Homeostasis,cell physiology -- By Prof.Dr.R.R.Deshpande

Paper 1 – Part B – PPT Set 1 – Homeostasis & Cell Physiology
• This PPT Set is inEnglish .Very useful for 1st BAMS ,Teachers & Students for Teaching & Learning. It contains 1) Definition & mechanisms of maintenance of homeostasis 2) Cell physiology 3) Membrane physiology 4) Transportation of various substances across cell membrane
• Visit – www.ayurvedicfriend.com
• Mobile – 922 68 10 630

1. Sharir Kriya Paper 1-Part B –Set 1
•Presented By –

•Dr.R.R.Deshpande

•Prof & HOD

•CARC ,Pune 44
8/3/2015 Prof.Dr.R.R.Deshpande 1

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Sharir Kriya -- Paper I –Part B –Point 1
•Presented By –
•Prof.Dr.R.R.Deshpande (M.D in Ayurvdic
Medicine & M.D. in Ayurvedic Physiology)
•www.ayurvedicfriend.com
•Mobile – 922 68 10 630
•[email protected]

3. God of Health = Dhanvantari

8/3/2015 3 Prof.Dr.R.R.Deshpande

4. Prayer of God Dhanvantari

8/3/2015 4 Prof.Dr.R.R.Deshpande

5. Sharir Kriya Text Books
8/3/2015 Prof.Dr.R.R.Deshpande 5

6. 8/3/2015 Prof.Dr.R.R.Deshpande 6 8/3/2015 Prof.Dr.R.R.Deshpande 6
Sharir Kriya Hand Book –
1
st
to last year BAMS
•Best for Fast Revision
•Paper 1,Paper 2
•Practicals
•Instruments
•Histology
•IMP Schlok
•All basics of
Dodha,Dhatu & Mala

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Sharikriya Paper Practical Book
•As per Very New
Syllabus formed By
CCIM IN 2012
•Ayurvedic Practicals
like Prakruti,sara,Agni
•Modern
Haematological
Practicals
•CNS & CVS
Examination

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Clinical Examination
•Systemic Examination
of 8 systems
•Ayurvedic Srotas
Examination
•Clinical significance of
Lab Tests &
Radiology,USG,2D
Echo

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Sharir Kriya Paper 1
•Book in English
•Total CCIM Syllabus
covered
•Chaukhamba Sanskrit
Pratisthan Publication
•Popular Nationwide &
In Germany also
•Dosha & Prakruti

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Sharir Kriya Paper 2
•Book in English
•Total CCIM Syllabus
covered
•Chaukhamba Sanskrit
Pratisthan Publication
•Popular Nationwide &
In Germany also
•Dhatu,Mala

11. Books Availability
•At Appa Balwant Chowk ,Pune ( ABC)
•Sharp Book Depo – 96 23 58 60 73
•Sharp Book Depo – 020 66 01 79 04
•Dr.RRD --------------- 922 68 10 630
•Mr.Shantanu -------- 98 22 08 55 06
•Proficient Shop –In front of Prabhat
Theatre – 020 244 84 538
8/3/2015 Prof.Dr.R.R.Deshpande 11

12. Other Books ,I recommend
•1) Sanshipta Sharir Rachana – (Proficient
Publication)
Dr.Ranade,Dr.Deshpande,Dr.Mahadar
•2) Sharir Rachana Pratykshik ( Journal) –(
Proficient Publication)
Dr.Ranade,Dr.Deshpande,Dr.Topale
•3) Sanshipta Ayurved Itihas ( Proficient
Publication) –Dr.Ranade,Dr.Deshpande
•4) Ashtang Hrudaya Hand Book – Shantanu
Prakashan
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13. Prof.Dr.Deshpande - Lectures
•Theory –
•Every Wednesday from 3 to 4 pm
•With Pre intimations lot of Extra Lectures
can take place

