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8/11/2019 Laporan Kasus IV Demam Rematik

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Modul Organ Kardiovaskular

LAPORAN KASUS IV

Tati, 12 Tahun, !ngan K!luhan !"a"

K#LOMPOK VIII

030.09.133 LADY DIANA

030.09.135 LAKSMI PUTRI AYUKINANTI

030.09.137 LUSIANA JEANNETTE C

030.09.139 M. AGUNG SANTARA

030.09.141 MALVIN GIOVANNI

030.09.143 MARGO SEBASTIAN CHANDRA

030.09.147 MAYA LIANA

030.09.149 MELIA INDASARI

030.09.151 MELLY UTAMI030.09.152 MEUTIA MA IRA RINDRA

030.09.153 MICHAEL !ONG

030.09.155 MOCHAMMAD RI KI MAULANA

030.09.157 MONICA RAHARJO

$AKULTAS K# OKT#RAN UNIV#RSITAS TRISAKTI

%AKARTA

&1 M!i 2'11

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a7!t3lglu7osa"in!8 -ada dinding s!l dan "!".ran s!l str!-to7o77us . M$($ )$%' '&-($)$% $/&'8 % - A ($% +')%$& $/&' )' &"%+$)$ " '& ($% +')%$& % - A $/

&'/ ' "%+- -/ $/ )"/ $/ % / ,', $/ (-%$/ $'(. 12

A(' $& %"$(,' ,'*$/ $/&' )' )$/ ,"*8T $/ )' "/&-( *"+ &- -+ -/&-( #"*$:$/ '/ "(,'

,&%" & ( (-, #$($ &"% $)' % ,", $-& '#-/ $)$ $/&-/ (-*'& $/ *'$ $,$*', )$/ ,"/)'

,"+'/ $ #"/'# -*($/ " $*$ $/ &"%*'+$& $)$ )"#$# %"#$&'(. S"&"*$+ "%' )" *$&"/

,"('&$% 3 #'/ - "%(',$% $/&$%$ 185 #'/ - #$($ &'# -*$+ " $*$ $'&- 6$%)'&', / )-*

,- (-&$/ "%'&"#$ #$% '/$&-# )$/ $%&%'&',. C+ %"$ #"# -/ $' "%' )" *$&"/ $/ *" '+

$/ $/ )' $/)'/ ($/ )"/ $/ " $*$ *$'/ $ $'&- ,$# $' -*$/. G" $*$ (*'/', $*'/

,"%'/ -/&-( )"#$# %"#$&'( '$*$+ *'$%&%'&', )$/ )"#$#. P *'$%&%'&', &"%)$ $& $)$ 08

75 ($,-, )"#$# %"#$&'( 6$%)'&', 508 0 6+ %"$ 2 830 ,")$/ ($/ "%'&"#$

#$% '/$&-# )$/ / )-* ,- (-&$/ 5 . 11 G" $*$ $/ &"%)$ $& $)$ $,'"/ '/' '$*$+ ($%)'&',

)$/ *'$%&%'&', #' %$/,;

a# *arditis

C$%)'&', #"%- $($/ #$/' ",&$,' $/ $*'/ ,"%'-, )$%' )"#$# %"#$&'(. P$)$

6$%)'&', &"% $)' '/ *$#$,' "%- $ "/) 6$%)'&', # 6$%)'&', )$/ "%6$%)'&',.

E/) 6$%)'&', +$# '% ,"*$*- &"% $)' $)$ 6$%)'&', )$/ #"%- $($/ '/ *$#$,' *$ ',$/

$/&-/ $/ $*'/ "% $+$ $ ($%"/$ )$ $& #"/ " $ ($/ ("%-,$($/ $/

"%#$/"/ $)$ %+"-#$&'6 +"$%& )',"$,". M 6$%)'&', )$ $& &"% $)' #"/ " $ ($/

"% $/ $/ $/ )$%' '/&"%@$* PR $)$ "#"%'(,$$/ EKG '/' )'," $ ($/ *"+

+$# $&$/ $)$ $*'%$/ ( /)-(,' *',&%'( $/&-/ . P"%'6$%)'&', $%$/ )')$ $&($/

20


22/36


23/36

E ', )" )"#$# %"#$&'( $/ "%-*$/ $($/ #"/ " $ ($/ "/" $*$/ )$/

($*,' '($,' )$%' ($&- $/&-/ $/ ,-)$+ #"/ $*$#' ("%-,$($/. A(' $&/ $ &"% $)'

,&"/ ,', ($&- $/ #"%- $($/ ,-$&- ("%-,$($/ "%#$/"/. K"%-,$($/ "%#$/"/

($&- $/&-/ &"%)$ $& $)$ %+"-#$&'6 +"$%& )',"$,".

