Upper limb gangrene treatment in 70 Orthopedic surgery clinics in Asia

Great service👍,we thank the doctors and nursing staff from 4th and 5th floor for their great service they provided to me and my father as liver transplant patients came from Kurdistan Salute 🙏

My mother in law was admitted in fortis hospital on18 nov 23. In ICU. On 23 nov Dr told to shift to room. Icu dept informed us that they will shift within three hours. So we waited out side ICU. But they shifted him on 24 evening. In these 36 hours we were only listening they will shift with two hours like this. In the room they were serving lunch at 3 pm. The patient was diabitic and old but they were serving not before 3 pm. Thinking fortis should improve the services.

It was a good experience. A Huge thank you to Medsurge India who made the whole experience from Nigeria to India a smooth and memorable one. Mr. Dushant, Mrs. Shweta and Allen. Thank you so much. Fortis Memorial Research Institute is neat, the cleaners are constantly cleaning. The environment is serene, not noisy and uncomfortable at all. Even though there was construction ongoing, there was minimal dust and noise. The food for patients on admission is usually suited to your taste which is highly commendable. The doctors are professional and focused on their functions. A big shout out to Dr. Amitabh Singh and Dr. Niranjan Naik who performed the surgery so excellently. God bless you. Thank you to Dr. Gustave and Dr. Vivek in ICU 4 for the immediate after surgery care. The nurses in the wards are swift, dedicated and skilled at their jobs too. A special thank you to Nurse Aman on 3rd Floor, Nurse Anu, Nurse Amantika and Nurse Sheila. Thank you all so much for the care you rendered through out our stay at Fortis Hospital. I would recommend this hospital for your treatment and care in India. The are focused on you.

This hospital is the epitome of atrocity globally. My father was admitted due to a heart-related issue, and they subjected his frail body to numerous tests and experiments, further weakening him. Despite his delicate state, they proceeded with the bypass surgery without assessing his thin and feeble condition or considering whether his body could endure the procedure. The experiments conducted by them ultimately cost him his life. The doctors displayed a complete lack of support and denied visitation. During my last attempt to see my father before the surgery, they refused entry, escorting him to the operation theatre without allowing a proper farewell. From a distance, my father kept looking at me, desiring to meet, but these heartless individuals denied us that privilege. The management is deplorable. My father meant everything to me, and now, we are facing financial hardship, finding ourselves on the streets. In just four days, they generated a bill of 8 lakh rupees. I earnestly implore you to refrain from choosing this hospital based on the harrowing experience my family endured. I wouldn't wish this upon anyone else, but the decision is yours. The repercussions of such suffering only affect the families involved, not others.

Recently i admit my dad in Metro Hospital under Gastrology, we have a worst experience, - The doctor in gastro OPD recommended , sleeping pills to a serious liver patient, my dad, which is wrong as per medical science. - OPD to Ward - Ward To HDU - in just 1 DAY - NO improvement only worse condition in 4 days - - The nursing staff is worse in ICU HDU , which is the main thing they do not have the correct knowledge. - Very much Money Minded Hospital .

Highly satisfied with my gynecologist Dr. Ravinder Kaur Khurana! She is excellent...Exceptional care throughout pregnancy and a smooth normal delivery. Professional, empathetic, and skilled. Would highly recommend. Also impressed with the hospital's cleanliness and affordability. A great experience overall...

Every step felt designed to maximize profits. The staff are lovely although there is too much pressure on doctors who are stressed in comparison. Not a nurturing experience although Orthopedics is good

I never imagined I'd leave a bad review, but it's important to share my experience. While I understand medical facilities have their limitations, my experience here was a nightmare. I won't delve into specifics, but I strongly advise you stay out of this place. Wishing everyone a pleasant day.

Fantastic staff, nurses and doctors Quick biopsy quick admission and aftercare It is dearer than the government hospitals but they are under equipped and to be frank some simply not welcoming I have visited on a few occasions the Bangkok hospital and on every occasion it has been a great service. I do agree that at times it can seem others are drawn into your diagnosis or treatment and that will increase the cost. But given the choice of a government hospital or here. Bangkok wins hand down.

