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ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
:
ﻳﻒﺮ
ﻌﻮﺗ
ﻴﻭﻏ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﺩ
ﻴﮏېﻥښې ﻨﻴ
ﻠﻪﮐ
ﺍﺳﻄﻪﻭﺰﻡﭘﻴﻧﺍ
ﺭګﻭﺍ
ﻭﺮﮑﻳ
ﺎﺪﻱﻣﻧﻭﻮژﻳﺭﺕﺩﻱچېﺩ ﺎ
ﺒﻪﻋ ﻮڅﺧ ﻴﻭﻏﺭﺎ
ﻮﻧﻐﻪﻫﻟ
ﻮچې ﻠﻰﺷﻳ
ﺎﻭﻭﻳﻮﻱﺍﻪﮐﺗ
ﻣﻦځ ﺍ
ﻳﺖ کېﺭ ﻮ
ﻪﻋﻀ ﻪﭘ ﺑﺭ
ﻮ ﮐ
ﻪﺩ ﻧ
ﻮﻧﻮﻟ
ﺪﻴﮏﺑ ﻮﺟﻟﻮﻳ
ﺰېﻭﻓﻥښﻥ ﺍ
ﺍ
ﻪﻠ
ﻳﺎ
ﻪﭘﺩﻝېﭘﺎ
ﻣﺠﻣﻦځﺩﺮﻪﺗﺑ
ﺭﻮﻭﮐﻻﻞﺍ
ﻭﻍۍﺩﻣ ﺭ
ﺎﻧ
ﺎﺕﺩﻱچېﺩ ﻮﺷﺒﻲﺗﺸ ﻳﺮﺗﺨﺎ
ﻮﻱﻳ ﻔﻴﻪﻭﻇﻐﻫ
.
ږﻱ
ﻪکږ ﺗ
ﻣﻦځﺍﻮکېﺭ ﻳﻄﺍ
ﺮﻮﺷ ﻳ
ړځﻥګﻪﺍ ﺎﻝﭘﻳﺮﻴ
ﭘﺎکېﺩﭼ
.
ږﻱ
ﻩکږ ﺮﺮﺳﻪﺗﺍﺳﻄ
ېﻪﻭﻧﮏ ﭘ ﻭ
ﺩﻟږ
ګﻱ ﻲځﻥ ړ
ﻩﺍ ﻮﻳﻪﺩﻧﺪﻳﺩ
ﻟږﻭﻍۍ ﻲﺭﺎ
ﻧﺩ
ﻭ.
ﺪﻯ ﻱ ﻧ
ﻭ ﺮژﻴﺎﻏ
ﺪﻯﻳ ﻧ
ﻭﺍﻯﺷﻲژ ﺩﺩ
ﻧﮏېک ﻭﻭﺩﻟږ
ﺍﻲ ﺩ
.
ږﻱ
ﻠﻞکږ ﻩﺑ
ﺭﻮﺪﻝﻏﻧﭖژ
ﻮ ژﺗ
ﺎﻮﺍﺻﻄﻼﺣﻴﻧﺪﻧﻩﻻ ﺭ
ﺎﭙﻟ
ﺪﻥې ﻧ
ژژﻮﺩښې ﭖ ﻴ
ﻭﻏ ﺭ
ﺎﻧﻲﻧﺎ
ﺘﻧﺍ
ﺩ
:ﻪﻧ
ﻮﻠﻣﻮﻻﺍ ﻴ
ﻭﻏ ﺎﺭ
ﻧﯽﻧﺎﺘ
ﻧﺩﺍ
:
(I
nfect
iﺎﻥ)on
ﺘﻧ
:ﺍ(
i)
ﻭځ
ﺪﻴﺗ
ﺎﻳ
ﻭﺯﺩﻭﺍ
ﺎﺕېکﺩ
ﺪﻱﭘ
ﻧﻭژ
ﻮ کېﺩ
ﺎﺟﻧﺴ
ﻪﺍﻪﭘﺑ
ﺭﻮﮐ
ږﻱچېﺩﻳﻞ کږ
ﻪﻭﺰﻡﺗﻴ
ﻧﺍ
ﺭګﻭ
ﻪﺍﻐ
ﻫ
ﺩ.
ﻮﻱ ﻱﻳﺸﻞﺷ
ﻪﻭﻟ
ﻭﻩډﻭېﻪﺩ
ﺮﻱچ ﭘﻟ
ﺍکﻭ
ﻭ
:
(Pat
ﻮﺟﻦ)hogen
ﺘ:ﭘ
ﻟﻒﺍ
.
ﺭځﻱﻻﻞګﻭﻍۍ ﻣ ﺭ
ﺎﻧ
ږﻱچېﺩﻳﻞکږ ﻪﻭﺰﻡﺗﻴﻧ
ﺍﺭګﻭﻭﺍﺮﮑﻳﺎ
ﻪﻣ ﻐ
ﻫ
.ږﻱ
ﻳﻞکږ ﻪﻭړﺎﺗ
ﻴﺍﺕګﻭﺗﻪﺭﺗﻣﻦځﻭﻍۍﺩ ﺭﺎﻧ
ﺘﻲﺩ ﻨﺴﻮﺟﺘﭘ
ﻨ ﺲټﻱ
ﻮﺟﺘﭘ
ﻌﻦېﺩ ږﻱﻳ
ﻳﻞ کږ
ېﻪﻭﻮﺕﮐﭻ ﺗ ﻭﻗﺍکﺍﻭﻮﺟﻦﺩځﺘ
ﭘﻨﺴﻲﺩ ﻴﻟ
ﻭﺮﻳﺍ
ﺮﺧﻼﻑﻭ ﺩېﭘﺩ
ﺎ
ﻴﻧ
ﻮﻤNonencapsulﻧ
atﺮedﺎﻧﻈﻴ
ﻧﻮﻤ
ټﺪﻧ
ﻟﻲ ﻳﻮﭙﺴډﻝﺍﻥﮐ
ﻪﻭ،ﺩﺏګګﻝېﭘ ﻳﻲﺍېﻪﻭ
ﺭﺝ ﺗ ﺩ
.ﺮﻱﻟﻨﺴﻲﻴﻟ
ﻭﺮﻳﺍﺎﺕﻭﻳﻪﺯﺗ
.
ﺮﻱﻟ
ﻩړﺭېﺍ
ﻮﻭﭘﺭﻮﺍﺱېﻧﻭﺩﻭﺍﻭﺎ
ﻴﺗ
ړېځﻥګ
ﻳﮏ ﺍ ﺰ
،ﻓﺭ
ﺷﺭ
ﻪ ﻢﺎﻥﭘﺘﻧ
ﺍﻨ ﺲټﻱﺩ ﻮﺟﺘﺎﻥﭘﺘﻧ
ﺍﺩ
:
(NonPat
ﻮﺟﻦ)hogen
ﺘﺮﭘ
ﻴ:ﻏ
ﺏ
ﻭ:
ﻪډﻝ ،ﺩﺏﻝﻝګېﭘ ﻮﻱ ﮐﺍ
ﺪﻴﻳﮏېﭘ ړډﻝﺍډﻝ ﻭﻩﻭ ﺮ
ﻪﺳ ﺑﺭ
ﻮ ﻪﮐﻟ ﻪﻧ
ﻮ ﻣﺰﻴ
ﻧﺍﺭګ ﻭ
ﺍﻭﺮﮑﻳﺎډﻝﻣﺍﻭﺩ
ﻪﺎﻥﻧﻳ
ﻮﻡﺯ ﻪﮐ ﻪﺗﺑ
ﺭﻮﻻﻦﮐﻮﻱ ﮐ ﻩﮐ ﻳﺖ ګټ ﺯ
ﺍﺮﺭﺕ کېﭘ ﻮﻪﺩې ﺻ :ﭘCommensel ism .١
ﺪېژﻧﺎﻪﺑ ېﺮﺳﻄﺤ ﺘﮏ ﭘ ﻮﺳ ﭘ
ﻪچېﺩ ﻧﻮ
ﻟﻭ Corډ ynebact eri
ډﻝﺩ um ﻪﻭ ﻮﻱﺩﺏﻝﻝګېﭘ ﺭﺳ
.
ﻠﻲۀﺍﺧ ﻪګټ ﻪڅﺧ ﺑﺭﻮﮐﻪﺩ ﻠ
ﭙﻻﻦﺧ ﻮﻱ ﮐ ﻪﺭﺳ ﺎﻥﻧﻳﻮﻡﺯ ﻪﮐﻪﺗ ﺑﺭ
ﻮﻭﮐ ﻮﻱﺍ ﺪﮐﻧﻭ
ﻪﻪﺩﻱﮐ ﻧﻮ ﺑ
ﻭﺮﮑﻴﻴﻞﻣﻣﻦﺳ ﺎﻪﮐﻐ:ﻫ(Appor tuni sticinfect iېﺎonﻧﮏ ﻳ ﻭﺪﻴﻊﻟ ﻗ ﻮ
.ﻣ ٢
ﻔﺴﻲﻨﻨﻲﺗ ﺗﺭﻮﻪﭘﻧ ﺲچېﭘ ﺍﺪﻳﺮ
ﻳﻮکﻭ ﮐﻮ ﺘ
ﭘﺮﺘﻪﺳ ﮑږﻱﻟ ﻟﻲﺪﻮﺟﻦﺑ ﺘﻪﭘ ﻩﺷﻲﭘ ﺮﺑ
ﺍﺮﻪﺑ ﺗ
ﺭﻊﻭ ﻗﻮﻣ
ﻱﻭ
ﻮځ ﺍ ﻨﻪﻧﻨﻲﺗ ﻳ
ﻪﻭ ﺘﻭﺳﺭﻪﻭ ﻣﻲڅﺧ ﻭﻠﮏټ ﻧﺴﺍ
ﺎټ ﻭﻳﻮﺍﻠﺘﻳﺴښﻪﺍ
ﺎ ﻟ ږﻱﺩﻏ ﻭﺳﻲ ﺘﻢکېﺍ ﻴﺴ ﺳ
ﻩچې ﺍﺩﺭﻮ ﻠ
ﻓﻮﻤﻟﻮﮐ
ﻩﻱېﺩ ﻪ ﺏﻝﻝګ ﻠ.ﺑﻮﻱ ﻪﮐﺗﻣﻦځ ﺍﺍﻱټﺱﺭ ﺩ ﺭﺎ
ﮐﺍﻭﺪﻧﻳﻞﺍﺭﺎکټ ﻭټﺑ ﻭﺳﺐﺍک
.
ږﻱ
ﻻﻞکږ ﻭﻍۍ ﻣ ﺭﺎﻧ
ﻪﺩ ﺘ
ﻭﺳ ﺭﻭﻭ ﺪﻴﻠﺍﺧېﻪﺩ
ﺍﻥک ﻟ ﻮﺘﻳ
ﺮﻪﭘﭘ
ﺭﻥﺍ
ﺪﻤ.ﻫ ﻳﻢﻮﺒﻳﺯﺍ
ﻪﺭﮑ،ﻟﻮﻱﻩﮐ ﻩګټ ړﺍ
ﻭﻳﺖﺩ ﺯﺍ
ﺮﻭﭘ ﻪﺍ ﺑ
ﺭﻮﻟﺖکېﮐ ﺎﻪﺩېﺣ :ﭘ But ual i
sm . ٣
ﻭK ﻴﻦ Bﺍ ﻣﺍﻪﻭټ ﻪﺗ ﺑﺭ
ﻮE.چېﮐ Col ﻪi ﮑ
ګﻥېﻟ ﺎﺍ ﻳ
ﺮﺘﮐﺎ
ﺭﺑﺷﺭﻮ ﻢ ﻮ کېﻳ ﻤﻟﻮ
ﻮﮐ ﻳ
ﻮ ﻪﻟﻩﭘ ګ
ﻩﻪ ګټ ﺩ څﺧ ﻮﻪﻭﺟ ﻪﻟﺑﺭﻮﮐﻪﻫﻢﺩ ﻠﭙﻭﺧ ږﻱﺍﻻﻞ کږ ﺎﻣ ﻴﺘﻧﺎ
ﺍﺳ ﻭﺩ ﺪﻴ
ﺑﺬﻭﺩﺟ ړﻮﻭﺩﺧ ﻭﻱﺍ ﺮ
ﺑﺍﺮ
ﺑ
.ﻮﻱ ﻪﮐﺗ
ﺭﻮﭘ
ېﻪ
(چ ﻟ ﺮﻱ)Exogenous ﺎﻟ
ﻨﺸﺮﻥۍﻣ ﻬ ﻪﺑﻧﻮﺑ
ﻭ ﺮ
ﮑ ﻴ
ېټﻝﻣﻳﻞﺷﻲچ ﻭ ﻭﺪﻭ ﻳﺎ
ډﻝﺑﻣﻲ ﻭ ﻮﻤﻪﻋﭘ
ﻠﻲﻪﺍﺧ ﻧﺮچﻥ ﻪﺳ ﻨﻧ
ﻪﺩ ﺩﻟ ﻮ
ﻪﺩ ﻭﺟ ﺑ
ﺭﻮ ﮐﺎﺩﻭﻳ ﻮځﻱﺍ ﻨﻪﻧ ﻪﺗ ﺑﺭﻮﻪﮐ ﺎﻝ څﺧ ﻳ
ﺮﻴﭘﺎﻧﻲ ﭼ ﺮﻬ
ﺑ
.ﺎﺕ ﻧﺎ
ﺘﻧ
ﻧﮏېﺍ ﻭﺪ ﻴ
ﻟﻊﻗ ﻮﻪﻣﮑ ﻟ()Endogenous
ﻪ ﻭﺳﺮﻧﯽﭘ ﺎ
ﺘﻧ
ﺍ
1
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﻪ
ﻪﭘﺮﯼﭼﻟ
ﻭﺍړ
ﺮﻣﻦځﺕ ﻮﺗﻧﻮﻣﺰ
ﻴﻧﺍ
ﺭګﻭﻮﺍﻣﺸﺨﺼﻭﺍ
ﻮ ﺎﺻﻪﺩﺣﻩﭼﺭﺕﺩ
ﺎﺒﻪﻋﻠﯽڅﺧﺮﺣﻐﯽﻣﺩﻫ
ﻪ
ﺎﺱڅﺧ ﻤ
ړﯽﺗﻮﻡﻧﻟ
ﻮﺩﻧﻮﻣ
ﺰﻴﻧﺍ
ﺭګﻭﺍ
ﻪﺩﻠﺮﺣ
ﺍﻣﻭﺩﻮﯼﺍﺎﻑﮐﮑﺸﻧ
ﻮﮐﯽﺍﻳﻄﺍ
ﺮﯿﺸﻴﻄ
ﻮﻣﺤ ﺎﺻﺧ
ﺮﯼ.
ﻟﻪﻣﺍ
ﺩﺭﯼﺍﻮ
ﻭﭘ ﺪ
ﻴﺭﺟﺎﺎﺧﻭﻳ
ﻮﺍﻠﻠ
ﻩﺗﻪﻣﻦځﻟﻩﺭ
ﻮ ﻩﻪﭘ
ﻳﺖڅﭘ ﻮﻪﺩﻋﻀﺑ
ﺭﻮﻭﺩﮐﺍﻭﻉﺮﺷ
:
ﺰﺱﻴ
ﻨﻮﺟ
ﺘﺎﻥﭘ
ﺘﻧ
ﺍﺩ
ﻳﮏې
ړﻣﻦځﺍ
ﺮﺎﻝﺗﻳ
ﺮﻴﭘ
ﺎﻭﭼﻣﻞﺍﺎ
،ﺩﻋﻭﻍۍﺭ
ﺎﻧ
ﻪﺩ ﺑ
ﺭﻮﮐ
ﻪچېﺩ ﻠﺭځﻱﮐﻪﺍ ﺗ
ﻪﻭﺧﺖﻣﻦځ ﻐﻭﻏﻲﻫﺭﺎ
ﻧ
ګﻱډﻝ
ځﻥ ړ ﻭ
ﻪﺍ ﻮﭘ ﻧ
ﻭﺭﻮ
ﺘﮑﺭﻓﺷﺭ
ﻮ ﻢﻪﻳﺪېﭘﻧﺎ
ﻪﺑﺑﺭﻮ
ﻪﮐ ﺰېﭘﻴﻭﻍۍﺍﻏ ﺭﺎ
ﻧﺷ.ﺩ
ﻭې ﻲډې ډ
ګ
ﻧﮏېﺩﻱچېﻭﻮ
ېﻭﻣﺸﺨ ﺺﮐ ﻧﮏ ﺍ
ﻮﮐﺍ
ﻨﺲټﻱ ټ ﻮﺟﺘﭘ
ﻪﺩ ﻧ
ﻭﺭﻮﺘﮑ
ﻪﻓ ،ﺩﻏﺮﻱﻩﻟ
ړﺭېﺍﻮ
ﻮﺟﻦﭘﺘﭘ
.
ږﻱﺩﻱﺎ
ﻮﻡﻳﻪﻧﻮﭘﻧﻭ
ﺭﻮﺘﮑﺘﻲﻓﻴﺴﻨﻮﺟﺘ
ﭘﺰﻡﺩ
ﻴﻧﺍ
ﺭګﻭ
ﺍﺩ
ﺪ
ﻧﻭژ
ﻪﺩﺗ
ﺭﻪچېﻭ
ﻠﺘﻼﻯﺷﻲﮐ
ﻴﺴﻩﺍﺧ
ډﻝګټ
ﻩﻭﻪښ
ﻪﻭﺧﺖﭘﻐ
ﻪﻫ ﻪڅﺧ
ﺑﺭﻮ
ﭙﻞﮐﻪﺧﻮﺟﻦﻟﺘﭘ
.
ﺍﺷﻲ
ﺪﻴړځﻯﭘ
ﺪﻥېﻭ ﺍ
ﻴﺗﺎ
ﻳﻭﺯﻮﺍ
ﻟﻮﮐ
،
ﻮﻱﻪﮐﺘﺮﺳ
ﻩﻣﺮﻭﺳﺪﻳ
ﺮﭙﺩډﻝﺩ ﺧ
ﻭﺏ ﻭ ﺮﮑ
ﻴﻣﻮﺩ ﻪﺩﻯ ﺧﻩﻧ
ﻪ ګټ ﻮﺟﻦﭘﺘﭘ
ﻣګﺩﻪﺮ ﺑ
ﺭﻮﮐ
ﺩ
ﻪ
ﻧﻭﺭ
ﻮﺘﮑ
ﻪﻓ،چېﺩﻏ
ﻮﻱﻨﻴ
ﻣﺎﺎﻱښﺕﺗ
ﻭﭘﻪﺍ
ﻧﺪﻳﺮ
ﭙﻮﺟﻦﺧ ﺘﭘ
ﻪکېﺩﺑﺭﻮ
ﻪﮐ ﻪﭘ
ﻧﻭﺭ
ﻮﺘﮑﺘﻲﻓﻨﺴ
ﻮﺟﺘ
ﭘ
ﺩ.
ﺩﻱ ﻮ
ﻮﺟﻮﺟﻦکېﻣ ﺘﻪﭘډﻝﭘ
ﻌﻲ ﻭﺒ
ﺎﻃﻭﻳﺛﻲﺍ
ﺭﻪﺍ
ﭘ
ﺷ:
ﻻﻞ ﻲ
ﻭﻍۍ ﻣ
ﺭﺎﻧ
ﻭﺩﺗڅ
ﺮﻱﺮ
ﻟﻭېﻭ
ﺎﻴﺗ
ړېځﻥګ
ﺪ ﺍﻧ
ﺪﻻﻳ
ﺎﻮﺟﻦﺑ
ﺘﻮﭘ
ﻳ
.
ﺮﻱﻟ
ﺍکﻭ
ﻭﻭځ
ﺭﺕﺍ
ﺪﺪﻥېﻗ
ﻳﺩﻟږ
ﻭﻲﻮﺍ
ﻟﻮﺪﮐ
ﻧﻭژ
ﺎﻝکېﺩ
ﻳﺮﻴ
ﭘﺎ
ﻪﭼﭘ .
1
ﻭ.
ړﻱ ﺎﺱﻭ
ﻤﺗ
ﻩﺩﺮ
ﻪﺳﻄﺢېﺳ
ﻟﻪﺑ
ﺭﻮﮐ
ﺩ .
2
ﻣﻦځ
ﺍﺪﺭ
ﺮﺿﺎﻥﭘ
ﺘﻧ
ﺍﺍﺩ
ﻮﻪﻟﺨ
ﺑﺭﻮ
ﮐﻩﻭﻱچېﺩ
ﻮګﻮﺟ
ﻟﻮﺑ
ﻮﻠﻐ
ﻣﻮﺩ
ﻧﻮﻣ
ﺰﻴﻧ
ﺎﮑﻴ
ﺎﻋﻲﻣ
ﻓﻮﺩ
ﻐ .ﺩﻫ3
.
ږﻱ
ﻪکږ
ﺗ
.
ﻮﻱﺭﺳ
ﺎﻥﻭ
ﻳﻪﺯ
ﻪﺗﺑ
ﺭﻮﻪچېﮐ
ﻧﺩﻮ
ﻟﺭﺍکﺩ
ﻭﺩېځ
ﺩ .
4
ډﻝ
ﻌﻲ ﻭ
ﻴﺒﻪﻃ
ﻴﺲچېﭘ
ﺯﺳﺎ
ﻴﺒ
ﻴﻣﻪﺍ
ﮑ،ﻟ
ﻮﻱﻪﮐ
ﺗﻭﻪګ
ﻪﭘﺑ
ﺭﻮګﻱﮐ
ځﻥ ړ
ﻪﺍﻧﻮﻠ
ﻣﺎ
ﻧﻲﻋ ﺎ
ﺘﻧ
ﺭﺍﺷﺭ
ﻮ ﻢﻳ
.
ﻮﻱﻩﮐﺭﻮ
ﺎﻥﻏ ﻧ
ﺎﻧﺴ
ﺍﻩﺮ
ﺳ
.ﺩﺏﻝﻝ
ړﻱﻩکﺭ
ﺎﮐﺭښ ﺍ
ټﻦګ
ړﺪې ﻳ
ﻧﺮﻭﺍﻮﭘﺗ
ﺎﻧ
ﺎﺘ
ﻧﺭﺍ
ﺷﺭ
ﻮ ﻢﻳﮑﻦﺩﻤ
ﻪﻫﻢﻣﺑﺭﻮ
ړېﮐﺩځﻥګ
ﺎﺍﺍﻣﺍ
Viچېv
ﻳﻢax
ﺩﻮﻣﺯ
ﺩﻼDufﺩﻱ ﭘ
fybloodGroupnegat
ivﻠﮏ چېe
ﻪﺧ ﻐډﻝﻫ
ﻪﻭګېﭘ
.ږﻱ
ﻻﻞکږ
ټﻱټﺱ ﻣﺎﺍﭙ
ﻴﺩﻫ
ﮐﻻ
ﺪﻮﻧﻭﻩژ
ﻪښ ﺘ
ﻠﻩچېﻫﻩﺩﺭﺎ
ﭙﺩېﻟ
ېﻪ ﺩ
ﺮﺥ ﺗړېﺑځﻥګ
ﺩﺍ ﻮﻭﺟﻼﻪﺩ
ﺰﻡﻋ ﻗﻴﻧ
ﺍﺭګﻭﺍ
ﻭﺮﮑﻴ
ﻮﻣ ﺩﻏ
ﺩ
ﺎﺕ
ﻧﺎ
ﺘﻧ
ﻴﮏﺍﺑﻭﺮ
ﻳﻮﺍ،ﺧﻴﺴﻲځﻯﻧ
ﻭﺍﻪﺍﺘﻴﺸﻮ کېﻣ
ﻤﻟﻮﺎﺕچېﮐ ﻧ
ﺎﺘ
ﻧAnaerﺍobic:ﻪﮑ
ﺷ،ﻟ
ﻯ ﻲ
ﺘﻢکﻴﺴ
ﻔﺴﻲﺳ ﻨﻪﺗﻮکﭘﮐ
ﻮﺘﭘ
ﺮﺘ،ﺳ
ﻴﺴﻲ ېځﻯﻧ
ﻮک ﺍ ﺮﺧﻮﺑ
ﻴﻧړﻮﻡ
ﻟﻪﻮﭘﻤﻟ
ﻮﮐﻭﺩﻮﻡﺍﻌﻠ
،ﺑﻪﻟ
ﻮﻪﺧﭘ
.
..
ﺭﻮﺍﺱېﻧ
ېﻭﺩﺘﻢک ﺍﻴﺴﻤﻲﺳ ﻭﻫﻀﻟﻲﺍﻮEﻪﺑ
.ﭘColiې
ﻪﺘ
ﻧﺍ
ﺮېځګﻱﺣﺠځﻥ ړ
ﻪﺍﻧﻮﻨ
ﻮﺟﺘځﻦېﭘ
ړﻱکېﻫﻢ ﻳ ګﻱﻍ
ځﻥ ړ
ﻪﺍﺘﻰﭘ ﻳﻞﺷﻲچېﺣ ﻭﺪﻭﻳﺎ
ﺑ
ﻮﻱچېﺩﺒﻳ
ﺮﺮېﺗﺨﻴﻞﺣﺠﻠﻴ
ﺘﻴﭘ
ﻪﺍﻐﻮﻫﻤﻟ
ﻮﮐﻩﺩ
ﺮﺗﺎ
ﻳRotﺯ
av i
rﻩus
ﻮګ ﻪﺗټکېﺩﺏﻝﻝګېﭘﺍ
ګﻱ
ېځﻥ ړ
ﺭېچ ﺍ ﻪﻻﻮﻟﺗ
ﺍﺮ
ReoViﺩ Mﺣﺠ r
ﻭus ﺮﻱﺍ
ېځﻯﻟ
ﻪک ﺍ ﺮﺧﺗﻦۍﺑﺭﻮ
ﻪﭘViﭘl
lus
.
ږﻱﻠﻲ
ﺍﺧښﻲﺩ
ېﻮ ﻟ
Payﻱ ﭘer'
sPatېﻭches
ﺮﺍ ﻴﻞﺣﺠﻠ
ﺘﻴﭘ
ﺍ
2
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
:
(Epi
thel
i
alAt
tachment
ﻥښﻪ)
ﻨ
ﻩ ﺗﺮ
ﻴﻞﺳ
ﻠﻴ
ﺘﻴﭘ
:ﺍﻟﻒ
ﺍ
ﻟ ،چې
ﻪ ﻥښﻲ ﺍﺳﻄ
ﻪﻭ ړﻮﭘ
ګﻭ ﻍﻳ
ځﻥ ړ
ﻩﺩﺍﺮﻮﺳﺮﺧﻮﺑ ﻴ
ﻨﻳﺪ
ﻧﺎﻁﺩﻻﺎﺩ ﻣﺨﻳﺮﺘ
ﮐﺎﻩﺑﺮﺗﺎ
ﻳﺯ
ﺎ ګﻻ
ﻴﻦﻳ
ﺗﻭﺮ
ﻮﭘ ﺮﻱ چېﻳ
Lectﻟ
i Piﺳﻄﺢېn
lﺩi
ږﻱ ﺍ
ﻳﻞ کږﻪﻭﺗ
ﺭPiﻭlﻳi
(ﺎFimbri)ae
ﻧ.
ېﭖژﻲ
ﻮﻥ ژ ﺎﺕېﺷګﻱﭘ
Sځﻥ ړ
ﺪېﺩ ugarﺍﻧﺎ
ﻮﺑﮑﻧ
ﻭﻭﭘژ
ﻪﺮﺑﺭ
ﻮﮐﻭﺩﻴﻦﺩﻯﺍﺗﻭ
ﺮﭘﻮﮑﻳ
ﻪ ﺳﻄﺢ
ﮐﺎﻧ
ﺮﻱښ ﺮﺳﻬ
ﻮﺑﮑﻧ
ﻭﻪژﻮکﻟﮐﻮﻠ
ﻴﻓﺎ
ﺘ Coagulﺳ
aseNr gati
vﻪeﮑﻭېﻟﺎ
ﻳﺮﺘ
ﮐﺎځﻦېﺑ
ﻳ
ﺟړ
Biﻮ
ofi
lګﻩ m
ېﻪ ډ
ﻮﻱچ ﭘﻪﮐﺘﺮﺳ
ﻩﻣ ﺮ
ﻮﺳ ﺗ
ﻮ ﻨ
ﻪﻧﻟﻭﻭ
ﺎﻳﺮ
ﺘﮐﺎ
ﻓﻲﺑ ﺎ
ﻭﺍﺿﺭﻮ
ﻧﻱﻭﺩ
ړﺍ ﻭﺍ
ﻪﺭﺗﻣﻦځ
ﺩ.
ﺭﻯ ﺎ
ﻣﻦﮐﺰﻧ
ﻮﺘړﻝﺳ ﻩﻭBﻪﻣﻦځ
iﻟofi
l
ﺩې mﻭﻱ ﺩ
ﻩ
ﻪ ﻥښ
ﻮﭘﻠ
ﭙﺎﺩﺧ
ﮑﻴﺗ
ﻮﻟ
ﺎﺘ
ﺎﻫﺴ
ﺒﻴ
ﻣﺎﺘ
ﻧﻭﺍ
ﻳﻢﺍ
ﺩﻮﻣ
ﺯ،ﭘﻼ
ﺍ
ﻭﺯﻮ
ﺗﻭﺮ
،ﭘ(
HIﻪ)Vﮑ
ﻪﻟ ﻧ
ﻮﻭﺳﺮﻳ
ﺍځﻦېﻭ
ﻳ
ﻟ.
ﻩﻥښﻲﺮﻭﺳ
ﺬﻮﺍﺧﻳ
ړځﻥګ
ﻪﺍﻟﻮ
ﮑﻧﻭ(ژTar
getﻮ)
ﻳﻮﺷ
ﻮ
ﻤﻟﻮ
ﮐ ،چېﺩ
ﺮﻱړﻱﻟ
ګﻱﻍ
ځﻥ ړ
ﻭﺍﺪ
ﻴﻟﺎﻥﺩﻥښ
ﻴﻧﺠ
ﻧﮏې چﻥ
ﻭﺮﻪ ﭼﻦګکﻟﮑ
ﻪﻟﻧﻮ
ﺘﻳﺯﺍ
ﺮﺭﭘﻮﻧ
.
ﻴﺴﻲﻠﮏﻧﻮﻡﮐﻴﻠ
ﺘﻴ
ﭘﺍ
ﻪ
ﻮﻝﭘ
ﮑﻴﻟ
ﺎ
Hem Agglﻣ
uti
niﻩﺩne
ﺮﻮﺳ
ﮑﻧﻭ
ﺎﻃﻲژ
ېﻪﻣﺨ
ﺭﻟ ﻔﺴﻲﻻ
ﻨﺗ
ﺮﺱﺩ ﻳ
ﺍﺍﻭ
ﺰﻨ
ﻳﺍ
ﻮﻠ
ﻔﻧ
ﺍﺩ
.
ﻮﻱﻟ
ځﻥﻥښﻪﺍﺍﺳﻄﻭ
:
Col
oni
zat
ion:
ﺏ
ﺎﺩLumen
ﻳﻭږﻱﺍ
ﺎﺕې کږ
ﺮﺳﻄﺢېﭘ
ﻮﻡﭘ
ﻴﻠﺘ
ﻴﭘﺍ
ﺎﺩﻮﺟﻦﻳﺘﻪﭘ
ﺘﻭﺳﺭﻭﻭﺪﻴ
ﻟﺮﻥښﻴﻞﺗﻠ
ﺘﻴ
ﭘﺍ
ﺩ
.ﻮﻱﺪﮐﻳ
ﺮﻮﺑ
ﺎﺟﻧﺴ
ﺍﺮﺎﭘ
ﻴﻭﺑ
ﺍﻮﻱځﻥﺭﺳ
ﻪﺍﺍﺧﻞﺗ
ﺩ
ﻪﺩﻱچ
ﻧﻮﻨ
ﻴﻮﺟ
ﺘﻪﭘ
ﻐﻪﻫ
ﻧﻮﻟ
ﻭﻳﻢډ
ﺩﻮﻣ
ﺯﺩﻼ
،ﭘ
ﻪﻧﻮﻟ
ﻭﺎډﻴ
ﻧﺎ
ﻤﻟﺸ
Toxoplﺩasmagandi،
ﻪﻧ
ﻮﺮﺳﻳ
ﺍﻭ
.ﻴﺴﻲېځﻯﻧ
ﻪک ﺍ ﻨ
ﻧېﻪﺩ
ﻧﮏ ﭘﻭژ
ﻪﺩﺘ
ﻭﺳﺭﺪﻭﻳﺮ
ېﺮﺑ
ﺗ
ﻪژ
ﻪﻟﺘ
ﻭﺳﺭ
ﺪﻭﻳ
ﺮېﺮﺑ
ﺎﺕﺩﻱچ ﺗ
ﻧﺎ
ﺘﻧ
ﻪﺍﻐ
ټﺎﻫ
ﮑ
ټﻮ ﻳ
ﻟ
ﺎﻫ ﺲﺍ
ﺒﻴ
ﻣﺍﻭﺍﻥټ
ﻮکﺍﮐﻮ
ﺘﭘﺮ
ﺘ،ﺳﻮکﮐﻮ
ﻣﻮﻧ
.
ﻴﺴﻲځﻯﻧ
ﺮﺍﻬﻧﮏېﺑﻭ
ﺎﺕﺩﻱچېﻥﻍﻍ
ﻧﺎ
ﺘﻧ
ﻪﺍﻐ
ﺭﻫﻮ
ﺍﺱېﻧ
ﻭﺩﺯﺳ ﺲﺍ
ﺎﻴﻣ
ﻭﺯﻮﻧ
ﺎﭙ
ﻳﺮ،ﺗ
ﺯﺳ ﺲﺎ
ﻳﺭ
ﻓﻼ،ﻴﻴﺲﺯﺳﺎ
ﻴﻣﻭ
ﺯﻮﺘ
ﺷﺴ
.ﻴﺴﻲﺪېﻧﻧ
ﺪﻻ ﻳ
ﺮﺮﺑ
ﺮﺗﻴﻬ
ﻭﻱﺑﺎﻔ
ﻤﻟﺎ
ﻳﻦېﺑ
ﻭﻍﻪﺩ
ﻪﻥ ﻏﭘ
:
(Ti
ssueDy
sfuct
iﻳﺐ)onorDamage
ﺮﻮﺗﺨ
ﺎﺟﻧﺴ
ﺍ:ﺩ
ﺝ
.
ﻮﻱﻪﮐ
ﺗﻣﻦځ
ﺍﺎﺭ
ﻴﺘ
ﻭﻏﺭ
ﺎﻪﻧ
ﻧﻮﻣ
ﺰﻴﻧ
ﺍﺭګ
ﻭﺍﻭ
ﺮﮑﻳ
ﺎﻪﻣ
ﺍﺳﻄ
ﻪﻭﻮﭘ
ﻧﻮﺗ
ﻴﮏﺕ
ﻧﺎ
ﻴﺨﺪېﻣ
ﻧﺩﻻ
:
ﻴﻦﮐﺴ
ﻮﺗﻭ
ﺰﮐﺍ
-١
:
ﻪﮑ،ﻟ
ږﻱﺯﻱ
ﺍﺮﻓ
ﻪﺍﻭڅﺧ
ﺮﻱچې ﺭ
ﻩﻟړ
ﺭېﺍ
ﻮﺎﻥﭘ
ﺘﻧ
ﻪﺍﻐ
ﻪﻫ ﻧ
ﻮﺘﻴ
ﻟﺎ
ﻌېﻭﻓ
ﺰﺍﻴﻩﺍﻏړﻭ
ﺎﻴﻦﻧ
ﮐﺴ ﻮ
ﺗﻭﺰ
ﮐﺍﺩ
.
ﻮﻱﻮﻯﮐﻴ
ﻨﻭﻣﺨﺪﻳړ
ﻮﻴﻦﺩﺟ
ﺗﻭﺮﭘ
ﻴﻦﺩﮐﺴﻮﺎﻝﺗ
ﻳﺮﺘ
ﻔﻳﺩ
.
ﺮﻱﻟ
ﺰېﻴ
ﺍﻏﺮﺟﻦې
ﻮﺯﻫ
ﺑﺎ(ﺮﺍﻋﺼ
Neurﭘ
otoxi
ﻴﻦ)n
ﮐﺴﻭ
ﺰﻡ ټ
ﻴﻟ
ﻮﻭﺑﭽ
ﻮﺱﺍ
ﻧﺎﺘ
ﻴﺗ
ﻭ
ﺪﻴﺭﺟ
ﺎﻮﺩﺧ
ﻧﻮﺘ
ﻴﻟ
ﻭﺮﺘ
ﮑﻟﻭﺍ
ﻮﺍﺑ
ﻭﺍﻪﺩ
ﻮڅﺧ
ﻤﻟﻮ
(ﻪﮐ
entﻟ
erot
oxi
ﻴﻦ)n
ﮐﺴﻭ
ﺍټﺮ
ﻟﻮEﻭﮐ
.ﺍCol
ﺩi
.
ږﻱ
ﻻﻞکږ
ﻣ
:
ﻴﻦﮐﺴ
ﻭﻭټ
ﺪﻧ-ﺍ
٢
ﺟړ
ﻪ ﻮﻮڅﺧ
ﺮﺧﺩېﺑ
ېﻪ ﺭ
ﺪﺩﻯچ ﻟ
ﻳﺍﺮ
ﮑﻟﻲﺳ
ﻮﭘﻮ
ﭙﻳﺍﻝﻻ
ﻮﻳﻭﻱﺩ
ﺮګﻮﺩﺣﺠ
ﻧټﺎﺍ
ﻳﺎک ﺭ
ﻔﻲﺑ
ﻨﺍﻡﻣ
ﺭﺩګ
3
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﺩ.
ﻮﻯ ﻯ
ﺷ
.
ﺮﻱﻟ
ﻴﺖﻟ
ﺆﻭﻣﺴ
ﺰﻴﺍﻏ
ﻮﻨﺮﺟ
ﻩﺯﻫ
ﺭﻮ:ﺩﻏ
ﻪﺎﺣ
ﻮﻱﺳ
ﺘ:ﻫﺴ
ﻟﻒﺍ
ﻮ
ﻳﻩﺩ
ﺮ Liﺳpi
ﻩ چې dA
ﻧﮏېﺩﻭ
ﺮﻟﺯ
ﻭﺯﻭ ﻫﻲګ
ﺯﺍﻮﺘﭙ
ﻴﻪ چېﺩﻫ ﺮﺧ
ﺪﺑﻳﺍ
ﺮﮑﻭﺳ
ﻟﻲګ
ﻭﺍ:ﺩﺏ
ﻭ.
ېټﻦګ ﻱ
ﻳﮏ ﻳړ
ﺭېﺍ(ﻪﻻ
KDO)Ketﻟodeoxyoctanoi
caciﻨﻰd
ﻌﺪﻳﻨ
ﻮﻝﻗ
ﻤﻌﻣﺮ
ﻴﻏ
ﻪ
ﻭڅﺧ
ﺰﻴﺎﻝﺍﻏ
ﻳﺮﺘ
ﮐﺎﺍﻥټﻱﺑ
ﻭﻡﺩ
ﺮﻴﺎﺩﺳ
ﻳﺮﺘ
ﮐﺎﻔﻲﺑ
ﻨﺍﻡﻣ
ﺭﺮچېګ
ﻳﺩﺯﻥځ
ﺍږ
ﺪﻭﻳ
ﺍﺮﮑ
ﻟﻲﺳ
ﻮﭘ:ﺩ
ﺝ
.
ﺗﻲﺎ
ﺳ
،چې
ږﻱﻻﻞ کږ
ﺯﻣﺍﺮﻓ
ﺍIﻭTNFﺩﻪLﺍ ﮑ
ﻮکﻥﻥﻟ ﺘﻳ
ﺎﻭﺩﺳﻮﻱﺍﻪﮐﺒﻨ
ړۍﺗﻮﻝﻧﻭ
ژﺎﻓ
ﻭﺮﮑ
ﻣﺪAﺩ ﻴ
ﭙﻴﻟ
ﺭ ټﻱټﺎ
ﻳﻦېﻓﺸﻭ
،ﺩ،،ﺗﺐ
ﻳﺐﺮﺗﺨﻴﻞﺩﺗ
ﻭ ﺪ
ﻧﺍ،چېﺩﻮﻱﻟ
ﺎﻌ
Clﻓott
iCﻭng
omplﺍﺎementﻴﺍﺑ
ﺩ
.
ږﻱ
ﻻﻞکږ ﻮﻣﻧﻮ
ﻧﻮﻟﺪﻴﮏﺑﻮﺟﻟﻮﻳ
ﺰﻭﻓﻼﻲﺍ
ﻘﺑﺘﺭﺍﺳ
ﺷﺭ
ﻮ ﻢﻳﻭﺩ
ﺍﺎکﻴﮏﺷ ﺘ
ﭙﻴ،ﺳ
ﻟﻰﺍ
ﻭ
ګﻮ
ﻠﻣﻲ ﻳ
ﻮﻤﻭﻋ
ﺭﻮﻧ
ېﻭﺩ
ﺗﺐ ﺍ
ﺩ،چېﺩ
ﻮﻝ ﻯ
ﮑﻴﻟ
ﺎ
Pyﻣ
rogeni
ﻤﻦc
ﮐﺍﻭ
ﻮځﻮکېﻳﻧﺎ
ﻧﺎ
ﻧﺴTﻪﺍ
NFﭘ
.
ږﻱ
ﻻﻞکږ ﻩﻣﺭ
ﻮﻏ
:
ﺭﻮﺘ
ﮑﺯﻓ
ﻭﺮﮑ
ﻴﺭﻧ
ﻮﻣﻮ
ﺗ
.ږﻱ
ﺩﻱﺍﺯﻪﺍ
(څﺧ ﻮﻧ
ﻭﺎﻱټﻮﺳ ﻧ
ﻮﻣﻭﻮﺍﻧ
ﻭژﺎ
ﻓﻭﺮﮑﻣ
ﻮ) ﮑ
ﻧﻭﻴﮏژ ﺘ
ﻳﺎ
ﻭﺳ ﻮ ﻑګ ﻔ
ﻠﺘﻣﺨTNFﺩ
.
ږﻱﺩﻱﺍﺯ
ﺍﻪ(څﺧ Natur
alKil
lerCelﺍl
ﻳﺖﻭ ﺎ
ﻮﺳﻔﻤﻟ
ﻮ)ﮑﻧ
ﻭﻴﮏژ ﺘﻳ
ﺎﻭﺳﺮﻑګ ﻴTNFBetﺩﻏ ﺩa
ﭙﻞ
ﻪﺧ ﺩTNF.ﭘګﻥ ﻯﺮﻭﺒﻮﻏﻳﺖﻳ ﻮړﺪېﺩﻋﻀﻧ
ﻪﻭﺍ ﻮﻥﭘﻤﺴﺑﻲﻟﺎﻬ
ﺘﻟ
ﻭﺍﺎﻥﺍﺘﻧﺍ
ﺪﻝﺩ ﻳﺩ
ﺍﺯﺩTNFﺍ
ﻳ،
ډﻦ ﺎګﻻﻥﺘ
ﻭﺳﺮ،ﭘﻮکﻥﻥ٦ ﻟ
ﺮﺘﻧ
،ﺍ ١
ﻮکﻥﻥ ﻟ
ﺮﺘﻧ
ﻪﺍﮑﻭﻟﺩﺍ
ﻮﻮﻣ ﻳ
ړﻭﻣﻦځګ ﺭﻮړﻧﻮﻝ ﻳﻩﺩ ﺮ
ﺑﺖﺳ ﻮ
ﻧ
ﻭﺰ
ﻴﻪﺍﻏﻮﭘﺗﺎ
ﻧﺎ
ﺘﻧ
ﺍﻨ ﺲټTNFﺩ ﻪﺩېﺑ ،ﻮﭘ
ږﻱﻧﻻﻞ کږ
ﻭﻣ ﺪﻳﺩﺍ
ﺯﺍﻴﻦﺩﭘﻭﺮ
ﺗﻮﮑﻴﺗ
ﺭﻮﻭﮐﻳﻦﺍ ﺭ
ﻮټﮑﻴﻟ
.
ﺮﻱ ﻟﻪﺮﺧﻩﺑﺮﺘکېﺳ
:
(Ti
ssuei
nvasi
ﺪ)on
ﻳﺮﻮﺑ
ﺎﺟﻧﺴ
:ﺮﺍ
ﺩﭘ
ﻭﻱﺟړ
ﺑﺴﻲ ﻮ ﻌﻦېﺍ،ﻳﺮﻱﺍکﻟﻭﺪځ ﻳﺮ
ﺑﻮﺩﺎﺟﻧﺴﺍ
ﺮﻮﺱﭘ ﻳ
ﺭﻭﻮکﺍ ﮐﻮﻠﻴﻓﺍ
ﻪ ﺱټ ﮑﺎﺕﻟ ﻧ
ﺎﺘﻧ
ﺭﺍﺭﻮﺷﻢ ﻳ
ﻟﻲﺍ
ﻭﺭﻮﺍﺥﺳ ﺮ
ېﻭﭘﺎﺳﺖ ﺍﻧﺲﻧ ﺷ،چېﺩﻭﻻﻯ ﻲ ﺟړ
ﻴﻦ ﻮ ﮐﺴ ﻭﻩټ ﺭﻥګ ﺍ
ﺪ ﻤﻭﻫﺎﺍﻴ ﻤ
ﻳﺭﺎکټ ﻭﻫﻢﺑ ﺍ
.ږﻱ
ﻻﻞکږ ﻣ
ړﺪکﻴﻟﻮﻴﻦﺗﮐﺴﻮﻪﺩېچېﺗ ﻪﻟﺗ
ﺮE.ﭘCol
ﻴﮏi ﻨ
ﻮﺟ ﺘ
ځﻦېﭘ ﻪﻳ ﮑﺎﺕﻟ ﻧﺎ
ﺘﻧﺭﺍﺷﺭ
ﻮ ﻢ ﺮﺧﻼﻑﻳ ﺩېﭘﺩ
.ﻮﻱﺪﮐ ﻳﺮﻮﺑﺎﺟﻧﺴﻱﻪﺍ
ﭘ
ﻭﻟﺖﺍﺎﻣﺖ ﺣ ﻭ
ﺎﻘiﺩﻣmmuni t
ﻭy ﻨﯽﺩﯼﺍ ﻌﻪﻣﻣﺖﭘ ﻭﺎﻘ
Iﺩﻣ mmune : I mmuni ty
ﺮﯼ ﻟﺑﻞﮐﯽﺎﻘ
ﻪﻣ ﻮﭘﺍﺿﺮﻣ
ﺍﺪﻥﻳﯽﺩ ﺍﻥﺑﻮﻴﺎﺣ ﺎﻥﻳﻧﺴ ﺍ
ﻪﺩ ﻳﻲﭼ ﺍ
ﻪﻭ ﻴﺖﺗ ﻠ
ﺑﺎﻗ
ﻳﻲ.ﺍ
ﻪﻭ ﻭﺳﯽﺗ ﺮﻣﺖﭘ ﻭﺎﻘ:ﺩﻣ Immuni zation
ﻮﻠ
ﻣﺍﻮﺭﺟﯽﻋ ﺎ
ﻣﺖﺩﺧ ﻭﺎ
ﻘﺪﻥﻣ ﻮﺩﺑﺗﺎ
ﻧﺍ
ﻮﻴﻪﺩﺣ ﻩﭼﺭﺕﺩ ﺎﺒﻪﻋﻠﻢ څﺧ ﻪﻋ ﻐ:ﺩﻫ I
mmunol ogy
ﺎﺝﻧﺴ
ﺍ،ﺍﺕﺮﻪﺣﺠ ﻐﺪﻥﻫﺑﺎﻥﺩﻧﺴﺑﻞﮐﯽ(ﺩﺍ ﺎﻘﻪﻣﻮﭘﻧﻮﺑﻭﺮﮑﻴ
ﺎﺩﻣ ﻮﺻ ړﯼ)ﺧﺼ ﺑﻞﮐﯽڅﻱ ﺎ
ﻘﻪﻣ ﭘ
ﺮﯼﻟﻭﻝﻬﻢﺭﺍﺕګﮐﯽﻣ ﻪﺭ ﺗ
ﻪﻣﻦځ ﻴﺖﭘ ﺎﻓﻌﻪﺩﻣ ړﯼﭼ ﻭﻍ ﺍ
ﺍﺕﺮـﺣﺠ ۱
monocy te,Macr ophage.
Lymhocy t
ei ncludingNat ur alKil
lercell
Epithelr
eticularandEndot hel i
alcell
(PMN Neutrophil)s
ﻪﺪﻥﭘﺑﻪﺩﻩﭼ ډﻝﺩﺎﻭ ﺎﺻﻠﺨﻮﺑﻨﻈﻢﻧﺴﺞﻳ ړﯼﺍﺻﻼﺩﻣ ﻮﻣ
ﻮﻧ:Ly mphoi dt iﺎﺝ ssue ﻧﺴـﺍ۲
4
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
5
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﺩ.
ړﻱ ﺯښﺕﻭ ﺭﺍ
ﻪﺩ ﻨﺘ
ﻟﺖﮐ ﺎﺣ
ﻪﺩﺒﻭﻍﺗ ﺭﺎ
ﻧﺩ،ﺩ
ﻴﮏ ﻯ ﺮﺟﺘﻴﻟ ﻪﻭﮐﻧﻲﺍﺎ
ﻴﺠ ،ﻫ ﻪﻣﺍﺭ
ﺎﻗ،ﻧ
ﺎﺏېﻋﻼ ﻲ ﻳﻪﻭﺷﻲچېﺍ ﻧﺮﻠ
ﻣﺎﻪﺩېﭘ ﻭﻍﺗ ﺭﺎ
ﻧ
ﻧﻲﺎﺘ
ﻧﻭﺍ ﺮﻳ
ﻪﺩډ ﺒ
،ځﻪﺗ
ﺭﻭﺷﻲ ﮐ ﺍ
ټﻦګﺎﺕ ﻳ ﻳﺪېﺩېﺯ ﻧﺎ
ﺭﺝېﺑ ﻭﺩ ﺎﺍﻴﺗړﺷ،ځﻥګ
ﻩ ﻲ ﺍ ﺯﺍﺪﻧېﺍ
.ﻩﻩ
ﻴﮏېﻥښ ﺩ ﻨﻴﻠﻪﮐﻤ ﻬﻮﻣ ﻴﻭﻏ ﺭﺎ
ﻧ
،
ﺎﻴ
ﻤ ﻳ
ﺭﻮ :ﻳ
ﻪ ﮑﻮﻱﻭﻱﻟ ﺍﺏﺷ ﺮﺘﻢﻱېﺧ ﻴﺴ ﺘﻲﺳ ﻴ
ﻓﺎﻌﻠﮏچېﻣ ﻪﺧ ﻐﻭﻫ ﻠﮏﺍ ﻩﺧ ړﺍﺍﻯﺷﻲﺯ ﺩ ﺩﺎکﻣﺍ
ﻴﻢﻪﺩېچېﻭﺧ ﻟﻩﺮﺮﻱﺳ ﻠ
ﻧﻪﻭ ﺒ
ﺍﻯﺷﻲﺗ ﺩﺩﻠﻲک NSAIﺍﺧ ﺎD ﻭﻥﻳ ﺰﻴﺗﺭﻮﻪچېﮐ ﻐﺎﻫﻳ
ﻭ ﺯﺱﺍ ﻭﺮ ﻴﺳ
.
ﺮﻱ ﻟﺎﻥﻭ ﺘﻧ
ﺍ
ﻪﺗ
ﻭﻪګ ﭘﺍ
ﻪﺭ ﻧ
ﻮﻧﻮﻟﺪﻴﮏﺑ ﻟﻮﺑﺎ
ﺘﻴﻭﻣﻴﮏﺍ ﻣ ﺎ
ﻨﻳﺍ
ﺩﻮ ﻤ
ﻴﺭﻫ ﺷﺭ
ﺒﻲ ﻢ ﻠﻭﻗ ﺭﺍﺷﺭ
ﻔﺴﻲ ﻢ ﻨ،ﺗﺭﺎﻳﻦېﻓﺸ ﻭﺩ
.ﻮﻱ ﮐ
،
ﻮک ﮐﻭﻨﻦګ ،ﻮﻣﻮﻧ ﺪﻝﺷ ﻴﻟ
ﻪﻭ ﻧﻮﭘ
ﺎPetﺧ ichiﮐal
ﺷ .ﻪﺘﻞ ﻲ ﮐﻩﻭﺮﺭﺳ ﻮېﻪﻏﮑﻰﺩ ﭘ ﺘﻮﺳ ﻭﻍﭘ ﺭﺎ
ﻧﺩ
ﻡﻭﺭﺪﻨﺎکﺳ ﻴﮏﺷ ﮐﺴ ﻮﻪﺗﺎﭘ ﻣ
ﺭﺩﻭﺮﺘﻳ
ﺮﻳ،ﺍﺮﻭﺷﻲ ﮑRﻪﺩېﻓ ockymountﺗ ainSpot tedFev er
ﻭ.
ﺩﻱ ﻮ
ﻮﺟ ﻪکېﻣ ﺒ
ﻪﺗ ﻠ
ﻣ ﻪﺍﻟﻮ ﻠﻣﺭﻭﺩﺩ ﺍ
ﻧﺲ ﺭ
ﺗډﻭﻦ ﻮﺏﺍ ړﺳ،ﭖ ﻟﻰﺍﻭﺭﻮﻪچېﺳ ﻧﻮﻳﺍﻪځ ﻐ،ﻫړﻩ
ﺯښﺕﻭ ﺩ ﺭﺍ
ﻪﺩ ﻨ
ﺘﻮﮐ ﺎﺟﻧﺴ ﻮﺍﻣ ﺮ
ﻧﻭ ﻮﺍﺗﺩﻋﻀﻼ
ﻭ.
ﺪﻱ ﻧﺭګﺯﺱڅ ﻭﺮﮑﻧﻮﻳﺎ
Myﻭﻣ
osiﺍ tis,Necr otizingFasci ti
ﻮs ﺮﻱﻧ ﻟ
ﻴﮏﻥ ﻮﺟﻟﻭﺭ
ﻮ ﻴځﻱېﻧﻭﺍ ﻟﻰﺍ ﺍﻮ
ړېﺷﺨ ﺎﻩﺩﻏ ﺭﻥګ ﺍﺪﻤ
ﻩﻫ ﺭﺎ
ﭙﺘﻲﻟ ﭘﻮﻟﺎﻔﻧﺴﺍ
ﻪﺩ ﻨ
ﺘﻟﺖﮐ ﺎ
ﺎﻏﻲﺣ ﻣ ﺩﺩ
.ﺮﻱ ﻟﺯښﺕ ﺭﺮﺍﻳښېډ
ﻭﻭﻍټ ﻮټ ﻭﻱﻏ ﺎ
ﻔﻤﻟﻟﻲﺩﺍﻣﻲګ ﻮﻨﻴﻠ
ﭙ،ﺳ ﻟﻲﺍﻣﻲګ ﻮﺗﺎﭙ
ﻴ:ﻫﻪﮑ ﻮﻥﻟﺘﻟﻲﺷ ﺍﻭﻭﺩﻍټ ﺩړ
ﻩﻍ ﺭﻥګ ﺍ
ﺪ ﻤﻫ
.ﺮﻱﻟﺯښﺕ ﺭ
ﺎﺕﺍ ﻳﺮکﺕﺕﺯ ﻭﺗﺤ ﺍﻧﺲ ﺭﺪﻨ،ﺗﻟﻰﺍﻮﺘ
ﺍ،ﺳﺨ ﻭﻯځﻯ ﻭﺩﺩ ﻟﻰﺍﺍ
.ﻩﻪﺩ ﻤﻬ
ﻩﻣ ﺭﺎ
ﭙﻟﻮﻴﻭﻏﺭﺎﻭﻱﻧ ﺮﺯﻫﻪﺩﻨﻳﺎ
ﻌPeniﻣ ﻭs ﺪﺍﻌﻘ،ﻣ ﺒﻞﻬﻣﻩﺩ ﺭﻥګ ﺍ
ﺪ ﻤﻫ
ﻪﻨ
ﻠﻣﺭﻮﺩ ﻴﻭﻏ ﺎﺭﻧﯽﻧ ﺎﺘﻧﺩﺍ
ﻴﻦﻠ
ﻨﺴ ١کېﭘ ٩٤ﮐﻝ٠ﻪﺎ ﻭﭘ ﻮﻝﺍSulﮐﺸﻒﺷ foneami ﻩdes ﺭﺎﭙ
ﻟ ړﻱځﻝ ﻮﻡ ﻟ١کېﺩ ٩٣ﮐﻝ٦ﻪﺎ ﭘ
.ﺗﻞﻭﻭﺍډﺭﻪﺭ
ﻴﻦ ګﺗ ﻳﺴﺎﻣ ﻮﺘﭘﺮﺘﻭﺳ ﺍ
.ﮐﻝﻭﻩﺎ ﺭﻮﺍﺕګﻏ ﻪﺭﺗﻮﺩﻣﻦځ ﻠﻣﺭﺪﺩ ﻭﺏ ﺿ ﺮﮑﻴﮐﻝﺩﻣ ١ﺎ ٩٥٠
:
ﻳﻲ ﺍﻭﺍﺏﻭ ﻭﻪځ ښﻮﺗﻨ
ېﻮ ﺗ ﺪﭘ ﻧﺪﻻ ﻳﺎ
ﺭﺑډکټ ﻪﻣﺨﮏېﺍ ړېڅﺧ ﺭک ﺮﻭﻮﺗ ﻠ
ﻣ ﺭﺪﺩ ﻭﺏ ﺿ ﺮﮑﻳﺎﻣﺩ
؟ږﻱﻩکږ ﺮ
ټﺮﺳﻨﺲ ﺗ ﻭﺮﺑﻴﮏېﻥښ ﭘ ﻨ
ﻴﻠﮐ
ﻪﺩ ﻨ
ﻠﻣﺭﺪﺩ ﻭﺏ ﺿ ﺮﮑﻴﻣ ﺎﺩﻳ.ﺍ 1
ﻧ؟
ﻪﻪ ﻮﻱﮐ ﻟږﻝﺷ ﻪﻲ ﺭﺗﺍ
ﻮﺗﺍ
ﺮ ﺑ
ﺩﻻ ﺍﻮﺮﺿﻲﻣ ﻩﻣ ﺭ
ﺎﭙﻟﻴﺺ ﻴﮏﺗﺸﺨ ﻮﺟ ﻟﻮﻴﺑﻭﺮﮑﻴﺎﻣ ﻳ.ﺍ 2
ﻭ؟
ﻩﻱ ﻪڅ ﻻﻞﺑﻠﻲ ﻣ ﮐځﺭۍﺍټ ﺭﻥ ﻭ ﻭﻍﺩ ﺭﺎﻧ
.ﺩ 3
ﻣﻦځ ﻭﺩ ﻤﻲﭘﻲښ ﻭﻫﻮکېﺩﺩ ﮑﻠﻮﺧ ﻳﻮﻪﺷ ﺘﻪﺍﺧ ﻭﭘ ﺗڅ
ﺷ،ﺮﻭﻝ ﻲ ﺭﺎﮐﺪﻭ ﻳﺎﺎﺕﺑ ﻣﺎﻤﺘﻮﻡﺍﻫ .ﮐ 4
؟ﻮﻯﻭﺷﻲ ﻴﻨ
ﻪﻣﺨ ﺩﻭڅﺧﻪکﺩ ﺘﺍﺧ ﻮﺩ ﮑﻠ
ﻭﺧ ﺭﻮﻭﻫﻢﺩﻧ ﻮﺍﻠﺗﺍﻪﺭﺗ
ﺩ؟
ﻩﻩ ﺭﻭﻪګټ ﻭﻍﺗﺭﺎ
ﻪﻧ ﻨﻠﻣ
ﺭﺪﺩ ﻭﺏ ﺿ ﺮﮑﻴﻣﻪچېﺩ ﺘﻴﻞګېﺷ ﻴﮏېﺑ ﻨﻴﻠﺎﮐﻳ.ﺍ 5
ېﻮښﺪﭘ ﻧﺪﻻ ﻳﺎ
؛ﺑﻮ ﻮﻡﺷ ﻠﻌﻪکېﻣ ﻠ
ﻳﺎ
ﻪﭘ ﻮﭘ ﺗ
ﺎﻨﻳﺎ
ﻌﺭﻱﻣ ﺍﻮﺗ
ﺍﺮﺑﻻﻞﺩﻻګﻯ ﻣ ۍځﻥ ړ
ﻭﻍ ﺍ ﺭ ﺎ
ﻧﻪچېﺩ ﻠ
ﮐ
ﺷ:
ﻮﻝ ﻲ ﻴﻧﺮکېﻭ ېﻪﻧﻈ ﺗﻦ ﭘ
ﻮﻠ
ﻣﺭﻮﺩ ﻳﻮﻭﻉﺷ ﺮړﻲﺷ ﻮﻡﻧ ډﻝﺩﻟﻨﻲ ﻭ ﻴﻤﻪﺗﺨ ؛ﻮﭘﻮﻧ ﺪﻝﺷ ﻧژژﻣﻞﻭﭖ ﺎګﻯﻋ ېځﻥ ړ
ﻪچ ﺍ ﻠ
.ﮐ 1
؟ﻭﻉﺷﻲ ﺮﻣﻞﺷ ﺭﺪﺩ ﻭﺏ ﺿ ﺮﮑﻴﻣګﻱﺩ ځﻥ ړﺪﺍ ﻳ ﺎ
ځﻯﺑﺮﺍ ﭘ
ﻧ؟
ﻪﻪ ړﻦﺩﻱﮐ ﻭﻝﺍﻳ ﺭﺎګډﻝﮐ
ﻪ ډﻭ ﻮﭘ ﻠ
ﻣﺭﺪﺩ ﻭﺏ ﺿ ﺮﮑﻴﻭﻣ ﺎڅ ﺪﻳ ﻭﺏ ﺿ ﺮﮑﻴ ﺩﻮﻣﺎﻳ ﻳ.ﺍ 2
ﺩ؟
ﻩﻩ ﺮﻣﻭﻩڅ ﺩﻮﻠﻦېﻣ ﻣﺭﻭﺩﺩ ﺍﻻﻩﻴﻖ ﺭﺒﺗﻄﺩ،ﺩ
ﺯړﻭ ﻮﻭ ﻠ
ﻣ ﺭﺪﺩ ﻭﺏ ﺿ ﺮﮑﻴﻣ .ﺩ 3
ﺮګﺒړﺪېﻏﻧېﺮﻭﺍ ﻠﻦ ﭘ ﻣﺭ
ﻮ کېچېﺩﺩ ﻧﺍ
ﺭﻭﻮﺭﻥځ ﻐﺮﻫ ﺪﭘﻳﺎﻪﺑﻧﻮﺗﺎﻱښ ﻣﺯګﻱﺍځﻥ ړﻮﻡ ﺍ .ﮐ 4
؟ﻮﻝﺷﻲ ﺍﭼ ﺭﻭﺎﻪﮐ ﻭﻱﭘ ﺪﻧﺭګ ﻪڅ ﻭﻥﻧ
؟ړﻱﻪﻭک ﺘﺮﺳ ﻩﻣﺮﺩﻭﺳ ﻩکﺩ ﻮﺎﻥﺩﻣﺤ ﺘﻧﻭﺩﺍ ﺗڅ
ﺷ،ﺮﻭﻝ ﻲ ﺭﺎﮐﺎﺕﻭ ﻣﺎﻤﺘﻓﻲﺍﻫ ﺎ
ﻮﻡﺍﺿ .ﮐ 5
6
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
:
ﺎﺏ ﺘﺨﻧﻮﺍﻠﻣﺭﺪﺩ ﻭﺏ ﺿ ﺮﮑﻴﻣ:ﺩI
ﻮﻟ
ﻭﻩډﻭﻪﺩﻪﭘﻧﻭﺭ
ﻮﺘﮑېﺍﻓ
،چ ﺩﺮﻱﻩﻟړ
ﺭېﺍﻮﻮﭘﻧ
ﻭﺭﻮﺘﮑﺭﻓﺷﺭ
ﻮ ﻢ ﺎﺏﻳ ﺘﺨﻧﻮﺍ ﻠ
ﻣﺭﺪﺩ ﻭﺏ ﺿ ﺮﮑﻴﺩﻣ
ﺩ:
ﻮﻱ ﻱ ﻭﺵﺷﻞﺷ
:
ﻪﻧﻭﺭﻭړﻲﻓﮏټ ﺭېﺕﻟ ﻮﻪﭘ ﺑﺭﻮ-ﻪﮐ١ﭘ
.
ﺭﻮﻭﻧ
ﻭﻏﻲﺍ ﺭ
ﺎﻧ
ﺭ،ﺩځﻱګ ﺯ
ﺍډﻪﻱ ﮑﻟﻮﻥ ﺘ
ځﻯﺷ ﻮﺍ ﻮﻳ ﻴﻭﻏﺭﺎﻭﻧ:ﺩڅ ﻟﻒﺍ
.
ﺰېﻴۍﺪېﺍﻏېﺎﻣﺨﮏﻥﻥ ﺑ ﺮﻳ ﻴﻮﺗﻠﻣﺭ:ﺩﺩ ﺏ
.ﻪ
ﻠﻣﻪﺍﻟﻮ
ﻴﻭﻏﺭﺎ
ﻧﻭﺩﺭګﻮﺗ
ﺭﺎ ﭖښﻟﻰﺩځﻱګﻳ ﺍﻮﺑﺍ
ﺮﺩﻭﺧﺭﺝﺩ ﺎ
Dﻭﺧ etﺍ oxifiﻮﺩed ﻠ
ﻣ ﺭ
:ﺩﺩ ﺝ
ﻋ.
ﺮځﺭ ﻤ
ﺭﻥ ﻭ :ﺩﺩ
.ﺭﻱﺍﻭﺪﻴﻣ:ﺍ ـ
ﻩ
:ﻪﻧﻭﺭﻮﺘﮑړﻲﻓﺭېﺕﻟ ﻮﻮﭘ ﻠﻣﺭ
-ﻪﺩ٢ﭘ
.
ﺮﻴﻬﺩﻭﺑ
ﺭﺝﺩ ﺎﻭﺧ ﻊﺍﻳﺯﻮ،ﺗﺬﺏ ﻣﻞﺩﺟ ﺭ:ﺩﺩ ﻟﻒﺍ
ﺗ.
ړﺎ
ﺫﻭ ﻴ ﻮﻔ
ﺎﻧﺩﻭﻳﺮﺩ ﻴ
ﻮﺩﺗ ﻠﻣﺭﻪﺩﺩ ځﻯﺗﺘﻦ ﺍ ﻨ:ﻣﺏ
.
ﺭﺕﺪﻭﻗ ﺪ ﻴ
ﻠﻮﺩﺣ ﻠ
ﻣ ﺭ:ﻪﺷﺤﻢکېﺩﺩ ﺝﭘ
ﺳ.
ﻩﻮﺮ ﻠ
ﻣﺭﻭﺩﺭ
ﻮﻧﺰېﺩﻴﺘﮏﺍﻏﻴﻧﻮکﻥ ﻣﺭﺎﻭﻓﻴﮏﺍ ﻣﺎ
ﻨﻳډﻮﻣﺭ ﺎ
ﻮﻓ ﻠ
ﻣ ﺭ:ﺩﺩ
ﻪ کېﺩﻨﻠ
ﻣﺭﻠﻲﺩﮐﭘﺍټﺩ .ﻪ
ﻬﻢ ﻯﺭﻣ ﺭ
ﺑﻞ کېډ ﺎ
ﻘﻪﻣ ﻮﭘﻠﻣﺭﻴﺖﺩﺩ ﺎﺳﻭﺏﺣﺴ ﺮﮑﻴﺎﻣ ﺎﻥﻳ ﺘﻧ
ﺩﺍ
ﻭﻴﮏﺍﻣ
ﺎﻨﻳ
ﺩﻮﻣﺭﺎ
ړﻓﻪﻭﻭﻍﺗﺭﺎ
ﺮﻧﻣﻞچېﻧﻈ ﺭﻪﺩﻐﻪﻣﻦځکېﻫ ﻮﭘ ﻠﻣﺭﻭﺩﻭ ﻧﮏ ﻭ
ﺮ ﻟﻮﺗ
ﺍﺮﻴﺛﺎﺎﻥﺗﻮﺷ ﻳ
ﺷ.
ﮐﻞ ﻲ ﺍ
ﻪﻭﻱﻭټ ﻧ
ﺍﺯﺭ
ﻪﻱېﺍ ﻴﻭﺑﺮﻱﺍﻟﺰېﻭ ﻴﺘﮏﺍﻏ ﻴﻧﻮکﻥ ﻣﺭﺎﻓ
7
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﮐﻰ
ﺮﭘﻭﻫﻢڅ
ﺩ
ﻭﻍۍﺭﺎ
ﻧﻲﻧﺎ
ﺘﻧ
ﺍﺎﺻﻲ ﺘﺼﺍﺧ
ﺯﺱ ﻮﻠ
ﻴﺷﺠ
Baci
ll
aryDysentr
y
:
ﻳﻒ ﺮﻌ
ﺗ
ﻪﺭځﻱ ﭼﻪﺍ ﺗ
ﻪﻣﻦځﻠﻣﻼﻪﺍﻴﻟﻩچېﺩﺷﺠ ﻭﻏﻲﺩ ﺭ
ﺎﺑﻲﻧﺎ
ﻬﺘﻟ
ﻧﻲﺍﺎ
ﺘﻧړﻥۍﺍﻩ ﺏړ
ﻮﻮﻳ ﻤﻟ
ﻮﮐﻭﺩﻍټ
ﻪﻪﮐsmalڅﺧ lbl
oodymucopur ul
entstiﻭool
ntﺍesti
nalcrﻪ ampsﺒﻪﺗﻩﭘﺘﺼﻒﺩ ﻣ
ﻭﺮﻱﺍﺘﻰﻟﺎﺳﻠﻦﻧﺲﻧﺑ
ﻭ ﺯېﺍﺍ
ﻮﺎﻥﻳﻭﻏﺭﺎ
ﻮګڼﻧ ﻳﻲﺧ ﺍ
ﺮﻱﻭﺘﻧﺰ
ﻳﺮﻱﺩ ﻠ
ﻴۍﻪﺑﺴ
ﻭﻍ ﺗﺭﺎﻩﻫﻢﺩېﻧ څ
.ږﻱ
ﻪکږ ﺘ
ﻪﺍﺧ ﺮﻱﻧﺘ
ﻨﻳﺰ
ﻳﻪﺩﭘ
ﻳﻞﻭﻪﻱېﻭ ﻟﺖﺗﺎ
ﻪﺣﻐﻭﻫ ﻮﺍﻭﻝﺷﺭﺎﮐ
ﺍﻭﻮﻟﺨﺍﺕﺮﮐﻮﭙ
ﻴﻩﺩﻫﺭﺎ
ﭙﻟړﻱځﻝ ﻮﻡﻟ
ﺮﻱﺍﺻﻄﻼﺡﺩ ﺘﻨﻳ
ﺰﻳﺩﺩ
ﻭ.
ځﻯ ﻱﻮﺍ ﻩﻳ
ﺮﻪﺳ ﻌ
ﻓﻪﺩﮐ
ﺎﻧ
ﺩ ﺭ
ﻭﺩﺎﻁﺍ،ﻣﺨﻪﻨﻳ
،ﻭ،ﺯ
ﺎﻴﺘ
ﻮﻡکېچېډکېﻣ ﻪﮐﭘ
ﻣ:
ﺒﻲﻻﻞ ﺒ
ﺳ
ﻪﺩﻴﻞﺩﯼ ﭼnon sporﺑﺴef or
miﻪ ng ﺘ
ﮐﺮﻔﻲ ﺏې ﺣ ﻨﺍﻡ ﻣ
ﺭﻨﻰ ګﻮﭼﻮﮐ ﻴﻼﻳ ﺷﺠ
.ﺮﻱﻟ
ﻭﺍړ
ﺭېﺕ ﻮﻴﻞېﭘﺒ
E.ﻗCol
i ﺎﺩﻴ
ﺑﺍ
ﺮﻱچېﺩ ﻟﻩړﺭېﺍﻮﺭﻥۍﭘﻮﺎﺳﻲﮐﻳﺮﺘ
ﮐﺎﺑ
ﻭﺮﻴﺘ
ﻧﺍ
ﻪﮐﺸﻒﺍﺳﻄ
ﻮkiﭘ
yoshishi
ﻮﺟﺲټga ﻟ
ﻮﻴﻭﺑﺮﮑﻴﻧﯽﻣﺎ
ﭘﺎﻮﺟ ﮐﻝﺩﻳ۱ﺎ۸۹ړﯼځﻝ۷ ﻮﻡﻪﻟچېﭘ
ﻪﻟ
ﺭﺕﺩﯼ ﺎ
ﺒﻬﻢﻳﯽﻋﻪﻣﻮﯼﭼﺪﻝﺷ ﻧﭘژ
serﻲotypes۴ ۳
ﻴﻼ۰ﺭﯼﺩﺷﺠ ﻮﻪﭘﻭﺳﺍﺮﻮﺗﺷ
(Grﺮﻱ)oupA ﺘ
ﻧﺰﻳ
ﻴﻼﺩ .ﺷﺠ 1
(GroupB)Shi gell
aFlexneri . 2
(Grﺩﻱ)oupC ﻮﻴﻼﺑ .ﺷﺠ 3
(GroupD)Shi gel
laSonnei . 4
:
ﻮﺟﻲ ﻟ
ﻮﻤﻳﺪﻴﭘ
ﺍ
ﻮﺳﻢﻪﻣ ړﻱﭘﻭﺍ
ﻮﺩﺍﺷﻲﻧ ﻟﻰﺭﺮﻧﻲﭘﺴ ﺍ
ﺭﺎﻪﺑﺘ
ﻭﺳ ﺭ
ﻪﻭ ﻣﻲڅﺧ ﻭچژﻪچېﺩ ﻠﻠﻲﺩﻱﮐ ﻳﺍﺕﻭ ﺮ
ﮐﻮﭙﻴﻫ
ﻭ.
ﺮﻱ ﻱ ﻳ
ﺮﻱﭘﻲښېډ ﺘﻧﺰﻳ
ېﻪﺩﺩکﺑ
ﻩﻭڼګﻩګﻮ ڼ ﻳ
ﺩﻭړ
،ګ ﺎﺕﻧﺸﻲ ﺍﻋﺮﻩﻣﻪښ ﻨ
ﺗﺎﺎﺳﻴﺘ
ﻭﻏ ﻮ کېچېﺭ ﻧ
ﻮﻳﺍ
ﻪځ ﻐﻪﻫ ﭘﻲښېﻱېﭘ
ﺎﺕﻳېﻪﻭﻱﺯﺩﻧ ﻮ
ﻮﺟ ﻪﻣﺑﻭﺎکېﺍﻩ ﺻﺤﻲﭘ ﺭﻥګ ﺍ
ﺪﻤﻭﻫ (ﻭﻱﺍ ﻪ
ﻧﻮﺒ
ﺘﮑ،ﻣﻪﻧ
ﻮﻧﻮﺘﮐړ
،ﻭﻪﻧﻮﻧ
ﺍﺪﻧ
ﻪﺯ ﮑﻟ
)
ﺪﻝک ﻴﻟﻪﻭﻱﺘﮐﻪښ ﻮڅﺧ ﻠﮐېﻪ٥
ﺮﻱ ﻟ ﻤﻮکېچېﻋ ﻧﺎ
ﻣ ﻮﺎﺷﻮﻣﻐﻪﻫﻪﭘﻩﮐﭽ ﻟړ
ﻭﻍۍﻮ ﺭﺎﻧ
ﺩ،ﺩ
ېﻱ
.ږﻱ
ږ
ﺍﻯﺩﺩ
،چېک ﺩږﻱ
ﻟږﻱﺭې ﻲFﻪﻻ ecalorﻟﻪﺩal ﺎﻥﺗﻧﺴﻪﺑﻞﺍ ﺎﻥڅﺧ ﻧﺴ
ﻮﺍ ﻪﻳﻩﻟﺮﺗ
ﺎﻳﻭﻍۍﺯ ﺭﺎ
ﻧ
ﻪﺑﻭ
،ﺍﻩړ
ﺍﻮﻩﺧﺮډﻝﺳﻴﻢ ﻭﻘﺘﻣﺴﺮﻴﻪﻏﺎﭘﻱﻭﻳ
ړﺍ ړک ﻪﮐﮏ ﻧﻮﺯېﻻﺳﺎﻴﺘ
ﻍﻪډکېﻣ ﻍﻪﻥ ﻏﺷﻲﻥﻍ ﭘ
.
ړﻱ ړېکﺪېﮐﮏ ﻴ
،ﺷ
.
ﺮﻱﻟﻭﻝﻩﺭﺭﻮﻪکېﻏ ﻧﺪﻳ
ﺩﻟږ
ۍﻪ ﻲ
ﻭﻍ ﭘ ﺭﺎ
ﻧﺎﻥﻫﻢﺩﻣﭽ
ﻭ کېﺯﺎﻴﺘ
ډﻮﻣﻪﮐ ﺰﻡﭘﻴﻧﺍ
ﺭګ ﻭ
ﺭېﺍ ﻮﻮﭘ ﻴ
ﻧﻭږﺍﺮ ﺷﭗ ﺘﻰﺗ ﻟﺖ کې ﺣﺎﻪﺣ ﻭﻍۍﭘ ﺭﺎﻧ
ځﺭﺩﺭﻥ ﻭ
.ﻭﻱﺩﻟږ
ﻪﻲ ﺎﻝﺗﻳﺮ
ﻴﭘﺎﭼ
ﻭﺣﻝکېﻩ ﻪﺎ ﻭېﭘ
ﻮﺩ ﺩ ﻪﺩﻯﺧ ﺎﺕﻧﻳﻩﺯﺮﻣﻭﮑﻞﺩﺪﺷ ﻳﺪﻭﻍۍﺷ ﺭ
ﺎﻧ
ﻮکېﺩ ﻧﻭﺩ
ﺍﻭﻭﺘﻲﻩ ﻌ
ﻨﻪﺻ ﭘ
.ږﻭ
ﻣﺦکږ ﺎ
ﻩﻣﺨ ﺮﺮﻱﺳ ﺘﻨ
ﻳﺰﻳ
ﻧﮏېﺩ ﻭ
ژﺘﻰﻭ ﺪﺣ ﻳ
ﺪۍﻪﺷ
ﻭﻍ ﻟ ﺭﺎﻧ
ﻮکېﺩ ﻧ
ﻭﺩﺍﻭ
ﻪﻤﻞېڅﺧ ېﻪﺩېﺟږﻱچ ﻟﻪکږ ﺘﻭﻍۍﺍﺧ ﺭﺎ
ګﻱﻪﺩېﻧ
ﻪﻭړ ﭘ ﻧﻮﻠ
ﻴﻣ١
٦ړۍکې٥ ﻪﻥ ﻟ
ﻭﻪټ ﺎﻝﭘﮐﺮﻫ
ړﺎﺕﻡﻳﻪﺯﻮﻥڅﺧ ﻠﻴ
ﻩﻣﻮېﻪﻳﺩﻟ ږږﻱﻭﻥ
ﻪکږ ﺍ ﺗﻣﻦځﺍﻮکېﺭ ﻧ
ﻭﺩﺍﻭ
ﻭﺣﻝﻩﻭېﻪ ﺎ
ﻪﻭ ﺩ ﭘ ﻧ
ﻮﻠﻴ
١ﻣ ٠
٠
8
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
.ږﻱ
ﻩکږ
(%٦١)ﺩ.
ﺎﺕ ﻯ ﻳﻪﮐﻢﻭﻱﺯ ﻮڅﺧ ﻧﻮﻠﺮﻱېﺩ٥ﮐ ﻤﻮکېچېﻋ ﻧﺎ
ﻣﻮﺎﺷﻮﻣ ﻐﻪﻫ ﻪﭘ ﻨ
ﻳړﻡ
:
ﺰﺱ ﻴﻨﻮﺟ ﺘ
ﭘ
ﻌﻲ ﻧ
ﺎﺪېﺩﻣ ﻌﻣږﻱﺩ ﻠﻲﺍﺧ ﺭېﺩ ېﻪﻻﻮﻝ ﻟ ﺎﻥﺩﺧ ﺘﻧ
ﺩ،ﺍﻪﻱ ﻧﻮﻣﺰﻴﻧﺍﺭګ ﻭ١ﺍ٠٠
-١ﺯ٠ﻭﻧﻲﺩ ﺎ
ﺘﻧﻭﻍۍﺍ ﺭﺎﻧ
ﺩ
.ﻮﻱﻪﺭﺳ ﻮﺗ ﻤﻟ
ﻮ ﻱځﻥﮐ
ږ ﺍ ﺮﻱ ﻴﻩﺗﺮﺎﻥۍﺳ ﻪﺍﺳ ﻪﭘڅﺧ
ﻴﺴﻲ ﺪېﻧﻧﺪﻻ ﻳﺮﺮﺑښﻲﺗﻮﻟ ﺎﺝﻱېﭘ ﻧﺴ ﺍ
ﺪﻴﺋﻮﻔﻤﻮﻟ ﻤﻟ
ﻮ ﮐﺭېچېﺩ Mﻪﻻ celﻟ lﻟﻢېﺩs ﻮﻴﻼﮐ ﺷﺠ
.ږﻱﺭﺳﻲ Tﻪﻭiﺗ ghtJunct iﻮon ﮑ ﻧﻭﻴﻞژ ﻠ
ﺘ ﻴ
ﭘﺍﮐﻻﻯﺩځﻪچېﻧﺸﻲ ﻮ ﮐ
ﺭﻑژ ﻮﻟﻲﻣ ﻮﭘﻭﺩ ﻭﺍﺪﻳﺩﺍﺯﺍﻮﺩ ﻧﻮکﻥ ﺘﻳﺎ
ﻮﺩﺳ ړېﺷﻲﻧ ﺎ
ﻳﺠ ﻧﮏېﻭ ﻭﺪې Mژ ﻧ
ﺎﻁﻻ ﻣﺨ ﻪچېﺩ ﻠ
ﮐ
ﻪﺧﻼﺻﻲ ﺍﺳﻄ ﻪﻭ ﺭﻑﭘ ﻮﻟﻲﻣ ﻮﭘTﻪﺩ
iﺗ ghtJunct iﻻﻩonﻩﺭ ﻮ ږﻱﻭﻳ
ﻻﻞکږ ﺍ ﺩﻭ ﻣ
ﻭکﺩ ﻮﺩټ ﮑ ﻧ
ﻭ
ﻴﺴﻲ ﻧ
ﺪېﻭ ﻧ
ﺪﻻ ﻳﺮEﺮﺑ
ntﺗ erocy t
ﻪe ﺩېڅﺧ ﺮﻭﻱﭘ ﺪﺎﻋﻗﮐﻻﻯﺷﻲچېﺩ ﻴﻼ ﻮ ﻭﺱﺷﺠ ﻮﺍږﻱﻧ
ﺩې
ږﻱچې ﺩ ﺮﻱﭙﻪﺧ ﺮېﺗ ﻪﺑﻞې ﺣﺠ ﺮېڅﺧ ﻮې ﺣﺠ ﻪﻳ ﻮﻟ ﻮځﻱﻧ ﻨﻪﻧ ﻼﻡﺗ
ﭘﺯ ﻮﺘﻳﺎ
ﻪ چې ﺳ ﻠ
ﮐ
ﺩ.
ﻴﻦ ﻯ ﺗﻭﺮ120-ﭘ ﻮKDaUncode ﻴﻦﻳ ﺍﺟﻮﻱﺩ ﻮﺏﮐ ﺘ ﻳړViﻣﻦځګ ﻩrGgene ﺭﺎﭙﻟﻭﺳﻲ ﺮ
ﭘ
ېﺍ
ﻪچ ﺩ ﻧﻮﻨﻴﺎﺕﺟ ﻳﻻﻦﺯړﻦﺩﻯ ﮐ ﻩﺍﻳ ﺭﺎﭙﺪﻟﻳﺮﺑ
ﻴﻼﺩ ﻟﻰﺩﺷﺠ ﺍﻮﺘﺪﺷ ﻴﻣﺯ220-ﭘﻼ ﻩﻫﻢﺩKB ﻪڅ ﮐ
.ږﻱ
ﺪﻝکږ ﻴ ﻟﻭﻡکې ﺯﻮ ﻣﻭﺮﻪﮐﻮﻱﭘ ﻤﻴﻨﻈﻪﺗ ﻭﺳ ﺮ
ﭘ
ﻭﻱچ ﺟړ
Exotﻮ oxiﻤﻦn ﮐﺍﻭSﻮځ .ﻳ Dy senter yTy ﻪpe1 ﮑ ﻟﻪﻧﻮﻟ
ﻭ ﻌﻀﻲډ ﺮﻱﺑ ﺗ
ﺰ ﻨ
ﻳﺍﻴﻼﺩ ﺩﺷﺠ
ﻮﻧﻭﺩګ
ﻭﺭ ﻪﺩﻯﺍ ﺗﺭﻪﻭ ﻴﻦﺗ ﮐﺴ ﻮE.ﺗCol ړښﺕﻱېﺩi ﻮ،ﺟ ږﻱ ﺩﻱ ﺎ
ﻮﻡﻳ ﻪﻧ Shiﭘgat oxi ېﺩn
.ﻮﻱﺗﺎ
ﻳﻳﺐﺯ ﺮﻌﻲﺗﺨ ﻮﺿ ﻣ
ﻪک ﺗﻣﻦځ ﺍ
(ﺭ H.U.ﻭﻡ)S ﺭﺪﻨﻴﮏ ﺳ ﻤﻳﺭﻮﻴﮏﻳ ﺘﻳﻮﻻ ﻤﻴﻪﻫ ﻠ
ﻣﻪﺍ ﻭﻟ ﺪﻳﺮﭙﻣﻲﺧ ﻮﻤﻴﻦﺩﻋ ﮐﺴ ﻮﺩېﺗﺩ
.ږﻱږ
.ږﻱ
ﻩکږ ﺮﺮﺳ ﺍﺡﺗﺮﺍﻃ ﻮﺗﺎﻌﻳﺎﻣ
ډﻝﺩ ﺎﻝ ﻭ ﻌېﻪﻓﻮک ﭘ ﻤﻟ
ﻮﻮﮐ ﻴﻨﻮﭼ ﻪﮐﭘ
:
ﻩﻴﮏېﺏڼ ﻨﻴﻠ
ﮐ
ﻮﻤﻟﻮ
ﻮﮐ ﻳﻮﻟ،ﻪ
ﺩﻭﭘﻊکﺩ ﻳﺎﺎﺕې ﺿ ﻳﺯ
ﻮﺩ ﺗﺎﻌﻳ
ﺎﻣﻪﺩ ﻮڅﺧ ﻤ ﻟ
ﻮﻮﮐ ﻴﻨﻮﭼ ﻩﻪﮐ
ﻴﮏېﺏڼﻟ ﻨﻴ
ﻠﺮﻱﮐ ﺘﻧ
ﺰﻳﺍﺩﺩ
ﻪﺗﻣﻦځﺍﻪﺭﻠﻣﻪﺍﻭﻟ ﺰ
ﻴﺑﻲﺍﻏ ﺎ
ﻬﺘﻟﺍ
Exotﺩ oxiﻭn ﻮﺍ ﻧﻮﻤﺯﺧ ﻮﺩﻤ ﻟ
ﻮ ﻮﮐ ﻳﻮﻟ
،ﺩﻟﻰ ﺍ
ﻮﺑﺍ
ﺮﺬﺏﺧ ﺎﺟ ﻴﺑ
کېﺩ
.
ږﻱکږ
ﮐږﯼﻳﺸﻞ ﻲ ﻮﻭ ﻠ
ﺮﺣ ﻭﻣ ﺭﻮﻟ
ﻪڅ ﻩﭘﺮﻨﻈﮑﯽﻣ ﻴﻨﻴﻠ
ﮐ
ﻭړﯼ
ﻡ ک ﺍﻭﻭځﯼﻫﻢﺩ ﻪ۸ﺭ ﻠﻪﮐﻠﺍﯼﺷﯽﮐ ﺪﻴﻭﮐ ﺍﻭځﯼﻭﯼ ۴ﺭ -ﻩ۱ﺭ
ﻭ ﻳﺤﯽﺩ ﺮﻔـﺗ
۱
crډﯼampy ؛ﻱﺎﻳﯽﺩ ﻬﺘﻠﯽﺑﯽﺍﺷ ﺒﻤﻪﺗ ﺒ
ﻪﺗﻭﻍﺗ ﺭ ﺎ
ﻪﮐﯽﻧ ﻠﺮﺣﻪﻣ ﻟ
ﻭ:ﻪﺍ Diﭘarrـhealphase ۲
ﮐږﯼ
ﺍﻲ ﺪﻴtﭘ ﯼﻭenusmus ﻪﮐﻦګ ﺍ ﻧ
ﻭﺩ ﺭ
ﺩ
ﻭﻍﺩ ﺭﺎ
ﮐږﯼﻧﺍﯽ ﺪﻴdyﭘ sent erﻪy ﻭﻍﺗ ﺭﺎ
ﻭﻧﻭځﻭﺭ ﻮﺍ ﻧﻮ
ﺘﺎﻋﻪﺩﺳ ﺘﻭﺳﺭﻭDy sentri
cPhase- ۳
ﻭﮐﯽﺩ ﺯﺎ
ﻴﺘډﻮﻣﻪﮐ ﺩﭘ ﺭډﯼﺩ ﻩﺩګﻱ ﺭﻥګ ﺍ
ﺪﻤ،ﻫﻮﻱ ﺯېﮐ ﺎ
ﻴﺘﺭېډکېﻣ ﻮﻪﭘ ﻟ
٤ځ ﻟﻰ٠ ٢ﺍﺭځې٠ ﻭﺩ
ﻮﮐﯽ ﮑﻠﻭﺧ ړ
ﻭﺯ ﻮﺍﻧﺎﻣﻮﺎﺷﻪﻣ ﻪﭘ ﻠﻪﮐﻠﻪﮐ ﺪﻭﯼﭼ ﻳﺪ ﻩﺷ ﺮﻣﻭﮑﯽﺩ tﭘﺍensmus ﻳﺖﻭ ﺩﻮﻮﺟ ﻨﯽﻣ ﻳﻭ
ﮐږﯼﺒﺐ ﻲ rﺳ ectalpr olﺩapse
ﺮﻪﺗﺗﺭﻭﯼﻭ ﺍ
ﺪﻭﺗ ﺎﻝﺍﻣﺭﻮﺘﻢﻧ ﯿﺴ ﺘﯽﺳ ﯿ ﻓﺎﻌ
ﻭﻍﻣ ﺭﺎ
ﻧﻪﺩ ﺗﺮﯿﻪﭼ Postiﮐ nfectiousphase - ۴
ﻪک ﻩﻧﺮﺮﺳ ﻭﯼﻫﻢﺗ ﺍ
ﺪﻭﺗ ﻪﻭﯼﺍ ﺎﻝﻧﻣﺭﻮﺘﻢﯾﯽﻧ ﯿﺴ ﺘﯽﺳ ﯿﻓ
ﺎﻌﻪﻣ ﯼﻭﮐږﺍ ﺟړﯼ
ﻭﻍ ﻮ ﺭﺎﻮﻧﻩﺷﯽﻧ ﺮﺳ
ﮐږﯼ
ﺒﺐ ﯽ ﻮﺳ ﺗﺎ
ﺘﻼﻃ ﺍﺧ ﯼﻮﺩړﻧ
: ﺎﺕﺘﻼﻃ ﺍﺣ
per f
oration, rectal prolapseToxi cmegacol on: l
ocal- ۱
hy pogl ycemi ahy ponny t
remi adehy drati
on: met abol i
c- ۲
:
other s- ۳
9
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﻭﻍﺭﺎ
ﻪﺩﻧ ﺭځﯼﭼ ځﻪﺍﻪﻣﻦ ﺗ ﺍﺳﻄﻮﭘSHGDy sent rhemolﺩy yt i
cur emi csy ndr ome -
ﺯﯼﻮﻮﮐﯽﺩﭘ ﺗ
ﺎﻻﻮﺣ ﻨ
ﻳﻪځ iﭘrrati
bi l
ty, astﻭ heni a، ﻓﺖ ﺎ
ﻪﺧﺴ ﻟﺭﺕﺩﯼ ﺎﺒ
ﻭﻋﻼﻳﻢﻋ ﺍ ﺽﺍﺮﺍﻋ
ګڅﻪ
ﺍﺕ ﺧ ﻨﯽﺭﻳڅﻪﺩﻭ ﻮ ﺧ ﻳﺭﻭﻭﺍ
ﺍﯼﺪﯿ
ﻪﮐ ﺘﻼﺕﺩﯼﭼ ﮑﻞﺍﺧ ﯿﻮﺟ ﻮﻟ ﻧ
ﻮ ﻤﯾﺍ
ﻭړ(ﺍﯼrﺩ eact ivear thrit
i)s Reitersy ndr ome -
ﻪﺘﺼﻒﺩﯼﭘ ﻭﻣ ﺍﺳﺸﯽﺍ ځﻪﺭﻪﻣﻦ ﺗ ﺍﺳﻄ ﻮﺮﯼﭘ ﻨﮑﺴ ﯿﻠ
ﯿﻼﻓ ﻮﺩﺷﺠ ﺘﺎﺷﯿﻭﻣ ﻮﺍﺘﻔﻪﺩﻫ ﺘﻭﺳ ﺭﺷﯽﺩﻭ
ar t
hr i
tisconj i
ct viti
sur it
hrits
ﻪﻭﯼﺩ ﺗ
HIﺍ ﻭ V ﺬﯼﺍ ﻐﻭﺗ ﻮﻪﺳ ﻪﭘ ﺭځﯼﭼ ﻪﺍ ﻮﮐﯽﻣﻦځﺗ ﮑﻠ
ﻪﺧ ﻐﻪﻫ ﻩﭘ ﺮﺜﮐ-Bactﺍ remi a
ﻮﮐﯽ ﻧ
ﺎﻭﻏﺭﺎﻩﻧﺮﻤڅﻪﮐﻢﻋ ﻮ ﺧ ﻧ
ﻮﻟﺎ
ﻩﺩ۵ﮐ ﺮﺜﮐ
SEZURES,ﺍ del i
riﻟﯽ um ﺍ
ﻮﺑﺍ
ﺮﻟﺖﺧ ﺎﺭﯼﺣ ﻮﻐﺷ
ﻮﯼﻟﺖﮐ ﻭﺩﻻ ﺭﺍﺰ
ﻧﺍﻮ ﺑ
ﺍﺮﻪﺧ ﻪﭘﺍځﯼﭼ ځﻪﺭﻣﻦ ﺗ
ﮐږﯼ
ځﻪ ﯽﺍﻣﻦ ﺗ ﻩﺭ ﺭﺩﺎVagiﻧ ni
tis, keratconj ictivitis، ﺎﯿ
ﻧﻮﻤ-ﻧ
:ﻴﺺ ﺮﻱﺗﺸﺨ ﻴ
ﭘﻮﺗ
ﺎ
ﻨﻴﺭﺳﺎ،ﻳﺯﺱ ﻮ ﻠ
ﻴﻧﻮﻤ
ﻠ،ﺳ C.Jejﻪuni ﮑ ﻪﻟﻠﺒ
ﻪﮐ ﻮﻟ ﻧﻮﻠﻣﺑﻲﻻ ﻭﺮﮑﻳﺎ
ﻭﻣ ﺭ
ﻮ ﻧ
ﮐﻻﻱټﺱچېﺩ ﺑﻲ ﻮ ﺎ
ﻬﺘﻟ
ﺍ
ﻣﻦځﺍﻪﺭ ﻠ
ﻣﻪﺍ ﺯﺱﻟ ﺎﻴﺒ
ﻴﻣﻪﺍ ﮑﻭﻍۍﻟ ﺭﺎ
ﻳﻲﻧ ﺍ
ﻭﺯﻮ ﺗ
ﺮ Dﻭﭘiﺍ ffi
cilﻮﻡes ﻳﺩﻭﺮﺘﻮﺳ ﻠ،ﮐﺘﺲ ﻳﻮﻻ ﮐﻭﺮﻴﺘﻧ
ﺍ
ﻭﻍۍ ﺭ
ﺎﻭﻥﻧ ﺮﻭﮐ ﮐﻻﻱټﺱﺍ ﻴﻒ ﻮ ﺗﺍﺮﻴﻟﺴﻩﻪﺍ
ﺭﻥګﻟ ﺍ
ﺪﻤﺷ،ﻫﻴﺺ ﻲ ﺮﻱﺗﺸﺨ ﻴ
ﭘﻮﺪﺗ ﻳﺎﻮﻱﻭﻱﺑ ﻪﺷ ﺗ
ﺷ.
ﻩ ﻲ ﺮﺮﺳ ﺮﺗ ﻴﭘﻮﻩﺗ ﺮ
ﺳ
:
ړﻥې ﻭﺍﻪﺭﺘﺭﻱﻻﺳ ﺍﻮﺗﺍ
ﺮ ﺑ
ﻭﻻ ﻴ ﺺﺍ ﺗﺸﺨ
ډﻮ
ټﻝ ﺷﻲﺩ ﮐ ﻴﻼﻭ ﻭ ﺮﻱ ﺷﺠ ﻟ
ﻪﻭ ﺒﻭﺗ ﻪﺍ ﺘﺎﺳړﻥۍﻧﺲﻧ ﻮ کېچې ﺏړ ﻧﺎ
ﻭﻏ ﺭﺎ
ﻮﻧ ﻐﻮﻫ ﻟ
ﻭﻪټ ﭘ
،
ږﻱﺪﻝکږ ﻴﻟ ﻭﺮګﺘېﻪﺳﺮﻱک ﭘ ﺘﻧ
ﺰﻳ ﻩﺩﺪ ﻳ
ﺪﻪﺷ ﺎﻁﭘ ېﻭﻣﺨﻳﻦ ﺍ ﺮﻱﻭ ﻟﺯښﺕ ﺭﺮﺍﻳﻪډ ﻨﺘ ﻭﮐ ﺯﺎ
ﻴﺘﻣ
.ﺩډږﻱټﻝکږ ﻧﮏېﻝ ﻭ ﻭ ﻴﻦېژ ﭙﺳېﻭﺳﻳﻦې ﺮ ﺍ ﻭ ﻪکېﺩ ﻨﺘﻴﮏﮐ ﭘﻮﮑﻭﺳ ﺮﮑﻳ
ﺎﻪﻣ ﻭﭘ ﺯﺎﻴﺘډﻮﻣﺩﮐ
ﻼﺪﺍﻱ
ﻪﺳﻳ ﺯېﭘ ﺎﻴ
ﺘﻩډکېﻣ ﺮﻩﻗﻄ ﻮ ،ﻳﺮﻱﻟﺎﻁﻭ ﻳﻞﺷﻲچېﻣﺨ ﺎ
ﻣ ﺯﺍ
ﺪﻭ ﻳﺎﻪﺑﺮﺧ ﻪﺑ ﻐﻭﻫ ﺯﺎﻴ
ﺘﻮﻣ ﮐ
ﻭﺯﺎ
ﻴﺘډﻮﻣﻪﮐ ﻟﻰﭘﺍﻪﻭ ﺘ
ږﻱﺩWBCﺷ ﻪکږ ﻓﺎﺮﻱﺍﺿ ﻮﭘ ﻠ
ﻴﻦﺑ ﻠ
ﺘﻴﺍڅکېﻣ ﻩڅ ﻭ ږﻱﻭﺩ
ﺩﻝکږ ﺍ ﻭښ
ﺮﻭﻱ؛ ﻴﭘﻮﻩﺗ ﺮﻭﺳ ﻭﺎ
ﻳﺮﺘﮐﺎﻴﮏﺑ ﻨﻮﺟﻨﻴﮐﺴ ﻮﺗﻭﺮﺘﻧﺎﺍﻭﺳﻲﻳ ﺮﻳ
:ﻭ ﻪﮑﻮﻟ ﺘﺎﺳﻭﻧ ﺲﻧ ﺭﻮ ﻧﻴﻼﺩ کېﺷﺠ
ﻪﺮﻧﻴﭘﻮﻪﻱېﺗ ﺮڅﺧ ﻴﺘﮐﺎ
ﺑﻮﻠﻳﺎ
ﭙﻣﺎ،ﮐ ﻴﻼﻧﻮﻤﻠ
،ﺳ ﺎﻴﻨﻴﺮﺳ:ﻳ ﻪﮑﻪﻟﻮڅﺧ ﺗ
ﺎﻧﺎ
ﺘﻧﺪﻱﺍ ﻳﺮﺭﺑ ﺭﻮﺷﻢ ﻳﻮﺩﺧ
ﺷ.
ﻪ ﻲ ﻨ
ﻳﺎﻌﺪﻣ ﻳﺎ
ﺯېﺑ ﺎﻴﺘ
ﻩډکېﻣ ﺯﺎﺍﻯﺗ ﺩﺩ ﺷﻲک
ﻧﮏېﻭﺪ ﻴ
ﺗﺎﺳ،ﻣﻩﻮښ ﺮ Mucopurﭘ ul،ﺩent ﺎ
ﻤﻴﺘﻳﺮﻳﻩﺍﺮ ﺘﺸﻨﭘﻲ کېﻣ ﻮﮑﻭﺳ ﺪﻴﻳﻮﻣ ﻪ ﺱګ ﭘ
.ږﻱ
ﺪﻝکږ ﻴ ﻟ
ﺮﻱ ﻟﺮﻩﻗﻄ ﺮﺘﻠﻲﻣ ﺮ٧ﻣ ﻪﺗ ﻪچې٣څﺧ ﻧﻮﻤ ﻭﺯﺧ ﺎﻁﺍﻣﺨ
ﻪSwabﺩﺱ ﻮﻥڅﺧ ﻟﻮﺎﮐﻮﻡﻳ ﺘﮑﻳېﻪﺭږﻱچ ﻟ ﻩکږ ﺮﺮﺳ ﻭﺗﺪ ﻴﻟﻼﻪ
ﻴﭘ ﻪﺩﺷﺠ ﻠ
ﭙﻴ ﺺﺧ ﻨﻲﺗﺸﺨ ﻴﻘﻳ
ﺗﺍ
ﻮﻪ ﻧﻭﺮﻠﭽﭙﺲېﮐ ﻟﺮﺩېﭘږﻱﺭ ﻩکږ ﺮﺮﺳ ﺮﺗﻠﭽ ږﻱﻭﮐ
ﺘﻞکږ ﺍ ﻴﺴ ﻪﻭﺧﺖکېﺍﺧ ﭘﻲﭘ ﻮﮑﺪﺳ ﻳﻮﻣګ
ﺷ.
ﺘﻞ ﻲ ﻴﺴ ﺍﺧﺯېﻭ ﺎ
ﻴﺘﻩډکېﻣ ﺯﺎ
ﻭﺗ ﺗڅ
ﻩﻭﺷﻲﺮ ﺪﻩڅ ﻳﺎ
ﻱﻭﺑږﺍ ړﺎﭘﻲښﻱ ﻴ
ﺗ
ځﻪچﺮﻱ ﮐ ﺕﻪﻟﺯښ ﻧ ﺭﻴ ﺺکېﺍ ﻪﺗﺸﺨ ﻩﭘﺮﻣ ﻭﻪﺩ ﻧﺭﺷﺭ
ﻮ ﻢ ﮑ ﻧﻭﻮژﻨﻴﭙﻪکېﺩﺳ ﻨﻳﺎﻌېﻪﻣﻳﻦ ﭘ ﺩﻭ
ﻭ.
ﺎﺕ ﻱ ﻳﻪﺯﻌﺐڅﺧ ﮑﺮﻣ ﺘﻠﻲﻣ ﻣﺮ٣ﭘ ٠،٠٠ﻟ٠
ﺎﻪ ﻭﻳﻪﮐﻢﺍ ٣څﺧ ٠
٠ﺍﻯﺷﻲچېﺩ٠ ﺩﺩېک
ځﻪ چې
ﻮﻱ ﮐ ﻪﮐ ﻪﻧﺘﺮﺳ ﻩﻣ ﺮﻣﻭﻴ ﺺ کېﺩ ﻪﺗﺸﺨ ړﻥېﭘ ﻴﮏېڅﻱ ﻮﺟ ﻟﺍ
ﺮﻴﻩﺳ ﻮګ ﻩﺗ ﺰﻴ ﻟ
ﻭﻪټ ﭘ
ﻪﻮڅﺧ ﻧړﻴﮏېڅﻱ ﻮﺟ ﻟ
ﺍﺮﻴﻱﻻﻦﺩﺳ
ﺭځ ﮐ ﻪﺍ ﻪﻧ ﺗﻪﻣﻦځ ﺭﻱڅﺧ ﻮﮑﻳﺭﺩﻱﻣﺨﮏېﺩ ﺎﺘﻲﺑ ﻧﺭﻝﺍ ﻮﻤﻴﻫ
.
ږﻱﺘﻞکږ ﻴﺴ ﻩﺍﺧ ﻮﺟﻲکېګټ ﻟ
ﻮ ﻤﻳﺪﻴﭘﻪﺍﭘ
:ﻪﻨﻠ
ﻣﺭﺩ
ﻭﺏ ﺮ
ﮑﻳﺎﻣ،ﺩﺭﻱ ﻮﺪژﻏﻧﻭﻟﺖکېژ ﺎﺪﺣ ﻳﺪﻪﺷ ﻪﭘ ﻨ
ﻠﻣ ﺭﻟﻲﺩ ﺍ
ﻪﻭ ﺘﮐﺭﺩښ ﺎ
ﻳﻦېﻓﺸ ﻭ ﻭﺩ ﺭﺷﻦﺍ ﺪﻳﺎﻬﻳ
ﺩډ
.
ږﻱﻩکږ ﺮﺮﺳ ﻪﺗﻨﻠﻣ
ﺭﻪﺩ ﺍﺳﻄ ﻪﻭ ﻮﭘ ﻠ
ﻣ ﺭ
ﺪﺩ ﺿ
٥٠
٠Cipr ofloxaciﻳnﻩﺎ ﺭﺎﭙﻟﻭﻭځ
١ﺭ ٠-ﺭځې٧ ﻪﺩﻭ ﻟ
ﻩځ ﻭګﻝۍﺩ ډﻞ ﻭ ﻩﺑ ﻭCo-ﺩ Trimexazol e
ﻭﻭځ
ﺩې ﺭﺭځېﺩ ﺭ ﻮځﻝﺩﻭ ﻪﻳﻣﺍﺭﻠﻲګ ٥ﻣ ٠ﻴﻦ٠ ﺍﺳ ﺰﮐﻮﻠ
ﻓﻮﻴﺎﻟﺭځېﻳ ﻩځﻝېﺩﻭ ﻭ ﻪﺩ ﻣﺍﺭﻠﻲګ ﻣ
10
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﻮﻱﺪﻝﺷ ﻴ
ﻧﮏېﭘﻲښېﻟ ﻭ ﻮﺭﮐﺍ
ټﻦګ ﻴﻼ ﻳ ﺑﻞ کېﺩﺷﺠ ﺎ
ﻘﻪﻣﻴﻦﭘ ﻠﻴﺴﭙﻣ
ﺍ،ﺩږﻱﻮﻝ کږ ﮐﺭﻩﻭ ﺭﺎ
ﭙﻟ
ﻴﻦﻠ
ﺎﺳﮐﺴﻮﻣ،ﺍږﻱ
ﻮﻝ کږ ﮐ ﺭﺭځېﻭ ﻪﺩﻭ ﻟ
څﺭځﻮﻪﻟ ﻣ ﺍ
ﺭﻠﻲ ګ ٥ﻣ٠ﺎﺱﻭﻱ٠ ﺭېﺣﺴ ﺭﻪچ ﺎﮐﻣﺩ،ﺍ
ﻱ
ﺷ.
ﻭﻝ ﻲ ﺭ
ﺎﻪﮐﻧﺪﻭ ﻳﺎ
ﻪﺩﻱﺑ ﺪﻧﻨﻣﺰﻴﺍﻏ
ﻭﻝﺷﻲ ﺭﺎ
ﻪﮐ ﻧﺪﻭﻳﺎ
Parﺑ egoriﻭc ﻴﺖﺍ ﻠ
ﻴﮐﺴﺍﻮﻨ
ﻴ ﺍﻯﻓ ﻪﺩ ﮑﻟ
ﻮﻱ ﻤﺎﺕﮐ ﮐ
ﺮﻮﺣ ﻤﻟﻮﮐﻣﻞچېﺩ ﺭﻪﺩﻐﻫ
ﻭ.
ډﻱ ﻪځﻥ ﻧﺩﺩﺎکﺰﻡﭘﻴﻧﺍ
ﺭګ ﻭﺍﻭﺮﮑﻳ
ﺎﻣ ﻪﺩﻮڅﺧ ﻤﻟﻮ
ﮐﻭﺩ ﺪﻭﻱﺍ ﻳ
ﺪ ﺍ ﺽﺗﺸ ﺮځﻪچېﺍﻋ ﮐ
ﻭ.
ﻣﻦ ﻱﺰﻴﺍﻏ ﻪکې ﻨﻠ
ﻣﺭﻪﺩ ﻴﻦﭘﺘﮑﺎﭘﻮﺕﻳ ﻤېﻪﺩﻱچېﺑﺴ ﺩﻧ ﻮﻮﺟ ﺍﺱېﺏﻝﻝګېﻣ ﺩ
.ﻩ
ﺪﻳﻮ ﺩﻝﺷ ﻭﻪښ ﻨ
ﻠﻣﺭﻪﺩ ﺍﺳﻄﻪﻭ ﻮﭘ ﻠﻣﺭ
ﺪﺩ ﻭﺏ ﺿ ﺮﮑﻴ
ﻣﻭﻝکېﺩ ﺪ(ﺟ ٢-
٢ ﭘ)
ﻪ
ﺎﻥﻣﻮ ﺎﺷﻣ ټﻥﻍﺍ
ﺯﻭ ﺩ ﻣﻞ ﺭﺩ ﺯﻭﺩ ﻣﻞ ﺭﺩ
ﺮﺮﻫﺪﻥﭘ ﺑ
ﻪﺩ ﻣ ﺍﺭ
ﻠﻲ ګ ﻣ٥٠ ﻭﻥ ﺰﮐﺍﺮ
ﺘﻔ ﻴ
ﻠﻲ ګ ﺳ ٥ﻣ ٠
٠ ﻴﻦﺍﺳﺰ ﮑ
ﻠﻓﻮﻴﻟ
ﻪﺩګﻟﺯﻥ ﺭﺍﻡﻭ ﺭﻮګ ﻟ
کﻝ (
Cef trﺭځې )axon ﻭﻪﺩ ﻣﺍ
(ﺭ Lev ofloxaci)n
ﻭځ
ﻭﺭ ﭘﻦځﺭځېﺩ ﺭېﺩﻭ ﻻ ﺩېﻮځﻝﺩ ﺭ ﻳ
ﻪ ﻱې ﻩ ﮐﭽ ﻟړ
ﻩ ﻮ ﺭﺎ
ﭙﻭﻟ ﻩﺭ
ﺎﭙﻟﻭﻭځ
ﺭ
ﺭځې ﻭﻪﺩﻣﺍﺭ٤ګ
ﺮ کﻝ ﺮﻫ ﻪﭘ ﻣﺍﺭﻠﻲ ګﻣ ٨ ﻳﻢﺰﮑﻔ ﻴ
ﻪ ﺳ ﻣﺍﺭﻠﻲګ ﻣ٥٠
ﻴﻦ ٠ ﺍﺳﺰﮑ ﻠ
ﻓﻭﺮﭙﺳ
١ﻝﺎ٢ﻮځ ﻳﺪﻥﻳ ﺑﺯﻥﺩ ﻭﻮﻟ (
Cef i
xiﻪ ﺩ )m ﻟﻩ ځ ﻭ(ﺩ Ciprofloxaci)n
ﻭﻭځﻭﺭ ﭘﻦځ ﺪﺩ ﻌﻪﺑﺘﺎﻋﺳ ﺩېﺭځېﺩ ﺭ ﻭ
ﻩ ﺭ
ﺎﭙﻟ ﻩﺭ
ﺎﭙﻟﻭﻭځ
ﺭ
ﺮکﻝ ﺮﻫ ﻪﭘ ﻣﺍﺭﻠﻲ ګ ﻣ١٠ ﻴﻦﻳﺴ ﺎ
ﻣ ﻭ
ﺮ ﺘﻳ
ﺯﻪﺍ ﻣﺍﺭﻠﻲګ ﻣ٤٠
٠ ﻴﻦﺍﺳ ﺰﮑﻠﻓ
ﺭﺎﻧ
ﻮځ ﺭځېﻳ ﻭﺪﻥﺩ ﺑ
ﺯﻥﺩ ﻭﻮ(ﻟ Azithromy ciﻪ )nﻟځ ﻩﻭ( ﺩ NorFl oxaci)n
ﻩﺭ
ﺎﭙﻟ
ﻭ ﻭځ
ﺩې ﺭﻝﺩﺭ ﺩېﺭځېﺩ ﺭ ﻭﺩ
ﻩﺭ
ﺎﭙﻟﻭﻭځ
ﺭ
ﻪﺩ ﻟ
ﺩېځ ﻪﺭ ﻣﺍﺭﻠﻲ ګﻣ١٠٠ ﻴﻦ ﻣ ﺰ
ﮐ ﺎ
ﻔﻳﻪﺭ ﻣﺍﺭﻠﻲګ ﻣ٥٠
٠ ﻴﻦﻳﺴ ﺎ
ﻣ ﻭ
ﺮ ﺘ
ﻳﺯﺍ
ﻩ ﺭ
ﺎﭙﻟ
ﻭ ﻭځ
ﺩې ﺭﺭځېﺩﺭ ﻭ (Ri
fazi mi ﺩې )nﻮځﻝﺩ ﺭ (ﻳ Azithromy ci
)n
ﻩﺭ
ﺎﭙﻟﻭﻭځ
ﺭ
ﻮﻟﻪﻓﻲ کﻝ ﻣﺍﺭﻠﻲ ګﻣ٢ ﻴﻦ ٥ ﺍﺳﺰﮑﻠﻓﻭﺮ ﭙ
ﻪ ﺳ ﻣﺍﺭﻠﻲګ ﻣ٢٠
٠ ﻴﻦﻣ ﺰ
ﮐ ﺎ
ﻔﻳﺭ
ﺭځې ﻭﺪﻥﺩ ﺑ
ﺯﻥﺩ ﺍﻡﻭ ﺭ( ګ Ciprofloxaci ﺩې )nﺭځې ﺭ ﺩﻭ (Rifazimi)n
ﻟﻰﺩېﺍﺪﺩ ﺭ ﻌﻪﺑ ﺘ
ﺎﻋ١ﺳ ٢ ﺭﺩېﻭﻪﺩ ﺭ ﻟځ
ﻩ
ﺭﺎﭙﻟﻭﻭځﻩﺭ ﭘﻦځ ﻩ ﺭﺎ
ﭙﻟﻭځ
:ﻮﻯﻴﻨﻣﺨ
ژﻩﻭﺮﻩﺩﺣﺸ ﺭﻥګﺍﺪﻤﺩ،ﻫ
ړﻱ ﻱ ﮐﻢېک ﺍ
ﻭﻍۍﭘﻲښېﺭ ﺭﺎ
ﻧﻴﺸﻦﺩ ﻧﻭﺭﻮﻠ
ﻭﮐ ﻭﻝﺍ ﺮﺑ
ﺍﺮﻮﺑ ﺑﻭﻮﺍﮐﺎﭘﺩ
.
ﺮﻱ ﻟﺯښﺕ ﺭﺍﺍﺭﻮﻮﻝﺧ ﭘځﻯﮐﻩځﻯﺮﺍﻮګ ﺍ ﻪﺗﻤېﻪﺳﺯﭘ ﺎ
ﻴﺘﻭډکېﻣ ﺍﻪﻧﻭﺭﺎﻮﮐﻠﻣﺭﻮﺩ ﮑﻧﻭ
ﺩډﻭﻪﻣﺨﮏېﺍ ﻮڅﺧ ﻟړﻮﻭﺩﺧ ړﻮﺷ،ﺩﺧﺪﺟﻼ ﻲ ﻳﺎ
ﻪﺩﻱﺑ ﺘﻭﻍۍﺍﺧ ﺭﺎېﻪﻧ
ﺎﻥچ ﭘ ﻭﻏﺭﺎﻪﻧﻐټﻝﻫ ﻭ
ﻣﻞﺭ
ﺪﺩ ﻭﺏ ﺿ ﺮﮑﻴﻣﻪﺩﺗﺭﺭﻭ ﻱﻭژ
ﻴﻦځ ﺍ ﻣﻮﻥﻭ ﺑﺎﻪﺻ ﻪﭘ ﻧ
ﻮﻪﻻﺳ ﺘ
ﻭﺳ ﺭﻪﻭﻮڅﺧ ﻟﻮﮐﻭﺩ ﺯﺎﻴﺘﻮﻣ ﮐ
.ﻪﺘﻪﻻﺱکېﻧﺸ ﻣﻦﻭﻱﭘ ﺰﻴ
ﻴﻦچېﺍﻏ ﮐﺴ ﺍ
ګﻱﻭځﻥ ړﻮﻡ ﺍ ﺷ،ﮐ
ﻪ ﻲ ﻴﻮﺻ ﺗ
11
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﻭﭼﮏۍ
(Typhi od)Ent ericFev er
ږږﻪکﺗﻣﻦځ ﺍ
ﻪﺭ ﺍﺳﻄSﻪﻭ.ﭘ Par at yﺍphiS.ﻭ Tyﻩچېﺩphi ﻭﻏﻲﺩ ﺭﺎﻪﻧ ﮑﻴ ﻤﺘﻴﺴﻩﺳ ﻮﻭﭼﮏۍﻳ
ﺩ.
ﺭﺕ ﻱ ﺎﺒﻪﻋ ﺩڅﺧ ﺭﻱېﺩ ﻭﺩګ ډ ﻪﺍﺒﻩﻱېﺗ ﻴﮏېﺏڼ ﻨﻴﻠړېﮐ ځﻥګﻱﻭ ﺍﺍ
.ﻩﻪﺩﺗﺭTﻪﻭyﺗ ﻩﻱېphus ﻴﮏېﺏڼ ﻨﻴﻠ
ﻳﻲچېﮐ ﺍ
Tyﻭ phoi ځﻪdۍﻪ ﮐ ﻭﻍ ﺗ ﺭﺎﻧ
Pﻭ
ayﺍ er'sPat ډﻝﺩch ﺪﻭ ﻧﺭګ ﻪڅ ﻮﺟﻲﭘ ﻟ
ﺎۍﺘ
ړﻮ کېﺩﻭﭼﮏ ﭘ ﻮﻡﻳ ﻪﻟﮐﻝﭘ ﻣﻼﻱﺎ ١ﻴﺩ ٩٠ﺩ٠
.
ﻩﻮﺪﻝﺷ ﻧژژﺪېﻭﭖ ﻧﺎﻟﻲﺑ ﺍ
ﻭﻭﻪﻍټ ﻮټ ﭘ ﻭﻱﻏ ﺎﻔﻤ ﻟﻳﮏﺮﺘﻧ
ﺰﻴﻣ
.
ﻮړﻯﺷ ﻮﻡکﺍ ﻠ
ﻌځﻯﻣ ﻴﮏ ﺍ ﻣﻭﺎټ ﻧﺎﻥﺍ ﺘﻧﺍ
ﮐﻝکېﺩ ١ﻡﺎ ٩٦ﻪ٩ﭘ
ﻣ:
ﻻﻞ
ﻩﻮګﻪﺗ ﻪﭘ ﺑ
ﺭﻮﮐﻪﺩ ﻮڅﺧ ﺗﺎﻧ
ﺍﻮﻴﻭﺣ ﻮﺍﻧﺎﻧ
ﺎﻧﺴﺍﺮﻱچېﺩ ﻟﻪﻧﻮﭙﻳﺎﺗﻭﺮ
ﻴﺎﺕﺳ ﻳﻪﺯ ٢څﺧ ٤٠ﻴﻼﺩ٠ ﻧ
ﻮﻤﻠﺳ
NonTy phoiﻪچېdal ﻧﻮﭙﻳﺎ
ﻭﺗ ﺮﻴﻭﺳ ړﻮ ﻣ
ﻮ ﻧ.ﺩﻮﻱ ﻪﮐﺗﻣﻦځ ﺍﻭﻍۍﺭ ﺭﺎډﻝﻧډﻝ ﻭ ﻭﻭ ﻠﻲﺍ ﻩﺍﺧګټ
ﻪﻮﭘ ﮑﻧﻮﺗﻮﻟ
ﻭﺍﺍ ﻮﺗ
ﺍﺮ،ﺣﺸ ﻮﮑﻧﻭﺮﻟ ﻪﺗﻲ ﮑﻟﻮﺗﺎﻧ
ﺍﻮﻴﻮﺣ ﻔ
ﻠﺘﻣﺨ ږﻱچېﺩ ﺩﻱ ﺎ
ﻮﻡﻳ Sﻪﻧ
alﭘ monel l
a
ﺮﺿﻲﺩﻱچې ﻩﻣ ﺭﺎﭙ
ﻟ ﻮ
ﻧﺎﻧﺎ
ﻧﺴ ﺍﻪﺩﻟﻭډ٢٠ﻪ٠ ﺎﺳﭘﻩﺩﻮڅ ﻧﻮ
ﭙ ﻳﺎﺗ
ﻭﺮﻴﺩېﺳ .ﺩ ﻮﻱ ﺪﮐﻧﻭﻮکېژ ﻤﻟ
ﻮﮐ
.ﺭځﻱ ﻻﻞګﺎﻣ ﻴﻤﻳﺮﺘﮐﺎ
ﺑﺎﺩ Lﻭﻳ ocalﺍ infect i
on، ﻳﺖ ﺮﺘﻧﺍﻭﺮﺘﻩﻱېﺩګﺳ ﺮ
ﺗﺎﻳ
ﺯ
ﺮﻱﻟﻩړﺭېﺍ ﻮﺭﻥۍﭘ ﻮﺎﺳﻲﮐ ﻳ
ﺮ ﺘ
ﮐﺎﺑﻭﺮﻴﺘﻧﺍ
ﻮﻯGenusﺩﻯچېﺩ ﻟﻮﻮﻳ ﺗﺎ
ﻧﺎﺘﻧﻔﻲﺍ ﻨﺍﻡﻣ ﺭﻴﻼﺩګ ﻧ
ﻮﻤﻠﺳ
ﻩچې ﻮﺪﻝﺷ ﻴﻟ
ﻮﻱﻭ ﻩﺷ ﺮﺮﺳړﻥېﺗ ﻮڅﻱ ﻧﻮﻟﻭﻮډ ﺗﺎﻳ
ﻪﺯ ٢څﺧ ٠٠ﭘ٠
ﻭﺮ ﺎﻳﺮﺘﮐﺎﺑﮐﻝکېﺩ ١ﻡﺎ ٩٨،ﻪ٣
ﭘ
ﻨ ﺲټټ ېﻪﺩېﺑﻮچ ﭘ ﻳﺸﻞﺷ ﻭ ﻮﻭ ﻧ
ﻮ ﭘﻭﺭﻪ٧ﺳﺐګ ﻩﭘﺮﻪﻧﻈ ﻟ ﻮﻧ
ړﻮڅﻱ ﺗﺎﻳﻭﺯ ﺭﻮﻧﻮDNAﺩ ﻟﻭﺩټ
Enter i
ﻳca (ﺎChol erﻭﭖکې)ae ﺭﻭﻝګ ﻪﺍ ﻮﺟﻦﺩﻱﭘ ﺘ
ﻩﭘ ﺭﺎﭙ
ﻟ ﻮﻧﺎﻧﺎﻧﺴﺍﻪچېﺩ ﻧ
ﻮ ﻟﻭﻪډﻐﻭﻝﻫ
،ﺩﺳﺐګ ږﻱ
ﻻﻞکږ ﺩﻭ ﻣﻪکﺩ ﺗﻣﻦځ ﺍﺭﺎﻥﺩﺘ ﻧ
ﺍًﺩﺍﺭ
ﺩﺎﻪچېﻧ ﻧﻮﭘﻭﺭﻪﺳﺐګ ﻐﻭﻫ ﺍﻮﻝﻣﻞﺷ ﺎ
کېﺷ
.ﻮﻝ ﻮﻝﺷ ﻣﻮ ﻧ
ﻪﻭ ﻣﺎbﻪﻧSﻭ 3ﭘ .ﺍ Ar i
ﻭﭖ)zonea)3a ﺭ
ﻭ.
ﺟړ ﻱ
ﻪﻮ ﺭﻧﻮﭙﻡﺩﻯچېﺳ ﺰﻴﻧ
ﺍﺭګﻭ ﺮکﺍ ﺘﺤ Aﻭﻣ naerﺍ obi ﻴﻼc ﻧ
ﻮﻤﻠﺳ
:ﻮﻱﻳﺸﻞﺷ ﻮﻭ ﻧﻮﭘﻭﺭﺩېګ ﻪﺭ ﻩﭘ ﺮﻪﻧﻈ ﻟ ﻮﺍﺻ ﻮﺘﻲﺟﻦﺩﺧ ﻧﺍ
ﺩ
Somat icOAnt igen . 1
Sur faceVi ant igen . 2
Flagel l
arHAnt igen . 3
:
ﻮﺟﻲ ﻟﻮﻤﻳ
ډﭘﻲ ﺍ
ﻨ ﺲټﺩېﺑ ﺮ
ﻮﭘ ﻪﺩﻯﻧ ﺑﺭﻮﺎﻥﮐ ﻧﺴﺯېﺍ ﺍﻮﻩﻳ ﺭ
ﺎﭙﻻﻞﻟﻭﭼﮏۍﺩﻣ ﺮﺧﻼﻑﺩ ﻮﺑ ﻧﻮﻟ
ﻭ ﻭډ ﺭ
ﻮ ﻧﻴﻼﺩ ﻧ
ﻮﻤﻠﺩﺳ
ﻍﻪ
،ﻥﻍ ﭘ ږﻱﺮﻱﭙﻪﺧ ﻠﺒ
ﻪﮐ ﻟﺎﻤﻠﮏﺗ ﮐﻩﺩ ﺮﻧﮏېﺳ ﻭ ﺩﻟږ
ﺎﻥ ﻲﺘﻧډﻲﺍ ﺎځﻥﻧ ﻭﻳ ﻭﻍﺍ ﺭﺎ
ړﻲﻧﺑﻲﻧ ﻭﭼﮏۍﺩ
ًﭘﻲښﻱ ﺍ
ﺭﺩﺎﻮﻧﺍﻯﺷﻲﺧ ﺩﺩﺭېﻫﻢک Fﻪﻻ ecalOrﻟ ﻪﺩal ﻪﺑﻞﺗ ﻮﮐ ﺲڅﺧ ﻪﻳ ﻟ ﻪﻧ
ﺪ ﻳﺮﭙﻍﻪﺧ
ﻥﻏ
.ږﻱ
ېﺮ
ﻭک ﺗ ﺯﺎﻴﺘډﻮﻣﺍﻡ ﮐﺭﻮګ ﻪﻳګﻥېﭘ ﺎﺍﻳﺮﺘﮐ ﺎ
ﻪﺑ ﻧﻮﻴﻠﻴ
١ﺑ ﺗ٠
ﮐﻻﻯ ﺷﻲ ﺮ ﮑﻰ ﻮ ﻧﻭﺩﻟږ
ﻴﻼ ﻲ ﻧ
ﻮﻤﻠﺩﺳ
.ﻭﻱﺩږﻟﻲ ﻪﻭ ﺎﻝﺗﻳﺮﻴﭘﺎﺭېﭼ ﻮﻮﭘﻧﻮﻠ
ﮐ
.
ږﻱ ﺮﻱ ﭙﻪﺧ ﺍﺳﻄ ﻪﻭ ﻮﭘﺑﻭﺎﺍﻭﻳ ﺩﺍ
ﻮ ﻳﻲﻣ ﺍﺬ ﻭﻏ ړﮐﮏ ﺭېﭘﻲښېﻱېﺩ ﺭ
ډ
ﺍﻯﺩﺩ
ﺘﻦ ک ﻨ
ﻪﻣ ﺍﺳﻄﻪﻭ ﺎﺱﭘ ﻤﺗﻩﺩ ﺮﻭﻍﺳ ﺭﺎ
ډﻝﻧ ﺒﻲ ﻭ ﻪﮐﺴ ېځﻦېﻭﺧﺖﭘ ﻧﮏ ﻳ ﻭﻮﮐﺭﺎﻳﻲﮐ ﺎ
ﺘﻭﻏﺭ
ﺩ.
ﺹﻪ ﻱﻪﺧﻼ ﻧ ﺮڅﺧ ﻪﺩېﺧﻄ ﻟﻧﮏېﻫﻢ ﻭﻮ ﮐﺭﺎﺭﮐﺍ
ﻮ ﺗﺍﺮ
ﺑﺷ.ﺩﻻ
ﻲ
ېﻻﻞ
ﻮﻱﺩﻱچ ﻣ ﻭﭼﮏۍﭘﻲښېﮐﻢېﺷ ﻮﺩ ﺪﺥﺧ ﭘﺍﻭﺭﺰﻴﻟﺴ ﻭ ﺭﻮﻟ
ﻮکېﺩڅ ﻧﻭﺩ ﺍ
ﻭﻭﻮﻩ ﻠ
ﻠﺘﻣﺨﺮﻪﭘﭘ
ﻮﻝﭘځﻯﮐ
ځﻯﺮﺍ ډﻝ ﺍﻳﻲ ﻭ ﺎﻴﺘﻭﻏﻪﺭ ټﻮﭘﻴﻭﺩچﻟ ﻭﻝﺍ ﺮﺑﺍ
ﺮﻮﺑ ﺑ
ﻭﻭﻭﺍړﺍ ﻮﺪېﺩﺧ ﻧﻮﻻ ﻳﻄﺍﺮﻭﺷ ﻱې ښ
ﺩ.
ﻱ
ﻮﻱﻴﺖﺷ ﺒﺜﺎ کېﺗ ﮑﻳﺮﻣﻪﺍﻩﭘﻲښېﭘ ﻮﺭﺳﻮ ﻟ
ﺩېڅ ږﻭﭼﮏۍﻥ ﺎﻝﺩ ﮐﺮﻮ کېﻫ ﻧ
ﻮ ﻠ
ﻮﮐ ﻭﻟﺴ ﺮ
ﻴﻪﺗﭘ
12
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
13
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
.ﻳﻲ ﺍ
ComaViﻭ gi ﺍl
ﻭ
ﺮﻴ
ﺪﺳ ﻳﺪﻪﺷ ﻠﺗ
ﺮﻪﭘ Parﭘ aTy ﻴﻼpiﻧﻮﻤﻠ
Tyﺩﺳ ﻴﻼpi ﻧﻮﻤﻠﻮچېﺳ ﻳﺍ
ﻭ ﺪﻭ ﻳﺎﻩﺑ ﻮګ ﻩﺗ ﺰﻴﻟ
ﻭﻪټ ﭘ
.ﺮﻱﻟ
ﻭ(ﺍEpist axiﻪ)s ﻧﺪﻴ
ﻬﻳﻦېﺑ ﻭﻪﺩ ﺯېڅﺧ ﻮ ﻪﭘ ،ﻟﻟﻲﺍﻮﻳﻮﺭﻱﻟ ﻮﻭﺗ ﺭﺍ،ځﻱګ RoseSpot ﺩs
ﺩ.
ﻳﮏېﻥښﻱ ﻱ ﺰړﻥۍﻓ ﻮﻡﻟﻭﻍۍ ﺭﺎ
ﻧﻮکېﺩ ﻧﺎﻭﻏﺭﺎ%٥ﻧ ﭘ٠Relﻪ at i
v eBr ady car dia
ﺮﻱﺮﻟﻩﻗﻄ ﺮﺘ
ﻠﻲﻣ ﺮ٣ﻣ ٢ﻪﺗMaculﺩﻯچې ﻧ opapul ﻻﻲarRashes ﻩګﺑ ﺮ RoseSpotﺳ s
%٣ ﻪ٠،ﭘ ﻮﻱﺍﻡﮐ ﻭﺭېﺩﻮ ﻭﭘ ﻭځﺮ ٥ﺭ ﻪﺗﻭﺩ٢څﺧ ﻮﻱﺍ ﮐﺭﻪﻭ ګﻪﻻﺳ ﻪﺭﻥ ﻟ ﺍﺳﻄ ﻪﻭ ﺭﭘ ﺎﻓﺸ ﺩ
ږﻱ
ﺪﻝکږ ﻴﻟﺮﻳﺎکېډ ﻭﺷ ﻪﺍﻨﻴېﻪﺳږﻱچ ﭘ ﺪﻱ ﻧ
ﺭګ ﺮکېڅ ۍﻪﺍﺧﻭﻥ ﭘ ړﻥۍﺍ ﻮﻡ ﻟ
ﻮکېﺩ ﻧﺎﻭﻏ ﺭ
ﺎﻧ
ﺷ.
ﺍﻯ ﻲ ﺩﺩﺪﻝک ﻴﻟﻩ ﺮ
ېﻪﺳﺨﺖۍﺳ ﻮک ﭘ ﺘﻮﺳ ﺭﭘﻮﻪﺗ ﻮﭘ ﺧ
ﺎﻝﮑﻴﻮﺳﻴ ﻟ
ﻪﺍﺮﺧﻼﻑﮐ ﻭﺑﻴﺖﺍ ﻤﻮﺍﺻ ﺮﻉﺷﻲﻧ ﻪﻗ ﺮﺧﺘﻦۍﺑ ﮐﺍښ ﻮ ډېﺩکڼڼېﺧ ډﺭېﺩګ ﺭﻪچ ﮐ
ﻭﻳﻲﺍ ﺍﻼﻪ ﻭ Podalﻋ ﻣ ﻪ ka ږﻱ چېﺩېﺗ ﺎﺱ کږ Crﺍﺣﺴ epit
at i
ﻪ ﺟ ﺲ ﺷﻲ on ﻴﺎﺣﻧ
ﻭ.
ﻪﻱ ﺘﺒﺜﻮکېﻣ ﻧﺎﻭﻏﺭﺎﻧ%٥ ٠
،ﺩﺭﻱﺎﮐﺎﭖ ښ ﻮﭼ ﻧﻭﺎښﻳﻲﺩﻏ ﺍﻮﻭﺧﺎﻩﻭﺷږﻍټﺍ ًﻝﺎﻤﻮﺣﺠ ﺪﻝﺷﻲﻧ ﻴ
ﻟﻪﻭ ﺑﻮژ ﻧﺎﻭﻏﺭﺎﻧﺭېﺩ ﺭﻪچ ﮐ
ﺭﻱﺭﻥ ﺍﻮﺎﻧﺼ ﻓﻻﻱﻳ
ﻭ ﻮﺩ ﻩﺍ ﺭﺍ
ﺩ ﺭﺎ
ﻪﺑﺑﻱﻮژ
ړﻧ ﭙﻞک ﺮﺧ ﻴﻴﻢﺳ ﻭﻏﻲﻭﺧ ﺭﺎﻪﻧﻪﻭﻱﮐ ﮐﺎ
ﻪﭘ ﮐﻭژﺏېڅ
.
ږﻱ ﺩﻱ ﺎ
ﻮﻡﻳ Fﻪﻧ
ulﭘ igi
nosi ﻮﻱچېﺩs ﻩﮐ ﺭﻮﻪﻏ ﺘﻧﺍګځ
ږﻱچېﺩ ﻪ کږ ﺗﻣﻦځ ﺍ
EndogenousCarﺭ otenemi ﻪa ﻠﻣﻪﺍ ﻟﻲﻟﺍﻮﺑﺍ
ﺮ ﻭﺩﺧ ﺪﻧﺭﺩﺩ ﺩځﻱګ
.ﻳﻲ ﺍ
ﻩﻭ Fiﻥښ l
lipoviېﻪchږﻱچېﺩ ﺗ ﻻﻞکږ ﻟﻲ ﻣ ﺍﻭړ
ژﻱ ﻮﺩ ﻠﺗ
ﻭﺩ ﻭﺩﭖښ ﺍﻭ ﻮﺭﻏﻭ
ﻮ کې ﻧﺎ
ﻭﻏ ﺭﺎ
ﻪﻧ ﻴﺼﺩېﻓﻪﺭ ﻭﭘ ﺩﻭﻱﺍ ﻮﻮﺟ ﻮ کېﻣ ﻧﺎﻭﻏﺭﺎ%٥ﻧ ﻟﻰ٠ﺍﻭﺭﻍټ ﻭ ځﻱګ ﺭﻱﺍ ﻮﺗﺩ
.ږﻱ
ﻪکږ ﺗﻣﻦځ ﺍNecrﺭ ot i
zingchol ecy stiti
s
.ﺭځﻱ ﺭګﺎﺍﻴﻭﻍۍﺑ ﺭﺎﻮکېﻧ ﻧﺎ
ﻭﻏ ﺭﺎ
ﻧ%١ ﭘ٠ﻪ
ﺩ.
ﺎﺕ ﻯ ﻳﺮﺯﻭﻍۍﺧﻄ ﺭﺎﻧﻮکېﺩ ﻧ
ﻮﺘﻟﺎﺪېﺣ ﻧﻪﻻ ﭘ
.
ﻮکې ﮑﻠځﻮﺧ ﻠ
ﻴﺖ ﭘ ﻓﺎﻌ .ﻣ 1
.
ﺮﻱﻟډﻱګﻭﻭډ ﺭګﻮﺗﻭﺩﭖښ ﺍﻭﻱ ﺍﺮﻔ
ﺎﻥچې ﺻ ﻭﻏ ﺭ
ﺎﻪﻧ ﻐ .ﻫ 2
ﻮګﻤ ﻴ
:ﻫ ﻪﮑ،ﻟﺮﻱ ﻭېﻟ ﺎ
ﻴﺗړﻴﻢګ ﺘﻢ کېﻧ ﻴﺴ ﻴﻞ ﺳ ﻠ
ﻴﺗﻭﺪﻧﻟﻢﺍ ﻮﮑﻴﺘﻳﺎﻥ چېﺭ ﻭﻏ ﺭﺎ
ﻪﻧ ﻐ .ﻫ 3
.
ﺯﺱ ﻮﻣﺯﭘﻼﻮﺘﻭﻫﺴ ﺯﺱﺍ ﻮﻠﻴﻧﻮﺗﺭﺎ
،ﺑﺯﺱ ﺎﻴﻣﻭﺯﻮﺘﺭ،ﺷﺴ ﻼﺎ
،ﻣ ﻳ ، ﺎﺕﭘﻮ ﻨ
ﻴﺑﻮﻟ
:
ﻳﻦې ﻮﻣﺯﺁ ﺭﻱﺍ
ﻮ ﺗﺍﺮﺑ
ﻻ
ﻭﺎﺍﻴﻨﻴﭘ
ﻮ ﮐﻮﻴﻭ کېﻟ %٢ﭘﻲښ ٥-١
ﻪ٥ ،ﭘﻩﻪﺩ ﻨ
ﻳﻮﻣ ﺯ
ﻔﻲﺍ ﻟﻰﻭﺻ ﺍ
ﻮ ﺘﺒ
ﺜﺮﻥېﻣ ﮐﻩﺩ ﺭ
ﺎﭙﺩﻭﭼﮏۍﻟ
ﻪډﻝﭘګﻱ ﻭځﻥ ړﻪﺍ ﺩﻭﻱﭘ ﻮﻮﺟ ﺯﺱﻫﻢﻣ ﻮﺘﻳﺎﻮﺳﮐ ﻮ
ﻴﺍﻯﺷﻲﻟ ﺩﺩﻮک ﻩﻭﻱﺧ ﺩﻮ ﻮﺟﺎﻣ ﻴﻨﻴﭘ
ﻭ ﺮﺗﻮﻴﻧ
ړﻪک ﻨﻮﻫﺎﻥﻻﺳ ﺘﻧﺎﺑﻞﺍﻳﻭﺩﻝﺍﺭﻱکﺩ ﻮﻮﺳ ﻤﻟﻮﮐ:ﺩﻪﮑﻮﻟ ﺗ
ﺎﻻﺘﻼﻃﻲﺣ ﻪﺍﺧ ېﻭﻫﻢﭘ ﻮک ﺍ ﻧﺎ
ﻣ ﻮﺎﺷﻣ
ﻭ.
ﻣﻞ ﻱ ﺭﺎ
ﺭﻧ ﺷﺭ
ﺎﻫﻢﺩ WBCﻢ ﻴ
ﻩﺑﺮﻩﺳ ﺮﻟﻲﺳ ﺍﻮﺘﺎﻥﺩﺷ ﺘﻧﺍ
ﻭکېﺩ ﻩﭘﻲښ ﺮ ﺗﺎ
ﻳﻪﺯ ﺎﭘﻣﻱﻭﻱﺍ
ﻴﮏﺘﮑﻟ ﻭﺰﺍﻴﺘﻔﺎﺳﻴﻦﻓ ﻠ
ﮑﻟ،ﺍﺰﻳ
ﺮﻔ ﻧﺴﺍ
ﺮﺗﻮﻨ
ﻴﻣﺍډﻱﺩ ګﻭﻭډ ﺪﻧﺭﺩﺩ ﻪﺩځﻱګ ﮑ ﻟﻪﻧﻮﻧﻮ ﻟ
ﺪ ﺭﻱﺑﺍﻮ ﺗ
ﺍﺮﺑ
ﺭﻻ ﻮﻧ
ﺩTﻭST
ﻔﻲ ﺍ ﺮﻭﺻ ﻴﻪECGکېﻏ ﻩﭘ ﺭﻥګ ﺍﺪﻤ،ﻫ ږﻱ
ﺪﻝ کږ ﻴﻟﻰﻟ ﺍ
ﻭﻟړ
(ﻮ ﺰ)LDH ﻴﻨﻭﺟ ﺭ
ﺪ ﻳﺎﻬﻳﺩ
ﻭ.
ﻩﻱ ﺩﻮ ﻮﺟﻣ
%٩ﻭﻥۍکې٠ ړﻥۍﺍ ﻮﻡﻪﻟ ﻟﻰﺩﻯچېﭘ ﺍﺒﺖﻭ ﺜﺮﻣ ﻠﭽﮐﻳﻦېﺩ ﻭﻪﺩ ﻨﻳ
ﻮﻣ ﺯﻪﺍ ﻴﺼ ﻪﺗﺸﺨ ﺗﺯښ ﺭﺎﺍﺑ
.ږﻱﻪکږ ﺘﮐﺍښ %ﻪﺭ٥ﺗ ﻟﻰ٠ ﺍ
ﻮ ﺘ
ﺒﺜﻭﻥۍکېﻣ ﻪﺍ ﻤﻳﺭﻪﺩ ﻭﭘ ﺒﺖﻭﻱﺍ ﺜ
ﻣ
RoseSpot ېﻪs,ﻪچ ﻟ ﻧ
ﺮﺮﮐ ﻭﭘ ﺩ
ﺍﻮﻮﻣ ﻐ
ﻭﺩﻫ ﻭﺍ ﺯﺎ
ﻴﺘﻣﻮ،ﺗﺸ ﻭﺯﺎﻴ
ﺘﭘډﻮﻣ
ﻴ ﺺﺮ ﮐ ﻩﺗﺸﺨ ﺭﻥګ ﺍﺪﻤﻫ
%٩ﺮ٠ ﻠﭽ ﺰﮐﻐ ﻣﻮﺩ ﮐﻭﺩډ
،ﻩ ږﻱﺩﻝ کږ ﻭ
ﺘﻞ ﺷﻲﺍﻱښ ﻴﺴ ﺍﺧﻪﻭ ﺪېڅﺧ ﻌﻭﻣ BoneMarﺍ r
ow
ﺘﻰﻴﺴ ﻳﮏﻫﻢﺍﺧ ﻮټ ﻴ
ﺎﺕﺍﻥټﻱﺑ ﻳﺎﺯﺭځېﻳ ﻩﻭ ﺘﻰﭘﻦځ ﻭﻍﺣ ﺭﺎﺩېچېﻧ ﻩﺩ ﺮﺎﺱﺗﺴﺖﺩﻯﺳ ﺣﺴ
ﻭ.
ﻱ
14
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﺒﺖ
ﺜﻭﻥۍکېﻣﻪﺍ
ﻤﻳﺭﻪﺩ
ﻪﭘﺘﻭﺳﺭ
ﺎﻭﻣﻔﻲﻭﻱﺍﻨ%٧ﻣ٠-
٦ﻭﻥۍکې٠ ﻪﺍ
ﻟﻭﻪﺍﻧ
ﺮﻭﮐﺯﺎ
ﻴﺘډﻮﻣ
ﺩﮐ
ﺷ.
ﺍﻯ ﻲﺩﺩ
ﺒﺖک ﺜ
ﻭکېﻫﻢﻣ ﻴﻼﻧ
ﻮﻤﻠ
ﻭﺳ ﺭ
ﻮﻪﻧځﻪﭘ
ﻩﮐﻪﺩﻪﻧﻧ
ﺮﻩﮐﺭﻮ
ﻩﻏ ﺮ
ﻣﻭﻮﺩﻭﻱﺧ
ﺒﺖ
ﺜﻭﻏﺠﻦﻣ
ﺭﺎﺕﺩ
ﻳﺗﺴﺖﺯﺍ
ﺭﺩWiﻡګdalt
est:ﻪﮑ
ﻪﻟﺘﻳﻦېﻫﻢﺷﻮ
ﻣﺯﻴﮏېﺍﻮﺟﻟﺍ
ﺮﻴﺭﺳﺷﺭ
ﻮ ﻢﻳ
.
ﺮﻱﻟﻟﻰ
ﺍﻔﻲﻭﻨﻭﻣﻟﻰﺍ
ﺍﻭ
:
ﻴﺺ ﺮﻱﺗﺸﺨﻴﭘ
ﻮﺗ
،
ﻧﻲﺎ
ﺘﻧ،ﺍ
ﺯﻮﻠﮐ
ﺮﺑﻮ
ﺗﺮﺷﻲ)ﻴﭘ
ﻮﻪﺗﻮڅﺧ ﻴ
ﻭﻏﺭ
ﺎﻳﻲﻧﺎﻌ
ﺪېﻣ ﻌ
ﻭﻣﻮﺍﮑﻧﻭﺮ
ﻪﻟﺒﻮﺗ
ﻟﻭﺪﺩټ ﻳﺎ
ﻭﻏﻲﺑﺭﺎ
ﺍﻧﺩ
ﺎټﭙ
ﻴﺮﻝﻫ ﻳﺍ
ﻩﻭﺭﻥګﺍ
ﺪﻤ(ﻫQ.
FevTﻭer
yﺍ ﺭphus،
ﻼﺎ
،ﻣ ﻳﺎ
ﻣﻮﻔﻤ،ﻟ
ﺯﺱ ﻮﻠ
ﻴﻭﺳﺮ،ﺑﺘﺲﻳﺍ
ﺩﺭﺎ
ﮐﻭﺪ
ﻧﺍ
ډﻝ
ګﻱ ﻭځﻥ ړ
ﻪﺍ ﻩﻭﭘ
ﻴﮏې ﺏڼﺍﻨ
ﻴﻠﻭﻍۍﮐﺭﺎﻧ
ﺮﺷﻲچېﺩ ﻴ
ﭘﻮﻪﻫﻢﺗ ﺯﺱڅﺧ ﺎﻴﺒ
ﻴﻣټﺱﻭﺍ
ﺍﻱ ﺍ
.ﺮﻱ
ﻟﺯښﺕ ﺭ
ﻪﺍﻴﺼﻟﻰﺗﺸﺨ ﺍ
ﻮﺘﺒ
ﺜﺮﻣﻠﭽﻳﻦېﮐﻭﺩ
:
ﺎﺕﺘﻼﻃ
ﺍﺧ
ړﻦ
%٧ﺩﻡﻳ
ﻱﻭ٥
ﺭځ ﺍ
ﻪﺍﺗ
ﻮﻱﻣﻦځ
ېﻪﻭﻱﺷ
ﻪﻱ ﻧﻨﻠ
ﻣﺭﻮکېچېﺩﻧﺎ
ﻭﻏﺭﺎ
ﻮﻧﻐ
%٣ﻫ ﭘ٠
ﺎﺕ ﻪ
ﺘﻼﻃ
ﺍﺧ
:
ﻪﻟﺭﺕﺩﻱﺎ
ﺒﺎﺕﻱېﻋﺘﻼﻃﺍﺧﻩ
ﺭﻮ.ﻏ
ږﻱ
ﻻﻞکږېﻣ
ﻣﻦځ
ﺍﻭکېﺭﻪ%٥ﭘﻲښﻪﭘ
ﺘﻭﺳ
ﺭﻪﻭﻭﻥۍڅﺧ ﻭﻫﻢېﺍ
:چېﺩﺩInt
esti
nalhemorrhage.1
ږﻱچېﺪﻱﻧ
ﺭګﺎکﻥښې څ
ﻭﺩﺷږﻱﺍ
ﻪ کږ
ﺘﮐﻪ ښ ﺭﺟ
ﻭﺥېﺩﺩﻮ
ﺩﺩﺗ ﻮﻧڅﻪﺩﻭﺟ
ﭘ
،ﺎﺍ ږﻱﻪ کږﺗ
.
ږﻱﺭﺟﻲﺎ
ﻭکېﺧ ﺯ
ﺎﻴﺘ
ډﻮﻣ
ﻪﮐﻪﭘﻨﻳ
ﻩﻭﺯﺎ
ﺎﺗﻭﻳﻩﺍ
ﺭﻮﻪﺗﺘﻭﺳ
ﺭﻭ
ږﻱﺪﻱ
ﻧﺭګ ﻮکېڅﻧﺎ
ﻭﻏﺭ
ﺎﺮ%٣ﻧﻪﺗﺩﻝﺩﻱچې١څﺧﺭﻱکﺩﻮ
ﻮﺳ ﻤ
ﻟﻮﮐ
ﺘﻼﻁﻱېﺩ ﻩﺍﺧﺭ
ﻮ.ﺑﻞﻏ2
ﺘﻼﻁﻣﻦ ېﺍﺍﺧ
ﻭﻥۍک ﺩ ﻪﺍﻤ
ﻳﺭﻪﺩ
ﻩﭘﺮﺗ
ﺎﻳ
ځﻯﻭﻱچېﺯﻮﺍ
ﻩﻳﺮﻴﺖﺳﺎﺳﻭﺣﺴ ﺩﺍﺭ
ﻱېﺩﺩچېﺩګ ډ
.ﻮﻱﻮﺏﮐﺘ
ﻳﺯﺎ
ﺘﺘﻼﻁﺍﺳﺩېﺍﺧ
ﺍﺕګﺩ ﻪﺭ
ﺗﺯﺱﻣﻦځ
ﻮﺘﻳ
ﺎﻮﺳ
ﮐﻮﻴﻟﻭﺍ
ﺎﻳﺩ
ﺭﺎﺗﮏېﮐﺭځﻱﺩﻪﺍﺗ
ځ
ﺎﻱټﺱﺘ
ﻴﺴﻟﻲﺳﻮ،ﮐ
ﺎﻱټﺱ ﻨﺠ
ﻨ،ﻣﺎ
ﻴﻧ
ﻮﻤ،ﻧﺪﻝﻳ
ﺪﻨﻭﺑ
ﺯﺎﻴ
ﺘﻣﻮ
ﺗﺸ:ﺩﻪﻟﺭﺕﺩﻱﺎﺒﺎﺕﻋﺘﻼﻃﺭﺍﺧﻮ.ﻧ3
،
ﺘﺲﻳ
ﺍﺩﺭ
ﺎﮐﻮ
ﻳﺎ،ﻣﺘﺲﻳﺍ
ﺮﻔ،ﻧ(
All
opeciﺎ )aﻴ
ﻴﺴﭘﻮﻟ
،ﺍﻳﺲ ﺯﻮ
ﮑﻳﺎ ،ﺳﺎﻱټﺱ ﺒﻴ
ﻠﻴ
ﻓﻮﺒ
ﻣﻭﺮ،ﺗ
ﺍ،
،
ﺑﺴﻲ ګﻥ ﺭﺍﻭ ځﻱګﺭﻱﺍﻮﺗ
ﺘﺲ ﺩ ﻳ
ﺎﺗﺍ
ﺮﮑﻧ
ﺎ،ﭘﺘﺲﻳﺍ
ﺮﺗ
ﺭ،ﺍﺘﺲ ﻳﺎﻻ
ﻴﻣﻮ
ﺘﻭﺳ،ﺍ ﺘﺲﻳﺍ
ﺩﺭﺎ
ﮐﻭﺪﻧ
ﺍ
.ږﻱ
ﻪکږ ﺗﻣﻦځﺍ
ًﺭﺍ
ﺭﺩﺎ
Orﻫﻢﻧchit
is
ﻪ
ﻐﻪﻫ
(ﭘRel
ﻪ)apseﻧ
ﺪﻳﺭځ
ﺍګﺭ
ﺎﻴﻭﻍۍﺑﺭ
ﺎﻧ
ﺎﻫﻢﺩ
ﻴﻩﺑ
ﺮﻩﺳ
ﺮړﻱ ﺳﺭکﻮﻭ
ﻠﻣﺭ
ﺪﺩ ﻭﺏ ﺿ
ﺮﮑﻴ
ﻣﺩ
.ږﻱ
ﺪﻱﻧﺭګ
ﻭکېڅ %١ﭘﻲښ ﭘ٠
ﻭ،ﻪ
ﻮﻯ ﻱ
ېځﻞﺷ
ﺘﻢﻱ ﭘ ﻴﺴ
ﺘﻲﺳﻴﻓﺎ
ﻌﻮکېچېﻣ ﮑ
ﻠﺧ
ﺪې
ﻧﺎﻮﺑﮑ
ﻧﻭﺩﻟږ
ډﻲ ﻲﺮﺿﻲځﻥﻧﺮﻋﻴ
ﻩﻏﺭ
ﺎﭙﺎﺕﻭﺧﺖﻟ ﻳ
ﺯﺎﻥﺩﻭﻏﺭﺎ
ﻭﭼﮏۍﻧ ﺮ%٥ﺩﻪﺗﺩې١څﺧ ږﻥ
،ځ
ﻭﻱ ﺩ
ﻟږ
ﻪﻲ ﺎﻝﺗ
ﻳﺮﻴﭘ
ﺎﺎﺕﭼ
ﻳﻪﺯﮐﻝڅﺧ
ﻮﺎ ېﻪﻳ
ﻭک ﻟﺯﺎ
ﻴﺘﻮﻣﻭﺗﺸډﻮﺍ
ﻼﻪ ﮐ
ﻴﭘ ﻧ
ﻮﻤﻠ
ږﻱچېﺳ ﻟﻲﺪﺑ
ﻭ کېﺯ
ﺎﻴﺘ
ډﻮﻣﺍﻡ ﮐ
ﺭﻮګﻪﻳګﻥېﭘ
ﺎﺍﻳ
ﺮﺘﮐﺎﺭېﺑﻮ
ﻮﭘﻧﻮﻴ
ﻠﻴﺑ
١ﺮ٠ﮐﻻﻯ ﺷﻲﺗ
ﻧﮏې ﻮﻭﺩﻟږ
ډﻰ ﻲ
ﻥﻧ
.
ﻭﻱﺩ
ږﻟﻲﻪﻭﺎﻝﺗ
ﻳﺮﻴ
ﭘﺎ
ﭼ
ﻭﻍ
ﺭﺎﻭېﻧ
ﺩکڅړ
ﺍﺮﻔ
ﻮکېچېﺩﺻ ﮑﻠ
ﻮﺧﻐ
،ﻫﻭ
،ښځ،
ﻮکﮑﻠ
ﻭﺧړﻪﺯﻧ ﺲﭘ
ﺎﻮﭼﮑ
ﻧﻭﺩ
ﻟږ
ډﻲ ﻲ
ﺩځﻥﻧ
ﺮﻱ
ﻟﺎﻥﻭﺮﻃ
ﻮﺳﻤﻟ
ﻮﻭﮐﺪېﺍ
ﻌﻣﺎﺩ
ﻭﻳﺮﻱﺍ
ﻟ(ﻭ
ﺎﻥﺮﻃ
ﻭې ﺳ
ﺍ کڅړ
ﺮﻔﺎﺩﺻ
ﻳﻭږېﺍ
ﻭﻱﺗﻲﺍﺮ
ﻔۍ)ﺻ
ﺩ.
ﺎﺕ ﻯﻳ
ﺯ
.
ﻭﻱﺮ
ﺑﺍ
ﺮﻪﺑ
ﻨﻴﻣ
ﻮکېﺯ
ﮑﻠﻪﺩېﺧ
ﻩﭘﺭ
ﺎﭙﻟ
Col
oni
zat
iﻩon
ﺭﺍﺪ
ﻣﺍﻭ
ډﻱﺩﺩ
ګﻭ
ﻴﮏ ډ
ﻣﻮﺗ
ﺎﻧ
ږﻱﺍ
ﺮکږ
ﮑﻓ
:
ﻪﻨﻠ
ﻣﺭﺩ
ﻪ
ﻮﻝﭘ
ﮑﻨﻴ
ﻔﻣﺍ
ﺭﻮﻠ
ﮐﻮﺩ
ﺩﻝﺧ
ﻩکﺩ
ړﺎﻥﻡ
ﻭﻏﺭ
ﺎ%١ﻧ
ﺍ٥ﻮ
ﻭﻥېﻣﺨﮏېﭘﺨ
ﺭﺎﺮﮐ
ﻮﺗﻠ
ﻣﺭﺪﺩ
ﻭﺏ ﺿ
ﺮﮑﻴ
ﻣﺩ
15
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
.
ﻮېﻪﺷ
ﺘﮐﺍښ
ﻟ%١ﻫﻢﺭ
ﺩړﻦېﭘﻲښېﻱېﻪ
ﻮ ﻡﻳ
ﺩﺷﻭ
١ﻡکېﺩ
٩٤ﮐﻝ٨
ېﻪﺎ
ﻩچ ﭘ
ﺮﻭﻥېﺳ
ﺭﺎﮐ
ﻭﭼﮏﻮﻝﺩﮑﻴ
ﻨﻴﻔﻣ
ﺍﺭﻮﻠ
ﻮﮐﻩﻧﺪﻴ
ﺭﺳﻭﻪﻭ
ﻭځ ﺗ
ﺗ ٥ﺭ
ﻪﺮ ﻪﺩ٣څﺧﻭڅﺧﻭځ
%٢ﺭ٨
-١ﺎﻱښﺕﺩ٤ﺒﻲﭘﺗﺩ
ﻴﻦ
ړﺪېﺗ
ﻧﺮﻭﺍﻮﭘﻠﻣ
ﺭﺩېﺩﮐﻝ ﺩ
١ﻡﺎ
٩٧ﭘ٠
ﺭﻪ ،ﻡګﻮﻝ
ﺪﻝﺷ ﻧ
ژژﻣﻞﻭﭖ
ﺭﻩﺩﻮښ ﻪکېﻳﻨﻠ
ﻣﺭﻪﺩۍﭘ
.ﻮېﺪﻝﺷ ﻧ
ژژﺰېﻭﭖ
ﻴﺮﺟﻦېﺍﻏﺪېﻱېﺯﻫﻧﺎ
ﺰﺑﻐېﻪﻣ
ﻭک ﭘﺩډ
ﻭﻩﻮﺍﻪﺷﺗ
ﻣﻦځ ﺍ
ﺭﺭﺍ
ګ
ﻪ
ﻟﻩځ
ﻭﻴﺖﺩ
ﺑﺎ
ډﻞﺗ
ﻮﺑCo-ﻳ
Tri
mexazol
ﻭeﻪﺍ
ﺘﻭﺳ
ﺭﻪﻭ
ﺘﺎﻋږﺳ
ﺮﺷﭗﺍﻡﻫﺭﻮګﻴﻦﻳﻠ
ﻴﻴﺴ
ﭙﻣﺍ
.ﻩﺪ
ﻳﺭځ
ﻨ ﺲټﻭګ
ﻠﻦېﺑ
ﻣﺭﺭځېﺩﺩﻭﺩ
ﻭﻩﺍﻮﻪﺷﺗﻣﻦځﺍ
Tyﺭﻴﻼphiﻧﻮﻤ
ﻠMulﺩﺳt
idr
ugr esi
st(antﻡﮐﻝ)MDR
١ﺎ٩٨
ﻪ٩ ﻮﭘﺧ
ﻴﻦﻠ
ﮑﻳﺎ
ﺍﺳﺮ
ﺘ،ﺗ
ﻳﻢﺮ
ﭘﻮﺘ
ﻴﻤﻳ
ﺍﺮ،ﺗ
ﻴﻦﻳﺴ
ﺎﻣﻮ
ﺘﭘﺮ
ﺘ،ﺳ
ﻮﻝﮑ
ﻴﻨﻴ
ﻔﻣﺍﺭ
ﻮﻠﮐ
ګﻥېﺩﺎﺍﻳ
ﺮﺘﮐ
ﺎﺑ
ﺍﻩچېﺩﻮﻪﺷ ﻣﻮﻠ
ﻌﻣ
.ﺮﻱﻟﺭﺍ
ېټﻦګ
ﺑﻞک ﻳ ﺎ
ﻘﻪﻣﺪﭘ
ﻳﺎﻣ
ﺎﻧﻮ
ﻔﻠﻭﺳﺍ
ﻭﺱ کﻥ
ﺎﺱﺍ
ﻪﺩېﺍﺳ
ﻮﭘﻩﻧﺩ
ﻮﻟﺭ
ﺎ کېMDRﺩﮑﻳ
ﺮﻣﻪﺍ
ﻴﻼﭘﻧﻮﻤ
ﻠ%٢ﺳﮐﻝ کې١
١ﻡﺎ
٩٩ﮐﻝ٤
ﻪﺎ ﭘ
.
ږﻱ
ﻭﻝکږ ﺭ
ﺎﻪکېﮐ
ﻨﻠﻣ
ﺭﻪﺩﻳﻦﭘﺭ
ﻮﭙﻮﺳﻟﺎ
ﻔﻳﺸﻦﺳ
ﺮﻴﻨ
ﻴﻳﻢﺟ
ﺭﺎﺩﻮﻥﻳ
ﻟﻮﻧ
ﻭځ
ﻟﺲ ﺭﺭېﺩېﻪﻻ
ﻮﻝ ﻟ
ﺭځېﺩﺧ ﻭ
ﻪﺩﻟﻩځﻭﻪﺩ
ﻣ ﺍ
ﺭﻠﻲګﻣ
٥٠٠Ci
profl
oxaciﻮﻥکېn ﻴ
ﻟﻮﻧ
ﻪکﻥ ﭘ
ﻪ
ﻟﻩځﻭﻮﺩﻧ
ﻭﺯﻭﺮﻱﺩ
ﻪﮐﺴ ﺯﻥﭘ
ﺍﻡﻭﺭﻮګﻟ
ﺮکﻝ ﺪﻥﭘﺑ
ﻪﺩﻣﺍ
ﺭﻠﻲګﻣ١٥
-١٠Ofl
oxaciﻳn
ﻭﺎﻩﺍﺭﺎ
ﭙﻟﻭ
.ږﻱ
ﻮﻝکږﮐﺭﻩﻭ
ﺭﺎﭙ
ﻟﻭﻭځﺮ ٣ﺭﻪﺗ
ﺭځېﺩ٢څﺧ ﺩﻭ
ﻭ
ﻭځ٧ﺭ
-ﻭکې٥
ﺘﻼﻃﻲﭘﻲښ
ﺮﺍﺧ
ﻴﻪﻏ
ﺭځېﭘﻭ
ﻮځﻝﺩﻪﻳﻣﺍ
ﺭﻠﻲګ٥ﻣ
٠ﻴﻦ٠
ﺍﺳﺰ
ﮐﻮﻓ
ﻮﻴﻟ
ﻩﺭﻥګﺍ
ﺪﻤﻫ
ﺷ.
ﺍﻯ ﻲ
ﺩﺩﻮﻝکﮐ
ﺭﺭځېﻭ
١ﻭ٤-١
ﻭکې٠ﺘﻼﻃﻲﭘﻲښﻪﺍﺧﭘ
ﻭﻩﺍ
ﺭﺎﭙ
ﻟ
ﻭ.
ﻮې ﻱ
ﻪﺷﻣ
ﺎﮐﺎ
ﻭﻱﻧ
ﺍﺪﻮﻥﺗ
ﻟﻮﻧ
ﻭکﻥ
ﺭﻮﻠ
ﻓﻮﻱﺩﻱچېﺩ
ﻪﺷﺗ
ﻭﻪګ
ﭘﺍﺍﺱېﮐﻢېﺏﻝﻝګېﺭ
ﻮﺩﺧ
ﺍﺱې ېﻪﺩ
ﻮچ ﭘ ﺪﺷ ﻧﺭګﺭڅ ﺍټﻦګ
ﻩﻳ ﺮﺪﺳ ﻴﻴﮏﺍﺳ ﮑﺴﻳډﻟﻲﺎېﻧ
ﺎﻡک ﺩ ﻨﺘ
ﻳېﻪﻭ
١ﻡک ﭘ ٩٩
ﮐﻝ٣ ﻪﺎﭘ
ﺯﻥﺍﻡﻭﺭﻮګﻟﺮکﻝ ﺮﻫ ﺪﻥﭘ ﺑﻪﺩﻣﺍﺭﻠﻲګ ١ﻣ ﻌﻦې٠ ږﻱﻳ ﻟړﻱ
ﺯﻮ ﻭ
Ciﺩ profl
oxaciﻭکېﺩn ﭘﻲښ
ﺯﻥﺍﻡﻭﺭﻮګ ﻟﺮ کﻝﻪﻫ ﻪﭘ ﻣﺍﺭ
ﻠﻲ ګ١ﻣ ٥-
١ﻴﻦ٠ ﺍﺳﺰﮐﻮﻠ
ﻓﻭﺎﺍ ﻩﻳﺭﺎ
ﭙﻭﻟﻭځﻟﺲ ﺭ ﺭځېﺩﻪﺩﻭ ﻟﻩځﻭﺩ
ﻣﻞﺎﺮﺿﻲﻋ ﻣﻞ چېﻣ ﺭﺪﺩﻭﺏ ﺿ ﺮﮑﻳ
ﺎﻣﺭﺩ ﻮ ﺎﻧﻳﻭﻩﺍﺭﺎﭙﻭﻟ ﻭځ
١ﺭ ٠-
ﺭځېﺩ٧ ﻭ ﻪﺩﻟ
ﻩځ ﻭ ﺪﻥﺩ ﺑ
ﺩ
.
ږﻱﻭﻝکږ ﺭﺎ
ﺎﺱﻭﻱﮐ ﻩﺣﺴ ﺮﺭﺳﻭ
ﺭﺎ
ﭙﺭېﺳ ﻮﻭﭘ ﻭځ
ﻮﺭ ﻟﺴﺭﺍ
ﻭﺮڅ ﻪﺗﻮڅﺧ ﻟﺴﺭېﺩ ﻪﻻ ﻮښېﻟ ﺎﺩﻏﺪﻱﻳ ﻳﺭﻪﻭﻣﺍﺭ
٢ګ -
١Cef t
riaxone
ﻮځﻝﺍﻡﻳﺭﻮګ ﻪچېﻳ ﻴﻦڅﺧ ﻳﺴﺎ
ﻣﻭﺮﺘﻳﺯﻪﺍ ﺭﺕﺩﻱﻟ ﺎ
ﺒﻣﻞﻱېﻋ ﺭﺘﻲﺩ ﺎﺳځﻯﻧ
ږﻱﺑﻞ ﺍښﺕکږ
ﻭځ
ﻭﺭ ږ
ﺭځېﺩﺷﭗ ﻪﺩﻭ ﻣﺍ
ﺭﻠﻲګ ﻣ ٥
٠ﻪ٠ﺘﻭﺳ ﺭ ﻭځﻭ
ﻪﺭ ﻟﻭﺍﻡﺍﺭﻳ١ګ
ﻭﺎ ﻩﺍ ﺭ
ﺎﭙﻟﻭ
ﻭځﻭﺭ ﭘﻦځﺭځېﺩ ﻭﺩ
.
ږﻱﻭﻝکږ ﺭﺎﻩﮐﺭﺎﭙ
ﻟﻭ
Otundation,Del ir
iﻪ um, ﮑډﻱﻟګﻭﺭډ ﻮﻌﺗ،ﺩﺷې)ﻪ
ﻭک ﺒ ﻮﭘﻲښ ﮐﺎﻧ
ﺮﻪ ﺧﻄ ﺩﻭﭼﮏۍﭘ
ږﻱ٣ﻮﻝ کږ ﮐﺭﻪﻭ ﻭﻍﺗ ﺭ
ﺎﻭﻥﻧ ﺯﺎ
ﺘﻴﻣﺎ
ﮑﺴ ﻳ
(ډ ﺮﻱﻟﻮﻥﻭ ﺘﺎکﺷ ﻴﮏﺷ ﺘﭙﻴﻪﺳ ﺎﮐﻭﻳﺎﺍﻣﻮ،ﮐStupor
ﺮکﻝ ﺮﻫﺪﻥﭘ ﺑﺍﻡﺩﺭﻠﻲګ ﻩ١ﻣ ﺯﻭﻪ٨ﺩ ﺘﻭﺳ ﺭﺯﻭ ﻭﻭﻝﺩ ﺯﻥﺍ ﺍﻡﻭﺭﻮګﻟﺮکﻝ ﺮﻫﺪﻥﭘ ﺑ
ﻪﺩ ﻣﺍ
ﺭ ﻠﻲګﻣ
ﻪ%٥څﺧ ﺩړﻦېﭘﻲښېﻱېﺩ٦ ږﻱچې ﻡﻳ ﻭﻝکږ ﺭﺎ
ﻪﮐﺘﻭﺳ ﺭﻪﻭﺘﺎﻋږﺳ ﺮﺷﭗ ﺯﻥکېﻫ ﺍﻡﻭ ﺭ
ﻮګ ﻟ
ﺩ.
ړﻱ ﻱ%ﻪﮐﻢېک ١ﺗ ٠
ﻪږﻱچېﭘ ﻪ کږ ﻨﻠ
ﻣﺭﻩﺩ ﺭﺎ
ﭙﻮﻟﻴﻧﻭﻪﺩ٦ﺍ ﺍﺳﻄ ﻪﻭﻳﮏﭘ ﻮټ ﻴﺎﺳﺐﺍﻥټﻱﺑ ﻨﻣﮑﻰﺩ ﻧ
ﻭﺩﻟږ
ډﻰ ﻲځﻥﻧ
ﻣﻞﺩﻯچې ﺎNorﺷ f
loxaciCﻭniﺍ profloxaci n,Co- Trimoxazol e،ﻴﻦﻠ
ﻴﻴﺴﭙﻣﻪکېﺍ ﻨ
ﻠﻣﺭ
ﺩ
ﺪﺩﻳﺎ
ﺮﻱﺑ ﻟ
ﻮﻥﻭ ﺘ
ﻪﺷ ﺑېﮐﻭډﺮ ﺭګ ﻮﺗ
ﺎ ﭖښ ﺍﻳﺮﻔﻪﺩﺻ ﮑﻟډﻱګﻭﻴﮏ ډ ﻣﻭ،ﺎټ
ﻧﺮﻱﺍﻟﻮﺏ ﺘﻨ
ﻣﺰﻴ%٨ﺍﻏ٠
ﺷ.
ﻪﺍﺻﻼﺡ ﻲ ﺍﺳﻄېﻪﻭﻠﻲ ﭘﻤﺍﺣﻲﻋ ﺮﺟ
16
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
:
ﻭﻝﺮﺘﻨﻭﮐ
ﻮﻯﺍ ﻴ
ﻨﻣﺨ
ﺪې
ﻧﻮﻻﻳﻄﺍ
ﺮﺎﻱﺷ
ﻴﺘﻭﻏ
ﺭﻮﺩ
ﺮﻱﻧ ﻟ
ﻩﻭډ
ﻪﻥ ﺗ
ﺎﻳ
ﻪﺯﺑﻭﻩﻭﺍ
ړﺍﺍﻮ
ﻭکېﺧ ﺪﻳ
ﺮﭙﻭﻍۍﺧ ﺭﺎ
ﻧﻩچېﺩ څﻥګﺭ
ړﻱ
ﮐﻢېک ﺍ
ﻭﻍۍﭘﻲښېﺭﺭﺎﻧ
ﻮکېﺩ ﻧ
ﻭﺩﺍ
ﻭﻭﻮﻩﻴﻠ
ﻠﺘ
ﻣﺨﺮﻭﻝﭘﺭﺎ
ﻮﮐﺑﻭﻮﺍﮐ
ﺎﭘﻩﻭﺩ
ړﺍﺍﻮﻮﻱﺧﺟړﺷﻮ
ﺩ.
ﻱ
ﺯښﺕﺭړﻝﺍ
ﻩﻭ(ﻪﻣﻦځ
ﺎﻥﻟﻣﭽﻮ)ﺗ
ﺍﺮ،ﺩﺣﺸﻴﻦځﻝﻮﻣﻧﻮﻪﺩﻻﺳﮑﻪﻟ
ﻨﺗﺎ
ﺎﺳﻴﺘﻭﻏﻧﻲﺭﺍ
ﻩځ ﺭﻥګﺍﺪﻤﻫ
.ﺮﻱﻟ
ﺮﻱ
ﻟﻪﮑ
ﻳړﻏﺍ
ﻍﻪﻥﻍﻪ
ﻩﻥﻍ ﭘﺮﻭﻍﺳ ﺭ
ﺎﻭﭼﮏۍﻧ ﺎﺩ
ﻳﻭﻮﻱﺍﺮﮐﻔﻪﺳﻮﺗﻤﻴﻮﺳﮑﻴﻤ
ﻳﺍډ
ﻠﮏچې ﻥ ﻪﺧ ﻐﻫ
.ﻮﻱﻪﮐﺗ
ﻣﻦځﺍﻴﺖﺭﻓﺎ
ﻌﻤﻲﻣﻴﻦﺷﻲچېﻗﺴ ﮐﺴﺍ
ﺪﻭ ﻳ
ﺎﻮﺑﻧ
ﻤﻢ
ﻭﺗﺴ
ړﻮﻭﺩﺧ
ﺍﺎﻝ
ﻬﺍﺳ
ﻧﯽﺎ
ﺘﻧ
ﺍﺩﺎ
ﺣ
:ﻳﻒﺮﻌ
ﺗ
ﻧﺴﯽ ﻮﮑﯾﺮ
ﻮﻁﻓ ﻐﻪﺩﺗ ﺩﭼﺍﻮﻪﻣ ﻴﻄﺭﯼﻏ ﻮﻮﭘ ﻣﺍﺭ۳ګ ۰ﺗ۰
ﻩﺮ ۲څ۰ﻮﮐﯽﺩ۰ ﺘﺎﻋ ۲ﺳ ﻪ۴ ﻭﻍﭘ ﺭﺎﻮﻧﻪﻳﮐ
ﺎﺭﺕﺩﯼ ﺒڅﻪﻋﺎﻝ ﺧ ﻬﺍﺳ ړﯼﻭﯼﺩ ﺮک ﻴﻐﻡﺗﺍﻮﻭﻗ ﺩ
ﺍﻮﻪﻣ ﻳﻄﺎﻭﻫﻢﺩﻋ ﺍ ﺎﺕﻳ۳څﻪﺯ
ﻳﻲﺩ ﺧ
ﻪﺩﯼ ﻟﻭﻩډ ﻭﻪﺩ ﺎﻝﭘ ﻬﺍﺳ ﻩﺮﻪﻧﻈ ﻟ ﻡﺍ
ﻭﺩﺩ
ﺮﯼ ﻟ
ﻡﻭ ﺍ
ﻭ څﻪﮐﻢﺩﻮ ﺧ ﺘﻔﻩﻫ ﻭﻩﺩ ﻪﺩ Acutﭼ eDi ar r
hea- ۱
ﺮﯼ ﻟ
ﻡﻭ ﺍﻭڅﻪﮐﻢﺩ ﻮ ﺧ ﺘﻔﻩﻫﻭ ﻪﺩﺩ Chrﭼ oni cDi arrhea- ۲
ﻪﺩﯼ ﻟ
ﻭﺭﯼډ ﻝﻪﺩﺎ ﭘ ﻬﺍﺳ ﻩﺮﻪﻧﻈ ﻟﺪﺕﺩﺷ
ﻴﮏ ﻤﺘ
ﻴﺴ ﻪﺳ ﻭﻧﺍﻌﯽ ﻮﺿ ﻪﻣﻪﻧ ﺩﻭﯼﭼ ﻮﻮﺟ ﺎﻝﻣ ﻬﺍﺳﻭﻍﮐﯽ ﺭﺎﻪﻧﻴﻒﭼ ﻔMiﺎﺧ
lﻳ d- 1
ﺮﯼ ﻟﻭﻋﻼﻳﻢﻭ ﺍﺍ ﺽﺭ ﺮﺍﻋ
ﻭﻍ ﺭﺎﻪﻧﻭﭘﺍﻮﯼ ﺍﮐﺮﺍﺟﻤﻞ ﻮﻁﻋ ﺘﻌﺎﺕﺩﺗ ﻳ۴څﻪﺯ
ﻳﺩ ﺧ ﺭځﯼ۴ﺎ ﻭﻭﻍﺩ ﺭ
ﺎﻪﻧ Moderﭼ at- 2
ﺩﻮﻮﺟ abdomiﻣ nal cramps, tender ness, t
ﻪenusmus ﮑ ﺍ ﺽﺗﺮ lﺍﻋ ﮐﯽocal
sﻪﻭﯼ yﻧ stemi ﻭc ﺍﻭﯼ
ﻌﯽ ﻮﺿ ﻭﺩﻣﻭﻋﻼﻩ ﺍﻮﯼ ﺍﮐﺮﺍﺟﻤﻞ ﻮﻁﻋ ﻌﺭځﯼﺗ ﻭﺎﺕﺩﻳﻳ۴ﻪﺯ
ﻳ ﺾﺩ۴ﺎ ﻧ ﺮSevﻣ er- 3
ﻭchiﺍ lﻪlﺒﻪﺗﮑﻟﺍﺽ ﺮ ﺍﻋﻴﮏ ﻤﺘﻴﺴ ﻭﻍﮐﯽﺳ ﺭﺎ
ﻪﻧ څﻪﭘ
ﻮ ﺧ ﻤﻭﻋﻼﻳ ﺍﻮﺍﺿ ﺮﺍﻋ
ﺩﻭﯼ ﻮ ﻮﺟdehyﻣ drat i
on
ﻪﺩﯼ ﻟﻭﻩډﻭ ﻪﺩ ﺎﻝﭘ ﻬﺍﺳ ﻧﯽﺎﺘﻧ
ﺍ
bllﻭﻍody ﺭﺎﮐږﯼﻧ
ﻪﻲ ﺘﺍﺧ ﻪﻮﻥﭘ ﻟ
ﻮﻩﮐ ﺮ
ﺗﺎﻳ
:iﺯ nfl
ammat oryori nv asivedi arrhea- ۱
ﺎﻳﺖ ﮑڅﻪﺷ abdomiﺧ nalcer amps, t
ﻪ enusmus ﺒsmalﺗ l v
ol umest ool
shegi ll
a, salmomenal l
a, campy lobact erv ﻪ,ﻟﺭﺕﺩﯼ ﺎ
ﺒﻪﻳﯽﻋ ﻧﻮﻠﻣﺍﻬﻢﻻ ﻮﯼﻣ ﮐ
clost ridi
,ﻭ um entamoebahiﺍ st ol
y ti
ca y erseniainv asiv est rainofEcol i
dڅﻪ
efﺧ ici
t
ﺩﻭﯼ ﻮﻮﺟ ﻭ RBCﻣ lﺍ eukcy tepuscel ﻪﮐﯽl ﻨﺎﻳﻌﻪﻣ ﻭﭘ ﺩﺍﻮﻪﻣ ﻳﻄﺎﺩﻋ
ﻭﺩ ﺍﻮﯼ ﻪﮐﺘﺍﺧﻤﯽ ﻟﻮ
ړﯼﮐ ﻩﻭ ﺮﺗﺎ
ﻳ:ﺯ NonI nflamat orryornoni nvasi vedi ar rhea- ۲
largev olﻭﻍﮐﯽ ume ﺭ
ﺎﻪﻧﻪﭘ ﻮﯼﭼ ﻪﮐ ﻠ
ﺍﺧﺪﻪﮐﯽﻣ ﻭﺳ ﺮﺬﺏﭘ ﻪﺟ ﻮﭘﺑﻭ ﺍﻭﺩ ﺍﻳﻢﻮﺩ ﺳ
ﻪ ﻟﺭﺕﺩﯼ ﺎ
ﺒﻪﻳﯽﻋ ﻧ
ﻮﻠﻣﺍﻬﻢﻻ ﻪﻣ ﺩﻭﯼﭼ ﻮ
ﻮﺟ watﻣ erydiarrheanausea, v omi ti
ng
cry ptospor odiﻭ um gerﺍ diﻩa ﺮﻟ
ﻮ Rotﮐ av i
rus, Nor ov i
rus, Adenov irus
څﻪ
ﺧ
17
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﻮﺟﯽﻟ
ﻮﯿﻣډﭘﯽﺍ
ﻭځﻮﺍﻟ
ﺪﻳﺯږ
ﻮﻱ ﻳﻮډﻝﻧ
ګﻱ ﻭ
ځﻥ ړ
ﺩ،ﻪ ﺍ
ﻻﻞ ﻯﭘ
ﻩﻣ ﺭﻮړﻮﻏ
ﻨﻭﻡﻳ ﻮﺍﻧ
ﻮﺘﻴﺑ
ﻮﻴﻌﻣ
ﺍﻱټﺱﺩ ﺭﺍﻥټﻭﺮﺘ
ګﺳ
ﻪ
ﻧﻮﻠ
ﻴ١ﻣ٠
٠ﺘﻲ٠ﺎﺳړﻲﻧﺲﻧﺑﻲﻧﺎﻝ کېﺩﮐﺮ
ېﻪﻣﺦېﻫ ړﻥ ﻟﺩWHOﺩڅﻱ ﻮ کې. ﻧ
ﺎﻣﻮ
ﺎﺷﻮﻣ ﻧﺍ
ﻭ
،
ږﻱ
ﻩکږ ړﻪﻱېﻡﻧﻮﻠ
ﻴﺗ٤ﻣ
٣څﻪﺮ
ږﻱچې ﺧ ځﻪکږﺘﻣﻦﺗﺍﻮکېﺭ ﻧﻭﺩﺍ
ﻭﻭﺣﻝﻩ
ﻭېﻪ ﺎ
ﭘﻲښېﺩ ﺩ ﭘ
٣ﮐﻝ کې٨
ﻪﺎ ﺎﻥ کېﭘﺘ
ﻟﺴﻪﺍﻥګ،ﭘﻩﻩﺩﺰ
ﻧﻮﺘ
ﻩﺳ ﻩﻍټ ﻮﻳﺍ
ﻮ کېﻫﻢﺩ ﻧﻭﺩﺍ
ﻭﻭﻮﻩﻴﻠﻠ
ﺘﻣﺨﺮﺁﻥﭘ
.ږﻱ
ﺪﻝکږ ﻴﻟﻪﭘﻲښې ﻧﻮﻠ
ﻴﻣ
ﺮ
ﺘﻮﻥکېﺑﺴ ﺘ
ﻭﻏېﻪﺭ
٣ﻱ ﭘ ٢
٥٠٠
ږﻱچې٠ﺩﻝکږﻪﭘﻲښېﻝﺩ ﻧﻮ
ﻠﻴ٧ﻣﮐﻝکې٦ ېﻪﺎ
ﺎک ﭘ ﮑﻳﺮﻣ
ﻪﺍﭘ
.ږﻱ
ﻩکږ ړ٥ﻱېﻡ ٠٠
ﺧ٠
ﻤﻞېڅﻪ ﻪﺩېﺟ ﻟﻭ
ﺍ
ﺭ
ﻪﻻﻟﺭﻝﻭﺍﮑﻞ
ﻴﻓﻳﺠﻦټﺩﺍﻧﻲﺎ
ﺘﻧﺍ
ﺎﻪﻳﻠ
ﻣﺍﻪ
ﻟﻮﮑﻳ
ړﺍﻩﺩﺮ
ﺎﻥﺳ ﺘ
ﻧﺍﻪﻟﻍﻪ
ﻍﻪﻥ ﻏﻩﭖښښېﻥﻍ ﭘ ﺮﺗ
ﺎﻳ
ﺯ
.ﺩږﻱ
ږﻱږﺭېﻝﻪﻻﻟډۍﻭﻭډﺍﻮﺑﻭﺍ،
ﻮﻧﻮ
،ﻻﺳ ﻭﻮښ ﻟﻮ
ﻳﻮړﺷﮐﮏ ېﺎﺩ
ﻳ
ﻤﻢﻭﺩﺗﺴ ﺧړ
ﺭځﯼﺩ ﻮ ﻪﺍ ﺗﻪﻣﻦځ ﻠ
ﻣﻪﺍﺍکﻟﺭﻮﻭﺩﺧ ﺧړ
ﻮ ﻮ ﻳﻮړﺷ ﮐﮏﻭﻍۍچېﺩ ﺭﺎﻪﻧ ﻟ
ﻪډﻐټﻝېﻫ ﻭ
.
ږﯼﺩﯼ ﺎ
ﻡﯾ ﻮﻪﻧﭘ
ﻩﻮ
ﺭﻥګﻳ ﺍ
ﺪﻤﻮﻱﻭﻱﻫ ړﺷ ﻪﮐﮏﺍﺳﻄ ﻪﻭﻭﭘﺩﺍﻮﻮﻣ ﻨﺮﺟﺯﻫﻩﺩﺩ ﺎﺩﺎﻥﻳﺘ ﻧ
ﺍﺪﯿﺍﯼﺷ ﺪﯿﻩﮐ ﺧړ
ﺍ
:ﻮ ﻪ ﻧ
ﻮ ﻠ
ﻣ ﻻ
ﺧړ
ﮐﻻﻯﺷﻲﺩ ﻮ ﺮﻱﻫﻢ ﻮ ﻠﻪﻧﻨﺸﻧﻲﻣ ﺎ
ﺘﻧ
ﺩچېﺍ ﺍ
ﻮ ﺮﺟﻦﻣ ﻴﮏﺯﻫ ﻧ
ﺍﺭګﻭﺮﺍ ﻴﻭﻏﻴﮏﺍ ﻧﺍﺭګﻭﺭﺍﻮﺭﻧﺷﺭ
ﻢ
.ړﻱﻪک ﺗﻣﻦځ ﺍ
ﻤﻢﺭ ﻪکېﺗﺴ ﻠ
ﻳﺎﻪﭘﭘﻭﺍﻻﻞﺷﻲ ﻮﻣ ﻟﺪﻳ
ړﮐﮏ ﻭﺩ
:ﻤﻢﻭﺗﺴ ړ
ﻮﮐﻞﺩﺧ ﻮﮐﻮﻠ
ﻴﻓﺍ :ﺱټ ﻟﻒ ﺍ
ﻮﻻ ﻨﺘ
ﻨﻣ،ﺩږﻱﻭﺳﻲ ﻩﺍﺮCډﻝ ﺳ
ﭘ ommensalﻭ ﻮ کې ﻪ ﻳﺭﻮﻮﺳ ﻧﻪﻣﺨﮏﻥ ﺯېﭘ ﻮﭘﻭﺏﺩ ﺮﮑ ﻴﻣﺍ
ﺩ
ﻪﮑﻩﻟﺧړ
ﺍ
(چې ﻮ ﺮﻱﺭﻟﺎ
ﺑﻭﺭﺎ
ﻩﮐﺮﻭﺳ ﺪﻳﺟړ
ﻭ ﻮ ﺩﺍﻮﺍکېﻣ ﺭﻮﻮچېﺩﺧ ﮑ ﻠﻮﺧ ﻐ
ﺩﻫ ﻪ) ﺍﺳﻄﻪﻭ ﻮﭘ ﻧﻮﺳ
ﻪﺍﺳﻄﻭﻪﻭﺧړ ﭘ
ﻮ ﻮ ﻐﻩﺩﻫﺭﻥګ ﺍ
ﺪﻤ،ﻫﺩږﻱ
ﻟږﻱړﻱ ﻲ ﻩک ړ
ﻩﮐﮏ ﻮښ ﺷېﻏﻪ ﻮ ،ﭘﺨ ﻮﻻﺕ ﻭﻣﺤﺼ ﺪ ﻴﺩﺷ
.
ږﻱﻪکږ ﻣﺮﻳېﻪﺯ
ﻮک ﻧ ﻳﻄﺍ
ﺮېﻪﺷﺩږﻱچ ﭘ ﻟږﻱﻫﻢ ﻲ
:
ﻩﻴﮏېﺏڼ ﻨﻴﻠ
ﮐ
،
،ﻭک %٨ﭖښښ ﻪ٢ﺎﻥګېﭘ .ﮐﻟږﻱ
ﻭﭖﻝﻲ ﺎﻥګﻭﮐ ﺍﻟﻲﺍ
ﻭ ﺪﻩﺑړﭘﺯ
ﻪﻪ ﺘﺎﻋﺗ٦ﺳ١څﻪﺮﻩ ﺧ ﺭ
ﻭﻳﺢﺩ ﺮﻔ
ﺗ
ﻭﺏ ﺮﮑ
ﻴﻣﺍﮑﻦﮐﻢﻭﻱﺩ ﻤﺘﻰﻣ ﺎﺳﻭ،ﻧﺲﻧﻩ ﻱ ﺩﻮﻮﺟ ﻭکېﻣ %١ﭖښښ ﻪ٦ ﺒ
%ﻭﺗ٦ﺍ ﺘﻰ٨ ﺎﺳﻧﺲﻧ
ﻣﻦﺍﺭﺷﻦﺭ ﺪ
ﻳﺎﻬﻳ
ﺪﺩ ﻳﺪﺍﻯﺷﻲﺷ ﺩﺩ
ﺮﻱک ﻴﺖﻟ ﻟ
ﺆﺩﻭﻣﺴﻪکﺩ ﺗﻣﻦځﺍﺭګﻮﺩﻠﻭﻱچېﺩ ﻳ ﺪﻴﻟ
ﻮﻴﻦﺗ ﮐﺴ ﻮﺗ
.
ږﻱ
ﻻﻞکږ ﺎک ﻣ ېﻥﺩﺷ ړﻱچ ﺁ ﻪک ﺗځ
:ﻪﻨﻠ
ﻣ ﺭ
ﺩ
ﺩ.
ﻨﺲټ ﻯ ﻠﻦېﺑ ﻣﺭﻣﻞﺩﺩ ﺭﺪﺩ ﻭﺿ ﺎﻥګ ﮐﻭﺩ ﺍﻪ
ﻭﺿ ﺎ
ﻌ ﻩﻣﺭﻮﻮﭘﺗﺎ
ﻌ ﻳﺎ
ﻣﺩ
ﺷ.
ږﻝ ﻲ ﻟﻲﻩﻭﺭﺎﭙﻟﻮ
ﻟﻮﻣﻮ ﻠ
ﻌﻣﻴﻦﺩ ﮐﺴ ﻮېﻭﺗ
ﺮﻥ ﺍ ﮐﻩﺩﺧړ
ﺍﻤﻦ ﻮ ﮑﺷ
:
ﻭﺱ ﺮﻴﻮﺱﺳ ﻠﻴ:ﺑﺴ ﺏ
ﻩﻱ ﺭﻭﻳﺢﺩﺮﻔﺍچېﺗﻮﺩ ﻮﻱﻳﻪﮐ ﺗ
ﻣﻦځ ﺍ
ﻪﺭ ﻧ
ﻮﻣﻭﺭﺪﻨﻤﻲﺳ ﻤ ﻳﻲﺗﺴ ﺍﺬګﻱﻏځﻥ ړﻪﺍ ﻟ
ﻭﻩډ ﻭﻭﺏﺩ ﺮﮑ ﻴﻣﺍ
ﺩ
%١ﭖ ٠
ﺩ٠ﺭﭙﻲﺩ ﻣﺮډېﮐ ډ
ﻭﺩګ ﺎﻥګېﺍ ،ﮐﻟﻰﺍﻭ
ﺪ ﻩﺑړډﻝ کېﺯ ﻪﺩې ﻭ (چېﭘ ﻪﺘﺎﻋ٦ﺳ-١ﺩ)
ﻪﻩ ﻤېﮐ
ﺭﺕﻮﻪﺩې ﺻ ﻳﻲﭘ ﺍﻡﻫﻢﻭ ﻭﺭﺪﻨ
E.ﺳ miېﻪcﺩﻭﻱچېﺩ ﺗ ﻮﻮﺟ %٣ﻣ ﺘﻰ٣ ﺎﺳېﻭﻧﺲﻧ ﻭک ﺍ ښښ
ﻮﻱچ ﺟړﺷﻭکې ﻮ ﺧړ
ﻮﻮ ﻳﻮړﺷﻪﮐﮏ ﻴﻦﭘ ﮐﺴﻮېﻪﻣﺨﮏېﺗ ﻪﻣﺨﮏ ﻟ ﺍﺳﻄ Bﻪﻭ.ﭘ Cer کېﺩeus
(Vanill
ﺍ)aSauces ﻭﺭ
ﻮ ﻮټﻱﺷ ﻪﺑﻣﺯﻪﻭ ﺗﻭﺮﻴﭘ
ېﻭﺩﻮﺍ ﻴﻩﻣ ﺯﺎ
،ﺗﻳﺠﻲ ﺭﻪﻱېﻭ ﻧﺮچﻥﻩﺳ ېﻍټ
ﺩ.
ﻱ
٢ﺮ٤ ﺘﻰﺗ ﻪﺣ ﺘﺎﻋ١ﺳ ٦-
٨ﺍږﻩﻭﻱ)ﻩ ﻭﺩ ږڅ ﻩ ﻱې ﻝ ﺭﻭﻳﺢﺩ ﺮﻔﺗﻪﺩﻱ چېﺩ ﻐډﻝ ﻫ
ﻭﻫﻢ ﻭ ﺩ
%٩ﺘﻰ٦ ﺎﺳﻠﻦﻧﺲﻧ ﺑ
ﻭﺟړﻱچېﺍﻴﻦ ﻮﻭ ﮐﺴ ﻮﻮکېﺗ ﻤﻟ
ﻮﺎﮐ ﻳ
ﺮ ﺘﮐ
ﺎﺭﺕکېﺑ ﻮ(ﻪﺩې ﺻ ﺭېﭘ ﻮﻮﭘ ﺘﺎﻋﺳ
.ﻩﻩﺩﺭﺩﺎ
ﻪﻧﺒﻭ،ﺗ
ﺎﻥګېﻫﻢ ﻱ ﻭکېﮐ %٣ﭖښښ ﻪ٣ ﺍﻯﺷﻲﭘ ﺩﺩ%ﻭک٧ﺍ ﺩ٥ ﺭﭙﻲﺩ ﻣﺮ
ډېﮐ ډ ﺩګ
18
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
:
ﻪﻨﻠﻣ
ﺭﺩ
.ﻩﻩﺩﺭ
ﻩﻻﻠﻦې ښ ﻣﺭ
ﻮﻝﺩﺩ ﮐ
ﺭﻮﻭ ﺗ
ﺎﻌﻳ
ﺎﻣﻩﺩﺮړېﺳﻪﺑﻲ ﭘ
:
ﻨﺲﻴﻨﺠﻳﺮ
ﺮﻓﻡﭘ ﻭﺪ
ﻳﺮﺘﻟﺴ
ﻮ :ﮐﺝ
ﻮ،ﻏ
ږﻱ
ﺍکږﺪﻴﻭکېﭘﺭ
ﻭﺎﻭﺧﻮﺍ
ﻤﻟﻮﻪﮐﻮﭘﻳﻭ
ﺭﺍډﻝﺩڅ
ﺭﻭ ﻮﭙﻪﺧﺭﭘﻮﭙﻨﺲﺳ ﻴﻨﺠﻳ
ﺮﻓﺮډﻡﭘ
ﺮﻱﻭ ﺘﻮﺳﮐﺩ
ﺩېﻪ
ﻩﺷﻲ ﺩ ﭘﺮﻴ
ﻟﺖکېﺫﺧﺎAnaerﺣ obi
ﻳcﻭﺎﻪﺷﻲﺍ ﻪﻧﺎﺧﻩﭘﺭﻮ
ﻮﻻﺕچېﭘ ﺩېﻣﺤﺼ ﻩﻭ ﺩ
ښﺍ
.ږﻱړﻱﻪﮐﮏﺍﺳﻄ ﻭ
ﻭ.
ﺟړﻱ
ﻮﻱ ﻮﻪﮐﻧﺪ
ﻴﺗﺎ
ﻳﻡچېﺯ ﺰﻴ
ﻧﺍ
ﺭګﻭﺍﺪﻯﻧﻭ
ﻭژ ﺍ(ﻭﻫﻲGerminatﻴﺶ)e ﻧﺭﻮﭙﺳ
ﻪﺷﻲﺗﻣﻦځﺍ
ﺍﻯﺷﻲﺭﺩﺩ
ﻟﻰﻫﻢک ﺍ
ﻭﺪﻩﺑړﺩ.ﺯ
ﺩﻯ ﺭﻪﺩﻟ
ﻭﻣﭗډ ﺮﻱېﮐ
ﻭﺩګډ ﺘﻰﺍﺎﺳګﻞېﻱېﻧﺲﻧ ﻳ
.
ﺭځﻱ
ﻪﺍﺗ
ﻪﻣﻦځ ﺘﻭﺳﺭﻭﻭﺧړ
ﺮﻮﻪﺗ ﺘ
ﺎﻋ١ﺳ٢-ﺭﺩﻱچې٦ ﺩﺎ
ﻪﻧ ﺒ
ﻭﺗﺍﺎﻥګې ﺎﮐﻣ
ﺍ
:
ﻧﻲﻮ
ﻴﺠﺮﺟ
ﺘﮐﺎ
ﺑﻮﻠ
ﻳﺎ
ﭙﻣﺎ
:ﮐﺏ
ﻪﻱې
ﻧﺮچﻥ
ﻩﺳﺭ
ﻮﻠﻲﻏ
ﻪﺍﺧﻨﺸ
څﻪﻣ
ﻮ ﺧﻤ
ﻟﻮﻪﮐګﻮﻟ
ﻧﺍﺍ
ﻮﻭﻏګﻮﺍ
ﻧ
ﺮﺍﺯﺱﺩﻯﺩﭼﻮﻧ
ﻭﻡﺯﺰ
ﻴﻧﺍ
ﺭګﻭﺍﺍ
ﺩ
ﺷ.
ﻭﻻﻯ ﻲ
ړﻮﻻﺕﮐﮏﻭﻣﺤﺼﺪﻴ
ﻩﺩﺷﺭﻥګﺍ
ﺪﻤ،ﻫ
ﺍ(ﻩ
ګﻮﺩ
ﺮﻧ ﻪﺩﭼ
ﮑﻟﻩ)ﻮښﻏ
.
ﻩ٥ﺭځېﺩ
-ﻭﻩﻱې٢
ﺭﻭﻳﺢﺩ
ﺮﻔﺗ
ﺩ
،
ﻟﻰﺍ
ﻭﺪﻩﺑړ
،ﺯږﻱ
ﻪ کږﻟﻄ
ﺎ
ﻐﻩﻣﺮ
ﻭﺳ ﺍﺣﻲﭘﻲښﺮﺪﻭﻱچېﺩﺟﻳ
ﺪﻩﺷﺮﻣ
ﻭﺩﺩﺭ
ﻴﮏېﺩﻟﻮ
ډېﮐ ډﺩګ
ﻪ
ﺘﺎﻥﺍﺧﻧ
ﺍﻭ
ﻩځﺮﺗﺎ
ﻳﻭ،ﺯ
ﮑﻰ ﻱﻧ
ﻭﺮﻪﻟ
ﻨﻳﺘﻰﻭ
ﺎﺳﺩﻭﻱچېﻧﺲﻧ
ﻮﻮﺟﺘﻰﻣ
ﺎﺳﻩﻧﺲﻧږڅ
ﻭﻝ ﺎﻥګېﺍﮐ
.ﻮﻱﮐ
ﺪ
ﻭﺏ ﺿ
ﺮﮑﻴ
ﻣﻱﻭﺩ
ﺩږ ﺍ
ﺍږﻱ
ېګﻞېﻭ
ﻭک ﻳ %٢ﭘﻲښ٠-
١ﭘ٠
ږﻱ ﻪ
ﻩکږﻪښ ﻠ
ﭙﻪﺧﺘﻭﺳﺭﺭځېﻭ٧ﻭ-٥
.ږﻱ
ږړﺎﭖښښﻴ
ﺗﺍﺗ
ﻻﺪﻪﻭﻳﺮﮑ
ﺎﻣﻴﻦﻳ
ﺎﺳﮐﺴ
ﻮﻠﻓﻭ
ﺮﭙﻪﺳﮑﻟ
ﻮ ﻠ
ﻣﺭﺩ
ﺩ.
Reactﻯ
iveAr
thr
it
iﻭs
ﺍﻡﻭ
ﺭﺪﻨ
Guiﺳ
l
lanBar
rﺘﻼﻁﻱېe
ﺍﺧﻬﻢ
ﻣ
:
(Li
ster
iosi
ﻳﺲ)s
ﺯﻭﺮ
ﻴﺘﻴﺴ
ﻟ:ﺝ
،ځﺎ
ﻴﻤﻳ
ﺮﺘﮑ
ﺑﺍﺩﺮ
ﺜﮐﻭ،ﺍﺍ
ړ ﻱﺩﺮﮐﮏﻴ
ﻨﻩﻭﭘ
ﻮښﺍګﻮﻏ
ﻧ
ﺮﺍ ډﻝﺩﭼ
ګﻱ ﻭ
ځﻥ ړ
ﻪﺍ ﻮﺟﻦﭘﺘﻳﺎ
ﻮﺳﻧﻮ
ﻣﺍﺮﺘ
ﻴﺴﻟ
ﻮ
ﻟﺪﻳ
ﺯږ
ﻮﻱ ﻳﻮ،ﻧ
ﻭﻭ ښځﺭ
ﺍﻭﺪ
ﻴﻣﻪﺍ
ګﻱډﻝﭘ
ځﻥ ړ ﻭ
ﻪﺍ .ﭘ
ږﻱ
ﺒﺐ کږ ﺎﻱټﺱ ﺳﻨﺠﻨﻭﻣﺎﻥﺍﺘ
ﻧﻳﻲﺍﺍ
ﺩ.
ﻳې ﻱ
ﻮکېﻱېﭘﻲښېډﺮ ﮑ
ﻠځﻮﺧ
ﻠﻴﺖ ﭘ
ﻓﺎﻌ
ﻭﻣﺍﻮﻧ
ﺎﻭﻏ
ﺭﺎﺮېﻧ
ﮑ،ﺩﺷﻮﻧ
ﺎﺘ
ﻟﺴﻮﮑﻟ
ﺍ،
ﻮﻧﺎ
ﻣﻮﺎﺷﻣ
:
Sal
monel
l
a:ﺩ
ﻟډډﻝﺩ ګ
ﻪﻦ ﻭﻭﭘ
ﺷېﺍ
ﻩ ﻮ
ﺩﺎﻪﺑﺤﺚ کېﻳ
ﻴﻼﭘ
ﻧﻮﻤ
ﻠډﻝﺩﺳ
ﻔﺼﻞ ﻭﻪﻣﺮﻱﭘ
ﻪﻟﻧ
ﻮﻟ
ﻭ٢ډ٣٠
ﺩ٠ﺍ
.
ﻭﻮﻪﮐ
ﻧﻭﺩ
ﺎټﺱڅﻪﻱېﻳ
ﺧ ﺍﻱ
ﺮﺘ
ﻧﺍ
ﻭﺮﺘﺳ
ﻩﻭﻩ
ﻮښﺍﺮګېﻏ
ډﻝﺩﭼ
ګﻱ ﻭ
ځﻥ ړ
ږﻱﻪ ﺍ
ﻩکږ ﭘ
ﺮﺮﺳ
ﻪﺗﺍﺳﻄ
ﻭﻪﻭ
ﺧړ ﭘ
ﻭ ﻮ ﻮﺍ
ﺑﻭﺩﺩﺍ
ﻟږ
ﻭﻍۍ ﻲ
ﺭﺎﻧ
ﺩ
.ﻩﻪﺩﻧ
ﺮچﻥﻩﺳګۍﻱې ښ
ﺍﻯﺷﻲډکېﺩﺩ
ﻧېګﻞېﺩﻱک
ﺭګﺪ ﻳ ﺎﻥګېڅ
ﻭﮐﺘﻰﺍﺎﺳ.ﻧﺲﻧﻩ
ﻪﺩ ﺘ
ﺎﻋ٧ﺳ
٢-١
ﻩﻱې٢ﺭﻭﻳﺢﺩ
ﺮﻔﺗ
ﺩ
.ږﻱ
ﺪﻱﻧ
ﺭګﺍﻱټﺱڅ
ﺮﺗ
ﺭﺍﻴﻒ
ﺘﮐﺍ
ﻭ%٢ﺭﻱﺍﺎ
ﻴﻤﻳ
ﺮﺘﮐ
ﺎﻮکېﺑﻧ
ﺎﻭﻏﺭ
ﺎﻧﮏېﻭﻱ%٥ﻧﻭ
ﺮﻟﻪ
ﻨﻳﺯېﻭ
ﺎﻴ
ﺘﻣ
:
E.Col
i:
ـﻩ
ﻩﺏﻝﻻﺏﻝﺮﻱﭘﻦځﻮﻥﻟ
ﺘﻮکېﺷ ﻤ
ﻟﻮﻪﮐ
ﻮﭘﻧ
ﺎﻧ
ﺎﻧﺴ
ﺍE.ﺩCol
ﻪﺩiﻧ
ﻮﭙﻳ
ﺍﻭټﺮﻴ
ﺎﺕﺳ ﻳ
ﻮﺟﻲﺯ ﻟ
ﻮﻤﻳ
ﺪﻴﭘ
ﺍ
ﻭ.
