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CHAPTER-42 Powered By Docstoc
					                                       O 4O
                           uef'j:yf vg[ A,)u]|5
uef'j:yf vg[ A,)u]|5
;dfhdf\ v[s v[jm ei k[ s[ dftfg]\ s[ L5tfg]\ A,)u|]5 hf[ g[u[L*j cmi tm ;fdfGitO tdg[ 5}zf
dLcg[ af/s g yfi$ vyjf tm s;]jfj) y. hfip j/l sm. tm v[j]\ 56 dfg[ k[ s[ v[g[ ,lw[ tdg[ af/s wfz6
szjfdf\ ts,lo 5)[ k[p vfd hifz[ A,)u|]5 g[u[L*j cmi Tifz[ ac[gmg[ dfgL;s Lr\tf ac] zc[tl cmi
k[p tm vfjm ac[gm$ ;z/ efqfdf\ t[gf Ljx[ #*O:om* szlv[p

;f{yl 5c[,f\ hf[.v[ s[ A,)u|]5 v[*,[ x]\ M

A,)u|]5 4 hftgf\ cmi k[p
S1F A (Group ) u|]5 $ SzF B (Group ) u|]5 $S3F B (Group ) u|]5 $ S4F A
B(Group ) u|]5
    vfg[ “ ABO (Group ) u|]5 sc[jfip

;fy[ ;fy[ alh]\ A,)u|]5 cmi k[ h[g[ Rh- Positive vg[ Rh-negetiv System sc[jfi k[p

hGdyl 9- *sf JiLstvm Rh Positive S 5mLH*ljF cmi k[ $hifz[ z- *sf JiLstvm Rh –netive
Sg[u[L*jF cmi k[p

ABO (Group )u|]5df\ 5LtV5Tgl sm.56 u|]5gf cmi tm v[gl v;z uef'j:yffg[ sm. d]Xs[,l 5)tl
gylp wfzm s[ 5Lt “A” u|]5gf cmi vg[ 5Tgl “B” u|]5gf cmi tm vfjgfz af/sg[ sm. ts,lo 5)tl gylp
df*[ t[gf Ljx[ vf56[ rrf' gcl\ szlv[p

cj[ h[ alÒ :l:*d k[ v[*,[ s[ Rh-L;:*d $ t[gf Ljx[ ym)l rrf' szlv[p

S1F hf[ 5Lt Rh-5mLH*lj cmi vg[ 5Tgl 56 Rh-5mLH*lj cmi tm Losz szjfgl h~z gylp

SzF hf[ 5Lt Rh-g[u[*lj cmi vg[ 5Tgl 56 Rh-g[u[*lj cmi tm Losz szjfgl h~z gylp

S3F hf[ 5Lt Rh-g[u[*lj cmi vg[ 5Tgl 56 Rh-5mLH*lj cmi tm Losz szjfgl h~z gylp

tm Losz sifz[ szjl M

hf[ 5Lt Rh-5mLH*lj cmi vg[ 5Tgl Rh-g[u[*lj cmi Tifz[ Losz szjlp

vf P5zyl tdg[ v[*,l ;dh6 5)x[ s[ 5Tgl Rh-g[u[*lj cmi Tifz[ A,)Vu|]5gl hf6 cmjl h~zl k[p

cj[ td[ 5}kxm s[ sif sfz6m;z ts,lom yfiM
5Tgl Rh-g[u[*lj k[p

5Lt Rh-5mLH*lj k[p

vfjgfz af/s Rh-g[u[*lj 56 vfj[ vg[ vfjgfz af/s Rh-5mLH*lj 56 vfj[p hf[ af/s Rh-g[u[*lj vfj[
tm sm. ts,lo gylp

