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がん治療関連心機能障害の診療における心エコー図検査の手引き 第3版(2026) 日本心エコー図学会・2026・43 ページ · 心エコー・画像・検査 · 腫瘍・緩和ケア
p.1
 

঳ಹ঺੮১য ঩মੱ ग़॥ش௕৾ ভ

ऋ॒ ੘௜ঢ়৴ੱ ਃચ௽૩भ൧௜पउऐॊੱ ग़॥ش௕ਫ਼ਪभু ਬ

෋ൿ঻ق෋ൿದكૣ

ি ર৕ ௗಛ਩য়ऋ॒ ७থॱش ৛ি ೗፶ ೉ਣপ৾  িরೢ ਮ ઋૺ প৾  ૝૊ ཪ੶৕ ದଠൡপ৾  ௳ম ੸୙ ଠ৶े ौतৼ୥ਚ୰੹ প୅ ෎୏ূ ਎੓৕ୢ ఐপ৾ ౣ

ૐ

঳ಹ঺੮১য঩মੱ ग़॥ش௕৾ ভੱ

ग़॥ش௕फ़ॖ ॻছॖ থ੿ਛ੻৩ভ

ਗ৖௬੼঻

ি⁕ ঳৥ ਣஉপ৾  நఈ ൞౓ূ ਎ঋॖ ؞ఓ਍৘ਆୢ ௜७থॱش

ਗ৖ਪഭ

঳ಹ঺੮১য঩মᇯᯂ࿯୭ஓ৾ ভ

फ़ॖ ॻছॖ থ੿ਛ੻৩ভ
p.2


 ৯ઃ

ਸ਼, ฆ ऋ॒ ੘௜ঢ়৴ੱ ਃ௽૩؟੕૛ قڭك ੝ၖभూବ       3 قڮك ऋ॒ ੘௜ঢ়৴ੱ ਃચ௽૩पउऐॊ৷ୁ भ৒ଝ   3 قگك &75&' भ൧૵੦૆ध੎ඪ২ীథ     3 قڰك &75&' भᄄ২؞੒৏धଫ਋൧૵भਔଝ    3 قڱك &75&' भজ५ॡಽશ৲धঐॿش४ওথॺ    3 ਸ਼,, ฆ &75&' भ൧૵ قڭك ग़॥ش௕ਫ਼ਪ       3 

L ం஼ઽೠચ      3 LL ం஼ఁ୑ચ      3 LLL క஼ਃચधཡ৿ဿಓ     3 قڮك जभ౎भॖ ওش४থॢ       3

L ටறୢ৾ قੱ ൙३থॳॢ ছইॕ شك   3 LL ට05,       3 ਸ਼,,, ฆ ऋ॒ ఇ੟௜১॑ ষअ೩঻पৌघॊੱ ग़॥ش௕ਫ਼ਪभউটॺ॥شঝ قڭك ऋ॒ ఇ੟௜১৐भੱ ग़॥ش௕ਫ਼ਪ     3 قڮك ऋ॒ ఇ੟௜১রभੱ ग़॥ش௕ਫ਼ਪ     3

L ইज़টش॔ ॵউभᄄ২ध਋৑    3 LL ਫ਼ਪඨ৯       3 قگكऋ॒ ఇ੟௜১ીവ৏भੱ ग़॥ش௕ਫ਼ਪ

L ইज़টش॔ ॵউभᄄ২ध਋৑    3 LL ਫ਼ਪඨ৯       3 ਸ਼,9 ฆ ඊႵॳख़ॵॡএॖ থॺ༛૩ఇपे ॊੱ ഷଵ௽૩ قڭك ੕૛        3 قڮك ,&,V ঢ়৴ੱ ൙༇भੱ ग़॥ش௕ਚৄ      3 قگك ,&,V ঢ়৴ੱ ൙༇भ൧૵੦૆     3 قڰك ग़॥ش௕ਫ਼ਪध౎ঔॲজॸॕ धभଁ় ৓௬੼   3 قڱك ,&,V ঢ়৴ੱ ൙༇भ੘௜      3 ਸ਼9 ฆ ऋ॒ ੘௜पൣ अजभ౎भ় ಡඪŒੱ ग़॥شपे ॊ௬੼धৌૢ  قڭك ཡৈഷಓඪ       3 قڮك ञऒणऻඪ౜ණ       3
p.3


 ਸ਼9, ฆ ଣೝ଍੘௜৏भੱ ഷଵႈ೩

قڭك ੕૛        3 قڮك ૚૛        3

L Ⴭႈ೩       3 LL ൙௽૩       3 LLL ఉჍඪ       3 LY ་৿ဿႈ೩      3 قگك ଣೝ଍੘௜৏भইज़টش॔ ॵউ     3 ਸ਼9,, ฆੱ ग़॥ش௕ੑ ೾पउऐॊৰಏ෫঱भି ਔਡ قڭك ᇯᯂ࿯୭ஓ৾ भਤனधੱ ग़॥ش௕भ૽ સ    3 قڮك &75&' भঔॽॱজথॢ ੐ఏधಖ২ଵ৶भ੎ਏਙ   3 قگك ग़॥شಖ২ଵ৶भञीभதఠణਫ਼ਪ஼पउऐॊ৳ஹधઇ୘ 3 قڰك ग़॥ش௕ਫ਼ਪपउऐॊ೏ਔਡ     3

L ৐৚ੑ ೾க؞ঋش५ছॖ থੑ ೾கभનੳ   3 LL ৊गਫ਼঻पे ॊੑ ೾     3 LLL ৊गਃஓपे ॊੑ ೾     3 LY ೾கभ༜ਊਙपणःथभનੳ    3 قڱك যੵ ੴચقDUWLILFLDOLQWHOOLJHQFH$,كभણ৷   3 قڲك گ'ੱ ग़॥ش௕भણ৷      3 قڳك ग़॥ش஼ઈ੾ிભ঻      3

૞અધ൴        3  
p.4


 ਸ਼⋛ฆ ऋ॒ ੘௜ঢ়৴ੱ ൙௽૩؟੕૛

قڭك੝ၖभూବ

঩মੱ ग़॥ش௕৾ ভदम ফपَಿ ऋ॒ ද੘௜ঢ়৴ੱ ൙௽૩भ൧௜पउऐॊੱ ग़॥ش௕ਫ਼

ਪभু ਬُ॑ ੿ਛखञق ফਸ਼ ග ਰৣَু ਬُ ك؛जभ৏ؚ  ফप(6&ق(XURSHDQ6RFLHW\ RI&DUGLRORJ\ ௎ପੱ ට୰৾ ভكऋ(+$ق(XURSHDQ+HPDWRORJ\$VVRFLDWLRQ ௎ପഷั৾ ভكؚ(6752 ق(XURSHDQ 6RFLHW\ IRU 7KHUDSHXWLF 5DGLRORJ\ DQG 2QFRORJ\ ௎ପଣೝ଍ᇯᯂ৾ ভكؚ ,&26 ق,QWHUQDWLRQDO&DUGLR2QFRORJ\6RFLHW\ ব੠ᇯᯂ࿯୭ஓ৾ ভكध় ৊द  ফप঩মᇯᯂ࿯୭ ஓ৾ ভध঩মಏ෫ᇯᯂ৾ ভऋ় ৊द ᇯᯂ࿯୭ஓफ़ॖ ॻছॖ থ॑ ৅໷खञ؛औै पؚ ,&,ق,PPXQH FKHFNSRLQWLQKLELWRU ඊႵॳख़ॵॡএॖ থॺ༛૩දكऩनभৗखःऋ॒ ఇ੟௜১॑ அिঞ४ওথऋఃৃ खؚੱ ൙༇ऩनभৗञऩ୰ଙ॑ ৽ୡघॊਃভऋ૶ੜखथःॊ؛ऒभे अऩ૾ யৣ पउःथੱ ग़॥ش௕ਫ਼ ਪम૗ॎै ङؚੱ ൙௽૩भਫ਼লपउःथ।شॺय़شঃشभ૽ સ॑ ટञघశଞप੎ਏऩॶشঝदँ ॉؚ ऒ भञलু ਬ॑ ੝ၖघॊऒधधऩढञ؛ऩउমഺभ2QFRFDUGLRORJ\ फ़ॖ ॻছॖ থपउऐॊ&75&' قFDQFHUWKHUDS\UHODWHGFDUGLDFG\VIXQFWLRQك਀੶प૆गथ ਬभ਀਻َ॑ ऋ॒ ੘௜ঢ়৴ੱ ਃચ ௽૩भ൧௜पउऐॊੱ ग़॥ش௕ਫ਼ਪभু ਬُ ध૗ಌखञ؛ قڮكऋ॒ ੘௜ঢ়৴ੱ ਃચ௽૩पउऐॊ৷ୁ भ৒ଝ &75&' मؚੱ ग़॥ش௕୩ୠदम॔ থॺছ१ॖ ॡজথ௺ఇදؚಿ +(5ಿ ৬ఇपे ॊਛযभఇදਙੱ ൙௽ ૩ق໚ऋؚ॒ பਙজথঃᇯؚ ঳৖भஜഷ୰ؚ ෿ᇯऩनभఇ੟௜১॑ ਭऐञ೩঻ك॑ৌ଴धखथ*/6ق*OREDO ORQJLWXGLQDO VWUDLQكपे ॊ&75&' ଫ਋൧૵भग़অॹথ५ऋનয়औोञ৽༬ऩनऊैؚ FDQFHU WKHUDSHXWLFVUHODWHGFDUGLDFG\VIXQFWLRQقಿ ऋ॒ ද੘௜ঢ়৴ੱ ൙௽૩كऩनभ৷ୁ ऋ৷ःै ोथऌञ ഄఴ৓৽༬ऋँ ॊ؛঳্ؚ ಏ෫ਠৃ दमఇදਰਗभ੘௜पൣ अੱ ഷଵ௽૩ऽदஅीथ৊஘भୁ ऋ৷ःै ोॊऒधऋँ ॊऋؚ মু ਬदम৷ୁ भ೴৊॑ ೂऐॊञीؚ ଣೝ଍੘௜पକ౤घॊੱ ഷଵ௽૩म5,+' ق5DGLDWLRQLQGXFHG KHDUW GLVHDVHكधखؚ ඊႵॳख़ॵॡএॖ থॺ༛૩ఇقLPPXQH FKHFNSRLQW LQKLELWRUV؟,&,Vكपൣ अੱ ൙༇मؚ ඊႵঢ়৴થ૩হ଴قLU$(LPPXQHUHODWHGDGYHUVHHYHQWكभ঳ णधखथেगॊ,&,V ঢ়৴ੱ ൙༇धखथ਄ॉඞअ؛ऒोै म&75&' धम౮ऩॊ୰ଙदँ ॉঐॿش४ওথ ॺृ ੘௜্ ଉु ౮ऩॊञीયશघसऌदँ ॊ؛ञटखৰ੠पम&75&' भਉ౤ఇද॑ ਫનपયશघॊऒ धऋ൑୔ऩඪ୻ु ৽ୡऔोॊ؛਀ڭ प(6& ᇯᯂ࿯୭ஓफ़ॖ ॻছॖ থऩनप੦तऌؚ &75&'ؚ ,&, पे ॊੱ ൙༇पਸइथഷଵႈ೩قಯဿഷዟؚ ৿ဿഷዟऩनكؚ ৈഷಓඪؚਂ ତဿ॑ ಡ৅घॊऋ॒ ੘௜॑ં घ؛ قگك&75&' भ൧૵੦૆ध੎ඪ২ীథ

(6& फ़ॖ ॻছॖ থमؚ &75&' भ੎ඪ২ীథ॑ ৗञप઀๼खञق਀ك؛ऒभ੎ඪ২मؚ ऋ॒

੘௜भಲਢ؞૗ಌृؚ &75&' ੘௜قలਟ৓पੱ ৳૧ఇ॑ রૃ दऌॊऊಉكभਔઓৠ৒पઉ੥घॊञीؚ &75&' भ൧૵ध৊ৎप੎ඪ২॑ ৥ન৲घॊऒधभ੎ਏਙऋਘ৹औोथःॊ؛धऎप૮ඪ౜ਙ&75&' भ ੎ඪ২ਖ਼৒मؚ ం஼ฌল૨ق/9()كध*/6॑ ৷ःॊञीؚੱ ग़॥ش௕ਫ਼ਪऋরੱ धऩॊ؛ऩउؚ ऋ॒ ୩ ୠभથ૩হ଴௬੼पम&7&$(ق&RPPRQ7HUPLQRORJ\&ULWHULDIRU$GYHUVH(YHQWVكऋ৷ःै ोॊ؛ &7&$( द௬੼घॊَ થ૩হ଴ُ धम೩঻औ॒ ऋਭऐॊँैॅ ॊ஀ऽखऎऩःඉ౜दँ ॉؚ ૑ङखु ੘௜
p.5


