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In Tripura (26.4% of men and 53.0% of women) and Manipur (37.5% of men and 39.8% of women), betel quid with tobacco is widely used

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According to a 2020 study by researchers from the Stanford University School of Medicine, the University of North Carolina at Chapel Hill, and St

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however, its pathogenesis is thought to stem from a genetic predisposition resulting in dysregulated interactions between the immune system and environmental factors