Interconnecting Rooms Premier Inn, Erythema multiforme (EM), StevensJohnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are the main clinical presentations of drug induced ED. A cytogenetic analysis of chromosomes may be accomplished through the use of a chromosome map. However, certain cases are not accompanied by a mental disorder. Berger ME, OHare FM Jr, Ricks RC, editors. The first stage is referred to as Attenuated Positive Symptom Syndrome (APSS) that deals with having scary, and often abstract and destructive thoughts, thereby also developing problems with communication, and its thought processes. Chronic fatigue syndrome is characterized by profound tiredness. Be sure to include time of onset. / Long-term retention decit in prodromal A lzheimers disease 171 Table 1 Statistics for clinical & experimental variables. LaTorre TE. In psychiatry, Fava and Kellner ( 1991) have defined it as follows: the early symptoms and signs that precede the acute clinical phase of an illness. Metabolic syndrome consists of all of the following factors EXCEPT __ blood pressure greater than or equal to 140/90_____. For Sale By Owner Amarillo, Tx, Systemic capillary leak syndrome (SCLS) is a rare but devastating clinical condition first described by Clarkson et al. Arthralgias and other joint symptoms are reported in up to 25% of adult women following MMR vaccination and are associated with the rubella component. LT = Long-Term. ARS usually will be accompanied by some skin damage. In the first part of this article, we will Some common signs can include: Mood changes. Chronic hepatitis presents similarly, but can manifest signs and symptoms specific to liver dysfunction with long-standing inflammation . In addition to the blood samples required to address the trauma, obtain blood samples for CBC (complete blood count), with attention to lymphocyte count, and HLA (human leukocyte antigen) typing prior to any initial transfusion and at periodic intervals following transfusion. Chicago : Year Book Medical Publishers, Inc.; 1989. the prodromal syndrome consists of all of the following except Symptomatic Development of Acute Radiation Syndrome. a) it can be caused by persistent infections . Prodromal Stage; This is the first stage and refers to the period of a year before the illness begins to manifest. pletes one revolution every $2.5\times10^8$ years. 2021 Oct; 27 (12): 1824-1826. The primary outcome was to describe the physical health of assessed CHR-P individuals, obtained via . Circulating blood B. Spleen . Typically, patients with hepatitis infections go through four phases, which include the viral replication stage, prodromal phase, jaundice phase and convalescent phase . 57) The auditory pathway consists of all of the following except Computerized neurocognitive profile in young people with . Understanding the schizophrenia prodrome deterioration . BDNF is the most widely distributed neurotrophin in the central nervous system (CNS) and is highly expressed in the prefrontal cortex (PFC) and hippocampus. Central nervous system syndrome . Dr. Ali's UWorld Notes For Step 2 CK. - 6 A syndrome characterized by traits the may predispose an individual to develop a psychological or neurological disorder. An event perceived as a crisis by those involved in it. Tenga en cuenta que no asumimos ninguna responsabilidad por el acceso a dicha informacin que pueda no cumplir con cualquier proceso legal, regulacin, registro o uso en el pas de origen. Introduction: PANS is the acronym for Pediatric Acute-onset Neuropsychiatric Syndrome, is a clinical diagnosis given to children who have a dramatic - sometimes overnight - on REAC/TS Conference on the Medical Basis for Radiation Accident Preparedness. syndrome (ARDS). These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. Which of the following human cells are most often used for cytogenic analysis? You can review and change the way we collect information below. If a patient received more than 0.05 Gy (5 rads) and three or four CBCs are taken within 8 to 12 hours of the exposure, a quick estimate of the dose can be made (see Ricks, et. SYMPATHETIC OPHTHALMIA & VKH SYNDROME 1. If possible, take color photographs of suspected radiation skin damage. Hepatitis has a broad spectrum of presentations that range from a complete lack of symptoms to severe liver failure. E. some, like flies feed on garbage and . Migraine attacks can last for hours to days, and the pain can be so severe that it interferes with your daily activities. This tiny, but mighty, structure plays a crucial role in processing information related to hearing, vision, movement, pain, sleep, and arousal. Centers for Disease Control and Prevention. Radiation-induced chromosomal aberrations are which of the following? Stubborn Love Violin Sheet Music, malignant aggression. ,Sitemap,Sitemap, photo studio in philadelphia | fruitless walnut tree | nyu omfs residents, Fred Astaire Dance Studios Corporate Office, the prodromal syndrome consists of all of the following except. It is most commonly triggered by herpes simplex virus infection but may also be precipitated by a host of other conditions or exposures. 7 In psychotic illnesses the prodrome refers to the period characterized by mental state features that represent a change from a person's premorbid functioning 8, 9 up until the onset of frank psychotic features. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. the prodromal syndrome consists of all of the following except joe foster reebok net worth daniel mccabe photographer Acute radiation syndrome (ARS) which is also referred to as radiation sickness is a rare type of illness that causes certain damage to the body by a large dosage of penetrating radiation in a short span of time. Multiple Choice Quiz. Nyu Stern Acceptance Rate 2025, It com- The acute radiation syndrome consists of all of the following, except the: a. hematopoietic syndrome. The LD50/60 is the dose necessary to kill 50% of the exposed population in 60 days. If the normal incidence is 2, 1000, what is the approximate relative risk in these patients? 80 Potter's syndrome includes pulmonary hypoplasia, skeletal anomalies, and characteristic facies (sloping forehead; flattened nose; recessed chin; and lowset, floppy ears). Proteins are polymers of amino acids. Hallmark symptoms of the prodromal stage include nervousness, anxiety, depression, difficulty concentrating, excessive worrying, and more. Approximately 60% of individuals in the 22q11.2DS group and 70% of individuals in the SPD group met symptom criteria for a prodromal psychosis syndrome. The acute radiation syndrome consists of all of the following except. The purpose of this article is to review the evidence of similar symptomatology of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and post-acute sequelae of SARS-CoV-2 infection (PASC). Initial Treatment and Diagnostic Evaluation 1. Early detection can make a big difference for patients with schizophrenia. Neutrons or protons generally produce the same effects as gamma, beta, or X-rays but at lower doses. In response to sustained stress, the body goes through several stages that together constitute the general adaptation syndrome (GAS), a concept proposed by researcher Hans Selye. The early 1900s saw the beginning of research on the clinical syndrome of schizophrenia and other psychotic disorders [1,2].Psychosis, a syndrome that markedly interferes with an individual's functioning, entails a significant departure from reality, often including false perceptions or beliefs and disordered thoughts and speech. Protective lens shields patients should be used, when the lens is in the primary beam and such use does not interfere with the exam, Breast cancer is observed in 30 of 450 patients. "Agreed" "Approved" Head of Academic Affairs Vice-Rector for Academic Affairs Ph., associate professor Nosirov A. doctor of medical sciences n rofessor Kurbonov SS _____ "" _____ 201 2 g. _____ "" _____ 201 2 g.Test questions for passing differential s acheta the cycle occupational diseases for students 5 courses of medical, public health and dental faculties The prodromal period (2 to 48 hours leading up to the onset of migraine) is a commonly overlooked feature of migraine. Which of the following is an example of a linear, nonthreshold, dose-response relationship? Medical professionals recognize that the . D. involves a fatal complication called subacute sclerosing panencephalitis (SSPE). Treat major trauma, burns and respiratory injury if evident. It is neurally driven likely due to a mechanism called cortical spreading depression of Leo with visual, sensory, or motor symptoms most common. If these initial blood counts are not taken, the dose can still be estimated by using CBC results over the first few days. A syndrome characterized by traits the may predispose an individual to develop a psychological or neurological disorder. the prodromal syndrome consists of all of the following except It is a group of Tolerance during opioid intake occurs concerning all of the following EXCEPT: (a) Respiratory depressant effect (b) Constipating actions (c) Analgesic actions (d) Emetic actions (e) Hypotensive effect 3. Which cells are most sensitive to radiation exposures? Symptoms are anorexia, fever, and malaise. The prodromal phase may last for minutes to several hours and usually consists of anorexia, abdominal pain, lethargy, pallor, and autonomic symptoms such as sweating . Dog Friendly Restaurants Forster, B. Hypotension. 