5z\t] hf[ vfjgfz af/s Rh-5mLH*lj cmi tm af/sg]\ ,mcl dfgf xzlzdf\ hfi vg[ df Antibody
Sv[G*lam)lF PT5GGf sz[ k[ vf v[G*lam)l vfjgfz af/sg[ sx]\ g]sxfg g sz[ v[*,[ s[ af/s
azfaz hGd[$ 5z\t] vf af/s[ dfgf ,mcldf\ v[G*lam)l oztf sif'p vf v[G*lam)l dftf hifz[
alÒjfzgl 5|[UgG;l wfz6 sz[ vg[ t[ af/s Rh-5mLH*lj cmi tm vf v[G*lam)l ue':y Lxx]gf\
zsts6mg[ tm)l gfbx[ vg[ vfjgfz af/sg[ ym)l ts,lo Plel sz[$ h[g]\ 5|df6 dftfgf\ ,mcldf\ oztf
v[G*lam)lgf 5|df6;z zc[x[p

cj[ hf[[ Rh-g[u[*lj dftfg[ s;]jfj)m yfi tm vf56g[ baz gyl s[ ue' Rh-5mLH*lj ctm s[ Rh-
g[u[*lj p df*[ vfjl dftfvmg[ hifz[ hifz[ s;]jfj)m yfi Tifz[ t[g[ >Gh[sxgm vf5jfdf\ vfj[ k[p t[g[
“v[LG*V)lVU,mAi]L,g” sc[ k[p vfj]\ >Gh[sxg dftfgf xzlzdf\ agtf Rh- v[G*lam)lgm gfx
sz[ k[p

ac[gm$ vfgf P5zyl td[ v[*,]\ hf^i]\ s[ hf[ Rh-g[u[*lj cmi vg[ L5tf Rh-5mLH*lj cmi tm
5c[,l 5|[UgG;ldf\ sm. h )z zc[tm gylp

alÒ jbtgl 5|[UgG;l jbt[ 56 hf[ 5c[,]\ af/s Rh-g[u[*lj cmi tm 56 sm. h )z zc[tm gylpsfz6
s[ vfjgfz af/s jbt[ dftfgf xzlzdf\ v[G*lam)lH ag[,f zc[tf gylp

5z\t] hf[ 5c[,]\ af/s Rh-5mLH*lj cmi tm alÒ jbtgl 5|[UgG;ldf\ #6]\ h Wifg zfbj]\ 5)[ k[p
vyjf tm 5c[,l jbt s;]jfj) y. u. cmi vg[ .Gh[sxg g ,lw]\ cmi tm 56 alÒ jbtgl 5|[UgG;ldf\ Wifg
zfbj]\ 5)[ k[p

cj[ vf56[ hf[.v[ s[ vfjgfz af/s P5z xl ts,lo y. xs[ k[M

vfjgfz af/s P5zgl ts,log]\ 5|df6 dftfgf\ ,mcldf\ oztf v[G*lam)lH s[*,f k[ t[gf P5z vfwfz
zfb[ k[p vfjgfz Lxx] v[g[Lds cm. xs[p vyjf tm sd/m s[ sd/l ;fy[ t[gm hGd yfip cj[ hf[
v[G*lam)lHg]\ 5|df6 dftfdf\ #6]\ jwfz[ cmi tm sm. jbt dftfgf 5[*df\ h af/sg]\ d"Ti yfi k[p

ac[gm$ jf\rlg[ uezfxm gcl\p sfz6 s[ ;f{yl 5c[,f s], ;uef' :=lvmdf\yl ost 1- *sf ;uef'j:yfdf\
Rh-5mLH*lj af/s ag[ k[p

vg[ vf 5|Ls|ifg[ ,lw[ af/sg[ v;z yjgl xsitf #6l h vmkl k[p ,uei 4--V5-- 5|[UgG;ldf\yl v[sg[
v;z yfi k[$ h[ vf ;fiG;gf hdfgfdf\ v*sfjl xsfi k[p

tm rf,m$ cj[ hf[.v[ s[ dftfgf\ ,mcldf\ oztf Rh- v[G*lam)lHg[ s[jl zlt[ v*sfjl xsfi k[M vg[ hf[
oztf cmi tm t[gl *+l*d[G* xlM

