iosr-JDMS   Volume-17 ~ Issue-7 ~ July-2018

Abstract: This prospective hospital-based study was conducted on 50 patients with chronic suppurative otitis media (CSOM). Those with acute exacerbation of their disease were excluded. Patients satisfying inclusion criteria were interviewed on a semi structured proforma for demographic details and hygiene related practices. A detailed history was elicited followed by ENT examination and pure tone audiometry. The mean age of female patients was 36.33 years with a Standard Deviation of 15.21 years, while that of male patients was 25.43 years with a Standard Deviation of 10.11 years. 13(26%) patients had severe aural disease. The difference in the proportion of men and women having tympanic membrane perforation was statistically highly significant (X2=10.67 and p=0.001). 1(2%) of the patients required bilateral tympanoplasty while 5 (10%) of the patients required unilateral modified radical mastoidectomy. 32 (64%) of those who needed surgery had deferred the procedure.

Keywords – CSOM, Otorrhoea, Earache.

[1]. Morris P., Chronic Suppurative Otitis Media, BMJ Clinical Evidence, 2012. Accessed at: https://ncbi.nlm.nih.gov/pmc/articles/PMC3412293/ on 8th Jul 2018
[2]. Berman S., Morris P. et.al., Chronic Suppurative Otitis Media, Burden of Illness and Management Options, Child and Adolescent Health and Development, Prevention of Blindness and Deafness, World Health Organisation, 2004.
[3]. Dubey S., Larawin V., Complications of Chronic Suppurative Otitis Media and Their Management, The Laryngoscope, Volume117, Issue2 Feb 2007, Pages 264-267
[4]. Hunt L., Muluwafu W., Prevalence of paediatric chronic suppurative otitis media and hearing impairment in rural Malawi: A cross-sectional survey, PLoS One. 2017 Dec 21;12(12)
[5]. Bhalla A., Singh A., et.al., Chronically Discharging Ears: Evalution with High Resolution Computed Tomography, Pol J Radiol. 2017 Aug 23;82:478-489

Abstract: A double blind Randomized Controlled study to compare the Postoperative analgesia and degree of motor blockade between 0.2% Ropivacaine with Fentanyl 5mcg/ml and 0.125% Levobupivacaine with Fentanyl 5mcg/ml in below umbilical Surgeries. 100 patients in the age group of 35 – 75 years of either sex falling under ASA grade I & II were enrolled and allotted in to two groups A & B of 50 each. Group 'A' received Ropivacaine 0.2% with Fentanyl 5mcg/ml and group 'B' received 0.125% Levobupivacine with Fentanyl 5mcg/ml through epidural block in the Post operative period. Intraoperative Anesthesia was provided by General Anesthesia. After completion of surgical procedure, when patient complaint of pain, epidural infusion was activated and parameters were monitored as per planned intervals up to 48 hours. Pain score were monitored by using visual analog scale and degree of motor block was monitored by using bromage scale and observed that significant difference in onset of analgesia (group 'A' 6.46 min and group 'B' 5.8 min), (P value 0.008) and no significant difference in peak action of analgesia between both the groups both drugs are equally potent in analgesia and motor blockade.

Keywords: (Below umblical Surgeries – Epidural – Fentanyl – Levobupivacaine – Ropivacaine)

[1]. Fischer RL, Lubenow TR, Liceaga A, McCarthy RJ and Ivankovich A. comparison of constinuous epidural infusion of fentanyl-Bupivacaine and morphine-bupivacaine in management of postoperative pain.
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[3]. Morgan Jr. GE and Mikhail MS. 2006. Pain management. Clinical auesthesiology (page No. 598). Philadelphia, PA; Lippincott-Raven.
[4]. Rawal, N.(1999). Pain control in the preoperative period. Surgical Clinical of North America, 79, 331-334.
[5]. Palmer SK, Bosnjak ZJ, Hopp FA, Von Colditz JH, Kampine JP. Lidocaine and Bupivacaine differential blockade of isolated canine nerves. Anesth Analg. 1983 Aug; 62(8):754-7..

