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  1. 1. The FOGSI-FIGO ConnectionInternational Federation ofGynecology & ObstetricsThe Federation of Obstetric &Gynecological Societies of;;facebookpageN E W S L E T T E RJan. - April 2013Dear Fogsians,Greetings to one and allDr. Narendra MalhotraRepresentative of FOGSI to FIGOPP FOGSIn.malhotra@rainbowhospitals.orgFOGSI - FIGO’sInternational conference on RecentAdvances Obstetrics & Gynaecology(FOGSI-FIGO ICRAOG 2013)Sept 13-15 - 2013Hyderabad International convention centreHyderabad, IndiaContact for FOGSI-FIFO connection newsletter willcome to you all with news from FIGO, every 4months.India (FOGSI) has a huge role in FIGO.a) We are the largest member body of FIGOb) We have a President elect from next FIGOsessionc) India is probably the only country whichhas given 3 FIGO Presidentsd) A lot of our members figure in importantFIGO committeese) FOGSI has done great work in theAdolescent health activities of FIGOf) Many many more laurels in FIGO to FOGSIread ahead for details...Dr. Narendra MalhotraRepresentative of FOGSI to FIGOn.malhotra@rainbowhospitals.orgLike us & visit us on Facebook FIGO Connect-India1
  2. 2. MASSAGE FROM FIGO PRESIDENTDear ColleaguesS ArulkumarIt has been over six months since Itook office as President of thisprestigious organisation. A greatdeal has been achieved by eachand every one of you, both asindividuals and as members ofyour respective national societies.Over the years you have strivenhard to reduce maternal mortalityworking on serious or near miss morbidity audits. These tools wouldbe greatly beneficial for India and several other countries.In March, Professor Cabero-Roura and I attended the 7thInternational DIP Symposium on Diabetes, Hypertension, MetabolicSyndrome, and Pregnancy in Florence, Italy - a FIGO Pre-CongressWorkshop, organised in collaboration with the World DiabetesFoundation (WDF), was attended by over 200 delegates.Obstetricians and gynecologists have a major role to play inreducing obesity and diabetes, and their consequences. Maternaland morbidity and to improve womens health. My sincere thanks foryour ongoing efforts. The past FIGO Presidents, Officers, ExecutiveBoard members, Chief Executive, Administrative Director and staffhave all worked alongside you on these goals. You can certainlyexpect the same commitment from the new Officers, Board and staff.There is, naturally, much more to do to help achieve womens rightsand health.Working with valuable partnersWe need to continue to work together with various like-mindedorganisations, such as our national societies and RegionalFederations, the International Confederation of Midwives (ICM), theInternational Paediatric Association (IPA) and many, many others.For example, we wanted to have a strong relationship with variousUnited Nations organisations: now we have a UN representative oneach of our FIGO Committees. This will ensure timely alignment ofaims and activities, and a strong link at both HQ and on the groundlevels.Education and training: a FIGO cornerstoneOur swift progress with FIGO activities in education and training hasbeen achieved to a great extent under Past-President ProfessorGamal Serours expert leadership through the FIGO Committee forCapacity Building in Education and Training, chaired by ProfessorLuis Cabero-Roura. Two major FIGO Regional Conferences will beheld in 2013: Cartagena, Columbia, from 1-4 May 2013, and AddisAbaba, Ethiopia, from 2-5 October 2013 (see page nine for details).FIGO will also participate in a FOGSI-FIGO International Conferenceon Recent Advances in OBGYN in Hyderabad, India, in September.FIGO has also continued its ongoing collaboration with OlympusSurgical Technologies on Minimally Invasive Surgery (MIS)Workshops, the most recent one being held in Khartoum, Sudan, inFebruary.More generally, the Committee has provided educational sessions ina number of national and subject-specific conferences. One suchsession at the 56thAll India Congress of Obstetrics and Gynecology(AICOG; January 2013), organised by the Federation of Obstetric andGynaecological Societies of India (FOGSI), was a great success. Itwas a staggering 8000 participants. My sincere congratulations tothe outgoing and incoming Presidents, Professors P K Shah andHema Divakar. FOGSI has a major role to play to improve all aspectsof Womens health. The past presidents, office bearers andcommittees have done extremely well and I feel proud of theirachievements and FOGSIANs. FIGO should benefit from theexperience of FOGSI. In addition to the President elect we haveFOGSI members contributing