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How to relieve back pain

Doctors often prescribe a variety of exercises, diets, stretch exercises, etc to relieve back pain. According to statistics, more than 200 million Americans alone suffer back pain. Some patients endure surgery, while others find ways to minimize the pain. Unfortunately, some people turn to alcohol and drugs to relieve such pain.

When pain is chronic, it makes it difficult to cope with daily duties. Most pain in the back starts at the lower region. With so much suffering, many people make a hobby out of finding relief.

Back pain mild or chronic can slow activities, mobility, and so on. While there are, many medical causes and sometimes-mysterious causes the fact is the majority of people in the world fail to maintain ROM of the joints by stretching and exercising regularly.

For this reason, back pain is the number one cause of time loss and money spent. The fact is back pain alone is one of the prime reasons that people must call in to work sick. According to statistics, the increase in back pains the total estimate of loss and medical costs soars up to $60 billion dollars annually.

Some people are lucky. That is some people mysterious experience back pain and in a few months, the pain vanishes, never returning. Lucky dogs!

While the large percentage of people soon recover naturally from back pain, another percentage makes up 100 and these people find relief by modifying their weight, adjusting sitting arrangements, and stretching.

Still, others suffer enduring back pain. Some of these people will sit inappropriately in chairs, or on couches until they lower back finally dents, forming the shape of the chair position they had sit. These people often spend a lifetime indulging in over-the-counter meds, such as analgesics. If they would get off the couch, align the back with stretch exercises and support of Chiropractors, thus the pain may disappear.

Still, other people suffer life-long back pain due to injuries, trauma, disease, and so on. The downside is these people rarely get the treatment they deserve, since it is rarely recommended by doctors. In short, doctors will often recommend over-the-counter medications, i.e. painkillers to resolve the problem. Doctors rarely tell patients to exercise, diet, etc. Sometimes you may hear, “Loose some weight,” yet the doctor will rarely tell the patient how it is done.

Painkillers work to eliminate inflammation and sometimes pain, yet what doctors fail to tell the patients is that some of these painkillers are in fact killers. In addition, painkillers do not have the same affect on all persons. For sure, some painkillers will reduce pain for some, while others may continue hurting.

This leads us to drug addictions and alcoholism, since these people need help coping with the pain, and if doctors are not offering that help, thus drugs and alcohol is the answer. We have another problem.

In view of the facts, back pain recoveries lay behind information. When a patient has an idea as to what is causing his/her pain, thus he/she can move to treatments that help them to find relief.

Fact: When a person is aware of cause, effect, only then can he take action to eliminate the cause. When a person is aware of cause, he moves to acceptance, in turn acceptance moves him to act.

How do I find the cause?

You find the cause by researching your condition. Once you begin research your eyes will open, which leads you to discuss with your doctor, treatments to eliminate your pain. Doctors prescribe medicines, recommend tests, and encourage surgeries in some instances, thus these people rarely focus on REAL HEALTH, which includes exercise.

Exercise has proven to reduce even the worst back pain. Exercise has gone as far as proven to prevent death from internal injuries. Most people would ordinary die after six months from internal injuries; however, one person stood against doctors and should them that exercise is the gatekeeper to good health.

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What is Psoriasis?

Psoriasis is a chronic skin condition in which skin cells on certain parts of the body are produced much more rapidly than normal, up to ten times faster, causing a build up on the surface of ugly scaly patches, most commonly on the elbows or knees. These can be unsightly and painful. There may be itching, cracking and bleeding even keeping the sufferer awake with discomfort. It is known to be triggered by a number of factors, including trauma, infections, injury, drug reactions, smoking, alcohol and most notably emotional stress. Sufferers normally want to cover up their unsightly rashes during the summer months.

Psoriasis is non-contagious. Its most common form, plaque psoriasis, appears as raised, red patches or lesions covered with a silvery white build-up of dead skin cells, called scale. In 10- 30% of sufferers the psoriasis can also present as psoriatic arthritis, which causes pain, stiffness and swelling in and around the joints. Severe bowel problems can also develop.

There are several different types of psoriasis, but discoid or “plaque” psoriasis is far and away the most common form. It is distinguished by patches of inflamed, scaly skin on the trunk and limbs, appearing particularly on the elbows, knees and scalp. Additionally, a sufferer’s nails may become pitted, thickened or separated from the nail beds. Gutate psoriasis is the form most frequently found in children: small patches appear rapidly over a wide area, often after the child has had a sore throat.

