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Sindrom Nistagmus Infantil -, Elvira; Wibawa, Made Dwi Surya; Surasmiati, Ni Made Ayu
Cermin Dunia Kedokteran Vol 47, No 10 (2020): Optalmologi
Publisher : PT. Kalbe Farma Tbk.

Nistagmus berasal dari bahasa Yunani, nystagmos yang berarti mengangguk dan kata nystazein yang berarti mengantuk. Nistagmus merupakan gerakan involunter dan osilasi ritmik mata yang dapat fisiologis ataupun patologis. Angka kejadian nistagmus diperkirakan 24 per 10.000 populasiumum. Nistagmus infantil motorik atau sindrom nistagmus infantil (SNI) merupakan tipe nistagmus infantil yang paling sering.Onset dan manifestasi klinis dapat membantu diagnosis; pemeriksaan penunjang biasanya dilakukan pada usia diatas 6 bulan. Beberapa terapi di antaranya terapi optikal, terapi obat, terapi pembedahan untuk meningkatkan tajam penglihatan dan terapi pembedahan untuk merelokasi Null Zone ke posisi primer.Nystagmus, adopted from Greek nystagmos, means nodding and nystazein means sleepy. Nystagmus is involuntary movement and oscilation of the eye;may be physiologic or pathologic. Th incidence is about 24 in 10.000 population. Motor infantile nystagmus or infantile nystagmus syndrome is the most common type of infantile nystagmus. Diagnosis is based on onset and clinical manifestations; additional examination is for baby older than 6 months. Therapy is to improve visual acuity and surgery to relocate Null Zone to primary position.

GAMBARAN KUALITAS HIDUP PADA PASIEN STRABISMUS DI RUMAH SAKIT UMUM PUSAT SANGLAH DENPASAR PERIODE 2016 - 2017 Yovita Govert; Ni Made Ayu Surasmiati; Wayan Gede Jayanegara
E-Jurnal Medika Udayana Vol 10 No 4 (2021): Vol 10 No 04(2021): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2021.V10.i4.P05

ABSTRAK Strabismus merupakan kondisi dimana terdapat ketidaksejajaran antar kedua mata. Salah satu mata dapat terlihat lurus menuju suatu objek, sedangkan mata yang lain dapat terlihat mengarah ke dalam, ke luar, ke atas, ataupun ke bawah. Kondisi ini dapat mempengaruhi kualitas hidup pasien secara negatif. Namun, hingga saat ini, penelitian terkait strabismus maupun kualitas hidup pasien strabismus di Indonesia, khususnya di Bali masih sangat jarang dilakukan. Oleh karena itu, penelitian ini dilaksanakan dengan tujuan untuk mengetahui gambaran kualitas hidup pada pasien strabismus di Rumah Sakit Umum Pusat Sanglah Denpasar periode 2016 - 2017. Desain penelitian yang digunakan adalah deskriptif potong lintang. Pengumpulan data menggunakan teknik consecutive sampling dengan menggunakan data sekunder yang didapatkan dari data rekam medis pasien strabismus Rumah Sakit Umum Pusat Sanglah Denpasar pada periode 2016 - 2017 serta menggunakan data penelitian sebelumnya yaitu data yang diambil dari kuisioner Amblyopia & Strabismus Questionnaire (A&SQ) yang telah dilakukan sebelumnya. Dari 22 sampel pasien strabismus, ditemukan karakteristik umum sampel. Gambaran kualitas hidup pasien strabismus pada penelitian ini dinilai dari total skor A&SQ yaitu sebesar 63,88 (18,21) yang berarti bahwa kondisi strabismus mempengaruhi kualitas hidup pasien secara negatif. Walau setiap domain pada A&SQ mempengaruhi kualitas hidup, domain ‘kontak sosial serta kosmetik’ merupakan kontributor terbesar terhadap rendahnya kualitas hidup pasien strabismus. Kualitas hidup pasien strabismus juga dapat digambarkan dengan membandingkan total skor A&SQ dan skor domain A&SQ bedasarkan jenis kelamin, jenis deviasi, dan status pekerjaan. Kata kunci : strabismus, kualitas hidup, gambaran, mata juling

