Anemia NCP

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J}sfja Kfeajlsfs _}cimo{fpm Eo{fpf{v O}ms9 Fj{lbmejom ‒Jehfhfbl e{ mbe{mk {l jejahfhfje fncebejom egl*„ es  cm{qmmj lxvamj pmcebfymk cv s}ttbv, kmbfpmv {hm te{fmj{* ejk kmnejk es mpfkmjomk cv9 Lcimo{fpm O}ms9 )Clkv )CT9 5?4,84 qmegjmss ejk SS9 35 ctn `e{fa}m qf{h TS9 1= ctn mtl{ l`  )Hac9 61 B kmomesmk Ho{9 4*36 B mxmofsm eo{fpf{v ) Oljsofl}s {lbmejom ejk olhmmj{ )Fjomesm CT ) o tmsmjom l`  )Kmomesm Hac  clkv qmegjmss ejk Ho{ bmpmbs ejk `e{fa}m )Sms{bmssjmss ) Tll ettm{f{m7 oljs}nmk ² l`  {hm `llk smpmk ) Bfnf{mk SLN )Enc}be{lv qf{h essfs{ejom

_ofmj{f`fo Tbejjfja Se{fljebm E te{fmj{ qhl E`{m 8 hl}s l`  hes }jkmaljm j}sfja  cbllk fj{mpmj{flj" fj{mpmj{flj" {hm {ejs`}sflj fs  te{fmj{ qfbb9 }s}ebbv }jkm  )kmnljs{e{m e  cmk ms{ `l e kmomesm fj `mq kevs {he{  thvsflblafoeb nev hfjkm hm  sfajs l`  {l tm`ln hm  fj{lbmejom fj{lbmejom m*a* }s}eb eo{fpf{v*  t}bsm" Tefj nev ebsl mstfe{flj ejk  cm tmsmj{ ejk CT mnefj ebsl fjhfcf{s {hm qf{hfj te{fmj{‖s obfmj{ {l jlneb ejam*  tlssfcbm ejams )mtl{ ej l` nl{flj* Ejk fjomesm fj k}m {l kmomesm eo{fpf{v Hac bmpmb" {lbmejom qhfoh fs {hm fjob}kfja EKBs* lxvamj oefm  fj {hm cbllk" E`{m = kevs l`  {ejstl{e{flj j}sfja l` lxvamj {l fj{mpmj{fljs" {fss}m qes {hm te{fmj{ qfbb9 fntefmk ejk )kfstbev ej hvtlxfe eoomt{ecbm ejam kmpmblts {h}s l` becle{lv obfmj{ qfbb peb}ms l` Hac mxtmfmjom ejk Ho{* `e{fa}m l  )cm `mm `ln qmegjmss* qmegjmss ejk

J}sfja Fj{mpmj{fljs  Fjkmtmjkmj{9 5* Essmss te{fmj{‖s ecfbf{v {l tm`ln jlneb {esgs, EKBs jl{fja mtl{s l`  qmegjmss" `e{fa}m ejk kf``fo}b{v fj eoolntbfshfja {esgs*

Se{fljebm

Mpeb}e{flj

5* Tlnl{ms E`{m 8 hl}s ekmu}e{m ms{" l` j}sfja nefj{efjs mjmav fj{mpmj{flj" bmpmb ejk aleb qes ebbmpfe{ms s{efj lj  te{febbv nm{ oekfeo ejk es mpfkmjomk mstfe{lv  cv kmomesmk hv{hn* CT9 534,84 SS9 34 ctn 3* Nljf{l CT" t}bsm" 3* [l jl{m TS9 16 ctn mstfe{flj k}fja sfajf`foej{ )mtl{mk ejk e`{m eo{fpf{v* ohejams {he{ nev fjomesm  cm cl}ah{ ecl}{ eo{fpf{v ?* Smolnnmjk u}fm{  cv {hm kfsmesm* {lbmejom e{nlsthmm" cmk ms{ fjob}kfja f` fjkfoe{mk* ?* Mjhejoms ms{ EKBs* {l blqm clkv‖s ;* Mbmpe{m hmek l`  lxvamj E`{m = kevs  cmk es {lbme{mk ejk mu}fmnmj{s l` j}sfja mjol}eam kmmt mk}ofja clkv fj{mpmj{fljs"   cme{hfja mxmofsm* qmegjmss* aleb qes  te{febbv nm{ =* Tlpfkm, ;* Mjhejoms b}ja es mpfkmjomk molnnmjk mxtejsflj {l  cv fjomesmk essfs{ejom qf{h nexfnfym Hac9 554 eo{fpf{fms,enc}be{flj lxvamje{flj `l  Ho{9 4*?= f` jmomssev* ombb}be }t{egm* )cm `mm `ln qmegjmss ejk Olbbeclse{fpm9 =* Eb{hl}ah hmbt fsg l`  0* Nljf{l  nev cm jmomssev" olntbfoe{flj becle{lv s{}kfms l`  smb`.ms{mmn fs fs tmpmj{mk*

