Difference between revisions of "Health-and-Nutrition/C2/Kangaroo-Mother-Care/English-timed"

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{|border=1
 
{|border=1
 
 
|<center>Time</center>
 
|<center>Time</center>
 
|<center>Narration</center>
 
|<center>Narration</center>
 
  
 
|-
 
|-
 
|00:00
 
|00:00
|Welcome to the Spoken Tutorial on '''Kangaroo mother care'''.
+
|Welcome to the '''Spoken Tutorial''' on '''Kangaroo mother care'''.
  
 
|-
 
|-
Line 15: Line 13:
  
 
|-
 
|-
|0:08  
+
|00:08  
|What is '''Kangaroo mother care'''?
+
|what is '''Kangaroo mother care'''?
  
 
|-
 
|-
 
|00:10
 
|00:10
|The components, importance and
+
|the components, importance and
  
 
|-
 
|-
 
|00:13
 
|00:13
|Procedure of '''Kangaroo mother care'''
+
|procedure of '''Kangaroo mother care'''.
  
 
|-
 
|-
 
|00:17
 
|00:17
|Let us first begin with the introduction of '''Kangaroo mother care'''?
+
|Let us first begin with the introduction of '''Kangaroo mother care'''.
  
 
|-
 
|-
Line 36: Line 34:
 
|-
 
|-
 
|00:24
 
|00:24
|it involves, keeping the baby in skin to skin contact with the mother.
+
|it involves keeping the baby in skin to skin contact with the mother.
  
 
|-
 
|-
 
|00:29
 
|00:29
|and it is popularly known as '''KMC'''.
+
|And, is popularly known as '''KMC'''.
  
 
|-
 
|-
Line 56: Line 54:
 
|-
 
|-
 
|00:48
 
|00:48
|who do not require continuous monitoring  
+
|who do not require continuous monitoring.
  
 
|-
 
|-
Line 68: Line 66:
 
|-
 
|-
 
|01:03  
 
|01:03  
|Continuous and prolonged skin to skin contact between the mother and her baby.
+
|continuous and prolonged skin to skin contact between the mother and her baby
  
 
|-
 
|-
|01:09
+
|01:10
|and Exclusive breastfeeding
+
|and exclusive breastfeeding.
  
 
|-
 
|-
 
|01:13
 
|01:13
|Let’s discuss these components in detail.
+
|Let’s discuss these 2 components in detail.
  
 
|-
 
|-
Line 84: Line 82:
 
|-
 
|-
 
|01:21
 
|01:21
|it improves the Let down reflex  
+
|It improves the '''let down reflex'''
  
 
|-
 
|-
Line 92: Line 90:
 
|-
 
|-
 
|01:28  
 
|01:28  
|Let down reflex has been explained in another tutorial of the same series.  
+
|'''Let down reflex''' has been explained in another tutorial of the same series.  
  
 
|-
 
|-
Line 100: Line 98:
 
|-
 
|-
 
|01:38  
 
|01:38  
|Note that-
+
|Note that  
  
 
|-
 
|-
 
|01:40  
 
|01:40  
|Exclusive breastfeeding is recommended for the first 6 months.  
+
|exclusive breastfeeding is recommended for the first 6 months.  
  
 
|-
 
|-
Line 112: Line 110:
 
|-
 
|-
 
|01:50
 
|01:50
|Prolonged skin to skin contact during '''KMC''' helps maintain the baby's body temperature  
+
|Prolonged skin to skin contact during '''KMC''' helps maintain the baby's body temperature  
  
 
|-
 
|-
Line 120: Line 118:
 
|-
 
|-
 
|02:01
 
|02:01
|'''KMC''' also decreases -
+
|'''KMC''' also decreases
  
 
|-
 
|-
Line 127: Line 125:
  
 
|-
 
|-
|02:05
+
|02:06
 
|the rate of apnea in babies.
 
|the rate of apnea in babies.
  
