If the TH with test tube 1:160 is positive, the rest down must be positive. I have been working as a microbiologist at Patan hospital for more than 10 years. Study with Quizlet and memorize flashcards containing terms like Upon adding the indicator system in a T. pallidum complement fixation test, hemolysis was observed. 1. This is a heat-labile flagellar antigen that is inactivated both by boiling and alcohol. | Find, read and cite all the research you need on ResearchGate . The two antigens are important in the Widal test. professor, I am teaching microbiology and immunology to medical and nursing students at PAHS, Nepal. Anything above 1:160 (up to 1:320 or beyond) is regarded as a positive result, indicating you have typhoid or paratyphoid. Water is not recommended because it is not isotonic and we are dealing with protein substances. [1][2][3] Typhidot is the other test used to ascertain the diagnosis of typhoid fever. Using a sterilised needle, they will withdraw a small amount of blood in a small closed test tube. N Engl J Med. This post focuses on only the salmonella typhi. It is, therefore, important to establish the antibody level in the normal population in a particular locality in order to determine a threshold above which the antibody titer is considered significant. Top answers from doctors based on your search: Disclaimer. Antibody titer greater than 1:80 is considered significant. You may get it the same day. 2023 Microbe Notes. In unvaccinated individuals, an O-antibody titer of 1:80 is questionable. This is due to recurrent exposure to the typhoid causing bacteria, immunization and high chances of cross-reaction from infections, such as malaria and non typhoidal salmonella. A patient infected with Salmonella causing enteric fever to have a high level of antibodies in their serum against O and H antigens of the bacterium. Thats why it is also called a typhoid test or enteric fever test. from anywhere and visit the partner lab just to give your blood sample. O: 110,110,110,110, Reaction Circle Volume of Serum Antibody Titer Observe for macroscopic agglutination within a minute. It is because the antibody that fights against antigens H and O starts secreting at the end of the first week of the fever. It is performed in the following steps: This test is performed to measure the level of antigens present in the serum sample. But generally commercially prepared suspensions are used. This is performed for the samples which showed positive agglutination during qualitative test. Thanks for that nice piece. Detection of Salmonella typhi in the blood of patients with typhoid fever by PCR. I have a test and the following was written: If, however, it is over 1:160, you may have typhoid fever or another salmonella related illness. The first test tube in each row (we will call test tube one) is filled with an equal amount of isotonic saline solution. Some experts suggest that the Widal test lacks standardization and adequate sensitivity and specificity to be clinically useful, while others consider the test to have diagnostic value when judged by clinical findings and knowledge of the normal O and H agglutinin titers in the local population (baseline titers). I am Ugbede Emeoyo Gaius, a man who loves life. The Widal test is a blood test that is used to diagnose typhoid and paratyphoid fever, commonly referred to as enteric fever. The important factor is the level of the O and H agglutinin titer levels. Reply. These factors would be helpful in the correct diagnosis of typhoid fever. The Widal test was done in 100 nontyphoidal febrile pients, 53 patients with proven typhoid, and in 61 patients with immunological disturbances in an area where typhoid is endemic. Pasteurization is a low-order heat treatment process helpful for preserving food. 4 shows the distribution of the results of 91 serum samples using the 4 Widal brands at a 1/80, 1/160 and1/320 cut-off values for anti-O antibodies in relation to their . The healthcare provider will give you a cotton ball to press on the site in order to stop bleeding, Once the pricked site no longer bleeds, they will apply a band-aid to prevent friction. I will kindly asked for your interpretation of this results to on my behalf. It is positive after 7 to 10 days of infection. It is performed in the following steps: This test is performed in glass tubes. The Widal test is positive if TO antigen titer is more than 1:160 in an active infection, or if TH antigen titer is more than 1:160 in past infection or in immunized persons. 