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Malik Y, Dar J, Alkaylani M, Inshasi J, Almadani A. Role of myasthenia gravis auto-antibodies as predictor of myasthenic crisis and clinical parameters. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.1302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Abdelrahman H, Almadani A, El-Menyar A, Shunni A, Consunji R, Al-Thani H. Home-related falls: An underestimated mechanism of injury. J Family Community Med 2018; 25:48-51. [PMID: 29386962 PMCID: PMC5774043 DOI: 10.4103/jfcm.jfcm_148_16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND: The home is a leading location for falls, but the epidemiology and outcome of falls at home (FH) have not been adequately described. Our aim was to evaluate FH, particularly in the bathroom. MATERIALS AND METHODS: We conducted a retrospective analysis of patients with a history of FH admitted to the Level I trauma center in Qatar. Patients were divided into Group 1: <60 years and Group 2: 60 year or older, and their data were analyzed and compared. RESULTS: A total of 98 patients with FH in the bathroom with a mean age of 51 ± 18 years, mostly males (73.5%) were identified over 3 years. One out of every 50 trauma patients admitted was a victim of a fall in the bathroom. Group 2 had significantly more females and sustained a single-site injury. Group 1 had more involvement of alcohol (P = 0.02) and sustained more multiple injuries (44% vs. 23%; P = 0.02). The mean Injury Severity Score and length of hospital stay was comparable among the two groups. Head, abdomen, and facial injuries were significantly higher in Group 1 whereas lower extremity injuries and mortality were significantly higher in Group 2. CONCLUSION: FH, particularly in the bathroom, is an underrecognized mechanism of injury with a unique dichotomous epidemiology based on age. This needs increased public awareness and primary prevention programs for high-risk populations.
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Affiliation(s)
- Husham Abdelrahman
- Department of Surgery, Section of Trauma Surgery, Hamad General Hospital, Doha, Qatar
| | - Ammar Almadani
- Department of Surgery, Section of Trauma Surgery, Hamad General Hospital, Doha, Qatar
| | - Ayman El-Menyar
- Department of Surgery, Clinical Research Unit, Section of Trauma Surgery, Hamad General Hospital and Clinical Medicine, Weill Cornell Medical School, Doha, Qatar
| | - Adam Shunni
- Department of Surgery, Section of Trauma Surgery, Hamad General Hospital, Doha, Qatar
| | - Rafael Consunji
- Department of Surgery, Injury Prevention, Section of Trauma Surgery, Hamad General Hospital, Doha, Qatar
| | - Hassan Al-Thani
- Department of Surgery, Section of Trauma Surgery, Hamad General Hospital, Doha, Qatar
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Baker L, Almadani A, Ball CG. False negative pericardial Focused Assessment with Sonography for Trauma examination following cardiac rupture from blunt thoracic trauma: a case report. J Med Case Rep 2015; 9:155. [PMID: 26152189 PMCID: PMC4502616 DOI: 10.1186/s13256-015-0640-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Accepted: 06/18/2015] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION The Focused Assessment with Sonography for Trauma examination is an invaluable tool in the initial assessment of any injured patient. Although highly sensitive and accurate for identifying hemoperitoneum, occasional false negative results do occur in select scenarios. We present a previously unreported case of survival following blunt cardiac rupture with associated negative pericardial window due to a concurrent pericardial wall laceration. CASE PRESENTATION A healthy 46-year-old white woman presented to our level 1 trauma center with hemodynamic instability following a motor vehicle collision. Although her abdominal Focused Assessment with Sonography for Trauma windows were positive for fluid, her pericardial window was negative. After immediate transfer to the operating room in the setting of persistent instability, a subsequent thoracotomy identified a blunt cardiac rupture that was draining into the ipsilateral pleural space via an adjacent tear in the pericardium. The cardiac injury was controlled with digital pressure, resuscitation completed, and then repaired using standard cardiorrhaphy techniques. Following repair of her injuries (left ventricle, left atrial appendage, and liver), her postoperative course was uneventful. CONCLUSIONS Evaluation of the pericardial space using Focused Assessment with Sonography for Trauma is an important component in the initial assessment of the severely injured patient. Even in cases of blunt mechanisms however, clinicians must be wary of occasional false negative pericardial ultrasound evaluations secondary to a concomitant pericardial laceration and subsequent decompression of hemorrhage from the cardiac rupture into the ipsilateral pleural space.
