Main
News
Having epilepsy does not imply guilt
27 March 23
One more reflection on the "Purple Day". "Aravot" spoke with Ani Gevorgyan, the head of the Neurology Department.    Read, be informed and try to differentiate epileptic seizure from epilepsy disorder, learn about the main types of seizures and epilepsy, their causes and risk factors, modern treatment options. Know how to take an approach, if someone nearby is having an epileptic seizure. Most importantly, remember that epilepsy is not a sentence, and it is not fair to label people with epilepsy or hide the condition to avoid being labeled.  Everyone has some kind of problem, no one is immune, and a person is not to blame if they have, for example, epilepsy.
March 26th: World Epilepsy Day - Purple Day 
26 March 23
Today is March 26th, also known as Epilepsy Awareness Day or Purple Day.   Around 50 million people in the world have epilepsy. It is a problem, but not a sentence. Modern medicine offers effective treatments for people with epilepsy, such as medical, surgical and even lifestyle modifications.    The team of neurologists and neurosurgeons of the “Arabkir” Medical Center in Armenia brings all the innovations in epileptology and is with patients, providing the most effective treatment methods. The pediatric epilepsy dispensary operates in “Arabkir”, where more than 3600 patients aged 0-18 are registered. Most of them receive medical treatment, and surgery is indicated to some, which is also available in our medical center.   This time, listen to the answers to the most frequently asked questions about epilepsy from adult neurologist Lusine Vardanyan, be informed and take the right approach, if the person next to you is having epileptic seizures.
Pediatric Respiratory Medicine Course
24 March 23
Dear colleagues,    We invite the attention of pulmonologists, allergists, pediatricians and cardiologists to the Children's Respiratory Medicine training course which will take place at "Arabkir" Medical Center. The honored guest speaker of the course is Professor Alexander Moeller, the head of the Respiratory Diseases and Sleep Disorders Department at the University Children's Hospital of Zurich. Following topics will be covered during the lectures:  wheezing in preschoolers, bronchial asthma and its diagnosis, treatment of bronchiolitis/bronchitis, acute and chronic cough.   The lectures will be held on March 29 and 30 at 15:00-17:00, in the Green Hall of "Arabkir" MC. The course is organized in cooperation with "Arabkir" MC and the University Children's Hospital of Zurich. Please note that CPD credits will not be provided.  To register, please follow the link: https://forms.gle/yHFnDUtcMZWjkX2q6
Neurosurgery: Epilepsy
21 March 23
News.am's reference to the recently performed complex surgery in the neurosurgical service of the “Arabkir” Medical Center intended to remove a child’s brain tumor and thus prevent epileptic episodes.   The head of the Neurology and Epileptology service Biayna Sukhudyan, and the head of the Neurosurgery service Niko Arzumanyan provided details about the case, the surgery and, as a whole, about this problem and its modern solutions.    In “Arabkir” Medical Center, a surgical treatment of epilepsy was performed on an 8-year old girl, using modern technologies. Studies have shown that the cause of the child’s epileptic seizures over several years was a large tumor, which compressed nearby areas of the brain. During the tumor removal, neuromonitoring was used to bypass the motor nerve fibers and avoid damage to the child’s motor functions. According to Niko Arzumanyan, the head of the Neurosurgery service who spoke with NEWS.am Medicine, the issue in this patient’s case was not the tumor itself, but the compression of nearby areas of the brain by the tumor, resulting in epilepsy.  What is neuromonitoring?  "Neuromonitoring was very important for this surgery, because the tumor was directly adjacent to the motor areas of the brain and cerebral cortex, as well as corresponding pathways. During the removal of every millimeter of the tumor, we use a special tool to stimulate the brain tissue.    Depending on amount of electric current used to stimulate the brain and elicit a response, we estimate how far we are from the corresponding motor nerve fibers. The main goal of this is so that during the surgery and post-operative care we will not have any deficit and will not damage the motor ability of the body," he said.  According to Niko Arzumanyan, surgical treatment of epilepsy with simultaneous monitoring is one of the new directions that is being developed in “Arabkir” Medical Center. Until now such operations were performed here with the participation of foreign partners, but now the doctors of “Arabkir” MC work independently. The surgery lasted almost 10 hours, because the tumor was quite large and solid. It took the doctors multiple efforts and hours to remove it without damaging the vessels and nerves of the brain.    Biayna Sukhudyan, the head of the Neurology and Epileptology service of “Arabkir” Medical Center mentioned, that the child had been under the of doctors at “Arabkir” MC for several years, her illness appeared with seizures. Various examinations such as MRI and video-EEG monitoring were performed and right parietal tumor with epileptic activity were diagnosed.  “For the first time in Armenia, tractography was performed, which allowed us to understand that the tumor does not include important nerve fibers, however, our neurosurgeons chose to use neuromonitoring during surgery to be safer,” she said.    Video EEG Electroencephalography remains as one of the most important diagnostic tests for epilepsy. Video-EEG or video electroencephalography is one of the newest methods used in “Arabkir” MC. It is a study that records the electrical activity of the brain over a long period of time, which significantly increases the chances of accurate diagnosis of epileptic foci.  “Electrodes are attached with special paste to the heads of our children and adults, and the patients remain in the hospital for 24, 48 or 72 hours. Then the doctor deciphers the results and tries to determine where that electrical activity comes from. If a number of studies confirm and coincide, all showing the same epileptogenic focus, then the patient's chances of overcoming the disease with surgical intervention in the future are quite high,” she explained.  The operated child will undergo EEG monitoring again in a few months to check the effectiveness of the surgery. She will take her medicine for several years, after which, the doctors are sure that she will finally get rid of epilepsy and will live a full and healthy life.   Epilepsy Statistics  The head of the service, Biayna Sukhudyan stated that 70% of the epilepsy cases can be managed through medical treatment, while 30% are difficult to control, and 15% require surgical treatment.  All children in Armenia with epilepsy are under the supervision of "Arabkir" Medical Center. Not only children, but many adults with epilepsy and other neurological disorders receive treatment in the hospital, according to Biayna Sukhudyan. “Currently over 3600 children aged 0-18 are under our care, all of whom have some form of epilepsy, whether genetic or acquired.  Today we have adults and children under our control, and the state program includes people up to the age of 40 who may potentially be candidates for surgery. We also receive adults with drug-resistant epilepsy” she explained.
6th International Medical Congress of Armenia
20 March 23
Dear colleagues, the 6th International Medical Congress of Armenia will be held on July 6-8.   The mission is to strengthen relations between Armenia and the Diaspora, discuss the problems of healthcare systems of Artsakh and Armenia, define priorities, promote the exchange and localization of experience in medical and healthcare fields.   During the congress, lectures by internationally renowned scientists will be presented, scientific sections, satellite symposiums and seminars will be organized. On the third day, as a tradition, various projects aimed at healthcare and medical education that have been organized through Armenia-Diaspora cooperation, will be discussed.  The topics covered will be published in a collection.    To participate, please register via the link:  https://www.facebook.com/watch/?v=123244887263922
Dermatology: Excimer Laser
15 March 23
Skin problems often become more active during the spring and with the sun. Those who have dealt with such issues, are well aware of this. Modern medicine offers various methods to calm skin exacerbations and alleviate them.   One such method is the excimer laser, which can be used to treat vitiligo, psoriasis, focal hair loss and localized eczema. By emitting waves of a special length, this treatment can  have selective anti-inflammatory effect on the skin, prevent further aggravation of the problem and control its course. The necessary number of interventions and treatment plan is determined by the doctor.   Dermatologists assure that this is a safe and effective way to address skin problems. To learn more, check out the Dermatology service of “Arabkir” Medical Center via the link: https://arabkirmc.am/hy/services/105.
Pediatric Radiology Symposium
14 March 23
The Pediatric Radiology Symposium took place at “Arabkir” MC featuring guest speaker Professor Erich Sorantin from the University of Graz, Austria.   The days of symposium were filled with news and intense discussions, in which over 150 specialists from “Arabkir” Medical Center and other medical institutions of Yerevan and regions participated.    Professor Erich Sorantin not only heads the Department of Pediatric Radiology at Graz University Hospital in Austria, but also leads the Digital Information and Image Processing Research Group. He coordinates a multidisciplinary, multi-institutional academic network in Central Europe focused on developing biomedical imaging and technologies, implementing them in practical medicine, and ensuring radiation protection. The symposium provided a great opportunity to hear Professor Sorantin’s motivating, live and interactive lectures, participate in a practical ultrasound course, discuss clinical cases, as well as service development opportunities.  The symposium was organized by the Diagnostic Radiology Service of “Arabkir” MC-ICAH, the Arabkir Young Physicians Association /AYPA/ and Armenian Pediatric Association as part of the Open Medical Institute’s satellite symposium program. Participants will receive 10 CPD credits from the Ministry of Health: 2 practical and 8 theoretical.