ځﻯ ﻱ
ﻮﺍﻩﻳﺮﺘﻲﺳﺎﺳﻧﺲﻧ
ېټﻝﻱېﺩ
ﻮﻱچ ﻭ ﻪﮐ
ﺗﻣﻦځﺍ
ﻪﺭﻧ
ﻮﻧﻮ
ﻟﺪﻴﮏﺑﻮﺟ
ﻟﺎ
ﺘېﻭﭘ
ﻴﮏ ﺍﻨ
ﻴﻠ
ﻝﮐ
19
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
:
Ent
reot
oxi
geni
cE.
Col
i(ETEC)-
١
ﻡ
ﻭﺎﻘ
ﻣﺮﻴﻮﻏﻭﻳﻡﺩﻯﺍ ﻭ
ﺎﻘﻩﻣ ﺮ
ﻭﺥې ﺳﺩﻮ
ﺗﻡﺩ
ﺰﻴﻧﺍ
ﺭګﻭ
ﻻﻞﺩﻯﺍﻩ ﻣ ﺭ
ﻮﺘﻰﻏ ﺎﺳﺮﻱﻧﺲﻧﻔﺩﺳ
،
ﻩﺭځېﺩ٢ﻭ
-ﻩﻱې١ﺭﻭ
ﻳﺢﺩ ﺮ
ﻔﺗ،ﺩ
ږﻱﻭﻻﻞکږ
ﺎﻥګ ﻣﻭﮐﺘﻲﺍﺎﺳ
ﻧﺲﻧ ﻭﻱچېﺩﺪﻴ
ﻟﻮﻴﻦﺗ
ﮐﺴﻮ
ﺗﻭﺮ
ﻴﺘﻧ
ﺍ
.ﻮ
ﺘﻼﻯﺷﻴﺴﺍﺧﻩ
ﻪکېګټ ﻨ
ﻠﻣ
ﺭﻪﺩڅﻪﭘ
ﻮ ﺧﻠ
ﻣﺭﺪﺩﻭﺏ ﺿﺮ
ﮑﻴﻣ
،ﺩﻮﻱﻡﮐﺍ
ﻭ٤ﺭځېﺩ
-ﻭﻭﻏﻲ٣ﺭﺎ
ﻧ
:
Ent
ero-
inv
azi
veE.
Col
i(EI
EC)-
٢
ﻻﻞ
ﻳﺐ ﻣ
ﺮﺩېﺩﺗﺨ
ﻭﺩﻮﻱﺍ
ﺪﮐﻳ
ﺮﺪېﺑ
ﻧﺎﻮﺑ
ﮑﻧﻭ
ﺎﻃﻲژ
ﻣﺨﺮ
ﻮﻥﭘ
ﻟﻮﮐﻪﺩﻯچېﺩ ﺗ
ﺭﻼﻪﻭ
ﻴﺗ ډﻝﺷﺠﺍﻭ
ﺩ
.
ﻭﻱﺪﻴ
ﻟﻮﻪﺗ
ﻴﻦﻧﮐﺴ
ﻮﺗﻭ
ﺮﻴﺘ
ﻧﺍ،
ږﻱ
کږ
ﺰې
ﻳﺩﻭ
ﻮﻥﻱېﺩ
ﺘﻳﻦېﺷ
ﻭﻭکېﺩ
ﺯﺎﻴ
ﺘډﻮﻣ
ﻪﮐﻭﭘ
ﺩﺍﺭ
ﭙﻲﺩﻣﺮﻱېﮐ
،ﺩګډﺘﻰ
ﺎﺳﻠﻦﻧﺲﻧ
ﺑﻭ
ﺑړﻲﺍ
ﻲﻧ
.
ږﻱﺪﻱﻳ
ﺪﺍﺷ
ً
ﺭﺩﺎ
ګﻞېﺩﻱچېﻧ
ﻭﻳ ﺍﻥښې
:
Ent
eropat
hogeni
cE.
Col
i(EPEC)-
٣
ﻭ
ﺪﻴﺑ
ﺬﻣﻞ ﺟ
ﺭﺎﻭﻧﻳﺐﺍﺮ
ﺗﺨﻮﺩﻤ
ﻟﻮﮐ
ﻻﻞﺩﻯ چېﺩ
ﻬﻢ ﻣ
ﺘﻲﻣ
ﺎﺳﻧﺲﻧﻮﺩ
ﻧﺎﻣ
ﻮﺎﺷﻮﻣﻟ
ﺪﻳﺯږ
ﻭﻱ ﻮ
ﻧﺩﺍ
ﺩ
ﻧﮏېﻧﺲﻭﺮﻪﻟﻨ
ﻳﺮﻭڅﻪﺗ
ﺘﻲ ﺧﺎﺳ
ﻴﻒﻧﺲﻧ ﻔ
ېﻪﺧ
،ګﻞېﻱ ﻟ
ږﻱ ﻳ
ﻻﻞ کږ
ﻟﻲ ﻣﺍ
ﻮﺑﺍ
ﺮﻴﺖﺩﺧﻓﺮﻇ
ﺷ.
ﮐﻻﻯ ﻲﺮﻮﻴﺭېﺳﻮﺘﻲﭘﺎﺳ
ﻧ
:
Ent
ero-
aggr
egat
iveE.
Col
i()EAEC
-٤
ﺎﻝ
ﻌﻳﻲﻓ
ﺍﮐﻻﻯ ﺷﻲ چې ځ
ﻮ ﻮ
ﺮﻱ ﺧ ﺩﻟﻮ
ﻴﮏﮐﺘﻨﻩﺟ
ﺭﺎﭙ
ﻭﻟﺪﻴ
ﻟﻩﺩﻥښﺮ
ﺎﻁ ﺳﻪﻣﺨډﻝﻟ
ﺍﻭﺩ
ﻭ.
ﻩﻱ ﺭ
ﺍﺪﻣ
ﺍﻭﻪﺩﺘ
ﺎﺳډﻝکېﻧﺲﻧ
ﻱﻪﺩې ﻭ
ړﭘ ﺪک
ﻴﻟﻮ
ﻴﻦﻫﻢﺗ
ﮐﺴﻮﺗ
ﻭﺮﻴ
ﺘﻧﺍ
:
Ent
erohaemor
rhagi
cE.
Col
i()EHEC
-٥
(چېﺩVer
ocyt
otoxi
ﻴﻦ)n
ﮐﺴﻮﺗ
ﻭﺮﻴ
ﺘﻧ
ډﻝﺍ
ﻮﻭ ﻭﻫﻢﻳ
ﺮﻱﺍﻟﺩﻮﻴﮏﮐﺘ
ﻴﻨﻩﺟ
ﺭﺎﭙ
ﻟﻭﺪﻴ
ﻟﺩډﻝﺩﻥښ
ﺍﻭ
ﺩ.
ډﻝ ﻯ
ﻮﻯ ﻭﺪﻝﺷﻧژ
ژﻩﭖﺩې ښ
E.ﺩcol
i0157:
7.ﻭﻱﺪ
ﻴﻟﻮ
ﺮﻱﺗﻟﻟﻰﺍ
ﻪﻭﺗ
ﺭﻩﻭﺮShiﺳ
gatoxi
n
،
ﻮﺎﻫ
،ﮐ،
ﺪﻴﺍﻯﺷﻲﺷ
ﺩﺩﻩک
ﺭﻥګ
ﺍﺪﻤ
ﺭﺩﻯﻫﺎﮑ
ﻩﭘﺭﺎ
ﭙﺍﺕګﻟﻪﺭﺗ
ﻣﻦځ
ﻭﻍۍﺩﺭ
ﺎﻧ
ﻪﺩﻧ
ﻮﻣﺰ
ﻴﻧﺍ
ﺭګﻭ
١ﺍ٠
٠-
١٠
ﺷ.
ﻪ ﻲ
ﻧﺮچﻥﺎﻥﺳﺘﻧ
ﺍﻱﻭﺩ
ړﺍړکﻮﺱﮐﮏﺩڼﻱﭼ
ۍﻭ ﻡ
ﺳېﻣﻞ ﺍ
ﺮ
ﺪ
ﻳﺪﻭﺷ ﻩﺍﺭﺍ
ﺪﻣﺍ
ﻭﻱېﺩﺩﺘﻰﺩګډ ﺎﺳ
ﻠﻦﻧﺲﻧ ﺑﻭﺮکېﺍړﻱﺳ ﻡﻮﻪﻟﻩﭘﺭځېﺩ٧ﻭ-
ﻩﻱې١ ﺭ
ﻭﻳﺢﺩﺮﻔﺗ
ﺭ
ﻭکېڅ ﺯﺎ
ﻴﺘډﻮﻣ
ﻪﮐ ﻪﭘﻨﻳ
ﻪﻭﺘﻭﺳﺭﻩﻭﻱﻭ ﺩﻮ
ﻮﺟ ﻪﻣﺒ
ﻭﺗ ﺎﻥګېﺍﻩﮐﺭﻥګﺍ
ﺪﻤﻭ،ﻫ
ځﻯ ﻱ
ﻮﺍ ﻩﻳﺮ
ﺩﺳ ﺭﺩ
ﻪګ ﮑﻮﻟﺎﺟ
ﻧﺴﻭﺍﺭﻮﻪﻧﻩﭘﺭﻥګ ﺍ
ﺪﻤﻭﻫﻮ کېﺍ ﻤﻟ
ﻮﻪﮐﻩﭘ ﺰﻴ
ﻌﻲﺍﻏ ﻮﺿﻴﻦﻣﮐﺴﻮ
ﺗﻭﺮ
ﻴﺘﻧ
،ﺍږﻱ
ﺪﻱ ﻧ
ګ
ﻪ
ﭘﺍږﻱچېﺩ(ﻻﻞ کږ
ﻡ) HUSﻣ ﻭﺭﺪ
ﻨﻴﮏﺳ ﻤﻳ
ﺭﻮﻴﮏﻳﺘﻳﻮﻻﻤﻴﻧﮏېﻫﻭﺩژ
ﺮﻱچې ﻭﺪېﻟﻧ
ﺎﻭﻝﺑﺮﻴ
ﻣﻮﻟ
ﻭﺩ ﺍﺍﻮﻳ
ﺭﻮﻴﮏﭘ ﻨ
ﻴﭘﻮﺘ
ﻳﺎ
ﻮﺳ ﺒ
ﻣﺮﻴﮏﺗ ﺗ
ﻮﺒﻣ
ﺮﺗﻩﺩ ﺭﻥګ
ﺍﺪﻤ،ﻫ ږﻱﺪﻱﻧ
ﺭګﻭ کې څ %١ﭖښښ ٥-
١٠
.ږﯼ
ﻻﻞکږﺘﺲ ﻣﻳﮐﻻ
ﻴﮏ ﻮﺍﺟ
ﺭﻮﻤﻴ
ﻫ
20
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﺍ
ﺮﻟ
ﻮﮐ
(
Choler
)a
:ﻳﻒ ﺮﻌﺗ
ﻻﻞ
ﻣګ ﻣ ﻭﺮ ﺍﻳﺸﻦ ﺭﺪﻳﺎ
ﻬﻳژﺭﺩ
ﻮکېﺩﻭ ﻧﻮﺘﺎﻋېﻪﺳﻩچ ﭘ ﻭﻏﻲﺩ ﺭﺎ
ﺍﺱېﻧ ﺘﻲﺩ ﺎﺳړﻲﻧﺲﻧ ﺑﻲﻧﺍﺩ ﺮﻟ
ﻮﮐ
ېڅﻪ
ړﻦ ﺧ ﻪﻡﻳ ﻭﻍﻟ ﺭﺎﻧﻩﺩ ﺮﻠﻦې ﺳ ﻣﺭﻮﻱﺩ ﻳ
ﻮﻘﻭﺗ ﺭﻮﻭﻧ ﻮﺍﺗﺎﻌ
ﻳﺎﻩﻣ ﺭﻮﭘﻪﺩ ﺮﻏﻪﻣ ﮑﻴ
ﻧﺩﺎ
ﻣږﻱﺍ کږ
ﺷ.
ﺍﻯ ﻲ ﺩﺩﻮﻯک ﻴﻨﻣﺨ
ﻣ:
ﺒﻲﻻﻞ ﺒﺳ
ﻟﻰﺍ
ﺍږﻭ
ﻴﻞﺩﻯﻭﺩ ﺮکﺑﺴ ﺘﺤﻔﻲﻣ ﻨﻡﻣ ﺍ
ﺭﻮګ ﻳﺍViﺩﻯچېﺩ br i
oChol erﻻﻞa ﺒﻲ ﻣ ﺒ
ﻭﻍۍﺳ ﺭﺎ
ﺩېﻧ ﺩ
ﻪﻱ ﻧ
ﻮ ﭙ
ﻳﺎ
ﺗﻭﺮﻴ٢ﺳ٠ﺩې٦ ږﻭﻥږﻱﺍ ﻪﺭﺳﻲ ﻭﺗ ﺮﺘﻣﻭﺮ
ﮑﻳﺎ٠ﻣ ،
٨-٠،ﺮﻱې٥ ېﻭﻗﻄ ﺭﺍ ﻮﻭﭘﺮﺘﻣﻭﺮﮑﻳﺎ
٣ﻣ -ﻱې١
ﺭځﻦېnono1 ﺩ،ﻡګ ﻳ ﻮﻱ ﻱ ﻳﺸﻞﺷ ﻨﺲټﻭ ﺑ
ﺮﻴﻦﭘ ﻨﻴﺗ
ﻮ ﻟ
ﺩګﻭﻯﺍ ﻮﻱﺩﻱچېﺩ ﺪﻝﺷ ﻧژژﻭﺱ ﭖ ﺍې
oﻭ
lV.ﺍﺯېc ﺍﻮۍﻻﻞﻳ
ﻭﻍ ﻣ ﺭ
ﺎﻧﺩﺎ
ﻣﻮﻱﺍ ﻪﮐ ﺗﻣﻦځ ﺍ
ﺘﻰﺭ ﺎﺳﻩﻧﺲﻧ ﺮډﻝﺳ ﻳﮏ ﻭ ﺩ
ﺍﺭﻮﭙﻪﺳ V.ﻫﻢﭘ ch
.
ږﻱOlکږ 39
.
ﺪﻯ ﻳﻮﻳﺸﻞﺷ ﻳﭗﻭ ﺎﺗﻮﻴﺑﻭ
ﻭﺩ ﺍ ﻳﭗ ﺎ
ﺗﻭﺮﻴ
ﺩېﺳ ټﻪ ﺭ
ﻨﺲ ﭘ ﺮﺑﺍﻥټﻱﺟﻦﭘ ﻴﮏ ﺗ
ﺎﻣﻮﺍ01ﺩﺳ ﺭ
ﻮﮐ ﻭﺮﺒﻳ
ﺩ
ﻭﺘﻲﺍﻧېAﻭBﺍ
ﻳﭗOgawaچ ﺍ ﺎﺗ
ﻭﺮﻴ،ﺳ ﻭﻱ ﺩ
ﻟږ
Aﻭ Cﺍﻥټﻱﺟﻦ ﻲ ,ﺍ iچېO ﻳﭗnaba ﺎﺗﻭﺮﻴﺳ
.ﻭﻱ ﺩﻟږ
ﺘﻲ ﻲ ﻧﺍBﻭC ,ﺍﺍﻫﻢA Hiچېﺩ kojiﻳﭗma ﺎﺗﻭﺮﻴﺳ
ﺮﻱﻴﺖﻟ ﻟﺆﻣﺴﻮﻴﻤﻳﺪﻧ
ﺎﻭﭘ ږﻳﭗﺩﺷﭗ ﺎ
ﺗﻮﻴﻴﮏﺑ Biﺩﻱ چېﮐﻼﺳ oty Elﻱېpes tﻭor ﻴﮏﺍ ﮐﻼﺳ
ﺩ.
ﻮﻱ ﻱ ﻪﺷ ﺗﻣﻦځ ﺍﻪﺭﺍﺳﻄ Eﻪﻭlﭘ tﻤﻲﺩor ﻳډﺎﻥﻩﭘﻭﻨﻲﺩ ﺘﺭﺳ ﻭﻭﺍ
ﺮﺿﻲ ﻩﻋ ﻮﻭکېﻳ ﺮﺿﻲﭘﻲښ ﺮﻋﻴ١ﻏ٠ﺗ٠څﻪ ﺮ٢ﺧ ﻪ٠ﭘﺮﺿﻲﺩﻯ) ﺮﻋﻴﻳﭗﻏ ﺎﺗ
ﻮﻴElﺑtﻩor ﺮﺗﺎﻳﺯ
ﺎﻣﺍ
.(ﻮﻱﻪﮐ ﺗ
ﺍﻣﻦځ ﭘﻲښېﺭ
.
ږﻱﻭﺳﻲ ﺍ(کې Brackishest uariﻮ)es ﺑﻭﺍګﻮ
ﻨﻟﻲ ﻳ ﺎ
ﻪﻣ ﻭﺏﭘ ﺮ
ﮑﻴډﻝﻣﻌﻲ ﻭ ﻴ ﺒ
ﻪﻃ ﭘ
ﻭ،
ړﻱ ﺎﻥﮐﮏ ﻧ
ﺎﻧﺴﺭﺍ ﻮﺎﻥﻧﻧﺴ ﺍﺍﺪﻤﻮﻫ ﻮﻧ ﺘﻦ ﺷ ﻨ
ﻪچېﻣ ﻠ
ږﻱﻭﮐ
ﺘﻦ کږ ﺍ ﻨ
ډﻝﻣ ﭘﻲ ﻭ ﺍ
ﻧڅ
ﻪﺎ ﺎﻥﭘ ﻧﺴﺍ
ﻟږﻱ
ﻠﻲﻭﻱ ﻲﺩ ﺍﻏﺎﺱﺭ ﻤﻪﺗﻩﭘ ﺮﻭﺳ ﺯﺎ
ﻴﺘډﻮﻣﺎﻥﺩ ﮐ ﻧﺴﺍڅﻪچېﺩ ﻮ ﺧ ﺑﻭﺍﻮﻳﻮړﺷ ۍﻪﮐﮏﻭﻍ ﻟ ﺭﺎﻩﻧ ﺮﺗ
ﺎﻳ
ﺯ
ﮐﻻﻯ
ﺪﻮ ﻧﻭﺎﻥژﺘﻧ
ﻭﺍ ﻭځ١ﺭ ېﺮ٤ﻭک ﺗ ﺧړ
ﻪ ﻮ ﺩﻻﻯﺷﻲﭘ ﻟږﻭﻭﻏﻲ ﻲ ﺭﺎﻮکېﻫﻢﻧ ﺍکېﺗ ﺭﻮﻮﺧ ږﻱﺧ
ﺩ.
ﺎﺱ ﻯ ﺎﻥﺣﺴ ﺘﻧﺍﻩﺮ
ﺭﺕﺳ ﺍﺮﻮﺩﺣ ﺷﻲﺧ
.ﻮﻯ ﺪﻝﺷ ﻧژژ
ﻪﺩﻯﭖ ډﻝﻧﻪﻭ ﺰﻥﭘﻣﺨ ﺍﻥﺩ ﻮﻴﺣ
.
ږﻱﻪکږ ﺗﻣﻦځﺍﻮﺳﻢکېﺭ ګﻡﻣﻩﻪ ﺭﺯﻮګﭘ ﺯﺗ ﺩېﻪﺩﻤﻲﻱ ﭘ ﻳﺪ ﻤ
ﻴﭘﺍ
ﺎ
ﻭﻳ ﺮﻱﺍﻟH.ﻭPy lorﻠﮏچېi ﻪﺧ ﻐﻪﻫ ﮑﻩﺩﻱﻟ ﺭﻮﻩﻏ ﺭﺎﭙﺪﻥېﻟ ﻳﺩږ
ﻟﻲ ﻪﻫﻢﺩ ﻧﻭﺭﻮﺘﮑﻨﻲﻓ ﻳ
ﻪځ ﺑﺭﻮﮐ
ﺩ
ﻩﺮﺎﻥﺳ ﺘ
ﻧﻴﻢﺍﻪﻭﺧ ﻭﺁﻥﻟ ﻩﺍ ﺮﺗ
ﺎﻳHyﻭﻱﺯ pochl orhy dri
ﺎc ﻭﻳ ﺮﻭﻱﺍ ﻔﻭﭖﻱې ﺻ ﺭﻳﻦېګ ﻭﺩ
ﻮﻪﺗﻤېﻪﺳﺯﭘ ﺎ
ﻴﺘﺎﻥډکېﻣ ﻧﺴﺍ
ﻮکېچېﺩ ﻧﻭﺩﺍ
ﻭﻭ ﺎﺕېﻩ ﻪﭘﺘﻭﺳﺭﻩﻪﻭﺭﻥګﭘ ﺍ
ﺪﻤ،ﻫ ږﻱ
ﻣﺦکږ ﺎﻣﺨ
ﻩﻭڼګﻩ ګ
ﻮ ڼ ﮑﻠﻭﺩﺧ ﻪﻭﻱﺍ ﻮﻱﻧ ﺍﻋﺖ ﺷ ﺮﻳﻂﻣ ﺍ
ﺮﻳﻲ ﺷ ﺎ
ﻴﺘﻭﻏﻪﻭﻱﺭ ﻮﻱﻧ ﭘځﻯ ﺷ
ﻩځﻯ ﺮﺍګ ﺍ
.ﺎﻥﺘ
ﻭﺳ ﺪﻨ
،ﻫﻳﺶ ﻪﺩ ﻟ
ﻪﺑﻦګ ﮑﻟﺩ،
ﻪﻱ ﺗﺎﻳﻪﺯﻧﺪﻳﺩﻟږ
ﻩﻭﻱ ﻲ ﺩﻮ ﻮﺟﻣ
ﺩ.
ﻧﮏې ﻱ ﻭﺪﻴﻭﺳ ﺍﺪﻨﻴﺩﺳﺍﻭګﻥګ ﺍﺎﻥﺘﻭﺳﺪﻨﺍﺻﻼًﺩﻫ ﺎﻥﻪﮐﺴ ﺘﺍﺧﺍﺮﻟﻮﻪﮐ ﭘ
Eﻪ
lﻟ t
ﻤﻲﺩor ﻳ
ﺪ ﻧ
ﺎﻭﺳﻦۍﭘ ﺍﻮﻱﺩﻱچېﺩ ﻪﺷ ﺗﻣﻦځ ﺍﻤﻲﺭ ﻳﺪﻧﺎ
ﻩﭘ ﻭﺍﺭې ﻮ
ﻪﭘ ﻭﺳ ﺍﺮﻡڅﻪﺗ
١ﺧ ٨ ١ﺩﻝ٧ﺍ
.ﻩکېﺩﻪړ ﻧﺪﻳﺩﻟږ
ﻪﻱې ﻲ ﺗﺎﻴﺍﺳﻪﻟﻭﺷېﻭټ
ﻭﻉ ﻮ ﺍ ﺮﻡکېﺷ ١١٩٦١
ﺎک ﻳﺰﻴﻧ
ﻭ ﺪ
ﻧﺍﻪ ﻪﭘﻠﻣﺍ
:ﺰﺱ ﻴﻨﻮﺟ ﺘﭘ
ﺭﻪچ ﺯﻱېﮐ ﻭﻧﻲﺩ ﺎﺘﻧ
ﻴﻦﺩﻱﺍ ﺗﻭﺮﻤﻦﭘ ﮐ
ﺍﻭﻴﻦﻱېځ ﮐﺴ ﻮﻩچېﺗ ﻭﻏﻲﺩ ﺭﺎ
ﻧﮏېﻧ ﻭﺟړ
ﻴﻦ ﻮ ﮐﺴﻮ ﺍﺗﺮﻟ
ﻮﮐ
٤ ٢ ٦ ٣
ﺩ.
١ﻯ ٠-١ﻮ٠ ﻧﮏېﻭﻱﻧ ﻭ
ﺩﻟږ
ﻩﻲ ﺧړ
ﺍﻪﻮ ١ﻭﮐ٠-ﺍ ١ﻮ٠ ﻧﮏېﻭﻱﻧ ﻭﺩﻟږ
ﻪﻲ ﺑﻭﺍﺭې
H2-Recept or,، ﺪ ﻴ
ﺘﻲﺍﺳ ﻧ
ﺍ:ﺩ ﻪﮑﻮﻱﻟ ﻪﮐ ﺘﮐﺪ ښ ﻴﺪېﺍﺳ ﻌﻣﺎﻻﺕ چېﺩ ﻪﺣ ﻐﻩﻫ ﺭﻥګ ﺍ
ﺪﻤﻫ
ﻮﻪﺷ ﺗﻣﻦځﺍﻪﺭﻠﻣHﻪﺍ
.ﻟ Pylorﺍﻱټﺱچېﺩi ﺮﺘډﻰګﺳ Gastځﻥﻧ rectomy ,Blockerdr ugs
21
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
.ﻮﻱ ﺗ
ﺎﻳ
ﺮﺯﻭﻍۍﺧﻄ ﺭ
ﺎﻧ
ېﻭﻱﺩ
.
ﺮﻱ ﻟﻩﺪﺍﺣﺮﻋﻲﻭ ﻩAﻓ ﻭﻭﺩ ﺍﺮﻋﻲ ﻩBﻓ ﻴﻦﭘﻦځ ﮐﺴﻮﺗﻭﺮﻴﺘﻧ
ﺍﺍﺮﻟ
ﻮ ﮐ
ﺩ
(ﻭﻥ GM)Gangi l
osi ﻪde ﻩﭘﺮﻭﺳ ﺬ
ګﻱﺍﺧ ځﻥ ړﻮﻱچېﺩﺍ ﮐﺭ
ﻩﻭ ﺯﺎﻪﺍﺟ ﻴﻦﺗﮐﺴ ﻭSubuniټ tB
.ﺮﻱﻟېځﻯ
ﺎﻁک ﺍ ﻪﻣﺨ ﻮﭘ ﻤ
ﻟﻮﮐﺎﻥﺩﻧﺴﺍښﻲچېﺩ ﻟ
Adeny latecy clﺪﻝﺩase ﻴ
ﻟﺎﻌﺮﺥېﻓ (A1ﺑ AﻭA2 1(.ﺍ ﺮﻱﺮﺥېﻟ ﻩﺑﻭﻮﻥټAﺩ ﺎﻝﺳﺐﻳ ﻌ
ﻓ
ﻪﻨ
ﻧﻪﺩ ﻮﭘ ﮑﻧ
ﻭژ(ﺩ CyclicA. M.ﻴﺖ)P ﻔﺎﺳﻓﻮﻧﻮﻳﻦﻣ ﺯﻮﻨﻳﺩﻴﮏﺍﻠﮑﻳﺎ
ږﻱچېﺳ ﻻﻞکږ ﺩې ﻣ ﻪﻡټﺩ ﭘ
ﻭﺪﻭﻱﺍ ﻨﻮ کېﺑ ﮑﻧﻭﻪژ Viﭘll
ﺭﺕﺩus ﻮﭙﻧﺴﺍﺮﻭﺗ ﺪﻴﺑ
ﺬﻳﻢﺩﺟ ﺩﻮ
ﻮﺩﺳ ﻤﻟﻮﮐﺩﺍ
ﺎﺕﺷﻲچېﺩ ﻳ
کېﺯ
ﻪکې ﻨ
ﻧﻪﺩ ﻣﻦﭘ ﻮﻟ
ﺪﺩ ﻳﺍﺭﻮﻠ
ﻳﻢﮐ ﺩﻮﻪکېﺳ ﻠﻳ
ﺎﻪﭘ ﻮﻱﭘ ﺗ
ﺎﻳﻮکېﺯ ﮑﻧﻭCﻪژrﭘ y
ﺍﺡﺩpt ﺮﺪﺍﻃ ﻳ
ﺍﺭﻮﻠﮐ
ﺩ
،ﻮﺩ
ﻮﻱﻧ ﮐﺖﮐ ﺮ ﻪﺣﻣﻦﺗ ﻮ
ﻟﺗﻲ ﺎ
ﻮﻻﻝټﻱﻭﺳ ﻣﺯﻩچېﺍ ﺭ
ﺎﭙﻟﺩېډﻝ ﺩ
Passiﻭ vﻪe ﻪﭘﺑﻭﻱﻭﺍږﺍ ﺗﻲﺎﻳ
ﺯ
ﻊﻳﺎ
ﻪﻣ ﺗﺎﻳ
ﻩﺯ ﺮﻣﻭﮐﻻﻯﺩ ﻪ ﺷﻲ ﻮ ﻧﮏېﻧ ﻭﻮژ ﻤ
ﻟﻮﮐږﻱﺩ ﺗﻲ ﺎ
ﻳﻣﻦ کېﺯ ﻮ ﻪﻟﻊﺣﺠﻢﭘ ﻳ
ﺎIﻣ sotonic
ﻭﻪﺍﻠﻣﻪﺍﺎﻉﻟ ﻴﻊﺩﺿ ﻳﺎﺎﺕېﻣ ﻳ
ﺯﺎکﺩ ،ﺷ ږﻱﻪ کږ ﺗﻣﻦځ ﺍ
ﺘﻰﺭ ﺎﺳﻠﻦﻧﺲﻧ ﺑﻭﻱﻮﺍ
ړﻧ ﺬﺏ ک ﻩﺟ ﺭﺎﺑ
ﻭﺩ
.ږﻱﻪکږ ﺗ
ﻣﻦځ ﺍﻪﺭ ﻠ
ﻣﺍﻪﻟ ﺩﻭ
ﻳﺢکﺩ ﺎﻧﻲټﺩﺿ ﻮﺑﺭﺎﺎﻯﮐﺑﺯﺱﺩ ﻭﺪﻴﺍﺳ
:
ﻥښﻥې
ﻴﮏېﻥښې ﺍ ﻨﻴﻠ
ﮐ
ﻩﻧﺲ ﺩﺭﻠﻦ ﺏېﺩ ﺑ
ﻭﻪﺍ ﻭﻏﻲﭘ ﺭﺎﻩﻧﺮډﻝﺳ ﺑړﻲ ﻭﻪ ﻲﻧ ،ﭘ ﻩﻪﺩﺘﺎﻋ٤ﺳ ٨ -
٢ ﻩ٤ﺭﻭﻳﺢﺩ ﺮﻔﺗﻭﻍۍﺩ ﺭﺎﻧ
ﺩ
ﺎﻥګﮐﺘﻰﺩ ﺎﺳ
ﺭﻧﺲﻧ ﻳژﺍﻯﺷﻲچېډﺮ ﺪﻴ ﺗ
ﺎﻳﻩﺯﺯﺍﺪﻧﺍﻩﻱې ﺮېﻪچټکۍﺳ ږﻱچ ﭘ ﻠﻲﻴﻩﭘﺮﺘﻲﺳ ﺎﺳﻧ
.
ږﻱﺒﻲ ﻴﻘ
ﻌﻪﺗ ﺍﺳﻄﻭﻪﻭﭘ
ﺮﻱﻭﻫ
ږﺍ mlﻪﺭﺳﻲ /ﺗ kg٢ ٥ﻮکې٠ ﻧﻮﺘ
ﺎﻋ٢ﺳ ﻮ٤ ﻟ
ﻭﺍﻪﺘﻲﺣﺠﻢﭘ ﺎﺳﻧﺲﻧ ﻮکېﺩ ﻧﻮ
ﺘﻟﺎ
ﻮﺣ ﻤﻴ
ﻪﻭﺧ ﭘ
ﺷ.
ﻊ ﻲ ﻳﺎﻪﺿ ﺑﻭﺍﺮﺘﻴﻟﻮﮑﻦﻳ ﻤﻩﻣﺮ ﻭﺳﺯﺎﻴﺘډﻮﻣ
ﺭﮐ ﺍ
ﻭ
.
ږﻱﻪکږ ﺗﻣﻦځ ﺍ
ړﻪﺭﻨﺁﻥﻡﻳ ﻭ ﺍﺎکﻴﮏﺷ ﻤﻴﻟ
ﺍﻭﻮﭙﻳﺎﻮﻫﻪﺷﻲﻧ ﻩﻧﺭﻮﻪﭘ ﻧﻮﺘﻳﻭﻻﺮ
ﺘﮑﻟﺍﻭﺍﻪﺑﻭﺍﺭېﺭﻪچ ﮐ
ﺩﻭ
ﻊکﺩ ﻳﺎﻮﺩﺿ ﻧ
ﻮﺘﻳﻭﻻﺮﺘﮑﻟ
ﺍﻣﭗﺩ ﺮﻮﮐﺗﻩﻭﻱﺩﻋﻀﻼ ﺩﻮﻮﺟ ﻭکېﻣ ﻮ ﭖښښ ﻤﻪﮐ %څﻪﭘ
ﻪﺩ ٥ﺧ ﺒﺗ
.
ږﻱ
ﻪکږ ﺗﻣﻦځ ﺍﻪﺭﻠ
ﻣ ﺍﻪﻟ
ﺍﻯﺷﻲ ﺩﺩﺎک ﻭﻳﻪﻭﻱﺍ ﻩﻧﺩﻮﻮﺟ ﻪکېﻣ ﻪﭘﻨﻳﻭ،ﻭ
ﻩﻱ ړﺭﻥګ ﻭﺥ ﻪﺍﻳﻮ ﺯېﺏېﺑ ﺎﻴﺘ
ﻭﻍډکېﻣ ﺭﺎﻧ
ﺩ
ږﻱ
ﻳﻞکږ RiﻭceWat ﺗer
ﻭﻪ ﺯﺎﻴﺘډﻮﻣ
ډﻝ ﮐ ېﺍﻭ
ږېﻭېچ ﺩ ﻮځﻦېﻭﺧﺖﺧ ﺮﻱ ﻳ ﻟ
ﺭچېﻭ ﺎ
ﺎﻁﭘ ﻣﺨﺩ
ﻭ.
ﻮﻱ ﻱ ﻴﻦځﻝﺷ ېﻪکېﻣ ﻳﺞ ﭘ ﺭﺮﻱچېﻭ ﻟﻟﻰ ﺍ
ﻪﻭ ﺗ
ﺭﻪﻭ ﻮﺗﺑﻭﺍﻮﻐﻌﻦېﻫ ﻳ
څﻪﮐﻢ %٥ﺧ ﺭېﺩ- ﺭﻪچ ﻌﻦېﮐ ﺯﻱﻭﻱﻳ ﺍ
ﻮﻩﻣ ﺮﺩﻭ ﺳ
ﻊ کﺩ ﻳ
ﺎﻭﻥېﺩﺣﺠﻢﺩﺿ ﺪﻧ
ﺭګ ﻴﮏېڅ ﻨﻴﻠ
ﮐ
.
ږﻱ ﺪﻱﻧﺭګﻩڅ ﺪﻨﻮﻯﻭﻱﺗ ﻊﺷ ﻳﺎ
ﺯﻥ ﺿ ﻣﻞﻭ ﺭﺎﻧ
ﻟﻰﺍ
ﻮﺗﺎﻳﻮﺯ ﺗ
ﺎﮐ
ﺮ ﻩﺩﺣړ،ﺯ
ﺘﻲﺩ ،ﺳﺴ ﻟﻰﺍﻪﻭﺘﮐ ﺘﻲ ښ ﻴﻌﺭﻭﺿ ﺎ
ﻓﺸﻮﺩ ﻮﻯﻭﻱﻧ ﻊﺷ ﻳ
ﺎﺯﻥ ﺿ%۱ﻭ ۰-
ﻪﺩ٥ ﮐ
ﻟﻲﻭﻮﺍﻮﻯﻭﻱﻧ ﻊﺷ ﻳﺎﺎﺕﺣﺠﻢ ﺿ ﻳ%څﻪﺯ
١ﺧ ﮐ٠ﻱﻭ ﻪ
ږﺍ ﺪﻱﻧﺭګﻟﻰڅ ﺍﻮﻤTurﮐ ﺘﮏېgor ﻮﺳﭘﻭﺩ ﺍ
ﻧﺞﻮ(ﻏ Font anelﻮﺕېl ﻨﻡﻭﻱﻧ ﻮﺎﺷ)ﻪﻣﺮګې ﮐ ﺘ
ﻮﺕې ﺳ ﻨ،ﻧﺭک ﻭﺎﻴﻒﻳ ﻌﺒﺾ ﺿ ،ﻧﺎ
ﻳﺭﻮﻳﻭګ
.ږﻱ
ﻪکږ ﺗ
ﻣﻦځ ﺍ
ﺎﺭ ﻣﻮﻩﮐﺮﺎﻻﺧ ﺍﺑ
ﻟﺖﻭ ﺎ
ﻮﺏﺟﻦﺣ ،ﺧ(ﮑﻰ)Washerwomen ﺘﻮﺳﭘ
22
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
.
ږﻱ
ﺪﻝکږ
ﻴﻟﻭﻍ
ﺭﺎﻪﻧ
ﺘﺍﺧ
ﻳﺸﻦ
ﺭﺪﻳ
ﺎﻬ
ﻳﺪﺩ
ﻳﺪﻪﺷ
ﻪﭘﻠ
ﻣﺍﻪ
ﻟﺍﺮ
ﻟﻮﮐ
ﮑﻞکېﺩ
(ﺷ٤
-٢)
،
ږﻱ
ﻩ کږ
ړﺎﻥ ﻱېﻡ
ﻣﻮﺎﺷ
ﻣ٥ﻮ کې٠
ﻠﻪﺳ
ﺮﻱ چېﭘﺭﻟ
ﺍﺰﻧ
ﺍﺏﺍ
ﺮﻭ کې ﺧ
ﻩ ښځﺭﺍ
ﻭﺪﻴ
ﻣﻪﺍﺍﭘﺮ
ﻟﻮﮐ
.ﺮﻱﻟ
ﺮﻴﺎکﺳ
ﻧﺮ
ﻮکېﺧﻄ ﮑ
ﻠﻭﺧ
ړﭘﺯ
ﻩﻪ ﺭﻥګ
ﺍﺪﻤ
ﻫ
.
ږﻱ
ﻪکږ
ﺗﻣﻦځ
ﺍﺎﺭ
ﻤﻳﺯ
ﺍﻭږ
،ﺩﺱ
ﺯﺱﻭ
ﺪﻴﺍﺳ
ﻴﮏﻟ
ﻮﺑ
ﺎﺘ
ﻴﻣﺪ
ﻳﺪ،ﺷ
ﻪﻳﺎ
ﻔﻡﮐ
ﺪﻭﻋ
ﺭګﻮ
ﺗﻪﺩﭖښ
ﮑﻟﺎﺕ
ﺘﻼﻃ
ﺍﺧ
ﻮکﻤ
ﻟﻮﻭﮐ
ﻮﻪﺷ
ﺍﺧﺮ
ﻪﭘﻪﭘﺘﻟ
ږﻱچېﺩﺪﻱ
ﻧﺭګﻪڅﻠ
ﻪﮐﻠ
ﮑﻞﺩﻯﮐ ﺍﺏﺷ
ﺮﺍﺧﺮﻟ
ﻮﮐﺩ
ﺍSiچېﺩﺍccaﺮﻟﻮ
ﮐ
ﺪ
ﻧﺭګ
،ځﻪﺩڅ
ﻩ ﮐﻪﺩ
ﻨﻣﺰ
ﻧﻮﺘ
ﻩﺳ ﺮ
ۍﻪﻧﻈ
ﻭﻟ ﺍﺪ
ﺗﺑﻲﺩ
ﺎﻳ
ﺯﺭﻭﻍﺍ
ﺭﺎﺍﺱېﻧ
ﺩ.ﺩ
ږﻱﺎﺕېکږ ﺪﻱﭘﻨ
ﻪﺑﺑﻭېﺍ
ﻭ.
ﻪﻱﺩﻧ
ﻮﻮﺟﺪﻣ ﺍﻫ
ﻮﻳﺸﻦﺷﺭﺪ
ﻳﺎﻬﻳ
ﺩ
ﻭ.
ﻩﻱ ﺎﻥښ
ﻴﻤﻴ
ﻴﺴﻟ
ﻮګﭙ
ﻳﺎ
ﺍﻯﺷﻲﺩﻫ
ﺩﺩﺘﻼﺝک
ﺍﺧﺎ
ﻭﻳﺍ
ﺭﻱﻮ
ﻌﺮﺷ
ﻴﻮکېﻏ
ﻧﺎﻣ
ﻮﺎﺷ
ﻪﻣﭘ
ږ
ږﻪک ﺗ
ﻣﻦځ
ﺍﻪﺭ
ﻠﻣﻪﺍﻟﺩﻭ
ﻊکﺩﻳ
ﺎﻮﺩﺿ
ﻧﻮﺘ
ﻳﻭﻻﺮ
ﺘﮑﻟ
ﻭﺍﻮﺍ
ﺑﻭﺎﺕېﺍ
ﻳﺯ
ﺎﺕﺩﺘﻼﻃﻩﺍﺧ
ﺭﻮﻭﻍۍﻏﺭ
ﺎﺩېﻧ
ﺩ
ﺭ
ﻮﭘﺍ
ﻮکېﺭﻨ١ﺗ
٠٠
ﭘ٠١ﭘﻲښې ﻪ
٠،
ﺭﺕﺩﻱ٦ﺎﺒ
ېڅﻪﻋ
ﺎﻱ ﺧ ﻔ
ﻡﮐﺪﻭﺩﻋﺭګ
ﻮﺗﻩﻱېﺩﭖښ ﺭ
ﻮﻱچېﻏ
ﺩ.
ﻮﻯ ﻯ
ړﻝﺷ ﺭک
ﻭ
:
ﺭړﻥې
ﻭﻪﺍﺘ
ﺭﻱﻻﺳ
ﺍﻮﺗ
ﺍﺮ
ﺑﻻ
ﻳﻢ
ﺩﻮﻩﮐﻢﺳ
ږڅﺎﻝ
ﻣﻞﻳ
ﺭﺎﻭﻧ
ﻴﻢﺍ
ﺎﺷﺗ
ﻮﺎﮐﻢﭘ
ﻣﻞﻳ
ﺭﺎ،ﻧ
ﺯﺱﻭ
ﺪﻴﻴﮏﺍﺳﻟ
ﻮﺑ
ﺎﺘ
ﻴ،ﻣﺎ
ﻴﻤﻴ
ﺗﻭﺯ
Prﺍer
enal
.
ږﻱ
ﺪﻝکږ ﻴ
ﻟﻡکې ﻭﺮﻴ
ﺪﺳﻳ
ﺍﺭﻮ
ﻠﮐ
ﻭ.
ﻟړ ﻱ
ﻪﻮ
ﻠﻣﺍ
Hﻪ
emoconcentﻟ
rat
iﻼﺎکېﺩon
ﻣﭘﭘﺯ
ﻳﻢ ﻪ
ﺰﻴﻧ
ﻭﻡګ
ﺍﻴﻢ
ﻠﺴﻡﮐ
ﻭﺮﻴ
ﺩﺳ
.
ږﻱ
ﻪکږ
ﺗﻣﻦځ
ﺍﻟﻰﺭ
ﺍ
ﻮﺗﺎ
ﻳﮑﻞکېﺩWBCﺯ
ﺪﺷﻳ
ﺪﻪﺷ
ﭘ
Hy
pov
olumi
ﻪچېﺩa
ﻠﻣﻪﺍ
ﻟﻲﻟ
ﺍ
ﻮﺗﺎ
ﻳﺯ
ﻭﻥﺩ
ﺰﻴﺗ
ﺭﻮﻭﮐ
ګﻥﺍﺎﻭﮐ
ﻮﻟ،ګﻳﻦﺮ
ﻔﭘﻲﻧ
ﺍﺎﺩ
ﻴﻤﻴ
ﻳﺴﺮګﻻ
ﭙﻳﺎ
ﻫ
ﺷ.
ﺗﻼﻯ ﻲﺍ
ﻪﺭﺗږﻱﻣﻦځ
ﻪکږﺒﻨ
ﻪﺗﺍﺳﻄ
ﻪﻭﭘ
23
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
:
ﻴﺺﺗﺸﺨ
ﻭ
ﺘﻞﺷﻲﺍﻴﺴﺍﺧ
ﺯېﻭﺎﻴ
ﺘﺭﺩېډکېﻣ ﻮژﺍﺷﮏﻭﻱﻧﺮﻟ
ﻮﮐځﺭﺩ
ﺮﺭﻥ ﻭ
ﻩﭘﺮﻪﻧﻈ
ﻴﮏﻟ ﻨ
ﻴﻠ
ﮐﺭېﺩ
ﺭﻪچ ﮐ
ﻩ
څﻪ ګټ
ګﻱﻭﺳﻂ ﺧ ځﻥ ړ
ﻪ ﺍﻩﻟﺭﺎ
ﭙﺪﻟﻳ
ﺮﺗﺠ
ﻡﺩ ﺰ
ﻴﻧﺍ
ﺭګﻭﺍ
ﭘﻲﺩﻱﺩ ﻮ
ﮑﻭﺳﺮﮑﻳ
ﺎDarﻣkField
ږ
ږﻳﻞک
ﻪﻭﺗﺭ
(ﻭthi
osulf
ateci
tr
atebil
esal
tsucroseAgar
ږﻱچې)TCBS ﺘﻞکږﻴﺴﺍﺧ
.
ﻱ
:
ﻪﻨ
ﻠﻣ
ﺭﺩ
ﻩﺷﻲ
ﺩﺎﻨﺲټﺍﻋ
ﺑﺮ
ړﺎﭘ
ﻴ
ﺍﺗﻪﺩ
ﻧﻮﺘ
ﻳﻭﻻ
ﺮﺘﮑ
ﻟﻭﺍ
ﻊﺍﻳ
ﺎﺪﻣ
ﻳﺎﺭﺑ
ﻳژږﻱډﺮ
ﻩکږﺮ
ﺮﺳﻪﺗﻨ
ﻠﻣ
ﺭﻩﺩﺮﺎﻥۍﺳﻪﺍﺳ
ﭘ
ﺩ.
ږﻯ%څﻪﻝ
ﻟ ١ﺧ ﺮﻪﺩړﻦېﺧﻄ
ﻩ ﻡﻳ
ﺮﻩﺳ ﺮ
ﻠﻦېﺳﻣ
ﺭړﺩﺩﻭ
ﻳﺸﻦ
ﺭﺪﻳ
ﺎﻬ
ﻳﺪﺩ
ﻳﺪﻪﺷ
ﻭﭘﺮﻱﺍ
ﻟﻪﻧ
ﻤﻞﻭ
ﻊﺗﺤ
ﻳﺎﻣ
ﺭېﺩ
ېﻪﻻ
ﻮﻝ ﻟﻳﺸﻦکېچېﺩﺧﺭ
ﺪﻳﺎ
ﻬﻳ
ﻮﺳﻂﺩ ﺘ
ﻪﻣﭘ
.
ږﻱ
ﻮﻝکږﮐﺭ
ﻊﻭﻳ
ﺎﺭېﻣﻪﻻﻟ
ﺪﻳﺭ
کېﺩﻭ
ړ
Maiﭖ
ntﻭenance
ﺍﻭﺍ
ړﻳﺸﻦﭖ
ﺭﺪﻳ
ﺎﻬ
ﻳﻌﻦېﺩﺩ
ږﻱﻳ
ړﻱﻭکېﺑﺸﭗ
ﻭﺍړ
ﻩﭖﻭ
ﻪﺩﻩﭘ
ﺩﺎﺍﻋ
ﻮﺗﺎ
ﻌﻳﺎ
ﻣﺩ
.
ﻭﺍ
ﻊ
ﻳﺎ۲ﻣ
٠٠-
٥٠
ml/
kg/
Hour،
ﻴﺴﻲ
ﻪﻧﻧ
ﺎﺕﻭﺧﺖﻭ
ﻳڅﻪﺯ
ﻮ ﺧﺘ
ﺎﻋﺭﺳ
ﻮﻟﺪﺩڅ
ﻳﺎﻭﺑ
ﺍړﻳﺸﻦ ﭖ
ﺭﺪﻳ
ﺎﻬ
ﻳﺩﺭ
.
ږﻱﻮﻝکږﻨﺠﺳ
ﺰ
ﻳﺩﻭ
ﻮ کېﺩﻧﺎ
ﻭﻏﺭﺎ
ﻪﺩېﻧ(ﭘ
PH<٧ ،
٢ﺯﺱ) ﻭﺪ
ﻴځﻪچېﺍﺳ
ﻮﻝﺩﻯ ﮐ ﻠﻩﻣﺤﺮښ ﻳﻴﺖډ ﺘﮑ
ﺭﻟﻳﻦګﺭ
ﺩ،
ﻩﻯ ﻮﻝﻱې ښ ﮐﺭ
ﺭېﻭېﻪﻻ
ﻮﻝ ﻟړﻝﺷﻲﺩﺧ ﺭکﺪﻭﻳﺎ
ﻴﻢﻫﻢﺑﺎﺷﺗﻮﻓﻲﭘﺎ
ﺭﺍﺿ ﻮﻩﻧﻮڅﺩﻯﺁﻥﻳ
ﺷ،
ﻯﻪ ﻲﮐﻻ ﻧ
ﺯﺱﺍﺻﻼﺡ ﻮﻭﺪﻴ
ﻴﮏﺍﺳ ﻟ
ﻮﺑ
ﺎﺘ
ﻴﻱځﻪچېﻣ
ږ ﮐ ﻟﻲ
ﺎﻤ
ﻌﺘﻪﺍﺳﺎﺕﻧﻳ
ﻩﺯﺮﻣﻭ ﻴﻦﺩﻟ
ﺎ
ﻣﻞﺳ ﺭ
ﺎﻧ
ﺷ.
ړﻝ ﻲﺭکﻪﻭﻭﻍﺗﺭ
ﺎﺎﻋﺖکېﻧﻴﻢﺳﻭﻝﻧﺍﺪﻳ
ﺎﻳﻲﺑﺎ
ﻤﻴﻊﻧ
ﻳﺎﻮﻱﻣ ﻮﻝﺷﻨﺠ
ﺩﺳ
ﺎﺩﻭﻳNaso gastﺍ
rict(ubeﻮ)NGTﻣﻦﻭﻱﻧﺰﻧﻮﺘ
ړﻝ ﺳ ﺭکﻊﻭﻳﺎ
ﺪﻱﻣ ﻳﺭ
ﺭېﻭ ﺭ
ﻪچ ﮐ
ټﻝ
ﺷ) ﻭ
ړﻮﻭﺑﺸﭗ ﺍ
ړﻳﺸﻦﭖﺭﺪﻳﺎ
ﻬﻳ
ﺭﻪچېﺩ
ﻠ،ﮐ
ږﻱ
ﻮﻝکږ ﮐ
ﺭﻊﻭﻳﺎﺭېﻣﻪﻻﻟﺮﺘ
ﻴﺘIﮐ
ntr
aosseous
ﻪﺩېڅﺎﻟ
0ﻭﻳ
.ﺍ5ml /
kg/ﺯېhﺎﻴ
ﺘﻭﻍﺗﺶېﻣﺭ
ﺎﻧ
ﻭﺩﻩﻻېﺷﻲﺍ
ﻪﻣﻦځ ړ ﻳﺸﻦﻥښېﻟ ﺭﺪ
ﻳﺎﻬ
ﻳﺩﺩ
.
ږﻱ
ﻭﻉکږﺮﻭﺷﺍ
ړMaiﭖ ntﺷ(ﻮﺩanence
ﺎﺕې ﻲﻧ ﻳﻪﺯﺧ
ﻩﻮ
ﻮﻳﮐﻻﻯﺷ ﻓﻲﺩﻱچې ﻮﺎ
١ﮐ٠
٠٠
-٥٠
٠ml
/ږﻱh
ﻮﻝکږ ﮐ
ﺭﻊﻭ ﻳ
ﺎﺭېﻣېﻪﻻ
ﻮﻝ ﻟﻭکېﺩﺧ ﺍ
ړﻪﺩېﭖ ﭘ
،
ﻭړﺟړکﻮﻝ ﻮﻠﻭﻭﻣﺤ
ړﺍګﻩک
ﻮ کې ډﺑ
ﻭﺮﺍﺘ
ﻴﻮﻟﻪﻳﻩﭘﺮﺭېﺳ ﻮ
ﻮﺑﻘﺎﺷ
ﻭﻗ ﺭ
ﻮﻟﻩﻪڅ
ﻣﻝګﻟﻪﺎ ﻘ
ﺎﺷﻗ
ﻭﺏﺮﮑﻴﻣﻩچېﺩﻟﻲﺩ
ﺩﻭﻭښﺪﺍﻫﻮ
ﻴﮏېﺷ ﻨ
ﻴﻠ
،ﮐﺮﻱ
ﻟ ﻭﻝ
ﻭﻫﻢېﺭ ﻪکېﺩ ﻨ
ﻠﻣ
ﺭﻪﺩﻣﻞﭘﺭﺪﺩ
ﻭﺏ ﺿ ﺮﮑ
ﻴﻣ
ﻳﻲﺎ
ﻤﻴﻭﺣﺠﻢﻱېﻧ ﺯ
ﺎﻴﺘ
ډﻮﻣ
ﻱﻭ ﮐ
ړﺍ ﻡﮐﻢکﺍﻭ
ﺘﻲﺩ ﺎﺳ
ﻧﺲﻧ ﻳﺸﻦکېﺩ ﺭﺪ
ﻳﺎﻬ
ﻳﺪﺩﻳ
ﺪﻪﺷﻣﻞﭘ ﺭ
ﺪﺩﺿ
ﺩ.
ړﻯ ﻯﻪک ﺘ
ﮐﺍښﻪﺭ ﺗ
ﻪﻣﺍ
ﺭﻩګﻭﻮ ځﻝﺩﻪﻳﻣﻞﺩﻱﭘﺭﺑﻲﺩﺎﺘﺨ
ﻧDoxyﺍ
cycl
iﺎneﻭﻳ
ﻴﻦﺍﻠ
ﮑﺍﺳﺮﺘ
ﺭېﺗﻪﻻ ﻮﻝېﻟﺩﺧ
ﻮکې ﻧ
ﺎﻣ
ﻮﺎﺷۍﻭﻣ
ﺭﺍﺍﻭ
ﺪﻴﻣﺩ.ﻪﺍ
ﻣﻞ ﻱﭘﺭﻓﻲﺩﺎ
Doxﮐycycl
i
ﻪneﻣﺍ
ﺭﻠﻲګﻣ٣٠
ﻳ٠
ﻭﺎ ﻴﻦﺍ
ﻠﮑﻳ
ﺎﺍﺳ
ﺮﺘﺗ
ﻭﻴﻦﺍﺎﺳ
ﻣﻭﺮ
ﺘﻳﺮ
ﻳﻭ کېﺍﻭ ښځ
ﺭﺍﻭ
ﺪﻴﻣ
ﻪﺍړﻝ ﺷﻲﭘﻧﮏﺭ
څﻪﮐﻢﻭﻱﻭﮐﻮ ﺧﻟ
ېﻪ٨ﺎﺮﻱ ﻟﻤچېﻋ
.
ږﻱﻟﻲ
ﺎﻤﻌ
ﺘﺍﺳﻭﻥﺪﻴﻟ
ﻭﺯﺍ
ﺭﻮﻓ
ﺎﺕﻳ
څﻪﺯ
ﻡ ﺧ ﺍ
ﺭﻮګﻳﺯﻥچېﺩﻡﻭﺍﺭ
ﻮګﻟ
ﺮکﻝ ﻪﻫ
ﺪﻥﭘﺑ
ﻪﺩﻣﺍ
ﺭﻠﻲګﻣ
٣ﻴﻦ٠
ﺍﺳﺰ
ﮐﻮﻠ
ﻓﻭﺮ
ﭙﻩﺳ
ﺭﻥګﺍ
ﺪﻤﻫ
ﻪﻣ
ﺍﺭﻠﻲ ګ
ﻣ٤ﻴﻦ٠
ﻳﺴﺎﻣ
ﻭﺮﺘ
ﻳﺭ،ﺍ
ږﻱ
ﻭﻝ کږﺭ
ﺎﻩﮐﺭ
ﺎﭙ
ﻭﻟﻭځ
ﺩې ﺭ
ﻪﺩ ﺭ
ﻟﻩځﻭ١ﺩ
٥mg/ﺎkg
ﻭﻳﻧﺸﻲﺍ
24
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﺩ.
ﻣﻞ ﻱ
ﺭﻣﻦﺩ
ﺰﻴﺍﻏ
ﻩﻩښ
ﺭﺎﻭځﻝﭘ
ﺩېﺭ ﻭ
ﻮﺩﺭ
ﻧﻭﺯ
ﻭﺮﻱﺩ
ﺩېﮐﺴ
ﻪﺭﺯﻥﭘ
ګﻡﻭ
ﺍ
ﻮﺭﻟ
ﺮکﻝ
ﻪﻫﺪﻥﭘ
ﺑﺩ
،
Adsor
bant،
ﻴﻼﺕ
ﮐﺴﻮ
ﻨﻴﺍﻯﻓ
،ﺩﺪ
ﻳﺎﻣ
ﺍﺮﭘ
ﻮﻟﻣﻞ)
ﺭAntﺩ
imoti
li
tﻪyﮑﺎﻝﻟ
ﻤﻌﺘ
ﻮﺍﺳ ﻠ
ﻣﺭﻭﺩﺭﻮ
ﻧﺩ
ﺩ.
ﻩﻪ ﻱ
ﻪ ښﻧﻧ
ﻭﺭﺎ
ﻣﻞﮐﺭ
ﺪﺩ ﻭﺿﺎﻥګﮐ
ﻭﺩ ﺍﻳﮏ
ﺰﻠﺠﻧ
ﺍ
:
ﻮﻯﻴ
ﻨﻣﺨ
ﻭ
ړﻮﺩﺧ
ﻭﻪﺍ
ﻳﺬﻐ
ﻩﺗ،ښ
ﻮﻝځﻯﮐ
ﻪﺍځﻯﭘ
ﻭﺍﺯ
ﺎﻴ
ﺘډﻮﻣ
ډﻝﺩ ﮐ
ﻳﻲ ﻭ
ﺎﻴ
ﺘﻭﻏ
ﻪﺭ ﺎ،ﭘ
ﻤﻝﻌﺘﻮﺍﺳ
ﺑﻭﻮﺍﮐﺎ
ﭘﺩ
ﺩ.
ړﻱ ﻱ
ﺍﭘﻲښېﮐﻢېک ﺮ
ﻟﻮﮐ
ﻪﺩﻧﺮ
ﻠﻣﺎ
ﻩﭘﻪښ ﻮﺗ
ﻣﺮﻳﺯ
ﺯﻱﻭﺮﺩﺘﻮﺳ(ﺑﻭﻥۍﻪﺍﻣﺭﻮﻟ
ﻭڅ ﻪﺍﻟ
ﻭﺍ
ږﻱ)ﻟﻲﺎﻤ
ﻌﺘﻮﺍﺳﻧ
ﻭﺯﻭﻭﺩﻭﻪﺩ ﻡﮐﻢﺩﻯﭘ ﺍ
ﻭﻴﻦﺩﮐﺴﺍﻭ
ﺍﺩﺮﻟ
ﻮﮐﺩ
ﻮځﮐﺎﻧ
ﺮﻪﺧﻄ ﺍﭘﺮ
ﻟﻮﮐ
ﻭﺩ ﺎﺕﻭﻱﺍ ﻳ
ﻪکېﺯ ﺮﭘﺍﺧﻄ ﺮ
ﻟﻮﮐ
ﻪچېﺩ ﻮﺗﮑﻠﻮﺧﻐﻪﻫﺘﻭﺳﺭﺎﺷﺖېﻭ ﻴ
ﻣې٦
ﻣﻦﺍ
ﻮﻱﭘﻲښېﺭ ﻠﺘ
ﻪچېﮐ ﻠ
ﺘﻲﺩﻱﮐ ﻤﻴﻡﻗ
ﺍﺭﻭګﺮﻴﺸﻦﭘﻨ
ﮐﺴﺍﻭ،ﺩږﻱ
ﻭﻝکږ ﺭﺎږﻱﮐﻭﺳﻲﻮکېﺍ ﻧﻮ
ﻳﺍ
ﺷChemo ،ﻪﻭ ﻲ ﻟﻲﺗﺍﻮﮐ
ﺎﻮﭘ ﮐ
ﻮﺍکېﺗ ﺭ
ﻮﻭﺧ ﻮﺍ ﺑ
ﻭﺍﻪﺩ ﻧ
ﺮﻠ
ﻣ ﺎ
ﻪﭘﺗﺎ
ﻳﺪﺯ ﻳ
ﺎﻮﺑﺷېﻧﻪ ﻮ ﺗ
ځ
ﻣﻦﺰ
ﻴﻩﺍﻏﺭﺎ
ﭙﻭﻟﻭځ
ﺩې ﺭﺭځېﺩ ﺭ ﻭﻪﺩﻟ
ﻩځ ﻭﻪﺩﻣﺍﺭ
ﻠﻲ ګﻣ٥
٠ﻩ٠ ﺮ
ﻴﻦ ﺳﻠﮑ
ﻳﺎﺍﺳ
ﺮﺘﺗ
،ﺩprophyl
axis
ﺩ.
ﻱ
ﺯﺱ ﺎ
ﻴﺒﻴﻣﺍ
(Amebi asi)s
.
ﺭځﻱﻪﺍﺗﻪﻣﻦځ ﻠ
ﻣﺍﻪ ﻟﺎ
ﮑﻴﺗﻮﻟ
ﺍ
ﺎﻫﺲټ ﻴﺒﻴﻣﺎ
ﺘﻧ
ﺍ،چېﺩ ﻩﻭﻏﻲﺩ ﺭﺎ
ﻳﻲﻧ ﺍﺯ
ﻮ ﺗ
ﻭﺮﻩﭘﻮﻮﻳ ﻤﻟ
ﻮﮐﺩ
ﺍﻯﺩ
ﺩﺮﻱچېک ﻭﻥېﻟﺪﻧﺭګﻴﮏېڅ ﻨﻴﻠ
ﺎﻥﻱېﮐ ﻭﻏﺭﺎ%١ﻧ ﻭ٠ﺮﺿﻲﺩﻱﺍ ﺮﻋ ﻴﺎﻥﻏ ﻭﻏﺭﺎ
%٩ﻧ ﺩې٠ ږﻥ
ړﻮ
ﻭﻍﻳ ﺭﻮﻧﺎﺩﻭﻳﺑﺴﻲﺍ ﺭﺍﺎﺩځﻱګ ﻳﻭټﻱﺍﺰﻥ ﺭ ﻳ
ﺪﺩ ﻳﺪﺮﺷ څﻪﺗﺘﻲ ﺧ ﺎﺳﻴﻒﻧﺲﻧ ﻔﻩﺧ ﻮﻳﺷﻲﺩ
ﺷ.
ﺪ ﻲ ﻧ
ﺭګ ﻪﺏڼېڅ ﻮﭘﺑﺴﺍﺩ
:ﻩﻱې ﺭﻭﺪﺩ ﻧﻭ
ژﻭﺩ ﺍﻪﻧ
ﺪﻳﺩﻟږ
ﻲ
ﻪﺑ
ﻭ،ﺍﻩﺧړ
ﺍ
ﻴﺲټ ﻮ ﺍﺳ ﻭﺩﮑﻞﻭﻱﺍ ټﻪﺷﻴﺲ ﭘ ږﻱچېﺩﺳ ﺍﺧﻞږﺭېﺩ ېﻪﻻﻮﻝ ﻟ ۍﻻﻞﺩﺧ
ﻭﻍ ﻣ ﺭﺎ
ﻧﺩ
ﺩ.
ﺎﺕې ﻱ ﻳFoodborﭖښښېﺯ ﻮﺩn ړﻭﻱﺧ ﻪﮐﮏ ﻧ
ﻮﻳﻻﺳ ﺎ
ﻪﺎﭘﻳ
ﻭﻟﻲﺍ ﺍ
ﺩېﻭ ږ
ﻨﺴﻲﻥ ﺪﻱﺟ ﻌﻘ ېﺎﻣ
ﻮﻝ ﻳ ،ﺩﺧﻮﺑﻭﻮﺍ ﻳﻮ
ﻮﺷ ﻟ
ﻪﺩچټ ﻧﺪﻳﺩﻟږ
ﻭکې ﻲ ﻭﭘﻲښ ږﻪﻝ ﭘ
ﺷ.
ﺍﻯ ﻲ ﺩﺩځﻪک
ﺘﻣﻦﺗ ﺍ
(ﺭ ﭘﻲﻮ
ﮑ ﻮﺳﻧﻮﻟ
ﻮﮐﻭﺧﺖ) ﺮIﭘrri
gat i
ﻮﻥﺩon ﻟ
ﻮﮐﻭکېﺩ ﻮ ﭖښښ ﻤﻭﮐﺮﻳډ
ﺩ.
ﮑﻰ ﻯ ﻧﻭﺩﻟږ
ﺰﻲ ﻳﺩﻭﻳﺖﺩ ﺯﺍ
ﺮﭘﻮﺩﺎﻫﮐ
ﺷ.
ﻟﻰ ﻲ ﻭ
ﺩﻟږ
ﻭﻍۍ ﻲ ﺭﺎ
ډﻝﻧﻪﻭ ﺭﭘﻮﺘﮐﻴﮏېﻭ ﻧ
ﺎﻴﺨ ﻣﺍﺕﺩﺮﺭﺣﺸ ﻮﺭﻧﺷﺭ
ﻮ ﻢ ﻭﻳ ﺍﺎﻥﻩﻣﭽ ﺭﻥګﺍﺪﻤﻫ
ﻮکېﺩ ﻧ
ﺎﻭﻏﺭﺎ
ﻩﻧﺮﺗ
ﺎﻳ
ﻪﺯ ﻱﻭﭘ
ږﺍ ﺩﻱ ﺍ
ﺯﻭﻱټﺍ ﺯﻮﻓﻭﺮﻩﺗ ﺪﻧ
ﻮځ ټڅﻪﺧ
ﻴﺲ ﺧ ﻮکېﺩﺳ ﻤﻟ
ﻮﻮﮐ ﻴﻨ
ﻮﭼ ﻪﮐﭘ
ﻭﻱﺯﻮﻓﻭﺮﻪﺗﻠ
ﻪﮐ ﻠ
ﻮﮐﻮﻱﺧ ﺪﮐﻧ
ﻭ ﻮکېژ ﻤﻟ
ﻮﻮﮐ ﻳﻮﻟﻪﻪﭘ ﺗ
ﺮﻮﻥېﭘ ﺭﺭﺳ ﺮﻪﺿ ﻟﺎﻥCommensalﭘﺸ
ږﻱﻠﻲﺍﺧﻪﺩﻳﻦېﺗ ﺍچېﻭ ﺎﺩﻭﻳﮐﻻﻱټﺱﺍ ﺮﺿﻲ ﻮ ﻭﺩﻋ ﻮﻱﺍﺪﮐ ﻳﺮﺪېﺑ ﻧ
ﺎﺎﻁﺑ ﺮﻣﺨ ﻮﻥﭘ ﻟ
ﻮﮐټﺩ
.ږﻱ
ﻻﻞکږ ﻮﻣ ﺑﺴﺍﺎﻏﻲﻣﻭﻭﺩږﺍ ،ﺱ ﺪﻱ ﺒ
ﮐﺩ
.ﺮﻱﻟ ﺮﻭﻥﻗﻄ ﺮﮑﻳﺎ
ﻮﻣﻴ١ﻣ ٤
-١ډﻝ٠
ﺰﻭ ﻳﺩﻭﻪﺩﻴﺴﺖﭘ ﺳ
ﺷ،ﻪ
ﮐﻻﻯ ﻲﭘ ﺪﻮ ﻧ
ﻭﺎﺷﺖېژ ﻴ
ﻭﻣ ﺘﻰڅ ﻮﺣﻴﻧﻭﻭﺍﺗڅﺎﻝکېﺮ ﻳﺮﻴ
ﭘﺎﺎﺳﺐﭼ ﻨﻪﻣ ﺮﭘ ﻬ
څﻪﺑ
ﺩ ﺧ ﻮﺩﻭﺟ
ﺷ.
ﮐﻻﻯ ﻲﺪﻮ ﻧﻭﻮژﺘﺎﻋ٤ﺳ ﺗ٨
ږﻱﺮ ﺗﻞکږ ﺎﺪکېﺳ ﻳﺭﺘﻲګ ﻧ
ﺎ٢ﺳ٥-٢
ﻭکېچې٠ ﺧړ
ﻪﻮ ﻐﻫ
ﺮﭙﻞﺳ ېﻪﺧﺎﻝک ﭘ ﻳ
ﺮﻴﭘ
ﺎﺮﻥۍچېﭼ ﻬﺮﻱﺑﻟﺮﻭﻥﻗﻄ ﺮﮑﻳﺎ
ﻣﻮﻴ٥ﻣ ٠
-١
ﮑﻞﻱېچې٢ ﻳﺖﺷ ﻭﺯ
ﻮ ﻓ
ﻭﺮﻮﺗﺧ
ﺩ،
ﺎﺱ ﻱ ﻩﺣﺴ ﺮﻮﺳ ﻧﻮﻤﻳ
ﺍﺰﻧﺍﻭﺍﺪﻴﺍﺳ ﺪېﻌﻣﻩﺩﺭﻥګ ﺍ
ﺪﻤ،ﻫ ﻩځﻱ ﺭﻪﻣﻦځژﻟ
25
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
:ﻮﺟﻲ ﻟ
ﻮﻤﻳﺪ ﻴ
ﭘﺍ
ﻩﺪﻳﺮﻩﻱېﺏېﺑ ﺮ ﺗ
ﺎﻳﻪﺩﻱچېﺯ ﺘﺪېﺍﺧ ﻧﺎ
ﺎﻥﺑ ﺘﻧ
ﺎﺍ ﻴ
ﺒﻴﻣﺎﺘﻧ
ګﻱﻪﺍ
١ﻭړ ﭘ ﻮکې٠ ﻠېﻪﺳ ﺩﭘ ږړۍﻥ ﺩﻥ
،چې ږﻱ
ﻪ کږ ﺗﻣﻦځ ﺍﻪﺭ ﻠ
ﻣﻪﺍ ﺎﻟﮑ ﻴﺗ
ﻮﻟﺎﺘﺎﻫﺴ ﻴﺒﻴﻣﺎﺘ
ﻧﺍﻭﻍۍﺩ ﺭﺎﺯﺱﻧ ﺎﻴ
ﺒﻴﻣﺍﻮﺩ ،ﺧ ﺮﻱ E.ﻟdispar
ﻮﻯﺩﻯ ﺪﻝ ﺷﻧژژﻻﻞ ﭖ ﻬﻢ ﻣ ﻳﻢﻣ ﺭﺩړﻦېﺩړۍ کې ﻡﻳ ﻪﻥ ﻪ کېﭘ ﻠﻤ
ﻪﺟ ﻮﭘ ﻴﻭﻏ ﺭﺎ
ﺯﻱټﻱﻧ ﺍﺮﭘﺩ
.(Sڅﻪ
chiﺧ st osomi asi ﻭs ﺍﺩﻼﻱ
ﻪ ﻣﺭ ﺘﻭﺳ ﺭﻭ)
ﻩﻭﻱ ﻭڼ ګﻩګ
ﻮ ڼ ﻮﺳﻔﻧږﻱﺎﺩ
ﺍﻋﺖکږ ﻳ ﺮﻩﻪﻣﻳﻂﻱې ښﻧ ﺍﺮﻳﻲﺷ ﺎﻴﺘﻭﻏﻮکېچېﺭ ﻧ
ﻮﻳﺍﻮځ ﻐﻪﻫ ﭘ
ﻭﺎﺍﻴﮑﻞﺍﺳ ﻴ
ﭘﺍ
ﺮ،ﺗ ﺎ
ﮑ ﻳ
ﺮﻣﻠﻲﺍ ﻴ
ﻬﻭﺳ ﺰﻱﺍ ﮐﺮ،ﻣﺎﻳ
ډ،ﺍﻥ ﻮ ﮑﻴﮑﺴﻪﻣ ﻪﭘ ﮑﻟﺎﺕېﺩﻱ ﻳﻭﻍۍﭖښښېﺯ ﺭ ﺎ
ﻧﺩ
.ﻮکې ﻧﻭ ﺩﺍ
ﻭﻭ ﺎﻱېﻩﻘﻳﺮﻓﺍ
(ﻪﻨﻳ
ﺭﺎﻧﻟﻲ)ﺎ
ﻨﺲﭘ ﻭﻫﻢﺟ ﻪﺍ ﻧ
ﻮﺗﺮﺎﺟ ﻬ
،ﻣ ﻪﻧﻮﺗ
ﺮﻓﺎﻻﻞﻣﺴ ﻬﻢ ﻣ ﻭﻍۍﻣ ﺭﺎﻧ
ﻮکېﺩ ﻧﻭﺩﺍ
ﻭ ﻭﻮﻩ ﻠﻠ
ﺘﻣﺨﺮﻪﭘ ﭘ
ﺩ.
ﻱ
،
ﻭﻩ ښځ ﺭﺍ
ﻭﺪﻴﻣ،ﺍ ﻮﻧﺎ
ﻣﻮﺎﺷ ﻟﻲﻣ ﺪﻳﺯږ
ﻮﻱ ﻱ ﻪﻧ ګﻱډﻝﭘ
ځﻥ ړ ﻭ ﻪﺍ ﻮ کېﭘ ﻧﺎﻣﻮﺎﺷ ﻪﻣ ﻭﻍۍﭘ ﺭﺎ
ﺍﻧ ﺩ
ﻭﺪﺍﻳﺪ ﻮ کېﺷ ﻧﺎﻭﻏﺭﺎﻪﻧﺘﺍکۍﺍﺧ ﻭﺭځ ﺍ
ﻮ ﻪﺧ ﻭﭘ ﻪﺍﺘ ﻮﺍﺧﻴﻭﻏﺭ ﺎﻧﻲﻧ ﺎ
ﺮﻃ ،ﺳ ﻮﮑ ﻧ
ﻮﻟﺎﻤﻌﺘﻭﻥﺍﺳ ﺰﻴﺗﺭﻮﮐ
.
ﺮﻱ ﻟﺮﻴﻴﻢﺳ ﻭﺧ
ﻪﻧﻮﻠ
ﻴ٥ﻣ ﻌﻦې٠ %١ﻳ ﺧ٠ېﻪﺩېډﻝېڅﻪ ﻪﺩﻱچ ﻟ ﺘﺎﺍﺧﻴﺒﻴ
ﻣﺎﺘﻧﻪﺍ ﻠﮏﭘ ﻪﺧ ﻧﻮﻠﻴ٥ﻣ ٠ړۍ کې٠ ﻪﻥ ﭘ
ﺩ.
ﺮﺿﻲ ﻱ ﺮﻋ ﻴ
ﻠﮏﻏ ﻩﺧ ﺮﺗﺎﻳ
ﺮﻱچېﺯ ﻟ ﺎ
ﮑﻴﺗﻮ ﻟ
ﺎﺘﺎﻫﺴﻴﺒﻴﻣﺎﺘ
ﻧﺍ
.ږﻱ
ﻩکږ ړﮐﻝکېﻡ ١ﻪﺎ٠ﻟ ٠
٠٠ﺧ٠
ﻤﻞې څﻪ ﺩېﺟﻪﺩﻱچېﺩ ﺘﺍﺧ ﮑﻞﺪﻱﺷ ﻳﺮېﺮﺑﻪﻱ ﭘ ﻧ
ﻮﻠﻴﺯې٥ﻣ ﺍﻮﻳ
:
ﻮﺟﻲ ﻟﺎﺘﻭﭘﺍ ﺰﺱ ﻴﻨ
ﻮﺟ ﺘﭘ
ﺯېﺍﻮﻮﻳ ،ﺧﻮﻱﺪﮐ ﻧ
ﻭﻣﻦکېژ ﻮﻪﻟ ﻮﭘ ﻤﻟ
ﻮ ﮐ
ﻭﻱټﺩ ﺯﻮﻓ ﻭ
ﺮټﻭﺗﻴﺲ ﺍ ﻌﻦېﺳ ﻪﻳ ﻧﻮﻠ
ﮑ ﻩﺷ ﺩړ
ﺍﻴﺐ ﻭ ﻣﺍﺩ
ﺮﻱﻟﺮﻭﻥﻗﻄ ﺮ
ﮑﻳﺎﻮﻣ ﻴ٦ﻣ ﻟﻰ٠٢ﺍﻭﻱټ٠ ﺯﻮﻓﻭﺮ،ﺗﻮﻱ ﺪﮐ ﻳﺮ
ﺪېﺑ ﻧﺎﻮﺑ ﺎﺟﻧﺴېﺮﺍ
ﮑﻞﻱ ﭘ ﻭﻱټﺷ ﺯﻮﻓﻭﺮﺗ
ﻭﺎﻁﺍ ﻮﻥﻣﺨ ﻟﻮﮐﻭﻱټﺩ ﺯﻮﻓﻭﺮﺩ،ﺗ
ﺘﭻې ﻯ ړېﻫﺴ ﻳېځﻥګ
ﻭﻮ ﺍ ﻭﻝﺍﺍکﻭ ،ﻭ ،ﻧﮏېﺩﻫﺴﺖ ﻭﺮچېﻟ
ﻪﻥ ﺍﺳﻄ (ﻪﻭ
Galﭘ /galNAc)Gl act oseN- acet ylglact oseami ﻩﺩne ﺮﻮﺳ ﮑ ﻧ
ﻭﻴﻞژ ﻠﺘﻴ
ﭘﺍ
ﺑﻲﺎﻬﺘﻟ
،ﺍﺮﻱېڅﻪﺳ
ېﻪﺩ ﺧ ،چ ﻟ ﻮﻱ ﻪﮐ ﺗ
ﻣﻦځ ﺍﻮﭼﻦېټﭖﺭ ﺮﮐ ﻳﺎﻁکېډ ﻯﻪﻣﺨ ړﭘ ﻡﻮښﻲچېﻟ ﻟ
ﻮﺪﻝﺷﻲﻧ ﻴ
ﻟﻨﻰ ټﭖﻭ ﻮﭼﮐﺍﻪﺩ ﺍﺳﻄ ﻪﻭ ﭘﻲﭘ ﻮﮑﻮﺳ ﺘﮐﻭﺮﺭېﺩﭘ ﺭ ﻪچ ،ﮐږﻱ
ﺩږ ﺍﺯﻧﮏېﺍ ﻭﻴﻞژ ﻠ
ﺘﻴﭘﻭﺍﺍ
Flﮑﻞ ask ﻴﻒ ﺷ ﻗﻌﻦېﺩ ﺮﻱﻳ ﻌﺖﻟ ﻪﻭﺳ ﺗﺍ
ﻮﺒﻖې ﺧ ﻧې ﻃﺎﻁﻻﺪ ﺮﻣﺨ ﻭﺗ ښﻲﺍﻭﺗ ړې ﻱېﺍ ﺎ
ﻏ
.
ﻮﻱ ﻩﮐ ﺭ
ﻮ ﻪﻏ ﺘﻧﺍ
Shapeځ
ﻪ کې ﺯېﭘ ﺎ
ﻴﺘﻪ چېډکېﻣ ﻧﻮﻳﺍﻪځ ﻐ ﻮﻥﻫ ﻟﻮﮐﻩﺩ ﺮﺗﺎﻳ
ﻪﺯ ﺍﺳﻄ ﻪ ﻭ ﻴﺐﭘ ﻣ ﺍ
ﻳﻞ ﺷﻲﺩ ﻭﺪﻭ ﻳ
ﺎﺑ
ﻮﻥ ﻟ
ﻮﺪﮐ ﻴﺋ
ﻮﻣﻮﺱګ ﺘﮑﻳ،ﺭﻩﺪﺎﻋ،ﺻ ﻡﻮﮑﻴ:ﺳ ﻪﮑ،ﻟ ږﻱ
ﻣﻦ کږ ﺰﻴ ﻮﻱ ﺍﻏ ( ﮐ St asiﻪ )s ﻧﺪﻳﺭﺩ
.ﮐﺲﻫﻢ ډﭘﻦﺍﺘﻰ ړﻱﺣ ﻪک ﺘﺍﺧ ﻫځ ﺍﻯ ﻮﺮ ﻤﻟﻮﮐﺍﻯ ﺷﻲﺩ ﺩﺩﺎکﻣﺍ
ﺩې
،ﺩ ږﻱﺩﻱﺎ
ﻡﻳ ﻮAﻪﻧﺟړﻱچېﺩ moebomaﭘ ﻪ ﻮﻭ ﻠ
ﺘﻩﮐ ﻮﺎﻥﻳ ﺘ
ﻧﻮﺍﻤﻟﻮﮐﻭکېﺩ ﻮ ﭖښښ ﻤﻪﮐ ﭘ
ﻪﻨﻳﻭﻭ ﻟﻲﺍﺪﻴړﺳ،ﭖ ډﻪ ﻱېﭘﻦ ﻧﻭﻮښ ﺭﭘﻮ ﻭﻧﻤﻲﻭﻱﺍ ﻭﺯﺧ ﺯکﺍ ﺎﺎﻁﻧ ﻮﻯﻣﺨ ﻮښﻝ ﺷ ﺘﻞېﭘ ﮐ
ﻭ.
ﻧﮏې ﻱ ﻭﻮ ﮐﺭ
ﻭ
Extracel l
ulﻮﻱې ar ﺮﻱ چېﻳ ﻭﻝﻟ ﺪ کېﺭ ﻳﺮ
ﻪﺑ ﻴﺐﭘ ﻣﺍﻪﺩ ﻧ
ﻭﺭﻮﺘﮑﻧﺴﻲﻓ ﻭﻻ ﺮﻳﺍ
ﺭﻭ ﺷﺭ
ﻮ ﻢ ﻳ
ﻭAnaphyﺍ l
at oxiﻭnC3a LgA.lﺍ ﻴﻦ gG ﺘﺟ،ﺍﻻﺳﮐﻻ ﻦcyﺩﻯ چې ﻮ sti
enpr oti
enase
ﻣﻦځ ﺮﻮﺗ ﮑ
ﻧﻭﻴﻞژ ﻠ
ﺘﻴﭘﻮﺍﻤﻟﻮﮐﻥښﻞﺩﻴﻦ ﺗ ﺗ
ﻭﺮﭘﻮ ﮑﻳﻪﺩګﻻ ﻧ
ﻮﻤ ﻳﺍﺰﻧ
ﺭﺍ ﻮﺭﻧ ﺷﺭ
ﻮ ﻢ .ﻳ ﻮﻱ ﺑﺍ
ﺮ C5aﺧ
.
ﻮﻱ ﮑﻳﺮﭘ
ﻮﻝ ﮑﻧﻭﺭژﻭﺩځﻱګ ﺍﻮﻤﻟ
ﻮﮐ،ﺩﺎﻱټ ﻮﺳﻔ ﻤ
ﻟ ،
ﺎﻱټ ﻮﺳ ﻧﻮ،ﻣﻴﻞﻓﻭﺮﺗ ﻮﮐﻻﻯﺷﻲچېﻧ ﻴﺐ ﻮ ﻣﺍﻩﺭﻥګ ﺍ
ﺪ ﻤ
ﻫ
ﺎ
ﻭﻳ ﻪﺍ ﺍﺳﻄﻪﻭ ﺎﺱﭘ ﻤﻴﻢﺗ ﻘﺘﻣﺴﻳﻲﺩ ﺍﺰې ښ ﻴ
ﻴﮏﺍﻏ ﺘ
ﭘﻮﻻﺘﻳﺎﻴﺐ ﺳ ﻣﺍﺩﺍ
.چېﺩ ړﻱﻳﺐ ک ﺮړۍﺗﺨ
.
ﺮﻱ ﻟ
ﻩﻭ ړﺍﺭېﻮ ﻭﭘﺪﻳﺩﺍﺯﺍPﺮ
orﺗ ef ormi ngpept iAﻭdes ﺰﺍ ﻴﭙ
ﻴﻟ
ﻮ ﻔ
ﺎﺳ ﻓﺩ
26
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
:ﻥښﻥې
ﻭ ﺍ ﺍﻴﮏېﻥښې ﻨﻴﻠ
ﮐ
ﺩ:
ﻮﻱ ﻱ ﻳﺸﻞﺷ ﻮﻭ ﺮﺧ ﻭﺑ ﻭﻪﺩﭘ
:ﺯﺱ ﺎﺒ
ﻴﻣ ﺍﻮﻤﻟﻮﮐﺩ-
١
ﻧﮏﻭﺩﻟږ
ﻭﻍۍ ﻲ ﺭﺎ
ﻧﻭﺩﺮﻱﺍ ﻟېﻪﺎګﻝﻝ ﻧ ﻣړﻭﻱﺍ ﺎﻥﮐﮏ ﺘﻧﻪﺍﺎﻥﭘ ﻭﻏ ﺭﺎ
ﻩﻧ ﺮﺗ
ﺎﻳ:ﺯﺎﻥﺘﻧﺮﺿﻲﺍ ﺮﻋ ﻴ:ﻏﻟﻒ ﺍ
ﻭ.
ﺟړﻱ ېﻮ
:ﮐﻻﻱټﺱ ﻭﻣﻦځﻥۍ ﻮ ﺍ ﻴﻒ ﻔ:ﺧﺏ
ﺷ.
ﺍﻯ ﻲ ﺩﺩﻪک ﺗ
ﻣﻦځ ﺍ
ﺮﺳﻦکېﺭ ﻪﻫ ږﻱﻭﭘ
ﻪکږ ﺍ ﺘﺍﺧډﻝﻭﻱ ﻭ ﺎﻪﻣﺴ ﻪﭘ ﻧ
ﻮ ﻨﺴﻩﺟ ﺩړ
ﺍ
ﻭ
.
ﺮﻱﻟﻪﻪﻧﻨﻳﻮﻱچېﻭ ﺯېﮐ ﺎ
ﻴﺘﺪېډکېﻣ ﻣﺎﻪﺟ ﻤﻴ
ﻩﻧ ﺯﺍﺪﻧﺍﻪﻤﻪﮐ ﻭﻍﭘ ﺭﺎﻟﺖکېﻧ ﺎﻪﺩېﺣ ﭘ
ﻭ.
ﺩﻱ ﻮﻮﺟ ﮐﺩﻝﻣ
ﺯﻥ ﻢﺩ ﻭ،ﺩﺎﻴﺘﻧ
ﺎﻣ ﻮﺘﺑ،ﺳﺩﺩ،ﺎ
ﺩډې ﺭ ډﺍﻯﺷﻲﺩګ ﺩﺩ ک
ﻭﻥۍ،ﺍ،ﺭځﺍﻯﺷﻲﻭ ﺩﺩ ﻪک ﻠﺮﺣﺩﻭﻣ ﻪکﺩ ﺗﻣﻦځ ﺍ
ﺭ ﺎ
ﻴﺑﻭﺩ ﺩﻭﺍ
ﻩکﺩ ﻪﻭﻱﺩښ ﻩﻧﺩﻮﻮﺟ ﻮﻻًﻣ ﻤﻌﻪﻣ ﺒ
ﺗ
.ﺮﻱ ﻟ ﻴﺖ ﺒﻀ ﻭﻍﻗ ﺭﺎ
ﺭﺷﻞکېﻧ ﻪﺩﺩﻭﭘﻩکﺩ ﻭړﻱﺩښ ﻡ ک ﺍ
ﻭ ﺎﺕﻭﺧﺖﺩ ﻳﺎﺯﻭﻳ ﺍ
ړﺍکﺪ
ﻴTenderﭘ ﻭness ﻟﻰﺍ ﺍ
ﻮﺗﺎﻳﻮﺯ ﺗ
ﺎﮐ
ﺮ ﺭﻱﺣ ﺍﺪﺘﺍﺳ،ﺩ ﻮﺏ ړﺳ ﺍﻯﺷﻲ ﭖ ﺩ
ﺩﻪکېک ﻨ
ﺘﻪﮐ ډېﭘ ډﺩګ
ګﻱډﻝ
ځﻥ ړ ﻭ ﻪﺍ ړﻭﻱﭘ ﻭﺩﺟﺲﻭ ﭘډﺍﻮﻥﻱې ﻦ ﻟﻮ.ﮐ ﺮﻱ ﺎﻥﻟ ﺘﻧﻧﻲﺍ ﺪﻧ
ﺎﻥ چېځ ﻭﻏ ﺭﺎﻭځﻦېﻧﻳ
ﺍﻯ ﺷﻲ ﺩﺩﺪﻝ ک ﻳ
ﺩﺍﺯﻭﺍ ﺩﺍ
ﻮ ﻮﻣ ﻨﺮﺟﺯﻫڅﻪﺩ ﺎﻥ ﺧ ﺘﻧ
ﻪﺍ ﻮﻥﻟ ﻟ
ﻮ ﮐ.ﺩ ﻮﻥﻟﻮﻩﮐ ﺪﺎﻋﻭﺻ ﻡﺍ ﻮﮑﻴﺳ
ﻣﻦځﺍډﻱﺭ ګﻭ
ﻮ ډ ﻧ
ﻮﻤﻳﺍﺰﻧﺍ
ﺭﺩ ﻩﺩځﻱګ ﺮ
ﻩﺳ ﺯﺍﺪ
ﻧﻪﺍﻤﻭﮐ ﻟﻰﺍﺍﻭﺭږﻍټ ،ﺩځﻱګﻝ ﺎﺏ ﻬﺘﻟPerﺍ ipor t
al
.ﻮﻻﻯ ﮐﺍﺪﻴﻮﭘ ېﻪﺷﺭک ﻧ ﻭﻱټځﻱګ ﺯﻮﻓ ﻭﺮﺭﺕکېﺗ ﻮﻪﺩې ﺻ ﻻﻦﭘ،ﮐ ړﻱﻪک ﺗ
:
ﮐﻻﻱټﺱ ﺪﻮ ﻳﺪ:ﺷ ﺝ
ېﻭ
ﻠﻦ ﺍﺑﻭږﻱچېﺍﺎﺕږ ﻳﺎﺕﺯ ﻌﻓ
ﻭﺩ ﺯﺎﻴ
ﺘډﻮﻣﻭﻍﺩ ﮐ ﺭﺎﻧ
ﺪﻭﻱﺩ ﻳﺪﺎﻥﺷ ﺘﻧﻮﺍﻤﻟ
ﻮﮐﺭﺕکېﺩ ﻮﻪﺩې ﺻ ﭘ
ﻩﻱې ﺯﺍ
ﺪﻧﻭﺍﺯﺎ
ﻴﺘډﻮﻣ
ﻪځﻱچېﺩ ﮐ ﺎﺏﺗﻨ٢ځﻝېﺗﺸ ﻟﻰ٠ ١ﺭځې٠ ﺘﻰﺩﻭ ﻭﺣ ﺮﻱﺍ ﻟﻪﻧﻮﻳﻦېﺧﻄ ﺩﻭ
.ږﻱﺎﺕږ ﻳﺎﺝﻱېﺯ ﻧﺴ ﺍﻴﮏ ﺗ
ﻭﺮﮑ ﻭﻧﺍ ﻪﻨﻳﻻﻦﻭﻪﮐ ﻤﮐ
ﻮﻱﮐﺍ
ﺪﻴ(ﭘ ﺪ
ﻳﺭﺘﻲګ ﻧ
ﺎ٤ﺳ ٠،٥ﻪ)ﺒﻪﺗ ﺭﺟﻩﺩ ﻟړ
ﻭﻮ ﺍﻴﮏ ﮐﺴ ﻭﻭﻍټ ﺭﺎﻩﻧﺮﻟﻲﺳ ﺍ
ﻮﺗﺎ
ﻳﻪﺯ ﻟ ﺪﺕ ﻭﻍۍﺩﺷ ﺭﺎﻧ
ﺩ
ﻭﺭﻍټ ﻴﺖﺩځﻱګ ﺎﺳ ډېﺣﺴ ډټﻝېګ ،ﺩ ﻭ ،ﺎﻥګ،ﮐ ﻪﻨﻭﻫﺭﻭ،ﺯ ﻪ ﻧ
ﻭ ﺩ
ﺭﺪﺩ ﻳﺪډېﺷ ډﻩﺩګ ﺭﻥګ ﺍﺪﻤ،ﻫ
.ږﻱﻪکږ ﺗﻣﻦځ ﺍTenderﺭ ﻭness ﺍﻟﻰ ﺍ
ﺎﻁﻣﺨ،ﺩ ﮐﻻﻱټﺱ Flﻮ umi nat iﺩng،ﺩﻝ ﺭﻱ ک ﻮﻮﺳ ﻤﻟﻮﮐ،ﺩ ﺎﻱټﺱ ﻳﺴډﭘﻦﻪﺍ ﮑﺎﺕﻟ ﺘﻼﻃ ﺍﺧﺭﺩﺎ
ﻧ
ﺷ.
ﺍﻯ ﻲ ﺩﺩﻪک ﺗﻣﻦځ ﺍړﻪﺭ
ﻨﺎﻯکېﻡﻳ ﻪﭘ ﻭﭘ ﺍﻪﻧﺪﻴﻬ
ﻪﺑ ﻨﻳ،ﻭ ﻳﺐ ﺮﺮﺗﺨ ﺘﺸ ﻨ
ﻣ
ﺪﺎﻋ
ﻩﻣﺴ ﺭﺎﭙ
ﻟﮐﻻﻱټﺱ Fulﻮ mi ﻪﺩnant ﻧﻭﺭﺎ
ﺪﮐ ﻳﻭﺮﻳﻮ ﺱټ ﮑﻳﺭټ ﻮﮐېﻭﺩﺍک ﺍ ﻭ ﺭځﺍﻮ،ﺧ ﺭﻱ ﺍﻭ
ﺪ ﻴﻣﺍ
،ﺩﺘﻰﺎﺳﮑﻰﻧﺲﻧ ﻧﻭﺮﻪﻟ ﻨ
ﻳ ﻩﻭ ﺮﺗ
ﺎﻳ،ﺯ ﺭWBC ﺷﺭ
ﻟړ ﻢ ﺗ،ﻮﻪﻩﺒ ﻟړ
ﻮ کېﻮ ﻧﺎ
ﻭﻏﺭﺎ
ﻪﺩېﻧ ﻨﻲﺩﻱﭘ ﻴﻣېﺯ
ﺩ.
%٤ﻯ ﺮﻱې٠ ﺩړﻦېﺧﻄ ﻭ ﻡﻳ ﺍﺮﻱ ﻟﻮﻥ ﺘﺭﺷ ﺎﻳﻦېټﻱټﻓﺸ ﻭﺩ،ﺩﺩﺮﺭ ﺘﺸﻨډېﻣ ډګ
ږﻱچﻪکږ ﺗ
ﻣﻦځ ﺍ
ﻭکېﺭ ﻩﭘﻲښ ﺪﻴﺼ ٠ﻓ،ﭘ٥
ﺘﻼﻁﺩﻯچېﻪ ﻴﻢﺍﺧ ﻮﺑﻞﻭﺧ ﻮﻥﻳ ﻟﻮ ﮐﺍ
ﻴﮏﻣﻲګ ﮐﺴ ﻮ
ﺗ
.ﻮﻱ ﮐﺍﺪﻴړﺎﭘ
ﻴﺗﺍﺗ
ﻣﻲﻪ ﻮﺘﮑ ﻴﻟ
ﻮﻭﻍﮐ ﺭﺎ
ېﻧ
:(
LocalizedUl cer ati
vel esionoft heCol ﻳﻲټﭖ)on ﺍ
ېﻮځ ﻮک ﻳ ﻤﻟ
ﻮ :ﻪﮐ
ﺩﭘ
ﻪﺯﺧﻢ ﻭﮐﻮﻱﺍ ﺯېﮐﺎﻴ
ﺘ ﻧﮏېډکېﻣ ﻭﺮﻟﻪﻨﻳﻠﮏېﻭ ﻭﻍﮐ ﺭ ﺎ
ﻮﻧ ﺍﺷﻲﻧ ﺪﻴﻡکېﭘ ﻮﺘﮑ ﻳﺭېټﭖﺭ ﺭﻪچ ﮐ
ﻪﻮﺣﻟﺎﻱټﺱ ﻳﺴﺪﻨ
ﭘﺍﻭﺩ ﺘﻰﺍ ﺎﺳﻴﻒﻧﺲﻧ ﻔﺭﺕکېﺧ ﻮﻪﺩې ﺻ ﻮﭘ ﺪﺷﻲﻧ ﻧﺭګ ﻪکېڅ ﺮﺧ ﻡﺑ ﻮﮑﻴﺳ
.
ﻮﻱ ﻠﻴﺜﻤ
ﺗ
:(Local izedGr anulomat ousl esionoft hecol ﺎ)on ﻣﻮﺒﻴﻣﺍ:ﺝ
ﻪک ﺗ
ﻣﻦځ ﺍګﻥکېﺭ ﺮﻭ ﺒﻪﻏ ﺎﻥﭘ ﺘﻧﺒﮏﺍ ﻴ
ﻣ ﺍ
ﺎﺝﺩ ﻧﺴﻴﺸﻦﺍ ﻟﻮﻧ
ﺍﺭﺎﺕګ ﻳ
ﺭﺯ ﺷﺭ
ﻮ ﻢ ﺭﺕکېﻳ ﻮﻪﺩې ﺻ ﭘ
ﺍﻯﺷﻲ ﺩﺩﺮﻱچېک ﻟړښﺕ ﻮﺎﻥﺟ ﻪﺷ ﺭﭘ ﻮﻣﻮﻨﻈﻢﺗ ﻣﺮﻴﻮﻏ ﻳﻪﺩ ﻠ
ﺘﮐﺍﺟړﻱچېﺩ ﻪ ﻮﻭ ﻠﺘﻩﮐ ﻮږﻱﻭﻳ
ږﺍ
.ﺮﻱﻟﻟﻰﻭ ﺍ
ﺍږﻭ
ﻩﻭﺩ ﺮﺘﺘﻲﻣ ﻧﺎ
ﻭﺳ ﻭڅ ﺍﺍﻥېﻭﻱ ﻭﺩ ﺎڅ ﻩﻳﻮﻳ
ﺩ.
ﻱګﻞې ﻱﺪښ ﻳ ﻨ
ﻭﺑ ﺍ ﻮﻝﮐﺭﻪﻭ ﻨ
ﻳﺩ،ﻭ
ﺩ ﻩﻱېﺭ ﻴﮏېﺏڼ ﻨﻴﻠ
ﻩﮐ ﺭﻮﻏ
27
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
.ﻮﻱ ﮐﺭ
ﺎﻝﻭ ﻴ
ﺎﻥﺧ ﻡﭘﺸ ﻭﺮﻨ
ﻳﻭﺎ
ﻣ ﻮﻟ
ﻮﻧﺍﺭ
ﻤﻒګ ﻟﺎ
ﺯﻳﻮﻠ
ﮐﺮﺑﻮ،ﺗﺎﻣﻮﻨ
ﻴﺭﺳﺎﻮﻥﮐ ﻟﻮﮐ ﺮېکېﺩ ﮑﺴ ﻳﺍﻪﭘ
،
ږﻱﺪﻝکږ ﻴﻟﻮﻱﮐﺭﻪﻭ ﻨﻳ
ﻩﻭ ﺮﺎﻥۍﺳ ېﻪﺍﺳ
ﻪچ ﭘ ﻠ
ﺘﻩﮐﺮﻩﺳ ﻮﻮﻳﻩﺷﻲﻧ ﺮ
ﺮﺳ ﭘﻲﺗ ﻮ ﮑﻭﺳ ﺪ ﻧ
ﺭېﺍ ﺭﻪچ ﮐ
.ږﻱ
ﺍکږ ﺪ ﻴ
ﻮﻥکېﭘ ﻟ
ﻮAscendiﮐ ﻭng ﺍﻡﻮ ﮑﻴﻪﺳ ﻩﭘ ﺮﺗ
ﺎﻳﺯﺎﻣﻮﺒﻴﻣﺍ
:
ﺯﺱ ﺎ
ﻴﺒﻴﻣﺍﺮ ﻬڅﻪﺑﻮ ﺧ ﻤﻟﻮﮐﺩ-
٢
:ﺯﺱ ﺎ
ﻴﺒﻴﻣ ﺍﺭ:ﺩځﻱګ ﻟﻒ ﺍ
ﺷﺭ
،ﻮ ﻢږﻱﻳ ﻪکږ ﺗﻣﻦځ ﺍ
ﻪکېﺭ ﻠ
ﻳﺎ
ﻪﭘ ﺯﺱﭘ ﺎﻴ
ﺒﻴﻣﺍ
ﻮﻤﻟ
ﻮﻭکېﺩﮐ ﻟﻰ%٩ﭖښښ ﺑﺲې٣ﺍ ﺭﺍﺩځﻱګ
%٤ﻟﻰ٠ ٣ﺍ ﻮ٠ﺮﻱ ﺧ ﻠ
ﺍ ﺽﻧ ﺮﺯﺱﺍﻋ ﺎ
ﻴﺒﻴ
ﻣ ﻮﺍﻤﻟ
ﻮﮐﺮﻱﺩ ﺑﺴﻲﻟ ﺭﺍﺎﻥ چېﺩځﻱګ ﻭﻏ ﺭﺎﻪﻧ ﻐﺎﺕﻫ ﻳﺭﺯ
ﻭ.
ﻩﻣﻞ ﻱ ﺮﺘﻲﺳ ﺎﺳېﻪﻧﺲﻧ ﻮک ﻟ ﻧﺎﻭﻏﺭﺎ
ﻧ
ځﻯﻭﻱﻮﺍ ﻩﻳﺮﺗﺐېﺳ ﻭﺩ ﺩﺍﺭډېﺩ ډ
ﺎﺩګ ﻳﻭﮐ(ﺍ
ﻭڅﻪ ﻢ
ﻭځ ﺧ ﻟﺲ ﺭ ﻧڅﻪ)
ﭘﺍﻯﺷﻲﺎﺍ ﺩﺩﻴﻞک ګﻮﭘﻠﺩﻳ
.
ﻮﻱ ﻡﮐﺍﻭﺎﺷﺖېﺩ ﻴﺎﻣﻳﻭﺍﻭﺭځېﻳﺠﻲﻭﻱچېڅ ﻭ ﺭ
ﺪ ﺍﻯﺷﻲﺗ ﺩﺩک
ﺭګﻳېڅ ﻨﺲټﺰ ﺭﻱېﺑ ﺎﺱځﻱګ ﻪﺣﺴ ﮐﺎ
ﻧﺩﺭ
ﻭﻍټﺩ ﺩﺍﺭﻴﮏﺩ ﺘﻳﺭﻮﻠﻴ
ﺎﭘﺑﺖﻳ ﺎﻩﺛ ﺭﺍﺪﻣﺍﻭﺗ،ﺩ
ﻪﻩﺒ ﻟړ
ﻮ
ﻮڅ ﻟﺪ
ﻴ ﻤﺯﻥﮐﻭﻭ ﻳﻲﺍﺎﻬﺘ ،ﺏېﺍﺷ ،
ﻮﻝ ،ﺧ،ﺯړ
،ﻝ ﻟﺖﺎ
،ﮐﺴ ﺎ
ﻳړﺍﻥﺩﺳﺖ ﺭ
ﻭﻩﺭﻥځ ﺭﻥګ ﺍ
ﺪ ﻤﺩ.ﻫﻭﻥې ﻱ ﺪ
ﻧ
ﻭ.
ګﻪﻣﻦ ﻱ ﻠ
ﻪﻳ ﺧ
ﻪﻭﻱ ﻧ
ﺍﻩﺩ ﻮﻩﻳﺮﺗ
ﺎﻳ،ﺯﺮﻱﻟﺮﻭ ﺭېﻗﻄ ﻮﻭﭘﺮﺘﺘﻲﻣ ﻧ
ﺎ١ﺳﺗ٥څﻪﺮﻭ ﺧ ﺮﺘﻠﻲﻣ ﻭﻣ ﻪڅ ﻟﺍﻯﺷﻲ ﺩﺩﺑﺴﻲک ﺍ
ﺎﺕې ﭖ ﻳﻪﺅکېﺯ ﻨﻳﺭﺎ
ﻪﻧ ږﻱﻭﭘ
ﻪ کږ ﺍ ﺗﻣﻦځ ﺍ
ﻪ کېﺭ ﺮﺧﺗﻦۍﺑ ﺭﻮ
ﻪﭘ ﻪﭘ ﺑ
ﻮ ﺭﺩښﻱﻟ چېﺩځﻱګ
.ږﻱږښښ
ږږ
ﻪﻭﺷﮏ ړﻮﺗ
ډﻮﻍﻳﻭﻥﻳ ﺍ
ﺭګ ﻮ
ﻭﻧﻮﻥﺍ ﺘﻳﺮ،ﭘ
ﺩﺭﺎﮑ
ﻳﺮ،ﭘﺍ
ﺭﻮﻠ
ﺍﻯﺷﻲﭘ ﺩﺩ
ﺑﺴﻲک ېڅﻪﺍ
ﻠﻦ ﺧ ﻣﺭېﻪﺩﺏﻟ
ﺷ.
ﻻﻞ ﻲ ﺩړﻦې ﻣﻱﻭ ﻡﻳ ﺍ
:ﻴﺐ ﻣﺍﻭ ږﻭﺱ ﺍﺍ
ﺭﻮ ﻠ
ﭘ:ﺩﺏ
ﻪﻠ
ﻣﻪﺍ ﺩﻭﻟ
ﺑﺲېﺩﺷﮏﺩ ﺍﺮﺥېﺩ ﺗﻦۍﺑ ﺭﻮﭘﻮﺏﺩ ﺘﻼﻁﺩﻯچېﺩښﻱﻟ ﻬﻢﺍﺧ ﻮﻣ ﺑﺴﻲﻳ ﺭﺩﺍ ﺩځﻱګ
.ﻮﻱﻪﮐ ﺗﻣﻦځﺍﺯﺱﺭ ﺎﺘﮑﻴﻠ
ﻴﺗﺍﻥﻭ
ژﺍ ﻮﻴﻔﻳﺍﺭﻝﻮﻠﻪکېﭘ ﻠ
ﻳﺎېﻪﭘ
ږﻱچ ﭘ ﻪکږ ﺗﻣﻦځ ﺍ
ﺭ
ﻭ.
ﺩﻱ ﻮﻮﺟﻭﺧﻰﻣ ،ټﻩﺗﻦګﻱ ﺎﺩ،ﺳ
ﺩﻴﮏﺭ ﺘﻳﺭﻮﻠ
ﺗ،ﭘ
ﻪﻮکېﺒ ﻴﻭﻏﺭﺎﻪﺩېﻧ ﭘ
ﺎڅﻧ
ﻭﻍکېﺩ ﺭﺎ
ېﻪﻧږﻱچ ﭘ ﻪکږ ﺗﻣﻦځ ﺍ
ﻮﺏکېﺭ ﻪﺟ ﺍﭘﺭﻮﻠﭘ
ﻪﺩ ﻠ
ﺒﻪﮐ ﻟﺩﻭ
ﻳېکﺩ ﺑﺴﻲﺩڅﺮ ﺍﺎﺩﻤﻳﺎﭙﻣﺍ
.ﺮﻱﻟړﻪ
ﻨ٣ﻡﻳ ﻟﻰ٥ ﺍ١
ﻮکې٠ ﻠ
ږﻱچېﺳ ﻻﻞکږ ﺩﻣ ﺭDﻭﺩiﺍ st rﻔﺴﻲess ﻨﭘﻲﺗ ﺍ
.ږﻱ
ﻩکږ ﻪښ ﻠ
ﭙېﻪﺧﻩچ ﭘ ﻪﺩﻩﻧﺰﻳ
ﺩﻭﺩﺎﻪﻫﻢﻧ ﻧﺪﻳﺟړ
ﻮﻝ ﻮ ﺘﻧﮏﻝﻝﻓﺴ ﺍﺮﺑﻮﺗﺎ
ﭙﻴﺩﻫ
ﺭﺕکې ﻮ ېﻪﺩې ﺻ
ﻮﻱچ ﭘ ﻪﮐ ﻧ
ﺩﺩﻪﺷﮏ ﺗ
ﺍﻥﻣﻦځ ﻮﺘﻳﺮ
ﭘﻭکېﺩ ﻟﻰ%٧ﭘﻲښ ﻩﻪ٢ﺍ ﺭﺧﻦځﭘ ﺩځﻱګ
.ﻩﻩ
ﻟړ ﺩﻪﻮ ړﻦېﮐﭽ ﺩﻡﻳ
ﻪښ ﺘﻭﺳ ﺭﻭﻥېﻱېﻭ ﺪ
ﻧﺭګ ﻴﮏېڅ ﻨﻴ
ﻠځﻪچېﮐ ﻮﻱ ﮐ ﻪﮐﻧﺩﺩﻪﺷﮏ ﺗﺎ
ﻳﺑﺴﻲﺯ ﻮﺏﺍ ﺭﺩﭼﭗﻟ ﺩځﻱګ
.ږﻱ
ﻩکږ ﺭﺎ
ﮐ
ﻻﻞ
ﺎک ﻣ Cﻭﺷ arﺍdiact ﺘﻼﻁﺩﻯچېﺩemponade ﻴﻢﺍﺧ ﺮﻭﺧ ﻳﻮډﺭﺧ ﺩﺎﻴﺐﻧ ﻣﻳﻞﺍ ﺩﺭﺎﮑﻳﺮﻴ
ﭘ
.ږﻱکږ
:ﺯﺱ ﺎ
ﻴﺒﻴﻣﺍﺮﻬڅﻪﺑﻮ ﺧ ﻤ ﻟ
ﻮﺭﺩﮐ ﻮ:ﻧﺝ
ﻪﺎﻥﭘﺘﻧﻴﮏﺍ ﺗ
ﺎﺘ
ﺎﺳ ﺘ
ﻴﻩﻣ ﺭﻥګ ﺍﺪ
ﻤﺍﻯﺷﻲﻫ ﺩﺩ
ﻪک ﺗﻣﻦځﺍﻪکېﺭ ﺮﺧ Perﺑiﭘanalﺎﻥ ﻪ ﺘﻧﺘﮏېﺍ ﻮﺳ ﭘ
ﺩ
ﺷ.
ﺍﻯ ﻲ ﺩﺩﻪک ﺗﻣﻦځﺍﻩﺭﺮډﻝﺳﺭﻭ ﺩﺎېﻪﻧ
ﺎﻍک ﭘ ﻣ،ﺩږﻱ :ﺱ ﻪ ﮑﻟﻮﺮﺧ ﻭﺑ ﺭﻮ
ﻧ
:ﺭړﻥېﻭﻪﺍ ﺘﺭﻱﻻﺳ ﺍﻮﺗﺍ
ﺮﺑﻻ
:ﺯﺱ ﺎﻴﺒﻴﻣﺍﻮﻤﻟﻮﮐ-ﺩ١
ﺎ
ﻭﻳ ﻴﺐﺍ ﻣﻭکېﺍ ﺯ
ﺎﻴﺘډﻮﻣېﻪ ﮐ
ﻪچ ﭘ ﻠ
ږﻱﮐﺩﻝکږ ﻭﻴ ﺺﺍﻱښ ﺯﺱﺗﺸﺨ ﺎﻴﺒﻴ
ﻣﻮﺩﺍ ﻤ ﻟ
ﻮﮐ ﻪﻭﺧﺖﺩ ﻐﻫ
ﻩﺯﺎ
ﻭﺗﺯ ﺎ
ﻴﺘډﻮﻣڅﻪﺩ ﮐﻭﻍ ﺧ ﺭﺎ
ﺩ،ﻪﻧ
ﺎﺱ ﻯﻟ ﺮﺣﺴ ﻳﺪﻝﺩ ﻴ
ﻣﻮﻠﻌﺘﻲﺟﻦﻣ ﻧ
ﺍ،ﺩﻭړﺍک ﺪ ﻴﺘﻲﺟﻦﭘ ﻧﻱېﺍ
ﺷ.
ﻪ ﻲ ﻨ
ﻳﺎﻌﺭﻣﺪژ ﻳ
ﺎږﻱﻭﺑ
ﺘﻞکږ ﺍ ﻴﺴ ﺍﺧ ﻪﻧ
ﻮ ﻤ
ﻧ
28
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
29
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﻪﻣﺍ
ﺭﻠﻲ ګ ٦ﻣ ٥٠Iodoqui nolDi l
oxanid Fur oate ﻮﻤﻟ
ﻮﮐﺩ
ﻩﺭﺎ
ﭙﻟﻭﻭځ
٢ﺭ ١ﺭځېﺩ ﻭﻪﺩ ﻟ
ﺩېځ ﻪﺩ ﺭ ﻟﺩېځﻪﺭ ﻣﺍﺭﻠﻲ ګ ﻣ٥٠
٠ ﺮﺿﻲ ﺮﻋﻴﻏ
٣٥-
٢٥ Par amomy ci
ﺎ ne ﻳ ﻩ
ﺭﺎﭙﻟﻭﻭځ
ﻟﺲ ﺭ ﺭځېﺩ ﻭ ﻭﺏﺮﮑﻴﻣ
ﻮګﻟﺮکﻝ ﺮﻫ ﺪﻥﭘ ﺑ
ﻪﺩ ﻣﺍ
ﺭﻠﻲګ ﻣ
ﺮﺪﺗﻳﺎ
ﻩﺑ ﺭﺎ
ﭙﻭﻟ ﻭځ
ﺯﻥﺩ٧ﺭ ﻡﻭ ﺍ
ﺭ
ﺷ.
ړﻝ ﻲ ﺭک ﻪﻭﺘﻭﺳ ﺭ
ﻭﻭ ﺧړ
ﻮ
ﺎ
Diﻳ loxani d Fur oatﻠﻲ ګ e ٧ﻣ ٥ﻭﻝ٠ ﺯﺍﺪﻴﻧﻭﺮ
ﺘﻴﻔﻲ ﻣﻴﻔﻪﺧ ﻟﻮﻤ
ﻟﻮﮐﺩ
ﻴﻦﻠ
ﮑﻳﺎﺍﺳﺮﺘﻊﺗﻤIﺟ odoqui ﻟﺲnol ﺭځېﺩ ﻭﻪﺩ ﻟﺩېځﻪﺭ ﻣﺍ
ﻭﻍ ﺭﺭﺎ
ﻣﻦځﻥۍﻧ ﺮﺗ
ﻮﻟﺴﻪﺩﻟڅﺭځﻮﻪﻟ ﻣﺍﺭﻠﻲ ګ٢ﻣ ٠ Ti
٥ niﻳdazolﻩﺎ ﺭﺎ
ﭙﻭﻟ ﻭځ
Nonﺭ ۍ
ﻴﺐﻘﻌﺮﺗ ﺍﭘﻭﺩېﺩ ﻩﺩ ﺭﺎﭙﻭﻟ ﺩې ﺭ
ﻭځ ﺭځېﺩ ﺭ ﻭﻪﺩ ﻣﺍﺭﻩګ ﻭﺩ dysenteri
c
ﻪﺩ٧ ﻣﺍﺭﻠﻲ ګ ٥ﻣ ٠
ﻭکﻥﻥ٠ ﺭﻮژﻢ ﮐ
ﻠ ﻨﻰﺭﻳ ﺗﺭﻮﻩﭘ ﺭﺎﭙﻭﻟ ﻭځ
ﺭ col
iti
'
s
ﺎ
ﻳ ﻩﺭﺎﭙﻟ ﻭﻭځ
ﺎ ﺭ Diﻳ loxani ﻊ d ﻤﺟ
ﺎ
ﻴﻪﺑ ﺘ
ﻭﺳ ﺭParﻭ amomy ciﺎ neﻳ Ioduqui nol
ﺮﮐﻪﺩﺫ ﺍﺳﻄﻪﻭ ﻭکﻥﻥﭘ ﺭﻮﻠ
ﮐﺮﺩ Parﭘ amomy cine
ﻮﻝ ک ﮐﺭﻡﻭ ﺍ
ﻭ ﺯې ﺩﺍﺪﻧ
ﺷېﺍ ﺯې ﻮ ﺍ
ﺪﻧﺷې ﺍ
ﺮ ﻮ ﮐﻪﺫ ﺗ
ﺭﻮﭘ
.
ږﻱږ ﺳ.
ﻩﺮ
ﻪﺩ ﻣﺍ
ﺭﻠﻲ ګ ٥ﻣ ٠
ﻴﻦ٠ ﻠﮑﻳﺎ
ﺍﺳﺮﺘﻠﻲ ګ ﺗ٧ﻣ ٥ﻭﻝ٠ ﺯﺍﺪﻴﻧﻭﺮ
ﺘﻴﻩﻣ ﺪ
ﻳﺪﻮ ﺷ ﻤﻟ
ﻮﮐﺩ
ﻭﻭځ
ﻭﺭ ﭘﻦځ ﻪﺩ ﻟڅﺭ ځ
ﻮﺭځې ﻟ ﺭځې ﻭ ﻭﺩې ځﻝې ﺩ ﻪ ﺭ ﻣﺍ
ﺭ ﻭﻍۍ ﺭ
ﺎﻧ
ﻪﻣﺍ
ﺭﻠﻲګ ٢ﻣ ٠ﺎ٠ﻴﻪﺑﺘﻭﺳﺭﻩﻭ ﺭ
ﺎﭙﺎﻟﻩ ﻳ ﺭﺎﭙ
ﻭ ﻟ ﻭځﻟﺲ ﺭ ﺩ Dy sentery
ﻭﻭځ
ﻭﺭ ﭘﻦځ ﺭځېﺩ ﻭﻪﺩ ﻟ
څﺭځﻮﻮځﻝ ﻟ ﻪﻳ ﻣﺍﺭ
ﻭﻝ ٢ګ ﺯﺍﺩ
ﺎﻨﻴ
ﺗ
ﺍ
ﻭﺩېﺩﻮﺩ ﻮﻻﻯﺷ ﮐﺭﻡﻭ ﺍ
ﻭﻩﺩ ﺭ
ﺎﭙﻩﻟ ﺭ
ﺎﭘﻭﺩ ﻭځ
ﺭځې ﺩ ٥ﺭ ﻭﺩ
Dil
oxani ځﻯ d ﻮ ﺍ ﻩﻳ ﺮ Diﺳ l
oxanidf uroat ﻊe ﻤﺟ
I
oduqui ﺎ nol fﻳ uroatﻩe ﺮ
ﺯې ﺳ ﺍ
ﺪ ﻧ
ﻮﻱﺍ ﺮﺷ ﮐﻪﺫ ﭘ
ﻭکﻥﻥ ﺭﻮﻠﻪﮐﺘﻭﺳ ﺭﻪﺷﻲﻭ ﻓﺎﺭﺕﺍﺿ ﻭﺮﻪﺿ ﻗﻲﺗ ﺭﺭېﺯ ﺭﻪچ ﮐ
ﻩﺭﺎ
ﭙﻭﻟﻭځ
١ﺭ ﻪﺩ٤ ﻣﺍ
ﺭﻠﻲګ ٥ﻣ ﺪﻱ ٠
٠ ﻳﺭ
ﻭ ﻮﻧ ﺮﻱ ﻟ
ﻭ
ﺷ.
ﻴﺐ ﻲ ﻘﻌﻠﻲ ﺗ٥ﻣ ٠
٠Met r
oni dazol
ﻮﺭﺕﻭﻱﻧ ﻭﺮﻪﺿ ﺍﺗﻭﻗﻲﺩ ﺭﻪﺯﻪﮐ ﺘ
ﺎﻋﻪ ﺳ ﺗ
ﺮﺍ ﻪ ﻫ ﻣﺍﺭګ
ﻡﺍﺭ
ﻠﻲګ ١Dehyﻣ droemet ﻭﻍ n
i ﺭﺎ
ﻪ چېﻧ ﻠﻭﮐ ﻪﺍ ﺘﻭﺳﺭﻭ
ﺯﻥﺩ ﻡﻭ ﺍﺭ
ﻮګ ﻟﺮ کﻝ ﺮﻫ ﺪﻥﭘ ﻤﻲ ﺩ
ﺑ ﺯﻏﺍﻭﻭﺭېﺩ ېﻪﻻﻮﻝ ﻟ ﺩﺧ
٥-
ﻠﻲﺩ٣ ﻧېﺎﻋﻀ
ﺘﮏېﻻﺪ ﻳ ﻮﺳﻩﭘ ﺮ
ﺭﺳﻭﻭ ﻴﻞﺷﻲﺍ Orﭘ ﻧalﻮ
ﻪﻨﻠ
ﻣﺭﻪﺩﺘﻭﺳ ﺭﻩچېﻭ ﺭﺎ
ﭙﻭﻟ ﺎ ﺭ
ﻭځ Diﻳ loxani ځﻯ d ﻮﺍ ﻳ
Dil
oxani ﻊ d ﻤﻴﻦ ﺟﻠﮑﻳﺎ
ﺍﺳﺮﺘﺷ .ﺗ
ﻪ ﻲ ﻓﺎ
ﺍﺿ Iodoqui nol
ﻩﺮIﺳoduqui ﺎ nolﻳfuroate
ﻴﺐﻘﻌﻪﺗ ﺩېﭘ ،ﺩ ږﻱ
ﻴﺐ کږ ﻘﻌﺗ
ﺷې
ﺮ ﻮ ﮐﻪﺫ ﺗ
ﺭﻮﻪﭘ ﻭکﻥﻥﭘ ﺭﻮﻠ
ﮐ
.ږﻱﻮﻝکږ ﮐﺭﺯېﻭﺍﺪﻧﺍ
Emet i
Dﺎn ehyﻳ droemet ﺎn
i ﻳ ﻭﻝﺯﺍﺪﻴﻧﻭﺮ
ﺘﻴﺑﺲې ﻣ ﺍﺭﺩځﻱګ
ﻭکﻥﻥ ﺭﻮﻠﻴﺐ ﻱېﮐ ﻘﻌﻪﺗ ﻊ چېﭘ ﻤﺟ Tinidazol
ﺭځېﻭﻪﺩ ﻟﻩځ ﻭﻪﺩ ﻣﺍ
ﺭﻠﻲګ ٥ﻣ ٠
ﺎ٠ Diﻳloxanidf uroate
30
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﻪﺘﻭﺳ ﺭ
ﻭﻭ ﻩﺍﺭﺎ
ﭙﻭﻟﻭځ
ﻩﺭ ﻭﺮ ﺩﺩ ﮐﻪﺫﺗﺭ
ﻮIﻪﭘ
odoquiﭘ nol
ﺭځېﺩ ﻭﻮځﻝﺩ ﻪﻳﻣﺍ
ﺭﻠﻲګ ٥ﻣ٠ﺩ٠ ﺍ
ﺎﺩ ﻴﺯې چېﺑ ﺍﺪﻧ
ﻮﻱﺍ ﺷ
Diloxani
ﻊd ﻤﻩﺟ ﺭ
ﺎﭙ
ﻟ ﻭﻭځ
١ﺭ٩٥ ٠
ﻪ٠ ﺍﺳﻄﻪﻭﻭکﻥﻥﭘ ﺭﻮﻠﮐ
Iodoquiﺎ nol fﻳ ur ﺭe
oat ١ﻭﺭځېﺩ٤ ﻭﻪﺩﻣﺍﺭﻠﻲګ ﻣ
.
ږﻱ
ﻮﻝکږ ﮐﺭ
ﻭ .
ږﻱﻮﻝکږ ﮐﺭﻩﻭﺭﺎﭙ
ﻟﻭځ
ﺎﻥﻪﺷ ﺑﺲېﭘ ﺍﺭﺩ ﻪﺩ ﺩځﻱګ ﺎﻟﺎﻳ ﻣﻮﺒﻴ
ﻣﺍ
ﻪ کې ﻭکﻥﻥ ﭘ ﺭﻮﻠﻮﮐ ﺮ ﺧ ﻬڅﻪﺑﻮ ﺧ ﻤﻟ
ﻮﮐ
.ﺮﻱﻟﻪﻭﻥﻧډګ ﻭﻍۍ ﺭﺎ
ﻧ
.
:ﻮﻯﻴﻨ
ﻭﻣﺨ ﺍﻭﻝ ﺮﺘ
ﻨﮐ
ﻭړ
ﻮڅﻪﺩﺩﺧ
ﻮ ﺧﻧﺎ،ﻪﻣﭽ
ﻮﻝﻟ ﻩﭘﺨﺭﻮﻭﭘړﻮ،ﺩﺧDiﻭspose ﺯ
ﺎﻴﺘډﻮﻣ
ﻧﻲ ﮐ ﺎﻧﺴ،ﺍﻮﺑﻭﻳﻲﺍﺎ
ﻴ ﺘ
ﻭﻏﺭﺩ
ﻮﻯﻴ
ﻨڅﻪﻣﺨ
ﺯﻯ ﺧﺎﻨﺲﺑ ﻤﺠﻝﻭﺩﻫ
ﻳﻦځ ﺍ ﻮﻥﻭﺑﺎ
ﻪﺻ ﻪﭘﻧ
ﻮڅﻪﻻﺳﻭ ﺧ ﺯ
ﺎﻴﺘ
ﻮﻣ ﮐﻪﺩﺩ ﺘ
ﻭﺳ ﺭ
،ﻭ ﻪﻨ
ﺗﺎ
ﺳ
ﺩ.
ﺭې ﻱ ﻮﻱﻻ ﻳ
ﺎﻗښېﻭ
.ﻪﺘ
Cﻪﻻﺱکېﻧﺸ hemoprﭘ ophylaxiﻳs
ﻭﺎ ﺍﻴﻦ ﮐﺴﺍ
ﻣﻦﻭ ﺰﻴﺍﻏﻡﻮﮐ
:ﺭ
ﺍﺰﻧ
ﺍ
ﺎﺕېﻳ
ﻪﺷﻲﺯﻧ
ﻪﻭ ﻨﻠ
ﻣﺭﻪﺩﺎ کېﮐﻣﻮﺒ
ﻴﻣېﻭﺍ
ﺑﺲ ﺍ ﺭﺍ،ځﻱګ ﺮﻱﺘ
ﻧﺍﺰﻳ
ﻩﺩ ﺪﻳ
ﺪﻪﺷ ﺩړﻦېﭘﻲښېﭘ ﻡﻳ
ﺩ.
ﻩﻱ ﺭښ ﺍ
ﺰﻧ
ﺍ ﻩﺮﻠﻦېﺳ ﻣ
ﺭ ﺪﺩ ﻭﺏ ﺿﺮﮑﻴ
ﻣ ﺩ،ﺩ
ﻱ
ټﻱټﺱA
ﺎﺍﭙ
ﻴﻫ
:ﻳﻒﺮﻌ
ﺗ
ﮑﻰﻧ
ﻭﺩﺩ
ﻩکﻪ ښ
ﻠﭙﻪﺧﻭﭘ
ﺑړﻰﺍ
ﻮ ﻲﻧﺭﻳ.ﺩځﻱګﺩﻩ
ﻳﻞ کﺩ
ټﻱټﺱﻭ
ﺎﺍﭙ
ﻴﮑﺸﻦﻫﻔﻧ
ﻪﺍﺗﺭ
ﺍﻭﻮﭘﺨ
ﻪﻩﭘ
ﻮګړېﺗ
ځﻥګ
ﻪﺍﺎﺕېﺩﻱﭘ
ﻳړۍ کېﺯ
ﻪﻥ ﻟ
ﻭﻪټ،چېﭖښښېﻱېﭘﻩﺎﻥﺩ
ﺘﻧ
(ﺍSel
fl
imit
)
.
ږﻱ
ﺮږﭙﺎﺕﺧﻳ
ﻮکېﺯ ﻧ
ﺎﻣﻮ
ﺎﺷﻣ
31
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﻮﻻ ﻧ
ﻮﺘﻴﺑﻮﻴ
ﻌﻪﺩﻣ ﻪﻣﻦځﻥۍﮐﭽ ﺭځﻦېﭖښښېﭘ ﺩ،ﻡګ ﻳﮑﻞ ﻱ ﻴﻨﻴﻠﺎﺕېﭖښښېﻱېﺳﺐﮐ ﻳﺯ
ټﻱټﺎﺍ ﭙﻴ
ﺎﻥچېﺩﻫ ﻭﻏ ﺭﺎ
ﺭ%١ﻧ ،ﻡګ ﻩﻪﺩ ﻤ%څﻪﮐ
٠ﺧ ،
ﻟ١
ړﻪﻪ ﻨﻭﻍۍکېﻡﻳ ﺭﺎ.ﻪﺩېﻧ ږﻱﭘ ﻣﻞکږ
.ږﻱ
ځﺭږﻪﻭ ﻠ
ﻣ ﺍﻪﻟﻭﻏﻲ ﺭﺎ
ﻧﮏېﻧ ﻭﻭﺍښ ﻭﺪګ ﻧﻭﺪژ ﻳ
ﺪﻮﻱﺩﺷ ﺮﺷ ﺘﻮﻥکېﺑﺴ ﺘﻭﻏﻪﺭ ﻪﭘ ﻠ
ﻣﺍ ﺱAﻪ
ﻟ
:ﻮﺟﻲ ﻟﻭﺮﻳ
ﺍﻭ
.
ﺮﻱ ﻟﻩ
ړﺍ ﺭېﻮﺭﻥۍﭘ ﻮﺮﺱﮐ ﻳ
ﺍPiﻭcorﺩ،چېﺩna ﺮﺱ ﻯ ﻳﺍﺎﻭﺘﭙﻴﻮRNAﻫ ﺍﻳﺩ
ﻭﻳﮏﺍ ډﺍ
ﺭﻮﭙﻪﺳ .ﭘﺮﻱ ﺮﻟﻩﻗﻄ ﺮﺘﻣﻮﻧﺎ٢ﻧ٧.ﺮﻱ ﻳﭗﻟﺎﺗ
ﻮﻨﻴﻧﻲﺟ ﺎﻧﺴڅﺭﺍ
ﻮ ﻭﻟ ﻳﭗﺍ ﺎﺗ
ﻭ ﺮﻴړېﺳ ځﻥګﻮﺍ ﻳ
ﻮﻧﻮ
ﻳﺍﻮځ ﻐﺩ.ﻫ
ﺭﻝ ﻯ ﻭﮑﻞﺍ ﻴﻩﻓ ﺮﺗ
ﺎﻳﻪﻱېﺯ ﻧﺩ
ﺩ ﺩ
ږږ،ﻝږﻱ
ﻻﻞکږ ﺎﺏ ﻣ ﻬﺘﻟ
ﺭﺩﺍ ډﻝﺩځﻱګ ﻤﮏ ﻭ ﻳﺪﻴﭘ
ﺍ
ﻭ.
ﺍﺏ ﻱ ﺮﻳﻂﻱېﺧ ﺍ
ﺮ ﺗﻦېﺷ ﺎﺎﺩﺳ ﻴﺘﻭﻏﻩﻭﺩﺭﻭڼﺍ ګﻩګﻮ ڼ ﮑ ﻠ
ﺩ،چېﺩﺧ ﺭې ﻱ ﺭکېﻱېﭘﻲښېډ
ﺷ.
ﺮ ﻲ ﻬﻭکېﺑ ﺯﺎ
ﻴﺘډﻮﻣﻪﮐ څﻪﭘﻭ ﺧ ﻭﺎﻴ
ﺗﺪﻧﺭګﻴﮏېڅ ﻨ
ﻴﻠﮐ
ﻭﻥۍﻣﺨﮏېﺩ ﺍﻩ ﻭﺍﻯﺷﻲﺩ ﺩﺩﺮﺱک ﻳ
ﺍﻭ
.ږﻱ
ﺍکږ ﺪﻴﻭکېﭘ ﺯﺎﻴﺘډﻮﻣ
ﻩﻪ ﮐﻮګﭘ ﻩﺗﺭﺩﺎ
ﻪﻧ ﻪﭘ ﺘﻭﺳ ﺭ
ﻭﻥۍﻭ ﺍړۍ ﻡﻮﻟ ۍﻪ
ﻭﻍ ﻟ ﺭﺎ
ﻧﺩ
.ﻩﻩ
ږﺩ ﻪﻝ ﻠﺒ
ټﺱﻪﮐ
ټﻱ ﻟ ﺎﺍ ﭙﻴ
ډﻝﻫﺩې ﻭ ړﻪ ﺩﻨﻭﻡﻳ ﺍﺛﺖﺎﺒ
ﺧ
.ﺮﻱ ﻟ
ﻪ ﮑﻰﻧ ﻧ
ﻭ ﺩږږډﻰﻝﻱﻭﻫﻢځﻥﻧ ﺭځ ﺍ
ﻪﺍ ﻪﻧﺗټﻱټﺱAﻣﻦځ ﺎﺍ ﭙﻴډﻰﻫ ځﻥﻧ
ﻭ.
ﺪﻱ ﻳﺪﺮﺷ ﻴﻴﮏېﺳ ﻨﻴﻠ
ﻪﮐ ﻠ
ﺗﺮﻪﭘ ﻮﭘ ﻧ
ﺎﻣﻮﺎﺷﻣ ټﻮکېﻱېﺩ ﻧﻪﻍﺍ ﭘ
ﺪﻴﻟﻡکې ﻭ
ﺮﻴﻪﺳ ﭘI
IﻭgG ﻩ gMﺍ ﺩړ
ﺍ.ﻭ ږﻱ
ﺪږ ﻧﺭګﻮکېڅ ﻧﻭﺍړړﻮ ﭖﻡﻳ ﻮﻟ
ۍﻪﻭﻍ ﭘ ﺭ
ﺎډﻱﺩﻧﺎﺩ ﺘﻲﺑ ﻧ
ﺍ
I
gA. ﻮﻱﻡﮐ ﺍ
ﻭ ﺎﺷﺖېﺩ ﻴ٦ﻣ -ږﻱﻭ٣
ﻪﺭﺱږ ﺍ ړېﮐﭻېﺗ ېﻮ
ﻭﻥۍک ﻟ ړۍﺍ ﻡﻮ ﻪﻟ IﭘgM . ﻮﻻﻯ ﺷ
.ﻮﻱ ﻡﮐﺍﻭﻩﺩﺭﺎﭙﻟﻮﻧﻮﻠﮐږﻱﻭﺩ
ېﻪﺭﺱږ ﺍ ړېﮐﭻ ﺗ ېﻮ
ﺎﺷﺖېک ﻟ ﻴړۍﻣ ﻡﻮﻟۍﻪ
ﻭﻍ ﭘ ﺭﺎ
ﻧﺩ
:ﻮﺟﻲ ﻟﻮﻤﻳﺪﻴﭘ
ﺍ
ﺭېﻮﻮﭘ ﻧ
ﻮﻠ١ﮐﺮ٤ ٥څﻪﺗ
ﺮﻱېﺩ ﺧ ﻤﺎﻥچېﻋ ﻣﻮﺎﺷﺩ.ﻣ
ﺎﺕې ﻱ ﻳړۍ کېﺯ ﻪﻥ ﻟ
ﻭ ﻪټ ﭘﻲښېﻱېﭘ
.ږﻱﻪکږ ﺘﺍﺧ ﺎﺕﻳﻭﻱﺯ
.ږﻱ
ﻪکږ ﺘﺍﺧ ﻭﺱ ﺮﻳټﻱټﺱAﻭ ﺎﺍ ﭙﻴ
ګﻱﻪﻫ
١ﻭړ ﭘ ٣٤٠٠
ﺗ٠٨څﻪﺮ ٠ﺧ ٠٠
ﻫﮐﻝﺩ٠ ﺎکې ﺮﺎ ﮑﻳﺮﻣﺍﻪﭘ
ﻟړ
ټﻪﻮﻨﺲ ﭘ ﺩېﺑ ﺮ،ﻮﭘ
ږﻱﻧﺍﺡکږ ﺮﺍکېﺍﻃ ﺮﻔﻪﺻ ﻭﭘﻮﻱﺍ ﻪﮐ ﻧ
ﺩ ﺩ
ﺎﺕ ﻳﺭکېﺯ ﻪځﻱګ ﻭﺱﭘ ﺮ
ﻳﺍﺍﻭﺩ
ېﻭ
ﺭځېﻣﺨﮏ ﺍ ٢ﻭ ١-
١ﺎﻥ٤ﺘﻧﮐﻻﻯﺷﻲﺍ ﺯې ﻮ ﺎﻴﺘ
.ډکېﻣ ﺮﻱﻟ ﻮﻥﺘ ﻭکېﺷ ﺯ
ﺎﻴﺘډﻮﻣ ﻪﮐ ﻩﭘ ﺮﻠﻈﺖﺳ ﻏ
ﻮﻧﺎ
ﻣﻮﺎﺷﻮﻣ ﻟ
ﺩﺩ ږ
ږﻮﺯ ﻳ
ﻮ .ﻪﻧ
ﻭﻱﭘ ﺩږږﻪﻭﻝ ﺎﻝﺗﻳﺮﻴﭘ
ﺎڅﻪﭼﻧﺩﻭ ﺧ
ﺭګﺪﺩ ﻱﻪڅړﻟ ﻪﺩژﻱ ﺘﻭﺳ ﺭﺭځېﻭ ٨ﻭ
ﻮکېډک ﻧ
ﺎﻣﻮﺎﺷﻮﻣ ﻟ
ﺩ ﺩږ
ږﻮﺯ ﻳﻮﻪﻧﭘﺗ٦ﺁﻥﺮ ﻩﺭﺎﭙﻟﺎﺕﻭﺧﺖ ﻳﻪﺩﺯ ﻠﺗﺮﻪﭘټﻮﭘﻧ
ﺯېﺩﻍﺍ ﺎﻴﺘکېډکېﻣ
ﻭ.
ﺘﻦې ﻱ ﻨﺭېﻣ ﻮﻮﭘ ﺘﺎﺷﻴﺗ٦ﻣﺁﻥﺮ ﻩﺭﺎ
ﭙﻟﺎﺕﻭﺧﺖ ﻳﻪﺩﺯ ﻠ
ﺗﺮﻪﭘ ټﻮﭘﻧﺯېﺩﻍﺍ ﺎ
ﻴﺘېﻣ
ﺪېﻧﺎ
ﻩﺳ ﺮﺗ
ﺎﻳ
ﺯﻩ) ﺧړ
ﺍﻪچې ﻮ ﻠﻌﻦېﮐ ږﻱﻳ
ﺩږ ږږFﻪﻻﺭېﻝ ecalorﻟ ډﻝﺩal ﺰﻭ ﻳ
ﺩﻭﻪﺩ ﻭﻏﻲﭘ ﺭﺎ
ﻧ
ﻪﺍﺳﻄﻪﻭ ﻭﭘﺯﺎﻴﺘډﻮﻣﻮﮐ ﻨ
ﺘﻨﻣﻪﺩ ﺑﻭ(ﻭﺍShelﺍ lf
iﻮﺥsh ﻴﻢﭘ ،ﻧﻮﺱ ﻧﺞﺟ ﺭﺎﺎ،ﻧ
ﻮﻟ ،ﮐﭽ ﻩﻮښ ،ﻏ ﻳﭻﻭ
ﺷ.
ړې ﻲ ﮐﮏ
ﻪﻭک ﻨﻳ
ﺭﺎ
Biﻧ ﺍsexualﭘHomosexualﻭ ،چېﻪ ﻩ
ﻩﺩﺭﻪﻻ ﻠﺩﻥېﺑﺩﺩ ږږOrﺩﻝ alanal ﻩ
ﺭﻥګ ﺍﺪﻤﻫ
ﺩ.
ﺎﺕ ﻱ ﻳېﺯ
ﺎﺕې ﻳ
ﻮکېﺯ ﻧﻮﻳﺍﻮځ ﻐﻪﻫ ﻭﻍۍﭘﻲښېﭘ ﺭﺎ
ﻧ،ﺩﺩږﻱ
ﻟږﻱﺎﻥ ﻲﺘ ﻧ
ﻩﺍﺮ ﺭﺕﺳ ﺪ ﻪﻧﻪﭘ ﺍﺳﻄ ېﻪﻭﻳﻦ ﭘ ﺩﻭ
ﻪﻧ
ﺮﻠﻣﺎﻩﭘﻪښ ﻮﺗﻳﻄﺍﺮﺎﺷ ﻴ
ﺘﻭﻏ ،ﺭږﻱ
ﭘځﻯکږ ځﻯﺮﺍ ﻩﻪ ﺍﻮګﻧ ﻪﺗ ﻤېﻪﺳﺯﭘ ﺎ
ﻴﺘﻧﻲډکېﻣ ﺎﻧﺴﺍﺩﻱچې
ﻭ.
ﻪﻱ ﺗ
ﺎﻳﻩﺯ ﻭڼګﻩګګﻭ ڼ ﻭړ ﻭﺩﺍ ﻪﺷﻲ ﻧﻭ
ﺎﺕﻳﻴﻞکېﺯ ﻪﭘ ﻣﻲﭘ ژﻭﺩﺍﻨﻲ ﻪﻣ ډﻝﭘګﻱ ﻭځﻥ ړېﻪ ﺍ
ﻮک ﭘ ﻤ ﻴﻮﺳ ﻣﺭېﻪګﻩﭘﻲښېﻱ ﭘ ﺭﻥګ ﺍﺪﻤﻫ
ﻭ.
ېﻱ
:ﻭﻥې ﺪ ﻧ
ﺭګ ﻴﮏېڅ ﻨﻴ
ﻠﮐ
ﻭکې %٧ﭘﻲښ ﭘ٠
ﺎﻥ ﻪ ﻣﻮ
ﺎﺷ ۍڅﻪﮐﻢﻣﻠﻦ ﺧ ږﮐ ،ﺩﺷﭗﻩﺭځېﺩ ٤ﻭ ﺗ٥١څﻪﺮ
ﻩﻱې ٥ﺧ ﺭﻭﻳﺢﺩ ﺮﻔ
ﺗﺩ
.
ﺮﻱ ﻟﻪﺍ ﺽﻧ ﺮ
ﺍﻋ
ﻪﺒ
ﻪﺗ ﺭﺟﻪﺩﻤﻭﮐ ﺩﺍ ﺭ
ﺎﻥﺩ ،ﺧﻳﻲ ﺎﻬﺘ
،ﺏېﺍﺷ ﻟﻰﺍﻭ
ﺪﻩﺑړﻪﺯﮑﻟګﻞېړې ﻳ ځﻥګﺎﺍ ﻪ ﭖﻝﻝکېﻧ ﻭﻍﭘ ﺭﺎ
ﻧ
32
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﻪﺯﻏﻢ ﻭﻧﺎﺱﺍ ﺮکېﺍﺣﺴ ﮐړﺪېﺩﻧﻭﺮﻭﺍ ﺭټ ﭘﻭﻭ ﺱګﺧړ ﺍﻭ ﻮ ړﻮﺎﻥﺩﻏﻭﻏ ﺭﺎﺭﻧﺷﺭ
ﻮ ﻢ ،ﻳ ﻭﻱﺪ ﻧ
ﺭګڅ
ﻩﺭﺍ
ﺪﻣﺍﻭﻭﺩڅﻪچېﮐﻢﺍ ﺩ ﺧ ﺭﺮﺥېﺩ ﺗﻦۍﺑ ﺭ
ﻮ ﭘ
ﻱېﺩRﻭﺩګ ډ .ﺍ U.ﺎﻥQ ﻭﻏ ﺭ
ﺎﻩﻧﺭﻥګ ﺍﺪﻤ،ﻫﻮﻱ ﮐﺍ
ﺪﻴﭘ
.
ﺮﻱ ﻟګﻪ
ﻠ
ﻭﻱ ﻳ
.ﻭ
ږﻱﺍ ﻤﻲګﻞېﮐﻩﻳ ﺮﻭﺳ ﺪ ﻳ
ﺪﻧﺭګ ړﻱﺩڅ ژﻱ
ږﻱچېﺩ ﺪﻱ ﻧ
ﺭګړﻱڅ ﻪژﻱ ﺘﻭﺳ ﺭ
ﻭﻥۍﻭ ﻩﺍ ﻭﺮﺩ ﻩﺗﻮﻳ
ﻭ.
(ﻱ Palﻴﻦﺑﺨﻦې)e ﭙﺯېﺳ ﺎ
ﻴﺘﻭډکېﻣ ﺍﻩ
ﺭﺎﻴﺯېﺗ ﺎ
ﻴﺘ
ﻮﻱﺗﺶېﻣ ﺎﺱﮐ ﺍﺣﺴ ﺎﻴﺘﻭﻏﺭﻭﻍﺩ ﺭﺎ
ﻧ
.ږﻱ
ﻭکېﺟﺲکږ %٧ﭘﻲښ ﭘ٠
ﻭﻪ ﺍ ﮑﻰﻭﻱ ﻧﻭﺮ
ﻟﺩﺭﻪﺩ ﻠ
ﻪﮐ ﻠ
ټﻭﮐﺭﻍ ﺍ ﻪکېځﻱګ ﻨﺘﻳﮏېﮐ ﺰﻪﻓﭘ
ﻭ.
ﻩﻱ ﺩ
ﻮ ﻮﺟ ﻟﻲﻣﺍ
ﻮﻣﻲګ ﻨﻴﻠ
ﭙﻭکېﺳ %١ﭘﻲښ ٥-ﭘ٥
ﻪ
ﻭﮑﻞﺍ ﻳﻭﺮ
ګﻱډﻝ ﺳ
ځﻥ ړ ﻭ ﻪ ﺍ ﻮﭘ ﺪﻻﻯ ﺷ ﻧﻮﻟﻰ ﻣﺍﻭﻪ ﻍټ ﮐﺎﻧ
ﺩﺭﻭﺩ ﻮټ ﻭﻱ ﻏ ﺎﻔﻤﻪﺩﻟ ﻠ
ﻪﮐ ﻠﮐ
.ﻮکې ﻧﻮﻳﺍ
Epiځ tr
ochl ear
(١
٤-٢ﻠﻲ)ﻳﺎ
ﺑﺯﻥﻭ ﻮﻭﻟڅﺭکﻝﻮﺍﻯﺷﻲ ﻟ ﺩﺩﻭﻍک ﺭﺎ
،ﻧږﻱ
ﺪﻝکږ ﻴ
ﻟ ﻪکې ﻨSﻪﺗ piﭘdernav ﻪi ﻠ
ﻪﮐﻠﮐ
.ﺪﻯﻳﻮځﻯﺷﻪﺍ ځﻯﭘېﻭﻥښې ﺍ ګﻞ ﺍﻭﻍ ﻳ ﺭﺎ
ټﻱټﺱAﻧ ﺎﺍﭙﻴﻭﻝکېﺩﻫ ﺪ
ﺟ
ﻯﻪ
ﺯړ ﭘ
ﺍﻯﺷﻲچې ﻱ ﺩﺩ،کﻮﻱ ﻪﮐ ﺘټﻥﺍﺧﻩﻍﺍ ﺮﺗ
ﺎﻳ
ډﻝﺩﻯچېﺯ :ﺑﻞ ﻭ Chol estani cHepat it
is
ﺘﻲﻧlﻭﺍ
ﻡ gMﺍ ﻭ ﺮ
ﻴځﻯﻭﻱﺳ ﻮﺍﻩﻳ ﺮﺭښﺕﺳ ﺎﺪﺧ ﻳ
ﺪﻱﻭﺩﺷ ﻭړ ﺍ
ﻡ ک ﺍﻭﺭځېﺩ ١ﻭ١
ﺗ٠٤څﻪﺮکې ٢ﺧ
ﺩ.
ﻩﻯ ﺭﻱې ښ ﺍ
ﺰﻧ
ﺍﺒﺖﻭﻱ ﺜHAVﻣ
ﺭځﺭګ،ﺍﺭځﻱﺭګﻩﺍ ﺭﺎ
ﺑﻭﻭﻍۍﺩ ﺭﺎﻪﻧﺘﻭﺳ ﺭﺭځېﻭ ٩ﻭﺗ٠
٣څﻪﺮﻪ ٠ﺧ ﻠ
ﻪﮐﻠ:ﮐ RelapsingHepat it
is
ﻡﺍ
ﻭﺎﺷﺖېﺩ ﻴﻭﻣ ﺍﻯﺷﻲڅ ﺩﺩﺎﻥﺩﻯ ک ﻪﺷﻭﻍۍﭘ ﺭﺎﻠﻲﻧ ﻩﺩﺍﺻ ﺮﻪﻧﻈﺭﻟ ﺍﻮﺗ
ﺍﺮﺑ
ﻭﻻ ﻴﮏﺍ ﻨ
ﻴﻠﮐﻪﺩ ﻧ
ﺪﻳ
.
ﻩځﻱ ﻪﻣﻦځ ﻟ ﻻﻦ
ﻭړﻱ ﮐک
ﻮﻩﻳﺮCrﺳ yoglobul i
nemi ﻭa ﺘﺲﺍ ﻳﻮﻻﮑﺍﺳ،ﻭﺘﺲ ﻳﺍ
ﺮﺗﺭﺍ
ﻪﺩﻧﺩﺭﺩ
ﺭګځ ﻩﺍ ﺭﺎﺑ
ﻭﻩﺩﺮډﻝﺳ ﺭﻭ ﺩ
ﺎﻪﻧﭘ
ﻭ.
ځﻯ ﻱ ﺍ
ﻩښ ﺮﺗ
ﺎﻳ
Vasculچېﺯ i
tﺘﮏېs ﻮﺳ ﻳﺍﻯﺷﻲچېﺩ ﺩ
ﺩﺭېﺩﻱک ﺩﺎ
ﻭېﻧ ﺎ
ﻴﺗﺪ ﻧ
ﺭګ ﺮڅﻬﺭڅﻪﺑ
ﺩځﻱګ ﺧ
،
ﺎﻴﺗ
ﺭﺎﺩﻯﮐﺍﺮ
،ﺑﺘﺲ ﻳﺎﺗ
ﺍﺮﮑﻧ
ﺎ،ﭘﻪﻳ
ﺎﻔﻡﮐ ﺪﻭﻋ ﺭګﻮﺗ،ﺩﭖښ ﻮﻱ ﻪﮐﻨ
ﻣﺰﻴﻪﺍﻏﺮﺧ ﻭﺑﺎټ ﻧ
ﻮﮐﻭﺩ ﻳﺖﺍ ﺎﻬﻨﻰﻧﺘﮐ
ﻭ.
ﻎښﺕې ﻱ ﻧ
ﺍﻪکېﺭ ﺍﺕﭘ ﺮﻴ
ﻐﺩﺗ ﻮﻮﺟ PﻭQTﻣ ﺍﻑکېﺩ Rﺍ ﺭﻗﻲګ ﺮﻩﻪﺑړﭘ ﺯﻭﺩﺍ ﺘﺲ ﻳ
ﺎﻳ
ﺩ ﺭﺎ
ﮐﻮﻴﻣ
Guill
ianBar reSy ndrome ، ﺎﻴﻤﻴﻧﻴﮏﺍﺘﺍﻼﺳ،ﭘ ﺘﻼﺝﻮ کېﺍﺧ ﻧﺍﺭﻭډﻝﺩېﺭﻥځ ﺭﻭ ﺩﺎﻪﻧﭘ
ﺩ.
ﻮﻯ ﻯ ﻮﻝﺷ ﮐﺭ
ﺭﻭ ﻮﭘﺍ
Trﻫﻢﺭ ansv ersmy elit
is
ﻪﺗ
ړﻪﻣﻦځ ﻨ
ﻭﻡﻳ ﺎﺍﻣ
ﻮﺭﮐ ،ﺩځﻱګ ټﻱټﺱ ﻴﭗﺍ Fulﻫ mi ډﻝnantﺭﺕ ﻭ ﺪﻪﻧ ﻮ کېﭘ ﻧﺎﻭﻏﺭﺎ
ﻪﺩېﻧ ﭘ
.ﺭځﻱﺍ
33
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﻩ
ﺮﻨﻈ
ﻔﻲﻣ
ﻭﻭﺻ
ﺯﺎﻴ
ﺘﻮﻣ
ﻭﺗﺸ
ﺭﺎﻴ
ﻱﻭﺗ
ړﺍ
ﻭﻍکېﺩژﻱ
ﺭﺎﺘﺲAﻧ
ﻳﺎ
ﺗﺎ
ﭙﻴ
ﻮﻫﻪﻳ
ﮑﻞﭘ
٢ﺷ٧
-٢
34
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
.
ﻪﻨﻠ
ﻭﺳ ﻭﻥښ ﺍ
ګﻮ
ﻠﻭﻍﺩ ﻳ ﺭﺎ
ﻧټﻱټﺱAﺩ ﺎﺍ ﭙﻴ(ﺩﻫ ١٤-٢ﻭﻝ)ﺪ ﺟ
ﻥښې ګﻞېﻳ
%٧٨--
--
--١ﻟﻰ ٤ ﺍﻭﺭﻍټ ﺩځﻱګ %٨ ٥--
--
--
٧١ ﻳﻲﺎﻬﺘﺍﺷﺏې
%٤ ٦-
---
--
٣ ﻴﺖ ٦ ﺎﺳﺭﺣﺴ ﺩځﻱګ %٧ ٩-
--
--
-٦ﻭ٧ ﻟﻰ ﺍ ﺍﻭﺪﻩ ﺑ ړﺯ
ﺎﻥګې ﮐ
%١٣--
--
---
٣ ﻟﻰﺍ
ﻭﺭﻱﻍټ ﻮ ﺗ
ﺩ %٨ ٠-
--
--
-٧٦ ﺎﻴﺘﺳﺴ
%٨ ٠
--
--
--٤٠ ړﻯ ژﻱ %٥ ٨---
--
--
١٨ ﻪ ﺒ
ﺗ
%١ ﻮ٧ ﺗﺎ
ﮐﺮﻩﺩ ﺣ ړﺩﺯ %٧ ٣---
--
--
١٩ ږﻮﺮﺧﺳ
ﻟﻰ ﺍ
ﻮﻤﮐ
ﻭ ﻍ %٤ ﻮټ ﻭﻱ ﻏ ﺎﻔﻤﻟ
ﺩ %٩ ٤--
--
--
-٦٨ ﻡ ﻮ
ﻳېﺧ ﺩګﺪ
ﻟﻰ ﺍ
ﻭټ
%١ ﻪ ٤ ﻧﻮﭘﺎﺘﮏېﺧ ﻮﺳ ﭘﺩ %٥ ٨-
--
---
--
٥ﺯې ٢ ﺎﻴﺘﻩﺗﺶېﻣ ﺭﺎ
ﻴﺗ
%٥ ٨--
---
--
٥ﻴﻦ ﺑﺨﻦ ډکې ٢ ﭙﺳ
ﺯېﺎﻴﺘﻣ
%١ ٩--
--
--
-٨ ﺩﺭﻮﺩ ﻧ
ﻭﺪ ﻨ
ﺑﺩ
:
ﭘﻞټﻥې
ﻭک ﺯ
ﺎﻴﺘﻮﻣﻪﺗﺸ ﺎﻫﻢﭘﻴﻮﺑﻭ؛ﺧﻣﻞ ﻱ ﺭﺎﻴﻦﻧﺑﻭﺮﻠ
ﻴﻡﺑﻭﺮﻴ
Prکېﺩﺳ odromal st ۍﻪageﻭﻍ ﭘ ﺭﺎ
ﻧﺩ
.
ﺮﻱ ﻟﻮﻥﺘﻟﻰﺷﺍﻮﺗ
ﺎﻳUrﺯobili
ﻭnogen ﺍﺎﻳﺭﻮﻴﻦﻳﺑﻭﺮﻠﻴ
ېﺑ
ﻭ.
ﻩﻱ ﻟړ
ﻪﻮ ﺗﺎ
ﻳﻩﺯﺭﺭﻪډ ﻠ
ﻪﮐ ﻠ
ﻩﻭﮐﻱڅﻪﻣﺨﮏېﺟﻲګﺍ ﺯړ ﺧ ﻪﻱ ﻟ ﻪAﻭALTﮐﭽ ﺩ STﺍ
ﻩﻭﺮﺩﻮﺗﻱڅﻪﻳ
ﺯړ ﺧ Aﻪ ﻱﻡ STﻟ ﻭﺮﻴ
.ﺩﺳ ﻭﻱ ﺪﻧ
ﺭګﻪڅ ﺯړﻱﮐﭽﻴﻦﺩ ﻱ ﺑﻭﺮﻠ
ﻴﻭکېﺑ ﺍړﻱﻪ ﭖ
ﺯړ ﭘﺩﻱ
٣ﻪﺭﺳﻲ٠ﺗ٠IU/AﺮLﻡ LTﺗ ﻭﺮﻴ٥ﻭﺩﺳ ٠ﺍ ٠
IU/ ،چېLAST ږﻱ ېﻪﺭﺳﻲ
ړېﮐﭻ ﺗ ﻮﻟﻪﺘﻭﺳ ﺭﺭځېﻭ ﻭ
.ږﻱ
ﺮﻪﺗﻠ
ﻪﮐ ﻠ
ﺘﻰﮐ ېﻭﺣﺭﺍ ﻮﻮﭘﻴﻧﻭﻭﺍ ﺍﻯﺷﻲڅ ﺩ ﺩ
ﻪک ﻳﻮﺰﺳﻳﺮﻴﻔﻧﺴﺍﺮ
ﺗﻮﻨ
ﻴﻣﺍﺭکﺷﻲﺩ ﺯړﻯﻭﻪچې ﻱ ﻠ
ﮐ
ﺷ.
ﺎﺕې ﻲ ﻩﭘ ﻟړ
ﺭېﻮ ﻮﻮﭘ ﺘﺎﺷﻴ
٦ﻣ
ﺪﻝﻴﻟ
ﺮېﻭ ﺮﺣﺠ ﻴﻠﮐﻮﻧ
ﻮﻧﻮAtﻣ ypiﺍﻯﺷﻲcal ﺩﺩﻭ،کﻩ ﻱﺩﻮﻮﺟ ﺎﻣﻴﻨ
ﻴﭘ
ﻮ ﮐﻮﻪ کېﻟ ﻨ
ﻳ ﺎ
ﻌﻪﻣ ﻳﻦېﭘ ﻭﺩ
ﺷ.
ﻲ
Prot
hr omiﻮکې n ﻧﻮﺘﻟ
ﺎ
ﻭﺣ ﺪﻳﺪﻪﺷ ﻭﭘ ﺒﺖﺍ ﺜ
'Coombsﻣ Posit
iveHemol yticanemi a
ﻭ.
ﻟړ ﻱﻳﻦېESRﻮ ﻭﻮﻥﻭﻱﺩ ﺘﻟﻲﺷ ﺍ
ﺍږﻭ
tﻭﺩ ime
ۍﻪ
ﻭﻍ ﭘ ﺭﺎ
ﻧ،چېﺩ ﻮﻱﻻﺖﮐ ﻟﺖﺩﻟ ﺎ
ﺑړﻲﺣۍﻪ ﻲﻧ ﻭﻍ ﭘﺭﺎﻧ
ﻟﻰﺩ ﺍ
ﻮ ﺘ
ډﻱﺷ ﺎﺘﻲﺑ ﻧIﺍﻪکېﺩ gM ﻨﻳ
ﻪﻭ ﭘ
ﻮﻡﮐﺍ
ﻭ ﺎﺕﺩﻳﻮﻫﻢﺯ ﻧﻮﻠ
ﻭﮐ ﻭﺮﺩﻪﺗ ﻠ
ﻪﮐ ﻠ
،ﮐﻮﻱ ﻡﮐﺍﻭﺭېﺩﻮﻮﭘﺘﺎﺷﻴﺗ٦ﻣﺩېڅﻪﺮ
،ﺭ ﺧ ږﻱږړېﻮ
ﻴﻞک ﻟ ﭘ
ﺷ.
ﻻﻯ ﻲ
ﻭﺍﺮﻱﻟﺯښﺕ ﺭ
ﺍﻪ ﻴ
ﻴﺼږﺗﺸﺨ ،ځﻪﻝږﻱ ﮐﺎﺕېکږ ﺭېﭘﻮﻮﭘﻧﻮﻠﺮﮐډﻝﺗ
ﻩﻭ ﺭﺍ
ﺪﻣ ﺍ
ﻭ ﻱﻪﺩډﭘ ﺎ
ﺘﻲﺑ ﻧﺍI
gG
ﻩﻮڅﻪﻳ
ﻴﻞ ﺧ ﻪﭘګﻮﻟﻠ
ﺮﻱﺩ ﻳ ﻮﻥﻟ ﺘۍڅﻪﺷ
ﻠﻦ ﺧ ٥ﮐﻟ٠ﻪﻪﺘﻭﺳ ﺭډﻝﻭﺰﻭ ﻳ
ﺩ ﻭﻪﺩ ﺩﻱﭘ ﺎﺘﻲﺑ ﻧ
IﺍﻫﻢgG
.ږﻱ
ﺍکږ ﺪﻴﻭﻥۍﻣﺨﮏېﭘ ﺍﻩﻭﺮﺩﺗ
:ﻴﺺ ﺮﻱﺗﺸﺨ ﻴ
ﭘﻮﺗ
ﻪﻟﻮﻠ
ﻣﺭﻭﺩﺩ ﻮﺍﻧ
ﻮ ﻟ
ﻭﻭډﺭﻮټﺱﻪﻧ
ټﻱ ﻟ ﻴﭗﺍ ﺮﺳﻲﻫ ﻳ
ﺍګﻱﺩﻭځﻥ ړﻪﺍ ﻩﭘﺮ ﻮﺳ ﻧﻮﻠﻣﻭﻻ ﺭﻮﻱﻪﻧ
ړﻟ ﺯﻱﺩ
ﻧې
ﻩچېﻻﺪ ﺮﻮﺳ ﻴ
ﻭﻏﺭﺎﻭﻧﺭﻮﺭېﻧ ﺷﺭ
ﻮ ﻢ ﻩﻪﻳﺭﻥګﻟ ﺍﺪﻤ
.ﻫږﻱﻩ کږ ﺮﺮﺳ ﻩﺗﺮټﻱټﺱﺳ ﻴﭗﺍ ﻪﻫ ﻠ
ﺒﮐ
ﺷ.
ﺮ ﻲ ﻴ
ﭘﻮﺪﺗ ﻳﺎ
ﻮﻱﺑ ﺮﺷ ﮐﺫ
ﺳ:
ﻩﻮﺮ ﻴﻭﻏﺭ ﺎ
ﻧﻲﻧ ﺎ
ﺘﻧﺍﺭﻮﻪﻧﻟ-
١
35
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
36
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
.
ﻮﻱ ﺮﮐﻔﻪﺳ ﻮﺗﻧ
ﻮ ﻳ
ﺍﻴﮏځ ﻤﻳﺪﻧ
ﺍﻳﻦچېﺩHAV ﺮﻓﺎ
ﻪﻣﺴ ﻐﻫ .
3
،چېﻮﻱﺪﮐﻧﻭ
ﻪکېژ ﻨ
ﻟﻭ
ﺍﺱېټ ﻭﺩڅﻪﮐﻢﻭﻱﺍ ﻮ ﺧ ﻧ
ﻮﻠ
ﺮﻱېﺩ٢ﮐ ﻤﺎﻥچېﻋ ﻣﻮﺎﺷﻪﻣﻐﻫ .
4
ﻭ.
ﺭې ﻱ ﺭ
ﻪﺩHAVﭘﻲښېډ ﺘﻠ
ﻫ
.ﻧﮏېﻮ ﺘ
ﻴﺴ ﺍﺧﻣﻞﺭﻗﻲﺩﺭ .ﺯ 5
ﺩ.
ﻣﺦ ﻱﺎﻩﻣﺨﺮﺮﺳﺎﻥﺩﺧﻄ ﺘﻧﺍ
BloodBor ﻪﺩn ﺎﻇ
ﻟﺤ ېﻪ
ﺪﻟ ﻧ
ﻠﮏچېﺩﺩ ﻪﺧ ﻐﻫ .
6
.ﺎﻥﻭﻏﺭﺎ
ﺎﻧﻴ
ﻠﻴﻓﻮﻤ
ﻴ .ﺩﻫ 7
.
ﺮﻱﻟﻳﮏېړﺍ ﻩ
ﺮﻮﺳ ﻧﺎ
ﻭﻏﺭﺎېﻪﻧ
ﻧﮏېچ ﻟ ﻭ ﻮ
ﮐ ﺭ
ﺎﻪﮐ ﻐ
ﻱﻭﻫړﺍ ﺭﻍﻮﮐ .ﺩ 8
(el
i
sa ۱۴۴۰
)1mlhav ri
ﻪx ﮑﻴﻦﻟﮐﺴﺍﻮﯼﻭ ﻮﯼﻧ ﻩﻣﺦ ﺷ ﺮﺮﺱ ﺳ ﻳﺍ
ﻪﻭ ﻪﭼ ﻮﺗﻧﺎ
ﻭﻏﺭﺎ
ﻪﻧﻐﻫ
ﻪﻤﺗ
ﻭﺍﻡﺍږﺭډﺯ ﺷﭗ
ﻮﺱټ ﻭ ﻪﺑ ﺘ
ﻭﺳ ﺭﯼﺩﻻﯼﻭ
ﺭ ﻮښ vﺩﻏ aqta1ml (50uni tﻳ)suniﺎt
s
ﻪﺩﺩﯼﮐﻮﻮﺟﻪﻣﺘ
ﻟﺎ
ﻩﺣ ﻭﻮﯼﻭﯼﺩ ﻩﻣﺦﺷ ﺮﺮﺱﺳ ﺩﺍﻳ
ﻭﻍ ﻭ ﺭﺎ
ﻪﻧﮐږﯼﮐﻮﻝ ﻲ ﮐﺭ
ﻪﻭ ﻭﻍﺗﺭﺎ
ﺎﺷﺖﻧ ﻴ
ﻣ
ﺎ
ﻭﻳﺍﺏﻭﯼﺍﺮﺘﻢﺧﻴﺴﺘﯽﺳ ﻴﺎﻓﻌ
ﺎﻣﻭﻳ ﺎﺕﻭﯼﺍ ﻳڅﻪﺯﮐﻮ ﺧ
ﻟ۴ﺎ ﺩ۰ ﺎ
ﻭﻳ څﻪﮐﻢﺍﮐﻝ ﺧﺩﻮﺎﺮﻳﯽ ﻳﻤﻋ
۴ﺍ۰
ﺩﻮﻭ
ﺮﻳﯽ ﻳ ﻤ
ﻪﻋ (ﻭﮐ
0.ﺍ02ml/ ﻭ)kgﻮﮐﺭﻴﻦﻭ ﻟ
ﻮﺑﻮﻟ
ﻮګ ﻨ
ﻴﻣﻮﺍ ﺮﯼﻧﻟﻭﻏﯽﻭ ﺭ
ﺎﺭﻧﻣﻦﺩڅﻱګ ﺰ
ﻣ
.ﮐږﯼ
ﻮﻝ ﻲ ﮐﺭﻪﻭﺗﺭﻴﻦﻭ ﮐﺴﺍ
ﻭﻮﺮﻣﻦځﻭﯼﻧ ﮐﻮﺗ
ﻟ
ﺎ
ټﻱټﺱﺑﻲ
ﻴﭗﺍ
ﻫ
37
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﺷ.
ﺪﻱ ﻲ ﻧ
ګ
ﺭډHBV- ﻭDNA. ﺯﻱ ﻱ ﺍ
ﻮﻩﻣ ﺮﻮﻥﺳ ﺘHﻪﺷﻡکېﺩ BeAgﻟ ﻭ ﺮﻴ
ﻪﺳ ﻟﻰﭘ ﺍﻮ ﺘﺩېﺷ HBV-ﺩ DNA- ٥
ﺯېﺩ ﺍﻮHBV-ﻳ ﻩﺩDNA ﺯﺍﺪﻧ
ﻪﺍﻤﻩﮐﺭﺭړﺎ ښﻱډ ﻴﻭﮐﮏﺗ ﻮﺍ ﻟﺪﻴﺗﺎﻳﺮﺱﺯ ﻳﺍﺩ،چېﺩﻭ ﺎﺱ ﻯ ﺭﺣﺴ
؛ک ﺮﻱﻟټﻱټﺱﺑﻲﻭ ﻴﭗﺍ ډﻰﻫﺎﻥچېځﻥﻧ ﻭﻏﺭﺎﻪﻧﻐ،ﻫږﻱﻡږ ﻮ ﻠ
ﻌﻡکېﻣ ﻭﺮ ﻴﻪﺳ ﻪﭘﺍﺳﻄ Pﻪﻭ CRﭘ
ﺷ.
ﺎﺕې ﻲ ﻪﭘ ﻩﮐﭽ ﻟړ
ېﻪﻮ ﻡک ﭘ ﻭ ﺮ
ﻴﻪﺳ ﺍﻯﺷﻲﭘ ﺩﺩ
:
ﻮﺟﻲ ﻟ
ﻮﻤﻳﺪﻴﭘ
ﺍ
ېﺍ
،چ ﺩ ږﻱ
ﺩږ ږږ
ﻪﻝ ﻡﺗ ﻮ
ﺎﺷ څﻪﻣ
ﺭﺧ ﻮﻣﻭﻫﻢﺩ ﻟﻲﺍﺍﻮﻳﺩ
ژﻨﺴﻲﻥ ،ﺟ ﻮﺗﻮﻻﻣﺤﺼ ﻳﻦېﺩ ﻭﻏﻲﺩ ﻭﺭﺎ
ﺍﻧﺩ
(Cﻪﻭﺧﺖکې hiﭘldBirtﻪﺩh ﻡﺗﻮﺎﺷ څﻪﻣ
ﺭ ﺧ ﻮېﻪﻣ
ﻌﻦ ﻟ ﻳډﻝ) Verﻭ ti
ﭘcal ﻩﻪ ﺮﺗ
ﺎﻳﺘﻰﺯ ﻭﺳﺭﻭ
ﻮﻠﻣﺭﻩﺩﻧړ
ﻭﺭېﺎ ﺩګﻪﻻ
ﻪ کې ﺭ ﻟ ﻧ
ﺩﺩﺩږږ
ﻪﻝ ﻩﭘ ﺭﻥګ ﺍﺪﻤ
.ﻫ ﻩ ﻩﺩ ږﻩﻝ ﺭﺭﻪﻱېډ ﻧﺩﺩﺩږ
ږﻤﻲﻝ ﻭ.ﺭﺣﻱ
ﺎ
ﭙﻴ.ﻫ ﺮﻱﻟﻭﻝ(ﺭ ﻭﻝﺭﺎ
ﺘﻦﭘﻞﮐ ﻨ
ﻣﺩﺧﻱﻞ)
ﻩ ﺮﻳ ﺮﻳ،ږAcupunct ure، (Tat toi،ﺧﻝﻭﻫﻞ)ng ﻪﺎ ﻧﻭﺭﺎ
ﮐ
ﻪﻠﻪﮐﻠﻭﮐﻭﺍ ﺪﻴﻴﻦېﺷ ،ﺩﺳ Colostr
ums، ﻨﻲ،ﻣ ﻊﻳ
ﺎﻠﻲﻣ ﺒﻬ،ﻣ ﻭړ،ﻻ،ﻳﻦ ﻪﻭ ﺮﺱﻟ ﻳ
ﺍټﻱټﺱﺑﻲﻭ ﺍ
.ﻮﺭړﻯﺷﻭﻪﻻﺱﺍ څﻪﭘ
ښﻮ ﺧ ﻭ ﮐ ﺍﻭ ﺍﻮﻟ
ﻮ ،ﺧ ﻭﺯﺎﻴﺘډﻮﻣ،ﮐ ﺍﺮ
ﻔ،ﺻ ﻭﺯﺎ
ﻴﺘﻮﻣ ﻪﺗﺸﻟ
ﻩﺭﻮﻮکېﻏ ﻧﻮﻳﺍﮑﻞځ ﻴﭘ
ﺍﺮﻪﺗډﻝﭘګﻱ ﻭ
ځﻥ ړﻪﺍ ﺎﺷﻲﭘ ﻴﻭﻣ ږېﺍ ﻪﺳﭗ ﮑﺍﺕﻟ ﺮ
ﻧﮏېﺣﺸ ﻭﻪڅښ ﻨ
ﻳﻭ
.
ﻮﻱ ﺪﻝﺷ ﻴﻟ
ېﻪﺩﻱ ﺭک ﻧ ﻮﺘﮐﻪﺩېﻭ ﻪﭘﻧﺩﺩﺎﺕﻳﺮﺱﺯ ﻳﺍ
ﻭﺷ،چېﺩ ﻳﻞ ﻲ ﻭﺪﻭ ﻳﺎ
ﺷ.ﺑﺍﻯ ﻲ ﺩﺩﺭک ﻮﺘﮐﻭ
ﻭ.
ﺎﺕې ﻱ ﻳﻮکېﺯ ﻧ
ﺍﺯﺎﻨﺲﺑ ﻤﺠ ېﻪﻫ
ﭘﻲښېﻱ ﭘ
ﻭﺍﻥﺍ ﺮﺘﮐﺍ
ﻮډ ﻧﻭﺎښ ،ﺩﻏ،ﻧﮏﻭﻮﮐﺭ
ﺎﻧﮏ ﮐ ﺎ
ﻳﻦېﺑ ﻭ،ﺩ ﺎﻥﺮﺳ ،ﻧ ،
ﻧﮏ ﻭ ﻮﮐﺭﺎ Hemodiﮐ alysiﺩs
ﺩ.
ﻣﺦ ﻱ ﺎ
ﺎﺕﻣﺨ ﻳﻩﺯ ﺮﺮﺳ ۍﻪﺧﻄ ﻭﻍ ﻟ ﺭﺎ
ﻧﺎﻥﺩ ﺘﻮﺟﺴﻟﺎ
ﺘﭘ
:
ﻪﻟ ﺭﺕﺩﻱ ﺎ
ﺒﻭړﻱﻋﻣﺦ ک ﺎﺎﺕﻣﺨ ﻳﻩﺯﺮټﻱټﺱﺑﻲﺳ ﻴﭗﺍ ﻮکېﺩﻫ ﻧﻭﺩ ﺍ
ﻮﻴﻮﻫﻠﻠﺘﻣﺨﺮﻪﭘﭘ
.ﻭﻱﺭﺎﻣﻞﮐ ﺭﺭېﺩ ﺩګﻪﻻ
ﻠﮏچېﺭ ﻟ ﻪﺧ ﻐ ﻫ .1
.ﻧﮏې ﻭﻮﺍﻃﺖﮐ ﻮ .ﻟ 2
.
ﻳﮏې ړﺍﻨﺴﻲ ﻩﺟ ﺮﺒﺖﮐﺲﺳ ﺜHBsﻣ .3
.
ﻮﻱ Renalﮐ dialysiﺎﻥچېs ﻭﻏﺭﺎ
ﻪﻧﻐ ﻫ .4
.ﻧﮏېﻭ ﻭړﻱﺥښ ﻭﻡ ﺍﺍﻥﺮ ﺘﮐﺍ
ﻮډ ﻧﻭ ﺎښ ،ﺩﻏﺎﻥﺍﺣﺮﺟ .5
.ﺎﻥﻣﻮﺎﺷﻟﻲﻣﺩﺩږﻮﻱﺯﻱ څﻪﻧﻭ ﺧ ﺪﻨ
ﻴﻭﻣ ﻭﻧﮏ ﻭﺮﻟﺘﻲﺟﻦ ﻧ
ﺍﺒﺖ ﺜ
ﻪﻣ .ﻟ 6
.ﻠﻲﺍﺧ ﻪ
ﻨﻳډﻝﻭ ﺭﻱ ﻭ ﺍ
ﺮﮑ ېﻪﺗ
ګﻱچ ﭘ ﻪﻭړ ﻐ ﻫ .7
:
ﻩﻴﮏېﺏڼ ﻨﻴﻠ
ﮐ
ﺩ.
ﮑﻞ ﻱ ﻴﻨ
ﻴﻠ
%٩ﭘﻲښېﻱېﺳﺐﮐ ٠.ېﻩ
ﺎﺷﺖ ﺩ ﻴ٦ﻣ -
ﻩ٣ ﺭﻭ ﻳﺦﺩ ﺮ ﻔ
ټﻱټﺱﺑﻲﺗ ﻴﭗﺍ ﺩﻫ
ﺩ.
ﻣﻦ ﻯ ﺰﻧ
ﻮﺘﺮﺳ ﻴ
ﭘﻮﻩﻱېﺗ ﺮﻮﺳ ﻟ
ﻭﻭډ ﺭﻮ ټﺱﻪﻧ
ټﻱ ﻟ ﻴﭗﺍ ﻩﺩﻫ ﺮﻪﻧﻈ ﻟﻴﮏﻨﻴﻠ
ﮐﺩ
.ږﻱ
ﻴﻞږ ډﻝﭘ ﻳﺠﻲ ﻭ ﺭﺪﻩﻪﺗ
ﻮګﭘ ﻩﺗﺰﻳﺩﻭﻪﺩﭘ
ﻭﺎﻥګېﺍ ،ﮐﻟﻰ ﺍ
ﻭﺪﻩﺑړ،ﺯﻳﻲﺎﻬﺘ
،ﺏېﺍﺷ ﺎ
ﻴﺘﻧ
ﺎﻣﻮﺘﻳ،ﺳ،
ﺎﻥګﻞ ﻪﺷ ﺍﭘﺰﻨﻳﺍﻮﻠﻔﻧﺍ
ﻭﻍﺩ ﺭﺎ
ړﻮکېﻧ ﻡﻳﻮﻟﻪﭘ
.ﻭﻱﺪ ﻧ
ﺭګ ﺩڅ ﺭﺮﺥېﺩ ﺗﻦۍﺑ ﺭﻮﺍﺩﭘ ﻮﻱېﺩ ښۍﺧ ﺩګډ
ﻡړﻪﻝ ﮑﻟﻨﮏﻴ ﻠ
ﺎﻥﮐ Sﻪﺷ
erﭘ um siﻭکېﺩckness %٢ﭘﻲښ ﺗ٠١ﺮ ﭘ٠
ﺍﻯﺷﻲ ﻪ ﺩ
ﺩﻩک ﺭﻥګ ﺍ
ﺪﻤﻫ
ﺭځې ١ﻭ٠-ﺎ٧ﻴﻭ،چېﺑﻮﻥ ﻱ ﺘ
ﺯړﻱﻣﺨﮏېﺷ ﺮﻱ ﺎﺏﺗﻬﺘﻟﻭﺍﺪ ﻨﺑ
ﻭﺩ ﺩﺍﺭﻮﺩ ﻧ
ﻭ ﺪﻨﺑﺗ،ﺩ
ﻪ،ﺒﺭښﺕ ﺎ،ﺧۍ
ﻳﮏې ﺰﻪﻓ .ﭘږﻱګﻞېﮐﻢږ ﻭﻍ ﻳ ﺭ
ﺎﻩﺩﻧ ﺮﻧﺩﻮ ﺳ
ﻟ
ﺭګﺪﺩ ﻪڅ ړﻱﭘ ژﻱ .ﺩ ږﻱﺪږ ﻧ
ﺭګ ړﻯڅ ﻪژﻱ ﺘﻭﺳﺭﻭ
ﻭ.
ﺩﻱ ﻮﻮﺟ ﻟﻰﻣ ﺍ
ﻭﺭﻍټ ﻯﻭﺩځﻱګ ﺯړ ﺍﻪکې ﻱ ﻨﻳﺎ
ﻌﻣ
.ږﻱ
ﺪږ ﻧﺭګﻮکېڅ ﻧﺎ
ﻣﻮﺎﺷﻣﺮﻤﻪټﻱټﻋ ۍڅﻪﭘ
ﻠﻦ ﺧ ﻮﮐ ﻪﻳ ﻟً
ﺍﺭﺩﺎټﻱټﺱﻧ ﻴﭗﺍ ﺮﺿﻲﻫ ﻋ
ﺭﻳﺩځﻱګ ﻭﺎ ﺍ
ﻪ HDV ﮑﺎﻥﻟ ﺘ
ﻧډﺍﻮ کېچېﺑﻞ ګ ﻧ
ﺎﻭﻏ ﺭ
ﺎﻮﻧ ﻐ ﻪﻫ ﺍﻯ ﺷﻲﭘ ﺩ ﺩۍګﻞې ک
ﺑړﻥ ﻳ ﻲ
ﻭ.
ﺪې ﻱ ﻳﺪﺮﻱﺷ ﻟﻭﻏﻲﻭ ﺭﺎﻴﮏﻧ ﻟ
ﻮﮑﻟ
ﺍ
ﻮ کې ﻧﺎ
ﻭﻏﺭﺎﻪﻧﻮﭘ ؛ﺧﻩځﻱ ېﻪﻣﻦځﻩک ﻟ ﺩﻮ ﻪﻣ ﻮﭘﺘﺎﺷﻴ٣ﻣ -ډﻝﺩ١ ﺰﻭ ﻳﺩ ﻭﻪﺩ ړﻯﭘېﻭژﻱ ګﻞ ﺍﻳ
38
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
.
ږﻱﺎﺕېکږ ﺭېﭘ ﻮﺩﻮﭘﻟ
ﻣﻞکﺩ ﺭ
ﺎﺮﻧﺰﺗﻳﺮﻔﻧﺴﺍﺮﺗﻮﻨﻴﻣﺍﺁﻥﺩ ﺎﻴﺘﻧ
ﺎﻣﻮﺘﻱﻭﺳ ﻩﻝټ ﺍ ﺭﺍﺪﻣﺍ
ﻭﺩ
ﺷ.ﻪ
ﻪ ﻲﭘ ﺗ
ﻣﻦځ ﺍﺍﻯﺷﻲﺭ ﺩﺩﻮکېک ﻧ
ﺎﻭﻏﺭﺎ
%٠ﻧ ،٥-٠
،ﭘ١
ﻮﻪ ﺩ،ﺧﺭﻯ ﺩﺎ
ټﻱټﺱﻧ ﻴﭗﺍ Fulﻫ mi nant
ﺎﻏﻲﻣ ېﻭﺩ
ﺎﺕ ﺍ ﭘﻮﻟ
ﺎﻔﻧﺴ،ﺍCoagul opat ﻪhy ﮑﺎﻱېﻥښېﻟ ﻔﻡﮐ ﺪﺭ ﺩﻋ ﺭﺕ کېﺩځﻱګ ﻮﺩې ﺻ
.ﺩﺭځﻱﻪﺍ ﺗﻪﻣﻦځ ﺘﻭﺳ ﺭ
ﺭځېﻭ ٢ﻭ ﺩﻭ٨ﻴﻞﺩ ﺮﭘ ګﻮﺗ
ﻠﺘﻼﻁﺩ ﻳ ﺍﺍﺧډﻝﺩﺰﻭ ﻳ
ﺩ ﻭ.ﻪﺩږﻱﭘﺪږ ﻧﺭګﺎڅ ﻤﻳﺯﺍ
ړﺮﻭ ﺮﺱﭘ ﻳﺍﻪ کېﺩﻭ ﻭﺳﺮﻪﺩېﭘ ﮑﻦﭘ ﻴﺩ،ﻟ
ﻪﻯ ﻡﻧﻮ ﻠ
ﻌﺰﺱﻣ ﻴﻨ
ﻮﺟ ﺘټﻱټﺱﭘ ﻴﭗﺍ Fulﻫ mi nant
.ﺮﻱﻟﻭﻝ ګﻥﺭﺮﻭ ﺒﻮﻥﻏ ﻤﻳﺍMassi vﺭﺩe ﺪېﺩځﻱګ ﻧ
ﺍ
ﺩ.
%٦ﻯ ﻮکې٠ ﻧﺎﻭﻏﺭ ﺎ
ﻪﻧ ﺘ
ﺍﺧ Fulmi ﭘnant ﺮﻪ ﺩړﻦېﺧﻄ ﻡﻳ
۹۰
ﻮ٪ ﮑﻠ
ﻠﯽﺧ ﭘﻴﺖځ ﻓ ﺎ
ﻌiﻭﻣnfﺍ ant s neonat ﺭe (ﻡګ Chroni chepat i
tiﺎﻥ)s ﻭﻏﺭﺎ%۲ﻧ -
۱
ږﯼ ﻟﻲﺪﻗﻞﺑﺎﻣﻦﻧ ﺰﻪﻣﭘ
،
ﻮﻱ ﻣﺨﺖګﮐ ﺮ
ﻪﭘ ﺗ
ﺍﻮﺎﻥﺧ ﺮﻃﻭﺳ ﺯﺱﺍ ﻭﺮﻴﺭﺳ ﺎﻥﺩځﻱګ ﻭﻏ ﺭﺎ
%٤ﻧ ٠-٢٠Chr onicHepat itiﺩsB
ﺩ.
ﺎﺕ ﻯ ﻳﻭکېﺯ ﻪﻭ ﻨﻳﺭﺎ
ﺮﭖﻧ ېﺍﺧﻄ چﺩ
ﺒﺖﺜﻪکېﻱېHBeAgﻣ ﻨﻳﻧﮏېچېﻭ ﻭﺩږږﻪﻝ ﻐ،ﻫﺮﻱ ﻟ ﺪېﻧﻣﻞﺩ ﺭﺎﺭﻧﻧﮏېﺩځﻱګ ﻭﺩږږﺎﺕﻝ ﻳ
ﺯ
،
ټﻱټﺱ ﻴﭗﺍ Chrﻫ onicPer sistﺎﺕﺩant ﻳ
ﻭﻯ کېﺯ ﻪﺩ ،ﭘﺮﻱﻟAntﻭ ﻪiHBe ﻩﮐﭽ ږﻪﻝ ﻭﭘﺍ
ﺷ.
ﻪﺮﺘ ﻮﺧﻄ ﻠ
ﺗﺍ
ﻪﺭ ﺗ
ﻣﻦځ ﺎﻥﺩ ﺮﻃ ﺭﺳ ﻭﺩځﻱګ ﺍﺯﺱ ﻭﺮﻴ
،ﺳ Chr onicact i
vehepat it
is
ﻔﻲﻭﻱ ﻨ
ﺘﻲHBeﻣ ﻧ
ﺍ ﻭﺍﺒﺖﻭﻱ ﺜﺘﻲﺟﻦﻱېﻣ ﻧ
ﺍﻳHBS ﻧﮏېﻭﻱﺎ ﻭ ﺩږږ
ﻪ ښځېچېﺩHBeﻝ ﻐﻫ
.ﺮﻱﻟړﺎ
ﻴ
ﻮﻭﺗ ﻟﻮﺘﻦﮐ ﻨﻣﻮﺩ ﻧ
ﺎﻣﻮﺎﺷﻮﻣ ﻠﭙﻭﺧﺖﺩﺧ ﺮﺯږﻥﭘ
ﺎﺕېﺩ ﻱﻭ ﻳﺍ ښځېﺯ ﺩ
ﻪﻧ
ﻮ ﻧ
ﺎﻳﺮﻨﻲﺷ ﻮﭼﻭﮐ ﻮﺳﻂﺍ ﺘPolچېﻣ yar thri
tiﻪs ﻟﺭﺕﺩﻱ ﺎﺒﻭېﻋ ﺎﻴﺗ
ﺪﻧﺭګ ﺮڅ ﻬ
ﺭڅﻪﺑ
ﺩځﻱګ ﺧ
،
Essent iﺘﺲal ﻳ
ﺍﺮﺗﺭ
،ﺍﺘﺲ ﻳﺍ
ﺩ ﺭﺎ
ﮐﻮ ﻳﺎ
،ﻣ ﺎﮑ
ﻴﺗﺎﻣﻭ،ﺭﺎﻟﺠﺎ
ﻴﻟﻲﻣ ﻮ،ﭘﺘﺲ ﻳﺍ
ﺮﻔﻮﻧ ﻟ
ﻭﺮﻴ ﻣ
ﻮﻟ،ګ ﻮﻱ ﻪﮐ ﺘ
ﺍﺧ
ﻮﻥﻴﻣ ﺍ
ټﻝﺩېﺍ ﻭGڅﻪ چ ﺩ uiﺧ l
li'ansBar i
eSy ndr ﻭ om Miﺍ xedCr y oglobulinemi a
.
ﺮﻱ ﻟﻭﺍ
ړﺭېﺕ ﻮﺮﻱﭘ ﻴ
ﺗﮑﺲﻭ ﻠﭙﻣﺎ
ﮐ
:ﻴﺺ ﺗﺸﺨ
ﻩ HbsAgﺩ ﺭﻥګ ﺍ
ﺪ ﻤﻭ،ﻫ
ﺩﻱ ﻮﻮﺟ ﻡکېﻣ ﻭﺮﻴHﻪﺳ ټﻱټﺱﺑﻲکې BsAgﭘ ﻴﭗﺍ ﺑړﻲﻫﻪ ﻲﻧ ﭘ
ﻭ.
ﺩﻱ ﻮﻮﺟ ﻡکېﻫﻢﻣ ﻭﺮﻴﻭﻪﺳﻭﭘ ﻧﮏ ﻭﺩږږډﻲﻝﺩځﻥﻧ HBV
ﻭﻥۍ ﻩﺍ ﻭﺮ HBSﺩ ﻪ چېﺗ ﺍﺳﻄ ﻪﻭ Iﭘ gM- Ant ﻴ ﺺﺩiHBc ﻟﺖﺗﺸﺨ ﺎړﻲ ﺣﺑﻲﻧ ﻭﻍۍﺩ ﺭﺎﻧ
ﺩ
ﻩک ﺩﻮﻪﻣ ﻮﭘﺘﺎﺷﻴﻭﻣ ﻭﺩڅ ﺘﻼﻃﻲﭘﻲښ ﺮﺍﺧﻴېﻪﻏ،چ ﭘ ږﻱ
ﺩﻝکږ ﻭږﻱﺍښښ ﻩکږ ﺭﺎﮐﻪښ ﺘﻭﺳﺭﻭ
.ﻮﻱ ﻡﮐ ﺍ
ﻭ ﻩﺩﺭﺎ
ﭙ ﻟﺎﺕﻭﺧﺖ ﻳډﻱﺯ ﺎﺘﻲﺑ ﻧﺍAnt icoreAg. ږﻱﺭکږ ېﻭ
Ant ﻭﺩi ﺘﻲﺟﻦﺍ ﻧﺮﺱﺍ ﻳﺍ
ﻪچېﺩﻭ ﺍﺳﻄ Rﻪﻭ adiﭘ oi ﻴ ﺺﺩmmuneassay ﺭﻱﺗﺸﺨ ﺍ
ﻮﺗﺍﺮ
ﺑﻻ
.
ږﻱﻩکږ ﺮﺮﺳ ﻮﻱﺗ ﻣﻮﻠ
ﻌګﻥېﻣ ﺩﻱ ﺍ ﺎ
ﺘﻲﺑ ﻧﺍHepat it
is
ړړﻱﻣﺨﮏېﭖ ﺗژﻱ
ډﻝﺮ ګﻱ ﻭځﻥ ړ،ﻪ ﺍ ږﻱﭘ ږړېﻮ
ﻴﻦﮐﭻ ﻟ ﺑﻭﺮ ﻠ
ﻴTﻭﺑ
rﺍ ansami ﺭnases ﺩځﻱګ
.ﻭکې ﺍ
.ږﻱﺪﻝکږ ﻴﻟﻧﮏېﻭﺎﻱټژ ﻮﺳﻔﻤﻟ ﻔﻲ ﺮﻭﺻ ﻴﻪﻍټېﻏ ﻠﻪﮐ ﻠﻭ،ﮐ
ﻳﻝې ﻱ
ﻣﻞﺎ ږ ﺭﺎﺍﻯﺷﻲﻧ ﺩﺩWBCک
ﻭ.
ﺩﻱ ﻮﻮﺟ ﺎﻣﻳﺭﻮﻴﻦﻳ ﺑ
ﻭ ﺮﻠ
ﻴﻭﺑ ﺍﺎ
ﻳﺭﻮټﻦﻳﻭﻳ ﺮﻪﭘﻩﮐﭽ ږﻪﻝﭘ
:ﺎﺕﺘﻼﻃ ﺍﺧ
ﺭﻮﻪﻟﺎﻥﭘ ﺮﻃﺭﺳ ﻭﺩځﻱګ ﺯﺱﺍ ﻭﺮﻴﺭﺳ ټﻱټﺱچېﺩځﻱګ ﻴﭗﺍ ډﻰﻫ ،ځﻥﻧ ﻪ ﻳﺎ
ﻔﻡﮐ ﺪﺭﻋ ﺩځﻱګ
ﺩ.
ﺎﺕ ﻱ ﺘﻼﻃ ﺍﺧ ﻩﺭﻮﮐﻻﻯﺷﻲﻏ ﻣﺨﺖګ ﻮ ﺮ
ﭘ
Transv ers ، ﺘﺲ ﻳﺍ
ﺩﺭﺎ
ﮐﻮ ﻳ
ﺎ،ﻣ ټﻱټﺱ ﺍﺍ ﺮﮑﻧﺎ
،ﭘ ﻪﻧﻮﭘﺎ
ﺘﮏې ﺧ ﻮﺳ ﭘ
،ﺩ ﻪﻳﺎﻔﻡﮐ ﺪ
ﻭﻋ ﺭګﻮﺗﺩﭖښ
ﺩ.
ﺎﺕ ﻱ ﺘﻼﻃ ﺍﺧ ﺭﺩﺎ
ﺎﻱېﻧ ﻴﻧﻮﻤﺎﻝﻧﮑﻴﭙﻳﺍﺍټmyﻭ elit
is
ﺳ:
ﺮﻭﻍۍ ﻴ ﺭﺎﻧ
ﺩ
ﭘ%١ﺭﻥځ ټﻱټﺱﻪ ﻴﭗﺍ Fulﻫ mi ﻮnant ږﻱﺧ ﻩکږ ډﻝ ښ ړﻭ ﻪﺑﺸﭗ ﺎﻥﭘ ﻭﻏ ﺭﺎ
ﺎﺕﻧ ﻳ
ﺭﺯ ﺷﺭ
ﻮ ﻢ ﻳ
39
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
Hepatocell
ulټﺱﻭar
ټﻱ ﺍ ﻴﭗﺍ ډﻰﻫ ﻮکېځﻥﻧ ﻧ
ﺍﺭ
ﻭ ﺭﺭﻥځ ﺭﻮﺷﻢ .ﻪﻳږﻱﭘ ﺪږ ﻧ
ﺭګ ﻮکېڅ ﻧﺍ
ﺭﻭ
.
ږﻱږړﻮﻗﻞﺟ ﺎﻣﻦﻧ ﺰﺮﺿﻲﻣ ﺮﻋﻴﺮﻏ ﻴﻤﻮﺷ ﻭﻳﺍ ﻮﻱ ﺎﺳﺲﮐ Carﺗ cinoma
ﺷ:
ﻭﻻﻯ ﻲ ﺩ
ﺎډﻝﻱېﻳﻧې ﻭېﻪﻻﺪ ﺮﻱچ ﭘ ﻟ ﻩړ
ﺍ ﺭېﻮﻮﭘ ﻧ
ﻭﺭﻮﺘﮑﺭﻓﺷﺭﻮ ﻢ (ﻪﻳOutﭘ ﻪﻱې)come ﻠﻳﺎ
ﭘ
.ﻧﺲ ﻭﻻ ﺮﻳﺍﺮﺱﻭ ﻳﺍ .ﺩﻭ 1
.ﻟﺖ ﺎﺘﻲﺣ ﻴﻓﺎ
ﻌ ﻪﻣﺑﺭﻮﮐ .ﺩ 2
ﻋ.
ﺮﻭﻍ ﻤ ﺭﺎﻧ .ﺩ 3
.
ﻪﻧﻭ ﺭ
ﻮﺘﮑﻳﮏېﻓ ﻨﻲټ ځﻦېﺟ ﻭﻳ .ﺍ 4
:ﻪﻨﻠ
ﻣﺭﺩ
ﺑړ
ﺭﺩ ﻲﺪﺩځﻱګ ﻳﺎ
ﻭﻍﺑ ﺭﺎ
.ﻧﺮﻱﻟﻪ ﻪﻧﻨﻠﻣﺭړېﺩ ځﻥګﻪﺍ ﻣﻮ،ﮐ ﻩ
ﻮﻱﺩ ﻳﻮﻘ
ډﻝﺗ ټﺱAﻪ ﻭ
ﭘ ټﻱ
ﻴﭗﺍ ﺩﻫ
ﺩ.
ﻪﻯ ﻡﻧﻮ ﻠ
ﻌﻭﻝﻣ Lamiﺭ vudiﺷ.ﺩne ﻮﻝ ﻲ ﻴﻧ
ﻧېﻭ ﺭﻥېﻻﺪ ﺍﺮڅ ﻩﺗ ﺭﺎﭙﻟ ﻳﻲﺎﻔﻡﮐ ﺪﻧﻲﻋ
:ﻮﻯ ﻴﻨ
ﻣﺨ
ﻩﺮﻮﺳﮑﻠ
ﻮﺧ ﻧ،ګﻪﻧﻭﺭﺎﺘﻦېﮐډېﺳ ﻪﺩ ګ ﮑﻮﻯﻭﺷﻲﻟ ﻴﻨڅﻪﺩېﻣﺨ ﻮ ﺧ ﻧﻭﺭﻮ ﺘﮑﻮﻓ ﻟ
ﻭﻪټ ﺮﻟ ﺩﺧﻄ
ﺩﺮﻭﭘ
ﻭﻧﮏﻭﺭﺎﮐ
ﺭﺩﺍﻮﺗﺍ
ﺮﺑﻭﻻﻮﻥﺍ ﺘﻭﻏﺭ ،ﺩﺎﻱښﺕ ﻣﺯ
ﻳﻦېﺍ ﻭړﺪېﺩﻧړېﻭﺍ ﺭک ،ﺮﻭﻟﻰﺗ ﺍ
ﺩېﻭ ږﻨﺴﻲﻥ ﺟ
ﻪﻩﭘﺮ
ﻳﻦېﺳ ﻮﻭ ﺗ
ﺎﻌ
ﻳﺎﻪﻣ ﻟ
ﻮﻧﺎ
ﻪﮐﺴ ﺘﺍﺧﻭﻍۍﺩ ﺭﺎﺮﻧ(ﻭﭘ
ﻩﺍ ﺬﺘﻦېﻭﺧ ﻪ)ﺳ ﻧﻮ ﻮﺧ ﻨﭽ ﺘﻭﻯچېﺳ ﺎﻮﻫېﭘ
.
ﺮﻱ ﻟﺎﺱﻭ ﻤﺎﻁﺗ ﻴ
ﺘﺍﺣ
:ﻳﺸﻦ ﺰ
ﻳﺎﻧﻮﻤﻳﺍ act i
v Pﻭe assiﺍ ve
ﺷ:
ﻴﻦ ﻲ ﮐﺴ ﺍﺪﻭ ﻳﺎﺮډﻝېﺑ ﻧېﺩﺧﻄ ﻻﺪ
.
ﻧﮏې ﻭ ﻮﮐﺭﺎﺎﮐ ﻴﺘﻭﻏ ټﻝﺩﺭ .ﻭ 1
.
ړﻱ ﺭﻥېډﻝېﻍ ﻮ ۍﻭژﻏړﻥ ﺍ ﺑﻲ .ﺩ 2
.(Mortici
ansandembal mer ﻧﮏې)s ﻭﻮﻳﻲﮐ ﺎ
ﻴﻣﻮېﻭﻣ ﻧﮏ ﺍ ﻭﻮ ړﻱ ښﺧ .ﻡ 3
.ﻮﻱ ﺪﮐﻧﻭﻪکېژ ﻤﻴﻪﺳ ﺮﭘﺎﻥچېﺩﺧﻄ ﻣ ﻮﺎﺷﻪﻣ ﻐ .ﻫ 4
.ﺮﻱ ﻟ
ﺎﻭﻴﻠﻴﻓﻮﻤﻴﻠﮏچېﻫ ﻪﺧ ﻐ .ﻫ 5
ﺩ.
ﻧﺖکې ﻱ ﻮPsyﻳ chiat riﺎﻥچېc ﻭﻏﺭﺎﻪﻧﻐ .ﻫ 6
ﻭ.
ﻩکې ﻱ څﻥګﺰﺍ ﻴﻟ
ﺎﺩﻳ
ﻭﺩ ﺍﺮﻱ ﻟ
ﻪﻭ ﻳﺎﻔﻡﮐﺪډﻰﻋﻭځﻥﻧ ﺭګﻮﺗﺎﻥچېﺩﭖښ ﻭﻏﺭﺎﻪﻧﻐ .ﻫ 7
.ﻳﻦﺮﻓ ﺎ
ﻪﻣﺴ ﻟ
ﺎﻬ
ﻣ ﺩﺍږ
.ﻭ 8
.
(ﻮﻝ ﻌﻔﻣ)Prost i
tutﻭes ﺍﺍﻥ ﺭﺎﮐ
ﺎﻧ،ﺯ ﺍﻥﺭﺎﺍﻃﺖﮐ ﻮ.ﻟ 9
.ﻭﻱ ﺭﺎ
ﻣﻞﮐ ﺭ
ﻩﺩ ﻧړ
ﻭﺭېﺎ ﻪﻻ ﻟﺪ ﻳﺭﻠﮏچېﺩﻭ ﻪﺧ ﻐ.ﻫ 10
ږږ
ﻮﻝک ﮐﺭﻪﻭﻮﺗﮑﻠﻧېﺧ(ﻻﺪ ﺎﻴﻤﻴﻨﻴ
ﻟﻮﺑﻮﻟ
ﻮګ ﻤﻳVﻭﺍ acciﺍnat i
ﻌﻦېon ﻳ)Pr ophy l
axi ځﻯsﻮﺍ ﻳ
:ﻱ
ﻭ.
ﻮﻱ ﻱ ﻤﻲﺷ ﻪﺯﺧ ﺍﺳﻄ ېﻪﻭﺘﻦ ﭘډﻝﺩﺳ ﭘﻲ ﻭﺍﻧڅېﻪﺎګﻱچ ﭘ ﻪﻭړ ﻐ .ﻫ 1
.
ﺎﻥﻴﻨﻮﭼﻟﻲﮐ ﺩﺩږﻮﻱﺯﻱ څﻪﻧ
ﻭ ﺧ ﺪﻨﻴﺒﺖﻣ ﺜ ﻪHBsAgﻣ .ﻟ 2
.
ﺮﻱﻟﻳﮏېﻭ ړ ﺍﻨﺴﻲ ﻩﺟ ﺭﺍﺪﻣﺍ
ﻭﻩﺩ ﺮ
ﻭﻍﺳ ﺭﺎﺒﺖHBSAgﻧ ﺜېﻪﻣﻪچ ﻟ ﻐ .ﻫ 3
ﺎﺕېﻩﺩېﭘ.ﭖټ ږﻱﻮﻝکږ ﮐﺭ٢ﻭ٠٠IﻪU ﻡﺗ ﻮﺎﺷﻟﻲﻣ ﺩﺩږ
ﻮﻱﺯﻱ ﻭﻧﺍﻴﻦﻟﻮﺑﻮ ﻟ
ﻮﻥګ ﻤﻳﺍ ٥٠
٠IﻪU ﺎﻫﻞﺗ ﮐ
ېﻪﺑﻞﻻﺱکې ﻴﻦﺩ ﭘ ﻟ
ﻮﺑﻮﻟ
ﻮګ ﻧ
ﻮﻴ ﻣېﻭﺍ
ﻪک ﺍ ﻠ
Delﻋﻀ t
oiﻻﺱﻪd
ﺩﻮ ﭘ ﻴﻦﺩې ﻳ ﮐﺴ ﺍ
ﻪﻭﻱچېﻭ ﻧ
ﺷ.
ﻴﻖ ﻲ ﺒﺗﻄ
:
(Activeimmuni zat i
ﻳﺶ)on ﺰ
ﻳﺎﻧﻮﻤﻳﺍﺎﻝﻌﻓ
ﻭﻝک ﺭ
ﺎﻪکېﮐ ﻠDﻪﻋﻀ elﭘtoiﻩﺩd ﺭﺎ
ﭙﻟ ﺬﺏ ﻩﺟ (ﺩښ ﺎﺷﺖې ﻴ١ﻭ٦ﻣ-ﺍ ٠ﻪ) ﻗﺭ ﺩېﺯ:ﺭ ژﻢ
ﻭﺭﻳ ﺯﺍﻭﺩ
ﺷ.
ﮐﻻﻯ ﻲ ﻪﻮ ﻓﻈ ﺎ
ﺎﺕﻣﺤ ﻳ%څﻪﺯ
٩ﺧ ﻩﺩ٠ ﺭ ﺎ
ﭙﻟﻟډﻭﺧﺖ ږﻱﺩﻦ ږ
ﻭ(
ډﻥﻪګ ﺯﭘﺪﻳ
Hﻭﺍ
Iﺍ ﺎﻥ)Vﻭﻏﺭﺎﻠﻲﻧ ﭘﻴﺖځ ﻓﺎ
ﻌ ﻭﻣﻟړﻭﻱﺍﻮﻮ ﻧﻮﻠ٥ﮐﺗ٠
ﺮﻱېﺮ ﻤﺎﻥچېﻋ ﻭﻏ ﺭﺎﻪﻧﻐﻫ
40
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﻭ.
