Podiatry Blogs | Foot Doctor Metropolis, IL 62960 and Eldorado, IL 62930

Monday, 15 October 2018 00:00

Is Rheumatoid Arthritis Common?

One of the most common types of arthritis is referred to as rheumatoid arthritis. Many people may experience symptoms of this condition in the feet and are aware of the pain and discomfort that typically exists with this ailment. There are specific symptoms that may accompany this type of arthritis, including swelling and soreness in the feet, difficulty waking, which may be a result of unstable joints, or the foot possibly changing shape. Research has shown the part of the foot that may be affected the most are the toes, which consist of smaller joints. They may begin to look deformed and may have difficulty in moving or bending. There may be additional foot conditions that may arise including the development of corns and calluses. This may be a result of changes in the foot shape. If you are afflicted with rheumatoid arthritis, it is suggested to consult with a podiatrist who can offer proper treatment techniques.

Because RA affects more than just your joints, including the joints in your feet and ankles, it is important to seek early diagnosis from your podiatrist if you feel like the pain in your feet might be caused by RA. For more information, contact Dr. Dean D. Hinners of Illinois. Our doctor will assist you with all of your podiatric concerns.

What Is Rheumatoid Arthritis?

Rheumatoid Arthritis (RA) is an autoimmune disorder in which the body’s own immune system attacks the membranes surrounding the joints. Inflammation of the lining and eventually the destruction of the joint’s cartilage and bone occur, causing severe pain and immobility.

Rheumatoid Arthritis of the Feet

Although RA usually attacks multiple bones and joints throughout the entire body, almost 90 percent of cases result in pain in the foot or ankle area.

Symptoms

Swelling and pain in the feet
Stiffness in the feet
Pain on the ball or sole of feet
Joint shift and deformation

Diagnosis

Quick diagnosis of RA in the feet is important so that the podiatrist can treat the area effectively. Your doctor will ask you about your medical history, occupation, and lifestyle to determine the origin of the condition. Rheumatoid Factor tests help to determine if someone is affected by the disease.

If you have any questions please feel free to contact one of our offices located in Metropolis and Eldorado, IL . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.

Monday, 08 October 2018 00:00

Is There A Reduction of Bunions in Non-Western Countries?

If you notice a large bony protrusion on the side of your big toe, you may have what is referred to as a bunion. It is considered to be a deformity, and there may be several reasons why this condition may occur. Research has shown that genetics may play a significant role in the formation of bunions. If you happen to have a pre-existing case of bunions, wearing shoes that do not fit correctly could possibly make it even worse. This type of footwear may include shoes that have a narrow toe area, which does not have adequate room for the toes to move about in. This may result in the toes being forced to squeeze into an area that is too small. There is a significant reduction in the development of bunions in non-western countries and this may be a result of wearing shoes that fit correctly. If you feel you have a bunion, it’s suggested to speak with a podiatrist who can begin treatment options that are right for you.

If you are suffering from bunions, contact Dr. Dean D. Hinners of Illinois. Our doctor can provide the care you need to keep you pain-free and on your feet.

What Is a Bunion?

A bunion is formed of swollen tissue or an enlargement of boney growth, usually located at the base joint of the toe that connects to the foot. The swelling occurs due to the bones in the big toe shifting inward, which impacts the other toes of the foot. This causes the area around the base of the big toe to become inflamed and painful.

Why Do Bunions Form?

Genetics – Susceptibility to bunions are often hereditary

Stress on the feet – Poorly fitted and uncomfortable footwear that places stress on feet, such as heels, can worsen existing bunions

How Are Bunions Diagnosed?

Doctors often perform two tests – blood tests and x-rays – when trying to diagnose bunions, especially in the early stages of development. Blood tests help determine if the foot pain is being caused by something else, such as arthritis, while x-rays provide a clear picture of your bone structure to your doctor.

How Are Bunions Treated?

Refrain from wearing heels or similar shoes that cause discomfort
Select wider shoes that can provide more comfort and reduce pain
Anti-inflammatory and pain management drugs
Orthotics or foot inserts
Surgery

If you have any questions, please feel free to contact one of our offices located in Metropolis and Eldorado, IL . We offer the newest diagnostic and treatment technologies for all your foot care needs.

