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Pregnancy / Obstetrics

How to know that a period is coming



There are a couple of ways a person can say when a time is due. When their hormone levels drop, many people experience a range of physical and emotional symptoms called premenstrual syndrome (PMS).

We address some common signs and symptoms of cycles in this article, and explain how they vary from those of early pregnancy.

They also cover when people may need to suggest seeing a doctor about the effects of their cycles.

Signs and symptoms

A girl in her period
A individual may experience abdominal bloating a couple of days before the start of a period.

Many people experience PMS a few days before their cycle begins, which causes a variety of symptoms.

PMS symptoms appear in 95 percent of reproductive-age females according to study.

PMS occurs after ovulation, when an ovary releases an egg into a fallopian tube.

The levels of estrogen and progesterone drop significantly after ovulation, which may explain why people have PMS symptoms.

PMS can cause symptoms in both physical and emotional ways.

PMS can involve physical symptoms like:

  • abdominal bloating
  • abdominal cramping
  • tender or swollen breasts
  • back pain
  • changes in appetite
  • pimples or acne
  • sleeping more or less than usual
  • headaches
  • sensitivity to light or sound
  • discharge becoming clear and slippery

Emotional symptoms of PMS may include:

  • irritability
  • anxiety
  • fatigue
  • food cravings
  • difficulty concentrating
  • feelings of sadness or apathy
  • crying spells or angry outbursts
  • decreased libido

Symptoms of PMS usually resolve once the levels of estrogen and progesterone in the body begin to rise, which typically occurs 4 days after a person’s period begins.

PMS has no similar effect on everyone. Many people have their period without PMS, or just a few mild symptoms, while others have severe symptoms that interfere with their daily activities. Symptoms in about 5 percent of women with PMS are serious.

Symptoms of PMS can change during a person’s lifetime. People may experience various symptoms of PMS as they get older or after their first pregnancy.

Period vs. pregnancy

Periods and PMS may cause early pregnancy symptoms similar to those.

Both menstruation and pregnancy affect the hormone levels of a person, and this can lead to significant physical and emotional symptoms.

Bleeding or spotting

The menstrual bleeding happens on average every 25–30 days. Over their time, most people lose around 2–3 tablespoons of menstrual blood, but some individuals may have heavier or lighter periods.

While hemorrhage usually does not occur over PMS, some people experience light bleeding or spotting.

This sign can occur during early pregnancy, too. During the first trimester, about 15–25 percent of pregnant women experience spotting or mild bleeding.

When this occurs in the uterine lining 1–2 weeks after a fertilized egg implant it is called implantation bleeding.

Bleeding from the implantation is much less than bleeding from menstruation. It may look like a light pink or brown discharge, while bright red menstrual blood appears.

When women experience severe bleeding at any stage in their pregnancy, they should contact their doctor.

Abdominal pain or cramping

The abdominal pain can be caused by both PMS and pregnancy.

People in the lower abdomen can also feel mild to moderate cramping.

These cramps feel similar to menstrual and premenstrual cramps during pregnancy, and they occur as the embryo grows and the uterus stretches.

Breast changes

Both PMS and pregnancy affect hormone levels which can lead to changes in the breast, such as:

  • pain
  • tenderness or sensitivity
  • swelling
  • heaviness

Breast changes associated with PMS usually resolve at the beginning or end of a person’s duration.

Moreover, changes in the breast occurring when a woman becomes pregnant continue throughout the pregnancy.


Exhaustion reflects both a symptom of PMS and early pregnancy.

During pregnancy exhaustion may be due to elevated levels of hormones during pregnancy.

A neurotransmitter imbalance known as serotonin can lead to feelings of fatigue during PMS. Serotonin helps to regulate mood and the sleep cycle of the body, and its levels can vary throughout the menstrual cycle of an individual. These changes can have more effect on some people than on others.

People who feel extremely tired may have a more serious form of PMS, called premenstrual dysphoric disorder (PMDD), before their time.

The Women’s Health Bureau reports that about 5 percent of people who receive cycles have PMDD.

The symptoms that cause PMDD are similar but more severe than those of PMS.

