ESSENTIAL OILS

Have you ever stuck up with choosing the oil for cooking ??? Here are some facts to be considered and to know before choosing the oils… For the country like india we are definitely not on the right track for choosing oils. Earlier people use to consume oil of what they get from their locality( for eg, south they preferred coconut and sesame oils, east and north with mustard oil, west and centre with groundnut oil) … They did cold compressed process to make it edible…All of a sudden everything was inversed and industrialized refined oils started to rule us…. Does it have impact on our health !!!!!

For an instance, we all know there are increase in cardiovascular diseases (heart problems) in india on recent decades. Do that have correlation with the oils we use now??? yes, it does….

Firstly what are essential oils and why are they  required!!!!!

Certain fatty acids like linoleic acid, linolenic acid (ALA), arachidonic acid, eicosapentaenoic acid( EPA), decosahexanoic acid (DHA) which are all certain unsaturated fatty acids are cannot be synthesized by our body and so we depend on plants and other animals as a source of supplement.

Why are they necessary!!!!

  • They are required for fat soluble vitamins (A, D, E, K)
  • For transporting certain essential elements from in and out of the cell
  • To maintain the integrity of the cell membrane
  • They are responsible for the synthesis of certain vital substances like prostaglandins, prostacyclin, thromboxane, leukotriene etc .. which plays an important role in body defense mechanism, as a platelet aggregation and to stop bleeding, etc.

Thus certain amount of oil intake per day in our regular diet is essential. For an optimal health benefit, try to limit the total fat intake to 25-30 percent of your total calorie intake.

So now, we all talk about trans fats, saturated FA, mono unsaturated FA, polyunsaturated FA, omega 3 and 6 FA!!! What are their clinical significance and which one is necessary for the healthy life!!!! Here comes a brief idea…

Saturated fatty acids (SFA):

  • They are the major component of meat products ( mainly red meat) making it white greasy and soilds at room temperature
  • Other main sources are dairy products and palm oils
  • consumption of saturated fats causes imcreased incidence of coronary heart disease by increasing total plasma cholesterol and LDL cholesterol, and increased risk of prostrate and colon cancer

Monounsaturated fatty acids (MUFA):

  • It lowers both plasma cholesterol and LDL cholesterol but maintains or increase HDL cholesterol thus decreasing incidence of coronary heart disease.
  • Olive oil is rich in MUFA

Polyunsaturated fatty acids (PUFA):

  • consumption of omega 6 PUFA lower plasma cholesterol and LDL cholesterol but HDL cholestrol is also lowered.
  • Consumption of omega 3 PUFA protects from coronary heart diseases and lowering the BP but they have little effect on LDL  or HDL cholesterol levels. Flax seeds, canola oil, soyabean oil, and fish oil ( salmon fish) are their main source.
  • Nuts, avocados, soyabean, sesame oil, cottonseed oil, corn oil, sunflower oil, canola oil, safflower oil, mustard oil, groundnut oil , rice bran oil, etc mainly have omega 6 PUFA and minimal amount of MUFA and SFA. 

Now, what are trans fats !!!!

Before knowing about the trans fats, we should know about something called ” SMOKE POINT” . It is the temperature at which the oil starts to burn and smoke.

Why is it so important???

When the oil burns( or reaches it smoke point), the double bonds in unsaturated FA is converted into trans double bonds by partial hydrogenation thus they are chemically unsaturated FA but behave like saturated FA which is termed as trans fatty acid. Dietary intake of trans fatty acids raise the level of triglycerides and LDL cholesterol and reduce the HDL cholesterol level thus increasing the risk of cardiovascular disease and diabetes... The dietary values referring partial dehydrogenation is nothing but the trans fatty acids.

Reference link for smoke point of different oils

Thus it is very much important of knowing what oil to use for what purpose…

IMG_0430

On coming to refined and unrefined oils,
Unrefined / raw/ virgin / extra virgin oils are simply cold compressed oils which are minimal or nil heat processed whereas refined oils are subjected to high temperature inorder to get its texture , deodorize, colourless, and to increase the smoke point. Thus there are maximum chances of undergoing partial dehydrogenation and becoming trans fatty acids.

Thus choosing up an oil have a silent and critical role to play with our health and fitness.

REFERENCES:

https://goo.gl/nxnJa8

https://en.m.wikipedia.org/wiki/Smoke_point

 

Tooth sensitivity

OMGGGG !!!!! What a shooting pain was this !!!! For cold and hot and sweet and sour….For everything and on everything i eat…was this pain or sensitivity !!!! My dentist calls this sensitvity and i say this as PAIN….