Line 135: Line 133:
  
 
|-
 
|-
|02:13
+
|02:14
 
|Apart from these-  
 
|Apart from these-  
  
Line 143: Line 141:
  
 
|-
 
|-
|02:20
+
|02:21
|And it strengthens the emotional bonding between the mother and her baby.  
+
|And, it strengthens the emotional bonding between the mother and her baby.  
  
 
|-
 
|-
Line 156: Line 154:
 
|-
 
|-
 
|02:33
 
|02:33
|keeping the baby in radiant warmer.
+
|keeping the baby in radiant warmer  
  
 
|-
 
|-
Line 164: Line 162:
 
|-
 
|-
 
|02:40
 
|02:40
|It also improves the satisfaction and confidence in the mother-
+
|It also improves the satisfaction and confidence in the mother
 
   
 
   
 
|-
 
|-
Line 176: Line 174:
 
|-
 
|-
 
|02:54
 
|02:54
|Father or  
+
|father or  
  
 
|-
 
|-
 
|02:56
 
|02:56
|Any adult family member too.
+
|any other family member too.
  
 
|-
 
|-
 
|02:58
 
|02:58
|We will now discuss the points to be followed by '''KMC''' provider:
+
|We will now discuss the points to be followed by '''KMC''' provider.
  
 
|-
 
|-
Line 201: Line 199:
 
|03:16
 
|03:16
 
|daily bath,
 
|daily bath,
 +
clipped fingernails,
  
 
|-
 
|-
|03:17
+
|03:19
|clipped fingernails,
+
 
+
|-
+
|03:18
+
 
|tied up hair
 
|tied up hair
  
Line 216: Line 211:
 
|-
 
|-
 
|03:22
 
|03:22
|He or she should not wear any jewellery, watches and threads -
+
|He or she should not wear any jewellery, watches and threads
  
 
|-
 
|-
|03:26
+
|03:27
|as these may become the barriers to maintain the hygiene.
+
|as these may become the barriers to maintain the hygiene
  
 
|-
 
|-
|03:31
+
|03:32
 
|and it can cause injury to the baby.
 
|and it can cause injury to the baby.
  
 
|-
 
|-
|03:35
+
|03:36
 
|Now, let us discuss the type of clothes the provider should wear during '''KMC''' -  
 
|Now, let us discuss the type of clothes the provider should wear during '''KMC''' -  
  
 
|-
 
|-
|03:42
+
|03:43
 
|clothes should be front open and lightweight.
 
|clothes should be front open and lightweight.
  
Line 240: Line 235:
 
|-
 
|-
 
|03:51
 
|03:51
|Note that,
+
|Note that the '''KMC''' provider should wear this front open gown or blouse around '''KMC''' wrap.
  
 
|-
 
|-
|03:52
+
|03:59
|The '''KMC''' provider should wear this front open gown or blouse around '''KMC''' wrap.
+
 
+
|-
+
|03:58
+
 
|'''Kangaroo''' bags or binders can be bought from the market as well.
 
|'''Kangaroo''' bags or binders can be bought from the market as well.
  
Line 255: Line 246:
  
 
|-
 
|-
|04:09
+
|04:10
 
|Alternately, the '''KMC''' provider can use soft clean cotton fabric.
 
|Alternately, the '''KMC''' provider can use soft clean cotton fabric.
  
 
|-
 
|-
 
|04:16
 
|04:16
|Whereas, the baby during '''KMC''' should -  
+
|Whereas the baby during '''KMC''' should -  
  
 
|-
 
|-
Line 268: Line 259:
 
|-
 
|-
 
|04:22
 
|04:22
|if the baby passes stool or urine during '''KMC''' then -
+
|If the baby passes stool or urine during '''KMC''' then  
  
 
|-
 
|-
Line 275: Line 266:
  
 
|-
 
|-
|04:30
+
|04:31
 
|Next, we will move ahead to the procedure of '''Kangaroo care''' in detail.  
 
|Next, we will move ahead to the procedure of '''Kangaroo care''' in detail.  
  
Line 283: Line 274:
  
 
|-
 
|-
|04:40
+
|04:41
|Then, either a health worker or any family member should do the following things, step-wise-
+
|Then, either a health worker or any family member should do the following things step-wise-
 
 
 
|-
 
|-
 
|04:48
 
|04:48
|By supporting the baby’s bottom and head-
+
|by supporting the baby’s bottom and head,
  
 
|-
 
|-
Line 296: Line 287:
 
|-
 
|-
 
|04:56
 
|04:56
|then, turn the baby’s head to one side.
+
|Then turn the baby’s head to one side.
  
 
|-
 
|-
 
|05:00
 
|05:00
|Make sure,
+
|Make sure the baby’s head is slightly bending backward.
the baby’s head is slightly bending backward.
+
  
 
|-
 
|-
|05:04
+
|05:05
|This position will -
+
|This position will keep the baby’s nose airways open
keep the baby’s nose airways open
+
  
 
|-
 
|-
Line 318: Line 307:
 
|-
 
|-
 
|05:18
 
|05:18
|Remember -
+
|Remember to keep baby’s arms above the mother’s breast
to keep baby’s arms above the mother’s breast and
+
  
 
|-
 
|-
 
|05:23
 
|05:23
|legs below the mother’s breast and
+
|the legs below the mother’s breast and
  
 
|-
 
|-
|05:27
+
|05:26
 
|the baby’s abdomen on the chest of the mother.  
 
|the baby’s abdomen on the chest of the mother.  
  
 
|-
 
|-
|05:29
+
|05:30
|Before wrapping with the cloth-
+
|Before wrapping with the cloth,
 
 
 
|-
 
|-
 
|05:32
 
|05:32
|Cover the baby with a blanket if environment is cold.  
+
|cover the baby with a blanket if environment is cold.  
  
 
|-
 
|-
Line 343: Line 331:
 
|-
 
|-
 
|05:39
 
|05:39
|Then,
+
|Then wrap a cloth around the baby and mother’s chest and abdomen.  
Wrap a cloth around the baby and mother’s chest and abdomen.  
+
  
 
|-
 
|-
 
|05:45
 
|05:45
|While wrapping make sure -  
+
|While wrapping, make sure -  
  
 
|-
 
|-
|05:47
+
|05:48
|The center of the cloth is on the baby.
+
|the center of the cloth is on the baby
  
 
|-
 
|-
|05:50
+
|05:51
|And both ends of the cloth should -
+
|and both ends of the cloth should  
  
 
|-
 
|-
Line 368: Line 355:
 
|-
 
|-
 
|05:59
 
|05:59
|After that bring the edges of the cloth in the front.
+
|After that, bring the edges of the cloth in the front.
  
 
|-
 
|-
Line 375: Line 362:
  
 
|-
 
|-
|06:09
+
|06:10
 
|This is comfortable and helps support the baby.
 
|This is comfortable and helps support the baby.
 
 
Line 384: Line 371:
 
|-
 
|-
 
|06:17
 
|06:17
|Remember-
+
|Remember, as the mother becomes comfortable, she should learn to wrap the cloth by herself.  
 
+
|-
+
|06:18
+
|as the mother becomes comfortable, she should learn to wrap the cloth by herself.  
+
  
 
|-
 
|-
 
|06:24
 
|06:24
|The technique of -
+
|The technique of self-wrapping during '''KMC''' will be explained in another tutorial of the same series.
Self-wrapping during '''KMC''' will be explained in another tutorial of the same series.
+
  
 
|-
 
|-
Line 408: Line 390:
 
   
 
   
 
|-
 
|-
|06:46
+
|06:47
|While using a stretchy band-
+
|While using a stretchy band,
 
 
 
|-
 
|-
Line 417: Line 399:
 
|-
 
|-
 
|06:54
 
|06:54
|Then, tilt the baby’s head slightly-
+
|Then, tilt the baby’s head slightly
  
 
|-
 
|-
Line 425: Line 407:
 
|-
 
|-
 
|06:59
 
|06:59
|to make eye to eye contact with the mother as explained earlier.
+
|to make eye-to-eye contact with the mother as explained earlier.
  
 
|-
 
|-
Line 433: Line 415:
 
|-
 
|-
 
|07:11
 
|07:11
|it should be comfortable enough for the baby to breathe freely.
+
|It should be comfortable enough for the baby to breathe freely.
  
 
|-
 
|-
 
|07:15
 
|07:15
|Remember, while carrying a baby in '''KMC''' position, mother should be able to-
+
|Remember, while carrying a baby in '''KMC''' position, mother should be able to
 
 
 
|-
 
|-
 
|07:20
 
|07:20
|walk,
+
|walk, stand, sit or
 
+
|-
+
|07:21
+
|stand,  
+
+
|-
+
|07:22
+
|sit or
+
 
 
 
 
 
|-
 
|-
Line 457: Line 431:
 
|-
 
|-
 
|07:26
 
|07:26
|If a mother is very comfortable then-
+
|If a mother is very comfortable then
 
 
 
|-
 
|-
Line 465: Line 439:
 
|-
 
|-
 
|07:35
 
|07:35
|Now let’s discuss how to feed the baby during '''KMC'''-
+
|Now let’s discuss how to feed the baby during '''KMC'''.
 
 
 
|-
 
|-
|07:40
+
|07:41
|Either mother can feed the baby-
+
|Either mother can feed the baby
 
 
 
|-
 
|-
Line 476: Line 450:
 
 
 
|-
 
|-
|07:46
+
|07:47
 
|positioning the baby for breastfeeding.  
 
|positioning the baby for breastfeeding.  
 
 
 
|-
 
|-
 
|07:50
 
|07:50
|Or she can manually express breast milk and
+
|Or, she can manually express breast milk and
  
 
|-
 
|-
 
|07:54
 
|07:54
|feed the baby using a cup or spoon.
+
|feed the baby using a cup or a spoon.
  
 
|-
 
|-
|07:57
+
|07:58
|Remember,
+
|Remember, each day baby should gain up to 25 to 30 grams of weight.
Each day baby should gain up to 25 to 30 grams of weight.
+
  
 
|-
 
|-
 
|08:03
 
|08:03
|Expected weight gain of a baby in a month is up to 900 to 1,000 grams.  
+
|Hence, expected weight gain of a baby in a month is up to 900 to 1,000 grams.  
  
 
|-
 
|-
 
|08:10
 
|08:10
|Hence, mother or health worker should -
+
|Hence, mother or health worker should  
 
 
 
|-
 
|-
Line 506: Line 479:
 
|-
 
|-
 
|08:17
 
|08:17
|If the baby fails to gain sufficient weight-
+
|If the baby fails to gain sufficient weight,
 
 
 
|-
 
|-
Line 514: Line 487:
 
|-
 
|-
 
|08:25
 
|08:25
|check how many times the baby urinates  
+
|check how many times the baby urinates.
  
 
|-
 
|-
|08:28
+
|08:29
|also, guide the mother about the correct latching.
+
|Also, guide the mother about the correct latching.
  
 
|-
 
|-
|08:32
+
|08:33
 
|Correct latching has been explained in an another tutorial of the same series.  
 
|Correct latching has been explained in an another tutorial of the same series.  
 
 
 
|-
 
|-
 
|08:39
 
|08:39
|Next,
+
|Next, let’s learn how to remove the baby from the wrapped cloth.
Let’s learn how to remove the baby from the wrapped cloth -
+
 
 
 
|-
 
|-
 
|08:44
 
|08:44
|firstly, the mother should sit in the upright position.
+
|Firstly, the mother should sit in the upright position.
 
 
 
|-
 
|-
 
|08:48
 
|08:48
|then, start untying the knot with one hand and
+
|Then start untying the knot with one hand and
  
 
|-
 
|-
|08:53
+
|08:52
 
|support the baby’s bottom with other hand on the outside of wrapped cloth.
 
|support the baby’s bottom with other hand on the outside of wrapped cloth.
  
 
|-
 
|-
 
|08:58
 
|08:58
|After that-
+
|After that, loosen the wrapped cloth with the same hand which was earlier used for untying the knot.  
loosen the wrapped cloth with the same hand which was earlier used for untying the knot.  
+
  
 
|-
 
|-
|09:04
+
|09:05
|Then-
+
|Then shift the hand under the cloth which was supporting the baby’s bottom and
shift the hand under the cloth which was supporting the baby’s bottom and
+
  
 
|-
 
|-
Line 556: Line 526:
  
 
|-
 
|-
|09:16
+
|09:17
|Then, lift the baby up and free her from the wrapped cloth.
+
|Then lift the baby up and free her from the wrapped cloth.
 
 
 
 
 
|-
 
|-
|09:21
+
|09:22
|After that, remember to hold the baby’s head in a way-
+
|After that, remember to hold the baby’s head in a way
 
 
 
|-
 
|-
|09:26
+
|09:25
 
|where the thumb is behind one ear and  
 
|where the thumb is behind one ear and  
  
Line 572: Line 542:
  
 
|-
 
|-
|09:30
+
|09:31
|During '''KMC'''-
+
|During '''KMC''',
 
 
 
|-
 
|-
Line 581: Line 551:
 
|-
 
|-
 
|09:37
 
|09:37
|if the baby is not alert and active.
+
|if the baby is not alert and active,
  
 
|-
 
|-
 
|09:41
 
|09:41
|if the baby is breathing too fast or taking too long pauses.
+
|if the baby is breathing too fast or taking too long pauses,
  
 
|-
 
|-
Line 593: Line 563:
 
|-
 
|-
 
|09:50
 
|09:50
|and if baby’s feet are cold
+
|and if baby’s feet are cold.
 
   
 
   
 
|-
 
|-
|09:53
+
|09:54
|This brings us to the end of this tutorial on '''Kangaroo mother care'''.
+
|This brings us to the end of this tutorial
  
 +
Thanks for joining.
 
|-
 
|-
|09:58
 
|Thanks for joining.
 
 
 
|}
 
|}

Latest revision as of 14:40, 4 July 2020

Time
Narration
00:00 Welcome to the Spoken Tutorial on Kangaroo mother care.
00:05 In this tutorial, we will learn -
00:08 what is Kangaroo mother care?
00:10 the components, importance and
00:13 procedure of Kangaroo mother care.
00:17 Let us first begin with the introduction of Kangaroo mother care.
00:22 As the name suggests -
00:24 it involves keeping the baby in skin to skin contact with the mother.
00:29 And, is popularly known as KMC.
00:32 Remember, KMC should be given as soon as the baby is born.
00:39 It is especially recommended for low birth weight babies-
00:44 whose birth weight is less than 2.5 kilograms and
00:48 who do not require continuous monitoring.
00:52 However, it can be used for all normal, healthy full-term babies too.
00:59 KMC consists of two main components:
01:03 continuous and prolonged skin to skin contact between the mother and her baby
01:10 and exclusive breastfeeding.
01:13 Let’s discuss these 2 components in detail.
01:17 The first component is skin to skin contact.
01:21 It improves the let down reflex
01:24 and ultimately increases the breast milk production.
01:28 Let down reflex has been explained in another tutorial of the same series.
01:34 The second component is exclusive breastfeeding.
01:38 Note that
01:40 exclusive breastfeeding is recommended for the first 6 months.
01:45 Next, let’s discuss the importance of Kangaroo care.
01:50 Prolonged skin to skin contact during KMC helps maintain the baby's body temperature
01:57 and the baby feels more secure.
02:01 KMC also decreases
02:03 the frequency of infection and
02:06 the rate of apnea in babies.
02:09 Apnea is defined as long pauses in breathing.
02:14 Apart from these-
02:15 KMC improves the frequency and duration of breastfeeding.
02:21 And, it strengthens the emotional bonding between the mother and her baby.
02:26 KMC also helps the baby-
02:28 to gain weight than any other conventional methods such as-
02:33 keeping the baby in radiant warmer
02:36 which creates stress for the baby and the mother.
02:40 It also improves the satisfaction and confidence in the mother
02:45 as she takes extra effort for her baby.
02:49 Interestingly, apart from mothers, KMC can be provided by-
02:54 father or
02:56 any other family member too.
02:58 We will now discuss the points to be followed by KMC provider.
03:04 The KMC provider should be healthy and free from illness.
03:09 He or she should follow basic hygiene practices such as-
03:14 hand washing,
03:16 daily bath,