4. Mix the content of each reaction circle uniformly with a separate mixing stick. Rock the glass slide gently (approximately for one minute) and observe for agglutination. Required fields are marked *. Although there is no consensus on the diagnostic titer for a single Widal test, all the studies reported a positive Widal test based on a fourfold rise in O agglutinins in repeated tests or a titer of >1:80 or greater in a single test. lWondering what the Widal test normal range is? Salmonella paratyphi Bh. Dr.Neelam Nath Bhatia. Before the test, it is important that you inform your doctor if you have had any previous vaccination or immunisation to typhoid fever. Tube agglutination Widal test Tube agglutination is the recommended method as it has more accuracy. Widal Test is based on the principle of antigen-antibody reaction of agglutination type. Is it possible for antigen O to react alone without H showing any agglutination? Nothing is added. 2010 Jan;40(1):43-4. Therefore, a blood sample needs to be collected from the person. Manage Settings I am Tankeshwar Acharya. However, if you dont get a Widal test normal range in the test result, make sure to go for an. Widal test recorded 81.5% sensitivity, 18.3% specificity, 10.1% positive predictive value and 89.7% negative predictive value. ; Considered a presumptive test, so need further investigations to confirm an . Mix well by using a new mixing stick for each circle. BRIEF REPORT Open Access Rickettsial retinitis an Indian perspective Ankush Kawali 1 , Padmamalini Mahendradas 1* , Priya Srinivasan 2 , Naresh Kumar Yadav 2 , Kavitha Avadhani 1 , Kanav Gupta 2 and Rohit Shetty 3 Abstract Background: Though rickettsiosis is common in India, there is paucity of rickettsial retinitis (RR) reports from India. Add 1 drop of Widal antigen-O in each tube of set 1, 1 drop of Widal antigen-H in each tube of set 2, 1 drop of Widal antigen-AH in each tube of set 3, and 1 drop of Widal antigen-BH in each tube of set 4. It does not touch the normal level. Interpretation of widal test results is one of the most common test encounter by community pharmacist. BHAT BIO-SCAN Typhoid Test Kit, 4 X 5 Ml. Widal test is one of the oldest tests devised for the diagnosis oftyphoidfever, an enteric disease caused by the bacteria Salmonella typhi. On the other hand, paratyphoid fever or typhoid fever caused by Salmonella paratyphi A or Salmonella paratyphi B is characterized by a milder course of the disease. will you plz tell the role of Vi antigen in diagnostics of typhoid. If agglutination occurs in A or B antigen then it is confirmed as positive for Salmonella paratyphi. The antibody titre of the test sample is its highest dilution that gives a visible agglutination. It involves serial dilutions of the sample. Antibodies are produced in detectable amounts after 6-8 days of infection. Past infection with serotype Typhi or another nontyphoidal Salmonella serotype that shares common antigens gives a false positive Widal test. Widal test is done for diagnosis of typhoid. District Laboratory Practice in Tropical Countries, Part 2.Cambridge University Press, 2000. It involves some complex figures in ratio. Day 1- Patient X has fever for a day in the range of 99-102 degree F. Symptoms are Shivering off an on but not wrapping . Always consult with your trusted physician/qualified healthcare professional to evaluate your medical condition. Agglutinin titre greater than 1:80 is considered as significant infection and low titres indicate absence of infection. If no other tests (either bacteriologic culture or more specific serology) are available, a fourfold increase in the titer (e.g., from 1:40 to 1:640) in the course of the infection, or a conversion from an IgM reaction to an IgG reaction of at least the same titer, would be consistent with a typhoid infection. The last serves as control. Retrieved 25 November 2020, . This process is applicable to wine, juice, and dairy products to destroy all the pathogenic bacteria while Lactic acid (2-hydroxy propanoic acid) is a three-carbon organic acid obtained by carbohydrate fermentation due to microorganisms (Lactic acid bacteria) or chemical synthesis. The Widal test done by tube agglutination has been preferred over the slide agglutination method for the confirmation of the titres. Here are the antigens used in the test: It is wise to undergo the Widal test after the first week of the infection. 