Had you ever visited your dentist for this reason !!!! Or on least case, had you ever encountered this problem ??? And you doesn’t know whether it is a pain or sensitivity but for a few moment it had banged your head?? And you had no idea why this was happening !!!

This is something called as “Dentin hypersensitivity “. Tooth has only one sensation and that is pain sensation…Any insult that happens to the tooth structure will be elicited as pain. Depending on the level and depth of insult, we categorize it as either pain or sensitivity…

So why this sensitivity happens and what is the reason behind this !!! The outermost covering in the crown of tooth is called enamel and it is devoid of nerve supply thus protects the tooth from any sort of sensation. When this enamel wears off ( causative factors are many – either due to decay or trauma causing enamel to chip out or excessive grinding of tooth or toomuch of abrasion/attrition, or excessive brushing of teeth or receding of gums or gastric esophageal reflux causing acid erosion or bleaching the tooth ) on such case, the underline structure called dentin which contains nerve endings are exposed to the outer environment… Any substances that comes in contact with that particular portion will elicit pain.

This is not bound with the age limit( though elderly people are more prone), anybody can get it and lifestyle is an influential factor as well.

Only way to escape from this sensitivity is to occlude the exposed nerve ending.  But how far it could be kept occluded is questionable.

There is no universally accepted gold standard treatment for dentin hypersensitivity which reliably relieves pain for long term.

Depending on the severity, at home and in office methods are used.

Desensitizing toothpastes or mouth wash or chewing gums which contains potassium nitrate/citrate/chloride, strontium chloride/acetate , Calcium carbonate/calcium sodium phosphosilicate, hydroxyapatite are believe to have role in nerve desensitization with various mechanisms.

When the pain is severe, in office methods are implemented… Which includes dental sealants, or restoring the defective portion with the filling materials preferably which has the flouride content or with the use of mouth guard if the problem is due to teeth grinding.

How to prevent tooth sensitivity???

  • avoid using tooth abrading toothpastes
  • brushing teeth with soft or medium bristles
  • gingival recession can be avoided by healthy dietary and proper oral hygiene practices
  • devoid of stress
  • taking food at proper time
  • Limiting consumption of acidic foods and drinks

Tooth sensitivity still can be controlled with our quality of life.

 

Tooth avulsion and its management

What if a tooth gets knocked in an accident??? Is that so we lose that tooth permanently??? No, there are still ways to save those from further damage by acting promptly. Trauma can occur anytime. Depend on the amount of injury occured, it can be treated from the conservative way to an advanced procedures.

Irrespective of the level of injury, from mild blow to the massive tear, it is a must to visit your dentist immediately. This helps a lot to prevent from massive damage to the tooth and its supporting structures.

8E28C78D-EE73-407F-9ECD-C24EBB137CA6-2532-0000032663F0CA55

Now, what can we do if a tooth completely comes out of the socket due to a heavy blow or an accident!!!! Can we fix our own natural tooth into our socket as before and give a rebirth to it???? Yes offcourse we can…But this is highly depends on how fast we act and how effectively we handle the avulsed tooth.

yes, there are certain procedures to be followed to preserve the structure from further damage so as to get the proper fixation of the same tooth without losing its quality and function.

It includes,

  • Hold the tooth only on the crown portion and DO NOT touch or scrap the root portion of the tooth ( touching the root portion will damage the periodontal ligament )
  • wash the tooth in the running water or milk for about 10 seconds. ( this ensures the wash off of infection)

3A3D7BAD-38A2-482F-8A2A-575EE991B694-2532-0000033701E51957

  • Rinse your mouth as well
  • Try to replace the tooth back into the socket using gentle, steady finger pressure ( do only if the person can able to tolerate the pain). Align the tooth properly and insert into the socket and hold it for 5 minutes

2D25A6CB-F011-4D5F-B7D5-1B155E8D36F0-2532-00000333811EA301

0622C69E-E1E3-4D1C-99C4-D8487D71C682-2532-00000334C72469DD

If the tooth cannot be replaced into the socket, then care in transporting that tooth to the dentist becomes essential. The tooth must be carried in a moist vehicle to maintain the viability of the torn periodontal ligament.

The tooth SHOULD NOT be wrapped in a dry handkerchief or paper tissue because the periodontal ligament will become dehydrated.