Those symptoms might include:

  • persistent irritability
  • symptoms of depression and anxiety
  • panic attacks
  • mood swings
  • difficulty falling asleep
  • severe daytime fatigue
  • food cravings
  • binge eating
  • headaches
  • bloating
  • cramps
  • joint and muscle pain

Changes in mood

The hormonal changes occurring during menstruation and pregnancy can affect the mood of a person, leaving them feeling anxious, sad or irritable.

Mood swings are also common both during PMS and early pregnancy.

Persistent feelings of sadness, apathy or irritability lasting longer than 2 weeks can suggest depression or another mood disorder.

When to see a doctor

Before and during their time many people experience a variety of physical and emotional symptoms.

Usually such symptoms resolve at the beginning or end of a period.

People may want to see a doctor if they have symptoms affecting their daily lives or occurring outside of their time.

Many of the PMS symptoms occur during pregnancy, too.

These may include changes in mood, fatigue, mild bleeding or spotting and abdominal pain.

If they are mild and do not interfere with their daily activities, people don’t need to worry about these symptoms.

Heavy bleeding and extreme abdominal cramping may however signify complications of pregnancy, such as loss of pregnancy and ectopic pregnancy.

If females experience any of the following symptoms during pregnancy, they should contact their doctor:

  • heavy bleeding
  • intense lower back pain
  • painful abdominal cramps
  • a sudden, intense headache
  • severe, persistent fatigue
  • difficulty breathing
  • vomiting several times a day


Before and during their lifetime many people experience physical and emotional changes.

Such changes include:

  • vaginal bleeding or spotting
  • abdominal pain or cramping
  • bloating
  • lower back pain
  • swollen or tender breasts
  • nausea
  • headaches
  • fatigue
  • acne
  • irritability
  • frequent mood changes
  • symptoms of anxiety or depression

While those symptoms can cause discomfort, they should not interfere with the everyday life of a person.

People may want to talk to a doctor if they continue to experience emotional or physical symptoms which continue after the end of their time.

Prolonged feelings of sadness, hopelessness or anxiety may signify a condition of mental health which can be managed by doctors with therapy and medication.

Heavy or prolonged bleeding between cycles can be a symptom of underlying health problem, such as ectopic pregnancy, an infection, or a hormonal imbalance.

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Immune System / Vaccines

Types, symptoms, and treatments of cytomegalovirus



Cytomegalovirus is a typical herpes virus. Many people are unaware they have it since they show no signs or symptoms.

However, the virus can cause issues during pregnancy and in people with a compromised immune system because it remains dormant in the body.

The virus spreads through bodily fluids and can be passed on to an unborn child by a pregnant woman.

Cytomegalovirus, also known as HCMV, CMV, or human herpesvirus 5 (HHV-5), is the most frequent virus transmitted to a growing baby.

According to the Centers for Disease Control and Prevention (CDC), more than half of all people in the United States have contracted the virus by the age of 40. It affects both men and women equally, regardless of age or ethnicity.


consulting a doctor

Fluids such as saliva, sperm, blood, urine, vaginal fluids, and breast milk can spread acquired cytomegalovirus between people.

The virus can also be contracted by touching a virus-infected surface and then touching the interior of the nose or mouth.

The virus is most commonly contracted in childhood, at daycare centres, nurseries, and other places where children are in close proximity to one another. The immune system of a child at this age, on the other hand, is typically capable of dealing with an infection.

CMV can recur in people who have a compromised immune system as a result of HIV, organ transplantation, chemotherapy, or long-term use of oral steroids.

Congenital CMV develops when a female catches the virus for the first time during pregnancy or shortly before conception.

A dormant CMV infection might resurface during pregnancy, especially if the mother has a compromised immune system.


Depending on the type of CMV, the symptoms will vary.

Acquired CMV

The majority of people with CMV do not show any symptoms, however if they do, they may include:

  • swollen glands
  • joint and muscle pain
  • low appetite and weight loss
  • fever
  • night sweats
  • tiredness and uneasiness
  • sore throat

After two weeks, the symptoms should be gone.

Recurring CMV

The symptoms of recurrent CMV differ depending on which organs have been affected by the infection. The eyes, lungs, and digestive system are all likely to be affected.

Among the signs and symptoms are:

  • fever
  • diarrhea, gastrointestinal ulcerations, and gastrointestinal bleeding
  • shortness of breath
  • pneumonia with hypoxemia, or low blood oxygen
  • mouth ulcers that can be large
  • problems with vision, including floaters, blind spots, and blurred vision
  • hepatitis, or inflamed liver, with prolonged fever
  • encephalitis, or inflammation of the brain, leading to behavioral changes, seizures, and even coma.

Any of these symptoms should be reported to a doctor by someone with a reduced immune system.

Congenital CMV

According to the National CMV Foundation, approximately 90% of kids born with CMV show no symptoms, but 10–15% will develop hearing loss during their first 6 months of life. The degree of hearing loss varies from mild to complete deafness.

The infection will affect only one ear in half of these children, but the other half will experience hearing loss in both ears. Hearing loss in both ears can increase the risk of speech and communication issues in the future.

If congenital CMV is present at birth, symptoms may include:

  • enlarged spleen
  • seizures
  • jaundice
  • pneumonia
  • spots under the skin
  • low birth weight
  • Purple skin splotches, a rash, or both
  • enlarged liver

Some of these signs and symptoms can be treated.

In roughly 75% of babies born with congenital CMV, the virus will affect the brain. This could lead to difficulties later in life.

They may be exposed to the following conditions:

  • autism
  • central vision loss, scarring of the retina, and uveitis, or swelling and irritation of the eye
  • cognitive and learning difficulties
  • deafness or partial hearing loss
  • epilepsy
  • impaired vision
  • problems with physical coordination
  • seizures
  • small head


Scientists have been looking for a CMV vaccine, however there is no cure as of yet.

People with acquired CMV who encounter the virus for the first time can ease symptoms with over-the-counter (OTC) pain relievers like Tylenol (acetaminophen), ibuprofen, or aspirin, and should stay hydrated.

Antiviral drugs, such as ganciclovir, can be used to inhibit the spread of CMV in people who have it congenitally or on a regular basis.

These drugs have the potential to cause side effects. Hospitalization may be required if there is substantial organ damage.

It’s possible that newborns will need to be admitted to the hospital until their organ functions return to normal.


The following precautions may help minimise the risk of developing CMV:

  • Hands should be washed with soap and water on a frequent basis.
  • Kissing a small child should be avoided at all costs, including contact with tears and saliva.
  • When passing around a drink, avoid sharing glasses and kitchen equipment.
  • Diapers, paper handkerchiefs, and other such items should be disposed of with care.
  • To prevent CMV from spreading through vaginal secretions and sperm, use a condom.

The Centers for Disease Control and Prevention (CDC) advises parents and caregivers of children with CMV to seek treatment as soon as possible, whether that means taking medication or attending all appointments for services such as hearing tests.


CMV infections are classified as either acquired, recurrent, or congenital.

  • When a person contracts CMV for the first time, it is known as acquired or primary CMV.
  • When a person already has CMV, it is referred to as recurrent CMV. The virus is dormant and then becomes active due to a weak immune system.
  • When a person contracts CMV while pregnant and passes it on to the foetus, this is known as congenital CMV.

Except when it affects an unborn child or a person with a weakened immune system, such as a recent transplant recipient or someone living with HIV, CMV is normally not an issue.

CMV infection can cause organ failure, eye damage, and blindness in HIV patients. In recent years, advances in antiviral treatment have lowered the risk.

Immunosuppressants are used by people who have had organ and bone marrow transplants to suppress their immune systems so that their bodies do not reject the new organs. In these people, dormant CMV can become active and cause organ damage.

Antiviral medications may be given to transplant recipients as a prophylactic against CMV.

The virus can be passed to the foetus by a pregnant woman. This is referred to as congenital CMV.

According to the Centers for Disease Control and Prevention, about one in every 200 newborns is born with the virus.

The majority of these babies will show no signs or symptoms, but about 20% will have symptoms or long-term health issues, such as learning challenges.

Vision and hearing loss, small head size, weakness, trouble using muscles, coordination issues, and seizures are all possible symptoms.


A blood test can detect antibodies produced by the body as a result of the immune system’s response to the presence of CMV.

A pregnant woman faces a low risk of CMV reactivation affecting her unborn child. If a doctor suspects a pregnant woman has CMV, an amniocentesis may be recommended. To determine whether the virus is present, a sample of amniotic fluid is extracted.