ﻪﻱ ﻪﻧ
ګﻥﺷﺮﻭﺒ
ډﻱﻏ ﺎ
ﺩﻥټﻱﺑ
ﻭﻯکې ﺍ ېﻪﺩ
،ځﻪچ ﭘ
ﺮﻱ ﮐ ﻟړﺎ
ﻴﺗﺍﺗ
ﻮﻪ ﻧ
ﻭﺯﻭﺭﻱﺩ
ﺍﺮ
ﮑﻟړﻭﺗ
ﻮﺍ
ډﻱﺩ
ﻱﺎ
ﺍﻥټ ﺑ
ﺷ.ﺩ
ﻩ ﻲ
ﺯﺍﺪ
ﻧﻪﺍﺘ
ﻭﺳﺭﺎﺷﺖېﻭﻴﻣﺮ٩ﺗ
څﻪ٧
ﺯ ﺧ ﻭړﻱﺩ ﻡﻮﻪﻟﺪﻟﻳ
ﺎﻪﺑډﻱﮐﭽﻱﺎ
ﺩﺍﻥټ ﺑ
ﺷ.
ﻴﻖ ﻲﺒﻪﺗﻄﺘ
ﻭﺳﺭﮐﻪﻭ
ﻟ
ﺗ٥ﺎﺮ٣ﺮډﺯﻫ Boostﻭﺪer ﻳﺎ
ﻩﺑﺭ
ﺎﭙﻟ
ﻮﻠﺗ
ﺎﻪﺳﺗ
ﺭﻮﭘﮐﭻېﺩ
:
ﻮﻭﻻﻯﺷﺩﺎ
ډﻝﻱېﻳﻧې ﻭ
ېﻪﻻﺪ،چ ﭘ ﺮﻱﻟ ﻪ
ﻧﻮﻧ
ﺎﻳ
ﺭﺯﺷﺭ
ﻴﻦګڼ ﻢ ﮐﺴ ﺍ
ﻭ
.
ﺍﺕګﻪﺭ ﺗ
ﺩﻣﻦځ ﺭﻪکېﺩﺩ ﻴ
ﺎﺣﺷېﻧ
ﺭﻕ ﻮ ﻪﺯﭘ-
١
.ﺍﺕګ
ﻪﺭﺗFlﻣﻦځueLikeil
l
ﻭness ﺍﻮﻧ
ﻮﭘﺎ
،ﺧ،ﻪﺩﺗﺐﻠ
-ﻪﮐﻠ٢ﮐ
ټﻱټﺱﺳﻲ ﻴﭗﺍ ﻫ
ﻩ٦ږږﺮﻝ،ﻝﺗﺮﻱ ﻟﻟﻰﺍ
ﻪﻭ ﺗﺭ
ﻩﻭ ﺮFlﺳavivirﺩ،چېﺩus ډﻝ ﻯﺩﻭ ﺭﺪﻨ
ﺘګﻯﺳځﻥ ړﺮﺱ ﺍ ﻳﺍ
ﻭ ﺩﺩRNA ﺍ
.
ﺮﻱﻟﻪ ﻧ
ﻮﭙﻳ
ﺍﻮټ ﻨ
ﻴﻍټﺟ
ﻭﺱ%٤ﭘﻲښېﻱ ﺭﺍ،ﻡګ،ﻠﻞﺗﺍ
ﻪﺭ ﺗ
ﻪﻣﻦځ ﺘﻭﺳ ﺭﻥڅﻪﻭ
ژ ﺧ ﻮﻴﻔﻧﺴﺍﺮ
ېﻪﺗ
ﻳﻦ ﻟ ﻭ%٩ﭘﻲښېﺩ ﺍ٠ﻮﭘﺨ
ﻩﻧړ
ﻭﻮکېچېﺎ ﮑﻠ
ﻮﺧ ﻐﺎﺕېﭘﻲښېﻫ ﻳ
%څﻪﺯ ٥ﺧ .ﺩ٠ﺮﻱ ﻟﻭﺍ
ړﺭېﺕ ﻮژﻥﭘ ﻮﻴﻔﻧﺴﺍ
ﺮﻳﻦېﺩﺗ ﻭ ېﺩ
ﺮﺰﻫﻢﺩﺧﻄ ﻴ
ﻟﺎ
ﻳﺩﻮﻤﻴﻭﻫ ﺎﻝﺍﻤﻌﺘ
ﻳﻦﺍﺳ ﺎﮐﻮﮐﺍﺧﻞکېﺩ ېﻪﺩ
ﺯﭘ ﻮ.ﺩﭘږﻱ
ﺩږ ږږ
ﻭﻱﻝ ﺭﺎ
ﻣﻞﮐ ﺭﺪﻱﺩ ﻳﺭﻭ
ﺩ.
ﻪﻱ ﻧ
ﻭﺭ ﻮﺘﮑﻓ
ﻮﻟ
ﻭﺏﻝﻻﺏﻝ ﻠﮏچېڅ ﻪﺧ ﻐﺎﻫ ﻣﻩﺍږﻪﻝ ﻧﺩﺩﺩږږﻪﻝﻡﺗ ﻮﺎﺷڅﻪﻣﺭ ﺧ ﻮﻣېﻭﺩ
ﺭﺍ ﻪﻻ ﻟﻮ
ﮑ ﻳ
ړ ﻨﺴﻲﺍ ﺩﺟ
ﺩ.
ﻣﺦ ﻱ ﺎﻩﻣﺨ ﺮﺮﺳ ﻪﺧﻄ ﻟﺮﻱﻟﻳﮏې ړﺍﻨﺴﻲﻩﺟ ﺮﻮﺳ ﮑﻠﺧ
.ﻪﺘﺪﻧﺸﻨﻡﺳ ﻮﺩﻥېﮐﺩﺩ ﻟږ
څﻪﻱېﺩ ﻲ ﻭ ﺧ ﺪﻴﻪﺷ ﻟ ﺭﻮﻣﺩ
.ږﻱ
ﺍکږ ﺪ ﻴﻮکېﭘ ﻧ
ﺎﻏ ﻭﺭ
ﺎﺒﺖﻧﺜHIﻣ HﻪV%٥ﭘﻲښېﺩ CVﭘ ٠-٣٠
ﺷ.
ﻪ ﻲ ﺗﻣﻦځ ﺍ
ﺯﺱﺭ ﻭ ﺮﻴ
ټﺱﻭﺳ
ټﻱ ﺍ ﻴﭗﺍ ډﻰﻫ،چېځﻥﻧ ږﻱ
ﻻﻞکږ ﺩې ﻣﻟﻰ ﺩ ﺍ
ځﻯﻭHﻮ ﺍIﻳ ﺩV
ﺩ،چېﻠﮏ ﻱ ﻪﺧ ﻐﻪﻫ ﻧ
ﻮﻠﻴ١ﻣ،ﻭ٣ ﻧﮏېﺩﻱﺍ ﻭﺩږږ
ﻠﮏHCVﻝ ﻪﺧ ﻧ
ﻮﻠﻴ
٢ﻣ ،
ﺩې٧ ږﺎ کېﻥ ﮑﻳﺮﻣﻪﺍ ﭘ
ﻭ.
ﻮﻱ ﻱ ﺎکﺷ ﻭﺱﭘ ﺍﺭ ﻭ،ﻡګ
ﻮﻱ ﻱ ﺘﻦﺷ ﻨ
ﻪﻣ ﻠ
ﻣﺍﻪﻟﺮﺱ ﻳﺍﻣﺨﮏېﺩﻭ
ﻭ.
ﺮﺿﻲ ﻱ ﺮﻋﻴﺍﻏ ً
ﺮﺜﮐﻭﺍ ﻴﻒﺍ ﻔډﻝ ﺧﺰ ﻭ ﻳﺩ
ﻭﻪﺩ ﻴﮏ ﻱېﭘ ﻨﻴﻠ
.ﮐ ﻩ
ﻭﻥۍﺩ ٧ﺍ -ﻩ٦ ﺭﻭﻳﺦﺩ ﺮﻔﺗ
.ږﻱ
ﻪکږ ﺘﮐﻱﻭ ښږﺍ ږ
ړېﻮ
ﻪک ﻟ ﺰﭘﻳﺮ
ﻴﻔﻧﺴ ﺍ
ﺮﺗﻮ ﻨ
ﻴﻣﺍ
Trﻱې ansferﺍﻯﺷﻲases ﺩﺩﺮﻱ ک Viﻟremi ﻩچېa ﺮﻩﺳ ﺮېﻪﺩېﺳ ﻭک ﻟ ﻩ ښځ ﺭﺍﻭﺪﻴﻣﻪﺍ ﭘ
ﻳﺖﺮﻔﻧﻭ
ﺮﻴﻣﻮﻟ
Cﻭګ yﺍ roglobulinemi HCV.ﺩa ږﻱږړﻮﻟﻪﺘﻭﺳﺭﻪﻭﺪڅﺧ ﻟ
ﻮﺭﻪﺗﻭ،ﻡګﻟﻣﻞ ﻱ ﺭﺎ
ﻧ
ﻴﮏﺗﺎﻮﺳﻔﻤ
،Autﻟ oi mmune t hy roiditi
ﻩs ﺭﻥګ ﺍ
ﺪ ﻤ
ﺩ .ﻫﺭ ﻯ ﻮﺘ
ﮑ ﻴﮏ ﻓ ﻨ
ﻮﺟﺘﻮﭘ ﻩﻳ ﺭﺎﭙ
ﻟ
.ﺮﻱﻟﻳﮏېړﺍﻩﺮﺎﺳ ﻣﻮﻔﻤﻟﺎﻻً ﻤﺘ
ﺍﺣ Iﻭ
diﺍ opaht hicPul monar yfibrosis،Sialadeni tis
ﻭ.
ﺎﺕ ﻱ ﻳﺮﺯTyﺧﻄ peIIDi ټﻱټﺱCکېﺩabet ﻴﭗﺍ ډﻲﻫ ﻪځﻥﻧ ﭘ
ﻮﻱﮐﻞﺷ ﺍډﻱټ ﺎ
ﺘﻲﺑ ﻧﺍ
ﺪېچېﺩHCV ﻧﺎ
ﻮﻥAssayﺑ ﻤﻳﻳﻢﺍﺍﺰ
ﻧﻪﺍﻴ ﺺﭘټﻱټﺱﺳﻲﺗﺸﺨ ﻴﭗﺍ ﺩﻫ
.ږﻱ
ﻩکږ ﺮ ﺮﺳ ﻭﻱﺗ
:
ﻮﺟﻲ ﻟ
ﻮﻤﻳﺪ ﻴﭘ
ﺍ
،
ږﻱﺩږږږ
ﻪﻝ ﺍﺳﻄﻪﻭ ﻊﭘﻳﺎﻣﻳﺖﺩ ﻮﺎﺩﻋﻀ ﻳېﻭﻭﻳﻦ ﺍ ﻭﻭﻏﻲﺩ ﺭﺎ
.ﻧږﻱ
ﺍکږ ﺪﻴﻭټکېﭘ ﺮګ ﻪﻫ ړۍﭘ ﺩﻥ
.
ږﻱﻩ کږ ﺮ
ﺮﺳ ﻪﻫﻢﺗ ﺍﺳﻄ ﻪﻭ ﺭۍ ﭘ ﺎﮑﻴﭽ ﻭﭘ ﺘﻦېﺍ ﺷې ﺳړې ﻮ ﻪ ﻱېﮐﮏ ﻧ
ﺩﺩﺩږږﻩﻝ ﺭﻥګ ﺍ
ﺪ ﻤﻫ
ﺭﮐﻢ ﭖ ﺭﻪډﻠﺗ
ﺮﻪﭘ ټﻱټﺱBﭘ ﻴﭗﺍ ،ﻻﻦﺩﻫ ږﻱ ﮐ ﺩږ ږږ
ﺍﻯ ﺷﻲﻭﻝ ﺩﺩﺭې ک ﻪﻻ ﻮﻟﮑﻳړﻨﺴﻲﺍ ﺩﺟ
.ﻩﻩﺩﺰﻳﺩﻭﺮﺩﻴﻪﻏ ﻧ
ﺩﺩﺩﻟږ
ډﻝ ﻲ Verﻭ ti
ﭘcalﻪﻪ ﻡﺗﻮﺎﺷڅﻪﻣ
ﺭ ﺧ ﻮ.ﻪﻣ
ږﻱﻟ ږ
ښښ
ﻮ کېﺩ ﻧﺎ
ﻭﻏﺭﺎ
%٤ﻧ ﻪ٠ ،چېﭘ ﺮﻱ ﺎﻥﻟﺘﻧ
ﺍﺍﺎﻥﺩ ﻧ
ﺎﻧﺴﻪﺍ ﻧ
ﻮﻠﻴ٢ﻣ٤ﺗ٠١څﻪﺮ
٧ﺧ ړۍ کې٠ ﻪﻥ ﻟﻭﻪټ ﭘ
ﻭ.
ﻣﻞ ﻱ ﺭﺎ
ﻪﻧﺰﮐﭽ ﻳﺮﻔ
ﻧﺴ ﺍ
ﺮﺗ
ﻮ ﻨ
ﻴﻣ ﺍﻡﻭﺮﻴ ﺳ
ﻪﻭکې ﻨ
ﻳﺭﺎ
ﻪﻧﺮﭘﺷ.ﺍﺧﻄ
ﻪ ﻲﺩ ﺘﺍﺧﺯﻭﺮﻴﻪﺳ ﺍﻯﺷﻲﭘ ﺩﺩﻪک ﺘﻭﺳ ﺭ
څﻪﻭﻮ ﺧ ﻧ
ﻮﻠ٢ﮐﻟ٠ﺎﻥﻪﻭﻏ ﺭﺎ%٢ﻧ ٠
ﻪ.ﭘﻮﻝڅښﻱ ﮑﻟﺎﺕﺍﻳڅﻪﺯﻮ ﺧ ﻣﺍﺭ٥ګ ﺭځېﺩ٠ ﻭﺎﻥچېﺩ ﻭﻏﺭﺎﻪﻧﻐډﻝﻫګﻱ ﻭځﻥ ړ
ﻪﺍ ﺎﺕﺩﻯﭘ ﻳﺯ
41
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
،
ﺎﻴﻤﻴ
ﻨﻴﻟ
ﻮﺑﻮﻟ
ګﺎګﻣ ﻮﺍ ﭙﻳﺎ
ﻪﻫ ﮑﻭ،ﻟ
ﻮﻯ ﻱ ېځﻞﺷ
ﺘﻢﻱ ﭘ ﻴﺴﺘﻲﺳ ﻴﻓﺎ
ﻌﺎﻥچېﻣ ﻭﻏﺭﺎﻪﻧﻐډﻝﻫ ﺪې ﻭ ﻤﻫ
ﻮﻥﻤﻳﺎﻥ چېﺍ ﻭﻏﺭﺎﻮﻱﻧ ﺪﺷ ﻧﻮﻴﻭﭘﺩړ
ﻭ ﻍ ﻪ ﻭﻱﺍ ﻤﻩ ﻱېﮐ ﺯﺍ
ﺪﻧﻧﮏې چې CD4ﺍ ﻭﺮHIﻟ V
.ﻮﻱﻣﺨﺖګﮐ ﺮﻪﭘﺗﺍ
ﻮﺯﺱﺧ ﻭﺮﻴﺭﺳﻠﻲﻫﻢژ ﺍﺧ ﻣﻞ ﺭﺩSupr essive
ﻴﭗډﻲﻫ ﻴﻒځﻥﻧ ﻔﻩﺧ ﺮﺗﺎ
ﻳﻭﺯ ﻣﻞﻭﻱﺍ ﺭ
ﺎﻪﻱېﻧ ﺰﮐﭽ ﻳﺮﻔﻧﺴﺍ
ﺮﻮﺗ ﻨ
ﻴﻣﻡﺍﻭ ﺮﻴ
ﺍﻥچېﺩﺳ ﺭﻭ ﻪﺭﻥځ ﻐﻫ
%١ﻪ٠ ﺯﭘﻭﺮﻴﺎﻫﻢ ﺳ ﻴ،ﺑﻮﻱ ﻣﺨﺖګﮐ ﺮﺭﭘﻮﻪﻟ ﺯﭘﻭﺮﻴ ﻭﺳ ﺭﻭﻭ ﺭﺎﻭﻭﻳ ﺮﻱﻫﻲڅﺍ ﻟ
ټﻱټﺱﻭ ﺍ
.
ﺷ.
ﺍﻯ ﻲ ﺩﻧﺩ
ﺭګﺪ ﻮکېڅ ﻧﺎ
ﻭﻏﺭﺎ
ﻧ
:
ﻩﻴﮏېﺏڼ ﻨﻴﻠ
ﮐ
.
ﻩ٥ﺭځېﺩ ﻪﻱې ٠ﻭ ،چېﻣﻦځﻥۍﮐﭽ ﻩ١ﺭځېﺩ٢ﻭ ٠-
١ېﻪ٤ﻩﻱ ﻟ ﺭﻭﻳﺦﺩ ﺮﻔﺗ
ﺩ
.
ږﻱﺪږ ﻧ
ﺭګړﻯڅ ﻮکېژﻱ ﻧﺎﻭﻏﺭﺎ%٢ﻧ٥-١
ﺩ٥.
ﺎﻥ ﻯ ټﺱﻪﺷ
ټﻱ ﭘ ﻴﭗﺍ ﺮﺳﻲﻫ ﻳﺍﻭﻭ ﺭﻮﻴﮏﻱېﺩﻧ ﻨﻴﻠ
ﮐ
ﻭ.
ﮑﻞ ﻱ ﻴ
ﻨﻴﻠﻩﭘﻲښېﻱېﺳﺐﮐ ﺮﺗ
ﺎﻳ
ﺯ
،ﺩګﻟﻰﺍﻮﺑ
ﺍﺮﺎﺧﻬ ﺘﺍﺷ،ﺩ،ﻝټﻱ ﺎ
ﻴﺘﻪﺳﺴ ﮑﻟګﻞې
ړې ﻳ ځﻥګېﺎ ﺍﻩک ﻧ ﺭﻭﻪﻣﺨﮏېﺩ ﻱڅﻪﭘ
ړ ﺧ ﻪژﻱ ﻟ
ټﻱټﻴﭗﺍ .ﺩﻫ ﻮﻱ ﻡﮐ ﺍﻭﺭځېﺩ ١ﻭ٠-
ﻭ،چې٢ﻩﻱ ﺩﻮ
ﻮﺟ ﻪﻣ ﺒﻪﺗﺭﺟﻪﺩ ﻤﻪﮐ ﻭﭘﺩﺍ ﺭﺍﺩﻮﻱېﺩښۍﺧ ډ
ﻪﺩ ﮑ
ګﻞېﻟډﻝ ﻳ ﻪﻭ Serﭘ um si ﻮ کېﺩckness ﻧﺍ
ﺭﻭ ﻮﺭﻥځ ﻨ
ﻳﻪځ ﺎﻥﭘ ﻪﺷ ﻮﭘ ﻧﺎ
ﻭﻏ ﺭﺎ
ﺱﺑﻲﻧ
ﺩﻮﻮﺟﺍﻯﺷﻲﻣ ﺩ ﺩ
،ک ږﻱﻩکږ ﻩښ ﺮ
ﻪﺳ ﺗﻣﻦځړﻱﺩ ﺩچېﺩژﻱ ﺭﻮﺩ ﻧ
ﻭﺪﻨﺑۍﻭﺩﻡﺍ ړ،ﻝ ﺘﮏېﺭﺵ ﻮﺳﭘ
ﻭ.
ﻱ
ډﻰ
ﻩ ځﻥﻧ ﺮﺗﺎ
ﻳﺮﻱﺯ ﻪﻟﻳﺨﭽ ﺭﺎ
ړﻱﺗ ژﻱﺍﻥ چېﺩ ﺭﻭﻪﺭﻥځ ﻐ.ﻫ ﻮﻱﻡﮐ ﺍ
ﻭ ﻭﻥۍﺩ ٢ﺍ -ﻱګﻞې١
ړ ﻳ ژﻱﺩ
.
ﻪځﻱ ﺮﻑﺗ ټﻱټﺱﻃ ﻴﭗﺍ ﻫ
ډﻝ
ﻪ ﭖټ ﻭ ﻭﻏﻲﭘ ﺭﺎ
ﻭ؛ﻮﻧ
ېﻪ ﻱﻧ ﺘﻦ ﻧګﻞېﺷ ﺎﻥ ﻳﺘﻧﺑړﻲﺍ
ﻭکېﺩ ﻲﻧ %٨ﭘﻲښ ېﻪ٥ﻩچ ﭘ څﻥګﺭ
ﺪﻳﺎ
ﻨﺲټﺑ ﺩېﺑ ﺮ.ﻮﭘړﻱﻧ ﻪک ﺗﻣﻦځﺍStﺭﻨﻰage ﺘ
ﻭﺳ ﺭﻮﻭ ﻴﻭﻏﺭﺎ
ﻧﺭﺩﻭچېﺩځﻱګ ﺮڅ ﻮﻱﺗ ﻡﮐ ﺍ
ﻭﺩ
ﺷ.
ﻪ ﻲ ﻨﻳﺎﻌﻡﻱېﻣ ﻭﺮ
ﻴﺎﺕﻭﻱﺳ ﻳﻪکېﺯ ﺮﭘﻮچېﺧﻄ ﮑﻠﻮﺧ ﻐډﻝﺩﻫ ﻮﻱ ﻭ ﻔﻗﻪﻭﭘ
ﻮﻩﻳﺮCyﺳ rglobul inemi ﺘﺲﺩa ﻳﺍ
ﺮﻔﻧﻮ
ﻟﻭﺮﻴﻣﻮﻟ
ﻪګ ﺭﺕﺩﻱﻟ ﺎ
ﺒﻭېﻋ ﺎﻴﺗ
ﺪ ﻧ
ﺭګ ﺮڅ ﻬڅﻪﺑﺭﺧ ﺩځﻱګ
.
Pڅﻪ
orﺧ phy racutneat arﻭda ﺍﻴﺲ ﺗﺍﺮﺗ
ﺭﺍﺍ،
ځﻯ
Lﻭ
iﺍ chenpl anus، Siccasy ndrﻭﻫﻢﺩ om ﻩﺍﻩﺩ ﻟړ
ﻮﻉﻮ ﻴﻴﺖﺷ ﺑ
ﺎﻳﻮکېﺩﺩ ﻧﺎ
ﻭﻏﺭﺎﻪﺩېﻧ ﭘ
ﺩ.
ﻧې ﻯ ړﻥېﻻﺪ ړﺮڅﻟﻰﺗﺍځﻯﻭNﻮ ﺍ onSpeciﻳ fi
cHodgki nl ymphoma
:ﻴﺺ ﺗﺸﺨ
ﻪﺘﻲﺟﻦﭘ ﻧﺍډﻱﺩ ﺎﺘﻲﺑ ﻧﻪچېﺍ ﻠ
،ﮐږﻱ
ﺩﻝ کږ ﻭﻪﻭﺧﺖﺍﻱښ ﻐ
ﻴ ﺺﻫ ټﻱټﺱ ﺳﻲﺗﺸﺨ ﻴﭗﺍ ﺩﻫ
ﺷ.
ﺪﻝ ﻲ ﻴﻟ
ﻡکېﻭ ﻭﺮﻴﻪﺳ ځﺭﭘ
ﺭﻥ ﻭ ﺑﻞکېﺩ ﺎ
ﻘﻣ
ﺷ.
ﺪ ﻲ ﻧ
ﺭګ Crڅ ossReact i
ﺍﻯﺷﻲon ﺩﺩﻪک ﻠﻪﮐﻠﺷ،ﮐ
ﻪﻩﺘ ﺭﺎ
ﭙﻟﺩېAssyﺩ ډﻝsډﻝ ﻭﻭ
ﺷ،چېﺩ ﻡ ﻲ ﻮ
ﻠﻌﺪﻣ ﻳﺎﻡﺑ ﻮﻨﻴﺮﺱﺟ ﻳﺍ
ﻭﻩﺩ ﺭﺎ
ﭙﻴ ﺺﻟﻩﺗﺸﺨ ﺭ
ﻮﭘﻮﺩ ﺷ؛ﻧ
ﺒﺖ ﻲ ﺜﺭې ټﺱټﻣ ﺭﻪچ ﮐ
.ږﻱ
ﻩکږ ﺮﺮﺳ ﻪﺗ ﺍﺳﻄ Pﻪﻭ CRﭘ
ﺪﻳﺎ
ﻮﻱﺑ ﻪﮐ ﻪﻧﺘﺮﺳ ﻩﻣ ﺮﻴ ﺺﺳ ړﺗﺸﺨ ﻪﺑﺸﭗ ﺪﻝﻟ ﻴ
ډﻱﻟ ﺎ
ﺘﻲﺑ ﻧﺍ
ټﻱټﺱکېﺩ ﻴﭗﺍ ډﻲﻫ ﻪځﻥﻧ ﭘ
ﺷ.
ﮐﻞ ﻲ ﺍRNAPCRﻭټ
ﻭﻥۍ ږﺍﻮﺷﭗ ﮐﻻﻯﺷ ﺘﻲ HCVﻮ ﻧ
ﻭﺍڅﻪﺍ
ﺎﻥ ﺧ ﺘﻧ
ﻪﺩﺍ ﺘﻭﺳ ﺭﻭﻥۍﻭ ﻩﺍ ﻭﻟﻰﺩ ﻩﺍﻮ RNAﺩHCVﻳ
.ﻭړﻡک ﻮﻠﻌﻪﻣ ﺘﻭﺳﺭﻭ
:ﺎﺕ ﺘﻼﻃﺍﺧ
ﺩ.
ﺎﺕ ﻱ ﺘﻼﻃ ﺍﺧ ﻩﺭﻮټﻱټﺱﻏ ﻴﭗﺍ ډﻝﻫﺩې ﻭﺎﻥ ﺩ ﺮﻃﺭﺳ ﻭﺩځﻱګ ﺍﺯﺱ ﻭﺮﻴﺭﺳ ﺩځﻱګ
ﻩﺍګﺭﻥګ ﺍ
ﺪ ﻤ.ﻫږﻱﺪږ ﻧﺭګﻩکېڅ ﺭ
ﻭﻪﺩ ﺎﻫﺖﭘ ﻘﻧ
ټﻱټﺱﺳﻲﺩ ﻴﭗﺍ ﻪﺩﻫ ﻠﻪﮐ ﻠ
ﺎﮐ ﻴ
ﻤ ﻴ
ﻧﻴﮏﺍ ﺘﺍﻼﺳﭘ
ﺷ.
ﺍﻯ ﻲ ﺩﺩﻪک ﺗﻣﻦځ ﺍﺎﺕېﺭ ﭘﻭﺭ
ﻮ ﻴ
ﻴﻄﻲﻧ ﻭﻣﺤ ﺍ ﺎ
ﻴﻨﻴﭘ
ﻮ ﺘﻳ
ﺎﻮﺳ ﻟ
ﻮﻧﺍ
ﺭ
ﺩ.
ﺎﺕ ﻱ ﺘﻼﻃ ﺍﺧ ﺭﺩﺎﻪﻧﻳﺎﻔ
ﻡﮐﺪﻭﻋ ﺭګﻮ ﺗ
ﻭﺩﭖښ ﺍ ﺯﺱ ﻮ
ﻧﺎﻴ
ﻭﺳ ﺮﮐﺍ،Cryogl obulimemi a
42
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
:ﻭﻝﺮﺘﻨﻭﮐﺍﻮﻯ ﻴ
ﻨﻣﺨ
ټﻱ
ﻴﭗﺍ ﺩېﻫ،ﺩ ږﻱ
ﻭﻝکږ ﺭﺎ
ﻮﻱکېﮐ ﻴﻨ
ﻪﻣﺨ ټﻱټﺱﺑﻲﭘ ﻴﭗﺍ ﺮچېﺩﻫ ﻴﺑ
ﺍﺪﻣﻲﺗ ﻮﻤﻪﻋ ﻐټﻝﻫﻭ
.ږﻱ
ﺘﻞکږ ﻴﺴﺍﺧ ﻩﻭڅﻪګټﻮﻱکېﻫﻢ ﺭ ﺧ ﻴﻨ
ټﺱﻪﻣﺨ
ﭘ
ﺘﻞﻴﺴﺍﺧﻩﻭﻭڅﻪ ګټﻪچې ﺭ ﺧ ﺘ
ﻪﻻﺱکېﻧﺸ ﻴﻦﭘ ﻟ
ﻮﺑﻮﻟﻮﻥ ګﻤﻳګﻯﺍځﻥ ړ
ﺎﺍ ﻭﻳﻴﻦﺍ ﮐﺴﺍﻡﻭﻮﮐ
ﺷ.
ﻲ
:ﻪﻨ
ﻠﻣﺭ
ﺩ
ﺘﮏﻮﺳﭘﻪچېﺩ ﺍﺳﻄ Pﻪﻭ egiﭘnterf
erﻳonﺎﺎﻔﻟ
ﻭﻥﺍﺮﻴﻓﺮﺘﻧﺍ
ﻪﺩ ﻨ
ﻠﻣﺭ
ټﻱټﺱﺳﻲﺩ ﻴﭗﺍ ړﻲﻫﺑﻲﻧﺩ
ډﻲ
ﻩ کېﺩځﻥﻧ ﺩﻮ ﻪﻣ ﻮﭘﻴﻧ
ﻭﺍ٢
٤-،چېﺩ٦ ږﻱ
ﻩ کږ ﺮ
ﺮﺳ ﻭﻥۍکېﺗ ﻪﺍﻪﭘﻟﺩېځ ٣ﺭ ﻧېMU ېﻻﺪ
%٥ﭘ٠
،چې ﻪ ږﻱ
ﻮﻝ کږ ﮐﺭﻩﻭﺭﺎ
ﭙﻮﻟﺘﺎﺷﻴ
١ﻣ ﻪﺩ٢ ﻮﺗﻧ
ﺎﻭﻏﺭﺎﺮﻧﻴﻤﻮﺷ .ﻳﻮﻱﻤﺮﮐټﻱټﺱﺧﻄ ﻴﭗﺍ ﻫ
ﻭﺩځﻱ ﺍﺭک ېڅﻪﻭ
ﻳﻦ ﺧ Hﻪﻭ
ﮐ CVRNA،ﻟ ﻪېﻪ ښﺘﻣﻞېﮐﭻ ﺗ ﺭﺎ
ﻪﻧ ﻧ
ﻭﺯﺎ
ﻨﻴﻣﺍﻧﺲ ﺍﺮ
ﻮکېﺗ ﻧﺎ
ﻭﻏﺭﺎﻧ
،
ږﻱﺎﺕېکږ ﻩﭘﺮډﻝﺳ ﻩﻭ ﺭﺍﺪ
ﻣﺍﻭېﻪﺩﻮک ﭘ ﻧﺎ
ﻭﻏﺭﺎ
%٢ﻧ ٥-
١ﻪ٥ ګﻥﭘ
ﺮﻭ ﺒ
.ﻏږﻱﺎﺏﺍﺻﻼﺡکږ ﻬﺘﻟ
ﺭﺍګ
.ږﻱږړ
ﻮﻟﻩﺮﻮﺳ ﻟ
ﻭ ډ
ﺭګ Rﻪﻭ
iﭘ bav i
ri
ګﻥﺩn ﺮﻭ ﺒﺭﺍﻏ
ﻡګﺩ
ﺍﻯﺩﺩ
ﺮېک ﻴﻟڅﻪ
ﺩ ﺧ ﻮﻪﻭﺟ ﻟﻪﺗ
ﺮﻠﻦېﭘ ﻣﺭ
ﻪﺩ ﻟﺮﺱﻳﺍﻮکېﻭ ﻧ
ﺎﻭﻏﺭﺎ
%٢ﻧ ﭘ٠
ټﻱټﺱﻪ ﻴﭗﺍ ړﻲﻫﺑﻲﻧﺩ
Pﻪ
egiﭘnterferﻳonﺎﺎ ﻔﻟ
ﻭﻥﺍﺮﻴﻓﺮﺘ
ﻧﺍ
ﻩکېﺩ ﺩﻮېﻪﻣ
ﺎﺷﺖ ﭘ ﻴ٤ﻣ-ﻪچې٣ ﻮﺗ ﻧ
ﺎﻭﻏﺭﺎﻪﻧﻐﺷ.ﻮﻫ
ﻲﻧ
.ږﻱ
ﻪکږ ﻓﺎﺍﺿ ﻪکې ﻨﻠ
ﻣﺭRﻪﺩ
iﭘ bav i
ri
؛ﻮnﻮﻧﻪﺷ ﺎکﻧ څﻪﭘ
ﺩ ﺧ ﻮﻪﻭﺟ ﻟﺮﺱ ﻳﺍﻪﻫﻢﻭ ﺍﺳﻄﻭ
:
ﺭﺱ ﻮﻭﻍۍﮐ ﺭ
ﺎﻧ
ﺩ
ﻟﻰﺍ
١ﻮ کې٠ ﻧ
ﺎﻭﻏﺭﺎ%٢ﻧ ﻟﻰ٠١ﺍ٥.ږﻱ
ﻪ کږ ﺗ
ﻣﻦځ ﺍ
ﻭﻏﻲﺭ ﺭﺎډﻥۍﻧ ﺭځﻥ ﻮ کېﺩځﻱګ ﻧﺍ
ﺭﻭ%٨ﺭﻥځ ٥
ﻣﺨﺖ ﺮﻪﭘﺗ
ﺍﻮﺎﺧ ﻣﻮﻨﻴﺭﺳﺎHepatﮐ ocel
lular%١ ﻟﻰ٥٧.ﺍ ږﻱ
ﺪږ ﻧ
ﺭګ ﺯﺱڅ ﻭﺮﻴﻪﺳ ﺘﻭﺳ ﺭﮐﻝﻭ٣ﺎ٠
.
ﻮﻱګﮐ
ﺭﺮﻱژﻟﻳ٤ﻭﻳﭗ١ﺎ ﺎﺗ
ﻮ ﻨ
ﻴﻭﺟ ﻪﻭﻱﺍ ﺗﺭﻮ
٤ﮐﻮﭘ
ﻟﺮﻱېﺩ ٠ﺎ ﻤﻪ چېﻋ ﻨ
ﻳﺭﺎ
ﻪﻧ ﻐ
ﻭﻫ ﺎﻥﺍﻭﻏﺭﺎﻪﻧﻨﻳ
ﺭﺎﻧ
.ږﻱ
ﻪکږ ﺗﻣﻦځ ﺍﻪکېﺭ ﺯﺱﭘ ﻭﺮﺒ
ﻓ
43
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
Hepatit
isD
-
٣ ﺩ٥.
ﺮﺱ ﻯ ﻳ
ﺍګﻯRNAﻭ ﻴﻢ ړېﻮﻧ،چ ﻳ ﻳﻲﺍټﻱټﺱﻫﻢﻭ ﻴﭗﺍ ﺍﻫ ټﺱﻪډﻝټ
ټﻱ ﺗ ﻴﭗﺍ ﺩډﻝﻫ
ﺍﻭ
ړټﻦګېﺍﻩﻳ ﺮ.ﺩHBVﺳ ﮐﻻﻯﻧﺸﻲ ﻪﻮ ﺗﻣﻦځ ﺍ
ﻭﻏﻲﺭ ﺭﺎډﻝﻧ
ګﻱ ﻭ ځﻥ ړ
.ﻪ ﺍﺮﻱﭘ ﻟﺮﻩﻗﻄ ﺮ ﺘﻮﻣ ﻧ
ﺎ٣ﻧ٧
ﺷ.
ﺎک ﻲ HBS-ﭘ ﻪچېAg ﻠږﻱﮐﺎکږڅﻪﭘﺩ ﺧ ﻮﻪﻭﺟ ﻟﻪﻭﺧﺖ ﻐ
ﻭﻫ ﺍ ﺮﻱﻟﻳﮏې
ﺭېﻱېﺩ ﺩﻥېﻻﺩﺩﻟږ
.ﺩ ﻲﺮﻱﻧﮏېHDVﻫﻢﻟ ﻭﺩ
ﻟږ
ﻪ HBVﻲ ﻧﻮﻠﻴ١ﻣﺩې٥ ږړۍ کېﻥ ﻪﻥ ﻟﻭﻪټ ﭘ
ﻭﻝﺩږږ
ﻪﻝ ﺍﺳﻄﻪﻭ ﻮﭘﺗﺍ
ﺯﺍ
ﺮﻓﺍ
ﻳﺖﺩ ﻮﻭﺩﻋﻀ ﻮﺍﺗ
ﻮﻻﻣﺤﺼ ﻳﻦېﺩ ﻭ،ﺩ،ﻳﻦﻭﻌﻦېﺩ ﺩ.ﻳ
ﺎﻥ ﻱ Hﻪﺷ BVﭘ
.ږﻱ
کږ
ټﻝ
ﻮ ﻭ ﻭﻱﺧ ﺭﺎﻣﻞﮐﺭﻩﺩﻧړ
ﻭﺭېﺎ ﺩګﻪﻻ
،چېﺭ ﻟ ږﻱ
ﺪﻝکږ ﻴﻟﻮکې ﮑﻠ
ﻮﺧ ﻐﻪﻫ ﻩﭘﺮﺗ
ﺎﻳﭘﻲښېﻱېﺯ
ﺷ.
ﮐﻻﻯ ﻲ ﻪﻮ ﺘﺍﺧ ﻧېﻭﻱﺮﻻﺪ ﺩړﺧﻄHﻮ
ګﻱچېﺩ BVﻟ ﻪﻭړ ﻐﻫ
ﺮڅﻪﺗ
ټﻱټﺱ ﺧ ﻴﭗﺍ ړﻲ ﻫ
ﺑﻲﻧ ﻭﻥې ﺩ ﺪﻧﺭګﻴﮏې څ ﻨ
ﻴﻠ.ﮐ ۍﻩ
ﻭﻥ ﺩ ٧ﺍ -ﻩ ﻱې ٣ ﺭﻭ ﻳﺦ ﺩ ﺮﻔﺗ
ﺩ
ﻭﺮﻱﺍﻟﻪﻧ
ګﻞېﻭﺍﻯﺷﻲ ﻳ ﺩﺩﻭﻏﻲک ﺭ
ﺎﺪڼۍﻧ ﻧ.ځﺮﻱﻟ ﺮ
ﻴﺭېﺳ ﻮ Fulﭘmi nantHepat icFai lure
ړﻪکﺗﻣﻦځ ﺍ
ﺎﺭﻣﻮﻨ
ﻴﺭﺳﺎﺎﺕککﮐ ﭙﻴﻭﻫ ﺯﺍﻭﺮﻴﺭﺳﺍﻯﺷﻲژ ﺩﺩ.ک ﻭﺳﻲ ﻧﮏېﺍ ﻭﺩږږډﻝﻝډﻲ ﻭ ﻪځﻥﻧ ﭘ
.ﻱ
ﺎ Superﻭﻳﻩﺍ ﺮ
Co-ﺩ HBVﺳ i
nfecti
on. ﻮﻱﻪﮐ ﺗﻣﻦځﺍﻮﺡېﺭ ﻴﮏېﻟ ﻨ
ﻴﻠ
ﻩﮐ ﻭﺎﻥﺩ ﺘﻧ
ﺑړﻰﺍﻲﻧ
.
ﺪې ﻧﺎ
ټﻱټﺱﺑﻲﺑ ﻴﭗﺍ ډﻲﻫiﺮځﻥﻧ nfﭘ ection
ډﻝ
ﺰﻭ ﻳﺩﻭﻪﺩ،چېﭘ ږﻱ
ﻪ کږ ﺗ
ﻣﻦځ ﺍ
ټﻱټﺱﺭ ﻴﭗﺍ ﺑړﻰﻫﺭﺕ کې ﻲﻧ ﻮﻪﺻ Co-ﭘ inf ectiﺩon
ﻮکېچې ﮑﻠﻮﺧ ﻐ
ﻪﻫ ﻳﻲﭘﻲښېﭘ ﺎﻔ
ﻡﮐ ﺪړﻲﻋﺑﻲﻧﺭﺩ .ﺩځﻱګ ﺮﻱړﻪﻟﻨ
%٢ﻡﻳ ﻟﻰ٠ﻭ٢ﺍ ﺪﻭﻱﺍ ﻳﺪﺷ
ډﻪځﻥ ﺍﻥﭘﺭ
ﻭ%٥Co-ﺭﻥځ i
nfect i
ﺩ.ﺩonﻮﻯ ﻯ ړﻝﺷ ﺭکﺭﻭﻮﭘ ﺍ
ﺎﺕﺭ ﻳﻭﻱﺯ ﺭﺎ
ﻣﻞﮐﺭﺪﻱﺩ ﻳﺭ
ﻩﻭ ﻧړ
ﻭﺎ
.ږﻱ
ﺪﻝږ ټﻱټﺱﺑﻲﺑ ﻴﭗﺍ ﻧﻲﻫ
ډﻪچېځﻥ ﻠ
.ﮐﺮﻱﻣﻼﻥﻟﻪﻴ ﺗﺍ
ﻮټﻱټﺱډﻱﺧ ﻴﭗﺍ ډﻲﻫ %٨ځﻥﻧ ﻟﻰ٠٧ﺍ٠Superi nf ect i
ﻮon ﺧ
.ږﻱ
ﺪﮐﻢږ ﻳﺪټﻱټﺱﺷ ﻴﭗﺍ ﺭﺱﺩﻫ ﻮﻴﮏېﮐ ﻨ
ﻴﻠ؛ﻮﮐ
ﻮﻧ ﻪﺷ ﺗ
ﻣﻦځ ﺍﺎﻥﺭ ﺘ
ﻧﺍﻧﻰ
ﺩې
ﺎﺭ ﻣﻮﻨ
ﻴﺭﺳﺎﻴﻞﮐﺎﺕککﺳ ﭙﻴﺮﺩﻫ ﻱﻭﺧﻄټﻱټﺱډ ﺍ ﻴﭗﺍ ډﻲﻫ %ﻪځﻥﻧ٨ﭘ ﻟﻰ٠٦ﺍ ﺯﺱ٠ ﻭﺮﻴﺳ
.ږﻱ
ﺎﺕږ ﻳﻩﺯﺪﻨﭼ
I
gM ant i.ږﻱﻟﻲ کږﺍﻮﺘ
ﻪﺷ Iﭘ gM ant iHBe، IgM ant idel t
ډﻝﺩa ﺰﻭ ﻳﺩ
ﻭﻪﺩ ﻴ ﺺﭘ ﺗﺸﺨ
ﺎﺕېﺭېﭘﻮﻮﭘﻴﻧﻭﺍ١ﺗ٢
،چېﺮ ږﻱﻩکږ ﺭﺎﮐﻪکې ښ ﻨ
ﻳﻪﻭ ﻪﭘﺘﻭﺳ ﺭﻭﻥۍﻭ ﺍﻩ
ﻮ ﺍﻳ
ﺩﺩﺘﻦک ﻨdﺮﻣ elﺗta
ﻭ.
ﻔﻲ ﻱ ﻨHﻭHBVDNAﻣ Be-ﺍ ﻮAg ﻧﺎﻭﻏﺭﺎ
ﺩېﻧډﻝ ﺩﺰﻭ ﻳ
ﺩﻭ .ﻪﺩږﻱﭘ کږ
ﺩ.
ﻧﮏې ﻱ ﻭﺩ
ﻭﻨﻲ ښ ﻳﺯﺍ
ﻮﺩﻭﻳﺘﻦکﺩ ﻨﻣﻟﻰﺩ ﺍ
ﻭﻟړ
AﻭALTﻮ ﺩ STﺍ
44
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
Hepat
it
isE
ﺮﻱ
ﻟﻟﻰ
ﺍ
ﻪﻭﺗ
ﺭﻩﻭ
ﺮCalﺳ
i
civ
irﺮﺱﺩﻯچېﺩus
ﻳﺍ
ﻨﻰRNAﻭﻮﭼﻻﻞﮐ
ټﻱټﺱ ﻣ
ﻴﭗﺍ
ډﻝﻫ
ﺩې ﻭ
ﺩ
ﺩ.
ﻩﻯ ﺮﺘ
ﻣﻮﻧ
ﺎﻧ
٣ﺗ٢
٢څﻪﺮ
ﺮﻱېﺩ ٤ﺧﻭﻗﻄﺍ
:
ﻮﺟﻲ
ﻟﻮﻤ
ﻳﺪﻴ
ﭘﺍ
ﻮﺟﻲﻱې ښ
ﻟﻮﻤﻳ
ﺪﻴﭘ
.ﺍږﻱ
ﺩږﺎﻡﻫﻢﻳﻮټﺱﻪﻧ
ټﻱ ﭘ ﻴﭗﺍWatﻫerborټﻱټﺱﺩnﻴﭗﺍﺩډﻝﻫ
ﺍﻭ
،
ﺎﻥﺘ
ﻭﺳﺪ
ﻨ،ﻫ
ﺎﻥﺘ
ﻧﺴﺎﻐ
ﻓﻪﺍﮑﻮ کېﻟﻧ
ﻭﺩﺍ
ﻮﻴﻭﻫﻪڅړۍﭘ
ﻤﻲﻱېﺩﻥﻳﺪﻴﭘ
ﻮﺍ؛ﺧﻩ
ﺷېﻪﺩ
ﻳﺢ ﻮ ﻧﺮ
ﻩﺗﺸ
.ﺷﺩﻩ
ﺪﻝ ﻮﺩ ﻴ
ﻟﺍﻕکې ﺮ
ﻭﻋ ﺍﺍﻥ
ﺩﻮېﻪﺳ
ﻮک ﭘﻴ
ﺘﻭﺳ
ﺭﻪﺩېﻭ ﻭﭘ
ﺍﻮﮑﻴ
ﮑﺴ،ﻣ
ﺎ
ﻳﺮﻴ
ﻟﺠﺍ
،ﺎ
ﻣﺮﺑ
ﻊ
ﺒﻨﺎﻥﻣﺘ
ﻧﺍ
ﺩ.ﺩ
ﺎﺕ ﻯ
ﻳﻪﺅکېﺯ ﻨ
ﻳﺭ
ﺎډﻝﻧ
ګﻱ ﻭ
ځﻥ ړ
ﻪﺍېﻭﭘ
ﻮک ﺍﻧ
ﺎﻧ
ﺍﻭ
ﻪځ ﻩﭘ
ﺮﺗﺎ
ﻳﻮﻉﺯﻴﻭﻍۍﺷﺭﺎ
ﻧﺩ
ﺭ
ﻪﻻ ﻟ
ﺭﻝﻭﺍﮑﻞﻴ
ﻓﻪﺩ
ﺎﻥﺗﻧﺴ
ﺍڅﻪﺑﻞ
ﺎﻥ ﺧﻧﺴ
ﺍﻮﻪﻳﻟ
ﺍﻯﺷﻲﺩ
ﺩﻩک
ﺭﻥګﺍﺪﻤ
ﻭﻫﺍﻪﺩﻱﺑﻭﺍ
ﺷېړې ﻮ
ﮐﮏ
.ږﻱ
ﺩږږږ
ېﻫﻢﻭﻝ
ﺷ.
ﺩﻻﻯ ﻲ
ږﻭ
ږﻭﺱﻝ
ﺮﻳﺎﻥﻫﻢﻭ
ﻴﻟ
ﻮﻭﻧ
ﺍګﻥ
ﻮﺍ،ﺧ
ﺎﻥﻴ
ﭙﻭکېﺳ
%٣ﭘﻲښ
ﭘ٠ﻩﻪ
ﺭﻥګ
ﺍﺪﻤ
ﻫ
ﺭېﺭ
ﻪچ.ﮐږﻱ
ﺩږږ
ږﻪﻭﻝﺍﺳﻄ
ﻪﻭﻮﭘ
ﮑ ﻳ
ړﻨﺴﻲﺍﺎﺩﺟ
ﻮﻳﺗ
ﺎﻴ
ﻗﺭﺯ
ﻭﻏﻲﺩ
ﺭﺎﻪچېﻧﺘ
ﻭﻥېﻧﺸ ﺪﻧ
ﺭګﺍﺱېڅ ﺩ
ﺭ(چېڅ%٢٠
-١
٠ﻩﻭﻱ)
ﻟړ
ﻭﻯکېﻮ ﻪﺩﻪﭘﺩړﻦېﮐﭽ
؛ﻮ ﻡﻳ
ړﻱﻧﻪک
ﺘﺍﺧ ښﻩ
ﻩ ځ ﺭ
ﺍﻭﺪﻴ
ﻣﺍﺎﻥﺘ
ﻧﺍﺑړﻰ
ﻲﻧ
ﺩ.
ﻪﻯﻡﻧﻮﻠ
ﻌﻴﻞﻱېﻣ ﻟ
ﺪﺩﻧ
ګ
:
ﻩﻴﮏېﺏڼ
ﻨﻴﻠ
ﮐ
.
ﺮﻱﻟ
ﻟﻰﺍ
ﻪﻭﺗ
ﺭټﺱAﻪﻭ
ﺗ ټﻱ
ﻴﭗﺍ
ﻴﮏﻱېﻫ
ﻨﻴﻠ
،ﮐﻩ
٤ﺭځېﺩ
٠ﻭ-٢
ﻩﻱې٨
ﺭﻭﻳﺦﺩ
ﺮﻔﺗ
ﺩ
ﺩ.ﺩ
ګﻞې ﻱ
ﻩﻳ ﺭ
ﻮﻭﻍﻏ ﺭ
ﺎﻪﺩﻧﺒ
ﻭﺗﺩﺍﺭﻱېﺩ
،ﺩګ ډ
،ﺎﻥګ،ﮐ
ﻟﻰﺍ
ﻭﺪﻩﺑړ
،ﺯﻟﻰ
ﺍﻮﺑ
ﺍﺮ
ﺎﺧ ﻬ
ﺘﺍﺷ
،ﺩﺎ
ﻴﺘ
ﻧﺎ
ﻣﻮﺘ
ﺳ
%٣-
٠،
ﻪ٥ﻳ
ﺎﻔ
ﻡﮐ ﺪﺭﻋFulﺩځﻱګminant.
ږﻱ
ﺪږ ﻧ
ﺭګړﻯڅﻪژﻱ ﺘ
ﻭﺳﺭېﻪﺩېﻭﻟﻰچ ﻟﺍ
ﻭﺭﻍټځﻱګ
ﺷ.
ﺪﻻﻯ ﻲ ﻴ
ﻪﺭﺳ ﮐﭽﺍ
ﺭېﺩﻮ%٢ﭘﺗ٥
ﺭکېﺮ ﻤﺲټ ﻳﺍ
ﺮﻳﻢﺗ
ۍﻪﺩﺭ
ﺭﭘ ﺍﻭﺪﻴ
ﻣﺍﻮﺩ،ﺧږﻱږ
کېﭖښښ
ﻪ
ﻐﻮﻫ،ﺧ
ږﻱ
ﻪ کږ
ﻻﻞﻧ
ﺮﻣﻧﺴﺎ
ﻭﮐﺯﺱﺍﻭ
ﺮﻴ،ﺳټﻱټﺱ
ﻴﭗﺍډﻲﻫ ﺮﺱﺩځﻥﻧﻳﺍ
ټﻱټﺱEﻭ ﻴﭗﺍ ﻫ
ﺭ
ﺍﻯﺷﻲﺩځﻱګﺩ
ﺩﺮﻱک
ﻟځﻯﻭ
ﻮﺍﻩﻳ
ﺮﺎﻥﺳﺘ
ﻧﺑړﻲHEVﺍ
ﻪ ﻲﻧﻭﻏﻲﻟﺭ
ﺎﻪﻧ
ﻠﺭﺑ
ﺍﻥچېﺩځﻱګ ﺭ
ﻭﺭﻥځ
.ړﻱﻪک ﺗ
ﻣﻦځﺍ
Decompensatﺭi
on
:
ﻴﺺﺗﺸﺨ
ﻩځ
ﻪﻣﻦځ
ﻟﻪﺘ
ﻭﺳﺭ
ﺎﺷﺖېﻭ
ﻴ٦ﻣ-
،چې٤ږﻱ
ﺪﻝکږﻴﻟI
gM ant
iﻭکېHEV ﺍ
ړﻪﭖﺎﻥﭘ
ﺘﻧ
ﺍړﻲ
ﺑﻲﻧ
ﺩ
.
ﺮﻱﻟ
ﻮﻥﺘ
ﻣﻦځﺷﺮ
ﻭﻥۍﺗﺍﺗﻢې
ﺍﻭﺍ
ړۍﻡ
ﻮﻟﻭکېﺩ %٩ﭘﻲښﭘ٠
ﺎﻥ ﻪ
ﺘﻧ
ﺍړﻲ
ﺑﻲﻧ
ېﺍﺩ
،چ ﺩ
ﻱ
ﻳﻦې
ﺎﻌﻭﻣ
ﺯﺎﻴ
ﺘډﻮﻣ
ﻩﺩ ﮐ
ﺭﻥګ
ﺍﺪﻤ
.ﻫږﻱ
ﺪږﻧ
ﺭګConvکېڅul
santst
Iﺩageډﻝ gM
ﺰﻭﻳﺩ
ﻭﻪﺩ
ﭘ
ﺩ.
ﻮﻯ ﻯ
ړﻝﺷﺭکﺭﻭ
ﻮﭘﺍ
ﻮﻥﺭﺘ
Iﺩﺷﻪﻫﻢﺩ gM
ﺍﺳﻄPﻪﻭ
ﻭﺩ CRﭘﺍ
:
ﻭﻝﺮ
ﺘﻨﻭﮐ
ﺍﻮﻯ
ﻴﻨﻣﺨ
ﻭﻪﺍ
ﻨﺗﺎ
ﺎﺳﻴﺘ
ﻭﻏﺎﻝﺭ
ﻳﺮﻴﭘﺎ
،ﺩﭼ
ﻪﻧ
ﻭﺮﺑ
ﺍﺮ
ﻮﺑﺑﻭ
ﻮﺍﮐﺎ
ﭘﺩ؛ﻮﺩ
ﻪ ﻱﻧﺑ
ﻭټﺭﺍ
ﻬﻢﻭک ﻭﻭﻍۍﻣﺭﺎ
ﻧﻩچېﺩڅﻥګ
ﺭ
ټﻱ
ﻴﭗﺍ ﻩﺩﻫﺮ
ﻮﺳ ﻟ
ﻮﻴﻡکېﻧﺎ
ﻪﭘﻮﭘﻧﻭ
ﺮﻴﺑ
ﺪﻪﺗ
ﺗﺭﻮﭘ
.ﺩﻪﻭﺷﻲﻧﺮ
ﻠﻣﺎ
ړېﭘځﻥګ
ېﻪ ﺍ
ﻟﺼﺢ ﺗﺍﻔﻆ
ﻪﺣﻣﺎﻋ
.ﺮﻱﻟﻪ
ﻴﻦﻧﻟ
ﻮﺑﻮ
ﻟﻮګﻤ
ﻳﺍﻭ
ﺍﻴﻦﮐﺴﺍ،ﻭ
ﻮﻱﮐﻢېﺷ
ﺍټﺱEﻲښېﺭ
ﭘ
:
ﻪﻨ
ﻠﻣ
ﺭﺩ
ﻩچ
.څﻥګ
ږﻱ ﺭ
ﻩکږ
ﺮﺮﺳ
ﻪﺗﻨ
ﻠﻣ
ﺭﺮﺿﻲﺩ
ﺎﻥﻋ
ټﺱAﻪﺷ
ﭘ ټﻱ
ﻴﭗﺍ
.ﻫﻪ
ﺘﻪﻧﺸ
ﻨﻠ
ﻣﺭړېﺩ
ځﻥګ
ﻪﺍﻣ
ﻮﮐ
45
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
.
ﻪﺘړﺎﻧﺸ
ﻴﺗﺍﺗ
ﻠﻦېﻪ
ﻣﺭﺪﺩ
ﺮﺱ ﺿ
ﻳﺍ
؛ﻮﺩﻭ
ﻮﻱﻧګﻪﮐ
ﻣﺨﺖ ﻧ
ﺮﻪﭘ
ﺗﺍ
ﻮډﻲﺧ
ﻭﻏﻲځﻥﻧ
ﺭﺎېﻧ
46
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﺍ
ﺰﻧ
ﻮﻠ
ﻔﻧ
ﺍ
ﻭ
ﺍﺩﺭ
ﻠﯽﺩ
،ﻋﻀ
ﺯﯼﺮ
،ﻟﺒﯽﭘﯽﺗﺍ
ﻧڅ
ﻩ ﭼﯽﺩﺎ ﻭﻍۍﺩﺭﺎ
ﻭﺳﯽﻧﺮﯾ
ﻩﻭ ﻮ
ﺍﯾﺰﻧ
ﻮﻠ
ﻔﯾﻒﺍ
ﻧ ﺮ
ﻌﺗ :
.ﮐځﯼ
ﻻﻞ ﺮ
Rhiﻣ
nit
iﻭsﺍﺩﺭ
ﻧﯽﺩﻮﺘ
،ﺳﻭﺧﯽﻪټﮑﻟ
ﻮﺍﺿﺮ
ﺍﻋﻔﺴﯽﻨ
ﺗ
ﻣ:
ﻭﻍۍﻻﻞ
ﺭﺎﻧ
ﻪ
ﻟﺭﺕﺎ
ﺒﻮﯼﭼﯽﻋ
ﺪﻝﺷ ﻧﭘژ
ﻪﯾﯽ ﯽﻟﻭﺭﯼډ
ﻭﺱﺩﯼﺩﺮﯾ
ﻣﻞﻭﺍﻭﻍۍ
ﺭﺎﻧ
ﮐځ
ﺒﺐ ﺮ
ﻭﻍۍﺳ
ﺭﺎﻧ
ګﻮﮐﯽﺩ
ﻧ
ﻮﺍﻭﺧﺍ
ﻮﻧﺎ
ﺮﻏﻮﻣﻧ
ﺎﻧ
ﺎﻧﺴ
ﺍﻪډﻝﯾﯽﭘ
ﻪﻭ:ﺩﻏ
Type-
A.1
.
ﯼ
.
ﮐځﯼ
ﺒﺐ ﺮ
ﻭﻍۍﺳ
ﺭﺎﻧ
ﻮﮐﯽﺩ
ﻧﺎﻧ
ﺎﻧﺴ
ﺍﺍځﯼ
ﻮ:ﯾ
Type-
B.2
.
ﺭځﯼ
ﺒﺐ ګ
ﻭﻍۍﺳ
ﺭﺎﻧ
ګﻮﮐﯽﺩ
ﻧﺮﺍﻭﭼ
ﺍﻮﻧ
ﺎﻧ
ﺎﻧﺴ
ﺍ:ﻪ
Tyﭘ
pe-
C.3
ﻩړﺭﯼﺍﻮﺭﻥۍﭘﻮOﻪﮐrﭘ thomy xov i
ri
ﻡﭼﯽﺩdea ﻮﻭﺱﺩﯼﮐ ﺮﯾﺍ
ﻮRNAﻭ ﻭﺱﯾ ﺮﯾﺍﻭﺰﻧﻮﻔ
ﻧﺍﺩ
.
2n1H, 2N3H.ﻪ1N1H ﮑﻟﻮﯼﺪﻝﺷ ﻧﭘژ
Stﯽrai
ﻭns ﺩAﻮڅ
ﺍ ﯾ ﺰﻧ
ﻮﻠﻔﻧ
ﺍ.ﺩﺮﯼﻟ
ﺮﯿﻐﺗ
ﺍﻮﯼﭼﯽﺩ ﮐ
ﺭﺮﻭ ﯿﻐ
ﻪﺗ ﻮﺗﺍﺻﻮﺘﮏﺧ ﯿ
ﻨﺘﯽﺟ ﻧﭙﻞﺍﺭﺧژﺮﯾ
A,ډ ﻨﯽB ﻌﻪﯾﻧﻮﻟ
ﻭﻩډﺩړ
ﺍ
ﺍﻭ ﺰ
ﻧﻮﻠﻔ
ﻧﺍﺩ
.ﻮﯼ ﻟ
ﺪﺑ
ﻭPandemiﭘﯽښ ﻭcﺍﯿﮏ ﻣﺪﯿﭘ
ﺍﯼﻪ
ﯾﮏﭘﯽښ ﭘ ﺩ
ﺍﺭﻮ
ﭙﺍﺳ ﺰ
ﻧﻮﻠﻔ
ﻧﺍﺩ
(ﯿﻦ Mﺗﻭﺮﻭﭘ(ﺍﯿﻦ)NP ﺗ
ﻭﺮﭘﻮﯿ
ﻠﮐﻮ
ﺩﻧ ﺎ
ﯿﻨﻪﺑﺗﯽ ﺟﻦﭘ ﺍ
ﻪﺩ ﻧﻮﺮﺳﯾA,ﻭB,ﻩC ﺮﻪﻧﻈړښﺕﻟ ﻮﺩﺟ
()H(ﻭﺱﺩ Hem ﺮﯾ
ﺍ Aﻭ ﺰﻧﻮﻠ
ﻔﻧ
ﺍﺮﺩﯼﺩ ﻩﭘﺮﯿﺮﺳﻮﯼﺩﯼﺑ ﻩﺷ ﻪ ﻥښ ﻩﭘﺮ) ﺳ (
mat ri)x
ﺩ.
ﻮﯼ ﯼ ﺪﯼﺷ ﻨﺒ
ﻟﻮډﻧﻮﭘ
ﻭﺭﺮﻋﯽګ (ﻪﻓﯿﻦ)NPﭘ ﺗﻭﺮﭘ
ﻮﯿﻠﮑ
ﯿﻧﻭ
ﺍagglutini)n
ﺎﻥﻪﺷ ﻪﺩ Aﭘ ﮑﻪﻟﻧﻮﻨ
ﯿﺘﯽ ﺟﻧﺮﻋﯽﺍﻻﻦﻓﻪﺩﯼ ﮐ ﺗ
ﺭﻩﻭ ﺮ
ړښﺕ ﺳ ﻮﻮﺟ ﻧﻮﺮﺳﯾﯾﭗﻭﺍﻭ Cټ ﺩBﺍ
ﻪﺪﯼﭘ ﻧ
ﺍړﻪﻭﻭﺱﭘ ﺮ
ﯾﺍﻭﺰﻧﻮﻠ
ﻔﻧ
ﺍﻧﯽﺩﺍډﯼګ ﺎﺘﯽﺑﻧﺑﻞﮐﯽﺍ ﺎﻘ
ﻪﻣ ﺘﯽﺟﻦﭘ ﻧ
ﺩ.ﺍ Hﺍ
ﻪ ﯼﺩ ﻔﯽﻧ ﻭﺻ
ﻭﺱ ﺮﯾﻭ
ﺍﺩ ﺰ
ﻧﻮﻠ
ﻔﻧ
ﺍﺩﺑﻞﮐﯽﺩ ﺎ
ﻘﻪﻣﺘﯽﺟﻦﭘ ﻧ
ﺍﺣﻝﮐﯽﭼﯽﺩN ﺍﺳﯽ ﺎﻪﺩ ﺮﯼﭘﻟﻭﻝﻩﺭﺪﻤﯿﺖﮐﯽﻋ ﻔﻌﻣ
Strai
ځﯽnsNonhumaniﺩﻧ nfl
ﺎﻥﺩuenza ﻧﺴﺮﯼﭼﯽﺍ ﻟ
ﺎﻥﮑﻣﺍﻫﻢﺍﻩﻭﯼﺩ ﺩ
ﻭﺪﻪﻣﺤ ﻧﺪﯾﺮ
ﭙﺧ
.
ﻮﻧﺴﻞ ﻧ
ﺎﺮﻏګﻭﻣ
ﻮﺍ ﻪﺩﺧ ﮑﻟﺘﻦﺷﯽ ﻨ
ﻪﻣ ﺍﺳﻄﻪﻭ ﭘ
:
ﻮﺟﯽ
ﻟﺎ
ﯿﻣﺪ
ﯿﭘﺍ
ﻭﻍۍﺭﺎړﯼﻧ ﻮﻣﻮﻧﻮﯼﺩ ﻪﮐﻣﻦځﺗ ﺍﻤﯽﭘﯽښﯼﺭ ﯾﺪﯿﭘﺍ
ﻪﺩﻪﮐﭽ ﻟﺍ
ړﻮ
ﻪﻥﯾ ﺎﻝﭘ ﮐ
ﺮﻭﻍۍﻫ ﺭﺎړﯼﻧﻮﻣﻮﻧ
ﻭﻝﺭﻭﮐﻦټ ﻮﯼﺍ ﯿﻨﻣﺨﻧﯽﺩﺍﺍګﻭ
ﺪﺩ ﻭﺱ ﺿ ﺮ
ﯾﻭﺮڅﻥګﺩ ﺗ
ﻭﻪﺍﺘﻪﺷﻧﻮﻨ
ﯿﮐﺴﺍﻣﻦﻭ ﺰﯿﻩﺍﻏﺭﺎﭙﻟﻮﯼﯿﻨ
ﻣﺨ ﺩ
.ږﻟﯽﺎﻤﻌﺘﺍﺳﻪﻮﺧﻪﻣ ﭘ
ﻮﯼځﻪﮐ
ﻣﻦ ﺗ ﻭﻍۍﺍ ﺭﺎ
ﻧﻭړﯽښﯼﺍ ﻡﻭﭘ ﺎ
ﭘﻪﺩ ﻧ
ﻮﯿﻠ
۵ﻣ ،
ﻪ۳ ﻪﮐﭽﻟﺍ
ړﻮ
ﻪﻥﯾ ﺎﻝﭘ ﮐ
ﺮ ﺎﺕﻫ ﻧﺎﺘﻧ
ﺍﺍﺰﻧ
ﻮﻠﻔﻧﺍ
ﺩ
ﻮﻥﮐﯽ ﺘﻭﻏﻪﺭ ۲ﭘﯽښﯼﯾﯽﭘ ،
۲۶ ۰۰۰ﻭﻮﯼﺍ ﮐﺭ
ړﻪﻭ ﻨ
ﺭﯼﻡﯾ ﻮ۵۰ﺑ
۰۰۰ﺗ۰
۲ﻪﺮ،ﻧ ۵۰۰
۰ډﻝ۰ﺍﻭﺪﻤﻭﻫﺍ
ﻮﭼﯽ ﻔﯾﺮﻌﺍﺳﯽﺗ ﻤﯽﺩ ﯾﺪﻧ
ﺎﺍﭘﺰﻧﻮﻠ
ﻔﻧﺍﺩ
ﻭ ﺮﯼﺍﯿﮏﭘﯽښﯼ ﻫﻢﻟ ﻣﺪﻧ
ﺎﻭﻏﯽﭘ ﺭﺎ
ﻨﯾړﻮﻣﻮﮐږﯼﻧﺮ ﯽ ﺘﺑﺴ
ﻭﺍﻭﻝﺷﯽ ﺩ ږﻟﯽﻩﻭﺮﮐﯽﺳ ﻪچټ ﻪﭘ څﻪﺑﻞﮐﺲﺗ ﮐﺲ ﺧ ﻮﯾ
ﻭﺩ ﺍ
ﻩﺷﯽ ﺮﭙﻪﺧ ﻪﮐﭽ ﻟﻮﯾړۍﻪﻥﻭﻍ ﭘ ﺭﺎ
ﻧ
.ﺮﯼﻟﻪﻧﯿﺖﻭ ﻓﺎ
ﻌﺎﻫﯽڅﻣ ﺮﮐﻢﯾ ﯾ
ﺪﯼډ ﻧ
ﺍړAﻪﻭ
-ﭘ subtyﻮﯼpe ﻧﺍﺩﺰﻧ
ﻮ ﻠﻔ
ﻧﺍﺎﻥﺩ ﻪﮐﺴ ﺩﻏ
ﻪﻠ
ﺒﻪﮐﻮﯼﻭﯼﭼﯽﻟ ځﻪﺷﻣﻦ ﺗﺍﯿﮏﭘﯽښﯼﺭ ﻣﺪ
ﻧﺎﺍﭘﺰ
ﻧﻮﻠ
ﻔﻧﺍ
ﻩﮐﯽﭼﯽﺩ ﺩﻮﻪﻣ ﻮﭘ ﻧﻮﻟ
ﺎ۱ﮐ۹۱۹-
۱۹۴۳ﺩ
ﻩﮐﯽﺩﻮﻪﻣ ﻮﭘ ﻧﻮ۲ﮐ۰۰
۹-۲
۰۱۰
ﻩﺩﺭﻥګ ﺍﺪﻤﻭﻫﻩﺍړﯼﻭځﻪک ﻣﻦ ﺗﺍ
ړﻪﯾﯽﺭﻨﻮﻡﯾ ﻧ
ﺎﻧ
ﺎﻧﺴ ﻪﺍﻧﻮﯿﻠ
ﯿ۲ﻣ۱ﯾﯽﺩ
ﻭ.
ﻪړﻟﺍړﻪﻭﻨ
ﻪﯾﯽﻡﯾ ﻮﺗﻧ
ﺎ۱ﮐﺴ۴۵۰ﻪﯾﯽ۰ ﻠﺒﻪﮐﻟﻩﭼﯽ ﻮځﻪﺷ
ﻣﻦ ﺗ ﺍ
ﻤﯽﺭ ﯾﺪ
ﻧﺎﭘ
ﻮﻪﯾ ﺍﺳﻄ ۰ﻪﻭ۹ﭘ /
۱N۱H
47
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﻩﺭﺎ
ﻪﺣ ﻮﭘ
ﺗﯽﻭﯼﺧ ﺎﯾ
ﻭﻍۍﭘﯽښﯼﺯ ﺭ
ﺎﻧ
ﻡﮐﯽﺩ ﻮﻮﺳﻪﻣﻣﯽ ﭘژﺂﺩﻮﺻ ﻮﮐﯽﺧﺼ ﻤﯿﻭﺳ ړﻪﺱ ﭘ
ږﺗﯽﺎ
ﯾﻪﯾﯽﭘﯽښﯼﺯﻟﻩځﻭﺎﺩ
ﻮﯾﺩﻭﯼﭼﯽﯾﻮﻮﺟﺍږﻭﮐﯽﻣ
ﻪﻭﺩ ﺎﻝﭘ ﮐ
ﻭﺱﺩ ﺮﯾړﯼﻭﻮﻣ
ﻮﻮﮐﯽﻧ ﻤﯿ
ﺳ
ﺭﯼﻮﻮﺳﻢﭘﻪﻣﯼځﯽﻭﺧﺖﭘ
ﯿﮏﭘﯽښ ﻧﻣﺪﻧﺎ
ﻭﺱﭘ ﺭ
ړﯼﻭﻮﻣﻮﻧ
ﻧﯽﻭﯼﺩ ﺍ
ﺭﺎ
ﻮﺳﻢﺑﺂﭼﯽﻣ ﻮﺻﯼﺧﺼ
ﻪﮐﺪﻏﻤﻪﻫﯿﺐﯾﯽﭘﻘ
ﻌﻪﺗﻩﭼﯽﭘﻮﺪﻝﺷﯿ
ﻟﻤﯽﻭﯾ
ﺪﻧﺎ
ﻩﭘﻮﻭﻉﮐﯽﯾ ﺮ
ﻪﺷ ﮐﻝﭘ۲ﺎ۰۰
۹ﻪﺩﮑﺮﯼﻟﻩﻪﻟ
ړﻧﺍ
.
ﻩﻮﺪﻝﺷﯿﻟ
ﻤﯽﻫﻢﻭ ﯾ
ﺪﻧﺎ
ﻪﭘﻠﻩﺑﻮﺎﺷﺖﮐﯽﯾﯿﻪﻣﭘﺮ
ﺑﻮﺘﮐ
ﺍﺎﻝﺩ
:
ﯿﺖﻓ
ﺎﻌﻭﻣ
ﺍﺰﺱ
ﻨﻮﺟ
ﺘﭘ
ﯿﺴﯽﭼﯽ ﺭﺕﻧ ﻮﻪﺻ ﺍﺳﻄﻪﻭ ﭘ
ﻮﺗﺍ
ﺯﺍ
ﺮ ﻓﺘﻦﺍﻨﻣﻪﮐﺲﺩ ﺘﺍﺧ ﻪﺩ ﻧ
ﺪﯾﺩﻟږ
ﻭﺱ ﯽ ﺮﯾﺍ
ﺍﻭﺰﻧﻮﻠ
ﻔﻧ
ﺍﮑﻞﺩﺩﺷ ﺎ
ﻪﺣ ﭘ
ﺩﻟږ
ﻮﯽ ﻧ
ﻮﺮﺳ ﯾ
ﺍﻭﻩﻫﻢﺩ ﻪڅﮐږﯼﮐﺘﻦ ﯽ ﻨﯿﻞﻣﻠﯿﺘﭘ
ﻔﺴﯽﺍ ﻨﻪﺗﺍﺳﻄ ﻪﻭﻭﺱﭘ ﺮﯾ
ﺍﻭﻭﮐﯽﺩ ﺍ
ړړﯼﭖ ﻡﻮﻟ ﻪ
ﭘ
ﻟږﯾﯽ
ﻩﯽ ﺮﺗﺎﯾ
ﺯﻮﺩږﯼﺧﻭږﯼﻪﻝ ﺍﺳﻄ ﻪﻭﭘﻭﺎﻥګ ﮐﻪﮐﺲﺩ ﺘﺍﺧﺘﯽﺩ ﻟﯽﺣﺍﻭړﮐﮏﻮﺩ ﻧ
ﻮﺍﯼﺷﯽﺩﻻﺳ ﺪ ﯿ
ﮐ
ﻩﺮﺗ
ﺎﯾ
ﺎﻥﺯﺘﻧﺭځﯼﭼﯽﺍځﻪﺍﻪﻣﻦ ﺗ ﺍﺳﻄ ﻪﻭ ﻭﻋﻄﺴﯽﭘ ﻭﺧﯽﺍ ﻪﭼﯽﺩټ ﺍﺳﻄAﻪﻭ erﭘﺩﯾﯽﺩosol
ﻮﯼﻧﺍ
ﻮﺘړﯼﮐﯽﺍﺳ ﻡﻮﻪﻟﺎﻥﭘﺘﻧ
ﻭﺳﯽﺍ ﺮﯾ
ﺩږﯼﻭ ﻟږﯼﺎﺕ ﯽ ﯾﻪﺯ ﺍﺳﻄﻪﻭ ﻮﭘﺗﺍ
ﺭﻮﺫ ﯿﻨ
ﻮﭼﮐAerﺩﺩosol
،
ﺍﺕﺮﻮﺣﺠ ﺎﺟﻧﺴﺍﻪﺩﮑﺍﺕﻟﺮﺭﺣﺠ ﻮﻻﯼﻧﻔﺴﯽ ﺭ ﻨﺗﺎﺩﻣﯿﺴﯽﺍ ﺪﯼﻧ ﻧ
ﺪﻻﯾﺮﺮﺑﺍﺕﺗﺮﮑﯽﺣﺠ ﻧﻭﺮﺍﺏﻟﺪﺍﺣ
۶-
ﻪﺩ۴ ﻧﻮﺮﺳﯾﻮﮐﯽﻭ ﺗﺍﺮ
ﻮﯼﺣﺠ ﺘﻦﺷ ﻨﻪﻣ ﻟﯽﺷﯽﭘ ﻮ ﻪﮐ ﺘﻪﻫﻢﺍﺧ ﻧﻭ
ژ ﺎ
ﻓﻭﺮﮑﻭﻣﺍﺕﺍﻭﺪﺎﻃﯽﻏ ﻣﺨ
ﻪﺩﯼﮐږﯼﭼﯽﭘ ﺘﻦ ﯽ ﻨﺍﺕﻫﻢﻣ ﺮ
ﯿﺐﯾﯽﺩﺳﻦګﺣﺠ ﻘﻌﻪﺗ ﻮﯼﭼﯽﭘ ﺮښﺕﮐ ﯾﻩﮐﯽډ ﺩﻮﻪﻣ ﭘ
ﻮﺘﺎﻋﺳ
ﻪﻮﺗﺗﺍ
ﺮﻔﺴﯽ ﺣﺠ ﻨﻮﺗﺗﺎ
ﯾﻩﮐﯽﺯ ﺩﻮﻪﻣ ﻮﭘ ﺘﺎﻋﻭﺳ څﻪﺩڅﻮ ﺧ ﻧﻮﻗﺍ
ﺮﻭﻣﺤ ﺩﻭ
ﺪﻭﻣﺤ ﺎﻥﺩڅ ﺘﻧﻩﺍﻮګ ﺗ
ﻪﻩﭘﺮﻪﻧﻈ ﯼﻪﻟ
ﺎژ ﻟ
ﻮﻟﺘﭘﻮﺘ
ﻩﺩﻫﺴ ﻮﯼﺩ ټﻞ ﺷﻪﺍ ﮐ ﺘ
ﺎﻋ ۱ﺳ ۸-
۷ﻩ۲ ﺭ
ﻭﯾﺢﺩ ﺮﻔﺗﻭﻍۍﺩ ﺭﺎ
ﻧږﯼﺩ ﺮﯼﭙﺧ
ﻮﺏړﺳ،ﭖﯾﺸﻦ ﺰﯾ
ﻮﻻﯿﮐﺍ
ﻭ ،
ﯿﺸﻦﻮﻟﻧﺍ
ﺭﻪګ ﮑﺍﺕﻟﺮﻮﯼ ﺣﺠ ﻟﺎﺘﺤﻮﮐﯽﺍﺳ ﺗ
ﺍﺮﺘﻦ ﺣﺠ ﻨ
ﮑﯽﻣ ﻧﻭﺮ
ﺍﺏﻟ ﺪﺍﺣ
ځﯽځﻪﻧ ﮐږﯼﭘ
ﻠﺴﯽ ﯽ ﻔ
ﮐږﯼﺗ
ﻪ ﯽ ﺘﺯﺱﺍﺧ ﻭ
ﺮﮑ ﻪﻧﺍﺕﭘ ﺮځﯽﺣﺠ ﻭ.ﻧ
ﻪ ﯼ ﺘﺘﯽﺷ Pyﻫﺴ knot i
ﺍcﻭ
.
ږﯼﻟﯽﺪﻮﺑﺗ
ﺍﺮ Metﺣﺠ aplast i
ﺍc
ﻊﻭ ﻪﻣﺴﻄ ﺍﺕﭘﺮﮑﻞﺣﺠ ﺎﯼﺷ ﻧﺍ
ﻮﺘﺍﺳﻮﮐﯽ ﻧﻮﯾﺍ
:
ﻪﻮﺣ
ﻟﮑﯽ
ﯿﻨﯿ
ﻠﮐ
ﻪډﺪﻏﻤﯼﻭﻫﺩږ ﺍ
ﻟږﯼ
ﻪﯽ څﻪﺑﻞﮐﺲﺗ ﮐﺲ ﺧ ﻮﯾﻪﺩﺍﺳﻄﻪﻭ څﻮﭘ
ﺍﮐ ﺘﻦڅﻨﻣﻩﺩﺮﺗ
ﺎﯾﻭﺱﺯ ﺮ
ﯾړﯼﻭ ﻮﻣﻮﻧ
ﻮﺍﺿﺮﺍﻋﺩ
ﻮﻪﺷﯽﻧ ﺘﻭﻍۍﺍﺧ ﺭ
ﺎﻪﻧﮐﺲﭘ ﻮﻪﭼﯽﯾ ﻠﺩږﯼﮐ
ﻟږﯼﻪﻫﻢ ﯽ ﺍﺳﻄﻪﻭ fﭘomi tﺘﻦ cﻨﻣﻭﻝﺩ
ﻭﻭځ
۵ﺭ -
۱۰
ﯼﻭﺩ ﻉ ﯽ
ﮐږ ﺍ ﻭﺮﻧﺲﺷ ﺎﻭﭼ ﺪﯾﺮﭙﻭﺱﺩﺧ ﺮﯾﮑﯽﺩﻭ ﺎﻋﺘﻪﻣﺨ ۲ﺳ ﻪ۴ ﻭﻉﻧﺮﺩﺷ
ﻭﻮﺍﻧ
ﺎﻣﻮﺎﺷﻩﻪﻣ
ﭘﯽښ ﭘ ﺍﺮﯼﭼﯽﺩ ﮑﯽﻟﯾړ
ﻐﯽﺍﯿﻩﻧﺮﺭﺟﯽﺳ ﺩ
ﺒﯽﺩ ﺗ
ﻪﺩ ﻧ
ﺪﯾﺮﭙ
ﻭﺩﺧ ﻮﯼﺍ ﻡﮐ ﺍﻭ
ﺭﯼﺩ ﻮﭘ
ﻩﭼﯽﻣﻦځﻥۍ ﺭﯼﺩﻮﻭﭘﻭځ
۴ﺭ ـ۱
ﻩﺩﺭﻭﯾﺢﺩﺮﻔ
ﺗﻭﻍۍﺩ ﺭﺎﻧ
ﺩږﯼﺩﺍږﯼ
ﻮﮐﯽﻭ ﻧﺎ
ځﻮﮐﯽﮐﺴ ﻠﯿﺖ ﭘ ﻓﺎﻌﻣ
.
ﯼﻩ
ﻭځ ﺩ ﻩﺭ ﻭﻩﯾﯽﺩ ﺭﻭﺩ
ﺍﺽ ﺮ
ﺎﻥﺍﻋ ﺘ
ﻧﺍ
ﺮﺧﯽﺩ ﺗﻦۍﺑﺭﻮﭘ
ﺘﻢﺩﯿﺴﻔﺴﯽﺳ ﻨﺗﻭﺩﺩﺍﺭﺮﺩ،ﺳ ﻩ
ﺯړﺩ،ﻝ
ﺩﺍﻥ ﺭ،ځﺩﺭﺪﯿﻠ
ﺗ،ﻋﻀ
ﻪ ﭘﯽﺒ ﺍ
ﻧڅﺎ
ﻭﻍۍﺭ ﺎ
ﻪﻧﻡﭘ ﻮﺎﺷ
ﻪﻣ ﻭ.ﮐ
ځﯼ ﯼﻮﺍﻩﯾﺮﺭﺳﻠﻞﻭﺗﺍ
ﻮﺭ ﺑ
ﻭﺍ
څﻪﺩﺯﯼ ﺧ ﻮ
ﭘﺩ،ﺩ ﺭ
ﻧﯽﺩ ﻮﺘ،ﺳ ﻭﺧﯽ ﻪټ ﮑﻟ
ﻮﯼځﯼګ ﻧﺭﺩﺮﯼﻡګﻟﺍ ﺽﻭﺮ
ﻻﯼﺍﻋﻔﺴﯽ ﺭﻨﻨﯽﺗﺗﺭ
ﻮﻪﭘﺎﭘﻭﯾ ﺮﯼﺍﻟ
ﻪﻭ ﺒ
ﺍځﯼﺗ ﻮ
ﺪﯾ ﯾﺎﻮﺷ ﻪﻭﯼﻧ ﺘﺍﺧ
ﻪﺩﮑﺮﯼﻟ ﻟ
ﻩﻭﮑﯽ ﺏڼ ﯿ
ﻨﯿﻠ
ﻪﮐﻔﻠ
ﺘﻭﻍۍﻣﺨ ﺭﺎ
ﺍﻧﺰ
ﻧﻮﻠﻔ
ﻧﺍ
ﻪﺩ ﺭﺕﮐﯽﭘ ﻮﻪﺻ ﻭﭘ ﺪ
ﯿﻪﮐ ﺘﺍﺧﻡﺩﻮ ﺎﺷﻟﯽﻣﺪﯾ
ﯿﻦﮐﺴﺍﺎﻥﭼﯽﻭ ﻪﮐﺴﻐﻪﻭﯼﻫ ﻪﺑﻮﺣﻟﺎﻥ
sﻪﺷ epsiﭘﺘﯽﺩs ﺎﺣﻭﯾﺍﻮﺍﺿﺮﺍﻋﻔﺴﯽ ﻨﻔﯽﺗﺮﯼﻭﺻ ﯿﺩﻏ
.
ﺮﯼﻟﺮﻭﯿﯿﻒ ﺳﻔۍﻪﺧ
ﻭﻍ ﭘ ﺭ
ﺎﻮﻧﺮﯼﻧﻟ
ﯿﺖﻭ ﻓ ﺎ
ﻌﺪﯼﻣﻧﺍ
ړﻪﻭﺍﭘﺰﻧﻮﻠ
ﻔﻧﺍ
ﻭﺩ ﺍﻮﯼﻭﯼ ﺷ
:
ﺎﺕﺍﻃ
ﺘﻼﺍﺧ
ﻪ
ﮐږﯼﭼ
ﺒﺐ ﯽ
ﺎﺕﺳ
ﺘﻼﻃ
ځﯽﺍﺧ
ﺎﻧﯿ
(ﭼﯽﺑ
sel
fli
mit
iﯾ)ng
ﮑﯽ ﺎﻧ
ﻭﺪﯿ
ﻪﺭﻏﻠﭙ
ﻮﭘﺨﻩﻫﻢﯾﻪڅ ﮐ
:
ﻪﻟﺭﺕﺩﯼ
ﺎﺒ
ﻋ
ﺩ.
ﺘﻼﻁ ﯼ
ﺍﺧ ﻮﻝ
ﻤﻌﺎﻥﭼﯽﻣ
ﺘﻧﺍ
ﯾﯽﺎﯾ
ﺮﺘﮐ
ﺎﺑ
.1
Ot
it
ismedi
n.2
48
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
Cr
oup.
3
Br
onchi
oli
ti
s.4
ﺎ
ﯿﻧ
ﻮﻤﻧ
.5
ﻭFiﺍbri
le seizures ،
ﺘﺲ ﯾﺎﻻﻔﻧﺴMyﺍ o Carditi
ﻪs ﺭﺕﺩﯼﻟ ﺎﺒ
ﺎﺕﯾﯽ ﻋ ﺘﻼﻃﺭﺍﺧ ﻮ
ﻧ
ﺮﺧﯽﺎﻕﺑﻭﺳ ﻮﯼﺍ ډﻩﮐ
څﻪ ډ
ﻮ ﺧ ﻠﻡﻭﻫ ﺪﻗﻭﺩﺭﺎ
ﺭﺕﮐﯽﻧ ﻮmyﻪ ﺻ
osiﭘ tiﺩ.ﺩs
myڅﻪ ﯼ
ﺧ ositi
s
ﮑﻞﺩ Rhabdo ﺭﺷ ﺩﺎ
ﻪﻧﻮﭘږﯼﺧ ﺟړﯼ
ﻪ ﻮ ﻠﭙ
ﻪﺧ ﻩﭘﺮﺗ
ﺎﯾﻟﺖﺯﺎﺍﺣﻮﯼﭼﯽﺩ ﻪﮐﯾﺎ
ﮑڅﻪﺣﺩ ﺧ ﺭﺩﺩ
ﻭﻍﺩpost ﺭﺎﻪﻧ ﻠ
ﻪﮐ ﻠ
.ﮐﻮﯼ ﮐﺭﻪﻭ ﯾﺎﻔ
ﻡﮐ ﺪﻭﻋ ﺭګﻮﺗ
ﺮﻑ ځﯼ ﭼﯽﺩﭖښ ﻪﻃ Myﭘ ol
ysis
ﺍ
ځﻪﺭ
ﻪﻣﻦ ﺗ ﻠﺒ
ﻪﮐ ﻟګﻥ
ﺮﻭ ﺒﺪﯼﻏ ﻧ
ﺍړﻪﻭﻭﺱﭘ ﺮﯾ
ﮐﯽﻭﯼﭼﯽﺩﻭ ﺎڅﻪﺷ
ﻭ ﺧ ﺎﯾ
ﺎﻘiﺑ
nfl
uenza.C.N.S
Gull
i
anbar re.synd،ﺘﺲﯿﻟﺎﻻﻔﻧﺴﺍﻪﺩﺘﻭﺳﺭڅﻪﻭ
ﺍ ﺧﺰﻧﻮﻠ
ﻔﻧﺍ
،ﺩﺗﯽﺎ
ﻮﭘﻟ
ﺎﻔﻧﺴﺍﻪﻟ
ﺭﺕﺩﯼ ﺎ
ﺒﯼﻭﻋ
ځﺍ
.Tڅﻪ
rﺧ ansversMy el
it
iﻭs ﺍ
ﻮﻁﻪﺗ
ﺘﻼ ﭘSuperiﺍﺧ ﺪﯼ mpose ﻧﺍ
ړۍﻪﻭﻭﻍ ﭘﺭﺎ
ﻧﺍﺩﺰ
ﻧﻮﻠ
ﻔﻧﺍ
ﻡﭼﯽﺩ ﻮ
ﺎﻭﯼﮐ ﯾﺮ
ﺘﮑﻮﯼﺑﻧﺎ
ﻮﻝﺛﻤﻌﻣ
ﻮﺱ ﻠ
ﯿﻓﻮﻤ
ﯿﻭﻫ ﺎﺍﯿﻧﻮ
ﻤﻮکﻧﻮﮐ ﺘﭘﺮﺘ،ﺳ
ﻭﺱ ﺮﯾ
ﺍﻭﻮﮐﻮﮐﻮ
ﻠﻓﻪ ﺱټ ﺭﺕﺩﯼﻟ ﺎﺒ
ﮐږﯼﻋځﻪ ﯽ
ﻣﻦ ﺗ ﺍ
ﻩﺭ ګ
ﻻﻞ
ﺎﻣ ﯿﻧ
ﻮﻤﻠﯽﻧﻠﺘ
ﻣﺨ ﺮﺪﯼﭘﯾﺪ
ﺭﺱﯾﯽﺩﺷ ﻮﯾ
ﻭﮐﺲﺍ ﺎ
ﻮﻣ ﻠ
ﻓڅﻪ ﺱټﻠﯽ ﺧ ﻤﺩﯼﺟ څﻪﭼﯽﺩﺍ ﺧﺰﻧﻮﻠ
ﻔﻧﺍ
ﺍﻫﻢﯼﻭﺩ
ﺭځ ﺍ ﻻﻞﻫﻢګ ﻡﻣ ﻭﺭﺪﻨTrﺳ acheit
iTﻭ s
oxiﺍ
ﺮڅﻥګﯾﯽﺩ cshock ﯼﻭﺗ
ﺭځ ﺍ ګ
.ﺍﺷﯽځﻪﺭ
ړﻪﻣﻦ ﺗﻨ(ﻭﻡﯾﺗﯽ ﺍ ﺎ
ﭘﻮﻟﺎ
ﻔﻧﺴﺍﯿﮏﺗ
ﺎﭙ
ﯿﺩﻫﺎ)ﺣReyessyndrﺮﯼﭼﯽome ﻟﺎﻥﮑﻣﺍ
:
ﯿﺺﻭﺗﺸﺨ
ﺍﻧﯽ
ﺪﻧﻮ
ﺭﯼﻣ
ﺍﻮﺗ
ﺍﺮ
ﺑﻻ
ﻮﺗﺎﻻ
ﻭﺣ ﺭﻮﻪﻧﻮﭘﮐږﯼﺧﺩﻝ ﯽﻭﻪﻣﺨﯽﺍښ ﻟﯿﮏ ﻨ
ﯿﻠ
ﮐﯿ ﺺﺩ ﻭﮐﯽﺗﺸﺨ ﻪﭘﯽښ ﻤﯽﭘ ﯾ
ﺪﯿﭘ
ﺍﻭﻍۍﺩ ﺭ
ﺎﻧﺩ
.ﻩ
ﻪﺩ ﺗ
ﺭﻪﻭﺍﺗﺰﻧ
ﻮﻠﻔ
ﻧﺍﻪ
ﻮﺣﻟﮑﯽ ﯿﻨ
ﯿﻠ
ﺎﻥﮐﺘﻧﺍﻻﯼ
ﻔﺴﯽ ﺭ ﻨ
ﻨﯽﺗ ﺗ
ﺭﻮﭘ
ځﻪﭼﯽﺩ ﻣﻦﺩﯼ ﮐ ﺰﻧﻮ
ﺘﮐﯽﺳ
ﻮﻮﻝﺩﯼﯾ ﺮﮐ ﻠﭽ
ﻭﮐ ﺘﻞﺍﯿﺴﻮﺍﺧﺗ
ﺍﺯﺍ
ﺮﻓڅﻪﺩﺍ
ﮑﺲ ﺧ ﻧ
ﺍﺮﻓﻭ
ﺯﺎﻧ
ټﯽﺩﻪﭘﻞ ﻧﯿﯿﺼ ﻣﻦﺗﺸﺨ ﺰﯿﻩﻭﺍﻏ
ښﺍ
ﻪ Ag ﺭﺕﺩﯼﻟ ﺎﺒ
ﻪﺩﯼﭼﯽﻋ ﺘ
ﻮﯼﺷ ﻪﮐ ﺗﻭﻪګ ﻻﻞﭘ
ﯿﺺ ﻣ ﺭﺩﺗﺸﺨ ﻨﯽﭼﯽﺯ ﯾ
ﻮﻣﺯﺮچټکﺍ ﯿ
ﻤﺷ
ﻪﻨﻟ
ﻭﻪټ ﺎﺕﺩﯼﭼﯽﭘ ﯾﻪﻭﺧﺖﺯ ﻐﻟﯽﻫ ﺍ
ﺒﺖﻭ ﺜ
ﻮﻣ ﻨﯾ
ﻮﻣﺯﻪﺍﺩﻏﯿﺐﺩﻘﻌﻪﺗ.ﭘPڅﻪ
ﻭ CRﺧ ﻧﯽﺍﺪﻧﻮﻣ
ﺯښ ﺭﻮﺍﻧ
ﻭړﯼټﺱټ ﻮﻣﻮﻧ
ﻮﺩﻪﻭﯼﻧ ﻤ۱څﻪﮐ
۰ﺧ ٪ﻪﺩﻮﻋﯿﻪﺷ ﻮﮐﻪﻭﯼﺧ ﺗﺎﯾ
ﻪﺯ ﻮﻋﯿﻭﻍۍﺷ ﺭﺎ
ﻧﮐﯽﺩ
ﯼﻮ
ﺭځ ﻧﺮﺍﯿﻐAntﺗigeni
ﻡc ﻮﻭﺱﮐﯽﮐ ﺮﯾﺍﻭﺰﻧ
ﻮﻠﻔ
ﻧﻪﺍﻩﭼﯽﮐ ﺍﺩ
ﺎﯾﯽﺩ ﯿﺗ
ړﯿﻢګﻩﻧ ﻭﻻﺕﮐﻢﺩﯼﺍ
ﺮﻠﭽﮐ
ﻩﺩ ﻮګټﻪﺗ
ﻪچ ﮐ ﮐ.ﭼﯽﭘﻩﯽ ﻪﭘﯽښ ﯿﮏﭘﻤﯾﺪﻧ
ﺎﭘﻪﺩﮑﻟﻟﯽﻮﺪﯼﮐﻧﺍ
ړﻪﺷﯽﻭ ﺎﺕﻧﻣﻮﻠﻌﻮﻥﻣ ﻟ
ﺪﺑﺩ
ﻨﯽﺩﺣﻝﻭﻫ
ﺮﯼ ﺎ ﻨﯽﺣﺠ ﻮﭼﺮﮐﯿﻤ
ﻮﺷ ﻡﭼﯽﯾ ﻮﯿﮏﮐ ﻨ
shelﺗﺨ lvi
ﭘal
ﻤﻞﺩﯼ ﻪ ﺘﻮﻝﺩﯼﻣﺸ ﺍﮐﺮﺍﺟ
.
ﮐږﯼ
ړﻝ ﯽ ﺭﻭﺎﻪﮐﻩﮐﯽﭘﺩﻮﻩﻣﻟډ
ﻪﻦ ﻩﭘﺭﺎ
ﭙﻟﻮﻟ
ﺩﻭﯿﺠﻦﺩ ښ ﺘ
ﻧﺍﺍ
ﺰﻧ
ﻮﻠﻔ
ﻧﺍﻮﯼﻭﯼﺩ ﯾﻦﺷﻮﻠﺎﻥﺗﻪﺷ ﭘ
:
ﯿﺺﻘﯽﺗﺸﺨ
ﯾﺮﻔ
ﺗ
ﺪﯾ
ﺎﻮﺑ
ﯿ ﺺﺷﯽﺧ ﻪﻭﯼﭼﯽﺗﺸﺨ ﻨ
ﻣﺰﻧ
ﻮﺘﻪﻣﺨﯽﺳﻟﻮﺣﯽﻟﮑﯽﯿ
ﻨﯿﻠ
ﮐﻩﻪﺩ
ګﯼﭘﯽښﺑ څﻥ ړﺍﺍ ﺰﻧ
ﻮﻠﻔﻧﺍ
ﺩ
ﺷ.
ﯿﺺ ﯽ ﻘﯽﺗﺸﺨ ﯾ
ﺮﻔﻩﺗﺮ
ﻮﺳ ﯿﻭﻏﺭﺎﺪﯼﻧﻧﺩﻻ
ﻪﻣﻦځﻠﺒ
ﻪﮐﻟ
ﺎﯿﻧ
ﻮﻤﻼﺎﻧ
ﻣﻮﭘﺯ
ﮑﯾﺎ
ﻣﺎﺩﻮﯾﺗ
ﺍﻮﻧ
ﻮﺮﺳ
ﯾﺍ
ﻔﺴﯽﻭﻨﻮﺗﻔ
ﻠﺘ
ﻣﺨ ﻮ)ﭼﯽﺩ ﯿ
ﻭﻏﺭﺎ
ﻔﺴﯽﻧ ﻨﺩﺗﺎﺩﺣ -
۱
ﺭځﯼ(ﻪﺍ ﺗ
Str
epttococcalphary ngiti
s-۲
ﻪ
ﻠﺮﺣﻪﻣﻣ
ﺪﻘﺎﻣﯿﻧ
ﻮﻤﺎﯾﯽﻧﯾﺮ ﺘ
ﮑﺑ-ﺩ۳
:
ﻪﻨ
ﻠﻣ
ﺭﺩ
ﻭﺍﺒﯽ
ړﻝﺷﯽﺩﺗﺭکﺎﺕﻭﯾﺎ
ﻌﺪﻣ
ﯾﺎﻪﺑﻮﺗﻧﺎ
ﻭﻏﺭ
ﺎﻨﯽﻧ
ﻌﻮﯼﯾﻓﻈ
ﺎﻩﻣﺤﺮ
ﺗﺎ
ﯾﻪﺯ
ﻨﻠ
ﻣﺭﻭﻍۍﺩﺭﺎ
ﺍﻧﺰ
ﻧﻮﻠ
ﻔﻧ
ﺍﺩ
.
ﮐږﯼ
ﻮﻝ ﯽﮐ
ﺭIﻭ
buprof
ﻭ enﺍ
ﯿﻦ ﻓ
ﻮ ﻨ
ﯿﻣﺍﯿﺖﺍﺳﻪ
ﮑﻟﻣﻞ
ﺭﺪﺩﺒﯽ ﺿ
ﻩﺩﺗﺭ
ﺎﭙﻟ
ﻮﻟړ
ﻩﻭﺩﻪﻣﻦځ
ﺩﻟ ﺭﺩ
49
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
.ﺭځﯼﻻﻞګ ﻡﻣ ﻭﺭﺪﻨReyﺳ ځﻪﺩes ﺎﺏﺩﯼ ﮐ ﺒﺘﺍﺳ ﺎﺏ ﻮﻝﻣﻀ ﮐﺭﯾﻦﻭ ﺮﭙﺍﺳ ﻪﻮﺗﻧﺎ
ﻣﻮ ﺎﺷﻮﻣ ﺧ
ﻪﮑﻭﻉﺷﯽﻟ ﺮﻣﻞﺷ ﺭ
ﺪﺩ ﻭﺱ ﺿ ﺮﯾ
ﮐږﯼﭼﯽﺩﻭ ﺍ ﯽ ﺪﯿﺭﺕﭘ ﻭ
ﺮ ﻪﺿ ﻠﻪﮐ ﻠ
ﻩﮐ ﺭﺎﭙﻭﻍۍﻟ ﺭ
ﺎﺍﺩﻧ ﺰﻧﻮﻠﻔ
ﻧﺍ
ﺩ
.Neur omi ni dasei nhibitor Aﻭs damantﺍ anes- I
ﯼﻭ
ﮐځ ﺍﻻﻞ ﺮﻮﻣ ﻟ
ﺪﯿﻤﻮﺩﮐ ﺍﺿﺮﺎﻝﺷﯽﺩﺍﻋ ﻤﻌﺘﻮﮐﯽﺍﺳ ﺘﺎﻋ۲ﺳ ﻪ۳ ﻭﻉﭘ ﺮﻭﻍۍﺩﺷ ﺭﺎ
ﻣﻞﺩﻧ ﺭﺍﺩﻪﺩ ﮐ
ﻩﺮډﻝﺳﯿﻒ ﻭ ﻔﻭﻏﯽﺩﺧ ﺭﺎ
ﻧﻭﺩﺮﯼﺍﻟ ﻪﻧ
ﻮﺵﻭ ﺘﯽﺗﺸ ﯿﻓﺎﻌﺎﻥﭼﯽﻣ ﻭﻏﺭﺎﻪﻧ ﻐ.ﻫﻮﯼmorﻫﻢﮐ bidit
y
ﻮﺵ ﺘﯽﺗﺸ ﯿﻔﻌﻪﭼﯽﻣ ﻮﺗ ﻧ
ﺎﻪﮐﺴﻐﺭﻫ .ﻡګ ﮐږﯼ
ﻪﯽ ﯿﻮﺻ ﻪﺗ ﻪﻧﺗﺭﻣﻞﻭ ﺭﺪﺩﻭﺱ ﺿ ﺮﯾﮐﯽﻭﯼﻥﺩﻭ ﺎﺷ
ﺷ.
ﻭﻉ ﯽ ﺮﻪﺷ ﺗ
ﺭﻣﻞﻭ ﺭړﯼﺩ ﻮﻣﻮﺪﻧ ﯾﺍﻮﺪﻭﯼﻧ ﯾﺪﻧ
ﺎﺮﺕﮐ ﻮﺧﻄ ﺗﺎ
ﺘﻼﻃ ﺍﺧﺍﺍﺩﺮﯼﻭ ﻟ
ﻭ
Ri mant adin۲Amant adine۱
ﻥښﯽ
ﻩ ﻟ ﺮټﻦﺳ ﻭﯾ ﺮځﻪﭼﯽﺩm2ﭘ ﻮﯼ ﮐ ﻩﮐﺰﯿﺪﯼﺍﻏ ﻧﺎډﻝﺑ
ﻪ Aﻭ ﺍﭘﺰﻧ
ﻮ ﻠﻔﻧ
ﺍځﯼﺩﺍ ﻮﻣﻞﯾ ﺭﻪﺩﺩﻏ
ﻮﮐﯽ ﺘﺎﻋ
۴ﺳ ړﯼ۸ ﻡﻮﻪﻟ ﻭﻍۍﭘ ﺭﺎ
ﻧﻣﻞﺩ ﺭﺍﺩ ﺩﻭﯼﺩ ﻮﻮﺟ ﻪﻣ ﻪﺳﻄﺤ ﻭﺱﭘ ﺮﯾړﯼﻭ ﻮﻣﻮﻧﻡﭼﯽﺩ ﻮﮐ
.
ﺮﯼ ﻟﺪﯼګټﯼ ﻧ
ﺎﻝﺷﯽﻻ ﻤﻌﺘ
ﺍﺳ
ﻭﻪ ښﻭځ ﺗ۱ﺭ -ﻩﺩ۲ ﺩﻮﻭﻣ ﺪﯾ
ﺮﭙﻭﺱﺩﺧ ﺮ
ﯾ۳ﺩﻭ ﻮﯼ ﻤﺍ ﺽﮐ ﺮﯿﮏﺍﻋ ﻤﺘﯿﺴ۲ﻮﺳ ﻮﯼ ﻧ ﻤﺩﮐ ﻮﺒﯽﻣ ۱ﺩﺗ
ﯿﺠﯽﺣ ﻬﺗ
،ﺑﯽﻮ،ﺑﯽﺧ ﻟﯽﺍ
ﻭﺪﻩﺑړ،ﺯﻟﯽﺍﻮﻤﺎﮐﻬﺘﻪﺍﺷ ﺭﺕﺩﯼﻟ ﺎ
ﺒﺰﻋ ﯿ
ﻮ ﺽﺍﻏ ﻠﻣﺭﻩﺩ ړ
ﻮ ﻣﻮﻮﯼﺩﻧ ﻪﮐ ﺘ
ﮐ
ﺭﺕﺩﯼ ﺎ
ﺒSڅﻪﻋ
eiﺧ zurﻭe ﺍﻮﻥ ﻤﺴﻟ ﺰﯼﺩ ﯿ
ﺍﻏ ﺰﯼﯿ ړﺧﻫﺍ
ﻪCNSﮐﯽﯾﯽ ﺮ ﻭﭘ ﺍ ﻟﺖﺎ
:ﮑﯽ ﻧﻮﻬﯽﮐ Neuramiﻧ ni ـdase ۲
ږﺮﯼﻪﭘﻭﻧ ﻮﯼﺍﺬﯼﺑﻼکﮐ ځﻪﭼﯽﺩNAﺍﺧ ﺮﯼ ﮐ ﻟ ﺰﯼﯿډﻝﺍﻏ Aﻭ Bﻭ ﺍ ﺍ ﺰﻧﻮﻠﻔﻧﻪﺍﻣﻞﭘ ﺭﻭﭖﺩ ﺭﺍګﺩ
ﺩ.
ﻣﻞ ﯼ ﺎ
ﻣﻞﺷ ﺭﻩﺩ ﻭﻩﺩﺩﮐﻼﺱﮐﯽﺩ ﻪﻩ ښﯽﭘ ﻩﻭﻥ ﻟ ﺮﺎﺳ ﻭﯼﻏﺸ ﺮﻪﺣﺠ ﺑ
ﺭﻮ ﮐ
ﻭﺱﺩ ﺮﯾﺩﯼﭼﯽﻭ
.
ږﯼ ﻟﯽﺎﻌ ﺘﺍﺳﻻﯼﻪﺭ ﻟ ﻟﯽﻮAOselﭼﯽ ﺧ tami vi
r
.ږﯼ ﻟﯽﺎﻤﻌ ﺘ
ﺍﺳ ډﻝﻗﯽ ﻭ ﺎ
ﻧﺸ ﺍﻪBZanamiﭼﯽﭘ vi
r
ﺍﭼﯽ ﺩﻮﺮﯼﯾ ﻟﺪﯼګټﯼ ﻧ
ﻩﮐﯽﻻ ﺩﻮﻪﻣ ﻮﭘﺘﺎﻋ۲ﺳ ۸ـ۲
ﻪ۴ ﻮﻉﭘ ﯿﻭﻍۍﺩﺷ ﺭ ﺎ
ﻧﺎﻝﺩ ﻤﻌﺘﻮﺍﺳ ﻣ
ﺭﻪﺩ ﺩﺩﻏ
ﻩﺰﯿ
ﻪﺍﻏ ﻣﻮﻩﮐﺩﻮﻪﻣ ﻭﭘ ﺪﯾ
ﺮﭙﻭﺱﺩﺧ ﺮﯾﺭﺍﻭ
ﻮﯼﻡګ ﺩ ﻤﺍ ﺽﮐ ﺮ
ﯿﮏﺍﻋ ﻤﺘﯿﺴ ﻭﻫﻢﺳ ﻮﯼﺍ ﻤﻩﮐﺩﻮ ﺒﯽﻣ ﺗ
ﺩ
.
ﺮﯼ ﻟﻪﻧ
ﮑﯽﺩ ﻧﻮﻠ
ﺑﻭﻩځﻥژ
ﺭﻥګ ﺍ ﺍﺪﻤ
ﻭﻫ ﺍځﻥﺭﻭ ﻭګ ﺍﻟﯽ ﺍ
ﻭ ﺪﻩﺑ ړﻟﺯ
ﺭﺕ ﻪ ﺍ ﺍﺽ ﻮ ﺒﯽﻋ ﻧﺎ
selﺟ tami vi
ﺩr
ﺩ.
ﻮﯼ ﯼ ړﻝﺷ ﺭکﺭﻫﻢﻭ ﻮﭘﺍ
ﻮﺭ ﺗﺎ
ﻧﺎﯾ
ﺰﺎﺱﻭﻫ ﺍﺣﺴ Selfdamage
ﻮﯼﺩﯼ ﺪﻝﺷ ﯿﻟﻡﭘﯽښﯼﻫﻢ ﺰﭙﻮﺩﺳ ﺗ
ﺎﺒﻮﮐﯽﺩﻗﺼ ﻧﺎﻭﻏﺭﺎﻪﻧ ﻪﭘﻠﺒﻪﮐﻟ ﺎﻝﻌﺘﺍﺳ Zanamavﺩ i
ﺩr
ﻮﯼﻭﯼﭖ ﻪﺷ ﺘﺍﺧ ﻪﯾﺎ
ﻔﻡﮐﺪﻭﻪﻋږﭘ ﻭﺱ ﺍ ﺎ
ﻤﺘﺍﺳ ﺒﯽ ﻪﻗﺼ ﻪﭼﯽﭘ ﻮﺗﻧﺎﻮﮐﺴ ﻐ
ﻣﻞﻫ ﺭﺍﺩځﻪﺩ ﻮﮐ ﻧ
ﺷ.
ړﻝ ﯽ ﺭک ﻭﻝﻭ ﺭﻭﮐﻦټ ﺍﺎﻁ ﯿﺘ
ﺍﺣ
ﺩ.
ﺩﯼ ﻮ ﻮﺟﯿﻦﻣ ﮐﺴ ﺍﻪﻭ ﻟ
ﻭ ﻩډﻭﻩﺩ ﺭ
ﺎﭙﻟﻭB ﺍﺍﺩA ﺰﻧﻮﻠﻔﻧ
ﺍﺩ
ﻪﻻ ﻠﯽﻟﯿﻦﺩﯼﺩﻋﻀ ﮐﺴ ﺍﺎﻝﻭﻌﺮﯼﻓ ﯿﻮﻏ (ﭼﯽﯾ Trival enti nfl
uenzav accine)TI V- 1
.ﮐږﯼﯿﻖ ﯽ ﺒﺭﯼﺗﻄ
.
ږﯼﻟﯽ
ﺎ
ﻤﻌﺘ
ﺍﺳﺭﯼ
ﺍﻪﻟ
ﺰﯼ(ﭼﯽﺩﭘ
Liv
eat
tenuat
edi
nfl
uenzav
irus)LAI
V-2
ﻪﻭﺗﺯ
ﻭﻩﺩﻭڅﻪﮐﻢﻭﯼﺩ
ﺩﯼ ﺧﺎﺩ ۸ﮐﻪﯾ
ﻟ
ﺮﯾﯽ ﺎ ﻤ
ﻪ ﭼﯽﻋ ﻮﺗ ﻧ
ﺎﻣ
ﻮﺎﺷﻪﻣ ﻐ
ﻪﻫ ﻧ
ﻮﻨﯿ
ﮐﺴﺍﻨﯽﻭﺗﺭ
ﻮﭘ
.ﮐږﯼ
ﯿﻖ ﯽﺒ
ﻪﺗﻄﺘﻭﺳﺭﻭﻥۍﻭﺍڅﺭ
ﻮﺮﻟ ﺮﯼﭼﯽﻫ ﻟﺭﺕﻭﺮ
ﺿ
ﻮﻭﺧﺖ ﻪﯾ
ﺪﭘﯾﺎﺎﻝﻭﯼﺑ
ﻌﺮﯼﻓﯿﺎﻏﺪﯼﯾﻧﻭﻪ ﭼﯽژ
ﻧﻮﻨ
ﯿﮐﺴﺍﻪﻭﻐﺭﻫﻮﻩﻧﺮﻮﺳ ﻧ
ﻮﻨﯿ
ﮐﺴﺍﻨﯽﻭﺗﺭ
ﻮﭘ
ﭼګﻮﺩﻩ
ﻧﺎﻥﭼﯽﺩ ﺮﺍﻪﮐﺴﻐﯼﻭﻫ
ږﺍ ﺭﯼ
ﺎﯿ
ﻪﻩګۍﮐﯽﺗ ﭼګﻮﭘ
ﻧﻪﺩ ﺮﺍ ﻧﻮﻨ
ﯿﮐﺴﺍﻨﯽﻭﺗ
ﺭﻮﯿﻖﺷﯽﭘ ﺒ
ﺗﻄ
ﺷ.
ﻪ ﯽ
ﯿﻖﻧﺒ
ﻪﺗﻄ ﺗ
ﺭﯿﻦﻭﮐﺴﺍ
ړﯼﻭﻮﻣﻮ
ﺪﻧﯾﺎﺮﯼﺑ
ﻟﯿﺖﺎﺳﻩﺣﺴ ﺮﯿﻦﺳﺗﻭ
ﺭﻮګۍﺩﭘ
ﯿﻖﺒ
ﺎﺕﻭﯼﺗﻄﯾڅﻪﺯ
ﺩﯼ ﺧ
ﺎﺩﻭﯾﻮﺍﺘﺎﺷ
ﯿﻭﻣږﻪﺷﭗﺮﯾﯽﻟ ﻤﻪﭼﯽﻋ ﺗﻮ
ﻧﺎﻣ
ﻮﺎﺷﻪﻣﻐﯿﻦﻫﮐﺴﺍTIﻭV
.
ﮐږﯼ
ﯽ
50
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﺪﯾ
ﺎﻪﺑﻮﺗﻧﺎ
ﺪﯼﮐﺴﻧﻭﻻﯿﻖﺷﯽﺍ ﺒﺮﻣﻦځﻭﯼﺗﻄﻮﺗﻧﻮﻠ
۴ﮐ۹ـ
ﺮﯾﯽﺩ۲ ﻤﻪﭼﯽﻋﻮﺗﻧ
ﺎﻪﮐﺴﻐﺪﻫﯾﺎ
ﯿﻦﺑﮐﺴﺍ
LAIﻭ V
ﻪﻐ
ﯿﻦﻫ ﮐﺴﺍ
ړﯼﻭﻮﻣﻮ.ﻧ
ﻠﯽﯿﺴﻼﺕﺍﺧﻠﺎﻥﭼﯽﺳﻪﮐﺴﻐـﻫﺭﯼ۴ﺍ
ﻭﺪﻨ
ﯿﻣ-ﺍﻮﺵ۳ﺘﯽﺗﺸﯿ
ﻓﺎﻌ
-ﻣﺎ۲ﻤ
ﺘ-ﺍﺳ
ﺷ۱
ﻪ ﯽﯿﻖﻧﺒﺗﻄ
ﻮﺏﺘﻨ
ﺰﻣ ﯿ
ﯿﻦﺍﻏﮐﺴ
ﺍړﯼﻭﻮﻣﻮﺩﻧ
ﻭ.
ﻪﯼ ﺘﻡﺍﺧ
ﻭﺭﺪ
ﻨ Gulﺳl
inbarr
ﻪe ﻭکﭼﯽﭘﯿﻖﺷﯽڅ ﺒ
ﺎﻁﺗﻄﯿ
ﺘﻪﺍﺣﻪﭘﻮﺗ
ﻧﺎﮐﺴ
ﺮﻤ
ﺎﻥﭼﯽﻋ ﻪﮐﺴﻥټﻝﻫ
ﺩﻭﯼ ﻭ ﻮﻮﺟﯿﻦﻣﮐﺴﺍﻩﻭ ﺭ
ﻮﺍﭘﺰﻧ
ﻮ ﻠ
ﻔﻧﺍ
ﻪﮐﯽﺩ ﻨ
ﻟﻭﻪټ ﺮﯼﭘﯿﻪﭼ۹۰ﺩﯼﮐﻪﮐ ٪
ﺷ.
ﯿﻖ ﯽ
ﺒﻪﺗﻄ
ﺗﺭﺪﻭ
ﯾﺎﻫﮐﻝﺑ
ﺎﺕﻭﯼ ﺮﺎ
ﯾﺎﺯ
ﺘﯽﯾ
ﺎﺷﯿ
ږﻣﯾﯽﺷﭗ
Chemopr
ophi
l
axi
ﺰﺱs
ﮐﻓﻼ
ﻭﺮﻮﭘ
ﻤﯿﮐ
ﻪﻮﭘﺩﻭﯼﻧﻮ ﻮﺟﺎﺏﻣﺒﺘﻄ
ﺩﺍﺳ ﺎ
ﺍﭼﯽﻣﻀ ﺎﺩﻭﯾ
ﺮﯼﺍ ﻟ
ﻪﻧﺎﻥﻭﮑﻣﻮﺍﻟ
ﻮﯿﻦﮐﮐﺴﺍﻫﮐﻝﻭ
ﺮﯼﺩ ﺮﺎ ﯿﻩﭼګ
ﻩکټ ﺭﺎ
ﭙﻟﻮﯼ ﯿ
ﻨﻭﻣﺨﺍﻭﻝﺮﺘﻨ
ﻩﺩﮐﻮګﻪﺗﻭﻫﻢﺧﻂﭘ څﻪﺩﺩ
ﻮ ﺧ ﻠ
ﻣﺭﺪﺩﻭﺱ ﺿ ﺮ
ﯾﺍ
ﺭﺕﮐﯽﺩﻭ ﻮﺩﯼ ﺻ
ﻪﯿﻦﺗﮐﺴﺍ
ﺮﻭ ﻪﻧﻈﻘﯾﺮ
ﻪﻃ ﻮﺩﻏړﯼﺩﯼﺧ ﻤﯽکﮐﺍ۲ﭘﯽښﯼﺭ ۰ـ
۴ ۰
ﻪﯾﯽ٪ ﻠ
ﻣﻪﺍﺎﻝﻟﻤ
ﻌﺘﻮﭼﯽﺍﺳ ﻠﻩﺍﺧ
ﻪﺎﻝﭘﻤ
ﻌﺘﺍﺳﻪﺩﻓﺮﻪﻃﻠﻪﺑ
ﻟ ﻭ
ﺍﺎﺕﯾﺭ ﺽﺯ
ﺍﻮﺒﯽﻋﻧ
ﺎﻣﻞﺟﺭﺍﺩﺩﻮﻮﯼﺧ ﯾځﻪﭼﯽﺩﻩﮐ ﻪﺩ ﻨ
ﺎﻥﻣﯾﻩﺯﻮڅﯾ
.ږﯼﺗﯽﺎﯾ
ﻣﺖﺯ ﻭ
ﺎﻘﻭﺱﻣ ﺮﯾ
ﺍﺭﺕﮐﯽﺩﻭ ﻮ
ﺻ
ﻮﻠ
ﺍﺧ ﺭ
ﺎCڅﻪﮐ
hemoprﺧ ophyl
axiﻪsﻟﻮﮐﯽ ﺗ
ﺎﻻﺪﯼﺣﻧﻪﻻﭘ
ﻣﺦﺩﯼ ﺎﻩﻣﺨ ﺮ
ﺮﺳ ﺩړﺧﻄ
ﻮﻮﻟ ﺗ
ﺎﺘﻼﻃ
ﺍﺧﻭﻍۍﺩ ﺭﺎ
ﻧﻭﺩﺍﻪﻭﯼﻮﯼﻧ ﯿﻦﺷﮐﺴﺍ
ﺎﻥﭼﯽﻭ ﻪﮐﺴﻐ-ﻫ1
ﮑﯽ
ﯾړږﯼﺍ
ﻩﻥﺩ
ﺮﻮﺳ
ﻧﺎﺩﮐﺴ
ﺮﻟړﺧﻄ
ﻭﻍۍﺩﻮ
ﺭﺎﻧ
ﻭﺩﻪﻭﯼﺍ
ﻮﯼﻧ
ﯿﻦﺷ
ﮐﺴﺍ
ﺎﻥﭼﯽﻭ
ﻪﮐﺴ
ﻐ-ﻫ
2
ﺮﯼﻟ
ﻣﺦﺩﯼ
ﺎﻩﮐﺨ
ﺮﺮﺳ
ﺩړﺧﻄ
ﻮﻮﻟﻮﯼﺩﯼﺧ
ﯿﻦﺷ
ﮐﺴﺍ
ﺎﻥﭼﯽﻭ
ﻣﻮﺎﺷ
ﻪﻣﻐ
-ﻫ3
ﻣﻞ
ﺭﻪﺩ
ﻩﻟﺭ
ﺎﭙ
ﻭﻝﻟ
ﺮﺘﻨ
ﺘﯽﮐ
ﻗﻮﻣ
ﻮﺩﻮﯼﻭﯼﻧځﻪﺷ
ﻣﻦ ﺗ
ﺍﻮﻉﺭﯿ
ﻭﻍۍﺷ ﺭ
ﺎﻧ
ﺍﺩﺰﻧ
ﻮﻠ
ﻔﻧ
ﺍﻪﭼﯽﺩﻠ
ﮐ-
4
:
ټﻢ
ﻮﺹ ﯾﯿﻖﻣﺨﺼﺒ
ﻭﺗﻄﺍ
ﻮﻟﻮ
ﻠﯽﮐ
ﻤﯿﺖﺩﻋﻓﺎ
ﻌﻩﻣ
ﺭﺎﭙ
ﻟﺍﺰ
ﻧﻮﻠ
ﻔﻧ
ﺍﺩ.
ﻮﻠ
ﺍﺧﻩڅﻪګټ
ﺧ
:
ﻨﯽﺗﺭښﺎ
ﭙﻩﺳ ﺭﺎ
ﭙﻟﻮﻧ
ﺎﻣﻮﺎﺷ
Aﺩﻣ
ﻭ
ﺎﻥﺍ
ﻣﻮﺎﺷ
ﻨﯽﻣ
ﻌﺷ.ﯾ
ﯿﻦ ﯽ ﮐﺴﺍ
ﺪﻭﯾﺎ
ﻫﮐﻝﺑ
ﺭﯼﻭﯼ ﺮﺎﻮﻮﭘﺘﺎﺷﯿ
۶ﻣ-
۱ﺮﯾﯽﺩ۸ﻤﺎﻥﭼﯽﻋ ﻣ
ﻮ ﺎﺷ
ﻪﻣﻐﻫ
ﻪ
ﺘﯽﮐﯿﻦﺷﯽﺣﮐﺴ
ﺍﺭﻭﻭ
ﺮﺪﺿ ﯾﺎ
ﻣﺦﻭﯼﺑﺎ
ﻩﻣﺨ ﺮ
ﺮﺳ ﻟړﺧﻄﻮﺩﻮﺗ
ﺎﺘﻼﻃﺍﺧ
ﺍﺩﺰﻧ
ﻮﻠﻔ
ﻧﺎﻫﻼﻥﭼﯽﺩﺍ ﮐ
ﺷ.
ﯿﻖ ﯽﺒ
ﺪﻫﻢﺗﻄﯾ
ﺎﻪﺑﻮﺗ
ﮑ ﻠ
ﺪﯼﺧ ﻧ
ﻭﻻﺍﻩﮐﻢﻭﯼﺮﻪﻧﻈﻟﺭﺍ
ﺪﻘﻣﯿﻦﺩﮐﺴ
ﺍﻭ
ﻭ.
ﺭﯼ ﯼﻮﮐﻮﭘ
ﻟ
ﺮ۴ﺎڅﻪﺗ
ﻮ ﺧﺘﺎﺷﯿږﻣﺮﯾﯽﺩﺷﭗﻤﺎﻥﭼﯽﻋ ﻣ
ﻮﺎﺷﻪﻣﻐ-ﻫ1
ﻟړ
ﯾﯽ)ﺩﻮ ﺎ
ﺒﯽﻭﻋ ﻠ
(ﻗﺎ
ﻤﺘﺍﺳ
ﺘﻢ)ﯿﺴ
ﻔﺴﯽ ﺳ
ﻨﻪﺗﮑ
ﺮﯼﻟﻟ
ﻭﻍۍﻭﺭ
ﺎﻨﯽﻧﻣ
ﺰﺎﻥﭼﯽﻣﻪﮐﺴﻐ-ﻫ
2
ﻭﻍۍ
ﺭﺎﯿﮏﻧ
ﻟﻮﺑ
ﺎﺘ
ﯿﻨﯽﻣﯾﺩﻭ،
ﻠﯽﺒﯽﻋﻀ،ﻋﺼ
ﺒﯽ،ﻋﺼ
ﺭ،ځﯼګ
ﺭګﯼﻮﺗ
(ﭖښ ﺮ
ﯿﻪﻏ
ﻪﭘ ﺭﻧﺎ
ﻓﺸ
.(
D.)M
ﻪ
ﺘﮐﺘﻢ ښ
ﯿﺴﺘﯽﺳﯿ
ﻓﺎﻌ
ﯾﯽﻣﺎ
ﻭﯾﺮﯼﺍ
ﻟﻮﺵﻭﺘﻢﮐﯽﺗﺸﯿﺴﺘﯽﺳﯿﻓ
ﺎﻌﻪﻣﺎﻥﭼﯽﭘﻪﮐﺴ
ﻐ-ﻫ3
ﺮﯼ.ﻟ
ﻭﻍۍﻭﺭﺎ
HIﻧ
ﯾﺩV
ﻭﺎﺍﻪﻭﯼ
ﻠﺒ
ﻪﮐﻟﺎﻝ
ﻤﻌﺘ
ﺍﺳﻮﺩ ﻠ
ﻣﺭﻪﺩﺩ
ﻠﯽﻭﯼﮐ
ﺍﻏﺭ
Rﺮ
eyﺗ
essy
ndr
ﻪﯾﯽome
ﻠﺒ
ﻪﮐﻟ
ﻭﻠﯽﺍ
ﯾﻦﺍﺧ
ﺮﭙﻩﺍﺳ
ﺭﺎﭙ
ﻟﺩﯼ
ﻮﺍږﯼﻣ
ﺎﻥﭼﯽﺩﻭﺩ
ﻪﮐﺴﻐ-ﻫ
4
ﻭ.
ﺪﯼ ﯼ
ﻧﺮﻻ
ﺧﻄ
ﮐ.
ﻪﻭﺧﺖ ﯽ
ﻮﺳﻢﭘ
ﻣﺍﺩ
ﺰﻧ
ﻮﻠ
ﻔﻧ
ﺍﺭﯼﺩ
ﺍﻭﺪ
ﯿﻣﺍ
-5
:
ﻨﯽﺗ
ﺭښﺎ
ﭙﻮﺳﻧﺎﻫﻼ
ﺩﮐ
ﺮ
ﯿﻪﻏ
ﯿﻦﭘ
ﮐﺴﺍ
ﺍﻭﺰ
ﻧﻮﻠ
ﻔﻧ
ﻮﮐﯽﺩﺍ
ﮑﻠﻪﺧ
ﻟﺪﯼډ
ﻧ.ﻪﻻ
ﻭړﯼﭘ
ﯿﻦ ک
ﮐﺴﺍ
ﺍﻭﺰ
ﻧﻮﻠ
ﻔﻧ
ﻫﮐﻝﺩﺍ
ﺪ ﺮﺎﯾ
ﺎﺎﻫﻼﻥﺑ
ﮐ
51
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﻟړ
ﻪﻮ ﻮﭘﺗ
ﺎﺘﻼﻃﺍﺩﺍﺧ
ﺰﻧ
ﻮﻠ
ﻔﻧ
ﻪﺩﺍﻠﮏﺑﻪﺧ
ﻟﻪډﯼځﻪﭼﯽﺩﻏ
ﮐږ ﮐﻪ ﯽ
ﯿﻮﺻڅﻪﺗ
ﺎﺏ ﺧﺒﺘﻄﺩﺍﺳﺎ
ﻣﻀ
ډﻝ
ﻻﯼ ﻭ
ﻪﺩ ﺎﻥﭘ
.ﺍﮐﺴ
ﺮﯼﺩﻟ
ﮑﯽﯾ
ړږﯼﺍ
ﻩﻥﺩﺮﻮﺳﻧ
ﺎﺮﮐﺴﺩړﺧﻄ
ﻮﻠﮏﭼﯽﻟﻪﺧﻟﻪډﻐ
ﺎﻫﻭﯾﺮﮐﯽﺍﺧﻄ
:
ﻭﻮﻪﮐﺗﻭ
ﻪګ ﭘ
.ﻪ(ﺗ
ﺭﻮڅﻪﭘ
ﻐﯽ ﺧﺎﺩﻫ
ﻭﯾﺍﻠﻦ
۵ﮐ۰)
ﺮﻤ-ﻋ
1
ﻮﺳﻢﮐﯽ
ﻪﻣﺍﭘ
ﺰﻧ
ﻮﻠ
ﻔﻧ
ﺍﺭﯼﺩ
ﺍﻭﺪ
ﯿﻣﺍ
-2
(
ﺭﺎ
ﻟړﻓﺸ
ﺮﺩﻮﯿ
ﻪﻏﭘ
ﻮ) ﻧ
ﻭﻩﻭﺭګ
ړﺍ(ﺩﺯ
ﺎﻤﺘ
ﺍﺳﻔﺴﯽ)ﻨ
ﻪﺗﮑﻭﻏﯽﻟﺭ
ﺎﻨﯽﻧ
ﻣﺰﺎﻥﭼﯽﻣﻪﮐﺴﻐ
-ﻫ3
.ﺮﯼﻟ
ﻭﻏﻲﻭﺭ
ﺎﯿﮏﻧ
ﻟﻮﺑ
ﺎﺘ
ﯿﻭﻣﺍ
ﻨﯽﯾﺩﻭ
،ﻠﯽﺒﯽﻋﻀ،ﻋﺼﺭ،ځګ
ﻭﺭګ
ﻮﺗﭖښ
ﻪ.
ﻠﻣﺍ
ۍﻪ
ﻭﻍ ﻟ
ﺭﺎhiﻧ
vﯾﺩ
ﻭﺎﺍ
ﻪﻭﯼ
ﻠﺒ
ﻪﮐﻟ
ﺎﻝﻤ
ﻌﺘﺍﺳ
ﻣﻞﺩ
ﺭﻪﺩﺩ
ﻟﯽﮐ
ﺍ
ﻮﺘﺘﯽﻧﺸ
ﯿﻓﺎ
ﻌﻣ-
4
.
ﻮګﻥ
ﺘﺍﺳ
ﻡﻮﺮﺳﻦګﻫ
ﺩﻧ-
5
.
ﻧﻞﻮ
ﺮﺳﻮﭘ
ﻧﺭﺍ
ﯾﯽڅ
ﺎﯿ
ﺘﻭﻏ
ﺩﺭ-
6
.
ﻮﯼﺎﺭﮐ
ﻮﻥﮐﯽﮐ
ﺘﮐړ
ﻪﻭﺎﻥﭼﯽﭘ
ﻨﯽﮐﺴ
ﻟﺎ
ﭘﻮﺩ
ﻧﺎﻣ
ﻮﺎﺷ
ﺩﻣ
Di
pht
her
ia
:ﻳﻒﺮﻌﺗ
ﻪﺍﺳﻄﻮCorﭘ y nBact erium Dipht heriﻩچېﺩ a ﻭﻏﻲﺩ ﺭ
ﺎﻧ
ړﻮﻱﻭ ﻴ
ﻨﻭﺩﻣﺨ ﻧﻲﺍﺎﺘ
ﻧﻩﺍﺩ
ﺎﻩﺣ ﻮﻳ
ﺑﻲﺫﺎ
ﮐﻭﺎﺍﻴﻤﻴﮐﺴﻮ ﺪﻱﺗﻳﺪ،ﺷ ﺎﺏﻬ
ﺘﻟﻌﻲﺍ ﻮﺿ ﻴﻞﻣﺘﻴ
ﭘﺮﻱﺩﺍﻨﺠﻭﺣ ﻡﺍﻮﻌ
ﻠﻧﺴﻞﺑ ﺎﺭځﻱچېﺩﺗ ﻪﺍ ﺗ
ﻣﻦځ
ږﻱ
ﺒﺐکږ ﻭﺳﺪ ﻳ
ﺟړ
ﺩﻱﺩ ﻮ ﺮﭘ
ﻪﻳﺨﭽ ﺭﺎ
ﺗ
۱کې۸ ۸
ﮐﻝ۲ ﻪﺎ ﻮﭘ ﻳﻒ ﺷ ﺮﻌﻪﺗﺍﺳﻄ ﻮﭘ
Kl۱کېﺩ ebs ۸۸ﮐﻝ۱
ﻪﺎ ﻩﭘﺭﺎ
ﭙﻟړﻱځﻝﻟ ﻣﻞ ﻢﺎﻭﻏﺊﻋ ﺭﺎ
ﻧﺩ
ﮐﻝ
ﻪﺎ ﻭﭘ ﻊﺍﻴﻮﺿ Exotﺗ oxiﻪnﺘﻭﺳ ﺭﻟډﻭﺧﺖﻭ ﺩﻦ ،
ړﻭﺍ
ﻪﺭ ﺘ
ﻴﻞﻻﺳ ﺎﺳﻪﺑﺍﺳﻄ ﻮﺮﭘﻠﭽLoefﺩﮐ f
ler
.
ﻩړﻳﺢک ﺮﺗﺸAnti
serﻩ um ﺭ
ﺎﭙ
ﻟﻭﺉﺍﺪﺩﺗVonbehr i۱کېng ۸۹۴
ﻩﮐﺸﻒ ﺭ ﺎ
ﭙﻟﻳﻖﺮﻔﻮﺩﺗ ﺎﺻﻮﺍﺷﺨ ﺎﺳﻭﺣﺴ ﻭﺍﺎﻑﺍ ﻌ
ﺪﻱ ټﺱټﺩﻣ ﻠ
Sﻮﺟ chiﻳ ۱کېck ۹۱
ﮐﻝ۳ﻪﺎ ﭘ
Diphtheriﻩa ﺭﺎﭙ
ﻟi
mmuni zatiﺎﻝ on ﻌZiﺩﻓngher،Par۱کې k ۹۱ﮐﻝ۴ ﻪﺎﺯﭘ ﺍ
ﺍﺭﺪﻤ،ﻫ
ړګ
.
ړToxoiﮐﺸﻒک de
ﺭﺕکې ﺍﺮﻪﺣﻮﭘ ﺭﺟ۶ﺩ ﻭﺩ۰ ﺍﺮﻱﻠ
ﭙﺭﻧﻴﻞﺩﻱچېﺳﻮ ﺎﺳﺮکﺑﺘﺤﻣﺮﻴ
،ﻏﺒﺖ ﺜ:ګﻡﻣ
ﺍ
ﻣﻞ ﺭ ﺎﻭﻏﺊﻋﺭﺎﺩﻧ
ﺭﻱډﺷ،ﺩﺍﻱ ﻲ ﺩﺩﺎﺕېک ﺪﻱﭘﻧﻭﺘﻲژ ﻔﻭﻫ ﻴﻂکېڅ ﻪﻳﺦﻣﺤ ﻱﻭﭘ
ﻩځ ﺍ ﻮکېﺩﻣﻦځ ﻘﻴﻗ
۱ﺩ ﭘ۰
ﻪ
.
ﺮﻱﻟﻪﻟﻭ
Corynbact eri
um Mi ti
s
CorynBact erium intermedi us
Corynbact erum Gr av i
s
Exotoxiﻭ ne ﺍﺮﻱﻟﻧﺲ ﻭﻻ ﺮ
ﻳﻟړﻭ
ﺘﻲﻳﻲﻮ ﻭﺳﺭﻩﻭﻭږﻱﻭﺩ
ﺒﺐکږ ﺍ ﻭﻏﺊﺳ ﺭﺎﺍﺩﻧﺭﺩﺎ
ﻮﻉﻳﻲﻧ ﻟړﻱﻧ
ﻢ
.ږﻱ
ﺒﺐکږ Toxemiﺳ ﻭﻱچېﺩa ﺪﻴﻟ
ﻮﺗ
:ژﻱﻮﻟ
ﻮﻤﻳﺪﻴﭙﻳ
ﺍ
ﻮﻱچې ﺭﮐﺎﺘﺸﻧﺍﻪﻴﻂﺗﻮﻱچېﻣﺤ ﻟ
ﻊﺗﺸﮏﻝ ﺒﻨ
ﺎﻥﻣﺘﻧ
ﺍﺍﺕﺩ ﺯ
ﺍﺮﻓ
ﺍﻧﺠﻲﺮﻭﭘ ﺍﻟﻲﻮﺘﻦﺷﺨ ﺺﺩﺧ ﻨ
ﺩﻣ
52
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
٪٪ﭘﻲ
۸ږﻱ۰
ﺍکږ
ﺪﻴﻨﻲکېﭘ
ﻭﻣﻣﻲﺍ
ﻪژﮐﻻﻯﻱﺑﻲښﻱﻳﻲﭘ
ﺭﻮﺎ
ﺘﺸﻧﺎﻥﺍ
ﺘﻧﺘﻲﺍ
ﻔڅﺭﻫ
ﻮﺮﻟﻩﺗﻭﺩ
ږﻱ
ﺪﻝکږ
ﻴﻟﻮکې
ﻧﺎﻣ
ﻮ ﺎﺷ
ﻮﮐﻢﻣﻧﻮﻠ
ﮐ۱
۵ښﻱﻳﻲﺩ
:
ژﻱ ﻮﻟ
ﻮﻤﻳﺪ ﻴ
ﭙ ﻳ
ﺍ
ﻪﺍﺳﻄﻮﻭﺧﻲﭘ ﻭټ ﺍﻧﺠﻲ ﺮﺍﺕچېﺩﭘ ﺯﺍ
ﺮ ﻓ
ﺍ ﻧﻲﻮﺘﻭﺳ ﺍﻟﻲﻮﺎﻥﺩﺧ ﻧﺴﺍﻭﻍ ﺭﺎ
ﺩﻧ ﺭ:
ﻳﺖﻻﻩ ﺍﺮﺎﻥﺩﺳ ﺘ
ﻧﺍ
ﺩ
ﻪﺎﺣﻪﺳ ﻓﻭﺎ
ﻪﻣ ږﻱچېﭘ ﺪﻝ کږ ﻧژژﺭﻱ ﭖ ﺎﻭﻍﺳ ﺭ
ﺎﻐﻲﻧ ﺮﻫ ﻮﻱﺗ ﻳﺖﮐ ﺍ
ﺮﻪﺳ ﻮﺗ ﮑﻠ
ﻭﺧ ﺟړ
ﻱﻭ ﻮﻭځ ﺍ ﺍ
ﺭ
ﻣﻲ ﻭژﻨﻲﺍﻭﻏﻲﺩﻣ ﺭﺎ
ﻮﻻﻱﺷﻲﻧ ﻴ
ﻧﻲﻧ ﻭ۴ﺍ -ﻮﻻً۲ ﻤﻌﺩﻭﻱچېﻣ ﻮ ﻮﺟﻣﻞﻣ ﺎﺮﻱ ﻋ ﻴﺘ
ﻔ کېﺩﻳ
ﺮﻤﻪکېچېﻋ ﺘﺎﻥﺍﺧ ﻣﻮﺎﺷﻪﻣ ﻐﺎﺕﻫ ﻳ٪۸ﺯ ﺭړﻱچېﺩ۰ ﻭ
ﻪﺍ ﺗ
ﻤﻲﻣﻦځ ﻳﺪﻴﭘﻭﺍ ﻤﻲﺍﻳﺪﻧﻮﺳﻢکېﺍ ﻣ
.ﻮﻱ ﻪﮐﺘﺍﺧ ﺮﻳ
ﺎﻥډ ﻣﻮ ﺎﺷﺮﻣ ﻤﻮﻋﻧﻮﻠ
۵ﮐ -ﺎﺩ۲ً
ﻮﺻ څﻪﮐﻢﻭﻱﺧﺼ ﻮ ﺧ ﻧﻮﻠ
۱ﮐ ﺗ۸ﻳﻲﺮ
.ږﻱﻩکږ ﺮﺮﺳ ﻪﺗﺍﺳﻄ ﻮSchiﺗﺴﺖﭘ ﻴﺖﺩck ﺎﺳﺑﻞکېﺩﺷﺨ ﺺﺣﺴ ﺎ
ﻘﻭﻏﺊﻣ ﺭﺎ
ﺩﻧ
ﺎﻝﻘﺘﻧ
ﻪﺍﺭﻧﻮ:ﺩﻣ ﻴﺖ ﻓﺎ
ﻌﻌﻞﻣ ﻔﻨﺷ،ﻣ
ﺗﻼﻱ ﻲ ﺍ
ﻪﺭﺗﻴﺖﻣﻦځ ﻓﺎ
ﻌﻪﻣ ﻟﻭ
ﻩډ ﻭ ﺑﻞ کېﺩ ﺎ
ﻘﻭﻏﺊﻣ ﺭ ﺎ
ﺩﻧ
ﺪﻳﺩﺍږ
ﺯﻱﻭ ﺍ
ﺪﻧ
ﻮﻱﺍ ﺮﻳ ﻮﺗﺘﺎﺷﻴﺗ۶ﻣﻭﺮ ﮐﻻﻯﺷﻲﺍ ﺮﻮ ﻴﺛﺎ
ﺘﻲﺗ ﺎﺷﻴﺭﻱﻣ ﻪچېﺩ ﻡﺗ ﻮﺎﺷﻴﺖﻣ ﻓﺎ
ﻌﻮﻱﻣ ﺷ
ﺷ.
ﻻﻱ ﻲ
ﻠﮏچې ﻪﺧﻐېټﻝﻫ
ﻳﻞﺷﻲچ ﻭ ﻭ ﺪﻭ ﻳﺎ
ﺭځﻱﺑ ﻪﺍ ﺗ
ﻪﻣﻦځ ﺘﻭﺳ ﺭ
ﻮﻭ ﻟﻭﺮ
ﻴﻭﻏﺊﺩﺗ ﺭﺎ
ﺩﻧ:ﻴﺖ ﻓﺎﻌﺎﻝﻣ ﻌ
ﻓ
ﻪ USکېﺩ ﻴﺴﻲﭘ ﻭﻏﻲﻧ ﺭﺎ
ﻩﻧ ﺭ
ﺎﺑ
ﻭ ﻠﮏﺩ ځﻲﺧ ځﻪ ﻧﻮﮐ ﻱﻭﻧ
ﻭﻻ ﺍ ﺟړ
ﻴﺖﻧﺸﻲ ﻮ ﻓﺎﻌﻭﻱﻣ ﺮﻴﻭﻏﻲﺗ ﺭﺎﻧ
ﻪ،ﭘړﻱﻪک ﺘﻭﻏﺊﺍﺧ ﺭﺎﻩﻧﺭﺎﺑ
ﻭﻮﻱ چېﺩ ړﺷ ﺭکﻮﻭ ﻧﺎ
ﻭﻏﺭﺎﺮﻱﻧ ﺘﻔﻳ
ﻪﺩ ﻐﺭﺩﻫ ﻮﭘﺍ
ﮐﻝ۵ﭘﻲښﻱﺭ ﺎ
ﮑﺲ ږﻱﻋﺭﻕکږ Iﺯnt r
ader ﻪ mal ﻭﻍﺗ ﺭﺎ
Toxiﻧ ﺮﻱ ode ﻴﺘ
ﻔﻳ0,ﺩSchiکې 1mm ckTest
ﻪﺘﻭﺳﺭﻭځﻱﻭڅﺭ ﺭ
ﻮټڅﻪ ﻟږﻱﺩټﺱ ﺧ ﺍکږ ﺪﻴﮑﻞﭘ ﻪﺷ ﺑﻲﭘ ﺪEﻭﺩﺯﺧﻢﺩﻧ rﺍ y
tﻤﻞﺩ hema ﻌﻟﺍ
ﻮﻳﻲﻥښﻱ ﻴﻧ
ﻭﻭﺍ ېﺮڅﺭځﻱچ ﺗ ﻪﺍ ﺗ
ﺎﺕﻣﻦځ ﻳﺮﺩﻱﺯ ﺎﺗIﻭﻳndurﺍ ati
ﻩ on ﺯﺍ
ﺪﻧﻪﺍﺮﭘﺘﻠﻲﻣ ۱ﻣﺩ۰
ﻪټ ﻭﮐ ﺎﺱﺩﻱﺍ ﺑﻞکېﺷﺨ ﺺﺣﺴ ﺎﻘﺮﻱﻣ ﻴﺘﻔﻳ
ﻮﺩﺩ ﺒﺖﻭﻱﻧ ﺜﺭﻱ ټﺱټﻣ ﻪچﺭ ،ﮐږﻱ
ﺎﺕېکږ ﭘ
ﺮﻱﻟﻪﻴﺖﻧ ﻓﺎﻌﻭﻍﻣ ﺭﺎ
ﻮﻧﻔﻲﻭﻱﻧ ﻨﺳﺖﻣ
:ﺎژﻱﻮﻟﺘﭘ
،
ږﻱﺒﺐکږ ﺎﺳﻴﻤﻴﮐﺴ ﻮﻭﺩﺗ ﻭﻱﺍﺩﺍﺯExotﺍ oxiﻪ ne ﺘﻭﺳﺭﻭﻭ ﺪﻴﻠﻴ
ﺍﺧﻪﺩﺩ ﺘﻢﺗ ﻴﺴﻔﺴﻲﺳ ﻨﻣﻞﺩﺗ ﺎ
ﻋ
ﻠﻲﻱﻭﺩﻣﺼ ﺭړ ﺍ
ﻭځﻪﺍ ﻴﻦ ﺗ ﺯﻣ ﻭﺮﮑﻡﻧ ﻮﻠﻴﺘ
ﻴﭘﻭﺩﺍ ډﻝﺍﻌﻲ ﻭ ﻮﺿ ﻪﻣﺎﻥﭘ ﻘﺘﻭﺍﺣ ﺎﺍﻤﻳﺫﻩﺍﺭﻥګ ﺍ
ﺪﻤﻫ
ﻣﻞﺩ ﺎ
ﻭﻏﺊﺩﻋ ﺭﺎ
ﻭﺩﻧ ﺎﺍﻳ
ﺎﻘﻮﺑﺗﺍ
ﺮﻴﮏﺣﺠ ﺗﻭﺮﮑﻮﺩﻧ ﺗﺩﺍﺮﻮﺣﺠ ﻨ
ﻴﭙﻮ،ﺳ ﺗ
ﺍﺮﻭﺣﺠ ﺮ
ﻭ،ﺳ ﺩﺍ
ﻮ ﻨﻲﻣ ﻳﺮﺒﻴ
ﻓ
ﻭﺍﺮﻱﻟﺎﻕﺘﺼﻟﺍﻩﺮﻘﻲﺳ ﺒﻨﻲﻃ ﻳﺪﻧ
ﺭځﻱچېﺩﻻ ځﻪﺍﻴﻦ ﺗ ﺎﻣﺮﻱﺭﻥګﻏﺸ ﺘﮐﺴﺎﻴﻦﺧ ﭙﻪﺳ ﻠ
ﺒﻪﮐ ﻟﮐﻢﺍﺮﺗ
.ﺭځﻱﻪﺍ ﺗ
ﺰﻱﻣﻦځ ﻳﺮﻧ
ﻮ ﻩﻳﻲﺧ ﺮﻮﺳ ﻟ
ﻮ ﮐﻪﺟﻼ ﭘ
ﺪﻝ ﺷﻲ ﻴﻟ
ﻩﻭ ﺮ
ﮑﻞ ﺳ ﻴﻒ ﺷ ﻔﺎﺧ ﻭﻳ ﻪ ﺷﻲﺍ ﮑﻦﺗﺸﮏﻝﻝﻧ ﻤﻴﻞ کېﻣ ﻪﭘ ﻭﻏﺊﭘ ﺭ
ﺎﺎﺩﻧ ﻪﻏﺸ ﺑ
ﺫﺎ
ﮐ
ﻠﺞﻔﺴﻲﻓ ﻨ،ﺗ
ﻔﺲ ﻟ
ﻮ ﻧﻲﮐ ﺍ
ﺭﻭﺩ،ﺘﻲﻳﺎ
ﻔﻩﺑﻲﮐ ړﺩ،ﺩﺯ ﺍﺪﻧﺴﺭﻱﺍ ﺎ
ﻴﻔﺴﻲﻟ ﻨPulﺩﺗ monar ycol laps
ﺮﻱ ﻟ
ﻩﻭﺍﺭﻱﻮ ﻮﭘﻠﻣﺍﻮﺪﻱﻋ ﻧ
ﺪﺕﺩﻻ Toxemiﺷ ﺭځﻱﺩa ﻪﺍ ﺗ
ړﻪﻣﻦځ ﻨ
ﻪﻡﻳ ﻠﺒ
ﻪﮐ ﻟﺎﻴ
ﻧﻮﻤﻧﻮﮑ ﻧ
ﺮﺑﻭﺍ
ﻧﺲ ﻭﻻ ﺮﻳﻣﻞﻭ ﺎﻭﻏﻲﻋ ﺭﺎ
-ﺩﻧ ۱
ﻩﺯﺍﺪﻧ
ﺍ ﺎ
ﺫﺑﻲﻏﺸ ﺎ
ﺩﮐ -
۲
ﻌﺖ ﻴﻗﻮﺮﻱﻣ ﻴﺗ
ﺮﺿﻲﻭ ﺩﻣ -
۳
ﺩﻮﻮﺟﻪکېﻫﻢﻣ ﻨﻳﻪﻭ ډﻝﭘﺩﻭ ﺍﺯږﻱﻪﺍ
ﻴﺖکږ ﭘ ﺒﺜﻮکېﺗ ﺎﺟﻧﺴېﻪﺍﺪﻱچ ﭘ ﻪﻟﺗﺮ
ﻴﻦﭘ ﮐﺴ ﻮﺗﻭﻭﺰﮑﻳﺍ
ﺎﺕﻳﻪﺯﻴﻠﮑ
ﻟﻮﻕﺍﻭﻓ ﻮﻱﺍ ﻴﻠ
ﮐ، ﺒﻲ،ﻋﺼﺒﻲ ﻠ
ﻩﻗ ﺮﺗﺎﻳ
ﻮﺯﮐﻻﻯﺷﻲﺧ ﺭﻮ ﺮﺘﻀﺎﺝﻣ ﻧﺴﻠﻒﺍ ﺘﻴﻦﻣﺨ ﮐﺴ ﻮ ﻭﻱﺗ
ﻮﻱ ﻪﮐ ﺘ
ﺍﺧ
ﺒﺐک ﻮﺵﺳ ﺘﻢﺩﺗﺸ ﻴﺴ ﻟﻲﺳ ﺎ
ﻘﺘﻧ
ﻭﺩﺍ ﻊﺍﻮﺳ ﻩﺩﺗ ړ،ﺩﺯﻟﻲﺎﺘﺤﻮکېﺩﺍﺳ ﺎﺟ ﻧﺴﺒﻲﺍ ﻠ
ﻗﻭﻮﺍﺗﻪﻋﻀﻼ ﭘ
ﻮﺗ
ﺍﺮﻟﻲﺣﺠ ﻮﺑﻮ
ﻭﻪﺗﺭګ ﭘ ﻮﺗږﻱﺩﭖښ ﺒﺐکږ ﺍﻱټﺱﺳ ﺭﻮﻴﻟﻲﻧﻮﺘﻢکېﺩﭘ ﻴﺴ ﺒﻲﺳ ﻪﻋﺼ ږﻱﻭﭘ
ږﺍ
53
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﻮﺗ
ﻨﻲﻋﻀﻼ ﻴ,ﺩﻋSof
tplate،ﻩﺩﺭﻥګﺍﺪﻤ،ﻫ
ﺭځﻱﻪﺍ ﺗ
ﺘﺲﻣﻦځ ﻳﺍ
ﺭﻮﻴ
ﺎﻧﻳ
ﻭﺍﺕﺍ ﺮ
ﻴﻐﻮﻱﺗﻟ
ﺎﺘﺤکېﺍﺳ
ږﻱ
ﺒﺐکږ ﻠﺞﺳ ﻮﻓﺗﺎ
ﻳﺎ
ﻬﻭﺩﻧﺍ ﻠﺞﻓ
ﻩﻴﮏېﺏڼ ﻨ
ﻴﻠﮐ
ﺍ
ﺪﺍﺟ ﺪﺍﺕﺟ ﺮﺎﻫﻮﻣﻲﺗﻈ ﻤﻭﻋﻌﻲﺍﻮﺿ ﻩﻳﻲﻣ ﺮﻪﻧﻈﻴﮏﻟﻨﻴ
ﻠﺩ،ﺩﮐﺭﺧﻲ ﻩ ۶ﻭ-ﻩ۱ﺩﻮﻳﺦﻣﺮﻔﺩﺗ
ﻭﻮﻪﮐﻌﻟﺎ
ﻣﻄ
:
ﺍﺕﺮﺎﻫﻣﻲﺗﻈ ﻮﻤ
ﻋ
ﻭﺍﺩﺭﻭﺩﺩړ
ﺪﻥ ﻍ،ﺩﺑﺎﻱﻬﺘﺍﺷﻱﻭﺑﻲ
ږﺍ ﻟړﻱ
ﻪﻮ ﺭﺟ۳ﺩﻮﻻً۹ ﻤ
ﻌﻪﻣﺒﻮﻱﺗﻴﻞﮐډﻝﭘ
ﺩﻭ ﺎ
ﻪﺣ ﻭﻏﻲﭘ ﺭ
ﺎﻧ
ﻩﻧﻲﺩ ﻮ (Looksiﺷll
ږﻱ) ﻣﻲﻮ
ﻠﻌﻭﻍﻣ ﺭ
ﺎﺮﻧ
ﻳﻭډ ﻴﮏﺍﮐﺴ
ﻭﻭﻍ ټﺭﺎ
ﻭ،ﻧ
ځﻱ ﻱﻮﺍ ﻩﻳﺮﺭﺳ ﺩﻭﺭﺮﺩﺳ
ﻡﺪډﻋ ﺍګﻻﻥﺮﭘ
ﻮټﺱﻭﺩﺳ
ډﻱ ﺍ ﺭﺍﺎ
ﮐﻮﻳ
ﺎﻪچېﻣ ﻠ
ﮐﺮﻱ،ﻟ
ﺎﺕﻭﻧﺎ
ﻳﺬﻭﻫﺎﺕﺍﻮﺷﺭﻱﺗﺸ ﻮﻌ
ﻡﺷ ﻮﺎﺷچېﻣ
ﺍﺕﺮﺎﻫﺪﺗﻈﻧﻭړ
ﺍﺍ
ﺪﺕﻭ ﺎﺷ ﻴﻤ
ﻴﮐﺴﻭﺩټ ﻭﺭځﻱﺍ
ځﻪﺍﻴﻦ ﺗﭙﺲﻣ ﻟ
ﻮﻧﻲﮐﺍﺭ
ﻭﻮﺩ ځﻪﺷﻲﻧﻣﻦ ﺗ ﺍ
ﻪﺭ ﻳ
ﺎﻔﮐ
.ﺮﻱﻟ
ﻩړﺍﺭﻱﻮﺍﻯﭘﻮﻱځ ﻤﻦﺷ ﻧﺎ
ﻳﺯ
54
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
:
ﺍﺕﺮﺎﻫ
ﻌﻲﺗﻈ ﻮﺿﻣ
.ﺮﻱﻟﻩړ
ﺍﺭېﻮﺎﺣﻲېﭘ
ﻮﻱﻧﺭﻱﺷﺮﺘﻀﻭﻣ
ﺍﻮﻱﻩﺷ ﺮ
ﺛﺎﺘ
ﺍﺕﻣ ﺮ
ﺎﻫﺍﺗﻈ
ﺩ
ﺩړ
ﺍ
ﺎﻭ ﺍﻳﻮﻩﺧ ﻮﺍﺕﻳﺯ
ﺍﺮﻓ
ﺯﻱﺍﻮﺩﭘ
، ﻮﻱﻴﻞﮐﻩﭘ
ﻪ ﺏڼﺰﺵﭘﻳﺩﺭﺎ
ﻭﻏﻲﺩﺣﺭﺎ
:ﻧNasalDiphtheri
a
ﻭ.
ﻴﺤﻲ ﻱﺎﻗﺎﻃﻲﻳﻓﻲﻣﺨﺰﺍﺕﻧ
ﺯﺍ
ﺮﻓﺍﺍﻱﺷﻲچېﺩﺩ
ﺭځﻱک ﻪﺍﺗﺍﻣﻦځﻮﻩﺧ
.
ږﻱﺒﺐکږ Iﺳmpeti
ﻭ goﺍ
ﻳﺶ ﺮ
ډﻱﺩﺗﺨﻮﻥﻨﻲﺷ ﺗ
ﺭﻮﺍﺕﺩﭘﺯﺍ
ﺮﻓﺍ
Treatment
1-Antit oxi
n
2-Antibioti
c
3-Suppor ti
vetr
eatment
Compl icati
onmanagement
:
Ant iToxiﻻﻱ neﻪﺭ ﻟﺪﻱ ﻳﺭ
ﺎﻭﻠﻲﻳﻪﺩﻋﻀ ﺘﻭﺳ ﺭﻮﻭﻟﻮ
-ﺩټﺱټﮐ ١
ﺮڅ ﺮﻱﻫﻩﻟړﺭېﺍ ﻮ
ﻌﺖﭘ ﻴﻣﻗ
ﻟژﻥﺩ ﻮ iﻭﺩ ﻲ ntﺍoxi catiﺎon،ﻴﺘﺍﺧﺮﭘ،
ﺩﻱﻮ ﻓﺖﺩﻣ ﻩﻳﻲﺩﺍ ﺯﺍ
ﺪﻧﺍ
ﺍﻥکې ﺭ
ﻭېﻪﺩﻴﻦچ ﭘ ﮐﺴﻭﻪټ ﻐځﻪﻫﻴﻖﺷﻲ ﮐ ﺒﻴﻦﺗﻄ ﮐﺴ ﻭﺪﺍﻥټﻱټ ﻳﺎﺮﻱﺑ ﺎﻥﻟﮑﻣﺍ
ﺭﻩچېژ ﺮﻣﻭ
.ﻩځﻱ ﻣﻦځ ﻪﺩ ﺍﺳﻄﻮﺩﻱﺩﺩﻱﭘ
ږﻱ
ﻴﻖکږ ﺒ
ﻩﺗﻄ ﻮګﺪﻱﺗ ﻧ
ﻪﻻ ﺭﭘﺍﺪﻘﻴﻦﻣ ﮐﺴﻭ ﺩﻥټﻱټ ﺍ
I
U۴ ۰۰
۰۰
-۲۰
۰۰ﻮﻱﻭﻱ۰ ﺮﺷ ﻴ
ﺮﻱﺗ ﻮﮐﻢﻭﺧﺖﭘ ﻧ
ﻮﺘﺎﻋ۴ﺳ ﻭکېچېﺩ۸ ﻪﭘﻲښ ﺮﻱﭘﻨﺠﻭﺣ ﺍﻡ ﻮﻤ
ﻌﻠﺩﺑ
ﻮﻱﻭﻱ ﺮﺷﻴﺮﻱﺗﻩﭘ ﺩﻮﻪﻣ ﺗ
ﺎﻳ
ﺮﺩﻱﺯ ﺎﺗ
ﻪﻳﺘﺎﻋ۷ﺳ ﻭځﻱ۲ ﺭﻱ ﺭ ﺭﺕکېچېﺩ ﻮﻪﺻ ﻓﺖﭘ ﻊﺍﻴﻭﺩﻭﺳ ﺍ
ﻩﺮﻨﻲﺳﻠﻣ
ﺭﺩﻭﻍﺩ ﺭﺎ
ﻭﻧ ﻮﺍﺍﻧﺸﺪﻴﻟﻲﭘ ﺍ
ﻩﻭﻩښ ﺮﺯﻱﺳ ﺍﺪ
ﻧﻮﻱﺍ ﺩﺷﺎﻪﺩﻳ ږﻱﮐ ﻘﻲ ﻴﺒ
IﺗﻄU۱ ۲
۰۰۰
۰-۸۰۰۰
۰
ﺑﻞ کېﺩﺎﻘAntﻣ iToxi ﺍ چېﺩne ﺩ
ږﻱ، ﺍ کږ ﺮﺍﺍﺟ
ًﺭﺮﮑSerﻣ otherﻮ apy ړﻧﻧﮏ ﺭ
ﺍﺏﻭ ﻭ ځ
ﺪﻱ ټکﻧﺪﻻﻳﺎﻮﺑﺩﻭﻱﻧ ﻮ
ﻮﺟ ﺮﻣ Serﺧﻄum Si ډﻝﺩckness ډﻲ ﻭﻪځﻥﻧ ﺎﭘﻭﻳﺎکﺍﻴﮏﺷ ﺘﮑﻠ
ﻓﺎﻧ
ﺍ
ﻭ.
ﺮکې ﻱ ېﻧﻄ
ﻩﻩﺩﺩ ﻮ
ﻮﺟځﻪﻣﺭﻱ ﭼ ﺎ
ﻭﺗ ﻴﮏﭘﻲښ ﺮﺟﻟﺍ-ﺎﺩ
ﻳ
۱ﺍ
ﻮﻝ ﺍﮐ ﺮ
ﺍﺟ ﺮﺟﻲټﺱ ﻟ
ﺍﺩ-۲
ږﻱ
ﺭﻕکږ iﺯntrraderﺮ mal ﺘﻴﻠﻲﻟ۱ﻣ
.ﺍ۰ﻴﻖﻭ ﻗ۱ﺭ۰۰
:ﺪﻱ ټﺱټکې۱ ﺪﻱ ټﺱټ:ﭘ ﻠ
ﻟﻒ ﺟ ﺍ
-
۱ﻪﺩ۰ږﻱﮐﻴﻖکږ ﺒ۰ﺗﻄ۵،ﺧ۰
ﻮﻝڅﻪ ﻠ
۱ﻣﺤ ۰۰۰
:ﺎ۱ﻴﻮﺑﻩﻭﻱﻧ ﺩﻮ
ﻮﺟ ﻪﻣ ﻳﺨﭽﺭﺎﺍژﻱﺗﺮﺭﻱﺩﻟﻪچﺭ ﻭﮐﺍ
ﻴﺖ ښﻱ ﺎﺳ ﻟړﺣﺴﺍﻮ ﻮﺩﻮﻧ ﻩﺷ ﺭ
ﺎﮐﻪ Whealښ ﺘﻭﺳﺭﻘﻲﻭ ﻴﺩﻗ۳۰
ﻠﻲﻔېﻪﺳ
ﺍڅک ﭘ ﻮڅ ﻪﻳﻮﻝﻧ ﻠ
ﻮﻱﻣﺤ ﻴﻖﺷ ﻗ۱ﺭ۰:ﺪﻱ ټﺱټکېﺩ۱ :Conjﭘ ecti
valTest: ﺏ
ﻪﻠ
ﻩﻪﺑ
ﻮګ ﭘﻪﺗ ﺪﭘﺎﻫﻴﻦﺩﺷ ﻟ
ﺎﺍڅکېﺳ ﻮڅ ﻭﻳﺍﻭﻔﻦ کېڅڅ ﻮﻱﺟ ﻠﻪﻋ ﺍڅکېﭘ ﻮڅ ېﻭﻳﻔﻦک ﺍ ﺟ
ﻟﻲﺍ
ﻭﺭﻮ
ﻤﻲ ﺳ ﻨﻈﻭﺩﻣ ﻭﺪﻝﺍﻴﻬښﻮﺑﺩﻭ ﮐ
ﻪﺍ ﺘﻭﺳﺭ ﻘﻲﻭ ﻴ
ﻗ ۳ﺩﻟﻲ۰ﻟﺲﺍ ږﻱ،ﻭﻝکږ ﻪکېڅڅ ﮐﺮﺘﺳ
ﺭﺩﻮﻭﻧﻴﮏﺍ ﺘﮑ
ﻠﻓﺎﻧ
ﻪﻭﺧﺖ کېﺩﻱﺩﺍ ښﻲ ﺩﺗﺲټﭘ ﻪ ﻳ ﺛ
ﺩﺎﻴﺖﺣ ﺎﺳﻩ کېﺩﺣﺴ ﻪ ﺳﺖګ ﺑ
ﻭﻴﺠﻦﺍﮐﺴﺎﺕ،ﺍ ﺑ
ﺮکﺏ ﺪﺗ ﻳ
ﻭﺭﻭﺩ ﺱټ ﻴﻦﺍ ﻟ
ﺎﻨ
ﻳ ﺭﺩ
ﻪﺍ ﮑﺩﻭﻱﻟ ﻮﻮﺟﺭﻱﻣ ﺎﻴﻟﻲﺗ ﺩﺎﻴﺖﺩﻣﺠ ﺎﺳﺣﺴ
.
ټﺭ
ﻟﻲ ﻭ ﺎ
ﻳﻮډﮑﻧﺍﺮ
ﺑ
55
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
:
ﻪﻧﻭﺩﻮﺘﻴﻭﻣ ﺍ ﻻﻱ
ﻴﻖ ﺭ ﺒﻴﻦﺩﺗﻄ ﮐﺴ ﻭﺘﻲټ ﻧﺍ
ﺩ
ﺩﻻﻱ
ﺭ IﻴﻦﺩM ﮐﺴ ﻭﻮﺍﻥټﻱ ټ ﻔﻲﻭﻱﻧ ﻨ
ﻭ ټﺱټﻣ ﻩﻭﻱﺍ ﺩ ﻮﻮﺟ ﻪﻣ ﻳﺨﭽﺭﺎﺍژﻱﺗﺮ ﻪﺩﻟ -ﮐ۱
ږږ
ﻴﻖک ﺒ1:ﺗﻄﺩ 10 0.ﺭﺕکې5ml ﻮﻪﺩﻱ ﺻ ﺭﺕﻭﻱﭘ ﻭﺮﻪﺿ ﻴﻖﺗ ﺒﺪﻱﺗﻄ ﻳﺭﺭﻱﻭ،ﻪچﺭ ﻭﮐﻮﻘﻴﺒﺗﻄ
ﺷ.
ﺭﻕ ﻲ ﻭﺯ ﺍﻴﻖﻗ ﺭ
۲۰:ﻪﻳﻲ۱ ﺮﺧ ﺎﺕېﺑ ﻮﭘ ﻩﺷﻲﻧ ﺭﺎ
ﮐﻩښ ﻳﮏﭘﻲښ ﺍژ
ﺩﺮ
ﻪﻟ ﻱﮐ
ﻴﻦﮐﺴ ﻭﺘﻲ ټ ﻧ
1:ﺍﻮ10 ﻔﻲﻭﻱﻧ ﻨ
ﺍژﻱټﺱټﻣ ﺮﻭﺩﻟ ﻪﺍﺘﺒﺜﻪﻣ ﻳﺨﭽ ﺭﺎﻴﺖﺗ ﺎﺳﻪﺩﺣﺴ ﺯﮐ ﺍ
ﺍﺭﺪﻤ ﻭﻫﺍ
ﺎﺩﺧ ﻴﻮﺑ ﺪﻝﺷﻲﻧ ﻴﻪﻟﻧﻪﻭﺛﺩﺎﻪﺣ ﻣﻮﻪﮐ .ﻱﮐ ﺭﻕ کې ﺪﻱﺯ ﻧﺘﮏېﻻ ﻮﺳ ﻩﺩﭘ ﺯﺍ
ﺪﻧﻪﺍﺩ۱ﺳﻲﺳﻲﭘ
ﻪﻧ
ﻩﻭ ﻪﭘﻲښ ﻣﻮﻤﻞﮐ ﻌ ﻠ
ﮑﺴﻪﺩﻋ ﺭﻕﮐ ﺪﻱﺯ ﻠﻟﺠﻩﺗﺤﺖﺍ ﺯﺍﺪﻧ
ﻪﺍ ﺩﻮﺳﻲﺳﻲﭘ ﻴﻦ ﻳ ﮐﺴ ﻭﺘﻲ ټ ﻧﻟ ﺺﺍﺎ
ﺷ.
ﻴﻖ ﻲ ﺒﺎﻥﺗﻄﻪﺷ ﺩﭘﻮﺘﻴﻭﻝﻣ ﺍﻪﺩ ﮑ ﻟډﺯ
ﻮﻱ ﻭ ﻮﻝﺷ ﻨﺠﻮﺩﺳ ﺎﻧﻴﻮﺑ ﻳﻞﺷﻲﻧ ﺪﻴ
ﻟ
ﻟړ
ﻓﻲﺩﻢ ﺍﺮﺗﻭﺮ
ﻴﺪﻱﻭﺧﺖکېﺳ ﻮﭘﻮﻧ ﺒﺖﺷ ﺜﻪﻣ ﻴﺠ ﺘﻭﺩټﺱټﻧ ﺍ ﻔﻲﻨځﻪﻣﺭﻱ ﭼ ﺎ
ﺍژﻱﺗ ﺩﺮ
ﻪﻟ -ﮐ ۲
.
ﻭﻮﻠﻲﮐ ﻤﻪﻋ ﺩﭘﻮﺘﻴﻱﻣ
0ﻪ
.ﭘ ﻟﺖکې05ml ﺎ
ﺪﻱﺣ ﻮﭘ ﺒﺖﻭﻱﻧ ﺜﻩﻣ ﺩړ
ﺍﻭ ټﺱټ ﻭ ﻪﺍ ﻳﺨﭽ ﺭﺎﺭﺕکېچېﺗ ﻮﻪﺻ ﻐ-ﻪﻫ۳ﭘ
1.0ﻭ3ml .ﺍ ﻮکې1ml ﻘﻴ
ﻗ ۱ﺩﻫ۵
ﻮﺩ ﺮ ﻭﻧﻪﻭ ﺩﻧﻮ ﻮﺟ ﻤﻞﻣ ﻌﻠ
ﮑﺴ ﻡﻋ ﻮﻪﮐﺭﻕﮐ ﺪﻱﺯ ﻠﻟﺠ ﺍ۲ﺗﺤﺖ :
۱
ﺷ.
ﺒﻲ ﻲ ﻡﺗﻄﻭ ﺮﻴﻟ ﺺﺳ ﺎ0.ﺧ ﺎ2ml ﻴ
ﻪﺑ ﺘﻭﺳ ﺭ0ﻭﻭ.ﺍ ﺍ1ml ﻮﻝﻭ ﻠ
۱ﻣﺤ ۰:ﺩ۱
.ږﻱ
ﻮﻝکږ ﮐ ﺭ
ﻴﺢﻭ ﺮﺟﻪﺗ ﻓﻲﺗ ﺍ
ﺮﺗﻭﺮ ﻴﺪﻱ ﺳ ﻳﺭﻮکېﻭ ﺗﺎﻻﻮﺣ ﻤﻴﻪﻭﺧ ﭘ
ﻭﻴﻦﺍ ﻠ
ﻴﻨﺴږﻱچېﭘ ﻪکږ ﻴﻮﺻ ﻪﺗﻧﻮﮑﻴﺗﻮﻴﺘﻲﺑ ﻧﺪﻱﺍ ﻧﻩﻻ ﺭﺎﭙ
ﻮﻟ ﻟ
ړﻩﻭ ﺩﻪﻣﻦځ ﺒﺐ ﻟ ﻭﻏﺊﺩﺳ ﺭﺎ
-ﺩﻧ ۲
ﺩ.
ﻣﻞ ﻱ ﺭﺑﻲﺩ ﺎﺘﺨﻧﺍﻴﻦﻳﻲ ﻳﺴ ﺎﻣﻭﺮﺘﻳﺮﻳ
ﺍ
ږږ
ﻮﻝک ﮐﺭﻩﻭ ﺭﺎﭙﻟ
ﻭﻭځ ﻭﺭ ﻭﻴﻦﺩﺍ ﻭﺳ ﺮﺘﻳ
ﺮﻳﺯ ٍﺍ ﺍﺍﺭﺪﻤﻩﻫ ﺭﺎﭙﻟ
ﻭ ﻭځ
ﻭﺭ ﻭﻪﺩﺍ ﮑﻟ۱
ﻴﻦ۲ ﻠﻴﻨﺴ ﻴﻦﭘ ﺗ
ﺍﺰﻨ
ﺑ
.ﻱ
ﺍ
ﺪﻤﻭﻫ ﻧﻲﺍ ﺍﺍګﺬﻧﮏېﻏ ﻭﺪﻴﻤﻪﻫﻀ ﻧﺎﺍﺳﻭﺭﻱﺍ ﻮﻟﺎﻩﮐ ﻟړ
ﺍﺣﺖ،ﻮ ﺮﺘﻪﺍﺳ ﻮﺗ ﻧﺎ
ﻭﻏﺭﺎ:ﻧ
ﻪ ﻨ
ﻠﻣﺭﻮﻱﺩ ﻳﻮﻘ-ﺗ۳
.ږﻱﻮﻝکږ ﮐﺭﻣﻞﻭ ﺭﺪﺩﺒﻲ ﺿ ﺗﻭﺍﻣﻞﺭﺪﺩ ﺩﺿ ﺭﺩﺯﺩ ﺍ
ﺭ
ﻴﺠﻦ ﮐﺴﻮﺏﺍ ﺮﻃ ﻪﻣ ﻭﻍﺗ ﺭﺎ
ﻮﻧﺩﻭﻱﻧ ﻮﻮﺟ ﺪﺵﻣ ﻨږﺑﺘﻢﻝ ﻴﺴﻔﺴﻲﺳ ﻨ
:ﻪﺩﺗﻪﮐ ﻨ
ﻠﻣﺭﻮﺩ ﺗﺎ
ﺘﻼﻃ ﺍﺧ -ﺩ۴
ﻮﻱ ﺩ ﻻﺖﮐ ﺪﺵﺩﻟ ﻨﻤﻞﺑ ﮑﻪﻣ ﻻﻱﭘﻔﺴﻲ ﺭ ﻨﻮﺩﺗ ﺩﻭﻱ ﻧ ﻮ ﻮﺟ ﻮﻥ ﻣ ﻟ
ﺪﺯﺑﺍﻭﻪﺩﺍ ﻭﮐ ﻪﺍ ﻴﻮﺻ ﺗ
ﺍکﺱ ﺮ
Alﻱېﻥښېﺩﻱﺗ anansi St ri
dor, Chesti ndr awi ng,،
Dy ﺯﺱ spnea ﻮﻧﺎﻴﺳ
ﻣﻝګﻱﻤﻲ ﺎ ﮐ
ﺮﺣﺖﺩ ﺘﺮﺍﺳﺘﻪﺩﺑﺴ ﻭﻍﺗ ﺭﺎ
ﻳﺖ کېﻧ ﺩ ﻮﻮﺟ ﻪﻣ ﺘﺲﭘ ﻳﺍډﺭﺎ
ﮐﻮﻴﺍﺷﻲﺩﻣ ﺮ ﻣﻲﺍﺟ ﻮﺘﺳ
ﻴﻖﺒﻳﻒﺗﻄ ﺍټﺳډ
،ﻭ ﻲ ﺑﻖﺍکﺱﺳﺠﻦ ﺍ ﺎ
ﻴﮏﻣﻄ ﻨﻴﻠ
ﻭﻍﺩﮐ ﺭﺎ
ﻧړﻦﺩﻱﺩ ﻭﻝﺍﻳ ﺩﻭﺪﻮﻣﺤ ﺗﺎﻌﻳﺎﻭﻣ ﺍﺍﺬﻏ
ﻴﻖﺒﻮﺏﺗﻄ ﺘﻴ
ﻧﺠ ﺪﺍﻳﺎﺭﺕﺑ ﻮ
ﻪﺻ ﻠﺞﭘ ﻨﮏﺩﻓ ﻭﺩﺣ ﺮﻱﺍ ﻩﻟﻮﻝګټ ﻘﻴﺒ
ﻳﮏﺗﻄ ﻭټ ﺮ
ﻳﺍﻪډ ﻠﻪﮐ ﻠﮐ
ﻭﺷﻲﺍ
.ږﻱ
ﻪکږ ﻴﻮﺻ ﻴﻦﺗ ﻣﺍ
ﻭکېﻭﻱټ ټﺱﻪﭘﻲښ ﺍﻱ ﭘ ﺭ
ﻮ ﻴﻟﻲﻧ ﻮﺷﻲﺩﭘ
.
ږﻱ
ﻪکږ ﻴﻮﺻ ﻓﻲﺗ ﺍ
ﺮﺗﻭﺰﻴﺭﺕکېﻓ ﻮﻪﺻ ﺩﻭﭘ
ﻊکﺩ ﻓﻭﻏﺊﺩﺭ ِﺭﺎﺩﻧ
:
ﺭﺍﺰﻧ
ﺍ
ﻴﻦﺩ ﮐﺴﻮﺘﻲﺗ ﻧﻮﺩﺍ ﻩﺧ ﺪﻴ
٪ﻪﺭﺳ ۵ﺗ ۰-
۳ﺪﻱ۰ ﻧﺍړﻪﻭ ﻴﻦﺩﮐﺸﻒﻧ ﮐﺴﻭ ﺘﻲ ټ ﻧ
ړﻪ ﺩﺍﻨﺮﻱﻡﻳ ﺘ
ﻔﻳﺩﺩ
ﺭﻣﻦځ ټﺱﻪژ
ډﻱ ﺑ ﺭﺍ ﺎ
ﮐﻮﻳﺎ
ﻪﻣ ﺯﮐ ﺍ
ﺍﺭﺪﻤﻩﻫ ﻮﻱﺩ ﻪﺷ ﻤ٪څﻪﮐ
ﺪﻱﺩ ۵ﺧ ﻴﺼ ﺍﻓﻪﺩ ﺘ
ﻭﺳ ﺭﻪﻭ ﺎﻝﻧﻤﻌﺘﺍﺳ
ﻳﻞﺷﻲچېﺩ ﻭ ﺪﻭ ﻳﺎږﻱﺑﺭﺳﻲ ﻪﻭ ﻩﺗ ﺪﻴﺼ۲ﻓ ۵-ﻪ۵ ﻨﻲﮐﭽ ﻳړﺍﻱﺷﻲچې ﺩﻡ ﺩﺩﻮک ﺍﺷﻲﻧ ﻪﺭﺗ
.ﺮﻱﻟﺮﻴﭘﻮﻩﺗ ﺮﻴﺖﺳ ﻮﻋﻭﻏﺊﺩﻧ ﺭﺎ
ﺭﻳﻲﺩﻧ ﺍﺰﻧ
ﺍ ﻭﺍﻪﻨﻲﮐﭽ ﻳړﻧﮏېﺩﻡ ﻭ ﺪ
ﻳﻪﭘﻲښ ﻭﻏﺊﻧ ﺭﺎ
ﻧ
ً
ﺎﻮﺻ ﻣﻞﻳﻲﺧﺼ ﺎ
ﺒﻲﻋ ﺒGrﺳ aviﺮﻱs ﻟ ﺮﻴﻴﻢ ﺳﺮﻭﺧ ﻳﮑﻞﻳﻲډ :ﺷ ﻟﻒﺍ
ﻴﺖ ﻌﻗﻮﻓﺖﻣ ﺍﻌﻲ ﻮﺿ :ﺩﻣ ﺏ
ﻟﺖ ﺎ
ﺘﻲﺣ ﻴ
ﻓﺎﻌ:ﺩﺷﺨ ﺺﻣ ﺝ
ﻭﻱﺍﺪﻭﺗﺍﻴﺺ ﻡﺗﺸﺨ ﺪﻘ:ﻣ ﺩ
ﻠﺞﻔﺴﻲﻓ ﻨټﺱﻭﺗ
ډﻱ ﺍ ﺭﺍﺎ
ﮐﻮﻳﺎﻣ،
ﺪښﺕ ﻨ
ﻻﻱﺑ ﻔﺴﻲ ﺭ ﻨ
ﻪﺩﺗ ﮑﻣﻞﻟ ﺍﻮﻨﻲﻋ ﻳ
ړﻪﺩﻡ ﻠﻣﻪﺍ ﺮﻱﻟ ﻴﺘ
ﻔﻳﺩﺩ
56
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﻭ.
ﺟړﻱ Respiﻮ r
at oryPar alysis
:
ﻮﻱ ﻴﻨﻣﺨ
ﻭﺰﻱﺍ ﺗﻞﺷﻲچېﺩﭘ ﺎﺪﻭﺳ ﻳﺮﻪﺗﺠ ﻐ
ﺮﻫ ﺎﻥﺗﻭﻏﺭﺎ
ﺪﻧ ﻳﺎ
ﺮﺑ ﺎﻃﻪﺧ ﻮﻱﭘ ﻴﻨ
ﻳﺖﺩﻣﺨ ﺍ
ﺮﻪﺩﺳ ﻭﺗ ﺭﻮ
ﻧ
ﻭﺩﺍﻮﺪﻣ ﻧﻲ ﺿ ﻮ ﻓ
ﻮ ﺪﺩﻋ ﻳ
ﺎﺩﺑ ﺍ
ﻮ ﻮﻱﻣ ﺎﻝﺷ ﻤﻌ
ﺘټﻝﺍﺳﻭﻍ ﻭ ﺭ
ﺎﻔﻲﺷﻲﺩﻧ ﻨﺮﻣ ﻠﭽﻭﮐ ﺩﺍ
ﻮ ﻧﻲﺩﻣ ﻮﺘﺳ
ﺪﻳﺎ
ﻪﺩﺑ ﻮ کېﮐ ﮑﻧﻭﺮﺎﺱﻟ ﻤ Schiﺗ ﺒﺖ ﺷﻲck ﺜﺮﻣﻠﭽ ﻭﮐ ﻧﻲ ټﺳﺖﺍ ﻮﻔﻭﺑﻲﻋ ﺎکﺍ ﻪﭘﺍﺳﻄ ﻮﭘ
،ږﻱ
ﺪﻝکږ ﻧژژ
ﮑﻞﭖ ﻪﺷ ﻗﻞﭘ ﺎﻔﻲﻭﻱﺩﻧ ﻨ
ﻩﻣ ﺩړ
ﺍﺮﻭ ﻠﭽټﻭﮐ،ﻪټﺱ ﺍ ﻭﻱﺷﻲﮐ ﺍﺪﮑﻞﺗ ﻪﺷ ﻭﻍﭘ ﺭﺎﻧ
ﺩ
ﻟړ
ﻪﻮ ﻴﻦﭘ ﻠﻴﻨﺴ ﺎﭘډﺯﻳ
ﺮﻭ ﺘﻮﺳ ﻴﻦﺑ ﮐﺴﺍﻩﺩﻭ ﺭ
ﺎﭙ
ﻮﻱﻟ ﻐﺪﻱﺩﻫ ﻳﻮ ﻴﻦﺷ ﮐﺴ ﺍ
ﻴﻦچېﻣﺨﮏېﻭ ﻠﻗﺎ
ﻪﻧ ﻐﻫ
ﺒﻖﻴﻦﺗﻄ ﮐﺴ ﻭﺘﻲ ټ ﻧ
Iﺍ U۱ ۰۰۰ﺪ۰ ﻳ
ﻮﮐﺴ ﻭﻩټﺭﺎﭙﻟ
ﻮﻱ ﻐﻪﻭﻱﺩﻫ ﻮﻱﻧ ﻴﻦﺷ ﮐﺴ ﺍ
ﻪﻭ ﺎﮐﻣﻪﺷﻲﺍ ﻴ
ﻮﺻ ﺗ
ﻪﭘﻴﻦﺩ DPT ﮐﺴ ﺍ
ﻭﻏﺊﻭ ﺭﺎ
ﺩېﻧ ﺩ،ﺩ ﻴﻖ ﻱﺒﻴﻦﺗﻄﮐﺴ ﺍ
ﻪﺩﻭ ﻘﻳﺮ
ﻩﻃ ﺮﺛﻮ
ﻮﻱﻣ ﻴﻭﻏﺊﺩﻣﺦﻧ ﺭﺎ،ﺩﻧ ﺷﻲ
ﺭﻱﺎﻴﻟﻪﻟﻠﻲ ﻩﺩﻋﻀ ﺮﺘﻴﻟﻠﻲ ٠ﻣ ،
ﻪکې٥ ﻠﺎﺻﻪﻓﻮﭘ ﺘ
ﻔ۶ﻫ -۴ﺭﻱﺩ ﺍﺭﻱﻭ ﻣﻞﺩﻱچېﺩ ﺎﺮکﺏﺏکېﺷ ﺗ
ﺎ
ﻭﻳ ﺍﻪ ﺘ
ﻭﺳ ﺭ ﮐﻝﻭﻮﺎ ﻪﻳ ﻟﺯﻳﻲ ﻭﺮﺩ ﺘﻮﺳﻭﺑﺍﻭﻉﺮﻪﺷ ﺘﻭﺳ ﺭ
ﻨﺊﻭ ﺘﺎﺷﻴﻩﻣﻭ ﻪﺩﻟ ﻴﻦﮐﺴﺍﻭ،ږﻱﻴﻖکږ ﺒﺗﻄ
.
ږﻱ ﻘﻲﻴﺒﻪﺗﻄ ﺘﻭﺳ ﺭ
ﮐﻮﻭﻟ۵ﺎ -ﻪ۴ ﻟ
:ﻪﻧ
ﺭﺍ
ﻮڅ ﮑﻧﻭﺮﻟﺎﺱ ﻤﺩﺗ
ﺩﻭﻱ ﻮ ﻮﺟﻼﻢﻣ ﻪﻋﻳ ﻭﮐ ﻪ ﺷﻲﺍ ﻨﻳﺎ
ﻌﺪﻣ ﻳ
ﺎﻩﺑﺮﻪﻧﻈ ﺮﻱﻟ ﻴﺘﻓﺩﻑ ﻧﻲﺩ ﻮﺘﻭﺳ ﻩﺍﺰﻮﭘ ﮑﻧﻭﺮﺎﺱﻟ ﻤﺩﺗ
ﺘﻲﻪﻭﻱﺍﺧﺴ ﺪﻧﻴﮐﺴﻭ ﻮکېﻳﻲ ټ ﻧﻮﻠﮐ
ﻮ۵ ﻴ
ﺘﻭﺳ ﺭ
ېﻪﻭﻠﮏچ ﭘ ﺎﻑﺧ ﻌ
ﺮﺿﻲﻣ ﺮﻋ ﻴ
،ﻏ ﻭﻱﺩﻱﺷﻲ ﺍﺪ
ﺗ
ﺷ.
ﺰ ﻲ ﻳﺎ
ﻧﻮﻤﻳﺍﺪﻳﺎ
ﺑ
ﺯﻥ ﺪﻥﺩﻭ ګﻡﺩﺑﺍﻮﺭ ﻟ
ﺮﻓﻲکﻝ ګﻡﭘﺍ
ﻠﻲ ﺭ ۴ﻣﺮﻱ۰ ﻟ
ﺎﺱ ﻤژﻱﺗ
ﻩﻥﺩ ﺮﻭﻍﺳ ﺭﺎﻠﮏچېﺩﻧ ﺎﻑﺧ ﻌ ﺮﻣ ﻴ
ﻏ
ﺎﻥﻭﻏﺭﺎﻭﻧ ﺍﺍﺮﻳﺸﻦﺍﺟ ﺰﻳﺎ
ﻧﻮﻤﻳﺎﻝﺍ ﻌﻭﻓﻩﺍﺭﺎ
ﭙﻟﻭﻭځ
ﻭﺭ ﻭﻴﻦﺩﺍ ﻠﻴﻨﺴIﭘU۲ ۵۰
۰ﻳ۰ﻭﺎ ﻴﻦﺍﻳﺴ ﺎ
ﻣ ﻭ
ﺮ ﺗ
ﻭ ﺮﻳ
ﺍ
ﺷ.
ﻮﻝ ﻲ ﻴﻧ
ﺪﻱﻭ ﻧﻧﻲﻻ ﺭﺍﺩڅ
ﺯﺱﻮﻠﮑﻴ
ﻮﻧﻧﻮﮑﺸﻦﻣ ﻔﻧﺍ
(Infecti
onmononucl eosi )s
:ﻳﻒ ﺮﻌ
ﺗ
Epst ei،چېﺩn ﻩ
ﻭﻏﻲﺩ ﺭﺎﻧﻲﻧ ﺎﺘ
ﻧﺍﻩﻮ.ﻳ
ﻳﻲﺍkiﻫﻢﻭ ssingDi Moﻭseaseۍﻪ noﺍ ﻭﻍ ﺗ ﺭﺎ
ﺩېﻧ
ﮑﻞﭙﻳﺍﺍټﻟﻰﻭ ﺍ
ﻮﻳﻮﻭﻟﻮټ ﻭﻱﻏ ﺎ
ﻔ ﻤ
ﺩ،ﺩﻟ
ﺩﻧﻲ ﺭﻮﺘ،ﺳ ،
.ﺮﺗﺐ ږﻱﭘ ﻪ کږ ﺗ
ﻣﻦځ ﺍﻪﺭ ﻠﻣBﻪﺍ
arﻟ rVi rus
ﺩ.
ﺘﺼﻒ ﻯ ﺪېﻣ ﻧﺎ
ﺯﺱﺑ ﻭﺎﻱټ ﻮﺳ ﻔﻤﻟ
ﻪﻟ
ېﻪﺩېډ ځﻯﻭﻱچ ﭘ ﻮﺍ ﻩﻳ ﺮﻮﺳ ﻧﻭﺭﻮﻣﺭ
ﻮﻧﻲﺗﺎﺘﻧ
ﺭﺍﺷﺭ
ﺩﻮ ﻢ ﻩﻳ ﺭﻥګ ﺍﺪﻤEpstﻫ ei nBar rVi rus
ﻮ کېچې ﻧﺎ
ﻭﻏ ﺭ
ﺎﻪﻧ ﻐﻪﻫ ﻭﭘ ﺎﺍﻣﻮﻔﻤﮑﻦﻟﻮﺟ،ﻫ ﺎ
ﻣﻮﻔﻤBurﻟ kitt
's،ﺎﻣﻮﻨﻴﺭﺳ ﺎ
ﻴﻞﮐ ﻧﺠ ﺭﺎ
ﻓﻭﺰکېﻧ
.
ﺮﻱﻟﻭﻥډﺎﻫﻢګ ﻣﻮﻔﻤﻟB. Cell
ﻮﻯﻭﻱs ېځﻞﺷ
ﻴﺖﻱ ﭘ ﻓ ﺎ
ﻌﻣ
ﻪﺩﻱ ﻟﻭﻩډ ﻭ ،ﺩﺮﻱDNACorﻟ ﻮﺧﻄﻲe ړﻯﺩﻯﻳ ﺭﻥۍﻍ ﻮHerﺩﮐ pesVi ri
ﺮﺱﺩdae ﻳﺍﺍﻭﺩ
ﺩ.
ﺍﻥ ﻯ ﺭﺮګ ﻴﭘﻮﻩﺗﺮﻪﺑﻞﺳ ﻟېﻮ
ﻩﻱ ﻳ ﺮﻪﻧﻈ ﻟﻮﺟﻲ ﻟﺍ
ﺮﻴEﻭEBV2چېﺩﺳ BV1ﺍ
:ژﻱﻮﻟﻮﻤﻳﺪﻴﭘﺍ
ﻠﻦۍ ٣ﮐ ﺗ٥
١څﻪﺮﻟ ٠ﺧ ﻩﭘﻲښېﻱېﻪ ﺮﺗ
ﺎﻳ
،ﺯږﻱ
ﺍکږ ﺪﻴړۍکېﭘ ﻪﻥ ﻟﻭEﻪټ pstﭘ einBar rVi rus
.
ږﻱ ږ
کېﭘﻲښ
ﻭ ټﻱټټ ﻪﺍﻨﺗﺎ
ﺎﺳ ﻴﺘﻭﻏﻪﺭ ﺑﺍ
ﺮ ﻮکېچېﺧ ﻨﻟ
ﻭﻮټ ﻐﻪﻫ ﻭﭘ ﻩﺍ ﻭﻏﻲﺩ ﺭﺎﻮﻧﻧﺎﻫﻼﻮﮐ ﻧﺍ
ﻭﺩﺩځ ﻌﻦېﺍ ﻳ
ېګﻮ
ﻠﺎﺕېﭘﻲښېﻱې ﺏ ﻳ ﻳ.ﺯ ﻮﻱﻪﮐ ﺘ
ﺭﺍﺧﺭﺎﻥډ ﻣﻮﺎﺷ ﻩﻣﺮﻤ ،ﮐﻢﻋ ﺮﻱﻟﻟﺖﻭ ﺎ
ﺩﻱﺣ ﺎﺘﺼ ﻗ
ﺰﺍ ﻴﻨﻟ
ﻭ
ﻭ.
ﻱ
ﺎﻫﻪﺏېګﻝﻝېﮐ ﻟﻪﻪﮐﭽ ﺗﺎﻳﻪﺯ ﺮﺱﭘ ﻳﺍ
.ﺍﻭ
ږﻱﺩﺩږ ﻟږ
ﺭې ﻲ ﻪﻻ ﻟﺎﺱ ﻤﺗﻭﺩ ﺍ
ﻮ ﺗﺍﺯ
ﺍﺮﻓ
ﺍﻮﻝېﺩ EBVﺩﺧ
ﻟﻲ ﻪﺍﺳﻄ ﻭﻪﻭړﭘ ﻳﻻﻮﺎ ﺑ
ﺎﻌﻟﻮﻝېﺩ ﺮﻭﺧﺖﺩﺧ ﻮﭘ ﻟ
ﻮﻠ
ﮐﻪﺩ ښ ﻮﺗ ﻧﺎ
ﻧﺍ
ﻭ ﻭځ ﺭﻮﻭﻧ ﻮﺍﻧ
ﺎﻴﻨﻮﭼڅﻪﮐﻮ ﺧ ﻧﻼ
%٩ .ﺩ٠ ږﻱ
ﺩږ ﻟږ
ﻪﻫﻢ ﻲ ﺍﺳﻄ ﻪﻭ ﺪﭘﻧﻮﻴﭘ
ﺰﺩ ﻐ
ﻭکېﺩﻣ ﺩډ
ﻭﻩ ړېﺍ ﺭک ﻳﻦېﺩﻭ ﻩﺩﻭ ﺭﻥګ ﺍ
ﺪﻤ.ﻫ ږﻱﺩږږ
57
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
.ﺮﻱﻟﻮکې ﺗ
ﺍﺯﺍ
ﺮﻓﺍﻴﻞﻧﺠ ﺮﺭﻓﻭﺍ ﻪﺮﺱﭘ ﻳﺍﻠﮏﻭ Serﺧ oposi tivېګﻞېe
ﺎﺕﺏ ﻳ ﻳڅﻪﺯﺧ
:ﺰﺱ ﻴﻨﻮﺟ ﺘﭘ
ﻮټې ﻪﻏ ﻴﺑ
ﺎﻌﻭﻟﻡﺍﻮﻴﻠﻴﺘﻴ
ﭘﻴﻞﺍﻧﺠ ﺮﻓﻭﺭﻭړﻯﺩﺍ ﻡﻮﺮﺱﻟ ﻳﺍ.ﻭږﻱﺩږﻟږ
ﻪﻲ ﺍﺳﻄ ﻪﻭﻭﭘ ړﺮﺱﺩﻻ ﻳ
ﺍﺍﻭ ﺩ
ﻮﺩ ﮑ
ﻧﻭېﺣﻝ کېچېBژ ﺍﺱ ﺎ ﻪﺩ ﭘ،
ﻮﻱ ځﻥﺭﺳ ﻪﺍ ﻮﺗ ﮑﻧﻭ
ﻭژ ﺭﻮڅﻪﻧ
ېځﻯ ﺧ ﻪﺩ ﺍ ﺎﻟﻴﻭﺑړﻱﺍ ﮐﮏﻭ
ﺎﻱټﻮﺳ ﻔﻤﻪﻟﻐ،چېﻫ ﻩﺩﻝېﺩ ﻭﻮښ ﻧ
ړړﺷ.څړ ﻲ ﮑﻦﮐﮏ ﻤﻪﻣﺘﻭﺳ ﺭ
څﻪﻭ ﺎﺱ ﺧ ﻤﻪﺗ ﻮﻟﮑ ﻧ
ﻭﻴﻞژ ﺘﻴ
ﭘﺍ
ﻪﻟﺎﻥﻳﺮ
ﻳﻦېﺩﺟ ﻭﺎﺩ ﻴ
ﺮﺱﺑ ﻳﺍ
،چېﻭ ږﻱﺘﻦکږ ﻨﻪﻣ ﻐﻴﻪﻧ ﻎﭘﻴﺮﻱﻧ ﻟﺩ
ﻮ ﭙﺖکېﻭﺟ ﻳﺮﺮﮐ ﻠﻧﺴﺎ
ېﻪﺗچﭘ
.
ﺭځﻱ ﻻﻞګ ﻟﻲ ﻣﺍﻭﻮﺩﻍټ ﺎﺟ ﻧﺴﺍﻭﻱ ﺎﻔﻤﻟﻳﺸﻦﺩ ﺮﺘﻠ
ﻔﻧﺍﻮﮑﻧﻭﻮBژ ﻨ
ﺘﻨﻣ.ﺩږﻱﺮږ ﭙﺭېﺧ ﻻ
ښ:
ېﻭﻥ ې ګﻞ ﺍﻳ
ﺗ،ﻝ
ړﺎ
.ﺳﺖﻴ ﻩﻭﻥۍﺩ ٦ﺍ -
ﻩ٤ ﺭ
ﻭ ﻳﺦﺩ ﺮﻔﺯﺱﺗ ﻮﻠﮑﻴﻧ
ﻮ ﻧﻮﮑﺸﻦﻣ ﻔﻧﻮکېﺩﺍ ﻧﺎ
ﻧﺍﻭېﻪځﻮک ﭘ ﻧﺎﻧ
ﺍﻭﻪځ ﭘ
ﻟﻰﺍ
ﻭﻭﻍټ ﻮټ ﻭﻱﻏ ﺎﻔﻤﻭﻟﺩﺍﺭﻧﻲﺩ ﻮﺘﺗ،ﺩﺳ ﻪﻟېچېﺒ ﻭﻥۍﻣﺨﮏېﺪ ٢ﺍ-
ﻪ١ ﻧ
ﻭ ﺩ
ﺭﻠﻲﺩ ﻱﻭﻋﻀ ټﺍ
ﻪﺒ
،چېﺗ ﻩګﻥۍﺩ ﺭﻱ ﻭ ﺯﺱﺩ ﻮﻠ
ﮑ ﻴﻧ
ﻮﻧﻮﮑﺸﻦﻣ ﻔﻧ
ﻩﺩﺍ ړﺩېﺍ
ېﺍ ﺭ ﻭﻭ،چ ﺩ ﺩ ﻱ ﻮﻮﺟﺍﺷﻲﻣ ﻪﺭ ﺗ
ﻣﻦځ
ﺷ،چېﺍﻯ ﻲ ﺩﺩ
ﻭﻫﻢ ک ﻩﺍﻩﺩ ﺰ
ﻳﺩﻭ ﻪﺩ ﺗ
ﺎﻳﻮ کېﺯ ﻴﻧﻭﻩﺍﻭړﻮﺩﻡﻳ ﻮﻪﻟﻮﭘ ﻭ؛ﺧﻪ ﻱ ﺭﺟﻩﺩ ﺍ ټﻱټ ً
ﺮﺜﮐﺍ
ﺎﺳﭗ ﻣﻭ،ﺩ
ﻩﻱ ﺩﻮﻮﺟﻮکېﻣ ﻧ
ﺎﻭﻏﺭﺎﻪﻧﻨﻠ٩ﺳ ﻪ٠ ﻱﻭﭘﻭړ ﺍﻡ ک ﺍﻭﺎﺕﺩ ﻳېڅﻪﺯ
ﺎﺷﺖ ﺧ ﻴﻳېﻣﻪﻮ ﻪﻟﺒﺗ
.(ﺭﺝې ﺪﺩ ﻳ
ﺭﺘﻲګ ﻧ
ﺎ٣ﺳ ٩
-٣٨ږﻱ) ږړﻮﻟﺍﻮﻟﺨ ښﻦ
ﻳ
ﺭګﺎﺕڅ ﻳ
ﺭﺯ ﺭﺎﻱټﺱډ ﻧﺠ ﺍ
ﺮﻭﻓ ﻟﻰﺍﺍﻭﻭﻍټ ﻮټ ﻭﻱﻏ ﺎ
ﻔﻤﻮ کېﺩﻟ ﻴﻧﻭﻩﺍﻭړﻮﺩﻡﻳﻮ ﻪﻟﻭﻍۍﭘ ﺭﺎ
ﺩﻧ
ﺗﻦۍﺎﻭ.ﺷﺪ ﻱ ﻧﺭګﺭڅ ﺭﻭﻥۍکېډ ﻪﺍﻤﻳﻭ ﻪﺩ ﻟﻰﭘ ﺍ
ﻭ ﺭﻱﻍټ ﻮېﺣﻝ کېچېﺩﺗ ﺍﺱ ﺎ ﻪﺩ ،ﭘﻭﻱ ﺪﻧ
ﺍﻯ ﺷﻲ چې ﺩ
ﺩﻭک (ﺍ ﻪﻨﻠ
٩ﺳ ٠-
٨ ٠).ږﻱﻪ کږ ﺘﺎﺕېﺍﺧ ﻳﺭېﺯ ﺭﻮټې ډ Cerﻏ v i
(cal ﻔﻲ ﻠ
)ﺧ
ﻥښﻰ
ﻭ،ﻻﻦ ﺗ ﺰ ﻱ ﮐ ﻴړﺧﻩﺍ ﻭ
ﻭﺩ ﺎکﺍ ﻧﺩﺭ،ﺩﺎﺱ ﺎﺕﺣﺴ ﻳﺍﺕﺯ ﺪﻘﻭﻱﻋ ﺎﻔﻤﻮﻯﻟ ﺷ،ﻟ
Generﻲ alized
ﺷ.
ﺍﻯ ﻲ ﺪ ﻳ
ﻮټېﻫﻢﻍټ ﺮګﻏ ﻭﺩﺗﺨ ﺍ ﻨﻲﺒﻐ،ﻣSubmandi bulﺩar.
(ﻪ ﻯ Fiﻧ )xed
ﺍﺕﺩﻭﺰﮐﻟﻰﺩﺍ ﺍ
ﻭﻮﻍټ ﻧﻮﻠ
ﻧﺴ ﺎ
ﺍﻯﺷﻲﺩﺗ ﺩﺩ ﻭ،چېک ﻩﻱ ﻩ ﻥښ ﺭﺎﮐ
ﻩښ ﺭﺭﻪډﻠﻪﮐﻠﺎﻱټﺱﮐ ﻧﺠﺍﺮﻓ
.ﺮﻱﻟﻟﻰﻭ ﺍ
ﻪﻭ ﺗﺭﻪﻭ ﺘﺲﺗ ﻳ
ﺎﻧﺠﺍﺮﮐﻞﻓ ﻮﮐﻮﺘﭘﺮﺘ
ﻭﺳ ﺍځﻯﻭﻱ ﻮﺍ ﻩﻳ ﺮﺳ
.ﺩﺱ ږﻱﺪﻝکږ ﻴﻟﺪېﻧﺎ
ﻭﻭﺗﻦېﺑ Pﻪﻡټﺍ upulﭘ ﻳarRash Morﺎ bili
forﻮکې m ﻧ
ﺎﻭﻏﺭﺎﭘ%٥ﻧ ﻪ
،ﺩګﻱ ﻟﻰ ﺍ
ﻭﻳﻦېﻍټ ﻮکېﺩ ﻧ
ﺎﻭﻏ ﺭﺎ
%١ﻧ ٥-١ﻪکې٠ ﻨ
ﺘﻪﮐ ﻱېﭘﺎﺩګډ ﻣﻣﻞﻭﻱﺍ ﺭﺎ
ﻪﻧ ﻨﺘﻩﮐړﻭﻭﺯږﺍ
ﻭ.
ﺩﻱ ﻮﻮﺟ ﺯړﻯﻣﻮکې ﻱ ﻧﺎﻭﻏﺭﺎ
ﻭ%٥ﻧ ﺍﻮﻧﺎﻭﻏﺭﺎﻪﻧﻨﻠ
٥ﺳ ﭘ٠ﻟﻰ ﻪﺍﻭﺭﻱﻍټ ﻮﺗ
،ﺩ ﻴﺖ ﺎﺳډېﺣﺴ
ﺭﻮﻮﭘﺘﺎﺷﻴېﺮﻣ
ﺰﺗ ﻧﻮ
ﺘﺰﺳ ﮐﺮﻤﺮﻱﺗ ﮑﻓﻱﻭﺩﻻﻦﻝټ ﺍ ؛ﮐ ﺮﻱ ﻟ
ېګﻞې
ﺭ ﻳ ﻮﻮﭘ ﻴ
ﻧﻭ٤ﺍ-ﺎﻥﺩ٢ ﻭﻏﺭﺎﻩﻧ ﺮﺗ
ﺎﻳﺯ
ﺯﺱ ﻮﻠﮑﻴﻧ
ﻮﻧﻮﮑﺸﻦﻣ ﻔﻧﺰﺍﻳګﻪﺍ
ﻠ
ﻮکېﺩﻳ ﻧﺎ
ﻣ ﻮﺎﺷﻮﻣ ﻧﺎﻧ
ﺍﻭﻭځ ﻮﺍ ﮑﻧ
ﻭﺧړ
ﺪې ﻮ ﻴ،ﻪﺷږﻱﭘ ﺎﺕېکږ ېﭘ
ﻭ.
ﺭېﮐﻢې ﻱ ﺭ
ﭘﻲښېډ
ﻭړﺎﺍ
ﻴﺗ ،ﺳﺖﺗﻪﻩﺒ ﺭﺍﺪﻣﺍ
ﻭﻭ،ﺩﺩې ﻱ ﻮﻮﺟ ﻔﻲ ګﻝﻝېﻣ ﺮﻭﺻ ﻴﻮﻻًﻏ ﻤﻌﻮ کېﻣ ﻧﺎﻭﻏﺭﺎﻭﻧ ړﻪﺯ ﭘ
ګﻱ
ﻴﻢ ړ ﻪﻧﺯﺱﭘ ﻮ ﺘ
ﻳﺎﻮﺳﻔﻤﻔﻲﻟ ﺮﻭﺻ ﻴ
ﻭﻏ ﻟﻰﺍﺍﻮﻳﻮﺭﻱﻟ ﻮﺗ،ﺩﺘﻲ ﭘ
ﻮﻨﻳ
ﺩ ﻤﻒﺍ ،ﻟﺘﺲ ﻳﺎ
ﻧﺠ ﺮ،ﻓﺎ
ﻴﺘﻧﺎﻣﻮﺘﺳ
.
