmchymrrhythbnms

  Camssninfj ms

  Lrmjymrrhythbnms
  Mtrnma
  Eukctn`kma
  Yfktrncuamr 
  Hfmrt La`cos
 

FAFCZ\NCMA C@KJVCZN@K
C@BW@KFKZS5-

 Snk`mtrnma (SM) k`jf

 Nktfrmtrnma trmct (Lmchbmkk„
(Lmchbmkk„ss lukjaf)
 Nktfrk`jma trmcts
 Mtrn`vfktrncuamr (MY) k`jf
 Lukjaf `i Hns
 \ndht mkj afit lukjaf lrmkchfs
 Wuronkef inlrfs
 

C@KJVCZN@K WMZHTM^5-
 

 Zmchymrr
 Zmchymrrhythbnms
hythbnms - Sybpt`bs
 Dfkfrma5 pmapntmtn`ks, andht hfmjfjkfss, sykc`pf, imtnduf, Sh`rtkfss

`i lrfmth, chfst pmnk

 Nkimkts5 p``r iffjnkd, tmchypk`fm, nrrntmlnanty, saffpnkfss, pmaa`r,
v`bntnkd
 Hfb`jykmbnc nkstmlnanty5 rfspnrmt`ry jnstrfss/imnaurf, hyp`tfksn`k,
 p``r fkj-`rdmk
fkj-`rdmk pfriusn`k, a`ss `i c`kscn`uskfss,
c`kscn`uskfss, sujjfk c`aampsf

KFAS@K ZFXZL@@O @I WFJNMZ\NCS <=st FJNZN@K

 

 Zmchymrr
 Zmchymrrhythbnms
hythbnms - Cmusfs
 Wrnbmry5 Vkjfraynkd c`kjuctn`k mlk`rbmantnfs

 Sfc`kjmry5 \fvfrsnlaf Hs & Zs

 – Hyp`v`afbnm
 – Hyp`xnm

 – H+ n`ks (mcnj`sns)
(mcnj`sns)
 – Hyp`/Hypfromafbnm
 – Hyp`thfrbnm
 – Hyp`daycfbnm
 – Z`xnks
Z`xnks
 

Zmbp`kmjf
 – Zmbp`kmjf
 – Zfksn`k
Zfksn`k pkfub`th`rmx
pkfub`th`rmx
 – Zhr`bl`sns (c`r`kmry
(c`r`kmry,, puab`kmry)
 – Zrmubm
Zrmubm
 

 Z
 Zmchymrr
mchymrrhythbnms
hythbnms - @rndnkmtnkd nk thf
mtrnm
=. SNKVS M\\^ZHBNM
  K`rbma physn`a`dnc vmrnmtn`k
vmrnmt n`k nk nbpuasf jnschmrdfj ir`b SM k`jf
nk rfamtn`k t` rfspnrmtn`k
 H\ sa`ws jurnkd fxpnrmtn`k, nkcrfmsfs jurnkd nkspnrmtn`k

Jruds anof jnd`xnk fxmddfrmtf nt
 Ml`anshfj ly fxfrcnsf

KFAS@K ZFXZL@@O @I WFJNMZ\NCS <=st FJNZN@K

 

Ymrnfj WW nktfrvma. K` sndknincmkt chmkdf nk W wmvf b`rph`a`dy/W\

nktfrvma
 

<. SNKVS ZMCH^CM\JNM

 Zhf snkus k`jf sfkjs `ut nbpuasfs imstfr thmk usuma ;;H\ 

 Nk rfsp`ksf t` l`jy„s kffj i`r ;;C@ 5fxfrcnsf, mkxnfty, ifvfr,

hyp`v`afbnm `r cnrcuamt`ry sh`co, mkmfbnm, CHI, mjbnknstrmtn`k `i

cmtfch`ambnkfs, thyr`t`xnc`sns & by`cmrjnma jnsfmsf.

KFAS@K ZFXZL@@O @I WFJNMZ\NCS <=st FJNZN@K

 

W wmvfs mrf prfsfkt mkj k`rbma , kmrr`w ]\S, lfmt t` lfmt vmrnmlnanty
 

3. W\FBM
W\FBMZV\F
ZV\F MZ\NMA
MZ\NMA C@KZ\MCZN
C@KZ\MCZN@KS
@KS
• Lfkndk nk thf mlsfkcf `i ukjfraynkd hfmrt jnsfmsf
• C`bb`k nk kfwl`rk pfrn`j
• Jfpfkjnkd `k prfbmturnty `i thf lfmt, WMC„
WMC„ss bmy rfsuat nk
nk m

k`rbma/pr`a`kdfj/mlsfkt ]\S c`bpafx

C`kjuctfj t`  K`t
vfktrncaf wnth c`kjuctfj

mlfrrmkt
wnjfkfj `r 
]\S t` vfktrncaf,
mppmrfkt
KFAS@K ZFXZL@@O @I WFJNMZ\NCS <=st FJNZN@K
 c`bpafx  pmusf
 

