Getting to Know Portions

Cornerstone Family Healthcare’s Nutritionist: Barbara Moschitta, MPS, RD, CDN

Our eyes are bigger than our stomach and the concept of portions are changing. The traditional plate and cup sizes have increased over the years. The availability of supersized portions, and “suggested” serving size on product labels make it difficult for us to understand what the real recommend serving sizes are. We are also unaware of what a true portion is. Brian Wansink, PhD, nutrition professor, food psychologist and author of “Mindless Eating,” sheds light on our food behaviors and how food marketing has deceived us and he also explains “why we eat more than we think.” I often suggest to patients that if it is larger than the palm of your hand it is more than one portion. Measuring utensils are useful and give us more exact information of what a standard portion size is.

You can also purchase portion size plates with dividers, or purchase a lean frozen entrée, and afterwards using the container for portioning. In many cases starchy foods like potatoes, corn, rice and pasta go by standard 1/3-1/2 cup portions cooked. Nuts and seeds are a mere ¼ cup, and cheese three dice cubes or two tablespoons. Juice is four ounces. When I show patients what this looks likes, it is no wonder why we have so much obesity in our country, as the standard juice bottle drink is 15-20 ounces, and suggested serving size on bottle states “1 bottle” which is really 5x the standard portion translating to 5x the calories at 240 kcal vs. 48 calories! An option for reducing portions of starch is using open face sandwiches, lettuce wraps, or “thin” flat versions of your favorite bagel, bread, or wrap while checking grams of carbohydrates; one serving is 15 grams, a slice of pizza depending on size can equal three servings, where a bagel is equal to six slices of bread!

These basic tips are helpful, but often we are pressed for time, so try your best to plan what’s on your plate with these simple rules:

  • ½ plate of non-starchy vegetables/greens
  • ¼ plate starch or grain
  • ¼ plate protein

For more information on how to portion for a healthier diet or to make an appointment with our nutritionist, please visit or call (845) 563-8000.

You can also check out these resources:

  • ChooseMyPlate.Gov
  • •

You can also check out these books :

  • The Portion Teller-Dr. Lisa Young
  • Mindless Eating –Btian Wansink PhD.
  • Volumetrics –Barbara Rolls PhD.

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Skin, Sun, and Sunscreen









Tracy Lucas, FNP,  Chief of Ambulatory Pediatrics, Cornerstone Family Healthcare

As the weather becomes warmer and the sun gets a little bit stronger it is important to remember sunscreen. In observance of Skin Cancer Detection and Prevention Awareness Month, we recognize how sunburn effects an abundance of people; some worse than others. Cornerstone Family Healthcare’s Chief of Ambulatory Pediatrics, Tracy Lucas, FNP helped us to understand the best way to protect your children and yourself from sunburn this summer by answering some frequently asked questions.

Who needs sunscreen?

Everyone needs sunscreen, including those with darkly pigmented skin. Even though skin may be darker, it does not preclude the risk of skin cancer which may be in their genetic makeup.

How do you determine the right sunscreen to use?

SPF 30 is generally recommended or SPF 50 if you will be outside for long periods of time.

When should sunscreen be used?

Anytime you are outside, including cloudy days. The sun is strongest between the hours of 10am and 4pm.

How much do we need to use and how often should it be applied?

One ounce every two hours should be used; especially when in the water.

How do you apply sunscreen effectively?

Cover all areas that are exposed, use adequate amounts to cover skin.

Broad-spectrum sunscreens protect against both UVA and UVB rays. What is the difference between the rays?

UVB rays peak at mid-day, while UVA rays last all day long.

Is a high-number SPF better than a low-number one?

Yes a high-number SPF is better. SPF 15 or higher to achieve adequate protection and 30 or higher is recommended for extended time spent outside.

How do you protect a baby or toddler from the sun?

Newborns to six months of age should be kept out of the sun. Babies six months or older can use sunscreen. It is best to keep babies in the shade with a wide brim hat, long sleeves and long pants. Any exposed skin should have sunscreen applied. Sunglasses with UV protection that are sized for the little one are also a good idea. It is also helpful to have sun shades in the car windows on car trips.

