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Dr. Anand Govind

Radiologist, Chennai

Dr. Anand Govind Radiologist, Chennai
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I'm dedicated to providing optimal health care in a relaxed environment where I treat every patients as if they were my own family....more
I'm dedicated to providing optimal health care in a relaxed environment where I treat every patients as if they were my own family.
More about Dr. Anand Govind
Dr. Anand Govind is one of the best Radiologists in Padi, Chennai. You can visit him at Rajan Nursing Home in Padi, Chennai. You can book an instant appointment online with Dr. Anand Govind on Lybrate.com.

Lybrate.com has an excellent community of Radiologists in India. You will find Radiologists with more than 43 years of experience on Lybrate.com. You can find Radiologists online in Chennai and from across India. View the profile of medical specialists and their reviews from other patients to make an informed decision.

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No 43,Sathya Nagar,Padi,Landmark:Near To Sajred Heart School, ChennaiChennai Get Directions
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I am having problem in my spinal cord disc L4 -L5. With some loss of fluid. Now my knee joint also getting pain. What you wil suggest.

BPTh/BPT, MPTh/MPT
Physiotherapist, Noida
I am having problem in my spinal cord disc L4 -L5. With some loss of fluid. Now my knee joint also getting pain. What...
Core strengthening exercises- straight leg raised with toes turned outward, repeat 10 times, twice a day. Back stretching- lie flat, pull one of the knee forward to chest, hold for 3 seconds, then bring the other knee forward to the chest and again hold for 3 seconds. Then pull both knees towards the chest and hold for 3 seconds. Repeat 10 times each exercise twice a day. Do the cat/cow stretch. Get on all fours, with your arms straight and your hands directly under your shoulders; your knees hip-width apart.
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I am a student. Usually I used to sit more than 8 hours a day in chair. Now a days I am feeling very much pain on regions of backbone and neck. Is this a chance of disk failure?

BPTh/BPT, MPTh/MPT
Physiotherapist, Noida
I am a student. Usually I used to sit more than 8 hours a day in chair. Now a days I am feeling very much pain on reg...
Neck advice hot fomentation x twice daily. Neck exercises. Neck stretching. Postural correction. Shoulder shrugs. Core strengthening exercises. Take frequent breaks at work use cervical pillow. Use back support. Back advice. Apply hot fomentation twice daily. Avoid bending in front. Postural correction- sit tall, walk tall. Extension exercises x 15 times x twice daily. Bhujang asana. Core strengthening exercises. Back stretching. Do the cat/cow stretch.
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I'm 42 years old. I'm suffering from l-s 4 slip disc. please tell what can be done?

MBBS, MS - Orthopaedics
Orthopedist, Delhi
(A) Sleep on a hard bed with soft bedding on it. (B) Use no pillow under the head. (C) Kindly take BioD3 Max 1 tab dailyx10 Paracetamol 250mg OD & SOS x5days (D) Do back(spine)/shoulder/knee exercises (E)Make sure you are not allergic to any of the medicines you are going to take (F) Do not ignore it. It could be beginning of a serious problem. (G) If no relief in 4_5 days,then contact me again. (H) Contact your family doctor or nearest hospital for emergency help.
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I am 24yr old male and have backache for 7 month. My mri report is mild annular disc bulge is seen at l4-5 level with subtle anterior thecal sac impression. What should I do?

Diploma in Radio-Diagnosis
Radiologist, Shimla
At this age only excersises-lumber and sacral, har, bed rest, avoid jjerky movements, and sitting posture normal advised.
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I am 20 years old. But my weight is 85 and my height is 5.11 so is it correct weight or should reduce my weight? tell me how to reduce. And I have a backache means one disk in my back has pressed inside than the normal of other disks. So please give a perfect solution.

