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Dr. Sashi Shyamsundar

Endocrinologist, Chennai

500 at clinic
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Dr. Sashi Shyamsundar Endocrinologist, Chennai
500 at clinic
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I believe in health care that is based on a personal commitment to meet patient needs with compassion and care....more
I believe in health care that is based on a personal commitment to meet patient needs with compassion and care.
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Dr. Sashi Shyamsundar is a renowned Endocrinologist in Alwarpet, Chennai. You can consult Dr. Sashi Shyamsundar at Dr. Sashi Shyamsundar@Girishwari Hospital in Alwarpet, Chennai. Don’t wait in a queue, book an instant appointment online with Dr. Sashi Shyamsundar on Lybrate.com.

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#19, KB Dhasan Road, SIB College Road, Alwarpet, Landmark: Opp. Vidya ENT Hospital, ChennaiChennai Get Directions
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Know Everything About Hypothyroidism

MBBS, MRCGP ( UK), Diploma in Diabetes (UK), DFSRH (UK), DRCOG (UK)
Endocrinologist, Hyderabad
Know Everything About Hypothyroidism

Hypothyroidism is a condition in which the thyroid gland is not producing the thyroid hormones adequately. This is a fairly common condition.

What is thyroid gland?

The thyroid gland is a small butterfly-shaped gland located just below Adam’s apple. It encircles the windpipe or the trachea. It is about 4 cms in height and weighs about 18 gms. This gland is responsible for the secretion of thyroid hormones. Hormones are chemicals produced by special glands like thyroid, adrenals, ovaries etc. They act as messengers and are carried by the blood to the various target organs.

What are the hormones produced by thyroid gland and what do they do?

The thyroid hormones are of two types – T3 (Tri iodo thyronine) and T4 (Thyroxine). These hormones are mainly responsible for the body’s metabolism - a process in which food is converted into energy in the cells. They influence growth and development and regulate various bodily functions which are mentioned below:

  • Heartbeat
  • Body temperature
  • Breathing
  • Body weight
  • Metabolism of fat
  • Menstrual cycles in females
  • Functioning of Nervous system
  • Digestion
  • Burning calories etc.

What is Hypothyroidism?

Inadequate production of hormones by the thyroid gland is termed as hypothyroidism. This is also called Underactive thyroid state. Hypothyroidism can make the body’s development to slow down and reduces metabolism rates.

What are the causes of Hypothyroidism?

Hypothyroidism can be caused by a number of factors:

  1. Hashimoto's thyroiditis: This is the commonest cause. This is an autoimmune disorder (normally body’s defence system fight against external infections. In autoimmune disorder the defence system attacks the healthy cells of the body by mistake). In Hashimoto’s thyroiditis the immune system/defence system produces antibodies that attack the thyroid gland and destroy it.
  2. Iodine deficiency in diet. For the production of thyroid hormones iodine is very important. The body does not produce iodine normally, so it needs to be supplemented from outside. Iodine is mainly present in the food we eat. It is mainly present in shellfish, salt-water fish, eggs, dairy products. If a person does not eat iodine rich foods, he may end up with iodine deficiency leading to hypothyroidism. Currently, this causative factor is on the decline due to government initiative of table salt with iodine.
  3. Surgery: Surgery to remove thyroid gland (for e.g. thyroid cancer treatment, overactive thyroid etc.)
  4. Radiation to the neck (to treat cancer in the neck area): The thyroid gland cells are damaged due to the radiation.
  5. Treatment with radioactive iodine: This treatment is used for managing hyperthyroidism/overactive thyroid, where the thyroid gland produces excessive thyroid hormones. One of the treatment modalities is by radioactive iodine. Sometimes this radiotherapy destroys normal functioning cells which lead to hypothyroidism.
  6. Certain medicines: Certain medicines used to treat heart conditions, cancer, psychiatric conditions etc. – for e.g. amiodarone, lithium, interleukin-2, interferon-alpha.
  7. Pregnancy: Pregnancy (the reason is unclear but it has been noticed that the thyroid may get inflamed after delivery – this is called Postpartum thyroiditis.
  8. Damage to the pituitary gland: Pituitary gland is a gland which is present in the brain. It produces a hormone called TSH (Thyroxine-Stimulating hormone).The TSH tells the thyroid gland how much thyroid hormone it should make. If the levels of thyroid hormone in the blood are low, then the TSH will stimulate the thyroid gland to produce more Thyroid hormone.
  9. Hypothalamus disorders: This is an organ in the brain. This produces a hormone called TRH (Thyrotropin Releasing Hormone) which acts on the Pituitary gland to secrete TSH. So any disorder of Pituitary gland will indirectly effect the production and secretion of Thyroid hormones. These are very rare disorders.
  10. Congenital thyroid defects: Some babies are born with thyroid problems. This is due to the thyroid not being developed normally during pregnancy. Sometimes the thyroid gland does not function normal. This can be identified by screening for thyroid disorders in the first week after delivery. This is usually by a blood test using a small drop of blood from the baby’s heel.

