Displaying publications 1 - 20 of 114 in total

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  1. Maimaiti N, Ahmed Z, Md Isa Z, Ghazi HF, Aljunid S
    Value Health Reg Issues, 2013 09 13;2(2):259-263.
    PMID: 29702874 DOI: 10.1016/j.vhri.2013.07.003
    OBJECTIVE: To measure the clinical burden of invasive pneumococcal disease (IPD) in selected developing countries.

    METHODS: This is an extensive literature review of published articles on IPD in selected developing countries from East Asia, South Asia, Middle East, sub-Saharan Africa, and Latin America. We reviewed all the articles retrieved from the knowledge bases that were published between the years 2000 and 2010.

    RESULTS: After applying the inclusion, exclusion, and quality criteria, the comprehensive review of the literature yielded 10 articles with data for pneumococcal meningitis, septicemia/bacteremia, and pneumonia. These selected articles were from 10 developing countries from five different regions. Out of the 10 selected articles, 8 have a detailed discussion on IPD, one of them has s detailed discussion on bacteremia and meningitis, and another one has discussed pneumococcal bacteremia. Out of these 10 articles, only 5 articles discussed the case-fatality ratio (CFR). In our article review, the incidence of IPD ranged from less than 5/100,000 to 416/100,000 population and the CFR ranged from 12.2% to 80% in the developing countries.

    CONCLUSIONS: The review demonstrated that the clinical burden of IPD was high in the developing countries. The incidence of IPD and CFR varies from region to region and from country to country. The IPD burden was highest in sub-Saharan African countries followed by South Asian countries. The CFR was low in high-income countries than in low-income countries.

    Matched MeSH terms: Meningitis, Pneumococcal
  2. Aljunid S, Maimaiti N, Ahmed Z, Muhammad Nur A, Md Isa Z, Azmi S, et al.
    Value Health Reg Issues, 2014 May;3:146-155.
    PMID: 29702920 DOI: 10.1016/j.vhri.2014.04.008
    OBJECTIVE: To assess the cost-effectiveness of introducing pneumococcal polysaccharide and nontypeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV) in the National Immunization Programme of Malaysia. This study compared introducing PHiD-CV (10 valent vaccine) with current no vaccination, as well as against the alternative 13-valent pneumococcal conjugate vaccine (PCV13).

    METHODS: A lifetime Markov cohort model was adapted using national estimates of disease burden, outcomes of pneumococcal disease, and treatment costs of disease manifestations including pneumonia, acute otitis media, septicemia, and meningitis for a hypothetical birth cohort of 550,000 infants. Clinical information was obtained by review of medical records from four public hospitals in Malaysia from the year 2008 to 2009. Inpatient cost from the four study hospitals was obtained from a diagnostic-related group-based costing system. Outpatient cost was estimated using clinical pathways developed by an expert panel. The perspective assessed was that of the Ministry of Health, Malaysia.

    RESULTS: The estimated disease incidence was 1.2, 3.7, 70, and 6.9 per 100,000 population for meningitis, bacteremia, pneumonia, and acute otitis media, respectively. The Markov model predicted medical costs of Malaysian ringgit (RM) 4.86 billion (US $1.51 billion) in the absence of vaccination. Vaccination with PHiD-CV would be highly cost-effective against no vaccination at RM30,290 (US $7,407) per quality-adjusted life-year gained. On comparing PHiD-CV with PCV13, it was found that PHiD-CV dominates PCV13, with 179 quality-adjusted life-years gained while saving RM35 million (US $10.87 million).

    CONCLUSIONS: It is cost-effective to incorporate pneumococcal vaccination in the National Immunization Programme of Malaysia. Our model suggests that PHiD-CV would be more cost saving than PCV13 from the perspective of the Ministry of Health of Malaysia.

