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The Sanskrit word ‘Prakriti’ denotes "nature". It’s the "natural tendency" of a person's constitution. [[Ayurveda]] system defined ‘deha prakriti’ as the somatic constitution (Code:VA-2888).<ref>National AYUSH Morbidity and Standardized Terminologies Electronic Portal by Ministry of AYUSH Available on http://namstp.ayush.gov.in/#/Ayurveda</ref> It makes each person unique in terms of anatomical, physiological, and psychological characteristics. It is determined not just by an individual's genetic composition received from parents. But additional elements(epigenetic factors) also play significant role. These factors are dietary and lifestyle habits of the mother during pregnancy (matuaahara-vihara), time scale(kala), health status of uterus(garbhashaya), and basic elements(mahabhutavikara).
The Sanskrit word ‘Prakriti’ denotes "nature". It’s the "natural tendency" of a person's constitution. [[Ayurveda]] system defined ‘deha prakriti’ as the somatic constitution (Code:VA-2888).<ref>National AYUSH Morbidity and Standardized Terminologies Electronic Portal by Ministry of AYUSH Available on http://namstp.ayush.gov.in/#/Ayurveda</ref> It makes each person unique in terms of anatomical, physiological, and psychological characteristics. It is determined not just by an individual's genetic composition received from parents. But additional elements(epigenetic factors) also play significant role. These factors are dietary and lifestyle habits of the mother during pregnancy (matuaahara-vihara), time scale(kala), health status of uterus(garbhashaya), and basic elements(mahabhutavikara).
In [[Ayurveda]], people are classified based on the presence of three elements known as "[[dosha]]." These are biological, functional units that help to understand both normalcy (prakriti) and abnormalities (vikriti) in an individual. The three [[dosha]] are [[vata]], the source of kinetic or movements; [[pitta]] represents the body's metabolism and transformation; and [[kapha]] as a source of potential energy represents the body's growth and maintenance.<ref name=Prasher>Prasher B, Aggarwal S, Mandal AK, Sethi TP, Deshmukh SR, Purohit SG, Sengupta S, Khanna S, et al. Whole genome expression and biochemical correlates of extreme constitutional types defined in Ayurveda. J. Transl. Med.2008:6. 1–12. </ref> These physiological principles are closely related to the phenotype of an individual. This article describes the concept and practical utility of deha prakriti (somatic constitution) in healthcare.
In [[Ayurveda]], people are classified based on the presence of three elements known as "[[dosha]]." These are biological, functional units that help to understand both normalcy (prakriti) and abnormalities (vikriti) in an individual. The three [[dosha]] are [[vata]], the source of kinetic or movements; [[pitta]] represents the body's metabolism and transformation; and [[kapha]] as a source of potential energy represents the body's growth and maintenance.<ref name=Prasher>Prasher B, Aggarwal S, Mandal AK, Sethi TP, Deshmukh SR, Purohit SG, Sengupta S, Khanna S, et al. Whole genome expression and biochemical correlates of extreme constitutional types defined in Ayurveda. J. Transl. Med.2008:6. 1–12.</ref> These physiological principles are closely related to the phenotype of an individual. This article describes the concept and practical utility of deha prakriti (somatic constitution) in healthcare.
{{Infobox
{{Infobox
'''05.Sama doshaja prakriti:''' Prakriti is sama when the three [[dosha]] are in proportion to each other. These individuals are healthy and continue to be so.
'''05.Sama doshaja prakriti:''' Prakriti is sama when the three [[dosha]] are in proportion to each other. These individuals are healthy and continue to be so.
===Bhautika prakriti===
The five essential elements [[Akasha]], [[Vayu]], [[Agni]], [[Aap]], and [[Prithvi]] make up the human body, as well as three basic principles known as the tri[[dosha]]. The body air principle known as [[vata]] is manifested from the [[Akasha]] and [[Vayu]] components. This principle is referred to as [[vata dosha]] in Sanskrit. The [[Agni]] and [[Aap]] elements come together in the body to form [[pitta dosha]]. The [[Prithvi]] and [[Aap]] components manifest as [[kapha]]. There are "five" varieties of prakriti based on the predominance of these panchabhautik components. Vayavya, Jaliya, and Aagneya prakriti have characteristics that are similar to [[Vata]], [[Kapha]], and [[Pitta]] dominant prakriti, respectively. The stature of a person with a parthiva constitution is large, and he or she is firm, powerful, and muscular. The nabhasa constitution is characterized by piousness, longevity, and huge aural cavities. [Su.Sa.Sharira Sthana 4/79]<ref name=Susruta/>
===Prakriti classification as per era===
Prakriti was categorized by Kashyapa based on time (kala). An individual's personality concerning his birth in a typical century or yuga. Kala is classified into two types: auspicious (shubha) and inauspicious(ashubha).