MBBS, MS - Orthopaedics
Orthopedist, Delhi
I am 20 years old. But my weight is 85 and my height is 5.11 so is it correct weight or should reduce my weight? tell...
Sleep on a hard bed with soft bedding on it. SPRING BEDS, FOLDING BEDS OR THICK MATTRESS ARE HARMFUL Use no pillow under the head. DO HOT FOMENTATION. Paracetamol 250mg OD & SOS x 5days. Caldikind plus 1tab OD x10. Do neck back knee & general exercises. It may have to be further investigated. Make sure you are not allergic to any of the medicines you are going to take. For emergency treatment contact your nearest hospital or family doctor. Weight reduction can not be done overnight. You have to take it as a way of life. Do Diet control. no sugar in tea,coffee,milk etc. NO sweets Take small frequent meals. When you get used to it, skip one meal. Then after 3 months skip another meal, & so on? You should do non weight bearing Yoga exercises. Do ask for detailed treatment plan. Do not ignore It. could be beginning of a serious problem. Why not discuss with me in a video conference?( Facility Provided by lybrate.com) Why not discuss with me in a video conference? (Facility provided by lybrate.com)
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Umbilical Hernia Diet

M.Sc. in Dietetics and Food Service Management , Post Graduate Diploma In Computer Application, P.G.Diploma in Clinical Nutrition & Dietetics , B.Sc.Clinical Nutrition & Dietetics
Dietitian/Nutritionist, Mumbai

Umbilical hernia diet

An umbilical or belly button hernia occurs when a part of the intestines or the abdominal lining protrudes through an opening in the abdominal muscles. The protruding intestines may get squeezed or strangulated resulting in the blood supply getting cut off. Surgery may be required in serious cases of umbilical hernia. Doctors often suggest a special diet for umbilical hernia patients as this helps to prevent further complications.

Foods to avoid

Certain foods are not recommended for people with an umbilical hernia and should be avoided.

These include:

White refined flour foods made from white refined flour have a low fiber content. Eating these foods may cause constipation and should therefore be avoided. This is because constipation causes straining of the abdominal muscles during bowel movements and may cause further protrusion of the intestines through the abdominal muscles in the region of the belly button.

Low fiber fruits and vegetables the low fiber content in these foods can also lead to constipation. Examples of fruits and vegetables with low fiber content include skinless raw fruits, cooked fruits, and canned or cooked vegetables without seeds, hulls or skin.

Fatty foods foods with a high fat content should be avoided. This is because obesity results in greater pressure on the abdominal muscles and can increase the risk of umbilical hernia. Examples of foods with a high fat content include fatty meat such as pork, whole milk, butter, cream, margarine and fried foods.

Sugar limit your calorie intake by cutting down on foods such as pastries, cakes, chocolates and soda pop. Limiting your sugar intake will also help you to lose some weight, taking pressure off your abdominal region.

Foods to include

A special diet is required after umbilical hernia surgery. This will help you to minimize your convalescence time. The special dietary requirements include:

Fruits fresh fruits that have high fiber content and are rich in antioxidants should form a part of every meal. The high fiber content will ensure that you do not get constipated and the antioxidants will help protect your body and boost your immune system. Try to eat different types of fruits so as to get adequate amounts of different vitamins. Citrus fruits, berries, and apples are some examples of fruits with a high fiber and vitamin content.

Vegetables these too have a high fiber content that will guard against the dangers of constipation after an umbilical hernia surgery. They also have high levels of vitamins and minerals and should also be included with every meal.

Lean meat meat is a source of protein, which is essential to the repair of damaged tissue. Lean meat like poultry and fish is an excellent source of low fat protein. Have one good source of low fat protein with every meal.

Low fat dairy products these are a good source of protein and can be alternated with lean meats to provide your body with sufficient protein.
High fiber breakfast foods will aid digestion and so your breakfast should consist of foods made from whole wheat flour, wheat germ, oatmeal, or bran.

4 people found this helpful

All About Bone Cancer

M.Ch - Orthopaedics, Fellowship in Arthroscopy & Sports Medicine, MS - Orthopaedics, MBBS
Orthopedist, Delhi
All About Bone Cancer

Cancer that originates in the bones of a human body is referred to as bone cancer. Any bone could come under the threat of this disease, but generally the longer bones of your body, so to say the bones of your limbs, are at a greater risk. 

A few factors that might push you an inch closer to bone cancer are:

  1. Genes could jinx your health: A few typical genetic syndromes could increase a person's chances of contracting bone cancer. These syndromes could have been active in any person belonging to your lineage. One such syndrome is Li-Fraumeni.
  2. Treatment for one kind of cancer can make you prone to some other kind: Radiation affects your bones adversely. A patient of breast cancer might be undergoing radiation therapy that further increases his or her risk of contracting bone cancer in future.  
  3. Paget's disease can have unfavorable implications: Paget's disease is a disease that affects elderly people. This condition, if left untreated, can turn into bone cancer at a later stage. 

