Skip to main content

Scrotal Lymphedema: Dziwani zomwe zimayambitsa, zizindikiro, ndi chithandizo

Scrotal Lymphedema: Dziwani zomwe zimayambitsa, zizindikiro, ndi chithandizo

Kodi munayamba mwamvapo ngati chipolopolo chanu cha m'mimba mwayamba kutupa mwadzidzidzi? Kapena khungu lomwe lili m'derali limakhuthala ndikumva mosiyana mukalikhudza? Ngakhale kuti nkhaniyi ndi yovuta komanso yochititsa manyazi kukambirana, ndikofunikira kwambiri kudziwa za vutoli. Chifukwa ngati silinyalanyazidwa, lingayambitse matenda aakulu. Lero tikulankhula za vuto lomwe lingayambitse zizindikiro ngati izi, zomwe zimadziwika kuti Scrotal Lymphedema .

Kodi Scrotal Lymphedema ndi chiyani kwenikweni?

Mwachidule, Scrotal Lymphedema ndi vuto lomwe mtundu wa madzi otchedwa lymph umasonkhana mkati mwa minofu yofewa ya scrotum yanu, zomwe zimapangitsa kutupa. Nthawi zina, kutupa kumeneku kumatha kufalikira ku mbolo ndi madera ozungulira.

Tsopano mwina mukudabwa kuti, "Kodi madzi a m'thupi awa ndi chiyani?" Tangoganizirani, thupi lathu lili ndi dongosolo lomwe limachotsa zinyalala ndi poizoni , monga njira yotayira zinyalala mumzinda. Timatcha dongosolo la lymphatic . Dongosolo ili ndi gawo lofunika kwambiri la chitetezo chathu chamthupi. Madzi a m'thupi ndi madzi omveka bwino omwe amayenda m'dongosololi ndikuthandizira kuchotsa zinthu monga zinyalala ndi mabakiteriya .

Choncho, ngati pazifukwa zina mitsempha ya lymph kapena ma lymph nodes mu dongosolo la lymphatic, makamaka m'dera la groin, awonongeka kapena kutsekeka, madzi a lymph awa sangathe kuyenda bwino. Pamenepo ndi pamene madziwo amasonkhana m'malo monga scrotum ndikuyamba kutupa.

Kodi zizindikiro za vutoli ndi ziti?

Chizindikiro chachikulu komanso chodziwika bwino cha matendawa ndi kutupa kwa machubu a m'mimba. Nthawi zina, kutupa kumeneku kumatha kukwera kangapo kukula kwake kwabwinobwino, kukhala kukula kwa lalanje, mpira wa basketball, kapena kukulirapo. Madokotala amatcha izi 'Giant Scrotal Lymphedema'.

Tiyeni tiwone zizindikiro zina zomwe zili.

Chizindikiro Kufotokozera
Kutupa kwa chidendene Kukula kwake. Poyamba kumakhala kofewa pokhudza, koma pakapita nthawi kumatha kukhala kolimba chifukwa cha kukhuthala kwa minofu (fibrosis).
Ululu wokhalitsa Kupweteka kosalekeza kapena kusasangalala mkati ndi mozungulira malo otupa.
Matenda obwerezabwereza Matenda a pakhungu la bakiteriya (monga cellulitis) ndi ofala. Zizindikiro zake zingakhale kufiira ndi kutentha kwa khungu.
Kusokoneza zochita za tsiku ndi tsiku Kuvuta kuyenda kapena kulephera kuyenda. Kuvuta kukodza.
Mavuto okhudzana ndi kugonana Kuvuta kugonana.
Mbolo Yokwiriridwa Vuto limene mbolo imakutidwa ndi minofu ya m'mimba chifukwa cha kutupa kwambiri, zomwe zimapangitsa kuti isaonekere.

Kodi ndi zifukwa ziti za scrotal lymphedema?

Pali zifukwa zingapo zazikulu zomwe zimayambitsa vutoli. Makamaka m'maiko ngati Sri Lanka, chomwe chimayambitsa izi ndi Lymphatic Filariasis . Ichi ndi matenda opatsirana ndi udzudzu. Tizilomboti timawononga dongosolo lathu la lymphatic.