Figure 01: Kala and its subtype classification.
[[File:Kala_and_its_subtype_classification.png|500px|'''Image 1: Kala and its subtype classification'''|thumb]]
Prakriti is classified as follows:
*Prakriti of a person born in the Adiyuga, Devayuga is unknown because it is not mentioned anywhere.
*A person born in the Kritayuga has Narayana prakriti.
*A Tretayuga person's prakriti is of the Ardhanarayana type.
*A person born in the Dwaparayuga has a Kaisika prakriti.
*A person born in the Kaliyuga has PradnaptiPishitaprakriti.[Ka.Sa.Sharirasthana 1/2]<ref name=Kashyapa> Kashyapa. Kashyapa Samhita. Edited by P. V. Tewari. Reprint. Varanasi: Chaukhambha vishvabharati;2008.</ref>
The description shows presence of physical and mental superpowers in initial yugas. These attributes declined in consecutive yugas. This led to an increase in disease incidence and a shorter life span. The person of kaliyuga is a human being today. Research in this aspect of prakriti is required to establish facts.
==Formation of prakriti==
Prakriti is formed by [[dosha]] dominance at the time of the gamete union. [Cha.Sa.[[Vimana sthana]] 8/95] It is an individual's basic constitution, which is determined from the time of conception and remains constant throughout life.[Su.Sa. Sharirasthana 4/78]<ref name=Susruta/>
'''Determining factors of prakriti:'''
Individuals from all ethnic groups are classified as belonging to one of the seven types of prakriti. It is influenced by genetic and environmental variables. Many other variables influence an individual's prakriti at the time of birth.[Cha. Sa. [[Vimana Sthana]] 8/95]
#Shukra-shonitaprakriti (sperm and ovum)
#Kala-prakriti is a type of kala-prakriti (time of conception or season)
#Garbhashayaprakriti (health status of uterus)
#Maturahar-viharprakriti (diet and lifestyle habits of mother) [Bh. Sa. Vimana sthana 4/12-15]
#Panchamahabhutavikaraprakriti
Prakriti is derived by both genetic (sperm and ovum) and epigenetic (uterus state, period of conception, availability of food, and mother's behaviors) variables throughout its formation.
'''Factor influencing the prakriti:'''
Some factor sare recognized as influencing or regulation factors of prakriti. [Cha. Sa. [[Indriya sthana]] 1/5]
#Jatiprasakta (Race/caste/ Occupation): Caste/ Occupation have significant effect in shaping a man's fundamental constitution and personality.
#Kulaprasakta (family/ancestry): The temperament of a family's progeny is always influenced by the family's character and conduct.
#Desha-anupatini (geo-climatic factors): The habitat based on geo-climatic regions is categorized into three parts: anupa (marshy region), sadharana (normal region), and jangala (arid region). [Cha. Sa. [[Kalpa sthana]] 1/8] The majority of people living in an ecosystem have their prakriti aligned with the ecosystem's prakriti. As a result of the similar nature of prakriti, it is logical to conclude that persons living in marshy region are more likely to have [[Vata]]-[[Kapha]] [[dosha]] dominant prakriti.
#Kala-anupatini (time scale): Season (ritu) and time (time of conception) influence an individual's prakriti.
#Vaya-anupatini (age): The [[dosha]] dominance in individual's physiology is influenced by age. The dominance of [[dosha]] in each age group like – [[kapha]] in childhood, [[pitta]] in middle age, and [[vata]] in old age- are delineated. Age denotes the changeability of body constitution through time in terms of quantitative change.
