Tibia osteosynthesis in 88 Orthopedic surgery clinics worldwide

I had an appointment with the leading urologist for a consultation at 12:30, came at 12:15 at the reception desk, they said that the doctor was delayed in the hospital, but now he will be at 13.00 versions, there was a difference in one, the doctor was there but didn’t see me and left... apparently not having survived such a tragedy, although I was always under the door of his office. the other version was announced so they got confused and thought that I was at 13-30, that is, they don’t see the recording 😄 but nevertheless, now the doctor was aware and finally went to the meeting .. after waiting until 13-10 I left .. What to say Circus and Carelessness

Abdominal pain and severe nausea appeared. I immediately made an appointment with a therapist. The doctor diagnosed gastritis with high acidity. I follow a diet and take medications. Thank you for your attentive attitude!

I would like to thank Dr. Virani. Osteoarthritis of the knee joint haunted my husband. After an ultrasound and MRI, he consulted and wrote a report with recommendations. Doctor's attitude 10 out of 10

I was very disappointed with the doctor, instead of curing me and solving my problems, he only referred me to treatments that I didn’t need at all. Thanks to the wasted time, my illness worsened. I am very sorry that I did not turn to specialists. I was booked in for a remote consultation where a doctor with 21 years of experience made a diagnosis and told me about the limitations. When asked what limitations I have, she didn’t even answer, saying that the diagnosis was not made accurately. People should not go to this clinic under any circumstances; they will make you worse instead of curing you.

I accidentally pinched my ring finger in a door, resulting in a subungual hematoma. I contacted a surgeon at this clinic. They did not postpone the operation to remove the nail; everything was done immediately on the day of treatment. The impression of service is positive!

I practiced judo for many years, but unfortunately, after an injury to the meniscus of my right knee, I had to say goodbye to the sport. The question arose of how to get rid of the pain. This is the second year I have been receiving treatment and observation from Sredin Konstantin Evgenievich. A competent doctor, he understands sports problems well. I forgot about the pain, thank you!

I needed a full body MRI as soon as possible. I contacted the SM Clinic. I signed up for an overnight stay to get a discount. The study did not last long. I received the results the very next day.

An ultrasound of the heart of a 6-month-old child was performed by the wonderful doctor Ilya Igorevich Kravtsov. The appointment was carried out professionally, the results were ready immediately, on the same day. The doctor explained and described our situation in detail.

I was treated for a dislocation at this medical center. They quickly did an X-ray and an ultrasound. Anesthesia was used during treatment. The dislocation was old and the treatment process was not easy. But I'm glad that everything worked out in the end and I feel great now.

Be careful in this clinic!!! Due to staff shortages, employees are prohibited from taking sick leave. Serves employees with ARVI, influenza and other seasonal diseases. There is a real risk of not only not being cured, but also of catching something contagious as a gift. For me, this is a so-so bonus program!

We had an appointment with the surgeon on October 23, 2023, paid for the consultation, and the operation was scheduled for October 24 at 21:00. In addition to the cost of the operation, the cost of the consultation was also included in the bill. When asked why there was another consultation if it was yesterday, and today we came for the operation, the administrator’s answer was that this was a repeat consultation. Actually, the doctor performed the operation, no so-called consultation was carried out, but an extra 2200 rubles. no one removed it from the bill. There are no complaints about the doctor’s work; the operation was performed well.

The clinic is what all of our medicine should be. I was lying in the ward and I couldn’t even believe that this place was a hospital and not a sanatorium. Everything is perfectly arranged. It’s convenient to take tests, the doctors are polite. The result of treatment is that all polyps are removed.

I turned to the surgeon proctologist A.A. Oganesyan. at the end of November, with a problem that I don’t want to voice. I have been suffering for a long time, and was already aiming for surgery. We talked everything through, told everything, ordered tests, which I took the very next day. The results came the same day. The day of the operation was set. The operation went well, the staff was very responsive, they explained everything and listened to requests. The rooms are good. The prices are not astronomical, in my opinion. Now I am recovering under the supervision of a surgeon. Thanks to all the staff for their work. (The reception desks of both branches also have red-haired employees who supported and advised). After the operation, nurses regularly came by and asked what I wanted. They brought tea, water, cookies. It was very comfortable.

The only place where they do an EEG while a child is sleeping under excellent conditions. I would like to express my deep gratitude to nurse E.I. Shevchenko for her wonderful attitude and professionalism! She answered all our questions, helped with everything and dispelled our fears. In the end, everything worked out great for us. Thank you very much!!!

Medica Mente, good place. Friendly staff. I visited for the first time, in two branches. Endocrinologist and orthopedist. Received recommendations. Pharmacy on the premises of the clinic. Prices are moderate, pensioners get a discount. I will visit.

No one expects to get injured and have surgery however this happens to a lot of us. I'm very grateful for the fantastic treatment, care and attentive guidance from pre to post opp over a span of 12 months. The staff are excellent and took extra care of me, special thanks to Mr Mellor, Omyini and all their teams for turning what has been a physical trauma into a strength. Highly recommended.

I had my surgery at this hospital a week ago, and I had a great experience; from the pre-op assessment, the nurse was fantastic and kind. On the day of the surgery, everything started on time; the room was impeccable, and the staff was kind and attentive. They made me feel safe at every minute, and after my dressings changed, I also received the best care possible from the nurses. I felt so good overall; I got the best surgeon, Mr. Floyd, and this hospital experience at every stage was excellent! Thank you!

A fantastic hospital! I had ACL surgery -all my appointments were on time and all the staff were extremely kind and helpful. Post surgery I have done physio with Gladys Ojugo who has been exceptional. Gladys is always very thorough, and her physio plan for me has been absolutely excellent! Thank you

We turned to cardiologist Tselikova - she helped as if she were a relative - sympathetically, attentively, professionally at all stages. It is a rare feeling that every patient is extremely important. She involved other specialists, and Yu Govorova won her over with her rigor and responsible attention. Thanks to them and Hadassah! 🙏

I thank Kmet Viktor Igorevich for the delicately performed FEGDS procedure. I was afraid of endoscopy, did not want to swallow the endoscope, but the doctor paid extra attention to the preparation, taught me how to breathe correctly during the study, so I calmly agreed and followed all the doctor's instructions. During FEGDS, Viktor Igorevich distracted me, told me about what he saw. It really got me distracted. Thank you for the delicacy, tact, care and attention!

I operated on my mother at Hadassah in Skolkovo. All at the highest level! They diagnosed me in one day, scheduled surgery the next day, and discharged the next day. Everything is clear, you know the treatment plan and all upcoming expenses in advance. Very comfortably! The rooms are comfortable, like in a hotel. Beauty is all around. A person does not feel like he is in a hospital, which means he recovers faster. Many thanks to the team of doctors! True professionals and wonderful people. Thank you very much to the junior and nursing staff for your care. Mom felt like family here. Good luck in your business!

I had a good experience with Dr Carlos for MRI scans and follow-up appointments. However, the billing team and administration is very unorganized and has caused me a huge amount of stress and suffering. I am a full yinsured patient and they have been unable to submit my invoices to correct insurers, failed to communicate with me when my insurance companies have missed something, and start chasing down payments of plus 2 years old using debt collection agencies. Beware, stay away from the Schoen Clinics as they are very unprofessional. Have never experienced anything quite like this. In April 2023, a debt collection agency contacted me saying invoice over due with Schoen Clinic. I was shocked as my insurance company should have settled this 1 year ago. Cigna subseqeuntly settled the bill quickly on my behalf once I took lead on it. To be clear, I never recieved one piece of communication from Schoen Clinic saying the bill had not been settled by my insurance company and they went straight to debt collection agency even though I have a long history with the clinic as an insured patient. In November 2023, I get contacted again by a debt collection agency. Schoen were unable to tell me in April 2023 that there was also £175 invoice and a fee of £100 that had not been paid by Axa in 2020. Clearly at this point I am losing all hope with the Schoen Clinic and am insulted that they would raise these trivial amounts via agency this long ago. I struggle to even remember what they are for, have not recieved invoices and to make matters worse you cant even contact somebody in person to talk to about it.

Absolutely terrible. Didn’t help my knee at all. Left in the waiting room for 50mins for appt. Then I apparently had £12 bill outstanding. I had a baby. Then I find out they’ve passed the £12 bill to a debt collector who has rolled it up and added a load of fees.

This review is for the administration, not the health professionals, which I will post separately. I attended for a consultation on 14th March and paid an invoice that day which I was led to believe covered everything. At the end of July I was chased for an outstanding invoice of £400 for two x-rays which was supposedly raised on 15th March. I queried it, but to no avail. And only today have I finally received the actual invoice, 5 months late! In view of my being originally misinformed and the delay in providing the invoice, a small reduction? Not a chance!

They giving your personal data to Delta Generli bank, after that operators from bank call you every 3 weeks and trying to sell you insurance, avoid this clinik....

My dad had called the nurses on the buzzer 20 times they did not attend so he called me. I had to leave my apartment to come and see him so he could go to the toilet very unprofessional.

I made an appointment for surgery with general anesthesia in 16.30. I didn’t eat and drink for almost a day before the anesthesia. I called the clinic twice before the surgery to make sure everything was ok. When I arrived at the appointed time, my time had been moved to 11.30! Of course, the operation was canceled. Very unprofessional attitude towards patients.

I would like to express my deep gratitude to the doctors of the traumatology.orthopedics clinic.for their sensitive attention.and care during.my stay.Starting from.the head.of.the.department.to.the.coordinator. Christina, the doctor who operated on Tkalin. Artem Nikolaevich, attending physician Mikhail Belash. Andreevich, Alekhan Andrey Nikolaevich. That's what people in their places mean. I bow to you for your hard work.

There are no complaints about the doctors. There are also no complaints about the conditions that I almost wrote about the content. But ! Administrators of this institution! Make sure that you don’t have one at checkout, at the checkout counter, at the register, or at the reception desk!!!! your specialist was rushing about, but at least half of the declared 13 windows were working! I completed the procedure faster than sitting in the queue at the reception at the cash desk! Again ? You have one employee working for you! One !

According to the profile of treatment, they were satisfied with the doctor and the attitude towards the patient. Nice and professional doctors. Ambiguous opinion about a paid hospital. 6600 rubles a room. Disgusting food. True, how can you feed "it"? Cold jelly soups made from some kind of pasta, with a hint of defrosted chicken meat, half-dried pies. The husband asked the clerk for lunch instead of soup for potatoes, she said that she had promised her to another ward))). For breakfast, kefir and orange))). A bathroom with a persistent smell of sewerage, which was not eliminated, even by pouring a product into it (from home, by the way). Each gesture of the staff and procedures is paid in addition to the cost of the ward. Free was only a thermometer at night)))). Well, in general .... having such prices for paid services and the state budget, the FNCC of the 90s and 2023 remained the same (with the exception of the new CDC). The same doors in the departments, the same shabby floors, the same stream in which to find a competent doctor is a lottery for a million. All good and health!

I am very grateful to S.P. Markin for the spinal surgery. This is a surgeon from God! God bless him!

Many thanks to traumatologist-orthopedist V.V. Romanenko. for your attentiveness and qualified assistance to my son Kirill, God bless you

This is the fourth time in this institution, two hip replacements, two repeat hip joints, each time it gets worse and worse, initially cups of the wrong size were placed, when asked why they were asked, there was no other answer at that time, the result dislocations of the left joint began, they underwent re-endoprosthetics in 2019, the right leg turned out to be 2 cm shorter, which caused the ankle to fly, in 2022 dislocations of the right joint began, I was admitted to the clinic on August 30, I just lay in bed for four days, they took a blood test, did an x-ray, That’s it. The attending physician came once and asked what and where it hurt, where the dislocations were going, that’s all. No one really reads the stories, right before the operation they asked which joint should be operated on, right or left, if he hadn’t said that it was right, they would have operated on the left one, since the dislocation of the left joint is indicated everywhere, even in the discharge the left joint appears everywhere, in the department no one bothers to read the medical history, the prescription list contains contraindications for injecting NSAIDs, which I cannot take until the allergy begins and I asked the question what they are pricking, the lack of professionalism of the treatment nurses is off the charts, they punctured all the veins and were unable to place a catheter; a nurse from the intensive care unit placed a subclavian catheter without anesthesia, because... I’m allergic to lidocaine, the second nurse on duty didn’t come on time to the call, the IV ran out, the result was that the catheter was clogged, they couldn’t flush it out, they removed it, they tried to put the catheter in the arm, they punctured all the veins again, they couldn’t put it in, the nurse from the intensive care unit put it in again, for that I thanked her very much, I told her to warn the nurse on duty when she was administering the medicine so that she would press on the vein because the whole boat didn’t go in because of adhesions in the vein, when I tried to show what needed to be done, she threw my hand away and started yelling that she knew better what to do, she started tugging at the catheter, naturally she pulled it out of the vein, and refused to put another one in for me, she screamed rudely that she knew better what to do, he sent her away and told her not to come close to me anymore, my brother came, tried to put an intravenous drip, again nothing worked, the nurse from the intensive care unit did it again, my hands were punctured into rubbish, blue, more than 30 punctures, they react disgustingly to calls, as if you can’t go out into the corridor, the sisters and nannies sit in their little room, either drinking tea or gossiping in the corridor, in general, I was left with a disgusting impression of the work of the LLP2 staff, management conduct a staff certification, many of the staff do not correspond to the position, what they do. There are no complaints about the surgeons, anesthesiologists, operating room nurses, everything was done clearly, conscientiously, for which many thanks, special thanks to the intensive care unit for their care. Case history170188.

State of the art hospital and wonderfully caring staff. Amazing attentiveness from all the doctors, technicians and engineers; the staff are very professional and genuinely kind. They answer any questions and are incredibly comforting and patient. I had an MRI of 2 sections done here, was really well taken care of. Special thanks to head nurse Katarina and the engineer Zvonimir Matic. An extraordinary team. Would definitely recommend.

Amazing Hospital! Incredible service, very attentive staff, extremely accommodating and takes excellent care of patients. The facilities are state of the art and impeccably clean. Definitely worth the money! The level of service is fantastic! Thank you to Katarina, the head nurse at radiology, who was lovely! Pat

Billed the examination directly to me even though it was covered by my insurance. Refused to fix the mistake when pointed out. Definitely avoid

Yesterday I visited the medical department at Krasnaya Presnya. I have always been pleased with the service in other branches, but this left just a terrible impression. The slowness of the receptionist's work could have been tolerated, but the way the security guard behaved is simply a disgrace to the nurse. I was with an elderly mother and one-year-old son; we were not allowed in with our stroller. The security guard held the elevator and did not let us go up, all the visitors to the clinic swore at him, but he put on a show out of his integrity and rudeness. Then we waited 15 minutes for the stroller from the clinic on the first floor, which is why we were late for our appointment with the pediatrician. The nerves frayed for me, my mother and my son. I'm deeply disappointed. I also don’t understand what kind of rules these are so unique to the red freshwater department. In all other departments they allowed us in with a stroller without any problems. These rules were invented by an idiot who never carried rude children on himself. It was painful to look at the poor mothers who moved with mother's bags and babies from floor to floor. Why are there no free strollers for infants downstairs if you are not allowed to bring your own strollers? What does this ban on strollers save?

My attending physician insisted on pressotherapy as part of my course of treatment (I have a venous circulation disorder in the lower extremities). And I am very glad that he insisted on this. After pressotherapy, the heaviness in my legs that had already become familiar went away, and there was such lightness that words cannot express it (only those who have similar problems will understand). This procedure helped me a lot.

My son is 6 months old, there is slight muscle hypertonicity, our pediatrician advised him to get a massage. We completed a course of procedures in the children's department of the Medsi CDC on Krasnaya Presnya. The impressions from the specialist were exceptionally good, he was very attentive to the children, it was immediately obvious. He behaved carefully and attentively with the child. I will keep this institution in mind for the future.

A very bad experience, where the professor examined the knee by palpation and established the type of injury without performing an MRI or any imaging of the knee, determined that therapy costing 500e is needed, with 5 injections at a 7-day interval, at the first examination he extracts my synovial fluid and injects, when asked if there are any side effects or if rest is necessary, he said and wrote in the report normal activity, I come home after 3-4 hours, the knee starts to swell and it hurts so much that I cannot independently I am moving, which was not the case before coming to him. The next day I call to tell about the given problem, he tells me that he can't believe it and that I am not the first one he has done this to. And that he didn't do anything special to make it look that way. And that they are there so he won't run away. The swelling doesn't go away, I go to the emergency room, I get a plaster cast from hip to foot, and the agony starts. It happens with my knee. different hospitals. Now, I am currently waiting for another magnetic resonance imaging with contrast to be performed because a piece of metal was observed at the injection site where the professor from VozdMedic poked me. So I don't have any nice comments. Very bad experience!

Excellent service, great doctors and friendly staff! I only perform examinations at Vozdmedik, for a reason. The clinic is superbly equipped and has the best equipment and technology.

👍🏻👍🏻👍🏻

Knee replacement was performed. The operation was painful and complicated.. I was very pleased. High specialists, masters of their craft. Just wizards. And what else I liked was the attitude of the staff. The team is united and attentive. thank you for everything

On July 20, 2023, an operation to replace the left knee joint was performed. I would like to very much thank the entire operating team of doctors and nurses of Anesthesiology for their professionalism, sensitive attitude, attention to patients, and also say words of gratitude to the entire team at the trauma department of the hospital. Thank you very much. Good health to everyone

The hemorrhoid surgery and subsequent hospitalization went perfectly. I highly appreciate the helpful and friendly attitude of the doctors, nurses and other staff. The surgery department is very nicely renovated, in every room a clean modern shower, toilet, Smart TV, WiFi. The food is very tasty by hospital standards. Thank you very much for the pleasant course of hospitalization.

We completed the birth and follow-up care at the hospital. I positively acknowledge a parking lot with sufficient capacity and a price of CZK 10/hour. I also really liked the breakfast buffet concept. Of course, the quality of the food corresponded to the amount paid by the client for health insurance. The hospital's equipment also matches the price. The birth took place normally, thanks to extra-standard care (own midwife and doula). A very noisy renovation was taking place in the hospital, when the client's bed was also vibrating. So it was necessary to leave the hospital earlier. The behavior of the staff corresponds to the 20s of the 21st century in the Czech Republic. In other words, normal and nice during normal communication. In case of problems, arrogance and threats start. Some of the staff also only speak broken Czech. Overall, the vaunted Czech care has once again shown what it really is. No one died and in this case no one has any lasting effects, but would anyone want to go through it again?...No........I recommend considering the alternative of not paying for the birth in Germany or Austria. It can be stated that the care provided fully corresponded to the amount of health insurance paid in the Czech Republic.

Very unprofessional attitude of some doctors (Nguyen Duc, M.D. does not understand and is not interested in you and nurse Adéla is arrogant) in the gynecology department. Of course they will accommodate you and nothing is a problem, but my personal experience with this hospital is disastrous. In the winter of 2023, I underwent a hysterectomy. I was to be operated on by MUDr. Radek Poláček, who was absent at the time and no one informed me. All the pre-operative examinations were negative. After the operation, Mudr. Josef Hajči, who finally operated on me, came to me and told me that he had no information about me in the card and that he was sorry, he was very tired and we accidentally removed one ovary. After the operation, the drip dripped out of my vein, my hand was swollen, when I called the nurse she scolded me. They will never see me in this hospital again, although they have new equipment, but humanity and professional behavior are missing. it was the fourth one's turn and by mistake he also removed the ovary ovary

If you're a tourist, for your safety please DON'T go there. No English, not helpful, non professional and most of all they insisted that I pay although I was explaining to them that I have a proof that I have a European insurance card. After a lot of time, they called the only doctor that could speak English and he explained to me that there was a misunderstanding because they didn't believe that I was a citizen of the European union. How is that possible while I gave them many time my ID with belgian nationality and proof of European insurance??? The second doctor also gave me pain killers and apologized that the first doctor didn't give me any and didn't explain me what happened. I will file a complaint mentioning the name of the incompetent nurse and doctor because it's not normal to be so incompetent while having a big "European union" flag in front of the hospital while not knowing the applicable rules. I had to stay there until midnight to solve it while I was I pain. My attempt to give them my phone with Google translate where useless because they didn't want to help. A big thanks to the second doctor.

Was treated with much care and professionalism. In 5 minutes the procedures had alread started and everyone did their best to overcome language barriers. Thanks!

