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Severe sinus infection symptoms and conditions

Here are side effects posted by other members, that mention severe sinus infection.
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50 Side Effects posted for severe sinus infection

June 5th
2009
1:18 PM

A year ago I was diagnosed with Sarcoidosis and began taking 50mg Prednisone per day. The worst side effects in the beginning were weight gain, moon face, facial hair, hump-back neck, bruising (for example, just by my knees being together while I sleep,) excruciating joint pain and water retention to the point I felt my skin would split open. And poor vision which could have led to glaucoma, but an eye specialist put me on eye drops to reduce the pressure to normal levels. I've felt horrified and embarrassed by the change in my appearance but relieved that my sarcoid was being treated.
I feel confident in my case that Prednisone was the necessary treatment. My pulmonologist, opthamologist and regular doctor all agreed on a course of treatment. But I really advise people to get a second or third opinion before they take it. A friend of mine was prescribed a weeks course of Prednisone for a severe sinus infection. Luckily she didn't have any side effects but I really question if it was necessary. I'd also like to stress that if you're on Prednisone and experience worsening vision, please see an opthamologist who is a glaucoma specialist because it can lead to blindness if not treated.
And lastly, sorry this became a novel! I have been tapering off and I'm down to 20mg. But recently I've noticed my hair is thinning so much. I lose a ton when I brush it and it clogs the drain when I shower. Also my skin is shedding. When I shower and use a loofah sponge like I've always done and I lose layers of skin like a snake. I would really like to know if my hair will start to grow back when I'm finally off the Prednisone or am I going to lose it completely??

-- By travelseeker | Reply | (1) replies | Private Message me

March 15th
2009
11:45 AM

I am on the nuvaring for about 2 months now and have had 2 severe SINUS INFECTIONS about 3 weeks after I started the Nuvaring and now again 3 weeks later i have the same severe Sinus Infection. I never used to get sinus infections but now I have realized that the cause of this is from the nuvaring. I went online and read about some of the side effects and one of them, believe it or not, is a Sinus Infection, strange as it may sound I am suffering terribly from this sinus infection and will need to get onto antibiotics to get rid of it.
So to all those that don't want to go through what I am going through right now just take this into consideration before trying the nuvaring.

-- By sralter9 | Reply | (1) replies | Private Message me

February 5th
2009
8:24 AM

For just over two years I suffered with chronic sinus infections and I could not understand what the cause of it could be. My doctors (two sinus specialists and also GP) did not even know about this side effect of Lisinopril. I was on antibiotics five times last year. The sinus specialists told me I must go for sinus surgery. I tried to remember when my sinus problems started and tried to link it to something else. Then I realized that I started taking Lisinopril in September 2006. Shortly after this I had my first severe sinus infection and I almost had pneumonia from it. Shortly after I recovered (after taking a strong course of antibiotics) it was not three weeks then I had it again. I had sinus problems the whole of 2007 and 2008. I decided to do some research on the internet to see if the infections are related to Lisinopril. I was shocked to discover that so many people reported the same side effects. I requested my GP to change my BP medication to a different group (Non-ACE Inhibitor). I cannot believe the difference. No more sinus infections! Also, I had flu once so far and I managed to recover from it without the use of antibiotics. This is a real breakthrough for me. I am just glad that I found this forum.
JM, South Africa

-- By johnmocke | Reply | (2) replies | Private Message me

February 4th
2009
12:40 AM

1 year ago my wife had a severe sinus infection. Her doctor gave her Z-Pak . She took the 5 day doses 1 day later she had a SEIZURE. My wife has no history of seizures. Now im looking for ancers
Can Z-PAK cause seizures ??

-- By jaycris2004 | Reply | (1) replies | Private Message me

November 10th
2008
10:48 AM

Hi, All

I normally do not post on websites, however, the issues that I read about in other toddler has me concerned for my grandson as well..

