Tomato Flu in India: As cases of viral disease rise in country, health officials on high alert

Tomato Flu Latest Update: Amid fears of the Monkeypox outbreak and the impact of COVID-19, several viral diseases are being reported across India. One such disease, Hand Foot and Mouth Disease commonly known as Tomato Flu is being detected among infants and schoolchildren in several states in India, particularly in the southern part of the country, over the past three months. On May 6, 2022, the first case of Tomato flu was reported in the Kollam district of Kerala. According to The Lancet Respiratory Medicine, as of July 26, 2022, more than 82 children younger than 5 years with the infection have been reported by the local government hospitals. The rare viral infection is in an endemic state and is considered non-life-threatening; however, because of the dreadful experience of the COVID-19 pandemic, the vigilant management is desirable to prevent further outbreaks,” the report published last month in the medical journal stated. Last week, the central government issued an advisory directing parents to ensure that their children avoid hugging or touching their peers. As of now, no death has been reported due to Tomato flu in India. What is Tomato Flu? Caused by Coxsackie virus A16 (a non-polio enterovirus), Tomato Flu is highly contagious and spreads through contagious secretions from the nose, throat, fluid from the blisters, and feco-oral route. According to doctors, several states are witnessing a drastic surge in cases of Hand Foot and Mouth Disease. According to The Lancet report, the primary symptoms observed in children with tomato flu are similar to those of chikungunya, which include high fever, rashes, and intense pain in joints. The disease is called Tomato Flu as there are eruptions of red and painful blisters throughout the body that gradually enlarge to the size of a tomato. “This is a kind of enterovirus which is a common infection in children with less than 5 years of age. It can cause blisters in hand, foot, palm and mouth. Sometimes they cause red blisters which resembles with tomato and that’s why its named as tomato flu or fever,” Dr Sushila Kataria, Senior Director – Internal Medicine, Medanta Hospital told Financial Express.com. ALSO READ | What is Tomato Flu that has put health officials of Kerala and neighbouring states on high alert? Symptoms of Tomato Flu According to the Union Health Ministry, along with blisters, other symptoms include fatigue, nausea, vomiting, diarrhoea, fever, dehydration, swelling of joints, body aches, and common influenza-like symptoms. This disease usually affects children and flare-ups are usually seen in those attending kindergarten. Moreover, doctors advised that these lesions on the skin are highly contagious and should not be scratched. There may be striking ulcers present on the palate of the mouth. The initial symptoms of the disease resemble those of other viral infections and include mild fever, poor appetite, malaise and often a sore throat followed by fever, sores in the mouth and a skin rash. These sores are usually found on the tongue, gums, inside cheeks, palms, and soles. Officials have said if children show symptoms, they should be quickly isolated for 5-7 days to prevent the spread of infection to other children or adults. How Tomato Flu is diagnosed? According to experts, among children with symptoms, molecular and serological tests are done for the diagnosis of dengue, chikungunya, zika virus, varicella-zoster virus, and herpes. After Tomato Flu is confirmed, symptomatic treatment is required as there is no specific therapy. According to the Lancet Journal, if the outbreak of tomato flu in children is not controlled and prevented, transmission might lead to serious consequences by spreading in adults as well. It is noteworthy that children under five years of age are at high risk of getting infected. However, in the current outbreak Children up to the age of Nine years have also been infected with Tomato Flu in Odisha. Moreover, immunocompromised adults are also at a greater risk of getting infected with this viral disease. “It is a highly contagious virus and can spread through respiratory secretions from the nose and mouth and can cause transfer through faecal oral route that is through food and dirty hands. Children less than 5 years are more exposed and are at risk population for this flu,” Dr. Kataria said. Treatment of Tomato Flu Reportedly, precautionary measures are being taken by the Kerala Health Department at present to monitor the spread of the viral infection and prevent its spread in other parts of India. According to the Lancet report, as tomato flu is similar to chikungunya and dengue as well as hand, foot, and mouth disease, treatment is also similar—isolation, rest, plenty of fluids, and a hot water sponge for the relief of irritation and rashes. Moreover, supportive therapy of paracetamol for fever and bodyache and other symptomatic treatments are required. “Similar to other types of influenza, tomato flu is very contagious. Hence, it is mandatory to follow careful isolation of confirmed or suspected cases and other precautionary steps to prevent the outbreak of the tomato flu virus from Kerala to other parts of India. Isolation should be followed for 5–7 days from symptom onset to prevent the spread of infection to other children or adults,” the study revealed. “Hand foot mouth diseases usually are a common diseases in children and their occurrence becomes common during the summer and monsoon season. We can control the spread by maintaining proper hand hygiene, observing respiratory etiquettes, wearing mask, not sending the infected children to school,” She added. ALSO READ | Tomato flu in India: Uttar Pradesh issues advisory to parents of children in vulnerable age group The advisory released by the centre for the prevention of Tomato flu says that the recommended course of treatment is the same as for other viral infections i.e. isolation, rest, plenty of drinks, and hot water sponges to soothe itching and rashes. At present, no antiviral drugs or vaccines are available for the treatment or prevention of tomato flu.

Medical latest news How To Find A WSIB Physiotherapy Clinic That Performs Modern Day Miracles

“The quality of life is more important than life itself” Alex Carrel “Our job is improving the quality of life, not just delaying death.” Robin Williams If you’ve ever lost any functional aspect of your body due to injury, illness or age then you‘re familiar with frustration. When the ability to perform at a certain level is taken away from you it doesn’t just affect your body but also weighs on your mind. This can greatly affect your emotional state as well as any other aspect of life that your physical performance is tied into. Most people recognize that the ability to return from an injury is incredibly important to your career as a professional athlete. The truth is that the ability to recover from an injury is incredibly important to everyone-no matter what station in life you happen to occupy. Good physical health contributes to emotional health When you find a person who can facilitate restoring your physical health there are a series of benefits that topple into place like dominos. Once you see you’re not stuck in the land of physical dysfunction your confidence soars. You become hopeful, faithful, your stress reduces, your frustration subsides and your happiness grows. If you find a good physiotherapist that can effectively improve your physical condition, they become your personal modern-day miracle maker. When it comes to finding a WSIB physiotherapy clinic in any big city the competition is quite fierce. There are dozens of physiotherapy clinics within a 5-block radius in every direction. The real issue is not about availability, but about who to trust with caring for your body. Want to know how to find a great physiotherapist? Follow these guidelines to make the best choice when deciding which physiotherapist is right for you. Do they provide an effective Program of Care? Does the physiotherapist you’re seeing have a plan for each stage of your recovery? Despite the fact that each patient is different, a good physiotherapist will have an established Program of Care. For example, if you were looking for a physiotherapist in Toronto and happened to find Global Health Physiotherapy Clinic you would see its 5 Level Program of Care directly on the website. Manual Therapy Active Exercise Program Pain Control Program Educational Program Custom Home Exercise Program This is a general template for most systems of recovery. If your physical therapist doesn’t follow a system remotely close to this, consider it a red flag. A good physiotherapist is able to walk you through each step of your program. From the moment your injury or condition is diagnosed, there should be clear communication about what is causing the problem and how they intend to solve it. If you look at the Program of Care above, education and home exercise are a part of the system. If you don’t fully understand the problem or solution, how can you fully recover? If you’re left in the dark you run the risk of repeating the same mistakes and not doing your homework effectively. Make sure your physiotherapist is licensed Have you ever seen the first Batman movie, where Joker goes into a shady basement to have plastic surgery? Unfortunately, things aren’t always what they seem. Not all unlicensed physiotherapists work out of a dimly lit shady basement. You might not see it coming but it happens. In both Canada and the US, you have to be licensed to practice physiotherapy. This means that by law, you’re required to have graduated with a degree from a physiotherapy school. In Canada, physiotherapists are required to have passed the “Physiotherapy National Exam” AND you must be in good standing with the provincial College Of Physiotherapists. Doing a background check on your physiotherapist isn’t the first thing people think of but the truth is there are people out there practicing illegally. Who’s to say exactly why they don’t have their affairs in order. Maybe yours happens to be a physiotherapist. Do you really want to take that chance with your body? If you’re in Ontario you can find out whether your physiotherapist is registered and in good standing by going to this link and searching for their name. Is there more than one “great” physiotherapist in the clinic? When it’s possible to go to a clinic and be happy with any of the physiotherapists that work there, it’s a tell-tale sign of a high-quality environment. The best physiotherapists are genuine about their motivation to help and are effective at what they do. They generally surround themselves with other like-minded individuals. When you have a group of effective physiotherapists, they are constantly motivating each other and raising the bar for the standard of work they do. There’s a high possibility that they share their results and continue to learn from one another. A group of talented physiotherapists under one roof is an excellent place to be for recovery. Consider customer service a major aspect of your experience It’s not the first thing you think of when you’re looking for a good physiotherapist but nonetheless, it makes a big difference. If you have third-party insurance or are making a WSIB claim, you can get buried in the paperwork. This can leave you frustrated with the whole experience. If your physiotherapist knows the system and handles direct billing and WSIB claims it makes your life ten times easier. You only need to worry about restoring your health and can leave the rest of the paperwork headaches to the professionals. Check reviews for insight into the therapists quality of care We live in a transparent society. Everyone wants to know the truth. We appreciate and value the truth about the companies we buy from and the service providers who care for us. Reviews are an excellent way to get the inside scoop on the therapist you’re considering. Anyone can get a few good reviews. In fact, there is a lot of tampering when it comes to Google reviews, however, you can’t hide the bad ones! Any half-decent physiotherapist who has been around for a while should be able to accumulate a respectable cross-section of reviews. If t

Medical latest news 5 ways to support a friend or family member to move forward after a DUI

For everyone involved in a DUI, the event, the immediate impact, and the aftermath can all be pretty draining. Many will be unsure how they can help their friend or family member to properly move forward afterwards, tentatively trying to help but being entirely unsure if it will work. Here are five tried and tested ways to support someone to move forward after a DUI. Reserve judgment When it comes to crimes, whatever the magnitude, the person who has done the deed will know and understand that they did something wrong. Judging them and telling them how disappointed you are in them will serve zero purposes at all. In fact, doing so could prevent them from getting the help they truly need and moving on with their life in a positive way. Indeed, mental health challenges, including suicidal thoughts, are common when feeling like you have let everyone down. Encourage them to follow instructions It can be difficult to follow instructions and orders when it inconveniences you. However, if your friend or family member does not comply with what the court has ordered them to do, they may well find themselves in even hotter water. Not only is it imperative that they comply but doing so could even impact positively on their futures. For example, DUI classes at Cornerstone can support people to get their lives back on track and have healthier relationships with alcohol and drugs, for example. Offer to drive them Being without a driver’s license can be challenging, particularly when you rely on your vehicle to get to important appointments, your workplace or even to court. Without the support of friends and family members, the person on the receiving end of the DUI may feel tempted to jump behind the wheel of a car yet again rather than feeling as though they are putting others out by expecting lifts. However, in doing so, they are jeopardizing their good behavior expectations and putting themselves at risk of further court action. Rethink social occasions Meeting up regularly is still important, but it is also key to arrange things that are near your friend or family’s members’ house to make it easier for them to get there. Furthermore, it would be useful to consider the type of activity you do. If your usual meet would involve a few beers, perhaps relocate to a bowling alley or the cinema instead where there are fewer temptations. Rather than organizing things for the evening, why not meet in the afternoon and have a coffee instead of rum and coke? Or lace up your trainers, then go for a run or have a kick about in the park. Do not offer legal advice It can be ever so tempting to hop onto Google and research the DUI and ways in which you could get it overturned. However, offering legal advice could backfire, and it may result in your friend or family member getting their hopes up unnecessarily. Furthermore, seeking proper legal advice is definitely what they need rather than someone who has read a few websites.

Medical latest news Tips for Finding a Reliable Medical Supplier for Your Family

When you need medical supplies for your family, you will want to shop with a company that is reliable and reputable. Whether it’s daily living aids, butterfly bandages for your first aid kit, or a wheelchair, a home delivery pharmacy supplier should be able to give you what you need. So what should you look for in a supplier? Here are our top tips for finding the right one for your family. Find a Company You Can Trust When shopping for home medical supplies and equipment look for a trustworthy company. Simply Medical is a reputable brand with an extensive range of products. They offer discreet packaging and free shipping when you spend over $25. Plus, there is a user-friendly returns policy, with credits or refunds available within 45 days of purchase. Often you will be buying multiple items or making repeat purchases, so choosing a reputable company for your medical supplies will make this process easier. Shop Conveniently Online You can avoid the stress of going to the store by ordering your medical supplies online. For your peace of mind, there are a few things you should consider before handing over your credit card details. The company should be based in the U.S., with a street address listed on their website. This will ensure you get your medical goods quickly, and they will meet strict safety standards. Search for reviews from previous shoppers, noting shipping times, the condition of the products and customer service. Don’t forget to check for safe payment processing — look for a padlock next to the URL to confirm the website is secure and encrypted. Choose Quality and Durability Your medical supplies should support your ailments without making them worse. This is one area you should invest in, choosing quality and durability over ridiculously cheap prices. It could be a grab rail or shower seat for those who need mobility support, a brace for a twisted ankle or a walker to help you stay active. No matter what type of medical supplies you need, look for a supplier who only stocks quality products and well-known brands such as 3M, Ensure, McKesson, One Touch and Lady Dignity. Look for a Medical Supplier With a Large Range Save time and shipping costs by using a medical supplier that is a one-stop-shop. With everything you need in one place, you will always have the accessories you need. Whether it’s a mask, bathroom aid, walking cane, underwear liners, food supplements, meal replacements or first aid and wound care products, the ideal supplier will sell them all. Medical supplies should be available for both one-off purchases and bulk orders. Finding a Reliable Medical Supplier If you need medical goods, there are a few things you should look for in your supplier. You need a company you can trust, with local customer service, fast shipping and a clear returns policy. Shopping online will make the process easy, but it doesn’t come without risks. You can ensure you are using a reputable company by reading previous reviews, and checking that they have a local street address. Remember to choose quality over quantity, and look for a brand with a large range. With everything you need in one place, you could save on shipping costs.

medical latest report Tips for Finding a Reliable Medical Supplier for Your Family

When you need medical supplies for your family, you will want to shop with a company that is reliable and reputable. Whether it’s daily living aids, butterfly bandages for your first aid kit, or a wheelchair, a home delivery pharmacy supplier should be able to give you what you need. So what should you look for in a supplier? Here are our top tips for finding the right one for your family. Find a Company You Can Trust When shopping for home medical supplies and equipment look for a trustworthy company. Simply Medical is a reputable brand with an extensive range of products. They offer discreet packaging and free shipping when you spend over $25. Plus, there is a user-friendly returns policy, with credits or refunds available within 45 days of purchase. Often you will be buying multiple items or making repeat purchases, so choosing a reputable company for your medical supplies will make this process easier. Shop Conveniently Online You can avoid the stress of going to the store by ordering your medical supplies online. For your peace of mind, there are a few things you should consider before handing over your credit card details. The company should be based in the U.S., with a street address listed on their website. This will ensure you get your medical goods quickly, and they will meet strict safety standards. Search for reviews from previous shoppers, noting shipping times, the condition of the products and customer service. Don’t forget to check for safe payment processing — look for a padlock next to the URL to confirm the website is secure and encrypted. Choose Quality and Durability Your medical supplies should support your ailments without making them worse. This is one area you should invest in, choosing quality and durability over ridiculously cheap prices. It could be a grab rail or shower seat for those who need mobility support, a brace for a twisted ankle or a walker to help you stay active. No matter what type of medical supplies you need, look for a supplier who only stocks quality products and well-known brands such as 3M, Ensure, McKesson, One Touch and Lady Dignity. Look for a Medical Supplier With a Large Range Save time and shipping costs by using a medical supplier that is a one-stop-shop. With everything you need in one place, you will always have the accessories you need. Whether it’s a mask, bathroom aid, walking cane, underwear liners, food supplements, meal replacements or first aid and wound care products, the ideal supplier will sell them all. Medical supplies should be available for both one-off purchases and bulk orders. Finding a Reliable Medical Supplier If you need medical goods, there are a few things you should look for in your supplier. You need a company you can trust, with local customer service, fast shipping and a clear returns policy. Shopping online will make the process easy, but it doesn’t come without risks. You can ensure you are using a reputable company by reading previous reviews, and checking that they have a local street address. Remember to choose quality over quantity, and look for a brand with a large range. With everything you need in one place, you could save on shipping costs.