When psoriasis occurs the cycle of cell growth is accelerated. In healthy skin the cycle of cell creation to the cell being shed is about 1 month; in skin affected with psoriasis the cycle is reduced to 3-4 days. The skin becomes thickened and red due to an increased blood supply required to support the increased activity and the dead skin cells appear as a white flaky build up. It is believed that it is the immune system that is causing the effect by sending faulty signals.

A genetic link has been suggested. Around 2% of Europeans and Americans contract the disease and it is less common in black and Asian communities. Symptoms usually appear for the first time in those in the 10-30 year old age bracket.

Our skin is the largest organ of our body. We have no conscious control over what happens in our skin. Embarrassment or exercise may make our skin become redder and fear or illness may make it go pale. Our unconscious mind controls our skin, as such, hypnosis is also effective for treating wide variety of skin complaints eg acne, eczema, warts, hives, rosacea, pruritis and embarrassing problems such as blushing and sweaty palms.

The Orthodox Treatment of Psoriasis

Orthodox treatment advises exposure to the sun or to an ultra-violet lamp (light therapy) but only in small doses. An emollient (moisturizing cream) can also help. If an attack worsens, it is usually treated with an ointment containing coal tar or dithranol. Other options include P.U.V.A. (a type of phototherapy), corticosteroids and other drugs such as methotrexate. Psoriasis sufferers who experience accompanying arthritis may be treated with non-steroidal anti-inflammatory drugs (N.S.A.I.D.’s), anti-rheumatic drugs or methotrexate and tranquillizer or antidepressant medication in severe cases.

Other forms of treatment include nutrition, detoxification, trichology, homeopathy, Ayurveda, acupuncture, healing and stress management.

The power of hypnosis with Psoriasis

This may be explained by the science of Psychoneuroimmunology which explores the correlation between how good one feels mentally and the strength of the immune system.

The unconscious learnt how to respond to a trigger to cause excessive cell growth. By reprogramming the unconscious to deal with similar triggers in a different way, the symptoms of psoriasis should subside.

Many health conditions where emotional factors play a significant role may be relieved by hypnosis. Why is this? Our emotional states may appear to arise autonomously, in a way that is outside our control. However, while it is true that emotional response is not a conscious behavior, it has been clearly demonstrated that the nature, intensity and duration of such responses can be modified with hypnosis. The skin has been called the “mirror of the mind” and may well be the external manifestation of an internal conflict. Possible emotions may be anger, aggression, frustration or guilt.

Just as blood pressure can be raised or lowered, healing can be sped up, immune response can be strengthened and pain can be reduced or eliminated. Hypnosis is an extremely effective way to bring about such changes by reprogramming the so-called instinctive responses controlled by the unconscious mind.

In some cases, uncovering early memories and removing the association with the memory have lead to a significant improvement in the condition.

The National Psoriasis Foundation, the American charitable body, states that hypnotherapy can be useful in the treatment of psoriasis. They highlighted that hypnosis is a relaxation technique and stress is a well known as a trigger for psoriasis.

It is also believed that psoriasis may be caused by trapped emotion or an inappropriate release mechanism for emotion. The discovery of the emotional cause and development of an alternative method to release that emotion can control the psoriasis. The sufferer may not be aware of the cause. Even those who have suffered from birth can benefit from hypnosis.

A download hypnosis mp3 Psoriasis treatment allows you to attain a much greater level of control over your condition through the use of powerful metaphor and hypnotic visualization. You will soon find yourself not only feeling much calmer, but noticing increasing improvements in your skin and general health. A transformative metaphor is utilized to help the person activate their own unconscious healing processes and relieve the psoriasis.

Scientific Study on the Effect of Hypnosis on Psoriasis

One study, conducted by Jon Kabat-Zinn, Ph.D., former professor of medicine at the University of Massachusetts, which was published in the September/October 1999 issue of Psychosomatic Medicine, examined the use of meditation-based relaxation tapes in psoriasis patients undergoing ultraviolet light (UV) treatments. Patients who listened to the tapes during the treatments cleared their skin more quickly (in some cases, twice as fast) than patients who had the light treatment alone.