Abstract: Fibro -osseous lesions represent a varied group of entities in which the normal bone is replaced by cellular fibrous tissue containing mineralized foci that may vary in amount and appearance. These lesions predominantly affects the jaw and craniofacial bone. This is a retrospective study of 15 cases from June 2015 to May 2017 over a period of 24 months. Variables examined include clinical details, radiographic findings and histological examination by H & E stain.Most of the lesions were ossifying fibroma followed by fibrous dysplasia. The mean age of presentation is 30 years with slight female predominance. Osseous lesions show considerable overlapping in the clinical, radiological and histological features. So athorough knowledge of these lesions is mandatory for interpretation and appropriate diagnosis.

Keywords: :fibro - osseous lesions, ossifying fibroma, fibrous dysplasia..

[1]. Speight PM, Carlos R. Maxillofacial fibro‑osseous lesions. Current DiagPathol2006; 12:1‑10.
[2]. Barnes L, Eveson JW, Reichart P, Sidransky D. World Health Organization Classification of Tumors Pathology and Genetics of Head and Neck Tumors. Lyon, France: IARC press; 2005. p. 284‐327.
[3]. Langdon JD, Rapidis AD, Patel MF. Ossifying Fibroma‑one disease or six? An analysis of 39 fibro‑osseous lesions of the jaws. Br J Oral Surg1976; 14:1‑11.
[4]. Alsharif MJ, Sun ZJ, Chen XM, Wang SP, Zhao YF. Benign fibro‐osseous lesions of the jaws: A study of 127 Chinese patients and review of the literature. Int J SurgPathol2009; 17:122‐34. 7.
[5]. Ogunsalu CO, Lewis A, Doonquah L. Benign fibro‐osseous lesions of the jaw bones in Jamaica: Analysis of 32 cases. Oral Dis 2001; 7:155‐62.

Abstract: Aim: The aim of this study is to study the effectiveness and efficacy of 2% lignocaine gel for anaesthesia in pterygium surgery combined with amniotic membrane graft. Materials And Methods: A prospective, interventional study, comprising of30 patients (30 eyes) having nasal pterygium, was conducted at a tertiary eye care centre. Pterygium excision with amniotic membrane grafting was done under 2% lignocaine gel. Patient's intraoperative comfort, time of surgery, anycomplications and surgeon's comfort were noted. Patients were followed up for a period of 3 months for recurrence and graft displacement.Results: Thirty eyes of 30 consecutive patients including 17 males and 13 females were operated. No pain was noticed in 23 (76.6%) patients. Lid squeeze was present.........

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[2]. Fernandes M, Sangwan VS, Bansal AK, Gangopadhyay N, Sridhar MS, Garg P, et al. Outcome of pterygium surgery: Analysis over 14 years. Eye (Lond) 2005; 19:1182‑90.
[3]. Kurna SA, Altun A, Aksu B, Kurna R, Sengor T. Comparing treatment options of pterygium: Limbal sliding flaptransplantation, primary closing, and amniotic membrane grafting. Eur J Ophthalmol 2013; 23:480‑7.
[4]. Osayande OO, Mahmoud AO, Bolaji BO. Comparison of topical lidocaine [2% gel] and injectable lidocaine [2% solution] for incision and curettage of chalazion in Ilorin, Nigeria. Niger Postgrad Med J 2010; 17:270‑6.
[5]. Gupta SK, Kumar A, Agarwal S. Cataract surgery under topical anaesthesia using 2% lignocaine jelly and intracameral lignocaine: Is manual small incision cataract surgery comparable to clear corneal phacoemulsification? Indian J Ophthalmol 2010; 58:537‑40..

Abstract: Introduction: Increased retinopathy progression has been reported after cataract surgery in patients with diabetes mellitus [1]. Light has toxic potential and the eye has adapted several mechanisms to protect the retina from light-induced injury. The two most important sources of tissue absorption through which electromagnetic radiation may be propagated are the cornea and the lens [2]. After cataract surgery and IOL implantation amount of UV light entering the eye increases and leads to retinal damage and increase in pre-existing diabetic retinopathy. So in this study we studied the effect of UV light on DR in pseudophakic eyeMaterial And MethodS-30 patients with immature senile cataract and NPDR in both the eyes were selected. One eye was operated for cataract............