Commonly available transport medium for the avulsed tooth includes,

  • Raw milk ( either place the tooth in the cup of milk or in a plastic bag with milk and place it in the cup of ice cubes)

B5BAA249-56E2-41DD-A926-51CDFA7E32AC-2532-0000033F71D33393

  • Tender coconut
  • own saliva ( simply place the tooth in the mouth inbetween the cheeks and the gums)
  • Least preferably plain water

Other solutions includes,

  • HBSS (hanks balanced salt solution)
  • physiological saline solution

06107EC4-85E4-4918-937A-3752C64C6F64-2532-00000306CD518592

 

It is to be noted that extraoral time for an avulsed tooth optimally should not exceed 20 minutes for proper re plantation without quality degradation, the person must be taken to dentist immediately. The sooner the replantation, the better the prognosis.

 

References:

https://goo.gl/gDKXDGhttps://goo.gl/H447MAhttps://goo.gl/n5hKIZhttps://goo.gl/Hjn5QGhttps://goo.gl/oI2NHAhttps://goo.gl/PZda7Fhttps://goo.gl/QCHuLP

 

Choke and its management

Choking occurs when a foreign object enters into the windpipe and block any of its pathway. We generally encounter it while having food and we cough to expel it out. What if it doesn’t comes out?? What if it goes serious??? How serious it can go and what complication it can cause !!!

4D0CD8C2-277D-446D-92E1-8AFEA0744E90-912-00000118EAAB3D3E

Not only food, any foreign object entering the windpipe causes choke. When it occludes the airway, oxygen supply to the brain will start to deplete and now the alarm begins.

Signs and symptoms of choke includes,

  • Inability to talk
  • Inability to breath or very feeble breath
  • May or may not be able to cough

on severe condition

  • skin turns blue
  • victim becomes unconscious

How to manage if someone choke!!!

1) Back blow :

First position the victim slightly forward and give 5 continuous back blow inbetween the shoulder blades with the heel of your hand. If the object expels out, make the victim to most comfortable position.

2) Abdominal thrusts :

If the victim is not pregnant or too obese, and still the object is inside, give abdominal thrusts. Stand behind the victim and wrap around the waist. Place the clenched fist just above the navel and wrap the fist with the other hand. Give 5 quick inward and upward thrust as if lifting the whole body.

E1F9C521-8DB1-432D-8F46-BA7236CC66BF-912-00000119BD255FC6

 

Repeat both the process until the object expelled out or the person starts to breath or the person becomes unconscious.

Remove the object from the mouth only if you could see it. Do not simply sweep the finger inside the mouth as this may push the object more inward.

If there is no one to help, still abdominal thrust can be done by taking support from a hard object like chair or any counter top.

8CD6B5EB-0370-4D7B-9F66-F8286004414D-912-00000120E1CA11F4

 

If the person is pregnant or too obese, the chest thrust should be given by placing the fist little high to the normal position, more precisely at the base of the chest bone.

1383B1C0-76F4-4222-B4F6-0003DC3197A6-1521-000001956E2E0DC4

If the person becomes unconscious before or after the object expels out, call for the ambulance and start giving CPR Cardio pulmonary resuscitation (CPR)

References:
https://goo.gl/6ggLqj
https://goo.gl/msTKmm
https://goo.gl/k2s3CF
https://goo.gl/zo3Fui
https://goo.gl/P3ZruF
https://goo.gl/bNcmXo

 

 

 

Cardio pulmonary resuscitation (CPR)

Emergency is something that can occur anywhere, anytime and to anyone. It is very important to know how to manage it. Most of the time the emergency situation get worsen due to lack of awareness. It is not that only an expertise can handle the emergency situations. Anybody can give the basic life support(BLS), and expertise can take over to give the advance life support(ALS). Taking quick and appropriate step at the right time can save thousands of life.

so what is CPR and when it should be given???

It is very important to know that, when the brain deprive of oxygen supply for 4-10mins maximum, will leads to brain death. To say precisely, the brain will start losing its function when there is a lack of oxygen supply for 4 mins and it tries to withstand maximum upto 10mins. Longer the time, sooner will be the loss.

So when there is no breathing (respiratory arrest) and no blood circulation (cardiac arrest) , immediate action should be taken to preserve intact brain function until further measures are taken to restore spontaneous breathing and blood circulation. This process is called cardio pulmonary resuscitation or CPR. When the person becomes  unconscious/ unresponsive, CPR should be performed. 