# Poliartritis "igrans

K"*$'/$/ '/' #"%- $($/ ("*$'/$/ #$ % $/ $*'/ #"%$/6-($/ )$/ #-/ ('/

#"/ " $ ($/ (",$*$+$/ )'$ / ,', *" '+ $/ $( )$%' $)$ #$/' ",&$,' *$'/. A%&%'&',$(-& )"#$# %"#$&'( $)$*$+ ,$/ $& / "%'. T')$( $%$/ $/$( )"/ $/ "/&-( $%&%'&',

'/' #"/ *$( #"/ ' '/($/ #"/-&- ,"/)' $/ &"%("/$ :$*$- -/ +$/ $ )"/ $/

"/-&- ($,-% #$- -/ $($'$/. S"/)' "%:$%/$ #"%$+ +$/ $& )$/ "/ ($(.

A%&%'&',/ $ "% '/)$+ '/)$+ )$/ #"/ "/$' " "%$ $ ,"/)' "% $/&'8 $/&'; ,'(-

*-&-& "% "*$/ $/ ($(' )$/ "% "*$/ $/ &$/ $/. J$%$/ &"% $)' $)$ $%' &$/ $/

$%' ($(' )$/ ( *-#/$ @"%&" %$*',. T')$( +$%-, ,'#"&%',. M-/ ('/ $)$ " -,'. J'($

,"/)' )' $, '%$,' '$,$/ $ $($/ )' &"#-($/ *"-( ,'& ,', *"-( ,'& *'# % /-(*"$% $)$*$+ ,"* $/ ,"%'/ )' &"#-($/. N$#-/ &')$( $)$ "/"#-$/

*$ %$& %'-# , ",' '( $)$ 6$'%$/ , / @'$*. P *'$%&%'&', #' %$/, $)$ )"#$#

%"#$&'( '$,$/ $ &')$( #"/'/ $*($/ " $*$ ,',$ )$/ )$ $& ,"# -+ ,"# -%/$ '($

)' $&' )"/ $/ $'(. 9

K"*-+$/ *$'/ $/ #-/ ('/ &"%)$ $& $)$ $,'"/ '/' '$*$+;

c# +odul Su kutan

22


24/36

N )-* ,- (-&$/ &"%)'%' $&$, -/'& $%'/ $/ $/ /"(% &'( )' $ '$/ ,"/&%$* )$/

)'("*'*'/ ' *"+ *$ ',$/ ,"* # / /-(*"$% $/ &"%,-,-/ ,"6$%$ %$)'"% )"/ $/

$%'/ $/ '($& $/ $)$& )$/ )' '/ '*&%$,' *"+ ,"*8,"* -*$&. D' "%('%$($/ +$,'* )$%'

%", / $-& '#-/ /$#-/ $& "/",', $/ &" $& #$,'+ "*-# "*$,. N )-*

,- (-&$/ $%$/ #"# "%'($/ ("*-+$/ $($/ &"&$ ' "/&'/ -/&-( )'$ / ,&'(.

B'$,$/ $ &'# -* $)$ #'/ -8#'/ - "%&$#$ )$/ '$,$/ $ / )-* '/' #"%- $($/

$%'/ $/ $)$& &')$( / "%' "%+- -/ $/ )"/ $/ &"/) / ($ ,-* "%,"/)'$/ )$/

$,'$. T"%-&$#$ &"%)$ $& )' $ '$/ "(,&"/, % ,'(- $%'8 $%' *-&-& -/ -/ )$/

(" $*$.9

d# 0horea

C+ %"$ $)$*$+ "%$($/ )' *-$% (",$)$%$/ $/ 6" $& #"/ "/&$( "/)"( )$/

"%-*$/ -*$/ $/ )' #-*$' ,$&- $ '$/ &- -+ )$/ ,"%'/ ($*' ,"6$%$ &"%-,

#"/"%-, ,$# $' $ '$/ &- -+ *$'// $. C+ %"$ )' $(' $&($/ *"+ @"%$(&'@'&$, $&$-

("%-,$($/ $)$ $,$* $/ *'$. B$ '$/ &$( $/ "% -/ ,' #"# "%#-)$+ )$/

#"/ ( %)'/$,'($/ "%$($/ $/ )' #-*$' *"+ '# -*, , $%$ )$%' &$(. P$)$

(" $/ $($/ "/&-( 6+ %"$ ("*" '+$/ ) $#'/" $/ #"%- $($/

/"-% &%$/,#'&&"% -&$#$ $/ )' $($' )' $,$* $/ *'$ #"/6" $+ $,$* $/ *'$

)$%' -/ ,'/ $ ,"6$%$ / %#$*. O $& )$/ "/ $('& $/ #"/'/ ($&($/ ($)$%

) $#'/" $&$- #"/'/ ($&($/ ,"/,'&'@'&$, ,"* , $%$ (" ) $#'/" 6"/)"%-/

#"# "% -%-( 6+ %"$. C+ %"$ #-/ ('/ &"% $)' "%-*$/ /$#-/ (" $)'$/ -*$/ $/

'/' '$,$/ $ $%$/ . 9 S"%$/ $/ 6+ %"$ $(-& '$,$ )',"%&$' *"+ $/ -$/ ,'(',

," "%&'irrita ility (" %' $)'$/ o sessive compulsive )$/ " $*$8 " $*$ ,'( &'(.13

e# (ritema "arginatum

U/&-( "%'&"#$ #$% '/$&-# "*-# )'("&$+-' $& ',' * ' $/ #"/)$,$%'/ $ $)$)"#$# %"#$&'(. 4

K* Ko"-likasi

D"#$# %"#$&'( $/ )'$*$#' $,'"/ #"#'*'(' " "%$ $ ( # *'(,' $ $ '*$ &')$( )' $&'

)"/ $/ $)"(-$& ( # *'($,' &"%," -& $)$*$+;

23


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1. R+"-#$& ') H"$%& D',"$," RHD ; R+"-#$& ') H"$%& D',"$," #"%- $($/ ,-$&-

("$)$$/ )'#$/$ ($&- $/&-/ #"/ $)' %-,$( $(' $& )"#$# %"#$&'(. K"$)$$/ '/'

-#-#/ $ &"% $)' )"/ $/ $)$/ $ '/ "(,' $)$ $/&-/ "%- $ "/) 6$%)'&',

"%'6$%)'&', )$/ # 6$%)'&',. P$)$ -#-#/ $ "/) 6$%)'&', )'&$/)$' )"/ $/ $)$/ $

'/,- ','"/,' ($&- $/&-/ . D$*$# +$* '/' ($&- #'&%$* $/ #"/ $*$#' $/ -$/

&"% $/ $( ("#-)'$/ ($&- $ %&$ ($&- &%'(-, ') )$/ ($&- -*# /$* #"%- $($/

(" $)'$/ $/ ,$/ $& $%$/ . A $ '*$ ("$)$$/ '/' "%*$/ ,-/ $(-& )$/ $%$+ #$($

("$)$$/ '/' )$ $& #"%$# $& #"/ $)' $ $* $/&-/ . 14

2. G$ $* J$/&-/ ; G$ $* $/&-/ #"%- $($/ ,-$&- ,'/)% #$ (*'/'( $/ )'," $ ($/ *"+

(" $ $*$/ $/&-/ -/&-( #"#"/-+' (" -&-+$/ (,' "/ &- -+ $/ 6-(- . P$)$

-#-#/ $ " $*$ '/' #"%- $($/ " $*$ &"%#'/$* )$%' ,"#-$ #$/' ",&$,' "/ $('& $/&-/ . P$)$ $,'"/ '/' ("#-/ ('/$/ )$ $& &"% $)' $ $* $/&-/ ($%"/$ )$%' +$,'*