Kuphatikiza apo, palinso zifukwa zina:

  • Mankhwala a khansa: Chithandizo cha radiation kapena opaleshoni, makamaka m'chiuno, chingawononge dongosolo la lymphatic.
  • Opaleshoni: Maopaleshoni ena ochitidwa m'mimba kapena m'chiuno angayambitsenso kuwonongeka kwa mitsempha ya lymphatic.
  • Kunenepa Kwambiri: Chiwopsezochi chimakhala chachikulu kwa anthu omwe ali ndi BMI yoposa 30.
  • Mavuto obadwa nawo: Anthu ena amabadwa ndi zofooka zina mu dongosolo la lymphatic.

Chofunika kwambiri ndichakuti uwu si matenda opatsirana kapena matenda opatsirana pogonana (STI), choncho musachite mantha mosafunikira.

Kodi izi zingayambitse mavuto otani?

Ngati vutoli silinachiritsidwe bwino, mavuto osiyanasiyana angabuke pakapita nthawi.

  • Matenda a Pakhungu (Cellulitis): Matenda a minofu yomwe ili pansi pa khungu nthawi zambiri amapezeka.
  • Nthenda ya Elephantiasis (Khungu longa la njovu): Iyi ndi njira yoopsa kwambiri ya 'barawa'. Khungu limakhala lolimba kwambiri, lalikulu, komanso lolimba.
  • Kuchira kwa bala mochedwa: Ngati bala lapezeka m'malo oberekera, zimatenga nthawi yayitali kuposa masiku onse kuti lichiritsidwe.
  • Zotsatira za maganizo: Matendawa angayambitse kusintha kwa maonekedwe, kuvutika kuyenda, komanso kudziona kuti ndi wosafunika, komanso nkhawa, kupsinjika maganizo, ndi kuvutika maganizo . Ili ndi vuto lovuta kwambiri, kotero pali mwayi waukulu wa kuvutika maganizo.

Kodi dokotala amazindikira bwanji izi?

Mukapita kwa dokotala yemwe ali ndi zizindikirozi, adzayamba kukuyang'anani mwakuthupi ndikufunsani za mbiri yanu yachipatala. Angakulangizeninso mayeso ena kuti apeze zifukwa zina zomwe zimayambitsa kutupa ndikupeza malo enieni omwe atsekeka m'thupi lanu.

  • Lymphoscintigraphy: Kuyesa komwe zinthu zochepa zowopsa zimalowetsedwa mu dongosolo la lymphatic ndipo sikelo imagwiritsidwa ntchito kuyang'anira kayendedwe kake. Izi zitha kudziwa komwe kutsekeka kwa magazi.
  • Kujambula kwa MRI (Magnetic Resonance Imaging): Kuyesa komwe kumagwiritsa ntchito mphamvu ya maginito ndi mafunde a wailesi kuti kujambula zithunzi za minofu mwatsatanetsatane.
  • Kujambula kwa CT (Computed Tomography): Kuyesa komwe kumagwiritsa ntchito X-ray zingapo kuti zijambule zithunzi zatsatanetsatane ndikuzindikira zotsekeka.

Kodi mankhwala ochizira izi ndi otani?

Iyi si matenda ochiritsika kwathunthu pakadali pano, chifukwa kuwonongeka kwa dongosolo la lymphatic sikungatheke. Komabe , pali mankhwala omwe angathandize kwambiri kuthetsa zizindikiro, kuchepetsa kutupa, ndikukulolani kukhala ndi moyo wabwinobwino.

Chithandizo chosagwiritsa ntchito opaleshoni (Complex Decongesstive Therapy - CDT)

Uwu ndiye mankhwala oyamba omwe amalimbikitsidwa. Amatha kuchepetsa kutupa pang'ono mpaka pang'ono, makamaka koyambirira.

  • Kusunga khungu loyera: Sungani khungu loyera pogwiritsa ntchito sopo yapadera yoletsa mabakiteriya kuti mupewe matenda.
  • Kutulutsa Madzi a Lymphatic ndi Manja:Iyi ndi njira yopumira yofatsa yomwe imachitidwa ndi katswiri wodziwa bwino ntchito yake. Imagwira ntchito poyendetsa madzi a lymph osakhazikika kupita ku ma lymph nodes omwe amagwira ntchito, kuchepetsa kutupa.
  • Kuvala zovala zapadera zopanikiza: Kupanikizika komwe kumachitika ndi zovalazi kumachepetsa kuchulukana kwa madzi m'thupi ndipo kumaletsa kutupa.
  • Kuchita Masewera Olimbitsa Thupi: Kutsatira pulogalamu inayake yochita masewera olimbitsa thupi yomwe idapangidwira inu ndi katswiri wa zamaganizo kudzakuthandizani kusintha kayendedwe ka magazi m'thupi.

