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Practical Physiology
N Geetha
SECTION 1: HEMATOLOGY
CHAPTER 1:
Compound Microscope
INTRODUCTION
LIGHT MICROSCOPES
Parts of the Compound Microscope
Mechanical Parts
Optical Magnifying Parts
Image Formation by the Microscope
Working Distance
Magnification of the Microscope
Resolving Power
Adjustments of the Microscope
Low Power Adjustments
High Power Adjustments
Adjustments for Oil Immersion
Care of Microscope
Other Microscopes
Phase Contrast Microscope
Electron Microscope
Fluorescence Microscope
VIVA QUESTIONS
CHAPTER 2:
Microscopic Examination of Blood
AIM
APPARATUS
EXAMINATION OF FRESH BLOOD UNDER THE MICROSCOPE
Observation
EXAMINATION OF BLOOD IN ISOTONIC SOLUTION
BLOOD IN HYPOTONIC SALINE
BLOOD IN HYPERTONIC SALINE
VIVA QUESTIONS
CHAPTER 3:
Collection of Blood Sample
INTRODUCTION
In Vivo Anticoagulants
COLLECTION OF BLOOD
Capillary Blood
Procedure
Collection of Venous Blood
Procedure
VIVA QUESTIONS
CHAPTER 4:
Erythrocyte Sedimentation Rate
PRINCIPLE
METHODS
Westergren's Method
Apparatus
Procedure
Disadvantages
Wintrobe's Method
Apparatus
Procedure
Advantages
Disadvantages
Esrite Method
Apparatus
Procedure
Precautions While Doing ESR
Micro-ESR Kit
RESULT
DISCUSSION
Rouleaux Formation
Factors Affecting Rouleaux Formation
VIVA QUESTIONS
CHAPTER 5:
Packed Cell Volume (PCV) or Hematocrit
PRINCIPLE
METHODS
Wintrobe's Method
Apparatus
Procedure
Observations
Calculations
Microhematocrit Method (Micro-PCV)
Advantages
DISCUSSION
VIVA QUESTIONS
CHAPTER 6:
Estimation of Hemoglobin (Hemoglobinometry)
COLORIMETRIC ESTIMATION OF HEMOGLOBIN
Principle
Sahli's Method
Principle
Apparatus
Procedure
Precautions
Result
Disadvantages of Sahli's Method
Cyanmethemoglobin Method
Principle
Procedure
Tallquist's Method
Haldane's Method or Carboxyhemoglobin Method
Gasometric Method
OTHER METHODS OF ESTIMATION OF HEMOGLOBIN
Estimation of Iron
Spectrophotometry
Oxygen Carrying Capacity Determination
DISCUSSION
VIVA QUESTIONS
CHAPTER 7:
Hemocytometer and Red Blood Cell Count
HEMOCYTOMETRY
HEMOCYTOMETER
RBC Pipette
WBC Pipette
The Hemocytometer or Neubauer Counting Chamber
Special Cover Glass
WBC Diluting Fluid (Turk's Fluid)
RBC Diluting Fluid (Hayem's Fluid)
Composition of Hayem's Fluid
RED BLOOD CELL COUNT
Principle
Requirements
Procedure
Charging the Counting Chamber
Counting the Cells
Calculations
Precautions
RESULT
DISCUSSION
NORMAL RBC COUNT
Variations in RBC Count
Physiological Variations in the Red Blood Cell Count
Pathological Variation in Red Cell Count
Polycythemia
Types of Polycythemia
VIVA QUESTIONS
CHAPTER 8:
Blood Indices—MCV, MCH and MCHC
MEAN CORPUSCULAR VOLUME OR MCV
MEAN CORPUSCULAR HEMOGLOBIN OR MCH
MEAN CORPUSCULAR HEMOGLOBIN CONCENTRATION OR MCHC
VIVA QUESTIONS
CHAPTER 9:
Determination of Specific Gravity of Blood
PRINCIPLE
Phillips and Van Slyke's Copper Sulfate Method
Advantages of Copper Sulfate
Requirements
Procedure
Normal Values of Specific Gravity
VIVA QUESTIONS
CHAPTER 10:
Determination of Osmotic Fragility of Red Blood Cells
PRINCIPLE
APPARATUS
PROCEDURE
OBSERVATIONS
RESULT
DISCUSSION
VIVA QUESTIONS
CHAPTER 11:
White Blood Cell Count or Total Count
PRINCIPLE
APPARATUS
WBC PIPETTE
WBC DILUTING FLUID (TURK'S FLUID)
Procedure
Counting
Calculation
VIVA QUESTIONS
CHAPTER 12:
Differential Count of Leukocytes
PRINCIPLE
APPARATUS
Preparation of Leishman's Stain
METHOD
Preparation of the Blood Smear
When observed in good light an ideal smear should satisfy the following criteria:
Staining
Distribution of Different WBCs in Different Parts of the Smear
Identification of Different Cells in the Peripheral Smear
The White Blood Cells
Neutrophil
Eosinophil
Basophil
Lymphocyte
Monocyte
Differential Counting of Leukocytes
Procedure
Precautions
Calculations
Red Blood Cells and Platelets in the Peripheral Smear
Red Blood Cells
VIVA QUESTIONS
CHAPTER 13:
Absolute Eosinophil Count
PRINCIPLE
APPARATUS
Procedure
Calculation
Discussion
CHAPTER 14:
Reticulocyte Count
PRINCIPLE
PROCEDURE
Wet Method or Cover Slip Preparation
Smear Preparation (Dry Preparation)
Automated Electronic Method
DISCUSSION
VIVA QUESTIONS
CHAPTER 15:
Platelet Count
APPARATUS
Composition of Rees-Ecker Diluting Fluid
Procedure
Calculation
Precautions
AUTOMATED ANALYZER
DISCUSSION
Variation in Platelet Count
VIVA QUESTIONS
CHAPTER 16:
Determination of Bleeding Time and Clotting Time
BLEEDING TIME
Principle
Methods
Finger Prick Method
Duke's Method
Ivy's Method
Discussion
CLOTTING TIME
Principle
Methods
Capillary Tube Method
Lee and White Method
Other Tests used to Measure the Efficiency of Coagulation
Discussion
VIVA QUESTIONS
CHAPTER 17:
Determination of Blood Group
PRINCIPLE
APPARATUS
PROCEDURE
OBSERVATIONS
DISCUSSION
The ABO System
The Rh System
VIVA QUESTIONS
SECTION 2: CLINICAL EXAMINATION
CHAPTER 18:
General Examination
INTRODUCTION
Overall Appearance, Posture and Gait
Build and Nourishment
Height and Weight
Anemia (Pallor)
Jaundice (Icterus)
Cyanosis
Clubbing
Lymphadenopathy
Edema
Skin, Hair and Nails
Pulse
Blood Pressure
Jugular Venous Pressure (JVP)
Respiratory Rate
Temperature
Normal Report Pattern of General Examination
General Examination
CHAPTER 19:
Physical Examination
INSPECTION
PALPATION
PERCUSSION
Rules of Percussion
AUSCULTATION
Parts of the Stethoscope
CHAPTER 20:
Determination of Arterial Blood Pressure
PRINCIPLE OF MANUAL BLOOD PRESSURE MEASUREMENT
Sphygmomanometer
Mercury Manometer
Rubber Bag with a Linen Cuff
Rubber Pump
METHODS OF SPHYGMOMANOMETRY
Recording of Blood Pressure in Different Postures and after Exercise
SAMPLE REPORT PATTERN
VIVA QUESTIONS
CHAPTER 21:
Examination of the Respiratory System
INTRODUCTION
INSPECTION
Upper Respiratory Tract
Trachea
Examination of Chest
Front
Side
Back
Shape of the Chest
Respiratory Rate
Rhythm of Respiration
Type of Breathing
Chest Movements
Pulsations
PALPATION
Position of Trachea
Apex Beat
Chest Measurements and Chest Expansion
Respiratory Rate
Chest Movements during Respiration