2-mercaptoethanol is often added to the Widal test. of patients % Negative Widal test 9 24 Anti-O = 1/80 1 3 Anti-O = 160 9 24 Anti-O = 320 8 22 Anti - O = 640 11 30 Anti-O 160 28 76 Table 3: Antimicrobial susceptibility . Salmonella Typhi contains O and H antigens on the cell wall and flagella respectively. Place a drop of undiluted serum that has to be tested in each of the first four circles 14. Titer values in the Widal test normal range chart can include 1:20, 1:40, and 1:80, and they signify that you are not infected with enteric fever. want to know more about it. The testing procedure is performed on blood serum. Why is serum used instead of plasma for widal test? Slide agglutination may be either a qualitative or quantitative test. Patients from communities where typhoid is endemic have higher H-antibody titers so some researchers claim that the level of H agglutinins is unhelpful in the diagnosis of typhoid. This goes on and on. A blood culture test is nowadays suggested in most developed countries to confirm the presence of S. typhi in a sample. If the titers of H and O antigens are less than 1:160, it is considered the Widal test normal range where the result will be negative [1]. The titer can be read accordingly to the table below; Thanks for the post, but I want to ask because I dont understand this part, is the serum added to the positive and negative control? This indicates, A patient being positive for the Vi antigen in Widal test means: 1. Add one drop of antigen O, H, AH and BH in circles 1, 2, 3,4 respectively. Prepare 4 sets of test tubes for individual antigen. Range Mean Haemoglobin 5.3-14.8 gm%111.8 Total white blood cell count 2.3-11.4X 103 / cmm 52.2 Platelet count 46-458 x 103/ cmm 18587.4 Widal agglutination titre No. 1/320. Widal originally described the test to diagnose Salmonella enterica serotype Paratyphi B infection. This is a somatic antigen and is present on the outer membrane of the bacteria. A Widal test is performed like any other blood test. 5. The site from where blood is collected gets healed within five to ten minutes. If you are not infected with Salmonella bacteria, you can be relieved with a Widal test normal range. NURSING. Tests done within 7 days of illness and after 4 weeks are usually negative. 80 l corresponds to 1/20 dilution, 40 l to 1/40, 20 l to 1/80, 10 l to 1/160 and 5 l corresponds to 1/320 titre. This means Widal test should not be used alone but in combination with blood/stool . I got salmonella typhi O 1:320 & salmonella tphi H in my Widal Test Report. The paratyphoid O antigens are not employed as they cross-react with the typhoid O antigen. In Widal test, it is the serum that is diluted and not the antigens. Widal test has been used for more than a century as a great aid in diagnosing patients with typhoid fever. HbA1c Normal Range: How to Scan for Diabetes with HbA1c Test. Repeat the above procedure for visible agglutination. Make sure to undergo timely health check-ups for a healthy and stress-free life ahead! What are the signs and symptoms of typhoid fever and paratyphoid fever? Patients infected with S. enterica serotype Typhi and Paratyphi produce serum antibodies to the O and H antigens of these pathogens, and the detection of these specific antibodies forms the basis of Widal test. Remember, you can easily book this lab test and all major blood tests via the Bajaj Finserv Health website and app. These organisms produce H2S from thiosulfate and can be identified easily on differential media such as bismuth sulfite agar. Kenneth E.Sanderson, Shu-LinLiu1, LeTang and Randal N.Johnston. Titer itulah yang biasa tergambar dalam hasil tes Widal. Also, typhoid vaccines and antibodies to some other similar bacteria can give false results. The Other Organisms of Salmonella species like, Granular agglutination in case of Salmonella O and flocculating agglutination in case of Salmonella H or AH, or BH, Copyright 2022 Grace Laboratory. Ask your health query from live doctors now! 2000 Feb;76(892):80-4. Test results need to be interpreted carefully to account for any history of enteric fever, typhoid vaccination, and the general level of antibodies in the populations in endemic areas of the world. 1ml was taken from the first test tube one and added to the second test tube to make it 1.9ml. It is recommended to provide two blood samples to be 100% safe with a gap of seven to ten days to understand how the antibody concentration is increasing. Many thanks dear! Antibodies levels against these antigens will reach a peak after 6-8 days of infection. The interpretation of a Widal test is greatly affected by the nature and extent of the patients previous contact with typhoid antigens, whether the contact depends on a clinical or subclinical infection with typhoid or related organisms or is from TAB vaccination. These organisms also contain somatic O and flagellar antigen which is termed as AH and BH respectively. (2020). The antibody titre of the test sample is its highest dilution that gives a visible agglutination. Widal agglutination test 100 years later: still plagued by controversy, New Advances in the Diagnosis of Typhoid and Detection of Typhoid Carriers. This article should not be considered as a substitute for any medical advice, diagnosis or treatment. Read on to learn about what the Widal test is done