& &+ %$(, &"*$+ &"% $)' +' "%&% ' @"/&%'("* ('%'. H' "%&% ' @"/&%'("* ('%' #"%- $($/

#"($/',#" ( # "/,$,' $/&-/ -/&-( #"# "%&$+$/($/ 6-%$+ $/&-/ . A $ '*$

( # "/,$,' '/' "%*" '+$/ )$/ ("#-)'$/ &')$( *$ ' " "(&' -/&-( #"#" "%&$+$/($/

6-%$+ $/&-/ #$($ $/&-/ $($/ #"/ $*$#' (" $ $*$/ )$*$# -/ ,'/ $ ," $ $'

# $. A)$/ $ &"($/$/ $/ &'/ ' )' $&%'-# ('%' - $ )$ $& #"/ $(' $&($/ $ $*

$/&-/ ack!ard failure . P$)$ +$,'* & &+ %$(, T$&' &"%*'+$& +' "%&% ' $&%'-# ('%'$/ - $ )$ $& #"/ $%&'($/ $)$/ $ &"($/$/ $/ ",$% $)$ $&%'-# &"%," -&.

RHD )$/ $ $* $/&-/ ," "/$%/ $ "% ")$ /$#-/ (")-$/ $ ,$*'/ "%+- -/ $/. P$)$

RHD ("%-,$($/ $/ &"% $)' "%- $ "/) 6$%)'&', # 6$%)'&', $&$- "%'6$%)'&', )$/

("%-,$($// $ "*-# &"%*$*- $%$+ ,"+'/ $ $/&-/ #$,'+ )$ $& #"# "%'($/ $,- $/

(,' "/ $/ 6-(- . P$)$ $ $* $/&-/ ("%-,$($/ ,-)$+ "%&$# $+ $%$+ )'#$/$ ',$

&'# -* ("$)$$/ )'#$/$ $/&-/ &')$( )$ $& #"#"/-+' $,- $/ (,' "/ -/&-( )'%'/ $

,"/)'%' '/' $($/ #"/ " $ ($/ '/ $%( . S"($*' -/ "% ")$ /$#-/ $ $* $/&-/ )$ $&

"%$,$* )$%' RHD. RHD $/ &"%*$*- $%$+ )$ $& #"/ $(' $&($/ &"% $)'/ $ "/ $('&

$ $* $/&-/ $)$ $,'"/.

L* P!natalaksanaan

Penatalaksaan "edikamentosa

24


26/36

P"/$&$*$(,$/$$/ $/ )'*$(-($/ $)$ $,'"/ '/' #"#'*'(' &' $ &- -$/ -&$#$ $'&-;

#"/ "%$)'($,' '/ "(,' ,&%" & ( (-, #"/ $&$,' '/ *$#$,' $/ #"/6"&-,($/ " $*$ )$/

#"/6" $+ '/ "(,' %"(-%"/ )"/ $/ % '*$(,',.

1. T"%$ ' "%$)'($,'

P"/$&$*$(,$/$$/ )"#$# %"#$&'( +$%-, )'*$(-($/ ," *$+8 *$+ #$,'+ &"%)$ $&

'/ "(,' )$%' S&%" & 6 66-, #",(' -/ &')$( )'&"#-($/ % $/',# )$*$# (-*&-%.

M$($ &"%$ ' "%$)'($,' "%*- )'*$(-($/ ," $ $' "/ "/)$*'$/ )$/ -/&-(

#"/ +'*$/ ($/ $(&"%' $& "/ $'&- S&%" & 6 66-, "&$ +"# * &'6-, % - A.

U/&-( &"%$ ' "%$)'($,' )' "%'($/ $/&' ' &'( ,"," "%$ #-/ ('/ ,"*$#$ 10 +$%'.

A)$ -/ $/&' ' &'( $/ )$ $& )' "%'($/ '$*$+; 4

P"/','*'/ V )"/ $/ ) ,', 2=500 #


27/36

,"*$#$ 10 &$+-/ $+($/ ,$# $' ,"-#-% +')- ,"&"*$+ #"/)$ $& ,"%$/ $/

)"#$# %"#$&'( ,"+'/ $ #"#"%*-($/ (",$ $%$/. P% '*$(,', $/ )$ $&

)' "%'($/ $)$*$+ ," $ $' "%'(-&; 4

B"/ $&'/ "/','*'/ G 1 2 -&$ '.# ,"&'$ 4 $&$- 3 #'/ - $ ' $/

"%",'( &'/ ' -/&-( %"(-%"/ P"/','*'/ V 2=500 # %$* S-* $')'$ '/ 1 %$#


28/36

M* Prognosis

A) @'&$# ; )- '$ $) /$#

H$* '/' ($%"/$ $)$ $,'"/ "*-# &"% $)' $ $* $/&-/ #"/ '/ $& &"($/$/)$%$+/ $ / %#$* ,"+'/ $ $,'"/ #$,'+ )$ $& "%&$+$/ +')- .