    Study site: UKM Medical Centre, Hospital Kuala Lumpur, Hospital
    Alor Setar, and Hospital Queen Elizabeth, Kota Kinabalu
    Matched MeSH terms: Meningitis
  3. Richardson A, Morris DE, Clarke SC
    Vaccine, 2014 Jul 16;32(33):4119-23.
    PMID: 24907487 DOI: 10.1016/j.vaccine.2014.05.062
    Streptococcus pneumoniae, Haemophilus influenzae type b and Neisseria meningitidis are leading causes of vaccine-preventable diseases such as meningitis, sepsis and pneumonia. Although there has been much progress in the introduction of vaccines against these pathogens, access to vaccines remains elusive in some countries. This review highlights the current S. pneumoniae, H. influenzae type b, and N. meningitidis immunization schedules in the 10 countries belonging to the Association of Southeast Asian Nations (ASEAN). Epidemiologic studies may be useful for informing vaccine policy in these countries, particularly when determining the cost-effectiveness of introducing new vaccines.
    Matched MeSH terms: Meningitis, Haemophilus/prevention & control; Meningitis, Meningococcal/prevention & control; Meningitis, Pneumococcal/prevention & control
  4. Eamsobhana P, Prasartvit A, Gan XX, Yong HS
    Trop Biomed, 2015 Mar;32(1):121-5.
    PMID: 25801261
    Angiostrongylus cantonensis is the most frequent cause of eosinophilic meningitis in humans in Thailand and worldwide. Because of difficulty of recovering the Angiostrongylus larvae from infected patients, detection of parasite-specific antibodies is used to support clinical diagnosis. This study tested serum samples from eosinophilic meningitis patients and individuals at risk of infection with A. cantonensis to evaluate a recently developed simple and rapid dot-immunogold filtration assay (DIGFA) for detection of specific antibodies against A. cantonensis. Purified 31-kDa glycoprotein of A. cantonensis and protein A colloidal gold conjugate were employed to detect the 31-kDa anti-A. cantonensis antibody in patients sera from the parasite endemic areas of northeast Thailand. The results were compared with those obtained by dot-blot enzyme-linked immunosorbent assay (ELISA) with 31-kDa A. cantonensis antigen. The overall positivity rate of DIGFA and dot-blot ELISA for A. cantonensis infection in 98 clinically diagnosed cases from three highly endemic districts in Khon Kaen province were 39.79% and 37.75%, respectively. Among 86 sera of subjects at risk of infection with A. cantonensis, 24.41% were positive by DIGFA and 23.25% by dot-blot ELISA. There were good correlation between the visual grading of DIGFA and dot-blot ELISA in both groups of defined sera. DIGFA is as sensitive and specific as dot-blot ELISA for confirming eosinophilic meningitis due to A. cantonensis infection, with advantages of simplicity, rapidity and without the use of specific and expensive equipment, and can be used in field settings.
    Matched MeSH terms: Meningitis/diagnosis*
  5. Yew MMT, Lip JQ, Ling APK
    Trop Biomed, 2021 Sep 01;38(3):435-445.
    PMID: 34608117 DOI: 10.47665/tb.38.3.086
    Ever since the first reported case series on SARS-CoV-2-induced neurological manifestation in Wuhan, China in April 2020, various studies reporting similar as well as diverse symptoms of COVID-19 infection relating to the nervous system were published. Since then, scientists started to uncover the mechanism as well as pathophysiological impacts it has on the current understanding of the disease. SARS-CoV-2 binds to the ACE2 receptor which is present in certain parts of the body which are responsible for regulating blood pressure and inflammation in a healthy system. Presence of the receptor in the nasal and oral cavity, brain, and blood allows entry of the virus into the body and cause neurological complications. The peripheral and central nervous system could also be invaded directly in the neurogenic or hematogenous pathways, or indirectly through overstimulation of the immune system by cytokines which may lead to autoimmune diseases. Other neurological implications such as hypoxia, anosmia, dysgeusia, meningitis, encephalitis, and seizures are important symptoms presented clinically in COVID-19 patients with or without the common symptoms of the disease. Further, patients with higher severity of the SARS-CoV-2 infection are also at risk of retaining some neurological complications in the long-run. Treatment of such severe hyperinflammatory conditions will also be discussed, as well as the risks they may pose to the progression of the disease. For this review, articles pertaining information on the neurological manifestation of SARS-CoV-2 infection were gathered from PubMed and Google Scholar using the search keywords "SARS-CoV-2", "COVID-19", and "neurological dysfunction". The findings of the search were filtered, and relevant information were included.