Opaleshoni

Pa milandu yoopsa yomwe siiyankha ku chithandizo chomwe chili pamwambapa, opaleshoni ingakulimbikitseni. Izi zimaphatikizapo kuchotsa minofu ndi khungu lowonjezera lomwe lasonkhana ndikuphimba malowo ndi khungu labwino (khungu lodulidwa) lotengedwa kuchokera mbali ina ya thupi (nthawi zambiri ntchafu). Izi zimachitika ndi dokotala wa urologist ndi dokotala wa opaleshoni yokongoletsa ziwalo pamodzi.

Kodi muyenera kupita ku ETU (Emergency Treatment Unit) nthawi yomweyo liti?
Ngati muli ndi Scrotal Lymphedema, pitani ku chipatala chapafupi cha Emergency Department (ETU) nthawi yomweyo ngati mukupeza zizindikiro zotsatirazi za matenda :
- Malungo opitirira madigiri 38 Celsius (100.4 Fahrenheit). - Kuwonjezeka kwa ululu.
- Kutentha mukakhudza malo otupa. - Kusintha kwa khungu (lofiira, lofiirira, lofiirira) kapena mawonekedwe a mizere.

Kodi ndi zinthu ziti zomwe mungachite nokha?

Pamodzi ndi chithandizo, kusintha pang'ono kwa moyo wanu kungathandize kwambiri kuthetsa vutoli.

  • Samalani khungu lanu: Kupewa matenda ndi chinthu chofunika kwambiri. Tsukani malowo bwino tsiku lililonse ndipo pakani mafuta odzola.
  • Makhalidwe abwino odya: Chepetsani kumwa mchere. Mchere umawonjezera kusunga madzi m'thupi. M'malo mwake, gwiritsani ntchito zinthu monga adyo, ufa wouma wa chili, ndi oregano kuti mukometse chakudya chanu.
  • Imwani madzi ambiri:Yesani kumwa magalasi osachepera 8 a madzi patsiku.
  • Pewani zovala zolimba: Pewani kuvala zovala zamkati zolimba kapena mathalauza oletsa kuyenda.
  • Pewani kutentha kwambiri: Pewani zinthu monga kusamba m'madzi otentha kwambiri komanso kugwiritsa ntchito sauna.
  • Khalani ndi kulemera kwabwino: Lankhulani ndi dokotala wanu ndipo pitirizani kulemera kwabwino komwe kumakuyenererani.

Uthenga Wopita Nawo Kunyumba

  • Scrotal Lymphedema ndi kutupa komwe kumachitika chifukwa cha kuchulukana kwa madzi am'mimba m'thumba la mabere. Si khansa.
  • Filariasis, matenda ofalitsidwa ndi udzudzu m'maiko ngati Sri Lanka, ndiye chifukwa chachikulu cha vutoli.
  • Iyi si matenda opatsirana, komanso si opatsirana pogonana.
  • Ngati muwona kutupa, kukhuthala, kapena kupweteka kwachilendo m'machende anu , musachite manyazi kapena kuchedwa, koma pitani kwa dokotala.
  • Kuzindikira msanga ndi kulandira chithandizo kungalepheretse mavuto aakulu ndikutsogolera moyo wabwino.
  • Kusunga khungu loyera komanso lonyowa ndikofunikira kwambiri kuti tipewe matenda.

Scrotal Lymphedema, kutupa kwa scrotal, lymphatic system, lymphatic filariasis, elephantiasis, thanzi la amuna
⚠️ Important: The medical articles and information on Nirogi Lanka are for general awareness only, and are by no means a substitute for professional medical advice, diagnosis, or treatment. For any medical problem you have, consult a qualified physician immediately.

💬 Comments (0)

Palibe ndemanga zomwe zatumizidwa pano. Onjezani ndemanga yanu pano koyamba.