to the FIGO oncology, save themothers and new born, ethics and scientific programme committee.FOGSI has done wonderfully well with the FIGO logic project andgenerated an electronic maternal death review format and arenutrition, pre-term birth, intrauterine growth restriction, immediatebreast-feeding and the infant childhood period are some of thefactors that determine the final outcome. Early influences atgametogenesis and early development may promote epigeneticchanges that may have a major impact on NCDs. The first 1,000days from conception appear to be the key in reducing thisepidemic, compared with our efforts to reduce the 5 Ss in adult life(salt, sugar, saturated fatty acids, sedentary life and spirits inexcess). FOGSI should progress this agenda as it is a majorepidemic. This can be done by linking up with governments,midwives, paediatricians and public health physicians.Web-based knowledge transferIn this highly sophisticated age of technology - eg mobile phones,tablets, computers - we should be able to provide obstetricians,gynecologists and health professionals with education anywhere,and at any time, through books, images, videos and master classes.Not every professional has adequate access to this. To counter this,FIGO has signed an historic Memorandum of Understanding (MOU)with the Global Library of Womens Medicine (GLOWM –, founded by Paula and David Bloomer, makingGLOWM its educational platform and helping provide content withthe input of FIGO Committees and experts from various nationalsocieties. I have now assumed the position of Editor in Chief (mythanks to former Editor in Chief Professor Jack Sciarra, FIGO Past-President, for his able leadership), and will work with the GLOWMeditorial team to bring you the latest in evidence-based practice.Please use this excellent educational platform and recommend it toothers (more detail can be found in the Chief Executives report onpage three).Transfer of skillsFIGO is currently exploring a joint collaboration with ProfessorHarshad Sanghvi, from Jhpiego, and Mr Tore Laerdal, Chairman ofthe Laerdal Foundation, on the enhancement of teaching and trainingin life-saving skills. Through a specific programme of Buy one -Donate one, they have agreed to donate a large number ofMamaNatalie® birthing simulators - FIGO will explore how best todeploy them in teaching centres so that they are constantly used tobenefit healthcare workers, medical and midwifery students, andprofessionals. They will also assist with funding to organise Pre-Congress Workshops on essential obstetric functions, principally onprevention and treatment of post-partum haemorrhage and helpingbabies breathe. The first such Workshop has been funded and will beheld before the first FIGO African Regional Conference in Ethiopia,October 2013.Clinical fellowshipsFIGO has also recently signed a Memorandum of Understanding(MOU) with Wellbeing of Women, a leading charity in the UK2
  3. 3. promoting womens health by funding research and educationalfellowships. Annually, WOW gives several fellowships to doctors,midwives and medical students to do research, travel abroad tocentres of excellence, and gain clinical experience - it has nowagreed to work with FIGO to provide some fellowships to enabledoctors to come from outside the country to the UK to gainexperience for a limited period of time. We look forward to fruitfulcollaboration on this, and other, activities.FIGO has also recently signed a Memorandum of Understanding(MOU) with Wellbeing of Women, a leading charity in the UKpromoting womens health by funding research and educationalfellowships. Annually, WOW gives several fellowships to doctors,midwives and medical students to do research, travel abroad tocentres of excellence, and gain clinical experience - it has nowagreed to work with FIGO to provide some fellowships to enabledoctors to come from outside the country to the UK to gainexperience for a limited period of time. We look forward to fruitfulcollaboration on this, and other, activities.Recognition and celebrationInternational Womens Day, World Health Day, and the InternationalDay of the Midwife have all recently taken place; FIGO is alwayskeenly supportive of these important global enterprises, and I amgrateful to Alexandra Gilpin, our communications contact, forassisting with the issuing of FIGO statements (available Women Deliver (WD) conference is an important event takingplace in Kuala Lumpur from 28-30 May 2013, under thephenomenal leadership of WD founder Jill Sheffield. This conferenceattracts a substantial global mix of policymakers, healthadministrators, healthcare