    Matched MeSH terms: Meningitis, Viral/virology
  6. Pathmanathan R, Soo-Hoo Tuck Soon
    Trans R Soc Trop Med Hyg, 1982;76(1):21-4.
    PMID: 7080152
    Between January 1974 and June 1980, 85 cases of cryptococcosis were diagnosed in the University Hospital, Kuala Lumpur, Malaysia. The diagnosis was based on positive culture of the organism in 81 cases; the remaining four were diagnosed on histopathological findings. Cerebral cryptococcosis was the most common presentation and Chinese are particularly susceptible (72% of cases). The incidence of the disease is shown to be far greater than previously suspected. Association with compromised host status is uncommon (14%). The local literature is briefly reviewed and the findings discussed.
    Matched MeSH terms: Meningitis/etiology; Meningitis/epidemiology
  7. Chuah CH, Ong YC, Kong BH, Woo YY, Wong PS, Leong KN, et al.
    J R Coll Physicians Edinb, 2020 Jun;50(2):138-140.
    PMID: 32568283 DOI: 10.4997/JRCPE.2020.211
    Talaromycosis typically occurs as an opportunistic infection among immunocompromised individuals. Infection caused by species other than T. marneffei is uncommon. While most reported cases describe infection in the lungs, we report an extremely rare intracranial Talaromyces species infection. This 61-year-old with end-stage renal disease who was unwell for the previous two months, presented with fever and worsening confusion lasting for three days. Lumbar puncture was suggestive of meningitis. Cerebrospinal fluid (CSF) culture was later confirmed to be Penicillium chrysogenum. The patient was co-infected with Group B Streptococcus sepsis. He improved with amphotericin B and ceftriaxone and was discharged with oral itraconazole for four weeks. However, he died of unknown causes two weeks later at home. Talaromyces species infection in the central nervous system is uncommon. This case highlighted a rare but life-threatening fungal meningitis. Among the four reported cases worldwide, none of the patients survived.
    Matched MeSH terms: Meningitis; Meningitis, Fungal
  8. Ghani NA, Jaafar R, Ishak S, Zainuddin AA, Mukari SA, Mahdy ZA
    J Obstet Gynaecol Res, 2007 Apr;33(2):195-8.
    PMID: 17441895
    We report the case of a 25-year-old Malay woman, admitted for preterm delivery at 35 weeks' gestation. Vaginal swab did not isolate any organism. She delivered a baby girl who developed respiratory distress syndrome, requiring ventilation. Although chest radiograph showed hyaline membrane disease with pneumonia, septic workout was negative. The mother was discharged on the next day. Seven days postpartum, the mother presented with fever and fits and was diagnosed to have meningo-encephalitis. Lumbar puncture isolated group B Streptococcus (GBS) and MRI revealed a superior cerebellar abscess. She was treated and survived the episode. This case illustrates the uncommon situation where GBS infection was confirmed via maternal septic workout rather than neonatal, although both presented with severe disease.
    Matched MeSH terms: Meningitis, Bacterial/complications; Meningitis, Bacterial/epidemiology*
  9. Nissapatorn V
    PMID: 19058599
    Southeast Asia is a region where the number of people infected with HIV/AIDS is one of the fastest growing in the world. Tuberculosis (TB) has grown along with the HIV epidemic. TB is not only the most common AIDS-defining illness but is also the leading cause of morbidity and mortality in AIDS patients. Cryptococcosis (meningitis or disseminated) is one of the most common opportunistic infections in AIDS patients. Cryptococcal meningitis is the first in the differential diagnosis considered with meningeal irritation. Penicillosis, a unique systemic mycosis, is an important emerging public health problem and has been classified as an AIDS defining illness in endemic areas like Thailand. Pneumocystis carinii (jiroveci) pneumonia has been one of the most important opportunistic infections in AIDS patients. Among parasitic infections, cryptosporidiosis is the most common intestinal protozoan infection relating to diarrhea in AIDS patients and toxoplasmosis is the only parasitic infection of the nervous system with a substantial incidence, up to 14.8%. Cytomegalovirus (CMV) retinitis has a lower prevalence compared to other opportunistic infections. In the era of highly active antiretroviral therapy (HAART), the incidence of opportunistic infections has significantly reduced in the past few years. Subsequently, the phenomena of immune restoration inflammatory syndrome (IRIS) in AIDS patients has been reported in this region as a result of HAART.