[1]. Klein BEK, Klein R, Moss SE. Prevalence of cataracts in apopulation-based study of persons with diabetes mellitus.Ophthalmology 1985;92:1 191-6.
[2]. Sample PA, Esterson FD, Weinreb RN, Boynton RM. The aging lens: in vivo assessment of light absorption in 84 human eyes. Invest Ophthalmol Vis Sci 1988; 29(8):1306–1311
[3]. Plato. Phaedo. In: Jowett B, translator. The Dialogues of Plato. New York,NY,Charles Scribner & Sons, 1911.
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[5]. Boettner EA, Wolter JR. Transmission of the ocular media. InvestOphthalmol [now Invest Ophthalmol Vis Sci] 1962;1:776–783..

Abstract: Endometrial cancer is a most common malignancy in developed countries. Among the various risk factors for endometrial cancers this study deals with certain genes such as Bcl-2 and Ki67 and its association with various endometrial carcinoma. Aims and Objectives- To determine the expression of Bcl-2 an antiapoptotic gene and Ki-67 a proliferative marker by immunohistochemistry. Materials and methods- 30 endometrial samples were collected from patients who presented with post menopausal bleeding and subjected to immunohistochemistry. Conclusion- Endometrial intraepithelial neoplasia showed 100% positivity for both Bcl-2 and Ki67 denoting the high mitotic activity and low apoptotic activity in this clonal neoplasm. This indicates the increased potential for these lesions to transform into frank malignancies.Bcl-2 expression decreases with increasing grade of the carcinma whereas Ki-67 index increases. This indicates increased apoptotic and mitotic activity with higher grade carcinoma and negative correlation of the Bcl-2 and Ki67 expression.

Key words; Endometrial carcinoma, EIN, Bcl-2, Ki67

[1]. Konno R, Yamakawa H, Utsunomiya H et al. Expression of survivin and Bcl-2 in the normal human endometrium. Molecular Human Reprod. 2000 Jun, 6, 529–34.
[2]. Lydia J. Taylor, Tracy L. Jackson et al . The differential expression of estrogen receptors, progesterone receptor, Bcl2 and Ki67 in endometrium polyps, BJOG Sep 2003, vol . 110 , 794-798.
[3]. Rebekka K. Jones, Roger F. Searle et al , Apoptosis, Bcl2 expression and proliferative activity in human endometrial stroma and endometrial granulated lymphocytes, Biology of reproduction ,58, (1998) 995-1002.
[4]. K Rekha, MD, A Malini, MD, R Xavier, PhD, K Baba MD, Apoptosis in Endometria of Dysfuntional Uterine Bleeding Women, Med J Malaysia Vol 60 No 1 pg 41-45
[5]. R. Hurskainen et al, Expression of sex steroid receptors and Ki67 in the endometria of menorrhagic women: effects of intrauterine levonorgestrel. Molecular Human Reproduction vol6,2000: 1013-1018..

Abstract: With increasing complexity of health problems, demand of facial aesthetic and awareness of proper treatment there is need for increased multidisciplinary treatment. Now a days interdisciplinary treatment is making uphold to the dentistry and provide much superior outcomr. Constant interaction , communication and integrated work by all the members and patient at every level of treatment are the key to the success of all the treatment. This review article merely focus on the deep shell use of interdisciplinary approach toward the growing obstacle within the proper treatment planning. Integrated work of all the departments i.e. Periodontics, Prosthodontics, Endodontics, Pedodontics, Surgery, Diagnosis, Speech and ENT have been discussed along with Orthodontics.

Key words; Interdisciplinary Treatment ;orthodontic Treatment ;Orthodontic relation.

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Abstract: Prospective randomized double-blind controlled study in which patients was randomized into three groups by using online Research Randomizer software (Research Randomizer (Version 3.0) [Computer software] by computer generated number into three groups of 30 each. We compared groups for hemodynamic parameters and incidence of myoclonus ,pain on injection ,postoperative nausea vomiting upon induction with intravenous injection of propofol (P),etomidate(E) and 50% admixture of etomidate and propofol(PE) . Incidence of myoclonus statistically significant (P<0.001) in group E as compared to Group P , significantally reduced from 76.6% in group E to 6.6% in group PE . Statistically significantally (P<0.001) reduction of incidence of pain on injection in group PE and statistically significant fall in systolic, diastolic blood pressure and mean arterial blood pressure in...........