Boon Talk: Ara Babloyan
12 March 23
“Boon TV” has published the discussion of Professor Babloyan and the “Healthcare” series author Violeta Zopunyan, which was recorded months ago. Following topics were covered:  Principles for healthcare reforms Healthcare in first years of independence Participation of medical workers in development of reforms Continuing professional development Right to health and social justice Reforms of cardiac surgery and prevention of myocardial infarction  The correct ways of using international experience Is it possible to change the system without changing the people?
Happy Women’s Day!
08 March 23
Dear women,   On the occasion of International Women's Day, March 8, I want you to enjoy your rights to health, peaceful living, creating and feeling the joy of motherhood, and infinite love, which will empower you to overcome difficulties.   Thank you for making our lives more interesting and warm with your presence, more secure and trustworthy with your work and more meaningful with your devotion.     Arman Babloyan, Director of "Arabkir" MC
Clubfoot
07 March 23
What is congenital clubfoot? How is it expressed? What are the modern solutions to this problem and how effective are they?   Watch the video, where Vahe Yavryan, the head of the department of Traumatology and Orthopedics of “Arabkir” Medical Center, talks about clubfoot, and be more informed.
World Hearing Day
06 March 23
March 3rd is World Hearing Day, an important date on the medical calendar.    Hearing is one of our senses that connects us with the world and it requires special attention and care. This year's theme from the World Health Organization is “Ear and hearing care for all”. Specialists are calling for special attention to hearing health, advising regular check-ups with primary care providers and taking immediate steps to prevent further hearing loss, if problems are detected.    “Arabkir” Medical Center is the largest center providing services to children with hearing impairments in Armenia. Here, follow-up care for over 1200 children is carried out. With the help of our audiology team, children even with severe hearing loss learn how to speak, integrate fully into society, including attending public schools.  https://arabkirmc.am/hy/services/93
We are hiring nurses
02 March 23
“Arabkir” Medical Center is hiring nurses on a permanent basis, for shift and day work schedules.      Responsibilities: perform the appointments of doctors accurately and fully, with quality and on time, perform the organization of laboratory and instrumental examinations on time, monitor the results, perform therapeutic care of patients, diagnostic, treatment and prevention interventions according to the doctor’s appointment.   Requirements: secondary vocational education, kind, friendly and willingness to learn.   Advantages: opportunities to work with modern equipment, high-quality materials and instruments, invaluable experience of working in a professional team with doctors, continuous professional development.   Trial period. before becoming a full member of our team, the candidate goes through a 3-month trial period, however, the trial period may be shortened, depending on its course, the trial period helps to get acquainted with the internal regulations of the company and with the performance of work, gain professional practical and theoretical skills. To apply, send your CV and motivational letter to [email protected].
Boon TV interview with Sergey Sargsyan
01 March 23
Pediatrician Sergey Sargsyan, the head of the Institute of Child and Adolescent Health answered questions on Boon TV: most common conditions in children, child mortality rate in last years, accessibility of medical services, state order and patients’ flow, the role of primary healthcare and the importance of working in regions, effective communication between parents and doctors, pediatric palliative care.
About Medical Insurance
28 February 23
Professor Babloyan answered questions about medical insurance on “Yerkir Media” TV channel.
Symposium: Pediatric Radiology
27 February 23
Dear colleagues, We are pleased to inform you that a Pediatric Radiology symposium will be held at "Arabkir" MC-ICAH as part of the Open Medical Institute project on March 7th and 9th.   We are honored to have Professor Erich Sorantin, the head of the Department of Pediatric Radiology at Graz University Hospital in Austria, as our guest speaker. Professor Sorantin will also be leading a practical course on joint ultrasound.   To participate, please register via this link: https://forms.gle/ZpjnnhEjppwwbUvE7   We look forward to seeing you at the symposium.