professionals and womens advocates.FIGO will be attending, and will also participate in the specialsecond Global Midwifery Symposium taking place prior to it,organised by the United Nations Population Fund (UNFPA) andpartners. I encourage you all to attend WD, and contribute to itsimportant objectives.World Congress 2015Preparations have started in earnest for FIGOs next World Congress,to be held in Vancouver, Canada, from 4-9 October 2015. The 2012Rome Congress was an enormous success, and I have no doubt that2015 will also exceed expectations. Dr Abdul Aziz Yahya, Chair ofthe Congress Organising Committee, will work closely withProfessor Joanna Cain, Scientific Programme Committee Chair, andDr Mark Heywood, Chair of the Canadian Local OrganisingCommittee and his team. Marta Collins, FIGOs Events and MeetingsManager, will liaise with FIGOs Chief Executive, Professor HamidRushwan, and Administrative Director, Bryan Thomas. The Lord Patelhas agreed to be our adviser, and we will certainly benefit from hisvast knowledge, experience and wisdom. Please keep the datesfirmly reserved in your diary, as we would like to see as manycolleagues as possible there.FIGO on the groundFIGO Initiatives continue apace, as you will see from the updateswithin this Newsletter. It is most important that FIGOis active at thegrassroots level in as many countries as possible, workingcollaboratively with national societies. This is the priority, and wecontinue to explore additional opportunities to enhance ouractivities.Officers Meeting, February 2013The new Officers group had a stimulating and challenging meetingheld over two days in early February. Everyone brought in new ideasto enhance FIGO activities: Professor C N Purandare, President-Elect, on improving our income; Professor Ernesto CastelazoMorales, Vice-President, on closer interaction with nationalsocieties; Professor Gian Carlo Di Renzo, Honorary Secretary, on theimportance of our expert Committees issuing good practiceguidelines; Professor Wolfgang Holzgreve, HonoraryTreasurer, onthe revenues and matters related to the publication of FIGOs journal,the International Journal of Gynecology & Obstetrics (IJGO); andProfessor Gamal Serour, Past-President, on the Alliance for WomensHealth, and other partnership activities. These were well receivedand the resultant proposals will be submitted to the Executive Boardfor approval and action when it meets in London in mid-June.Committee Chairs and members were also finalised at the meeting,with care taken to ensure appropriate geographical and genderrepresentation. In future Newsletter issues, we will carry more in-depth reporting on Committee and Working Group activities. Allthese specialist FIGO bodies - ably co-ordinated by Marie-ChristineSzatybelko, FIGOs Senior Administrator and Committee Manager -will regularly keep us in the picture on their myriad of activities, andbring us up to speed with the latest developments in the differentspheres of our discipline.I wish you a happy and productive year.Professor Sir Sabaratnam ArulkumaranFIGO President3
  4. 4. EXCERPTS FROM FIGO NEWSLETTER April 2013Dear Friends andCollegues,C.N. Purandare(President Elect FIGO)Dr. Hema DivakarFOGSI FIGO...Working together todo what worksFOGSI very much forward to theopportunity to work in collaborationwith FIGOJoseph Kurian(Member FIGO Committee)Duru Shah(Member Ethics Committee)P. K. Shah(Member Ultrasound Committee)Nozer Sheriar(Member Scientific ProgrammeCommittee)The vision mission of FOGSI, a crucial member of the FIGO, reflectthe vital role health professional organizations play in the promotionof women’s health and in global efforts to achieve MillenniumDevelopment Goals 4 and 5 to reduce child and maternal mortalityspecifically-but not only, as most of the MDGs have an impact onwomen’s health.“Professional organizations can do a tremendous amount in thisrespect, from influencing policy decision-making to raisingawareness of issues and their solutions, to setting standards, toeducating and training healthcare professionals and providers,’’declared Professor Gamal Serour, outgoing President of FIGO.FOGSI has 212 member societies and 27,000 members all overIndia. It undertakes important educational, publication, and advocacyactivities. FOGSI expresses its support and keen intent to collaboratewith FIGO in implementing innovations that work for developingcountries. We have to deliver the interventions. However we have toinnovate the way we deliver. If we do not innovate the way we deliverand test them rigorously we definitely will be behind for severalmore years.“INNOVATION to IMPLEMENTATION” is the theme for FOGSI2013 and marks the new beginning of the mission for making apositive impact to Women’s Healthcare in India. We acknowledgeand appreciate that joining hands with partners like FIGO enhancesour strength. We believe we will be the catalyst for the change wewant to see in Women’s Health Care in India.We resolve to do bit as”Change Makers”Sincerely,Dr. Hema DivakarPresident FOGSINarendra Malhotra• FOGSIs Representative to FIGO• Member Fetal Medicine Committ4