fsg l`  olntbfoe{flj fs  tmpmj{mk*

Hca ejk Ho{ bmpmbs* 1* Tlpfkm lxvamj es jmmkmk* 8* Qhlbm cbllk,  teogmk SCO‖s (TSOs& cbllk  tlk}o{s es fjkfoe{mk* Nljf{l  oblsmbv `l  {ejs`}sflj meo{fljs*

mjhejomk qhmj  te{fmj{ klms {hfjas `l smb`* 0* Fkmj{f`fms km`fofmjofms fj SCO olntljmj{s e``mo{fja lxvamj {ejstl{ ejk {me{nmj{ jmmks,mstljsm {l {hmetv* 1* Nexfnfyfja lxvamj {ejstl{ {l {fss}ms fntlpms ecfbf{v {l `}jo{flj* 8* Fjomesm / l`  lxvamj oevfja ombbs7 olmo{s km`fofmjofms {l mk}om fsgs l`  hmnlheam fj eo}{mbv olntlnfsmk fjkfpfk}ebs*

Essmssnmj{

Kfeajlsfs

_ofmj{f`fo Se{fljebm _}cimo{fpm  J}{f{flj E`{m  O}ms9 Fncebejomk bmss {ejs`}sflj" {hm ‒Qebe eglja {hej clkv  clkv jmmks aejeja g}nefj mu}fmnmj{s mx{e oeblfms e{ necfbfs eglja mbe{mk {l ejk tl{mfj `l  netealk*„ es km`fofmjov l`  `es{ molpmv* pmcebfymk cv ecslcfja E{ {hfs {fnm" {hm te{fmj{ j}{fmj{s nejv tmltbm jmomssev `l  mxtmfmjomk Lcimo{fpm O}ms9 {hm `lne{flj l`  slnm tefj ejk )Qmfah{9 =? ga jlneb SCO‖s `e{fa}m* [hm ) o tmsmjom l`  es mpfkmjomk cv9  clkv!s ecfbf{v {l  clkv qmegjmss ) s}kkmj qmfah{ }sm j}{fmj{s ejk `e{fa}m blss nev ebsl cm )je}sme )tll ettm{f{m7 ohejamk k}m {l )Sms{bmssjmss oljs}nmk ² l`  {hm m``mo{s l`  ) Tll ettm{f{m7 {hm `llk smpmk  cbllk oljs}nmk ² l`  )kmomesmk {ejs`}sflj* {hm `llk smpmk {lbmejom `l  )Flj eo{fpf{v" s}ttbmnmj{9 qmegjmss ejk Hmnee{m @E `e{fa}m

Tbejjfja

J}sfja Fj{mpmj{fljs E`{m 8 hl}s l`   Fjkmtmjkmj{9 j}sfja 5* Lcsmpm ejk fj{mpmj{fljs" molk te{fmj{‖s `llk {hm te{fmj{ qfbb9 fj{egm* )hepm allk ettm{f{m9 3* Qmfah{ oljs}nmk 3,; l`   tmflkfoebbv es {hm `llk smpmk* ettltfe{m*

E`{m = kevs l`  j}sfja fj{mpmj{fljs" {hm te{fmj{ qfbb9 )kmnljs{e{m s{ecbm qmfah{ qf{h jlneb becle{lv peb}ms* )mtl{ ecsmjom l` je}sme" fjomesmk ettm{f{m ejk cm ecbm {l mbfmpm  clkv qmegjmss ejk maefj s{mja{h*

?* Smolnnmjk snebb `mu}mj{ nmebs ejk,l cm{qmmj nmeb jl}fshnmj{*

Se{fljebm

Mpeb}e{flj

5* Nljf{l  oeblfo fj{egm l  fjs}``fofmj{ u}ebf{v l` `llk oljs}nt{flj*

E`{m 8 hl}s l`  j}sfja fj{mpmj{fljs" aleb qes nm{ es mpfkmjomk cv allk ettm{f{m9 oljs}nmk 3,; l`  {hm `llk smpmk*

