Vol 6 Issue 2 October 2018-March 2019

Abstract: Extracorporeal Shock Wave Therapy, (or ESWT), is a new technology using shockwaves to treat chronic, painful conditions of the musculoskeletal system.  A shockwave is an intense, but very short energy wave traveling faster than the speed of sound. The word "Extra-corporeal" means "outside the body" and refers to the fact that the shockwaves are generated outside the body.

Methods: Evidences Reviewed From Literature Search 2005-2018.It was taken from pubmed, Googlescholar, wiley online libraby.

Conclusion: EWST is often a last resort treatment once other less expensive treatments have failed (ie. manual therapy, US). Best results when used in conjunction with exercise Not a stand-alone modality. Positive findings for plantar fasciitis, patellar tendinopathy, and Achilles tendinopathy.  Mixed results for calcific tendinopathy of the shoulder and lateral epicondylitis.

Keywords: Extracorporeal Shock Wave Therapy, plantar fasciitis, tendinopathy, epicondylitis.

Title: EXTRACORPOREAL SHOCKWAVE THERAPY: AN EVIDENCE BASED PRACTICE

Author: DR.CHIRAG P. SOLANKI, DR.RAHUL M. CHHATLANI

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: This National Health and Morbidity Survey of Maternal and Child Health (NHMS 2016: Maternal and Child) aimed to determine mother’s perception of importance of their young children’s oral healthcare, practice of oral health and dental utilization of their child. All mothers with children aged 0-59 months, aged 15-49 years and last childbirth less than 2 years prior to the survey in the selected Living Quarters (LQs) were invited to participate in this survey. A face-to-face interview by trained research assistants using a structured questionnaire through mobile device application was used during the data collection period from mid-February until end of May 2016.  About 26.8% (95% CI: 21.55 – 32.76) of mothers reported it is very important for them to look after their child’s teeth, 72.8% (95% CI: 66.87 – 78.06) reported it is important, while 0.3% (95% CI: 0.16 – 0.55) did not think looking after their child’s teeth is important.  About 74.0% (95% CI: 71.51 – 76.37) of mothers reported they cleaned/brushed their child’s teeth or supervised their child’s tooth brushing daily, while 19.0% (95% CI: 17.12 – 21.02) reported they had only done so once a while. A low percentage of mothers (7.0%, 95% CI: 5.74 – 8.49) reported they had never ever cleaned/brushed their child’s teeth or supervised their child’s tooth brushing. About 73.3% (95% CI: 69.61 – 76.71) of mothers reported they had never brought their child for a dental visit (dental check-up/dental treatment) before. About 38.3% (95% CI: 34.53 – 42.17) of mothers opined that they need to bring their child for their first dental visit before their child was two years of age, 27.5% (95% CI: 24.67 – 30.42) when their child was two to three years old and 25.3% (95% CI: 22.89 – 27.89) when their child was four to five years old. A further 9.0% (95% CI: 6.44 – 12.34) of mothers reported not knowing when they should bring their child for their first dental visit. The findings highlight the need to need to promote greater awareness of the role of mothers in maintaining good oral health of their young children. Oral health promotion advice for mothers need to include good oral hygiene habits for the very young child as well as bringing children for their first dental visit before the age of two years.

Keywords: mother’s perception, young children oral healthcare, practice of oral health, dental utilization.

Title: Perceived Importance of Child’s Oral Health, Oral Health Practice and Oral Healthcare Utilization among Mothers

Author: Yaw Siew Lian, Natifah Che Salleh, Nurrul Ashikin Abdullah, Mohd Fuad Mohd Anuar, Noor Ani Ahmad, Norazizah Ibrahim Wong, Rajini Sooryanarayana, Tahir Aris

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: All consenting 300 cases of normal level of serum magnesium pregnant women and 300 women with low level of serum magnesium attending antenatal clinic for antenatal checkup of >/= 20 weeks who fulfills the inclusion and exclusion criteria were included in the study. Each patient were included only once in the study. Gestational age, parity, socioeconomic status and BMI were matched between cases and controls. History noted and after general physical and obstetric examinations, urine analysis is done to note the extent of proteinuria by dipstick method or by 24 hours urine protein estimation. Then 4 ml of venous blood is drawn from the subjects and sample is analysed for magnesium. Serum magnesium was measured by Calmagite method. Result: Of the 300 cases of low serum magnesium level primigravida pregnant women, 24 developed pre-eclampsia and 2 developed eclampsia. The subjects were primigravida in the age group of 18-30 years and belonging from low socio-economic status. The mean serum magnesium was 1.137+/-0.280 in the cases of low level of serum magnesium. In contrast out of 300 cases of normal level of serum magnesium primigravida pregnant women, 6 developed pre-eclampsia. The subjects were primigravida in the age group of 18-30 years and belonging from low socio-economic status. The mean serum magnesium was 1.921+/-0.322 in the cases of normal level of serum magnesium. . The difference between the mean serum magnesium level in low level of serum magnesium cases and normal level of serum magnesium cases was statistically significant (p=0.0018).