What are the different types of hypothyroidism?

One classification is based on whether the defect is with the thyroid gland or not:

  1. Primary hypothyroidism: The problem is in the thyroid gland itself and thus there is reduced production /secretion of thyroid hormones.
  2. Secondary hypothyroidism: Here the problem is with the Pituitary gland or the Hypothalamus. This results in abnormal production of TSH or TRH, which indirectly leads to less production and secretion of thyroid hormones.

Another classification is based on the symptoms and levels of the thyroid hormones and TSH:

  1. Overt hypothyroidism: Here the patient is having the symptoms. Further the T3/T4 are low and TSH is high
  2. Subclinical hypothyroidism: Here patient may or may not have symptoms. The T3/T4 levels are normal but TSH is high. In this situation the patient is at an increased risk of developing overt hypothyroidism in the future especially if he has Thyroid peroxidase antibodies on testing.

Who are at risk of developing Hypothyroidism?

  1. Women have a higher risk of suffering from hypothyroidism than men.
  2. Older people are at increased risk.
  3. People suffering from other autoimmune diseases like Coeliac disease, Type-1 Diabetes Mellitus, Vitiligo, Pernicious anemia, Multiple sclerosis, Rheumatoid arthritis, Addison’s disease etc.
  4. People with psychiatric conditions such as bipolar disorder
  5. People with Chromosomal abnormalities like Down syndrome, Turners syndrome also have a high risk of suffering from hypothyroidism.

What are the symptoms of hypothyroidism?

Symptoms vary from person to person. They may also mimic other conditions and hence be difficult to diagnose. Symptoms may also develop very slowly over a span of moths-years. Some of the characteristic symptoms of this disease are:

  1. Depression
  2. Constipation
  3. Hair loss
  4. Dry hair
  5. Dryness of the skin
  6. Tiredness
  7. Body pains
  8. Fluid retention in the body
  9. Irregular menstrual cycles
  10. Increased sensitivity to cold
  11. Reduced heart rate
  12. Increase in size of the thyroid gland – called Goitre. This is due to constant stimulation of the thyroid gland by TSH.
  13. Weight gain
  14. Carpal tunnel syndrome
  15. Hoarse voice
  16. Infertility
  17. Loss of libido/sex drive
  18. Confusion or memory problems especially in the elderly

What are the symptoms to look for in a baby if you suspect hypothyroidism?

Infants suffering from congenital hypothyroidism may show no symptoms or exhibit signs of excessive drowsiness, cold hands, cold feet, constipation, hoarse cry, poor growth or absent growth, poor appetite, bloating of abdomen, puffiness of face, swollen tongue, persistent jaundice.

How to diagnose hypothyroidism?