Fmray p wmvf, s`bftnbfs wnth jniifrfkt b`rph`a`dy thmk m snkus p wmvf

 

:.TMKJF\NKD MZ\NMA WMCFBMOF\ 

 Wmcfbmofr shnits ir`b snkus k`jf t` mk`thfr mtrnma sntf
  K`rbma vmrnmkt
 Nrrfduamr rhythb
 KFAS@K ZFXZL@@O @I WFJNMZ\NCS <=st FJNZN@K
 

6.SVW\M YFKZ\NCVAM\ ZMCH^CM\JNM

 @rndnkmtnkd ml`vf thf vfktrncafs

 B`st c`bb`k mlk`rbma tmchycmrjnm sffk nk pfjnmtrnc prmctncf

 B`st c`bb`k mrrhythbnm rfqunrnkd trfmtbfkt nk pfjnmtrnc
 p`puamtn`k
 B`st irfqufkt mdf prfsfktmtn`k5 =st 3 b`kths `i anif, <kj pfmos G
8-=7 yrs mkj nk mj`afscfkts
 KFAS@K ZFXZL@@O @I WFJNMZ\NCS <=st FJNZN@K
 

 Wmr`xysbma, sujjfk `ksft & `iisft

 @ccurrnkd mt rfst
 Nk nkimkts, prfcnpntmtfj ly nkifctn`k mkj nk chnajrfk ly
 lr`kch`jnamt`rs, jfc`kdfstmkts

\mtfs `i SYZ vmry wnth mdf (;=87 lpb)
 Sh`rt pmr`xysbs usumaay mrf k`t jmkdfr`us
 Wr`a`kdfj mttmco amstnkd i`r 9-<: hrs `r H\ ; 377 lpb afmj t` hfmrt
imnaurf
 KFAS@K ZFXZL@@O @I WFJNMZ\NCS <=st FJNZN@K
 

 @ajfr chnajrfk prfsfkt wnth pmapntmtn`k

 ^`ukdfr chnajrfk – Lmsma H\ hndhfr i`r thmt mdf, H\ ;; drfmtay wnth crynkd

 W wmvfs jniincuat t` jfinkf, lut =5= wnth k`rbma ]\S

 FCD snbnamr t` snkus tmchycmrjnm
Jniifrfktnmtnkd ifmturfs 5

 H\ <37lpb, ukvmrynkdKFAS@K
H\, mlk`rbma WWFJNMZ\NCS
ZFXZL@@O @I wmvf mxns <=stniFJNZN@K
sffk
 

 • 3 bme`r typfs

- rf-fktrmkt tmchycmrjnm wnth mk mccfss`ry pmthwmy

- \f-fktrmkt tmchycmrjnm wnth`ut mk mccfss`ry pmthwmy
- Fct`pnc/mut`bmtnc tmchycmrjnms

  MY\Z
  MYK\Z
  MZ\NMA FCZ@WNCS
  EVKCZN@KMA FCZ@WNCS
  MZ\NMA IAVZZ
IAVZZF\ 
F\ 
KFAS@K ZFXZL@@O @I WFJNMZ\NCS <=st FJNZN@K
 KFAS@K ZFXZL@@O @I WFJNMZ\NCS <=st FJNZN@K

 
  MZ\NMA INL\NA
INL\NAAM
AMZN@K
ZN@K

 ZZ\N@YFKZ\NCVAM\
Z\N@YFKZ\NCVA
MMCH^CM\JNM
 ZMCH^ M\Z)5-
CM\JNM (MY\ \FCNW\@CMZNKD
\FCNW\@CM
(MY\Z)5- ZNKD
 B`st c`bb`k bfchmknsb `i SYZ nk nkimkts
 \f-fktrmkt tmchycmrjnm wnth mk mccfss`ry pmthwmy
 Ia`w `i nbpuasfs bmy lf lnjnrfctn`kma `r rftr`drmjf `kay
• T`aii-Wmronks`k-Thntf sykjr`bf 5
- Chmrmctfrnzfj ly thf prfsfkcf `i m buscuamr lrnjdf c`kkfctnkd mtrnm
mkj vfktrncafs `k fnthfr thf
t hf rndht `r afit snjf `i MY
MY rnkd
- Ia`w `i nbpuasfs ns lnjnrfctn`kma
KFAS@K ZFXZL@@O @I WFJNMZ\NCS <=st FJNZN@K
 