Keywords: Eclampsia,  pre-eclampsia, proteinuria, serum magnesium.

Title: THE ASSOCIATION BETWEEN DIETARY FACTOR OF LOW LEVEL MAGNESIUM AND DEVELOPMENT OF PRE-ECLAMPSIA AND ECLAMPSIA

Author: Chaitali Mondal, Dr. Dipak Das

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: Worldwide, 415 million of adult people live with diabetes (one out of eleven), also there are 5 million die from diabetes every year(1). Saudi Arabia is now classified by the International Diabetes Federation to be among the top 10 countries globally with the highest prevalence of diabetes in 2015 (17.6%)(1). Even KSA has the highest prevalence rate of diabetes in the Middle East region(1).

Objectives: To investigate the magnitude and determinants of the problem of refusing insulin therapy among poorly controlled type II diabetic patients despite of having the maximum dose of oral hypoglycemic medications.

Subjects and Methods: The study conducted at the diabetic centers, belonging to Ministry of Health, Taif city. Diabetic center has four clinics dealing with all problems of diabetic patients. It is a descriptive, cross sectional study, facility based included adult patients with type 2 diabetes during the study period will constitute the target population for the study. Self-administered Arabic questionnaire was used for collecting data. It included socio-demographic, duration of type 2 diabetes and last HbA1c reading, their willingness to start insulin therapy if it was recommended by doctor and their concerns and beliefs about. It is rated on a 5-point likert scale from “strongly agree” to “strongly disagree”. Statistical Package for Social Sciences (SPSS) software version 22 was used for data entry and analysis.

Results: One hundred fifty respondents were included in the study. The age of more than half of them  (76%) were aged between 50 to less than 70 years, (54.7%) were male, (55.3%) were married, (62%) not working, (65.3%) live in Taif, and (52.7%) had less than secondary level of education. Majority of respondents 64 (442.7%) experience DM 5 to 10 years duration and the mean of last reading of HbA1c% was 9.461. More than half of respondents were unwilling to start insulin. Majority of respondents 84 (56%) have negative attitude, while 66 (44%) have positive attitude towards insulin therapy.

Conclusion: Respondents have negative attitude toward insulin therapy. So, it important to explore reasons for their reluctance to commence insulin can address his/her specific concerns and beliefs, and promote the future uptake of insulin therapy.

Keywords: type 2 diabetic patients, diabetic centers, insulin therapy, International Diabetes Federation.

Title: Refusal of insulin therapy among poorly controlled type 2 diabetic patients in Taif city: Prevalence and reasons

Author: Dr. Hanadi Aljohani, Dr. Noha Saleh Mohammed

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: Parkinson’s disease (PD) is a progressive disorder of the central nervous system (CNS) with both motor and non motor symptoms. Motor symptoms include the cardinal features of rigidity, bradykinesia, tremor, and, in later stages, postural instability. PD is a common disease that affects an estimated 7 to 10 million people worldwide. More than 2% of people older than 65 years of age have PD among neurodegenerative disorders. Functional tasks such as rolling over in bed or moving from supine-to-sitting that are likely to prove difficult. These activities have a large rotational component of the trunk, typically lacking in many patients with PD. Modified Rivermead Mobility Index (MRMI) is designed to assess functional mobility for people with a wide range of abilities. The Modified Rivermead Mobility Index has been designed to measure wide range of ability to maintain the mobility that make it suitable for using in clinical setting. It is cheap, quick, easy to access and simple to administer for mobility evaluation in parkinson’s disease. It is reflective of clinical practice and hence, objective of study is to find out the inter-rater and intra- rater reliability of Modified Rivermead Mobility Index Scale in parkinson’s patients.

Methods: An Observational study included 30 patients, both male & female with Parkinson’s between age group of 50 to 65 years. The patients were assessed using MRMI scale by two rater for inter-rater reliability and by same rater at different time (24 hours of duration) for test retest reliability.

Results: Data were analyzed by using SPSS software 14.00 by Intraclass Correlation coefficient which showed significant positive correlation between Rater A1 and Rater A2; Rater A1 and Rater B.

