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  • And Yet no one from the mainstream is looking at suggesting diabetics to cut down carbs. Diabetics cannot handle carbs well. So telling them to eat high carbs is like telling a lung cancer patient to keep smoking.

  • Great explanation!

  • Anup

    You are still modest talking to cut down carbs. A few people postulate zero carbs because 56% of protein and 10% fats get converted to carbs. Also drastic reduction in the carbs don't put stress on thyroid in their opinion. There should be trials on that track too. Obviously glucose is not our fuel howsoever good and freely available it might be. 😊😊

  • sorry but brain utilize as fuel only glucose, by the way 50% of total body required glucose is utilized by our brain.

  • WRONG!

    That's an ADA Lie.

  • Not ADA it's science. Physiology

  • WRONG.

    Read something about Ketones and how large part of brain can run on Ketones too.

    If not, ANNA Hazare would have been a brain dead man long long ago.

  • Our brain / system is a hybrid model

    Brain can use ketones as well

    There are a few cells in brain and few more places which uses only Glucose & our liver is capable to providing this amount.

    Nature has very well provided an organ which does not depend on what we eat. It can as well produce glucose from proteins / fats via gluconeogenesis.

  • Dr Richard Bernstein would not have lived to this day -- 70+ years as Type 1-- and 40+ years on 30 grams carbs a day. Don't think anyone understands diabetes management better than Dr Bernstein as he is living that life with A1C < 5.0 for all these years.

    As per dubious ACCORD trial, he should have been a dead man due to heart failure because ACCORD concluded at the behest of ADA in closed room that lowering A1C = more fatal heart attacks. They never looked at how many were from AVANDIA of GSK and GSK finally got sued for manipulating data on AVANDIA after making billions of dollars.

  • @Anup

    This drugs - glitazones are the most disreputed not because they are bad but certain complications assigned to them. Weight gain, increased incidence of chd and dyslipidemia may not be because of them but wrong high carb diet. I have been taking pioglitazone for about 14 years because i'm allergic to sulfa which su drugs and acarbose group contain. I have maintained my weight almost constant with low carb diet except for last 7 month i have been on lchf and reduced about 10 kg. My lipid profile was good with statinsthen and now without statins for last 7 months. So if you give bad diet and assign complications to the medicines πŸ’πŸ’πŸ’ Ye baat kuchh hazam nhi hui. Further most of the studies would quote the method and conclusions but don't explain the science of those particular complications. There should be cause effect relation explained scientifically and preferably with proof.

  • So if you give bad diet and assign complications to the medicines

    Bottom line:

    Get fasting Insulin levels down to lower end of the lab range. T2 starts with over production of insulin and not shortage. The lab range for Fasting insulin is obnoxiously too wide. Anything above 7 or 8 maybe, is a red flag.

  • anup,

    The values are recommended by ada. We always look at them for everything. We must have our data. Can only be done if we have data. In us they have separate hospitals for every disease. Hiv, eclampsia, diabetes and so on. Here our health system reaquires big rectification. We can have very large database.

  • suramo, I will send you a PM in a minute. Don't worry! It's okay!πŸ˜€

  • I sent you the PM now, suramo. Please check.

  • Can you please explain, dharmendrapanchal?

  • dharmendrapanchal

    You need to also learn a bit of whats not taught to you by the med school

    While the basic physiology actually teaches the right thing it actually is twisted later on by the guidelines / recommendation

    The world follows ADA for diabetes

    ADA is influenced by food & pharma industry

    So their recommendations are biased

    Millions of diabetics the world over are rejecting this carb / glucose fuel based model to fat / ketone based model to have a good control of blood sugars & also reduce / eliminate costly patented pills / insulin analogues.

    Suggest to visit various websites across to learn something new..

  • As I said in my first post, mainstream still is not looking at real issue, so keep pushing the BROKEN diet. Do any mainstream doctors who deal with diabetics ever look at Fasting insulin and aim for lower end of the range. The lab range for fasting insulin is obnoxiously wide. Do any recommend getting A1C to 5.6 or lower? NO. All are just reciting ADA pamphlets and scaring people based on what AHA says.

    No more than 48 hrs of nutrition is taught to doctors in medical schools and dietitians know absolutely nothing beyond just giving out a computer generated diet chart which remains same for everyone.

  • Anup

    Issue is even if fasting insulin is tested.. then what..?

    How will this insulin be reduced. The main stream is ignorant about this.. Why..? Because still carbohydrate is the major macro recommended. This just will not reduce the secretion of excess insulin

    I know a few Drs when i interacted mentioning that even if fasting insulin is measured what can we do about it

    So its a vicious cycle & diff to get out unless the fat/ketone model is accepted by the mainstream

  • They don't recommend fasting insulin because they are aware that it will EXPOSE how great this ADA diet is. So, probably, they know everything but can't get away from the industry pressures to sell medications

    It's HIGH TG and High Insulin that's the problem with diabetics and all the diabetes complications. Add n-6 PUFA loaded seed oils nonsense that's sold as heart friendly and problem complicates more.

    But, experts just pass it off as side effect of being a diabetic. They don't tell you that it is because ADA says 6.5 to 7.5 is great A1C to have. After all, they have to sell Invokana and Januvia as the manufactures give ADA huge donations.

  • Anup

    Why only fasting insulin? Why not 5 hour gtt with insulin measurements and plotting it on a chart initially when diagnosed as D and later on? This will give an idea about our ir and beta cell response to that. Higher the insulin response more is ir.

    And one more thing about carbs and the vascular accidents. D or not if one takes high carb diet one is more likely to get cardiovascular accidents because carbs are the real culprit for inflammation in our body. These carbs also regulate lipids in our body. The lipids are mere firemen wrongly incriminated for atherosclerosis and chd cvd cva. People with familial hypercholesterolemia also if reduce their carb intake significantly the incidence of chd cva cvd will come down in them.

  • Yes on OGTT.

    Dr Attia says that OGTT without insulin check is never to be done. In short, it's useless if we are not checking insulin levels also. And, if we are just looking at 2 hr OGTT readings, it's sheer waste of money and time.

  • My dear friends and Doctors will you please understand that diabetes is

    Condition and not a disease. When less

    Insulin is produced

    You should eat less at

    A time and the frequency

    of eating

    Should be


    So, after

    Bringing diebetes to

    Nearer to borderline

    One should star t

    Eating at a time and the number

    Of times

    Should be


    Take a special food medicine

    as Fenugreek with each

    Food. In 3 months

    Time your Diebetes

    Will be permanently be cured. All

    The diebetologist world over please try this and let me know the resul.God


  • Type 2 diabetes is a disorder of insulin resistance/ excess insulin secretion . Not less insulin secretion as u claim. Pl study more on this.

    Also frequents meals will put load on the pancreas to keep releasing insulin.

    Also frequent eating will not cure diabetes


  • This is where the study went wrong. In fact the beta

    Cells produce

    Less insulin resistance in Type 2. that is why the glucose , instead

    Of going to the cells directly goes to the blood stream.

    That is why insuline

    Is injected

    To lower

    Diebetes; it is hereidern medicinehas gone wrong. That is why I ask you to eat one serving of

    Fenugreek whic stimulates the Beta cells and repairs the dried cells.I ask American Diebetic

    Association to go forward

    With related experiments; O.K?

  • Please introduce yourself. Are you a diabetic? If so, what's the present status?Are you on any medicine and what are the BS levels? What are the hba1c levels?

  • I am not a doctor nor am I a Diebetic

    Patient. I am a person who gave this advice to numerous Diebetic friends

    Who no longer suffer from this condition. If you like it you can follow and be benefitted or close this chapter here.Bye.

  • I am not Diebetic nor am I a doctor.

    I have successfully managed this condition of my friends

    all of whom enjoy life . If you think it will benefit you try and tell me or else close this chapter.God bless. Good night.

  • Thanks for the concern. I am not Diabetic. I am Dr Dharmendra Panchal MD. I am a Diabetologist.

  • I posted that for Cochin_ali123

  • Also frequent eating will not cure diabetes

    That's just a way to make it worse even more in the long run. This in short means never let your body ever enter into fat burning mode, which is counter productive.

  • This concept is not known to many

  • As long as the need for the amount of insulin is not much , pancreas does not get overloaded because the main duty of pancreas is that only.When insulin is demanded in large amounts the pancreas gets overloaded .So ir is a wrong notion that pancreas is penalised if small frequent meals are taken . We can see that in case of children . They take food several times with out any bad results . Of course this point does not validate excess carb orexcess calories in case of adults .

  • Thank you for the explanation, swathy.

  • You cannot compare a growing baby with adults because a baby's brain needs 40% more carbs than grown ups.

    Also, how long does a baby sleep in a day? 12 to 18 hrs? Is a growing babies metabolism same as that of an adult diabetic? We can't be comparing apples to oranges.

    If you really compare a Type 1 baby with a Type 1 adult and how the numbers fluctuate, you will know what I am talking. Without just it's just an OPINION that eating 8 times a day doesn't overload body.

  • not only small babies even children up to the age of 18 come under the category of eating 6 to 7 times per day .Whether type 1D or type 11D ,eating several small meals does not cause any harm as long as total intake does not exceed the required calories. In fact their growing bodies constantly demand food . That ensures the limit of insulin supply and associated risks of insulin resistance or deficiency .

  • Really? Do those 16 to 18 year children go to school or stay at home always? Are they all diabetic?

    Remember, we are discussing everything with "diabetes" in view and not even talking of anyone metabolically normal here. So, apples to oranges comparison comes up.

    I remember I was a boarder in Mussoorie. The only meals that we got during the entire day was B/F, Lunch and Dinner with a 1 cup tea and some wafers before we headed out for two hrs sports sessions after end of classes at 4PM. Sports sessions lasted from 4:30 to 6:30 PM and then within 30 minutes we were to be ready for dinner. Then post dinner 2 hrs self study and hit bed at 9:30 pm.

    I never saw any kid from class V to 12 (back then) in that school ever eat 6 to 7 times a day. It was simply not possible and available. The boarding school in question is St George's College, Mussoorie so not a small time establishment.

    Eating 8 times a day is most UNPRODUCTIVE for a diabetic. I call it a Band Aid solution and it will keep insulin levels elevated for entire day. Not a great thing for anyone who really understands diabetes management.

    BTW, welcome back swathy! for the 10th time :)

  • swathy

    And, let's do some maths

    6 hrs in school + 8 hrs sleep + 1 hr in school bus (bare minimum) = 15 hrs.

    Actually, my nephews have to reach bus stop at 7AM for school (DPS) that starts at 9AM, but I am considering just 1 hr in bus, though actually it could be 2 hrs for to-and-fro

    1 hr for bath, nature's call, getting ready, chaning clothes. So 16 hrs gone. 1 meal during lunch in school

    So one has to eat 5 to 6 meals in 8 hrs.

    So eat every 100 minutes? Does it really happen for a normal school/college going kids in real life?


  • some types of foods do not need plates , spoons , forks tables and hours . Here the question is of energy , strength , and non spiking of insulin. If not 7 or 8 times , at least 6 meals ----- 3 small and 3 medium sized meals can be taken . This applies to diabetic or non diabetic people . Some 15 years back when I asked a doctor the diet plan for weight reduction , he advised me to take food 5 or 6 times saying ---- people who take food like that do not put on weight . This advice was given to a non diabetic .

  • Still did not explain how a school going kid with the timeline that I specified gets to eat 6 times a day. My two nephews I haven't seen them doing that. No boarding school anywhere in the world can do it. There's simply no time window available.

    As for doctors and weight reduction, 6 meals a day is non sustainable even for 5 years for maintaining the weight. Saying this as there's lot of research to prove this. To reduce weight, one has to get insulin levels down and eating 6 times a day is surely not going to do it. Intermittent fasting is the way to achieve that. And, we on LCHF finally settle with skipping a meal.

  • School going kids have definitely three meals per day , which are medium sized , and one small in the mid morning session and another in the mid evening session , the last and final one before going to bed . These three small meals can be a dark chacolate , a small fruit and the last one a plantain .A plantain gives a very good sleep . Though it has sugar content , when compared with its' benefits the sugar contributing calories can be overlooked . This meal plan works very well to diabetics of T1 and T2 . Even this is good for non diabetics as well .I am not contesting your diet plan but just giving another view point since we are doing an extensive study on the etiology and pathology of diabetes . ultimately our goal is to see that all are free from diabetes .

  • Morning breakfast

    School Lunch

    Evening snacks after back from school (or in school for boarders)


    That's the normal schedule both for day scholars and boarders across different boarding schools that I have checked.

    Abnormal schedule can be eating 7 to 8 times a day. Munching chocolates and wafers for 3 to 4 meals a day isn't a great idea.

  • not three chacolates , once a chacolate , then a seasonal fruit and then a plantain in that order . All are nutrient and the growing childrens' bodies just need that extra food . Here my explanation does not pertain to kids alone , even adults can follow that program . Children can go for that with out any apprehension .

  • I think then my nephews are living a below poverty line life then. Just 4 meals a day. :)

  • Guess here we are missing one thing that kids are growing... demands and needs of growing body are different than grown up... and declining body...

  • I already said that cure :)

    Eating 7 times a day somehow I just can't find HOW. Boarding school kids are far more fit and healthy and no boarding school will ever give 6 to 8 meals a day, even to class 4 or 5 boarders.

    My brother was a boarder in Barne's School, Devlali (again a very reputed school) and even he said there were no 7 meals a day :)

  • as per the theory mentioned by dr dharmendrapanchal and explained by Dr suramo (Bhai) fat cells got lot to do with IR....

    Also liver... Does size of liver is also important???

    In kids size must be growing....so capacity to store must be increasing...

  • As per my understanding liver does not grow beyond a point and after certain point . I may be wrong . Any doctor in the forum can clear that point .

  • even at Bhonsala Military School nasik we had two times meals and 2 times snacks...

    Break fast use to be 'Usal'...

  • For us,

    B/F used to be Boiled Eggs + Milk Or Bread+Butter/Jam + Milk (Non veg/Veg)

    Lunch used to be 2 Daals, Rice, Chapati, One Sabji

    Dinner : Matar Paneer/Chicken Rice Chapati

    Snacks: 1 Cup tea + wafers.

    My brother tells me B/F in Barne's school Devlali used to be Porridge.

    Nowhere did any school served more than 4 including Snacks. And, 2 hrs sports was compulsory even during heavy monsoons, when we were made to run through 11 km up/down through hilly terrain no matter how much it was raining :)

    On Outing days (2X per month), we never got lunch or snacks as we were on our own in town (after breakfast) living the day in Rs 20 is 1980 - lunch, movie, ice ceam, video games all included in that 20 bucks :)

  • Those days are different .Now all children get many treats . Of course with the latest trend of health conciousness most of the families are putting restrictions on junk food and are not allowing children to eat any thing out side .While packing the lunchboxes a seasonal fruit , a chacolate or any goody is being added for in between nibbling .It is not a big deal . when it comes to hostels I don't know exactly the situation .Next time when I go for a study trip , I would try to find out .

  • The discussion is about the overloading of pancreas . The reference to children's food habits is not directly connected to the diabetic state . What I want to impress upon is if pancreas gets so easily affected with overloading how come children take all the extra food . It is true that the needs of growing bodies are different . But still pancreas does never get overloaded on its own . But diabetic state is different .That is equally true . So a way has to be found out to remove that from the body .

  • is size on pancreas is also growing in growing up kids???

  • It is given that pancreas volume increases up to 30 years . The size of Liver and lungs increases up to late teens . Thus it is established , that the children need more food up to 20 years . From the age 20 to 60 the pancreatic volume remains constant . However the size gets reduced with the onset of diabetes.Deficient insulin leads to the reduction in the size . Whatever may be the reason more food is not required after the age 20 , because the growth is over by that time . But the feeling of hunger haunts almost up to 60 .This haunt subsides with the distribution of intake in to 5 or 6 meals . The other option could be LCHF of which I don't have an idea .whether diabetic or non diabetic , reduction of calories is important .

  • Please note that diabetes means not only insulin related defects.

  • What you are aiming to say is that it is

    Auto immunedisease; you call

    Hyperand hypothyroidism with this pet name. This is for confusing people.

    My dear, please

    Understand from me

    that I am talking about type 2 and not type 1 or Gestational

  • please go through my recent post

  • anup if you have seen the investigation list i advised to lady with 284 sugar included c peptide.. hope you know what is c peptide..

  • Yea I know what is c-peptide and exactly when c-peptide and GAD65 tests are to be done. Also, how (and when) to use the values of c-peptide/fasting insulin on HOMA - II

  • I love this talk from an Engineer and a Doctor from Stanford:

    He talks about switching from Metabolically deranged (Carb dependent) to Metabolically flexible where once adapted body starts using fat for fuel and starts preserving glucose :)

    World over, diabetics who lead Keto LCHF life, prove his talks to be true. We Indians would find it difficult to get to Ketogenic state, so our brand of LCHF restricts us to 100 grams carbs a day and 60% of energy is from Fat.

    Yours truly is into seventh year medication FREE type 2 diabetic and eat all the saturated fat from eggs, butter, VCO, cheese etc and still LIPIDS are normal, A1C 5.6 or lower. There are hundreds of Indian diabetics that I know of who have replicated this success of living on 100grams or less carbs per day.

    Carbs is enemy #1 for us. Fat is our friend and we love saturated fat.

  • dharmendrapanchal

    So what about ketones ? Do our brain utilize ketones as well ? Is ketone a more efficient fuel than carb or not ? Humans can use two fuels. Glucose and ketones. But since carb is freely easily and universally available we take carbs as our fuel. Fine. But we are misfit creatures. Can't use carbs effectively and high bs because of that damages our machinery. So we need to use ketones which is 100% safe efficiently utilized by our body. So we need to use that.

  • ketones are rescue fuel..

  • dharmendrapanchal 😁😁😁. You are absolutely right. They are to rescue us from complications of D. Jokes apart the days have gone when we would be starving extremely. On the contrary most of us are overfed. You know the key to reverse D is to lose abdominal fats. That's the key.

    Also the people engaged in endurance exercises use keto diet. As @anup says shaina nehwal and all the disciples of Gopichand follow keto diet strictly to improve performance. So let's change the concept that ketones are rescue fuel. Ketones are better fuel for athletes and we - the D people. My car is diesel. I can't use petrol instead in part or whole even if petrol is a better fuel. My body as D is not fit for glucose i have to use the alternate fuel for me and that's ketones. I wish we all could pursue keto diet. If thyroid permits.

    I'd love to here from you what you mean by " rescue fuel ". Rescue from what ? Starvation ?

    Physiologically also we use ketones. Early morning after overnight starvation. 😊😊😊

  • So let's change the concept that ketones are rescue fuel.

    I think Concerned will be able to delve more on this but let me try too:

    (1) Carbs (Glucose) is preferred/needed fuel for anaerobic mode where a sudden burst of energy for short duration is needed. Sprint, power lifters etc.

    (2) Fat is cleaner fuel with less ROS

    That said, any activity that lasts beyond 2 min or so, anaerobic component starts dominating. And Fat as fuel is definitely better.

    Here's a nice "loaded" article by Dr Peter Attia. Loaded as it has the characteristics of a typical Dr Attia article -- numbers, graphs & data


    Gopichand during his active career was always on a Keto diet with input items to diet being just 12 or so. He could beat the best in terms of stamina on court and just could go on and on.


  • ketones are:

    rescue fuel in case of starvation ketosis

    primary fuel in case of "nutritional" ketosis.

  • Brain can not utilize FFA but ketones very well.

  • Fat is cleaner fuel suramo

    But lot of LIES have been spread for over four decades now. But, you as a practicing doctor and a diabetic who lives on LCHF diet knows that it's all a LIE peddled for money.

    I always say -- these associations are cozy clubs that function from behind iron curtain. They are never ready to accept challenge.

  • Anup

    Yes i agree and i being a doctor understand what i'm doing and talking. It's 100% science that we should not use carbs but fat/ ketones as a fuel. But as a vegetarian it's really very difficult to have keto diet.

  • There are still doctors who advise that some sugar and carbs are essential. Even half doctors- the dietitians- give absurd advice to eat rice, potato, little sugar etc. We have to review the advises and come out of the shadow of aha ama ada.

    The whole world got badly exploited on lipid theory for more than 60 years and all kind of irrational things like cholesterolfree oils, nonstick cookwares and floods of antiatherotic oils are now available in the market and more and more people are using such oils to keep cholesterol in check. But the cholesterol theory is on the way to burst. Now ama aha ada saying only LPa particles are important and not the cholesterol.😊😊😊

  • That nonsense -- potato and high carbs zero animal fat -- usually comes from VEGANS like Dr McDougall, Dr Barnard (PCRM-PETA infamy)

  • Sir.... as medical professional what you will suggest to survive out of this TSUNAMI ???