3*Nljf{l  qmfah{ blss ejk m``mo{fpmjmss l`  j}{f{fljeb fj{mpmj{fljs

E`{m = kevs l`  j}sfja fj{mpmj{fljs" ?* Nev mk}om aleb qes `e{fa}m ejk {h}s  te{febbv nm{ es ;* Ekpfsmk {l me{ mjhejom fj{egm* mpfkmjomk cv )te{fmj{‖s `llk foh fj ;* [l maefj o}mj{ qmfah{ oeclhvke{ms s}oh fs == ga* es sl`{ fom l cmek* s{mja{h ejk )kmnljs{e{m mjmav* s{ecbm qmfah{ qf{h jlneb =* Mjhejom Olbbeclse{fpm9 becle{lv ettm{f{m ejk leb =* Mjol}eam allk peb}ms* fj{egm* leb oem* )mtl{ ecsmjom Kfnfjfshms l` je}sme"  ceo{mfeb alq{h 0* Nljf{l  fjomesmk nfjfnfyfja becle{lv ms}b{s ettm{f{m ejk cm m*a* Hca,Ho{" C]J"  tlssfcfbf{v l`  ecbm {l mbfmpm fj`mo{flj flj" pf{enfj C53"  clkv qmegjmss `lbfo eofk" ejk ejk maefj 0* Smtbeomnmj{s mbmo{lbv{ms* s{mja{h* jmmkmk kmtmjk

1* Eknfjfs{m  nmkfoe{fljs es fjkfoe{mk* Pf{enfj ejk nfjmeb s}ttbmnmj{s m*a* Pf{enfj C53" `lbfo eofk ejk pf{enfj O

lj {vtm l`  ejmnfe ejk,l   tmsmjom l` tll  leb fj{egm ejk fkmj{f`fmk km`fofmjofms 1* Nev cm  cmjm`fofeb fj slnm {vtms l`  flj km`fofmjov ejmnfe*

Essmssnmj{

Kfeajlsfs

_}cimo{fpm O}ms9

Sfsg `l  fj`mo{flj mbe{mk {l fjpesfpm  tlomk}m

∍

Lcimo{fpm O}ms9 )Cbllk {ejs`}sflj )o tbefj J__ 5B D 644 oo bmpmb )[9 ?1 O )Tbe{mbm{ Ol}j{9 ?41 nn? )o tmsmjom l`   clkv qmegjmss ejk `e{fa}m )tebbl 

_ofmj{f`fo Tbejjfja J}sfja Se{fljebm Fj{mpmj{fljs [hm sgfj fs {hm E`{m 8 hl}s l`   Fjkmtmjkmj{  `fs{ bfjm l`  j}sfja 5* Tltm hejk km`mjsm eaefjs{ fj{mpmj{flj" {hm qeshfja* fj`mo{flj* Ejv  te{fmj{ qfbb9  cmeg fj f{s )nefj{efjmk 3* Nefj{efj s{fo{ olj{fj}f{v qfbb jlneb ejam l`  esmt{fo {mohjfu}m ebblq {mntme{}m* qf{h tlomk}ms* nfollaejfsns )cm ecbm {l {l mj{m {hm pmcebfym ?* Mjol}eam  clkv" qhfoh fj }jkms{ejkfja l`  `mu}mj{ tlsf{flj {}j oej oe}sm hmeb{h {meohfjas ohejams, fj`mo{flj*  tlpfkmk {l enc}be{flj, Fjpesfpm  tmpmj{ stmek ol}ahfja ejk  tlomk}ms nev l` fj`mo{flj* kmmt cme{hfja olj{fc}{m {l {hm mxmofsm* kmpmbltnmj{ l`  E`{m ; kevs l`  `}{}m fj`mo{fljs* j}sfja ;* Tlnl{m fj{mpmj{fljs" ekmu}e{m `b}fk {hm te{fmj{ qfbb9 fj{egm* )cm ecbm {l mxhfcf{ kmomesm =* Nljf{l  fsg `l stmek l`  {mntme{}m* fj`mo{flj*  Jl{m tmsmjom l`  ohfbbs ejk {eohvtjme qf{h l qf{hl}{ `mpm*

Se{fljebm 5* Tmpmj{s olss olj{enfje{flj,  ceo{mfeb olbljfye{flj*

Mpeb}e{flj

E`{m 8 hl}s l`  j}sfja fj{mpmj{flj" aleb qes nm{ es mpfkmjomk cv 3* Smk}om fsg l`  {mntme{}m e{  ceo{mfeb jlneb ejam* olbljfye{flj, )cm ecbm {l fj`mo{flj* pmcebfym }jkms{ejkfja l`  ?* Tlnl{ms hmeb{h {meohfjas pmj{fbe{flj l` ebb  tlpfkmk {l b}jas smanmj{s  tmpmj{ stmek l`  ejk efks fj fj`mo{flj* nlcfbfyfja smom{fljs {l E`{m ; kevs l`   tmpmj{ j}sfja  tjm}nljfe* fj{mpmj{fljs" aleb qes nm{ es ;* F{ s}ttl{s mpfkmjomk cv ofo}be{fja )te{fmj{ plb}nm ejk mxhfcf{mk {fss}m tm`}sflj kmomesm fsg `l  ejk f{ efks fj {hm stmek l`  mbfnfje{flj l`  fj`mo{flj* nfollaejfsns {he{ nev olj{fc}{m {l {hm loo}mjom l`  fj`mo{flj*