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Affiliation(s)
- Laura Baker
- McGill University, 845 Rue Sherbrooke Ouest, Montreal, Quebec, H3A 0G4, Canada.
| | - Ammar Almadani
- University of Calgary, Foothills Hospital, 1403 29 Street NW, Calgary, Alberta, T2N 2T9, Canada.
| | - Chad G Ball
- University of Calgary, Foothills Medical Center, 1403 29 Street NW, Calgary, Alberta, T2N 2T9, Canada.
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Inshasi J, Almadani A, Alrukn S, Abdool S, Alboudi A. Intracranial Germinoma: Very rare mimicker of multiple sclerosis. Mult Scler Relat Disord 2014. [DOI: 10.1016/j.msard.2014.09.168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Inshasi J, Almadani A, Alrukn S, Alboudi A. Fingolimod (Gilenya) may improve the chances of conception in women with multiple sclerosis (MS) associated with secondary infertlity. Mult Scler Relat Disord 2014. [DOI: 10.1016/j.msard.2014.09.179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Hashim H, Alrukn S, Almadani A. Extensive cerebral sinus thrombosis involving bilateral internal jugular, sajittal, sigmoid and trans/INS;ver/INS;se sinuses with clinical presentation of subarachnoid hemorrhage. J Neurol Sci 2013. [DOI: 10.1016/j.jns.2013.07.805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Al-Hassani A, Tuma M, Mahmood I, Afifi I, Almadani A, El-Menyar A, Zarour A, Mollazehi M, Latifi R, Al-Thani H. Dilemma of Blunt Bowel Injury: What are the Factors Affecting Early Diagnosis and Outcomes. Am Surg 2013. [DOI: 10.1177/000313481307900931] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Blunt bowel and mesenteric injury (BBMI) is frequently a difficult diagnosis at initial presentation. We aimed to study the predictors for early diagnosis and outcomes in patients with BBMI. Data were collected retrospectively from the database registry between January 2008 and December 2011 in the only Level I trauma unit in Qatar. Patients with BBMI were divided into Group A (surgically treated within 8 hours) and Group B (treated after 8 hours). Data were analyzed and χ2, Student's t test, and multivariate regression analysis were performed appropriately. Among 984 patients admitted with blunt abdominal trauma (BAT), 11 per cent had BBMI with mean age of 35 ± 9.5 years. Polytrauma and isolated bowel injury were identified in 53 and 42 per cent, respectively. Mean Injury Severity Score (ISS) was higher in Group A in comparison to Group B (18 ± 11 vs 13 ± 8; P = 0.02). Presence of pain and seatbelt sign ( P = 0.02) were evident in Group B. Hypotension ( P = 0.004) and hypothermia ( P = 0.01) were prominent in Group A. The rate of positive Focused Assessment Sonography for Trauma was greater in Group A ( P = 0.001). Among operative findings, bowel perforation was more frequent in Group B ( P = 0.04), whereas mesenteric full-thickness hematoma was significantly higher in Group A. Pelvic fracture was more frequent finding in Group A ( P = 0.005). The overall mortality rate was 15.6 per cent. In patients with BAT, the presence of abdominal pain, hypotension, ISS greater than 16, hypothermia, pelvic fracture, and mesenteric hematoma might help in early diagnosis of BBMI. Moreover, base deficit and mean ISS were independent predictors of mortality. Delayed operative interventions greater than 8 hours increased morbidity rate but had no significant impact on mortality.