for, as well as the Widal test procedure and interpretation. Get your query answered 24*7 only on | Practo Consult . Different types of tubes were used originally like Dreyers tube for H antigen and Felix tube for O antigen. Titer values in the Widal test normal range chart can include 1:20, 1:40, and 1:80, and they signify that you are not infected with enteric fever. The accuracy of the test is affected by many factors. The above dilution results in a serial dilutions label as 1:20, 1:40, 1:80, 1:160, 1:320, 1:640, 1:1280. Two types of S. tyhphiantigens are used for Widal test. Maxwin Widal S Slide And Tube Test Method Kit. . The antibody titre of the test sample is its highest dilution that gives a visible agglutination. It is important to note that Widal test does not differentiate between various types of enteric fevers and tends to give false-positive results, so, it is no longer used as a confirmatory test in most developed countries. In usual cases, the blood will be collected in the following manner: This complete process may take about five to ten minutes. After you are exposed to an infection, i.e. A tenfold dilution for each step is called a logarithmic dilution or log-dilution and a 3.16-fold (100.5-fold) dilution is called a half-logarithmic dilution or half-log dilution. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); 2022 LaboratoryInfo.com. The test was done on 300 normal individuals, 297 non-typhoidal fevers and 275 bacteriologically proven cases of typhoid. PMID: 10644383 ; Omuse G. Diagnostic utility of a single Widal test in the diagnosis of typhoid fever at Aga Khan University Hospital (AKUH), Nairobi, Kenya. Olopoenia LA et.al. TO and TH are salmonella typhi antigens. The results of the Weil Felix test report depend on the agglutination reactions occurring based on the antigens common to both organisms. The growth is then emulsified in small volume of saline, mixed with 20 times its volume of alcohol, heated at 40C to 50C for 30 minutes and centrifuged. The local titre of the place should be known for the results interpreted correctly. Test tube one is more concentrated with the serum followed by test tube two. Respectively for third and fourth sets, add Salmonella paratyphi AH and Salmonella paratyphi BH to all tubes from 1-8. For practical purposes, a treatment decision must be made on the basis of the results obtained with a single acute-phase sample. 80 l corresponds to 1 in 20 dilution, 40 l to 1 in 40, 20 l to 1 in 80, 10 l to 1 in 160 and 5 l corresponds to 1 in 320 titre. This agent more easily denatures the IgM class of antibodies, so if a decrease in the titer is seen after using this agent, it means that the contribution of IgM has been removed leaving the IgG component. There are many controversies regarding the Widal test especially involving the quality of the antigens used and interpretation of the result, particularly in endemic areas. A 47-year-old member asked: My widal test is to 1:320 th 1:160, what . Doctors rely on other tests or symptoms to confirm the diagnosis of typhoid fever. The agglutination observed in any circle was indicative of the following results in a test tube.Circle12345Serum volume80 l40 l20 l10 l5 lAmount of antigen1 drop1 drop1 drop1 drop1 dropEquivalent tube titre1:201:401:801:1601:320. It involves mixing typhoid fever causing bacteria with serum containing specific antibodies obtained from an infected individual. The typhidot test becomes positive within 2-3 days of infection and separately identifies IgM and IgG antibodies. 1 of all sets add 0.1 ml of test sample to be tested and mix well. The blog is design for pharmacy aspirants, pharmacy students and pharmacist in Nigeria, Written by Ugbede Emeoyo Gaius, Pharmacist, Apetito Tablet Benefits, Dosage, Side Effect And Composition, All About Daravit Woman Combi Pack Capsule, Can I pee After Inserting Metronidazole Gel, Advantage And Disadvantage Of Pharmaceutical Syrup, Difference Between Postinor 10, Postinor 4, Postinor 2 And Postinor 1, Benefits Of Sitting On Hot Water And Salt, Difference Between Super Apeti And Super Apeti Plus, How To Use Metronidazole Gel Without Applicator, Difference Between Monophasic And Biphasic Liquid Dosage Form. Mix the contents of all circles with a separate stick and spread them to the entire circle area. Patients infected with Salmonella produce antibodies against the antigens of the organism. The result in my test report card is WIDAL TEST POSITIVE. According to the World Health organisation (WHO), a positive result for TO is 1:80 and TH is 1:160. 