This crews (room 209 and 210) was so amazing and helpful. Always interact with them on quarterly basis during my appointment. There are truly an asset to SJMC

Nurashifa from Dato' Dr. Siti Zaliha Zainal's clinic as always awesome in giving services. It really made my day. Keep it up! Love Dato', love Syhifa and love SJMC always.😍😍😍

Feeling blessed to get my treatment in SJMC. The service is good. My doctor is Dato Yip, she is superb, professional and efficient. I also want to express my “thank you” to all the nurse/staff i met along- department imaging, biopsy, operation, ward, educator and etc. They all are very caring, professional and always carry smile on their face. Thank you for everything, I feel safe, i been taking good care there. Definitely will recommend SJMC to others.

Why does a hospital labeled "World Class" provide an ultrasound schedule a month later? This issue isn't recent; they could have addressed it by adding more machines to handle the patient load. St. Luke's moved Maxicare to their HMO Concierge, despite the limited space in the small building. Only a few individuals can enter the office, leaving others waiting outside in the sweltering heat.

The service when checking in is quite nice and welcoming, unfortunately, for me it's downhill after that. Very very noisy nurses, it takes minimum of 10 minutes before a nurse comes to my room after pressing the red button because my dextrose kept beeping since it was almost empty. this happened several times. What if it was an emergency?!

I’d say majority of the staff are very well mannered and trained. Everytime I ask anyone that works there some information, they guided me immediately. I’d say the art building though is a bit old and dirty but the main building is pretty clean and sometimes confusing to navigate. Better to bring in cash or card because unfortunately their gcash doesn’t work. One of the downsides in some of the services here are usually packed with people so best to call in advance. I do love the service and the professionalism but this is definitely a very expensive hospital. Besides all this, there are food places inside where they serve really good food.

Better triaging system in ER than other hospitals like Asian hospital. The staff in ER have truly taken care of us. The room (regular private) is also very clean and frequently being taken care of by the housekeeping. The doctors and nurses are also very accommodating and have truly taken care of us during our confinement. Please continue to be a patient centered facility.

Felt like we were in a Hotel than a Hospital because of how clean the building is and the staff were very courteous, friendly and accomodating. Even though we went there for a walk in accommodation, the service was fast. Parking was a bit confusing though, so glad there were signs in every corner that guided us to B4.

The hospital itself is organized and beautiful, the nurses and staff are nice and attentive to my inquiries. While waiting the hospital offers snacks and drinks like water, coffee, and some juices. Place is clean The toilets are clean everything is good. You can't say bad about St. Lukes of course except for the price LOL😅. St. Lukes no.1

Thank you for taking care of me for about 2 months due to knee surgery. I waited about a year and a half for the surgery to be performed by Dr. K. Fuji, an excellent doctor. Ever since he was broadcast on TV Tokyo's Cambria Palace, he has become a famous doctor among knee patients and is known for his very careful surgeries. I am very satisfied with the results. This hospital also seems to be famous for its rehabilitation department, and I received encouragement both physically and mentally. In particular, Mr. Yada, who works in the rehabilitation room of a general hospital, is very good at the treatment, and there were complimentary comments on Ameblo.

In mid-May of last year, I was admitted to the hospital for a complete removal of breast cancer by a breast surgeon, and I received great care. Although I live in the prefecture, I initially planned to have the surgery performed at a nearby university hospital. but… I couldn't find the doctor in charge, and while I was researching various surgical methods, I realized that the breast surgery at Kameda Hospital was an endoscopic surgery, and most of all, when I asked for a second opinion, the cancer consultation center I decided to have the surgery at this hospital because of the personality of Dr. Fukuma, the nurse in charge of breast surgery and the chief breast surgeon. I am very grateful to Dr. Fukuma and other outpatient nurses at Kamogawa for their help. I had to see Dr. Fukuma several times because the surgery was far away, but even though he was tired from seeing dozens of patients a day from the beginning, he continued to talk to me late into the night in detail about the condition of the disease and the surgical procedure. Even when I was hospitalized, he came to my room until late at night. Thank you for treating me in such a friendly and calm manner when I was really anxious and scared. Even though I didn't know much about cancer, she taught me a lot of things, and even though I wasted a lot of time, the detailed explanations made me feel at ease. I made an unreasonable request to have the first surgery done early in the morning, but I was able to have the surgery done before the doctor's appointment, so I am truly grateful to the doctor. Unfortunately, I was not able to see the doctor perform the surgery because I was under general anesthesia. (lol) The reason I chose Kameda Hospital was not only because of the endoscopic surgery, but also because there were many different doctors there, and I was able to call and talk to the nurses several times before the surgery, which made me feel at ease. It was my first time being hospitalized after getting sick, but the food was delicious, and I was able to enjoy the view of the Pacific Ocean, swallows, and surfers, which made me feel better after the surgery. In particular, there is a beauty salon in the women's ward, and I felt comfortable in the private rooms that required reservations. I would like to thank Dr. Fukuma, nurse Kawana-san, and Yoshida-san from the consultation center for their help. Cancer requires long treatment even after surgery, and for those who are considering treatment, there are Kameda Hospital in Kamogawa, Makuhari, and Kyobashi in Tokyo, so if you can commute, you may want to consider it...Also, before surgery In addition to MRI, there are excellent tests such as PET-CT. I am really glad that I had the surgery at this hospital. It seems that no one person has the same symptoms of breast cancer, so the surgical method and post-operative treatment will vary depending on the person, and the treatment will last several years, so please choose the hospital that suits you without regrets. I am currently undergoing post-surgical treatment and am indebted to Dr. Nashimoto, who also performed the same surgery on me. Dr. Nashimoto gave me a detailed explanation of the surgery and reconstruction before the surgery, which made me feel at ease. Thank you very much for your kind explanation even though you were tired until late at night. One year has passed safely, so I would like to write this to express my gratitude.

Very nice hospital with top surgeons and friendly nurses. The rooms are nice and some have a swell view of the ocean. There are busses that run from the hospital to various places in Chiba and Tokyo.

the nurse's service at night was unsatisfactory, the nurse was asked to be unresponsive, the glass for the medicine did not replace a new one, the floor was dirty and there were lots of cockroaches, for a big hospital in Kaohsiung it was very disappointing.

Very bad experience under Dr. 李Oㄑㄧˊ’s diagnosis, less friendly to patient, being late for daily morning check and couldn’t explain well, asking for doing nonsense tests, waste time.

Huge hospital with good facilities, friendly staff and clean surrounding. With McDonald's inside the hospital and family Mart.

apparently, this poor guy took the high speed rail all the way from 台中 to see the doctor only to find out that the doctor in question took the day off or something and the hospital didn’t even notify him that there was a substitute doctor instead. given that it was the same doctor i was scheduled to see, i can confirm that it was indeed a different doctor, but she was perfectly fine for my needs. it is, however, really scummy that the hospital didn’t notify its patients of this swap, and i would have expected far better of a private hospital.

Went to 家醫科 Number 19 . The doctor was superrrrrrrrrrrrr bad . he talked to me with high notes and said "do you understand chinese, you understand or no!" like for hundred times i just asked one part that i rly didn't understand what he meant. and this his job to tell me the detail. why he got angry to me lmao. hate that doctor. gonna remember in my life and won't ever comeback to this place again.Never

Referred over by a small clinic that had already provided photos of the issue - I waited an entire six hours in a wheelchair unsure if I was still hemorrhaging internally while they lackadaisically ran a few tests and at the end I wasn’t even sure if which nurse/doctor was in charge of my case and just sent home with meds. I give a one star because I’m still alive but to wait six hours in an EMERGENCY room is ridiculous.

This hospital prefers earning money rather than customer service and support. The personel is not well educated for patience support. The staff didn't know their mr machine is out of service. After the complain about the hospital communication problem about the mr machine, the receptionist told us the doctor will give you some pain killer, then we went to dr office and get some pain killer prescription.If you are not a doctor dont suggest pain killer.That is unprofessional

If there is anything below 1 star I would give it to them. This is my second visit where I have to take my son to do some simple stiching due to injury in his forehead. Firsr I paid a high amount of money just to see doctor and instead of doing his job stiching the injury. He wanted me to do CT Scan and suggest to arrange an appointement with plastic sergeon and make the thing bigger than it supposed to be! And of course for the sake of making you paying extra amount of alot of money! Anyway left the hospital to went to another devlet hospital where I got all of that done within less than 20 minutes free of charge. Don't let yourself fooled with this hospital. They are only care of charging you alot of money on all levels hospital and even parking. Especially if you are foreigner.

Excellent, exceptional and high quality health care and very devoted care providers across all hospital departments. And their foreigner patient service department is truly wonderful and helpful, especially thankful to Mr. Hussain from the aforementioned department

The nurses are bad and my roomate dont relate with my disease(mine is infectious disease)

Clean and good services

The hospital is quite clean and clear.

The hospital has clean space and rooms, modern and fairly new facilities, and quite enthusiastic staff. The dishes in the hospital meals are delicious and delicious, my mother complimented me after eating them (3 meals/day are included in the hospital room fee). But the wifi in the room is weak and not prepared for patients with pillows and blankets, so it is a bit lacking in this regard. Hopefully the hospital will improve so that patients and relatives can be comfortable and worthy of the money spent.

It's not an international hospital, as they are trying to make it look like. They don't provide translation service. And their administration are laggy and corrupted, just trying to make people move round and round without giving an actual response, especially any case regarding English. The quality of room is acceptable in comparison to price, but the services are not that good.

I am a person who is quite sensitive to hospitals because of spiritual factors. But when I come here I feel comfortable (good energy field). Surprisingly, the leaders of this side focus on finding treatment solutions for customers to prevent diseases with advanced technology instead of focusing on business to make a profit or cure. Focusing on helping customers prevent illness is a place I think few places do. So satisfied Not to mention the visibility is also very far, so there are diverse examination areas or treatment functions suitable to the needs of customers. My family also experienced medical examination and treatment at the hospital here. Service is okay. Delicious food. The space is clean and airy. Regarding price, I have a life guarantee so it doesn't cost money. Basically, when you come here, there are enough services for both patients and caregivers. No need to worry about going out. If you come here, go in the direction the rocket is pointing, don't take the road according to Google, it will be a bit flooded. In the near future, there will also be apartments and a medical school here. There's also aeomall next door for convenient shopping for what you need.

You guys don't think much about the staff letting work 12hrs continuously for 5days and give them duty on next day. This is an hospital and you guys need to keep your staff mentally and physically fit and not exploiting them. You such type of work ethic could lead to many legal cases so I request the HR department to regularly monitor the incharge and many of your staff are quitting there job so you better find the reason why they are quitting and stop recruiting the bunch of people every week.

This is my first visit with Escort Fortis hospital Jullena. One of the worst services in return of hefty charges by hospital against the services provided to patients and attendent. On the cash counter only one resource is there who is managing discharge of IPD patients, emergency patient registration,issuing of ward pass,answering of query call,handling patient attendents. It is really called save 100% money without hiring man power. It took 30 min for me just for the patient registration. Nurse in emergency rudely behave with patients. She was on mobile and doctor asked her to attend the patient then after 5-10 min she start work as per Dr instructions. She didn't use curtain to cover the female patient and start procedure. In emergency there is a bed but bed sheet of patient bed looks very dirty not washed properly. There is no glucose bottle stand on each bed of emergency. Really Fortis hospital only charging royalty amount from us. I recommend hospital management have a look of holy family hospital and learn hospitality cleanliness and administration from them. At least holy family hospital has sufficient staff and caring nurses with clean floor and washrooms. I will give bed sheet photo also but patient was there and you can see there is no side stand there. Emergency bed charges 1000 Doctor 2100 Registration 200 Plus. Lab charges. Don't know how they are managing labs do they really take care of hygiene or not. Hospital charges are high and services in negative -100.

They deserved 5 stars for treatmet but i gave 3 for their billing irregularities. Please check your bill twice before making final payment. I've found inconsistency in their billing. Being an international patient they charged me in USD but refund my excess payment in rupeis for which i had to struggled a lot. Moreover they gave me counterfeit notes which they declined to replace from me.

I called cmc to take an appointment, the operator was unprofessional they were laughing and try to talk to me sarcastically! I would never call them again if they have this kind of staff

I was visiting Dubai and had to do some blood tests. I have visited CMC Dubai and informed them that I need the results the second day as I am traveling. Despite several calls and trials to follow up, I was not able to get a satisfying answer, until my call was attended by Raymond, whom he had offered the needed assistance and made sure to receive the results in a timely manner. Raymond has been very helpful, professional and proactive. He followed up on my request and called after to make sure that my case has been resolved. He has demonstrated a high level of patient care and service. Thank you Raymond and keep up the good work

YOU👇 whose reading this review i hope i am saving your life and your beloved ones ⚠️ Very bad experience rude and disrespectful staff , nurses are unprofessional and unhumanitarian. i don't advice anyone to make operations there you really take a Huge RISK ! if you choose it The hospital is materialistic and OVERRATED!