 ૪઼ धभ౤ટঢ়બऋऩःਡदَౢ ੿৷ُ धम౮ऩॊৃ় ऋँ ॊ؛੎ඪ২म*UDGH द਀औोؚ *UDGLQJ

मਰৣ भधउॉदँ ॊ؛*UDGH  मೄ২ऩથ૩হ଴ق૮ඪ૾ ऽञमೄ๶ऩඪ૾ؚ ೄ๶ऩਫ਼ਪਚৄ كद੘ ௜ஂ োਂ ਏऩु भदँ ॉऋ॒ ੘௜मಲਢ૭ચदँ ॊऒधऋ੗ः؛*UDGH  मরಉ২भથ૩হ଴قඪ૾ मँ

ॊऋফೡৼૢ भମभ৚ॉਰਗभ঩ଞেણ৿੿भ਑଒पधनऽॊكदँ ॉਈ৵଒طଂਚ৓طశ෶๷৓੘ ௜॑ ਏघॊ؛ऋ॒ ੘௜मభ਋ऽञमর૵औोॊৃ় ऋँ ॊ؛*UDGH  म੎ඪऽञमୢ৾ ৓प੎পदँ ॊ ऋؚ ञटठपে୵॑ ะऊघु भदमऩःથ૩হ଴दँ ॉো੹ऽञमো੹਋৑भభশ॑ ਏघॊ؛ຄষরभ ऋ॒ ੘௜मর૵عીവقঞ४ওথभ૗ಌ॑ அिكऔोॊ؛*UDGH  मে୵॑ ะऊघથ૩হ଴दಸ૶૪઼॑

ਏघॊ؛ऋ॒ ੘௜मીവऔोॊ؛*UDGH मથ૩হ଴पे ॊଈಝदँ ॊ؛ऩउؚ &7&$(9HU दमੱ ට௽૩ؚ ం஼ਃચਂ ৸भඨऋླྀ ৗऔोਰৣ भे अपਝ৒औोञ؛*UDGH؟ం஼ฌল૨ق/9()كۺ ऊणਰৣ भ णਰ঱॑ ௥ञघ؛ك*/6 भঋش५ছॖ থऊै भ॑ தइॊৗञऩ଩ৣؚ كੱ ටংॖ ड़ঐشढ़شभৗञऩ঱ಊ؛*UDGH؟/9() ऋऊणਰৣ भ णਰ঱॑ ௥ञघ؛ك/9() भ ਰ঱भ଩ৣؚ ك*/6 भঋش५ছॖ থऊै भ॑ தइॊৗञऩ଩ৣؚ كੱ ටংॖ ड़ঐشढ़شभৗञऩ ঱ಊ؛*UDGH؟ৗञप/9() ऋ౞௥प଩ৣ ؛*UDGH भਝ৒मऩः؛ قڰك&75&' भᄄ২؞੒৏धଫ਋൧૵भਔଝ

থॺছ१ॖ ॡজথधॺছ५ॶ६ঐঈ॑ ৊ৎ਺ଖखञঞ४ওথقع ফكदमం஼ਃ

ચ௽૩ऋ٫ؚੱਂ ৸ऋ٫धாഈप੗ऎ ऒभঞ४ওথ॑ ೂऐॊऒधऋ௓တऔोथःॊ؛ ফ ع ফपষॎोञ॔ থॺছ१ॖ ॡজথ௺ఇදपৌघॊੱ ৳૧ఇभ஍ટ॑ ௬੼घॊञीभছথॲ঒৲ૻ

ຎ૥ୡق5&7ك॑ ૐ৺खञওॱ॔ ॼজ३५पे ॊधؚ /9() मঋش५ছॖ থऊै  না৏भৎਡद਴಑ قك଩ৣ खؚ॔ থॺছ१ॖ ॡজথ௺ఇද਺ଖ୤मॻय़९ঝঅ३থఌ઴दPJP दँ ढञ؛ऩउऒभওॱ॔ ॼজ३५म໚ऋ॒ ඪ୻भऺ ऊपഷั ऋ॒ ඪ୻॑ ৌ଴धखञଢ଼஢ु அऽोथःॊ؛  ফ৻प॔ থॺছ१ॖ ॡজথ௺ఇදऋઞ৷औोमगी ফ৻पੱ ෼ਙभਾઔऋৼઃःटञी੺ ফभঞ४ওথमੱ ෼ਙपଦൟऔोथउॉؚ ऒभऒधऋખ಩औोथःॊधઅइॊ؛॔ থॺছ१ॖ ॡজথ௺ ఇදपे ॊ&75&' म౥ຄ৏ڭফਰ৔प٫भඪ୻ऋ৅ඪघॊध੉ॎोथःॊ؛औै पؚ &75&' ৅ඪ ඪ୻पउःथଫ਋पੱਂ ৸੘௜ஂ োघोय੘௜पખૢ घॊન૨ऋੜइॊऒधऋં औोथःॊ؛ऒभञीؚ &75&' भଫ਋൧૵؞੘௜ஂ োऋ੎ਏदँ ॊ؛ قڱك&75&' भজ५ॡಽશ৲धঐॿش४ওথॺ

(6& फ़ॖ ॻছॖ থदम&75&' भজ५ॡ౤৕௬੼১॑ ઀๼खथःॊ؛ੱ෼ਙ੟ସषभച່ٙੱਂ ৸জ५ॡقੱਂ ৸५ॸش४$كदँ ॊभद ঞ४ওথओधपੱ ग़॥شইज़টشभᄄ২ऋ௓တऔोथः ॊ؛&75&' मَ କऒढथऊै ৌ૪घॊभदम೚ःُ धऔोथउॉؚ ऋ॒ ੘௜৫઩ৎق৫઩৐كभঋش५ ছॖ থ௬੼ؚ ऋ॒ ੘௜রभঐॿش४ওথॺق१شঋॖ ছথ५كؚ ऋ॒ ੘௜౥ຄ৏भ१ংॖ ংش३ॵউॣ॔ ऋ੎ਏदँ ॊ؛૑ङखु ৸୻दঐॿش४ওথॺऋ૑ਏदमऩःऋؚੱ ෼ਙभँ ॊऋ॒ ੘௜॑ ઱ষऔोॊ জ५ॡभৈःඪ୻पৌखथ੗૙ரੈ ௮द় ৶৓ऩஂ ো্ ১॑ ૚઱ਝभ૾ யप় ॎचथਫ਼ୈघॊऒधऋ੷ ीै ोॊ؛ 
p.6


 ਸ਼,, ฆ &75&' भ൧૵

قڭكੱ ग़॥ش௕ਫ਼ਪ

ग़॥ش௕ਫ਼ਪमؚ ଣೝ଍଺यऎऋऩऎశ෶๷৓दؚ ೷ॉନख઱ষदऌؚ ঳ಹಏ෫दઁ ऎ൤఺ख

थःॊ؛ম১पे ॉؚ &75&' भ൧૵੦૆दਹ৷औोॊ/9() ऋੑ ೾दऌॊ؛खञऋढथؚੱ ෼ਙभ૭ચ ਙऋँ ॊఇදृ ଣೝ଍௜১पे ॊऋ॒ ੘௜৐भੱ ਃચ௬੼ؚ ऋ॒ ੘௜রع੘௜৏पउऐॊੱ ਃચঔॽॱ জথॢ पउःथؚ ਈु ᄄ৷औोथःॊ઺൸ਫ਼ਪ১दँ ॊ؛ऽञম১मؚ ం஼उे लక஼भ१ॖ ६ؚੱ

ਃચقઽೠચؚ ఁ୑ચكभ௬੼॑ घॊञीप৷ःै ोॊटऐदऩऎؚ༘ ഷਙੱ ႈ೩ؚ ఉჍඪؚ পഷଵႈ ೩ؚ ཡৈഷಓඪ؜ੱ Ⴭႈ೩ऩनஓସ৓ऩੱ ؞ഷଵႈ೩ؚੱ ටᇯᯂقਉ৅ਙؚ ૡ୎ਙكभ൧૵ृ ୰ଙभ੎ඪ ২௬੼पु ᄄ৷औोॊ؛णऽॉؚੱ ग़॥ش௕ਫ਼ਪमؚ &75&' भ൧૵भाऩै ङؚ ᇯᯂ࿯୭ஓ൧௜पउ ऐॊੱ ႈ೩भ൧૵पઁ ऎથ৷दँ ॊ؛ Lం஼ઽೠચ D/9()

&75&' पउऐॊੱ ਃચ௽૩भ৒ଝपஅऽोथउॉؚ ਫનऊणગਠਙऋ૿ ৳औोञ৒୤௬੼ऋ੷

ीै ोॊ؛ ⋇ੑ ೾্ ১

૵ಽ১पे ॊੱ ቉৖஛ᒷ૵એउे लੱ ቉৖੸ᒷ૵એ॑ ৷ःथؚ ઽೠଜ਋उे लఁ୑ଜ਋भం஼ੱ ৔Ⴭ୆ੀ॑ ॺঞش५खथ઴লघॊॹॕ ५ॡ১ऋ௓တऔोॊ؛ञटखؚ ॹॕ ५ॡ১पे ॊ/9() भ೾৒पु ਖ਻ਡऋँ ॉؚ ૑ङखु ગਠਙऋৈःधम੉इऩः؛ऒोै पৌघॊৰಏ෫पउऐॊৌૢ पणःथम ৏஽घॊقਸ਼⋝ฆك؛৪বੱ ग़॥ش௕৾ ভق$6(ك௎ପੱ ഷଵ઺൸৾ ভق($&9,كम ઃ੪ੱ ग़॥ش௕১ पे ॊ/9() भ೾৒॑ ௓တखथःॊ؛தఠణ൧૵ಎ઼ धঽ৿ੑ ೾ૼ ୒भਤనपे ॉؚ ం஼ઍ஋पঢ়ख थमؚ  ઃ੪ੱ ग़॥ش௕১पे ॉଐ஀ऩ઺൸ॹشॱऋ਄੭दऌोयؚ ॹॕ ५ॡ১द੷ीञகे ॉु ਫનद ગਠਙभৈःੑ ೾கऋ੭ै ोॊे अपऩढञ؛खऊखؚ ঝشॳথदگઃ੪ग़॥ش௕ਫ਼ਪ॑ ઱ষखथः ॊ઱ਝम૘ऩऎؚ ઺ସभਖ਻ऊैੑ ೾ऋ૭ચऩ୻ऋ଒ै ोॊऒधؚ  ઃ੪ੱ ग़॥ش௕১पे ॊ/9() भ ਫଞகमॹॕ ५ॡ১धम౮ऩॉ &75&' पउऐॊढ़ॵॺड़ইகऋৠऽढथःऩःऒधऩनऊैؚ ਠৎ ਡदम&75&' पउऐॊৢ ଞ൧௜पउःथम௓တदऌऩः؛ৢ ଞभ&75&' मलऽ॒ ਙभం஼෢ઈ৿౮ ଞ॑ Ⴋघॊऋؚ ऋ॒ ఇ੟௜১म༘ ഷਙੱ ႈ೩भ৅ඪজ५ॡ॑ ੜপऔचॊञी ం஼ଂਚ෢ઈ৿౮ଞ॑ ऌञघৃ় ऋँ ॊ؛ం஼෢ઈ৿म૑ङखु ঳஘प଩ৣ घॊॎऐदमऩःऒधؚ /9() भਫનऩ৒୤௬੼ऋ ੷ीै ोॊऒधऩनऊैؚ ଳಁ ৓௬੼H\HEDOO ()ृ 0 ঔشॻ১पे ॊ7HLFKKRO] ১पे ॊ௬੼दमਂે

ীधઅइै ोॊ؛ ⋈੦૆க

 ফप৅ষऔोञ$6(ੱ ᒷ৒୤फ़ॖ ॻছॖ থदमؚ /9() भਫଞৣ ଒கम٫दँ ढञ؛

जभञीؚ &75&' भ൧૵੦૆भ/9()ु ٫ऋ৷ःै ोथःञ؝ ফप໷ষऔोञ৊फ़ॖ ॻছॖ থ भਈৗගदमؚ जोਰఋभଢ଼஢੥ટऋਸ௡औोथؚ /9() भਫଞৣ ଒கऋधਝ৒औोञ؛(6& भ SRVLWLRQ SDSHU दमؚ &75&' भ৒ଝَ॑ /9() ऋঋش५ছॖ থे ॉु এॖ থॺ॑ தइथ଩ৣ खؚ
p.7