    Matched MeSH terms: Meningitis, Cryptococcal/microbiology; Meningitis, Cryptococcal/epidemiology; Meningitis, Cryptococcal/virology
  10. Ramli SR, Leong MC, Khaithir TM, Aziz MN, Loons LC, Rafia MH
    PMID: 23431829
    We report a case of Cryptococcus humicolus meningitis complicated by communicating hydrocephalus in an apparently immunocompetent 49-year-old psychiatric patient from a nursing home. He presented with a history of poor oral intake, weight loss, headache, vomiting, blurred vision, frequent falls and unsteady gait for the previous three months. He had a history of chronic cough, productive of whitish sputum for the previous month but no hemoptysis. Cerebrospinal fluid culture was positive for Cryptococcus humicolus. He was treated with intravenous amphotericin B and oral fluconazole and had clinical and microbiological improvement after three weeks of treatment. Unfortunately, the patient acquired nosocomial methicillin-resistant Staphylococcus aureus infection and died due to overwhelming sepsis.
    Matched MeSH terms: Meningitis, Fungal/complications*; Meningitis, Fungal/drug therapy; Meningitis, Fungal/microbiology*
  11. Othman N, Abdullah NA, Wahab ZA
    PMID: 15916093
    An immunocompetent 5 year-old girl presented with pyrexia of unknown origin associated with headache. Initial investigations showed leukocytosis and an increased erythrocyte sedimentation rate. A Widal-Weil Felix test, blood film for malarial parasites, mycoplasma IgM antibody, cultures from blood and urine, full blood picture, Mantoux test, and chest x-ray were all negative. A lumbar puncture was done as part of a work-up for pyrexia of unknown origin. Cryptococcus neoformans was seen on India ink examination and confirmed on culture. She was treated with 10 weeks of intravenous amphotericin B and 8 weeks of fluconazole. Further immunological tests did not reveal any defect in the cell-mediated immune system. C. neoformans meningitis may present with non-specific symptoms and should be considered in a work-up for pyrexia of unknown origin.
    Matched MeSH terms: Meningitis, Cryptococcal/diagnosis; Meningitis, Cryptococcal/drug therapy; Meningitis, Cryptococcal/physiopathology*
  12. Salasawati H, Ramelah M, Pitt TL, Holmes B
    PMID: 10772579
    The purpose of this investigation was to evaluate the usefulness of a co-agglutination procedure for the typing of Flavobacterium meningosepticum. The sensitivity and specificity of the co-agglutination test was compared to the slide agglutination test using reference strains of the bacterial species. Antisera were characterized by both technics to determine their titer and working dilution. The specificity of the sera was assessed by performing tests which include strains of other species and serotypes. A collection of 47 strains of F. meningosepticum isolated from clinical specimens were typed by both co-agglutination and slide agglutination methods. Co-agglutination proved to be markedly more specific than the slide procedure although both methods were similar in sensitivity. It was concluded that co-agglutination proved to be an excellent method for the serotyping of F. meningosepticum.
    Matched MeSH terms: Meningitis/microbiology
  13. Hussain IH, Sofiah A, Ong LC, Choo KE, Musa MN, Teh KH, et al.
    Pediatr Infect Dis J, 1998 Sep;17(9 Suppl):S189-90.
    PMID: 9781759
    To determine the pattern of postneonatal childhood meningitis in Malaysia.
    Matched MeSH terms: Meningitis, Haemophilus/epidemiology*
  14. Vui HC, Lim WC, Law HL, Norwani B, Charles VU
    Med J Malaysia, 2013 Oct;68(5):389-92.
    PMID: 24632867
    INTRODUCTION: Percutaneous endoscopic gastrostomy (PEG) placement in patients with ventriculo-peritoneal shunt (VPS) may be associated with complications. This study reports our experience of PEG in patients with VPS.