  7. 7. DURU SHAH’s Speech at FIGOAward Ceremonysuffering sexual abuse and domestic violence, every minute ofthe day somewhere in this world, we as primary carephysicians to women, really needtodomuchmore!I come from the land of Gandhi who said, “Nearly everythingyou do, may seem insignificant, but it is most important that youdo it! You may never know the result of your actions, but ifyou donothing there will be no result!” Hence it is so important for usto take that first step and create a legacy, which does not endwith the positions we occupy, but goesbeyondour own lives.Acceptance SpeechPresident Gamal Serour, President Elect Sir. Arulkumaran Sabaratnam,Chief Executive officer Hamid Rushwan. Members of the Board of FIGOEminent Past Presidents of FIGO, my fellow Fogsians, my belovedfamily, ladies andgentlemen,I speak on behalf of the awardees of the distinguished award today. Weare truly honoured and emotionally touched to receive this veryprestigious award, which means the world to us! We accept it with allhumility; we are proud yet humbled, elated yet anxious, because thereis so much to do! Receiving this award does not mean that it is the endoftheroadfor us, ratheritistheinspiration todo much more!With one woman dying every few minutes of childbirth and many moreThank you FIGO for giving us the opportunity to developbeautiful relationships and weave partnerships. Thank you forthis excitement in our lives, which will propel us with the windbeneath our wings, to soar high towards our precise destinationofimproving womenslives!Thank you FOGSI, my parent Organization for givingme the opportunity and the strength to achieve whateverI could. There are hundreds of Fogsians present heretoday, this award is for all of us who have worked togethershoulder to shoulder, which I am accepting on behalf of allof us!And last but not the least, a special thanks to my family beforemarriage who educated and empowered me and to my familyafter marriage ie. My husband Sushil and my beautifuldaughters Aparna and Ameera, who gave up their time withme, so that I could make a difference to someone elseslives!Ladies and Gentlemen, we thank all of you for being with ustoday to share our joy, and our determination to make adifference.= Duru Shah7India plays role model for “Adolescent Sexual ReproductiveHealthCare” during the XXFIGOWorld Congress of Gynecology and Obstetrics-ROME 2012 Dr.Roza Olyai Chairperson Adolescent Health Committee FOGSIhad been nominated by FIGO to speak during the FIGO WorldCongress which was held in Rome between 7th and 12thOctober 2012. She represented FIGO during the WHO sessionon Addressing adolescents in the context of preconception care-What is currently being done in this area in high, middle andlow income countries with special emphasis on the workcurrently being done in India by her. Samples of the CD, bookmaterials & the Adolescence Magazine published by her since2009 was shared amongst the delegates during the session, waswell appreciated by everyone. Adolescent Health Committee FOGIwill be collaborating with other countries towards ARSH. Dr. RozaOlyai was also invited to participate in the workshoporganized by the FIGO working Committee on Women’s Sexualand Reproductive Rights. This interactive workshop was tounderstand as to how FIGO proposes to “Integrate the teachingof Human Rights. and Women’s Health in to educational andclinical practice’’. There were few other selective participantsmonths to have such more workshops country wise to spreadthemessageSAFOG AGRA 2013