 ऊणਫଞৣ ଒க॑ৣ ৚ॊُ धऔोथःॊऒधऊै   /9() ऋঋش५ছॖ থे ॉु এॖ থॺ॑

தइथ଩ৣ खؚ ऊण॑ৣ ৚ॊُ धऌप&75&' ध৒ଝऔोथऌञ؛खऊखؚ /9() पउऐॊ೾৒ෙ ୷ृؚ औै पम/9() भਫଞகऋ૗৿৓दँ ॊऒधऊैؚ মু ਬऌदमَ /9() ऋঋش५ছॖ থे ॉु এॖ থॺ॑ தइथ଩ৣ खؚ ऊण/9() ऋ॑ৣ ৚ॊُ धऌप&75&' ध৒ଝघॊऒधधखञ؛घ ऩॎठؚ /9()٫ڀ٫दँ ोयؚ ੦૆॑ ௥ञघऋؚ /9()ڀ٫ؚ /9()٫ڀ٫दँ ोय੦ ૆॑ ௥ञऔऩःऒधपऩॊ؛঩মᇯᯂ࿯୭ஓ৾ ভऋౣ ૐखञᇯᯂ࿯୭ஓ൧௜ঁ থॻঈॵॡ ؜঩মಏ ෫ᇯᯂ৾ ভभ2QFRFDUGLRORJ\ फ़ॖ ॻছॖ থ दु  /9() भৣ ଒கम٫धऔोथउॉؚ ਠ૾ दमऋ॒

੘௜पൣ ढथ/9() ऋ٫॑ৣ ৚ढञৃ়॑ &75&' ध൧૵घॊऒधऋ੗ः؛০৏ؚ ଢ଼஢ऋਤाग़অ ॹথ५ऋ໮஋औोॊऒधपे ॉؚ ऒभ੦૆கम૗৲घॊ૭ચਙऋँ ॊञीؚ॔ ॵউॹشॺऋ૑ਏदँ ॊ؛ ऽञؚ  णभਯஊद৥નपীऐै ोॊॎऐदमऩःञीؚ ऒभ੦૆॑ ௥ञखथःऩऎथुؚ /9() ऋ଩ৣ ൊ਱पँ ोयؚ ইज़টش॔ ॵউ਋৑॑ ಢऎघॊऩनؚ ৰಏ෫दभฑໞऩৌૢ ऋ੎ਏदँ ॊ؛ E*/6

ॹॕ ५ॡ১पे ॊ/9() भੑ ೾ෙ୷म৺दँ ॉ  ঋش५ছॖ থऊै ٫଩ৣ धःअ

&75&' भ൧૵੦૆धಉखःऒधमؚ পऌऩਖ਻ਡदँ ॊ؝ગਠਙभਖ਻ऊैؚ /9() भகभॎङऊऩ૗ ৲म૑ङखु ઌभ૗৲धम੉इऩःऒधुँ ॉؚ ੺ফؚ ५ঌॵॡঝॺছॵय़থॢ ১॑ ৷ःञ*/6 ऋਹ৷ औोॊे अपऩढञ؝*/6 मؚ /9()े ॉुੱ ൙௽૩॑ ૎২े ऎਫ਼লदऌؚ ऊणؚ ગਠਙपરोञ੐ఏ धखथؚ ௎৪भ࿯୭ஓঢ়৴भफ़ॖ ॻছॖ থ टऐदऩऎؚ ৪বᇯᯂ৾ ভभफ़ॖ ॻছॖ থदु जभઞ৷ ऋ௓တऔोथःॊ؛ऒोप૆गथ؜঩মಏ෫ᇯᯂ৾ ভभ2QFRFDUGLRORJ\ फ़ॖ ॻছॖ থपउःथु ؜ ऋ॒ ఇ੟੘௜রभ৒਋৓ऩੱ ग़॥ش௕ਫ਼ਪपउऐॊ*/6 भੑ ೾ऋൠऎ௓တऔोथःॊ؝ऩउؚ মু ਬद म*/6 मബৌகद਀੶घॊ؝५ঌॵॡঝॺছॵय़থॢ ১पे ॊ*/6 ऋ೾৒दऌॊ୭୆पऩः઱ਝदमؚ */6 ध৊गऎం஼শກ্ ਱भੱ ൙ઽೠચ॑ ௬੼खञ੐ఏदँ ॊ0 ঔشॻ১द઴লखઽೠ਋ᄀၣఉ୽୎৿ ෱௞ق0$36(؟PLWUDODQQXODUSODQHV\VWROLFH[FXUVLRQكु खऎमੌ ௶ঃঝ५ॻউছ১पे ॊઽೠ਋ᄀ ၣఉ୽ઈ৿ச২ق6bكदभ௬੼ु ௓တऔोथःॊ؛खऊखऩऋैؚ 0$36(ؚ 6bधु पؚ */6 भे अप ऋ॒ ఇ੟௜১पे ॊੱ ෼ਙ॑ ਫ਼লघॊढ़ॵॺड़ইகऋோ૔खऩःञीؚ ৐৚கउे लঋش५ছॖ থகधૻ

ຎखथ෩৥ऩ଩ৣ ऋੳीै ोोयؚ ཎ૔ਙभం஼ੱ ൙௽૩॑ ઑअधःअੰ ๸पधनऽॊ؛ ⋇ੑ ೾্ ১

*/6 मؚੱ ቉৖ ૵એقশກ૵એؚ ੸ᒷ૵એؚ ஛ᒷ૵એكभੱ ఢ਋पॎञॊ৿઺ॹشॱऊैؚ

੸ઃ੪५ঌॵॡঝॺছॵय़থॢ ১॑ ৷ःथಎ઼ प৔୉औोञ९ইॺक़ख़॔ँ ॊःमੰ ෲ৷॥থআগشॱ شदੰ ෲघॊ؛঳ಹ৓ऩ९ইॺक़ख़॔ दमؚ ఏ૆৓ऩੱ ቉৖॔ উটشॳگ૵એऊै ੿ਛऔोञॢ টشং ঝ५ॺঞॖ থශ଍भআشॡக॑ ਴಑खञக॑ */6 धखथःॊ؛ঐॖ ॼ५கधखथলৡऔोॊৃ়ुँ ॊ ऋؚ মু ਬऌदमബৌகقউছ५கكधखथඞढञ؛५ॺঞॖ থੑ ೾म؜52, भਝ৒قੱ ৔Ⴭડ؜৸ಽऩ नكृ ॺছॵय़থॢ ১पಎ઼ قঋথॲشك৑भ୷ऋँ ॊञीؚ ৊঳भಎ઼ؚ ९ইॺक़ख़॔ द৽ૌ॑ ୯अऒ धऋਘऎ௓တऔोॊ؛ ⋈੦૆க
p.8


 ঩মযभ*/6 भਫଞகमؚ 7DNLJLNXै भਾઔऋँ ॊ؛ऋ॒ ੘௜৫઩৐भ*/6ੑ ೾पे ॊॖ

ঋথॺ੒೾पणःथभਾઔ॑ ਀ पऽधीञ؛ऒोै भଢ଼஢द৷ःै ोञ*/6 भढ़ॵॺड़ইகमؚ ع٫दँ ढञ؝*/6 भਫଞৣ ଒கधखथऋ৷ःै ोॊऒधऋ੗ःऒधऊैؚ ౞௥मৈজ ५ॡदؚ عम୆ੀୠधऔोॊ؛ಿ ऋ॒ ද਺ଖ৐धૻ ຎखथؚಿ ऋ॒ ද਺ଖ৏पঋش५ছॖ থधૻ ຎख*/6 ऋৼৌ৓पਰ঱଩ৣ खञඪ୻मق୻؟٫ڀ٫؟ৼৌ৓प٫੖द੦૆॑ ௥ञघؚ ٫ڀ٫؟ৼৌ৓प٫੖द੦૆௥ञऔङكؚ ञधइથਔऩ/9() भ଩ৣ॑ ੳीऩऎथुؚ ऋ॒ ఇ੟ ௜১पे ॊੱ ෼ਙقཎ૔ਙभం஼ੱ ൙௽૩ऋँ ॉكऋ઩ऽढथःॊधਖ਼૵घसऌधऔोथःॊ؛঳্ؚ

ऋ॒ ఇ੟௜১৐धૻ ຎखथؚ ऋ॒ ఇ੟௜১৏भ*/6 भৼৌ৓ऩ଩ৣ ऋ౞௥दँ ोयؚ ऋ॒ ఇ੟ ௜১पे ॊੱ ෼ਙमੳीऩःقཎ૔ਙभం஼ੱ ൙௽૩मऩखكधऔोथःॊ؛ LLం஼ఁ୑ચ

ం஼ఁ୑ચ੐ఏऋؚ &75&' भ൧૵ृ ৽ૌ௴௄ؚ ੒৏੒೾पથ৷दँ ॊधःअॹشॱम࿅खः؛

खऊखؚ ใோभफ़ॖ ॻছॖ থपజढथؚৢ ଞभঝشॳথਫ਼ਪदষॎोॊ௺ଁ ৓ऩం஼ఁ୑ચ௬੼धजो प੦तऎం஼ౄ௥ಓभ௬੼॑ ষअसऌदँ ॊ؛ऋ॒ ఇ੟௜১पൣ अଓัृౢ ੿৷قᚉဇؚৣ በऩनكद ଀෰૖੯ऋ૗৿घॊञीؚ ం஼ౄ௥ಓभ௓৒प(Hb॑ ৷ःॊ੠पି ਔ॑ ਏघॊ؛ం஼ౄ௥ಓभ঱ಊमੱਂ

৸भோ૔॑ંྮ घॊञीؚ ৊ਚৄ ऋ௴௄औोञৃ় पमؚ ඪ૾ ऋႀਙदऩऎधु ࿯୭ஓ৔ఐୢ प॥থ १ঝॺघॊऒधऋ஦ऽखः؛ LLL క஼ਃચधཡ৿ဿಓ

క஼ਃચ௬੼ऋؚ &75&' भ൧௜पથ৷दँ ॊधःअॹشॱम࿅खः؛ॲ१ॳॽঈ॑ அिॳট३

থय़ॼش८༛૩ఇऩनཡ৿ဿਙཡৈഷಓभজ५ॡभँ ॊ੘௜ఇ॑ ৷ःॊৃ়ؚँ ॊःमؚ ऋ॒ ঢ়৴ഷዟ ඪऋઑॎोॊৃ় पमؚ క஼ઽೠચभ௬੼ऋ੎ਏधऩॊ؛ऽञؚ 3770 قཡᇯᯂഷዟਙ๶৵ഷଵඪ 3XOPRQDU\WXPRUWKURPERWLFPLFURDQJLRSDWK\धःअ૶ਙཡৈഷಓඪ॑ ਟघऋ॒ ঢ়৴ႈ೩भ൧૵पुੱ

ग़॥ش௕ਫ਼ਪमથ৷दँ ॊ؛ੱ ग़॥ش௕ਫ਼ਪदؚ క஼ఁপृ క஼ઽೠચभ଩ৣ॑ ੳीञৃ়ؚँ ॊः मཡৈഷಓऋંྮ औोॊৃ় पमؚ ࿯୭ஓ৔ఐषभ॥থ१ঝॺऋ௓တऔोॊ؛ قڮكजभ౎भॖ ওش४থॢ  Lੱ ටறୢ৾ قੱ ൙३থॳॢ ছইॕ شك

ঐঝॳ।شॺੱ ਗ਼௕৊਋ੱ উشঝॖ ওش४থॢ ১पे ॉؚ /9() ऋ೾৒दऌॊ؝ऒोमؚ P ॸ

ॡॿ३क़঒॑ ஧ഷૉपહାऔचؚੱ ਗ਼௕৊਋॑ औचथ̤ ढ़ওছद๡୶खؚੱ ට৔भढ़क़থॺ॑ ষअ্ ১ दँ ॊ؛ম১॑ ৷ःथ৲৾ ௜১রभੱ ਃચঔॽॱজথॢ॑ ষअऒधऋदऌؚ  $+$ق৪বੱ ටੈ ভ$&& ق৪বੱ ට୰৾ ভكभफ़ॖ ॻছॖ থदॡছ५⋛$ भిૢ धऔोथःॊ؛ੱ ෼ਙभଫ਋৅ৄ पથ৷दँ ॊधःअਾઔुँ ॊ؛ગਠਙुे ऎؚੱ ग़॥ش௕ਫ਼ਪद/9() ऋ௬੼दऌऩःৃ় पથ৷दँ ॊऋؚ ଺ ᓄधৈःୢ ௜॥५ॺऋਂ ਹऩਡदँ ॊ؛ LLੱ ට05,