Can I use the sunscreen I bought last summer, or do I need to purchase a new bottle each year? Does it lose its strength?

Sunscreen generally has an expiration date and is good for about 3 years.

Will using sunscreen limit the amount of vitamin D we get?

No. Once your body has completed making an adequate amount the mechanism shuts down.

How do you treat sunburn?

Mild sunburn can be treated with cool compresses, NSAID medication such as Ibuprofen, moisturizing lotion or aloe and drinking plenty of fluids. Any sunburn in a baby under a year old is a medical emergency.

How do you know if your sunburn is worth an urgent medical visit?

Blisters, fever, pain, not feeling well all indicate medical attention is necessary.

How much sunburn can result in skin cancer?

Any sunburn!

If you would like more information on how to protect your children and yourself from sunburn please call Cornerstone Family Healthcare at (845) 563-8000 or visit us at to make an appointment today!

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Every Kid Healthy Week









Adeola Ayodeji, MD, FAAP

Every Kid Healthy Week was created to celebrate school health and wellness achievements. Observed the last week of April each year, this special week shines a spotlight on the great efforts school partners are doing to improve the health and wellness of their students and the link between nutrition, physical activity and learning. Everyone in the country can get involved and be a part of the celebration to help support sound nutrition, regular physical activity and health programs in schools.

At Cornerstone Family Healthcare, our pediatrics department is constantly working to improve the health of children in the communities we serve. Dr. Adeola Ayodeji, MD, FAAP a pediatrician at Cornerstone explained some important ways to help kids stay healthy while in school since they spend a large portion of their time in the classroom!

A nutritious lunch is a major factor in staying healthy in school. Students need to have healthier options for food and remove choices that are unhealthy. If a packed lunch is given to a child, the My Plate model of nutrition is a great example of what to include in your child’s lunch box.

Some things to include rather than sweets and snacks could be:

  • Pre-cut veggies in a clear container
  • 6-8 ounces of 100% fruit juice
  • Lots of water
  • Apple sauce
  • Fresh Fruit
  • Deli meat roll-ups
  • Crackers and Hummus

Vegetables and fruits rather than snack foods are easy to include in lunch because they can be prepared beforehand and stored in the refrigerator.

Younger children tend to get multiple snack times during the school day. This is a great time for those pre-cut veggies and fruits! And don’t forget lots of water.

For older kids, unless there is a medical condition, there is no need for multiple snacks a day. Have a good breakfast and a good lunch. Even if students have a later lunch, eating breakfast should help with hunger cravings throughout the day. Foods given to older kids should be limited on saturated fats and sugars. High cholesterol can also be an issue in older kids because of their diet. It is encouraged for kids to learn how to check out food labels and be conscious of what they are consuming.

Another important factor in staying healthy in school is making sure kids get enough exercise. It is recommended for kids six years old and under to get at least 60 minutes each day of active play. With more vigorous activity at least three days per week.

Younger children get recess time most days as well as participating in gym class, but older children tend to avoid gym or physical activity in general.

It is crucial that kids are actually participating in gym no matter how old they are in school.

Middle school kids are tough when it comes to participating in physical activities. Girls in gym class commonly stand off to the side and not participate, while young men will be much more active.

If you would like more information on ways to help your child stay active in their daily activities or would like to make an appointment to visit with one of Cornerstone’s pediatricians visit our website at or call at (845) 563-8000.

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Poison Ivy: “Leaves of Three, Let them Be”





Kate Michalak, L.Ac., PA-C, Cornerstone Family Healthcare

What is Poison Ivy?

It is a rash comes from the oil of certain plants.  The oil is called urushiol.  The rash is itchy and can spread to wherever the oil touches.  The rash tends to be patchy or linear, raised and fluid filled, and very itchy.

Is it contagious?

The rash is not contagious, however the oil is present on and object and that object touch the skin the rash and break out.  An example is if the oil get on a pair of gardening gloves any area of skin that those gloves touch, may break out in the rash.

How do I avoid getting it?

The best way to avoid getting the rash is to know what the plant looks like, and remember the rhyme “Leaves of three, let them be.”