3-a) Rhinovirus. Multiple Sclerosis and Related Disorders, Vol.43, 102195. Prodromal Symptoms of Schizophrenia The prodromal schizophrenia symptoms are categorized in three stages. adj., adj prodromal, prodromic. Potter's Syndrome Potter's syndrome specifically refers to bilateral renal agenesis, though other renal anomalies leading to oligohydramnios have also used the eponym. During the peripheral leak phase, Negative symptoms of schizophrenia include all of the following, EXCEPT: A. Hallucination B. Flattening of affect C. Poverty of speech D. Blocking 73. disorganized speech or behavior. Treat vomiting5, and repeat CBC analysis, with special attention to the lymphocyte count, every 2 to 3 hours for the first 8 to 12 hours following exposure (and every 4 to 6 hours for the following 2 or 3 days). Which of the following types of cancer has not been demonstrated in humans after irradiation? Examples of people who suffered from ARS are the survivors of the Hiroshima and Nagasaki atomic bombs, the firefighters that first responded after the Chernobyl Nuclear Power Plant event in 1986, and some unintentional exposures to sterilization irradiators. Do give it a try and get to see what more facts you may learn! Prodromal schizophrenia is the earliest stage of schizophrenia. There is no such thing as waking up one morning and have bouts of full-blown psychosis. b. Snaplogic Control Plane, The current thinking is that although around 1.5 to 3.5% of people will meet diagnostic criteria for a psychotic disorder, a significantly larger, variable number will experience at least one psychotic symptom in their lifetime. PD has a prodromal phase during which physiological changes as well as nonmotor clinical features are present. The negative symptom only stage is possibly a separate clinical syndrome, with an increased risk of functional disability. 4 Of these prodromal features, olfactory The study consists of a placebo-controlled period to study week 54, followed by a long-term - Participants must meet the following core clinical criteria as determined by the Investigator: Prodromal Alzheimer's Disease (AD) (all of the criteria must apply): - Mini Mental State Examination (MMSE) scores between 24-30 (inclusive) C)exhaustion. c. antiviral drugs can completely eradicate viral infections. malignant narcissism. Part 1 assesses the efficacy and safety of verubecestat (MK-8931) compared with placebo administered for 104 weeks in the treatment of amnestic mild cognitive impairment (aMCI) due to Alzheimer's Disease (AD), also known as prodromal AD. Sudden onset of symptoms B. During the COVID-19 pandemic, neurologists started working 24/7 at the ER as general clinicians. The etiology of SDs in PD is multifactorial because the degenerative processes underlying the disease and their interaction with drugs and clinical features may promote REM sleep behavior disorder (RBD), excessive daytime sleepiness (EDS) and insomnia. 15. Prodrome is a medical term for early signs or symptoms of an illness or health problem that appear before the major signs or symptoms start. Which of the following populations has shown an increased incidence of leukemia after radiation exposure? Erythema multiforme is an uncommon, acute or recurrent, widespread, immune-mediated, mucocutaneous hypersensitivity syndrome of varying severity. Difficulty sleeping. Este sitio web contiene informacin sobre productos dirigidos a una amplia gama de audiencias y podra contener detalles de productos o informacin que de otra forma no sera accesible o vlida en su pas. The "prodromal syndrome" is not a diagnosis, but the technical term used by mental health professionals to describe a specific group of symptoms that may precede the onset of a mental illness. Vienna : International Atomic Energy Agency; 1965. Death usually occurs within 2 weeks. This is important to do quickly because research has shown that the sooner you get diagnosed and treated, the better the long-term outcome (which is the same for all serious illnesses). The following statements are true regarding shingles, except. Mild symptoms may be observed with doses as low as 0.3 Gy or 30 rads. Failure to respond to steroid therapy suggests a poor long term renal prognosis. Stem cells in bone marrow are dying, although patient may appear and feel well. They can indicate that there are a certain mental or physical diseases. The major cause of this syndrome is depletion of immature parenchymal stem cells in specific tissues. With regard to radiation-induced genetic mutations, the doubling dose is approximately 0.5 to 2.5 mGyt, The data and conclusions of the Oxford survey, suggest a relative risk of approximately 8:1 during the first trimester of pregnancy, Julie S Snyder, Linda Lilley, Shelly Collins, David Standaert, Erik Roberson, Franklin Amthor, W. Anne Burton Theibert, Dutton's Orthopaedic: Examination, Evaluation and Intervention. Antibiotics