Causes and Symptoms of a Broken Foot

People who have broken their foot are most likely familiar with the severe pain and discomfort that may be associated with this condition. Typical symptoms of this type of fracture may include swelling, bruising and the inability to walk on the foot. The most common reasons for this to occur may be from a fall or from overuse, which may be a result of consistent running and jumping. If you feel you have broken your foot, a proper diagnosis must be performed, which will determine the severity of the fracture. This is accomplished by having an X-ray, CT scan or bone scan taken. When this occurs, proper treatment may begin, which may include wearing a cast or a supportive boot. In severe breaks where the bone protrudes from the skin, surgery may be a necessary option to repair any damage the foot has incurred. It is suggested to speak with a podiatrist if you have broken your foot and would like to learn about treatment options that are correct for you.

A broken foot requires immediate medical attention and treatment. If you need your feet checked, contact Dr. Dean D. Hinners from Illinois. Our doctor can provide the care you need to keep you pain-free and on your feet.

Broken Foot Causes, Symptoms, and Treatment

A broken foot is caused by one of the bones in the foot typically breaking when bended, crushed, or stretched beyond its natural capabilities. Usually the location of the fracture indicates how the break occurred, whether it was through an object, fall, or any other type of injury.

Common Symptoms of Broken Feet:

Bruising
Pain
Redness
Swelling
Blue in color
Numbness
Cold
Misshapen
Cuts
Deformities

Those that suspect they have a broken foot shoot seek urgent medical attention where a medical professional could diagnose the severity.

Treatment for broken bones varies depending on the cause, severity and location. Some will require the use of splints, casts or crutches while others could even involve surgery to repair the broken bones. Personal care includes the use of ice and keeping the foot stabilized and elevated.

Monday, 24 September 2018 00:00

Why is it Important for Seniors to Maintain Proper Foot Care?

There are several ways seniors can practice proper foot care. These may include wearing shoes that fit correctly and are comfortable to wear during daily activities. It’s important the toes have adequate room to move around inside, and this may possibly avoid a pre-existing case of bunions from becoming worse. It may also prevent corns from developing. Additionally, performing a gentle exercise program frequently, may aid in keeping the blood flowing. These may include walking and stretching, which may help to maintain proper circulation. Washing the feet and drying thoroughly between the toes may be beneficial in preventing athlete’s foot from developing. When a moisturizing lotion is used, a painful condition referred to as cracked heels may be avoided. When the toenails are trimmed properly, occurrences of ingrown toenails may decrease. If you are a senior, it’s suggested to consult with a podiatrist on a frequent basis to discuss any foot conditions that may be present.

Proper foot care is something many older adults forget to consider. If you have any concerns about your feet and ankles, contact Dr. Dean D. Hinners from Illinois. Our doctor can provide the care you need to keep you pain-free and on your feet.

The Elderly and Their Feet

As we age we start to notice many changes in our body, but the elder population may not notice them right away. Medical conditions may prevent the elderly to take notice of their foot health right away. Poor vision is a lead contributor to not taking action for the elderly.

Common Conditions

Neuropathy – can reduce feeling in the feet and can hide many life-threatening medical conditions.
Reduced flexibility – prevents the ability of proper toenail trimming, and foot cleaning. If left untreated, it may lead to further medical issues.
Foot sores – amongst the older population can be serious before they are discovered. Some of the problematic conditions they may face are:
Gouging toenails affecting nearby toe
Shoes that don’t fit properly
Pressure sores
Loss of circulation in legs & feet
Edema & swelling of feet and ankles

Susceptible Infections

Diabetes and poor circulation can cause general loss of sensitivity over the years, turning a simple cut into a serious issue.

Different Types of Foot Pain

There are several different types of foot pain that many people experience. Some patients may feel pain that radiates in the entire foot, which may be caused by a condition that is referred to as neuropathy. This may occur among diabetic patients as a result of elevated blood sugar levels, and may cause nerve damage. Additionally, if the pain is located in the ball of the foot, a condition known as Metatarsalgia may develop. This commonly occurs as a result of wearing shoes that do not fit correctly. Gout, hammertoe, or bunions may cause toe pain, and proper treatment may include adapting a lifestyle change or taking prescription medications. A common form of heel pain may be indicative of plantar fasciitis, which typically affects the tissue that links the heel and the toes together. It’s suggested that if you are experiencing any type of foot pain, a consultation with a podiatrist will be helpful in determining the best course of treatment.

Foot Pain

Foot pain can be extremely painful and debilitating. If you have a foot pain, consult with Dr. Dean D. Hinners from Illinois. Our doctor will assess your condition and provide you with quality foot and ankle treatment.

Causes

Foot pain is a very broad condition that could be caused by one or more ailments. The most common include:

Bunions
Hammertoes
Plantar Fasciitis
Bone Spurs
Corns
Tarsal Tunnel Syndrome
Ingrown Toenails
Arthritis (such as Gout, Rheumatoid, and Osteoarthritis)
Flat Feet
Injury (from stress fractures, broken toe, foot, ankle, Achilles tendon ruptures, and sprains)
And more

Diagnosis

To figure out the cause of foot pain, podiatrists utilize several different methods. This can range from simple visual inspections and sensation tests to X-rays and MRI scans. Prior medical history, family medical history, and any recent physical traumatic events will all be taken into consideration for a proper diagnosis.

Treatment

Treatment depends upon the cause of the foot pain. Whether it is resting, staying off the foot, or having surgery; podiatrists have a number of treatment options available for foot pain.

Foot Conditions That May Occur as a Result of Wearing Flip Flops

The type of footwear referred to as flip flops are popular summer shoes that are made of thin soles and typically are not meant to be worn for extended periods of time. Despite the fact that many people indulge in wearing these types of shoes, there may be moderate discomfort and symptoms that can be associated with them. These may include an achy feeling that may be present in the foot and ankle in addition to the formation of calluses and blisters. Other foot conditions that may develop as a result of wearing flip flops may be the development of bunions and hammertoes. The risk of injury may be increased from choosing to wear this type of shoe and this may occur as a result of a lack of stability. If you have questions pertaining to flip flops and would like additional information about the pros and cons for wearing this type of shoe, please schedule an appointment with a podiatrist who will be able to answer any questions you may have.

Flip-flops can cause a lot of problems for your feet. If you have any concerns about your feet or ankles, contact Dr. Dean D. Hinners from Illinois. Our doctor will assist you with all of your foot and ankle needs.

Flip-Flops and Feet

Flip-flops have managed to become a summer essential for a lot of people. While the shoes may be stylish and easy to slip on and off, they can be dangerous to those who wear them too often. These shoes might protect you from fungal infections such as athlete’s foot, but they can also give you foot pain and sprained ankles if you trip while wearing them.

When Are They Okay to Wear?

Flip-flops should only be worn for very short periods of time. They can help protect your feet in places that are crawling with fungi, such as gym locker rooms. Athlete’s foot and plantar warts are two common fungi that flip-flops may help protect your feet against.

Why Are They Bad for My Feet?

These shoes do not offer any arch support, so they are not ideal for everyday use. They also do not provide shock absorption or heel cushioning which can be problematic for your feet. Additionally, you may suffer from glass cuts, puncture wounds, and stubbed toes since they offer little protection for your feet.

More Reasons Why They Are Bad for Your Feet

They Slow You Down
May Cause Blisters and Calluses
Expose Your Feet to Bacteria

Tuesday, 04 September 2018 00:00

What Foods to Avoid if You are Afflicted with Gout

When specific foods are ingested on a frequent basis, a flare-up of a condition known as gout may occur. There are several symptoms that accompany this ailment, including severe pain and discomfort surrounding the big toe, redness, and extreme tenderness when the area is touched. Certain foods have elevated levels of purines, which is known to raise uric acid levels in the blood. This causes crystals to form, and may lodge in the joints of the feet, most commonly the big toe. Research has shown that certain foods should be limited or avoided, which are high in purine levels. These may include alcohol, shellfish, and meat. For patients who experience gout, it may be advised to drink plenty of fresh water frequently, increase the amount of fruits and vegetables that are eaten on a daily basis, and to lose weight slowly if obesity is a factor. Please schedule a consultation with a podiatrist if you are afflicted with gout for immediate treatment options.

Gout is a foot condition that requires certain treatment and care. If you are seeking treatment, contact Dr. Dean D. Hinners from Illinois. Our doctor will treat your foot and ankle needs.

What Is Gout?

Gout is a type of arthritis caused by a buildup of uric acid in the bloodstream. It often develops in the foot, especially the big toe area, although it can manifest in other parts of the body as well. Gout can make walking and standing very painful and is especially common in diabetics and the obese.

People typically get gout because of a poor diet. Genetic predisposition is also a factor. The children of parents who have had gout frequently have a chance of developing it themselves.

Gout can easily be identified by redness and inflammation of the big toe and the surrounding areas of the foot. Other symptoms include extreme fatigue, joint pain, and running high fevers. Sometimes corticosteroid drugs can be prescribed to treat gout, but the best way to combat this disease is to get more exercise and eat a better diet.

Swollen Feet During Pregnancy is Natural

Despite weight gain being a natural occurrence during pregnancy, many women often notice abnormal swelling in their feet. This is partially due to women experiencing a change in their center of gravity, which may prompt a difference in standing and walking. The feet can enlarge and should be measured regularly, so the correct shoe size can be worn for maximum comfort. This may prevent certain uncomfortable foot conditions from occurring such as ingrown toenails, and it can prevent an existing case of bunions from becoming worse. There may be several ways to control unwanted swollen feet. Many women may find relief by elevating their feet frequently, practicing a healthy lifestyle that includes consuming foods with a lower sodium content, and exercising regularly. Additionally, wearing comfortable shoes may aid in providing additional support for the feet and general health of the body. If you would like additional information about how pregnancy affects the feet, please consult with a podiatrist.

Pregnant women with swollen feet can be treated with a variety of different methods that are readily available. For more information about other cures for swollen feet during pregnancy, consult with Dr. Dean D. Hinners from Illinois. Our doctor will attend to all of your foot and ankle needs.

What Foot Problems Can Arise During Pregnancy?

One problem that can occur is overpronation, which occurs when the arch of the foot flattens and tends to roll inward. This can cause pain and discomfort in your heels while you’re walking or even just standing up, trying to support your baby.

Another problem is edema, or swelling in the extremities. This often affects the feet during pregnancy but tends to occur in the later stages.

How Can I Keep My Feet Healthy During Pregnancy?

Wearing orthotics can provide extra support for the feet and help distribute weight evenly
Minimize the amount of time spent walking barefoot
Wear shoes with good arch support
Wear shoes that allow for good circulation to the feet
Elevate feet if you experience swelling
Massage your feet
Get regular, light exercise, such as walking, to promote blood circulation to the feet

Monday, 20 August 2018 00:00

Helpful Tips for Proper Foot Care

Foot care is considered to be an essential part of one’s overall well-being, so it is crucial that you take precautions to care of your feet. Perhaps the most important tip to follow is to never ignore pain in your feet. As soon as you notice a substantial amount of pain in either of your feet, you should immediately contact your podiatrist. Another tip is to perform daily foot inspections, so you will be able to treat any issues before they progressively become worse. Additionally, it is important to practice proper hygiene and to wash your feet on a daily basis to ensure that you are not exposing yourself to harmful bacteria. The way you trim your toenails has an influence on whether or not you will develop painful ingrown toenails. The best way to trim your nails is to trim them straight across instead of in a rounded shape. For diabetics, it is especially important that you take care of your feet, because these ordinary foot conditions can easily become more serious.

Everyday foot care is very important to prevent infection and other foot ailments. If you need your feet checked, contact Dr. Dean D. Hinners from Illinois. Our doctor can provide the care you need to keep you pain-free and on your feet.

Everyday Foot Care

Often, people take care of their bodies, face and hair more so than they do for their feet. But the feet are a very important aspect of our bodies, and one that we should pay more attention to. Without our feet, we would not be able to perform most daily tasks.

It is best to check your feet regularly to make sure there are no new bruises or cuts that you may not have noticed before. For dry feet, moisturizer can easily be a remedy and can be applied as often as necessary to the affected areas. Wearing shoes that fit well can also help you maintain good foot health, as well as making it easier to walk and do daily activities without the stress or pain of ill-fitting shoes, high heels, or even flip flops. Wearing clean socks with closed shoes is important to ensure that sweat and bacteria do not accumulate within the shoe. Clean socks help to prevent Athlete’s foot, fungi problems, bad odors, and can absorb sweat.

Causes of Cracked Heels

Studies have shown that cracked heels are a common ailment for men and women of all ages. This problem may cause simple activities like walking to become difficult. If you are experiencing problems related to cracked heels, it is important that you seek treatment right away before your condition potentially progresses into eczema, or other types of inflammation. There are many different reasons why you may have cracked feet. Some common causes include obesity, aging, psoriasis, pregnancy, fungal infections, and vitamin deficiency. While these are not the only causes for cracked heels, these are some of the most common reasons why people develop them. Treatment for cracked heels typically begins with a good moisturizer. You can either opt for medicated solutions, or you can try to treat your cracked heels at home. Common household items that are used to treat dry feet are olive oil, coconut oil, and rice flour.

If the skin on your feet starts to crack, you may want to see a podiatrist to find treatment. If you have any concerns, contact Dr. Dean D. Hinners from Illinois. Our doctor can provide the care you need to keep you pain-free and on your feet.

Cracked Heels

It is important to moisturize your cracked heels in order to prevent pain, bleeding, and infection. The reason cracked heels form is because the skin on the foot is too dry to support the immense pressure placed on them. When the foot expands, the dry skin on the foot begins to split.

Ways to Help Heal Them

Invest in a good foot cream
Try Using Petroleum Jelly
Ease up on Soaps
Drink Plenty of Water

Ways to Prevent Cracked Heels

Moisturize After Showering
Skip a Shower
Keep Shower Water Lukewarm
Don’t Scrub Your Feet

If you are unsure how to proceed in treating cracked heels, seek guidance from a podiatrist. Your doctor will help you with any questions or information you may need.

More...

Monday, 06 August 2018 00:00

Causes of Ingrown Toenails

A condition that is referred to as ingrown toenails commonly develops as a result of the toenails being trimmed incorrectly. This occurs when the corners of the nail grow into the skin, often producing pain and discomfort. There are several symptoms that may lead to the conclusion that an ingrown toenail has begun to form including redness and swelling around the affected area or a liquid discharge that comes from the nail. If the shoes that are worn fit poorly, this condition may begin to develop in addition to specific repeated activity, in which the toe consistently kicks a ball. The patient may find moderate relief by soaking the toe in warm salt water frequently throughout the day, in addition to inserting a small piece of dry cotton under the affected area. It’s strongly advised to consult with a podiatrist for correct treatment remedies that are right for you.

Ingrown toenails may initially present themselves as a minor discomfort, but they may progress into an infection in the skin without proper treatment. For more information about ingrown toenails, contact Dr. Dean D. Hinners of Illinois. Our doctor can provide the care you need to keep you pain-free and on your feet.

Ingrown Toenails

Ingrown toenails are caused when the corner or side of a toenail grows into the soft flesh surrounding it. They often result in redness, swelling, pain, and in some cases, infection. This condition typically affects the big toe and may recur if it is not treated properly.

Causes

Improper toenail trimming
Genetics
Improper shoe fitting
Injury from pedicures or nail picking
Abnormal gait
Poor hygiene

You are more likely to develop an ingrown toenail if you are obese, have diabetes, arthritis, or have any fungal infection in your nails. Additionally, people who have foot or toe deformities are at a higher risk of developing an ingrown toenail.

Symptoms

Some symptoms of ingrown toenails are redness, swelling, and pain. In rare cases, there may be a yellowish drainage coming from the nail.

Treatment

Ignoring an ingrown toenail can have serious complications. Infections of the nail border can progress to a deeper soft-tissue infection, which can then turn into a bone infection. You should always speak with your podiatrist if you suspect you have an ingrown toenail, especially if you have diabetes or poor circulation.

How Many Different Types of Corns Are There?

If you have ever experienced a corn on the top of the toes, you most likely are aware of the pain that is associated with it. Corns are generally the result of increased pressure and rubbing, and typically originates from shoes that do not fit correctly. It appears to be a small area, and the skin will be hardened and thick. There are known to be two types of corns and are referred to as hard and soft corns. The latter generally develops in between the toes and are often soft, because of the excess moisture and sweat that is present. Hard corns come from wearing shoes that are too tight and may often cause the toes to endure unwanted pressure, resulting in pain and discomfort. There are different types of treatments that may be used to eliminate corns, and it’s advised to speak with a podiatrist for possible relief options that are correct for you.