He started to live with us in Georgia three months ago. He was 20 months old. Over Labor Day weekend he developed a severe sinus infection and virus with a fever. Against our better judgment then, we allowed his doctor to prescribe an antibiotic which seem to help him for about two weeks, but her began having excessive mucus and coughing constantly. He had no fever. When we returned to the doctor, they suggested that he use Claritin because he had no infections, but a lot of mucus and drainage. Claritin worked, however, the side effects were he was a little sluggish. The doctor recommended trying Singular. We tried it for three weeks. Over that three weeks, we noticed that his appetite decreased and his aggression level increased where he started a fight with another toddler. He is normally an easy going little boy. He has been very aggressive lately, plus he has had dry coughing and gagging worse than when he was on Claritin. When I read the literature that says this medication causes sinusitis, I immediately decided to discontinue it. He will not be using this medicine again. It may be great for some children, but they really ought to make parents aware of the side effects. They are awful.

-- By msterry1 | Reply | (1) replies | Private Message me

October 27th
2008
2:08 PM

I was “poisoned” by Levaquin -- resulting in acute tendinitis in both Achilles tendons.

Background:
I am a healthy, athletic male in his mid-50s who has never had an Achilles tendon problem. In early July 2008, my doctor (general practitioner) prescribed Levaquin for an infection. I took the medication for 14 days, as prescribed.
Sudden onset of acute tendinitis in my Achilles tendons occurred near the end of the medication period. The tendinitis occurred in both Achilles tendons simultaneously. Nothing related to my lifestyle would have caused the tendinitis.

Symptoms:
Symptoms included the following at one time or another:
1. aching
2. sharp pain
3. feeling of heat/burning
4. tightness
5. pins and needles in small areas (micro tears?)
6. weakness at rear/base of each heal.
7. When I woke-up each morning my tendons and the back of my heal pads felt sore, weak and tight.
At the height of the problems, I had extreme difficultly walking and negotiating stairs, and I thought there was a risk that my tendons would detach from my heal bone.

Doctors’ Advice:

My general practitioner’s and my podiatrist’s advice was to: (a) not run, cycle, hike or otherwise exercise my legs in any manner other than easy walking and swimming, (b) gently stretch, (c) take ibuprofen, (d) ice regularly, and (e) use heal lift shoe inserts made by my podiatrist. Their advice was based on the view that the damage that was done is more like damage cause by an injury than damage caused by an insidious drug. My readings on the subject indicate that little is known about the mechanisms behind this fluoroquinolone-specific toxicity. It is believed that the tendon’s collagen fibers become disorganized and infiltrated with small blood vessels -- resulting in weakness. And there are no specific treatment plans for this problem.

After 2 months of living with these symptoms, I decided to change course.

My Approach to Healing:

Because I never believed my pain was the result of inflammation, I stopped icing and taking ibuprofen. Because stretching seemed to further weaken the tendon and set me back, I stopped stretching. Because I believe that the body heals itself best when used, I started cycling at an easy pace. I then worked-my-way-up to cycling more aggressively, and to walking in the neighborhood. That’s where I am today. Two days ago I had my first day without discomfort in 3 months. Yet, I have a long way to go. I am not yet hiking or running. It’s a slow healing process with occasional setbacks when I push my tendons a bit harder than I should, Given the progress I have made, I am hopeful for a full or nearly-full recovery in another few months.

Other things I have done in the past month:

1. Taken L-Lysine (1000mg daily), which is believed to aid collagen formation.

2. Taken Magnesium (250mg daily), which some believe may help leech the fluoroquinolone molecules from the tissues because of the affinity of these antibiotics for minerals.

3. Taken Fish oil pills (3000mg daily), which improves circulation

4. Used a heating pad, which improves circulation

5. Started regular Acupuncture (first time for me), which improves circulation

What you can do:

1, Be easy on your tendons until you get a handle on the problem. Don’t over-use tendons when they are in a weakened state.

2. “Listen” to your body and take steps you think best to help the healing process.

3. Tell your friends to beware of potential side effects from fluoroquinolones.

4. File a MedWatch report with the FDA at fda.gov.

5. Share your findings/advice on this forum.

Good Luck

-- By gm01 | Reply | (1) replies | Private Message me

October 23th
2008
12:55 AM

I was given Dexpak for a severe sinus infection. I took it for 5 days and could no longer take the side effects, so I quit it cold turkey. I have been off from work almost the whole month because of this drug.

The side effects I had from it were:

• anxiety
• hyperactive
• uncontrolled talking
• severe tremors and shakes
• overheating
• loss of appetite
• sitting still and the room spinning
• loss of vision
• severe headache
• loss of concentration
• unable to think
• no sleep
• all upper body muscles tied into knots
• esophagus swollen and raw
• dizzy
• personality change

After I quit I became ravenous the next day. I ate a lot of protein and fruit. It has almost been a week since quitting. I still have problems sleeping, headaches, a swollen esophagus, sore muscles and my personality is not quite normal. Hopefully I will get back to normal.