HbA1c and Serum Level of VEGF in Diabetic Retinopathy Patients Surasmiati N.M.A.; Wijayati, M.P; Pramita, I.A.A; Pantjawati, N.L.D.; Andayani, A.
Indian Journal of Forensic Medicine & Toxicology Vol. 16 No. 3 (2022): Indian Journal of Forensic Medicine and Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v16i3.18311

Objective: This study aims to determine whether HbA1c level has a correlation with vascular endothelial growthfactor (VEGF) serum level in diabetic retinopathy (DR) patients.Methods: This is an analytical cross-sectional study of patients with DR due to type 2 diabetes, with a purposivesampling technique. Patients were grouped into non-proliferative DR (NPDR) and proliferative DR (PDR). HbA1cand VEGF serum levels were assessed by taking the patient’s venous blood.Results: A total of 82 samples were included, in which the mean HbA1c levels were 8.17% ± 1.91% and the medianVEGF levels were 85.78 ng/L (range 38.23-149.43 ng/L). A total of 23 out of 35 NPDR patients were female (65.7%),while 29 out of 47 PDR patients were male (61.7%). Approximately 61.7% of PDR patients had a DM duration ofmore than 10 years, while 62.9% of NPDR patients had DM duration of less than 10 years. There was an increasein the mean of HbA1c levels in the PDR group compared to NPDR, although it was not statistically significant (p =0.214), and there was no difference in the median VEGF levels of the two groups. Spearman’s correlation analysisrevealed no correlation between HbA1 and VEGF levels in diabetic retinopathy, in both the NPDR and PDRgroups (correlation coefficient 0.183 and -0.022 respectively).Conclusion: No statistically significant correlation was found between HbA1c and VEGF serum levels in diabeticretinopathy patients. In this study poor glycemic control were not proven for their implications for VEGFprogression. VEGF serum levels may not be used as a marker of DR severity.

Sindrom Nistagmus Infantil Elvira -; Made Dwi Surya Wibawa; Ni Made Ayu Surasmiati
Cermin Dunia Kedokteran Vol 47, No 10 (2020): Optalmologi
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v47i10.1082

Nistagmus berasal dari bahasa Yunani, nystagmos yang berarti mengangguk dan kata nystazein yang berarti mengantuk. Nistagmus merupakan gerakan involunter dan osilasi ritmik mata yang dapat fisiologis ataupun patologis. Angka kejadian nistagmus diperkirakan 24 per 10.000 populasiumum. Nistagmus infantil motorik atau sindrom nistagmus infantil (SNI) merupakan tipe nistagmus infantil yang paling sering.Onset dan manifestasi klinis dapat membantu diagnosis; pemeriksaan penunjang biasanya dilakukan pada usia diatas 6 bulan. Beberapa terapi di antaranya terapi optikal, terapi obat, terapi pembedahan untuk meningkatkan tajam penglihatan dan terapi pembedahan untuk merelokasi Null Zone ke posisi primer.Nystagmus, adopted from Greek nystagmos, means nodding and nystazein means sleepy. Nystagmus is involuntary movement and oscilation of the eye;may be physiologic or pathologic. Th incidence is about 24 in 10.000 population. Motor infantile nystagmus or infantile nystagmus syndrome is the most common type of infantile nystagmus. Diagnosis is based on onset and clinical manifestations; additional examination is for baby older than 6 months. Therapy is to improve visual acuity and surgery to relocate Null Zone to primary position.

Tatalaksana bedah pada eksotropia traumatika et causa ruptur total otot rectus medial: laporan kasus Christine Natalia Gunawan; Ni Made Ayu Surasmiati; I Made Agus Kusumadjaja; Ni Made Laksmi Utari
Intisari Sains Medis Vol. 12 No. 1 (2021): (Available online : 1 April 2021)
Publisher : DiscoverSys Inc.

Introduction: Traumatic strabismus may result because of closed or open head and/or orbital trauma. Trauma to the extraocular muscles will often result directly in specific ocular motility disorders. Vertical transposition is one of the surgical management in traumatic exotropia with medial rectus muscle total rupture. The aims of case report are to know about examination and management in patient with traumatic exotropia.Case Illustration: Male, 30 years old, came with chief complaints pain on the right eye after being exposed a wire bounce when take off a banner wire, with squint eye, blurry vision, diplopia, redness, bleeding. On ophthalmology examination, 45° exotropia, visual acuity on the right eye 6/18 ph NI, proptosis, edema, hematom, spasm palpebral. Medial rectus muscle rupture, full thickness conjunctival rupture, cresent shaped, 15x7mm, 3 mm from limbal. Eyeball movement limited to medial, superomedial, inferomedial, FGT medial parese right eye (RE). visual acuity on the left eye 6/6, anterior and posterior segment within normal limit. Patient was diagnosed with traumatica exotropia et causa medial rectus muscle total rupture right eye (RE) with complication axial proptosis ec retrobulbar hemorrhage, palpebral hematom, full thickness conjunctival ruptured, sub conjunctival bleeding, erosion cornea, iridoplegy, traumatic iritis. Vertical transposition with augmented Hummelsheim technique, cantotomy cantolysis, repair conjunctival ruptured was done to the patient. Conclusion: Vertical transposition is one of the surgical management in traumatic exotropia caused by medial rectus muscle total rupture Pendahuluan: Eksotropia traumatik dapat disebabkan oleh adanya trauma terbuka/tertutup pada kepala/mata. Trauma pada otot ekstraokuler akan menyebabkan gangguan gerakan bola mata yang spesifik. Salah satu penanganan bedah pada eksotropia traumatik karena ruptur total otot rektus medial adalah dengan transposisi vertikal. Tujuan dari pembuatan laporan kasus in adalah untuk mengetahui pemeriksaan dan penanganan pasien dengan eksotropia traumatika.Laporan kasus: Pria dengan usia 30 tahun, datang dengan keluhan nyeri pada mata kanan setelah terkena pentalan kawat, disertai mata juling keluar, pandangan ganda, kabur, berdarah, mata merah. Pada pemeriksaan oftalmologi didapatkan eksotropia 45°, tajam penglihatan mata kanan 6/18 ph NI, dengan proptosis, edema, hematom, spasme pada palpebra. Pada konjungtiva didapatkan tampak ruptur rektus medialis, ruptur konjungtiva full thickness bentuk bulan sabit ukuran 15x7mm, 3 mm dari limbus. Gerakan bola mata terhambat ke medial, superomedial, inferomedial, Forced Generation Test (FGT) mata kanan paresis ke medial. Tajam penglihatan mata kiri 6/6, segmen anterior dan posterior dalam batas normal. Pasien didiagnosis dengan eksotropia traumatika et causa ruptur total otot rektus medial oculi dextra (OD) dengan komplikasi proptosis axial ec suspek pendarahan retrobulbar, hematom palpebral, ruptur konjungtiva full thickness, pendarahan sub konjungtiva, erosi kornea, iridoplegia, traumatic iritis. Pada pasien ini dilakukan transposisi vertikal dengan teknik augmented Hummelsheim, kantotomi kantolisis, dan repair ruptur konjungtiva full thickness. Simpulan: Transposisi otot rektus vertikal merupakan salah satu tindakan untuk tatalaksana pembedahan pada eksotropia traumatika et causa ruptur total otot rektus medial

Strabismus sebagai komplikasi pemasangan sclera buckle pada ablasio retina regmatogen: laporan kasus Pande Putu Adityo Ananta Ardika; Ari Andayani; Ni Made Ayu Surasmiati; Ni Made Ari Suryathi; I Made Agus Kusumadjaja
Intisari Sains Medis Vol. 12 No. 3 (2021): (Available online: 1 December 2021)
Publisher : DiscoverSys Inc.