  8. 8. FIGO @ AICOG MUMBAIFOGSI FIGO Session at the 56th AICOG in MumbaiThe 56th AICOG the annual congress of the Federation of Obstetric andGynecological Societies of India was organized in Mumbai fromJanuary 16 to 20, 2013. With over 11000 delegates this was the largestever conference of our specialty in India. The scientific program wasconductedinseventheme based hallsoverthreedays.As is the annual tradition the AICOG hosted as part of the scientificprogram international sessions in partnership with FIGO, AOFOG,SAFOG and RCOG. This year these sessions were also theme basedand planned in partnership scientific committee. This ensured that thesessions were delegate centric and aimed at the practicing clinician byaddressing issues related to daily clinical practice. The FIGO sessionwas titled FIGO Guidance in Clinical Practice and was formatted jointlyby Sir Sabaratnam Arulkumaran, President, FIGO, Prof Luis Cabero,Chair of the Education and Capacity Building committee, FIGO and Dr.NozerSheriar, Chair, Scientific Committee,56th AICOG.The FIGO session was held in the Dr. VN Shirodkar Hall and was chairedby Dr. Hema Divakar, President, FOGSI, Dr. Nozer Sheriar, SecretaryGeneral, FOGSI and Dr. Narendra Malhotra, Representative of FOGSI toFIGO. In this session Sir Sabaratnam Arulkumaran, President, FIGOspoke on FIGO Guidelines on Management of the Second Stage ofLabor, Prof CN Purandare, President Elect, FIGO spoke on FIGOGuidelines on Prevention and Management of PPH and Prof SiladityaBhattacharyaspokeontheFIGO Fertility Tool Box.The session was conducted in a hall that had delegates standing in theaisles as over 550 delegates attended this very informative andinteractive session. While looking forward to such sessions at AICOGs,FOGSI believes that such sessions would be an excellent modality forFIGOtoreachoutto memberassociationsattheirnationalconferences.8AICOG MUMBAI
  9. 9. FOGSIANS AWARDED AT FIGO-ROME 2012DR. Duru ShahMD FRCOG FCPS FICS FICOG FICMCH DGO DFP(Member) Dr Kamini RaoDr. Duru Shah has been in clinical practice since 1981. Shehas been a guide for postgraduate students in Obs. Gyn. forDoctorate of Medicine, Mumbai University and for theDiplomate of National Boards, India. A renowned Past Prof. ofObs. & Gyn. Mumbai University, India, her interest coversInfertility, Menopause and Reproductive Endocrinology. Shehas also been deeply involved in promoting womens health inIndia.Dr. Duru Shah is the Immediate Past Chairman of the IndianCollege of Obstetricians & Gynecologists (ICOG) which is theacademic arm of the Federation of Obstetric & GynaecologicalSocieties of India (FOGSI). She has been the President ofFOGSI, which is a 25000 strong professional body ofGynecologists, affiliated to the International Federation ofGynecology & Obstetrics (FIGO). At present, she representsFOGSI at FIGO, is a member of the Ethics Committee of FIGO,and a Member of the Technical Advisory Committee of FOGSIto Government of India for “Maternal Mortality”.Dr. Duru Shah has been involved in the field of academics andhas more than 100 publications to her credit. She has initiatedmany Educational programs such as the “Satellite School” atFOGSI, the Post Graduate Review Course at ICOG, and the PostGraduate Quiz at the Indian Menopause Society. She has beenresponsible for creating Collaborative Exchange Programsbetween IMS- India and British Menopause Society andbetween FOGSI with the Royal College of Obstetricians &Gynecologists.She is a Peer Reviewer for many journals, besides the IndianJournal of Obstetrics and Gynaecology of FOGSI. She is alsoon the Editorial Board of the “Climacteric” and the “TOG”of the Royal College of Obs. & Gyn. and “MenopauseInternational” of the British Menopause SocietyDr. Shah has been the proud recipient of many Awards andOrations, the most prominent being the “HonoraryFellowship of the Royal College of Obstetrics &Gynecology” conferred on her in November 2008 in Londonand the “Henry Burger Oration” which was conferred onher at the Asia Pacific Menopause Federation conference heldat Sydney in 2010. She was the first India recipient of the“Distinguished Merit Award” by FIGO, which was formallyawarded at the Opening Ceremony at FIGO conference held inRome in October 2012.President of the Indian Society for Assisted Reproductionduring the years 2006 to 2008 and of the Federation ofObstetric & Gynecological Societies of India in the year 2000,Dr. Kamini Rao is a pioneer of the Assisted Reproductionfraternity in India. She is the Founder Director of Milann – TheFertility Center formerly known as BACC, which has anongoing IVF program and a success rate comparableworldwide.Dr Kamini Rao is the Editor in Chief of two prestigious indexedjournals – The Journal of Human Reproductive Sciences ajournal indexed with PubMed and the International Journal ofInfertility & Fetal Medicine. Dr.Kamini Rao is academicallyoriented and has authored over thirty books of which “TheInfertility Manual”, “The Laboratory Manual of ART”, “TheAndrology Manual” and “Endoscopy in Infertility” are aimedat superspecialists and are hugely popular. She has broughtout a number of books targeting