Vocal Fremitus
PERCUSSION
AUSCULTATION
Breath Sounds
Abnormal Breath Sounds
Added Sounds or Adventitious Sounds
Vocal Resonance
REPORT PATTERN
GENERAL EXAMINATION
RESPIRATORY SYSTEM EXAMINATION
Inspection (both sides of the chest to be compared)
Palpation
Percussion
Auscultation
VIVA QUESTIONS
CHAPTER 22:
Examination of Cardiovascular System
EXAMINATION OF ARTERIAL PULSE
Rate
Rhythm
Volume
Character of the Pulse
Abnormal Pulses
Symmetry
Condition of the Vessel Wall
Radiofemoral Delay
Palpation of Other Peripheral Vessels
MEASUREMENT OF ARTERIAL BLOOD PRESSURE
JUGULAR VENOUS PRESSURE (JVP)
Measurement of JVP
Hepatojugular Reflux
EXAMINATION OF PRECORDIUM
Inspection
Palpation
Percussion
Auscultation
REPORT PATTERN
General Examination
Cardiovascular System Examination
Inspection
Palpation
Percussion
Auscultation
Impression
VIVA QUESTIONS
CHAPTER 23:
Examination of Nervous System
EXAMINATION OF HIGHER FUNCTIONS
MENTAL STATE
General Appearance and Behavior
Emotional Behavior (Mood)
Sleep
Orientation in Place, Person and Time
Attention and Level of Consciousness
Intelligence
Delusions and Hallucinations
MEMORY
SPEECH
Types of Speech Disorders
POSTURE AND GAIT
Abnormalities in Posture and Gait
VIVA QUESTIONS
CHAPTER 24:
Examination of the Sensory System
REQUIREMENTS
METHOD
TOUCH SENSATION
Fine Touch and Tactile Localization
Two Point Discrimination
Pressure
PAIN SENSATION
Superficial Pain
Deep Pain or Pressure Pain
VIBRATION SENSE
TEMPERATURE
STEREOGNOSIS
APPRECIATION OF PASSIVE MOVEMENT AND SENSE OF POSITION (PROPRIOCEPTION)
Sense of Passive Movement
Sense of Position
GRAPHESTHESIA
DOUBLE SIMULTANEOUS STIMULATION
TEST THE SENSORY CRANIAL NERVES (I, II, VIII) AND THE SENSORY PARTS OF MIXED NERVES
REPORT PATTERN OF A NORMAL SUBJECT
General Examination
Higher Functions
Sensory System Examination
IMPRESSION
DISCUSSION
VIVA QUESTIONS
CHAPTER 25:
Examination of Motor System
INSPECTION
BULK OF MUSCLE
MUSCLE TONE
Position of Joints
Feel of the Muscles
Resistance to Passive Movements
Pendular Movement of Extremities
COORDINATION OF MOVEMENT
In the Upper Limbs
Finger-Nose Test
Finger-to-Finger Test
Pronation and Supination (Diadochokinesis)
Rebound Phenomenon
Past Pointing
In the Lower Limb
Heel-Knee Test or Heel-Shin Test
Romberg's Test
Straight-Line Test (Tandem Walking)
Speech
Incoordination
MUSCLE POWER OR STRENGTH OF THE MUSCLES
Muscle Groups to be Tested
MUSCLES OF UPPER LIMB
Muscles of Fingers and Wrist Movements Abductor Pollicis Brevis (Median Nerve C8, T1)
Adductors of Thumb
Opponens Pollicis (Median Nerve)
Dorsal Interossei (Ulnar Nerve; T1)
Palmar Interossei (Ulnar Nerve; T1)
Lumbricals [Median Nerve (Lateral 2) and Ulnar Nerve (Medial 2)]
Abductor Digiti Minimi (Ulnar Nerve; C8, T1)
Flexors of the Fingers (Median Nerve and Ulnar Nerve; C7, 8 and T1)
Extensors of Fingers
Flexors of the Wrist (Median Nerve and Ulnar Nerve; C7, 8)
Extensors of the Wrist (Radial Nerve; C6, 7)
Muscles Acting on Elbow Joint Brachioradialis (Radial Nerve; C5, C6)