Hypnotherapy can be of great help to psoriasis patients, according to a new report. Researchers at the Department of Dermatology, The John Hopkins School of Medicine, Baltimore, USA carried out a three month study into the use of hypnotherapy in adults suffering with stable, chronic, plaque-type psoriasis.

Five patients were given specific positive suggestions about their skin. Six were given neutral suggestions. All the patients showed some benefit, but those who were given hypnotic suggestions specifically directed at their psoriasis enjoyed much better healing. The researchers found that the highly hypnotizable patients received far greater benefit than those who were only moderately hypnotizable.

Although only a small scale study, it suggests that hypnotherapy may be a useful therapeutic treatment for psoriasis Tausk F, Whitmore SE: ‘A Pilot Study of Hypnosis in the Treatment of Patients with Psoriasis.’ Psychotherapy & Psychosomatics 1999;68:221-225 (DOI: 10.1159/000012336)

Further information:

Book: Hartland’s Medical & Dental Hypnosis” by David Waxman

http://www.sich.co.uk/psoriasishistories.htm Psoriasis case study summaries with photos. The treatment included Hypno-analysis, Self-hypnosis, suggestion therapy and NLP techniques.

?Antonia Harrison 2009 is the leading English Hypnotherapist in Belgium and recommends Download Hypnosis Mp3 for immediate, affordable hypnosis Mp3s to improve your life. Professional hypnosis scripts are also available on the same site.

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Psoriasis is a chronic, recurring, non-contagious skin disorder that is characterized by raised, thickened reddish patches on the skin covered with silvery-white scales that may vary in severity and affect any part of the body, including the nails, scalp and the genital region. There are about 125 million psoriasis sufferers world wide. This makes up 3% of the world’s total population! It is estimated that six to seven million Americans have psoriasis, and each year 150,000 to 260,000 new cases are diagnosed.

The incidence of psoriasis is much lower in dark-skinned West Africans and African-Americans than in light-skinned persons of European origin. Incidence is also low in the Eskimos and the Japanese, and is extremely rare in Native Americans. Genetic, geographic and environmental factors may play a major role in this striking disparity between the races.

Most psoriasis patients undergo intense emotional turmoil while they fight to control their disease which tends to have periods of flare ups and remissions the year around. Though no cure has yet been discovered, observing certain principles in life style and skin care management will provide patients a scope for optimum control of the disease. Following are a few tips that would be useful for the psoriasis sufferers:

1. Maintain desirable health habits. Psoriasis flare ups are common when you are weak or tired. Taking a balanced diet while reducing red meats and alcohol will go a long way in helping the skin to maintain a calm milieu interior. Patients should also drink plenty of water and get at least 7-8 hours of uninterrupted sleep every day. Do moderate exercises at least 3-4 times every week.

Remember that good nutrition, rest and exercise tune up your body and mind and keep up the equilibrium which is essential to reduce the psoriasis flare ups. These healthy habits will also reduce the chances of contracting infection, another important factor in psoriasis aggravations.

I always remind my patients that medications have only about 30% role in the management of psoriasis. Rest of the 70% involves lifestyle adjustments.

2. Quit Smoking. Many studies have pointed out that pustular psoriasis of the palms and soles, a variant of psoriasis, is aggravated by smoking. Patients who quit smoking found their lesions clearing up faster. Research also suggests that severity of psoriasis may be linked to smoking. Hence it is highly imperative that you totally give up smoking if you want to get rid of those itchy, scaly, red patches.

3. Avoid alcohol. Alcohol is a trigger for psoriasis. There is no doubt about it. Though some dermatologists allow moderate consumption of alcohol in psoriasis, it is my personal observation that even a small quantity of alcohol (like a glass of wine or beer) does cause flare ups in patients. Hence the verdict is – No Alcohol in any forms!

4. Learn to manage your stress. Stress has long been linked to the induction and exacerbation of all types of psoriasis. As mentioned above, psoriasis can be considered a life style disease (much like hypertension or increased blood pressure), a combination of genetic predisposition and psycho- neuro-immuno-hormonal triggers playing a significant role in the causation, initial triggering and maintenance of the disease.

Psoriatics should try to learn and master any one of the stress management techniques like progressive relaxation, biofeedback, yoga etc. Counselling sessions and psoriasis support group participations will be beneficial for those who find it difficult to relax by themselves. According to the National Psoriasis Foundation, stress reduction works best when combined with appropriate medical treatment.