Onjezani ndemanga yanu

Chonde werengani: 4 + 6 =
Scrotal Lymphedema: Dziwani zomwe zimayambitsa, zizindikiro, ndi chithandizo
ZizindikiroFebruary 26, 2026

Scrotal Lymphedema: Dziwani zomwe zimayambitsa, zizindikiro, ndi chithandizo

Kodi munayamba mwamvapo ngati chipolopolo chanu cha m'mimba mwayamba kutupa mwadzidzidzi? Kapena khungu lomwe lili m'derali limakhuthala ndikumva mosiyana mukalikhudza? Ngakhale kuti nkhaniyi ndi yovuta komanso yochititsa manyazi kukambirana, ndikofunikira kwambiri kudziwa za vutoli. Chifukwa ngati silinyalanyazidwa, lingayambitse matenda aakulu. Lero tikulankhula za vuto lomwe lingayambitse zizindikiro ngati izi, zomwe zimadziwika kuti Scrotal Lymphedema .

Kodi Scrotal Lymphedema ndi chiyani kwenikweni?

Mwachidule, Scrotal Lymphedema ndi vuto lomwe mtundu wa madzi otchedwa lymph umasonkhana mkati mwa minofu yofewa ya scrotum yanu, zomwe zimapangitsa kutupa. Nthawi zina, kutupa kumeneku kumatha kufalikira ku mbolo ndi madera ozungulira.

Tsopano mwina mukudabwa kuti, "Kodi madzi a m'thupi awa ndi chiyani?" Tangoganizirani, thupi lathu lili ndi dongosolo lomwe limachotsa zinyalala ndi poizoni , monga njira yotayira zinyalala mumzinda. Timatcha dongosolo la lymphatic . Dongosolo ili ndi gawo lofunika kwambiri la chitetezo chathu chamthupi. Madzi a m'thupi ndi madzi omveka bwino omwe amayenda m'dongosololi ndikuthandizira kuchotsa zinthu monga zinyalala ndi mabakiteriya .

Choncho, ngati pazifukwa zina mitsempha ya lymph kapena ma lymph nodes mu dongosolo la lymphatic, makamaka m'dera la groin, awonongeka kapena kutsekeka, madzi a lymph awa sangathe kuyenda bwino. Pamenepo ndi pamene madziwo amasonkhana m'malo monga scrotum ndikuyamba kutupa.

Kodi zizindikiro za vutoli ndi ziti?

Chizindikiro chachikulu komanso chodziwika bwino cha matendawa ndi kutupa kwa machubu a m'mimba. Nthawi zina, kutupa kumeneku kumatha kukwera kangapo kukula kwake kwabwinobwino, kukhala kukula kwa lalanje, mpira wa basketball, kapena kukulirapo. Madokotala amatcha izi 'Giant Scrotal Lymphedema'.

Tiyeni tiwone zizindikiro zina zomwe zili.

Chizindikiro Kufotokozera
Kutupa kwa chidendene Kukula kwake. Poyamba kumakhala kofewa pokhudza, koma pakapita nthawi kumatha kukhala kolimba chifukwa cha kukhuthala kwa minofu (fibrosis).
Ululu wokhalitsa Kupweteka kosalekeza kapena kusasangalala mkati ndi mozungulira malo otupa.
Matenda obwerezabwereza Matenda a pakhungu la bakiteriya (monga cellulitis) ndi ofala. Zizindikiro zake zingakhale kufiira ndi kutentha kwa khungu.
Kusokoneza zochita za tsiku ndi tsiku Kuvuta kuyenda kapena kulephera kuyenda. Kuvuta kukodza.
Mavuto okhudzana ndi kugonana Kuvuta kugonana.
Mbolo Yokwiriridwa Vuto limene mbolo imakutidwa ndi minofu ya m'mimba chifukwa cha kutupa kwambiri, zomwe zimapangitsa kuti isaonekere.

Kodi ndi zifukwa ziti za scrotal lymphedema?

Pali zifukwa zingapo zazikulu zomwe zimayambitsa vutoli. Makamaka m'maiko ngati Sri Lanka, chomwe chimayambitsa izi ndi Lymphatic Filariasis . Ichi ndi matenda opatsirana ndi udzudzu. Tizilomboti timawononga dongosolo lathu la lymphatic.

