Categories
Ailmemts & Remedies

Pain

Definition:
Pain is an unpleasant feeling often caused by intense or damaging stimuli, such as stubbing a toe, burning a finger, putting alcohol on a cut, and bumping the “funny bone”. The International Association for the Study of Pain‘s widely used definition states: “Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.”

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Everyone feels pain at some point in their lives. Unfortunately, there is no machine to objectively assess pain. Physicians have to rely on what the patient says. Sensitivity to pain varies – acute pain may make a person only grit her teeth and wince whereas the same injury can produce “severe, unbearable pain” with weeping and wailing in others.

Pain forces a person to take notice of a body part they had probably taken for granted. This is particularly true of acute pain such as a toothache, sinusitis, appendicitis or urinary tract infection.

Our bodies are plentifully supplied with “nociceptors” in the skin, bones, muscles and internal organs. Noxious stimuli, (either injury or infection) activates them. They release electrical currents and biochemical agents. These travel along the nerves, up the spinal cord and eventually reach certain areas in the brain. The reaction occurs in a flash and the perception of pain is instantaneous

Pain motivates the individual to withdraw from damaging situations, to protect a damaged body part while it heals, and to avoid similar experiences in the future. Most pain resolves promptly once the painful stimulus is removed and the body has healed, but sometimes pain persists despite removal of the stimulus and apparent healing of the body; and sometimes pain arises in the absence of any detectable stimulus, damage or disease.

Symptoms:
Pain may occur with other symptoms depending on the underlying disease, disorder or condition. For instance, if your pain is due to arthritis, you may experience pain in more than one joint. Pain due to a compressed nerve in the lower back can even lead to loss of bladder control. Pain is often a major symptom of fibromyalgia, which is also characterized by fatigue and sleep problems.

Symptoms that might occur along with pain:

The range of symptoms that may occur with pain include:

*Depression
*Flu-like symptoms (fever, chills, sore throat, fatigue, headache, cough)
*Inability to concentrate
*Loss of appetite
*Muscle spasms
*Numbness
*Sleep disturbances
*Unexpected weight loss

There are certain Serious symptoms that might indicate a life-threatening condition:
In some cases, pain may occur with other symptoms that might indicate a serious or life-threatening condition, such as a heart attack. Seek immediate medical care  if you, or someone you are with, have any of these serious symptoms, with or without pain, including:

*Bleeding symptoms, such as bloody urine or bloody stools
*Change in consciousness or alertness; confusion
*Chest pain radiating to the arm, shoulder, neck or jaw
*Difficulty breathing, wheezing, or shortness of breath
*High fever (higher than 101 degrees Fahrenheit)
*Increased or decreased urine output
*Loss of bladder or bowel control
*Progressive weakness and numbness
*Redness, warmth or swelling
*Seizures
*Stiff neck and headache, with or without nausea or vomiting
*Weakness or lethargy

Causes:
Hundreds of diseases, disorders and conditions can cause pain, such as inflammatory syndromes, malignancy, trauma, and infection. In some cases, pain may be a symptom of a serious or life-threatening condition, such as a heart attack or cancer.

The experience of pain is invariably tied to emotional, psychological, and cognitive factors.

Pain can be due to a wide variety of diseases, disorders and conditions that range from a mild injury to a debilitating disease. Pain can be categorized as acute, chronic, referred, cancer, neuropathic, and visceral.

Acute pain is experienced rapidly in response to disease or injury. Acute pain serves to alert the body that something is wrong and that action should be taken, such as pulling your arm away from a flame. Acute pain often resolves within a short time once the underlying condition is treated.

Chronic pain is defined as lasting more than three months. Chronic pain often begins as acute pain that lingers beyond the natural course of healing or after steps have been taken to address the cause of pain.

Referred pain is pain that originates in one part of the body but is felt in another part of the body.

Cancer pain is due to malignancy.

Neuropathic pain is caused by damage to the nervous system and is often perceived as tingling, burning, and pins-and-needles sensations called paresthesias.

Visceral pain is caused by a problem with the internal organs, such as the liver, gallbladder, kidney, heart or lungs.