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Affiliation(s)
- Ammar Al-Hassani
- Section of Trauma, Trauma Surgery Section, Hamad General Hospital, Doha, Qatar
| | - Mazin Tuma
- Section of Trauma, Trauma Surgery Section, Hamad General Hospital, Doha, Qatar
| | - Ismail Mahmood
- Section of Trauma, Trauma Surgery Section, Hamad General Hospital, Doha, Qatar
| | - Ibrahim Afifi
- Section of Trauma, Trauma Surgery Section, Hamad General Hospital, Doha, Qatar
| | - Ammar Almadani
- Section of Trauma, Trauma Surgery Section, Hamad General Hospital, Doha, Qatar
| | - Ayman El-Menyar
- Clinical Research, Trauma Surgery Section, Hamad General Hospital, Doha, Qatar
- Clinical Medicine, Weill Cornell Medical College, Doha, Qatar
| | - Ahmad Zarour
- Section of Trauma, Trauma Surgery Section, Hamad General Hospital, Doha, Qatar
| | - Monira Mollazehi
- Section of Trauma, Trauma Surgery Section, Hamad General Hospital, Doha, Qatar
| | - Rifat Latifi
- Section of Trauma, Trauma Surgery Section, Hamad General Hospital, Doha, Qatar
- Department of Surgery, University of Arizona, Tucson, Arizona
| | - Hassan Al-Thani
- Section of Trauma, Trauma Surgery Section, Hamad General Hospital, Doha, Qatar
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Al-Hassani A, Tuma M, Mahmood I, Afifi I, Almadani A, El-Menyar A, Zarour A, Mollazehi M, Latifi R, Al-Thani H. Dilemma of blunt bowel injury: what are the factors affecting early diagnosis and outcomes. Am Surg 2013; 79:922-927. [PMID: 24069992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Blunt bowel and mesenteric injury (BBMI) is frequently a difficult diagnosis at initial presentation. We aimed to study the predictors for early diagnosis and outcomes in patients with BBMI. Data were collected retrospectively from the database registry between January 2008 and December 2011 in the only Level I trauma unit in Qatar. Patients with BBMI were divided into Group A (surgically treated within 8 hours) and Group B (treated after 8 hours). Data were analyzed and χ2, Student's t test, and multivariate regression analysis were performed appropriately. Among 984 patients admitted with blunt abdominal trauma (BAT), 11 per cent had BBMI with mean age of 35 ± 9.5 years. Polytrauma and isolated bowel injury were identified in 53 and 42 per cent, respectively. Mean Injury Severity Score (ISS) was higher in Group A in comparison to Group B (18 ± 11 vs. 13 ± 8; P = 0.02). Presence of pain and seatbelt sign (P = 0.02) were evident in Group B. Hypotension (P = 0.004) and hypothermia (P = 0.01) were prominent in Group A. The rate of positive Focused Assessment Sonography for Trauma was greater in Group A (P = 0.001). Among operative findings, bowel perforation was more frequent in Group B (P = 0.04), whereas mesenteric full-thickness hematoma was significantly higher in Group A. Pelvic fracture was more frequent finding in Group A (P = 0.005). The overall mortality rate was 15.6 per cent. In patients with BAT, the presence of abdominal pain, hypotension, ISS greater than 16, hypothermia, pelvic fracture, and mesenteric hematoma might help in early diagnosis of BBMI. Moreover, base deficit and mean ISS were independent predictors of mortality. Delayed operative interventions greater than 8 hours increased morbidity rate but had no significant impact on mortality.
