(LML) New publications on cross-cutting issues and NTDs, July 2017

 

 

Leprosy Mailing List – July 25,  2017

Ref.:   (LML) New publications on cross-cutting issues and NTDs, July 2017

From:  Ilse Egers, Amsterdam, the Netherlands

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Dear Pieter,

This newsletter provides you with a selection of news items and recent publications on cross-cutting issues in NTDs. Our starting point is to add articles covering a wide variety of issues. Unfortunately, this is not always possible due to a limited diversity in and shortage of articles on cross-cutting issues and NTDs. Feel free to contact us (infontd@leprastichting.nl) with any questions or to receive the full text versions if a link to the full text is not included. Our document delivery service is free! Kind regards,   Ilse Egers InfoNTD Information officer

 

 

News

 

 

How the Gates Foundation seeks to energise the global fight against neglected tropical diseases. Read more

 

 

New publications

 

 

The importance of patient compliance in repeated rounds of mass drug administration (MDA) for the elimination of intestinal helminth transmission. Farrell SH, Truscott JE, Anderson RM. Parasit Vectors. 2017; 10(1):291. Abstract Systematic non-compliance to chemotherapeutic treatment among a portion of the eligible population is thought to be a major obstacle to the elimination of helminth infections by mass drug administration (MDA). Here we develop an individual-based stochastic model of helminth transmission and MDA treatment to investigate how different patterns of compliance influence the impact of MDA for two groups of helminths, the soil transmitted nematode infections and the schistosome parasites. Download PDF Measuring the observance of contact precautions when treating Buruli ulcer patient in a tertiary hospital in Benin. Ahoyo TA, Fonton PFD, Lozes EMC. Med Res Arch. 2017; 5(5). Abstract Buruli ulcer, caused by Mycobacterium ulcerans, remains a public health issue in Benin. Good hygiene is important for its management. We assess the observance of contact precautions practices by healthcare workers. Inadequate compliance was noticed despite good knowledge of standard precautions. The lack of qualified personnel and financial resources allocated for this program justified the weak compliance Download PDF Integrated morbidity management for lymphatic filariasis and podoconiosis, Ethiopia. Bulletin of the World Health Organization. 2017. Abstract To establish health-care services for integrated lymphoedema morbidity management, the health ministry and partners used existing governmental structures.. Experienced professionals on lymphoedema management trained government-employed health workers on integrated morbidity management. To monitor the integration, an indicator on the number of lymphoedema-treated patients was included in the national health management information system. In Ethiopia, an integrated approach for lymphatic filariasis and podoconiosis morbidity management was feasible. The processes used could be applicable in other settings where these diseases are co-endemic. Read more Lymphatic filariasis patient identification in a large urban area of Tanzania: An application of a community-led Mhealth system. Mwingira U, Chikawe M, Mandara WL, et al. PLoS Negl Trop Dis. 2017; 11(7):e0005748. Abstract This system of identifying, recording and mapping patients affected by LF greatly assists in planning, locating and prioritising, as well as initiating, appropriate morbidity management and disability prevention (MMDP) activities. The approach is a feasible framework that could be used in other large urban environments in the LF endemic areas. Download PDF Impact of mass drug administration for elimination of lymphatic filariasis in Nepal. Ojha CR, Joshi B, Kc KP, Dumre SP, et al. PLoS Negl Trop Dis. 2017; 11(7):e0005788. Abstract We assessed the impact of MDAs on LF in selected districts of Nepal after the recommended six MDA rounds had been completed. Although Nepal has achieved significant progress towards LF elimination, five rounds of MDA were not sufficient to disrupt the transmission cycle in all districts, probably because of high baseline prevalence. Download PDF Mobile-phone and handheld microscopy for neglected tropical diseases. Rajchgot J, Coulibaly JT, Keiser J, et al. PLoS Negl Trop Dis. 2017; 11(7):0005550. No abstract Download PDF First evidence of lymphatic filariasis transmission interruption in Cameroon: Progress towards elimination. Nana-Djeunga HC, Tchouakui M, Njitchouang GR, et al. PLoS Negl Trop Dis. 2017; 11(6):e0005633. Abstract Lymphatic filariasis (LF) is among the 10 neglected tropical diseases targeted for control or elimination by 2020. In Cameroon, once-yearly mass administration of ivermectin and albendazole has been implemented since 2008. The aim of this study was to assess progress towards the elimination goal, looking specifically at the impact of six rounds of MDA on LF transmission in northern Cameroon. Download PDF Challenges in developing methods for quantifying the effects of weather