If you see any of these in your yard, garden, or play area avoid them.  If possible cover all skin with clothing and gloves and remove plants, then wash clothing in hot water to dissolve the oils.  If you think you came into contact with the plants or oils, shower in hot/warm water with soap, and wash all clothing hot water.  This will dissolve the oil and prevent it from spreading.  There are some commercial preparations that are available over the counter  for washing, such as Technu.

Is it serious?

The rash for poison ivy is general not serious just uncomfortable and last 2-3 weeks.  It can be more serious if it is on the face and around the mouth and eyes.  Some individuals that are highly allergic may have swelling.  If there is any swelling of mouth or tongue, or if any shortness of breath it is import to seek medical care immediately.  It is also possible to develop an infection due to breaks in the skin.  If there is any signs of increasing redness, pain, warmth to area seek medical attention.

How is it treated?

The rash is treated differently based on severity and location.  Treatments range from topical steroid creams, to oral antihistamines and steroids.  The treatments don’t lessen the duration of the rash, but they do help lessen itching and discomfort.

If you are concerned about symptoms of the rash, please contact your doctor. You can also visit our Urgent Care. A list of our hours are listed here:

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Oral Cancer Awareness Month

Tiana Osbourne, DDS, Cornerstone Family Healthcare


Can you imagine life without your tongue or the ability to taste and chew your favorite foods?  This could be a potential reality of surviving aggressive oral cancer treatment.

Each year about 50,000 people are diagnosed with oral cancer. Oral cancer accounts for four percent of all cancers, but has a higher death rate than more common cancers like thyroid, endocrine or cervical. Not because it is a more aggressive than the rest; many times it is not diagnosed until its later stages.

What is oral cancer?

Oral cancer refers to any cancer that appears on any part of the mouth, including the lips, gums, tongue, floor and roof of the mouth.

What are signs and symptoms of oral cancer?

  • Red or white patches that do not go away
  • Swelling around the jaw
  • Painful or loose teeth
  • Bleeding or numbness in the mouth
  • Pain or tenderness in the lips or mouth
  • Difficulty chewing, swallowing, and moving your tongue or jaw

What are the risk factors for oral cancer?

People who heavily smoke or chew tobacco, drink alcohol and are over the age of 50 are at an increased risk for developing oral cancer. About 75 percent of head and neck cancers are caused by smoking tobacco and consuming alcohol. Men are twice as likely to develop oral cancer as women. In non-smoking patients, the HPV version 16 virus is a sexually transmitted disease that increases the risk of oral cancer. People with weak immune systems and infectious diseases are also more at risk development of oral cancer.

How is it treated?

Most cases of oral cancer are curable! The earlier the diagnosis, the easier it will be to treat.  Many times oral cancer is treated with a combination of therapies such as surgery, targeted drug therapy, chemotherapy and radiation.  Patients who are treated early for cancer reduce their chances of post-operative disfigurement, while those whose cancer is caught at a later stage, surgical removal of the lymph nodes, jawbone or tongue may be necessary. So don’t delay, get you oral cancer screening completed today!

How do I get screened for oral cancer?

Dental Professionals are trained to look for common signs and symptoms of oral cancer.  In a typical exam, we check for abnormalities and enlarged lymph nodes in your head, neck and mouth. The best way to improve your chances of diagnosing oral cancer in its early stages is to be seen for routine dental treatments. Stop by one of Cornerstone Family Healthcare’s dental offices, where an oral cancer screening will be completed as part of your routine comprehensive oral exam.

Visit our website at or call (845) 563-8000 to make an appointment today!

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National Autism Awareness Month

Cornerstone Family Healthcare Pediatrician, Dr. Alicia Pointer, DO

As we observe April as National Autism Awareness Month, one of Cornerstone’s pediatricians, Dr. Pointer, answered some frequently asked questions about the disorder and how to help your child if you suspect signs or symptoms.

What is autism?

Autism, or autism spectrum disorder, is a condition that affects children’s social skills, communication and behavior. It is made up of a spectrum of symptoms meaning that some children are affected differently than others. For example, some children with autism may have normal language development while others may rarely speak.

What are the symptoms of autism?