-- By pictest123 | Reply | Private Message me

August 23th
2008
6:52 AM

I saw an elderly ENT who prescribed Biaxin XL 1000mg/once per day for a severe sinus infection of the ethmoid, maxillay and frontal sinuses. I was not getting any better, in fact I was getting worse. I decided to go for a second opinion and learned that Biaxin is not as wide spectrum of an antibiotic as Augmentin is for sinus infections. The key strains of bacteria are not being obliterated from the Biaxin. MDs who prescribe Biaxin are not staying on top of current literature as Biaxin was commonly prescribed in the 1980s and 1990s.

My incredible side effects to Biaxin XL (including not wiping out the bacteria) include: lingering bad bitter taste, night sweats, insomnia, extreme stomach cramping, constant stomach churning (which kept me up at night), terrible diarrhea, nausea. The only plus side is that was more mentally alert.

If your doctor prescribes Biaxin for sinusitis, leave that doctor immediately and seek help from another practitioner who is more current on medications of choice for treatment.

-- By pxtxrdh | Reply | Private Message me

August 11th
2008
10:23 PM

I was prescribed 750 mg. Levaquin, one a day for 14 days for a severe sinus infection. We left to visit my son and family in Texas two days after starting the medicine. The entire time we were there I could not sleep. The second day we were there I was walking down the stairs when a pain hit me in my left calf that was so bad I thought I had surely torn a muscle or something worse. It continued to be painful for several days. We returned in four days and I noticed that I was aching all over. I have arthritis and some other problems, so didn't think too much about it. However, it continued to get much worse. My feet hurt so badly that I could hardly bear to walk. My heels are especially painful. I cannot bend my toes without terrible pain and my feet have been swollen. I have sharp tingling pain in my toes as well. My hips and knees are very painful. I am shuffling around just trying to walk and get up and down. I started having a strange pain in my right shoulder area. Am still having insomnia. This is very scary and after reading all the posts it is even more frightening since you don't know what to expect even further down the road. I have an appointment in the morning with a neurologist. I don't know what they can do and I don't want to be put on a bunch of other drugs. I just hope he acknowledges that the Leviquan caused this and doesn't try to come up with some excuse. I have absolutely no doubt the Leviquan caused this as it was immediate and continued to get worse as I took it. I stopped after 11 days and only wish I had stopped sooner, but you just keep making excuses for the weird things that are happening until you finally realize there is something very wrong. I have experienced a lot of pain in my life, but nothing like this. My brother has acute leukemia and has horrible neuropathy in his hands/arms, feet/legs caused by a clinical trial with two chemotherapy drugs. Now I am afraid I may have it in my feet, or something as bad. If the doctor has anything worth reporting I will let you know. Good luck to everyone and thanks for listening.

-- By sls68 | Reply | Private Message me

July 13th
2008
12:56 AM

I thought I had sinuses for years..got test for allergies and was founded to be allergic to nothing! Despite having at least 3 infections a year and on my 3rd nose spray, zyrtec, nyquil at night..ect..because I was contantly congested and had drainage & headaches..3-4 infections a year.. She ordered a cat scan and was told that my sinuses had spurs but was clear; my septum was severely deviated and I needed a ENT to have surgery to correct it...The ENT wanted to do major surgery which included a plastic surgeon... so I went for a second opinion to another ENT that was well known who told me I had rebound headaches..and referred me to a neurologist..my goal was to get off all the meds (nose sprays, nettie pot, antihistamines..nyquil..ect..) ..he was a dinosaur and was convinced that although I had a severe deviated septum~he didnt want to do surgery but wanted me to stop all meds I was on and to go to his neurologist that he liked *(another dinosaur) who put me on Topamax..50mg in the morning and 50 mg at night..I had panic attacks right away so he added 20 mg of klonopin at night to help with that and flexeril to help me relax...he hinted at me going to a pysch doctor which pissed me off right as if I was psychosomatic or something... and stiffled me a few times when I tried to talk to him about my drainage and congestion~he wanted to hear none of that because he already made his mind up what I had and "sinuses" didn't jive with his impression that I had migraines.