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Affiliation(s)
- Ammar Al-Hassani
- Section of Trauma, Trauma Surgery Section, Hamad General Hospital, Doha, Qatar
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Abdulrahman H, Afifi I, El-Menyar A, Al-Hassani A, Almadani A, Al-Thani H, Latifi R. Clinical outcomes of multiple rib fractures: does age matter? Eur J Trauma Emerg Surg 2013; 39:605-11. [DOI: 10.1007/s00068-013-0291-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2012] [Accepted: 04/08/2013] [Indexed: 01/07/2023]
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10
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Al-Hassani A, Afifi I, Abdelrahman H, El-Menyar A, Almadani A, Recicar J, Al-Thani H, Maull K, Latifi R. Concurrent rib and pelvic fractures as an indicator of solid abdominal organ injury. Int J Surg 2013; 11:483-6. [PMID: 23603027 DOI: 10.1016/j.ijsu.2013.04.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Revised: 03/16/2013] [Accepted: 04/08/2013] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To study the association of solid organ injuries (SOIs) in patients with concurrent rib and pelvic fractures. METHODS Retrospective analysis of prospectively collected data from November 2007 to May 2010. Patients' demographics, mechanism of injury, Injury severity scoring, pelvic fracture, and SOIs were analyzed. Patients with SOIs were compared in rib fractures with and without pelvic fracture. RESULTS The study included 829 patients (460 with rib fractures ± pelvic fracture and 369 with pelvic fracture alone) with mean age of 35 ± 12.7 years. Motor vehicle crashes (45%) and falls from height (30%) were the most common mechanism of injury. The overall incidence of SOIs in this study was 22% (185/829). Further, 15% of patient with rib fractures had associated pelvic fracture. SOI was predominant in patients with concurrent rib fracture and pelvic fracture compared to ribs or pelvic fractures alone (42% vs. 26% vs. 15%, respectively, p = 0.02). CONCLUSIONS Concurrent multiple rib fractures and pelvic fracture increases the risk of SOI compared to either group alone. Lower RFs and pelvic fracture had higher association for SOI and could be used as an early indicator of the presence of SOIs.
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Almadani A, Rahman HA, Tuma MA, Latifi R, Al Thani H. Critique of: Blunt splenic trauma: Splenectomy increases early infectious complications: A prospective multicenter study. Journal of Emergency Medicine, Trauma and Acute Care 2012. [DOI: 10.5339/jemtac.2012.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- Ammar Almadani
- Trauma Surgery Section/Department of Surgery at Hamad Medical Corporation, Doha, Qatar
| | - Husham Abdul Rahman
- Trauma Surgery Section/Department of Surgery at Hamad Medical Corporation, Doha, Qatar
| | - Mazin A. Tuma
- Trauma Surgery Section/Department of Surgery at Hamad Medical Corporation, Doha, Qatar
| | - Rifat Latifi
- Trauma Surgery Section/Department of Surgery at Hamad Medical Corporation, Doha, Qatar
| | - Hassan Al Thani
- Trauma Surgery Section/Department of Surgery at Hamad Medical Corporation, Doha, Qatar
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12
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Alani M, Zarour A, Almadani A, Al-Aieb A, Hamzawi H, Maull KI. All Terrain Vehicle (ATV) crashes in an unregulated environment: A prospective study of 56 cases. Journal of Emergency Medicine, Trauma and Acute Care 2012. [DOI: 10.5339/jemtac.2012.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- Mushrek Alani
- Section of Trauma Surgery,
Department of Surgery, The Trauma Centre at Hamad, Hamad General Hospital,
Doha, Qatar
| | - Ahmad Zarour
- Section of Trauma Surgery,
Department of Surgery, The Trauma Centre at Hamad, Hamad General Hospital,
Doha, Qatar
| | - Ammar Almadani
- Section of Trauma Surgery,
Department of Surgery, The Trauma Centre at Hamad, Hamad General Hospital,
Doha, Qatar
| | - Abubaker Al-Aieb
- Section of Trauma Surgery,
Department of Surgery, The Trauma Centre at Hamad, Hamad General Hospital,
Doha, Qatar
| | - Hazim Hamzawi