#Pratyatmaniyata (individuality): Though the offspring's genomic constitution is established by the material of both parents' genomic constitutions, the offspring's genomic constitution is ultimately decided by gene splicing during meiosis 1 during fertilization. It gives babies a genome that is completely different from both parents.<ref name=miko>Miko, I. (2008) Mitosis, meiosis, and inheritance. Nature Education 1(1):206.</ref> Individuality (pratyatmaniyata) is the variance that is unique in each person. It is the unique permutation and combination of [[panchamahabhuta]]. This may be inferred to be governed by Daiva (destiny) or purvajanmakrita samskara (past life deeds).
'''Un-changeable nature'''
When any of the formative components is disrupted by inner and outside environmental variables, then prakriti spontaneously responds in the form of transient changes in the intensity of phenotypic expressions associated with [[vata]], [[pitta]] or [[kapha dosha]]. The [[dosha]] balance is influenced by changes in the environment including diurnal & seasonal variations. This change is in the intensity (quantitative) of expression rather than a change in the nature of expression (qualitative). However, a dynamic equilibrium of its constituent [[dosha]] is always maintained. [[Dosha]] predominant features in the particular time of day, night and season are also observed in the person irrespective of the prakriti. But it doesn’t mean the prakriti of the person is changed. This is merely a transitory change in the periphery of the prakriti. Prakriti's core does not alter. Death is indicated by a change in prakriti's core.[Su.Sa.Sharira Sthana 4/77]
[[File:Prakruti_perifery_and_core.png|500px|'''Image 1: Samprapti of Kasa'''|thumb]]
Figure 02: Prakriti Periphery and Core.
'''Non-harmful nature:'''
The dominance of [[dosha]] in determination of prakriti is normal. The [[dosha]] predominance of prakriti represented by specific qualities is never destructive to the own trait in any manner, but rather stands out as a distinct, recognizable quality of that person. But this predominance of [[dosha]] is always susceptible to abnormalities (vikriti) of corresponding [[dosha]]. The diet and lifestyle provoking similar [[dosha]] as that in prakriti makes the person susceptible to diseases of that [[dosha]]. Therefore, the prakriti having single [[dosha]] dominance (vataladya) is always prone to diseases. The inherent [[dosha]] dominance in prakriti up to a certain limit is not harmful. Just like the inherent toxin in animals is not harmful to the creature itself.[Su.Sa. Sharira sthana 4/78]<ref name=Susruta/> [A. Hr. Sutra sthana 1/9]<ref name=Hridaya/>
'''Characteristic features of [[dosha]] specific prakriti'''
There are seven different types of somatic constitutions. The following table lists the characteristics of [[vata]], [[pitta]], and [[kapha]] dominating prakriti as well as their [[guna]] (property).
{| class="wikitable"
|+ Table 1: Characteristics features of [[vata]], [[pitta]], and [[kapha]] predominance prakriti.
|-
! S.No !! [[Dosha]] predominance !! [[Guna]] (property) !! Characteristics
|-
| | 01 || Vata (Code: VA-2889) || Ruksha (dry or ununctuous) || Dryness or ununctousness, thin built, short stature.
Unclear, unpleasant, feeble, stammering, broken, and hoarse voice,
Easily awakening or keeping awake
|-
| | || || Laghu(light) ||Thin, light weight built and fast gait,
Quick action,
Fast eating habits,
Fast spoken.
|-
| | || || Chala(mobile) || Unstable or highly flexible joints.
Unsteady gaze.
Unsteady eyebrows, jaws, lips, tongue, head, shoulder, hands, and legs.
|-
| | || || Bahu(abundance) ||Talkativeness,
Prominent tendons and veins
|-
| | || || Sheeghra(swift) || Quick initiation of actions,
Quickly gets agitated,
Less tolerance, less power and get frightened easily. quick comprehension and less memory.
|-
| | || || Sheeta(cold) || Intolerance to cold,
Always feeling coldness/shivering/stiffness.
|-
| | || || Parusha(rough)|| Rough hair, nails, teeth, face, hands, and legs.
|-
| | || || Vishada(non slime)|| Easy cracks or less integrity in body structures,
Crackling sound during movements
|-
| | 02 || Pitta(Code: VA-2890) || Ushna(hot)|| Intolerance to heat.
The tendency for frequent ulceration of the mouth, Redness of the face.
Delicate body.
Presence of moles, pimples, freckles, and marks.
The early presence of wrinkles.
Premature greying and baldness.
Excessive hunger and thirst.
Soft and brown hair in the face, head, and other parts of the body.
|-
| | || || Tikshna(sharp)|| Very brave/velour.