The newborn will be tested within the first three weeks of life if the doctor suspects congenital CMV. Testing for congenital CMV after 3 weeks will not be definitive because the kid may have contracted the virus after birth.

Even if the virus is not active, anyone with a weaker immune system should get tested. Testing for vision and hearing issues will be done on a regular basis as part of the CMV complications monitoring.


CMV causes just a small percentage of healthy people to become very ill.

CMV mononucleosis, a condition in which too many white blood cells have a single nucleus, can occur in people with a weaker immune system.

Sore throat, swollen glands, swollen tonsils, fatigue, and nausea are some of the symptoms. It can cause hepatitis, or inflammation of the liver, as well as spleen enlargement.

Mononucleosis induced by the CMV is comparable to mononucleosis caused by the Epstein-Barr Virus (EBV). Glands fever is another name for EBV mononucleosis.

Other CMV problems include:

  • gastrointestinal problems, including diarrhea, fever, abdominal pain, colon inflammation, and blood in the feces
  • liver function problems
  • central nervous system (CNS) complications, such as encephalitis, or inflammation of the brain
  • pneumonitis, or inflammation of lung tissue.



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Pregnancy / Obstetrics

What are the risks of having an epidural?



A person may receive an epidural, a sort of regional anesthesia, during delivery or other medical operations. It’s a pain-relieving technique that causes numbness, mainly in the belly and pelvic region. While the surgery is usually without difficulties, some people may develop adverse effects or long-term complications.

An epidural is a type of pain relief that is administered through an injection in the lower back. The drug is a nerve blocker that can help with labor, childbirth, and certain types of surgery. Although epidurals are generally safe, they do come with some risks and adverse effects, including as headaches, pain, and a drop in blood pressure. They may potentially cause consequences such as irreversible nerve damage in very rare cases.

In this post, we’ll look at how an epidural is administered by a healthcare professional, as well as the risks, side effects, and potential issues.

What is an epidural?

labour lady

An epidural is a sort of regional anesthetic that is also known as an epidural block. An anesthetic is a drug that helps to keep a person from feeling pain. A regional anesthetic is a medication that causes numbness in a significant area of the body, such as the lower extremities.

The location of the numbness varies based on the type and placement of the epidural used by the doctor. An epidural for labor, for example, causes a band of numbness to run from the belly button to the upper legs.

The name derives from the location where the drug is injected, which is into the epidural space by a doctor. The space between the dura mater or dural membrane, a thick layer of protecting tissue, and the spinal cord is referred to as this area. By inhibiting the nerves in the spinal cord that would normally send a signal to the brain to register pain, this drug can assist to prevent pain.

In medical operations such as spinal and abdominal surgeries, as well as during labour and delivery, a doctor may consider utilizing an epidural.

How to use an epidural

A catheter is generally used to provide an epidural during labor. A healthcare expert uses a needle to implant a tiny tube into the lower region of the back. The catheter remains in place after the needle is removed, allowing the medicine to be delivered through the tube. During birthing, the individual receiving the epidural will remain awake and attentive, but will experience some loss of feeling and pain in the bottom half of their body.

A local anesthetic is usually used to numb the injection location before the epidural is administered. A local anesthetic is a medication that numbs a specific part of the body. During the injection, you may feel a small amount of pressure or tingling. However, there should be very little pain after the epidural is injected. When the needle is inserted, a person may still feel some pressure.

The anesthetic staff will try to provide pain relief to a woman giving birth for as long as she needs it. They may try to switch to oral pain medications and stop using the epidural catheter after the first 48–72 hours.

However, an epidural is not necessary for everyone, and patients can explore their alternatives with the anesthetic care team. In fact, an epidural may not be appropriate for some people. Individuals with bleeding disorders, those on blood thinners, or those with a history of spine or brain abnormalities may be at risk.

A person may obtain an epidural through a single needle injection for different treatments, such as surgery or pain relief. People normally experience pain relief within minutes, however adjusting the dose for best pain relief may take some time.

People can also get a combination spinal-epidural using both procedures. This gives the anesthesia staff immediate pain relief that they can sustain with the epidural catheter.

Side effects and risks

Epidurals are quite effective in relieving pain, with just around 1 out of every 100 people requiring additional pain relief during labor. With an epidural, however, there are still some risks and adverse effects to consider.

Epidurals may cause the following side effects:

  • A decrease in blood pressure: Following the administration of an epidural, a person’s blood pressure may drop. This may cause the baby’s heart rate to slow down during birthing. A person may need to drink more water and rest on their side to lessen the chances of this happening.
  • A sore back: There may be some discomfort at the injection location. This type of discomfort normally only lasts a few days.
  • Headache: The epidural injection might occasionally breach the spinal cord’s protective coating. A dural puncture is the medical term for this. This can cause in 2–3% of cases, causing spinal fluid to flow out and causing a headache.
  • Itchiness: Itching is a common side effect of opioid therapy. Other medications might be able to help with the itching.
  • Tingling and numbness in the legs: It’s possible that a person’s legs will feel heavy. Additionally, people may experience leg weakness.
  • Problems with urination: If a person has trouble peeing following an epidural, they may need a urinary catheter.

The following are some less prevalent side effects:

  • epidural abscess
  • osteomyelitis
  • nausea
  • vomiting
  • epidural hematoma
  • sepsis
  • breathing problems
  • fever
  • infection, such as meningitis

An epidural is thought to pose very minimal risk to a baby, according to research. It may, however, raise the risk of a baby’s having short-term changes. These can include the following:

  • tiredness
  • a decrease in muscle tone
  • a decrease in breastfeeding
  • changes in heart rate
  • problems with breathing

Potential long-term complications

Serious complications with epidurals are extremely rare, according to the American College of Obstetricians and Gynecologists. Long-term complications, on the other hand, may include:

  • permanent injury to the spinal cord or nerves
  • breathing problems
  • persistent numbness or tingling

While back pain can cause at the injection site and during labor, an epidural is unlikely to cause long-term back pain. While permanent nerve injury is not impossible, research suggests that it is extremely improbable, as it occurs in fewer than 1 in 240,000 cases.

A link between an epidural and autism in children has also been suggested by several authors. However, research from Canada and Denmark show that epidural exposure and autistic spectrum disorder in children are unrelated.

If a person is concerned about the side effects or risks of an epidural, they should discuss their treatment choices with their healthcare provider.


An epidural is a form of localized anesthetic used to treat pain below the waist. It’s something a doctor might use during surgery or to help with labour and delivery. An epidural is usually administered by a healthcare worker putting a catheter into the back with a needle. Some operations, like as minor surgeries or pain relief, may just require a needle epidural injection.

Headache, soreness, urinary issues, and a drop in blood pressure are all possible adverse effects of an epidural. Long-term problems are exceedingly uncommon, but they can cause irreversible nerve damage and numbness and tingling.



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Pregnancy / Obstetrics

Urinary incontinence after childbirth: Things to understand



Urinary incontinence occurs when a person passes urine accidentally. The risk of urine incontinence increases if you give delivery vaginally. It’s a frequent side effect after childbirth, and it normally goes away as the body heals.

According to a 2019 study, between the second trimester of pregnancy and the first three months following childbirth, one-third of people develop urine incontinence.

The symptoms, risk factors, treatment, and prevention of postpartum incontinence are discussed in this article.

When to consult a doctor

While pregnant, a little degree of urinary incontinence is common, and it might continue for a few weeks after childbirth without causing worry. If people are worried or if it persists 6 weeks after delivery, they should consult a doctor, midwife, or nurse.

If urinary incontinence is affecting a person’s quality of life or mental health, it is also critical to seek medical help. Professionals in the medical field can assist a person in developing a treatment plan to alleviate symptoms and enhance their quality of life.

Postpartum incontinence

baby and mother

Females have incontinence twice as often as guys. This might be due of the hormonal changes that occur during pregnancy, delivery, and menopause, according to the Office on Women’s Health.

The bladder is supported by the pelvic floor muscles. Hormonal and structural changes occur throughout pregnancy and after birth, and the strength of the pelvic floor muscles declines.

In the course of giving birth, some people might injure their pelvic floor muscles. During childbirth, especially a vaginal delivery, the nerves that regulate the bladder might be injured.