[1]. Stoelting Robert and Simon C.Hiller. Pharmacology and Physiology in Anesthetic practice. 4th Ed. Philadelphia: Lippincott Williams and Wilkins publishers, 2006; 159-160.
[2]. Larsen R, Rathgeber J, Bagdahn A, et al. Effects of propofol on cardiovascular dynamics and coronary blood flow in geriatric patients, a comparison with etomidate.Anaesthesia1988;43(Suppl):25-31.
[3]. Van Aken H, Meinshausen E, Prien T, et al. The influence of fentanyl and tracheal intubation on the haemodynamic effects of anesthesia induction with propofol/N2O in humans. Anesthesiology 1988; 68:157-163.
[4]. J. G. Reves, Peter Glass, David A. Lubarsky. In: Ronald D Miller, editors. Miller's Anesthesia. 7th Ed. Philadelphia: Churchill Livingstone Elsevier; 2005. P.719-769.

[5]. Fatma S, Sennur U, Oguzhan A,Funda A,Ulku A. A clinical comparison of etomidate- lipuro, propofol and admixture at induction. Saudi J Anaesth.2011; 5:62-66.

Abstract: One of the most common abdominal wall surgeries performed by general surgeons is hernia repair surgery. With the advent of Mesh for hernia repair the recurrence rates of hernia has appreciably decreased. But mesh related complications have emerged. This is a prospective study done during May 2017 to May 2018 in a tertiary care hospital. The study included 1282 cases of hernia repair done with mesh and found 28 (2.18%) cases to have developed mesh related infections. In all the patients the mesh was removed and the infection resolved. There was no recurrence or persistent infection after removal of mesh.

[1]. Hesselink VJ, Luijendijk RW, de Wilt JH, Heide R, Jeekel J.An evaluation of risk factors in incisional hernia recurrence.Surg Gynecol Obstet 1993; 176: 228–234.
[2]. Luijendijk RW, Hop WC, van den Tol MP et al. A comparison of suture repair with mesh repair for incisional hernia. N Engl J Med 2000; 343: 392–398.
[3]. Schumpelick V, Conze J, Klinge U. Preperitoneal meshplasty in incisional hernia repair. A comparative retrospective study of 272 operated incisional hernias. Der Chirurg 1996; 67: 1028–1035.
[4]. Gilbert AI, Felton LL. Infection in inguinal hernia repair considering biomaterials and antibiotics. Surg Gynecol Obstet 1993;177:126-30.
[5]. Shulman AG, Amid PK, Lichtenstein IL. The safety of mesh repair for primary inguinal hernias: results of 3,019 operations from five diverse surgical sources. Am Surg

Abstract: Thyroid gland is highly vascular, ductless gland that clasps the upper part of the trachea. It extends from the fifth or sixth tracheal ring to the oblique line on the thyroid cartilage,and is enclosed in a sheath of pretracheal fascia attached to that line and to the arch of the cricoid cartilage. The gland varies greatly in size,and is relatively larger in women and children than in men.[1]Method : The present study was carried out in 25 adult cadavers. The midline structures of the neck were dissected in layers and finally thyroid gland was exposed by separating the strap muscles. The gland was examined morphologically and looked for variations. Photographs were taken and later the results were statistically analyzed. Results: Levator glandulae thyroi-deae, pyramidal lobe ,absence of isthmus were noted in the present study.

Key words: LGT (levator glandulae thyroideae), Pyramidal lobe, Isthmus, Hyoid bone.

[1]. G.J Romanes ,Cunningham's Manual of practical Anatomy.15th Edn:Vol 3,Head and Neck and Brain;p: 64- 67
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[3]. Marshall CF. Variations in the form of the thyroid gland in man. J Anat Physiol 1895;29:234–39.
[4]. Testut L, Latarjet A. Anatomia Human. Tomo IV. 9th ed. Barcelona: Salvat editors; 1978; 402-4. Spanish. Cited by Sankar KD, Bhanu SP, Susan PJ, Gajendra K. Agenesis of the isthmus of thyroid gland, with bilateral levator glandulae thyroidae. Inter J Anat Vari 2009; 2:29-30.
[5]. Sinnatamby CS. Head, neck & spine - triangles of neck. In: Sinnatamby CS, eds. Last's Anatomy, Regional and Applied. 10th ed. London: Elsevier-Churchill Livingstone; 1999: 330-331..