All of the sudden within days I really did have migraines..they just hit me! HARD...I had to call him and tell him I was in excruciating pain on the right side...he called in Imitrex inj. and they worked within 5 min. and my Topamax went from 100 mg total > 250 mg/day! I had at least 6 shots since and the side effects of the Topamax have profoundly changed my personality...I have no word recall..like being stoned in the 70's but worse because I have a special needs child and I need to engage her and am like a zombie! I have ALL the same sx that are mentioned but notice one that isnt noted which is my tongue is raw as well as my throat...all the way down into my stomach...I am having to take zantac for acid indigestion~it is like my insides are raw!
I am also having extreme constipation...I lost weight in the first 2 mos. where I couldn't eat nothing..but now I am eating cause it's there but it is not leaving me even when I take multiply doses of my old standby... I am drinking tons of water..at least 64 oz a day but it is not helping. My eyes are burning at times...I need my reading glasses all the time now. Some days my heart is beating out of my chest for no reason..at rest..I just feel ill like something is not right at all! I don't go nowhere & have become a hermit. My headaches are gone but I feel I am just a shell of a person and want to get off...I am slowly weaning off by doing it 25mg at a time for one week at a time....then another 25mg another week......I know I will have migraines but I will just bite the bullet and suffer through it till I am off this poison....I have some injections left..MY main goal was to be off meds and these side effects are horrible! Once I am completely off I am going to a good ENT that can do the surgery to fix my sinuses so that I can hopefully be drug free as I intended. I too wasn't told of these side effects at all. So much time & $$$$ wasted! I think if I stay on this too much longer it will truly do long term harm!

-- By shellrtx | Reply | (1) replies | Private Message me

May 14th
2008
9:36 PM

My baby is 3. She had strep throat from Jan to April. I'm talking off the antibotic for max 4 days and the fever would return along with swollen glands, difficulty swallowing and just plain miserable. Took me 2 ENT referrals for someone to finally agree with me that this is not normal and something needs to be done. We scheduled a T & A for April 18th. The surgeon told me that she had a severe sinus infection as well (surgery day). He recommended that we start Singulair 4mg at night along with Nasonex to possibly help with her constant sinus congestion. I gave it to her and noticed nearly an immediate a change in her disposition.(looking back now) At the time I simply chalked it up to having her tonsils out. She was on the medication until Friday May 9th. Her babysitter said that she was seeing what I was at home...only I hadn't shared my dgtrs behavior at home with her...call it guilt for being a single mom who works...I just thought she was having trouble adjusting from a week at home with mom from the surgery recovery to getting back into the "norm" routine. At home she would cry at the drop of a hat. Not just wimper or whine....but tears and screams for nearly an hour. I would ask her why she was crying and she'd simply reply "I don't know Mommy." One minute we'd be playing and she's be laughing and the next she was angry and anxious. She would complain of "tingles in her feet"...I thought she had just been sitting on her legs and her foot had fallen asleep. She would deliberately instigate her older sister...totally not her. She became fearful of her room at nighttime...and took for ever to get to sleep. A co worker had mentioned that a little boy she worked with had his medicine changed b/c the dr said one of his meds may contribute to his behavior issues. Being a nurse I asked what med...SINGULAIR. I immediately went to the web and googled singulair. I found this site...and began to read parents horror stories of their experiences. She has not had another singulair nor will any of my children - EVER. I feel guilty that I didn't take the time to research it before I put her on it. I feel blessed that I was in the right place at the right time to find out about this site. I thought that my kind and sweet little girl had turned into. I know it's only 5 days off the med but she's back to her sweet self about 75%. I am blessed that my experience was not even a month long...but losing your child to a medication that no one warns you about even for a day is WRONG. I think I would be more "forgiving" if anyone along the line of me picking up the med had said ANYTHING...but no one said a thing. My prayers are with those who were not as lucky as I was to stop this med so quickly. I hope your children return to their pre singluair selfs quickly and permanently.

-- By rhondajrowles | Reply | (1) replies | Private Message me

April 27th
2008
6:51 AM

I am a 57 year old man, who has been suffering from asthma several years. This spring my doctor put me on Singulair as an additional medicine to my cortisone-inhalator. after one month I feel symptoms of depression an mood-changing, severe ups and downs.
AND - as an additional symptom i have partially lost my feeling in some fingertips, and now parts of my left thumb and even a feeling of "cold2, mostly in my left hand.
anyone who share that symptom?
M.