Recent studies have found that some people with chronic pain may have low levels of endorphins in their spinal fluid. Endorphins are neurochemicals, similar to opiate drugs (like morphine), that are produced in the brain and released into the body in response to pain. Endorphins act as natural pain killers. Chronic pain most often affects older adults, but it can occur at any age. Chronic pain can persist for several months to years.

Complications:
Complications associated with pain depend on the underlying disease, disorder or condition. For example, pain resulting from a degenerative condition such as multiple sclerosis can lead to inactivity and its associated complications. Fortunately, pain can often be alleviated or minimized by physical therapy, basic self-help measures, and following the treatment plan outlined by your doctor.

However, in some cases the degree and duration of your pain may become overwhelming and affect your everyday living. Research into the diagnosis and treatment of chronic pain is ongoing, so contact your health care professional for the latest information.

Over time, pain can lead to complications including:

*Absenteeism from work or school
*Dependence on prescription pain medication
*Pain that does not respond to treatment (intractable pain)
*Permanent nerve damage (due to a pinched nerve) including paralysis
*Physiological and psychological response to chronic pain
*Poor quality of life

Diagnosis:
A person’s self-report is the most reliable measure of pain, with health care professionals tending to underestimate severity.A definition of pain widely employed in nursing, emphasizing its subjective nature and the importance of believing patient reports, was introduced by Margo McCaffery in 1968: “Pain is whatever the experiencing person says it is, existing whenever he says it does”. To assess intensity, the patient may be asked to locate their pain on a scale of 0 to 10, with 0 being no pain at all, and 10 the worst pain they have ever felt. Quality can be established by having the patient complete the McGill Pain Questionnaire indicating which words best describe their pain.

As an aid to diagnosis:
Pain is a symptom of many medical conditions. Knowing the time of onset, location, intensity, pattern of occurrence (continuous, intermittent, etc.), exacerbating and relieving factors, and quality (burning, sharp, etc.) of the pain will help the examining physician to accurately diagnose the problem. For example, chest pain described as extreme heaviness may indicate myocardial infarction, while chest pain described as tearing may indicate aortic dissection.

Physiological measurement of pain:
fMRI brain scanning has been used to measure pain, giving good correlations with self-reported pain.

Hedonic adaptation:
Hedonic adaptation means that actual long-term suffering due to physical illness is often much lower than expected.

Legal awards for pain and suffering:
One area where assessments of pain are effectively required to be made is in legal awards for pain and suffering. In the Western world these are typically discretionary awards made by juries and are regarded as difficult to predict, variable and subjective, for instance in the US, UK, Australia and New Zealand.

Treatment:
Inadequate treatment of pain is widespread throughout surgical wards, intensive care units, accident and emergency departments, in general practice, in the management of all forms of chronic pain including cancer pain, and in end of life care. This neglect is extended to all ages, from neonates to the frail elderly. African and Hispanic Americans are more likely than others to suffer needlessly in the hands of a physician; and women’s pain is more likely to be undertreated than men’s.

The International Association for the Study of Pain advocates that the relief of pain should be recognized as a human right, that chronic pain should be considered a disease in its own right, and that pain medicine should have the full status of a specialty. It is a specialty only in China and Australia at this time. Elsewhere, pain medicine is a subspecialty under disciplines such as anesthesiology, physiatry, neurology, palliative medicine and psychiatry. In 2011, Human Rights Watch alerted that tens of millions of people worldwide are still denied access to inexpensive medications for severe pain.

A number of medications can be used to treat acute pain. Many of these are available OTC (over the counter). Commonly used medication is paracetemol (10 mg /kg/dose in children 500 mg per dose in adults). It can be repeated every four hours. Paracetemol helps with fever as well, so if the aches and pains are due to seasonal flu, there is rapid improvement. It also blocks the areas of the brain that recognise pain. NSAIDs (non steroidal anti inflammatory drugs) like ibuprofen (Brufen) and nalidixic acid relieve pain but do not have much effect on fever. They act by blocking prostaglandin, one of the chemicals responsible for feeling pain. Topical anti-inflammatory medications, particularly those containing capsaicin are very effective. They should be applied lightly over the painful area followed by an ice pack.