Biceps (Musculocutaneous Nerve; C5, C6)
Triceps (Radial Nerve; C6, 7, 8)
MUSCLES OF SHOULDER
Supraspinatus (Suprascapular Nerve; C5, 6)
Deltoid (Axillary Nerve; C5, 6)
Infraspinatus (Suprascapular Nerve; C5, 6)
Pectoralis (Lateral and Medial Pectoral Nerves; C5, 6, 7, 8, T1)
Serratus Anterior (Long Thoracic Nerve; C5, 6, 7)
Latissimus Dorsi (Thoracodorsal Nerve; C6, 7, 8)
MUSCLES OF NECK, ABDOMEN AND BACK
Muscles of Neck (C3, 4, 5)
Muscles of Abdomen (T5 to L1)
Erector Spinae and Muscles of Back
Trapezius
Diaphragm (Phrenic Nerve; C3, 4, 5)
MUSCLES OF LOWER LIMB
Flexors and Extensors of Toes
Dorsiflexors (Common Peroneal Nerve; L4, 5) and Plantar Flexors (Tibial Nerve; L5, S1) of Ankle
Extensors of Knee (Femoral Nerve; L3, 4)
Flexors of Knee (Sciatic Nerve; L4, 5)
Extensors of Thigh (Inferior Gluteal Nerve; L5, S1)
Flexors of Thigh (Femoral Nerve; L1, 2, 3)
Adductors of Thigh (Obturator Nerve; L2, 3, 4)
Abductors of Thigh (Superior Gluteal Nerve; L4, 5, S1, 2)
Rotators of Thigh
GRADING OF POWER OF MUSCLES
Abnormalities in Muscle Power
MOTOR CRANIAL NERVES
GAIT
ABNORMAL MOVEMENTS
REPORT PATTERN
General Examination
Higher Functions
Motor System Examination
Impression
VIVA QUESTIONS
CHAPTER 26:
Examination of the Cranial Nerves
I. OLFACTORY NERVE
Examination of Olfactory Nerves
Abnormalities
II. OPTIC NERVE
Method
Acuity of Vision
Method
Field of Vision
Color Vision
Examination of Optic Fundus
OCULOMOTOR, TROCHLEAR AND ABDUCENT NERVES (III, IV, VI)
Inspection
Oculomotor Nerve - III Cranial Nerve
Pupillary Light Reflexes
Abnormalities of Light Reflex
Accommodation Reflex
IV and VI Cranial Nerves
Eye Movements
Examination of the Extraocular Muscles
Convergence
V. TRIGEMINAL NERVE
Sensory Component
Motor Component
Reflexes
Sensory Part
VII. FACIAL NERVE
The Sense of Taste (Special Sensory)
Method
General Sensory
Somatic Motor
VIII. VESTIBULOCOCHLEAR (ACOUSTIC) NERVE
Testing the Cochlear Part
Watch Test
Rinne's Test
Weber's Test
Schwabach Test
VESTIBULAR PART
Method
Caloric Test
IX. GLOSSOPHARYNGEAL NERVE
X. VAGUS NERVE
XI. ACCESSORY NERVE
Sternomastoid
Trapezius
XII. HYPOGLOSSAL NERVE
Report Pattern of a Normal Subject
General Examination
Higher Functions
EXAMINATION OF CRANIAL NERVES
I. Olfactory Nerve
II. Optic Nerve
OCULOMOTOR (III), TROCHLEAR (IV) AND ABDUCENT NERVE (VI)
V. TRIGEMINAL NERVE
VII. FACIAL NERVE
VIII. VESTIBULOCOCHLEAR NERVE
Tests for Cochlear Function
Tests of Vestibular Function
IX. GLOSSOPHARYNGEAL NERVE
Taste Sensation
X. VAGUS NERVE
XI. SPINAL ACCESSORY NERVE
XII. HYPOGLOSSAL NERVE
Impression
VIVA QUESTIONS
CHAPTER 27:
Examination of Reflexes
INTRODUCTION
Types of Reflexes
Deep Reflexes or Stretch Reflexes
Superficial Reflexes
Reinforcement
DEEP REFLEXES OR MUSCLE STRETCH REFLEXES (TENDON JERKS)
Precautions while Eliciting the Deep Reflexes
Jaw Jerk (Trigeminal Nerve)
Biceps Jerk (Musculocutaneous Nerve; C5, 6)
Triceps Jerk (Radial Nerve; C6, 7 and 8)
Supinator Jerk (Radial Nerve; C5, 6)