Corns can make walking very painful and should be treated immediately. If you have questions regarding your feet and ankles, contact Dr. Dean D. Hinners of Illinois. Our doctor will treat your foot and ankle needs.

Corns: What Are They? And How Do You Get Rid of Them?
Corns are thickened areas on the skin that can become painful. They are caused by excessive pressure and friction on the skin. Corns press into the deeper layers of the skin and are usually round in shape.

Ways to Prevent Corns
There are many ways to get rid of painful corns such as:

Wearing properly fitting shoes that have been measured by a professional
Wearing shoes that are not sharply pointed or have high heels
Wearing only shoes that offer support

Treating Corns

Although most corns slowly disappear when the friction or pressure stops, this isn’t always the case. Consult with your podiatrist to determine the best treatment option for your case of corns.

Monday, 23 July 2018 00:00

Can Toenail Fungus Be Prevented?

Many people are unaware that they may have toenail fungus, and this may often be a result of a lack of pain and discomfort. Common symptoms that are associated with this ailment may include the toenail becoming dry and brittle, the nail appearing yellow and thick, or a separation from the nail and the nail bed. It’s important to take proper care of your feet, which may possibly avoid this unsightly condition from developing. There are several ways to accomplish this, including wearing shoes that fit properly, trimming the toenails correctly, and wearing appropriate shoes in the shower and pool areas. If you are afflicted with toenail fungus, it’s suggested to speak with a podiatrist who can provide proper guidance for the best treatment options.

For more information about treatment, contact Dr. Dean D. Hinners of Illinois. Our doctor can provide the care you need to keep you pain-free and on your feet.

Toenail Fungus Treatment

Toenail fungus is a condition that affects many people and can be especially hard to get rid of. Fortunately, there are several methods to go about treating and avoiding it.

Antifungals & Deterrence

Oral antifungal medicine has been shown to be effective in many cases. It is important to consult with a podiatrist to determine the proper regiment for you, or potentially explore other options.

Applying foot powder on the feet and shoes helps keep the feet free of moisture and sweat.

Sandals or open toed shoes – Wearing these will allow air movement and help keep feet dry. They also expose your feet to light, which fungus cannot tolerate. Socks with moisture wicking material also help as well.

If you have any questions please feel free to contact one of our offices located in Metropolis and Eldorado, IL . We offer the newest diagnostic tools and technology to treat your foot and ankle needs.

What is the Difference Between a Heel Spur and Plantar Fasciitis?

If you experience the pain of a heel spur, it may be mistaken for a plantar fasciitis injury. The symptoms are similar and may include tenderness and pain at the bottom of the heel, and this may cause difficulty in walking. A heel spur is identified as a bony protrusion that extends from the heel bone, and it may often represent a hook. Having an X-ray performed is generally an effective way to differentiate between the two conditions and this will allow the bony growth to be seen. Research has shown that it typically originates from a poor running or walking pattern, shoes that fit poorly, or from obesity, because the heel must endure additional pressure. Effective treatment remedies may include possibly ceasing the activity that caused this injury to occur in addition to performing proper stretching techniques that may provide moderate relief. It’s advised to consult with a podiatrist for additional information about heel spurs.

Heel spurs can be incredibly painful and sometimes may make you unable to participate in physical activities. To get medical care for your heel spurs, contact Dr. Dean D. Hinners from Illinois. Our doctor will do everything possible to treat your condition.

Heels Spurs

Heel spurs are formed by calcium deposits on the back of the foot where the heel is. This can also be caused by small fragments of bone breaking off one section of the foot, attaching onto the back of the foot. Heel spurs can also be bone growth on the back of the foot and may grow in the direction of the arch of the foot.

Older individuals usually suffer from heel spurs and pain sometimes intensifies with age. One of the main condition's spurs are related to is plantar fasciitis.

Pain

The pain associated with spurs is often because of weight placed on the feet. When someone is walking, their entire weight is concentrated on the feet. Bone spurs then have the tendency to affect other bones and tissues around the foot. As the pain continues, the feet will become tender and sensitive over time.

Treatments

There are many ways to treat heel spurs. If one is suffering from heel spurs in conjunction with pain, there are several methods for healing. Medication, surgery, and herbal care are some options.

If you have any questions feel free to contact one of our offices located in Metropolis and Eldorado, IL . We offer the latest in diagnostic and treatment technology to meet your needs.