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The wife of the former Maoist leader now serving as Nepal's prime minister died in the Himalayan republic on Wednesday after a long illness, her husband's physician said.
Sita Dahal married Pushpa Kamal Dahal, better known as Prachanda ("The Fierce One"), more than half a century ago when both were teenagers.
Sita, 69, had long suffered from numerous ailments including diabetes and hypertension. According to an ANI report, the first lady was also suffering from progressive supranuclear palsy (PSP), a rare neurological disorder, and was declared dead at 8:33 AM, the hospital announced.
Yubraj Sharma, the prime minister's official doctor, said in a statement that she suffered a cardiac arrest on Wednesday morning.
"Despite resuscitation (attempts), she could not be revived," he said.
Sita was serving as an adviser to her husband's Nepal Communist Party (Maoist Center).
"Our entire party is shocked by the tragic death of Comrade Sita Dahal," the party said in a statement.
Sita "played a coordinating role as the parent of the entire party during the stormy years of the civil war, to resolve challenges, crises and disputes within the party", the statement added.
In neighbouring India, Prime Minister Narendra Modi said he was "extremely saddened" to learn of her death.
"I express my sincere condolences... and pray that the departed soul finds eternal peace," he wrote on Twitter.
The couple had four children, two of whom have since died.
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