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Article
Incdence of Rheumatoid Arthritis [2001 to 2011]

Author: Ali Mohammed Hussein Alkazzaz
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2013 Volume: 12 Issue: 4 Pages: 568-572
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT: BACKGROUND :The incidence of rheumatoid arthritis[RA] varies from country to another which not depend on genetic bases alone but can explained by environmental exposure and genetic and environmental interaction, area of military conflict ,there was stress induced pathway that elevates the risk for rheumatoid arthritis, in Iraq rheumatoid was 1% of population in 1975.OBJECTIVE:To evaluate incidence of RA in Babylon –Iraq from 2001-2011PATIENTS AND METHODS:This study was done to examine the incidence of RA in Babylon between 2001-2011 by Retrospective cohort study in Merjan Teaching Hospital ,Rheumatology unit .Data included sex .birth year ,residency and latex test , from 2001 to 2011.All patients were diagnosed as Rheumatoid Arthritis according to American College of Rheumatology ACR 1987revised criteria of RA .the numbers of patients of RA who were received DMRADs included methotrxate therapy were recorded each year and incidence of each year was found then the cumulative incidence was calculated.RESULTS: There were1039 patients with rheumatoid arthritis from 53786 patients in rheumatology unit. 50.1% living in urban area while 49.9% in rural area. The incidence in 2001 was 1.60 while in 2011 was 3.02 for the same population and the cumulative incidence in 2011 was22.74. Latex test was 52% in2001 while in2011 was 58% in rheumatoid patients in the same year. The P value for age mean difference between female and male was [0.009].CONCLUSION:The incidence of RA was increasing from 1.60% in 2001 to 3.02% in 2011 and the cumulative risk wasb22.74% in Babylon –Iraq.KEY WARDS: rheumatoid arthritis.


Article
Hand Deformities in Patients with Rheumatoid Arthritis

Author: R. R. Merza
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2009 Volume: 8 Issue: 1 Pages: 27-32
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Objective To estimate the types of hand deformities in patients with rheumatoid arthritis (RA). Methods: A group of 100 patients who had been admitted to the department of rheumatology and rehabilitation center in Sulaimany general hospital and those who had been attended to the rheumatology and rehabilitation center between June 2006 and January 2007 were included in this study.86% were females and 14% were males . Patients who had undergone articular surgery and patients below 16 years had been excluded. Results Hand deformities recorded in 47% of cases. The frequency of deformities was as follow; swan neck deformity (48.90%), boutonniere deformity (43.04%), Z deformity(59.5%), ulnar deviation of the metacarpophalangeal joints (MCPJ) (78.7%), radial deviation of the wrist (91.48%), subluxation of the wrist (27.6%), and subluxation of the MCPJ(36.17%).There was a significant correlation between disease duration and development of deformities,other factors that had been studied but had no effect on the development of deformities were rheumatoid factor positivity ;occupation of the patients ;effect of weather;and geographical distribution of the patients. Conclusion Rheumatoid arthritis is an important disease that affects the hands and cause deformities. Understanding these deformities is necessary for the proper management of these patients. This study is representative for RA related hand deformities and factors that contribute to their development.


Article
Hand Deformities in Patients with Rheumatoid Arthritis

Author: R.R.Merza
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2008 Volume: 7 Issue: 2 Pages: 27-32
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Objective: To estimate the types of hand deformities in patients with rheumatoid arthritis (RA).Methods: A group of 100 patients who had been admitted to the department of rheumatology and rehabilitation center in Sulaimany general hospital and those who had been attended to the rheumatology and rehabilitation center between June 2006 and January 2007 were included in this study.86% were females and 14% were males . Patients who had undergone articular surgery and patients below 16 years had been excluded.Results: Hand deformities recorded in 47% of cases. The frequency of deformities was as follow; swan neck deformity (48.90%), boutonniere deformity (43.04%), Z deformity(59.5%), ulnar deviation of the metacarpophalangeal joints (MCPJ) (78.7%), radial deviation of the wrist (91.48%), subluxation of the wrist (27.6%), and subluxation of the MCPJ(36.17%).There was a significant correlation between disease duration and development of deformities,other factors that had been studied but had no effect on the development of deformities were rheumatoid factor positivity ;occupation of the patients ;effect of weather;and geographical distribution of the patients.Conclusion: Rheumatoid arthritis is an important disease that affects the hands and cause deformities. Understanding these deformities is necessary for the proper management of these patients. This study is representative for RA related hand deformities and factors that contribute to their development.


Article
Effect of Methotrexate on Serum Levels of IL-1α and IL-8 in Rheumatoid Arthritis

Authors: Ahmed A. Al-Hassan --- Mohammed O. Hamzah --- Batool H. Al-Ghurabei
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2013 Volume: 12 Issue: 3 Pages: 404-408
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

BACKGROUND: Pathogenetic therapy of RA is a complex task,according to modern views on the development of* Dept. of Microbiology, Medical College, Al-Nahrain Univ. ** Dept. of Clinical Biochemistry, Medical College, Al-Nahrain Univ. *** Dept of Basic Science, College of Dentistry, Univ. of Baghdad. (1). autoimmune inflammation in RA, cytokineimbalance plays a great part in RA pathogenesis Rheumatoid arthritis is a chronic systemic inflammatory disease affects many tissues and organs, butprincipally attacks flexible (synovial) joints. Methotrexate is the most commonly used disease-modifyingantirheumatic drug for the treatment of rheumatoid arthritis. OBJECTIVE:The aim of this study was to evaluate the effect of methotrexate on serum levels of IL-1α and IL-8 inrheumatoid arthritis. SUBJECTS AND METHODS: Blood samples were collected from 50 patients with rheumatoid arthritis (25 patients without treatment and 25 patients are received methotraxate) and from 30 healthy age and sex matched individuals served ascontrols. Serum IL-1α and IL-8 were measured by means of enzyme-linked immune-sorbent assay.RESULTS: The present results showed that serum levels of IL-1α and IL-8 were significantly higher in RA patientsthan in healthy controls (P<0.01), furthermore, level of IL-1α was significantly decrease in patientstreated with methotraxate as compared to those patients who have received no treatment (P<0. 01). On theother hand serum level of IL-8 did not showed any significant differences between patients treated withmethotraxate and those patients without treatment (P>0. 05).CONCLUSION: These finding demonstrate that methotrexate turns out to be a good inhibitor for IL-α production. Inaddition, IL-1α and IL-8 may have a significant role in the pathogenesis of rheumatoid arthritis, and couldbe use a


Article
تقدير تركيز الكلوبيولينات المناعية في مرضى التهاب المفاصل الرثوي Rheumatoid Arthritis

Authors: علاء جواد حسن --- احمد سعد نعمة --- لبنى عبد العظيم البياتي
Journal: Journal of University of Babylon مجلة جامعة بابل ISSN: 19920652 23128135 Year: 2012 Volume: 20 Issue: 3 Pages: 967-972
Publisher: Babylon University جامعة بابل

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Abstract

The study included 30 cases, 15 patients suspected with rheumatoid arthritis (RA) from margan hospital and Hilla general hospital in Babylon governorate, and 15 apparently healthy subject with no history of RA and were selected as control group. The immunoglobulins concentration of sera were estimated by using single radial immunodiffusion assay . The study showed significant elevation in concentrations of immunoglobulins IgG and IgA in patients in comparison with control group , while there was non- significant elevation in concentration of immunoglobulin IgM in comparison with control group.

شملت الدراسة 30 حالة ، 15 مريضاً يشكو أعراض التهاب المفاصل الرثوي في مستشفى مرجان التخصصي ومستشفى الحلة التعليمي في محافظة بابل و 15 من الاشخاص الاصحاء بدون علامات سريرية سابقة لوجود التهاب المفاصل الرثوي كمجموعة سيطرة . تم تقدير تركيز الكلوبيولينات المناعية المصلية للمرضى والاصحاء باستخدام طريقة الانتشار المناعي الشعاعي المنفرد، و أظهرت الدراسة وجود ارتفاعاً معنوياً في تراكيز الكلوبيولينات المناعية IgG و IgA عند المرضى مقارنة مع مجموعة السيطرة ، في حين لوحظ وجود ارتفاع غير معنوي في تركيز الكلوبيولين المناعي IgM مقارنة مع مجموعة السيطرة .


Article
Evaluation of Some Genetic Factors in Rheumatoid Arthritis patients in Iraq
تقييم بعض العوامل الوراثية في مرضى التهاب المفاصل الرثوي في العراق

Author: Israa K. Al –Yasiri Jaafar K. Al-Mousawi Ali M.Al- Mohana
Journal: Iraqi Journal of Biotechnology المجلة العراقية للتقانات الحياتية ISSN: 18154794 Year: 2014 Volume: 13 Issue: 2-2 Pages: 66-74
Publisher: Baghdad University جامعة بغداد