students the prominentamong them being the “Under Graduate textbook of Obs. &Gyn.” as well as books aimed at the General Practitioner like“Before She Conceives” one of a series of five books dealingwith Pregnancy, the others being “Maternal Nutrition”, “AGuide to A Healthy Pregnancy”, “Postpartum Weight Loss”and “Breast Feeding – Current Concepts.Keeping in mind her long standing work in the field ofInfertility she has been invited by the Ministry of Health &Family Welfare to serve as a Member of the National AdvisoryCommittee on Assisted Reproductive Technology to reviewand monitor the implementation of the national ART guidelinesand advise the Central Government on all policy mattersregarding the same. She is also a member of the NationalApex Committee for Stem Cell Research & Therapy institutedby Indian Council of Medical research and the Dept. ofBiotechnology, Govt. of India.Dr.Kamini Rao has been the recipient of a number of Awardsincluding the prestigious Karnataka State Award (RajyotsavaAward), the Vidya Ratan National Award, the Swastha BharatSamman Award and the Medscape India National Award ofexcellence. She has been recognized on Google as one of thetop ten Indian Doctors for her strong commitment toimproving the health and status of women in India and forputting assisted reproductive technology on the medical mapof India.9
  10. 10. EXCERPTS FROM FIGO NEWSLETTER April 2013FIGO participation on ARSHduring Adolescent Health Committeeworkshop AICOG 2013 MumbaiThe Adolescent Health FOGSI Committee workshop was held on17thJanuary 2013 at the Trident Hotel, Bandra (E) Mumbai during theAICOG2013 Mumbai which was a great success with good numberof participants involved.The scientific session was chaired by Professor Dr. Alka Kriplani,HOD AIIMS Delhi & Professor Dr. Walker, Senior Vice President ofthe RCOG, UK.Due to an important FIGO committment Prof. Hamid RushwanChief Executive FIGO could not come for the workshop but he waskind enough to share his presentation which was well coveredby Professor Dr. C.N.Purandare, President Elect FIGO talked indetail on the topic of “Adolescent Sexual Reproductive HealthGlobal views”Professor Dr. Lesly Regan, FIGO Committee on Womens Sexual& Reproductive Rights, spoke on the topic of “Adolescent healthissues in UK , the need for prevention and life skills approach towomens health”The Adolescence magazine issue 08 was released in presence ofthe invited guest speakers & faculty members by Dr. NarendraMalhotra past president FOGSI & FIGO representative who praised thework done by the committee & encouraged the members for theircontinued goodefforts.At the end, Dr. Roza Olyai,Vice President Elect FOGSI 2014,shared overview of the Adolescent Health committee FOGSIactivities of which she has been the chairperson since 2009 till date .This was followed by a special award ceremony for the advisors &members of the committee. Special thanks were given to Dr. HamidRushwan Chief Executive FIGO & Dr. Arulkumaran President FIGOunder whose guidance the Adolescent Health committee FOGSI wasdoingitsprojects.The program ended by hightea.=Roza OlyaiIndia plays role model for “Adolescent Sexual Reproductive HealthCare” during theXX FIGOWorld Congress of Gynecology and Obstetrics-ROME 2012 Dr. RozaOlyai Chairperson Adolescent Health Committee FOGSI had beennominated by FIGO to speak during the FIGO World Congress whichwas held in Rome between 7th and 12th October 2012. Sherepresented FIGO during the WHO session on Addressing adolescentsin the context of preconception care-What is currently being done inthis area in high, middle and low income countries with specialemphasis on the work currently being done in India by her. Samples ofthe CD, book materials & the Adolescence Magazine published by hersince 2009 was shared amongst the delegates during the session, waswell appreciated by everyone. Adolescent Health Committee FOGI willbe collaborating with other countries towards ARSH. Dr. Roza Olyai wasalso invited to participate in the workshop organized by the FIGOworking Committee on Women’s Sexual and Reproductive Rights. Thisinteractive workshop was to understand as to how FIGO proposes to“Integrate the teaching of Human Rights. and Women’s Health in toeducational and clinical practice’’. There were few other selectiveparticipants months to have such more workshops country wise tospread themessage5th May 2013
  11. 11. FOGSI-FIGO INTERNATIONAL CONFERENCEHYDERABAD- INDIA•-- -- -- ---··-------.. ..... •• "I I., •r·-..-.- ..-• I--···-I-.._ -- I- - - --- - - -- --
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