A) ,$/$&' /$# ; )- '$ $) #$*$#

P$)$ "/ $('& )"#$# %"#$&'( ( /)',' "/ $('& ,$/ $& #-/ ('/ -/&-(

#"/ $*$#' %"(-%"/,'. H$* '/' ($%"/$ "/ $('& '/' #"%- $($/ ,-$&- "/ $('&

'#-/'&$, )'#$/$ $-& $/&' )' )$/ $-& ,"*8T $/ ,-)$+ &"% "/&-( #$,'

"%,'%(-*$,' )' )$*$# )$%$+ ,"+'/ $ '*$ &"% $)' '/ "(,' *"+ S&%" & 6 66-, "&$

+"# * &'6-, % - A $/ "%-*$/ #$($ )$ $& #"/'# -*($/ ("# $*' " $*$8" $*$ )"#$# %"#$&'(.

A) -/ ,' /$# ; )- '$ $) #$*$#

P$)$ $,'"/ '/' ("*$'/$/ ($&- $/&-/ "%,' $& %"@"%,' "* )"/ $/ "/ $&$/

$/&'8'/ *$#$,' ,"+'/ $ -/ ,'/ $ )$ $& ("# $*' / %#$*. N$#-/ ,-)$+

&"% "/&-( /" @$,(-*$%',$,' $)$ ($&- $/&-/ ,"+'/ $ '*$ &"% $)' '/ "(,' -*$/

)$%' S&%" & 6 66-, )$ $& #"/ " $ ($/ ("%-,$($/ $/ *" '+ $%$+. B'*$

("%-,$($/ $)$ ($&- &"%-, &"% $)' $(' $& %"'/ "(,' S&%" & 6 66-, $&$- %"(-%"/,')"#$# %"#$&'( #$($ )$ $& &"% "/&-( $%'/ $/ '($& $/ #"# -$& ($&- #"/ $)'

($(- )$/ $(+'%/ $ #"/ " $ ($/ RHD.

(A( IV

TIN%AUAN PUSTAKA

D"#$# %"#$&'( #"%- $($/ ,-$&- "/ $('& '/ *$#$,' ,',&"#'( / / ,- -%$&' $/

)' * / ($/ $)$ ("*$'/$/ @$,(-*$% ( *$ "/ $&$- ("*$'/$/ $%'/ $/ '($&. P% ,", %"#$&'( '/'

#"%- $($/ %"$(,' "%$)$/ $/ $/ )$ $& #"/ "/$' $/ $( % $/ &- -+ &"%-&$#$ $/&-/

,"/)' )$/ ,',&"# ,$%$ -,$&.

M$/' ",&$,' (*'/', "/ $('& )"#$# %"#$&'( '/' $(' $& (-#$/ S&%" & 6 66--, G%- 8A SGA

"&$ +"# *'&'(-, $)$ & /,'* $%'/ '&', )"/ $/ #$,$ *$&"/ 183 #'/ -. M",(' -/ ,"/)'8 ,"/)'

#"%- $($/ % $/ $/ $*'/ &"%,"%'/ )'("/$' &"&$ ' $/&-/ #"%- $($/ % $/ )"/ $/

27


29/36

("%-,$($/ $/ &"% "%$&. S")$/ ($/ ("&"%*' $&$/ % $/8 % $/ *$'/ "%,' $& '/$( )$/

,"#"/&$%$.

P"/ $('& )"#$# %"#$&'( )$ $& #"/ $(' $&($/ " $*$ ,',$ ," -"*" $/ $#$& "/&'/ $)$

$/&-/ ," $ $' $(' $& "%$& %'/ $// $ ($%)'&', ,"*$#$ ,"%$/ $/ $(-& )"#$# %"#$&'(.