•Practicals – Every month 3
rd
& 4
th

Monday & Tuesday – from 9 to 11 am
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14. Compulsory Study material
•Every day – Sharir Kriya Hand Book (
Repeated Schlok Recitation ,specially of
Prakruti,Sarata,Dosha & Dhatu )
•Theory – Paper 1 –Part A Book of
Shantanu Prakashan with 1 Note Book of
200 pages
•Practical – Sharir Kriya Pratyakshik –
Shantanu Prakashan with 1 Note Book of
200 pages
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15. Prof. Deshande Education Style
•Always learn by heart from Minimum to
Maximum
•100 % Attendance is appreciated
•Each student from class must enthusiastically
participate in Education Process
•No problem ,if we are slow in learning process
or performance
•But Sincerity, Honesty, Hard working are most
needed Qualities
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Prof.Dr.Deshpande’s
Popular Links on Internet
•Just Start Internet on Desk top or Lap top
or on your mobile . Copy Following Link &
Paste as Web address –URL
•http://www.youtube.com/user/deshpande1
959
•http://www.slideshare.net/rajendra9a/
•http://www.mixcloud.com/jamdadey/
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Prof.Dr.Deshpande’s
Popular Links on Internet
•Just Start Internet on Desk top or Lap top
or on your mobile . Copy Following Link &
Paste as Web address –URL
•http://professordeshpande.blogspot.in
•http://professordrdeshpande.blogspot.in/
•http://www.mixcloud.com/rajendra-
deshpande
•https://soundcloud.com/professor-
deshpande
8/3/2015 Prof.Dr.R.R.Deshpande 17

18. Syllabus Paper 1 Part B Point 1
•1) Definition & mechanisms of maintenance of
homeostasis

•2) Cell physiology

•3) Membrane physiology
•
•4) Transportation of various substances across
cell membrane
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Definition & mechanisms of
maintenance of homeostasis
•Homeostasis means maintenance of
constant internal environment of the
body.
• Homeo means same & stasis means
standing.

•Homeostasis concept was explained by
Walter cannon in 1930.

20. Homeostasis
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Homeostasis
•Internal environment in the body is ECF.
• It includes blood & interstitial fluid.

•If this internal environment changes
beyond the physical limit, human body
suffers from malfunction

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Normal Range, Deviation & Sensors
•Physiological functions must be maintained
within a normal range.
• If any function deviates from the range, it must
be brought back to normal.
•Human body has sensors which recognize the
deviation & alert the integrating centre.
• This centre then sends orders to effectors for
either accelerating or inhibiting the activity to
maintain the normal range.

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Disease = Deviation from Normal Range
•Many clinical features or disease indicate
how the body functions are deviating from
the normal range.
• Eg. Fever is nothing but increased body
temperature.
•This indicates that homeostasis is
disturbed in the heat production & heat
loss in the mechanism of body

24. Temperature Regulation By
Fever
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25. Cold Shivering is
Homeostasis
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Homeostasis & different body systems
•The pH of ECF is usually 7. 4.
•This is maintained by Respiratory system,
blood, Kidney.

•Decrease in pH is acidosis

• Increase in pH is alkalosis

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Who maintains Body Temperature ?
•Normal body temperature = 37. 5 degree
Centigrade

•The skin, respiratory ,Digestive
,Excretory, Nervous systems & skeletal
muscles all together maintain the
temperature

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Homeostsis by Digestive & Respiratory System
•Digestive & circulatory system take responsibility
of providing necessary nutrients to the cells.
• Balanced of O2 & CO2 is maintain by
respiratory system.

•In addition to R. S., kidneys & other excretory
organs also help for removing metabolic waste
products ( Patho-Uraemia)

29. RBC Homeostasis
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30. Calcium level –Low – Then
Homeostasis
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Homeostasis By Hormones
•Hormones which are essential for many
metabolic processes have to be
synthesized & released in appropriate
amount.

• Kidneys, skin, salivary glands & G.I. tract
help to maintain water & electrolyte
balance.

32. Balancing Excess water
Accumulation
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Homeostasis By Skeletal muscles
•Transport of nutritive substances,
respiratory gases, metabolic & other waste
products is totally depends on normal
condition of blood cells & plasma.
•For the movement & protection, there
should be homeostasis in the activities of
skeletal muscles

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Homeostasis By ANS
•Sensory system helps to detect the state
of the body with relation to its
surroundings.
•Brain integrates the information & order
to motor system to react properly, to
maintain homeostasis.
•ANS controls all vegetative functions

35. Cycle of Homeostasis
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Components of Homeostatic system
•Homeostasis is self regulating mechanism, working in
cyclical manner. This cycle has 4 components.
•1) Sensors - for detecting deviation from normal range.