ږﻱ ږﺍ ﭖښښ ًﺭ
ﺩﺎﻮکېﻧ ﮑ ﻠﻭﺧ ړﭘﺯ
ډﻝ ﻪ ﻭ
ښ:
ېﻭﻥ ې
ﻩګﻝﻝ ﺍ ﺭ
ﻮﻭﻍۍﻏ ﺭ
ﺎﻭﻝﺩﻧ
ﺪ١ﺟ
٠-
٢
(
Siﻥښې)gns (Symptګﻝﻝې)oms
ﻭﻮټﻭﻱﻏﺎﻔ
ﻤﻟﺩ
%٩
٥ ١
٠٠
-٨٣ %٧٥ ٨
١-ﺩ٠
٥ ﺭ
ﻧﻲﺩﻮ ﺘ
ﺩﺳ
ﻟﻰ
ﺍﻭﻍټ
%٩
٣ ١
٠٠-
٦٠ ﻪ
ﺒﺗ %٤
٧ ٧
٦-٤ﻝټﻱ ٢
ټﺱﻭ
ﺎﻱ ﺍ ﻧﺠﺮﻓ ٦٧-
٢٢
%٨
٢ ٩
٠-٦
٨ ږ
ﻮﺮﺧﺳ
ﻧﺴﻼﻱټﺱ ﺎﺗ %٣٨
58
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ړ
ﺩ،ﺯ
ﺩ
ﻱې ﺭ
ﺩګډ ﻻ
٢
٥-٥
%٥
١ ٦
٤-ﻟﻰ ٣
٤ ﺍ
ﻭﺭﻱﻍټ
ﻮﺗﺩ ﻭﺍﻟﻰ
ﺍ
ﻭﺪﻩﺑ
%١
٧
ﺎﻥګېﮐ
١
١-
٩
%١
١ ١
٥ﻟﻰ ٦
- ﺍ
ﻭﻳﻦېﻍټ
ﺩ ﻩ
ﺯړﻝ
%١
٠
%١
٠ ٢
٥-(٠ﻪ)Rashﻧﻮ
ﭘﺎﺧ
ﺍﻮ
ﻭﺧ ﺎ
ﻭﺷ ﺮګﺘ
ﺩﺳ
%١
٣ ٣٤-٢
ﻮﺏړﺳﭖ
%٥ ١
٠-
٢ ړﻯژﻱ
:ﻭﻥېﺪﻧ
ﺭګ ﺭﻱڅﺍﻮﺗ
ﺍﺮ
ﺑ
٢٠
٠٠٠
-١
٠٠٠
ﺭ٠
ﺷﺭﻩ
ړکې ﻢ ۍﻪﻝﻭﻥ ﭘ ﻳﻢېﺍﺭېﻭﺩ
ﻳﻢ ﺍﻭﻭﻍۍﺩﺩ ﺭ
ﺎﻧﻭﺩﻟړﻭﻱﺍﺍﻮً
ﺮﺜ
ﮐﺮﺍﻴﻤﺩWBCﺷ
%١٠ﻭﻭﺩﻭﻱﺍﻮﻮﺟﻭکېﻣ %٧ﭘﻲښ ﭘ٠،چېﻪ ﻩﻩﺩﻩﻥښ ﺭﻮﺯﺱﻏ ﻮﺘﻳﺎ
ﻮﺳ ﻔ
ﻤﻟ،چېږﻱﺭېﺭﺱږ ﻮﭘ
ﻭﻮﻯﺍﻼﻡﻱېﻟﭘﺯﻮﺘﻳ
ﺎﺩ.ﺳ
ﻪﻱ ﻧ
ﻮﺘﻳ
ﺎﻮﺳ ﻔ
ﻤﻮﻯﻟﻧﮏېﻟﻭﺩژ
ﻔﻲﻭﻱچېﺍ ﺮﻭﺻ ﻴ%٣ﻱېﻏ ﺗ٠څﻪﺮ
ﺧ
ﻔﻲﺮﻭﺻ ﻴ.ﻏږﻱ
ﺪﻝ کږﻴﻪ کېﻟ (ﭘindent
atiﺗﻞ)onﻮﻨ
ﺩېﻧ ﺮﺯېﭘ ﺯ
ﻧﮏﻭﻭﺩژ ﺮﻱﺍ ﻭﻝﻟ
ﺍکﻭ ﻭ
ﻭﺎﺍﻴﻨﻴ
ﭘﻭﺮﺗ
ﻮﻴﻩﻧﺯﺍ
ﺪﻧ
ﻪﺍ ﻤﻪﮐ ﺩ ،ﭘ
ﻮﻱ ﻱ ﺩﻝ ﺷ ﻭﮑﻞ کې ښ ( ﺷ ١
٨-٢ﻪ)ﻪﭘ ﻧﻮﺘﻳ
ﺎﻮﺳﻔﻤ
ﻟ
ﻮﭖ ﺗﺎ
ﻳﻪﺯ%څﻪﭘ
٩ﺧ ﻟ٠
.ﻪ ﻩﻩﺩﺰ
ﻳﺩﻭﻩﺩﺭﺭﺎﺷﺖ کېډ ﻴ
ړۍﻣ ﻡﻮﻪﻟﻭﻍۍﭘ ﺭﺎ
ﺎﺩﻧ ﻴ
ﻨﻴﭘ
ﻮﺘﻳﺎ
ﻮﺳﺒﻣﻭﺮ
ﺗ
ﻮﻨﻴ
ﻣﻡﺍﻭﺮﻴ
ﻩﺩﺳ ﺮ
ﺯېﺳ ﺍ
ﺪﻧﻔﻲﺍﻴﻔ
ﻭ،ﻪﺧ
ﻣﻞ ﻱﭘ ﺭ
ﺎﺮﻧﻴ
(ﻏﻪ)LFT ﻨ
ﻳﻮﻣﺯﻩﺍﺰﻳ
ﺪﻧﻭکېﺩﻳﻦېﺩ ښښ
ﻭ.
ﻟړ ﻱ
ﻴﻦﻮﺑﻭﺮ
ﻠﻴﻡﺑﻭﺮ
ﻴﻭکېﺩﺳ %٤ﭘﻲښ ﭘ٠
ﻟړﻭﻱ ﻪ
ﺰﻮ ﻳ
ﺎﺳﻒټ ﻴﻦﻓﻠ
ﮑﻟ
ﺍﻭﺍﺰﻳﺮﻔ
ﻧﺴﺍﺮ
ﺗ
.
ږﻱ
ﺪﻝکږ
ﻴﻟﻧﮏې
ﻭﺮژ
ﻴﻠ
ﮐﻮﻧ
ﻮﻧﻮ
ﻔﻲﻣ
ﺮﻭﺻ
ﻴﮑﻞکېﻏ
(ﺷ١
٨-٢
ﭘ)ﻪ
:ﺎﺕﺘﻼﻃﺍﺧ
ﺭ
ﺷﺭ
ﻮ ﻢﻳړﻪﺩ
ﻨ
ﻪﻡﻳ ﻠ
ﻪﮐﻠ
،ﮐﻩﺩﻩ
ﺭﺩﺎ
ﻩﻧﺭ
ېﺭ
ﻪک ډ ړﻪﭘ
ﻨ
.ﻡﻳ ږﻱ
ﻪ ښې کږ ﻠ
ﭙﻳېﭘﻲښېﭘﺨ Iډﺮ ﺩM
:
ﻪﮑﻟﻪﻠ
ﻣﺍﻪﻟﻮﺗ
ﺎﺘﻼﻃﺍﺧ
ﺩ.
ﺩﻝﻪک ﺘﺍﺧ ﺘﻢﻴﺴﺒﻲﺳﺰﻱﻋﺼ ﮐ
ﺮﻣ .ﺩ 1
ﺩ.
ﺩﻝﻳېکﺭﻱڅﺮ ﻮ
ﺗ .ﺩ 2
.ﺪښﺕ ﻨﻪﺑ ﻻﻭﭘ
ﻳﻲ ﺭﺍ
ﻮﻮﻫ ﻴ
ﻨﺗﺭ
ﻮﭘ .ﺩ 3
.ﺮﻱﻟ
ﻩړﺍﺭېﻮﺍﺧﻞېﭘﺪﻪﻣ ﻮﭘ ﺗ
ﺎﻧ
ﺎﺘ
ﻧﺍﻳﻲﺎ
ﻳﺮﺘ
ﮐﺎﺎﺑ
ﻭﻳ .ﺍ 4
ﻪ
ﻩﭘﺮ
ﺗﺎ
ﻳ.ﺯﺍځﻱﻪﺭ
ﺗﻭﻥۍکېﻣﻦځﺍﻪﻤ
ﻭﻫ ﻭﺩﺍړۍﻡ
ﻮﻟ ﻪ
ﻮﭘ ﺗ
ﺎﻧ
ﺎﺘ
ﻧﺍﻩﺩEBVﺩ ﺮﺗ
ﺎﻳﺘﻼﻁﺯﺍﺧ ﺩCNS
59
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﻮﻧﺎ
ﻭﻏﺭﺎ
ﺩ.ﻪﺩېﻧﺎﺕ ﻱﭘ ﺘﻼﻃ ﺒﻲﺍﺧ ﺰﻋﺼ ﻳﺩﻭﺮﺩﻳﺘﺲډ ﻳﻔﻼﻴﻧﺴﻭﺍ ﺘﺲﺍ ﻳﺎ
ﻨﺠ ﻨﻮکېﻱېﻣ ﻧﺎ
ﻣﻮﺎﺷ ﻣ
ﻳﺲ ﺯﻮﮑﻳﺎ
Hﻭﺳ emiﺍ pl egiﺑړﻥۍa ،ﻲ Cereber alat axiMeﺎa
niﻳ ngiږsmus ﻮ،ﺮﺧ کېﺳ
ﺎﻝﮑﭙﻴ
ﺗﻪﭘﮏېﺍ ﻠﻪﮐ ﻠ
،ﮐ ﺮﻱ ﺯﺱﻟ ﻮﺘﻳ
ﺎﻮﺳﻔﻤﻩﻟﻮګ ﻩﺗﺪ ﻤﻪﻋ ﺷ،چېCSFﭘ ﺗﻼﻯ ﻲ ﺍﻪﺭ ﺗﻫﻢﻣﻦځ
ﺩﺎﺕېک (ﺩﭘSequel ﻮ) ﻧﻮﺎﺕېﺷ ﺒﻲﭘ ﻳېﭘﻲښېﻱېﺩﻋﺼ ﻭډﺮ ﻮﺍﺪﻻﻯﺷ ﻴﻟﺯﺱﻫﻢ ﻮﺘﻳﺎﻮﺳﻔ ﻤ
ﻟ
ﻭ،ﻪځ
ځﻯ ﻱﭘ ﻮﺍ ﻩﻳﺮﻭڼﺳ ﻪګﺯ ﻟﻮﺍﺟﻭﺯﻔﻲﺍﺎﻥﺩﻗﺤ ﺘﻧﺑړﻥۍEBVﺍ .ﻲ ﻣﻲ ﻮﻟﻰﻣ ﺍﻩﻭ ﻪښ ﺗ
ﺮﻭﭘ ﺩ
ﻭTrﺍansv ersemy elit
iﻭs Guiﺍ lli
anBar esy ndr ome، ﻭﺝ ﻔﻲﺯ VIﻗﺤ ګﻱډﻝI
ﺍﻥ ړ ﻭ
ﻭ%٣ﭘﻲښ -٠
،ﻱﻪ٣ږﭘ ﻪﻝ ﻨ
ﻳﻴﮏﻭ ﺘﻳ
ﻮﻻ ﻤ
ﻴﻮﻥﻫ ﻤﻳ
ﺍﻮﻭﺗ ګﻯﻭﻱﺍ ﻩﻣﻞ ﺭ ﺮﺭﺳNeurﻫﻢﻭ i
tiﻴﻄﻲs ﻣﺤ
.
ﺭځﻱﻪﺍ ﺗړکېﻫﻢﻣﻦځ ۍﻪﻝﻭﻥ ﭘ ﺍﻭﻫﻢې کېﺩﺩ
ﺎﻥﻏﻭﺭﺎ
ﺭﻧ ﺷﺭ
،ﻮ ﻢﻮﻱﻳ ﻡﮐ ﺍﻭﺎﺷﺖېﺩ ﻴ٢ﻣ-ﻪﻭﻱﺩ١ ﻤږﻱﮐ ﻪﻝ ﻨﻳ
ﻮکېﻭ ﻧ
ﺎﻭﻏﺭﺎﻮﻧ ﺗ
ﺎﻳﻪﺯ ﺰﭘﻳﻮﻻ ﻤ
ﻴ ﺩﻫ
ﻭ.
ﻩﻱ ﺪﻧﺭګﺎڅ ﻳ
ﺭﻮﻴﻦﻳ ﺑ
ﻮﻟﻮګ ﻤﻴﻯﻭﻫ
ړﺍ ﻩﺷﻲچېژﻱ ﺪﻳﺪﺍﻯﺷﻲﺷ ﺩﺩک
ﺎﻥ،ﭘﺎ
ﻴﻨ
ﻴﭘﻮ ﺘ
ﻳﺎ
ﻮﺳ ﺒ
ﻣﻭﺮ،ﺗﺯﺱ ﻮﺘﻳ
ﺎﻮﺳ ﻟ
ﻮﻧﺍﺭ
ﺪﺍګ ﻳ
ﺪ،ﺷ RedCel lapl asiﺍﻯﺷﻲﺩa ﺩﺩﻭﻍۍک ﺭﺎﺍﻧﺩ
ﻭ.
ځﻯ ﻱ ﻮﺍ ﻩﻳﺮHemophagoctﺳ i
csy ndr ﻭome ﺍ ﺎ
ﻴﻨﻴﭘﻮﺘﻳﺎﺳ
ﺪښﺕﻻ ﻨ
ﺭېﺩﺑ ﻔﺴﻲﻻ ﻨﺗﻦۍﺗ ﺭ
ﻮ ﭘ
Adenoiکېﺩ ﻳdﻧﺲﺎ ﺎHﻪﺗ
yﭘ pertrﻮophy ﺎﺟ ﻧﺴﻭﻱﺍ ﺎﻔ
ﻤ ﻟﺩ
ﻻﻞ
ﻮﺏ ﻣ ړﺳ(ﺩﭖ Vulv ،ژﺏۍ)ae ﻡﻮﻌﻠ
،ﺑEpiglottiﮐﻻﻯﺷﻲچېﺩs ﻭﻫﻢ ﻮ ﺍﻯﺷﻲﺍ ﺩﺩﻣﻞ ک
ﺷ.
ﻲ
ﺎﺕﻳﻪﺯﻠﺗﺮﻭﻪﭘ
ﻮکېﺩ ښځ ﭘ ﻧ
ﺍﺮېﻪﻧ
ﺭځﻱچ ﭘ ﻪﺍ ﺗﻭکېﻣﻦځ %٠ﭘﻲښ ،ﭘ٥
ﺩﻝ ﻪ ﻳېکﺩ ﺭﻱڅﺮ ﻮﺩﺗ
ﻳﻢېﺭېﻭﺩﻳﻢ ﺍ ﻭﻪﺩﻭ،ﭘﻲښېﻱېﭘ ﻩ ﻱ ړۍﻥښ ﻡﻮﺯﺱﻟ ﻮﻠ
ﮑﻴﻧ
ﻮ ﻧﻮﮑﺸﻦﻣ ﻔﻧﺍﻯﺷﻲﺩﺍ ﺩﺩﺩ،کﻱ
ﺩ.
ﺎﺕې ﻱ ﻳﻭﻥۍکېﺯ ﺍ
ﺘﺭﺍﺧﺩﺎ
ﺭﻧ ﻮ،ﻧ
ﺭځﻱﻪﺍ ﺗﺘﺲﻣﻦځ ﻳﺎﻨﺠﻳﺮﮐﻞﻓﻮﮐﻮﺘﭘﺮﺘ
ﻭکېﺳ %١ﭘﻲښ ﭘ٠
ﺯﺱ ﻪ ﻮﻠﮑﻴﻧ
ﻮ ﻧ
ﻮ ﮑﺸﻦﻣ ﻔﻧ
ﺍ
ﻮﻧﻮﻧ
ﻮﻟﺪEﻪﺑﺘﺲﺩ CGﻟ ﻳﺍﺩﺭﺎ
ﮑﻳﺮﻴﺎﭘﺘﺲﻳ ﻳﺍ
ﺩﺭﺎ
ﮐ ﻮﻳ
ﺎﻭ،ﻣﻴﻢ ﻱ ټﻱټﺱچېﻭﺧ ﺎﺍ ﭙﻴﺎﺕﻱېﻫ ﻼﻃ
ﻭGeniﺍ talUl ceration، ﻳﺖﺮﻔﻼﻲﻧﻟﺨﻟ ﻴﻦﺍ ﻩﺑﺮ ژﻥ ﺳ ﻮ
ﻴﻔﻳﺭﻝﺍ ﻮﻠ
pneumoniﺩﭘ ﺳc،ﻩﺮ
ﺩ.
ﺭﺕ ﻱ ﺎﺒ
vڅﻪﻋ asculﺧ itis
:
ﻴﺺ ﺗﺸﺨ
:
ﻳﻦې ﻮﻣ ﺯ
ﺍ ﻳﮏې ﺍژ
ﻮﻟﺮﻴ ﺳ
ﻩﺪﻨ٤ﭼﻟ٠ﺪﻪ ﻴﺋﺎ
ﻳﺲټﺗ ﺩېټ ﻪﺩ .ﮐږﻱ
ﺩﻝکږ ﻭﻴ ﺺﺍﻱښ ﻪﺗﺸﺨ ﺍﺳﻄ ټﻪﻭﻳﺲ ﭘ ﻴﮏ ټ ﻠﻴﻓﻭﺮﺘ
ﻴ ﺩﻫ
ﻻﺖﺑړﻥۍEBVﺩﻟ ﻪﻲ ﻮﭘ ګﻯﻭﻱﻧ ﻩﻣﻞ ﺭ ﺮﺭﺳﺯﺱﻭ ﻮﺘﻳﺎ
ﻮﺳ ﻔﻤﻔﻲﻟ ﺮﻭﺻ ﻴﻭﻏ ﺎﺕﻭﻱﺍ ﻳڅﻪﺯ
ﺧ
ﺒﺖﺜﻭکېﻣ %٩ﭘﻲښ ٠-٨ ﻭﻥۍکې٨ ﻪﺍ ﻤ
ﻳﻭﻪﺩ%ﻭﭘ٤ﺍ ﻭﻥۍکې٠ ړۍﺍ ﻡ ﻮټﻪﻟﻳﺲ ﭘ .ﺍ ټﻮﻱﺩ ﮐ
ﺷ.
ﺍﻯ ﻲ ﺩ
ﺩﺎﺕېک ﺒﺖﭘ ﺜﺭېﻣ ﻮﻮﭘﺘﺎﺷ ﻴﻮﻣ ﻳ
ﺭټﺮﺩﻳﺲ ﺗ ﺍټ ﻮﺩ ﻭﻱﺧ
ﻪ.ﭘﺮﻱﻮﺏﻟ ﺘ
ﻳړ%ځﻥګ
٩ﺍ ﻭ٠ ﺎﺱﺍ ﻭ کېﺣﺴ ﻮﭘﻲښ ﺗ
ﺎﻳﻪﺯ%څﻪﭘ
٧ﺧ ﺩ٥MonospotTest
ﻼﺎ
ﻳﻭﻣﺭ ﺘﺲﺍ ﻳﺎﺗ
ﺎﭙﻴﺮﻝﻫ ﻳﺍ،ﻭﺎﻣﻮﻔﻤﻟ،
ﻮﻴﻭﻏﺭﺎ
ﻨﻀﻢﻧﺴﺞﻧ ﻪﺩﻣ ﻨﻳ
ﻮ ﻣﺯﺍﺍﺍﻯﺷﻲﺩ ﺩﺩﻭﻝک ﻭﻏﺠﻦﺩ ﺭﺩ
ﺷ.
ﺒﺖ ﻲ ﺜکېﻣ
ړﻡﻮېﺮﻟ
ﻮﻱچ ﺗ ﻪﮐ ﺗ
ﻭﻪګ ﭘ
ﺍﺎﻥﺭﺘﻧﺑړﻰﺍ
ﺪ ﻲﻧ ﺮﺿ ﻴﺠﻦﭘ ﺘ ﻧ
ﻭﺳﻲﺍ ﺮﻳﻟﻰﺩﻭ ﺍﻭﻟړ
ډﻱﻮ ﺎﺘﻲﺑ ﻧﺩ 1gMﺍ
.ﺮﻱﻟﺕﻪ
ﺯښ ﻧ ﺭﺍﻪﻴﺼ ﻩﺗﺸﺨ ﺮ
ﻣﻭډﻱﺩ ﺎﺘﻲﺑ ﻧﺍﺎ 1gM ﻣﺍﻟړﻭﻱ ﺭېﻮ ﻮ ﻮﭘﺘﺎﺷ ﻴ٣ﻣ -
ﻮ٢ ﻳ
ﻪﺜﻴﺒ
ډﻝﺧ ډﻝ ﻭ
ﻳﮏېﺩ ﻭ ړﺮﺱﺍ ﻳ
ﺍ،چېﺩﻭ ﺮﻱﻟﺯښﺕ ﺭﮐﻞﻫﻢﺍ ﺍ
ﻴﻦ ټ ﺗ
ﻭﺮRﺎﭘ
NA,ﻳ DNA, ﺩEBV
.
ﻮﻱ ﻪﮐ ﺗﻭﻪګ ﭘﺍﻩﺭ ﺮﻮﺳ ﺗﺎﻓ
ﺍ
:
ﻴﺺ ﺮﻱﺗﺸﺨ ﻴﭘﻮﺗ
ګﻮ
ﻟ
ﻣﻲﺍ ﻭﺎﻱټ ﺪﺩﺳ ﻳﺎ
ﻴ ﺺﺑ ﺮﻱﺗﺸﺨ ﻴﭘﻮﺯﺱﺗ ﻮﺘﻳﺎ
ﻮﺳ ﻔﻤﻔﻲﻟ ﺮﻭﺻ ﻴﻭﻏ ﺯﺱﺍ ﻮﻠﮑﻴﻧ
ﻮﻧﻮ ﮑﺸﻦﻣ ﻔﻧ
ﺩﺍ
ﻭﻫﻢﺩ ﺍﺮﺱ ﻳ
ﺍټﻱټﺱﻭ ﻴﭗﺍ ،ﻫHum her pesv i
rus, HIV،ﮐﺲ ﺮﺘﻧﺍﻮﺯﺳ ﻮﻣ ﺯ
ﭘﻼ ﻮﮐﺴ ﻮ،ﺗﺮﺱ ﻳﺍﻭ
.
ﻩﻭﺷﻲ ﺮﻴﺖﺳ ﺎﺳړﺪېﺩﺣﺴ ﻧﺮﻭﺍ ﻮﭘﻠﻣﺭﺩ
60
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
61
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
.
ژﻥﻮﻴﻔ
ﻧﺍﻮﮑ
ﻧﻭﻴﮏTژ ﮐﺴﻮﻮﺗﺘﻳ
ﺎګﻱﺳ
ﺩځﻥ ړ
ﻳﺩ EBVﺍ ژﻥﺎ
HﻭﺩEBVﺩ
LA-ﺍ
Mat
ﻳched
Autﺎ
olﻩogonsﺭﺎ
ﭙﻟﻮﮑ
ﻧﻮﺘﻴﺴﺍﺧﺪﻧ
ﻮﻴړﻮﺩﭘ
ﻭﻍﻳﺪﻣﺎ
.ﺩﺟ 7
.ژﻥﻮﻴ
ﻔﻧﺍ
ﻮ ﮑ
ﻧﻭﻴﮏTژﮐﺴﻮﺗﻮ
ﺘﻳﺎ
ګﻱﺳ
ځﻥ ړ
ﺍ
.
ﭘﻲﺍﺭ
ﺭﻮﺕﻣﻡ
ﻴﮏک ﮐﺴﻮ
ﺗﻮﺘﻳ
ﺎﺳ
(
Hookwor ﺎﻥ)m ﻴﻧﺠﭼﻦګکې چﻥ
:
ﺯﺱ ﻭﺪﻴﻟﻮﻟ
ﺍﻥګ ﺮﺘﺳ
ﺍږ
ﻩﻭﺮﺘﻠﻲﻣ ﻟﻰ٢ﻣ ٠ﺍ،
ﺩ،چې٤ﻧﺠﻰ ﻯ ﻨﻰچﻥ ﻮﭼ ﺭﮐ ﺭﻮډ Stﻳ r
ongy loidosisSt ercor alosis
ﻮﺗ
ﺎﻧ
ﺎﺘ
ﻧﺭﺍﺷﺭ
ﺎﺕ ﻢ ﻳﻮﺯ ﻳ
ﺍﺩً
ﺮ ﺜ
ﮐ،ﺍﻮﻱﺘﻲﮐ ﻳﺯﺍﺮﺎﭘﺮﺥېﻏﺸ ﺗﻦۍﺑ ﺭﻮﭘﻮﺩ ﻤﻟ
ﻮﻮﮐ ﻴ
ﻨﻮﭼ ﮐ،ﺩ ﺮﻱﻟﻰﻟ ﺍ
ﻭﺩ
ﻪډﻮﭘ؛ﺧ ﻮﻱﻮکېﻩګۍﺍﭼ ﻤﻟﻮﻪﮐﻧﺠﻰﭘ ړﻯچﻥ ﻮﻣﻮ.ﻧ ږﻱ
ﻻﻞکږ ﺎﻣ ﻴﻠﻴ
ﻓﻮﻨﻳ
ﺰﻳﻩﺍﺭﺍﺪﻣﺍﻭﻮﻥﺩﺩ ﺘﺷ
Fi
lari
ﻧﮏېal ﻭﻮﺘﻦﮐ ﻨ
ﻭﻣ ﻮﻱﺍﻩﮐ ﺩ
ﻩکېﻭ ﺭﻭﺎﻪﺧ ﻨﻤﺠ ﻪﻧ ﭘ.
ږﻱ ﺭﺟﻲ ﺎ
ﻻﺍﺧﻭﺯې ﺭ ﺍ
ﻮ ﻭکېﻳ ﺯ ﺎ
ﻴﺘﻮﻣﮐ
.ږﻱ
ﺪﻝږ ﺪېﺑ ﻧﺎ
ﻻﺍﺑ
ﻭ fﺭ orm
ﻭﺍ
ړﻩﭖ ﻮﻭېﻳﺎﻥﺩ ﺩ ﻪﺷ ﻮﭘﮑﻧﻭﺮﻟﺷ،ﺩﭼﻦګک ﺍﺧﻞ ﻲ ﻪﺩ ﺪﻥﺗ ﺎﻥﺑ ﻧﺴﺍ
ﺭېﺩ ېﻪﻻﺘﮏ ﻟ ﻮﺳ ﻪچېﺩﭘ ﻠ
ﮐ
ﺟړ
ﺭﻯ ﻮﻮﻪﺳ ېځﻥﺗ
ﻪک ﺍ ﺮﺧ ﻧېﺑ
ﺎﻁﻻﺪ ﻭﻣﺨ ﺎﻃﻲﺍ ﻪﻣﺨ ﻮﭘ ﻤﻟ
ﻮﮐﻧﺠﻰﺩ ﻪچﻥ ﻨ
ﻳ،ﻻﻦ ښځ ﻭﻱ ﮐ ﺮﻴ
ﺗ
ﻭ.
ﻱ
ﻪﺘ
ﻭﺳ ﺭ
ﺎﻭ ﻴ،چېﺑ ړﻱﻩک ﺭﻮﮑﻞﻏ Fiﺷl
arialf or ﻮ کې m ﻤﻟ
ﻮ ﻪﮐ ﮑﻦﭘ ﻤګﻥېﻣ ېﻻﺍ ﺍ
ﻭځﻦ ﺭ ﻳ
ﺭﺕک ﻮېﻪﺩې ﺻﻮځﻱچ ﭘ ﻨېﻪﻧ
ﺘﮏ ﺗ ﻮﺳ ﺎﺣﻲېﭘ ﻧ
ﺎﻥﺩ ﺎﺩﻋﺠ ﻱﻭﻳﻮځ ﺍ ﻨ
ېﻪﻧ
ﺩﺗ ﺮ
ﺎﻃﻲﭘ ﻮﻣﺨ ﻤﻟ
ﻮﮐﺩ
ﻮﺗ
ﺎﻧ
ﺎﺘ
ﻧStﺍ r
ongy loiږﻱﺩdes Iﻻﻞ کږ
ntﻣ ract ablei nfectiAﻭﺩon utﺍoinfect iېﺩon
ﺩ.
ړﻯ ﻯ ﻡک ﺍﻭﺭېﻱېﺩ ﻮﮐﻮﭘ
ﻟ٣ﺎ ﺗ٥
،چېﺮ ﺪﻱ ﻳ
ﻮ ﺪﻝﺷ ﻴﻟﻮکې ﻧﺎ
ﻳﻀ ﺮﻪﻣﻪﻫﻢﭘ ﻧﻮﻠﮑﺍﺱېﺷ ﺩ
ډﻝ
ګﻱ ﻭځﻥ ړ
ﻪﺍ ،ﭘ ږﻱږﺎﺕ ﭖښښ ﻳ
ﻮ کېﺯ ﻤﻴﻩﺳ ﺭﺎﻟﺤﻭﺗﺤﺖﺍ ﻩﺍﺭﺎﻪﺣ Stﭘrongy l
odoar is
.
ﺮﻱ ﻟﺭېﭖښښې ېﺭ
ﺘﻲځک ډ ﺧ
ﺭﺭګ
ﺎﺍﻴﺎﻥﺑﺘﻧﺮﺿﻲﺍ ﺮﻋﻴﻣﻦﻏ ﺰﻣﺩ.ﺩ
ﻪﻱ ﺘﻮﺍﺧ ﻧﺎ
ﻴﻧﺠ ﻪﺩې چﻥ ﺎﻥﭘﻧﺎ
ﻧﺴ ﻪﺍﻧ
ﻮﻠﻴ٦ﻣ ړۍ کې٠ ﻪﻥ ﭘ
،
ﺎﻥﺘﻧ
ﻴﻢﺍﻭﺧ ﻻﻮ)
ﻠﻮﺩﻳ ﻟ
ﻴﺖﺩﺏﻝﻻﺏﻝ ﻓﺎ
ﻌﺩﻣ ﻮ ﻭﺟ ﻪچېﺩ ﻠ
،ﮐ ږﻱ
ﻪ کږ ﺗ
ﻣﻦځ ﺍ
ﻪﻭﺧﺖﺭ ﻐﻪﻫ ﻧﺩﺩځ
ﺷ.
ﺍﺏ ﻲ ﺮﻪﺧ ﻠﺒ(ﻪﮐ
ﻮﻟ ﻧﻮﺘ
ﻟﺎ
ﻧﻲﺣ ﺎﺮﻃېﻭﺳﺍک ﺍ ﻭﺭځ ﺍ
ﻮ ،ﺧ ﻭﻍۍ ﺭ
ﺎﻴﮏﻧ ﻟ
ﻮﺑﺎ
ﺘﻴ،ﻣﻪﻧﻭﺭﺎﻭﻥﮐ ﺰﻴﺗ
ﺭﻮﮐ
:
ﺎژﻱﻮﻟ
ﺘﭘ
ګﻥ
ﺮﻭ ﺒﺑﻲﻏﺎﻬﺘﻟ
ﺍﻭﺩ ﺟړﻱﺍ
ﺪې ﻮﻭ ﻨﺎکېﮐ ﺎﻃﻲﻏﺸ ﻪﻣﺨ ﻪﭘ ځﻥﺗﻧﺠﻰ ﺍ ﻪ چﻥ ﻨ
ﻳﻮکې ښځ ﻤﻟ
ﻮﻪﮐﭘ
ﻪﻨ
ﻤﻧﺎ
ﻳﮑﻞﺯ ﻴﻢﺷ ﺭﻭﺧ ﺭﻪډﻩﭘ ﺩﺮ
ﺎﻃﻲﭘ ﮑﻦﻣﺨ ﻤﻮ کېﻣ ﺗﺎﻧ
ﺎﺘﻧﻮﺍﻤﻴﻪﻭﺧ ،ﭘږﻱ
ﺒﺐ کږ ﺩﻭﺳ ﺍکﺩ ﺪﻴ
ﭘﺩ
ﺷ.
ﺒﺐ ﻲ ډۍﺳ ګﻭ
ﺬﺏﺩ ډ ﻭﺩﺟ ﺍﺷﻲ
.
ﺭړﻱ
ﻭځﻪﺍPerﻣﻦ ﺗ i
toniti
ﻭs ﺭﻱﺍﻮﻮﺳ ﻤﻟ
ﻮﻭﺁﻥﺩﮐ ﺯﺍ ﻭ ﺮ
ﮑ ﻪﻧﻧﻮﻧﻮﻟ
ﺪ ﻮﺑﺗﺎ
ﻣﻮﻟ
ﻮﻧﺍﺭﺍﻯﺷﻲګ ﺩﺩ
ک
ﻭ کېﺯﺎ
ﻴﺘډﻮﻣﻪﮐ ېﻻﺍﭘ
ﻭﻧﮏ ﺭ ﻭﻮﮐﺖﮐ ﺮﮑﻞﺣ ﺎﻝﺷ ﻌﻪﻓ .ﭘﻮﻱ ﻡﮐ ﺍﻭﮑﻞﺩ ﺰﺷ ﻳ
ﺩﻭ ﻪﺩﺎﭘ ﻴﻠﻴﻓﻮﻨ
ﻳﺰﻳ
ﺍ
ﺷ.
ﺒﺐ ﻲ Stﺳ rongy l
odioiﻴﮏs ﻤﺘﻴﺴﻧﮏېﺳ ﻭژﮑﻦﺩﻭ ﻤځﻞﻣﺘﻢ ﭘ ﻴﺴﺘﻲﺳ ﻴﻓ ﺎ
ﻌﻣ،ﺩ ږﻱ
ﺭﺝږ ﺎﺧ
:ﻩﻴﮏېﺏڼ ﻨﻴﻠ
ﮐ
ﺘﮏېګ ﻮﺳ ﭘړﻯﺩﻡﻮ ﻟ،چېږﻱﺪږ ﻧ
ﺭګﻡڅ ﻭ ﺭﺪﻨ
ﺑړﻰﺳ ﻪ ﻲﻧ ﻠﻪﮐﻠ،ﮐﺮﻱ ﻟېﻪ
ګﻞ ﻧﺎﻥ ﻳ ﻭﻏﺭﺎ%٣ﻧ ﺎ٠
ً
ﺒﻳﺮ
ﻘﺗ
.ږﻱ
ﻴﺐږ ﻘﻌ
ګﻮﺗﻠ
ﻤﻲ ﻳ ﻭﻫﻀ ﺍﻔﺴﻲ ﻨﻪﺗﻪﭘ ﺘﻭﺳ ﺭېﻭﻭﻭک ﺍ ډﻝﭖښ ﺰﻭ ﻳﺩﻭ ېﻪﺩﻳﻞ ﭘ
.ﻩﺭﺕﺩ ﺎﺒ
ۍڅﻪﻋ
ﻡ ﺧ ړېﻭﻝﺎﺳﺖ ﺍ ﺩ،ﻧﺲﻧ ﺩﻨﻲﺭ ېﻪﺑﻄﺩېګﻥ ﻟ
ﻪﺭ ﻭ ﮑﻴګﻮﮐﻼﺳ ﻠﺩﻳ
62
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﺍﻯﺷﻲﻝ ﺩ
ﺩﻭ،چېک ﺩې ﻱ ﻮﻮﺟﻭکېﻣ %٦ﭖښښ ﻪ٦ ﻭﭘﻔﻲﺩﻱﺍﻭېﻭﺻ ﺎﻴﺗ
ﺪﻧﺭګ
ﺘﮏېڅ ﻮﺳﭘﺩ-
١
ﻭ.
ﺭښﺕ ﻱ ﺎ
ﺪﺧ ﻳ
ﺪPﻭﺷ etﺍi
chia،
ﺎﺏﻬﺘﻟ
ﺍ،
ﻮﺏ ړﺳﻌﻲﭖ ﻮﺿ ﻡ،ﻣ
ړۍ
ﻔﺦﻭﻧﺩﺍﺭﻱېﺩ،ﺩګ ډﺘﻲﺎﺳﻭ،چېﻧﺲﻧ ﺪې ﻱﻳﺪېﺎﺷ
ﺍﻯﺷﻲﮐﻢ ﻳ ﺩ
ﺩګﻞېکﺘﻢ ﻳ ﻴﺴﻤﻲﺳ ﺩﻫﻀ -
٢
ﻱې
،ﺩګډ ،
ﺎﻥګ ،ﮐﻟﻰﺍ
ﻭﺪﻩﺑړ،ﺯﻳﻲﺎ
ﻬﺘﻩ ﺏېﺍﺷﺭﻥګﺍﺪﻤﻭ،ﻫ
ګﻪﻣﻦ ﻱﻠﺎﺕ ﻳ ﻳ
ﻭﻍﺯ ﺭﺎ
څﻪﻧﺩ ﺧ ﺎ
ﺑﻭ
ﻴﺖﺒﻀﻗډﻝﺩﻭﺏ ﻭ ﺎﻨ
ﺘﻪﻣﺘﻰﭘﺎﺳﻭ.ﻧﺲﻧﺩﻱ ﻮﻮﺟﺍﻯﺷﻲﻣ ﺩﺩﺭښﺕک ﺎﺪﺧ ﻌ
ﻘﻭﻣ ﺍﺩ
ﺭځﻯﺩﻨﻲ ﺍﺗ
ﺭﻮﭘ
.ﺮﻱﻟ
ﺎﻁﻭ ﻭﻣﺨ ﺍﻪﻨ
ﻳﺯېﻭﺎﻴﺘ
ﺍﻯﺷﻲډکېﻣ ﺩﺩ
ﻭکېک ﻭﭘﻲښ ﺪ
ﻳﺪﻪﺷ ﻭﭘﺍﻴﺐﻘﻌﻪﺗﺍﺳﻄﻪﻭﭘ
ﺘﻲﭘﻭﺮ
ﻴﺘﻧ
Prﺍ otei
nlﻭoss ﻟﻰﺍﺍ
ﻮﺑﺍ
ﺮﺬﺏﺧ ﺍﻯﺷﻲﺩﺟ ﺩﺩﻪک ﻠ
ﻣﻪﺍﻟ
ﻳﺖ ﺩﻮ
ﻮﺟ ﻮﺩﻣﻴﻧﺠﻮچﻥ ﺗ
ﺎﻳﺩﺯ
ﺷ.
ﻪ ﻲ ﺗ
ﻣﻦځ ﺍ
ﺭ
،ﺩ
ﻭﺧﻰ ﺗ(ﻭچ ټﺮېﻪ ﻨﺠﻭﺣ ﻮﺍﻧ
ﻮﮑﺴ ﻧ
ﺍﺮ
،ﺑﻭږ
ﻪ)ﺱ ﻠﻣﻪﺍﻮﻟﻠ
ﻻﺍﺩﺗ
ﻭﺘﻢ کېﺩﺭ ﻴﺴﻔﺴﻲﺳ ﻨ
ﻪﺗ ﭘ
-٣
ﺎ
ﻴﻧ
ﻮ ﻤ
ﻮﻧ ﮑ
ﻧﺍ
ﺮﺷ.ﺑ
ﻪ ﻲ ﺗﻣﻦځﺍﺰﺱﺭ ﻴ
ﺘﭘﺎ
ﻤﻴwﻭﻫ
heeziﺍng،ډﻱﺗ،ﺳﻦ
ﻟ
ﻪﺎ ﻪﺒﺭﺟﻪﺩ ﻤ
،ﮐﻳﺶ ﺮﻧﻲﺗﺨﻮﺘﺳ
ﺷ.
ﺍﻯ ﻲ ﺩﻧﺩ
ﺭګﺪ Miﻫﻢڅ li
arﻱﻭyAbscessesډﺍ ېﺳﻦ
ﻟﻠﻞ ﺎﺘﻣﺨﺮژﻥﭘﻮﻴﻔ
ﻳﺍﺭﻝﻮﻠ
،ﭘﻴﺖﻧﺸﺍﺮ
،ﺑ
:
Hyperi
nfect
ionsy
ndr
ome-
٤
ﻪﺗ
ﻣﻦځﺍ
ﺎﺕﺭﺘﻼﻃﺍﺧﺭ
ﺷﺭ
ﻮ ﻢﻪﻳ ﻠ
ﻣﺍﻪﻟ
ﺍﺪﻳ
ﺮﭙﺎﺕﺧﻳﻻﺍﺩﺯ
ﻭ Fiﺭlar
ifor
ﻭﻪﺩ m
ړﺗ ﻭﻍﺭﻮﻭﻧﺍ ږﻮ
ﺩﺱﻳ
ﻭې
ﺍ کڅړﺮ
ﻔﺎﺩﺻﻣﻮﻟ
ﻮﻧﺍ
ﺭﺭګ ،ﺩځﻱګﺘﺲ ﻳ
ﺍﺩ
ﺭﺎﮐ
ﻮﻴ،ﻣﺘﺲ ﻳ
ﺍﺩ
ﺭﺎﮑﻳ
ﺮ،ﭘژﻥﻮ
ﻴﻔﻳﺭﻝﺍﻮ
ﻠﻪﭘﮑ ،ﻟږﻱ
کږ
ﺩﺭﻱکﻮﻮﺳﻤﻟ
ﻮﮐﺩ
Paral
yti
cI l
ﺮﺥېکېeus ﻫېﺑ
ﻪﺮ ﺘﻢﭘﻴﺴﻤﻲﺳ ﻪﺩﻫﻀﻧﻮﭘ،ټﺍ
ﺭﻮﭘ
ﺭﻮ،ﭘﺎﺏﻬﺘﻟ
ﺍ
ﻴﮏﺗ
ﻭﺮﻔ
ﻳ.ﻧ
ړﻪ
ﻭ ﻡﻨﺎکﺍ،ﺷ Cachexi
a، ﺘﺲﻳﺎ
ﻨﺠﻨ
،ﻣ Sepsiﻔﻲ sﻨ
ګﻡﻣﺍ
،ﺭ ﺘﺲﻳﺎ
ﻧﻮﺘﻳﺮﺩ،ﭘ
ﻝ
ﺷ.
ﺩﻻﻯ ﻲ ﺩﺍ ﭖښښًﺭ
ﺩﺎﻡﻧﻭﺭﺪﻨ
ﺳ
:
ﺘﻦې
ﺭﻱﮐ
ﺍﻮﺗ
ﺍﺮ
ﺑﻻ
ﻩچېﺷ.څﻥګ
ﻪ ﻲ ﺭ ﻨ
ﻳﺎ
ﻌﺪﻣﻳﺎ
ﻧېﺑ
ﻮﭖﻻﺪ ﮑﻭﺳﺮﮑﻳ
ﺎېﺮﻣ
ﺯﺗﺎﻴ
ﺘﻭﻍډکېﻣ ﺭ
ﺎﻧﻩﺩﺭﺎ
ﭙﻟﻻﺍ
ﻭﻩﺭﺪﻧﻮځ
ﺩﺧ
ﻩﻱېډکېﺭﺎ
ﭙﻴ ﺺﻟﺪچېﺩﺗﺸﺨ ﻳ
ﺎ؛ﺑ
ﻴﺴﻲ ﺭﺕﻧﻮډﻝ ﺻ
ﺘﻲ ﻭﺑ
ﻮﻪﻧﻪﭘﻧﺩ
ﺩﺍﺡ کﺮﻧﺠﻲﺍﻃ
ﺩېچﻥ ﺩ
ﻻﺍ
ﻭﻧﺠﻲ ﺭ
څﻪﻫﻢﺩچﻥ ﻊ ﺧ ﻳ
ﺎﺷېﻣ
ﺘﻞ ﻮﻳﺴﻪﺍﻡﻟﻮﻨ
ﻴﻴﺠﺷ.ﺩﺟ
ړﻝ ﻲﻪک ﻨﻳﺎ
ﻌﻭځﻝېﻣ ﺯېڅﺎﻴﺘ
ﻣ
ﻩﺮ
ﻪﻧﻈژﻱﻟﻮ
ﻟﻭﺮﻴ
ﻭﺩ ﺳ ﺮﻱﺍﻮﺏﻟړﻯﺗﻧﮏﺍ %٩ځ٢-
٨ﻭ٤ﻪﺍﺎﺳ %٩ﺣﺴ٥-٨
،چې٤ﻮﺪﻻﻯ ﺷﻧﻮ
ﻣ
.ﺮﻱﻟCrossr
eact
iﻩ on
ﺮFiﺳ l
ari
ﻭaﺍﻮﻧ
ﺎﻴ
ﻧﺠﻭ چﻥﺭﻮ
ﻮﻧ ﻮﻱﺧﻪﮐﺘﺮﺳ
ﻣELISA
ﻟړ
ﻩﻮ ږڅﻴﻞﻝ
ﻓﻮﻧ
ﻭﺰﻳﺍ
ﻮﻭ؛ﺧ
ﻣﻞ ﻱ
ﺭﺎډﻝﻧ
ﺰﻭﻳﺩ
ﻭېﻪﺩ
ﻧﮏ ﭘﻭ
ﻴﻦېژﭙ
ﻳﻦېﺳ ﻭﺎﻥکېﺩﺘ
ﻧﺍډﻲ
ﻪځﻥﻧ ﭘ
.ﻪ
ږﻱﭘ٢ﻪﺭﺳﻲ
٠ﺗ٠٠ﻭ٠WBC
%ﻪﺍ
٥ﺗ ﻴﻼ٠
ﻓﻮﻧ
ﻭﺰﻳ
،ﻮﺍ
ﺎﺕﺗﺸﻲﻧ
ﻳﺮﺕﺯﺎﺟﻬﻻﺍﻣ
ﻭ
ﻪچېﺩﺭ ﻠ
ﺎﮐﻣﻭ،ﺍ
ﻱ
ﻭ.
ﻪﻱ ﺩﻧ
ﻮﻮﺟﺎﻣ
ﻴﻠ
ﻴﻓﻮ
ﻧﻭﺰ
ﻳﺍﻮکې ﮑ
ﻠځﻮﺧ
ﻠ
ﻴﺖ ﭘ ﻓ
ﺎﻌﻣ
ﺷ.
ﻮﻻﻯ ﻲ
ﻴﺭﺕﻧ
ﻮﻴ ﺺﺻ
ﻻﺍﺗﺸﺨ
ﻭېڅﻪﻫﻢﺩﺭ
ﺮﻥ ﺧﻪﮐ
ﻟﻭﺯ
ﺎﻴ
ﺘډﻮﻣ
ﺩﮐ
:
ﻪﻨ
ﻠﻣ
ﺭﺩ
ﻩﻭ
.ﺎﺩ
ږﻱﻳ
ﻮﻝ کږﮐﺭ
ﺯﻥﻭ
ګﻡﻭ
ﺍ
ﻮﺭ ﻟ
ﺮکﻝ
ﺮﻫﺪﻥﭘﺑ
ﻪﺩﻣﺍ
ﺭﻭګﺮ
ﮑﻳﺎ
٢ﻣ٠ﺯ٠
ﻭﻩﺩﻮﻪﻳIﭘver
mect i
n
،چېږﻱ
ﻮﻝ کږ
ﮐﺭﭘﻪﭘﺲېﻭ
ﻟ
ﺭځې ﺮﻩﻭ
ﻭﺪﻥﺩﺑ
ﺯﻥﺩګﻡﻭ
ﺍﻮﺭ
ﻟﺮ کﻝ
ﺮﻫ ﻪﭘ
ﻣﺍﺭ
ﻭګ ﺮ
ﮑﻳﺎﻣ
٢٠ﻩ٠ﺯﻭﺩ
ﺩ.
%٩ﻯ٨-٨ﻮﺏﻱې٢ ﺘﻨﻣ
ﺰﻴﺍﻏ
ﻭﻭځ
ﺩې ﺭ
ﻪﺩﺭ ﺘﺎﻋ
١ﺳﻫ٢
ﺪﻥ ﺮ
ﺑﺯﻥﺩګﻡﻭ
ﺍﻮﺭ ﻟ
ﺮکﻝﺮﻫﻪﭘﻣﺍ
ﺭﻠﻲګﻣ١
ﺭې٥ېﻪﻻ
ﻮﻝ ﻟ
ﻭﻝﺩﺧﺯﺍ
ﺪﻨ
ﻴﺒ
ﻟﺍ
ﻮﺏﻱﺘﻨﻣ
ﺰﻴ،چېﺍﻏږﻱ
ږړﺎ ﭖښښ
ﻴﻫﺍﺗ
ېﻪﻱې ﻢ
ﻠﻦ ﺗ
ﻣﺭﺭﺱﺩﺩﻮﻭﻫﻢﮐ،چېﺩ
ږﻱﻮﻝکږﮐ
ﺭﻩﻭﺭﺎ
ﭙﻟ
ﺩ.
%٩ﻯ٥-
٣ې٨
ﻮ
ﻟﺮکﻝ
ﻪﻫﻪﭘ
ﻣﺍﺭ
ﻭګﺮ
ﮑﻳﺎ
٢ﻣ٠
٠I
ver
mect
iﻪﺩn
ﻭﻍﺗ
ﺭﺎﻟﺖکېﻧ
ﺎ
ﻪﺣﻡﭘ
ﻭﺭﺪ
ﻨﮑﺸﻦﺳ
ﻔﻧﺍ
ﺮﭙ
ﻳﺎ
ﻮﺩﻫ
ﺧ
63
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
.
ږﻱ
ﻪکږ
ﻴﻮﺻ
ﻩﺗﺭ
ﺎﭙ
ﻟېﺭځې
ﺷړﺳﻢ ﻭ
ﺎېﻭ ﭙ
ﻟﺴﻢ ﺍ
،ﭘﻦځ
،
ﻭﻫﻢ
،ﺩړۍ
ﻡﻮﻟ
ﺪﻥکېﺩ
ﺑﺯﻥﺩ
ګﻡﻭ
ﺍ
ﺭ
:
(Cysti
cercosiﻳﺲ)s ﺯ
ﻮﮐﺮﺘﻲﺳ ﻴﺴﻭﺳ ﺍﻴﻢﻟﻮﺎﺳﻨ
ﻴﺗ
ﺭڅﻮﺭﻧﺷﺭ
ﻮ ﻢ ﻩﻳﺭﻥګ ﺍ
ﺪﻤ.ﻫ ﺮﻱﻩﻟﻭډ
ﻩﻥ ﻮګﻪﺗﻪﭘﺑﺭ
ﻮځﻲﮐﻣﻦﻧ ﻮګﺩ ﺩ.ﺧ
ﻪﻯ ﺑﺭ
ﻮﻨﻰﮐ ﻳﺯ
ﺍﻮﺎﻥﻳﻧﺴﺍ
ﺷ.
ﺍﻯ ﻲ ﺩﺩﻪک ﺑ
ﺭﻮﻩﮐ ﺭ
ﺎﭙﻟﻻﺍ
ﻭﻭﻱﺩ ﺭ ﺭﺍ
ﺎ کېﻱې ﻴﺘﻲځېﺍﺳ ﻭﺧ ،چﻥﻥﺍ ﺎ
ﻘﻳﺮﻓ،ﺍ
ﺎﮑﻳ
ﺮﻣﻪﺍﻨﻴ
ﺗﻪﻻ ﻮﭘ ؛ﺧږﻱﺍکږ ﺪﻴ
ړۍ کېﭘ ﻪﻥ ﻟ
ﻭ ﻪټ ﭘ
ﺎﻫﻞ
ﺍچېﮐ :ﻮﺩږﻱﻳﻻﻞکږ ﻮﻣ ﻴﻭﻏ
ﺭﺎﻧﻲﻧﺎﺘﻧ
ﺍګﻱ
ځﻥ ړﻪﺍﻟﻭﻩډﻭﻴﻢﺩﺩ ﻟ
ﻮﺎﺳﻴﻨ
ﻴﺩ.ﺗ
ﺎﺕې ﻱ ﻳ
ﭘﻲښېﺯ
ﻮکېژ ﺎﺟﻧﺴېﻪﺍ
ﮑﻞﺩﻯچ ﭘ ﻻﺍﺷﻭﻭﺑﻞ ﺭ ﻮﻱﺍﺪﮐ ﻧ
ﻭﻮکېژ ﻤﻟ
ﻮﻪﮐ ﺎﻥﭘﻧﺴﺍﻭﺩﺟړﻱﺍ
ﻧﺠﻰ ﻮﻭ چﻥ
.
ږﻱﻪکږ ﺗﻣﻦځ ﺍ
ﻪﺭﻠﻣﺍۍﻪ
ﻭﻝ ﻟ
ډﺍﻩﺩک ﺮﺗ
ﺎﻳ
ﻳﺲﺯ ﺯﻮﮐﺮ
ﺘﻲﺳ ﻴﺴ.ﺳﻮﻱ ﺪﮐﻧ
ﻭ
:ﺰﺱ ﻴﻨ
ﻮﺟﺘﻭﭘﺍﻻﻞ
ﻣ
ﺎﺕېﺪﻯﭘ ﻧﻭﺭېژ ﻮﻮﭘ ﻧ
ﻮﻠﺮﮐﮐﻻﻯﺷﻲﺗ ﻧﺠﻰ ﻮ .چﻥﻮﻱﺪﮐ ﻧﻭﻡ کېژ ﻮﻨﻴﻴﺠﻪﺟ ﻧﺠﻰﭘ ﺍﻥچﻥ ﻭځ
ﻮﻱې ﺮﻳ ،چېﻫ ﺮﻱﻟ prﻭoglott
id١٠٠
ﺍﻯﺷﻲ٠ ﺩﺩﻭکﺮﻱﺍ ﻟﻰﻟﺍ
ﺍږﻭ
ﻭ ﻭﺩ ﺮﺘ
٨ﻣ -ﺎ(٢
ﮐﻪ
٢ﻟ ٠
-١٠
ﺷﻲ)
ﻪ چېﻩګۍﺩ ﻠ
ﺷ.ﮐﮐﻻﻯ ﻲ ﺪﻮ ﻧ
ﻭﺎﺷﺖېژ ﻴﻭﻣﺎﻝ کېڅ ﻳﺮﻴ
ﭘﺎ
ﻪﭼ .ﻩګۍﭘ ﻮﻱ ٥ﻩګۍﺍﭼ ٠٠
٠٠
ﺩﻟږ
ﻪﻲ ﻮﺗ ﺎﺟﻧﺴﺎﺍﻴﻱﻭﺑ
ﻪځ ﺍ ﺍﻝﺗﻮﻳﻮﺩ ﻤ
ﻟﻮﮐ
ﺟړﻱﺩ
ﺷ،ﻻﺍ ﻮﻭ
ﻭړﻝ ﻲ ﺭ ﻮﺍﻭﺧ ﻮﻪﻟﺨﺑﺭﻮړﻱﮐ ﻣﻦځګ
Cysti
cer ﻪci ﺘ
ﻟﺭځﻱ چېﺩ ﻪﺍ ﺗ
ﻭﻣﻦځ ﺍړ
Cﻻﺍ ﭖ
ﻭ yﺭ sti
ﺍﺧﻞc ﻪﺩ ﺘﻭﺳﺭﺭځېﻭ ٩ﻭ٠-
٦٠. ږﻱ
ږ
ﺷ.
ﻟﻰ ﻲ ﻮ ﺪﮐﻧﻭﻩژﺭﺎ
ﭙﻟﻮﻧﻮﻠ
ﺎﮐﻮﻳﺘﺎﺷﻴﻣﺩ
ﻩﻮښ ﻪﻏﻐ(ﻫ Por ﺯﻱ)kﻮﮐﺮﻪچېﺩﺳ ﻠ،ﮐږﻱ
ﻪکږ ﺘﻧﺠﻲﺍﺧﻮﻱچﻥ ﺘﻴﻪﻓﻮﭘ ﻤ
ﻟﻮﮐﻪﻭﺧﺖﺩ ﻐﺎﻥﻫﻧﺴﺍ
ﺯﺱ ﻮ
ﮐﺮﺘﻲﺳ ﻴﺴﻧﻲﺳ ﺎ
ﻧﺴﺭﺍ.ﻡګ ﺭﻱﻮﺷېﻪﻭﻱﻭﺧﻪ ﻮﻧ ﻩﭘﺨ ﻭښ ﺯﺱﻭﻱﺍ ﻮﮐﺮﻧﮏېﺩﺳ ﻭﺮچېﻟ
ﻪﺗ
ﻣﻦځ ﺍ
Autﺭ oi
nf ect
iﻳonﻭﺎ ړﻝﺷﻲﺍ ﻮﻴﻢﻩګۍﻭﺧ ﻟﻮﺎﺳﻨ
ﻴﺗﻪچېﺩ ﻠ
،ﮐﺭځﻱﻩﺍ ﻪﻭﺧﺖﻣﻦځ ﻐ
ﻫ
ﻭﻱﺩږ
ږﻪﻝ ﺎﻝﺗ ﻳﺮ
ﻴﭘﺎﻧﻲﭼ ﺮ
ﻬﻧﺠﻲﻩګۍﺑ ﻮﻯﺷﺨ ﺺچېﺩچﻥ ﻪﺷ ﺘﻪﺍﺧ ﻠ
ﭙﺎچېﺧ ﻧ
ﺎﻪﺩېﻣ ﺷ،ﺍﭘ
ﻲﺩ
.ﺭﻱﻮﺍﻩګۍﻭﺧ ﺪﻤ
،ﻫ
ﻭ.
Scolﻱ
ﮑﻰﺩex
ﻧﻭﺮ
ﻟﺩ،چې
ﺮﻯ ﺘ
ﺘﻲﻣ
ﻧﺎ
١ﺳ-
٠،
ﺮﺩ٥
ﻴﺴﺖﻗﻄ
ﺩﺳ
:ﻴﻢﻟﻮ
ﺎﺳ ﻨﻴ
ﻮﺗﻤﻟﻮﮐ
ﺩ
ﺯﻥ،ﻭﺎﺱ ږېﺍﺣﺴ ﻭﻝ ،ﺩﻟﻰﺍ
ﻭﺪﻩﺑړﺩ،ﺯ
ﺩﺮﺥې ﺭ ﺗﻦۍﺑ ﺭﻮﭘﻱېﺩ،ﺩګډ ﺮﻱﻪﻟ ﻧ
ګﻞېﻭ ﺍﻯ ﺷﻲ ﻳ ﺩﺩک
ﻮﻟ
ﺪﻴﺭﺟﺎPrﺧ oglotti
ﻭکېd ﺯﺎ
ﻴﺘډﻮﻣ
ﻪﮐ ﻭﻍﭘﺭﺎﻭ.ﻧ
ﺩﻱ ﻮﻮﺟﺍﻯﺷﻲﻣ ﺩ
ﺩﺘﻰک ﺎﺳﻭﻧﺲﻧ ﻟﻰﺍﺍﻮﻤ
ﮐ
.ﻮﻱ ﻪﮐ ﻳﺎ
ﮑڅﻪﺣﺧ
:(Sycti
cercosiﻳﺲ)s ﺯﻮ ﮐ
ﺮ ﻴﺲﺗﻲﺳ ﺳ
ېﻪﺩې،چ ﻟ ږﻱﻪکږ ﺘﺎﻥﺍﺧﻧﺎ
ﻧﺴﻪﺍﻧﻮﻠ
ﻴﻣ٢ﺎﻝ٠ﮐﺮړۍکېﻫ ﻪﻥ ﻪﭘﺍﺳﻄﻪﻭ ﻳﺲﭘ ﺯﻮﮐﺮﻴﺲﺗﻲﺳ ﺩﺳ
.ږﻱ
ﻩکږ ړﻫﮐﻝﻡ
٥ﺮﺎ ٠
٠٠ﺧ٠
ﻤﻞېڅﻪ ﺟ
ﻮﻪﮐﺘﻪﺍﺧ ﺮﺧ ﻩﺑﺮﺩﻫ ﻮﻭﺟCectﺩicerﺩci.
ﺮې ﻱ ﻴﻐﺘ
ﻭېﻣ ﺎ
ﻴﺗﺪﻧ
ﺭګﻴﮏېڅ ﻨﻴ
ﻠCestﮐ icercosiﺩs
ﻭﻮﺍﺎﺟﻧﺴﻧېﺍېڅﻪﻻﺪﺘﮏ ﺧ ﻮﺳﭘ،ﺩﻮﺗ
ﻠﻲټﻱﻋﻀﻼ ﮑ،ﺍﺳﺎﻍﻣېﻪﺩ
ډﻝﻱ ﭘ ګﻱ ﻭځﻥ ړ
ﺷ،ﻪ ﺍﻻﻯ ﻲﭘ
.
ﻮﻮﻻﻯﺷ ﮐﺍﺪﻴ
ﻭکېﻱېﻫﻢﭘ ﺮګﺘﺳ
.ﺮﻱﻟﻩ ړﺍﺭېﻮScarﭘ r
iﻭng ﺍګﻥ
ﺮﻭ ﺒﺑﻲﻏﺎﻬﺘﻟﺍ
ﺍ،
،ځﻯ ﺭ
ﺷﺭ
ﻪ ﻢ ﺎﻥﭘﺘ
ﻧﺍﻭېﺩﺎﻴﺗﺪ
ﻧﺭګ ﻴﮏېڅ ﻨ
ﻴﻠ
ﮐ
-
ﻩﻱې١ ﺭﻭﻳﺦﺩ ﺮﻔﺗ؛ﻮﺩ
ړﻱﻧ ﺍکﺪﻴﺍ ﺽﭘﺮﻪچېﺍﻋ ﻠ،ﮐﺮﻱﻟ ېﻪ
ګﻞ ﻧ
ﻴﺴﺖ ﻳ ﻮکېﺳ ﻧ
ﺎﻭﻏﺭﺎﻩﻧﺮﺗ
ﺎﻳ
ﻪﺯ ﭘ
ﻨﻲﻴﺎﺑﻄﻭﻳ ﻴﻦﺍ ﻣ
ﺍﺭﻮﺎﻍﻓ ﻣ
ﻭ،ﺩﺩﺮګﻥ ﺒﺑﻲﻏ ﺎ
ﻬﺘﻟ
،ﺍ،ﺘﻞﮐﻭېﺩ ﺎ
ﻴﺗﺪﻧ
ﺭګﻴﮏېڅ ﻨﻴﻠ
.ﮐﻩﺭېﺩ ﻮﻮﭘﻧ
ﻮ ﻠ
٥ﮐ
ﻭ.
ﻪﻱ ﻠﻣﺍﻪﻟﺩﻭ
ﺪﺩ ﻨﺑﺘﻢﺩﻴﺴﺳ
ﺭګډﻝڅﻪﻭ Jacksoniﭘ ﺎanﻭﻳ ﻣﻲﺍ ﻮﻤ،ﻋ
ﻌﻲ ﻮﺿ ﻪﻣ ېﺍﭘ
ﻭ،چ ﺩﺩ ﻱ ﻮﻮﺟﺍﻯﺷﻲﻣ ﺩﺩﺘﻼﺝک ﺍﺧ
.ږﻱ
ﺪږ ﻧ
Arachnoi diti
ﻳﺩs ﻭﺎ ﺍ
ﺎﺏ ﻬ
ﺘﻟ
ﺍ،Cysticeri
ﻟﻰﺍﻭﺪ ﻨ
ﻪچېﺑ ﻠ
ﻣﺍﻪﻟﺩﻭ
ﺪﺩﻨﺑﻮﺱﺩCSFﺩ ﻟﺎ
ﻔﻭﺳﺭﺪﻳﺎ
ﻫ
64
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
65
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﻮﻱځﻥﺭﺳېﻪ ﺍ
ﺘﮏ ﺗ ﻮﺳ Perﭘiﺧanal
ﺪڅﻪ ﻌﻘېﻪﻣ
ﻪک ﻟ ﭙﻪﺷ ﻧﺠﻰﭘ ﻪچﻥ ﻨ
ﻳﻩ ښځ ﺭﺍ
ﻭﺪﻨﻴ
،ﻣ ﻮﻱﻟ
،
ږﻱ
ﻪکږ ﺗ
ﻣﻦځ ﺍ
ﺎﻥﺭﺘﻧﻮکېﺍ ﺘ
ﺎﻋﻭﺳ ﻪڅڅﻪﭘﺩګﻮ ﺧ
(ﻩﻳ ١
٠،٠
٠ﺎ٠
ًﻨ
ﻴﻤﺗﺨﻮﻱ)ﺭﻩګۍﺍﭼ ﺷﺭ
ﺎﺕ ﻢ ﻳﻭﺯﺍ
ېڅﻪ
ﺭ ﺧ ﻪﺩېﻻ ﻭﻟﻮﻱﺍ ﻨﺘﻨ
ﻪﻣ ﻧ
ﻮﻭﻻﺳ ﺮﺵﺍ ﻫ،ﻓ
ﺍ،ﻮ ﺮ
ﺘ،ﺑﺴﻟﻲﺎ،ﺩﺷﭗېﮐ ﻪ
ﺑﻭ،ﺍ،
ﻮکﺍکېﺗ ﺭﻮچېﺧ
ﺍ
ﻮﻧېﺧﻻﺍﻻﺪﻭ(ﻭ ﺭ
Hatﺍ ﺑﻲ)chﺭﺎ
ﺮکېﻩګۍﺷ ﺎﻋﺸ ﻨ
ﺛﺍ.ﻪ
ږﻱﭘﻊکږ ﻠﻌﻦېﺑ،ﻳږﻱﻠﻲ ﺍﺧېﻪﺩ
ﻮﻝ ﺗ ﺧ
.ږﻱ
ﺩږږږﻪﻝ ﻡﺗ ﻮ
ﮑﻴﻌﻦېﺳ ﻳ
ﻩﻭ
.ﻩګۍﺩ ﻩړﺎﺩ
ﻴ
ﺗﺍﺗﻮﻪ ﻴﻧﻭ٤ﺍ-
ﺎ٣ً
ﺒﻳﺮ
ﻘ،ﺗﻮﻱﺍﭼﻮﻻﻯﺷﻲﻩګۍﻭ ﮐ
ﻧﺠﻰچېﻭ ﻪچﻥ ﻨﻳﻮﺥ ښځ ﻮﭘﻳ
ﺭځې٤ﻭ٥-٣ﻩ٠ﺩﻮﻪﻣﻟﻭﺪټ ﻧ
ﻭﻧﺠﻲﺩژ ﻭﺩچﻥ ﮐﻻﻯﺷﻲﺍ ﺪﻮ ﻧﻭﺮژﻬڅﻪﺑ
ﻪ ﺧ ﺑ
ﺭﻮۍﻪﮐ
ﻭﻥ ﻟ ﺩېﺍﺮﺭ ﺗ
.
ﻩﺩ
:ﻩﻴﮏېﺏڼ ﻨﻴ
ﻠﮐ
،
ﻮﺏۍ ﻭ ،ﺏې ﺧ
ﺍ ﻱ ﻮﻩﺩﺷﭗېﻟﺨ ﺮﺗ
ﺎﻳ
ﺕڅﻪ چېﺯ
ﺭښ ﺧ ﺎ Perﺧi
ﻟanalﺎﻥ ﻪﻭﻏﺭﺎﺭﻧﺷﺭ
ﺎﺕ ﻢ ﻳﺯ
ﻭ.
ګﻪﻣﻦ ﻱ ﻠ
Eڅﻪ ﻳ
nurﺧ i
si
ﻭs ﺍﻴﺖ ﻳﺸﺮ،ﺗﺨﻡۍ ﺍﺭﺎ
ﻧ
ﺩﮑﻰ کﺘﻮﺳﺍﭘﻮﻭﺧﺎﺪﺷ ﻌﻘﻣ.ﺩﻮﮐﻼﻯﺷﻧﺠﻰ ﺘ ﺍ کېچﻥ ﻮﻭﺧ ﺎ
ﻪﺷ ﺪﭘﻌﻘﻣﺍﺩﻮﻪﺩﺷﭗېﻟﺨ ﻠﻪﮐﻠﮐ
ﺷ.
ﻪ ﻲ ﺗ
ﻣﻦځ ﺍ
IﺭMpiti
ﻭgo ﺍﺘﻦﺷﻲ ﻨﻪﻫﻢﻣ ﺍﺳﻄﻪﻭ ﻭﺏﭘ ﺮﮑﻳ
ﺎﺑﻞﻣ ﺍﻯﺷﻲﺩ ﺩ
ﻪچېﺩ ﻴﻞﺗﻠﺎﺍﺣﺯﻳﺎ
ﻬﻮﻝېﺟ ﻪﺑﻧ
ﺎﻧﻪﺩﺯﮑﻟ،ږﻱ
ﻪکږ ﺗﻣﻦځﺍﻪﺭﻧﺩﺩﺩ
ږږﻧﺠﻲﻝ ﻩﺩچﻥ ﺮډﻝﺳ ﺭﻭ ﺩﺎﻪﻧﭘ
ﺍﻥ
ﻮﺘﻳﺮ
،ﭘ ﺯ
ﺎﻬﻟﻲﺟ ﻮ
،ﺑ ﻮﻥﻟﻮﻪﮐCﺎﭘ
yﻳ t
iti
s،Diverti
culi
ti
s، ﺘﺲ ﻳ
ﺎﻳﺴﺪﻨﭘ
،ﺍVulvov aginiti
sA
ﮐﻻﻱټﻴﮏ ﻮﻠﻴﻓ
ﻮﻨﻳﺰ
ﻳﺍﻭ ﺍﻪﻧ
ﻮﭘﻮﻥټ ﻟﻮ
ﮐﺷ.ﺩ
ﮐﻻﻯ ﻲ ﻪﻮ ﺗﻣﻦځﺍګﻥﺭ
ﺮﻭ ﺒﺎﻏﻣﻮﻟﻮﻧﺍ
ﺭﻮکېګ ﺮﺧﻭﺑ ﺭ
ﻮﻧ
ﺩ.
ﻮﻯ ﻯ ړﻝﺷ ﺭکﺭﻭ ﻮﭘ
ﺍﺱﺭ
ﺷ.
ﻻﻞ ﻲ ﻮﻣ ﻠ
ﻠﻳﺎ
ﺯﻥﺑﻭﻭﺍ ﺩ
ﺭﻱېﺩﺍﻯﺷﻲﺩګ ډ ﺩﺩ
ﻭ؛کﺎﺕ ﻱ ﻳ
ﺭﺯ ﺷﺭ
ﻮ ﻢ ﻴﻧﺠﻪﺩچﻥ ﮐ
:ﺭﻱﭘﻞټﻥې ﺍﻮﺗﺍ
ﺮﺑﻻ
،
ﻭړﺍکﺪﻴﺘﮏېکېﻩګۍﭘ ﻮﺳﺍﭘﻮﻭﺧﺎ
ﻪﺷ ﺪﭘﻌﻘﻣ
ﻪچېﺩ ﻠ،ﮐږﻱ
ﺩﻝکږ ﻭﻪﻭﺧﺖﺍﻱښ ﻐﻴ ﺺﻫﺗﺸﺨ
ﺪﻌ
ﻘﻣﺩ،چېﺩﺍﺱې ﻯﺩﺩﻮﺘﻴﻩﻣﺭښ ،ﺭ
ﻮډﻮﻻﻯﺷ ﮐﺍ
ﺪﻴﻭکېﻩګۍﭘ ﺯﺎ
ﻴﺘډﻮﻣ
ﻪﮐ ﻩﭘﺮ
ډﻝﺳﺭﻭ ﺩ
ﺎﻪﻧﭘ
ږﻱ
ﺩﻝکږ ﻭﺍﻱښ (
ScotchTy pe)Cell
ulosepressuresensit
ivﺪېeﻧﺎ
ﺘﮏېﺑﻮﺳ ﺍﭘﻮ
ﻭﺧ ﺎ
ﺷ
ﺎ
ﻴﺗ
ﺪﻧﺭګﻪﺩ ښېڅ ﺘﺒ
ﻟﺍ
.ږﻱ
ﺪﻝکږ ﻴ
ﻟﻧې
ﻮﺏﻻﺪ ﮑ
ﻭﺳ ﺮ
ﮑﻳﺎ
ﺮﻣﻱﻭﺗ
ږﺍ ږړﻮ
ﻭڅﻪﺟ
ﻼﺪ ﺭ ﺧ
ﻪﺳﻳ ﺘﻭﺳﺭﻭﻭﺍ
ﺮ
ﻮﻥېﻫ ﻤﺩېﻧ
ﺷ .ﺭ
ﻪ ﻲ ﻣﻮ
ﻠﻌﻪﻣﮐﺎﻪﭘﺎﺣﻭﺳ ﺗڅ
،ﺮږﻱ
ﺘﻞ کږﻴﺴﻩﺍﺧTڅﻪ ګټ
ulﺧ ﻪuene ﻩﻟﺭﺎ
ﭙﻟ
ﻭ.
ﺪﻱ ﻴ
ﺋﺎ
ﻭکېﺗ %٩ﭘﻲښ ﭘ٠
ﻴ ﺺﻪ ،چېﺗﺸﺨ ږﻱ
ﺘﻞکږ ﻴﺴﻮﻣﺨﮏېﺍﺧ ﻟ
ﻮﺮﮐﻭﺗﺯ
ﺎﻴ
ﺘډﻮﻣﺭﺩ ﮐﺎﻬ
ﺳ
ﻳډﻮ
ﻭﺎ ﮐﭘﻲﺍﻮﮑﻮﺳﻧ
ﻪﺍﻧﺠﻰﭘ ﻍﻪچﻥﻍﻪﻥ ﻏ
،ځﻦېﻭﺧﺖﻥﻍ ﭘ ږﻱ ﻳﻪکږ ﺗﻣﻦځﺍ
ﺍﺭ
ًﺭﺩ
ﺎﺎﻧﻴ
ﻠﻴﻓ
ﻮﻨﻳﺰ
ﻳﺍ
.
ږﻱ
ﺪﻝکږ ﻴﻟﻭ
ﺮګﺘېﻪﺳ
ﻭک ﭘ ﺯﺎ
ﻴﺘﻣ
:
ﻴﺺﺮﻱﺗﺸﺨ
ﻴﭘﻮ
ﺗ
،Fi
ssur
e،Pr
oct
it
is،
ﺮﻴ
ﺍﺳﻮ
،ﺑﻴﺖﺎﺳ
ﺎﻥ ﺣﺴ
ﺘﻧ
ﻴﮏﺍﺗ
ﻮﮑﻳ
ﺎﻣﺪﺩﻳ
ﺎﺭښﺕﺑﺎ
Piﺧ
nwor ﺩm
ﺮکﻴ
ﭘﻮږﻱﺗ
ﻻﻞکږ
ﺭښﺕ ﻣﺎ
ﺍﺧﻮﻭﺧ
ﺎﺪﺩﺷﻌﻘ
ﻣڅﻪچېﺩ
ﻮ ﺧﻧ
ﻮﺘﻟ
ﺎﺭﺣ
ﻮﻪﻧﻟ
sﻭ
tﺍr
ongyl
oidi
asi
s
.ﻭ
ړ
:
ﻪﻨ
ﻠﻣ
ﺭﺩ
:
ﺎﺕﻣ
ﺎﻤﺘ
ﺍﻫﻣﻲ
ﻮﻤ-ﻋ
١
ﻮﻪﻳړﻯﭘ
ۍټﻝﻍ
ﺭﻥ ﻭ ﻮﮐﺪﺩﻳﺎ
ﻮ کېﺑ
ﻧﻮﺘﻟ
ﺎ
ځﻮﺣﻨﻪﻳﻭﭘﻪﻭﺷﻲﺍﻨﻠ
ﻣﺭﺪﺩﻳﺎ
ﻮﺑﻧ
ﺎﻭﻏﺭ
ﺎﻮﻧﻨ
ګﻪﻣﻠ
ﺩﻳ
ﻪ
ړﻪﻧ
ﻨﻪﺍﻳﻨ
ﻠﻣ
ﺭﻮﺩﻧﺎ
ﻭﻏﺭﺎ
ګﻪﻣﻦﻧﻠ
ﺮﻳ ﻴ
ﻩﻫﻢﺩﻏ ﻪڅډﻝﮐ
ﻣﻲ ﻭﻮ
ﻤﻪﻋﻮﭘﺷ.ﺧﻪ ﻲﻨﻠ
ﻣﺭﻭﺧﺖکېﺩ
ړﻦ
ﻮﻣﺨﮏېﺍﻳ ﻟ
ﺧړ
ﺮﻮ ﻭﺗﻪﺍﺘ
ﻭﺳﺭﻮﻭﻟ
ﻮﺮﮐﻭﺗﺯﺎ
ﻴﺘ
ډﻮﻣ
ﻪﺩ ﮐﺍﺳﻄ
ﻪﻭﻮﻥﭘﺑﺎ
ﻴﻦځﻝﺩﺻ ﻮﻣﻧ
ﻮ.ﺩﻻﺳﻩﺩ
ﺩ.
ﺭﻱ ﺎﮑ
ﺘﻞﭘﻴﺴﺍﺧﻮﻧ
ﺎﮐﻮ
ﻧﺩ.ﺩ
ﻯ
66
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
:
ﺎﺕﻣ
ﺎﻤﺘ
ﺍﻫګﻱ
ځﻥ ړ
-ﺍ
٢
ﺎ
ﻭﻝﻳﺯﺍ
ﺪﻨﻴ
ﺒ،ﻣﻭﻝﺯ
ﺍﺪﻨ
ﻴﺒ
ﻟﺷ.ﺍ
ﺭ ﻲﺍ
ﺮﮑﻪﺗﺘﻭﺳ
ﺭﻭﻥۍﻭ٤ﺍ-ﺮ٢ﻪﻫﻨ
ﻠﻣ
ﺭﻪﺩﺍﺳﻄﻪﻭګﻮﭘ
ﻧﺍﺍﻭﻧېﺩ
ﺩﻻﺪ
ﻮ ځﻝ
ﻪﻳ ﻣ
ﺍﺭﻠﻲ ګ
٤ﻣ ٠
٠.ﺮﻱ
ﻳﺖﻟﺮﺛﻮ%١ﻣ٠
ﻭﻝ٠ﺯﺍ
ﺪﻨﻴ
ﺒﻟ
ﺩ.ﺍ
ﻣﻞ ﻱﺭړﺩPyﻭr
antelpamoat
e
.ﻮﻱﻪﮐﺗ
ﻣﻦځ
ﺍﺍﺭ
ً
ﺭﺩﺎ
ﻪﻧﺘﺎﺳ
ﻭﻧﺲﻧ ﺍ
ﺩﺭﻱېﺩ
ږﻱﺩګډﻮﻝکږﮐﺭ
ﻭ
ﺷ.
ﻭژﻝ ﻲ
ﻩﻭ ﺭ
ﺎﭙ
ﻟﻳﻞې
ﺎﺪﺩښېﭘ
ﻳﺎﻭﺑ
ﺍﻣﻞﺩﻱ
ﺭﻣﻦﺩ
ﺰﻴﺍﻏ
ﻪﻫﻢ
ﻣﺍﺭ
ﻠﻲګ
١ﻣ٠
ﻮځﻝ٠
ﻪﻳﻭﻝﭘ
ﺯﺍﺪ
ﻨﻴﺒ
ﻣ
ﻮﻟ
ﺮکﻝﺮﻫﺪﻥﭘﺑ
ﻪﺩﻣ
ﺍﺭﻠﻲګ
ﻣ١٠.
ﺮﻱﻟ
ﻳﺖﺮﺛ
ﻮ%٩ﻣﻣﻞﺩﻱ٥
ﺭﻣﻦﺩﺰﻴﺭﺍﻏ
Pﺭ
yډ r
antelpamoate
ﺎ،
ﻬﻝ،ﺍﺳ
،ﺎﻥګ
ېګﻞېﻱېﮐ
ﺰ ﻳﻴﺰېﺍﻏ
ﻴړﺧ
ﺰېﺍﻳ
ﺩﻭﺩ.ﺩ
ګﻡ ﻯ
ﺍ
ﻮﺭ ﺯﻱېﻳ ﻭﻳﻲﺩ
ﺎﻬ
ﺯﻥ کېﻧګﻡﻭ
ﺍﺭ
ﺩ.
ﻟﺖ ﻱﺎ
ﻮﺏﺟﻦﺣ ېﻭﺧ
ﺳګﭻ ﺍ
،ﺮﻳ ﺩﻱ
ﺭﺩﺮ
ﺳ
67
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﺘﺲﻳ
ﺎﻨﺠ
ﻨﻳﻲﻣ
ﺎﻳﺮ
ﺘﮐﺎ
ﺑړﻰﺑ
ﻲﻧ
(
Acut
eBacter
ialMeni
ngi
ti
)s
:
ﻳﻒ ﺮﻌﺗ
ﻪﺘﻢﻟﻴﺴﺒﻲ ﺳ ﺰﻱﻋﺼ ﮐﺮﻣﺭﺕﺩﻯچېﺩ ﺎ
ﺒڅﻪﻋﺎﻥ ﺧ ﺘﻧﻴﺤﻲﺍ ﻘﺑړﻲﺗ
ﺎﻑې ﻲﻧ ﺪﻣﺴ ﻴ
ﺋﻮﻨﮐﺭﺩﺳﺐﺍ
ﺭﺎ
ﻠﻲﻓﺸ ﺍﺧﻗﺤﻒﺩﺩ ،ﺩﻮﺗﺎ
ﺘﻼﺟ ،ﺍﺧ ﻟﻲ ﺍ
ﻮ ﻤﺭﺩﮐﻮ ﻌ
ﻳﻲﺩﺷ ﺍځﻯﻭﻱچې ښ ﻮﺍ ﻩﻳ ﺮګﻥﺳ ﺮﻭ ﺒﺑﻲﻏ ﺎﻬﺘﻟ
ﺍ
ﺷ.
ﻻﻞ ﻲ ﻭک ﻣ ﺮﺘﻭﺳ ﺍﻟﻲﺍﻭﻟړ
ﺩﻮ
ږﻱ
ﻪکږ ﺘ
ټﻝﺍﺧﻴﻢ ﻭ ﻧﺸ ﺍ
ﺮﺎﻏﻲﭘ ﻣ ﻭﺩ ﻪﺍ ﻓﺎ
ﺪﻣﺴ ﻴﺋﻮﻨﮐ
ﺭ،ﺳﺐﺍ ﺎ
ﻳﺎﻪکېﺳﺤ ﻭﺳ ﺮﭘېﭘﻩچېﺪ څﻥګﺭ
ﺩ.
ﺭﺕ ﻯ ﺎ
ﺒټﺱڅﻪﻋ
ﺧ ﻔﻼﻱﻧﺴ ﺍﻮﻨﺠﻨﻡﻣﻮﻩﺳﻢﻧ ﺭﺎ
ﭙﻟ ﺩې
ﺮﺩ ﺎﻃﭘېﺧ ﻮﺪ ﻧ
:ﻮﺟﻲ ﻟﻮﻤﻳ
ﺪ ﻴﭘ
ﺍ
ﻮک ﻴﺘ
ﻭﺳ ﺭﭘېﻭﺩ،چېﺪ ډﻝ ﻯ ﻬﻢ ﻭ ﺎﻥﻣ ﺘﻧ
ﺍ ﻴﺤﻲﻘﺘﻢﺩﺗ ﻴﺴﺒﻲﺳ ﺰﻱﻋﺼ ﮐﺮﺎﻱټﺱﺩﻣ ﻨﺠﻨﻳﻞﻣ ﺮﺘﮐﺎ
ﺑ
ﺩ.
ﺎﺕې ﻱ ﻳ٢څﻪﺯ
،ﺧ ګﻭکېﺩ٥ ١ﻭړ ٠٠
٠٠ﭘ٠
ﺎکېﻪ ﮑﻳﺮﻣﺍﻪ ېﻱېﭘﻲښېﭘ
ﻪﻌﻦېﭘ ﻟﻰﺩﻯﻳ ﺪﻧﻮﻮﻥﻣ ﻟ
ﺪﻮ کېﺑ ﻧﻮﺘﺩېﻭﺧ ږ
ﭘېﻥ ﻮﺟﻲ ﺪ ﻟﻮ
ﻤﻳﺪ ﻴ
ﭘﺎﻱټﺱﺍ ﻨﺠ ﻨ
ﻳﻞﻣ ﺮﺘﮐ
ﺎﺩﺑ
ﻭک ﻪ ﭖښښ ﺎﭘ ﻳﺮ
ﻴﻳﺴ ﺎ
ﻩﺩﻧ ږڅ ﻭﻝ ﻮﻱﺍ ﮐﻢېﺷ ﺍH.ﭘﻲښېﺭ i
nflﻩﺩuenzae ﺮډﻝﺳ ﻴﮏ ﻭ ﺗﺎ
ﻣﺍﺭﺩ
.
ﻩﻪﺩ ﻨﺘ
ﻴﺴ ﺍﺧ ﻩﻪګټ ﻣﺎ
ﻮﻋ ﻨﻴﮐﺴ ﺍﺪﺩﻭ ﺮﺿ ﻭﻯﭘﻻﻞﻱېﺩﺩ ﻬﻢ ﻣ ﻠﻰچېﻣ ﺍﻏېﻫﻢﮐﻢښﺕﺭ
ﻪﻧ
ﻮﻠﻣﺎﻱټﺱﻻ ﻨﺠﻨ
ﺋﻰﻣ ﺎﻳ
ﺮﺘﮐﺎCommuniﺑ t
yacqui rﻭﺱﺩed ﺍﺍ ﺪ
ﻤﻪچېﻫ ﻧ
ﻮ ﻣﺰ
ﻴﻧﺍ
ﺭګ ﻭﻪﺍ ﻐﻫ
:
ﻪﻟ ﺭﺕﺩﻱ ﺎ
ﺒﺟړﻱﻋ
ﻮﻭ
%١ﺩې٥ ږﻮکﻥ ﮐﻮﺘ
ﭘﺮﺘﻭﭖ ﺳ ﺭ،ﺩBګ %٢ﺘﺲ٥ ﻳﺎ
ﻨﺠﻨNeiﻣ sser i
a، %٥ﺩې٠ ږﮐﺲﻥ ﻮ ﮐﻮﺘﭘ
ﺮﺘ ﺳ
ﻮﺱ ﻠ
ﻓﺎﻤ
ﻴﺣﻝ کې چېﻫ ﺍﺱې ﺎ ﺪﻭﭘ %١ﭘﻲښ ﺩې٠ ږﻮﺟﻦ ﻥ ﺘﻳﺎ
ﻮﺳ ﻧﻮﺎﻣ ﻳﺮﻴﺘﻴﺴﻭﻟ ﭘﻲښېﺍ
.ږﻱﻻﻞګڼﻝکږ ﺘﺲ ﻣ ﻳﺎﻨﺠﻨ
ﻳﻞﻣ ﺮﺘﮐﺎ
%څﻪﮐﻢﺩﺑ ١ﺧ ﺍﺩ٠ ﺰﻨﻳ
ﺍﻮﻠﻔﻧ
ﺍ
:
ﻪﻧﻮﻠﻣﻻ
ږږ
ﻻﻞګڼﻝک ﻩﻣ ﺭ
ﻮﺎﻱېﻏ ﻴﻧﻮﻤ ﻮکﻧ ﮐ ﻮﺘﭘﺮﺘ
ﺭﻭﻱﺳ ﺭڅﻪډﻮ ﺧ ﻧﻮﻠ
٢ﮐ ﻟ٠
ﺮﻱېﻪ ﻤګﻱچېﻋ ﻪﻭړ ﻐﻫ
ﻭ.
ﺟړﻱ ﻻﻞ ﻮ ﺘﺲ ﻣ ﻳﺎﻨﺠﻨ
%٤ﺩﻣ ﺎکې٧ ﮑ
ﻳﺮﻣﺍ(ﻪ
ﮐﻝکېﭘ ١ﺎ١/ ١
٠٠
٠٠ﺎ٠
ًﺒﻳ
ﺮﻘﺗﻱ)
ﻣﻦ:ﺩﻪﻟﺭﺕﺩﻱ ﺎﺒﻮﻱچېﻋ ﺗ
ﺎﻳﺮﺯ ﺘﺲﺧﻄ ﻳ
ﺎﻨﺠﻨﮐﻞﻣ ﻮ
ﮐﻮﻤ ﻧ
ﻪچېﺩ ﻧ
ﻮ ﺘ
ﻟﺎﻧﮏېﺣ ﻭ ﻮﺪﮐ ﺎﻋﺮﻣﺴ ﻴﻤﻮﺷ ﻳ
،
ﺍﻱټﺱ ﺯﻮﻨﻳ
ﺎ،ﺳ ﺎﻴ
ﻧﻮﻤ،ﻧ ﻡﺰﻴﻟ
ﻮﮑ ﻟ،ﺍ(ﺎﻳډﺎﻱټﺱﻣﻲ ﺗ
ﻭﺍﺎﺏ) ﻬﺘﻟ
ډﻰﺍ ﻭ ځﻥﻧ ﺑړﻰﺍﻏږ ﻲﻧ ځﻲ ﻮ ﻧ
ﻭﻟﻰﺍﺍﻮﺘﻨﺖﻧﺸ ﻴ
ﻤﻠﭙﻣﺎ
،ﺩﮐ ﺎﻴﻤﻴﻨﻴﻟ
ﻮ ﺑ
ﻮ ﻟګﺎ ګ
ﻣﻮﺍ ﭙﻳﺎ
،ﻫ ﻣﻰﻮﺘﮑﻴﻨﻴ
ﻠﭙ،ﺳ ﺑﻲټ ﺎﻳ،ډ ﺍﻱټﺱ ﺩﺭﺎ
ﮐﻭ ﺪﻧ
ﺍ
CSFRhi norr
ﻳﺩhea ﻭﺎ ﺮﺍ ﺪېﮐﺴ ﺎﻋﻗﺤﻒﺩﻗ ډﻝﺩ
ګﻱ ﻭ ځﻥ ړﻪﺍ څﻪچېﭘ ﻴﺾ ﺧ ﺮﺿ ﻔﻰﺗ ﻗﺤ
ﻭ.
ځﻯ ﻱﻮﺍ ﻩﻳﺮ ﺳ
.ﺭځﻱﻪﺍ ﺗړﻪﻣﻦځ ﻨﻭکېﻡﻳ %٢ﭘﻲښ ﭘ٠ﻩﻪ ﺮﻩﺳ ﺮﻠﻦېﺳ ﻣ ﺭﺪﺩﻭﺏ ﺿ ﺮﮑﻳ
ﺎﺩﻣ
ﻭﻮﺍﻧﺎ
ﻭﻏﺭﺎﺪﻱﻧﺒﻣﻦﮐ ﺰ
،ﻣ ﻡﺰﻴﻟ
ﻮ ﮑﻟ،ﺍﺎ
ﻣ ﻮﻟﺎ
ﻴﭘﻝﻣﻮﻝټﻱﺎ ،ﻣﻣﻲﻮ ﺘﮑ
ﻴﻨﻴﻠﭙ
ﻪﺳ ﻴﻢېﭘﻲښېﻱېﭘ ﻭﺧ
.
ﺭځﻱ ﻪﺍ ﺗ
ﺍکۍکېﻣﻦځ ﻭﺭځﺍﻮ ﺧ
ﻪ٠ﭘﻲښېﭘ ،
ﻌﻦې٦ ﺟړﻱﻳ
ﻻﻞ ﻮﻭ ﺘﺲ ﻣ ﻳﺎ
ﻨﺠﻨﻳﻞﻣ ﺮ
ﺘﮐﺎﺑﻭکېﺩ %٢ﭘﻲښ ﺘﺲ٥ ﻳﺎ
ﻨﺠﻨﺎﻣ ﻳ
ﺮﻴﻳﺴ ﺎ
ﻧ
ﻮﻧﺎ
ﻧﺍ
ﻭﻭځ ﻮﺍﻧﺎ
ﻣﻮ ﺎﺷﻪﻣ ﻐېﻪﻫ
%٦ﭘﻲښېﻱ ﭘ ﺎ٠ً
ﺒﻳﺮﻘ
ږﻱچېﺗ ږﮐﻝکېﭘﻲښ ېﻪﺎﻮک ﭘ ﮑ ﻠ
١ﺧ ٠٠٠٠
٠
ﺭګﻭﻮﻯﺍﺩﺷ ﺎ
.ﻳﺮﻱ ﻟړﻪ
ﻨ%١ﻡﻳ ٣-ږﻱچې٣ ﺪﻝکږ ﻴﻟﻣﻦځﻭﻱ ﺮﻮﺗﻧﻮﻠ
٢ﮐ ﺍ٠ﺮﻱېﺩ٢ﻭ ﻤکېچېﻋ
ﻧﮏېﻭﺩﻟږ
ﺮﺿﻲ ﻲ ﺮﻋ ﻴﺍﻯﺷﻲﻏ ﺩﺩﻴﺴﻲچېک ېځﻯﻧ
ﮑﺲک ﺍ ﻧﺮﻓﻭﺰﻪﻧﻩﭘﺭﺎﭙړﻱځﻝﻟ ﻡﻮ ﻡﺩﻟ ﺰﻴﻧ
ﺍ
.ړﻱﻪک ﺗﻣﻦځ ﺍ
ﻧﮏېﺭ ﻭﻮﺪﮐ ﻳﺮﺎﺑﻭﻳﺍ
.ﺩﺏﻝﻝ ﺮﻱ ﻟﻩړﺍﺭېﻮﻡﭘ ﺰﻴﻧ
ﺎﮑﻴﺎﻋﻲﻣ ﻓﻪﺩ ﺑﺭﻮﮐ
ﻭﺩ ﺍﻧﺴﻲ ﻭﻻﺮﻳﺍ
ﻳﻞﻭ ﺮﺘﮐﺎ
ﺑﺍﺕګﺩ ﻪﺭ ﺗ
ﻭﻍۍﻣﻦځ ﺭﺎﺩﻧ
ﻴﮏﻱﻭﺩﮐﻼﺳ ړﺍ ﺪک ﻴﻟ
ﻮ ﺩﻱﺗﺎﺘﻲﺑ ﻧ
ﮐﻞﺍ ﻮﻭﮐﻨﻦګ ﻴﺮﻱچېﻣ ﻟ
ﻴﺖﻭ ﻓﺮﺍﻇ ﺪﺩﻳﺎﻪﺑ ﺑ
ﺭﻮډﻝﮐﻪﻭ ګېﭘ
ګﻱچېﺩ ﻪﻭړ ﻐ؛ﻮﻫﻮﺳﻲﻧ ﻩﻳ ﻪﻣﻦځ ﻮکﻟ ﮐﻭﻨﻦګﻴﻪﻣ ﺍﺳﻄﻮﻭﭘ ﺭﺎ
ﻴﻨﺖﻟ ﻴﻤﻠ
ﭙﻣﺎAlﮐ ternativﻭe ﺍ
68
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
69
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
.
ﺮﻱﻟ
ﺪﻳ
ﺮﺑ،ﺩږﻱ
ﻪکږ ﺗ
ﻣﻦځﺍﺰﺱکېﺭ ﻴﻨ
ﻮﺟﺘﻪﭘﺘﺲﭘﻳﺎ
ﻨﺠﻨ
ﻳﻞﻣﺮﺘﮐﺎ
ﺑﻧﮏېﭘﻲښېچېﺩ ﻭ
ﻭ ړﺎ
ﻳﺠﻡېﻭﻮﮐ
ﺎﺕﺩ ﺘﻼﻃﻭﺍﺧﻭېﺍﺎﻴ
ﺗﺪﻧ
ﺭګﺒﻲ څ
ﻩﻋﺼ ﺮ
ﺗﺎ
ﻳﺩ.ﺯ
ﻪ ﻱ ﻠ
ﺒﻪﮐګﻥﻟ
ﺮﻭ ﺒﺑﻲﻏﺎﻬ
ﺘﻟ
ﺎﺩﺍﻳﺮﺘ
ﮐ ﺎ
ﻧﮏېﺑﻭﻮﮐ
ﻪﺩﺑﻞ کېﺩﻱﻧ ﺎﻘ
ﻮﺟﻦﻣ ﺘﻧﮏېﭘﻭﻮ
ﺪﮐ ﻳﺮ
ﻪﺩﺑﻠﺒ
ﻪﮐګﻥﻟﺮﻭ ﺒ
ﺘﻲﻏ ﻴ
ﻓﺎﻌ
ﺘﺲﺩﻣ ﻳ
ﺎﻨﺠﻨﻳﻞﻣ
ﺮﺘﮐ
ﺎﺑ
ﻪﺩﻟﻪﺘﻭﺳﺭﺍﻯﺷﻲﻭﺩﺩﻳﺐک ﺮ
ﺎﻏﻲﺗﺨﻣﺎﺱﺩﭘېﺍﺳ
؛ﻮ ﺪ
ﻪﻧﻠ
ﺒﻪﮐﻟﻳﺐﺮﻴﻢﻧﺴﺠﻲﺗﺨﻘﺘﺎﺩﻣﺴﻳ
ﺮﺘﮐ
ﺎﺑ
.ﻭړﻱ
ﻣﺨﺖګ ک ﺮ
ﺎکﺷﻲﻫﻢﭘ ﻪﭘﺍﺳﻄﻪﻭﻮﭘﻠﻣ
ﺭﺪﺩﻭﺏﺩ ﺿﺮﮑ
ﻴېچېCSFﺩﻣ
ﺍ
ﻪﺭﺗﻪکېﻣﻦځ ﻓﺎ
ﺪﻣﺴ ﻴﺋ
ﻮﻨﮐ
ﺍﻪﺳﺐ ﺩﭘﺍ
ﻮﻡﻣﻮڅﻪچېﮐړﺎ ﺧ
ﻴﺎﺗﻳﺠﻪﻭﻟﺍﻝ
ﻮﻳﺯﺩﺯﻧﮏﻭﺎﺩژﻳﺮﺘ
ﮐ ﺎ
ﺩﺑ
ﺍﺕﺩﺩﻭﺯﻴﭻېﺍګ ﻗ
ﻪ کېﺩ ﻓﺎ
ﺪﻣﺴ ﻴﺋ
ﻮ ﻨ
ﮐﺭﺩ،چې ﺳﺐﺍ
ﻭ ﻯ ﺍ
ړړﻰ ﭖﻡﻧﻮګﻥﻟ
ﺮﻭ ﺒﺑﻲﻏ ﺎ
ﻬﺘﻟ
ځﻱﺩﺍ
،
ﺎﻳ
ﺮﺘﮐﺎ
ﻔﻲﺑ ﻨ
ګﻡﻣﺍ
ﺪﺩ ﺭ ﻳ
ﺍﺮﮑﻟﻲ ﺳ
ﻮﭘﻮﭙﻴﻪﻟﮑ
ﺩﻟﺍﻮ
ﺍﻝﻣ ﻮﻳ
ﻳﻲﺩ ﺎﻳﺮ
ﺘﮐﺎ
.ﺩﺑ ږﻱ
ﻻﻞ کږﻭ ﻣ ﺩﺩړﻮﺟ
ﻟ،
ګﺎ
ﻭﻴ ﺮﮑﻳ
ﺎﻪﻣﮑﻧﮏېﻟﻭﺮژﻴﻤﻮﺷ ﺩ،چېﻳﻮک ﻯﮐﻮﺘ
ﭘﺮﺘ
ﺎﻥﺩﺳ ﮑﻳﻭګﻻﺪﻳﺎ
ﺘﭙ
ﻴﻭﭘﺪﺍ ﻴ
Teiﺍﺳ choic
څﻪ
ﻭﻯ ﺧ ﻭﺩﺩ ﻮﻱﺍﻪﮐﺒﻨ
ﻳﺖﺗ ﺎ
ﻮﺳ ﮑﻴېﻭﺩCSFﻟﻧﮏ ﺍﻭﻴﻞژ ﻠ
ﻴﺗﻭ
ﺪﻧ،ﺍ
ﻳﺖﺎﻮﺳﻧﻮ
،ﻣ ﻳﺖﺎ
ﻭﺳ ﺮﺘﻴﺴﻫ
.
ﺭځﻱ ﻻﻞګﺎﺏ ﻣﻬ
ﺘﻟﺍﺮ
ﺘﺸﻨﺎﺩﻣﻴېﺍﺑ
ﻭﻱچ ﺩ ﺩﺍ
ﺯﺍﻪﻧ
ﻮﻧﻮکﻥﻤﻴﻭﺷﺍﻪﻧﻮﻧ
ﻮکﻥ ﺘﻳ
ﺎﺑﻲﺳ ﺎﻬ
ﺘﻟ
ﺍ
ﺎ کې
ﻳﺎ
ﻪﺳﺤLiﭘpoPol
ySachari
ﻩdeﺮ
ډﻝﺳﻮﻱ ﻭﺑ
ﺮﻪﺗﺠﺭېﭘﺭﻪچ،ﮐﻩ
ﺩﻝېﺩ ﻭ
ﺍښ ﻮﺩ ﻧ
ړړڅ
ﺩې
ﻭﺩ ږﻱﺍږ
ړﻮﻮکﻥﻥ ١ﺟﻟ
ﻭﺮﺘ
ﻧﻭﺍﻩ کېTNFﺍ ﺩ
ﻮﻪﻣ ﻮﭘﺘﺎﻋ
٢ﺳ -
ﺩې١ ږ
ﺭﻱ ﺷﻲ ﻥ ﺎ
ﮑﻴﭽﭘ
ﻠﻈﺖﻴﻦﺩﻏ
ﺗﻭﺮ
ﻪCSFکېﺩﭘ ﻪﭘﻐﺭځﻱﻫ
ﻪﺍﺗ
ګﻥﻣﻦځ
ﺮﻭ ﺒﻡﻏﻮﺑﻞکېچېﮐ ﺎ
ﻘﻪﻣﻮﭘﻧﻮ
ﻨﻳﺎ
ﮐﻮﺘ
ﻳﺎﺳ
ﺩ.
ﺭﺕ ﻱ ﺎ
ﺒڅﻪﻋ
ﻟﻲ ﺧﺍ
ﻮﺗ
ﺎﻳ
ﻮﺩﺯ ﺗ
ﺎﻳ
ﻮﻳﺮ
ﻮﮐ ﻨ
ﻴﭙﻭﺩﺳﺍ
،
ﻴﺠﻦ
ﮐﺴReactﺍ
ive،
ﻪﻧ
ﻭﺪﻴﺍﺳ
ﻮﻨﻴ
ﻣExciﺍ
tator
ﻩyﺭﺭ
ﺮﺏﻮﺳﻧﻮﻧ
ﻮکﻥﺘﻳ
ﺎﺑﻲﺳ
ﺎﻬ
ﺘﻟ
ﻭﺍﺎﺍ
ﻴﻤﻳ
ﺮﺘﮐ
ﺎﺩﺑ
ﺭ
ﻮﻭﻧ(ﺍﻳﺖﺮ
ﺘﻳﺎ
ﮐﺴﻰﻧﺍﺮ
ﻭﭘ ﺪﺍﻳﺎ
ﮐﺴﻳﮏﺍ ﺮ
ﺘﻳﺎ
،ﻧﮑﻞ
ﻳﺩﺍ
ﻴﺠﻦﺭﮐﺴﺩﺍﺍ
ﺯﺍ
ﻪ)ﻧ
ﻮﻟﻭ
ﻭﺟﻦډ ﺮﺘ
ﻳﺎ
ﺩﻧ
.ﺮﻱﻟ
ﻩﻭﻭډ
ړﻪکې ﻥﻨ
ﻪﻡﻳﻮﭘﮑﻧ
ﻭﺎﻏﻲژ
ﻣﮐﻻﻯﺷﻲﺩﺩ
ﻪﻮ ﻧ
ﻭﺭﻮﺗ
ﺎﻳ
ﺪﻴﻣ
ﻟړ
ﻮکﻥﻥﺩﻮ ﻤ
ﻴﻥﻭﺷﻮکﻥ ﺍﺘﻳﺎ
ﻪﺩCSFﺩﺳ ﻐﻴﻪﻧﻎﭘﻴ
ﻩﻧﺮﺗ
ﺎﻳ
ﻮﺟﻲﺯﻟﻮﻳ
ﺰﻓﻮﺘ
ﺘﺲﭘ ﻳ
ﺎﻨﺠ
ﻨﻳﻞﻣﺮ
ﺘﮐﺎ
ﺩﺑ
ﺩﻥېﻭﺪﻳﺮ
ﻴBlﺩﺗoodBrainBarri
ځﻯﺩer
ﻩﻮﺍﺩړﻳ
ﺍ
ﻮکﻥﻥ ١ﻭ ﻟ
ﺮﺘ
ﻧﺍTﻭ
NF.ﺍﺮﻱ
ﻟﻩړ
ﺍﺭېﻮﻟﻲﭘﺍ
ﻭ
ﺪﻴ
ﺋﻮﻨ
ﮐﺭژﺳﺐﺍ ﺎ
ﮑﻴﻮﻟ
ﻨﻴﺗ
ﻭﺮﻡﺩﭘ ﻭ
ﺮﻴVﻭﺩﺳ
asogeniﺍﻪ کېcodema ﻠ
ﻳﺎ
ﻪﭘﻮﻱچېﭘ ﺗ
ﺎﻳ
ړﺎﺯ
ﻴﺗ
.
ﻮﻱﻪﮐﺗ
ﻣﻦځﺍﺎﻑېﺭﻣﺴ
ﻮﺩﻱﺩCSFﺗ
ﺎﻳ
ﻮﻳﺮ
ﻮﮐﻨ
ﻴﭙﻭﺳﻭﺍﺩﺍ
ﻮﻨﻲﻣﻴ
ﺗﻭﺮ
ﻧﮏېﺩﭘ ﻭﺮﺍﺕچېﻟﺩﻭﺰ
ﮐﺎﻑېﺍﺪﻣﺴﻴ
ﺋﻮﻨ
ﮐﺭﺩﺳﺐﺍ
ﻪﻮﻱچېﭘ
ﻤﺍکﮐﻭﺬﺏځﻩﺟﺭ
ﺎﺑﻭDurکېﺩﺩ alsi
ﻭnus ﺭﺍ
ﻮﻪﻟﺘﻢﭘﻴﺴﻨﻲﺳﻴ
ﺎﻏﻲﺑﻄ
ﻣﺮﺩﺩﻴﻬ
ﺑ
.
ږﻱﻪکږ ﺗ
ﻣﻦځﺍ
Iﺭnter
sti
ti
alﻭedema ﺍﻮﺱﻟ
ﺎﻔﻴ
ﻭﺳﺭ
ﺪﻳﺎ
ﺎﻯکېﻫﭘ
ﻮﻱچې ﻪﮐﺗ
ﻣﻦځﺍﻩﺭﺮ
ﻮﺳ ﮑﻧ
ﻭﻴﻞژﻠ
ﻴﺗ
ﻭﺪﻧ
ﻮﺩﺍﻧﻭ
ﻪﺩﺭګﻧ
ﺪﻴﻟ
ﻳﺖﻥښ ﺎ
ﻮﺳﮑ
ﻟﻪﺩﻧ
ﻮﻧﻮکﻥ
ﺘﻳﺎﺑﻲﺳﺎ
ﻬﺘﻟ
ﺍ
ﻪﻮﺗﻧ
ﻮﻨﻴ
ﺗﻭﺮ
ﻼﺎﭘ
ﻣ
ﻭﺩﭘﺯ ﻪﺷﻲﺍﺗﺎ
ﻳړﺎﺯ
ﻴﺪﻥېﻭﺗﻳﺮﻴ
ﻮﺩﺗ
ﻧﻭﺩګ
ږﻱچېﺭېﻻﻞکږ
ﻪﺩﺩ ﻣ ﻧﺪﻴﻟ
ﺍﻥښ ﺩ
.ږﻱ
ځﻯکږﻮﺍ ﻩﻳﺮ
ﺍﺕﺳ ﺩﻭ
ﺰﮐﺍﺑﻲ
ﺎﻬ
ﺘﻟ
ﺍﺎﺩﻴ
ېﺍﺑ
ﻭړﻱچ ﺩ
ژ کﺎﮑ
ﻴﻟﻪ
ﺗﺍ
ﻮړﻱچېﺩCSFﺧ ﺭکﻩﻭﺯ
ﺎﺍﺟ
،چې
ږﻱﺩﻱ
ﺍﺯﺩﺍ
ﺍﻮﻴﮏﻣ
ﻟﻮﺑ
ﺎﺘ
ﻴﺮﺟﻦﻣﺭﺯﻫﺍ
ﺪﻘﻮﻣﻪکېﻳﻠﻳ
ﺎDﻪﭘ
egrﭘ
anul
ati
ﻮﺩonﻧﻮﻠ
ﻴﻓﻭ
ﺮﺗﻮ
ﺩﻧ
.ږﻱ
ﻻﻞکږړﻦې ﻣ
ﻭﻡﻳﺍﺩﻭ
ټﻲکﺩﻮﭘﮑﻧ
ﻭCyﺩژtot
oxi
ﺩcedema
ﺭﻝ
ﺩډﻮ
ﻮﺱ ﻳ
ﻟﺎ
ﻔﻴ
ﻭﺳﺭ
ﺪﻳﺎ
ﭘې کېﻫ
ﻩﺪﺭﻥګ
ﺍﺪﻤ
.ﻫﻩﻪﺩﻠ
ﻳﺎ
ﺎﭘﻤ
ﻳﺯﺮﻝﺍﺒ
ﻳﺮﻴ
ﻩﺩ ﺳ
ﺮﺗﺎ
ﻳﺘﻖﺯ
ﺎﻏﻲﻓ
ﻣﺩ
.ﺮﻱ
ﻟﻭﻝ
ﺯﺱﻫﻢﺭ ﻮﺒﻣ
ﺮﺪﺗﻳﺭ
ﺪېﺩﻭﺎﻋ
ﻗﻭﺩ
ﺍﻨﺲﻳ
ﺎﺳ
:
ﻩﻨﮏېﺏڼﻴ
ﻠﮐ
ﻣﺨﺖ
ﺮﻮکېﭘ
ﻧﻮﺘ
ﺎﻋﻭﺳ
ېﻪڅ
ﺍﺷﻲچ ﭘ
ﻪﺭﺗ
ډﻝﻣﻦځ
ﻴﻢ ﻭ
ﻭﻭﺧ
ﺑړﻲﺍ
ﻪ ﻲﻧ
ﺍﻯﺷﻲﭘ
ﺩﺩﺘﺲکﻳ
ﺎﻨﺠ
ﻨﻣ
70
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﮐﻻﻯ
ﻣﺨﺖګ ﻮ ﺮﻭکېﭘ ﻭځﻭﺭ ﻪڅ ﺍﺷﻲچېﭘ ﻪﺭ ﺗډﻝﻣﻦځ ﻪﻭ ﺎﻥﭘ ﺘ
ﻧﺩﺍﺎﻟﺤﻳﺩﺗﺤﺖﺍﻭﺎ ﻮﻱﺍ ګﮐ
ﺷ.
ﻲ
څﻪ
ﻟﻲ ﺧ ﺍ
ﻮړېﺷﺨ ﺎ
ﻭﺩﻏﺩﺍﺭﺩﺮﺗ،ﺳﻪﻪﺒﻩﻟ ﺭﺕﺩ ﺎ
ﺒګﻥېﻋ ﺭﻱ ﻭ ﻪﺩ ﮑ
ﻴېﻭﮐﻼﺳ ﻴﮏ ﺍ ﻨ
ﻴﻠ
ﺘ ﺲﮐ ﻳﺎﻨﺠﻨﻣ
ﺩ
ﻭ.
ﺩې ﻱ ﻮﻮﺟ ﻭکېﻣ %٩ﭘﻲښ ﭘ٠
ېﻭﻧﺦښې ﻪ ېﺍګﻝﻝ ﺍ چﺩ
څﻪ
ﻟﺖ ﺧ ﺎ
Letﺣ harﻳﻲﺩgy ﺍﺍښ ﻱﻭﺩﺭځ ﺍﻪﺍ ﺗ
ﻮکېﻣﻦځ ﻧﺎ
ﻭﻏ ﺭ
ﺎ%٧ﻧﻪ٥ ﻮﻥﭘ ﻟ
ﺪﻟﺖﺑﺎﺎﻏﻲﺣ ﻣﺩﺩ
Photophobiﻭﻭaﺎﻥګﺍ ،ﮐﻟﻰﺍﻭﺪﻩﺑړ
ﻭﻍﺩﺯ ﺭﺎ
ﻩﻧ ﺭﻥګ ﺍ
ﺪ ﻤ،ﻫﻣﻲﻮﻣﻮﻥﻭ ﻟﺪﺭېﺑﻮﺎﭘﻣ
ﻮ ېﺮﮐ
ﻮﻝ ﺗ ﻴﻧ
ﻭ.
ﺪﻱ ﻨګﻪﻣ
ﻠڅﻪ ﻳﺧ
ﺘﻼﻌﻲﺍﺧﻮﺿ ﻭ.ﻣ
ﺩﻱ ﻮ
ﻮﺟ ﺘﻼﺝﻣ ﺭﺷﻞکېﺍﺧ ۍﻪﺩﻭﻍ ﭘ ﺭﺎﺍﻯﺷﻲﺩﻧ ﺩﺩ
ﻮکېک ﻧﺎ
ﻭﻏﺭﺎ
%٤ﻧ ٠-٢
ﭘ٠ﻪ
ﻩﺮژﺳﺍﺭ
ﻮﻤﻴﺯﺱچېﻫ ﻮﺒﻣﻭﺮ
ﻮﺗ ﻧﻭﺪﻳﺭ
ﺮﺩﻭ ﻗﺸ ،ﺩﮐﺸﻦ ﺭﺎ
ﻔﻧﺎﺍﻡﺎﻳ
ﻴﻧﻲﺍﺳﮏﻣ ﺎ
ﻳﺮﻌﻲﺷ ﻮﺿ ﺍﺩﻣًﺮﺜﮐﺝﺍ
ﻭ.
ﻪﻱ ﻠ
ﻳﺎﺎﭘ
ﻤﻳﺩﺍﻌﻲ ﻮﺿﻳﺩﻣﻭﺎ ﺍځﻯﻭﻱ ﻮﺍ ﻳ
ﻪﺎﭘﻣ
ﻩﺍﻪﺩﻠﻳﺎ
ﺎﭘﻴﮐﺴﻮﻧ
ﺑﻞﺍﺮﻴﻭﺳ ﺎﺍﻴﻤ
ﻳﺮﺘﻮﻧﭙﻳﺎ
ﻟﺖﺩﻫ ﺎﻴﮏﺣ ﺘ
ﻴﻠﻴﭙ
ﻳGﻭﺍ
enerﺍ ali
zedSei zures
ﻴﻦﻠ
ﻨﺴﺯﭘﻭﻟړﺩ
ﻪﻮ ﻪﭘﮑﻟﺍﻯﺷﻲ ﺩ ﺩﻪﻫﻢک ﻠ
ﻳﺎ
ﺰېﭘ ﻴﻮﺩﺍﻏ ﻠﻣﺭﺪﺩﻭﺏ ﺿ ﺮﮑﻳﺎﻣﻭکېﻱېﺩ ﻮﭘﻲښ ﻤ
ﮐ
.ﻮﻝ ﮐﺭ
ﻭ
ﺭﻮﻌ
،چېﺩﺷ ﻩﺭﺕﺩ ﺎ
ﺒڅﻪﻋ
ﻟﻲ ﺧ ﺍ
ﻭﻟړ
ﺭﺩﻮ ﺎﻔﻲﻓﺸ ﺎﺩﻗﺤ ﻴﺗﺪﻧ
ﺭګ ﻩڅﺭﻮﻩﻏ ﺭﺭﺘﺲډ ﻳ
ﺎﻨﺠﻨﻳﻞﻣ ﺮﺘﮐﺎ
ﺩﺑ
CSFOpeni ngpr essurﻮe ﻧﺍ
ﺭﻭﺎﺕﺭﻥځ ﻳ%څﻪﺯ
٩ﺧ .ﺩ٠ ږﻱ
ﻠﻞکږ ﻮﻝﺑ ﺌﺎﻣﺴﻣﻮﻭﮐﻟﻲﺍ ﺍﻮﺑﺍ
ﺮﺩﺧ
ﻮﺑ
ﻭﺮﺍﺘﻠﻲﻣ٤ﻣ ٠
ﺭﺩ٠ ﺎ
Openiﻓﺸ ﻳﻲ ng ﺍ
%٢کې ښ ﭘ٠
ﻭﻪ ﺎﺕﻭﻱﺍ ﻳڅﻪﺯﻮ ﺧ ﺑﻭ
ﺮﺍﺘﻠﻲﻣ ١ﻣ ٨ﺩ٠
ﻭ.
ﺎﺕ ﻱ ﻳڅﻪﺯ
ﺧ
ﻟﻲﻥﺍﻮﺗ
ﺎﻳ
ﺭﺩﺯ ﺎ
ﻓﺸ ﻗﺤﻒﺩ :ﺩﻭړﺍک ﺪﻴ
ﻭﻍکېﭘ ﺭ
ﺎﻪﻧ ﻧېﻥښېﭘ ﻮﻻﺪ ﮐﻻﻯﺷ ﻪکې ﻮ ﻨ
ﺘﻳﮏېﮐ ﺰﻪﻓ ﭘ
ﻩﺮﻪﺳﺒﻨ
ﺎﺗﻭﻳﺪﻝﺍ ﻴ
ﺍﺧﺮﺪﻕېﭘ ،ﺩﺣﺎﻤﻳ
ﺩﺪﻕېﺍ ،ﺩﺣ ﻟﻰ ﺍ
ﻮﻤﺯېﮐ ﺍ
ﺪ ﻧ
ﺭﺩﺍﻮﻌﺎﺩﺷ ﻳﻭﻮﻥﺍﻟ
ﺪﺭﺑﻮﻌ ،ﺩﺷ ،
ښ
.ﻮﻥﺘﻪﺷ ﺎﻧﻳ
ﻭ ﺍﮐﺩﻝ
ﺍﺏ ﻢﺩ ﻭﻪځ ﻐﺩﻫ
ﮑﺲ ﻴﻠ
ﻔﻳ
Cushiﺭ ﻭng ﻴﺖﺍ ﻌCerﻭﺿ ebratﺪېﺩed ﻧ
ﺎﺮﺑ ﺘ
ﺮﺑﺴ ﻩﭘﻠﺞﻥښ ﻡﻋﺼﺐﺩﻓ ږﺩﺷﭗ
ﺩ.
ﺭﺕ ﻯ ﺎ
ﺒ(څﻪﻋ
ﻔﺲ ﺧ ﻨﻨﻈﻢﺗ ﺮﻣﻴﻭﻏﺍ ﻨﺸﻦﺗﺮﭙ
ﻳﺎ
،ﻫﺎﻳﺩﺭ
ﺎﺩﻯﮐ ﺍ
ﺮﺑ)
ﺭﺕﺎﺒ
څﻪﻋﺘﻖ ﺧ ﺰﺩﻓ ﻐﺘﻼﻁﺩﻣ ﻪﺍﺧﮐﺎﻧ
ﺮﻭﺧﻄ ﺭﺪﺍﺭﺑ ﻟﻲډ ﺍ
ﻮﺗﺎ
ﻳIﺩﺯntraCr anialpressur ﺩe
.ږﻱږﻭکېﭘﻲښ ﺗ%٨ﭘﻲښ %څﻪﺮ
ﺩېﺩ ١ﺧ ږ
ﺘﻼﻁﻥ ﺍﺧ ېﺍ
ﺩﻯچ ﺩ
ﺎﺩﻴږﻱﻭﺑ
ﻮﻝکږ ﺍ ﮐﺭﻴﺖﻭﻌ ﺎﻍﻭﺿ ﺘ
ﻧﻲﺳ ﻮ
ﺘﻪﺳ ﻭﻍﺗﺭﺎ
ﻟﺖکېﻫﻢﻧ ﺎﭘېﺣ:ﺪ Brudzinski’
sSign
ﻮﻟ
ﻭﺭټﻪﺍ ﻧﻮ
ﻧﻭﻭﺯﻥګ ﻪﺍﻧﻮﻧﺭﻩﻭﺩړ
ﺍ
ﺭﺕ کې ﻭ ﻮﻪﺻ ﻟﻲﭘﺍﺒﺖﻭ ﺜ،چېﺩﻣ ږﻱ
ﺒ ﺾ کږ ﻩﻗ ړ
ﺎﻭﻍﻏ ﺭﺎ
ﻧ
.ﻮﻱ(ﮐﺒﺾ ﻗ)
ﻩﺩﺮﺗﺎﻳ
ﻪچېﺯ ﻧﻮ ﭘ
ﺎﺮﺧﻟﻮﭘ
ﺎﺮﭘ ﻟ
ﻮﮑﻩﻣﺭﺭﻥګﻮﻮﺳ ﻻﻞﻭﻱﻧ ﺘﺲ ﻣ ﻳ
ﺎﻨﺠﻨ
ﻮکﺩﻣ ﮐﻭﻨﻦګ ﻴ
ﺭېﻣ ﺭﻪچ ﮐ
ﻪﻪﭘ ﻧ
ﻮﭘﺎﺮﺧﻟ
ﻮﭘﺎﺮﭘﻟ
ﻮﮑﻩﻣ ﺭﺭﻥګ ﻮﻪﺳﻮکﺩﻏ ﮐﻭﻨﻦګﻴﺭﺩﻣ ﺎﻥﻭﻱﻡګ ﻪﺷ Exantﭘ ﺮﺱ hem ﻳ
ﺍﻭ
،
ﻭﺩﺮﺎﻃﻲﭘ ﻪﻣﺨ ،ﭘﻮﺗﺎ
ﻳﺎﻬ
ﻨﻲﻧ ﺘﮐ ،ښﺭ
ﻪ ټټ ﻩﭘ ﺮ
ﺗﺎ
ﻳ،چېﺯ ږﻱﻟﻲﺪﺪېﺑ ﻧﺎ
Petﺑ echiﺮaﻩﭘ ﺑړ
ﻲ
ﺷ.
ﺍﻯ ﻲﺩﺩﺪﻝک ﻴﻟﺪېﻧ
ﺎﻭﺑﺪﻧﻮﻭﭘﺍﻮﻱ ﺭﻏﻪﻭﻪﭘ ﻠ
ﻪﮐﻠﻭﮐﺍﻪﻤﻨﻈﻣ
:
ﻴﺺ ﺗﺸﺨ
ﻪﻣﺨ ﻩﺩﺮڅﺮﻫ ﻮﺗﺰﻭﺷﻲﻧ ﻳ
ﺪ ﻧ
ﺍړ
ﺘﺲﻭ ﻳﺎ
ﻨﺠﻨﻳﻞﻣﺮﺘﮐ
ﺎﻪﻡټﺩﺑ ﻭﭘﻭﺎﻴﺗ
ﺪﻧﺭګﻴﮏېڅ ﻨﻴ
ﻠﮐﺭېﺩﺭﻪچ ﮐ
ډېﻪځﻥﻪﺏ ﻟ ﻭﻍﺗ ﺭﺎ
ېڅﻪﻣﺨﮏېﻧﻳﻞ ﺧ ﺎ
ﻪﭘ ﻟ
ﺮﻠﭽﮐﻭﺩﺘﻞﺷﻲﺍ ﻴﺴﺍﺧﻩﻭﺭ ﺎ
ﭙﻟﺮ
ﻠﭽﻪﺩﮐ ﻨﻳﻭﻍﻭﺭﺎﺩﻧ
.
ږﻱﻴﻞکږ ﻣﻞﭘ ﺭ
ﺪﺩ ﻭﺏ ﺿ ﺮﮑﻳ
ﺎﻩﺩﻣ
ﻪﻧﻮ
ﻧﻮ ﻟ
ﺪﻧېﺑ
،چېﻻﺪ ږﻱﻪﺭﺳﻲ ﺗﺮېﻪﻡټﺳﻳﻦ ﭘﺎﻌﻣ
ﻮﺩ ﺑﻭ
ﺘﺲﺗﺸﺨ ﺺﺩCSFﺩﺍ ﻳﺎﻨﺠﻨ
ﻳﻞﻣ ﺮ
ﺘﮐﺎﺩﺑ
ﻭ:
ﺩﻱ ﻮﻮﺟﻪکېﻣ ﭘ
71
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
څﻪ
ﻮ ﺧ ﮑﻧﻭ١ژ٠ﻟ٠
ﺭکېﻪ ﻟﻲټ ﻭﺮﮑﻳﺎﻮﻣ ېﻪﻳ
ﺯﺱچ ﭘ ﻮ ﺘ
ﻳﺎﻮﺳ ﮐﻮﻟﻮﮑﻧﻭﺮژ ﻴ
ﻠﻮﮐ ﻧﻮﻓﺭ
ﻮﻟﻲﻣ ﻮ .ﭘ 1
.ږﻱ
ﺪﻝکږ ﻴﻟﻭکې %٩ﭘﻲښ ﭘ٠ېﺍ ﻪ
ﻭ،چ ﺩﺎﺕ ﻱ ﻳ
ﺯ
ﺍچېﺩ ﺎﺩ<(ﻭﻳ
40mg/ﺍ dl<ﺎ
2,ﻳ2mmol /ﻟﻰ)L ﺍﻮﺘﻟﻲﺷ ﺍﻮﻤﮐﻠﻈﺖﺩ ﺯﺩﻏ ﻮﮐﻮ ﻟ
.ﺩګ 2
.ږﻱ
ﺪﻝکږ ﻴﻟﻭکې %٦ﭘﻲښ ﭘ٠
ﻪﻭﻱچېﻪ ﺘﮐ ٠څﻪ ښ
،ﺧ ﺒﺖ٤ ﺯﻧﺴ ﻮﮐﻮﻟﻡﺩګ ﻭﺮﻴCﻭﺩﺳ SFﺍ
.(
%٩کې ﭘ٠>45mg/ﻪ ﻳdL0ﻭﺎ,ﺍ 45g/ ﻟﻰ)L ﺍﻮﺗﺎ
ﻳﻠﻈﺖﺯ ﻴﻦﻏ ﺗﻭﺮ .ﺩﭘ 3
(ﻭکې %ﻲښ ٩ﭘ ٠()څﻪﻮ ﺧ ﺑﻭﺍﻩﺩﺮﺘ ﻠﻲﻣ١ﻣ ٨ﻟﻰﺩ٠ ﺍﻮﺗ
ﺎﻳﺭﺯﺎOpeniﻓﺸ .ﺩng 4
ﺩ.
څﻪﮐﻢ ﻯ ﻮﻥ ﺧ ﺘﻪﺳ ﻟ ﻮﺑ
ﻭ ﺍ
ﺮﺩ ﺘﻠﻲﻣ ١ﻣ٨ﺭﺩ٠ ﺎOpeniﻓﺸ ﺎﻝng ﻣﺭ
ﻮټﻮکېﻧ ﻧ
ﻪﻍﺍ ﭘ
ﺍګﺎﺕﺭ ﻳ%څﻪﺯ
٦ﺧ ﻪﻡټ٠ ﻳﻦﭘ ﻮﻠګﻡﺗ
ﺍﻭﺩ ﺭ ﺒﺖﻭﻱﺍ ﺜﺮﻣ ﻠﭽﻮ کېﺩCSFﮐ ﻧﺍ
ﺭﻭ%٨ﺭﻥځ ﻪ٩ﭘ
ﺰﻴړﺧﻭﻍﺍ ﺭﺎږﻱچېﻧ ﺪﻱﻧﺭګ ﻩڅ ﺭ ښ ﺭﻪﻭﺧﺖډ ﻐﺭﻫ ﺎOpeniﻓﺸ ng. ږﻱ
ﻩ کږ ﺭ
ﺎﮐﻪ ښ ﻧﻮﻣﺰﻴﻧ
ﺍ
ﻭ.
ﻟﻰ ﻱ ﻮ
ﻴﻴﺖﻧ ﻌ
ﻭﺿ
،
ﺘﺲ ﻳ
ﺎﻨﺠ ﻨ
ﺎﻣ ﻳ
ﺮ ﻴ
ﻳﺴ ﺎ
،ﻧﻮک ﮐﻮ ﺘﭘﺮﺘ(ﺩ ﺳ LA)CSFLat exAggl utinatiﻩﺩonTest ﺭﻥګ ﺍ
ﺪﻤﻫ
ﻴﺠﻦﺩ ﺘﻧﻭﺩﺍ ﺎﻳﺮﺘﮐﺎ
ډﻝﺑ KIE.ﻭ Col ﺍi
ﻮک ﻭ ﮐ
ﻮﺘﭘﺮﺘﻭﭖBﺳ ﺭ،ګﻳﭗB ﺍ
ﺍټ ﺰ ﻨ
ﻳﺍ
ﻮﻠﻔﻧ
ﻮﺱﺍ ﻠﻴﻓﺎ
ﻤﻴﻫ
.
ږﻱړﻝکږ ﺭﻭ ﺎﻪﮐﻩﭘﺭﺎﭙﻟﻮﻟ
ﻮ ﻣﻮﻠ
ﻌﻣ
ﺒﺖ ﺜ
ﻭکېﻣ %١ﭘﻲښ ٠٠-٩ټﺱﻪ٥
ﺎﻱ ﭘ ﻨﺠﻨﺎﻣﻳﺮﻴﻳﺴﺎﻭﻧ ﺎﺍ
ﻴﻧﻮﻤﻮکﻧ ﮐﻮ ﺘﭘ
ﺮﺘCSFLAټﺱټﺩﺳ
ﻭ.
ﻱ
ﻳﻦېﺩﻱﺩ ﺎ
ﻌﻠﻲﻣ ﻠﺘﻣﺨﺮﻩﭘ ﺭﺎﭙﻴ ﺺﻟ ﺘﺲﺩﺗﺸﺨ ﻳﺎ
ﻨﺠ ﻨ
ﻳﻲﻣ ﺎﻳ
ﺮﺘﮐﺎ
ﮑﻦﺩﺑ MRﻭCTﺳ ﻩ Iﺍ ﺭﻥګ ﺍ
ﺪﻤﻫ
ﻩﺭﺎ
ﮐﻡﺎﻫﻢ ښ ﻴﻭﺍﺳﮏﻣ ﺎﺍﻤﻳﺫﺎﻏﻲﺍ ﻣ،ځﻪچېﺩ ږﻱ ﮐ ﻩګڼﻝکږ ﺭﻮ
څﻪﻏ ﮑﻦ ﺧ ﻪﺩCTﺳ ﻨﻳﺎﻌ
MRIﻣ
ﺷ.
ﮐﻻﻯ ﻲ ﻮ
ﺮﺘﻞﺷﻲﺗ ﻴﺴ ﺍﺧﻭڅﻪﻭ
ﭘﺴﻲ ﺭ ﺧ ﻮﻳﺎﺪﺑ ﻳ
ﺎﻮﺑﻩﻭﻱﻧ ﺩ ﻮﻮﺟPetﻣ echiﻪa ﺎﺳﭘﺘﮏېﺩ ﻮﺳ ﺭېﺩﭘ ﺭﻪچ ﮐ
ﺷ.
ټﻝ ﻲ ﻮکﭘﮏېﻭﻝ ﻭ ﮐ ﻭ
ﻨﻦګ ﻴﻭﻣ څ
:ﻴﺺ ﺮﻱﺗﺸﺨ ﻴﭘ
ﻮﺗ
ﭘﺲ ﺮﻩﺩ ﻫ ﻮګ ګﻱﺗ ځﻥ ړﻪ ﺍ ﻩﻳ ﺮﺘﺲ ﺳ ﻳﻔﻼﻧﺴ ﺍ
ﻭﻨﻦګ ﻴﺮﺳﻲ ﻣ ﻳ
ﺍﺘﺲ ﺩ ﻭ ﻳ
ﺎﻨﺠﻨﻳﻲ ﻣ ﺎﻳ
ﺮﺘﮐﺎ
ﺑ
ﺗ،
ﻪ،ﺒ ﺩﺭﺩﺮﻔﻼﻱټﺱکېﺳ ﻴﻧﺴ ډﻝﺍېﻪﺩې ﻭ ﺮﺷﻲچ ﭘ ﻴ ﭘﻮ
ﻩﺗ ﺮﺘﺲﺳ ﻳﻔﻼﻴﻧﺴ ﺮﺱﺍ ﻳﺍ
ﮑﺲﻭ ﻴﻠ
ﭙﻤﻴﺳ
ﻭﻌﻲﺍ ﻮﺿ ،ﻣ(ﺰﺱ ﻳ
ﺭﺎﻤﻲﭘ ﻴ،ﻫ ﺎﻳ
ژﺎﻔﻳﺴﺩﻴ ﺺېﻥښې) ﻘﻴﮏﻧ ﻮﺟ ﻟ
ﺍﺭﻮﻴﮐﻞﻧ ﻮ ﻓ
،ﺩ ﻮﻥﻟﺪﺭﺑ ﻮﻌﺩﺷ
ﻭ.
ﺩﻱ ﻮﻮﺟ ﺎﺕﻣ ﺘﻼﺟ ﺍﺧﻣﻲ ﻮﻤﻋ
.ږﻱﻪﺭﺳﻲ ﺗﺮﻪﻡټﺳ ﻮﭘﻨﺘﺒﻲﮐ ﻮﻋﺼ ﻠﻠ
ﺘﻣﺨ ﺮ
ﻭﭘ ﺭﻮEﻭﻧ EG،ﺍ ،
ﻳﻦ ﺎﻌﻣﺩﻴ ﺺﺩCSF ﺮﻱﺗﺸﺨ ﻴﭘ
ﻮﺗ
ﻳﻞﺮﺘﮐﺎ
ﻪﺑ ﺎﭘﻣﺯﺱﻭﻱﺍ ﻮﺘﻳﺎ
ﻮﺳ ﻴ
ﻠﺘﮏﭘ ﻳﺎﻮﺳ ﻔﻤ
ﻭﻟ ﻣﻞﺍ ﺭﺎ
ګﺯﻧﻮﻭ ﻠﺎﻥ کېﺩCSFﮐ ﺘﻧﺮﺳﻲﺍ ﻳﺍﻪﻭﭘ
ﻭ.
ﺯﺱ ﻱ ﻮ ﺘ
ﻳﺎﻮﺳﻴﻠ
ﻭﺩPMNﭘ ﺍﻠﻈﺖﮐﻢ ﺯﻏﻮ ﮐﻮﻟ
ﺘﺲکېﺩګ ﻳﺎ
ﻨﺠﻨﻣ
ﺮﻴﭘﻮ
ﺪﺗ ﻳﺎﺮﻱﺑ ﻩﻟﻴﮏې ﺏڼ ﻨﻴﻠﺎﻥﮐ ﻪﺷ ﺎﻱټﺱﭘ ﻨﺠ ﻨ
ﻳﻞﻣ ﺮﺘ
ﮐ ﺎ
ﻭﻍۍﺩﺑ ﺭﺎ
ﻳﻲﻧ ﺎ
ﻴﺘﺴﮑﻳﻩﺭ ﺭﻥګ ﺍ
ﺪﻤﻫ
٩ﺍﻥﺩ٦ ﺭﻭﻭﻍۍﺭﻥځ ﺭﺎﺩېﻧﺍﺩ ً
ﺮﺜﮐ.ﺍﺩږﻱ
ﻟږﻱ ﻪﻲ ﺍﺳﻄ ﻪﻭ ﻮﭘ ﻠ
ﺭګېﺩچچﭼ ﻭﻏﻲﺩﻭ ﺭ
ﺎېﺍﻧ
ﻭﺷﻲچ ﺩ
ﺮﻭﻱ ﻟ
ﻮ ﭘﺎ
ﭘﻮﻟﻮﮑﻩﻣ ﺮﺮﺳ ﺘﺸﻨﻪﻣ ﻧﻮﭘﺎېﺍﺧﻮﻱچ ﺩ ﻩﮐ ﺭﺎ
ﮐﻪښ ﻧ
ﻮ ﭘ
ﺎګﻱﺧېځﻥ ړﻩک ﺍ ﺩﻮﻪﻣ ﻮﭘﻧﻮﺘﺎﻋﺳ
ﻪﻪ ﺷﻲﭘ ﻪﻧ ﻨﻠ
ﻣﺭﺭېﺩ ﺭﻪچ ﻪﮐ ﻧﻮﭘﺎﻪﺧ ﺩ.ﺩﻏﻣﻦ ﻯ ﺰﻧ
ﻮﺘ ﺮﺳ ﻴﭘ
ﻮﻩﻱېﺗ ﺮﺎﺳ ﻤﻴﮐﺴﻮﮐ ﻭﻨﻦګ چېﻣ
ﻓﺖﺭﻥ ﺩېﺍ.ﺩ ﻮﻱ ﻪﮐﺗﻣﻦځ ﺍﻳﻦﺭ ﺭګﻥګﻭﺍ ﺯﺍﻭﺮﮑﺘﮏېﻧ ﻮﺳﺎﻯکېﺩﭘ ﻪﭘﻭﭘ ﺍﺍﺭﻮﭘ
ﺭﻮ،ﭘPet echia
.ﻣﻲ ﻮﻮﻥﻣ ﻟﺪﺭېﺑ ﻮ
ﺭﺭﻥګﭘ ﻮﻭﺗ ﺍﻴﻦ،ﺷ ړ
ﺳ،ژﻱﺭﻩﻮ ﺭ
ﺎﻴېﺮﺗ
ﻮﻝ ﺗ ﻴڅﻪﻧ
ﺭ ﺧ ﻮښﻥﺩﺳ ﻭﺍ ګﻪﺭﻟ
ﺭېﻫﻢ ﻮ ﻭﭘﺪﻧﻮﻭﭘ ﻮﻱﺍﺭﻏﻳﻲﻭ ﺍﺩﻭﻱچې ښ ﻮﻮﺟﺪکېﻣ ﻨ
ګﻪﺑﻧ
ﺯﻥﺍ ﻭﺩ ﺪﺍﻧﻭړ،ﻡﻪﻻﺱ ﻪﭘ ﻧ
ﻮﭘﺎﺍﺧﺩ
ﻩﺮﺮﺳ ﻪﺗ ﺘ
ﺮﺳ ﻪﻣ ﭘﺴﻲﭘ ﻮﻳﺎﺘﮏېﺩﺑ ﻮﺳﭘﻭﺩ ﻳﻦﺍﻮﻠﻨﺖﺗ ﻭﺳ ﺭﻮﻠ
ﻮﻓ ﻧ
ﻮ ﻴ
ﻣ ﻴ ﺺﻱېﺩﺍ ﺷ.ﺗﺸﺨﻩ ﻲ ﺭ
ﺎﭙﺧ
.ږﻱ
کږ
ﻭګﻥېﺍﺎﺍ ﻤﻴﭙﻣﺭﻝﺍ ﻮﻳﭙﻲﺩ ﻳﻭﺍ ﺭﻝﺍ ﻮﻳﻪ ﺳﺐﺩ ﮑﺎﺕﻟ ﻧﺎﺘﻧ
ﻴﺤﻲﺍ ﻘﻌﻲﺗ ﻮﺿ ﻩﺩCNSﻣ ﺭﻥګ ﺍ
ﺪﻤﻫ
.
ږﻱ ﺮﻱﻴﭘﻮﻪﺗ ﺍﺳﻄ ﻪﻭ ﮑﻦﭘMRﻭCTﺳ ،چې Iﺍ ﻮﺎﺳﻪﺑ ﻧﻩﻭﺩﺎﻪﻳ ﻟﺪﻳ
ﺎﺑﺲېﺑ ﺍﺎﻏﻲﻣﺩ
72
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﻪ ﺳﺐ
ﮑﺮﻱﻟﻴﮏﻟﻨ
ﻴﻠﺎﻥﮐﻪﺷ ﺎﻱټﺱﭘ ﻨﺠﻨ
ﻳﻞﻣ ﺮ
ﺘﮐﺎ
ډۍﻫﻢﺩﺑ ګﻭ
ﻧﻲ ډ ﺎ
ﺘﻧ
ﺮﺍﻴﺭﻏﻮﺮﻧﻴ
ﻤﻮﺷ ﻳ
ﻪﻐ
ﻭﻫﺘﺲﺍ ﻳ
ﺎﻨﺠ
ﻨﺯﻣ ﻮ
ﺗﺎﻣﻮ
ﻔﻤﻭﻟﺯﺍﻮﺗ
ﺎﻣ
ﻮﻨﻴ
ﺭﺳﺎ،ﮐChemicalmeningi
ti
s، ژ
ﺍﻮﻤ
ﻴﺪﻫﻴﺋ
ﻮﻨﮐ
ﺭﺍ
ﻩ
ﺮځﺭۍﺳ
Behcet،ﺭﻥ ﻭSEL،ﺪ
ﻴﺋﻮ
ﮐﺭﺎ
ﻪﺳ ﮑﻟډﻮ
ګﻭﻳ
ﺑﻲ ډﺎ
ﻬﺘﻟ
ﻮﺍﮑ
ﻴﻤﺘ
ﻴﺴﻭﺳ ﺭ
ﻮﻧﺘﺲ چېﺩﻳﺎ
ﻨﺠﻨﻣ
ﻭ.
ځﻯ ﻱ
ﻮﺍ ﻳ
:
Adj
unct
iveTr
eat
ent
ﻮ
ﺮﻱﻧﻩﻟﻭډ
ﻩ ﻥ
ﺮﺘﻮکﻥﻥ ١ﺳﻟ
ﺮﺘﻧ
ﻭﺍﺰﺱ کېTNFﺍﻴﻨ
ﻮﺟﺘﻪﭘﺘﺲﭘﻳﺎ
ﻨﺠﻨ
ﻩ چېﺩﻣ څﻥګ
ﺭ
،
ﻮﻱﻬﻲﮐ
ﻪکېﻧﺮﺧmﻪﺑ
ﺩﻝﺩ RNAﭘ ﺩړﻮ
١ﻭTNFﺟ
ﻮکﻥﻥ ﺍﻟ
ﺮﺘﻧ
ﻮﻝچېﺩﺍﮐﺭ
ﻭﻥﻭﺯﺎ
ﺘﻴ
ﻣﺎﮑﺴ
ﻳﺩ
ﺩ.
ﺭﻯ ﺎﻩﮐﻮﻱ ښ
ﺘﺑﺎ
ﻭBBBﺛﺍﻮﻱ
ﻪﮐﺘ
ﮐﻣﺖ ښﻭ
ﺎﻘﺑﻞکېﻣﺎ
ﻘﻪﻣ
ﺎﻥﭘﻳ
ﺮﺩCSFﺩﺟ
ﺪ
ﻴﻟﻮ
ﺷ،ځﻪچېﺩTNFﺗ
ړﻯ ﻲ ﮐﺭک
څﻪﻭ
ﺪ ﺧﻭﺏ ﺿ ﺮ
ﮑﻳﺎ
ﻴﻖېﻣﺨﮏېﺩﻣﻗ٢ﺩﺪ٠
ﻳﺎﻭﻥﺑﺯ
ﺎﺘﻴ
ﻣﺎﮑﺴﻳﺩ
ﻧﮏېﺩﻭﺍژﻪ چېﺩ
ﻠ،ﮐ
ﻮﻱﻬﻲﮐ
ﻪﻭﺧﺖﻧ ﻐﺯې ﻫﺍ
ﻮﻪﻳﺍﺳﻄ
ﻪﻭګﺎﭘ
ﻴ
ﻭﻟ ﺮﮑﻳ
ﺎﻭﻣ ژﺍﺎ
ﻓﻭﺮﮑﺩﻣ
.
ﻮﻻﻯﻴﻪﻧﺸﻲﻧ
ﻮﻱTNFﻣﺨﺟړﺷ
ﻭﻥﺩ ﻮ
ﺯﺎﺘ
ﻴﻣﺎ
ﮑﺴﻳﻭ.ﺩ
ﺷېﻪ ﻱ
ﺎﻝې ﻮ ﻧ
ﻌﻪﻓﺍﺳﻄﻪﻭﻴﻦﭘﮐﺴﻮﺗﻭ
ﺪﻧﺍ
ﺎ
ﻭﻳ ﺍﺍ
ﺰﻨﻳ
ﺍﻮﻠ
ﻔﻧ
ﻴﺲﺍ ﻠ
ﻴﻓﻮﻤﻴګﻱډﻝ چېﻫ
ځﻥ ړ ﻭﻪﺍ ﻪ کېﭘﻨ
ﻠﻣ
ﺭﻪﺩﻮﭘ ﻧ
ﺎﻣ
ﻮﺎﺷﻭﻥﺩﻣ ﺯﺎ
ﺘﻴ
ﻣﺎﮑﺴﻳ
ﺩ
ﻴﮏSequelﻮﺟﻟﺍ
ﺭﻮﻴ
ﻭﻧ ﺎﺏﺍﻬ
ﺘﻟ
ﻴﻞﺍﻨﺠﻨ
ﺩ،چېﻣﻣﻦ ﻯﺰ
ﻴﺮﻱﺍﻏﻟ
ﺘﺲﻭ ﻳﺎ
ﻨﺠﻨﺎﻣﻴﻧ
ﻮﻤﻮکﻧﮐ
ﻮﺘﭘﺮ
ﺘﺳ
ړﻱﻡﻮﻟ
ﺮﻴﮏﺗﺗﻮﻴ
ﺘﻲﺑﻧﻴﻖېﺩﺍﻗ٢ﺩ٠
-١
ﺪﻱ٥ ﻳ
ﺭﻪﻭﻣﺍ
ﺭﻠﻲګ
١ﻣﻭﻥ٠ﺯﺎ
ﺘﻴﻣ
ﺎﮑﺴﻳ.ﺩﻮﻱﻤﻟﻰﮐ
ﺍﮐڼﻭ
ﻪﻮ ﮑﻟ
.
ږﻱﺭﻱﺍﺮ
ﮑﻪﺗﺘ
ﻭﺳ ﺭﻪﻭﺘ
ﺎﻋږﺳﺮﺷﭗ ﻩﻫﺭ
ﺎﭙ
ﻟﻭﻭځ
ﺯﺩ٤ﺭﻭﺍﺩﺪﻤ
ﻱﻭﻫږﺍ ﻟﻲﺎ
ﻤﻌﺘ
ﺍﺳړﺪې
ﻧ
ﺯﻭﺍ ﻭ
ﺩ
:
ﻪﻨ
ﻠﻣ
ﺭﺭﺩ
ﺎﻟړﻓﺸ
ﺎﻍېﺩﻮ
ﻣﺩﺩ
ﻴﺸﻦ)25Paco2
ﻠﻴ
ﺘﻨﻳ
ﺮﻭﭙ
ﻳﺎ
ﻭﻫﻴﺸﻦﺍﺑ
ﻮ ﺘ
ﻧ.ﺍږﻱ
ﻪکږ ﺗ
ﺭﻮﺭﺝېﭘ
ﺩ٤٥-
٣ﺳ٠
ﻭﻍ ﺮ
ﺭﺎډﻝﺩﻧ
ﺑړﻲ ﻭ
ﻪ ﻲﻧﭘ
ﻮﻝﻴ
ﻧﻧېﻭ
ﺭﻥېﻻﺪﺍېﺮڅ
Iک ﺗﻪCUﺪﭘ
ﻳﺎﺎﻥﺑﻭﻏﺭﺎ
.ﺍﻧ
ږﻱﺩ
ﻮﻝکږ ﮐﺭ
Manniﻭt
(ﻭol-ﺍ
30mmHg
ﺷ.
ﻲ
:
ﺭﺍ
ﺰﻧ
ﺍ
ﻮک
ﮐﻮﺘ
ﭘﺮﺘ
ﻭﭖﺳﺭﺎBګﺘﺲﻳﻳ
ﺎﻨﺠ
ﻨﺎﻣﻳ
ﺮﻴﻳﺴ
ﺎ،ﻧ
ﺍ
ﺰﻨﻳ
ﺍﻮﻠ
ﻔﻧ
ﺍﻮﺱ ﻠ
ﻓﺎﻤ
ﻴﻻﻞﻱېﻫ
ﺘﺲچې ﻣﻳﺎ
ﻨﺠﻨ
ﻪﻣﻐﻫ
ﻮک
ﮐﻮﺘ
ﭘﺮﺘ
%ﻭﺩ ﺳ
١ﺍ ړﻪ٥
ﻨ
ﺘﺲﻡﻳ ﻳﺎ
ﻨﺠﻨ
ﻮﺟﻦﻣ ﺘ
ﻳﺎ
ﻮﺳﻧﻮﻣﺎ
ﻳﺮ
ﻴﺘﻴﺴﻭﺩﻟ
ﻩﺍ%٧ﺩ-
ړﻪﻱې٣ﻨ
ﻭﻱﻡﻳ
.
%ﻩ
٢ﺩ ړﻪ٠
ﻨﺎﻡﻳﻴ
ﻧﻮﻤ
ﻧ
:
ﻩﻩ
ﻟړ ﺩ
ﻪﻮړﻦېﮐﭽ
ﺘﺲﺩﻡﻳ
ﻳﺎ
ﻨﺠﻨ
ﻮکېﺩﻣ
ﻧﻮﺘ
ﻟﺎ
ﻧېﺣ
ﻪﻻﺪ
ډﻝﭘ
ﻣﻲ ﻭ
ﻮﻤﻪﻋ
ﭘ
ﻭ.
ﻩﻪ ﻱ
ﻪﻱې ښﻧ
ﺭﮐﭽ
ﻮﻌږﻱﺩﺷ
ﺮﻱﺘ
ﻭﻍﺑﺴ
ﺭﺎﻪچېﻧ
ﻠﮐ .
1
.
ﻮﻥﺘ
ﻮﺷﻧ
ﻭﺪﻳ
ﺮSeiﺑ
zur
ﻮکېﺩes
ﻧﻮﺘ
ﺎﻋ٢ﺳ
ﻮ٤ﻟ
ﻭﺍﻪ
ﭘ .
2
.
ﻮﻥﺘ
ﻭﺷﻟﻲﺩﻥښ
ﺍ
ﻮﺗﺎ
ﻳﺭﺩﺯ
ﺎﻔﻲﻓﺸ
ﺍﺧﻞﻗﺤ
ﺩﺩ .
3
څﻪ ښ
ﺮ ﺧﺘ
ﻴﻟﻳﺴﻲ
ﺮﺩﺮﻫ
ګﻡﭘ
ﺍﻠﻲ ﺭ
٤ﻣﻟ٠
ﻠﻈﺖﻪ
ﺯﻏﻮﮐﻮ
ﻟﺭېﺩCSFﺩګﺭ
ﻪچﻩﮐﺭﻥګﺍ
ﺪﻤ .ﻫ 4
ﻭ.
ﻪﻱ ﺗﺭ
ﻮڅﻪﭘ
ﻳﺴﻲ ﺧﺮﺩ
ﺮﻫګﻡﭘ
ﺍ
ﻠﻲ ﺭ٣ﻣ
٠ﻟ٠
ﻴﻦﻱېﻪﺗ
ﻭﺮﻭﭘﺍﻪﻭﻱ
ﺘﮐ
ﻭ
ﮐڼ،ﻮ
ﺎﺕﺘﻼﺟ
،ﺍﺧ
ﻟﻰﺍ
ﻮﺑ
ﺍﺮﻓﻆېﺧﺎډﻝﺩﺣ
ﻣﻲ ﻭﻮ
ﻤېﻪﻋ
ﻮﻥ ﭘﺎﺕېﺷ
ﺘﺲﭘﻳ
ﺎﻨﺠ
ﻨﻭﻍکېﺩﻣﺭﺎ
ﻪﻧﭘ
.ړﻱ
ﺎﻐﻧ
ﺍﻟﻰﺭ
ﺍ
ﻮﺑﺍ
ﺮﻮﺧ
ﻠﻡﻭﻫﺪ
ﻗ،ﺩﻟﻰ
ﺍ
ﻮﻤښﺭۍﮐ
ﺎ
ﻮﻳېﻭﻫ
ﻩﺍﻮﭘ
،ﺩﻴﺖ،ګﻥګﺳ
ﻟﻰﺍ
ﻭ.
ﺎﺕ ﻱ
ﻳڅﻪﺯ
ﻮ ﺧﻧ
ﻮﻠ
٥ﮐﻟ٠
ﺮﻱېﻪ
ﻤﻠﮏچېﻋ
ﻪﺧﻐ
ﻭﻫﺍ
ﻡﻮﺎﺷ
ﻟﻰﻣ
ﺪﻳﺯږ
ﻮﻯ ﻱ
ﻧ .
5
ﺩ.
ﻪﺩﻧ
ړﺎﭖښښ
ﻴﺗﺍﺗ
ﻴﺸﻦﻪ
ﻠﻴ
ﺘﻨﻳ
ﮑﻞﻭ
ﻴﻧﺎ
ﮑﻴﺎﻣ
ﺎکﻳ
ﻪﺷﮑ
ﻟﻟﻰ
ﺍ
ځﻯﻭ
ﻮﺍﻮﻳ
ﻧﻮﺘ
ﻟﺎ
ﻭﺣﺭ
ﻮﺩﻧ .
6
73
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
.
ﻟﻰﺍ
ﻪﻭﺘ
ﻭﺳﺭ
ﻴﻞکېﻭ
ېﻪﭘ
ﻠﻦ ﭘ
ﻣﺭﺩﺩ .
7
(
tuber
cul
osi
cMeni
ngi
ti
ﺘﺲ)s
ﯾﺎ
ﻨﺠﻨ
ﯾﮏﻣ
ﺯﻮﻠ
ﮐﺮﺑ
ﻮﺗ
ﺎڅﻩﯾ
ﻮﻨﯽﻭﺧﺖﯾ ﯾ
ﺟړﯼځ
۵ﻮﻭﺯ٪ﻮﻠﮐ
ﺮﺑﻮ
ﺪﯼﺗ ﻧ
ﺎﻭڅﻪﺩﺑ
ږ ﺧ ﺮﯼﺭﻥځﺩﺱ ﺘﻢﻧ
ﯿﺴﺒﯽﺳﺰﯼﻋﺼﮐﺮﻣﺩ
ﮑﻞﯿﻢﺷﺮﻭﺧﯾ
ﻮډﺗﺎ
ﻧﺎﺘ
ﻧﯾﮏﺍ
ﺯﻮﻠ
ﮐﺮﺑ
ﻮﺘﺲﺩﺗ ﯾﺎ
ﻨﺠ ﻨ
ﯾﮏﻣﺯﻮﻠ
ﮐﺮﺑ
ﻮﺩﻭﯼ.ﺗﻮﻮﺟﻪﮐﯽﻣﺎﭘﻣ
ﻮﻠﮐ
ﺮﺑﻮ
ﻭﺗ
ﻮﮐﯽﮑﻠ
ﺮﺧﻤﻮﺥﻋﻪﭘﯼﻭﭘ
ﺭځ ﺍ
ځﻪﺍ
ﻮﮐﯽﻣﻦ ﺗ ﻧﺎ
ﻣﻮﺎﺷﻪﻣﻩﭘ
ﺮﻩﺳ ګﯼﻮګ
ځﻥ ړ ﺗ
ﻪﺍﻩﻭﺧﺖﭘﺮﺗ
ﺎﯾ
ﺩﯼﺯ
ﺘﻦﻭﯼﻨ
ﺪﯼﻣﻧ
ﺎHIﺑﻪFﻮﯼﭼﯽﭘﻣﺨﺖګﮐ ﺮ
ﻮﮐﯽﭘ ﮑﻠ
ﻮﺧ ﻐ
ﻪﻫ ﺂﭘ
ﻮﺻﺭځﯼﺧﺼ ﻻﻞګ
ﻣﺨﺖګ ﻣ ﺮﺩﭘ
ﻻﯼﺩ
ﻪﺭﻟﺯﻮﻠ
ﮐﺮﺑ
ﻮډﯼﺗﮑﻦﺭ
ﯿﺎﺳﯾﻭﺍ
ﺮﯼﻤﯾ
ﺍﺮ
ﻭﺩﭘږ
ﯾﺩ ﺱ
ﻭﺎ ﺍﻪﮐﯽﻠ
ﯾﺎ
ﻪﭘ ﻮﭘﻟ
ﺪﯾﺮ
ﭙﻻﯼﺩﺧ
ﻪﺭ ﻟﻨﯽ
ﯾﺩﻭ
ﮐﻞﺩ Sub ﺮﺑ
ﻮSub ependyﺗﺩmal
ﺭځﯼ ﺍ
ﻪﺍﮐﻞﻣﻦځﺗ ﺮ
ﺑﻮ(Sub ependyﺗ)mal
Suberi
conoi
ﻪd ﺑﺭ
ﻮﺎﺱﮐﺩﺩﺣﺴ ﺍ
ﻮﻧﯽﻣﺎ
ﺘﻧ
ﯾﮏﺍﺯﻮﻠ
ﮐﺮﺑ
ﻮﻭﺗ
ﻮﯼﺍ ﺭﭼ ﻮﻠ
ﻓﯽﭘﺎ
arﻣﺴi
conoid
ﺎﻏﯽ
ﻣﺎﻥﺩﺩﺘ
ﻧﯼﻭﺍ
ﺭځ ﺍ
ﻪﺍﺗ
ﯿﻦځګﻥﻣ
ﺮﻭ ﺒ
ﺑﯽﻏﺎ
ﻬﺘ
ﻟﯾﮏﺍ
ﺍژ
ﺮﻮﻟﯼﻪﺩﯼﻭﺧﺖﮐﯽﯾ ږﭘﺩﯼﺍ
ﺯﻪﺍ
ﻓﯽﺗﺎﻣﺴ
ږﯼ.ﺮﯼﭙ
ﻻﯼﺧﻪﺭﻟﻮﺑ
ﻭﺍﮐﯽﻮﺷ
ﮐﯽﺍ
ﺪﯿﺯﭘﻮﻠ
ﮐﺮﺑ
ﻮﯿﺖﺗ ﻨﺠﻨ
ﻩﻣ ﻮګﻪﺗﺎﺕﭘﺘﻼﻃﻭﮐﯽﻫﻢﺩﺍﺧ ﻭﭘﯽښ ﻮﻣﻞﺷ ﺭ
ﺩﺎﻪﻧ
ﺯﭘ ﻮﻠ
ﮐﺮﺑ
ﻮ ﺮﯼﺗﯿ
ﻠﯿﻣ
ﮐﯽﻮﻏږ ﺷ
ځﯽ ﻮ ﻩﺩﻣﻦﻧ ﺮ
ډﻝ ﺳګﯼ ﻭ
ځﻥ ړﻪﺍ ﻭﭘ ډﺯﻩﻮﻠ
ﮐﺮﺑ
ﻮﺩږﯼﺗ
ﻪ ﻥﺩ ﻪﺗﻭﺗﺎ
ﯾﺎﻪ ﺳﺤﻠﻪﮐ ﻠ
ږﯼﮐ
ﺯڅﻮﻠﮐ
ﺮﺑﻮ
ﯿﺖﺗ ﻨﺠﻨﺍﭼﯽﻣ ﻟﯽﺷﯽﺩ ﺪﯿ
ﻪﺭﺳ ﺗ
ﺭﺎﻭﯾﺎﻪﺳﺤ ﻐ
ﯿﻪﻧﻎﭘﯿﺎﻥﻧﺘ
ﻧﺍڅﻪ
ﻮ ﺧﺮﺧ ﻭﺑﺭﻮﻭﻧﺍﺎﻉﻧﺨ
ډﻮ
ﻭﻥﯾﺍﯿﺖګ ﻨﺠﻨﻮﯼﭼﯽﻣ ﻪﮐ ﺗ
ﻭﻪګﺍﭘږﯼﻫﻢﺩ ﮐﯽ ﺍ
ﺪﯿڅﻪﭘ
ﺮﯼ ﺧ ﻠ
ﯿﻪﻣﺘﻭﺳﺭﻨﯽﻭﺘﺎﺷﯿۍﺎﻣ
ﻭﻥ ﯾ ﺍﻭ
ﻭﻍﺭ
ﺎځﯼﺩﻧﻓﺖ ﺍ ﻪﺍﺎﺗ
ﻤﯾﺮ
ﺘﮐﺎﺒﺖﺑﻪﻧﺴﺘﻟ
ﺭځﯼﺩﻪﺍ ﺗڅﻪﻣﻦځ
ﻟﯽ ﺧ ﺍﻮ
ﺍﺧﺮﻪﭘﻐﯿﻪﻧ
ﻎﭘ ﯿﺎﻥﻧﺘﻧ
ﺍﻮﺩﺮﺧﺑ
ﻭڅ
ﻪﺭ ﻮﻧﻠ
ﯿﮐﻞﺑﺴ ﺮﺑ
ﻮﺍﻕﭼﯽﭼﯽﺩﺗ ﺮ
ﻪﻣﺤ ﻐﺯﻫﻮﻠﮑﺑﻮ
ﺮﯼﺗﯿﻠ
ﯿ ﺮﯼﺩﻣﻟﻭﻝﺮﺭﯾﻮﮐﯽډ ﻟﻮﮐ
ﺍﺪﯿۍﻪﭘ
ﭘ
ټﻮﮐﯽ
ﻧﻪﻍﺍ ﻭﭘ ﻭڅﻪﺍ
ﻮټ ﺧ ﻭﯼﻏ ﺎ
ﻔﻤﻟﺮﯼﯾﺩﺛ
ﻭﺎ ﯿﻢﺍﻧﺸﺍ
ﺮﻭﭘږﻮﮐﯽﺩ ﺱ ﻧﺎ
ﻣﻮﺎﺷﯼﻪﻣ
ږﭘ ﺮﯼﭙﻪﺧﺧ
ﻠﯽ.ﺍﺧﻪﻨﺸڅﻪﻣﺍﻕ ﺧﺮﻧﯽﭖټﻣﺤ ﺍﻮډﻝﭘﺨ
ګﯼ ﻭځﻥ ړﻪﺍ ﺍﻕﭘﺮ
ﯾﮏﻣﺤ ﺯﻮﻠ
ﮐﺮﺑ
ﻮﺪﯼﺗ ﻧﺎ
ﻭﺩﺑ ږ
ﺩﺱ
ﺎﻍﺩﻣ
ﺩﯼﺩﺩ ﺮ
Subarﭘ conoiﻪﺩd ﮑﻮﯼﻟﺑ
ﻮﻭﻝﻟﻪﻫﻢﺭﻧﻭ
ﺭﻮﺘﮑﯾﮏﻓژﻮﻟ
ﻮﯾﺰ
ﻭﻓﯿﮏﺍﻣﻮﺘ
ﻧﻨﯽﺍﯿﺧ
ﻮﺱﯾﺯﺎ
ﻭﮐﺯﺍﻮﻨﯿ
ﮐﻻﺟ
ﭘږ ﻮﺎﺕ ﯽ ﯾ
ﺮﺯ ﯾ
ﻪډ ﺘ
ﻟﯼځﻪﺩ
ﮐږ ﮐﻪ ﯽ ﺘﻩﺍﺧﺮﯾﻪډﺮﺧژﯼﺑ
ﻩ ﻥﺩﺮ
ﺪﯼ ﺳ ﺎﻋ
ﻗ
ﻟﯽﻣﻦځﺍ
ﻮﺑ
ﺍﺮﯿﮏﺧﻤﯿﮑ
ﻭﺍﺳ ﺯﺍﻮ
ﺒﻣﺮﺎﻍﺗ
ﻣ ﺩﺩ
څﻪﺩﻭ ﺧﺪﯿ
ﻪﮐﺘﻮﺩﺍﺧ ﻧ
ﻭﺩګ
ﻭﺭ ﯿﺴﯽﺍځﯼﻧ
ﺍﺕ ﺍﺩ
ﻮﮐﺴﺍ
ﮐږﯼ
ﺪﻝ ﯽﯿ
ﻟMyﻫﻢ el
it
iټﺱﻭs
ﻔﻼﯼ ﺍ ﻧﺴﺍ،Ar
ter
it
is،ﺮﯼﺭﻥځﻮﻉﻧ ﻮﺿﻨﯽﻭﺧﺖﻣﯾﺭځﯼځﻪﺍﺗ
:
ﻧﯽﻭ
ﺪﻨﮐ
ﺭﮑﯽڅ
ﯿﻨﯿ
ﻠﻭﮐ
ﺍﯿﺺ
ﺗﺸﺨ
ﯾﯽﺎ
ﻬﺘﻪﺑﯽﺍﺷﯾﻮ،ﺪﺧ
ﻪﺑ ﺘﺍﺣﺭﺎ
ﻭﻏﯽﻧ ﺭ
ﺎﻪﻧﻭﻝﮐ ﻮﯼﺍﯿﻞﮐډﻝﭘﯾﺠﯽ ﻭﺭﺪﻪﺗﻩﭘﺮﺗ
ﺎﯾ
ﻪﺯﻠﻤ
ﻭﻏﯽﺣ ﺭﺎﺩﻧ
ﺍﯼﺪ
ﯿﺎﮐﯼﻭﯾ
ږﺍ ﮐﯽﺍ
ﺪﯿﻩﻭﯼﭘ ﺮﺭﺳﻟﯽﻭﺍﻮﺑ
ﺍﺮﻟﺖﺧ ﺎﺎﻏﯽﺣﻣﺩﯼ ﭼﯽﺩ ﺭﺩﺮ
ﻪﺳ ﻭﻍﺗﺭﺎ
ﺎﻧﯿﺮﯼﺑﻪﻟ
ﺒﻭﺗﺍ
ﺘﺍﺧژﻥ،ﻮﯿ
ﻔﻧﺎ
،ﮐﻮﻥﻟ
ﺪ ﻟﺖﺑﺎ،ﺩﺣﺴﯽﺣ ﻟﺖﺎړﯼﺣ ﻮﺑﻮ،ﺧﻭﺎﻥګډﻝﮐﺑړﯽ ﻭ
ﻪ ﯽﻧﻭﻏﯽﭘ ﺭﺎ
ﺷﯽﭼﯽﻧ
ﺩﯼﺩﺭﺩﺮ
ﻭﺳ ﻮﻥﺍﻟ
ﺪﺍﺝﺑﺰﻮﮐﯽﺩﻣ ﮑﻠ
ﻭﺧ ړﻪﺯﻮﭘ ﯿﻞﺷﯽﺧ ﻩﭘﺮﺎﺳﻣﻮﻭﮐﻮﺍﻟ
ﺪﯿﺘ
ړﯼﺩﺳﺨ ﺩﺎ
ﻼﺝ ﻏ
ﻭﻍﮐﯽﺩ ﺭﺎ
ﺎﻧﯿ
ﻭړﺑ
ﻣﺨﺖګ ک ﺮ
ﯿﺖﭘ ﻨﺠﻨﻪﮐﯽﻣ ﻪﭘ ﻠ
ږﯼﭼﯽﮐ ﻠﻞګﯼﻠﯽﺑﯾﻩګﺭﻮړﯼﻏﻡ ﻮ
ﻭﻍۍﻟ ﺭﺎ
ﻧ
ږﯼﺩﮐﯽﺍﺪ
ﯿNuchalrﭘ i
gidit
ﻭy ﻭﺩﻋﺼﺐﺍ ﺮګﺘﺂﺩﺳﻮﺻ )Parﺧﺼ esi
ﻮs ﺑ
ﺎړﯼﺩﺍﻋﺼﻮﭖ ﮐ
ﻔﯽډﻪﻭﺻ ﮐږﯼﭘځﻪ ﯽ
ﻣﻦ ﺗ ﺍ
ﺎﺭﯿﻤ
ﯿﮑﺎﻏﯽﺍﺳ ﻣ
ﻭﻍﮐﯽﺩ ﺭﺎ
ﻪﻧ ﻪﭘﻠ
ﺒﻪﮐﻟﻮﻟ
ﺪﯿﻪﮐ
ﺘﻮﺩﺍﺧ ﻨ
ﯾﺍﺮ
ﺎﻍﺩﺷ ﻣﺩ
ﻮﯼﻣﺨﺖګﮐ ﺮﯼﻭﭘ
ﺭځ ﺍځﻪﺍ
ﻭﻣﻦ ﺗ ﺭﻭﻭﺭﻪﻭ ﺭﯼﭘﻮﻮﭘ ﯿ
ﻧﻭﻩﺍﻭﺮﺩﺮﺗﻪﺗﻮﯼﻧﻭﻏﯽﺩﯾ ﺭﺎ
ﻩﻧﺮﻭﻝﺳ
74
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﺍږﻩﻭﯼ.
ﺘﺲﻭﺩ
ﯾﺎ
ﻨﺠﻨ
ﯾﻞﻣ
ﺮﯿﺘ
ﮑﺒﺖﺑ
ﻩﯾﯽﻧﺴ
ﺭﻭﭼﯽﺩ
ﺎ
ﻥﻭﯾ
ﻟژ ﺍ
ﻧﯽ ﯽﺍ
ﻮﻓﯽﮐﯽ ﺩﭘﺨ
ﺍﺭډﻮګ
ﺍﯾﻪﺭﻨﯽﭘﯿ
ﻮﮐﯽ ﺩﺳﺗﺎﻻﻮﺣ ﺗ
ﺎﯾ
ﻪﺯڅﻪﭘ
څﻪ ﺧ
ﯾﯽ ﺧﺎﻤﯿ
ﺩﻧ
ﻭﻍۍ
ﺭﺎﻟﯽﻧﺎ
ﻌﺎﺩﻓﻭﯾﻪﺍﯾﺨﭽﺭ
ﺎﺯﺗﻮﻠ
ﮐﺮﺑ
ﻮﻧﯽﺗﺍ
ﻮﮐږﯼ ﺩﭘﺨ
ﺪﻝ ﯽ ﯿﻧﯽﻟﻮ
ﻤﺯﻧ
ﻮﻠﮐ
ﺮﺑﻮ
ﺮﯼﺗ ﯿ
ﻠﯿ
ﻣ
ﺍﯼﺷﯽ.ﺪﯿ
ﺪﻝﮐ ﻧ
ﻮﻮﮐﯽﻣ
ﻧﺎﻭﻏ
ﺭﺎﻮﻧﺗ
ﺎﯾ
۷څﻪﺯ
۵ﺧﯾﺖﺩ٪ ﺩ
ﻮﻮﺟﻣ
ﻧﯽ
ﺪﻧﻮ
ﺭﯼﻣ
ﺍﻮﺗ
ﺍﺮ
ﺑﻻ
ﻮﺑ
ﻭﮐﯽﺍﻮﺎﻏﯽﺷ ﻣﺩﮐږﯼﺩ
ڼﻝ ﯽﻪکړ ﻨ
ﺘﻩﮐﺰﯾﻨﺲټ ﻩﺑﺭ
ﺎﭙﻟ
ﯿﺺ ﺘﻞﺩﺗﺸﺨ ﯾﺴﻮﻭ ﺑ
ﻭﮐﯽﺍﻮﺎﻏﯽﺷﻣﺩﺩ
ﺮﺘ
ﯿﻭﻟﺮﮑ
ﯿﺮﻣﻪﻫ ﺭﯼﭘﻮ۱ﭘ۰۰
-۵۰
ﻪﮐﯽ۰ ﻪﭘﺮﺑﯿ
ﻤﻭﺷ ﺮﻟړﻭﯼ،ﺩﺣﺠ ﺭﯾﯽﻮ ﺎ
ﺯړﻭﯼﻓﺸ CSFﺭﻥګ ﯼ
ﻪﮐﯽ ړﯼﻭﺧﺖﮐﯽﭘ ﻡ
ﻮﻪﻟﺎﻥﭘﺘﻧﻮﺩﺍ ﻩﻭﯼ ﺧ ﻟړ
ﻪﮐﯽ ﻮ ﻩﭘﺯﺍ
ﺪﻧﻮﺍﻧﻮﺘ
ﯾﺎ
ﻮﺳ ﻔﻤﻟ
ﮐﯽﻭﯼ) ﭼﯽﺩ
)1-ﻭﯼګ 8g/ (l ﺎ
(100–800Mg/ﯾ ﻪﮐﯽﺩ)dl ﻩﭘﺯﺍ
ﺪﻧﯿﻦﺍﺗ
ﻭﺮﻟړﻭﯼ(ﺩﭘ ﯿﻞﻮﻓﻭﺮﺘ
ﻧ
ﻮﺑ
ﻭﮐﯽﺍﻮﺎﻏﯽﺷ ﻣﻩﮐﯽﻭﯼﺩﺩ ﺯ
ﺍﺪﻧﺎﻝﺍﻣ
ﺭﻮﺍﯼﺷﯽﭼﯽﻧ ﺪﯿﻪﺩﯼﮐ ﻟﻩﺮﻮﺳ ﻪﮐﯽﮐﻢﻭﯼﺧ ﺯﭘﻮﮐﻮﻟ
ﻪﺑ
ﻭﻭځﯽﺩCSFﺍﻪڅ ﻟ ﻮﮐﮐږﯼ ،ﺧﺪﻝ ﯽ ﻧﻮﻭﮐﯽﺩAFBﻣ ۲ﭘﯽښ ۰ﻪ٪ ﻨﯽﭘﺘﻪﮐﻐﯿ
ﻪﻧﻎﭘ ﯿ
ﻧ
ﻭﮐﯽ۸ﭘﯽښ ۰
ﻭ٪ﺮﯼﺍ ﻟ
ﺯښﺕ ﺭ
ﻪﺍﯿﯿﺼ ﮐﻝﺗﺸﺨﻩﺷﯽﺩ CSFﺮ ﻟړ
ﺪﯼﻮ ﯿﺼﺍﻓﮑﻦﺩ ﻤ
ﺘﻞﺷﯽﻣ ﯾﺴﻭﻭ
Ependyﻭﺩmabasal ﺩﻭﯼﺍ ﻮﻮﺟﻮﺱﻣ ﻟ
ﺎﻔﻭﺳﺭﺪﯾ
ﺎﻪﮐﯽﻫ ﻨﺘ
ﻪﮐ ﺍMRIﭘﺒﺖﻭﯼ.ﺩ CTﻭ ﺜﻣ
ﺒﯽﺰﯼﻋﺼ ﮐ
ﺮﻭMRIﺩﻣ ﮑﻦﺍﻮﯼﻭﯼCT .ﺳ ﻩﺷ ﻟړ
ﻩﻮﺮﻩﺳ ﻮګﺎﻝﺗﻣﺭﻮ
ﺮﻧﯿﻪﻏ cﻪﮐﯽﭘ
iﭘ st
erna
ﺮﯾ
ﻪڅ Riﭘﯾﺩngړﯼﺎ ﺩﯼ کﺭﺩګﺎﻣﻮﻟﻮﻧ
ﺍﺭﺮﯼ.ګ ﺯښﺕﻟ ﺭ
ﯿ ﺺﮐﯽﺍ ﻪﺗﺸﺨ ﺎﭘﻣﻮﻠ
ﮐﺮﺑ
ﻮﺘﻢﺩﺗﯿﺴﺳ
ﻮﯼ.ﮐﺭ
ﻮﻟﺎ
ﯿﺧ
ﻮ
ﻠﮐﺍ
ﻪټﻭﭘﺭ
ﺍﺰﻧ
ﺍﻭﻍۍﺩﺭ
ﺎﯿ ﺺﺩﻧ
ﻩﺩﺗﺸﺨﺮ
ﯿﺮﺳ
ﻟﯽﺑﺍ
ﻭﻟړ
ﻮﻮ
ﻨﯿﺗ
ﻭﺮﻭﭘ
ﺭﺍﺎ
ﻊﻓﺸﯾﺎ
ﮐﯽﻣﻮﺎﻏﯽﺷﻣ
ﺩﺩ
ﻊ
ﯾﺎﻩﻣﺮ
ﻧﯽ ﺳﺮ
ﻠﻣﺎ
ﻪﭘﺪﭘﯾﺎ
ﻟړ ﻭﯼﺑ
څﻪ ﻮ
ﺭﺩ 300mmH20ﺧ ﺎ
ﻪﻓﺸ ﺮﯼ ﮐﺭﻟﻮ
ﮐﯽ ﻫﻢﻟ
ﺘﻞﺷﯽ.
ﯾﺴﻭﻭ
:
ﯿﺺﺮﯼﺗﺸﺨ
ﯿﭘﻮ
ﺗ
ﻭﻍۍﺭﺎ
ﻮﺩﻧﻩﺷﯽ.ﺧ ﺮ
ﺮﺳﯿ ﺺﺗﺮﯼﺗﺸﺨ ﯿﭘﻮﺪﺗﯾ
ﺎﻩﯾﯽﺑ ﺮ
ﻮﺳ ﻧ
ﻮﻟﻭ
ﻭډ ﺭ
ﻮﯿﺖﺩﻧﻨﺠﻨﺩﻣ
ﻭﺯﺩﯼښ ﻮﻠ
ﮐﺮﺑ
ﻮﻭﺗﻟﯽﺍﺍ
ﺎﺕﻭﯾﻮﺯﺘﯿﻮﺳﻔﻤﻮﮐﯽﺩﻟ ﺑﻭﮐﯽﺍﻮﺎﻏﯽﺷﻣﻪ،ﺩﻠ
ﻤﯾﺠﯽﺣ ﺭﺪ
ﺗ
ﮑﯽﺘﻮﺳ
ﺮﯼﺩﭘﻟﺯښﺕ ﺭﺍﺮﯾ
ﯿ ﺺﮐﯽډ ﻪﺗﺸﺨ ﻪﮐﯽﭘ ﺮﺧﻪﺑﻠ
ﻪﺑﺮﺧﻪﺑﻠ
ﺪﻥﺑﯾﺖﺩﺑﺩﻮﻮﺟﻣ
ﻪﻟﻩ
ﺮﺒﺖﻭﯼﺳ ﺜﻮﮐﯽﻣﻧﺎ
ﻭﻏﺭﺎ
ﻮﻧﺗﺎ
ﯾڅﻪﺯ
ﺭﯼ ﺧ ﺩ
ﺮﻩﭘﻭﻪﮐﯽﺩﺩ ﯾﺲټﻫﻢﭘ ﯿﻦ ټﻠ
ﮐﺮﺑﻮ
ﺗ
ﻭﯿﺲﺍﻠﻔﻪﺳ ﮑ
ﺘﺲﻟ ﯾﺎ
ﻨﺠﻨﺯﻣﻮ ﺗ
ﺎﻣﻮ
ﻟﻮﻧ
ﺍﺭﺭګ ﻮﻭﻧ ﺪ ﭼﯽﺩﻓﻦګﻝﺍ ﯾ
ﺎﻪ ﻫﻢﺑﻨﯾ
ﺩ
ړﻝﺷﯽ.ﻩک ﺮﺮﺳﯿ ﺺﺗﺮﺗﺸﺨ ﯿ
ﭘﻮﻩﯾﯽﺗﺮﺘﺲﺳ ﯾﺎ
ﻨﺠﻨﺯﻣ
ﻮﺗﺎ
ﻣﺎ
ﻨﯿ
ﺭﺳ ﺎ
ﮐ
:
ﺎﺕﺘﻼﻃ
ﺍﺧ
ﻭﻍۍﺭﺎ
.ﺍﻧ
ﮑﯽﻭﯼ ﺩﻧﻭ
ژﻩﻭ
ﺮﻪﺳﻩﻣﺨﻮﻪﯾ
ﻟﻪﺘﺲﺑﯾ
ﺎﻨﺠﻨ
ﯾﮏﻣﺯ
ﻮﻠﮐ
ﺮﺑﻮ
ﺪﻝﺷﯽﺗﻧﭘژ
ﻪﯽﻧ
ﺮﯼﻭﯿﻪﭼﮐ
ﺘﻼ
ﺒﯽﺍﺧ ﻮﻋﺼﻤﯿ
ړﻭﺧﺩﻮﻝ
ﻭﮐﯽ ﯾ۲ﭘﯽښ۵ﻪﺩﯼ٪ﻟﻩ
ﺮﻮﺳﻮﯼ.ﺧﮐﺭﺍﺏﻭ
ﻭﻩځﺮﺍﭖۍﺳﺮ
ﺗﻮﻤ
ﯿﺩﮐ
ﯿﻒﺘ
ﮐﺮﺘﺑﺴﻭک،ﺍﺭﻠﺞ ،ﺱټﻮﻓﺑ
ﺎړﯼﺩ ﻋﺼﻮﭖ
،Seiﺩﮐ zurﻪeﮑﻮﻟﻧ
ﻮﺗﯽ ﺷ
ﺎﻭﭘﻮﺍﺗ
ﺎﻃ
75
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﯿﮏﺩﻤ
ﻠﺗ
ﻮﭙﯾ
ﺎﻭﻫﺍﺪﯼ
ﻣﯽﻏ ﺎ
،ﻧﺨﺪﻝ
ﯿﻤﻭﺕﮐﺎ
ﮐ،ﺩﺯﻟﯽﺍ
ﻭﮐڼ
،ﻮﻟﯽﺍﻭ
ﺪﻧﻭ
،ړﻔﯽﯿﻌ
،ﺿ ﻮﺱ ﻟ
ﺎ
ﻔﻭﺳﺭﺪﯾﺎ
ﻫ
ﺪﻝ،
ﯿﻧﺍ
ﻭﮑﯽ ځ
ﻪﻣﺨ ﺘ،ﻪﻭﺧ
ډﺱ ﻟﻧﺴﻒﺎﺏټﺱﺍ ﯾ
ﺍﻟﯽ،ډﺍ
ﻮﺎﻏ
ﻪﭼ ﮑﻭﻟﻟﯽﻥښﺍﻮﺑ
ﺍﺮ
ﻮﯼ ﺧﻔﯿﻭﻇ
ﮐږﯼ.
ﺒﺐ ﯽﻮﺳﻠﻠ
ﺗﺍ
ځﻪﺭ
Hyﺩﻣﻦ ﺗpopi
tuit
ari
sm
ﺪﯼﻧ
ﺎﻮﺑ
ﻧﻭﻪﺭګ
ﻮﭘﺮﺧﻭﯼﺑ
ﺪﺎﻋﻭﺩﻗﺎ
ﯾﺎ
ﻪﭼﯽﺩﺳﺤﻠﺒ
ﻪﮐﺍﺕﻟﺩﻮﮐﺴﺑﯽﺍ
ﺎﻬ
ﺘﻟ
ﺎﺕﺩﺍﺘﻼﻃړﯼﺍﺧ
ﻮﻣﻮﻧ
ړﻭﮐﯽﺩﻡ۲ﭘﯽښ۰-
۲۵ﺂ٪ﺒ
ﯾﺮﻘ
ﻩﺗﺮ
ﻩﺳ ﺮ
ﭘﯽﺳ
ﺍﺮ
ﺗﻮﻤ
ﯿﻨﯽﮐﻣ
ﺰﯿﺍﺍﻏﺭځﯼﭼﯽﺩځﻪﺍ
ﻮﯼﻣﻦ ﺗ ﻩﮐﺰ
ﯿﺍﻏ
ﮐږﯼ.
ﻻﻞ ﯽ
ﻨﯽ ﻣﯾ
:
ﻪﻨﻠ
ﻣﺭﺩ
ﯾﮏﺯ
ﻮﻠﮐ
ﺮﺑﻮ
ﺮﺩﺗ ﺗ
ﺎﻪﺧﻮﺩﮐﻢښﺕﭘ ﻧﻮ
ﺗﯽﺷ ﺎﻩﺩﭘﺮﻭﻍۍﺳ ﺭ
ﺎﺕﻭﺩﻧ
ﺎﯼښ ﺍ ﺪﺩﭘﻧﻭ
ﻭﻍﺩژ ﺭﺎ
ﺩﻧ
ﺭﻭﯼﻭﺮ
ﯿﻞ ﺿﻨﯽﭘﻠ
ﻣﺭﯿﮏﺩ
ﺗﻮﯾﺎ
ﺘﯽﺑ
ﻧﻠﯽﺍﮐ
ﺭﺕﮐﯽﻫﻢﺩﺍټ ﻮﻪﺻﯿ ﺺﭘﻟﯽﺗﺸﺨﺎ
ﻤﺘﺍﺣ
ﺘﺲﺩ ﯾ
ﺎﻨﺠﻨ
ﻣ
ﻪﯾﯽﻠ
ﯾﺎﻧﯽﭘﺮ
ﮐﻮﺩﺩﻭﯼ ﺧﻮﻮﺟﺪﻣﯿ
ﺍﻫﻮﮑﯽ ﺷﯿ
ﻨﯿﻠ
ﺘﺲﮐ ﯾ
ﺎﻨﺠ
ﻨﯾﮏﻣﺯﻮ
ﻠﮐﺮ
ﺑﻮﻭﻍﮐﯽﺩﺗ ﺭ
ﺎﻪﻧﻪﭘﮐ
ﮐږﯼ
ﻮﻝ ﯽ
ﮐﺭﮑﻢﻭﻨﯽﺣﻠﻣ
ﺭﯾﮏﺩﺯﻮﻠ
ﮐﺮﺑ
ﻮﺘﯽﺗﻧ
ﺍﺭﺱﻮﻤﻞﮐﮑﺩﻮﻣ
ﻪﻭﯼ ﯾ ﻪﻫﻢﻧﺘﺒ
ﺜﻣ
ﯾﻦ
ﺯﺍ
ﺮﯿ
ﻭﭘﯿﻦﺍ
ﭙﻣﺎ
ﻔﯾ
ﻟﯽﺷﯽﺭﺪﯾ
ﺮﯿڅﻪﺗ
ﻭ ﺧﺩ
ﺮﻭﺩﭘ
ﺎﯾﺎ
څﻪﺳﺤ
ﻨﯽ ﺧﯾ
ﻩﺩﻭﺮﻪﺳﻧ
ﺎﻪﺍﺳ
ﺪﭘ ﯾ
ﺍﺯ
ﺎﯿ
ﻧﻭﺰ
ﯾﺍ
ﻠﯽﺷﯽ.
ﺗﻮ
ﻨﻪﻧﻭﺗﺎ
ﯾﺎ
ﻩﺳﺤ
ﺮﻧﯽﺳ
ﺎﺍﺳﻪڅﻪﭘ
ﻭ ﺧﺩ
ﺮﻭﺩﭘ
ﺎﯾﺎ
ﺑﯽﺳﺤﺎ
ﻬﺘ
ﻟﺍﺪﻫﻢﺩﯾﺎ
ﻣﺍ
ﻪﺘﺲﭘﯾ
ﺎﻨﺠﻨ
ﯾﮏﻣﺯ
ﻮ ﻠ
ﮑﺑ
ﻮﻩﺩﺗ ﺮ
ﺎﺏۍﺳ ﯿﻣﺎ
ﻭﺩﮐ ﻩﻩﺍ
څﻪ ښ ﺩ
ﻭ ﺧ ﺎ
ﯾﺎ
ﻪﻫﻢﺩﺳﺤ ﻧﺪ
ﯾﺮﯿ
ﻮﻝﺗﺘﯿﺒ
ﻣﺎﺘ
ﯾﺩﺍ
څﻪﻫﻢ
ﻭ ﺧﺎﯾ
ﺎﻪﻫﻢﺩﺳﺤ ﻧﺪ
ﯾﺮﯿﺪﺗ
ﯾﺎﻮﺳﮑﯾ
ﻮګﻻﻨﯿﻣ
ﻟﯽﺷﯽﺩﺍ ﺪ
ﯿﺘﻞﮐ ﯿﺴﺭﺍﺧﺎ
څﻪﮐ
ﺭ ﺧﻪﮐﯽﻭ ﻨﻠ
ﻣﺭﺩ
ډﻝﺩ
ﻪﻭ ﺮﯼﺭﻥځﭘږﺩﻧﻮﺩ ﺱ ﻡﺷﯽﻧ ﺎ
ﻤټﺭﺗ
ﻭک ﻭ ﻣﻞﺍ
ﺎﻪﺷﻨﻠ
ﻣ ﺭ
ﻪﺩ ﺍﯼﺷﯽﭼﯽﭘ ﺪﯿﻩﮐﻪﺩﻩﻧﺪﭘ
ږﯼ.
ﻣﯽ ﺎ
ﻤژﻢﺗﻞﺗ
،ﺭﯾ ﯿﻦ
ﯾﺴﺎﻣﻭ
ﺭﭖټ ،ﺱټﺪﯾ
ﺎﻣﺍﯾﻦﺯ
ﺍﺮﯿ،ﭘ
ﯿﻦﯿﺴﭙ
ﻣﺎﻔ
ﯾ،ﺭﺪ
ﯾﺯﺎﯿ
ﻧﻭﺰﯾ
ﺍ
ﻭﻍﺭ
ﺎﻧ
ﺪﯾﻮ
ﮑﯿﺗﺭ
ﻮﻮﮐ
ﮐﻮﻟ
ځﯼګ
ﻮﺍﻩﯾﺮ
ﻣﻞﺳﺭﻪﺩﺩﻩﭼﯽﮐ
ﻮﯼﺩ
ﻪﺷ ﺗﻭ
ﻪګ څﻪﭘ
ﻮ ﺧﻨ
ﯾﻮﻣ
ﺯﮑﯽﺍﯿﻨ
ﯿﻠ
ﺩﮐ
ﻪﻪﺑ
ﺎﻝﺗﻣﺭ
ﻮﯼﻭﻧ
ړﺍﺪﯼکﻧ
ړﻪک
ﻮﻝﺑﻤﺭﺳ
ﺎﻟړﻓﺸ
ﻐﯽﺩﻮﯼﻭﺩﻫ
ﻣﻞټ ﺍﺭ
ﺎﻨﺑ
ړﻝﺷﯽﺩCSFﺍ ﺭکﻪﻭﺗ
ځﯼ.
ﺭﻭ ﻭګﺍ
ﯾﯽﺭ
ځﯽﺩﺩځ
ﯼڅﺭ ﻟ
ﻮﻭځ ﻟ
0.ﺩ ﺭ
15Mg/ﯾKg
12Mg/ﺎﻮﻥdayﺎﺳ
ﺘﯿ
ﻣﺎﮑﺴ
ﯾﻪډﮑ
ﻟﺪﯾ
ﻮﮑﯿﺗ
ﺭﻮﮐ
ﻮﮐﻮ
ﻟﺩګ
ﯾﮏ
ژﻮﻟ
ﻭﺭﻮ
ﯿﻭﺩﻧﻮﯼﺍ
ﺗﺎﯾ
ﻧﺲﺯﺎ
ﻮﭼﻟ
ﺪﯿﺗﯽﮐ
ﺎﺪﯼﭘ
ﻧﻭﻭﻍﺩژﺭ
ﺎﺭﯼﺩﻧﻮ
ﻮﭘﯿﻧ
ﻭﻭﺍ
ږﺮﺷﭗ څﻪﺗ
ﻭ ﺧﺭﻮ
ﻟ
ټﯼ.
ﻩﺭټﯼ ﻭﺯ
ﺍﺪﻧ
ﺍﻮﻧ
ﻮﺗﯽﺷﺎ
ﭘ
ﻪﺪﻥﭘ
ﻮﺩﺑﺗﺎ
ﯾڅﻪﺯ
ﻩ ﺧ
ﻮﯾﺩﯾﻭﺎﻩﺍﻮﻪﯾﻩﭼﯽﭘﻩﺩﻩﭘﯽښ ﺩﻭ
ﺩﺎﻮﻧﺯﯾﻮﻠ
ﮑﺑ
ﻭﻮﺎﻫﻢﺩﺗﻣﻮﻠ
ﮐﺮﺑﻮ
ﺗ
ﮐځﯼ
ﻭﻻﻞ ﺮ
ﻮﻋﯽﻥښ ﻣﻮﺿ Sﻭﻣ
eiﺍ
zur
ﻮﻵﺩesﻤﻌ
ﻟﯽﺷﯽﻣ ﺪﯿﺩﮐﻮ
ﻮﺟ SpiﮐﯽﻣceOcuping
ﭘﺴﯽﯾﯽﺩﻮ
ﯾﺎﻮﺑ
ﮐږﯼﺧ
ﺪﻝ ﯽﯿ
ﻟژﻥﻟ
Contﯽr
asenhancedri
ﺍMRIﮐﯽﺩng ﮑﻦﻭ ﻪCTﺳ ﭘ
ﺭﯼﻭﯼ.ﻭ
ﺮﻩﺿ ﺭ
ﺎﭙ
ﻟﯿﺺ ﺗﺸﺨ
76
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﻼﺎ
ﻳﻣﺭ
(
Mal
ari
)a
:
ﻳﻒﺮ
ﻌﺗ
ﻪ
ﻨﻳﻭﺩښځ
ږﻱﺍ
ﻪ کږ
ﺗﻣﻦځ
ﺍﻪﺭ
ﺍﺳﻄﻪﻭﻳﻢﭘ
ﺩﻮﻣ
ﺯﺩﻼ
ﻩ چې ﭘ
ﻭﻏﻲﺩﺭ
ﺎﻳﻲﻧﺍ
ﻭﺯﻮ
ﺗﻭﺮ
ﻩﭘﻮﻼﺎﻳ
ﻳ
ﻣﺭ
.
ﺩږﻱ
ﻟږﻱ
ﻪﻲ څﻪﺑﻞﮐﺲﺗ
ﻩﮐﺲ ﺧﻮﻪﻳﻟﻪ
ﺍﺳﻄﻪﻭﺎﺷﻲﭘ
ﻴﻴﻞﻣﻓﺎ
ﻧﺍ
ﻩ
ﻩﺩﺭ
ﺎﻪﺍﺷ
ﻮﻥﺗﺘﻮﺷﮑﻳړ
ﻮﺍﻐﻮﻯﺩﻯچېﺩﻫ ﺘﻞﺷﻴﺴڅﻪﺍﺧ
ﺍ ﺧ
ﻮﺍﺏېﻫﺮﻪﺧﻟﻡ
ﻮ ﻭﻍۍﻧﺭ
ﺎﻧ
ﺩﻼﺎﺩ
ﻳﻣﺭ
ړۍکړﻪﭖﻤﻟﺴ
ﻭﻪﺍ
ﻪﭘﺗﺭﻩﻭ
ﺭ ﺎ
ﭙﻟړﻱځﻝﻡ
ﻮﻟﻡچېﺩﻮﻧﺍ
ﺩ،ﺩ
ﺩﻱﻮﻮﺟﻣﻦځﻣﺮ
ﺍﺗﻮۍﻭﺩﻫ
ﻭﻍ ﺍﺭﺎ
ﻧچېﺩ
ﺩ.
ﻮﻯ ﻯ
ړﻝﺷ ﺭک
ﻪﻭﻭﻏﻰﺗﺭ
ﺎﺍﺩېﻧﻮ
ﻮﭘﺨﻟ
ﺪﻧژ
ژﺮﭖﻻﻞﺗ
ﻩﺩﻣ ﻭﺭ
ﺎﮐﻮﻭ
ﻧﺎﻳ
ﻮﻟﺎ
ﺘﻳ
ﺍې
:
ﻪﻟﺭﺕﺩﻱ
ﺎﺒ
ﺭځﻱچېﻋ
ﻪﺍﺗ
ﻪﻣﻦځ
ﺍﺳﻄ
ﻪﻭﻮﭘ
ﻧﻮﻟ
ﻭﻭډ
ﺭﻮﻟ
ﻳﻢﺩڅ
ﺩﻮﻣ
ﺯﺩﻼ
ﻭﻏﻲﭘ
ﺭﺎﻧ
ﺍټﺍﺱې څﻪﺩ
ﻼﺎ ﺧ
ﻳ
ﻳﻢﻣﺭﺩﻮ
ﻣﺯﺍﭘﻼ
ﺍﻝﻭ
ﻭﻭﺍ
ﻳﻢﺩﻮ
ﻣﺯ،ﭘﻼﮐﺲﺍ
ﻮﻳﺍ
ﻳﻢﻭﺩ
ﻮﻣﺯ،ﭘﻼﻡﺭ
ﺎﭙ
ﻴﻠﺴ
ﻳﻢﻓ
ﺩﻮﻣ
ﺯﭘﻼ
ﻪﻮﭘﻧ
ﺎﻧ
ﺎﻧﺴﺍ
ﺎﺩﻴ
ﻭﺑﻪﺍﻮﺗ
ﻧﺎ
ﻧﺎ
ﻧﺴڅﻪﺍ
ﻮ ﺧﺗﺎ
ﻧﺍ
ﻮﻴﻪﺣﻩﻟﺭﺎ
ﭙړﻱځﻝﻟﻡﻮﻟ
ﻭﻏﻲﺩ ﺭﺎ
ېﺍﻧ
ږﻱچ ﺩ
ﮐﻞ کږ
.ﻩ
ﺪﻳﻮﻩﺷﺮﭙ
ﻪﺧ ړۍﺗټﻝېﻥ
ﻪ ﻭﻠ
ﻴﻭﺳ
ﻮﻫﮐﻝﻳ
ږﻱچې ﺮﺎ
ېڅﻪګڼﻝکږ
ﻪډﻝ ﺧ ﻮﻟ
ﻴﻭﻏﺭ
ﺎﺯﻱټﻱﻧ
ﺍﺮ
ﻩﭘﺭﻮ
ﻮﻏ ﻐﻮکېﺩﻫ ﻧﺎ
ﻧﺎ
ﻧﺴﻪﺍﻼﺎﭘ
ﻳﻣﺭ
%٤ﺩﺍ٠
ږﻱﻭ
ﻪکږﺘﭘېﺍﺧ
ګﻱﺮ
ﻮﻭړ ﻧﻮ
ﻠﻴﺩېﺑ
ﺮﺭڅﻪﺗ
ﻮ ﺧېﻪﻳ
ﻮک ﻟﻧﻭ
ﺩﺍﻭﻭﻮﻩﻟ
ﺩېﺏﻝﻻﺏﻝ ﻮﺭ ﻠ
ﺳ
ﻪﻧ
ﻮﻠ
ﻴﺩېﻣ
ﺮﺭڅﻪﺗ
ﻮ ﺧ ﻪﻳ
ﻟﺎﻝ
ﮐﺮﻪﻫ
ﻭ،ﻪﻣﻦځﻥۍﮐﭽ
ﻣﺦ ﻱﭘ ﺎ
ﻩﻣﺨﺮﺮﺳﺩﻼﺎﺩﺧﻄ
ﻳ
ﻴﺖ ﻣﺭ ﻌﻤړۍﺟﻥ
.ﺭړﻱ
ﻭﻪﺍﺗړﻦېﻣﻦځ
ﻡﻳ
ﺩ.
ﺎﻥ ﻱ
ﻴﻨ
ﻮﭼﺭېﮐ
ﻮﻮﻥﭘ
ﻠﻴﻮﻣ
ېﺮﻳ
ﻪﻣﺦ ﺗ
ﻟﻳﻲ
ﺎﺍﺣﺼ
ﻮېﻳ
W.ﺩ
H.ﻪﺩO
ﺮﺧﻪﺑ
ﺗﺎ
ﻳﺩړﻮﺯ
ﻨﻡﻳ
ﻭﺳﻲېﻭﺭﺍﺎﻴﻟ
ﺍ
ﺮﺘﺍﺳ،
ﺎﮑﻳ
ﺮﻣﺍﻟﻲﺎ
ﻤﻪﺷﮑﻟړۍﻠﻲﻥﻠﺘﻣﺨﺮﻪﭘﺩﻼﺎﭘﻲښېﭘ
ﻳ
ﻪ ﻣﺭﻠﺒ
ﻭﻪﮐ
ﭙﺲېﻩڅﻟ ﻟ
ﺮﭘ
ﺩ
ېﻻﻞﻱې
ﻩچ ﻣ ﻩﺩﺩﻮ
ﻮﺟ ډﻝﻣ
ﺎﻝ ﻭﻌﻪﻓﻭﺱﻫﻢﭘ ﻮکېﺍ ﻤﻴ
ﻩﺳ ﺭ
ﺎﻪﺣﻮﭘﻠﻲﺩﻱﺧﻠﻩﺗېﻪﻣﻦځ
کﻟ
ﻮﻠ
ﻣﺭﻮﺩﮑ
ﻧﻭژﻩﻭﺮﻩﺩﺣﺸﻮﻠﻪﭘﻠ
ﻪﺑﻭﻟﺪﻝﺍﻴﺗ
ﺎﻳ
ﺭﺯﺍټﻦګﻳﺖﺩ ﻳﺯﺍ
ﺮﭘ
ړﺪېﺩﻧ
ﺮﻭﺍﻮﭘﻠ
ﻣﺭﻩﺩﺩﻮﻠ
ﻩﭘﻮﻪﻳﻟ
ﻪځﺎﭘﮑﻳ
ﺮﻣﻭﺍﺎﺍ
ﭘﻭﺭ
ﺍﺩﺩﻟږ
ﻳﺖ ﻲﺯﺍ
ﺮﭘډﻝﺩ
ﻳﻲ ﻭﺍﻪځ ﻪﭘﻠ
ﻪﮐﻠﺩ،ﮐ
ﺭﻯ ﺍېټﻦګ
ﻧﮏ ﻳ ﻭﺩږ
ﻟﻲړﺪېﺩ
ﻧ
ﺮﻭﺍ ﭘ
.ﻮﻱﻪﮐﻧ
ﻭﺪﻧﺭګﺍښڅ ﻭ
ﻩﺩګ ﺭﺎ
ﭙﻟﻮﻧ
ﻭﺩﺍ
ﻭﻭﺩېﻩ
ږﻱچېﺩ ﺪﻝکږ ﻴ
ﻟﻮکې ﻤﻴ
ﻭﺳﺘﻲځﻭﺧ ﺍﺑﻲ
ﻮﻨﻮﺟﻨﻳ
ﻭ
ﻟړ
ېڅﻪﻱېﻮ
ﻪﺳﻄﺢ ﺧ ﺮﻟ
ﺑﺤﻩچېﺩﺭﺎ
ﭙﻮﻟﮑﻠ
ﻮﺩﺧﻤﻴ
ﻮﺳﻐﺎﺩﻫ
ﻮﻳﻤﻴﻩﺳ
ﺭﺎﺍﺩﺣ
ﻮﻳېﺧﻪﻮﻼﺎﻟ
ﻳ
ﻣﺭ
ﻭ
ډﻭکﻮﺍ
ﮑﻠﻮﺩﺧ
ﻤﻴﻮﺳ
ﮑﻴﻤﻳ
ﺪﻧﺮﺍ
ﻴﻩﺩﻏ
ﻮﻠﻪﭘ
ﻠﻪﺑﻭﻟ
ﺪﭘﻲټﻯﺩﻯﺍﻧﻭ
ﺭﺭېﻭﻱﺩﻮﻭﭘﺮ
ﺘ١ﻣ٥
٠ﺗ٠
ﻟﻰﺮﺍ
ﺩ.
ﺮﻯ ﻮﻯﺧﻄﻟﻩﺭ
ﺎﭙ
ﻟﻮﻟ
ﺍ
ﺎ
ﻴېﻮځﻝﺑ
ﻠﻲﻭ ﻳ
ﻠﻩﺗېﻪﻣﻦځ
ﻪک ﻟﺩﻼﺎﭘﻲښېﭘ
ﻳﻮکېچې ﻣﺭ ﻤ
ﻴﻮﺳﻐېﻪﻫ
ﻮک ﭘﻴﺘ
ﻭﺳ ﺭ
ﺍﻭﻪﺩﭘ
ﺪﻝﻴ
٣ﭘﻲښېﻟ٠٠
٠ﻮکې٠ ﻨ
ﻳﺮﻓ
ﺎﻪﻣﺴ
ﻮﭘﻧ
ﻭﺩﺍ
ﻭﻭﻮﻩﻠ
ﻠ
ﺘﻣﺨﺮ
ﭘډﻝﺩ
ﻨﻲ ﻭﻠ
،ﻪﮐ
ﻩﭘﺪﻳ
ﻮﺪﻝﺷﻴﻏﻲﻟﻭﺭ
ﺎﻧ
ﺍﺩ
.
ږﻱ
ﻻﻞکږﺩړﻦې ﻣ
ﻮ ﻡﻳﻨ
ﻮﺗﻧ
ﻭږﻱچېﺩﺳﻞګکږ
.
ﺩ(
%٤ﻱې PFﻱ
٤ﻮﻱ)
ړﻯﺷ
ډکﺍ
ﺭﺎﮑ
ﻳﺭېﺭ
ﻮ١ﭘ
٠٠
ﺗ٠
ﻠﻦۍﭘﻲښېﺮ
ﻭﻍۍﮐ
ﺭﺎﻧ
ﺎکېﺩ
ﮑﻳﺮ
ﻣﺍﻪ
ﭘ
ﻧﮏ
ﻮﻠ
ﺗﺍ
ﻪﺭڅﻪﭘ
ﺮ ﺧﻬ
ېﻪﺑ
ﻪﻱ ﻟ
ﺮﺧﻩﺑ
ﺮﻳږﻱچېډ
ﺭېﭘﻲښﻱ
ﻮ٢ﭘ
٠٠ﺗ٠
ﭘﻲښېﺮ
ﺍﺎﻥکېﺩ
ﺘﻟﺴ
ﻪﺍﻥګ
ﭘ
.ږﻱ
ﺪﻝکږﻴﻟ
ﻭکېﻭ
:
ﺰﺱﻴ
ﻨﻮﺟ
ﺘﻭﭘ
ﺍﻪﻧ
ﻮﻠ
ﻣﻻ
ﻳﻢ
ﺩﻮﻣ
ﺯ،ﭘﻼ
ﮐﺲﺍ
ﻮﻳﺍ
ﻳﻢﻭ
ﺩﻮﻣ
ﺯﺩﻼ
ږﻱچېﭘ
ﻻﻞګڼﻝکږ
ﻭﻍۍ ﻣ
ﺭﺎﻧ
ﺩﻼﺎﺩ
ﻳ
ﻪ ﻣﺭ
ﻟﻭڅﺭډ
ﻮﻳﻢ ﻟ
ﺩﻮﻣ
ﺯﺩﻼ
ﭘ
77
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
څﻪﻱېﭘ
ﻮ ﺧﻧ
ﻮﻟ
ﻭﻪډ
ﺗﺭﻮ
ېﻪﭘ
ﺭﺕﺩﻱچ ﻟ
ﺎﺒ
څﻪﻋ
ﻡ ﺧ
ﺭﺎﭙ
ﻴﻠﺴ
ﻳﻢﻓ
ﺩﻮﻣ
ﺯﺍﭘﻼ
ﻼﺎﻭ
ﻳ
ﻳﻢﻣﺭﺩﻮﻣ
ﺯﺍ،ﭘﻼ
ﻭﻝﻭﺍ
ﺩ.