5. Avoid aggravating medications. Certain medications taken for other diseases can aggravate or even precipitate psoriasis. Medications that can trigger psoriasis are:

Anti-malarial drugs like chloroquine
Beta-blockers (medication used to treat high blood pressure) and heart medication.
Corticosteroids. Steroids are double edged swords. They can control severe psoriasis quickly, but sudden withdrawal can cause severe flare ups. Personally I avoid prescribing steroids to my patients unless it is absolutely necessary, that is, psoriasis is severely compromising their quality of life. Only after exhausting other treatment modalities do I take up this group of medications and most patients would do well to steer clear of steroids as a first line of treatment for psoriasis. Even topical steroids should be used very carefully and under medical supervision in psoriasis.
Non-steroidal anti-inflammatory drugs like indomethacin worsen psoriasis in most patients.
Lithium , the antipsychotic drug is a known aggravator of psoriasis.
If you have a family history of psoriasis or you are suffering from the disease, inform your physician if you are taking any of the above drugs. Your doctor may be able to substitute alternate medication.

6. Avoid Scratching, rubbing and picking at the lesions. Any injury to the skin in both involved and uninvolved areas can produce new psoriasis lesions by irritating the basal layer of the skin and switching on the spurting action of the epidermal cells. Research shows that about 50% of people with psoriasis experience the ‘Koebner phenomenon’ – developing a psoriatic lesion at the site of a skin injury. Hence patients should carefully avoid any direct injury to the skin. Scrubbing to remove the scales is a mistake, as this can worsen the disease.

7. Treat any infectious foci at the earliest. Studies show that some infections can trigger psoriasis. Streptococcal throat infections often precedes an outbreak of guttate psoriasis(small drop like lesions), especially in children. Inverse or flexural psoriasis is frequently aggravated by a candidal infection in the folds. Severe generalized psoriasis recalcitrant to treatment is seen in immunodeficient conditions like HIV infection. Treating the infection lessens or clears the psoriasis in most cases. Also look for signs of any infectious foci in your mouth(dental caries), throat(tonsillitis), sinusitis, gall bladder(cholecystitis), urinary bladder(cystitis) etc. Finding and treating these infections could give much better control over your psoriasis status.

8. Treat the disease before it worsens. Most effective way to stop the itching and appearance of new lesions in psoriasis is to treat the psoriasis properly as soon as the lesions appear. Consult your dermatologist at the earliest sign of a break out.

9. Take good care of your skin. Keeping the skin moist and supple is of paramount importance in psoriasis. Any dryness will increase the scaling, flaking and itching which will further aggravate the condition.

Soak in a luke-warm oatmeal bath. This relieves itching and hydrates the skin layers.

Pat your skin dry; do not rub or scrub. See tip number 6 above. Developing a habit of gently patting your skin dry is advisable.

Apply emollients and moisturizers. Emollients soften the skin. Moisturizers lock in the skin’s own moisture to prevent dryness and cracking. One of the best ways to lock in moisture is to apply moisturizer after bathing. Regular use of moisturizers can help prevent the itch and pain of dry skin and reduce scaling and inflammation. A urea containing lotion is preferred during the day and a cream or ointment(if you don’t mind a little messiness) at night to maintain the hydration of the epidermal layers.

Use sunscreen. Patients using retinoids should apply sunscreen 15 to 20 minutes before going outdoors and wear protective clothing. Sun exposure can cause sunburn, which can in turn trigger psoriasis. But complete avoidance of sun can cause more harm than good. A moderate supply of UV rays is indeed good for clearing up of the psoriatic lesions!

Wear cotton clothing .Synthetics will irritate and heat up the skin and worsen psoriasis and are best avoided. If you have to wear them, wear thick cotton undergarments beneath.

Look out for winter worsening: Cold, dry weather worsens psoriasis. Emollient creams and ointments should be used copiously during winter months. Before application of the moisturizer, remember to moist the skin with luke warm water. The use of humidifiers, both at home and work, can add moisture to the air in winter months and help in avoiding exacerbations. Remember that air-conditioning can dry out the skin and aggravate psoriasis just like winter! Keeping the AC to minimum required coolness and regular application of moisturizing creams can overcome this problem.