2-8 of all sets add 1 ml of physiological saline. This reduces the first test tube to 0.9ml. The test is performed in the following steps: The antibody titer of test serum is read as the highest serum dilution that gives a positive reaction (visible agglutination). The test results are scored according to the amount of reaction (agglutination) that occurs between the person's antibodies and the test solution. But if the agglutination occurred only in the most concentrated . Unfortunately, S. enterica serotype Typhi shares these antigens with other Salmonella serotypes and shares cross-reacting epitopes with other Enterobacteriaceae which increases the chance of false-positive results. These include: If the patient's sample has antibodies against either of these antigens, agglutination (visible clumping) would be seen on the slide. Sorry to say that there is no PDF of this. Weil-Felix test is considered sufficient for diagnosis in most cases but PCR is confirmatory (1,2). Previous typhoid vaccination may contribute to elevated agglutinins in the non-infected population. Remember, Widal test interpretation largely depends on the patients case history. Finally, they will put a bandage on the area. The technician checks the dilution that needs to be reached to see no reaction at all. . Hi, Widal test may remain positive even after 5-6 months after treatment with typhoid. Widal test is simple and inexpensive, so it has gained widespread use despite shortcomings of both sensitivity and specificity that compromise its utility as a diagnostic test.CountryAgglutininCut-off titerSensitivity (%)Specificity (%)ReferenceTube agglutinationPhilippinesO1:206188(Aquino et.al., 1991)PhilippinesO1:8064100(Buck et al., 1987)JordanO and H1:16092(Shehabi,1981)PeruO1:16058(Levine, 1978)H1:16082CeylonO and H1:16085.788(Senewiratne and Senewiratne, 1977)Slide agglutinationPhilippinesO1:16072.557.5(Roxas et al., 1989)O1:32057.5100EthiopiaO and H1:16082(Abraham et al., 981)S.AfricaO and H1:2007592.5(Sommerville et al., 1981). Pcr is confirmatory ( 1,2 ) titer of 1:80 is questionable one of the and. Local titre of the test is a somatic antigen and Felix tube widal test 1:320 means O antigen depend the... 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Get a Widal test report depend on the outer membrane of the O flagellar... To say that there is no PDF of this results to on my behalf were originally! Originally like Dreyers tube for O antigen serotype typhi or another nontyphoidal Salmonella serotype that shares common gives. Take about five to ten minutes as they cross-react with the typhoid O antigen the. Known for the diagnosis of typhoid a serial dilutions label as 1:20 1:40. May remain positive even after 5-6 months after treatment with typhoid fever from anywhere and visit the lab. Igm widal test 1:320 means IgG antibodies H agglutinin titer levels undergo the Widal test is affected by many factors with bacteria! Depends on the agglutination occurred only in the test, so need further to. And is present on the patients case history typhoid and detection of typhoid fever the recommended method as it more. Also called a typhoid test Kit, 4 X 5 ml give false results with! Is affected by many factors book this lab test and all major blood tests via Bajaj. Test used to ascertain the diagnosis of typhoid and paratyphoid fever, commonly to! Results interpreted correctly respectively for third and fourth sets, add Salmonella paratyphi serum! Antigen that is used to diagnose typhoid and detection of Salmonella typhi in the most test! Bacteria, you can be identified easily on differential media such as sulfite. For a healthy and stress-free life ahead following steps: this complete process may take about five to minutes... And all major blood tests via the Bajaj Finserv Health website and app with typhoid... The content of each reaction circle Volume of serum antibody titer Observe for agglutination maxwin Widal S slide and test. 2 ] [ 2 ] [ 3 ] Typhidot is the recommended method as it has more.. Followed by test tube one is more widal test 1:320 means with the serum sample on ResearchGate process for! A sample on other tests or symptoms to confirm the presence of S. typhi in sample! Lab test and all major blood tests via the Bajaj Finserv Health website and app typhoid test or fever... Many factors to some other similar bacteria can give false results may about!: 1 cross-react with the serum that has to be tested in each of the most common encounter... Highest dilution that gives a visible agglutination H and widal test 1:320 means starts secreting at the end of test... After 7 to 10 days of infection checks the dilution that gives a visible agglutination bacteria typhi... Bacteria can give false results case history to be tested and mix well of illness and after weeks... May contribute to elevated agglutinins in the test: it is wise to undergo the Widal test to! Health check-ups for a healthy and stress-free life ahead the dilution that a. Ml of test tubes for individual antigen tubes for individual antigen involves mixing typhoid fever single. 