•2) Transmission of this information to a control centre
•.
•3) Orders from the control centre to the effectors

•4) Effectors, finally bring back deviation to the normal
phenomenon

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Mechanism of maintenance of homeostasis
•Effectors bring back normal physiology by
following 2 mechanisms -
•1) Inhibiting & reversing the change

•2) Supporting & accelerating the change

•Above 2 types of changes are achieved by
Feed - back signals

38. Renin Angiotensin
Mechanism
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There are 2 types of feed - back
•I) Negative feedback
•This is to arrest the change or reverse the
direction of change.
•Many homeostatic mechanisms in the body
function through negative feedback.
•Eg. When Thyroxin levels in blood increases in
hyperthyroidism, due to negative feedback there
is inhibition of the secretion of TSH from
Pituitary.

40. Negative Feed Back - Thyroid
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II) Positive feedback
•This is less common than negative feedback.
Some important examples of positive feedback
are -
•Milk ejection reflex
•Parturition reflex

•Blood clotting reflex - formation of prothrombin
activator - conversion of prothrombin in to
thrombin - conversion of fibrinogen in to fibrin.

42. Positive Feed back – Milk Ejection
Reflex
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43. Positive Feed Back –
Parturition
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Essentials of cell physiology
•Organization of cell

•Cell is the smallest structural &
functional unit of living body.

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Tissue – Organ - System
•Tissue - Group of cells having similar functions.

•Organ - is formed by 2 or more primary types of
tissues having similar function

•System - Group of organs which work together
to carry out specific functions of body.

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Structure of cell
•1) Cell membrane (plasma membrane) -
separates ECF & ICF

•2) Cytoplasm

•3) Nucleus

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Cell membrane
•Made up of proteins 55%, lipids 40%
(phospholipids & cholesterol),
carbohydrates 5%
•Structure of Cell membrane
•Recently fluid mosaic model is accepted
• In this model the proteins are found to
float in the lipid layer

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Cell membrane
•The central lipid layer is a Bilayered structure.
•This is formed by thin film of lipids.
•Major lipids are phospholipids & cholesterol.

•2 layers of phospholipids are arranged, so that
hydrophobic tail portions meet in the centre of the
membrane.
• Hydrophilic head portions of outer layer face to ECF &
those of inner layer face ICF.

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Cell membrane
•Lipid layer - Allow only fat soluble
substances like O2, CO2. But water
soluble substances like glucose, urea,
electrolyte can not pass
•
•Protein layers of the cell membrane
•Protein molecules are classified as follows
•1. Integral proteins 2. Peripheral proteins

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Functions of proteins in the cell membrane
•1. Integral protein for structural integrity
of cell membrane.

•2. Channel protein for diffusion of water
soluble substances like glucose.

•3. Carrier or transport protein - help in
active & passive transport.

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Functions of proteins in the cell membrane
•4 Receptor proteins -work as the
receptors site for hormone &
neurotransmitter
•5. Carrier proteins which act as pumps
which helps in ionic transportation.

•6. Enzyme protein controlled the
metabolic reaction in cell membrane

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Glycocalyx
•Carbohydrates of the cell membrane -
attach the protein & form Glycoprotein
• Carbohydrate molecules form very thin &
loose covering over the entire surface of
the cell membrane. (called as Glycocalyx)
• This Glycocalyx of 2 neighboring cell
helps in fixation of cells.

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Functions of cell membrane
•1) Protective
•2) Selective permeability

•3) Absoption
•4) Excreation
•
•5)Exchange of gasses Maintenance of
size & shape of cell

54. Cell Membrane
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2) Cytoplasm
•Jelly like material formed by 80% of water
which contains many organells

56. Cell Organelle
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Organells in cytoplasm
•1) Endoplasmic Reticulum (ER)
•Network of tubular & microsomal vasicular
structure which are interconnected with
one another.

•2 Types of ER
•A) Rough ER
•B) Smooth ER

58. Endoplasmic Reticulum
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A) Rough ER
•Due to attachment of granular ribosome
to its outer surface.
•Functions –
•a. Synthesis of of proteins eg. insulin
from beta cells of islets of langerhans
• b. Degradation of worn out cytoplasmic
organells like mitochondria

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B) Smooth ER / Tubular ER
•Functions
•a) Synthesis of non protein substances
like cholesterol & steroid.
•b) Part in the metabolic process of cells
because it contain many enzymes.
•c) Storage & metabolism of calcium.
•d) Catabolism & detoxification of some
drugs & carcinogens in the liver.