ਠ૔ؚ ం஼ઍ஋ؚ /9() भੑ ೾दम०شঝॻ५ॱথॲشॻधऔोॊਫ਼ਪदँ ॉؚ ਈु ਫનऩం஼

ઍ஋ऋ੭ै ोॊ؛ऽञؚੱ ට05, दमؚੱ ग़॥ش௕ਫ਼ਪदमਂ ૭ચऩੱ ൙ਙ૾ भ௬੼ऋ૭ચदँ ॊ؛
p.9


 ॺছ५ॶ६ঐঈ॑ ਺ଖखञ໚ऋ॒ ೩঻पउःथؚ ం஼ડ෢पफ़ॻজॽक़঒೚భୗ୶ऋाै ोॊधःअਾ

ઔृ  থॺছ१ॖ ॡজথद੘௜॑ ਭऐञऋ॒ १ংॖ ংشभরपؚ 7 PDSSLQJ दৈਦಀ॑ં घཎ૔ ৓ऩੱ ൙௽૩॑ ਟखथःॊ୻ऋँ ॊधःअਾઔऋँ ॊ؛ੱ ට05, मؚ ଺ᓄऋऩऎ਍৸ਙपરोؚ ਫન ਙؚ ગਠਙुे ःਫ਼ਪदँ ॉؚ &75&' भ൧૵ਰਗपु ऋ॒ भੱ ටषभ࿠ဋृ ૡ୎भ൧૵पु ৷ःै ोॊ؛ खऊखؚ ਫ਼ਪৎ৑ऋশःऒधृୢ ௜॥५ॺभਖ਻ऋँ ॉؚ ઱ষदऌॊ઱ਝऋ଒ै ोथःॊ؛खञऋढथؚੱ

ग़॥ش௕ਫ਼ਪद/9() भ௬੼ऋ൑୔ऩৃ় पਫ਼ୈऔोॊसऌदँ ॊ؛  ਸ਼,,, ฆ ऋ॒ ఇ੟௜১॑ ষअ೩঻पৌघॊੱ ग़॥ش௕ਫ਼ਪभউটॺ॥شঝ قڭكऋ॒ ఇ੟௜১৐भੱ ग़॥ش௕ਫ਼ਪ

ऋ॒ ੘௜৐भਫ਼ਪभ৯৓मؚੱ ഷଵ୰জ५ॡभ௬੼धؚ କऒॉ੭ॊੱ ഷଵ় ಡඪभ੒೾ؚ ऩै ल

प੘௜৽ૌपउऐॊੱ ഷଵ় ಡඪभଫ਋൧૵भञीभ॥থॺটشঝॹشॱ॑ ਄ॊऒधदँ ॉؚ ৸थभੱ ෼ਙभँ ॊऋ॒ ੘௜भ৐पमؚ ੦ম৓पम৸୻पষअसऌदँ ॊ؛ৢ ଞभੱ ग़॥ش௕ਫ਼ਪद೾৒घॊඨ ৯म৸थ૑೼ඨ৯दँ ॊ؛્ पం஼ฌল૨भੑ ೾मऋ॒ ੘௜ঢ়৴ੱ ൙௽૩भ৒ଝजभु भपु அऽोथ ःॊञीؚ ਈ੎ਏඨ৯दँ ॊ؛(6& फ़ॖ ॻছॖ থदम/9() भੑ ೾म ઃ੪ੱ ग़॥ش௕ਫ਼ਪदੑ ೾घॊ ऒधऋ௓တऔोथःॊ؛ऽञؚ ం஼ੱ ൙௽૩भे ॉོ สऩ੐ఏधखथ*/6 भੑ ೾ऋ௓တऔोथउॉ  ೾ऋ૭ચऩ઱ਝदम*/6ु ૑೼ඨ৯दँ ॊ؛௕ पऋ॒ ఇ੟௜১॑ ষअ೩঻पৌघॊੱ ग़॥ش௕ ਫ਼ਪभউটॺ॥شঝ॑ં खञ؛মউটॺ॥شঝम૮ඪ౜ਙभඪ୻॑ ୳৒खथःॊऋؚੱਂ ৸ඪ૾॑ ੳी ॊधऌृ ౯৒दऌऩःधऌؚ ऽञংॖ ड़ঐشढ़شق%1317SUR%13ؚ ॺটএॽথكऩनदੱਂ ৸॑ ઑअ धऌमి ࿤ੱ ग़॥ش௕ਫ਼ਪ॑ ୯ਸघॊऒध॑ ௓တघॊ؛਀ प৻਀৓ऩಿ ऋ॒ දपउऐॊইज़টش॔ ॵ উ਋৑॑ં घ؛জ५ॡಽશ৲म+)$,&26 জ५ॡ५॥॔  ऩन॑ ૞සघॊ؛



قڮكऋ॒ ఇ੟௜১রभੱ ग़॥ش௕ਫ਼ਪ قLكইज़টش॔ ॵউभᄄ২

থॺছ१ॖ ॡজথ௺ಿ ऋ॒ ද਺ଖরपमؚ ਀ पં खञे अपؚ জ५ॡपૢ गथ৒਋৓पੱ

ग़॥ش௕ਫ਼ਪ॑ ষअ؛ऽञؚ॔ থॺছ१ॖ ॡজথ௺ಿ ऋ॒ දपे ॊੱ ൙௽૩म৷୤ൂ ோਙऋৄै ोॊञ ीؚ ଩ؚ রজ५ॡदुؚ ਺ଖ੕୤ऋॻय़९ঝঅ३থఌ઴द ⋸P தइञৎपमੱ ग़॥ش௕ਫ਼ਪ॑ ষःؚ ਺ଖ୤भ୯ਸपൣ ःইज़টش॔ ॵউभੱ ग़॥ش௕ਫ਼ਪ॑ ষअ؛ऽञؚ ࿯୭ஓ৔ఐୢ ऋಿ ऋ॒ ද भ਺ଖ୤ऋཔ඼खपऎःਠ૾ुँ ॉؚ जभৃ়ؚ ইज़টش॔ ॵউ਋৑भ৯਍धखथؚ  নাपڭ৚ங২ध खؚ ઱ਝओधभ૾ யपૢ गथৠ৒घॊ؛ਈु ੎ਏऩऒधमؚ ૑ਏऩইज़টش॔ ॵউऋ௷ऐ૳ठऩःे अप घॊऒधदँ ॊ؛঳্ दؚಿ +(5ಿ ৬ఇदँ ॊॺছ५ॶ६ঐঈभੱ ൙௽૩मؚ॔ থॺছ१ॖ ॡজথ௺ಿ

ऋ॒ දधૻ ຎखथ৷୤ൂ ோਙऋाै ोऩःऒधऋ੗ः؛੘௜রमి ਫઞ৷फ़ॖ ॻप੶ൗऔोथःॊे अपؚ  না൐भইज़টش॔ ॵউऋ஦ऽखः؛ऽञؚ ৗૠఇදपुؚి ਫઞ৷फ़ॖ ॻपऒभे अऩইज़ টش॔ ॵউपঢ়घॊ੶ൗऋऩऔोथःॊ؛ञटखؚి ਫઞ৷फ़ॖ ॻप੶ൗभग़॥ش௓တᄄ২मؚ ग़অॹথ ५भँ ॊु भयऊॉदमऩऎ੗ऎऋ૚ఇදभ૥ୡॹ२ॖ থभ੠भੱ ग़॥ش५ॣ ४গشঝ॑ ૴৷खञु भ
p.10


 दँ ॉؚి ਫઞ৷फ़ॖ ॻप੶ൗऔोथःॊᄄ২৸थदইज़টش॔ ॵউੱ ग़॥ش௕ਫ਼ਪ॑ ষअऒधमਠৰ

৓दमऩः؛ৰಏ෫पउःथमؚ ಏ෫ඪ૾ লਠৎؚ ๢৖; ଍ृ ๢৖&7 द੘௜৐पૻ सथੱྔ ୶भఁপ ൊ਱ऋँ ॊधऌऩनؚ ಏ෫঱૑ਏऩৎपి ࿤ੱ ग़॥ش௬੼॑ અൟघॊ؛৐஽खञ&75&' भ੦૆॑ੂ ीथ ௥ञखञৃ়ؚੱ ৳૧ఇभ਺ଖउे लಿ ऋ॒ දभಲਢभ૭౯पणःथؚ ऋ॒ ੘௜ୢ ध࿯୭ஓ৔ఐद৮૛ घॊ؛जभ੠ؚ ૘ऩऎधुੂ ৚मؚ ڮٕ گౝਰ৔प঳২ੱ ग़॥ش௕ਫ਼ਪ॑ ইज़টشघॊ؛जभ৏࿯୭ஓ৔ ఐधऋ॒ ੘௜ୢ दৼ୥खऩऋैి ࿤ੱ ग़॥ش௕ਫ਼ਪ॑ ইज़টشखؚಿ ऋ॒ ද੘௜भর૵طગ৫॑ ৠ৒ख थःऎ؛ قLLكਫ਼ਪඨ৯

੘௜রपষॎोॊਫ਼ਪभ৯৓मؚ &75&'॑ ଫ਋प৅ৄ खؚੱ ৳૧ఇभ਺ଖृ ঞ४ওথभ৹ତऩ

न॑ ষअऒधपे ॉؚ ૭ચऩ଒ॉऋ॒ पৌघॊ੘௜॑ ౥ຄघॊऒधऋदऌॊे अपघॊऒधदँ ॊ؛ಿ ऋ॒ ද੘௜রभইज़টش॔ ॵউੱ ग़॥ش௕ਫ਼ਪभᄄ২मؚ ৐ඨपં खञधउॉदँ ॊऋؚ घसथभ೩঻ प࿽ഡऩইज़টش॔ ॵউ॑ ষअऒधमਫ਼ਪ஼भঐথঃডشभਡऊैु ୔खः؛खञऋढथؚ ૑೼ඨ৯ध खथम&75&' भ৒ଝपुৄै ोॊం஼ઽೠચभ௬੼ؚ उे लੱਂ ৸भଫ਋৅ৄ पથ৷धऔोॊংॖ ड़ ঐشढ़شق%1317SUR%13ؚ ॺটএॽথكऩनभ੐ఏप଒৒घॊ؛नभ੐ఏपঢ়खथु ৐৚கउे

लঋش५ছॖ থகधभૻ ຎऋ੎ਏदँ ॊ؛્ प*/6 म&75&' भଫ਋৅ৄ पથ৷धऔोथउॉؚ ऋ॒ ఇ੟௜১৐भகऊै জ५ॡ॑ ಽશ৲दऌॊधःअਾઔु ੺ফऩऔोथःॊق਀ك؛ قگكऋ॒ ఇ੟௜১ીവ৏भੱ ग़॥ش௕ਫ਼ਪق਀ك قLইज़টش॔ ॵউभᄄ২ध਋৑

৵ుऩै लपਛয॑ ਖॎङؚಿ ऋ॒ දभઞ৷मেၺपॎञढथੱ ൙௽૩৅েभজ५ॡपऩॊध

ਾઔऔोथःॊ؛્ प॔ থॺছ१ॖ ॡজথ௺ಿ ऋ॒ ද॑ ઞ৷खञඪ୻पঢ়खथमؚ ౎भఇදधૻ ຎखथੱ

൙௽૩॑ ৅েघॊન૨ऋৈऎؚੱ ग़॥ش௕ਫ਼ਪؚ ংॖ ड़ঐشढ़شऩन॑ ৷ःथؚ ৒਋৓ऩইज़টشऋ૑ ਏदँ ॊ؛॔ থॺছ१ॖ ॡজথ௺ಿ ऋ॒ දपे ॊੱ ൙௽૩भऋ ফਰ৔प৅ඪखؚ ਴಑ নাद ৅ඪघॊधਾઔऔोथःॊभद ਺ଖ৫઩ ऊা৑म્ पడ੎ऩইज़টشऋ૑ਏदँ ॊ؛ইज़টش॔ ॵ উીവभৎ਋पঢ়खथमؚ ग़অॹথ५ऋऩःऋؚಿ ऋ॒ ද੘௜রउे ल੘௜৏पؚੱ ਃચ଩ৣ ऩनपे ॉੱ

৳૧ఇभ਺ଖृಿ ऋ॒ දউটॺ॥شঝभৄ ઉख॑ ষढञඪ୻पঢ়खथम঳েၺभইज़টشق ফपڭ ৚ங২॑ ৯਍؛ੱ ਃચृ ಏ෫ඪ૾ पૢ गथৠीॊكؚ ੘௜রउे ल੘௜৏ না৏भਫ਼ਪदੱ ਃચप౮ଞ॑