“Arabkir”-Belarus: Liver Transplant
16 February 23
  Professor Oleg Rummo and his team from the Minsk Scientific and Practical Center of Surgery, Transplantology and Hematology, paid another visit to the “Arabkir” Medical Complex. The primary focus of our 4-year cooperation is children’s liver transplantation. Besides discussing the details of new surgeries, the team also met with previously operated patients and their parents, evaluating the children’s condition.    The patient operated on during this visit was 14-year-old Rafael Khachinyan. The boy was diagnosed with liver fibrosis, cirrhosis and transplantation was indicated. The operation went successful, and Rafael is now in the post-operative recovery phase. His family is from the Tsaghkavan village in Tavush region. The total cost of operation was 19 million AMD, of which 5 million AMD was provided by the government, and the remaining 14 million was raised through the fundraising organized by the “Heath Fund for Children of Armenia”.    We are grateful for our patients, including Rafael, and all kind people who have contributed to this cause. Your donations have helped our children, their families and doctors in their difficult journey. Your support is truly invaluable. 
The Future Armenian: Mane Tadevosyan
14 February 23
  Mane Tadevosyan is one of our young neurologists, who was on a medical mission in Artsakh with the head of the neurology service, Biayna Sukhudyan, and became trapped there due to a blockade. She believes that the future of our country lies in working in our homeland and for it”. To learn more about Mane and her work, watch the video by “The Future Armenian” project featuring her. 
Armenian State Symphony Orchestra at “Arabkir” MC
11 February 23
The Armenian State Symphony Orchestra and the “Havat” NGO of hard hearing children’s mothers’ combine their efforts towards the mission of creating public values. A memorandum of cooperation was signed between the parties. They will work together to contribute to the socialization of children with hearing impairment, full and effective inclusion of hearing impaired youth in all spheres of public life.   The partnership will be aimed at projects implemented for the purpose of purchasing hearing aids and treatment, to give children the ability to perceive and appreciate the beauty of sound through their hearing. The joint programs will also aim to introduce classical music to hearing impaired children and adolescents. Children with hearing problems were also present at the event and presented their musical, dancing and reciting performances.    The Artistic Director and Principal Conductor of the Armenian State Symphony Orchestra Sergey Smbatyan highlighted the fact that the challenges faced by children with hearing impairment are also challenges for the orchestra. "We all want to build a better society with healthy communication, and it's important that the children here today become our listeners in the future and are able to enjoy the music of the orchestra," said Maestro Smbatyan.   Karine Harutyunyan, a representative of the "Havat" NGO, added: "Musicians represent Armenia to the world through their hearing. Our children need to enter the world, but their hearing is not as good as we would like as parents. Even if the children here today do not become musicians, we want to ensure that they become good people, and we hope that our friendship with the Symphony Orchestra will help to achieve this."   The “Havat” NGO of hearing impaired children’s parents has been operating since 1996 in close proximity to the audiology center of the medical center, where more than 1000 children adolescents aged 0-18 with hearing impairment who live in Armenia are registered.  The scientific head of the “Arabkir” Medical Center Ara Babloyan noted that our main goal is for children to be relaxed and maximally included in society. The signed memorandum is aimed at that goal. The musicians of the Armenian State Symphony Orchestra, in turn, presented beautiful musical performances to the children, as well as gifts, including Dan Brown’s illustrated book “Wild Symphony”.    Check out the video via the link. 
Artsakh Humanitarian Support Initiative
03 February 23
Armenian doctors from all over the world are uniting for Artsakh. They’ve created the Artsakh Humanitarian Support Initiative led by Professor Ara Babloyan.    “A human is human, no matter where he is: in Artsakh, Russia, France, the USA or Africa, and has the same rights everywhere. And the people of Artsakh have the right to live and work in their ancestral lands”. Listen to the interview of Professor Babloyan and members of the initiative Hambardzum Simonyan and Aramayis Galumyan on the “Esquisses” (“Sketches”) program of the Artsakh Public TV company.  
We are hiring a night cashier
23 January 23
"Arabkir" Medical Center is hiring a night cashier-registrar.  Working hours: 17:00 - 09:00. Shift: every 3 days /one day at work, two days at home/. Computer knowledge and skills are required, prior work experience is desirable for this position.  Send your CV and motivational letter to [email protected] .
Uniting for Artsakh
18 January 23
Ara Babloyan and Hambardzum Simonyan, members of the Artsakh Humanitarian Support Initiative, met with the Minister of Foreign Affairs of Artsakh Sergey Ghazaryan.   
Computed Tomography
18 January 23
Marine Grigoryan was invited to the “I am healthy” program of the Public Radio of Armenia. She is the head of the Diagnostic Radiology Service of “Arabkir” MC. The doctor talked about computed tomography, explained what kind of examination it is, about its indications and effectiveness in diagnosis and evaluation of different diseases and about the differences between computed tomography and magnetic resonance imaging. Find out more about this modern diagnostic method, as well as about other methods of diagnostic radiology.
Sergey Sargsyan about viruses
17 January 23
Dear parents, listen to the “Armenpress” podcast with Sergey Sargsyan, the head of the “Arabkir” MC - Institute of Child and Adolescent Health, Pediatrics Advisor of the Ministry of Health. Protect your children from viruses with the simplest and easiest methods, recognize the signs of acute respiratory infections, remember “do’s” and “don'ts” and stay in touch with your pediatrician.
Life with a transplanted heart
16 January 23
The only person in Armenia living with a heart transplant is receiving follow-up care at the “Follow-up care department for organ transplanted patients” at “Arabkir” MC. The department is unique in the country; it serves all patients with kidney and liver transplants, as well as the hero of this “Sputnik Armenia” article, Yeghishe, who has a heart 20 years younger than him. We wish you health!
Merry Christmas and Happy New Year! 
06 January 23
May the sky be peaceful over your heads, wherever you are, may everyone with health problems be healed, and everyone’s cherished dream come true with the Christmas miracle.  Merry Christmas and Happy New Year!
Interesting Medical Cases 2022
30 December 22
It’s a tradition at “Arabkir” MC to sum up the year with the presentation of interesting medical cases. There were many outstanding clinical cases this year, but, according to the format of the event, each department and service can present only one case. The specialists compare the case with similar cases that have happened both during their and international colleagues’ practices. They talk about the given pathology and answer questions that arise.  The event is traditionally organized by the AYPA (Arabkir Young Physicians Association) and the prizes given were no less remarkable.  The team of “Arabkir” MC doctors wishes health and peace to everyone sparing no effort for the recovery of patients.
Santa’s helpers at “Arabkir” MC
26 December 22
Santa’s helpers have started visiting our little patients at “Arabkir” MC.  One of them, who looked so much like a real Santa, along with his helpers from the DAA hospital  school went around the departments, handing out gifts, talking and cheering up the children in the hospital.    The second helper also came with presents. He came to the Speech development center with the snow maiden, listened to children’s poems and were happy that the children were speaking clearly.  The children asked the most questions to the other helper, who visited the kindergarten. They tried to find out whether he came from Lapland and why he came without the snow maiden. After they sang in different languages and received the long-awaited presents.
The child from Artsakh is being transferred to Yerevan 
24 December 22
The resuscitation team of “Arabkir” MC is transporting the 4-month-old baby, who is in critical condition, from Artsakh to “Muratsan” Hospital Complex, Armenia with a critical care car.    The transportation of the child from Artsakh to Armenia became possible thanks to the cooperation of the Ministries of Health of Armenia and Artsakh, the Red Cross Society, “Arevik” Children's Hospital in Stepanakert and “Arabkir” Medical Center. The child was in serious condition for several days in “Arevik” Children’s Hospital and was diagnosed with leishmaniasis.    Thank you to all the devotees who helped to transport the baby to Armenia and to those who work in Artsakh to save children’s lives.