=* [l jl{m `l   tlamss ejk mpeb}e{m `l fsg  l` fj`mo{flj

Essmssnmj{ _}cimo{fpm O}ms9 ‒Getea je{etls je ce eja  teasebfj ja k}al" neafafja neevls je ce egl*„ es pmcebfymk cv {hm te{fmj{ Lcimo{fpm O}ms9 )o tmsmjom l`   clkv qmegjmss ejk `e{fa}m )Sms{bmssjmss )Fjeoo}e{m `lbblq.{hl}ah l` fjs{}o{flj

Kfeajlsfs

_ofmj{f`fo Se{fljebm Gjlqbmkam Tmsmjom l`  km`fof{ maekfja gjlqbmkam oljkf{flj" km`fof{ fs k}m {l  tlajlsfs" slnm }j`enfbfe  {me{nmj{" smb`  fj`lne{flj {he{ oem ejk oe}sms kfsoheam jmmks olj`}sflj {l {hm mbe{mk {l beog l`   te{fmj{ {he{ mxtls}m,moebb jmmks {l cm fj`lne{flj ejk kfso}ssmk ejk }j`enfbfef{v obef`fmk* qf{h fj`lne{flj nmes}ms

Tbejjfja

J}sfja Fj{mpmj{fljs E`{m 8 hl}s l`   Fjkmtmjkmj{9 j}sfja 5* Tlpfkm fj{mpmj{fljs" fj`lne{flj {hm te{fmj{ qfbb9 ecl}{ ejmnfe ) pmcebfym ejk mxtbefj {he{ }jkms{ejkfja l`  {hmetv kmtmjks {hm je{}m l` {hm lj {hm {vtm ejk  tlomss" smpmf{v l` {hm kfeajls{fo ejmnfe*  tlomk}ms ejk  tl{mj{feb 3* Mxtbefj {he{ olntbfoe{flj l`   cbllk {egmj `l   cbllk becle{lv {ejs`}sflj* s{}kfms qfbb jl{ )pmcebfym qlsmj ejmnfe* }jkms{ejkfja l`  {hmetm}{fo ?* Mjol}eam jmmks* omsse{flj l`  snlgfja* E`{m = kevs l`  j}sfja fj{mpmj{fljs" ;* Tlpfkm {hm te{fmj{ qfbb9 fj`lne{flj )pmcebfym ecl}{ t}tlsm" }jkms{ejkfja l`  klseam" kfsmesm tlomss" sohmk}bm"  tmoe}{fljs ejk  tlajlsfs" ejk ekpmsm meo{flj  tl{mj{feb {l ebb tmsofcmk olntbfoe{fljs* nmkfoe{fljs*

Se{fljebm

Mpeb}e{flj

5* Tlpfkms gjlqbmkam cesm `ln qhfoh te{fmj{ oej negm fj`lnmk ohlfoms* Ebbevs ejxfm{v ejk nev  tlnl{m olltme{flj qf{h {hmetm}{fos mafnmj*

E`{m 8 hl}s l`  j}sfja fj{mpmj{flj" aleb qes nm{ es mpfkmjomk cv )te{fmj{ pmcebfymk }jkms{ejkfja l` {hm tlomss" kfeajls{fo  tlomk}ms ejk  tl{mj{feb olntbfoe{flj l`   cbllk {ejs`}sflj* ) Pmcebfymk }jkms{ejkfja l` {hmetm}{fo jmmk

3* [hfs fs l`{mj ej" }jstlgmj oljomj {he{ oej tl{mj{fe{m  te{fmj{‖s ejxfm{v* ?* _nlgfja kmomesms epefbecbm lxvamj ejk oe}sms pesloljs{fo{flj ;* Fj`lne{flj mjhejoms olltme{flj qf{h mafnmj* Smolpmv `ln ejmnfe oej cm sblq" mu}ffja bmja{hv {me{nmj{ ejk tmpmj{flj l`  smoljkev olntbfoe{fljs*

E`{m = kevs l`  j}sfja fj{mpmj{fljs" aleb qes nm{ es mpfkmjomk cv  te{fmj{ pmcebfymk }jkms{ejkfja l` kfsmesm  tlomss"

0* Kfso}ss {hm fntl{ejom l`  {egfja leb flj  tmtee{flj*

0* Flj s}ttbmnmj{s }s}ebbv {egm ?. 0nls*

1* Kmomesmk 1* Kfso}ss bm}glov{m fjomesmk  tlk}o{flj s}somt{fcfbf{v {l  tl{mj{fe{ms fsg l`  fj`mo{fljs" sfajs fj`mo{flj* ejk svnt{lns mu}ffja nmkfoeb fj{mpmj{flj m*a* `mpm*

 tlajlsfs" ejk  tl{mj{feb olntbfoe{fljs*

Essmssnmj{

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