The inability to control one’s bladder after giving birth is known as postpartum incontinence. This can start throughout pregnancy, but it’s more common after a baby is born.

Females suffer from two forms of urinary incontinence: stress and urge incontinence.

When the bladder is affected by stress or pressure, stress incontinence occurs. The bladder and urethra are put under strain by weak pelvic floor muscles. Urine might flow as a result of sneezing, laughing, or coughing.

Overactive bladder is another term for urge incontinence. Urine leakage happens when a person has a strong desire to pee but is unable to access a bathroom.

Mixed incontinence occurs when a person with urine incontinence has both forms of incontinence.


Urinary incontinence causes people to leak urine accidentally. Other signs and symptoms to look out for include:

  • going to the bathroom more than eight times a day or more than twice per night
  • urinating while sleeping
  • spasms and pressure in the pelvic area

The following activities might cause urine leakage as a result of stress incontinence:

  • lifting something heavy
  • standing up
  • exercising
  • laughing
  • bending over
  • coughing
  • sneezing

Depending on the severity of incontinence, the strenuousness of the activities that cause leaks will vary.

Leaking urine and a sudden or uncontrolled need to pee are two indications of an overactive bladder.

Risk factors

According to the Australian Department of Health, people are more likely to develop urine incontinence after giving birth if they:

  • are having their first baby
  • develop bladder issues while pregnant
  • are expecting a baby with a high birth weight
  • already have incontinence before they give birth
  • experience difficulties during delivery, such as requiring stitches, tearing, or needing forceps
  • experience a long labor

According to research from 2021, vaginal birth is the leading cause of stress incontinence.

When compared to vaginal birth, people who had a cesarean delivery may have a slightly lower chance of developing stress urinary incontinence.

Management and treatment

To address urinary incontinence, people might attempt a variety of lifestyle and medication therapies.

Absorbent pads

It’s possible that a person will need to wear absorbent underwear or special underwear intended to catch any leaks.

Depending on the severity of the leaks, they might range from little panty liners to adult diapers. They might be re-usable or one-time-use only.

They absorb urine invisibly and prevent it from seeping through a person’s clothing, regardless of the kind.

Exercises for the pelvic floor muscles

Pelvic floor muscle exercises, often known as Kegel exercises, can help strengthen the pelvic floor muscles.

People should consult a midwife or healthcare practitioner about the ideal timing to begin Kegel exercises after birth, according on the circumstances.


One method of therapy is to place a pessary into the vaginal canal to support the urethra and prevent leaks.

There are custom-made pessaries available, as well as those that can be purchased over the counter. Some pessaries are single-use disposables, while others may be used for a longer period of time.


If a person develops urinary incontinence as a result of labor and delivery, it usually resolves when the muscles have had time to repair.

If urinary incontinence lasts longer than 6 weeks after childbirth or if a person has specific concerns, they should discuss with their doctor, nurse, or midwife.

The pelvic floor may never fully heal for some people. However, by speaking with a healthcare expert about the issue, a person can reduce the chances of urinary incontinence becoming permanent.

Urinary incontinence remained for 12 years after birth in three-quarters of females, according to a 2016 longitudinal research including 3,763 people.


After giving birth, a person can take efforts to reduce their chance of having long-term urinary incontinence. These are some of them:

  • Maintaining a moderate weight: Obesity has also been associated to incontinence, according to the National Health Service (NHS) in the United Kingdom. As a result, people who are overweight may be able to minimize their risk of incontinence by decreasing weight.
  • Performing Kegels: Even before becoming pregnant, people can begin these workouts. Structured pelvic floor muscle training can help avoid urinary incontinence after childbirth and during late pregnancy, according to a 2020 study.
  • Maintaining healthy bowel movements: Constipation can cause urinary incontinence by putting pressure on the bladder and urethra. To avoid constipation, people should consume a sufficient amount of fiber-rich meals.


Urinary incontinence is prevalent after delivery, affecting around one-third of people during the second and third trimesters of pregnancy and three months following birth.

It usually happens as a result of hormonal and anatomical changes that occur during pregnancy and delivery.

Urinary incontinence normally goes away when the body recovers following delivery, although it might continue longer in rare situations. However, if it lasts longer than 6 weeks after childbirth or if you have specific concerns, you should see a doctor.



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