This document discusses retropharyngeal abscess, including its definitions, epidemiology, etiology, pathophysiology, clinical features, investigations, treatment, and complications. It notes that retropharyngeal abscess is most common in children under 6 years old and can be caused by infections spreading from nearby structures. Symptoms may include fever, neck swelling, sore throat, and difficulty swallowing. Diagnosis involves imaging like CT scans. Treatment requires protecting the airway, administering antibiotics, and surgically draining the abscess if needed to prevent life-threatening complications. Prognosis is generally good if identified and treated early.
This is a seminar presentation conducted by 4th year medical students under supervision of a lecturer. Reference were not attached here, but all information are from google, few textbooks and also from previous ENT posting's seminar.
What is the LPR
Esophageal anatomy
Pathophysiology
Risk factors
CLINICAL MANIFESTATIONS
Reinke’s edema
Patterns and Mechanism of LPR and GERD
DIAGNOSIS
Symptom Questionnaire:
Laryngoscopic Findings
Therapeutic Trial for LPR
Ambulatory PH Monitoring
Treatment
Lifestyle modifications
Dietary modification
PHARMACOLOGICAL
Drug therapy
Surgery
This is a seminar presentation conducted by 4th year medical students under supervision of a lecturer. Reference were not attached here, but all information are from google, few textbooks and also from previous ENT posting's seminar.
What is the LPR
Esophageal anatomy
Pathophysiology
Risk factors
CLINICAL MANIFESTATIONS
Reinke’s edema
Patterns and Mechanism of LPR and GERD
DIAGNOSIS
Symptom Questionnaire:
Laryngoscopic Findings
Therapeutic Trial for LPR
Ambulatory PH Monitoring
Treatment
Lifestyle modifications
Dietary modification
PHARMACOLOGICAL
Drug therapy
Surgery
Ludwig's Angina is an infective condition of the floar of mouth above and below the mylohyoid muscle. Tongue is raised, mouth remains open and there may be compromised airway and require tracheostomy. Treatment is medical in the form of antibioticsand pain killers and surgical in the form of incision and drainage.
Please find the power point on Labyrinthitis and its management. I tried to present it on understandable way and all the contents are reviewed by experts and from very reliable references. Thank you
Ludwig's Angina is an infective condition of the floar of mouth above and below the mylohyoid muscle. Tongue is raised, mouth remains open and there may be compromised airway and require tracheostomy. Treatment is medical in the form of antibioticsand pain killers and surgical in the form of incision and drainage.
Please find the power point on Labyrinthitis and its management. I tried to present it on understandable way and all the contents are reviewed by experts and from very reliable references. Thank you
Unusual Presentation of Hydatid Cyst in a Childsemualkaira
Pulmonary hydatid disease remains an important healthcare problem in children. We report a case report of a 4-year-old child with chronic cough and hemoptysis for 2 months. he had no contact with dogs. Pleuropulmonary examination showed well-transmitted bladder murmurs and well-perceived vocal vibrations. The diagnosis of pleuropneumopathy was retained and the patient was treated with amoxicillin - acid clavulanic antibiotic therapy. In front of non-clinical improvement, ultrasound showed a left basal, rounded, thickened-walled, non-vascularized, non-doppler, single loculate basal cyst formation which is related to a hydatic cyst . Surgey consisted of a left posterolateral thoracotomy associated with a puncture-evacuation of the contents of the hydatic cyst, an exterioration of the proligeus membrane. The recovery was good.
Acute epiglottitis is an acute inflammatory condition of the epiglottis and nearby structures like the arytenoids, aryepiglottic folds, and vallecula.It is a life-threatening infection that causes profound swelling of the upper airways which can lead to asphyxia and respiratory arrest.Bacterial etiology is the most common cause of epiglottitis. Soft tissue lateral xray of neck shows thumb sign. Airway management is the main concern of epiglottitis.
Abstract Lung Abscess is a liquefactive necrosis of the lung tissue and arrangement of cavitation (in excess of 2 cm) containing necrotic debris and liquid brought about by parenchymal infection. It very well may be brought about by yearning, which may happen during changed cognizance and it for the most part causes a discharge filled depression. In addition, liquor addiction is the most widely recognized condition inclining to lung abscesses. Lung abscess is viewed as essential (60%) when it comes about because of existing lung parenchymal process and is named auxiliary when it entangles another procedure, e.g., vascular emboli or follows rupture of extrapulmonary abscess into lung. There are a few imaging strategies which can distinguish the material inside the thorax, for example, electronic tomography (CT) output of the thorax and ultrasound of the thorax. Broad Spectrum anti-biotics to cover blended vegetation is the pillar of treatment. Pneumonic physiotherapy and postural drainage are additionally significant. Surgeries are required in specific patients for pneumonic resection Keywords: Lung abscess, anti-bodies, video-assissted thoracoscopic medical procedure (VATS), thoracoscopy
Similar to Retropharyngeal Abscess by Boluwatife Afolabi (20)
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
3. Retropharyngeal abscess and other deep neck space
infections are potentially life threatening conditions and
can often present with diagnostic and therapeutic dilemmas
to the physician.
The incidence and morbidity of deep neck space infections
has been significantly reduced with the introduction of
antibiotic therapy.
3
8. Abscess- A localized collection of pus surrounded by
inflamed tissue.
Retropharyngeal Abscess- This is the presence of an
abscess cavity within the retropharyngeal space.
8
9. It is almost exclusively a paediatric diagnosis although it is
now being observed with increasing frequency in adults.
50% occur in patients 6-12 months of age.
96% occur before 6 years of age.
Peak age incidence is between 3-4 years.