Many children with autism have normal motor skills and growth. Initially, they may seem to have typical development. Some early signs of autism include:

  • Speech or language delay
  • Loss of milestones
  • Does not respond to her name
  • Does not look at things that parent is looking at
  • Does not try to get parent to look at things that are interesting to him
  • Does not point
  • Difficulty making friends or interacting with other children
  • Overly sensitive to sounds, smells or touch
  • Does not do imaginative or pretend play
  • Frequent repetitive movements such as rocking or hand flapping
  •  Trouble understanding others’ facial expressions or feelings
  • Poor eye contact or too much eye contact

How is autism diagnosed?

There is no single test for autism. Autism cannot be diagnosed with a blood test or brain scan. A pediatrician, developmental specialist, neurologist or psychiatrist can diagnose autism by talking to you and your child and observing your child in the office. There are some developmental tests and screening tools that can help diagnose autism or rule out other diagnoses. Your child’s pediatrician will likely do an autism screening called the MCHAT at 18 months and 2 years old.

How is autism treated?

There is no single treatment or medicine for autism. Instead, the treatment of autism involves addressing a child’s individual challenges. There are several interventions that may help children with autism improve their language, social and self-care skills. Early Intervention is a program for children up to age 3 who have developmental delays. It provides in-home services such as speech therapy, occupational therapy or physical therapy based on a child’s needs. There are other specific therapies such as Applied Behavioral Analysis (or ABA) that help children improve the way they interact with other people. The local school system may provide services for school-age children.

What should I do if I am worried about my child’s development?

Trust your instincts and talk to your pediatrician. Children develop at different paces so a child may seem delayed compared to some peers but still be meeting milestones for her age. Also, some behaviors, such as head banging when frustrated or hand flapping when excited, are commonly seen in typically developing children who do not have autism. The earlier you talk to your pediatrician, the sooner your child can get the intervention and support that he needs.

Where can I find more information?

The following websites have helpful information about autism that is written for parents by experts:

CDC-Learn the Signs. Act Early.


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Finding Hope Through Health Education

Annia Reyes, Health Education Coordinator

Imagine you are an individual who lives without a car in an area with limited public transportation and work a minimum wage job that does not offer health insurance benefits. After 10 years of not going to see a doctor because it was not in the budget, you go to the doctor and get diagnosed as pre-diabetic. This means that you are on the path of becoming diabetic, if you do not change your habits to live a healthier lifestyle.

This brings up questions such as: how are you going to obtain fresh fruits and vegetables without a car? How are you going to pay for regular doctor visits to keep an eye on your health without health insurance? Working a minimum wage job will not provide enough money to keep your home and make healthy meals every night, especially without the knowledge of understanding how to give your body exactly what it needs. Where do you begin in managing your health?

Communities served by health centers are in areas where access to healthcare is limited. These communities suffer from a host of obstacles, known as health disparities, which impact individuals’ health and life in general. Healthcare disparities refer to differences in access to or availability of facilities and services.

Patient education is the process by which health professionals and others impart information to patients and their caregivers that will alter their health behaviors or improve their health status. At Cornerstone Family Healthcare, health educators host several programs that offer opportunities to teach patients with chronic diseases how to develop healthier daily routines and control their conditions. Some of the programs offered aside from one-on-one sessions include:

  • Living Well with Diabetes
  • Tobacco Cessation
  • Healthy Heart
  • Managing Your Health (Chronic Disease Self-Management)
  • Free Farm Stand
  • And more…

In health education programs, patients often walk in feeling overwhelmed with whatever is going on in their life and when they leave they feel empowered to conquer the obstacles they are facing.

There can be an overwhelming sense of defeat and a “why is this happening to me” attitude when a patient is first diagnosed with a chronic condition. As the participants talk to one another in the health education programs, they realize that there are many people who are going through the same thing and there are people out there who want to help; patients have constant support from providers, peers, and staff.

Mary Macdonald has been with Cornerstone for over 25 years participating in the Living Well with Diabetes and Managing Your Health education programs. “I don’t know what I would do without these classes,” said Macdonald. “They gave me the zest to fight my illness, taught me how to manage my health, and gave me an outlet to be around people going through the same thing.”