More often chronic pain is due to the various types of arthritis (rheumatoid, osteoarthritis), autoimmune diseases, gout and mechanical problems like a disc prolapse. It needs to be diagnosed correctly so that appropriate treatment can be started. The medications taken may be steroids, opiods or the coxib group of drugs.

Acute pain is usually managed with medications such as analgesics and anesthetics. Caffeine when added to pain medications provides some additional benefit. Management of chronic pain, however, is much more difficult and may require the coordinated efforts of a pain management team, which typically includes medical practitioners, clinical psychologists, physiotherapists, occupational therapists, physician assistants, and nurse practitioners.

Sugar taken orally reduces the total crying time but not the duration of the first cry in newborns undergoing a painful procedure (a single lancing of the heel). It does not moderate the effect of pain on heart rate and a recent single study found that sugar did not significantly affect pain-related electrical activity in the brains of newborns one second after the heel lance procedure. Sweet oral liquid moderately reduces the incidence and duration of crying caused by immunization injection in children between one and twelve months of age.

The brain has to be retrained in its perception and response to pain. This can be done with a combination of physiotherapy and aerobic exercise. Judiciously used, these interventions help to reduce long-term dependence on pain medication.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://www.healthgrades.com/right-care/bones-joints-and-muscles/pain–symptoms
http://www.telegraphindia.com/1141229/jsp/knowhow/story_5590.jsp
http://en.wikipedia.org/wiki/Pain

Categories
Ailmemts & Remedies

Ulcerative colitis

Categories
Ailmemts & Remedies

Xanthoma

Other Names: Skin growths – fatty; Xanthelasma

Description:
A xanthoma, from Greek xanthos, “yellow”, is a deposition of yellowish cholesterol-rich material that can appear anywhere in the body in various disease states.It is a skin condition in which certain fats build up under the surface of the skin. They are cutaneous manifestations of lipidosis in which lipids accumulate in large foam cells within the skin. They are associated with hyperlipidemias, both primary and secondary types.

Tendon xanthomas are associated with type II hyperlipidemia, chronic biliary tract obstruction, and primary biliary cirrhosis. Palmar xanthomata and tuboeruptive xanthomata (over knees and elbows) occur in type III hyperlipidemia.

Types:
Xanthelasma:
A xanthelasma is a sharply demarcated yellowish collection of cholesterol underneath the skin, usually on or around the eyelids. Strictly, a xanthelasma is a distinct condition, only being called a xanthoma when becoming larger and nodular, assuming tumorous proportions. Still, it is often classified simply as a subtype of xanthoma.

Xanthoma tuberosum:
Xanthoma tuberosum (also known as tuberous xanthoma) is characterized by xanthomas located over the joints.

Xanthoma tendinosum:
Xanthoma tendinosum (also tendon xanthoma or tendinous xanthoma) is clinically characterized by papules and nodules found in the tendons of the hands, feet, and heel. Also associated with familial hypercholesterolemia (FH).

Eruptive xanthoma:
Eruptive xanthoma (ILDS E78.220) is clinically characterized by small, yellowish-orange to reddish-brown papules that appear all over the body. It tends to be associated with elevated triglycerides.

Xanthoma planum:
Xanthoma planum (ILDS D76.370), also known as plane xanthoma, is clinically characterized by macules and plaques spread diffusely over large areas of the body.

Palmar xanthoma:
Palmar xanthoma is clinically characterized by yellowish plaques that involve the palms and flexural surfaces of the fingers.  Plane xanthomas are characterised by yellowish to orange, flat macules or slightly elevated plaques, often with a central white area which may be localised or generalised. They often arise in the skin folds, especially the palmar creases. They occur in hyperlipoproteinaemia type III and type IIA, and in association with biliary cirrhosis. The presence of palmar xanthomata, like the presence of tendinous xanthomata, is indicative of hypercholesterolaemia.

Tuberoeruptive xanthoma:
Tuberoeruptive xanthoma (ILDS E78.210) is clinically characterized by red papules and nodules that appear inflamed and tend to coalesce.[2]:532 Tuberous xanthomata are considered similar, and within the same disease spectrum as eruptive xanthomata.

Symptoms:
A xanthoma looks like a yellow to orange bump (papule) with defined borders.

Xanthomas are common, especially among older adults and people with high blood lipids.

Xanthomas vary in size. Some are very small. Others are bigger than 3 inches in diameter. They appear anywhere on the body, but are most often seen on the elbows, joints, tendons, knees, hands, feet, or buttocks.

Causes:
Xanthomas may be a sign of a medical condition that involves an increase in blood lipids. Such conditions include:

*Certain cancers
*Diabetes
*Hyperlipidemia
*Inherited metabolic disorders such as familial hypercholesterolemia
*Primary biliary cirrhosis
*Pancreatitis
*Hypothyroidism

Xanthelasma palpebra, a common type of xanthoma that appears on the eyelids and may occur without any underlying medical condition, is not necessarily associated with elevated cholesterol or lipids.

Diagnosis:
Your health care provider will examine the skin. Usually, a diagnosis of xanthoma can be made by looking at your skin. A biopsy of the growth will show a fatty deposit.

You may have blood tests done to check lipid levels, liver function, and for diabetes.

Treatment:
If you have a disease that causes increased blood lipids, treating the condition may help reduce the development of xanthomas.

If the growth bothers you, your doctor may remove it. But xanthomas may come back after surgery.

Prognosis:
The growth is non-cancerous and painless, but may be a sign of another medical condition.

Prevention:
Control of blood lipids, including triglycerides and cholesterol levels, may help reduce development of xanthomas.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://www.nlm.nih.gov/medlineplus/ency/article/001447.htm
http://en.wikipedia.org/wiki/Xanthoma
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Categories
Ailmemts & Remedies

Takotsubo cardiomyopathy

  1. Other Names: Broken-heart syndrome, Transient apical ballooning syndrome, Apical ballooning cardiomyopathy,Stress-induced cardiomyopathy, Gebrochenes-Herz-Syndrom, and Stress cardiomyopathy.
    Definition:
    Takotsubo cardiomyopathy is a type of non-ischaemic cardiomyopathy in which there is a sudden temporary weakening of the myocardium. Because this weakening can be triggered by emotional stress, It occurs as the response of the heart to sudden, intense emotional stress such as the death of a spouse; rejection at the workplace; acute fear; or uncontrolled anger. These intense emotions can cause immediate breathlessness or strokes. The broken heart can occur simultaneously or a few minutes later. Stress cardiomyopathy is a well-recognized cause of acute heart failure, lethal ventricular arrhythmias, and ventricular rupture.

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Around ten years ago, there were a few high profile deaths in young people. They were diagnosed as having died from a “broken heart”. Now, a broken heart or stunned myocardium syndrome is a documented condition.
Symptoms:
Takotsubo cardiomyopathy or Broken heart syndrome symptoms can mimic a heart attack.The symptoms are similar to a heart attack – chest pain, sweating, giddiness or dizziness, nausea, vomiting, weakness and palpitations. Blood pressure may drop. Heart failure may develop.

Any long-lasting or persistent chest pain could be a sign of a heart attack, so it’s important to take it seriously and call your doctor if you experience chest pain.

Causes:
The exact cause of Takotsubo cardiomyopathy is not very clear. It is thought that a surge of stress hormones, such as adrenaline, might temporarily damage the hearts of some people. How these hormones might hurt the heart or whether something else is responsible isn’t completely clear. A temporary constriction of the large or small arteries of the heart may play a role.

