View of गर्भावस्था की सामान्य एवं गम्भीर स्वास्थ्य समस्याओं का एक सूक्ष्म अध्ययन

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xHkkZoLFkk dh lkekU; ,oa xEHkhj LokLF; leL;kvksa dk ,d lw{e v/;;u fnO;k dqekjh

'kks/k Nk=k] x`gfoKku jk¡ph fo'ofo|ky;] jk¡ph >kj[kaM xÒkZ/kku dh fØ;k ds i'pkr~ u;s tho ds

fodkl dh ÁfØ;k ÁkjEÒ g¨ tkrh gSA bl voLFkk d¨ xÒkZoLFkk ¼Pregnancy½ dgk tkrk gSA xÒkZoLFkk ,d ÁkÑfrd lq[k gSA ,d nEifr ds thou dk lcls lq[kn {k.k g¨rk tc mUgsa larku lq[k dh ÁkfIr g¨rh gSA eka cuus ds mijkUr gh ,d L«kh iw.kZ ekuh tkrh gSA xÒkZoLFkk esa vkdj v©j f'k'kq d¨ tUe nsdj L«kh ekr`Ro dk vf/kdkj ikrh gSA efgYkk ds thou dkYk esa xÒkZoLFkk ,oa f'k'kq i¨"k.k dk le; cM+k gh uktqd g¨rk gSA f'k'kq tUe v©j xÒkZoLFkk ds n©jku dh le; lhek dk LokLFkh; ewY;kadu vfr vko';d g¨rk gSA

,d xÒZorh L«kh ds fYk, cPps dkss tUe nsuk ,d u, thou d¨ ikus ds rqY;

g¨rk gSA L«kh ds iwjs xÒZdkYk d¨ 3 «©ekfld esa ckaVk x;k gSA

xÒZ/kkj.k ls 3 ekg rd & ÁFke «©ekfld 4 ekg ls 6 ekg rd & f}rh; «©ekfld 7 ekg ls 9 ekg ¼tUe rd½ & r`rh;

=Sekfld

vFkkZr~ dqYk feYkkdj iwjk xÒZdkYk 40 lIrkg dk g¨rk gSA xÒkZoLFkk ds u© eghusa efgYkkv¨a ds fYk, cM+s mrkj p<+ko okY¨ g¨rs gSA ÁR;sd «©ekl esa xÒZorh d¨ cgqr lh LokLF; lEcfU/kr leL;kv¨a dk lkeuk djuk gS ;fn ÁkjEÒ esa budh tkudkjh u g¨ ik, vFkok le; ij budk mipkj u fd;k tk r¨

bldk nq"ifj.kke xÒZLFk f'k'kq ,oa xÒZorh n¨u¨a ij iM+rk gSA

ruko] otu c<+uk flj esa nnZ g¨uk]

ekfuZax fldusl] Òw[k u Ykxuk] vfuæk] dCt tSlh dbZ ijs'kkuh ls YkxÒx gj xÒZorh L«kh dks n¨ pkj g¨uk iM+rk gSA Y¨fdu bu lkekU;

leL;kv¨a ds lkFk xÒkZoLFkk ds bu u© eghu¨a esa dqN xEÒhj LokLF; leL;k,a Òh g¨ ldrh gS ftlds ckjs esa xÒZorh efgYkk d¨ tkuuk csgn t:jh g¨rk gSA vkt 21oha lnh ds nkSj esa gekjh Hkkxe nkSM+ dh ftUnxh esa vkt ds ifjos'k esa f'k'kq j{kk dks ysrs gq, LokLF; ds izfr T;knk laosnu'khy jgus dh vko';drk gSA

xÒkZoLFkk esa g¨us okYkh lkekU; LokLF; leL;k,a

↓

↓ ↓ ↓ ↓ ↓ ↓ ↓ ↓

izkr% dky th fepyuk

is'kh; ,saBu ckj&ckj is'kkc vkuk

dCt coklhj vfunzk nUr {kj.k f'kjkvksa dk

Qwy tkuk

↓ ↓ ↓ ↓ ↓ ↓ ↓ ↓

lek/kku

 fcLrj ls mBus ls igys ehBk@rh[kk [kk,a

 FkksM+s&Fk¨M+s vUrjky ij [kk,a

 ozr miokl ls ijgst

lek/kku

 lqcg@'kke /khjs&/khjs Vgyuk

 iSj dks FkksMk Å¡pk djds lksuk

 dSfY'k;e]