Abstract: Chronic hepatitis C infection is a major health issue in India. We studied the neurological manifestations in 50 HCV positive patients presenting to the department of neurology at GGH-SMC, Vijayawada. In the 50 chronic hepatitis C patients, 50% had at least one neurological manifestation. Peripheral neuropathy was the most common neurological manifestation (46%). Screening for neurological illness in HCV positive patients is needed.

[1]. Mohd Hanafiah K, Groeger J, Flaxman AD, Wiersma ST. Global epidemiology of hepatitis C virus infection: New estimates of age-specific antibody to HCV seroprevalence. Hepatology. 2013. April;57(4):1333–42. doi: 10.1002/hep.26141 [PubMed]
[2]. Luma HN, Eloumou SAFB, Malongue A, Temfack E, Noah DN, Donfack-Sontsa O, et al. Characteristics of anti-hepatitis C virus antibody-positive patients in a hospital setting in Douala, Cameroon. Int J Infect Dis. 2016. April;45:53–8. doi: 10.1016/j.ijid.2016.02.013 [PubMed]
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[4]. Mathew S, Faheem M, Ibrahim SM, Iqbal W, Rauff B, Fatima K, et al. Hepatitis C virus and neurological damage. World J Hepatol. 2016. April 28;8(12):545–56. doi: 10.4254/wjh.v8.i12.545 [PMC free article] [PubMed]
[5]. Adinolfi LE. Chronic hepatitis C virus infection and neurological and psychiatric disorders: An overview. World J Gastroenterol. 2015;21(8):2269 doi: 10.3748/wjg.v21.i8.2269 [PMC free article] [PubMed].

Abstract: Introduction: cervical epidural anaesthesia is a regional anaesthesia technique which has been used for upper limb surgery, upper thoracic wall surgery, carotid artery surgery and neck dissections. anaesthesia for thyroid surgery can be complicated due to the altered functional status of the thyroid or its large size. Objective: this comparative study was designed to evaluate of safety, effectiveness and ease of thyroidectomy under cervical epidural and general anaesthesia. Materials And Methods: A prospective study of total of 50 patients undergoing thyroid surgery from Department of Anesthesiology, MGM Medical College and Hospital, Jamshedpur. they were randomly allotted into CEA (cervical epidural) and GA (general anaesthesia ) groups of 25 members each. Results: in the.............

Keywords: cervical epidural anaesthesia, general anaesthesia, thyroid surgery

[1]. Siddharth N Shah, Shashank R Joshi. Think Thyroid Supplment to JAPI Jan.2011; 59
[2]. Khanna R, Singh DK. Cervical epidural anaesthesia for thyroid surgery. Kathmandu Univ Med J (KUMJ). J.2009; 7: 242–5.
[3]. Trivedi V. Continuous cervical epidural analgesia for Isshiki type – I thyroplasty. (retracted?) Indian J Anaesth.2010 Jan; 54(1): 52-5.
[4]. Macchiarini P, Rovira I, Ferrarello S. Awake upper airway surgery. Ann Thorac Surg.2010 Feb; 89(2): 387-90.

[5]. Jahanbakhsh S, Ravari H, Khashayar P. Resection of a large carotid artery aneurysm under cervical epidural anaesthesia. ActaCardiol. 2008 Feb; 63(1): 81-3.

Abstract: Introduction: Caudal analgesia, has gained popularity in paediatric intraoperative and postoperative pain management, more so with the use of adjuvants to prolong its duration, each of them having various results. Clonidine, an alpha2-adrenergic agonist is being used for its analgesic effects in various doses with 0.25% Bupivacaine. Aims And Objectives: To assess the safety, efficacy, onset and duration of analgesia of 0.25% Bupivacaine and 0.25% Ropivacaine when equal volumes of Clonidine is added as an adjuvant in paediatric caudal block. Materials And Methods: The present Study is a comparative randomized study where sampling method was purposive sampling. 80 children aged between 1 to 6 years weighing < 20 Kgs posted for circumcision were divided into..............