4721AE89-CAC9-4187-8896-A926E946CA7D-14013-00000925EF817FAB

How to perform CPR???

There are certain steps to be followed to perform proper CPR.

  • Check the surroundings and call for ambulance
  • check for the response
  • Check A-B-C ( airway – breathing – circulation )
  • Mouth to mouth resuscitation
  • cardio pulmonary resuscitation

Check the surroundings and call for ambulance:

Whenever a person becomes unconscious, check for the reason. If the reason is out of any poisonous outbreak, do not attempt saving, first clear the spot(along with the victim if possible).

If the surrounding is clear, call the ambulance for the expertise support.

Check for the response:

If the victim is responsive and conscious, Put him in the comfortable position ( lying down flat with legs rised – this helps to increase blood circulation to the heart and brain)

Talking loud or shaking the body will be helpful to know the responsiveness. If the person is unresponsive or unconscious, it is time to initiate CPR

Check airway – breathing – circulation (ABC):

Make the victim to lie flat facing upward and losen the clothes. For clearing the airway, first make sure if there is no spinal injury. On that aspect,sit at one side(right/left) of the victim and push the forehead back and tilt the chin upward, this helps to free the airway from tongue obstruction.

D894545F-21B2-4E97-8CDA-4F05965DB1BD-14013-000009498C0D3C35

If the person have spinal injury, sit at the back and hold the lower jaw bone and push up. Do not tilt the neck

DE06EAC3-F9A9-45D6-B84A-10E18DE1D503-14013-0000094CD8D8587E.jpeg

For Breathing,

listen for the breath sound, look for chest expansion and by tactile sense of airflow. In some cases a mild roaring sound will be heard which should not be consider as breath.

D0D02868-C822-4709-A428-EDCF4CAB7F69-14013-0000095580D51921

For circulation,

Check the carotid pulse. Place the fingers on the adams apple and slide down on one side to reach the border of the trachea to feel the carotid pulse.

C6A8EACE-B852-4567-AEB2-A21803493E3D-14013-000009584D656D7B

Mouth to mouth resuscitation:

The above all process should be analyzed quickly say within a minute and no time should be wasted with this.

When there is no breathing but still the carotid pulse is palpable, mouth to mouth resuscitation should be initiated.

Either can use CPR pocket mask (which facilitates one way airflow) or on its absence can go for direct rescue breathing.

Sit on one side of the victim, after clearing the airway (by head tilt/chin lift method as mentioned above), close the nostrils ( this prevents the blowing air from escaping out) and give two slow breathing each for one second.

While doing this, chest expansion should occur, this ensures proper rescue breathing.

96557514-DAAA-40CC-A45B-A356B65F59A2-15415-0000096516A954ED

Now check for breathing again, if no improvement then repeat the process. Repeat one breath for every 5 seconds until the breath reverts back.

Simultaneously check for the circulation (carotid pulse). When there is no circulation (cardiac arrest), start with CPR.

Cardio pulmonary resuscitation:

When there is no breath and no blood flow, CPR should be initiated either with the help of artificial defibrillator or compressing manually.

For manual compression,

kneel down on one side of the victim, Elbow should be straight and force should be applied from the shoulder and not merely from the palms.

place the heel of one hand on the middle-lower portion of the sternum. To determine the exact location, place two fingers on the lower part of sternum where the ribs come together and place the heel of the other hand just above these fingers.

4085A2AC-61E9-4FFC-B002-5104E60828F5-15415-000009722351AFA5

Now take the other hand and interlock with this and start compressing the chest.

The compression force should be 2 inch depth. To combain chest compression and rescue breath, the ratio 30:2 is recommended. Meaning, for every 30 compressions, 2 rescue breaths are given. The rate of chest compression should be 100 pumps per minute.

53ACBBCC-FF8F-4AD1-932D-47F6D1344042-15415-000009787DE773B2

After every minute, breath and circulation should be accessed and the procedure should repeat until the air and blood flow reverts back or the emergency team arrives.

Providing timely help with our quick and immediate action will save someone from entering into gods glory. 

References:
https://goo.gl/IHJH4I
https://goo.gl/jAOx8i
https://goo.gl/OfKFOf
https://goo.gl/TQfosH
https://goo.gl/frzpZ5
https://goo.gl/ibTA4J
https://goo.gl/TiislU
https://goo.gl/4DETpx
https://goo.gl/9I0u5G

 

 

Relationship between the heart and the tooth

Dentist : Hi Mr.(name), good morning, what’s your problem!! How can i help you ???