Dr. ABED from general surgery is amazing. Very down to earth, friendly and helpful. He did the procedure really quickly, and the pain I had was gone. Appreciate his kind approach.

I am writing to express my gratitude for the exceptional care and support provided by your hospital staff during my recent visits. In particular, I would like to extend my sincere thanks to (Doctor Aatif Shaikh, Consultant Physician , UROLOGY) and the entire medical team involved in my treatment. Their expertise, compassion, and dedication have made a significant difference in my recovery. I would also like to take this opportunity to provide some feedback and make a recommendation regarding the booking of required tests, such as X-rays, blood tests, and especially ultrasound appointments after the operation. I believe implementing an automated system to schedule these tests before visiting the doctor would greatly benefit patients.

Overall great facility (especially after the renovation) and very good doctors. I would have placed reviews on many of their doctors across several departments but many of them have left. Right now, I can highly speak about Dr Nathalie El Moukari, consultant radiologist. She’s confident and very thorough in her examination and takes the time to explain to the patient their situation and what they need to do. She communicates very well in, at least, three languages. Her team, I can cite Ms Mandy, is equally pleasant to deal with. The clinic is clean. Parking lots are available.

Obstetrics and Gynecology Dr. Chen Fangx is rude and has no medical ethics Ask a group of patients and family members to go in first and wait. I don’t want others to hear about my condition I didn’t speak too quietly either. He was deliberately laughed at loudly and broadcast loudly I'm afraid that others won't know The internal clinic is only separated by a curtain Next to him is the patient’s boyfriend, husband or children The light shines on, looking at the shadow outside and his loud voice You can all know roughly what postures and actions are taking place inside. It feels like embarrassing patients is her pleasure! This person with no medical ethics is still in this hospital.

The injection staff in the injection room on the first floor are really bad. If they can't find a blood vessel, they just keep inserting and turning the needle back and forth. Don't you know how the patients feel? There wasn't even an apology at the end, which was really bad!

The doctor made an appointment for us to receive the second dose of the vaccine half a year ago. However, the hospital called us 2 hours before the day of vaccination to say that the vaccine was out of stock (people were already on the way from Xizhi) and said there was no need to go there. Because I have to cancel the reservation I made half a year ago, and I don’t know when it will be in stock. If I want to buy it, I can go outside and buy it myself! This kind of casual attitude towards handling things is really disgraceful! 1. If the appointment made six months ago was not "guaranteed to reserve the vaccine for administration," shouldn't it be mentioned in advance when making the appointment? 2. When you find that the stock is almost out, can you not notify us in advance? I had already asked for leave that day to get vaccinated, but ended up visiting clinics and other hospitals asking if the vaccine was available. The second dose was scheduled, and the feeling of being swayed was really bad.

Gleneagles Hospital Gleneagles Hospital is a 221-bed private hospital in Singapore that provides a wide range of medical services and surgical treatment. Trusted, extensive and international - Gleneagles' network of multi-speciality private hospitals provides world-class excellence, from superior clinical outcomes to the highest standards of quality and care. As the signature international brand under IHH, Gleneagles hospitals are located in Malaysia, Singapore, India, China, Hong Kong and Brunei. Each offers dedicated personalised care and comprehensive modern facilities for ultimate comfort. Our continuous strive for excellence and superior care has been embedded in our culture since our first hospital opened in Singapore in 1959. At Gleneagles, empathy is at the heart of everything we do. We recognise that feeling better begins with knowing that they are in trusted hands, and that is why our patients and th

Very undesirable environment for some of group of the employees with no SOP from HR. Without proper protocol for meal time duration. Limited food variety in-house for the group of employees. Shift/annual leave schedule planning with non standard protocol and left it to department in-charge with unequal treatment subjected to their whim and fancy. Management may need to review to provide a better positive work environment to all.

Came to one of their clinics located here. Given wrong station exit info by Goggle maps (had to wait and cross the traffic junction twice), and exit 1 is the correct exit that leads up to the hospital. Staff at the front desk should be more attentive in the morning when patrons approached the desk. Had to "interrupt" to get to the right building.