MEDICAL latest news Fruitful Testing the Cancer-Killing ‘Trojan Horse’ Drug

The Core The University of Edinburgh has again excelled in amazing us. Yes, thanks to the scientists at Edinburgh for doing a successful test of the ‘Trojan Horse’ drug and targeted different cancerous and bacterial cells. The good news is that the scientists have done so without damaging the adjacent healthier tissues. Background Scientific minds at the University of Edinburgh did miraculous research by combing two components. They joined chemical food substance and tinier molecules SeNBD. SeNBD is a can-killing molecule. Well, who knew scientists will be using the ‘Trojan Horse’ drug for saving lives? This intelligent combination is capable of tricking the malignant cancerous cells and lead them to ultimate ingestion. The study was peer-reviewed. Scientists use cells of humans and zebrafish for experimental study. However, the scientists have expressed the need to do further studies for confirmation. So, that the safety and swiftness of the method are proved in earlier stages of the cancer cells in addition to bacteria having drug resistance. So, the ‘Trojan Horse’ drug is the new miracle drug. Using ‘Trojan Horse’ Drug Intelligently What’s the Underlying Trick The trick of using food items is a good one. Because you see the cancer cells are very greedy and they love to have higher quantities of food for fulfilling their energy needs. In fact, they are known for ingestion of food to a greater extent in comparison to the healthier cells. These are the statements issued by the scientists at the University of Edinburgh. However, for the time being, we can trust the cancer-killing drug for making difference. So, the scientists used the food substance to target the cancer cells by making it a good prey material for the harmful cancer cells. And the wonderful thing is that the malignant cells have no idea that they are going to be doomed. So, scientists have taken advantage of this non-awareness of the malignant cells to target them. It is quite intelligent of the Edinburgh scientists to use the toxicity against malignant cancer cells by combining with food material. Scientific Proceeding | ‘Trojan Horse’ Drug The scientific publication in the journal Nature Communications is the scientific proof of the suitability of the ‘Trojan Horse’ drug for targeting cancer cells. Professor Marc Vendrell is the Chairperson of translational chemistry and Biomedical Imaging at the University of Edinburgh. He led this scientific research venture. He expressed his views as: “This research represents an important advance in the design of new therapies that can be simply activated by light irradiation, which is generally very safe.” ‘Trojan Horse’ Drug | Strength & Safety Today’s ‘Trojan Horse’ drug actually originated from the Greek myth of ‘Trojan Horse’. The Greek soldiers are known for offering Troy city a big horse made from wood. They did so in a bid for securing safe passage to home. So, in simple words, we can say ‘Trojan Horse’ is the symbolism of strength and safety. In a similar manner, the ‘cancer killing’ drug is safe against malignant cancer cells. Also, it is gaining strength against cancerous cells. Wrapping Up On ‘Trojan Horse’ Drug Though there are always chances for improvement in any domain. So, it is true for cancer and its related drugs. Humanity must be grateful to the scientific minds targeting cancer cells through the ‘Trojan Horse’ drug. However, time will be a better determinant of the utilization of the ‘Trojan Horse’ drug for targeting cancerous cells. General FAQs Which drugs are is typically used for the treatment of cancer? Though, there are many drugs used for treating cancer. However, some of them are very typical. For example, they are methotrexate, 5-fluorouracil, gemcitabine, and 6-mercaptopurine. They are used for treating different types of cancerous cells e.g. cancer of intestines, ovaries and breasts. What was the last latest drug before ‘Trojan Horse’ drug? Before testing ‘Trojan Horse’ drug on cancer cells, medical doctors have been using tisagenlecleucel (Kymriah) for treating cancer in different people. However, the work is ongoing in this domain and scientists are trying to develop new kinds of treatments which are more effective, strong and safe for non-target cells.

Medical; latest news First Total Artificial Heart Implant Carried Out With a Feminine at UOFL Health, Louisville, Kentucky

