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Once the leaves have been selected, they are placed in large, airtight containers known as fermentation tanks. These tanks are carefully controlled to ensure the optimal conditions for the fermentation process, including the right temperature, humidity, and oxygen levels

More recent work supports this hypothesis, with Shah [69] demonstrating albuminuria and abnormal renal function in tobacco chewers and Gupta et al.[70] indicating that chewers had systolic and diastolic blood pressures, resting heart rates, total cholesterol, LDL cholesterol and triglycerides comparable to smokers

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