iksVSf'k;e]

eSXuhf'k;e

;qDr vkgkj ys

lek/kku

 mÙ¨td inkFkZ dk lsou de djsa

 oSfYod ¶Yk¨j O;k;ke djsaA

 is'kkc j¨ds ugÈ

lek/kku

 rjYk inkFkZ dk lsou T;knk djs

 fu;fer 'k©p fuo`fÙk

 Ò¨tu esa js'¨nkj [kk|

inkFkZ dk lekos'k

 Á¨Vhu]

dSfY'k;e ;qä vkgkj

lek/kku

 rjYk inkFkZ dk lsou

 js'¨;qä inkFkZ dk T;knk Á;¨x

 fepZ@elkY¨nkj Ò¨tu ls ijgst

lek/kku

 lknk lqikP;

Ò¨tu

 vkjkenk;d oó igus

 ruko] fpUrk eqä jgsA

 'kkUr laxhr lqus

lek/kku

 vkgkj esa i;kZIr ek«kk esa Ca, Fe foVkfeu Mh], dk lekos'k

 nw/k o nw/k ls cus inkFk¨±

dk vkgkj esa mi;¨x

lek/kku

 isM+w dh iÍh dk Á;¨x

 Å¡ph ,M+h dk pIiYk u igus

 iSj dk Fk¨M+k Å¡pk djds l¨,a

1- Ákr%dkYk th fepYkkuk

xHkkZoLFkk ds nkSjku vf/kdka'k fL=;ksa dks th fepykus dh f'kdk;r gksrh gSA vDlj tc xHkZorh L=h lqcg lksdj mBrh rks mls mcdkbZ vkrh gSA ;g d"V xHkZ ds izFke ekg ls ysdj pkSFks ekg rd jgrk gSA blds ckn

Lor% lekIr gks tkrk gS ijUrq dqN xHkZorhL=h esa ;g leL;k iwjs xHkZdky ds le; jgrh gSA 'kks/kks ls Li"V gksrk gS fd yxHkx 80 izfr'kr xHkZorhL=h dks izFke

=Sekl esa ekfuZx fldusl dh leL;k gksrh gSA

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fpfdRldksa ds vuqlkj Morning Sickness dk dkj.k xHkZorh L=h dh laosxkRed vfLFkjrk gS TkSls izFke izlo ds dkj.k Hk;] vkfFkZd v;ksX;rk] ifjokj dk dygiw.kZ okrkoj.k bR;kfnA blds vfrfjDr ,LVª¨tu gke¨Zu ds Lrj esa o`f) ekuo d¨fj;¨fud xükM¨VªkfQu] xSfLVªd leL;kvä v©j i¨"k.k lEcU/kh dfe;ä ds c<+us ds Lrj ds dkj.k g¨rh gSA

lek/kku

 lqcg fcLrj ls ckgj fudYkus ls igY¨ dqN uedhu ;k dqN rh[kk [kkus dh d¨f'k'k djuk pkfg,A

 Ò¨tu d¨ de ek«kk esa N¨Vs&N¨Vs varjkYk ds ckn [kk,aA

 vnjd dh pk; ihus ls ;k uÈcw dh [kq'kcw ls ferYkh 'kkUr djus esa enn feYkrh gSA

 elkY¨nkj] xfj"B ,oa olk;qä Ò¨tu ugÈ nsuk pkfg,A

 xÒZorh L«kh d¨ ozr o miokl ls ijgst djuk pkfg,A

2- lhus esa tYku

lhus esa tYku dh f'kdk;r xÒkZoLFkk ds vfUre «©ekl esas vf/kd vuqÒo g¨rk gsA xÒZLFk f'k'kq dk c<+rk Òkj ekrk ds mnj dh v¨j ncko MkYkrk gS] ftlls dkfMZ;d laoj.kh