"Arabkir" MC doctors trapped in Artsakh
24 December 22
The pediatric neurology service of “Arabkir” MC, with the head of the service Biayna Sukhudyan went to “Arevik” Children’s Hospital in Stepanakert the day before the blockade of Artsakh. Our doctors were visiting Artsakh again, as part of the “Doctors for Artsakh” project by the Fund for Armenian Relief, in cooperation with “Arabkir” MC and “Arevik” Children’s Hospital.  https://www.facebook.com/watch/?v=697527118668200&extid=CL-UNK-UNK-UNK-AN_GK0T-GK1C&mibextid=6IxyOt&ref=sharing   [Biayna Sukhudyan, pediatric neurologist, Arabkir MC] We came here on the 11th and starting from our first working day there was a blockade.   [CivilNet] Biayna Sukhudyan is a neurologist, the head of the pediatric neurology and epileptology service of Arabkir MC, Yerevan. She moved to Artsakh and has since been unable to return to Armenia. Biayna and a group of enthusiastic pediatric neurologists have been visiting Artsakh for health-related consultations on a regular basis since the end of the war.  Now, as the Azerbaijani blockade of the Goris-Stepanakert highway enters the 12th day, she is trapped in Artsakh along with 120.000 other people. Her main concern is the lack of basic medication.    [Biayna Sukhudyan, pediatric neurologist, Arabkir MC] We have seen many acute and chronic conditions, when children are in need of medications which do not exist here, for example painkillers, some antibiotics and antiseizure drugs , which are very important for children with epilepsy. Sooner or later we will have a shortage of baby formula.    [CivilNet] 120.000 people, including 3000 children, remain under a blockade. Families remain separated.   [Ruben Vardanyan, State Minister of Artsakh] We should be ready for this reality and should not lie to ourselves. As the State Minister and the head of the operational headquarters we’ve discussed various solutions for this situation and before making any decision I want to discuss the opportunities and listen to your opinion.    [Biayna Sukhudyan, pediatric neurologist, Arabkir MC] We kept one infant with visceral leishmaniasis. If it was before the blockade, the child would definitely be transferred to Armenia.    [CivilNet] The shelves of grocery and drug stores are half empty. 29 patients including 8 children are under intensive care. Some of them need to be immediately transferred to Armenia to receive timely medical treatment.
Artsakh, our love
20 December 22
After the closure of Artsakh-Armenia vital road, lots of children from Artsakh haven’t been able to return home. Today Ara Babloyan, the scientific head of the “Arabkir” Medical Center, Nina Arikyants, the medical director of the “Arabkir” Medical Center, Mariam Hakhverdyan, pediatrician and Armen Martirosyan, the director of the “Health Fund for Children of Armenia”, visited the wonderful children.    The children are students of Stepanakert music school who came to Yerevan to participate in the Junior Eurovision Song Contest. Some of them are athletes with serious successes. They talked about their dreams, the most important of which at the moment is to return home and reunite with their families.    Enjoy the performances full of love and longing of little singers, who already have become popular.
Pre-Holiday Sales
02 December 22
Laser Cosmetology Service offers pre holiday sales for hair removal procedures until December 30. Upper and lower lips - 1 500 AMD instead of 2 500 AMD Face - 10 000 AMD instead of 15 000 AMD Neck - 6 000 AMD instead of 10 000 AMD Neck (male) - 7 500 AMD instead of 15 000 AMD Forehead - 3 000 AMD instead of 5 000 AMD Nape - 6 000 AMD instead of 10 000 AMD Chin - 3 500 AMD instead of 4 500 AMD Sideburns - 4 500 AMD instead of  6000 AMD Cheekbones - 3 000 AMD instead of 5 500 AMD Armpits - 5 000 AMD instead of 8 000 AMD Arms - 14 000 AMD instead of 18 000 AMD Arms /above the elbow/ - 6 000 AMD instead of 8 000 AMD Arms /under the elbow/ - 8 000 AMD instead of 10 000 AMD Bikini - 10 000 AMD instead of 15 000 AMD Deep Bikini - 15 000 AMD instead of 20 000 AMD Chest area - 12 000 AMD instead of 20 000 AMD Abdominal area - 18 000 AMD instead of 30 000 AMD  Belly button area - 6 000 AMD instead of 10 000 AMD  Legs - 35 000 AMD instead of 50 000 AMD Legs /thighs/ - 20 000 AMD instead of 30 000 AMD Legs /calves/ - 18 000 AMD instead of 25 000 AMD Back - 25 000 AMD instead of 40 000 AMD Waistline - 13 000 AMD instead of 20 000 AMD Buttocks - 13 000 AMD instead of 20 000 AMD Hair removal is performed through the popular device GentleMax Pro of Candela brand, with Alexandrite method, which provides radical removal of hair, painless and with permanent effect. 
Pediatrician Day
20 November 22
Dear Pediatricians,   Congratulations on your professional day and thank you for your dedication and warmth, for your efforts and professional help towards children’s health. Your work is priceless. Stay healthy and happy with your families.
1
...
5
6
7
8
9
10
11
12