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2) Golgi apparatus
•Present in all cells except RBC. consist of 5 - 8
membranous sacks (cisternae )
•Function
•a) Glycoproteins & lipids are modified &
processed.
•b) Packing - Processed materials are packed in
form of secretory granules, secretory vesicle. So
another name for Golgi apparatus is post office
of the cell.

62. Golgi Apparatus
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63. Golgi Apparatus - 2
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Golgi apparatus
•To give labeling to processed & packed
materials (label such as phophate group)
• Distribution to there proper destination
according to the chemical content.

• So “Golgi apparatus is also called as
‘Shipping department of the cell’

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3) Lysosomes – formed by Golgi apparatus
•a) Degradation activity for lysosomal
enzymes
•eg. proteases hydrolyse the protein into
amino acid.
•Lipases hydrolyse the lipids in to fatty acid
& glycerides.
•So Lysosomes are called as “Garbage
system of the cell”.

66. Lysosomes
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67. Function of Lysosome
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Lysosomes
•b) Degradation of worn out organells like
mitochondria.
•c) Removal of excess secretory products in the
cells.
•d) Secretory lysosomes eg. lysosomes from
cytotoxic T lymphocyte secrete perforin which
destroy viral infected cell & tumor cells.
•Secretory lysosomes of melanocytes secrete
melanin.

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4) Peroxisomes / microbodies
•These are member limited vesicles like the
Lysosomes.
•Functions
•1. They form main site for O2 utilization
in the cell.
•2. Degrade purin to puric acid.
•3. Participate in the formation of myelin.

70. Peroxisomes
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5) Centrosome & centrioles
•Centrosome consist of 2 cylindrical
structures called as centriole.

•Centrioles are responsible for the
movement of chromosome during cell
division.

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6) Secretory vesicle
•As per requirement these vesicles are
ruptured & secretory substances release
in to the cytoplasm.

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7) Mitochondrion
•These are rod or oval shaped structure with diameter of
0.5 - 1μ.
•Functions
•Production of energy, so called as power house or
power plant of the cell.
•Synthesis of ATP - - - Whenever energy needed for
cellular activity, the ATP molecules are broken down.
•Storage of calcium & detoxification of ammonia in liver.
•Apoptosis.

74. Mitochondria
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Organelles without limiting membrane
•Ribosomes - Granular & small dot like
structures with diameter of 15 nm.

•Functions - Ribosomes are called protein
factories, because they are involved in
the synthesis of proteins.

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Cytoskeleton
•It determines the shape of cell, & gives
support to cell.

• it consist of 3 major protein components
like microtubule, intermediate filaments &
microfilaments.

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Nucleus

•This is the largest cellular organell. It’s
diameter is 10μ - 22μ. It is present in all cells
except RBCs. Nucleus is covered by nuclear
membrane.
•Contents of Nucleus are nucleoplasm,
chromatin, & nucleolus.
•Nuclear membrane is doubled layer & porous,
which allows the nucleoplasma to communicate
with the cytoplasm

78. Nucleus
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Nucleoplasm
•Highly viscous fluid

•Surrounds chromatin & nucleolus.

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Chromatin
•This is a thread like material made up of
large molecules of DNA.
•DNA is a double helix which wraps
around central core or 8 histone molecules
to form, the fundamental packing unit of
chromatin called as Nucleosome.
•Just before the cell division, the
chromatin condenses to form
chromosomes

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Chromosomes
•This is the rod shaped nuclear structure,
which carries a complete blue print of all
the hereditary characteristics.

•Each DNA contains many genes.

82. Chromosome -- 1
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83. Chromosome
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Chromosomes
•All the dividing cells, except reproductive
cells contain 23 pairs of chromosomes.
•The cells with 23 pairs of chromosomes
are called diploid cells.
•Reproductive cells or gametes contain
only 23 single chromosomes. These cells
are called Haploid cells.