-- By manique1 | Reply | (5) replies | Private Message me

April 10th
2008
2:51 PM

I have actually been prescriped Levaquin a few times for sinus infection. My experience has been good. No side effects, quick relief of sinus pain and pressure. I have taken each prescription exactly as directed with great results. At the advice of my doctor I always eat yogurt each day and for a few days following taking any antibitic. I would like to add that some of the symptoms described here (emotional trouble, severe headaches, mood etc.) remind me of what my daughter experienced when she had an undiagnosed (therefore untreated) severe sinus infection. I am not a doctor, and do not mean to minimize the seriousness at all, but maybe some of them are due to the infection not being cleared.

-- By amjag1aolcom | Reply | (1) replies | Private Message me

April 5th
2008
9:56 AM

I was prescribed Levaquin Leva-Pak for a UTI and severe sinus infection. I took the first pill last night. I DID NOT SLEEP A WINK!!! I am so exhausted and i feel like im in a fog. I will not be taking this medication again, and personaly i feel that the FDA should take this medication off the market!!!

-- By lford | Reply | Private Message me

April 3th
2008
6:06 PM

I have been on Leva-pak for 2 days and have not been able to sleep. I have been sleeping for an hour at a time, I then wake up and can't sleep again for another hour. I AM EXHAUSTED!!!! I am taking it for a severe sinus infection and double ear infection.

-- By tsaann01 | Reply | Private Message me

March 19th
2008
11:10 AM

I am a 51 year old female who has been taking Advair 500/50 for a number of years now. About a year ago I got a severe sinus infection and have been battling recurring bouts ever since like clockwork. I've lost my sense of smell and my voice sounds like I am sick 24/7. The ENT I went to was absolutely clueless on asthma and allergy medications and their side effects. She told me my sinus problems were caused by my allergies. They may have caused the problem but I should be healthy enough to recover in a week or two not a year or two!!! I have NEVER have a sinus infection before taking Advair. I also now have been diagnoses with Osteopenia and a recent blood test showed elevated blood sugar and cholesterol. My GP says it is a side effect of Advair. I have also recently went thru a barage of tests because of an irregular heart beat and palpitations. I am a triathlete and marathon runner, eat a healthy balanced diet and work hard at trying to keep my weight in check. There is no doubt in my mind that Advair is the cause of these health problems.
I decided to come off Adbvair cold turkey. For about a week I felt exhausted (an understatement). I did experience a few episodes of tightness in my chest but using a puff or two of albuterol was all I needed. I take peak flow readings ever morning and actually had some of my highest readings in months, after stopping. Best part of all, I am starting to get my sense of smell back and have been without symptoms of sinusitus for the first time in over a year!!! My energy is coming back. But the big test will be when I start back training at full throttle.
When I was prescribed Advair the only thing I was told was to make sure that I rinse my mouth out after taking it. No reason and no education on the short and long term effects. This forum is AWESOME!!! This is the first site that I have encountered that gave me honest hard facts and information I can work with. THANKS TO ALL who have posted!!!

-- By epattyj | Reply | Private Message me

March 9th
2008
6:25 PM

I was given Metoprolol, a generic for Toprol-XL several months ago, for high blood pressure. It was prescribed after I was determined to be allergic to Lisinopril. ( It caused a cough that lasted 3 months; I sounded like a TB patient.) Anyway, I have been taking Effexor for years, for anxiety attacks. Now that I take Metoprolol along with the Effexor, I am so tired and drained all the time, that I am contemplating quiting work. I go to the grocery, come home and lie down. I can't seem to have energy to breath correctly. My Dr. won't believe that this has anything to do with meds. I have now developed blood and mucous in my stools, diarrhea, and very urgent BMs. This all started after taking these two meds in combination for about 4 months.

-- By taterwood1 | Reply | (4) replies | Private Message me

February 5th
2008
9:13 PM

Was prescribed Levaquin during the flu for the "possibility" of an infection. Developed severe leg cramps and swelling. Insomnia, have slept a total of about 3 hours in 3 nights. Episodes of depression, crying and anxiety with racing heart. If this was the only drug available to save myself from a severe sinus infection, or even death, I would chose the infection! Stay away from this antibiotic, it's unbelievable this drug is legal and even more so that doctors actually prescribe it to people. I guarantee they wouldn't take it themselves or give it to loved ones.