Introduction: Sclera buckle is one of the operative management of rhegmatogenous retinal detachment. Sclera buckle can combine with vitrectomy in young people, phakic, myopia more than 6 dioptri, axial length more than 26mm, proliferative vitreoretinopathy stage C, multiple inferior break and recurrent break. Complications from the installation of sclera buckle is one of them the occurrence of strabismus after the installation of sclera buckle. Treatment can be done to remove the sclera buckle and further surgery for extraocular muscle.Case Description: Male patients aged 31 years, patients present with complaints right eyes rolling inward since 8 months ago. The patient had a history of surgical sclera buckle and tamponade with silicone oil. Patient also complain blurry vision since 1 month ago after removing silicone oil. The patient has a history of -5.00 glasses in both eyes. In examination obtained Hirschberg esotropia 15 degrees and retinal detachment on right eyes. Patient was diagnosed with right eye Detached Retina post evacuation of silicone oil (16 days), acquired esotropia Suspect et cause sclera buckle installation. Patients are planned to undergo Re-Vitrectomy Pars Plana (VPP), Release Sclera Buckle , Endolaser, Silicon Oil tamponade, and evaluation of extraocular muscle at surgery. During evaluation of extraocular muscle there was fibrosis cover four rectus muscle and no tear was found. Then we removed of fibrosis and released sclera buckle. Strabismus complaint did not feel better after removed of fibrosis so we planned for further action was medial rectus recess with adjustable sutureConclusion: Sclera buckle can combine with vitrectomy on young people, phakic, myopia more than 6 dioptri, axial length more than 26mm, proliferative vitreoretinopathy, multiple inferior break and recurrent break. Installation of sclera buckle can cause complications in the form of postoperative strabismus. One of the causes of this complication is fibrosis of the extraocular muscles, so there is an attachment called fat adherent syndrome. Treatment that can be taken to treat strabismus after sclera buckle surgery is one of them with the release of sclera buckle, but if strabismus complaints did not improve, surgery can be done on extraocular muscles to improve the position of the ball Pendahuluan: Sclera buckle merupakan salah satu tindakan operatif dalam menangani ablasio retina regmatogen. Tindakan sclera buckle dapat dikombinasikan dengan vitrektomi pada orang muda, phakia, riwayat miopia lebih dari 6 dioptri, panjang bola mata lebih dari 26 milimeter, ditemukan adanya proliferatif vitreoretinopati stadium C, robekan multiple pada bagian inferior retina dan robekan berulang. Komplikasi dari pemasangan sclera buckle ini adalah salah satunya terjadinya strabismus pasca pemasangan sclera buckle. Penanganan yang dapat dilakukan berupa pelepasan sclera buckle, dan operasi strabismus jika kondisi otot ekstraokular tidak membaik.Deskripsi Kasus: Pasien laki-laki, usia 31 tahun, datang dengan keluhan mata kanan bergulir ke dalam sejak 8 bulan yang lalu. Keluhan dirasakan setelah pasien melakukan operasi pemasangan sclera buckle dan silicon oil 8 bulan yang lalu. Saat ini pasien juga mengeluhkan pandangan kabur yang sudah dirasakan sejak 1 bulan yang lalu setelah dilakukan pengangkatan silicon oil. Pada pemeriksaan ditemukan Hirschberg esotropia 15 derajat dan ditemukan ablasio retina pada mata kanan. Pasien didiagnosis dengan okuli dekstra rekuren ablasio retina pasca pengeluaran silicon oil (16 hari), dan kecurigaan esotropia didapat (acquired esotropia) ec pasca pemasangan sclera buckle. Pasien direncanakan untuk dilakukan Re-Vitrektomi Pars Plana (VPP), pelepasan sclera buckle, endolaser, re-tamponade silicon oil dan evaluasi otot ekstraokular durante operasi. Pada saat dilakukan evaluasi otot ekstraokular ditemukan adanya fibrosis pada keempat otot rektus dan tidak ditemukan adanya robekan pada otot ekstraokular. Kemudian dilakukan pembersihan dari fibrosis dan pelepasan dari sclera buckle. Keluhan strabismus tidak dirasakan membaik pasca dilakukan pembersihan fibrosis sehingga direncanakan untuk dilakukan tindakan lanjutan yaitu medial rectus reses dengan adjustable suture.Simpulan: Tindakan sclera buckle ini dapat dikombinasi dengan vitrektomi pada pasien muda, phakia, riwayat miopia tinggi lebih dari 6 dioptri, panjang bola mata lebih dari 26 milimeter, ditemukan adanya proliferatif vitreoretinopati, robekan multiple di bagian inferior retina dan robekan berulang. Pemasangan sclera buckle ini dapat menimbulkan komplikasi berupa strabismus pasca operasi. Penyebab dari terjadinya komplikasi ini salah satunya fibrosis pada otot ekstraokular sehingga terjadi perlekatan yang disebut dengan fat adheren syndrome. Tindakan yang dapat dilakukan untuk penanganan strabismus pasca operasi sclera buckle ini adalah salah satunya dengan pelepasan dari sclera buckle, namun apabila keluhan strabismus tidak membaik bisa dilakukan operasi pada otot ekstraokular untuk memperbaiki posisi bola mata.