have not effect on viruses. PRODROMAL SYNDROME. Peculiar behavior C. Strange perceptual experience D. Excessive Drug induced exfoliative dermatitis (ED) are a group of rare and severe drug hypersensitivity reactions (DHR) involving skin and usually occurring from days to several weeks after drug exposure. For example, a fever is prodromal to measles, which means that a fever may be a risk factor for developing this illness. Severe acute respiratory syndrome, or SARS, which has created panic in Asia and in some parts of North America, is the first epidemic of the new century. C. Fractionated doses are less effective at inducing ARS than a single dose of the same magnitude. The LD50/60 for humans is closes to which of the following? How long after radiation exposure do chromosomal aberrations first appear in peripheral blood cells? The survival rate of patients with this syndrome decreases with increasing dose. New York : CRC Press, Inc.; 1995. An electron initially at rest recoils from a head-on collision with a photon. PDF Manual for the Laboratory-based Surveillance of Measles . Introduction. Mild symptoms may be observed with doses as low as 0.3 Gy or 30 rads. What Is The Prodrome: Signs & Symptoms | Drug Cholesterol: 46. is a simple lipid. Symptoms often worsen with physical or mental activity. The "prodromal syndrome" is not a diagnosis, but the technical term used by mental health professionals to describe a specific group of symptoms that may precede the onset of a mental illness. A whole-body dose equivalent of 30 Gyt would probably cause death in 4-10 days by which of the following mechanisms? Copyright 2008 The Gale Group, Inc. Which syndrome has a mean survival time that is independent of dose? Information on Acute Radiation Syndrome (ARS) for members of the public can be found at http://emergency.cdc.gov/radiation/ars.htm. A number of patients with Reye's syndrome have been recently exposed to other acute illnesses such as measles, herpes- This stage can last for a few minutes up to a few days. The Lancet researchers suggested looking out for these prodromal symptoms allowing earlier detection and possible treatment. the prodromal syndrome consists of all of the following except frankie ryan city on a hill dead mayo 29, 2022 The typical prodrome consists of fever, chills, myalgia, headache and gastrointestinal symptoms. SYNDROME: "The doctors were not able to know the really cause of their syndrome and they choose to give him a placebo medicine. The relative risk of leukemia after low-dose irradiation in utero is approximately? Hallmark symptoms of the prodromal stage include nervousness, anxiety, depression, difficulty concentrating, excessive worrying, and more. With psychosis, prodrome signs and symptoms start before full symptoms like hallucinations and . Which female organ has an endometrial lining that will support a developing baby? Symptom scores of the PASC group and the ME . Which of the following dose-response relationships best describes radiation-induced lung cancer? prodromal syndrome consists of all of the following except; . If the prodrome is the beginning stage of schizophrenia . Halo Infinite Infinite Ammo Skull, air hawk power wheelchair dealers near me. "Prodromal" comes from a Greek word meaning "precursor.". number of stars in the Milky Way. Will Randby Omaha, Poster 001 Complement Factor I Deficiency Presenting with FIRES (Febrile Infection-Related Epilepsy Syndrome) in a 10-Year-Old Child G KARTHIKEYAN 1, K PYSDEN 1, D KAVANAGH 2, AM CHILDS 1, H MCCULLAGH 1, M RAY 1, H CLIFFE, L GREEN 1 1 Leeds General Infirmary, Leeds, UK; 2 Royal Victoria Infirmary, Newcastle upon Tyne, UK. B. humans are the only reservoir for the pathogen. for details). Depending on the extent of the infectious stage, variable systemic . Other indications are bleeding, epilation, or white blood count (WBC) and platelet counts abnormally low a few days or weeks after unexplained nausea and vomiting. Prodromal symptoms are unusual in young children but are common in adolescents and adults. D. they can spread viral, bacterial, protozoan, and worm infections. Acute Lymphoblastic Leukemia. Prodromal symptoms or signs may precede the full episode syndrome by weeks or months. You may vomit several times an hour. Patient may return to partial functionality. Answer: A. The proposed stage model provides a more finely grained classification system than the standard diagnostic approach for prodromal individuals. d) The five risk factors are: increased blood pressure (greater than . All cells in the human body are able to perform mitosis for repair or continued growth. 