    MATERIALS AND METHODS: Consecutive patients undergoing PEG insertion in a gastroenterology unit over 18 month's period were retrospectively analyzed. All patients were evaluated by an attending gastroenterologist for fitness for procedure. Instructions were given for routine antibiotic prophylaxes before the procedure and continued for 48 hours. Patients were followed for immediate complications in particular, wound infection, signs of meningitis, deterioration in neurological state and shunt malfunction. Post discharge, patients were given routine follow-up for review.

    RESULTS: Of 86 patients who had PEG inserted during the study period, 14 had VPS including 2 of which had VPS after PEG. The main common indications for VPS were intracerebral bleed and head trauma and for PEG were requirement of long term enteral feeding. Twelve patients had PEG at a mean interval of 61 days (range 1-187 days) after VPS. Of these, eight received prophylactic antibiotic or were on antibiotic for other indications before PEG. Two patients developed mild PEG site infections within a week of insertions, including one patient who was not given antibiotic prophylaxis, both treated successfully with antibiotics. The latter patient developed worsening hydrocephalus secondary to VPS blockage. At a mean follow-up period was 140 days (range 20-570 days), there were no death or further complications encountered.

    CONCLUSIONS: Although safe in the majority of patients with VPS, PEG infection can lead to intracranial complications. We recommend antibiotic prophylaxis for VPS patients before PEG.
    Matched MeSH terms: Meningitis
  15. Shekhar K, Lye MS, Norlijah O, Ong F, Looi LM, Khuzaiah R, et al.
    Med J Malaysia, 2005 Aug;60(3):297-304.
    PMID: 16379183
    From July through December 1997, 11 previously healthy children in Peninsular Malaysia succumbed to an illness clinically characterised by an acute severe refractory left-ventricular failure, following a brief prodromal illness, in the midst of an outbreak of hand, foot and mouth disease (HFMD), similar to the reported experience in Sarawak and Taiwan. Retrospective reviews of the clinical features and results of laboratory, pathological and virological investigations of cases were conducted. The median age of the 11 case-patients was 31 months (range, 13 to 49 months); 6 were males. A brief prodromal illness of 3 days (range, 2 to 5 days) was characterised by fever (axillary temperature > 38 degrees C) (100%), oral ulcers (72%), extremity rashes (45%) and significant vomiting (55%). Upon hospitalisation, 7 of 11 case-patients had features suggestive of cardiogenic shock, while 4 of 11 case-patients developed shock during hospitalisation as evidenced by marked sustained tachycardia (heart rate > or = 180 beats per minute), poor peripheral pulses and peripheral perfusion, mottled extremities, pulmonary oedema (haemorrhagic pulmonary secretions in 8 of 11 cases during tracheal intubation, often precipitated by conservative crystalloid boluses, and radiographic evidence of acute pulmonary oedema in 5 of 7 cases) and markedly impaired left ventricular function on echocardiographic examination (7 of 7 cases). Three of 4 case-patients had aseptic meningitis while one case-patient also had an acute flaccid paraparesis. Despite supportive therapy, death occurred within a median of 13.4 hours following hospitalization. Post-mortem findings (all 8 specimens examined) consistently demonstrated brain-stem encephalitis with foci of neuronal necrosis and micro-abscesses. None of the 11 specimens examined revealed histological evidence of myocarditis. Enterovirus 71 (EV71) was detected in 10 of 11 case-patients, many (7) from various sterile tissue sites (5 from central nervous tissues). No other viruses were isolated or identified. Clinical features and pathological studies closely paralleled the reported experience in Sarawak and Taiwan. The uniform necropsy findings of necrotizing brain-stem encephalitis coupled with essentially normal myocardial histology, in concert with the concurrent and consistent detection of EV71 points to a primary EV71 encephalitis; as yet unclear neurogenic mechanisms may account for the cardiovascular manifestations.
    Matched MeSH terms: Meningitis, Aseptic/mortality; Meningitis, Aseptic/pathology
  16. Yeat SW, Mukari SZ, Said H, Motilal R
    Med J Malaysia, 1997 Sep;52(3):285-90.
    PMID: 10968099