and climate on water-associated diseases: A systematic review. Lo Iacono G, Armstrong B, Fleming LE, et al. PLoS Negl Trop Dis. 2017; 11(6):e0005659. Abstract Climate and weather factors are known to affect the transmission and distribution of infectious diseases and statistical and mathematical modelling are continuously developing to investigate the impact of weather and climate on water-associated diseases. Our objective is to review and summarize statistical and modelling methods used to investigate the effects of weather and climate on infectious diseases associated with water, in order to identify limitations and knowledge gaps in developing of new methods. Download PDF Coverage and compliance of mass drug administration against lymphatic filariasis in Kalaburgi district. Biradar MK, Holyachi S. Int J Community Med Public Health. 2017; 4(7):2502-2505. Abstract Study was done to assess coverage and compliance of mass drug administration (MDA) against lymphatic filariasis in Kalaburgi districts. This cross-sectional coverage evaluation survey was done in one urban and three rural clusters in district. There is an urgent need for more effective drug delivery strategies and also proper IEC should be done to educate and to improve the coverage and compliance in the districts. Download PDF Burden of trachoma in five counties of Eastern Equatoria state, South Sudan: Results from population-based surveys. Sanders AM, Stewart AEP, Makoy S, et al. PLoS Negl Trop Dis. 2017; 11(6):e0005658. Abstract Five counties in Eastern Equatoria state were surveyed in order to monitor progress of programmatic interventions and determine if additional rounds of Mass Drug Administration with azithromycin were needed. The results show that despite years of interventions, four of the five surveyed counties require a minimum of five additional years of SAFE strategy implementation, with the fifth requiring at minimum three more years. Download PDF Lessons from implementing mass drug administration for soil transmitted helminths among pre-school aged children during school based deworming program at the Kenyan coast. Musuva RM, Matey E, Masaku J, et al. BMC Public Health. 2017; 17(1):575. Abstract In Kenya, during the National school-based deworming exercise, pre-school aged children (PSAC) have to access treatment at primary schools as the pre-school teachers are not trained to carry out deworming. This was a cross-sectional qualitative study using Focus group discussions (FGDs) and Key informant interviews (KIIs). It was conducted in 4 sub-counties with high STH prevalence at the Kenyan coast (Matuga, Malindi, Lunga Lunga and Msambweni) to understand best practices for implementing MDA among PSAC. Download PDF Surveillance efforts after mass drug administration to validate elimination of lymphatic filariasis as a public health problem in Vanuatu. Taleo F, Taleo G, Graves PM, et al. Trop Med Health. 2017; 24:18. Abstract Vanuatu was formerly highly endemic for lymphatic filariasis (LF), caused by Wuchereria bancrofti and transmitted by Anopheles mosquitoes. This paper reviews the surveillance activities done after stopping MDA to validate the interruption of transmission and elimination of LF as a public health problem. Download PDF Dengue seroprevalence and force of primary infection in a representative population of urban dwelling Indonesian children. Prayitno A, Taurel A-F, Nealon J, et al. PLoS Negl Trop Dis. 2017; 11(6):e0005621. Abstract Indonesia reports the second highest dengue disease burden in the world; these data are from passive surveillance reports and are likely to be significant underestimates. To better understand dengue infection history and associated risk factors in Indonesia, a representative population-based cross-sectional dengue seroprevalence study was conducted in 1-18-year-old urban children. This study revealed that more than 80% of children aged 10 years or over have experienced dengue infection at least once. Download PDF A possible case of mycetoma in ancient Rome (Italy, 2nd-3rd centuries AD). Killgrove K, Böni T, Galassi FM. SocArXiv. 2017. Abstract Reports of historical individuals with mycetoma are anecdotal in the palaeopathology literature, particularly in more temperate areas of the world. This article details a probable case of mycetoma in Imperial-era Rome, Italy. Differential diagnoses of leprosy, erosive arthropathy, sarcoidosis, and mycoses are considered. Given the morphology and pattern of the lower leg lesions and the ecology of the disease, the authors conclude that mycetoma is the most likely explanation. Download PDF Exploring on the elderly health management model in tropic area. Song Y, Jiao J-G, Chen Z-J. Asian Pac J Trop Med. 2017. Abstract In this article, based on the characteristics of tropical area, we analyze the beneficial and the disadvantage of tropical area to human health, points out the existing problems in elderly health management pattern in the tropics area, accordingly we discuss how to establish tropical characterized elderly health management, and put forward constructive suggestions. Download PDF