ੳीऩऊढञඪ୻दमؚ॔ থॺছ१ॖ ॡজথ௺ಿ ऋ॒ දઞ৷୻भৃ় म੘௜ીവ৏ ফ৏ऽदইज़ট شखथ౮ଞऋऩऐोयইज़টش॔ ॵউીവधघॊ؛॔ থॺছ१ॖ ॡজথ௺ಿ ऋ॒ ද॑ ઞ৷खथःऩःඪ ୻भৃ় म੘௜ીവ৏भਫ਼ਪद౮ଞऋऩऐोयইज़টش॔ ॵউીവधघॊ؛ञटखؚ ੒৏ऋ଒ै ोञਤ ষऋ॒ भ೩঻पੱ ग़॥ش௕ਫ਼ਪभইज़টش॑ िृ ापಲਢघॊभमి જदमऩःभदؚ ऋ॒ भਤষ২ृ ੒৏॑ ༓ाथ଻શ৲घसऌदँ ॊ؛ قLLكਫ਼ਪඨ৯

੘௜৏भইज़টش॔ ॵউਫ਼ਪपঢ়खथमؚ ੘௜৐भਫ਼ਪध৊஘ؚৢ ଞभੱ ग़॥ش௕ਫ਼ਪद೾৒घ

ॊඨ৯॑ घसथੑ ೾घॊ؛ऽञ*/6 भੑ ೾पঢ়खथु ৊஘दँ ॊ؛
p.11


  ਸ਼,9 ฆ ඊႵॳख़ॵॡএॖ থॺ༛૩ఇपे ॊੱ ഷଵ௽૩

قڭك੕૛

ऋ॒ ඊႵ௜১भ৅னपे ॉؚ ,&,V म੗ऎभऋ॒ ரपउःथ੘௜भ৭උ࿔धऩढथःॊ؛,&,V पे ॉಿ ᇯᯂඊႵऋણਙ৲औोॊऋؚ ৸ମभऔऽकऽऩටஓदभঽഞඊႵሤણ৲ऋਉ౤धઅइै ोॊඊႵ ঢ়৴થ૩হ଴भ৅েऋି ৯औोथउॉؚ ऩऊदुੱ ෼ਙमಱଈ৓धऩॉ੭ॊ় ಡඪदँ ॊ؛,&,V पे ॊੱ

෼ਙमੱ ൙༇ؚੱ Ⴭ༇ؚ ञऒणऻඪ౜ණؚ శ༇ඪਙੱਂ ৸ؚ ཡৈഷಓඪऩन੗วपॎञॊ؛ളਯभ,&,V॑ ಡ৷घॊৃ়ؚ ౐ද௜১े ॉुੱ ൙༇भ৅ඪ૨ऋৈऎऩॊ؛,&,V ঢ়৴ੱ ൙༇म৅ඪᄄ২tध ወदँ ॊऋؚ ಱଈ૨मtधৈऎؚ ଫ਋൧૵ध੘௜ஂ োऋாीथ੎ਏदँ ॊ؛৷୤శൂ ோਙप৅ඪ खؚ ,&,V भੂ ৚਺ଖऊै ৅ඪऽदभ਋৑म ধাਰ৔ऋ੗ः؛๢൱؞ళล൑୔؞৿ᠶ؞ଷઋऩनभඪ૾ ऋँ ॊऋؚ ඪ૾ ऋశ્ ౮৓ऩৃ়ुँ ॊभदି ਔऋ૑ਏदँ ॊ؛ قڮك,&,V ঢ়৴ੱ ൙༇भੱ ग़॥ش௕ਚৄ 

,&,V ঢ়৴ੱ ൙༇્ થभੱ ग़॥ش௕ਚৄ धःअु भमऩः؛঳ಹ৓प૶ਙੱ ൙༇दमؚੱ ൙भ༇

ඪ৖ਜ਼प঳ಱखञ෢ෝௐध෢ઈ৿଩ৣؚੱ ৔ᒷभ໭৵৲؜ੱ Ⴭั ฅ೏॑ ੳीॊ؛ం஼෢ઈ৿म؜ੱ ൙भ༇ ඪऋઁ ෇೧प఺वৃ় पमलऽ॒ ਙप଩ৣ घॊऋ؜༇ඪऋଂਚ৓ऩৃ় मଂਚ৓෢ઈ৿౮ଞ॑ Ⴋघॊ؝ ం஼෢ઈ৿଩ৣ ऋ৯য়ञऩःৃ় पउःथु ؜जभ৏प૶ౕ प෢ઈ৿ऋப৲घॊৃ় ऋँ ॊभदؚ ৽ৎ ৓ऩইज़টشऋ૑ਏदँ ॊ؛ऽञؚ క஼ਃચभ௬੼ु ੎ਏदँ ॊ؛ੱ ൙༇भরपमక஼॑ રਜ਼प௽૩घॊु

भऋँ ॉؚ క஼)$&قIUDFWLRQDODUHDFKDQJHكृ7$36(قWULFXVSLGDQQXODUSODQHV\VWROLFH[FXUVLRQك भ৒୤৓௬੼ऋ஦ऽखः؛ قگك,&,V ঢ়৴ੱ ൙༇भ൧૵੦૆

,&,V ঢ়৴ੱ ൙༇भಏ෫൧૵पमؚ ഷরॺটএॽথகभથਔऩ঱ಊपਸइथؚ ਌ਏ੦૆ ඨ৯ऽ

ञमౢ ੦૆ ඨ৯ਰ঱॑ ௥ञघ૑ਏऋँ ॊق਀ؚ ڲك؛ੱ ൙༇भ൧૵पमؚ ॺটএॽথभ೾৒पमੱ ൙્ ౮ਙभৈःؚ ৈ૎২ॺটএॽথ,قKV7Q,كऋ௓တऔोणणँ ॉؚ */6 भ૗৲धੌ ा় ॎचॊऒध दଫ਋൧૵षभ๾൴ऋ਋ୄ औोॊ؛,&,V ੘௜৏ଫ਋भ*/6 भ଩ৣ मؚ KV7Q, भ঱ಊपથਔऩঢ়৴ऋँ ॉؚ ଫ਋ੱ ൙௽૩भ੐ఏधऩॊ૭ચਙऋંྮ औोथःॊ؛ قڰكੱ ग़॥ش௕ਫ਼ਪध౎ঔॲজॸॕ धभଁ় ৓௬੼ੱ

ग़॥ش௕ਫ਼ਪमල೶ਙ؞శ෶๷ਙपરोॊ঳্ द્ؚ ౮২भએदम଒ੀऋँ ॊ؛ੱ ට05, म

77PDSSLQJृ फ़ॻজॽक़঒೚భୗ୶पे ॉੱ ൙༇भ൧૵पउःथરोॊऋؚ ೄඪ୻दमྔ ਙधऩॊ ऒधुँ ॊ؛ऽञؚ )'* 3(7&7 ਫ਼ਪ॑ జਟਫ਼ਪ১धੌ ा় ॎचॊऒधद؜ੱ ൙༇भણ৿ਙृ ෇೧भ௬ ੼ऋदऌॊटऐदऩऎؚ ੘௜஍ટभਖ਼৒पु થ৷दँ ॊ૭ચਙऋँ ॊ؛*D'27$72&3(7&7 ऩनৗ ञऩறୢ৾ ৓ু ১ु ৫৅औोणणँ ॉؚ ऒोै धभੌ ा় ॎचपे ॊঐঝॳঔॲজॸॕ ௬੼ऋ௓တऔो ॊ؛ قڱك,&,V ঢ়৴ੱ ൙༇भ੘௜

ऽङఇද॑ রૃ भअइؚ ५ॸটॖ ॻঃঝ५௜১॑ ষःؚ जभ৏৽ઠউঞॻॽ॰টথप૗ಌखؚ ඪ
p.12


 ॺটএॽথகؚੱ ਃચؚਂ ତဿऩनभ৚୮॑ નੳखऩऋै ሰ੖घॊ؛५ॸটॖ ॻ຅ಿ ਙभৃ়ृ แඪ

஑ੱ ൙༇पৌघॊ੸ઃ੘௜धखथളਯभඊႵ೪਑ঞ४ওথऋਫ਼઒औोथःॊऋؚ ਠৎਡदग़অॹথ५म ࿅खः؛  ਸ਼9 ฆ ऋ॒ ੘௜पൣ अजभ౎भ় ಡඪŒੱ ग़॥شपे ॊ௬੼धৌૢ  قڭكཡৈഷಓඪ

ཡৈഷಓඪق3+SXOPRQDU\K\SHUWHQVLRQكमؚ ঳ಹ৓पਸ਼ ණقంੱਂ ৸पे ॊ3+كभᄄ

২ऋৈः ऋؚ ᇯᯂ࿯୭ஓ୩ୠपउःथम౮ऩॊ୰ଙ॑ खयखय৽ୡघॊ؛ཡ৿ဿഷዟኋዟඪق37(كؚ ऋ॒ ఇ੟௜১पे ॊ3+ؚ 3770ؚ ཿਙ෗ᇈੜ༢ਙႈ೩قཿਙ෗ᇈਙஜഷ୰ऩनك पे ॊ3+ दँ ॊ؛ ৏ ঻मऋ॒ जभु भपे ॊ3+ दँ ॊقਸ਼ థك भदؚ ऒऒदमસఎघॊ؛ऩउؚ ཡഷଵ෿ᇯقਸ਼ థपীథऔोॊكؚ জথঃဿଵ൙ᇯඪق/$0؟O\PSKDQJLROHLRP\RPDWRVLVكقਸ਼ థكؚ ഷଵ৔প಍ཝ஑ % ಍ཝਙজথঃᇯु 3+॑ ਬऌକऒघወऩႈ೩दँ ॊ؛37( म&$7قFDQFHU DVVRFLDWHG WKURPERVLV ऋ॒ ঢ়৴ഷዟඪكभ঳ฮधखथऋ॒ पे ॊૌᅼಕपे ॉಡ৅घॊऒधऋँ ॊऋؚ ऋ॒ ఇ੟௜১भౢ ੿৷ धखथु ੴै ोथउॉؚ ৻਀৓ऩఇදम३५উছॳথؚ ഷଵৗে༛૩දقঋং३६ঐঈऩनكؚ ,&,V दँ ॊ؛ऒोै॑ ৷ःञঞ४ওথदमಯဿഷዟඪ॑ ಡ৅घॊऒधऋँ ॉؚ ཡৈഷಓඪपे ॊకੱ ଀෰؞కੱ ਃ ચ଩ৣ ऋ੎২भৃ় मঞ४ওথ૗ಌऋਫ਼ୈऔोॊऒधुँ ॊ؛ऋ॒ ఇ੟௜১पे ॊ3+ म'3$+ق'UXJ LQGXFHGSXOPRQDU\DUWHULDOK\SHUWHQVLRQكधखथਸ਼ ණपীథऔोॊق਀ك؛&75&' ध৊஘प 3+ भਉ౤ऋ੎ളघॊඪ୻ु धऌप৽ୡऔोॊऋؚੱ ग़॥ش௕ਫ਼ਪदभਕ቉ఉಗ૴আشॡഷ૴சे ॉ3+॑

ੳीञৃ় म૭ચऩ଒ॉා౤॑ અ௄घॊधधु प૑ਏऋँ ोयؚ ऋ॒ ੘௜प੍ ௽॑ ऌञऔऩः෇೧द ಖഡਫ਼ਪ॑ ਫ਼ୈघॊ؛ قڮكञऒणऻඪ౜ණ

ऋ॒ ೩঻मઔੴपे ॊಖઋ৓५ॺঞ५ऊै ञऒणऻඪ౜ණ॑ ಡ৅घॊऒधऋँ ॊ؛ऽञؚ ऋ॒ ఇ੟௜১पे ॊञऒणऻඪ౜ණु ৽ୡऔोؚ )8ؚ ढ़ঌ३ॱঅথؚ ঋং३६ঐঈؚ ॥থঈঞ५ॱॳথ قমഺदमಏ෫ઞ৷౞كؚ জॶय़३ঐঈؚ ॳট३থय़ॼش८༛૩දؚ ,&,V ड़३ওঝॳॽঈ ऩनदਾ ઔऋँ ॊ؛  ਸ਼9, ฆ ଣೝ଍੘௜৏भੱ ഷଵႈ೩ قڭك੕૛

๢৖قం๢৖उे लອ࿒كपৌघॊଣೝ଍੘௜मؚ பਙজথঃᇯृ ໚ऋؚ॒ ཡऋؚ॒ ୫੊ऋ॒ ऩ

नदষॎोथःॊ؛ऊणथमଣೝ଍੘௜पे ॊੱ ටृ ഷଵपৌघॊ୶஭म૘ऩःधऔोथःञऋؚ ऋ॒ ੘௜भਤనपൣ ःশ਋েோ঻ऋੜइॊधؚྻ ৅ਙ় ಡඪधखथੱ ഷଵႈ೩ऋ৅ඪघॊऒधऋীऊॉି ৯ औोथःॊ؛ଣೝ଍੘௜भසೝ෇೧पे ढथੱ Ⴭ༇ृੱ ൙ඪؚ ఉჍඪؚ ་৿ဿႈ೩ऩन॑ ৅ඪघॊ૭ચਙ ऋँ ॉؚ ੘௜৏f ফदfप৅ඪघॊधऔोॊऋؚ ႈ೩पे ढथमਯે ফ৏प৅ඪख੒৏ਂ ଐ भ౤৕धऩॊञीؚे ॉশ਋৓ऩইज़টش॔ ॵউऋ૑ਏदँ ॊ؛5,+' ৅ඪभ஠૫౤৕धखथमؚ ଄ফ
p.13


 ঻ؚ ଣೝ଍଍୤ऋৈःؚ॔ থॺছ१ॖ ॡজথ௺ఇදभઞ৷ऩनऋँ ॉق਀ك ஠૫౤৕॑ થघॊৃ়

म્ पି ਔऋ૑ਏदँ ॊ؛ قڮك૚૛ قLكੱ Ⴭႈ೩

૶ਙੱ Ⴭ༇मଣೝ଍੘௜भ૶ਙ਋় ಡඪदँ ॊऋؚ සೝ଍୤भ଩੖ृ සೝ෇೧भచ੖दᄄ২म

଩ৣ खथःॊ؛ଣೝ଍੘௜भਯౝ৑ऊै ਯফ৏पमཿਙੱ Ⴭ༇ऋেगؚੱ Ⴭभ଍೐ਙෝௐؚ Ⴉାउे लཿਙੱ Ⴭั ฅ೏॑ ੳीؚ ઽೠਙੱ Ⴭ༇॑ ৅ඪघॊऒधऋँ ॊ؛ઽೠਙੱ Ⴭ༇मع٫ங২पੳीै ोؚ සೝ଍୤ऋੜइॊध৅ඪᄄ২ु ੜਸघॊ؛ قLLੱ ൙௽૩

൙಍ཝঽ৬म಍ཝীຝ॑ କऒऔऩःञीଣೝ଍पৌखथິ ਙ॑ ੅णधऔोॊऋؚ ഷଵ৔ຜम௽૩॑ ਭ ऐॊ؛जभञी๶৵ഷଵ௽૩पे ॊ༘ ഷऋেगॊऒधपे ढथؚੱ ൙ႈ೩॑ ৅ඪघॊधऔोॊ؛ੱ ൙৑ସ भ଍೐৲भਤষपൣ ढथੱ ൙भ॥থউছॖ॔ থ५ऋ଩ৣ घॊञीؚ ఁ୑ਃચ଩ৣ ऋ਌৬धऩॊऋؚ ઽೠ ਃચ଩ৣ॑ ਟघऒधुँ ॊ؛ඵౕ ஫଑௺ऋ௽૩॑ ਭऐॊऒधुँ ॊ؛৅ඪमங২धऔोथःॊऋ ؚ ঍४य़থজথঃᇯपৌघॊଣೝ଍੘௜৏भੱ ൙௽૩॑ ৹ਪखञਾઔदमؚ॔ থॺছ१ॖ ॡজথ௺ఇද॑

ಡ৷खऩऊढञৃ় दुؚ  ফभྸ ஋ੱਂ ৸৅ඪ૨मؚ *\ दؚ *\ दؚ *\ ਰ঱दध଍୤ൂ ோਙपੜਸघॊऒधऋં औोथःॊ؛ قLLL ఉჍඪ

ଣೝ଍੘௜भ୶஭दؚ ఉ቉ृ ఉఢ೧ੌ ௶पෝௐृ ଍೐৲ؚ ಢೠؚ લ࿏৲ऋেगॊ؛కੱ ௺े ॉु

ంੱ ௺प੗ःऒधऊैؚ ৅ඪपमಓ଀෰ऋঢ়ଖघॊधऔोथःॊ؛ఉ቉੔ഈृ ઐ৴৖भ૗ਙऋ૘ऩःऒ धृؚ ঱ষপ৿ဿृ ఉ୽৖पु લ࿏৲ऋ఺वऒधऋজक़ঐॳਙ૗৲धम౮ऩॊ؛প৿ဿصᄀၣఉ଍೐ਙ ৴ਢ৖भෝௐृ લ࿏৲ऋؚ ଣೝ଍੘௜ഄभ્ ඉधऔोؚ जभங২म੒৏पঢ়৴खथःॊ؛ఉभಢೠऋ েगॊञीؚ ໭ᒡඪे ॉु ಗ૴ऋেगॊऒधऋ੗ः؛ಏ෫৓पથਔऩఉჍႈ೩मؚ ଣೝ଍੘௜৏ ফद ؚ  ফदؚ  ফदங২दँ ॉؚ ଣೝ଍੘௜৏ ফदؚ ೄ২প৿ဿఉಗ૴ऋؚ রಉ২ ਰ঱भপ৿ဿఉಗ૴ऋؚ ೄ২عরಉ২भপ৿ဿఉ໭ᒡඪऋؚ ೄ২ᄀၣఉಗ૴ऋؚ ೄ২ཡ ৿ဿఉಗ૴ऋங২धऔोथःॊ؛੎২भఉჍႈ೩दু ୒॑ ਫ਼ୈघॊৃ় मؚ ອ࿒भႩାؚ ཡभ଍ ೐৲ृ ঱ষপ৿ဿभલ࿏৲ऩन৫ੱ ୒भজ५ॡऋৈःऒधुँ ॉؚ প৿ဿఉ໭ᒡඪभৃ় पम৽ढ़ॸش ॸঝ৓প৿ဿఉ઼ ఌ୒ु ਫ਼ୈऔोॊ؛ قLY ་৿ဿႈ೩

ଣೝ଍੘௜पे ॊ་৿ဿႈ೩मؚ ഷଵ৔ຜ௽૩पे ॉ৿ဿໂ৲ऋയਤघॊऒधदেगॊ؛੘௜৏

 ফदႀ૔৲खؚ ଄ফ঻भ্ ऋৈೡ঻े ॉु ৅ඪखृ घः؛঍४य़থজথঃᇯपৌघॊଣೝ଍੘ ௜৏भ་৿ဿႈ೩॑ ৹ਪखञଢ଼஢दमؚ ੘௜৏ ফभৎਡदप་৿ဿ୰૗॑ ੳीञधਾઔऔोथ ःॊ؛་஠૫౤৕ऋ੗ःध୰૗ऋਤষखृ घऎؚ ం๢पଣೝ଍සೝ॑ ਭऐॊంડ໚ऋ॒ ऩनदमؚ ం ་৿ဿ਌ୌ৖ृ ੺ਜ਼৖भ୰૗ऋ੗ः؛৫ੱ ୒मজ५ॡऋৈऎؚ ऽञؚ ढ़ॸشॸঝ੘௜दमৢ ଞभ৿ဿ ໂ৲୰૗े ॉु ગ໭ᒡऋ੗ःधऔोؚ ੘௜ిૢ मඦ੎ऩਖ਼૵ऋ੷ीै ोॊ؛
p.14


 قگكଣೝ଍੘௜৏भইज़টش॔ ॵউ

ଣೝ଍੘௜৐ؚ ੘௜রप૑ङखु ঝشॳথपੱ ग़॥ش௕ਫ਼ਪ॑ ষअ૑ਏमऩःऋؚ ੘௜৏पঢ়ख

थमؚ ৐஽भे अपؚ ଣೝ଍ਙੱ ௽૩म੗ऎभৃ় ਯফؚु खऎम ফਰ঱भফা॑ ৽थऊै ႀ૔৲घ ॊऒधऋ੗ःञीؚ ৒਋৓ऩ൧௄ऩै लपজ५ॡই॓ ॡॱشभ௬੼ऋ੎ਏदँ ॊق௕ك؛੺ফमੱ ୉ष भසೝम଩੖औोथःॊु भभؚ জ५ॡपૢ गथؚੱ ग़॥ش௕ਫ਼ਪपे ॊ৒਋৓ऩশ਋৑भইज़টش॔ ॵউऋ૑ਏदँ ॊ؛  ਸ਼ 9,, ฆੱ ग़॥ش௕ੑ ೾पउऐॊৰಏ෫঱भି ਔਡ قڭكᇯᯂ࿯୭ஓ৾ भਤனधੱ ग़॥ش௕भ૽ સ

০঩ऽदपؚੱ ग़॥ش௕पे ॊ/9() उे ल*/6 मؚ &75&' भঔॽॱজথॢ पਂ ૭ಳऩ੐ఏ

धखथનয়औोञ؛ऒोै भ੐ఏभ૗৲मؚ ऋ॒ ೩঻भ੘௜্ ଉ॑ ంకघॊ੎ਏऩ౤৕दँ ॊ؛ऋ॒ ೩঻ ऋ਍৸ऊणి જऩ੘௜॑ ਭऐॊऒधऋदऌॊे अपؚੱ ग़॥ش௕ਫ਼ਪ॑૿ अ঻मؚ जभಖ২ଵ৶प౑ी ऩऐोयऩै ऩः؛ ফप৅਀औोञَ ঩মੱ ग़॥ش௕৾ ভಿ ऋ॒ ද੘௜ঢ়৴ੱ ൙௽૩भ൧௜पउऐ ॊੱ ग़॥ش௕ਫ਼ਪभু ਬُ  दमؚ ৰಏ෫पउऐॊੱ ग़॥ش௕ৰᄷभି ਔਡधಖ২ছॖ থपणःथ஽सञ؛ खऊखؚ जोਰఋु ৗञऩऋ॒ ఇ੟௜১્ؚ प,&,V ऋಏ෫भৃ दઁ ऎ৷ःै ोॊे अपऩॉؚ जोपൣ अੱ ෼ਙभ୰ଙृ ௬੼১पঢ়घॊੴৄ ऋ஥ऽढञ؛ऽञؚ যੵ ੴચق$,؟$UWLILFLDOLQWHOOLJHQFHك॑ मग ीधघॊૼ ୒୓ৗपे ॉؚੱ ग़॥ش௕भੑ ೾ಖ২ध஍૨ਙमఄ ඩ৓प਱঱खणणँ ॊ؛औै पؚ  ফ पम(6& फ़ॖ ॻছॖ থ ऩनؚ ব੠৓ऩ৾ ভऊैु ৗञऩ௓တऋ઀ં औोथःॊ؛ऒऒदमؚ  ফ ගু ਬभ௓တহඨ॑ ગਫ਼઒खؚ ਈ੺भੴৄ॑ ਸइथؚ ৰಏ෫पउऐॊੱ ग़॥ش௕भಖ২ؚ ગਠਙؚ उे ल થ৷ਙ॑ औै पৈीॊञीभ্ ১पणःथ஽सॊ؛ قڮك&75&' भঔॽॱজথॢ ੐ఏधಖ২ଵ৶भ੎ਏਙ

ग़॥ش௕पे ॊ/9() उे ल*/6 मؚ &75&' भঔॽॱজথॢ पਂ ૭ಳऩ੐ఏधखथનয়औ

ोथःॊ঳্ दؚ जभગਠਙقੑ ೾भयै णऌكपमି ਔऋ૑ਏदँ ॊ؛੺ফभਾઔदुؚ /9() भਫ਼঻ ৔؞ਫ਼঻৑ෙ୷म৺عங২  दँ ॉؚ */6 पणःथु ৺ங২ भෙ୷ऋেगॊधऔोथ ःॊ؛*/6 म/9()े ॉु &75&' भଫ਋৅ৄ पથ৷ऩ੐ఏदँ ॉؚ ગਠਙपु રोॊऒधऊैؚ (6& ऩनব੠फ़ॖ ॻছॖ থदुੱ ൙௽૩भଫ਋ਫ਼ল৯৓द*/6 ೾৒ऋ௓တऔोथःॊ؛ु ढधुؚ ऒोै भ ગਠਙपणःथभਾઔभ੗ऎमؚે ীऩੱ ग़॥ش௕भ৽ୡधૼ ୒॑ ਏघॊ઱ਝऊै दँ ॉؚ ঳ಹ৓ऩ৘ র୰੹ृ ൧௜ਚद৊गગਠਙ॑૿ ৳दऌॊधम଒ै ऩः؛્ पؚ /9() भ٫भෙ୷म&75&' भ൧૵ ੦૆पु ୶஭घॊகदँ ॊऒधपି ਔखऩऎथमऩै ऩः؛ৰಏ෫दमؚ ৵औऩ/9() ૗৲ق౞௥ ऩनكमੑ ೾ෙ୷भ෇೧৔दँ ॊ૭ચਙ॑ ୛୍ प઼ ऌؚ */6 भ૗৲ु અൟखथ੕় ৓ऩਖ਼૵॑ ষअ૑ਏ ऋँ ॊ؛ قگكੱ ग़॥شಖ২ଵ৶भञीभதఠణਫ਼ਪ஼पउऐॊ৳ஹधઇ୘ق਀ك