¼Cardiac-Sphinecter½ <hYkh g¨ tkrh gSA rFkk vkek'k; ds inkFkZ iqu% xzkluyh esa ig¡qpdj muesa fp< ¼Irritation½ mRié djrs gSaA

tuZy vkWQ ,YktÊ v©j fDYkfudYk bE;wuŸkkWth esa Ádkf'kr ,d 'kks/k 2017 ds v/;;u ls Kkr gksrk gS fd xÒkZoLFkk ds n©jku gkVZcuZ dh nok Yüs okYkh ekrkvä ls iSnk güs okY¨ cPpä esa vLFkek dk t¨f[ke g¨

ldrk gSA lek/kku

 Ò¨tu djus ds 2&3 ?k.Vs ckn gh l¨uk pkfg,A

 Ò¨tu esa QYk o lYkkn dk Òjiwj Á;¨x djuk pkfg,

 fepZ elkY¨ nkj Ò¨tu ugÈ djuk pkfg,A

 Ò¨tu vPNs ls pckdj [kk,aA

 1 di xeZ ikuh esa 1 cM+k pEep lsc dk fljdk feYkk,a o fnu esa n¨ ckj fi,aA

 'kjhj esa ikuh dh deh u g¨us nsaA

 [kkus ds chp esa rjy inkFkZ u fi,aA

 Ykglqu dh j¨tkuk ,d Qkad [kkus ls lhus dh tYku esa jkgr feYkrh gSA 3- is'kh; ,asBu

Vkax¨ esa ,asBu xÒkZoLFkk esa ,d vke leL;k gSA ;g leL;k eq[;:i ls nwljs v©j rhljs frekgh esa g¨rk gSA xÒkZoLFkk ij gq, dbZ 'k¨/k¨a esa ;g ik;k x;k gS fd 5 ls 75 Áfr'kr xÒZorh efgYkkv¨a esa is'kh; ,saBu dh leL;k xÒkZoLFkk ds vfUre «©ekl esa g¨rh gSA

is'kh; ,saBu dk dkj.k vkgkj esa dSfY'k;e dh dehgSA izkstsLVªkWu gke¨Zu iSj¨a dh ekalisf'k;¨a d¨ ÁÒkfor djrk gSa ;g ,saBu]

Fkdku v©j okVj fjVsa'ku ds dkj.k jkr esa vf/kd g¨rk gSA

CYkM Ás'kj ds fYk, ew«ko/kZd nok,a Y¨us ls [kfut dh deh g¨ ldrh gSA cgqr de dSfY'k;d] i¨Vsf'k;e v©j eSXuhf'k;e dh ek«kk iSj¨a esa ,sBu iSnk dj ldrh gSA

xÒkZ'k; ds c<us ls iSjä ls ân; rd jä d¨ LFkkukarfjr djus okYkh ulä ij ncko curk gS ftlls iSjä esa ,sBu dh f'kdk;r g¨rh gSA

lek/kku

 lqcg&'kke /khjs&/khjs VgYkuk pkfg,A

 l¨rs le; iSj¨a ds uhps rfd;k j[kdj l¨uk pkfg,A

 vkgkj esa dSfY'k;e] i¨VSf'k;e]

eSXuhf'k;e dh Òjiwj ek«kk Y¨uh pkfg,A

 ikuh [kwc ih,a] ukfj;Yk ikuh fi,a ftlls bY¨DVª¨YkkbV larqYku cuk jgsA 4- ckj ckj is'kkc vkuk

;g leL;k xÒkZoLFkk ds 2&3 ekg ls ÁkjEÒ g¨dj 4&5 ekg rd pYkrh gS blds ckn de

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g¨ tkrh gS ,oa iqu% xÒkZoLFkk ds vfUre

«©ekl esa ckj&ckj is'kkc vkus dh leL;k rhoz g¨ tkrh gSA

bl leL;k dk eq[; dkj.k xÒkZ'k;

v©j ew«kk'k; dk ikl ikl g¨uk gSA xÒkZ'k;

dk vkdkj c<+us ds dkj.k ew«kk'k; ij ncko iM+rk gS ftlls ckj ckj is'kko dh leL;k c<+rh gSA