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Abstract

Rheumatoid arthritis (RA) is a chronic, destructive autoimmune disease affecting the joints. With more sophisticated and effective therapies becoming available and with the understanding that early intervention is crucial in preventing irreversible joint damage. The main purpose of this observational study was to evaluate and detects a good genetic factors may be used in early detection of RA. A total of 40 patients with RA who were fulfilled four or more of the 1987 American College of Rheumatology (ACR), 20 patients with joints problems (JP), 20 RA patient relatives (PR) and 10 apparently healthy control individuals were included in this study. Human leukocyte antigen (HLA) genotyping was performed using Mr. Spot SSO system. The distribution of HLA class II genotypes in 20 RA patients and 30 control groups were studied. HLA-DRB1*04 was significantly most common genotypes in the RA patients (70%) compared to control groups (23.3%). While, the frequency of HLA-DRB1*11 was very high among controls (53.3%) compared to RA patients (25.0%), but the difference was not statistically significant. RA susceptibility in most Iraqi patients was associated with the HLA-DRB1*04 genotype. The HLA-DRB1*04 allele contributed significantly to the development of RA .HLA- Therefore, HLA-DRB1*04 allele appears to play an important pathogenic role in all subsets of RA.

التهاب المفاصل الرثوي هو من أمراض المناعة الذاتية المزمنة والمدمرة التي تؤثر على المفاصل بالعلاجِ المتطوّرِ والأكثرِ فعّالية الذي أصبح متوفرا وبالفَهْم بأنّ التدخّلِ المبكّرِ حاسمُ في مَنْع الضررِ المشتركِ الغير قابل للعكس فان من المهم والمهم جدا تشخيص التهاب المفاصل الرثوي في مرحلة مبكرة جدا ولتسهيل التشخيص في المراحل المبكرة من المرض، في كثير من الأحيان عندما لم يكن كل الأعراض السريرية واضحة للعيان، إن الغرض الرئيسي لهذه الدراسةِ هذه هو الكشف عن اختبار للعوامل الوراثية يمكن استخدامه في الكشف المبكر عن التهاب المفاصل الرثوي . شملت هذه الدراسة أربعين مريض يعانون من التهاب المفاصل الرثوي لديهم أربعة أو أكثر من العلامات المحددة من قبل الجمعية الأمريكية للروماتزم, 20 مريض يعانون من مشاكل في المفاصل، 20 شخص من أقارب المرضى الذين يعانون من التهاب المفاصل الرثوي و 10 أشخاص أصحاء كمجموعة سيطرة. كما تم استخدم تقنية مستر سبوت نظام SSO (التسلسل المتخصص أحادي النيوكليوتيدات) من أجل الكشف الوراثي عن مستضد كريات الدم البيض البشرية (HLA). تم دراسة التوزيع الوراثي لمستضد كريات الدم البيض البشرية (HLA) الصنف الثاني لعشرين من مرضى التهاب المفاصل الرثوي وثلاثين من مجاميع السيطرة، أثبتت هذه الدراسة أن HLA-DRB1 * 04 كان معنويا وأكثر شيوعا (70٪) بين المرضى بالمقارنة مع مجموعات السيطرة (23.3٪). في حين HLA-DRB1 * 11 كان موجودا في عدد صغير نسبيا من مرضى التهاب المفاصل الرثوي (25٪) بالمقارنة مع مجموعات السيطرة (53.3٪). ومع ذلك، لا توجد هنالك فروق معنوية. وجد ان الحساسية للإصابة بمرض التهاب المفاصل الرثوي في المرضى العراقيين مرتبط بوجود العامل الوراثي HLA-DRB1 04 * و أن أليل 04 * HLA-DRB1 ساهم بشكل كبير في تطوير التهاب المفاصل الرثوي، ولذلك، يبدو أن HLA-DRB1 * 04 أليل تلعب دورا هاما في التهاب المفاصل الرثوي.

Keywords

Rheumatoid arthritis --- HLA.


Article
Assessment of Cyclosporine Oral Solution in Patients with Severe Rheumatoid Arthritis
تقييم محلول سايكلوسبورين الفموي في معالجة المرضى المعتلين بالْتِهابُ المَفاصِلِ الرُّوماتويديّ

Author: Riyadh A. Sakeni رياض الساكني
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2007 Volume: 20 Issue: 4 Pages: 490-496
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