K"($# -+$/ $/ &"% $/ $( )$/ &"% "/&'/ $)$*$+ $(' $& "% $*$/$/ "/ $('& )"#$#

%"#$&'( '&- ,"/)'%'. C-(- $/ $( )'*$ %($/ '/,')"/, )$%' ("($# -+$/ )"#$# %"#$&'( $/

"%*$/ -& )$/ #"/ $(' $&($/ P"/ $('& J$/&-/ R"#$&'(.

P"/6" $+$/ )"#$# %"#$&'( $)$ 2 6$%$ $'&-;

1. P"/6" $+$/ %'#"%; $'&- - $ $ "/6" $+$/ '/ "(,' S&%" & 6 66--, "&$ +"# *'&'(-,

%- A ,"+'/ $ &"%6" $+ )$%' "/ $('& )"#$# %"#$&'(.2. P"/6" $+$/ ,"(-/)"%; $'&- - $ $ #"/6" $+ #"/"&$ / $ '/ "(,' S&%" & 6 66-, "&$

+"# *'&'(-, %- A $)$ "($, $,'"/ )"#$# %"#$&'(.

S&" & 6 66-, &"/ % ($/ D"#$# %"#$&'(

G* #"%-* /" %'&', $(-&

S&%" & 6 66-, (-*'&

Patog!n!sis

T"% $)' %"$(,' '#-/ $/ $ / %#$* *"+ &- -+ &"%+$)$ $/&' "/ ,&%" & 6 66-, %- A.

)' "%('%$($/ &"%)$ $& ,-$&- ("#'%' $/ $/&$%$ $/&' "/ $(&"%' )"/ $/ ,"* $/&-/ $)$ #$/-,'$

$/&' "/'6 #'#'6% . P$)$ "/ "*')'($/ )'&"#-($/ 2 +$* $'&-;

1. A)$/ $ "%,$#$$/ $/&$%$ ($% +')%$& )$%' ,&%" & 6 66-, %- A )"/ $/ * 6 % &"'/

)$%' ($&- $/&-/2. T"%)$ $& "%,$#$$/ # *"(-*"% $'&-; ,&%" & 6 66$* M. P% &"'/ )"/ $/ ,$%6 *"#$ ,"*

#' ($%) $)$ #$/-,'$

B"%)$,$%($/ +$* )'$&$, &"% $)'/ $ $-& '#-/'&$, $/ #-/ ('/ #"%- $($/ #"($/',#"

&"% $)'/ $ ("%-,$($/ $%'/ $/ $)$ )"#$# %"#$&'( &"%-&$#$ ($%)'&',.

$aktor Pr!dis-osisi

2>


30/36

D"#$# %"#$&'( ,"*$*- )')$+-*-' *"+ $%'/ '&', )$/ & /,'*'&', ,&%" & 6 66$* &"&$ ' +$/ $

," $ '$/ )''(-&' )"#$# %"-#$&'(. O*"+ ($%"/$ '&- +$%-, $)$ $(& % $/ #"/"/&-($/

&"% $)'/ $ )"#$# %"-#$&'(. $(& % &"%," -& $)$*$+;

1. U,'$T"% $/ $( $)$ -,'$ 581 &$+-/ $+($/ 385 &$+-/.

2. P"/)"%'&$ $/ ,-)$+ #"/)$ $& ,"%$/ $/ )"#$# %"#$&'( K$%"/$ $)$ "/)"%'&$ 6"/)"%-/ %"(-%"/ ,"%$/ $/ -*$/ '$,$/ $ #"/ -*$/ '

,$#$ )"/ $/ ," "*-#/ $3. $(& % ("*-$% $

K"# $% # / ' & *" '+ ,"%'/ &"%("/$ )"#$# %"-#$&'( )-$8)-$/ $ )$%' $)$

)' ' &4. O@"% 6% :)'/

D' %-#$+ ,"( *$+ #"#-)$+($/ $/$(8 $/$( -/&-( #"/)$ $&($/ '/ "(,'

,&%" & 6 66-,

Patologi

K$%)'&', ;