What many people do not understand is how they can benefit from participating in these programs. The information presented not only includes education about how to change your lifestyle habits, but it also includes an array of other benefits. It is not a room where people sit and get lectured on a regular basis because it is an interactive session. These programs include real people who share their difficulties in life, and in return they make relationships with one another, build trust, and find a place that is safe to open up about their feelings. At the programs, participants also receive free fruits and vegetables to take home.

Macdonald met her best friend in Cornerstone’s Living Well with Diabetes health education course. The two have built a special bond through spending time together in the 12-week course. They practice the recipes learned in class and find constant support in one another to get through their struggles.

Research shows that people are more likely to implement a change in their behavior if they talk about it in a group. Not only do the programs change behavior, but it also changes patients’ perspective about their situation. Often times, when many participants graduate from the program they are empowered to give back to their community by volunteering to help people who are in similar situations to theirs.

MacDonald is a regular volunteer at Cornerstone’s free farm stand held at the Newburgh Armory. Not only does she enjoy the vegetables she receives there, but she also enjoys seeing her friends from the programs and helping her community all at the same time.

Health educators begin to learn about the patients and begin to understand them and their needs a little bit better every time they see one another. Health educators are able to connect patients in their programs to other resources in the community, and services such as Care Coordination at Cornerstone Family Healthcare. Care Coordination is a free program that focuses on your specific needs as a patient and makes managing your health a lot easier.  Care Coordination services help patients to overcome obstacles that contribute to health disparities, such as lack of housing, transportation or connection to childcare, which can get in the way of achieving good health.  A few examples of services they provide include:

  • Helping patients set and reach health goals
  • Make and confirm doctor appointments
  • Secure transportation to and from the appointment
  • Monitor prescriptions
  • Coordinate lab testing
  • Linking patients to resources like housing, education, employment, and support groups

Partnering with Care Coordination and other area resources, Cornerstone’s Health Education Department assists patients on a much deeper level than education alone. One of the main goals of health education is to be a dynamic part of the integration of what it means to be healthy and to work with other departments to overcome the health disparities many people face in low socio-economic communities.

Macdonald came into class thinking that diabetes was a death sentence because of family history with the disease. “Cornerstone saved my life,” said Macdonald. “They really saved my life.”

Cornerstone Family Healthcare, Crystal Run Health Care, RECAP, and St. Luke’s Cornwall Hospital will be hosting a conference “Health Follows Wealth?” on April 7, 2017 to discuss the link between poverty and health outcomes. It is imperative to understand how one’s health is the nucleus that affects all other areas of life of a productive life. The goal of this discussion is to increase access to high-quality care, reduce barriers to receiving care, and ensure that all people are heard. For more information on the event please email

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Sound the Alarm: National Diabetes Alert Day

Held March 28, 2017, American Diabetes Association Alert Day is a day to sound the alarm about the prevalence of type 2 diabetes in American adults. An estimated 86 million Americans have prediabetes, and 90 percent of them don’t know they have it. Prediabetes can lead to type 2 diabetes and its many serious complications. It’s crucial for people to know their risk because prediabetes can be reversed with healthy food choices, weight loss, exercise, other lifestyle changes and medication.

Each year on the last Tuesday of March, American Diabetes Association Alert Day encourages everyone to take the Type 2 Diabetes Risk Test and participate in workplace-friendly activities that will teach them about reversing the risk for diabetes.

Cornerstone Family Healthcare hosts a weekly 12-week diabetes self-management program called Living Well with Diabetes to educate and assist patients with managing their diabetes, symptoms, and to help in keeping track of health goals. The ultimate goal of this program is to get diabetic patients to a point in their life where it is much easier for them to manage their condition on their own with confidence.

During the weekly sessions, the program works with patients with the following:

  • Check in with a health care provider and nutritionist
  • Peer support
  • Check in on self-management goals
  • Exercise such as Zumba, chair yoga, walking, tai chi
  • Stress reduction guided exercise
  • Healthy snacks
  • Free fruits and vegetables
  • Health related information to help participants stay on track with their goals and better manage diabetes or prediabetes
  • Assistance with making appointments to medical care

Living Well with Diabetes also hosts guest speakers such as Cornerstone’s Optometrist, the Cornell Cooperative Extension, and Shoprite’s Registered Dietitian for a grocery store tour.