Several symptoms of bone cancer can be found below:

  1. Sudden loss of weight: If you lose a considerable amount of weight in a few weeks time without having made any effort at all, you should probably be worried about the health of your bones. Bone cancer can result in sudden and unintentional weight loss. 
  2. Unexpected bone fracture or breakage: Cancer of the bones is known to gnaw at the strength of your bones. Weakened and diseased bones can break or get fractured very easily. An unexpected fracture should not be overlooked so as to prevent chances of anything more harmful.
  3. Long spans of unyielding exhaustion: Constant fatigue and sleepiness might be hinting at a more serious underlying problem. The bones in your body hold you together; cancerous bone cells can make you feel exhausted without much exertion as your bones lose their inherent potency.
  4. Persistent pain in the bones: Excruciating cramps or pangs of stinging pain in a person's bones either continuously or at odd hours, could be indicative of bone cancer. Such instances require the advice and guidance of an experienced oncologist.
  5. Bone swelling: The area affected by bone cancer can grow big and tender or the bone itself can swell up.
3244 people found this helpful

Treatment of Cerebral Ischaemia and Cerebral Congestion With Homeopathy

BHMS
Homeopath, Gurgaon
Treatment of Cerebral Ischaemia and Cerebral Congestion With Homeopathy

Cerebral ischaemia or brain ischemia is a medical condition that restricts the flow of blood to the brain, resulting in an unmet metabolic demand. This leads to limited oxygen supply in the brain, which could result in death of brain tissues, cerebral infarction or an ischemic stroke. Thus, a cardiorespiratory arrest, a stroke, and irreversible brain damage are few possible consequences of cerebral ischaemia.

People with compressed blood vessels, low blood pressure, congenital heart defects or sickle cell anaemia have a high risk of developing cerebral ischaemia, since compressed blood vessels or very low pressure can lead to restricted blood flow. Also, sickle-shaped cells have a greater tendency to clot, causing obstructed blood flow.

Patients with cerebral ischaemia experience a host of symptoms, such as weakness in the body, problems in coordination and movement, vision and speech impairment and unconsciousness.

Cerebral congestion, on the other hand, refers to excessive quantity of blood in the brain vessels, causing pressure on the cerebral substance. Cerebral congestion is of two types. It is termed as active when there is too much arterial blood flow and passive when there is undue quantity of venous blood in the veins of the brain. Both conditions cause symptoms, such as severe headache, insomnia, irritability and unconsciousness. The patient gets little sleep and is disturbed, often followed by dreams. When awake, the patient’s mental activity in the brain is very high.

Homeopathy is now a well-established school of medicine backed with years of research and practice. Gone are the days when homeopathy was considered no more than an extension of herbal home remedies. Homeopathic laboratories around the world produce large number of medicines covering almost all ailments. The benefits of homeopathic treatment are now well established due to its holistic approach and minimal side effects. Homeopathy is undoubtedly a ray of hope for patients with cerebral ischaemia and cerebral congestion, as it delivers a comprehensive treatment plan designed to target the signs and symptoms of the disease and address its non-occurrence.

The medications deal with mild to severe symptoms, including inflammation of the brain, headache, vomiting, insomnia, stroke/convulsions and seizures. The stramonium drug, for example, deals with seizures. Belladonna is an effective remedy for sharp shooting headaches, a common symptom of cerebral congestion. Ferrum is believed to be a valuable remedy for brain ischaemia. Few drugs deal with the symptoms of both ischaemia and congestion—nux is a suitable drug for the treatment of ischaemia as well as for passive cerebral congestion. Similarly, phosphorus can be used to treat brain ischaemia and congestion. Zincum metallicum is a highly recommended drug for chronic cases of ischaemia.

The treatment is comprehensive and long term and shows substantive results. Regular follow-ups and consultation with a homeopath specialist is the key to an effective treatment.

4598 people found this helpful

Health Tip

Doctor Of Physical Therapy (DPT), Bachelor of Physical Therapy
Physiotherapist, Bangalore
Health Tip

Herniated disks or bone spurs in the vertebrae of the neck may become the reason behind severe neck pain. They sometimes take too much space and compress the nerves branching out from the spinal cord.