K$%)'&', $(' $& )"#$# %"#$&'( $)$*$+ "%'($%)'&', "%$%&' #"/ "/$' "/) ($%)'-#

#' ($%)'-# )$/ "%'($%)'-#. P$)$ "/)"%'&$ $/ #"/'/ $* $(' $& ($%)'&', )"#$# %"#$&'(

#' ($%) &$# $( -6$& *"# "( -)"#$&-, ,")'('& +' "%&% '( %-$/ $/ $/&-/ )'*$&$,' ,$&-$&$- *" '+ ($&- #"/ $*$#' '/( # "&"/ 6 % / )-* &%$/,*-,"/ $/ )'," -& @"%%-6$"

)')$ $&' $)$ '/ '%8 '/ '% )$%' )$-/ ($&- . S"6$%$ #'(% ,( ', /$# $( )" "/"%$,' $/

#"/ "*-%-+ )$/ "# "/ ($($/ ,"%$ -&8,"%$ -& #' ($%) - $ /$# $( )" "/"%$,' ' %'/ ')

)$%' $%'/ $/ ( *$ "/. D'&"#-($/ A,6+ )'", ,-$&- "/&-($/ /"(% ,', )'("*'*'/ '

(-# -*$/ # / /-6*"$% )$/ ,"*8 ,"* '$/& #-*&'/-6*"$%.

A,6+ )'", '/' , ",' '( -/&-( )"#$# %"#$&'( (" "%$)$$// $ "%&$+$/ *$#$ ,",-)$+

&$/)$8 &$/)$ )"#$# %"#$&'( $(&' #"/ +'*$/ . P"%'($%)'-# #-/ ('/ "%',' "(,-)$&. P$)$

,&$)'-# *" '+ *$/ -& $'&- ,"%$/ $/ %"(-%"/# )$-/ ($&- /$# $( $ / %#$* &"%)$ $& %"&%$(,'

#"/" $* )" %#'&$, ( #',-%$ #"*"/ ("& ,$&- ,$#$ *$'/ ( %)$ &"/)'/$" - $ %"&%$(,' )$/

,$*'/ #"*"/ ("&.

N )-* S- (-&$/ ; P$)$ "#"%'(,$$/ #'(% ,( ', /$# $( ," "%&' / )-* $)$ %"-#$& ')

$%&%'&', $'&- $%"$ ,"/&%$* &"%)'%' )$%' $%'/ $/ /"(% ,', )'("*'*'/ ' *"+ )"%"&$/ $%$*"*

)$%' $)$ ' % *$,.

29


31/36

C+ %"$ S /)"/+$# ; S"6$%$ +',& * ', ("*$'/$/ &"%-&$#$ $)$ $/ *'$ $,$*', )$/ ,"6$%$ )' -,

#"/ "/$' ,"*-%-+ &$(.

A%&%'&', ; N$# $( "(,-)$& &')$( $)$ +' "%&% ' , / @'$ "% ,' &-*$/ $&$- +'*$/ / $ ($%&'*$ .

E%'&"#$ #$% '/$&-# ; B"*-# )'("&$+-' "*$,.

P!r0alanan P!n3akit

$," '/ "(,' ,&%" & 6 66-, "&$ +"# * &'6-, %- A $*'/ ,"%'/ $)$ /$, $%'/ . A)$ -/

$%'/ '&', *"+ ,&%" & 6 66-, +$%-, )'("/$*' ,"6$%$ (*'/', )' "%'($/ $/&' ' &'($ $/ &" $& )$/

) ,', 6-(- )"/ $/ #$(,-) "%$)'($,' ,&%" & 6 66-, )$/ )"/ $/ )"#'('$/ #"/ +'/)$%'

&"% $)'/ $ )"#$# %"-#$&'( %'#$% % + *$=', .

C'%'86'%' $%'/ '&', ,&%" & 6 66-,;

D"#$# S$('& &"/ % ($/ N "%' &"($/ ("*"/ $% *"+"% T /,'* $%'/ '&',

P&"('" $*$&-# E% ,' ("%$( *- $/ +')-/

$,"8 $," '/ "(,' ,&%" & 6 66-,;

$," *$&"/&; 183 #'/ - ,",-)$+ '/ "(,' )'#$/$ )"#$# )$/ #$/'/ ",&$,' (*'/', *$'/

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