BJGMC

Byramjee Jeejeebhoy Government Medical College (BJGMC), and Sassoon General Hospitals (SGH)
Jai Prakash Narayan Road, Near Pune Railway Station
Pune, India 411001
www.bjmcpune.org    

 

About:

  • Among the top 10 medical schools in India
  • 200 medical students, 130 residents per year; 50 nursing students per year
  • SGH: State-funded 1500-bed tertiary-care public hospital, 21 outpatient clinics, and links to multiple NGOs in the community
  • CCGHE partnership established in 1999 for HIV studies; now investigates other infectious diseases, noncommunicable diseases, and comorbidities 
  • In 2011, JHU field office established at BJGMC Clinical Research Site: 3 full time Hopkins faculty and 20 staff; 150 BJGMC clinical research staff.
  • Clinical research as well as leadership and oversight for clinical rotations and field studies

 

Field Study Administrators:

P2010: Phase III Study of the Virologic Efficacy and Safety of Dolutegravir-Containing versus Efavirenz-Containing Antiretroviral Therapy Regimens in HIV-1-Infected Pregnant Women and their Infants “VESTED”

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2019-02-06
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Full Title: P2010: Phase III Study of the Virologic Efficacy and Safety of Dolutegravir-Containing versus Efavirenz-Containing Antiretroviral Therapy Regimens in HIV-1-Infected Pregnant Women and their Infants “VESTED”: V irologic E fficacy and S afety of ART Combinations with T AF/TDF, E FV, and D...

Prevalence of Tuberculosis in Severely Malnourished Indian Children

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2018-12-18
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This study is funded and conducted under the U.S. National Institutes of Health, Fogarty International Center. PIs are Robert Bollinger, MD, MPH; Dr. Muralidhar Tambe, BJGMC Severely malnourished children are vulnerable population for communicable and non-communicable disease. Diagnosis of TB among...

Characterization of Genomics and Metabolomics among Individuals Highly-Exposed, but Resistant to MTB Infection

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2018-12-13
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New study launched in India & South Africa to identify functional relationships between genomics & metabolomics, & to characterize fundamental biological systems underlying resistance to Mtb infection.

Host RNA Expression for Diagnosis and Monitoring of Pediatric TB in Africa and India

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2018-12-13
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We are leveraging the RePORT platform by including a cohort of Indian children together with South African children in a large validation study to study on changes in gene expression profiles during treatment for TB

Immune Responses and Effect of Disulfiram on MTB Infected PBMCs as a Potential Host Directed Therapy

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2018-11-26
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Dr. Mandar Paradkar is lead investigator for this study that is assessing the immune responses of adult pulmonary TB patients enrolled in the CTRIUMPh study, using PBMC samples of those with harmful use of alcohol assessed by AUDIT scores ≥ 8 compared to non-alcoholics (AUDIT < 8). Aim 1: To...

Characterization of TB-specific T Cell Responses in Highly-exposed, but Uninfected Health Care Workers in India

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2018-10-25
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This study is funded and conducted under the U.S. National Institutes of Health, Fogarty International Center. PIs are Robert Bollinger, MD, MPH; Jyothi Rengarajan, MD, Emory University. Primary Research Question Do health care workers who remain TST negative, despite high-exposure to TB,...

Vaginal Microbiota in HIV Infected and Uninfected Pregnant Women (Stand Alone)

Post Date: 
2018-10-16
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Amita Gupta, MD, MHS, and Shilpa Naik, MD, are PIs for this study; Rupak Shivakoti, PhD, MSPH, is Co-Investigator The makeup of vaginal microbiota is dynamic and may play a role in the birth outcomes of pregnant women. While HIV and pregnancy both uniquely impact vaginal microbiota, the impact of...

Validating a Novel Functional Correlate of Immune Protection of Tuberculosis

Post Date: 
2018-10-03
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This C-TRIUMPH study is a longitudinal assessment of PBMC samples of progressors and non-progressors among adult household contacts of active TB patients. The purpose of the study is to probe the functional diversity of T cell responses to several of the antigens encoded by Mtb simultaneously in...

Assessing the Impact of Psychosocial Involvement in Health Care Workers with and without Active Tuberculosis at the Byramjee Jeejeebhoy Government Medical College, Pune, India

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2018-09-13
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This study is funded and conducted under the U.S. National Institutes of Health, Fogarty International Center. The overall goal is to understand the psychosocial involvement in health care workers with and without active tuberculosis. The specific aims of this study are: To understand the...

Assessment of Depression and Anxiety among HIV-infected Adolescents in Pune, India

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2018-07-22
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This study is conducted under the TREAT Asia Network and funded by amfAR. PURPOSE The purpose of this study is to estimate the prevalence of depression and anxiety among adolescents living with HIV in India and their determinants. DESIGN Cross-sectional, single time point, conveniently sampled...

Assessing Psychological Distress among Tuberculosis Patients and Their Household Members

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2018-07-17
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By assessing psychological distress, Indo-JHU researchers hope to better understand the correlation between depression and TB severity.

Evaluating the Source of Neonatal Bloodstream Infections due to Classically Hospital Acquired Pathogens in the Neonatal Intensive Care Unit in Pune, India

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2018-07-12
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This study is part of CDC's Safe Healthcare, Epidemiology, and Prevention Research Development (SHEPheRD) Program under Domain 7: International HAI and Other Adverse Healthcare Event Prevention. The PIs for this study are Dr. Julia Johnson of Johns Hopkins and Dr. Shilpa Naik of BJGMC. CoPIs are Dr...

Assessing the Feasibility and Acceptability of a Computer-based Avatar-delivered Alcohol Reduction Intervention

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2018-07-05
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Study is assessing whether computer-delivered alcohol screening and intervention helps overcome barriers to treatment in India.

Molecular Signatures of Tuberculosis-Diabetes Interaction: Metabolomics Study

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2018-06-15
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This study is using stored samples from the Cohort for Tuberculosis Research by the Indo-US Medical Partnership (C-TRIUMPH), under the Regional Prospective Observational Research for Tuberculosis (RePORT) Network, an international TB consortium. Type 2 diabetes mellitus (DM) is an acquired host...

Molecular Signatures of Tuberculosis-Diabetes Interaction: Transcriptomics Study

Post Date: 
2018-06-15
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This study is using stored samples from the Cohort for Tuberculosis Research by the Indo-US Medical Partnership (C-TRIUMPH), under the Regional Prospective Observational Research for Tuberculosis (RePORT) Network, an international TB consortium. Type 2 diabetes is an acquired host factor that...

Gut Microbiota of HIV Infected Pregnant Women

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2018-06-14
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Birth Outcomes in HIV Both antiretroviral-therapy (ART)-naïve and ART-experienced HIV-infected pregnant women have higher incidences of pre-term birth (PTB) compared to HIV-uninfected women. For example, the global prevalence of PTB is around 8%, while the rates in in HIV-infected populations are...

Optimal Approach for TB Screening among HIV Infected Indian Children

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2018-06-11
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This study was funded by the Fogarty International Center at the U.S. National Institutes of Health. Determining TB status (ie, uninfected, latent, and active TB disease) is more difficult among children, particularly HIV-infected children. Diagnosis of TB disease is more difficult among HIV...

P2005: A Phase I/II Open-Label, Single-Arm Study to Evaluate the Pharmacokinetics, Safety, and Tolerability of Delamanid in Combination with OBR for MDR-TB in HIV-Infected and Uninfected Children with MDR-TB

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2018-06-07
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New study will characterize the pharmacokinetics of delamanid using a model-based approach, and evaluate safety and tolerability of over 24 weeks of study treatment in HIV infected and uninfected children.

Implementing the Comprehensive Unit-based Safety Program to Reduce Healthcare-Associated Sepsis in the Neonatal Intensive Care Unit in Pune, India

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2018-04-19
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This study is part of CDC's Safe Healthcare, Epidemiology, and Prevention Research Development (SHEPheRD) Program under Domain 7: International HAI and Other Adverse Healthcare Event Prevention. Dr. Aaron Milstone is the PI, and Dr. Amita Gupta and Yuka Manabe are Co-PIs. The Study Investigator is...

Predictors of Resistance Emergence Evaluation in Multidrug Resistant-Tuberculosis Patients on Treatment (PREEMPT Pilot Study)

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2018-03-20
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Indo-JHU Clinical Resarch Partnership is participating with Brazilian colleagues in a 3-year effort led by Boston University to identify what contributes to TB drug resistance.

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Elevated highly sensitive C-reactive protein and d-dimer levels are associated with food insecurity among people living with HIV in Pune, India.

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2019-03-04
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Public Health Nutrition
Abstract OBJECTIVE: To assess the prevalence and determinants of food insecurity among people living with HIV (PLWH) in Pune, India and its association with biomarkers known to confer increased risks of morbidity and mortality in this population. DESIGN: Cross-sectional analysis assessing food...

Female global health leadership: Data-driven approaches to close the gender gap

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2019-02-09
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The Lancet
Lancet article investigates gender-based challenges of female health trainees and professionals and identifies interventions

HIV testing uptake among the household contacts of multidrug-resistant tuberculosis index cases in eight countries

Post Date: 
2019-01-07
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International Journal of Tuberculosis and Lung Disease
International Journal of Tuberculosis and Lung Disease : The Indo-JHU Clinical Research Parentership participated in this multinational study to determine if it's feasible to provide HIV testing for household contacts of MDR-TB cases.

Is there a connection between gestational diabetes, human immunodeficiency virus infection, and tuberculosis?

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2019-01-01
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International Journal of Tuberculosis and Lung Disease
IJTLD article reviews the epidemiology and immunology of gestational diabetes and finds there's a lot we don't know about interactions between diabetes, pregnancy, and tuberculosis in both HIV+/- women

Drug-resistant Enterobacteriaceae colonization is associated with healthcare utilization and antimicrobial use among inpatients in Pune, India

Post Date: 
2018-10-04
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BMC Infectious Diseases
BACKGROUND: Healthcare exposure may increase drug-resistant Enterobacteriaceae colonization risk. Nascent antimicrobial stewardship efforts in low- and middle-income countries require setting-specific data. We aimed to evaluate risk factors for inpatient drug resistant Enterobacteriaceae...

Barriers to screening and isoniazid preventive therapy for child contacts of tuberculosis patients

Post Date: 
2018-10-01
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International Journal of Tuberculosis and Lung Disease
Universal, timely TB screening and IPT for exposed children are urgently needed to reduce pediatric TB in India

Inflammation and micronutrient biomarkers predict clinical HIV treatment failure and incident active TB in HIV-infected adults: a case-control study

Post Date: 
2018-09-24
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BMC Medicine
Factors identified through exploratory factor analysis were associated with adverse outcomes in HIV-infected individuals.

Ovarian mass - tuberculosis or malignancy? Need for early intensified evaluation

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2018-09-14
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EXCLI Journal
Letter to the Editor Dear Editor, We read with interest the case report by Chien et al. on Peritoneal Tuberculosis (TB) mimicking ovarian cancer (Chien et al., 2016[1]). We want to congratulate the authors on this case report. We encountered a similar case in our clinical setting in western India...

The association of household fine particulate matter and kerosene with tuberculosis in women and children in Pune, India

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2018-09-07
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Occupational and Environmental Medicine
Use of kerosene cooking fuel is positively associated with TB in women and children in our analysis using reported sources of exposure.

Resource utilization for multidrug-resistant tuberculosis household contact investigations (A5300/I2003)

Post Date: 
2018-09-01
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International Journal of Tuberculosis and Lung Disease
Current guidelines recommend evaluation of the household contacts of individuals with multidrug-resistant tuberculosis; however, implementation of this policy is challenging.

The effect of diabetes mellitus on the pharmacokinetics and pharmacodynamics of tuberculosis treatment

Post Date: 
2018-08-20
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Antimicrobial Agents and Chemotherapy
DM and higher HbA1c increased the risk of not achieving therapeutic targets for pyrazinamide, but higher pyrazinamide concentrations were asociated with worse microbiologic and clinical outcomes

Trends in HbA1c levels and implications for diabetes screening in tuberculosis cases undergoing treatment in India

Post Date: 
2018-07-01
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International Journal of Tuberculosis and Lung Disease
SETTING: The optimal timing of screening for diabetes mellitus (DM) among tuberculosis (TB) cases is unclear due to the possibility of stress hyperglycemia. DESIGN: We evaluated adult (18 years) pulmonary TB cases at treatment initiation as well as at 3 months, 6 months and 12 months. DM was...

Loss to follow‐up and mortality among HIV‐infected adolescents receiving antiretroviral therapy in Pune, India

Post Date: 
2018-06-25
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HIV Medicine
Over 6 years, one-third of HIV+ adolescents in this study discontinued medical treatment, indicating a critical need for retention counselling and closer clinical monitoring.

Sources of household air pollution and their association with fine particulate matter in low-income urban homes in India

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2018-05-23
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Journal of Exposure Science and Environmental Epidemiology
INTRODUCTION: Household air pollution (HAP) is poorly characterized in low-income urban Indian communities. MATERIALS AND METHODS: A questionnaire assessing sources of HAP and 24 h household concentrations of particulate matter less than 2.5 microns in diameter (PM 2.5 ) were collected in a sample...

Diabetes and pre-diabetes among household contacts of tuberculosis patients in India: is it time to screen them all?

Post Date: 
2018-05-22
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The International Journal of Tuberculosis and Lung Disease
Authors find that screening contacts of TB patients for pre-DM/DM and linking them to care may mitigate the risk of developing tuberculosis and improve management of diabetes.

Addressing knowledge gaps and prevention for tuberculosis-infected Indian adults: a vital part of elimination

Post Date: 
2018-05-02
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BMC Infectious Diseases
BMC Infectious Diseases : Our survey among TB patients' household contacts with evidence of recent exposure found that knowledge is poor and families are confused about disease transmission.

Shorter treatment for minimal tuberculosis (TB) in children (SHINE): a study protocol for a randomised controlled trial

Post Date: 
2018-04-19
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Trials
Trials: Evidence for TB treatment in kids is largely based on adult studies. The SHINE study aims to fix this

Prevention of HIV-1 transmission through breastfeeding:efficacy of safety of maternal antiretroviral therapy versus infant nevirapine prophylaxis for duration of breastfeeding in HIV-1-infected women with high CD4 cell count (IMPAACT PROMISE)

Post Date: 
2018-04-01
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Journal of Acquired Immune Deficiency Syndromes
BACKGROUND: No randomized trial has directly compared the efficacy of prolonged infant antiretroviral prophylaxis versus maternal antiretroviral therapy (mART) for prevention of mother-to-child transmission throughout the breastfeeding period. SETTING: Fourteen sites in Sub-Saharan Africa and India...

Vector-borne disease is a common cause of hospitalized febrile illness in India

Post Date: 
2018-03-26
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American Journal of Tropical Medicine and Hygiene
Diagnostic strategies adapted for season and age may reduce diagnostic uncertainty and identify causative organisms in treatable, fatal causes of AFI.

Intestinal barrier dysfunction and microbial translocation in HIV-infected pregnant women is associated with preterm birth

Post Date: 
2018-03-24
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Clinical Infectious Diseases
Our results show select immune markers can identify women at higher risk for PTB in HIV-1-infected populations and suggest modulating gut barrier integrity and microbial translocation may affect PTB.

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Pitfalls in Chest X-ray Scoring of Patients Receiving Treatment for Active Tuberculosis in Pune, India

Post Date: 
2019-03-28
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Orsini E , Gupte A, Paradkar M, Jain D, Raskar S, Lokhande R, Mave V, Gupta A. Pitfalls in Chest X-ray Scoring of Patients Receiving Treatment for Active Tuberculosis in Pune, India. Johns Hopkins Global Health Day 2019. Baltimore, MD. March 28, 2019.

The prevalence of perinatal depression and associated birth outcomes in Pune, India

Post Date: 
2019-02-11
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Grossman TB , Mathad JS, Suryavanshi N, Alexander M, Mave V, Bhosale R, Gupta A. The prevalence of perinatal depression and associated birth outcomes in Pune, India. Society for Maternal-Fetal Medicine 39th Annual Pregnancy Meeting. Las Vegas, NV. February 11-16, 2019.

Mental Health and TB: High Prevalence of Depression among Drug-resistant TB Patients not Associated with Cycloserine

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2019-02-04
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Shivakumar SVBY , Tornheim JA, Gajjar I, Porwal S, Kishore G, Karane M, Sayed S, Chawla PK, Rodrigues C, Ashavaid TK, Gupta A, Udwadia ZF. Mental Health and TB: High prevalence of depression among drug-resistant TB patients not associated with cycloserine. 8th Annual Regional Prospective...

Host Lipidomic Profile Associated with Adverse Tuberculosis Treatment Outcomes

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2019-02-04
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Shivakoti R , Chandrasekaran P, Hannah LE, Thiruvengadam K, Saravanan N, Karunaianatham R, Gupta A, Mave V, Gupte N, Kulkarni V, Pradhan N, Gupte A, Paradkar M, Shivakumar SVBY, Bharadwaj, Kagal A, Gaikwad S, Sangle S, Borkowski K, Newman J, Fiehn O. Host Lipidomic Profile Associated with Adverse...

IL-6, TIMP-2 and TGFβ-2 Are Associated with Respiratory Impairment During and Following Successful Treatment of Pulmonary Tuberculosis

Post Date: 
2019-02-04
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Gupte A , Paradkar M, Selvaraju S, Kumar P, Lokhande R, Kulkarni V, Hanna LE, Thiruvengadam K, Sekar K, Momin A, Shivakumar SVBY, Gupte N, Babu S, Salvi S, Golub J, Checkley W, Bollinger RC, Andrade B, Mave V, Chandrasekaran P, Gupta A. IL-6, TIMP-2 and TGFβ-2 are associated with respiratory...

Impact of Fogarty HIV-TB Training Program on ‘Institutional Research Capacity Building’ at the Byramjee Jeejeebhoy Government Medical College (BJGMC), Pune, India

Post Date: 
2018-10-27
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Dhumal G, DeLuca A, Chandanwale A, Kadam D, Joshi S, Kinikar A, Suryavanshi N, Mave V, Gupta A, Bollinger R. Impact of Fogarty HIV-TB Training Program on ‘Institutional Research Capacity Building’ at the Byramjee Jeejeebhoy Government Medical College (BJGMC), Pune, India. Session: Building...

Mobile Phone Access and Comfort: Implications for HIV and Tuberculosis Care in India and South Africa

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2018-10-04
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Cox SN , Elf J, Lokhande R, Ogale YP, DiAndreth L, Dupuis E, Milovanovic M, Mpongose N, Martinson N, Mave V, Suryavanshi N, Gupta A, Golub JE, Mathad JS. Mobile Phone Access and Comfort: Implications for HIV and Tuberculosis Care in India and South Africa. I DSA. IDWeek 2018. San Francisco, CA,...

Perinatal Depression among HIV and TB Infected and Uninfected Women in an Urban Slum in India: Prevalence and Associated Birth Outcomes

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2018-10-04
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Grossman TB , Bhosale R, Alexander M, Suryavanshi N, Mave V, Jain D, Patil NU, Gupta A, Mathad JS. Perinatal depression among HIV and TB infected and uninfected women in an urban slum in India: prevalence and associated birth outcomes. IDSA. ID Week 2018. San Francisco, CA. October 3-7, 2018.

High Prevalence of Dengue among Pregnant Women in India

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2018-08-27
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Alexander M, Naik S, Robinson M , Sapkal G, Deshpande P, Kulkarni V, Nimkar S, Sambarey P, Kinikar A, Mave V, Suryavanshi N, Gupte N, Bollinger R, Gupta A, Bharadwaj R, Mathad J. High Prevalence of Dengue among Pregnant Women in India. 2018 International Conference on Emerging Infectious Diseases...

Association of Maternal Viral Load and CD4 Count with Perinatal HIV-1 Transmission Risk during Breastfeeding in the PROMISE Postpartum Component

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2018-07-26
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Flynn P, Taha T, Cababasay M, Butler K, Fowler MG, Mofenson L, Owor M, Fiscus S, Stranix-Chibanda L, Coutsoudis A, Gnanshanmugam D, Chakhtoura N, McCarthy K, Mukuzunga C, Makanani B, Moodley D, Nematadzira T, Kusakara B, Patil S, Vhembo T, Bobat R, Mmbaga B, Masenya M, Nyati M, Theron G, Mulenga H...

Mobile Health and Behavioral PMTCT Intervention among Community Health Workers Improves Exclusive Breastfeeding and Early Infant Diagnosis in India: A Cluster Randomized Trial

Post Date: 
2018-07-24
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Suryavanshi N, Kadam A, Hegde A, Sivalenka S, Kumar VS, McKenzie-White J, Kanade S, Gupta A, Bollinger RC, Shankar A, Gupte N, Mave V. Mobile Health and Behavioral PMTCT Intervention among Community Health Workers Improves Exclusive Breastfeeding and Early Infant Diagnosis in India: A Cluster...

Opportunities, Challenges and Implications of m-Health Oral Cancer Screening for HIV-positive Individuals in India

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2018-07-23
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Joshi S, Chandanwale A, Sangle S, Marbaniang I , Khaire S, Thakur R, Gupta A, Chigurupati R, Mave V. Opportunities, Challenges and Implications of m-Health Oral Cancer Screening for HIV-positive Individuals in India. AIDS 2018. Amsterdam, The Netherlands. July 23-27, 2018.

Health-related Quality of Life in the A5274 Trial of TB Therapy in Advanced HIV

Post Date: 
2018-07-22
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Lando R, Sun X, Miyahara S, Hosseinpour MC, Bisson GP, Kumwenda J, Gupta A, Nyirenda M, Katendey K, Torres TS, Suryavanshi N, Beulah F, Opollo V, Shah NS on behalf of the A5274 study team. Health-related Quality of Life in the A5274 Trial of TB Therapy in Advanced HIV. TB 2018, Amsterdam, The...

Role of Maternal Viral Load and CD4 Count on Perinatal HIV-1 Transmission during Breastfeeding in the PROMISE Postpartum Component

Post Date: 
2018-07-20
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Flynn P, Taha T, Cababasay M, Butler K, Fowler MG, Mofenson L, Owor M, Fiscus S, Stranix-Chibanda L, Coutsoudis A, Gnanshanmugam D, Chakhtoura N, McCarthy K, Mukuzunga C, Makanani B, Moodley D, Nematadzira T, Kusakara B, Patil S , Vhembo T, Bobat R, Mmbaga B, Masenya M, Nyati M, Theron G, Mulenga H...

Association between Dietary Intake and the Composition of the Vaginal Microbiota

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2018-06-20
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Shivakoti R , Tuddenham S, Caulfield LE, Robinson C, Rave J, Ghanem K, Brotman R. Association between dietary intake and the composition of the vaginal microbiota. Society for Epidemiologic Research 51st Annual Meeting. Baltimore, MD. June 19-22, 2018.

Association between Dietary Intake and the Composition of the Vaginal Microbiota

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2018-06-09
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Shivakoti R , Tuddenham S, Caulfield LE, Robinson C, Rave J, Ghanem K, Brotman R. Association between Dietary Intake and the Composition of the Vaginal Microbiota. Oral presentation at Nutrition 2018 Conference. American Society for Nutrition. Boston, MA. June 9, 2018.

Bloodstream Infections among Neonates Admitted to Neonatal Intensive Care Units in Pune, India

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2018-05-05
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Johnson J , Rajput U, Valvi C, Bharadwaj R, Parikh T, Agarkhedkar S, Robinson M, Randive B, Gupte N, Smith R, Westercamp M, Mave V, Manabe Y, Milstone A, for the CDC SHEPheRD India Study Team. Bloodstream Infections among Neonates Admitted to Neonatal Intensive Care Units in Pune, India. Pediatric...

Importance of Diagnosis of TB Infection in Pregnant Women in India: Findings from a Cohort Study in Pune, India

Post Date: 
2018-04-24
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Mathad J. Importance of Diagnosis of TB Infection in Pregnant Women in India: Findings from a Cohort Study in Pune, India. Oral Presentation. Presented at Global Health Research Initiative’s Scientific Conference, Weill Cornell Medical College, April 24, 2018.

Similar Clinical Outcomes Between Formula and Breastfeeding Women In PROMISE

Post Date: 
2018-03-07
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Hoffman RM , Angelidou K, Brummel S, Saidi F, Dula DE, Mave V, Fairlie L, Theron G, Kamateeka M, Chipato T, Violari A, Chakhtoura N, Currier JS, Fowler MG, for the IMPAACT PROMISE 1077BF/FF Team. Similar Clinical Outcomes Between Formula and Breastfeeding Women In PROMISE. CROI 2018. Boston, MA...

Randomized Trial of Safety of Isoniazid Preventive Therapy During or After Pregnancy

Post Date: 
2018-03-07
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Gupta A, Montepiedra G, Aaron L, Theron G, McCarthy K, Onyango-Makumbi C, Chipate T, Masheto G, Shin K, Zimmer B, Sterling TR, Chakhtoura N, Jean-Philippe P, Weinberg A for the IMPAACT P1078/TB APPRISE Study Team. Randomized Trial of Safety of Isoniazid Preventive Therapy During or After Pregnancy...

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