Takotsubo cardiomyopathy is often preceded by an intense physical or emotional event. Some potential triggers are:

*News of an unexpected death of a loved one
*A frightening medical diagnosis
*Domestic abuse
*Losing a lot of money
*Natural disasters
*A surprise party
*Having to perform publicly
*Job loss
*Divorce
*Physical stressors, such as an asthma attack, a car accident or major surgery

It’s also possible that some drugs, rarely, may cause broken heart syndrome by causing a surge of stress hormones. Drugs that may contribute to broken heart syndrome include:

*Epinephrine (EpiPen, EpiPen Jr), which is used to treat severe allergic reactions or a severe asthma attack
*Duloxetine (Cymbalta), a medication given to treat nerve problems in people with diabetes, or as a treatment for depression
*Venlafaxine (Effexor XR), which is a treatment for depression
*Levothyroxine (Synthroid, Levoxyl), a drug given to people whose thyroid glands don’t work properly
Differances between Takotsubo cardiomyopathy and hear attack are:

Heart attacks are generally caused by a complete or near complete blockage of a heart artery. This blockage is due to a blood clot forming at the site of narrowing from fatty buildup (atherosclerosis) in the wall of the artery. In Takotsubo cardiomyopathy, the heart arteries are not blocked, although blood flow in the arteries of the heart may be reduced.
Diagnosis:
Takotsubo cardiomyopathy or Transient apical ballooning syndrome is found in 1.7–2.2% of patients presenting with acute coronary syndrome. While the original case studies reported on individuals in Japan, Takotsubo cardiomyopathy has been noted more recently in the United States and Western Europe. It is likely that the syndrome went previously undiagnosed before it was described in detail in the Japanese literature.

The diagnosis of Takotsubo cardiomyopathy may be difficult upon presentation. The ECG findings are often confused with those found during an acute anterior wall myocardial infarction. It classically mimics ST-segment elevation myocardial infarction, and is characterised by acute onset of transient ventricular apical wall motion abnormalities (ballooning) accompanied by chest pain, dyspnea, ST-segment elevation, T-wave inversion or QT-interval prolongation on ECG. Elevation of myocardial enzymes is moderate at worst and there is absence of significant coronary artery disease.

The diagnosis is made by the pathognomonic wall motion abnormalities, in which the base of the left ventricle is contracting normally or is hyperkinetic while the remainder of the left ventricle is akinetic or dyskinetic. This is accompanied by the lack of significant coronary artery disease that would explain the wall motion abnormalities. Although apical ballooning has been classically described as the angiographic manifestation of takotsubo, it has been shown that left ventricular dysfunction in this syndrome includes not only the classic apical ballooning, but also different angiographic morphologies such as mid-ventricular ballooning and rarely local ballooning of other segments.

The ballooning patterns were classified by Shimizu et al. as takotsubo type for apical akinesia and basal hyperkinesia, reverse takotsubo for basal akinesia and apical hyperkinesia, mid-ventricular type for mid-ventricular ballooning accompanied by basal and apical hyperkinesia and localised type for any other segmental left ventricular ballooning with clinical characteristics of takotsubo-like left ventricular dysfunction.

The ECG changes are atypical, with imprecise changes in the ST segment and T waves. They are “suspicious of but non conclusive” of myocardial infraction. Blood tests for the enzyme creatine kinase and proteins troponin should be done. These are elevated in a heart attack. In a stunned heart, these results too are inconclusive. The echocardiogram is the clincher. The heart is ballooned out. This change occurs typically at the apex of the heart. It is important to make a distinction between heart attack and takotsubo as the medication is different.

Treatment:
The treatment for takotsubo is mainly supportive. Medication is given to remove fluid from the lungs and prevent clots. Recovery occurs within a few days.

About two per cent of people who were thought to have a heart attack actually had broken hearts. In the case of women, this increases to seven per cent. Women, mainly menopausal ones (60-75 years), have “broken hearts” eight to nine times more often than men. Some people are genetically prone to “broken hearts.” Depression plays a role in susceptibility to this condition. Recurrences can occur in 10 per cent of people.

People who are in poor physical condition do not need severe emotional stress to suffer a broken heart. An episode may be precipitated by a minor event like rejection, or even a lecture or talk before an audience.