Conclusion: The result suggested that the MRMI scale is an easy-to-administer clinical test with intra rater and inter rater reliability in subjects with Parkinson’s to assess functional mobility.

Keywords: Parkinson’s disease, rigidity, bradykinesia, tremor, postural instability, Modified Rivermead Mobility Index, Reliability.

Title: TO FIND OUT THE INTER – RATER AND INTRA – RATER RELIABILITY OF MODIFIED RIVERMEAD MOBILITY INDEX IN ASSESSMENT OF MOBILITY OF PARKINSON’S PATIENTS – AN OBSERVATIONAL STUDY

Author: DR.CHIRAG P. SOLANKI (PT), DR.RAHUL M. CHHATLANI (PT)

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: Recently, social media has become an essential part of life of people, particularly young population representing the main source of obtaining news and connecting them with others. Conflicting results have been reported on the association between the utilization of social media and depression in previous studies.

Objectives: To investigate the social media use among medical students in Taif University, and exploring the impact of its overuse on depression and academic performance of the students.

Subjects and Methods: This cross-sectional analytic study was conducted in college of medicine, Taif University. All regular Saudi medical male and female students of the fifth and sixth were invited to participate in the study by filling in the study questionnaire during 2018. The questionnaire consists of the following parts;.Socio-demographic characteristics of the students, details regarding utilization of social media use, history of factors that could be associated with the development of depression and assessment of  depression using a PHQ-9 instrument.

Results: Three hundred eighty eight students were included in the study. Their age ranged between 22 and 27 years with an arithmetic mean of 23.5 years and standard deviation “SD” of ±0.9 years. The most frequent programs were chatting programs (30.4%), snapshot (25.6%) and Twitter (21.6%). Concerning daily usage, more than one third of them (36.4%) used social media for three to six hours daily while 11.3% used them for more than 9 hours daily. The prevalence of depression was 62.4%; 36.3% was mild whereas 19.6% and 6.4% was moderate or severe, respectively. Multivariate logistic regression analysis revealed that  Female, single students, those with study/academic problems, drug and/or alcohol users and students exposed to physical or psychological violence were more likely to develop depression than their counterparts. There was no significant association between social media use and depression. Academic performance of students was significantly affected by the duration of social media use, p<0.001.

Conclusion: Depression is highly prevalent among senior medical students at Taif University with no significant association between it and social media use However, academic performance of students was significantly affected by the duration of social media use.

Keywords: social media, senior medical students, academic performance.

Title: Social Media Overuse and Its Association with Depression and Academic Performance of Senior Medical Students at Taif University

Author: Dr. Mohammed Saleh Alghamdi, Dr. Mohammed Alzaydi

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: Individuals with eating disorders are known to use different strategies to reduce weight either by restrictive or purging behavior. Anorexia nervosa is an eating disorder that is predominately treated with psychotherapy. Cultural and religious beliefs could influence eating disorders. Here, we report a challenging case of acute anorexia nervosa management with contraindicated religious fasting during the holy month of Ramadan.

Keywords: Anorexia, Bulimia, Nervosa, fasting, eating disorder, religious fasting, body weight.

Title: Case Report: Religious Fasting and Management Difficulties in Anorexia Nervosa

Author: Sumayah Aljhani

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: World's growing population by 2050 food production target will have to be doubled and simultaneously the dependence on chemical fertilizers and pesticides will be reduced. In order to achieve this goal a study of many beneficial subjects in between the plants and Micro-organisms becomes necessary. Micro-organisms become more important due to their beneficial activities, ingestion of major nutrients, and in the development of branches and roots. In general, Micro-organisms used in agriculture include species of pseudomonas sp. trichoderma sp. streptomycitis sp. and many other Micro-organisms.

Keywords: Healthy food, Healthy life, chemical fertilizers, food production, Micro-organisms.

Title: Healthy food, Healthy life

Author: Ms. Harsha Sharma

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: Coarctation of the aorta (CoA) is a relatively common defect that accounts for 5-8% of all congenital heart defects. Although coarctation ballooning has been done by many cardiologists retrogradely or via subclavian artery antegradely, yet we had one unique idea of doing it via venous approach through VSD, thus helping to avoid carotid/ subclavian puncture unnecessarily. We present a case of severe neonatal juxtaductal coarctation with VSD, 2 day 2.6kg baby. With the help of BMW 0.04 wire we tried the usual method to cross the tight coarctation but failed. Then instead of crossing the wire via subclavion artery puncture, we took the coronary wire antegradely thruogh the IVC to RV, RA, VSD and then the Aortic valve to reach the coarctation site, where we could easily cross the wire and later dilated the coarctation with 4mmx2cm coronary balloon followed by Mini Tyshaq II 5mmx2cm and achieved our goal. Post balloon angiography showed a well open arch with no siginificant gradient and no aortic dissection.

Keywords: Coarctation of the aorta; Balloon angioplasty; Right atrium, Right ventricle, Ventricular septal defect; atrial septal defect.

Title: Antegrade (transvenous) approach for coarctation ballooning in a neonate with VSD and severe coarctation of aorta

Author: Bisht Dinesh MD, Mahajan Viresh MD, Rawal Nidhi MD, Tyagi Himanshu MD

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: This is a retrospective study of 85 cases of reactive lymphoid hyperplasia, reviewed with Professor Wilson I. B. Onuigbo, from 1972-2002. The clinicodemographic data retrieved included age, sex, location of lesions, duration and sizes of lesions. The mean age of the patients was 30.5 years and percentages by sex are 55.4 and 44.6 respectively. A total of 42.7% of the lesions are located in the groin, 19.51% in the axilla and 19.51% multiple lymph nodes, 12.20% in the neck and 6.10% mesentery. Fever constituted 24.44% of the clinical features, followed by pains 21.11%;weight loss 12.22%  and the rest follows in decreasing order. The sizes of the lesions in the widest diameter were as follows: 41% for 2cm, 20.3% for 3cmand 12.7% for 1cm. 52.73% of lesions lasted for one to six months. Using chi-square, there is no significant difference in age of both sexes (P value >0.05); Outcome of fever (P value > 0.05) and that of the sizes of lesions (P value >0.05). There is predominance of lesions In the inguinal region (P value < 0.05) and one to six months lesions(P value 0.05).Thus this study shows equal affliction to both sexes, predominantly, at the inguinal groin, with no specific predominant symptoms or size of lesion, as cases are not often acute.

Keywords: lymphoreticular system, lymph node, hyperplasia, clinicodemographic.

Title: RETROSPECTIVE STUDY OF REACTIVE HYPERPLASIA IN LYMPH NODES

Author: BERNARD KAFOR

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: Angiosarcoma is a vascular malignancy that derived from mesenchymal cell source. It reports around 1- 2% of all soft tissue sarcomas. The incidence of angiosarcomas cannot be determined by age because of insufficient data. The Angiosarcomas are found more commonly in men in comparing to women.

Case presentation: 12 years old female presented with swelling of the left upper tibia since 3 months, progressive over time. X-Ray, MRI and bone scan were done (Fig. 1, 2). There were an Osteolytic lesion at the proximal tibial epiphysis and metaphysis with extension to epiphysis broad plate. The first biopsy was interpreted as Telangiectatic Osteosarcoma. There was no Fever, no discharge from swelling and no history of trauma. After repeating the biopsy with special immunostaining, the final diagnosis was made to High grade angiosarcoma of the bone.

Conclusion: The angiosarcoma of the bone is extremely rare, according to our knowledge, no such cases have been reported in children. This case report shows the radio-pathological correlation in regarding to understanding those cases in the future.

Keywords: Angiosarcoma, Bone, Children.

Title: Angiosarcoma of the Left Tibia in 12 Years Old Child; An Extremely Rare case

Author: Mohammed Saleh Aldamegh, Nawaf Faisal Almukaibil

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: Vitamin D deficiency is an important public health problem in Saudi Arabia. Exposure to sunlight has a great importance in this regard; because of its health effects on building of vitamin D and being the main source of vitamin D.

Objectives: To explore the knowledge, attitude and practice of sun exposure affecting vitamin D among adult male visitors of Primary Health Care Centers In Taif City.

Subjects and Methods: Analytical cross-sectional study was carried out in Taif governorate in the western region of Saudi Arabia including a representative sample of adult male visitors older than 18 years attending primary health care centers (PHCCs) within the city limits of Taif governorate throughout the study period (January-February, 2018). A pre-designed Arabic self-administered questionnaire was used for data collection.

Results: The study included 354 males.  More than one-third of them either aged between 25 and 39 years (40.3%) or between 40 and 60 years (34.2%). Most of them (76.3%) were Saudis. Majority of the participants (82.5%) have heard about vitamin D. The most frequent reported sources of awareness about vitamin D were friends/relatives (31.2%), physicians (29.5%), internet (27.4%) and TV (21.9%). Overall only 16.7% of the participants expressed sufficient knowledge regarding vitamin D. Majority of the participants (88.7%) agreed that vitamin D is important for their health. Majority of the participants were like to be exposed to sunlight either always (38.4%) or sometimes (41%) whereas only 4.8% avoided exposure to sunlight and 15.8% exposed to sunlight rarely. Regarding nationality, 11.9% of non-Saudi compared to only 2.6% of Saudis avoided exposure to sunlight, p=0.001. Regarding participants` educational level, 10.7% of illiterates compared to only 0.7% of university/above educated males avoided sunlight exposure, p=0.010. Overall adequate practice regarding sunlight exposure and vitamin D intake was observed among approximately two-thirds of the participants (66.4%).