 Ia`w `i nbpuasfs ns mktfdrmjf thr`udh thf MY k`jf mkj rftr`drmjf

thr`udh thf mccfss`ry pmthwmy t`wmrjs thf mtrnub

SYZ nk m chnaj wnth TWT sh`wnkd k`rbma ]\S c`bpafxfs wnth W wmvfs
 sffk `k upstr`of `i Z wmvfs KFAS@K ZFXZL@@O @I WFJNMZ\NCS <=st FJNZN@K
 

 Zypncma ifmturfs `i TWT mrf mppmrfkt whfk tmchycmrjnm sulsnjfs

 Tnjf ]\S c`bpafxfs, jfatm wmvfs, sh`rt W\ nktfrvma


 \nso `i sujjfk jfmth KFAS@K ZFXZL@@O @I WFJNMZ\NCS <=st FJNZN@K
 

Bmkmdfbfkt `i SYZ5-
  K`k phmrbmc`a`dncma bfmsurfs anof5-
anof5-

-Wamcnkd mk ncf lmd `vfr thf imcf

-Ymasmavm bmkfuvfr 
-Strmnknkd

-Lrfmth h`ajnkd
 Ni thf chnaj ns hfb`jykmbncmaay stmlaf, rmpnj nv push `i mjfk`snkf (rnso `i

MI)
 Nk `ajfr chnajrfk, CCL anof vfrmpmbna cmk lf dnvfk nv (C/N nk 1=yfmr)
 KFAS@K ZFXZL@@O @I WFJNMZ\NCS <=st FJNZN@K
 

 Ni thf chnaj ns k`t stmlaf, sykchr`knzfj JC cmrjn`vfrsn`k (= E/od)


Ni thf tmchycmrjnm
s`tma`a, mbn`jmr`kfns rfsnstmkt, nv pr`cmnkmbnjf, qunknjnkf, iafcmnknjf,
cmk lf trnfj
 Ni SYZ stnaa pfrsnsts, cmthftfr mlamtn`k wnth succfss rmtf `i 87->6%
-\mjn`irfqufkcy
-Cry`
-Surdncma
 Bmnktfkmkcf thfrmpy

- Thfk snkus rhythb ns rfst`rfj, i`r a`kd tfrb bmnktfkmkcf, J@C ns lftm
 la`cofrs nk l`th TWT mkj K`k TWT sykjr`bfs
sykjr`bfs
 
- Jn `xn
`xnk
k cmk lf nvf
nvfk
k nk nki
nkimkt
mktss wn
wnth
th k` mcc
mccfss
fss`r
`r mthwm
mthwm KFAS@K ZFXZL@@O @I WFJNMZ\NCS <=st FJNZN

 Z Y K@JMA
K @JMA
 ZMCH^ \ F-FKZ\MKZ
\F-FKZ\MKZ
MMCH^CM\JNM5
CM\JNM5--
 C`bb`k i`rb `i SYZ nk mj`afscfkts Nkv`avfs thf usf `i <

 pmthwmys wnthnk thf MY k`jf

 Wrfcnpntmtfj ly fxfrcnsf
 Wrfsfkt wnth sykc`pma mttmcos
 D``j c`ktr`a `k mktnmrrythbnc thfrmpy
 Lftm la`cofrs rfbmnk thf jrud `i ch`ncf i`r bmnktfkmkcf
 KFAS@K ZFXZL@@O @I WFJNMZ\NCS <=st FJNZN@K
 

MZ\NMA FCZ@WNC ZMCH^CM\JNM5-


Vkc`bb`k nk chnajrfk
 Ymrnmlaf H\, usumaay ;<77lpb
 Juf t` m snkdaf i`cus `i mut`bmtncnty

@k stmrtnkd
j`wk phmrbmc`a`dnc
`kay t` thfrmpy, thf tmchycmrjnm drmjumaay sa`ws
spffj up mdmnk
 FCD sh`ws fct`pnc p wmvfs wnth mk mlk`rbma mxns
KFAS@K ZFXZL@@O @I WFJNMZ\NCS <=st FJNZN@K
 

BVA
BVAZNI
ZNI@CMA
@CMA MZ\NM
Z\NMAA ZMCH^CM\JNM5-
 B`rf c`bb`k nk nkimkts thmk nk `ajfr chnajrfk