HCG gke¨Zu t¨ xÒkZoLFkk ds n©jku lfØ; g¨rk gS] vR;f/kd is'kkc vkus dk Áeq[k dkj.k gSA ;g isfYod {¨«k v©j xqnsZ dh v¨j jä Áokg c<+krk gSA ftlls 'kjhj fo"kkä inkFkZ ls NqVdkjk ikus dh d¨f'k'k djrk gSA

ew«k ekxZ dk laØe.k Òh ckj&ckj is'kkc vkus dk eq[; dkj.k gSA Òkjr esa xÒkZoLFkk esa ew«kekxZ dk laØe.k dhlEHkkouk YkxÒx 3 Áfr'kr ls 24 Áfr'kr gSA

lek/kku

 mÙ¨td inkFkZ pk;] dkWQh dk lsou de ls de djsA

 iSfYod ¶Yk¨j O;k;ke djus ls ew«k vla;e d¨ j¨dk tk ldrk gSA

 is'kkc d¨ j¨ds ugÈ] is'kkc d¨ j¨dus ls isfYod {¨«k dh ekal isf'k;k det¨j g¨ tkrh gSA

5- dCt

YkxÒx 90 Áfr'kr efgYkkv¨a d¨ xÒkZoLFkk ds n©jku dCt dh f'kdk;r jgrh gSA bl voLFkk esa Á¨tsLVjkWu ¼Progesterone½ uked gkeksZu dk L=ko.k vf/kd gksrk gS ftlls isf'k;kaW eqyk;e gksdj <hyh gks tkrh gaSAA

vkWCLVsfVªDl vkSj xk;uksykWth ¼2007½ esa Ádkf'kr ,d v/;;u esa crk;k x;k fd

xÒkZoLFkk ds n©jku yxHkx ,d p©FkkbZ efgykvksa dks xÒkZoLFkk ds rhu eghu¨a ds ckn dCt ÁÒkfor djrh gSA

Yk©g rRo ds lsou ls Òh ekalisf';ka<hYkh g¨dj Ykpdnkj g¨ tkrh gS t¨ dCt dk dkj.k curh gSA

xÒkZ'k; dk vkdkj c<+us ds dkj.k vkar¨a ij nokc iM+rk gS ftlls Ò¨tu ipus esa nqfo/kk g¨rh gS ftlds dkj.k dCt dh leL;k mRié g¨rh gSA

lek/kku%

 vR;f/kd rjYk inkFkZ rFkk tYk dk lsou djsaA

 Ò¨tu esa js'¨nkj [kk| inkFk¨aZ dk mi;¨x djsaA

 fu;fer 'k©p fØ;k ls fuo`Ùk g¨a A

 i;kZIr ek«kk esa Á¨Vhu v©j dSfY'k;e

;qä vkgkj Y¨aA 6- coklhj%

Ykxkrkj dCt dh f'kdk;r jgus ds dkj.k eYk}kjk dh f'kjk;sa QwYkdj e¨Vh g¨ tkrh gS rFkk 'kq"d eYk fu"dklu ds le; f'kjk;sa QV tkrh gSaA ftlls jä lzko g¨us Ykxrk gSA

rhljs frekgh esas YkxÒx 85 Áfr'kr xÒZorh efgYkkv¨a d¨ coklhj dh leL;k g¨rh gSA

lek/kku

 Ò¨tu esa vf/kd ls vf/kd rjYk inkFk¨Z dk lekos'k djsaA

 js'¨;qä [kk| inkFk¨Z dk Á;¨x T;knk ls T;knk djsaA

xÒkZoLFkk ds n©jku g¨us okYkh xEÒhj LokLF; leL;k,a

↓ ↓ ↓ ↓ ↓

jDrvYirk mPpjDr pki e/kqesg xHkZikr gkbijbesfll xzsfoVsje

↓ ↓ ↓ ↓ ↓

lek/kku

 gjh iÙ¨nkj lfCt;¨a dk lsou

 Q¨fyd ,flM ,oa vk;ju dh x¨Ykh dk lsou

 nw/k ,oa nw/k ls cus inkFk¨Z dk lsou

 foVkfeu lh dk lsou

lek/kku

 vkgkj esa ued dk de Á;¨x

 ruko eqä jgs

 fu;fer LokLF;