Blood tests:

  1. TSH: This hormone is made in the pituitary gland and it stimulates the thyroid gland to produce thyroxine. If the thyroxine levels are low in the blood, the pituitary gland produces and secretes more TSH into the blood to act on the thyroid gland to produce more thyroxine. A raised TSH level indicates hypothyroidism. Other tests are not usually necessary unless a rare cause of hypothyroidism.
  2. T4: A low level of thyroxine indicates hypothyroidism.
  3. T3: these levels are generally not needed to diagnose hypothyroidism
  4. Anti-Thyroid peroxidase antibodies (anti-TPO antibodies) or Anti- thyroglobulin antibodies are present in 90-95% of patient with autoimmune thyroiditis.
  5. Other blood tests include Creatinine Kinase, Serum Lipids, Complete blood picture etc.
  6. Ultrasound of the neck is done if the patient presents with a thyroid swelling.

What is the treatment of hypothyroidism?

Overt hypothyroidism is treated by synthetic Thyroxin hormone which should be taken every day on an empty stomach at least 30 – 45 minutes before breakfast. The treatment is continued for the rest of the patient’s life. Regular thyroid function tests are done once every 8 weeks-12 weeks to adjust the dose of the thyroxine in the initial period of diagnosis. Once the thyroxine dose is stabilised, the tests can be done even once a year. This treatment is quite effective.

Sub-clinical hypothyroidism is only treated if the patient is a woman and is contemplating pregnancy, in patients with symptoms or if the TSH is quite high.

What are the side-effects of thyroxine medication?

There are few side effects if any. Most people tolerate these medications quite well. An important consideration before starting medication is to check if the patient has chest pain/angina. These people are started on the least available dose. If these patients are started on a higher dose they notice a worsening of their angina pains.

Side effects mainly occur if the thyroxine dose is high which leads to hyperthyroidism. The symptoms of this could be palpitations 9increased heart beat), weight loss, profuse sweating, anxiety, irritability etc.

There are some tablets which increase with thyroxine tablets. These include carbamazepine, iron supplements, calcium supplements, rifampicin, phenytoin, warfarin etc.

What are the complications of hypothyroidism?

If untreated hypothyroidism can lead to:

  • Heart problems like heart attack due to increased levels of bad cholesterol like LDL, or heart failure due to fluid retention
  • Obesity
  • Infertility
  • Joint pains
  • Depression
  • A pregnant woman with hypothyroidism is at increased risk of giving birth to a baby with congenital hypothyroidism, also known as cretinism. Further, the woman may have pregnancy related complications like pre-eclampsia, premature delivery, low birth weight baby, anemia, post-partum haemorrhage (bleeding after delivery) etc.
  • Myxoedema is another complication where the patient has extremely low levels of thyroid hormone. The body temperature drops drastically making the person lose consciousness or go into a coma. If you wish to discuss about any specific problem, you can consult an endocrinologist.
3123 people found this helpful

Sir my mother is suffering from hyperthyroid. She is taking medicine from last 5-6 months but she doesn't getting any relief. So please tell how she get relief from thyroid. Which type of precautions we will do for caring her. And consult any doctor in lucknow region. Thank you.

Nuclear Medicine Physician, Gurgaon
She may go for radioiodine ablation therapy for hyperthyroidism. It will possibly cure her hyperthyroidism at once. The therapy is very safe and effective, established treatment.
1 person found this helpful
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My mother is a patient of high BP and diabetes. Her sugar level was 210 when last time checked. But she wants to eat potatoes. Is there any way to let her eat potatoes? Again kindly suggest me a proper and detail diet/ meal/ fruit chart for her for making her healthier. Thank you in advance sir.

MPH
General Physician, Dehradun
My mother is a patient of high BP and diabetes. Her sugar level was 210 when last time checked. But she wants to eat ...
The things are possible with limitations but still the sugar is not appreciable many more things in body to be regulated as your physician might have advised so just consultation on line is not simple also not advisable her dietary scheduling and liking are to be regulated your mother is really lucky and blessed by god that does not have the higher rannge if proper consultation is dome may it be possible to have good controll by changing few things and till she can maintain with out medication later can switch on to medicines if taking we need to know many information to manage human onditions wish you all the best.
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I am 42 year old man and I am having diabetes since 2 years ago but last 4 months I am suffering pain in my teeth its a quite low pain but shall I go for dental surgery.