5 people found this helpful

I am 36 year old having problem of of disc slip in lumbar spine Dr. Asked for the surgery is only surgery is the option please suggest me other treatment.

DNB (Radiodiagnosis), DMRD, MBBS
Radiologist, Bangalore
Hi, thanks for writing in to us. It is possible that the disc bulge might have increased in severity recently. Please get a repeat mri scan done and discuss the findings please. It is possible that you might get relief through physical therapy or mild pain relief medications. If there is no relief with medicines then there is the option of steroid injection and radio frequency nerve block procedure. Surgery is the last resort and done only in extreme cases. Please do not worry. Regards,
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I have slip disc l4 l5 over three years. What can I do for it some thing different?

MBBS, MS - Orthopaedics
Orthopedist, Delhi
Investigations advised - hb, tlc, dlc, esr, sugar f & pp, uric acid, vit d3 urine r/e x ray of the affected part. Anyway you may try- sleep on a hard bed with soft bedding on it. Spring beds, folding beds or thick mattress are harmful use no pillow under the head. Do hot fomentation. Paracetamol 250mg od & sos x 5days. Caldikind plus 1tab od x10. Do neck back knee & general exercises. It may have to be further investigated. Make sure you are not allergic to any of the medicines you are going to take. If no relief in 4_5 days, then inform again.
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Treating Breast Cancer With Ayurveda

Skin Diseases Cancer Heart Diseases Musculoskeletal Disorders Male Sexual Disorders AIDS, Hypertension Diabetes Mellitus Blood Disorders Respiratory Disorders, Gastrointestinal Disorders Endocrine Disorders ENT Disorders, Gynecological Disorders Opthalmic Disorders Psychiatric Disorders Urological Disorders
Ayurveda, Indore
Treating Breast Cancer With Ayurveda

Breast cancer, is a type of cancer, which is common to women, where cancer cells grow on the breasts or the female mammary gland. It starts out with the formation of a small lump in your breast and can spread out to your other organs very rapidly. It generally affects women above forty years of age. Breast cancer can be classified into two types. They can either start forming on the inner linings of your milk ducts ( known as Ductal carcinoma) or in the lobules which supply milk (known as Lobular carcinoma).

There are many causes responsible for breast cancer they are mentioned below

  • Obesity or post-menopausal obesity (Learn more about Heart Diseases Post Menopause)
  • Exposure to frequent radiation (X-ray)
  • Consumption of alcohol
  • Being taller than average
  • Start of periods at an early age
  • Late menopause
  • Hormone replacement therapy
  • Consumption of birth control pills

The most common symptoms of breast cancer are as follows

  1. Formation of a lump in your breast
  2. Swelling or shrinking of your breast
  3. Change of size, shape and color of your nipple
  4. Blood or milk discharge from the nipple
  5. Breast pain
  6. Itching sensation
  7. Appearance of rashes (Learn more about to maintain the skin health)

Breast cancer if not diagnosed and treated at an early stage may turn out to be fatal. Ayurveda offers promising cures for breast cancer.

A few of the Ayurvedic remedies are mentioned below

  1. Include foods, which are well supplied with vitamin D in your diet. Researches show that women with less amount of vitamin D in their bodies are more likely to develop breast cancer. Consider including foods like eggs, orange juice, dairy products and fish like salmon in your diet.
  2. Drink more of green tea as it has anti cancer properties.
  3. Exercises like walking, yoga, meditation and certain breast exercises can help you to relax the pain sensation, reduce stress and also get cured.
  4. Incorporate bitter gourd in your diet. Researches show that bitter gourd can kill those cancer cells, which cause breast cancer.
  5. Ayurvedic herbs like Ashwagandha, tulsi, curcumin have certain properties that can destroy cancer cells.

Since, breast cancer has less survival rates, it is absolutely essential for you to visit an Ayurvedic practitioner if you wish to get cured through Ayurvedic treatment.

5880 people found this helpful

I am 33 years old my weight 69 kgs .l will take medicine to my disc problem before take medicine my weight 60 how to weight loss give me suggestion?

BHMS
Sexologist, Noida
I am 33 years old my weight 69 kgs .l will take medicine to my disc problem before take medicine my weight 60 how to ...
Mr. Lybrate-user I suggest you to take homoeoptahic medicine tuberculinum 200 and ars. Iod 30 tds for 1 month ok with take milk mixed with turmeric ok raise your immunity ok so solve your problem. Becouse of your immunity is very low ok.
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Bone Cancer - 4 Signs You are Suffering from it!