ijh{k.k

lek/kku

 'kdZjk o LVkpZ ;qä vkgkj ls ijgst

 XYkwd¨t Lrj lkekU; ls Åij u g¨A

 otu u c<+us nsA

lek/kku

 xÒZorh d¨ iw.kZ vkjke djuk pkfg,

 larqfYkr o i©f"Vd Ò¨tu djsaA

 lkQ&lQkbZ dk /;ku j[¨aA

 fpfdRld dh ns[k&js[k esa jgsaA

lek/kku

 ruko eqä jgsA

 xfj"B o olk;qä Ò¨tu ls ijgst

 Ò¨tu ds lkFk T;knk ikuh u ih,aA

 gYdk QqYdk O;k;ke djs

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1- jäghurk

xÒkZoLFkk ds n©jku jäghurk xÒZorh efgYkkv¨a esa e`R;q dk eq[; dkj.k gSA xÒkZoLFkk ds n©jku fge¨XYk¨fcu dk Lrj 7-0

gm/dl xaÒhj jäghurk dh v¨j ladsr djrk gS ,oa tc fge¨XYk¨fcu dk Lrj 7-0 ls 9-9-0 gm/dl g¨ rce/;e jäghurk dh v¨j ldsr djrk gS ,oa fge¨XYk¨fcu 10-0 ls 11

gm/dl g¨ r¨ fge¨XYk¨fcu dk Lrj lkekU;

ekuk tkrk gSA

,d xÒZorh ds fYk, Yk©g rRo dh vko';drk lkekU; efgYkk dh vis{kk T;knk g¨rh gS D;¨afd xÒZorh efgYkk d¨ Lo;a ds fYk, ,oa xÒZLFk f'k'kq ds fodkl ds fYk, Yk©g rRo dh vko';drk g¨rh gSA

xÒZorh efgYkk ds 'kjhj esa [kwu dh deh foVkfeu ch dh deh ds dkj.k g¨ ldrh gSA

ikrkA

lek/kku%

 xÒZorh d¨ vius vkgkj esa gjh iÙ¨nkj lfCt;¨a dk lekos'k djuk pkfg,A

 Áfrfnu YkxÒx 70 gm izksVhu dks fofHkUu :i¨a esa lfEefYkr djuk pkfg, tSls&nw/k nw/k ls cus inkFkZ] v.Mk]

nkYk bR;kfn

 Q¨fYkd ,flM ,oa vk;ju dh x¨Ykh dk lsou fu;er% djuk pkfg,A 2- mPp jä pki

oSf'od Lrj ij 10 Áfr'kr xÒkZoLFkk mPpjä pki ds dkj.k tfVYkrk dk f'kdkj g¨rk gSA Áh ,DYËifl;k] ,DYËifl;k ÁloiwoZ e`R;q dk eq[; dkj.k gSA YkxÒx 5&7 Áfr'kr xÒZorh efgYkk,a Áh&,DYËifl;k ls ÁÒkfor g¨rh gSA fofÒé 'k¨/k v/;;uä ls Li"V gqvk gS fd e¨Vkik ds dkj.k xÒkZoLFkk ds n©jku 10 xquk mPp jäpki fodflr güs dh lEÒkouk g¨rh gSA

lekkU;r% ,d L=h dk jä pki 110&120@70&80 mm Hg jgrk gS] ijUrq

fo"kkDrrk dh fLFkfr esa jäpki 130@90 mm Hg g¨ tkrk gS bl jDrpki ls LokLF; ij dksbZ cqjk izHkko ugha iM+rk ijUrq 130@90

mm Hg ls T;knk jDr pki gksus ij xHkZorh o xHkZLFk f'k'kq nksuksa ij gh izfrdwy izHkko iM+rk gSA

vkgkj esa iks"kd rRoksa dh deh ,oa izloiw.kZ mfpr ns[kHkky u gksus ds dkj.k mDrjDrpki dh leL;k tUe ys ldrh gSA lek/kku%

 vkgkj esa 5&6 gm ued dk iz;ksx djsaA

 ruko eqDr jgsaA

 xfj"B Hkkstu ls cpsaA

 fu;fer LokLF; ijh{k.k djkrs jgsaA 3- e/kqesg%

balqfyu nok dh [kkst ds igys xHkZdkyhu e/kqesg dh fo"ke fLFkfr ds dkj.k 65 izfr'kr ekeyksa esa isV ds Hkhrj] izlo ds nkSjku vFkok mlds ckn uoukr f'k'kq dh e`R;q gks tk;k djrh FkhA