 

 

Events

 

 

Neglected Diseases in South East Asia: Building Capacity in Epidemiological Modelling August 28-September 1, Kuala Lumpur, Malaysia University of Malaya Southeast Asia countries face common threats from infections, including neglected tropical diseases (NTDs) and neglected zoonotic diseases (NZDs) that particularly affect marginalized communities―the most vulnerable to exposure and least able to seek treatment. Understanding the transmission and control of infectious diseases can be aided by mathematical modelling, helping to predict disease outbreaks, quantify intervention impact, estimate economic and health-care burdens, and inform cost-effective public health strategies. This workshop will introduce participants to topics from bacterial & viral to helminth NTDs and NZDs through series of lectures and practicals followed by group discussions and Q&A sessions, addressing: a) basic models for vector-borne diseases; b) infection intensity frameworks for helminth infections, and c) models for zoonotic infections. Read more

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LML - S Deepak, B Naafs, S Noto and P Schreuder

LML blog link: http://leprosymailinglist.blogspot.it/

Contact: Dr Pieter Schreuder << editorlml@gmail.com

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(LML) The ENLIST ENL Severity Scale

Leprosy Mailing List – July 21,  2017

Ref.:  (LML)   The ENLIST ENL Severity Scale

From:  Steve Walker, London, UK

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Dear Pieter,

 

On behalf of the Erythema Nodosum International STudy (ENLIST) Group I would be grateful if you could circulate the link to our recently published validation study of the 10-item ENLIST ENL Severity Scale (EESS) which is accompanied by a User Guide.

The paper can be found at: http://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0005716

The final version of the EESS and User Guide can be found in the Supporting Information section.

We hope that colleagues will find the scale useful in both the clinical assessment of patients with ENL and in research studies. We would welcome comments or queries about the work of the ENLIST Group (enlist@LSHTM.ac.uk).

We are extremely grateful to the Austrian Leprosy Relief Association / AHWÖ Aussätzigen-Hilfswerk Österreich (http://www.aussaetzigen-hilfswerk.at/) and Leprosy Research Initiative (https://www.leprosyresearch.org/) for the generous support of this work.

 

Best wishes

 

Steve

	Stephen L. Walker PhD, MRCP(UK), DTM&H
	Associate Professor
	London School of Hygiene & Tropical Medicine
	Keppel St | London WC1E 7HT | United Kingdom

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LML - S Deepak, B Naafs, S Noto and P Schreuder

LML blog link: http://leprosymailinglist.blogspot.it/

Contact: Dr Pieter Schreuder << editorlml@gmail.com

 

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(LML) Re-infection of lepromatous patients after release from MDT

Leprosy Mailing List – July 19 ,  2017

Ref.: (LML)  Re-infection of lepromatous patients after release from MDT 

From:  H K Kar, New Delhi, India

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Dear Pieter,

 

To thank Joel Almeida (LML, 18-07-2017) for bringing back the relevant observation which is discussed by the leprologists off and on. We know that there are two types of lepromatous leprosy. We encounter in our clinical practice:

-Sub-polar lepromatous leprosy which are the downgraded ones from borderline/indeterminate types of leprosy because of the delay in diagnosis and appropriate treatment of these cases, which are the majority of all LL cases.

-And another small group of LL cases,  those from the beginning,  manifest as LL with  bilateral symmetrical  hypo-pigmented or erythematous ill defined small macular lesions without loss of sensation all over the body or as diffuse fine infiltrations especially on face and extensor aspects of the trunks and extremities without any apparent peripheral nerve involvements initially. These cases create diagnostic problem clinically unless we do Slit skin smear (SSS) examination for detection of AFB with or without skin histopathological examination.