Keywords: Caudal block, Clonidine, Bupivacaine, Ropivacaine, Circumcision.

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[3]. B Locatelli, P Ingelmo, V Sonzogni, A Zanella, V Gatti, A Spotti, et al, "Randomized, double-blind, phase III, controlled trial comparing Levobupivacaine 0.25%, Ropivacaine 0.25% and Bupivacaine 0.25% by the caudal route in children" British Journal of Anaesthesia 2005; 94 (3): 366-371.
[4]. G Ivani, P De Negri, A Conio, M Amati, S Roero, S Giannone, et al, "Ropivacaine-Clonidine combination for caudal blockade in children" Acta Anaesthesiologica Scandinavica 2000; 44: 446-449.
[5]. J J Lee, A P Rubin, "Comparison of a Bupivacaine-Clonidine mixture with plain Bupivacaine for caudal analgesia in children" British Journal of Anaesthesia 1994; 72: 258-262.

Abstract: The Human Immunodeficiency virus(HIV), Hepatitis B and C viruses are blood borne viruses that cause chronic infections. Because of their shared modes of transmission, coinfections with these viruses are commonly found in patients. The problem of coinfections in HIV infected patients are further compounded by the impact of the toxicity of the Antiretroviral drugs on the liver thus increasing the liver associated morbidity and mortality in these patients. Both hepatitis B and C are also reported to affect the outcome of HIV treatment. Our study aims to find the seroprevalence of markers of Hepatitis B and C viruses in HIV infected patients who are accessing HIV care in our facility as well as the HIV treatment outcomes in those who are coinfected. A total 249 patients were included in the study. Eighteen (7.2%) and 24(9.6%) of the were seropositive for hepatitis B surface antigen and Hepatitis C antibodies respectively. Coinfection with Hepatitis B or C did not affect treatment outcomes in these patients as more than 80% of those who are coinfected had most recent HIV viral load of 1000 copies or..........

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[3]. Nyirenda M, Beadsworth MB, Stephany P, Hart CA et al. Prevalence of infection with hepatitis B and C virus and coinfection with HIV in medical inpatients in Malawi. J infect.2008 Jul;57(1):72-7 doi:10.1016/j.infect.2008.05.004.Epub2008june13.
[4]. Akyala IA, Obande G, Ishaleku D. Seroprevalence of Hepatitis B and C coinfection among cohort seropositive HIV patients accessing health care in Nasarawa state, North Central Nigeria. British Journal of Psychological Research.Dec2013; Vol1; No.1pg15-24. www.ea-journals .org
[5]. Chiekulie KD, Emmanuel CO, Oguamanam OE, Jerome EA, Nathan CN. Seroprevalence of hepatitis B virus and hepatitis C virus among HIV patients in a Suburban University Teaching Hospital in South-East Nigeria. The Pan African Medical Journal.2013;16:7 doi.10.11604/pamj.2013.16.7.3077.

Abstract: Purpose: To evaluate conventional techniques Magnetic Resonance Imaging for detection of pelvic lymph node metastasis in patients with cervical and uterine cancers. Materials and Methods: In this retrospective study, 30 patients with proved endometrial cancer were studied in MRI ward of the imaging center of Imam Khomeini Hospital in Tehran. The subjects, selected by purposeful sampling method, underwent the pelvis imaging before the surgery. T1W and T2W, T1-W sequence with contrast enhancement, and adoption of the results correlation with pathological result Results: 45 lymph nodes among 30 patients were assessed. Mean age of patients was 54.9±10.1 years, 16 lymph nodes were malignant in pathology result. Sensitivity, specificity, positive and negative predictive value and accuracy were respectively for the; morphology (94, 83, 76, 96 and 87%) T1W (88, 83, 75, 92, and 85%) T2W (82, 77..........

Key Words: endometrial cancer; conventional techniques; lymph node metastasis; magnetic resonance imaging; 3T.

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