-- By jeffnett2 | Reply | (1) replies | Private Message me

January 26th
2008
8:21 PM

I was prescribed Sulfamethoxazole-TMP tablets for a severe UTI that I developed. I was given 10 tablets total--and instructed to take two per day. Within an hour of taking the first tablet, my UTI felt much better, however, the rest of me felt horrible! I got nausea, dizziness, extreme confusion and depression, and stiffness and pain in my neck and shoulders. I continued the medication anyway, b/c I never had sulfur or ANY medicinal allergies. I had difficulty sleeping the next few nights, I would wake up in the middle of the night for no reason. The soreness of my neck and shoulders then extended to my butt and thighs. I can't describe how uncomfortable this was. I was sitting at work literally writhing in pain from what I felt in my legs. (and I blamed it on my poor desk chair!!) This happened on day three of five. Also, while at work I had an "episode" if you will, where I became extremely confused and disoriented, and nearly had a panic attack. It felt like the world was crashing down on me!! It only lasted for 15 minutes or so, but I will not forget the way I felt. All the while, my UTI symptoms were getting better and better. I was completely unable to have a bowel movement...sorry for this information...but it will start to make you worry if you can't poo for 5 days!! Day four of five is what I like to call "The Enlightenment". I was getting in the shower, still dizzy as hell, and noticed that I was very itchy. I looked at my lower back and I was covered in red, itchy bumps. I was say they looked like small mosquito bites, all in a cluster of about 8 on either side of my lower back. I realized then and there that this medication really was ravaging my body like I had feared. I found this site and others online which confirmed that I wasn't crazy...just poisoned. Later that day I was resting on my couch and looked in the mirror and saw that my entire face was covered in a red rash. (and I got a horrific headache) The worst part is you don't really look outwardly sick or anything...you just feel terrible. Everyone I told was very nonchalant about it..."Oh just take some Benadryl". I've lost my faith in the FDA. I stopped this medication one pill shy of my last dose. I am terrified of the possible lasting effects and will never take this drug again!! PLEASE!! NEVER TAKE THIS MEDICATION!! YOU WILL REGRET IT!!

-- By lindsayyorkie | Reply | (29) replies | Private Message me

January 17th
2008
5:25 PM

I started taking Levaquin last Friday ( the 11th) for a severe sinus infection. I was prescribed 750 mg for 5 days. I finished that but my sinus infection didn't improve so I was prescribed another 5 days of 750 mg. I took the pill yesterday and today ( totally 7 pills) I noticed on about day 2 or 3 that my legs felt tight, but thought it was a normal side effect. Then my lower back. I wasn't in serious pain at all so I ignored it. Today my knees, knuckles, shoulders, elbows, are extremely sore and i get sharp pains every now and then. It also hurts to sit for too long. I started researching the drug and now am so terrified after reading all these horror stories. Has anyone had this only last while taking it and not for months afterwards? Or am I pretty much in this for the long haul. And to the people who say that it lasts for months or years is it pain that disables you from working and doing daily things? I'm only 23 and I live a very active life and I'm totally freaked out now. PLEASE HELP

-- By barbaral | Reply | (4) replies | Private Message me

December 15th
2007
11:29 AM

My 16 yr old son was prescribed this drug 9 days ago for a severe sinus infection. He came home from school yesterday with several small raised welts on the creases of his arms. I took him immediately back to his Dr who said he was having an allergic reaction, prescribed steroids and said it would get worse before it got better. Within a few hours his elbows had visible knots in different places, then his knees did the same thing, then his feet started getting knots on the bottom and he had different whelps breaking out on his torso and lower stomach. We immediately took him to the ER last night when he said his tongue "felt funny". The attending immediately diagnosed an acute severe allergic reaction and gave him a huge steroid and Benadryl dose. He released him because the itching had stopped and his tongue no longer felt funny. Last night he kept drenching himself with sweat during sleep. Today so far some of the whelps are gone but he has some pretty severe joint involvement with visible knots around the elbow and knees and feet.

-- By song0fthesouth | Reply | Private Message me


 

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