 Chmrmctfrnzfj ly 3 `r b`rf fct`pnc W wmvfs mkj vmrynkd W\ nktfrvmas

 Sp`ktmkf`us rfs`autn`k
rfs`autn`k `ccurs usumaay ly 3 yfmrs `i mdf
 Chm`tnc FCD pmttfrk wnth buatnpaf fct`pnc W wmvfs wnth mlk`rbma mxfs
KFAS@K ZFXZL@@O @I WFJNMZ\NCS <=st FJNZN@K
 

 EVKCZN@KMA FCZ@WNC
 ZMCH^
 ZMCH^CM\JNM5
CM\JNM5--
 Juf t` mk mlk`rbma i`cus `i mut`bmtncnty
 Zhf i`cus lfnkd m c`kjuctnkd tnssuf vfry ca`sf t` thf MY k`jf
(eukctn`kma)
 Jnschmrdf `i nbpuasfs ir`b eukctn`kma tnssuf fxcffjs SM k`jma jnschmrdf
afmjnkd t` MY
MY jnss`cnmtn`k
jnss`cnmtn `k
 @ccurs nk fmray p`st `p pfrn`j `r bmy lf c`kdfkntma
 NY mbn`jmr`kf ns thf J@C i`r p`st-`p EFZ
 C`kdfkntma EFZ rfqunrfs cmthftfr mlamtn`k

 Bmnktfkmkcf thfrmpy wnth mbn`jmr`kf/s`tma

mbn`jmr`kf/s`tma`a
`a
KFAS@K ZFXZL@@O @I WFJNMZ\NCS <=st FJNZN@K
 

MZ\NMA IAVZZF\5-
 Mas` cmaafj nktrm-mtrnma rf-fktrmkt tmchycmrjnm

H\ ; :77-977 lpb nk kf`kmtfs, ;<67-377 lpb nk chnajrfk
 Juf t` rf-fktrmkt pmthwmy a`cmtfj nk thf rndht mtrnub cnrcankd thf trncuspnj
vmavf mkkuaus
 MY jnss`cnmtn`k `ccurs mkj vfktrncafs rfsp`kj t` <kj - :th mtrnma lfmt
 @ccurs nk kf`kmtfs wnth k`rbma hfmrts mkj nk chnajrfk wnth
  \mpnj mkj rfduamr smw-t``thfj iauttfr wmvfs
KFAS@K ZFXZL@@O @I WFJNMZ\NCS <=st FJNZN@K
 

 Zfbp`rmry sa`wnkd `i H\ ly vmdma bmkfuvrfs/mjfk`snkf/CCL

 Sykchr`knzfj JC cmrjn`vfrsn`k ns thf Z@C
 Wmtnfkts wnth chr`knc mtrnma iautttfr mrf mt ;; rnso i`r thr`bl`fbl`ansb
mkj str`of
  -rfqunrf mktnc`mduamkts
 Bmnktfkmkcf thfrmpy wnth typf = mkj typf 3 mdfkts
 KFAS@K ZFXZL@@O @I WFJNMZ\NCS <=st FJNZN@K
 

MZ\NMA INL\NAA
INL\NAAMMZN@K5-
 Vkc`bb`k nk nkimkts mkj chnajrfk

H\ ; :77-477 lpb
 Nrrfduamray nrrfduamr rhythb `k FCD mkj puasf
 W`st `p, nk CHJ wnth fkamrdfj mtrnm, thyr`t`xnc`sns, puab`kmry
fbl`ansb, pfrncmrjntns, cmrjn`by`pmthy
 Ni stmlaf, CCL, nv pr`cmnkmbnjf/mb
pr`cmnkmbnjf/mbn`jmr`kf
n`jmr`kf
 Ni ukstmlaf, JC cmrjn`vfrsn`k
 KFAS@K ZFXZL@@O @I WFJNMZ\NCS <=st FJNZN@K
 

Mlsfkcf `i cafmr W wmvfs mkj mk nrrfduamray nrrfduamr vfktrncuamr rfsp`ksf

(K` tw` \-\ nktfrvmas mrf thf smbf)

 

 Zmchymrrythbnms
 Zmchymrrythbnms-@rndnkmtnkd
-@rndnkmtnkd nk thf
vfktrncafs5-
=.W\FBMZV\F YFKZ\NCVAM\ C@KZ\MCZN@KS – 
• Vkc`bb`k nk chnajrfk
• Vkni`cma/buatni`cma
• Ml`anshfj `k fxfrcnsf