Sindrom Nistagmus Infantil Elvira; Made Dwi Surya Wibawa; Ni Made Ayu Surasmiati
Cermin Dunia Kedokteran Vol. 47 No. 8 (2020): Oftalmologi
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v47i8.577

Nistagmus berasal dari bahasa Yunani, nystagmos yang berarti mengangguk dan kata nystazein yang berarti mengantuk. Nistagmus merupakan gerakan involunter dan osilasi ritmik mata yang dapat terjadi secara fisiologis ataupun patologis.2 Angka kejadian nistagmus diperkirakan 24 per 10.000 populasi umum. Nistagmus infantil motorik atau sindrom nistagmus infantil (SNI) merupakan tipe nistagmus infantil yang paling sering terjadi. Onset dan manifestasi klinis dapat membantu diagnosis; pemeriksaan penunjang biasanya dilakukan pada usia di atas 6 bulan. Beberapa terapi di antaranya terapi optikal, terapi obat, terapi pembedahan untuk meningkatkan tajam penglihatan, dan terapi pembedahan untuk merelokasi Null Zone ke posisi primer. Nystagmus, adopted from Greek nystagmos, means nodding and nystazein means sleepy. Nystagmus is involuntary movement and oscilation of the eye;may be physiologic or pathologic. The incidence is about 24 in 10.000 population. Motor infantile nystagmus or infantile nystagmus syndrome is the most common type of infantile nystagmus. Diagnosis is based on onset and clinical manifestations; additional examination is for baby older than 6 months. Therapy is to improve visual acuity and surgery to relocate Null Zone to primary position.

Strabismus Surgery for Traumatic Ocular Misalignment: Twelve Cases in Five Years: Poster Presentation - Case Series - Ophthalmologist NI MADE AYU SURASMIATI; NI LUH MADE NOVI RATNASARI; KEVIN ANGGAKUSUMA HENDRAWAN; I WAYAN EKA SUTYAWAN
Majalah Oftalmologi Indonesia Vol 49 No S2 (2023): Supplement Edition
Publisher : The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35749/pdg34475

Introduction : Trauma can cause an ocular misalignment due to damage of extraocular muscles, nerves and orbital tissue around the eye. Direct trauma causing extraocular muscle rupture needs immediate surgery, meanwhile indirect trauma resulting in traumatic sixth nerve palsy or other reversible ocular misalignment without orbital floor fracture can be observed for six months. This study describe the characteristic of patients undergo single-step strabismus surgery for traumatic ocular misalignment, mechanism of injury, eye alignment, amount of ocular deviation before and after strabismus surgery. Case Illustration : This was a case series based on medical record of patients underwent strabismus surgery secondary to head or eye injury from 2017 until 2022. Discussion : Twelve individuals with post-traumatic strabismus correction participated in this study. All subjects were male age ranging from 18-51 years. Direct trauma was observed in 6 (50%) patients causing medial rectus muscle rupture in 4 patients and inferior rectus muscle rupture in 2 patients. Indirect trauma was observed in 6 (50%) patients caused by sixth nerve palsy on 4 patients The misalignment was exotropia, esotropia, and hypertropia with amount of 5, 4, and 3 respectively. The deviation was between 30-90 prism dioptre (PD) and 7 (58%) patients had deviation less than 65 PD. Strabismus surgery performed was muscle transposition with or without recession of the antagonist muscle. Conclusion : Single step surgery for traumatic ocular misalignment can provide good result in cases of deviation less than 65 PD