Knee Jerk or Patellar Jerk (Femoral Nerve; L 2, 3 and 4)
Ankle Jerk (Tibial Nerve; L5, S1, 2)
Methods to Elicit Clonus
Ankle Clonus
Patellar Clonus
SUPERFICIAL REFLEXES
CORNEAL AND THE CONJUNCTIVAL REFLEXES (V AND VII CRANIAL NERVE)
PHARYNGEAL AND PALATAL REFLEXES (IX AND X CRANIAL NERVES)
PUPILLARY REFLEXES (II AND III CRANIAL NERVES): (REFER TO PAGE 198)
ABDOMINAL REFLEX (T6 TO T12 SPINAL SEGMENTS)
CREMASTERIC REFLEX (L1, 2)
PLANTAR REFLEX (L4, 5, S1, 2)
ANAL REFLEX (PUDENDAL NERVE; S3, 4, 5)
VISCERAL REFLEXES OR ORGANIC REFLEXES
Report Pattern
General Examination
Higher Functions
Examination of Reflexes
Superficial Reflexes
Deep Tendon Reflexes
Visceral Reflexes (from History)
VIVA QUESTIONS
SECTION 3: EXPERIMENTAL PHYSIOLOGY (AMPHIBIAN EXPERIMENTS)
CHAPTER 28:
Common Appliances Used in the Experimental Physiology Laboratory
ELECTRICAL EQUIPMENTS
Low Voltage Unit
Du Bois-Reymond Inductorium
Parts of Inductorium
Base
Electromagnet
Induced Current
Vibrating Interrupter
Stimulating Electrodes
Simple Key
Short-Circuiting Key
Mercury Commutator
Muscle Bath or Luca's Trough
Time Tracer (Fig. 28.6)
Electrically Driven Kymograph
MECHANICAL EQUIPMENTS
Power Shaft and Pulleys
Pulley Driven Kymograph or Sherrington-Starling Recording Drum
Side Hoof
Shaft
Contact Arms or Strikers
Gear and Pulley Arrangement
Myograph Stand, X-Block and Femur Clamp
Frog Board or Myograph Board
Writing Lever
Muscle Lever
Isotonic Muscle Lever
Isometric Muscle Lever
Heart Lever
Weight Hook
Recording Surface
Smoking
Varnishing
Electrical Connections
VIVA QUESTIONS
CHAPTER 29:
Pithing of Frog and Dissection of Muscle Nerve Preparation
PITHING OF FROG
Materials
Procedure
DISSECTION OF THE NERVE-MUSCLE PREPARATION
Procedure
VIVA QUESTIONS
CHAPTER 30:
Mounting the Muscle-Nerve Preparation
PROCEDURE
Electric Connections
Adjustments in the Kymograph
Mounting the Cylinder
Mounting the Preparation
Adjustments of the Myograph and the Lever
Precautions
CHAPTER 31:
Simple Muscle Twitch
MATERIALS
PROCEDURE
Connections for Electric Circuit
Adjustments of Kymograph
Mounting the Preparation and Recording the Graph
OBSERVATION
Latent Period (LP)
Contraction Period (CP)
Relaxation Period (RP)
Precautions
VIVA QUESTIONS
CHAPTER 32:
Effects of Two Successive Stimuli on Muscle Contraction
REQUIREMENTS
METHOD
OBSERVATIONS
VIVA QUESTIONS
CHAPTER 33:
Genesis of Tetanus
APPARATUS
Electric Connections
PROCEDURE
OBSERVATION
VIVA QUESTIONS
CHAPTER 34:
Effect of Afterload and Freeload in Skeletal Muscle Contraction
PRINCIPLE
REQUIREMENTS
Afterloading
Procedure
Observation
Freeloading
Aim
Observation
Recording of Afterloaded and Freeloaded Contractions on a Stationary Drum
Calculation of Work Done by the Muscle for Each Contraction
VIVA QUESTIONS
CHAPTER 35:
Effect of Continuous Stimulation of a Muscle (Study of Fatigue and Recovery)
PRINCIPLE
REQUIREMENTS
ELECTRICAL CONNECTIONS
PROCEDURE
OBSERVATIONS
PRECAUTIONS
VIVA QUESTIONS
CHAPTER 36:
Effects of Temperature on Muscle Contraction
PRINCIPLE
REQUIREMENTS
PROCEDURE
PRECAUTIONS
OBSERVATION
VIVA QUESTIONS
CHAPTER 37:
Velocity of Nerve Impulses
PRINCIPLE
REQUIREMENTS
PROCEDURE
CALCULATIONS
VIVA QUESTIONS
CHAPTER 38:
Normal Cardiogram of Frog
ANATOMY OF THE FROG'S HEART
PROCEDURE
REQUIREMENTS
RECORDING OF THE NORMAL CARDIOGRAM
OBSERVATION
PRECAUTIONS
VIVA QUESTIONS
CHAPTER 39:
Effect of Temperature on Frog's Heart
INTRODUCTION
REQUIREMENTS
PROCEDURE
OBSERVATION
VIVA QUESTIONS
CHAPTER 40:
Stannius Ligatures
INTRODUCTION
REQUIREMENTS
PROCEDURE
OBSERVATION (FIGS. 40.2A TO C)
Inference
VIVA QUESTIONS
CHAPTER 41:
Extrasystole and Compensatory Pause
INTRODUCTION
Apparatus
Procedure
Observations
CONCLUSIONS
VIVA QUESTIONS
CHAPTER 42:
Effect of Vagal Stimulation on Frog's Heart
INTRODUCTION
Procedure
Exposure of Vagosympathetic Trunk
Stimulation of Vagosympathetic Trunk
Observations
VIVA QUESTIONS
CHAPTER 43:
Effect of Drugs and Ions on Isolated Frog's Heart
PRINCIPLE
REQUIREMENTS
PROCEDURE
PRECAUTIONS
SECTION 4: BIOPHYSICS EXPERIMENTS
CHAPTER 44:
Cathode Ray Oscilloscope
INTRODUCTION
Controls on the Panel
Precautions
Uses of Cathode Ray Oscilloscope
CHAPTER 45:
Electrocardiography
ELECTROCARDIOGRAPH
Electrodes
Bipolar Leads
Unipolar Leads
Amplifier
Recording Device
Paper Recording
Heated Stylus Method
ECG Paper
Standardization
METHOD
Paper Recording
Observation
Normal Electrocardiogram
P Wave
P-R Interval
QRS Complex
ST Segment
T Wave
U Wave
VIVA QUESTIONS
CHAPTER 46:
Spirometry
SPIROMETER
Procedure
Report
VIVA QUESTIONS
CHAPTER 47:
Stethography
AIM
APPARATUS
Stethograph
Marey's Tambour
PROCEDURE
Normal Respiratory Movements
Voluntary Hyperventilation
Effect of Swallowing
Effect of Breath Holding
Effect of Exercise
OBSERVATION (FIG. 47.5)
PRECAUTIONS
VIVA QUESTIONS
CHAPTER 48:
Perimetry
PERIMETER (FIG. 48.1)
APPARATUS
Perimeter Chart
PROCEDURE
OBSERVATIONS AND INFERENCES
PRECAUTIONS
DISCUSSION
Binocular Vision
CHAPTER 49:
Electromyography
PRINCIPLE
APPARATUS
ELECTRODES
Uses of EMG
CHAPTER 50:
Audiometry
APPARATUS
Pure Tone Audiometer (Fig. 50.1)
PROCEDURE
OBSERVATION
DISCUSSION
CHAPTER 51:
Ergography
INTRODUCTION
PROCEDURE
Observations and Inferences
Calculation of the Work Done
SECTION 5: MAMMALIAN (RABBIT) EXPERIMENTS
CHAPTER 52:
Perfusion of Isolated Rabbit's Heart and the Effects of Drugs and Ions
PRINCIPLE
REQUIREMENTS
Composition of Ringer Locke's Solution
Langendorff's Apparatus Consists of:
PROCEDURE
PRECAUTIONS
OBSERVATION
VIVA QUESTIONS
CHAPTER 53:
Recording of Rabbit's Normal Intestinal Movements and the Effects of Drugs
PRINCIPLE
REQUIREMENTS
Composition of Tyrode Solution
Dale's Apparatus (Fig. 53.1)
PROCEDURE
Observations (Fig. 53.2)
Precautions
VIVA QUESTIONS
SECTION 6: NORMAL VALUES
CHAPTER 54:
Hematologic Values and Fluids Used in the Laboratory
NORMAL VALUES
COMPOSITION OF DIFFERENT FLUIDS USED IN THE LABORATORY
SECTION 7: MODEL OF PRACTICAL EXAMINATION
CHAPTER 55:
Sample Questions
INDEX
TOC
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