ﻻﻞ ﻯ
ﺮﻣﺘﺩړﻦېﺳ
ﻡ ﻡﻳ
ﺭﺎﭙ
ﻴﻠﺴ
ﻳﻢﻓﺩ
ﻮﻣﺯ
ﻼ
ﺩ:
ﻮﻱ ﻱ
ﺩﻝﺷ
ﻭﻭې ښ
ﺎﻴﺗ
ړځﻥګ
ﻮﺍﻧ
ﻮﻤﻳ
ﺩﻮﻣ
ﺯﺩﻼ
ﻭﻝکېﭘ
ﺪ(ﺟ
٦-٢
ﭘ)ﻪ
ﻳﻢ ﻣﻼ
ﺩﻮﻣ
ﺯﭘﻼ ﻳﻢ
ﺩﻮﻣ
ﺯﭘﻼ ﻳﻢﺩ
ﻮﻣﺯﭘﻼ ﻳﻢ
ﺩﻮﻣﺯﭘﻼ ﻭې
ﺎﻴﺗ
ړځﻥګ
ﺍ
ﺎﻳ
ﺭ ﺍﻝﻭﻭ
ﺍ ﮐﺲﺍﻮ
ﻳﺍﻭ ﻡ
ﺭﺎﭙ
ﻴﻠﺴﻓ
١
٠ ٩ ٨ ٥
،ﻪ ﻣﻦځ کې ٥
ﺭﭘﺩځﻱګ
ځ(
)ﺭ ې
ﻡﻭﺍ
ﻭﺩ
١
٥٠٠
٠ ١
٥٠٠
٠ ١
٠٠
٠٠ ٣
٠٠٠
ﻪ٠ ﻧ
ﻮﺘﻳ
ﻭﺯﻭﺮ
ﻴﺭﻣﺷﺭ
ﻪ ﻢ ﻐ
ﻫ
ﺘﻦﻨ
ﻮېﻣ ﻳ
ﺭﺩچېﺩځﻱګ
ږﻱﺩﻱﺍ
ﺯﺍېڅﻪ
ﻧﮏ ﺧﻭېژ
٧
٢ ٥
٠ ٤
٨ ٤
ﻮک ٨
ﮑﻧﻭ
ﻭژ ﺮ
ېﻪﺳﻳﻦ ﭘﻭ
ﺩ
(ﺎﻋﺖﻡ)ﺳ
ﺍﻭېﺩ
ﺱې ژ
ﺯې ړﻳﺖ ړ
ﺎﻮﺳ
ﻟﻮﮑ
ﻴﺘﻳ
ﺍﻥې ژ ﺭﻭﻧﮏ ځﻭﺍﻥې ژﻭﻮ ځ
ﻧﮏېﺧ
ﻭﺳېژ
ﻳﻦې ﺮﻭﺩ
ﻧﮏې
ﻭ ﻧﮏې چېﮐﻻﻯ ﻭ
ﺎ ﻮ ﻣېﺍ ښﻝ
ﻭ
ﺮﺮ ﻱېﺗﻤ
ﻪﻋ ﺮﭘﻤﺮﻋ
ﺷﻲﺩﻫ
ﺭﻮ
ﻭﭘﻭځ
١ﺭﺪ٤ ﻳﺮ
ﻭ ﺑ ﺮ
ﺣﺠ
ېﻭﻱ ﻭړﻱ
ک
ﺎ
ﻳ ﻥښﻲ
ﺗ ﻩژ
ﺮﻪ ﺳﻨﺘ
ﻨﻣ ﻨﻈﻢﻣ
ﺮﻴ Riﻏ
ﻩ ng ﺮ
ﺗﺎ
ﻳﺯ ژﻱ
ﻮﻟﻮ
ﻓﺭﺎ
ﻣ
rect ﻭa
oangul ﻩﺍﻪ ﻍټ
ﮑﻧﮑﻞ ﻍټ ﻭ ﮑﻞ ﺩکﻝﻝې ﺷﺷ
ﮑﻞ
erﺷ ﻮﻱﻭﻱﻴﻀﺑ ،
Riﻪ ng(ﭘ)Banana
ﻮﺕ ﻳ
ﺯﻮﻓﻭﺮ
ګﺗ ډﻝ
ﻭ
ﻩژﺮﻩﺳ ﻪ ﻍټ ﻧ
ﻮﺘﻳ
ﺎﻮﺳﺘﻴ
ﻣﺍ
ﻭﻪ ﺍ ﮑﻧ
ﻭ
schuffi
ner
'sdots
ﺭﻱ
ﺍﻮﺭﻧﺼ
ﻮﺭﻱ ﺗ
ﺍﻮﻩﻧﺼ
ﺭﺎﻴ
ﺭﻱ ﺗ
ﺍﻮﺯړﻧﺼ
ﻱ ﺭ
ﻮﺗ ﺎﻍﺭﻥګ
ﺒﺩﺻ
ﺮﻱ
ﻠﻧ ﺮﻱ
ﻟ ﺮﻱ
ﻟ ﺮﻱ
ﻠﺍک ﻧ
ﻭﺩﻥېځ
ﺭﺩ
ﺭګځ
ﺎﺍ
ﻴﺑ
ﺩ
ﻪﺩچچ ﺪﻥﺗﺎﻥﺑﻧﺴ
ﺍﺎﺷﻰﺩ ﻴﻞﻣ
ﻓﺎﻧ
ﻪﺍﻨﻳ
ﻪچې ښځ ﻠږﻱﮐﺎﻝﭘﻲښﻱ ﻬﻪﻣﻐﺩﻝﻫﺘﻦ کﺩﻨﺎﻥﻣﻧﺴﺍ
ﺩ
ﺎ
ﻴﻪﺑﺘ
ﻭﺳ ﺭ
ړﻱچېﻭ ﻪک ﻨ
ﻧﻭﻱټﺩﺯﻭﺭﻮ
ﭙﻳﻢﺳ ﺩ
ﻮﻣﺯ
ﺩﻼ
ﻏېڅﻪ ﭘ
ﻪﺪ ﺧ ﻴﺑ
ﺎﻌ
ﭙﻞېﻟ ﻪﺧ ﻭﺧﺖﻟﺮﻮﭘﻠﭼ
ړﻝېﻪﻭ
ﺭېﻳﻦ ﺗ ﻪﻻﺍﻥﻟﺭﻭﻳﻦېﺩﺩﻭﻩﺩﺮﻪچټکۍﺳ ﻡﭘﺰﻴ
ﻧﺍ
ﺭګﻭﻴﮏﺍﭘﻮﮑﻭﺳﺮﮑ
ﻳﺎﻩﻣﺪﻧ
ﻮځﻪﺧ ﺩﻏ
.ﻮﻱﻴﻞﮐﺮښﺕﭘ ﻳ
ﻭﺟﻲډ ﺯﺮﻴ
ﻪﻏﻪﭘﺘ
ﻭﺳ ﺭﻮﻭﻠ
ﺗﻮﻨ
ﺮﻧﻪﺗ
ﻴﻢﺗﻧﺸﺍﺭ
ﺎﺭﭘږﻱﻭﺩځﻱګ
کږ ﺍ
ﻳﺶ کې
ﻧﻲﻭ
ﻭﻭګ
ﺮﻴﺎﻣ
ﻧﻲﻳ
ﻭﻭګ
ﺰﻴ Prﺷ
eer
ythr
ocy
tiIﺎc
ntﻳ
rahepat
iﻪc
ېډﻝﭘ
ﻪﺩ ﻭ
ﭘ
78
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﻪ
ﻮﭘﻟﺩ
ﻭﺎﻮﺩﭼﮑﻧ
ﻭژﺭﺩ
ﻱﻭﺩځﻱګ
ږﺍ ﺟړﻱ
ﻪ ﻮ ﻧ
ﻮﺘﻳ
ﻭﺯﻭﺮ
ﻴ٣ﻣ٠٠
٠ﺗ٠
١څﻪﺮ
٠ﺧ ٠
٠ﺧ٠
ﻭﻱټڅﻪ ﺯﻭ
ﺭﻮﭙﻮﺳﻳ
٤څﻭﺩ٨ ﻮﻱﺍ
ﻪﮐﺘﻪﺍﺧﮑ
ﻧﻭﻩژ
ﺮﻳﻦېﺳﻭږﻱچېﺩ ﻮﻱﻪﻟ
ﺍﻥﺗﺭﻭ
ﻪﺩﻧ
ﻮﺘﻳ
ﻭﺯﻭﺮﻴ
ﻩﻣﺪﻧﻮځﻪ کېﺧﻠﻳ
ﺎﭘ
.
ﻮﻱﻪﮐﻧ
ﺪﻴﺗ
ﺎﻳ
ﻩﺯﺪﻨ
٢ﭼ ﺗ٠
٦څﻪﺮ
ﻩکې ﺧ ﺩﻮﻪﻣﻮﭘ
ﻧﻮﺘﺎﻋ
٧ﺳﺗ٢ﻪﺮﺧ
ﻪﺩځﻱ ﻧ
ﻮﺘﻳ
ﻭﺯﻭﺮ
ﻴﺭﻣﺷﺭ
ﻮ ﻢ ﻩﻳﻪﺩﻨﮑ
ﻤﻮکېﻣﻧ
ﻮﻟ
ﻭﻪډﺍﻝﭘ
ﻭﻭﻳﻢﺍﺩ
ﻮﻣﺯ
ﺍﭘﻼ
ﮐﺲﻭ ﺍ
ﻮﻳﺍ
ﻳﻢﻭﺩﻮ
ﻣﺯﺩﻼ
ﭘ
ﺰﻳ
ﺩﻭﻪﺩﭘ
ﺎﺕېﺷﻲ) ﻩﭘﺪﻴ
ﻩﺑﺭﺎ
ﭙﻟﻮﻭﺧﺖﻳﻱﻭﺩ
ړﺍ ﻪکﻧ
ﻪﻭﻨﻳﺸﻩﻭﺮېﻪچټکۍﺳ
ﺭﻪﻣﻦځک ﭘګﭘ
ﻳﻲچﺍﻳﺖﻭﻭﺯﻮ
ﻨﭙﻴ
ﻪﻫﮑﻞﺗﻩﺷﺪ ﻴ
(چېﺩېﺑﺎﺕ
ﻳېڅﻪﺯ
ﻪﺩ ﺧ ﻟﺎﻭﻳ
ﺍﺗﮐﻪ
ﻟ
څﻪﺮﺎﻮ ﺧﻴ
ﻧﻭﺍﺩې
ډﻝﺩﺭﻭ
.
ﺭځﻱﻻﻞګ
ﺪﻥې ﻣﻳ
ﺭځﺍګﺭ
ﺎﻴ
ﺑﺍﺩ
ﺪﻤېﻫ
ﻮځﻝﻭﻱ
ﻭﻳﺍ
ړځﻰ ﭖ
ﺭﻣﻦﻧ
ﻮ کېځﻱګ
ﻧﻮﻟ
ﻭﻪډ
ﻼﺎﭘ
ﻳ
ﻳﻢﻣﺭ
ﺩﻮﻣ
ﺯﻭﭘﻼ
ﻡﺍ ﺭ
ﺎﭙﻴ
ﻠﺴﻳﻢﻓﺩ
ﻮﻣﺯ
ﺩﻼﺎﭘﻣﺍ
(ږﻱﺟړﻱ
ﻪﻮ ﻳﺖﻧﻭ
ﺯﻮﻨ
ﭙﻴ)ﻫ
ټﺭ
(ﺭﺳﭗ ﻭ
ﺮﻥ)ﺳﻄﺢېﻴ
ﺮﺳګﻭﺑ
ځﻥ ړ
ﻪﺍ ﻐ
ﻪﺩﻫﻧ
ﻭﻭﻱټﺯ
ﻭﺮﻴ
ﻪﻣﺘ
ﻭﺳ ﺭ
ﻮﻭﺗ
ﻮﻨﺮﻧ
ﻪﺗﺍﻥﺗ
ﺭﻭﻳﻦېﺩﻭ
ﺩ
.ږﻱ
ﻟﻲﺪ
ﻳﺖﺑﻭﺯ
ﻮﻓﻭﺮﻪﺗ
ﻱﻭﭘ
ﻮﻱځ ﺍﻨ
ﺮﻱﻧ
ﻟځﻯ
ﺮﺍﺮﺳﻧﮏېﭘ
ﻭﺮېژﻪچېﺩﺳﺘﺮﺳﻪﻣﭘ
FyFﻭb
yﺍ Dﻥټﻱﺟﻦﺩa ufﺍf
yBloodGrﻪoupﻧﻭ
ﺭﻮﺘ
ﭙګﻯﺭﺳ
ځﻥ ړ
ﻪﺍډﻝکېﺩﻏPﻪ ﻭ
.ﭘ ﺩV
Duff
y Fyﺘﮏېﺩa ﻮﺳ
ﺭﭘﻮﺎﺗﮑﻳ
ﺮﻣﺍ
ﻭﺩګﻱﺍ
ﺭﻭړ ﺷﺭ
ﺎﺕ ﻢﻳﺎﺯ
ﻘﻳ
ﺮﻓﺪﻱځېﺍ
ﻳﻮﻟ
ﺍچېﺩﻭﺩﺩﻱﺍ
ځﻯ
ﻮﺍ ﺗ
ﻮﻨﻧ
ﻪﺩﻳﺖﺗﺯ
ﺍﺮځﻪچېﭘ
ﺮﻱ ﮐﻟﺭﺍ
ېټﻦګ
ړﺪ ﻳﻧPﺮﻭﺍ
.ﭘﻮﺩVﻧﮏېﺩﻱﻧﻭﺮ
ﻟNegati
veFhb
.
ﻪﺘﻧﺸ
ﻪچ ﻧﻮﻟ
ﻭ(ډRiﻪ)ngﺗﺭېﻪﻭ
ﻭﺕ ﺗ ﻭېګﻳﺖ ړﺯﺍ
ﺮﻭکېﭘ ﺍ
ړړﻱﭖ ﻡﻮﻟېﻪ
ېﻪﻣﻦځک ﭘ ﻧﮏ ﭘﻭﺮېژ ﺩﺳ
ډﺮﻳﺖﻍټﺷﻲﺩﻫ ﻭﺯﻮﻓﻭﺮﻩچېﺗﺮﻣﻭﻭ،څ
ﺟړﻱﺎﻥﻭﻱ ﻮﻮﺷ ﻩﻳﺮﻮکېﺳ ﻧ
ﻮﻟ
ﻭ ﻭډﺭﻮﻟ
ﻪڅ ﺩﻼﺎﭘ
ﻳ ې ﻣﺭ
ﺮﻴ
ﻮﻏ ﻳﺖﻳﺯﺍ
ﺮ،ﭘږﻱ
ړکږ ﻭﻭﺪﻴﻟ
ګﻦټﺩډﻝچېﭖ ﻣ ﻱﻪﺩې ﻭږﭘ ﺪﻱﻧ
ﺭګ ﺭڅ
ﻪﺍ ﻧﻮﻧ
ﻮﻟ
ﺪګﻱﺑځﻥ ړ
ﻭﻝ ﺍ
ﻩکې ﺩﻮ
ﻪﻣ ﻮﭘﻧ
ﻮﺘﺎﻋ٧ﺳ٢ﻩکې) ﺩﻮﻪﻣﻮﭘﻧﻮﺘ
ﺎﻋ٤ﺳﻭﺩ٨ ﻮﻱﺍﻩﮐ ﺭﻮﮑﻞﻏ(ﺷ Amoeboi ﻨﻈﻢ)d ﻣ
ﺮﻑ ﻪﻣﺼ ﻪﭘﺍﺳﻄﻪﻭﻳﺖﭘ ﺯﺍﺮ
ﭘﻴﻦﺩﺑﻮ
ﻟﻮګﻤﻴېټﻝﻫ
ﻧﮏ ﻭ ﻭﺮېژ ﺩېﺩﺳ ږ(ﻥﻩﺭﺎﭙ
ﻟﻼﺎ
ﻳ
ﻳﻢﻣﺭ ﺩ ﻮﻣ
ﺯ ﺩﻼ
ﭘ
،
ږﻱﻳﻞ کږ ﻧﺖﻭﺍﺰﻴ
ﻭ کېﺷ ﺍړ
ﻪﺩېﭖ ﻪﭘﺗ
ﺭﻮﻭﻭﺱﻧ ﻴﺴﻲﺍ ځﻯﻧﺮﺍ ﻳﻧﮏېډ ﻭﺮېژﻱﻭﺩﺳږﺍ ﺭﺳﻲ
٢ﺮ
ﻭڅﻪ٤ﺗﻭﺭ ﺧ ﻮﻱﺍﻪﭼ ﮑ ﻧ
ﻭﺮکېژ (ﻪﺍﺧ
SchiﭘzogonyorMer ogonyﻮﻱ) ﻪﮐﻨﻳﺸﻮﻱﻭ ﺘﻫﺴ
ﻪﺗ
ﺭ ﻮﻱﻭﭘ
ړﺍ ﻪک ﺘ
ﺍﺧﻪ ﮑﻧ
ﻭﻩژﺮﻧېﺳﺮﻱچېﻮ ﻟ
ﺍکﻭﺩځ
ﻳﺖﺍ ﻭﺯﻭﺮﻴﺮﻣږﻱچېﻫ ﺩﻱﺍﺯ
ﺍﻪﻧﻮﺘﻳ
ﻭ ﺯ
ﺮﻴ٣ﻣ ٢
:
ﻪﮑ ﺩﻟﺍﻮ
ﺭﻣ ﺷﺭ
ﻮ ﻢ څﻪﻳﻭ ﺧ ﺪﻳﺩ
ﻭﺎﻧﮏېﺩﭼ ﻭﺮېژﻳﻞ ﺷﻲ چېﺩﺳ ﻭﺪﻭ ﻳ
ﺎړﻱﺑ ﺭک ﺍ
ﺮﮑﺍﻥﺗ ﺭﻭﺩ
ﻪږﻱﻭﭘ
ﻻﻞ کږ ﺍﻭﻣ ﺪﻴﻟﺎ
ﻌﻓﻮﺩﻧﻭژ
ﺎﻓﻭﺮ
ﮐﺎﻣ
ږﻱچېﺩ ﺩﻱﺍﺯ
Glﺍ ycosylphosphat edyloinositol
ﺯېړﺩ،ﻝﺩ
،ﺭ ﺒﻲﺗ
ﻪﺩ ﻧ
ﻮﻨﻴﮐﺴﻮﺘﻳ
ﺎﺍﺳﺪﻤږﻱچېﻫ ﺩﻱﺍ
ﺯﻮکﻥﻥﺍ ﺘﻳﺎ
څﻪﺳﻮ ﺧ ﻧﻭژﺎﻓﻭ
ﺮﮐﺎ
ېﻪﻣﻪک ﻟ ﻠﻳ
ﺎﭘ
.
ﺮﻱﻟﻴﺖ ﻟ
ﺆ ﺅﻣﺴﺎﻴﺗ
ﺪﻧﺭګﻴﮏېڅ ﻨﻴﻠ
ﻭﮐ ﺭﻮﻭﻧﺍ
ﻮﻪﺟﻧ
ﻮﺘﻴﻣﺍ
ﻪګ ﻨ
ﻳﻭ ښځ ﻪﺍﻨﻳ
ﺭﺎﻌﻦېﻧﮑﻞﻳﻭﺟﻲﺷﺍﺧﻞکېﺯ ﻪﺩﻮﭘﮑﻧ
ﻭﻭژﺮﻪﺩﺳ ﻧ
ﻮﺘﻳ
ﺯﺍ
ﺮﺭﭘﺭﻮﺷﻢﻳ
ﻮﻤ
ﻠﻪﮐ
ﺎﺷﻲﭘ ﻴﻣ
ﻭﺩ ﻠﻲﺍﻪﺍﺧﻧﻮﺘﻴﻣ
ﺍﺩګ
ﻮﺍ ﻪﻭچچﭼﻞﺷﻲﻧ ﺍﺳﻄ
ﻪﻭ ﺎﺷﻲﭘﻴﻣ
ﻪچېﺷﺨ ﺺﺩ ﻠﻭ،ﮐ
ړﻱ
ﻪﺘ
ﻭﺳﺭﻮﻱچېﻭ ﻟﻭﺕﺗﺸﮏﻝ ﺍﻱګږﻱﺯځﻯ کږ
ﻮﺍﻪﻳﻧ
ﻮﺘﻴﻣ
ﺍﻪګ ﻨ
ﻳﻭ ښځ ﻪﺍ
ﻨﻳﺭ
ﺎ(ﻧMedgutکې)
ﻮﻱﻩﭼﺮﺎﻻﺧ
ﺮﻱﺑﻟﻪ ﻧ
ﻮﺘﻳ
ﻭ ﺯ
ﻭﺮﻴ١ﻣ٠٠
ﺩې٠ږﻨﻲﻥﺘ
ﻭﺳﺭېﺍﻭ
ږﻱچ ﺩ ﺟړﻱ
Oocyﻮ tﺎeﻴ
Oﻭﺑ
okiﺍnet
.ږﻱﺭېﺭﺳﻲ ﻪﻻﻟﻤﻒﻟېﻭ
ﻳﻦ ﺍﻭ
ﻪﺩ ﻮﺗﺗ
ﺍﻭ
ﺪ ﻭﻏړ
ﺎﺷﻲﺩﻻﻴﻣﻪﺩﻧﻮﺘ
ﻳﻭﺯ
ﻭﺮﻴﻭﻣﺍ
ﻮ
ﻠ٥ﮐ
ﺗ٠
ﮐﻻﻯﺷﻲﺮ
ﻭ PMﻮ
ﮐﻝﺍ
ﻴﻢﺎ
ﻧﻮﻳ
ﺎPF،ﺩ
ﮐﻮ
ﻩﻟﭘﻦځ
PﻭPOﺩ
ﺭﺕکې Vﺍﻮ
ۍﻪ ﺻ
ﻠﻦ ﭘﻣ
ﺭﺩﺎ
ﻧﺩ
.ﻭړﻱ
ﺪ کﻧ
ﻭﺩکېژ
ﻮﻪﻭﺟﺎﻥﭘ
ﻧﺴﺍ
ﺭېﺩﻮﭘ
:
ﻮﺟﻲ
ﻟﻮﻤ
ﻳﺪﻴ
ﭘﺍ
ﺩﻼ
ﻮﭘﺭځﻱ ﺧ
ﻪﺍﺗ
ﻮ کېﻣﻦځ
ﻤﻴﺩې ﺳ
ږﻪﻥ
ﻮﺗﻣ
ﺭﻭګ
ﻮﺍﻣ
ﺭﻮګ
ﻟﻭﻪټ
ﺩېﭘ
ږﻭﻍۍﻥ
ﺭﺎﺩﻼﺎﻧ
ﻳﻣﺭ
79
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﮐﺲﭘﻲښې ﺍﻮﻳﺍ
ﻳﻢﻭ ﺩﻮﻣﺯﺩﻼېﻭ ﭘ
ﺘﻲ ک ﺍ ﻳﺎ
ﻭﻫ ﻨﻲﺍ ﻳﻮګ ﻴ
،ﻧ ﺎ
ﻘﻳ
ﺮﻓ ﻪﺍﻡﭘﻲښېﭘ ﺭﺎﭙﻴﻠﺴﻳﻢﻓ ﺩﻮﻣﺯﺍ
ﺎ
ﻴﺰېﺍﺳ ﻴﺘ،ﺧ ﺎ
ﮑ ﻳ
ﺮﻣﺑﻲﺍ ﻮﻨ
،ﻪﺟ ږﻱﭘ ﺪﻝکږ ﻴﺎﺕېﻟ ﻳﻪﻭچېکېﺯ ﻳﻮﻪﻟﺪﭘ ﻨﻭﺩﻫ ﺎﺍﮑﻳﺮﻣﺰﻱﺍ ﮐﺮﻪﻣﭘ
ﻪﻭﻱﮐﭽ ﺎ
ﻪﻣﺴ ﺩېﭘ ږﻡﭘﻲښېﻥ ﺭ
ﺎﭙﻴﻠﺴﻳﻢﻓ ﺩ ﻮ
ﻣ ﺯﭘﻼﻭﮐﺲﺍ ﺍ
ﻮﻳﺍ
ﻳﻢﻭ ﺩﻮﻣﺯﺩﻼﻪ کې ﭘ ﻴ
ﻮﺳ ﻧﺎﻴ
ﻗﻭﺍ ﺍ
.ږﻱ
ﺪﻝکږ ﻴﻟ
ﻭ Sub ﺎﺍﻘﻳﺮﻓﻪﺍګﻱﻮګﻫﺦﭘځﻥ ړ ﺗ ېﻪ ﺍﻮک ﭘ ﻤﻴﻮﺳ ﮑ ﻤﻳ
ﺪﻧﻭﺍﻟړ
ﻪﻮ ﻼﺎﭘﻲښېﭘ ﻳﻳﻢﻣﺭ ﺩﻮﻣ ﺯ
ﺩﭘﻼ
ﺍﻝﻭﻭﻳﻢﺍﺩﻮﻣﺯﺩﻼ،ﭘ ږﻱږﭘﻲښﻱ ﻪﻝ ﻠ
ﺗﺮﻪﭘ ﻮﭘ ﻧﻮﻟ
ﻭ ﻭډﺭﻮ ﻧ
ﻮﺩ ﺮﻱﺧ ﻮﻥﻟ ﺘﻮ کېﺷ ﻤﻴ
saharﺳ an
ﺩﻼﺎ
ﻳﻭ ،ﻣﺭ ﺟړﻱﺎﺕېﭘﻲښې ﻮ ﻳ%څﻪﺯ
ﺰﻱﺩﻱ چېﺩ ١ﺧ ﻳﺩ
ﻭﺮﺩ ﻴ
ﺮﻏ ﻬڅﻪﺑﺎﺧ ﻘﻳﺮﻓﻪﺍﭘﻲښېﻟ
ﺪﻝک ﻴﻟﻪ ﻧ
ﻭﺮﻴﭘﻮﻣﻦځﻫﻢﺗ ﺮﻮﺗ ﻤﻴﺩېﺳ ږ
ﻭﻭﻥ ړﺍ ﻭﻭ ﺮ
ﻳﺘﻰﺩډ ﻩچېﺣ ﻠﻲﺩ ﻴﭽﻩﭘ ﺮﻳﻮﺟﻲډ ﻟﻮﻤﻳﺪﻴﭘﺍ
ږږ
ﺪﻝک ﻴﻟۍﻪ
ﻭﻍ ﻧ ﺭ
ﺎﻧﺍﻪﺩﺘﻠ
ﺮﻱﻫ ﻟﻟﻰﻭ ﺍ
ﻭﻟړ
ﻭﻮ ﺮﺘ٢ﻣ ٠٠
ﺗ٠
څﻪﺮ ﺭ ﺧ ﺪﻨﻤېﻪﺳﻴﻢېچ ﻟ ﻪﺳ ﻐﻮﻫ .ﺧ ږﻱږ
.ﻱ
ﻪﭘږﻱ)
ټﻞکږ ﻪﻣﺦېﺍ ﮐ ﻟﻟﻲﺍﻭﺭﻱﺩﻍټ ﻮﺗﺎﺩ ﻪﻳﺎﮐﭽ ﻴﻤﺘﻳﺯ
ﺍﺭﺎﭘ
ﻩﺩ ﺭﺎﭙ
ﻟ ﻮﻟ
ﺩﻭﺘﻲﺩښ ﻤﺴ ﻳﺪ
ﻧﺍﺩﻼﺎﺩ
ﻳﻣﺭ
ﻮږﻭﻱﻧ %څﻪﻝ ١ﺧ ﻟﻲﭘﻲښېﺩ٠ ﺍﻭﺭﻱﺩﻍټ ﻮﺗ
ﺭېﺩ ﺭ
ﻪچ (ﮐﻮﻱړﻝﺷ ﻮکېڅﻱ ﻧﺎﻴﻨ
ﻮﭼ ﻮﮐ ﻨﻠ
٩ﮐ -
٢
ﻣﻦځﻭﻱ ﺮ%٧ﺗ ٥-
٥ﺭې١ ﺭﻪچ ،ﮐ ﻴﮏ ﻤﻳ
ﺪﻧﺍﻭﺰﻴﻣﻦځﻭﻱﻣ ﺮ%٥ﺗ ٥-١ﺭېﺩ١ ﺭﻪچ ،ﮐ ﻴﮏﻤﻳﺪ ﻧ
ﺍﻮﭙﻳﺎ
ﻫ
.ږﻱﺩﻱ ﺎ
ﻡﻳ ﻮﻪﻧﻮﭘ ﻤ
ﻴﻴﮏﺳ ﻤﻳﺪﻧﺍﻮﻟ
ﻮﻮﺩﻫ ﺗﻲﻭﻱﻧ ﺎﻳ%څﻪﺯ
٧ﺧ ﻟ٥
ﺭېﻪ ﺭﻪچ ﻭﮐ ﺍﻴﮏ ﻤﻳ
ﺪ ﻧﺍ
ﺮﭙﻳﺎ
ﻫ
ﺩﻼ
(ﭘ ﻨﻲ ﻳﻮګﻴﻧﺎﻴﻢېﻳ ﻣﻲﺳ ﺭﺎګ ﻘﻳﺮﻓ
ﻪﺍ ﮑﻟﻮ کې) ﻤﻴﻴﮏﺳ ﻤﻳ
ﺪﻧﺍ
ﻮ ﻟ
ﻮ ﻭﻫ ﻴﮏﺍ ﻤﻳډﺍﻥﺮﭙﻳﺎ
ﻪﻫ ﺍچېﭘ ﺩ
ډﻝ
ګﻱ ﻭځﻥ ړﻪﺍ ﻴﺖﭘ ﺑﻮﻴﻌﻭﻣ ړﻪﺍ
ﻨ،ﻡﻳ ږﻱﺘﻦکږ ﻨ
ﺭﻣ ﻠﮏژ ﻪﻭﻱﺧ ﺗﺎﻳﻪﺯﻧﺪﻳﺩﻟږ
ﻡﻲ ﺭﺎﭙ
ﻴﻠﺴﻳﻢﻓ ﺩﻮ ﻣ
ﺯ
ﻭﻍۍ ﺭﺎ
،ﺩﻧ ږﻱ
ﻪکږ ﺘﻼﺎﺍﺧ
ﻳﻪﻣﺭ ډﻝﭘﺭﻱ ﻭ ﺍﺮﮑګﻱﻪﺗ
ﻴﻢېﻭړ ﭘ ﺩېﺳ ﻭﺩ ﺮﻭﻱﺍ ﻳ
ﻮکېډ ﻧﺎ
ﻣﻮ ﺎﺷﻪﻣﭘ
ﻭﻴﮏﺍ ﻤﻳډﺍﻥﻮﻟ
ﻮﻪﻫ ﻭ،ﭘﺮﺿﻲ ﻱ ﺮﻋ ﻴﺎﻥﻏ ﻭﻏ ﺭ
ﺎﻩﻧ ﺮﺗ
ﺎﻳﻭ،ﺯ
ﺩې ﻱ ﻮ ﻮﺟ ﮐﻝ کېﻣ ټﻝ ﺎﻪ ﻭ ﭘﻲښېﭘ
Stablﺮﻱ چې e ﻮﻥﻟ ﺘﮐﻝ کې ﺷ ټﻝ ﺎﻪ ﻭ ﻭﻍۍﭘﻲښېﭘ ﺭ ﺎ
ﻧﻮ کېﺩ ﻤﻴﻮﺳ ﮑﻴﻤﻳ
ﺪ ﻧﺍ
ﺮﭙﻳﺎ
ﻫ
.ږﻱ
ﻠﻞکږ Trﺑ ansmi ssion
ﻭﻍﺭﺎ
ېﻪﻧﺩﻭﻱچ ﭘ ﻮﻮﺟ ﻪﻣ ﻩﮐﭽ ږﻭﻝ ﻌﻲﺍ ﻮﺿ ﻪﻣﻭﻍۍﭘﻲښېﭘ ﺭﺎﻧ
ﻮکېﺩ ﻤﻴﻴﮏﺳ ﻤﻳﺪﻧ
ﺍﻮﭙﻳﺎﻪﻫﭘ
ېﺍ
ﺭځﻱچ ﺩ ﻪﺍ ﺗ
ږﻣﻦځ ﺍﻝﺭﻮﻴﺖﺧ ﻓﺎﻌﺎﻋﻲﻣ ﻓږﻱﻭﺩ
ﺪﻝکږ ﺍ ﻴﻟﻪ
ﻮﺣ ﻟ ﻴﮏې ﻨﻴﻠ
ﻩﮐ ﺪﻧﺭګﺩﻼﺎڅ
ﻳکې ﻣﺭ
.ږﻱ
ﻠﻞکږ Unstﺑ abl eTr ansmi ssiﻟﺖon ﺎﺣ
ﻭﻍۍ ﺭﺎ
ږﻱﺩﻧ ﺗﻲﺎﻳ
ﺪﺯ ﻴﻟ
ﻮﺎﺷﻲﺗ ﻴﻣﻮﺳﻢکېﺩ ﻧﻲﻣ ﺍﺭ
ﺎېﻪﺑ
ﻮک ﭘ ﻤﻴSﻪﺳ tﭘ ableTr ansmi ssion
ﻪﺗ
ډﻝﻣﻦځ ﻪﻭ ﻤﻲﭘ ﻳﺪﻴﭘﺍ
ﺩﻼﺎﭘﻲښېﺩ ﻳﻮکې ﻣﺭ ﻤﻴځﻮﺳﻨ،ﻪ ﻳﺭځﻱﭘ ﻟﻰﺍ ﺍﻮﺗﺎﻳ
ﻭکېﻫﻢﺯ ﻪﭘﻲښ ﭘ
ﻪUnstﭘ abl eTr ansmi ssi ﻭﻍۍon ﺭﺎﻧﻮ کې چېﺩ ﻤﻴﻪﺳ ﻐﻪﻫ ګﻱډﻝﭘ
ځﻥ ړ ﻭ ﻪﺍ ﺭځﻱﭘ ﺍ
ﻭﺎﺍﻘﻳﺮﻓ
ﺑﻲﺍ ﻮ ﻨ
،ﺟ ﺎ
ﻴﭘﻮ ﺘ
ﻳ،ﺍﺎﻴﻩﺍﺳ ﺘﻲځ ﻮﺏ ﺧ ﻨﻧ ،ﺟ
ﻼﺎ
ﻳﮑ ﺮ
،ﺳ ﻪﺮﺧ ﻟﻲﺑ ﺎ
ﻤ ﺪﺷ ﻨﻪﺩﻫ ﮑﺩﻭﻱﻟ ﻮﻮﺟﻣ
ﻮﻧ
ﻮ ﻧ
ﻮﻟﺪﻭﺑ ﺰ
ﻴﻨﻟ
ﻭ ﻭټ ﺩﻱﺍ ﺎ
ﺘﺼ ﻗ،ﺍﻤﻲ ﻴﻠ
ﻗﺍﻠﻞﺩ ﺗﺍ
ﻪﺭ ﺗﻤﻲﻣﻦځ ﻳﺪﻴ
ﭘﺍﻮکېﺩ ﻤﻴېﻪﺩېﺳ ﺮچ ﭘ ﮑ ﺎﺳﺪﻏﻣ
ﺎﻱېﻳﺭﻣﻼﺮﻴېﻪﻏﻪچ ﻟ ﺘ
ﻭﺳ ﺭﻮﻭ ﻧﻮﺗﺮﺎﺟﻬﻮﻱﻣ ﻠﺘ
ﺎﮐ ﻪﻳ ﺘﻭﺳﺭﻮﻭ ﻧ
ﻮ ﻧﺍ
ﺭﺎﻭﺑ ﺪﻳﺪﺮﺷ:ﺗ ﻪﮑ
ﻪﻭﻱﻟ ﻠ
ﺒﻪﮐ ﻟ
ﻤﻲﭘﻲښې ﻳ
ﺪ ﻴﭘ
ﺍﻩﺩ ﺭﻥګﺍﺪﻤ،ﻫ ږﻱ ﻪﺭﺳﻲ ﺗﺮﺭﺳ ﻮﻪﻟﻴﻢېﭘ ﻧﮏې ﺳ ﻭﺮﺮﻟﺩړ ﺧﻄﻮېڅﻪ ﻟ
ﻴﻢ ﺧ ﺳ
ږږ
ﻻﻞک ړﻦې ﻣ ﺎﺕېﻡﻳ ﻳﺯﻭﺩ ﺪېﻭﻱﺍ ﻳﺪﺭﺕکېﺷ ﻮۍﻪ ﺻ
ﺭﭘ ﻭﺰﻤﮐﻮﺩ ﻧﻭﺮﻴﺑﺪﻮﻱﺗ ﻳﺎ
ﻗﻭﻭ ﻭﻝﺍ ﺮﺘﻨﮐ
ﺩ
.ﻱ
ﻭﻳﻞﺍﺎﻤﺗﻮﺩ ﻠ
ﻮﺩچچﭼ ﻧ
ﺎﻧ
ﺎﻧﺴﺍ،ﺩ ﻮﻟ
ﺪﻳډﻮﻥ ﺎﺷﻲﻏ ﻴﻴﻞﻣ ﻓﺎﻧﺍ
ﻪﺩ ﻧﻭ
ﺭﺎﻴﻌﺰﻣ ﻳﻨﺲټ ﻤﻲﺑ ﻳ
ﺪﻴﭘﺍ
ﺩﻼﺎﺩ
ﻳﻣﺭ
ﻪﻳﺖﻧ ﺯﺍ
ﺮﺩﻼﺎﭘ
ﻳ
ﻪ ﻣﺭ ﻧﻮﻟﻭټﻝډﺎﺷﻲ ﻭ ﻴﻣﻴﻞﺩ ﻓ ﺎ
ﻧﺍ
ځﻪﺩﺮﻱ ﮐ ﻩﻟړ
ﺭېﺍ ﻮﻟﻲﭘ ﺍﺍږﻭ
ﻪ ﻭﺩ ﺮﭘ ﻤ
ﺎﺷﻲﺩﻋ ﻣﺩ
.ﻩﻮﻉﺩ ﻨ
ﺘړﺎﻱېﻫﻢﻣ ﻴﺩﻭﺗ ږﻟﻲﻭﺩ ﺍﻮﻉﻭﻱ ﻨﺘﺮﻣ ﻳﺎډ
ًﺘﺒ
ﺮﻱﻧﺴ ﻟ
ﺎﻴ
ﺗړﺩﻭ ږﻟﻲډﻝچېﺩ ﻡﻭ ﻮﻭﮐﺍ ﻭﻱﺩﻟږ
ﻲ
ﻧېځﺭﺕﺩﻯچېﻻﺪ ﺎﺒ
څﻪﻋډﻝ ﺧ Aﻪ ﻭ.ﻟ Gambi ﺎﺷﻰﺩae ﻴ
ﮑﻰﻣ ﻧﻭﺩﻟږ
ﻩﻲ ﻮښ ﻟ
ﻭﺮټ ﺩﻼﺎﺗ
ﻳﻣﺭ
.ﺮﻱﻟﻭې ﺎ
ﻴﺗړﺍﻥګ
.ﺮﻱ ﻟﺮﻤ
ﺮﻋ ﻳ:ډﻟﻒ ﺍ
ﻭ.
ﺩﻱ ﻮﻮﺟ ﻩﻣﺮﺭﺳ ﺷﺭ
ﺮ ﻢ ﻳ
ېﻪﺩﻮﺳﻢک ﭘ ګﻡﻣ:ﻪ ﺭ ﺏﭘ
80
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
.
ﺮﻱ ﻟړﺎ
ﻴﻮﻭﺗ ﻟ
ﺪﻴﺗﺎﻳ
ﺯ ﻧﺴﻞﺩ ﻩﺩﻮګ ټﻪﺗ:ﻪﺝ ﮐ ﺝﭘ
.ﺮﻱ ﻟﺎﻴ
ﺘﻟﺍ
ﻮ ﻴﻟﻪﺗ
ﺎﻳﻪﺯﻮﺗ ﻠﺎﻥچچﭼ ﻧﺴﺍﻪﺩﻠﺗﺮ
ﻪﭘ ژﻭﭘﻭﻭ ﺭﻮﻧ:ﺩﺩ
ﻴﺦﻘﻠ
ﻩﺩﺗ ﺮېﻪﻧﻈﻩﻟ ﻮﺪﻥېﭘ ﻧ
ژژﻩﭖ ﺮﺭﺩﺣﺸ ﺎﻴﻌﺪﻣ ﻧ
ﺭګ ﺮڅ ﻳﻩډ ﺭﺎﭙﻟﻮﻟ
ﻮ ﻣﻮﻠﻌﺭﻣﺭﺩﺩﺷﻢ ږﻟﻲﺩﻼﺎﺩ
ﻳﻣﺭ
ﻩﺭﺷﺭ
ﻪ ﻢ ﻭﻟﺬﻭﺧ ﻮﺩﺎﺷﻮﻣ ﮑﻧﻭﺮﻳﺖﻟ ﻭﺯﻭﺭﻮ ﭙﮐﻝکېﺩﺳ ﻮﺎ ېﻪﻳﺭﺕﺩﻯچ ﭘ ﺎﺒ
ﺭڅﻪﻋ
ﺷﺭ ﺧ ﻪ ﻢ ﻐﻪﻫ ﻟ
څﻪ
ﻟ ١ﺧﻮکېﻪ ﻤﻴځﻮﺳﻨﻪﻳ ﺎﭘﻴﺘﻲځېﺍﺳ ﻮﺏﺧ ﻨﻭﺟ ﺎﺍﮑﻳﺮﻣﻨﻲﺍ ﻴﺗ
ﺭﺩﻻ ﺷﺭ
ېﺍ ﻢﺮﻭﻱچ ﺩ ﺑﺍ
ﺮﻩﺑ ﺮﺳ
ﻭ.
٣څﻪﮐﻢ ﻱ ٠ﺧ ﻟ٠ﻮکېﻪ ﻤﻴﻩﺳ ﺭﺎ
ﻪﺣ ﺎﭘﻘﻳﺮﻓﺍ
ﻭﺩ ﺍﺎﺕ ﻳ
ﺯ
:ﻪﻧﻮﻧﻮﻟ
ﺪ ﻮﺑﮑﻧﻭﻭژ ﺮﻼﺎکېﺩﺳ ﻳﻪﻣﺭ ﭘ
ﻩګﻱﻮګ
ځﻥ ړ ﺗﻪﺍ ﻴﻦﭘﺗﻭﺮ
ځﻰﭘ ﻧﮏېﻣﻦﻧ ﻭ ژﻳﺖﺩ ﺯﺍﺮﺩﻼﺎﭘ
ﻳﻪ ﻣﺭ ﺘﻭﺳ ﺭﻮﻭ ﻠ
ﺗﻮﻨﺮﻧېﻪﺗﻧﮏ ﺗ ﻭﺳېژ ﺮ
ﻠﻲﺍﻏﻪﺭﺗېڅﻪﻣﻦځ
ﺰﻱ ﺧ ﻪﺗﺠ ﻴﻦﻟﺑﻮﻟﻮګ ﻤﻴډﻝﺩﻫﻪﺩې ﻭ ﻭﭘ ﻮﻱﺍ ﻴﻞﮐ ﻮﭘ ﻟ
ﻮ ﻓ
ﺮﻪﻣﺼ ﻴﻦﭘ ﺑﻮﻟ
ﻮګ ﻤﻴﻫ
ﻭﻡﺍﻮﻴﻠﻴﺗ
ﻭﺪﻧ
ېﺮﺍږﻱچ ﭘ ﺩﻱ ﺎﻡﻳﻮﻪﻧ ﺎﻍﭘ ﺒﺎﻱې ﺻ ﻳﺭ
ﺩﻼږﻱچې ﻣ ﻟﻲﺪﻳﻦﺑ ﺯﻮﻤﻴﻪﻫ ﺮﻱHemeﭘ ﺯﻫ
ﻪﻳﻮﻣﻭﺩ ﻨﺖﺍﻴ ﻤﻠ
ﭙﻣﺎ
ﻭ،ﮐﺮګﻥ ﺒﺑﻲﻏ ﺎﻬﺘﻟ
ﺪﺍ ﻳﺪﺩﺷﺎﻴﻭﺑ ږﻱﺍ Deposiکږ ﺪېt ﻧﺎﻮﺑ ﺎﺟﻧﺴﺍﺍﻮﻭﺧ ﺎﺷ
.
ﺭځﻱ ﻻﻞګﻭﻣ ﺪﻴﻟ
ﺎﻌﻓﻮﺩﺗﺎﻔﺤ ﺻ
ﺀﺎ
ﻪﺩﻏﺸ ﮑﻮﻱﻟ ﻪﮐ ﺗ
ﻣﻦځ ﺍﻪﺭ ﻧﻮﻧﻮﻟ
ﺪﺭﺑ ﺷﺭ
ﻮ ﻢ ﻧﮏې کېﻳ ﻭﺳېژ ﻳﺖ ﺮ ﺯﺍﺮﺩﻼﺎﭘ
ﻳﻩ ﻣﺭ ﻮﻠ
ﻪﭘ ﻠﻪﺑ ﻟ
ﻪﻳﺖﭘ ﺯﺍﺮ
ﭘږﻱﻭﺩ
ﻩ کږ ﺍ ﺭﺎ
ﮐ ﺘﻲﺟﻦ ښ ﻧﻳﮏﺍ ﺮﻱټ ﺮﺳﻄﺢېﮐ ېﺮﺳ ﻧﮏ ﭘ ﻭژﻪﻭﻱﺩ ﺑ
ﺍﺮﺭﺕﺧ ﻮﭙﻧﺴﺍﺮﺗ
ﻨﻈﻢﻣﺮﻴﻪﻏ ﮑﻧ
ﻭ ﻪژ ﻠ
ﺒﻪﺩېﮐ ﻮﻟ ﻮځﻱﻧ ﻨﺎ کېﻧ ﻭﻱﻏﺸ ﺮﻪ ﺣﺠ ټﻦﭘﻭﻳ ﺮﻠﻰﭘ ﺍﻏ
ﻪﺭ ﺗ
ﻪﻣﻦځ ﺍﺳﻄ ﻭ
.
ﻮﻱ ﻠ
ﭙړﺎﺧﻴDefﻭﺗ or mabi l
it
ﺩږyﻭﻝ ﺍ ﺎ
ﻴ ﺗ
ړځﻥګﻴﮏ ﺍ ﻨﻴ،ﻥټﻱﺟ ړښﺕﺍ ﻮﺟ
ړﻮ
ﻡﻳ ﻮﻟ
ﻳﺶﺩ ﻭﺟﻲﻭ ﺯ
ﺮﻴﻠﻲ ټکېﺩﻏ ﺗﺎ کېﻭ ﻭﻱﻏﺸ ﺮﻪﺣﺠ ډﻝ کېﭘ ﻪﻭ ﻡﭘﺭ ﺎ
ﭙﻴﻠﺴﻳﻢﻓ ﺩﻮﻣﺯﺩﻼﭘ
ﻧﮏﻮﺗﻴﮏﻥښ ﻨﻴﺘﻲﺟ ﻧ
ګﻯﺍځﻥ ړﺯﻥ ﺍ ﻟﻲﻭ ﻮﮑﻴﻟﺎ
ﺩړﻣﻮﺭځﻱچېﻟ ﻪﺍ ﺗﺮکېﻣﻦځ ﻪﺍﺧ ﻮﭘ ﻧ
ﻮﺘﺎﻋ٢ﺳ ٤
ﻧﮏېﻭﻱچ ﻭﺮ(ﻟPFEMPI )P. Faciform Er ythocy temember anepr oteiﻴﻦn1 ﺗﻭﺮېﭘ
ﻪﻥښﻲ چې ﺩې ﭘﻲښې ﺗ ﻟ ﻩﺮﻭ ﺳ ﺬﺍﺧﻡﺩ ﻮﻴﻠﻴ
ﺗﻭﺪ ﻧ
ﺍﺮﻱ ﺩ ﻠﻴﭙﻭﮐ Venulﺍ ې ﺩ es
.
ﻳﻲ ﺍ
Cyﻭ toadher ence
ﻪﭘﺎ
ﺘﻨﺩﻼﺳIﻭ ﭘ
ntﺍ ercellulaeadhesi onmol ecul-ﻩ1 ﺭﺎﭙﻭﻟ ﺪ
ﻴﻟﻮکېﺩﻥښ ﻧﻭﺎﻏﻲﺭګ ﻣ ﻪﺩﭘ
ﻩﺭﺎ
ﭙﻭﻟﺪﻴﻟړﻮ کېﺩﻥښ ﻭﻍﻳ ﺭﻮﻪﻧCﻭﭘ honodrﺍ oitinSul fat ﻩeB ﺭ
ﺎﭙﺍﻟ
ﺪ ﻴﻟ
ﻮ کېﺩﻥښ ﻧ
ﻭ ﺭګ
ﺩ.
ړﻯ ﺯښﺕﻭ ﺭﺍ
CD36ﺩ
ﻭﻮﻱﺍ ېﻥښﻪﮐ
ﻨﺗ ﻪک ﻠﻲﺳﻄﺤ ﺍﺧﻪﺩ ﻮﭘﻧﻭ ﻭﺭګ ړﺍﺩﻭ ﻮﻳېﺧ ېﻪ ﻮﻧﮏ ﻟ ﻭﺳېژﻨﻲ ﺮ ﺘﻨ
ډﻝﻣﻪﺩې ﻭ ﭘ
ﻮژﮑﻧﻭﺮﻟﻳﺖﺯﺍﺮﻭﭘﺭﻮﻧﻭﻫﻢﺩ ﺍﺟړﻱ
Rosetﻮﻭ t
ﻭes ﺍځﻯ
ﻮﺍ ﻩﻳﺮ ﻮﺳ ﮑﻧﻭﻭژ ﺮﻮﺳ ﻤﻟﺎ
ﺍﺩﺳ ﻮﻪﺑﻞېﺧ ﻟ
ﻭﺍګ ﺟړﻝﺍ
Rosetﻮﻭ t
e,Cy toadher ﻨﺲټence ﻪﺩېﺑ ﻮﭘ ﻮﻱﻧ ﻴﺸﻦﮐ ﻨ
ﻴﺗﻮﻟﻩﺍګ ﺮﻮﺳ ﮑ ﻧ
ﻭ
ﺩ.
ﻪﻱ ﻧﻭﻨﺲټ ﺎﺳﻲﺑ ﺍﺳ ﻭﺍﺰﻱﮐﺮﺰﺱﻣ ﻴﻨﻮﺟ ﺘﭘ
ﺩﻼﺎﺩ
ﻳ
ﻴﺸﻦﺩ PFﻣﺭ ﻨﻴﺗﻮﻟ
( کې ﺩ ﻭږﻭ ﺱ ﺎﺍ ﺘﻨ
،ﭘﻼﺳ ،
ﺘﮏ ﻮﺳ ،ﭘ ﻭﺭګﻮ ﺗ
ﻳ ،ﭖښ ﻪ ،ﻨ ﺎﻍﻣﺩړﻮ کې ) ﺗﻲ ﻍﻳ ﺎﻴﻪ ﺣ ﭘ
ﺷې
ﻩﻮ ﺪﻨ
ﺑﺍ
،ﺩﺭځﻱ ﻻﻞګډﺎ ﻣﻴګﻭﺗﻘﻼﺏﺩ ډ ﺘﺍﺳﻭﺩ ﻟﻰﺍﺍﻮﺑﺍ
ﺮ،ﺧ ﺪښﺕ ﻨﺮﺑﻴﻬﺑMiﺩ crociucul ation
ﻪﺩې ږﻱﻮﭘ
ﺎﺕېکږ ﻧ ﻟېﭘڅﻪﺮﻳﺸﻦ ﺧ ﺮﺘﻠﺭﻱﻓ ﻮﺗﻪﺩ ﮑﻟﻴﮏﺕﺕ ﻧﺎﻴﺨﺎﻋﻲﻣ ﻓﺩﺩﺩ ﻮﻪﺩﻭﺟ ﮑﻧﻭﻩژ ﺮﺳ
ﮑﻞﺩ Riﺷ ﺍﻥng ﻭﻳﺖځ ﺯ
ﺍﺮﭘﺯېﺩ ﺍﻮﺍﻥکېﻳ ﺭﻭﻴﻄﻲﺩ ېﻪﻣﺤ ﻡک ﭘ ﺭﺎﭙﻴﻠﺴﻳﻢﻓ ﺩﻮﻣﺯﭘﭘﻼﻨﺲټﻪ ﺑ
ﺎ
ﻴﻤﻴﺘﻳﺯﺍ
ﺮﻨﻲﭘﻳﻴﻄﻲﻭ ﻣﺤ ﻮﺩ ﻭﻱﻧ ﺪﻧﺭګ ﺭڅ ﺷﺭ
څﻪ ټﻱټ ﻢ ﺎ ﺧ ﻴﻤﺘﻳﺯﺍﺭﺎ
ﻘﻲﭘ ﻴﻘ
ېﻪﺣ ړﻭﻱچ ﻟ ﻭﻭ ﺪﻴﻟ
.ﻟﻰﻮﻨﻴﻤﻪﺷﻲﺗﺨ ﻪﻧﮐﭽ ﺎ
ﻴﻤﺘﻳﺯﺍﺭ
ﺎټﻝېﭘ ﺩﺩ ﻭ ﻮﻭﺟ ﻩﺩﺯﺍﺪﻧﺍ
Defor mabili
tﻮﺩy ﮑ ﻧ
ﻭﻩژ ﺮﺘﻦﺳ ﻨﻣﺮ ﻴ
ﻼﺎکېﺩﻏ ﻳ
ﻡﻣﺭ ﺭ
ﺎﭙﻴﻠﺴ ﻳﻢﻓ ﺩﻮﻣ ﺯ
ﻩﭘﻼ ﺪ ﻳ
ﺪﻩﻪﺷ ﺭﻥګ ﭘ ﺍﺪﻤﻫ
ﺒﺐک ﻮﺳ ﻟ
ﺪﻳړﺎﻳﺠﺎﻝﺩﻭ ﻬ
ﻣ ﺮﺍﭘﺪﻳﺮﻴﺗ
څﻪﺩﻮ ﺧ ﻧﻭﻮﺭګ ﻳﻮﻭﺷ ﺪﻨﻪﺑ ﻟډﻝ
ﻤﻲ ﻭ ﻪﻗﺴ ﻱﻭﭘږﺍ ﻤﻲړﺎﮐﻴﻭﺗ
.ږﻱږ
ﺪټ ﻧﻭژﻳﺖﺩ ﺯﺍ
ﺮﭘﻭﺩﻴﺴﻲﺍ ﻪﻧﺭﺕﻧ ﻮ Sequesrﺻ ati
ﻮکېon ﻧﻮﻟﻭﻮډ ﻤﻴﻠ
ﻮﺳ ﻳﺭﻭﺩ ﺭ
ﻮﻪﻧ ﺩﻼﺎﭘ
ﻳﻣﺭ
ﺎ
ﻮﻳ ﮑﻧﻭﻭژﺮﻭﺳ ړﺯﻨﻲﺩ ﻳ
ﻭﻪﺩ ﻧﻮﻟﻭډﻩﺍ
ﺭﻥګ ﺩ ﺍ
ﺪﻤﻭ،ﻫړﻱ ﻭﻭ ﺪﻴﻟﻪکېﺩ ﻨﻳﻴﻄﻲﻭ ﻪﻣﺤ ﻪﭘ ﻧﻭ
ﻭ ﺍ
ړﻭﻝ ﭖ
81
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﺎﻻﻴ
ﻤﻴﺘ
ﻳﺯﺍ
ﺭﺎ
ﺎﺕېﭘﻳﺯ
%څﻪﺩ
ﻩﻪ ٢ﺧ ﻮګﻟ ﻩﺗ
ﺭﺩﺎ
ﻪﻧﻭﭘﺍ
ﺮﻱﻟﻣﻼﻥﻫﻢ
ﺩﻭ ﻴ
ﻪکﺩﺘﺍﺧ
ﺎﻱټﺩ
ﻮﺳﻟ
ﻮﮑﻴﺘ
ﻳﺭﺩ
ېﻪ
ﺮک ﭘﻤﺮﻋېﻪﻫﻧﮏ ﭘ
ﻭﻨﻲژﻳ
ﻭډﻝﺩﻡﻭ ﺭ
ﺎﭙﻴ
ﻠﺴﻳﻢﻓ
ﺩﻮﻣﺯﺩﻼ
ېﺣﻝکېچېﭘ
ﺍﺱ ﺎ ږﻱﻪﺩ
ﻣﻞکږ ﭘ
.
ږﻱ
ﻻﻞکږﺎﻣﻴﻤ
ﻴﺘﻳ
ﺯﺍﺭ
ﺎړېﭘﻮﻟ
ﻭﺩﺍﻴﺴﻲﻧېﻧ
ﺪﻻﺪﻳ
ﺮﺮﺑ
ﺎﺕﺗﻳ
ﻭﺮﺍﻥﮐ
ﻭډﻝځ
ګﻱ ﻭ
ځﻥ ړ
ﺍ
82
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﻭ:
ﺮګﻥ ﺒ
ﻪﻏ ﺑ
ﺭﻮﮐﺩ
ړټﺮﻭ
ﺯﻱ ﭘ ﺍ
ﺮﭘﻪﺩ ﺍﺳﻄ ﻪﻭ ﻴﮏﺕﺕﭘ ﻧﺎﻴﺨ(ﻣ Nonspeci fiﺎﻋﻲ)c ﻓﻔﻲﺩ ﻭﺻ ﺮ
ﻴ ﺪﻥﺩﻏ ﻴﻞ کېﺑ ﻪﭘﭘ
ﻪﺩېډ ﻱﻭﭘﺭځ ﺍﻟﻰﺍ ﺍﻮﺗﺎﻳﻭکېﺯ ﺪﻧﻳﺸﻦﺩ ﺭﻭﻓﻞټ ﻳﮏﺍ ژ ﻮﻟ
ﻮﻧﻮﻤﻳﻪﺍ ﺭﻱﭘﻮﺗښﻰﺩ ګﻥ ﻳ ﺮﻭ ﺒ
ﺪېﻏ ﻧﺍ
ﺒﻲځ ﻳﺮ
ﺩېﺗﺨ ﺭﻱ ﺩ ﻮ ﺗ
ﻧﮏېﺩ ﻭﺘﻲژ ﻳﺯﺍﺮ،ﻮﭘ
ږﻱﻧ ﺗﻲﺎﻳﻪﺯ ﻧﺪﻳړ
ﺎﻳﺠﻮﻭ ﮑﻧ
ﻭﻮژ ﻨﺘﻨﻣﺮ ﻴﻭﻏ ﻮﺍﻨﺘﻨﻣﻭﻝﺩ
ﻮڅﻪﻳ
ﻮ ﺧ ﻟ
ﺪ ﻳﺩ
ﻭ ﺎ
ﺩېﺩﭼ ،ﺩ ﻮﻱﻧﺖﻭﭼ ﺍﺰﻴ
ﻪچېﺷ ﻠږﻱﮐ ړﻱ ﺎﻳﺠﻪﻭﺧﺖﻭ ﻐ
ﻭﻫ ﺕښﻲﺍڅﻪ ﺗ ﺍک ﺧ ﻭ
ﻻﻞ
ﻭﻣ ﺪﻴ
ﻟﺎﻌﻓﻮﺩ ﻧ
ﻭ ژﺎﻓﻭﺮﮐ ﺎ
ﻣږﻱچېﺩ ﺩﻱ ﺍﺯ
Glﺍ ycosy lphosphat edyli
nosi tﻪol ﮑﻟﺩﺍ
ﻮ ﺭﻣﺷﺭ
ﻢ
ﻭﺰﻴ
ﻮﺍﻏ ﮑﻴﻮﺟ ﻟ
ﺎﺘﻭﭘ ﺭﻮېﻭﻧ ﺗﺐ ﺍ ږﻱچېﺩ ﺩﻱﺍﺯﻪﺍﻧﻮ ﻧ
ﻮکﻥ ﺘ
ﻳﺎﻭڅﻪ ﺳ
ژ ﺧ ﺎﻓﻭﺮﮐ ﺎ
ﺩېﻣ ږﻱچې ﺩ کږ
.ږﻱ
ﺆﻝګڼﻝکږ ﻣﺴ
ﻨﺲټ ﻪﺩېﺑ ږﻱﻮﭘ
ﻻﻞکږ ﻧ ﻳﺐ ﻣ ﺮ
ﺗﺨ ﻳﺖﺩ ﺯﺍﺮ
ﻮﺥﭘ ﭘﺭﺕﺩ ﺍﺮﺭﺝېﺣ ﺩ٤ﺎﻥکې٠ ﺘ ﻧ
ﻮﻱﺍ ﻪﺷ ﻨ
ﻠﻣﺭﺩﺎﻪﻧﭘ
ﺭځېﺩېﻭﺎﺭ ﻩﻳ ﻭﺮﺩ ﻌﻦېﻫ ږﻱﻳﻪ کږ ﻤﻨﻈﻪﻣ ﺒﻭﺗ ﺭځﻱﺍ Syګ nchroni ﮑﻞze ﻳﺎﻳﺖ ﺳ ﺯﺍ
ﺮ ﭘ
ﺩ
ﻨﻈﻢېﺗﺐ ﻮﻉېﻣ ﻧﺍﻠﻲﺩ ﺍﺧﻣﻞﻭ ﺭﺪﺩﺩﻼﺎ ﺿ
ﻳ
ﻣﻦ ﻣﺭ ﺰﻴﺍﻏﺎﻥچې ﻭﻏﺭﺎﻪﻧ ﻐ
ﻮﻫ ،ﺧ ږﻱ ﺪﻱ ﻧﺭګﻪڅ ﺘ
ﻭﺳ ﺭﻭ
ﻭ.
ﺪﻱ ﻨګﻪﻣ ﻠ
ﺍﻳ ً
ﺭﺩﺎ
ېڅﻪﻧ
ﺧ
ﻪﻧ
ﻭﺭﺎﻴ
ﻌﻟﻲﻣ ﻭ ﺮ
ﺘﻨﻩﮐ ﺭ ﺎ
ﭙG6PDDefﻟ i
ciﻭency ﺎﺍﻴﻤﻴﻧ
ﻴﻞﺍ ﮑﻞﺳ ﻴ،ﺳ ﺎﻴ
ﻤﻴﺩﻼﺳﺩېچېﺗ ﺮړﺪېﺗﻧﻭﺍ
ېﺍ
ﻪچ ﺩ ﻟ
ﺩﻭ ﻮﻭښ ﻧ
ړ ﮑﻦڅﻱ ﻴ
ﻟﺩﻪ
ﻟﻩګڼﻝکﺩ ﺪﻧﻭړﺭېﺍ ﻮﺮﭘ ﻴﻪﺳ ﺩﻼﺎﭘ
ﻳﻭﻍۍ ﻣﺭ ﺭﺎﻧﺍ
ﺍﺷﻲﺩ ﻪﺭ ﺗﻣﻦځ
ﻡﻣﻼ ﺭ
ﺎﭙﻴ
ﻠﺴ ﻳﻢﻓ ﺩﻮﻣ ﺯﺩﻼﻠﮏېﭘ ﺮﻱﺑﻩﻪﻟړﻧ ﺭېﺍ ﻮﻮﺡېﭘ ﻪﻟﺩﻼﺎﭘ
ﻳﺍچې ﻣﺭ ﺯېﺩ ﺍﻮۍﻪﻳ ﻭﻍ ﻧ ﺭﺎﺛﻲﻧ ﺭﺍ
ﻩﺪﻨ
ږﭼ HbA/ﺷﭗ ډﻝS ﻪﻭ ﻮﻱﺩﺏﻝﻝګېﭘ ﻮﻯﻫﻢﮐ ﻴﻨړﻦېﻣﺨ ﻧﮏېﻡﻳ ﻮﻠﺗ
ﺍﻪﺭ ﺗﻪﻣﻦځ ﻠﺒﻪﮐﺎﻟ ﻳ
ﺭ
ﺩﻳﺖﺩﻭ ﺯﺍﺮﭘﻪﺩﻠﺒﻪﮐ ﻟ ﻟﻲﺍﻮﻤﮐﻴﺠﻦﺩ ﮐﺴ ﺍ
ﻴﻞﻱېﺩ ﻟ
ﻮﻱچېﺩ ﻤﻪﮐﻠﻣﻪﺍ ﻟﻼﺎ
ﻳﺮﺩPFﻣﺭ ﺩړﻦېﺧﻄﻡﻳ
ﺩ.
ﻮﻯ ﻯ ﻴ ﻨﻣﺨﺖګﻣﺨ ﺮېﻭﭘﺍ
ﻪﺎﻥﭘﺘﻧ
ﺍﺭېﺩ ﻮﺮﻱﺗ ﻟﺰېﻭ ﻴﻮﻱﺍﻏ ﻓﻈﺎﻌ ﺾېﻣﺤ ﺍﻯ ﺷﻲﺑ ﺩﺩﻟﻰﻫﻢ ک ﺍ
ﻮﻤﭙﻦېﮐ ﻭﺳ ﺍ
ﻩﺩ ﺍﻥګ ﺭﺪﻤﻫ
ﺑﻞکې ﺎﻘ
ﻪﻣ ﺎﻥﭘ ﺘﻧﺍﻮﻯﻭﻱﺩ ﺘﻞﺷ ﻳﺴﺭېﻱېﺍ ﻮﺎﻥچېﺗ ﻭﻏ ﺭﺎ
ﻪﻧﻐﻭﻫ ﺮﻱﺍﻟﻩﻭډ
ﻪﻥ ﻤﻭﻝکېﺍﻫ ﺮ ﺘﻨ
ﮐ
ﻭ.
ﺎﺱ ﻱ ﺮﺣﺴ ﻳ
ډ
ﻭﭘﻼﮐﺲﺍ ﺍ
ﻮ ﻳﺍ
ﻳﻢﻭ ﺩﻮﻣ ﺯﺩﻼ
ﻮکېﭘ ﻧﻮﻠﻮﮐ ﻴ
ﻧړﻡﻮﻪﻟ ﺪﭘﻧﻭژﺎﻥﺩ ﻭﻏﺭﺎ(ﻧMel anesi ﺎ)aﻴﻤﻴﺩﺎﺗﻼﺳﻔﻟﺍ
ﻭﻍۍﺩﻣﻦځ ﺭﺎ
ﺪېﻧ ﻳﺪﺩﻝﺩﺷ ﻪکﺩ ﺘﺍﺧ ﺎﻴ
ﺎﺑﻴېﺍﺑ
ږﻱچ ﺩ ﻪکږ ﺘﺍﺧ ﺎﺕﻳﻼﺎﺯ
ﻳﻪﻣﺭ ﻡﭘ ﺭﺎﭙ
ﻴﻠﺴﻳﻢﻓ ﺩﻮﻣﺯ
ﻭﻱﺮEﻪ ﺣﺠrﻟ ythrocy t Melکېe anesiaOv al
ocy tosiﻪs ځﻪﭘﻮﻱ ﮐ ﻮﻯﮐ ﻴ
ﻨﻮﻣﺨ ﻠ
ﺗﺍ
ﻪﺭ ﺗ
.
ﻮﻱ ﻮﻯﮐ ﻴﻨﻮﻣﺨ ﻠ
ﺗﻮﻨ
ﻧﻭﻱټﺩ ﺯﻭ ﺮ
ﻴڅﻪﻣﺎ ﺧ ﻏﺸ
ټﺎڅ
ﻤﺯﻱ ﻳﺍﺭﺎ
ړېﭘ ﻮﻪﻟ ﻮﻱﻟ ﻟﻭﺮﺘﻨ
ﺍﺕګﮐ ﺎﻥﺭ ﺘ
ﻧﺍګﻥﺩﺮﻭ ﺒ
ﺘﻲﻏ ﻴﻓﺎ
ﻌ ګﻯﻣ ېځﻥ ړ
ړﺪ ﺍ ﻧۍﺮﻭﺍﻭﻍ ﭘ ﺭﺎﻧ
ﺩ
ﺩﻼ
ﻮکېﭘ ﻤﻴﻴﮏﺳ ﻤﻳﺪﻧﺍﻮﭙﻳﺎ
ﻭﻫ ﻴﮏﺍ ﻤﻳﺪﻧ
ﺍﻮﻟﻮ
ﻪﻫ ځﻪﭘ،ﻮ ﮐڅﻪﻧﺎﻥ ﺧ ﺘﻧﺍ
ﻪﺩ ﻮﻧﻮﻱﺧ ﻮﻯﮐ ﻴﻨﻪﻣﺨ ﺧ
ﻪ(ﭘﻲښېﭘ Primunat iﺎ)onﻴﻤﻴﺘﻳﺯﺍ
ﺭﺎﺮﺿﻲﭘ ﺮﻋ ﻴﻡﻏ ﺭﺎﭙﻴ
ﻠﺴﻳﻢﻓ ﺩﻮﻣﺯ
ﻭﭘﻼ ﮐﺲﺍ ﺍ
ﻮ ﻳ
ﺍﻳﻢﻭ ﺩﻮﻣﺯ
ﻴﺖﻓﺎﻌ
ﻭﻣ ﻭ ﻧﮏﻭﻭژ ﺭﻝﺍ ﻮ ﻤ
ﻴﻮکېﻫ ﻤ ﻴ،ﻪﺩېﺳ ږﻱﭘ ﺪﻝکږ ﻴﻟﺎﺕې ﻳﻮکېﺯ ﻧﺎ
ﻴ ﻨﻮﭼ ﻮﮐ ﻳﻮﻟﻭﻮﺍﻧﺎﻳﻮﻟ
ﺩېﻭﺎﺩ ﻣﻮﻯﺍ ﺪﻝﺷ ﻧژژﻪﺩﻯ ﭖ ډﻝﻧ
ړﻭ ﻪﺑﺸﭗ ﻴﮏﺕﺕﭘ ﻧﺎ
ﻮﻣﺨ ﻧﻮﺘﻴﻓﺎ
ﻌﺩېﻣﻮﺩ ﺩ،ﺧړﻯ ﻭﻭﺪ ﻴﻟ
ﺩ
ﺩېﺍﻥټﻱﻪﺩېچې ﺩ ﻩﻟ ﺮ
،ﺳ ږﻱ
ﺪﻝ کږ ﻴړېﮐﭻېﻟ lﻮ
lﻭgAﻟ gM,lﺍ ﻡ کېﺩgG ﻭﺮﻴﻪﺳ ﻮﭘ ﻳړګ
ﻪ کېﻨﻳﻪﻭ ﺩﻱﭘ ﺎږﻱچېﺍﻥټﻱﺑ ﺮ کږ ﮑﻮﻓ ﺮﻱ ﺧ ﻪﻟﻭﻧ ﺍړﻩﺕ ﺮﻴﺖ ﺳ ﻓﺎﻌﻣﻪﺩ ﺮﺧ ﻪﺑﺗﺎﻳﺩﻱﺯ ﺎ
ﺑ
.
ږﻱﻻﻞکږ ﻮﻣ ﻟﻮﻤﮐ ﺍﺩ ﺪﻴﺗ
ﺎﻳﺯ
ﻳﺖﺩ ﺯﺍ
ﺮ ﭘ
ﺩ
ږﻮ ﺷﻲ
ﻟﻟﻲﺩ Pډﻝﻭ assiﻭ vﻪe ﻪﭘ ﻮﺗ ﻧﺎ
ﻴﻨﻮﭼlﮐ څﻪ gGﻮ ﺧ ﻧ
ﺎﻳﻮﻮﻟ ﮑﻧ
ﻭﺮﻴﺖﻟ ﻓ ﺎ
ﻌ ېﻪﻣﺭﻟ ﺭﻪچ ﮐ
ﺍﻥټﻱﻪﺩ ﻡﺗ ﻮﺎﺷﻟﻲﻣ ﺪ ﻳﺯږ
ﻮﻱ ﻱ څﻪﻧ
ﺭ ﺧ ﻮﻪﻣ ږﻱﻭﻟ
ﻻﻞکږ ﺍ ﻮﻣ ﻟﻮﻪﮐ ﺘﮐﻮﻱېﺩښ ﺎﺩﺳ ﻴﻤﻴﺘﻳ
ﺯﺍﺭﺎﭘ
ﺩ
ﻼﺎڅ
ﻳﺪېﻣﺭ ﻳﺪ ېﻪﺷ(ک ﻟ ﻮﺘﺎﺷﻴﻭﻣږ ﺮﺷﭗ ﺗ
ﻮ) ﺘﺎﺷﻴړﻮﻣﻡﻳ ﻮﻟﻪﺪﭘ ﻧﻭژﻪﺩﻐﺩﻫ ﻟږ
Passiﻲ vډﻱe ﺎ
ﺑ
ﺮﻱﻟﻭﻝﻴﺖکېﺭ ﻓﺎﻌﻪﻣ ﻡﭘﻮﺎﺷﻟﻲﻣ ﺪﻳﺯږ
ﻮﻱ ﻱ ﻧﻮﻥﻫﻢﺩ ﺘﻮچېﺩHbFﺷ ﻳ ﺍ
ﻭﺪﻭ ﻳﺎېﻭﺑ
ﺎﺕ ﺍ ﻪﺳ ﺧ
ﻩﺭﺎ
ﭙﻟﺎﺕﻭﺧﺖ ﻳﺎﺯ ﻮﻳ ﺘﺎﺷ ﻴ
ﻭﻣ ﺮﺩڅﻬڅﻪﺑﻮ ﺧ ﻤ
ﻴﻴﮏﺳ ﻤﻳ
ډ ﺍﻥګﻭکېچېﺩ ﻮﻭړ ﻐﻪﻫ ﻴﺖﭘ ﻓﺎﻌﻣﺍﻮﺩ ﺧ
.ﻩځﻱ ﻪﻣﻦځ ﻟ
ﺎﺕېﺷﻲ ﭘ
83
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
84
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ځﻪ
ﺎﺕﺩﻯ ﮐ ﻳﻪکېﺯ ﻟﻲﭘﺍﻭﺭﻱﻍټ ﻮﺗږﻱﺩﻭﺳﻲ ﻮکېﺍ ﻤ
ﻴﻮﺳ ﮑﻴﻤ
ﻳﺪﻧﻪﺍﺩﻼﺎﭘ
ﻳ
ﺎﻥچې ﻣﺭ ﻭﻏﺭﺎﻪﻧﻐﻫ
.
ږﻱﻣﺦکږ ﺎ
ﻩﻣﺨ ﺮ
ﻼﺎﺳﻳﻪﻣﺭ ﻟډﻝﭙﺲې ﻭ ﻟ
ﺮﭘﭘچېﻪ
ﻪځ ډﻝﭘګﻱ ﻭځﻥ ړﻪﺍ ﻟﻰﭘﺍﻮﻳ
ﻮږﻟﺭﻝ ﻟﺖ کېﺩځﻱګ ﺎ
ﺘﻼﻃﻲﺣ ﺍﺧﺮﻴ
ﻪﻏ ﻡﭘ ﺭﺎﭙﻴ
ﻠﺴﻳﻢﻓ ﺩﻮﻣﺯﺩﻼ
ﭘ
ﻭﻥۍ ٣ﺍ-ﺩﻭﻱچې١ ﻮﻮﺟړﻯﻣ ﻴﻒژﻱ ﻔﻮﺧ ﻧ
ﺎﻳ
ﻮﻪﻟ ﻭﭘ ﺩﻭﻱﺍ ﻮ
ﻮﺟ ﺰﻣ ﻳ
ﺩﻭﻪﺩ ﻮ کېﭘ ﻧ
ﺎﻣ
ﻮ ﺎﺷﻮﻣ ﻧ
ﺍﻭ
.
ﻩځﻱ ﻪﻣﻦځ ﻟﻪﺘﻭﺳﺭﻭ
ﺭډﺩﺎ
Pﻪﻧ etﭘ echialHemor r
ﺩېhage ﺮﺎﻃﻲﭘ ېﻭﻣﺨﺘﮏ ﺍ ﻮﺳ ﭘ
ﻡکېﺩ ﺭﺎﭙﻴﻠﺴﻳﻢﻓﺩﻮﻣﺯﭘﭘﻼﻪ
ﻪﻪ کېﭘ ﺒﻴﮏﺗ ﺍﺟﺭ
ﻮﻤﻴﺮﻝﻫ ﻳﺍ
ﻭﻭ ﺯﺱﺍ ﻭﺮﻳﺎ
ﭙﻮﺳﺘﭙﻪﻟ ېﺣﻝ کېچېﭘ ﺍﺱ ﺎ ﻪﺩ ﺭځﻱﭘﻪﺍ ﺗﻭﻝﻣﻦځ
ﻭ.
ﺩﻱ ﻮ
ﻮﺟ ډﻝﻣﺰﻭ ﻳ
ﺩﻭﺩ
ﮐﻞﺎ
ﮐﻭ ﻨﻦګ،ﻣ ﻔﺲ ﻳ
ﺎ،ﺗ ﻪﻭﭼﮏۍ ﻡ چېﭘ ﻮﻪﻭﻱﮐ ﺩﻧ ﻮﻮﺟ ﻪﻣ ﻧ
ﻮﭘﺎ
ﺘﮏې ﺧ ﻮﺳ ﭘﻼﺎ کېﺩﻳﻪﻣﺭ ﭘ
ﻩﻣﻼ ﺭﻥګ ﺍ
ﺪﻤ،ﻫ ږﻱ
ﺪﻝ کږ ﻴګﻥ کېﻟﺮﻭ ﺒﻪﻏﻮﭘ ﻠ
ﻣ ﺭځﻮﺩﻨ
eﻭﺩﻳ xantﺍ ﺮﻝhema ﻳﺍ
،ﻭﺎﻴﻤﻴ
ﻴﺴ ﺘﭙ
ﺳ
ﻪﺍﻯ ﺷﻲﭘ ﺩﺩ
ﻮک ﻮﻱ ﺧ ﻪﮐﻤﻞﻧ ډﻝﻋﻪﻭ ﺎﻥﭘﺘﻧﻧﮏېﺍ ﻭ ﺪﻴﻊﻟﻗﻮﻣﻮ کېﺩ ﻧ
ﺎﻭﻏ ﺭ
ﺎﻪﻧﺯﭘ ډﺍﻱﺎﺩﻳﺭ
.
ﺍﺷﻲ ﻪﺭ ﺗ
ﻟﺖﻣﻦځ ﺎ
ﺍﺣﻭکېﺩ ﻭ ښځ ﺭﺍﻭﺪﻴ
ﻣﺍ
:ﺎﺕﺘﻼﻃ ﺍﺧﺩﻼﺎ
ﻳﻣﺭ
ﺭ:
ﻼﺎ
ﺎﻏﻲﻣ ﻳ ﻣ-ﺩ١
ﻩﺮﻠﻦېﺳ ﻣﺭېﻪﺩﻩچ ﻟ ﻪﺩ ﻮﺣﻴﮏېﻟ ﻨ
ﻴﻠﻪﮐﻮﺳﻨﺤ ﻭﻣ ړېﺍځﻥګ ﻩﺍ ﻮﻼﺎﻳ
ﻳﻡﻣﺭ ﺭﺎﭙﻴﻠﺴﺪېﻓ ﻳﺪﺩﺷ ﺎ
ﻣﻮﮐ
،
ﻮﻥﻟﺪﻮﺑ ﺍﺻﻮﻭﻍﺩﺧ ﺭﺎﻧ.ﺩﺭړﻱ
ﻭﻪﺍ ﺗ
ړﻪﻣﻦځﻨ%١ﻡﻳ ﻮ کې٥ ﻧﺎ
ﻴﻨﻮﭼﻪﮐ ﭘﻭ
%٢ﺍ ﻮ کې٠ ﻧ
ﺎﻳﻮﻪﻟﻩﭘ ﺮ
ﺳ
ﺍﻯﺩ
ﺩﻼﺎکﻳﺎﻏﻲﻣﺭ ﻣ.ﺩ ﻪﻭﺷﻲ ﻧ
ﺮﻠ
ﻣ ﺎ
ﺪﻱﭘ ﺪﺟ ﻳ
ﺎﻝﻪﻫﻢﺑ ﺘﻼ ﺗ ﺭﺍﺧﻮﻌﻩﺩﺷ ﺯﺍ
ﺪﻧ
ﻩﺍ ږﻪﻝ Dﻭﭘ
elﺍ ir
ium
(Symmet ri
ﺗﻲc ﺎﻳﻮﻟﺎ
ﻔﻧﺴﺍﺰېﻴړﺧﺍﻩﻭﻭﺩﺩ ﺍﻴﻞﺷﻲ ﻩﭘﺮﺘﻼﺝﺳ ﺍﺧ ﻪ
ﻟډﻝﻭﻭ ﺭﺎﻭ ﻧڅﻪﻳ
ﭘﻪﺎﺍ ﺷﻲﭘ
ﺰېﺩﻱ ﻳﺩﻭﺮﺩ ﻴ
ﻪ کېﻏ ﺒﻲﻧﻲښېﭘ ﻳﻲﻋﺼ ﺍ.ځﺮﻱ ﻭېﻟ ﺎ
ﻴﺗﺪﻧﺭګﺎﻥڅ ﻪﺷ Encephalﭘ opat hy)
ﻳﺶﻥ ﺮﺗﺨﻭﺩ ﺎ
ﻳﺎ
ﺩﺳﺤ ﻮﺮﻱﺧ ﻟﺭﺍ
Passiټﻱګ vﻩe ېﻮڅړﺪ ﻳﻧ
ﻪﻭﺍ ﻮﭘ ﻟ
ﻮﺒ ﺾﮐﻗ ﻩﺩ ﺮ
ﺩېچېﺳ ﻩﺩ ﺮ
ﺳ
ﻭﻫﻢPout ﮐﻻﻯﺷﻲﺍ ﻩﻮ ﺭﻮﻟﺖﻏ ﺎ
Diﺣ verﺮګېgent ﺘﻭﻍﺳ ﺭﺎ
ﻧﺮﻱﺩ ﻮﻥﻟﺘډﻝﺷ ﺭﻭ ﺩ
ﺎﻪﻧ ښېﭘ
څﻪ
ﺎ ﺧ ﻣﻮﻭېﮐژﺭ ﻪﺩﺗﺮﻭ.ﭘ
ﻪﻱ ﺩﻧﻮﻮﺟﻪﻣ ﻧﻮﮑﺴﻠﻔ
ﻳPrﺭ imat ivﺭeﻮﻮﻧ ﻭ،ﺧ
ﺩﻱ ﻮﻮﺟ ﺍﻣ
ًﺮﺜ
ﮐﺍ ﮑﺲ ﻠﻔ
ﻳﺭ
ﮐﻢﺎ
ﺎﺕﻳ ﻳﺍﻯﺷﻲﺯ ﺩﺩټﻥکﻠﻲ ﻭ ﻭ،ﻋﻀﺎﺕې ﻱ ﺪﻱﭘ ﻧﻮﻪﺧ ﻧ
ﻮ ﮑﺴﻠﻔ
ﻳﻳﻦېﺭ ﺮﻗ
ﻮکېﺩ ﻧ
ﻮﺘﻟ
ﺎﻭﺣ ﺭﻮﻪﻧﭘ
ﻟﺖکې ﺎ
ﻪﺣ ﺎﺑﺴﻂﭘ ﺒ ﺾﻳ ﻗ
ﺍﻯﺷﻲﺩ ﺩﺩPlک anterr eflﻭex،
ﺮﻱ ﻴﻐﺘﻪﻣﻧﻮﮑﺴ ﻴﻠ
ﻔﻳﻭﺭﺭﺎﺗﻭﺍ
ﻭ.ﺩﻱ
ﺎ
ﺒ ﺾﻳ ﻗﺍﻯﺷﻲﺩ ﺩ
ﺩﻟﺖ ک ﺎﻭﻍﺣ ﺭﺎ
ﻧﻭ،ﺩ
ﻪ ﻱ ﺩﻧﻮﻮﺟ ﻪﻣ ﻧﻮﮑﺴ ﻴ
ﻠﻔﻳCrﺭemast eriﻭcﻨﻲﺍ ﻭ،ﺑﻄﻱ
ډﻝﻭﻱ.ﻪﻭ ﺑﺴﻂﭘ
ﻩﺷﻲ ﺮ
ﺮﺳOphtﺗhalډﻝmoscopyﻴﻢ ﻭﻘﺘ
ﺮﻣﺴ ﻴﻭﻏﺍ ړﻝﺷﻲ ﺭکﻟﻰﻭ ﺍ
ﻮﺍﺧﺮﻪﭘﻗﻲﺗﺪﺭېﺣ ﺭ
ﻪچ ﮐ
%٤٠
-٣ﺗ٠
ﺪﻱﺮ ﻴﺼﻓﺍ
ﺪﻝﺷﻲچېﺩ ﻴ
ﻟHemorﻭ r
Retکېhage aiﻪnaﻭکېﭘ %١ﭘﻲښ ﻪ٥ﻮﭘﻧ
ﺷ.
ﻳﻻﻯ ﻲﻟړﺪﻫﻢﻮ
ﻭ.
ﺩﻱ ﻮﻮﺟډﻝﻣ
ﻪﻭ ټﻮﭘﻭ ﮐﺮﭙRetﺩﺧ i
nal opacificati
ﻭکېon %٦ﭘﻲښ ٠-
٣ﭘ٠
ﻪ
،
ﺮﻱﻟﻮﻥﺘډﻝﺷﺭﻭﺩﺎ
ېﻪﻧ
ﻮک ﭘ ﻧﺎ
ﻳﻮﻟﻪېﻭﭘ
ﻭک ﺍ ېﻪ%٨ﭘﻲښ ﻮک ﭘ ﻧ
ﺎﻴﻨ
ﻮﭼ ﻪﮐﻮﺏﭘ ړﺳ
ﻗﻲ ﭖ ﺪﺩﺣ
ﻮﻧ
ﻭﺩګ
ېﺎ ﺭ
ﻮک ﻳﻧﻭﭘﺭګﺒﮏﻱﻱﻪ Cﻭﺩﺷ otﺍtonWoolSpot ﻭکېs ﻭﭘﻲښ ږﻪﻝ%څﻪﭘ
ﺩ ٥ﺧ
ﻭ.
ړﻱ ﻭﻭﺪﻴ
ﻟDecolﺩ or
izatiډﻝonﻌﻲ ﻭ ﻮﺿ ېﻪﻣ
ﻪک ﭘ ﺮﺧﻩﺑﻮﻪﻳﭘ
ﻮکې ﻧ
ﺎﻭﻏﺭ
ﺎ%٥ﻧ
ﭘ٠ﻼﺎ ﻪ
ﻳﺎﻏﻲﻣﺭﻣﺩږﻱچېﺩ ﺭﻱﺍ
ﺮﮑډﻝﺗ
ﺭﻭ ﺮﮑﺘﻪﻣﻭﭘ ﺍﻣﻲﻭﻱ ﻮﻤﺍﻋ
ًﺮ
ﺜﮐﺍﺎﺕﺘﻼﺟﺍﺧ
.ږﻱ
ﺪﻝکږ ﻴ
ﻟ(ﻮکې ﻧ
ﺎﻴ
ﻨﻮﭼﺎﮐ
ًﻮﺻ)ﺧﺼ
ﻮکې ﻧ
ﺎﻴﻨ
ﻮﭼېﺣﻝکېچېﮐﺍﺱ ﺎ ږﻱﻪﺩ
ﺎﺕېکږ ﭘ ډﻝﭘﺭﻭ ﺩﺎSﻪﻧ
equelﭘ ﺒﻲs ﻮکېﻋﺼ ﻧ
ﺎﻳ
ﻮﻟﻪﭘ
85
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
Hemi plegia,Cer ebralpal sy ,: ﻪﮑ،ﻟږﻱﺪﻝ کږ ﻴﻭ کېﻟ %١ﭘﻲښ ﻪ٠ ﺰېﭘ ﻧ
ﻮ ﺘﺒﻲ ﺳﻋﺼ
ﻪﻐﻩﻫ ﻮګ ګﻱﺗځﻥ ړﻪﺍ ﻟﻰﭘ ﺍ
ﻮﺑﺍﺮﻩې ﺧ ﻮﻭﭘ ﻔﮏککﺍ ﺗ
ﻭﺩ ﻟﻰﺍ ﺍﻭﮐڼ
،ﻮ Cor tical,Bl indness
ﻳژ
ﻤﻞېﺎ ﺭﻱﺣ ﺍ
ﺮﮑﺘﻼﺝﺗ ﺍﺧ،ﺩ ﺎ
ﻴﻤﻴﻮګﻻﺳ ﭙﻳﺎ
،ﻫ Anemi ﻩa ﺪﻳ ﺪ
ږﻱچېﺷ ﺭکږ ﺮﺘﻀ ﺎﺕﻣ ﻳﺎﻥﺯ ﻴ
ﻨﻮﭼﮐ
.ﺮﻱ ﻟﺎﻭﻣﻮﻩﮐﺭﻭ
:
ﺎﻴﻤﻴﻳﺴ ﻮګﻻ ﭙﻳﺎ
-ﻫ٢
ﻮﺑﺍ
ﺮږﻱچېﺩﺧ ﻻﻞګڼﻝکږ ﻩﻣ ﺭ ﻮﺘﻼﺝﻏ ﻭﺍﺧ ﺎﺍﻣﻮﮐ ﺘﻼﻁﺩﻯچېﺩ ﺰﺍﺧ ﻳﺩﻭ ﻮﺩ ﻼﺎﻳ
ﻳﺪېﻣﺭ ﻳﺪﺩﺷ
.
ږﻱﻻﻞکږ ﻭﻣ ﺰﻧﻮﺘﻮﺳ ﺗﺎ
ﻳﺯﻮکېﺩ ﻧﺎﻴ
ﻨﻮﭼ ﻭﻭﮐﻭ ښځﺍ ﺭ
ﺍﻭﺪﻴﻣﺍﻪﻭﭘ ﺍﺭېﻭﻱ ﻩﻣﻞګ ﺮﻭﺳ ﺭﺍ
ﺰﻧ
ﺍ
ﺍ
ﻮ ﺯﻱټﻟﺨ ﺍ
ﺮﭘﻭﺎﻥﺍﺑﺰﻴﻣﻭﻫﻢﺩ ﺎﻁﺍ ﻧﺤﻄﺍﺰﺱﺩ ﻴﻨﻴﻮﺟ ﻴﻧﻮﮐﻮ ﻟ
ﺭﺩګ ﻼﺎ کېﺩځﻱګ ﻳﻪﻣﺭ ﻟﺖﭘ ﺎ
ﺍﺣﺩ
ﻪQuiﻟ nidiﻭ ne ﻴﻦﺍ ﻧ
ﻮﻩﮐ ﺭﻥګ ﺍﺪﻤ ،ﻫﺭځﻱﻪﺍ ﺗﻪ کېﻣﻦځ ﻠﻳﺎ
ﻪﭘ ﺮﻑﭘ ﻣﺼ ﺯﺩ ﻮ ﮐﻮﻟﺎﺕ ګ ﻳ
ﺯﺩ
ﺯﻮﮐﻮﻟ
ﻧﻲګ ﺍﺭ
ﻭ ﻟﻰﺩﺍﻮﺗﺎ
ﻳﻮﻱېﺯ ﻪﺩﺳ ﻐﺍﻥکېﺩﻫ ﺭﻭﻪﺩ ﻭﭘ ﻮﻱﺍ ﻪﮐ ﺒﻨ
ﺯﺗ ﺍ
ﺮﻴﻦﻓ ﻟ
ﻮﻧﺴ ﺍ
څﻪﺩﺍﺹ ﺧ ﺮ
ﻘﻧﺎ
ﭘ
ﻪﻪﭘﻴﻦﮐﭽ ﻟﻮﻧﺴﺍ
ﻭﺩ ﻮﻱﺍ ﻪﮐ ﺒﻨ
Iﺗ sletCel lﻭﻱچېs ﺯﺍﺮﻓټﺭﺍﺍﺱېﻓﮏ ﻭ ﺯﻱټﺩ ﺍ
ﺮﻭﻫﻢﭘ ﻮﻱﺍﻤﮐ
.ﻮﻱ ﺗ
ﺎﻳﺍﻥکېﺯ ﺭﻭﺩ
ﺰېﻳﺩﻭﻎېﺩ ځﻪﺩﻫﺍﻥﺩﻯ ﮐ ﺭﻴ ﺺګ ﻴﮏېﺗﺸﺨ ﻨ
ﻴﻠﺎﮐﻴﻤﻴﻳﺴ ﻮګﻻ ﭙﻳﺎ
ﻟﺖکېﺩﻫ ﺎ
ﺪﺣ ﻳﺪۍﻪﺷ ﻭﻍ ﭘ ﺭﺎﻧ
ﺩ
ﻟﺖ کې ﺎﻪﺩېﺣ ﺭﺕﺩﻯﭘ ﺎﺒGڅﻪﻋ
boseFlﺧ ﻭesh ﺎﺍﻳﺩﺭﺎﺩ،ټکېﮐ ﺩﻮ
ﻮﻝېکﻟ ﻥښېچېﺩﺧ
ﺘﻼﻪﺍﺧ ﻟﺩﻼﺎ
ﻳ ،ﻣﺭ ﺭځﻱﻪﺍ ﺗ
ﻪﻣﻦځ ﻠ
ﺒﻪﮐ ﻟﺎ
ﻴﻤﻴﻳﺴﻮګﻻ ﭙﻳﺎﺘﻼﻝچېﺩﻫ ﺒﻲﺍﺧ ﻭﻫﻢﻋﺼ ﻪﻭﻱﺍ ﺩﻧ ﻮﻮﺟﻣ
.ږﻱ ډﻱ ګﻭ
ﻩډ ﺮﻝﺳ
ﻪځ ﻮﻥ کېﭘ ﺘﻭﻏﻪﺭ ږﭘﻮﻥ ﻣﻪﺯ ﻭﮐﭽ ﺘﻼﻁﺩﭖښښ ړﻱﺍﺧ ﻮﻣﻮﻧﻨﺲټﺩ ﺑ
ﺮ ﺑﻲﭘ ﺮﺎﺩﺷﺨﺼﻲﺗﺠ ﻣﺯ
ﻩډ ﺮ
ﻮﺳ ﻟ
ﻮﮐﺭﻭﺯﺩﻮ ﮐﻮﻟ
ﻴﮏګ ﻧ
ﻮﺗﺮﭙﻳﺎﻪﺩﻫ ﺮﻏﻪﻣ ﮑﻴﻧﻭﺩ ﻪﺩﻯﺍ ﺗﺎﻳ
ﻭکېﺯ ﺪﻧﻩﻡﻥ ﺭ
ﺍﻭﺪ ﻴ
ﻣ ډﻝﺍګﻱ ﻭﺍﻥ ړ
ﻭﻍچې ﺭﺎﻪﻧﻐﺮﻫﻡچېﻫ ﻮﺰﮐ ﻳﺪﻧﺍړﻪﻭ ﻮﺗ ﻧ
ﺎﺒﺎﺣﺭﺻ ډکټ ﻮﺍ ﻧﺭﻩﺩ ﺯﻮ،ﻧﻮﻱﻩﮐ ﺭﺎ
ﮐګﻥ ښ ﺮﻭ ﺒ
ﺭﻏ ﺮژﻳ
ﺯﻮﮐﻮﻟ
ﻴﮏ ګ ﻧ
ﻮ ﺗ
ﺮﭙﻳﺎ
ﺪﻫ ﻳﺎړﻯﺑ ﻡﻮ ﻪﻟ ﻭﺗ ﻩ ښځ ﺭﺍﻭﺪﻴﻣګﻱډﻝﺍ
ځﻥ ړ ﻭ ﻪﺍ ﺘﻞﻭﻱﭘ ﺭ ﻱېﻣﺨ ﻮﻌﺷ
ﻭ.
ﻮﻯ ﻱ ﻮﻯﺷ ﻴﻨ
ﻮﻣﺨ ﺗﺎﺘﻼﻃ ﺍﺧ ﻮ ﺑ
ﺍﺮﺎﺩﺧ ﻴﻤﻴﻳﺴﻮګﻻ ﭙﻳﺎﻭﺩﻫ ﺗڅﻮﻝﺷﻲﺮ ﮐﺭﻭ
:ﺯﺱ ﻭ ډﺍﺳﻲ ﻴﮏﺘﮑﻟ
-٣
ﺭځﻱﻪﺍ ﺗځﻯﻣﻦځ ﻮﺍ ﻩﻳﺮﺎﺳ ﻴﻤﻴﻳﺴ ﻮګﻻ ﭙﻳﺎ
ﻪﻫ ﻟ ﺯﺱ ﻭﺪ ﻴﻴﮏﺍﺳ ﺘﮑ ﻟ
ﻮکې ﻧ
ﺎﻭﻏ ﺭﺎ
ﻪﻧ ﻼﺎﭘ
ﻳﺪېﻣﺭ ﻳﺪﺩﺷ
.ږﻱﻻﻞکږ ﺩړﻦې ﻣﻭﻍ ﻡﻳ ﺭﺎ
ﻧﻩﺩ ﺩړ
ﺍېﺍ ﻭ
چﺩ
ﻔﺲ ﻨﻴﮏﺗ ﺗﻭﺪﻴځﻯﻭﻱﺍﺳ ﻮﺍ ﻩﻳ ﺮﺯﺱ ﺳ ﻭﺪﻴﻪﺍﺳ ﻟﻰﻟ ﺍ
ﻮ ﺑﺍ
ﺮﻭﺧ ﺪ ﻧ
ﻭﺩﺩ ﺭګ ﻮﺗﻮ کېﺩﭖښ ﻧﺎﻳ
ﻮﻪﻟﭘ
ږﺒﻲﻴﻘﻌﻪﺗﺍﺳﻄ ﻪﻭﻳﻲﭘ ﺎﻔﻡﮐ ﺪﻧﻲﻋ ﺍﺭﻭﻩچېﺩﺩ ﻩﺩﻭﻥښ ﺭﺍﺰﻧﻮﺍﺑﺍ
ﺮDiﻱېﺩﺧ strﻔﺴﻲess ﻨﺗ
ﺎﻳﻭ
ﺍ
ﻪﻩﻟﺮﺎﻝﺳ ﻤﻌﺘﺍﺳﻮﺩ ﻠ
ﻣ ﺭ
Iﺩ notropi ﻳc ﺎﻁﺎ ﻧﺤﻄ ﻔﺴﻲﺍ ﻨﺎﺗﻟﻲﻳ ﺍﻮﺗﺎ
ﻳﺯﻧﻲﺣﺠﻢﺩ ﺍ
ﺭﻭﻡچېﺩﺩ ﻮﻱﮐ
.
ﻩﻪځﻱ ﻣﻦځﻧ
ﻭﺭﺍﺰ
ﻧﻭﺍ ﺪﺑﻭﻍۍﺩ ﺭﺎﻧﮐﻢﺩ ﺍﺮﻴﮏﺗ ﺘﮑ ﺎﻟﻴﺖﻳ ﻧﻮﺑﺭﺎﮑﻳ
ﺎﻡﺑ ﻭﺮﻴﻼﺎ کېﺩﺳ ﻳﻩﻣﺭ ﺪﻳﺪ ﻪﺷ ﻩﭘ ﺭﻥګ ﺍ
ﺪﻤﻫ
.ږﻱﻻﻞګڼﻝکږ ﻩﻣ ﺭﻮﻏ
.ږﻱﻪکږ ﺗﻣﻦځ ﺍ
ﻪﺭ ﻠ
ﻣﺍﻪﻟﻻﻮﻠ
ﻧېﺩﻳ ﺯﺱﺩﻻﺪ ﻭﺪ ﻴﺍﺳ ﻴﮏﺘﮑﻟ
ږﻱ
ﻪکږ ﺗ
ﻣﻦځ ﺍAnaerﺭ obi cGl ycol ysiﻱﻮsږﻧ ﺪﻱ ﻨMiﺑ crocirculatiﻩچېon څﻥګ ﺭ .1
.
ږﻱ ﺗﻲﺎﻳﺪﻝﺯ ﻳﺟړ
ﺪﻮ ﻴﺍﺳ ﻴﮏ ﺘﮑﻟﻪکېﺩ ﻠﻳﺎﺩېﻪﭘ
ﻭﺩ ﭘ ﺍ
.ږﻱﻩکږ ﺮﺮﺳ ﻪﺗﻧﺪﻳﺟړ
ﺪﻮ ﻴﺍﺳ ﻴﮏﺘﮑﻟ
ﻪﺩ ﺍﺳﻄ ﻪﻭ ﻳﺖﭘ ﺯﺍﺮﭘ .ﺩ 2
.ږﻱ
ﻟﻰﮐﻢږ ﺍﻮﮐﺎ
ﺪﭘ ﻴﺍﺳﻴﮏ ﺘﮑ ﻟ
ﻪﺩ ﺍﺳﻄ ﻭﻪﻭ
ﺭګ ﭘ ﻮﺗ
ﺭﻭﭖښ .ﺩځﻱګﺍ 3
.ﻟﻰﺍ
ﻮ ﺗ
ﺎﻳﺪﺯ ﻴﻟﻮ
ﺗﻪﺩ ﺍﺳﻄ ﻪﻭ ﻮﭘ ﻧﻮکﻥ ﺘ ﻳ
ﺎﺑﻲﺳ ﺎﻬﺘﻟ
ﺍ ﻭﺭﻮTﻭﻧ .ﺩ NFﺍ 4
:
( NonCar diogeni cPul monar ﺎ)yOdema ﻤﻳ
ﺫ ﺍﻮﻱ ﻳﺒﻲﺭ ﻠ
ﻗﺮﻴ-ﻏ٤
ﻭﻍ ﺭ
ﺎﺩېچېﻧ ﻩﺩ ﺮږﻱﺳﻪکږ ﺗ
ﻣﻦځ ﺍﻪﺭ ﻠ
ﺒﻪﮐ ﻟﻡﺭﺎﭙﻴ
ﻠﺴ ﻳﻢﻓ ﺩﻮﻣﺯﺪﭘﻼ ﻳﺪټﻮکېﺩﺷ ﻧﻪﻍﺍ ﻟﺖﭘ ﺎ
ﺍﺣﺩ
ﺮﻴﻼﺎﺳﻳ
ﮐﺲﻣﺭ ﺍ
ﻮﻳﺍﻳﻢﻭ ﺩﻮﻣﺯﺘﻼﻃﻲﭘﻼ ﺍﺧﺮﻴﺍﻯﺷﻲﺩﻏ ﺩ ﺩﻭ،کﻴﺴﺖې ﻱ ﻣﻞﻫﻢﺍﺧ ﺭﺭځېﺩ ﻭﻭ څ
86
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
87
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
.ږﻱ
ﺪﻝکږ ﻴﻟﺮﻱﻟﻟﺖﻭ ﺎﺭﻱﺣ ﻮﻌﺮﺷ ﻴﺎﺕﻏ ﻳ
څﻪﺯﺧ
ﻴﻼﻧ
ﻮ ﻤ
ﻠﻪﺩﺳ ﮑ
ﺗﻼﻯ ﺷﻲﻟ ﺍﻪﺭ ﺗ
ﺎﻫﻢﻣﻦځ ﻴﻤﻴ
ﻴﺴ ﺘ
ﭙﻴډﻝ ﺳ
ﻪﻭ ﺘﻼﻁﭘ ﺍﺧ ﻩﺩ ﺮ
ﻼﺎ ﺳ
ﻳﺪېﻣﺭ ﻳﺪﻪﺷ ﻟ
ﻭ.
ګﻯ ﻱ ﻩﻣﻞ ﺭ ﺮ
ﻡﺳ ﺭﺎﭙ
ﻴﻠﺴﻳﻢﻓﺩﻮﻣ ﺯﺩﻼ
ﺍﭘًﺮﺜﮐﺍﺎﭘﻲښېچې ﻴﻤﻳﺮﺘﮐﺎ
ﺑ
ﺯﻥﺍ
ﻮﺗﻮﺩ ﻧﻮﺘﻳ
ﻭﻻﺮﺘﮑﻟ
ﻭﺍ ﻮﺍﺑﻭﺍ(ﺩ ﻴﭻﺵﺵ ،ﭘﺘﻰﺎﺳﻧﺲﻧ ﻡ) ﻭﺭﺪﻨﻤﻲ ﺳ ،ﻫﻀ ﻟﻰﺍ
ﻮﺑﺍ
ﺮﺘﻢ ﺧ ﻳ
ﻩﺭ ړ
ﺯﺩ
ﺷ.
ﺍﻯ ﻲ ﺩﺩﺪﻝک ﻴﻟﺮکې ﻴﻪﺳ ﭘ
ﺎﻳﺭﺎﻏﻲﻣﻼ ﻣﺩﻟﻰﻫﻢﺩ ﺍ
ﻮ ﺑ
ﺍﺮﺧ
:ﺭۍکې ﺍ
ﻭ ﺪﻴﻣﺍﻪﻼﺎﭘ
ﻳﻣﺭ
ﻮک ﻤﻴﻴﮏﺳ ﻤﻳډﺍﻥﺮ
ﭙﻳﺎ
ﺎﻫ ﻴﮏﻳ ﻤﻳ
ډ ﺍﻥﻮﻟﻮﻪﻫﻭﭘ ﺮﻱﺍﻟﻤﻞﻭﻫﻢﺣ ﻯﺎﺩړﻳ ﻡ ﻮﻟﻮکېچې ﻨﻣﺮﻴ
ﻮﻣ ﻐﻪﻫﭘ
ﻭ(ﺍﻪﻣﺍ
ﺭ ١ګ٧ډﻝ٠ځﻲ ﻭﻪﻣﻦﻧ ﭘ
ﻟﻲ) ﺍ
ﻮ ﻤﮐ
ﺯﻥﺩ ﻡﺩﻭ ﻮﺎﺷﻟﻲﻣ ﺪﻳﺯږ
ﻮﻱ ﻱ ﻧﻼﺎﺩ
ﻳﻮﻱﻣﺭ ﺪﮐ ﻧﻭېژ
.ږﻱ
ﻻﻞکږ ﻟﻲ ﻣﺍﻮﺗﺎﻳ
ﺯﺩړﻮﺩ
ﻨﺭې ﻡﻳ ﻭﻟﻲﺩﺩ ﺍﻮﻴﻨﻮﭼﮐﺩ
ﻭﻍۍ ﺭ
ﺎﻪﻧ ﺮﻱﭘﻟﻮﻥﻭ ﺘ
ﺩﺷ ﻟږ
ﻭﻍۍ ﻲ ﺭﺎﻧډﻝﺩﺑﺖ ﻭ ﺎ
ﻪﺛﻮ کېچېﭘ ﻤﻴ
ﻮﺳ ﻐﻪﻫ ﻩﭘﻮګ ﻣﻲﺗ ﻮﻤﻪﻋ ﭘ
ډﻝ
ﺪﻭ ﻳ
ﺪ ﻪﺷ ﻴﺸﻦﭘ ﻟ
ﻮﮐﺮﻭﺳ ﺮﮑﻳﺎ
ﺎﻣ ﺘ
ﻨﺩﻼﺳ ﺩېچېﭘ ﻩﺩ ﺮﻭ،ﺳ
ﺮﺿﻲ ﻱ ﺮﻋ ﻴ
ﻩ ښځېﻏ ﺭﺍﻭﺪﻴ
ﻣ ﻪﺍ ﺘ
ﺍﺧ
ﻭ.
ﻮﻯ ﻱ ﺎﻝﺷ ﻐﺍﺷﻪ ﺍﺳﻄﻪﻭ ﻮﭘﮑﻧﻭﻭژ ﺮ
ﻮﺳ ﻨﺘﻨ
ﻣﺩ
ﻼﺎ
ﻳﻻﻱﻣﺭ ﻭﻭﺩ ﺍﺯﻥﮐﻢﻡﻭ ﻮﺎﺷ ﻟﻲﻣ ﺪﻳﺯږ
ﻮﻱ ﻱ ﻧﻭﻯﺩﺮﻱﺩﺩ ﻟﺎﻥﺘﻧﺍHIﻩ ښځېچېﺩV ﺭﺍﻭ
ﺪ ﻴﻣﺍﻪﻐﻫ
ﻭ.
ﺭې ﻱ ﻩﻣﻞګ ﺮﺳ
ﺩﻼ
ﻭکې ﻣ ﻭ ښځ ﺭﺍﻭﺪﻴﻣﺍﻪﺩﻭﻱﭘ ﻮﻮﺟ ډﻝﻣ
ﺑﺖ ﻭ ﺎ
ﺮﺛﻴﺩﻪﻏ
ﻟږﭘﻭﻍۍ ﻲ ﺭﺎ
ﻧﻮکېچېﺩ ﻤﻴﻮﺳ ﻐﻪﻫﭘ
ﺎ
ﻤﻳﺫﭘﻲﺍﺍﻧڅ
ﻭﺎ ږﻭﺩﺱ ﻟﻰﺍﺍ
ﻮ ﻤﺯﮐﻮ ﮐ
ﻮ ﻟ
ﻳﻦېﺩګ ﻭ،ﺩAnemi a،ﺎﻴﻤﻴﺘﻳ
ﺯﺍﺭﺎ
ﻩﭘ ﻟړ
،ﻮ،ﺪېﭘﻲښ ﻳﺪ ﺎﺷ ﻳ
ﺭ
ﻮﻟ
ﺪﻳﺯږ
ﻮﻱ ﻱ ﻧSﺎﺩ
tﻳ i
llBirth،ﺯږﻥ
ﻪ ﻱﻭ ﺘﻭﺧ ،ﻣﺨﮏېﺩ FetalDi strﺭځﻱچېﺩess ﻪﺍ ﺗ
ﻣﻦځ
.
ږﻱﻻﻞکږ ﻟﻲ ﻣ ﺍ
ﻮﻤﮐﺯﻥﺩ ﻭﺩ
:ﻮکې ﻧﺎ
ﻴﻨﻮﭼﻪﮐ ﻼﺎﭘ
ﻳﻣﺭ
(ﻪ
ﻡﻟ ﺭ
ﺎﭙﻴﻠﺴﻳﻢﻓﺩﻮﻣﺯډﻝﭘﻼګﻱ ﻭځﻥ ړ ﻪﺍ ﭘﺩﻼﺎ)
ﻳﮐﻝ ﻣﺭﺮﺎ ګﻭڅﻪچېﻫﻪﻭړ ﺧ ﻧﻮﻠﻴ
٣ﻣ -ﻮ١ ﻐﻪﻫ ﻟ
،
ﺎﻣﻮ،ﮐﺘﻼﺝ ﻮ کېﺍﺧ ﻧﺎﻣﻮ
ﺎﺷ ﻪﻣﺘ ﻼﺎﺍﺧ
ﻳﻩﻣﺭ ﺪ ﻳ
ﺪﻪﺷ ﺎﻥﻭﻱﭘ ﻴﻨﻮﭼﻪﻱېﮐ ﺮﺧﻩﺑﺮ ﺗ
ﺎﻳﺮﻱﺯ ﻪﻣ ﻠﺒ
ﮐ
ېﺣﻝکېچې ﺍﺱ ﺎ ﻪﺩ ﻩﭘﻪﺩ ﻣﺎ
ﺎﻋًﺘﺒAnemiﻧﺴ ﻩa ﺪﻳ
ﺪﻭﺷ ﺯﺍ ﻭﺪﻴﻴﮏﺍﺳ ﻟ
ﻮﺑﺎ
ﺘﻴ،ﻣﺎﻴ
ﻤﻴﻮګﻻﺳ ﭙﻳ
ﺎﻫ
.ﻩﻩﺩﺰﻳ
ﺩ ﻭﺩﺎ
ﺎﻧﻤﻳﺫﺍﭘﻲ ﺍ
ﻧڅﻭﺎ ږﻭﺩﺱ ﺍﻪﻳﺎ
ﻔﻡﮐﺪ ﭘﻲﻋ ﺍﻧڅ
ﻭﺎ ﺭګ ﻮﺗ
،ﺩﭖښ ړﻯﺪژﻱ ﻳﺪﺷ
ﻔﺲﻥښې ﻨ
ژﺭﺗﻪﺩﻭ ﻠ
ﺒ ﻪﮐﺯﺱﻟ ﻭﺪﻴﻴﮏﺍﺳ ﻟﻮ
ﺑﺎﺘﻴ
ﻣﻮ کېﺩ ﻧﺎﻴ
ﻨﻮﭼ ﻮﮐ ﮑﻧﻭﺮAnemiﻟ ﻩa ﺪﻳﺪﻪﺷ ﭘ
ﺩﻼﺎ
ﻳﺎﻥ ﻣﺭ ﻴﻨ
ﻮﭼﻪﮐ ﺮﻏﻪﻣ ﮑﻴ
ﻭ،ﻪﻧ
ځﻯ ﻱﻟ ﻮﺍ ﻩﻳﺮﻟﻲﺳ ﺍ
ﻮﻤﮐﻧﻲﺣﺠﻢﺩ ﺍ
ﺭﻭ ﺍﺩﺩًﺮ
ﺜﮐﺩېﻭﻱچېﺍ ﻮ ﻮﺟﻣ
.
ﻮﻱ ﻩﮐﺭﺎﮐګﻥ ښﺮﻭ ﺒډﻝﻏﻪچټک ﻭ ﻩﭘﺮﺭﺳ ﻭﻭ ﺍﺮﻱ ﻟ
ﻩﺯﻏﻢ ﻩښ ﺮﻮﺳ ﻠ
ﻣ ﺭﺪﺩﺿ
ﻭﭙﻦېﺍ ﻭﺳ،ﺍﻨﮏ ﻳ
،ﺯﻴﻦ A ﻣﺍ
ﻭﻱټ ﻭﺩ ﺍکۍﺍ ﻭﺭځﺍﻮ
ﻮ کېچې ﺧ ﻧ
ﺎﻣﻮﺎﺷﻮﻣ ﻐﻪﻫ ﻪﭘ ﺩړﻦېﮐﭽﻡﻳ
ﺘﻼﺩﻼﺎﺩﺍﺧ
ﻳﻩﺷﻲ ﻣﺭ ﻟﺖ ښ ﺎ
ﺬﻱېﺣ ﻐﻡﺗﻮﺎﺷﻣﺭېﺩ ﺭﻪچﻭﮐ ﻩﺍﻪﺩ ﺗ
ﺎﻳﻪﻭﻱﺯ ﺘ
ﻟﻲﺍﺧ ﺍﻮﻤﻪﮐﻴﺖﭘ ﻟ
ﻮﻓ
ﺷ.
ﺍﻯ ﻲ ﺩﺩ
ﻮﻯک ﻴﻨﻩﻣﺨ ﻧڅﻩﺎېڅﻪڅ
ړﻦ ﺧ ﻭﻡﻳ ﺍﻮ ﺗ
ﺎﻃ
:
ﺎﺕ ﺘﻼﻃﺍﺧﻧڼﻱ ﺩﻼﺎځﺪ
ﻳﻣﺭ
Tropical splenomegal (y Hyperreacr iveMal ar i
aSpl enomegal y)
ﻪAﻭﭘ
nemiﺍ ﻴﮏaﺘﻳ
ﺎﻮﺳﻣﺭ
ﺎﻴﮏﻧﻣﻭﺮﮐ
ﻮﻣﺭﺎ
،ﻧﺎ
ﻴﻤﻴﻨ
ﻴﻟ
ﻮﺑﻮﻟ
ګﺎګ
ﻣﺮﺍﭙﻳ
ﺎﻼﺎﺩﻫ
ﻳﺭﻱﻣﺭ ﺍﺮ
ﮑﻭﺗډﻲﺍځﻥﻧ
.
ږﻱﻻﻞکږﻟﻲ ﻣﺍ
ﻣﻲګ ﻮﻨ
ﻴﻠ
ﭙﺍﺳﻮکېﺩ ﺗﺎﻻ
ﺭﺣ ﺭ
ﻮﺷﻢ ﻳ
ﺭﺪڅﺮﺿ ﻼﺎﭘ
ﻳ
ﺭﻱﻣﺭ ﺍ
ﺮﮑﺗګﻥﺩ
ﺮﻭ ﺒﻳﮏﻏژﻮﻟ
ﻮﻧ
ﻮﻤﻳﻣﻞﺍﺭﺎ
ﻨﺑ
ﻮﺍﻧﮏېﻳﻭﺪﻴﻭﺳﻨﻲﺍﻳ
ﻮځ ﻤ
ﻴﻮﺳﮑﻴﻤﻳﺪﻧ
ﺍﺩ
ﻟﻰﺍ
ﻭﻟړ
lﻮﻡ gMﻭﺮﻴ
،ﺩﺳHepatomegaly،ﻟﻲﺍ
ﻣﻲګ ﻮﻨ
ﻴﻠ
ﭙMassiﺳvﺮe ګﻥﭘ
ﺮﻭ ﺒﺍﻏ
ﻭﻱچېﺩ ﺪﻧ
ګ
ﺪېﻣﺸﺨ ﺺک ﻧﺎ
ﺯﺱﺑﻮ ﺘ
ﻳﺎ
ﻮﺳﻔﻤBcelﻟ
ﻴﻄﻲlﻪﻣﺤ ﻭﭘﺯﺱﺍ ﻮﺘ
ﻳﺎ
ﻮﺳﻔﻤHepatﻟicSinusoidal،
ﻭﻮﺍﻧﻮ
ﺘﻳﺎﻮﺳﻔ
ﻤCD8+TCelﻟ ډﻱﺩl ﺎﺘﻲﺑﻧ
lﺍ ﻴﮏ gMﮐﺴﻮﺗ
ﻮﺘﻳ
ﺎﻡ کې ﺳ ﻭ
ﺭﺪﻨﻪﺩې ﺳ ،ﭘږﻱ
ږ
ﻟړﻱ
Cڅﻪﻮ
D8+TCelﺧ lﺒﺖﺩﻭﻫﻢﺩCD4+Tﻧﺴ ﺍږﻱﺟړﻱ
ﺪﻮ ﺮﺿﻮﭘ ﻧ
ﻮﺘﻳ
ﺎﻮﺳﻔﻤﻟCD5+TCel l
88
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
89
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﻭ.
ﺭﻯ ﻱ
ﻼﺪ
ېڅﻪﺳﻳ ﻳﻦ ﺧ ﺪﻱﻭ ﻳﺭېﻪﻭﺭﻟ ﺭ
ﻪچ ﺘﻞﺷﻲﮐ ﻴﺴ ﺍﺧۍڅﻪﻭ
ﻡ ﺧ ﺮږﻪﻧ
ﻮﻟ ېﺎﺩﻏﻭﺕ ﻳ ﺪﺩګ ﻳﺎﻪﺑ ﻨﻳ
ﻭ
ﻭﺭﻮﻭﻪﻧ
ﺗڅﻟ ﻪﺷﻲﺮ ﻨ
ﻳﺎﻌﺟړﻭﻣ
ﻼﺪ ﻮﺍ څﻪﺳﻳ ﻮ ﺧ ﻠ
ﺘﻴﺴ ﺍﺧ ﻳﻦېﻪﻭ ﻟ ﻪﺘﻭﺳﺭﻪﻭ ﺪﻻﺳ ﻤﺪﺳ ﻳ ﺎ
ږﻱﺑ ﺟړﻱﻮ
ﺷ.
ﺭﻝ ﻲ ژﻮ
څﻪﻭﻏ ﻮ ﺧ ﻧﻮﻧﻮﻟﺪﺑ
ﺩېﺮﻩﭘ ﺮﻴﺑﺮ
ږﻱ ﺳړ ګڼﻝ کږ ﻩﻭ ﺮﻟﻮ ﺳﻟ
PH ٧ﺮ ،Giﺭﻥګﺩ٢ ﻩﺩesma ﺭﺎﭙﻮﻟ ﻧﻭﻼﺪﺭﻥګ ﺩﺳﻳ
ﺷ.
ﺍﻯ ﻲ ﺩﺩﻭﻝک ﺭﺎﻪﻫﻢﮐ ﻧﻭLeiﺭﻥګ ﺎshman ﻳﻭﺍFi el'ds, Wr it
ht '
s
ﻪﺍﭘﻮﻩﺩﻫ ﺮﻪچټکۍﺳ ﺪﭘ ﻳﺎﻠﻢﺑﺮﻯﻓ ﻳﻦېﻧ ﻭﻪﺷﻲﺩ ﻨﻳﺎﻌﺟړﻭﻣ
ﻪ ﻮﺍ ﻧ
ﻮﻤﻠﻓﭘډ
ﻭﻦ ﺮﻱﺍ ﻳﻦېﻧ ﻭﺪﺩ ﻳﺎﺑ
ﻧېﺩOiﻻﺪ ﺗl
څﻪﺮﻮ ﺧ ﻧﻭﻪﺭﻥګ ﻪﻟ ﺘ
ﻭﺳ ﺭﻭﻭ Fiﺷﻲﺍ ﻪx ﺍﺳﻄ ﻪﻭ ﻮﻝﭘ ﻧ
ﺎﺘﻴﻟ ﺺﻣ ﺎﻭﺩﺧ ﻪﻭچﺍ ﻠﻴﻭﺳ
ﻩﺭﻫﻢګټ ﺎ
ﭙﻮﻟﻠﮐ
ﺍډﻝﺩټ ﺯﻱټﺩ ﻭ ﺍﺮﭘڅﻪﺩﻠﻢ ﺧ ﺮﻱﻓ ﻪﻧ ﻪﻟ ﺘﺒ
ﻟﺘﻞﺷﻲﺍ ﮐﻪﻭ ﺍﺳﻄ ﻮ ﻮﭖﭘ ﮑﻭﺳ ﺮﮑﻳﺎ
ﻣ
.
ﻮ ﺘﻼﻯﺷ ﻴﺴﺍﺧ
ﺭﺷﺭ
ﻮ ﻢ ﮑﻧﻭژﻭﺮﻧﮏېﺳ ﻭﺮﻟﻳﺖ ﺯﺍ
ﺮﭘﻮکېﺩ ﻧﺎ١ﺧ ٠٠ﭘ٠
ﻼﺪ ﻪﻩﺩﺳﻳ ﺭﺎﭙﻟﻮﻟﻮﻣﻮﻠﻌﻣﮐﭻېﺩ ﺎﺩ ﻴﻤ
ﻴﺘﻳ ﺯ
ﺍﺭﺎﭘ
ﺩ
ﻭﺭﻮﻪﻧﺩﻼﺎﭘ
ﻳ ،ﻣﺭﻭﻱ ﺪﻧﺭګ ﺭڅ ﺷﺭ
ﻳﺖ ﻢ ﺯﺍﺮﭘﺭکېﺩ ﻟﻲټ ﻭﺮﮑ ﻳ
ﺎﻮﻣ ﺭﻪﻳﺷﺭﭘړﻯ ﻢ ﻮ ﻣﻮ ږﻱچېﻧ ﻨﻲ ﻴﻌﺗ
ﻡکې ﺭﺎﭙ
ﻴﻠﺴﻳﻢﻓﺩﻮﻣﺯﭘﭘﻼ ېﺣﻝکېچېﻪ ﺍﺱ ﺎ ﺪ ږﻱﭘﻟړﻱﻪﻮ %څﻪﻧ
ﻪ ٢ﺧ ﻟﺎﻴ
ﻤ ﺘﻳﺯﺍﺭﺎ
ﻮکېﭘ ﻧﻮﻟ
ﻭډ
.ږﻱ ﺗﻲﺎﻳ
%څﻪﻫﻢﺯ ٣ﺧ ﮐ٠
ﻪﻪ ﻠﻪﮐ ﻠ
ﮐ
ﻩﺭﻮﻩﻏ ﺗﻲﺏڼ ﺭ
ﺎځﻦېﻱېﺗﺠ ﻭﻳ ﺍﻧېﺩﻱ ړﻥېﻻﺪ ېﺮڅﻱېځﻦېﻱ ﺗ ﻳﻦېچ ﻳ ﻮﻣﺯﺁ ﻴﺼﻲ ﺭېﺗﺸﺨ ﻮﻧ
ﺩﻼ
ګﻱډﻝ ﭘ
ځﻥ ړ ﻭ ﻪﺍ ېځﻦېﻱېﭘ ﺍﻥېﺩﻱ چ ﻳ ﺭړﻪ ګ
ﻪﺍﺧ ﻠﻪﺑ ﻟ
ﻭﻠﻲﺍ ﻴﭽ ﺍﭘﻮﻳې ﺧ ﻪﻮ ﻩﻟ ﺪﻳړک
ﻪﮑﻪﻟﻧﻭ ﺩ
ﻮ ﺘ
ﻴﺭﻣ ﻮﻭﻧﻪﺍ ﻧ
ﻭﺩ ﻮﺘﻴDiﻣ pstick,ELI ﻪ SA ﮑ ﺎﺳﻲﺩﻱﻟ ﻩ ﺣﺴ ﺭﺎﭙﻡﻟ ﺭﺎﭙﻴﻠﺴ ﻳﻢﻓ ﺩﻮ ﻣ
ﺯ
pﻭ
olﺍ ymenr aseChai nr eaction,Quant itati
vebuf fyCaotcent ri
f ugalsy stem
ډﻱﺗﺲ ﻱﺎ
iﺍﻥټ ﺑ ndirectFl uorﻟesent ﺩﺩﻯﻪ ﻮﺘﻴګﻯﻣځﻥ ړﻭﺍ ﺎﺱﺍ ﺮﺣﺴ ﻳډﻝﻱېچېډ ﺑﻞ ﻭ
ﺩ.
ﺭﺕ ﻱ ﺎﺒ
ټڅﻪﻋ
ﺧ
ﻪﻐﻩﻫ ﻮګ ﻣﻲﺗ ﻮ
ﻤﻪﻋ ﻮﭘ ﻠﻲﺩﻱﺧ ﻴﭽﻳېﭘ ﻳﮏېډﺮ ړﻣﻦځﺍ ﺮﻭﺗ ﺭﺍ
ﺰﻧﺍﻭﻍۍﺩ ﺭﺎﻧPﻭﺩ
arﺍ asi temi ﺩa
٥
ﻴﺖ ﻓﺎ
ﻌﻮﻣ ﻣﺦﻭﻱﺧ ﺎﺮﻣﺨ ﻳﻩډ ﺮﺍښﺳ ﻭېﻪګﺩړﻦ ﻟﺮﻱ ﻡﻳ ﻟﺎﻭﻴﻤﻴﺘﻳﺍ
ﺯﺭﺎﻪﭘﺗﺎﻳ١څﻪﺯ
ګﻱچېﺩ ٠ﺧ ﻭړ
ږګﻱﻝﻧﮏېﻭړ ﻭﺮﻴﺖﻟ ﻓﺎ
ﻌﻤﻲﻣ ﻗﺴ ﻭﺩ ﺮﻱﺍ ﻪﻫﻢﻣ ﻠﺒﻪﮐﺎﻟ ﻴﻤ
ﺘﻳﺯﺍﺭﺎﺭﭘﺍﺪﻘﺩږﻣګﻱ ﻝ ﻧﮏېﻭړ ﻭﺮﻪﻟ ﻧ
.ﻭﻱﺪ ﻧﺭګﻩګﻞېڅ ﻮڅ ﻳ ﻩﻳ ﺮﺎﺳ ﻴ
ﻤ ﺘﻳﺯﺍ
ﺭﺎﺭﭘ ﺍ
ﺪ ﻘ
ﻣ
ﺎ
ﻴﻨﻴﭘﻮﮐﻮﻪﻟﺘﻭﺳﺭﻭﻭ ﺩﻭﻱﺍ ﻮﻮﺟ Trﻣ ansi entl eukocy tosiﻪ کېs ﻔﺤ ﻮﻱ ﺻ ﻠﻤ ﻪﺣ ﻭﻍۍﭘ ﺭﺎﻧ
ﺩ
ﻭ.
ګﻯ ﻱﻩﻣﻞ ﺭ ﺮﻟﻲﺳ ﺍ
ﻮﺗﺎﻳ
ﻪﺯ ﻟﻮﮑ ﻧ
ﻭ ﺮژﻴﻠﮐﻮﻧﻮﻧﻮﻮﻣ ﻳ
ﻮ ﻟ
ډﻝﺩ ﺒﻲ ﻭ ېﻪﻧﺴﺭځﻱچ ﭘ ﻪﺍ ﺗ
ﻣﻦځ
ﻍﻪ
ﻍﻪﻥ ﻏ څﻪﻥﻍ ﭘ ﻮ ﺧ ﻟ
ﻮ Fiﮐ ﻪxﻪﻟ ﺗ
ﺮﻭﭘ ﻪﺷﻲﺍ ﻴﻬډﻝﺗړﻭ ﻪﻭ ﻠﻢﭘ ﭘډﻓ
ﻳﻦې ﻦ ﻭ ﻩﺩ ﺭﺎﭙﻴ ﺺﻟ ﺗﺸﺨ ﺩ
-
٢ﻧ٠ﻴﺴﻲﻮ ځﻯﻧﻪﺍ ﺎﺳ ﭘﺑﻞﺩ ﺭﻮﺩﺷﺭﻳﺮ ﻢ ﻳﻮډ ﮑ ﻧ
ﻭژﻠﻢکېﺩ ېﻪﺩېﻓ ﺍچ ﭘ ﺷ،ﺩ
ړﻯ ﻲ ﻭﺭﻥګکﺍ ﻭچﺍ
،ﻪﺳﻼﻮﻱﭘ ږﻱﮐﻪکږ ﻧﺎ
ﻴ ﺺﺍﺳ ﻱﻭﺗﺸﺨ ږﺍ ﺗﻲ ﺎﻳﻧﺲﺯ ﺎ
ﻮﭼ ﻟ
ﺪ ﻴ
ﻟﻳﺖﺩ ﺯﺍﺮ
ﭘﻪﺩ ﻠﺗ
ﺮﻪﭘ ﻠﻢﭘ ﺮﻱﻓ ﻧﻪﺩ ﻟ
٤ځ ٠
ﻮﮑﻧﻭﻮژ ﻨ
ﻴﭙډﻝﺩﺳځﻲ ﻭ ېﻪﻣﻦﻧ ﺭﻝﺷﻲچ ﭘ ﻩﻭﺷﻢﺭ ﺩړ
ﺍ
ﺎﺕ ﻭ ﻳ
ﻭ ﺮﻴﻦﮐ ﭙﻭﺳ ﻪﺍﻧﻮﺘﻳﺯ ﺍ
ﺮﺪﭘ ﻳ
ﺎډکېﺑ ﻱ
ﮑﺖ ﻔﻳ
ﺭټ ﺍﺍً
ﺮﺗﺎ
ﻳﻭ کېﺯ ﺪﻴﻪﻟﻠﻢﭘ ډﻓ ﭘﻦﺍچېﺩ ،ﺩﺪﻯ ﻳﻮﻨﻞﺷ ٨ﻣ ٠٠ﺭکې٠ ﻟﻲټ ﻭ ﺮﮑ ﻳﺎ
ﻮﻣ ﻪﻳ ﺭﭘ ﺷﺭ
ﻢ
.ﻩړﺎﺩ
ﻴﺗﺍﺗﺑﻲﻪ ﺮﻭﺗﺠ ﺍﺎﻴﺘﮐﺮﻳﻳېځﻭﺧﺖډﺮ ﺮﻳﻦېﭘ ﺎﻌﻣ ﻮﺩ ﺩﻭﻱﻧ ﻮﻮﺟ ﻣ
ﺎﺡې٢ﺳ ٠٠-
١٠
ﻪ٠ ﻐ
ﺪﺩﻫ ﻳ
ﺎﻩﻭﺷﻲﺑ ړﻳﮏ ﺮﻪﭘﻠﮑﻪﻫ ﻴﺞېﭘ ﺘﻔﻲﻧ ﻨ
ﻣ ﻠﻢﺩ ﭘډﻓ
ﻮﻦ ﻳېﻪﺩېچېﺩ ﻣﺨﮏ ﻟ
ﻟﻲﻮټﻭﭘﺎﻱ ﺍ ﻮﺳﻧﻮېﻪﻣﻳﻦ ﭘ ﻴﻄﻲﻭ ﻣﺤ ﻭﺩ ﺪﻝﺷﻲﺍ ﻴﻟﻪﻧﻳﺖﻭ ﺯﺍ
ﺮ ﺩﻼﺎﭘ
ﻳﺭې ﻣﺭ ﮐﺭ
ﻮﭻ ﻪﺷﻲﺧ ﻨﻳﺎ
ﻌﻣ
ﺩﻼ
ﻮﻱﻭﺧﺖکې ﻣ ﺮﺷ ﻴﺩېﺗ ږﻪﻥ ﭘﺍ
ﻮﺩ ﺪﻝﺷﻲﻧ ﻴﻟ
Piﻭ ﺩﻼﺎgment ﻳﻮکې ﻣﺭ ﮑﻧﻭﻮژ ﻨﻴ
ﭙﺭﻑﺳ ﻮﻣ
ﻭ.
ﻭﻯ ﻱ ﺪﻧﺭﺎﮐﺎﻥ ښ ﺘﻧﺍ
ﺎﺩ ﻳ
ﺭ
ﻪ ﻑګ ﺎﻍﭘ ﺒﺩﻼﺎ ﺻ
ﻳ
ﺭې ﻣﺭ ﻮﻭﭘ ﻭځ
ﻭﺭ ﺗڅﻪﺮ ﺘﻭﺳ ﺭﺩﻭﻭﺘﻢﺩ ﺯﻱټﺧ ﺍ
ﺮﭘڅﻪﺩﺍﻥ ﺧ ﺭﻭ ﻩﻪﺩﺭﻥګﻟ ﺍﺪﻤﻫ
ﻪﺘPڅﻪﺩﻻﺳ
unctﺧ urﻪe ﻨ
ﻧﺘﮏېﺩ ﻮﺳ ﭘﺎﺩﻳﻭﻳﺸﻦﺍ ﺭﺎ
ﭙﻪﺍﺳ ﺰﻟ ﻐﻣﻧﮏېﺩ ﻭﺩډﻮ کې ﻩ ﮑﻧﻭﻳﺖژ ﺎﻭﺳ
.
ږﻱﺪﻝکږ ﻴﻟﻪکې ﻨﻳﺎ
ﻌﻪﻣ ﻼﺪﭘ
ﻮﻱﺳﻳ ړﺷ ﻮ ﻊﺩﺟ ﻳﺎ
ﻠﻲﻣ ﺍﻏ
ﺭ
90
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﺎ
ﻴﻤﻳ
ﺯﻱټ ﺍﺭﺎﺎﻝﺩﭘ ﻤﻌﺘ
(ﺍﺳ Acridi
neOr ﻴﻦټﺭﻥګ)ange ﺭﺳﻮﻠﻓﻩﺩﺭﺎ
ﭙﻮﻟﻟﻭﺭﻥګﻠﻢﺩ ﻳﻦېﻓ ﺩﻭ
.
ﻮﻱ ﻊﮐ ﻴ ﺺﻭﺿ ﻩﻭچټکﺗﺸﺨ ﻠﻄﺖکېﻫﻢ ښﺍ ﻪټﻱټﻏ ﭘ
:
ﺪﻥې ﻧ
ﻮ ﺭﻱﻣﺍﻮﺗﺍ
ﺮﺑﻻ
ﻭ.
ﻩﻱ ﺩ
ﻮ ﻮﺟﻩﻣ ﺮ
ﺗﺎﻳ
Anemiﺯ ﻳﮏa ﺎﻱټ ﻮﺳﻣﺭﺎﻴﮏﻧ ﻣﻭﺮﮐﻮﻣﺭﺎ
ﻧ
ﻟﺖﺎ
ﺎﻥﺣ ﺘﻧﺪﺍﻳ ﺪ
ﻪﺷ ﺍﻯﺷﻲﭘ ﺩﺩﻮک ږﻭﻱﺧ څﻪﻝﺎﻝ ﺧ ﻣ
ﺭﻮﻩﻧﻮګ ﻣﻲﺗ ﻮﻤﺭﻪﻋﺷﺭﭘ
ﻮ ﻢ ﮑﻧﻭﻮژﻨﻴﭙﺩﺳ
ﺷ.
ﺪﻝ ﻲ ﻴﻟ
ﻟړﻭکېﻮ
ﻭ.
ﻩﻱ ﺩﻮﻮﺟ ﻩﻣﺮﺗ
ﺎﻳC-ﺯReact ivﻭﺩe ﺍﻴﺖ ﻭﺟﺰﻟﺩﻼﺎ
ﻣ
،ﭘﺯ E.S.R
٧څﻪﻫﻢ
٠ﺧ ٠٠ﺍﻯﺷﻲﺩ٠ ﺩﺩږﻱﻪPFکېک ﻪکږ ﭘ ﺘﮐ١ﻪ ښ٠ﺗ ٠
٠٠٠
ﺍµL ً
ﺮﺜ
ﮐﺭﺍ ﺷﺭ
ﻮ ﻢ ﻧﻮﺘﻳﺎﻮﺳ ﺒﻣ
ﻭ ﺮﺗ
ﺩ
Part
ialthor mboplastintiﺩږmeﻭﺍﻯ ﺷﻲ ﺍ ﺩﺩﻟﺖ ک ﺎﻧﻲ ﺣ ﺎ
ﺘﻧ
ﺪﺍ ﻳ
ﺪ ﺪﻝ ﺷﻲ ﺷ ﻴ
ﻟﻪﻭ ﺘﮐښ
ﻭ.
ﺭې ﻱ ﻩﻣﻞګ ﺮﺎﺳﻴﻨﻴ
ﭘﻮﺘﻳﺎ
ﻮﺳ ﺒﻣﻭﺮﺪېﺗﻳﺪTﻭﺷiﺍ ﻴﻦme ﺒﻣﻭﺮﺗ
ﻭ ﺮ
ﭘ
ﻭ.
ﻪﻱ ﺘﮐ
ﻟﺖکېﻫﻢ ښ ﺎﻧﻲﺣ ﺎ
ﺘﻧﺍﻴﻒﻔﻪﺧ ﺁﻥﭘ ﻪIﮐﭽIﻴﻦI ﺒ
ﻣﻭﺮﺘﻲﺗ ﻧﺍ
ﺩ
ﻪﺎﻝﭘﻣﺭﻮﺍﻧً
ﺮﺜﮐﻴﻦﺍﻨﺗﺎ
ﻳﺮBﻭﮐ
UN،ﺍ ﻠﻈﺖ ﻮﻏ ﻧ
ﻮﺘﻳﻭﻻﺮﺘﮑﻟ
ﺍﺩﻼﺎﺩ
ﻣﻼﺎ کې ﭘﺯ ﻳﺘﻼﻃﻲﻣﺭ ﺍﺧﺮﻴﻪﻏ ﭘ
،
ﻴﺖﻧﻮﺑﺭﺎ
ﺎﻯﮐ ،ﺑﻳﻢﺩﻮ
،ﺳ ﺯﻮﮐ
ﻮﻟﻼﺎ کېﺩګﻣ ﻪﭘﺯ ﻭﭘ ﺯﺱﺍ ﻭﺪ ﻴ
ﻴﮏﺍﺳ ﻟ
ﻮﺑﺎ
ﺘﻴﻼﺎ کېﻣﻳﻩﻣﺭ ﺪﻳﺪﺷ
ﻭﺩځﻱ ﺍﻠﻲ،ﺩﻋﻀ ﺎ
ﻳﺭ
ﻮ،ﻳﻴﻦﻨ
ﻴﺗﺎ
ﻳﺮ،ﮐBUN، ﻴﺖﺘﮑﻟ
ﻭﺩ ﺍﻪﻧﻮﺘﻠﻈﻴﻦټﻱټﻏ ﻣﻮﺒﻟ
ﺍﻭﺍﻴﺖ ﻔﺎﺳ،ﻓﻴﻢﻠﺴﮐ
ﻭ.
ﺩﻱ ﻮﻮﺟ ﻪﻣﻧﻮﺘ
ﻠﻈ ﻟړﻏ
ﻴﻦﻮ ﺑﻭﺮﻴﻠ
ﻴﻭﺝﺑ ﺩﺰﺮﻣﻴﻭﻏﺍ ﻭﺝﺩﺰﻣ،ﺩﻮﻧﻮﻤﻳﺍ
ﺰﻧﺍ
ﺭﺩ ګ
ﻩﺮ
ﺗﺎﺩﻳﻪﺯﻩﮐﭽ ﻟړ
ﻴﻦﻮ ﻟ
ﻮﺑﻮﻟ
ګﺎګﻣﻮ کېﺩﺍ ﻳﻭﻭړ
ﻭ ګ ﻧﮏ ﻭﺮﻴﺖﻟ ﻓﺎ
ﻌﻪﻣ ﻤﻴ
ﻧﻭﻭﺍ ﻭ
ﻧﮏ ﻭﺮﻴﺖﻟ ﻓﺎﻌ
ﻪﻣ ﭘ
ﻭ.
ﻩﻱ ﺩﻮﻮﺟ ﻣ
ﻭ.
ﻪﻱ ﻟﺎ
ﻣ ﺭ
ﻮډﻝﻧﺰﻭ ﻳﺩﻭﻪﺩﻪﭘ ﻳ
ﺰﻭﺗﺠ ﺯﺎ
ﻴﺘﻮﻣ ﺗﺸﺩ
ﺮﻭﺧﺖ ﺬﻝﭘ ﻨﻲﺑ ﻗﻄMeanOpeniﺩ ngPr essurﻼﺎکېﺩe ﻳﺎﻏﻲﻣﺭ ﻣﻪﺩ ﻮﭘﻧﺎ
ﻴﻨﻮﭼ ﻭﮐﻮﺍ ﻧ
ﺎﻳﻮﻟ
ﺩ
ﺩ.
ﺩې 160mmﺩ CSFﻯ ژﻥ
ﺭﺷﺭ
ﻮ ﻢ ﮑﻧﻭ ژ(ﻭﺩ<g-ﺍLit
ﻟﻰ)ﺍﻭﻟړ
ﻩﻮ ﻮڅ ﻴﻦﻳ ﺗ
ﻭﺮټﻝﭘﻳﺩ ﻭﻪﻭﻱﺎ ﻟ
ﺎﻣﺭ
ﻮﻪﻧ ﻨ
ﺘﺭﻱﮐ ﺍ
ﻮﺗﺍﺮﺑ
ﺩCSFﻻ
ﻭ.
ﺩﻱ ﻮﻮﺟ (ﻣ<20- )µL
91
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﻭﻳﺖﺍ ﺯ
ﺍﺮ،ﭘﮑﻰ ﻧﻭ
ﺩﻟږ
ﺎﻥ ﻲ ﺘﻧﺍﻮﻱ چېﺩ ﺭﮐﺍټﻦګﻩ ﻳ ﺮﺒ
ﻪﺩې ﺧ ړﻥېﭘ ﺷېڅﻱ ﻩ ﻮ ړﻪﺍ ﺩﻼﺎﭘ
ﻳﻣﺭ
ﺷ.
ﺘﻞ ﻲ ﻭﺳﺍﻧېﺭﻭﻝﻻﺪ ﺮﺘﻨﮐﺮﺪﺗﻳﺎﻳﮏېﺑ ړﺍﻣﻦځ ﺮﺎﻝﺗ ﻳﺮﻴﭘﺎﭼ
ﺩﻼﺎ
ﻳﻴﻦ ﻣﺭ ﮐﺴ ﺍﻧﮏۍﻭ ﻭﺮ ﻟﺮﺛﻩﺍﺭﺍﺪﻣﺍﻭﺩﺩﻭﻮﻥﺍ ﺌ،ﻣﺼ ﻣﻦﺰ ﻴﻪﺍﻏ ﻭﺳﺍﺮﻩﺗﺮ ﻩﺳ ﺮﻮﺳ ﻧﻮ ﺗ
ﻭﻝګښ ﺮ
ﻳ ﺩډ
ﺷ.
ﻪﻴﻞې ﺘ ﻮﺏﻫ ﺘ
ﻴﻟﺎ
ﻳﺮﺑﻮﺩ ﻮﻯﺧ ﺟړﺷﻪﺩﻯ ﻮ ﻩﻧﺭﺎﭙﻟ
:ﻪﻧﺭﻮﺩﻱژﻏ ﺮ
ړﺪېﻓ ﻧﺮﻭﺍ ﺩﻼﺎﭘ
ﻳﻣﺭ
ﻴﺴﻲډ ﻪﻧﺩﻣﺨ ږﻟﻲﻳﺖﺩ ﺯﺍﺮﭘګﻱﻪﺩ
ﺳﻢﻭړ ﺗ ﻟ
څﻪ ﺎ ﺎﺷﻲ ﺧ ﻴﻗﻞﻣ ﺎﻴﻞﻧ ﻓﺎ
ﻧﺍﻪچېﺩ ﻧ
ﻭ ﺭﺎ
ﻴﻌﻩﻣ ﺩﺎﻪﺳ ﻐﻫ
:ږﻱ
ﻪکږ ډﻝﺧﻼﺻ ﻧې ﻭ ېﻪﻻﺪ ﺮﻱچ ﭘ ﻟﺯښﺕ ﺭﺍ ﺮ
ﻳ
ﻡﺍ،ﺎښ
ﺭﻣ ﺎ
ﻬ:ﺳ ﻪﮑﻪﻟﻧﺭﻮېځﻥژﻏګﻱﻭﺧﺖک ﺍ ځﻥ ړېﻪ ﺍﺬﻱ ﭘ ﻐﺗ
ﻮﻯﺩ ﻐڅﻪﺩﻫﻮ ﺧ ﺘﺎﺷ ﻴﻪﻣ .ﻟ 1
.ﺍ
ﻮﻟﺨ ﺎﺩﺷﭗې ﻳ
ﻮﺟ ﻳﻮ
ﻮﻉﺷ ﺒﻣﺸﻪﺩ ﺍﺳﻄ ﻪﻭ Perﭘ mithri
ﻳﺩn ﺎﺱﺎ ﺒړﻟﻪﻭ ﮑﻭﻝﻟ ﺭﺎﻮﮐ ﮑﻧﻭړﻮﺩﺵ ﺗ
ﺍﺮ .ﺩﺣﺸ 2
١٠
()DET Diethyltolumi de): ﻪﮑ
ﻟ ﻮﻠ
ﻣﺭﺩﻮﮑﻧﻭژﻮﻭ ﺎﺷﻴﻣ ﻮﺩ ﺮﺧﻭﺑ ﻮڅ ﻟﺮﺪﻥﭘ ﺑ
ﺎﺩ ﺎﻝﻳ ﻤﻌﺘﻮﺍﺳ ﻴﻟ
ﺎ
.ﻪﺘﻭﺳ ﺭﻪﻭ ﺘﺎﻋ٤ﺳ -ﺮ٣ﻭﻝﻫ ﺭﺎ(ﮐ%٥ ﺮڅﻪﺗﺧ
ﻪﻭﺁﻥﭘ ﻮﻱﺩﻱﺍ ﺩﻼﺎﭘﻲښېﮐﻢې ﺷ ﻳ
ﻩ ﻣﺭ ﻮګ ﻪﺗ ﻣﺎﻪﻋ ﻩﭘ ﺮ ﻭﻝ ﺳ ﺭﺎ
ﻪﮐ ﻮﭘ ﻴﻟ
ﺎﻮﺟ ﻳﻮﻮﻉ ﺷ ﺒ
ﻣﺸ ﺩ
.
ﻩکېﺩﻪړ ﻤﻪﮐ ﺩړﻮﮐﭽﻨﺎکېﻱې ﻡﻳ ﻘﻳﺮﻓﺍﺑﻲ ﺮﻭﻏ ﺍ ﻗﻲ ﺮﺷ
.
ﻪ ﻧ
ﺪﻨﻴﺍﺷ ﻭﺪﺩ ﺮﺿ ﻮﭘ ﺗﺍ
ﺮډﻝﺩﺣﺸ ﻨﻈﻢ ﻭ ﻪﻣ .ﭘ 3
.
ﻮﻝ ﮐﺍﺪﻴﺎﻥﭘ ﻳ
ﺮﻪﺟ ﻮﺗﺑﻭﺍ ﻭړ .ﻭﻻ 4
.
ﻭﻝ ﺭﺎ
ﻮﮐ ﻴﻟ
ﺎﻭکېﺩﺟ ﺯﺍﻭﺭﻪﺩ ﻭﭘ (ﺍﻭ)Fan ﻭ .ﭘﮏ 5
ﻭﺱﺩﻣ ﻪﺍﻠﻣﻪﺍﻟﻮﻟ
ﻭ ﺭ
ﺎﻮﮐ ﻧﺎ
ﻪﺧ ﻭﭘﺸ ﻮﻮﻉﺷ ﺒﻣﺸ ﻩﺩ ﺮﻭﺳ ﺩ ﺍ
ﻮ ﻭېﻣ ﺎﻴﻣﻡﺭکېﻫﻢﺩک ﺍږﻪ ښ ﻮﻥﭘ ﻣﺯ
ﺩ.
ﻮﻱ ﻱ ﻩﮐﻢېﺷ ﻧڅﻩﺎ ﻮڅ ﺒﺖﻳ ﻪﻧﺴ ﺍﭘﻮﭘﺨ ﻼﺎﭘﻲښېﺩ ﻳﺭ
ﺩ:
ﻮﻱ ﻱ ﻳﺸﻞﺷ ﻮﻭ ﻟ
ﺩېډ ﻪﺭ ﻩﭘﺮﻪﻧﻈ ﻟ ﻭﺰﻴﺍﻏﻣﻞﺩ ﺭﺪﺩ ﺩﻼﺎ ﺿ
ﻳﻣﺭ
ﺭېﻪځﻱګﻣﻞﺩﻱچ ﭘ ﺭﻪﺩ ﻐﺍﻫ(ﺩ TissueSchi zant oci dalﻧﮏې) ﻭژﻧﺖﻭ ﺍﺰﻴ .ﻧﺴﺞکېﺷ 1
ﻪﻧﻮ
ﺘﻧﺍ
ﺰﻴPﻭPOﺷ ډﻝﺩ Vﺍ ګﻱ ﻭ ځﻥ ړېﻪ ﺍPrچ ﭘ imaqui ne: ﻪﮑﻟ ړﻱﻩﻭ ﻪﻣﻦځ ﻟﻪﻧﻮﺘﻧﺍ
ﺰﻴکېﺷ
.ړﻱﻩﻭ ﻪﻣﻦځ ﻟ
Supperssiv ېﻪe
(ﺩېډﻝ ﺗ BloodSchi zant oci dalﻧﮏې) ﻭژﻧﺖﻭ ﺍﺰﻴﻪکېﺷ ﻨ
ﻳﻪﻭ .ﭘ 2
ﻭکﻥﻥ ﺩﻮﻴ
ﻣ ﺍ،
ﻴﻦ ﻧ
ﻮ،ﮐﻭکﻥﻥ ﺭﻮﻠ:ﮐﻪﮑﻟړﻱﻩﻭ ﻪﻣﻦځ ﻟﻧﺖ ﺍﺰﻴﻮکېﺷ ﮑ ﻧ
ﻭ ﻭژ ﺮﻳﻲچېﺳ ﺍﻣﻞﻫﻢﻭ ﺭﺩ
.
ﺎﺕﻘﺘﻴﻦﻣﺸ ﻧ
ﺰﻴﻤﺗ
ﺭﺍﻭﺩ ﺍﻴﻞﻧﺍ
ﻭ ﻭګ ﺮ،ﭘAt avaqui ne، ﻳﻦ ﺮﺘ
ﻧﺎﻔﻠ
،ﻫ ﻮکﻥﻥ ﻠﻔﻴ،ﻣ
ډﻝ
ﻪﻭ ړﻱﺩﺏﻝﻝګېﭘ ﻩﻭ ﻪﻣﻦځ ﻪﻟﻧﻮﺘﻴ
ﻣﺍﻪګ ﻨﻳېﻪﻭ(چ ﭘ Gamet oci ﺪ)de ﻳﺎﻮﺳ ﺘﻴﻣﺍ .ګ 3
ﺩ.
ﻭکﻥﻥ ﻯ ﺭﻮﻠﻩﮐ ﺭ
ﺎﭙﻟﻮﻧﻮﺘ
ﻴﻣﺍ
Pﻭ PMګ ﻥﻭﺩ Vﺍ ﺎکﻥ ﺍ ﻤ ﻳﺮﻩﭘﺭﺎﭙﻟﻮﻧﻮﺘﻴﻣﺍﺩPFﺩګ
:
(Chemopr ophy l
axi ﻮﻯ)s ﻴﻨﺩﻼﺎﻣﺨ
ﻳﻪ ﻣﺭ ﺍﺳﻄ ﻪﻭ ﻮﭘ ﻠ
ﻣﺭ ﺩﺩ
،
ﻮﮑﻴﮑﺴ،ﻣﺎﮑﻳﺮﻣﺰﻱﺍ ﮐ
ﺮ:ﻣ ﻪﮑ ﺮﻱﻟ ﻮﻥﻟﺘﺎﺱPFﺷ ﻩﺣﺴ ﺮﻭکﻥﻥﺳ ﺭﻮﻠﻪﮐ ﺘﻠﻪچېﻫ ﻧﻮﻳﺍﻪځ ﻐ
-ﻫ ١
ﺩ.
ﻣﻞ ﻱ ﺭﻣﻦﺩ ﺰﻴﺍﻏ ﻩﻭکﻥﻥ ښ ﺭﻮﻠ
ﺭﮐ ﻮﻥﻭﻧ،چﻥ ﺍ ﻪ ﻧ
ﻮﻳﺍﻌ ﺾېځ ﻧﻲﺑﺎﻴﺮﻕﻣ ،ﺩﺷ ﻴﻦﺑﺍﺭﺎ
ﮐ
ﻭﻥۍﻣﺨﮏ ﻩﺍ ﻭڅﻪﺩ
ﻩ ﺧ ﻮېﻮځﻝﻳ ﻭﻥۍک ﻳ Bﻪﺍ
ﻪ aseﭘ ﻣ ﺍ
ﺭﻠﻲګ ٣ﻣ ٠ﻳ٠
ﻩﺎ ﻣﻝګﻪﺎ ﻣﺍ
ﺭﻠﻲګ ﻣ ٥٠
٠
ﺮﻱښ ﭘځﻯﺩ
ﻴﮏ ﺍ ﻤﻳﺪﻧ
ﺍﻭﻥۍﺩ څﺭﺍ
ﻮږﻱﻭ ﻟ
ﻭﻉکږ ﺍ ﺮﻭړﻱﺷ ﺮ ک ﻔﻪﺳ ځﻯﺗﻴﮏ ﺍ ﻤﻳﺪﻧېﻪﺩېچېﺍ ﻟ
.
ږﻱﻮﻝکږ ﮐﺭﻡﻭ ﺍﻭﻪﺩﺘ ﻭﺳ ﺭ
څﻪﻭ ﻭ ﺧ ﺩﻭ
ډﻝ
ﻩﻭ ﻪښ ﻭکﻥﻥﭘ ﺭﻮ
ﻠﺍﻯ ﺷﻲﮐ ﺩﺩځﻯ کﻮﺍ ﻩﻳ ﺮ
ﺭﺳ Prﻫﻢﻭ oguani ﻭ کېl ﻩ ښځ ﺭﺍﻭﺪﻴﻣ ﻪﺍﭘ
ﻭﺍﻣﻲړ،ﻝﻳﻲ ﺎﻬ
ﺘﺍﺷ ،ﺏې ډﻱ ګﻭ
ﻤﻲ ډ ،ﻫﻀ ږﻮﺮﺧ،ﺳ ﻟﻲﺎﻠﮏﺩﺏېﺣ ﺩېځﻦېﺧ
ﻩﺩ ﻳ ﺮږﻱﺳ ﻤﻞکږ ﺯﻏ
.ﻮﻱ ﮐﺮټ ﺕڅﻪﺳﺭښ ﺧ ﺎګﻱﺩﺧﺘﮏېﻭړ ﻮﺳ ﺭﭘ ﻮ
ﺗ
ګﻱ
ځﻥ ړﻩﺍ ﻮړﻝﺷﻲﻳ ﻮﺎﺕﻭﺧ ﻳڅﻪﺯﮐﻮ ﺧﻟ
ﻭﺎ ﭘﻦځ ﻪﺩ ﻮﮐ ﻮﻅﺩﻱﺧ ﻔﺭۍکېﻣﺤ ﺍ
ﻭ ﺪﻴﻣﻪﺍﻣﻞﭘ ﺭﺍﺩﺩ
.
ږﻱﺪﻝکږ ﻴ ﻟً
ﺍﺭ
ﺩﺎﻩﻧﭘﻲښ ﺍ
ﺯﺩ ﻭﻪﺩﻮﻱﭘ ﻴﻨﻣﺨ ﻮﺩ ،ﺧﺭړﻱﻭﻪﺍ ﺗ
Retﻣﻦځ inopat hy
92
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﺩ.
ﺭﻯ ﺩﺎګﻥﻧﺮﻭ ﺒﺒﻲﻏ ﻠﻲﻋﺼ ﻘﻭﻋ ﺍﻪﻧﻮﭘ
ﺎﺘﮏېﺧ ﻮﺳﭘﺩ
ﺎﻁﻴﺘ
ﻥﻪﺍﺣﻭکﻥ ﭘ ﺭ ﻮﻠ
ﺪﮐ ﻳﺎﺎﻥﺑﻭﻏ ﺭﺎ
ﻧﮏېﻧ ﻭﺮﻟ ﻮﺵ ﻳﻦېﺗﺸ ﻭﻭﺩ ﺒﻲﺍ ،ﻋﺼﺭﻳﻦﺩځﻱګ ﺩﺎ
ﺘﻌﻮﻣ ﻟﻮﮑﻟ
ﺍﺩ
.ړﻱ ﺎﻝک ﻤﻌﺘﺍﺳ ﻩﺮ
ﺳ
.
ﺮﻱﻟﺎﺏ ﺒﺘﻄﺍﺳ ﺩﺎ
Psorکېﻣﻀ i
asiﻪs ﭘ
Kﻭ
oalﺍin:ﻪ ﮑ
ﻟ ﻣﻞ ﺭﺘﻲﺩ ﺎﺳﻧﺲﻧ ﺕﻭﺩﻠﮏﺕ ﺍ ﺍﻯﺳ ﺮ ﻳﻢﺗﺰﻴﻧ
،ﻡګ ﻴﺖ ﻧﻮﺑﺭ
ﺎﻴﻢﮐ ﻠﺴ:ﮐﻪﮑﻟﺪ ﻴ
ﺘﻲﺍﺳ ﻧ
ﺍ
ﺷ.
ﻭﻝ ﻲ ﺭﺎﮐﻥڅﻪﻭﻭکﻥ ﺧ ﺭﻮﻠ
ﻪﮐ ﻟﻪﺘﻭﺳ ﺭېﻭﻭﻭټﻥﻣﺨﮏ ﺍ ﻪﺍ ﻪﭘ ﺘﺎﻋڅﺭﺳ
ﻮPectﺩﻟ in
ﻭ.
ﺩﻱ ﻮﻮﺟ ﻧﮏېPFﻣ ﻭﻮﺭﮐ ﺍټﻦګﻩﻳ ﺮ ﻭکﻥﻥﺳ ﺭﻮﻠﻪچېﮐ ﻧ
ﻮ ﻳﺍ
ﻪځ ﻐ-ﻫ٢
ﺟړ
څﻪ ﻮﻪ ﺧ ﻣﺍﺭﻠﻲګ ١ﻣ٠ ٠Pr oguani ﺍl
ﻪﻭ ﻣﺍﺭﻠﻲګ ﻣ٢ ٥
٠Atov Malچېﺩaquone ar one: ﻟﻒﺍ
ﺩ.
ﻣﻞ ﻱ ﺭﺑﻲﺩ ﺎ
ﺘﺨ ﻧﺍﻮﻯﺷ
ږﻱ
ﻭﻉکږ ﺮﻭځﻣﺨﮏېﺷ ﻩﺭ ﻮﻭړﻱﻳﺮ ک ﻔ ﻪﺷﺨ ﺺﺳ ځﻯﺗ
ﻴﮏ ﺍ ﻤ
ﻳﺪ ﻧ
ﻪچېﺍ ﻠﻴﺖﮐ ﻠﺑ
ﺎﻮﺗ ﺭځېﻳ ﺩﻭ
.ږﻱ
ﻭﻝکږ ﺭﺎڅﻪﻭځﻱﮐ ېځﻯ ﺧﻪچ ﺍ ﻠ
ﻪﮐ ﺘﻭﺳ ﺭ
ﻭﻥۍﻭ ﺍ ﻩﻮﻭﻳﺍ
ﺩ.
ﺎﺏ ﻯ ﺒﺘﻄﺍﺳ ﺩﺎﻮکېﻣﻀ ﻴﻭﻏ ﺭ
ﺎﻮﻧﻠ
ﻠﺘﻣﺨ ﺮﻭﭘﺭګﻮﺗۍﻭﺩﭖښ ﺭﺍ ﺍﻭﺪﻴﻣﺍﻪﭘ
ﺮ،ﺳﻪﻧﻮﭘﺎ
ﺘﮏېﺧ ﻮﺳ ﭘ،ﺩږ ﻮﺮﺧﺩ،ﺳ ﺩډې ﺭ ډ،ﺩګ ،ﺎﻥګ ،ﮐﻟﻰﺍﻭﺪ
ﻩﺑ ړﺯﺭﺕﺩﻱﺩ ﺎﺒ
ﺰېﻱېﻋ ﻴﺰېﺍﻏ ﻴړﺧﺍ
.څﻪ
ﻟﻲ ﺧ ﺍ
ﻭﻟړ
ﺰﻮ ﻳﺮﻔﻧﺴ ﺍ
ﺮﺗﻮﻨ
ﻴﻣﺍﺭﻩﺩځﻱګ ﺯﺍ
ﺪ ﻧ
ﺍﻪ ﻤﻪﮐﻭﭘ ﺍګﻥګﺳﻲ
%ﻪ
٥ﭘ ٠
-٤ﻧ٠
ﻭﻝﺷﻲ ﻮ ﺭﺎﮐځﻯﻭ ﻮﺍ ﻩﻳ ﺮﺪﺳ ﻳﺎﻣﺍﺮﭘﻮﻠﮐﻮﺘﻴ،ﻣﻴﻦﻠ
ﮑﻳﺎﺍﺳﺮﺘ،ﺗRifampi ﻣﻞcne ﺭﺍﺩﻪﺩ ﮐ
.ﻮﻱﻪﮐ ﺘ
ﮐﻪښ Atﮐﭽ ovﻼﺎکېﺩaqone ﻣﭘﺯ
ږﻱ
ﻮﻝکږ ﮐ ﺭ
ﻭﻥۍﻭ ﻩﺍ ﺮ
ﻪBaseﻫ ﻣﺍ
ﺭﻠﻲګ ٢ﻣ ٢ﻳ٨ﻩﻭﺎ ﻣﻝګﺍ ﻪﺎ ﻣ ﺍ
ﺭﻠﻲګ ﻣ ٢
٥٠Mef l
oqui ne: ﺏ
ېڅﻪﮐﺲﻭځﻱ ﺎﺣﻲ ﺧ ﻴﮏﻧ ﻤﻳﺪﻧﺍ
ﻪچېﺩ ﻠﻪﮐ ﺘﻭﺳ ﺭﻭﻥۍﻭ څﺭﺍ
ﻮېﻭ ﻟﻭﻥۍﻣﺨﮏ ﺍ ﺩېﺍ
څﻪ ﺭﻩ ﺧ ﻮﻳ
.ږﻱ
ﻮﻝکږ ﮐ
ﺭ ﻡﻭﺍﻭﺩ
ﺎ Fuzzy ﻟﻰﻳﺍﻮﻮﺷ ﻐﺸ ﻮﻣ ﺗﺎﻻﻴ،ﺩﺧ ﻟﻰﺍﻮﺑ
ﺍﺮﻮﺏﺧ ،ﺩﺧ ﻴﺖ ،ګﻥګﺳ ﻟﻰﺍﻭﺪﻩﺑړﻴﻒﺯ ﻔﻩﺧ ﺮﺍﺳ ﻭﺩﺩ
.ﺮﻱﻟ ﻮﻥﺘډﻝﺷ ﻡﻭ ﺎﻪﻋ ﺎﭘً
ﺘﺒﻟﻲﻧﺴﺎtﻭﺏېﺣ hiﺍ nking
ﮑﻰﻧﻮﻠﻩﺗﻪﻣﻦځ ﺭﻟ ﻭژ ﺑړﻥۍﺍ ﻩ ﻲ ﺮ ﻠﻦې ﺳ ﻣﺭﻮﻱﺩ ﻳﺎ
ﻗﻭﻭ کېﺩ ١ﭘﻲښ ٠ ٠
ﺮ٠ ﻪ١ﭘ ﺎﭘ ً
ﺒﻳﺮ
ﻘﺗ
ﺎﺕېﭘﻮﻟﺎ
ﻔﻴﻧﺴﻭﺍ ﺘﻼﺝﺍ ،ﺍﺧ ﺯﺱ ﻮﮑ ﻳ
ﺎ،ﺳ ژﻥ ﻮﻴﻔﻧ
ﺎﮐﺭځﻱچېﺩ ﻪﺍ ﺗ
ګﻥﻣﻦځ ﺮﻭ ﺒﻳﮏﻏ ﺮﺗ
ﺎﮑﻳﺎﻭﺳ ﺭ
ﻮﻴﻧ
ﻭ.
ﮑﻰ ﻱ ﻧﻭ
ﺮﻟ
ﺎکې ﻘﻳﺮﻓ
ﻪﺍ ﺍﭘﻮﻳېﺧ ﻪﻮ ﻟځﻪ
ﻩﮐ ﻧﻲﺩ ﺎﻨ
ﻴﻤﺍﻃﺮ ﻴ
ﻭکېﻏ ﻩ ښځ ﺭﺍﻭﺪﻴﻣﻪﺍﻪﭘ ﻳ
ﺎﻗﻩﻭ ﺮﻮکﻥﻥﺳ ﻠ
ﻔﻴﻣﺩ
ﺪﻨﻴ
ﻟﺎ
ﭘﺗﻩﻪ ﻮﻠﻪﭘﻠﻪﺑ ﻭﻟﻪﺩﻯﺍ ﻮﻯﻧ ﺑﺖﺷ ﺎﻴﺖﺛ ﻧ
ﻮ ﻭﻣﺼ ﻳﺖﺍ ﺮ
ﺛﺆﻣﻞﻣ ﺭﺩېﺩڅﻪ ﺩ
ﻮ ﺧ ﻧړﻮڅﻱ ﻳﻮﺩﺷ
ﻮﻯﺎﺕﺷ ﻳ
ﺮﺯ Stﺧﻄ i
llbi rtﻩﺩh ﺮﻣﻞﺳ ﺭېﻪﺩېﺩ ﻮﻱچ ﻟ ﻩﺷ ﺪﻧﺭګ ېڅﻪڅ
ړﻥ ﺧ ﻮﻱڅﻱ کېﺩﺷ
ﺩ.
ﻯ
ﺘﻢﻴﺴﻪﺳ ﻴﻟﺎ
ﻘﺘﻧﻩﺍړ ﺯ،ﺩﻭﻍۍ ﺭ
ﺎﺭﻧ ﻮ کېﺩځﻱګ ﺘﺎﺷﻴﺩېﻣ ړﻱ ﺭ ﻡ
ﻮ ﻪﻟﺭۍﭘ ﺍ
ﻭﺪ ﻴﻣﺍ
ﺪﺩ ﻳﺎ
ﻣﻞﺑ ﺭﺍﺩﺩ
Halfﻥﻭanﻭکﻥ ﺍ ﺭﻮﻠ،ﮐ ﻳﻦﺪﻴﻧ،کﻥ ﻴﻦﻧﻮﮐﻭﻫﻢﺩ ﻮﻝﺷﻲﺍ ﻪﮐ ﻧ
ﺭepiکېﻭ lﻭepsy ﺘﻲﺍ ﻠﻣﺭﺎ
ﻨﺑ
ﺍ
.
ږﻱﻮﻝکږ ﮐﺭﻪﻭ ﻩﻧ ﺮ
ﺳ
ﻭﻉﺮﺭځېﻣﺨﮏېﺷ ﻩﻭ ﻭ څﻪﺩﺮ ﺧ ﻔﻪﺩﺳ ځﻯﺗﻴﮏ ﺍ ﻤﻳﺪ ﻧ
ﺭځېﺍﻭ ﻪﺩ ﻣﺍﺭ
ﻠﻲګ ﻣ١
٠ ٠Doxcy cy l
in:ﺝ
ﻭﻪﺍﻧ
ﺍﺯﺭDoxyﺍ cy cli
n، ږﻱﻮﻝکږ ﮐﺭﻡﻭ ﺍ
ﻭ څﻪﻭځﻱﺩ ځﻯ ﺧ ﻴﮏ ﺍ ﻤ ﻳﺪﻧ
ﻪچېﺍ ﻠﻭﻥۍﮐ ږﻱﻭ٤ﺍکږ ﺍ
ﻩﺩﺮﻳﻲﺳ ﺎ
ﻧﻭښ ﻪﺭ ﻟ
ﻭVolﺍ voVagi nalTr ush، ﺘﻲ ﺎﺳﻧﺲﻧ ﻮﺩ ﺩ،ﺧﻣﻞ ﻱ ﺭﻧﮏېﺩ ﻭ ﺪﻴﻤﻩﺯﻏ ښ
ﺷ.
ﺍﻯ ﻲ ﺩﺩ ﻻﻞکﻴﺖ ﻣ ﺎﺳﺣﺴ
ﺷ.
ﻪ ﻲ ﺎﻝﻧ ﻤ
ﻌ ﺘ
ﺍﺳ ﺪﻳﺎﻭکېﺑ ﻩ ښځ ﺭﺍ
ﻭﺪ ﻴ
ﻣ ﺍﻪﻭﭘ ﺍﻮ ﮑﻧ
ﻭﺮﻟﺮﻤږﻋ ﻪﻝ څﻪﭘ
ﻮ ﺧ ﻧﻮﻠ
ﮐﻩﻪ٨ﺭﻥګﻟ ﺍﺪﻤﻫ
:
ﻩﺭﺎﭙﻟﻮﻟړﻩﻭﺩﻪﻣﻦځ Pﻭ Poﻟ :ﺩ Vﺍ ﺩ
ﻪﺭېﭘ ﻮﻭﭘ ﻭځ١ﺭ ﺮ٤ ﻭځﺗ ﻩﺭ ﺮﻪ Baseﻫ ﻣ ﺍ
ﺭﻠﻲ ګ ﻣ٣ږﻱ٠ﻮﻝ کږ ﮐﺭ
ﺎکﻥﻥﻭ ﻤﻳ
ﺮﻩﭘ ﺭ
ﺎﭙﺩېﻟﺩ
ﺷ.
ﻭﻝ ﻲ ﺭﺎﻪﮐ ﻧﺎﻯﻭ ﻮﺣﻩﻳ ﺮﻴﻦﺳ ﻧ
ﻮ Gﻭﮐډﻱ 6PDDﺍ ګﻭ
ﻮﻥ ډ ﻴﻣﺍ
ﻮﺗﻭﺍ،ﺭۍ ﺍ
ﻭ ﺪﻴ
ﻣﺍ
93
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
:ﻪﻨ
ﻠﻣﺭﺩﻼﺎﺩ
ﻳﻣﺭ
ﻠﻲﻭﻱ ﺍﻏڅﻪﺭ
ﻮ ﺧ ﻤﻴﻮﺳ ﮑ ﻴﻤﻳﺪﻧﻪﺍﻟ ﻱﺎ
ږﻳ ﻭﺳﻲ ﻮکېﺍ ﻤﻴﻮﺳ ﮑﻴﻤﻳﺪﻧ
ﻪﺍ ﺩﻼﺎﭘ
ﻳﺎﻥچې ﻣﺭ ﻭﻏ ﺭ
ﺎټﻝﻧﻭ
ﻭﻍۍ ﺭﺎ
ﻧﻭﺩ ﺗڅ
ﺷ،ﺮﻪ ﻲ ﻨﻳﺎﻌﺟړﻭﻣ
ﻠﻢ ﻮﺍ ﭘډﻓﻭﻦ ﺮﻯﺍ ﻳﻦېﻧ ﻭﻮﻯﺩ ﻐﻪﺩﻫ ﺪﻻﺳﻤ ﺪﺳ ﻳﺎ
ﺮﻱﺑ ﻟﻪﻭ ﺒ
ﻭﺗ ﺍ
ﻪﺘﺎﻋ
١ﺳ ﺮ٢ ﺪﻫ ﻳﺎ
ﻮﺑ ﻔﻲﻭﻱﻧ ﻨﻪﻣ ﻠ
ﻳﺎ
ﺭېﻱېﭘ ﺭﻪچ ﺷ،ﮐﮐﻞ ﻲ ﺍډﻝﻭټ ﻳﺖ ﻭ ﺯﺍ
ﺮﻭﺩﭘ ﻴ ﺺﺍ ﺗﺸﺨ
ﺷ.
ﻪ ﻲ ﻨﻳ
ﺎﻌﺟړﻭﻣ
ﻪ ﻮﺍ ﻧ
ﻮﻤﻠﺭﻱﻓ ﺍ
ﺮﮑﺭېﺗ ﻮﻭﭘﻭځﺭېﺭ ﺩ ﺮﻪﺗﺘﻭﺳ ﺭ
ﻭ
ﻪﻣﺦې ﻴﺖﻟ ﺎﺳﻳﺖﺩﺣﺴ ﺯﺍﺮﭘﻪچېﺩ ﺘﻣﻞﺷ ﺭ ﺭېﺩ ﻮﻝېﺩﻻ ﻩ ﺏﻝﻻﺏﻝﻝﺩﺧ ﺭﺎﭙﻠﻦېﻟﻣﺭﺩﻼﺎﺩﺩ
ﻳﻣﺭ
.ږﻱ
ﻩکږ ﺭﻮﻏ
ﺭﺍ
ټﻦګﮐﺲ ﻳ ﺍ
ﻮﻳﺍ
ﻳﻢﻭ ﺩﻮﻣ ﺯﺩﻼ
ﻮ کې ﭘ ﻧﻭﺩﺍ
ﻭ ﻭځﻮﻩﻨﻪﻳ ړﺪېﭘﻧﺮﻭﺍ ﻭکﻥﻥﭘ ﺭﻮ ﻠ
ﮐﺩېچېﺩ ﻩﺩ ﺮﺳ
ﻭﭘﻼ ﺍﻝﺍ ﻭ
ﻭﻳﻢﺍ ﺩﻮﻣﺯ،ﭘﻼ ﮐﺲ ﺍ
ﻮﻳﺍﻳﻢﻭ ﺩ ﻮ
ﻣﺯ ﺩﻼ
ﺎﻫﻢ ﭘ ﻴﻮﺑ ﺷېﺩﻱ؛ﺧ ﺩﻝ ﻮ ﻧﮏېﭘﻲښېﻝﺩ ﻭ ﻮ
ﮐ
ﻧﮏې ﻭﻭﻮښ ﻭﺧ ﻩﺍ ﺭﺮﻩ ﺏې ﺿ ﺭ ﺎ
ﭙﻠﻦېﻟ ﻣ ﺭﻭﺩ ﺎﻱېﺍ ﻗﻭﺩﻭ ﻮ ﭖښښ ﻤﻴﻠﻼﺎﺩﺳﻳ
ﻳﻢﻣﺭ ﺩﻮ ﻣﺯ
.
ږﻱﻣﻞګڼﻝکږ ﺭ(ﺩChoi )ce
ﻮﻤﻴﻡچېﺩﻫ ﻮ ،ﮐﻮﻱ ﻤﻞﮐ ﻪﻋ ﺍﺳﻄ ﻮﺍﭘﺩﺩﻩﺩﻥښﻝ ﺮFerﺳ ri
protopor phy ri
nI ﻥﻪXﻭکﻥ ﻟ ﺭﻮﻠ
ﮐ
.ږﻱ
ﻻﻞکږ ﻭﻣ ﺩﺩړﺎﻳﺠﻭﺩېﺩ ﺮﭘﻳﺖﺩ ﺯﺍ
ﺮﭘﻱﻭﺩږﺍ ﺩﻱﺍﺯﺍﻡکې ﻭﺯﻭﺰﻳ
ﻪﻭﺧﺖکېﻻ ﻴﻦﺩﻫﻀﻢﭘ ﺑ
ﻮ ﻟ
ګ
ﻩﻪ
ږﭘ ږﺮﻝڅﻪﻝﺗ ﻮ ﺧ ﻧﻮ
ﻨﻳﻭټ ﺮېﻪﭘ
ﺩﻟ ﺮﭘﻡﺩ ﻭﺯﻭ ﺰ
ﻳﺭﺕکېﺩﻻ ﻮﻪﺻ ﺭﭘﺍټﻦګﻩﺩ ﻳ ﺮﻭکﻥﻥﺳ ﺭﻮﻠ
ﻪﮐ ﻟ
څﻪﺩﻪ ﺧ ﻐﻪﻫ ﻭﻟﻮﻱﺍ ﺗ
ﺎﻳﻴﺖﺯ ﺑﺍﺰ
ﻴ ﻡﺗﻭﺯﻭ ﺰ
ﻳﺭځﻱچېﺩﻻ ﻪﺍ ﺗﻳﺸﻦﻣﻦځ ﻮټ ﻴﻮ کېﻣ ﻧﻮﻨﻴﺗﻭﺮﻭﭘ ﻭ
ﺩ
.ﺭځﻱ ﻻﻞګﻟﻲ ﻣ ﺍﻮﺗ
ﺎﻳﺯﺩﻭﺩ
ﺭﺝﺩ ﺎﻮﺩﺧ ﻠﻣﺭ
ﺩ
ﻭ:
ﻪﻱ ﺩﻧﻮ ﻮﺟ ﺭﻣ ﺍ
ټﻦګ ﻩﻳ ﺮﻭکﻥﻥﺳ ﺭﻮﻠﻮکېچېﮐ ﻧ
ﻮﻳﺍﻮځ ﻐﻪﻫ ﻪﭘﻨﻠ
ﻣﺭﺩﻼﺎﺩ
ﻳ
:ﻣﺭ I
ﻩﻣﻝګګﻡﺎﺍړﻯ ١ﺭﻡ ﻮﻭکﻥﻥﻟ ﺭﻮﻠﺭېﮐ ېﻪﻻﻮﻝ ﻟ ﻭکېﺩﺧ ﺘﻼﻃﻲﭘﻲښ ﺮﺍﺧ ﻴ
Pﻪﻏ Pﻭ Mﭘ ﺩ Fﺍ -١
،
ﻪﺘﻭﺳ ﺭ
ﻪﻭ ﺘ
ﺎﻋﻪ٦Baseﺳ ﻣﺍﺭﻠﻲ ګ ٣ﻣ ٠
ﻳ٠ﻩﺎ ﻣﻝګﻪﺎ ﻣﺍﺭ
ﻠﻲ ګ ﻣ٥٠٠،ﻪBase ﻣﺍﺭ
ﻠﻲ ګ ﻣ٦٠
ﻳ٠ﺎ
ﻪﻣﺍﺭ
ﻠﻲګ ﻣ٣٠
ﺎ٠ﻴﻪﺑ ﺘﻭﺳﺭ ﻪﻭ ﺘﺎﻋ٤ﺳ ﻴﺐ٨ ﺗﺮﺪېﺗ ﻤﻪﻫ ﻭﭘ ﻪﺍﺘﻭﺳ ﺭ
ﻪﻭ ﺘﺎﻋ٢ﺳﻪ٤Base ﻣ ﺍ
ﺭﻠﻲګ ﻣ٣٠٠
ﻪBase ﻣﺍ
ﺭﻠﻲګ ﻣ١٥ﻳ٠ﻭﺎ ﻣﻝګېﺍ ﻪﺎ ﻣﺍﺭﻠﻲګ ﻣ٢٥ﻭکﻥﻥ٠ ﺭﻮﻠ
ﮐﻴﺖﺩ ﻠ
ﺑﺎ
ﻮﺗ ږﻱﻳﻮﻝ کږ ﮐ ﺭBaseﻭ
ﺩ.
ﻮﻯ ﻯ ﺟړﺷڅﻪ ﻮﺧ
ﻣﻝګﻪﺎ ﻣﺍﺭ
ﻠﻲګ ﻣ٥٠
ﻻﻦ٠ﺎﻥ ﮐ ﻪﺷ ډﻝﭘﻪﻭ ﺗ
ﺭﻮ ﭘﻭکﻥﻥﺩ ﺭﻮﻠﺭېﮐېﻪﻻﻮﻝ ﻟ ﻩﺩﺧ ﺭﺎﭙﻟPﻭPo-ﺩ Vﺍ ٢
ﺭﻪﻭﻣﺭﻮﻟځﻯڅﻮﺍ ﻩﻳ ﺮږﻱچېﺩېﺳ ﻮﻝکږ ﮐﺭ ﻭځﻭ١ﻪ ﺭﻭځﻭ٧ﻣﻪﺭ ﺍ ﻤﻟﺴﻪBase ﻣﺍﺭﻠﻲګ ﻣ٣٠ﻳ٠ﻩﺎ
.ږﻱ
ﻮﻝکږ ﮐﺭﻭﻭ ﻭځ١ﺭ ﺗ٤ ﻭځﺮ ﻩﺭ ﺮ
ﻭﻉﺷﻲچېﻫ ﺮﺪﺷ ﻳﺎ
ﺎکﻥﻥﻫﻢﺑ ﻤﻳ
ﺮﻪBaseﭘ ﻣﺍﺭﻠﻲګ ﻣ ٣ځ٠
ﻩڅﻪګټ ﻳﻦ ﺧ ﺪﻴﻧﺎکﻥ ﻳﻭ ﺍﻴﻦ ﻨ
ﻗﻲﮐ ﺭﻮﺯ ړﺎﻭﻱﻧﻴﺗﺍﺗﻮﻪ ﻠ
ﻣﺭﻗﻲﺩ ﺭﻭﺯﺍ ﻩﻭﻱﺪ ﻳ
ﺪ ﻩﺷ ﺭېﭘﻲښ ﺭﻪچ ﮐ
ﻠﻲ٥ﻣ٠ﭘ٠
ﺯﻥ ﻪ ﻡﻭﺍﺭﻮګ ﻟﺮکﻝ ﻪﻫ ﻪﭘ ﻣﺍﺭ
ﻠﻲګ ٢ﻣ ﺯ٠ ﻭLoadiﺩ ړﻯng ﻡﻮﻟﻴﻦﻧﻮﺘﻞﺷﻲچېﮐ ﻴﺴﺍﺧﻭ
ﺎ
ﻴږﻱﻭﺑ
ﻪکږ ﺍ ﻴﻮﺻ ﻩکېﺗ ﺩﻮﻪﻣ ﻮﭘ ﻧﻮﺘﺎﻋﺭﺳﻮ ﻟ
ﺭېﺩڅ ﻪﻻ ﻟﺪﻳﺭﺯکېﺩﻭ ﻮﮐﻮﻟ
ﻩګ ﺪﻴﺼﻩﻓ ﺮﭘﻦځ ﺘﻴﻟ
ېﻪ
ﻮﻝ ﻟ ﻪچېﺩﺧ ﻐﻱﺮﻫ ږﺗ ﺭﻱﺍﺮﮑﻪﺗ ﺘﻭﺳ ﺭﻪﻭ ﺘﺎﻋ
ﻪﺳ ﺗﺮﺍﺪﻥﻫ ﺑﺯﻥﺩ ﻡﻭ ﺍ
ﺭﻮګ ﻟ
ﻪکﻝ ﻪﭘﻣ ﺍﺭﻠﻲګ ﻣ١٠
ﺷ(
ﻪ ﻲ ﺎﺕﻧ ﻳﻭځکېﺯ ﻪﺭ څﻪﭘﻮ ﺧ ﻣ ﺍ
ﺭﻠﻲګ ﻣ١٨٠٠
ﺍﺷﻲ) ﺪﻴﻠﻦېﺯﻏﻢﭘ ﻣﺭﺭېﺩﺩ ﻻ
.
ږﻱﻮﻝکږ ﮐﺭﻭکﻥﻥﻭ ﺭﻮﻠ
ﻮﮐ ﺍﺷﺪﻴﺭېﺯﻏﻢﭘ ېﻪﻻﻮﻝ ﻟ ﻪچېﺩﺧ ﻠ
ﮐ
ﺷ.
ﺍﻯ ﻲ ﺩﺩﻭﻝک ﺭﺎ
ﻭکﻥﻥﻫﻢﮐ ﺭﻮﻠﻗﻲﮐ ﺭAﺎﺯ
rﻳ temet her ,Artesunat ﻗﻲe ﺭﻩﺯ ﺭﻥګ ﺍ
ﺪﻤﻫ
ﻪﺘﻭﺳﺭﻩ کېﻭ ﺩﻮﻪﻣ ﻮﭘ ﺘ ﻋﺎ
ژﻥ٨ﺳ ﻮﻴﻔﻧډﻝﺍﻩﻭ ﺭﺍﺪﻣﺍ
ﻭ ﻪBaseﺩ ﻣ ﺍ
ﺭﻠﻲ ګ ﻣ١
ﻭکﻥﻥ٠ ﺭ ﻮﻠ
ﻗﻲﮐ ﺭﺯ
ږﻱ
ﻮﻝکږ ﮐﺭ
ﻩکېﻭ ﺩﻮﻪﻣ ﻮﭘ ﺘﺎﻋ
٢ﺳ ډﻝ٤ ﻥﻪ ﻭژﭘ ﻮﻴﻔﻧﺯﻥﺩﺍ ګﻡﻭ
ﺍﻮﺭ ﻟ
ﺮکﻝ ﻪBaseﭘ ﻣ ﺍ
ﺭﻠﻲګ ﻣ١٥
ﻪﺘﺎﻋ
ږﺳ ﺮ ﺷﭗ ﻧېﻫﺘﮏېﻻﺪ ﻮﺳﻭﭘ ﺪﻥﺩﻋﻀﻞېﺍ ﺑﺯﻥﺩ ګﻡﻭ ﺍ
ﻮ ﺭ ﻟﺮ کﻝ ﻪﭘ ﻣﺍ
ﺭﻠﻲ ګ ٣ﻣ ،ﺎ٥ﻳﻭﺍ
ﻪﺎﺕﻧﻳڅﻪﺯﺪﻥ ﺧ ﺑﺯﻥﺩ ﻡﻭ ﺍ
ﺭﻮګ ﻟﺮ کﻝ ﻪﭘ ﻣﺍ
ﺭﻠﻲګ ﻣ٢ﺯﻱې٥ ﻭ
ﻮﻋﻲﺩ ﻤږﻱﻣﺠ ﻴﻖ کږ ﺒﻪﺗﻄ ﺘﻭﺳ ﺭ
ﻭ
ﺷ.
ﻲ
:
ﻪ ﻨﻠ
ﻣﺭﺎﻥﺩ ﺘﻧ
ﺍﻧﮏې ﻭﻮﮐﺭﺍټﻦګﻩﺩ ﻳ ﺮﻭکﻥﻥﺳ ﺭﻮﻠ
ﮐ:ﺩII
94
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
.
ﻪﻨﻠ
ﻣﺭﺭېﺩ ېﻪﻻﻮﻝ ﻟﺘﻼﻃﻲPFﺩﺧ ﺍﺧ ﺮ ﻴ
ﻧﮏېﻏ ﻭﻮﺭﮐ ﺍ
ټﻦګ-ﺩ ﻳ ١
ﺭﺮ٧ﻭ څﻪﺗ
ﻮ ﺧ ﻳﺭﺭځېﺩ ﻪﺩﻭ ﻟﺩېځﺪﻥ ﺭ ﺑ
ﺯﻥﺩ ګﻡﻭﺍﻮﺭ ﻟ
ﺮکﻝ ﻪﭘﻣ ﺍﺭ
ﻠﻲګ ١ﻣﻴﺖ٠ ﻔﻠﻴﻦﺳ ﻧ
ﻮ:ﮐ ﻟﻒﺍ
.ﻮﻱ ﮐﺭﺭېﻭ ﻮﻭﭘځ
ﺪﺩ ﻳ
ﺎﺮﻱﺑﺮﻟ ﻴ
ﺛﺎﻳﺸﻲﺗ ﺮ
ﺎﺗﺨﺎﻃﻲﻏﺸ ېﻪﻣﺨ ﺪﭘ ﻌﻣ ﻭﺩﻣﻞﺩﻱﺍ ﺭ ﻳﺦﺩ ﺮﺮﺗ ﻳﻴﻦډ ﻧ
ﻮ ﺭېﮐ ېﻪﻻﻮﻝ ﻟ ﺩﺧ
ﺷ.
ړﻝ ﻲ ﺭک ﻪﻭ ﺘﻭﺳ ﺭﻭڅﻪﻭ
ﺧړ ﺧ ﻮ
ﻩﺩ ﺯ
ﺍﺪﻧﻪﺍﻤﻪﮐ ،ﭘ ﻟﻲﺍ
ﻭﺪﻩﺑړ ږﺯ
ﻮ،ﺮﺧ ﻭﻍﺩﺳ ﺭﺎ( کېﻧ Cinchoni ﻨﻲ)sm ﻴﮐﺴ ﻮﻭﻣﻦځﻥۍﺗ ﮐﻢﺍ
ﻠﻲﻳﺩګ
ﺭېﺍ ﺭﻪچ ګﻪﻣﻦﻭﻱﮐ ﻠڅﻪ ﻳﺭﻯ ﺧ ﺎ
ﻮﺑﻦګﻫ ﻧ
ﻭ ږ
ﻮﻩﺩﻏ ږڅ ﻭﻝ ﺳګﻥګﺳﻲﺍ ،ﺮ ډﻱ ګﻭ
ﺪډ ﻴﻟ
ﺩ.
ﻪﻱ ړﻦﻧﺍﻳ ﻭﻝ ﺪﻨ
ﻮﺑ ﻠ
ﻣﺭﻮﺩﺩ ﺍﺷﻲﻧ ﺪﻴﭘ
،
ﻟﻰ ﺍ
ﻭﺪﻧﻭ،ړﻪﻧ
ﺪ ﻴﻩﻟﻭ،ﺩ ﻪ
ﻧﻮﭘﺎ
ﺘﮏېﺧ ﻮﺳ ،ﭘﻟﻰﺍﻭﮐڼ
ﺗ ،ﻮ
ﻪﻭﻍﺒ ﺭﺎﻡ کېچېﻧ ﺰﻳ
ﻮﮑ ﻨ
ﻴﺪﺳ ﻳﺪﻪﺷ ﻮﭘ ﺧ
ﺭﻮﺗ،ﺩﭖښ ﺎﺕﻮﺷ ،ﺗﺸﺘﻢﻴﺴﻟﻲﺳ ﺎ
ﻘﺘﻧ
ﺍﻩ ړ،ﺯ
ﺎﺕﺩ ﺘﻼﺟ ﺍﺧ،ﺑﻲﻮ،ﺏېﺧ ﻪﻧﺪﻳﺭځ ﺳګ
ﺗ ،ﺮړﺎ
ړﭖﻴ ﺎﻏﻲﺥ ﻣﺩ
ﺪﻨﻣﻞﺑ ﺭ
ﺮﻱﺩ Agrﻟ anolocy t
osiﻭs ﺎﺍﺘﻴﺑﻮﺘ
ﻳﺎﻮﺳﺒﻣﺮ،ﺗBl
ackwat erf ever، ﻪﻳﺎﻔﻡﮐ ﺪﻭﻋ ګ
ﺷ.
ﻲ
ﺷ:
ﻭﻝ ﻲ ﺭ
ﺎﮐځﻯﻭﻮﺍ ﻮﻳﻠﻣﺭﻧېﺩ ﻮﺩﻻﺪ ﺪﻳﻳﺎﻩﺑ ﺮ
ﻮﺳ ﻨﻴﻧﻮﮐﺩ
.ﻩﺭﺎ
ﭙﻟﻭﻭځ
ﺩﺭځېﺩ٧ﺭ ﻪﻭ ﻟﻩځ ﻭﻪﺩ ﻣﺍ
ﺭ ﻠﻲګ ١ﻣ ٠٠Doxy cyli
n
.
ﻩﺭﺎ
ﭙﻟﻭﻭځﺩﺭځېﺩ٧ﺭ ﻪﻭ ﻟ
ﺩېځ ﻪﺭ ﻣ ﺍ
ﺭﻠﻲګ ٩ﻣ ٠ﻴﻦ٠ﻳﺴ ﺎ
ﻣ ﺍﺪﻨ
ﻴﻠﮐ
.
ﻩﺭﺎ
ﭙﻟﻭ ﻭځ
ﺩﺭځېﺩ٧ﺭ ﻪﻭ ﻟ
څﺭځﻮﻪﻟ ﻣﺍﺭﻠﻲګ ٥ﻣ ٠
٠-٢٥ﻴﻦ٠ ﻠ
ﮑﻳﺎﺍﺳﺮﺘ ﺗ
ﻠﻲګ ٢ﻣ ٥ګﻝۍﻱې٠ ﻩ ﻭ ﺮﻩچېﻫ ﺭﺎ
ﭙﻟﻭ ﻭځﺩې ﺭ
ﺭځېﺩﺭ ﻭﻪﺩﻟﻩځ ﻭ ګﻝۍﺩ ﻩ ﻭ ﻭMalﺩ arone: ﺏ
.ﺮﻱ ﻟ
ﻴﻞ ﻧ
ﺍﻭﻭګ ﺮ
ﻪﭘ ﻣﺍﺭ
ﻠﻲګ ١ﻣ ٠ﺍ٠
Atﻭ ov ﻪaquon ﻣﺍﺭ
ﻪچېټ ﻣﺍﺭ
ﻠﻲګ ٥ﻣ ﻪ٠ﺘﻭﺳﺭﻪﻭ ﺘ
ﺎﻋ١ﺳ ﺗ٢
٦څﻪﺮړﻯځﻝ ﺧ ﻡﻮ ﻟﻪﻣﺍﺭﻠﻲګ ٥ﻣ ٠
٠Mef l
oquine: ﺝ
.ږﻱ
ﻪکږ ﻣﺍ
ﺭﻠﻲګ ﻣ١٢٥ﻭﻝ٠
ﺩې
ﺭځې ﺭ ﻭ ﻪﺩﻟﻩځ ﻭﻩﺩ ﺮﻴﻦﺳ ﻠﮑﻳ
ﺎﮐﺴﻲﺳ ﻭﻪﺩ ﻣﺍ
ﺭﻠﻲګ ١ﻣ ٠
ﻪﺩ٠ ﻣﺍﺭﻠﻲګ ﻣ٥٠٠At ov aquone: ﺩ
.ﻩﺭﺎ
ﭙﻟﻭﻭځﺭ
ﻩﺩ ﺭ
ﺎﭙﻟﻭﻭځ
ﺩې ﺭﺭېﺩﺭ ېﻪﻻ
ﻮﻝ ﻟ ﺪﻥﺩﺧ ﺑ
ﺯﻥﺩ ګﻡﻭﺍﻮﺭ ﻟ
ﺮکﻝ ﺮﻫ ﻪﭘﻣ ﺍ
ﺭﻠﻲګ ﻣ٤Ar tesunat e:ـﻩ
.ږﻱ
ﻮﻝکږ ﮐﺭﺯﻭ ﻭﻮﻱﺩ ﺮﺷ ﮐﻪﺫ ﺗ
ﺭﻮMeﻪﭘ
fﭘ loqui ځﻯne ﻮﺍ ﻩﻳ ﺮﻮﺳ ﻠﻣﺭېﺩ
ﻪﻪﭘﺘﻭﺳ ﺭﻭﻥۍﻭ ﻩﺍﻮﻭﻳﻩﺍﺯﻭﺩېﺩﻪﺭ ﺘﻭﺳ ﺭ
ﻪﻭ ﺘﺎﻋږﺳ ﺮﺷﭗ ﻪﻫ ﻣﺍ
ﺭﻠﻲګ ﻣ ٥٠
٠:Hal ofantrine: ﻭ
.
ږﻱ ﺭﻱﺍﺮﮑﺯﺗﻭﺪېﺩ ﻤﻫ
ﻴﻦﻨ،ﮐﻮکﻥﻥ ﻠﻔ
ﻴﻣ ﻭﺩ ﺍﺮﻱﻟ
ﺘﻲﻭ ﻠﻣﺭﺎ
ﻨﺑ
ﺍ ﺘﻢﻴﺴ ﻟﻲﺳ ﺎﻘﺘ
ﻧﺍﻩړېﺯ
ﺎﻥچ ﺩ ﻭﻏﺭﺎﻪﻧ ﻐ،ﻫ،
ﺭ ﺍ
ﻭﺪﻴﻣ ﺍﻪﻣﻞﭘ ﺭﺍﺩﺩ
ﺷ.
ﻪ ﻲ ﺎﻝﻧﻤﻌﺘﺍﺳځﻯﻮﺍ ﻩﻳﺮTerﺳ fenadi Aﻭne stﺍ emizol e، ﻭکﻥﻥ ﺭﻮﻠ،ﮐ
ﻪ٦ ﻳﻦﭘ ﺮ
ﺗﺎﻔﻤ
ﻪﻟ ﻣﺍﺭﻠﻲ ګ١ﻣ ٢ﻭ٠ﺮﺍﺘﻴﻤ ﺗ
ﺭﻪﺍ ﻣﺍ
ﺭﻠﻲ ګ٢ﻣ ٠Ar temet her+Lumef ant r
ine: ﺯ
ﻭځ
ﻪﺭ ﻤﻭﻫ ګﻝۍﺩ ﺑ ٤ﻭ ﺎ
ﻪﻴ ﺘﻭﺳ ﺭ
ﻪﻭ ﺘ ﺎﻋۍ٨ﺳګﻝ، ﻭځ ٤ﻭ ړﻯ ﺭ ﻡﻮ ږﻱﻟﻮﻝ کږ ﮐﺭﻮ کېﻭ ﻧﻭﺯﻭﺩ
.ږﻱ
ﻮﻝکږ ﮐﺭﻪﻭﻟﻩځ ﻭ٤ګﻝۍﺩ
ﻭځ ﻭ ﻪﺭ ﻤﻳﺭﻭﺩ ﺍﻪﻟﻩځ ﻭګﻝۍﺩ ٤ﻭ
ﺷ.
ﺍﻯ ﻲ ﺩﺩﻪک ﻴﻮﺻ ﻪکېﺗ ﻨ
ﻠﻣﺭﻪﺩ ﻼﺎﭘ
ﻳﺘﻼﻃﻲﻣﺭ ﺍﺧﺮﻴﺯﺩﻏ ﻭﻮﺩ ﻪﻳ ﻪﭘﺘ ﻴ
ﻠﺑﺎ
ﺩېﺗ ﺭﺭ ﺍ
ﺪﻴﻧﺴﺎﭘ
:ﻪ ﻨ
ﻠﻣﺭﺭېﺩېﻪﻻﻮﻝ ﻟ ﺭﻱPVﺩﺧ ﺍ
ﻴﻦګ ﺗ
ﻩﺩ ﺮﻭکﻥﻥﺳ ﺭﻮﻠﮐ-ﺩ٢
.
ږﻱﻮﻝکږ ﮐﺭﻩﻭ ﺮﺯﺳ ﻭﻮﻱﺩ ﺩﺷ ﺎ
ﻨﻲﻳ ﺗﺭﻮﻥﻪﭘ
ﻮکﻥ ﭘ ﻠﻔﻴﺎﻣﻭﻥﻳ ﺭﻣﻼ:ﻴ ﻟﻒﺍ
.
ږﻱﻮﻝکږ ﮐﺭﺯﻭﻭﻮﻱﺩ ﺩﺷﺎﻪﻳﺗﺭﻮﻪﭘځﻯﭘﻮﺍ ﻩﻳﺮﻴﻦﺳ ﻠﮑﻳﺎﮐﺴﻲﺳ ﻭ ﻴﻦﺩﺩ ﻧﻮ:ﮐﺏ
:ﻪﻨ
ﻠﻣ
ﺭﻗﻲﺩ ﺭ
ﻤﻞېﺯ ﺪېﺣﻳﺪ-ﺷ٣
،
ﻴﻦﻠ
ﮑﻳﺎ
ﮐﺴﻲ ﺳ ﻭ
ﺪﻱﺩﻳﺭځﻯﻭ
ﻮﺍﻩﻳ
ﺮﻨﺖ ﺳ
ﻳﻮﮐ
ﻮﻟﻳﻦ ګﺪ
ﻴﻧﺎ کﻥ
ﺪﻳ ﻳ
ﺍﺭﻮ
ﻠﮐﻭ
ﺭﺪﻳﺎ
ﻬﻳﻴﻦﺩﻧ
ﻮ:ﮐﻟﻒﺍ
ﻮ
ﻮﻧﺍﺷﺪﻴﻠﻦېﺯﻏﻢﭘ
ﻣﺭﺭېﺩﺩ
ېﻪﻻ
ﻮﻝ ﻟ
ﻪچېﺩﺧ ﻠ
ږﻱﮐﻪ کږﻴ
ﻮﺻ ﻴﻦﺗﻳﺴﺎ
ﻣﺍ
ﺪﻨﻴﻠ
ﺎﮐﻴﻦﻳﻠ
ﮑﻳﺎ
ﺍﺳﺮ
ﺘﺗ
95
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
.
ږﻱﻮﻝکږ ﮐﺭﺯﻭ ﻭﻮﻱﺩ ﺩﺷ ﺎ
ﻪﻳ ﺗﺭ
ﻮ ﻪﭘﻴﻦﭘ ﻧﻮﻪﮐ ﺘﺒ
ﻟﺍ،ږﻱ
ﻮﻝکږ ﮐﺭ ﺭېﻭ ېﻪﻻﻮﻝ ﻟ ﺍﺩﺧﻭﺩ
١،
ﻪ٦ ﺘﻭﺳﺭﻭځﻭ ړﻯ ﺭﻡﻮﺪﻥﻟ ﺑﺯﻥﺩ ګﻡﻭﺍﻮﺭ ﻟﺮ کﻝ ﻪﭘﻣ ﺍ
ﺭﻠﻲګ ٣ﻣ ،
ﺭې٢ ﻪﻻ ﻠﻲﻟ ﺮﺩﻋﻀ ﺘﻴﻤﺗﺭ:ﺍﺏ
ﺭېﻪﻻ
ﻮﻝ ﻟ ﻭﻍﺩﺧ ﺭﺎ
ﻪچېﻧ ﻐ ﺮﻫﻩﺗ ﺭﺎ
ﭙﻟﻭ ﻭځ
ﺩېﺭ ﻪﺩﺭ ﻤﮐﺮﺪﻥﮐﻢﺗ ﺑ
ﺯﻥﺩ ګﻡﻭﺍﻮﺭ ﻟﺮکﻝ ﻪﭘ ﻣﺍﺭﻠﻲګ ﻣ
ﺯﻥﻡﻭ ﺍﺭ
ﻮګ ﻟ
ﺮکﻝ ﻪﭘﻣﺍﺭﻠﻲګ ٢ﻣ ،ﺭې٤ ﻪﻻ ﺪﻟﻳﺭArﺩﻭ tesunat ﻳeﻭﺎ ﻤﻲﺍ ﺯﻏArﻭ tesunat ېe
ﻩﺭﺎ
ﭙﻭﻟﻭځﺩې ﺭﺭځېﺩ ﺭ ﺪﻥﺩﻭ ﺑﺯﻥﺩ ګﻡﻭﺍﻮ ﺭ ﻟﺮکﻝ ﻪﭘ ﻣﺍﺭﻠﻲ ګ ﻣ١،
ﻪ٢ ﺘﻭﺳ ﺭﻭځﻭ ړﻯ ﺭ ﻡ
ﻮ ﺪﻥﻟ ﺑ
ﺩ
ﺷ.
ړﻝ ﻲ ﺭک ﺯﻭﻭ ﻮﻱﺩ ﺩﺷ ﺎﻥﻪﻳ
ﻮکﻥ ﭘ ﻠﻔﻴﺪﻣ ﻳﺎﻪﺑﺘﻭﺳ ﺭﺩېڅﻪﻭ
،ﺩ ﺧ ږﻱﻮﻝکږ ﮐﺭ
ﻭ
ﻠﻦېﻣﺭﻪﺩ ﻭﭘﺘﻼﻃﻲﭘﻲښ ﺍﺧﺮﻴﻼﺎﺩﻏﻳ
ﻡﻣﺭ ﺭﺎ
ﭙﻴﻠﺴ ﻓ
ﺍﺩ ﻮﺎﻟﺨ ﻣېڅﻪچېﺯ ړﻥ ﺧ ﻎېڅﻱ :ﺩﻫ ﻪﻧﻭﺩﺎ
ﻳ
ېﻪ
ﺍﺧﻞ ﭘ ﻮﻥﺩﺩ ﺘﻭﻏﺭ
ﺎﻴﺘﻭﻏﻠﻲﺭ ﻣ ﺎ
ﺭﺩﻋ ﺎﺭﻫﻧﻦګ ﮐﻝکېﺩ ١ﺎ٣ ٨ﻪ٧ ﻪﭘ ﺍﺳﻄﻪﻭ ﻴﻦﭘ ﻧﻮﻥﻭﮐ
ﺭکﻥ ﺍ ﻮﻠﮐ
ﺩ
:
ﻡﻮﻪﮐ ﻧﻭﺩﺎﻳﻞېﻳ ﺎﭘډﻝﻱېﺩ ﻟډ ﻭ
ﺷېﻪ ﻦ
ﻩ ﻮﭘ ﺮﺮﺳﻮﺗ ﻧ
ﺎﻭﻏ ﺭﺎ
ﻧ٢٠ﭘ٠
ﻩکېﻪ څﻥګﺍ
ړﺮڅﻱ ﻩﺗﺩﻮﻟﺭېﻪﺩ
ﺘﻼﻁﻱ ﻧ ﻭﺍﺧ ﻭﺍﺒﺖﻭ ﺜﻼﺪﻱېﻣ ﻳﻦېﺳﻳ ﻭ ﺎﻥچېﺩ ﻭﻏ ﺭﺎﻼﺎﻧ
ﻳﻡﻣﺭ ﺭﺎﭙﻴﻠﺴﻓﺩ٢٠٠
.ﻮﻝ ﻮﻝﺷ ﻴﻧﻧېﻭ ﻥېﻻﺪ
ﻭﻩﺍﻮړﻝﺷ ﻪﻱېﻭڅﻱ ﻠﻳﺎﻠﻦېﭘ ﻣﺭﻮﺩﺩ ړﻝﺷ ﺭک ﻴﻦﻭ ﻧﻮﻪﮐ ﻮﺗ ﻨﻥﻭﺳﻞﺗ ﻭکﻥ ﺍ ﺭ
ﻮﻠﻪﮐ ﻮﺗ ﻨﺳﻞﺗ
ﺭﺍ
%ټﻦګ
١ﻳ ﺯې٥ ﻮړﻭﻳ
ﻩکﺍ ﺭﺎﮐګﻥ ښﺮﻭ ﺒﻩﻏ ﻩښ ﺮﻭکﻥﻥﺳ ﺭﻮ ﻠ
ﮐﻮﺩ ﻧﺎ
ﻭﻏ ﺭﺎ%٨ﻧ ﻮچې٥ ﺪﻝﺷ ﻴﻟ
ﻭ
ﺪېﻳﺪﻤﻢﺷ ﺗﺴ ﻴﻦﺩ ﻧ
ﻮﮐﻪﺩ ﻮﺗ ﻧ
ﺎﻭﻏﺭﺎﺯې%٥ﻧ ﺍﻮ
ﻭﻳ ﻩﺍ %٩ﻭ ګﻥ٥ ﺮﻭ ﺒ
ﻴﻦﻏ ﻧﻮﮐﻭ،ﺩﻧﮏېﭘﻲښې ﻱ ﻭﻮﮐ
ﺘﻼﺍﺧﺮﻴﻥﻪﻏﻭکﻥ ﭘ ﺭ
ﻮﻠﻮچېﮐ ﺪﻝﺷ ﻴﻟ
ﻮﻭ ﻩﻧﻮ ﻩﺷ ﺪﻨﺍﺑﻭﺍﺩًﺭﻮﺒﻮېچېﻣﺠ ﺍﺷ ﺪﻴ
ېﻭﻥښېﭘ ګﻞ ﺍﻳ
ﺰېﻴﺰېﺍﻏﻴړﺧ ﺩ،ﺍ
ﻣﻞ ﻱ ﺭ
ﻪﺩ ﻧﺍ
ﺯﺭېﻭﺍﻧﮏ ﺍ ﻮﻤﻩﺯﻏ ﺍښ ﻮﺑﻞېﺧ ﻭﺩ ﻭﺍﻣﻦﻭ ﺰﻴﻭکېﻫﻢﺍﻏ ﻃﻲﭘﻲښ
.ﻭﻟډﻭ
ﻩﻦ ﺮﻭﻥېﺳ ﺭﺎﮐﻮﺩ ﻠ
ﻣ ﺭ
ﺩېﺩ ﺮﻭﺧﺖ ﺩ ﺘﺑﺴ ﻭﻍﺩ ﺭ
ﺎﻧﻱېﮐﻢېﺩ
:
ﻪ ﻨ
ﻠﻣﺭﻡﺩ ﺭﺎ
ﭙﻴﻠﺴ ﻳﻢﻓ ﺩﻮﻣﺯﺪېﭘﻼ ﻳﺪﺩﺷ
ﻠﮏﻮﻥکېﮐ ﺘﻭﻏېﻪﺭﻩﻩچ ﭘ ﻴﮏېﭖښښ ﺩ ﻨﻴﻠړﻥۍﮐ ﻩ ﺏړ ﻮﻼﺎﻳ
ﻳﻡﻣﺭ ﺭﺎ
ﭙﻴ ﻠﺴﻳﻢﻓ ﺩﻮﻣ ﺯﻩﭘﻼ ﺪﻳﺪﺷ
.ﺮﻱﻟړﺎ
ﻴﺗﺍﺗﻠﻦېﻪ ﻣﺭېﻭ ښېﺩ ﺭﻥ ﺍ ﺍېڅ
ﻪﻐﻭﺩﻫ ﻮﻝ ﺷﻲﺍ ﺍﭼړﺥﻭ ﻳﺍﻪﻮ ﺪﭘ ﻳﺎ
ﻟﺖ کېﻭﻱﺑ ﺎﻪﺣ ﺎﭘ ﻣ
ﻮ ﮐﺭېﺩ ﺭﻪچ ﺯﻥ ﺷﻲﮐ ﺪﻭ ﻳ
ﺎﻭﻍﺑ ﺭﺎﻧ
ﺷ.
ﻮﻝ ﻲ ﻴﻧ
ﻧېﻭ ﺘﻦېﻻﺪ ﺮﮐﻩﺗ ﺭﺗژﺭﺮ ﻟﺖژ ﺎﻣﻲﺣ ﻮﻤﻋ
ﺭﺎ
ﺘﻈﻧﻪﺍﻮﺗ ﻠ
ﺗﺍ
ﻳﻞېﺭ ﺎ
ﭘﺭﺩﺍﻮﺗﺍﺮﺑ
ﻟېچېﺩﻻ ﻪﺪ ﺗﺮﻮﭘ ﺩﻭﻱﻧ ﻮ ﻮﺟڅﻪﻣ ﻮ ﺧ ﺗﺎﻻﻧېﺣ ﻪﻻﺪ ﻟ ېﻮ
ﺭﻳ ﺭﻪچ ﮐ
ﻪﻭﻍﺗ ﺭ
ﺎﺯﻧﻭLoadiﺩ ړﻯng ﻡ ﻮﻟﻭﻴﻞﺷﻲﺍ ډﻝﭘﻗﻲ ﻭ ﺭﻪﺯ ﻣﻞﭘ ﺭﺪﺩ ﺩﻼﺎ ﺿ
ﻳﻩ ﻣﺭ ﺭﺗژﺭﺮﺪژ ﻳ
ﺎﻭﺑ ﻭړ
ک
ﺷ.
ﻴﻖ ﻲ ﺒ
ﺗﻄ
.ﺮﻱﻟﻪﻧﺎﻥﻭﮑ ﻣﺍﻪﻨﺘﻴﺴﺍﺧ ﻮ ﻠ
ﻣﺭﺭېﺩﺩ ېﻪﻻﻮﻝ ﻟ ﺭېﺩﺧ ﺭﻪچ :ﮐ ﻟﻒﺍ
ﻼﺎ
ﻳ
ﺎﻏﻲﻣﺭ ﻣ:ﺩ ﺏ
.
ﻟﻰﺍﻮﺘﻮﺷ ﺗﺎ
ﺘﻼﻃ ﺍﺧ ﻭ:ﺩکڼ ﺝ
ﻪﻩﮐﭽ ﻟړ
ﻪﻮ ﻟېڅﻪﭘ
(ﺎﺪ ﺧ 250,ﻳ \000 ﺎµL)%٥ ﻴ
ﻤﻴﺘﻳﺯﺍ
ﺮ ﺍﻥ کېﭘ ﺭ
ﻭ ﻴﻄﻲﺩ ﻪﻣﺤ ﺭېﭘ ﺭ
ﻪچ :ﮐﺩ
ﻭ.
ﺩﻱ ﻮﻮﺟﻣ
ېﻪ
ﻭکﻥﻥﺩﻋﻀﻞ ﻟ ﺭﻮﻠ
ﻭﮐ ﻴﺖﺍ ﻧ
ﻮ ﻴﺴﺗﺭ،ﺍﻴﻦﻧﻮ
ﻮﮐ ،ﺧږﻱﻮﻝکږ ﮐﺭﺭېﻭ ﺩګﻪﻻ
ﻣﻞ ﺭ ﻟ ﺭ
ﺪﺩ ﺩﻼﺎ ﺿ
ﻳﻣﺭ
ﺷ.
ﺍﻯ ﻲ ﺩ
ﺩ ﺭﻕک ﻧېﻫﻢﺯ ﺘﮏېﻻﺪ ﻮﺳﭘﻭکﻥﻥﺩ ﺭﻮﻠ
ﻩﮐ ﺭﻥګ ﺍﺪﻤﺷ،ﻫﺍﻯ ﻲ ﺪ ﻴﻟ
ﺎﻤ
ﻌﺘ ﺍﺳﺭېﻫﻢ ﻻ
ﺪﻳﺎ
ﻱﻮﺑﺭځ ﻧﻪﺍ ﺗﻨﺸﻦﻣﻦځ ﻴﺗﻮﭙﻳﺎﺎکﻫ ﻧﺮﻩﺧﻄ ﺮ ﺭﻕﺳ ﺪﻱﺯ ﻳﺭﻳﻦﺩچټکﻭ ﺪ ﻴﻧﻮﺎﮐﻴﻦﻳ ﻧﻮﺍچېﺩﮐ ﺩ
ﻴﻦﻧﻮﻩﺩﮐ ﺭﺎ
ﭙﻟﻠﻦې ﻣﺭ
ﻼﺎﺩﺩ ﻳ
ﺪېﻣﺭ ﻳ
ﺪﺷ،ﺩﺷﺍ ﻲ ﺮﻪﺍﺟ ﻨﻠ
ﻣﺭډﻝﺩ ﻮﻱ ﻭ ﻭﻝﺷ ﺮ ﺘﻨﻩﮐ ﻭښ ﺎﻁﺍ ﻴﺘﻪﺍﺣﭘ
µﻭ
\ gﺍ ml ١
٥-ﺪ٨ ﻳﺎ
ﻠﻈﺖﺑ ﻴﻦﻏ ﻧ
ﻮ ﮐﻼﺎکېﺩ ﻣﭘﭘﺯ ﺭﻪ ﻪﺩﻯﻡګ ﻮﻯﻧ ﻴﻦﺷ ﻌﺭﺗ ﺍ
ﺪ ﻘﻴﻦﻣ ﻌﻳﻦﻣ ﺪﻨﻳﻮﻭﮐ ﺍ
ﺷ.
ﻪ ﻲ ﻻﻞﻧﻤﻢ ﻣ ﺗﺴ ﻭﻫﻢﺩ ﺍﻊﺷﻲ ﻗﺍﻣﻦﻭ ﺰﻴﺍﻏﻭ ﺗڅ\µgﻭﻱﺮ ml ٨-٣،
ﻠﻈﺖ٥ ﻳﻦﻏ ﺪﻴﻧﻮﮐ
ﺩ
ﻪﻟﻱﻭ
ږﺍ ﻤﻲ څﻪﮐﺍﻥ ﺧ ﺭﻭﻪﺩ ﻟﻮﻝ ﮐﺎﻮﭘﻧﻭﺪ ﻴ
ﺋﻮﮑﻟﻮﺍﻴﻨﺗﺭ
ﻮﭘﺍﺩ ﻮﻳېﺧ ېﻪ ﻮﻼﺎک ﻟ ﻳﻩﻣﺭ ﺪﻳﺪ ېﻪﺷﺍچ ﭘ ﺩ
ﻪﺘﻭﺳﺭڅﻪﻭړې ﺧ ﺭکﻪﻭ ﺯﻟ ﻭﻴﻦﺩ ﻌﻣ،ﻮﺩږﻱﻧ ﺗﻲ ﺎ
ﻳﻪﺯ ﺗ
ﻩﻱېﻥښ ﺮﻮﺳ ﻧ
ﻮ ﻨ
ﻴﺗﻭ ﺮﻪﭘ ﺩﻼﺎﻟ
ﻣﻩ ﭘﺯ ﻮﻠﻪﭘﻠﺑ
ﻭ.
ړﻱ ﻭﻭ ﺪﻴﻟﻪکېﺩ ﻨﻳﻪﻭ ﻠﻈﺖﭘ ﻟړﻏ
ﺎﻮ ًﺘﺒ
ﻱېﻧﺴ
96
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
97
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﻪﻐﻪﻫ ﻟﻭځﻭ
ﻩﺭ ﺍ ﺮﺭېﻫ ﻮﺩﻭﭘ
ﺘﻢﺩ ﺮﺧ ﺎﺗﻴﻤﻴﺘﻳﺯﺍ
ﺭﺎﭘ
ﻭﺩ ﺍړﻝﺷﻲ ﺍﻭ ﻩﻭ ﺭېﺮﻻﻮﻝ ﭘ ﻪﺩﺧ ﻨﻠﻣﺭﻭﺩ ﺍﺎﺕ ﻌﻳﺎ
ﻣ
ﺷ.
ﻪ ﻲ ﻨ
ﻳﺎﻌ
ﻭﻣ ﺍ ﻪﻴ
ﻬﻠﻢﺗﻳﻦېﻓ ﻭﻭﻍﺩ ﺭﺎﻧ
ﻭﻥۍﺩ ﺍﻩﺮﻩﻫ ﺭ
ﺎﭙﻟﻮ ﻟ
ﻮ ﻣﻮﻠﻌﻣRecrﺩ ﻪudescence ﺘ ﻭﺳﺭﻭ
:ﻮﻯﻴﻨﺭﻣﺨ ﺍېټﻦګ
ړﺪ ﻳ ﻧﺮﻭﺍ ﻮﭘ ﻠﻣﺭﺩﺩ
څﻪ
ﻴﻞ ﺧ ېﻪﭘ
ﻠﻦ ﻟ ﻣﺭﺭېﺩﺩ ﺭﻪچ ﻡﺩﻯﮐ ﻭﺎﻘړﺪېﻣﻧ
ﻪﻭﺍ ﻮﭘ ﻠﻣﺭﻳﺖﺩﺩ ﺯ ﺍ
ﺮﻮ چېﭘ ﻭﻼﻯ ﺷ ﻪﻳ ﻠﻫ
څﻪ
ﻠﻦې ﺧ ﻣﺭﻭﺩ ﻭځﻪ٧ﺭ ﺍچېﻟ ﺎﺩ ﻪﻧﺸﻲﻳ ﺘﮐڅﻪ ښ %٢ﺧ ﻪ٥ ﺎﻟ ﻴﻤﻴﺘﻳﺯﺍﺭﺎﻪﭘ ﺘ
ﻭﺳ ﺭﻪﻭ ﺘﺎﻋ٤ﺳ٨
ﻟﻲﺍ
ﻮﺘﺭﺩﺷ ﺍ
ټﻦګ ﻮﺩ ﻳ ﻩﻭﻱﻧ ﺩﻮﻮﺟ ﻪﻣ ﻮﺣ ﻟﻴﮏې ﻨﻴﻠ
ﺩﻼﺎﮐ
ﻳﻭ ﻣﺭ ﻔﻲﻧﺸﻲﺍ ﻨﻼﺪﻣﻳﻦېﺳﻳ ﻭﻪﺩﺘ ﻭﺳﺭﻭ
ﺷ.
ﺪﻝ ﻲ ژﻢﺑﻠﻦېﺭﻳ ﻣﺭﺪﺩﺩ ﻳﺎﻪﺑﺘﺎﻥﺷ ﮑﻣ
ﺍ
ﻪﻧﮏېﭘﻲښېﻣﺦﭘ ﻭﻮﺭﮐ ﺍ
ټﻦګ ﻡ ﻳ ﺭ
ﺎﭙﻴﻠﺴﻳﻢﻓ ﺩ
ﻮﻣﺯﺩﻼﻮ کې ﭘ ﻤﻴﻭﺳ ﺩ ﻮﻪﺗ ﻩﭘﻮګ ﻣﻲﺗ ﻮﻤﻪﻋ ﭘ
ﻮ کې ﻤﻴ
ﻮﺳ ﮑ
ﻴﻤ ﻳ
ﺪﻧﻪﺍﺪﭘ ﻳﺎ
ﻩچېﺑ ﻩﺩ ﺩﻮﻮﺟ ﻪﻣﻳﺮﻩﻧﻈﻮ ﻣﻦځﻳ ﺮﻮﺗ ﻧﺎﻮﻫ ﭘ
ﺩﻼﺎﺩ
ﻳﺩ،ﻮ ﻣﺭﻭ ﻱﻧ ﺪ ﻴ
ﺗﺎﻳ
ﺯ
ﻩﻭﺷﻲچېﺏﻝﻻﺏﻝﻝې ﺩﺎﻔﺘCڅﻪﺍﺳ
ombiﺧ net her ﻪapy ﻟﻩﺭ ﺎ
ﭙﻟ ﻮﻱ ﻴﻨﻣﺨﻭﺩ ﻮﭘﻲښ ﻣ ﻭﺎ
ﻘﻣﺩ
ﺪﻼﺎ ﺿ
ﻳﻧﮏېﻣﺭ ﻭﺮﺰﻟﻴﻭﺍﻏ ﺭﻮﻭ ﻪﻳ ﻩﻟﺭﺎﭙ
ﻭﻟ ﻭځﻮﺭ ﻳﺭﺮﺩﺩ ﺘﻤﻴﺗﺭﺎﺍﻴﺖﻳ ﻧﻮ ﻴﺴﺗﺭﻪﺍﮑﺮﻱﻟ ﻟﺰېﻭ ﻴ
ﺍﻏ
ﺳ.
ﻩ
ﻣﻞ ﺮ ﺭﺩ
ﻩﺮښ ړﻯﮐ ﻡﻮﻭکﻥﻥﻟ ﺭﻮﻠﻮﮐ ﺎﺱﺩﻱﻧ ﻩﺣﺴ ﺮﻭکﻥﻥ ﺳ ﺭ
ﻮ ﻠﮐﻳﻢﺩ ﺩﻮ ﻣﺯﻮ کېچېﭘﻼ ﻤ ﻴ
ﻮﺳ ﻐﻪﻫ ﭘ
ﻮﻻﺩﻭﻱﻧ ﻮﻮﺟﺭﻣ ﺍ
ږټﻦګ
ړﺪېﻝ ﻳ ﻧﻥﺮﻭﺍ ﻭکﻥ ﭘ ﺭﻮﻠﮐ
ﻮکېچېﺩ ﻤﻴﻮﺳ ﻐﻪﻫ ﭘﻭ ﺍږﻱ
ﻣﻞګڼﻝکږ ﺭﺩ
.
ږﻱ ﻟﻲﺎﻤﻌﺘﺍﺳ ګډﻝ
ﻪ ډﻭ ﻣﻞﭘ ﺭﻧېﺩﺪ
.ﻴﻦﻳﺴﺎ
ﻣ ﺍ
ﺪﻨﻠﺎﮐﻴﻦﻳﻠﮑﻳﺎ
ﺍﺳ ﺮﺘﻭﺗ ﺍﻴﻦ ﻧ
ﻮﺎﮐ ﻳﻦﻳﺮﺘﻧ
ﺎﻔﻴﻣﻮﻟ ﻭﺍﺮﺘﻤﻴﺗﺭﺍﻥﺎ
ﻮکﻥ ﻳ ﻠﻔﻴ
ﻭﻣ ﺍ ﻴﺖﻧﻮ ﻴﺴﺗﺭ
ﺍ
ﻠﻲګ (ﻣ Proguani l100+At ov ﻭﻥ)aquone250 ﺭ
ﺎﻻ ﺎﻝﻣ ﻬﻣﺮ ﺎﻥﭘ ﮑﻣﺍﺭﺩ ﺍ
ټﻦګﻩ ﻳ ﺭﻥګ ﺍ
ﺪﻤﻫ
ﺷ.
ﺍﻯ ﻲ ﺪﻴﻟﺎ
ﻤ ﻌﺘﺍﺳځﻯﻮﺍ ﻩﻳﺮﻴﺖﺳ ﻧﻮﻴﺴ ﺗﺭﺍ
ﻣﻞﺩﻱچېﺩ ﺭﻣﻦﺩ ﺰﻴﺍﻏﻪﻫﻢ ﻣﺍ
ﺭ
ﻭﻴﺖﺍ ﻧﻮﻴﺴﺗ
ﺭﺩﺩﻯﺩﺍ ﻮﻮﺟﺭﻣ ﺍ
ټﻦګ ﻩ ﻳ ﺮﻮکﻥﻥﺳ ﻠﻔﻴ
ېﻪﻣ ﺎ کېچ ﻟ ﻳﺩﻮ ﺒﻤﻭﮐ ﺎﺍﻣﺮ،ﺑډﻴﻦﻟﺍﻪټ ﭘ
.ږﻱﻣﻞګڼﻝکږ ﺭﻣﻦﺩ ﺰ ﻴﺍﻏﻪﻭﺳ ﺍ
ﺮﺗﻭﻝﻻ ﺭﺎځﻯﮐﻥﻮﺍﻮکﻥ ﻳ ﻠ
ﻔﻴﻣ
ﻭﻍۍﺩ ﺭﺎ
ﻴﻒېﻧ ﻌﻭﺿ ﻮﺳﻂېﺍ ﺘﻣﻡﺩ ﺭﺎ
ﭙﻴﻠﺴﻳﻢﻓ ﺩﻮﻣﺯﻡېﭘﻼ ﻭﺎ
ﻘ ﻣﻭﺩ ﺎﻱېﺍ ﻗﻭﻮکﻥﻥچېﺩ ﻠ
ﻔﻴﻣ
ﻭﭘﻼ ﺍﻝﺍﻭﻭﻳﻢﺍ ﺩﻮﻣﺯ
ﻭﭘﻼ ﻴﺖﺍ ﻣﺍﭘګﻡﺮ ﺭﺎﭙﻴﻠﺴﻳﻢﻓﺩﻮﻣ ﺯﺩﻼﮑﻦ ﭘ ﻴږﻱﻟ ﻟﻲﺎﻤﻌﺘډﻝﺍﺳﻪﻭ ﻠﻦېﭘ ﻣﺭﺩ
،
،ﺎﻥګ،ﮐﻟﻰﺍﻭﺪﻩﺑړﻪﺯﮑ ﻟﻭﺰﻴﻭﺍﻏ ﺰﻴړﺧ ﻣﻞﺍﺭ ﺩېﺩ،ﺩﺮﻱﻟ ﻪﻩﻧ ﺰﻴﻪﺍﻏ ﻠ
ﺮﺣ ﺪﻱﻣ ﺒﺮﮐ ﮐﺲﭘ ﺍ
ﻮ ﻳ
ﺍﻳﻢﻭ ﺩﻮﻣﺯ
ﻮﻳﺰ
ﻧﻮﺘﺒﻲﺳ ﻭﻋﺼ ﻧﻲﺍﺍﻭﺭﻩﺩ ﺭﻥګ ﺍ
ﺪ ﻤﻮﺏۍﻫ ﻭ ﺏېﺧ ﺎﺍﻴﺘﻔﻴﻌ،ﺿ ﻴﺖ ،ګﻥګﺳ ږ
ﻮﺮﺧ ،ﺳ ﺘﻰﺎﺳ ﻧﺲﻧ
ﺩ.
ړﻦ ﻱﺍﻳ ﻭﻝ ﺪﻨ
ﻠﻦېﺑ ﻣﺭﺎﻝﺩﺩ ﻬﻣﺮﻮﭘ ﻠ
ﺗﺍﻪﺭﺗﻣﻦځ ﺭﺩ
ﻭﻥﺭﺎﻻﺩ(ﻣ
ﺯﻯ ﺎﻣﺠﺮﻴﺎﻏً
ﻧﻮﻧﺎ
ﻗ ﻳﻦ) ﺮﺘﻧﺎﻔﻴﻣ
ﻮ ﻟ،ﺎﺕﻘ
ﺘﻴﻦﻣﺸ ﻧ
ﺰ ﻴﻤﻴﺗﺭ
ﺍﻮکېﺩ ﺗﺎﻻﻳﻩﺍﺪﺘﺤ ېﻪﻣﻳﮏ ﭘ ﺮﻣﺍ
ﺩ
.ﺮﻱ ﻠ
ﺭ ﺽﻧ ﺍ
ﻮﺒﻲﻋ ﻧﺎ
ﻠﻰﺟ ﮐﺍږﻱﻭټﻤﻞکږ ﺍ ډﻝﺯﻏﻩﻭ ﻪښ ﭘ
:
ﻪ ﻠ
ﻨﻣﺭﻮﺩ ﺗ
ﺎﺘﻼﻃ ﺍﺧﺩ
:(Acut eRenal Failurﻪ)e ﻳ
ﺎﻔﻡﮐ ﺪ ﭘﻲﻋ ﺍ
ﻧڅﻭﺎ ﺭګﻮ ﺗ:ﺩﭖښ ﻟﻒﺍ
ﺪﻳﺎ
ﻮﺑ ﻩﺷﻲﻧ ﻟړ
ﻪﻮ ﻴﻦﮐﭽ ﻨ
ﻳﺎټ ﻳﺮBﻭﮐ ﻳﻦېﺩ UNﺍ ﻭﺎﻫﻢﺩ ﻴﻩﺑ ﺮﻩﺳ ﺮ ﻳﺸﻦﺳ ﺭﺪﻳﺎ
ﻬﻳړﺭېﻪﻭﺭﻟ ﺭﻪچ ﮐ
ﻭﺭګﻮﺗﻟﺖ کېﺩﭖښ ﺎﻪﺩېﺣ ﺪﺷﻲچېﭘ ﻨﺮ ﺽﺑﻪﻏ ﻮﻱﭘ ﻴ ﻨ
ﻣﺨ Ovﺩ er lﻮﻝﺩoad ﮐﺭﻮﻭ ﺗﺎﻌﻳﺎ
ﻣﺩ
.ﺮﻱﻟﺎﺏ ﺒﺘﻄ ﺍﺳ ﺰﺱ ﻳﺎﻻﻳﺎﻥﺩﻪﺷ ﻮﭘ ﻳ
ﺎﻔ ﻡﮐ ﺪﭘﻲﻋ ﺍﻧڅ
Hyﺎ percatabl oliﺭcﻮﻧ
ﻮﺎﺕﺩﻯﻧ ﻳ
ﺎﻥﺯ ﮑﻣﺎﻥﺍ ﺘﻧ
ﻳﻲﺍ ﺎﻳﺮﺘﮐﺎﻭﻫﻢېﺑ ﺎﻫﻢﺩﺩ ﻴﻩﺑ ﺮﻩﺳ ﺮﺰﺱ ﺳ ﻳﺎﻻﻳﻧﻲﺩ ﺍﻮﺘﻳﺮړﭘ ﺍچېﺩﻭ ﺩ
.ږﻱ
ﻮﻝکږ ﮐﺭﻴﺢﻭ ﺮﺟ ﻪﺗ ﻳﺸﻦﺗ ﺮ ﺘﻠ
ﻓ ﻮﻤﻴ
ﻭﻫ ﺍ ﺯﺱ ﺎﻻﻳﻮﻤﻴﻫ
ﻮﺩ ﺗ
ﺎﻌﻳﺎ
ﻣﻮﻱچېﺩ ﺯېﮐ ﺎﻴﺘﻩﻣ ﺯ ﺍ
ﺪﻧﻩﺍ ﻮڅ ﺎﻥﻳﻭﻏﺭﺎ
ېځﻦېﻧﺎﻱ ﻳ ﻔﻡﮐ ﺪﭘﻲﻋ ﺍ
ﻧڅﺭګﻱﺎ ﻮﺗﺩ ﭖښ
ﺎ
ﺩﻳ
ﺮﻁچې ﺩ ﭘېﺷ ﻮﺪ ﻮﻱﻭﻱﺧ ﻓﻈ ﺎﻪﻣﺤ ﻪﺑ ﻨﻠ
ﻣﺭﻮﺩﻧﺎ
ﻏ ﻭﺭﺎﺩېﻧﻮﺩ ﻓﻲﻭﻱﻧ ﺎ
ﻩﮐ ﺭﺎ
ﭙﻟﻭﻝ ﺮﺘﻨﮐﺯﻥﺩ ﺍ
ﻮﺗ
ﻮﻥېﻩﺭﻏ ﺭﻮﭘﺭﺩ ﻣﻲﻡګ ﻭﺭﺩﻭﺩﻩکﺩ ﻪښ ﻭکېﻣﺦﭘ ﻭځﻭﺭ ﻪڅ ﻴﺖﭘ ﻟﺎ
ﻌﻭﻓ ډﻭډڅﻪﺩﺏ ﺰﺱ ﺧ ﻳﻻ
ﺷ.
ﻪړﺎ ﺘ ﻴﺗﺍﺗ
ﻮﻪ ﻴﻧﻭﺍﻭﻩڅ ﺭ
ﺎﭙﻟ
98
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
:ﺎﻤﻳﺫﺍﭘﻲﺍﻧڅ
ﻭﺎ ږ:ﺩﺱ ﺏ
ﺭﺝېﻮﻱښﺕﺩ ﻟﻩڅ (ﭘﻦځ upri
ght ﻟړ)
ﺪﻮ ﻳﺎ
ﻪﺑﻭﻍﺗ ﺭﺎ
ﻮﻧ ﺍﺷﻲﻧ ﻪﺭ ﺗﻣﻦځ ﺎ
ﻤﻳﺫﻭﺍ ږ
ﺭېﺩﺱ ﺭﻪچ ﮐ
ﺷ.
ړﻝ ﻲ ﺭکﻴﺠﻦﻭ ﮐﺴﺍﻭﺍﻣﻞﺭDiﺩ uretiﺪﻱc ﻳ
ﺭړﻝﺷﻲﻭ ﺭک ﻴﺖﻭ ﻌﻭﺿ
ړﺪﻥېﻭ ﻳﺮ
ﻴﺗﻮﺩﻴﻭﻋﻪﺍ ﻳﺮ
ﻌ ﻭﺷ ږﺎﻝﻭﻱچېﺩﺱ ﻣﺭ
ﻮﺭﻧﺎOcclﻓﺸ usi ﺎﻥon ﻳﺮﻮﻱﺷ ﻳ
ﺭﺍﻯﺷﻲﺩ ﺩﺩک
.
ﻮﻱ ﻻﺖﮐﻟﻲﺩﻟ ﺍﻮﺗﺎ
ﻳﻪﺯ ﺎﭘﻴ
ﺗ
ﻴﻞﻩﭘړړ
ﻪﺏ ﻪﭘﻭﻍﺗ ﺭﺎﻪﻧﻳﻮﻬﻧېﺗﺭﻻﺪ ﺎﺒﺖﻓﺸ ﺜﺮﻣﺪﺗﻳﺎﻮﺑﻡېﺷﻲﻧ ﺎﮐﺎ
ﺭﻥېﻣ ﺍ
ﻧﻰڅ ړړﺭېﺏ ﺭﻪچ ﮐ
ﺷ.
ﻲ
:(
Hy pogl y cemi ﺎ)aﻴﻤﻴﻳﺴﻮګﻻ ﭙﻳﺎ
:ﻫ ﺝ
ﻡﺍﺭ
ﻠﻲګ ١ﻣ-ﻭﺩ٢ ﺍﻴﻞ ﻪﭘﻭﻍﺗ ﺭﺎ
ﺭېﻧ ﻪﻻ ﻟﺪﻳ
ﺭﺯﺩﻭ ﻭﺮﺘﮑﺴﻳ%٥ﺩ ٥ﺳﻲﺳﻲ٠ ﺪ٠ﻳﺎﺭﺕکېﺑ ﻮﭘې ﺻﺪ
ﺷ.
ﻴﺐ ﻲ ﻘﻌﻪﺗﺍﺳﻄﻪﻭﺯﭘ ﻮﮐﻮﻟ
%١ګ ﭘ٠ﺪﻥ ﻪ ﺑ
ﺯﻥﺩ ګﻡﻭﺍ
ﻮﺭ ﻟ
ﺮکﻝ ﺮﻫﭘ
ﻮګﻻﭙﻳﺎ
ډﻝﻫ ﺭﻱ ﻭ ﺍ
ﺮﮑﻪﺗ ﻮﻻًﭘ ﻤﻌ
ځﻪﻣ ﮐﻞﺷﻲ ﮐ ﺍډﻝﻭټ ﻨﻈﻢ ﻭ ﻪﻣ ﺪﭘﻳﺎﻪﺑﺯﮐﭽ ﻮ
ﮐﻮ ﻟ
ﻳﻦېﺩګ ﻭﺩ
ﻳﻦﺪﻴﻧ
ﻮﺎﮐﻴﻦﻳ ﻧﻮېﻪﮐﻮ کېچ ﻟ ﻧ
ﺎﻭﻏﺭﺎﻮﻧﻐﻪﻫ ﻩﭘﻮګ ګﻱﺗځﻥ ړﻪﺍ ﺗﻼﻯﺷﻲﭘ ﺍﻪﺭﺗﺎﻣﻦځ ﻴﻤﻴﻳﺴ
.ږﻱﻪکږ ﻨﻠﻣﺭﻩﻱېﺩ ﺮﺳ
ﺭځﻱﻪﺍﺗځﻯﻣﻦځ ﻮﺍ ﻩﻳﺮﺯﺱﺳ ﻭﺪﻴ
ﺍﺳ ﻴﮏ ﺘﮑ
ﻟ ﺎ
ﻴﮏﻳﻟﻮﺑﺎﺘ
ﻴﻣﺎﺩﻴﻤﻴﻳﺴ ﻮګﻻ ﭙﻳ
ﺎﻼﺎکېﻫ ﻳ
ﻩﻣﺭ ﺪﻳﺪﻪﺷ ﭘ
ﺩ.
ﻭﻯ ﻯ ﺪﻧ
ﺭﺎﮐﻭښ ﺭﺍ
ﺰﻧﺍﻮﺑﺍ
ﺮچېﺩﺧ
:
ﺎﺕ ﺘﻼﻃ ﺍﺧﺭﻮ:ځﻦېﻧ
ـ ﻳ ﻩ
ﻩﺯﺎ
ﻪﺗﻮﻯﺗ ﻐﺪﻫ ﻳ
ﺎﺍﺷﻲﺑ ﻪﺭ ﺗﻪﻣﻦځ ﻠ
ﭙېﻪﺧHemorﻱ ﭘ r
ﻮکېچېhage ﻧ
ﺎﻭﻏﺭﺎﻮﻧﻐﻪﻫ ﺩﻼﺎﭘ
ﻳﻣﺭ
ﺷ.
ړﻝ ﻲ ﺭک ﻴﻦKﻭ ﻣﺍﺪﻱﻭﻱټ ﻳﺭﻭﻭﺍ ﻪﻨ
ﻳﻭ
ﻭﺩﻝﺷﻲ
ړﺎ ﻝﺩ ﻴﺭېﺍﺗ ﺭﻪچ ﻭﮐ ﻪﺷﻲﺍ ﻨﻠﻣﺭﻪﺩﺍﺳﻄﻪﻭ ﻡﭘﺎﭙﻳ
ﺯﺎﻳﺪﻱﺩ ﻌ ﻘﺎﻣﺪﻱﻳ ﻳﺭﺪﺩﻭ ﻳﺎﺎﺕﺑﺘﻼﺟ ﺍﺧ
ﺷ.
ﺘﻞ ﻲ ﺍﺥﺱﺳ ﺭﻭﺎېڅﻪﮐ
ﺮﺳﺖ ﺧ ﻔﺴﻲﻣ ﻨ
ﻪﺗ ﻟ
ﻪﺘﺎﺍﺧ
ﻴﻧﻮﻤﻳﺸﻦﻧ ﺮﻴ
ﭙﻪﺍﺳ ﺍﻯﺷﻲﭘ ﺩﺩﺮﻱک ﻟﺭ
ﺎﺕﻭ ﺘﻼﺟ ﻭﺍﺧﻟﺖﺍ ﺎﺭﻱﺣ ﻮﻌﺮﺷ ﻴﺎﻥچېﻏ ﻭﻏﺭﺎ
ﻪﻧ ﻐﻫ
ﻮﺪﺩﻏﻳﺎﻮﺑﺮﻱﻧ ړﺎﻟ
ﻴﺗﺍﺗﻴﺸﻦ ﻪ ﻠﻳ
ﻭﻥټ ﺮﭙ
ﻳﺎﻩﻫﺭﺍﺪ
ﻣﺍﻭﺎﻥچېﺩ ﻭﻏﺭﺎﻪﻧ ﻐﻩﻫ ﻮګ ګﻱﺗځﻥ ړﻪﺍ ﺷﻲﭘ
ﺷ.
ړﻝ ﻲ ﺭکﻴﺠﻦﻭ ﮐﺴﺍﻭﺍﻣﻞ ﺭ
ﺪﺩ ﻭﺏ ﺿ ﺮﮑ ﻴﻣﺭېﺩ ﺪﻱﻻ ﻳ
ﺭﻪﺩﻭ ﻮﺗ ﻧ
ﺎﻭﻏﺭﺎ
ﻧ
ﻡﺩﻯ ﺎ
ﻮکېﻋ ﻧﺎﻣﻮﺎﺷﺎﻱېﻣ ﻘﻳ
ﺮﻓېﻪﺍ
ﻪچ ﭘ ﻨﻠ
ﻣﺭﻮﺩﺗﺎ
ﻧﺎﺘﻧ
ﻭﺍﺭﻮﻧﻭﺩ ﻪﺍ ﻨﻠ
ﻣﺭﻪﺩ ﮑﻴﻣﻴﺲټ ﻴﻼﺳ ﻧﻮﻤﻠﺩﺳ
ﻭ.
ګﻱ ﻱﻪکېﻣﻞ ﺭ ﻨﻠﻣﺭﻪﺩ ﻡﭘﺭﺎﭙﻴﻠﺴﻳﻢﻓﺩﻮ ﻣ
ﺯﺩﻼﺪﭘ ﻳﺎ
ﺑ
ﺍﺏﺷﻲ ﺮﺭﺧ ﻮډﻝﻧﭘﻲ ﻭ ﺍ
ﻧڅﻪﺎ ﻴﺖﭘ ﻌﺎﻥکېﻱېﻭﺿ ﻳﺮېﻪﺟﻠﻦ ﭘ ﻣ ﺭ
ﺪﺩ ﺩﻼﺎ ﺿ
ﻳﺎﻥچې ﻣﺭ ﻭﻏﺭﺎ
ﻪﻧ ﻐﻫ
ﻔﻲﻨﻡﻣ ﺍ
ﺭﻭګ ﺎﺍﻴﻤﻴﻳﺴﻮګﻻ ﭙﻳﺎ
ﺪﻫ ﻳﺎﻮﺑﻪﻭﻱﻧ ﺩﻧ ﻮﻮﺟﻴﻞﻣ ﻟﺪﺩ ﻧﺭګ ﻡڅ ﻮﻩﺑﻞﮐ ﺭﺎﭙﻪﻟﻐﻭﺩﻫ ﺍ
ﺷ.
ځﻝ ﻲ ﺭﻭ ﻮﻪﻏ ﻧﻪﻭﻣ ﺎ
ﻪﭘﻟﺎﻴﻤﻴﻴﺴﺘﭙﻴﺳ
ﺯﺱ ﻮ
ﻠﻴﻭﺳﺮ
ﺑ
(
Brusel
losi
)s
:ﻳﻒﺮﻌﺗ
ﻩﻮ
،چېﻳﻳﻲ
ﺍMalﻫﻢﻭ t
aFev ﻭer 'Bangﺍ
sDiﺗsease،
ﻪ Undulﺒﻪantﺯﺱﺗﻮﻠﻴﻭﺳﺮﺑ
ﻮﻱڅړﺷ،چېﮐﮏ ﻩﻏﻲﺩﻭﺭﺎ
(ﻧﻪﮑﻴ
ﺗﻮﻧ
ﻭﺯﻧﮏې)ﻭﺩ
ﺩﺩﻟږ
څﻪ ﻲﻮ ﺧﻳ
ﻭﺭﺍﻪڅ ﻳﻲﻟﺎ
ﻳﺮ
ﺘﮐﺎ
ﻪﺑﮑﻴ
ﻤﺘﻴﺴﺳ
.ږﻱ
ﺩږږږ
ﻪﻝ ﺎﻥﺗﻧﺴ
ﺍډﻝ
ﻴﻢ ﻭ
ﻘﺘﺮﻣﺴﻴ
ﻪﻏﺎﭘﻍﻪﻳ
ﻍﻪﻥ ﻏڅﻪﻥﻍ ﭘ
ﻭﻱ ﺧ ﺭﺍ
:
ﻪﻧﻮﻠ
ﻣﻻ
ﻮډﻟ
ېﻪ ﺏﻝﻻﺏﻝ
،چ ﭘږﻱ
ﻪکږ ﺗ
ﻣﻦځﺍﻪﺭﺍﺳﻄ(ﻪﻭ
Stﭘrai
ډﻝ)n
ﻴﻼ ﻭﻭﺳﺮﺯﺱﺩﺑ ﻮﻠ
ﻴﻭﺳﺮ
ﻧﻲﺑ ﺎ
ﻧﺴﺍ
ﺩ.
ﻮﻱ ﻱﻮﻭﺵﺷﻞﺷ ﻟ
99
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ښﻥ
ﻭﺍ ېﻭﺍﺯﺍ ﻭ،ﺍ
ﻪﻧﻮ ﻻﻞﺩﻯﭘﺴ ﺰﻣ ﻳﺩﻭﻭﻍۍﺩ ﺭﺎ
ﺮﺿﻲﻧ ﻮکېﺩﻋ ﻧ
ﺎﻧﺎ
ﻧﺴ Meﻪﺍ
lﭘ itensiﻴﻼs ﻭﺳ ﺮ
ﺑ
ﺩ.
ﺮچﻥﻥې ﻱ ﻳېﺳ ﻨﺲټﺰ ﻱېﺑ
ﺩ.
ﺮچﻥﻥې ﻱ ﻳې ﺳﻨﺲټﺰ ﻭﻣﻲښېﺑ ګﻥېﺍﺍﺍ ﻮﻳﻲﻏ ﺍ
ﺮ ،ﺻﺤ ﺭﻥۍ ﻮﻩﮐ ﺭﺎﭙAborﻟ t
ﻴﻼus ﻭﺳ ﺮ
ﺑ
Neotﺩ ﻴﻼomae ﻭﺳ ﺮBﻭﺑ
-ﺍ OVIﻮS ﻧ
ﻮﺩﭘﺴ ،ﻮﻴﭙ
Caniﺩﺳ ﻴﻼs ﻭﺳ ﺮ،ﺑﺯﻱ ﻮﮐﺮSuiﺩﺳ ﻴﻼs ﻭﺳ ﺮ
ﺑ
.ږﻱ
ﺩږ ږ
ږﻪﻝ ﺎﻥﺗ ﻧﺴﺍڅﻪﻮ ﺧ ﻧﺎ
ﮐﻣږ
ﻳﻲ ﻮ ﺍﺮﻮ ﺻﺤ ﻳ
ړ ځﻥګﺍ
ﻭﺮﻱﺍ ﻪﻟ ﻮﻝﻧ ﭙﺴﻭ،ﮐﺟړﻱﻪ ﻮ ﺭﻧﻮﭙﺩ،چېﺳ ﻪﻱ ﻧﻮﻠﻴﺑﺴﻮﮐ ﻮﻔﻲﮐ ﻨګﻡﻣﺍﻨﻰ ﺭ ﻮﭼ ﻴﻼﮐ ﻭﺳ ﺮټﻝﺑﻭ
ﻭﺥې ﺩ ﻮﻭﻣﻦځﻥۍﺗ ﻳﺸﻦﺍ ډﺍﺰﺭﻳﺎ
ﻧﻮﻳ،ﺍﻭړﻥګﺮﻭﺍ ﻤﻟ
ﻡﺩ ﺰ ﻴﻧ
ﺍﺭګ ﻭ.ﺍﺍ
ﻮﻱﺩ ﻩﮐ ﺩﺎﻝکېﻭ ﻳ
ﺮﻴﭘﺎﺯېﭼ ﺍ
ﻮﻳ
ﻩﺮﻭﺩﻭ ﺳ
ﻭ چﺩ ﻱﻻﻦﻳﺦﺍ ﻩځ ﮐ ېﻪﻣﻦځ ﻭک ﻟ ﺪﻴ
ﺩﺷ ﺰﻳﺍﺭﻮﺘﺎﺳ ﻭﭘ ﻮﺵﺍ ﻪﺟ ﺩ،ﭘﺎﺱ ﻯ ﻩ ﺣﺴ ﺮﺳ
ﻮﻯ ﺟړﺷڅﻪ ﻮ ﻭ ﺧ ﺪ ﻴﻪﺷ ﻮﻟﻧﻮﺎﭘﺴ ﻭﻳﺯﻭﺮکېچېﺩﺍ ﻴﻨﻪﭘﻐ ﻪﻫ ﺍﻯﺷﻲﭘ ﺩﺩﻴﻼک ﻭﺳﺮﻡﺩﻯﺑ ﻭﺎﻘﻣ
ﻩﺮﻮﺳ ﺗﺍ
ﺯ ﺍ
ﺮﻓﻠﻲﺍ ﺒ
ﻬﺎﻣ ﻭﻳﺯﺎﻴ
ﺘﻮﻣ ﺍﻥﺩﺗﺸ ﻮﻴﻩکېچېﺩﺣ ﺭﻭ ﺎ
ﻪﺧ ﻪﻭﭼ ﻐﻪﻫ ﻭﭘ ﻮﺍﺘﺎﺷ ﻴ
ﻩﻣ ﻭﺮﺩ ﻭﻱﺗ
disinf ectiﺭon ﺷﺭ
ﻮ ﻢ ﻩﺩﻳ ﺮ
ﺎﻥۍﺳ ﻪﺍﺳ ﻩﭘﺭﻥګ ﺍﺪﻤ.ﻫ ﻭړﻱ
ﺪ ک ﻧ
ﻭ ﻮژ ﺘﻔﺮ٦ﻫ ﺷېﻭﻱﺗ ﻩ ﻮ ړﮐﮏ
.ﻩځﻱ ﻪﻣﻦځ ﻟ ﻩﺮﻭﺳ ﺩﺍﻮﻣ
:
ژﻱ ﻮﻟ
ﻮ ﻤﻳﺪﻴﭘ
ﺍ
ړﻝﺭک ﺭﻭ ﻮﭘﺍ٥ﭘﻲښېﺭ ٠
٠٠
٠ﮐﻝ٠ﻪﺎ ﻮ کېﭘ ﻧ
ﻭﺩﺍﻮﻴ١ﻫ ٠
ﭘ٠ړۍ ﻪ ېﻪﻣﺦېﺩﻥ ﺎﻱ ﻟ ﺍﺣﺼ ﺩWHOﺩ
ګﻱ
ځﻥ ړ ږﻱﻪ ﺍ
ﺎﻝږ ﭘ ﻘﺘﻧﺍﻪﻮﺗ ﻧ
ﺎﻧ
ﺎﻧﺴﺍ څﻪ
ﻮ ﺧ ﻳﻭﺭﺍﻠﻲڅ ﺍﻫ ،چېﺩ ﻩﻭﻏﻲﺩ ﺭﺎﻪﻧﮑ ﻳﻮټ ﻧﻭﻩﺯﻮ.ﺍﻳ
ﻮﻯﺩ ﺷ
څﻪ
ﻮ ﺧ ﺗﻮﻻﻪﻣﺤﺼ ﻮﻟ ﻳﻭﺭﺍﻳﺩڅ ﺮﻱﺎ ﺭﻟﺎﮐﻭﺮﻩﺳ ﺮﻮﺳ ﺗ
ﺎﻧﺍ
ﻮ ﻴېﻪﻣﺦېﺣ ﺪﻟ ﻧﻠﮏچېﺩﺩ ﻪﺧ ﻐډﻝﻫ ﻭ
ﻪﻧﮏې چېﭘ ﻭﻮﮐﺭ
ﺎﻪﮐ ﻐﻭﻫ ﺍﻥﺍ ﺮﻧﺮﺘ
ﻳ،ﻭ ﻪﻧﺎ
ﭙﺭ ،ﺷ
ﺑګﺍﻥ ﻪﺰ ﮑ،ﻟ ږﻱﻪ کږ ﺘﺎﺕﺍﺧ ﻳ.ﺯ ﻠﻲﻩﺍﺧ ګټ
ﻮﻥ ﻤﺷېﻧړې ﻮ ېﻪﮐﮏ ﻧﮏېچ ﻟ ﻭﻮﮐﺭﺎﺭﮐﺍﻮﺗﺍ
ﺮﺑﻩﺩﻻ ﺭﻥګ ﺍﺪﻤﺩ.ﻫﺪﻱ ﺎﻋﺮﻱﻣﺴ ﻟﻩﺪ ﻧﻮکېﺩ ﻧﻮﻠﺨﻣﺴ
ﺷ.
ﺍﻯ ﻲ ﺩﺩﻪک ﺘﺍﺧ ﻩﻣﺦﻭﻱ ﺮېﺳ
ﻭﺭﺭﻪډ ﻳﻢﻟ ﺮﮑﻳﺴﻭﺍ ﺪېﺍ ﻴ Unpastﺷ uerized، ﺮﻴﻨﻡﭘ ﺮګﻱډﻝﻧ
ځﻥ ړ ﻭ ﻪﺍ ﻮﻻﺕﭘ ﻳﻲﻣﺤﺼ ﺍﺬﻏ
ﺩﻪک ﻧﺮچﻥ ﺰﻫﻢﺳ ﻐ ﻮﻣ ﮐﻭﺩډ
ﻩﻭ ﻩﻮښﺍ ﻪﻏ ﻣﺎ
ﻮکېﺧ ﺗﺎﻻﻳﻲﺣ ﺎﻨﺜﺘﻪﺍﺳ څﻪﺩﻱﭘ ﻮ ﺧ ﻧ
ﺮچﻥ ﻮﺳ ﻤﻬﻣ
ﺷ.
ﺍﻯ ﻲ ﺩ
ېﻭ
ﻳﻦ ﺍ ﺎﻥﺩﻭ ﺘﻧﺍﻯﺷﻲﺍ ﺩ
ﺩ ﺎک ﻣﻩﺍﻩﺩ ﺭﺩﺎ
ﻩﻧ ﺭﺭﻪډﻧﺩﺩﺩږږ ﻪﻱېﻝ ﺎﻥﺗ ﻧﺴ څﻪﺑﻞﺍ ﺎﻥ ﺧ ﻧﺴﻮﺍ ﻪﻳﻟ
.
ږﻱﺩږ ږږﻪﻭﻝ ﺍﺳﻄ ﻪﻭ ﺪﭘﻧﻮﻴﻧﺴﺞﺩﭘ ﺩ
ﻪﻫﻢ ﺍﺳﻄ ﻪﻭ ﺎﺱﭘ ﻤ ﻩﺩﺗ ﺮﺎﺳ ﺎﻃﻲﻏﺸ ېﻭﻣﺨ ﺘﮏ ﺍ ﻮﺳ ،ﭘﻮﻟﺧړ
،ﻮ ﺎﻕﻧﺸ ﺍ
ﺍﻯﺷﻲﺩ ﺩﺩﺯﺱ ک ﻮﻠﻴﻭﺳ ﺮ
ﺑ
ﻮﺗ
ﺎﻳﻪﺯ Sڅﻪﭘ uiﺧ ﺯﺱs ﻮﻠ
ﻴ ﻭﺳﺮMeﻭﺑ
lﺍ i
tensiﺯﺱs ﻮﻠﻴﻭﺳﺮ ﻨﺲټﺩﺑ ﺪېﺑ ﻤﺮﻫ ؛ﻮﭘ
ږﻱﻧ ﺩږ ږﻟﻲﻭ
.ږﻱ
ﺘﻞکږ ﻴﺴﺍﺧ ﻩﻡکېګټ ﺰﻳﺭﻭﺮﻴ
ﺗﻮﻳﺎ
ﻪﺑ ډﻝﭘېﻪ ﻭﻴﮏېﻭﺳﻞ ﭘ ﻮﺟ ﻟﺎ
ﺩﻴ
ﻮکې ﺑ ﻧﻭﺩﺍﻮﻴﻫ
:
ﺰﺱ ﻴﻨﻮﺟ ﺘ
ﭘ
ﺩﻥ
ﺩﺩ ږﻟﻲ ﻭﺩﻩﺍ ﺯﺍ
ﺪﻧﺎﻥﺍﺘﻧﺍ
،ﺩﻟﺖ ﺎﺘﻲﺣ ﻴﻓﺎﻌ،ﻣﻟﺖﺎﻳﻲﺣ ﺍﺬﻪﻏ ﺑ
ﺭﻮﮐ ﺍﺕګکېﺩ ﻪﺭ ﺗۍﻪﻣﻦځ ﻭﻍ ﭘ ﺭﺎﻧ
ﺩ
Abor t
Meﻭus lﺍ itensiﻴﻼs ﻭﺳﺮﻟﻰﺩﺑ ﺍﻮﻤﺪېﺩPHﮐ ﻌډﻝﺩﻣ ﻪﻭ .ﺩﺏﻝﻝګېﭘ ﺮﻱﻟﻭﻝ ﻩﺭ ﺭېﻻ
.ﻮﻱﻮﻯﮐ ﻴﻨﺍﺧﻞﺷﻲﻣﺨ ﺭېﺩ ېﻪﻻﻮﻝ ﻟ ﻪﺩﺧ څﻪﮐﺧ
ﻪ ﻑګ ﺑﺭﻮﺮﻱچېﺩﮐ ﻟﺍک ﻭﺍځ ﺩ؛ﻮﺩ
ﻮﺟﻦ ﻯﻧ ﺘﺍﺧﻞکېﭘ ېﻪﺩﻧﮏ ﭘ ﻭ ﻴﻼﺩژ ﻭﺳ ﺮ
ﻩچېﺑ څﻥګ ﺭ
ﻴﻼ ﻭﺳ ﺮﻩﺑ ېڅﻥګ
ﺩ،چ ﺭ ﻪﻯ ﺪﻧ ﻧ
ﺭګ ﻡڅ ﺰﻴﻧﺎ
ﮑﻴﺍﻣﺎﺩﻣ ﺍﻭړﻱ
ﻪ ک ﻧﺩﺩﺎﺕ ﻳﻭﺯ ﺍﺪﻧﻭﻮکېژ ﮑﻧﻭﻳﺖژ ﺎ
ﻭﺳ
ﻤﻲګ ﻭﻫﻭﺩ ﺍړﻰﻡﻧ ﻮﻟﺎﻫﻢ ﻴ
ﻮﺑ .ﺧ ږﻱ
ﺗﻞکږ ﺎڅﻪﺳﻮ ﺧ ﮑ ﻧ
ﻭېﻪPMNژ ﺍﺧﻞک ﻟ ېﻪﺩﻧﮏ ﭘ ﻭ ﺩژ
.
ﺮﻱ ﻟ ﻭﻝ ﻮﻝﺭ ﻬﻲﮐ Cu-znsuperﻧ oxiﻊde ﻤﺘﻢﺟ ﻴﺴ(ﺳ ډﺰ)H2O2 ﻳﮐﺲﺍ ﺍﺮﭘﻮﻟﺎ
،ﻴ
ﻴﺸﻦﻣ ﻟﻮﻧﺍ
ﺭ
ﻭﺩ neutﺍ rophi ﻪ submucosaﮐﯽﺩl ﻮﭘﺍﺧﻞﺷﯽﻧ ﻪﺩ ﺩﺗﻮﻡﻭﺟ ﺰﻴﻧﺍﺭګ ﻭﺍ
ﻭﺮﮑﻴﻪﻣ ﻪﭼ ﻠ
ﮐ
ﻪږﯼﮐ ﻟﻲﺎﻘﺘﻧ
ﻪﺍ ﻮﺗ ﻧ
ﻭﻧډ
ﻤﻒﻮ ﻟﺎﻥﺘﻧﺍﯼﻭ
ﮐږ ﺍ
ﻩﻣﺦ ﻲ ﺮﻤﻞﺳ ﻌﻟﺍﮑﺲ ﻮﺩﻋ ﻧﻭژﺎﻭﻓﺮﮑﻮﺩﻣ ﺎﺟﻧﺴﺍ
ﻡﺰﻴﻧﺍﺭګﻭﺍ ﻭﺮ
ﮑ ﻳﺎ
ﯼﻭﻣﺭځ ﺍځﻪﺍﺎﻣﻦ ﺗ ﻴﻤﻳﺮ
ﺘﮑﻮﺑ ﻪﻭﯼﻧ ﻔﻴﻌﺘﻢﻇ ﻴﺴﺘﯽﺳ ﻴﻓ ﺎ
ﻌﺎﻥﻣ ﺑﺰﻴﺮﯼﺩﻣ ﻴﭼ
ﺮﯼﺩ ﻴﻪﭼ ﺭړﯼﮐﻭ ځﻪﺍﻪﻣﻦ ﺗ ﻣﻮﻟ
ﻮ ﻧ
ﺍﺭﻪګ ﺘﻠ
ﯼﻭﻫﻟږ ﺍﺎﻲ ﻘﺘﻧ
ﺍ ﻪﺰﺗﻐﻮﻣ ﮐﻭډﺭﻭﺩﻩ ،ځﻱګﺍ ﺎﻝ ﻃﺤ
100
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﻪﺭړﯼﭼﻭځﻪﺍﻪﻣﻦ ﺗ ﻣﻮﻟ
ﻮﻧﺍﺭﻪګ ﻳ
ﻮﻟﻮﻪﺷﯽﻧ ﻭﯼﻧ ﺍ
ﺪﻭﻍﺗ ﺭﺎ
ﻭﻧ ﺍﺎﺕﻳﺩﺯ ﺍﺪﻌﻡﺗﺰﻴﻧﺍﺭګ ﻭﺍﻭﺮﮑﻳﺎﻣ
ﺍﺎﺭﻴﻤﻳﺮ
ﺘﮑﻩﺑ ﺭ
ﺍﺪﻣﺍﻭﺎﺩﺩﻨﺸﻮﻣ ﻪﮐﯽﻳ ﻠﻳ
ﺎﻪﭘﻪﭘ ﻮﯼﭼ suporﮐ atiﻪ onﻣ ﻮﻟ
ﻮ ﻧ
ﺍﺭړﯼګ ﻮﻣ ﻮﻪﻧﺘﻭﺳ ﺭﻭ
ﺍﻝﻮﻳﻭﯼﺩ ﺮﻪﺣﺠ ﻡﭘ ﺰﻴ
ﻧﺍ
ﺭګ ﻭﺍﻭ ﺮﮑﻴﻮﯼﻣ ﻳﺖﮐ ﺍﺮﻡﺳ ﺰﻴ
ﻧﺍ
ﺭګ ﻭﺍ ﻭﺮﮑ ﻴ
ﻭﻪﻣړﺗ ﻭﻍ ﺭ ﻮﻭﻧﺍ ﻮﯼ ځﻪﮐﻣﻦ ﺗ
ﻪM Antﭼ i
ﻭ gen ﮑﯽﺩ Aﺍ ﻧ
ﻭﺮﻟﻪﺩﺩﯼﭼ ﻮ ﻮﺟsurﻣ facel ipopol ysachar ri
ﮐﯽde
ﺟړﯼ
ډﯼ ﻮﻭ ﺎﺘﯽﺑﻧﺍﺑﻞﮐﯽ ﺎﻘﻪﻣ ﻮﭘﻧﻮﻧﻮﺘﯽﺟ ﻧﺍﻭړﻮ ﻣ
ﻮ ﺩﻫﻢﺩﻧ ﻮ ﺎﻥﻭﺟ ﺑﺰﻴﻣﺩ
:ﻩﻴﮏېﺏڼ ﻨﻴﻠ
ﮐ
ﺩ.
٢ﺭځې ﻯ ﺗ ١ﻭﻩ٥ﺮ ﻮګﻩﺗﺰﻳﺩﻭېﻪﺩﻩﻱ ﭘ ﺭﻭﻳﺦﺩ ﺮﻔ ﺗ
ﺩ
ﺩﻼ،ﻣ ږﻮﺮﺧ،ﺳ ﻳﻲﺎﻬﺘ
،ﺏېﺍﺷ ﺎ
ﻴﺘ ،ﺳﺴ ﻪﻟﻮﺗ،ﺧ
ﻪﻪﺒ ﮑﻟڅﻪ
ګﻭګﻮ ﺧ
ﻠﻧځﻥ ړ ﻳ ﻭﻍﺩﺎﺍ ﺭﺎﺯﺱﻧ ﻮﻠﻴﻭﺳﺮ ﺩﺑ
ﻭ.
ﺑړﻰ ﻱ
ﺎ ﻲﻧ ﻳﺠﻲﻳ ﺭﺪﺍﻯﺷﻲﺗ ﺩﺩ
ﻴﻞک ﻭﻍۍﭘ ﺭ
ﺎګﻪﻣﻦﻭﻱﺩﻧ ﻠﺧږڅﻪ ﻳ
ﻮ ﺧ
ﺍ
ﻮ ﻟﺨ ډﻝﺩﺷﭗې ګﻱ ﻭځﻥ ړﻭ.ﻪ ﺍ
ځﻯ ﻱﭘ ﻮﺍ ﻩﻳ ﺮﻮﺳ ﻟ
ﻮﻪچېﺩﺧ ﺒﻭﻍۍکېﺗ ﺭ
ﺎﻪﻧ ﺯﺱﭘ ﻮﻠﻴﻭﺳﺮ ﺩﺑ
.ﺮﻱﻟ
ﻮﻯﻭ ېﺪﺑ ﻮﻝ ﺑ ﺍﻯﺷﻲﺧ ﺩﺩﺩﻭﻱک ﻮ ﻮﺟ ګﻪﻣﻦﻭﻱﻣ ﻠېڅﻪ ﻳ
ﻪﺩ ﺧ ﻟﻭﻍ ﺭﺎ
ﻧ
ﻮﮑ ﻧ
ﻭﺮﻟﻪﺒ
ﻭﺗ ﺭﻮﺮﺩﻧ ﻴﭘﻮﺯﺱﺗ ﻮﻠﻴﻭﺳﺮﻮکېﺩﺑ ﻧ
ﻮ ﻳ
ﺍﻴﮏځ ﻤ
ﻳﺍډ
ﻪﻥ ﭘ
ﻩﺮﻮﺳ ﻴ
ﻭﻏﺭﺎﻭﻧﺭﻮﻧﻭېﺩﺗﺐېﺩ ﺎ
ﻴ ﺗ
ړځﻥګړې ﺍ ځﻥګﻩﺍ ﻭﺎﻫﻢﺩ ﻴﻮﺑ ﺩ.ﺧ
ﻣﻦ ﻯ ﺰﻧﻮﺘڅﻪﺳ ﻮ ﺧ ﻴﻭﻏﺭﺎﻧ
ﻩﺭﺎ
ﭙﻭﻥۍﻟ ﻮېﺍ ﻳ
ﻪﺩ ﺒﺯﺱﺗ ﻮﻠﻴ
ﻭﺳ ﺮﻮﺩﺑ ﻮﻱﻧ ﻪﻭﻱﺷ ﻪﻧﻨﻠ
ﻣﺭ ﻪﺩ ﺍچېﮐ ﻮﺩ ﻮﻱﻳ ښﻪﮐﻧﻭﺍ ﺮﺭﻴﭘﻮﺗ
ﻪﺩ ﺒﺯﺱﺗ ﻮﻠﻴﻭﺳﺮﺍچېﺩﺑ ﻪﺩ ﻠ
ﻱﻭﺑ ﺭځ ﺍﺭګﺎﺍ ﻴ.ﻭﺑږﻱﺍ ﻪﮐﻢږ ﺘ ﻭﺳﺭږﻱﻭﻭ
ﺎﺕېکږ ﺍ ﻩﭘﺭﺍﺪﻣﺍﻭﺩ
ﻭ.
ځﻯ ﻱ ېﻮ ﺍ ﻮک ﻳ ﻧﺎ
ﻭﻏ ﺭﺎﻳﻲﻧ ﺎ
ﻤﻴﻪﻧﻩﭘ ﺮ
ﻭﺳ ﻭﻥښ ﺍ ګﻮ
ﻠ
ﺘﻲ ﻳ ﻴﻠﮑﺍﺳ ﻠﻲﻋﻀ
ﺯﺱ ﻮﻠﻴﻭﺳﺮﺭﺑ ﺎﻥﺩﻯﻡګ ﻮﺷ ﻮﻳ ﻧﻮﻟﻭ
ﻮډ ﻟﻭﺯﺱﺩ ټ ﻮﻠ
ﻴﻭﺳ ﺮ ﺩېﺩﺑ ږﻭېﻥ ﺎﻴﺗ
ﺪ ﻧﺭګﻴﮏېڅ ﻨﻴﻠ
ﮐ
ﺑﺴﻲ ﻳﻲﺍ ﺍ
Suiځ ﺯﻱs ﻮﻠ
ﻴﻭﺳ ﺮ
ﻭﺩﺑ ﺮﻱﺍﻭﻥېﻟ ﺪ ﻧ
ﺭګ ﺪېڅ ﻳﺪۍﻭﺷ ﺑړﻥ ﺍﺎﻥ ﻲ ږﺷ Melﻝ i
tensi s
.
ﺮﻱ ﻟﻩﺭډﻲ ﺕګﻻ ږﻱﻭځﻥﻧﻪکږ ﺍ ﺗﻣﻦځ ﺍ
ﻭﺭ ﺭ
ﻭﻭ ﺭAborﻭ t
ﺯﺱus ﻮﻠ
ﻴﻭﺳ ﺮﺎﺑﻣښﻱﺍﻮ ﻭ ﺩﻝﺧ ﺩړﻮ ﺟ
ﻪﺗګﻮﻣﻦځ ﻠ
ﻭﻳ ﺭﻮېﻭﻧﻩﺗﺐ ﺍ ﺭېﺩ ﻮﻮﭘ ﺘ
ﺎﺷﻴﻭﻣ ﺮڅ ۍڅﻪﺗ
ﻭﻥ ﺧ ﻳېﺍﻪﻮ ﻩﻟﺭﻭﻳﺦﺩ ﺮﻔﻭﻍۍﺩﺗ ﺭﺎﻧ
ﺩ
،
ړﻯ ،ﺳﺖ ،
ﺍﻥ ﺏېﻋﻼﻕ ﺭﻭﻩﺭﻥځ ﺭﺭﺮﺏ ﻮﻝېﺳ ېﻭﺧﺮﺗﺐ ﺍ ډﻝﭘ ﻭﻭ ﺭﻪﻭ ﺎﭘﭘﻲﻳ ﺍ
ﻧڅﻳﻲﺎ ﺍﺍﺕګ ښ ﺭ
ګﻪ
ﻠڅﻪ ﻳﺎﺱ ﺧ ﻳﺨﻦۍﺍﺣﺴ ﻭﺩ ﺩﻱﺍ ﺭﺩﺮﻮﺳ ﻧ
ﻭﺩ ﺭ
ﻠﻲﺩ ﻩﺩﻋﻀ ﺭﻥګ ﺍﺪﻤﻪﻭﻱﻫ ﻧﺯﻭﮐﻢﻭ ﺎﺍﻬﺘﺏېﺍﺷ
.
ﻣﻲﻮ ﻣﻮﻥﻭ ﻤﻩﺳ ﺮ
ﻮﺳ ﻧ
ﻮﺘ ﻳﺎ
ﮑ ﺩېﺷﻪﺭ ﻟﺍﻯﺷﻲ ﺩﺩﻭﻥېک ﺪﻧﺭګﺭېڅ ﻮﺯﺱﻧ ﻮﻠﻴﻭﺳ ﺮﺑ
ﻣﻦﻭﻱﺩ
ﻭ.
ﺪﺕﻱېﮐﻢ ﻱ ﺭﺷ ﺎﻥﻡګ ۍﻪﺷﻪﺩﻭﭼﮏ ﭘ ﺒ:ﺗﻟﻒﺍ
ﻮﻧﺎ
ﻣ ﻮﺎﺷﻮﻣ ﻧ
ﺍﻭﻪځ Hiﭘ pJoiﻭnt ګﻥﺍډﻝﺯﻥ ﻭ ګﻱ ﻭ ځﻥ ړﻪﺍ ﺘﺲﭘ ﻳﺍ
ﺮﺗﺭﻮﺍ ﻧ
ﻮﺑړﻲﻣﻭ ﻲﻧ ﻪﺍﺒ:ﺗﺏ
.ﻮﻱ ﻪﮐ ﺘﺍﺧ کې
.
ﻮکې ﮑﻠ
ﻭﺧ ړ ﭘﺯ
ﻩﻪ ﺮﺩﺳ ﺭﺪﺩ ﻨﻴﭗﺑ ﻳﺩﻫﻩﺎ ﺮﺩﺳ ﺭﻼﻪﺩ
ﻪﺩﻣ ﻟ ﺒﻩﺗ ﺭﺍ
ﺪﻣ ﺍ
ﻭ:ﺩ ﺝ
ﻮﺗﻭﻋﻀﻼ ﻴﺖﺍ ﻠﮑﻩﺩﺍﺳ ﺭﻮﺭﻏېﺭ
ﺩېﻭﻱچ ډ ﻮ ﻮﺟ ﻮکېﻣ ﻧ
ﺎﻭﻏ ﺭﺎﻭﻧﺮﺗﺎ
ﻳېﻪﺯﻭﭘ ﺎﻴﺗﺪﻧﺭګ ﻌﻲڅ ﻮﺿ ﻣ
ﺩ.
ﺩﻯ ﺭﺩ
ﻪﻮﭘ ﺗﺍ
ﺮﻘﺭﻱﻓ ﺪﻨﻲ ﺻ ﺗﺭﻮﻭﭘﺒﻲﺍ ﻗ،ﺭﺍﺕﺮﻘﺭﻱﻓ ﺪﻨﻰ ﺻ ﺘﮐﻭ ښ ﻨﻲﺍ ﻩﻗﻄ ﺮ
ﺗﺎﻳﺘﺲﺯ ﻳﻳﻼ ﺎﻮﻣ ﻴﺘ
ﻭﺳ ﺍ
.ﻮﻱ ﻪﮐ ﺘﺍﺧ ﺎﺕﻳﻪﺯ ﻠﺗ
ﺮﭘ
Sterﻭﺩ no ږېﺍ ﻭ
،ﺩﺍ Sacr oili
ac، Hip، ګﻥﺘﺲﺯﻥ ﻭ ﻳﺍﺮﺗﺭ
ﻴﮏﺍ ﺘﭙ
ﻴګﻱډﻝ ﺳ
ځﻥ ړ ﻭ ﻪﺍ ﭘ
ﺘﺲ ﻳﺍﺮﺗ
ﺭﻟﻲﺍ ﻮ
ﺎﭘﻭﻳ ﺘﺲﺍ ﻳﺍﺮ
ﺗﺭﺮﺍ ﻟ
ﻮ ﻠﮑ
ﻴﺗﺭ
ﻮﺍ ﻧ
ﻮﻣ ﺍﻯﺷﻲﺩ ﺩﺩﻮﻱچېک ﻪﮐ ﺘClﺍﺧ av icularJoi nt
ﺷ.
ﻪ ﻲ ﺗﻣﻦځ ﺍ
ﻴﺐﺭ ﻘﻌﻪﺗﺘﺲﭘ ﻳﺍﺮﺗ
ﺭﺍ ﻴﮏ ﺘﭙﻴ
ﺍﻯﺷﻲﺩﺳ ﺩﺩﻴﺲﻫﻢک ﺗﻳﻼ ﺎ
ﻮﻣ ﻴﺘﻭﺳ ﺍﻭﻱ
ﻭﺩ ﺘﻲﺍ ﭘ
ﻮﻨﻳﺭﻱﺩﺪ ﺍﺧﻞ ﺻ،ﺩﺎﻤ
ﻳ ﺎ
ﭙ ﻣ،ﺍﺘﺲﻳﺎﮑﻧ
ﺍﺮ،ﺑﻐﻞ ﻪﺑﻨﻴ
ﻪﺳ ﻠﻪﮐ ﻠﻭﮐﻭﺧﻲﺍ ﺍﻯﻭچ ټ ﺩﺩﺎﻥک ﻭﻏ ﺭﺎ
ﻧ
.ﺮﻱﻟﺑﺴﻲﻭ ﺍ ﻭ
ږ ﺱ
ﻩﺩﻮﻮﺟ ﺘﻲﻣ ﭘﻮﻨ
ﻳﺩﻤﻒﺍ ﻮکېﻟ ﻧﺎﻭﻏﺭﺎ%٢ﻧ٠-١
٠. ﻟﻰﺍﻭﺭﻱﻍټ ﻮ ېﻭﺗﻳﻦ ﺍ ﻮکېﺩ ﻧﺎ
ﻭﻏ ﺭﺎ
%٣ﻧ ﻟﻰ٠ ٢ﺍ٠
ﻪﻓﺮﻮﻃ ډﻝﻳﺰﻭ ﻳ
ﺩﻭېﻪﺩﺭځﻱچ ﭘ ﻪﺍ ﺗ
Epiﻣﻦځ didy moOr chi ti
ﺑړﻰs
ﻮکې ﻲﻧ ﻧ
ﺎﻭﻏ ﺭﺎ
%١ﻧ ﻭ٠.
ﻱ
ﻭ.
ﻱ
101
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
،ګﺘﺲ ﻳﺍ
ﺮﻔﻼﻲﻧ ﻟﺨﻟ ﻴﻦﺍ،ﺑﺘﺲ ﻳﺍﺮﻧﻮﻟ
ﺎﻴﻭﭘﺘﺲﺍ ﻳ ﺎ
ﻧﺠﺎﻔ
ﻠ،ﺳ ﺎﺏﻬﺘﻟﮑﻞﺍ ﻳﺯﻨﻞﻭ ﻴﻤﻴﻭﺳ ﺘﺲﺍ ﻳﺎ
ﺘﻭﺳﺮﭘ
ﺷ.
ﻪ ﻲ ﺗ
ﻣﻦځ ﺍ
ﺍﻯﺷﻲﺭ ﺩﺩ
ﺘﻲک ﭘﻭ ﺮﻔﻴ1gA،ﻧ ﺘﺲ ﻳﺍﺮﻔﻧ
ﻮﻟﻭﺮﻴ
ﻣﻮﻟ
ﺩ.
ﺎﺕ ﻯ ﻳﻮکېﺯ ﻧﺎﻭﻏ ﺭﺎ
ﭘېﻧﺍﺕګﺪ ﻪﺭ ﺗ
(ﻣﻦځ Abor ti
ﻘﻂ)on ﻭکېﺩﺳ ﻩ ښځ ﺭﺍ
ﻭﺪﻴﻣﺍﻪﭘ
ﻪﻟﺖﭘ ﺎﻳﺠﻦﺣ ﻮﻭﺧ ﻳﺸﻦﺍ ﺮﭙ ﻳﻪډ ﮑﺰېﻭﻱﻟ ﻳﺩﻭﻮ کېﺩ ﻧ
ﺎﻭﻏ ﺭ
ﺎﻪﺩېﻧ ﻭېﭘ ﺎ
ﻴﺗ
ﺪﻧﺭګ Neurڅ ologic
ﻪﻭﺗﺭ ﻩﻭﺮﺮﻱﺭﻥځﺳ ﺒﻲﻧﺘﺲچېﻋﺼ ﻳﻓﻼﻮﻧﺴ ﻭﺍﻨﻦګ ﻴﮏﻣ ﺘﻳﺎﻮﺳﻔﻤ ﻮکېﻟ ﻧ
ﺎﻭﻏ ﺭﺎﻮﻧ ﻤﺭﮐﺷﺭ
ﻮ ﻢ ﻳ
ﺷ.
ﺍﻯ ﻲ ﺩﺩﻪک ﺗﻣﻦځ ﺍﺮﻱﺭ ﻟ
ﻟﻰﺍ
ﻻﻞﺷﻲ ﻮﻣ ﺗ
ﺎﻮﺷ Clﺗﺸ ottiﻭng ﺎﺍﻴﻨ
ﻴﭘﻮﺘﻳﺎ
ﻮﺳ ﺒﻣ ﺮ
،ﺗﺎﻴﻨ
ﻴﭘﻮﮐﻮ،ﻟAnemi ﺍﻯﺷﻲﺩa ﺩ ﺩ
ﻴﻼک ﻭﺳﺮﺑ
ﺷ.
ﺍ ﻲ ﺪﻴﺰکېﭘ ﻐﻪﻣ ﻮﭘ ﮐﻭﺩډ
ﺎﻩ ﻣﻮﻟﻮﻧ
ﺍﺭﺍﻯﺷﻲګ ﺩﺩﻭکېک %٧ﭘﻲښ ﭘ٥
ﻪ
ﺎﻏﻲﻣ ﻭﺩﺩﻝﺍﻳېکﺩ ﻡڅﺮ ﺰﻳﺭﻮﻴﻧﻴﮏﺍ ﺗﻮﮑﻳﺎ
ﻣېﻭﺩﻭﺍ ﺎﻴﺗ
ړﻴﻢګ ﻮﻧ ﺍﺟﻭﺯﻔﻲﺍ ﻮﻗﺤ ﻠﻴﺑﺑﻼ
ﻩﺩﻴ ﺭﻥګﺍﺪﻤﻫ
ﻭ.
ﺩﻱ ﻮ ﻮﺟ ﺮﻣﺎﺧﻄ ﻣ ﻮﻟ
ﻮﻧﺍﺭEﻭګ piﺍ dural abscess، ﻮﺑﺴﺍ
ﻮﻱﻪﮐ ﺘ
(ﺍﺧ ﻴﮏ ﺗﺎﺘﻭﺳ ﺮﺎﭘﻌﻲﻳ ﺒﻡ)ﻃ ﺎﺮﺩﺳ ﻬﺑﻩﺩﺍ ﺮﺗﺎ
ﻳﺘﺲچېﺯ ﻳﺍ
ﺩ ﺭﺎﮐﻭﺪﻧ
ﻭکېﺍ %٢ﭘﻲښ -ﻪ١ﭘ
ﺩ.
ﺎﺕ ﻱ ﺘﻼﻃ ﺍﺧﺭﺩﺎ(ﻧD. V.ﺯﺱ)T ﻮﺒﻣﺮﺪﻱﺗ ﻳﺭژﺭﻭ
ﻭﻭ ﺍ ﻡﺰ
ﻳﺭ ﻮﻴﻧﺍﻴﮏﺗﻮﮑﻳﺎ،ﻣ ﺘﺲ ﻳﺍ
ﺩﺭﺎﮑﻳ
ﺮﭘ
ﻪډﺎﺏﭘ ﻬ
ﺘﻟ(ﺎﺍ
Miﻳ gratorﻮ)yAbscess ﺑﺴﻮﺍ ﮑﻧﻭﺩ
ﺩﺩﻟږ
ﻪﺩ ﻲ ﺮﺧ ﻩﺑﺮ ﺪﻥﻫﻩﺩﺑ ﺮډﻝﺳ ﻟډ ﻭﻪﻦ ﭘ
ﺮﻴ
.ﻏ ږﻱ
ﻪ کږ ﺘﻮﻻًﺍﺧ ﻤﻌﻩﻣ ﺪﺪﻏ ﻳ
ﻭ ﺮﻳﺎ
ﻭﺗ (ﺍ Breastﻪ) ﻧﻮﻴﻭﺗ ﺍﻯ ﺷﻲﺩ ښځ ﺩﺩﻪک ﺘﻭﻝﺍﺧ
.ږﻱ
ﻪکږ ﺗ
ﻣﻦځ ﺍډﻝﺭﺰﻭ ﻳﺩ
ﻭ ﺩﺎ
ېﻪﻧﺪﭘ ﻧ
ﺎﺘﮏېﺑ ﻮﺳ ﻪﭘ ﻪﭘ ﻧﻮﭘ
ﺎﺮﺧ ﻟﻮﭘﺎﻮﭘ ﻟ
ﻮﮑﻔﻲﻣ ﻭﺻ
:
ﻴﺺ ﺗﺸﺨ
.ﻮ
ږﻱﻧ ﺮکږ ﻴﭘﻮﻪﺗ ﻧ
ﺍﺭﻪګ څﻪﭘ ﻮ ﺧ ﻴﻭﻏﺭﺎﻮﻧﮑﻧﻭﺮﻪﻟ ﺒ
ﻭﺗ ﺭ
ﻮ ېﻪﻧ
ﻭﻟ ﺎﻴ
ﺗﺪ ﻧﺭګﻴﮏېڅ ﻨﻴﻠ
ﻩچېﮐ څﻥګﺭ
.ﺮﻱﻟ ﺯښﺕ ﺭﺍﺍﺭﻮ ﻴ ﺺکېﺧ ﺘﻦېﺗﺸﺨ ﺭﻱﮐﺍﻮﺗﺍﺮ
ﺑېﻭﻻﻳﮏ ﺍ ړﺍﻩﺮﻮﺳ ﺗﺎﻧﺍ
ﻮ ﻴ،ﺣﻪﻳﺨﭽ ﺭﺎ
ﺗ
ﻩﺭﻮﻩکېﭘ ﺭﺎﻪﺑ ﻮﭘ ﻟﺧړ
ﻭ ﻮ ﺪ ﻴ،ﺷ ﺮﻴﻨ
ﻡﭘ ﺎﻪﺩﺧ ﮑﺍکﻟ ﺭ
ﻮېﻭﺧ ﺪﺍ ﻧﺳ،ﺩﺩﺮﺪﺩ ﻔ ﻳﺎ
ﻪکېﺑ ﻳﺨﭽ ﺭ
ﺎﻪﺗﭘ
ﺷ.
ﻪ ﻲ ﺮﻻﺳ ﺎﺕﺗ ﻣﻮﻠ
ﻌﻣ
ﻭ.
ﻟړﻱ ﻴﻦﻮ ﺑ
ﻭ ﺮ
ﻠﻴﻭﺑ ﺍﻪ ﻧ
ﻮﻤﻳﺍﺰﻧﺍﻨﻲﻳﺍﻯﺷﻲﺩ ﺩﺩﺎک ﻣﺍﺪکېﻭﻱ ﻣﻞﺣ ﺭﺎېﻪﻧﺘﻦ ﭘ ﻴﮏﮐ ﻤﻮﺷﻴﻴﻦﺑ ﺗ
ﻭﺭ
ﻭ.
ﺩ ﻱ ﻮﻮﺟ Relﻣ ativeLy mphocy tosiﻭs ﻪﻭﻱﺍ ﺘ
ﮐﻩ ښ ږڅ ﺎﻝ ﻣﻞﻳ ﺭﺎ
ﻩﻧ ﺯﺍﺪ ﻧ
ﻳﺖﺍ ﺎ
ﻮﺳ ﮐﻮﻟ
ﺩ
ﺷ.
ﻪ ﻲ ﺗﻣﻦځ ﺍﺍﻯﺷﻲﺭ ﺩﺩDIک ﻭC ﺍﻮﺳﺲ ﺘﻳﺎﻮﺳﺒﻣﺮ،ﺗAnemi ﻪa ﻔﻴﻔ
ﺧ
ﻭ.
ﺩﻱ ﻮﻮﺟ ﺯﺱﻣ ﻮﺘﻳﺎ
ﺎﺳ ﻔﻤ
ﻟ ﻮکې ﺑﻭﺍﻪﻮﭘ ﻧﻭﺪ ﻨ
Cﻭﺑ
ﺩ SFﺍ
ﺎ
ﻣﻮﻟﻮ ﻧ
ﺍﺭ
Noncaseatګ i
ﺘﻞﺷﻲﻥng ﻴﺴﺍﺧ ﭘﺴﻲﻭ ﻮﻴ
ﻭڅﻪﺑ
ﻮټ ﺧ ﻭﻱﻏ ﺎ
ﻔﻤﻟېﻭ
ېﻪﻳﻦ ﺍ ﺭﻟ ﺭﻪچ ﮐ
ﻭ.
ﻔﻲ ﻱ ﻨAﻪکېﻣ ciﭘ dFastBaci lښﻲچې ﻳ
ډﻱﺎﺘﻲﺑ ﻧ
ﺍﺎﻥکې 1gM ﺘﻧ
ﺍ ﺑړﻲ
.ﻪ ﻲﻧ ﺮﻱﭘ ﻟﺯښﺕ ﺭﺍﺘﻦېﻴﮏﮐ ﻮﺟ ﻟ
ﺍ
ﺮ ﻴﻪکېﺳ ﻧ
ﺪ ﻧ
ژ ژۍﻪﭖ ﻭﻍ ﭘ ﺭﺎ
ﻧﺩ
ﻱګﻥېﺩﺍډ ﺍ ﺎﺘﻲﺑ ﻧ.ټﻝېﺍ
ږﻱ ﻭ ﺪږ ﻧﺭګlڅ lﻭgA ﻪgGﺍ ﺘﻭﺳﺭﺩېڅﻪﻭ
ږﻱچې ﺩ ﺧ ﺪږ ﻧ
ﺭګ ﻧﻲڅ ﺍ
ګ
.
ږﻱﻪ کږ ﺘﮐﻪښ lﮐﭽ ﻩﺷﻲ gM ړړﺪېﻻ ﻧﻪﻭﺍ ﻭﻏﻲﻣﺦﭘ ﺭﺎﻪچېﻧ ﻠﺎﻝېﻭﻱﮐ ﻌﻩﻓ ﺭﺎﭙﻴﺸﻦﻟ ﻨﻴ
ﺗﻮﻟ
ګ
ﻮک ﻤ ﻴ
ﻮﺳ ﮑﻤﻳﺪﻧﺷ.ﻪﺍ
ﻪ ﻲﭘ ﻠﺗﺮﻩﭘﺮﻭﺳ ﺎ
ﻴﺗﺪﻧﺭګﻴﮏېڅ ﻨ
ﻴﻠېﻭﮐﻳﺨﭻ ﺍ ﺭﺎﺪﺩﺗ ﻳ
ﺎﺘﻦېﺑ ﻴﮏﮐ ﻮﺟ ﻟ
ﺍﺮﻴ
ﺳ
ﻪﻭﭘ ﻪﺩﻯﺍ ﻴﻴﺼ ﺭېﺗﺸﺨ ﻮ١ﭘ :٦٤ﺗ٠
١ﺮ :٣٢ﺮ٠ ﺘﻳﺎ
ﻴﻦﺗ ﻨﺗ
ﻮﻟﺮﻱﺍګ ﺎﺱﻟ ﻤﺪېﺗ ﻧ
ﻠﮏچېﺩﺩ ﻪﺧ ﻐېﺎﻫ
ﻳ
.١:
١٦ﻮکې٠ ﺮﺧ ﻤﮏﺑ ﻳﺪﻧ
ﺍﺮﻴﻏ
.ځﺮﻱ ﺯښﺕﻟ ﺭﻪﺍ ﻴﺼ (ﺗﺸﺨ ﻴﺸﻦ ټﺱټ)SAT ﻨﻴﺗ
ﻮﻟﺩﺍګ ﺭﺪﻨ
ﺘﻭﺱﻫﻢﺳ ﻮ کېﺍ ﻧﻭﺰﮐﺮﻮﻣ ﺗ
ﺎﻳﻪﺯﭘ
ﺯﺱﺩ ﻮ
ﻠﻴﻭﺳ ﺮﻧﻲﺑ ﺎﻧﺴ ﺍﻫﻢﺩﺍ ﻮﻱ چېﺩ ﺰﮐ ﻳﺪ ﻧ
ﺍړRoseBengaltﻭ ﻧﮏېﺩest ﻭړړﻳﻦې څ
.
ﺮﻱ ﻟﺯښﺕ ﺭﺍ ﻩﺭﺎ
ﭙﻟﻴﺺ ﺗﺸﺨ
:ﻴﺺ ﺮﻱﺗﺸﺨ ﻴﭘ
ﻮﺗ
،
Q.Fev er، ﺎﻴﻤﻳﺮﻟ
ﻮ ،ﺗﺍﺰﻨ
ﻳﺍ
ﻮ ﻠﻔﻧ
ﻪﺍ ﮑ ﻮﻟﻴﻭﻏﺭﺎﻭﻧ ﻭﻧﮏ ﻭﺮ
ﻪﻟ ﺒﻮﺗﻴﻧﺑړ
ﺭﻲ ﺷﺭ
ﻮ ﻢ ﻳﺪﺩ ﻳﺎﺯﺱﺑ ﻮﻠ
ﻴﻭﺳﺮﺑ
ﺮﻯ،ﻧﻭﻏﻲ ﺭﺎﮑﻦﻧ ﻮﺟ ﺪﻫ ﻳ
ﺎﮑﻞﻱېﺑ ډﻰﺷ ﺷ.ځﻥﻧ ﺮ ﻲ ﻴﭘ
ﻮﻩﺗ ﺮﻭﻭﭼﮏۍﺳ ﺯﺱﺍ ﻮﻠﮑﻴﻮﻧ ﻧﻮﻧﻲﻣ ﺎ
ﺘﻧ
ﺍ
ﺷ.
ﺮ ﻲ ﻴﭘﻮﻩﺗ ﺮCocciﺳ domy cosiﻭs ﺍ ﺯﺱ ﻮﻣ ﺯﭘﻼﻮﺘ،ﻫﺴ ﻼﺎ
ﻳ،ﻣﺭ HIځVﺭﻥ،
102
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
:
ﻪﻨ
ﻠﻣ
ﺭﺩ
ړ
ﻩﻭ ﻪﻣﻦځﻭﺏﻟﺮﮑ
ﻳﺎﻨﻲﻣﻭﺳ
ﻭﺩﺍ ﻮﻱﺍﻴ
ﻨRelﺩﻣﺨapse،
ﻟﻲﺍ
ﻮﻤﮐ
ﺩګﻮﺩ
ﻠ
ﻪ ﻳ ﻨ
ﻠﻣﺭ
ﺪﺩﻭﺏ ﺿﺮﮑﻴﻣﺩ
،
ﻩړﺎﺩ
ﻴﺗﺍﺗ
ﺍﺣﻲﻪﺮ
ﻮﺟ ﺩﻭﻱﻧﻮﻮﺟ
ﻭﻥېﻣ ﺪﻧﺭګ
ﻌﻲڅ ﻮﺿﻭﻍۍﻣﺭ
ﺎﺭېﺩﻧﺭﻪچږﻱﮐﺎﻝږﻤ
ﻌﺘﺍﺳﻩ
ﺭﺎﭙ
ﻟﻮﻟ
ﻩ
ﺭﺍﺪ
ﻣ ﺍ
ﻭﺪﺩﻳﺎ
ﺩېﺑﺮﻩﭘﺭﺭ
ﺮﺏ(ﺳ ﻮﻝﻟ
ﺪﻮﺑﻧﻭﺪ
ﻨﺑ،ﺩ
ﻮﻝﻟﻲﮐﺎ
،ﺩﺧﻦځﻯﺧ ﻮﻝ
ﻟﺪﻡﺑﺎﻩﺩ ﺳړ
ﺯﺩﻪ)ﮑﻟ
.
ﻠﻲﺍﺧﻣﻞﻫﻢﻭﺭﺪﺩﻭﺏ ﺿﺮﮑﻳ
ﺎﻣﺩ
ﺎﻝ
ﻤﻌﺘ
ﻣﻞﺍﺳ
ﺭﻮﺩ
ډﻝﻳ
ګﻱ ﻭ
ځﻥ ړ
ﻪﺍﻪﭘ
ﺎﻝﺷﻲﮐ
ﻤﻌﺘ
ﻩﺍﺳ
ﺮګﻩﺳ
ﻪ ډﻣﻞﭘ
ﺭﺪﺩﻭﺏ ﺿﺮﮑ
ﻳﺎﺪﺩﻣﻳ
ﺎﺑ
ﺩ.
%٥ﻱ
ﻪﻱې٠Relﮐﭽ
ﻮﺩapseﺷﻲﻧ
ﻮګﺮﻳڅﻪﺗ
ﻮ ﺧﻣﺍ
ﺭﻠﻲګ ٧ﻣ٥
٠Steptomyci
ﺭېne ﻪﻻﻟ
ﻮښې ﻩﺩﻏﺭ
ﺎﭙ
ﻟ ﻠﻦې
ﻣﺭټﻮکېﺩﺩ ﻧ
ﻪﻍﺍ ﭘ
ﮐﺴﻲﻭ
ځﻯﺩﻮﺍ ﻩﻳﺮﺩ.ﺩﺩې ﺳ
ﻣﻞ ﻱ ﺭﺑﻲﺩﺎ
ﺘﺨﻧﻩﺍﻩ ښ
ﺭﺎﭙ
ﻭﻟﻭځ
٢ﺭ ١
-١ﺭځېﺩ٤ ﺭېﺩﻭ ﻮﻪﭘﻣﺍ
ﺭ
ﺭﺭګ
ﻩﺍﺭﺎ
ﺑﻭﻭﻍۍﺩ
ﺭﺎږﻱﺩﻧﻮﻝکږﮐﺭﻩﻭﺭﺎ
ﭙﻮﻟﻴ
ﻧﻭﺭځېﺩ٦ﺍﻪﺩﻭﻟﻩځﻭﻪﺩﻣﺍ
ﺭﻠﻲګ ١ﻣ٠ﻴﻦ٠
ﻠﮑﻳ
ﺎﺳ
ﺩ.
%١ﻯ ٠-
ﻪ٥ﺘ
ﻭﺳ ﺭڅﻪﻭ
ړې ﺧ ﺭک
ﻭژﻢﺩ
(ﺩﺩېﺭﻳ Relﻪ)apseﻧ
ﺩﺩځ
ﺩﺭځې
ﺭې ﻭ
ﻮﻮﭘ
ﻣﺍﺭ
ﻠﻲګ ٩ﻣ٠٠
-٦٠
ﻴﻦﺩ٠
ﭙﻣﺎ
ﻔﻳ
ﻮﻯﺭړﺪېﺷ
ﻧﺍﻭﺍ
ﻮﻟﺨ
ژﻢچېﺩWHO ﻮﺿﻲﺭﻳ ﺩﺩېﻋ
ﺭﺭګ
ﺎﺍﻴ
ﻩﺩﻯچېﺑﺭ
ﺎﭙﻟ
ﻮﻴﻧﻭ
ﺍځﻯﺩ٦ﻮﺍﻩﻳﺮﻪﺳﻟ
ﻩځﻭﺭځېﺩﻭ
ﻴﻦﺩﻠ
ﮑﻳﺎ
ﮐﺴﻲﺳﻭﻮﺩﻣ
ﺍﺭﻠﻲګ١ﻣ٠
ﺩ٠
.
ږﻱ
%ﻪﺭﺱږ
٢ﺗ ﻪ٠ﻠ
ﻪﮐﻠ
ﻭﮐﺍ
%١ﺩﻯ ﻪﻱې٠ﻧ
ﺩﺩځ
ﻪ
ﺩېﭘ
ﺎﺩ
ﻴﻮﺑ
ﺘﻰﻧﻴﺴ
ﻪﺷﻲﺍﺧﻴﻦﻧﻠ
ﮑﻳﺎ
ﺍﺳﺮﺘ
ﺎﻥچېﺗ
ﻣﻮﺎﺷ
ﺎﻣﻩ ښځېﻳﺭ
ﺍﻭﺪ
ﻴﻣﻪﺍﮑ
ﺎﻥﻟ
ﻭﻏﺭﺎ
ﻪﻧﻐ
ﻫ
.
ږﻱ
ﻮﻝکږﮐ
ﺭﻪﻭﻧ
ﻮﺘﻴ
ﻠﺑ
ﺎﺩﺗﺭ
ﺪﻨﺘ
ﻳ٣ﺳ
ﻭﻝﺷﻲچې٢ﺎ ﺭ
ﺎﮐﻭﻝﻭﺯ
ﺎﮐﺴﻮ
ﺍﻯﻣﺮ
ﺗﻮﻮ ﺽﮐ
ﻋ
ﺮکﻝ
ﻪﭘﻣ
ﺍﺭﻠﻲګ
٦ﻣ-
٥Net
imy
ciﻳn
Gentﺎ
amy ci
ﻮ ﺽﺩn ﻪﻋﻴﻦﭘ
ﻳﺴﺎ
ﻣﻮﺘ
ﭘﺮﺘ
ﻩﺩﺳ ﺭﻥګﺍ
ﺪﻤﻫ
ﺷ.
ﺍﻯ ﻲ
ﺩﺩﻩکﺩﺎ
ﻔﺘﺍﺳ
ﻩﺭﺎ
ﭙﻟﻮ
ﻴﻧﻭﺍ
ﺩﺭځېﺩ٢
ﺪﻥ ﻭﺑﺯﻥﺩ
ګﻡﻭﺍ
ﻮﺭ ﻟ
ﻴﻦ
ﺍﺳﺰ
ﮐﻮﻠ
ﻓﻭﺮ
ﭙﻴﺎﺳﺭځېﻳ
ﻪﺩﻭ ﻟ
ﻩځﻭګﻡﺩ
ﺍﻠﻲ ﺭ٤ﻣ٠ﻴﻦ٠ﺍﺳ
ﺰﮐﻮ
ﻠﻓﻭ
ﻪﺍﮑ
ﻮﻥﻟ
ﻟﻮﻧ
ﺯکﻥ ﻭ
ﻟړﺩﻭﻫﻢﻮﺍ
.
ﻮﮐﻻﻯﺷ
ﻪﻮ ﻴ
ﻮﺻ ځﻯﺗ
ﻮﺍﻩﻳﺮ
ﻴﻦﺳ ﭙ
ﻣﺎﻔ
ﻳﻩﺩﺭﺭ
ﺎﭙ
ﻟ ﻮ
ﻴﻧﻭﺍﻭ
ږﺩﺭځېﺩﺷﭗﻪﻭﻟ
ﻩځ ﻭﻪﺩ
ﻣﺍﺭﻠﻲګ٥ﻣ
٠٠
Cef
tri
ﺎﺷﺖېچېxone
ﻴ١ﻣ
ﻟﻰ٢
ﻌﻦې٦ﺍ
ﺩ،ﻳ
ﺩﻯﺍږ
ﻡﻭﺍﻭ
ﻠﻦېﺩ
ﻣﺭﻭﻍۍﺩ
ﺭﺎﺎﻏﻲﻧ
ﻣﺯﺱﺩﻮﻠ
ﻴﻭﺳ
ﺮﺑﺩ
ﺩ.
ﺩﻯ ﺭ
ﺪﻨﺘ
ژﻢﺳ
ﺭﻳ
ﻩ
ﺮﺪﺳ
ﻳﺯﻮ
ﮑﻳﻮګﻻ
ﻨﻴﻣ
ﻭﺍﻴﻦﺍ
ﭙﻣﺎ
ﻔﻳ
،ﺭﻴﻦ
ﻠﮑﻳ
ﺎﺍﺳ
ﺮﺘ
ﻩﺗﺮﻮﺳﻠ
ﻣﺭﻪﺩﻟ
ﻭﺩېډ
ﺘﺲﺩ ﺭﻳ
ﺍﺩ
ﺭﺎﮐ
ﻭﺪﻧ
ﻴﻼﺍ
ﻭﺳﺮﺑ
.ږﻱ
ﻮﻝکږﮐﺭ
ﻪﻭﻣﺍ
ﺩﺍﻮ
ﺘﺎﺷﻴ
ﺗ٦ﻣ
ږﻱﻭﺮ
ﻪکږ ﺍﻨﻠ
ﻣﺭﺩ
103
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﮐﺲ
ﺍﺮﺘ
ﻧﺍ
(
Ant
hr)ax
:
ﻳﻒﺮ
ﻌﺗ
ړ
ﻪﮐﮏ ﺎﻥﻟ
ﻧﺴږﻱﺍ
ﻪ کږﺗ
ﻣﻦځﺍﻪﺭﻠ
ﺒBﻪﮐ
aciﻟ
l
lusAnthr
aci
،چېﺩsﻩﻭﻏﻲﺩ
ﺭﺎﻪﻧ
ﮑﻴﺗ
ﻮﻧﻭ
ﻩﺯﻮ
ﻳ
.ږﻱ
ﻣﻦکږﺰﻴﺍﻏ
ﻪﻠﻣ
ﺍﻪﻟﻮﮑ
ﻳړﺍﻩﺩ
ﺮﻮﺳﺗ
ﻮﻻﻭﻱﻣﺤﺼﺭﺍ
ﻳﺩڅ
ﻭﺎﺍﻍﻪ
ﻍﻪﻥ ﻏ
ﻩﻥﻍ ﭘﺮﻭﻱﺳﺭﺍ
ﻮﻱڅﺷ
ﻴﺚ
ﺒ،ﺧ
ﻮﺏړﺳ
ﻴﺚ ﭖ
ﺒ،ﺧ
ﺭ ټﭖ
ﻮ،ﺗ
Char
bon،
S.Ber
ianUl
cer،Woolsort
er'
sdisease
ﺩ.
ﻪﻱﻧ
ﻮﻣﻮﺭﻧ
ﻮ ﮐﺲﻧ
ﺮﺘﻧ
ﺍRagsorﺩ
ter
'Pﻭs
ustﺍ
ule
ﻭﻡﺍ
ﺍﺭﻭګ
ﺮﻩﭘﺮﻱ ښﻧ
ﺮﺗ
ﺎکېﺩﻭﮑﻳﺮ
ﻣﻟﻲﺍ
ﺎ
ﻤﻭﺷﺎﺍ
ﭘﻭﺭ
ﻩﺍﺘﻲځېﻪﺧ
ﺩﭘږﮐﺲﻥ ﺮ
ﺘﻧﻭﺱﺍ ﻩﻫﻢﺍﻪڅ ﮐ
ﺰﻱﮐ
ﺮ،ﻣﺎ
ﻘﻳ
ﺮﻓ،ﺍ
ﺎ
ﻴﻪﺍﺳﮑﻮکېﻟ
ﻧﻭﺩ
ﺍﻮﻴ
ﺣﻝﻫ
ﻭېﻪ ﺎ
ﺎﺩ ﺩ ﭘﻣﻠﻲﺩﻱﺍ
ﻠﻩﺗ
ﻪﻣﻦځﻪﻟﻠﻣﻪﺍ
ﻴﺸﻦﻟ ﻨ
ﻴﮐﺴﺍ
ﻭ
.
ږﻱ
ﺪﻝکږ ﻴ
ﻟﺎکېﻱېﭘﻲښې ﮑﻳ
ﺮﻣﺍ
ﻮ
ﺍﻯﺷﻲﻧ
ﺩﺩﻮک
ﻮﻱﺧ
ﻪﮐﺘ
ﺍﺧګﻥې
ﺍﺍ
ﻮېﻭﻏ
ﺯﺍﻭﺍ،
ﻪﻧ
ﻮﻪﭘﺴﮑ
ﻟﻭﻱ
ﺭﺍﺭڅ
ﺷﺭ
ﻝﻮ ﻢ
ړﻯځ ﻳﻡ
ﻮﻟﮐﺲﺮ
ﺘﻧﺍ
.
ړﻱړکﻩﻫﻢﮐﮏﻭﻣﻲښﺍﺯﻯ
ﻮﮐﺮ
،ﺳﻓﻼﻥ
ﻪﻴﮑﻟ
ﻭﻱﺭ
ﺍڅ
ړ
ﻮکېﺩﻡ
ﻧﻮﺘ
ﺎﻋ٢ﺳ
ېﻪ٤
ﺩ،چ ﭘ
ﺪې ﻱ
ﺎﻋﻩﻣﺴ
ﺭﺎﭙ
ﺎﻥﻟ
ﺘﻧ
ﻴﮏﺍ
ﻤﺘﻴﺴ
ډﻝﺩﺳ
ګﻱ ﻭ
ځﻥ ړ
ېﻪ ﺍ
ګﻥ ﭘ
ﺍﺍﻮﻏ
.ږﻱ
ﻻﻞکږ
ﻳﻦې ﻣ
ړﻲ
ﻡﻧ
ﻮﮐﺲﻟ
ﺮﺘﻧ
ﮐﺲﺩﺍ
ﺮﺘﻧ
ﻴﻞﺍ
ﻧﺠﺮ
ﻓﻭﺭ
ﻭﻭﺍ
ﻗﻲﺍ
ﺎﻧﺸ
،ﺍﻳﻲ
ﺎﻌﺪېﻣ
ﻌ،ﻣ
،
ﺘﮏﻮﺳ
ﭘﻮ کېﺩ
ﻧﺎﻧ
ﺎﻧﺴ
ﻪﺍﭘ
ﺩ.
ﻪﻱ ﻧﻮ
ﻠﮑﺷ
ﻭ
ﺮﻟﺩﻭ
ﺎﻪﻳ
ﺪﭘ ﻳ
ﺎﻮﻯﺩﻯﺑﺪﺷﻴ
ﻟﮐﺲ ﺮﺘ
ﻧﺘﮏېﺍ
ﻮﺳ%٩ﭘﻲښېﺩﭘﺎکې٥ﮑﻳ
ﺮﻣېﻪﺍ
ﺭﭘﻮ
٢ﭘ٠٠٢
-٢٠
٠ﺗ١
ﺮ
ګﻱډﻝ
ځﻥ ړ ﻭﻪ ﺍ ږﻱﭘ
ﺘﻞ کږﻴﺴ
ﻩﺍﺧ ډﻝ ګټ
ﻪ ﻭڅﻪﺩﻭﺳﻞېﭘ
ﻴﻞ ﺧ ﻪﺑﺴﮐﺲﻟ ﺮ
ﺘﻧﺍ
چېﺩ
.
ږﻱ
ﻻﻞکږډﻝ ﻣ
ﺎک ﻭﻧ
ﺮﻭﻍۍﺩﺧﻄﺭﺎ
څﻪچېﺩﻧ
ﮐﺲ ﺧﺮﺘ
ﻧﺍﻗﻲ
ﺎﻧﺸﺍ
ﻡکېﺩ ﺰ
ﻳﺭﻭﺭ
ﻮﺗﻮﻳ
ﺎﺑ
ﻣ:
ﻻﻞ
ﺭﻱېﻮ
ﭙﺩ،چېﺳ
ﻴﻞ ﻯ
ﮑﻰﺑﺴﻧ
ﻭړﻮ
ﺭﺟ ﻮ
ﭙ(ﺳ
ﻴﮏﺑ
ﻭﺮﻳ
ﺍﺯﻱ)ﺍ
ﻮ،ﻫ
ﻪﺘﮐ
ﺮ،ﺏېﺣ ﺒﺖﺜ،ګﻡﻣ
ﺍ
ﻮﻯ ﺭ ﻮﻟﺍﻳ
ﺩ
ﺭﻮ
ﭙﺷ.ﺳ
ﮐﻻﻯ ﻲ
ﺪﻮﻧﻭ
ﺭېژﻮ
ﻮﭘﻧﻮﻟ
ﺎﻭﮐېﺮڅ
ﻮک ﺗﺗﻮﻻﻧﻲﻣﺤﺼﺍ
ﻮﻴﻭﺣﻩﺍﺭﻭ
ﺎﻪﺧ ﮑ
ﺎﻝﻟﻳ
ﺮﻴﭘ
ﺎﻪﭼﭘ
.
ﺮﻱﻟ
ړښﺕ ﻮﺎﻥﺟﻪﺷﻩګۍﭘﺩ
:
ﻮﺟﻲ
ﻟﻮﻤ
ﻳﺪﻴ
ﭘﺍ
ﻭﺱ ﺎﺍ
ﻣﻮﻱﺍﻴﻞﺷ ﻳﺸﻮﻭﻧﻮﻟ
ﻭﺘﻲډﻌﻨ
ﻭﺻ ﺘﻲﺍﺍﻋ
ﺭﻪﺯﻩﭘﺮﻩﺳﻮګ ﻣﻲﺗﻮ ﻤ
ﻪﻋ ﮐﺲﭘﻲښېﭘ ﺮﺘ
ﻧﺩﺍ
ﻭﻱﺭﺍ
ﻮﻱڅ ړﺷﻪﺩﮐﮏ ﻮﺗﻧﺎ
ﻧﺎ
ﻧﺴﺘﻲﭘﻲښېﺍ ﺍﻋﺭ
ﺩ.ﺯ
ﻳﺶ ﻯ ﻮﻟ
ﻴﮏډ ﻮﺟﻟ
ﻮ ﻤ
ﻳﺪﻴ
ﭘﻡﻥﻭﻯﺍ ﺰﻳ
ﺭﻭﺮﺗ
ﻮﻳﺎ
ﺑ
ړﺍﻥﺩﻡﻮﻴ
ﻮﻱﺣ ړﺷﮐﮏ ﻪﻣﭻﻫﻢچېﺩ ﻠﻪﮐﻠ
.ﮐږﻱ
ﻩکږ ﻣﻦځﺍ
ﻪﺭﻠﻣﺍﻪﻟ
ﻮﮑ ﻳ
ړﻏﺍ
ﻍﻪﻥﻍﻪﻩﺩﻥﻍ ﭘ ﺮﺳ
ﻪﻮﭘﻟ
ﺧړ
ﻮښېﺩ ﻮ ﻡېﻏﻭﻩﺩﺍﺭﻥګﺍ
ﺪﻤﺷ.ﻫ
ﺩﻻﻯ ﻲﻟږﻭ
ﻪﻲ ﺎﻥﺗﻧﺴ
ﺎﻥﺍﺘﻧﻮﻱﻭﻱﺍ ﺘﻦﺷﻨ
ﻪﻣﻠﻣﻱﻪﺍ
ﻟ
ﻪ چېﺩﻠ،ﮐږﻱ
ﻪ کږﺗ
ﻣﻦځ ﺍ
ﻪﻭﺧﺖﺭ ﻐﺘﻲﭘﻲښېﻫ ﻌﻨﺷ .ﺻ
ﺍﻯ ﻲ ﺩﺩﺘﻦ کﻨﺎﻥﻣﻧﺴ
ﻪﻫﻢﺍ ﺍﺳﻄﻭ
ﻭکېﮐﮏ ډېﻭﻩ
ﺘﮏ ﺍﻮﺳ،ﭘړۍ،ﻭ
ﻮﺗﻭﻭﻱښ ﺯ
ﻭ،ﺍﻮﻧ
ﻮﻪﺩﭘﺴﮑﻟﻮﺗ
ﻮﻻﻮﻣﺤﺼ ﺗ
ﺎﻧ
ﺍﻮﻴ
ﺭﺩﺣﻮﭙﮐﺲﺳ ﺮﺘﻧ
ﺍ
104
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
.
ړﻱﺍک
ﺪﻴﺎﺱﭘ
ﻤﺎﻥﺗ
ﻧﺴﺍ
ﻩﺮﻭﻯﺳ
ﻱﻭﺩ
ړﺍ
ړک
(Ai
rbor
nPart
icl
ﺯې)esﻮﭼﻦۍﺭﻳﻲﮐﺍ
ﻮﻪﻭﺧﺖچېﻫ ﻐﻮﻻًﻫﻤﻌﻪﻣﻧﺩﺩ
ﺩږږډﻝﻝﻗﻲ ﻭﺎ
ﻧﺸﺩﺍ
ﺎﺕﻳ
ﺭﺩﺯﻮﭙﮐﺲﺳ ﺮ
ﺘﻧﻩچېﺩﺍ.څﻥګ
ږﻱ ﺭ
ﻩکږ ﺮ
ﺮﺳ ﻪﺷﻲﺗ ﺗ
ﻣﻦځﺍ
ﻪﺭﻠﻣ(ﻪﺍ
ﺩﻥېﻟﺩړﻮﻌﺖ)ﺟﻨﺩﺻ
ږﻱږ
ړﻮﺍﻥڅﻫﺦﺟﻮﻴﻮﻱﺣړﺷېﻪک
ﺎﻥچ ﻟﻴ
ﺘﻲﺷ ﻌﻨ
ﺭﺻ ﺷﺭ
ﻮ ﻢﺷ؛ﻮﻳ
ﮐﻻﻯ ﻲﻧ ﺪﻮ ﻧﻭﻩژﺭﺎ
ﭙﻟﺩې
ﻮېﻣ
ﺍﻯ ﺷﻲﺩﺩﺩ
ﺭکﻮﺍﺱېﻧ ﻭﺩﻪﺍﻧ
ﻮﻣﺮ
،ﭼﮑﻰﺘﻮﺳ
ﺯېﭘ ﻭ،ﺩﺮﺱﻮﺑﻠ
ﻳﺮ
ﻳېﺧ ږﺮ،ﺩړۍړﻦې ﺵﻪﻭﻳ ﮑ
ﻟ
.
ﺮﻱ ﻟ
ﺎﻥﻭﺘ
ﻧﺍﻩﺭﺎ
ﭙﻟﺎﺕﻭﺧﺖﻳﺯ
.
ږﻱ
ﺩږ
ږږﻪﻝ
ﻴﻞﻧ
ﮐﺲﺑﺴ
ﺮﺘﻧ
ﺍﻪﺩ
ﺎﻥﺗ
ﻧﺴﺍ
څﻪﺑﻞ
ﺎﻥ ﺧ
ﻧﺴﺍ
ﺩﻮ
ﻳ
:
ﺰﺱﻴ
ﻨﻮﺟ
ﺘﭘ
ﻪﺍﺳﻄﻪﻭﻮﭘﻠﺍﻥﺩچچﭼ ﻮﻴﺎﺣﭖﻭﻳ
ﻮﻱ ټ ﺍ ﻳېﺷﺍﺯﻡﺩڅﺮﺭګﻥﺯ ﻭﮐﺲ کېﺍ ﺮﺘﻧ
ﻪﺍﺘﮏېﭘ ﻮﺳﺩﭘ
ﻪچ ﻠ
ﺗﻰﻧﺸﻲﮐ ﻮﻨ
ېڅﻪﻧ
ﺘﮏ ﺧ ﻮﺳ ﻣﻞﭘ
ﺭﺎﻪﻧﻡﻟﺰﻴﻧ
ﺍﺭګﻭږﻱﺍ
ﺍﺧﻞږ ﺭېﺩېﻪﻻﺘﮏ ﻟ ﻮﺳﻮﻱﭘ ﺭﺏﺷ ﺎ
ﺩﺧ
.
ﻮﻱ (ﮐGerminati
ﻪ)onﻧﺩﺩ
ﻭک ﺭټﻮ ﭙ
ﮐﺲ ﺳ ﺮﺘﻧﺪﺩﺍ ﻴ
ﺭﺳﻪﻭ ﻮﺗ ﺎﺟﻧﺴﻧېﺍﺘﮏېﻻﺪ ﻮﺳېﺩﭘ
ﻭﺍﻮﺏړﺳ،چېﭖ ﺮﻱﻟﺍکﻭﺍځﻴﻦﺩﮐﺴﻮ
ﻭ.ﺗ
ﺟړﻱ ﺩﻮ ﺍﻮﻟﻲﻣﻮﭙﺴ
ﺪﮐ ﻳﺖ ﺿ ﺎ
ﻭﺳ ﻭﺩ ﻑګ ﺍﻴﻦﮐﺴﻮﺗﻭﺰﮐ
ﺍ
ﻮﺱ ﺘﻳ
ﺎﻭﺳﻡ ﻑګﺰﻴﻧ
ﺍﺭګﻭ
ﻪﺩﺍ ﺍﺳﻄﻪﻭژﭘ ﺎ
ﻓﻭﺮ
ﮑﻌﻲﻣ ﻮﺿ.ﺩﻣړﻱ ﻪک ﺗ
ﻣﻦځ ﺍﺯﺱﺭ ﻭﺮﮑﻮﻧﺎﺟﻧﺴﺩﺍ
ژﺍ
ﺭﻮﻤﻴ
ﻭﻫ ﺟړﻱﺍ
ﺮ ﻮﻭ ﺭﺯﻫﻮﻪﻧﺘ
ﻟ،چېﺩږﻱﺩږږږ
ﻭﻝ ﻮټﻭﻱﻏ ﺎ
ﻔﻤﺩېﻟږﻪﻥ ﻴﻞﺗﻭﺑﺴ ﻴﺴﻲﺍ ﺭﺕﻧﻮﺻ
ﺍﺧﻞﺷﻲ ﻪﺩﺍﻥﺗﺭ
ﻭﺍﻯﺷﻲﺩ ﺩﺩﻴﻞک.ﺑﺴﻮﻱﻪﮐﺗﻣﻦځ ﺍ
ﺘﺲﺭ ﻳﺎ
ﻨﻳ
ﺍﺩ ﻤﻒ ﻟ
ﻟﻲﺪ ﻴ
ړﺳ ﻭﭖ ﺍﻴﮏﺗﻭﺮ
ﮑﻳﮏﻧ
ﺷ.
ﻻﻞ ﻲ SyﻣstemicToxi ci
tﻭﺩyﺍﺎﻴﻧ
ﻮﻤ،ﻧﺎﻱټﺱ ﻨﺠﻨ
ﻴﻪﺩﻣ ﻠ
ﻪﮐﻠﻭﮐﺍ
ﺟړﻱ
ﻪﻫﻢ ﻮﻭ
ﻧﻮﻨ
ﻳﺎ
ﮐﻮﺘ
ﻳﺎ
ډﻝﺳ
ډﻝ ﻭ
ږﻱ ﻭ
ېﻻﻞکږ
ﺩﻥ ﻣﺮﺩﭙ
ﺎﻥﺩﺧﺘﻧ
ﺩېچېﺩﺍﺮ
ﻩﭘﺭ
ﺭﺮﺏ
ژﺳ ﺎ
ﻓﻭﺮ
ﮑﻣ
.
ږﻱ
ﻻﻞکږګﻥ ﻣ
ﺮﻭﺒ
ﺑﻲﻏﺎ
ﻬﺘ
ﻟﺍﻣﻲ
ﻮﻤﻭﻋﺍﻌﻲ
ﻮﺿﺪﻣﻳ
ﺪﺎﺩﺷﻴ
ېﺍﺑ
چﺩ
ﻡﺘﻞ کﻴﺴ
ﻩﺍﺧﻭڅﻪګټ
ﻩﺭ ﺧﻮګﻪﺗ
ﺪۍﻭﺳﻞېﭘﻧﻭﻭﺱﺩژ ﺭﺍ
ﻩﻡګ ﮐﺲﮐﻢﻭ ﺍ
ﺮﺘ
ﻧﻗﻲﺍﺎ
ﻧﺸﺍﺍﻮ
ﭘﺨ
ﻪچې ﻠ
ﺭځﻱﮐﻪﺍ
ﺗﻪﻭﺧﺖﻣﻦځ
ﻐﻳﻲﻫﺍ
Woolsorﻫﻢﻭt
er'
sdiﻪﻱېseaseﮑﻞﺗﻗﻲﺷﺎﻧﺸﻣ.ﺍ
ﻲ
ﺷ.
ﺎﻕ ﻲﻧﺸﺍ
٥څﻪﮐﻢﻭﻱ
ﺮﻱې µmﺧ ﻭﻝچېﻗﻄ
ﺯﻭﺮﻳﺍﻧﮏې
ﻭﺮﻟﺭﻮ
ﭙﺳ
ﻪ
ﻮﭘﮑﻧ
ﻭﺩېژږﻱﺩﺧړﻝکږﻪﻮﺍﺳﻄﻪﻭﻮﭘ ﻧ
ﻭژﺎ
ﻓﻭﺮ
ﮑﻪځﻱﺩﻣ ﻮﺗ
ﺎﺧﻨﺭﺍﺳﻮ
ﭙﻮﺳﻮﻧﺎﻕﺷﻧﺸﻪچېﺍﻠﮐ
ﻭ
ﻮﻱﺍ(ﮐGerminat
iﻪ)on
ﻧﺪﻴ
ﺗﺎ
ﻳﻪﺯﺘﻟږﻱچېﺩﻭﻪﺭﺳﻲﻮټ ﺗﻭﻱﻏﺎﻔ
ﻤﻭﻟﻡﺍ
ﻮﻨﻴﺘ
ﺎﺳﻳ
ﺪﻴﻪﻣﺍﺳﻄﻭ
ټﺱﻻﻞ
ﻣ ﺎﻱ
ﻨﻴﺘ
ﺎﺳﻳﺪ
ﻴټﺱﻭﻣ
ﺎﻱ ﺍ ﻨ
ﻳډﻤﻒﺍﻳﮏﻟژﺍ
ﺭﻮﻤ
ﻴMassiﻫvﺪeﻳﺪﺎﺩﺷﻴ
ﺟړﻱچېﺑ
ﺮ ﻮﻭ ﺯﻫ
.ږﻱ
کږ
ړﻱ
ﻤﻦک
ﻧﺎ
ﻳﻴﻞﺯ
ﻠﺗ
ﻭﺪﻧ
ﻮﺍﻧ
ﻭﻮﺭګ
ﻴﻨﻮﭼ
ﮐﻭﺩ
ږﻍﻪﺩ ﺱ
ﻍﻪﻥ ﻏ
ﮐﻻﻯﺷﻲچېﻥﻍ ﭘﻴﻞ ﻮ
ﮐﺲﺑﺴ ﺮ
ﺘﻧﺩﺍ
.
ږﻱ
ﻻﻞکږ
ﺎﻱې ﻣ
ﻔﻡﮐ
ﺪﻔﺴﻲﻋ
ﻨﻭﺗ
ﺍﺯﺱﻮﺒﻣ
ﻭﺮچېﺩﺗ
ﺷ.
ﺪﻝ ﻲ
ﻴﻟﻳﻲﻭ
ﺍﻳﮏﻭﻱ ښ
ژﺍ
ﺭﻮﻤ
ﻴﺍﻫ
ً
ﺮﺜ
ﮐﺍﻪچې
ﻧﺪﻴ
ﻟﻭﻊټ
ﻳﺎﻣ
ﺍکېﺩ
ﺭﻮﻠ
ﻪﭘﭘ
ﺍﻯﺷﻲ
ﺩﺩږﻱﻭﺁﻥک
ﺒﺐکږ ﺍ
ﺎﺳﻴ
ﻤﻳﺮ
ﺘﮐﺎ
ﺑﺍﺧﻞﺷﻲچېﺩ
ېﻪﺩ
ﻳﻦ ﺗﺍﻯﺷﻲﻭﺩﺩﻴﻞکﮐﺲﺑﺴﺮﺘ
ﻧﺩﺍ
ﺷ.
ﻻﻞ ﻲ
ﺎﻱټﺱ ﻣ
ﻨﺠﻨﻳﮏﻣژ
ﺍﺭﻮ
ﻤﻴېڅﻪﺩﻫ
ﺭ ﺧ ﻪﺩېﻻﻟ
ﺩ.
ﻪﻱ ﻧ
ﻮﻠ
ﻣﻬﻢﻻ
ړﻦېﻣ
ﻮﺏﺩﻡﻳ
ړﺳﻭﭖ
ږﻭﺩﺱ
ﺍﺎک
،ﺷﻪ
ﻳﺎﻔ
ﻡﮐﺪ
ﻔﺴﻲﻋ
ﻨﺗ
ﺪې
ﻌﺎﻣﮑﺲﻳﻧ
ﺮﻓﻭ
ﺭﻭﺍﻯ ﺷﻲﺍ
ﺩﺩڅﻪ ک
ﺍک ﺧ ﺭ
ﻮﻪﺧ ﻮښېﻟ ﺷېﻏ
ﺍﺏېﭘﺦې ﻮ ﺮ
ﺷېﺧړې ﻮﺩﮐﮏ
ﻮﺏړﺳ
ﻌﻲ ﭖ
ﻮﺿﻮﻣ ﻮﻧ
ﻪﺷ ﺗ
ﻣﻦځﺍﮐﺲﺭﺮﺘ
ﻧﮑﺲﺍ ﻧ
ﺮﻓﻭ
ﺭﻭﻪچېﺍ ﻠ
ﺷ.ﮐ
ﻪ ﻲﺗ
ﻣﻦځﺍﮐﺲﺭﺮﺘ
ﻧﻳﻲﺍ
ﺎﻌﻣ
.ږﻱ
ﻻﻞکږﺘﻲ ﻣﭘ
ﻮﻨﻳ
ﺩﺍﮑﻞﻳ
ﻭﺮﺕﻭﺳ
ﺪښ ﺍﻧﺮېﺩﻨﺠ
،ﺣﻡﻮﻌﻠ
ﻪﺑﭘ
105
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ږﻱﻪﺩې
ﻻﻞکږ ﭘﻭﻣﺭﺪ
ﻨGastﺳr
oint
esti
ﻮﺩnalﺪﻧﻴ
ﺭﺳﻪﻭ
ﻮﺗﻤﻟ
ﻮﻮﮐﻴﻨ
ﻮﭼﻡﮐﺰﻴﻧ
ﺍﺭګﻭ
ﻪچېﺍﻠ
ﮐ
ﻭﻱچې
ﺪﻴﻟ
ﻮﺮﺗ
ﻭﺯﻫ
ﺍﻮﻱﻪﮐ
ﻧﺩﺩ
ﻭکGﺎټ erﻳ
minati
ﻪکېonﻘﺒﻧېﻃ
ﺎﻁﻻﺪ ﻣﺨﺭﺩﻮﭙ
ﻟﺖکېﺳﺎﺣ
.
ږﻱ
ﻻﻞکږﺯﻣﻭﺮﮑ
ېﻭﻧ
ﺪﻥ ﺍﻴﻬ
ﻪﺑﻨﻳ
،ﻭﻮﺏړﺳﺩﺩﭖ
ﺍ
ﺗ،
ﻪ،ﺒ
،ﺎﻥګ
،ﮐﻟﻲﺍ
ﻭﺪﻩﺑړﺩ،ﺯ
ﺩﻱې ﺭ
ﻩﺩګډﺭﻥګﺍ
ﺪﻤﻩﻭﻱﻫﺰ
ﻳﺩﻭﺘﻲﺩ
ﭘﻮﻨ
ﻳﺩﻤﻒﺍﻟﻳﮏﺮ
ﺘﻧﺍ
ﺰﻴ
ﻌﻲﻣﻮﺿ ﻣ
ﻭ
Asciﺍt
iﻳﮏsژﺍﺭﻮ
ﻤﻴ،ﻫﺎﻱټﺱﻨﻳ
ﻳﮏډﺮ
ﺘﻧﺍ
ﺰﻴ
،ﻣﺘﻰﺎﺳ
ﮑﻰﻧﺲﻧ ﻧﻭ
ﺮﻪﻟ ﻨ
ﻳ،ﻭﻮﺏړﺳﻱې ﭖ
ﺩګډ
ړﻪ
ﻨ%٧ﻡﻳ٥-٢
ﺩ،چې٥ډﻝ ﻯﻴﻢ ﻭ
ﮐﺲﻭﺧﺮﺘﻧ
ﮑﻞﺩﺍﻳﻲﺷﺎﻌﺪېﻣﻌ
.ﻣږﻱ
ﻪ کږ ﺗ
ﻣﻦځﺍﺎﺭﻴ
ﻤﻴﺴ
ﺘﭙﻴ
ﺳ
.
ﺮﻱﻟ
:
ﻥښﻥې
ﻴﮏېﻥښې ﺍ
ﻨﻴﻠ
ﮐ
.
ږﻱ
ﺪﻝکږ
ﻴﻟﻭکې
%٩ﭘﻲښ
ﭘ٥:ﻪ
ﮐﺲﺮ
ﺘﻧﺍ
ﺘﮏې
ﻮﺳﭘ
ﺩ-١
ﻪﻭﻯﻟﻳﺩﺩﻭﺎﻮﺍﻧ
ﻮ،ﭘﺴﻭﺯﻭﺍ،ﺍ
ګﻮ
ﺍﻧﻮﻪﻏ ﮑ
ﻮﻟ ﺗ
ﺎﻧ
ﺍﻮ
ﻴېﻪﺣﻮ کېچ ﻟﮑﻠﻮﺧﻐﻪﻫ ډﻝﭘ
ﺰﻭﻳﺩﻭ
ﻪﺩ ﭘ
ﺪﻴﻡﭘﻲښېﻫﻢﻟ ﺰﻳ
ﺭﻭﺭﻮﺗ
ﻮﻴﻩﺩﺑ
ﺭﻥګﺍ
ﺪ ﻤ
ﺩ.ﻫﺭې ﻱﺭﺮﻱﭘﻲښېﻱېډ ﺭﻟﺎ
ﮐﻭﺮ
ﻩﺳ ﺮﻮﺳﺗ
ﻮﻻﻣﺤﺼ
ﻡﺰﻳﺭ
ﻭﺮﺗ
ﻮﻴﺎ کېﺩﺑ
ﮑﻳﺮ
ﻣﻪﺍ٤ﭘﻲښېﭘ ﻮ کې١ﺘﺎﺷﻴ
ﺮﻣﺑﻮﺘ
ﮐﻭﺍﺮﺍ
ﺒﻣﻮ
ﻪﻧ ﮐﻝﭘ
٢ﺎ ٠
٠ﺩ.ﺩ١
ﻭﻱ ﻱﻮﺷ
ېڅﻪ٧ﭘﻲښېﻤﻞ ﺧ ېﻪﺩېﺟﺩ،چ ﻟ
ﻮﻱ ﻱﻟږﻝﺷﻪﻲ ﺍﺳﻄ(ﻪﻭ
Postﭘﺘﻲ)ﻮﺳﺷېچېﺩﭘﺪ ﻮ ﻴ
ﻟﻭ
ﻭ.
ﻤﻦې ﻱﮑېﻭ٤ﭘﻲښېﻱېﺷ ﺑﺖ ﺍﺎﺛ
،
ﻩړ
ﻣ،ﺎ
ﻪ ﺦﻏ
ﮑﻟﻮ
ﺮﺧﻭﺑ
ﻮڅﻟ
ﻪﺪﻥﭘ
ﺑډﻝﺩ
ﺰﻭﻳ
ﺩﻭﻪﺩ
ﻓﺖﭘ
ﻩﺍﻭﺩ
ﻭځ١ﺭﻟ١څﻪ٢
ﻩﻱېﻪ ﺧ ﺭﻭﻳﺦﺩ
ﺮﻔﺩﺗ
.
ږﻱ
ﺪﻝکږ
ﻴﻟﻮکې
ﻧﻮﻭﻭﻻﺳ
ﺍږﺍ
ﻭ
ﻩﺮ
ﺩﻭﺳ
ﺮﺩﻴ
ﻭﻪﺗ
ﻭځ ﭘ
ﻭﺭ،چېﺩڅږﻱ
ﺪږﻧ
ﺭګ(څPapul
ﻮﻝ)eﭙ
ﮑﻰﭘﻧﻭﺮ
ﻟﺭښﺕ
ﺎﻨﻰﺧﻮﭼ
ﻯﻮﮐړﻳﻡﻮﻟ
ﻮﻱﻭﻱ
ﺮﺷ ﻴ
ﭘﺎ
ﻪﭼﺍﺳﻄﻮ
ﮑﻞﭘﻳ
ﺰﻳﻨﻲﻭ
ﻮﭼﮐﻭﺩ
ﺮﻱﺍ ﻩﻟ
ﺪﺎﻋ
ﻪﻗﮑﻴ
ﺗﻭﺮ
ﮑﻩ ټﭖچېﻧ
ﺮﺍﺑﻼﺧ
ﮑﻞ ﻭ
ﻳﺰﻳ
ﻭ
.
ږﻱﺪﻝکږﻴﻟ
ﻪ
ﻭﺗﺮ
ﺘﺘﻲﻣ
ﻧﺎ
ﻭﺳ،څ
ږﻱږ
ﻩﻍټ
ﺯﺍﺪ
ﻧﻩﻱېﺍ
ﺮﺩﻭﺳ
ﺮﺩ
ﻴﻪﺗ
ﻮﭘﻴ
ﻧﻭﻭﺍ
ﺮﻱﺩڅ
ﻟ(ﺭﭼﻖ
ﺍﮐﻰ)
ﺮﺘﺭﭘ
ﻮټﭖﺗ
.
ږﻱﺭﺳﻲ
ﻩ
ﻪﭘﻲښ
ﻤﻴﻪﻭﺧ
ﺮﻱﭘ
ﻪﻟﺩﻧ
ﺭ(ﻭﻱچېﺩ
Brﺭﻱ)own
ﺍﻮﻭﻧﺼ
ﻨﻲﺍ
ﻴﺗ
،ﺟﻼNonpi
tt
ing،
ﻮﺏړﺳ
ﭖ
ﺷ.
ﺭ ﻲﻮﭙ
ﻮﺏﺧړﺳﺍﻯﺷﻲﭖﺩﺩ
کېک
ېﻪ
،ځﻪچ ﭘ
ږﻱ ﮐ
ﻻﻞکږﺩﻭ ﻣ
ﻪکﺩﺘﮐ
ﺭښ ﺎ
ﻳﻦېﺩﻓﺸﺷ،چېﺩ
ﺭ ﻲﺭ
ﻩډﺮ
ﻣﻭﻮﺏﺩړﺳ
ﺘﻰ ﭖﻪﺣﻠﻪﮐﻠ
ﮐ
.
ږﻱﻟﻲ
ﻭﺭټ
ﻪﺍﺘ
ﻟﻭﺩ
ﺍﻮﻱﮐﺖﮐﺮ
ﻪﺣﻮﺗﺎﺟ
ﻧﺴﺍ
ﻧېﺘﮏېﻻﺪﻮﺳ
ﺮﭘڅﻪﺗ
ﻮ ﺧﻧﻭﻟﺭګ
ﻊﻪﻳ
ﺎﻪﻣ
ﻧﺎ
ﻤﻴﻪﭘﺗ
ﺎﻳ
ﺯ
ﻭﻠﻲﺍ
ﺒﻨ
،ﺗﻮ
ﻧﻭﺩ
ﺭﻠﻲﺩ،ﻋﻀ،
ﺮﻱﺩﺗﺐﮐﺲﻟ
ﺮﺘﻧ
ﻌﻲﺍﻮﺿﺘﮏېﻣﻮﺳﺯېﺩﭘﺍ
ﻮﺎﻥ چېﻳ
ﻭﻏﺭ
ﺎﻩﻧﺮ
ﺗﺎ
ﻳﺯ
ېګﻞې
ﻴﮏ ﻳ ﻤﺘ
ﻴﺴﺭﻭﻱﺳﺭ
ﻮﺏډړﺳ
ﻭکېچېﭖ ﻮﭘﻲښﻐ
ﻪﻫﺎﭘﻣ
ﺍګﻪﻣﻦﻭﻱ
ﻠ
څﻪﮐﻢ ﻳ
ﺩﻱ ﺧﺭﺩﺮ
ﺳ
ﻭ.
ﺪې ﻱ ﻳ
ﺪﻫﻢﺷ
ﺷ.
ﻻﻞ ﻲ
ﺘﺲ ﻣ
ﻳﺎ
ﻨﺠﻨ
ﻭﻣﺍ
ﺎﻤﻳ
ﺮﺘﮐ
ﺎﺑ
ﮐﻻﻯﺷﻲﺩ
ﺷ،چې ﻮ
ﺍﻯ ﻲ
ﺪﻳﺪ
ﻧﺭګ
ﺘﻲﻫﻢڅ
ﭘﻮﻨ
ﻳﺩﻤﻒﺍ
ﻟﻌﻲ
ﻮﺿﻣ
،
Brownrecl
use spider bi
te، ﻮﻻﻱټﺱ ﻠﻴ
ﺑ ،ﺳ
ﺩ
ﺮﺥ ﺎ ﺪﺩ ﺳ ﻳﺎ
ﮐﺲ ﺑ ﺮﺘ
ﻧﺘﮏېﺍ ﻮﺳﭘﺩ
ﭘﺲﺮ Local،ﻫ
Ecthyma gangr enosum ،ﻭﻍۍﺭ
ﺎCatscrﻧ at
ch ،Ri
ckettsial
pox
ﻭ Tyﺍphus ،ﻮﻥﺎﻋ
( ﻃ ﻮکﮐﻮﺘ
ﭘﺮﺘﻭ ﺳ ﻮک ﺍﮐﻮ
ﻠﻴﻓ
ﺎﺘﺩﺳﻴﺖ ) ﻨﻳ
ﺩﺎﻝ ﺍﻳ
ﺮﺘﮐﺎ
،ﺑ ﺮﺱﻳﺍﻭ
،ځﻪ
ږﻱ ﮐ
ﻠﻂږ ﺍﻏ
ً
ﺭﺩﺎ
ﻴ ﺺﻧﮐﺲﺗﺸﺨ ﺮ
ﺘﻧﺘﮏېﺩﺍ ﻮﺳ
ﭘﺷ.ﺩ
ﺮ ﻲﻴﭘ
ﻮ ﻩﺗﺮ
ﺎﺳ ﻴ
ﻤﻳﺮ
ﻟﻮUlﺗ
ceroglandular
.
ﻮﻱﻊﮐﻴ ﺺﻭﺿﺎﻑﺗﺸﺨ ﻭﺻ ﺍﻭﺩټﭖ ﺍﻪﻳﺨﭽﺭﺎ
ﻪﺗﻘﻴﻗچېﺩ
106
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
:(I
nhal ational anthr axﮐﺲ) ﺮﺘﻧ
ﺍﻗﻲ ﺎﻧﺸﺍ-
٢
ﺩ.
ﺭېﮐﻢې ﻱ ېﺭ
ﺎﭘﻲښېﻱ ډ ﻣﺍږﻱ
ﻻﻞکږ ﺩړﻦې ﻣﻩ ﻡﻳ ﺮﺗﺎ
ﻳﮐﺲﺯ ﺮﺘ
ﻧﺍﺩډﻝ
ﺍﻭ
ږږ
ﺪﻝک ﻴﻟﻭکې ﻮﻧ
ﻭﻭﺍړﻭﭖﻭﻪﺩ ﻩﭘﺮډﻝﺳﻣﻲ ﻭ ﻮﻤﻪﻋ ﻭﻏﻲﭘ ﺭﺎ
.ﻧ ﻩ٤ﺭځېﺩ٢ﻭ -ﻩﻱې٢ ﺭﻭﻳﺦﺩ ﺮﻔﺩﺗ
:ﻱ
:
ﻭﺍ
ړﻴﻞﭖ ﭘﺩ
،ﺩﻋﻀﻼ ﺎﻴ
ﺘﻧﺎ
ﻣﻮﺘ
ﺗ،ﺳﻪﻪﺒ ﮑ
ﺭځﻱﻟﻪﺍ ﺗﺎﻥﻣﻦځ ﺍﭘﺸﺰﻨﻳﺍ
ﻮﻠﻔﻧ
ﺍ ﺽﺩﺍ ﺮګﻱﺍﻋﻧځﻥ ړ
ﻪ کېﺎﺍ ﻠ
ﺮﺣ ﭘېﻣﺪ
ﻪﺩې ﻳﮏېﻥښېﭘ ﺰﻭ.ﻓ
ﺩﻱ ﻮ
ﻮﺟ ﺩﻣﺭﺭﺩﻳﻲﺩټټ ﺍ
ﻭښ ﺍﻪ ﻟ
ﻮ ﻭﺧ ﺍﻭﺧﻰ ،ﻭچټ ﻟﻰﺍ،ﺳﺴﺖﻭ ﺩﺭﺩ
ﻮﺗ
ېڅﻪ
ﺩ ﺧ ﻮﮐﻢېﻣﻪﺩ ﺘﻭﺳﺭ.ﻭږﻱ
ﻩ کږ ﻩ ښ ﺭﺎ
ﭙﻭﻟﻭځﻭﺭ ﻭﻍﺩڅ ﺭﺎ
ﻭﻧ ﻳېﮐﻢېﻭﻱﺍ ﻭ کېډﺮ ﺍړ
ﭖ
.ږﻱﻴﻞږﻪﭘ ﻔﺤﻪﺻ ﻤﻭﻫﺩ
:ﻭﺍ
ړﻭﻫﻢﭖ ﺩ
ﻴﻦ،ﺩﺳ ﺭ
ﻭﺪﻳﺍ
ﺮﺘ،ﺳHemopt ysis،ﺎ
ﻴﮐﺴﻮ ﭙ
ﻳﺎﻪﻫﮑﺎکﻟ ﺗ،ﺷ
ﻪ ،ﺒ ﻟډﻱﻩﻦ ﺎﻩﺳ ﺪﻳﺪﻭکېﺷ ﺍړ
ﻪﺩېﭖ ﭘ
ﻭ.
ﺩې ﻱ ﻮ ﻮﺟﻮﻝېﻣ ﻭﺧ ﺍﺩ ﺭ
ېﺩ
ﻭﺮﺍﺗږﻱځﻦېﻭﺧﺖﺩ ټ
ﺍکږ ﻳ ﺪﻴﻴﻞګېﭘ ژﻥﺑﻮ ﻴ
ﻔﻳﺭﻝﺍﻮﻠﭘﻭﺩ ﻴﺸﻦﺍ ﺘﻴﭙ
ﻳﺮﻪ کېﮐ ﻨﺘﻳﮏېﮐ ﺰﻪﻓﭘ
.ږﻱ
ﺪﻝکږ ﻴﻟ ﻮﺏﻫﻢ ړﺳﻧېﭖ ﺘﻲﻻﺪ ﮑﺘﻮﺳﺮﭘ ړېﺗﺎﻏ
.
ږﻱ ږړﺭﻮﺷﺭﻟﻮ ﻢ ﮑﻧﻭﻮژ ﻨ
ﻴﭙﻮﺩﺳ ﻧ
ﺎﻭﻏ ﺭﺎ
ﺩﻧ
ﻧﮏې ﻭﺮﻟﻪ
ﻨﻳﺍﻯﺷﻲﻭ ﺩﺩژﻥک ﻮﻴ
ﻔﻳﺭﻝﺍﻮﻠږﻱﻭﭘ
ﺍﺥږ ﺍ ﺮ
ﻡﭘ ﻮﻨﻴﺘﺎﺳﻳﺪﻴﻓﻲکېﻣ ﺍ
ﺭﻮګ ﻳ
ﺩﺍﺭﻪﺭ
ﺩ ټټﭘ
ﻭ.
ﻱ
ﻪﻨ
ﻳﺭﺕکېCSFﻭ ﻮېﻪﺩې ﺻﺷ،چ ﭘﻪ ﻲ ﺗ
ﻣﻦځ ﺍ
ﺎﻱټﺱﻫﻢﺭ ﻨﺠﻨﺍﻯﺷﻲﻣ ﺩ ﺩﻪک ﻠﺒ
ﻪﮐ ﻟﺎ
ﻴﻤﻳﺮﺘﮐﺎﺑ
ﺩ
.
ږﻱ
ﺪﻝکږ ﻴ
ﻟPMNPlﭘﮏې eocy tosiېﻭﺩsﻧﮏ ﺍ ﻭﺮﻟ
:(Gastointestinal Ant hraxﮐﺲ) ﺮ
ﺘﻧﺍﻳﻲ ﺎ
ﻌﺪېﻣ ﻌﻣ
-٣
ﻣﻦﺍﺮﻱﺭﻟﺭﻭﻮﭙ
ﮐﺲﺳ ﺮﺘﻧ
ﻭڅﻪچېﺩﺍړ ﺧ ﻮﻮښېﺩﺧ ﻡېﻏ ﺎﻴﻢﺧ ﻪﺩﻧ ﺘﻭﺳﺭﺭځېﻭ ﻩﻭﻟﻰﭘﻦځ ﻩﺍﻭﺩ
.
ږﻱﻪکږ ﺗځ
ﻩﺮﻪچټکۍﺳ ،ﭘﻪﻨ
ﻳﻮ کېﻭ ﻤﻐ
ﻠ،ﺑBloddydi arrږheaﺧ،ﻱې ﻮ ﺎﻥﺩګډ ﻭﻏﺭﺎډﻝ کېﻧﻪﺩې ﻭ ﭘ
ﻧﮏې ﻭﺮﻟﻪ
ﻨﻳﺍﻯﺷﻲﻭ ﺩﺩﻪک ﻠ
ﻪﮐﻠ.ﮐﺮﻱﻟړﺭﻥګ ﻊﻱېژﻱ ﻳ
ﺎﻪچېﻣ ﻧ
ﺩﻭﺩ
ﺭټﻝ ﻮﺍ ﺑ
ﻭ ﺍ
ﻩکېﺩ ډﻪګﻱ ﭘ
ﻭ.
ﻱ
ﺎ
ﻡﻳ ﻮﻴﻠﻳ
ﻨﻞﺍﻴﻣﺮ
ﻪﺗﻩﭘ ﺮﺗ
ﺎﻳ
ړﻰ ټﭖﺯ ﻡﻧ ﻮﻭ.ﻟ
ﺩ ﻱ ﻮﻮﺟﻩﻣ ﺮﺗﺎﻳﺎﻱټﺱﺯ ﻨﻳ
ډﻳﮏﺍ ﺮﺘﻧ
ﺍﺰﻴﻩﻣﺭﻥګ ﺍ
ﺪﻤﻫ
.
ﺮﻱﻟ ړﻪ
ﻨ
%٥ﻡﻳ ﻪځﻱچې٠ ﺗﺍ
ﻮﺎکﺧ ﻭﺷ ﺍﺎﻴﻤ
ﻴﮐﺴ ﻮ
ړﺪېﺗﻧﻪﻭﺍ ﻭﻏﻲﻣﺦﭘ ﺭ
ﺎ.ﻧږﻱ ږ
ﻡکېﭘﻲښ ﻮﮑﻴﺳ
ﺩ،ﺩ
ﺩﻧﻲ ﺭﻮﺘﻭﻍﺩﺳ ﺭ
ﺎﺭﺕ کېﻧ ﻮﻪﺩې ﺻ ﻮﭘﺎﺕېﺷﻲﻧ ﮑﺲ کېﭘ ﻧﺮﻓﻭﺭﻭﻪﺍﺭﭘ ﻮﭙﮐﺲﺳ ﺮﺘﻧﺍﻪﺩﮐ
ﻩﺎ
ﻭﺳ ﺭﺍﺎ
ﺪېﻓﺸ ﻧ
ﺎﺗﮏېﺑ ﻮ
ﻪﺗ ځﻦېﻭﺧﺖﭘ ﻭﻳ ﺘﻲﺍ ﭘﻮﻨﻳ
ډ،ﺍ ﻩﺰﻧ
ﻮ ﺘﻮﺳ ﻟﻭﺮ
ﻴړۍﺗ ﻡ،ﺩﻮﺏ ړﺳړې ﭖ ﺎﻏ
ﺩېﺮﻭﻏﺠﻦې ﭘ ﺭﻮې ﺩ ﻳ
ﻡ ټﭖ چې ﺩ ﻮﻌﻠ
ﺎﺑ ﻮﻝې ﻳ ﻭ .ﺩﺧ ګﻪ ﻣﻦ ﻱ ﻠ
څﻪ ﻳ ډۍ ﺧ ﻟﻦ
ﺷ.
ﺪﻝ ﻲ ﻴ
ﻟﺍﻯﺷﻲﻭ ﺩﺩ
ﻮﻯک ﻮښﻝﺷ ﻪﭘ ﺍﺳﻄ (ﻪﻭPseudomembrﭘ )ane
ﻗﻲﺎ
ﻧﺸﻪﺩﺍﺘﻭﺳﺭﮑﻞﻭﺍﺷﻩﺩﺮﺗﺎ
ﻳ،چېﺯړﻱﻪکﺗﻣﻦځﺍﺘﺲﺭﻳ
ﻔﻼﻴﻧﺴﺍ
ﻭﻨﻦګ ﮐﻻﻯﺷﻲﻣﮐﺲ ﻮ ﺮ
ﺘﻧﺍ
.
ږﻱږڅﻪﭘﻲښﮐﺲ ﺧ ﺮ
ﺘﻧﺍ
ﻮﻻﮑ
ﺍﺳ،ﻭﺎ
ﻣﻮﺗﺎ
ﻤﻴ،ﻫ
ﻪﻧ
ﺪﻴﻬ
ﻪﺑ ﻨ
ﻳﻴﻢﻭﻧﺸ
ﺍﺮ
ﺎﻍﺩﭘﻣﮐﻻﻯﺷﻲﺩﺩﮐﺲ ﻮ ﺮ
ﺘﻧﻼﻩﺍ
څﻪﻋ ﻭ
ﺘﺲ ﺧ ﻳﺎ
ﻨﺠﻨ
ﻣﺩ
ﺷ.
ﻻﻞ ﻲ Hemorﻣrﺪhageﻴ
ﺋﻮﻨ
ﮐﺭﺍﻭﺳﺐ ﺍﻮﺏ ړﺳ
ﺎﻏﻲﭖ ﻣ
،ﺩﺘﺲﻳ
:ﺭړﻥې
ﻭﻪﺍﺘﺭﻱﻻﺳﺍ
ﻮﺗ
ﺍﺮ
ﺑﻻ
ﻪﻣﻦځﻥﺎﭘﻣﻞﻳﺭﺎ
ﻭﻝکېﻧ ﻪﺍﻩﭘﺭﺷﺭ
ﻮ ﻢﮑﻧ
ﻭﻮژﻨﻴﭙ
ﻔﻲﺩﻯﺩﺳ ﺮﻭﺻ ﻴﺭړﻥېﻏﻭ
ﻪﺍ ﺘ
ﺭﻱﻻﺳ ﺍ
ﻮﺗ
ﺍﺮ
ﺑﻻ
107
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﮐﺲکې ﺮﺘ
ﻧﻗﻲﺍ ﺎﻧﺸﻪﺍﻊﭘ ﻳﺎ
ﺍﻣﺭﻮﻠﺎﺕېﻭﻱﺩﭘ ﻳﻧﮏېﻱېﺯ ﻭ
ﻭ،چېPMNژ ﺷې ﻱ ﻩ ﻮ ﻟړ
ﻪﻮ ۍﮐﭽ
ﻭ.
ﻧﮏې ﻱ ﻭﺮﻟ ﻪﻨ
ﻳﺍﻯﺷﻲﻭ ﺩﺩﻊﻫﻢک ﻳﺎﻭCSFﻣ ﺍﻧﮏېﻭﻱ ﻭﺮﻟﻪ ﻨ
ﻳﻭ
ﺍ
ﺭﻮﻠ،ﭘ،
ﻳﻦ،ﻭﻓﺖ ﺍﺘﮏېﺩ ﻮﺳﭘﻻﻞﺩﻭﻍۍ ﻣ ﺭﺎ
ﻧﻪچېﺩ ﻠ
،ﮐ ږﻱ
ﺩﻝکږ ﻭﻪﻭﺧﺖﺍﻱښ ﻐﻴ ﺺﻫ ﻮڅﺗﺸﺨ ﻏ
.ﺍﺷﻲ ﻪﺭﺘﺭﺕکېﻻﺳ ﻮېﻪ ﺻ ﺮﻥ ﭘ ﮐېڅﻪﺩ
ﻳﻦ ﺧ ﺎﻌﻳCSFﻣ ﺎ
ﻴﮏﻮﺟ ﻟﻮﻨ
ﻴﻣﻮﺩﺍ ﻧېﻭﻱﻧ ﺮﺷﮏﻻﺪ ﻩﺗﺮﻱﻪﻧﻈژﻟ ﻮﻟﻮﻤﻳﺪﻴﭘﻭﺍﻴﮏﺍ ﻨﻴﻠ
ﮐﻭﻍۍﺩ ﺭﺎ
ﮐﺲﻧ ﺮﺘ
ﻧﺭېﺍ ﺭﻪچ ﮐ
ﺘﻞﻴﺴﻩﺍﺧ څﻪګټ ﻮ ﺧ ﻟ
ﻮ ﻣﻮﻠ
ﻌﺘﻲﺟﻦﻣ ﻧﻮﻝﺍ ﭙﺴ،ﺩﮐ ﺎﺕ ﻨﻳ
ﺎﻌﻴﮏﻣ ﻮﺟ ﻟ
ﺍﺮﻴ،ﺳﻪPCR ﮑﻟڅﻪ
ﻮ ﺧ ﻧﻮﺘﺗﺴ
.
ږﻱکږ
،
ﻟﻰﺍﻮﺍﺧﺮﻡﭘﻮ ﻨ
ﻴﺘﺎﺳﻳﺪﻴﻭﺩﻣ ﻩﺍﻪﺩ ﻨ
ﺘﻪﮐ ﺎﺳﻩﺣﺴ ﺭﺭﻩډ ﺭﺎ
ﭙﮐﺲﻟ ﺮﺘﻧﻗﻲﺍ ﺎ
ﻧﺸﻓﻲﺩﺍ ﺍﺭ
ﻮګ ﻳﺩﺍ
ﺮﺭ ﺗﺩټ
ﻮﻱﻪﮐ ﺗﻭﻪګ ﭘﺍ
ﻪﺭ ﻧﺪﻴﻟ
ﻭﻊټ ﻳ
ﺎﺍ کېﺩﻣ ﺭﻮﻠﻪﭘ(ﻭﭘﻪﺍ ﻠ
ﺒHﻪﮐ emorﻟ rhagiclymphadent iti
)s
ﺍ
ﺪﻴﺪﺷﻦﻥښېﭘ ﻴﻟﻮﻧﺴﺎﻳﺩﮐﻭﺎ ﻳﺸﻦﺍ ﺮﺘﻠﻔﻧ
ﻮﻱﺍ ﻳ
ﺭﻮکېکېﺩ ﻧﺎﻭﻏ ﺭ
ﺎڅﺭﻧ
ﻮﺩېﺮ ﻟ
ﻩﺭ ﭘ ﺭﻥګ ﺍ
ﺪﻤ ﻭﻫﺍ
.ﻮﮐﻻﻯﺷ ﻮ
:
ﻴﺺ ﺮﻱﺗﺸﺨ ﻴ
ﭘﻮﻭﻍۍﺗ ﺭﺎﻧ
ﺩ
ﻩﻱې ﺮﻮﺳ ﻴﻭﻏﺭﺎﺭﻧﺷﺭ
ﻮ ﻢ ﺎﻫﻢﺩﻳ ﻴﺮﻱﺑ ﻩﻟﺮﻨﻈړېﻣ ځﻥګﻪﺍ ﺩېچېﺷ ﻩﺩ ﺮﮐﺲﺳ ﺮﺘ
ﻧﺘﮏېﺍ ﻮﺳﭘﺩ
،
Rat bitef everTul aremi a، Ulcer oglandul ګﻱډﻝar
ځﻥ ړ ﻭ ﻪ ﺍ ﺮ ﻭﺷﻲﭘ ﻴﭘﻮﺪﺗ ﻳﺎ
ﺑ
ﻗﻲﺎﻧﺸﻧ.ﺍ
ﺭﺍﺱې ﻮ ﻭﺩ ﺎﻥﺍﺘﻧ
ﻡﺍ ﻮﻳﺮﺘﮐﺎ
ﻮﺑ ﮑﻳﺎﺘﮏېﻣ ﻮﺳ ﭘ،ﺩﻮﻥﺎﻋ ،ﻃ Ecthy magangr enosum
ﺘﻦ چې ﺩ ﺎﺳﻳﺪﻴﺯﻱ ﻣ ﻭﺮﺒ
،ﻓ څﻪ
Mediﺧ ast i
nitiﻳﻲ s ﺎﻳﺮﺘﮐﺎﻭﺑ ﺭﻮﻪﻧ ﺪﻟ ﻳﺎﮐﺲ ﺑ ﺮﺘﻧ
ﺍ
ﺮﺳﻲ ﻳﺍ
ﻭﻭ ﮑﻞﺍ ﻴ
ﭙﻴﺗ.ﺍږﻱﻪ کږ ﺗ
ﻣﻦځ ﺍ
ﻪﺭ ﻠ
ﺒﻪﮐ Cocciﻟ dioidomy cosis، Histoplasmosi s
ﺷ.
ﺮ ﻲ ﻴﭘﻮﻩﺗﺮSarﺳ coi dosiSﻭsiﺍ l
i
cosi s،ﺎﻴﻧ
ﻮ ﻤ
ﻧ
ﺪښﺕ ﻨﻮﺑﻤﻟ
ﻮ ﮐ
،ﺩPer itonit
is،Pept icUl cer، Gast r
oent eritiﺪﺩs ﻳﺎﮐﺲﺑ ﺮﺘﻧ
ﻳﻲﺍ ﺎﻌﺪېﻣ ﻌﻣ
ﺷ.
ﺮ ﻲ ﻴﭘﻮ ﻩﺗ ﺮ
ﺩﻭﺳ ﺭﻱکﺩ ﻮﻭﺩﺳ ﺭﺎ
ﺍﺣﺸ ﻭﺩﺍ
:ﻪﻨﻠ
ﻣﺭﺩ
،
ﻴﻦﺎﺳ ﻣﺍ
ﺪﻨﻴﻠ
،ﮐ ﻮﻝ ﮑﻴﻨﻴﻔﻣﺍ
ﺭﻮﻠ
،ﮐ ﻴﻦﻠﻴ
ﺍﺳ ﺰﮐ
ﻮ ﻣ،ﺍ ﻴﻦﻠﻨﺴ Iکې ﭘ nv i
trﻪo ﻴﻞ ﭘﮐﺲﺑﺴ ﺮﺘﻧﺩﺍ
ﻭ،ﺍ Rif
ampi n ، Macr oli
des ، ﻴﻦﺎﺳ ﮐﺴﻮﻠﻓﻭﺮ ﭙ ،ﺳ ﻴﻦ ﻠ
ﮑ ﻳﺎ
ﮐﺴﻲ ﺳ ﻭ ،ﺩ Imi penem
ﻨﺲټ ﺩېﺑﺮﻮﭘ ﺮﻱﻧﻟﺰﻭ ﻴﻤﺘ
ﮑﻟﺎ
ﺘﻴﺍﻯﺷﻲﺑ ﺩﺩﻴﻞک ﮐﺲﺑﺴ ﺮﺘ
ﻧﺩ.ﺩﺍﺎﺱ ﻱ ﻩﺣﺴ ﺮVancomyﺳ cin
ﻭﻴﻦﺍ ﻠﻨﺴﻭﺱﭘ ﻴﻞﺍ ﻟﻪﺩېﺩ ﻮﭘ ﻭړﻱﻧ ﺭ ک ﺍټﻦګﻳﻲ ﻳ ﺍ
ﻩ ښ ﺮﻴﻦ ﺳ ﻠﻨﺴﻭﭘ ﻳﻦﺍ ﺭﻮﭙﻮﺳ ﻟ
ﺎﻔﺳ
.
ږﻱﺎﻝږ ﻤﻌﺘﺍﺳ ﻪﻩﻧﺮﻣ ﻭﻩﺩﻮګ ﻪﺗ ﻮﭘ ﻠ
ﻣﺭﻮﺩ ﻳړﺩځﻥګ
Amoxiﺍ cill
in
ﮐﺴﻲ ﻭﻪ کېﺩ ﻧﻮﻴﻨﻪﻣﺨ ﻭﻫﻢﭘ ﻪﺍ ﻨﻠﻣ
ﺭﻪﺩ ﻣﻞﺩﻱﭘ ﺭ(ﺩ Choi ﮑﻰ)ce ﻧ
ﻭ ﻮښ ﻴﻦﺧ ﺍﺳﺰﮐﻮﻠﻓﻭﺮﭙﻴﺳ
ﺩ.
ﻣﻞ ﻱ ﺭﻭﻫﻢﺩﻴﻦﺩ ﻠﮑﻳﺎﺳ
ﺷ.
ﻭﻝ ﻲ ﺭ ﺎ
ﮐﻣﻞﻭ ﺭﺪﺩﻭﺏ ﺿ ﺮﮑﻳﺎﻩﺩﻣ ﺮګډﻝﺳﻪ ډﻭ ﺪﭘ ﻳ
ﺎﻮکېﺑ ﺗ
ﺎﻻ ﻧېﺣﻻﺪ
.ﮐﺲ ﺮﺘﻧ
ﺍ ﻗﻲﺎﻧﺸﺍ-
١
.ﮐﺲ ﺮ
ﺘﻧﺍﻳﻲﺎﻌﺪېﻣ ﻌﻣ -
٢
ﺩ.
ﺭﻯ ﺭ
ﻮﺏډ ړﺳ ﻌﻲﭖ ﻮﺿ ﺎﻣ ﻱﻭﻳړﺍ ﻪک ﺘﺍﺧ ﻩﻱې ړ،ﺎ
ﺮﻏ ﻣ،ﺳﮐﺲچې ﺦ ﺮﺘﻧ
ﺍﺘﮏې ﻮﺳ ﭘ
-٣
ﻭ.
ﺎﺕ ﻱ ﻳﺎﻱټﺯ ﻮﺳ ﮑﻴﻟﺎﺎﻳﻳﺩﺭﺎﺗ،ﺗﮏېﮐﻪ ﻪﺒ ﮑﻟ ﻴﮏېﻧﺶې ﻤ ﺘ
ﻴﺴﺎﻥﺳ ﺘﻧ
ﺍﺩ -
٤
ﺍږ
ﻠﻦېﻭ ﻣ
ﺭږﻱﺩﺩ ﺎﻝږ ﻤﻌﺘﻪﺍﺳﺘﻭﺳ ﺭﺩﻭﻭﻣﺦ کﺩ ﺎ
ﺮﻣﺨ ډﻝﺗﻪﻭ ﻮﻱﭘ ﻴ
ﻨﺯېﺩﻣﺨ ﺍﻮﻣﻞﻳ ﺭړېﺩ ځﻥګﺍ
ﺩ.
ﻪﻯ ﻮﻯﻧ ړﻝﺷ ړﻩڅ ﻩښ ﺮﻣ ﻭﻟﻰﺩﺍﻭﺩ
ﻪچې ﻠ
ﻩﮐ ﺭ
ﺎﭙﮐﺲﻟ ﺮﺘﻧﺭﺍﻮﭙﻭﺧ ﻳﻲﺍ ﺎﻌﺪېﻣ ﻌ،ﻣ ﻗﻲﺎﻧﺸ ﻭﺩﺍ ﺭځېﺍ ١ﻭ ٠-ﻩ٧ ﺭ
ﺎﭙﮐﺲﻟ ﺮﺘﻧ
ﺘﮏېﺍ ﻮﺳ ﺩﭘ
ﻩچېﺩ څﻥګﮑﻦ ﺭ ﻴ
،ﻟږﻱﻮﻝ کږ ﮐ ﺭﻣﻞﻭ ﺭﺭﻫﻢﺩ ﻮﻭﻥۍﻧ ﻩﺍﻭﻮﺩ ﻮﻧﻩﺷ ﺭﺎ
ﮐګﻥ ښ ﺮﻭ ﺒﻴﮏېﻏ ﻨﻴﻠ
ﮐ
ﻭﺏﺮ ﮑﻳﺎ
ﺭځېﺩﻣ ٦ﻭ ﻧ٠
ﺩﻭﻱﻮ ﻮ ﻮﺟ Biکېﻣ oterroriﻪ sm څﻪﭘﺭ ﺧ ﻮﭙﻪ ﭖټﺳ ﻟﺮRelﺧﻄ apes
.
ږﻱﻮﻝکږ ﮐ
ﺭﻣﻞﻭ ﺭ
ﺪﺩ ﺿ
108
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﺪﻧ
ﺭﻻ ﺎ
ېﺮﻓﺸﺭﺗ ﻳﻲﻻﺍﻮډﻝﻫګﻱ ﻭځﻥ ړﻭ.ﻪ ﺍ
ﺮ ﻱﭘ ﻳ
ﻮﺏډ ړﺳﺭېﭖ ﺭﻪچ څﻪﮐﻭﻥ ﺧ ﺰﻴﺗﺭﻮﻪﺩﮐ ﻠﻪﮐ ﻠ
ﮐ
.
ږﻱ
ﺘﻞکږ ﻴﺴﺍﺧ ﻩﺭﺕکېګټ ﻮﻪﺻ ﺘﺲﭘ ﻳ
ﺎﻨﺠﻨﻭﺩﻣ ﺍېﻭﻱ
:ﺷېﻩ
ﺩﻝ ﻮ ﺩ ﻭﻪښ ﻨ
ﻠﻣﻭﻝکېﺩﺭ ﺪ(ﺟ ٧
-٢ﭘ)ډﻝ ﻪﻟډ ﻭﻪﻦ ﭘ
Ciprof loxaci ﻴﮏ n ړۍﻟ ﻡ ﻮﻟ
ﺩ
ﻠﻲګ ٤ﻣ ٠
ﻳ٠
ﺭېﺎ ېﻪﻻﻮﻝ ﻟﺭځېﺩﺧ ﻩځﻝېﺩﻭ ﻭ ﻪﺩ ﻣﺍ
ﺭﻠﻲګ ٥ﻣ ٠
ﻭ٠ ﻣﻞ ﺍﺭ ېﺩ
.
ﺭېﻪﻻ ﻟﺪ ﻳﺭ
ﻪﺩﻭ ﺘﻭﺳﺭﻪﻭ ﺘﺎﻋ١ﺳ ﻫ٢ﻪﺮ ﻣ ﺍ
ﺭ ﺯﻱې ﻭﺩ
Dox ycy ci
lli
ne
ﺭﻪﻻﻟﺪﻳﺭﻳﺩﻭﻮﻝېﺎ ﻪﺩﺧ ﺘﻭﺳﺭﻪﻭ ﺘﺎﻋﻟﺲﺳ ﻭﺮﺩ ﻪﻫ ﻣﺍﺭﻠﻲګ ١ﻣ ٠
٠
.ېڅﻪ
ﺧ
:Amoxi ci
llﻭﻫﻢې ne
i ﺩ ﺩ
.ﺭېېﻪﻻﻮﻝ ﻟ ﺩﺭځېﺩﺧ ﻪﻭ ﻟ
ﺩېځ ﻪﺭ ﻣﺍﺭﻠﻲګ ٥ﻣ ٠
ﻣﻞ ٠ ﺭﻴﮏې ﺩ ﻟ
:Penci l
l
in-G ﺯﻱې ﻭﻭﺩ ﺍ
.ﻪﻻﺭې ﻟﺪﻳﺭﻪﺩﻭ ﺘ
ﻭﺳ ﺭﻪﻭ ﺘﺎﻋ
څﺭﺳ ﻮﺮﻟ ﻩﻫ ﻮﻥټ ﺍﻳﻩﻣﻲګ ﻭﺩ
:Rifampi n ﻴﻒ ﺗﺎﻧ
ﺮﺘﻟﺍ
ېﺎ
ﻮﻝ ﻳ ﺭځېﺩﺧ ﺯﻥﺩﻭ ګﻡﻭﺍ
ﻮﺭ ﻟ
ﺮکﻝ ﺮﻫ ﺪﻥﭘ ﻪﺩﺑ ﻣﺍﺭ
ﻠﻲګ ١ﻣﺯ٠ ﻭ ﻭﺩ ﻣﻞﺍ ﺭ
ﺩ
.ﺭېﻪﻻ ﻟﺪﻳﺭﻭ ﻱې
:Clindamy cin
.ﺭېﻪﻻﻟ ﺪ
ﻳﺭېﺎﻭﻮﻝ ﻳﻪﺩﺧ ﺘ
ﺎﻋﻪﺳ ﺗﺍﺮﻪﻫ ﻣﺍﺭﻠﻲګ ٦ﻣ ٠٠
-٥٤٠
:Clar i
thr omy cin
ځ.
ﺩﺭ ېﻩځﻝې ﻭ ﻭﻪﺩ ﻣﺍﺭﻠﻲګ ٥ﻣ ٠
٠
:Erythr omy cin
.ﺭېﻪﻻ ﻟﺪﻳ
ﺭﻪﺩﻭ ﺘ
ﻭﺳ ﺭﻪﻭ ﺘﺎﻋﻫ٦ﺳ ﻪﺮ ﻣﺍﺭﻠﻲګ ٥ﻣ ٠
٠
:Vancomy cin
٥٠٠I
mi ﺭې penem ﻪﻻﺪﻟ ﻳﺭ
ﻪ ﺩﻭ ﺘﻭﺳ ﺭﻪﻭ ﺘ
ﺎﻋ ١ﺳ ﺮ٢ ١ګﻡﻫﺍ
ﺭ
.ﺭېﻪﻻﻟﺪ ﻳ
ﺭﻪﺩﻭ ﺘﻭﺳﺭﻪﻭ ﺘﺎﻋ
ﻫ٦ﺳ ﻪﺮ ﻣ ﺍ
ﺭﻠﻲګ ﻣ
:ﻮﻯ ﻴﻨﻣﺨ
ﺷ:
ﻴﻦ ﻲ ﮐﺴﺍﺪﻭ ﻳﺎ
ﻠﮏﺑ ﺩ.ﺧ
ﻪﻱ ﺘﻪﺷ ﻧ
ﻮﻨﻴﮐﺴﺍګﻱﻭ ځﻥ ړﻩﺍ ﺭﺎﭙ
ﻟ ﻮﻳﻭﺭ
ﺍﻭڅ ﺍﻮﻧﺎﻧﺎ
ﻧﺴ ﺍ
ﺩ
.ﺮﻱﻟﺭ
ﺎﮐﻭ
ﺮﻩﺳ ﺮﻡﺳ ﺰﻴﻧﺍ
ﺭګﻭﺍﻍﻪﺩﻍﻪﻥ ﻏ ﻧﮏېچېﻥﻍ ﭘ ﻭ ﻮﮐﺭﺎﻪﮐﻐ ﺭﻫﺍﻮ
ﺗﺍﺮﺑ
.ﺩﻻ 1
.ﻮﻱﺍﺕﮐ ﺩﺭﺍ
ﻮﻭ ﺗ
ﻮﻻ ﻭﻯﺩﻣﺤﺼ ﻭﺩﺩ ﺍﻮﻳﻭ ﺭﺍ
ﻠﮏچېﺩڅ ﻪﺧ ﻐ .ﻫ 2
ﻭ.
ﻪﻱ ﺗ
ﺎﻳﻮﻉﺯﻴﮐﺲﺷ ﺮ
ﺘﻧﺍﻡکېچېﺩ ﻮ،ﮐﻮﻱ ﺮﮐ ﻔﻪﺳ ﻭﺗﺩﺍﻮﻴﺍﺱېﻫ ﺍﻥچېﺩ ﺮﻧ
ﺮﺗﻪﻭﻐ .ﻫ 3
ﺩﻭ
ﻣﺦ کﺩ ﺎ
ﻣﺨ ﻩﺩﺮﻡﺳ ﺰﻴ
ﻧﺍ
ﺭګ ﻭﻡ کېچېﺍ ﻮﻪځﻱﮐ ېځﻯﺗ
ﺍﺱ ﺍ ﻧﻞچېﺩ ﻮﺮﺳ ﺮﻱﭘ ﮑ .ﻋﺴ 4
.ﻭ(
ﻩﻱ ﻟړ
ﻪﻮ ﺮﮐﭽ ﻴﮏېﻭﺳﻞېﺩﺧﻄ ﻮﺟﻟﺎ)ﻴ
ﺑ
ﻭ.ﺩﺎﺕ ﻱ ﻳﺮﺯ ﺧﻄ
ﺷ.
ﻴﻦ ﻲ ﮐﺴ ﺍﺭﺕﻭﻱﻭ ﻭﺮﺭﺿ ېﺭ
ﺭډ ﺭﻪچ ﻩ ښځېﮐ ﺭ
ﺍﻭﺪﻴﻣ .ﺍ 5
ﺭﺩﻮﻩﻧﺯﻭ
ﺩېﺩ .ﺭږﻱ
ﺭﻕکږ ﻧېﺯﺘﮏېﻻﺪ ﻮﺳ ﻪﺩﭘ ﺘﻭﺳ ﺭﻭﻥۍﻭ ﻩﺍﻭ ﺮﺩﻪﻫ ﻗﺭﺩېﺯړﻯﺭ ﻡﻮﻴﻦﻟ ﮐﺴ ﺍ
ﻭ
ﺮﺘ
ﻮﺳ ﮐﻝﺑ
ﺮﺎ ﻪﻫﺘﻭﺳﺭﺎﻭﻴږﻱﻭﺑ
ﺍږ ﺍ ﺮ
ﮑﻪﺗﺘﻭﺳ ﺭﺎﺷﺖېﻭ ﻴﻠﺲﻣ ﺗﻭﺍﻟﺲﺍ ﻭ،ﺩ ږﻧېﺷﭗ ﺘﮏېﻻﺪ ﻮﺳﭘ
.
ږﻱﻪکږ ﻴ
ﻮﺻ ﺯﺗﻭﺩ
ﻪﺩچېﭘ ﺭ،ﺩﻟﻰﺍ
ﻭﺭﻮﻌﻲﺳ ﻮﺿ ږﻣځﻯ کېﻝ ﻮﻱ ﺍ ﺭﻕﺷ ﻪﺯ ﺩ:ﭘ
ﺭﺕ ﻱ ﺎ
ﺒﺰېﻋ ﻴﺰېﺍﻏ ﻴ
ړﺧ ﻴﻦﺍ ﮐﺴ ﺍ
ﻭﺩ
ﻭکې ٠ﭘﻲښ ،
ﻪ٢ګﻥﭘ
ﺮﻭ ﺒ
ﻴﮏﻏ ﻤ
ﺘ ﻴﺴﺩ.ﺳ
ﺭﻯ ﺩﺎګﻥﻧﺮﻭ ﺒﻴﻢﻏ .ﻭﺧ ﺭځﻱ ﻪﺍ ﺗﻭکېﻣﻦځ %٣ﭘﻲښ ٠
.ږﻱ
ﺪږ ﻧﺭګ څ
109
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﺷ.ﺩ
ﻴﻦ ﻲ
ﮐﺴﺍ
ﻭﻱﻭ
ﺭﺍﻭﻍ څ
ﻭﺭځﻝ ﺷﻲﺍ
ﻮﻭﺪﻭﺳ
ﻳﺎﻭﻱﺑﺭ
ﺍﻮﻱ څﻩﺷړﺘﻦﻡﻨ
ټﻝﻣﻩ ﻭﺭﻥګ
ﺍﺪﻤ
ﻫ
ﺷ.
ﻳړﻝ ﻲﻩﻮ
ﺕﻪﻣﻦځ
ﻮﻻ ﻟ
ﺭﻣﺤﺼﻮﻩﻭﻧ
ﻮښﺍ ،ﻏ،
ﺘﮏﻮﺳ،ﭘ
ړۍﻮﻭﻳ
ﻭﺭﺍ
ﻮڅﻨ
ﻤﮑﺷ
ﻭﻏﻲﺭ
ﺎﭙﻲﻧﻧﻲﺳﻮﻴ
ﻟﺩ
(
RabiesVi
r)us
:
ﻳﻒ ﺮﻌﺗ
ﻪچېﺩ ﻠ،ﮐږﻱ
ﻪکږ ﺘﻭﻍۍﺍﺧ ﺭﺎ
ﭘېﻧﻪﻭﺧﺖ ﺮ ﻐ
ﺎﻥﻫ ﻧﺎﻧﺴﻩچېﺍ ﻭﻏﻲﺩ ﺭﺎﻭﺳﻲﻧ ﺮﻳ
ﺍﻩﻭﻮRabiﻳ es
ﺷ.
ﻭړﻝ ﻲ ﺍﺮﻱ ﺩ ﻟ
ﺮﺱﻭ ﻳﺍﻭکېﻭ ړﻮﻻ ﻠ
ﭙېﻪﺧ ﺍچ ﭘ ﻮﻪﺧ ﻟﻭﻱﺭﺍ
ﺘﻦڅ ﻨ
ﻣ
.ږﻱ
ړکږ ﺍﺷﻲﻫﻢﺷﺨ ﺺﮐﮏ ﺎﺱﺭ ﻤ ﻪﺗﻻېﭘړې ړ ﻩﮐﮏ ﺮﻮڅټﭖﺳ ﻟﻪﻩﮐﺭﻥګ ﺍ
ﺪ ﻤ
ﻫ
.
ﻳﻲ ﺍﻭﻏﻲﻫﻢﻭ ﺭﺎ
Lyﻧ Rﻭssa ۍﻪ ageﺍ ﻭﻍ ﺗ ﺭ
ﺎﺩېﻧ
:ﻪﻧﻮﻠ
ﻣﻻ
ﻴﻞډ ﻴﻞﺑ٧.ﺑ ﺮﻱﻩﻟړﺭېﺍ ﻮﺭﻥۍﭘ ﻮRﻪﮐ habdoViﭘ rﻪﺩus ﻧ
ﻮﻭﺳ ﺮﻳﺍ
ﺭﻭ ﻮﺪﻧﻧﻭ ړ
ﺩېﺍﻭﺩ ﻴﺲﺍ ﺑ
ﺍﺭ
.
ږﻱﻻﻞکږ ﻭﻍۍ ﻣ ﺭﺎ
ﻧﻲﻧﺎﻧﺴﺍﺍﺩً
ﺭﺩﺎﺭﻱېﻧ ﻮ ږﻧ.ﺷﭗ ﺮﻱﻟﻪﻧﻮﻟ
ﻭ
ﻭAntﺍ igeniﺩېﺩc ﻭﺩ ﻮﻯﺩﻯﺍ ړﻝ ﺷ ﺪک ﻳﺮﺮﺱﺗﺠ ﻳﺍ
ﻴﺲﻭ ﺑڅﻪﺭﻮ ﺧ ﻳﻭﺭﺍ
ﻮڅ ﻟ
ﺑﻼﺏﻝﻪﻴ ﻟ
.ږﻱ
ﻴﻞږ څﻪﺑﻪﺑﻞ ﺧ ﻟېﻮ
ﻪﻣﺦ ﻳ ﻟﻭﺎﻴﺗړ
ځﻥګﻴﮏ ﺍ ﻮﺟﻟﻮﻴﺑ
ګﻯ
ځﻥ ړﻮﺍ (ﻭﻳ
Envﺍ olﻪﻳﻲ)oped ﻠﻄ ﺍﺧﻞﺧ ،ﺩ(Bul lﻪ)etShaped ﺗﺭېﻪﻭﺩک ﺗ ﺮﺮﺱﻣ ﻳﺍ
ﺍﻭ ﺩ
ﺮﻱچې ﻪﻟ ﻧ
ﻮﻨﻴﺗ
ﻭﺮﻪﭘ ﻟ
ﻭﻩډ ﺮﺱGenom codeﭘﻦځ ﻳﺍ
ﺩېﻭ .ﺩ ﺮﻱﻔﻲﻗﻄﺐﻟ ﻨRNAﺩﻯچېﻣ
ﻟﻰﻮﻮﻯﭘ ﻟﻭﻴﻦﺍﺗﻭﺮﭘ
ﺪ ﻴﺘ
ﻳﻭﻻ ﺭﻮ
ﻔﺎﺳ،ﻓﻴﻦ ﺗﻭ
ﺮﭘﻮﮑﻳ،ګﻻ ﻴﻦﺗﻭﺮﮑﺲﭘ ﻳ
ﺮﺗﺎ،ﻣﻴﻦ ﺗ
ﻭ ﺮﭘ
ﻮ ﻠﮐ
ﻮﻴﺭﺕﺩﻱﺩﻧ ﺎﺒ
ﻋ
.څﻪ
ﻴﻦ ﺧ ﺗﻭﺮﺰﭘﻳﺮﻴ
ﻣ
:
ﻮﺟﻲ ﻟ
ﻮ ﻤ
ﻳﺪ ﻴ
ﭘﺍ
ﺎﻥﻧ
ﺎﻧﺴﺍً
ﺍﺮﺜﮐﺍ
.ږﻱﺍکږ ﺪﻴڅﻪﭘ
ﺎ ﺧ ﮑﻴﺘﮐﺮﺘﻧﺍﻪﻟ
ﻪ ﺗ
ﺮﻮکېﭘ ﻳ
ﻭﺭﺍﻮڅ ﮑﻧﻭﺮﻟﻪﺗﻲ ړۍﭘ ﺩټﻝېﻥ
ﻴﺲ ﻭ ﺑﺭ
ﺭﻮﻮﻱﻭﻱﻧ ﺰﺷ ﻳﺎ
ﻧﻮﻤ
ﻳﺎﻥﺍ ﻴﭙﻮکېچېﺳ ﻧﻮﻳ
ﺍﻪځ ﻐﺎﻫ ﻣږﻱﺍﻪکږ ﺘﻪﺍﺧ ﺍﺳﻄ ﻪﻭ ﻮﭘ ﻟ
ړﺩﺍ
ﻮ ﺩ ﻧﺎﻴ
ﭙﺩﺳ
.ﻭﻱﺩږږﺮﺱﻝ ﻳﺍ
ﻪﻭ ﻮﺗﻧﺎﻧ
ﺎﻧﺴﺍﻭﻱ ﺭ
ﺍﻭﺣﺸﻲڅ
Rabiﺩ es. ږﻱ
ﻩکږ ړۍڅﻪﻡ
ﻭﻍ ﺧ ﺭﺎﻪﺩېﻧ ﺎﻥﻟﻧﺎﻧﺴ ١ﺍ٠
٠٠٠
ﮐﻝ٠ﺮﺎ ﻨﺲټﻫ ﺮﺑ ﺭﭘﻮﭘﺍ
ﺩWHOﺩﺭ
:
ﺮﻱ ﻟﻪﻟ
ﻭﻩډ ﻭ ﻩﺩﺮﻪﻧﻈ ﻟﻮﺟﻲ ﻟ
ﻮ ﻤ
ﻳﺪ ﻴ
ﭘﺍ
ﻪﻮﭘ ﻧﺎ
ﻴﭙﻧﻲ ﺳ ﺭ
ﻮﻮﮐ ﻳﻮﺰﺷ ﻳﺎ
ﻧﻮﻤﻳ
ﺮﺍ ﻴ(چېﺩﻏ Ur banRabi ﻴﺲ)es ﺑﺍﻮﺭ ﮑ ﻧ
ﻭﺩﺩﻭﺱ ﺭﺍﺍﺩښ -١
.
ﺩږﻱ
ږﻱ ږﻪﻝ ﺍﺳﻄﻭ
،
Veccoons ، (
ړﻥګ )Skunks ﻮﭖﺍ ﻴﺸﭘ،
ﻮ ﻧﺍ
ﻮ ﻴﻟ،
ﻭﻳړ
Syچې ﺩ ګﺪ l
v ati
c Rabi es- ٢
.ﺩږﻱ
ﻟږﻱﻪﻲ ﺍﺳﻄ Moﻪﻭ
ngoosesﭘ
ﻩﺮ
ﻳ ﺎﻥډﺘﻧﻳﻞﺷﻲچېﺩﺍ ﻭ ﺪﻭﻳﺎﺑ
.ﻩﻪﺩ ﺗﺎ
ﻳﺎ کېﺯ ﮑ ﻳﺮﻣﺘﻲځېﺍ ،ﺧﻴﻦ ﭙ
ﻠﻓ،ﺎﻥﺘﻭﺳ ﺪﻨﻪﻫ ﻭﻍۍﭘ ﺭﺎﺍﻧﺩ
ﻳې
ﻭﻍۍﭖښښېډﺮ ﺭﺎ
ﻮﻝﺩﻧ ﮐﺰﻳ
ﺎﻧ
ﻮﻴ ﻣﻭﺍﻭﻝﺍﺮﺘﻨﻭﻱﮐ ﺎﻥﺩﻱ چېﺩﺩ ﻴﭙﻧﻲﺳ ﺭﻮﻪﮐﻧﺮچﻥﻪﺳ ﻤﻬ
ﻣ
ﺩ.
ړﻱ ﻱﮐﻢېک ﺍﺭ
:ﺰﺱ ﻴﻨ
ﻮﺟ ﺘﭘ
ﺍﻥګﺭﺪﻤﻭړﻱﻫﺍﻪﺩ ﺑ
ﺭﻮﻭﻍﮐ ﻭﻱﺭﺭﺍﺘﻦڅ ﻨﻪچېﻣ ﻠږﻱﮐ ﻩکږ ﺮﺮﺳ ﻪﻭﺧﺖﺗ ﻐﻪﻫ ﻧﺪﻳ
ﺩﻟږ
ﻭﺱ ﻲ ﺮ
ﻳﺍﺩﻭ
څﻪ
ﺪ ﺧ ﻧ
ﻮ ﻴ
ﻪﭘ ﻧﻲﻟﺮﻭﻗ ﺍ
Aer ړﻱﺩosol ړک ﮐﮏ (ﻪﻟﻮ،ﺧ ﻩﺯ
ﻮﭘ،،
ﺮګﺘ)ﺳ ﺎ
ﺎﻃﻲﻏﺸ ېﻻې ﻣﺨﻪچ ړ ﻠﻩﮐ
ﺷ.
ﺍﻯ ﻲ ﺪﻳﺩﻟږ
ﻭﺱ ﻲ ﺮﻳﺍ
ﻫﻢﻭ
.چ ږﻱ
ﻩکږ ﺮېﺮﺳﻮک ﺗ ﮑ ﻧ
ﻭ ﻪژﻮﭘﺗﻮﻋﻀﻼ ځﻯﻣﺨﻄﻄ ﻮﻱ ﺍ ړﻝﺷ ﺩﺍ
ﻪﺩ ﻧﺪﻴ ﺗ
ﺎﻳړﻥۍﺯ ﻡﻮﻟﻭﺱ ﺮ
ﻳﺍﺩﻭ
ﺩﻭ
ﺍﺧﻞﺩ ﻭﺩ ﺩﻥښﻮﺍ
ﻠﺗ ﻮﻧﻮﻭﺳ ﺮﻳ
ﻭﻴﻦچېﺩ ﻟ
ﻮﻳﻞﮐ ﺎﺘﻴﻪﺍﺳ ﮑﻟﺬې ﺮﺍﺧﺘﻤﻧﺴ ﺍﺮﺗ
ﻭ ﺭ
ﻮ ﻴﻧ
ﺎﺩﻴﻪﺑﺘﻭﺳﺭېﻭ
ﻼﻡﺩﻻﭘﺯ ﻮﮐﺴﺍﻮﺩﺑﺎ
ﺍﻋﺼ ﻴﻄﻲ ﺮﺱﺩﻣﺤ ﻳ
ﺍﻪﻭ ﺘ
ﻭﺳ ﺭ ﻪﻭ ﻐ.ﻪﻫ
ﻮﻱﻟ ﻣﻦﮐ ﺰﻴﺍﻏ ږﻱ
ﻩګڼﻝکږ ﺭ
ﻮ کېﻏ
110
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
.
ﻮﻱ ﮐﺖﮐ ﺮ
ﻪﺣ ﺘﻢﺗﻴﺴﺒﻲﺳ ﺰﻱﻋﺼ ﮐﺮﻩﻣ ﺮﺘﻠﻲﻣ ﺩېﻣ ﺎﻋﺖکېﺭ ﺍېﻪﺳ
ﺭﭘ
ږﻱچېﺩ ﺮ کږ ﮑﺍﺱېﻓ ﻻﻦﺩﺪﻯ ﮐ ﻳﻮړﻝ ﺷﺭک ﺭﻭﻮ ﭘﺍ
ﻮ کېﺭ ﺗﺎﻻﻮﻱ ﺣ ﺑﺮﻪﺗﺠ Viچېﭘ r
emi a
.
ﺮﻱﻟ ﻪﻭﻝﻧ ﻭﻍۍکېﺭ ﺭﺎﺒﻲﻧ ﻌﻲﮐﺴ ﻴﺒﻃ
ﺩﺎﺕﻳ(کېﺯ Gr aymat terﺩې) ﺎﺥېﻣ
ﻪړ ﻩﭘﺯﺍﺪﻧ
ﺍ ﻩﺭﺭﻪډ؛ﻮﭘږﻱﻧﺭﺱږ Cﻪﻭﺮﺱ NSﺗ ﻳﺍﻪچېﻭ ﻠ
ﮐ
ﻮﻪﻏﻴﺑﺎﻌﻟﻪﮑﻟږﻱﺭږ ﺭﻪﺕ ﻮﺗﺎﺟ ﻧﺴﺍﻭﺭﻮﺭېﻧﻪﻻ ﻟﻴﮏﻋﺼﺐ ﻣﻮﻧ
ﻮ ﺗ
ﺍ ﻪﺩ ﺘﻭﺳﺭﻪﻭ ﻐﻪﻫ ﻟﺎﻴﻭﺑ ﺍ ﻮﻱﻪﮐ ﻧ
ﺩ
.
ږﻱﻩﻪﺭﺱږ ړﺗ ﺍﺯ
ﺘﮏېﻭ ﻮﺳ،ﭘﺘﻲﻋﻀﻼﺕ ﻴ
ﻠﮑﺍﺳ ،ږﻱ،ﺱ ﺭګﻱ ﻮﺗ،ﭖښ ﻭﻻ ﺪﻴ ﻨﻞﻣ ﻳﺭﺩﺍ،
ﻭټ
ﻮک ﮑﻧﻭMuciژ nogeni caci ﭘnarﻪﻪ ﻧ
ﺩﺩﺎﺕﻳﺮﺱﺯ ﻳﺍﻭﻭﺩﻪﺍ ﻧ
ﺩ ﺩﺭﺭﺮﺱ ﺕ ﻳﺍﻪﺩﻭ ﻮﺗ ﺗ
ﺍﻭ ﺪﻪﻏ ﻴﺑ
ﺎﻌﻟ
.ﻭﻱﺮﺑﺍ
ﺮﻭېﺑ ﺎﻴﺘ
ﻧﺎﺍﺳ ﻩﺭﺎﭙﻟﺩﻥېﺩﺩ ږږﺭېﻝ ﻭﺩﻻ ړېﺩﻻ
ځﻲډﻪﻣﻦﻧ ﭘﺩ)
ﺭې ﻩ ﻮﮐﻝﭘﻩﺎ ﻮﺮﻳﻭڅﻪﺗ
ﻭځ ﺧ ﻪ ٧ﺭ ﻟ ﻩﻧﮏېﺩ ﻮﻨﻮﻥﻣ ﻟﺪﻩﺑﺭﻭ ﻳﺢﺩ ﺮﻔ Rabiﺩﺗ ﺩes
ﺎﻋﻲﻓﻪﺩ ﺪﻥﭘ ﺑ،ﺩﺭﺷﺭ
ﻪ ﻢ ﻮﭘ ﮑﻧﻭﻭژ ﻮﻪﺷ ﺘ
ﺭﺩﺍﺧ ﺍﺪﻘﺮﻣ ﺮﺱﭘ ﻳﺍﻭﺍﺩ(چېﺩ ﺎﺷﺖې ﻴﻣ ٢
-ﻭﻝ١
.ﺮﻱ ﻟﻩړ
ﺍ ﺮﻱﻟﺩﻮﻣﻦځﻭﺟ ﺮﺩځﻯﺗ
ﻴﺢ ﺍ ﻘﻠCﻭﺩﺗﻪچېﺩ NSﺍ ﻠﺎﺻ ﻫېﻓ ﻭﻎ ﺍﻡ ﺰ
ﻴﻧﺎ
ﮑﻴﻣ
ﻪﻐﻪﻫ ړﻪﭘﻨډﻝﻡﻳ ځﻲ ﻭﻪﻣﻦﻧ ﻮﻱﻭﻱﭘ ړﻝﺷ ﺍ
ﻣﺦﺩ ﺮ ،چېﭘ ﻩ
ﻩﺩ ﺭﺭﻮ کېډ ﻧﺎﻭﻏﺭﺎﻪﻧ ﻐ
ﻪﻫ ړﻪﭘﻨ
ﻡﻳ
ﻮﮑﻠ
ﻪﺧ ﺎﻏﻪﻫ ړﻪﭘ
ﻨﻭﻡﻳ ﻮکېﻭﻱﺍ ﻧﻮﻭﻭﻻﺳېﻪﻡټﺍ ﻪﻱ ﭘ ﺎﺣﺷېﺳ ړﻝ ﻮ ﺍېﻪﺩﻮکېﻭﻱچ ﭘ ﻧ
ﺎﮐﺴ
ﻭ.
ﻮﻱ ﻱ ړﻝﺷ ﺍﻮﺩ ﭙ
ېﻪﺧ ﻪچ ﭘ ﻤکېﮐ
ﻪښ ﻭﻍۍﭘ ﺭﺎﻧ
ﺩ.ﺩﻮﻯ ﻯ ړﻝﺷ ﺭک ﺭﻭ ﻮﭘ
ﺍﺭېﻫﻢﺭ ﻮﮐﻮﭘﻟ
٧ﺎ -
ﻩ٢ ﺭﻭ ﻳﺢﺩ ﺮﻔﻮ کېﺩﺗ ﺗﺎﻻ
ﻭﺣ ﺭ
ﺩ ﺎ
ﻪﻧﭘ
ﺑﺲ ﺍ
.ﺩﺭ ﺮﻱ ﻭﻝﻟ ﻬﻢﺭ ډﻝ ﻣﺮﺱ ﻭ ﻳ
ﺍﻭﻭﺩ ګﻥﺍ ﺮﻭ ﺒﺘﻲ ﻏ ﻴﻓﺎﻌﺎﻥ ﻣﺑﺰﻴﻣﺩﻭ کې ﺩ ﻩ کﺩ ﺭﺎ
ﮐ
ﻮﻟ
ﻪ ﺏﻝﻻﺏﻝ ،ﭘ ﺎﻥﻘﺘ
.ﺍﺣ ﺮﻱﻟﻰﻟ ﺍﻪﻭ ﺗ
ﺭﻩﻭ ﺮﻮﺳ ﻴﻭﻏﺭﺎﺮﺳﻲﻧ ﻳﺍ
ﻭﻭ ﺭﻮﻮﺟﻲﺩCNSﺩﻧ ﻟﺎ
ﺘﭘﻭﺭﻮﻴ
ﻧ
Vir
ﻮ chow ﮑﻧ
ﻭ ﺒﻲ ژ ﻭ ﺩﻋﺼ Pyﺍ knosiﻮﻱ s ﺘ
،ﻫﺴ Chr omat olysiﺳs ، ﻩﻮ ﺮ ﺭﺟﺩ
ﻤﻞﻴﻧﺸﺍﺭﺎﻮﺩﭘ ﮑﻧﻭﺒﻲژ ﻭﻋﺼ ﺎﺡﺍﺗﺸﺭﻮﺍﮑﻧﻭﻴﻞژ ﻟ
ﻭګ ﺮﮑﻳﺎNeurﺩﻣ onophagi aRobi nSpace
ﻪﺍﺳﻄﻮﺮﺱﭘ ﻳﺍ
Rabiﻭ ﻩﺩes ﺪ ﻣﻲﻏ ﺎ
ﻮ کېﻧﺨ ﺗﺎﻧ
ﺍﻮﻴﻮﻱﺣ ﺑ
ﺮ ﻪﺗﺠ .ﭘږﻱ
ﺪﻝ کږ ﻴﻳﺐﻟ ﺮ ﺮﺥېﺗﺨ ﺑ
ﺪﻝﻳﺩﺍ
ﺯﻮﻥﺍ ﻣﺭﺎ
ﻴﻦﻫ ﻭﺳ ﺮ
ﭘﻭﺯﺍﻭﻭ ﻮﻥﺍ ﻣﺭ
ﺎGrﻫ owt ﺭﺕ کېh ﻮﻪﺩې ﺻ ﺷ،چېﭘ ﺍﻯ ﻲ ﺩ ﺩﺘﻦ کﻨﻣ
ﻮکېﺩ ﻧﻭ ﺭ
ﻮﻴېﻪﻧﻭﻥ ﭘ ﺪﻧﺭګﻴﮏڅ ﻮﺟ ﻟ
ﺎﺘ
ﻔﻲﭘ ﻴﺲﻭﺻ ﺑﺍﺘﻢکېﺩﺭ ﻴﺴ ﺒﻲﺳ ﺰﻱﻋﺼ ﮐ ﺮ.ﻪﻣږﻱﭘ ﻤﻲﮐ
ﺘﻞېﻴﮏﮐ ﻠﻓﻮﻨﻳ
ﺯﻮ ﻳ
ﺮېﺍ .ﺩﻫﻳﻲ ﺍﻪﻭ ﺗ
ﺭNegrﻭ ibodi ﺩ،چېes ﺩﻝ ﻱ ﺩړﻮژﻥﺟ ﻮﻠﮑﻧﻴﮏﺍ ﻣﺯﭘﻼﻮ ﺘ
ﻳﺎﺳ
ﺷﺩ
ﻩ ﻮ ﺟړ
څﻪ ﻮ ﻮ ﺧ ﺭﭼﺎﻪﭘﺮﺱﻟ ﻳﺍ
ﻴﺲﻭ ﺑﺍ
Fﻭﺭ abrﺍ i
llarMat ri
ﻪx ﮐﺯﺎ
ﻧﻭ،ﺩ
ﻩ ﻱ ﺮﺘﻮﻣ ﻧﺎ١ﻧﻩ٠ ﺯ
ﺍﺪﻧ
ﺍ
ﺎﻍﻣ،ﺩﺩ Ammonshor ﻪn ډﻝﭘګﻱ ﻭځﻥ ړﻪﺍ ،ﭘږﻱﺍکږ ﺪﻴﺎﻍ کېﭘ ﻣټﻝﺩ ﻪ ﻭ ﻡﭘ ﺎ
.ﺍﺍﺟﺴ ﻩﺩ ﺩ
DorsalSpi ﻭﻫﻢ nal ﻮﺍ ﮑﻧﻭPurژ kiﻪng ﻴﺦﭘ ،ﺩﻣﺨ ﻮﺱ ﻣﺗﻼﻮﭙﻳﺎ
Brﻫ ainSt em ، ﺮﻗﺸ
.
ږﻱﺪﻝکږ ﻴﻟ ganglکې ia
ﻮﻥﺘﻪﺷ ږﻱﻭﻧ
ﺪﻝکږ ﺍ ﻴﻟېﻪ
ﻭﻍۍک ﻧ ﺭﺎ
ﻪﻧ ﭙﻲﭘ ﻧﻲﺳ ﻮﻴﻟﻡﺩ ﺎNegrﺍﺟﺴ ېﺍi
ﻭک ﺩ %٢ﭘﻲښ ﭘ٠
ﻪ
.
ﻭﻻﻯﻧﺸﻲ ﺩﻴ ﺺﺭ ﻱېﺗﺸﺨ
:ﻭې ﺎ
ﻴﺗﺪﻧﺭګ ﻴﮏېڅ ﻨﻴﻠ
ﮐ
ﺩ.
ﻮﻱ ﻱ ﻮﻭﺵﺷﻞﺷ ﻧﻭﻭﺍ
ړﻭﭖ ﺭﻮﻟېﺮڅﻭﻥ ﭘ ﺪﻧﺭګ ﻴﮏېڅ ﻨ
ﻴﻠﻭﻍۍﮐ ﺭﺎﭙﻲﻧ ﻧﻲﺳ ﻮﻴﻟ
ﺩ
.ﻭﺍړ
Prﭖ odor ﻳme ﻔﻲﺎ ﺮﻭﺻ ﻴ .ﻏ 1
.ﺮﻱﻟﻟﻰﺍﻪﻭ ﺗ
ﺭﻩﻭ ﺮﺘﺲﺳ ﻳ
ﻔﻼﻴﻧﺴﺍﺮﺳﻲ ﻳﺍﻭﻭﺭﻮ ﺘﺲچېﺩﻧ ﻳﻔﻼﻴﻧﺴ ﺍﺩﺎﺎﺣ ﺑړﻰﻳﻲﻧ .2
ﺭﻔﻲڅ ﺘﺲﻭﺻ ﻳﻔﻼﻴﻧﺴRabiﺍ ﻟﻰچېes ﺍﻮﺑﺍ
ﺮژﺭﺧﻮﻭ ﻔ ﻳ
ﺎﻭﺩﻭﻇ ﺰﮐﺍﺮBrﺩﻣ ainSt .ﺩ em 3
.ﺭړﻱ
ﻭ ﻪﺍ ﺗﻭﻥېﻣﻦځ ﺪﻧګ
.
ﻟﻰ ﺍ
ﻩﻭ ﺍښ ًﺭﺩﺎﺎﻧړﻪﻳﻨ .ﻡﻳ 4
ﺩ.
ﻔﻲ ﻱ ﺮﻭﺻ ﻴېﻭﻥښېﻱېﻏ ﻮﻱچېګﻝﻝ ﺍ ﻡﮐ ﺍ
ﻭ ﺭځېﺩ ٤ﻭ -ډﻝ١ ﺰﻭ ﻳﺩﻭ ﻪﺩ ﻭﭘ ﺍړﻣﻞ ﭖ ﻭﺭﺩ
ﻭ ﺮ
ﭘ
،
،ﺎﻥګ،ﮐ ﻟﻰﺍﻭﺪﻩﺑ ړ
،ﺯ ﻳﻲﺎﻬﺘ
،ﺏېﺍﺷ ﻟﻰﺍﻮﺗ
ﺎﻳړﺎﺯ
ﻴ،ﺩ ﺳﺖﺗ ﻪﻧﻭﺩﺭﻠﻲﺩ ،ﻋﻀ ﻟﺖ ﺎ
،ﮐﺴ ږﻮﺮﺧ ،ﺳ ،ﺗﺐﺩ
Rabiﻪګﻝﻝېچېﺩes ﻐﻭﻫ ﺍ
ړﺩېﭖ ﺩ .ﺩ
ﺭﺕ ﻯ ﺎﺒڅﻪﻋﻭﺧﻲ ﺧ ﻧﮏېټ ﻭ ﺮﻐﻢﻟ ﻠ
ﻭﺑ ﺩﺍﺭﻧﻲﺩ ﻮﺘﺩﺳ
111
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﺎ
Fﻭﻧ asiﺍ culati
on، Par ast hesi ﺍ کېa ﻮﻭﺧ ﺎﻪﺷ ﻴﺢﭘ ﻘﻠﺮﺱﺩﺗ ﻳﺍ
.ﺩﻭ ﻮﻱ ﺰﮐ ﻳ
ﺪﻧﺍړﻭﻍۍﻭ ﺭﺎﻧ
Dor sal ﻪﻠ
ﺒﻪﮐﻟﺮﺜﮑﺗﺮﺱﺩ ﻳﺍ
ﺍﻯﺷﻲﺩﻭ ﺩﺩﺎﺱک ﺍﺣﺴ ﻪﺩ،چېﺩﻏ ﺭﺕ ﻱ ﺎﺒڅﻪﻋﺎﺱ ﺧ ﺍﺣﺴ ﻡۍﺩ ﺍ
ﺭﺍ
ﻪﻠ
ﺒﻪﮐ ﺮﻟ ﺜﮑﺮﺱﺩﺗ ﻳﺍﺍﻯ ﺷﻲﺩﻭ ﺩﺩﺎﺱ ک ﻪﺍﺣﺴ ﺩ،چېﺩﻏ ﺭﺕ ﻱ ﺎ
ﺒڅﻪﻋ ﺎﺱ ﺧ ﺍﺣﺴ ﻡۍﺩ ﺍﺭﺎﺍﻧ
کې
ﺍ ړ ﻭ ﺭځﻯﻱېﺍ ﻮﻱ ﺍ ړﻝﺷ ﺩﺍ
ﻳﺖ کېچې ﺩ ﺎﻬﻪﻧ RootGanglﺩﺣﺴﻲﻋﺼﺐﭘ ionDor sal
ﺩ.
ﻮﻯ ﻯ ړﻝﺷ ﺭک ﺭﻭﻮ ﭘﺍ
ﺍﺭﻮ ﻪﺧ ﻟﻮ ﻧ
ﺎﻭﻏﺭﺎ%٨ﻧ ٠-٥ﻱﻭﺩ٠ﺭځ ﺍ ﻪﺍ ﺗ
ﻩﻣﻦځ ﺩ
:ﻭﺍ
ړﺘﺲﭖ ﻳﻔﻼ ﻴﻧﺴﺍ
ﻤﻞ،ﺣ ﻴﺸﻦ ﻨﻴﻮﺳﻟ
ﺎﺗ،ﻫ
ړﺎ
ړﭖﻴ ﺎﻏﻲﺥ ﻣ،ﺩAgitatiﻴﺞon ﻬ،ﺗږﻱﺎﺕږ ﻳﻴﺖﺯ ﻟ
ﺎﻌﺮکېﻓ ﻭکېﺣ ﺍ
ړﭘېﭖ ﺪ
،
Meni ngesmus ، ﻨﺞ ﻮﺗﺸ ﺗ
،ﺩ ﻋﻀﻼ ﻟﻰﺍﻮﺑ
ﺍﺮﺮﺧ ﮑﻔ،ﺩﺗ (Combt i
v ﻩ)eness ﺩﺎ
ﻣﻪﺍ ېﺗ
.
ږﻱ
ﻩکږ ﺭﺎﮐﺭښ ﺯﺱژ ﺰﻳ
ﭘﺍﻻ
ﺭﮐﻞﺎ ﻮﻭﻓ ﺍﺎﺕ ﺘﻼﺟ ﺍﺧ ،Opist hotoni cPost uring
ﺎﺱ ﺭﺣﺴ ﺭﻩډﺮﺎ(ﺳ)ﻤﻝﻴﻢ ﺷ ﻡﻧﺴ ﺮﻭﺁﻥﺩﻧ ﻳﻲﺍ ﺎﻧ
ﻭښ ﺎﺱﺭ ﻤ،ﺗﺯﺍﻭﻟړﺍ
ﻭﻍﺩﻮ ﺭﺎ
،ﻧHy persthesi s
ﺩ.
ﺰﻯ ﻳﺩﻭﻭﻱﺩ
ﺗﻲﺎﺒ.ﺩﻧ ږﻱﻪﺭﺳﻲ ﺪﺗ ﻳﺭﺘﻲ ګ ﻧﺎ
٤ﺳ ﻩ چې٠ ﻩﺩ ﻟړ
ﻪﻮ ﺭﺟﻭﺥېﺩ ﺩﻮېﻪﻣﺦېﺩﺗ ﺘﻦ ﻟ ﻳﮏېﮐ ﺰﺩﻓ
ﻭړېڅﻪﺩﻻ
ﻮﻝ ﺧ ،ﻪﺧﻟﻰﻟ ﺍﻮﺗﺎﻳ
ښﻮﺯ ﻭ ﮐ ﺍ،ﺩPupi ﺍﺥl ﺮﻪﭘ ﻤﻨﻈ ﺮﻣ ﻴډﻱچېﻏ ګﻭ
ﺘﻢ ډ ﻴﺴﺒﻲﺳ ﻋﺼ
Uppermot ،ﺩor Post ural hy potensi (ﻭon Perﺍ spiratiﻪ)on ﻟﻮ،ﺧ (
Salivatiﺍﺕګ)on ﺭ
Extensorpl antﺍerﻟﻰﻭ ﺍﻮﺗﺎﻳﮑﺲﺯ ﻠﻔﻳ
ﺮﻱﺭ ﺗﻭﻭ ﺭﻭ،ﺩژ ﺎ
ﻴﺘ،ﺳﺴ ﺍﺕګ ﻪﺭ ﺗﻠﺞﻣﻦځ neurﺩﻓ one
ﻭﻍۍ ﺭ
ﺎﭙﻲﺩﻧ ﻧﻲﺳ ﻮﻴﻪﺩﻟ ﻧﺎﺘﺑﺨﺪ ﺩ.ﺑ
ﺰﻯ ﻳﺩﻭﻠﺞﻫﻢﺩ ﻮﻝﻓ ﺒ
ﺗﻲﺣ ﻮ ﺩ.ﺩ ﺻﺰﻯ ﻳﺩﻭګﻥﻫﻢﺩ ﺮﻭ ﺒ
ﻏ
ﻪﻠ
ﺒﺪېﮐ ﻤﻪﻫ ږﻱﻮﻟ
ﻴﻞږ ﻧ ﻪﺑ څﻪﻧﻮ ﺧ ﻴﻭﻏ ﺭ
ﺎﺒﻲﻧ ﻭﻋﺼ ﺮﺳﻲﺍ ﻳﺍﻭﻭ ﺭﻮېﻭﻥښېﺩﻧ ﻩګﻝﻝ ﺍ ﺩﻮ ﻮﺟﻣ
ﻪﻭﻍۍﭘ ﺭﺎAerﺩﻧ ophobi Hﺎayﻳ drophobi a. ﺭځﻱﻪﺍ ﺗﻟﻰﻣﻦځ ﺍﻪﻭ ﺘﻭﺳ ﺭﻴ ﺺ کېﻭ ﻪﺗﺸﺨ ﭘ
څﻪ
ﻭ ﺧ ﺍړ
ﻪﭖ ﻟﺘﺲ ﻳﻔﻼ ﻧﺴ.ﺩﺍ ﻭ(
ﺩﻱ ﻮﻮﺟ ﻮکېﻣ ﻧﺎ
ﻭﻏ ﺭﺎ
ﻪﻧ ﺮﺧﺑ٢٣ﻮﻱ) ﻪﮐ ﺘﺮﺳ ﻩﻣﺭېﺭ
ﻴ ﺺک ډ ﺗﺸﺨ
.ږﻱﻠﻲ ﻴﻭېﭘ ﺎ
ﻴﺗﺪﻧﺭګ ﻟﻰڅ ﺍﻮﺑﺍ
ﺮﺩﺧ ﻭﺪﻧBrﺩﺩ ainSt ﻪﺩ em ﺘﻭﺳ ﺭﺭﻭژ
ﻭOptﺍ i
cneur i
ti
s، Faci alpar alysis،(Di plopiګﺪ)a ﻴﺮﻟ ﺒﺩﻝﻏ ﻪ کﺩ ﺘﻮﺍﺧ ﺍﺟﻭﺯﻔﻲﺍ ﻗﺤﺩ
ﺰېﻣﻦځ ﻧﻮﺘﻮﺩﺳ ﻟﻭﺭﺭﻪﺕ ړۍﭘ ﻡﻭﺩ ﺑﺩﻝﺍ
ﻭﻪﺩ ړﻮﻻ ﺗﺎ
ﻳ.ﺩﺯ ږﻱﻻﻞکږ ﻭﻣ ﺰﻧﻮﺘ ﻔﻲﺳ ﻮﻝﺩﻭﺻ ﻬﻲﮐ ﻧ
.
ﻩﻩﺩ ﺮﻨﻈ ﻩﻣ ﺰﻳ
ﺩ ﻭﻩﺩﺭﻮﺍﺕګﭘ ﻪﺭ ﺗ
ﺩﻱﺍﺭﺮﺍﻴﻪﻏ ﮐﺎﻧ
ﺩﺭﻮﺩ ﺗﺮېﻋﻀﻼ ﻨﺠﻭﺣ ﻣﻲﺍ ﻮﻌﻠﻔﺴﻲﺑ ﻨﻓﻲﺗ ﺎ،ﺍﺿ ﺰﺎﺟﺎﺏﺣ Hyﺩﺣﺠ drophobi a
.ږﻱ
ﺪﻝکږ ﻴ
ﻟﻭکې %٥ﭖښښ ﭘ٠
ږﻱﻭ ﻪ
ﻴﻞږ ﺍ ﻪﻭﺧﺖکېﭘ ﺩﻭﭘ
ﻊکﺩ ﻠ
ﺑﻊﺩ ﻳ
ﺎﺎﺕﺩﻱﺩﻣ ﻠﺼ ﻘﺗ
ږﻱ
ﻪکږ ﺗﻣﻦځ ﺍ
ﺪﻝﺭ ﻴﻟڅﻪﻭ ﺧ ﺪﻴﻟ ﻮﺑﻭﻪﺩﺍ ﺘﻭﺳﺭﻪچېﻭ ﻠ
ﻤﺘﻼﺟﻲﺣ ﻔﻲﺍﺧ ﮑﻞکېﻭﺻ (ﺷ ١٧-٢ﭘ)ﻪ
ﺩ.
ﻮﻱ ﻱ ﺩﻝﺷ ﻭښ
ﻪﺗ
ﺍﻝﻣﻦځ ﺰﻧ
ﺮﺍﭙﻞﺳ ﻪﺧ Pﻭﭘrﺍ iapiﮑﻦ sm ﻤﻪﻣ ﻠﻣﻪﺍ ﻟﺩﻭ
ﻪکﺩ ﺘAmyﺍﺧ gdal oidneucl ﺩeus
.ﺍﺷﻲﺭ
.
ﺭځﻱ ﻪﺍ ﺗApniﻣﻦځ cDeat ﻪh ﻠﻣﺍﻪﻟ ﺩﻭ
ﻪکﺩ ﺘﺍﺧ ﺰﺩ ﮐﺮﻔﺴﻲﻣ ﻨﺗﻱﻭﺩ
ږﺍ ﻠﻲ ﺍﺧﻪﺩ ﺎﺗﻣﻮﺎﻥﮐ ﻭﻏﺭﺎﻧ
ﻪﻭﭘ ﻩﺍ ﺭځېﺩ ډﻝ٤ﻭ ځﻲ ﻭ ﻪﻣﻦﻧ ﻩﭘﺩﻮ ﺩﻭﻣﺎﺕې کﺩ ﺪﻱﭘ ﻧ
ﻭ ﻪﺩژ ﺘﻭﺳ ﺭڅﻪﻭﻴﻞ ﺧ ﻪﭘګﻮﻟﻠﺩﻳ
ﺎﺕﺘﻼﻃ ﺭﺍﺧ ﺷﺭ
ﻮ ﻢ ﺷ؛ﻳ
ﻮﻝ ﻲ ﻴﻧﺎﺕﻭ ﻣﺎ
ﻤﺘﺪﻱﺍﻫ ﻔﺴﻲﺟ ﻨﺭېﺗ ﺭﻪچ .ﮐﻩﺭځېﺩ ٢ﻭ ډﻝ٠ﻤﻲ ﻭ ﺍﻋﻈ
ﻩړ
،ﺩﺯ (Di abetusI nspi ﺯ)dus ﺍﺮﻓﻓﻲﺍ ﺎ
ﮐﺎېﻪﺩېکېADHﻧ ﺍﺷﻲچ ﭘ ﻪﺭ ﺗ
ﻪﻣﻦځ ﺘﻭﺳ ﺭﮑﻦﻭ ﻤﻣ
Par al
y t
iﻭc ﺎﺍﻴ
ﻨﻴﭘﻮﺘ ﻳ
ﺎﻮﺳ ﺒﻣﻭﺮ ،ﺗGIBl eedi ng، ARDS، ﺎﺕﺒﻡﺛ ﺪﻳﻲﻋ ﺎ
ﺍ،ﻭﻋ،
ﻤﻲ ګﻥ ﺏېﻧﻈ
.
ﺮﻱ ﻟﻭﻥډiګ l
lus
ﻭ.
ﻭﻱ ﺭﺭﻭ ﺭﺍﺷﻲډ ﻪﺭﺗﻪچېﻣﻦځ ﻠﻮﮐ ﺭﺩﻯﺧ ﺩﺎﺭﻧﺭﻟﻰډ ﻩﺍ
ښﻭ
Landy lGui l
l
ainBar reSy ndr ،چېﺩ om ﺭځﻱﻪﺍ ﺗﮑﻞﻫﻢﻣﻦځ ﻪﺷ ﻠﺞﭘ ﻪﻓ ﻟ
ﺯﺎ،ﻧRabi es
.
ﺮﻱ ﻟﻟﻰﺍﻪﻭ ﺗﺭﻩﻭ ﺮ(ﺳ DumbRabi )es
،
ﺮﻱ Sﻪﻟ
eiﻧ zurﻭes ﻟﻰﺍ ﺍ
ﻮ ﺗﺎ
ﻳﻴﺖﺯ ﻟﺎ
ﻌ،ﻓ ﺎ
ﻴﺑﻮﻓﻭ ﺮﻳ
،ﺍHy dr ophobi ﻭﻍa ﺭﺎﻭ کېﻧ ﺍړﻠﺠﻲ ﭖ ﻪﻓ ﭘ
112
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﺷېﻭﻱ
ﺘﻦ ﻮ
ﻨﻪﻣ
ﺍﺳﻄ
ﻪﻭﺮﺱﭘ
ﻳﺍ
ﻮکېچېﺩﻭﺗ
ﺎﻳ
ﺎﻬ
ﻮﻧ ﻐ
ﻪﻫډﻝﭘ
ګﻱ ﻭ
ځﻥ ړ
ﻪﺍﻩﻭﻱﭘﺪ
ﻳﺪﺘﻲﺷﺳﺴ
.
ﻪځﻱ
ﺎﺗﻣﻮﻭﮐﺍړﺎ
ﻴړﭖﺗﺎﻏﻲﺥﻣ
ﻭﻍﺩﺭﺎ
ﻪکېﻧﻠ
ﻳﺎ
ﻪﭘﻭﭘ
ﺍ
:
ﻭﻥې ﺪﻧﺭګﺭﻱڅ ﺍﻮﺗﺍ
ﺮﺑﻻ
ﺮﻴ
ﻭېﻫﻢﻏ ﺎ
ﻴﺗﺪﻧ
ﺭګﺭﻱڅ ﺍ
ﻮﺗﺍ
ﺮﺑﺎﻥﻻﻭﻪﺷ ﻭﻥښ ﭘ ﺍ ېګﻮ
ﻠ
ﻴﮏ ﻳ ﻨ
ﻴﻠ
ﻭﻝکېﺩﮐ ﺍۍﻪ
ﻭﻍ ﭘ ﺭﺎﻧ
ﻴﺲﺩ ﺑﺍ
ﺭﺩ
ۍﻪ
ﻭﻍ ﭘ ﺭﺎﺮﺳﻲﻧ ﻳ
ﺍﺑړﻥۍﻭ Diﺩﺑﻞې ﻲ fferenti
ﺍalComplﻭ etebl oodcount ﻭ).ﻔﻲ ﻱ ﻭﺻ
ﻪ CSFکې ﻪﻭﻱﭘ ﻠﻣﻪﺍ ﺮﺱﻟ ﻳﺍ
ﺮﻭ ﺘﺲ کېچېﺩﻫ ﻳﺎ
ﻨﺠﻨﻭﻣﺘ ﺲﺍ ﻳﻔﻼﻴﻧﺴﻪﺍﻪﭘ ﮑﻭ(ﻟ
ﺎﻥ ﻱ ﺷ
ﻭ.
ځﻯ ﻱ ﻮﺍ ﻩﻳﺮﺯﺱﺳ ﻮ ﺘﻳ
ﺎﻮﺳﻔﻤﻟﺩﺎ(ﺩﺣ>5cel l
/ml ()Pleocy t
osiﻴﻒ)s ﻔ
ﺧ
ﻭ.ﻪCSFک ﺎﻝ ﻱﭘ ﻣ ﺭﻮﻮﻻًﻧ ﻤﻌﺯﻱېﻣ ﻮﮐﻮﻟﻻﻦګﻩﻭﻱ ﮐ ﻟړ
ﻩﻮږﻳﻲﻝ ﺍ
ﻪښ ﻳﻮﻴﻦﺳ ﺗﻭﺮﭘﺩCSFﺩ
،
ﺯﺱ ﻭﺪﻴﺋﻮﮐﺮﺮ ،ﺳ
ﻳﻝ ﺎ
ﭙﻮﺳ ﺘ
ﭙﻴ،ﻟﺘﻲﻳﺯﺍﺮ،ﭘTB ،ﻪﻓﻦګﺱ ﻟﻰﭘ ﺍﻭ
ﻮﻱې ټﻱټ ﺯﺩ ﺳ ﻮﮐﻮﻟېﺩ ګ
.
ﻮﻱﻻﺖﮐ Neoplﺩﻟ asticmeni ngiti
ﻳsﻴﮏﺎ ﺘﻠﻔﻴ
ﺳ
ﻮﻧ
ﻮ ﻠ
ﻣ ﺑﻲﻻ ﺎﻬﺘﻟ
ﻭﺍﺭﻮﺎﻧﺮﺳﻲﻳ ﻳﺍ
ﺮﻭ ﻴ
ﮐ(ﻪﻏڅﻪ ﻢﭘ ﺮ ﺧ ﺘﻴﻠﻲﻟېﺮﻣ
ﻧﮏ ﭘ ﻭ١ژ ٠٠
٠)Plecy tosiﺪsﻳﺪﺷ
.
ﻮﻱ ﻻﺖﮐﺪېﺩﻟ ﻧﺎ
ﺑ
ځﻦ
ﻭﻳ ﻮﺍ ﺗﺎﻧ
ﺎﺘﻧ
ﻴﮏﺍﺒﻴﻣ ،ﺍLeptospirosiﻮs ﺗﺎﻧ
ﺎﺘ
ﻧﻳﻲﺍ ﺎ
ﻳﺮﺘ
ﮐﺎﻪﺑﻟﻰﭘﺍﻮﺗ
ﺎﻳﺭﺯﺷﺭ
ﻮﺩ ﻢ ﮑﻧﻭﺩPMNژ
.ﻮﻱﻻﺖﮐ ﻮﺩﻟ ﻭﺳﺮﻧﻲﭘ ﺎﺘ
ﻧﺍﺮﻴېﻏ
ړﻦېﻪﻡﻳ ﻮﻝﺩﻱﻟ ﺍﮐ ﺪﻴﺮچﻥﻥېﭘ ﻩﺳ ﺪﻤﺘﺲﻋ ﻳ
ﻔﻼ ﻴﻧﺴﻪﺩﺍﻧﺭړ
ﻭﻪﺍ ﺘ
ﻩﻻﺳ ﺭﻮﻪﻣﺦېﻏ ﺭﻟﺍ
ﻮﺗﺍﺮ
ﺑﺩﻻ
(ﻪﻭCDC)Centﭘ ralofDi seaseCont r
ﺍol
ړﻮﻭ ﺭﻥۍﺩﻍﻳ ﻮﻴ ﺺﺩﮐ ﻴﺲﺗﺸﺨ ﺑﺍﻪﺩﺭ ﺘ
ﻭﺳ ﺭﻭ
ﻭﻍﺩ ﺭﺎ(ﻭﺩﻧ FrﺍeshSal i
vﻭ)a ړ
ﻩﻻ ﺯﺎ
،ﺗﻡﻭﺮﻴ،ﺳ ﻪﺩCSF ﻧ
ﻮﻤﺍﻯﺷﻲچېﻧ ﺩﺩﻩک ﺮﺮﺳ ﻪﺗﺍﺳﻄ
ﻪﺘﺮﺳﻩﻣ ﺭﻮ ﻴ ﺺکېﭘ ﻪﺗﺸﺨ ﻪﭘﻧﻮﻤڅﻪﻧ
ﺰ ﺧ ﻐﻩﻣﺯﺎﺎﺩﺗﻣ.ﺍږﻱ
ﺘﻞکږ ﻴﺴېڅﻪﺍﺧ
ﺘﮏ ﺧ ﻮﺳ ړېﺩﭘ ﺎﻏ
.
ﻮﻱ ﮐ
:ډﻱﺎﺘﻲﺑ ﻧ
ﺍړېځﻥګ ﺮﺱ ﺍ ﻳ
ﺍﻴﺲﻭ ﺑﺍﻭCSFکېﺩﺭ ﺍﻡﻭﺮﻴﻪﺳ ﭘ
ﻪﺍﺧﺮﻪﭘ ﻪﭘ ﺍﺳﻄﻪﻭﺘﻢﭘ ﻴﺴ ﺘﻲﺳ ﻴﻓﺎ
ﻌ ﻣ.ﺩږﻱ
ﺎﺕېکږ ﻪCNSکېﭘ ﺮﺱﭘ ﻳﺍ
ﻴﺲﻭ ﺑﺍ
ﻩچېﺩﺭ څﻥګﺭ
ﺍﺷﻲ ﻪﺭﺗﺘﺲﻣﻦځ ﻳ
ﻔﻼ ﻴ ﻧﺴﻭﺍﺮﻭﻱﺍ ﻭېﺍﺧ ﺎ
ﻴﺗﺪﻧ
ﺭګ ﻴﮏېڅ ﻨﻴﻠ
ﻪچېﮐ ﻠ،ﮐږﻱ
ﻴﺐږ ﻘﻌ
ﻪﺗ ﻩﻧﺮﻪﺳ ﻧﺎ
ﻤﻴﭘ
ډﻱﺎﺘﻲﺑ ﻧړﺪېکېﺩﺍ ﻧ
ﺩېﺮﻭﺍﻮﺩ ﭘ ﻣﻲﻧ ﻮ ﺭﻣﺎﺘﺸﻧ
ﺎﺕﺍ ﻳﺭﺯﺭﺘﻲﺟﻦډ ﻧ
ﺮﻝﺍ ﻳﺍ
ﻪﺩېﻭﺧﺖکېﻭ ﻮﭘﻧ
.ږﻱ
ﺪږ ﻧﺭګ Cyڅ totox i
cT- CellInflﻱﻭﻫﻢﺩuxﺭځ ﺍﻪﺍ ﺗ
ډﻝﻣﻦځ ﻪﻭ ګﻥﭘﺮﻭ ﺒﺩﻏ
ﺮﻴ
ﻮ ﻱېﻏ ،ﻳږﻱ
ﺪږﻧﺭګ ډﻱ څ ﺎ
ﺘﻲﺑ ﻧړېﺍ ځﻥګﺮﺱ ﺍ ﻳﺍ
ﻴﺲﻭ ﺑﺍ
ﻪﺩﺭ ﺍﺳﻄﻪﻭ ﻮﭘﻧﻭﺩﻮﺘﻴﻩﻣ ﻭﺩﺩ
Rڅﻪ
apiﺧ dFluroscentI nhibitiont ټﻭﺑﻞﻱېest ډﻱټﺱ ﺍ ﺎﺘﻲﺑﻧﻨﺖﺍ ﻭﺳﺭﻮ ﻠ
ﻴﻢﻓ ﻘ
ﺘﻣﺴ
ﺩ.
ﺭﺕ ﻯ ﺎ
ﺒﻋ
:ﻴﺺ ﺮﻱﺗﺸﺨ ﻴﭘﻮﺗ
ږﻱ
ﻻﻞ کږ ﺘﺲ ﻣ ﻳ
ﻔﻼ ﻴﻧﺴ ﺍ
ﻪچېﺩ ﻧﻮﺘﻟ
ﺎﻪﺣ ﻐ ټﻝﻫﻴ ﺺ کې ﻭ ﺮﻱﺗﺸﺨ ﻴﭘﻮﻭﻍۍﺗ ﺭ
ﺎﭙﻲﻧ ﻧﻲﺳ ﻮ ﻴ
ﻟﺩ
.
ږﻱﻣﻞږ ﺎ
ﺷ
ﺮﺱ)West ﻳﺍ
ﻮﻭ ﺑ
ﺭ ﻭﺍ ﺮﺱﺍ ﻳﺍ
ﻭﻭ ﺮﻴﺘﻧ
،ﺍﺮﺱ ﻳﺍ
ﭘﺲﻭ ﺮﻪﺩﻫ ﮑﺎﺕﻟﻧﺎ
ﺘﻧﺮﺳﻲﺍ ﻳﺍډﻝﻭ
ګﻱ ﻭ ځﻥ ړ
ﻪﺍ ﭘ
113
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
.ﺭ
ﻮ (ﻭﻧNiﺍ l
eVi rus
Herﻪ pes ﻐﻩﻭﺷﻲﻫ ﺮﺭﺳﻴ ﺺﻭ ﺮﻱﺗﺸﺨ ﻴﭘﻮﺪﺗ ﻳﺎﻪ چېﺑ ﻧﻮﺮﺳﻳ ﺍ
ﻬﻢﻭ ﻪﻣﻐ څﻪﻫﻮ ﺧ ﻟ
ﻭﻪټ ﻟ
،
ﺮﺱ ﻳﺍ
ﻭﻭ ﺮﻴﺘﻧﻮﻝﺍ ﻤ ﻌ
ږﻣ ﻭﻝ ﺮﺱﺍ ﻳ
ﺍ Varﻭ icella Zost er، Simpl ex v ir
us t ype 1
ﺮ٦څﻪﺗ
٨Humanentﺧ erov irust yﻭpe ﺮﺱﺍ ﻳﺍﻮﻭ ﻴ
ﻟﻮ،ﭘﺮﺱ ﻳﺍﻭﻮﮑ ﻳ
،ﺍﺮﺱ ﻳﺍCoxsackiﻭ e
ﺩ.
٧ﻱ ١
:
ﻪﻨﻠﻣﺭ
ﺩ
ﺭﻩڅﻴﮏېﺏڼ ﻨ
ﻴﻠﻭﻍۍﮐ ﺭﺎﻪچېﺩﻧ ﻠ
.ﮐ ﻪﺘ
ﻪﻧﺸ ﻨﻠﻣﺭړېﺩ ځﻥګ ﻪﺍ ﻣﻮﻩﮐ ﺭﺎ
ﭙﻟﻭﻍۍ ﺭﺎﭙﻲﺩﻧ ﻧﻲﺳ ﻮﻴﻟ
ﺩ
ﻪﻣﺍ
ﺭﻪﺍﺪﭘ ﻳﺎ
ﻭﻍﺑ ﺭﺎﻌﻦېﻧ ﺩ.ﻳ
ﻮﻱ ﻱ ﻓﻈ ﺎټﻝﻣﺤﺎﺕ ﻭ ﻣﺎﻤﺘﺒﻲﺍﻫ ،ﻃ ږﻱ
ﻪکږ ﺗ
ﻣﻦځ ﺍﻣګﺭﻩﺮ ﻮﻩﺷ ﺪﻧګ
ﺷ.
ﺮﺳﻦګ ﻲ ﻩﻧﻭښ ﺍ ﺮﺘﻪکېﺑﺴ ﻧﻮﺧ
،
ﻡ ﺎ
ﭙﻳ
ﺯﺎﻳ،ﺩﻴﻦﻓﺭﻮﻪﻣ ﮑﻣﻞﻟ ﺭ.ﺩﻪﻭﺷﻲ ﻧﺮﻠ
ﻣﺎﻩﭘﺭﻮ ېﻪﻱېﭘ ﺬﻱ ﺗ ﻐ ﻭﺗﺘﻢﺍ ﻴﺴﻳﻲﺳ ﺎﺒﻲﻭﻋ ﻠ،ﻗﻔﺴﻲ ﻨﺗ
.ږﻱ
ﻮﻝکږ ﮐ ﺭ
ﻪﻭﻱﻭ ﻣ ﺍﺭﺍﺎ
ﺭﻧﺭﻪډ ﻳﻦﮐ ﺯﺎﻣﻭﺮﭘﺭﻮﻠ
ﮐ
:ﻮﻯﻴﻨﻣﺨ
ﭙﻲ ﭖﻧﻲﺳ ﻮﻴﻟﻪچېﺩ ﻠ:ﮐ(Postexposur epr ophy laxiﻮﻯ)s ﻴﻨﺩﻭﻣﺨﻣﺦکﺩ ﺎ
ﻪﺩﻣﺨ ﺘﻭﺳ ﺭ
ﻭ
ﺎﻱېﻗﺎﻥﺩﻭ ﺘﻧﺷ،چېﺩﺍ ﻴﻖ ﻲ ﺒﺍﺗﻄ
ًﺭﻮﻭPEPﻓ ﺎکﺍ ﺭﺩېټﭖﭘ ﺗژﻩ ﺭﺮ ﻮژ ﺪﻝﺷﻲﻧ ﻧ
ژ ژﻩﻭﭖ ښښ
ﺩ.
ﻣﻦ ﻱ ﺯﺍﺯ
ﺭﻍ ﺭﻩډ ﺭﺎ
ﭙﻟ
ﻩډﻪښ ﻮﻯﭘ ﻴﻨﻭﻍۍﻣﺨ ﺭﺎﻪﺩﻧ ﻠﻣ
ﻪﺍ ﻟﻮﻟﺩﻮﻟ
ﺭﻭﺩﺩ ﺰﻧ
ﻮ ﺘﺩﻱﺳ ﺎ
ﺘﺼ ﻗﻮکېﺩﺍ ﻧﻭﺩﺍ
ﻮ ﻴﺣﻝﻫﻭېﻪ ﺎﺩﺩ ﭘ
ﺩ.
ﺭې ﻱ ﺭﻪﻱېﭘﻲښېﻫﻢډ ﻠﻣﺍﺪې ﻤﻪﻫ ﻟ،ﻮ
ږﻱﻧﻩکږ ﺮﺮﺳ ﻪﺗ ﻭﻝﻧ
ﺎکډﻝﭘ
ﻴﮏې ﻭ ﻧ
ﺎﻴﺨﻪﻣ ﻭﭘﺍ ﻴﻦځﻝﺷﻲ ﻣﻪﻭﺍﺳﻄ ﻪﻭ ﻮﻥﭘ ﺑﺎﺪﺩ ﺻ ﻳﺎ
ﺑﻮﻭ ﺩﻭﻱﻧ ﻮﻮﺟ ﺭېټﭖﻣ ﺭ
ﻪچ ﮐ
Centrimoni um ، Benz alKoni um %٤ -ﻪ١ ﮑﺎﺕﻟ ﺒﮐﺮﻧﮏېﻣ ﻭﺮﻴﻢﻟ ﻧﻮﻣQuatﺍ er nar ﺷy.
ﻲ
ﻮﺭﺕﻭﻱﻧ ﻭﺮﻪﺿ .ﮐ ږﻱ
ﺘﻞ کږ ﻴﺴﻪﺍﺧ ﺗ
څﻪ ګﻮ ﺧ ﻟﻮﻠPrﻣﺤ vidonei odi%ﺎne ١brﻳ omi de
ﺷ.
ﻭﻝ ﻲ ﺭﺎﮐﻴﮏﻭ ﺗﻮﻴﺘﻲﺑ ﻧ
ﺍ ﻮﻱﻳﺎﻗﻭﻭ ﺍ
ﺪ ﻳﺎﮐﺴﻮ ﻮﺱﺗ ﻧ
ﺎﺘﻴﺗ
ﺩ
ﻪﺘﺎکېﺷ ﮑﻳﺮﻣېﻪﺍ
ﻪﻱ ﭘ ﻟﻭﻩډ ﻭ،چېﺩ ږﻱ
ﻣﻞږ ﺎﻴﻦﺷ ﮐﺴ ﻩﻭﺍ ﺯﻭﻪPEPکې٥ﺩ ﻴﺲﭘ ﺑﺍ
ﻧﻲﺭ ﺎ
ﻧﺴﺩﺍ
ﺩ.
ﻱ
.
ږﻱﻮﻝکږ ﮐﺭﻭځﻭﻪﺭ ٢ﻣ ١ﻭ٨٤،ﺍ ٧، ٣،ﭘ١
ﻌﻦېﻪ ،ﻳږﻱﺮږ ﺑﺍ
ﺮﺵﺵﻪﻣﺦېﺑ ﻟ ﻮﻟ
ﺎﻬﺯﻣ ﻭﻴﻦﺩ ﮐﺴﺍﺩﻭ
ﺭﺭﻪچږﻱﮐﻮﻝکږ ﮐﺭHumanRabiﻭ es1g20I U/ځﻯkg ﻮﺍ ﻩﻳﺮﻴﻦﺳ ﮐﺴﺍ(ﻭﺭځې)0 ړۍﻭ ﻡﻮﻟ
ﺩ
ﺭځېﻡېﻭ ﻭﻪﺍ ﻮﻟﻟﻰ ﺷ ﻮﮐﺭﺭېﻭ ﻮﺭځېﭘ ﻡېﻭ ﻭ ﺮﺍﻮﺗ ﻪﻭﻱﻧ ﺩﻧ ﻮ
ﻮﺟ ﻴﻦﻣ ﻟ
ﻮﺑﻮﻟ
ﻮﻥ ګ ﻤ ﻳﻭﺱﺍ ېﺍ
ﻭ.
ﺟړﻱ ډﻱ ﻮ ﺎﺘﻲﺑ ﻧ
ﻪﺍ ﻠ
ﭙﻪﺧ ﺪﻥﭘ ﻪﺑﺘ ﻭﺳﺭڅﻪﻭﺭځې ﺧ ﻡېﻭ ﻭېﻪﺍ
ﺩ،ځﻪچ ﻟ
ﻪﻱ ﮐ ړﻦﻧﺎﺍﻳ ﻴ ﻪﺑﺘﻭﺳ ﺭ
ﻭ
.
ﺭړﻱﻭﻩﻪﺍCountﻣﻦځﺗ erPr oduct ivﻮﻝe ﮐﺭډﻱﻭ ﺎ
ﺘﻲﺑ ﻧﺍﻪ ﻨﺸ ﻤ
ﻟﺍﺭﺝ ﺎ
ﺧ
ﻮﻴﻖﮐﺒﻪﺗﻄ ﺗ
ﺭ ﻮﻫﻢPEPﻭ ېﻪﻭﻱﻧﺩﻧ ﻮﻮﺟېګﻞېﻣﻴﮏ ﻳ ﻨ
ﻴﻠﻱﻭﮐ
ﻭړ ﺍﻪ ک ﻌﺍﺟﺮﻪﻣ ﺘﻭﺧ ﺎﻭﻍﻧ ﺭ
ﺎﻪﻧﮐ
.ﻮﻻﻯﺷ
:(Preex posur eRabi ﺩ)es ﺩﻭﻣﺦک ﺎﻣﺨ ﻣﺨﮏېﺩ
.
ﺮﻱﻟﺮﻭ ﺩﻭﺧﻄ ﻣﺦکﺩ ﺎ
ﻣﺨ ﻩﺩﺮﻴﺲﺳ ﺑﺍ،چېﺩﺭ ږﻱﻭﻝکږ ﺭﺎﻩﮐ ﺭﺎ
ﭙﻟﻮﮑﻠ
ﻮﺧ ﻐﻴﻦﺩﻫ ﮐﺴ ﺍ
ﺍﻭﺩ
ﻪﻴﻮﺻﻭځﺗﻪﺭ ٢ﻣ٢ﻭ٨١،ﺍ ٧، ﭘ١
ﺭېﻪ ېﻪﻻﺯﺩﻋﻀﻞ ﻟ ﻭ ﻩﺩﺮ ﺘﻴ
ﻟﻠﻲ ﻮﻣﻴﻦﻳ ﮐﺴﺍﺮﻭﻠﭽModerﮐ ncel l
.ږﻱ
کږ
ﺑﻞکې ﺎﻘﻪﻣﻴﺲﭘ ﺑ
ﺍﻩﺩﺭ ﺭﺎ
ﭙ ﻟ
ﺮﻤﺩټﻝﻋﻮ ﻭ ﻴﻦﻭﺷﻲﻧ ﮐﺴ ﺍﺪﻭ ﻴﺲ ﺿ ﺑ
ﺍﻪﺭ ېﻮﺷﺨ ﺺﺗ ﻮځﻝچ ﻳ ﻳ
ﺪPost ﻳ
ﺎﻮﻱﮐﺲﺑ ﺰﺷ ﻳﺎ
ﻧﻮﻤﻳﺍﻮﻣﺨﮏېﺩ ﻮﻧﻡﺷ ﺎﻩﻣﺨ ﺮﻭﻍۍﺳ ﺭ
ﺎﺭېﻧ ﺭﻪچ .ﮐږﻱﺎﻑګڼﻝکږ ﻌ
ﻣ
ﺷ.
ﻪ ﻲ ﻳﻮﻘﻪﺗﺘﻭﺳ ﺭﺩېﺭځېﻭ
ﺮﺭ ﻭ ﻪﻫ ﺍﺳﻄ ﻪﻭ ﻮﭘ ﻧﻭ
ﺯ ﻭﻩﺩﻭﺮﺩ ﺘﻮﺳ exposurﺑ e
ﻩﺮﺮﺳ ۍﻪﺧﻄﻭﻍ ﻟ ﺭ
ﺎﭙﻲﺩﻧ ﻧﻲ ﺳ ﻮﻴﻪچېﺩﻟ ﻮﺗ ﮑﻠﻮﺧ ﻐﻴﻦﻫ ﮐﺴ ﺍPrﻭ eExposur eRabi es
ﻮﻱﻪ ﺕګﮐ ځﻯﺗﻴﮏ ﺍ ﻤﻳ
ﺪ ﻧ
ﻳﻦچېﺍ ﺮﻓﺎ
،ﻣﺴ ،
ﻧﮏ ﻭﻮ ﺭﮐ ﺎ
ﻩﮐ ﺮ
ﻮﺳ ﺗﺎ
ﻧﺍ
ﻮ ﻴ،ﺣ ﺍﻥﺮ
ﻧﺮﺘﻳ
ﻪﻭ ﮑﻣﺦﻭﻱﻟ ﺎﻣﺨ
114
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
.
ږﻱ
ﻮﻝکږ ﮐ
ﺭﻭ
٢ﺍ١
ﻪﻭﻣ
ﻭﻭﺍ،
ﺭځﻪﻭﻟ
ﻭﺍﻩﺯ
ﺩېﺩﻭ
ﺭېﺭ ېﻪﻻ
(ﺩﻋﻀﻞ ﻟHDCV)HumanDi ploi
dCell Vaccine
ﻮﻱﻪچېﺷﺨ ﺺﺩﻗ ﻠ،ﮐ
ږﻱ
ﻮﻝ کږﮐﺭ
ﻭځﻭ٢ﻪ ﺭ
٧ﻭ٨ﻣﻭﺍ ﺮﺍﺘﻴ
ﻠﻲﻟ٠ﻣ
،ﺭې١ګﻪﻻ
ﻳﺩﺭ ﻟ٢ﻪﺎﻳ٨ﻣ ﺎ
ﺎﻑ ګڼﻝکﻌﺮﻣﻤ
ټﻝﻋډﻝ ﻭ
(ﻭ I
ndivi
dual
ﺩﻱ)ﺍﺮ
ﻔﻧﻪﺍ؛ﻮﭘ
ﻮﻧﺰﺷﻳ
ﺎﻧﻮ
ﻤﻳﻪﺍﺍﺳﻄﻪﻭ ﻴﻦﭘﮐﺴ ﺍ
ﻭ
.
ږﻱږ
ﺍ
ﻭﻪﻭ
ﻭځ ﭘ
ﺩې ﺭ
ﻪﺩﺭ ﻟ
ﻩځﻭﺪﺩ
ﻳﺎﺯﺑ
ﺮﺩﻭ ﺘ
ﻮﺳPostexposurﺑﻮe
ﻮﻧﻡﺷ ﺎ
ﻩﻣﺨ ﺮ
ﺮﺱﺳ ﻳﺍ
ﻪﻭ ﺎﮐﻣﺍ
.ﻠﻲﺍﺧټﻥﻭ
115
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﻮﺱﻧ
ﺎﺘ
ﻴﺗ
(
Tet
)anus
:ﻳﻒ ﺮﻌﺗ
،چې ږﻱ
ﺎﺕږ ﻳﻪﺯﻠﻣ
Tﻪﺍ etﻟanospasmi ﻡﺩn ﺰﭙﻭﺳ ﻮﻥﺍ ﻮﺗ ﺗ،چېﺩﻋﻀﻼ ﻱﻩ
ډﺩ ګﻭ
ﺒﻲ ډ ﻩﻋﺼ ﻮ
ﻳ
.ږﻱﺯﻱﺍﺮ
ﻓﺍﻪﺍﺳﻄ Cﻪﻭ
lﭘ ost r
idium t etani ﺩ،چېﺩ ﻴﻦ ﻯ ﮐﺴ ﻮﻨﻲﺗﻴﺗ
ﻭﺮﻤﻦﭘ ﮐﺍ
ﻭﻮځ ﺍﻳﺩ
ﻮﻟ
ﺪﻳﺯږ
ﻮﻱ ﻱ ﻧ،Generﺩ aliﻪze ﮑ،ﻟږﻱ
ﻪ کږ ﺗ
ﻣﻦځ ﺍ
ﻮﺭ ﻧﻮﻠﮑ ﻴﮏې ﺷ ﻨﻴﻠډﻝﮐډﻝ ﻭﻪﻭ ﻮﺱﭘ ﻧ
ﺎﺘﻴﺗ
.ﻭﻍۍ ﺭﺎﻌﻲﻧﻮﺿ ﻭﻣﺍ ﻮﻧ
ﺎﻣﻮﺎﺷﻣ
ﻣ:
ﻻﻞ
ﻮﻱﻴﻀ ﺩ،چېﺑډﻯ ﺍﺒﺖﺭ ﺜ
ګﻡﻣﺍﺮک ﺭ ﺘﺤ (ﻣ Anaer obiﺯﻱ)c ﺍﻮﺮﻫ ﻴﻮﻏ ﻧﻲﻳ ﺎﺘ
ﻴﻡﺗﻮ ﻳ
ﺪ ﻳ
ﻭﺮﺘﻮﺳ ﻠ
ﮐ
ﺩﺮ
ﻨﺲ ﻟ ﻳﻳﺩټ ﻟګﻱﺎ ډﻝﺩﺮ،چېﺩ ﻭ ﺮﻱ ﻟ
ﺭﻮ ﭙﻪکېﺳ ﺮﺧﻭﺳﺖۍﺑ ﺭﻪﻭ ﻩﻭﭘ،ﺏېﺭﻥګﺍ ﺮﻱﻟﮑﻞ ﺷ
،ﺮﻱﻟﻟﻰﺍ
ﻪﻭ ﺗﺭﻩﻭﺮګﻱﺳ
ﻪﻠ
ﻪﮐ ﻠ
ﻭﮐ ﻭﺍﺯﺎﻴ
ﺘډﻮﻣﻪﮐ ژﻭﭘﻩﺩ ﻭ ﺭﻥګﺍﺪﻤ،ﻫږﻱﺍکږ ﺪﻴﻩکېﭘ ﺭﻭﺎﻪﺧ ړۍﭘ ﺩټﻝېﻥ
ﻡ ﻭ ﺰﻴﻧ
ﺍﺭګ ﻭﺍ
ﻮﻧﻮﻟ
ﺎ
ﻳﺮﻴﭘﺎ
ﻮﭼ ﻨﻳېﻪځﺭﭘ ﻮﻮﭘ ﻧ
ﻮﻠﺮﮐﺍﻯﺷﻲﺗ ﺩ ﺩ
ﺭک ﻮﭙ.ﺳ ږﻱ
ﺍکږ ﺪﻴﻭکېﭘ ﺯﺎﻴ
ﺘډﻮﻣ
ﻪﮐ ﻮﭘﻧﺎﻧ
ﺎﻧﺴﺩﺍ
ﻮکې ﺑﻭﻮﺵﺍ .ﻪﺟﻮﻱﭘ ﻩﮐ ﺭ
ﺎﮐﺭښ ﺍ
ېټﻦګ
ړﺪ ﻳ ﻧﺮﻭﺍ ﻮﭘ ﮐ
ﻮ ﻮﺗ ﮑﻧﻮﮐﺎﻮﭘ ﻠ
ﻴﺑﺑﻼ
.ﺩﻴ ﻭړﻱ
ﺪ ک ﻧ
ﻭکېژ
ﺷ.
ﮐﻻﻯ ﻲ ﺪﻮ ﻧ
ﻭﺭېژ ﻮﻮﭘﻘﻴﻗ٢ﺩﺗ٠ﺮ
ﻭﻴﻦﺍﻠﻨﺴﻪﭘﮑﻮﻟ ﮑ
ﻴﺗﻮﻴﻮﺍﻥټﻱﺑ ﻟ
ږﻱﻭﺩﺏﻝﻻﺏﻝ ﺰېکږ ﺍ ﻴ ﺭ ﺏېﺍﻏ ﻧﮏېﻱېژ ﻭVegetژ ative
.
ږﻱږړﻮڅﻪﺟﻮ ﺧ ﮑ ﻧ
ﻭVegetژ ativﻴﻦﺩe ﻣﺯﺎﭙﻮﺳ ﻧ
ﺎﺘﻴﺩ.ﺗ
ﺎﺱ ﻯ ړﺪېﺣﺴ ﻧMeﺮﻭﺍ
tﭘ ronidazol e
:
ﻮﺟﻲ ﻟ
ﻮﻤﻳﺪﻴﭘﺍ
.
ږﻱﻪکږ ﺘﺍﺧ ﻭﻍۍ ﺭﺎﻪﺩېﻧ ﺎﻥﭘﻧﺎﻧﺴﺍﻮﻥﻴﻠﻴ
ېﻮﻣﮐﻝک ﻳ ﻪﺎ ﭘ
.
ږﻱﺪﻝکږ ﻴﻟډﻝﻳﮏ ﻭ ﺩﺍ
ﺭﻮﭙﻪﺳ ﻮﺱﭘ ﻧ
ﺎﺘﻴﺗ
ﻠﮏچې ﻪﺧ ﻐﺎﻫﻭﻳﺮﻱﺍ ﻟ
ﻴﺖﻭ ﻓﺎﻌګﻯﻣﻴﻢ ړﻠﮏچېﻧ ﻪﺧ ﻐ،ﻫ ﺮﻱﻪﻟﻴﺖﻧ ﻓﺎ
ﻌ ﻠﮏچېﻣ ﻪﺧ ﻐﻩﻫﺮﺗﺎﻳ
ﺯ
ﻠﻰﺍﻏ
ﻪﻭﻱﺭ ﻪﻧﺗﻪﻣﻦځ ﺍﺳﻄﻪﻭ ﻴﻦﭘﮐﺴ ﺍ
ﺯﻭ ﻭﺮﺩﺘﻮﺳ ﻴﺖﻱېﺩﺑ ﻓﺎﻌﻓﻲﻣ ﺎﺭﮐ ﺮﻱﻡګ ﻟ
ﻴﺖﻭ ﻓﺎﻌﻩﻣﺭ ﻮ
ﭘ
.
ږﻱ
ﻪکږ ﺘﺍﺧ
ﻭﻮﺍﻤﻴ
ﻮﺳ ﻟ
ﺍﻮﻴﻠ
ﻮکېﮐ ﺘﺎﺷﻴﻪﻣﺑﻲﭘ ﻭډﻝﺩﺩګﻱ ﻭ ځﻥ ړېﻪ ﺍ
ﻮﺳﻢک ﭘ ګﻡﻣﻪﺭ ﻭﻍۍﭘﻲښېﭘ ﺭﺎﺩﻧ
ﻭ.
ﺎﺕې ﻱ ﻳﻪﻭکېﺯ ﻨ
ﻳﺭﺎﻧ
ﻮﻟ
ﺪﻳﺯږ
ﻭﻱ ﻮﻪﻧﻭﻍۍﭘﻲښېﭘ ﺭ
ﺎﺮﻱﺩﻧ ﻪﻟ ګﻡﻧ
ﺍﻭﺭ ﺮﺘﻲﭘ ﻴﻓ ﺎﻌ
ﻩﻣ ﻮ کېچې ښ ﻧﻭﺩﺍﻮ
ﻴﻮﻫ ﻐﻪﻫ ﭘ
ﻭ.
ﺭې ﻱ ېﺭ
ﻮک ډ ﻧ
ﺎﻣﻮﺎﺷﻣ
ﻭﺪﻝﺍﻳﺭﺩ،ګﺩﻝ ﺭې ک ﺭﻪڅ ﮑﺑړﻲ ټﭖﻟﻪﺩ ﻲﻧ ﺘﻭﺳﺭﻩﭘﻲښېﻭ ﺮﺗﺎﻳ
ﻮﺱﺯ ﻧ
ﺎﺘﻴ
ﺗﺎ کېﺩ ﮑﻳﺮﻣﻪﺍﭘ
.
ږﻱ ﻪکږ ﺗﻣﻦځ ﺍ
ﭖڅﻪﺭ
Punctټ ﺧ ure
ﺍ
ﺪﻴﻮﭘﻭکېټﭖﻧﺸ ځﻮﭘﻲښ ﻨﻪﻳ ﭘ
ﻭ،
ﺎﺕې ﻱ ﻳﻮکېﺯ ﻧ
ﺍﺭ
ﺑګ ﻭﺰ ﻮﺍ ﻧﺎ
ﻧﺍﻮﺎﻏﻪﺑﻮﺱﭘﻲښېﭘ ﻧﺎ
ﺘﻴﺩﺗ
.
ﮐﻻﻯﻮ
Drug ، ﺍﺣﻲ ﺮ
،ﺟ ﻭﺏ ﺮﮑﻴ
ﻏږﻣځﻲ ﻮ ﻣﻦﻧ ،ﺩ Fr ostBi tﺩe، ،
ﺩﻥ ﻮځﺍﻯ ﺷﻲﺩ ﺳ ﺩﺩﻮﺱ ک ﻧ
ﺎﺘﻴﺗ
ﻭ.
ځﻯ ﻱﻮﺍ ﻩﻳ ﺮ
ﺘﮏېټﭖﺳ ﻮﺳ ﭘ
ېﻭﺩ ﺑﺲ ﺍ ﺍ،
abuser ,
Abor tion
:
ﺰﺱ ﻴﻨﻮﺟ ﺘ
ﭘ
ﺩﻭکﻭ.ټ ﻮﻯ ﻱ ړﺷ ﻪﮐﮏ ﺍﺳﻄﻪﻭ ﺭﭘﻮﭙﻮﺱﺩﺳ ﻧﺎ
ﺘﻴﺪ ټﭖﺩﺗ ﻳﺎﻩﺑﺭﺎﭙﺍﺕګﻟ ﻪﺭﺗﻭﻍۍﺩﻣﻦځ ﺭﺎﻧ
ﺩ
ﻪﺩﮑﻮﻟ ﻳﻄﺍ
ﺮﻮﺷ ﻳړﺭځﻥګ
ﺭ ﺍ ﻮﺷﻢ ﻳ
ېﻪ ټﭖکېﺩ ﺯﭘ ﺍﻮﺪﻳﻴﻟﻮ ﻴﻦﺗ ﮐﺴﻮﺗ(ﻭﺩGerﺍ mi nati
ﻪ)on ﻧ
ﺩ
.ږﻱ
ﻩکږ ﺮﺮﺳﻮﻥکېﺗ ﺘﻪﺷ ﻭﺏﭘ ﺮﮑﻴﺎﻝﻣﻌﺎﻓ ﻭﻳﺍﻡﺎﺍﺟﺴ ﻧﻲ ﺮ
ﻬ،ﺑﺎﺝﻧﺴ ﺍﻩړ،ﻡﻟﻰﺍ
ﻮﻤﻳﺸﻦﮐ ﺪﻴﮐﺴ ﺍ
ﻮﻥﮐﺴﻥښﻲﺍ
ﻩ ﻟ ﺮ
ﺮﺥېﺳ ﺮﻱﺑ ﻪﺍﺧﻟﻭﻥ ﺭﻮﻴﻧ
ﺭﻮﺗﻮﻴﻄﻲﻣ ﻣﺤ ﻮﺩ ﺪﺷﻲﻧ ﻴﻟﻮﻴﻦچېټﭖکېﺗ ﮐﺴ ﻮﺗ
116
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﻪﺘ
ﻟ،چېﺩ ﺩږﻱ
ﻟږﻱﻪﻲ ﻮﺟﺴﻢﺗ ﮑﻧ
ﻭ ﺒﻲژﺎﻉﺩﻋﺼ ﻮکېﻧﺨ Bﻭﺩﺷrﺍ ai
nsSt .ﺩ em ږﻱﻠﻲﺍﺧ ﻪﺩﺗ
ﺎﺩﻴ ،چېﺑ ﻮﻱﻪﺭﺳ ﻨﻞﺗ ﻴ
ﻣﺮﻴﮏﺗ ﺘﭙﻨ
ﻳﺎﭘې ﺳ
ځﻥ ﺮﻭ ﺍ ږﻱﺍ ﺮﻱﻴ
څﻪﺗ Syﺧ ﻪ naps ﻴﻦﻟ ﮐﺴﻮﺗ
ﻪﻠ
،ﮐﻴﺴﻲ ﻪﻧ ﻧﮏېﻣﺨ ﻭﻮ ﻬﻰﮐ(ﻧﺪ)GABA ﻴﺍﺳﻳﮏﺮﻳﺎﺗ
ﻮﻴﻮﺑ ﻨ
ﻴﻣﺍګﺎ
ﻣﻭﺍ ﺍﻴﻦﻳﺴﺮګﻻ ﺘﻴﻤﻧﺴﺍ
ﺮﺗﻭ ﺭ
ﻮﻴﻧ
ﺭﻮ
ﺗﻮﺎﻣﻔﻟﺴﺍ RestﺩingFi reRatﻱﻭeږﺍ ﻤﻲ ﺩﻝﮐ
ﻬﻲکﺩ ﺷ؛ﻧ
ﻮﻝ ﻲ ﻴﻧ
ﻪﻭ ﻧﮏېﻣﺨ ﻭﻮﻬﻲﮐ چېﺩﻧ
ﺎﻉ
ﻮکېﻧﺨ ﻟﻰﺩﺷ ﺍﻮ
ﻤ ﺩﻮﮐﻟ
ﻬﻲکﺩ ﻩﺩﻧﺭﻥګ ﺍﺪ
ﻤ.ﻫږﻱﻻﻞکږ ﻟﻲ ﻣ ﺍ
ﻮﺩﺩﺷﺨ ږﻱچېﺍ ﺗﻲﺎ
ﻳﻭﻥﺯ ﺭ
ﻮﻴﻧ
ﺪېﻫﻢ ﻧ
ﺎﻮﺑ ﻧﻭﺭ
ﻮﻴﺎﺕککﻧ ﭙﻤﻴﮏﺳ ﻧﻮﻴﻟ
ﺎﻥګﺮﻱﮐ (کېﺩﭘ Gr ayMat terﺩې) ﺎ
ېﺥېﻣﺰ ړ ﻴړﺧ ﭘﺍ
ﻪ
ﻧﻲﺍ
ﺭﻭځﻯﺩﺩ ﻮﺍ ﻩﻳ ﺮ
ږﻱچېﺩېﺳ ﺗﻲﺎﻳ
ﻴﺖﺯ ﻟﺎ
ﻌﻮﻓﺑﺎﺎﺕککﺍﻋﺼ ﭙﻤ
ﻪکېﺩﺳ ﻠ
ﻳﺎﻪﭘﻭﭘ ﻮﻱﺍﻩﮐ ﺰ
ﻴﺍﻏ
.
ږﻱږړېﻮ
ﺍﻥک ﻟ ﺭﻭﻪﺩ ﻪﻫﻢﭘ ﻮﮐﭽ ﻨ
ﻴﻣﺍﻮﻝ ﮑﻴﺘﮐ
ﮑﺸﻦکېﺩ ﻨﺒﻲﻋﻀﻞېﺟ ېﻪﻋﺼﺷ،چ ﭘﮐﻻﻯ ﻲ ﺎﻥ ﻮ ﻪﺷ ﻴﻦﭘ ﮐﺴ
ﻮﻡﺗ ﺰ
ﻴﻟﻮﻴﻦﺩﺑﭽ ﻣﺯﺎﭙ
ﻮﺱﺳ ﻧﺎﺘ
ﻴﺗ
ﻌﻲﻮﺿ ﻪﻣ .ﭘږﻱ
ﻪ کږ ﺗﻣﻦځ ﺍﻠﺞﺭﺎﻓﺘﻲﻳ ﻪ کېﺳﺴ ﻠﻳ
ﺎﻪﭘﻴﺴﻲچېﭘ ﻪﻧ ﺯﻣﺨ ﺍﺮﻓ
ﺮﺍ ﺘﻤﻧﺴﺍ
ﺮﺗﻭ ﺭ
ﻮﻴﻧ
ﻭ.
ﻮﻱ ﻱ ﻴﺐﺷ ﻌﺼﻪﺗﺍﺳﻄ ﻪﻭ ﻭﻑﻋﺼﺐﭘ ﺎ
ږﻱچېﻣ ﻣﻦکږ ﺰ
ﻴﺍﻏﻪﻋﻀﻼﺕ ﻐ
ﺯېﻫ ﺍ
ﻮ ﻮﺱکېﻳ ﻧﺎﺘ
ﻴﺗ
:ﻩﻴﮏېﺏڼ ﻨﻴ
ﻠﮐ
Gener alizedTet anus
ﻭﻭځ
١ﺭ ﻭکې٤ %١ﭘﻲښ ﭘ٠
ﻭﻪ ﺭځېﺍ %١کېﺩ٣ﻭ .ﻪ٥
ﻩﭘ ﺭڅېﺩﻩﻱې٧ﻭ ﺭﻭﻳﺦﻣﻦځﻥۍﺩ ﺮﻔ
ﺗﺩ
ﻭ.
ﻪﻱ ﺗ
ﺎﻳڅﻪﺯﺧ
(چې Tri
smusorl ږﻱ)ockJaw ﺗﻲﺎﻳ
ﻮﻥﺯ ﻮﺗﺗMassetﻋﻀﻼ ړﻯﺩer ﻡﻮډﻝﻟګﻱ ﻭځﻥ ړﻪﺍ ﭘ
ﻟﻰﺍ
ﻮړېﺷﺨ ﺎ،ﺩﻏ(Dysphagi ﻩ)aﺰﻧﻮﺘ
ﺪﻥېﺳ ﻳﺮ
ﻴﺗړۍﺩ ﻡﺩ.ﺩ
ﻮﻯ ﻯ ﺩﻝﺷ ﻭ ﮑﻞکې ښ (ﺷ ١
٣ -٢ﭘ)
ﻪ
.ﺑ
ږﻱﻪکږ ﺗﻣﻦځﺍﻪﺭﺘﻭﺳ ﺭﻩﻭږڅ ﺎﻝﻭﻳځﻯﺍﻮﺍ ﻩﻳﺮﺩﺩLockJawﺳ ﺭﻮﺩ ﺗﺩﻼﻋﻀﻼ ﻭﻭ ﻣ
ﺍږﺍ ،ﺩﻭ
ﺪﻳ
ﺎﻟﻰﺑﺍﻮﻮ ﺷﺨ ﺗﻱېﻋﻀﻼ ﻪﺩ ګ ډ ﮑ،ﻟږﻱﺪﻱﻧﺭګﻪڅ ﺘﻭﺳ ﺭﺩﻝﻭﻪ کﺩ ﺘﻮﺍﺧ ﺗ
ﻭﻋﻀﻼ ﺭﻮﻧﻩﺩ ﺮﻼﺧ
ﻩﺭ
ﺍﺪﻣﺍ
ﻭﻮﺩ ﺗ
ﻣﺦﺩﻋﻀﻼ .ﺩږﻱﻪﺷﺨﻲ ډﻝﻧ
ﺒﻲ ﻭ ﻪﻧﺴ ﻭﻋﻀﻼﺕﭘ ﻭ ﭖښ ﻮﺍ ﻧ
ﻮﻳﻞﺷﻲچېﺩﻻﺳ ﻭﻭ
ﺩﻼﺩ
ﻭﻣ ﻮﻯﺩﻯﺍ ﺩﻝﺷ ﻭﮑﻞکې ښ (ﺷ ١٤-
٢ﭘ)
ږﻱچېﻪ Rﻻﻞکږ iﻣ susSor doni ﻠ ﺺﺩcus ﻘﺗ
.
ږﻱﺩﻝکږ ﻭﮑﻞکې ښ (ﺷ ١٢-
٢ﭘ)
ﻮﻱچېﻪ ﮐﺭﮑﻞﻭﺎﻥﺷ ﻤ
ﻼﻪﺩﮐﻠ ﺺﻣ ﺗ ﻘﻮﺗ ﺗ
ﻋﻀﻼ
ﺒﺐکﺯﺱﺳ ﻮﻧ
ﺎﻴ
ږﻱچېﺩﺳ ﺪﻱﻧ
ﺭګﻡڅﺰﭙ
ﻮﻱﻋﻀﻞېﺳ ﻠ
ﻤﺪﺣﻳﺪﻪﺷﮐﺎ
ﻧﺩﺭﻮکېﺩ ﻧ
ﺎﻭﻏﺭ
ﺎځﻮﻧ
ﻨﻪﻳ ﭘ
ﻪ
ﻠﭙﻪﺧﺍﻯﺷﻲﭘﺩﺩ
ږﻱچېک ﻪکږ ﺗ
ﻣﻦځﺍ
ډﻝﺭﺭﻱ ﻭ
ﺍﺮﮑ
ﻪﺗﻡﭘﺰ
ﭙﻭ.ﺍﺳ
ﺍښﻱﺩ ﻭﻪګ ﻳﻮ
ﻬﺘﻰﺗږﻱﻭﺣ
ږﺍ
ﺷ.
ﺪ ﻲ ﻳ
ﺪﻪﺷ ﺍﺳﻄﻪﻭﻪﭘﺒﻨ
ﮐﻢېﺗﺎﺩﻭﻳ
ﺍ
ﺩ.
ﻮﻱ ﻱﻳﺸﻞﺷ ﻮﻭﻟ
ﻭﺩېډ
ﻪﺭ ﻮﺱﭘ ﻧﺎ
ﺘﻴ
ﻩﺗﺮﻪﻧﻈﻟ
ﺪﺕ ﺩﺷ
ﻪ
ﺩﻧﻮﻮﺟﻡﻣﺰ
ﭙﺎﻫﻲڅﺳ ﺭﮐﻢﻳﺭﻟﻰډ
ﺍﻮ
ﻮﺷﺨ ﺗﻟﺖکېﺩﻋﻀﻼ ﺎېﻪﺩېﺣ
:چ ﭘ ﮑﻞﻴﻒﺷ ﻔ .ﺧ 1
ﻭ.
ﻱ
ﻭ
،ﺷﺨﻲﺍﻩ
ﺰﻧﻮ
ﺘﺩﻥې ﺳ
ﺭﺩﺭړۍ ﺕ،ﺩﻡTr
iﻟﺖ کېsmus ﺎ
ﻪﺩېﺣ :چېﭘ ﮑﻞځﻰ ﺷ .ﻣﻦﻧ 2
117
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﻭ.
ﺩﻱ ﻮ
ﻮﺟﻡﻣ
ﺰﭙﺳ
ﻭ.
ﻩﻱ ﺩ
ﻮﻮﺟ
ﻭﺷﺨﻲﻣ
ﺍﺎﺕ
ﺘﻼﺟ
ﺍﺧﺪ
ﻳﺪﺭﻱﺷ
ﺍﺮ
ﮑ:ﺗ
ﮑﻞﺪﺷﻳ
ﺪ .ﺷ 3
118
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
.
ږﻱﺑﻲﺍ
ﺮېﻪﺧﻮک ﻧ ﻧﺎﻭﻏﺭﺎ
ﻪﺩېﻧ ﻟﺖﭘﺎﺎﻏﻲﺣﻣﺮﻱﺩ ﻠ
ﻧﺎﻱېﻭ ﻭﻳﺍﺮﻱﻟ
ﻪﻭ ﺒﺍﻯﺷﻲﺗ ﺩﺩﻭﻏﻰک ﺭﺎ
ﻧ
ﻩﺩړ،ﺩﺯﻟﻰ
ﺍﻭﻟړ
ﺭﻮﺎ:ﺩﻓﺸ ﻪﻟﺭﺕﺩﻱ ﺎ
ﺒﻭﻥښېﻋ ﺪﻳړﺎ
ﻳﺠﻭﻭ ﺪﻧﻴﮏﺩ ﻣﻮﻧ
ﻮﺗﻭﻮکېﺩﺍ ﻧﺎ
ﻭﻏ ﺭﺎ
ﻪﺩېﻧ ﭘ
ﻭﺯ
ﺍﻴﻄﻲﻭ ،ﻣﺤ (
Hy perpy r
exiﺭﺕ)a ﺍﺮﻟړ ﺣ
،ﻮﻪﻟﻮﻩﺧ ﺭﺭ
،ډ ﻟﻰﺍﻮﺑ
ﺍﺮﺘﻢ ﺧ ﻳ،ﺭﻟﻰﺍ
ﻮ ﺗ
ﺎﻳﻮﺯ ﺗ
ﺎﮐﺮﺣ
ﻩړ
ﺍﻯﺷﻲﺯ ﺩ
ﺩﻪک ﻠﻪﮐﻠﻟﻰﮐ ﺍ
ﻮﺗ
ﺎﻳﺯېﺯ ﺍ
ﺪﻧ
ﺍﻴﻦﺩﻣﻮﻝﺍ ﮑﻴ
ﺘﺩﻼﺎﺩﮐ
ﻣ ﻭ ﭘﺯ ﻭﺍﺯﺎﻴﺘﻮﻣ ﺗﺸ،ﺩﮑﺸﻦ ﻳﺮﺘ
ﻧﺴ ﺎ
ﮐ
ﺩ.
ﻪﻯ ﻡﻧﻮﻠﻌ
ﻴﻞﻱېﻣ ﻟږﻱچېﺩ ﺭﻱ ﺩډﻝﻭ
ﭘﻲ ﻭ ﺍﻧڅ
ﻪﺎ ﭘ
ﻮﻧ
ﻭ ﺪ
ﻳﺭﻭﻭﺭﻭﺩ،ﺩژ
ﺩﻝ ﻳېک ﻮڅﺮ ﺗ،ﻋﻀﻼ ﺪﻝﻴﺗ
ﺎﻮﻣﮐﻭﺩډ
،ﻩ ﺎ
ﻴﻧﻮﻤﻳﺸﻦﻧ ﺮﻳﺎ
ﭙﻪﺍﺳ ﮑﺎﺕﻟ ﺘﻼﺟ ﺭﺍﺧﻮﻧ
(ﻫﻢRhabdomy olysiﺩﻝ)sﻪکﺩ ﺑ
ﻭﻮﺍﺗﻭﺩﻋﻀﻼ ﻪﺍﻧﻮﭘ
ﺮټ ﺘﺑﺴ،ﺩﻡﺰ
ﻴﻟﻮﺒﻣﺮﻱﺍ ﻧ
ﻮﻤﻠ،ﭘﺯﺱ ﻮﺒ
ﻣ ﺮ
ﺗ
ﺷ.
ﺍﻯ ﻲ ﺩﺩﻪک ﺗﻣﻦځ ﺍ
ﺭ
:
ﻴﺺ ﺗﺸﺨ
ﺩ.
ړﻯ ﻴﮏېﺏڼېﻭﻻ ﻨﻴﻠﻪﮐﻴ ﺺﭘ ﻭﻍۍﺗﺸﺨ ﺭﺎﺩﻧ
ﻪټ ﻟﻧﻲﺎ
ﺘﻴ
ﻡﺗ ﻮ
ﻳﻭﺪﻳﺮﺘ
ﻮﺳ ﻠﺍﻯﺷﻲﮐ ﺩ
ﺩﺷ.کﺍ ﻲﺮﻪﺍﺟ ﻧ
ﺮﭖڅﻪﮐ
ﺪﺩټ ﺧ ﻳﺎﻩکېﺑ ﻪﭘﻲښ ﻨ
ﻤﮑﻪﺷ ﭘ
ﺷ.
ﺪ ﻲ ﻳ
ﺮړﻱﺗﺠ ﻪک ﺗ
ﻣﻦځ ﺍﻭﻏﻲﺭﺭﺎﻪﺩېچېﻧ ﻟﻪﺗﺮﭖڅﻪﭘ
ﺧ
ﻭ.
ﻣﻞ ﻱ ﺭﺎﻪﻧﻨ
ﻳﺎﻌﻊﻣ ﻳﺎ
ﺩCSFﻣ
ﻭ.
ﻪﻱ ﺗﺎ
ﻳﻳﻲﺯ ﺍﻩښ ﺯﺍﺪﻧﺍﻮﻧﻮﻤﻳ
ﺍﺰﻧ
ﺍ ﻮﺩﺗﺩﻋﻀﻼ
ﻪﮑﻮﻱﻟﻪﮐﺗﻣﻦځﺍTrﺭiﻩچېsmus ﺮ
ﻮﺳ ﻧ
ﻮﺘﻟ
ﺎ
ﻮﺣ ﻐ
ﻮﻫ ﻟﻭﻪټ ﺪﻟ ﻳﺎ
ﻴ ﺺﺑ ﺮﻱﺗﺸﺨ ﻴ
ﭘﻮ ﻭﻍۍﺗ ﺭﺎ
ﻧﺩ
ﻭ(ﺍMetoclopramiګﻥ)d ﺮﻭ ﺒګﻮﻏﻧﺍﺍﻭDyﺩ stonic،ﻤﻢ Stﺗﺴ ry
chi nine ،،
ﺮ ﺧﻦځ ﻟ
ﻮﻳﻮﻟ
ﺍ
.
ﻩﻭﺷﻲ ﺮ(ﺳ Tetaniﺩ)ﻮﺒﻤﻴﻢﮐﻠﺴﮐ(ﻭﺩPhenotﺍ hiazin
ﻧﻲﻮﻴﻟ
،ﺩﺘﺲﻳﻔﻼﻴﻧﺴ،ﺍ
ﺘﺲ ﻳ
ﺎﻨﺠﻨﻪﻣ ﮑ
ږﻱﻟﻪ کږﻟﻄﺎ
ﻐﻩﻣ ﺮﻮ ﺱﺳ ﻧﺎﺘ
ﻴﻪﺗﻪﻫﻢﻟ ﻧﻮﺘﻟ
ﺎﺭﺣ ﻮﺮﻧﻴﻤﻮﺷ ﻳ
ﻭ.
ﻡکې ﻱ ﺎ
ﻪﭘ ﺪﭘﻳﺎ
ﺩﺑﻄﻦچېﺑ ﺎﻭﺣ ﺍﻭﻏﻲ ﺭ
ﺎﭙﻲﻧ ﺳ
:ﻪﻨﻠ
ﻣﺭﺩ
ﻪﻭﻱﺩ ېﻥښﻲﻧ
ﺗ ﺮچ ﻪﺯﻫﻐ،ﻫ ړﻝﻩﻭﻪﻣﻦځ ﻊﻟ ﺒ
ﻨﻣﻭﺩ ﺮ
،ﺩﺯﻫ ﻪ
ﻧﺭﺍ
ﻊېڅ ﻣﻲﻭﺿ ﻮﻤﻭﻍﺩﻋ ﺭﺎ
ﻧﺩ
119
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﺟړ
ﻨﺲټ ﻮ ﻠﻦېﺑﻣﺭ
ﻮﻝﺩﺩ ﻪﮐﻳﻮﻘ
ړﻮﺗ
ﺗﻲﻍﻳ ﺎ
ﻴﻭﺩﺣﻮﻯﺍ ﻴﻨ
ﻡﻣﺨ ﺰﭙﻮﺩﺳ ﺗ،ﺩﻋﻀﻼ ﻮﻝﻮﻯﺑﻼکﮐ ﻐﻫ
ﻭ.
ﻱ
:ﺎﺕ ﻣ
ﺎﻤﺘ
ﺍﻫ ﻣﻲﻮﻤ .ﻋ 1
ﺷ.
ﻟې ﻲ ﻭڅﻪﺮ
ﻡﺭ ﺧ ﺎ
ﺍﺟﺴﻧﻲﺮﻬ
ﻭﺑﺍﺎک،ﺯﺧﻢﭘ ﺮ
ﺘﻩکېﺑﺴ ﻮټ ﻪﮐﻣﺍﺭﺍﻪﺪﭘﻳﺎ
ﻭﻍﺑ ﺭﺎ
ﻧ
:
ﻪﻨ
ﻠﻣﺭﺪﺩﻭﺏ ﺿ ﺮ
ﮑﻳﺎ
ﻣ .ﺩ 2
ﻩ
ﻊﺩ ﺒﻨ
ﻴﻦﻣ ﮐﺴﻮﻩ چېﺩﺗ ﺭ
ﺎﭙﻮﻟﻟ
ړﻩﻭﻪﻣﻦځ ﻮﻟﮑﻧﻭVegetژ ati
ﻣﻞﺩon ﺭ
ﺪﺩ ﻭﺏ ﺿ ﺮﮑ
ﻳﺎﻣﺩ
.
ﻴﻦﻠﻨﺴ.ﭘږﻱﻟﻲﺎ
ﻤﻌﺘﺍﺳ
ﻪﻣ
ﺍﺭﻠﻲګ٥ﻣ٠ﻭﻝ٠ﺯﺍ
ﺪﻴﻧ
ﻭﺮﺘ
ﻴﺪﻣ ﻧ
ﻪﺍﻮﭘﻧ
ﺎﻮﻫ
ﻮﭘ ﻨ
ﻳﺭﺩځ ﻩﻡګ ﺭﺎ
ﭙﻭﻟﻭځ
ﻟﺲ ﺭ ﺪﻱﺩ ﻳ
ﺭ ﻪﻭﻧﻮﻴﻠ
ﻴ١ﻣ٢-
١٠
ﺩ.
ﺭﻯ ﻭﻪګټ ﺘﻭﺳﺭﻪﻭﺘﺎﻋ
١ﺳ ﻫ٢
ﻳ١ګﻡ ﺮ
ﺍ
ﻪﺎ ﺭ ﺘﺎﻋ
ﻫ٦ﺳ ﺮ
:ﻪﻨ
ﻠﻣﺭﺪﺩﻴﻦ ﺿ ﮐﺴﻮﺗ .ﺩ 3
.
ﻭﻱﺪﻨېﻪﻭﻱﺑ
ﻮﻥښﺕ ﻧ ﮑﻧ
ﻭﺒﻲژ ﻪﻋﺼ ﻴﻦﭘﮐﺴﻮﻪﺗﻐﻭﻫﺍ ﻧﻲﺍﺭ
ﻭﺯېﺩ ﺍ
ﻮﺍﻳﺩ
ځﻪ
ﻮﮐﻧﺯﻭ
ﺮﻱﺩ ېﻪﮐﺴ
ﺭﭘ ېﻪﻻ
ﻪﺩﻋﻀﻞ ﻟﺘ
ﻧﻮ٦ﻳ
٠٠٠
-٣٠
٠(٠
HIG)Humanimmunegol
obul
in
ﺯﻱېﻭ
ﺭﻱﺩ ﺍ
ﺮﮑﻮﺗﺮﻱﻧ
ﻟHal
fli
fﺩe
ﺍږ
HIﻭ
ﻩچېG ،څﻥګ
ږﻱ ﺭ
ﻮﻝکږ ﮐ
ﺭﺎﺕﺩﻯﻭ
ﻳچېﺣﺠﻢﻱېﺯ
ﺩ.
ﻪﻯړﻦﻧ
ﺍﻳ
:
ﻭﻝﺮ
ﺘﻨﻡﮐ
ﺰﭙﻮﺩﺳ
ﺗﺩﻋﻀﻼ .
4
.
ږﻱ
ﻭﻝکږ
ﺭﺎﻩﮐ
ﺭﺎﭙ
ﻟﻮﺥې
ﺩېﻣ
ګﻩﺩ
ﻪډﺎﭘ
ﻭﻳﺍ
ډﻝﺯې ﻭ
ﺍﻮﻪﻳ
ﻣﻞﭘ
ﺭﺎﺕﺩ
ﻳﺮﺯ
ﻴﻤﻮﺷ
ﻳ
ﻮﻻﻯ
ﮐﺭﻭځﻭ
ﻪﺭﻪﭘ
ﻣﺍﺭ
ﻠﻲګ ٢ﻣ
٥ﺗ٠
.ﺁﻥﺮږﻱ
ﻭﻝ کږ
ﺭﺎﺎﺕﮐﻳ
ﻴﺴﺖﺩﻯﺯ ﻧ
ﻭﭙﻢچېGABAﺍګ ﻳ
ﺯﺎ
ﻳﺩ
Halﻱېﮐﻢﺩﻯﻫﻢfl
if
ﻟﻢچې eﻭﺯ
ﺍډﻭﻣﻲ
ﺎﺕﺩﻯﺍ ﻳﻡﻱېﺯ ﺍ
ﻭﺰېﺩﻴ
ﭙﻢچېﺩﺍﻏ ﻳﺯ
ﺍﺭ
ﻮ.ﻟﻮﺷ
ﺩ.
ﻣﻞ ﻯ
ﺭﻭﻫﻢﺧﻂﺩﻳﻦﺩﺯﺎ
ﻣﻭﺮﭘ
ﻭﺭﻮ
ﻠﻭﮐﺍﻳﺖ
ﺭﻮﺘﺑ
ﺭﺎ
ﺩ.ﺑ
ﻣﻞ ﻯ
ﺭﻣﻦﺩﺰﻴ
ﺍﻏ
ﻪچې
ﻠ،ﮐ
ږﻱ
ﻭﻝ کږﺭ
ﺎﻪﻭﺧﺖﮐﻐﻣﻞﻫﺭﻧﮏېﺩﻭ
ﻮﻬﻲﮐ
ﺒﻲﻋﻀﻞېﻧﻭﻋﺼ ﻴﺸﻦﺍ
ﻠﻴ
ﺘﻨﻳ
ﻴﮏېﻭﻧ
ﺎﻴﺨﻣ
ﺷ.
ﻻﻞ ﻲﻟﻲ ﻣ
ﺍ
ﻮﺑﺍ
ﺮﻮﻱېﺩﺧ
ﻬﺗﻡﺩ
ﺰﭙﺎﺳﻱﻭﻳ
ړﺍ ﻪک
ﻩﻧﺭ
ﺎﮐګﻥ ښ
ﺮﻭﺒ
ﻩﻏ ﺮ
ﻮﺳﻠﻣﺭ
ﻭﺩﺭﻮ
ﻡﺩﻧﺰﭙ
ﺳ
:
ﻪﻧ
ﺭﺍ
ﻔﺲڅ
ﻨﺗ
ﺩ
ﻮکې
ﻧﻮﺘ
ﻟﺎ
ﻧېﺣ
ېﻪﻻﺪ
ﺯﭘﺍﻮ
ﺎﻳځﻯﻳ
ﻮﺍﻩﻳ
ﺮﻴﺸﻦﺳ
ﻠﻴ
ﺘﻨﻳ
ﮑﻞﻭ
ﻴﻧﺎ
ﮑﻴﻪﻣ
ﻟﻣﻲ
ﻮﺘﻮﺳ
ﻴﺍﺧ
ﺮﺎﺗ
ﻴﺸﻦﻳ
ﺑﻮﺘ
ﻧﺍ
.
ږﻱ
ﻭﻝکږﺭﺎ
ﮐ
ﺍﻏﻞې
ﻪﺭﺗ
ﻪﻣﻦځ
ﻠﺒ
ﻪﮐﻡﻟ
ﺰﭙﻭﺳ
ﺮﻥګ
ﻟOﺎﺩ
vﻳ erSedat
iﻩچېﺩon
ﺭﺎﭙ
ﻴﺸﻦﻟ
ﻠﻳ
ﻳﻦټ
ﻭﻮﭙﻳ
ﺎﻪﻫ
ﻐﺩﻫ-
١
.
ږﻱ
ﻭﻝکږﺭ
ﺎﻮکېﮐﻧ
ﻮﺘﻟ
ﺎ
ﺣ
ډ
ګﻭ
ﻮډﻟ
ﻭﺮﻴ
ړۍﺩﺗ
،ﺩﻡ
Tri
ﺭچېsmus
ﻮﻨﻈ
ﻪﻣﻮﻱﭘ
ﻴﻨﻳﺸﻦﺩﻣﺨ
ﺮﻴﭙ
ﻮکېﺩﺍﺳﻧ
ﺎﻭﻏﺭ
ﺎﻪﻧﻐ
ﻪﻫ ﭘ
-٢
.
ﺮﻱﻟ
Dyﻭsphagi
ﻳaﻱﺎ
:
ډﻱګﻭ
ﻭډﺪ
ﻧﻮﺩﺩ
ﺑﺎﺍﻋﺼ
ﻴﮏﻣ
ﻮﻧﻮ
ﺗﺍﺩ
ﻪځﻣﻮﻠﻲﻭﻱﮐﺍﻏ
ﻪﺭﺗ
ﻪﻣﻦځ ﻠ
ﻣﻪﺍﻟﻲﻟ
ﺍ
ﻮﺗﺎ
ﻳﻴﺖﺩﺯﻟ
ﺎﻌ
ﻮﺩﻓﺑﺎ
ﺎﺕککﺍﻋﺼ ﭙ
ﻤډﻱچېﺩﺳ ګﻭ
ﻪ ډﻐﻫ
ﻭﻝ
ﺭﺎﺍﮐ
ﻮﻟﺨﻮ
ﻧﺎﻮﻫ
ﻮﭘﻨ
ﻳﻼﺮﺩﻯﺩځﺎﺑﮐﺘ
ﻴﻭﺑ
ﺎﺍﻔ
ﻟېﻮﺍ
Labetچ ﻳol
ﻫol
ﺎﻢ ﻴ
ﺮﻱﺑﻟﻪ
ﻪﻧﻨ
ﻠﻣ
ﺭړېﺩﺍﻥګ
ﺩ.
ﻮﻯ ﻯ ړﻝﺷﺭک
ﺭﻭﻮﭘﺍ
ړﻦېﺭ
ﭘﻲﻡﻳﺍﻧڅ
ﻩﺩﺎﺮﻩﺳ
ﺮﻭﻥېﺳ ﺭ
ﺎﻪﮐ
ﻟﻮﻠﻣ
ﺭﺩېﺩ
ﺭﺩ،ﻡګږﻱ
کږ
:
ﻮﻯﻴ
ﻨﻣﺨ
ﺩېﭘ
ﺭېﺩﺭ
ېﻪﻻ
Toxoiﺩﻋﻀﻞ ﻟ
ﻮﺱd
ﻧﺎﺘ
ﻴږﻱچېﺩﺗ
ﻩکږ
ﺮﺮﺳ
ﻪﺗﺍﺳﻄ
ﻪﻭﻳﺸﻦﭘ
ﺰﻳﺎ
ﻧﻮﻤ
ﻳﺎﻝﺍ
ﻌﻓﺩ
120
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﺭړ
ﻭﻪﺍﺗ
ﻴﺖﻣﻦځ
ﻓﺎﻌ
ﻡﻣﺎ
ﻩﺗﺭ
ﺎﭙ
ﻟﮐﻮ
ﻟ
ﻭﺎډﻝﺩﭘﻦځ
ﺰﻭﻳ
ﺩﻭ.ﻪﺩ
ږﻱﭘ
ﻮﻝکږ
ﮐﺭﻩﻭ
ﺭﺎﭙ
ﻟﻮﺘ
ﺎﺷﻴ
ﻪﭘﺲېﻣ
ﻟﺭ
.
ﻱ
(ﻭﺧﻞې)DPTﺭېټ
ﻮﻭﺗ
ﺎﺍﻳ
ﺮﺘﻔ
ﻳ،ﺩ
ﻮﺱﻧﺎ
ﺘﻴ
څﻪﮐﻢﻭﻱﺩﺗ
ﮐﻮ ﺧ
ﻟ
ېﻪ٧ﺎﺮﻱ ﻟﻤ
ﺎﻥچېﻋ ﻭﻏﺭ
ﺎﻪﻧ
ﻐﻫ
ﺭﻱﺍ
ﺮﮑﺎﺕﺗ
ﻳ.ﺩﺯ
ږﻱ
ﻩکږﺮ
ﺮﺳﻪﺗﺘ
ﻭﺳﺭﮐﻪﻭ
ﻟﻟﺲﺎﺭﻕﻱېﺮﺯﺘ
ﻮﺳ.ﺑږﻱ
ﻪکږﻴﻮﺻﻪﺗ
ﺗﺭﻴﻦﻭﮐﺴ
ﺍډﻭګ
ﺷ.
ﺍﻯ ﻲ
ﺩﺩﻻﻞک
ګﻥ ﻣ
ﺮﻭ ﺒ
ﻩﺩﻏړﺭکﺯﻭ
ﻭﺩ
ﺭﺝې
،ټﻱټېﺩ
ﻮﺏړﺳ
،ﭖﻴﺖ
ﺎﺳﻌﻲﺣﺴ
ﻮﺿﻪﻣ
ﻟﺭﺕﺩﻯ
ﺎﺒ
ګﻥﻋ
ﺮﻭ ﺒﻴﻒﻏ
ﻔﺪﺧﻴ
ﺋﻮﮐﺴﻮﻮﺱﺗ
ﻧﺎﺘ
ﻴﺩﺗ
ﺩ.
ﺭﻯ ﺩ
ﺎګﻥﻱېﻧ
ﺮﻭﺒ
ﺪﻏ ﻳ
ﺪېڅﻪﺷ
ﺗﺐ ﺧ
:
ږﻱ
ﻮﻝکږ
ﮐﺭﻮکېﻭ
ﺗﺎﻻ
ﻧېﺣ
ﻴﺖﻻﺪ
ﻓﺎﻌ
ﻌﻞﻣ
ﻔﻨﻣ
ﻠﻰﺍﻏ
ﺎﺱﺭﻤﻪﺗﻩﭘﺮ
ﻭﺳ ﺯ
ﺎﻴ
ﺘﻳډﻮﻣ
ﻭﻭﺎ ﮐ
ړﺍ ،ﻻ
ﻭﺭﻭ
ﺎېﻪﺧ
ﻭ ټﭖﻱ ﻟ ﺮﻱﺍﻟ
ﻪﻧﻮﭘ
ﺎﻥچېټ ﻭﻏﺭ
ﺎﻪﻧﻐ
-ﻫ١
ﺮﻪﻭﻱﺗﻴﺖﻧﻓ
ﺎﻌﺎﻝﻣېﻌ
ﻮک ﻓﻧﻮﻠ
ﻮ٥ﮐﻴ
ﺘﻭﺳﺭ
ﻪﻭﻪﭘﻮﺗ
ﻧﺎﻭﻏ
ﺭﺎﻭﺩېﻧﺍﺮﻱﻟ
ﺎﺝﻭﻧﺴ
ﺍﺯﻱ
ﻭﺮﮑﺎﻧﻭﻳ
ﺍﻭﻱ
.
ﻮﻯﻩﺷ ﺮ
ﺳ
.
ﻡﻮﻠ
ﻌېﻪﻭﻱﻣ
ﻟﺖﻱ ﻧ
ﺎ
ﺘﻲﺣ
ﻴﻓﺎ
ﻌﻪچېﻣ
ﻮﺗﮑ
ﻠNoniﺧ
ﻪmmune
ﻐ-ﻫ
٢
.
ږﻱ
ﻮﻝکږ
ﮐﺭﺭېﻭ
ېﻪﻻ
ﺭېﺩﻋﻀﻞ ﻟ
ﻮ٥ﭘ
٠٠I
٢څﻪﺕU
٥ﺧ(ﺩ٠
HTI
ﻴﺖ)G
ﻓﺎﻌ
ﻌﻞﻣ
ﻔﻨﻣ
DengueFev
er
:
ﻳﻒ ﺮﻌﺗ
Aedesmosquiﺩچ tﻱﻭﺩo
ﺭځ ﺍﻪﺍ ﺗ
ﻪﻣﻦځ ﻠ
ﻣfﻪﺍ
lﻟavivi
rﻭﻍۍچېﺩus ﺭﺎ
ﺒﻲﻧګﻮﺩﺗﺩﺩﻥ ﻳ
ﻮﻠﻲﺗﮐ
ﭘﺍټ
ﻫﮐﻝ ﻪ
ﻭﺱﺩﻱ ﺮﺎ ﺮﻳ
Siﻭ ngl
est r
ﻭﺱandedRNA ﺮﻳ.ﺍﻭ
ﺩږﻱﺩﻟږﻱ
ﻪﻲ ﻠﺒﻪﮐﻟﻮﻠچﭼ
denguehemor r
hagi
cfevﺭﻱﺩer ﻮﻭﭘﺭﻩﺯﻮ
څﺭﺳﻮ
ﺮﻟ ﻭﺗﺭﺍﻮ
ﻴﻳﻦګﻓ ﻪﺩﺩ ﻧ
ﻮﻴﻠ
۱ﻣ ۰
۰-
۵ﻩﺩ۰ ګ
.
ږﻱﺪﻝکږ ﻴﻟړۍکې ﻱﻪﻥﭖښښ ﭘ
:
ﻻﻞCause ﻣ
.
ﺮﻱﻟ4-Seroty
ﻭﺱpe ﺮﻳډﻦګﻭﺩﻳ
ﻩﺩﻮګﻩﺗﺰ
ﻴﻟ
ﻭﻪټ ﻫډﻝﭘ
ﺩ.ﺩﺩﻱ ﺮ ﻭﺭﺕ ﻱﺎﺒ
Dڅﻪﻋ
ENV-ﺧ 4DENV- 3DENV-2DENV- چېﺩ1
ړﻪﻭډﻝﭘ
ﻪﻭ ﺎﻏ
ﻤﻠﻲﻭﻱﺩﻫﺍﻏﻪﺭﺗﻭﻍۍﻣﻦځ ﺭﺎ
ﻩﻧﺮﻴﭗﺳ ﻧ
ﻭﺮﻴﺩﻮﺳ
ﻪﻳ ﺩﻱﺷﻲﮐ ﺒﺐکﺩ ﻭﻍۍﺳ ﺭ
ﺎﻧ
ﻴﺖکېﺩ ﻓﺎ
ﻌﻪﻣﻪﺩﻏﺪﻱﭘﻧ
ﺍړﻪﻭډﻝﭘ
ﻮﺩﺑﻞ ﻭ ﺭځﻱﺧﻪﺍﺗﻧﻲټﻱﻣﻦځ ﻮﻴ
ﻣﻩﺍﺭﺎ
ﭙﻟﺮﻤ
ﺩټﻝﻋ
ﺪﻱ ﻭ ﻧﺍ
ﻭ.
ﻩﻱ ﺭﺎ
ﭙﻟﺩﻱﻮﻟډﻱﻣﻦ
121
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
Cl
i
nical
Findi
ng
:ﻭﻥښﻱ ﺍﻠﻲ ﻳﻭﻍۍګ ﺭﺎ
ﺩﻧ
Sev ﻴﮏer، ﺗﺎ
ﻣﻭﻤﭗټ ﺮﺳ ﻟﻲﺗ ﻮﻴڅﻪﻧ ﻟﺖ ﺧ ﺎ(ﺣ asy mpt omat iﻭﻍۍ)c ﺭ ﺎ
ډﻦګﻧ ﺩ ﻳ
ﺭځﻱ ﺒﺐګ ﻨﻲﺳ ﻳ
ړﺭﻱچېﺩﻡ ﻮdengueshock-ﭘ syndr ﺘﻲome hﻭﺣ emorﺍ rhagi cf ever
.ږﻱﺪﻝکږ ﻴﻟ
ﭘېﻮګ
ﻮﺪ ﺗ ﺭﻱﻭﻱﻧ ﻮﻭﭘ ﻭځ۷ﺭ -ﻩﺩ۴ ﻮګ ځﻲﺗ ېﻪﻣﻦﻧ ﻱﻩچ ﭘ ﻭځ ﺩ ۱ﺭ ۴-ﻩﺩ۳ ﺭﻭﻳﺢﺩ ﺮ ﻔﻭﻍۍﺗ ﺭﺎ
ﺩﻧ
ﺍ
ﻪﺭ ﺒﻪکېﺗ ﻪﭘﺘﻭﺳ ﺭ
ﻭڅﻪﻭﻭځ ﺧ ۱ﺭ ﻪﺩ۴ ﺍﺷﻲﮐ ﻪﺭ ﺭﺗﻮڅﻪﮐ ﺎﺣﻲ ﺧ ﻤﮏﺳ ﻳ
ﺪ ﻧ
ﻳﻦﺩﺍ ﺮﻓ ﺎﻩچېﻣﺴ
.ړﻱﻧﮏ ﻩګﻱﻭ ﺪﻨﻳ
ﺎﻤڅﻪﻧ
ﺒﻲ ﺧ ډﻦګﺗ ﻪﺩﻳ ﺍﺑ ﺍﺷﻲﺩ ﺪﻴ
ﭘ
ﻪﻧ
ﻭ ﺩﺭﺮﺧﻲﺩ ﺍﺑﻮﻭﺧ ﻩﺍﺎﻭﺷ ﺮګ ﺘ،ﺩﺳﺩ ﺭﺩﺮ،ﺳ ،
ﻤﻞ ﻩﺣ ﺮﺒ
ﺑﺎ
ﺒﻲﺩﻧ ﻠﻲﺩﺗ ﻳګﻱګ ځﻥ ړ ﺭﺍ ﻮﻴﻭﻓ ډﻦګ ﺩﻳ
ﻭﻍۍﺕګﻻ ﺭﺎ
ﺩېﻧﺭﺕﺩﻱ ﺩ ﺎ
ﺒRڅﻪﻋ
ﻪ ashﺧ ﺎﺳ ﺘﮏېﺩﭘ ﻮﺳﻭﺩﭘ ﺩﺍﺭﻮﺩ ﻧﺪﻨ،ﺩﺑ ﻪﻧﻭﺩﺭﻠﻲﺩ ،ﻋﻀ
.ﺭځﻱﻪﺍ ﻧﻭﻭﺍړ
ﺭﻱﭖ ﻩکېﺩ ﺭ
(ﺒﺠﻦ ﺗ)Febr il
e
(
ﻧﻲ ﺍﺮﺑﺤ)Cr i
ti cal
(ﻟﻲﺍﻮﻭﻏ ﺭ)Recov er y
ﻪﺣ ﺮﻱﺩﻏ ﻟﻳﺖ ﺎ
ﮑڅﻪﺷ ﺩ ﺧ ﺭ
ﺪﻥﺩ ټﻝﺑﻭ ﻭ ﺮﺍ ﺒﻲﺩﺳ ﺭﺟﻲﺗ ﻭﻍکې40cﺩ ﺭﺎﻭکېﻧ ﺍ
ړFebrﭖ il
e
ېﻪ
ﻮک ﭘ ﻧﺎ
ﻭﻏ ﺭ
ﺎﻪﻧﻨﻠ
ﺮ80ﺳ 5ﻪﺗ
ﺍﻱﺷﻲ 0ﻧ ﺩﺩﻭکېک ﺍړﺪﻱ ﭖ ﻮﻱﭘ ﻡﮐ ﺍ
ﻭ ﺭﻱﺩ ﻮ ﻭﭘﻭځ۷ﺭ -ﻟﺖﺩ۲ ﺎ
ﺘﮏېﺭﻥګ ﻮﺳﺩټﻝﭘ
ېﻪ ﻭ ﻭځک ﺑ ﻭﻫﻢ ﺭ ﺎﺩ ﻪﻳ ﻟ
ﻭﻪﺍ ﺪﺷﻲچېﭘ ﻧﺭګRﺍڅﺘﮏېکې ashﺭ ﻮﺳﭘ
ﻮﻥﻟﺪډﻝﺑ(ﻪ ﻭ
measlﭘ es-l
iﺮﻱ)kes ېﻪﺩﺷ ﻩک ﺑ ﺩ ﻮﻭﻪﻣ
ﻭځ ﭘ7-ﺭ ﻪﺩ4 ﺘﻭﺳ ﺭﺎﻭ ﻴﻭړﻱ.ﺑ ﻭﺭﺍ ﻮﺳ
ﺭﻭﺮﺩﺯ ﺗﻲﺳ ﻭ
ﻮﻥﺩﻱچېﺩګ ﺘ(ﺷ pet echi alﻮ) ﻧﻮﭘﺎ
ﻭﺧ ﺮﻭﺳ ړﺍکېﺩﻭ ﻮﻪﺧ ﺩېﭘ ﻣﻲ .ﺩ ﻮﻣﻭ
ﻭﺍﺰﻱ ﻨﻲﻭﺧﺖﺩﭘ ﻳﺭځﻱځ ﻪﺍ ﺗ
څﻪﻣﻦځﻮ ﺧ ﻟﺪﻴﺗﺎ
ﻮﺩﻣ ﻧﻭﻭﺭګ ړﻱﻭﺩﻭ ﻩﻪځ ﺍ ﻪﻣﻦځﻧ ﻟﻩﺮ ﻮﺳ ﻟﻮ ﮐ
ﺭﻭ
ﻩﺰ
ﻴﭘﻩڅ ﻭﻪﺩﺒﺮﻱﺗ ﻮﻥﻟ ﺘﻪﻫﻢﺷ ﻧﺪﻴﻬﻨﻲﺑ ﻳﻩﺩﻭ ﺮﻤﻲﮐﭻېﺳ ﻪﮐ څﻪﭘﺩﻱ ﺧ ﺮﺎﻃﻲﭘ ﻟﻲﺩﻣﺨ ﻮﺧ
.
ﻩځﻱ ﻪﻣﻦځ ﻟ ﻩ
ﺭﺎﭙﻟﻭﻭځ۳ﺭ -ﺎﺩ۲ﻴﻩﺑ ﻮﻪﺷ ﻧ
ﺭګ ﻧڅﻪڅﭘېﻮځﻝﺎﺍ ﺮﻱچ ﻳ ﻟﺎﻴﺗﺭ(ځﻥګ
Biﺍ phasi )c
څﻪ
ﺒﻲ ﺧ ﻟړﻱﺗ
ﻭﻍکېﺩﻮ ﺭ
ﺎﻣﻲچېﻧ ﻭﺭﻪﺩ ﺗﻭﺍړ(ﭖ Cr iti
calﻧﻲ) ﺍﺮﻭﻍۍﺑﺤ ﺭﺎﻮ کېﻧ ﻧﺎ
ﻭﻏ ﺭﺎځﻲﻧﻧ
ﻩ کېﺩ ﺩﺩ
ﻭګ ﻪﺍﻨﻴﻪﺳ ﻪ کېﭘ ﻠ
ﺮﺣﺪﻱﻣ ﺭځﻱﭘ ﻪﺍ ﻠﺮﺣ ﻧﻲﻣ ﺍ
ﺮﻩﺑﺤ ﺮﻮﺳ ﻠﺗ
ﻪﻭ ﻭﭘ ﻭځﺭﻱ ﺭ ﻩﺩ ﻭ ﺩﺩ
ﻪﻠ
ﻳﺎېﻪﭘﺭځﻱچ ﭘ ﻪﺍ ﺗﻪﻣﻦځ ﻠﻣﺍژﻪ
ﺎﻟﮑﻴ ﻟﻭﺍ ﻟﻲﺍﻮﺗ
ﺎﻳړﺎﺩﺯﻴﻧﻲﺩﻭﺗ ﺩﺩﺮﻴﺮﺩﺗ ﻠ
ﭙ ﻪﺩﮐ ﻧﺪﻴﻟﻭﺭټ ﻮﺍ ﺗﺎﻌﻳﺎ
ﻣ
ﻭﻪﺩړﺗ ﺗﻲﻍ ﺎﻴﺪﻥﺣ ﻭﺩﺑ ﻟﻲﺍﺍﻮﻤﻪ کېﺩﮐ ﻪﮐﭽ ﻮﭘ ﺗﺎ
ﻌﻳﺎﺍﻥ کېﺩﻣ ﺭ
ﻭ ﻪﺩ ﻭﻍﭘ ﺭﺎ
ېﻪﻳﻲﺩﻧ کﺑ
(
orﻟﻲgans ﺍ
ﻮﺑﺍ
ﺮﻭﺧ ﺪﻧﻭﺩﺩ ړ
ﺘﻲﻍ ﻳﺎﻪکېﺩﺣ ﻠ
ﺮﺣ ﺪﻱﻣ ﺍﺷﻲﭘ ﻟﻲﺭ ﺍ
ﺎﺕېﻭ ﻮکېﭘ ﻟﻮﻪﺭﺳ ﻨﻲﭘ ﻳﻭ
sﻪځﻱچ ﻭﻍ hockﺗ ﺭﺎﻴﻞﺷﻲﻧ ﻪﭘﻧﺪﻴﻬﻪﺑ ﻨﻳﻪﻭ ﻤﻴﻪﻭﺧ څﻪﺑﻻﻱ ﺧ ﻤﻲ ﺭ dﻭﺩﻫﻀ yﺍ sf unct i)on
ﻮﻱﻧﺎېﻪﺛ
ﻮکېچ ﭘ ﻧ
ﺎﻭﻏ ﺭﺎ
ﻮﻧﻐﻪ5٪ﻫ ږﻱﻭﭘ
ﻳﻞکږ ﺍ ﻪﻭ ﺗﺭdengueshock–syﻭ ndr ې ome
.
ﺭځﻱ ﻪﺍ ﺗ
ﻮﻱﻭﻱﻣﻦځ ړﺷ ﻩﮐﮏ ﺮserﺳ otyﻮﻱpe ﺑﻞﻧﻭﺱﺩ ﺮﻳﻭﻭ ﻩﺩﻳﻦګ ﻮګﺗ
ﻩکېﺩ ﺩﻮﺪﻱﻣ ﻮﻱﭘ ﻡﮐ ﺍﻭﻭځﻱﺩ 3-ﺭﻩچې2 ﻪﺩ ﻠﺮﺣ (ﻣRecov eryﻟﻲ) ﺍ
ﻮﻭﻏ ﻪﻳﻲﺩﺭ ﻠ
ﺮﺣ ﻪﻣ ﻤﻳﺭ
ﺩ
ﻧﮏﻭﻮ ﻧﺍ
ﺮﻴﻪﺣ ﻧ
ﺪﻴﻭﻍﺭﻏ ﺭ
ﺎږﻱﺩﻧ ﺮﻱﻴﻪﺗ ﺍﻥﺗﺭﻭ ﻪﺩ ﺗ
ﺮﻴﺎﺕﺑ ﻌﻳﺎﻮﻱﻣ ژﺷ ﺎ
ﮐڅﻪﻝک ﻮ ﺧ ﺮﺧ ﻮﺑ ﺪﻥﺩﺗﺸ ﺑ
ﻭﻍۍ ﺭﺎﺮﻱﺩﻧ ﻟﻮﻥﺘﻪکېﺷ ﻠﺮﺣﺪﻱﻣ ﻟﻲﭘ ﺍﻮﻤﻮﮐ ﺗﺎﮐﺮﻩﺩﺣ ړﺕﻭﺯ
ﺭښ ﺍ ﺎ
ﺘﮏېﺩﺧ ﻮﺳ ﻮﺩﭘ ېﻭﻱﺧ
ﻪﺩﻱﺷﻲﭘ ﻪﻭﻱچېکﺩ ﺘﻮﻥﺷ ﺘ(ﺷ fluidov er l
ﻧﻲ)oad ﺪﻴﺗﺎﻳﻮﺩﺯ ﺗﺎﻌﻳﺎﻪ کېﺩﻣ ﻠﺮﺣ ﺪﻱﻣ ﭘ
ﺷ..
ﺒﺐ ﻲ (ﺳ seizurړﻭﺩﺝټکې)es ړﭖﺍ ﻟﺖﺥ ﺎﺭﻱﺣ ﻮﻌ ﻭﻍﺷ ﺭﺎﻭړﻱﺩﻧ ﻩ ک ﺰﻴﺍﻏ ﺎﻍﻣﺩ
:
ﻴﺺ ﻭﻍۍﺗﺸﺨ ﺭﺎ
ﺩﻧ
ﺮﻱﻭﻝﻟ ﻪﺭ ﻨ
ﺘﻳﮏېﮐ ﺰ
ﻭﻓ ﻠﻲﺍﻳﻠﻦککېګ ﻴ ﺺ کېﮐ ﻪﺗﺸﺨ ﺭﭘﻮ ﻴډﻦګﻓﻮ کېﺩ ﻳ ﺮﺧ ﻤﮏﺑ ﻳﺪﻧﻪﺍﭘ
ﻟﻲﺎ
ﻤﺘ ﻭﻍۍﺩﺍﺣ ﺭﺎ
ﻣﻦﺩﻱﺩﻧ ﺰﻧﻮ
ﺘﻮﻝ ﺳ ﻠﻴﻩﻳﻲﺑ ﺮﻮﺳ ﻴ
ﻭﻏ ﺭﺎ
ﻭﺳﻲﻧ ﺮﻳ
ﻭﻭ ﺭ ﻮﻭﻝ کېﺩﻧ ﻪﺍ ﻮﭘ ﺧ
.ږﻱ
ړﻦګڼﻝکږ ﺍﻳ ﻟﻲﺍﻮﺘﻭﺷ ﻳﻥښ ګﻮﺎ ﻠ
ﻩﻳ ﻭﻧېڅﻪﺩﺩ
ځﻱﺩﻻﺪ ﺧ ﻮﺍ ﻩﻳﺮﺒﻲﺳ ﻩﺩﺗ ﺭﺎﭙﻟﻴﺺ ﺗﺸﺨ
122
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
123
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
124
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
Rel
apsi
nFev
er
ﺘﯽ
ﻔﻭﻫ
ﺎڅﻮﯾ
څﻪﯾ
ﻭ ﺧ
ﺪﯾﺟړ
ﻭﻍﺩ ﻮ
ﺭﺎﻧ
ﻪﺩﺘ
ﻭﺳﺭ
ﯾﯽﭼﯽﻭ ﺍ
Relﻭ
apsai
ngfevﻩer ﻪځګﺩﯼﺗ
ﻮﯼ.
ﺩﮐﻮﻪﻋﻟ
ﻭځﺎڅﻮﯾﻭﻏﯽﯾﺭ
ﺎﻪﻫﻢﻧﺘ
ﻭﺳﺭﻭ
ﻣ:
ﻻﻞ
ړﯼﻮ
ﻣﻮﺮﯼﻧﻩﻟړﺭﯼﺍﻮBorﭘrel
i
ﺎﻥﺩﯼ ﭼﯽﺩagenus ﺘﻧ
Spiﺍrochetۍﻻﻞes
ﻭﻍ ﻣ ﺭﺎ
ﺩﯼﻧﺩ
ﺮﯼ
ﻟ ﻪﻠ
ﮑﻩﺷ ﻭﻭﻏﯽﺩﺭﺎ
ﻧ
ړﯼﻮ
ﻣﻮﻪﻧﻪﻭﺧﺖﭘ ﻐﺎﻥ ﻫ
ﻧﺴﻭﺍﺩﻭﯼﺍ ﻮﻮﺟRodentﮐﯽﻣﻪs ﮑﻞﭘړﯼﺷ ﻮﻣﻮTiﻧckborne–۱
ﯿﭽﻞﺷﯽ ﻪﻭﭼﺍﺳﻄ
Tﻪﻭiﭘ ﮐږﯼﭼﯽﺩck ﻪﯽ ﺘﺍﺧﻭﻏﯽﺭﺎ
ﻧ
ږﯼ. ﻟﯽ
ﺎﻘ
ﺘﻧﺍﻪ
ﻪﻧﺎﻥﺗ
ﻧﺴﺍڅﻪﺑﻞ
ﺎﻥ ﺧ ﻧﺴﺍ
ﻮ ډﻝﯾ
ﯿﻢ ﻭﻘﺘﻪﻣﺴﭘ
ﻮﻧ
ﻭﺩﺍ
ﻮﯿﻮﻫﮑﻧ
ﻮﻠ
ﺘ ﻣﺨﺮﻪﭘ
ﻭﭘﺩﻭﯼﺍ ﻮﻮﺟﻮﮐﯽﻣ ﻧ
ﺎﻧﺎ
ﻧﺴﻪﺍ
ﮑﻞﯾﯽﭘ ړﯼﺷ ﻮ
ﻣ ﻮ
:Louseborﻧ ne–۲
ﺍ
ﻮﻩﻫړﻭﺱ ﺬﯼﺍﻐ ﺗ
ﻮﻪ،ﺳﺗﺎ
ﯾﻩﻪﮐﯽﺯﻭڼ ﭘګﻩګﻪﮐﯽﭼﯽ ڼ ﻨﻟ
ﻭﻪټ ﻐﻪﻫ ډﻝﭘ
ګﯼ ﻭځﻥ ړ
ﻪﺍ ﮐﯽﭘ
ﺭځﯼ.ځﻪﺍﺎﺕﻣﻦ ﺗﯾﺎﺕﯾﯽﺯ ﻌﻗﺍﺮﯼﻭﻟ
ﻭ
:
ﻩﺮﻨﻈ
ﮑﯽﻣ
ﯿﻨﯿ
ﻠﮐ
،ګﻥګﯼ،ﺩ
ﻟﯽ ﺍ ﺍ
ﻭﺪﻩﭘړﯾ،ﺯ
ﮐډﺎ
ﺭ
ﮐﯽﺎﺯ ،ټړﻩﻭﻍﮐﯽ،ﻝ ﺭﺎﻪﻧﻭﭘﻧڅﻪﻭﯼﺍﭘ
ﻭﻉﺎﺍ ﺮﻭﻍۍﺷ ﺭﺎﺩﻧ
ﻠﻒﺭﺵ، ﺘ
،Splﻣﺨ eenomegal
ly،Hepat omegallﺩﯼy، ﺭ
ﺩﺮﻩﺳ ﺪ
ﯾﺪﺩ ،ﺷ ﺭﻮﺩﻧﻭﺪﻨ
ﺑ
ﻟړﯼ
Delﺩﻮ
eri
ﻭﻍﮐﯽ um ﺭﺎ
ﻩﻪﻧ
ﺭﻥګﭘﺍﺪﻤ
ﺩﻭﯼﻫ ﻮﻮﺟ
(Maculﻣ arPet echial,Papul)ar
-
۱ﻟ۰
ﻪﻪﺘﻭﺳ
ﺭﺭځﯼ.ﻭځﻪﺍ
ﻧﯽﻫﻢﻣﻦ ﺗﺍ
ﻤﯽګ ﯿﮏﺑﯽﻧﻈﻮﺟﻟﺎ
ﮑﯾﺎ
ﻭﺳ ﯿﮏﺍ ﻮﺟﻟ
ﻭ ﺭ
ﻮﯿﺭﻧﻮﻭﻧﻩﺍﺮ
ﺒﯽﺳ ﺗ
ﻪﺘﯽﭘﻔ
ړﯼﻫﻡﻮﻮﺩﻟﻮﯼﺧ ﺩﮐﻮﻩﻋﺭ
ﺎﺑ
ﻭ ﺘﯽﺩﻔ۱ﻫ-
ﻪﺩ۲ ﺘﻭﺳﺭﻮﻭﮐږﯼﺧ ﻩ ﯽ ﻭﻍ ښ ﺭﺎ
ﻭﻧ ﻭځ
۳ﺭ
ﻪﻭﭘﻪﺍ
ﻟ۳ځ-۱
ﮑﻞﮐﯽ۰ Tiﺷ
ckborﻪ neڅﻪﭘ
ﻭ ﺧ ﺪﯾﺟړ
ﻤﻞ ﻮ ﮑﮑﯽﺩﻣ ﯿﻒﻭﯼﻣﺨ ﻔﺒﺖﺧ ﻧﺴ
ﺩﻭﯼ ﻮ
ﻮﺟ ﺩﻣﻮﻩﻋ ﻭ
ﺎﺩ ﻮﯾLouseborﮐﯽﯾ ne
:
ﻨﯽﯾ
ﻮﻣﺯ
ﺍﺭﯼ
ﺍﻮﺗ
ﺍﺮ
ﺑﻻ
ﺎ
Wrﻭﯾ
iﺍﺮﺩghtﯿﻤﻨﯽ ﺳ
ﯾﻭﺩﻭﺘﻞ ﺷﯽﺍﯿﺴﺍﺧ
ﻪﻭﺧﺖﮐﯽﻭ ﺒﯽﭘﻪﺩﺗﻨ
ﯾڅﻪﻭ
ﻭﻍ ﺧ ﺭ
ﺎﻪﺩﻧﮐ
ﻪﺮﭘ
ﻠﭽﻩﺩﮐﺭﻥګﺍ
ﺪﻤﮐږﯼ.ﻫ
ﺪﻝ ﯽﯿﻪﮐﯽﻟﮐﯽټﭘ ﻭ
ﺮﯿﭙﻪﺭﻥګ ﺷﯽﻍټ ﺳ ﺍﺳﻄ
ﻪﻭ Giﭘ
emsa
ﻪ CSFﮐﯽﻮﭘﻮﯼﻭﯼﻧ ﻪﺷﺘ
ﺮﯼﺍﺧ ﺎﭘ
ﯾﺎ
ﻪ ﺳﺤﺗ
ﺮﯿﻪﭼﻮ.ﮐ ﮐﻻﯼ ﺷ
ﯿﺺ ﻮﻪﯾﯽﻫﻢﺗﺸﺨ ﺍﺳﻄﻭ
ﻪﮐﯽﺎﺕﭘﯾ
ﻭﺮﯿﻦﮐﭙﻮﺳﺩﻭﯼ ﺧﻮﻮﺟﺎﻣﯿﻨ
ﯿﭘ
ﻮﺘﯾ
ﺎﻮﺳﺒ
ﻣﺮﺎ،ﺗﯿ
ﻤﯿﻧﻪﺍ
ﻔﯿﻔ
ﺩﻭﯼ ،ﺧﻮﻮﺟﺍﺕﻣﺮﯿ
ﻐﺗ
ﺎﻝﻭﯼﻣﺭ
ﻮﻧ
:
ﻪﻨﻠ
ﻣﺭﺩ
ﯿﻦﺟﯽ ﻠ
ﻨﺴﯿﻦﭘﮐﻭﺮﻭﺩﭘ
ﻮډﺯ ﺎﯾﻭﯾ ﺍﻻﯼ
ﻪﺭ ﻟﻟﯽﻮﻪﺩﺧ ﻣﺍ
ﺭ۰ګ .ﯿﻦ۵ ﻭﺳﺮﺘ
ﯾﺭﺍ
ﺎﯿﻦﯾﻠﮑﯾﺎﺍﺳﺮ
ﺘډﺯﺗ
ﻮﻭ ﯾ
ﯼﻪ
ﻮښ ﻟ ﻮﮐﯽﺩﻏ ﻧﺎﻣﻮ
ﺎﺷﻩﻪﻣ
ﻮﻥټﭘ ﻪﯾﮑﻟڅﺭ
ﻮﺎﻟ ټﻮﮐﯽﯾﻧﻩﻪﻍﺍ ﻮﻥټﭘ ﻪﯾﮑﻟﻪﺗﺮﺍﻪﺗﻪﻧ ﮑﻟږ
ﺷﭗ
ﮐږﯼ.ﻮﻝ ﯽ ﮐﺭﻻﯼﻭﺭ
Tickborﻮﯼ ne ﺪﮐﯿﮐﺎ
ﺪﯼﺗ ﻧ
ﺎﻭﯼﺑ ﺍ
ﺪﺩﯼﺗﻮﺍږﯼﻣ
ﻩﺩﻭﺩ ﺭﺎﭙ
ﻮﯼﻟ ﯿﻨRelﺩﻣﺨ ﺎﺩaps ﻤﻠﻌﻀﯽﻋ ﺑ
ﻻﯼڅﻪﺭ ﻟﯽﻟﻮﯿﻦﺩﺧ ﯾﺴﺎﻣ
ﻭﺮﺘﯾﺭﺎﺍﻭﯾﯿﻦﺍﻠ
ﮐﺎ
ﺍﺳﺮﺘﻪﺗﻣﺍﺭ
۰ګ .ﻪ۵ ډﻝﭘټﻦ ﻭ
ﻭﯾ ﻪﺭ ﻭﺱﭘ ﻭﻏﯽﺍ ﺭ
ﺎﻧ
ﻪﺘﺘﻢﯾﯽﺍﺧﯿﺴﻪﺩCNSﺳ ﺗ
ﺮﯿﻪﭼ ﮐږﯼ.ﮐﻮﻝ ﯽﮐﺭﻪﻭﻭﻍﺗ ﺭﺎ
ﻩﻧ ﺭ
ﺎﭙﻟﻭﻭځ
ﻮﺭ ﻟﺴﻭځﯼﺩ ﻪﺩ ﺭ ﻟ
ﺭځ ﻮﻟ
ﺎ
ﻭﯾ ﻪﺍﺘ
ﻭﺳﺭﻪﻭ ﺘ
ﺎﻋڅﺭﺳﻮﺮﻟ ﻻﯼﻫﻪﺭ ﺪﻟﯾ
ﺭﻩﺩﻭ ﻮﻥټ ﻪﯾﻧﻮﯿ
ﻠﯿﺭﯼﻣ ﯿﻦﺟﯽﺩ ﻠﻨﺴﻮﺩﭘ ړﯼﻭﯼﻧ ک
ﮐږﯼ.
ﻮﻝ ﯽ ﮐﺭ
ﻩﻭ ﺭﺎﭙ
ﻟﻭﻭځ۱ﺭ۰-
۱ﻭځﺩ۴ﻩﺭ ﺮﻻﯼﻫﻪﺭ ﻟﺪﯾ
ﺭګﻡﺩﻭﺍ
ﻮﺭ ﻮﻥﯾ ﮑﺴ ﯾ
ﺍﺮﺘ
ﻔﺳ
ﻪﮐږﯼﭘ
ﺍ ﯽﺪﯿJarﭘishHerexHei merReact i
ﻪ on ﻭﻍﺗ
ِﺭ ﺎ
څﻪﻧﻭﯼ ﺧﺍﺪﻪﺩﺗ ﺘﻭﺳﺭﻪﻭ ﻠﻪﮐﻠﮐ
ﻭﯼڅ ﺍ
ﺪﮑﯽﺩﺗ ﻪﻣﺨ ﻮﺗﻧ
ﺎﻭﻏﺭ
ﺎﻠﮏﻧ ځﯽﺧﻮﻝﺷﯽ ﻧ ﯿﻧ
ﺪﯼﻭ ﻧﻭﻝﻻ ﺭﻭﻍﺩﮐﻦټ ﺭﺎ
ﺪﻧ ﯾﺎ
ﺭﺑ ﻮ
ﻨﻈ ﺪﯼﻣﻤﻫ
ﻮﯼ.ﮐﺭډﯼﻭﺎﺘﯽﺑﻧﺍAntiﻪTNF ﺧ
125
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
Yel
l
owFev
er
ﻭﺩﺍﺧﯽﺍځﻪﺭ
ﻪﻣﻦ ﺗﺍﺳﻄﻪﻭFlﭘav
ivir
ﻩﭼﯽﺩusﻭﻏﯽﺩ ﺭ
ﺎﻪﻧﮑﯿ
ﺗﻮﻧ
ﻭﻮﺯﻪﯾﺒ
ﻩﺗ:ﯼ
ﺯړ ﯾﻒﺮﻌ
ﺗ
(
۹۰٪ﺎ)
ﻘﯾ
ﺮﻓﻪﺍ
ﻩﭘﺮﺗﺎ
ﯾﻭﻏﯽﭘﯽښﯼﺯ ﺭﺎ
ړﯼﻧﻮﻣ
ﻮږﯼﺩﻧ
ﻟﯽﺎ
ﻘﺘﻧ
ﻪﺍﺍﺳﻄAﻪﻭ
edesmosquiﭘt
oes
ﻮﯼړﻝﺷﺭکﻪﺩﯼﻭﺭﻧﻮ
ﭘﺍﻣﯽﭘﯽښﯼﺭ ﻮ
څﻪﺩﮐ
ﺎ ﺧﯿ
ﺍﺳﻭﺩ ﺍ
ﺩﺩﯼﻮﻮﺟﺎﮐﯽﻣﮑﯾ
ﺮﻣﺍ
ﺑﯽﻮﻨ
ﻭﺟﺍ
:
ﻩﺮﻨﻈ
ﮑﯽﻣ
ﯿﻨﯿ
ﻠﮐ
ﺮﯼﻟ
ﺩﻮﻪﯾﯽﻭﺟ ﻧﻮﻠ
ﮑﻩﺷ ﻭﯼﻩﺩ
ﻭځ ﺩ
۳ﺭ -
ﻩﯾﯽ۶ ﺭﻭﻘﯽﺩﯾﺮ
ﻔﺗ
،Retﺑﯽroorbit
alpaiﻪn،ﺒﺩ،ﺗ
ﺭ ﺩ
ﺮﺘﯽ،ﺳ ﻪﺳﺴ ﺭﺕﺩﯼﻟ ﺎ
ﺒﺍ ﺽﯾﯽﻋ ﺮﮑﻞ:ﺍﻋ ﯿﻒﺷ ﻔ
–۱ﺧ
Cﻭ
onjﺍ
unctivali
njecti
on،Relati
vebradycardi
a، Photophobia،ﺎﻥګﯼ ،ﮐﯾﯽﺎﻬ
ﺘﺍﺷ
ﺧ.
ﻟﯽڅﻪ ﺍ
ﻭﺭﻮﺩﻣﺦﺳ
ﮑﻞﯿﻒﺷ ﻔﻭﻉﮐﯽﺧ ﺮ
ﯼﻪﺷﺭځ ﭘ
ځﻪﺍﻭﮐﯽﻣﻦ ﺗ ﻩﭘﯽښ ﺪﯿﺼ۱ﻓﻪ۵ﮑﻞﭘﯿﻢﺷ ﮑﻞ:ﻭﺧ ﯿﻢﺷ -ﻭﺧ۲
،Rel
ati
vebr adycardi
a، ﻪ
ﺒﻩﺗﺪﯾﺪﻭﻍﮐﯽﺷ ﺭﺎ
ﻪﻧ ﺘﻭﺳﺭﺩﻭﯼﻭ ﻮﻮﺟﻭﻏﯽﮐﯽﻣ ﺭ
ﺎﻪﻧﺍ ﺽﭘﺮ
ﺍﻋ
ﻪ(،ﻟﻮﻩ ،ﺧﺯ
ﻮ ﺘﻢ ﭘﯿﺴﻤﯽ ﺳ
ﺰﯼ)،ﻫﻀ ﯾﺮﻧ
ﻮﺯړﯼ ،ﺧ
،Hyﯼ pot
enti(on ، Fagetsi)gn
ﻪځﯼ ﺎﺗ
ﻣﻮﻭﮐﺍ ﺍ
ﺪﯿﻟﺖﭘﺎ
Delﺣ i
ri
ﻪ um ﻭﻏﯽﺗﺭﺎ
ﻪﻧﺘﻭﺳﺭﻭ
:
ﻨﯽﯾ
ﻮﻣﺯ
ﺍﺭﯼ
ﺍﻮﺗ
ﺍﺮ
ﺑﻻ
ﺮﯼﯿ
ﻩﻏ ﺯ
ﺍﺪﻧ
ﯿﻦﺍﺑ
ﻭﺭﻮﻠ
ﯿﻭﺑﻮﺍ
ﻧﻮﻤ
ﯾﺍ
ﺰﻧ
ﺍﺭﺩ،(5-ﺩځﯼګ 6gr
/L)،Prot
einur i
a،Leukopenia
Prﻫﻢothr
ombint i
ﻩﺩme ﺭﻥګﺍ
ﺪﻤﻩﻭﯼﻫ ﻟړ
ﻩﻮ ﺪﻨﻩﭼﻭ
ﻩﺩALTﺩ ﺯﺍﺪ
ﻧﻭﺩASTﺍ ﺎﻝﺍ
ﻣﺭﻮﻧ
ﻮﯼﻭﯼ. ﺎﺕﺷﯾﺯ
ﻭ.ﺩړﺍک
ﺪﯿIﭘﻪ gMﻮﭼﮐﻻﯼﺷﻪﻮﺍﺳﻄEﻪﻭ
LIﭘﻪﮐﯽﺩSA ﻠ
ﺮﺣConvﻣ al
ﻭescent ﻩﺍﺩﺎ
ﻪﺣ ﭘ
۴-
Iﺩ۳ﻮﮐﯽ gM ﮑ
ﻠ ۷ﺧ۳ﻪ٪څﻪﭘ
ﯿﻦ ﺧﮐﺴﺍ
ﻪﺩﻭ ﺘﻭﺳ
ﺭﻮﻭﮐﻻﯼﺷ
ﯿﺺ ﻮ ﻪﻫﻢﺗﺸﺨ ﺍﺳﻄ
Pﻪﻭ CRﭘ
ﺩﻭﯼ. ﻮﻮﺟﺭﯼﻣﻮﻮﭘﻧ
ﻮﻠ
ﮐ
:ﻪﻨ
ﻠﻣﺭ
ﺩ
ﻩﺩ
ﺭﻥګ
ﺍﺪﻤ
ﮐږﯼﻫ
ﻮﻝ ﯽ
ﮐﺭﯾﮏﻭ
ﺰﯿﻠﺠ
ﻧﺍﻪ
ﮑﻟﻭﯼﺍﺪ
ﺮﺿﯽﺗﻭﻏﯽﻋ
ﺭﺎﺮﯼﻧ
ﻟﻪﻪﻧﻨ
ﻠﻣﺭ
ﻪﺩﺎﺻﺧ
ﮐږﯼ.
ﻠﯽ ﯽ
ﺗﺎ
ﻪﺳﻧ
ﺯﺍ
ﻮﻮﻣﻧﻮﺘ
ﯾﺮﺘ
ﮑﯿﻟ
ﺍﻭﺍ
ﻮﺑﻭﺍ
Vesceral l
eismani asi(skalazar)
ﯼﻭﺩ
ﺭځ ﺍځﻪﺍﻪﻣﻦ ﺗﺍﺳﻄlﻪﻭeiﭘ
shmani ﻩﭼﯽﺩa ﻭﻏﯽﺩﺭﺎﯾﯽﻧﺍﻭﺯﻮﺗ
ﻭ ﺮﻩﭘ ﻮ
ﺯﺱﯾ ﺎﯿﻧ
ﺎﻤﻟﺸ
ﺩﺩﯼﭼﯽ ﻮﻮﺟﺯﺱﻣ ﺎﯿﻧ
ﺎﻤ
ﻟﺸﻪﻟﻭﺭﯼډ.ﺩږﯼﻟﯽﺎ
ﻘﺘﻧﺍﻪ
ﺍﺳﻄ ﻪﻭ Phlﭘebotomi nsandf l
yﻧﺚ ﻮﻣ
ﺧ.
ﺯﺱڅﻪ ﺎ
ﯿﻧﺎ
ﻤﻟﺸMucocutﻭaneous ﺍ ﺯﺱ ﺎ
ﯿﻧ
ﺎﻤﻟﺸ ﻮﯼ،ﺣﺸﺯﺱ ﺎﯿﻧﺎ
ﻤﻟﺸ ﺪﯼ ﻠ
ﻪﺟ ﻟ
ﺭﺕﺩﯼ ﺎﺒﻋ
ﻣ:
ﻻﻞ
ﮐږﯼﭼﯽﺒﺐ ﯽ ﺎﺳﯿﻧ
ﺎﻤ
ﻟﺸﻮﯼSpeciﯾﯽﺩﺣﺸ ﻩes ﻭﺮﯼﭼﯽﺩ ﻟspeci es۲ ﺂ۰ﺒﯾ
ﺮﻘﺎﺗﯿ
ﻧﺎﻤ
ﻟﺸ ﺩ
ﻪ ﻟ
ﺭﺕﺩﯼ ﺎﺒﻋ
Phl
ebot omiﺎﻝﯾﯽﺩﯼ n ﻘﺘﻧ
ﺍﻭﺍ(څﻪ
L-chagasiﺧ )L-i nfantLﻭ um -donovﺍ ani
څﻪ
ﺍﻥ ﺧﻮﯿﯾﺩﺣ (ﻭﺎ
Antﺍhr
eponat i
ﻪﺩ)c ﺎﻥﺗﻧﺴﺍ څﻪﺑﻞ
ﺎﻥ ﺧﻧﺴ ﺍﻮ
ﻪﯾ ﻟﻪﺍﺳﻄ sﻪﻭ andfﭘly
.ﯿﺴﯽ ﺭﺕﻧ ﻮﮑﻞ ﺻ
ﻪﺷ ﭘ(zoonot iﻪﺩ)c ﺎﻥﺗﻧﺴﺍ
(l
ivecy clﺍﻥ)eﺭﻭﺪﺩﻧﻭژﺩ
ﻪﺎﻥﺗﻧﺴﺍڅﻪﺑﻞ
ﺎﻥ ﺧ ﻧﺴ
ﺍﺘﻦﻨﺩﻮﻣ
ﻪﯾ ﺍﺳﻄ Pﻪﻭ
hlﭘ ebotoni
n-snddf lﻩﺩy ﺮﺗﺎﯾ
ﺎﻝﯾﯽﺯ ﻘﺘﻧ
ﺍ
ﮐږﯼ
ﻩﯽ ﺮﺮﺳﮑﻞﺗ(ﻪﺷZoonotﭘ i
ﻪ)c ﺎﻥﺗﻧﺴﺍڅﻪ
ﺍﻥ ﺧ ﻮﯿﺘﻦﺣﻨﻪﻣﻟ(ﻭAntﺍ hroponoti)c
ږﯼ
ﻟﯽﺎﻘ
ﺘﻧﺍ(ﻫﻢDruguserﻠﯽ) ﺍﺧﺭﺎ
ډﻝﮐ
ﺮک ﻭ ﺘﻪﻣﺸ څﻪﭘﺘﻦ ﺧﻮﺳ ﻠﮏﭼﯽﯾ ﻪﺧ ﻐ
ﻩﻫ ﺭﻥګﺍﺪﻤﻫ
126
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
127
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﺷ.
ﺍﯼ ﻮ
(ﻭELIﺍ SA)Enzy mel i
nckedI mmunosor ﻪbantassay ﮑﻟ ﻪﻧﻭﯾﺲټ ﯿﮏټ ﻮﺟ ﻟ
ﻭ ﺮﯿﺳ
ﻮﮐﯽ ﻧﻭﺭﺍ
ﻮ ﺗ
ﺍﺮﺑﻮﻻ ﻠﻠﺘﻣﺨﺮﻪﭘ (ﻫﻢﭘ IFAT)i ndir
ectI mmunof luor escentant ibody
ږﯼ. ﻟﯽﺎﻤﻌﺘﺍﺳ
ﺑﻞﮐﯽ ﺎ
ﻘ(ﻪﻣrﭘ ﺘﯽﺟﻦ)k39 ﻧﺍL-ﺩ infant Arﭼﯽﺩ um api dImmunochr omat ogaphi c
ﻩﺮﻮﻗﻄ څﻪﯾ
ﺗﯽ ﺧ ﻭ ﯾﺲټﮐﯽﺩګ ړﯼټ ﻮ ﻣﻮﯼﻪﻧ
ږﭘ ﻟﯽﺎﻤ
ﻌﺘﺍﺳ ړﯼﮐﯽ ﻪﻥ ﻮﯼﻫﻢﭘ ﻣ ﻮﻠ
ﻌډﯼﻣ ﺎﺘﯽﺑ ﻧ
ﺍ
ﻮﯼ. ﻣﻮ ﻠ
ﻌﻪﻣ ﯿﺠ ﺘﻮﮐﯽﻧ ﻘﯿﻗﻟﺲﺩ ﻪﭘﻦځ ﯼﻭﭘ
ﮐږ ﺍﺘﻞ ﯽ ﯿﺴ ﺍﺧ ﻡﺮﯿﺎﺳ ﻭﯾ ﺍﻪ ﻨ
ﯾﻭ
ﮐږﯼ.ﺘﻞ ﯽ ﯿﺴ ﺍﺧ ﺭ
ﺎPڅﻪﻫﻢﮐﯿ ﺺﮐﯽﯾﯽﺩ CRﺧ ﻩﻪﺗﺸﺨ ﺭﻥګﭘ ﺍﺪﻤﻫ
:ﯿﺺ ﺮﯼﺗﺸﺨ ﯿﭘ
ﻮﺗ
ﺯﺱ ﻮﻠﯿﺮﺳ،ﺑ ﺯﻮ
ﻠﮐﺮﺑﻮ ،ﺗﻪﻗﺮﻣﺤ ﺭ،
ﻼﺎ
ﻪﻣ ﯾ ﮑﻟ ﺮﯼﻟﻪﺒﻩﭼﯽﺗ ﺮ
ﻮﺳ ﯿﻭﻏﺭﺎﻪﻧ ﻐﻪﻫ ﻟﺪ ﯾﺎﯿ ﺺﺑ ﺮﯼﺗﺸﺨ ﯿﭘ
ﻮﺗ
ﻭﻏﯽﭼﯽ ﺭﺎﻪﻧﻐﻩﻫ ﺭﻥګ ﺍﺪﻤﻩﻫ ﺮ
Hestﺳ opl asmosi Sﻭs chiﺍ stosomi asi s،
Tropi cal، CML، Portal Hyperttensi ﻪon ﮑﻟﺮﯼ ﻟ Spl eenomegal ly
ﻩﻭﺷﯽ. ﺮSchiﺳ st osomi asi،ﻭs Splﺍ eenomegal ly
:ﻪ ﻨﻠ
ﻣﺭﺩ
Liﻪposomal ﻟ ﻩﺭﺕﺩ ﺎﺒﻣﻞﻋ ﺭ ﻪﺩ ﺘﻤﯿﻭﻗﮑﯽڅ ﻧﻭﺪﯿ
ﻤﻞﮐ ﻩﺗﺤ ﻩﻭ ښ ﺮښﺍ ﻪﮐ ﻟ
ﻭﺍﺑﯽ ﺎ
ﺘﺨ ﻧ-۱ﺍ
ﻭ ﻭڅ
1-ﺭ 5، 3MG/ KG/ ﻻﯼday ﻪﺭ ﻟﺪﯾ
ﺭﺯﯾﯽﺩﻭ ﻭ ډﺩﺭډAڅﻪ ﺱټﻥ mphotﺧ erici n-B
ﺮﯼ ﻟﯾﺖ ﺮﺛﻮﻨﯽﻣ ﯿﻪﯾﯽﭼﯽﻋ ﻘﯾﺮﻪﻃ ﻠﮐږﯼﺑﻮﻝ ﯽ ﮐﺭ
ﺎﻭﯿﻭځﭘ۲ﺭ ﺍ۱
ﻪﻭ ﻤﻟﺴ ﺭﺍﻭﻪڅ ﻪﭘﺘﻭﺳ ﺭﻩﻭ ﺭ
ﺎﭙ
ﻟ
ﻪﻘﯾﺮﻪﻃ ﻠ
،ﺑ ﮐږﯼ
ﻮﻝ ﯽ ﮐﺭﻭﮐﯽﻭ ﻭځ
۴ﺭ -۱
ﭘ۰(ﻪ 5MG/ ﻩ)KG ﺯﻭﯼڅﺭډ
ﻮ ږ ﻟ ﻟﯽ ﺎﻤﻌﺘﺍﺳ ﺪﮐﯽ ﻨ
ﻪﻫ ﻭﭘﺍ
ږﯼ. ﻟﯽﺎ
ﻤ ﻌﺘﺍﺳ (ﻮځﻝ 15MG/ﯾ ﯾﯽ)KG
Amphot erici
ﻟnB- ﻩﻪ ﺭﺕﺩ ﺎﺒﻩﭼﯽﻋ ﻪﺩ ﺗﺎ
ﯾﯿﺲټﯼﯾﯽﺯ ﮐﺴ ﻮﻮﺗ ﻪﺧ ﻧﺍﺯﺭﺍ،ﻩﺮ ﺛ
ﻮ ﻣﻞﭼﯽﻣ ﺭ ﺑﻞﺩ
ﺎ
ﻭﯾ ﺍ ﻩﺭﺎ
ﭙﻟﻭﻭځ15-ﺭ 1MG/ﺩ20 kg/ ﮑﻞday ﻥﻪﺷژﭘ ﻮ ﻔﻧ
ﺍ ﻣﻞﺩ ﺭړﯼﺩ ﻮﻣﻮ deoxycholﻧ ate
Liposomal amphot eri
ciﮐږﯼ.ﺩnB ﻮﻝ ﯽ ﮐﺭ
ﻩﻭ ﺭﺎﭙ
ﻟ ﻮﺘﻔ
ﺪﺩ۸ﻫ ﻌﻭځﺑ0ﻮ ﺭ .ﯾ 5MG/ KG
Hy pot ension، ﻩﺗﻦګﯼ ﺎﺯ،ﺳړﻩ ،ﻝ ﻪﺒ،ﺗ ﺍﺽﺮﺘﻢﻋ ﯿﺴﻤﯽﺳ ﻪﺩﻫﻀ ﻟﺭﺕﺩﯼ ﺎﺒﺭ ﺽﻋ ﺍ
ﻮﺒﯽﻋ ﻧ
ﺎﺟ
ﺧ.ﻮڅﻪ ﺗﺍﺮﺛ
ﺍﯿﮏ ﮐﺴ ﺎ
ﺪﯼﺗ ﻧﺎﻭﺑﺭګ ﻮ ﺗﺭﻭﭖښ ﻪځﯼګﺍ ﻭﭘﺍ
Pent av alﻪenat ﻟ ﺭﺕﺩﯼ ﺎ
ﺒږﯼﻋ ﻟﯽﺎﻤﻌﺘﺍﺳﺮﯾﻩډ ﺭﺎ
ﭙﻟﺯﺱ ﺎﯿﻧﺎ
ﻤﻟﺸ ﻣﻞﭼﯽ ﺭﯾﻢﺩﻭ –۲ﺩ
ﻪﻮﭘﻠﻣﺭﺩﯼﺩ ﺪﮐﯽﺩ ﻨﻪﻫ ﻮﭘ ﮐږﯼﺧ ﻭﻝ ﯽ ﺭﺎﻮﮐﯽﮐ ﻧ
ﻭﺩﺍﻮﯿﻭﻫ ﺮﯾﻪډ aڅﻪﭼﯽﭘ ntﺧ imonai ls
ﻪ
Sodiﭼ um st ibogl ﺩﺩﯼoconat ﻮﻮﺟ ﺍﺕﯾﯽﻣ ﺮﺘﺤﻀ ﻩﻣﺴ ﻭﻮﯼ.ﺩ ﺍﺷﺪﯿ ﻣﺖﭘ ﻭﺎﻘ
ﺑﻞﮐﯽﻣ ﺎ
ﻘﻣ
ﻪﻨﯿﺗﻪﻻ ﻪﭘMeglﭼ umi neant imoni tﯼﻭeﮐږ ﺍﻭﻝ ﯽ ﺭﺎﻮﮐﯽﮐ ﻧﻭﺩﺍﻮﯿﻭﻫ ﺭ ﻮﻭﻧ ﺮﯾﻭډﺍ ﺎ
ﮑﯾ ﺮﻣﺍﻪﭘ
ډﺯﻮﻭ ﺗﺍﺮﺘﺤﻀ ﻭﻣﺴ ﺩړ
ﺍﮐږﯼ.ﺩ ﻭ ﻭﻝ ﯽ ﺭﺎ
ﻮﮐﯽﮐ ﻧ
ﻭﺩ ﺍ
ﻮ ﯿ
fﻫ rﻭancophone ﺍ ﺎ
ﮑ ﯾﺮ
ﻣﺍ
ږﯼﺩ ﻟﯽﺎ
ﻤﻌ ﺘ
ﺍﺳ ﻻﯼﻪﺭ ﻟﻠﯽﺎﺩﻋﻀ (ﻭﯾﮐږﯼ ﺍ ﻮﻝ ﯽ ﮐ
ﺭﻊﻭ ﯿ
ﺮﺟ ﺗﻻﯼ)ﻪﺭ ﻟﺪ ﯾﺭ20MG/ﺩﻭ KG/ day
۲ﻩ۸ ﺭﺎﭙ
ﻟ ﺯﺱ ﺎ
ﯿﻧﺎ
ﻤ ﻟﺸ Mucocut ﻭaneus ﺍﻮﯼﯼﻭﺩﺣﺸ ﻭځ ﺍ۲ﺭ ﺯﺱ۰ ﺎﯿﻧﺎ
ﻤﻟﺸ ﺪﯼ ﻠﻩﺩﺟ ﺩﻮ ﻭﯼﻣ ﺍ
ﺪﺗ
ﺩ.ﻭځﯼﻩ ﺭ
ﺍﺮﮑﻧﺎ،ﭘﺩﺭﻮﺩ ﻧﻭﺪﻨ،ﺩﺑ ﻪﻧ
ﻭ ﺩﺭﻠﯽﺩ ،ﻋﻀ ﺩﺭﺩﺮ،ﺳ ﻪﯿﻪﺗﻟﺭﺕﺩﯼ ﺎﺒ
ﺭ ﺽﻋ ﺍﻮﺒﯽﻋ ﻧﺎﻣﻞﺟ ﺭ
ړﯼﺩ ﻮﻣ ﻮﺩﻧ
ﺧ.
ﭘﺴﯽڅﻪ ﺍ
ﺭﻕﺷﯽ ﻠﯽﺯﻪﻋﻀ .ﻭﮐټﺱﻭRashﺍ ټﯼ ﺍ ﺍ
2.5MG/ ډﺯﯾﯽKG ږﯼ ﻭ ﻟﯽﺎﻤﻌﺘﺍﺳ ﻻﯼﻪﺭ ﻟﻟﯽﻮﻪﺧ ﻟﻣﻞﺩﯼﭼﯽ ﺭځﯽﺩ ﺍﻧ ﻮMiﯾ ltefasi ne–۳
ﻪﻟ ﺭﺕﺩﯼ ﺎﺒ
ﺭ ﺽﯾﯽﻋ ﺍ
ﻮﺒﯽﻋ ﻧﺎ
ﮐږﯼﺟ ﻮﻝ ﯽ ﮐﺭﻪﻭ ﻭﻍﺗ
ِﺭﺎ
ﻩﻧ ﺭﺎﭙ
ﻟ ﻭﻭځ۲ﺭ ﻮﺩ۸ ﻧﻭﺯﻭ ﺮﯼډﻩﮐﺴ ﻭ ﻪﺩﭘ
ﺧ.
ﻟﯽڅﻪ ﺍ
ﻭﻟړ
ﻮﻮ ﻧﻮﻤﯾﺍ
ﺰﻧﺍﺭﺩ ﺎ،څﯼګ ﻬﻝ ﺍﺳ ،ﺎﻥګﯼ ﮐ
ﻮﺩ ﻩﺧ ﺍﺩﻭﻩﺩ ﺮ
ﺛﻮﻩﻣ ﺯﺍﺪﻧ
ﺍ Aﻪ
mphotﭘ er i
ci(ﺩn Paramomy cin)Ami nogl ycosi de–۴
ﻠﯽ11MG/ﺩﻋﻀ KG/ ﺩډﺯﯾﯽDay ﻣﻞ ﻩ ﻭ ﺭﻪﺩ ﻧ
ﺍﺯﺭﺍﺮﯾ
Miڅﻪډ
ﺧ l
tef osiAﻭn mphotﺍ ericin
128
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
Toxopl
asmosi
s
ﮐږﻱ
ﻪﯽ ﺗ
ﻣﻦځﺍ
ﮑﻞﺭﻣﻦﺷ
ﺰﻭﻣ
ﺍﺩﺎ
ﻪﺣﻮﮐﻲﭘﻧﺎ
ﻧﺎ
ﻧﺴﺍ
ﻪﻩﭼﻲﭘﻭﻏﻲﺩ ﺭ
ﺎﻳﻲﻧ
ﺍﻭﺯ
ﻮﺗﻭ
ﺮ ﻧﻲﭘﺎ
ﺘﻧ
ﺍﻩﻮ
ﯾ
ﻭﻏﻲ
ﺭﺎﮑﻲﻧ
ﯿﻨﯿ
ﻠﺍﮐ
ﺭځﻱﭼﻲﺩ
ﻻﻞګ
ﻭﻣ ﺪﯿ
ﻩﮐﺭ
ﺎﮐﻮﺩ ښﯿ
ﻭﻏﺭ
ﺎﮑﻲﻧ
ﯿﻨﯿ
ﻠﮐﻮﮐﻲﺩﻧ
ﻮﺘﻟ
ﺎﻭﺣ ﺩړ
ﺍ
ﻪﻭ ﭼﻲﭘ
:ﻪﻟﺭﺕﺩﻱﺎﺒ
ﻋ
Myocardit
i(s1
Encephal
i
ti(s
2
Pneumoni
ti
(s3
Chor
ior
eti
nit
i(s
4
Eti
ology
ﺍﺧﻞ(ﺩ
Obli
gat)e
ﺭﻮﺒﻮﻣﺠﻪﭼﻲﯾ ﺍﺳﻄTﻪﻭ oxoplﭘasmaGandi iﻮﺳﺲﺩ ﻣ
ﺯﭘﻼﻮﮐﺴﻮﺗ
ﻪﻟﺭﺕﺩﻱﺎ
ﺒﺍﭼﻲﻋﻮﻪﺧ ﻟﻮﻧ
ﺎﻤ
ﻟﺎ
ﻩﻋﻭﮐﻝﺩﺩ۱ﻉﺎ ۹
۰ﻪ۸ ﺯﯼټﺩﯼﭼﻲﭘ ﺍ
ﺮﻳﻲﭘﺍﻭﺯ
ﻭﺭﻮﭙ
ﻭﻱﺳ ﺮﻟﺤﺠﺍ
ﺭﺩﻭځﯼګ ﺍ
ﺭﻱﻮﺯﯼټﺩﺗ ﺍ
ﺮﻪﭘﻮﺩﻏﻧ
ﺎﻤﻟ
ﺎړﻱﻋﻮﻣﻮﻮﻧﺍﮐﺸﻒﺷ ﻮMaﻪﺧ
Nﻭ nceaxﻟ iﺍcolle
.
ﻭﺭړ
ﻭﻪﻻﺱﺍ څﻪﭘ
ﺮﺧ ﯿ
ﻤ ﺳ
ﻨﯽﻌﮐږﻣ
ﺎﻮﻮﺱﯾﯿﻦﺩﻗ ﮐﺴﻭﻩﭼﻲټ ﻮﻱﺩ ﺘﻞﺷﯿﺴ ﺍﺧڅﻪ
ﻮ ﺧ ﻤ
ﯿﻠﻧﻲﮐﺎﻧ
ﻮﻩﯾﻭﻼﺎﺩﺩ
ﻣ
ﭘﺯ ﻮﮐﺴﻭټ
څﻪ
ﻼﺎ ﺧ
ﻣﻟﭘﺯﻨﻲﻪﯾ
ﻼﺎﭼﻲﺩﻭ ﻣﺍﭘﺯ(ﻭﺮﻱﻟﮑﻞﻮﺱﺷ ﯾﺩﻗﻨﻲﺎ ﻨﺤ
ﻭﯼټﯾﯽﻣ ﺯ
ﻮﻓﻭﺮﺗ
)ﻮﻱﮐﺭﻭ
.ﮐږﻱ
ﺍﯽ ﺪﯿﻪﮐﻲﭘ ﻨ
ﯾﻪﻭﻩﭼﻲﭘ ﻮﻱﺩﺘﻞﺷ ﯿﺴﺍﺧ
ﺩ.
ﺯﯼټ ﯼ ﺍ
ﺮﺭﭘﻮﭙﻪﺧﻪﮐﭽ ﺩﻥېﭘ
ﻩ ړ ﺮ
ﻪﻧﻈ ﻟﻟﻲﺍ
ﻭﺭﻮ
ﭙﺯﯼټﺩﺧ ﺍﺮﻪﭘﺩﻏ
ﮑﻲ
ﻧﻭﺮﻟﺭﺗﻲ
ﻮﻪﻧﺗ
ﺮﻮﭘﻧ
ﺎﻧ
ﺎﻧﺴﺍﺮﻱﭼﻲﺩﻟSpeciﺎﺕes ﯾ۲څﻪﺯ
۰ﺧ ډﻝﺩ۰ﻌﻲ ﻭﺒټﻪﻃﺯﯼ ﭘﺍ
ﺮﺍﭘﻭﺩﺍ
ﺷ.
ﻟﯽ ﻲ ﻮﺘﻦﮐﻨﮑﻲﻫﻢﻣ ﻧ
ﻮﺗﻮﻟ
ﺍﻭﺍ
129
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﺭ:
ﺎﻝﻻﻱ ﻘﺘ
ﻧﺍﺩ
ﺎﻝﻘﺘﻧ
ﺍ ﻻﻱ
ﻟﻲﺩ ﺭﻮ:ﺩﺧﻟﻒﺍ
.
ږﻱﻟﯽﺎ
ﻘﺘﻧ
ﺍ ﻻﻱ
ﻟﻲﺩﺭ ﻮﻩﺩﺧﺯﺍﺪﻧ
ﺍﻪﺗﺎ
ﯾﻪﺯ ﻮﮐﻲﭘ ﻧﺎ
ﻧﺎﻧﺴﺍﻪﺎﻥﭘﺘﻧ
ﺍﻼﺎ
ﻣﭘﺯﻮﮐﺴﻮﺗ
Oocy ﺎﺕstﯾڅﻪﺯ
ﻮﻥ ﺧ ﯿﻠ
ﯿ۱ﻣ،ﺗ۱
ﻭځﮐﻲﺮ ﻪﺭ ﺍﯼﺷﻲﭘ ﺪﯿﻪﻭﻱﮐ ﺘﺍﺧ ﺎﻥﺘﻧﺍ
ﻪګﻥﭼﻲﭘ ﻮﺍ ﯿﺸﻪﭘﻐﻫ
ﺮﻱﻟ
ړﺎ
ﯿﻭﻭﺗ ﺪ
ﯿﺘﻦﮐ ﻨ
ﻩﺩﻣ ﺯ
ﺍﺪﻧﺍﻪ
ﺗﺎﯾ
ﻭﯼټﺩﻱﭼﻲﺯ ﺯ
ﻭ ﺭﻮ
ﭙﮑﻲﺩﺳ ﻧ
ﻭﺮﻟOocy ﺩstړﻱﭼﻲﺍ ﺍﺝکﺮﺍﺧ
ﺷ.
ﻪ ﻲ ﺗ
ﺎﺪﻱﭘﻧﻭﻮﮐﻲژ ﺑ
ﻭﺍﻭﺍﻩﺭﻭﺎ
ﻪﺧ ﺭﻱﭘﻮﻮﭘ ﻧ
ﻮ ﻠ
ﺮﮐﮐﻻﯼﺷﻲﭼﻲﺗ ﻭﻮ ﺍ
ﻭﻏﻲﺭﺎ
ﻧﻩﺩﺯﺍﺪ
ﻧﺍﻪﺗ
ﺎﯾ
ﻪﺯ ﻮﻱﻭﻱﭘ ﺘﻦﺷ ﻨ
ﺪﻱﻣ ﻧ
ﺎOocyﺑ ﭘstﻪﭼﻲ ﻪ ﺑﻭﺍﻭﺍ ﺩ
ﺍﻮﻳﻲﻣﺍﺬﻪﻏﻐﻭﻫﺍ
.ﺭځﻱﻻﻞګﺎﻝ ﻣ ﻘ
ﺘﻧﺍ
ﺩ
ﺎﻝﻘﺘﻧﺍﻻﻱ
ﻨﻲﺩﺭ ﯾ
ﻭﻭﻭﺩړﺍ
:ﻍ ﺏ
Serډﻝﺩo-ﯿﻢ ﻭﻘ
ﺘﻪﻣﺴ ﮐﻻﯼﺷﻲﭼﻲﭘ ﺪﻱ ﻮﻧﺍ
ﻼﺎګﻣﭘﺯ ﻮﮐﺴﻮڅﻪﺗﺎﻝ ﺧ ﻘﺘﻧ
ﺍﻟﻲﺩﻮﻼﻩﺩﺧ
ﺮﻋ ﻭﺑ
ﻭ
ﺭګﻮﺗ،ﭖښ ﻭږ،ﺱ ﺭﻩځﯼګړ،Sﻪﺩﺯ
erﺗo-negati
v erecipiﺧent
ﻭﻍڅﻪ ﺭ
ﺎposiﻧt
iveDonor
.
ږﻱ ﻟﯽﺎ
ﻘﺘﻧﺍﻪﺍﺳﻄﻪﻭ ﺪﭘﻧﻮﯿ
ﺍﺱﺩﭘ ﺮ
ﮑﻧﺎ
ﻭﭘﺍ
ﺭځﻱﭼﻲ ﻪﺍﺘڅﻪﻻﺳﺮ ﺧﻠﭽﻨﻲﺩﮐ ﯾRefﻭri
geratedant icoagulatﻪﺩed ﻧﻭ
ﺯﯼټ ﺍ
ﻭ ﺮ
ﺪﻱﭘ ﻧ
ﻭژ
ﻮﮐﻲﺩ ﺎﺻﺍﺷﺨ ﻮﻱﻪﺩﻏ
ﮐږ ﭘﻩﯽ ﺮﺮﺳﻪﺗﺗ
ﺭژﻥﻭ ﻮ
ﯿﻔﻧﺴﺍﺭ
ﻮﮐﻲﭼﻲټ ﺎﺻﺍﺷﺨ ﻪﻐﻪﻫﺍﯼﺷﻲﭘ ﺪﯿﮐ
ﻭ.
ﻊﻱ ﺒ
ﻨﻩﻣﻮﺎﻥﯾﺘﻧ
ﺍ
،
ﺰﻐﻣﻮﺩﮐﻭډﻮﮐﻲﭼﻲﺩﻩ ﺎﺻﺍﺷﺨ ﻪﻐﻪﻫﺪﻝﭘ ﯿﻪﮐ ﻟ
ﺎ
ﻌﻩﻓ ﺭﺎ
ﺑﻭﺪﻱﺩ ﻧﺍ
ﻼﺎګ
ﻣﭘﺯ ﻮﮐﺴﻮﺩﺗ
ﮐږﻱ
ﻩﯽ ﺮﺮﺳ ﻪﺗﺗ
ﺭﺪﻭﻧﻮﯿﺭﭘﻮﮐﻲﭼﻲﺩځﯼګ ﻧ
ﺎﻭﻏﺭﺎ
ﻪﻧﻐﻭﻫ ﺍHemat opoieti
cstem cells
ﺩ.
ﻮﯼ ﯼ ړﻝﺷ ﺭکﺭﻭﻮﭘﺍ
ﺭ
څﻪ
ﺎﺱ ﺧ ﻤﺗ
ﻮﺩ ﯿﺸﭙﻞﺩﺷﻤ ﻭﺩﺳ ﺍﻮﺎﺟ
ﻧﺴﺍ،
ﻮﻨﺘ
ﻭﺳ ړﺍﯼﺷﻲﺩﮐﮏ ﺪﯿﻧﻞﮐﻮ ﺮﺳﺭﭘﺍﻮ
ﺗﺍﺮ
ﺑﻩﺩﻻ ﺮ
ﺑﻼﺧﻭﺍ
ﺷ.
ﻪ ﻲ ﺘﺍﺧﺎﻥﺘﻧ
ﺍﻪﻪﭘﺘﻭﺳﺭﻭ
ﺎﻝﻘ
ﺘﻧﺍ
ﻻﻱﺎﺩ ﺭﺘﻨ
:ﺩﭘﻼﺳﺝ
ﻪﺩﻱړﯼﻭﻱﻟﺎﻥﮐﺴﺐک ﺘ
ﻧﺍﻼﺎ
ﻣﭘﺯ ﻮ
ﮐﺴ ﻮﺍﻥﮐﻲﻳﻲﺩﺗ ﺭﻭﻱﻪﺩ
ﻣﻞګ ﭘ ﺎﺪﻱﭼﻲﺩﺣ ﻨﯿﻪﻣﻐﻟﻲﻫﻭټ
.ﻮﻱ ﻟ
ﺎ
ﻘﺘﻧ
ﺍﺎﻥﺘ
ﻧﺍﻪﻡﺗﻮﺎﺷﭙﻞﻣﻪﺧ ﺮﺧﻪﺑﻤﯾ
ﺭڅﻪﻳﻲﺩﻠﯽ ﺧ ﻤ
ﺟ
.ږﻱﺗﯽﺎﯾ
ﻩﺯﺮﻭﺳ ﺪﯿﺗ
ﺎﯾ
ﻪﺯ ﺮﭘ
ﻤﯿﻦﺩﻋ ﻨ
ﺮﺩﺟ ﺎﻝﺧﻄ ﻘﺘ
ﻧﺍﭼﻲﺩ
(
٪۱۵
ﺮﮐﻢﻭﻱ)ﺎﻝﺧﻄ ﻘﺘ
ﻧﺍ
ﺎﻥﺩﺘﻧ
ﺍﻪﺷﻲﺩ ﺘ
ﺍﺧﺎﻥﺘ
ﻧﺍﻪﺮﮐﻲﭘ ﺘﻤﺴﯾ
ﺍﺮړﻱﺗﻡﻮ
ﻟﻪﺭﭘﻮﻩﻣﻮﻪﯾﺗﺮﯿ
ﻪﭼ ﮐ
ﻭ.
ﻪﻱ ﻤﯿﻭﻏﻲﻭﺧ ﺭﺎ
ﻡﮐﻲﻧ ﻮﺎﺷﺯږﻱﻣ
ﻮﯼ ﻪﻧ
ﻟﺖﮐﻲﭘ ﺎﻪﺩﻱﺣ ﭼﻲﭘ
ﺎﻥﺘ
ﻧﺍ
ﻪﺷﻲﺩ ﺘ
ﺍﺧ ﻮﺳﺲ ﻣﺯ
ﭘﻼﻮﮐﺴﻮﻪﺗﺮﮐﻲﭘ ﺘ
ﻤﺴﯾﺍﺮ
ﯾﻢﺗﺭﻱﻪﺩﻣﻞګ ﭘﺎﺭﺩﺣﻮﻩﻣﻮﺮﻱﯾ ﯿ
ﻪﭼ ﻭﮐﺍ
ﻭ.
ﻮﻱ ﺍﺿﺮﺍﻋﻮﻻًﺑﻲ ﻤ
ﻌﻡﻣ ﻮﺎﺷ
ﻟﯽﻣ ﺪﯾ
ﺯږ
ﻮﯼ ﯼ ﺭﻧﺎﺕﻭﻱﻡګ ﯾ٪څﻪﺯ
۶ﺧ ﺮﺩ۰ ﺎﻝﺧﻄﻘﺘﻧ
ﺍﺩ
Pat
hogenesis
څﻪ
ﯿﺴﺖ ﺧﺘﻢﮐﻲﺩﺳﯿﺴﻤﻲﺳﻪﻫﻀﻊﺷﻲﭘ ﻠ
ﻪﺑﺍﺳﻄ
ﻪﻭﺎﻥﭘ
ﺑﺰ
ﯿﯿﺴﺖﺩﻣ ﻪﭼﻲﺳ ﻠ
ﮐ
ﻤﻲ
ﻭﻫﻀ
ﺍﻡﺩﯼﻭ
ﺎﻘﺑﻞﮐﻲﻣ
ﺎﻘ
Pﻪﻣ
epsiﭘ
Brﺩnadyzoit
ﻪesږﻱﭼﻲﺩﻏﺩﯼﺍ
ﺯﺁBr
adyzoi
tes
130
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
131
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
:
ﻪﻟﺭﺕﺩﻱﺎﺒ
ﻧﻲﻋﺪﻧ
ﻮﮑﻲﻣ ﯿﻤ
ﺘﯿﺴ
ﻮﮐﻲﺳ ﻧﺎ
ﻭﻏﺭﺎ
ﻪﺩﻱﻧﻮﻱﭼﻲﭘ ﻪﮐﻌﺍﺟﺮ
ﺮﻱﻣ ﻟﻟﯽﺍ
ﻪﻭﺗﺭ
ﻩﻭﺮﺳ
ﺒﻲﻗﻩﺭ
ﺩﺭﻭﺑﻲﺩﺍﻟﯽﺍ
ﻮﯾﻮ
ﻟﺭﻭځﯼګﺍﺭﻱﻮﺗ
ﺩ،ﺩ
ﺩﻮﺭﺗ،ﺩﻋﻀﻼﻟﺖﺎﺩ،ﺴ
ﺩﮐﻧﻲﺭ ﻮﺘﺗ،ﺩﺳ
،ﻪ
ﺩﺒ ﺭﺩ
ﺮﺳ
.
ﺘﻲﭘﻮﻨ
ﯾډﺍﻤﻒﻟﻣﻲﻮﻤﺎﻋﯾ
:
ﻪﮑﻟﻮﻱﺮﮐ
ﺎﻫډﻝﺗﻈ
ﻪﻭ ﻭﻏﻲﭘ
ﺭﺎﺪﻱﻧﯾ
ﺪﻮﻱﺷ ﺎﺩﯾ
ﯿﻮﮐﻲﺑﻧﺎ
ﻭﻏﺭﺎ
ﺮﻧﯿﻤﺮﮐﻢﺷ ﯾ
ﺭﻪډ
ﻡګﭘ
Pneumoniti
s
Meningo-encephali
ti
s
Hepati
ti
s
Pol y
my osi
ti
s
Myocardi
ti
s
CongenitalInf
ecti
( on2
ﻩﭼﻲډ ﺮﺒﻩﺧﻮﻮﯾﻮﻭﻱﺧ ﺍﺿﺮﺍﻋﺎﺑﻲﻭﯾﺍﺮﻱﻟ
ﺍ ﺽﻭ ﺮﺍﻋ
ﻭﻍ ﺭﺎ
ﺍﯼﺷﻲﻧ ﺪﯿ
ﻟﺖﮐﻲﻫﻢﮐ ﺎﻪﺩﻱﺣ ﭘ
ﻪﻟﺎﻥﺘ
ﻧﺍ
ﻮﺩ ږﻱﺧﺗﯽﺎﯾ
ﺮﺯﺎﻥﺧﻄ ﺘ
ﻧﺍ
ﻩﺩ ﺮﻭﺳﺪﯾﺮﯿ
ﻪﺗ ﻣﻞګﻱﺩﻭﺧﺖﭘ ﺎ
ﻩﭼﻲﺩﺣ ﺩ
ﺍﻩﺩﻪﺩﻤ ﻬﻩﻣﺮﯾ
Earl
yFetﻣﻼًal ږﻱﺜﻤﯽ ﺮﮐSevﺧﻄ ereFetal diﮑﻲsease ﻧﻮﻠ
ﺗﺍ
ﻪﺭﺗﻪﻣﻦځ ﻠﻣﺍ
SeverﯾﺩeSﻭﺎ
tﺍ il
lbi
rt
h، SpontaneousAbor t
iﻩﺩon ﺯﺍﺪﻧ
ﺍﻪﺗﺎ
ﯾﻪﺯIﭘnfect i
on
.ﮐځﻱﻻﻞ ﺮ
Neonatﻣ al Disease
ﻟﺖ ﺎ
ﻪﺩﻱﺣ ﻪﺷﻲﭘ ﺘﺍﺧﻭﻏﻲﺭﺎ
ﻪﻧ ﺮﻭﺧﺖﮐﻲﭘ ﯿﺍﺧﻱﻪ
ﻣﻞګ ﭘ ﺎﻡﺩﺣ ﻮﺎﺷﻪﻣﺗﺮ
ﯿﻪﭼ ﮑﺲﮐ ﺮﻋﺑ
ﻩﺯﺍﺪﻧ
ﺍ ﻪ
ﻤﺎﮐﻭﯾ
ﺍﻣﻞ ﺭ
ﺎﻪﻭﺧﺖﮐﻲﻧ ﺪﭘﻟ
ﻮﺗﺎﻥﺩﺭﻏﻭﺎ
ﻩﻧﺮﺗ
ﺎﯾ
ﻭﺯ ﺍﺮﮐﻢ ﻭﻏﻲﺧﻄ ﺭﺎ
ﺪﻱﻧ ﯾﺪ
ﮐﻲﺩﺷ
CongenitalToxoplasmosi ﺮﮐﻲs ﻤﻪﻋﺘﻭﺳﺭﻪﻭﺍﯼﺷﻲﭘ ﺪﯿﻮﮐﺮﻱﺧ ﻟﻣﻞټﻱ ﺭ
ﺎﻨ
ﺑﺍ
ﺷ.
ﻪ ﻲ ﺗﻣﻦځ ﺍ
ﻪﮐﻲﺭ ﻼﻢﭘ
ﻭﻋﯾ ﺍﺍﺽ ﺮﺍﻋ
Reti
nochoriodi t
i(s3
Retڅinochori
odi
tiﺭﺕﺩs ﺎ
ﺒLatﻋ ePresentat
iﻭon ﺍﻡﺎ
ﺎﺕﻋ ﯾﻮﺳﺲﺯ ﻣﺯ
ﭘﻼﻮﮐﺴﻮﺩﺗ
ﺭځﻱ
ﻪﺍﺗﻪﻣﻦځ ﺘ
ﻭﺳﺭCڅﻪﻭ
ongeniﺧ t
al i
nfecti
ﻪﺩon ﺘﻭﺳﺭﻪﻭﻧﻮﻠ
ﻭﮐ ﺍﺘﻲﻔﻪﺩﯼﭼﻲﻫ ﺧ
ړﻱﻡﻮﻟﻪ
ﺪﭘﻧﻭﻮﮐﻲﭼﻲﺩژ ﻧ
ﺎﻭﻏﺭ
ﺎﻪﻧﻐﻪﻫ ﺍﯼﺷﻲﭘﺪﯿRetﮐ i
nochor i
oditi
ﻩsﺭﻥګ ﺍ
ﺪﻤﻫ
ﺩﻮ
ﻩﯾ ﺮﺗﺎ
ﯾﺎﻥﺯ
ﻭﻏﺭﺎ
ﺍﻧﻪﺷﻲﭼﻲﺩ ﺗﻣﻦځ ﺍ
ﺘﯽﻭﻱﺭ ﯿﺴﺍﺧ ډﻝ
ﺒﻲ ﻭﻪﮐﺴ ﺎﻥﭘﺘ
ﻧﺍﻭﺧﺖﮐﻲﻳﻲ
.ﻮﻱﻪﮐ ﻌ
ﺍﺟﺮﻩﻭﻱﻣ ﺮ
ﺭﺳ Uvﻭeiti
ﻩﭼﻲs ﺮﻭﻏﻲﺳ ﺭﺎ
ﻪﻧﻓﺮﻃ
:ﻪﻟ
ﺭﺕﺩﻱ ﺎ
ﺒﻼﻢﻋ
ﻭﻋﯾ ﺍﺍﺽﺮﺍﻋﻮﻧ
ﺎﻭﻏﺭﺎ
Retﻧ i
nochoroidi
tiﺩs
ﺍﺽﺮ
ﺍﻋﯿﮏ ﻤ
ﺘﯿﺴﻩﺳﺮﺜﮐ
ﺍ ﻟﺖﮐﻲﺎﻪﺩﻱﺣ ﺮﭼﻲﭘ ﯿ
ﻐﺪﺗﯾ
Pﻭﺩﺩ hotﺍophobi ﺩa،
ﺩﺮګﻱﺭ ﺘ
ﺩﺳ
ﻭ.
ﻪﻱ ﺩﻧﻮﻮﺟﻣ
ﺩﻭﻱﻮﻮﺟﻮﮐﻲﻣ ﺗ
ﺎﻻﻮﺣ ﻤ
ﻪﮐﻘ ﺺﭘ ﺪﻧﯾﺭﺩﺩﻩځﻱﻡګ ﻪﻣﻦځ ﻟ
ﻼﻢ
ﻭﻋﯾ ﺍﺍﺽ ﺮ
ﺍﻋﻩﺮﭼﻲﺑﻼﺧ
ﺷ.
ﻻﻞ ﻲﻟﻲ ﻣﺍ
ﻭ ﺪﻧ
ﻭﺍړ
ﺎﻭ ﻣﻮﮐﻮﻟ
ﺍﯼﺷﻲﺩګ ﺪﯿﭼﻲﮐ
Diseasei ntheImmunocompr omisedPer (son 4
ﻮﮑ
ﻧﻭﻮﻟ
ﺎﻤ
ﻌﺘﺍﺳﻮﻠ
ﻣﺭﻮﺩﮑ
ﻧﻮﭘﯿﺖځﻓﺎ
ﻌﻭﻣ
ﺍﺮﻨﺴﮐ،
ﺯﺍډ
ﻪﯼﺪﻝﭘﯿﻟ
ﺎ
ﻌﻩﻓﺭﺎﺑ
ﻭﻮﺳﺲﺩ ﻣﺯ
ﭘﻼﻮﮐﺴﻮﺩﺗ
.ﮐږﻱ
ﻪﯽ ﺗﻣﻦځﺍ
ﻮﮐﻲﺭ ﻧﺎ
ﻭﻏﺭﺎﻧ
ﻪﻟ
ﺭﺕﺩﯼ ﺎ
ﺒﺮﻋﺎﻫ
ﻡﺗﻈﺎ
ﺮﻋﯾﻮﺳﺲډﻣﺯﭘﻼﻮﮐﺴ
ﻮﻮﮐﻲﺩﺗ ﻧ
ﺎﻭﻏﺭ
ﺎﺯﻧﺍډ
ﻠﻲ ﯼﻠ
ﺘﻣﺨﺮﻪﭘﭘ
.
Encephal i
ti
s
:
ﻪﻟﺭﺕﺩﻱﺎﺒﺍﺕﻳﻲﻋ ﺮ
ﺎﻫﻭﮐﻢﺗﻈ ﺍ
ﻪ
ﻠﻣﺍﻪﻟ
ﯾﺶ ﻮﺗﺸﺪﺩ
ﯾﻭﺩﺩﺍ ﺩ
ﺭﺮګﻱﺩﺘ
ﺎﻥﺩﺳﻭﻏ
ﺭﺎﻟﺖﮐﻲﻧﺎ
:ﻪﺩﻱﺣRetﭘinochoriodi
ti
s. A
132
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
.
ﻮﻱﻪﮐ
ﻌﺍﺟ
ﺮﻣ
ږ
ﺭﯼﻭ
ﻱڅﻪځ
ډ ﺧﺳﻦ
ﻟ
ﻭﺎﺍ
ﻭﺧﻲ
،ټﺒﻲ
ﺎﻥﺩﺗ
ﻭﻏﺭ
ﺎﻟﺖﮐﻲﻧ
ﺎ
ﻪﺩﻱﺣ
:ﭼﻲﭘ
Pneumoni
ti
s.B
.ﻱ
ﻪ ﻠﯽﻭﻱﭘ ﺍﻏﺪﻱﺭ ﻧﺭﻻ ﺎ
ﺮﻓﺸ ﻪﺗﻠﻣﺍﻪﻟ
ﻮ ﻠ
ﻣ ﺭ
ﻭﺩﺩ ﺍﺎﻥﺮﻃﺘﻢﻳﻲﺩﺳ ﯿﺴ ﯿﺖﺳ ﻓﺎ
ﻌﺎﻥﭼﻲﻣ ﻭﻏﺭ ﺎ
ﻪﻧ ﻐﻫ
ﻼﻑﻪﺩﻱ
ﺯﺧ ﭘ ﺍډ
ﻪﺩ ﯼ ﺘ
ﻟﺭﺩﺮﻱﻡګ ﻟﻟﯽﺍ
ﻪﻭﺗﺭﺯﻪﻭﺍډﺗ
ﻮﺳﺲ ﯼ ﻣﺯﭘﻼﻮﮐﺴ ﻮﻮﮐﻲﺗ ﻧﺎﻭﻏﺭﺎﺩﻱﻧ
ﻣﻦ ﺍډﻝﺭ
ﺭﻭ ﺩﺎﻪﻧﺯﮐﻲﭘ ﺍډ
ﻪﯼ ﻡﭼﻲﭘ ﻮﻡﻭﻱﮐ ﺎ
Myﻋ ocardit
iPﻭs neumoniﺍ ti
ﻮﮐﻲs ﻧﺎ
ﻭﻏ ﺭﺎ
ﻧ
.
ﮐږﻱﻪﯽ ﺗ
ځ
Diagnosi s
ﻡ
ﺰ ﯿﻧ
ﺍﺭګﻭﺍﻪﺩﻱﭼﻲ ﻟﻩﺮﻭﺳ ﺭﻭﻮﮐﻲﻭګ ﺗ
ﺎﻌﯾ
ﺎﻭﻣﺍﻮﺎﺟﻧﺴﺍﻪﺩﭘﻮﻮﭼﻲﺩﻭﺟ ﮐﻻﯼﺷ ﻡﻮ ﺰﯿﻧﺍ
.ﺭګﻭ1ﺍ
ﻮﻣﻮ ﻪﻧﺪﻝﭘﯿﮐﺍﺪﯿﻡﭘﺰﯿﻧﺍ
ﺭګ ﻭﺍﺍﯼﺷﻲﭼﻲﺩ ﺪ
ﯿﻮﮐﻮﺧ ﺪﻻﯼﺷ ﯿ
ﻟﻮﮐﻲ ﺗﺎ
ﻌﯾﺎﻭﻣ ﺍﻮﺎﺟﻧﺴﺍﻪﺩﭘ ﻮﺩﻭﺟ
ﺭګ ﻭﺍﻮﻝﺩ ﻩﮐﺩﺎﻔﺘﺍﺳڅﻪﯾﻦ ﺧ ﻮﻠګﻱﺗ
ﺩځﻥ ړ
ﺎﻫﻢ ﺍ ﯿﻮﺑﮑﻞﻫﻢﻭﻱﺧ ﻮﮐﻲﻣﺸ ﺗﺎ
ﻌﯾﺎﻭﻣﺍﻮ ﺎﺟﻧﺴﺍ ﻭړ
.
ﻮﻱ ﻪﮐ ﻧ
ﺎﺁﺳ ﻮﻝﮐﺍﺪﯿﻡﭘ ﺰﯿﻧ
ﺍ
ﻭ.
ﺩﻱ ﻮﻮﺟ ﻣﻦﮐﻲﻣ ﺰﻭﻣ ﺍﺩﺎ
ﻭﺣ ﺩړ
ﺍ
ﻪﻭ ﯿﺴﺖﭘ ﻭﺳ ﺍښﻲ
ﺍﻳ ﺎﻥﺭ ﺘﻧ
ﺍ ﺩﺎ
ﺪﻝﺣ ﯿﻟTachy zoi t
ﺩes
،CSF، ﻨﻲ ﯾ
،ﻭ Amni oticFluiﺎﻥﺩd ﺘﻧ
ﺍﻮﭼﻲ ﮐﻻﯼﺷﻪﻫﻢ ﻮ ﺍﺳﻄPﻪﻭﻩﺩ CRﭘ ﺭﻥګ ﺍ
ﺪ ﻤﻫ
.
ﻭﺭړ
ﻭﻪﻻﺱﺍ ژڅﻪﭘ
ﺍ ﺧ ﻮﻟBroncho-alv eolﺍarAqueousHumorﻭ
ﻩ ﺭﺎ
ﭙ ﻟ
ﯿﺺ ﻮﺳﺲﺩﺗﺸﺨ ﻣﺯﭘﻼ ﻮ
ﮐﺴ ﻮﻪﺩﺗ ﻧ
ﻭﯾﺲټ ﯾﮏټ ژ
ﻮﻟﻭﺮ
ﯿﻠﻒﺳ ﺘ:ﻣﺨ ﺎﺕﻨﯾﺎ
ﻌﯾﮏﻣ ژ
ﻮ ﻟ
ﻭ ﺮﯿ
.ﺳ 2
:
ﻪﻟﺭﺕﺩﻱ ﺎﺒږﻱﭼﻲﻋ ﻟﯽﺎﻤ
ﻌ ﺘﺍﺳ
Sabi n-Feldman- dyet est. ۱
ELI SA. ۲
I
ndi r
ectFluor escentAnt i
bodyTest .۳
Aggl utinati
onTest .۴
.
ږﻱﻣﯽ ﻮﻠ
ﻌ ډﻱﻣﺎﺘﻲﺑﻧﺍI
IﻭgG ﻪ gMﺍ ﺍﺳﻄ ﻪﻭﻮﭘ ﻧﻭﯾﺲټ ﻪټ ﺗﺭﻮﭼﻲﺩﭘ
ﺘﻲ ﻧ
ﺍIﻱﻭ gMﮐږ ﺍﺗﻲ ﯽ ﺎﻩﭘﺭﺎ
ﭙﻟ ﺩﻭﺧﺖ ﺍږ
ﻱﻭﺩﻭﮐږ ﺍﻪﯽ ﺗﻣﻦځﺍﻮﮐﻲﺭ ﺘﻔ۲ﻫ -
ډﻱﺩ۱ ﺎ
ﺘﻲﺑ ﻧﺍIgG
ډﺎﺘﻲﺑ ﻧ
ﺍIﻪﭼﻲgG ﻠ
ﻮﮐ ږﻱﺧ ﻪﺭﺳﯽ ﺯﻱﺗ ﺍﺪﻧ
ﺍﻟړﻱ
ﻱﻭﻮﮐږ ﺍﻪﯽ ﺗﻣﻦځ ﺍﻪﮐﻲﺭ ﻠﺮﺣ ړﻱﻣ ﻡﻮﻟﻱﻪ
ډﭘ ﺎ
ﺑ
ﺷ.
ﻪ ﻲ ﺗ
ﺎﺭﻱﭘﻮﻮﭘ ﻧﻮﻠﺮﮐﺍﯼﺷﻲﺗ ﺪﯿ
ﺎﮐﻱﻭﯾږﺍ ﻤﯽﻩﮐ ﺮﺰﻱﺳ ﯿ
ﺭﻪﺗ
ټﯼټﭘ ﺎﻳﻲ ﺍ ﯿﻪﺷﻲﺑ ﺗﻣﻦځ ﺍﻱﺭ
:
ﻪﻨﻠﻣﺭﺩ
:ﻩﻮﻱﺩ ﯾﺸﻞﺷ ﻮﻭ ﻟﻭ
ﻭډ ﺭ
ﻮ ﻟ
ﻪڅ ﻪﭘ ﻨﻠ
ﻣﺭﻮﺳﺲﺩ ﻣﺯﭘﻼﻮ ﮐﺴﻮﺩﺗ
Pﻪ
rﭘ imaryi nfectiﺳﻢﻭﻱﺩon ﻟ
ﺘﻢﻳﻲ ﺎ ﯿﺴﺘﻲﺳ ﯿﻓﺎ
ﻌﺩﻣﻮﺎﻥﭼﻲﺩﻭﺟ ﻭﻏﺭﺎﻪﻧﻐﻪﻫ ﻟړﯼډ ﻡﻮﻟ
ﻪ ﻧﻮﺘﻟ
ﺎﺪﻱﺣﻧﻪﻻ ﺭﮐ ﮐږﻱﻡګﻩﯽ ﻪښ ﻠ
ﭙ ﺎﻥﭘﺨﻭﻏﺭﺎ
ﻩﻧ ﺮﺗ
ﺎﯾ
ﺮﻱﺯﻟ ﻪﺭﺕﻧ ﻭﺮﻪﺿ ﻨﻲﺗ ﻠﻣﺭﺭﺕﮐﻲﺩ ﻮﺻ
:ﻪﮑﻟړﻝﺷﻲ ﺭکﻣﻞﻭ ﺭﺪﺩﯾﺎ
ﻪﺑﺗﺭﻩﻭ ﺭﺎ
ﭙﻟﻮﺘﻔ۴ﻫ -ﻮﺩ۲ ﺩﻭﻱﻧ ﻮﻮﺟ ﻣ
ﻟﺖﺎﺪﺣ ﯾﺪﻭﻏﻲﺷ ﺭﺎ
ﻧﺩ.1
ﺪﻝ
ﯿﻩﮐ
ﺭﺍﺪ
ﻣﻭﻭﻏﻲﺩ
ﺭﺎﺩﻧ
.2
ﻭﻏﻲ
ﺭﺎﻮﻱﻧ
.ﺣﺸ
3
ﻪ
ﻨﻠ
ﻣﺭﺮﻱﺩ
ﻟPrﻭ
imaryinf
ecti
ﻪ ښځﻱﭼﻲonﻠﻣ
ﺎﻪﺣﻐ:ﻫ
ﻪﻨ
ﻠﻣﺭ
ﻭﮐﻲﺩ ﻪ ښځﻠ
ﻣﺎ
ﻪﺣ ﻭﻫﻢﭘﺩ
Congeni
tﻭﺩalﺍ
ﺎﻝﻘ
ﺘﻧﺍ
ﻪﻡﺗ
ﻮﺎﺷڅﻪﻳﻲﻣ
ﺭ ﺧﻮځﻪﭼﻲﺩﻣ
ﻩﮐ ﺭﻱﺩ ﻭ
ﺮﻳﻲ ﺿ
.ﻮﻱ
ﻤﺮﮐToxoplﺧﻄasmosis
133
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﺎﻥﭼﻲﻭﻏ
ﺭﺎﻪﻧﻐ:ﻫ
ﺮﻱﻟ
Retﻭ
inochoroidi
ti
ﻮﮐﻲﭼﻲs ﮑ
ﻠﻪﺧ ﻐﻪﻫﻪﭘﻨﻠ
ﻣﺭﯾﻢﺩﺭﺩ
ﻩﻳﻲ
ﺭﺎﭙ
ﻟﺎﺏ
ﺒﺘﻄ
ﺍﺳﻨﻲﺩﻠ
ﻣ ﺭ
ﺭﺩﺩﮐږﻱﻡګ
ﻩﯽ ﻪښ ﻠﭙ
ﻠﻲﭘﺨ ﻤ
ﻩﺣ ﺮ
ﺜﮐﺍﺮﻱ
ﻟRetﻭinochoroidi
ti
s
:
ﻮﻱﻪﮐﯿﻮﺻﻮﮐﻲﺗﺗ
ﺎﻻﺪﻱﺣﻧﻪﻻﻪﭘﺗﺭ
ﻪﻭﻨﻠﻣ
ﺭﺩﺩﻱﭼﻲﺩ ﻮﻮﺟﻪﻣ ﻧ
ﻭﺮﻠﻒﻧﻈ ﺘ
ﻣﺨ
Decreasedvisualacuit
y. 1
Mul
ti
pleorLar
geLesi
ons.
2
Macul
arLesi
ons.
3
Si
gni
fi
cantI
nfl
ammat
ionorPer
sist
encef
orov
eramont
h.4
ﺘﻲﯿﻓ
ﺎﻌﺎﻥﭼﻲﻣ ﺭﻏ ﻭﺎ
ﻪﻧ ﻐﻭ:ﻫ
ﻮﯼ ﻱ ځﻞﺷﯿﺖﻳﻲ ﭘ ﻓﺎ
ﻌﻮﮐﻲﭼﻲﻣ ﮑﻠﻪﺧ ﻐﻪﻫ ﻪﭘ ﻨﻠ
ﻣ ﺭﻡﺩ ﺭﻮﻟڅ
ﺷ.
ﻭﻱ ﻲ ﺍ
ﺪﺪﺗ ﯾ
ﺎﺮﻱﺑﻟ
ﺎﻥﻭ ﺘ
ﻧﺍﺎﻝﻌټﻭﻓﺘﻢﻳﻲټﻱ ﺍ ﯿﺴ ﺳ
ﻪﻨﻲﺗﻠﻣﺭ
ﻮﺩ ﻧ
ﺎﻭﻏﺭﺎﻭﻧړﻮﻣ ﻮﻮﯼﻭﻱﻧ ځﻞﺷﺘﻢ ﭘ ﯿﺴﺘﻲﺳ ﯿﻓﺎ
ﻌډﻝﻳﻲﻣ ﺭﻱ ﻭ ﺫګ
ﻪﺎﻥﭼﻲﭘ ﻭﻏ ﺭ
ﺎﻪﻧ ﻐﻫ
.ﮐږﻱ
ﻮﻝ ﯽ ﮐ
ﺭﻡﻭ ﺍ
ﻭﺭﻱﺩ ﻮﻮﭘ ﯿ
ﻧﻭﺍ۶-ﻪﺩ۴ ﺘ
ﻭﺳ ﺭ
څﻪﻭﻭ ﺧ ﺪﯿﻤ
ﺘﺮﺧ ﻮﺗ ﺍﺿ ﺮﺍﻋﺩ
ﻪﺩ ﻮﺗﻧﺎ
ﺭﻏﻭﺎ
ﻭﻧ ړﻮﻣﻮ(ﻧﺯﺍډ
)ﯼ ﺮﻱﻟﻩﻭﺰﻧ
ﻮﺘﺘﻢﺳ ﯿﺴﺘﻲﺳ ﯿﻓﺎﻌ
ډﻝﺩﻣﻤﻲ ﻭ ﯾﺍ
ﻪﺩ ﺎﻥﭼﻲﭘ ﻭﻏ ﺭﺎﻪﻧﻐﻭﻫ ﺍ
.
ﮐږﻱﻭﻱ ﯽ ﺍ
ﺪ ﻩﺗﺮډﺯﺳﺒﻲ ﻭﯿﻘ
ﻌﻪﮐﻢﺗ ﺎﻫﻢﭘ ﯿﻪﺑﺘﻭﺳﺭ(څﻪﻭ
ﻮ ﺧ ﯿﻧﻭﺍ۶-۴ﻨﻲ) ﻠﻣ ﺭ
ﻩﺩ ﺭ ﻮ
ﭘ
ﻮﻧﺎ
ﻭﻏﺭﺎ
ﺒﺖﻭﻱﺩﻱﻧ ﺜډﻱﯾﻲﻣ ﺎﺘﻲﺑﻧ
ﺍ I
ﺭgG ﺮﻱﻡګ ﻠﻧﺍ ﺽﻭﺮﺍﻋ ﺎﻥﭼﻲ ﻭﻏﺭﺎﻠﻲﻧﭘﯿﺖځ ﻓﺎﻌﻪﻣ ﻐﻫ
ﺷ.
ﻪ ﻲ ﯿ
ﻮﺻ Longtﺗ erm Chemopr ophy laxiﺪs ﯾﺎ
ﻪﺑ ﺗ
:
ﻣﻞ ﺭ
ﺩ
ﺮﯿﺛ
ﺎﻮﺗﻧ
ﻮﻠﮑﻭﺷ ﺭﻮﻪﻧ ﻭﭘ ﺍﻪﺩﻱ ﻟ
ﺎﻌ
ﺑﻞﮐﻲﻓ ﺎ
ﻘTﻪﻣ
achyﭘ xzoitﻼﺎﺩesﻣﭘﺯ ﻮﮐﺴ ﻮﺯﻱﺩﺗ ﺍﻮﻣﻞﯾ ﺭ
ﺩ
.ړﻱﻩک ﻮﻩﻣﺤ ﺮ
ډﻝﺳﻤﻞ ﻭ ﮑﻪﻣ ﺎﻥﭘﺘﻧﺍﮐﻻﯼﭼﻲ ﺩﻧﺸﻲ ﻮ ﺎﯿﻨ
ﻪﺩﻱﺑ ﻟېﻮﭘ
ﻪﺮ ﻧ ﻧ
ﺩﺭﺪﻨ
ﺘPyﺳ rimet hami Sﻭne ulﺍfadiaziﻩﺩne ﺭﺎﭙﻟﻮﻟ
ړﻩﻭﺩﻪﻣﻦځ ﮑﻞ ﻟ Tachyﺷ zoi tﺩes
ﻪﺘﻭﺳﺭLoadiﻭ ګﻡngdose ﺍﻠﻲ ﺭ۲ﻣ ۰
Pyﺩ۰ r
imet hami ﺩﺩﯼﭼﻲne ﻮ ﻮﺟCombiﻣ nat ion
ﻭځﻱځﻲﺩﺭڅﺭﻟ ﻮ
ﻪﻟ ﻣ ﺍ
ﺭ۵ګ .۱-
Sulﺩ۱ f
adiaziﻝﻭne ﻮځ ﺍ ﻭځﮐﻲﯾ ﻪﺭ ګﻡﭘﺍﻠﻲ ﺭ ۷ﻣ ۵ -۵ﺎﺩ۰ ﯿﺑ
ځﻲﺩBone ﻱﻮﻟﻭځ ﯾ ﻪﺩﺭ ﻣ ﺍ
ﺭﻠﻲګ ۲ﻣ۰-
۱Polﺩ۰ ini
caci ﻩڅﻥګﮐﻲd ﺮﺩﻱﺳ ﻱﻭﺩ
ﮐږ ﺍﻮﻝ ﯽ ﮐﺭﻭ
.ﮐږﻱ
ﻮﻝ ﯽ ﮐ ﺭ
ﻩﻭ ﺭﺎﭙ
ﻟﻮﻱ ﯿ
ﻨmarﺩﻣﺨ rowsuppr essi on
ﻪځ ﯾﻦﭘﺯﺎ
ﯾډﺎﻔﻠ
Cڅﻪﭼﻲﺩﺳ lﺧ i
ndamy ci
ﺭﺕﺩﯼﺩn ﺎ
ﺒFiﻋrstalternat i
vژﻢeړﻱﺭﯾ ﻮﻣ ﻮﺩﻧ
.
ﮐږﻱ
ﻮﻝ ﯽ ﮐﺭځﻲﻭﻱڅﺭ ﻟ
ﻮ ﻭځ ﻟ ﻪﺩﺭ ﻣﺍﺭﻠﻲګ ۶ﻣ ۰
ﺍ۰ږﻱﻭ ﻟﯽﺎﻤﻌﺘﺍﺳ ﺍﯼ
.Tڅﻪ
MP-ﺧ ﻪSMZ ﻟﺭﺕﺩﻱ ﺎﺒ
ږﻱﻋ ﻟﯽﺎﻤﻌﺘ
ﺍﺳ ځﯼﻪﺍ ﯾﻦﭘﺯﺎﯾډﺎﻔ
ﻠalﭼﻲﺩﺳ ternat i
vﺭe ﻮﻧ
ﻪﻟﻩﺭﺕﺩ ﺎ
ﺒﺑﻞﮐﻲﻋ ﺎﻘAﻪﻣ cutﭘeToxopl asmosi ﻪﺩs ﻨﻠﻣﺭﺭﻱﺩﺎﯿﻌﻭﮐﻲﻣ ﻪ ښځ ﻠ
ﻣﺎﻪﺣ ﭘ
ﻡﻮﺎﺷﻱﻭﺩﻣﮐږ ﺍ
ﻮﻝ ﯽ ﮐ ﺭ
ﻭځﻱﻭ ﻪﺩﺭ ﻟﺭﻱځ ﻻﻱﺩﻪﺭ ﻟ ﻟﻲﻮګﻡﺩﺧﺍﻮﺭ Sڅﻪﭼﻲﯾ piﺧ r omy cin
.ﮐږﻱ
ﻮﻝ ﯽ ﮐﺭ
ﻡﻭ ﺍ
ﻭﻪﺩﻨﻲﺗ ﻠﻣﺭﺭﻱﺩ ﻮﻭﭘ ﺪ ﯾ
ﺯږ
ﺮﯼ ﺗ
ﻪ
ﺗﻣﻦځ ﺍ
ﺎﻥﺭﺘﻧﺍﺩﺎﻭﮐﻲﺣ ﺮ
ﺍﺧﻭﺍ ﻱﻪ
ﻣﻞګ ﭘﺎﯾﺩﺣ ﻭﺎ ﺍﺩﻭﻱ ﻮﻮﺟﺪﻣ ﺍﻫﻮﺎﻥﺷ ﺘﻧﺍﯿﻦﺩﻨﻪﺩﺟ ﺗﺮﯿﻪﭼ ﮐ
ﻨﻲﺗﺭﻮﻮﮐﻲﭘ ﺗﺎﻻﻪﺩﻱﺣ ﻭ(ﻮﭘ
ﺎﺕ ﻱﻧ ﯾﺮﺯﺎﻝﺧﻄ ﻘﺘﻧﺍ
ﺎﻥﺩ ﺘ
ﻧﺍﻡﮐﻲﭼﻲﺩ ﻮﻪﮐ ﭘﺷﻲ)
.ﺮﻱﻟﺎﺏﺒﺘﻄﺍﺳ Combi nat ion
134
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
135
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
:
ﺯﺱﺎ
ﻴﻣﻮ
ﺘﻮﺳ
ﻠﮑﻧ
ﺍ
Necatﺎ orﻭﻳAncyﺍ
lost
omoasi
s dudoni al
i
ﺩﻝ ﺩ sﻪ کﺩﺘﻮﺍﺧﻤﻟ
ﻮﻮﮐﻴﻨ
ﻮﭼﮐﺩ
ﻪﻨ
ﻳﻭﻮکېﺩﻧﻮ
ﻳﺍﻩځ
ﺭﺎۍﻪﺣ
ﻭﻍ ﭘﺭﺎ
.ﺍﻧ
ﻮﻱﺩ
ﻪﮐ ﺗ
ﻣﻦځﺍﺯﺱﺭ ﺎ
ﻴﻣﻮ
ﺘﻮﺳﻠﮑ
ﻧﻪﺍ
ﺍﺳﻄAﻪﻭ
merﭘi
cans
ﺩ.
ﻪﻯ ﺑ
ﺭﻮﻨﻰﮐﻳ
ﺯﺍ
ﻮ ﺎﻥﻱېﻳﻧﺴﺍ
ﺩ.
ﻻﻞ ﻯ
ﻪﻣ (ﻣ
Anemiږﻱ)aﻝ
ﻟﻰ
ﺍﺍږﻭ
ﺮﻭﺩ ﺘ
ﺘﻲﻣ ﻧ
ﺎﻮﺳHookworﻳ ﻮﺥ m .ﭘﻩ
ﻩﺩﺰﻳﺩ
ﻭ ﺎﺩﻴﻠ
ﻴﻓﻮﻧﻭﺰﻳﻭکېﺍ ﺍړ
ړﻱﭖ ﻡ
ﻮﻪﻟﺎﻥﭘﺘ
ﻧﺍ
ﺩ
ﻭکﺯﺎﻴ
ﺘډﻮﻣ
ﻪﮐ ﻧﺠﻲﻩګۍﭘ .ﺩچﻥږﻱﻭﺳﻲﻪکېﺍ ﺮﺧﺗﻦۍﺑ ﺭﻮﻪﭘ ﻡﭘﻮﻨﻴﻴﺠﻭﺟﺮﺍﺎﻋﺸﻨﺛﺍ
ﻭﺩﺮﻱﺍﻟ
ﻓﻼ
ﻮﻴ ﻻﺍﻳ
ﻭﻧﺠﻲ ﺭ ړﻱچﻥﻮﻣﻮ
ﻧﻭکېﺩ ﺭﻭﺎ
ﻭﺧ ﻭﻧﮏﻭ
ﺮﻟﺭﻱ ﻮﻴ
ﻭﺳ ﻮﺍ ﺑ
ﻮﺮﻃﻮﻣ ﻣﺭ
.ﻪګږﻱﭘ ﺭﺟﻲﺎ
ېﺧ
،
ﻭﻪځﻱږﺗﻭﺱ ﻮﻱﺍﺭﻱﮐﻮﺘﮏېﺳ ﻮﺳﻧﻲﭘﺎ
ﻧﺴﻭﻯﺍﺎﺩﻴﻮﺑ؛ﺧ ږﻱېﻪﺭﺳﻲ ﺮﺣﻞ ﺗ ﻧﻲﻣﺎﺘ
ﻧﮑﻞﺍﺭﻱﺷ
ﻤﻲﻪﻫﻀ ﺗ
ﺮﻴڅﻪﺑ
ﮑﺲ ﺧ ﻧﺮ
ﺎﺩﻓ ﻴ
ﻱﻭﺑﺭځ ﺍ
ﻪﺍ ﻮﺗﺗ
ﺎﺒ
ﺎﻗﺼ ﻴ.ﺑږﻱﺭﺭﺳﻲ ﻪﻭ ﻮﺗﺎﺧﻨ
ﻭﻯﺍﺳ ﻪچېﺩ ﻠ
ﮐ
Ancyl
ost.ږﻱ
ﻪﺭﺱږ ﻭﺗﺍ
ړﺩﻭ ﭖ
ﭘﺦﺩﻮ کېﺩ ﻴﻧ
ﻭ٧ﺍ-ﻪ٤ .ﭘږﻱ
ﻊ کږ ﻠﻪﺑﻮﺗﻤﻟ
ﻮ ﻌﻦېﮐﺘﻢﻳﻴﺴﺳ
ﺷ.
ﮐﻻﻯ ﻲﺪﻮ ﻧﻭ
ﻩژ ﺭﺎ
ﭙﻟﻮﻧﻮﻠ٥ﮐ-Nectﺩ٣ ﺍorﻩﻭﺭﺎ
ﭙﻟﺎﻝ
ﮐﻮﻳ
ﺩ
ﺩ.
ﺎﺕې ﻱ
ﻳﻮکېﺯ
ﻧﻮﻳ
ﺍﻩځ
ﺭﺎﻟﺤ
ﺍﻭﺗﺤﺖ
ﺍﻩﺭ
ﺎﻪﺣ
ﻮﭘﻲښېﭘ
ﻧﺎﻴ
ﻧﺠﺩﭼﻦګکې چﻥ
ﺍډ
ﻮ کې ﻥ
ﺮﺧﻠﻲﺑﺎﺣﻪﺳﺍﻥېﭘﺮ
ﺘﻳﺪﻣځﻭﺩ
ﺘﻲ ﺍﺮېﺧﻴﻪﻟ
Ancyﭘ l
osthomoasisDudoni
ali
s
N.Ameri
ېﺣﻝکېچېcanﺍﺱ ﺎ ﻪﺩﺮﻱﭘﻟﺩ
ﻮﺎکېﻫﻢﻭﺟ ﻘﻳ
ﺮﻓﺍﻩﻪ
ﺭﻥګﭘ ﺍﺪ
ﻤ.ﻫﺮﻱﻟ
ﮑﻞﻴﮏﺷ ﻤ
ﻳ
ﺘﻲځکې ﺮېﺧﻴﻪﻟﻩﭘﺭﻥګ
ﺍﺪﻤ
ﻭﻫ ﺎﺍﮑﻳ
ﺮﻣﺑﻲﺍ
ﻮﻨﻭﺟﺰﻱﺍﮐﺮ
،ﻣﺎﻘ
ﻳﺮﻓ
ﺰﻱﺍﮐﺮ،ﻣ
ﺘﻲځ ،ﺧ
ﺪﻱځﻳﻮ
ﻪﻟﭘ
.
ﺮﻱﻟﮑﻞﻴﮏﺷﻤ
ﻳﺪﻧﺍ
ﺩ.
ﻪﻱ ﺘ
ﺍﺧﻮ
ﻧﺎﻴ
ﻧﺠ%ﻪﺩې چﻥ
٢ﭘ ﻳ٥
ړﻮ
ﻭګړۍﺩ
ﻩﺩﻥ
ﺮﺭﺕﺳ
ﻮﻣﻲ ﺻ
ﻮﻤﻪﻋ
ﭘ
136
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
.
ﻮﻱﺩﻝﺷ
ﻭډﻝ ښ
ﻧې ﻭ
ﻪﻻﺪ
ﺍﻥﭘ
ﺭﻭﺪﺩ
ﻧﻭژ
ﻧﺠﻲﺩ
ﺩچﻥ
ﺘﮏې
ﻮﺳﻧﻲﭘ
ﺎﻧﺴ
ﺍ
ﻭکې
ږﻪﺱ
ﭘ
ﺎکې
ﻴﺍﺧ
ﺮﻪﺗ
ﭘ
ېﻩګۍ
ﻩک ﺩﺭﻭ
ﺎﻪﺧ
ﭘ
څﻪ
ﻮ ﺧﻤ
ﻟﻮﮐ
ﺩ ﺑﻞ
ﺭﺎ
ﺷ
ﻨﺞې
ﻴﻮﺥﭼ
ﭘ
ﻟﻢې
ﻮﮐ
ﺍﻥ
ﺭﻭﺪﺩ
ﻧﻭژ
ﻧﺠﻲﺩ
ﮑﻞﺩ چﻥ
(ﺷ٢
٥-٢
)
ﻩګۍ
137
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
:ﺎژﻱ
ﻮ ﻟﺘﭘ
ﺭﻪچﺷ.ﮐﻻﻞ ﻲ ﺎﺏ ﻣ ﻬﺘﻟ
ﻴﮏﺍ ﺮﺟﻟﻮﺍﻳځﻯﺩﻪﺍ ﻭﭘ ﺪﻴﻠ
ﺍﺧ ﺘﮏېﺩﺩ ﻮﺳ ﭘﺍﻯﺷﻲﺩ ﺩﺩﻻﺍک
ﻭﻧﺠﻲ ﺭ ﺩ چﻥ
ړﻪک ﺗ
ﻣﻦځ ﺍﺎﺭﻴ
ﻠﻴﻓ
ﻮ ﻨ
ﻳﺰﻳﺍ ﻮﻱﻳﻪﻭﺧﺖکېﺭ ﺩﻭﭘﺮﺩ ﻴﺭېﺩﺗ ﻭﻪﻻږﻟ ﮑﻦﺩﺱ ﻤﻤﻦﻭﻱﻣ ﮐﺍﻭﺎﻥځ ﺘﻧﺍﺭې
.ﻱ
ﻪﻥښ ﺍﺳﻄﻪﻭ ﻮﻝﭘ ﭙﺴﮐﻮﻝېﺩ ﭙﻞېﺧ ﻩﺩﺧ ﺮﺩېﺳ ﺮﺎﻃﻲﭘ ﻪﻣﺨ ﻟﻮ ﻤﻟ
ﻮځﻥﺩﮐ ﭙﻞ ﺍﻧﺠﻰﺧ ﻪ چﻥ ﺩﻏ
Ancy l
osthomoasi ﻮs ﻭځکېﺩﻳ ﻩﺭ ﻮ ﻪﻳﺎﻉﭘ ﻴﻩﺿ ﺰﻳﻨﺲټ ﻳﻦېﺑﻭ .ﺩﺑﻲښﻱ ﻪﺯ ﻨﻳﻭﻭ ﻮﻱﺍ ﻟ
.
ﻩ٠ﺳﻲﺳﻲﺩ ،
٠ﻩ٣ ﺭﺎ
ﭙﻟN.Amer iﻩcan ﻮﻳﻭﺩ ﺍ٠ﺳﻲﺳﻲ ،
١ﻩ٥ﺭﺎ
ﭙﻟDudoni alis
ﻪﻭﻍﭘ ﺭﺎ
ړﻱﻧ ﻮﻣﻮ
ﻧﻠﮏېﺩ ،ﺑﺮﻱﻩﻪﻟ
ړﻧ ﺭېﺍ ﻮ
ﺎﻥﭘ ﺘﻧﻪﺍﺯېﭘ ﺍ
ﻮﻪﻳ ﮐﻢښﺕﮐﭽ ﻴﻦﺩﺗﻭﺮ
ېﻭﭘﭙﻦ ﺍ ﻭﺳ ﺩﺍ
ﺭﺭﻪچ ﺭېﮐﻮﻮﭘ ﻣﺮ
ﻳېﻪﺯﭙﻦ ﭘ ﻭﺳ ﻮﻱﮐﺲﺩﺍ ﻪﺷ ﺘﺍﺧډﻝﺩګﻱ ﻭ ځﻥ ړ ،ﻪ ﺍ
ﺮﻱﭘ ﻟﻩړ
ﻫﺍﺭې ﻢ ﻮﺬﻱېﭘ ﻐﺗ
.
ﻪﻧﺸﻲ ﺗ
ﻣﻦځ ﺍ
ږﻱﺭ ﻪﻝ ﻨﻳﺍﻯﺷﻲﻭ ﺩ ﺩﻭ،ک
ﺭﮐﻢ ﻱ ﺷﺭ
ﻮ ﻢ ﻴ
ﻧﺠ ېﺩ چﻥ
:ﻩﻴﮏېﺏڼ ﻨﻴ ﻠ
ﮐ
ځﻯکېچ ﻪﺍ ﻐېﻪﻫﺘﮏ ﭘ ﻮﺳﭘﺎﺏﺩ ﻬﺘﻟ
ﺍﺮ ﻟ
ﻮﭙ،ﭘﺭښﺕ ﺎﺘﮏېﺧ ﻮﺳ ﭘﻭ.ﺩ
ېګﻞې ﻱﺎﻥﺏ ﻳ ﻭﻏﺭﺎﻩﻧﺮ ﺗ
ﺎﻳﺯ
(GroundI tch). ږﻱﺪﻝکږ ﻴﻟﻭ،
ﺷې ﻱﻪﻮ ﻠ
ﺍﺧﻻﺍﺩﻭېﺭ
،چې ږﻱ
ګﻻﻞکږ ﺰﻥ ﻣ ﻳﻭﻭ ﻭﺧﻲﺍ ﻮﻱ ټ ﻠ
ﻤﻮﺣ ﻳﻭﻪﺩ
ږﺗ ﺩﻝ ﺱ ﺮﺩ ﻴﺩﻻﺍﺗ
ﻭﻮکې ﺭ ﺗ
ﺎﻧ
ﺎﺘﻧ
ﻭﺍ ﺪﻳﺪﻪﺷ ﭘ
ﺛﻒﺎﮑﻮﻱﺗ ﻘﻄﻧﻭکېﺩ ږ ﻪﺱ ﻟﺖﭘ ﺎ
ﻪﺣ ﻭﺩﻏ ځﻯﻭﻱﺍ ﻮﺍ ﻩﻳ ﺮﻐﻢﺳ ﻠﻧﮏېﺑ ﻭﺮﻪﻟﻨﻳ
ﻪﻭ ﺍﻯﺷﻲﻟ ﺩﺩک
ﺩ.
څﻪﮐﻢ ﻯ ﻳﺲ ﺧ ﺭ ﺎ
ﮑﺍﺳ ېﻪ
ﺪﺕﻱ ﻟ ﻻﻦﺷ ﻭ ،ﮐ
ګﻯ ﻱﻩﻣﻞ ﺭ ﺮ ﺳ
ﺮﺥېﺗﻦۍﺑ ﺭﻮﭘﻱېﺩﺎﻥګېﺩګ ډ ﻮکېﮐ ﻧ
ﺎﻭﻏ ﺭ
ﺎ،ﻪﻧ
ږﻱﭘ ﺭﺳﻲ ﻪﻭ ﻮﺗ ﻤﻟ
ﻮﻮﮐ ﻴﻨﻮﭼﻧﺠﻰﮐ ﻪچېچﻥ ﻠ
ﮐ
ﻭ.
ﺩﻱ ﻮﻮﺟﺘﻰﻣ ﺎﺳﻪﻧﺲﻧ ﻠ
ﻪﮐ ﻠ
ﻱﻭﮐﺭځ ﺍﻪﺍ ﺗ
،ﻣﻦځ ﺮﻱﻟ ﻟﻰﺍﻪﻭ ﺗ
ﺭﻩﻭ ﺮﺪېټﭖﺳ ﻌﻣﺩچېﺩ ﺭﺩ
ﻴﻦﺗﻭ
ﺮ،ﭘ ږﻱﻪﻝ ﻨﻳ،ﻭ ﮐﻢښﺕ ﭙﻦېﺩ ﻭﺳ ﮑﻦﺩﺍ ﻤ ،ﻣﺮﻱ ﺍکېﻟ ﻭ ﺍځﺭﻮﻮ کې چې ﺧ ﺎﺻ ﻪﺍﺷﺨ ﻐﻫ
ﭙﻦېﻭﺳ ﻮکېچېﺩﺍ ﮑﻠﻮﺧ ﻐﻪﻫ ﺍﻯﭘﺩﺩ ﺷ.ﻭک
ﻻﻞ ﻲﺍ ﺎﻣ ﻴﻤﻴﻨﻴﺗﻭﺮﭘﻮﭙﻳ
ﺎﻭﺩﻫ ﺘﻲﺍﭘﻮﻳﺮﺘ
ﻧ،ﺍLosi ng
.ړﻱﻪک ﺗ
ﻣﻦځ ﺍ
ﻩﺭ ړﻪﺩﺯ ﻳﺎﻔ
ﻡﮐ ﺪ Hiﻋ ﻳghoutput ﺮﻱ ﻮ ﻟږﻱﻪﻝ ﻨ
ﻳډﻥۍﻭ ځﻥ
ﺷ.
ﻻﻞ ﻲ ﺮﻣ ﻴﺎﺧﺎﻏﻲﺗ ﻣېﻭﺩ
ﻳﮏ ﺍ ﺰﻓﻮکېﺩ ﻧﺎﻴﻨﻮﭼﻪﮐ ﺍﻯﺷﻲﭘ ﺩﺩﻩک ﺭﻥګ ﺍﺪ ﻤﻫ
:
ﺭﻱﭘﻞټﻥې ﺍﻮﺗﺍﺮﺑﻻ
Occul tBlﻪﺩood ﻨﻳﺎﻌﻭﻣﺯﺎﻴﺘ
ډﻮﻣږﻱﺩ ﮐ ﺪﻝ کږ ﻴ
ﻧﺠﻲﻩګۍﻟ ﻪ کېﺩچﻥ ﻨ
ﺘﻪﮐﻭﭘ ﺯﺎ
ﻴﺘډﻮﻣ ﺩﮐ
ﻭ.