DIAGNOSING OCULAR MALINGERING IN CHILDREN WITH SIMPLE TEST: IS IT POSSIBLE? Poster Presentation - Case Report - Resident KEVIN ANGGAKUSUMA HENDRAWAN; NI MADE AYU SURASMIATI; I WAYAN EKA SUTYAWAN; ANAK AGUNG DEWI ADNYA SWARI; MADE KUSUMA WARDANI
Majalah Oftalmologi Indonesia Vol 49 No S2 (2023): Supplement Edition
Publisher : The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35749/c3exwd43

Introduction : Malingering is a condition in children which need a thorough and meticulous examination to diagnose the condition. According to several publication, simple test can be done to diagnose this condition without necessarily performing imaging and electrophysiologic tests. Case Illustration : An 8-year-old male patient, came to eye clinic with sudden visual loss on both eyes for the last 3 days, following pain on both eyes and headache which fluctuating over the last 3 weeks. Patient insisted on wearing black glasses during examinations. Preliminary examination revealed visual acuity no light perception on both eyes. Slit lamp examination and pupillary reflex were normal, fundus examination revealed normal fundus. We tried to do surprise test by suddenly swaying hand towards patient’s eyes and record a visual response. Afterwards we asked patient’s parent to wait outside while performing LEA test which revealed visual acuity 6/6 on both eyes. Further history taking revealed that patient got bullied on school that makes him try to avoid attending school. Discussion : Patient with malingering usually come with decreased vision but seldomly come with blindness. Though it was quite challenging, doing some simple test available in daily practice such as surprise test can help us to diagnose the suspicion. Handling such patient needs a cautious analysis towards patient’s condition and gentle approach towards the patient. It is crucial to rule out organic condition before diagnosing patient with malingering. Conclusion : Simple test such as surprise test can be done in assisting malingering diagnosis when carefully done with the support of thorough history taking and physical

Different Retinopathy of Prematurity Severity, Onset Therapy and Outcomes in Triplet Babies: A Case Report: Poster Presentation - Case Report - Resident PUTU ANINDYA AGRASIDI; I WAYAN EKA SUTYAWAN; NI MADE AYU SURASMIATI
Majalah Oftalmologi Indonesia Vol 49 No S2 (2023): Supplement Edition
Publisher : The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35749/1de12078

Introduction : Retinopathy of prematurity (ROP) is a vasoproliferative disease of the premature infants, characterized by abnormal vascularization at the junction of vascular and avascular retina. Intravitreal anti-VEGF injection is one of promising management of ROP. The aim is to present the therapy outcomes of triplet babies with different severity and onset therapy. Case Illustration : This case shows ROP in triplets born at 25-26 weeks gestational age. First baby, weighed 630 g with Bilateral Stage 2 Zone II Posterior with Plus Disease treated with intravitreal ranibizumab injection at 11 weeks (PMA 36-37 weeks). Second baby, weighed 620 g and get bilateral intravitreal ranibizumab injection a week after first baby, left eye got worse on first week, but getting better on the last follow up. Third Baby, weighed 750 g with bilateral Stage 3 Zone I with Plus Disease (worst eye condition), but because he had worst general condition, so the latest got screening, got no intervention. Two babies were treated with anti-VEGF therapy – bevacizumab. All babies has outcome regression, no recurrence of ROP in those short term end point, and no adverse reactions were observed until the last follow up at 27 weeks old (PMA 52-53 weeks) recorded for all babies. Discussion : Conclusion : Primary prevention through well-managed screening programme for premature infants was the more effective way to manage the ROP. Intravitreal anti-VEGF treatment could be promising for management of ROP if it was given on the right time and early stadium.

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