MBBS, DNB, Diploma Dyslipidemia, CCEBDM, CCMTD
General Physician, Gurgaon
I am 42 year old man and I am having diabetes since 2 years ago but last 4 months I am suffering pain in my teeth its...
How is your sugar control. You can definitely go ahead with your surgery provided the sugar control is good. You have to understand that everything is inter related. Bad sugars lead to bad teeth (infection) and bad teeth can lead to bad sugars so check your hba1c and fasting sugars.
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Sir, I am 49 years old men today. I had got checked my fasting sugar and it is found 115, You are requested please advise me on this subject. I am also BP patient.

MD - General Medicine, MBBS
General Physician, Kolkata
Sir, I am 49 years old men today. I had got checked  my fasting sugar and it  is found  115, You are requested please...
Right now you do not require any medication. Just follow dietary control and repeat fasting, 2 hour post prandial blood glucose and hba1c after 3 months.
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My mother has frequent loose motion problem. She face this approx every month and once she take medicines then it gets resolved. She has thyroid and diabetes. Please suggest what can be issue and any suitable testing which can be useful for further check.

CCEBDM, PG Diploma In Clinical cardiology, MBBS
General Physician, Ghaziabad
U have to improve your food habits do 1. Take 2/ 3 glass of warm water in the morning 2. Take more water in day 3. Take meals at fixed hrs 4. Take small amount of food at a time, take more frequent meals - may be five times a day. 5. No spicy/ fried/ fast/ junk/processed food. 6. No milk for few days, can take curd, no uncooked salad do for 7 days you will feel better
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Hello Doc I am 38 year old women diabetic patient since 2013. I have tremendous pain in my both feet I am taking Nurokind D3 but can not get the maximum benefit what to do please advice

M.D. (Ayurveda )
Ayurveda, Patiala
Hello Doc I am 38 year old women diabetic patient since 2013. I have tremendous pain in my both feet I am taking Nuro...
kindly take, madhumeha kusumakar rasa, 1 tab, twice a day, after meals. Apply dhanvantaram oil, for massage, on both the feets, twice a day, regularly. Warm the oil before use. Try to make optimum blood glucose levels. Share couple of previous FBS levels also. continue the regime for 45 days. good luck.
1 person found this helpful

I am 55 years of age. Recently diabetic detected for me. How I can reverse diabetes.?

MD - Diabetology, Membership of the Royal College of Surgeons (MRCS), MBBS
Endocrinologist, Kochi
I am 55 years of age. Recently diabetic detected for me. How I can reverse diabetes.?
Unfortunately, you cannot reverse or cure diabetes. But with the right knowledge and awareness, you can control it and lead a full, happy & fruitful life.
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Why Managing Blood Sugar Levels Is Extremely Important

PDDM, MHA, MBBS
General Physician, Nashik
Why Managing Blood Sugar Levels Is Extremely Important
The average blood sugar rises gradually and as it rises there is damage occurring throughout the body. Out of control blood sugar levels can lead to serious short term problems such as hypoglycemia, hyperglycemia, or diabetic ketoacidosis.

In the long run, uncontrolled blood sugar can also damage the vessels that supply blood to important organs, like the heart, kidneys, eyes, and nerves. This can occur even when you feel OK. That's why it's so important to take action as soon as you're diagnosed with diabetes. Our bodies are amazing, but unfortunately once you have a heart attack or stroke, or your kidneys fail, or you become blind, the damage cant be undone.

The good news is that paying attention to blood sugar control can help keep you healthy and prevent health problems from happening later. Some tips -

1) Keep your blood glucose within your goal range as much as possible. Work with your diabetes team to develop and maintain a plan.

2) Take your diabetes medication as prescribed. If you're on insulin, ask to see a diabetes educator to learn how to adjust your dose.