AbstractBackground: patients with severe rheumatoid arthritis treated with cyclosporine A, frequently showed variability in important improvement.Objectivs: This study aimed to assess the effectiveness of oral cyclosporine solution in management of severe rheumatoid arthritis.Methods: In this prospective study, the efficacy and safety of 5 mg per kilogram body weight per day, oral solution of microemulsion pharmaceutical formulation of cyclosporine (Neoral) was assessed in thirty three patients with severe refractory rheumatoid arthritis in Consultant clinic at Al-Yarmook teaching hospital during 2004. None of patient population showed any previous important improvement to methotrexate, sulfasalazine and/or hydroxychloroquine as monotherapy or in different combinations.Results: 21 out of 33 (63.6%) patients with severe rheumatoid arthritis showed marked improvement i.e. fulfill at least 50% improvement in American College of Rheumatology (ACR) criteria. The remaining number of twelve patients (36.4%) were discontinued the treatment because of adverse reactions and/or ineffective therapy. Patients who continued the therapy and showed improvement were; females rather than males, older, with longer duration of disease, the more period of morning stiffness, the higher leucocytes count, the lower hemoglobin level, and the higher frequency of positive latex test and higher serum C-reactive protein level.Conclusion: Microemulsion oral pharmaceutical formulation of, stable 5 mg per kilogram body weight per day cyclosporine A, is effective and safe remedy for severe rheumatoid arthritis.

الملخص:خلفية : يظهر المرضى المعتلين بالْتِهابُ المَفاصِلِ الرُّوماتويديّ ، عند معالجتهم بالسايكلوسبورين، تواتر متغاير في تحسنهم.أهداف: تهدف الدرلسة الى تقييم محلول سايكلوسبورين الفموي في معالحة المرضى المعتلين بالْتِهابُ المَفاصِلِ الرُّوماتويديّ طرق العمل: في دراسة ا سْتِباقِية عشوائية ، تم تقييم نجاعة ومأمونة جرعة 5 ميلي غرام لكل كيلوغرام من وزن الجسم في اليوم من محلول فموي للتركيبة الصيدلانية لدواء سايكلوسبورين والمعرف بنيورال، على 33 مريضا معتلا بالْتِهابُ المَفاصِلِ الرُّوماتويديّ ارتادوا العيادة الاستشارية في مستشفى اليرموك التعليمي في بغداد –العراق خلال عام 2004. ولم يكن من المرضى ممن استعملوا ادوية ميثوتريكسيت او سلفاسالازين او هيدروكسي كلوروكوين قد اظهروا اي تحسن ملموس.نتائج: 63،6% من حالات الْتِهابُ المَفاصِلِ الرُّوماتويديّ اظهروا تحسنا ملموسا وفقا لمعايير كلية طِبُّ الرُّوماتزم الامريكية ، اما بقية الحالات وعددها 14 حالة والبالغة نسبتها 36،4% فقد توقفوا عن تناول الدواء اما بسبب حصول تَفاعُلاتٌ ضائِرَة او لعدم نجاعة العلاج. واتسمت الحالات المرضية التي اظهرت تحسنا ملموسا واستمروا بتناول العلاج في كونهم : اناث اكثر من ذكور ، اكبر سنا، مدة مرض اطول، اكثر مدة تيبس صباحي، اكثر عدد في كريات الدم البيض واقل نسبة لخضاب الدم، اكثر تردادلاختبارلاتكس الايجابي واكثر مستوى مصلي في البروتينُ المُتَفاعِلُC .الاستنتاج: مستحضرسايكلوسبورين بالتركيبة الصيدلانية الفموية على هيئة مستحلب مكروي وبحرعة ثابتة 5 ميلي غرام لكل كيلو غرام من وزن الجسم في اليوم ، دواء ناجع ومأمون الاستعمال في الْتِهابُ المَفاصِلِ الرُّوماتويديّ .


Article
PREVALENCE OF PERIODONTAL DISEASE AMONG RHEUMATOID ARTHRITIS PATIENTS
مدى انتشار امراض اللثة في المرضى المصابين بالتهاب المفاصل

Authors: MOHAMMED TAHIR RASOOL محمد طاهر رسول --- SUZAN M. SALIH سوزان سليم --- HASHIM D. MOUSA هاشم موسى
Journal: Duhok Medical Journal مجلة دهوك الطبية ISSN: ISSN: 20717334 (online)/ ISSN: 20717326 (Print) Year: 2016 Volume: 10 Issue: 2 Pages: 69-76
Publisher: University of Dohuk جامعة دهوك

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Abstract

Background: Patients with rheumatoid arthritis (RA) may have higher prevalence ofperiodontitis.Aim: To determine the prevalence of periodontal disease among rheumatoid arthritis patients.Patients and methods: Cross-sectional study was done on 250 patients, who were selected byfrom patients attending Duhok Center for Rheumatic Disease and Medical Rehabilitation.Periodontal health status of the patients based on probing pocket depth score, clinicalattachment loss, and disease activity score was determined. Validated questionnaire was usedto record smoking, body mass index, tooth brushing, duration of rheumatoid arthritis disease.Results: The age range of patients was 35-60 years. All rheumatoid arthritis patients havesome degree of periodontal diseases, 133(53.2%) with mild and 117(46.8%) with moderateperiodontitis.A significant prevalence of periodontal diseases occurred in patients with age group (40-54)years was 144 (57.6%) compared to younger age 46 (18.4%) and older age 60 (24%)respectively, p-value <0.001 The duration of diseases was more significant in intermediate (1year to 3 years) 125 (50%) compared to early (< 12 months) 45 (18%) and longer disease (>3 years) 80 (32%) p-value<0.001.Conclusion: All patients were suffering from some degree of periodontal diseases with nosignificant difference in severity between males and females.