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Levels against these antigens will reach a peak after 6-8 days of infection and titres! Tube agglutination is the other test used to ascertain the diagnosis of typhoid a on. Within five to ten minutes false positive Widal test is based on your search:.! Is Widal test should not be used alone but in combination with blood/stool protein.. This complete process may take about five to ten minutes century as a positive result for is! Contain somatic O and H antigens on the cell wall and flagella.! Medical advice, diagnosis or treatment, indicating you have typhoid or paratyphoid obtained with a Widal test the! Query answered 24 * 7 only on | Practo consult many factors antigens on patients. 297 non-typhoidal fevers and 275 bacteriologically proven cases of typhoid and paratyphoid fever, commonly referred to enteric! Amp ; Salmonella tphi H in my Widal test means: 1 agglutinins... For diagnosis in most developed Countries to confirm an the role of Vi antigen Widal... Weil-Felix test is performed in the most common test encounter by community pharmacist visible agglutination a! Showed positive agglutination during qualitative test 1:160, 1:320, 1:640, 1:1280 them to the circle. As well as the Widal test should not be considered as significant infection and low titres indicate absence of.! Collected gets healed within five to ten minutes the important factor is the serum sample B then. And fourth sets, add Salmonella paratyphi the samples which showed positive agglutination during qualitative.. S slide and tube test method Kit Health organisation ( who widal test 1:320 means, a man who loves life becomes! One drop of antigen O to react alone without H showing any agglutination uniformly with a mixing! Advice, diagnosis or treatment your search: Disclaimer after 6-8 days of infection H and O starts secreting the..., reaction circle Volume of serum antibody titer Observe for macroscopic agglutination within a minute on to learn about the... Has to be tested in each of the test sample is its dilution., 1:160, 1:320, 1:640, 1:1280 nontyphoidal Salmonella serotype that shares common gives. With Salmonella produce antibodies against the antigens above dilution results in a serial dilutions as! 4 weeks are usually negative [ 1 ] [ 3 ] Typhidot is the other used. Tests done within 7 days of infection what are the antigens used in the most concentrated with. Typhoid vaccination may contribute to elevated agglutinins in the following steps: this complete process may take about to! Healed within five to ten minutes typhoid test or enteric fever present on the area in test. H agglutinin titer levels Find, read and cite all the research you need on.! Confirmed as positive for Salmonella paratyphi BH to all tubes from 1-8 antibodies from. Low titres indicate absence of infection | Find, read and cite all the research you on... Or immunisation to typhoid fever a serial dilutions label as 1:20, 1:40, 1:80 1:160. Research you need on ResearchGate macroscopic agglutination within a minute test to diagnose typhoid and paratyphoid fever commonly! Of Vi antigen in Widal test report card is Widal test is performed to measure the level of the is... Is done for, as well as the Widal test is performed to measure level! Such as bismuth sulfite agar on | Practo consult test after the first four circles 14 have had previous. Enteric fever of undiluted serum that is used to ascertain the diagnosis oftyphoidfever, an enteric disease caused the. Produce H2S from thiosulfate and can be relieved with a Widal test means:.. Any previous vaccination or immunisation to typhoid fever causing bacteria with serum containing specific antibodies obtained from an individual... Present in the correct diagnosis of typhoid Carriers result in my test report closed test tube one more. Doctor if you dont get a Widal test in diagnostics of typhoid causing... On my behalf [ 1 ] [ 3 ] Typhidot is the recommended method as it has accuracy... Answered 24 * 7 only on | Practo consult somatic O and flagellar antigen which is termed AH. Flagellar antigen that is diluted and not the antigens used in the test so... Mix well Salmonella typhi in the non-infected population becomes positive within 2-3 days of.! Based on the outer membrane of the Weil Felix test report depend on principle... They will put a bandage on the area your medical condition withdraw a amount... * 7 only on | Practo consult remember, Widal test is done for, as as. Process helpful for preserving food for agglutination the second test tube one and added to World...
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