Patient : I wanted you to pull my tooth out. It’s shaking and it is painful sometimes, giving so much of trouble, i cannot eat properly………….and its go on

Dentist : Ok ok relax…. yes, your gums are weak and no adequate bone support as well, we will treat it appropriately, not to worry about it. But before proceeding, i just wanted to know about your medical history…Do you have any medical complaints??so that i can plan accordingly!!!!

Patient : uhh…… …………. (blank)

( * mind voice – i have heart disease, diabetes, hypertension…..even i have done surgery in my heart….should i tell !!!!!

Just to remove this shaking tooth, this guy will send me back for an opinion….all unnecessary stuffs…i know i am fit enough to handle this, then why to tell him!!! Nothing going to happen…quick treatment will be done if i hide…….)

Dentist : Excuse me sir?????

Patient : Huh… No nooo…. i dont have any other medical complaints…. You can start the treatment directly

Dentist : Are you sure????

Patient : Ya ya, i am very much sure about it. I am completely fit 

Dentist : uhh……………..(blank)

(* Mind voice – oops……now how to find out yaar!!!!)

B97D12F3-2DA3-4538-8831-5599EEAB8A56-9514-0000078CEAB56577

Haha have you ever put your dentist to this situation!!!!! Ho please don’t… In this blog i will share a few things about the link between the heart disease and tooth related treatments.

There are three main reasons why your dentist is so much particular about knowing your heart condition if you have heart disease,

  • To get access on platelet and clotting factor mechanism
  • To have control over arrhythmia ( irregular or abnormal heart beat )
  • Role of micro organisms and infective endocarditis

To get access on platelet and clotting factor mechanism:

Blood thinner medicine are thumb rule tablets given to every cardiovascular complaint person. This helps to prevent from further clot formation on the blood vessels. But when the person wants tooth removal, intake of the same medicine will cause uncontrollable bleeding. It is to be noted that tooth and its supporting structures are highly rich in blood supply and it is difficult to control bleed when the blood clotting mechanism doesn’t respond properly.

At the same time it is highly NOT recommended to stop the drug just like that. Only the cardiovascular specialist knows the exact condition of every pumping organ. It is always advisable to have their opinion before taking the dental procedure. When the risk factor for the heart is more or on the moderate to severe illness condition, an alternative drug protocol will be recommended where an alternative antiplatelet drug takes up the role or the treatment regimen will be altered by the dentist. If the heart condition is under control, he may advise to go on with the procedure by stopping the drug for 5days or so…

* Person with the history of stroke or high blood pressure also will be prescribed with blood thinners. It is always better not to hide any medical history to the physicians.

To have control over arrhythmia:

As i said before, tooth structure is highly vascularised. In order to prevent excessive loss of blood during dental procedures, local anesthesia(LA) also contains a few percentage of “adrenaline ” in it. This helps for the constriction of the peripheral blood vessels thereby preventing from the excessive blood loss. Though adrenaline in the LA possess only very minimal percentage ( about 1:100000 dilution), for the person with uncontrolled blood pressure, this value is enough to shoot up the condition.

As like on blood vessels, the adrenaline has its own action on the pumping organ as well. Adr generally increases the heart rate and muscular contraction. So now when the person is having moderate to severe heart illness, this may worsen up. On such conditions LA without adrenaline is preferred if it is suggested by the cardiologists.

D43D9303-5062-41F0-BD66-93BCD2F31407-9674-000007CDFE141214

The role of micro organisms and the infective endocarditis:

It is well known that oral cavity is the main source of lodging micro organisms. Out of which, staphylococcus aureus and viridans streptococcus are the most predominant micro organisms which affect the inner wall of the heart called infective endocarditis. These bacteria quickly enters into the blood stream(bacteremia) to reach the heart valve. When the person is having heart valve defect or rheumatoid heart disease,  atmost care must be taken when going for the dental procedures. Antibiotic prophylaxis is a must for them. Without adequate precautionary steps, any procedures may end up into life threatening one.