 

These polar LL cases, though very small in number especially in India, are sources of reservoir of infection in the community. After adequate MDT the possibility of relapse/reinfection either from endogenous /exogenous sources respectively is a possibility because of inherent zero cell mediated immune (CMI) response against Mycobacterium leprae. These cases require immune therapy along with MDT for prevention of relapse or reinfection. These cases also create problem of showing slow or nonresponse to MDT (non-responders) in the form of delayed bacteriological clearance through SSS and dermal granuloma clearance (skin biopsy). We have found quicker clinical, bacteriological and histopathological responses when longer course of MDT (2 to 3 years) was added with 4 to 8 doses of Immunotherapy (Mw/MIP vaccine). We have seen lepromin conversion in more than 60% of these cases after immunotherapy (published reports).

 

Therefore through immunotherapy along with longer duration of MDT we can reduce chance of reinfection and relapse in these small group of LL patients at-least theoretically by 60%.

 

 

Thanks and Regards,

 

 

Dr H K Kar

 

Dr. Hemanta Kumar Kar

Medical Director - LA Skin

Head of the Department - Dermatology
Paras Hospital - Gurugram, Haryana
Max Smart Hospital - Saket, New Delhi

Email: hkkar_2000@yahoo.com

Ph: +919599114121

 

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LML - S Deepak, B Naafs, S Noto and P Schreuder

LML blog link: http://leprosymailinglist.blogspot.it/

Contact: Dr Pieter Schreuder << editorlml@gmail.com

 

 

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(LML) Re-infection of lepromatous patients after release from MDT

Leprosy Mailing List – July 17,  2017

Ref.:  (LML)    Re-infection of lepromatous patients after release from MDT

From:  Joel Almeida, Mumbay and London

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Dear Pieter,

Whole genome sequence analysis of M. leprae obtained from initial and relapse skin lesions demonstrated that reinfection with a different M. leprae strain can occur in lepromatous leprosy (LL) patients who remain in an endemic area after the conclusion of MDT (Stefani et al, 2017 in press, cited by Penna et al 2017, https://doi.org/10.1371/journal.pntd.0005725). 

Exogenous re-infection was first postulated in the 1980's to explain supposed "relapses" among smear-negative BL and LL patients in an endemic area of India (Almeida et al, 1983, Int. J. Lepr 51(3):382-4, and 1984, Int. J. Lepr. 52(1): 16-19). The recent genome analysis lends support to that view. 

 

So-called "relapse rates" among polar lepromatous patients in leprosy-endemic areas after MDT might be partly or wholly due to exogenous re-infection. For the interruption of transmission and the prevention of disfigurement, it seems important to identify polar lepromatous patients at diagnosis. They can then be protected against re-infection, by continued treatment, until they demonstrably develop specific immunity against M. leprae.

This is important for more than just the individual patient. It is crucial for leprosy control. One polar lepromatous patient is equivalent, in microbiological and epidemiological terms, to 10,000 or more TT or BT patients. Neglect of such microbiological and epidemiological realities renders our leprosy control efforts ineffective. It is a wholly avoidable error.

Joel Almeida

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LML - S Deepak, B Naafs, S Noto and P Schreuder

LML blog link: http://leprosymailinglist.blogspot.it/

Contact: Dr Pieter Schreuder << editorlml@gmail.com

 

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(LML) Infolep monthly mail with the latest publications on leprosy - July 2017

Leprosy Mailing List – July 5,  2017

Ref.:  (LML)  Infolep monthly mail with the latest publications on leprosy - July 2017

From:  Jiske Erlings, Amsterdam, the Netherlands

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Greetings from Infolep! Below you will find a selection of recent publications on leprosy and related subjects. Feel free to contact me (infolep@leprastichting.nl)  to receive the full text versions if a link to the full text is not provided. Assistance with your literature is also possible. We encourage readers of this mailing list to suggest additional documents of interest and to provide feedback on the articles selected. With kind regards, Jiske Erlings Infolep Information officer

 

 

Highlighted publications

 

 

International textbook of leprosy. Scollard DM, Gillis TP. American Leprosy Missions. 2016. Now online - with new chapters!

 

 

New publications

 

 

Serum macrophage migration inhibitory factor levels in leprosy patients with erythema nodosum leprosum. Bansal F, Narang T, Dogra S, et al. Indian J Dermatol Venereol Leprol. 2017. Download PDF The armadillo factor: lepromatous leprosy. Cleary LC, Suraj S, Haburchak D. Am J Med. 2017 Jun 13. Download PDF Role of S-100 Immunostain as An Auxiliary Diagnostic Aid in Leprosy. Dhakhwa R, Acharya S, Pradhan S, et al. JNMA J Nepal Med Assoc. 2017 Jan-Mar;56(205):141-144. Download PDF Health care needs of persons affected by leprosy in Kurnool division of Kurnool district. Guthi VR, Sreedevi A. Int J Community Med Public Health. 2017 Jul;4(7):2474-2481. Download PDF Leprosy in an Eight-Year-Old Child - An Exceptional Case with Unusual Oral Manifestation. Jain M. J Clin Diagn Res. 2017 Apr;11(4):ZD19-ZD20. Download PDF The formation of lipid droplets favors intracellular Mycobacterium leprae survival in SW-10, non-myelinating Schwann cells. Jin S-H, An S-K, Lee S-B. PLoS Negl Trop Dis. 2017 Jun 21;11(6):e0005687. Download PDF India resurrects forgotten leprosy vaccine. Kumar S. Science. 2017 Jun 9;356(6342):999. Read abstract Salivary anti-PGL-1 IgM may indicate active transmission of Mycobacterium leprae among young people under 16 years of age. de Macedo AC, Cunha JE, Yaochite JNU, et al. Braz J Infect Dis. 2017 jun 8. Download PDF Serum anti-phenolic glycolipid-1 IgA correlates to IgM isotype in leprosy patients: a possible candidate for seroepidemiological surveys? de Macedo AC, Guimarães JA, Rodrigues RO, et al. J. Clin. Lab. Anal. 2017 Jun 8. Read abstract Current trends in leprosy- a retrospective study from a tertiary care centre in Kerala. Mathew R, Sobhanakumari K. J Evol Med Dent Sci. 2017;6(30):2403. Read abstract Interpreting data in policy & control: The case of leprosy. Medley GF, Crump RE, Lockwood DNJ. Indian J Med Res. 2017 Jan;145(1):1-3. Download PDF Elevated Pentraxin-3 concentrations in leprosy patients: potential biomarker of Erythema Nodosum Leprosum. Mendes MA, de Carvalho DS, Amadeu TP, et al. J. Infect. Dis. 2017 Jun 3. Read abstract Assessment of vocation of rifabutin and rifapentine in replace of rifampcin in drug resistance leprosy patients: a molecular simulation study. Mohanty PS, Naaz F, Bansal AK, et al. Mol Biol Res Commun. 2017;6(3):113-122. Download PDF Cytological Diagnosis of Primary Cutaneous Aspergillosis Masquerading as Lipoma in a Known Case of Lepromatous Leprosy. Nerune SM, Arora S, Kumar M. J Clin Diagn Res. 2017 May;11(5):ED36-ED37. Download PDF Towards leprosy elimination by 2020: forecasts of epidemiological indicators of leprosy in Corrientes, a province of northeastern Argentina that is a pioneer in leprosy elimination. de Odriozola EP, Quintana AM, González V, et al. Mem Inst Oswaldo Cruz. 2017 Jun;112(6):419-427. Download PDF Renal involvement in leprosy: evaluation of patients in Turkey. Ozturk S, Ozturk T, Can I. Postepy Dermatol Alergol. 2017 Jun;(3). Download PDF Cystic lesions of peripheral nerves: Are we missing the diagnosis of the intraneural ganglion cyst? Panwar J, Mathew A, Thomas BP. World J Radiol. 2017;9(5):230-244. Download PDF Epidemiological and Clinical Characteristics of Children and Adolescents with Leprosy Admitted Over 16 Years at a Rural Hospital in Ethiopia: A Retrospective Analysis. Ramos JM, Ortiz-Martínez S, Lemma D, et al. J. Trop. Pediatr. 2017. Read abstract A 10 year retrospective analysis of Hansen’s disease patients in an urban leprosy centre of Himachal Pradesh. Rattan R, Tegta GR, Sharma A, et al. Int J Community Med Public Health. 2017 Jul;4(7):2470-2473. Download PDF Phenotypic, molecular and pathogenic characterization of Phlyctema vagabunda, causal agent of olive leprosy. Romero J, Raya MC, Roca LF, et al. Plant Pathol. 2017. Read abstract Anti-natural octyl disaccharide-leprosy IDRI diagnostic (NDO-LID) antibodies as indicators of leprosy reactions and neuritis. Serrano-Coll H, Muñoz M, Camilo Beltrán J, et al. Trans. R. Soc. Trop. Med. Hyg. 2017 Mar 1;111(3):125-131. Read abstract Efficacy and Safety of Mycobacterium indicus pranii as an adjunct therapy in Category II pulmonary tuberculosis in a randomized trial. Sharma SK, Katoch K, Sarin R, et al. Sci Rep. 2017 Jun 13;7(1):3354. Download PDF How accurately do clinical diagnosis correlate with biopsy findings in leprosy? Singh AK, Singh R, Singh S, et al. JPAD. 2017;27(1):23-29. Download PDF A Case of New Manifestation of Leprosy Six Months after Immigration to Germany. Sogkas G, Pott C-C, Schacht V, et al. Ann Clin Case Rep. 2017 May 12;2. Download PDF Whole genome sequencing distinguishes between relapse and reinfection in recurrent leprosy cases. Stefani MMA, Avanzi C, Bührer-Sékula S, et al. PLoS Negl Trop Dis. 2017 Jun 15:e0005598. Download PDF A Clinical Presentation of Tuberculoid Leprosy in a Rural GP Setting. Stewart R. Ir Med J. 2017 Mar 10;110(3):540. Download PDF A clinical study of plantar ulcers in leprosy. Subramoniam L, Kunjukunju BP. J. Evid. Based Med. Healthc. 2017 Jun;4(48):2904-2907. Download PDF Anticeramide antibody and butyrylcholinesterase in peripheral neuropathies. Sykam A, Gutlapalli VR, Tenali SP, et al. J Clin Neurosci. 2017 May 30. Read abstract Analysis of SGOT, SGPT, and IgM anti PGL-1 in multibacillary leprosy patient after multi drug therapy. Tabri F, Maskur Z, Amiruddin MD, et al. Glob J Health Sci. 2017;9(9):36-41. Download PDF A rare case presentation of pure neural leprosy. Torne K, Al-Ani S, Bailey M, et al. Eur. J. Paediatr. Neurol. 2017 Jun;21:e222. Read abstract Lepromatous leprosy with Lucio's phenomenon. Wang YF, Wang P, Huang H. Australas J Dermatol. 2017 Jun 28. Read abstract Leprosy: An ancient disease that still threatens global health. Wheeler L, Stewart TJ, Charlton OA, et al. Australas J Dermatol. 2017 Jun 29. Read abstract Integration of leprosy services into the General Health Service in Sri Lanka: overcoming challenges to implementation in a remote district. Wijesinghe TS, Wijesinghe PR. WHO South East Asia J Public Health. 2013 Jan-Mar;2(1):63-68. Download PDF

 

 

Journals & Newsletters

 

 

Community Eye Health Journal: http://www.cehjournal.org/ Disability, CBR & Inclusive Development: http://dcidj.org/ Hansenologia Internationalis: http://www.ilsl.br/revista/atual.php Indian Journal of Leprosy: http://www.ijl.org.in/index.html  Leprosy Review: https://www.lepra.org.uk/Pages/FAQs/Category/volume-88 Leprosy Review Repository (1928-2001) : http://leprev.ilsl.br/arquivo.php Plos Neglected Tropical Diseases: http://journals.plos.org/plosntds/   Revista de Leprología: http://www.leprosy-information.org/resource/revista-de-leprologia   WHO Goodwill Ambassador’s Newsletter for the elimination of leprosy: http://www.leprosy-information.org/resource/who-goodwill-ambassador-s-newsletter-elimination-leprosy

 

 

Websites & Services

 

 

Global Leprosy Programme http://www.searo.who.int/entity/global_leprosy_programme/en/ LML - Leprosy Mailing List - a free moderated email list that allows all persons interested in this theme to share ideas, information, experiences and questions. http://leprosymailinglist.blogspot.nl/ InfoNTD - Information on cross-cutting issues in Neglected Tropical Diseases (NTDs) https://www.infontd.org/

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LML - S Deepak, B Naafs, S Noto and P Schreuder

LML blog link: http://leprosymailinglist.blogspot.it/

Contact: Dr Pieter Schreuder << editorlml@gmail.com

 

 

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