MBBS, MD - Oncology, DNB - Super Speciality, Immuno Oncology
Oncologist, Delhi
Bone Cancer - 4 Signs You are Suffering from it!

We have more than 200 bones in our body and each of them is susceptible to bone cancer. However, long bones in the arms and legs are most susceptible to this condition. Bone cancer can be primary or secondary. Primary bone cancer involves uncontrolled and abnormal cell division within the bones while secondary bone cancer refers to cancer that originated somewhere else in the body and later spread to the bones. While children and adults are equally at risk for primary bone cancer, adults and elderly people are more susceptible to secondary bone cancer. If diagnosed early enough, bone cancer can be treated and even cured with surgery, chemotherapy or radiation.

Hence it is essential to recognize the signs and symptoms of bone cancer. Here’s what you should look out for.

  1. Pain in Bones: Pain is one the primary symptoms of bone cancer. As the tumour grows larger, this pain can become more intense. In its early stages, the pain may be experienced as a dull ache inside the bone or the affected part of the body. It may also increase or decrease according to your activity level or may be experienced only at night. However, not all bone pains signify ‘cancer’ as this is also a symptom associated with osteoporosis.
  2. Swelling: In some cases, the abnormal growth of bone cells can result in the formation of a lump of mass that may be felt through the skin. In other cases, the affected area may also show signs of swelling.
  3. Breaking of the Bone: Cancer can weaken the bones and make them more brittle. This may make the bones more susceptible to fractures. A bone breaking in an area that has been painful or sore for a long period of time may be a sign of cancer. This is known as a pathologic fracture.
  4. Reduced Flexibility: If the tumour is located near a joint, it may affect the range of movements possible and make simple actions uncomfortable. For example, a tumour around the knee may make walking and climbing stairs a painful exercise.

Other symptoms to look out for are sudden and drastic weight loss, tiredness, excessive sweating at night, fever and difficulty breathing in case cancer has spread to other organs. Since many of these symptoms are common to other medical disorders, you should consult a doctor immediately if you notice any of them. A physical examination and a couple of tests along with a biopsy will be required to confirm a diagnosis of bone cancer.

867 people found this helpful

Hello Dr. Sir, I am Harvinder singh from yamunanagar, Haryana. I have lower back pain since last 2 years. Its slip disc and sciatica pain in left leg. I am very unhappy with this problem. Please advice me best of best treatment for the same and where I can get the same.

BAMS
Ayurveda,
Hello Dr. Sir, I am Harvinder singh from yamunanagar, Haryana. I have lower back pain since last 2 years. Its slip di...
You may use yogi joint pain churna for few days, if its helpful for you, then continue to get relief from sciatica.
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I am 20yr old male. I had an accident 2 years ago & I had suffered severe back pain. My spinal cord's disc had moved a bit so that I have pain in my back till now. What should I do for this?

MBBS, MS - Orthopaedics
Orthopedist, Delhi
Kindly show me a photograph of the affected part. Rule out diabetes & vit. D deficiency or any other metabolic disorder. Sleep on a hard bed with soft bedding on it. Spring beds, folding beds or thick matress are harmful Do hot fomantation. Paracetamol 250mg od & sos x 5days. Caldikind plus 1tab od x10. Do neck, back & general exercises. It may have to be further investigated. You will need other supportive medicines also. Make sure you are not allergic to any of the medicines you are going to take. If it does not give relief in 4-5days, contact me again. Do not ignore. It could be beginning of a serious problem.
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Guideline Steps for Breast Examine by Patient

Homeopath,

Step 1: Begin by looking at your breasts in the mirror with your shoulders straight and your arms on your hips.


Here's what you should look for:

Breasts that are their usual size, shape, and color

Breasts that are evenly shaped without visible distortion or swelling

If you see any of the following changes, bring them to your doctor's attention:

Dimpling, puckering, or bulging of the skin

A nipple that has changed position or an inverted nipple (pushed inward instead of sticking out)

Redness, soreness, rash, or swelling


Step 2: now, raise your arms and look for the same changes.

 

Step 3: while you're at the mirror, look for any signs of fluid coming out of one or both nipples (this could be a watery, milky, or yellow fluid or blood).