• Ni ukni`cma/jnsmppfmrnkd wnth fxfrcnsf/ mss`cnmtfj wnth k`rbma hfmrt,

thfk c`ksnjfrfj lfkndk, k` thfrmpy kffjfj.
• Mjvnsf pmtnfkts t` mv`nj cmiifnkf mkj `thfr stnbuamkts.
 KFAS@K ZFXZL@@O @I WFJNMZ\NCS <=st FJNZN@K
 

 Fmray, wnjf ]\S c`bpafxfs

 Z wmvfs nk `pp`sntf jnrfctn`k `i ]\S
 Lndfbnky, snkus lfmt i`aa`wfj ly WYC, thns rfpfmtnkd ms m pmttfrk mas`
irfqufktay sffk
 

<. YFKZ\NCVAM\ ZMCH^CM\JNM5-

•Jfinkfj ms mt afmst 3 WYC s mt ;=<7 lpb
•Wmr`xysbma/nkcfssmkt
•Mss`cnmtfj wnth by`cmrjntns, mk`bma`us ACM, BYW, prnbmry cmrjnmc

tub`rs, cmrjn`by`pmthy / W`st-`p

•Wr`bpt trfmtbfkt t` prfvfkt jfdfkfrmtn`k nkt` YI
 KFAS@K ZFXZL@@O @I WFJNMZ\NCS <=st FJNZN@K
 

Tnjf ]\S (;7.78 sfc), W wmvfs bmy lf uknjfktninmlaf `r k`t rfamtfj t` ]\S

 Ni stmlaf, trfmt wnth NY mbn`jmr`kf/anj`cmnkf/pr`cmnkmbnjf

mbn`jmr`kf/anj`cmnkf/pr`cmnkmbnjf mkj c`rrfct thf
cmusf
  Ni ukstmlaf, JC cmrjn`vfrsn`k KFAS@K ZFXZL@@O @I WFJNMZ\NCS <=st FJNZN@K

3. YFKZ\NCVAM\ INL\NAAM
INL\NAAMZN@K5-
ZN@K5-
 Sffk nk chnajrfk wnth a`kd ]Z sykjr`bf `r Lrudmjm sykjr`bf
 Mss`cnmtfj wnth cmrjn`by`pmthnfs
cmrjn`by`pmthnfs,, structurma hfmrt jnsfmsfs
jnsfmsfs cmusnkd
vfktrncuamr jysiukctn`k
 Sujjfk jfmth `ccurs ukafss mk fiifctnvf vfktrncuamr lfmt ns rffstmlanshfj.

 Zrfmtbfkt5 nbbfjnmtf JC jfinlrnaamtn`k, CW\ 

 Ni nkfiifctnvf, dnvf NY mbn`jmr`kf, anj`cmnkf mkj rfpfmt jfinlrnaamtn`k

 Zrfmt thf cmusf `kcf snkus rhythb ns fstmlanshfj

KFAS@K ZFXZL@@O @I WFJNMZ\NCS <=st FJNZN@K
 
 KFAS@K ZFXZL@@O @I WFJNMZ\NCS <=st FJNZN@K
 

A@KD ]-Z S^KJ\@BFS5-

 Nkcaujf dfkftnc mlk`rbmantnfs `i vfktrncuamr rfp`amrnzmtn`k
 A`kd ]Z – nktfrvma `k FCD
 Mss`cnmtfj wnth bmandkmkt vfktrncuamr mrrythbnms afmjnkd t` sujjfk jfmth
 Mt afmst 67% mrf imbnanma

 Wrfcnpntmtfj ly fxfrcnsf
 A]Z= fvfkts mrf strfss nkjucfj
 A]Z3 `ccur jurnkd saffp
 A]Z< hmvf mk nktfrbfjnmtf pmttfrk

 A]Z3 hms hndhfst pr`lmlnanty `i sujjfk jfmth
KFAS@K ZFXZL@@O @I WFJNMZ\NCS <=st FJNZN@K
 

• Jnmdk`stnc crntfrnm

Wrfsfkt wnth sykc`pf, sfnzurfs, pmapntmtn`ks
 C`rrfctfj ]Z nktfrvma ;7.:4sfc `r m ]Z nktfrvma ;7.::sfc
  K`tchfj Z wmvfs
 A`w H\ i`r mdf
 Imbnanma hnst`ry `i A]ZS/sujjfk jfmth
•
Zrfmtbfkt
Zrfmtbfkt - Lftm la`cofrs whnch laukt thf H\ s rfsp`ksf t` fxfrcnsf
•
Ni jrud nkjucfj pr`i`ukj lrmjycmrjnm – pmcfbmofr 
•
Ni jrud rfsnstmkt,A
rfsnstmkt,A]Z3-
]Z3- nbpamktmlaf cmrjnmc jfinlrnaamt`r 
KFAS@K ZFXZL@@O @I WFJNMZ\NCS <=st FJNZN@K
 

Lrmjymrrhythbnms5-
 Wrnbmry 5 Mlk`rbma pmcfbmofr/c`kjuctn`k systfb (c`kdfkntma `r

 p`stsurdncma nkeury), cmrjn`by`pmthy

 p`stsurdncma cmrjn`by`pmthy,, by`cmrjntns
 Sfc`kjmry 5 \fvfrsnlaf Hs & Zs5
 – Hyp`xnm
 – Hyp`tfksn`k
 – H+ n`ks (mcnj`sns)
(mcnj`sns)
 – Hfmrt la`co
 – Hyp`thfrbnm
 

 – Hypfromafbnm
 – Zrmubm
Zrmubm (hfmj)
 – Z`xnks/jruds
Z`xnks/jruds (ch`ankfstfrmsf
(ch`ankfstfrmsf nkhnlnt`rs,
nkhnlnt`rs, Cm++ chmkkfa la`cofrs,
la`cofrs, μ la`cofrs,
jnd`xnk, ν< md`knsts, `pn`njs)
 

SNKVS L\MJ^CM\JNM5-
 Whysn`a`dncma (nf5 saffp, mthaftfs)
 Wmth`a`dncma (nf5 mlk`rbma fafctr`aytfs, nkifctn`k, jruds, hyp`daycfbnm,
hyp`thyr`njnsb, ↝NCW)
 KFAS@K ZFXZL@@O @I WFJNMZ\NCS <=st FJNZN@K
 

•
SNKVS M\\FSZ - Imnaurf `i nbpuasf i`rbmtn`k wnthnk SM k`jf

•
SNK@MZ\NMA LA@CO- La`co lftwffk SM k`jf mkj surr`ukjnkd mtrnub
 prfvfktnkd c`kjuctn`k `i nbpuasfs

 \mrf nk chnajrfk
 Jnd`xnk t`xncnty, fxtfksnvf mtrnma surdfry
 KFAS@K ZFXZL@@O @I WFJNMZ\NCS <=st FJNZN@K
 

• SNCO SNKVS S^KJ\@BF

 Juf t` mlk`rbmantnfs nk fnthfr thf SM k`jf / mtrnma c`kjuctn`k pmthwmys /
 l`th
 W`st surdfry i`r CHJ (i`ktmk, bustmrj, sfkknkd pr`cfjurfs) `r fvfk nk
 pmtnfkts wnth k`rbma
k`rbma hfmrt
 Vsumaay msybpt`bmtnc mkj j`k„t rfqunrf trfmtbfkt
 Wfrn`js `i bmrofj snkus sa`wnkd prfsfkt wnth jnzznkfss mkj sykc`pf
 pmcfbmofr ni sybpt`bs
sybpt`bs rfcur 
 KFAS@K ZFXZL@@O @I WFJNMZ\NCS <=st FJNZN@K
 

MY LA@COS5-
 
 KFAS@K ZFXZL@@O @I WFJNMZ\NCS <=st FJNZN@K

 
 KFAS@K ZFXZL@@O @I WFJNMZ\NCS <=st FJNZN@K
 

C@KDFKNZ
C@KDFKNZMA
MA C@BWAFZF
C@BWAFZF MY LA@CO5-
 Mut`nbbukf nkeury t` thf iftma c`kjuctn`k systfb ly bmtfrkmaay jfrnvfj
mktn-SSM/\`, mktn-SSL/Am mktnl`jnfs
 Bmtfrkma SAF `r se`drfk sykjr`bf
  KOX<-6 dfkf butmtn`k
butmtn`k hms c`kdfkntma c`bpaftf
c`bpaftf mv la`co wnth msj
 Hndh iftma a`ss rmtf
 Bmy afmj t` hyjr`ps iftmans
 Wrfsfkt wnth tnrfjkfss, irfqufkt kmps, nrrntmlnanty
nrrntmlnanty,, sybpt`bs mkj sndks `i
hfmrt imnaurf
 KFAS@K ZFXZL@@O @I WFJNMZ\NCS <=st FJNZN@K
 
 KFAS@K ZFXZL@@O @I WFJNMZ\NCS <=st FJNZN@K
 

YMVDHMK TNAANMBS
CAMSSNINCMZN@K5-
 Camss =m – s`jnub imst chmkkfa la`cofrs, pr`a`kd
rfp`amrnzmtn`k
 (qunknjnkf, pr`cmnkmbnjf, jns`pyrmbnjf)
 Camss=l – s`jnub imst chmkkfa la`cofrs, sh`rtfk rfp`amrnzmtn`k
 (anj`cmnkf, bfxnaftnkf, phfkyt`nk)
 Camss =c – s`jnub chmkkfa la`cofrs (iafcmnknjf, pr`pmifk`kf)
 KFAS@K ZFXZL@@O @I WFJNMZ\NCS <=st FJNZN@K
 

 Camss < – lftm la`cofrs (pr`prmk`a`a ,mtfk`a`a)

 Camss 3 – p`tmssnub
p `tmssnub chmkkfa `pfkfrs, pr`a`kd rfp`amrnzmtn`k
(mbn`jmr`kf)
 Camss : – bnscfaamkf`us (vfrmpmbna, mjfk`snkf, jnd`xnk)
 KFAS@K ZFXZL@@O @I WFJNMZ\NCS <=st FJNZN@K
 

H^WF\OMAFBNM5-
  K`rbma pamsbm p`tmssnub c`kcfktrmtn`k ns strnctay rfduamtfj
 lftwffk 3.6 t` 6 bFq/A.
 Hypfromafbnm, jfinkfj ms sfrub p`tmssnub afvfa ml`vf 6.6 bFq/A,

ns m p`tfktnmaay anif thrfmtfknkd c`kjntn`k.

   Sfvfrf hypfromafbnm whfk sfrub p`tmssnub Afvfas mrf
;9.7bfq/A.

jfcrfmsf nk rfkma fxcrftn`k ns thf b`st irfqufkt cmusf

 WFJNMZ\NC KFWH\@A@D^ SNXZH FJNZN@K, M\YNKJ LMDDM
 

CANKNCMA IFMZV\FS5-
 B`st `i Hypfromafbnc nkjnvnjumas mrf msybpt`bmtnc.
 Ni prfsfkt - sybpt`bs mrf k`kspfcninc mkj prfj`bnkmktay rfamtfj t`
buscuamr `r cmrjnmc iukctn`ks.
 Zhf b`st c`bb`k - wfmokfss mkj imtnduf.

 @ccmsn`kmaay, irmko buscaf pmrmaysns `r sh`rtkfss `i lrfmth.

@ccmsn`kmaay,
 Wmtnfkts mas` bmy c`bpamnk `i pmapntmtn`ks `r chfst pmnk.
 Mrrythbnms `ccur- Snkus Lrmjy, Snkus mrrfst, YZ, YI, Msyst`af


 Wmtnfkts bmy rfp`rt kmusfm, v`bntnkd, mkj pmrfsthfsnms
WFJNMZ\NC KFWH\@A@D^ SNXZH FJNZN@K, M\YNKJ LMDDM
 
 WFJNMZ\NC KFWH\@A@D^ SNXZH FJNZN@K, M\YNKJ LMDDM
 

BMKMDFBFKZ5-
 CMACNVB DAVC@KMZF =7%5- 7.6-= ba/od `vfr 6-=7 bnk ukjfr
FOD b`knt`rnkd rfpfmtfj q6-=7 bnk (bmxnbub t`tma j`sf 37 ba)
 JFXZ\@SF/NKSVANK5- \fduamr nksuank 7.=uknts/od wnth < ba/od
`i <6% jfxtr`sf `vfr 37 bnk.

Lftm< mjrfkfrdnc md`knst (Kfluanzmtn`k `r NY)
 S`jnub Lncmrl`kmtf5-=-< bFq/od `vfr 37-97 bnk
 Iur`sfbnjf5- =-< bd/od
 N`k fxchmkdf rfsnks5- S`jnub W`aystyrfkf Suai`kmtf =d/od q 8 hr
 W@ `r W\
WFJNMZ\NC KFWH\@A@D^ SNXZH FJNZN@K, M\YNKJ LMDDM
 

JND@XNK Z@XNCNZ^5-
 OJZ WHM\BMC@A@D^ 8 ZH FJNZN@K
 

Yfktrncuamr lndfbnky cmusfj ly jndntmans t`xncnty.

t`xncnty. Yfktrncuamr fct`py ns `kf `i thf b`st
b `st
c`bb`k sndks `i jndntmans t`xncnty
t`xncnty.. (M) Zhf ukjfraynkd rhythb ns mtrnma lrnaamtn`k.
lrna amtn`k. (L)
Fmch k`rbma ]\S c`bpafx ns i`aa`wfj ly m prfbmturf vfktrncuamr c`bpafx.
  Zhns jndntmans t`xnc mrrhythbnm ns m spfcnma typf `i vfktrncuamr tmchycmrjnm wnth ]\S
c`bpafxfs thmt matfrkmtf nk jnrfctn`k ir`b lfmt t` lfmt. K` W wmvfs mrf prfsfkt.
OJZ WHM\BMC@A@D^ 8 ZH FJNZN@K
 

 Mtrnma lrnaamtn`k
lrnaamtn `k wnth mk fxcfssnvfay sa`w vfktrncuamr rmtf lfcmusf `i jndntmans t`xncnty
t`xncnty..
Mtrnma lrnaamtn`k wnth
wn th m rmpnj vfktrncuamr rmtf ns rmrfay cmusfj ly jndntmans t`xncnty.
t`xncnty.
 OJZ WHM\BMC@A@D^ 8 ZH FJNZN@K
 

S^BWZ@BS5-
 Zhf inrst sybpt`bs `i jnd`xnk t`xncnty mrf dmstr`nktfstnkma (mlj`bnkma
crmbps, v`bntnkd, jnmrrhfm) mkj vnsuma jnsturlmkcfs (drffk `r yfaa`w
hma`s, ‑iuzzy shmj`ws‒‚anof jrnvnkd mt kndht wnth jnrty damssfs).
 C`kiusn`k mkj yfaa`w vnsn`k bmy `ccur wnth chr`knc t`xncnty
t`xncnty,,
i`aa`wfj ly mtrn`vfktrncuamr la`comjf, lrmjycmrjnm, mkj
vfktrncuamr mrrhythbnms.
 Jnd`xnk t`xncnty ns mas` w`rsfkfj ly hyp`omafbnm.
 C`kvfrsfay,, hypfromafbnm jnbnknshfs jnd`xnk's fiifctnvfkfss.
C`kvfrsfay

 M kublfr `i `thfr cmrjn`vmscuamr jruds prfjnsp`sf pmtnfkts t` jnd`xnk
t`xncnty,, nkcaujnkd vfrmpmbna, jnatnmzfb, qunknjnkf, mkj mbn`jmr`kf.
t`xncnty
OJZ WHM\BMC@A@D^ 8 ZH FJNZN@K
 

BMKMDFBFKZ5-

 M- L - C
 Hyjrmtn`k wnth NY iaunjs, `xydfkmtn`k mkj supp`rt `i vfktnamt`ry
iukctn`k, jnsc`ktnkumtn`k `i thf jrud, mkj, s`bftnbfs, thf
c`rrfctn`k `i fafctr`aytf nblmamkcfs.

 Iml mktnl`jy irmdbfkts mrf fxtrfbfay fiifctnvf nk thf trfmtbfkt `i

sfvfrf, mcutf jndntmans t`xncnty
t`xncnty..
 Cmrjnmc dayc`snjfs ukjfrd` s`bf jfdrff `i fktfr`hfpmtnc `r
fktfr`fktfrnc rfcnrcuamtn`k mkj mrf mjs`rlfj t` mctnvmtfj chmrc`ma .
 MC `r buatn-j`sf MC (BJMC) mrf rfc`bbfkjfj i`r jndntmans
t`xncnty .
OJZ WHM\BMC@A@D^ 8 ZH FJNZN@K
 

Bmkmdfbfkt `i mrrhythbnm5-

 Nk cmsf `i tmchycmrjnm5 dnvf anj`cmnkf `r phfkyt`nk (K` fiifct `k MY

c`kjuctn`k).
 Anif-thrfmtfknkd vfktrncuamr mrrhythbnms mrf trfmtfj mcc`rjnkd t` thf
Anif-thrfmtfknkd
mad`rnthbs `i mjvmkcfj cmrjnmc anif supp`rt (MCAS).

 Nk cmsf `i lrmjycmrjnm5 dnvf mtr`pnkf.

 C`rrfct fafctr`aytf jnsturlmkcfs
 Nk cmsf `i hypfromafbnm5 dnvf FJZM mkj dnvf nksuank + dauc`sf t` shnit
O+ nktrmcfaauamray Lut Cm dauc`kmtf ns c`ktrmnkjncmtfj.
  H`wfvfr, hypfromafbnm ntsfai j`fs k`t cmusf jfmth, mkj trfmtbfkt wnth
H`wfvfr,
 p`tmssnub-a`wfrnkd
 p`tmssnub-a`wfrnkd mdfkts j`fs k`t rfjucf b`rtmanty
b`rtmanty..
OJZ WHM\BMC@A@D^ 8 ZH FJNZN@K
 

JNDNIML5-
 

ZHMKO ^@V