Although no gender predilection has described but there is
higher incidence of as high as 60% in male children than
females.
There is however no racial predilection.
9
11. Adults
Dental infections
Salivary gland infections.
Pharyngeal trauma from endotracheal intubation, endoscopy,
foreign body ingestion.
Extension from adjoining deep neck space.
Immunocompromised or chronically ill, diabetics, alcoholics,
cancers etc
IV drug abusers.
11
12. In children, retropharyngeal abscess is usually caused by
infections that spreads to the retropharyngeal lymph nodes
from surrounding structures with subsequent cellulitis and
formation of abscess.
The retropharyngeal lymph nodes usually regress and even
atrophy with increasing age hence its reducing frequency.
In older patients, infection of the retropharyngeal space
usually occurs from penetrating trauma or direct spread
from adjacent neck spaces.
12
14. Symptoms in infants: fever, neck swelling, anorexia,
decreased appetite, irritability.
Symptoms in older children: fever, sore throat, malaise,
chills, odynophagia, decreased appetite, neck stiffness.
Symptoms in adults: fever, chills, malaise, sore throat,
odynophagia, dysphagia, sensation of lump in the throat,
muffled voice, neck pain, jaw stiffness.
14
15. In children
-pyrexia.
- stridor.
- drooling of saliva.
- tender cervical lymphadenopathy.
- posterior pharyngeal bulge.
-Associated signs like tonsillar enlargment and hyperemia, otitis
media.
- ‘tracheal rock sign’ in which there is pain on rocking the trachea and
larynx from side to side.
15
17. Laboratory studies
- Electrolyte, Urea and Creatinine
- Full blood count- May show leukocytosis but normal WBC count does not
rule out the diagnosis of a retropharyngeal abscess.
- Blood culture
- Retroviral screening
- Random blood sugar
- Abscess aspirate for m/c/s
Radiological
- Lateral neck X-ray- May show widening of the retropharyngeal space, gas-
fluid levels or gas in tissues, or even a foreign body in the retropharyngeal
space.
17
19. CT scan of the neck with
contrast
- Very useful in the
diagnosis and management
of RPA. RPA appears as a
hypodense lesion in the
retropharyngeal space
with peripheral ring
enhancement.
19
20. MRI can also be done
A chest x-ray is indicated to look for aspiration pneumonia and
mediastinitis.
Ultrasound is an imaging modality that is gaining popularity. It is safer
than CT scan, since it is portable and does not use radiation.
Ultrasound is also less traumatic to children, requiring less frequent
use of sedation.
In experienced hands, ultrasound can help determine the presence
and location of an abscess and can allow the clinician to distinguish
an abscess from cellulitis with some accuracy.
20
21. The three keys to successful management of deep neck
infections are:
- Protection and control of the airway.
- Antibiotic therapy.
- Surgical drainage.
21
22. Initial Care
Includes attention to the airway, fluid resuscitation if necessary, antibiotic
treatment, and preparation for an emergency operation. Frequent vital sign
checks and continuous oxygen saturation monitoring are essential.
Airway management
Apply supplemental oxygen. In young children, this can be done in a
nonthreatening way by letting the parent direct blow-by oxygen at the
child's face.
Endotracheal intubation may be required if the patient has signs of upper
airway obstruction. It may be difficult because of upper airway swelling.
Cricothyrotomy may be required in the patient with upper airway
obstruction who cannot be intubated.
Tracheostomy may be required for definitive airway management.
Intravenous fluids are required if the patient is dehydrated because of fever
and difficulty swallowing. 22
23. Consultation of an ENT specialist is necessary as soon as the diagnosis
of RPA is established or as soon as the diagnosis is suspected if the
patient is exhibiting signs of upper airway obstruction.
If it confirmed to be cellulitis rather than an abscess, IV antibiotics
should be commenced.
- Augmentin (Co- amoxiclav) or Ampicillin/sulbactam (unasyn)
-Metronidazole to improve anaerobe coverage.
-3rd generation cephalosporins and clindamycin are alternatives.
23
24. The approach of drainage is dependent on the location of
the abscess and its relationship with other structures.
Image guided aspiration for small, uniloculated abscesses
Transoral surgical drainage
Preoperative CT – precisely locate the carotid sheath and
its content.
External surgical drainage.
24
25. External surgical drainage
The anterior approach involves an incision paralleling the anterior
border of the sternocleidomastoid, dissection along the anterior
border of the muscle, lateral retraction of the carotid sheath,
medial retraction of the larynx, trachea and thyroid and exposure
of the abscess cavity at the hypopharynx.
The posterior approach utilizes an incision behind the
sternocleidomastoid, medial and anterior retraction of the muscle
and carotid sheath, opening into the abscess from posterior to the
great vessels.
25
29. Prognosis generally is good if they are identified early,
managed aggressively, and complications do not occur.
Once mediastinitis occurs, mortality approaches up to 50%
even with antibiotic therapy.
29
31. Acta Otorhinolaryngol Belg 2000; 54 (3) : 237 -41. Department of
Otorhinlaryngology, Head and neck surgery, University Hospitals leuven, Belgium
Medscape
Atlas of Human anatomy – Netters 2006.
Journal of urban health – R.J Ruben and N.Weg. N Y acad. Med 1976
Basic Otorhinolaryngology by Rudolf Probst, Gerhard Grevers, Heinrich Iro. Page 108
Abstract of paper presented at 11th annual and scientific conference of association
of Pediatric surgeons of Portharcourt between 22 – 24 th September, 2011.
Department of Otolaryngology, University of Portharcourt Teaching Hospital.
Wikipedia
Slideshare.com
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