10. Learn to live with Psoriasis. While there is no permanent cure, psoriasis can be successfully managed so that one experiences more good days than bad. Numerous treatment options are available, and recent advances are revolutionizing the management and care of psoriasis. No single treatment will be effective for all patients. Hence a dermatologist will consider a patient’s overall health, age, lifestyle, and the severity of the psoriasis and then decide on a treatment option that will achieve maximum effectiveness.

Psoriasis patients will do well to keep a positive mental attitude towards life and its happenings. Remember, any negative signal from the mind is an instant trigger for psoriasis!

Psoriasis, though quite a common disease, has not received the attention it deserves from the health authorities in most countries. As a result, the much needed awareness campaigns and funding of research projects have been lagging behind for decades. It was in this context that in 2004 the first World Psoriasis day was launched. Conceived by patients for patients, World Psoriasis Day is a truly global event that sets out to give an international voice to the 125 million psoriasis sufferers.

Visit http://www.worldpsoriasisday.com to learn more about the World Psoriasis Day on October 29th. There, you can also sign a petition calling on the World Health Organization to recognize psoriasis as a serious disease worth more attention and research projects than is presently available. This will give a boost to the Psoriasis Support Groups and will also bring in more resources to the world wide psoriasis research scenario.

Dr.Hanish Babu, MD is a Dermato-Venereologist, author, stress management trainer and a netpreneur. He has recently released a stress management package “10 Days to Stress Free Life”.

To subscribe to his Less Stress News Letter, go to: http://www.lesstress.net

For Skin Care Tips, go to: http://www.skin-care-tips-from-dermatologist.com

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Psoriasis is uncontrolled skin-cell growth caused by an overreaction of the immune system, which then causes skin inflammation and skin flaking. Where psoriasis is not present, new skin cells grow and are shed within about 4 weeks. Skin cells affected by psoriasis, grow much faster and are not shed like healthy skin cells. The result is a build up of excess skin.

In most cases psoriasis is confined to a few spots and seems to affect many people on the sides or at the back of the head. In more severe cases people can experience arthritic symptoms known as psoriatic arthritis. People with this type of psoriasis commonly complain of swollen, painful joints. Severe psoriasis can sometimes cause a loss of finger and toe nails as a result of dead skin build up pushing the nail out of the nail bed.

Psoriasis is a stubborn and difficult skin condition to treat but Psoriasis is non-contagious. Psoriasis may be hereditary, as it does run in some families. 60% of psoriasis sufferers have a relative with the condition. However, researchers are not yet sure of exactly how it is passed through family members.

Understanding psoriasis natural treatment is crucial for lasting psoriasis relief. It can significantly help psoriasis natural treatment if sufferers identify their individual triggers and learn the effects of stress and nervous tension on psoriasis. Psoriasis symptoms can come and go, even without psoriasis treatment

Once a person has psoriasis, there are certain conditions that trigger flare-ups. Triggers that cause psoriasis include:

? Infections

? Stress

? Changes in climate and weather conditions

? Certain medications, such as beta-blockers, depression drugs.

Psoriasis natural treatment largely consists of managing and controlling flare-ups by reducing them through lifestyle changes. It is important that a person wanting psoriasis relief takes daily precautions:

? Maintain a healthy diet and weight

? Avoid stress as possible

? Keep a strong immune system

? Avoid cigarette smoking

? Avoid alcohol consumption

? Avoid excessive exposure to the sun (avoid sunburns)

? Avoid skin injuries, especially surrounding the finger- and toenails

? Avoid medications

Irritated Skin patches, during a flare-up, are often itchy and uncomfortable. For psoriasis relief it is important not to scratch the irritated skin, as this causes further injury. For psoriasis treatment moisturise and soften the skin with a natural psoriasis cream and psoriasis shampoo and never forcefully tear skin patches away.

Throughout history, people have relied on Aloe Vera to help heal a wide range of human ailments, particularly skin problems such as drying, flaking, itching, cracking and fungal conditions. Organic Aloe Vera is a recommended psoriasis natural treatment Aloe Vera natural psoriasis cream and psoriasis shampoo encourage water retention in dry skin tissue, rids dead skin cells, and stimulate healthy skin growth.