I had an ongoing ear infection. I was seen by one the Ear, nose and throat doctor. I had a follow-up appointment at 10am, I had a confirmation text the day before. I took the day off work as I also had another doctor appointment at 11.30 not in the same hospital. Anyway, at 9.55am I got a call from Acibadem, someone speaking Turkish, I said in English please and then they hung up. Then at 9.57am I had another call from the hospital, this time someone speaking English saying that my appointment had changed to 11am, because my doctor arrived at that time. 3 minutes before the appointment and then I had to wait one hour, no explanations given, nothing. This is not a free hospital, I'm paying as an international patient more that I would pay back in my home country. Why do they feel like they can play with my time, no apologies. Nothing

Last week, I was at the hospital with my relative . We did a PET-CT and MRI scan. The oncologist wasn’t there that week, but we discussed with the hospital that we would do the interpretation of the results remotely with the doctor because we live in Tirana, Albania. However, it’s been 3 days, and they haven’t responded. I turned to your hospital with the idea that I might find a solution there. It is crucial to start treatment as soon as possible and you need to understand that the days that go by are not in his favor. I urgently need a meeting with the oncologist

You would have to be an absolute idiot to use this hospital, especially if you are not a Turk! I called today for an appointment and was told I would have to pay in Euro because I was not Turkish, but if I was from another Middle East country I would pay the same as the Turks. I have lived in Turkey for years, and married to a Turkish man. We make the Turkish LIRA! This is not the first bad experience we have had with this Hospital. This hospital will do everything they can to cheat you out of a dollar. If you are looking for terrible Doctors that don’t listen to your concerns, and to be treated like a walking bank, then it’s the hospital for you!!

If you are looking for a doctor that will be supportive, caring then look no more than Dr. Yasmin Kazi, trusted to provide quality and compassionate care. The best thing about her is her honesty. We totally trust her. When we came to Bahrain Specialist Hospital, we experienced that the doctor was very patient and gave positive hopes since the first visit. She treats and counsel her patients very calmly and with empathy. She is very friendly & supportive, listened to our doubts & resolved them carefully. We were happy with the decision we made in choosing BSH. Today we are pregnant and so very happy & appreciate Dr. Yasmin for her experience, regular observations and timely decisions and medications. We would like to first thank Almighty and then Dr. Yasmin Kazi. My heartiest best wishes to you doctor. Thanks for helping us in our difficult journey, by you it became a lot easier.. May Almighty bless you..

Dear Dr Yasmin Kazi I am writing this review to express my sincere gratitude towards you for my recent treatment that I went through. I am beyond satisfied with results and your dedication towards your patients. You are not only a skilled doctor but a wonderful person. You always keep in touch with all your patients and even you assisted and guided me on your holidays. I am so grateful for that. Your caring attitude and genuine liking for your patients differentiates you from other gynecologist.

Dear Dr. Salil and Lily, I am writing this review to express my sincere gratitude for the recent plastic surgeries I had at Bahrain Specialist Hospital. I cannot thank you enough for the amazing work you have done and for the excellent care I received during my stay. Dr. Salil, you are not only a skilled plastic surgeon, but also a wonderful human being. Your professionalism, expertise, and dedication to your patients are truly commendable. I am beyond satisfied with the results of my surgeries and I am grateful for your guidance and support throughout the entire process.I would also like to extend a special thank to Lily for her exceptional nursing care. She was always there to assist me with any needs or concerns I had, and her kindness and compassion made my recovery much easier.I am truly grateful to have had such a positive experience at Bahrain Specialist Hospital and I cannot recommend your services enough. Thank you for making my journey to a better version of myself a smooth and successful one.

Staff were very unhelpful and seemed to not know what they were doing everything took way too long and was too dragged out.

They took very good care of my Special Needs daughter. Thank you How ever when my son broke his leg we were treated bad, told to check out my son daily to return for a surgery that NEVER happened, just causing more heart ship on my special needs family. One Shabbat we had to sleep in the lobby because they checked out my son after Shabbat started and there aren't wheelchair cabs running on Shabbat. Very bad treatment for my special needs family!!!

Wonderful hospital - had to visit whilst on holiday in Israel. The staff were so kind and helpful. We were seen and treatment in the emergency department within 2 hours of arrival. Highly recommend