Strong digestive power.
Intake of large quantities of food and drinks.
Unable to handle difficult conditions.
High frequency of intake.
|-
| | || || Drava(liquid)|| Lax muscles.
Flexible joints.
Profuse sweating.
More stool formation.
Excessive urination.
|-
| | || || Vishtra (fleshy smell)|| Putrid/foul smell especially from axial, scalp, mouth, and head.
|-
| | || ||Amla (sour) and Katu(pungent)|| Less semen. Less sexual desire and less progeny.
|-
| | 03 || Kapha(Code: VA-2891) || Snigdha (unctuous) ||Unctuous skin
|-
| | || || Shalakshna(smooth) || Smooth and skin without moles, freckles, and dryness
|-
| | || || Mridu(soft) || The pleasant and delicate body
|-
| | || || Madhur(sweet) || Increase the quantity of semen, sexual desire, and progeny.
|-
| | || || Sara(firm) || Firm, compact and steady body
|-
| | || || Sandra(dense) || Good built
|-
| | || || Manda(slow) || Slow eating.
Slow actions,
Slow spoken.
|-
| | || || Sitmita(stable) || Delayed initiation.
Don’t get agitated easily.
|-
| | || || Guru(heavy) || Stable gait, heavy weight
|-
| | || || Sheeta(cold) || Less hunger and thirst.
Less sweating.
|-
| | || || Vijjala(viscous) || Compact joints
|-
| | || || Achcha(clear) ||Cheerful and pleasant appearance.
Softness in voice.
Pleasant complexion
|-
|}
'''Concept of personalized medicine:'''
Individual genetic and epigenetic distinctions are the foundation of individualized and entail prescribing patients individual-specific treatments based on their genetic makeup.<ref name=Jnana A>Jnana A, Murali TS, Guruprasad KP, Satyamoorthy K. Prakriti phenotypes as a stratifier of gut microbiome: A new frontier in personalized medicine?. J Ayurveda Integr Med. 2020;11(3):360-365. doi:10.1016/j.jaim.2020.05.013.</ref> [[Ayurveda]] concept of individuality is called ‘prakriti’ to provide tailored treatment based on the person's prakriti, which is a blend of the predominance of [[dosha]]-[[vata]], [[pitta]], and [[kapha]]. Prakriti is an important ayurvedic concept that describes an individualized approach to health and disease.<ref name=Chopra A>Chopra A, Saluja M and Tillu G. Ayurveda-modern medicine interface: A critical appraisal of studies of Ayurvedic medicines to treat osteoarthritis and rheumatoid arthritis. J. Transl. Med. 2010: 3. 190–198.</ref>
'''Applied aspect of prakriti:'''
*Disease susceptibility or predictive medicine: Prakriti assessment aids in determining susceptibility to various diseases as well as preventing disease development from progression towards severity.<ref name=Dey>Dey S, Pahwa P. Prakriti and its associations with metabolism, chronic diseases, and genotypes: possibilities of new born screening and a lifetime of personalized prevention. J Ayurveda Integr Med 2014;5:15e24.</ref>
*Prophylaxis or preventive medicine: Prakriti determination aids in medicine's preventive element.
*Prognosis: In ancient Ayurvedic literature, the concept of curability or incurability of disease is described. It further depends on the individual's prakriti. Disease prognosis is widely recorded in the text and is dependent on etiological factors, [[dushya]] (pathology's substratum, dhatu), causative [[dosha]], [[dosha]] of physical constitution, onset, and place or habitat. [Cha. Sa. [[Sutra Sthana]] 10/11]
*Selection of individualized treatment modalities or correct therapeutic agent.
*Selection of correct dietary and lifestyle habits.
*Assessment of drug response.
Prakriti will presumably contribute to public health programs aimed at preventing and combating communicable and non-communicable diseases.
'''Tool of prakriti assessment:'''
The "prakriti" assessment entails phenotyping a person, based on a variety of factors such as physical type, eating and bowel habits, disease resistance and healing skills, memory retention, metabolism, and so on. It's a clinical examination using the three types of examination viz. inspection (darshan), palpation (sparshan), and interrogation (prashna). There are morphological (rachanaanusari), physiological (kriyaanusari), and psychological (manoanusari) aspects to it. The prakriti is determined by a combination of all these characteristics. Validated and standardized tools for prakriti assessment are available on the following links:
*CCRAS prakriti assessment scale(http://ccras.res.in/ccras_pas/)
*AYUSOFT-CDAC (https://www.cdac.in/index.aspx?id=hi_dss_ayusoft_n)
*CSIR-IGIB prakriti assessment questionnaire- Short and main.
(http://namayush.gov.in/sites/default/files/doc/Prakriti_Questionnaires.pdf)
'''The new research group model:'''
Age, sex, and ethnicity (to some extent) are used as universal variables in modern medical research (control groups). However, these group results cannot be extended to the entire human population because each of these groups has a varied level of illness susceptibility and medication response. Prakriti displays itself in all ethnic groups, hence ethnic groups aren't required for research. It has an impact on an individual's entire life span by linking their nature to environmental factors such as their lifestyle and diet. Prakriti is an example of a strategy that can be used uniformly across the entire population to divide a stratified population into manageable subgroups (rather than hundreds of ethnic groupings). Future research may employ prakriti-based grouping.
==Future area of research===
The concept of prakriti is utilized in the Ayurgenomics (Genome-wide analysis of Prakriti), Ayurnutrigenomics (Genome wise analysis of nutrition need), Ayurpharmacogenomics (Assessment of right drug for right people and response of the drug). Prakriti-based gut microbe stratification, Epigenetics, Predictive medicine (Newborn screening), System biology, Exercise physiology, Sports science, Sleep medicine, Circadian rhythm are key areas of research.
==Thesis done==
#Studies on human psychosomatic constitution by anthropometric methods as described in ayurveda by H.C.Shukla, Dept. of Basic principles, I.M.S., Varanasi, 1970.
#A study of the relationship between Prakriti, Samhanana and Blood Pressure by H.T. Kumar,Dept. of samhita and siddhanta, IPGT& RA, Jamnagar, 1978.
#A study of Daihik Prakriti with special reference to reproductive power of animal by R.K.Gupta, Dept. of Sharira, State Ayurvedic College, Lucknow,1985.
#The Physiological study of Ojus (Bala/Immunity) in relation to Prakriti & Sara by MunugotiSomeshwar, Dept. of Kriya Sharira, National Institute of Ayurveda, Jaipur, 1999
#Fundamental and applied study of Kala-Vaya-Anupatani Prakriti in the context of Vyadhi Vartana by V.G. Suthar, Dept. of Samhita and siddhanta, IPGT & RA, Jamnagar,2002.
#Role of Prakriti on Stress and Evaluation of Antistress Activity of Shatavari (Asparagus racemosus) and Guduchi (Tinospora cordifolia) by Partha Biswas, University of Calcutta, 2006.
#A clinical study on the effect of vyayam in medovridhhi person of various deha prakriti by Tijender, Dept. Of Kriya sharira, A. & U. Tibbia College, Delhi,2006.
#A clinical study on onset of menopause (rajonivritti) in reference to deha prakriti by Jasvinder, Dept. Of Kriya sharira, A. & U. Tibbia College, Delhi,2006.
#A comparative study of changes in lipid profile in different age group wsr to prakriti by Manisha, Dept. Of Kriya sharira, A. & U. Tibbia College, Delhi,2008.
#A scientific study on chittodvega wsr to deha prakriti & role of pranayama in its regards by Santosh, Dept. Of Kriya sharira, A. & U. Tibbia College, Delhi,2008.
#A study on the effect on rtus on rakta dhatu wsr to prakriti by Richa, Dept. Of Kriya sharira, A. & U. Tibbia College, Delhi,2008.
#A clinical study on nidranasha & role of pranayama (anuloma -viloma) wsr to deha prakriti by Anupama, Dept. Of Kriya sharira, A. & U. Tibbia College, Delhi,2011.
#A study of certain Autonomic Responses in clinically healthy individuals with special reference to Deha Prakriti by SB Rapolu, Department of Kriyasharir, IMS, Banaras Hindu University, 2013
#Role of pranayama in the management of tamakaswasa in different deha prakriti by Rashmi, Dept. Of Kriya sharira, A. & U. Tibbia College, Delhi,2015.
#Application of eyesenck personality questionnaire- revised (epq-r) scale in dwandaja prakriti by Sarika Shivaji Pawar, Dept. of Kriya Sharira, Hon. Shri. AnnasahebDange Ayurved Medical College, Post Graduate & Research Center, Ashta, 2015.