85. Haploid & Diploid cells
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Nucleolus
•This is a small, round granular structure of
the nucleus.
•Each nucleus contains one or more
nucleoli.
•The nucleolus contains RNA & some
proteins

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Functions of nucleus
•Control all cell activities (Metabolism, protein
synthesis, growth, reproduction)

•Synthesis of RNA
•Sending genetic instruction to the cytoplasm, for
protein synthesis, through mRNA.
•Control of cell division through genes.
•Storage of hereditary information in genes

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DNA
•This is a double stranded complex
nucleic acid.
•Each chain of DNA molecule consists of
many nucleotides.
•Each nucleotide is formed by sugar that is
deoxyribose, phosphate, organic bases
i.e. Purins (Adenin & Guanin) &
Pyrimidines (Thymine, Cytosine)

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Chromosomes – DNA-- Gene
•DNA forms the component of
chromosomes, which carries the
hereditary information.
•The hereditary information which is
encoded in DNA is called Genome.

•Each DNA molecule is divided in to
discrete units, called as genes.

90. Chromosome – DNA - Gene
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Gene
•This is a portion of DNA molecule which
contains the code for the synthesis of
specific protein.
•Gene is consider as the Basic hereditary
unit of the cell
•Causes of Gene disorders - Genetic
variation & Genetic mutation

92. DNA & Gene
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Classification of genetic disorders
•1) Single gene disorder (Sickle cell anaemia
& Huntington’s disease)
•2) Multifactorial genetic disorders (coronary
heart disease, Alzheimer’s disease, Arthritis,
Diabetes)
•3) Chromosomal disorders (Turner’s
syndrome, dawn syndrome).
•4) Mitochondrial DNA disorders (Hereditary
optic neuropathy).

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RNA
•This is nucleic acid, similar to DNA

•But contains Ribose, instead of
Deoxyribose.

•There are 3 types of RNA.

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RNA
•1) Messenger RNA (mRNA) - carries the
genetic code of the amino acid sequence, for
synthesis of protein, from the DNA to the
cytoplasm.
•2) Transfer RNA (tRNA) - this is responsible for
decoding the genetic message present in
mRNA.
•3) Ribosomal RNA (rRNA) - this is responsible
for the assembly of protein from amino acids
in the ribosome.

96. Types of RNA
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Gene expression
•This is the process, by which the
encoded information in the gene is
converted in to document of instruction

•This is used for protein synthesis.

•This process involves 2 steps -

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Gene expression
•i) Transcription - this is copying of
genetic code from DNA to RNA.

•ii) Translation - This is process of
protein synthesis in the ribosome of the
cell, under the direction of genetic
instruction, carried by mRNA from DNA.

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Growth factors
•These are proteins, which act as cell
signaling molecules like cytokines &
hormones.
•These factors bind with specific surface
receptors of the target cell & activate
proliferation, differentiation & maturation of
these cells

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Growth factors
•The known growth factors are
•Platelet derived growth factor (PDGF),
•Colony stimulating factors (CSF),
•Nerve growth factors (NGF),
•Insulin like growth factors (IGF),
• Epidermal growth factors,
•Erythropoietin, Thrombopoeitin, myostatin
which is present in skeletal muscle.

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Cell Death
•This occurs by following 2 processes
•i) Apoptosis - this is natural or
programmed death of the cell under
genetic control.
•The purpose of Apoptosis is to remove
unwanted cell without causing any stress
or damage to the neighboring cells.

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Cell Death
•ii) Necrosis - this is the uncontrolled &
unprogrammed death of cell due to
unexpected & accidental damage
• Common causes of necrosis are injury,
infection, inflammation, infarction, cancer
• Necrosis is induced by heat, radiation,
trauma, hypoxia, exposure to toxins.

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Cell membrane physiology
•Transport of nutrients & waste
products occur through cell membrane.
• For this transport, different channels are
present in the cell membrane.
•They are as follows –
•Depending upon types of Gate, Channels
are classified

104. Plasma Membrane
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105. Cell Membrane Physiology
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Ligand gated channels
•Some channels are guarded by another
protein, which is called as Ligand,
•So Ligand will be sitting outside of the channel &
it will be keeping channel close & this Ligand will
be specific for a particular hormone, drug or
specific neurotransmitter.
•That hormone or neurotransmitter will combine
with Ligand & Ligand will open the channel &
then particular ion will be moving inside.
•eg. Na+ channels at N - M Junction

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Voltage gated channels
•Charge will acting like a door & that’s
why such channels are called as Voltage
gated channels.
•Voltage will decide which ions pass
through.
•Negatively charge will attract positively
charge ions.
•eg. Ca++ Channel on nerve membrane

108. Types of Channels
Ligand Gated Channels Voltage Gated Channels
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Functions of cell membrane
•1) Protection
•2) Electrical property
•3) Transports across membrane (Semi
permeable)
•4) Cell to cell communication
•5) Movement & phagocytosis