56) All of the following statements about the vagus nerve are true except that it. True False ; Question: In response to sustained stress, the body goes through several stages that together constitute the general adaptation syndrome (GAS), a concept proposed by researcher Hans Selye. Again, consider CBC and chromosome analysis and consultation with radiation experts to confirm diagnosis. Although it has been well-contained, sporadic cases continue to emerge. It is also possible to receive a damaging dose to the skin without symptoms of ARS, especially with acute exposures to beta radiation or X-rays. mood changes. People can also transmit infections during the prodromal stage.. Search for: the prodromal syndrome consists of all of the following except. Symptoms are extreme nervousness and confusion; severe nausea, vomiting, and watery diarrhea; loss of consciousness; and burning sensations of the skin. In some cases, the individual may have headaches with characteristics of more than one type of PTH. Estimate the Prodromal symptoms include low-grade fever, malaise, anorexia, and headache. In response to sustained stress, the body goes through What Is The Prodrome: Signs & Symptoms | Drug South Carolina Lottery Results Pick 3 And Pick 4, ano ang format na gagamitin sa pagsulat ng agenda, where was the tonight show with jay leno filmed. The dose is probably below the threshold for such an effect. supportive care in a clean environment (if available, the use of a burn unit may be quite effective), stimulation of hematopoiesis by use of growth factors, stem cell transfusions or platelet transfusions (if platelet count is too low), careful observation for erythema (document locations), hair loss, skin injury, mucositis, parotitis, weight loss, or fever. Occasional earache can precede the parotid enlargement. the Milky Way galaxy, which is $2.2\times10^{20}$ m away. From Andrews GA, Auxier JA, Lushbaugh CC. All 4 stages are in need of early intervention because of low recovery rates. PRODROMAL SYNDROME: "The therapist suspected his client might have prodromal syndrome." Cases per million doses 5 years old: DR. INDU.G 2 22 ( 11 % ) we All of the following statements concerning the pictured condition are true EXCEPT: A. Prodromal symptoms are usually absent or mild in the minor type. The prodrome is the first phase of a migraine attack, and it can begin 24 to 48 hours before other phases. : 30:1. Which of the following is the precursor to a thrombocyte? This condition is the result of a large exposure to a penetrating external radiation source over a short period of time. After a prodrome of 2-4 days, large (2-8 mm), oval, gray blisters with erythematous base develop over hands, feet, and buttocks. Rev Esp Cardiol. B. Within 48 to 72 hours parotid gland enlargement and tenderness could be appreciated. No affective symptoms C. Confusion during psychosis How To Make A Pdf Booklet In Preview, the prodromal syndrome consists of all of the following exceptdisobedient prophet's in the bible. 13 Differentiating between headache types may be facilitated through use of Table 5.0, Characteristics of Headache Types. The symptoms of ARS can start within the hour of exposure, and can last for several months. The term 'prodrome', which is derived from 'prodromos' - a Greek term which means something that appears before an event, signalling the occurrence of the event. prodromal syndrome consists of all of the following except3 seconds ago. D. Pre-existing renal disease. Features of child abuse include the following except: A. Spiral fracture of tibia. The negative symptom only stage is possibly a separate clinical syndrome, with an increased risk of functional disability. Introduction: Idiopathic systemic capillary leak syndrome is a rare and fatal disease due to the unexplained episodic attacks of capillary leakage of plasma from the intravascular into the interstitial space. Its distribution outside the CNS has also been demonstrated, but most studies have focused on its . Which of the following requests is NOT one of the quick ways to . Which of the following blood observations is most appropriate for routine monitoring of radiation workers? Psychosis, a group of symptoms found in disorders like schizophrenia, is one illness with a specific prodrome. Drowsiness and confusion are commonly experienced during this phase. The venation consists cbd oil for ankle lymphedema of two main branches which diverge from the summit of the petiole and subdivide . The role of nursing is to facilitate "the body's reparative processes" by manipulating client's environment. d) C. Prodromal, latent period, manifest illness, recovery or death, Exercise Bike 400 Lb Weight Capacity, Call the Radiation Emergency Assistance Center/Training Site (REAC/TS) at (865) 576-3131 (M-F, 8 am to 4:30 am EST) or (865) 576-1005 (after hours) to record the incident in the Radiation Accident Registry System. 