In order to never develop this condition; it is important to develop metal and physical toughness. Walking for 40-60 minutes a day at a brisk pace exposes the heart to small doses of adrenaline and nor adrenaline in a controlled manner. The heart gets conditioned and is immune to sudden chemical surges. Meditation and yoga provide calmness and the mental strength to cope with good days and bad.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://en.wikipedia.org/wiki/Takotsubo_cardiomyopathy
http://www.mayoclinic.org/diseases-conditions/broken-heart-syndrome/basics/causes/con-20034635
http://www.telegraphindia.com/1141208/jsp/knowhow/story_2612.jsp

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Herbs & Plants

Nicotiana benthamiana

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Botanical Name: Nicotiana benthamiana
Family: Solanaceae
Genus: Nicotiana
Species:N. benthamiana
Kingdom:Plantae
Order: Solanales

Synonyms: Nicotiana suaveolens var. cordifolia

Common indigenous names: Tjuntiwari and Muntju. Tangungnu, Ngkwerlp-pweter, Pinapitilypa, Tjiknga, Munju, Pirnki-warnu, Turlkamula

Habitat :Nicotiana benthamiana is native to Australia.It is found amongst rocks on hills and cliffs throughout the northern regions of Australia.

Description:
Nicotiana benthamiana is an erect, sometimes sprawling, annual herbaceous plant. This short-lived herb will reach from 0.65-5 feet (0.2-1.5 m) tall. Grown in containers, the plants rarely reach over 18 inches (0.45 m) tall by about half as wide. The dark green, broadly ovate leaves will reach up to 4 inches (10 cm) wide by 5 inches (12.7 cm) long. We selected this plant to use for TMV research because it is very susceptible to all kinds of viruses. Plants are easy to grow and we always keep several different ages of plants available at all times.

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Blooming: In the greenhouse, plants flower all year round, but in nature, they normally bloom from May-September. The small, white flowers are 3/8 inch (1 cm) across by 1.5 inches (3.8 cm) long.

A vigorous plant with numerous erect leafy stems. Its alternate leaves are broadly egg-shaped, dull green and soft. Except at the top of the stems, where they are stalkless, its leaves have slender stalks. Flowers are whitish, with a long, slender tube and five blunt lobes; fruits are capsules containing many pitted seeds.

This plant is a close relative of tobacco and species of Nicotiana indigenous to Australia.The plant was used by peoples of Australia as a stimulant – it contains nicotine and other alkaloids – before the introduction of commercial tobacco (N.tabacum and N.rustica). It was first collected on the north coast of Australia by Benjamin Bynoe on a voyage of the H.M.S. Beagle in 1837.

Cultivation:
Nicotiana benthamiana need full sun to partial shade using a well-drained soil mix. In the greenhouse, we use a soil mix consisting of 2 parts peat moss to 1 part loam to 1 part coarse sand or perlite. Since we grow these plants for research, they are given water on a daily basis to keep them stress free. They are fertilized weekly with a balanced fertilizer diluted to 1/2 the strength recommended on the label. Since we have to have these plants for research, once they set seed, plants are discarded. During the winter months, we use supplemental lighting to keep the plants growing strong.

Propagation: Nicotiana benthamiana is best propagated from seed.
Medicinal Uses:
The scientists have shown that transgenic versions of a plant Nicotiana benthamiana, also known as ‘Tjuntiwari’ in the native language, may be able to produce large quantities of a protein griffithsin which can be used as an anti-HIV microbicide gel.The protein has shown capabilities of neutralizing HIV as it binds to the virus molecule in such a way that the virus could not disguise itself from the immune system of humans.

Anti-HIV microbicide gel directly targets entry of the virus and averts infection at the surfaces but at present they are being produced using biologicals like bacteria E.coli, an expensive process which is not cost-effective.

The researchers from USA and UK altered the genetic nature of the plant using a tobacco mosaic virus which produced the protein griffithsin.(Published in The Times Of India)

Disclaimer : The information presented herein is intended for educational purposes only. Individual results may vary, and before using any supplement, it is always advisable to consult with your own health care provider.

Resources:
http://en.wikipedia.org/wiki/Nicotiana_benthamiana
http://www.plantoftheweek.org/week425.shtml
http://biolinfo.org/cmkb/view.php?comname=cmkb_public&scid=412

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