Kuphatikiza apo, palinso zifukwa zina:

  • Mankhwala a khansa: Chithandizo cha radiation kapena opaleshoni, makamaka m'chiuno, chingawononge dongosolo la lymphatic.
  • Opaleshoni: Maopaleshoni ena ochitidwa m'mimba kapena m'chiuno angayambitsenso kuwonongeka kwa mitsempha ya lymphatic.
  • Kunenepa Kwambiri: Chiwopsezochi chimakhala chachikulu kwa anthu omwe ali ndi BMI yoposa 30.
  • Mavuto obadwa nawo: Anthu ena amabadwa ndi zofooka zina mu dongosolo la lymphatic.

Chofunika kwambiri ndichakuti uwu si matenda opatsirana kapena matenda opatsirana pogonana (STI), choncho musachite mantha mosafunikira.

Kodi izi zingayambitse mavuto otani?

Ngati vutoli silinachiritsidwe bwino, mavuto osiyanasiyana angabuke pakapita nthawi.

  • Matenda a Pakhungu (Cellulitis): Matenda a minofu yomwe ili pansi pa khungu nthawi zambiri amapezeka.
  • Nthenda ya Elephantiasis (Khungu longa la njovu): Iyi ndi njira yoopsa kwambiri ya 'barawa'. Khungu limakhala lolimba kwambiri, lalikulu, komanso lolimba.
  • Kuchira kwa bala mochedwa: Ngati bala lapezeka m'malo oberekera, zimatenga nthawi yayitali kuposa masiku onse kuti lichiritsidwe.
  • Zotsatira za maganizo: Matendawa angayambitse kusintha kwa maonekedwe, kuvutika kuyenda, komanso kudziona kuti ndi wosafunika, komanso nkhawa, kupsinjika maganizo, ndi kuvutika maganizo . Ili ndi vuto lovuta kwambiri, kotero pali mwayi waukulu wa kuvutika maganizo.

Kodi dokotala amazindikira bwanji izi?

Mukapita kwa dokotala yemwe ali ndi zizindikirozi, adzayamba kukuyang'anani mwakuthupi ndikufunsani za mbiri yanu yachipatala. Angakulangizeninso mayeso ena kuti apeze zifukwa zina zomwe zimayambitsa kutupa ndikupeza malo enieni omwe atsekeka m'thupi lanu.

  • Lymphoscintigraphy: Kuyesa komwe zinthu zochepa zowopsa zimalowetsedwa mu dongosolo la lymphatic ndipo sikelo imagwiritsidwa ntchito kuyang'anira kayendedwe kake. Izi zitha kudziwa komwe kutsekeka kwa magazi.
  • Kujambula kwa MRI (Magnetic Resonance Imaging): Kuyesa komwe kumagwiritsa ntchito mphamvu ya maginito ndi mafunde a wailesi kuti kujambula zithunzi za minofu mwatsatanetsatane.
  • Kujambula kwa CT (Computed Tomography): Kuyesa komwe kumagwiritsa ntchito X-ray zingapo kuti zijambule zithunzi zatsatanetsatane ndikuzindikira zotsekeka.

Kodi mankhwala ochizira izi ndi otani?

Iyi si matenda ochiritsika kwathunthu pakadali pano, chifukwa kuwonongeka kwa dongosolo la lymphatic sikungatheke. Komabe , pali mankhwala omwe angathandize kwambiri kuthetsa zizindikiro, kuchepetsa kutupa, ndikukulolani kukhala ndi moyo wabwinobwino.

Chithandizo chosagwiritsa ntchito opaleshoni (Complex Decongesstive Therapy - CDT)

Uwu ndiye mankhwala oyamba omwe amalimbikitsidwa. Amatha kuchepetsa kutupa pang'ono mpaka pang'ono, makamaka koyambirira.

  • Kusunga khungu loyera: Sungani khungu loyera pogwiritsa ntchito sopo yapadera yoletsa mabakiteriya kuti mupewe matenda.
  • Kutulutsa Madzi a Lymphatic ndi Manja:Iyi ndi njira yopumira yofatsa yomwe imachitidwa ndi katswiri wodziwa bwino ntchito yake. Imagwira ntchito poyendetsa madzi a lymph osakhazikika kupita ku ma lymph nodes omwe amagwira ntchito, kuchepetsa kutupa.
  • Kuvala zovala zapadera zopanikiza: Kupanikizika komwe kumachitika ndi zovalazi kumachepetsa kuchulukana kwa madzi m'thupi ndipo kumaletsa kutupa.
  • Kuchita Masewera Olimbitsa Thupi: Kutsatira pulogalamu inayake yochita masewera olimbitsa thupi yomwe idapangidwira inu ndi katswiri wa zamaganizo kudzakuthandizani kusintha kayendedwe ka magazi m'thupi.