3) Increase physical activity. If you aren't physically active, talk to your health care provider about suitable activities. If you haven't exercised in a while, consider beginning with five to ten minutes of daily physical activity and gradually increase your activity to at least 30 minutes of physical activity most days of the week.

4) Achieve and maintain a healthy weight. Even a 5 percent to 7 percent weight loss will help you better manage your blood glucose.

The quality of your future life depends on the decisions and actions that you take today.

Click on consult privately to ask me any follow-up questions on this.

From Lybrate: If you found this tip useful, please thank the doctor by clicking on the heart icon below. Also, spread good health by sharing this tip with your loved ones.
1016 people found this helpful

I am 57 years old from bangalore, I would like to know how I can find a good doctor for my diabetics control status. Presently I am on M1 glimisave, morning one hour before b/f or lunch.

MBBS, CCEBDM, Diploma in Diabetology
Endocrinologist, Hubli-Dharwad
I am 57 years old from bangalore, I would like to know how I can find a good doctor for my diabetics control status. ...
Mr, if you are ok with online consultation then I can guide. But you need to give all details like fasting, pp sugar levels, hba1c %, present treatment with dosage, dietary pattern and extent of daily exercise. Thanks.
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I am diabetic, however I am not comfortable with medication. After taking medicines for week long, I start feeling uncomfortable. I feel lots of dizziness and weakness with medication. Please suggest me some better way out to fight diabetes.

PGP In Diabetologist, Fellowship in non-invasive Cardiology, MD - Medicine, MBBS
Endocrinologist, Delhi
I am diabetic, however I am not comfortable with medication. After taking medicines for week long, I start feeling un...
The only other way to fight diabetes is through weight loss. Worldwide, bariatric surgery has proven that weight loss is vital to diabetic reversal (a state where you are euglycemic without the need of any oral medication or insulin. A systematic review and meta-analysis of the english literature reported complete resolution of type 2 diabetes (defined as discontinuation of all diabetes-related medications and blood glucose levels within the normal range) in 78.1% of cases. But, there are two problems in this, first of all bariatric surgery is still very expensive in india (starts from rs 3-4 lakhs and above) secondly, it is not known clearly that all the benefits of post - bariatric surgery on diabetes reversal is entirely due to weight loss alone. On the other hand, dietary restriction and exercise (also known as lifestyle modification) can also theoretically cause weight loss and lead to diabetic reversal and has been tried world over. But, the fact remains that around 95% of weight loss achieved through lifestyle changes is short lived and does not translate into any benefit in the long run. Then there are stem cell therapies
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Hi sir/mam, I have hyperthyroid my weight is getting increase day by day I am feeling very lazy and restless please help me to get rid of my weight and laziness I am feeling hopeless now. I am taking throxyin 100 mcg and in weekends 125 mcg.

MBBS, CCEBDM, Diploma in Diabetology
Endocrinologist, Hubli-Dharwad
Manjuji, If you are on treatment if hypothyroidism is in check then TSH levels should remain between 3 to 4 milli units/ ml. If this is not achieved, then dose needs to be further increased. Once TSH levels are in the normal range, then exercise and restricted diet will help in reducing the weight. This has to be a very conscious effort and will take longer time to reach target level.
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My cholesterol ranges from 180 to 220. I am 57 years old. TLC 9000, DLC 55/43, LDL 105, HDL 45, Hb 15.3, sugar fasting 94.

Diploma in Cardiology
Cardiologist, Bhopal
My cholesterol ranges from 180 to 220. I am 57 years old. TLC 9000, DLC 55/43, LDL 105, HDL 45, Hb 15.3, sugar fastin...
Adopt a active life (walk atleast 30 min everyday) decrease ghee paneer and non veg in diet include frsh fruit vegs and nuts.
8 people found this helpful
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Hi my erection takes a long time and lasts for just one minute as I am over by then Have hypertension and diabetes.