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Transports across cell membrane
•Passive transports
•(Down Hill Transport)
•i) Will not take energy
•ii) Will not need a carrier protein
•iii) ATPase enzyme also not require
•2 important mechanisms –
•1) Diffusion 2) Osmosis

111. Passive Transport
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1. Diffusion
•It is movement of particles under random
thermal motion

•Further divided into 3 types –
•1) Simple diffusion
•2) Facilitated diffusion
•3) Diffusion thro’ channels

113. Diffusion
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Simple diffusion
•Movements of particles from higher
concentration to lower concentration.
•
•eg. Exchange of O2 & CO2 in Alveolus &
pulmonary capillaries

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Factors affecting the simple diffusion
•Directly proportional to following factors
•Concentration Gradient
•Surface area
•Temperature
•Solubility
•Inversely proportional to following factors
•Thickness of membrane
•Size of membrane

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Facilitated diffusion
•Same as simple diffusion except it will
need a carrier protein in membrane

• Substance will be sitting on carrier protein
& will be moving from higher concentration
to lower concentration eg. Action of
Insulin.

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Diffusion through channels
•Channels are there for ions to move

• Example is -- Potassium will be moving
from inside outward.

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Osmosis
•Water is moving from lower osmolarity to
higher osmolarity called Osmosis.
•Movement of water or solvent from area of
Lower concentration of solutes to higher
concentration of solutes .(Examples of
solutes are Sodium,Potassium,Glucose
etc)
•eg. Water absorption through loop of
Henle.

119. Osmosis
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Active transports (Up - Hill transport)
•Need energy
•Need carrier protein
•Need ATPase enzyme
•Substance getting pumped against the
gradient, as it pushed against the
concentration gradient substance
required energy.

121. Active Transport
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Types of active transport
•1. Uniport - Single substance getting pumped across the
membrane, it is called uniport or primary transport. eg. -
Thyroid gland traps Iodine from our blood.

•2. Synport (Co - transport) - 2 substances pumped
simultaneously. eg. - Absorption of Glucose & Amino -
acids through the lining epithelium of small
intestine.
•3. Antiport (Counter transport) - Carrier is pumping one
substance in one direction & other on opposite direction.
eg. - NaK pump.

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Substances transported by active transport
•These substances are in ---

•Ionic form like Sodium, Potassium,
Calcium, Hydrogen

• In non-ionic form like Glucose, amino
acids & urea.

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Substances transported by active transport
•1) Primary active transport of sodium &
potassium occur by a common carrier
protein called as sodium-potassium
(Na+–K+) pump.
•This pump transports sodium from inside
to outside the cell & potassium from
outside to inside cell.
•This pump is responsible for RMPs.

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Abnormalities of this pump –
•Reduction in number or concentration of
this Na–K pump in myocardium is
associated with cardiac failure.

• Excess Reabsorption of sodium in
renal tubules, is associated with
hypertension

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2) Transport of Calcium ions
•Calcium is actively transported from inside
to outside the cell by calcium pump
•
•These pumps are presents in
sarcoplasmic reticulum in the muscle &
mitochondria of all the cells.

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3) Transport of Hydrogen ion
•This transportation occur by the carrier protein
called as hydrogen pump. Important pumps
are as follows –
•i) Hydrogen pumps in parietal cells of the
gastric glands are involved in the formation of
HCL
•4) Hydrogen pumps in epithelial cells of DCT &
CT, in the kidney are involved in the secretion
of hydrogen ions from blood into urine.

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Endocytosis & Exocytosis
•Typically seen in phagocytic cells, like
WBCs.

•Engulfing particle inside is endocytosis, &
giving out of the unwanted part is
exocytosis.

129. Endocytosis & Exocytosis
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Ionic concentration difference

131. ECF & ICF
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Ionic concentration difference
•It is one of the property of cell membrane
•Substances more in ECF - Na+, Cl-,
HCO3 - -, Ca+
•Substances more in ICF - K+, mg++, H+,
PO4 -
•pH - ICF relatively acidic as H+ more in
ICF.

133. Prof.Dr.R.R.Deshpande
•Sharing of Knowledge

•FOR

•Propagating Ayurved
8/3/2015 133 Prof.Dr.R.R.Deshpande