clipped fingernails,

03:19 tied up hair
03:20 and clean clothes.
03:22 He or she should not wear any jewellery, watches and threads
03:27 as these may become the barriers to maintain the hygiene
03:32 and it can cause injury to the baby.
03:36 Now, let us discuss the type of clothes the provider should wear during KMC -
03:43 clothes should be front open and lightweight.
03:46 for example, sari-blouse or front open gown.
03:51 Note that the KMC provider should wear this front open gown or blouse around KMC wrap.
03:59 Kangaroo bags or binders can be bought from the market as well.
04:04 These are useful if KMC has to be done for an extended period.
04:10 Alternately, the KMC provider can use soft clean cotton fabric.
04:16 Whereas the baby during KMC should -
04:19 wear a cap and a nappy.
04:22 If the baby passes stool or urine during KMC then
04:27 she should be cleaned and dried thoroughly.
04:31 Next, we will move ahead to the procedure of Kangaroo care in detail.
04:36 Firstly, the mother should stand in an upright position.
04:41 Then, either a health worker or any family member should do the following things step-wise-
04:48 by supporting the baby’s bottom and head,
04:51 place the baby between the mother’s bare breasts in an upright position.
04:56 Then turn the baby’s head to one side.
05:00 Make sure the baby’s head is slightly bending backward.
05:05 This position will keep the baby’s nose airways open
05:08 and will allow the baby to make eye to eye contact with the mother.
05:14 Then bend the baby’s hips slightly outward.
05:18 Remember to keep baby’s arms above the mother’s breast,
05:23 the legs below the mother’s breast and
05:26 the baby’s abdomen on the chest of the mother.
05:30 Before wrapping with the cloth,
05:32 cover the baby with a blanket if environment is cold.
05:36 It will keep the baby and the mother warm.
05:39 Then wrap a cloth around the baby and mother’s chest and abdomen.
05:45 While wrapping, make sure -
05:48 the center of the cloth is on the baby
05:51 and both ends of the cloth should
05:53 pass through the armpits of the mother
05:56 and should cross at the back.
05:59 After that, bring the edges of the cloth in the front.
06:03 Secure these edges of the cloth with a safe knot under the baby’s bottom.
06:10 This is comfortable and helps support the baby.
06:14 Also it avoids slipping of the baby.
06:17 Remember, as the mother becomes comfortable, she should learn to wrap the cloth by herself.
06:24 The technique of self-wrapping during KMC will be explained in another tutorial of the same series.
06:32 It will increase the mother’s confidence and make her independent.
06:37 If mother is uncomfortable while using a cloth then she can use a stretchy band.
06:43 It is easy and comfortable to use.
06:47 While using a stretchy band,
06:49 adjust the edge of the band above the baby’s ear to support his head.
06:54 Then, tilt the baby’s head slightly
06:57 to breathe freely and
06:59 to make eye-to-eye contact with the mother as explained earlier.
07:04 The wrapped cloth or stretchy band should not be too tight or too loose.
07:11 It should be comfortable enough for the baby to breathe freely.
07:15 Remember, while carrying a baby in KMC position, mother should be able to
07:20 walk, stand, sit or
07:23 involve in different activities.
07:26 If a mother is very comfortable then
07:29 she can even sleep during Kangaroo care in a reclined or a semi-reclined position.
07:35 Now let’s discuss how to feed the baby during KMC.
07:41 Either mother can feed the baby
07:43 by simply loosening the wrapped cloth and
07:47 positioning the baby for breastfeeding.
07:50 Or, she can manually express breast milk and
07:54 feed the baby using a cup or a spoon.
07:58 Remember, each day baby should gain up to 25 to 30 grams of weight.
08:03 Hence, expected weight gain of a baby in a month is up to 900 to 1,000 grams.
08:10 Hence, mother or health worker should
08:13 monitor the weight of the baby during routine check-ups.
08:17 If the baby fails to gain sufficient weight,
08:21 health worker should monitor the breastfeeding technique of the mother or
08:25 check how many times the baby urinates.
08:29 Also, guide the mother about the correct latching.
08:33 Correct latching has been explained in an another tutorial of the same series.
08:39 Next, let’s learn how to remove the baby from the wrapped cloth.
08:44 Firstly, the mother should sit in the upright position.
08:48 Then start untying the knot with one hand and
08:52 support the baby’s bottom with other hand on the outside of wrapped cloth.
08:58 After that, loosen the wrapped cloth with the same hand which was earlier used for untying the knot.
09:05 Then shift the hand under the cloth which was supporting the baby’s bottom and
09:11 use the other hand to support the baby’s bottom from outside the cloth.
09:17 Then lift the baby up and free her from the wrapped cloth.
09:22 After that, remember to hold the baby’s head in a way
09:25 where the thumb is behind one ear and
09:28 other fingers are around the other ear.
09:31 During KMC,
09:32 the mother should immediately consult the doctor and the health worker -
09:37 if the baby is not alert and active,
09:41 if the baby is breathing too fast or taking too long pauses,
09:46 if the baby’s lips or tongue turns blue
09:50 and if baby’s feet are cold.
09:54 This brings us to the end of this tutorial

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Debosmita, PoojaMoolya, Rajani st, Sandhya.np14