    Post meningitic sensori-neural hearing loss was studied in forty new cases of bacterial meningitis and ten cases of viral meningitis treated at the Pediatric Institute, Kuala Lumpur Hospital from April 1991 to March 1992. Hearing assessment at 2 weeks, 3 months and 6 months following the diagnosis of meningitis using Brain Stem Evoked Response Audiometry showed that hearing loss was prevalent only in patients with bacterial meningitis. Hearing loss was detected in 32.5% of these patients during the acute phase of the disease, 22.8% after 3 months and 24.2% after 6 months. In 63.6% of the affected cases, hearing loss was bilateral. In 61.5% of the patients who had hearing loss during the acute phase of the disease, it was permanent, 16.7% had either partial or complete recovery and, 15.4% had deterioration in hearing level. In 2 cases the subsequent hearing level was unknown. The risk of developing sensori neural hearing loss was found to be significantly higher in patients who developed other neurological sequelae. The study highlights the importance of performing repeated hearing assessment in children with bacterial meningitis and the difficulty in appropriate selection of hearing aids in the early stages.
    Matched MeSH terms: Meningitis, Bacterial/complications*
  17. Said H, Cheah F, Mohamed AS, Hadi AR
    Med J Malaysia, 1993 Jun;48(2):222-4.
    PMID: 8350800
    The transseptal transsphenoidal hypophysectomy has become a relatively frequent procedure in recent years. We performed 20 such procedures between January 1984 and December 1987 for various pituitary disorders. Significant complications such as CSF rhinorrhea, meningitis, diabetes insipidus, haemorrhage and septal perforation are discussed. The mortality rate for the series was 5%. In analysing the data, we feel that this technique of hypophysectomy is a safe procedure.
    Matched MeSH terms: Meningitis/etiology
  18. Tee AC, Puthucheary SP, Fatimah H
    Med J Malaysia, 1995 Sep;50(3):226-32.
    PMID: 8926899
    A study was undertaken to determine the relationship of presenting features and outcome in primary childhood meningitis at the Paediatric Department, University Hospital, Kuala Lumpur from January 1980 to December 1989. A total of 177 cases of primary childhood meningitis admitted during the study period were analysed retrospectively. One hundred and nine cases (61.6%) had complete recovery, 49 cases (27.7%) recovered with residual complications and 19 cases (10.7%) died. The mean duration of illness of those with complete recovery, residual complications and acute mortality was 4.8 days, 9.6 days and 7.6 days respectively (p < 0.05). Neurological signs were more common in those with mortality and morbidity i.e. 89% and 78% respectively as compared to those who had complete recovery (58%). There was significant correlation between outcome and haemoglobin level on admission (complete recovery 11 gm%, residual complications 10.4 gm%, mortality 9.6 gm% with p < 0.05), mean CSF sugar content (complete recovery 2.2 mmol/l, residual complications 1.5 mmol/l, mortality l.1 mmol/l, p < 0.00001), and mean CSF protein level (complete recovery 168 mg%, residual complications 321 mg%, mortality 344 mg%, p < 0.001). Gram positive organisms were associated with higher mortality and morbidity i.e. 24% and 40%, as compared to gram negative organisms 12% and 31% respectively. There was no significant correlation' between age, sex, peripheral and CSF white cell count with outcome illness. Our data show that prolonged duration of illness, presence of neurological signs, low haemoglobin level, low CSF sugar content, high CSF protein level, and gram positive organisms were associated with poorer outcome of childhood meningitis.
    Matched MeSH terms: Meningitis/complications*; Meningitis/microbiology; Meningitis/therapy*
  19. Cheong YM, Jegathesan M, Lo SB
    Med J Malaysia, 1984 Mar;39(1):38-41.
    PMID: 6513838
    The usefulness of counterimmunoelectrophoresis (CIEP) and coagglutination (COAG) methods in the diagnosis of bacterial meningitis was evaluated. Out of the 31 cerebrospinal fluid (CSF) specimens which had a cell count of >5 x10^6 wbc/l and were negative on gram stain and culture, pneumococcal antigens were detected in four specimens and Haemophilus influenzae type b antigen was detected in one specimen by both the methods. No false positives were detected in 10 specimens obtained from cases of febrile fits whose CSF showed no evidence of meningitis. One CSF sample, from which Klebsiella spp. was isolated, cross reacted with the meningococcal polyvalent group A-D antiserum in the CIEP test. From this study we found that these methods are rapid, simple and useful adjunctive tests In the diagnosis of bacterial meningitis, especially in the partially treated cases.
    Matched MeSH terms: Meningitis/diagnosis*; Meningitis/immunology
  20. Lyn P, Pan Fui Lin
    Med J Malaysia, 1988 Mar;43(1):90-6.
    PMID: 3244328
    Matched MeSH terms: Meningitis/drug therapy*; Meningitis/epidemiology
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