ऽङதఠణ൧૵ಎ઼ ऋి ਫप૭৿खथੑ ೾ऋষॎोॊञीपुؚ தఠణਫ਼ਪ஼उे लਃஓଵ৶

पणःथमؚ फ़ॖ ॻছॖ থपปढञ৳ஹਡਫ਼॑ ষअऒधऋ੷ीै ोॊ؛ੱ ग़॥شੑ ೾கभಖ২॑૿ ৳
p.15


 घॊपमؚ ૘ऩऎधु  ফप঳৚म/9()ृ */6 भਫ਼঻৔ऩै लपਫ਼঻৑ෙ୷॑ નੳखؚ ઱ਝधखथभ

ಖ২ଵ৶प౑ीॊऒध॑ ௓တघॊ؛ऽञؚੱ ग़॥شੑ ೾भಖ২॑૿ ৳घॊञीपमؚ ५ॱॵইभઇ୘ऋ୦े

ॉु ੎ਏदँ ॊ؛৽ୡभฒःਫ਼঻पणःथमؚੱ ग़॥ش௕৾ ভੳ৒௧୅ૼ పृ ௧୅ୢ ऩन৽ୡ॑ે ী प஋॒ ट঻ऋઇ୘पਊञॉؚ ਫ਼ਪ૿ ਊ঻ऋ৊गे अपಖ২ଐऎੑ ೾॑ ষइॊे अ੐଑॑ ষअ؛औै पؚੱ ग़॥ش௕भಯૃ ઺ऩै लप৿઺मःणदु ૞සदऌॊे अप઺൸१شংشप৳ோखؚి ࿤ગੑ ೾॑ ষइ ॊे अਝ૟॑ ତइॊऒधऋ஦ऽखः؛ قڰكੱ ग़॥ش௕ਫ਼ਪपउऐॊ೏ਔਡق਀ك

ग़॥ش௕੐ఏभੑ ೾ෙ୷॑ লਟॊटऐ৵औऎघॊऒधऋؚి જऩ੘௜্ ଉৠ৒पम૑ਏदँ

ॊ؛ి જऩੑ ೾க॑ ઀୹घॊञीपुؚ ઃभਡप೏ਔखथਫ਼ਪपँ ञॊ૑ਏऋँ ॊ؛ L ৐৚ੑ ೾க؞ঋش५ছॖ থੑ ೾கभનੳ

ग़॥ش௕ਫ਼ਪभ઱ষഄऋँ ॊඪ୻पउःथमؚ ਫ਼ਪ৐प৐৚उे लঋش५ছॖ থभੑ ೾கऩै

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ᚰẘᛶࡢ࠶ࡿࡀࢇ⸆≀(o)ἲ㛤ጞ๓ࡢᚰ࢚ ࢥ࣮ ᅗ᳨ ᰝ LVEF<50% LVEF≧50% GLS<18% ᚰƫ⬟పୗࡢ⢭ᰝࢆ足࠸ࠊᚲせ࡟ᛂ ࡌ࡚ ᚰಖㆤ⸆ࡢᢞ୚࡞࡝἞(o)ࢆ足࠸㸪ࡀࢇ⸆≀(o)ἲ㛤ጞࡢྍྰ ࢆ᳨ウ

ࡀࢇ⸆≀(o)ἲࢆ㛤ጞ ࡀࢇ⸆≀(o)ἲࢆ㛤ጞ㸪₯ᅾhᕥ ᐊ཰⦰୙඲ࡢཎᅉࢆ᳨ ⣴ࡍࡿ㸨ࡀࢇ⸆≀(o)ἲ୰ࡢᚰ࢚ ࢥ࣮ ᅗ᳨ ᰝࡣ౑⏝⸆๣࡟ᛂࡌ࡚足࠺ (韭3ཧ↷) LVEF≧50% GLSࡢ᭷ព࡞పୗ࡞ࡋ CTRCD ࡢデ᩿ (韭2ཧ↷) ᚰ࢚ ࢥ࣮ ᅗ᳨ ᰝࡢࣇ࢛࣮ࣟ ࡣ౑ ⏝⸆๣࡟ᛂࡌ࡚足࠸ (韭3ཧ↷) ࡀࢇ⸆≀(o)ἲࡢ୰᩿ ࢆ᳨ウ

ࡀࢇ⸆≀(o)ἲࢆ⥅⥆

LVEF<50%

CTRCD ࡢデ᩿ (韭2ཧ↷) ᚰ࢚ ࢥ࣮ ᅗ᳨ ᰝࡢࣇ࢛࣮ࣟ ࡣ౑ ⏝⸆๣࡟ᛂࡌ࡚足࠺ (韭3ཧ↷)

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p.31
࢔ࣥ ࢺࣛ ࢧ࢖ࢡࣜࣥ ⣔ᢠࡀࢇ๣ࢆྵ ࡲ࡞࠸ ࡀࢇ⸆≀(o)ἲ⤊஢᫬ࡢᚰ࢚ ࢥ࣮ ᅗ᳨ ᰝ GLSࡢ᭷ព࡞పୗ࡞ࡋ GLSࡀ࣮࣋ ࢫࣛ ࢖ࣥ ࡜aʾリットルࡋ࡚ ┦ᑐh࡟15㸣ࢆ카࠼࡚ పୗ ᚰಖㆤ⸆ࡢᢞ୚

LVEF<50%

CTRCD ࡢデ᩿ (韭2ཧ↷) ᚰ࢚ ࢥ࣮ ᅗ᳨ ᰝࡢࣇ࢛࣮ࣟ ࡣ౑ ⏝⸆๣࡟ᛂࡌ࡚足࠺ (韭3ཧ↷)

ࣇ࢛࣮ࣟ ࢔ࢵࣉ⤊஢ ࢔ࣥ ࢺࣛ ࢧ࢖ࢡࣜࣥ ⣔ᢠࡀࢇ๣ࢆྵ ࡴ ࡀࢇ⸆≀(o)ἲ⤊஢᫬ࠊ⤊஢6࠿᭶ᚋ㸪12 ᭶ᚋࡢᚰ࢚ ࢥ࣮ ᅗ᳨ ᰝࢆ᥎ዡ 12࠿᭶ᚋ࡟GLSࡢ᭷ព࡞పୗࢆㄆ ࡵ࡞ࡅࢀࡤࣇ࢛࣮ࣟ ࢔ࢵࣉ⤊஢

LVEF≧50㸣GLSࡢ᭷ព࡞పୗ࡞ࡋ GLSࡀ࣮࣋ ࢫࣛ ࢖ࣥ ࡜aʾリットルࡋ࡚ ┦ᑐh࡟15㸣ࢆ카࠼࡚ పୗ ᚰಖㆤ⸆ࡢᢞ୚

LVEF<50%

CTRCD ࡢデ᩿ (韭2ཧ↷) ᚰ࢚ ࢥ࣮ ᅗ᳨ ᰝࡢࣇ࢛࣮ࣟ ࡣ౑ ⏝⸆๣࡟ᛂࡌ࡚足࠺ (韭3ཧ↷)

LVEF≧50㸣
p.32
ᨺᑕ⥺἞(o)

1ᖺࡈ࡜ࡢ⑕≧࣭サイクルయ᳨ ᰝ࣭ࣜ ࢫࢡࣇ࢓ࢡࢱ࣮ ࡢホ౯

⑕≧࡞ࡋ ⑕≧࠶ࡾ

ᚰ࢚ ࢥ࣮ ᅗ᳨ ᰝ

카㧗ࣜ ࢫࢡ ୰➼ᗘࣜ ࢫࢡ

ऋ॒ ੘௜ીവৎभজ५ॡಽશ৲

தৈজ५ॡ ؞0+'!*\

؞0+'ع*\ऊणॻय़९ঝঅ३থఌ઴ˀPJP

ৈজ५ॡ ؞0+'ع*\

؞0+'ع*\ऊणॻय़९ঝঅ३থఌ઴ˀPJP

রಉ২জ५ॡ ؞0+'ع*\

؞0+'*\ऊणॻय़९ঝঅ३থఌ઴ˀPJP

଩জ५ॡ ؞0+'*\ MHD(mean heart dose) 㸸ᖹᆒᚰ⮚⥺㔞࣭ MHDࡀ୙࡛᫂ ࠶ࡿሙྜ ࠊMHD>15Gyࡣᚰ⮚㡿ᇦ࡬↷ᑕ>35Gy࡜࡞ࡾࠊ카㧗ࣜ ࢫࢡ࡜㧗ࣜ ࢫࢡࢆุู࡛ ࡁ࡞࠸ࠋ࣭ MHD5㹼15Gyࡣࠊᚰ⮚㡿ᇦ࡬ࡢ↷ᑕ࡜ࡋ࡚ ࠾ࡼࡑ15㹼35Gy ᒙู ໬ࡍࡿ࣭ AYA: Adolescent and Young Adult 15ṓ࠿ࡽ30ṓ௦ࡢࡀࢇࢧࣂ࢖ࣂ࣮

㧗ࣜ ࢫࢡ పࣜ ࢫࢡ

࡞ࡋ ᡂே 5ᖺࡈ࡜ ᑠඣ࣭ AYA 5ᖺࡈ࡜

ᡂே 5ᖺࡈ࡜ ᑠඣ࣭ AYA 2ᖺࡈ࡜

ᡂே 1,3,5ᖺᚋ ࡑࡢᚋࡣ5ᖺࡈ࡜

ᑠඣ࣭ AYA 2ᖺࡈ࡜
p.33
表1

がん治療心血管毒性を引き起こすがん治療

・アントラサイクリン系薬剤・抗HER2 抗体療法・フルオロピリミジン・VEGF 阻害剤(血管新生阻害剤)・BCR/ABL チロシンキナーゼ阻害剤・BTK 阻害剤(ブルトン型チロシンキナーゼ阻害剤)・多発性骨髄腫治療・BRAF/MEK 阻害剤・ICI(免疫チェックポイント阻害剤)・前立腺がんに対するアンドロゲン除去療法・乳がんに対する内分泌療法・CDK4/6 阻害剤・ALK 阻害剤・EGFR 阻害剤・CAR-T 療法・放射線治療・造血幹細胞移植・そのほか
p.34
਀ڮ &75&' भ੎ඪ২ীథ  த੎ඪ ਘੱ දؚ ଓஃ࿯୭१এشॺ॑ ਏघॊؚ ऽञमੱ ୎೘॑ અൟघॊੱਂ ৸ ੎ඪੱਂ ৸ো੹॑ ਏघॊৃ়  রಉඪ ਗਟदਹႌදधੱਂ ৸੘௜ఇभਘ৲॑ ਏघॊৃ়  ೄඪ ೄ২भੱਂ ৸ඪ૾ ऋँ ॊऋ੘௜ਘ৲मਂ ਏ ੎ඪ ৗञप/9()धऩढञৃ়  ⋇ ⋈भःङोऊ ⋇/9() ऋৗञप٫ਰ঱଩ৣ खधऩढञৃ়  ⋈/9() ऋ٫౞௥भ଩ৣ द/9()٫धऩॉؚ ऊणਰৣ भःङोऊभৃ়  */6 भঋش५ছॖ থऊै भৗञऩৼৌ৓ऩ଩ৣ ق̆ */6كऋ॑ தइॊ ৗञऩੱ ටংॖ ड़ঐشढ़شभ঱ಊ
 /9()ۺ٫ */6! ऊणऽञम ৗञऩੱ ටংॖ ड़ঐشढ़شभ঱ಊ
 ੱ ටংॖ ड़ঐشढ़شभ঱ಊ؟F7Q,F7Q7 भ٫ॱॖ ঝਰ঱भ঱ಊؚ %13ۺSJPO؜17SUR%13ۺSJPO ऽञमঋش५ছॖ থऊै भৗञऩથਔऩ঱ಊقઞ৷॔ ॵ७ॖ भে੟৾ ৓ؚੰ ෲ৓ऩෙ୷॑ தइॊु भك
p.35
਀ ऋ॒ ఇ੟௜১प૑ਏऩੱ ग़॥ش௕ਫ਼ਪभ৯਍   ঳ಹ੡قറୁ ك ૹષ੡ ௓တੱ ग़॥شॱॖ ঑থॢ  ॻय़९ঝঅ३থ॔ ॻজ॔ ३থ ଩জ५ॡ؟੘௜৐ १ॖ ॡঝ৯ ফ৏ রজ५ॡ؟੘௜৐ १ॖ ॡঝ৯ ফ৏ ৈজ५ॡ؟੘௜৐؞؞ڲ१ॖ ॡঝ৯ ऊা৏ ফ৏  ଩রজ५ॡदमॻय़९ঝঅ३থఌ઴द ⋸P தइञৎ ਡदु ௓တ