EA3EF352-C13D-47E0-9F99-459BD63F3633-9674-000007CBD6FA432E

Not any medical history should be taken for granted. It is to be understood that human body is a complex structure and everything is inter connected…

 

References:

https://goo.gl/ym5BLv
https://goo.gl/x1O1Dd
https://goo.gl/UYV4zb
https://goo.gl/VN7kaD

 

A small change in our perception

One day,  a kid who was into his regular activities started noticing some sort of changes within him. He doesnt know what was that, but he felt it… He started to feel the difference so deep, he couldn’t resist himself from what was within him. Slowly he tried to change his appearance but still he found it hard to do so… The little heart pumped to search answer for himself… Why can’t he able to be like himself?? Why only he feel such difference within him and why not his friends??? His questions left unanswered..He felt so void and incomplete, made him to weep weep and weeppp…

But how long??? How long could he hold his breath??? Days passed…people started to notice his change in behaviour. His friends went apart( atleast their parents hold them), his playground went empty when he was in. His school wasn’t seems like before, he sat all alone in his desk, no one came nearby. He was cornered.

And so his parents too. They couldn’t take up this. Their concern was more on their society and not on their son. He was abused both physically and mentally. How long could he cry??? Neither family nor society accepted him from what he was going through. He mourn and mourn… But nothing helped him. He lost his temper, he crossed his threshold, he understood nothing going to help in holding him from what he was going through…

Finally he decided to let it go as how it goes. He changed his appearance, he changed his identity. He changed from HE TO SHE. He knew his house was no more his house, his family and friends were no more belongs to him, and so his school too. Still he felt happy to leave them. He found nowhere to the circle were he meant to be.

For an instant, let everyone of us put ourselves in the situation of how i narrated and feel how it would be!!!!!!!! Is that painful????? and so for them too….

Losing your indentity is not that easy to be accepted by yourself, then why to corner them????? What will they do if their hormones misbehave???? Why they have to be punishable for no crime????? Not even their fault rite!!!!!

That boy would have felt his first deep relief only after seeing the people of his own kind… Is that because they are all alike??? No, definitely not. It is all because ONLY THEY HAVE ACCEPTED HIM FOR WHAT HE IS. We (society) made them to move away. Ain’t that true!!!!

Oh my dear, are you scared of their rough and harsh behavior!!! May be yes, even i do!! But why they do so??what made them?? They consider it as their armed protection from this society, to overcome grieve they face...

All they need is a place for them in this society. A small change in our perception can give them a life.

Why cant we give a try !!!! How it would be, When all the institutions, all the forms and certificates, public places possess a special category called “Special gender or transgender” !!!

How it would be, when all of us address each of them with “Mx” !!!! They too do have emotions, they too strive to live a decent life in this society, to get a qualified education, to get a job to earn and to live and give…. They are not meant to beg for money but they left with no option… They actually beg for respect, to value their life, afterall they also own this motherland… Though a few institutions, companies and a few public places provide them a special place to move on, the ratio is very small… Irrespective of special provisions, let them to be one among us…

Let us widen our vision, to let them live…

 

Reference:

https://www.google.co.in/search?q=transgender+images&rlz=1C9BKJA_enIN659IN660&hl=en-GB&prmd=inv&tbm=isch&tbo=u&source=univ&fir=c0g2Hq4VF4r9yM%253A%252Cwe1ysp97GBY1MM%252C_%253BPTSB8xhDxZ1gGM%253A%252CeOXXbx4pVGjkyM%252C_%253BQaQRM9UXafLtcM%253A%252C5YrzIBwKYvNpUM%252C_%253BdTVejwrlzyDvfM%253A%252Cyh0Kz8Fbc-JzaM%252C_%253B6swGrcxikAGxAM%253A%252CXWmH-WF3KmeQgM%252C_%253BARgsS0F1dGQZQM%253A%252CFo0LrasDLeCawM%252C_%253BJSbkROp1Frg8rM%253A%252CwqOGx1PE9sXgZM%252C_%253BFuPWORgpZ_m-CM%253A%252CtuCI6atmGv6OkM%252C_%253Bx2Nje06A4K0LNM%253A%252C4c2ovuAMud4RoM%252C_%253BRouuNLsOCXdbxM%253A%252CLotjkyei6aWCHM%252C_%253BHdf9zSyFyccEWM%253A%252C3IpniT8rTkTLbM%252C_%253BZoAEUuMojtoOIM%253A%252Cp_hefvYetrS4LM%252C_%253B05pW1rJrBGIyRM%253A%252CqolQoFBSlhs9YM%252C_&usg=__2CRRLcHVBLBUMoTyLogGmdzqA1g%3D&sa=X&ved=0ahUKEwjCrZO74e_SAhXCGpQKHRKjAbwQ7AkINw&biw=768&bih=909#imgrc=QaQRM9UXafLtcM: