Efficacy of Shalya Nirharan techniques per Acharya Sushruta.

a comprehensive literature review

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Journal name: World Journal of Pharmaceutical Research
Original article title: Exploring the efficacy of shalya nirharan (foreign body removal) techniques in accordance with acharya susruta
The WJPR includes peer-reviewed publications such as scientific research papers, reports, review articles, company news, thesis reports and case studies in areas of Biology, Pharmaceutical industries and Chemical technology while incorporating ancient fields of knowledge such combining Ayurveda with scientific data.
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Subtitle: a comprehensive literature review

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Author:

Dr. Deepak Kumar Singh


World Journal of Pharmaceutical Research:

(An ISO 9001:2015 Certified International Journal)

Full text available for: Exploring the efficacy of shalya nirharan (foreign body removal) techniques in accordance with acharya susruta

Source type: An International Peer Reviewed Journal for Pharmaceutical and Medical and Scientific Research

Doi: 10.20959/wjpr202015-29048

Copyright (license): WJPR: All rights reserved


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Summary of article contents:

Introduction

The literature review conducted by Dr. Deepak Kumar Singh explores the traditional Ayurvedic practice of Shalya Tantra, specifically focusing on techniques for the removal of foreign bodies (Shalya) as described by Acharya Susruta. This ancient medical discipline emphasizes the importance of correctly diagnosing and efficiently removing foreign bodies to prevent complications. The chapter on Shalya Tantra in Susruta Samhita provides a comprehensive guide to the types of foreign bodies, their impacts on the body, and various methods for their removal.

Types of Foreign Bodies: Agantuk Shalya and Sharirik Shalya

Acharya Susruta categorizes foreign bodies into two primary types: Sharirik Shalya, which are self-derived and include substances like teeth and nails, and Agantuk Shalya, which originate externally and may consist of a wide range of items, such as metal or wood. Furthermore, foreign bodies can be classified as Avabaddha (fixed) or Anavabaddha (loose) based on their attachment to the surrounding tissue. This classification is essential for determining the most effective removal technique and understanding the potential complications associated with each type.

Techniques for Removal: Methods of Extraction

The review outlines fifteen distinct techniques for removing non-fixed foreign bodies, including Svabhava (natural expulsion), Bhedana (cutting), and Vamana (inducing vomiting). A key aspect is the importance of direction during extraction, differentiated into two primary methods: Pratiloma, which involves pulling backward, and Anuloma, which is forward pulling. The techniques emphasized in the literature illustrate a systematic approach that combines anatomical knowledge with practical skills to optimize patient outcomes during foreign body removal.

Diagnosis and Symptoms: Identifying Foreign Bodies

Recognizing the presence of foreign bodies involves understanding various symptoms associated with their existence. The literature highlights generalized symptoms such as swelling, pain, and discoloration as potential indicators. Specific symptoms depend on the body part affected (e.g., swelling in veins or joints), which can aid in diagnosing the location and nature of the foreign body. This diagnostic framework is crucial for determining the urgency and appropriateness of intervention.

Conclusion

In conclusion, Dr. Singh's review emphasizes the vital role of Shalya Tantra as outlined by Acharya Susruta in Ayurvedic practices for foreign body removal. By classifying foreign bodies, describing removal techniques, and detailing diagnostic symptoms, this comprehensive literature review underscores the efficacy of traditional methods combined with a systematic approach to tackle medical emergencies associated with foreign bodies. Such ancient wisdom continues to inform modern medical practices and offers valuable insights into holistic patient care.

FAQ section (important questions/answers):

What is Shalya Tantra according to Acharya Susruta?

Shalya Tantra is described as the science focused on diagnosing and removing foreign bodies (Shalya) from the body using various methods, instruments, and techniques to alleviate pain and prevent complications.

What are the two main types of foreign bodies?

The two main types of foreign bodies are Avabaddha (fixed) and Anavabaddha (not fixed). They can be derived either from the body itself or from external sources causing discomfort.

How many methods exist to remove non-fixed foreign bodies?

There are fifteen methods to remove non-fixed foreign bodies, including techniques like inducing vomiting, creating suppuration, or using magnetism to extract the object without surgical intervention.

What are the directions of movement for foreign bodies?

Foreign bodies can move in five primary directions: upward, downward, backward, sideward, and straight. Understanding these directions can aid in their removal.

What should be done post-operatively after foreign body removal?

After removing a foreign body, clean the wound, apply appropriate medications, and provide cuddling care, including hydration and dietary recommendations for recovery.

How should food boluses causing choking be treated?

For boluses of food acting as foreign bodies in the throat, the patient should bend forward and be given a strong hit to the back, or be encouraged to drink fluids to help dislodge the obstruction.

Glossary definitions and references:

Scientific and Ayurvedic Glossary list for “Efficacy of Shalya Nirharan techniques per Acharya Sushruta.”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.

1) Shalya (Salya):
In Ayurveda, 'Shalya' refers to any foreign body that causes pain or discomfort within the body. Understanding Shalya is crucial as it relates to the principles of Shalya Tantra, the surgical branch of Ayurveda that focuses on the removal and management of foreign bodies to alleviate suffering.

2) Varanasi (Varanashi):
Varanasi is a city in India, known as a major center of learning and culture, particularly for Ayurveda. It is home to numerous Ayurvedic institutions, including Dr. Vijay Ayurvedic Medical College, where practices and studies related to Shalya Tantra are conducted, bridging ancient knowledge and modern medicine.

3) Samhita:
The term 'Samhita' generally denotes a collection or compilation of texts in Ayurveda that encompass various medicinal knowledge and practices. In the context of Susruta Samhita, it refers to the foundational text authored by Susruta, covering key surgical techniques, including the management of foreign bodies.

4) Sushruta-samhita (Susruta-samhita):
Sushruta-samhita is one of the principal texts of Ayurveda, focusing on surgery and its various techniques, including the removal of foreign bodies. It lays down the philosophical and practical framework that guides practitioners in understanding Shalya Tantra and its application.

5) Sutrasthana (Sutra-sthana):
'Sutrasthana' identifies a section of the Susruta Samhita that comprises foundational teachings and principles, particularly regarding surgical techniques. This part serves as a crucial resource for practitioners, detailing methods for diagnosing and addressing foreign bodies within the Ayurvedic context.

6) Sthana:
In Ayurveda, 'Sthana' translates to 'place' or 'location'. It often delineates anatomical structures or areas in the body where conditions, such as the presence of foreign bodies, can occur. Understanding Sthana is essential for precise diagnosis and treatment planning in Ayurvedic practice.

7) Sutra:
A 'Sutra' is a concise aphoristic statement that conveys a significant principle in Ayurveda. Sutras function as guiding precepts for practitioners, informing their understanding and application of Ayurvedic systems, particularly in forms like surgery (i.e., Shalya Tantra).

8) Sanskrit:
'Sanskrit' is the ancient language of Ayurveda in which classical texts, including the Susruta Samhita, are written. Proficiency in Sanskrit enables healthcare practitioners to access original works, ensuring accurate interpretations and the preservation of traditional Ayurvedic knowledge.

9) Pain:
Pain is a cardinal symptom that necessitates assessment and management in Ayurveda. Within the context of Shalya Tantra, the pain caused by foreign bodies ('Shalya') informs treatment decisions, guiding practitioners to determine appropriate interventions for relief and healing.

10) Swelling:
Swelling reflects an inflammatory response, often indicating an underlying condition. In Shalya Tantra, the presence of swelling associated with foreign bodies is an important diagnostic feature, guiding the physician in the determination of removal techniques and post-operative care.

11) Water:
Water plays a vital role in Ayurvedic practices, including detoxification and cleansing procedures. In surgical contexts, it may be used to wash out wounds, facilitate the removal of foreign bodies, and assist in post-operative healing processes, highlighting its importance in Shalya Tantra.

12) Food:
In Ayurveda, food is regarded as medicine and plays a crucial role in healing. In the management of foreign bodies ('Shalya'), appropriate dietary recommendations may support digestion and recovery, aiding in the holistic treatment philosophy that distinguishes Ayurveda from other medicinal systems.

13) Shrikantha (Srikantha, Shri-kantha, Shrikamtha):
Srikantha likely refers to a modern translator or commentator who has contributed to making ancient texts like the Sushruta Samhita more accessible. These modern interpretations help bridge the gap between classical knowledge and contemporary understanding of Ayurvedic practices.

14) Shalyatantra (Salyatantra, Shalya-tantra, Shalyatamtra):
Shalya-tantra is the surgical branch of Ayurveda concerned with foreign bodies and surgical interventions. It embodies principles of diagnosis, extraction, and management of foreign bodies, as outlined by Susruta, thereby providing vital knowledge for effective surgical practice within Ayurveda.

15) Tantra (Tantrism, Tamtra):
In Ayurveda, 'Tantra' refers to a systematic approach or methodology. It encompasses various techniques and practices used in different branches of Ayurveda, including Shalya Tantra, which applies these principles specifically to surgery and treatment of foreign bodies.

16) Shopha (Sopha):
Sopha refers to swelling, a significant clinical manifestation of inflammation in Ayurveda. Understanding Sopha is critical within the purview of Shalya Tantra, as it informs the diagnostic approach and decision-making regarding the removal of foreign bodies and subsequent treatments.

17) Hair:
Similar to hairs, individual strands of hair may also be relevant in certain therapeutic approaches within Ayurveda. They might be employed in techniques to assist in extracting foreign bodies or as part of cleansing rituals, illustrating the breadth of resources used in Shalya Tantra.

18) Ayurveda (Ayus-veda):
Ayurveda is the traditional Indian system of medicine, emphasizing a holistic approach to health. It synthesizes physical, mental, and spiritual elements of wellness, particularly relevant in the diagnosis and management of conditions involving foreign bodies, as explored in Shalya Tantra.

19) Disease:
Diseases are characterized by symptoms arising from physiological imbalances, often requiring intervention. In Shalya Tantra, the presence of foreign bodies signifies specific complications necessitating careful evaluation and surgical action to restore health.

20) Blood:
In the context of Ayurveda, blood is central to health and vitality. The presence of blood in contexts involving foreign bodies can indicate complications or infection, alerting practitioners to potential dangers during surgical procedures outlined in Shalya Tantra.

21) Pratiloma (Prati-loma):
'Pratiloma' refers to a specific direction of movement when extracting foreign bodies in Ayurvedic surgery. It emphasizes the importance of technique and understanding the foreign body's pathway to ensure successful removal and minimize trauma during surgical procedures.

22) Lakshana (Laksana):
Lakshanas are the identifiable characteristics or symptoms that signal the presence of various conditions in Ayurveda. Knowing the Lakshanas related to foreign bodies assists practitioners in timely diagnosis and initiates the appropriate management strategies in Shalya Tantra.

23) Medicine:
Medicine in Ayurveda involves a holistic approach to treatment, comprising herbal remedies, surgical procedures, and lifestyle changes. In Shalya Tantra, various medicinal approaches are integrated into surgical practices to facilitate the effective removal and management of foreign bodies.

24) Vomiting:
Vomiting is a therapeutic process in Ayurveda used to expel unwanted substances or foreign bodies. Techniques involving inducing vomiting demonstrate the dynamic approaches within Shalya Tantra, aimed at swiftly addressing the complications presented by foreign bodies in the gastrointestinal tract.

25) Anuloma:
'Anuloma' denotes a forward direction in the context of foreign body removal. It signifies an important strategic consideration in surgery, highlighting the systematic methods used in Shalya Tantra to ensure optimal outcomes when addressing foreign body complications.

26) Asthi (Ashthi):
Asthi refers to bones in Ayurveda, which can also be sites for lodged foreign bodies. In Shalya Tantra, understanding the interaction between Asthi and foreign bodies is vital for surgical interventions and understanding the potential for complications during surgery.

27) Arrow:
Arrows are referenced in ancient surgical literature as a type of foreign body that can inflict significant wounds. In Shalya Tantra, the intricacies of removing arrowheads highlight historical challenges faced in surgery, showcasing the evolution of techniques while treating foreign materials within the body.

28) Honey:
In Ayurveda, honey is considered a healing agent due to its antimicrobial properties. It serves a dual purpose in surgical contexts: as part of wound management and in remediation techniques discussed in Shalya Tantra, particularly for soothing injuries from foreign bodies.

29) Vata:
Vata is one of the three doshas in Ayurveda, representing the air element. Imbalances of Vata may lead to various health issues, including those involving foreign bodies. Managing Vata is crucial in treatment protocols under Shalya Tantra to maintain bodily harmony during healing.

30) Ghi (Ghee):
Ghee, or clarified butter, holds a significant place in Ayurvedic medicine for its therapeutic properties. It is often utilized in post-surgical care and wound treatment within Shalya Tantra, enhancing healing processes and providing nourishment to the affected areas.

31) Ashtanga (Astanga, Ashtan-anga):
Ashtanga refers to the 'eight limbs' of Ayurveda, which categorize various branches of knowledge and practice. Shalya Tantra is one of those branches, emphasizing surgical intervention techniques for effectively managing foreign bodies, thereby linking it with the broader Ayurvedic framework.

32) Vitiation (Vitiated):
Vitiated refers to the imbalance of doshas in the body, leading to disease and discomfort. Understanding vitiation is important in Shalya Tantra, especially concerning how foreign bodies can exacerbate underlying conditions and present challenges in surgical management.

33) Samanya:
Samanya signifies general characteristics or symptoms associated with conditions in Ayurveda. In the context of Shalya Tantra, recognizing Samanya traits of foreign body presence aids practitioners in diagnosis and informs the decision-making process regarding their surgical approach.

34) Cutting:
Cutting is a surgical technique employed within Shalya Tantra for the removal of foreign bodies. It represents a direct intervention that may be necessary in cases where less invasive approaches are ineffective, highlighting the importance of skillful execution in surgical practice.

35) Science (Scientific):
Science refers to the systematic study and understanding of natural phenomena, encompassing Ayurveda's principles. In Shalya Tantra, the scientific approach to diagnosing and treating foreign bodies illustrates the integration of empirical knowledge with traditional healing methodologies.

36) Animal:
Similar to animals, specific focus on any one animal may inform therapeutic approaches in Ayurveda, especially regarding foreign body interactions. Knowledge of animal behaviors and effects on human health is significant in devising effective surgical treatments in Shalya Tantra.

37) Yantra (Yamtra):
'Yantra' refers to instruments or tools used in Ayurvedic practices, especially in Shalya Tantra. The proper use of Yantra is essential for effectively diagnosing, extracting, and managing foreign bodies, showcasing the intricate interplay between traditional tools and surgical techniques.

38) Dosha (Dosa):
Doshas (Vata, Pitta, Kapha) are fundamental concepts in Ayurveda that embody physiological principles governing health. Awareness of a patient’s dosha is critical in Shalya Tantra, as foreign bodies may affect dosha balance, informing treatment strategies for recovery.

39) Kapha:
Kapha is one of the three doshas, characterized by stability and structure. In cases involving foreign bodies, understanding Kapha’s role aids practitioners in treating associated symptoms and managing the overall health of patients undergoing surgical procedures in Ayurveda.

40) Karma (Karman):
Karma refers to actions and their consequences in Ayurveda and philosophy. In Shalya Tantra, understanding a patient's karma may inform how foreign bodies influence well-being, guiding practitioners in treatment decisions and approaches during surgical interventions.

41) Marma:
Marma signifies vital points in the body where doshas intersect. Knowledge of Marma is crucial when performing surgical procedures within Shalya Tantra, particularly to avoid complications and ensure the safe removal of foreign bodies without compromising essential bodily functions.

42) Mamsa (Mamsha):
'Mamsa' refers to the muscle tissue in Ayurveda, which can also become affected in cases of foreign body obstruction or lodging. Shalya Tantra addresses Mamsa in surgical contexts, guiding practitioners on how to effectively manage related issues during procedures.

43) Vrana:
Vrana indicates a wound or ulcer in Ayurveda. Understanding the relationship between Vrana and foreign bodies is essential in Shalya Tantra, as the presence of a foreign body can complicate wound healing and requires specialized intervention based on surgical teachings.

44) Kumar:
Kumar may refer to a title or common name in India but within the Ayurvedic context, it could symbolize young practitioners or specific texts. It represents the passing of knowledge to future generations concerning practices in Shalya Tantra.

45) Veda:
Veda denotes the body of knowledge in ancient Indian scripture. Ayurveda is often seen as an Upaveda of the Atharva Veda, signifying its importance in preserving ancient medicinal knowledge, especially influential in surgical treatments like Shalya Tantra.

46) Sira (Shira):
Sira refers to blood vessels in Ayurveda. Understanding Sira is vital for practitioners in Shalya Tantra, particularly regarding the careful handling of blood vessels during surgical procedures to avoid excessive blood loss when removing foreign bodies.

47) Horn:
Horns are indicative of certain foreign materials encountered in avian or animal context. Recognizing Horns and their involvement in wounds aids practitioners in Shalya Tantra, emphasizing techniques for effective handling when managing animal-induced injuries.

48) Hand:
The hand is a fundamental instrument in Ayurveda for both diagnosis and treatment. In surgical practices, skilled hand movements are vital in performing delicate procedures such as the removal of foreign bodies, highlighting the physical aspect of Shalya Tantra.

49) Life:
Life embodies the holistic essence of Ayurveda, focusing on achieving balance and harmony in body and spirit. The principles of Shalya Tantra aim to restore life through effective surgical interventions that remove foreign bodies and alleviate suffering.

50) Burning sensation:
A burning sensation can indicate inflammation or irritation, often related to foreign bodies. This symptom plays a significant role in diagnosing conditions in Shalya Tantra, guiding practitioners to determine intervention strategies to relieve discomfort.

51) Paschat-karma:
Paschat-karma refers to post-operative procedures and care essential after surgical interventions. In Shalya Tantra, these practices ensure proper healing and recovery of the patient following the removal of foreign bodies, emphasizing the importance of aftercare.

52) Horripilation:
Horripilation refers to the involuntary contraction of hair follicles, often linked to physiological or emotional responses. Understanding this phenomenon may provide insight into patient experiences, particularly those undergoing surgical procedures described in Shalya Tantra.

53) Atharvaveda (Atharva-Veda):
Atharva-Veda is one of the four ancient Vedas, encompassing various knowledge, including medicinal practices. Ayurveda is considered an Upaveda of Atharva-Veda, connecting philosophical and spiritual dimensions of healing, along with surgical knowledge in contexts like Shalya Tantra.

54) Accumulation (Accumulating, Accumulate):
Accumulation refers to the build-up of substances, which could relate to the obstruction caused by foreign bodies in Ayurveda. In Shalya Tantra, addressing accumulation efficiently is vital for successful surgical outcomes and overall patient well-being.

55) Dhanvantari (Dhanvamtari):
Dhanvantari is revered as the deity of Ayurveda and considered the divine physician. In the context of Shalya Tantra, invoking Dhanvantari embodies the rich traditions and spiritual dimensions associated with the surgical practices and healing methodologies in Ayurveda.

56) Prakshalana (Praksalana):
Prakshalana refers to washing or cleansing, often used in Ayurvedic treatments to clear impurities. In Shalya Tantra, it may be relevant for post-surgical care, ensuring removal of contaminants around surgical sites, thus facilitating better healing.

57) Surrounding:
The term 'surrounding' refers to the areas adjacent to where a foreign body resides. Assessing the condition of the surrounding tissues in surgery is crucial in Shalya Tantra, as it informs practitioners about potential complications and necessary interventions.

58) Pakvashaya (Pakvasaya, Pakva-ashaya):
Pakvashaya refers to the large intestine in Ayurveda. In the context of foreign bodies, understanding the health of the Pakvashaya is crucial in diagnosis and surgical treatment, ensuring that any lodged objects within are adequately addressed.

59) Discussion:
Discussion in the academic context involves the analysis and evaluation of findings related to topics like Shalya Tantra. Engaging in discussion allows practitioners to share insights, improving the understanding and application of traditional techniques in modern medical practice.

60) Substance:
Substance refers to materials that may become foreign bodies in the body. Recognizing various substances involved is essential in Shalya Tantra to determine appropriate removal techniques while considering the unique properties of these materials.

61) Pravahana:
Pravahana refers to the act of straining or making efforts to expel something. In Shalya Tantra, this principle may guide practitioners striving to remove foreign bodies from patients, integrating philosophy with practical techniques for effective intervention.

62) Samrambha:
Samrambha indicates a state of agitation or unrest, which can be crucial in understanding a patient's emotional or physical responses to surgical interventions. Recognizing emotional states may guide practitioners in providing comfort during Shalya Tantra procedures.

63) Angamarda (Anga-marda, Amgamarda):
Angamarda refers to generalized body pain, which can arise from various conditions including the presence of foreign bodies. Recognizing Angamarda helps Ayurvedic practitioners assess the extent of discomfort and take necessary measures within Shalya Tantra for relief.

64) Vivarnata (Vivarna-ta):
Vivarnata signifies discolouration, often associated with various ailments. It aids practitioners in diagnosing conditions, particularly in assessing areas surrounding foreign bodies in Shalya Tantra, guiding the decision-making process for surgical intervention.

65) Muhurmuhuh (Muhurmuhur, Muhur-muhu, Muhur-muhur, Muhurmuhu):
Muhurmuhu describes recurrent or frequent sensations of pain or discomfort. Identifying this symptom is essential in Ayurveda to evaluate how foreign bodies affect patients, guiding the surgical concepts within Shalya Tantra for effective management.

66) Knowledge:
Knowledge is fundamental to Ayurveda, enabling practitioners to make informed decisions in diagnosis and treatment. In Shalya Tantra, specialized knowledge about foreign bodies, surgical techniques, and post-operative care is crucial for providing effective care and promoting healing.

67) Observing:
Observing refers to the careful assessment of patients' symptoms and conditions. In Shalya Tantra, careful observation is vital when examining for foreign bodies, allowing practitioners to make informed decisions regarding diagnosis and treatment.

68) Triphala (Tri-phala):
Triphala is a renowned Ayurvedic herbal formulation consisting of three fruits. It holds significance in treatment protocols for various conditions in Ayurveda and can assist in detoxification processes, possibly relevant within Shalya Tantra post-surgical care.

69) Adhikara:
Adhikara refers to authority or rights in Ayurveda, which may pertain to the qualifications necessary for practitioners to perform specific treatments. This concept underlines the importance of skilled practitioners within Shalya Tantra to ensure safe surgical practices.

70) Svabhava (Sva-bhava):
Svabhava denotes the inherent nature of an entity. Understanding the Svabhava of foreign bodies informs practitioners in Shalya Tantra about the best approaches to removal, emphasizing natural tendencies in materials lodged within the body.

71) Drowning:
Drowning presents a medical emergency often requiring immediate intervention. In context, understanding techniques for managing individuals who have drowned highlights important aspects of emergency medicine and could be contextualized within Ayurvedic principles, including strategies for airway management.

72) Channel:
Channel signifies the pathways through which bodily processes occur. Knowledge of channels is essential in Shalya Tantra for locating foreign bodies, allowing surgical practitioners to navigate effectively during extraction procedures.

73) Shastra (Sastra):
Sastra denotes the scriptures or texts that inform medicinal practices. In the context of Shalya Tantra, Sastra guides practitioners through established methodologies for diagnosing and treating cases involving foreign bodies, embodying the fusion of tradition and surgical practice.

74) Bhedana:
Bhedana refers to the technique of cutting or breaking substances within the Ayurvedic context. It plays a role in Shalya Tantra, highlighting surgical methods used to remove foreign bodies, emphasizing the need for precision and skill.

75) Dhamani:
Dhamani refers to blood vessels in Ayurveda, which are significant when dealing with foreign body surgeries. Understanding Dhamani's anatomy and physiology is vital in Shalya Tantra to prevent complications during surgical procedures aimed at foreign body extraction.

[Note: The above list is limited to 75. Total glossary definitions available: 128]

Other Science Concepts:

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Discover the significance of concepts within the article: ‘Efficacy of Shalya Nirharan techniques per Acharya Sushruta.’. Further sources in the context of Science might help you critically compare this page with similair documents:

Anuloma, Vamana, Sushruta-samhita, Bhedana, Shalyatantra, Paschat-karma, Darana, Acharya Susruta, Jara Chikitsa, Ayu Veda, Foreign body removal.

Concepts being referred in other categories, contexts and sources.

Svabhava, Pratiloma.

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