The cardiothoracic surgical team performed the world’s first Aeson bioprosthetic total artificial heart implantation in a female patient at UofL Health–Jewish Hospital. The investigational device is part of an Early Feasibility Study (EFS) sponsored by CARMAT, a French medical device company, in collaboration with the University of Louisville and the UofL Health–Trager Transplant Center. It is currently being tested as a bridge to a heart organ transplant. We have approved only four programs in the country to conduct this type of clinical trial. Jewish Hospital is one of them. However,they implanted the device on Sept. 14, 2021, under the supervision of cardiothoracic surgeons Mark Slaughter, M.D., and Siddharth Pahwa, M.D., both of UofL Health – UofL Physicians and the UofL School of Medicine. Last month, the same team at Jewish Hospital accomplished the country’s second implantation in a male patient. Slaughter, UofL Health surgical director of heart transplantation and professor and chair of the Department of Cardiovascular and Thoracic Surgery in the UofL School of Medicine, said, “For the other half of the world’s population, the completion of this procedure by the Jewish Hospital team brings new hope for extended life.” “Size restrictions make it more difficult to implant artificial hearts of women, but the Aeson artificial heart is small enough to fit inside the smaller chest cavities more commonly found in women, giving hope to a broader range of men and women waiting for a heart transplant and increasing the chances of success.” In the United States, over 3,500 people are waiting for a heart transplant, with 900 of them being women. Patients with biventricular heart disease, in which both the left and right sides of the heart cannot pump blood, have few therapy options. By pumping blood in both heart chambers, the Aeson device overcomes the limits of conventional left-ventricular assist devices (LVADs), which only pump blood in one. Furthermore, they also included pressure sensors in Aeson, which assesses the patient’s blood pressure and automatically adjusts cardiac output based on the sensor data. It fully implanted as a cardiac substitute and powered by a portable external power source. During this treatment, an eight-hour surgery was performed to implant the Aeson complete artificial heart into a 57-year-old Kentucky lady with severe biventricular heart failure. The recipient, whose identity they have concealed at the request of the recipient, had previously had cardiac surgery but referred to Jewish Hospital’s Advanced Heart Failure Therapies Program with end-stage heart failure earlier this year. In the cardiopulmonary intensive care unit, the patient is doing well (CVICU). Pahwa, a cardiothoracic surgeon at UofL Physicians and an assistant professor in the UofL Department of Cardiovascular and Thoracic Surgery, said that the Aeson device’s varying pumping ability makes it more viable for more patients. “While other devices have a fixed rate or create a continuous flow, CARMAT created the Aeson to automatically adjust the flow, resulting in improved performance to meet the body’s changing blood flow needs.” The Aeson artificial heart is now being studied as a bridge to transplant for patients with end-stage biventricular heart failure, giving them extra time to get a permanent heart organ transplant. In Europe, where about 20 devices have been implanted, they have approved the device for this purpose. It’s currently being examined in the United States as part of a Food and Drug Administration-approved feasibility study. In July at Duke University Medical Center, the first Aeson artificial heart was installed in a male patient. In August, a second implantation took place at Jewish Hospital, this time in a male patient. This is the first time a female patient has taken part in a third implantation in North America. “Even as we fought this devastating pandemic, our researchers and health care workers were on the front lines of improving treatment and quality of life for not only Kentuckians, but for people all across the world,” Kentucky Governor Andy Beshear said. “I am delighted that UofL, Jewish Hospital, and its doctors are leading the way in implanting this exciting and novel gadget that could provide hope and time to thousands of patients in the coming years, including our spouses, moms, and other loved ones.” “This third implant in the United States was a landmark event not only because it allowed us to complete the enrollment of the first cohort of EFS patients, but also because it is the first time our device has ever helped a woman having heart failure,” said Stéphane Piat, chief executive officer of CARMAT. This result shows that the size constraints for adults are modest, giving us great confidence in Aeson’s ability to become a treatment of choice for a wide range of patients.” Over five years ago, preclinical research for CARMAT’s artificial heart began at the University of Louisville. Aeson’s autoregulation feature, which allows the device to alter its flows according to the patient’s needs by detecting variations in pressure in the device, put to the test by researchers at the University of Louisville’s Cardiovascular Innovation Institute (CII). For many years, UofL researchers have done preclinical testing of artificial heart components and mechanical assist devices at CII, testing a piece of practically every commercially available mechanical assist device. “This world-first artificial heart implant in a female patient shows UofL Health’s dedication to providing both today’s world-class care and developing tomorrow’s world-class standards,” said John Walsh, chief administrative officer of Jewish Hospital. “We recognize Drs. Slaughter and Pahwa, as well as the entire team, for their hard work in achieving this first. In the years ahead, they will measure the genuine impact of their labor in the dozens, hundreds, and thousands of lives that will improve.” The patient at Jewish Hospital who received the nation’s second Aeson implant on Aug. 20, 2021, is doing well. In the next weeks, expect an update.