- Section of Trauma Surgery,
Department of Surgery, The Trauma Centre at Hamad, Hamad General Hospital,
Doha, Qatar
| | - Kimball I. Maull
- Section of Trauma Surgery,
Department of Surgery, The Trauma Centre at Hamad, Hamad General Hospital,
Doha, Qatar
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Al-Hassani A, Abdulrahman H, Afifi I, Almadani A, Al-Den A, Al-Kuwari A, Recicar J, Nabir S, Maull KI. Rib Fracture Patterns Predict Thoracic Chest Wall and Abdominal Solid Organ Injury. Am Surg 2010. [DOI: 10.1177/000313481007600837] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Blunt trauma patients with rib fractures were studied to determine whether the number of rib fractures or their patterns were more predictive of abdominal solid organ injury and/or other thoracic trauma. Rib fractures were characterized as upper zone (ribs 1 to 4), midzone (ribs 5 to 8), and lower zone (ribs 9 to 12). Findings of sternal and scapular fractures, pulmonary contusions, and solid organ injures (liver, spleen, kidney) were characterized by the total number and predominant zone of ribs fractured. There were 296 men and 14 women. There were 38 patients with scapular fracture and 19 patients with sternal fractures. There were 90 patients with 116 solid organ injuries: liver (n = 42), kidney (n = 27), and spleen (n = 47). Lower rib fractures, whether zone-limited or overlapping, were highly predictive of solid organ injury when compared with upper and midzones. Scapular and sternal fractures were more common with upper zone fractures and pulmonary contusions increased with the number of fractured ribs. Multiple rib fractures involving the lower ribs have a high association with solid organ injury, 51 per cent in this series. The increasing number of rib fractures enhanced the likelihood of other chest wall and pulmonary injuries but did not affect the incidence of solid organ injury.
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Affiliation(s)
| | | | - Ibrahim Afifi
- Section of Trauma Surgery, Department of Surgery, Qatar
| | | | - Ahmed Al-Den
- Section of Trauma Surgery, Department of Surgery, Qatar
| | | | - John Recicar
- Section of Trauma Surgery, Department of Surgery, Qatar
| | - Syed Nabir
- Department of Radiology, Hamad General Hospital Doha, Qatar
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Al-Hassani A, Abdulrahman H, Afifi I, Almadani A, Al-Den A, Al-Kuwari A, Recicar J, Nabir S, Maull KI. Rib fracture patterns predict thoracic chest wall and abdominal solid organ injury. Am Surg 2010; 76:888-891. [PMID: 20726423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Blunt trauma patients with rib fractures were studied to determine whether the number of rib fractures or their patterns were more predictive of abdominal solid organ injury and/or other thoracic trauma. Rib fractures were characterized as upper zone (ribs 1 to 4), midzone (ribs 5 to 8), and lower zone (ribs 9 to 12). Findings of sternal and scapular fractures, pulmonary contusions, and solid organ injures (liver, spleen, kidney) were characterized by the total number and predominant zone of ribs fractured. There were 296 men and 14 women. There were 38 patients with scapular fracture and 19 patients with sternal fractures. There were 90 patients with 116 solid organ injuries: liver (n = 42), kidney (n = 27), and spleen (n = 47). Lower rib fractures, whether zone-limited or overlapping, were highly predictive of solid organ injury when compared with upper and midzones. Scapular and sternal fractures were more common with upper zone fractures and pulmonary contusions increased with the number of fractured ribs. Multiple rib fractures involving the lower ribs have a high association with solid organ injury, 51 per cent in this series. The increasing number of rib fractures enhanced the likelihood of other chest wall and pulmonary injuries but did not affect the incidence of solid organ injury.
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Affiliation(s)
- Ammar Al-Hassani
- Section of Trauma Surgery, Department of Surgery, Hamad General Hospital Doha, Qatar.
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