  • I have been reading the above discussion with interest. Just as body prepared its own cholesterol irrespective of whether we added it to the diet or not, we also synthesize glucose through gluconeogenesis. In fact almost 50% of our blood glucose comes through this. Certain tissues such as RBCs, brain need glucose for their functioning. Brain can switch over to ketones on prolonged fasting otherwise glucose is the preferred. So is it likely that with LCHF body will breakdown proteins for synthesis of glucose and then would there be a shortage of proteins?

  • auarvindekar

    1) most of carbs come from diet and if you take high carb diet gluconeogenesis is very less. Do you know ketones also can convert into glucose. (Pardon me if i'm wrong )

    2) with extreme keto diet we can cure morbid obesity too. You have to have patience.

    3) brain is better with keto diet. Just a few examples. Alzheimer's and epileptic convulsions in children are better cured with keto diet. The tremors of parkinson's too. Somebody please add more to the list.

    4) cancer patients do better on keto diet. We as diabetics are more prone to have cancers. If we pursue keto diet perhaps cancerous growths can be nipped in the bud imho.

  • So the deduction is people on keto diet suffer less with diabetes or cancer , a point which needs research . But diabetes is a well thriving , prosperous business for a section of business community which never allows a serious effort in this area .

  • swathy

    It's already researched. What i'm saying is not postulations but science behind it and what researchers have found out.

    "But diabetes is a well thriving , prosperous business for a section of business community which never allows a serious effort in this area ." I don't agree. The health care givers are wrongly trained, uninformed and misinformed. I wouldn't blame doctors for that. Black sheep are there but all sheep are not black .

    The problem in india is apathy of leaders. In gujarat we have the health minister who doesn't know what is the meaning of trauma !! This kind of people are health caretakers. Yesterday i went to my local mla but he was not very much interested!! But i'm not gonna leave. What can the doctors do? Recently i had a hot debate in ob gy society meeting about the necessity of system improvement in the medical field. May be there are a few black sheep but we have to defeat them. In india every doctor creates or has to create one's own system. That's wrong. There should be a system created by the government or the health caretakers which give clear guideline as to how to treat a patient.

    I have also sent a letter to our pm and his aide in person but no response yet. Don't know if they understand what i'm saying.

  • Each has it's own advantages as well as disadvantages . Keto diet is good according to many followers . But it is of recent origin . Even if it is good it should not be taken beyond a certain point .In the begining because of unused supply it could solve the problem . In the long run , taken in excess of the need it would fail .

  • swathy

    "Keto diet is good according to many followers . But it is of recent origin . Even if it is good it should not be taken beyond a certain point .In the begining because of unused supply it could solve the problem . In the long run , taken in excess of the need it would fail ."

    Any proof ? Please explain why it should fail. I don't think that's true. It's not of recent origin.

  • A proof comes after an extensive usage and research . Proof of experiments on rats is totally a wrong approach because the endocrinal , immunity , circulatory , gastrointestinal systems of rats is not exactly the same as humans.In humans pitutory gland is very important in controlling many functions

  • The wide scale use of keto diet was not prevalent in the past . Even those who followed , the resultant problems were not clearly known . But as of now , it is agreed that it is fruitful inmost cases according to the reports . Since ,no other option is available right now , even with half the rate of success as keto is promising ,till such time another alternative is found , we may be compelled to follow that course.

  • swathy

    Just go through the link.


  • swathy

    "The wide scale use of keto diet was not prevalent in the past . Even those who followed , the resultant problems were not clearly known "

    The world have seen worst starvations in droughts. And the people lost fats during this time. That were keto periods but could anybody have done any research then?

  • not few black sheep , but 90% is of that category only .

  • swathy


    Yes. You too joined the bandwagon that doctors in this country should be bashed insulted beaten and not trusted. They should sit at home if fear violence though the people who say this don't do their duty and remain under tight security. You get jail if just criticize them πŸ’πŸ’πŸ’πŸ’πŸ’. What a feudal mindset ? No swathy. I don't buy your views. Most anger against doctors comes from the fact that we have to pay them.

  • just as you are expressing your anger against some professionals . Do you know now plumbers are calling themselves technical experts .Just as doctors are indispensable , plumbers are also indispensable in modern society .

  • swathy


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