;fn efgyk dk otu 180 ikSaM ¼68 fd0xzk0½ ls T;knk g¨ r¨ mls xÒZdkYkhu e/kqesg ds dkj.k YkxÒx 5 ls 10 Áfr'kr uotkr f'k'kqv¨a ds fodkl esa tUetkr n¨"k ik, tkrs gSaA

fofÒé 'k¨/k¨a ls Li"V gqvk gS fd YkxÒx 90 Áfr'kr xÒkZoLFkk dh tfVYkrk e/kqesg ds dkj.k g¨rh gSA

lek/kku%

xÒZ/kkj.k ds ÁkjEÒ ls gh lko/kku jgsaA

 e/kqesg dh ?kjsYkw tk¡p fLVªi ;k XYkwdksehVj ls djrs jgsaA

 'kjhj dk otu cgqr T;knk u c<+us nsaA

 'kdZjk;qä vkgkj dk lsou de ls de djsa tSls& phuh] xqM+] dsd] isLVªh bR;kfnA

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 jä XYkwd¨t dk Lrj lkekU; ls Åij u g¨ ;g /;ku j[¨A

4 gkbijbesfll xzsfoVsje%

xÒZorh efgYkkv¨a d¨ lkekU;r% Ákr% ds le;

fepYkh o mYVh g¨rh gS t¨ xÒkZoLFkk ds 3&4 ekg ckn [kRe g¨ tkrh gSA ijUrq vxj ;g leL;k 6&7 ekg rd pY¨ ;k iwjs xÒZdkYk ds n©jku jgs r¨ mls gkbijbesfll xzzsfoVsje dgrs gSaA bldk ÁÒko xÒZorh o xÒZLFk f'k'kq n¨u¨a ij ÁfrdwYk :i ls iM+rk gSA

gkbijbesfll xszfoVsje dh f'kdk;r efgYkkv¨a esa vR;f/kd fpUrk o ruko] Álo Ò;] 'kkjhfjd vLoLFkrk ds dkj.k g¨rh gSA lek/kku%

 YkEcs le; rd [kkYkh isV u jgsA

 xfj"B Ò¨tu dk lsou u djsaA

 laosxkRed fLFkjrk cuk, j[¨A

 Ò¨tu ds lkFk tYk dh de ek«kk Y¨A

 gYdk QqYdk O;k;ke djsaA

 ruko eqä jgsaA fu"d"kZ

;g lkoZÒ©fed lR; gS fd xÒkZoLFkk ,d LokÒkfod voLFkk gSA ,d L«kh ds fYk, larku lq[k loZ lq[k¨a es lcls fÁ; lq[k gS gj L«kh fookg¨ijkUr ,d LoLFk o lqUnj f'k'kq dh dYiuk djrh gS rFkk larku lq[k ds ckn gh Lo;a d¨ iw.kZ ikrh gSA

xÒkZoLFkk dk dkYk gj L«kh ds fYk, d¨bZ QwYkä dh lst tSlk ugh g¨rk cfYd vR;Ur gh dfBukbZ;ä o leL;kvä ls Òjk g¨rk gS f'k'kq tUe ds le; L«kh nwljk tUe ikrh gSA dgrs gSa ^îM+h uSu esa fdjfdjh uSu cM+s cspSu** vFkkZr~ vka[k esa dqN d.k pYkk tk, r¨ ge cspSu g¨ mBrs gS mlh Ádkj ,d L«kh tc xÒZ/kkj.k djrh gS r¨ og dkYk mlds fYk, vlgtrk dk g¨rk gS vf/kdka'kr% xÒZorh L«kh d¨ dqN lkekU; ,oa xEÒhj LokLF;

leL;kv¨a dk lkeuk djuk iM+rk gSA vxj bu LokLF; lEcfU/kr leL;kv¨a d¨ vuns[kk fd;k tk, r¨ cgqr gh xEÒhj ifj.kke mRié g¨ ldrk gSA vr% dkj.k d¨bZ Òh g¨

xÒkZoLFkk esa ;fn LokLF; lEcfU/kr d¨bZ Òh

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