ﻪﻱ ﺘﺒﺜﻩﻣ ﺭﺎﭙ
ﻟ
ﻪﺩﻴﻦﮐﭽ ﺑ
ﻮﻟﻮګﻤﻴﻭﺁﻥﺩﻫ ﻩﻭﻱﺍ ﺪﻳﺪ ﺍﻯﺷﻲﺷ ﺩﺩAnemiچېک ﻴﮏa ﺘﻳﺎﻭﺳﺮﮑﻳﺎ
ﻴﮏﻣ ﻣﻭ ﺮ
ﮐ ﻮﭙﻳﺎﻫ
ﻪﺗﺭ
ﻮTIﭘ ﻪBC ﺘﮐﻪښ ﻨ
ﭙ ﻭﺳﺍﻡﻭﺮﻴﺭﺕکېﺩﺳ ﻮېﻪﺩې ﺻ ﺷ،چ ﭘ ﺪﻝ ﻲ ﻴﻟ
ﻪﻭﻱﻭ ﺘﮐ٢څﻪ ښ
grﺧ /dl
%ﻭ WBC ٦ﺍ ٠-
٣ﻴﻞ٠ ﻓ ﻮﻨﻳ
ﺰﻳﻭ کېﺍ ﺍړﻪﭖ ﺮﺕﭘ ﺎﺟﻬﻣﻭﻪﺩ ږﺗ ﻪﻭﻱ ﺱ ﺘﮐ Ferښ ri
tiﻡn ﻭﺮﻴﻭﺳ ﺍ
.ږﻱ 1ﻪﺭﺳﻲ
7000/ﺗ mcl
:ﻪﻨﻠﻣﺭﺩ
ﻮﺩ.ﻻﻦﻳ
ﻣﻞ ﻱ ﮐ ﺭﻩﺩ ﻩښ ﺭﺎﭙ
ﻭﻟ ﻭځ
ﺩې ﺭﻪﺩﺭ ﺘﻭﺳ ﺭ
ﻪﻭ ﺘﺎﻋﻟﺲﺳ ﻭﺮﺩ ﻪﻫ ﻣ ﺍ
ﺭﻠﻲګ ﻣ
١٠ﻭﻝ٠ ﺯﺍﺪﻨﻴﺒﻣ
ﻭﻥۍ ﻩﺍﻭﻭ.ﺩﺭ ﻱﺭﺭډ ﺷﺭ
ﻮ ﻢ ﻴﻧﺠﺭېﺩچﻥ ﺭﻪچ ﺩ،ﮐﻣﻞ ﻱ ﺭﻩﺩ ﺭﻮ ﻪﻏ ﻣﺍ
ﺭﻠﻲ ګ ﻣ٤٠
ﻭﻝ٠ ﺯﺍﺪﻨﻴ
ﺒﻟﺯﺍ ﻭﺩ
.
ږﻱﺭﻱﺍﺮﮑﻪﺗ ﺘ
ﻭﺳ ﺭﻭ
ﻪﻮﭘﺗﺍ
ﺮ ﺘﺤﻀﻣﺴ ﭙﻦېﺩ ﻭﺳ ﺍﻭ،ﺩ
ﺍﻏﻞې ﻱ ﻪﺭﺗﻪﻣﻦځ ﻠ
ﺒﻪﮐ ﻮﻟ ﻧﺎ
ﻴﻧﺠ ﺎچېﺩﭼﻦګکې چﻥ ﻴﻤﻴﻧﻎېﺍ ﺩﻫ
ﻪﻭﻱ ﺘﮐ٤څﻪ ښ
g/ﺧ ﻟdlﻴﻦﻪ ﺑﻮﻟﻮګﻤﻴﻪﻭﺧﺖچېﻫ ﻐ ﻩﻫ ړﺭکﻳﻦېﻭ .ﻭ ږﻱﻪکږ ﻨﻠ
ﻣﺭﻪﻱېﺩ ﺍﺳﻄ ﻭ
(ﺪﻥﺑ
ﺯﻥﺩ ﻡﻭ ﺍ
ﺭﻮګ ﻟﺮ کﻝ ﺮﻫ ﻪﭘ ﻣﺍﺭ
ﻠﻲ ګ ﻣ ١
٠)Py rant ﻩelpamoat ﺭﻥګﺍﺪﻤ.ﻫږﻱ
ﻩ کږ ﺮﺮﺳ ﺗ
ﻣﻞﺩ ﺭﻨﻲﺩ ﺘﻭﺳﺭﻭﺩ.ﺩ
ﻣﻦ ﻱ ﺰ
ﻴﻮ ځﻝﺍﻏ ﻪﻳ ﻣﺍﺭ
ﻠﻲ ګ ﻣ ١
٥ ٠lev ami ﻭﻫﻢzol ﻣﻞﺩﻱﺍ ﺭﻣﻦﺩ ﺰﻴﺍﻏ
ﺩ.
ﻪﻱ ﺮﻧﺛﻮﻩﻣ ﺮﻣﻭﻩﺩﺭﺎﭙﻟNectorAmer icans
ﻪډﻝﭘ
ګﻱ ﻭ ځﻥ ړ
ﻪﺍ ﺘﻞﭘ ﻮﺳ ټﻮﺍﻏ
ﻧﻮﺍ ﺑ
ﻭﺩ ﻮﻝﺍ ﺍﻋﺖﮐ ﺮﻮﻣ ﻳﻄ ﺍ
ﺮ ﻳﻲﺷ ﺎ
ﻴﺘﻭﻏﺭﻩﻱېﺩ ﺭﺎﭙﻮﻱﻟ ﻴﻨﻣﺨ ﺩ
138
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﺩ.
ﻣﻦ ﻱ
ﺰﻴﺍﻏ
ﻮکې
ﻧﺎﻴ
ﻨﻮﭼ
ﮐ
ﺎﻥ
ﻴﻧﺠﺩچﻥﺭ
ګ
:
(Ascar
iasi
ﺯﺱ)sﺎﻳ
ﺭﺎ
ﮑﺍﺳ
:ﻳﻒﺮ ﻌ
ﺗ
٦٠
٠٠ﮐﻝ٠
ﺮﺎ ﻭﻫ ﻪﺩﻱﺍ ﺘAscarﺍﺧ isLambr icoiﻪdes ﺎﻥﭘ ﻧﺎﻧﺴﻮﻥﺍﻠﻴﻮﺑﺩېﻳ ږړۍ کېﻥ ﻪﻥ ﭘ
.ږﻱﻩکږ ړ
ﻪﻡ ﻠﻣﺍﻪﻟﻳﺲ ﺭﺎ
ﮑ ﺍﺳﺎﻥﺩﮐﺴ
ﻭﺯېﺩﭖټ ﺎ
ﻴﺘﻮډکېﻣ ﻧﺎ
ﻧﺎﻧﺴﺍ
ﺍﺏﻭﻱﺩ ﺮﻳﻂﻱېﺧ ﺍﺮﺗﻦېﺷ ﺎﺎﺳ ﻴﺘﻭﻏﻮ کېچېﺭ ﻧﻮﻳﺍ
ﻮځ ﻐﻪﻫ ﭘ
ﺩ،
ﻪﻱ ﺘﻭﻍۍﺍﺧ ﺭﺎﻪﻧګﻱﭘﺎﻭړ ﻴ
ﺗﻮ کېﺍ ﻠ
ﻪﺳ ﺩېﭘ ږﻡﻮ کېﻥ ﻪﺩې ﺱﻣ ،ﭘﻭﻱﺭﺎﻩﮐﻮګ ﻪﺗ ﻭﭘﺮﺩﺳ
ﺎﻥﻱ ﻧﺴ
ﺩ.ﺍ
ﺭې ﻱ ېﺭ
ﻮک ډ ﻧﺎ
ﻴﻨﻮﭼېﻪﮐ
ﻮﭘﻲښېﻱ ﭘ ﺷ؛ﺧ
ﺍﻯ ﻲ ﺩﺩﻪک ﺗﻣﻦځ ﺍ
ﺮﺳﻦکېﺭ ﻪﻫ ﺎﻥﭘ ﺘﻧ
ﺍ
ﺩ.
ﻪﻯ ﺑﺭﻮ
ﻨﻰﮐ ﻳ
ﺯ ﺍ
ﻮېﻳ
ﺎﻁﺩ ﻩﺩﻣﺨ ﺭﻥګﺍﺪﻤ،ﻫﻮﻱ ﻤﺬﺏﮐ ﻳﻦﺟ ﺩﻮ
ﻳAﻭﺍ
ﻴﻦ ﺍ ﻣﺎﺘ
ﻳ،ﻭD- Xy l
ose، (f
atﻏړﻮ)
،ﻮﻳ ﻭﺟﻦ ﺮﺘﻳﺎﻧ
ﺩ
.
ﻮﻱ ﻤGrﮐowt hRat ﻪکېe ﻠﻳ
ﺎﻪﭘﻮﻱﭘ ﻪﮐ ﺘﮐﻴﺖ ښ ﻟ
ﺎﻌﻴﮏﻓ ﺘﮑ
ﻟ
ﻪﺘﻭﺳﺭFڅﻪﻭ
erﺧ t
il
izati.ﻪonﻮﻱﻟﺪﮐ ﻧﻭ
ﻪکېژ ﺮﺧﺗﻦۍﺑ ﺭﻮﻪﭘ ﻮﭘﻤﻟ
ﻮ ﻮﮐﻴﻨﻮﭼﮐﻧﺠﻰﺩ ﻮﺥچﻥ ﭘ
.ځ(
ﺭې ﻭﺩ٢
٠٠٠
٠ﺎ٠
ًﻨ
ﻴﻤﺗﺨﻮﻱ) ﺍﭼ ﺭﻩګۍ ﺷﺭ
ﺎﺕ ﻢ ﻳ
ﺭﺯ ﺭﻧﺠﻰډ ﻪچﻥ ﻨﻳښځ
ﺎﺕېک ﻭکېﭘ ﺭﻭﺎۍﻪﺧ
ﻭﻥ ﭘ ﺩېﺍ
ﺮﺭ ﻩﺗﻭ،ﻩګۍﺩ ﻪﻭځﻱ ﺎﻝﺗ ﻳ
ﺮﻴﭘﺎﺮﭼ ﻬ
ﻭکېﺑ ﺯﺎ
ﻴﺘ
ډﻮﻣﻪﮐ ﻩګۍﭘ
.(
ﻭړﻱ
ﺪ ک ﻧ
ﻭﺭېژ ﻮﺗﮐﻪﭘ
ﻟﮐﻻﻯﺷﻲﺮﺎ ړﻱ)ﻮ ﺍک ﺪﻴﻭېﭘ ﺎﻴﺗ
ړځﻥګﻧﻲ ﺍ ﺎ
ﺘﻧﺍﻭچې ﺗڅ
،ﺮ ږﻱ
ږ
ړﻝﺷﻲ ﻮﺩﻭﺧ ﺍ
ﻮ ﺍکېﻣ ﺭ
ﻮﻮﻱﺧ ﻪچټﻝﺷ ﺍﺳﻄﻪﻭ ﻩګۍﭘ ،چېﺩ ږﻱ
ﻪکږ ﺗﻣﻦځ ﺍ
ﻪﻭﺧﺖﺭ ﻐﺎﻥﻫ ﺘﻧ
ﺍ
ېﺍ
ﻭ،چ ﺩ ﺟړﻱﻻﺍ ﻮ
ﻭ ﻩﺭ ﺪﻧﻮځ ﻭﺧﻮﻱﺍ ځﻥﺭﺳﻪﺍ ﻮﺗ ﻤ ﻟ
ﻮﻮﭼﻦۍﮐ ﺷ.ﻩګۍﮐ ﻪﻭڅښﻝ ﻲ ﺑ
ﻭ ﺎﺍﻭﻳﺍ
ﻪﻩﺗړېځﻥ ښﻱﺯﺭ ﺍ ﻪﻻ ﻮﻟﻟﻮﻨ
ﻳﻮﻱﻭ ﻘﻳﺭ
ﺎﻭﻣﺴ ﻤﻒﺍ ﻟ
.ﺩږﻱﺮږﻴڅﻪﺗﺍﻝ ﺧ ﻮﻳ
ﻪﺩ ﻮﻟ ﻤﻟ
ﻮﻮﭼﻦۍﮐ ﮐﺩ
ﻪﺗ
ﺍﻮBrﺧ onchialtrﻭee ﻮﻱﺍﺭﻯﮐ ﻮﺍﻝﺳ ﻮ
ﻳﻮﺩ ﺎﺧﻨﺍﺳ،ﺩﻮﻱﮐﺖﮐ ﺮﻭﻪﺣږﺗ ﻩڅﻪ ﺱ
ړ ﺧ .ﺯ
ﻮﻱﺩ ﺭﺳ
ﻟﻰ٢ﺍﻧﺠﻰ٠ﻮﺥچﻥ .ﭘﻮﻱځﻥﺭﺳ ﻪﺍ ﻮﺗﻤﻟ
ﻮﻮﮐ ﻴ
ﻨﻮﭼﺎﮐ ﻴۍﻭﺑ
ﺮﺍ ،ﻣﻡﻮﻌﻠڅﻪﺑ
ېځﻯ ﺧ.ﻪﺩ ﺍ ږﻱﻟﺩږ ږږﻝ
ﻍﻪﻝﻍﻪﻥ ﻏﻣﻦځﻥﻍ ﭘ ﺮﻮﺗ ﻧ
ﺎﻧ
ﺎﻧﺴﺍ
.ﺩﺮﻱﻟﻟﻰﺍﻭﭘډ
ﻩﻦ ﺮﺘ
ﻠﻲﻣ ﻟﻰ٦ﻣ ﻭ٣ﺍ ﻟﻰﺍﺍﺍږﻭ
ﻩﻭﺩ ﺮ
ﺘﺘﻲﻣ ﻧﺎ
٤ﺳ ٠
.ﻴﺴﻲ ﻪﻧﺭﺕﻧ ﻮﻪﺻ ﻧ
ﺩﺩﺩږږ
ﺷ.
ﮐﻻﻯ ﻲ ﺪﻮ ﻧﻭ ﺭېژﻮﻮﭘ ﺘ
ﺎﺷ ﻴ٢ﻣﺗ٤١څﻪﺮ
ﻧﺠﻰﺩ ٠ﺧ ﻮﺥچﻥ ﭘ
139
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﻪ
ﺍﺳﻄ
ﻪﻭګﻮﭘ
ﻩﻳﻨﺠﻲﺩ
ﻴ:ﺩﭼ
ﻟﻒﺍ
ﺧړﻝ
ﺭې ﻮ
ﻭﺎﻮﻱﺧچټﻝﺷ
ﺎﻻ
ﺍﺑ
ۍﻪﻭ
ﺮﺗ ﻭڅﻪﻣ
ږ ﺧ ﻻﺍﺩﺱ
ﻭ:ﺭﺩ
ﻪځﻱ
ﺘﻢﺗ
ﻴﺴﻳﻲﺳ
ﺎﻌﺪېﻣ
ﻌﻩﻣﺮ
ﺧ
،
ﻮﻱﻩګۍ ﺧړﻝﺷ
:ﻮ ﺏ
Cﻪ
apiﺗ
l
lar
ﻮyﻤﻟ
ﻮﮐﻭﺩ
ﺍ ﻻﺍ
ﻭﺭ
.ﻭﻪځﻱ
ږﺗ ﻱﻭ ﺱ
ږﺍﻠﻲﺍﺧ
ﺩ
Cڅﻪ
apiﺧl
lar
ﻭyږﻻﺍﺩﺱ
ﻭ:ﺭﺝ
.
ږﻱﻠﻲ
ﺍﺧﻪﺩ
ﻮﺗﻧ
ﻮﻟﻮ
ﻴﻧﺸ
ﺍﺮ
ﻭﺑﺍ
ﻮﺎﺧﻨ
ﺍﺳ
ږﻱ
ﻟﻲﺪ
ﺒﻨﺠﻲﺗ
ﻴﻮﺥﭼ
ﻪﭘﻻﺍﭘ
ﻭ:ﺭـ
ﻩ
ﻧﻲ
ﺮﻬﻭکېﻩګۍﺑﺯ
ﺎﻴﺘ
ډﻮﻣ
:ﮐﻭ
.
ﻪﻭځﻱﺎﻝﺗ
ﻳﺮ
ﻴﭘﺎ
ﭼ
ﺍﻥ
ﺭﻭﺪﺩ
ﻧﻭژ
ﻧﺠﻲﺩ
ﻳﺲچﻥ
ﺭﺎ
ﮑﺍﺳ
ﮑﻞﺩ
(ﺷ٢
٣-٢
)
140
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
:
ﻥښﻥېﻴﮏېﻥښې ﺍ ﻨﻴﻠﮐ
.ﻻﺍ
ﻭږﻱ ﺭ ﻪکږ ﺗ
ﻣﻦځ ﺍ(ﺭHy persensi t
iv i
tyﻪ)ﻠﺒ
ېﻪﮐﺩﻥ ﻟﺩﺩ ږږ.ﺩﻝﺮﻱېﻪﻟګﻞ ﻧ ﺎﻥ ﻳ ﻭﻏ ﺭ
ﺎﻩﻧ ﺮﺗ
ﺎﻳﺯ
ﺗ،ﻭچ
ﻪﻩﺒ ﺯﺍﺪﻧﻪﺍﻤېﻪﮐﺎﻯک ﭘ ،ﻪﭘږﻱﭘﻻﻞکږ ﺩﻭ ﻣﺭکﺩ ﺮﺘﻀﻣ ﻮﺩﺎﺧﻨﻭﺍﺳ ﺮﻱﺍ ﻠﻴﭙﮐﻭکېﺩ ږﻪﺱ ﭘ
ﻩﺭﻥګﺍﺪﻤ.ﻫﻮﻱ ﻪﮐ ﺗﻣﻦځ ﺍ
ﺩﺭ ﺭﻴﻦېﺩ ګﻭﺩﺳ ﻳﻦ ﺍﺰﻳ،ﻭﻐﻢﻠﻧﮏېﺑ ﻭﺮ
ﻪﻟﻨﻳﻩﻭ ږڅ ،ﻝ ډﻱ،ﺳﻦ
ﻟ
ﻭﺧﻰ ﺎ ټ
ﺷ.
ﻻﻞ ﻲ ﻪﻣ ﻧﻮﭘﺎﻌﻲﺧ ﻮﺿ ۍﻭﻣﻡﺍ ﺩړ
ﺍﻯﺷﻲ ﻝ ﺩﺩک
ﻩﺪﻧ
ﻭړﺎﺩﺍ ﻴ،چېﺑ ﻮﻱ ځﻥﺭﺳﻪﺍ ﺎﻉﺗ ﻮکېﻧﺨ ﻭﻭ ﺷﺭګ ﺍ ﻮﺗ
،ﭖښ ﺎﻍﻣﺍﺩﻭ ﻩﻻﺭ ﺮډﻝ ﺳﺭﻭ ﺩﺎﻪﻧ ﭘ
.ږﻱ
ﺪږ ﻧﺭګﻭﻍکېڅ ﺭﺎېﻭﻥښېﻧ ګﻞ ﺍړﻮ ﻳ ﻭﻍﻳ ﻮﻣﻦﺷ ﺰﻴﺍﻏ
ﺪېﺩټﭖ ﻌ ﻣﺭﻱېﺩ ﺷﺭ
ﺎﺕ ﻢ ﻳ
ﻮﺯ ؛ﺧ ﺮﻱﻟېﻪګﻞ ﻧ
ډﻝ ﻳﺰﻭ ﻳﺩﻭېﻪﺩﻮک ﭘ ﻤﻟ
ﻮ ﻪﮐ ﻧﺠﻲﭘ ﺭچﻥ ﺷﺭ
ﮐﻢ ﻢ
ﺷﺭ
ﻪ ﻢﺎﻥﮐ ﻴﻧﺠ ﻪ چﻥ ﺎﺧ.ﭘږﻱ
ﻻﻞکږ ﺍﺣﺖۍ ﻣ ﺭ
ﺎﻱېﺩﻧﻪﺩګ ډ ﺘﻭﺳﺭﻭﻭ ﺧړ
ﺮﻮ ﺎﺗېﻭﻳګﻞ ﺍ ﺎﻥ ﻳ ﻪﺷ ﭘ
ﺭېﻪﻻ ﻡﻟﻮﺘﮑﻳ ﺎﺭېﻭﻳﺯﺍ ﻮﭘﺎﺩ ﻭﻳﻪﺍ ﺍﺳﻄ ﻪﻭﻭﺧﻲﭘ ﻭﺎ ټ
ﺎﻥګ ﻳ ﮐﺍﻯﺷﻲﺩ ﺩﺩﻭ،ک ﺎﺕ ﻱ ﻳﺭﻱېﺯ
ﺎ
Dﻭﻳiﺍ verticle،ﮐﺲ ﺪﻨ
ﭘ،ﺍﺎﺕ ﻨ
ﻴﮏﻗ ﺗ
ﺮﮑ ﻧ
ﺎ،ﭘﮐﺖ ﻳﻞﺩﺎﻣﻦﺑ ﺎ
ﮐﻻﻯﺷﻲﮐ ﻩﻮ ﺭﻥګ ﺍ
ﺪﻤﺷ.ﻫﺭﺝ ﻲ ﺎﺧ
ﻴﺤﻲﻘځﺭﺗ،ﺩ ګ ﺘﺲ ﻳﺎ
ﺘﻮﻝې ﺳﺴ ،ﮐ ﺘﺲ ﻳﺎ
ﺗﺮﮑﻧﺎ
،ﭘﺘﺲ ﻳﺎﻧﺠﻮﻻﮐ.چېﺩ ﺭړﻱﻭﺭﺍ ﺎﺪېﻓﺸ ﻧﺎځﻯﺑﺑﻞ ﺍ
ﻱﻭ
ړﺍ ﻩک ﺟړﻪ ﻮ ﻠﺘﮐﻻﻯﺷﻲﮐ ﻧﺠﻰ ﻮ ﺎﺕچﻥ ﻳﻩﺯﺭﻥګ ﺍ
ﺪ ﻤﺷ.ﻫ
ړﻻﻞ ﻲ ﺩﻱژﻱ ﻣ ﺍﺪﻧﺴﺎﺍ ېﻭﻳﺑﺲ ﺍ ﺍ
ﺷ.
ﻻﻞ ﻲ ړﻦې ﻣ ﺁﻥﺩﻡﻳ Vﻭ
alﺍ v ulus، ﺩﻭ
ﺪﺩ ﻨ
ﺑﻮﺩ ﻤﻟ
ﻮ ﮐ
Patchyi nfiltr
atiﺮon ﺎﻇﻨﺘﺮﻣ ﻴﻓﻲ کېﻏ ﺍ
ﺭﻮګ ﻳ
ﺩﺍﻪﺭږﻮﭘﺮﻭﺧﺖﺩﺱﻳ ﻭﻍۍﭘ ﺭ
ﺎﻧﺮﻕېﺩ ﻣﺤ ﺩ
ﺩ.
ړﻯ ﺪﻥېﻭ ﻴ
ﻟ(ﺩ ﻡ ﻭﺭﺪﻨLoefﺳ fler'
)s
ﻓﻲ کېﺩ ﺍﺭﻮګ ﻳﺩﺍ
ﻩﺭ ﺩﺎﻪﺳ ﻱېﭘﻭ؛ﻮﺩګډ ﻮﻱ ﻱﻧ ﺕﻻﻞﺷ
ﺪښ ﻣ ﻨﺑ
ﻮﺩ ﻤﻟ
ﻮﺎﻥﺩﮐ ﻴﻧﺠﺭېچﻥ ﺭﻪچ ﮐ
ﻪﺗ
ﻭﻪګ ﺍﭘ
ﻪﺭ ﻠﺘﻮﮐ ﻴ
ﻧﺠ ېﻭﺩچﻥ ﻟﻢ ﺍ ﻮﺪﻝېﮐ ﻴړﺳﺪﻫﻢ ﭖ ﻧﻭﺎ
ﺍﺳ ﺮﺘ
ﻟ.ﺍږﻱ
ﺪﻝکږ ﻴﻟ ﺎﻝﻴﻊﺧ ﻳ ﺎ
ﻭﻣ ﺍﺍﻮﻫ
.ﻮﻱ ﮐ
:
ﺭﻱﭘﻞټﻥې ﺍ
ﻮﺗﺍﺮ
ﺑﻻ
ﺎﺕېک ﻪﭘﺪېﮐﭽ ﻤېﻪﻫﺭﭘ ﻮﻮﭘ ﺘ
ﺎﺷ ﻴ
ﺮﻣ ﻱﻭﺗږﺍ %ﻪﺭﺳﻲ٥ﺗ ٠-٣ﺎ٠ﻴﻠﻴ
ﻓﻮﻨﻳﺰﻳﻪکېﺍ ﻠ
ﺮﺣ ﻭﻪﻣږﭘ ﺩﺱ
.
ﻮﮐﻻﻯﺷ ﺍﻮ ﺪﻴﻐﻢکېﭘ ﻠ
ﻪﺑ ﻻﺍﭘ
ﻭ ﻪﺭ ﻠ
ﻪﮐ ﻠ،ﮐږﻱږ
ﻪﻧﺠﻰﭘ ﻮﺥچﻥ ﻪﭘ ﻠ
ﻪﮐ ﻠﺩ،ﮐ
ړﻯ ﻮﻭﻻ ﻟ
ﺪ ﻴ
ﻟ ﻪﻩګۍﭘ ﻭکېﺩ ﺯﺎﻴﺘډﻮﻣﻪﮐ ﻴ ﺺﭘ ﺮﺣﻞېﺗﺸﺨ ﻣﻮﺩ ﻤﻟ
ﻮﮐ ﺩ
.ﻭځﻱ ﺍﻪﺭﺎﻝﺗﻳﺮﻴﭘﺎ
ﻧﻲﭼ ﺮﻬﺭېﺑ ېﻪﻻﻮﻝ ﻟﻳﺩﺧ ﻮﺏﺎ ﺘ
ﮑﻳﺭﻩﺩ ﺮﭙﻞﺳ ﺧ
ﻩﺩﻮ
ﻮﺟ ﺎﻣﻴﻠﻴ
ﻓ ﻮﻧﻭﺰﻳ
ﺍ ﻭکې ﺍړﻪﭖ ﻮﭘ ﻤﻟﻮ
ﮐ ،چېﺩ ﻪﻭﺷﻲ ﻧ
ﻭﺩﺎﺪﻳ ﻳﺎ
ېﻪﺩﻱﺑړﻦ ﻧ ﺍﻳ ﺘﻦې ﻴﮏﮐ ﻮﺟ ﻟ
ﺍﺮﻴﺳ
ﻭ.
ﻪﻱ ﻧ
:ﻴﺺ ﺮﻱﺗﺸﺨ ﻴﭘ
ﻮ ﺗ
،
ﺎﻤﺘ
ﺍﺳﻮ) ﻴﻭﻏﺭﺎﺯﻱټﻱﻧ ﺍﺮ
ﺮﭘ ﻴﺪﺩﻏ ﻳﺎ
ﻭ.ﺑ
ﺭې ﻱ ﻩﻣﻞګ ﺮﺭﺳ ﺎﻭﻴﻠﻴﻓﻮﻧ
ﻭﺰﻳﺯﺱچېﺍ ﻭﺪﻳ
ﺭ ﺎﮑﻭﺍﺳ ږﺩﺱ
(ﺯﺱﻮﻠﻴﻭﺟ ﺮ
ﻳﺎﭙﺮﻱﺍﺳ ﻧ
ﻮﻤﻠﻮﭘ ﮑﻧﺍ
ﺮﻴﮏﺑ ﺮﺟﻟ،ﺍﺘﺲ ﻳﺎ
ﻧﻮﻤﻴﮏﻧ ﻠﻴﻓﻮﻨ
ﻳﺯﻮﻳ،ﺍLoef f l
er'sSy ndr om
ﻧﮏې چﻥ ﻭ ﺮ،ﭼﻦګکﻟ ﺎﻴ
ﻠﻴ
ﻓ ﻮﻨﻳﺰ
ﻳﺮﻱﺍ ﻧ
ﻮ ﻤﻠ
ﮑﻞﭘ ﻴﭘﺍ
ﺮ،ﺗﺯﺱ ﺎﻳ
ﺭﺎﮐﻮﮐﺴ ﻮﺗ
ﻮ) ﻴﻭﻏ ﺭﺎ
ﻴﮏﻧ ﺘﻳﺯﺍ
ﺮ ﻭﭘﻩﺍ ﺮﺳ
ﺪېﻌﻣﻪﺩ ﮑﻮﻟﺑﺎﺒDﻪﺍﺳyﻟ spepsi ﻩﺩa ﺭﻥګ ﺍﺪﻤﺷ.ﻫ
ﺮ ﻲ ﻴﭘ
ﻮ ﻩﺗﺮ(ﺳ Strongy loidiasi s،ﺎﻥﻴﻧﺠ
ﺷ.
ﺮ ﻲ ﻴﭘﻮﻩﺗﺮﻮﺳ ﻴﻭﻏﺭﺎﺍ ﺹﻧﺮﻘﻧﺎ
ﭘHﻭﺩiﺍ atalher niﻭﻏﻲa ﺭﺎﻭېﻧﺍﺩکڅړ ﺮﻔ ،ﺩﺻ ﺯﺧﻢ
:
ﻪﻨﻠﻣ
ﺭ ﺩ
ﺩ.
ﻣﻞ ﻱ ﺭړﺩ Pyﻭ rantelpamoat ﻭe ﺍ ﻭﻝﺯﺍﺪﻨﻴﺒﻟ
ﺍ
:ﻭﻝﺯﺍﺪﻨﻴﺒﻟ
ﺍ
ﺭېچﻥ ﺭﻪچ .ﮐ ﺮﻱﻮﺏﻟ ﺘﻨ
ﻣﺰﻴﻭکېﺍﻏ %٩ﭘﻲښ ېﻪ٥
،چ ﭘ ږﻱ
ﻮﻝکږ ﮐﺭ(ﻭ ﻪﻣﺍﺭﻠﻲګ ﻣ٤٠٠ﺯ)ﻭ ﻮﺩ ﻳ
.
ﺮﻱ ﻟﺎﺏ ﺒ
ﺘﻄﺍﺳ ﺭﺱﻫﻢ ﻮﻭﮐ ﻭځﺮ٣ﺭ ٢څﻪﺗ
ﻮ ﺧ ﺎﺕﻭﻱﻧ ﻳﺎﻥﺯﻴﻧﺠ
ﻣﻞﺭﺍﺩﻣﻞګۍ کېﺩ ﺎﻪﺣ ﻭﭘ ﺰېﺍ ﻴﺰېﺍﻏ ﻴ
ړﺧﻪ ﻱېﺍ ﻮﻝېﺗ ﻭﺧ ﺯېﺍ ﻮ ﻪﭘ ﻧﺩﺩ ﺩ
ږږﻧﺠﻲ ﻝ ﺩچﻥ
.ﺮﻱﻟ ﻪﺎﺏﻧ ﺒﺘﻄﺍﺳ
141
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
.
ﻮﻱ ښﻪﮐﻨﺭﺗ ﺎﭙﻩﺳ ړﺭکﻮﻭ ﻠﻣﺭﺩېﺩ
ﺭۍکېﺩ ﺍ
ﻭﺪ ﻨ
ﻴﻪﻣ ﻭﺱﭘ ﺍﻻﻦWHO ﮐ
:
Py rant elpamoat e
ﻡﺍﺭ
ﻮګ ﻪﻱېﻳ ﻩﮐﭽ ﻟړ
،ﻮ ږﻱ
ﻮﻝ کږ ﮐﺭﺯﻭ ﻭﻮﺩﺯﻥﻳ ګﻡﻭ
ﺍﻮﺭ ﻟﺮ کﻝ ﺮﻫ ﺪﻥﭘ ﺑﻪﺩ ﻣﺍﺭﻠﻲګ ﻣ١١-١
ﻟ٠
ﻪ
،
ﺩﻱ ﺭ
ﺩﺮ،ﺳ ﺘﻰ ﺎﺳ،ﻧﺲﻧ ،ﺎﻥګ ﺩ ،چېﮐﺰې ﻱېﮐﻢې ﻱ ﻴ
ﺰېﺍﻏ ﻴړﺧﺩ.ﺍ
ﻣﻦ ﻱ ﺰﻴ%١ﺍﻏ ٠٠-
٨ﺩﻯ٥
.ږﻱﻮﻝکږ ﮐﺭﺭۍکېﻭ ﺍﻭﺪﻨﻴ
ﻱﻪﻣړﭘ ﺎﻐ
ﻧﺍDrﺭ owsi ﻭness ﺍﺮﺧﻲ ﺮﭼﺳ
:Mebendazol e
ږږﻮﻝک ﮐﺭﻩﻭﺭﺎﭙﻟﻭﻭځ
ﺩې ﺭﻪﺩﺭ ﺘﻭﺳﺭېﺎﻭ
څﻪﻣﺨﮏ ﻳ ړۍ ﺧ ﺭځېﺩﻡ ﻭﻩځﻝېﺩ ﻭ ﻪﺩ ﻣﺍﺭﻠﻲګ ١ﻣ٠٠
ﻊﻨﻮﻝﻣ ﮐﺭﺭۍکېﻱېﻭ ﺍﻭﺪﻨﻴﻪﻣ ﺩ.ﭘ
ﻓﻲ ﻱ ﺎ
ﻪﻫﻢﮐ ﻣﺍﺭﻠﻲګ ٥ﻣ ٠ﺯﻱې٠ ﻭﻩﺩ ﺮﻮﮐ ﻩﻳ ﺭﻥګ ﺍﺪﻤ،ﻫﻱ
ﺩ.
ﻱ
:Pepr azin
ﺮﻩﭘﻭ.ﺩﻩﻪﺩ ﻣﺍ
ﺭ٣ګ ،ﻩﻱې٥ ﺯﺍﺪﻧﻩﺍﻟړ
.ﻮږﻱﻮﻝکږ ﮐﺭ
ﺯﻥﻭ ګﻡﻭﺍﻮﺭ ﻟﺮکﻝ ﺮﻫﺪﻥﭘ ﺑﻪﺩ ﻣﺍﺭﻠﻲګ ﻣ٧٥
ېﺮڅﺯﻱ ﺗ ﻭﻭ؛ﻮﺩ
ﺎﺕ ﻱﻧ ﻳﺭﺯ ﺷﺭ
ﻮ ﻢ ﻧﺎ
ﻴﻧﺠﺭېﺩ چﻥ ﺭﻪچ .ﮐږﻱ
ﻪکږ ﻴﻮﺻ ﺩﺭځېﺗﻪﻭ ﻧﻭﺯﻭ ﻪﭘﺲېﺩ ﻟ
.ږﻱﺭﻱ ﺍ
ﺮﮑﻪﻫﻢﺗ ﺘﻭﺳ ﺭﻭﻥۍﻭ ﺍﻩ ﻮﺭﺱﻳ ﻮﻭﮐ ﻭځ
ﻩﺭ ﻭﻳﺩﺩ ﻭﺎ ﻭځﻭﺭ ﺭ
ﻮﻟ
ﺭﻝﻮﭙﻤ
ﻴﻪﺗ ﮑګﻞېﻟﻮﻳ ﺑﺎﺰﻱﺍﻋﺼ ﮐﺮﻣ.ﺩږﻱ
ﻪ کږ ﺗﻣﻦځ ﺍ
ﻪﺭ ﻠ
ﻪﮐ ﻠﺩﻱﮐ ﺭﺩﺮېﻭﺳ ګﻞ ﺍﻳﻲ ﻳ ﺎﻌ
ﺪېﻣ ﻌﻣ
ﻪﻐﺎﻫﻭﻳ ﻪﺍﻳﺎ
ﻔﻡﮐ ﺪﻪﻋ ﻭﭘ ﺭګ ﻮﺗﺭﻭﺩﭖښ ﻪځﻱګﺍ ﺍﭘﻭﺩ.ﺍﺩ
ﺭ ﻯﺩ ﺩﺎ
ﻟﻰﻧ ﺍﻮﺗ
ﺎﻳﺘﻼﺝﺯ ﺍﺧﻭﺩ ﺎﺍﻴﮑﺴ ﺗ
ﺍ
.ږﻱ
ﻮﻝکږ ﮐﺭﻪﻭﺮﻱﻧ ﻟ
ﻭﻏﻲﻭ ﺭﺎﺒﻲﻧډﻥۍﻋﺼ ﺝﺎځﻥﺘﻼ ﻳ ﺍﺧ ﻮچې ﻧﺎﻭﻏﺭﺎ
ﻧ
:
Lev ami sole
،ﺩګﻱﻭ ﺎﻥګ،ﮐﻟﻰ ﺍ
ﻭﺪﻩﺑړﻪﺯ ﻠﻪﮐ ﻠ
،ﮐږﻱ
ﻮﻝکږ ﮐﺭ
ﻮځﻝﻭ ﻪﻳﻣﺍﺭﻠﻲګ ﻣ١
٥ﺩ٠،
ﺎﺕ ﻯ ﻳﻮﺏﻱېﺯ ﺘﻨ
ﻣ ﺰﻴ
ﺍﻏ
ﻭ.
ګﻪﻣﻦ ﻱ ﻠ
ﻭﻍ ﻳ ﺭﺎېڅﻪﻧ
ﺳګﭻ ﺧ ﻭ ﺮﻳ ﺍ ﺩﻱﺭﺩﺮﺩ،ﺳﺩډې ﺭ
:
Ent erobiasi(s Pinewr om i nfect iﺭ)on ﻮﻴﮐﺴﺍ
ﻪﺑﺭ
ﻮﻨﻰﮐ ﻳﺯﺍ
ﻮﺎﻥﻱېﻳ ﻧﺴ.ﺍﻮکې ﻤﻴﻮﺳ ﻣﺭ
ﻪګ ډﻝﭘګﻱ ﻭځﻥ ړ،ﻪ ﺍږﻱﭘﺍکږ ﺪﻴړۍکېﭘ ﻪﻥ ﻟﻭﻪټ ﭘ
ﻪﻭکې ﻨ
ﻳﺭﺎ
ﭘﻮﻧﻟﻨﺲﺎ ﻤﺠﻪﻫ .ﭘﻲښېﭘ ږﻱ
ﻪ کږ ﺘﺎﺕﺍﺧ ﻳﻪﺯ ټﻮﺗ
ﻧﺮﻍﺍ ﺎﻥﻧﻈ ﻣ ﻮﺎﺷﺍﻥﻣ ﻭﺩ،ځﻯ
ﺩ.
ﺎﺕې ﻱ ﻳﺯ
.ﺮﻱ ﻟﻟﻰﺍ
ﺍږﻭ
ﺭېﻭﺩ ﻮﻩﭘﺮﺘﺘﻲﻣ ﻧ
ﺎﺗ١ﺳ ﺩ،چېﺮ ﻧﺠﻰ ﻯ ﮐﻰچﻥ ﻭړﻴﻦﻭ ﭙ
ﺳ
ځﻥﻥښ ﻩﺍ ﺮﺎﻁﺳ ،ﻣﺨ ﻮﻱ ﺪﮐ ﻧﻭﺭﺕکېژ ﻭ ﺎ
ﻪﻣﺠ ﻮﭘ ﻤ
ﻟﻮﮐﻭﺩ ﮐﺲﺍ ﺪﻨ
ﭘ،ﺍﻡﻮﮑﻴﻪﺳ ﻧﺠﻰﭘ ﺎﻫﻞچﻥ ﮐ
ﻮﻱځﻥﺭﺳ ېﻪ ﺍ
ﺘﮏ ﺗ ﻮﺳPerﭘ iﺧanal
ﺪڅﻪ ﻌﻘېﻪﻣﻪک ﻟ ﭙﻪﺷ ﻧﺠﻰﭘ ﻪچﻥ ﻨﻳﻩ ښځ ﺭﺍﻭﺪﻨﻴ،ﻣﻮﻱﻟ
،
ږﻱﻪکږ ﺗ
ﻣﻦځ ﺍﺎﻥﺭﺘﻧ
ﻮکېﺍ ﺘﺎﻋﻭﺳ ﻪڅ څﻪﭘ
ﺩګﻮ ﺧ(ﻩﻳ ١٠
،٠
٠ﺎ٠ً
ﻨﻴﻤﺗﺨﻮﻱ) ﺭﻩګۍﺍﭼ ﺷﺭ
ﺎﺕ ﻢ ﻳﻭﺯﺍ
ېڅﻪ
ﺭ ﺧ ﻪﺩېﻻ ﻭﻟﻮﻱﺍ ﻨ
ﺘﻨﻪﻣ ﻧﻮﻭﻻﺳ ﺮﺵﺍ ﻫ،ﻓ
ﺍ،ﻮ ﺮﺘ،ﺑﺴﻟﻲ ﺎ
،ﺩﺷﭗېﮐ ﻪ
ﺑﻭ،ﺍ،ﻮک ﺍکېﺗ ﺭﻮچېﺧ
ﺍ
ﻮ ﻧېﺧﻻﺍﻻﺪﻭ(ﻭ ﺭHatﺍ ﺑﻲ)ch ﺭﺎ
ﺮکېﻩګۍﺷ ﺎﻋﺸ ﻨ
ﺛﺍ.ﻪ
ږﻱﭘ ﻊکږ ﻠ
ﻌﻦېﺑ ،ﻳږﻱ ﻠﻲﺍﺧېﻪﺩﻮﻝ ﺗ ﺧ
.
ږﻱﺩږ ږږﻪﻝ ﻡﺗ ﻮﮑ ﻴ
ﻌﻦېﺳ ﻳ
ﻩﻭ.ﻩګۍﺩ ﻩړﺎﺩ
ﻴﺗﺍﺗ
ﻮﻪ ﻴﻧ
ﻭ ٤ﺍ-ﺎ٣ً
ﺒﻳﺮ
ﻘ،ﺗﻮﻱ ﺍﭼﻮﻻﻯﺷﻲﻩګۍﻭ ﮐ
ﻧﺠﻰچېﻭ ﻪچﻥ ﻨﻳﻮﺥ ښځ ﻮﭘﻳ
ﺭځې٤ﻭ ٥-٣ﻩ٠ﺩﻮﻪﻣ ﻟ
ﻭ ﺪټ ﻧﻭﻧﺠﻲﺩژ ﻭﺩچﻥ ﮐﻻﻯﺷﻲﺍ ﺪﻮ ﻧﻭﺮژﻬڅﻪﺑﻪ ﺧ ﺑﺭﻮۍﻪﮐﻭﻥ ﻟ ﺩېﺍﺮﺭ ﺗ
.
ﻩﺩ
:
ﻩ ﻴﮏېﺏڼ ﻨﻴ
ﻠﮐ
،
ﻮﺏۍ ﻭ ،ﺏې ﺧ ﺍ ﻱ ﻮﻩﺩﺷﭗېﻟﺨ ﺮﺗ
ﺎﻳﺕڅﻪ چېﺯ
ﺭښ ﺧ ﺎ Perﺧ iﻟanalﺎﻥ ﻪ ﻭﻏ ﺭﺎ
ﺭﻧ ﺷﺭ
ﺎﺕ ﻢ ﻳﺯ
ﻭ.
ګﻪﻣﻦ ﻱ ﻠ
Eڅﻪ ﻳ
nurﺧ isiﻭs ﺍﻴﺖ ﻳﺸ ﺮ،ﺗﺨﻡۍ ﺍﺭﺎ
ﻧ
ﺩﮑﻰ ک ﺘﻮﺳﺍﭘﻮﻭﺧ ﺎ
ﺪﺷ ﻌﻘﻣ.ﺩ ﻮﮐﻼﻯﺷﻧﺠﻰ ﺘ ﺍ کېچﻥ ﻮﻭﺧ ﺎﻪﺷ ﺪﭘ ﻌﻘﻣﺍﺩﻮ ﻪﺩﺷﭗېﻟﺨ ﻠﻪﮐﻠﮐ
ﺷ.
ﻪ ﻲ ﺗﻣﻦځ ﺍ
IﺭMpi t
iﻭgo ﺍﺘﻦﺷﻲ ﻨ
ﻪﻫﻢﻣ ﺍﺳﻄ ﻪﻭ ﻭﺏﭘ ﺮ
ﮑ ﻳﺎ
ﺑﻞﻣ ﺍﻯﺷﻲﺩ ﺩ
ﻪچېﺩ ﻴﻞﺗﻠﺎﺍﺣﺯﻳﺎﻬﻮﻝېﺟ ﻪﺑ ﻧﺎ
ﻧﻪﺩﺯ ﮑﻟ،
ږﻱﻪکږ ﺗﻣﻦځ ﺍ
ﻪﺭ ﻧﺩ
ﺩ ﺩ
ږږﻧﺠﻲﻝ ﻩﺩچﻥ ﺮ
ډﻝﺳ ﺭﻭ ﺩ ﺎ
ﻪﻧﭘ
142
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﺍﻥ
ﻮﺘﻳ
ﺮ،ﭘ
ﺯﺎ
ﻬﻟﻲﺟ ﻮ
،ﺑﻮﻥﻟ
ﻮﻪﮐCﺎﭘ
yﻳ ti
ti
s،Di
vert
iculi
ti
s،ﺘﺲﻳ
ﺎﻳﺴﺪ
ﻨﭘ،ﺍ
Vulvov
aginit
isA
ﮐﻻﻱټ
ﻴﮏ ﻮﻠ
ﻴﻓﻮ
ﻨﻳﺰ
ﻳﺍﻭﺍ
ﻪﻧﻮﭘ
ﻮﻥټ ﻟ
ﻮﮐﺷ.ﺩ
ﮐﻻﻯ ﻲﻪﻮ ﺗﻣﻦځﺍ
ګﻥﺭ
ﺮﻭﺒﺎﻏﻣﻮﻟ
ﻮﻧ
ﺍﺭﻮکېګ ﺮﺧﻭﺑﺭﻮﻧ
ﺩ.
ﻮﻯ ﻯ ړﻝﺷﺭکﺭﻭﻮﭘ
ﺍﺱﺭ
ﺷ.
ﻻﻞ ﻲﻮﻣ ﻠﻠ
ﻳﺎ
ﺯﻥﺑ
ﻭﻭ ﺍﺩ
ﺭﻱېﺩ
ﺍﻯﺷﻲﺩګ ډ ﺩﺩ
ﻭ؛ک
ﺎﺕ ﻱﻳﺭﺯﺷﺭ
ﻮ ﻢﻴ
ﻧﺠﻪﺩچﻥ ﮐ
:ﺭﻱﭘﻞټﻥېﺍﻮﺗ
ﺍﺮﺑ
ﻻ
،
ﻭړﺍکﺪﻴﺘﮏېکېﻩګۍﭘ ﻮﺳﺍﭘﻮﻭﺧﺎ
ﻪﺷ ﺪﭘﻌﻘﻣ
ﻪچېﺩ ﻠ،ﮐږﻱ
ﺩﻝکږ ﻭﻪﻭﺧﺖﺍﻱښ ﻐﻴ ﺺﻫﺗﺸﺨ
ﺪﻌ
ﻘﻣﺩ،چېﺩﺍﺱې ﻯﺩﺩﻮﺘﻴﻩﻣﺭښ ،ﺭ
ﻮډﻮﻻﻯﺷ ﮐﺍ
ﺪﻴﻭکېﻩګۍﭘ ﺯﺎ
ﻴﺘډﻮﻣ
ﻪﮐ ﻩﭘﺮ
ډﻝﺳﺭﻭ ﺩ
ﺎﻪﻧﭘ
ږﻱ
ﺩﻝکږ ﻭﺍﻱښ (
ScotchTy pe)Cell
ulosepressuresensit
ivﺪېeﻧﺎ
ﺘﮏېﺑﻮﺳ ﺍﭘﻮ
ﻭﺧ ﺎ
ﺷ
ﺎ
ﻴﺗ
ﺪﻧﺭګﻪﺩ ښېڅ ﺘﺒ
ﻟﺍ
.ږﻱ
ﺪﻝکږ ﻴ
ﻟﻧې
ﻮﺏﻻﺪ ﮑ
ﻭﺳ ﺮ
ﮑﻳﺎ
ﺮﻣﻱﻭﺗ
ږﺍ ږړﻮ
ﻭڅﻪﺟ
ﻼﺪ ﺭ ﺧ
ﻪﺳﻳ ﺘﻭﺳﺭﻭﻭﺍ
ﺮ
ﻮﻥېﻫ ﻤﺩېﻧ
ﺷ .ﺭ
ﻪ ﻲ ﻣﻮ
ﻠﻌﻪﻣﮐﺎﻪﭘﺎﺣﻭﺳ ﺗڅ
،ﺮږﻱ
ﺘﻞ کږﻴﺴﻩﺍﺧTڅﻪ ګټ
ulﺧ ﻪuene ﻩﻟﺭﺎ
ﭙﻟ
ﻭ.
ﺪﻱ ﻴ
ﺋﺎ
ﻭکېﺗ %٩ﭘﻲښ ﭘ٠
ﻴ ﺺﻪ ،چېﺗﺸﺨ ږﻱ
ﺘﻞکږ ﻴﺴﻮﻣﺨﮏېﺍﺧ ﻟ
ﻮﺮﮐﻭﺗﺯ
ﺎﻴ
ﺘډﻮﻣﺭﺩ ﮐﺎﻬ
ﺳ
ﻳډﻮ
ﻭﺎ ﮐﭘﻲﺍﻮﮑﻮﺳﻧ
ﻪﺍﻧﺠﻰﭘ ﻍﻪچﻥﻍﻪﻥ ﻏ
،ځﻦېﻭﺧﺖﻥﻍ ﭘ ږﻱ ﻳﻪکږ ﺗﻣﻦځﺍ
ﺍﺭ
ًﺭﺩ
ﺎﺎﻧﻴ
ﻠﻴﻓ
ﻮﻨﻳﺰ
ﻳﺍ
.
ږﻱ
ﺪﻝکږ ﻴﻟﻭ
ﺮګﺘېﻪﺳ
ﻭک ﭘ ﺯﺎ
ﻴﺘﻣ
:
ﻴﺺﺮﻱﺗﺸﺨ
ﻴﭘﻮ
ﺗ
،Fi
ssur
e،Pr
oct
it
is،
ﺮﻴ
ﺍﺳﻮ
،ﺑﻴﺖﺎﺳ
ﺎﻥ ﺣﺴ
ﺘﻧ
ﻴﮏﺍﺗ
ﻮﮑﻳ
ﺎﻣﺪﺩﻳ
ﺎﺭښﺕﺑﺎ
Piﺧ
nwor ﺩm
ﺮکﻴ
ﭘﻮږﻱﺗ
ﻻﻞکږ
ﺭښﺕ ﻣﺎ
ﺍﺧﻮﻭﺧ
ﺎﺪﺩﺷﻌﻘ
ﻣڅﻪچېﺩ
ﻮ ﺧﻧ
ﻮﺘﻟ
ﺎﺭﺣ
ﻮﻪﻧﻟ
sﻭ
tﺍr
ongyl
oidi
asi
s
.ﻭ
ړ
:
ﻪﻨ
ﻠﻣ
ﺭﺩ
:
ﺎﺕﻣ
ﺎﻤﺘ
ﺍﻫﻣﻲ
ﻮﻤ-ﻋ
١
ﻮﻪﻳړﻯﭘ
ۍټﻝﻍ
ﺭﻥ ﻭ ﻮﮐﺪﺩﻳﺎ
ﻮ کېﺑ
ﻧﻮﺘﻟ
ﺎ
ځﻮﺣﻨﻪﻳﻭﭘﻪﻭﺷﻲﺍﻨﻠ
ﻣﺭﺪﺩﻳﺎ
ﻮﺑﻧ
ﺎﻭﻏﺭ
ﺎﻮﻧﻨ
ګﻪﻣﻠ
ﺩﻳ
ﻪ
ړﻪﻧ
ﻨﻪﺍﻳﻨ
ﻠﻣ
ﺭﻮﺩﻧﺎ
ﻭﻏﺭﺎ
ګﻪﻣﻦﻧﻠ
ﺮﻳ ﻴ
ﻩﻫﻢﺩﻏ ﻪڅډﻝﮐ
ﻣﻲ ﻭﻮ
ﻤﻪﻋﻮﭘﺷ.ﺧﻪ ﻲﻨﻠ
ﻣﺭﻭﺧﺖکېﺩ
ړﻦ
ﻮﻣﺨﮏېﺍﻳ ﻟ
ﺧړ
ﺮﻮ ﻭﺗﻪﺍﺘ
ﻭﺳﺭﻮﻭﻟ
ﻮﺮﮐﻭﺗﺯﺎ
ﻴﺘ
ډﻮﻣ
ﻪﺩ ﮐﺍﺳﻄ
ﻪﻭﻮﻥﭘﺑﺎ
ﻴﻦځﻝﺩﺻ ﻮﻣﻧ
ﻮ.ﺩﻻﺳﻩﺩ
ﺩ.
ﺭﻱ ﺎﮑ
ﺘﻞﭘﻴﺴﺍﺧﻮﻧ
ﺎﮐﻮ
ﻧﺩ.ﺩ
ﻯ
:
ﺎﺕﻣ
ﺎﻤﺘ
ﺍﻫګﻱ
ځﻥ ړ
-ﺍ
٢
ﺎ
ﻭﻝﻳﺯﺍ
ﺪﻨﻴ
ﺒ،ﻣﻭﻝﺯ
ﺍﺪﻨ
ﻴﺒ
ﻟﺷ.ﺍ
ﺭ ﻲﺍ
ﺮﮑﻪﺗﺘﻭﺳ
ﺭﻭﻥۍﻭ٤ﺍ-ﺮ٢ﻪﻫﻨ
ﻠﻣ
ﺭﻪﺩﺍﺳﻄﻪﻭګﻮﭘ
ﻧﺍﺍﻭﻧېﺩ
ﺩﻻﺪ
ﻮ ځﻝ
ﻪﻳ ﻣ
ﺍﺭﻠﻲ ګ
٤ﻣ ٠
٠.ﺮﻱ
ﻳﺖﻟﺮﺛﻮ%١ﻣ٠
ﻭﻝ٠ﺯﺍ
ﺪﻨﻴ
ﺒﻟ
ﺩ.ﺍ
ﻣﻞ ﻱﺭړﺩPyﻭr
antelpamoat
e
.ﻮﻱﻪﮐﺗ
ﻣﻦځ
ﺍﺍﺭ
ً
ﺭﺩﺎ
ﻪﻧﺘﺎﺳ
ﻭﻧﺲﻧ ﺍ
ﺩﺭﻱېﺩ
ږﻱﺩګډﻮﻝکږﮐﺭ
ﻭ
ﺷ.
ﻭژﻝ ﻲ
ﻩﻭ ﺭ
ﺎﭙ
ﻟﻳﻞې
ﺎﺪﺩښېﭘ
ﻳﺎﻭﺑ
ﺍﻣﻞﺩﻱ
ﺭﻣﻦﺩ
ﺰﻴﺍﻏ
ﻪﻫﻢ
ﻣﺍﺭ
ﻠﻲګ
١ﻣ٠
ﻮځﻝ٠
ﻪﻳﻭﻝﭘ
ﺯﺍﺪ
ﻨﻴﺒ
ﻣ
ﻮﻟ
ﺮکﻝﺮﻫﺪﻥﭘﺑ
ﻪﺩﻣ
ﺍﺭﻠﻲګ
ﻣ١٠.
ﺮﻱﻟ
ﻳﺖﺮﺛ
ﻮ%٩ﻣﻣﻞﺩﻱ٥
ﺭﻣﻦﺩﺰﻴﺭﺍﻏ
Pﺭ
yډ r
antelpamoate
ﺎ،
ﻬﻝ،ﺍﺳ
،ﺎﻥګ
ېګﻞېﻱېﮐ
ﺰ ﻳﻴﺰېﺍﻏ
ﻴړﺧ
ﺰېﺍﻳ
ﺩﻭﺩ.ﺩ
ګﻡ ﻯ
ﺍ
ﻮﺭ ﺯﻱېﻳ ﻭﻳﻲﺩ
ﺎﻬ
ﺯﻥ کېﻧګﻡﻭ
ﺍﺭ
ﺩ.
ﻟﺖ ﻱﺎ
ﻮﺏﺟﻦﺣ ېﻭﺧ
ﺳګﭻ ﺍ
،ﺮﻳ ﺩﻱ
ﺭﺩﺮ
ﺳ
:
Tri
chur
isTr
ichur
(aWhi
pwor
ﺎﻥ)m
ﻴﻨﺠ
ﻧﮏېﭼ
ﻭﺮﻟ
ﻪﮐﻭ
ﺮﺘﻣ
ﻩ
ﻳﻂﻱې ښ
ﺍﺮ
ﻳﻲﺷ
ﺎﻴ
ﺘﻭﻏ
ﻮکېچېﺭﻧ
ﻮﻳﺍ
ﻪځﻐ
(ﻪﻫWhiﭘpworﺎﻥ)m
ﻴﻧﺠ
ﻧﮏې چﻥ
ﻭﺮﻟ
ﻪﮐﻭ
ﺮﺘﻣ
ﺩ.
ړﻱ ﻱ
ﻪکﺘ
ﺍﺧﺎﻥﻱې
ﻧﺎﻧﺴ
ﺍﻪﻧ
ﻮﻠ
ﻴ٨ﻣ
٠ړۍکېﻱې٠ﻪﻥﺎﺕﺩﻱﭘﻳ
ﻪﻭﻱﺯﻧ
143
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﻪ
ﺍﺳﻄﻮ ﺎﺩﺷﺨ ﺺﭘ
ﻴﻭﺑړﺷﻲﺍﻩﮐﮏ ﺮګﻮﺳ
ﻪﻩ ﻳﻧﺠﻰﻟﺩېچﻥ
ﻩﺩﺧړ
ﺍ
ﻭ ﻮ ﻩﺍﺭ
ﻭﺎﻪﻭﺧﺖچېﺧ ﻐﻫ
ﻪ
ﺮﻱﭘ ﻟﻰﻟﺍ
ﺍږﻭ
ﺭېﻭﺩﻮﻩﭘﺮﺘ
ﺘﻲﻣ ﻧ
ﺎ٥ﺳ-ﻧﺠﻰ٣ﺎﻫﻞچﻥ.ﮐ
ږﻱ
ﻪ کږﺘ
ﻭﻍۍﺍﺧ ﺭ
ﺎﭘېﻧ
ړﻝﺷﻲ ﺪﻮﻭﺧ
.
ﺮﻱﺎﻥﻟﻤﺘ
ﺎﺧﮑﻞﺳﻪﺷﻭکېﭘ ﺮ
ﺘﺷېﻣﻭ ﻮﻭﺎ
ﻮېﺗﻳﺎﻥﺩ
ﻴﻧﺠ
ﻮﻉچﻥېﺍﻧ
ﻳﺖ ک ﺩﺎ
ﻬﻥﻲﻧ
ﭙﻞﻣﺨﮏﻧ ﺧ
ﺪ
ﻧﻭﺍAnalcanalکېژﻮﻥﻭﻟﻮ،ﮐ
ﮐﺲ ﺪﻨ
ﭘ،ﺍ
ﻡﻮﻴ
ﻟﻨﻲﺍ
ﺘﮐ،ښﻡ
ﻮﮑﻴ
ﻪﺳ ﻧﺠﻲﭘﻧﮏېچﻥﻭﺮ
ﻪﻟﮐ
ﻭﺮﺘﻣ
.ﻮﻱﮐ
ﻩګﻮﺩﻴﻧﺠﺭېﺩچﻥ ﺭﻪچ ږﻱﮐ
ﻪکږ ﺘ
ﺍﺧﺎﺕ ﻳ
ﺎﻥﺯﻣﻮﺎﺷ
ﻮﻣﺷ؛ﺧ
ﮐﻻﻯ ﻲ
ﻪﻮ ﺘﺍﺧﺮکې ﻤﺮﻋﻪﻫ ﺎﻥﭘﻧﺴﺍ
ﺭﺩﺷﺭ
ګﻮ ﻢﻩﻳ ﻪﺩﻮﮐ.ﺧږﻱﻻﻞکږ ګﻮ ﻣ
ﻠ
ﺍﺩﻳ ً
ﺭﺩﺎ
ﻭ،ﻧ
څﻪﮐﻢ ﻱ
ﻭ ﺧﺯﺎ
ﻴﺘډﻮﻣ
ﭘګﻡ ﮐ
ﺍ١ﺮ ﺭ٠
٠٠ﺭ٠ﺷﺭ
ﻮ ﻢ ﻳ
،ﺩګﺘﻰﺎﺳ،ﻧﺲﻧ ﺩTensmus،ﺩﭙﻲ ﺭﻣﺮﻱېﮐ
ﺍﻯﺷﻲﺩګ ډ ﺩ
ﺩﻭ،ﻮک
ﻭ ﻱﻧ ﺯﺎ
ﻴﺘډﻮﻣ
ګﻡ ﮐ
ﺍ٣ﺮ ﺭ٠ﭘ ٠
٠٠
ﻮک ﻧ
ﺎﻣ
ﻮ ﺎﺷﻮﻣﻧﺍ
ﻭډﻝځګﻱ ﻭځﻥ ړ
،ﻪ ﺍ
ړﻱﭘ ﻪک ﺗ
ﻣﻦځﺍ
ﺎﻥګېﺭﻭﮐﻟﻰﺍ
ﺍﻭﺪﻩﺑړ
ﺑ،ﺯ
ﺩ،ﺎﻮﺏړﺳ ﻱې ﭖډ
Tr
ichuriﻪ s ﻠ
ﻣﻪﺍﺩﻭﻟ
ﻊ کﺩ ﻳﺎﻳﻦېﺩ ﺿ ﻭﻭ کېﺩﺯﺎ
ﻴﺘ
ډﻮﻣﻪﮐﻭﭘ ﺮﻱﺍﺘﻧ
ﺍﺰ
ﻳﻩﺩ ﺭﺍ
ﺪﻣﺍﻭېﺩﺩ
ﻴﻦګﺑ
ﻮﮐﻼ ﺗﻭ،ﺩګRectalprolapsed,Anemi ،چېﺩaږﻱ
ﻪ کږﺗ
ﻣﻦځ ﺍ
ﻡﺭﻭﺭﺪﻨ
dyﺳ sentery
.
ږﻱ
ﻴﺐکږ ﻘﻌ
ﻪﺗﺍﺳﻄﻪﻭ ﻟﻲﭘﺍ
ﻮ ﺑ
ﺍﺮ
ﻮﺧ ﻤﻧ
.
ږﻱ
ﻩکږ
ﺮﺮﺳ
ﻩﺗﺮ
ﻭﺳﺪ
ﻴﻟﻪ
ګﻮﭘ
ګﻭﻩ ﻳ
ﺩځﻥ ړ
ﻭکې ﺍ
ﺯﺎﻴ
ﺘډﻮﻣ
ېﻪ ﮐ
ﻴ ﺺﻱ ﭘ
ﺗﺸﺨ
:
ﻪﻨ
ﻠﻣ
ﺭﺩ
١ﺮ٢
ﻪﻫ ﻣﺍ
ﺭﻠﻲ ګ
١ﻣ٠ﻩ٠
ﺮﻭﻝﺳﺯﺍ
ﺪﻨﻴ
ﺒﻪﻱېﺩﻣ ﻨﻠ
ﻣﺭ.ﺩ
ﺮﻱﻪﻟړﺎﻧ
ﻴ
ﺗﺍﺗﻠﻦېﻪ
ﻣﺭﻭﻍﺩﺭ
ﺎﺮﺿﻲﻧﺮﻋﻴﻏ
ﻭﻝﺯ
ﺍﺪﻨ
ﻴﺒﻟ
ﻩﺍﺭﻥګ
ﺍﺪﻤ
ﺩ.ﻫ
%٨ﻱﻟﻰ٠٦ﺍﻮﺏﻱې٠ ﺘﻨ
ﻣﺰﻴ
ﻩچېﺍﻏ ﺭﺎ
ﭙﻭﻟﻭځ
٥ﺭ-
ﻪﺩ٣ ﺘ
ﻭﺳﺭﻪﻭﺘﺎﻋ
ﺳ
ﭙﻦې
ﻭﺳ ﺩ،ﺩﺍ
%٩ﻯﻟﻰ٠
ﺍ٣ﻮﺏﻱې٣ ﺘ
ﻨﻣﺰ
ﻴ،چېﺍﻏﻮﻮﻻﻯﺷﮐﺭﻩﻭﺮﺯﺳﻭﻩﺩ
ﺮﻮﺟﻪﻳﻣﺍﺭ
ﻠﻲ ګ
ﻣ ٤
٠٠
ﺩ.
ړﻦ ﻱ
ﺍﻳﻩﺭ
ﺎﭙﻟﺩﻭ
ﺍﺻﻼﺡکﺩږۍﺩﻪﻝﻨﻳ
ﻭﻮﻝﺩﮐﺭﻭ
144
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
:
(ﻧﺠﻲ
ﻮﻱچﻥ
ﺘﻴﺍﻓ
ﻮﺩﻏ
ﺎ)ﺗ
ﺎﻨ
ﻴﺎﺳﺠ
ﻴﻨ
ﻴﺗ
ﺎ
ﻭﻳﻪﺍ
ﻣﺎﻩﺧ
ﻮښﻮﻏ
ﻧﺎﻳ
ﺍﻮﻮکېچېﺩﻏ
ﻧﻮﻳ
ﺍﻮځ
ﻐډﻝﻫ
ګﻱ ﻭ
ځﻥ ړ
ږﻱﻪ ﺍ
ﺪﻝکږ ﭘﻴﻟ
ﻭکېﺩ
ﺍﻮﻴ
ﻩﻫﺮﺗ
ﺎﻳ
ﻪﺯﭘ
ﺷ.
ړﻝ ﻲ
ﻮېﻪﻭﻱﻭﺧ
ﻮﻧ ﻪﺷﻩﭘﺨﺭ
ﻮﭘ
،چې
ﺮﻱﻟﻰﻟ
ﺍﺍږﻭ
ﺭې ﻭﺩﻮ
ﻭﭘ ﺮﺘ
ﻣ١٠
-ﻧﺠﻰ٨
ﻮﺥ چﻥﺩ.ﭘ
ﻪ ﻯﺑﺭ
ﻮﻨﻰﮐﻳﺯﺍ
ﻮﺎﻥﻳﻧﺴ
ﻩﺍﺭﺎ
ﭙﻧﺠﻲﻟﻮﺥ چﻥ
ﭘﺩ
،چې
ﺮﻱﻪﻟﻧ
ﻭﺪﻨ
ﺭېﺑﻮ٢ﭘ٠٠
ﺮ٠ﻪﺗ ١څﺧ
٠٠
ﻭ٠Scolﺍ.ﻮex
ږﻱﻳﻭﺳﻲﻪ کېﺍﺮﺧﺗﻦۍﺑﺭﻮ
ﻮﻡﭘﻨﻴ
ﻴﺠﺩﺟ
.
ﺮﻱﻟ(
Sucker
ﻧﮏې) ﻭ
ېڅﺭﺯﺏښښﻮScolﻱ ﻟex
.
ږﻱږ
ړﻮﻧﺠﻰﺟ
ﻮﺥچﻥ
ﻪﭘﻭڅﺧ
ﻩکې ﺭ
ﺩﻮﻪﻣ
ﻮﭘﺘ
ﺎﺷﻴ
ﻣﻭﻭ
ﺷ،ﻮﺩﺩ
ړﻝ ﻲﻧ
ﻮﻧﺠﻲﻩګۍﻭﺧ
ﻪچېﺩچﻥ
ﻠﮐ
:
ﻩﻴﮏېﺏڼ
ﻨﻴﻠ
ﮐ
،
ﻟﻰﺍ
ﻮﻤﺯﻥﮐﻭﻭﺘﻲﺍ،ﺳﺴ
ﻮﻥﻟﺪﺎﺑ
ﻬﺘ،ﺩﺍﺷ
ﻟﻰﺍ
ﻭﺪﻩﺑړ
ﺩ،ﺯ
ﺩ
ګﺪېﮐﻢ ﺭﻪﺩ ﻳ
ﮑﻟ،ږﻱ
ﻻﻞکږګﻭګﻮ ﻣ
ﻠ
ځﻥ ړ ﻳﺎﺍﻧﺩ
ﮐﻻﻯﺷﻲﻭﻫﻢ ﻮﺍﻯﺷﻲﺍﺩﺩ
ﻻﻞﻫﻢک ﺩﻣﺭړﻲﺩﺑﻲﻧﻱېﺩ
ﺩ؛ﻮﺩګ ډ
ﻩ ﻯﻧ ﺪﻧ
ﻮځﺪﺧﻳﺎ
ﺗﻮﻟ
ﻭګﺮﻩچېﭘڅﻥګ
ﺭ
ﻪﻭﻧﺪﻨﺑ
ﻧﺠﻲ ﺩﻪ ﺩچﻥ
ﻠﭙﻭﻍ ﺧﺭﺎ
ړﻱﻧﺪ ک ﻨﺎﺕﺑﻨ
ﻭې ﻗﻭﻱ کڅړ ﺍ
ﺮﻔﻭ ﺩﺻ
ﺍ ﺹﺍ ﺮ
ﻘﻧﺎ
،ﭘﮐﺲډﭘﻦﺍ
.ﻮﻱګﻪﮐ
ﻠ
ﻪﻳ ﺩﻭڅﺧﺭﺝﺩﺎ
(ﻪﺧPrﻟogl
ott
i)d
:
ﻴﺺﺗﺸﺨ
ﺪ
ﻌﻘﺍﻯ ﺷﻲﺩﻣ
ﺩﺩ.ﻩګۍ کږﻱ
ﻩ کږ
ﺮﺮﺳ ﻩﺗ
ﺮﻭﺳﺪﻴﻪﻟPrﭘ
ogl
otti
ﺎdګﻮﻳ
ﻩﻳﻭ کېﺩ
ﺯﺎﻴ
ﺘډﻮﻣ
ﻪﮐﭘ
lﻮ
ﻭgEﻟﺎﺍ
ﻴﻠ
ﻴﻓﻮ
ﻴﻧﻭ
ﺰﻳ.ﺍ
ﻮﻱﮑ
ﻪﻧﺘﺮﺳ
ﻪﻣ ﻨ
ﻳﺎ
ﻌﻴﮏﻣﻮﺟ
ﻟﺍ
ﺮﻴﻭ.ﺳ
ﺩې ﻱ
ﻮﻮﺟﺍکېﻫﻢﻣﻮﻭﺧ
ﺎېﻪﺷ
ﺘﮏ ﭘﻮﺳﭘ
ﺩ
.
ﻮﮐﻻﻯﺷ
ﺍﻮﺪﻴ
ﻭﻡکېﭘﺮﻴﻪﺳﻟﻰﭘ
ﺍ
ﻭړ
:
ﻪﻨﻠ
ﻣﺭﺩ
،چېږﻱ
ﻩ کږﺮ
ﺮﺳﻪﺗﻨ
ﻠﻣﺭ
ﻪﺩﺍﺳﻄ
ﻪﻭ (ﭘ
ﺪﻥﺑ
ﺯﻥﺩﺍﻡﻭﺭ
ﻮګ ﻟ
ﺮ کﻝﺮﻫﻪﭘ
ﻣﺍﺭ
ﻠﻲګ ﻣ
١٠)Prazi
quantﺩel
ږږ
ژﻝکﻪﻣﺨﮏې ﻭﺎﻯڅﺧﻪﭼﻟﺭ
ﺎﻬﻮځﻝﺩﺳﻪﻳ
ﻣﺍﺭ
ﻩګ ﻭNiﺩ
closami
ﻩdeﺭﻥګﺍ
ﺪﻤﺩ.ﻫ
ﻣﻦ ﻱﺰﻴ%٩ﺍﻏ٩
ﺩ.
ﻣﻦ ﻱ ﺰ
ﻴ%٩ﺍﻏ،چې٠ ﻱ
:
ﻪﻧ
ﻮﻴﻨ
ﻣﺨ
ﺭﺝ
ﺩ٢ﻔﻲ٠
ﻨﻪﻣ
ﻭﭘﻩﺍ
ﺭﺎﭙ
ﻟﻮﻘ
ﻴﻗﺭﺕکېﺩ٥ﺩ
ﺍﺮﺭﺝېﺣ
ﺩ٥ﺷ.ﻪ٦
ﻪ ﻲﭘډﻝﭘﺨ
ﻩﻭﺭﻮﻪﭘ
ﺪﭘﻳ
ﺎﻩﺑ
ﻮښﻳﻲﻏﻮﺩﻏ
.
ږﻱ
ﻳﺐږ
ﺮﺍﺗﺨﻭ
ﺭﺎﻥﻻ
ﺘﻧ
ﺍﺭځېﺩ
١ﻭﻟﻰ٠
ېکې٧ﺍ
ﺯ
ﺍډ
ﻭﻱ
ﺍﺎﻥ
ﺘﻧ
ﺍHI
ﺩV
:ﻳﻒﺮﻌ
ﺗ
ﺩ،چ
ﺮﺱ ﻯ ﻳﺍ
ﮑﻰﻭﻧﻭ
ړﺎﻳﺠﺘﻢﻭﻴﺴﺘﻲﺳﻴﻓﺎ
ﻌﻣﺎﻥﺩﻧﺴﺮﺱﺩﺍﻳﺍHumanIﻭ mmunedef i
ciency
ﻡﻮHﻪﻧ
Iﭘ V-
ﺮﺱچېﺩ2 ﻳﺍ
ﻮﺑﻞﻭ ﻪﻳﺗ
ﺭېﻪﻭ
.ﺩ ﺗږﻱ
ﺩږ ﺎ
ﻡﻳﻮﻪﻧﺮﺱﭘ ﻳﺍ
HIﻭ V-
ډﻝﻱې1 ﻩﻭ ﺭ
ﻮېﻏ
ﺯﺍ
ﻮﻭﻳﺍﻪﺩﻯﮑﻰﻧﻧ
ﻭﻮﺮﻯﮐﻴﻩﺗ
ﺮ ﻣ
ﻭﻪﺩﻠﺗ
ﺮﻪﭘﭘHIV-
ﻮﺩ1 ﺷ.ﺧ
ﻠﻰ ﻲ ﭘﺘﻢځﻴﺴﺘﻲﺳ ﻴﻓ
ﺎﻌږﻱﻫﻢﻣﺩږﺎ
ﻳ
ﺩ.
ﺎﺕې ﻯ ړﻰﭘ
ﺭېﺕﻟ ﻮﺎﭘﻘﻳ
ﺮﻓﺍﺑﻲﺮ
ېﻪﻏﭘ
ګﻱډځﻥ ړ
ﻪﺍﻮﻱﭘﻪﮐﺘﻭﻍۍﺍﺧ ﺭﺎ
ﻪﻧﻩﭘﺭﺎ
ﭙﺮﻟﻤﺩټﻝﻋ
ﺎﺝ ﻭ ﻧﺴځﻦېﺍ
ﺪﻥ ﻳ ﺑﺎﻥﺩﻧﺴﺍ
ﻪﺩ ﻧ
ﻮﺮﺳﻳﺍ
ﺍﻭﺩ
ﺕﺮﺩې
ﺍﮐﻢښ ﺗ ږﻱﻭﺩ
ﻩﮐﻢږ ﺍ ﺮﺩﻭﺳﺭﺩﺭﻪﺕ ﻪچېﺩﻭﺧﺖﭘ ﻧ
ﻮﺘﻳ
ﺎﻮﺳﻔﻤﻭﻯﻟﺪﻨﺘﺮﺳ(ﻣﻭﻝ)CD4
AIﺩﻮDSﻟ
ﺭﺩﺭﻪﺕﻮﭘﻧﻮﻠ
ﮐﺎﻯکېﺩ ﻪﭘږﻱﻭﭘ
ﻻﻞکږ ﺍﺩځﻮ ﻣ
ﻠ
ﻴﺖ ﭘ ﻓﺎﻌ
ﻣ،چېﺩ ږﻱﺭېﺭﺱږ ﻮ
ﮐﭻېﭘ
145
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﺭﻮﺎﻧHﻭﻳ
Iﺍ ﻪV ﻠﭙ
ﺎﻯکېﺧ ېﻪﭘ،چ ﭘ ږﻱ
ﺪږ ﻧﺭګ(څ ﻡﻭﺭﺪﻨAcquiﺳ redimmunedef i
ci ency)
.
ږﻱﻻﻞکږ ﺩړﻦې ﻣﻭﻍ ﻡﻳ ﺭﺎﻧﺎﺕﺩ ﻧﺎ
ﺘﻧﺍﻴﻦ ﻊﺑﻗﻮﻣ
:ﻮﺟﻲ ﻟﻮﻤﻳﺪﻴﭘ
ﺍ
ﻟﺖکې ﺎ
ﻳﻠﺲﺍ ﻧﺠﻪﻻﺱﺍ ﺎﭘﮑﻳﺮﻣ ﺍ
ﻮﺳﻢکېﺩ ﻱﻪﻣ
ﺍړ ﭘﮐﻝﺩﻭ ١ﺎ ٩٨ﻩﺩ١ ﺭﺎ
ﭙﻟړﻱځﻝ ﻡﻮﻟﻭﻏﻲﺩ ﺭﺎ
ﺍﻧﺩ
ﺪﻝﻧژژﻩﻭﭖ ﻭﺩﻮﻟﺭ
ﺎﻱېﺩ ﻴﻧﻮﻤﻨﻲﻧ ﻳ
ﺮﺘﮏﮐ ﻳﺎ
ﻮﺳ ﻤﻪﻭ کېچېﻧ ﻨﻳﺭﺎ
Homosexulﻧ ﻭa ﻪﭘﻦځ ﭘ
ﻣﻞﻱې ﺭ
ﻗﻲﺩ ﺭﻭکېچېﺯ ﻮ ښځ ﻐﻭﻭﻫﻪﺍ ﻨﻳﺭ
ﺎﻪﻧﻭﻏﻲﭘ ﺭﺎﻩﻧﺮﺩﻮﺳ ﻟ
ﺭﺩ ﺭ
ﻪﺕ ﻮﭘ ﺘ
ﺎﺷ ﻴﻭﻣ .ﺩڅ ﻩﻮﺷ
.
ﻩﻮ ﺪﻝﺷ ﻧ
ژ ژﻪﻱېﻭﭖ ﻧﺩﺩﺩږږﺭېﻝ ېﻪﻻ
ﻳﻦ ﻟ ﻭﻪﺩ ﺘﻭﺳﺭﺭﻭﻭژ ﺍﻩ ﻮﺪﻝﺷ ﻴﻟﻮﻝﻭ ﻟﺎﻤ
ﻌﺘﺍﺳ
٤٥،
ﺮ٣ څﻪﺗ
ﻮ ﺧ ﻧﻮﻠﻴ٣ﻣ٦ ،
٧ﻪ) ﻪﻣﻦځﻥۍﮐﭽ ﻪﭘ ﻧﻮ
ﻠﻴ٤ﻣ ٠
،ﺭې٣ ﻮﮐﻪﭘﻟ
٢ﺎ ٠٠ﺗ٥ړۍ کېﺮ ﻪﻥ ﻟﻭﻪټ ﭘ
.
ﻭ ﻧﮏېﻭ ﻭﺪ ﻴﻭﺳ ﺍﺎﻘﻳﺮﻓﺍ
ﺩېﺩ ﺮﺭ ﻩﭘﻭﻭچېﺩ ﻪﻭ ﺘﺍﺧګﻱﻪﺩېﺭﻥځ (ﻭړ ﭘ ﺭېﻮﻮﭘ ﻧﻮﻠ
ﻴﻣ
څﻪﮐﻢﻮ ﺧ ﻧﻮ
ﻠ١ﮐېﻪ٥ﺮﻱ ﻟ ﻤﺎﻥچېﻋ ﻣ ﻮﺎﺷﻪﻣ ﻧ
ﻮﻠﻴ
٢ﻣ ،
ﺩې٥ ږﺩېﻥ ﺮﻩﭘﺭﺭﺮﺏ%٥ﻱې ښځېﺩﻱﺳ ٠
.ږﻱږړۍڅﻪک
ﻭﻍ ﺧ ﺭ ﺎ
ﻪﺩېﻧ ﻟﺩﻯ
ﺭګړۍکېڅ ﻪﻥ ﻮﻱﭘﻲښېﭘ ﻪﻧ ﻧﻮﻠ
ﻴﻩﻣ ٢کېﭘﻦځ ٠٠ﮐﻝ٣ټﻪﺎ ﻨﺲ ﭘ ﺮﺑﺭﭘ ﻮﭘﺍﺭAIﺩ ﺩUNﺩDS
ﻪﻪﻫﻢﭘ ﻠﻣۍﻪﺍ
ﻭﻍ ﻟ ﺭﺎ
ﺩېﻧﻪﺩ ﻧﻮﻠﻴﺩېﻣ(ﻭ ﺭﻭځکېﺍ ﻩﺭ ﺮﻪﻫ ﺎﻥﭘﺘﻧﻮﻱﺍﻩﻧ ﺭﻟﺲﺯ ﺭﺍ
ﻭ ﺷې)څ ﻧې ﻮﺪ
ﻮچې ﻭﻼﻯﺷ(ﻮ ﻳږﻱﻧﻩکږ ړﺎﻥﻡ ﻭﻏﺭﺎ٨ﻧ ٠
٠ﻪ٠ ﻠ
ﻣۍﻪﺍ
ﻭﻍ ﻟ ﺭﺎﺩېﻧﻭځ ﺩ)ﺮ ﺭ
ﻮﻱﺩﻱ ﻫ ﻩﺷ ړﮐﻝﻡ ﺩېﺎ
ﺩ.
ﻻﻞ ﻯﻡﻣ ﺭﻮﻟ
ﺩړﻦېڅېﺍ ﻡﻳړۍک ﺩ ﻪﻥ ﻟﻭﻪټ ﭘ
ﻭﺍﺎﻥﺘﻧ
ﻮﻱﺍ ﻮکېﻧ ﻴﻧ
ﺎﻫ٦ﺛ ېﻪ ﺮﻮچ ﭘ ﻠﻰﺷ ﻳ(ﻭڅﻪ
ﺎ ﺧ ﻴﻧ
ﻮ ﻤ
ﻭﻧ ﺍﻮﻴﻭﻏ ﺭ
ﺎﻩﻧړ،ﺯ
ﻭکﺩ ﺮﺘﻪﺩﺳ ﺘﻭﺳﺭﻭ)
.
ږﻱړکږ ﺮﻡ ﻔېﻮﻧﻮک ﻳ ﻘﻴﻗﻫ٥ﺩﺮ
ﺍﻱ.ﺩﻮﻱﺪﮐ ﻧ
ﻭﺎﻥژ ﻧ
ﺎﻧﺴﺍﻪﻧﻮ ﻠ
ﻴڅﺭﻣﻮ ﻪﻟ ﺘﺍﺧ ﺯﺍډ
ېﻪ ﻱ
ﺎﻥک ﭘ ﺘﻭﺳ ﺪﻨ
ېﻪﻫ،چ ﭘ ږﻱ
ﻳﻞکږ ﻩﻭ ﺭﻥګ ﺍ
ﺪﻤﻫ
.
ﺮﻱ ﻟﺰېﻴﺍﻏ ړﻥې ﺗﻲک ﺩﺎﻭﻋ ﺍﺒﻲﺬﻫ،ﻣﺮﻫﻦګﻱ ډﻝﻓډﻝ ﻭﺍﺕګکې ﻭ ځﻪﺭﺯﻪﻣﻦ ﺗ ډﭘ
ﻪﺮﺧﻼﻑﭘ ﺩېﺑ
ېﻭ ﺩﭘﻮ ک ﺍ ﻟﻨﺲﺎ ﻤﺠﻪﻫ ﻩﭘﺮﺗﺎ
ﻳﺯﺯﺍډ
ﻮ کې ﻱ ﻨﻟ
ﻭﻳﻲ ټ ﺎﭘﻭﺭﺑﻲﺍ ﻮﻨﻭﺟ ﺎﺍﮑﻳﺮﻣﻪﺍﭘ
ﺎﺕﻳﻮ کېﺯ ﻧ
ﺍﺭﺎ
ﮐ ﺎ
ﻧﻪﺯﺯﭘ ﺍډ
ﺎ کې ﻱ ﻘ
ﻳﺮﻓﻥﻭﺍ،چﻥ ﺍ ﺎﻥﺘﻭﺳﺪﻨ،ﻫ ﺎﻳ
ﺰﻴﻟﺎ
،ﻣﻡﺎﻨﺘﻳ،ﻭ ﺎ
ﭘﻭﺭﻗﻲﺍ ﺮﺑﻲﺷ ﺮﻏ
.ږﻱ
ﺪﻝکږ ﻴﻟ
ﻧﺴﻞﺩ ﻮ کېچېﺩ ﮑﻠ
ﻮﺧ ﻐﻭﻫ ﻮﺍ ﻧ
ﻭﺩﺍﻮﻴﻭېﻫﺮﺩ ﻩﻣﺦﭘ ﺮﺗﺎ
ﻳﺯﺯ ﺍډ
ﻩﻱ ﺮ
ﻪﻧﻈ ﻴﺖﻟ ﻌ
ﻗﻮ ﻭﻣ ﺩﺍﺎﺘﺼ ﻗﺍ
ﺩ
ﺩ.
ﺎﺕ ﻱ ﻳ
ﻟﺖکېﻭﻱﺯ ﺎﻪﺣ ﺮﭘﺜﮑﻭﺗ ﺍﺪﻴﻟ
ﻮﺗ
:
ﺰﺱ ﻴ
ﻨﻮﺟ ﺘﻭﭘﺍﻮﺟﻲ ﻟﻮﻳﺰﻓ
ﻮ ﺘ
ﭘ
.ﻩﻪﺩﻧﺩﺩ
ﺎﺕ ﻳ
ﻩﺯ ﺭﺍ
ﺪﻣﺍﻭﺮﺱﺩ ﻳﺍ
ﻭ ﻭﺩﺍ ﻟﻰﺍ
ﻮ ﺑ
ﺍﺮﺘﻢﺧﻴﺴﺘﻲﺳ ﻴﻓﺎﻌﻣHalﺩ lmar ﻬﻢk HIﻣ ﺮﺿﻲV ﺩﻋ
ﻧﮏې ﻭﺩژ
،چېﺍ ړﻱ ﻪک ﺘﺮﻱﺍﺧ ﻟﺘﻲﺟﻦﻭ ﻧ
ﻧﮏېچېCD4ﺍ ﻭﻪژ ﻐټﻝېﻫﮐﻻﻯﺷﻲ ﻭ ﺮﺱ ﻮ ﻳﺍ
ﻭ
ﺍﺧﻞﻭﺱﺩﺩ ﺮﻳﺍ
(ﺩﻭ CCR5- andcx cR4)Recept ﮐﻦor ﻮ ﻤﻴ.ﺷﻭﻱ ﺭ
ﺎﻩﮐﺭﺎﭙﻟ ﺩﻭ
ﺮﺱﺩﻥښﻝﺩ ﻳﺍ
ﻭ
ﻪﻮﮐ ،ﺧږﻱ
ﻪکږ ﺘﻪﺍﺧﺎﻥﻧ ﺘﻧﻪﺍ ﻩﭘ ﺮﻣﻭ،ﺩﺮﻱﻟﻟﻰﻭ ﺍ
ﻮﻤﻠﮏچېCCR5ﮐ ﻪﺧ ﻐﻭﻫ ﻬﻢﺩﻯﺍ ﻩﻣ ﺭﺎ
ﭙﻟﺩﻭ
ﺩ
.
ړﺪېځﻱ ﻧﻪﻭﺍ ﻪکېﻣﺦﭘ ﻭﭘﺭﻭﻭ ﺭﻭﻏﻲﻭ ﺭﺎ؛ﻮﻧﻮﻝﻧ ﻪﺷ ﺘﺍﺧ ﻮځﻝ ﻳ
Fﻻﻞ
usiﻣ ېﺎonړﻦ ﻳﻧﮏېﻡﻳ ﻭژﻭﺩ ﻮﻱﺍ ﻪﮐ ﻧ
ﺩﺩﺎﺕﻳHIﺯ ﻱﻮVﻮځ ﻧ ﻨ
ېﻪﻧﻧﮏ ﺗ ﻭﺮﺱژ ﻳﺍﻪچېﻭ ﻠ
ﮐ
.ږﻱ
کږ
ﻧﮏې ﻭﺩژ
ږﻱﺍﻣﻦېکږ ﺰﻴﺍﻏ ﺩ،چې ﻧﮏې ﻱ ﻭﻳېژﻨﺲټﺰ ﻪﺑﻐﻧﮏېﻫ ﻭﻪژﻳﻭﺪﻨﺘﺮﺳ ﻳﺖﻣ ﺎﻮﺳ ﻔﻤﻟCD4
ﻩﺩ ﺮﺩﻭ ﺳ
ﺎﺕﺩﻳﻪﺯ ﻡﻟﺍﻭﺎﻥﺩﺩ ﺘﻧﺍ.ﺩﻮﻱ ﻪﮐ ﻧ
ﻭﻭﺭښ ﻪﻻ ﻮﺗ ﮑﻧﻭﻭژ ﺭﻮﺒﮏېﻧ ﺘﻢﺩﺷ ﻴﺴﺘﻲ ﺳ ﻴﻓﺎ
ﻌﻣﺩ
ﻪﺗ
ﻣﻦځ ﺍﻮﻥﺭﻟﺪﻟﻲکېﻫﻢﺑ ﺍﻭڅﻥګ ﻪﺭ ﻮﭘ ﮑﻧ
ﻭﺩېژﺩې ﺩ ﺮﻩﭘﺭﺭﺮﺏ .ﺳ ږﻱ
ﻪکږ ﺘﮐﺍښ ﻩﺭ ﺯﺍ
ﺪ ﻧCD4ﺍ
.ږﻱ
کږ
.ږﻱ
ﺘﻦکږ ﻨﻪﻫﻢﻣ ﻧﻭژﺎ
ﻓ ﻭﺮﮐﺎ
ټﻭﻣﺎﻱ ﺍﻮﺳ ﻔﻤﻟﻪB ﮑﻟﻧﮏې ﻭﺭېژ ﻮﺒﮏېﻧ ﺘﻲﺷ ﻴﻓﺎ
ﻌﻣﺩ
ږږ
ﻪک ﺗ
ﻣﻦځ ﺍ
ﻪﺭ ﻠ
ﻣﺍ ﻪﻟ
ﻟﻲ ﺍﺍﺏﻭ ﺮ ﻭﺩﺧ ﺪﻧﻮﺩﺩ ﮑﻧﻭﻩﺩCD4ژ ﻮګ ﻩﺗﺰﻳﻨﺲټ ﻪﺑ ﺎﭘﻴﺗړﻴﻢګ ﻮﻧﮑ ﻧﻭ
ﺩBژ
ﺎ
ﻴﻤﻴﻨﻴﻟ
ﻮﺑ
ﻮﻟګﺎګ
ﻣﺮﺍ ﭙﻳﺎ
ﻩﻫ ﺮﺘﺸ ﻨﻭﻣ ﺗڅږﻱﺮﺒﺐکږ ﺩېﺳﺮﺩ ﻴﺛ
ﺎﻴﻢﺗ ﻘ
ﺘﺮﻣﺴ ﻴﻍﻭﻏﻍﻪﻥﻍ ﺍ ﺩﻥﻍ ﭘ .ﺍ ﻱ
146
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
؛ﻮ
ړﻯﻧ ﻪک ﺘﮐ
ړﺪې ښ ﻧﻪﻭﺍ ﺘﻲﺟﻦﭘ ﻧﻮېﺍ ﻧګﻥﺩﺮﻭ ﺒﻮﻏ ﮑﻧﻭﮐﻻﻯﺷﻲﺩBژ ﺷ،چې ﻮ ﻪ ﻲ ﺗ
ﻣﻦځ ﺍ
ﺭ
ډﻝ
ﻪﻭ ﺮچﻥﻥېﭘ ﻮﺳ ﻳژﺩ ﺎﻓﻭ
ﺮﮑ Miﺩﻯﻣ HIکېxed ﻪV ځﻞﭘﻴﺖ ﭘ ﻓﺎ
ﻌﻪﻣ ﻠﺒېﻪﮐﺰﻟ ﻴ
ﺪېﺍﻏ ﻤﺩﻫ
.ﻪﺘﻢﺗ ﻴﺴ ﺒﻲﺳ ﺰﻱﻋﺼ ﮐ ﺮﻪﻣﮑﻟ ﻭﻱ ﺩږږﻪﻱېﻝ ړﻮﺗ
ﺭ ﻍﻳ ﻮﻭﻧﺍ ﻮﻱ ﻣﺖﮐ ﺪ
Hﻪﺧ Iﺗ V
ﺍﺕﺮﻴﺛ
ﺎﺒﻲﺗ ډﻝﻋﺼ ډﻝ ﻭ ﻍﻪ ﻭﻪﻥ ﻏ ﺷ،ﻥﻍﻍﭘ ﮐﻻﻯ ﻲ HIﻮ څﻪV ﻭ ﺧ ﺰﻴﺘﻲﺍﻏ ﻴﻓ ﺎ
ﻌﻪﻣ ﻩﻟ ﺭﺭ
ﺮﺏ ﺳ
،چېﺩ ﺭځﻱﻪﺍ ﺗﻪﻣﻦځ ﻠﺒﻪﮐﺩﻭﻟﺩﺩ ﺍﺯNeurﺩﺍ otoxi ﻭnﻮﺍ ﻧﻮﻧﻮکﻥ ﺘﻳﺎﻮﺟﻲﺩﺳ ﻟﺎ
ﺘﭘﻭﺭﻮﻴ.ﻧﺮﻱﻟﻭ
.ږﻱ
ﻩکږ ﺮﺮﺳﻪﺗ ﺍﺳﻄ ﻪﻭﻮﭘ ﻧﻭ
ژﺎﻓﻭﺮﮑ ﻮﻱﻣ ﺘﻦﺷ ﻨ
ﻪﺩﻣ ﻧﺩﺩﺩﺍ
ﺯﺍﻭﻯ ﺩ
ExcitatorFﻭ ylﺍ ﻴﻢux ﻠﺴﮐ ﺩ.ﺩ
ﻪ ﻯ ﮐﺎﻨﺗ
ﺯښ ﺭﻟﻰﻫﻢﺍ ﺍ
ځﻯﻭ ﻮﺍ ﻪﺩCMVﻳ ﮑﻪﻟ ﻧ
ﻭﺭﻮﺘﮑﺭﻓ ﻮﻧ
.ﺮﻱﻟﻭﻝ ډۍکېﺭ ګﻭ
ﻪډ ﻭﭘ ﺪﻧﺒﻲﺩ Neurﻫﻢﺩﻋﺼ otransmi t
tersPer turbat i
on
ﻪﻠﻳ
ﺎېﻪﭘ
،چ ﭘ ﻮﻱﻪﮐ ﺘRenaltﺍﺧ ubul arcel ﺍlﻴﻞﻭ ﺘﻴ
ﭘﺘﻢﺍﻴﺴ ﻤﻲﺳ ﻍﻪﺩﻫﻀ ﻍﻪﻥ ﻏ HIﻥﻍ ﭘ V
.ږﻱﻪکږ ﺗﻣﻦځ ﺍﻭېﺭ ﺎ
ﻴﺗﺪﻧﺭګﻴﮏېڅ ﻨﻴ
ﻠﻮﮐ ﻧﻮﻤﺘﻴﺴ ﺩېﺳکېﺩ
:
ژﻱ ﻮﻟ
ﻮﻳﺰﻓﻮﺘﭘ
.ږﻱ
ﻪکږ ﺗ
ﻣﻦځ ﺍﻮﺭ ﻧﻮﻣﺰﻴﻧﺎ
ﮑ ﻴﺩېﻣﻧېﺭ ﻪﻻﺪ ﻡﭘ ﻭﺭﺪ ﻨ
ﻴﮏېﺳ ﻨﻴﻠ
ﺎﻥﮐ ﺘﻧ
ﺍHI ﺩV
ﭘ:
ﻴﺖځﻞ ﻓﺎ
ﻌﻣﺩ -
١
.ﺩږﻱ
ځﻞکږ ﺘﻢ ﭘ ﻴﺴﺘﻲﺳ ﻴﻓ
ﺎﻌﻪﻣ ﻠﻣﻪﺍ ﻭﻟﺰﻴﻍﻪﺍﻏﻍﻪﻥ ﻏ ﺎﻥﺩﻥﻍ ﭘ ﺘﻧHIﺍﻮﺩV ﮑﻧﻭﺘﻲژ ﻴﻓﺎ
ﻌﺮﻣ ﭘ
ﻡﻭﺭﻮﺘﮑﻴﭙﻮﺳ ﺮﻳﻧﺴ ﺎ
ﻭﮐ ﺎﻥﺍﺘﻧ
ﺍﻪﻫﻢﺩ ﺘﻟﺎﻥﺩﻪﺷ ﻮﭘ ﻧﻮﺘﻟ
ﺎځﻮﺣﻠ
ﻴﺖ ﭘ ﻓﺎﻌﺒﻲﻣ ﺎﮐﺴ ﻭﻳ ﺗﻲﺍ ﺍ
ﻭﺫ ﺭﻮﻧ
.ږﻱ
ﺪﻝکږ ﻴ
ﻟ
ﻮﻉﻴﻮﺷ ﺗﺎﻧﺎ
ﺘﻧ
ﺍ ﺭ
ﺭﻮﺷﻢ ﻳﺍچېﺩ ،ﻮﺩږﻱﻳ ﺪﻝکږ ﻴﻟﻪﻧﻮﺘﻟﺎ
ﺪﺣ ﻧﺭګﻩڅ ﻭځﻮکېﺩ ﻠ
ﻴﺖ ﭘ ﻓﺎ
ﻌHﻪﻣIﭘ ﺩV
ﺩﻪک ﺗﻣﻦځ ﺍ
ﻮﺭ ﻧ
ﻮﺘﻟﺎ
ﻧﻲﺣ ﺎ
ﺮﻃﺭﺳ ﺷﺭ
ﻮ ﻢ ﻳﺍچېﺩ Asperﺑﻞﺩ gill
osi Lﻭsiﺍ steriosiﻪs ﮑﻟږﻱﮐﻢږ
ﺎ
ﻮﻳ ﻧﺎ
ﮑ ﻠ
ﻪﻫ ﻩﭘ ﺮﺗ
ﺎﻳﻪﺯ ﻧﻮﺘﻟﺎ
ﻨﻲ ﺣ ﺘﻭﺳ ﺭېﺍﻭﺎچ ﺩ ﻣﻮﮐﺭﺎ Kaposiﺳ ﻭs ﺎﺍﻣﻮ ﻔﻤﻪﻟ ﮑږﻱﻟﺭږﺭﻪډ ﻧﺩ
.
ﺷﺩﻩ
ﻪ ﻮﺩ ﻤﺍﮐ ﻮﺪﺥﺧ ﭘﺍڅﻪﺭ
ﮐﻮ ﺧ ﻟ
١ﺎ ﻟ٥ﻮﻉﻱېﻪ ﻴﺎﺷ ﻣﺍﺎﺕﻭﻱ ﻳﻪﻭکېﺯ ﻨ
ﻳﺭﺎBiﻧsexual
ﺩ.
ﻻﻞ ﻯﺎﻣ ﻣ ﻮﮐﺭﺎKaposiﺳ (ﺩs HHV- ﻳ8ﻭﺱ)KSHXﺎ ﺮﻳﭘﺲﻭ ﺮﺷ،چېﻫ ﻳﻞ ﻲ ﻭﺪﻭ ﻳﺎ
ﺑ
ﻭ:
ﺮګﻥ ﺒﻟﻲﻏﺍﻮﺗﺎ
ﻳﻴﺖﺩﺯ ﺎﺳﻱﻭﺩﺣﺴ ﻮﻥټ ﺍ ﻤﻳ
ﺍ ﻮﺗﻭﺍ
-٢
ﻭﺩB ﻟﻲﺍ ﺍﺍﺏﻭ ﺮ(ﺩ ﺧ Cellulari ﻴﺖ)mmune ﻓﺎ
ﻌﺯﻣ ﺯﻧﮏﻭ ﺍﻯ ﺷﻲﺩژ ﺩ
ﺩﺘﻲ ک ﻧﻮﻴﻣﻮﺍﺗﻭﺍ
ﻩﺩړ
ﺍ
ډﻝ ﻭ ﻪ ﻭ ﻴﻞګېﭘ ﺑﺷ.ﺩﻪ ﻲ ﺗ
ﻣﻦځ ﺍﻪﺭ ﻠﻣﻪﺍ ﻟﻲﻟ ﺍﺍﺏ ﻭﺮﻭﺩ ﺧ ﺪﻧﻮﺩﺩ ﮑﻧﻭﻳﺖژ ﺎﻮﺳﻔ ﻤ
ﻟ
(Lymphocy ti
ci nter sti
tialPneumoni tiړﻮ کې )s ﻪ ﻍﻳ ﻳﺸﻦ ﭘ ﺮﺘﻠ
ﻔ ﻧ
ﻴﮏﺍ ﺘﻳﺎﻮﺳﻔ ﻤ
ﻟ
ېﺍ
،چ ﺩ ﻮﻱﻪﮐ ﺗﻣﻦځ ﺍ(ﺭ i
mmunol ogi ct hrombocy topeni ﺪ)a ﻴ
ﻟﻮډﻱﺗ ﺎﺘﻲﺑ ﻧﻮﻥﺍ ﻤﻳﺍ
ﻮﺗﻭﺍ
ﻮﻩﻳﺮځﻮﺳ ﻠ
ﻴﺖ ﭘ ﻓﺎ
ﻌﺪﻣ ﻧﺭګﻳﺩڅ ږﻱﻭﺎ
ﺪږ ﺍ ﻧ
ﺭګ ﻭکېڅ ﺍړﻴﮏېﭖ ﻨ
ﻴﻠۍﻪﮐﻭﻍ ﭘ ﺭﺎﺯېﺩﻧ ﺍﻮﻩﻳﺮﻴﺗﻭ
ګﻥ
ﺮﻭ ﺒﻳﮏﻏ ﺍژ
ﺮﻪﻟﻪﮐﭽ ﺗﺎﻳﻪﺯډﻝﭘ ګﻱ ﻭځﻥ ړ ﻪﺍ ګﻱﭘﺘﻦﻭړ ﻨ
HIﻣ ﻪV ﺩېﭘ ﺮ ﻩﭘﺭﺭﺮﺏ ﻭ.ﺳځﻯ ﻱ ﺍ
I
tﻮﻻﻱټﺱ)chy ﮑﻴﻟ
ﻮ ﺮﻓ ﻟ
ﻮﺎﺳﭽ ﻴﮏﭘ ﻠ
ﻴﻓ ﻮﻧ
ﻭﺰﻳﻪﺍ ﮑﻟﻳ،
ړﺪې ښﻲ ﻧ
ﻪﻭﺍ ﻮﭘ ﻧﻮ
ﻧﺍژ
ﺮﻮﻟ ﻳﻮﺪﻝﺷ ﻧژژﺎﭖﻧﺩ
ﻭﻪﺍﺒﻪﺗ ﮑ.ﻟ
ږﻱﺎﺕږ ﻳګﻥﺯﺮﻭ ﺒﻴﺖﻏ ﺎﺳﻩﺩﺣﺴ ﺮﻮﺳ ﻠﻣﺭﻩﺩﺩ ﺭﻥګ ﺍﺪﻤ(ﻫ RedBumpSy ndrom
.ړﺪېﻧ
ﻪﻭﺍ ﻭﻝﭘ ﺯﺎﮐﺴﻮﺍﻯﻣ ﺮﺗ
ﻮ ﻪﺩﮐ ﻧﻮﭘﺎ
ﺎﻥﺧ ېﻪﺷﺮﻭﻫﻦ ﭘ ﻤ ﻟ
ﺩ
.ﻟﻰﺍ
ﺍﺏﻭ ﺮﻭﺧ ﺭګ ﻮﺗﻭﺩﭖښ ﺍﻤﻲ ﺒﻲﻫﻀ -ﻋﺼ ٣
.ﻩﻮﻪﻭﺷ ﻧﻭﺩﺎﺰﺱکېﻱېﻳ ﻴ
ﻨﻮﺟ ﺘچېﻣﺨﮏېﭘ
:ﻩﻴﮏېﺏڼ ﻨ
ﻴ ﻠ
ﮐ
:
ﻪﻟﺭﺕﺩﻱ ﺎﺒﺮﻱچېﻋ ﻟﻪ ﻧ
ﻭ ﻭﺍ
ړﺩېﭖ ﻴﮏﺭ ﻨﻴﻠ
ﺎﻥﮐ ﺘﻧ
ﺍHI ﺩV
Ser oconv ersion-١
.Lat(entAsy mpt omat i
ګﻪﻳﻲ)c ﻠ
ﺮﻳ ﻴ-ﻏ٢
.(Sy mpt omat i
ګﻪﻳﻲ)c ﻠ-ﻳ ٣
147
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
148
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
.
ﻭﻱ ﺭﺎﮑ
ﭘ
ېﻪ
ﻮک ﭘ ﻧﺎ
ﻭﻏ ﺭﺎ
ﻮﻧ ﺘ
ﺒﺜﻮﻣ ﮑﻧﻭېﻪCD4ژ ،چ ﭘ ﺮﻱﻟCﻪ
ﻮکﻥﻥ C5ﻧ ﻤﻴ Colﺷ iﺎﻥgand ﻭﻏﺭﺎځﻦېﻧﻳ
NoN Sy ncy t
iﻪﺩ um ﻧﻮﺮﺳ ﻳﺍ
ﻭﻯﻭ ،ﺩﺩ ﻮﻱﻪﮐ ﺘﺮﺳ ﻩﻣ ﺮﻮﺳ ﻠﺗﻮﻨﻮﺩﻧ ﻧﻮﺮﺳ ﻳﺍ
CD4کېﺩﻭ
ﺩ.
ﻭﻯ ﺍړ
ﻮﻯﭖ ﺪﺷ ﻳﺮ
ېﻮﺗﺠ ﮐﻻﻯچ ﻳ ړﺎﻧﺸﻲ ﻮ ﻴSyﺑﺸﭗﺗ ncy t
oi ﺭېnduce iﻪﻻnduceﻟ
ﻭﻍﺭﺎﻴﮏېﻧ ﻨﻴﻠ
ﻭﺩﮐ ﺍ ﻟﻲﺍﻮﺑ
ﺍﺮ
ﺘﻢﺩﺧ ﻴﺴﺘﻲﺳ ﻴ
ﻓﺎﻌﻣ
،ﺩ ﻟﻲﺍﻮﺗ
ﺎﻳﻮﺩﺯ ﻧ
ﻮ ﺮﺳ ﻳﺍ
ﺎﻥﺩﻭ ﻭﻏﺭﺎﺍﻧﺣﻝﺩﺮﺎ ﻪﻫﭘ
ﻭ.
ﺟړﻱ ﻭﻮ ﺍ
ړﻧﮏېﭖ ﻮﻨﻪﻣ ﻮﻥﻧﻟﺪﻮﺑ ﻩﻳﺭﺎﭙ
ﻟ ۍ
:ﻭﻍۍ ﺭﺎږګﻪﻳﻲﻧﻠ
ﻝ ﻳ
ﻭﺩ ﻮ ﺏڼ ﺗﺎﻳﻪﺯﻣﺨﺖګﻱېﭘ ﺮﻪﭘ ﺘﻭﺳﺭ(چېﻭ Cat egoryBDi ﻭﻏﻲ)sease ﺭﺎ
ږګﻪﻳﻲﻧﻠﻝ ﻳ
ﻠﻞک ﺯﻪﺑﺍډﻧﻮﻱ ﺮﻱﺧ ﻪﻟ ﮑ
ﻳړﻩﺍ ﺮﺯﺳ ﺍډ
ﻩﻪ ﻱ
ﻪ ﺏڼﻟ ﻭﻱچېﺩﻏ ﺪﻧﺭګ ﻟﻰڅ ﺍ
ﻮ ﺑﺍ
ﺮﺘﻢﺧ ﻴﺴ ﺘﻲﺳ ﻴﻓﺎ
ﻌﻣ
.
ږﻱږ
ﻩﺭ
ﺎﭙﻟﺯډﺍﻱ،چېﺩ ﺘﻰﺎﺳ ﻭﻧﺲﻧ ﻪﺍﺒ،ﺗﻠﻞ
ﻳﺎﺯﻥﺑډﻝﺩﻭ ډﻲ ﻭېﻪځﻥﻧ ﻭﻍک ﭘ ﺭﺎېﻪﻧﻭک ﭘ ﺍړﻪﺩېﭖ ﭘ
ﺮﺘ
ﻭﺳ ﭘﺲﺯ ﺮ،ﺩﻫ ﺯﺱ ﺎﻳ
ﺪ ﻳ
ﺪﻧﺎ
ﺒﻞﮐ ﻬﻣېﺎﺩ
ﻮﻝ ﻳ ﻩﺩﺧ ﺭﻥګ ﺍﺪﻤﻭ.ﻫﺩې ﻱ ﻮ ﻮﺟﺩ،ﻣﻪﻱ ﻩﻥښېﻧ ﺭ ﻮ
ﭘ
ﭙﻼﻳﺴ ﮑﻞﺩ ﻳﻭﺮ،ﺳﺯﺱ ﻮﺗﺎ
ﻣﻮﻧﺠﺮﻱﺍ ﻠﻴﺎﺳ،ﺑﻭﻍۍ ﺭﺎ
ﺑﻲﻧ ﺎﻬﺘ
ﻟPelﺍviګc ﺍﺕ، ﻪﺭ ﺗ
ﻩﻣﻦځ ﺭﺎﺑ
ﻭ ﻮﺩ ﺗﺎ
ﻧﺎ
ﺘﻧﺍ
ﻭ.
ﻩﻱ ﺩﻮﻮﺟﺍﻣﺭﻮﻳﺭﻮﻴﮏﭘ ﻨﻴ
ﭘﻭﺎﻱټ ﻮﺳ ﺒﻣﻭﺮﺎﺕککﺗ ﭘ
ﻭ ﺪﻳﺍﻭﺍﺎﻳ
ﺯ
ټﻞ
ﮐﻪﺍ ﮐ ﻟ
١ﺎ ٠-
ﺩې٧ ږﺭېﻥ ﻮﻭﭘ ﺩﺩﻩ ﭖښښ ﺭﻮﭘ
ﻭﻍۍﺩ ﺭ
ﺎڅﻪﺩﻧﻮ ﺧ ﻠﺗﻮﻨﻪﻧﺎﻥﻟ ﺘﻧﺍ
ﻩﺩ ﺩﻮﻣﻦځﻥۍﻣ
.
ږﻱﺩږﺍږ
ﺭېﻭ ﻮﮐﻮﭘﻟ١ﺎﺗ٥ﻪﺮ ﻠ
ﻪﮐ ﻠ
ﻮﮐ ،ﺧ ﺷﺩﻩ
ﻮﺩ
:ﻩﻴﮏېﺏڼ ﻨﻴﻠ
HIﮐ ﺩV
.ﻩﺎﺩﻴﺗﺮ
ﺒﺮﺧ ﺍﺧﻭﺩ ﺍ
ړLatﭖ ﻟﻰﺩent ﺍﻮﺗﺎ
ﻳﻮﺯﻧﻮ ﺮﺳ ﻳ
ﺍﻭﺩﻭ ﺍﺪﻝ ﻳ
ړﺎﻳﺠ ﺩCD4ﻭ
ﺎﺕېﭘ ﻮﻨﻳ
ﺩﻤﻒﺍ ﻟﻣﻲ ﻮﻤﻮکېﻋ ﻧﺎ
ﻭﻏ ﺭﺎ
ﻩﻧﺮﺗﺎ
ﻳﺷ،ﻪﺯ
ﺍﺧﻞ ﻲﭘ ﻪﺩﻭﺗ ﺍ
ړﻴﮏېﭖ ﻨﻴﻠ
ېﻪﺩېچېﮐ ﻣﺨﮏ ﻟ
ﺎﻥ
ﺍﺳ ﻩﺭﺭ
ﻪډ ﻭﭘﺍﻪ ﺗ
ﺎﻳڅﻪﺯﺮ ﺧ ﺘ
ﺘﻲﻣ ﻧﺎ
ﻮﺳ ېﻪﻳ
ﻩﻱ ﻟ ﺯﺍﺪﻧﺍﻩﺪﻧﻮځ،ﺧ ﻪﺗﺭړﻪﻭﻟﻰﻱېﺭﺏﺗ ﺍ
ﻮ ﺘچېﺳﺨ
.ﺭځﻱﻪﺍ ﺗړﻭﻱﻣﻦځ ۍﺩﺟﺲﻭ
ﻤﻒﺍﻯﺷﻲﻟ ﺩﺩﻭک ﻮﻱﺍ ﻪﮐ ﻧ
ﻭ ﺪﻧﺭګReactڅ iveHi stocytosiﻟﻰﻱېﺩs ﺍﻭڅﻥګﻳﮏ ﺭ ژﻮﻟﻮﺘﻫﺴ
ﺷ.
ﺎﺕې ﻲ ﻩﭘﺭﺍﺪﻣﺍﻭﻭکېﺩ ﺍ
ړﻴﮏېﭖ ﻨﻴﻠ
ټﻝﮐ ﻪ ﻭ ﺘﻲﭘ ﭘﻮﻨﻳﺩﺍ
ﺭﺭ
ﺮډ ﺘﻭﺳ ﭘﺲﺯ ﺮېڅﻪﻫ
ﻤﻞ ﺧ ﺩېﺟ ﺷ،چې ﺩ ښﺩﻻﻯ ﻲ ﺎﺕﭘﻲ ﺩ ﻧﺎﺘﻧﺭ ګﻥﺍ ﻮﻭ کېﻧ ﺍ
ړﻪﺩې ﭖ ﭘ
ﻪځ ﻪﭘ ﺑ
ﺪﺍﻯﺷﻲﻧ ﺩﺩﻭ،ک Mulﻱ tiDer mat ﺍonal
ﺭﻭ ﺮﮑﺘﺪﻣﻳﺪﻪﻣﺦېﺷ ﻟ ﺪﺕ ﺩ،چېﺩﺷ ﺰﻯ ﻳ
ﺩﻭﺩ
ﻪﻫﻢ ﻧﻮﺑﻭﺮﮑﻳﺎ
ﻳﻲﻣ ﺎ
ﻳﺮﺘﮐﺎ
ﺎﻝﺑ ﻬ.ﺍﻣړﻱ ﺩﻪک ﺗ
ﻣﻦځ ﺍ
ﺘﮏې کېﺭ ﻮﺳﻭﺎﭘ ﺮګ ﻳ ﺘ
ﻪﺳ ﻩﭘ ﻮګ ګﻱﺗﺍﻥ ړ
.
ږﻱﻻﻞکږ ﺎﻣ ﻴﻤﻳ
ﺮﺘﮐﺎ
ﺎچېﺩﺑ ﻴ
ﻧﻮﻤﮐﻞﻧﻮﮐ ﻮﻤ،ﻧﻴﻼ ﻧﻮﻤﻠ
ﻪﺳ ﮑﻟﻮﻱ ﻪﮐﻠﺍﺧﺪﻣ
ﺎﻥ
ﻏ ﻭﺭﺎېﺍﻧ
،چ ﺩ ږﻱﺪﻝکږ ﻴﻟﻟﻰ ﺍ
ﻮ ﻤ
ﻴﻞﮐ ﻓﻭﺮﺗﻮﻴ
ﻧډﻝﺩګﻱ ﻭځﻥ ړﻪﺍ ﻟﻰﭘ ﺍ
ﻮﻤﻪکېﺩWBCﮐ ﻨﻳﻪﻭﭘ
.ﺮﻱ ﻟړﺎ
ﻴﺗﺍﺗﻠﻦېﻪ ﻣ ﺭﻮﻱﺩ ﺭېﻗ ﺭﺪډ ﻭﺏ ﺿ ﺮﮑﻳﺎﺩﻣ
:(
Ful l BlownAi ﺯ)ds ﺍډړﻱ ﺑﺸﭗ
9
؛
ږﻱ
ﺭﺱږ (ﻪﻭ0.ﺗ 2-0.ﺮ کې)4×10 ﺘ
ﻴﻮﻟﻪﻳ ﺭﭘﺷﺭ
ﻪچېﺩ CD4ﻢ ﻠ،ﮐﺭځﻱ ﻪﺍ ﺗﻪﻭﺧﺖﻣﻦځ ﻐﻫ
ړﻦ
ﻪﻡﻳ ﻟﺎﻥﻭﻏﺭﺎ
ځﻦېﻧ ﺍﻥ ﻳ ﺮﻱﻟ ﻩﺭﺷﺭ
ﻪﺩ CD4ﻢ ﻤېڅﻪﮐ
ﺯ ﺧ ﺍ
ﺪﻧﺍﻪﺩې ﻟﺎﻥﻭﻏ ﺭﺎ
ﻩﻧ ﺮﺗ
ﺎﻳﺯﺯ ﺍډ
ﻮﺩ ﻱ ﺧ
ﻭ.
ړﻪ ﻱﺷﺭﻮﻭﻧﻟ
ﺮﻱچېﺩ ﻢﺭ ﻟﻩﺯﺍ
ﺪﻧﺍﻪﻤﻩﮐ ﺭCﺭ
ﺎﺷﺖېﻣﺨﮏېﺩ D4ډ ﻴﻭﻣ ېڅﻪڅ
ﺧ
ﻭ.
ﻟړ ﻱ څﻪﻮﻡ ﺧ ﻮﻨ
ﻴ١ﺟ ٠
٠٠
ﻟ٠
ﺮکېﻪ ﺘﻴ
ﻟﻠﻲﻮﻣ ﻪﻳﻩﭘ ﺯﺍﺪﻧ
ﺍﻪﻧﻮﻭﺳ ﺮ
ﻳﺍﻪکېﺩﻭ ﻨﻳﻪﻭ ﻮﭘ ﻧ
ﺎﻭﻏﺭﺎﺩېﻧﺩ
ﻴﺺ HIﺗﺸﺨ څﻪﺩV ﻭ ﺧ ﺪﻴ
ﻟHﻪ
Iﻟ ﻪﺩV ﺗ
ﺮځﻯﻭﻱچېﭘ ﻮﺍ ﻩﻳ ﺮ
ﻮﺳ ﺗﺎﻧ
ﺎﺘﻧﺍﻪﻟﺎ
ﭙ ﻌ
ﻗﻮ ﻣﻩﭘﻲښېﺩ ﺮ
ﺗﺎﻳ
ﺯ
ﺯﺍډ
ﻮﻥﺩ ﻱ ﺘ ﻴﮏېﺏڼېﺷ ﻨﻴﻠ
ﻮﺩﮐ ﻧﻮﺑﻭ
ﺮﮑﻳﺎﻮﻣﻟﺎ
ﭙﻌﻗﻮﻣ ﻮکېﺩ ﻧﻮﺘځﻮﻭﺧ ﻨﺷ.ﻪ ﻳ
ﺍﻯ ﻲﭘ ﺩﺩﻊک ﻭﺿ
ﺟړﻱ
ﻭ ﻮﻭ ﺍ
ړPrﭖ odr omal ﻩ ﺭ
ﺎﭙﻟﻮﻥ ﺘﻮﺩﺷ ﻴﻭﻏﺭﺎﻧ
ﺩ
149
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
:
ﺎﺕ ﺘﻼﻃ ﺍﺧﺎﻥﺘﻧﺍHIﺩV
:
ﻭﻍۍ ﺭﺎ
ﺒﻲﻧ -ﻋﺼ ١
HIﻠﻲV ﻠ
ﺘﻣﺨ ﺮ
ﻪﭘ ﻴﮏﻱېﭘ ﻨﻴ
ﻠﻮﮐ؛ﺧ ﺭځﻱﻪﺍ ﺗﻭ کېﻣﻦځ ﺍ
ړړﻱﭖ ﻡﻮﻪﻟﻭﻏﻲﭘ ﺭﺎﻮﻧ ﺎﺟ
ﻧﺴﺒﻲﺍ ﺩﻋﺼ
:
ﻪ ﻟ
ﺭﺕﺩﻱ ﺎ
ﺒږﻱچېﻋ ﺪږ ﻧ
ﺭګ کېڅ
ﺘﺲ ﻳ
ﺎﻨﺠﻨ
Aseptﻣ i
ېﻭcﺎﺕ ﺍ ﭘ
ﻭﺭﻮﻴﻟﻲﻧﻮSensorﭘ y،(ADC)Ai dsDement iacompl ﺩex
.
څﻪ
ﺧ
ﻮﻯﺩﺷ ﻭ(ﺩ Highact i
v eantir
etrov i
ralTher څﻪ چېapy)HART ﻡﻭﺧﺖ ﺧ ﻮﻪﮐ ﻮﻟ ﺧ
.ږﻱ
ﺪﻝکږ ﻴﻟﺭﮐﻢ ﺭﻪډ ﻧﻮﺘ
ﻟﺎ
ﻨﻲﺣ ﺗﺭﻮﭘ
ږﻱﻭ
ﺪږ ﺍﻴﻟﻮﻴﻦﺗﮐﺴ ﻮ
ﺗﻭﺭﻮﻴﻪﻧﺍﺳﻄHﻪﻭIﭘ ﻪﺩV ﻠﭙ
ېﻪﺧ ،چ ﭘ ږﻱ
ﺪکږ ﻧﺍﺱېﺍ ﺰﺱکېﺩ ﻴﻨ
ﻮﺟ ﺘﻪﭘ ﭘ
.
ږﻱﻪکږ ﺗﻣﻦځ ﺍ
ﻤﻲﺭ ﻴﺖﺏېﻧﻈ ﻓﺎﻌﻣﻪﺩﻠﻣﺍﻪﻟﺘﻲﻠﻣﺭﺎﻨ
ﺑﺍﻭکﻥﻥﺩ ﺎﻱټ ﻩﺩﺳ ﺮډﻝﺳ ﻤﻲ ﻭﻭﻫ ﻪﺩ ﭘ
ﺪﻳ
ﺪﺮﺷ څﻪﺗﻟﻲ ﺧ ﺍ
ﻮﺑﺍ
ﺮﻓﻆې ﺧ ﺎﻴﻒې ﺣ ﻔﻮﺧ ﻪﻳﺮﻱﻟ ﺪﺕﻟ ﻩﺷ ﺮﻮﺳ ﺭﺟﻮﺩ ﻟ
ﻪ ﺏﻝﻻﺏﻝ ADCﭘ
ﻭ.
ﻧﻰ ﻱ ﻮ ﺘ
ﺭېﺷ ﻮﻟﻲﭘﺍﻮﺑ
ﺍﺮﻴﺖﺧ (ﺩﺷﺨﺼ Cogni ti
vedef ect )
ﺍﻯ ﺷﻲﺩﺩﻮک ﻭ؛ﺧﻣﻞ ﻱ ﺭ
ﺎﻮﻱCSFﻧ ﻪﮐ ﺗ
ﻭ ﻪګ ﭘﺍ
ﻪﺭ ﻧﻮﻧ
ﻮﻟﺪﻴﮏﺑ ﻓﻭﺮﺗﻟﺖ کېCTﺍ ﺎﺪﺣ ﻳﺪﻪﺷ ﭘ
ﻭ.
ﻟړ ﻱﻴﻦﻱېﻮ ﺗ
ﻭ ﺮﭘ
ﻪﻧ
ﻮﻭﻻﺳ ﻩ ﭖښېﺍ ﺮ
ﺗﺎﻳږﻱچېﺯ ﺪږﻧﺭګﺎﺕڅ ﻳﺎﻥ کېﺯ ﺘﻧHIﺍﻪV ﺘﻲﭘ ﭘﻭﺭﻮﻴﻟﻲﻧ ﻮSensorﭘ y
.
ﻮﻱﻣﻦﮐ ﺰﻴﺍﻏ
ﻣﻦﺰﻴ
ﺩﻝﺍﻏ ﺭﺩ
ﻭ ګځ ﻮﺏﺍ ﻭ ،چې ﺧ
ﺩ ﻱ ﻮﻮﺟ ﺩﻣﺭﺪﺩ ﻳ
ﺪﻭﺷ ﻟﺖ کېﺩﭖښ ﺎ
ﻠﻲ ﺣ ﻠﺘﻣﺨﺮﻪﭘ ﭘ
ږږ
ﻻﻞک ﻟﻲ ﻣﺍﻪﻭﺘﮐﺭﺩښ ﺎ
ﺘﻲﻓﺸ ﻴﻌېﻭﺩﻭﺿ ﺎﺳﺖ ﺍ ﻧﺲﻧ ﺘﻲﺩ ﻠ
ﻣﺭﺎ
ﻨﺑﻴﮏﺍ ﻣﻮ ﻧ
ﻮﺗﻭﻩﺍ ﺭﻥګﺍﺪﻤ.ﻫﻮﻱ ﮐ
.ږﻱ
ﺪﻝکږ ﻴﻟﻮکې ﻤ
ﻟﻮﻮﮐ ﻴﻨ
ﻮﭼ Nﻪﮐ
erﭘ vﻴﮏedamage ﻣﻮﻧﻮﺗﺍ.ﻱ
ﺩ.
ﻣﻞ ﻱ ﺭﺮﺩﺛﻮﻮکېﻣ ﻴﻭﻏﺭﺎﺒﻲﻧ Zﻪﻋﺼiﭘ dovudi ne
:ﻭﻍۍ ﺭﺎ
ﻭﻧﺮګ ﺘﺩﺳ -٢
ﻣﻲګﻝ ﻮﺘ
ﻳﺎﻴﻢﻱې ﺳ ﺭﻭﺧ ﺭ،چېډ ږﻱﺪږﻧﺭګ ﻭ کېڅ ﺍ
ړﻨﻲ ﭖ ﺘﻭﺳﺭﻪﻭ HIﭘ ډﻝﺩV ﺰﻭ ﻳ
ﺩﻭ ﻪﺩ ﭘ
ﺩ.
Retﻯ initi
s
ېﻪ
ﻠﻦ ﻟﻣﺭ
Riﺩﺩ f
abut i
ﺮګېﺩn ﺘ
ﺳېﺳ ﺑړﻰ ﺮﻭ ﻲﻧ ﻧﻰﻭﻱﺍ ﻮ ﺘ
ﺍﻯﺷﻲﺷ ﺩ ﺩUvﻫﻢک eit
iﻣﻲs ﺍ
ﺪ ﻗ
ﺎ
ﻣﻮﻔﻤﻭﻟﻴﺲﺍ ﻠﻔ،ﺳﺯﺱ ﻮﻣﺯﭘﻼﻮﮐﺴﻮ،ﺗﻨﻲﻳﺮPneumocyﮐ stic.ﺍﺷﻲ ﻪﺭ ﺗﺍﻯﺷﻲﻣﻦځ ﺩﺩﻪک ﻠﻣﺍ
ﻭﺎ
ﻴﺗ
ﺪﻧﺭګړﻥۍڅ ﻡﻮﻟﻮﻧﻮﺘﻟ
ﺎﻮﺣﻳﻮﺮﺷ ﮐﻪﺫﺗﺭﻮﭘﺍﻯﺷﻲﺩ ﺩﺩﺮګېک ﺘﻭﺳ ﻮﻻﻯﺷﻲﺍ ﻨﻣﺰ
ﻴRetﺍﻏ ina
ﺷ.
ﺍﻯ ﻲ ﺩ
ﺩﺪﻝک ﻴﻟﺎﻣ
ﻮ ﮐﺭﺎ
Kaposiﺳ ﺍکېs ﻮﻭﺧﺎﻭﻪﺷﺮګ ﭘ ﺘﻩﺩﺳ ﺭﻥګ ﺍ
ﺪﻤﻭ.ﻫېﻱ
:ﻭېﺎ
ﻴﺗ
ﺪﻧﺭګﺎڅﺎﻃﻲﻏﺸ ېﻭﻣﺨﺘﮏ ﺍﻮﺳﭘﺩ-
٣
ﻭ.
ګﻪ ﻱ
ﻠ
ﻭﻍ ﻳ ﺭﺎﻧ
ﺭښﺕﺩ ﺎ
ﻮکېﺧ ﻧﻭﺍ
ړﻮﭖ ﻟ
ﻭHﻪټIﭘ ﺩV
Papul
arer
upti
ﮑﻰon ﻧ
ﻭﺮﺭښﺕﻟ ﺎ
ﻮ کېﺧ ﺗﺎﻳ
ﺎﻬﻪﻧﻭ،ﭘ
ﻪ ﻱ ﮐﺯﺎ
ﻭﻧﺎﻥﻭچﺍ ﺗﻭﻭﻱښ ﮑﻰﺍ ﺘ
ﻮﺳ ﭘ
.ږﻱ
ﺪﻝکږ ﻴﻟ
.ﺩږﻱ
ﺪﻝ کږ
ﻴﻩﻟ
ﺮﻡۍ ﺳړFﻪﻝ olﻟ
li
culi
ti
ﻴﮏs ﻠ
ﻴﻓﻮ
ﻧﺰﻳ
ﺪېﺍ ﻧ
ﺎﻭﺑﻭ ﭖښ ﻭﺍﺮﻡټ ﻩﭘﺭﻥګﺍﺪ
ﻤﻫ
ﺷ.
ﻣﻦ ﻲ ﺰﻴ
ﺍﻏﮑﻰ ﺘ
ﻮﺳﺍﻯﺷﻲﭘ ﺩﺩ
ﻪک ﻠﻣ
ﺍېﻪ
ﻠﻦ ﻟﻣﺭ
ﺩ
ﻭﻍﺭ
ﺎﻧ
ﺍﻯﺷﻲﺩﺩﺩ
،چېک ږﻱ
ﻩکږ ﻭښ ﺭ
ﻭﻭﺭﻭﻭ ﺪﻭﻱﺍﻳﺪaphtچېﺷ housulcerati
ﺭﻱon ﺍ
ﺮﮑﺗ
.
ږﻱ
ﺪږ ﻧﺭګړﻱڅﺍﺏک ﺮﺍکﺧﺭﻮﺧ
ډﻝ
ډﻝ ﻭ
ﺩ .ﻭ
ځﻯ ﻯ
ﻩﺍ ﺭﻮ
ﻮﻏ ﺗ
ﺎﻧ
ﺎﺘﻧ
opporﺍt
unisti
ﮑﻰﺩc ﺘ
ﻮﺳﻮکېﭘ ﻧﻮﺘﻟ
ﺎ
ﻨﻲﺣ ﺗﺭ
ﻮﻪﭘﻩﭘﺭﺭﺮﺏﺳ
ﺮﺘ
ﻭﺳﭘﺲﺯ ﺮ،ﻫ
Herpessimpl ﻪexﮑﻟﻮﻻﻯﺷﻲ ﻨﻣ
ﺰ ﻴ
ﺍﻏﮑﻰﺘﻮﺳﻪﻫﻢﭘ ﻧ
ﻮﺮﺳﻳﺍ
ﻭ
150
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
:
ﺎﺕ ﺘﻼﻃ ﻴﮏﺍﺧ ﻮﺟ ﻟ
ﻮ ﺗﺎﻤﻴ-۴ﻫ
.ږﻱږﻪ ﭖښښ ﺗ
ﺎﻳﺎﺯﻴﻨﻴ
ﭘﻮﺘﻳﺎ
ﻮﺳ ﺒ
ﻣ ﺮﻭﺗﺍﺎﻴﻨ
ﻴﭘﻭﺮﺗ
ﻮ ،ﻧږﻱﻪﻝ ﻨﻳHIکېﻭ ﻠﻲV ﻠﺘﻣﺨ ﺮﻪﭘ ﭘ
ﻪږﻱﭘ ﻪﻝ ﻨﻳ
ﺎﻥﻭ ﺘﻧHIﺍډﻲV ﻮﻱﺩځﻥﻧ ﻣﺨﺖګﮐ ﺮﻭ،ﭘ
ﻪ ﻱ ﻤﻪﮐ ﻪچېﺩCD4ﮐﭽ ﻠ
:ﮐ ﺎﻴﻨﻴﭘﻮﻔﻤﻟ
ﻭ.
ﻴﻒ ﻱ ﻔﻮﺧ ﺰﺩﻯﺧ ﻳ
ﺩﻭﺎﺩﻴﻨﻴﭘﻭﺮﺗﻮﻭ.ﻧ
ﻴﮏ ﻱ ﺘﻳﺎ
ﻮﺳ ﻣﺭﺎﻴﮏﻧﻣ ﻭﺮﮐﻮﻣﺭﺎﻭﻧﺍﻪﻭﻱ ﻔﻴﻔډﻝﺧ ﺰﻭ ﻳﺩ ﻭﺩ
ﻪﻮﭘ ﮐﻭﺩډ
Megakarﻩ yocytﺍﻯﺷﻲe ﺩﻧﺩﺭګﺪ ﻭ کېڅ ﺍړ
ړﻱ ﭖ ﻡﻮﻪﻟ ﺎﭘﻴﻨﻴﭘﻮﺘﻳﺎ
ﻮﺳ ﺒﻣﺮ ﺯېﺗ ﺍﻮﻳ
ﻭ.
ﺷې ﻱ ﻪﻮ ﺑ
ﺍﺮﻩﻱېﺧ ﺪﻧﻮﺩ ږﻱﺧ ﺎﺕږ ﻳﺰکېﺯ ﻐ
ﻣ
ﻣﻲ ﻮﺘﻳ
ﺎ،ﺳAv iﻡ um ﻮ
ﻳﺮﺘﮐﺎ
ﻮﺑ ﮑﻳﺎ،ﻣﻮﺗﺎ
ﻧﺎ
ﺘﻧOpporﺍ tunistiډﻝﺩc ﺰﻭ ﻳﺩﻭPﻪﺩ ancyﭘ topeni a
.
ﺭځﻱﻪﺍ ﺗﺎکېﻣﻦځ ﻣ ﻮﻔﻤﻟ
ﻪﮑ ﻟﻮﻧﻮﺘﻟﺎ
ﻧﻲﺣ ﺎ
ﺮﻃ ﻭﺳ ﺍﺮﺱ ﻳﺍګﻮﻭﻟﺍ
:ﺍﺕﺮﻴﺛﺎﻳﻰﺗﺎﻌﺪېﻣ ﻌﻣ-٥
.ږﻱږﺎﺕﭖښښ ﻳ
ﻟﻰﺯ ﺍ
ﻮ ﻤﺯﻥﮐ ﻭﻭﺩ ﺍﺘﻰ ﺎﺳ ﻧﺲﻧ
،ﺘﻰﺎﺳﻪ چېﻧﺲﻧ ﻠ،ﮐږﻱ
ﻭﻝ کږ ﺭﺎ
ﻪﻭﺧﺖﮐ ﻐﻭﻫ ﻩﺍ ﻩﺍﺻﻄﻼﺡﺩ ﻮHIﻳ V Ent er opat hy
،ﻭړ
ﻪ ک ﺍﻧ ﺪﻴﻪﭘ ﺗ
ﺭﻮﺟﻲ ﻭ ﻟﺎﺘﻪﭘ ﻠﻭﺑ ﻧﻰ ﻭﻱﺍ ﻮ ﺘﻟﻰ ﺷ ﺍ
ﻮ ﻤﺯﻥ ﮐ ﻭﻭﺩ Malﺍ absor ption
ﺩ.
ﻮﻯ ﻯ ړﻝﺷ ﺭک ﺭﻭ ﻮ
ﭘﺍﻮکېﺭ ﻧﺎ
ﻭﻏ ﺭﺎځﻮﻧ
ﻨHﻪ ﻳyﭘ pochl or hydr i
a
ﺎﺕې ډﻝﭘ
ېﻪ ﻭﺮچﻥﻥ ﭘ ﺁﻥﺩﺳ ﻭﺍځﻯﺩﻯ ﺪﺍ ﺎﻋﻩﻣﺴ ﺭﺎﭙﻟHIﺎﺝﺩV ﻧﺴ ﺍﺪﻴﺋ
ﻮﻔﻤ ﻟﺘﻢﮑ ﻳ
ﻩﺩﺭ ﺭﻥګ ﺍﺪ ﻤ
ﻫ
ﺷ.
ﺍﻯ ﻲ ﺩﺩک
Oral،Candi diasiﻓﺠﻞs ﻭﺰﻳﺍOﻭrﺍ ophar y ngeal ،AphthousSt ﻮﻑephen ېﻪﺟﻮﻝ ﭘ ﺩﺧ
ﺷ،
ﺍﻯ ﻲ ﺪﻳﺪﻧ
ﺭګ Perڅ iadenit i
Gﻭsiﺍ ngiviti
s، ﻪﻧ
ﻮﭘﻮﻝېټ ،ﺩﺧ Hai ryLeukopl akia
:ﺎﺕﺘﻼﻃ ﺍﺧ ﻭﺭګﻮ ﺗﺩﭖښ -
٦
ﻮﻧﺎ
ﻳﺎ
ﻘ ﻳ
ﺮﻓﻪﻭﺍ ﻨﻳﺭ
ﺎﻮﻧﺘﻮﺳﺭﭘ ﻮﻪﺗ ډﻝﭘ
ﺭﻭ ﺩﺎ
(ﻪﻧ HIﭘ VAN)HI Vassoci at edNephr opat hy
.ږﻱ
ﺪکږ ﻳ
ﺪ ﻩﺷ ﺮﺎﻝﺳ ﻤﻌﺘﺍﺳ ﻪﻟﻮﻨﻳﻭﺮﻴ
ږﻱﻭﺩﻫﺪږ ﺍ ﻧﺭګ کېڅ
HIﺩ ،چېﺩV ﻩﻮﺟﻲﺩ ﻟ
ﺎﺘ
ﻩﭘ ﺰﻳﺩﻭ
ﻪﺩ ﻠ
ﻣﻪﺍ ﺘﺲﻟ ﻳﺍﺮﻔﻧﻮﻟ
ﻭﺮﻴﻣﻮﻟﻡﺩ Focalګ ﻭﺭﺪﻨ
ﻴﮏ ﺳ ﺗﻭﺮﻔﻧ
ﻩﻮ
ﺭﻥګﻳ ﺍ
ﺪ ﻤ
ږﻱﻫ ﻪکږ ﺗ
ﻣﻦځ ﺍ
ﺪېﺭ ﻧﺎ
ﻡﺑ ﻮﻠ
ﻴﺘﻴﭘRenalTubulﺍ ﭘarﻪﺮ ﻠﻣﻪﺍﻟﻭ ﺰﻴCyﺍﻏ pt opat hic
Iﺮ ﭖښ ndiﭘ naviﻭrﻳﻦﺍ ﺯ
ﺎﻳﺩﺎﻔﻠ
،ﺳ ﻭﻥﺪﻴﻣ ﺎﺘ
ﻨﻴ،ﭘﻴﻦB ﺍﺳﺮﻴﺗ
ﻮ ﻔﻣ،ﺍFoscar ﻪnet ﮑﻣﻞﻟ ﺭ ﺭﺩ ﺷﺭ
ﻢ
.ﺮﻱ ﻟﺰېﻴﺍﻏﻨﻲ ﺮﺟ ﺪېﺯﻫ ﻧﺎﻭﺑ ﺭګ ﻮﺗ
:ﺎﺕﺘﻼﻃ ﺍﺧ ﻔﺴﻲ ﻨﺗ-
٧
ﺪﻴﺋ
ﻮﻔ ﻤ
ﻭﻟ ،ﺍﻐﻞﻪﺑ ﻨ
ﻴ Pneumocyﺳ t i
cCar ini،ﺎﺕ ﻧﺎ
ﺘﻧﺘﻢﺍﻴﺴ ﻔﺴﻲ ﺳ ﻨﻨﻲﺗ ﺘﮐﻭ ښ ﻨﻲﺍ ﺗﺭﻮﭘﺩ
ﻮ کې ﻧﺎ
ﻭﻏﺭﺎ
ﻪﻧ ﻭ،چېﭘ ﺎﺕ ﻱ ﻳﻮ کېﺯ ﻧ
ﺎﻣﻮﺎﺷ ډﻝﻣګﻱ ﻭ ځﻥ ړ
ﻪﺍ Iﭘnterst i
tialPneumoni ti
s
ﺩ.
ﻧﻰ ﻯ ﻮﺘﻭﺧﻰﺷ ﻭټ ډﻱﺍ ﺳﻦﻟﺎ
ﻭ.
ﺎﺕې ﻱ ﻳ
ﻭﻍکېﺯ ﺭﺎ
ﻪﻧ ﺘﺍﺧHIﻪV ﺯﭘﻲښېﭘ ﻮﻠﮐﺮﺑﻮ
ﻩﺩﺗ ﺭﻥګ ﺍﺪ ﻤ
ﻫ
:ﺎﺕﺘﻼﻃ ﺍﺧﻨﻲ ﻳﺍﺮﮐﻭﺪ ﻧ
ﺍ-
٨
ﺪﺎﻝﻏ ﻨ
ﻳﺭﺩﺍﻭﺍﻟﻰﺍﻮﻤﻭﻥﮐﺮﻴﺘﺘﺴ ﻪﺩﺗﺴ ﮑﻟﺩ،
ﻮﻯ ﻯ ړﻝﺷ ﺭکﺭﻭ ﻮﭘﺍ
ډﻮﺭګﻭﻳﻨﻲ ډ ﻳﺍﺮﮐﻭﺪﻧﺍډﻝډﻝ ﻭ ﺩﻭ
ﺩ.
ﺩﻝ ﺍﺏ ﺮ
ﻭﺧ ﺪﻧېﺩﺩ
ﺎﺕ ﺘﻼﻃ ﺍﺧ ﺒﻲﻠﻗ-٩
ﻴﮏ ﺘ
ﻳﺎﻮﺳﻔﻤﺍﻯ ﺷﻲﻟ ﺩﺩ
ېﻻﻞ ک
ﺎﻱ ﻣ ﻔﻡﮐ ﺪﻧﻲﻋ ﺎﻘﺘﻩﺩﺍﺣ ړﻩﺩﺯ ﺮ HIﺳ ﻪV ﺘﻲﻟ ﭘﻮ ﻳﺎﻣﻮﻳﺩﺭﺎﮐ
ﺷ.
ﺗﻼﻯ ﻲ ﺍ
ﻪﺭ ﺗﺘﺲﻫﻢﻣﻦځ ﻳ
ﺍﺩﺭﺎﮐﻮﻳ
ﺎﻴﮏﻣ ﺗﻭﺮﮑﻧ
:
ﺭﻱﭘﻞټﻥې ﺍ
ﻮﺗﺍﺮﺑ
ﻻ
ﻳﺩﻮﺟﻲﺎ ﻟ
ﺍﺮ
ﻴScrﺳ ،چېﺩeen ﻩﻪﺩ ﻧﺪﻴ
ډﻱﻟ ﺎﺘﻲﺑ ﻧﻭﺍﺘﻲﺟﻦﺍ ﻧﺍ
ﻪﺩ ﻨﻳ
ﺎﻌړېﻣ ځﻥګﻩﺍ ﺭﺎﭙHIﻟ ﺩV
ﻪﺍﺳﻄ ﻪﻭﻮﭘ ﻧﻭﺩﻮﺘﻴ
ډﻝﻣ ﺩډﻝ ﻭ
ﺎ ﻭ ﻴ
ﻪﺑ ﺘﻭﺳ ﺭﻩﻭ ﻴﻞګ ﻪﺑ ﺘﺒ
ﺜږﻱﻣ ﻩ کږ ﺮ
ﺮﺳ ﻪﺗ ﺍﺳﻄ ﻪﻭ ELIﭘ SA
.(
West erbl otﻪ) ﮑﻟ ږﻱﺪږ ﻴﺋ
ﺎﺗ
151
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﻳﻦېﻮﻣﺯﺍژﻱﺍﻮﻟﺮﻴﻳﻦﺳﺮﮑﺎﺕﺩﻯﺩﺳ ﻳڅﻪﺯ
%٩ﺧ ٧،
ﻴﺖﺩ٥ ﺎﺳ ﻳﻦېﺣﺴ ﻮﻣﺯﻮﺟﻲﺩﺍ ﻟﺍ
ﺮﻴﻳﻦﺳ ﺮﮑ ﺩﺳ
ﻮکېﺩ ﻴﺘﻭﺳﺭېﻪﺩېﻭ ﻮکېچ ﭘ ﮑﻠ
ﻪﺧ ﻐﻪﻫﻪﭘ ﮑږﻱﻟﺪﻝکږ ﻴ
ﻪﻟ ﻠ
ﻪﮐ ﻠﻟﻰﻫﻢﮐ ﺍ
ﺒﺖﻭ ﺜﺭﻏﺠﻦﻣ ﻭﺩ
.ﺎﻥﻭﻏﺭﺎﻮﻧﺎﺟﻧﺴ ﺍﻨﻀﻢ ﻣﺎﺩﻮﻯﻭﻱﻳ ﻩﺷ ﺮﺮﺳ ﻴﻦﺗ ﮐﺴ ﺍ
ﺍﻭ ﺰﻨ
ﻳﺍﻮ ﻠ
ﻔﻧﺍ
ﺩ.
ړﻯ ﺯښﺕﻭ ﺭﺍ(ﻫﻢﺩ ﻴﮏ)PCR ﻨﻴﮏﺗﺨ ﻮﺟ ﻟ
ﺎﻴﺑﺮﻟ
ﻮ ﮑﻴﻟﺎ
ﻣ
ډﻝ
ګﻱ ﻭځﻥ ړﻪﺍ ﻟﻰﭘﺍﻮﻤﺭﮐ ﺷﺭ
،ﺩ WBCﻢ ږﻱﻪﻝ ﻨﻳﻪﻭ ﮑﻳﻦېﻟ ﻮﻣ ﺯﺭﻱﺍ ﺍ
ﻮ ﺗ
ﺍﺮﺑ
ړېﻻ ﻧځﻥګ
ﺭېﺎﺍ ﻮﻧ
،ﺩﺎﻴﻤ
ﻴﻨﻴﻟﻮﺑ
ﻮﻟګﺎ ګ
ﻣﺮﺍ ﭙﻳ
ﺎ Polﻫ yclonal، ﻟﻰﺍﻭﻟړ Sed Ratﻮ e، ﺎﻴﻨﻴﭘﻮﺘﻳ
ﺎﻮﺳ ﺒﻣﺮ،ﺗ ﺎﻴﻨ
ﻴﭘ ﻮﻔﻤﻟ
ﺩ.
ﺰې ﻱ ﻳ
ﺩﻭ Anerﻫﻢﺩ ﺘﮏېgy ﻮﺳ ﭘﻭﺩﺍ ﻟﻰﺍﻮﻤﻭﻝﮐ ﺮﺘﻟﺴﻮﮐ
ﺯښ ﺭ
ﺭﺍېﺭ
،چ ډ ﻮﻱ ﻪﮐﺗﻭﻪګ ﭘﺍ
ﺭﺭ ﺍ
ﺰﻧﻭﺍﺭښﺩﺍ
ﻠﻦېﻻ ﻭ ﻣﺭﻪچېﺩﺩ ﺘﺭﻱﻥښېﺷ ﺍﻮﺗﺍ
ﺮﺑﺭﻻ ﺷﺭ
ﻮ ﻢ ﻳ
ﻩکې ﺩﻮﻪﻣ ﭘﻮﻟﺎ
٥ﮐ-ﺷ؛ﻮﺩ٣
ﻪ ﻲﻧ ﻤ
ﺷﺭﻪﮐ
ﻧېﺍ ﻢﺭﻪچ ﺩ ﻠ.ﮐﻩﺷﺭﻪﺩ
ﻧﻳﺖ ﻢﺭ ﺎﻮﺳ ﻔﻤﻟﻪﻱېﺩCD4 ﮐ ﺎ
ﻨﺗ
.
ږﻱﺎﺕږ ﻳ
ﻪﺯ ﻠﺍﺧﺪﻮﻣ ﺗﺎﻧ
ﺎﺘﻧﺍﻮ ﻟ
ﺎ
ﭙﻌ ﻗﻮﻣﺩ
ﻩﻩﻥښ ﻩښ ﺭﺎ
ﭙﻟﻮﻟﻮﻣﻮ
ﻠﻌﻭﻣ ﺭﺍ
ﺰﻧﮐﻞﺩﺍ ﺍ
ﻪټ ﻨ
ﻠﻮﺳ ﮑﻧﻭ،چېﺩCD4ژ ﻩﺩﻝېﺩ ﻭﻮښ ﻧړړﺭڅ ﺷﺭ
ﻮ ﻢ ﻳ
ﺮﻮﺧﻄ ﺗﺎ
ﻧﺎﺘﻧ
ﻮﺍ ﻟ
ﺎﭙﻌ
ﻗﻮﻭﻣ ﻮﺍ ﻧ
ﻮﻧﺎ
ﺮﻃ ،ﺳ ﺮﻣﺨﺖګﺧﻄ ﺮﭘ
AIﺩ ﻮDS ﻩﻭﻱﻧ ږ%څﻪﻝ ٢ﺧ ﻪﺩ٠ .ﮐ ﻩ
ﺩ
ﺯښﺕ ﺭﻩﺍ ﺭﺎ
ﭙﻮﻟﻟﻮﻣﻮﻠ
ﻌﻭﻣ ﺭﺍﺰ
ﻧېﻭﺩﺍﺩﻥ ﺍﺎﺕﺩ ﻳﺯﻮﺩ ﻧﻮﻭﺳﺮﻳﺍﻭﻩﺩ ﺯﺍ
ﺪ ﻧ
ﺮﺱﺍ ﻳ
ﺍ HIﻭ ﻭ.ﺩV ﺎﺕ ﻱ ﻳ
ﺯ
.
ﺮﻱ ﻟ
:ﻴﺺ ﺮﻱﺗﺸﺨ ﻴﭘﻮﺗ
ﺎﻥچېﺩ ﻭﻏﺭﺎ
ﻪﻧ ﻐ؛ﻮﻫ
ﺮﻱﻧ ﻭﻥېﻟ ﺪﻧ
ﺭګ ﻴﮏېڅ ﻨﻴﻠﺎﻥﮐ ﻪﺷ ﻮﭘ ﻴﻭﻏﺭﺎﻭﻧﺭﻮ ډﻝﻧډﻝ ﻭ ﺎﻥﺩ ﻭ ﺘﻧ
HIﺍ V
،
ﺍﻱټﺱ ﺩﺭﺎﮐ
ﻭﺪ ﻧ
،ﺍﺯﻮﻠ
ﮐﺮﺑ
ﻮﻪﺗ ﮑﻮﻟﺗﺎ
ﻧﺎﺘﻧ
ډﻲﺍ،ځﻥﻧ ﻮﻧﻮ ﺘ
ﻟﺎ
ﻧﻲﺣ ﺎﺮﻃﺪﺩﺳ ﻳﺎ
ﺮﻱﺑ ﻟ
ﻪﻭ ﺒﻭﺗ ﻟﻰﺍ ﺍﻮ
ﻤ ﺯﻥﮐ ﻭ
ﺷ.
ﺮ ﻲ ﻴﭘﻮﻩﺗ ﺮﻡﺳ ﺰﻳﺪﻴﺋﻭﺮﻳﺎﺗ
ﺮ ﭙ
ﻳﺎﻪﻫ ﮑﻟﻮ ﻴ
ﻭﻏ ﺭﺎﻨﻲﻧ ﻳﺍ
ﺮﮐ ﻭﺪﻧﺍ
ﺪﻳﺎ
ږﻱﺑﻻﻞ کږ Pulﻣ monar yi nfil
trati
ﻼﻲon ﻟﺨﻟ ﻴﻦﺍ ﻪﺑ ﺍﺧﺮﺎﻻﺕچېﺩﭘ ﻪﺣ ﻐﻭﻫ ﺎﻥﺍ ﺘﻧﺍ
ﺷ.
ﺮ ﻲ ﻴﭘﻮﺗ
ﺎ
ﻮﻱﻳ ﻟﺪﻟﺖﺑ ﺎﺎﻏﻲ ﺣﻣﻩ چېﺩ ﺮﻮﺳ ﻧﻮﻠ
ﻣ ﻮﻻ ﻐﻪﻫ ﻮﻟ ،ﻧﺮﻱﻟﻮﻥﻭ ﺘګﻞې ﺷ ﺎﻏﻲ ﻳ ﻣﺭېﺩ ﺭﻪچ ﮐ
ﻭﻍۍ ﺭ
ﺎﺪﻧ ﻳ
ﻭﺮﻴﺋﺎ
،ﺗﻭﻍۍ ﺭﺎ
ﻭﻧ ﺭګﻮﺗ،ﺩﭖښ ﻭﻍۍ ﺭﺎﺭﻧ،ﺩځﻱګ ﻡﺰﻴﻟﻮﮑﻟﺍ:ﻪﮑﻟﻮﻱ ﻪﮐ ﺗﻣﻦځ ﺍﺘﻲﺭ ﭘﻭ ﺭﻮﻴﻧ
ﺷ.
ﺮ ﻲ ﻴﭘﻮﻩﺗﺮﻟﻲﺳ ﺍ
ﻮ ﻤﻮﮐ ﻧﻮﻨﻴﻣﺎ
ﺘﻳﻭ ﻭﺩ ﺍ
ﺷ.
ﺮ ﻲ ﻴﭘ
ﻮ ﺪﺗﻳﺎ
ﻩﺑﺮﻮﺳ ﻧﻮﻠﻣ
ﻭﻻ ﺭﻮﺎﻱټﺱﻧ ﻨﺠﻨډﻲﻣ ﻮﺩځﻥﻧ ﺮﻱﻧ ﻟ
ﻭCSFﻭ ﺍ ﺩﻱ ﺭﺩﺮﻭﻍﺳ ﺭﺎﻪﻧﮐ
ﮐﻻﻱټﺱچېﺩ ﻪﻮ ﻐ
،ﻫ ﻮﻻﻱټﺱ ﮐﻭﺮ ﻳ
ﻧﻲﺍﻥټ ﺎﺘﻧﻮﺍﻭ؛ﻧ
ﻳﺖ ﻱ ﺎﮑﺯﺷ ﺭﺎﺒ
ﺘﺘﻰﻣ ﺎﺳ ﺭېﻧﺲﻧ ﺭﻪچ ﮐ
ﺮ کېﻪﻧﻈ ﺬﺏﭘ ﻮﺟ ۍﻭﺳﻭﻍ ﺍ ﺭﺎﺑﻲﻧ ﺎ
ﻬﺘﻟﻮﺍﻤﻟ
ﻮﮐ ،ﺩږﻱﻪ کږ ﺗﻣﻦځ ﺍﻪﺭ ﻠ
ﻣﻪﺍ ﻮﻟ ﻠﻣﺭﺪﺩ ﻭﺏ ﺿ ﺮﮑ ﻳﺎ
ﻣ
ﻭ.
ﻱ
:
ﻪ ﻨﻠ
ﻣ ﺭ
ﺩ
:ﻣﻞ ﺭﺪﺩ ﺮﺱ ﺿ ﻳﺍﻭﻭ ﺮﺘﻳﺩﺭ
ﻪکېﻻ ﻟ
:ﻪﺩېډ Nuclﭘ eosi deRel atedr ev erset ranscr iptasei nhibitor (sNRTI )s-١
:ﺮﻱ ﻟﻭﻥ ډﻣﻞګ ﺭﻧېﺩ ﺪ
،
Lami vudi( ne 3TC) ، Zalcitabine ، Zi dovudi ( ne AZT- ZDV) ، Stav udi ne
ېﻮ
ﺭﻳ ﺭﻪچ ېڅﻪﮐ
ﻪډﻝ ﺧ ﻟﻮﻠﻣﺭ
AbacavﺩNRTIﺩ i
(r (ﻭ)ABC D4T)،ﺍ Didanosi (ne DDI )
ډﻝ
ګﻱ ﻭځﻥ ړﻪﺍ ﺎﺕﺩﻯﭘ ﻳﺮﺯﺭﺧﻄ ﺍ
ﺩټﻦګ
ﺮﺱ ﻳ ﻳ
ﺍﺷ؛ﻮﺩﻭﻭﻝ ﻲﻧ ﺭﺎ
ﮐﻩﻭ ﺮډﻝﺳ ﺯې ﻭ ﺍﻮﻪﻳ ﻣﻞﭘ ﺭ
ﺩ
ﺩﻪک ﺗ
ﻣﻦځ ﺍﻩﺭ ﺮ
ډﻝﺳ Crﻭﻪoss ﺭﭘﺍټﻦګﺑﻞکېﻫﻢ ﻳ ﺎ
ﻘﻪﻣ ﻭﭘ ﺭﻮﻩچېﺩﻧ ﺮ
Lamiﺳ vudi ﺩne
ﺷ.
ﺍﻯ ﻲ ﺩ
،ﻧﺲ،ﺎﻥګ (ﮐﻩځﻱ ﻪﻣﻦځ ﻟ ﻩﺮﻡﺳ ﺍ
ﻭېﻪﺩﻠﻦ ﭘ ﻣﺭﻟﻰ)چېﺩﺩ ﺍﻭﺪﻩﺑړﻪﺯ ﮑﻟﺰې ﻴﺍﻏ ﺰېﻴړﺧ ﺍ ﻠﻦېﻣ ﺭﺩﺩ
ﺭ،ﺩځﻱګ ﺎﻱټﺱ ﺗ
ﺍﺮﮑﻧ
ﺎﻩﭘﺭﻥګ ﺍ
ﺪ ﻤ.ﻫږﻱﻪ کږ ﺗ
ﻣﻦځ ﺍﺘﻲ ﺏﻝﻻﺏﻝﻝېﭘﻲښېﺭ ﭘﻭﺭﻮﻴﻭﻧ ﺘﻰﺍ ﺎﺳﻧ
ﺷ.
ﺍﻯ ﻲ ﺩﺩﻪک ﺗﻣﻦځ ﺍ
ﻟﻰﻫﻢﺭ ﺍﻮﻤﻮﮐ ﮑﻧﻭﻮژ ﻨ
ﻴﭙﻭﺳ ﺍﻭﺮﻳﻦېﺩﺳ ﻭ ﻭﺩ ﺍﻟﻰﺍﻮﺑﺍﺮﺧ
152
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
.
ږﻱﻪکږ ﺗ
ﻣﻦځ ﺍ
ﺍﺭًﺭﺩﺎ
Lactﻧ i
cAci dosi ﺩs.
ﺎﺕ ﻯ ﻳﻩﺯ ﺮ
Abacavﺳ i
ګﻥr ﺮﻭ ﺒﻴﺖﻏ ﺎﺳ ﺮﻁﺣﺴ ﺩﻓ
:(Pls)Vi r
al ProteaseI nhi bitor
ﺭېﺭ
Iچ ډ ndinav ir،Ritonav iﺩ(r
ﻩﻯ )Saquiچېﺯﻏﻢﻱې ښ nav ir:ﻪﻟﺭﺕﺩﻱ ﺎ
ﺒﻪﻋ ﻧ
ﻮ ﻠ
ﻣ ﺭﺍﺩﺩ
.Ampr enav iﺍr
Lopiﻭ nav i
r، Nal f
inav i
ﺩr،
ﻣﻞ ﻱ ﺭﻮﻱﺩ ﻗ
ﻭﻝ ﺭ
ﺎﮐډﻭﺪګ ﻳ
ﺎﻩﺑ ﺮﻮﺳ ﻠ
ﻣ ﺭ
ﻭﺩ ﺭﻮﻧ
ﻮﻱﺩ ﻤIکېﮐ nv ivIﻭonvﺍ it
r ﻪo ﻪﭘ ﻧﺩﺩﺎﺕﻳHIﺯ ﻣﻞﺩV ﺭﺍﺩﺩ
ﺷ.
ﻲ
ﻪﺩې ﻭﭘ ﻮﻱﺍﻬﻲﮐ ﺘﻢﻧ ﻴﺴ ﻡ P450ﺳ ﻭﺮﮐﻮﺘﻳﺎ
Riﺩ ﺳ tonav i
ډﻝr ګﻱ ﻭ ځﻥ ړﻪﺍ ﻣﻞﭘ ﺭﻨﻲﺩ ﺗﺭﻮﭘ
ﻣﻞ ﺭ
ﮑﻰﺩ ﻧﻭﻮﻤﻳﻢﮐ ﺍﺰ
ﻧﻴﻦچېﺍ ﻴﺴﭙﻣ ﺎ
ﻔﻳ.ﺭ ږﻱ
ﻻﻞ کږ ﻭﻣ ﺰﻴﻭﺍﻏ ﺰﻴ
ړﺧ ﻩﺩﺍ ﺮﻮﺳ ﻠﻣﺭﻮﺩﺗﺎﻳﻨﺲټﺩﺯ ﺑ
ږﻱ
ښﻪکږ ﻨﺭﺗ ﺎﭙﻪچېﺩPIﺳ ﻮﺗ ﻧ
ﺎﻭﻏ ﺭﺎ
ﻮﻧ ﻣﻮ؛ﻮﮐﻮﻱﻧ ﻤﻩﮐ ﺩﺎﻌﻟ
ﻮﻕﺍ ﻪکېﻓ ﻨﻳ
ﻪﻭ ﻩﭘﺯﺍﺪﻧﺩ.ﺩPIﺍ ﻯ
Retinoviﻪﺩr Oculﮐ art oxicitﻮy ﻠﻣﺭ
ﺩېﺩ ځﻪ ﺩﺯﻱ ﮐ ﻮﻳﺮﻪﭘ ﻳﻲﺗ ﺎ
ﻤﻴﺪﻧ ﻳﺎ
ﻩﺑ ﺯ
ﺍﺪﻧﻴﻦﺍ ﻔﻣ ﺎ
ﻔﻳﺩﺭ
.ږﻱﺎﺕږ ﻳﺎﻝﺷﻲﺯ ﻤﻌﺘﺍﺳ ډﻩګ ﺮﺳ
Antﺭi ﺷﺭ
ﻮ ﻢ ﻭﻳﺍ ﻣﻞﺭ ﺪﺩ ﺎﺿﻴﻤﺘﻳﺭﺍ ﻌ ﺾېﺩ ،ﺑﺮﻱﻟړۍﻭ Azolک ﻮچېﺩe ﻠﻣﺭﺪﺩﻪﺩﻓﻦګﺱ ﺿ ﮐ
.
ﻮﻱﻪﮐ ﺗ
ﻣﻦځ ﺍ
ﺰېﺭ ﻴﺍﻏ ﺰېﻴړﺧ ﻧﺍ
ﺎﻝﺷﻲﻮ ﻤﻌﺘﺍﺳ ډﻩګ ﺮhiﺳ st ami nics
ښﻪ
ﻨﺭﺗ ﺎﭙﺎﺕﺳ ﻌﻳﺎ
ﺪﻣ ﻳﺎ
ﻪﻭﺧﺖ کېﺑ ﺎﻝﭘ ﻤﻌﺘﺍﺳﺩېﺩ ﺩﺩﻱﻥ ﺩ ﺍ
ﻮﻨﺤﻞﻣ ﺮﻣ ﻴ
ﺘﻲﻏ ﺒ
ﻮﻧﺴ Iﻳ diav i
r
ﻮﻯ ﻴ
ﻨڅﻪﻣﺨﺯﺱ ﺧ ﻭﺮﮑ RenalTubulﻧ ېﻭarﺎﺳﺖ ﺍ ﻪﻧ ﻮﻟﻧﻮﻠﺘﺮﺳ ﮐﻭکېﺩ ﺯﺎ
ﻴﺘﻭﻪﻣﺮڅ ﭘ ﻭﺷﻲﺗ
.
ﻭﺷﻲ
ﻭﻟړ
ﻭﺩﻮ ﺪﻳ
ﺍﺮﻟﺴﺍﻯګ ﺮ ﻭﺗ ﻭﻝﺍﺮﺘﻠﺴﻮﺩﮐ ﺎﻝﺷﻲﻧ ﻤﻌﺘﻣﻞﺍﺳ ﺭPIﺩ ﻩS ﺭﺎﭙﺩېﻟﻮ ﺩېﻣ ﺩږ
ﻭﺭېﺍ ﺭﻪچ ﮐ
.ږﻱﻻﻞکږ Liﻣpody dy strﻭﺩophy ﺍﺎﻴﻤﻴﻳﺴ ﺭ
ﻮ ﺮﻳﭙﻴ،ﺩﻫ ﻟﻲﺍﻮﻤﮐﺯﺩﻮ ﮐﻮﻟ،ﺩګ ﻟﻲﺍ
څﻪ
ﻪﺩېډﻝې ﺧ :ﻟ Nonnucl eosi der ev erset ranscr iptasei nhibit(or NNTI )s-٣
څﻪ
ﻮ ﺧ ﻧﻮﭘﺎ
ﺘﮏېﺩﺧ ﻮﺳ ﭘﺰېﻱېﺩ ﻴ ﻩﺍﻏ ﻧړ
ﻭﻮﺎ ؛ﺧ ږﻱﻭﻝکږ ﺭﺎ
ﻩﮐ ﺭﺎﭙﻟﺩې ﻮﺩېﻣ ﺍږ
Nevﺩﻭ irapine
DelEﻭ afﺍ avirﺎenz ﺒ
ﻮﻱﺩﻱﻧﻦﺳ ړﻯﺷ %ﻪﮐﻢکﺍ ٢ﺗ ﺩې٠ ږﺎﻝﻥ ﻤ ﻌﺘﻣﻞﺍﺳ ﺭﺩېﺩﺩ .ﺩﺭﺕ ﻱ ﺎﺒﻋ
ﻣﻞ ﺭ
ﺮﺩ ﺛ
ﻮﺩ.ﺍﻣ
ﻟﻲ ﻱﺩ ﺪ ﻳﺭځړګ ﺎﻝﻭ ﻤ ﻌﺘﺍﺳﻮکېﺩ ﻧﻭﺩﺍﻮﻴ
ځﻮﻫ ﻨېﻪ ﻳﻮﻱچ ﭘ ﺪﺷ ﻴﻟ
ﻮvﻫﻢﺗ iri
dine
ﺩﻝ
ﻪکﺩ ﺗﻣﻦځ ﺍ
ﺍﺭﻪﺩ ﺘﺒﻟ.ﺍږﻱﻪکږ ﺗﻣﻦځ ﺍ
ﺭﺭ ﺭژﺭډMut atiﻮon ﻧ
ﻮﺮﺳ ﻳﺍړﺪېﺩﻭ ﻧﺩېﺮﻭﺍ
ﻮﺩ ﭘ ﺩﻱﺧ
ګﻩ
ﻪ ډ ﺩېﭘﺎﺭ ﻩﻳ ﻭ ﺭېﺩ ﺭﻪچ ﻭﮐ ﺎﻝ ﺷﻲﺍ ﻤﻌﺘ
ګﻱډﻝﺍﺳځﻥ ړ ﻭ ﻪﺍ ﻭ،چېﭘ ﺎﺕ ﻱ ﻳﻪﻭﺧﺖﺯ ﻐﻫ
ﻭ.
ﺮﻱېﮐﻢ ﻱ ﺍﺧﻄ ﻮﺩﺎﻝﺷﻲﻧ ﻤﻌﺘﺍﺳ
ﻭﺪﺍ ﻳﺍ
ﺮﻴﺴﻟﺍﻯ ګﺮﻪ چېﺗ ﻮﺗ ﻧﺎ
ﻭﻏ ﺭﺎﻪﻧ ﻐﻮﻫ ؛ﻧږﻱﻪ کږ Lﻻﻞﻧ iﻣ pody strﻣﻞﺩophy ﺭﺍﺩ ﺩ
؛
ږﻱﻪکږ ﻴ
ﻮﺻ ﺩﺭځېﺗ ﻩځﻝ ﻭ ﻭﻪﺩﻣ ﺍﺭﻠﻲګ ٢ﻣ ٠
٠Nev i
rapi ږﻱnﻮﻝکږ ﮐﺭﻟړﻭﻱﻭﻭﻝﻱېﻮ ﺮﺘﻟﺴﻮﮐ
ﺮﻮﺧﻄ ﻧﻮﭘﺎ
%٤ﺩﺧ ﻩ٠ﺮ ﺯﺳ ﻭ
ﻪﺩېﺩ ځﻪﭘﺭځېﻭﻱ ﮐ ﻮځﻝﺩﻭ ﻪﻳ ﻣﺍﺭﻠﻲګ ٢ﻣ ٠
ﺪ٠ ﻳﺎ
ﺯﺑﻭ ړﻯﺩ ﻡ ﻮﻟﻮﺧ
.ﻮﻱ ﻤﮐ
:Nov el Agent s-٤
ﺗﺑﻼکﻮﻪ ﮑﻧ
ﻭﺪﻝژ ﻴﻠ
ﺍﺧ HIﺩ ﺩ،چېﺩV ﻣﻞ ﻱ ﺭړﻲﺩ ﻡﻧ ﻮ
Engurﻟ atide: Ent ryInhibi tor: ﻟﻒﺍ
.
ږﻱﻮﻝکږ ﮐﺭﺩﺭځېﻭ ﻪﻭ ﻟ
ﻩځ ﻭﻧېﺩﺘﮏېﻻﺪ ﻮﺳ ﭘ
ﻪﺩ ﻣﺍﺭ
ﻠﻲګ ٩ﻣ ﻮﻱ٠ ﮐ
.ﻮﻱﻬﻲﮐ Iﻧntegr ﻭase ﺍﻪﻭﺳ ﺮﺮRNAﭘ ﻨﺠ ﻴHIﻣﺴ ﻣﻞچېﺩV ﺭ ﻪﺩ ﻐ
:ﻫ OtherAgent s: ﺏ
hi
ghlyact i
v eant iRet r
oVi ral Ther ﻭapy: ﻪ ﻨﺲټﻧ ﻭﻥېﺑ ﺭ
ﺎﮐﻮﺩ ﻠﻣﺭﺪﺩ Retﺿ roVi r
us
:
()HAART
:
ﻮﻭﻻﻯﺷ ﺩﺎډﻝﻳ
ﻧې ﻭ ېﻪﻻﺪ ﻮﺥ ﭘ ﻭﻥېﻣ ﺭﺎﮐﻮﺩ ﻠﻣﺭ
ﺪﺩ ﺮﺱ ﺿ ﻳﺍﻭﻭ ﺮﺘﻳﺭﺩ
.ﻮﻝ ﻤﺮﮐ ﺜﮑﺗ
ﻮﺩ ﻧ
ﻮ ﺮﺳﻳ ﺍ
.ﺩﻭ 1
.ﻮﻝ ﻤ
ﻭﮐ ﻮﭘﻲښ ﻣﻭﺎﻘړﺪېﻣﻧﺮﻭﺍ ﻣﻞﭘ ﺭ .ﺩﺩ 2
.
ﻟﻰﺍﻮﻤﻮﮐ ﺗﺎ
ﻧﺎﺘﻧﺍ
.ﺩ 3
153
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
.
ﻮﻯ ﻴﻨ
ﻭﻣﺨ ﺩﺩړﺎﻳﺠ ﺘﻢﺩﻭ ﻴﺴﺘﻲﺳ ﻴﻓﺎﻌﻣ .ﺩ 4
.
ﻪﻧﻮﺎﺭﻏﻴﺪېﺑ ﻧ
ﺘﻢﺩﺩ ﻴﺴﺘﻲﺳ ﻴﻓﺎﻌﻣ .ﺩ 5
ﺎﺕﻳﻭکېﺯ .ﻪﺩېﭘﻲښ ﻮﻱﭘ ﮐﺭ
ﻪﻭ ﻴﺠ ﺘ
ﻩﻧ ﻩښ ﺭﺭﻪډﻨﻠ
ﻣﺭﻭکېﺩ ﻮﭘﻲښ ﻳﻮ ﻪﺷ ﻨ
ﻠﻣﺭﺩﺎﻮﻧ ﻴﻧﺍﻮﻪﭘﺨﭘ
ﻮﻟ
ﺩﻮ ﻟ
ﺭﻪﺩ ﻮﭘ ﻧﻮﺮﺳﻳﺍﻮﻭﻤﺩځﻮﮐ
ﻨﻩټﻝېﭘﻲښې ﻳ ﻮګ ﻭ ﻩﺗ ﺰﻴ
ﻟﻭﻪټ ﻮﭘ ﺩ؛ﺧ ﻣﻦ ﻯ ﺰ
ﻴﻩﺍﻏ ﻣﻞ ښ ﺭ
ﺩ
ﺭﻱﭘﻲښېﻫﻢ ټﻱټې ﺍ
ﻴﻦګ ېﺍﮐﻢېﺗﻩچ ﺩ ﺭﺎﭙﻟﺩې
.ﺩ ﺮﻱ ﻟﺭ
ﺍېټﻦګ
ړﺪ ﻳ ﻧﺮﻭﺍ ﻮﭘ ﻠﻣﺭځﻮﺩﻨﻩﺩﻳ ﺮﺳ
ﻪﻟ
ﺪ ﮑﻞﺑ ﻟ
ﺎﻪﺑﻨﻠﻣﺭ
ﻮکېﻱېﺩ ﻧﻭﺩ
ﺍﻮﻴځﻮﻫﻨﺷ.ﻪ ﻳ
ﻩ ﻲﭘ ﺮﺮﺳ ﻪﺗ ﻨ
ﮐﺍ
ﻮټ ﻠﻣ ﺭېﻪﺩېچېﺩﺩ ﺷﻲﻣﺨﮏ ﻟ
ړﻡﻮﻟﻪ ﺎﻥﭘﻭﻏ ﺭ
ﺎ%١ﻧ ﺩې٠ږﻮکېﻥ ﻨ ﻟ
ﻭﻪﺩېټ ؛ﻮﭘ
ﺮﻱﻧ ﻟﮐﻦې ﺍړې ټځﻥګ ﻩﺍ ﺭﺎﭙﻟﻠﻦې ﻣﺭﺷېﻭﺩﺩﻮﺍ
ﻭﻝﺭ ﺎ
ﻮﮐ ﻠﻣﺭﺭﺩﺷﺭ
ﻪکېﺩګڼ ﻢ ﻨﻠﻣﺭ.ﻪﺩ
ﺮﻱﭘ ﻟﺭﺍېټﻦګ
ړﺪ ﻳ ﻧﺮﻭﺍ ﻣﻞﭘ ﺭډﻝﺩﻩﻭ ﻮﻳﻧﻲﻭﺧﺖکېﺩ
.ﻩ
ﻪﺩ ﮐﺎﻨ
ﺗﺯښ ﺭﺍﻩ ﺭﺭ
ﻪﻱېډ ﻠﻳ
ﺎﺭﻥېﭘ ﺍېﺣﻝکېچېﺩڅ ﺍﺱ ﺎ .ﻪﺩﺮﻱﭘ ﻟﻪﻠﻳﺎﻩﭘ ﻩښ ﺭﺭ
ډ
ﺪﻝ ﻳﺎﻪﺑﻨﻠ
ﻣ ﺭ؛ﻮﺩ
ﻨﻲﻧ ﻭﻝﻣ ﺭﺎﻮﮐ ﻠﻣﺭ
ﺭﺩ ﺷﺭ
ﺮچﻥﻥېﺩګڼ ﻢ ﺎﻥﺳ ﺘﻧ
ﺍﻮکېچېﺩ ﻧﻮ
ﻳﺍﻮځ ﻐﻮﻫ ﻟ
ﻭﻪټ ﭘ
ﺪﻧ
ېﻪﻻ ﻟﻰﻱ ﭘ ﺍﻭﻮړﻳﻤﻞﻭ ﻭﺩﺗﺤ ﺍﻩﺮﺛﻮﻩﺷﻲچېﻣ ﺮﺮﺳ ځﻯﺗﻮﺍ ﻩﻳﺮ ﻮﺳ ﻠﻣﺭﻪﺩ ﻟ
ﻭﺩېډﻩﺩﺭ ږږﺮﻝ
ﺗ
ﻭ.
ډﻝ ﻱ ېﻭ
Zidov udine+Lami vudi ne:ﻪﮑ ﻟېڅﻪﻭﻱ
ﻤﻞ ﺧ (ﻪﺟﺪﺩ)NNRTsﻟ ﻳﺎﻣﻞﺑ ﺭ
ﻩﺩ ﻭېڅﻪﺩﻪﺩ ﺧ ﻟ
ﺩ.
ﺭﻯ ﻭStﻫﻢګټ av udiﻊne ﻤ
DDIorlﺟ amivudi Zﻭne iﺍ dov udiﺎne+DDI ﻳ
ﻩDDIﺩ ﺭﻥګ ﺍﺪﻤﺮﻱښﻱﻫ ﻴﺲټﺑ ﻧﻭﺎګﺘﻧﻮ کېﺍ ﻧ
ﻭﻮﻣﻦځ ﻠ
ﭙ Stﺧ av udi ﻭne Ziﺍ dov udine
ﺩ.
ﻴﮏ ﻯ ﮐﺴ ﺍ
ځﻯټ ﻮﺍ ﻩﻳﺮZalﺳ citabine
ﻪکې ﻨﻠﻣﺭ
ﻪﺩ ﺎﺏﺷﻲﭘ ﺘﺨﻧېڅﻪﺍ
ﻤﻞ ﺧ Nﻪﺟ NRTIﻟ ﻳsﻭﺎ ېڅﻪﺍ
ﻤﻞ ﺧ Pﻪﺟﮑﻦﺩ Iﻟ ﻤﺍﻣ ﻭﻪﺩ ﻤﻳﺭ
ﺩ
ﻮېﻳ ﻌﻦېﺩ ،ﻳﻮﻱﻪﮐ ﺗﻣﻦځ ﺍ
ﻟﻰﺭ ﺍ
ﻮﻤﻩﮐ ﺩﺎﻌﻟ
ﻮﻕﺍ ( کېﻓ ﺭ)Load ﺎﻪﺑ ﻮﭘ ﻧﻮﺮﺳ ﻳﺍﻮﻝﺩﻭ ﺗﺎﻳﺩPIﺯ
.ﻮﻱ ﻪﮐ ﺗ
ﻣﻦځ ﺍ
ﻟﻰﺭ ﺍﻮ
ﻤﺭېﮐ ﻮﺘﻢﭘﻳﺭﺍﺗ٢ﻮګ
١ﺮ ﻟ ،
ﻟ٥ﻩکېﻪ ﺩ ﻮېﻪﻣﺎﺷﺖ ﭘ ﻴﻣ
ﻮکېﻣﻦ ﻴﻧﻭ١ﺍ٢-١
ﭘ٠ﻟﻰ ﻪﺍﻮﻤ ﺍﮐﻮﺩ ﻮﻱﺧ ﻤﻪﮐ ﻧﻮﺮﺳﻳﺍﻪﻭﺗﻦۍﮐﭽ ﺭﻮﻪﭘ ﺎﻝﻫﻢﭘ ﻤﻌﺘNNRTIﺍﺳ ﺩs
.ﺭځﻱﻪﺍ ﺗځ
ﻟﻰﺍﻮﻤﻩﮐ ﺩﺎ
ﻌﻟﻮﻕﺍ ﻪکېﻓ ﻪﮐﭽ ﻮﭘﻧﻮﺮﺳ ﻳ
ﺍﻪﺩﻭ ﺘﻭﺳﺭېڅﻪﻭ
ﻠﻦ ﺧ ﻣﺭ
ﺎﻝېﺩ ﻬﺩﻣ ﺩږ
ﻭﺎﻥﺍ ﻭﻏ ﺭﺎ
ﻩﻧ ﺮﺗ
ﺎﻳ
ﺯ
.ږﻱ
ﺭېﺭﺱږ ﻮﭘﻲﭘ ﺎﻡﮐ ﻮﻨ
٥ﺟ ٠
٠-٥ﺮکې٠ ﺘﻴ
ﻟﻠﻲﻩﻣ ﻮېﻪﻳ
ﺩﭘ ږ Viﻱېﻥ ral l
ﺁﻥoad ښﻲ
ﻳ
ﻭ.
ﺍﻥ ﻱ ﺭږګ ځﻮکېﻝ ﻳځﻮ ﺍﻨ
ﻪﻳ ﮐﺩﻝﭘ
ﻮ ﻢﺩ ﻧﻮﺮﺳ ﻳﺍ
ﻩﺩﻭ ﺭﻥګ ﺍ
ﺪﻤﻫ
ﺘﻢﺩ ﻴﺴ ﺘﻲﺳ ﻴﻓﺎﻌﻣ،چېﺩ ږﻱﺒﺐکږ ﻟﻲﺳ ﺍﻮﺗﺎﻳ
ﻮﺩﺯ ﮑ
ﻧﻭډﻝﺩCD4ژ ﻳﺠﻲ ﻭ ﺭﺪ ﻪﺗﻡﭘ ﺍﻭﻠﻦېﺩ ﻣﺭﺩﺩ
.ﺭځﻱ ﺭګ
ﻪﺍ ﻪﻧ ﻣﻞﺗ ﺭﺩﺎ
ﻪﻧﻠﮐﺪېﻫﻲڅ ﻧ
T-ﺩ Cellﻮﺩ ﺭړﻱﺧ ﻭ ﻪﺍ ﺗ
ﻪﻣﻦځ ﻧ
ﻮ ﺭﻏﺎﻴﺪېﺑ ﻧ
ﺩ
:ﻪﻟﺭﺕﺩﻱ ﺎﺒﻟﻲﻥښېﻋ ﺍ
ﻮﺗﺎﻳﺩېﺩﺯږﻱچېﺩ ﺎﺕږ ﻳ
ګﻥﺯﺮﻭ ﺒ
ﺘﻲﻏ ﻴﻓﺎﻌﻣﻭ ﺍﺑﻲ ﺎ
ﻬﺘﻟﺍﺣﻝﺮﺎ ﻪﻫﭘ
Retکې i
nalcy tomegal ov i
rﻪus ﻭﭘ ﻟﻰﺍ ﺍ
ﻮﺗﺎ
ﻳﺎﺕېﺯ ﭘﻮﻨﻳ
ﺩﺍﻮﻔﻤﻮېﺩﻟ ﺗﺎﻧ
ﺎﺘﻧﻳﻞﺍ ﺮﺘﮑﺑﻮﮑ ﻳ
ﺎﻪﻣﭘ
ﺩ.
ﺩﻝ ﺎﺕ ﻳﺎﺏﺯ ﻬﺘﻟﺍ Ocul ﺩar
ﻪﻟ
ﺎﭙﻌﻗﻮ ﻪﺩﻣ ﻧﻭﺮﻴ
ﺑﺪﻮﻱﺗ ﻳﺎ
ﻗ ﻤﻲﻭ ﻭﻫ ﻭﺩﺪﺍ ﻨﻪﺑﻧﻭﺮﻴﺑ
ﺪﻮﻱﺗ ﻳﺎ
ﻗړﻰﻭﻡﻧ ﻮ ﻟﻴﻞﺷﻲ ﻪچېHAARTﭘ ﻠ
ﮐ
١٠
×٠ ٥،
-٠،
ﺭ٤ﺷﺭﻩﻭﺩ CD4ﻢ ﺗڅ،ﺮﺮﻱ ﻟﻪﻣﺍ
ﺩﺍ ﺭېﻮﻪﻭﺧﺖﭘ ﻐﺮﻫﻪﺗﺘﺒﻟ
ﺍ ،
ﺮﻱ ﻟﻪﻭ ﻣﺍﺩﺍﺪ ﻳ
ﺎﻩﺑ ﺭﺎﭙﻟﻮﺗﺎ
ﻧﺎ
ﺘﻧﺍ
٩
.ږﻱ
ﺭﺱږ ﺮکېﻭ ﺘﻴﻟﻠﻲ ﻪﻣﭘ
Av i
ﻡ um ﻮﻳﺮﺘﮑﺑﻮﮑﻳﺎ
ﻭﻣ ﺎﺍ ﻴﻤﻳ
ﺮﻳCyﻭ tomegal ovir
ﺪ کېﺩus ﻮﻱ ﺣ ﺩﺷ ﺎ
ﻪﺩېﻳ ﺩCD4ﭘ
ﺩ.ﺩ
ﻪﻯ ﺍﺿﺢﻧ ﻭ کېﻭ ﺍ
ړﻪﺩې ﭖ ﻟﻰﭘ ﺍﻮﺘPneumocyﺷ sti
ccar iږﻱﻭﺩni ﺪﻝ کږ ﺍ ﻴﻟﻰﻟ ﺍ
ﻮﻤﮐ
ﺯﺍډ
ړﻱ ﻩﺩﺑﺸﭗ ﺪﻨﻩﭼ ﺭېﭘﻦځ ﻮ١ﭘ٩ ٩ﺮ٨١څﻪﺗ
٩ﺧ ١ﮐﻝ٣ﺎکېﺩﺎ ﭘ
ﻭﺭ ﻪﺍ ﻭﻝﭘ ﺭﺎﻠﻦېﮐ ﻣﺭ HAARTﺩ
.
ﻩ کېﺩﻪړ ﻤﮐﺍﻮﻉﺭ ﻴﺷ
؟
ږﻱﻭﻉکږ ﺮﻪﺷ ﻳﺎ
ﻗﻭﻭ ﺍﻪ ﻨﻠ
ﻣﺭ ﻪﺩ ﻠ
ﻪﮐ ﻭﻍﺗ ﺭﺎHIﻧﺩV
:
ﻩﺭﺎﭙﻟﻭﻍ ﺭﺎSerﻧ oconv er siﺩon -
١
ﻭﺍ
ړېﺍ ﭖﻪﺩېچ ﺩ ﻩﻟﺮﺩ،ﺳښﻦې ﻱ ﻮﺗ ﻠﻦېﻏ ﻣﺭړﺎﺩﺩﻴﺩﻮﻭﺗﻟﺘﻦ کﺩ ﻨﻣﻭﺩ ﻟﻰﺍ ﺍ
ﻮ ﺗﺎ
ﻳﻮﺯ ﻧﻮ ﺮﺳﻳﺍﺩﻭ
154
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﻪ کې ﻠ
ﺮﺣﺪېﻣ ﻤﻪﻫ ﻭﻍۍﭘ ﺭﺎ
SexualTrﻧ ansmi tted%٧ ﺩې٠ږ،ﻥ ﻩﻧﮏېﺩ ﻭﺪ ﻳﺩ
ﻭ ﺪﻪﻣﺤ ﻠ
ﭙﺧ
ړﺎ
ﻴﺗﺍﺗﻠﻦېﻪ ﻣﺭ
ډﻝ ﺏﻝﻻﺏﻝﻝېﺩ ﻩﻭ ﺭﺍﺪﻣﺍ
ﻭ ﻪﺩ ﻮﭘ ﺎﺕﻭﻱﻧ ﻳﺩﺯږږﻪﻝ ﻠﻣﻪﺍﻟﺎﺱ ﻤ،ځﻪﺩﺗږﻱ ﮐ ﺮږ ﭙﺧ
.
ږﻱ
ﻭﻝکږ ﺭﺎﻣﻞﮐ ﺭ ﻮکېﺏﻝﻻﺏﻝﻝﺩ ﻧ
ﻮ ﺘﻮﻭﺧ ﻟېﻪﺏﻝﻻﺏﻝ ،چ ﭘ ﺮﻱﻟ
:
ﻭﻍۍ ﺭﺎﺷېﻧﻴﺲ ﻮ ﺎﺳHIﺗ ﺩV -
٢
ﺮﺱ ﻳ
ﺍﺩ ،چېﺩﻭ ﺍ ﻯ ﮐﻰ ﻱېﺩ ﺘﻼﻑ ټ ﺍﺧ ﺩ.ﺩﺮﻱې ﻱ ﻪﺩېﻭﺧﺖ کې ﺏﻝﻻﺏﻝﻝېﻧﻈ ﭘ
ګﻪﻳﻲﻠ
ﺮﻳ ﻴﻪﻏﺎﻥﭘ ﻳﻭﺪ ﻧ
ړړﺩ.ځﻦېڅ
ﺰې ﻱ ﻳ ﻧ
ﻮ ﺘﻠﻦېﺳ ﻣﺭﺩېﺩﺩ ﻮﺩېﻣ ﺩږ
ﻭSﻭﺍ upprﺍ essi on
ﻠﻲﻮﻣ ﻪﻳﻪﭘ ﻮﮐﭽ ﻧﻮﺮﺳ ﻳﺍ
ېﺣﻝ کېچېﺩﻭ ﺍﺱ ﺎ ﻪﺩ ﻏړﻱﭘﺍﻮﻝ ﻮ ﻠ
ﻴژﻢﭘ Trﺭﻳ iplﻮ کېe ﻧﺎﻭﻏ ﺭ
ﺎﻧ
٩
ﻭ.
١ﻱ ٠×٠ ،
٥-٠
،ﺮکې٣ ﺘﻴ
ﻟﻮ ﻪﻳ ﻪﭘ ﻳﺩCD4ﮐﭽ ﻣﻦځﻭﻱﺎ ﺮ١ﺗ٠٠٠٠ﺍ٠
٥ﻭ ٠٠٠
ﺮکې٠ ﺘﻴﻟ
ړﺎ
ﻴﺗﺍﺗﻳﺩCD4ﮐﭻې ﻪ ﻭﺎ ﺷﺭﻮﺍ
ﻟﻮ ﻢﺭ ﻧ
ﻮﺮﺳ ﻳﺍﻱﻮﺩﻭ ړﻧ ﺍک ﺪﻴ
Hګﻞېﭘ
Iﻳ ﻭﻍﺩV ﺭﺎﻡﻧﻮ ﺭېﮐ ﺭﻪچ ﮐ
ﺷ.
ﻪﭖﻝﻝ ﻲ ﻨﻠﻣﺭﺪﺩ ﻳﺎﻪﺑ ﺘ
ﻧﺸ
:ﻪ
ﻳﺎﻗﻪﻭﺘﻭﺳ ﺭڅﻪﻭﺎﺱ ﺧ ﻤېﻪﺗﺘﮏ ﻟ ﻮﺳ ﭘ
ﺩ
ﻧﺲ ﺎ
%٠ﭼ ،
ﺩ٣ ږږﺎﻥﺩﻝ ﺘﻧﭘېﻭﺧﺖ کېﺩﺍ ﻮﺪ ﺍﺷﻲﻧ ﺎﺱﺭ ﻤﻪﺗﻩﭘﺮﺘﮏېﺳ ﻮﺳ ﻭﻍﭘ ﺭﺎ
HIﻧ ﻪﺩV ﮐ
ﻩﺮﺑ
ﺍﺮ
١ﺑ ٦-
ﺩﻝﻱې٥ ﺩﻮ ﭖښښ ﻮﻱﻭﻱﻧ ﻩﺷ ﺮ ﺮﺳ ﻩﺗ ﺮﻮﺳ ﻧﻮﻤﻭﺯﺧ ﺭﻭﻪژ ﺎﺱﻟ ﻤﻪﺗ ﻭﮐ ﻮﻥﻭﻱﺍ ﺘﺷ
ېﺣﻝ
ﺍﺱ ﺎ ﺪﻭ،ﭘ
ﻮﻯ ﻱ ﻩﺷ ﺮﺮﺳ ﻪﺗﺍﺳﻄ ﻪﻭ ﻮﭘ ﻨﺘﻭﺳ ړﮐﮏ ﺎﺱﺩ ﻤﻪﺗډﻝﮐ ﻪﻭ .ﺩﺏﻝﻝګېﭘ ږﻱﺎﺕږ ﻳﺯ
ﻪﻪﮐﭽ ﺗﺎ
ﻳېﻪﺯﻭ،چ ﭘﺍﻏﻞې ﻱ ﺎﺱکېﺭ ﻤﻪﺗ ﻩﭘ ﺮﻳﻦېﺳ ﻪﻭ ﻮﻟﻧﺎ
ﻭﻏﺭﺎﺍﺱېﻧ ﺘﻦېﺩﺩ ېﺍﺳکېچ ﺩ
.ﻮﻱﻮﻯﮐ ﻴﻨ%٨ﻣﺨ ﻪ٠ ﻨ
ﻠﻣﺭډﻝﺩﺯې ﻭ ﺍﻮﻪﻳﻩﭘ ﺮZiﺳ dovudi ﺎﻥne .ﺍﮐﺴ ﺮﻱﺩ ﻟﻪﻭ ﻧﻮﺮﺳ ﻳﺍ
ﻭ
ﻠﻦېﻣﺭﺩېګﻥېﺩ
؛ﻮ ﺭ ﻭ ﺍﺷﻲﻧ ﺎﺱکېﺭ ﻤ
ېﻪﺗﺘﮏ ﭘ ﻮﺳ ﭘﻩﺩﺮﺎﻥﺳ ﺘﻧ
ﻡﺍ ﻮﻠﻌﻪﻣ ﻡﮐﺲﻟ ﻮﺭېﮐ ﺭﻪچ ﮐ
ﻭﻥۍﺍ ېڅﺭﺍ
ﻮﻩﻱ ﻟ ﺩﻮ ﻮﻣ ﻟﻭﺭ
ﺎ،چېﺩﮐ ﺮﻱړﺎﻟ
ﻴ ﺗﺍﺗ(ﻪ indinav i
r+Lami vudi ne+Zi dov udi )ne
.
ﺷﺩﻩ
ټﻞ ﻮﺩ ﮐ
ﻩکې ﺩﻮﻪﻣ ﻮﭘ ﺘ
ﺎﻋﻭﺳ ﻭ ﺎﺩﺎﻋﺖﻳ ﻩﺳ ﻮ ﻳﻩﺩﺭ ﺗژ
ﺭﺮ ﻪژ ﺘﻭﺳ ﺭ
څﻪﻭﺎﺱ ﺧ ﻤﻪﺗﻟﺪ ﻳﺎﻪﺑ ﻭﺳ ﺮﻮﻱﭘ ﻳﺎﻗﺍﻭﺩ
ﺷ.
ﺘﻞ ﻲ ﻴﺴ ﺍﺧﻮﻥېﻭ ﻤ ﻩﻧﺭﺎ
ﭙﻟ ﻮﺗﺎﻨﻳﺎ
ﻌﻣHIﺩ ېڅﻪﻣﺨﮏېﺩV ﻠﻦ ﺧ ﻣﺭﻪﺩ ﻟﻭ ﺍﻴﻞﺷﻲ ﭘ
ېﻭ
ﺭﺍ ﻮﻮﻱﻣﺸ ﻔﻴﺍﺷﻲﻭﻇ ﺮﺍﺟﻪﺘﻭﺳ ﺭﺎﺷﺖېﻭ ﻴږﻣ څﻪﺷﭗ ﺎﺱ ﺧ ﻤﻪﺩﺗ ﻨﻳ
ﺎﻌﺎﻃﻲﻣ ﻴﺘﺍﺣ ﻩﺭﻥګ ﺍ
ﺪﻤﻫ
ﺩ.
ړﻦ ﻱ ﺍﻳ ﻭﻝ ﺭﺎ
ﻴﻠﻦېﺗ ﻣﺭﺩﺩ
:
ﻪﻧﻮﻴﻨﺮﻭﺧﺖﻣﺨ ﻤﻞﭘ ﻭکېﺩﺣ ﻪ ښځ ﺘ ﺍﺧ HI ﻪV ﭘ
ېﺍ
،چ ﺩ ږﻱ
ﻪﮐﻢږ ﺍﺳﻄ ﻪﻭ ﻮﭘ ﻧﻭﺮﻴﺑ
ﺪﺩځﻮﺗﻨ
ﺩﻝ ﻳ ﺮﺩ ﭙHIﺧ ﻪﺩV ﻮﺗ ﻧﺎ
ﻣ ﻮﺎﺷﻪﻧﺲ کېﻣ ﻭﭘ ﺪﻨﻴﻣ
ﺩ
:ﻪﻟﺭﺕﺩﻱ ﺎ
ﺒﺮﻋ ﻴﺑ
ﺍﺪﺗ
ﻣﻞﺭﺪﺩ Retﺿ r
ov i
rﻪﺩal ﻡﺗﻮﺎﺷﻭﻣ ﺭﺍﻮ ،ﻣږﻱﻮﻝکږ ﮐ ﺭ
ﻴﺢﻭ ﺮﺟ(ﻪﺗCaesarﺗ ﺯږﻥ)ean ﻡ ﻱﻭ ﺍ
ﺭﺁ
ﺭېﻮﺮﻭﺧﺖﭘ ﺯږﻥﺗ
ﻭﺩ ﻱﻭ ﺍﻭﻉﺷﻲ ﺮﺭۍکېﺷ ﺍﻭﺪﻴﻣﺍﻭﻥۍﺩ ﺍ١ﻟﻰ٤ ﺍ١ﺪ٢ ﻳﺎ
ﻪﺑ ﻨﻠﻣﺭ .ﺩﻮﻝ ﻪﮐ ﻴﻮﺻ ﺗ
ﺷ.
ﻮﻝ ﻲ ﮐﺭﻡﻭ ﺍﻭ
ﺩ
.ږﻱښﻪکږ ﻨ
ﺭﺗ ﺎﭙ(ﺳ ﻩﺭﺎﭙ
ﻟﻮﻴﻧﻭﺍ ﺩې
ﺩﺭ )Zi dov udiﻪne ﺘﻭﺳﺭ څﻪﻭﻭ ﺧ ﺩ ﺩږﻪﺩﺯﻱ ﻡﺗ ﻮﺎﺷﻣ
:ﻪﻧﻮﻴﻨ
ﻪﻣﺨ ﺘﻭﺳﺭﻟﻲﻭ ﺍ
ﻭﻭﺩږﻨﺴﻲﻥ ﻩﺩﺟ ﺮﻪﮐﺲﺳ ﺘHIﺍﺧ ﻪV ﭘ
.
ﻪﺘﺮﻧﺸ ﻴﺑ
ﺪﻮﻥېﺗ ﻴﻨ
ﻣﺨ ﺭېﺩ ﻮﻩﭘ ړﭘﺯﻪﻪ ﺘﻭﺳ ﺭﺎﺱﻭ ﻤﻨﺴﻲﺗ ﺮﺟ ﻩﺗ ﺮﻪﮐﺲﺳ ﺘ ﺍﺧ HI ﻪV ﭘ
:
ﻪ ﻧ
ﺭ ﺍ
ﻭڅ ﺍﻮﻯ ﻴﻨﻣﺨ
ﻩېﻮﻳﻲﭘ ﺎ
ﻴﺘﻭﻏﻪﺭ ﺍﺧﺮﺩ.ﺩﭘﻭﻝ ﻱ ﺭﺎ(ﮐ ﺎڼۍ)Condom ﮐﻮﭘﻪﺩﻧړﻪک ﻨﻣﺰﻴﺭﻥېﺍﻏ ﺍ
ېﻭڅ ﻮﻥ ﺍ ﻴﻨﻣﺨﺩ
.ﻠﻰﺍﻏﻪﺭﺗﻟﻰﻣﻦځ ﺍﺎﺕېﻭ ﻮﻱکېﭘ ﻴﻨ
ﻪﻣﺨ ﺩﻮﭘﻟ
ﺮﺩ ﭙHIﺩﺧ ﻮکېV ﻧﺍﺭﺎ
ﮐﺎﻧﻪﺯ ﺎﻫﻢﭘ ﻴﻩﺑﺮﻩﺳ ﺮﺳ
ﻩﻣﺦﺩﻱ ﺮ
ﺮﺳ ﻡﺧﻄ ﻮﻪﮐ ﻟﻭﻯ،چېﺩ ﻩﺎﺩﻴﺗﺭﺍﻧګﻮﺎ ﻧﺍ
ﺭﺎﮐﺎ
ﻧﻪﺩﺯ ﻠﮑﻪﻫځﻥﭘﻻﻞﺩﺍ ﻩﻣ ﺭﻮ ﻟﻲﻏ ﺍ
ﺎﺕېﻭ ﭘ
ﺩ
.ﻮﻱﮐﺭﻡﻭ ﺍﻭﻪﺩﻤﻞﺗ ﺪﻋ ﭙﻞﺑ ﻱﻭﺧ ﻩګڼ ﺍ ﺮﺒﺎﺧ ځﻥﻧﺍ
ﻮﻱﻴﻨ
ﻣﺨ HIﺩ .ﺩV ﻮﻱﻪﮐ ﺗ
ﻣﻦځ ﺍﻩﮐﻢښﺕﺭ ﺭﻮ ﺩﻭ کېﻏ ﺮﺩﭙﻪﺧ HIﭘ ﻪﺩV ﻨ
ﻠﻣ ﺭﻮﺩ ﻧﻮﻤﻨﻲﺯﺧ ﺒﻐﻣ
ﺩ
.ږﻱ
ﺭﺱږ ﻪﻭ ﺗﺮ
ﺎﺕﺳ ﻨﻳﺎ
ﻌﻩﻣ ﺭﻮﻮﭘ ﮑﻠ
ﻮﺧ ﮑﻧ
ﻭﻮﮐﺭﻳﻦېﻭ ﻭﺪﺩ ﻳﺎ،چېﺑ ﻩﺩﺍﻩﺩ ﺭﻮ ﻪﻏﻠﺑ
155
ﻭﻍۍ
ﺭﺎﻧﻲﻧ
ﺎﺘ
ﻧﺍ
ﻴﮏېﺗ
ﺎﻤﺘ
ﻴﺴﺪ ښېﺳ ﻳﺎ
ﻭﻪﺑ
ﻭﺗ ﻧﮏﻭﻮﻟ
ﺎﻤﻌﺘﻮﺍﺳ ﻠ
ﻣﺭﻩﺩﻧړ
ﻭﺪﻱﺎ ﻳ
ﺭﻭﺷ.ﺩ
ﺍﻝ ﻲﺪﻭڅﺭ ﻳﺎﻪﺑﻟﺩ
ﺎﺒ
ﻮﺗ ﻨ
ﺘﺩﺳ
ﺷ.
ړې ﻲ ﻮﻭﻥېﺟ ﻭﺭښ ﻻ
ﻮﺥﺩېﻣ
ﻭﺩ ﻪﻭﺷﻲﺍﻧﺭﺍ
ﻮڅ ﻧ
ﺎﻣﻮ
ﺎﺷﺪﺩﻣ ﻳﺎ
ﻭکېﺑ ﻪﺧﻲټ ﻭﭘﺪﻨﻴﺯږﻥﻣﺨﮏېﺩﻣﻩﺮ ﻱﻭ ﺭﻥګﺗ ﺍ
ﺪﻤﻫ
.ږﻱ
ﺭﺱږ ﻪﻭﺗ
ﺮﺪﺳ ﻳﺎﺎﺕﺑﻨﻳ
ﺎﻌﻭﻣﻭ ښځ ﺭ
ﺍﻭﺪﻴﻣﺍﻮﻟ
ﻭﻩﺩټ ﺭﺎ
ﭙﻟې
HIﭙﻞﺩVﺷ،چېﺧﻭڅﻝ ﻲ
ﺪ ﻩﻭ ﻳﺎ
ﻣﺦﺩﻱﺑ ﺎﻩﻣﺨﺮﺮﺳ Hﻪﺧﻄ Iﻟ ﭘګﻥۍچېﺩV ﻪﺮ ﻐﻩﻫﺭﻥګ ﺍ
ﺪﻤﻫ
ﻪﺮﻻﺳﺎﺕﺗﻣﻮ
ﻠﻌﺪﻣﻳ
ﺎﻪﺑ
ﻠﮑﻪﻫځﻥﭘ
ﻮﻝﺷﻲچېﺩﺍ ﻮﻫﭘﻭﻯﻭ ﻭﺩﻮﻱﺍ ﺭﺳﻪﻭﺗﺮ
ﺎﺕﺳ ﻨﻳﺎ
ﻌټﻝﻣﺪ، ﻧﻭړ
ﺍ
.
ﻠﻲﺍﺧﻩﻭﻭډ
ﻩﻥ ﺩﺎﻌ
ﻟﺍﻮﻕﺪﻓﻳﺎ
ﻪکېﺑ ﻧ
ﺭﺍ
ﻭڅ ﺍﻮﻱ ﻴﻨ
ﻪﻣﺨ ﺎﻥﭘﺘﻧ
ﺍﻧﮏېکېﺩ ﻮ ﻠ
ﺗﺍ
ﻪﺭﻱﻭﭘړﺍ ک
:
ږﻱﺭﺱږ ﻪﻭ ﺗ
ﺮﺪﺳ ﻳ
ﺎړﻥېﺑﻧېکﻩﻻﺪ ﺭﺎ
ﭙﻟﻮﻱﻴﻨﻣﺨHIﺩﺩV
ﺷ.
ﻭﻝ ﻲ ﺭﺎﮐ
ﻩﻭ ﺭ
ﺎﭙﻟﺑﺖﺭﺎ
ﻘﻨﺴﻲﻣ ﻡﺩېﺩﺟ ﺪ
ﻧﺎ .ﮐ1
ﺷ.
ﻩ ﻲ ﺮﺮﺳﺪﺗﻳﺎﺎﺕﺑﻨﻳﺎ
ﻌټﻝﻣﺪ ﻭ ﻧ
ﻭړﺍﺭېﻮﻳﻦېﭘﻪﻭ .ﭘ 2
ﺷ.
ﺩ ﻲ ﻭﺪﺩﻳﺎ
ﻴﮏﺑ ﻨ
ﻮﺗﺨ ﻟ
ﻮﻟ
ﺪﻮﺩﺑ ﻨ
ﺘ .ﺩﺳ 3
ﺷ.
ﻩ ﻲ ﺮ
ﺮﺳ ﺪﺗﻳﺎﺎﺕﺑﻨﻳ
ﺎﻌټﻝﻣﻭ ﻭ ﺪﻨﻴ
ﻭﻣ ﺭﺍ
ﻭﺪﻴﻣ
ﺍﺯږﻥﻣﺦېﺩﺮ ﻱﻭ .ﺗ 4
ﻭﺩﺪﻝڅ ﻳ
ﺮﺎﺿﻩﺣﻮښ ﻪﺧ ﻠ
ﭙﻪﺧﻮﻯﭘ ﻐﻣﺦﺩﻱﺩﻫ ﺎﻩﻣﺨ ﺮﺮﺳ HﻪﺧﻄIﻟ ﺎﻥچېﺩV ﻪﮐﺴﻐ .ﻫ 5
ﺷ.
ﺍ ﻲ ﺮﺍﺟﭘې
ﺎﺕﺮ ﻨﻳﺎ
ﻌﺪﻣ ﻧ
ﻭړﺍHIV
.ﻪ
ﻨﻠﻣﺭﻮﻯﺩ ﻐ
ﻭﺩﻫ ﺍﻪﻧ
ﺭﺍ
ﻮڅ ﻧﻮﻤ
ﻨﻲﺯﺧ ﺒﻐﻣ .ﺩ6
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