Sonam USG4

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DR. NAMRATA DIAGNOSTICS
.\'i'lam

~
~·eGs ~ID tRJ,'.·cJ ~~"05 SI
Ex HaJ ,11,'Y ,t S G PG I M S (L~v )
Forrner•y A~sl Prof PG ',IE R Rl,IL "-ew 0f ,h t
• Ult1Js11nug1Jphy • Color O1111pl111• G111dl·il l11l111v~1111011
• So11osJlp1ngog1Jphy • So1111111,ii111110\1r,1phy

UL_TRA~O.!-' ..rD Sl'UDV _OF onstnTRICS


(Tl/JS IS NOT AN A,\O.\ fAL Y ,,'( ':\.\')

• LMP IS 20/0~ / 202J EC .\ ll\ l.\1 1' 1s J ,, \\l'rl-.-. + () d ,I\S

• ~mgk liH· intrnutnuir h)(·tu ~ 1s ~<'<' ll 111 lnni:1t11d111,il lie , l11rn h p11·,c·11t.1tmn 111 tlH' t 11111 • of
cxnmination .

• roctal hr.irt ratr ic; 137 / 111111 .

• Foet.1I g,· ... 1.111on ngl" 1-.

• BPD 84mm ...


~ eek.a ♦
6day■
11 C :11. :, . I \ ' ,. , t ~ 1,\ 1) .,
• AC 297 mm + 5doye
fl I ,·; l .. u .\ 1 ( U •\ 5

• Placrn ta is in an tr nor u trnn~ ' "gmrnt nn<l ,ho\\, J.:rade II Ill mat u, it v chn111:r.,

• Amniotk Ouid rC'dU L d. An " G,8 ( 711,

• EFW is npproximntcl~• 2 J7J i 346 C m ■ .

• r-:no is npproximntt'ly 30/ C'5 /2'J2 ...


• No loop of rnrd 1s M'<'n ttdJ,1rrnt 10 f,·t,tl rn·< k 111 tllr 11111<' of c·x111111natio11 .

'JI-'.' •o (J f'U (Suoday Ev,nmg Clo\tdl


..
~.,,..,..._. .....
MBBS MO (RadlOdragnosrs)
Ell Rad1olog1sl S G PG IMS (Lko)
Formerly Assl Prof PGIMER. RML. New Delhi
• Sonosalpingogr111111,

COLOUR & PULSED DOPPLER STUDY

• The flow in maternal uterine artery is normal. No evidence of diastolic notching

• The umb]ical artery flow is normal.

• The flow in the umblical vein is normal . There is no pulsatility .

• The foetal MCA flow is within normal limits.

COLOUR & PULSED DOPPLER STUDY

MCA UA RTUT LTUT


PS 54.98cm/sec 30.09cm/sec l 14.22cm/sec 92 .64cm/sec
ED 10.93cm/sec 13.27cm/scc 7 l .95cm/sec 54.77cm/sec
SD 5.03 2.27 1.59 1.69
Rl 0.80 0.56 0.37 0.41
Pl l.76 0.76 0.48 0.55
CPR 112,4
Average pulsatility index:
0.45
Percentile:
2
Result:
I Nom-el

9 PINION:

♦ Sin&)e Uve foetus of 34 weeks + 3 day■ (± 2 weeka) ln breech presentation, anterior


placenta grade II-Ill maturity and oligohydramnlous
♦ Colour and pulsed Doppler study reveals No evidence of Uteroplacenta l insufficiency &
cerebral vascular redistribution.

I Dr r·: • :' "7A r .C • ... declare that while coaductia& ultruouad atudy of ; GUPTA 1 have neither
detected nor diaclosed the aex of her foetus to anybody in any manner. All conge anomalies cannot be
excluded on USG.

_, !.-. ,ult i::rn·:..,tion is r: "r.:.ssnr:J.


ir
~ GUPlA. .
l4 84 II JJ CaA • n.GIII
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@ NAMRATA DIAG NDsn cs
N,....,.. SOHAM GUPTA
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Fl (Hodlodd Iii 67 .81 mm 67.83

lO Calculatlons

75% (70 - 86%1 FUBPO 11"- 171 - .,,.,


Cl IBPO/0FDI
FI/HC IHodlockJ 022(0 20-02 21 Fl/AC 11"- l20 - .,.,.,,

HC/AC ICamp belll l OS 10 91 - l 111


~ •;~1.•J~\u-2 -4 -04-21 -33 SONAMGUPTA
Exam Dale . 21 .04 2024 1 55 28 P.

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DR. NAMRATA~DIAGNOSTICS
. Vi9an1
MBBS. ~ID tRad1od1agnos1s)
b Rad1olog1st S GP G I MS (Lko ) • Ultrasonography • Color Doppler • Guided lnterve~1 on
Formerly Asst Prof PGIMER. RML New Delhi
• Sonosalpingography • Sonomarnmography

PATIENT NAME- MRS . SONAM


REF BY_ __ ____ DR. AMITA GUPTA .DGO
DATE- OF INV Saturda ,
30 Mar , 2024

ULTRASOUND STUDY OF OBSTETRICS


(THIS IS NOT AN ANOMALY SCAN)

• LMP is 20/08/2023 EGA by LMP is 3lweeks + 6 days .

• Single live intrauterine foetus is seen · 1 · d


examination. m, ong1tu inal lie, breech presentation at the time of

• Foetal heart rate is 147 /min .

• Foetal gestation age is

BPD 77mm 3lweeks + ldays


• HC 289mm 3lweek:. + 6days
• AC 247mm 29weeks + Odays
rL 63n:..n 32weeks + 6days

• Placenta is in anterior uterine segment and shows grade II maturity changes .

• Amniotic fluid reduced . AFI- 6 cm

• EFW is approximately 1628 + /- 238 Gma.

• EDD is approximately 30/ 05 / 2024.

• No loop of cord is seen adjacent to fetal neck at the time of examination.

OPINION :-

◊ Single live intrauterine foetus of 31 weeks + 2 days ( ± 1 week ) ( Asymmetrical IUGR) in


breech presentation , anterior placenta grade II maturity ollgohydramnios

Note: ·· I llr Ni\1\1 JUT,'\ N\I :11M declare that while conducting ultrasound fitudy or \4,-.; S< '\:. ' have rn'll lwr delP<i .rn l nor
du,dmicd lhe sex of her fo<ltus to anybody in any manner. All congenital anomalies cannot be exclu1I on USG

Clinical correlation is necessary.

(DR. RATA NIGAM, MD)

Clinic : Timings :
A S Sector J, (Near BSNl l elephone Exchange). AliganJ, Lucknow. 9 AM to 6 PM (Sunday Evening Closed)
~tob11e 90-Wl5334. 9415584270, 9140380487 (after 6 pm emergency cases/on prior appointment onlyI
Kindly Jilott • Plea~e Intimate us for any typing mistakes and send the report lor correction w1th1n 7 days
, !ti, sc,enre of Rad1olog1cal d1~gnom 11based on the 111terpret at1onof vaPou1shadow1 produced b~both tne normal and abnormal111sue! and are no! alwa,s concll,s,,t
f urlher b,u,hemtLill 1nves1,gat1on & cl1nrcal correlation 1s req~ired to enable the cltn1c1an lo reach the final d,agnos11 T• p •t f 1 ,
' 'I It/ .• , r1t - - - -

@ NAMRATA DIAGNOSTICS
fthn•· IOHAM
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" 11 It mm II II
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r I /H( fHodlod1J 077(019 011) fl//lf ,.,. ,,o ,... ,
Hf/A{ ICumpi,olll l 1/1096 1111
'

.DR. NAMRATA DIAGNOSTICS


;,), . . \',1111'1,ll,1 •\'i~Jam ~
~1813S MD (R,1d1od1.1gnos15)
h R,1t11oloq1st S G PG IM S (Lko )
• Ultrasonography • Color Doppler • Guided Intervention
·- - - - - - apb~ Sonomaflli1logc.allh
!_>~. AMIT_A GUPTA .i:>rio --- - - _ __ _ _ j _ __ _ _ _ __ i
S•!~rd.9 -!..20 Ja~- L 2024 - - - - -- 7
------ -----
• LMP 20 / 08 /2023 EGA by LMP is 2 lweeks
6 days .
ts +