আছঝঅ३থ ॸছঝঅ३থ ই॓ ঝঔঝঅ३থ ग़আঝঅ३থ 

ই॓ ঝঔঝঅ३থ ॻय़९ঝঅ३থව෷জ঎९ش঒ଲද ॻय़३ঝಿ ॺছ५ॶ६ঐঈঁ ش७উॳথ ଩রজ५ॡ؟੘௜৐ ੘௜র ऊা൐ ৈজ५ॡ؟੘௜৐ ੘௜র ऊা൐

ॺছ५ॶ६ঐঈ ग़঒ॱথ३থ ढ़ॻ१ॖ ছ ॺছ५ॶ६ঐঈ ॹঝ५ॸढ़থ ग़থঁ شॶ ঌঝॶ६ঐঈ ঃش४ख़ॱ ঌঝॶ६ঐঈ؞ॺছ५ॶ६ঐঈଦ়  ইख़५० ঋং३ॶ६ঐঈ॔ ং५ॳথ ଩জ५ॡ؟੘௜৐ রজ५ॡ؟੘௜৐ ੘௜র ऊা൐ ৈজ५ॡ؟੘௜৐ ੘௜র ऊা൐ தৈজ५ॡदम঱੶पਸइؚ  ౝ৑৯॔

ইজঋঝ७উॺ २ঝॺছॵউ ছ঒३ঝঐঈ १ॖ ছ঒२ ५ॽॳॽঈ ५شॸথॺ ९ছইख़ॽঈ ॿॡ१ংشঝ ঃ॰ঃॽঈ দज़ॺজग़থॺ
p.36
॔य़३ॳॽঈॖ থছॖ ॱ ঞ०ছইख़ॽঈ ५ॳংشफ़ ংথॹॱॽঈ ढ़উঞঝ१ এॼॳॽঈ॔ॖ ॡঝ३ॢ  ढ़঎१থॳॽঈ ढ़঎ওॸॕ ॡ५ ঞথংॳॽঈ ঞথঅঐ অজ঒ঐঈ খش঎ॖ  ੘௜৐

ॽ঎ঝঐঈ ड़উ४ش঎ ह঒উটজ६ঐঈ य़ॖ ॺঝشॲ॔ ঋঝঐঈ ংঋথॳड़॔ ॸ॰জ६ঐঈ ॸ७থॺজॡ ॹॕ ঝংঝঐঈॖ ঑ইॕ থ४ ॺঞওজ঒ঐঈॖ ४গॻ ७঑উজঐঈ জঈॱচ
p.37
਀ ੘௜৫઩৐भ*/6 पे ॊॖ ঋথॺ੒೾ ق৅਀ফك ॹ२ॖ থ ৌ଴

قඪ୻ਯك ੘௜ ढ़ॵॺड़ইக ୯඄਋৑ ੒೾ಖ২؞੥ટ

৏ौ਱ऌ ॥঍شॺ

৸ऋ॒ ர ق ୻ك॔

থॺছ१ॖ ॡজথ

ਫ਼ୈऩख ق਴಑க؟ ك

রఙக  ফ

*/6 म0$&(ؚ ৸ଈಝभஆয় ੒೾౤৕

৏ौ਱ऌ ॥঍شॺ

৸ऋ॒ ர ق ୻ك

৲৾ ௜১ق੗ ஘ك

ਫ਼ୈऩख ق਴಑க؟ ك

ਈশ ফ */6 म৸ଈಝभஆয়੒೾౤৕

৏ौ਱ऌ ॥঍شॺ

ഷั பਙᇯᯂ ق ୻ك॔

থॺছ१ॖ

ॡজথ  রఙக

 ফ

*/6मੱਂ ৸ੱ ഷଵ ଈଈಝभজ५ॡऋ ೅धऩ ॉؚ */6 मஆয়੒೾౤৕

৐਱ऌ ॥঍شॺ

பਙজথঃᇯ ق ୻ك॔

থॺছ१ॖ

ॡজথ   ऊা

*/6 भाऋ੗૗୤दஆয়੒೾ ౤৕दँ ॉؚ */6 助द৲৾ ௜১৏भం஼ฌল૨भ଩ৣ॑ ੒೾૭ચ

৏ौ਱ऌ ॥঍شॺ

૶ਙஜഷ୰ ق ୻ك॔

থॺছ१ॖ

ॡজথ  রఙக

 ऊা

*/6मਈु ਘৡऩ੒೾౤ ৕

৏ौ਱ऌ ॥঍شॺ

৸ऋ॒  ق ୻ك॔

থॺছ१ॖ

ॡজথ 努 ऊা */6द&75&' भ৅ে

জ५ॡऋ঱ಊ
p.38
7KDYHQGLUDQDWKDQHWDO -$P&ROO&DUGLRO

৐਱ऌ 5&7

ৈজ५ॡ೩঻ ਌प໚ऋ॒  ق ୻ك॔

থॺছ१ॖ ॡজথ žॺছ५ॶ६ ঐঈ

ਫ਼ୈऩख  ফ */6 फ़ॖ ॻৣ पे ॊੱ ৳૧ఇ

଑োमం஼ฌল૨भ଩ৣ॑ ੒ଆ

৐਱ऌ ॥঍شॺ

໚ऋ॒   ୻ك॔

থॺছ१ॖ ॡজথٔ VHTXHQWLDO WDUJHWHG WKHUDS\



੘௜ ऊা৏  ফ ੘௜ ऊা৏ৎਡभ*/6 ऋ೚

৅ਙ&75&'॑ ੒೾

৐਱ऌ 5&7

+(5഻ ਙ໚ऋ॒   ୻ك

శ॔ থॺছ१ॖ

ॡজথ ਫ਼ୈऩख  ফ

଩জ५ॡ؞శ॔ থॺছ१ॖ ॡজ থઞ৷ණदमؚ */6 भ଩ৣ ऋँ ढथु ੒ଆఇऋਂ ਏदँ ॊ૭ ચਙ॑ંྮ 

৏ौ਱ऌ ॥঍شॺ

பਙজথঃᇯ ق ୻ك॔

থॺছ१ॖ ॡজথ žଣೝ଍௜১

ਫ਼ୈऩख রఙக

 ফ

ం஼ฌল૨ऋਫଞदु */6 ऋ ཿਙੱ ෼ਙभ৊৒पથ৷
p.39
਀ ,&,ۢ ঢ়৴ੱ ൙༇भ൧૵੦૆  ୰৶৾ ৓ન৒൧૵ੱ ൙಍ཝभ৥ै ऊऩശଈ॑ൣ अ੗༰ਙभ༇ඪਙ಍ཝ࿠ဋق୾৾ ႀ๶ྰ ك ಏ෫৓൧૵ ૶ਙ་ඪ౜ණृ ૎ഉਙੱ ൙༇॑ ௾ਗखञअइदؚੱ ൙ॺটএॽথக঱ಊٔ ਰৣ भअठ

਌ਏ੦૆ ඨ৯ऽञम ઃ੦૆ ඨ৯ਰ঱ ௥ञघऒध ਌ਏ੦૆ ૶ਙੱ ൙༇भ&05 ਚৄ قఊਫ/DNH/RXLVH ੦૆प૆ುكౢ ⋇ ಏ෫ඪ౜ق໸ௌؚ ൙൱ؚ ๢൱ؚ ളଳؚ ళล൑୔ؚ କౠళลؚৣ ࿔೟ᇯؚ ৿ᠶؚ ीऽःؚ ଷઋؚ ൙ৡ଩ৣؚ ३ঙॵॡك ⋈ ੱ ஼ਙਂ ତဿऽञम஫଑௽૩ ⋉ ం஼ઽೠચ଩ৣ قଂਚ෢ઈ৿౮ଞஅिؚ శञऒणऻ஑ك ⋊ ౎भLU$(ق੗৅൙༇ؚ ൙ඪؚ ੎ඪ൙૮ৡඪك ⋋ ઑॎखः&05 ਚৄ 
p.40
਀ ,&,ۢ ঢ়৴ੱ ൙༇भ੎ඪ২ীథ  แඪ஑ ࿯୭৿ଙਂ ਍৒ؚ శ෶๷؞෶๷৓ଓஃऋ૑ਏؚ ৈ২ඬ஼ঈটॵॡؚ ੎Ⴟऩਂ ତဿ శแඪ஑ ඪ౜ਙटऋ࿯୭৿ଙ਍৒ؚ ਗ਼ਞ৓౮ଞ॑ൣ अ೩঻؛ඊႵঢ়৴ॖ ঋথॺध৊ৎप၉৅৓प൧૵औोॊऒधुँ ॊ؛

ం஼ฌল૨଩ৣँ ढथु ੎ඪඉ౜ऩख؛ ५ॸটॖ ॻ຅ಿ ਙ ५ॸটॖ ॻ੘௜पु ऊऊॎै ङؚੱ ൙༇ऋశབੰँ ॊःमப৲घॊৃ় ق౎भ୰౤॑ ௾ਗ৏ु ॺটএॽথৈகऋ
p.41
਀ ఇ੟؞෼੟ා৅ਙ3+ ৅ඪपঢ়ଖघॊఇ੟ 3$+ ৅ඪषभનৰऩঢ়৴ऋँ ॊु भ 3$+ ৅ඪषभঢ়৴भ૭ચਙऋँ ॊु भ ॲ१ॳॽঈ ঐॖ ॺঐॖ ३থ& ढ़ঝইॕ ঝ॰঑ঈ॔

ঝय़ঝ৲ද ঎५ॳॽঈ এॼॳॽঈ ঋং३६ঐঈ ঎ঝॸ॰঑ঈ
p.42
਀ 5,+' ৅ඪभ஠૫౤৕ 

؞৐એऽञमం๢षभසೝ ؞ৈःྸ ஋ଣೝ଍଍୤قٜ *\ ؞଄ফ঻قٛ ୃ ك ؞ ৚ँ ञॉभৈःଣೝ଍଍୤قٜ *\GD\ ؞ੱ ට৔ऽञमੱ ටपਤனखञᇯᯂभோ૔ ؞ଣೝ଍ᄭ⎱भಳ࿰ ؞৲৾ ௜১भಡ৷ق॔ থॺছ१ॖ ॡজথ௺ఇදभઞ৷ك ؞་஠૫౤৕قႇႌ୰ؚླཱྀ ໛ؚ ෝ௥ؚ ৈഷಓؚ ࿫ସ౮ଞඪك ؞ੱ ഷଵႈ೩भใ༼
p.43
1 ਀ੱ

ग़॥ش஼पउऐॊਃஓధलपಖ২ଵ৶पঢ়घॊ௓တ ؞ੱ ग़॥ش஼उे लਃஓଵ৶पणःथमؚ फ़ॖ ॻছॖ থपปढञ৳ஹਡਫ਼॑ ষअऒध॑ ௓တघॊ؛ ؞ੱ ग़॥ش௕ਫ਼ਪ઱ষഄऋँ ॊඪ୻पउःथमؚ ਫ਼ਪ৐प৐৚उे लঋش५ছॖ থभੑ ೾கऩै लप઺൸भ ؞ੱ ग़॥شੑ ೾கपणःथमؚે ীऩ৽ୡ॑ ஋॒ टਫ਼঻ऋଳಁ ৓ऩ௬੼ध঳ಱखथःॊऊનੳ॑ ষअ؛ ؞৒਋৓पੱ ग़॥شਫ਼ਪ஼৔दੱ ग़॥شੑ ೾கपणःथਫ਼঻৔ऩै लपਫ਼঻৑ෙ୷पणःथનੳखؚੑ ೾ಖ ২ଵ৶प౑ीॊऒधऋ஦ऽखः؛ ؞ੱ ग़॥ش௕ਫ਼ਪभಯૃ ઺ऩै लप৿઺म઺൸१شংشप৳ோखؚి ࿤઺൸ၡ༮ऩै लपગੑ ೾॑ ষइॊे