Opaleshoni

Pa milandu yoopsa yomwe siiyankha ku chithandizo chomwe chili pamwambapa, opaleshoni ingakulimbikitseni. Izi zimaphatikizapo kuchotsa minofu ndi khungu lowonjezera lomwe lasonkhana ndikuphimba malowo ndi khungu labwino (khungu lodulidwa) lotengedwa kuchokera mbali ina ya thupi (nthawi zambiri ntchafu). Izi zimachitika ndi dokotala wa urologist ndi dokotala wa opaleshoni yokongoletsa ziwalo pamodzi.

Kodi muyenera kupita ku ETU (Emergency Treatment Unit) nthawi yomweyo liti?
Ngati muli ndi Scrotal Lymphedema, pitani ku chipatala chapafupi cha Emergency Department (ETU) nthawi yomweyo ngati mukupeza zizindikiro zotsatirazi za matenda :
- Malungo opitirira madigiri 38 Celsius (100.4 Fahrenheit). - Kuwonjezeka kwa ululu.
- Kutentha mukakhudza malo otupa. - Kusintha kwa khungu (lofiira, lofiirira, lofiirira) kapena mawonekedwe a mizere.

Kodi ndi zinthu ziti zomwe mungachite nokha?

Pamodzi ndi chithandizo, kusintha pang'ono kwa moyo wanu kungathandize kwambiri kuthetsa vutoli.

  • Samalani khungu lanu: Kupewa matenda ndi chinthu chofunika kwambiri. Tsukani malowo bwino tsiku lililonse ndipo pakani mafuta odzola.
  • Makhalidwe abwino odya: Chepetsani kumwa mchere. Mchere umawonjezera kusunga madzi m'thupi. M'malo mwake, gwiritsani ntchito zinthu monga adyo, ufa wouma wa chili, ndi oregano kuti mukometse chakudya chanu.
  • Imwani madzi ambiri:Yesani kumwa magalasi osachepera 8 a madzi patsiku.
  • Pewani zovala zolimba: Pewani kuvala zovala zamkati zolimba kapena mathalauza oletsa kuyenda.
  • Pewani kutentha kwambiri: Pewani zinthu monga kusamba m'madzi otentha kwambiri komanso kugwiritsa ntchito sauna.
  • Khalani ndi kulemera kwabwino: Lankhulani ndi dokotala wanu ndipo pitirizani kulemera kwabwino komwe kumakuyenererani.

Uthenga Wopita Nawo Kunyumba

  • Scrotal Lymphedema ndi kutupa komwe kumachitika chifukwa cha kuchulukana kwa madzi am'mimba m'thumba la mabere. Si khansa.
  • Filariasis, matenda ofalitsidwa ndi udzudzu m'maiko ngati Sri Lanka, ndiye chifukwa chachikulu cha vutoli.
  • Iyi si matenda opatsirana, komanso si opatsirana pogonana.
  • Ngati muwona kutupa, kukhuthala, kapena kupweteka kwachilendo m'machende anu , musachite manyazi kapena kuchedwa, koma pitani kwa dokotala.
  • Kuzindikira msanga ndi kulandira chithandizo kungalepheretse mavuto aakulu ndikutsogolera moyo wabwino.
  • Kusunga khungu loyera komanso lonyowa ndikofunikira kwambiri kuti tipewe matenda.

Scrotal Lymphedema, kutupa kwa scrotal, lymphatic system, lymphatic filariasis, elephantiasis, thanzi la amuna
⚠️ Important: The medical articles and information on Nirogi Lanka are for general awareness only, and are by no means a substitute for professional medical advice, diagnosis, or treatment. For any medical problem you have, consult a qualified physician immediately.

💬 Comments (0)

Palibe ndemanga zomwe zatumizidwa pano. Onjezani ndemanga yanu pano koyamba.

Onjezani ndemanga yanu

Chonde werengani: 4 + 6 =