We have been unable to find a doctor who will accept English-speaking patients and I HAD to use the hospital emergency today. My daughter was ill. I didn’t know which area to take her - adult or children’s - she is 15. The intake clerk downstairs was obviously a bit irritated that I didn’t understand her but she was willing to use her phone to translate and instructed me to go upstairs to the children’s ward. I was a bit confused because there isn’t a check-in window in what appears to be a waiting room. You must press a buzzer next to the closed door. I had to watch someone else who came in after 🫣 to see what to do. The nurse didn’t speak English but the PA (or perhaps she was a doctor) spoke well enough that we managed. (I got the impression that if we had been Ukrainian, we would have had to go somewhere else for treatment. But we’re American and have foreigner’s insurance.) We were treated kindly and well. Fortunately it wasn’t a busy morning so my daughter was seen immediately. I was also pleased by how nice the lady at the pharmacy downstairs was. She spoke English and made sure I understood how to take the medicine prescribed and also that I had a copy to give to insurance for reimbursement. I didn’t know to ask for that and am grateful.

Try taking the elevator to the 10th floor at OCHNÍ.... You wait 10 minutes for the elevator. One then arrives full of Ukrainians, and in the other they transport the patient from the hall to the ward. After another 15 minutes of waiting in the green zone in front of the elevator (so that the elevator would even know that I would like to go up), I preferred to walk up the stairs..... Terrible 🤮

When you enter, leave all hope. This is one of the most desolate hospitals I have ever seen. I went here with my kid who had a medical letter for an infectious disease and needed antibiotics. The receptionist started bullying me because I couldn't speak Czech well, so she basically sent me home. I started yelling back at her and some other lady there told me to stop yelling because she felt offended by me. I told her that she could take her offence and shove it. I pay taxes here and I demand to be treated humanely. Eventually we got into the emergency where one nurse took off with my phone to show doctors there the email from our doctor. Then she made us wait. Finally, another nurse came out and helped us register. The registration lady was nice. We went to section C at 1st floor and the people there were polite. We finally learnt we actually had to go to another hospital. To sum up, if a car crushes me in the street and the ambulance wants to rush me to Lochotin hospital, I prefer to be left to die in peace, rather than deal with such people again.

Went to the emergency room because I had some infection or allergic reaction on my lip and they told me to come back in 2 days because the right doctor isn’t there. What kind of emergency treatment is that? Also they don’t speak any English what makes communication extremely difficult..

If I were to evaluate the surrounding area and the outside of the hospital at the moment, it looks like a battlefield in terms of repairs and modifications, but the hospital itself is more important 🏥, and I already evaluated it once and my evaluation has not changed, i.e. I will never allow it to go to the FN, great doctors and, of course, nurses, with whom my patients communicate first. Above-standard care, just great respect and admiration for me. Thanks to all the medical staff 👍💐👏👌

I want to thank one-day surgery for the care during elbow surgery,, 👍🏻,, the attitude of the doctors is great and the nurses are amazing,,💯💯💯,, nurse Michaela Bulínová is simply the best!!!,, thank you for everything,,♥️😍🤗,, I hope, that the review will reach her,,🙋🏻‍♀️😉👍🏻😃

On July 4th, emergency admission.. we come with our son (16 months), he was bleeding from the head after a fall at home. First comes the queue lady, very unpleasant, she didn't even know how to buzz... then we sit in the waiting room, wait for 2 hours - I'm reminded of a one-year-old child with a head injury! Even the staff (probably the medical brother) found it strange that they still didn't take us!! And finally a Ukrainian woman came, she knocked, and let them take her right away, that she has a stomach ache, and they? They took her because, after all, the glory of Ukraine.. a mockery of Czech citizens and especially children.. UK is always preferred🙏🏽 I only give 1 star because of the attentiveness of the gentleman. I DO NOT RECOMMEND!!! We called Mulac's hospital, and despite the fact that they only treat children from 3 years old, they told us to come if they would leave us waiting like that with such a small child!!

A complete shock! For the planned procedure, instead of the morning, only at half past two, discharge instead of between 4 and 6. And when I asked where it was, the nurse told me that they didn't have a schedule for us

We came with my son with a broken leg and the nurse told us that we should have come in the morning and that we would have to wait for 2 hours but there was no one in front of us so I don't understand why she made us wait so long with the child!!!!! I do not recommend the surgical nurse at all!!!

I do not recommend!!! Sonography visit, unpleasant doctor, sono of the entire abdomen done in maybe a minute. Considering that a person comes to the doctor's office with a little apprehension, I would expect a more friendly approach. No one said a word about the examination. They forced me into the waiting room, after a few minutes they shoved a piece of paper into my hand and slammed the door. It was my first visit to this hospital and never again!!!