FESC, FSCAI, DM - Cardiology, MD - Internal Medicine, MBBS
Cardiologist, Delhi
Hi my erection takes a long time and lasts for just one minute as I am over by then
Have hypertension and diabetes.
Reduce your weight, many antihypertensive medicines medicines have a side effects like erectile dysfunction and diabetes is also a risk factor for the impotency,
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My grandmother has a thyroid problem. But she do not stool for 6 days. What she do. Please sir give any suggestion and tablet.

BHMS
Homeopath, Howrah
If she has only constipation problem, but not vomiting or fever or any other asociated problem then give her plain isabgoal powder one spoon in luke warm water. Give her warm drink to take.
2 people found this helpful
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I am 60 years old. Am debitic since last 10 years and mgt is 1000mg metformin +2 mg glimi in the morning and same doze in evening. Last six month there is burning feet sensation in my feet. Skin on both feet below ankles start getting hard and also there are cracks in palm of left foot which heels and dead skin comes and goes. But there is no wound. Please advise me.

CCMTD, CCEBDM, C.Diabetology, American Diabetes Association, DOMS, MBBS
Endocrinologist, Mumbai
You are having diabetic dermopathy. You can try doing medicated pedicure under strictly hygienic condition after controlling your blood sugar levels.
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I am having thyroid can you suggest me better Dr. or specialist please help I am having thyroid from 3 years thyronorm *50 mcg.

MBBS, CCEBDM, Diploma in Diabetology
Endocrinologist, Hubli-Dharwad
Hello, Thanks for the query. Since you are already on treatment with Thyroxine tablets (50 mcg/d), you will have to look at the TSH level, it should be maintained <3 mU/L to be free from all the symptoms. I can definitely guide you in controlling the condition effectively and be free from all the problems. If you come in a private conversation with following details: T4, T3 & TSH levels, weight and height, current dietary pattern and extent of daily exercise, then I will be able to guide specifically and help in control of the condition. Thanks.
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I have skin allergy from ornaments even gold, all clothes except cotton, even embroidery. I hv diabetes and thyroid too. Please suggest me preventive measures.

MBBS
General Physician, Cuttack
I have skin allergy from ornaments even gold, all clothes except cotton, even embroidery. I hv diabetes and thyroid t...
Do an allergy test after consulting allergist/immunologist and follow the advice and treatment. For diabetes follow the advice given below 1. Do regular aerobic exercise for 1 hour daily (brisk walking, jogging, running, swimming, cycling etc) 2. Reduce weight if overweight 3control diet a) avoid sweets, sugar/honey, milk, milk product excess calorie and carbohydrate rich diet like white bread, cereal, rice, pasta b) avoid all refined food like maida, pasta, starchy food like rice, potato, bakery item, processed food, c) include more fiber like pulse, green leafy vegetable, cucumber, carrot, tomato, j legume. D) avoid sweetened fruit like banana, mango, litchi, chickoo, sapota, seethaphal jack fruit, grape etc. Can have fruits like guava, pineapple, papaya, orange, mousambi, strawberry, watermelon, pomegranate, jack fruit, sweet potato, a handful of walnut daily (akhrot) e) avoid white/polished rice, take unpolished rice like brown rice/wheat/jowar/ragi, moong and chana dal. F) avoid ghee/ butter./coconut oil/excess salt intake like papad/pickle. G) avoid red meat. Take fish/chicken. H) avoid alcohol and carbonated drinks like soft drink 4. Adhere to a strict diabetic diet by consulting dietitian 5. Monitor your fasting, pp blood sugar 3 monthly and hba1c six monthly 6. Consult diabetologist for advice and treatment.
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How often should I visit you for checkups in order to stay as healthy as possible and avoid diabetic complications?

MBBS
General Physician, Mumbai
How often should I visit you for checkups in order to stay as healthy as possible and avoid diabetic complications?
If you (age -20) are fully fit than once in five years and if any disease has been diagnosed than once in a year or follow up as per the protocol
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