Aloe Vera is a mild anaesthetic, antibacterial & antifungal, containing anti-inflammatory fatty acids. These components have shown to give psoriasis relief by relieving itching, swelling, redness and pain. Aloe Vera penetrates rapidly and deeply, infusing dry skin with desperately needed moisture. It is cooling, soothing and moisturising and it stimulates the growth of new cells with natural steroids, enzymes, nutrients, vitamins, minerals, antioxidants and amino acids

The link below this article will provide you with a range of psoriasis natural treatment products, psoriasis cream and psoriasis shampoo for lasting psoriasis relief.

Contact Natural Skin and Beauty for Natural Skin Care, Natural Hair Care Products and chemical free Mineral Makeup that is truly hand made with love. Our psyche, what we eat, what we do and our skin are inter-related. Love the skin you’re in!

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The skeletal muscles supplies us movement, which is supported by the posture. Our muscles will shorten, tighten, contract, and promote mobility. The muscles join with bones that attach to the tendons. Once the muscles begin contracting, the muscles are stimulated and join the fibers through our motor neuron cells. The nerves makeup axon, body of cells, dendrites, etc, and these elements transmit impulses to the nerves, sending the impulses to the major components of our system, such as Central Nerve System. The network joins with cells, fibers, muscles, etc, and conveys messages, transmitting them through sensations that stop at the brain. The brain transmits signals that are sent from motor impulses and carries onto the organs and muscles. Collagen is produced from the muscle fibers, which the tendons surround the fibers via the softer tissues. (Paratenon)

Injuries in this area occur when a person suddenly stretches, or overexerts the tendons. The back muscles in the leg make up the gluteus medius, (Hamstrings) biceps femoris, (Hamstrings), gluteus maximus, iliotibial tract, Sartorius, adductor Magnus, gastrocemius, semitendinosus, and the soleus. In this area, the muscles can be completely ruptured, or incompletely ruptured. The soleus, tibia, fibula, Achilles, etc, is the areas that are usually strained, or ruptured. The pain can caused from the injury can also affect the back. Since the legs are limited, as well as the tendons, muscles, etc, mobility is limited, which restricts muscle movement. This means that muscles are not exerting daily on the level it requires to function properly. Tendons operate akin to the ligaments.

Ligaments are vigorous bands that mingle with threads of collagen fiber. The fiber connects to the bones. The fiber bands and bones connect and encircle the joints. We get our strength from these joints. Tendons are ligaments and muscles respectively, since tendons join with the muscles, which make up connective proteins and/or collagen. Tendons make up fiber proteins. The protein fibers are created in the cartilages, bones, skin, tendons, and interrelated connective tissues. Tendons are affected when various conditions interrupt its actions, including simple tendonitis, and peritendinitis.

Tendons are also interrupted when spinal or neck injuries occur. Neck injuries include whiplash, which many people believe is a head injury. Contrary to their notions, whiplash is a neck injury usually caused from rear-ends motorized collisions. Whiplash is neck damage, which can cause disjointed, fractures, ruptured spines, etc. Whiplash can lead to edema, hemorrhaging, and so forth. The problem causes pain around the neck and shoulders, but extends to the back. Whiplash can also depress the nerves, which leads to linear and/or comminuted difficulties. Comminuted difficulties arise from bone damage.

Spinal injuries often occur during falls, slips, inappropriate movement, muscle exertion, automobile accidents, trauma, and so on. In fact, the coccyx lies at the bed of the second spinal column. Damage to this baby can lead to serious problems, which the coccyx is non-supported. The coccyx creates the fused bones. The fused bones reside at the baseline of the spinal columns. The bones in summary are the tailbone.

The coccyx is at greater risk than any other element within the skeletal structure, since the coccyx can break easily from falls, thus leading to coccygodynia. Coccygodynia is a condition of the spinal that can create damning pain. Back injuries and injuries to the neck can affect the airway, breathing, and blood circulation. Some injuries require resuscitation.

Resuscitation is the process of clearing the airway. The act is performed by smoothly tilting the head back and lifting the chin. The tongue is pulled clear so that air can travel to the lungs. If neck injuries are present, you want to take extra precautions if resuscitation is necessary. Once you clear the airway use your ear, placing it over the mouth and listen for breathing. You can also put the hand over the mouth to feel breathe. If you cannot get results after testing for breathing, you will need to test the carotid pulses located in the neck to check for circulation.

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