• Single live intrauterine foetus is seen .


examination . m , lon gitu dinal lie, breech presentation at the time of

• BPD 49mm
HC 20 weeks + 6 daya
183 mm 2'.r- ec !ts +
.
• AC
FL
155 mm
37 mm
20 weeks
21 v l"t ks
+
5 d~ y:.
5 day5
• HL + 6 d.lyr.
34mm 2hreeka
BN + 6 day•
3 1m m 2 0w(•tks

. RADIUS
TL
28mm
34 mm
20 week.a
22weelu

+
+
2 days
5 day•
6 d· ys
• Mean gestational age is 21 weeks+ 2 days (+/ - 1 weeks) .

• Foetal weight is approx. 402 Gms .

• EDD by CGA is approx . 30 / 05 / 2024 (on basis of present Sonographic age) .

• Place nta is in anterior uterine segment. It shows grade 1 maturity . No evidence of retro placental
collection .

• Amniotic fluid is adequate . DVP- 4.8cm .

• Cervical length meas 3.8 c m .

• Single loop of cord around to fetal neck at the time of examination .

• FOETAL MORPHOLOGICAL CHARACTERS


❖ Foetal head shows normal cerebral ventricles. Falx is in midline. No evidence of hydrocephalus / cavum is
noted . Posterior fossa shows normal bilateral cerebellar hemisphere . Cisterna magna is normal in size.
LVW measures 4.9 mm . TCD measures 20 .8 mm . Cistern magna 6.6 mm. lOD measures 10 .8 mm . BN
measures 31 mm conesponding to 20 weeks 2 day s. Nasal bone meas 7 .3 mm , Nuchal thickness meas
4.5mm

❖ Foetal face shows normal bilateral orbit with normal nose, lips , palate , mandibular echo is seen
normally.

❖ Foetal neck does not show any obvious mass lesion

❖ Foetal spine appears normal in configuration . Cross sectional imaging shows normal trilaminar pattern .
No evidence of mass / spina bifida is seen . Foetal chest shows normal heart lung ratio . Foetal heart
shows normal position and ratio . 4 chamber foetal heart is noted .
❖ Foetal abdomen shows normal position of foetal stomach. Liver and spleen are normal in position . Gall
bladder is anechoic in lumen. Visualized bowel loops are normal . No evidence of abnormal dilatation /
mass is seen in bowel.
Clinic: Timings:
A 5, S1>ctor J, (Near BSNL TPlephone Exchange), Aliganj, Lucknow. 9 AM to 6 PM (Sunday Evening Closed)
Mobile · 9044715334, 9415584270, 9140380487 (after 6 pm emergency cases/on prior appointment only)
K1nfly Not, : • Please Intimate us for any typing mistakes and send lhe 1eport lor correction w1thm 7 days.
• The seteoce uf Rad1olog1cal d1agnos1s 1s based on the 1nterpretat1on ot va11ous shadows produced by both theno1mal and abnormal tissues •nd are not always conclus,ve
furl her b1ochenwc1lmves11gi11ton&cltmcal correlatt0n1srequ11edloenable1heclm1c1an1oreachthefmald1agnos1s. The Report "d I Im a not v 1 h, I' o I al Pwp e
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- R. NAMRATA DIAGN +{, w, t. · /.JI
s
:Jk .1mt1't'llla .,4i9m11 ~ ta f "' fl"'
MBBS, MD (Rad1od1agnos,s) t.on
• Ultrasonogra phy • Color Doppler • Guided lnterven
I MS (Lko )
b R.1d1olou1~t. S G PGMER mmography
, RML , New Delhi • Sono5a lpingography • Sonoma
Formerly Assl Prof PGI

10 c:lill ur:in~~y bladder is moderately distended .


: · . Leff ren;;ll pel vic i's normal ·
·•• f-o, t:11 lrlt lrnlncy is 110 nnn I rn . · ., ·
.... r or Ia I n. ,I1t kid . is· nor • SJZC. l
ma l rn size . Right renal pel vis is norma .
❖ N . g nr_y
s is see n . ommaJ wall
. dence of diluted ure ter . No evidence of foetal abd
... o f'V1 <· vessels and sho ws nor ma l in sertion
PoetaJ umblu.:aJ cord is lhre
de feel is seen . eru s and radius and ulna
are nonnaJ in
❖ :~::'. "l
limbs me normal. Bilriteral
fem ur, tibia and fibula, hum

• Fo eta l hen rt rat e is 14


3/m in .
.
❖ F? rtal hod _y and lim b movements are welJ seen .
wg
rin e art e h al fl
ow pat ter n. No evi den ce of dia sto lic no tch
❖ Bil ate ral ute 5
ow norm
ute rin e Pl =0.8 .
ry
❖ RI h =0 .6. , Left
g t ute rin e Pl :
❖ Average pulsat1lity index
❖ 0.7
❖ Percentile :
❖ •
❖ Result·
❖ / Noma!
OPINION :- tat ion , pla cen ta
h me an ees tat ion aie of 21 we eks + 2 day s. bre ech pre sen
◊ Sin gle Uve foe tus wit
ity and ade qu ate liquor. mm in ant eri or
an ter ior , gra de I ma tur me as 10J 12 mm in pos ter ior
& 15
hy po ech oic les ion
-.. '- Well def ine d a
m y om etr ium .... ... ... my om
. Moreover a
NOTE : by ultr aso und is app rox 60%
ctu ral congenital ano ma lies
of det ection of stru by rou tint ' lfor ma tion
Tht> overall sen siti vity rare detection of con gen ital ma

s not exc lud e a sign ific ant ano ma ly (Ref an<enataJ
nor ma l stu dy doe
ultr aso nog rap hy . Ro sen dah
l H. el al). orm alit y- Pet er W Cal len
wiJl hav t' no reco gnizable son ogr aph ic abn ser um
ses with down syn dro me ity . Additional res ts like
• At lea st 40 to 50 % frtu ic vill us sam plin g has I 00% sen siti vity and specific by qua dru ple tes t)
chr ion of cas es (70 %
199 4 . Arn nin oce nte sis and in det ecti ng more num ber
at 15- 20 we eks ) will hel p gen ital car dia c abn orm alit
ies.
ma rke rs (Qu adr upl e test det aile d feta l hea rt ana tom y to rule out con
adv ised for ow up stu dy.
• Frt al erh oca rdi ogr aph y is picked up only on serial foJl
ron diti ons pre sen t late in intr aut erin e life and are hav e no rec ogn izab le son ogr aph ic abn orm alit
y.
• Som e . Fun c<ional / Infect.ion) may
abn orm alit ies (viz the firs t tim e.
• Few of the con gen ital may pre sen t pos tna tal for def ect s ma_v
st in intr aut erin e life and wn lim itat ion and sub tle
• All ano ma lies do not ma nife son ogr aph ic exa min atio n due to its kno
) pre sen ce of all
det ect ed by a any or 2
• Not all ano ma lies can be dy can not com plet ely confirm J) abs enc e of for scr ren ing of
not be see n in all sca ns.
The pre sen t stu iod . USG ma rke rs
tus whi ch ma y be det ecte d in the pos t nat al per ' out pre sen ce of feta l
congeni<al ano ma lies in
the foe
evi den t. The ir abs l'nc e ma y not totally rult
ma y not alw ays be
chr om oso ma l ano ma ly occ ult spi n a
l ano ma ly. isol ated hem ive rteb rae /
chr om oso ma
in det ecti on of min or kh_yphoscoliotic def orm ity/ sca n , whi ch are sur gira lly
• Sen siti vity of Ult ras oun d
is low
& clef t pal ate are not looked up in a rou tine
ies like polyda cty ly
bifida . S~b tle abn orm alit
cor rec tab le afle r birt h
ecte d by USG
in the fetu s can not be det to rul r out the ir pre srn ce.
• Fun ctio nal abn orm alit ies & req uire serial follow up sca ns h elp s in
sen t late in intr aut erin e life gno sis of dise ase . It only
• Som e con diti ons pre
. Sol itar y inv esti gat ion ne ver confirm the final dia
itat ion
• Inv esti gat ion hav e the ir lim sym pto ms.
rnr rela tion 10 the clin ical
dia gno sin g the dis eas e in
ond opi nio n
• Pal ien r is free to see k sec
tal echo
Adv:- Qu ad rup le tes t & Fe G aft er 2 eek s
he r ce ntr e for sec on d op inion if req uir ed , ReviewMnUS \A\1 I ha det ecte d nor disc lose d
Refer to hig con duc ting ultr aso und stud
t whi le
y of . SO'
I\, IGAM dec lare tha
~.Ilk ;.:: I Dr r- .\ ,nu TA . All con gen ital ano mal ies
can not be exc lud ed on US
any bod y In any man ner (DR . N.~• TA r: :G.'-t. t !, !l.J I
the sex of her foe tus to . I
rre l:st ion is ruc c~~ ary
.-- i;:i i,·r i/ cC'
Timings :
ed)
(I IC . 9 AM to 6 PM (Sunday Evening Clos
Exchange), AliganJ. Lucknow. s/on prior appointment only j
AS St Ch)1 J. (NPar BSNL Telephone
1 (after 6 pm emergency case
l.1,1h• 1f' 91.4471533~. Q4 J5584270,
9140380487
l for correc11on w11h1n 7days. normal and abnormal 11ssues ,nd are
nol a/wars conclume
anr 1rpingm1slahs and send lhe repor var>ous shadows p1oduced br both Ifie
l,n11t, 1101t · PieHe lntlfTlale us /or 11s based on lhe inlerp re1a1,on of , r r u
• Ttw ml!flce ol R,!1111log1cal d,agnos1 cl:mc1an lo reach the final d,agnoSI!
O