Step 4: next, feel your breasts while lying down, using your right hand to feel your left breast and then your left hand to feel your right breast. Use a firm, smooth touch with the first few finger pads of your hand, keeping the fingers flat and together. Use a circular motion, about the size of a quarter.

 

Cover the entire breast from top to bottom, side to side — from your collarbone to the top of your abdomen, and from your armpit to your cleavage.

 

Follow a pattern to be sure that you cover the whole breast. You can begin at the nipple, moving in larger and larger circles until you reach the outer edge of the breast. You can also move your fingers up and down vertically, in rows, as if you were mowing a lawn. This up-and-down approach seems to work best for most women. Be sure to feel all the tissue from the front to the back of your breasts: for the skin and tissue just beneath, use light pressure; use medium pressure for tissue in the middle of your breasts; use firm pressure for the deep tissue in the back. When you've reached the deep tissue, you should be able to feel down to your ribcage.
 

Step 5: finally, feel your breasts while you are standing or sitting. Many women find that the easiest way to feel their breasts is when their skin is wet and slippery, so they like to do this step in the shower. Cover your entire breast, using the same hand movements described in step 4.

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Flattening of thoracic curvature ,to some extent .diminution of disc spaces with small osteophytes formation at the adjacent vertebral margins at T4>T8. No other obvious abnormality IMPRESSION - (Early/min) spondylitis changes -Mid-thoracic spine This is my x ray report please tell me is that a major problem or it can be heal with medicine and exercise and what r the reason for this. Please tell.

MPTh/MPT, BPTh/BPT
Physiotherapist, Gurgaon
Flattening of thoracic curvature ,to some extent .diminution of disc spaces with small osteophytes formation at the a...
This happens because foulty sitting posture. You should consult a good physiotherapist nearby and learn some stretching and strengthening exercises. Try to maintain neutral posture while sitting and standing. Avoid continues sitting for more than 30 minutes at a stretch.
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I have noticed that the space between c5 and c6 of my spine have increased and as a result my neck and shoulder are very painful. I have also little tmj. What will I do now? Please Please help me.

PG Diploma in Emergency Medicine Services (PGDEMS), Bachelor of Ayurveda, Medicine and Surgery (BAMS), MD - Alternate Medicine
Ayurveda, Ghaziabad
Hello Lybrate user according to Ayurveda Vata vikriti is the main factor for pain. Treatment- 1-apply prasarini oil or pranacharya restopain oil on your affected part and give hot water fomentation. 2-take yograj guggul and agni tundi vati after lunch and dinner with warm water. 3-Take maha rasnadi kwath 2-2 tsf twice a day. 4-Take pranacharya vatari capsule and syrup twice a day. Diet- Avoid fermented food. Junk food. Potato rice. Sleep well.
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I am 34 years old male. I am suffering from back pain for the last 3 years. I have done MRI. In MRI it is found that 1. MILD DIFFUSE DISC BULGE IS NOTED AT L3-4 LEVEL CAUSING ANTERIORTHECAL SAC indentation MINIMAL NARROWING OF BILATERAL NEURAL forminal AS WELL AS LATERAL RECESSES. 2. MILD DIFFUSE DISC BULGE IS NOTED AT L4-5LEVEL CAUSING ANTERIOR THECAL SAC INDENTATION AND NARROWING OF BILATERAL NEURAL forminal AS WELL AS LATERAL RECESSES. MILD facial ARTHROPATHY IS NOTED BILATERALLY. please MAKE ME UNDERSTAND WHAT IS THE PROBLEM AND WHAT IS THE SOLUTION.

Fellowship of the Royal College of Surgeons (FRCS), Membership of the Royal College of Surgeons (MRCS)
Orthopedist, Trichy
I am 34 years old male. I am suffering from back pain for the last 3 years. I have done MRI. In MRI it is found that ...
the problem is you have disc bulge at 2 intervertebral levels causing compression of the nerve root that comes out of the spinal canal at that level causing pain in the back and legs . (disc is like gelatinous cushion inbetween two vertebral bones and it acts like a shock absorber . sometimes the disc comes out of its normal position and presses on the nerve which comes from the spinal cord. depending on the nerve that is compressed you can get pain in the back and / or legs, numbness, weakness etc.
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