Conclusions: Overall knowledge regarding vitamin D was insufficient. Attitude and practice of the participants regarding importance of vitamin D to health and sunlight exposure was adequate, particularly among Saudis, living in urban areas and high educated individuals.

Keywords: vitamin D, adult male, public health problem.

Title: Knowledge, Attitude And Practices Regarding Exposure To Sunlight And Its Effect On Vitamin ( D)Among Adult Male Visitors Of Primary Health Care Centers In Taif City , Saudi Arabia

Author: Dr. Hani Raddah Alsufyani, Dr. Abdullah Ahmed Albarqi

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: Identifying those cases of placenta Previa at high risk for preterm delivery would aid in counselling as well as delivery planning. Our objective was to identify risk factors for preterm delivery and placenta Previa. We searched PubMed, and MEDLINE for studies published up to August 2018, for all studies discussing preterm delivery and placenta Previa. Placenta previa refers to a placenta that overlies or is proximate to the internal os of the cervix and occurs in about 1 in 250 pregnancies. Although placenta previa classically presents as painless vaginal bleeding in the second or third trimester, the inclusion of routine second trimester ultrasound evaluation in standard prenatal care has led to more frequent identification of placenta previa in asymptomatic women. In the majority of cases the mechanism of such bleeding is unclear. Some investigators hypothesize that FTB may indicate an underlying placental dysfunction, manifesting later in pregnancy with adverse perinatal outcome.

Keywords: placenta Previa, asymptomatic women, pregnancy.

Title: Review of pregnant with placenta previa and risk of preterm delivery

Author: Sara Ahmed Matrook Mohamed, Sharifah Radhi AlSammak, Batool Sayed Salman Baqer Ali, Jumana Mohamed Ali Mohamed Ali, Zainab Abdulaziz Zainuddin Mohsen

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: This review will address the categories of shock and aims to give recommendations for the management during the early phase of shock of patients hospitalised in the ICU. The focus is on the management of hypovolemic shock. This review was performed computerized search throughout electronic databases of PubMed, Web of Science and CENTRAL for all articles concerned with hypovolemic shock management in ER was performed our search in August 2018. Intravenous fluids (IVF) are regularly utilized to recover intravascular volume in individuals with distributive as well as hypovolemic shock. Although the advantages of the suitable utilization of fluids in intensive care units (ICUs) as well as medical facilities are well defined, there is expanding knowledge pertaining to the possible threats of volume overload as well as its impact on organ failing and mortality. To prevent volume overload as well as its connected issues, strategies to recognize fluid responsiveness are created as well as made use of regularly amongst ICU patients. Besides the quantity of fluid made use of for resuscitation, the sort of liquid utilized likewise impacts patient outcome.

Keywords: patients, intensive care units (ICUs), medical facilities, hypovolemic shock.

Title: Proper fluid management for hypovolemic shock in ICU

Author: Dr. Ali breek Alharthi, Dr. Ahmad ali alhussein, Dr. Mahmoud Modawi 

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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Abstract: In Malaysia, physicians both prescribe and dispense drugs. However, this practice is not applicable in retail pharmacies as medication is only dispensed when there is a valid paper prescription from physicians. Due to the escalating pricing of medication in the private sector, medication adherence has been greatly affected.

Methods and Findings: Systemic sampling method was used to collect data. The top twenty-five long-term medication pricing were collected from private clinics and retail pharmacies in four major geographical regions in West Malaysia. The mean prices per tablet were tabulated, and average savings comparing both settings were analyzed and discussed. Mean prices per tablet of the medication selected were also compared with the Consumer Price Guide (CPG) by the Pharmaceutical Service Division (PSD).

Conclusion: Medication supply in retail pharmacies has an average savings of 65% as compared to private clinics. Further measures including implementing dispensing separation, and enforcing a stringent price policy, will lead to a cost-effective drug expenditure.

Keywords: private clinics, retail pharmacies, drug expenditure, cost-saving.

Title: Evaluating Differences between Drug Prices in Private Clinics and Retail Pharmacies in Malaysia

Author: HIEW FEI TSONG, LEE YIN CHEN, THEN RU LUEN, ONG CHOONG KOON, NG JIN YONG

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

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