Eligible participants may receive:

Upon completion of the program, participants receive a Certificate of Achievement on Personal Diabetes Management.

The next session of the program will begin in May 2017. Please call (845) 563-8043 or visit for more information!

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Spring is near! Do you suffer from allergies?






Monica Francis, PA

Runny nose. Itchy watery eyes. Sneezing, sneezing, and more sneezing. It doesn’t have to be this way though. There are ways to manage the health of yourself and your family for allergy season.

Common seasonal allergies are the body’s allergic response to an outside allergen. Grass, pollen and mold are the most common triggers of seasonal allergies. Spring allergies begin in February and last until the early summer.

Climate conditions such as humidity, wind, and rainfall can affect different allergen levels.

Allergies are usually self-diagnosable. Symptoms include sneezing, runny nose, red, watery, and itchy eyes. People may also experience pain in the ear, nasal congestion, loss of smell, redness, runny nose, post-nasal drip, sneezing, or stuffy nose. The eyes may become itchy, puffy, red, or watery. It is also common to start breathing through the mouth or wheezing, coughing, fatigue, headache, itching, phlegm, or throat irritation.

There are more than 3 million cases per year in the United States of seasonal allergies. They can be treated with common over-the-counter antihistamines. Self-care includes avoiding allergens and nasal washing with saline water/spray. Severe allergies may require consulting with your doctor and possibly skin testing to find out about specific allergens and how to better treat them.

Medical treatments include prescription antihistamine decongestants and in some cases a procedure called desensitization which reduces allergic reactions by gradually increasing doses of the substance causing the reaction by injection. Consult with your primary care physician who may refer you to an allergy and immunology doctor, pulmonologist or otolaryngologist for further evaluation and treatment.

You may also call Cornerstone Family Healthcare at (845) 563-8000 or visit for more information.

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A Balanced Bite for Spring

Registered Dietician Barbara Moschitta, MPS, RD, CDN 

Spring is less than two weeks away, so get your kitchen ready with some healthy, vibrant meal ideas!


Grilled Salmon Fillets, Asparagus and Onions






Nutrients per Serving:

  • 255 Calories
  • 8g Total Fat
  • 1g Saturated Fat
  • 35g Protein
  • 8g Carbohydrates
  • 86mg Cholesterol
  • 2g Dietary Fiber
  • 483mg Sodium

Dietary Exchange: 1 Vegetable and 4 Meat

Makes 6 servings


  • ½ teaspoon paprika
  • 6 salmon fillets (6-8 ounces each)
  • 1/3 cup bottled honey-Dijon marinade or barbecue sauce
  • 1 bunch (about 1 pound) fresh asparagus spears, ends trimmed
  • 1 large red or sweet onion, cut into ¼-inch slices
  • 1 tablespoon olive oil
  • Salt and black pepper


  1. Prepare grill for direct cooking. Sprinkle paprika over salmon fillets. Brush marinade over salmon; let stand at room temperature 15 minutes.
  2. Brush asparagus and onion slices with olive oil; season to taste with salt and pepper.
  3. Place salmon, skin side down, in center of grill rack. Place asparagus and onion slices around salmon. Grill, uncovered, 5 minutes. Turn salmon and vegetables. Grill 5 to 6 minutes more or until salmon flakes when tested with fork and vegetables are crisp-tender. Separate onion slices into rings; serve over asparagus.


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  • Blog Authors

  • Providers involved include:

    Monica Francis, PA

    Avi Silber, MD, FAAP
    Tracy Lucas, FNP
    Adeola Ayodeji, MD, FAAP

    Chanchal Singh, MD
    Sneha Shrivastava, MD
    Penelope Guccione, FNP

    Julie A. O’Connor, CM, LM, MS
    Marian Seliquini, CM, LM, MS

    Koreen E. Thomas, FNP
    Andrea Giovinazzo, FNP-C

    Kate Michalak L.Ac., RPAC

    Alban Burke, DDS

    Neha Dada, O.D.

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