corre/a11on 11 iequ1•ed to enable lhe


& clJmcal
! u, Jhe, b10L1..,rural ,nvest19•t1on
DR. NAMRATA DIAGNOSTICS
b R,1,1,,,1,\l , t S G Fl; I M~ <I kp \
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'. PATIENT NAME MRS. SONAM l Mm f


! REF BY DR. AMITA OUl'TI\ , 1)0()l
~
DATE OF
----
INV _ , Saturday, 18 Nov, '..l02 J

11 1,TPA SO llf, l f. nrnv O F Ol"J 11' I Ill ' 'l


• L ll.11 · IS :.0 , Vi'i / 2\.J lJ I· ~,:\ 11, l.f\ i t' l'i 11. \\ ('f'h 'i I ,, d .1~•1

• S111gl<' g<'~t .111011 sar \\ l l h ~ 11 1g l1• livr lo rl11 , l'i MTll 11 1 111 1 , ,,.,. r11v Jl y
• C' RL lll<'a su rrs h J .O 111111 <rn n·spo11d111g lo l 'O(l of 12 '-" 1'1 k'i, ·, d., ~·•
• Foetal IH'art rail' is I Ei I / 111 i11u1<· .
• Pl:Jrrntn format ion is seen fu 11d nl n·g,011 , No prr ii:r, 1:ir ir111.rf < 11lln I H111 ,., ·,11 11
• NT mea,. 1. 1 mm (Noruutl)
• Nosal bone visuBUa,·d .
• Ductu.- vcno us shows rcv4.•rsal of 11 wave
• Cervical OS is rloscd .
• EDD is a pprox.in1Atcly. 27/ 05 / 2024 .
• (3-4) Well defined hypoechoic lesion mens 7-27 mm In po'lte rlor I'& 11 mm in ante ri()r
myometrium ...... .. . Myomas
RTUT LT UT

PS %cm/ sec 4qcm/sc·c

ED 20.4cm/ scc 10.2cm/ s<'c

SD 4.7 4.8

RI 0.7 0.7

Pl 1.7 1.8

Average pulsatility index:


• 1.75
Percentile:
63
Result:
j Norrral
OPINION:--

❖ Early live intrauterine pregnancy of 12weeks + 5 days ( ±1 days ).