   (I)    hifz[ 56 Rh-g[u[*lj dftfgl L)L,jzl yfi Tifz[ hGd[, af/sg]\ u|]5 hf6j]\ h~zl k[p t[gf
          df*[ af/sgl g;df\yl ,mcl gyl ,[tf$ 5z\t] vm)g[ rm\*[, gfi)fdf\yl tzt h A,) ,. ,[jfg]\p
          hf[ af/sg]\ u|]5 Rh-g[u[*lj cmi tm dftfg[ sxl ts,lo gyl t[dh af/sg[ 56 sxl ts,lo
          gylp
             hf[ af/sg]\ u|]5 Rh-5mLH*lj cmi tm dftfg[ “v[LG*V)lVU,mAi]L,g 35- mg
             SLd,lu|fdF” gfdg]\ .Gh[sxg L)L,jzl 5kl ,ueu 8z s,fsgl v\nz vf5j]\ hf[.v[p h[yl
             dftfgf xzlzdf\ oztf v[G*lam)lH vf .Gh[sxgyl vmkf yjf df\)[ vg[ t[g[ ,lw[ alhf ue'
             jbt[ t[ af/sg[ g]sxfg vmk]\ yfi k[p

     (II)     hf[ Rh-g[u[*lj dftfg[ s;]jfj)m yfi tm 56 vf .Gh[sxg vf5j]\ Lctfjc k[$ 5z\t] t[gm
              )mH ym)m vmkm vf5jmp

     (III)    vfjl dftf hifz[ alÒ jbt ue' wfz6 sz[ Tifz[ uef'j:yfgf 8V9V0 dLcgf jbt[ dftfgf
              ,mclgl t5f; szfjjl p t[g[ “ Rh- v[G*lam)l *f.*z “ sc[ k[p vg[ t[gf P5zyl gssl szj]\
              s[ dftfgl 5|[UgG;l jbt[ P5zgf\ .Gh[sxg h]nf h]nf )mHdf\ vf5jfyl gjf vfjgfz
              af/sg[ ts,lom vmkl y. xs[ k[p

   SIVF[        P5z h6fj[, t5f;df\ hf[ Titer S *f>*zF jwt]\ cmi tm #6l jbt af/sg]\ ,mcl vfb]\
              an,j]\ 5)[ k[p hifz[ af/s dfgf 5[*df\ cmi Tifz[ h S h[ ch] vf56[ Tif\ ac] agl xst]\
              gylF$ gcl\ tm 5kl dftfg[ jc[,l ;]jfj) szfjl n[jfyl af/s P5z jwfz[ v;z ytl zmsl xsfip

   SVF[   hGd[, af/sdf\ hf[ sd/fg]\ 5|df6 jwfz[ cmi tm t[gl imUi ;fzjfz szjfjl 5)[ vg[ ktf\
         56 t[ sd/m jwtm hfi tm af/sg]\ vfb]\ ,mcl an,l gfbj]\ 5)[ k[p t[g[ “v[s;r[.Gh
         *+fG;oi]Hg” sc[ k[p hf[ sd/fg]\ 5|df6 jwfz[ cmi tm af/sgf duh 5z t[gl v;z yfi
         k[ vg[ vf\rsl vfjjfgl x~vft yfi p
   SVIF[   hifz[ dftfv[ 5c[,l L)L,jzl ufd)fdf\ s[ #z[ szl cmi vg[ af/sgf\ A,) u|]5gl baz gf
         cmi vyjf tm t[vmv[ .Gh[sxg g ,lw]\ cmi tm t[jl dftfg[ 5|[UgG;l jbt[ vf .Gh[sxg
         vf5l n[j]\ Lctfjc k[p

df*[ ac[gm ¦ Rh-.GsmD5[L*LaL,*lHg[ sfz6[ af/s P5z h]nf h]nf 5|df6df\ vf) v;z y. xs[
k[p sm.s jbt[ ue'df\ h af/sg]\ d"Ti] 56 y. xs[ k[p 5z\t] t[gfyl uezfjjfgl h~z gylp ;uef'j:yfdf\
hf[ td[ tdfzf )ms*zg[ LgiLdt zlt[ atfjtf zcm vg[ t[ sc[ t[ 5|df6[ ;fzjfz szfjjfyl t[dh t[gl ;fy[
jftf',f5 szjfyl tdfzl #6l x\sfVs]x\sf n}z yfi k[ vg[ td[ v[s :j:y af/sg[ hGd vf5l xsm kmp

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posted:11/17/2011
language:Finnish
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