#Study of relation between prakruti and shukra dhatu according to kala (rutu) with special reference to semen analysis by Patil Panchakshari Dnyanoba, Dept. of Kriya Sharira, Hon. Shri. AnnasahebDange Ayurved Medical College, Post Graduate & Research Center, Ashta, 2016.
#A Study of Relationship between Prakriti and Performance of Professionals in Organisations by poonamarjun pandit, Institute of Management, Gujarat Technological University Ahmedabad, 2017.
==Current researches==
'''Association of Gut Microbe with prakriti phenotype:''' Studies discovered gut microbial patterns linked to a variety of host characteristics such as geography, age, and food. A few bacterial taxa were found to be specifically enriched in certain prakriti in recent scientific research. Chauhan et al.<ref>Chauhan NS, Pandey R, Mondal AK, Gupta S, Verma MK, Jain S, et al. Western Indian rural gut microbial diversity in extreme prakriti endo-phenotypes reveals signature microbes. Front Microbiol 2018;9:118.</ref> and Chaudhari et al.<ref>Chaudhari D, Dhotre D, Agarwal D, Gondhali A, Nagarkar A, Lad V, et al. Understanding the association between the human gut, oral and skin microbiome and the Ayurvedic concept of prakriti. J Biosci 2019;44: 112.</ref> detected extreme prakriti phenotypes (vata, pitta, and kapha) in a population from the VHDSS area in Pune and investigated if prakriti phenotyping can serve as a potential stratifier of the gut microbiota in that community and form the basis of personalized medicine.
'''Cosmetology and prakriti:''' The use of prakriti in cosmetic science aids in the selection of the appropriate cosmetic formulation; otherwise, cosmetic use at random can have a negative impact on beauty. The skin of healthy individuals with [[vata]] and [[pitta]] dominant prakriti was found to be dehydrated, but hydration was preserved in [[kapha]] dominant prakriti people.<ref>14. Suwarna UV, Deepak VM , Sheela KB, Kalpana SD. Variation in skin hydration on the basis of Deha Prakriti (body constitution): A cross-sectional observational study. Ayu2018;39:127-31.</ref>
'''Genomic and biochemical basis of constitutional:''' Individuals with the three most dissimilar constitutional types have notable variances in biochemical and hematological markers, as well as gene expression levels across the genome.<ref name= Prasher/> The differences in hemoglobin levels between the prakriti are correlated with higher expression of genes that regulate hemoglobin levels, such as HBA1, HBB, and NOV, in [[pitta]] compared to [[vata]] and [[kapha]]. The human leukocyte antigen (HLA) gene polymorphism has been found to have a reasonable connection with prakriti type.<ref>Patwardhan, B.; Joshi, K.; Chopra, A. Classification of Human Population Based on HLA Gene Polymorphism and the Concept of Prakriti in Ayurveda. J. Altern. Complement. Med. 2005, 11, 349–353.</ref> Individuals with [[pitta]] prakriti are observed to have phosphoglucomutase 1 gene.<ref>16. Govindaraj, P.; Nizamuddin, S.; Sharath, A.; Jyothi, V.; Rotti, H.; Raval, R.; Nayak, J.; Bhat, B.K.; Prasanna, B.V.; Shintre, P.; et al. Genome-wide Analysis Correlates Ayurveda Prakriti. Sci. Rep. 2015, 5, 15786</ref>
'''Risk factor (disease vulnerability) and prakriti:''' There is a close link between [[vata]]-[[kapha]] and [[kapha]] prakriti and risk factors (diabetes, hypertension, dyslipidemia), insulin resistance, and immune markers.<ref>Mahalle NP, Kulkarni MV, Pendse NM, Naik SS. Association of constitutional type of Ayurveda with cardiovascular risk factors, inflammatory markers and insulin resistance. J Ayurveda Integr Med 2012;3:150-7.</ref>There is a very strong link between prakriti (Kapha/KaphaPittaja) and type 2 diabetes.<ref>18. Gupta A, Ali A, Tewari P, Agrawal NK, Patel R, Byadgi PS. Association of Kaphaja and Kapha Pittaja Prakriti and methylenetetrahydrofolate reductase C677T allele with type 2 diabetes. Ayu2018;39:146-50.</ref>