No re · I Dr .\ 'AMRATA NIGAM declare that while conducting ultrasound study of Mr~ 50 • 1111 I hn 11e neither detrcted nor
disclosed the sex of her foetus to anybody in any manner. All conge11itnl anomalies cannot
:,.1,A ,;_ .J)._-fJl/:/4 ~(K.PV .
excluded on USG
(0 r•"r..... T., :- I Gl .. M . M.'JJ

Clinic : Timings :
A 5, Sector-J. (Near BSN LTelephone Exchange), AliganJ, Lucknow. 9 AM to 6 PM (Sund Evening Closed)
Mobrle · 9044715334, 9415584270, 9140380487 (after 6 pm emerge cy cases/on prior appointment only)
Kindly Note :• Please lnt,male us lo, any lypmgm,stakes and send the reporl lo, correcl10n within 7days.
• The science of Rad1olog1cdld1agnos1s ,s based on lhe mterpre1a11on of various shadows produced by both the normal and abnormal tissues and are no1always conclus1i1!
furlher b10chem1cal111ves1,ga1,on & chmcaf c01relat1on 11 requ11ed 1oenablR ihe clmic,an lo ,each lhe lmald1agnos1s. The Report and f ,"n.\ 11 • 1, J t , 1,4 • , lJ;al Purpou
MIIB S. MD (Ho11J1ud1,eur 1111111,)
I. l R,Hl111l1'1.11\I. 5 G Pl, IM (1 (I k11)
f urnwrly A~·, I 1'1111 f'IilMI I( flMI N1,w
I1,,11 11 111
-p~fTIENT NAME MR 8. SONAM AGY..
REF BY DR . AM ITA GUPTA , DGO
r DA TE OF INV Sunday , 12 Nov , 202 3

6'ff ,'ff JC~


ULTITA~i.OURD STU DY <JF OH

• by LMJ> i'i J '2 w1·1·h + () d:iy 'i .


L MP is 20/ 08/ '20 '23 EC! \

foct u't j -, ,,,.t n in ut<:rmc {,IJV Jfy •


• Sin gle gcs luti on tt11 c wilh tt in1i:l c Jive

ng to POU of 12 wee k, + 2 dri y s.


• CRL mcn surcs 5.6 2 mm cor respondi

• Foe tal hea rt rate is l 55/mi.nu1 e .


~en .
rly. No pc rige<;t.ational c,oU<:ction ic;
• Pla cen ta form atio n is see n anterio

• Cer vica l OS is clos ed .

• Cervical len gth me as 4 .5 mm .

4.
• ED D is app rox ima tely . 24/ 05 / 202
11 mm in ant erio r
on me as 7-1 2 mm in pos ter ior &
• (3-4) Well def ine d hyp oec hoi c lesi
my om etr ium ..... . ... Myom as

OPINION:--
of 12w eeb + 2 day s ( :tl day s).
❖ Early live intr aut erin e pre gna ncy

Note :-- I Dr NA A/RA. TA NIG AM decl are that whil e conducting ultrasound stud y of Airs
.~unmn
ot be ex ~
uve neither dete cted nor
on ysc
jr
of her foet us to any bod y in any man ner. All congenital anomalies cann
disclosed the sex ,
.
Cli nic a l correla tion is nec ess ary (DR . r· ... -.TA nG A.M , MD l

Timings :
Clinic : 9 AM to 6 PM (Sunday Evening Closed)
Aliganj, Lucknow
A-5, Sector-J, (Near BSNL Telephone Exchange), (after 6 pm emergency cases/on prior appo
intme nt only)
Mobile : 9044715334, 9415584270, 9140380487
es and send the repor t lor correchon w1lh111 7days. always conclus1v1
liMly Mot, :· Please lnumate us lor any typing f!llstak by bolh the normal and abnormal 1,ssue1 and are not
• The sc,enceol Rad1olog1cal d11gnos 11 1s b11ed on the interpretation ol various shadoWl produced 1 The 1,, •t 4 r 1, , r , 11 " ,
Imai agnos1
d1
hon 11 required 10 enable lhe clinician lo reach lhe
Further b,ochemtcal 1nvest1gat1on & chmcal correla
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-) ·~ SONAM, • NAMIIATA DIAGNOSTICS fb O.t 12.11.lOlJ


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