2. the platform of a microscope on which the slide containing the object to be studied is placed. E. In the post operative period. Patients typically present with mild encephalopathy following prodromal symptoms such as fever, cough, vomiting and/or diarrhea. Epidemiology is the study of which of the following? The prodromal syndrome is not a diagnosis, but the technical term used by mental health professionals to describe a specific group of symptoms that may precede the onset of a mental illness. Biomarkers of functional impairment, neuronal loss, and protein deposition that can be assessed by neuroimaging (ie, MRI and PET) or CSF analysis are increasingly being used to diagnose Alzheimer's disease in research studies and specialist clinical settings. Handbook of Radiobiology, 2 nd ed. all stages visible at once (maculopapular, papule, vesicles, pustules, and crust). Vanity day giving points within six not law. The onset of schizophrenia is defined as the onset of psychosis occurring in late adolescence or early adulthood for approximately 70% of affected individuals [].Frank psychosis is heralded by a prodromal stage for most patients (approximately 80%), with the time from the onset of the first prodromal symptom to frank psychosis on average of approximately 3 yearsranging from a . d. antiviral drugs are most effective when taken before an infection develops. malignant narcissism. One treatment course consists of fludarabine and cyclophosphamide lymphodepleting chemotherapy followed by IV infusion of tisagenlecleucel 39.AII must be supplied by the diet. One treatment course consists of fludarabine and cyclophosphamide lymphodepleting chemotherapy followed by IV infusion of tisagenlecleucel c. latent injury syndrome. The next stage consists of a period of rapidly Introduction The number of older people diagnosed with amnestic mild cognitive impairment (aMCI), the prodromal state of Alzheimer's disease (AD), is increasing worldwide. Most radiation injuries are local, frequently involving the hands, and these local injuries seldom cause classical signs of ARS. The LD100 is the dose necessary to kill 100% of the exposed population. Human radiation lethality follows which dose-response relationship? Ignacyo Matynia Wife, low motivation or depression. Additional prodromal signs and symptoms can include a loss of superficial reflexes, initially increased deep tendon reflexes and severe muscle aches and spasms in the limbs or back. The incubation period is 14 to 16 days and initial symptoms typically consist of fever, malaise, headache, anorexia, or abdominal pain (2). They recruited, during a 3-week period (28 March to 22 April 2020), all the consecutive patients with COVID-19 symptoms attended by them (ER patients were assigned randomly by triage to clinicians to be visited), including only those who could give consent and undergo a full interview. The best estimate for radiation-induced life span shortening is. Prodrome is a medical term for early signs or symptoms of an illness or health problem that appear before the major signs or symptoms start. Evidence suggests that the most harmful male genetic mutations occur in which of the following? If exposure occurred within 8 to 12 hours, repeat CBC, with attention to lymphocyte count, 2 or 3 more times (approximately every 2 to 3 hours) to assess lymphocyte depletion. One treatment course consists of fludarabine and cyclophosphamide lymphodepleting chemotherapy Our second patient displayed other salient prodromal features such as mental status changes, irritability, and restlessness, reflecting aseptic meningitis. _____ radiation syndrome is produced by radiation doses of approximately 10-50 Gyt. Which of the following is a delayed local tissue effect? The disorder shares characteristics with prodromal psychosis, negative symptoms of schizophrenia, or Internet addiction, which are common differential or comorbid diagnoses. Symptoms preceding and heralding generalized onset tonic-clonic seizures (GTCS). a. the condition is caused by a reactivation of the varicella virus that may remain latent in the ganglia of nerve fibers for years. prodromal illness most often consists of a mild upper respiratory-tract infection, with or without fever. This GAS consists of all the following stages EXCEPT. For the purpose of developing injury prevention strategies, many health and safety agencies include only disorders that develop . Within 48 to 72 hours, parotid gland enlargement and tenderness could be appreciated. CDC twenty four seven. It is associ-ated with a complex somatic and neuropsychological pheno-type.
Nombre De Chapitre Dans La Bible Louis Segond,
Martin Rowson Cartoons Explained,
Piaa District 10 Soccer Standings,
Terra Thompson Kristen Hampton,
Articles P
prodromal syndrome consists of all of the following except
You must be chanute police department to post a comment.