الخلفية والأهداف: احتمالية ان يكون التهاب اللثة اكثر انتشارا في المرضى المصابين بالتهاب المفاصل.تهدف الدراسة الى ايجاد مدى انتشار امراض اللثة في المرضى المصابين بالتهاب المفاصل.طريقة البحث: تمت الدراسة على 250 من المرضى الدين تتراوح اعمارهم بين 30-60 الدين يراجعون مركز التاهيل الصحي لامراض المفاصل. مدى صحة الفم واللثة يعتمد على قياس عمق الجيوب اللثوية و مدى فعالية المرض.النتائج: انتشار امراض اللثة في المرضى المصابين بالتهاب المفاصل كانت 133(53.2%) التهاب لثة خفيف و 117 (46.8%) التهاب لثة متوسط . يوجد اختلاف معنوي في امراض اللثة في المرضى الذين تتراوح اعمارهم بين (40-54) سنة كانت 144 (57.6%) مقارنة بالاقل اعماراً 46 (18.4%) والاكبر أعماراً 60(24%). الاستنتاجات: توصلت الدراسة الى انه لا يوجد اختلاف معنوي في شدة امراض اللثة بين الجنسين ولو ان نسبة الاناث اكثر من نسبة الذ كور.


Article
Electrocardiograph and Echocardiograph Electrocardiograph and Echocardiograph Electrocardiograph

Author: Basil N.Saeed*
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2012 Volume: 11 Issue: 2 Pages: 199-204
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:BACKGROUND:Rheumatoid arthritis (RA) is a systemic autoimmune disease with characteristic feature of persistant inflammatory synovitis in symmetrical distribution; it has a higher incidence of fatal and non-fatal cardiovascular events which account for half of all death in RA patients.OBJECTIVE:To study the cardiac involvement in long standing rheumatoid arthritis patients in comparison to healthy persons by electrocardiograph and echocardiograph.PATIENTS AND METHODS:A sample of 100 Iraqi patients with long standing rheumatoid arthritis and 100 healthy individuals who served as control group matched for sex and age were selected after exclusion of risk factors (hypertension, diabetes mellitus, smoking and previous cardiac problems), both groups were studied by electrocardiograph and echocardiograph under supervision of a cardiologist.RESULTS:There were a significant number of patients with rheumatoid arthritis having abnormal electrocardiographic findings 21(21%) in comparison to healthy persons 7(7%) (P-value 0.004), also there were significant number of rheumatoid arthritis patients with abnormal echocardiographic findings 36(36%) in comparison to healthy individuals 11(11%) (P-value o.ooo).while there were no significant association between disease duration and type of medications with cardiac abnormalities reported in this study.CONCLUSION:There is an increase of asymptomatic cardiac structural abnormalities in chronic rheumatoid arthritis patients in comparison to normal healthy individuals as detected by electrocardiograph and echocardiograph.


Article
Prognostic significance of specific proteins and immunoglobulins in sero positive Rheumatoid Arthritis patients

Author: Zina Anwer Salloum Marrow
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2006 Volume: 6 Issue: 2 Pages: 22-26
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Background: Increased levels of specific proteins and Immunoglobulines have been detected in serum from patient with rheumatoid arthritis (RA).Objective: To clarify the clinical significance of specific serum proteins and Immunoglobulin in RA. Methods: Forty- two patients with sero-positive rheumatoid factor (group 1 and 2 according to disease activity progresses) and twenty age- matched healthy subjects were included in the study. Serum total proteins, Protein electrophoresis and Immunoglobulin level were evaluated. Results: Acute phase reactants in RA patients showed a significant increase in comparison to healthy subjects (P < 0.001). There was a significant difference in the levels of α- globulins, γ-Nglobulins, IgG and IgM in group 1 as compared to group 2.Conclusion: The prognostic value of serum specific proteins and Immunoglobulin in patients with RA is high, and can provide some help in predicting the outcome of joint inflammation.

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