تاریخ انتشار : سه شنبه 18 آبان 1400 - 23:56
62 بازدید
کد خبر : 82382

مرگ بافت‌های استخوانی، جدیدترین عارضه مرتبط با کرونا در هند

مرگ بافت‌های استخوانی، جدیدترین عارضه مرتبط با کرونا در هند

متخصصان در هند از بروز برخی موارد ابتلا به «نکروز آواسکولار» یا مرگ بافت‌های استخوانی به دلیل کمبود خون رسانی به استخوان در بین مبتلایان به ویروس کرونا خبر دادند. به گزارش ایسنا، این بیماری که ممکن است به مرگ مبتلایان منتهی شود نگرانی متخصصان هندی را در پی داشته است. پیش‌ از این برخی

مرگ بافت‌های استخوانی، جدیدترین عارضه مرتبط با کرونا در هند

متخصصان در هند از بروز برخی موارد ابتلا به «نکروز آواسکولار» یا مرگ بافت‌های استخوانی به دلیل کمبود خون رسانی به استخوان در بین مبتلایان به ویروس کرونا خبر دادند.

به گزارش ایسنا، این بیماری که ممکن است به مرگ مبتلایان منتهی شود نگرانی متخصصان هندی را در پی داشته است. پیش‌ از این برخی موارد ابتلا به انواع قارچ در میان افرادی که به کرونا مبتلا شده بودند شناسایی شده بود اما حالا پزشکان احتمال داده‌اند عارضه‌ای جدید جایگزین آن شود.

نکروز آواسکولار یا مرگ بافت‌های استخوانی یک نوع بیماری است که در اثر اختلال در خون‌رسانی به استخوان‌ها ایجاد می‌شود و به گفته متخصصان در اغلب موارد به دلیل استفاده طولانی‌مدت از داروهای استروئیدی (کورتون) پدید می‌آید.

تجویز داروهای استروئیدی برای برخی مبتلایان به کرونا در هند عوارضی همچون ابتلا به انواع عفونت های قارچی را به دنبال داشت و حالا متخصصان این کشور از بروز یک بیماری دیگر ناشی از ابتلا به کرونا و استفاده از انواع کورتون خبر داده‌اند.

به گزارش رسانه‌های هند، به نقل از پزشکان این کشور تاکنون مواردی از ابتلا به نکروز عروقی اثبات شده و محققان احتمال داده‌اند در ماه‌های آینده شمار مبتلایان به عوارض استخوانی پس از بهبودی از کرونا افزایش یابد. این بیماری نیز همچون انواع عفونت قارچی در بین بیمارانی دیده شده که از کرونا بهبود یافته‌اند.

به گزارش روزنامه تایمز چاپ هند، سانجی آگاروالا، رئیس بیمارستانی که سه جوان زیر ۴۰ سال را که به عارضه استخوانی مبتلا شده‌ بودند درمان کرد در توضیح این بیماری گفت: آن‌ها دو ماه پس از بهبودی از کرونا به این بیماری مبتلا شدند. به گفته سانجی آگاروالا، این سه نفر در ناحیه استخوان ران دچار درد و خونریزی شدند. سایر متخصصان ارتوپدی نیز به رسانه‌های هند اعلام کرده‌اند که موارد مشابهی را در بیمارستان‌های دیگر مشاهده کرده‌اند. اغلب بهبودیافتگان کرونا که به عارضه استخوانی دچار می‌شوند از ناحیه ران و استخوان پا، درد و خونریزی را تجربه می‌کنند.

منبع:ایسنا

برچسب ها :

ناموجود
ارسال نظر شما
مجموع نظرات : 0 در انتظار بررسی : 0 انتشار یافته : ۰
  • نظرات ارسال شده توسط شما، پس از تایید توسط مدیران سایت منتشر خواهد شد.
  • نظراتی که حاوی تهمت یا افترا باشد منتشر نخواهد شد.
  • نظراتی که به غیر از زبان فارسی یا غیر مرتبط با خبر باشد منتشر نخواهد شد.

htthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtthtt